Guyton and Hall Textbook of Medical Physiology 12th Ed PDF

Guyton and Hall
Textbook of Medical Physiology

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EDISI KEDUABELAS
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John E. Hall, Ph.D.
Arthur C. Guyton Professor and Chair
Department of Physiology and Biophysics
Associate Vice Chancellor for Research
University of Mississippi Medical Center
Jackson, Mississippi
1600 John F. Kennedy Blvd.
Ste 1800
Philadelphia, PA 19103-2899
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Copyright © 2011, 2006, 2000, 1996, 1991, 1986, 1981, 1976, 1966,
1961, 1956 by Saunders, an imprint of Elsevier Inc.
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Library of Congress Cataloging-in-Publication Data

Hall, John E. (John Edward), 1946-
Guyton and Hall textbook of medical physiology / John Hall. – 12th ed.
p. ; cm.
Rev. ed. of: Textbook of medical physiology. 11th ed. c2006.
Includes bibliographical references and index.
ISBN 978-1-4160-4574-8 (alk. paper)
1. Human physiology. 2. Physiology, Pathological. I. Guyton, Arthur C. II.
Textbook of medical physiology. III. Title. IV. Title: Textbook of medical physiology.
[DNLM: 1. Physiological Phenomena. QT 104 H1767g 2011]
QP34.5.G9 2011
612–dc22 2009035327
Publishing Director: William Schmitt

Developmental Editor: Rebecca Gruliow
Editorial Assistant: Laura Stingelin
Publishing Services Manager: Linda Van Pelt
Project Manager: Frank Morales
Design Manager: Steve Stave
Illustrator: Michael Schenk
Marketing Manager: Marla Lieberman
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To
My Family
For their abundant support, for their patience and
understanding, and for their love
To
Arthur C. Guyton
For his imaginative and innovative research
For his dedication to education
For showing us the excitement and joy of physiology
And for serving as an inspirational role model
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viii
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UNIT I Apoptosis Kematian Sel yang Terprogram 40

Pengantar Fisiologi: Fisiologi Sel dan Umum Kanker 40
UNIT II
BAB 1 Fisiologi Membran, Saraf, dan Otot
Susunan Fungsional Tubuh Manusia dan
Pengaturan "Lingkungan Dalam" 3
BAB 4
Sel sebagai Unit Kehidupan Tubuh 3 Transpor Zat melalui Membran-Membran
Cairan Ekstraseluler "Lingkungan Dalam" Sel 45
3
Mekanisme "Homeostatik" Berbagai Sistem Sawar Lipid Membran Sel dan Protein
4 Transpor Membran Sel 45
Fungsional Utama
Sistem Pengatur tubuh Difusi 46
6
Ringkasan Keotomatisan Tubuh "Transpor Aktif" Zat melalui Membran 52
9
BAB 2 BAb 5
Sel dan Fungsinya 11 Potensial Membran dan Potensial Aksi 57
Susunan Sel 11 Fisika Dasar Potensial Membran 57
Struktur Fisik Sel 12 Pengukuran Potensial Membran 58
Perbandingan Sel Hewan Potensial Membran Istirahat Saraf 59
dengan Bentuk-bentuk Kehidupan sebelum Sel 17 Potensial Aksi Saraf 60
Sistem Fungsional Sel 18 Peran Ion Lainnya Selama Potensial Aksi 64
Pergerakan Sel Penyebaran Potensial Aksi
23 64
Penetapan Kembali Gradien Ion Natrium
BAB . dan Kalium sesudah Terjadinya
Pengaturan Genetik Sintesis Protein Potensial Aksi Arti Penting
Fungsi SEl, dan Reproduksi Sel 27 Metabolisme Energi 65
Gen-Gen dalam Inti Sel 27 Plateau (Garis Datar) pada Beberapa Potensial
Kode DNA dalam Inti Sel Ditransfer Aksi 66
ke kode RNA dalam Sitoplasma Irama pada Beberapa jaringan Peka
Sel Proses Transkripsi 30 Rangsang Pelepasan Muatan Beruntun 66
Sintesis Zat-Zat Lain dalam Sel 35 Aspek Khusus Transmisi Sinyal
Pengaturan Fungsi Gen dan Aktivitas dalam Batang Saraf 67
Biokimiawi dalam Sel 35 Perangsangan Proses Pencetusan
Sistem Genetik DNA juga Mengendalikan Potensial Aksi 68
Reproduksi Sel 37 Perekaman Potensial Membran dan
Diferensiasi Sel 39 Potensial Aksi 69
ix
Contents
BAB 6 BAB 11
Kontraksi Otot Rangka 71 Elektrokardiogram Normal 121
Fisiologi Anatomi Otot Rangka 71 Karakteristik Elektrokardiogram Normal 121
Mekanisme Umum Kontraksi Otot 73
Metode Perekaman Elektrokardiogram 123
Mekanisme Molekuler Pada Kontraksi Otot 74
Energetika Kontraksi Otot Aliran Listrik di Sekeliling Jantung Selama
78
Siklus Jantung 123
Karakteristik Kontraksi Seberkas Otot 79
Sadapan-sadapan Elektrokardiografik 124
BAB 7 BAB 12
Eksitasi Otot Rangka: Penghantaran Penafsiran Elektrokardiografik
Saraf Otot dan Rangkaian Kelainan Otot Jantung dan Kelainan Aliran
Eksitasi-kontraksi 83 Darah Koroner: Suatu Analisis Vektor 129
Penghantaran Impuls dari Saraf ke Prinsip-Prinsip Analisis Vektor pada
Serabut Otot Rangka: Gambaran elektrokardiogram 129
Taut Saraf-otot 83 Analisis Vektor pada Gambaran
Biologi Molekuler Pembentukan dan Elektrokardiogram Normal 131
Pelepasan Asetilkolin 86 Sumbu Listrik Rata-Rata QRS Ventrikel
Obat yang Meningkatkan atau Memblok 134
dan Maknanya
Penghantaran di Taut Saraf-Otot 86
Kondisi-Kondisi yang Dapat Menyebabkan
Miastenia Gravis Menyebabkan Kelumpuhan 137
86 Tegangan Abnormal pada Kompleks QRS
Otot
Potensial Aksi Otot 87 Pola-pola Kompleks QRS yang Aneh (Bizarre)
Rangkaian Eksitasi- Kontraksi dan Memanjang 137
88
Arus cedera (Current of Injury) 138
BAB 8
Kelainan Gelombang T 141
Eksitasi dan Kontraksi Otot Polos 91
Kontraksi Otot Polos 91 BAB 13
Pengaturan Saraf dan Hormon Aritmia Jantung dan Penafsiran
pada Kontraksi Otot Polos 94 Elektrokardiogram 143
Irama Sinus Abnormal 143
UNIT III Irama Abnormal Akibat Blok pada Sinyal
Jantung Jantung di Dalam jalur 144
Konduksi Intrakardiak 146
BAB 9 Kontraksi prematur 148
Otot Jantung; Jantung sebagai Pompa dan Takikardia Paroksismal 149
Fungsi Katup-Katup Jantung 101
Fibrilasi Ventrikel 151
Fisiologi Otot Jantung 101
Siklus Jantung Atrial Flutter 152
104
Hubungan antara Bunyi jantung dengan Henti Jantung 153
pompa jantung 107
Curah Kerja Jantung 107 UNIT IV
Energi Kimia yang Dibutuhkan untuk Kontraksi
4JSLVMBTJ
Jantung; Penggunaan Oksigen oleh Jantung 109
Pengaturan Pemompaan Jantung 110
#"#
BAB 10 Ikhtisar Sirkulasi; Biofisik Tekanan, Aliran,
Eksitasi Ritmis pada Jantung 115 dan Tahanan 157
Sistem Eksitasi dan Konduksi Khusus Karakteristik Fisik Sirkulasi 157
pada Jantung 115 Prinsip Dasar Fungsi Sirkulasi 158
Pengendalian Eksitasi dan Konduksi di Hubungan Timbal Balik antara Tekanan,
Dalam Jantung 118 Aliran, dan Tahanan 159
x
Contents
BAB 15 BAB 20
Distensibilitas VAskular serta Fungsi sistem Curah Jantung, Aliran Balik Vena, dan
Vena dan Arteri 167 Pengaturannya 229
Distensibilitas Vaskular 167 Nilai Normal Curah Jantung Saat Istirahat
Pulsasi Tekanan Arteri 168 dan Selama Beraktivitas 229
Vena dan Fungsinya 171 Pengaturan Curah Jantung oleh Aliran Balik
Vena Peran Mekanisme
BAB 16 Frank Starling pada Jantung 229
Mikrosirkulasi dan Sistem Limfatik: Curah Jantung Tinggi atau Rendah Patologis 232
Pertukaran Cairan Kapiler Metode-Metode untuk Mengukur Curah
Cairan Intertisial, dan Aliran Limfe 177
Jantung 240
Struktur Mikrosirkulasi dan
Sistem Kapiler 177 BAB 21
Aliran Darah dalam Kapiler Aliran Darah Otot dan Curah Jantung Selama
Vasomotion 178 Kerja Fisik; Sirkulasi Koroner dan Penyakit
Jantung Iskemik 243
Pertukaran Air, Zat Nutrisi, serta Zat-
Zat Lainnya antara Darah dan Cairan Pengaturan Aliran Darah Otor Rangka
Interstisial 179 Selama Istirahat dan Kerja Fisik 243
Interstisium dan Cairan Interstisial 180 Sirkulasi Koroner 246
Filtrasi Cairan Melewati Kapiler BAB 22
Ditentkan oleh Tekanan Gagal Jantung 255
Hidrostatik dan Osmotik Koloid,
181 Dinamika Sirkulasi pada Gagal Jantung 255
serta Koefisien Filtrasi Kapiler
Sistem Limfatik 186 Gagal Jantung Kiri Unilateral 259
Gagal Jantung dengan Curah Jantung Rendah
BAB 17 Syok Kardiogenik 259
Pengendalian Lokal dan Humoral Aliran Darah Edema pada Pasien Gagal Jantung 259
Jaringan 191
Pengendalian Lokal Aliran Darah sebagai Cadangan Jantung 261
Respons terhadap Kebutuhan Jaringan 191 BAB 23
Mekanisme Pengendalian Aliran Darah 191 Katup Jantung dan Bunyi Jantung;
Pengendalian Sirkulasi secara Humoral 199 Kelainan Katup dan Jantung Bawaan 265
BAB 18 Bunyi Jantung 265
Pengaturan sirkulasi oleh Saraf, dan Dinamika Sirkulasi Abnormal pada Penyakit
Pengendalian Cepat Tekanan Arteri 201 Katup Jantung 268
Pengaturan sirkulasi oleh Saraf 201 Kelainan Dinamika Sirkulasi pada Kelainan
Peran Sistem Saraf dalam Pengaturan Katup Kongential 269
Tekanan Arteri yang Cepat 204 Penggunaan Sirkulasi Ekstrakorporeal
Sifat Khusus Pengendalian Tekanan Arteri Selama Bedah Jantung 271
melalui Saraf 209 Hipertrofi Jantung pada Penyakit Katup dan
BAB 19 Penyakit Jantung Kongenital 272
Peran Ginjal dalam Pengaturan Tekanan BAB 24
Arteri Jangka Panjang dan Hipertensi: Sistem Syok Sirkulasi dan Pengobatannya 273
Terintegrasi Pengaturan
213 Penyebab Fisiologis Syok 273
Tekanan Arteri
Sistem Cairan Tubuh Ginjal untuk Pengaturan Syok Akibat Hipovolemia
Tekanan Arteri 213 Syok Hemoragik 274
Sistem Renin Angiotensin: Perannya dalam Syok Neurogenik Kenaikan kapasitas
Pengaturan Tekanan Arteri 220 Vaskular 279
Rangkuman Sistem yang Terintegrasi dan Syok Anafilaksis dan Syok Histamin 280
Multifaset untuk Pengaturan Tekanan Arteri 226 Syok Septik 280
xi
Contents
Fisiologi Pengobatan Syok 280 Kelainan Mikturisi 310

Henti Sirkulasi 281 Pembentukan Urine Dihasilkan dari
Filtrasi Glomerulus, Reabsorpsi
UNIT V tubulus, dan Sekresi tubulus 310
Cairan Tubuh dan Ginjal Filtrasi Glomerulus Langkah Pertama
Pembentukan Urine 312
BAB 25
Penentu LFG 314
Kompartemen Cairan Tubuh: Cairan
285 Aliran Darah Ginjal 316
Ekstraselular dan Intraselular; Edema
Kontrol fisiologis terhadap Filtrasi
Asupan dan Keluaran Cairan Seimbang Glomerulus dan Aliran Darah Ginjal 317
Selama Kondisi Keadaan Mantap 285
Autoregulasi LFG dan Aliran Darah Ginjal 319
Kompartemen Cairan Tubuh 286
Volume Darah 287 BAB 27
Konstituen Cairan Ekstraselular dan Pembentukan Urine oleh Ginjal:
intraselular 287 II. Reabsorpsi dan Sekresi tubulus 323
Reabsorpsi dan Sekresi Tubulus Ginjal 323
Pengukuran volume Cairan di Berbagai
Kompartemen Cairan Tubuh Reabsorpsi Tubulus Termasuk Mekanisme
Prinsip Pengenceran indikator 287 Pasif dan Aktif 323
Reabsorpsi dan Sekresi di Sepanjang
Penentuan volume kompartemen Cairan Berbagai Bagian Nefron 329
Tubuh yang Spesifik 287 Pengaturan Reabsorpsi Tubulus 334
Pengaturan Pertukaran Cairan dan Penggunaan Metode Bersihan untuk
Keseimbangan Osmotik antara Cairan Menghitung Fungsi Ginjal 340
Ekstraselular dan Intraselular 289
BAB 28
Prinsip Dasar Osmosis dan Tekanan Osmotik 290
Pemekatan dan Pengeceran Urine;
Keseimbangan Osmotik Dipertahankan antara Pengaturan Osmolaritas Cairan Ekstraselular
Cairan Intraselulardan Cairan Ekstraselular 290 dan Konsentrasi Natrium 345
Volume dan Osmolalitas Cairan Ekstraselular Ginjal Mengekskresi Kelebihan Air dengan
dan Intraselular pada Keadaan Abnormal 291 Membentuk Urine Encer 345
Glukosa dan Larutan Lain yang Diberikan Ginjal Mengonservasi Air dengan
untuk Tujuan Nutrisi 292 Mengekskresikan Urine Pekat 346
Penentuan Kepekatan dan Keenceran Urine
Kelainan Klinis Pengaturan Volume Cairan: 294 Ginjal: Bersihan "Air Bebas"
Hiponetremia dan Osmol 354
Edema: Kelebihan Cairan dalam Jaringan 296 Gangguan Kemampuan pemekatan Urine 354
Cairan dalam "Rongga Potensial" Tubuh 300 Pengaturan Osmolaritas Cairan Ekstraselular
dan Konsentrasi Natrium 355
Sistem Umpan Balik Osmoreseptor ADH 355
BAB 26 Pentingnya Rasa Haus dalam Mengatur
Pembentukan Urine oleh Ginjal; 1.Filtrasi Osmolaritas Cairan Ekstraselular dan
Glomerulus, Aliran Darah Ginjal, dan Konsentrasi Natrium 357
Pengaturannya 303
Mekanisme Keinginan Akan Garam untuk
Berbagai Fungsi Ginjal 303 Mengatur Konsentrasi dan Volume Natrium
Anatomi Fisiologi Ginjal 304 Cairan Ekstraselular 360
Miksi (Berkemih) 307 BAB 29
Anatomi Fisiologis Kandung Kemih 307 Pengaturan Ginjal terhadap Kalium, Kalsium,
Transpor Urine dari Ginjal melalui Ureter
Fosfat, dan Magnesium; Integrasi Mekanisme
Menuju Kandung Kemih 308 Ginjal Untuk Pengaturan Volume Darah dan
Pengisian Kandung Kemih: Volume Cairan Ekstraselular 361
Sistometrogram 309 Pengaturan konsentrasi Kalium Cairan
Refleks Miksi 309 Ekstrasel dan Ekskresi Kalium 361
xii
Contents
PengaturanEkskresi Kalsium oleh Ginjal dan BAB 31

Konsentarsi ion Kalsium Ekstrasel 367 Diuretik dan Penyakit-Penyakit Ginjal 397
Pengaturan Ekskresi Magnesium Ginjal dan Diuretik dan Mekanisme Kerjanya 397
Konsentrasi Ion Magnesium Ekstrasel 369 Penyakit-Penyakit Ginjal 399
Integrasi Mekanisme Ginjal untuk Mengatur Gagal Ginjal Akut
cairan ekstraselular 370 Gagal Ginjal Kronis: Penurunan Jumlah 399
Pentingnya Natruresis Tekanan dan diuresis Nefron Fungsional yang Ireversibel 401
Tekanan dalam Mempertahankan Gangguan Tubulus Spesifik
371 408
Keseimbangan Natrium dan Cairan Tubuh Pengobatan Gagal Ginjal dengan
Distribusi Cairan Ekstraselular Antara Ruang Transplantasi atau dengan Dialisis
Interstisial dan Sistem Vaskular 373 Menggunakan Ginjal Buatan 409
Faktor Saraf dan Hormon Meningkatkan
Efektivitas Pengaturan Umpan Balik Cairan UNIT VI
Tubuh Ginjal 373 Sel-Sel Darah, imunitas, dan
Respons yang Terintegrasi untuk Mengubah Pembekuan Darah
Asupan Natrium
Keadaan yang Menyebabkan Peningkatan 376 BAB 32
yang Besar dari Volume darah dan Volume Sel-sel Darah Merah, Anemia, dan Polisitemia 413
Cairan Ekstraselular 376
Sel-Sel Darah Merah(Eritrosit) 413
Keadaan yang Menyebabkan Peningkatan
Anemia 420
Besar pada Volume Cairan Ekstraselular
tetapi Volume Darahnya Normal 377 Polisitemia 421
BAB 30 BAB 33
Pengaturan Asam Basa 379 Pertahanan Tubuh terhadap
Konsentrasi H+ Di atur dengan Tepat 379 Infeksi:1.Leukosit, Granulosit, Sistem
379 Monosit Makrofag, dan Inflamasi 423
Asam dan Basa Definisi dan Artinya
Bertahan terhadap perubahan Konsentrasi H Sel Darah Putih (Leukosit) 423
+:Dapar,Paru, dan Ginjal 380 Sifat Pertahanan Neutrofil dan
Pendaparan H+ dalam Cairan Tubuh 380 Makrofag terhadap Infeksi 425
Sistem Dapar Bikarbonat 381 Sistem Monosit Sel Makrofag (Sistem
Retikuloendotelial 426
Sistem Dapar Fosfat 383
Peradangan: Peran Neutrofil dan Makrofag
Protein merupakan Dapar Intrasel 428
Eosinofil
yang Penting 383 430
Basofil
Pengaturan Pernapasan terhadap Asam 384 Leukopenia 431
Basa oleh Ginjal 385 Leukemia 431
Sekresi H+ dan Reabsorpsi HCO3- oleh 431
Tubulus Ginjal 386
Kombinasi H+ yang Berlebihan dengan dapar BAB 34
Fosfat dan amonia pada tubulus Pertahanan Tubuh terhadap Infeksi: II.
menghasilkan HCO3- yang "Baru" 388 Imunitas dan Imunitas Bawaan Alergi 433
Perhitungan Ekskresi Asam Basa oleh Ginjal 389 Imunitas Didapat (Adaptif) 433
Koreksi Asidosis oleh Ginjal Peningkatan Alergi dan Hipersensitivitas 443
Ekskresi H+ dan Penambahan HCo3- ke
dalam Cairan Ekstraselular 391 BAB 35
Koreksi Alkalosis oleh Ginjal Penurunan Golongan Darah; Transfusi; Transplantasi
Sekresi H+ oleh Tubulus Jaringan dan Organ 445
dan Peningkatan Ekskresi HCO3 - 391 Antigenisitas yang Menyebabkan Reaksi
Penyebab Klinis Gangguan Asam Basa 392 Imun pada Darah 445
Pengobatan Asidosis atau Alkalosis 393 Golongan Darah O-A-B 445
Pengukuran Klinis dan Analisis Golongan Darah Rh 447
Gangguan Asam Basa 393 Transplantasi Jaringan dan Organ 449
xiii
Contents
BAB 36 BAB 40
Hemostatis dan Pembekuan Darah 451 Pengangkutan Oksigen dan Karbon Dioksida
Peristiwa Hemostasis 451 di dalam Darah dan Cairan Tubuh 495
Konstriksi Pembuluh Darah 451 Pengangkutan Oksigen dari Paru ke
Mekanisme Pembekuan Darah 453 Jaringan Tubuh 495
Keadaan yang menimbulkan Perdarahan Pengangkutan Karbon Dioksida dalam Darah 502
Hebat pada manusia 457 Rasio Pertukaran Pernapasan 504
Keadaan Tromboembolik pada BAB 41
Manusia 459 Pengaturan Pernapasan 505
Antikoagulan untuk Penggunaan Klinis 459 Pusat Pernapasan 505
Tes Pembekuan Darah 460 Pengendalian Kimiawi pada Pernapasan 507
Sistem Kemoreseptor Perifer untuk
UNIT VII Mengendalikan Aktivitas Pernapasan Peranan
Oksigen dalam Pengendalian Pernapasan 508
Pernapasan Pengaturan Pernapasan Selama Latihan Fisik 510
Faktor-Faktor lain yang Memengaruhi
BAB 37 Pernapasan 512
Ventilasi Paru 465
BAB 42
Mekanika Ventilasi Paru 465
Insufisiensi Pernapasan Patotisiologi,
Volume dan Kapasitas Paru 469 Diagnosis, Terapi Oksigen 515
Volume Pernapasan Semenit Sama dengan Metode yang Berguna untuk mempelajari
Frekuensi Pernapasan Dikali Volume Tidal 471 Kelainan Pernapasan 515
Ventilasi Alveolus 471 Patofisiologis Kelainan Paru Spesifik 517
Fungsi Saluran Pernapasan 472 Hipoksia dan Terapi Oksigen 520
BAB 38 Hiperkapnia Kelebihan Karbon Dioksida dalam
Cairan Tubuh 522
Sirkulasi Paru, Edema Paru, Cairan Pleura 477
Anatomi Fisiologis Sistem Sirkulasi Paru Pernapasan Buatan 522
477
Tekanan dalam Sistem paru 477 UNIT VIII
Volume Darah di Paru 478 Fisiologi Penerbangan, Ruang Angkasa,
Aliran Darah yang melalui Paru dan dan Penyeleman Laut Dalam
Distribusinya 479 BAB 43
Pengaruh Gradien Tekanan Hidrostatik Fisiologis Penerbangan, Temopat Tinggi (High
dalam Paru terhadap Aliran Darah Regional Altitude), dan Ruang Angkasa
Paru 479 Efek Tekanan Oksigen yang Rendah Terhadap 527
Dinamika Kapiler Paru 481 tubuh 527
Efek Gaya Percepatan terhadap Tubuh pada
Cairan dalam Rongga Pleura 483
Fisiologi Penerbangan dan Luar Angkasa 531
"Iklim Buatan" dalam Pesawat Luar Angkasa
BAB 39 533
yang Tertutup Rapat
Prinsip-prinsip fisika Pertukaran gas; Difusi Keadaan tanpa Bobot di Ruang Angkasa 533
Oksigen dan Karbon Dioksida melalui
485 BAB 44
Membran Pernapasan
Fisika Difusi Gas dan Tekanan Fisiologi Penyelaman Laut Dalam dan
Parsial Gas 485 Keadaan Hiperbarik Lainnya 535
Komposisi Udara Alveolus Berbeda dengan Efek Tingginya Tekanan Parsial Masing-
Udara Atmosfer 487 Masing Gas terhdap Tubuh 535
Disfusi Gas melalui Membran Pernapasan Penyelaman dengan SCUBA (Self-Contained
489 Underwater Breathing Apparatus) 539
Efek Rasio Ventilasi Perfusi
Efek Rasio Ventilasi Perfusi terhadap Beberapa Aspek Fisiologi Kapal Selam 540
Konsentrasi Gas Alveolus 492 Terapi Oksigen Hiperbarik 540
xiv
Daftar Isi
UNIT IX Reseptor Nyeri dan Rangsangannya 583

Sistem Saraf: A.Prinsip-Prinsip Umum dan Dua Jaras untuk Pengiriman Sinyal Nyeri ke
Fisiologi Sensorik Dalam Sistem Saraf Pusat 584
Sistem Penekan Nyeri ("Analgesia") dalam
BAB 45 Otak dan Medula Spinalis 586
Nyeri Alih (Referred Pain) 588
Organisasi Sistem Saraf, Fungsi Dasar Nyeri Viseral 588
Sinaps, dan Neurotransmiter 543 Beberapa Nyeri Klinis Abnormal dan Sensasi
Desain Umum Sistem Saraf 543 Somatik Lainnya 590
Tingkatan Utama Fungsi Sistem Saraf Salit Kepala 590
Pusat 545 Sensasi Suhu 592
Perbandingan antara Sistem Saraf dengan
Sebuah Komputer 546
UNIT X
Sinaps Sistem Saraf Pusat 546
Beberapa Sifat Khusus Pengiriman Sistem Saraf: B.Indra Khusus
Sinaptik 557
BAB 49
BAB 46
Mata: I. Sifat Optik Mata 597
Reseptor-Reseptor Sensorik, Rangkaian
Prinsip-Prinsip Fisika Alat Optik 597
Saraf untuk Pengolahan Informasi 559
Susunan Optik Mata 600
Jenis Reseptor Sensorik dan Rangsangan
Sensorik yang Dapat Dideteksi 559 Oftalmoskop 605
Transduksi Rangsangan Sensorik menjadi Sistem Cairan Mata Cairan Intraokular 606
Impuls Saraf 560
BAB 50
Serat Saraf yang Menghantarkan Berbagai
Mata: II. Reseptor dan Fungsi Neural
jenis Sinyal dan Klasifikasi Fisiologisnya 563
Retina 609
Pengiriman Sinyal dengan Intensitas Berbeda
Anatomi dan Fungsi Unsur
pada Jaras Saraf Sumasi Spasial dan 609
564 Struktural Retina
Temporal
Fotokimia Penglihatan 611
Pengiriman dan Pengolahan Sinyal dalam
Kelompok Neuron 564 Penglihatan Warna 615
Instabilitas dan Stabilitas Sirkuit Neuronal 569 Fungsi Neural Retina 616
BAB 47 BAB 51
Sensasi Somatiik: 1. Susunan Umum, Indra Mata: III. Neurofisiologi
Taktil, dan Posisi 571 Penglihatan Sentral 623
Klasifikasi Indra Somatik 571 Jaras Penglihatan 623
Deteksi dan Pengiriman Sensasi Taktil 571 Susunan dan Fungsi Korteks
Jaras Sensorik untuk Mengirimkan Sinyal Penglihatan 624
Somatik ke Sistem Saraf Pusat 573 Pola Perangsangan Sel Saraf Selama
Analisis Bayangan Penglihatan 626
Pengiriman pada Sistem Kolumna Dorsalis Lapang Pandang: Perimetri 627
Lemniskus Medialis 573 Gerakan Mata dan Pengaturannya 627
Pengiriman Sinyal Sensorik Kurang Penting Pengaturan Otonom Akomodasi dan
dalam Jaras Anterolateral 580 Diameter Pupil 631
Beberapa Aspek Khusus Fungsi
Somatosensorik 581 BAB 52
BAB 48 Indra Pendengaran 633
Membran Timpani dan Sistem Tulang 633
Sensasi Somatik: II. Sensasi Nyeri, Sakit Pendengaran
Kepala, dan Suhu 583 634
Koklea
Jenis Nyeri dan Kualitasnya Nyeri Cepat dan Mekanisme Pendengaran Sentral 639
Nyeri Lambat 583 Kelainan Pendengaran 642
xv
Daftar Isi
BAB 53 Fungsi Otak dalam Proses Komunikasi Inpus

Indra Kimia Pengecapan dan Penghidu 645 Bahasa dan Output Bahasa 703
Indra Pengecap 645 Fungsi Korpus Kalosum dan Komisura Anterior
Indra Penghidu 648 untuk Memindahkan Pikiran, Memori, Pelatihan
dan Informasi Lainnya antara Kedua Hemisfer
Serebri 704
UNIT XI 705
Sistem Saraf: C.Neurofisiologi Pikiran, Kesadaran, dan Memori
Motorik dan Integritas BAB 58
Mekanisme Perilaku dan Motivasi pada Otak
BAB 54 sistem Limbik dan Hipotalamus 711
Fungsi Motorik Medula Spinalis: Refleks
Sistem Pendorong aktivitas Otak 711
Refleks Medula Spinalis 655
sistem Limbik 714
Organisasi Medula Spinalis untuk Fungsi
Motorik 655 Anatomi Fungsional Sistem Limbik; Peran
Kunci Hipotalamus 714
Reseptor-Reseptor Sensorik Otot Kumparan
Otot dan Organ Tendon Golgi serta Perannya Hipotalamus, Daerah Pengatur Utama untuk
dalam Pengaturan Otot 657 Sistem Limbik 715
Refleks Fleksor dan Refleks Menarik Diri 661 Fungsi spesifik Bagian-Bagian Lain Sistem
Refleks Ekstensor Silang 663 Limbik 718
Hambatan Timbal Balik dan Persarafan Timbal
663
Balik BAB 59
Refleks sikap Tubuh dan pergerakan 663
664 Aktivitas Otak Tidur, Gelombang Otak,
Refleks Menggaruk (Scratch Reflex)
Refleks-Refleks Medula Spinalis yang Epilepsi,Psikosis 721
Menimbulkan Spasme Otot 664 Tidur 721
Refleks-Refleks Otonom pada Medula Spinalis 665 Epilepsi 725
Transaksi Medula Spinalis dan Syok Spinal 665 Perilaku Psikosis dan Demensia Peran
BAB 55 Sistem Neurotransmiter spesifik 726
Pengaturan fungsi Motorik oleh Korteks dan Skizofrenia mungkin Terjadi Fungsi yang
Batang Otak 667 berlebihan pada Bagian sistem Dopamin 727
Korteks Motorik dan Traktus Kortikospinalis 667 BAB 60
Peran Batang Otak dalam Mengatur Fungsi 673
Motorik Sistem Saraf Otonom dan Medula Adrenal 729
sensasi Vestibular dan Pemeliharaan Susunan Umum Sistem Saraf Otonom 729
Keseimbangan 674 Sifat-Sifat Dasar Fungsi Simpatis dan
Fungsi Nuklei Batang Otak dalam Pengendalian Parasimpatis 731
Gerakan Stereotipik Tidak Disadari 678 Refleks Otonom 738
BAB 56 Perangsangan Organ-Organ Tertentu
Kontribusi Serebelum dan Ganglia Basalis pada Beberapa Keadaan, dan
pada Seluruh Pengendalian Motorik 681 Perangsangan Massal pada Keadaan
Lain oleh Sistem Simpatis dan
Serebelum dan Fungsi Motoriknya 681 Parasimpatis 738
Ganglia Basalis fungsi Motorik 689
Integrasi Berbagai Bagian Sistem Pengatur Farmakologi Sistem Saraf Otonom 739
Motorik Total 694
BAB 61
BAB 57 Aliran Darah Serebral, Cairan
Korteks Serebri, Fungsi Intelektual Otak, Serebrospinal, dan Metabolisme Otak 743
Proses Belaja, dan Memori 697 Aliran Darah Serebral 743
Anatomi Fisiologi Korteks Serebri 697 Sistem Cairan Serebrospinal 746
Fungsi Area Kortikal Khusus 698 Metabolisme Otak 749
xvi
Contents
UNIT XII Gangguan-Gangguan Lambung 799

Fisiologi Gastrointestinal Gangguan pada Usus Halus 801
Gangguan pada Usus Besar 802
BAB 62 Gangguan Umum Traktus
Prinsip-Prinsip Umum Fungsi Gastrointestinal 803
Gastrointestinal Motilitas, Pengaturan
Saraf, dan Sirkulasi Darah 753 UNIT XIII
Prinsip-Prinsip Umum Motilitas Gastrointestinal 753 Metabolisme dan Pengaturan Suhu
Kontrol Saraf terhadap Fungsi
Gastrointestinal Sistem Saraf Enterik 755 BAB 67
Jenis Gerakan Fungsional pada Metabolisme Kar9oh6drat dan
Traktus Gastrointestinal 759 Pem9entukan Adenosin Th6fosfat 809
Alirah Darah Gastrointestinal "Sirkulasi Peran Utama Glukosa dalam
Splanknik" 759 Metabolisme Karbohidrat 810
Transpor Glukosa melalui Membran Sel 810
BAB 63
Propulasi dan Percampuran Makanan dalam Penyimpanan Glikogen di Hati dan Otot 811
Saluran Pencernaan 763 Pelepasan energi dari Glukosa melalui
jalur Glikolisis 812
Pencernaan Makanan 763
Fungsi Motorik Lambung 765 Pelepasan energi dari Glukosa melalui
jalur Pentosa Fosfat 816
Gerakan Usus Halus 768
Pembentukan Karbohidrat dari protein dan
Gerakan Kolon 770
Lemak "Glukoneogenesis" 817
Refleks-Refleks Otonom Lain yang
Memengaruhi Aktivitas Usus 772 Glukosa Darah 817
BAB 64 BAB 68
Fungsi Sekresi Saluran Pencernaan 773 Metabolisme Lipid 819
Prisnip-Prinsip Umum Sekresi Saluran Transpor Lipid dalam Cairan Tubuh 819
Pencernaan 773 Deposit Lemak 821
Sekresi Saliva 775 Pemakaian Trigliserida untuk Energi:
Sekresi Esofagus 776 Pembentukan Adenosis Trifosfat 822
Sekresi Lambung 777 Pengaturan Pelepasan Energi dari Trigliserida 825
Sekresi Pankreas 780 Fosfolipid dan Kolesterol 826
Sekresi Empedu oleh Hati: Fungsi Pohon Aterosklerosis 827
Empedu 783
Sekresi Usus Halus 786
BAB 69
Sekresi Mukus oleh Usus Besar 787
Metabolisme Potein 831
BAB 65 Sifat Dasar Protein 831
Pencernaan dan Absorpsi dalam Traktus Transpor dan Penyimpanan Asam Amino 831
Gastrointestinal 789 Peran Fungsional Protein Plasma 833
Pencernaan Berbagai Makanan melalui
Hidrolisis Pengaturan Hormonal Metabolisme Protein 835
789
Prinsip-Prinsip Dasar Absorpsi
BAB 70
Gastroinstestinal 793
Absorpsi dalam Usus Halus Hati sebagai Suatu Organ 837
794
Absorpsi dalam Usu Besar: Pembentukan Anatomi Fisiologi Hati 837
Halus 797 Sistem Vaskular dan Limfe Hepar 837
BAB 66 Fungsi Metabolik Hati 839
Fisiologi Gangguan Gastrointestinal 799 Pengukuran Bilirubin di dalam empedu
Gangguan Menelan dan Gangguan Esofagus 799 sebagai alat Diagnostik Klinis 840
xvii
Daftar Isi
BAB 71 BAB 75
Keseimbangan Diet; Pengaturan Asupan Hormon-Hormon Hipofisis dan Pengaturannya
Makanan; Obesitas dan Kelaparan; oleh Hipotalamus 895
Vitamin dan Mineral 843 Kelenjar Hipofisis dan Hubungannya
Masukan dan Pengeluaran energi dengan Hipotalamus 895
Seimbang dalam Keadaan stabil 843
Hipotalamus Mengatur Sekresi Kelenjar Hipofisis897
Keseimbangan Diet 843 Fungsi Fisiologis Growth Hormone 898
Pengaturan Asupan Makanan dan Kelenjar Hipofisis Posterior dan
Penyimpanan Energi 845 Hubungannya dengan Hipotalamus 904
Obesitas 850
Inanisi, Anoreksia, dan Kaheksia 851 BAB 76
Kelaparan 852 Hormon Metabolik Tiroid 907
Vitamin 852 Sintesis dan Sekresi Hormon
Metabolisme Mineral 855 Metabolik Tiroid 907
BAB 72 Fungsi Fisiologis Hormon Tiroid 910
Energetika dan Laju Metabolisme 859 Pengaturan Sekresi Hormon Tiroid 914
Fungsi Adenosin Trifosfat sebagai "Alat Penyakit Tiroid 916
Bayar Energi" dalam Metabolisme 859 BAB 77
Pengaturan Pelpasan Energi dalam Sel 861 Hormon Adrenokortikoid 921
Laju Metabolisme 862 Sintesis dan Sekresi hormon
Metabolisme Energi Faktor yang Adrenokortikoid 921
Memengaruhi Keluaran Energi 863 Fungsi Mineralokortikoid Aldosteron
BAB 73 Fungsi Glukokortikoid 924
Pengaturan Suhu Tubuh dan Androgen adrenal 928
Demam 867 Kelainan Sekresi Adrenokortikal 934
Suhu Tubuh Normal 867 934
Pengaturan Suhu Dikendalikan oleh BAB 78
Keseimbangan antara Pembentukan Panas
Insulin, Glukagon, dan Diabetes Melitus 939
dan Pengeluaran Panas 867
Insulin dan Efek Metaboliknya 939
Pengaturan Suhu Tubuh Peran
Hipotalamus 871 Glukagon dan Fungsinya 947
Kelainan Pengaturan Suhu Tubuh Somatostatin Menghambat Sekresi Glukagon
875
dan Insulin 949
Ringkasan Pengaturan kadar Glukosa Darah 949
Diabetes Melitus 950
UNIT XIV
BAB 79
Endokrinologi dan Reproduksi Hormon Paratiroid, Kalsitonin, Metabolisme
Kalsium dan Fosfat, Vitamin D, Tulang, dan
BAB 74 Gigi 955
Pengantar Endokrinologi 881 Tinjauan Umum Pengaturan Kalsium dan
Koordinasi Fungsi Tubuh oleh Caraka Kimia 881 Fosfat dalam Cairan ekstraselular dan
Plasma 955
Struktur Fungsi Tubuh dan Sintesis Hormon 881
Tulang dan Hubungannya dengan Kalsium
Sekresi, Transpor, dan Bersihan Hormon 957
Ekstrasel dan Fosfat
dari Darah 884
Vitamin D 960
Mekanisme Kerja Hormon 886
Kalsitonin 962
Pengukuran Konsentrasi Hormon dalam
891 Ringkasan Pengaturan Konsentrasi Ion Kalsium 966
Darah
Patofisiologi Hormon Paratiroid 966
xviii
Daftar Isi
Vitamin D, dan Penyakit Tulang 967 Fungsi Plasenta 1005

Fisiologi Gigi 969 Faktor-Faktor Hormonal dalam Kehamilan 1007
Respons Tubuh Ibu terhadap Kehamilan 1009
BAB 80 Persalinan 1011
Fungsi Reproduksi dan Hormonal Laki-laki Laktasi 1014
(dan Fungsi Kelenjar Pineal) 973
BAB 83
Anatomi Fisiologi Organ Seks Laki-Laki 973 Fisiologis Fetus dan Neonatus 1019
Spermatogenesis 973 Pertumbuhan dan Perkembangan Fungsi
Kegiatan seksual Laki-Laki 978 Janin 1019
Testosteron dan hormon Seks Laki-Laki Lain 979 Perkembangan sistem Organ 1019
Kelainan Fungsi seks Laki-Laki 984 Penyesuaian Bayi terhadap kehidupan 1021
Disfungsi Ereksi pada Laki-Laki 985 Ekstrauterin
Masalah Fungsional Khusus Pada Neonatus 1023
Kelenjar Pineal Fungsinya dalam Mengatur Masalah-masalah khusus Prematuritas 1026
Fertilitas Musiman pada Sebagian Hewan 986 Pertumbuhan dan Perkembangan Anak 1027
BAB 81 UNIT XV
Fisiologi Sebelum Kehamilan dan Hormon- Fisiologi Olahraga
Hormon Perempuan 987
Anatomi Fisiologi Organ-organ Seks BAB 84
Perempuan 987 Fisiologis Olahraga 1031
Sistem Hormon Perempuan 987 Otot dalam Kerja Fisik 1031
Siklus Ovarium Bulanan; Fungsi Hormon- Pernapasan dalam Kerja Fisik 1036
Hormon Gonadotropik 988
Sistem Kardiovaskular dalam Kerja Fisik 1038
Fungsi Hormon-hormon Ovarium Estradiol
Panas Tubuh pada Kerja Fisik 1039
dan Progesteron 991
Pengaturan Ritme Bulanan Perempuan Cairan Tubuh dan Garam dalam Kerja Fisik 1040
Hubungan antara Hormon Ovarium dan Obat-Obatan dan Atlet 1040
Hipotalamus Hipofisis 996 Kebugaran Tubuh Memperpanjang Hidup 1041
Kelainan Sekresi Ovarium 999
Kegiatan Seks Perempuan 1000
Index 1043
Kesuburan Perempuan 1000
BAB 82
Kehamilan dan Laktasi 1003
Pematangan dan Pembuahan Ovum 1003
Nutrisi Awal Embrio 1005
xix
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*
UNIT
1FOHBOUBS'JTJPMPHJ
'JTJPMPHJ4FMEBO6NVN
1. Susunan Fungsional Tubuh manusia
dan pengaturan “Lingkungan Dalam”
2. Sel dan Fungsinya
3. Pengaturan Genetik Sintesis Protein,
Fungsi Sel, dan reproduksi Sel
BAB 1
UNIT I
4VTVOBO'VOHTJPOBM5VCVI.BOVTJBEBO
1FOHBUVSBOi-JOHLVOHBO%BMBNw
5VKVBO GJTJPMPHJ BEBMBI NFOKFMBTLBO LBSBLUFSJTUJL EBTBS UFSUFOUV ZBOH TFSVQB .JTBMOZB EJ EBMBN
CFSCBHBJ GBLUPS GJTJL EBO LJNJBXJ ZBOH TFNVB TFM PLTJHFO CFSFBLTJ EFOHBO LBSCPIJESBU MFNBL EBO
CFSUBOHHVOH KBXBC BUBT BTBM VTVM QSPUFJOVOUVLNFMFQBTLBOFOFSHJZBOHEJCVUVILBOVOUVLGVOHTJ
QFSLFNCBOHBO EBO LFNBKVBO IJEVQ TFM -FCJI KBVI MBHJ NFLBOJTNF LJNJBXJ VNVN ZBOH EJQBLBJ
4FUJBQKFOJTLFIJEVQBO NVMBJEBSJWJSVT VOUVLNFOHVCBI[BUHJ[JNFOKBEJFOFSHJQBEBEBTBSOZBTBNBEJ
ZBOHTFEFSIBOBTBNQBJQPIPOZBOHUFSCFTBSBUBVNBOVTJBZBOH TFNVB TFM EBO TFNVB TFM NFMFQBTLBO QSPEVL BLIJS SFBLTJ
QBMJOH SVNJU NFNQVOZBJ LBSBLUFSJTUJL GVOHTJPOBM TFOEJSJ LJNJBOZBLFDBJSBOEJTFLFMJMJOHOZB
TFOEJSJ 0MFI LBSFOB JUV CJEBOH GJTJPMPHJ ZBOH TBOHBU MVBT JOJ )BNQJS TFNVB TFM KVHB NFNQVOZBJ LFNBNQVBO VOUVL
EBQBUEJCBHJNFOKBEJGJTJPMPHJWJSVT GJTJPMPHJCBLUFSJ GJTJPMPHJTFM NFNQFSCBOZBLEJSJ6OUVOHOZB CJMBTBUVKFOJTTFMSVTBL TJTBTFM
GJTJPMPHJ UVNCVIBO GJTJPMPHJ NBOVTJB EBO CBOZBL MBHJ DBCBOH EBSJKFOJTUFSTFCVUCJBTBOZBBLBONFNCFOUVLTFMTFMCBSVVOUVL
ZBOHMBJO NFOHJTJVMBOHTFCBHBJQFSTFEJBOTFMUFSTFCVU
Fisiologi Manusia 1BEB 'JTJPMPHJ .BOVTJB LJUB CFSVQBZB

NFOKFMBTLBOCFSCBHBJLBSBLUFSJTUJLTQFTJGJLEBONFLBOJTNFQBEB Cairan Extraselular— “ Lingkungan Dalam”
UVCVI NBOVTJB ZBOH NFNCVBUOZB NFOKBEJ NBLIMVL IJEVQ
,FOZBUBBO CBIXB LJUB UFUBQ CFSUBIBO IJEVQ NFSVQBLBO IBTJM 4FLJUBSQFSTFOUVCVINBOVTJBEFXBTBBEBMBIDBJSBO UFSVUBNB
TJTUFN QFOHBUVSBO ZBOH LPNQMFLT LBSFOB SBTB MBQBS BLBO CFSVQB MBSVUBO JPO EBO [BU[BU MBJO .FTLJQVO TFCBHJBO CFTBS
NFOEPSPOH LJUB NFODBSJ NBLBOBO EBO SBTB UBLVU BLBO DBJSBO JOJ UFSEBQBU EJ EBMBN TFM EBO EJTFCVU DBJSBO JOUSBTFMVMBS
NFOEPSPOH LJUB NFODBSJ LFIBOHBUBO %PSPOHBOEPSPOHBO MBJO LJSBLJSB TFQFSUJHBOZB CFSBEB EJ SVBOH EJ MVBS TFM EBO EJTFCVU
BLBONFNCVBULJUBNFODBSJQFSUFNBOBOEBOCFSLFNCBOHCJBL DBJSBO FLTUSBTFMVMBS $BJSBO FLTUSBTFMVMBS JOJ UFSVTNFOFSVT
+BEJ TFCFOBSOZB NBOVTJB EBMBN CBOZBL IBM CFSHFSBL TFDBSB CFHFSBL EJ TFMVSVI UVCVI $BJSBO JOJ EFOHBO DFQBU EJBOHLVU EJ
PUPNBUJT EBO LFOZBUBBO CBIXB LJUB BEBMBI NBLIMVL ZBOH EBMBNEBSBIZBOHCFSTJSLVMBTJEBOTFMBOKVUOZBUFSDBNQVSBOUBSB
NFSBTBLBO TFOTBTJ FNPTJ EBO NFOHFSUJ TFHBMB TFTVBUV EBSBIEBODBJSBOKBSJOHBOTFDBSBEJGVTJNFMBMVJEJOEJOHLBQJMFS
NFSVQBLBO CBHJBO EBSJ SBOHLBJBO LFIJEVQBO ZBOH CFSMBOHTVOH 5FSEBQBU CFSCBHBJ JPO EBO [BU HJ[J EJ EBMBN DBJSBO
PUPNBTUJT JOJ TJGBUTJGBU LIVTVT JOJ NFNVOHLJOLBO LJUB IJEVQ FLTUSBTFMVMBS ZBOH EJQFSMVLBO PMFI TFM VOUVL NFNQFSUBIBOLBO
EBMBNCFSCBHBJNBDBNLPOEJTJ LFIJEVQBO EFOHBO EFNJLJBO QBEB EBTBSOZB TFNVB TFM IJEVQ
EBMBN MJOHLVOHBO ZBOH TBNB DBJSBO FLTUSBTFMVMBS 0MFI LBSFOB
Sel sebagai Unit Kehidupan Tubuh BMBTBOJOJMBIDBJSBOFLTUSBTFMVMBSEJTFCVUKVHBTFCBHBJMJOHLVOHBO
EBMBNUVCVI BUBVNJMJFVJOUFSJFVS JTUJMBIZBOHEJDFUVTLBOMFCJI
6OJU EBTBS LFIJEVQBO QBEB UVCVI BEBMBI TFM 4FUJBQ PSHBO EBSJUBIVOZBOHMBMVPMFITFPSBOHBIMJGJTJPMPHJQSBODJTBCBE
NFSVQBLBO LVNQVMBO EBSJ CBOZBL TFM CFSCFEB ZBOH EJTBUVLBO LFZBOHUFSLFOBM $MBVEF#FSOBSE
PMFICFSCBHBJTUSVLUVSQFOVOKBOHBOUBSTFM 4FM NBNQV IJEVQ UVNCVI EBO NFMBLTBOBLBO CFSCBHBJ
4FUJBQ KFOJT TFM CFSBEBQUBTJ TFDBSB LIVTVT VOUVL NFMBLVLBO GVOHTJ LIVTVTOZB TFMBNB PLTJHFO HMVLPTB CFSCBHBJ JPO BTBN
TBUVBUBVCFCFSBQBGVOHTJUFSUFOUVNJTBMOZB TFMEBSBINFSBIZBOH BNJOP MFNBL TFSUB VOTVSVOTVS QPLPL MBJO EBMBN LPOTFOUSBTJ
KVNMBIOZB NFODBQBJ USJMJVO QBEB NBOVTJB NFOHBOHLVU ZBOHUFQBUUFSTFEJBEBMBNMJOHLVOHBOEBMBN
PLTJHFO EBSJ QBSVQBSV LF KBSJOHBO 8BMBVQVO TFM EBSBI NFSBI
NFSVQBLBOTFMEFOHBOKVNMBITFMUVCVIQBMJOHCBOZBLEJBOUBSB Perbedaan antara cairan straselular dan ntraselular.
KFOJTTFMUVCVIZBOHMBJO NBTJIBEBTFLJUBSUSJMJVOTFMKFOJTMBJO $BJSBO FLTUSBTFMVMBS NFOHBOEVOH CBOZBL JPO OBUSJVN LMPSJEB
ZBOHNFMBLTBOBLBOGVOHTJZBOHCFSCFEBEBSJTFMEBSBINFSBI+BEJ EBO CJLBSCPOBU EJUBNCBI CFSCBHBJ [BU HJ[J VOUVL TFM TFQFSUJ
TFMVSVI TFM EJ EBMBN UVCVI NBOVTJB CFSKVNMBI LJSBLJSB PLTJHFO HMVLPTB BTBN MFNBL EBO BTBN BNJOP $BJSBO
USJMJVO FLTUSBTFMVMBS KVHB NFOHBOEVOH LBSCPO EJPLTJEB ZBOH EJBOHLVU
8BMBVQVO CBOZBL KFOJT TFM QBEB UVCVI TFSJOH LBMJ TBOHBU EBSJ TFM LF QBSV VOUVL EJFLTLSFTJ EJUBNCBI CFSCBHBJ QSPEVL
CFSCFEBTBUVTBNBMBJO TFNVBTFMUFSTFCVUNFNQVOZBJ TBNQBITFMMBJOOZBZBOHEJBOHLVULFHJOKBMVOUVLEJFLTLSFTJ
3
Unit I Pengantar Fisiologi: Fisiologi Sel dan Umum
$BJSBO JOUSBTFMVMBS TBOHBU CFSCFEB EBSJ DBJSBO

FLTUSBTFMVMBS NJTBMOZB DBJSBO JOUSBTFMVMBS NFOHBOEVOH
CBOZBL JPO LBMJVN NBHOFTJVN EBO GPTGBU EJCBOEJOHLBO
EFOHBO JPO OBUSJVN EBO LMPSJEB ZBOH CBOZBL EJUFNVLBO
EBMBN DBJSBO FLTUSBTFMVMBS #FSCBHBJ NFLBOJTNF LIVTVT
VOUVL USBOTQPSUBTJ JPO NFMBMVJ NFNCSBO TFM BLBO
NFNQFSUBIBOLBO QFSCFEBBO LPOTFOUSBTJ JPO BOUBSB DBJSBO
JOUSBTFMVMBSEFOHBOJOUFSTFMVMBS1SPTFTUSBOTQPSJOJEJCBIBTEJ
#BC
Mekanisme “Homeostatik” Berbagai Sistem

Fungsional Utama
Homeostasis
*TUJMBI IPNFPTUBTJT EJHVOBLBO PMFI BIMJ mTJPMPHJ VOUVL
NFOHBSUJLBO QFNFMJIBSBBO CFSCBHBJ LPOEJTJ ZBOH IBNQJS
TFMBMV LPOTUBO EJ MJOHLVOHBO EBMBN 1BEB EBTBNZB TFNVB
PSHBO EBO KBSJOHBO UVCVI NFMBLTBOBLBO CFSCBHBJ GVOHTJ
VOUVL NFNCBOUV NFNQFSUBIBOLBO LPOEJTJ ZBOH SFMBUJG
LPOTUBOJOJ.JTBMOZBQBSVNFOZFEJBLBOPLTJHFOCBHJDBJNO
FLTUSBTFMVMBS VOUVL NFOHHBOUJLBO PLTJHFO ZBOH EJQBLBJ PMFI
TFM HJOKBM NFNQFSUBIBOLBO LPOTFOUSBTJ JPO ZBOH LPOTUBO
EBOTJTUFNHBTUSPJOUFTUJOBMNFOZFEJBLBO[BUHJ[J
4BUV CBHJBO ZBOH CFTBS EBMBN CVLV JOJ NFNCBIBT
CBHBJNBOB UJBQ PSHBO BUBV KBSJOHBO NFNCBOUV
NFNQFSUBIBOLBO IPNFPTUBUJT 6OUVL NFOHBXBMJ
QFNCBIBTBO JOJ CBC JOJ NFOHVSBJLBO CFSCBHBJ TJTUFN
GVOHTJPOBM EJEBMBN UVCVI EBO LPOUSJCVTJOZB QBEB
IPNFPTUBUJT TFMBOKVUOZB LJUB BLBO NFNCBIBT TFDBSB SJOHLBT
UFPSJ EBTBS TJTUFN QFOHFOEBMJBO UVCVI ZBOH NFNVOHLJOLBO
CFSCBHBJ TJTUFN GVOHTJPOBM UFSTFCVU VOUVL CFLFSKB TBMJOH
NFOEVLVOHTBUVTBNBMBJO
Sistem Transportasi dan Pencampuran

Cairan Ekstraselular Sistem Sirkulasi darah
$BJSBO FLTUSBTFMVMBS EJBOHLVU LF TFMVSVI CBHJBO UVCVI EBMBN
EVBUBIBQ5BIBQQFSUBNBBEBMBIQFSHFSBLBOEBSBILFTFMVSVI
UVCVI EJ EBMBN QFNCVMVI EBSBI EBO UBIBQ LFEVB BEBMBI
QFSHFSBLBODBJSBOBOUBSBLBQJMFSEBSBIEBOSVBOHJOUFSTFMVMBS
EJBOUBSBTFMTFMKBSJOHBO
(BNCBS NFOVOKVLLBO TJSLVMBTJ EBSBI TFDBSB VNVN
4FMVSVI EBSBI EJ EBMBN TJSLVMBTJ NFMJOUBTJ TFMVSVI KBMVS
TJSLVMBTJ EFOHBO LFDFQBUBO SBUBSBUB BUBV LBMJ QFS NFOJU TBBU
JTUJSBIBUEBOFOBNLBMJQFSNFOJUTBBUTFTFPSBOHTBOHBUBLUJG
4FXBLUVEBSBINFMFXBUJLBQJMFS UFSKBEJQFSUVLBSBODBJSBO
FLTUSBTFMVMBS ZBOH UFSVTNFOFSVT BOBUBSB QMBTNB EBSBI
EFOHBODBJSBOJOUFSTUJTJBMZBOHNFOHJTJSVBOHBOUBSTFM
1SPTFT JOJ EJUVOKVLLBO QBEB (BNCBS %JOEJOH LBQJMFS
CFSTJGBU QFSNFBCFM UFSIBEBQ TFCBHJBO CFTBS NPMFLVM ZBOH BEB 1-2 Di
EBMBNQMBTNBEBSBI LFDVBMJUFSIBEBQNPMFLVMQSPUFJOQMBTNB
ZBOH UFSMBMV CFTBS VOUVL NFMJOUBTJ LBQJMFS 0MFI LBSFOB JUV
CBOZBL DBJSBO EBO [BU[BU UFSMBSVUOZB CFSEJGVTJ CPMBLCBMJL DBJSBO EBO NPMFLVM UFSMBSVU UFSVTNFOFSVT CFSHFSBL EBO
BOUBSB EBSBI EBO SVBOH KBSJOHBO ZBOH EJUVOKVLLBO PMFI BOBL NFNBOUVM LF TFHBMB BSBI EBMBN QMBTNB EBO DBJSBO JOUFSTFMVMBS
QBOBI1SPTFTEJGVTJJOJUFSKBEJBLJCBUHFSBLBOLJOFUJLNPMFLVM EBOKVHBNFMBMVJQPSJQPSJLBQJMFS#FCFSBQBTFMCFSKBSBLMFCJIEBSJ
ZBOHUFSEBQBUEBMBNQMBTNBNBVQVODBJSBOJOUFSTUJTJBM NJLSPNFUFSEBSJTFCVBILBQJMFSLFTFMUFSTFCVUEBMBNXBLUV
4
Bab 1 Susunan Fungsional Tubuh Manusia dan Pengaturan “Lingkungan Dalam”
CFCFSBQB EFUJL +BEJ DBJSBO FLTUSBTFMVMBS EJ CBHJBO UVCVI NBOB BLIJS EBSJ NFUBCPMJTNF TFM TFQFSUJ VSFB EBO BTBN VSBU
QVO CBJL EBMBN QMBTNB NBVQVO EBMBN DBJSBO JOUFSTUJTJBM TFDBSB LFMFCJIBOJPOEBOBJSZBOHCFSBTBMEBSJNBLBOBOZBOHNVOHLJO
UFSVTNFOFSVT EJDBNQVS TFIJOHHB EBQBU NFNQFSUBIBOLBO NFOVNQVLEBMBNDBJSBOFLTUSBTFMVMBS
IPNPHFOJUBTDBJSBOFLTUSBTFMVMBSEJTFMVSVIUVCVI
(JOKBMNFMBLTBOBLBOGVOHTJOZBEFOHBODBSBNFOZBSJOHMFCJI
EBIVMVQMBTNBZBOHNFMBMVJHMPNFSVMJLFEBMBNUVCVMVTEBMBN
UNIT I
Sumber Zat Gizi Cairan Ekstraselular KVNMBI CFTBS EBO LFNVEJBO NFOHBCTPSCTJ [BU[BU ZBOH
EJCVUVILBOUVCVILFEBMBNEBSBI TFQFSUJHMVLPTB BTBNBNJOP
Sistem Respirasi(BNCBSNFNQFSMJIBULBOCBIXBTFUJBQ BJS EBMBN KVNMBI ZBOH TFTVBJ EBO CBOZBL JPO 4FCBHJBO CFTBS
LBMJEBSBINFMJOUBTJTFMVSVIUVCVI EBSBIKVHBNFOHBMJSNFMFXBUJ [BUMBJOZBOHUJEBLEJCVUVILBOUVCVI LIVTVTOZBQSPEVLBLIJS
QBSV %BSBI UFSTFCVU NFOHBNCJM PLTJHFO EJ BMWFPMJ TFIJOHHB NFUBCPMJTNF TFQFSUJ VSFB TBOHBU TFEJMJU EJSFBCTPSCTJ EBO UFSVT
NFNQFSPMFI PLTJHFO ZBOH EJCVUVILBO PMFI TFM 5FCBM NFNCSBO NFMFXBUJUVCVMVTSFOBMJTNFOKBEJVSJOF
BOUBSBBMWFPMJEBOMVNFOLBQJMFSQBSV NFNCSBOBMWFPMVT IBOZB
TBNQBJ NJLSPNFUFS EBO PLTJHFO CFSEJGVTJ EFOHBO DFQBU
NFMBMVJQFSHFSBLLBONPMFLVMBSNFMJOUBTJQPSJQPSJNFNCSBOJOJ Saluran Gastrointestinal ;BU UJEBL UFSDFSOB ZBOH NBTVL
LFEBMBNEBSBI LFTBMVSBOQFODFSOBBOEBOCFCFSBQBTJTBNFUBCPMJTNFEJCVBOH
EJGFTFT
Saluran Gastrointestinal. 4FCBHJBO CFTBS EBSBI ZBOH
EJQPNQBLBO PMFI KBOUVOH KVHB NFMFXBUJ EJOEJOH USBLUVT Hati. 4BMBI TBUV GVOHTJ IBUJ BEBMBI EFUPLTJGJLBTJ BUBV
HBTUSPJOUFTUJOBM %JTJOJ CFSCBHBJ [BU HJ[J UFSMBSVU UFSNBTVL QFNCVBOHBO CBOZBL PCBU EBO CBIBOLJNJB ZBOH EJUFMBO )BUJ
LBSCPIJESBU BTBN MFNBL EBO BTBN BNJOP EJBCTPSCTJ EBSJ NFOZFLSFTJ CBOZBL TJTB NFUBCPMJTNF JOJ LF EBMBN FNQFEV
NBLBOBOZBOHEJLPOTVNTJLFEBMBNDBJSBOFLTUSBTFMVMBSEBSBI ZBOHQBEBBLIJSOZBBLBOEJCVBOHEJGFTFT
Pengaturan Fungsi Tubuh

Hati dan Organ Lain yang melaksanakan Fungsi
Metabolik Primer 5JEBL TFNVB [BU EJBCTPSCTJ EBSJ TBMVSBO Sistem Saraf. 4JTUFN TBSBG UFSEJSJ BUBT UJHB CBHJBO CFTBS
HBTUSPJOUFTUJOBM EBQBU EJHVOBLBO PMFI TFM EBMBN CFOUVLOZB CBHJBO NBTVLOZB TFOTPSJL TJTUFN TBSBG QVTBU BUBV CBHJBO
TFXBLUVEJBCTPSCTJ)BUJNFOHVCBITVTVOBOLJNJBXJCBOZBL[BU JOUFHSBTJ
EBO CBHJBO LFMVBSBO NPUPSJL 3FTFQUPS TFOTPSJL
JOJ NFOKBEJ CFOUVL ZBOH MFCJI NVEBI EJHVOBLBO EBO KBSJOHBO NFOEFUFLTJ LFBEBBO UVCVI BUBV LFBEBBO MJOHLVOHBO TFLJUBS
UVCVIMBJOTFMMFNBL NVLPTBHBTUSPJOUFTUJOBM HJOKBM EBOLFMFOKBS .JTBMOZB SFTFQUPS EJLVMJU BLBO NFNCFSJUBIVLBO LFQBEB LJUB
FOEPLUSJO NFNCBOUV [BU[BU ZBOH UFMBI EJBCTPSCTJ UBEJ BUBV TFUJBQ LBMJ TFCVBI CFOEB NFOZFOUVI LVMJU EJ NBOB QVO
NFOZJNQBOOZB TBNQBJ [BU UFSTFCVU EJCVUVILBO )BUJ KVHB UFNQBUOZB .BUB NFSVQBLBO PSHBO TFOTPSJL ZBOH NFNCVBU
NFNCVBOHCFCFSBQBNFUBCPMJTNFUVCVIEBO[BU[BUUPLTJLZBOH TFTFPSBOH NFOEBQBULBO HBNCBSBO WJTVBM UFOUBOH MJOHLVOHBO
EJUFMBO TFLJUBSOZB 5FMJOHB KVHB NFSVQBLBO PSHBO TFOTPSJL 4JTUFN
TBSBG QVTBU UFSEJSJ BUBT PUBL EBO NFEVMB TQJOBMJT 0UBL EBQBU
NFOZJNQBOJOGPSNBTJ NFOHIBTJMLBOJEF NFODJQUBLBOBNCJTJ
Sistem Muskuloskeletal. #BHBJNBOBTJTUFNNVTLVMPTLFMFUBM TFSUBNFNFOUVLBOSFBLTJZBOHEJQFSMVLBOPMFIUVCVITFCBHBJ
CFSQFSBO EBMBN IPNFPTUBUJT +BXBCBOZB KFMBT EBO TFEFSIBOB SFTQPOT UFSIBEBQ TFOTBTJ 4JOZBM ZBOH TFTVBJ LFNVEJBO
4FBOEBJOZBPUPUUJEBLJLVUCFSQFSBO UVCVIUJEBLEBQBUCFSHFSBL EJIBOUBSLBO NFMBMVJ CBHJBO NPUPSJL TJTUFN TBSBG VOUVL
NFOVKV UFNQBU ZBOH UFQBU QBEB TBBU ZBOH UFQBU VOUVL NFMBLTBOBLBOLFJOHJOBOTFTFPSBOH
NFNQFSPMFI NBLBOBO ZBOH EJCVUVILBO VOUVL [BU HJ[J 4JTUFN
NVTLVMPTLFMFUBM KVHB NFNVOHLJOLBO QFSHFSBLBO VOUVL 4VBUV CBHJBO QFOUJOH TJTUFN TBSBG EJTFCVU TFCBHBJ TJTUFN
NFMJOEVOHJ EJSJ UFSIBEBQ MJOHLVOHBO TFLJUBS ZBOH CFSCBIBZB PUPOPN 4JTUFN JOJ CFLFSKB QBEB UJOHLBU CBXBI TBEBS EBO
UBOQB QFSHFSBLBO JOJ TFMVSVI UVCVI CFTFSUB TFNVB QSPTFT NFOHBUVS CBOZBL GVOHTJ PSHBO EBMBN UFSNBTVL UJOHLBU
IPNFPTUBUJLOZBBLBOTFHFSBSVTBL BLUJWJUBT QFNPNQB KBOUVOH QFSHFSBLBO TBMVSBO
HBTUSPJOUFTUJOBM EBOTFLSFTJCBOZBLLFMFOKBSEBMBNUVCVI
Pembuangan Produk Akhir Metabolik
Sistem Endokrin %J EBMBN UVCVI UFSEBQBU EFMBQBO
Pembuangan Karbon Dioksida oleh Paru. 1BEB TBBU EBSBI LFMFOKBS FOEPLSJO VUBNB ZBOH NFOZFLSFTJ [BU[BU LJNJB ZBOH
NFOHBNCJMPLTJHFOEJQBSV LBSCPOEJPLTJEBEJMFQBTLBOEBSJEBSBI EJTFCVU IPSNPO )PSNPO EJBOHLVU NFMBMVJ DBJSBO
LF EBMBN BMWFPMJ QBSV EBO QFSHFSBLBO VEBSB NBTVL EBO LFMVBS FLTUSBTFMVMBSNFOVKVTFMVMVSUVCIVOUVLNFNCBOUVNFOHBUVS
QBSV TFXBLUV SFTQJSBTJ BLBO NFNCBXB LBSCPO EJPLTJEB UFSTFCVU GVOHTJ TFM .JTBMOZB IPSNPO UFSPJE NFOJOHLBULBO LFDFQBUBO
LFMVBS LF BUNPTGFS ,BSCPO EJPLTJEB NFSVQBLBO QSPEVL BLIJS TFCBHJBOCFTBSSFBLTJLJNJBEBMBNTFNVBTFM EFOHBOEFNJLJBO
NFUBCPMJTNFZBOHQBMJOHCBOZBLKVNMBIOZB NFNCBOUV NFOHBUVS LFDFQBUBO BLUJWJUBT UVCVI *OTVMJO
NFOHBUVS NFUBCPMJTNF HMVLPTB CFSCBHBJ IPSNPO LPSUFLT
Ginjal. "MJSBO EBSBI ZBOH NFMBMVJ HJOKBM BLBO NFNCVBOH BESFOBM NFOHBUVS JPO OBUSJVN JPO LBMJVN EBO NFUBCPMJTNF
TFCBHJBO CFTBS [BU EBMBN QMBTNB TFMBJO LBSCPO EJPLTJEB ZBOH QSPUFJO EBO IPSNPO QBSBUJSPJE NFOHBUVS LBEBS LBMTJVN EBO
UJEBLEJCVUVILBOPMFITFM;BU[BUJOJNFMJQVUJCFSCBHBJIBTJM GPTGBUUVMBOH+BEJ IPSNPONFSVQBLBOTJTUFNQFOHBUVSZBOH
5
Unit I Pengantar Fisiologi : Fisiologi Sel dan Umum
NFMFOHLBQJ TJTUFN TBSBG 4JTUFN TBSBG NFOHBUVS CFSCBHBJ Contoh-contoh Mekanisme Pengatur
BLUJWJUBT PUPU EBO BLUJWJUBT TFLSFTJ UVCVI TFEBOHBLBO TJTUFN
FOEPLSJONFOHBUVSCFSCBHBJGVOHTJNFUBCPMJTNF
Pengaturan Konsentrasi Oksigen dan Karbon Dioksida
dalam Cairan Ekstraselular 0MFI ,BSFOB PLTJHFO
NFSVQBLBOTBMBITBUV[BUVUBNBZBOHEJCVUVILBOVOUVLSFBLTJ
Perlindungan Tubuh LJNJB EJ EBMBN TFM UVCVI NFNQVOZBJ NFLBOJTNF QFOHBUVS
Sistem Imun4JTUFNJNVOUFSEJSJBUBTTFMTFMEBSBIQVUJI LIVTVT VOUVL NFNQFSUBIBOLBO LPOTFOUSBTJ PLTJHFO EBMBN
TFMTFM KBSJOHBO ZBOH CFSBTBM EBSJ TFMTFM EBSBI QVUJI UJNVT DBJSBOFLTUSBTFMVMBSBHBSTFMBMVLPOTUBOEBOIBNQJSTFMBMVUFQBU
LFMFOKBS HFUBI CFOJOH EBO QFNCVMVI MJNGF ZBOH NFMJOEVOHJ .FLBOJTNF JOJ UFSVUBNB CFSHBOUVOH QBEB TJGBU LJNJBXJ
UVCVI EBSJ QBUPHFO TFQFSUJ CBLUFSJ WJSVT QBSBTJU EBO KBNVS IFNPHMPCJO ZBOH UFSEBQBU EJ EBMBN TFNVB TFM EBSBI NFSBI
4JTUFN JNVO NFOZFEJBLBO NFLBTOJTNF CBHJ UVCVI VOUVL
)FNPHMPCJO NFOHJLBU PLTJHFO TFXBLUV EBSBI NFMFXBUJ QBSV
NFNCFEBLBO TFM TFOEJSJ EBSJ TFM EBO [BU BTJOH EBO
4FMBOKVUOZB TFXBLUV EBSBI NFMFXBUJ LBQJMFS KBSJOHBO
NFOHIBODVSLBO [BU BTJOH EFOHBO GBHPTJUPTJT BUBV EFOHBO IFNPHMPCJO LBSFOB BGJOJUBT LJNJBXJOZB ZBOH LVBU UFSIBEBQ
NFNQSPEVLTJ MJNGPTJU UFSTFOTJUJTBTJ BUBV QSPUFJO LIVTVT PLTJHFO UJEBL BLBO NFMFQBTLBO PLTJHFO LF EBMBN DBJSBO
NJTBMOZB BOUJCPEJ
ZBOH NFOHIBODVSLBO NBVQVO KBSJOHBO CJMB TVEBI UFSEBQBU UFSMBMV CBOZBL PLTJHFO EJ TBOB
NFOFUSBMJTBTJ[BUBTJOH /BNVO CJMB LPOTFOUSBTJ PLTJHFO EJ EBMBN DBJSBO KBSJOHBO
UFSMBMV SFOEBI PLTJHFO BLBO EJMFQBTLBO TFDVLVQOZB VOUVL
Sistem Integumen. ,VMJU EBO CFSCBHBJ QFOVOKBOHOZB NFOHFNCBMJLBO LPOTFOUSBTJ PLTJHFO BEFLVBU +BEJ QFOHBUVSBO
UFSNBTVL SBNCVU LVLV LFMFOKBS EBO TUSVLUVS MBJOOZB LPOTFOUSBTJ PLTJHFO EJ EBMBN KBSJOHBO UFSVUBNB CFSHBOUVOH
NFOVUVQ NFNCFSJLBO CBOUBMBO EBO NFMJOEVOHJ KBSJOHBO QBEB TJGBU LJNJBXJ IFNPHMPCJO JUV TFOEJSJ 1FOHBUVSBO JOJ
PSHBOUVCVIZBOHMFCJIEBMBNEBOTFDBSBVNVNNFNCFSJLBO EJTFCVUTFCBHBJGVOHTJEBQBUIFNPHMPCJOUFSIBEBQPLTJHFO
CBUBT BOUBSB MJOHLVOHBO EBMBN UVCVI EFOHBO EVOJB MVBS
4JTUFN QFOVOKBOH KVHB QFOUJOH VOUVL QFOHBUVSBO TVIV EBO ,POTFOUSBTJLBSCPOEJPLTJEBEBMBNDBJSBOFLTUSBTFMVMBSEJBUVS
FLTLSFTJ TJTB NFUBCPMJTNF EBO NFOZFEJBLBO LPNVOJLBTJ EFOHBO DBSB ZBOH KBVI CFSCFEB ,BSCPO EJPLTJEB NFSVQBLBO
TFOTPSJL BOUBSB UVCVI EFOHBO MJOHLVOHBO FLTUFSOBM ,VMJU
QSPEVLBLIJSVUBNBSFBLTJPLTJEBTJEBMBNTFM#JMBTFMVSVILBSCPO
VNVNOZB NFSVQBLBO TFLJUBS TBNQBJ QFSTFO CFSBU
EJPLTJEBZBOHUFSCFOUVLEBMBNTFMUFSVTNFOFSVTEJUJNCVOEBMBN
CBEBO
DBJSBO KBSJOHBO TFNVB SFBLTJ QFOHIBTJM FOFSHJ ZBOH UFSKBEJ EJ
EBMBNTFMBLBOCFSIFOUJ6OUVOHOZB LPOTFOUSBTJLBSCPOEJPLTJEB
Reproduksi EBMBN EBSBI ZBOH NFMFCJIJ OPSNBM BLBO NFSBOHTBOH QVTBU
SFTQJSBTJTFIJOHHBPSBOHUFSTFCVUBLBOCFSOBQBTDFQBUEBOEBMBN
,BEBOHLBEBOH SFQSPEVLTJ UJEBL EJBOHHBQ TFCBHBJ GVOHTJ *OJ BLBO NFOJOHLBULBO FLTQJSBTJ LBSCPO EJPLTJEB TFIJOHHB
IPNFPTUBUJL /BNV SFQSPEVLTJ TFCFOBSOZB NFNCBOUV LFMFCJIBO LBSCPO EJPLTJEB EJCVBOH EBSJ EBSBI EBO DBJSBO
NFNQFSUBIBOLBO IPNFPTUBUJT EFOHBO DBSB NFOHIBTJMLBO KBSJOHBO 1SPTFT JOJ CFSMBOHTVOH UFSVTNFOFSVT TBNQBJ
HFOFSBTJ CBSV HVOB NFOHHBOUJLBO PSBOH ZBOH UFMBI LPOTFOUSBTJLBSCPOEJPLTJEBLFNCBMJLFOJMBJOPSNBM
NFOJOHHBM ,FMJIBUBOOZB QFOHHVOBBO JTUJMBI IPNFPTUBTJT JOJ
UFSMBMV CFCBT UFUBQJ JOJ NFOHHBNCBSLBO CBIXB QBEB
IBLJLBUOZB TFNVB TUSVLUVS UVCVI UFSTVTVO TFEFNJLJBO SVQB Pengaturan Tekanan Darah Arteri #FCFSBQB TJTUFN
BHBS NFNCBOUV NFNQFSUBIBOLBO LFIJEVQBO ZBOH CFSQFSBO EBMBN QFOHBUVSBO EBSBI BSUFSJ 4BMBI TBUVOZB BEBMBI
CFSMBOHTVOHTFDBSBPUPNBUJTEBOUFSVTNFOFSVT TJTUFNCBSPSFTFQUPSZBOHNFSVQBLBODPOUPITFEFSIBOBEBOTBOHBU
CBJLUFOUBOHNFLBOJTNFQFOHBUVSZBOHCFLFSKBDFQBU%JEJOEJOH
EBFSBIQFSDBCBOHBOBSUFSJLBSPUJTEJMFIFS EBOKVHBEJBSLVTBPSUB
Sistem Pengatur Tubuh EJEBEB UFSEBQBUCBOZBLSFTFQUPSTBSBGZBOHEJTFCVUCBSPSFTFQUPS
ZBOH UFSBOHTBOHPMFISFHBOHBO EJOEJOHBSUFSJ#JMB UFLBOBOBSUFSJ
UFSMBMV UJOHHJ CBSPSFTFQUPS NFOHJSJNLBO SFOUFUBO JNQMVT TBSBG
5VCVI NBOVTJB NFNQVOZBJ CFSJCVSJCV TJTUFN QFOHBUVS
NFOVKV LF NFEVMB PUBL %J TJOJ JNQMVTJNQMVT UFSTFCVU
4JTUFN QFOHBUVS ZBOH QBMJOH SVNJU BEBMBI TJTUFN QFOHBUVS
NFOHIBNCBU QVTBU WBTPNPUPS ZBOH TFMBOKVUOZB NFOVSVOLBO
HFOFUJL ZBOH CFLFSKB EJ EBMBN TFNVB TFM VOUVL NFNCBOUV
KVNMBI JNQMVT ZBOH EJIBOUBSLBO EBSJ QVTBU WBTPNPUPS NFMBMVJ
NFOHBUVS GVOHTJ JOUSBTFMVMBS EBO FLTUSBTFMVMBS .BTBMBI JOJ TJTUFN TBSBG TJNQBUJT LF KBOUVOH EBO QFNCVMVI EBSBI
BLBOEJCJDBSBLBOEBMBN#BC #FSLVSBOHOZB JNQMVT EBO QVTBU WBTPNPUPS JOJ NFOZFCBCLBO
#BOZBLTJTUFNQFOHBUVSMBJOCFLFSKBEJEBMBNPSHBOVOUVL QFOVSVOBO BLUJWJUBT QPNQB KBOUVOH EBO KVHB EJMBUBTJ QFNCVMVI
NFOHBUVS GVOHTJ NBTJOHNBTJOH CBHJBO PSHBO UFSTFCVU EBSBI QFSJGFS TFIJOHHB BMJSBO EBSBI NFMBMVJ QFNCVMVI EBSBI
TJTUFNQFOHBUVSMBJOCFLFSKBEJTFMVSVIUVCVIVOUVLNFOHBUVS EBQBU CFSUBNCBI 4FCBMJLOZB ,FEVB QFOVSVOBO FGFL JOJ UFLBOBO
IVCVOHBO BOUBSPSHBO .JTBMOZB TJTUFN SFTQJSBTJ CFLFSKB NFOVSVOLBO BSUFSJ EJ UFLBOBO CBXBI BSUFSJOJMBJ OPSNBM LFNCBMJ
CFSTBNB TJTUFN TBSBG NFOHBUVS LPOTFOUSBTJ LBSCPO EJPLTJEB LF OJMBJ OPSNBMNFSFMBLTBTJ SFTFQUPS SFOHBOH TFIJOHHB QVTBU
EBMBN DBJSBO FLTUSBTFMVMBS )BUJ EBO QBOLSFBT NFOHBUVS WBTPNPUP NFOKBEJ MFCJI BLUJG EBSJ CJBTBOZB EFOHBO EFNJLJBO
LPOTFOUSBTJ HMVLPTB EBMBN DBJSBO FLTUSBTFMVMBS EBO HJOKBM NFOZFCBCLBO WBTPLPOTUSJLTJ EBO QFOJOHLBUBO LFSKB QPNQB
NFOHBUVS LPOTFOUSBTJ IJESPHFO OBUSJVN LBMJVN GPTGBU EBO KBOUVOH 1FOVSVOBO UFLBOBO BSUFSJ KVHB NFOJOHLBULBO UFLBOBO
JPOJPOMBJOEBMBNDBJSBOFLTUSBTFMVMBS BSUFSJLFNCBMJLFOJMBJOPSNBM
6
Rentang Nilai Normal dan Sifat Fisik Berbagai Sifat Dasar Umpan Balik Negatif pada Sebagian
Komponen Penting Cairan Ekstraselular Besar Sistem Pengatur
5BCFM NFNVBU EBGUBS CFCFSBQB LPNQPOFO QFOUJOH EBO TJGBU 4FCBHJBO CFTBS TJTUFN QFOHBUVS UVCVI CFLFSKB EFOHBO DBSB
GJTJL EBSJ DBJSBO FLTUSBTFMVMBS CFSTBNB EFOHBO OJMBJ OPSNBMOZB VNQBO CBUJL OFHBUJG ZBOH EBQBU EJKFMBTLBO QBMJOH CBJL EFOHBO
SFOUBOH OJMBJ OPSNBM EBO CBUBT NBLTJNVN ZBOH UJEBL NFMJIBU LFNCBMJ CFCFSBQB TJTUFN QFOHBUVS IPNFPTUBUJL ZBOH
UFMBI EJTFCVULBO TFCFMVNOZB %BMBN QFOHBUVSBO LPOTFOUSBTJ
UNIT I
NFOJNCVMLBO LFNBUJBO 1FSIBUJLBO CFUBQB TFNQJUOZB SFOUBOH
OJMBJ OPSNBM VOUVL TFUJBQ LPNQPOFO /JMBJ EJ MVBS SFOUBOH JOJ LBSCPO EJPLTJEB UJOHHJOZB LPOTFOUSBTJ LBSCPO EJPLTJEB EBMBN
DBJSBO FLTUSBTFMVMBS BLBO NFOJOHLBULBO WFOUJMBTJ QBSV )BM JOJ
CJBTBOZBEJTFCBCLBOPMFIQFOZBLJU
BLBO NFOVSVOLBO LPOTFOUSBTJ LBSCPO EJPLTJEB DBJSBO
)BM UFSQFOUJOH BEBMBI CBUBTCBUBT ZBOH EBQBU NFOZFCBCLBO
FLTUSBTFMVMBSLBSFOBQBSVNFOHFMVBSLBOLBSCPOEJPLTJEBEBMBN
LFNBUJBOCJMBEJMBNQBVJ$POUPIOZBLFOBJLBOTVIVUVCVIIBOZB
KVNMBIZBOHMFCJICBOZBLEBSJEBMBNUVCVI%FOHBOLBUBMBJO
TFCFTBS¡' ¡$
EJBUBTOPSNBMEBQBUNFOJNCVMLBOMJOHLBSBO
UJOHHJOZB LPOTFOUSBTJ LBSCPO EJPLTJEB NFNJDV QFSJTUJXB
TFUBO QFOJOHLBUBO NFUBCPMJTNF TFM ZBOH BLBO NFSVTBL TFM
QFSJTUJXB ZBOH NFOVSVOLBO LPOTFOUSBTJOZB NFOKBEJ OPSNBM
1FSIBUJLBO KVHB SFOUBOH OJMBJ LFTFJNCBOHBO BTBNCBTB UVCVI ZBOH CFSTJGBU OFHBUJG CFSMBXBOBO
UFSIBEBQ SBOHTBOHBO BXBM
ZBOH TFNQJU EFOHBO OJMBJ Q) OPSNBM EBO OJMBJ NFNBUJLBO 4FCBMJLOZB CJMB LPOTFOUSBTJ LBSCPO EJPLTJEB UVSVO UFSMBMV
ZBOH IBOZB CFSLJTBS EJ MVBS CBUBT OPSNBM 'BLUPS MBJO ZBOH SFOEBI BLBO UJNCVM VNQBO CBUJL VOUVL NFOJOHLBULBO
QFOUJOHBEBMBILPOTFOUSBTJJPOLBMJVNLBSFOBCJMBLPOTFOUSBTJOZB LPOTFOUSBTJOZB 3FTQPOT JOJ KVHB CFSTJGBU OFHBUJG UFSIBEBQ
UVSVO TBNQBJ LVSBOH EBSJ TFQFSUJHB OJMBJ OPSNBM TFTFPSBOH SBOHTBOHBOBXBMOZB
LFNVOHLJOBO BLBO NFOHBMBNJ LFMVNQVIBO BLJCBU
LFUJEBLNBNQVBO TBSBG VOUVL NFOHIBOUBSLBO TJOZBM TBSBG %BMBNNFLBOJTNFQFOHBUVSBOUFLBOBOBSUFSJ UFLBOBOZBOH
4FCBMJLOZB CJMB LPOTFOUSBTJ JPO LBMJVN NFOJOHLBU TBNQBJ EVB UJOHHJ NFOZFCBCLBO TFSBOHLBJBO SFBLTJ ZBOH NFNJDV
LBMJBUBVMFCJIEBSJOJMBJOPFNBM LFSKBPUPUKBOUVOHLFNVOHLJOBO QFOVSVOBO UFLBOBO EBSBI BUBV UFLBOBO ZBOH SFOEBI
BLBONFOVSVOEFOHBOQBSBI%FNJLJBOKVHB CJMBLPOTFOUSBTJJPO NFOZFCBCLBO TFSBOHLBJBO SFBLTJ VOUVL NFOJOHLBULBO
LBMTJVN UVSVO TBNQBJ TFLJUBS EJ CBXBI TFUFOHBI LBEBS OPSNBM UFLBOBO 1BEB LFEVB DPOUPI UFSTFCVU FGFL ZBOH EJUJNCVMLBO
TFTFPSBOH LFNVOHLJOBO BLBO NFOHBMBNJ LPOUSBLTJ PUPU UFUBOJL CFSTJGBUOFHBUJGUFSIBEBQSBOHTBOHBOBXBMOZB
TFMVSVI UVCVI BLJCBU QFNCBOHLJUBO JNQMVT TQPOUBO ZBOH 0MFI LBSFOB JUV QBEB VNVNOZB CJMB CFCFSBQB GBLUPS
CFSMFCJIBOEJTBSBGQFSJGFS#JMBLPOTFOUSBTJHMVLPTBUVSVOTBNQBJ NFOKBEJUFSMBMVCFSMFCJIBOBUBVLVSBOH TVBUVTJTUFNQFOHBUVS
EJ CBXBI TFUFOHBI OJMBM OPSNBM TFTFPSBOH TFSJOH NFOHBMBNJ BLBO NFOKBMBOLBO VNQBO CBUJL OFHBUJG ZBOH UFSEJSJ BUBT
JSJUBCJMJUBT NFOUBM ZBOH CFSBU EBO CBILBO LBEBOHLBEBOH TFSBOHLBJBO QFSVCBIBO VOUVL NFOHFNCBMJLBO GBLUPS UFSTFCVU
NFOHBMBNJLFKBOH LFNCBUJLFOJMBJSBUBSBUBUFSUFOUV TFIJOHHBNFNQFSUBIBOLBO
$POUPIDPOUPI JOJ TFIBSVTOZB EBQBU NFNCFSJLBO IPNFPTUBTJT
QFNBIBNBO NFOHFOBJ OJMBJ FLTUSFN EBO QFOUJOHOZB “Pencapaian” Sebuah Sistem Pengatur. %FSBKBU FGFLUJWJUBT
LFCFSBEBBO CFSCBHBJ CBOZBL
TJTUFN QFOHBUVS ZBOH EBQBU TVBUV TJTUFN QFOHBUVS VOUVL NFNQFSUBIBOLBO TVBUV LFBEBBO
NFOKBHB UVCVI BHBS UFUBQ CFLFSKB EFOHBO TFIBU CJMB TBMBI TBUV ZBOH LPOTUBO EJUFOUVLBO PMFI QFODBQBJBO ZBOH EJQFSPMFI EBSJ
TJTUFNQFOHBUVSJOJUJEBLBEB LFHBHBMBOGVOHTJUVCVIZBOHCFSBU VNQBO CBUJL OFHBUJG .JTBMOZB NBSJ LJUB BOEBJLBO TFKVNMBI
BUBVLFNBUJBOEBQBUUFSKBEJ CFTBS EBSBI EJUSBOTGVTJLBO LFQBEB TFTFPSBOH EFOHBO TJTUFN
Sifat-sifat Sistem Pengatur QFOHBUVS UFLBOBO CBSPSFTFQUPS ZBOH UJEBL CFSGVOHTJ EBO
$POUPIDPOUPI NFLBOJTNF QFOHBUVS IPNFPTUBUJL ZBOH UFMBI UFLBOBO BSUFSJOZB NFOJOHLBU EBSJ OJMBJ OPSNBM NN )H
EJVUBSBLBO TFCFMVNOZB IBOZBMBI CFCFSBQB DPOUPI EJ BOUBSB NFOKBEJ NN )H ,FNVEJBO NBSJ LJUB BOEBJLBO CBIXB
CFSJCVSJCV NFLBOJTNF ZBOH BEB EJ EBMBN UVCVI EBO WPMVNFEBSBIZBOHTBNBEJTVOUJLLBOLFQBEBPSBOHZBOHTBNB
TFNVBOZB NFNQVOZBJ TJGBUTJGBU VNVN UFSUFOUV 4JGBUTJGBU QBEB TBBU TJTUFN CBSPSFTFQUPSOZB CFSGVOHTJ EBO TFLBSBOH
JOJBLBOEJKFMBTLBOQBEBCBHJBOJOJ UFLBOBO IBOZB NFOJOHLBU TFCFTBS NN )H +BEJ TJTUFN
QFOHBUVSVNQBOCBMJLUFMBINFOHIBTJMLBOLPSFLTJ
Tabel 1-1 Komponen Penting dan Fisik Cairan Ekstraselular
Normal Value Rentan Nilai Perkiraan Batas Satuan
Normal Tidak Mematikan Jangka pendek
Oksigen 40 35-45 10-1000 mm Hg
Karbon dioksida 40 35-45 5-80 mm Hg
Ion natrium 142 138-146 115-175 mmol/L
Ion kalium 4.2 3.8-5.0 1.5-9.0 mmol/L
Ion kalsium 1.2 1.0-1.4 0.5-2.0 mmol/L
Ion klorida 108 103-112 70-130 mmol/L
Ion bikarbonat 28 24-32 8-45 mmol/L
Glukosa 85 75-95 20-1500 mg/dl
Suhu tubuh 98.4 (37.0) 98-98.8 (37.0) 65-110 (18.3-43.3) °F (°C)
Asam-basa 7.4 7.3-7.5 6.9-8.0 pH
7
Unit I Pengantar Fisiologi : Fisiologi Sel dan Umum
TFCFTBS NN )HEBSJ NN )H NFOKBEJ NN )H QFSEBSBIBO TFCBOZBL - KVNMBI EBSBI EJ EBMBN UVCVI BLBO
.BTJI UFSEBQBU LFOBJLBO UFLBOBO TFCFTBS NN )H ZBOH UVSVO TBOHBU SFOEBI TFIJOHHB UJEBL UFSTFEJB DVLVQ EBSBI VOUVL
EJTFCVULFTBMBIBOhZBOHCFSBSUJCBIXBTJTUFNQFOHBUVSUJEBL KBOUVOH BHBS EBQBU NFNPNQB EFOHBO FGFLUJG 4FCBHBJ BLJCBUOZB
FGFLUJG QFSTFO EBMBN NFODFHBI QFSVCBIBO 1FODBQBJBO UFLBOBO BSUFSJ UVSVO EBO BUJSBO EBSBI LF PUPU KBOUVOH NFMBMVJ
ZBOH EJIBTJMLBO PMFI TJTUFN JOJ LFNVEJBO EJIJUVOH EFOHBO QFNCVMVI LPSPOBSJB CFSLVSBOH ,FBEBBO JOJ NFOHBLJCBULBO
SVNVTCFSJLVU KBOUVOH NFOKBEJ MFNBI QFOVSVOBO GVOHTJ QFNPNQBBO NFOKBEJ
MFCJIQBSBI BMJSBOEBSBILPSPOBSJBMFCJICFSLVSBOH EBOKBOUVOH
,PSFLTJ
1FODBQBJBO= ,FTBMBIBO NFOKBEJ TFNBLJO MFNBI TJLMVT JOJ UFSVT CFSVMBOH TBNQBJ UFSKBEJ
LFNBUJBO 1FSIBUJLBO CBIXB TFUJBQ TJLMVT EJ EBMBN VNQBO CBMJL
+BEJ QBEB DPOUPI TJTUFN CBSPSFTFQUPS UFSTFCVU LPSFLTJOZB JOJNFOHBLJCBULBOKBOUVOHNFOKBEJTFNBLJOMFNBI%FOHBOLBUB
TFCFTBSNN)HEBOLFTBMBIBOZBOHNBTJIBEBBEBMBI MBJO SBOHTBOHBO BXBM ZBOH NFOZFCBCLBO LFBEBBO ZBOH LVSBOH
NN)H0MFILBSFOBJUV QFODBQBJBOTJTUFNCBSPSFTFQUPSQBEB MFCJITBNB EJTFCVUVNQBOCBUJLQPTJUJG
PSBOH UFSTFCVU EBMBN QFOHBUVSBO UFLBOBO BSUFSJ BEBMBI
6NQBO CBMJL QPTJUJG MFCJI EJLFOBM TFCBHBJ MJOHLBSBO TFUBO
EJCBHJ BUBV "SUJOZB TVBUV HBOHHVBO ZBOH
UFUBQJ VNQBO CBMJL QPTJUJG ZBOH SJOHBO EBQBU EJBUBTJ PMFI
NFOJOHLBULBO BUBV NFOVSVOLBO UFLBOBO BSUFSJ IBOZB
NFLBOJTNFQFOHBUVSBOVNQBOCBMJLOFHBUJGZBOHEJNJMJLJUVCVI
NFOJNCVMLBOTFQFSUJHBHBOHHVBOEBSJZBOHTFIBSVTOZBUFSKBEJ
EBO MJOHLBSBO TFUBO UJEBL BLBO UJNCVM $POUPIOZB CJMB PSBOH
TFBOEBJOZBTJTUFNQFOHBUVSUJEBLBEB
UFSTFCVUIBOZBNFOHBMBNJQFSEBSBIBOTFCBOZBL- EBOCVLBO
1FODBQBJBO ZBOH EJIBTJMLBO PMFI CFCFSBQB TJTUFN
- NFLBOJTNF VNQBO CBMJL OFHBUJG VOUVL QFOHBUVSBO DVSBI
QFOHBUVS GJTJPMPHJT MBJO KBVI MFCJI CFTBS EBSJQBEB
KBOUVOH EBO UFLBOBO BSUFSJ BLBO NFOHJNCBOHJ VNQBO CBMJL
QFODBQBJBO ZBOH EJIBTJMLBO TJTUFN CBSPSFTFQUPS .JTBMOZB
QPTJUJG EBO PSBOH JUV BLBO QVMJI LFNCBMJ ZBOH EJQFSMJIBULBO
QFODBQBJBO ZBOH EJQFSPMFI PMFI TJTUFN QFOHBUVS TVIV
EFOHBOLVSWBHBSJTQVUVTQVUVTQBEB(BNCBS
UVCVI BEBMBI TFLJUBS 0MFI LBSFOB JUV LJUB EBQBU
NFUJIBU CBIXB TJTUFN QFOHBUVS TVIV UVCVI KBVI MFCJI
FGFLUJGEBSJQBEBTJTUFNQFOHBUVSUFLBOBOCBSPSFTFQUPS Umpan Balik Positif Kadang Kala Berguna. 1BEBCFCFSBQB
LFBEBBO UVCVI NFOHHVOBLBO VNQBO CBMJL QPTJUJG VOUVL
Umpan Balik Positif Kadang Menimbulkan LFVOUVOHBOOZB 1FNCFLVBO EBSBI NFSVQBLBO DPOUPI
Lingkaran Setan dan Kematian QFOHHVOBBO VNQBO CBMJL QPTJUJG ZBOH CFSNBOGBBU #JMB UFSKBEJ
SPCFLBO QBEB QFNCVMVI EBSBI EBO NVMBJ UFSCFOUVL CFLVBO
0SBOH NVOHLJO CFSUBOZB NFOHBQB TFCBHJBO CFTBS TJTUFN EBSBI CFSCBHBJFO[JNZBOHEJTFCVUGBLUPSQFNCFLVBOEJBLUJGLBO
QFOHBUVS EBMBN UVCVI EJMBLTBOBLBO EFOHBO VNQBO CBUJL EJ EBMBN CFLVBO EBSBI JUV TFOEJSJ #FCFSBQB FO[JN JOJ CFLFSKB
OFHBUJG EBO CVLBO EFOHBO VNQBO CBUJL QPTJUJG #JMB LJUB QBEB FO[JN MBJO ZBOH CFMVN BLUJGZBOH BEB EBMBN EBSBI EJ EFLBU
NFMJIBU TJGBUTJGBU EBTBS VNQBO CBUJL QPTJUJG TFHFSB BLBO CFLVBOEBSBIUFSTFCVU TFIJOHHBNFOHIBTJMLBOQFNCFLVBOEBSBI
UFSUJIBU CBIXB VNQBO CBUJL QPTJUJG UJEBL NFOHIBTJMLBO ZBOH MFCJI CBOZBL 1SPTFT JOJ BLBO CFSMBOHTVOH UFSVT TBNQBJ
LFTUBCJMBO NFMBJOLBO LFUJEBLTUBCJMBO EBO QBEB CFCFSBQB MVCBOH QBEB QFNCVMVI EBSBI UBEJ UFSTVNCBU EBO UJEBL UFSKBEJ
LBTVTNFOZFCBCLBOLFNBUJBO QFSEBSBIBO MBHJ ,BEBOHLBEBOH NFLBOJTNF JOJ EBQBU MFQBT
(BNCBS NFOVOKVLLBO TFCVBI DPOUPI EJ NBOB LPOUSPMEBONFOZFCBCLBOQFNCFOUVLBOCFLVBOEBSBIZBOHUJEBL
LFNBUJBO EBQBU UFSKBEJ LBSFOB VNQBO CBUJL QPTJUJG (BNCBS EJIBSBQLBO #BILBO LFBEBBO JOJMBI ZBOH NFODFUVTLBO TFCBHJBO
JOJ NFNQFSMJIBULBO FGFLUJWJUBT QFNPNQBBO KBOUVOH ZBOH CFTBS TFSBOHBO KBOUVOH BLVU BLJCBU TVBUV CFLVBO EBSBI ZBOH
NFOVOKVLLBO KBOUVOH PSBOH TFIBU ZBOH NFNPNQB EBSBI NVMBJ EJCFOUVL EBSJ QFSNVLBBO EBMBN QMBL BUFSPTLMFSPUJL EBMBN
TFLJUBS -NFOJU #JMB PSBOH UFSTFCVU UJCBUJCB NFOHBMBNJ BSUFSJ LPSPOBSJB EBO LFNVEJBO UVNCVI UFSVT TBNQBJ BSUFSJ
UFSTFCVUBLIJSOZBUFSTVNCBU
1SPTFT NFMBIJSLBO NFSVQBLBO DPOUPI MBJO EJ NBOB
em ali ada VNQBO CBMJL QPTJUJG NFNBJOLBO QFSBO ZBOH QFOUJOH 4BBU
e da a an kondisi no mal LPOUSBLTJ VUFSVT TVEBI DVLVQ LVBU TFIJOHHB LFQBMB CBZJ
li e NVMBJ NFOEPSPOH TFSWJLT SFHBOHBO QBEB TFSWJLT BLBO
NFOHJSJNLBO TJOZBM NFMBMVJ PUPU VUFSVT LF CBEBO VUFSVT
TFIJOHHB LPOUSBLTJ NFOKBEJ TFNBLJO LVBU +BEJ LPOUSBLTJ
e da a an 1 li e VUFSVT NFSFHBOHLBO TFSWJLT EBO SFHBOHBO TFSWJLT
NFOZFCBCLBO LPOUSBLTJ NFOKBEJ MFCJI LVBU #JMB QSPTFT JOJ
DVLVQ LVBU CBZJ BLBO MBIJS #JMB UJEBL LPOUSBLTJ CJBTBOZB
IJMBOH EBO EJQFSMVLBO CFCFSBQB IBSJ TFCFMVN LPOUSBLTJ
EJNVMBJLFNCBMJ
ema ian ,FHVOBBO MBJO VNQBO CBMJL QPTJUJG ZBOH QFOUJOH BEBMBI
QFNCBOHLJUBOTJOZBMTBSBG*OJBEBMBITBBUNFNCSBOTVBUVTFSBCVU
TBSBG EJSBOHTBOH SBOHTBOHBOOZB BLBO NFOZFCBCLBO TFEJLJU
LFCPDPSBO JPO OBUSJVN NFMBMVJ LBOBM OBUSJVN EJ NFNCSBO TBSBG
em li an ngsi om a jan ng ang di asilkan LF CBHJBO EBMBN TFSBCVU UFSTFCVU *PO OBUSJVN ZBOH NBTVL LF
ole m an a ik nega i se ela e jadi ke ilangan da a EBMBNTFSBCVUTBSBGJOJLFNVEJBONFOHVCBIQPUFOTJBMNFNCSBO
se esa li e da i si k lasi ema ian dise a kan ole m an
a ik osi i ila e jadi ke ilangan da a se esa li e
8
EBO TFMBOKVUOZB NFODJQUBLBO QFNCVLBBO LBOBM ZBOH MFCJI MJOHLVOHBO EBMBN 4FMBNB LPOEJTJ OPSNBM EJQFSUBIBOLBO EJ
CBOZBL QFSVCBIBO QPUFOTJBM NFOKBEJ MFCJI CFTBS MBHJ EBO MJOHLVOHBO EBMBN TFM UVCVI BLBO UFSVT IJEVQ EBO CFSGVOHTJ
TFMBOKVUOZB NFOHIBTJMLBO QFNCVLBBO LBOBM ZBOH KBVI MFCJI EFOHBO CBJL 4FUJBQ TFM NFOEBQBU LFVOUVOHBO EBSJ
CBOZBL MBHJ EBO TFUFSVTOZB +BEJ TFCVBI LFCPDPSBO LFDJM IPNFPTUBUJT EBO TFCBMJLOZB TFUJBQ TFM UVSVU CFSQFSBO
NFOKBEJMPOKBLBOOBUSJVNZBOHNFNBTVLJCBHJBOEBMBNTFSBCVU NFNQFSUBIBOLBO IPNFPTUBUJT )VCVOHBO UJNCBM CBMJL JOJ
TBSBGTFIJOHHBNFODJQUBLBOQPUFOTJBMBLTJTBSBG1PUFOTJBMBLTJJOJ NFOHIBTJMLBO LFPUPNBUJTBO UVCVI TFDBSB UFSVTNFOFSVT
UNIT I
TFMBOKVUOZB NFOHIBTJMLBO BSVT MJTUSJL EJ TFQBOKBOH TJTJ MVBS EBO TBNBQBJ TBUV BUBV CFCFSBQB TJTUFN GVOHTJPOBM LFIJMBOHBO
EBMBN TFSBCVU TBSBG EBO NFNVMBJ QPUFOTJBM BLTJ MBJO 1SPTFT JOJ LFNBNQVBOOZB VOUVL JLVU CFSQFSBO EBMBN CFSGVOHTJ #JMB
CFSMBOKVUUFSVTNFOFSVTTBNQBJTJOZBMTBSBGEJIBOUBSLBOLFVKVOH LFBEBBOJOJUFSKBEJ TFNVBTFMUVCVIBLBONFOEFSJUB%JTGVOHTJ
TFSBCVUTBSBGUFSTFCVU ZBOH FLTUSFN BLBO NFOZFCBCLBO LFNBUJBO TFEBOHBO
1BEB TFUJBQ LFBEBBO EJ NBOB VNQBO CBMJL QPTJUJG CFSTJGBU EJTGVOHTJZBOHTFEBOHBLBONFOZFCBCLBOQFOZBLJU
NFOHVOUVOHLBO VNQBO CBMJL QPTJUJG JUV TFOEJSJ NFSVQBLBO
CBHJBO EBSJ QSPTFT VNQBO CBMJL OFHBUJG TFDBSB LFTFMVSVIBO
$POUPIOZB QBEBQFSJTUJXBQFNCFLVBOEBSBI QSPTFTQFNCFLVBO
VNQBO CBMJL QPTJUJG JOJ NFSVQBLBO QSPTFT VNQBO CBMJL OFHBUJG Daftar Pustaka
VOUVL NFNQFSUBIBOLBO WPMVNF EBSBI QBEB OJMBJ OPSNBM
Adolph EF: Physiological adaptations: hypertrophies and superfunctions,
%FNJLJBO KVHB VNQBO CBMJL QPTJUJG ZBOH NFOHIBTJMLBO TJOZBM
Am Sci 60:608, 1972.
TBSBG NFNVOHLJOLBO TBSBG UFSTFCVU CFSQBSUJTJQBTJ EJ EBMBN Bernard C: Lectures on the Phenomena of Life Common to Animals and
SJCVBOTJTUFNQFOHBUVSVNQBOCBMJLOFHBUJGTBSBG Plants, Springfield, IL, 1974, Charles C Thomas.
Cannon WB: The Wisdom of the Body, New York, 1932, WW Norton.Chien S:
Jenis Sistem Pengatur yang Lebih Kompleks Mechanotransduction and endothelial cell homeostasis: the
Pengatur daptif wisdom of the cell, Am J Physiol Heart Circ Physiol 292:H1209, 2007.Csete ME,
Doyle JC: Reverse engineering of biological complexity, Science
%JCBHJBOCFSJLVUOZBEBMBNCVLVJOJ QBEBTBBULJUBNFNQFMBKBSJ 295:1664, 2002.
TJTUFNTBSBG LJUBBLBONFOHFUBIVJCBIXBTJTUFNJOJNFOHBOEVOH Danzler WH, editor: Handbook of Physiology, Sec 13: Comparative
CBOZBLTFLBMJNFLBOJTNFQFOHBUVSZBOHTBMJOHUFSLBJU#FCFSBQB Physiology, Bethesda, 1997, American Physiological Society.
EJ BOUBSBOZB NFSVQBLBO TJTUFN VNQBO CBMJL TFEFSIBOB TFQFSUJ DiBona GF: Physiology in perspective: the wisdom of the body. Neural
ZBOH UFMBI EJCBIBT #BOZBL ZBOH CVLBO 4FCBHBJ DPOUPI control of the kidney, Am J Physiol Regul Integr Comp Physiol 289:R633,
2005.
CFCFSBQB HFSBLBO UVCVI UFSKBEJ CFHJUV DFQBU TFIJOHHB UJEBL BEB Dickinson MH, Farley CT, Full RJ, et al: How animals move: an integrative
DVLVQXBLUVVOUVLNFOHJSJNLBOTJOZBMTBSBGEBSJCBHJBOQFSJGFS view, Science 288:100, 2000.
UVCVI LF PUBL EBO LFNVEJBO LFNCBMJ LF QFSJGFS MBHJ VOUVL Garland T Jr, Carter PA: Evolutionary physiology, Annu Rev Physiol 56:579,
NFOHBUVSQFSHFSBLBO0MFILBSFOBJUV PUBLNFOHHVOBLBOTVBUV 1994.
QSJOTJQ ZBOH EJTFCVU QFOHBUVSBO VNQBO NBKV GFFE GPSXBSE Gao Q, Horvath TL: Neuronal control of energy homeostasis, FEBS Lett
582:132, 2008.
DPOUSPM
VOUVL NFOJNCVMLBO LPOUSBLTJ PUPU ZBOH EJQFSMVLBO Guyton AC: Arterial Pressure and Hypertension, Philadelphia, 1980, WB
1BEB QFOHBUVSBO JOJ TJOZBM TBSBG TFOTPSJL EBSJ CBHJBO ZBOH Saunders.
CFSHFSBL NFNCFSJ UBIV PUBL BQBLBI HFSBLBO ZBOH EJMBLVLBO Guyton AC, Jones CE, Coleman TG: Cardiac Output and Its Regulation,
TVEBI CFOBS #JMB UJEBL PUBL BLBO NFOHPSFLTJ TJOZBM VNQBO Philadelphia, 1973, WB Saunders.
NBKV ZBOH EJLJSJNLBO LF PUPU BQBCJMB HFSBLBO CFSJLVUOZB Guyton AC, Taylor AE, Granger HJ: Dynamics and Control of the Body Fluids,
Philadelphia, 1975, WB Saunders.
EJQFSMVLBO ,FNVEJBO CJMB NBTJI EJCVUVILBO QFSCBJLBO MBHJ Herman MA, Kahn BB: Glucose transport and sensing in the maintenance
QFSCBJLBOMFCJIMBOKVUBLBOEJMBLVLBOVOUVLHFSBLBOCFSJLVUOZB of glucose homeostasis and metabolic harmony, J Clin Invest 116:1767,
.FLBOJTNF JOJ EJTFCVU TFCBHBJ QFOHBUVSBO BEBQUJG 1FOHBUVSBO 2006.
BEBQUJGJOJ TFEJLJUCBOZBL NFSVQBLBOVNQBOCBMJLOFHBUJGZBOH Krahe R, Gabbiani F: Burst firing in sensory systems, Nat Rev Neurosci 5:13,
UFSUVOEB 2004.
Orgel LE: The origin of life on the earth, Sci Am 271:76, 1994.
+BEJ EBQBU EJMJIBU CFUBQB SVNJUOZB TJTUFN QFOHBUVS VNQBO Quarles LD: Endocrine functions of bone in mineral metabolism regulation,
CBMJL EJ EBMBN UVCVI ,FIJEVQBO TFTFPSBOH CFSHBOUVOH QBEB J Clin Invest 118:3820, 2008.
TFNVB TJTUFN VNQBO CBMJL JOJ 0MFI LBSFOB JUV TFCBHJBO CFTBS Smith HW: From Fish to Philosopher, New York, 1961, Doubleday.Tjian R:
CVLV JOJ EJNBLTVELBO VOUVL NFNCBIBT CFSCBHBJ NFLBOJTNF Molecular machines that control genes, Sci Am 272:54, 1995.
QFNCFSJLFIJEVQBOJOJ
Ringkasan—Keotomatisan Tubuh
5VKVBO CBC JOJ BEBMBI NFOFOLBOLBO QFSUBNB TVTVOBO UVCVI

TFDBSB LFTFMVSVIBO EBO LFEVB DBSBDBSB ZBOH EJKBMBOLBO PMFI
CFSCBHBJ CBHJBO UVCVI TFDBSB IBSNPOJT 3JOHLBTOZB UVCVI
TFCFOBSOZB BEBMBI TVBUV TJTUFN TPTJBM ZBOH UFSEJSJ BUBT LJSBLJSB
USJMJVO TFM ZBOH UFSTVTVO EBMBN CFSCBHBJ NBDBN TUSVLUVS
GVOHTJPOBM ZBOH CFCFSBQB EJ BOUBSBOZB EJTFCVU PSHBO 4FUJBQ
TUSVLUVSGVOHTJPOBMJOJUVSVUCFSQFSBONFNQFSUBIBOLBOLPOEJTJ
IPNFPTUBUJLEBMBNDBJSBOFLTUSBTFMVMBS ZBOHEJTFCVUTFCBHBJ
9
BAB 2
UNIT I
4FMEBO'VOHTJOZB
Protein 4FUFMBI BJS [BU LFEVB UFSCBOZBL EBMBN TFM BEBMBI

4FUJBQTFMEBSJUSJMJVOTFMZBOHUFSEBQBU QSPUFJO ZBOHEBMBNLFBEBBOOPSNBMKVNMBIOZBTBNQBJ
EBMBN UVCVI NBOVTJB NFSVQBLBO TUSVLUVS QFSTFOEBSJNBTTBTFM1SPUFJOEBQBUEJCBHJNFOKBEJEVBKFOJT
IJEVQ ZBOH EBQBU CFSUBIBO TFMBNB QSPUFJOTUSVLUVSBMEBOQSPUFJOGVOHTJPOBM
CFSCVMBOCVMBOBUBVCFSUBIVOUBIVOKJLBEJ 1SPUFJO TUSVLUVSBM UFSEBQBU EBMBN TFM UFSVUBNB EBMBN CFOUVL
TFLJUBSOZBUFSEBQBUDBJSBOEFOHBO[BUHJ[J GJMBNFO QBOKBOH ZBOH NFSVQBLBO QPMJNFS EBSJ CBOZBL VOJU
ZBOH UFQBU 6OUVL EBQBU NFNBIBNJ GVOHTJ PSHBO EBO TUSVLUVS NPMFLVMQSPUFJO,FHVOBBOQFOUJOHGJMBNFOJOUSBTFMVMBSUFSTFCVU
MBJO EBMBN UVCVI LJUB IBSVT MFCJI EVMV NFNBIBNJ TVTVOBO BEBMBI VOUVL NFNCFOUVL NJLSPUVCVMVT ZBOH NFSVQBLBO
EBTBSTFMEBOGVOHTJLPNQPOFOQFOZVTVOOZB TJUPTLFMFUPO PSHBOFM TFM TFQFSUJ TJMJB BLTPO TBSBG HFMFOEPOH
NJUPTJTQBEBTFMZBOHTFEBOHCFSNJUPTJT EBONBTTBUVCVMVTLVTVU
CFSGJMBNFO UJQJT ZBOH NFOBIBO CBHJBOCBHJBO TJUPQMBTNB EBO
Susunan Sel OVLMFPQMBTNB BHBS UFUBQ CFSBEB EJ LPNQBSUFNFOOZB NBTJOH
NBTJOH%JSVBOHFLTUSBTFMVMBS QSPUFJOEBMBNCFOUVLTFSBUIBMVT
4VBUV TFM ZBOH LIBT TFQFSUJ ZBOH UBNQBL NFMBMVJ NJLSPTLPQ UFSVUBNB EJKVNQBJ QBEB TFSBU LPMBHFO EBO FMBTUJO KBSJOHBO JLBU
DBIBZB EJQFSMJIBULBOQBEB(BNCBS4FMUFSTFCVUNFNQVOZBJ EJOEJOHQFNCVMVIEBSBI UFOEPO MJHBNFOUVN EBOTFCBHBJOZB
EVB CBHJBO VUBNB ZBJUV OVLMFVT EBO TJUPQMBTNB /VLMFVT 1SPUFJO GVOHTJPOBM NFSVQBLBO KFOJT QSPUFJO ZBOH CFSCFEB
EJQJTBILBO EBSJ TJUPQMBTNB PMFI NFNCSBO OVLMFVT EBO TFQFOVIOZB CJBTBOZBUFSEJSJBUBTLPNCJOBTJCFCFSBQBNPMFLVM
TJUPQMBTNB EJQJTBILBO EBSJ DBJSBO TFLJUBS TFM PMFI NFNCSBO TFM EBMBN CFOUVL UVCVMVTHMPCVMVT 1SPUFJO KFOJT JOJ UFSVUBNB
ZBOHEJTFCVUKVHBNFNCSBOQMBTNB NFSVQBLBO FO[JN TFM EBO UJEBL TFQFSUJ QSPUFJO TFSBU IBMVT
#FSCBHBJ NBDBN [BU ZBOH UVSVU NFNCFOUVL TFM TFDBSB QSPUFJO GVOHTJPOBM TFSJOH CFSQJOEBIQJOEBI EBMBN DBJSBO TFM
LFTFMVSVIBO EJTFCVU QSPUPQMBTNB 1SPUPQMBTNB UFSEJSJ BUBT MJNB #BOZBL KVHB QSPUFJO UFSTFCVU ZBOH NFMFLBU QBEB TUSVLUVS
[BUEBTBSVUBNBBJS FMFLUSPMJU QSPUFJO MJQJE EBOLBSCPIJESBU CFSNFNCSBO EBMBN TFM &O[JN NFMBLVLBO LPOUBL MBOHTVOH
EFOHBO [BU MBJO EBMBN DBJSBO TFM VOUVL NFNCBOUV UFSKBEJOZB
Air"JSNFSVQBLBONFEJVNDBJSVUBNBCBHJTFM ZBOHUFSEBQBU SFBLTJSFBLTJ LJNJB JOUSBTFMVMBS ZBOH TQFTJGJL $POUPIOZB
QBEB TFCBHJBO CFTBS TFM LFDVBMJ TFM MFNBL EFOHBO LPOTFOUSBTJ SFBLTJ LJNJB ZBOH NFNFDBI HMVLPTB NFOKBEJ LPNQPOFO
BOUBSB TBNQBJ QFSTFO #BOZBL CBIBO LJNJB TFM ZBOH MBSVU QFOZVTVOOZB EBO LFNVEJBO NFOHHBCVOHLBO LPNQPOFO
EBMBN BJS #BIBOCBIBO MBJO UFSEBQBU EBMBN BJS TFCBHBJ QBSUJLFM UFSTFCVU EFOHBO PLTJHFO VOUVL NFNCFOUVL LBSCPO EJPLTJEB
QBEBU 3FBLTJSFBLTJ LJNJB UFSKBEJ EJ BOUBSB CBIBOCBIBO LJNJB EBO BJS TFSUB TFDBSB CFSTBNBBO NFOHIBTJMLBO FOFSHJ ZBOH
ZBOH UFSMBSVU BUBV QBEB QFSNVLBBO QBSUJLFM QBEBU BUBV QBEB EJQFSMVLBO VOUVL GVOHTJ TFM TFNVBOZB EJQFSBOUBSBJ PMFI
NFNCSBO TFSBOHLBJBOFO[JNQSPUFJO
lon*POQFOUJOHEBMBNTFMNFODBLVQLBMJVN NBHOFTJVN GPTGBU

TVMGBU CJLBSCPOBU EBO ZBOH UFSEBQBU EBMBN KVNMBI ZBOH MFCJI em an
TFEJLJU OBUSJVN LMPSJEB EBO LBMTJVN 4FNVB JPO UFSTFCVU BLBO sel
EJCBIBT MFCJI NFOEFUBJM EJ #BC ZBOH NFNQFSIBUJLBO IVCVOHBO i o lasma
ZBOH TBMJOH CFSLBJUBO BOUBSB DBJSBO JOUSBTFMVMBS EFOHBO DBJSBO kleol s
FLTUSBTFMVMBS kleo lasma
em an
*PO NFSVQBLBO CBIBO LJNJB JOPSHBOJL EBMBN SFBLTJ TFMVMBS n kle s kle s
*PO KVHB EJQFSMVLBO VOUVL NFOKBMBOLBO CFCFSBQB NFLBOJTNF
QFOHBUVSBO TFM .JTBMOZB JPO ZBOH CFLFSKB QBEB NFNCSBO TFM
EJQFSMVLBO VOUVL USBOTNJTJ JNQVMT FMFLUSPLJNJB QBEB TFSBCVU
TBSBGEBOPUPU k sel dili a dengan mik osko a a a
11
Lipid. -JQJE UFSEJSJ BUBT CFCFSBQB KFOJT [BU ZBOH EBSJUPUBM NBTTB TFM UFUBQJ NFOJOHLBU TBNQBJ QFSTFO EBMBN TFM
EJLFMPNQPLLBO TFDBSB CFSTBNBTBNB LBSFOB TJGBU VNVN [BU PUPU EBO LBEBOH NFOJOHLBU TBNQBJ QFSTFO EBMBN TFM IBUJ
UFSTFCVU ZBJUV MBSVU EBMBN QFMBSVU MFNBL -JQJE ZBOH QFOUJOH /BNVO LBSCPIJESBU EBMBN CFOUVL HMVLPTB UFSMBSVU TFMBMV
BEBMBIGPTGPMJQJEEBOLPMFTUFSPM ZBOHCFSTBNBTBNBCFSKVNMBI EJUFNVLBOEBMBNDBJSBOFLTUSBTFMVMBSEJTFLJUBSTFMTFIJOHHBTJBQ
IBOZB TFLJUBS QFSTFO EBSJ UPUBM NBTTB TFM 1FOUJOHOZB TJGBU UFSTFEJB CBHJ TFM 4FKVNMBI LFDJM LBSCPIJESBU EJTJNQBO EJ EBMBN
GPTGPMJQJE EBO LPMFTUFSPM BEBMBI CBIXB LFEVBOZB UJEBL MBSVU TFM EBMBN CFOUVL HMJLPHFO ZBJUV TVBUV QPMJNFS UBL MBSVU EBSJ
EBMBN BJS PMFI LBSFOB JUV CFSHVOB VOUVL NFNCFOUVL HMVLPTB ZBOH EBQBU EJQFDBI EBO TFHFSB EJHVOBLBO VOUVL
NFNCSBO TFM EBO TBXBS NFNCSBO JOUSBTFMVMBS ZBOH NFOZFEJBLBOLFCVUVIBOFOFSHJTFM
NFNJTBILBOCFSCBHBJLPNQBSUFNFOTFM
4FMBJO GPTGPMJQJE EBO LPMFTUFSPM CFCFSBQB TFM NFOHBOEVOH
USJHMJTFSJEB EBMBN KVNMBI CFTBS ZBOH KVHB EJTFCVU TFCBHBJ Struktur Fisik Sel
MFNBL OFUSBM %BMBN TFM MFNBL LBEBS USJHMJTFSJEB EBQBU
NFODBQBJ QFSTFO NBTTB TFM -FNBL ZBOH UFSTJNQBO EBMBN 4FM UJEBL IBOZB NFSVQBLBO TVBUV LBOUVOH ZBOH CFSJTJ DBJSBO
TFM UFSTFCVU CFSQFSBO TFCBHBJ HVEBOH QFOZJNQBOBO VUBNB FO[JN EBO [BU LJNJB UFUBQJ KVHB NFOHBOEVOH TUSVLUVSTUSVLUVS
FOFSHJ UVCVI NFOHIBTJMLBO [BU HJ[J ZBOH EBQBU EJMBSVULBO GJTJL ZBOH UFSTVTVO EFOHBO TBOHBU SBQJ ZBOH EJTFCVU PSHBOFM
LFNVEJBOEBOEJHVOBLBOVOUVLNFOZFEJBLBOFOFSHJEJCBHJBO JOUSBTFMVMBS 4JGBU EBTBS TFUJBQ PSHBOFM UFSTFCVU TBNB QFOUJOHOZB
UVCVINBOBQVOZBOHNFNCVUVILBOOZB EFOHBO [BU LJNJB EBMBN TFM VOUVL GVOHTJ TFM $POUPIOZB UBOQB
Karbohidrat,BSCPIJESBUNFNJMJLJTFEJLJUGVOHTJTUSVLUVSBM TBMBI TBUV PSHBOFM NJUPLPOESJB NBLB MFCJI EBSJ QFSTFO
EBMBN TFM LFDVBMJ TFCBHBJ CBHJBO EBSJ NPMFLVM HMJLPQSPUFJO QFMFQBTBO FOFSHJ ZBOH CFSBTBM EBSJ [BU HJ[J BLBO TFHFSB CFSIFOUJ
OBNVOLBSCPIJESBUCFSQFSBOCFTBSEBMBNOVUSJTJTFM4FCBHJBO 0SHBOFMPSHBOFM UFSQFOUJOH EBO TUSVLUVS MBJO TFM EJUVOKVLLBO
CFTBS TFM NBOVTJB UJEBL NFNQVOZBJ DBEBOHBO LBSCPIJESBU QBEB(BNCBS
EBMBNKVNMBICFTBSKVNMBISBUBSBUBCJBTBOZBTFLJUBSQFSTFO
DNA dan kromosom
Sentriol
Granula
sekretori
Badan
Golgi
Mikrotubulus
Membran
nukleus Membran
sel
Nukleolus
Glikogen
Ribosom
Lisosom
Mitokondria Retikulum Retikulum Mikrofilamen

endoplasma endoplasma
bergranula halus (tidak bergranula)
ekons ksi s a sel ang k as men nj kkan o ganel in e nal di dalam si o lasma dan n kle s
12
Bab 2 Sel dan Fungsinya
Struktur Bermembran di Sel Sawar Lipid Membran Sel Menghambat Masuknya Air.
4FCBHJBOCFTBSPSHBOFMTFMEJMBQJTJPMFINFNCSBOZBOHUFSVUBNB (BNCBS NFNQFSMJIBULBO TUSVLUVS NFNCSBO TFM 4USVLUVS
UFSTVTVO BUBT MJQJE EBO QSPUFJO .FNCSBO JOJ NFODBLVQ EBTBSOZB BEBMBI TFCVBI MBQJTBO MJQJE HBOEB ZBOH NFSVQBLBO
NFNCSBOTFM NFNCSBOOVLMFVT NFNCSBOSFUJLVMVNFOEPQMBTNB MBQJTBO UJQJT MBQJTBO HBOEB TFMBQVU MJQJE TFUJBQ MBQJTBO IBOZB
NFNCSBONJUPLPOESJB MJTPTPN EBOCBEBO(PMHJ NFNJMJLJ LFUFCBMBO TBUV NPMFLVM ZBOH UFSCFOUBOH EJ TFMVSVI
QFSNVLBBO TFM .PMFLVM QSPUFJO HMPCVMVT ZBOH CFTBS UFSTFCBS
UNIT I
-JQJE QBEB NFNCSBO NFNCFOUVL TVBUV TBXBS ZBOH
NFOHIBNCBU QFSHFSBLBO BJS EBO [BU MBSVU BJS EBSJ TBUV TFMBOHTFMJOHEJMBQJTBOMJQJEUFSTFCVU
LPNQBSUFNFOLFLPNQBSUFNFOTFMMBJOLBSFOBBJSUJEBLMBSVUEBMBN 4USVLUVS EBTBS MBQJTBO MJQJE HBOEB EJCFOUVL PMFI NPMFLVM
MFNBL /BNVO NPMFLVM QSPUFJO EJ EBMBN NFNCSBO TFSJOH LBMJ NPMFLVM GPTGPMJQJE 4BMBI TBUV HVHVT EBSJ TFUJBQ NPMFLVM
EBQBUNFOFNCVTNFNCSBOTFQFOVIOZB NFMBMVJTVBUVKBMVSLIVTVT GPTGPMJQJE UFSTFCVU MBSVU EBMBN BJS TFIJOHHB EJTFCVU IJESPGJMJL
ZBOHTFSJOHUFSTVTVOTFCBHBJTFNBDBNQPSJQPSJ MJOUBTBOVOUVL[BU (VHVT TBUVOZB MBHJ IBOZB MBSVU EBMBN MFNBL TFIJOHHB EJTFCVU
[BU UFSUFOUV ZBOH BLBO NFMBMVJ NFNCSBO #BOZBL KVHB QSPUFJO IJESPGPCJL (VHVT GPTGBU EBSJ GPTGPMJQJE CFSTJGBU IJESPGJMJL EBO
NFNCSBO MBJO CFSQFSBO TFCBHBJ FO[JN ZBOH EBQBU NFOKBEJ LBUBMJT HVHVTBTBNMFNBLOZBCFSTJGBUIJESPGPCJL
TFKVNMBI CFTBS SFBLTJ LJNJB ZBOH CFSCFEBCFEB ZBOH EJCBIBT 0MFILBSFOBHVHVTIJESPGPCJLEBSJNPMFLVMGPTGPMJQJEEJUPMBL
EBMBNCBCJOJEBOCBCCBCCFSJLVUOZB PMFI NPMFLVM BJS UFUBQJ TBMJOH UBSJLNFOBSJL TBUV EFOHBO ZBOH
MBJO NBLB LFEVB MBQJT HVHVT IJESPGPCJL UFSTFCVU NFNJMJLJ
LFDFOEFSVOHBO VOUVL TBMJOH NFOFNQFM EJ CBHJBO UFOHBI
Membran Sel
NFNCSBO TFQFSUJZBOHUBNQBLQBEB(BNCBS#BHJBOHVHVT
.FNCSBO TFM EJTFCVU KVHB NFNCSBO QMBTNB
ZBOH GPTGBU ZBOH CFSTJGBU IJESPGJMJL NFNCFOUVL EVB QFSNVLBBO
NFOZFMVCVOHJTFM BEBMBITVBUVTUSVLUVSZBOHUJQJT MFOUVS FMBTUJT NFNCSBO TFM ZBOH VUVI ZBOH CFSLPOUBL EFOHBO DBJSBO
EFOHBOLFUFCBMBOIBOZB TBNQBJOBOPNFUFS.FNCSBOTFM JOUSBTFMVMBS EJ TJTJ EBMBN EBO CFSLPOUBL EFOHBO DBJSBO
IBNQJS TFMVSVIOZB UFSTVTVO BUBT QSPUFJO EBO MJQJE 1FSLJSBBO FLTUSBTFMVMBSEJTJTJMVBS
LPNQPTJTJOZB BEBMBI QSPUFJO QFSTFO GPTGPMJQJE QFSTFO -BQJTBO MJQJE EJ CBHJBO UFOHBI NFNCSBO CFSTJGBU UJEBL
LPMFTUFSPM QFSTFO MJQJE MBJO QFSTFO EBO LBSCPIJESBU QFSNFBCFM UFSIBEBQ [BU ZBOH CJBTBOZB MBSVU EBMBN BJS TFQFSUJ
QFSTFO JPO HMVLPTB EBOVSFB4FCBMJLOZB [BUZBOHMBSVUEBMBNMFNBL
TFQFSUJ PLTJHFO LBSCPO EJPLTJEB EBO BMLPIPM EBQBU EFOHBO
NVEBINFOFNCVTCBHJBONFNCSBOUFSTFCVU
Karbohidrat
Protein integral
Lapisan
lipid ganda
Protein
perifer
Sitoplasma
Protein integral
Struktur membran sel, memperlihatkan bahwa membran sel merupakan lapisan lipid ganda yang terutama terdiri atas
molekul fosfolid, namun juga disertai sejumlah besar molekul protein yang menembus lapisan tersebut.Gugus karbohidrat juga melekat
pada molekul protein pada bagian luar membran dan pada molekul protein tambahan di bagian dalam membran.(Digambar ulang dari
Lodish HF, Rothman JE: The assembly of cell membranes. Sci. Am., 240:48, 1979. Hak cipta George V. Kevin.)
13
Unit 1 Pengantar Fisiologi: Fisiologi Sel dan Umum
.PMFLVM LPMFTUFSPM QBEB NFNCSBO TFM TFCFOBSOZB KVHB (VHVT LBSCPIJESBU ZBOH NFMFLBU EJ QFSNVLBBO MVBS TFM
NFSVQBLBO MJQJE LBSFOB JOUJ TUFSPJEOZB TBOHBU NVEBI MBSVU NFNQVOZBJ CFCFSBQB GVOHTJ QFOUJOH
#BOZBL LBSCPIJESBU
EBMBN MFNBL .PMFLVM JOJ TFEJLJU CBOZBL MBSVU EBMBN LFEVB UFSTFCVU CFSNVBUBO MJTUSJL OFHBUJG ZBOH NFOZFCBCLBO TFCBHJBO
MBQJTBO NFNCSBO .PMFLVM LPMFTUFSPM UFSVUBNB NFNCBOUV CFTBS TFM NFNJMJLJ NVBUBO LFTFMVSVIBO QFSNVLBBO TFM ZBOH
NFOFOUVLBO EFSBKBU QFSNFBCJMJUBT BUBV JNQFSNFBCJMJUBT
OFHBUJG TFIJOHHB EBQBU NFOPMBL [BU[BU CFSNVBUBO OFHBUJG MBJO
LFEVB MBQJTBO NFNCSBO UFSIBEBQ CBIBO MBSVU BJS EBSJ DBJSBO
(MJLPLBMJLT CFCFSBQB TFM NFMFLBU QBEB HMJLPLBMJLT TFM ZBOH
UVCVI,PMFTUFSPMJOJKVHBNFOHBUVSCBOZBLTJGBUDBJS GMVJEJUZ
MBJO TFIJOHHBTFMEBQBUTBMJOHNFMFLBUTBUVTBNBMBJO
#BOZBL
NFNCSBO LBSCPIJESBU ZBOH CFSQFSBO TFCBHBJ TVCTUBOTJ SFTFQUPS VOUVL
Protein Integral dan Protein Perifer Membran Sel. NFOHJLBU IPSNPO TFQFSUJ JOTVMJO JOTVMJO ZBOH UFSJLBU QBEB
(BNCBSNFNQFSMJIBULBONBTTBHMPCVMVTZBOHNFOHBQVOH SFTFQUPS UFSTFCVU NFOHBLUJWBTJ QSPUFJO JOUFSOBM ZBOH UFSEBQBU EJ
EBMBN MBQJTBO MJQJE HBOEB .BTTB JOJ NFSVQBLBO QSPUFJO TFMEBOTFMBOKVUOZBNFOHBLUJWBTJTFSBOHLBJBOFO[JNJOUSBTFMVMBS
NFNCSBO ZBOH TFCBHJBO CFTBS NFSVQBLBO HMJLPQSPUFJO
#FCFSBQB HVHVT LBSCPIJESBU KVHB BLBO JLVU EBMBN SFBLTJ
5FSEBQBU EVB KFOJT QSPUFJO NFNCSBO ZBJUV QSPUFJO JOUFHSBM JNVO ZBOHBLBOEJCBIBTEJ#BC
ZBOH NFOFNCVT NFNCSBO TFQFOVIOZB EBO QSPUFJO QFSJGFS
ZBOH IBOZB NFMFLBU QBEB TBUV TJTJ QFSNVLBBO NFNCSBO EBO Sitoplasma dan Organelnya
UJEBLNFOFNCVTNFNCSBOTFQFOVIOZB
4JUPQMBTNB EJQFOVIJ PMFI QBSUJLFM TFSUB PSHBOFM CFSVLVSBO CFTBS
#BOZBL QSPUFJO JOUFHSBM ZBOH CFSQFSBO TFCBHBJ LBOBM
EBOLFDJMZBOHUFSTFCBS#BHJBODBJSZBOHCFOJOHEBSJTJUPQMBTNB
TUSVLUVSBM BUBVQPSJQPSJ
ZBOHEBQBUEJMFXBUJPMFINPMFLVMBJS
ZBOHNFSVQBLBOUFNQBUQBSUJLFMUFSTFCVUUFSTFCBSEJTFCVUTJUPTPM
EBO [BU MBSVU BJS LIVTVTOZB JPO ZBOH EBQBU CFSEJGVTJ BOUBSB
ZBOHUFSVUBNBNFOHBOEVOHQSPUFJO FMFLUSPMJU EBOHMVLPTBZBOH
DBJSBO FLTUSBTFMVMBS EBO DBJSBO JOUSBTFMVMBS ,BOBM QSPUFJO JOJ
UFSMBSVU
KVHB NFNJMJLJ TJGBU TFMFLUJG ZBOH NFNVOHLJOLBO UFSKBEJOZB
%JEBMBNTJUPQMBTNBUFSTFCBSMFNBLOFUSBMCFSCFOUVLHMPCVMVT
EJGVTJ[BUUFSUFOUVZBOHMFCJINVEBIEJCBOEJOHLBO[BUMBJO
HSBOVMB HMJLPHFO SJCPTPN WFTJLFM TFLSFUPSJ EBO MJNB PSHBOFM
1SPUFJO JOUFHSBM MBJO CFSGVOHTJ TFCBHBJ QSPUFJO QFOHBOHLVU
ZBOH TBOHBU QFOUJOH SFUJLVMVN FOEPQMBTNB CBEBO (PMHJ
VOUVL NFNCBXB [BU ZBOH KJLB UJEBL EJBOHLVU UJEBL EBQBU
NJUPLPOESJB MJTPTPN EBOQFSPLTJTPN
NFOFNCVT MBQJTBO MJQJE HBOEB ,BEBOHLBEBOH UFSKBEJ
QFOHBOHLVUBO [BU[BU LF BSBI ZBOH CFSMBXBOBO EFOHBO BSBI
HSBEJFO FMFLUSPLJNJB EJGVTJ ZBOH EJTFCVU USBOTQPS BLUJG Retikulum Endoplasma
1SPUFJOJOUFHSBMMBJOOZBCFSQFSBOTFCBHBJFO[JN (BNCBS NFNQFSMJIBULBO TVBUV KBSJOHBO CFSCFOUVL UVCVMVT
1SPUFJO JOUFHSBM NFNCSBO KVHB EBQBU CFSQFSBO TFCBHBJ EBO TUSVLUVS WFTJLFM HFQFOH EBMBN TJUPQMBTNB ZBOH EJTFCVU
SFTFQUPSVOUVL[BULJNJBZBOHMBSVUBJSTFQFSUJIPSNPOQFQUJEB SFUJLVMVNFOEPQMBTNB5VCVMVTEBOWFTJLFMJOJTBMJOHCFSIVCV
ZBOH UBL EBQBU NFOFNCVT NFNCSBO TFM EFOHBO NVEBI OHBOTBUVTBNBMBJO%JOEJOHOZBKVHBUFSCFOUVLEBSJNFNCSBO
*OUFSBLTJ SFTFQUPS EFOHBO MJHBO TQFTJGJL ZBOH UFSJLBU QBEB CFSMBQJT MJQJE HBOEB ZBOH UFSEJSJ BUBT TFKVNMBI CFTBS QSPUFJO
SFTFQUPS NFOHBLJCBULBO QFSVCBIBO CFOUVL QSPUFJO SFTFQUPS NJSJQ EFOHBO NFNCSBO TFM -VBT QFSNVLBBO TUSVLUVS JOJ QBEB
)BMUFSTFCVUTFMBOKVUOZBTFDBSBFO[JNBUJLNFOHBLUJWBTJCBHJBO CFCFSBQBTFMNJTBMOZB TFMIBUJEBQBUNFODBQBJTBNQBJLBMJ
JOUSBTFMVMBS QSPUFJO JOUFHSBM BUBV NFNJDV UFSKBEJOZB JOUFSBLTJ MVBTQFSNVLBBONFNCSBOTFM
BOUBSB SFTFQUPS EFOHBO QSPUFJO EBMBN TJUPQMBTNB ZBOH 4USVLUVS EFUBJM EBSJ TBUV CBHJBO LFDJM SFUJLVMVN FOEPQMBTNB
CFSQFSBO TFCBHBJ DBSBLB LFEVB TFIJOHHB NFOFSVTLBO TJOZBM EJQFSMJIBULBO QBEB (BNCBS 3VBOH ZBOH UFSEBQBU EJ EBMBN
EBSJ CBHJBO FLTUSBTFMVMBS SFTFQUPS LF EBMBN TFM %BMBN IBM JOJ UVCVMVTEBOWFTJLFMUFSJTJEFOHBONBUSJLTFOEPQMBTNB TVBUVNFEJB
QSPUFJO JOUFHSBM ZBOH NFOFNCVT NFNCSBO TFM CFSGVOHTJ DBJSZBOHCFSCFEBEFOHBODBJSBOEBMBNTJUPTPMZBOHCFSBEBEJMVBS
TFCBHBJTBSBOBQFOZBNQBJBOJOGPSNBTJNFOHFOBJMJOHLVOHBOEJ SFUJLVMVNFOEPQMBTNB.JLSPTLPQFMFLUSPONFOVOKVLLBOCBIXB
MVBSTFMLFEBMBNTFM SVBOH EJ EBMBN SFUJLVMVN FOEPQMBTNB CFSIVCVOHBO EFOHBO
.PMFLVM QSPUFJO QFSJGFS TFSJOH LBMJ NFMFLBU QBEB QSPUFJO SVBOHZBOHUFSMFUBLEJBOUBSBEVBMBQJTBONFNCSBOOVLMFVT
JOUFHSBM1SPUFJOQFSJGFSJOJIBNQJSTFQFOVIOZBCFSGVOHTJTFCBHBJ ;BU[BU ZBOH EJCFOUVL QBEB CFCFSBQB CBHJBO TFM BLBO
FO[JNBUBVTFCBHBJQFOHBUVSUSBOTQPSUBTJ[BUZBOHNFMBMVJQPSJ NFNBTVLJSVBOHSFUJLVMVNFOEPQMBTNBEBOLFNVEJBOEJTBMVSLBO
QPSJNFNCSBOTFM LF LPNQBSUFNFO MBJO EJ TFM %J TBNQJOH JUV MVBTOZB QFSNVLBBO
Karbohidrat Membran-"Glikokaliks" Sel. ,BSCPIJESBU SFUJLVMVN EBO CFSCBHBJ TJTUFN FO[JN ZBOH NFMFLBU QBEB
NFNCSBO IBNQJS TFMBMV UFSEBQBU EBMBN CFOUVL LPNCJOBTJ NFNCSBOOZBNFNCFSJLBOTUSVLUVSZBOHCFSQFSBOQFOUJOHEBMBN
EFOHBO QSPUFJO BUBV MJQJE TFCBHBJ HMJLPQSPSFJO BUBV HMJLPMJQJE GVOHTJNFUBCPMJTNFTFM
1BEB LFOZBUBBOOZB TFCBHJBO CFTBS QSPUFJO JOUFHSBM NFSVQBLBO
HMJLPQSPUFJO EBO LJSBLJSB TFQFSTFQVMVI NPMFLVM MJQJE NFNCSBO Ribosom dan Retikulum Endoplasma Bergranula. %J
NFSVQBLBO HMJLPMJQJE (VHVT HMJLP EBSJ NPMFLVM UFSTFCVU CBOZBL CBHJBO QFSNVLBBO MVBS SFUJLVMVN FOEPQMBTNB
IBNQJSTFMBMVNFOPOKPMLFMVBSEBSJTFM ZBOHUFSVOUBJLFMVBSEBSJ NFMFLBU TFKVNMBI CFTBS QBSUJLFM CFSHSBOVMB LFDJM ZBOH EJTFCVU
QFSNVLBBO TFM #BOZBL TFOZBXB LBSCPIJESBU MBJO ZBOH EJTFCVU SJCPTPN #BHJBO SFUJLVMVN UFNQBU SJCPTPN JOJ NFMFLBU EJTFCVU
QSPUFPHMJLBO UFSVUBNB NFSVQBLBO [BU LBSCPIJESBU ZBOH UFSJLBU SFUJLVMVN FOEPQMBTNB CFSHSBOVMB 3JCPTPN UFSTVTVO BUBT
QBEB JOUJ QSPUFJO LFDJ KVHB NFMFLBU UJEBL FSBU QBEB QFSNVLBBO DBNQVSBO EBSJ 3/" EBO QSPUFJO EBO CFSGVOHTJ VOUVL TJOUFTJT
MVBSTFM+BEJ TFMVSVIQFSNVLBBOMVBSTFMTFSJOHLBMJEJMBQJTJPMFI NPMFLVM QSPUFJO CBSV EJ EBMBN TFM ZBOH BLBO EJCBIBT LFNVEJBO
TVBUVTFMVCVOHLBSCPIJESBUMPOHHBSZBOHEJTFCVUHMJLPLBMJLT EJCBCJOJEBOEJ#BC
14
#BEBO (PMHJ CFLFSKB TBNB EFOHBO SFUJLVMVN FOEPQMBTNB

4FQFSUJ ZBOH EJQFSMJIBULBO EBMBN (BNCBS WFTJLFM
USBOTQPSLFDJM EJTFCVUKVHBWFTJLFMSFUJLVMVNFOEPQMBTNB BUBV
WFTJLFM 3&
TFDBSB UFSVTNFOFSVT EJMFQBTLBO EBSJ SFUJLVMVN
Matriks FOEPQMBTNB EBO TFHFSB TFUFMBI JUV CFSHBCVOH EFOHBO CBEBO
(PMHJ%FOHBODBSBJOJ [BUZBOHUFSQFSBOHLBQEBMBNWFTJLFM3&
EJBOHLVUEBSJSFUJLVMVNFOEPQMBTNBLFCBEBO(PMHJ;BUZBOH
EJBOHLVU UFSTFCVU TFMBOKVUOZB EJQSPTFT EBMBN CBEBO (PMHJ
VOUVL NFNCFOUVL MJTPTPN WFTJLFM TFLSFUPSJ EBO LPNQPOFO
TJUPQMBTNBMBJOOZBZBOHBLBOEJCJDBSBLBOLFNVEJBOEBMBNCBC
JOJ
Lisosom
-JTPTPN TFQFSUJ ZBOH EJUVOKVLLBO QBEB (BNCBS BEBMBI
PSHBOFM CFSCFOUVL WFTJLFM ZBOH UFSCFOUVL EBSJ CFCFSBQB
Retikulum
endoplasma Retikulum
CBHJBO CBEBO (PMHJ ZBOH MFQBT EBO LFNVEJBO NFOZFCBS LF
bergranula endoplasma TFMVSVI TJUPQMBTNB -JTPTPN JOJ NFNCFOUVL TJTUFN QFODFS
tidak bergranula OBBOJOUSBTFMVMBSZBOHNFNVOHLJOLBOTFMVOUVLNFODFSOB

Struktur retikulum endoplasma. (Dimodifikasi dari TUSVLUVS TFM ZBOH SVTBL
QBSUJLFM NBLBOBO ZBOH UFMBI
DeRobertis EDP, Saez FA, dan De Robertis EMF: Cell Biology. EJDFSOB TFM EBO
[BU ZBOH UJEBL EJJOHJOLBO TFQFSUJ CBLUFSJ
6th ed. Philadelphia: W.B. Saunders, 1975.) -JTPTPN CFSCFEB QBEB KFOJT TFM ZBOH CFSCFEB UFUBQJ CJBTBOZB
CFSEJBNFUFS BOUBSB TBNQBJ OBOPNFUFS -JTPTPN
Retikulum Endoplasma Tidak Bergranula. 4FCBHJBO EJLFMJMJOHJ PMFI NFNCSBO MJQJE HBOEB ZBOH LIBT EBO CFSJTJ
SFUJLVMVNFOEPQMBTNBUJEBLNFNJMJLJSJCPTPN#BHJBOJOJEJTFCVU TFKVNMBI CFTBS HSBOVMB CFSVLVSBO LFDJM ZBOH CFSEJBNFUFS
TFCBHBJ SFUJLVMVN FOEPQMBTNB UJEBL CFSHSBOVMB BUBV IBMVT TBNQBJOBOPNFUFS ZBOHNFSVQBLBOLVNQVMBOQSPUFJOZBOH
3FUJLVMVNUJEBLCFSHSBOVMBJOJCFSGVOHTJEBMBNTJOUFTJT[BUMJQJE UFSEJSJBUBTKFOJTFO[JNIJESPMBTF QFODFSOBBO
4VBUVFO[JN
EBOCFSQFSBOEBMBNQSPTFTTFMMBJOZBOHEJQFSBOUBSBJFO[JNZBOH IJESPMJUJL NBNQV NFNFDBILBO TFOZBXB PSHBOJL NFOKBEJ EVB
CFSBEBEJEBMBNSFUJLVMVN CBHJBO BUBV MFCJI EFOHBO DBSB NFOHHBCVOHLBO IJESPHFO ZBOH
CFSBTBMEBSJNPMFLVMBJSEFOHBOTVBUVCBHJBOTFOZBXBUFSTFCVU
Badan Golgi EBO NFOHHBCVOHLBO HVHVT IJESPLTJM EBSJ NPMFLVM BJS EFOHBO
#BEBO (PMHJ TFQFSUJ ZBOH UBNQBL EBMBN (BNCBS FSBU CBHJBO MBJO TFOZBXB UBEJ $POUPIOZB QSPUFJO EJIJESPMJTJT
IVCVOHBOOZB EFOHBO SFUJLVMVN FOEPQMBTNB #BEBO (PMHJ VOUVL NFNCFOUVL BTBN BNJOP HMJLPHFO EJIJESPMJTJT VOUVL
NFNJMJLJ NFNCSBO ZBOH NJSJQ EFOHBO NFNCSBO SFUJLVMVN NFNCFOUVLHMVLPTB EBOMJQJEEJIJESPMJTJTNFOKBEJBTBNMFNBL
FOEPQMBTNBUJEBLCFSHSBOVMB#BEBO(PMHJCJBTBOZBUFSTVTVOBUBT EBOHMJTFSPM
FNQBUBUBVMFCJIMBQJTBOWFTJLFMZBOHUJQJT HFQFOH EBOUFSUVUVQ #JBTBOZB NFNCSBO ZBOH NFOZFMVCVOHJ MJTPTPN BLBO
ZBOHUFSTVTVONFOVNQVLTFSUBUFSMFUBLEFLBUEFOHBOTBMBITBUV NFODFHBIFO[JNIJESPMJUJLZBOHUFSLVSVOHVOUVLCFSIVCVOHBO
TJTJOVLMFVT#BEBO(PMHJJOJQFOUJOHQBEBTFMTFLSFUPSJ EJNBOB EFOHBO [BU MBJO EJ EBMBN TFM EBO EFOHBO EFNJLJBO NFODFHBI
CBEBO UFSTFCVU UFSMFUBL EJ TJTJ TFM UFNQBU [BU TFLSFUPSJ BLBO LFSKB QFODFSOBBOOZB /BNVO CFCFSBQB LFBEBBO ZBOH NFSVTBL
EJLFMVBSLBO NFNCSBO CFCFSBQB MJTPTPN NFNVOHLJOLBO QFMFQBTBO FO[JN
Vesikel Golgi
QFODFSOBBO &O[JN UFSTFCVU LFNVEJBO BLBO NFNFDBILBO [BU
PSHBOJLZBOHCFSLPOUBLEFOHBOOZBNFOKBEJ[BUZBOHMFCJILFDJM
EBOTBOHBUNVEBICFSEJGVTJ NJTBMOZBBTBNBNJOPEBOHMVLPTB
#FSCBHBJ GVOHTJ MJTPTPN ZBOH TQFTJGJL BLBO EJCBIBT LFNVEJBO
EBMBNCBCJOJ
Badan Peroksisom
Golgi
Vesikel 1FSPLTJTPN CFSCFOUVL NJSJQ EFOHBO MJTPTPN UFUBQJ CFSCFEB
retikulum EBMBNEVBIBMQFOUJOH1FSUBNB QFSPLTJTPNEJZBLJOJUFSCFOUVL
endoplasma EFOHBODBSBNFSFQMJLBTJEJSJ BUBVNVOHLJOCFSBTBMEBSJCBHJBO
SFUJLVMVN FOEPQMBTNB IBMVT ZBOH MFQBT
EBO CVLBO EBSJ CBEBO
(PMHJ ,FEVB QFSPLTJTPN NFOHBOEVOH FO[JN PLTJEBTF EBO
Retikulum CVLBO IJESPMBTF #FCFSBQB FO[JN PLTJEBTF NBNQV
endoplasma
NFOHHBCVOHLBOPLTJHFOEFOHBOJPOIJESPHFOZBOHCFSBTBMEBSJ
CFSCBHBJ [BU LJNJB JOUSBTFMVMBS VOUVL NFNCFOUVL IJESPHFO
QFSPLTJEB )0
)JESPHFO QFSPLTJEB BEBMBI [BU ZBOH TBOHBU
NVEBINFOHPLTJEBTJ[BUMBJO EBOCFLFSKBTBNBEFOHBOLBUBMBTF
Sebuah badan Gotgi yang khas dan hubungannya TVBUVFO[JNPLTJEBTFMBJOZBOHEJUFNVLBOEBMBNKVNMBICFTBSEJ
dengan retikulum endoplasma (RE) dan nukleus. EBMBNQFSPLTJTPN VOUVLNFOHPLTJEBTJCBOZBL[BUZBOHCJMB
15
UJEBL EJPLTJEBTJ BLBO NFOKBEJ SBDVO CBHJ TFM 4FCBHBJ DPOUPI .JUPLPOESJB UFSEBQBU EJ TFNVB CBHJBO TJUPQMBTNB TFUJBQ TFM
LJSBLJSBTFUFOHBIEBSJKVNMBIBMLPIPMZBOHEJNJOVNTFTFPSBOH UFUBQJKVNMBIUPUBMQFSTFMTBOHBUCFSWBSJBTJ NVMBJEBSJLVSBOHEBSJ
EJEFUPLTJGJLBTJPMFIQFSPLTJTPNTFMIBUJEFOHBODBSBJOJ TFSBUVT TBNQBJ CFCFSBQB SJCV UFSHBOUVOH KVNMBI FOFSHJ ZBOH
EJCVUVILBO PMFI NBTJOHNBTJOH TFM 4FMBOKVUOZB NJUPLPOESJB
Vesikel Sekretori UFSLPOTFOUSBTJ EJ CBHJBO TFM ZBOH CFSQFSBO CFTBS UFSIBEBQ
NFUBCPMJTNF FOFSHJ TFM 6LVSBO EBO CFOUVLOZB KVHB CFSWBSJBTJ
4BMBI TBUV GVOHTJ QFOUJOH EBSJ CBOZBL TFM BEBMBI TFLSFTJ [BU[BU #FCFSBQBNJUPLPOESJBCFSEJBNFUFSIBOZBCFCFSBQBSBUVTOBOPNF
LJNJBLIVTVT)BNQJSTFNVB[BUTFLSFUPSJEJCFOUVLPMFITJTUFN UFS EBO CFSCFOUVL HMPCVMVT TFEBOHLBO NJUPLPOESJB MBJO
SFUJLVMVN FOEPQMBTNB CBEBO (PMHJ EBO LFNVEJBO EJMFQBTLBO CFOUVLOZB NFNBOKBOHCFSEJBNFUFS NJLSPNFUFS EFOHBO
EBSJ CBEBO (PMHJ LF EBMBN TJUPQMBTNB EBMBN CFOUVL WFTJLFM QBOKBOH NJLSPNFUFS TJTBOZB CFSDBCBOHDBCBOH EBO CFSCFOUVL
QFOZJNQBOBO ZBOH EJTFCVU WFTJLFM TFLSFUPSJ BUBV HSBOVMB GJMBNFO
TFLSFUPSJ (BNCBS NFNQFSMJIBULBO WFTJLFM TFLSFUPSJ ZBOH
4USVLUVS EBTBS NJUPLPOESJB TFQFSUJ ZBOH EJUVOKVLLBO EBMBN
LIBT EBMBN TFM BTJOJ QBOLSFBT WFTJLFM JOJ NFOZJNQBO QSPUFJO
(BNCBS UFSVUBNB UFSTVTVO BUBT EVB MBQJTBO MJQJE HBOEB
QSPFO[JN FO[JN ZBOH CFMVN BLUJG
1SPFO[JN LFNVEJBO BLBO
NFNCSBO QSPUFJO TFCVBI NFNCSBO MVBS EBO TFCVBI NFNCSBO
EJTFLSFTJLBONFMBMVJNFNCSBOTFMCBHJBOMVBS NBTVLLFEBMBN
EBMBN#BOZBLMJQBUBONFNCSBOEBMBNZBOHNFNCFOUVLSBLSBL
EVLUVTQBOLSFBUJLVTEBOEBSJUFNQBUUFSTFCVU NBTVLLFEBMBN
ZBOH NFSVQBLBO UFNQBU QFSMFLBUBO FO[JN PLTJEBUJG 4FMBJO JUV
EVPEFOVN EJ NBOB QSPFO[JN NFOKBEJ BLUJG EBO NFMBLVLBO
SPOHHB CBHJBO EBMBN NJUPLPOESJB KVHB EJQFOVIJ EFOHBO NBUSJLT
GVOHTJ QFODFSOBBOOZB QBEB NBLBOBO ZBOH CFSBEB EBMBN
ZBOH NFOHBOEVOH TFKVNMBI CFTBS FO[JN UFSMBSVU ZBOH
TBMVSBOQFODFSOBBO
EJCVUVILBOVOUVLNFOEBQBULBOFOFSHJEBSJ[BUHJ[J&O[JNFO[JN
Mitokondria JOJCFLFSKBTBNBEFOHBOFO[JNFO[JNPLTJEBUJGZBOHCFSBEBQBEB
.JUPLPOESJB TFQFSUJ ZBOH UFSMJIBU QBEB (BNCBS EBO SBL VOUVL NFOHPLTJEBTJ [BU HJ[J EFOHBO EFNJLJBO NFNCFOUVL
EJTFCVU TFCBHBJ HVEBOH FOFSHJ QPXFSIPVTF
TFM 5BOQB LBSCPO EJPLTJEB EBO BJS TFSUB QFMFQBTBO FOFSHJ QBEB TBBU ZBOH
NJUPLPOESJB TFM UJEBL BLBO EBQBU NFNQFSPMFI FOFSHJ ZBOH TBNB &OFSHJ ZBOH EJMFQBTLBO UFSTFCVU EJHVOBLBO VOUVL TJOUFTJT
DVLVQEBSJ[BUHJ[J EBOTFNVBGVOHTJTFMBLBOCFSIFOUJ TVBUV[BUCFSFOFSHJUJOHHJZBOHEJTFCVUBEFOPTJOUSJGPTGBU "51

"51 LFNVEJBO EJBOHLVU LFMVBS EBSJ NJUPLPOESJB EBO CFSEJGVTJ
LF TFMVSVI CBHJBO TFM VOUVL NFNCFSJLBO FOFSHJOZB EJ NBOB TBKB
an la FOFSHJUFSTFCVUEJCVUVILBOVOUVLNFOKBMBOLBOGVOHTJTFM3JODJBO
sek e o i
SFBLTJLJNJBQFNCFOUVLBO"51PMFINJUPLPOESJBEJCBIBTEBMBN
#BC UFUBQJCFCFSBQBGVOHTJEBTBS"51EBMBNTFMBLBOEJCBIBT
LFNVEJBOEBMBNCBCJOJ
.JUPLPOESJB EBQBU NFSFQMJLBTJ EJSJ ZBOH CFSBSUJ TBUV

NJUPLPOESJB EBQBU NFNCFOUVL NJUPLPOESJB LFEVB LFUJHB EBO
TFUFSVTOZB CJMBNBOB TFM QFSMV VOUVL NFOBNCBI KVNMBI "51
.JUPLPOESJB NFNBOH NFNJMJLJ %/" ZBOH NJSJQ EFOHBO %/"
ZBOH EJUFNVLBO EBMBN OVLMFVT %J #BC LJUB BLBO NFOHFUBIVJ
CBIXB %/" NFSVQBLBO CBIBO LJNJB EBTBS OVLMFVT ZBOH
NFOHBUVS SFQMJLBTJ TFM %/" NJUPLPOESJB NFNBJOLBO QFSBO
an la sek e o i esikel sek e o i dalam sel sel TFSVQB ZBOHNFOHBUVSSFQMJLBTJNJUPLPOESJB
asini ank eas
Sitoskeleton Sel—Struktur Filamen dan Tubulus
em an l a 1SPUFJOTFSBUIBMVTEBSJTFMCJBTBOZBUFSTVTVOTFCBHBJGJMBNFOBUBV
ongga dalam UVCVMVT 1SPUFJO UFSTFCVU NFSVQBLBO NPMFLVM QSPUFJO QSFLVSTPS
ZBOHEJTJOUFTJTPMFISJCPTPNEBMBNTJUPQMBTNB.PMFLVMQSFLVSTPS
is a a iks
UFSTFCVU TFMBOKVUOZB CFSQPMJNFSJTBTJ NFNCFOUVL GJMBNFO
$POUPIOZB TFKVNMBICFTBSGJMBNFOBLUJOZBOHTFSJOHUFSEBQBUEJ
[POB MVBS TJUPQMBTNB ZBOH EJTFCVU FLUPQMBTNB NFNCFOUVL
TUSVLUVSQFOVOKBOHZBOHFMBTUJTCBHJNFNCSBOTFM%BMBNTFMPUPU
GJMBNFO BLUJO EBO NJPTJO KVHB UFSTVTVO NFOKBEJ TVBUV NFTJO
LPOUSBLUJM LIVTVT ZBOH NFSVQBLBO EBTBS UJNCVMOZB LPOUSBLTJ
PUPU ZBOHBLBOEJCBIBTTFDBSBEFUBJMEJ#BC
n im
os o ilasi 4VBUV KFOJT LIVTVT GJMBNFO LBLV ZBOH UFSTVTVO BUBT NPMFLVM
ongga l a oksida i UVCVMJO ZBOH CFSQPMJNFS EJHVOBLBO EJ TFNVB TFM VOUVL
k se a mi okond ia imodi ikasi da i e
NFNCFOUVL TUSVLUVS UVCVMVT ZBOH LVBU ZBJUV NJLSPUVCVMVT
o e is ae dan e o e is Cell Biology (BNCBS NFNQFSMJIBULBO NJLSPUVCVMVT LIBT ZBOH EJBNCJM
ed iladel ia a nde s EBSJGMBHFMBTFCVBITQFSNB
16
oi oi kleo lasma
e ik l m
endo lasma
kleol s
UNIT I
el ng n kle s
l a dan mem an
dalam
a e i k oma in
i o lasma
k n kle s
ik o l s ang diam il da i lagela se a

IVCVOH EFOHBO SFUJLVMVN FOEPQMBTNB ZBOH CFSBEB EJ
s e ma a i ois en olme onno dan ene i
am a alaman Hak i a o a is o nda ion TJUPQMBTNB TFM EBO SVBOHBO BOUBSB LFEVB NFNCSBO OVLMFVT
se el mn a i a o nda ion KVHB UFSIVCVOH EFOHBO SVBOHBO EJ EBMBN SFUJLVMVN
FOEPQMBTNB TFQFSUJZBOHEJUVOKVLLBOEBMBN(BNCBS
$POUPIMBJOEBSJNJLSPUVCVMVTBEBMBITUSVLUVSSBOHLBUVCVMVT .FNCSBO OVLMFVT EJUFNCVT PMFI SJCVBO QPSJ QPSJ OVLMFVT
EJ CBHJBO UFOHBI TFUJBQ TJMJB ZBOH UFSTVTVO SBEJFS LF BUBT EBSJ ,PNQMFLT NPMFLVM QSPUFJO ZBOH CFTBS NFOFNQFM EJ UFQJ QPSJ
TJUPQMBTNB TFM TBNQBJ LF VKVOH TJMJB 4USVLUVS JOJ BLBO EJCBIBT QPSJ UFSTFCVU TFIJOHHB CBHJBO QVTBU EBSJ TFUJBQ QPSJ IBOZB
LFNVEJBO EBMBN CBC JOJ EBO EJUVOKVLLBO EBMBN (BNCBS CFSEJBNFUFSTFLJUBSOBOPNFUFS8BMBVQVOEFNJLJBO VLVSBO
4FOUSJPM EBO HFMFOEPOH NJUPTJT EBSJ TFCVBI TFM ZBOH TFEBOH JOJDVLVQCFTBSVOUVLNFNVOHLJOLBONPMFLVMEFOHBOVLVSBO
CFSNJUPTJTKVHBUFSTVTVOBUBTNJLSPUVCVMVTZBOHLBLV TBNQBJ CFSBU NPMFLVM VOUVL EBQBU MFXBU EFOHBO DVLVQ
+BEJ GVOHTJ VUBNB NJLSPUVCVMVT BEBMBI CFSQFSBO TFCBHBJ NVEBI
TJUPTLFMFUPO ZBOH NFSVQBLBO TUSVLUVS QFOVOKBOH ZBOH LBLV Nukleolus dan Pembentukan Ribosom
VOUVLCBHJBOUFSUFOUVTFM /VLMFVT EBSJ TFCBHJBO CFTBS TFM NFNJMJLJ TBUV BUBV MFCJI
TUSVLUVSZBOHTBOHBUNVEBINFOZFSBQ[BUXBSOBZBOHEJTFCVU
Nukleus OVLMFPMVT /VLMFPMVT UJEBL TFQFSUJ PSHBOFM MBJOOZB ZBOH
/VLMFVT NFSVQBLBO QVTBU QFOHBUVSBO TFM 4FDBSB TJOHLBU EJCBIBT EBMBN CBC JOJ UJEBL NFNJMJLJ TFCVBI NFNCSBO
OVLMFVT NFOHBOEVOH TFKVNMBI CFTBS %/" ZBOH NFSVQBLBO QFNCBUBT 4FCBMJLOZB OVLMFPMVT IBOZB NFSVQBLBO TVBUV
HFO(FOUFSTFCVUNFOFOUVLBOLBSBLUFSJTUJLQSPUFJOTFM UFSNBTVL LVNQVMBOTFKVNMBICFTBS3/"EBOQSPUFJOZBOHKFOJTOZBTBNB
QSPUFJO TUSVLUVSBM EBO FO[JN JOUSBTFMVMBS ZBOH NFOHBUVS EFOHBO QSPUFJO ZBOH EJUFNVLBO EJ SJCPTPN /VLMFPMVT
BLUJWJUBTTJUPQMBTNBEBOOVLMFVT NFNCFTBS TFDBSB CFSNBLOB CJMB TFCVBI TFM TFDBSB BLUJG
(FOKVHBNFOHBUVSEBONFOEVLVOHQSPTFTSFQSPEVLTJTFMJUV NFOZJOUFTJTQSPUFJO
TFOEJSJ (FO UFSTFCVU QFSUBNBUBNB CFSFQSPEVLTJ VOUVL 1FNCFOUVLBO OVLMFPMVT EBO QFNCFOUVLBO SJCPTPN EBMBN
NFNCFOUVL EVB VOJU HFO ZBOH JEFOUJL LFNVEJBO TFM BLBO TJUPQMBTNB EJ MVBS OVLMFVT
CFSBXBM EJ OVLMFVT 1FSUBNB HFO
NFNCFMBIEJSJNFMBMVJQSPTFTLIVTVTZBOHEJTFCVUNJUPTJTVOUVL %/" ZBOH TQFTJGJL EBMBN LSPNPTPN NFOZFCBCLBO TJOUFTJT
NFNCFOUVL EVB TFM BOBL ZBOH NBTJOHNBTJOH NFOFSJNB TBUV 3/"#FCFSBQB3/"ZBOHEJQSPEVLTJUFSTFCVUEJTJNQBOEBMBN
EBSJ EVB VOJU HFO %/" ZBOH UFSCFOUVL UBEJ 4FNVB BLUJWJUBT OVLMFPMVT UFUBQJTFCBHJBOCFTBSEJBOHLVULFMVBSNFMBMVJQPSJ
OVLMFVTJOJEJCBIBTTFDBSBEFUBJMEJCBCCFSJLVUOZB QPSJ OVLMFVT LF EBMBN TJUPQMBTNB %BMBN TJUPQMBTNB 3/"
4BZBOHOZB OVLMFVT ZBOH UBNQBL EFOHBO NFOHHVOBLBO CFSTBNBTBNB EFOHBO QSPUFJO ZBOH TQFTJGJL EJHVOBLBO VOUVL
NJLSPTLPQ DBIBZB UJEBL EBQBU NFNCFSJLBO CBOZBL QFUVOKVL NFNCFOUVL SJCPTPN ZBOH NBUBOH ZBOH CFSQFSBO QFOUJOH
NFOHFOBJNFLBOJTNFCBHBJNBOBOVLMFVTNFOHBUVSTFM(BNCBS QBEBQFNCFOUVLBOQSPUFJOTJUPQMBTNB ZBOHBLBOEJCBIBTMFCJI
NFNQFSMJIBULBO TFCVBI OVLMFVT EBMBN GBTF JOUFSGBTF MFOHLBQEJ#BC
QFSJPEFEJBOUBSBEVBNJUPTJT
EFOHBONFOHHVOBLBONJLSPTLPQ
DBIBZB ZBOHNFNQFSMJIBULBONBUFSJLSPNBUJOCFSXBSOBHFMBQEJ Perbandingan Sel Hewan dengan Bentuk-Bentuk
TFMVSVI CBHJBO OVLMFPQMBTNB 4FMBNB NJUPTJT NBUFSJ LSPNBUJO Kehidupan sebelum Sel
UFSTVTVO EBMBN CFOUVL TUSVLUVS ZBOH MFCJI LPNQMFLT ZBJUV
LSPNPTPN ZBOH EBQBU EJJEFOUJGJLBTJ EFOHBO NVEBI EFOHBO 4FM NFSVQBLBO PSHBOJTNF ZBOH TBOHBU LPNQMFLT ZBOH
NFOHHVOBLBO NJLSPTLPQ DBIBZB TFQFSUJ ZBOH EJJMVTUSBTJLBO EJ NFNCVUVILBOCFSBUVTSBUVTKVUBUBIVOVOUVLCFSLFNCBOHEBSJ
CBCCFSJLVUOZB CFOUVL LFIJEVQBO ZBOH QBMJOH BXBM TVBUV PSHBOJTNF ZBOH
NJSJQEFOHBOWJSVTTBBUJOJ ZBOHNVODVMQFSUBNBLBMJEJCVNJ
Membran Nukleus
(BNCBS NFNQFSMJIBULBO VLVSBO SFMBUJG EBSJ
WJSVT
.FNCSBO OVLMFVT ZBOH KVHB EJTFCVU TFMVCVOH OVLMFVT UFSLFDJMZBOHEJLFUBIVJ
WJSVTCFTBS
SJLFUTJB
CBLUFSJ
TFCFOBSOZBNFSVQBLBOEVBMBQJTNFNCSBOZBOHUFSQJTBI ZBLOJ EBO
TFM CFSOVLMFVT, ZBOH NFOVOKVLLBO CBIXB TFM
TBUVNFNCSBOEJEBMBNNFNCSBOZBOHMBJO.FNCSBOMVBSUFS NFNQVOZBJEJBNFUFSLJSBLJSBLBMJMFCJICFTBSEBSJWJSVT
17
Unit 1 Pengantar Fisiologi: Fisiologi Sel dan Umum
nm- i s ke il TJTUFNGVOHTJPOBMEBSJTFMZBOHNFOKBEJLBOTFMTFCBHBJPSHBOJTNF
nm- i s esa IJEVQ
350 nm- ike sia Penelanan oleh Sel—Endositosis
"HBS TVBUV TFM EBQBU IJEVQ UVNCVI EBO CFSLFNCBOH CJBL TFM
1 mm ak e i
IBSVT NFNQFSPMFI [BU HJ[J EBO [BU MBJOOZB EBSJ DBJSBO EJ
el TFLJUBSOZB 4FCBHJBO CFTBS [BU NFMFXBUJ NFNCSBO TFM NFMBMVJ
EJGVTJEBOUSBOTQPSBLUJG
%JGVTJ NFSVQBLBO HFSBLBO TFEFSIBOB NFMBMVJ NFNCSBO ZBOH
EJTFCBCLBO HFSBLBO BDBL NPMFLVM [BU UFSTFCVU [BU CFSHFSBL CBJL
NFMBMVJ QPSJQPSJ NFNCSBO TFM BUBV CJMB [BU UFSTFCVU MBSVU MJQJE
5–10mm+ NFMBMVJNBUSJLTMJQJENFNCSBO
e andingan k an o ganisme se el m sel 5SBOTQPS BLUJG NFSVQBLBO QSPTFT QFOHBOHLVUBO [BU ZBOH
dengan k an a a a a sel ang e da a dalam NFMBMVJ NFNCSBO PMFI TVBUV TUSVLUVS QSPUFJO ZBOH EBQBU
man sia NFOFNCVT NFNCSBO TFQFOVIOZB .FLBOJTNF USBOTQPS BLUJG
TBOHBUQFOUJOHCBHJGVOHTJTFMTFIJOHHBBLBOEJCBIBTTFDBSBEFUBJMEJ
UFSLFDJM EBO PMFI LBSFOB JUV NFNQVOZBJ WPMVNF LJSBLJSB #BC
NJMJBSLBMJMFCJICFTBSEBSJWJSVTUFSLFDJM4FKBMBOEFOHBOIBMJOJ 1BSUJLFM ZBOH TBOHBU CFTBS NFNBTVLJ TFM NFMBMVJ TVBUV GVOHTJ
GVOHTJ EBO TVTVOBO BOBUPNJ TFM KVHB KBVI MFCJI LPNQMFLT EBSJ LIVTVT NFNCSBO TFM ZBOH EJTFCVU FOEPTJUPTJT #FOUVL VUBNB
WJSVTUFSTFCVU FOEPTJUPTJT BEBMBI QJOPTJUPTJT EBO GBHPTJUPTJT 1JOPTJUPTJT CFSBSUJ
6OTVS QPLPL ZBOH NFNCFSJLBO LFIJEVQBO CBHJ WJSVT LFDJM QFODFSOBBO QBSUJLFM CFSVLVSBO LFDJM EFOHBO NFNCFOUVL WFTJLFM
UFSTFCVU BEBMBI BTBN OVLMFBU ZBOH UFSTJNQBO EBMBN TFCVBI ZBOH CFSJTJ DBJSBO FLTUSBTFMVMBS EBO [BU QBSUJLVMBU EJ EBMBN
TFMVCVOH QSPUFJO "TBN OVLMFBU JOJ UFSTVTVO BUBT CBIBO EBTBS TJUPQMBTNB 'BHPTJUPTJT CFSBSUJ QFODFSOBBO QBSUJLFM ZBOH
BTBN OVLMFBU %/" BUBV 3/"
ZBOH TBNB EFOHBO ZBOH CFSVLVSBO CFTBS TFQFSUJ CBLUFSJ TFM VUVI BUBV CBHJBO KBSJOHBO
EJUFNVLBO EBMBN TFM NBNBMJB EBO NBNQV VOUVL ZBOHCFSEFHFOFSBTJ
NFNQFSCBOZBL EJSJOZB TFOEJSJ EBMBN LPOEJTJ ZBOH TFTVBJ +BEJ Pinositosis. 1JOPTJUPTJT UFSKBEJ TFDBSB UFSVTNFOFSVT QBEB
WJSVTNFNQFSCBOZBLLFUVSVOBOOZBEBSJHFOFSBTJLFHFOFSBTJEBO NFNCSBO TFCBHJBO CFTBS TFM UFUBQJ UFSKBEJ TBOHBU DFQBU QBEB
EFOHBO EFNJLJBO NFSVQBLBO TFCVBI TUSVLUVS IJEVQ ZBOH QBEB CFCFSBQB TFM $POUPIOZB QJOPTJUPTJT UFSKBEJ TBOHBU DFQBU QBEB
IBLJLBUOZB TBNB EFOHBO TFM EBO NBOVTJB ZBOH KVHB NFSVQBLBO NBLSPGBH TFIJOHHB LJSBLJSB UJHB QFSTFO EBO TFMVSVI NFNCSBO
TUSVLUVSIJEVQ NBLSPGBH BLBO EJDFSOB EBMBN CFOUVL WFTJLFM TFUJBQ NFOJU
4FKBMBOEFOHBOFWPMVTJLFIJEVQBO CBIBOCBIBOLJNJBTFMBJO .FTLJQVO EFNJLJBO VLVSBO WFTJLFM QJOPTJUPTJT TBOHBU LFDJM
BTBN OVLMFBU EBO QSPUFJO TFEFSIBOB NFOKBEJ CBHJBO ZBOH UBL CJBTBOZBIBOZBCFSEJBNFUFSTBNQBJOBOPNFUFSTFIJOHHB
CJTB EJQJTBILBO EBSJ PSHBOJTNF UFSTFCVU EBO GVOHTJGVOHTJ TFCBHJBO CFTBS WFTJLFM QJOPTJUPTJT IBOZB EBQBU EJMJIBU EFOHBO
LIVTVT NVMBJ CFSLFNCBOH EJ CFSCBHBJ CBHJBO WJSVT 4FCVBI NJLSPTLPQFMFLUSPO
NFNCSBOUFSCFOUVLEJTFLFMJMJOHWJSVTEBOEJEBMBNNFNCSBO 1JOPTJUPTJT NFSVQBLBO TBUVTBUVOZB DBSB ZBOH EBQBU
UJNCVM NBUSJLT ZBOH DBJS #BIBO LJNJB LIVTVT CFSLFNCBOH EJ EJQFSHVOBLBO PMFI TFCBHJBO CFTBS NBLSPNPMFLVM CFTBS TFQFSUJ
EBMBNDBJSBOUFSTFCVUZBOHCFSUVKVBOVOUVLNFOKBMBOLBOGVOHTJ TFCBHJBO CFTBS NPMFLVM QSPUFJO VOUVL NFNBTVLJ TFM 1BEB
LIVTVTCBOZBLFO[JNQSPUFJOZBOHNBNQVNFOHBUBMJTBTJSFBLTJ LFOZBUBBOOZB LFDFQBUBO QFNCFOUVLBO WFTJLFM QJOPTJUPTJT
LJNJBCFSNVODVMBOEBOEFOHBOEFNJLJBONFOFOUVLBOBLUJWJUBT CJBTBOZBNFOJOHLBUTBBUNBLSPNPMFLVMNFOZFOUVINFNCSBOTFM
PSHBOJTNFUFSTFCVU (BNCBS NFNQFSMJIBULBO MBOHLBIMBOHLBI QJOPTJUPTJT
1BEB CFOUVL LFIJEVQBO UBIBQ CFSJLVUOZB LIVTVTOZB QBEB TFDBSB CFSVSVUBO ZBOH NFOVOKVLLBO UJHB NPMFLVM QSPUFJO ZBOH
UBIBQ SJLFUTJB EBO CBLUFSJ PSHBOFMPSHBOFM NVMBJ UFSCFOUVL NFMFLBUQBEBNFNCSBO.PMFLVMNPMFLVMJOJCJBTBOZBNFMFLBU
EBMBN PSHBOJTNF UFSTFCVU NFXBLJMJ TUSVLUVS GJTJL EBSJ
LVNQVMBO CBIBO LJNJB ZBOH NFOKBMBOLBO GVOHTJOZB TFDBSB
o ein ese o
MFCJIFGJTJFOEJCBOEJOHLBOEFOHBOIBTJMZBOHEBQBUEJDBQBJPMFI ek ngan
e sel ng
CBIBOLJNJBZBOHUFSTFCBSEBMBNNBUSJLTZBOHDBJS la in
"LIJSOZB QBEBTFMCFSOVLMFVT PSHBOFMZBOHMFCJILPNQMFLT
NVMBJ CFSCFOUVL EBO ZBOH UFSQFOUJOH EJ BOUBSBOZB BEBMBI
UFSCFOUVLOZBOVLMFVTJUVTFOEJSJ"EBOZBOVLMFVTNFNCFEBLBO
KFOJT TFM UFSTFCVU EBO TFNVB CFOUVL LFIJEVQBO ZBOH MFCJI
A B
TFEFSIBOB OVLMFVT NFSVQBLBO QVTBU QFOHBUVS TFNVB BLUJWJUBT
TFM EBO KVHB NFOHBUVS QFSLFNCBOHCJBLBO ZBOH QFSTJT TBNB
EBSJ TFM HFOFSBTJ MBNB LF TFM HFOFSBTJ CBSV TFIJOHHB TFUJBQ TFM k in dan miosin ela an kla in
CBSV NFNQVOZBJ TUSVLUVS ZBOH IBNQJS TBNB EFOHBO TFM
JOEVLOZB
Sistem Fungsional Sel

1BEBTJTBCBCJOJ LJUBBLBONFNCBIBTCFCFSBQBQFSXBLJMBO C D
Mekanisme pinositosis
18
JOJ CJBTBOZB NFMFLBU QBEB QSPUFJO SFTFQUPS LIVTVT QBEB Pencernaan Benda-Benda Asing Pinositosis dan
QFSNVLBBO NFNCSBO ZBOH TQFTJGJL VOUVL KFOJT QSPUFJO ZBOH Fagositosis di Dalam Sel—Fungsi Lisosom
BLBO EJBCTPSCTJ 3FTFQUPS CJBTBOZB UFSLPOTFOUSBTJ EBMBN )BNQJS TFHFSB TFUFMBI WFTJLFM QJOPTJUPTJT BUBV GBHPTJUPTJT
DFLVOHBOLFDJMQBEBQFSNVLBBOMVBSNFNCSBOTFM ZBOHEJTFCVU NBTVL LF EBMBN TFM TBUV MJTPTPN BUBV MFCJI BLBO NFMFLBU
DFLVOHBO CFSTFMVCVOH DPBUFE QJUT
%BMBN NFNCSBO TFM EJ QBEB WFTJLFM UFSTFCVU EBO NFMFQBTLBO IJESPMBTF BTBN LF
CBXBI DFLVOHBO UFSTFCVU UFSEBQBU TVBUV KBMBKBMB QSPUFJO TFSBU EBMBNOZB TFQFSUJ ZBOH EJUVOKVLLBO EBMBN (BNCBS
UNIT I
IBMVT ZBOH EJTFCVU LMBUSJO EBO QSPUFJO MBJO ZBOH NVOHLJO +BEJ TFCVBI WFTJLFM QFODFSOBBO UFSCFOUVL EBMBN TJUPQMBTNB
NFODBLVQ GJMBNFO LPOUSBLUJM BLUJO EBO NJPTJO 4FHFSB TFUFMBI TFM EJ NBOB IJESPMBTF NVMBJ NFOHIJESPMJTJT QSPUFJO
NPMFLVM QSPUFJO CFSJLBUBO EFOHBO SFTFQUPS TJGBU QFSNVLBBO LBSCPIJESBU MJQJE EBO [BU MBJOOZB EBMBN WFTJLFM )BTJM
NFNCSBO UFNQBU SFTFQUPS CFSVCBI TFEFNJLJBO SVQB TFIJOHHB QFODFSOBBO CFSVQB NPMFLVM LFDJM BTBN BNJOP HMVLPTB
TFMVSVI CBHJBO DFLVOHBO CFSJOWBHJOBTJ LF EBMBN EBO QSPUFJO GPTGBU EBO MBJOMBJO ZBOH EBQBU CFSEJGVTJ NFMBMVJ NFNCSBO
TFSBU IBMVT EJ TFLJUBS DFLVOHBO ZBOH CFSJOWBHJOBTJ JUV BLBO WFTJLFM LF EBMBN TJUPQMBTNB "QB ZBOH UFSTJTB EBSJ WFTJLFM
NFOZFCBCLBO UFQJUFQJ DFLVOHBO TBMJOH CFSUFNV EBO QFODFSOBBO EJTFCVUCBEBOSFTJEV NFSVQBLBO[BUZBOHUJEBL
NFOZFMVCVOHJ QSPUFJO ZBOH NFMFLBU EBO TFKVNMBI LFDJM DBJSBO EBQBUUFSDFSOB1BEBTFCBHJBOCFTBSLFBEBBO CBEBOSFTJEVJOJ
FLTUSBTFMVMBS 4FHFSB TFUFMBI JUV CBHJBO ZBOH CFSJOWBHJOBTJ EBSJ BLIJSOZB EJFLTLSFTJ NFOFNCVT NFNCSBO TFM NFMBMVJ QSPTFT
NFNCSBONFNJTBILBOEJSJEBSJQFSNVLBBOTFM EBONFNCFOUVL ZBOH EJTFCVU FLTPTJUPTJT ZBOH QBEB EBTBSOZB NFSVQBLBO
TFCVBIWFTJLFMQJOPTJUPT EBMBNTJUPQMBTNBTFM LFCBMJLBOEBSJFOEPTJUPTJT
)BM ZBOH NFOZFCBCLBO NFNCSBO TFM NFOHBMBNJ QFSVCBIBO +BEJ WFTJLFM QJOPTJUPTJT EBO GBHPTJUPTJT ZBOH NFOHBO
ZBOH EJQFSMVLBO VOUVL NFNCFOUVL WFTJLFM QJOPTJUPTJT NBTJI EVOHMJTPTPNEBQBUEJTFCVUTFCBHBJPSHBOQFODFSOBBOTFM
CFMVNKFMBT1SPTFTUFSTFCVUNFNCVUVILBOFOFSHJEBSJEBMBNTFM
FOFSHJJOJEJTVQMBJPMFI"51 TVBUV[BUCFSFOFSHJUJOHHJZBOHBLBO +BSJOHBO UVCVI
EJCBIBT LFNVEJBO EBMBN CBC JOJ 1SPTFT JOJ KVHB NFNCVUVILBO TFSJOH CFSFHSFTJ NFOKBEJ VLVSBO ZBOH MFCJI LFDJM .JTBMOZB
UFSTFEJBOZB JPO LBMTJVN EBMBN DBJSBO FLTUSBTFMVMBS ZBOH EJEVHB SFHSFTJ ZBOH UFSKBEJ QBEB VUFSVT TFUFMBI LFIBNJMBO PUPU ZBOH
CFSFBLTJ EFOHBO GJMBNFO QSPUFJO LPOUSBLUJM ZBOH UFSEBQBU EJ UBL UFSQBLBJ EBMBN XBLUV MBNB EBO LFMFOKBS QBZVEBSB QBEB
CBXBI DFLVOHBO CFSTFMVCVOH BLBO NFOHIBTJMLBO HBZB VOUVL BLIJS NBTB MBLUBTJ -JTPTPN CFSUBOHHVOH KBXBC QBEB SFHSFTJ
NFOKFQJUWFTJLFMNFOKBVIJNFNCSBOTFM UFSTFCVU .FLBOJTNF QFOJOHLBUBO BLUJWJUBT MJTPTPN ZBOH
EJTFCBCLBOLVSBOHOZBBLUJWJUBTEJTVBUVKBSJOHBO NBTJICFMVN
'BHPTJUPTJT CFSMBOHTVOH EFOHBO DBSB ZBOH EJLFUBIVJ
IBNQJS TBNB EFOHBO QJOPTJUPTJT LFDVBMJ CBIXB GBHPTJUPTJT 1FSBOLIVTVTMBJOEBSJMJTPTPNBEBMBIQFNCVBOHBOTFMZBOH
NFMJCBULBOQBSUJLFMCFSVLVSBOCFTBSEBOCVLBONPMFLVM)BOZB SVTBL BUBV CBHJBO TFM ZBOH SVTBL EBSJ KBSJOHBO ,FSVTBLBO TFM
TFM UFSUFOUV ZBOH NFNJMJLJ LFNBNQVBO GBHPTJUPTJT ZBOH QBMJOH ZBOH EJTFCBCLBO QBOBT EJOHJO USBVNB CBIBO LJNJB BUBV
EJLFOBMBEBMBINBLSPGBHKBSJOHBOEBOCFCFSBQBTFMEBSBIQVUJI GBLUPSGBLUPSMBJONFOZFCBCLBOMJTPTPNQFDBI)JESPMBTFZBOH
'BHPTJUPTJT EJNVMBJ LFUJLB TVBUV QBSUJLFM TFQFSUJ CBLUFSJ TFM EJMFQBTLBO TFHFSB NFNVMBJ QSPTFT QFODFSOBBO [BU PSHBOJL EJ
NBUJ BUBV EFCSJT KBSJOHBO CFSJLBUBO EFOHBO SFTFQUPS QBEB TFLJUBSOZB #JMB LFSVTBLBO TFM SJOHBO IBOZB TFCBHJBO EBSJ
QFSNVLBBO TFM GBHPTJU #JMB QBSUJLFMOZB CBLUFSJ TFUJBQ CBLUFSJ TFCVBI TFM VUVI ZBOH BLBO EJDFSOB EBO TFM LFNVEJBO
CJBTBOZB TVEBI UFSJLBU EFOHBO BOUJCPEJ ZBOH TQFTJGJL EBO EJQFSCBJLJ #JMB LFSVTBLBO ZBOH UFSKBEJ CFSBU TFMVSVI TFM BLBO
BOUJCPEJJOJMBIZBOHNFMFLBUQBEBSFTFQUPSGBHPTJU EBONFNCBXB EJDFSOB QSPTFTZBOHEJTFCVUBVUPMJTJT%FOHBODBSBJOJTFMEJ
CBLUFSJ CFSTBNB EFOHBO TFM GBHPTJU 6QBZB QFSBOUBSBBO ZBOH
EJMBLVLBO BOUJCPEJ JOJ EJTFCVU PQTPOJTBTJ ZBOH BLBO EJCBIBT EJ
#BCEBO#BC
'BHPTJUPTJTUFSKBEJEFOHBOMBOHLBIMBOHLBITFCBHBJCFSJLVU
isosom
1. 3FTFQUPSNFNCSBOTFMNFMFLBUQBEBQFSNVLBBOMJHBOQBSUJLFM
2. 5FQJ NFNCSBO EJ TFLJUBS UFNQBU QFSMFLBUBO NFOHBMBNJ
FWBHJOBTJ LF MVBS EBMBN XBLUV TFQFSTFLJBO EFUJL VOUVL
NFOZFMVCVOHJ TFMVSVI QBSUJLFM LFNVEJBO TFDBSB CFSUBIBQ esikel inosi osis
MFCJI CBOZBL MBHJ SFTFQUPS NFNCSBO ZBOH NFMFLBU QBEB MJHBO a a agosi osis
QBSUJLFM 4FNVB QSPTFT JOJ UFSKBEJ UJCBUJCB EFOHBO DBSB ZBOH
NJSJQ SJUTMFUJOH VOUVL NFNCFOUVL TFCVBI WFTJLFM GBHPTJUPTJT esikel en e naan
ZBOHUFSUVUVQ
3. "LUJOEBOGJCSJMLPOUSBLUJMMBJOEBMBNTJUPQMBTNBNFOHFMJMJOHJ
WFTJLFM GBHPTJUJL EBO CFSLPOUSBLTJ EJ TFLJUBS UFQJ MVBS WFTJLFM adan esid
NFOEPSPOHWFTJLFMLFCBHJBOEBMBNTFM
4. 1SPUFJO LPOUSBLUJM LFNVEJBO BLBO NFOKFQJU CBHJBO CBUBOH
WFTJLFM TBNQBJ CFOBSCFOBS UFSMFQBT EBSJ NFNCSBO TFM EBO ksk esi
NFOEPSPOHOZB LF CBHJBO EBMBN TFM EFOHBO DBSB ZBOH TBNB en e naan a dalam esikel inosi osis a a
TFQFSUJQFNCFOUVLBOWFTJLFMQJOPTJUPTJT agosi osis ole en im ang e asal da i lisosom
19
QSPTFT ZBOH EJTFCVU BVUPMJTJT %FOHBO DBSB JOJ TFM EJCVBOH 1. 3FUJLVMVN FOEPQMBTNB NFOZFEJBLBO FO[JNFO[JN ZBOH
TFMVSVIOZB EBOTFCVBITFMEBSJKFOJTZBOHTBNBCJBTBOZBBLBO NFOHBUVS QFNFDBIBO HMJLPHFO QBEB TBBU HMJLPHFO BLBO
EJCFOUVL NFMBMVJ QSPTFT SFQSPEVLTJ NJUPTJT EBSJ TFM ZBOH EJHVOBLBOTFCBHBJTVNCFSFOFSHJ
CFSEFLBUBOVOUVLNFOHHBOUJLBOTFMMBNBUFSTFCVU 2. 3FUJLVMVN FOEPQMBTNB NFOZFEJBLBO TFKVNMBI CFTBS FO[JN
-JTPTPN KVHB NFOHBOEVOH [BU CBLUFSJTJE ZBOH EBQBU ZBOH NBNQV NFOEFUPLTJGJLBTJ CFSCBHBJ [BU NJTBMOZB PCBU
NFNCVOVI CBLUFSJ ZBOH TVEBI EJGBHPTJU TFCFMVN CBLUFSJ PCBUBO ZBOH EBQBU NFSVTBL TFM %FUPLTJGJLBTJ JOJ EJMBLVLBO
UFSTFCVU NFOJNCVMLBO LFSVTBLBO TFM ;BU JOJ NFODBLVQ
EFOHBO DBSB LPBHVMBTJ PLTJEBTJ IJESPMJTJT LPOKVHBTJ EFOHBO
MJTP[JNZBOHNFMBSVULBONFNCSBOTFMCBLUFSJ
MJTPGFSJOZBOH BTBNHMVLVSPOBU EBOEFOHBODBSBDBSBMBJO
NFOHJLBU CFTJ EBO [BU MBJO TFCFMVN [BU UFSTFCVU NFSBOHTBOH
QFSUVNCVIBOCBLUFSJEBO
BTBNEFOHBOQ)TFLJUBS ZBOH Fungsi Spesifik Badan Golgi
EBQBU NFOHBLUJGLBO IJESPMBTF EBO NFOHJOBLUJGLBO TJTUFN
Fungsi Sintesis Badan Golgi. 8BMBVQVO GVOHTJ VUBNB
NFUBCPMJTNFCBLUFSJ
CBEBO (PMHJ BEBMBI NFOZFEJBLBO QFNSPTFTBO UBNCBIBO [BU[BU
ZBOH UFMBI EJCFOUVL EJ SFUJLVMVN FOEPQMBTNB CBEBO (PMHJ KVHB
Sintesis dan Pembentukan Struktur Sel oleh NFNJMJLJLFNBNQVBONFOZJOUFTJTKFOJTLBSCPIJESBUUFSUFOUVZBOH
Retikulum Endoplasma dan Badan Golgi UJEBL EBQBU EJCFOUVL EJ SFUJLVMVN FOEPQMBTNB )BM JOJ UFSKBEJ
Fungsi Spesifik Retikulum Endoplasma UFSVUBNB QBEB QFNCFOUVLBO QPMJNFS TBLBSJEB CFTBS ZBOH
-VBTOZB QFOZFCBSBO SFUJLVMVN FOEPQMBTNB EBO CBEBO (PMHJ CFSJLBUBO EFOHBO TFKVNMBI LFDJM QSPUFJO DPOUPI ZBOH QFOUJOH
EBMBN TFMTFM TFLSFUPSJ UFMBI EJUFLBOLBO 4USVLUVSTUSVLUVS BEBMBIBTBNIJBMVSPOBUEBOLPOESPJUJOTVMGBU
UFSTFCVU EJCFOUVL UFSVUBNB PMFI NFNCSBO MJQJE HBOEB ZBOH 4FCBHJBO EBSJ CBOZBL GVOHTJ BTBN IJBMVSPOBU EBO LPOESPJUJO
NJSJQ EFOHBO NFNCSBO TFM EBO EJOEJOHOZB UFSJTJ EFOHBO TVMGBU ZBOH UFSEBQBU EBMBN UVCVI BEBMBI TFCBHBJ CFSJLVU

FO[JN QSPUFJO ZBOH NFOHBUBMJTBTJ TJOUFTJT CBOZBL [BU ZBOH LFEVBOZB NFSVQBLBO LPNQPOFO VUBNB QSPUFPHMJLBO ZBOH
EJQFSMVLBOTFM EJTFLSFTJLFEBMBNNVLVTEBOTFLSFTJLFMFOKBSMBJO
LFEVBOZB
4FCBHJBO CFTBS TJOUFTJT CFSBXBM EJ SFUJLVMVN FOEPQMBTNB NFSVQBLBO LPNQPOFO VUBNB EBSJ TVCTUBOTJ EBTBS HSPVOE
1SPEVL ZBOH EJIBTJMLBO TFMBOKVUOZB BLBO EJCBXB LF CBEBO TVCTUBODF
EJ MVBS TFM EBMBN SVBOH JOUFSTUJTJBM ZBOH CFSUJOEBL
(PMHJVOUVLEJQSPTFTMFCJIMBOKVUTFCFMVNEJMFQBTLBOLFEBMBN TFCBHBJ [BU QFOHJTJ BOUBSB TFSBCVUTFSBCVU LPMBHFO EBO TFM

TJUPQMBTNB 5FUBQJ QFSUBNBUBNB NBSJMBI LJUB QFSIBUJLBO LFEVBOZB NFSVQBLBO LPNQPOFO VUBNB NBUSJLT PSHBOJL CBJL
QSPEVLQSPEVL TQFTJGJL ZBOH EJTJOUFTJT QBEB CBHJBO TQFTJGJL EBMBN UVMBOH SBXBO NBVQVO UVMBOH EBO
LFEVBOZB QFOUJOH
SFUJLVMVNFOEPQMBTNBEBOCBEBO(PMHJ EBMBNCBOZBLBLUJWJUBTTFMTFQFSUJNJHSBTJEBOQSPMJGFSBTJ
Protein Dibentuk oleh Retikulum Endoplosma Pengolahan Sekresi Retikulum Endoplasma oleh Badan
Bergranula. 3FUJLVMVN FOEPQMBTNB CFSHSBOVMB CFSDJSJLBO Golgi—Pembentukan Vesikel. (BNCBSNFSJOHLBTGVOHTJ
TFKVNMBI CFTBS SJCPTPN ZBOH NFMFLBU QBEB QFSNVLBBO MVBS VUBNB SFUJLVMVN FOEPQMBTNB EBO CBEBO (PMHJ 4BBU TVBUV [BU
NFNCSBOSFUJLVMVNFOEPQMBTNB4FQFSUJZBOHBLBOLJUBCBIBT UFSCFOUVL EJ EBMBN SFUJLVMVN FOEPQMBTNB LIVTVTOZB QSPUFJO
EJ #BC NPMFLVM QSPUFJO EJTJOUFTJT EBMBN TUSVLUVS SJCPTPN [BU UFSTFCVU EJBOHLVU NFMBMVJ UVCVMVT NFOVKV CBHJBO SFUJLVMVN
3JCPTPN NFOHFMVBSLBO TFCBHJBO NPMFLVM QSPUFJO ZBOH FOEPQMBTNB IBMVT ZBOH UFSMFUBL QBMJOH EFLBU EFOHBO CBEBO
EJEJOUFTJT MBOHTVOH LF EBMBN TJUPTPM UFUBQJ SJCPTPN KVHB (PMHJ4BBUJOJ WFTJLFMUSBOTQPSLFDJMZBOHUFSTVTVOBUBTTFCBHJBO
NFOHFMVBSLBO MFCJI CBOZBL MBHJ NPMFLVM QSPUFJO NFMFMVJ o masi o masi esikel
EJOEJOH SFUJLVMVN FOEPQMBTNB LF EBMBN WFTJLFM EBO UVCVMVT i osom o ein li id isosom sek e o i
FOEPQMBTNB ZBOHCFSBSUJLFEBMBNNBUSJLTFOEPQMBTNB
Sintesis Lipid oleh Retikulum Endoplasma Halus.

3FUJLVMVN FOEPQMBTNB KVHB NFOZJOUFTJT MJQJE UFSVUBNB
GPTGPMJQJE EBO LPMFTUFSPM ,FEVB MJQJE UFSTFCVU EFOHBO TFHFSB
EJKBEJLBOCBHJBOEBSJMBQJTBOMJQJEHBOEBSFUJLVMVNFOEPQMBTNB
JUV TFOEJSJ TFIJOHHB NFOZFCBCLBO SFUJLVMVN FOEPQMBTNB
UVNCVINFOKBEJMFCJICFTBS,FBEBBOJOJUFSKBEJUFSVUBNBQBEB
CBHJBOIBMVTSFUJLVMVNFOEPQMBTNB
6OUVLNFODFHBISFUJLVMVNFOEPQMBTNBBHBSUJEBLUVNCVI
NFMFCJIJ LFCVUVIBO TFM WFTJLFMWFTJLFM LFDJM ZBOH EJTFCVU
WFTJLFM 3& BUBV WFTJLFM USBOTQPS TFDBSB UFSVTNFOFSVT
NFNJTBILBO EJSJ EBSJ SFUJLVMVN FOEPQMBTNB IBMVT TFCBHJBO esikel
likosilasi ans o
CFTBS WFTJLFM UFSTFCVU TFMBOKVUOZB CFSNJHSBTJ EFOHBO DFQBU LF
CBEBO(PMHJ e ik l m e ik l m adan
endolasma endo lasma olgi
'VOHTJ-BJO3FUJLVMVN&OEPQMBTNB.'VOHTJMBJOZBOH kasa al s
QFOUJOH EBSJ SFUJLVMVN FOEPQMBTNB UFSVUBNB SFUJLVMVN
FOEPQMBTNBIBMVT BEBMBITFCBHBJCFSJLVU am a em en kan o ein li id dan esikel sel ole
e ik l m endo lasma dan adan olgi
20
LFDJM NFNCSBO SFUJLVMVN FOEPQMBTNB IBMVT TFDBSB UFSVT Ekstraksi Energi dari Zat Gizi Fungsi Mitokondria
NFOFSVT NFMFQBTLBO EJSJ EBO CFSEJGVTJ LF MBQJTBO UFSEBMBN ;BUVUBNBZBOHEJFLTUSBLTJPMFITFMVOUVLNFOHIBTJMLBOFOFSHJ
CBEBO (PMHJ 7FTJLFM JOJ NFOHBOEVOH QSPUFJO ZBOH EJTJOUFTJT BEBMBI NBLBOBO ZBOH EBQBU CFSFBLTJ EFOHBO PLTJHFO
EBOQSPEVLQSPEVLMBJOEBSJSFUJLVMVNFOEPQMBTNB LBSCPIJESBU MFNBL EBO QSPUFJO %BMBN UVCVI NBOVTJB QBEB
7FTJLFM USBOTQPS TFHFSB CFSTBUV EFOHBO CBEBO (PMHJ EBO EBTBSOZB TFNVB LBSCPIJESBU EJVCBI NFOKBEJ HMVLPTB PMFI
NFOHPTPOHLBOCBIBOZBOHUFSLBOEVOHEJEBMBNOZBLFEBMBN TBMVSBO QFODFSOBBO EBO ,BUJ TFCFMVN NFODBQBJ TFMTFM MBJO
UNIT I
SVBOH CFSWFTJLFM EJ CBEBO (PMHJ %J TJOJ HVHVT LBSCPIJESBU %FOHBO DBSB TFSVQB QSPUFJO EJVCBI NFOKBEJ BTBN BNJOP EBO
UBNCBIBO EJNBTVLLBO LF EBMBN TFLSFTJ 'VOHTJ CBEBO (PMHJ MFNBLEJVCBINFOKBEJBTBNMFNBL(BNCBSNFOVOKVLLBO
MBJO ZBOH QFOUJOH BEBMBI NFNBEBULBO TFLSFTJ SFUJLVMVN PLTJHFO EBO NBLBOBO HMVLPTB BTBN MFNBL EBO BTBN BNJOP
FOEPQMBTNB NFOKBEJ LFNBTBO CFSLPOTFOUSBTJ UJOHHJ ,FUJLB TFNVB NFNBTVLJ TFM %J EBMBN TFM NBLBOBO UFSTFCVU CFSFBLTJ
TFLSFTJ UFSTFCVU NFMFXBUJ MBQJTBO UFSMVBS CBEBO (PMHJ QSPTFT TFDBSBLJNJBXJEFOHBOPLTJHFOEJCBXBIQFOHBSVIFO[JNZBOH
QFNBEBUBO EBO QFOHPMBIBO CFSMBOKVU "LIJSOZB CBJL WFTJLFM NFOHBUVS SFBLTJ UFSTFCVU EBO NFOZBMVSLBO FOFSHJ ZBOH
LFDJM NBVQVO WFTJLFM CFTBS NFMFQBTLBO EJSJ TFDBSB UFSVT EJMFQBTLBO LF BSBI ZBOH UFQBU 1FOKFMBTBO MFOHLBQ NFOHFOBJ
NFOFSVT EBSJ CBEBO (PMHJ NFNCBXB TFSUB [BU TFLSFTJ ZBOH TFNVB GVOHTJ QFODFSOBBO EBO NFUBCPMJTNF JOJ BLBO EJCBIBT EJ
TVEBI EJQBEBULBO EBO TFMBOKVUOZB WFTJLFM UFSTFCVU BLBO #BCTBNQBJ#BC
CFSEJGVTJLFTFMVSVICBHJBOTFM 4FDBSB TJOHLBU IBNQJS TFNVB SFBLTJ PLTJEBTJ JOJ UFSKBEJ
6OUVL NFNCFSJLBO HBNCBSBO NFOHFOBJ MBNBOZB XBLUV EBMBN NJUPLPOESJB EBO FOFSHJ ZBOH EJMFQBTLBO EJHVOBLBO
QFOHPMBIBO JOJ 4BBU TFCVBI TFM LFMFOKBS EJSFOEBN EBMBN BTBN VOUVLNFNCFOUVLTFOZBXBCFSFOFSHJUJOHHJ"514FMBOKVUOZB
BNJOPSBEJPBLUJG NPMFLVMQSPUFJOSBEJPBLUJGZBOHCBSVUFSCFOUVL "51 CVLBO NBLBOBO EBMBN CFOUVL BTMJOZB ZBOH BLBO
EBQBUEJEFUFLTJEJSFUJLVMVNFOEPQMBTNBCFSHSBOVMBEBMBNXBLUV EJHVOBLBO EJ TFMVSVI CBHJBO TFM VOUVL NFOKBMBOLBO IBNQJS
TBNQBJ NFOJU %BMBN XBLUV NFOJU QSPUFJO ZBOH CBSV TFNVBSFBLTJNFUBCPMJTNFJOUSBTFMVMBS
UFSCFOUVL TVEBI EJUFNVLBO EJ CBEBO (PMHJ EBO EBMBN XBLUV
TBNQBJKBN QSPUFJOSBEJPBLUJGEJTFLSFTJLBOEBSJQFSNVLBBOTFM Ciri Fungsional ATP
Jenis Vesikel yang Dibentuk oleh Badan Golgi-Vesikel NH2

Sekretori dan Lisosom. %BMBN TFCVBI TFM ZBOH TBOHBU
N C
TFLSFUPSJ WFTJLFM ZBOH EJCFOUVL PMFI CBEBO (PMHJ UFSVUBNB C N
denin
BEBMBIWFTJLFMTFLSFUPSJZBOHNFOHBOEVOH[BUQSPUFJOZBOHBLBO HC
EJTFLSFTJ NFMBMVJ QFSNVLBBO NFNCSBO TFM 7FTJLFMWFTJLFM C CH
N N O O O
TFLSFUPSJ JOJ QFSUBNBUBNB BLBO CFSEJGVTJ LF NFNCSBO TFM
LFNVEJBO CFSTBUV EFOHBO NFNCSBO EBO NFOHPTPOHLBO JTJOZB O CH2 O P O~ P O~P O-
LF CBHJBO MVBS TFM NFMBMVJ NFLBOJTNF ZBOH EJTFCVU FLTPTJUPTJT C H H C O- O- O-
1BEB TFCBHJBO CFTBS LFBEBBO FLTPTJUPTJT EJSBOHTBOH PMFI os a
NBTVLOZB JPO LBMTJVN LF EBMBN TFM JPO LBMTJVN CFSJOUFSBLTJ H C C H
EFOHBO NFNCSBO WFTJLFM EFOHBO DBSB ZBOH NBTJI CFMVN OH OH
EJQBIBNJEBONFOZFCBCLBOQFOZBUVBONFNCSBOWFTJLFMEFOHBO i osa
NFNCSBO TFM ZBOH EJJLVUJ EFOHBO FLTPTJUPTJTZBJUV QFNCVLBBO
denosin i os a
QFSNVLBBO MVBS NFNCSBO TFM EBO QFOHFMVBSBO [BU[BU ZBOH
UFSLBOEVOHEBMBNWFTJLFMLFMVBSTFM
.FTLJQVO EFNJLJBO CFCFSBQB WFTJLFM EJUVKVLBO VOUVL
QFOHHVOBBOJOUSBTFMVMBS "51BEBMBITVBUVOVLMFPUJEBZBOHUFSEJSJBUBT
CBTBOJUSPHFO
BEFOJO
HVMB QFOUPTB SJCPTB EBO
UJHB SBEJLBM GPTGBU
Penggunaan Vesikel Intraselular untuk Menambah ,FEVBSBEJLBMGPTGBUUFSBLIJSEJIVCVOHLBOEFOHBOCBHJBOMBJO
NPMFLVMPMFIJLBUBOZBOHEJTFCVUTFCBHBJJLBUBOGPTGBUCFSFOFSHJ
Kembali Membran Sel. #FCFSBQB WFTJLFM JOUSBTFMVMBS ZBOH
UJOHHJ ZBOH EJUVOKVLLBO EBMBN TUSVLUVS LJNJB EFOHBO
EJCFOUVL PMFI CBEBO (PMHJ CFSTBUV EFOHBO NFNCSBO TFM BUBV
NFOHHVOBLBO UBOEB 1BEB LPOEJTJ GJTJL EBO LJNJBXJ UVCVI
EFOHBO NFNCSBO TUSVLUVS JOUSBTFMVMBS TFQFSUJ NJUPLPOESJB EBO
TFUJBQ JLBUBO CFSFOFSHJ UJOHHJ JOJ NFOHBOEVOH FOFSHJ TFLJUBS
CBILBOSFUJLVMVNFOEPQMBTNB)BMUFSTFCVUBLBONFOJOHLBULBO
LBMPSJ QFS NPM "51 ZBOH KBVI MFCJI CFTBS EBSJQBEB
MVBT NFNCSBO TUSVLUVSTUSVLUVS UFSTFCVU EBO EFOHBO EFNJLJBO
BLBO NFOBNCBI LFNCBMJ NFNCSBO TFUFMBI NFNCSBO UFSTFCVU FOFSHJ ZBOH UFSTJNQBO EBMBN JLBUBO LJNJB QBEB VNVNOZB
EJQBLBJ .JTBMOZB NFNCSBO TFM BLBO LFIJMBOHBO TFCBHJBO CFTBS TFIJOHHB NFOJNCVMLBO JTUJMBI JLBUBO CFSFOFSHJ UJOHHJ -FCJI
LBOEVOHBOOZB TFUJBQ LBMJ NFNCFOUVL WFTJLFM GBHPTJUPTJT BUBV MBOKVU JLBUBO GPTGBU CFSFOFSHJ UJOHHJ CFSTJGBU TBOHBU MBCJM
QJOPTJUPTJT EBO NFNCSBO WFTJLFM CBEBO (PMHJ BLBO NFOBNCBI TFIJOHHBMBOHTVOHEBQBUEJQFDBILBQBOQVOFOFSHJEJCVUVILBO
LFNCBMJNFNCSBOTFMUFSTFCVUTFDBSBUFSVTNFOFSVT VOUVLNFODFUVTLBOSFBLTJJOUSBTFMVMBSZBOHMBJO
4FCBHBJ SJOHLBTBO TJTUFN NFNCSBO SFUJLVMVN FOEPQMBTNB 1BEB TBBU "51 NFNCFCBTLBO FOFSHJOZB TFCVBI SBEJLBM
EBOCBEBO(PMHJNFSVQBLBOTVBUVPSHBOCFSNFUBCPMJTNFUJOHHJ BTBNGPTGBUEJMFQBTLBOEBOBEFOPTJOEJGPTGBU "%1
UFSCFOUVL
ZBOHNBNQVNFNCFOUVLTUSVLUVSJOUSBTFMVMBSZBOHCBSVEBO[BU &OFSHJZBOHEJCFCBTLBOUFSTFCVUEJHVOBLBOVOUVLNFOKBMBOLBO
TFLSFUPSJZBOHBLBOEJLFMVBSLBOEBSJTFM CBOZBLGVOHTJMBJOTFM TFQFSUJTJOUFTJT[BUEBOLPOUSBLTJPUPU
21
"51 1SPTFT SFBLTJ UFSTFCVU TBOHBU SVNJU EBO NFNCVUVILBO

2ADP 2ATP
CBOUVBOCBOZBLFO[JNQSPUFJOZBOHNFSVQBLBOCBHJBOJOUFHSBM
l kosa Gl SBLSBL NFNCSBOPTB NJUPLPOESJB ZBOH NFOPOKPM LF EBMBN
36 ADP
sam lemak FA
NBUSJLTNJUPLPOESJB-BOHLBIQFSUBNBOZBBEBMBIQFNCVBOHBO
TFCVBI FMFLUSPO EBSJ BUPN IJESPHFO TFIJOHHB BUPN IJESPHFO
sam amino AA sam i a CFSVCBI NFOKBEJ JPO IJESPHFO 1SPTFT BLIJS BEBMBI
sam ase ose a
QFOHHBCVOHBOJPOIJESPHFOEFOHBOPLTJHFO ZBOHNFNCFOUVL
NPMFLVM BJS EBO QFMFQBTBO FOFSHJ EBMBN KVNMBI CFTBS LF
se i o
QSPUFJO HMPCVMVT CFSVLVSBO CFTBS ZBOH EJTFCVU "51 TJOUFUBTF
O2 O2 O2 ADP
ZBOHNFOPOKPMTFQFSUJUPNCPMEBSJNFNCSBOSBLNJUPLPOESJB
CO2 CO2 CO2 H2O ATP "LIJSOZB FO[JN "51 TJOUFUBTF NFOHHVOBLBO FOFSHJ EBSJ JPO
IJESPHFOVOUVLNFOHVCBI"%1NFOKBEJ"51"51ZBOHCBSV
UFSCFOUVL EJBOHLVU LFMVBS EBSJ NJUPLPOESJB LF TFMVSVI CBHJBO
H2O H2O 36 ATP TJUPQMBTNB TFM EBO OVLMFPQMBTNB UFNQBU FOFSHJ UFSTFCVU
i okond ia EJHVOBLBOVOUVLNFOKBMBOLBOCFSCBHBJGVOHTJTFM
,FTFMVSVIBOQSPTFTQFNCFOUVLBO"51JOJEJTFCVUNFLBOJTNF
em an sel i o lasma
LFNJPTNPUJL QFNCFOUVLBO "51 1FOKFMBTBO LJNJBXJ EBO GJTJLB
em en kan adenosin i os a dalam NFOHFOBJ NFLBOJTNF JOJ EJCBIBT EFUBJM EJ #BC EBO CBOZBL
sel men nj kkan a a se agian esa di en k dalam QFSJODJBOGVOHTJNFUBCPMJTNF"51EJEBMBNUVCVIEJCBIBTEJ#BC
mi okond ia adenosin di os a TBNQBJ#BC
6OUVL NFNCFOUVL LFNCBMJ "51 TFM ZBOH TVEBI UFSQBLBJ
FOFSHJZBOHEJIBTJMLBOEBO[BUHJ[JTFMBLBONFOZFCBCLBO"%1 Penggunaan ATP untuk Fungsi Sel. &OFSHJ EBSJ "51
EBO BTBN GPTGBU CFSHBCVOH LFNCBMJ VOUVL NFNCFOUVL "51 EJHVOBLBOVOUVLNFOKBMBOLBOUJHBLBUFHPSJVUBNBGVOHTJTFM

ZBOHCBSV EBOTFMVSVIQSPTFTUFSTFCVUUFSKBEJCFSVMBOHVMBOH USBOTQPS [BU NFMBMVJ CFSCBHBJ NFNCSBO EJ EBMBN TFM
TJOUFTJT
0MFITFCBCJUV "51EJTFCVUTFCBHBJBMBUUVLBSFOFSHJTFMLBSFOB TFOZBXB LJNJB EJ TFMVSVI CBHJBO TFM EBO
LFSKB NFLBOJL
,FUJHBLBUFHPSJGVOHTJ"51UFSTFCVUEJJMVTUSBTJLBOEBMBN(BNCBS
"51 EBQBU EJQBLBJ EBO EJCFOUVL LFNCBMJ CFSVMBOH LBMJ ZBOH

VOUVL NFNCFSJLBO FOFSHJ CBHJ LFQFSMVBO USBOTQPS
NFNJMJLJ TFMBOH XBLUV BOUBSB EVB QSPTFT QFNCFOUVLBO
OBUSJVN NFMBMVJ NFNCSBO TFM
VOUVL NFOJOHLBULBO TJOUFTJT
CFCFSBQBNFOJUTBKB
QSPUFJO PMFI SJCPTPN EBO
VOUVL NFNCFSJLBO FOFSHJ ZBOH
EJCVUVILBOTFMBNBLPOUSBLTJPUPU
Proses Kimiawi dalam Pembentukan ATP—Peran
Mitokondria. 4BBU NFNBTVLJ TFM HMVLPTB EJIBEBQLBO QBEB 4FMBJOVOUVLUSBOTQPSOBUSJVNPMFINFNCSBO FOFSHJEBSJ"51
FO[JN EBMBN TJUPQMBTNB ZBOH NFOHVCBI HMVLPTB NFOKBEJ KVHB EJCVUVILBO VOUVL USBOTQPS NFNCSBO JPO LBMJVN JPO
BTBN QJSVWBU TVBUV QSPTFT ZBOH EJTFCVU HMJLPMJTJT
4FKVNMBI LBMTJVN JPO NBHOFTJVN JPO GPTGBU JPO LMPSJEB JPO VSBU JPO
LFDJM "%1 EJVCBI NFOKBEJ "51 PMFI FOFSHJ ZBOH EJCFCBTLBO IJESPHFO EBOCBOZBLJPOMBJOTFSUBCFSCBHBJ[BUPSHBOJL
TFMBNBQSPTFTUFSTFCVU UFUBQJKVNMBI"51ZBOHEJIBTJMLBOJOJ
LVSBOHEBSJQFSTFOEBSJLFTFMVSVIBONFUBCPMJTNFFOFSHJTFM
i osom
4FLJUBS QFSTFO QFNCFOUVLBO "51 TFM EJCFOUVL EJ
NJUPLPOESJB "TBN QJSVWBU ZBOH EJIBTJMLBO EBSJ LBSCPIJESBU e ik l m
BTBN MFNBL EBSJ MJQJE EBO BTBN BNJOP EBSJ QSPUFJO QBEB endo lasma
BLIJSOZB EJVCBI NFOKBEJ TFOZBXB BTFUJM,P" EBMBN NBUSJLT
NJUPLPOESJB 4FOZBXB UFSTFCVU TFMBOKVUOZB EJMBSVULBO ZBOH
CFSUVKVBO VOUVL NFOEBQBULBO FOFSHJOZB
PMFI TFSBOHLBJBO
a a
FO[JNMBJOEBMBNNBUSJLTNJUPLPOESJB TFIJOHHBJLVUCFSQFSBO
EBMBN TVBUV SBOHLBJBO SFBLTJ LJNJB ZBOH EJTFCVU TJLMVT BTBN
TJUSBU BUBV TJLMVT ,SFCT 3FBLTJ LJNJB UFSTFCVU NFNFHBOH
QFSBOBO ZBOH TBOHBU QFOUJOH TFIJOHHB BLBO EJKFMBTLBO TFDBSB i oknd ia
EFUBJMEJ#BC ATP
%BMBN TJLMVT BTBN TJUSBU JOJ BTFUJM,P" EJQFDBI NFOKBEJ
LPNQPOFO QFOZVTVOOZB BUPN IJESPHFO EBO LBSCPO EJPLTJEB
,BSCPO EJPLTJEB CFSEJGVTJ LFMVBS EBSJ NJUPLPOESJB EBO
TFMBOKVUOZB LFMVBS EBSJ TFM EBO QBEB BLIJSOZB BLBO
EJFLTLSFTJLBOEBSJUVCVINFMBMVJQBSVQBSV
%J QJIBL MBJO BUPN IJESPHFO CFSTJGBU TBOHBU SFBLUJG EBO
BLBO TFHFSB CFSHBCVOH EFOHBO PLTJHFO ZBOH KVHB UFMBI
CFSEJGVTJ LF EBMBN NJUPLPOESJB ,FBEBBO JOJ NFMFQBTLBO eg naan adenosin i os a ang di en k
FOFSHJ EBMBN KVNMBI ZBOH TBOHBU CFTBS ZBOH EJHVOBLBO PMFI dalam mi okond ia n k men ediakan ene gi n k iga ngsi
NJUPLPOESJBVOUVLNFOHVCBITFKVNMBICFTBS"%1NFOKBEJ ama sel ans o mem an sin esis o ein dan kon aksi o o
adenosin di os a
22
5SBOTQPS NFNCSBO TBOHBUMBI QFOUJOH CBHJ GVOHTJ TFM TFIJOHHB e ge akan sel
CFCFSBQBTFMDPOUPIOZB TFMUVCVMVTHJOKBMNFOHHVOBLBOTFCBOZBL
QFSTFO "51 ZBOH EJCFOUVL IBOZB VOUVL GVOHTJ USBOTQPS ndosi osis
UFSTFCVU
4FMBJOTJOUFTJTQSPUFJO TFMKVHBNFNCVBUGPTGPMJQJE LPMFTUFSPM se do odi m
QVSJO QJSJNJEJO EBO TFKVNMBI CFTBS [BU MBJO 4JOUFTJT IBNQJS
UNIT I
TFNVB TFOZBXB LJNJB NFNCVUVILBO FOFSHJ .JTBMOZB TFCVBI
NPMFLVM QSPUFJO UVOHHBM EBQBU UFSTVTVO BUBT CFCFSBQB SJCV BTBN ksosi osis
BNJOP ZBOH NFMFLBU TBUV TBNB MBJO NFMBMVJ JLBUBO QFQUJEB
QFNCFOUVLBO NBTJOHNBTJOH JLBUBO QFQUJEB JOJ NFNCVUVILBO
FOFSHJZBOHCFSBTBMEBSJQFNFDBIBOFNQBUJLBUBOCFSFOFSHJUJOHHJ
KBEJ CFCFSBQB SJCV NPMFLVM "51 IBSVT NFMFQBTLBO FOFSHJOZB
a ingan seki a ka an ese o
VOUVL TFUJBQ NPMFLVM QSPUFJO ZBOH EJCFOUVL .FNBOH BEB
CFCFSBQBTFMZBOHNFOHHVOBLBOQFSTFOEBOTFNVB"51ZBOH e akan ame oid se a sel
EJCFOUVL EJ TFM UFSTFCVU IBOZB VOUVL NFOZJOUFTJT TFOZBXB LJNJB
ZBOH CBSV UFSVUBNB NPMFLVM QSPUFJO IBM JOJ LIVTVTOZB UFSKBEJ NFOPOKPM.FNCSBOEBSJCBHJBOVKVOHTFMUFSTFCVUTFDBSBUFSVT
TFMBNBGBTFQFSUVNCVIBOTFM NFOFSVT CFSHFSBL LF EFQBO EBO NFNCSBO EBSJ VKVOH TFM
,FHVOBBOVUBNB"51ZBOHUFSBLIJSBEBMBIVOUVLNFOZFEJBLBO TFCFMBI LJSJ TFDBSB UFSVTNFOFSVT NFOHJLVUJ CFSTBNBBO
FOFSHJ CBHJ TFMTFM ZBOH EJLIVTVTLBO VOUVL NFMBLVLBO LFSKB EFOHBOQFSHFSBLBOTFM
NFLBOJL ,JUB BLBO NFOHFUBIVJ EJ #BC CBIXB TFUJBQ LPOUSBLTJ
TFCVBITFSBCVUPUPUNFNCVUVILBOQFNBLBJBOTFKVNMBICFTBS"51 Mekanisme Gerakan Ameboid. (BNCBS
4FMTFM MBJO NFMBLVLBO LFSKB NFLBOJL EFOHBO DBSB ZBOH CFSCFEB NFOVOKVLLBO QSJOTJQ EBTBS HFSBLBO BNFCPJE 1BEB EBTBSOZB
CFEB LIVTVTOZB EFOHBO HFSBLBO TJMJB EBO BNFCPJE ZBOH BLBO HFSBLBO JOJ UJNCVM LBSFOB QFNCFOUVLBO UFSVTNFOFSVT
EJCBIBT LFNVEJBO EBMBN CBC JOJ 4VNCFS FOFSHJ VOUVL TFNVB NFNCSBO TFM ZBOH CBSV QBEB VKVOH UFSEFQBO QTFVEPQPEJVN
CFOUVLLFSKBNFLBOJLUFSTFCVUBEBMBI"51 EBO BCTPSCTJ NFNCSBO ZBOH UFSVTNFOFSVT EJ CBHJBO UFOHBI
4FCBHBJ SJOHLBTBO "51 TFMBMV UFSTFEJB VOUVL NFMFQBTLBO EBO CFMBLBOH TFM +VHB BEB EVB FGFL QFOUJOH MBJO ZBOH
FOFSHJOZB EFOHBO DFQBU EBO EBMBN KVNMBI ZBOH CFTBS EJ CBHJBO EJQFSMVLBO VOUVL UFSKBEJOZB HFSBLBO TFM LF EFQBO &GFL
TFMNBOBTBKBFOFSHJUFSTFCVUEJQFSMVLBO6OUVLEBQBUNFOHHBOUJ QFSUBNB BEBMBI QFSMFLBUBO QTFVEPQPEJVN LF KBSJOHBO
"51 ZBOH UFSQBLBJ PMFI TFM TFKVNMBI SFBLTJ LJNJB ZBOH CFSKBMBO TFLJUBSOZB TFIJOHHB TFM CFOBSCFOBS NFMFLBU QBEB QPTJTJ
MFCJIMBNCBUBLBONFNFDBILBSCPIJESBU MFNBL EBOQSPUFJOEBO UFSEFQBOOZB TFNFOUBSB TJTB CBEBO TFM UFSUBSJL LF EFQBO
BLBO NFOHHVOBLBO FOFSHJ ZBOH EJIBTJMLBO EBSJ SFBLTJ UFSTFCVU NFOVKVUFNQBUQFSMFLBUBO1FSMFLBUBOUFSTFCVUEJTFCBCLBOPMFI
VOUVLNFNCFOUVL"51ZBOHCBSV-FCJIEBSJQFSTFO"51JOJ QSPUFJOSFTFQUPSZBOHNFMBQJTJCBHJBOEBMBNWFTJLFMFLTPTJUPTJT
EJCFOUVL EBMBN NJUPLPOESJB ZBOH NFOZFCBCLBO NJUPLPOESJB 1BEB TBBU WFTJLFM NFOZBUV EFOHBO NFNCSBO QTFVEPQPEJVN
NFOEBQBUTFCVUBOTFCBHBJHVEBOHFOFSHJTFM WFTJLFM BLBO UFSCVLB TFIJOHHB JTJOZB EBQBU EJLFMVBSLBO EBO
SFTFQUPSLFNVEJBONFOPOKPMLFMVBSEBONFMFLBUEFOHBOMJHBO
Pergerakan Sel EJKBSJOHBOTFLJUBSOZB
1BEB VKVOH TFM ZBOH CFSMBXBOBO SFTFQUPS NFNJTBILBO EJSJ
+FOJTHFSBLBOTFMUFSQFOUJOHZBOHUFSKBEJEJUVCVIBEBMBIHFSBLBO EBSJ MJHBO EBO NFNCFOUVL WFTJLFM FOEPTJUPTJT ZBOH CBSV
ZBOH UFSKBEJ EJ PUPU SBOHLB PUPU KBOUVOH EBO PUPU QPMPT ZBOH ,FNVEJBO EJ EBMBN TFM WFTJLFM JOJ CFSKBMBO NFOVKV CBHJBO
NFODBLVQ IBNQJS QFSTFO EBSJ LFTFMVSVIBO NBTTB UVCVI VKVOHQTFVEPQPEJVNTFM EJNBOBWFTJLFMUFSTFCVUBLBOEJQBLBJ
'VOHTJ LIVTVT TFM PUPU UFSTFCVU EJCBIBT EJ #BC TBNQBJ #BC VOUVL NFNCFOUVL MBHJ NFNCSBO ZBOH CBSV CBHJ
%VB KFOJT HFSBLBO ZBOH MBJO HFSBLBO BNFCPJE EBO HFSBLBO TJMJB QTFVEPQPEJVN
UFSKBEJEJTFMMBJO &GFLQFOUJOHLFEVBEBSJHFSBLBOBNFCPJEBEBMBIQFOZFEJBBO
FOFSHJ ZBOH EJQFSMVLBO VOUVL NFOBSJL CBEBO TFM LF BSBI
Gerakan Ameboid QTFVEPQPEJVN #FCFSBQB QFOFMJUJBO NFOHBKVLBO QFOEBQBU EJ
(FSBLBO BNFCPJE BEBMBI HFSBLBO LFTFMVSVIBO TFM ZBOH EBMBN TJUPQMBTNB TFMVSVI TFM UFSEBQBU QSPUFJO BLUJO EBMBN
CFSIVCVOHBO EFOHBO MJOHLVOHBO TFLJUBSOZB TFQFSUJ HFSBLBO TFM KVNMBITFEBOHTBNQBJCFTBS4FKVNMBICFTBSBLUJOCFSBEBEBMBN
EBSBI QVUJI NFMBMVJ KBSJOHBO 4FCVUBO HFSBLBO BNFCPJE EJEBQBU CFOUVL NPMFLVM UVOHHBM ZBOH UJEBL NFNJMJLJ UFOBHB QFOHHFSBL
EBSJLFOZBUBBOCBIXBBNFCBCFSHFSBLEFOHBODBSBTFQFSUJJOJEBO UFUBQJ NPMFLVM BLUJO UFSTFCVU BLBO CFSQPMJNFSJTBTJ VOUVL
BNFCB NFSVQBLBO DPOUPI ZBOH TBOHBU CBJL VOUVL NFNQFMBKBSJ NFNCFOUVL TVBUV KBSJOHBO CFSGJMBNFO EBO KBSJOHBO UFSTFCVU
GFOPNFOBUFSTFCVU BLBOCFSLPOUSBLTJCJMBCFSHBCVOHEFOHBOTVBUVQSPUFJOQFOHJLBU
(FSBLBO BNFCPJE ZBOH VNVN EJBXBMJ EFOHBO QFOPOKPMBO BLUJO TFQFSUJ NJPTJO 4FMVSVI QSPTFT UFSTFCVU EJHFSBLLBO PMFI
TFCVBI QTFVEPQPEJVN EBSJ TBMBI TBUV VKVOH TFM 1TFVEPQPEJVN TFOZBXB CFSFOFSHJ UJOHHJ "51 ,FBEBBO JOJMBI ZBOH UFSKBEJ EJ
NFOKVMVSNFOKBVIJCBEBOTFM EBOTFEJLJUEFNJTFEJLJUCFSQJOEBI EBMBNQTFVEPQPEJVNTFCVBITFMZBOHCFSHFSBL EJNBOBKBSJOHBO
LF EBFSBI MBJO KBSJOHBO 4FMBOKVUOZB CBHJBO TFM ZBOH UFSTJTB GJMBNFO BLUJO UFSTFCVU UFSCFOUVL CFSVMBOH LBMJ EJ EBMBN
UFSUBSJL NFOVKV QTFVEPQPEJVN (BNCBS NFOVOKVLLBO QTFVEPQPEJVNZBOHNFNCFTBS,POUSBLTJKVHBUFSKBEJEJEBMBN
QSPTFT UFSTFCVU ZBOH NFNQFSMJIBULBO TFCVBI TFM ZBOH NFNBO FLUPQMBTNB CBEBO TFM EJ NBOB KBSJOHBO BLUJO TVEBI BEB
KBOH EFOHBOVKVOHLBOBOTFMTFCBHBJQTFVEPQPEJVNZBOHNF TFCFMVNOZBEJCBXBINFNCSBOTFM
23
Jenis Sel yang Memperlihatkan Gerakan Ameboid. 4FM

ZBOH QBMJOH VNVN NFNQFSMJIBULBO HFSBLBO BNFCPJE EBMBN j ng
UVCVINBOVTJBBEBMBITFMEBSBIQVUJITBBUTFMUFSTFCVUCFSHFSBL
LFMVBSEBSJEBSBIEBONBTVLLFEBMBNKBSJOHBOVOUVLNFOKBEJ
NBLSPGBH KBSJOHBO 4FM KFOJT MBJO KVHB EBQBU CFSHFSBL EFOHBO
HFSBLBO BNFCPJE QBEB LFBEBBO UFSUFOUV .JTBMOZB GJCSPCMBT
CFSHFSBL LF EBFSBI ZBOH SVTBL VOUVL NFNCBOUV NFNQFSCBJLJ em an
LFSVTBLBO UFSTFCVU EBO CBILBO TFM HFSNJOBUJWVN LVMJU QVO
ZBOH CJBTBOZB NFOFNQFM FSBU QBEB EBTBS LVMJU KVHB BLBO o ongan melin ang
j ng silia
CFSHFSBLLFEBFSBIZBOHMVLBVOUVLNFNQFSCBJLJMVLBUFSTFCVU
"LIJSOZB HFSBLBO TFM KVHB CFSQFSBO QFOUJOH TFMBNB
QFSLFNCBOHBO FNCSJP EBO GFUVT TFUFMBI UFSKBEJOZB QFNCVBIBO ilamen
PWVN .JTBMOZB TFMTFM FNCSJPOBM TFSJOH LBMJ IBSVT CFSNJHSBTJ
KBVI EBO UFNQBU BTBMOZB LF UFNQBU ZBOH CBSV TFMBNB QFSJPEF
QFSLFNCBOHBOTUSVLUVSTUSVLUVSUFSUFOUV
e akan ke de an
Pengaturan Gerakan Ameboid—Kemotaksis. 1FNJDV
UFSQFOUJOHHFSBLBOBNFCPJEBEBMBITVBUVQSPTFTZBOHEJTFCVU
TFCBHBJ LFNPUBLTJT ,FNPUBLTJT UFSKBEJ LBSFOB BEBOZB [BU
LJNJB UFSUFOUV EBMBN KBSJOHBO ;BU LJNJB ZBOH NFOZFCBCLBO adan silia
UFSKBEJOZB LFNPUBLTJT EJTFCVU [BU LFNPUBLTJT 4FCBHJBO
em an
CFTBS TFM ZBOH NFNQFSMJIBULBO HFSBLBO BNFCPJE CFSHFSBL sel
NFOVKV TVNCFS [BU LFNPUBLTJT ZBJUV EBSJ TVBUV EBFSBI ZBOH e akan ke elakang
LPOTFOUSBTJ [BU LFNPUBLTJTOZB MFCJI SFOEBI NFOVKV TVBUV asa
EBFSBI ZBOH MFCJI UJOHHJ LPOTFOUSBTJOZB ZBOH EJTFCVU
LFNPUBLTJT QPTJUJG #FCFSBQB TFM CFSHFSBL NFOKBVIJTVNCFS ka
[BULFNPUBLTJT ZBOHEJTFCVULFNPUBLTJTOFHBUJG
5FUBQJ CBHBJNBOB LFNPUBLTJT NFOHBUVS BSBI HFSBLBO
BNFCPJE 8BMBVQVO KBXBCBOOZB NBTJI CFMVN QBTUJ EJLFUBIVJ
CBIXB TJTJ TFM ZBOH QBMJOH UFSQBQBS PMFI [BU LFNPUBLTJT BLBO
NFOHBMBNJ QFSVCBIBO NFNCSBO ZBOH NFOZFCBCLBO k dan ngsi silia imodi ikasi dan ai
QFOPOKPMBOQTFVEPQPEJVN ilia i m Hak i a onald a e o o
ee eo nji aga a
Silia dan Gerakan Silia

4FUJBQ TJMJB NFSVQBLBO QFSUVNCVIBO LFMVBS EBSJ TVBUV TUSVLUVS
+FOJT HFSBLBO TFM ZBOH LFEVB BEBMBI HFSBLBO TJMJB ZBOH
ZBOH UFSMFUBL UFQBU EJ CBXBI NFNCSBO TFM ZBOH EJTFCVU CBEBO
NFSVQBLBO TVBUV HFSBLBO TFQFSUJ HFSBLBO DBNCVL QBEB
CBTBMTJMJB
QFSNVLBBOTFM(FSBLBOJOJUFSKBEJIBOZBEJEVBUFNQBUEBMBN
UVCVI NBOVTJB QBEB QFSNVLBBO TBMVSBO QFSOBQBTBO EBO QBEB 'MBHFMB TFCVBI TQFSNB NJSJQ EFOHBO TJMJB CBILBO GMBHFMB
QFSNVLBBO EBMBN UVCB VUFSJOB UVCB GBMMPQJ
EJ TBMVSBO TQFSNBNFNJMJLJKFOJTTUSVLUVSZBOHIBNQJSTBNBEBONFLBOJTNF
SFQSPEVLTJ 1BEB SPOHHB IJEVOH EBO TBMVSBO OBQBT CBHJBO LPOUSBLTJ ZBOH IBNQJS TBNB QVMB /BNVO GMBHFMB KBVI MFCJI
CBXBI HFSBLBO TJMJB ZBOH NJSJQ DBNCVL NFOZFCBCLBO MBQJTBO QBOKBOHEBOCFSHFSBLNFOZFSVQBJHFMPNCBOHTJOVTPJEEBOCVLBO
NVLVTCFSHFSBLEFOHBOLFDFQBUBOLJSBLJSBDNNFOJUOFOVKV HFSBLBODBNCVL
GBSJOH EBOEFOHBODBSBJOJNFNCFSTJILBOTBMVSBOOBQBTTFDBSB %BMBNTJTJQBO(BNCBS EJUVOKVLLBOHFSBLBOTJMJB4JMJBJOJ
UFSVTNFOFSVT EBSJ NVLVT EBO QBSUJLFM ZBOH UFSQFSBOHLBQ BLBOCFSHFSBLLFEFQBOEFOHBOHFSBLBOZBOHDFQBU NFOHIFOUBL
EBMBN NVLVT %BMBN UVCB VUFSJOB TJMJB NFOZFCBCLBO TFQFSUJ DBNCVL TFCBOZBL TBNQBJ LBMJEFUJL EBO NFOFLVL
QFSHFSBLBODBJSBOZBOHMBNCBUEBSJPTUJVNUVCBVUFSJOBNFOVKV EFOHBOUBKBNEJUFNQBUNFODVBUOZBTJMJBUFSTFCVUEBSJQFSNVLBBO
LBWVN VUFSJ QFSHFSBLBO DBJSBO UFSTFCVU NFOHIBOUBSLBO PWVN TFM4FMBOKVUOZBTJMJBBLBOCFSHFSBLLFCFMBLBOHEFOHBOMBNCBULF
EBSJPWBSJVNLFVUFSVT QPTJTJ BTBMOZB (FSBLBO NFOEPSPOH LF EFQBO ZBOH DFQBU TFQFSUJ
4FQFSUJ ZBOH EJUVOKVLLBO EBMBN (BNCBS TFCVBI TJMJB HFSBLBODBNCVLJUVNFOEPSPOHDBJSBOZBOHBEBEJQFSNVLBBOTFM
NFNJMJLJCFOUVLTFQFSUJSBNCVUMVSVTBUBVNFMFOHLVOHEFOHBO UFSTFCVULFBSBIZBOHTFTVBJEFOHBOBSBIHFSBLBOTJMJBTFEBOHLBO
VKVOH ZBOH SVODJOH ZBOH NFOPOKPM TFKBVI TBNQBJ HFSBLBO MBNCBU ZBOH NFOEPSPOH TJMJB LF BSBI CFMBLBOH IBNQJS
NJLSPNFUFS EBSJ QFSNVLBBO TFM #BOZBL TJMJB TFSJOH LBMJ UJEBL CFSQFOHBSVI UFSIBEBQ QFSHFSBLBO DBJSBO UFSTFCVU
NFOPOKPM EBSJ TBUV TFM NJTBMOZB UFSEBQBU TFCBOZBL TJMJB "LJCBUOZB DBJSBO BLBO TFDBSB UFSVTNFOFSVT EJEPSPOH TFBSBI
QBEB QFSNVLBBO TFUJBQ TFM FQJUFM EJ EBMBN TBMVSBO QFOBQBTBO EFOHBO HFSBLBO TJMJB ZBOH DFQBU EBO LF EFQBO UBEJ 0MFI LBSFOB
4JMJBJOJEJMBQJTJPMFITVBUVQFSUVNCVIBOLFMVBSEBSJNFNCSBO LFCBOZBLBO TFM CFSTJMJB JOJ NFNJMJLJ TBOHBU CBOZBL TJMJB QBEB
TFM EBO EJTBOHHB PMFI NJLSPUVCVMVT UVCVMVT HBOEB ZBOH QFSNVLBBOOZB EBOLBSFOBTFNVBTJMJBUFSTFCVUCFSPSJFOUBTJQBEB
UFSMFUBLEJCBHJBOQFSJGFSTJMJB EBOUVCVMVTUVOHHBMEJCBHJBO BSBIZBOHTBNB LFBEBBOUFSTFCVUNFOKBEJTVBUVDBSBZBOHFGFLUJG
FOHBITJMJB ZBOHEJUVOKVLLBOEBMBNQPUPOHBONFMJOUBOHEBMBN VOUVL NFOEPSPOH DBJSBO EBSJ TBUV CBHJBO QFSNVLBBO LF CBHJBO
(BNCBS ZBOHMBJO
24
Mekanisme Gerakan Silia. 8BMBVQVO CFMVN TFNVB BTQFL Chacinska A, Koehler CM, Milenkovic D, Lithgow T, Pfanner N: Importing
mitochondrial proteins: machineries and mechanisms, Cell 138:628,
HFSBLBOTJMJBEJLFUBIVJ LJUBNFOHFUBIVJIBMIBMCFSJLVU1FSUBNB
2009.
LFTFNCJMBO UVCVMVT HBOEB EBO EVB UVCVMVT UVOHHBM TFNVBOZB Cohen AW, Hnasko R, Schubert W, Lisanti MP: Role of caveolae and caveo-
CFSIVCVOHBO TBUV TBNB MBJO PMFI TVBUV LPNQMFLT JLBUBO TJMBOH lins in health and disease, Physiol Rev 84:1341, 2004.
QSPUFJO LFTFMVSVIBO LPNQMFLT UVCVMVT EBO JLBUBO TJMBOH JOJ Danial NN, Korsmeyer SJ: Cell death: critical control points, Cell 116:205,
EJTFCVUBLTPOFNB,FEVB TFLBMJQVONFNCSBOOZBTVEBIEJCVBOH 2004.
UNIT I
Dröge W: Free radicals in the physiological control of cell function, Physiol
EBOUFSKBEJLFSVTBLBOQBEBFMFNFOMBJOOZBLFDVBMJBLTPOFNB TJMJB
Rev 82:47, 2002.
NBTJI EBQBU NFOHIFOUBL EBMBN LPOEJTJ ZBOH TFTVBJ ,FUJHB BEB Edidin M: Lipids on the frontier: a century of cell-membrane bilayers, Nat
EVB LFBEBBO ZBOH EJQFSMVLBO VOUVL LFMBOKVUBO IFOUBLBO Rev Mol Cell Biol 4:414, 2003.
BLTPOFNBTFUFMBITUSVLUVSTJMJBZBOHMBJOEJBOHLBU
LFUFSTFEJBBO Ginger ML, Portman N, McKean PG: Swimming with protists: perception,
"51 EBO
LPOEJTJ JPOJTBTJ ZBOH TFTVBJ LIVTVTOZB LFTFTVBJBO motility and flagellum assembly, Nat Rev Microbiol 6:838, 2008. Grant BD,
Donaldson JG: Pathways and mechanisms of endocytic recycling,
LPOTFOUSBTJ NBHOFTJVN EBO LBMTJVN ,FFNQBU LFUJLB TJMJB
Nat Rev Mol Cell Biol 10:597, 2009.
CFSHFSBL NBKV UVCVMVT HBOEB QBEB UFQJ EFQBO TJMJB CFSHFTFS LF Güttinger S, Laurell E, Kutay U: Orchestrating nuclear envelope disassembly
MVBS NFOVKV VKVOH TJMJB TFNFOUBSB UVCVMVT ZBOH CFSBEB EJ UFQJ and reassembly during mitosis, Nat Rev Mol Cell Biol 10:178, 2009. Hamill OP,
CFMBLBOH UFUBQ QBEB UFNQBUOZB ,FMJNB MFOHBO QSPUFJO NVMUJQFM Martinac B: Molecular basis of mechanotransduction in living
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Hock MB, Kralli A: Transcriptional control of mitochondrial biogenesis and
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function, Annu Rev Physiol 71:177, 2009.
CFSEFLBUBO Liesa M, Palacín M, Zorzano A: Mitochondrial dynamics in mammalian
#FSEBTBSLBO JOGPSNBTJ EBTBS UFSTFCVU UFMBI EJLFUBIVJ CBIXB health and disease, Physiol Rev 89:799, 2009.
Mattaj IW: Sorting out the nuclear envelope from the endoplasmic reticu-
QFMFQBTBO FOFSHJ EBSJ "51 TFXBLUV CFSLPOUBL EFOHBO MFOHBO
lum, Nat Rev Mol Cell Biol 5:65, 2004.
EZOFJO "51BTF NFOZFCBCLBO CBHJBO VKVOH EBSJ MFOHBOMFOHBO Parton RG, Simons K: The multiple faces of caveolae, Nat Rev Mol Cell Biol
UFSTFCVU VOUVL NFSBOHLBL EFOHBO DFQBU EJ TFQBOKBOH 8:185, 2007.
QFSNVLBBOUVCVMVTHBOEBZBOHCFSEFLBUBO+JLBUVCVMVTQBEBUFQJ Raiborg C, Stenmark H: The ESCRT machinery in endosomal sorting of
EFQBO NFSBOHLBL LF BSBI MVBS TFNFOUBSB UVCVMVT UFQJ CFMBLBOH ubiquitylated membrane proteins, Nature 458:445, 2009.
Ridley AJ, Schwartz MA, Burridge K, et al: Cell migration: integrating signals
UFUBQUJEBLCFSHFSBL IBMJOJBLBONFOZFCBCLBOQFOFLVLBO
from front to back, Science 302:1704, 2003.
$BSB QFOHBUVSBO LPOUSBLTJ TJMJB NBTJI CFMVN EJQBIBNJ 4JMJB Saftig P, Klumperman J: Lysosome biogenesis and lysosomal membrane
QBEB CFCFSBQB TFM ZBOH NFOHBMBNJ LFMBJOBO TFDBSB HFOFUJL UJEBL proteins: trafficking meets function, Nat Rev Mol Cell Biol 10:623,
NFNJMJLJ EVB UVCVMVT UVOHHBM EJ UFOHBI EBO TJMJB TFNBDBN JOJ 2009.
Scarpulla RC: Transcriptional paradigms in mammalian mitochondrial bio-
UJEBL NBNQV NFOHIFOUBL 0MFI LBSFOB JUV NVODVM BOHHBQBO genesis and function, Physiol Rev 88:611, 2008.
CBIXB CFCFSBQB TJOZBM ZBOH NVOHLJO NFSVQBLBO TVBUV TJOZBM Stenmark H: Rab GTPases as coordinators of vesicle traffic, Nat Rev Mol
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UFSTFCVUVOUVLNFOHBLUJGLBOMFOHBOEZOFJO Traub LM: Tickets to ride: selecting cargo for clathrin-regulated internaliza-
tion, Nat Rev Mol Cell Biol 10:583, 2009.
Vereb G, Szollosi J, Matko J, et al: Dynamic, yet structured: the cell mem-
Daftar Pustaka brane three decades after the Singer-Nicolson model, Proc Natl Acad Sci U
Alberts B, Johnson A, Lewis J, et al: Molecular Biology of the Cell, 6th ed, S A 100:8053, 2003.
New York, 2007, Garland Science.
Bonifacino JS, Glick BS: The mechanisms of vesicle budding and fusion,
Cell 116:153, 2004.
25
BAB 3
UNIT I
1FOHBUVSBO(FOFUJL4JOUFTJT1SPUFJO
'VOHTJ4FM EBO3FQSPEVLTJ4FM
)BNQJS TFUJBQ PSBOH UBIV CBIXB HFO Blok Bangunan Dasar DNA. (BNCBS NFOVOKVLLBO
ZBOH UFSMFUBL EBMBN JOUJ TFMVSVI TFM TFOZBXBTFOZBXBLJNJBEBTBSZBOHNFNCFOUVL%/" ZBJUV

UVCVI NFOHBUVS TJGBUTJGBU LFUVSVOBO BTBN GPTGBU
TVBUV HVMB ZBOH EJTFCVU EFPLTJSJCPTB EBO

EBSJ PSBOH UVB LFQBEB BOBLOZB UFUBQJ FNQBU CBTB OJUSPHFO EVB QVSJO BEFOJO EBO HVBOJO TFSUB EVB
TFCBHJBO CFTBS PSBOH UJEBL NFOZBEBSJ QJSJNJEJO UJNJO EBO TJUPTJO
"TBN GPTGBU EBO EFPLTJSJCPTB
CBIXBHFOZBOHTBNBJOJKVHBNFOHBUVS NFNCFOUVL LFEVB VOUBJ IFMJLT ZBOH NFSVQBLBO LFSBOHLB
GVOHTJ LFTFIBSJBO TFMVSVI TFM UVCVI (FO NFOHBUVS GVOHTJ TFM NPMFLVM%/" EBOCBTBCBTBOJUSPHFOUFSMFUBLEJBOUBSBLFEVB
EFOHBODBSBNFOFOUVLBO[BUBQBZBOHBLBOEJTJOUFTJTEJEBMBNTFM VOUBJBO EBO NFOHIVCVOHLBO LFEVB VOUBJBO UFSTFCVU TFQFSUJ
TUSVLUVSBQB FO[JNBQB EBO[BULJNJBBQBZBOHBLBOEJTJOUFTJT EJJMVTUSBTJLBOQBEB(BNCBS
(BNCBS NFOVOKVLLBO TLFNB VNVN QFOHBUVSBO Nukleotida. 5BIBQ QFSUBNB QFNCFOUVLBO %/" BEBMBI
HFOFUJL4FUJBQHFOZBOHNFSVQBLBOTFCVBIBTBNOVLMFBUZBOH NFOHHBCVOHLBO TBUV NPMFLVM BTBN GPTGBU TBUV NPMFLVM
EJTFCVU BTBN EFPLTJSJCPOVLMFBU %/"
TFDBSB PUPNBUJT EFPLTJSJCPTB EBO TBUV EBSJ LFFNQBU CBTB VOUVL NFNCFOUVL
NFOHBUVS QFNCFOUVLBO BTBN OVLMFBU MBJO ZBJUV BTBN SJCP TBUV BTBN OVLMFPUJEB +BEJ BLBO EJCFOUVL FNQBU OVLMFPUJEB
OVLMFBU 3/"
3/" JOJ LFNVEJBO NFOZFCBS LF TFMVSVI TFM ZBOH UFSQJTBI NBTJOHNBTJOH TBUV VOUVL LFFNQBU CBTB BTBN
VOUVL NFOHBUVS QFNCFOUVLBO TVBUV QSPUFJO TQFTJGJL 4FMVSVI EFPLTJBEFOJMBU EFPLTJUJNJEJMBU EFPLTJHVBOJMBU EBO
QSPTFT JOJ EBSJ USBOTLSJQTJ LPEF HFOFUJL EJ EBMBN OVLMFVT EFPLTJTJUJEJMBU (BNCBS NFOVOKVLLBO TUSVLUVS LJNJB EBSJ
IJOHHBUSBOTMBTJLPEF3/"EBOQFNCFOUVLBOQSPUFJOEJEBMBN BTBNEFPLTJBEFOJMBU
TJUPQMBTNBTFM TFSJOHEJTFCVUFLTQSFTJHFO
,BSFOBUFSEBQBUTFLJUBSHFOEJTFUJBQTFM TFDBSBUFPSFUJT
TFKVNMBICFTBSQSPUFJOTFMZBOHCFSCFEBEBQBUEJCFOUVL
#FCFSBQB QSPUFJO TFM UFSTFCVU BEBMBI QSPUFJO TUSVLUVSBM ZBOH
CFSTBNB EFOHBO CFSCBHBJ MJQJE EBO LBSCPIJESBU NFNCFOUVL
CFSCBHBJ TUSVLUVS PSHBOFM JOUSBTFMVMBS ZBOH UFMBI EJCBIBT QBEB
#BC /BNVO TFCBHJBO CFTBS QSPUFJO BEBMBI FO[JN ZBOH
NFOHBUBMJTBTJCFSCBHBJSFBLTJLJNJBEJEBMBNTFM4FCBHBJDPOUPI
FO[JN NFOJOHLBULBO TFNVB SFBLTJ PLTJEBUJG ZBOH NFOZFEJBLBO
FOFSHJ LF TFM EBO FO[JN NFOJOHLBULBO TJOUFTJT TFMVSVI CBIBO
LJNJBTFM TFQFSUJMJQJE HMJLPHFO EBOBEFOPTJOUSJGPTGBU "51

li i g
Gen-Gen dalam Inti Sel
%BMBN JOUJ TFM TFKVNMBI CFTBS HFO TBMJOH NFMFLBU EJ VKVOH
VKVOHOZB NFNCFOUVL IFMJLT VOUBJ HBOEB NPMFLVM %/" ZBOH
TBOHBU QBOKBOH EFOHBO CFSBU NPMFLVM NJMJBSBO 4FCVBI TFHNFO
ZBOH TBOHBU QFOEFL EBSJ NPMFLVM UFSTFCVU EJUVOKVLLBO QBEB
(BNCBS .PMFLVM JOJ UFSTVTVO BUBT CFCFSBQB TFOZBXB LJNJB
TFEFSIBOB ZBOH UFSJLBU CFSTBNB EFOHBO QPMB UFSBUVS ZBOH
EFUBJMOZBBLBOEJKFMBTLBOEBMBNCFCFSBQBQBSBHSBGCFSJLVUJOJ .
27
Unit I Pengantar Fisiologi Sel dan Umum
H H
N
N C
C N
H C
C C H
N N
O H H
O C H
H O P O C C
C H
O C
H
H O H
H
H
%/" UFSTVTVO EBSJ BTBN GPTGBU EBO NPMFLVM EFPLTJSJCPTB TFDBSB

CFSHBOUJBO ,FNVEJBO CBTB QVSJO EBO QJSJNJEJO NFMFLBU LF TJTJ
NPMFLVMEFPLTJSJCPTB-BMV EFOHBOJLBUBOIJESPHFOMPOHHBS HBSJT
EBO (BNCBS NFOVOKVLLBO TJNCPM TFEFSIBOB VOUVL QVUVTQVUVT
BOUBSB CBTB QVSJO EBO QJSJNJEJO LFEVB VOUBJ %/"
LFFNQBUOVLMFPUJEBZBOHNFNCFOUVL%/" UFSJLBUCFSTBNB5FUBQJQFSIBUJLBOIBMCFSJLVU
Penyusunan Nukleotida untuk Membentuk Dua Untai

5JBQ CBTB QVSJO BEFOJO EBSJ TBUV VOUBJ TFMBMV CFSJLBUBO
DNA yang Terikat secara Longgar Satu Sama Lain. EFOHBOCBTBQJSJNJEJOUJNJOEBSJVOUBJZBOHMBJO EBO
(BNCBS NFNQFSMJIBULBO DBSB TFKVNMBI OVLMFPUJEB UFSJLBU 5JBQ CBTB QVSJO HVBOJO TFMBMV CFSJLBUBO EFOHBO CBTB
VOUVLNFNCFOUVLEVBVOUBJ%/",FEVBVOUBJBO LFNVEJBO QJSJNJEJOTJUPTJO
CFSJLBUBOTFDBSBMPOHHBSTBUVTBNBMBJOPMFIJLBUBOTJMBOHZBOH
MFNBI TFQFSUJEJQFSMJIBULBOQBEB(BNCBSPMFIHBSJTQVUVT
QVUVTEJUFOHBI1FSIBUJLBOCBIXBLFSBOHLBEBSJTFUJBQVOUBJ
H O P O H
H
H
H H
O C O H
H O C C
C H
C
H
H
H
O
H
H H
N H O
N C N C H
C N
H C O C C C H
C C H
N N N C H
H H H
H
O
N H
N C N C
C N H
H C H O C C H
C C N
N N H N C
H H H
28
Bab 3 Pengaturan Genetik Sintesis Protein, Fungsi Sel, dan Repraduksi Sel
EBO NFNJMJOOZB NFOKBEJ TFCVBI IFMJLT 4FQVMVI QBTBOH

OVLMFPUJEB EBQBU UFSMJIBU QBEB TFUJBQ QVUBSBO QFOVI IFMJLT EJ
A T EBMBNNPMFLVM%/" TFQFSUJEJQFSMJIBULBOPMFI(BNCBS
P D P D
Kode Genetik
1FOUJOHOZB %/" UFSMFUBL QBEB LFNBNQVBOOZB VOUVL
UNIT I
NFOHFOEBMJLBO QFNCFOUVLBO QSPUFJO EJ EBMBN TFM %/"
NFMBLVLBOOZB EFOHBO DBSB LPEF HFOFUJL 4BBU LFEVB VOUBJ
NPMFLVM %/" EJQJTBILBO QFNJTBIBO JOJ BLBO NFOZFCBCLBO
G C CBTBCBTB QVSJO EBO QJSJNJEJO UFSQBKBO NFOPOKPM LF TJTJ UJBQ
VOUBJ%/" TFQFSUJZBOHEJUVOKVLLBOPMFIVOUBJBUBTEJ(BNCBS
P D P D
1FOPOKPMBO CBTBCBTB JOJMBI ZBOH NFNCFOUVL LPEF
HFOFUJL
,PEF HFOFUJL UFSEJSJ BUBT USJQMFU CBTB ZBOH CFSVSVUBO
BSUJOZB TFUJBQ UJHB CBTB CFSVSVUBO UFSTFCVU BEBMBI TFCVBI LBUB
LPEF 5SJQMFU ZBOH CFSVSVUBO UFSTFCVU BLIJSOZB NFOHBUVS
VSVUBO BTBN BNJOP EBMBN TFCVBI NPMFLVM QSPUFJO ZBOH BLBO
EJTJOUFTJT EJ EBMBN TFM 1FSIBUJLBO QBEB (BNCBS CBIXB
+BEJ QBEB (BNCBS VSVUBO QBTBOHBO CBTB ZBOH TBMJOH VOUBJBUBT%/" ZBOHEJCBDBEBSJLJSJLFLBOBO NFNJMJLJLPEF
CFSLPNQMFNFO BEBMBI $( $( ($ 5" $( 5" ($ "5 EBO HFOFUJL (($ "(" $55 EBO USJQMFU UFSTFCVU EJQJTBILBO TBUV
"5 0MFI LBSFOB TJGBU MPOHHBS EBO JLBUBO IJESPHFO JOJ LFEVB TBNB MBJO PMFI BOBL QBOBI #JMB LJUB NFOHJLVUJ LPEF HFOFUJL
VOUBJBOEBQBUUFSQJTBIEFOHBONVEBI EBOIBMJOJUFSKBEJCFSVMBOH QBEB (BNCBS EBO LJUB BLBO NFMJIBU CBIXB LFUJHB
LBMJ TFMBNB QBTBOHBOQBTBOHBO CBTB UFSTFCVU NFMBLVLBO USJQMFU CFSVSVUBO UFSTFCVU CFSUBOHHVOH KBXBC UFSIBEBQ
GVOHTJOZBEJEBMBNTFM QFOFNQBUBO UJHB BTBN BNJOP TFDBSB CFSVSVUBO QSPMJO TFSJO
6OUVLNFOHHBNCBSLBOQFSTQFLUJGGJTJL%/"ZBOHTFTVBJQBEB EBO BTBN HMVUBNBU EBMBN TFCVBI NPMFLVM QSPUFJO ZBOH CBSV
(BNCBS DVLVQIBOZBEFOHBONFOHBOHLBULFEVBVKVOHOZB UFSCFOUVL
P D P D P D P D P D P D P D P D P D P
G G C A G A C T T
C C G T C T G A A
P D P D P D P D P D P D P D P D P D
D P D P D P D P D P D P D P D P D P
G G C A G A C T T
C C G U C U G A
R
P R P R P R P R P R P R P R P
P P
P
C C G U C U G A A
P R P R P R P R P R P R P R P R P R
29
Kode DNA dalam Inti Sel Ditransfer ke Kode RNA Perakitan Rantai RNA dari Nukleotida yang Diaktifkan
dalam Sitoplasma Sel Proses Transkripsi dengan Menggunakan Untai DNA Sebagai Cetakan Proses
"Transkripsi"
0MFILBSFOB%/"UFSMFUBLEBMBNJUJTFM OBNVOTFCBHJBOCFTBS 1FSBLJUBO NPMFLVM 3/" EJDBQBJ EFOHBO DBSB TFQFSUJ ZBOH
GVOHTJ TFM CFSMBOHTVOH EBMBN TJUPQMBTNB IBSVT UFSTFEJB EJUVOKVLLBO PMFI (BNCBS EJ CBXBI QFOHBSVI TVBUV FO[JN
CFCFSBQBDBSBCBHJHFO%/"JOUJVOUVLNFOHBUVSSFBLTJLJNJB 3/" QPMJNFSBTF &O[JN JOJ NFSVQBLBO FO[JN QSPUFJO CFTBS
TJUPQMBTNB )BM JOJ EJDBQBJ NFMBMVJ QFSBOUBSBBO KFOJT BTBN ZBOH NFNQVOZBJ CBOZBL GVOHTJ ZBOH EJCVUVILBO VOUVL
OVLMFBUMBJO 3/" ZBOHQFNCFOUVLBOOZBEJBUVSPMFI%/"JOUJ QFNCFOUVLBONPMFLVM3/"1SPTFTOZBBEBMBITFCBHBJCFSJLVU
4FQFSUJ UBNQBL QBEB (BNCBS LPEF UFSTFCVU EJUSBOTGFS LF 1. 1BEBVOUBJ%/"UFQBUEJEFQBOHFOBXBM EJKVNQBJTFSBOHLBJBO
3/" QSPTFT JOJ EJTFCVU TFCBHBJ USBOTLSJQTJ 3/" TFMBOKVUOZB OVLMFPUJEB ZBOH EJTFCVU TFCBHBJ QSPNPUPS 3/" QPMJNFSBTF
CFSEJGVTJ EBSJ OVLMFVT NFMBMVJ QPSJQPSJ OVLMFVT LF EBMBN NFNQVOZBJ TUSVLUVS LPNQMFNFOUFS ZBOH TFTBJ ZBOH EBQBU
LPNQBSUFNFO TJUPQMBTNB UFNQBU 3/" NFOHBUVS TJOUFTJT NFOHFOBMJQSPNPUPSUFSTFCVU EBOLFNVEJBONFMFLBUQBEBOZB
QSPUFJO -BOHLBI JOJ BEBMBI MBOHLBI ZBOH QFOUJOH VOUVL NFOHBXBMJ
QFNCFOUVLBONPMFLVM3/"
2. 4FUFMBI3/"QPMJNFSBTFUFSTFCVUNFMFLBUQBEBQSPNPUPS 3/"
Sintesis RNA QPMJNFSBTFNFOZFCBCLBOUFSCVLBOZBTFLJUBSEVBQVUBSBOIFMJLT
4FMBNB TJOUFTJT 3/" CFSMBOHTVOH LFEVB VOUBJ NPMFLVM %/" %/" EBO NFNJTBILBO LFEVB CBHJBO VOUBJBO ZBOH UFSCVLB
UFSQJTBI VOUVL TFNFOUBSB TBMBI TBUV VOUBJ EJHVOBLBO TFCBHBJ UFSTFCVU
DFUBLBOVOUVLTJOUFTJTTFCVBINPMFLVM3/",PEFUSJQMFUEBMBN
%/" UFSTFCVU NFOZFCBCLBO QFNCFOUVLBO LPEF USJQMFU 3. ,FNVEJBO QPMJNFSBTF CFSHFSBL TFQBOKBOH VOUBJ %/" EBO
LPNQMFNFOUFS EJTFCVULPEPO
QBEB3/"LPEPOJOJTFMBOKVUOZB VOUVLTFNFOUBSBNFNCVLBEBONFNJTBILBOLFEVBVOUBJ%/"
BLBONFOHBUVSVSVUBOBTBNBNJOPEBMBNTFCVBIQSPUFJOZBOH QBEB TFUJBQ UBIBQ QFSHFSBLBOOZB 4FJSJOH EFOHBO
BLBOEJTJOUFTJTEJEBMBNTJUPQMBTNBTFM QFSHFSBLBOOZB QBEB TFUJBQ UBIBQOZB QPMJNFSBTF BLBO
NFOBNCBILBO TFCVBI OVLMFPUJEB 3/" ZBOH CBSV UFSBLUJWBTJ
Blok Bangunan Dasar RNA. #MPL CBOHVOBO EBTBS 3/" QBEB CBHJBO BLIJS SBOUBJ 3/" ZBOH CBSV UFSCFOUVL NFMBMVJ
IBNQJS TBNB EFOHBO %/" LFDVBMJ QBEB EVB IBM 1FSUBNB MBOHLBIMBOHLBICFSJLVUJOJ
HVMB EFPLTJSJCPTB UJEBL EJHVOBLBO EBMBN QFNCFOUVLBO 3/" a. 1FSUBNB 3/" QPMJNFSBTF NFOZFCBCLBO TFCVBI JLBUBO
5FNQBUOZB EJHVOBLBO PMFI HVMB MBJO ZBOH TFEJLJU CFSCFEB IJESPHFOUFSCFOUVLEJBOUBSBVKVOHCBTBVOUBJ%/"EBOCBTB
LPNQPTJTJOZB ZBJUV SJCPTB ZBOH NFOHBOEVOH JPO IJESPLTJM TFCVBIOVLMFPUJEB3/"EBMBNOVLMFPQMBTNB
UBNCBIBOZBOHNFOFNQFMQBEBTUSVLUVSDJODJOSJCPTB,FEVB b. ,FNVEJBO TBUV QFSTBUV 3/" QPMJNFSBTF BLBO NFNJTBILBO
UJNJOEJHBOUJPMFIQJSJNJEJOMBJO VSBTJM EVBEBSJUJHBSBEJLBMGPTGBUEBSJUJBQOVLMFPUJEB3/"JOJ EBO
NFNCFCBTLBOTFKVNMBICFTBSFOFSHJBLJCBUQFNFDBIBOJLBUBO
Pembentukan Nukleotida RNA. #MPL CBOHVOBO EBTBS GPTGBU CFSFOFSHJ UJOHHJ FOFSHJ JOJ EJHVOBLBO VOUVL
3/" NFNCFOUVL OVLMFPUJEB 3/" EFOHBO DBSB ZBOH TBNB NFNCFOUVL JLBUBO LPWBMFO EBSJ GPTGBU ZBOH UFSUJOHHBM QBEB
TFQFSUJ ZBOH EJKFMBTLBO TFCFMVNOZB VOUVL TJOUFTJT %/" %J OVLMFPUJEBEFOHBOSJCPTBQBEBCBHJBOVKVOHEBSJSBOUBJ3/"
TJOJ TFLBMJ MBHJ FNQBU OVLMFPUJEB CFSCFEB EJHVOBLBO EBMBN ZBOHTFEBOHUFSCFOUVL
QFNCFOUVLBO3/"/VLMFPUJEBJOJNFOHBOEVOHCBTBBEFOJO c. 4BBU 3/" QPMJNFSBTF NFODBQBJ VKVOH HFO %/" 3/"
HVBOJO TJUPTJO EBO VSBTJM 1FSIBUJLBO CBIXB CBTBCBTB JOJ QPMJNFSBTF BLBO CFSUFNV EFOHBO TFCVBI SBOHLBJBO
BEBMBICBTBZBOHTBNBEBMBN%/"LFDVBMJVSBTJMEBMBN3/" OVLMFPUJEB %/" CBSV ZBOH EJOBNBLBO SBOHLBJBO QFNVUVT
NFOHHBOUJLBOUJNJOEBMBN%/" SBOUBJ SBOHLBJBO JOJ BLBO NFOZFCBCLBO QPMJNFSBTF EBO
SBOUBJ3/"ZBOHCBSVUFSCFOUVLNFNJTBILBOEJSJEBSJVOUBJ
"Pengaktifan" Nukleotida RNA. -BOHLBI TFMBOKVUOZB %/" ,FNVEJBO QPMJNFSBTF EBQBU EJHVOBLBO LFNCBMJ
EBMBN QSPTFT TJOUFTJT 3/" BEBMBI QFOHBLUJGBO OVLMFPUJEB CFSVMBOH LBMJ VOUVL NFNCFOUVL LFNCBMJ SBOUBJ 3/" ZBOH
3/"PMFITVBUVFO[JN 3/"QPMJNFSBTF)BMJOJUFSKBEJEFOHBO CBSV
NFOBNCBILBO EVB SBEJLBM GPTGBU UBNCBIBO QBEB UJBQ d. 4FXBLUV VOUBJ 3/" ZBOH CBSV JUV UFSCFOUVL JLBUBO
OVLMFPUJEB UFSTFCVU VOUVL NFNCFOUVL USJGPTGBU EJQFSMJIBULBO IJESPHFOOZBZBOHMFNBIUFSMFQBTEBSJDFUBLBO%/" LBSFOB
QBEB (BNCBS PMFI LFEVB OVLMFPUJEB 3/" EJ TJTJ QBMJOH %/" NFNQVOZBJ BGJOJUBT UJOHHJ VOUVL CFSJLBUBO LFNCBMJ
LBOBOTFMBNBQFNCFOUVLBOSBOUBJ3/"
,FEVBGPTGBUUFSBLIJS
EFOHBO VOUBJ %/" LPNQMFNFOUFSOZB TFOEJSJ +BEJ SBOUBJ
UFSIVCVOHEFOHBOOVLMFPUJEBPMFIJLBUBOGPTGBUCFSFOFSHJUJOHHJ
3/" EJEFTBL NFOKBVI EBSJ %/" EBO EJMFQBTLBO LF EBMBN
ZBOHEJQFSPMFIEBSJ"51EBMBNTFM
OVLMFPQMBTNB
)BTJMQSPTFTQFOHBLUJGLBOJOJBEBMBIUFSKBEJOZBTFKVNMBICFTBS
FOFSHJ "51 VOUVL UJBQ OVLMFPUJEB EBO FOFSHJ JOJ EJHVOBLBO +BEJ LPEFZBOHUFSEBQBUQBEBVOUBJ%/"BLIJSOZBEJIBOUBSLBO
VOUVL NFOJOHLBULBO SFBLTJ LJNJB ZBOH NFOBNCBI TFUJBQ EBMBN CFOUVL LPNQMFNFOUFS LF SBOUBJ 3/" #BTB OVLMFPUJEB
OVLMFPUJEB 3/" CBSV QBEB CBHJBO VKVOH SBOUBJ 3/" ZBOH SJCPTB TFMBMV CFSHBCVOH EFOHBO CBTB EFPLTJSJCPTB EBMBN
TFEBOHUFSCFOUVL LPNCJOBTJCFSJLVUJOJ
30
Bab 3 Pengaturan Genetik Sintesis Protein, Fungsi Sel, dan Reproduksi Sel
#BTB%/" #BTB%/" 3/" NJLSP NJ3/"

NFSVQBLBO NPMFLVM 3/" VOUBJ
UVOHHBM ZBOH UFSTVTVO BUBT IJOHHB OVLMFPUJEB ZBOH
EBQBUNFOHBUVSUSBOTLSJQTJEBOUSBOTMBTJHFO
HVBOJO TJUPTJO
TJUPTJO HVBOJO RNA Caraka-Kondon
UNIT I
BEFOJO VSBTJM .PMFLVM N3/" NFSVQBLBO VOUBJ UVOHHBM 3/" ZBOH QBOKBOH
NFOHBQVOHEJEBMBNTJUPQMBTNB.PMFLVMNPMFLVMJOJUFSTVTVO
UJNJO BEFOJO BUBT CFCFSBQB SBUVT TBNQBJ CFCFSBQB SJCV OVLMFPUJEB
3/" EBMBN VOUBJ ZBOH UJEBL CFSQBTBOHBO EBO NFOHBOEVOH
LPEPO ZBOH UFQBU NFMFOHLBQJ LPEF USJQMFU HFO %/" (BNCBS
Empat Jenis RNA yang Berbeda 4FUJBQ KFOJT 3/" NFOVOKVLLBO TFHNFO LFDJM EBSJ TFCVBI NPMFLVM 3/"
NFNJMJLJQFSBONBOEJSJEBOTBOHBUCFSCFEBEBMBNQFNCFOUVLBO DBSBLB ,PEPOOZB BEBMBI $$( 6$6 EBO ("" ,FUJHBOZB
QSPUFJO BEBMBI LPEPO VOUVL BTBN BNJOP QSPMJO TFSJO EBO BTBN
3/" DBSBLB N3/"
NFNCBXB LPEF HFOFUJL LF TJUPQMBTNB HMVUBNBU5SBOTLSJQTJLPEPOJOJEBSJNPMFLVM%/"LFNPMFLVM
VOUVLNFOHBUVSUJQFQSPUFJOZBOHEJCFOUVL 3/"EJUVOKVLLBOPMFI(BNCBS
3/" USBOTGFS U3/"
NFOHBOHLVU BTBN BNJOP BLUJG LF
Kodon-Kodon RNA untuk Asam Amino yang Berbeda.
SJCPTPNVOUVLEJHVOBLBOEBMBNQFSBLJUBONPMFLVMQSPUFJO 5BCFM NFODBOUVNLBO LPEPOLPEPO 3/" VOUVL BTBN
3/" SJCPTPN CFSTBNB EFOHBO TFLJUBS QSPUFJO ZBOH BNJOP ZBOH VNVNOZB EJUFNVLBO EBMBN NPMFLVM QSPUFJO
CFSCFEBNFNCFOUVLSJCPTPN TUSVLUVSGJTJL EBOLJNJBUFNQBU 1FSIBUJLBO CBIXB TFCBHJBO CFTBS BTBN BNJOP EJXBLJMJ PMFI
QFSBLJUBONPMFLVMQSPUFJOZBOHTFTVOHHVIOZB MFCJIEBSJTBUVLPEPO
Tabel 3-1 Kodon RNA untuk Asam-Asam Amino dan untuk Mulai serta Berhenti
Asam Amino RNA Kodon
Alanin GCU GCC GCA GCG

Arginin CGU CGC CGA CGG AGA AGG
Asparagin AAU AAC
Asam Aspartat GAU GAC
Sistein UGU UGC
Asam Glutamat GAA GAG
Glutamin CAA CAG
Glisin GGU GGC GGA GGG
Histidin CAU CAC
Isoieusin AUU AUC AUA
Leusin CUU CUC CUA CUG UUA UUG
Lisin AAA AAG
Metionin AUG
Fenilalanin UUU UUC
Prolin CCU CCC CCA CCG
Serin UCU UCC UCA UCG AGC AGU
Treonin ACU ACC ACA ACG
Triptofan UGG
Tirosin UAU UAC
Valin GUU GUC GUA GUG
Mulai (CI) AUG
Berhenti (CT) UAA UAG UGA
CI, pemulai-rantai; CT, pengakhir-rantai
31
KVHB TBUV LPEPO NFXBLJMJ TJOZBM BXBM QFNCFOUVLBO NPMFLVM CBHJBOCBXBILPOGJHVSBTJEBVOTFNBOHHJ ZBOHEJUVOKVLLBOPMFI
QSPUFJOEBOUJHBLPEPONFXBLJMJTUPQQFNCFOUVLBONPMFLVM (BNCBS
4FMBNB QFNCFOUVLBO NPMFLVM QSPUFJO CBTB
QSPUFJO %BMBN 5BCFM LFEVB KFOJT LPEPO JOJ EJTFCVU BOUJLPEPOCFSJLBUBOTFDBSBMPOHHBSNFMBMVJJLBUBOIJESPHFOZBOH
TFCBHBJ $* VOUVL QFNVMBSBOUBJ EBO $5 VOUVL QFOHBLIJS CFSJLBUBO EFOHBO CBTB LPEPO QBEB N3/" %FOHBO DBSB JOJ UJBQ
SBOUBJ BTBN BNJOP EJVSVULBO TBUV QFSTBUV EJ TFQBOKBOH SBOUBJ N3/"
TFIJOHHB NFOHIBTJMLBO TVBUV SBOHLBJBO BTBN BNJOP ZBOH TFTVBJ
RNA Transfer-Antikodon EBMBNNPMFLVMQSPUFJOZBOHCBSVUFSCFOUVL
+FOJT3/"MBJOZBOHNFNBJOLBOQFSBOQFOUJOHEBMBNTJOUFTJT
QSPUFJO EJTFCVU TFCBHBJ U3/" LBSFOB 3/" UFSTFCVU
NFOHBOHLVUNPMFLVMNPMFLVMBTBNBNJOPLFNPMFLVMQSPUFJO RNA Ribosom
TFXBLUVQSPUFJOTFEBOHEJTJOUFTJT5JBQKFOJTU3/"CFSHBCVOH 3/"KFOJTLFUJHBZBOHUFSEBQBUEJEBMBNTFMBEBMBI3/"SJCPTPN
TFDBSB TQFTJGJL EFOHBO EBSJ BTBN BNJOP ZBOH BLBO ZBOH NFODBLVQ LJSBLJSB QFSTFO EBSJ SJCPTPN 4JTB SJCPTPN
EJHBCVOHLBO NFOKBEJ QSPUFJO U3/" LFNVEJBO CFSUJOEBL NFSVQBLBO QSPUFJO ZBOH NFODBLVQ LJSBLJSB QFSTFO KFOJT
TFCBHBJTVBUVQFOHBOHLVUVOUVLNFOHBOHLVUKFOJTBTBNBNJOP QSPUFJO ZBOH NFSVQBLBO QSPUFJO TUSVLUVSBM EBO FO[JN ZBOH
TQFTJGJLOZB LF SJCPTPN UFNQBU NPMFLVM QSPUFJO EJCFOUVL EJQFSMVLBOQBEBQFNCFOUVLBONPMFLVMNPMFLVMQSPUFJO
%BMBN SJCPTPN TFUJBQ KFOJT TQFTJGJL 3/" USBOTGFS BLBO 3JCPTPN NFSVQBLBO TVBUV TUSVLUVS GJTJL EBMBN TJUPQMBTNB
NFOHFOBMJ TVBUV LPEPO UFSUFOUV EBO N3/" BLBO EJKFMBTLBO UFNQBU TJOUFTJT NPMFLVM QSPUFJO ZBOH TFTVOHHVIOZB "LBO UFUBQJ
LFNVEJBO
EBO PMFI LBSFOBOZB NFOHIBOUBSLBO BTBN BNJOP 3/"SJCPTPNTFMBMVCFLFSKBCFSTBNBEFOHBOEVBKFOJT3/"MBJO
ZBOH TFTVBJ LF UFNQBU ZBOH TFTVBJ EJ EBMBN SBOUBJ NPMFLVM U3/" ZBOH NFOHBOHLVU BTBN BNJOP LF SJCPTPN VOUVL
QSPUFJOZBOHCBSVEJCFOUVL EJHBCVOHLBO LF EBMBN NPMFLVM QSPUFJO ZBOH TFEBOH EJCFOUVL
3/"USBOTGFS ZBOHIBOZBNFOHBOEVOHTFLJUBSOVLMFPUJEB TFEBOHLBON3/"NFOZFEJBLBOJOGPSNBTJZBOHEJCVUVILBOVOUVL
NFSVQBLBO TVBUV NPMFLVM ZBOH SFMBUJG LFDJM EJCBOEJOHLBO NFOHVSVULBO BTBN BNJOP EBMBN VSVUBO ZBOH CFOBS BHBS TFUJBQ
EFOHBO N3/" 3/" USBOTGFS NFSVQBLBO TVBUV SBOUBJ KFOJTQSPUFJOTQFTJGJLEBQBUUFSCFOUVL
OVLMFPUJEBZBOHUFSMJQBU UBNQBLNJSJQEBVOTFNBOHHJ TFQFSUJ +BEJ SJCPTPN CFLFSKB TFCBHJ QBCSJL QSPEVLTJ UFNQBU
ZBOHEJUVOKVLLBOEBMBN(BNCBS1BEBTBUVVKVOHNPMFLVM QFNCFOUVLBONPMFLVMQSPUFJO
TFMBMV UFSEBQBU BTBN BEFOJMBU BTBN BNJOP ZBOH EJBOHLVU
NFMFLBULFHVHVTIJESPLTJMSJCPTBQBEBBTBNBEFOJMBU
0MFI LBSFOB U3/" CFSGVOHTJ VOUVL NFOZFCBCLBO QFSMFLBUBO Pembentukan Ribosom dalam Nukleolus.(FO%/"VOUVL
BTBN BNJOP TQFTJGJL TFCVBI SBOUBJ QSPUFJO ZBOH TFEBOH QFNCFOUVLBO 3/" SJCPTPN UFSMFUBL EBMBN MJNB QBTBOH
EJCFOUVL TBOHBU QFOUJOH CBIXB TFUJBQ KFOJT U3/" KVHB LSPNPTPNEBMBNOVLMFVT EBOTFUJBQLSPNPTPNJOJNFOHBOEVOH
NFNJMJLJ TQFTJGJTJUBT UFSIBEBQ LPEPO UFSUFOUV EBMBN N3/" CBOZBL EVQMJLBU EBSJ HFOHFO UFSTFCVU LBSFOB 3/" SJCPTPN
,PEFTQFTJGJLEBMBNU3/"ZBOHNFNVOHLJOLBOOZBNFOHFOBMJ EJCVUVILBOEBMBNKVNMBICFTBSVOUVLGVOHTJTFM
LPEPOUFSUFOUV BEBMBITFLBMJMBHJNFSVQBLBOTVBUVUSJQMFUCBTB 4FXBLUV3/"SJCPTPNEJCFOUVL 3/"SJCPTPNBLBOCFSLVNQVM
OVLMFPUJEB EBO EJTFCVU TFCBHBJ BOUJLPEPO "OUJLPEPO JOJ EJEBMBNOVLMFPMVT TVBUVTUSVLUVSLIVTVTZBOHUFSMFUBLCFSEFLBUBO
UFSMFUBLLVSBOHMFCJIQBEBCBHJBOUFOHBINPMFLVMU3/" QBEB EFOHBO LSPNPTPN #JMB TFKVNMBI CFTBS 3/" SJCPTPN TFEBOH
EJTJOUFTJT TFQFSUJZBOHUFSKBEJEBMBNTFMZBOHNFOZJOUFTJTTFKVNMBI
CFTBS QSPUFJO OVLMFPMVT ZBOH IBOZB TFEJLJU NFOZJOUFTJT QSPUFJO
OVLMFPMVT CBILBO NVOHLJO UJEBL UFSMJIBU 3/" SJCPTPN TFDBSB
LIVTVTEJPMBIEJEBMBNOVLMFPMVT UFNQBU3/"SJCPTPNCFSJLBUBO
EFOHBO QSPUFJO SJCPTPN VOUVL NFNCFOUVL QSPEVL LPOEFOTBTJ
Histidin
HSBOVMBS ZBOH NFSVQBLBO TVCVOJU QSJNPSEJBM SJCPTPN 4VCVOJU
Alanin
Fenilalanin
TVCVOJU JOJ LFNVEJBO EJMFQBTLBO EBSJ OVLMFPMVT EBO EJBOHLVU
NFMBMVJ QPSJQPSJ CFTBS TFMVCVOH OVLMFPMVT LF IBNQJS TFMVSVI
Serin CBHJBO TJUPQMBTNB 4FUFMBI TVCVOJU NBTVL LF TJUPQMBTNB TVCVOJU
Transfer RNA
Prolin
UFSTFCVU EJSBLJU VOUVL NFNCFOUVL SJCPTPN GVOHTJPOBM ZBOH
NBUBOH0MFILBSFOBJUV QSPUFJOEJCFOUVLEJEBMBNTJUPQMBTNBTFM
Kodon awal EBO CVLBO EBMBN OVLMFVT TFM LBSFOB OVLMFVT UJEBL NFOHBOEVOH
SJCPTPNZBOHNBUBOH
GGG
A UG GCC UGU CAU GCC UUU UCC CCC AAA C AG GAC UAU
RNA Mikro
Caraka
+FOJT LFFNQBU 3/" EBMBN TFM BEBMBI NJ3/" NJ3/" BEBMBI
Ribosom Ribosom QFDBIBO VOUBJ UVOHHBM 3/" ZBOH QFOEFL IJOHHB
Pergerakan RNA
OVLMFPUJEB
ZBOH NFOHBUVS FLTQSFTJ HFO (BNCBS
NJ3/"
EJLPEFEBSJ%/"HFOZBOHEJUSBOTLSJQTJ OBNVOUJEBLEJUSBOTMBTJ
NFOKBEJ QSPUFJO EBO LBSFOB UV TFSJOH EJTFCVU 3/" OPODPEJOH
NJ3/" EJQSPTFT PMFI TFM NFOKBEJ LPNQMFNFOUFS VOUVL N3/"
EBO CFLFSKB NFOVSVOLBO FLTQSFTJ HFO 1FNCFOUVLBO NJ3/"
NFMJCBULBOQFOHPMBIBOLIVTVT3/"QSFLVSTPSQSJNFSZBOHMFCJI
32
+FOJT3/"NJLSPMBJOBEBMBITNBMMJOUFSGFSJOH3/" TJ3/B

KVHB EJTFCVU TJMFODJOH 3/" BUBV TIPSU JOUFSGFSJOH 3/" TJ3/"
NFSVQBLBONPMFLVM3/"VOUBJHBOEBZBOHQFOEFL TBNQBJ
OVLMFPUJEB ZBOHNFOHHBOHHVFLTQSFTJHFOUFSUFOUVTJ3/"
VNVNOZB NFOHBDV QBEB NJ3/" TJOUFTJT EBO EBQBU
UNIT I
EJUBNCBILBO VOUVL NFOHIJMBOHLBO FLTQSFTJ HFO UFSUFOUV
TJ3/"EJSBODBOHVOUVLNFOHIJOEBSJQFNSPSFTBOOVLMFVTPMFI
LPNQMFLT NJLSPQSPTFTPS EBO TFUFMBI TJ3/" NFNBTVLJ
TJUPQMBTNB TJ3/" NFOHBLUJGLBO 3*4$ TJMFODJOH DPNQMFY
NFNCMPL USBOTMBTJ N3/" 0MFI LBSFOB TJ3/" EBQBU
EJTFTVBJLBO VOUVL TFUJBQ VSVUBO TQFTJGJL EBMBN HFO TJ3/"
EBQBUEJHVOBLBOVOUVLNFNCMPLUSBOTMBTJN3/"BQBQVOEBO
EFOHBO EFNJLJBO NFNCMPL FLTQSFTJ HFO ZBOH VSVUBO
a OVLMFPUJEBOZB EJLFUBIVJ #FCFSBQB QFOFMJUJ UFMBI NFOHVTVMLBO
CBIXB TJ3/" EBQBU NFOKBEJ BMBU UFSBQJ ZBOH CFSHVOB VOUVL
Transpor NFOHIJMBOHLBOHFOZBOHCFSQFSBOQBEBQBUPGJTJPMPHJQFOZBLJU
miRNA
Pembentukan Protein pada Ribosom-Proses
pr -miRNA
"Translasi"
4FXBLUVTFCVBINPMFLVM3/"DBSBLBCFSLPOUBLEFOHBOTFCVBI
SJCPTPN 3/"DBSBLBCFSKBMBOEJTFQBOKBOHSJCPTPN NVMBJEBSJ
VKVOH NPMFLVM 3/" ZBOH UFMBI EJUFOUVLBO TFCFMVNOZB ZBOH
EJUFUBQLBO PMFI VSVUBO CBTB 3/" ZBOH TFTVBJ ZBOH EJTFCVU
TFCBHBJ LPEPO QFNVMBJ SBOUBJ ,FNVEJBO TFQFSUJ ZBOH
EJUVOKVLLBO PMFI (BNCBS LFUJLB 3/" DBSBLB CFSKBMBO EJ
TFQBOKBOH SJCPTPN TFCVBI NPMFLVM QSPUFJO EJCFOUVL TFCVBI
QSPTFT ZBOH EJTFCVU USBOTMBTJ KBEJ SJCPTPN NFNCBDB LPEPO
3/"DBSBLBEFOHBODBSBZBOHMFCJILVSBOHTBNBTFQFSUJTFCVBI
QJUBLBTFUZBOHEJCBDBTFXBLUVQJUBNFMFXBUJLFQBMBQFNVUBS
TFCVBI UBQF SFDPSEFS ,FNVEJBO CJMB TFCVBI LPEPO
CFSIFOUJ BUBV QFOHBLIJSSBOUBJ
NBTVL LF EBMBN SJCPTPN
CBHJBOBLIJSNPMFLVMQSPUFJOEJTJOZBMLBOEBONPMFLVMQSPUFJO
EJMFQBTLBOLFEBMBNTJUPQMBTNB
1PMJSJCPTPN TFCVBI NPMFLVM 3/" DBSBLB UVOHHBM EBQBU
NFNCFOUVLNPMFLVMQSPUFJOEBMBNCFCFSBQBSJCPTPNQBEBTBBU
ZBOH CFSTBNBBO LBSFOB CBHJBO BXBM EBSJ VKVOH VOUBJ 3/"
EBQBU NBTVL LF SJCPTPN CFSJLVUOZB TFUFMBI NFOJOHHBMLBO
SJCPTPN ZBOH QFSUBNB TFQFSUJ ZBOH EJUVOKVLLBO PMFI CBHJBO
LJSJ CBXBI (BNCBS EBO (BNCBS .PMFLVMNPMFLVM
QSPUFJO CFSBEB EBMBN UBIBQ QFSLFNCBOHBO ZBOH CFSCFEB EJ
TFUJBQ SJCPTPN "LJCBUOZB TFSJOH UFSCFOUVL LFMPNQPL
LFMPNQPL SJCPTPN TBNQBJ SJCPTPN NFMFLBU QBEB TBUV
3/"DBSBLBQBEBXBLUVZBOHCFSTBNBBO,VNQVMBOJOJEJTFCVU
QBOKBOH ZBOH EJTFCVU QSJNJ3/" ZBOH NFSVQBLBO TBMJOBO QPMJSJCPTPN
VUBNBHFOQSJNJ3/BLFNVEJBOEJQSPTFTEBMBNOVLMFVTTFMPMFI 4BOHBUQFOUJOHVOUVLEJQFSIBUJLBOCBIXBTFCVBI3/"DBSBLB
LPNQMFLTNJLSPQSPTFTPSNFOKBEJQSBNJ3/" ZBOHNFSVQBLBO EBQBU NFOZFCBCLBO QFNCFOUVLBO NPMFLVM QSPUFJO EBMBN
TUSVLUVS CBUBOH MFOHLVOHBO UFSEJSJ BUBT OVLMFPUJEB QSB SJCPTPN BQB QVO BSUJOZB UJEBL BEB TQFTJGJTJUBT SJCPTPN VOUVL
NJ3/"LFNVEJBOEJQSPTFTMFCJIMBOKVUEJTJUPQMBTNBPMFIFO[JN UJBQKFOJTQSPUFJO3JCPTPNTFDBSBGJTJLIBOZBNFSVQBLBOTVBUV
QFNPUPOHTQFTJGJLZBOHNFNCBOUVNFSBLJUTFCVBU3/"JOEVDFE QBCSJLQSPEVLTJ UFNQBUSFBLTJLJNJBUFSKBEJ
TJMFODJOHDPNQMFY 3*4$
EBONFOHIBTJMLBONJ3/" Banyak Ribosom Melekat pada Retikulum Endoplasma
3/"NJLSP NJ3/"
NFOHBUVSFLTQSFTJHFOEFOHBOCFSJLBUBO %J CBC EJCBIBT CBIXB CBOZBL SJCPTPN NFMFLBU QBEB
EFOHBO EBFSBI LPNQMFNFOUFS 3/" EBO NFOEPSPOH UFSKBEJOZB SFUJLVMVN FOEPQMBTNB ,FBEBBO JOJ UFSKBEJ LBSFOB CBHJBO
QFOFLBOBO USBOTMBTJ BUBV EFHSBEBTJ N3/" TFCFMVN EBQBU QBOHLBMVKVOHVKVOHEBSJCBOZBLNPMFLVMQSPUFJOZBOHTFEBOH
EJUSBOTMBTJ PMFI SJCPTPN NJ3/" EJZBLJOJ NFNBJOLBO QFSBO UFSCFOUVL NFNJMJLJ SBOHLBJBO BTBN BNJOP ZBOH MBOHTVOH
QFOUJOH EBMBN QFOHBUVSBO OPSNBM GVOHTJ TFM EBO QFSVCBIBO NFMFLBUQBEBSFTFQUPSTQFTJGJLEJSFUJLVMVNFOEPQMBTNBIBMJOJ
EBMBN GVOHTJ NJ3/" UFMBI EJLBJULBO EFOHBO CFSCBHBJ QFOZBLJU BLBONFOZFCBCLBONPMFLVMNPMFLVMJOJNFOFNCVTEJOEJOH
TFQFSUJLBOLFSEBOQFOZBLJUKBOUVOH
33
Unit I Pengantar Fisiologi Sel dan Umum
SFUJLVMVNEBONBTVLLFEBMBNNBUSJLTSFUJLVMVNFOEPQMBTNB TFCBHBJ CFSJLVU

4FUJBQ BTBN BNJOP EJBLUJGLBO PMFI TVBUV
,FBEBBOJOJNFOZFCBCLBOQFOBNQJMBOCFSHSBOVMBQBEBCBHJBO QSPTFT LJNJB ZBOH NFOHHBCVOHLBO "51 EFOHBO BTBN BNJOP
SFUJLVMVNUFSTFCVUUFNQBUQSPUFJOTFEBOHEJCFOUVLEBONBTVL VOUVL NFNCFOUVL TVBUV LPNQMFLT BEFOPTJO NPOPGPTGBU EFOHBO
LFEBMBNNBUSJLTSFUJLVMVN BTBN BNJOP TFIJOHHB NFMFQBTLBO EVB JLBUBO GPTGBU CFSFOFSHJ
(BNCBS NFOVOKVLLBO IVCVOHBO GVOHTJPOBM 3/" UJOHHJQBEBQSPTFTUFSTFCVU
"TBNBNJOPZBOHUFMBIEJBLUJGLBO
DBSBLB EFOHBO SJCPTPN EBO DBSB SJCPTPN NFMFLBU QBEB UFSTFCVU ZBOH NFNJMJLJ LFMFCJIBO FOFSHJ LFNVEJBO CFSHBCVOH
NFNCSBO SFUJLVMVN FOEPQMBTNB 1FSIBUJLBO CBIXB QSPTFT EFOHBO 3/" USBOTGFSOZB ZBOH TQFTJGJL VOUVL NFNCFOUVL TVBUV
USBOTMBTJ UFSKBEJ QBEB CFCFSBQB SJCPTPN EBMBN XBLUV ZBOH LPNQMFLT BTBN BNJOPU3/" EBO QBEB XBLUV ZBOH TBNB
TBNBTFCBHBJSFTQPOTUFSIBEBQSBOUBJ3/"DBSBLBZBOHTBNB NFMFQBTLBO BEFOPTJO NPOPGPTGBU
3/" USBOTGFS ZBOH
1FSIBUJLBOKVHBCBIXBSBOUBJQPMJQFQUJEB QSPUFJO
ZBOHCBSV NFNCBXB LPNQMFLT BTBN BNJOP LFNVEJBO CFSLPOUBL EFOHBO
UFSCFOUVL NFOFNCVT NFNCSBO SFUJLVMVN FOEPQMBTNB EBO NPMFLVM 3/" DBSBLB EJ EBMBN SJCPTPN UFNQBU BOUJLPEPO 3/"
NBTVLLFEBMBNNBUSJLTFOEPQMBTNB USBOTGFS NFMFLBU TFNFOUBSB QBEB LPEPO TQFTJGJLOZB EJ 3/"
/BNVO QFSMVKVHBEJQFSIBUJLBOCBIXBLFDVBMJEJTFMLFMFOKBS DBSBLB EBO EFOHBO EFNJLJBO NFSBOHLBJ BTBN BNJOP EFOHBO
UFNQBU EJCFOUVLOZB TFKVNMBI CFTBS WFTJLFM TFLSFUPSJ ZBOH VSVUBO ZBOH UFQBU VOUVL NFNCFOUVL TBUV NPMFLVM QSPUFJO
NFOHBOEVOH QSPUFJO TFCBHJBO CFTBS QSPUFJO ZBOH EJTJOUFTJT ,FNVEJBO EJ CBXBI QFOHBSVI FOTJN QFQUJEJM USBOTGFSBTF TBMBI
PMFISJCPTPNEJMFQBTLBOMBOHTVOHLFEBMBNTJUPTPMEBOCVLBO TBUV QSPUFJO EBMBN SJCPTPN
JLBUBO QFQUJEB UFSCFOUVL BOUBSB
LF EBMBN SFUJLVMVN FOEPQMBTNB 1SPUFJOQSPUFJO JOJ BEBMBI BTBNBTBN BNJOP ZBOH CFSVSVUBO TFIJOHHB TFDBSB CFSUBIBQ
FO[JNEBOQSPUFJOTUSVLUVSBMJOUFSOBMTFM NBLJO NFOBNCBI QBOKBOH SBOUBJ QSPUFJO 1FSJTUJXB LJNJB JOJ
Langkah-Langkah Reaksi Kimia pada Sintesis Protein NFNCVUVILBO FOFSHJ EBSJ EVB JLBUBO GPTGBU CFSFOFSHJ UJOHHJ
#FCFSBQBQFSJTUJXBLJNJBXJZBOHUFSKBEJQBEBTJOUFTJTNPMFLVM UBNCBIBO TFIJOHHB TFDBSB UPUBM FNQBU JLBUBO CFSFOFSHJ UJOHHJ
QSPUFJO EJUVOKVLLBO PMFI (BNCBS (BNCBS JOJ EJHVOBLBOVOUVLTFUJBQBTBNBNJOPZBOHEJUBNCBILBOLFSBOUBJ
NFOVOKVLLBO SFBLTJ ZBOH NFXBLJMJ UJHB BTBN BNJOP ZBOH QSPUFJO +BEJ TJOUFTJT QSPUFJO NFSVQBLBO TBMBI TBUV QSPTFT ZBOH
CFSCFEB "" "" "" EBO""5BIBQBOSFBLTJOZBBEBMBI QBMJOHNFNCVUVILBOFOFSHJEJEBMBNTFM
AA1 AA2 AA20

+ + +
asi AA1 AA2 AA20

+ + +
AA1 AA2 AA20

+ + +
AA1
AA5
AA3
AA9
AA2
AA13
AA20
AA1 AA5 AA3 AA9 AA2 AA13 AA20
34
Pembentukan Ikatan Peptida"TBNBTBNBNJOPZBOH IFXBO EFOHBO CFSCBHBJ KFOJT TFM KBSJOHBO EBO PSHBO
CFSVSVUBOEBMBNSBOUBJQSPUFJOBLBOCFSHBCVOHTBUVTBNBMBJO QFOHBUVSBO EJGFSFOTJBTJ FLTQSFTJ HFO KVHB NFNVOHLJOLBO
NFOVSVUSFBLTJZBOHLIBT CBOZBL KFOJT TFM ZBOH CFSCFEB EBMBN UVCVI VOUVL NFMBLVLBO
GVOHTJLIVTVTOZB.FTLJQVONJPTJUKBOUVOHNFOHBOEVOHLPEF
NH2 O H R HFOFUJLZBOHTBNBEFOHBOTFMFQJUFMUVCVMVTHJOKBM CBOZBLHFO
ZBOHEJFLTQSFTJLBOEBMBNTFMKBOUVOHZBOHUJEBLEJFLTQSFTJLBO
UNIT I
R C C OH + H N C COOH EBMBN TFM UVCVMVT HJOKBM 6LVSBO VUBNB EBSJ FLTQSFTJ HFO
NH2 O H R BEBMBIBQBLBI EBOCFSBQBCBOZBL
QSPEVLHFO QSPUFJO
ZBOH
EJIBTJMLBO LBSFOB QSPUFJO NFMBLTBOBLBO GVOHTJ TFM ZBOH
R C C N C COOH + H2O
EJUFOUVLBO PMFI HFO 1FOHBUVSBO FLTQSFTJ HFO EBQBU UFSKBEJ
QBEB TFUJBQ UJUJL EJ KBMVS USBOTLSJQTJ QFNSPTFTBO 3/" EBO
USBOTMBTJ
1BEBSFBLTJLJNJBJOJ TBUVSBEJLBMIJESPLTJM 0)
EJMFQBTEBSJ
HVHVT $00) BTBN BNJOP QFSUBNB EBO TBUV IJESPHFO )
EBSJ
HVHVT /) BTBN BNJOP ZBOH MBJO EJMFQBT ,FEVBOZB CFSHBCVOH Promotor Mengendalikan Ekspresi Gen4JOUFTJTQSPUFJO
NFNCFOUVLBJS EBOLFEVBUFNQBUZBOHEJUJOHHBMLBOQBEBLFEVB TFM BEBMBI TFCVBI QSPTFT LPNQMFLT ZBOH EJNVMBJ EFOHBO
BTBN BNJOP UFSTFCVU CFSJLBUBO TBUV TBNB MBJO TFIJOHHB USBOTLSJQTJ%/"NFOKBEJ3/"5SBOTLSJQTJ%/"EJLFOEBMJLBO
NFOHIBTJMLBO TFCVBI NPMFLVM UVOHHBM 1SPTFT JOJ EJTFCVU PMFIVOTVSVOTVSQFOHBUVSBOZBOHEJUFNVLBOEBMBNQSPNPUPS
QFNCFOUVLBO JLBUBO QFQUJEB 4FUJBQ LBMJ BTBN BNJOP UBNCBIBO TFCVBI HFO (BNCBS
1BEB FVLBSJPUB ZBOH NFODBLVQ
EJUBNCBILBO TFCVBIJLBUBOQFQUJEBUBNCBIBOBLBOUFSCFOUVL TFNVB NBNBMJB QSPNPUPS CBTBM UFSEJSJ BUBT VSVUBO UVKVI CBTB
5"5""""
ZBOH EJTFCVU LPUBL 5"5" UFNQBU CFSJLBUBO
VOUVLQSPUFJO5"5"JLBUBO 5"5"CJOEJOHQSPUFJO
5#1
EBO
Sintesis Zat-Zat Lain dalam Sel CFCFSBQB GBLUPS USBOTLSJQTJ QFOUJOH MBJO ZBOH TFDBSB LPMFLUJG
#FSJCVSJCV FO[JN QSPUFJO ZBOH EJCFOUVL NFMBVJ DBSB ZBOH CBSV EJTFCVU TFCBHBJ GBLUPS USBOTLSJQTJ LPNQMFLT **% 4FMBJO GBLUPS
EJKFMBTLBO QBEBEBTBSOZBNFOHBUVSTFNVBSFBLTJLJNJBMBJOZBOH USBOTLSJQTJ LPNQMFLT **% QBEB BSFB JOJ GBLUPS USBOTLSJQTJ **#
UFSKBEJ EBMBN TFM FO[JNFO[JN JOJ NFOJOHLBULBO TJOUFTJT MJQJE CFSJLBUBO EFOHBO LFEVB VOUBJ %/" EBO 3/" QPMJNFSBTF
HMJLPHFO QVSJO QJSJNJEJO EBO CFSBUVTSBUVT [BU MBJO ,JUB VOUVL NFNCBOUV USBOTLSJQTJ %/" NFOKBEJ 3/" 1SPNPUPS
NFOEJTLVTJLBOCBOZBLQSPTFTTJOUFTJTJOJEBMBNLBJUBOOZBEFOHBO CBTBM JOJ EJUFNVLBO EBMBN TFNVB HFO QFOZBOEJ QSPUFJO EBO
NFUBCPMJTNFLBSCPIJESBU MJQJE EBOQSPUFJOEJ#BCTBNQBJ QPMJNFSBTF IBSVT CFSJLBUBO EFOHBO QSPNPUPS CBTBM TFCFMVN
.FMBMVJTFNVB[BUJOJ CBOZBLGVOHTJTFMEBQBUCFSMBOHTVOH EBQBU NFNVMBJ QFSKBMBOBO EJ TFQBOKBOH VOUBJ %/" VOUVL
NFOZJOUFTJT 3/" 1SPNPUPS IVMV UFSMFUBL MFCJI KBVI TFCFMVN
UFNQBU EJNVMBJOZB USBOTLSJQTJ EBO CFSJTJ CFCFSBQB UFNQBU
Pengaturan Fungsi Gen dan Aktivitas JLBUBO VOUVL GBLUPS USBOTLSJQTJ QPTJUJG BUBV OFHBUJG ZBOH EBQBU
Biokimiawi dalam Sel NFNFOHBSVIJUSBOTLSJQTJNFMBMVJJOUFSBLTJEFOHBOQSPUFJOZBOH
UFSJLBU QBEB QSPNPUPS CBTBM 4USVLUVS EBO UFNQBU JLUBO GBLUPS
%BSJ QFNCBIBTBO LJUB TFKBVI JOJ TVEBI KFMBT CBIXB HFO USBOTLSJQTJEJQSPNPUPSIVMVCFSWBSJBTJQBEBTFUJBQHFOTFIJOHHB
NFOHFOEBMJLBO GVOHTJ GJTJL EBO LJNJBXJ TFM "LBO UFUBQJ UJOHLBU NFOHIBTJMLBO QPMB FLTQSFTJ HFO ZBOH CFSCFEB EBMBN KBSJOHBO
BLUJWJUBT HFO UFSTFCVU KVHB IBSVT EJBUVS CJMB UJEBL CFCFSBQB ZBOHCFSCFEB
CBHJBO TFM EBQBU UVNCVI CFSMFCJIBO BUBV CFCFSBQB SFBLTJ LJNJB
EBQBU CFLFSKB CFSMFCJIBO TBNQBJ NFNCVOVI TFM JUV TFOEJSJ 5JBQ
TFM NFNJMJLJ NFLBOJTNF QFOHBUVSBO VNQBO CBMJL JOUFSOBM ZBOH
sola o
LVBU ZBOHNFNQFSUBIBOLBOCFSCBHBJPQFSBTJGVOHTJPOBMTFMUFUBQ
TFKBMBOTBUVTBNBMBJO6OUVLTFUJBQHFO TFLJUBSHFOTFDBSB
LFTFMVSVIBO
UFSEBQBU QBMJOH TFEJLJU TFCVBI NFLBOJTNF VNQBO
CBMJL
1BEBEBTBSOZBBEBEVBDBSBQFOHFOEBMJBOBLUJWJUBTCJPLJNJBXJ
EJ EBMBN TFM
1FOHBUVSBO HFOFUJL ZBOH EFOHBO TFOEJSJOZB
NFOHFOEBMJLBO UJOHLBU BLUJWJUBT EBO QFNCFOUVLBO QSPEVL HFO
EBO
1FOHBUVSBO FO[JN ZBOH NFOHFOEBMJLBO UJOHLBU BLUJWJUBT RE RE TATA INR
FO[JNZBOHTVEBIUFSCFOUVLEJEBMBNTFM
Pengaturan Genetik
1FOHBUVSBO HFOFUJL BUBV QFOHBUVSBO FLTQSFTJ HFO NFMJQVUJ
TFMVSVIQSPTFT EBSJUSBOTLSJQTJLPEFHFOFUJLEBMBNJOUJTFMIJOHHB
QFNCFOUVLBOQSPUFJOEBMBNTJUPQMBTNB1FOHBUVSBOFLTQSFTJHFO
NFNCFSJLBO TFNVB PSHBOJTNF IJEVQ LFNBNQVBO VOUVL
CFSFTQPOTUFSIBEBQCFSCBHBJQFSVCBIBOEJMJOHLVOHBOOZB1BEB
35
5SBOTLSJQTJ HFO QBEB FVLBSJPUB KVHB EJQFOHBSVIJ PMFI PMFIQSPUFJOMBJO4FMBNB%/"CFSBEBEBMBNLFBEBBOQBEBU %/"

QFOHVBU ZBOH NFSVQBLBO BSFB %/" ZBOH EBQBU CFSJLBUBO UJEBLEBQBUCFLFSKBVOUVLNFNCFOUVL3/""LBOUFUBQJ CFSCBHBJ
EFOHBO GBLUPS USBOTLSJQTJ 1FOHVBU EBQBU UFSMFUBL QBEB KBSBL NFLBOJTNF QFOHFOEBMJBO NVMBJ EJUFNVLBO ZBOH EBQBU
ZBOHTBOHBUKBVIEBSJHFOZBOHEJQFOHBSVIJBUBVCBILBOQBEB NFOZFCBCLBO CFCFSBQB BSFB LSPNPTPN NFOHBMBNJ QFOHVSBJBO
LSPNPTPN ZBOH CFSCFEB 1FOHVBU KVHB EBQBU EJUFNVLBO CBJL QBEB TVBUV XBLUV TFIJOHHB USBOTLSJQTJ 3/" TFCBHJBO EBQBU
TFCFMVN NBVQVO TFUFMBI HFO ZBOH EJBUVS .FTLJQVO QFOHVBU CFSMBOHTVOH .FTLJQVO EFNJLJBO GBLUPS USBOTLSJQTJ TQFTJGJL
EBQBUUFSMFUBLQBEBKBSBLZBOHTBOHBUKBVIEBSJHFOTBTBSBOOZB BLBO NFOHFOEBMJLBO LFDFQBUBO USBOTLSJQTJ NFMBMVJ QSPNPUPS
QFOHVBUEBQBUUFSMFUBLSFMBUJGEFLBUEBSJHFOTBTBSBOOZBLFUJLB EBMBN LSPNPTPN +BEJ UFSEBQBU QFOHFOEBMJBO QBEB UJOHLBU ZBOH
%/" EBMBN LFBEBBO CFSHFMVOH EBMBN OVLMFVT %JQFSLJSBLBO MFCJI UJOHHJ ZBOH EJHVOBLBO VOUVL NFOHIBTJMLBO GVOHTJ TFM ZBOH
UFSEBQBUVSVUBOHFOQFOHVBUEBMBNHFOPNNBOVTJB TFTVBJ 4FMBJO JUV TJOZBMTJOZBM EBSJ MVBS TFM TFQFSUJ CFCFSBQB
IPSNPO UVCVI EBQBU NFOHBLUJGLBO BSFB LSPNPTPN TQFTJGJL EBO
%BMBN TVTVOBO LSPNPTPN BEBMBI QFOUJOH VOUVL
GBLUPS USBOTLSJQTJ TQFTJGJL TFIJOHHB EBQBU NFOHFOEBMJLBO NFTJO
NFNJTBILBOHFOBLUJGZBOHTFEBOHEJUSBOTLSJQTJEBSJHFOZBOH
LJNJBXJVOUVLGVOHTJTFM
EJUFLBO )BM JOJ EBQBU NFOKBEJ TVMJU LBSFOB CFCFSBQB HFO
NVOHLJO UFSMFUBL CFSEFLBUBO QBEB LSPNPTPN )BM JOJ EJDBQBJ 0MFI LBSFOB UFSEBQBU MFCJI EBSJ HFO ZBOH CFSCFEB EJ
EBMBN TFUJBQ TFM NBOVTJB NBLB UJEBL NFOHIFSBOLBO CJMB
EFOHBO JOTVMBUPS LSPNPTPN *OTVMBUPS JOJ NFSVQBLBO VSVUBO
EJUFNVLBO TFKVNMBI CFTBS DBSB QFOHBUVSBO BLUJWJUBT HFOFUJL
HFO ZBOH NFOHIBTJMLBO QFOHIBMBOH TFIJOHHB HFO UFSUFOUV
4JTUFN QFOHBUVSBO HFO TBOHBU QFOUJOH VOUVL NFOHFOEBMJLBO
EJJTPMBTJ UFSIBEBQ QFOHBSVI USBOTLSJQTJ HFO TFLJUBSOZB
LPOTFOUSBTJ BTBN BNJOP JOUSBTFM UVSVOBO BTBN BNJOP EBO
*OTVMBUPS EBQBU TBOHBU CFSWBSJBTJ EBMBN VSVUBO %/" OZB EBO
TVCTUSBU BOUBSB TFSUB QSPEVL NFUBCPMJTNF LBSCPIJESBU MJQJE EBO
EBMBN QSPUFJO ZBOH CFSJLBUBO EFOHBO NFSFLB 4BMBI TBUV DBSB
QSPUFJO
LFHJBUBO JOTVMBUPS EBQBU EJVCBI BEBMBI EFOHBO NFUJMBTJ %/"
*OJBEBMBIDPOUPINBNBMJB"MFMJCVNFNJMJLJJOTVMBUPSBOUBSB
Pengendalian Fungsi Intraselular melalui Pengaturan Enzim
QFOHVBU EBO QSPNPUPS EBSJ HFO ZBOH NFNVOHLJOLBO
4FMBJO QFOHFOEBMJBO GVOHTJ TFM PMFI QFOHBUVSBO HFOUJL CFCFSBQB
UFSKBEJOZB QFOHJLBUBO QFOFLBO USBOTLSJQTJ /BNVO VSVUBO
BLUJWJUBT TFM EJLFOEBMJLBO PMFI QFOHIBNCBU BUBV QFOHBLUJG
%/"BZBIUFSNFUJMBTJTFIJOHHBQFOFLBOUSBOTLSJQTJUJEBLEBQBU
JOUSBTFMVMBS ZBOH CFLFSKB TFDBSB MBOHTVOH QBEB FO[JN JOUSBTFMVMBS
CFSJLBUBO EFOHBO JTPMBUPS EBO HFO *(' EJFLTQSFTJLBO EBSJ
TQFTJGJL +BEJ QFOHBUVSBO FO[JN NFXBLJMJ LBUFHPSJ LFEVB EBSJ
TBMJOBOHFOBZBI
NFLBOJTNFZBOHNFOHBUVSGVOHTJCJPLJNJBTFM
Mekanisme lain untuk Pengendalian Transkripsi oleh Penghambatan Enzim 4FCBHJBO [BU LJNJB ZBOH EJCFOUVL EJ
Promotor. 7BSJBTJ NFLBOJTNF EBTBS VOUVL NFOHFOEBMJLBO EBMBN TFM NFNQVOZBJ FGFL VNQBO CBMJL MBOHTVOH EBMBN
QSPNPUPS UFMBI EJUFNVLBO EFOHBO DFQBU QBEB EVB EFLBEF NFOHIBNCBU TJTUFN FO[JN TQFTJGJL ZBOH NFOZJOUFTJT [BU LJNJB
UFSBLIJS JOJ 5BOQB NFOKBEJ UFSMBMV EFUBJM NBSJ LJUB MJIBU UFSTFCVU 1SPEVLQSPEVL TJOUFTJT UFSTFCVU IBNQJS TFMBMV CFLFSKB
CFCFSBQBEJBOUBSBOZB QBEB FO[JN ZBOH UFSMFUBL QBEB VSVUBO QFSUBNB EBSJ TVBUV
. 4FCVBIQSPNPUPSTFSJOHEJLFOEBMJLBOPMFIGBLUPSUSBOTLSJQTJ SBOHLBJBO EBOCVLBOQBEBFO[JNZBOHCFSJLVUOZB CJBTBOZBTFMBMV
ZBOH UFSMFUBL EJ UFNQBU MBJO EBMBN HFOPN "SUJOZB HFO CFSJLBUBO TFDBSB MBOHTVOH EFOHBO FO[JN UFSTFCVU EBO
QFOHBUVS NFOZFCBCLBO QFNCFOUVLBO TFCVBI QSPUFJO NFOZFCBCLBO QFSVCBIBO CFOUVL BMPTUFSJL ZBOH BLBO
QFOHBUVS ZBOH TFMBOKVUOZB CFSUJOEBL TFCBHBJ QFOHBLUJG BUBV NFOHJOBLUJGLBO FO[JN UFSTFCVU 4FTFPSBOH EFOHBO NVEBI EBQBU
QFOFLBOUSBOTLSJQTJ NFNBIBNJ NBOGBBU QSPTFT QFOHJOBLUJGLBO FO[JN QFSUBNB
. ,BEBOH CBOZBLQSPNPUPSZBOHCFSCFEBEJLFOEBMJLBOQBEB UFSTFCVU QFOHJOBLUJGLBO UFSTFCVU BLBO NFODFHBI QFOVNQVLBO
XBLUV ZBOH TBNB PMFI QSPUFJO QFOHBUVS ZBOH TBNB 1BEB QFNCFOUVLBOQSPEVLQSPEVLBOUBSBZBOHUJEBLCFSHVOB
CFCFSBQB LFBEBBO QSPUFJO QFOHBUVS ZBOH TBNB CFSGVOHTJ 1SPTFT QFOHIBNCBUBO FO[JN NFSVQBLBO TFCVBI DPOUPI MBJO
TFCBHBJ QFOHBLUJG VOUVL TBUV QSPNPUPS EBO TFCBHBJ EBSJ QFOHBUVSBO VNQBO CBMJL OFHBUJG QSPTFT JOJ CFSUBOHHVOH
QFOHIBNCBUVOUVLQSPNPUPSZBOHMBJO KBXBC NFOHBUVS LPOTFOUSBTJ JOUSBTFMVMBS CFSCBHBJ BTBN BNJOP
. #FCFSBQB QSPUFJO UJEBL EJLFOEBMJLBO QBEB UJUJL BXBM QVSJO QJSJNJEO WJUBNJOWJUBNJOEBO[BU[BUMBJOOZB
USBOTLSJQTJ EJ VOUBJ %/" UFUBQJ MFCJI KBVI EJ TFQBOKBOH Pengaktifkan Enzim. &O[JNFO[JNZBOHOPSNBMOZBUJEBLBLUJG
VOUBJ,BEBOHQFOHFOEBMJBOCBILBOUJEBLUFSKBEJQBEBVOUBJ TFSJOH EBQBU EJBLUJGLBO CJMB EJCVUVILBO 4FCVBI DPOUPI EBSJ IBM
%/" JUV TOFEJSJ UFUBQJ TBBU QFNSPTFTBO NPMFLVM 3/" EJ UFSTFCVUUFSKBEJTBBUTFCBHJBOCFTBS"51UFMBICFSLVSBOHEJEBMBN
EBMBN OVLMFVT TFCFMVN EJMFQBTLBO LF EBMBN TJUPQMBTNB TFM 1BEB LFBEBBO JOJ BEFOPTJO NPOPGPTGBU TJLMJL D".1
EBMBN
MFCJIKBSBOHMBHJ QFOHFOEBMJBONVOHLJOUFSKBEJQBEBUBIBQ KVNMBI CFSNBLOB NVMBJ EJCFOUVL TFCBHBJ IBTJM QFNFDBIBO "51
QFNCFOUVLBO QSPUFJO EJ EBMBN TJUPQMBTNB TFMBNB USBOTMBTJ BEBOZB D".1 JOJ TFMBOKVUOZB EFOHBO DFQBU NFOHBLUJGLBO FO[JN
3/"PMFISJCPTPN QFNFDBI HMJLPHFO GPTGPSJMBTF NFNCFCBTLBO NPMFLVM HMVLPTB
. 1BEB TFMTFM ZBOH CFSJOUJ %/" JOJUJ EJLFNBT EBMBN VOJU ZBOHEFOHBODFQBUEJNFUBCPMJTNFEBOFOFSHJOZBEJHVOBLBOVOUVL
TUSVLUVSBMZBOHTQFTJGJL LSPNPTPN%BMBNTFUJBQLSPNPTPN NFOHJTJ LFNCBMJ DBEBOHBO "51 +BEJ D".1 CFLFSKB TFCBHBJ
%/"EJMJMJUEJTFLJUBSQSPUFJOLFDJMZBOHEJTFCVUIJTUPO ZBOH QFOHBLUJG FO[JN VOUVL FO[JN GPTGPSJMBTF EBO PMFI LBSFOBOZB
TFMBOKVUOZBEJJLBUEFOHBOLVBUCFSTBNBTBNBNFOKBEJQBEBU NFNCBOUVNFOHFOEBMJLBOLPOTFOUSBTJ"51JOUSBTFMVMBS
36
4FCVBI DPOUPI NFOBSJL MBJO NFOHFOBJ QFOHIBNCBUBO FO[JN

EBO QFOHBLUJGLBO FO[JN UFSKBEJ QBEB QFNCFOUVLBO QVSJO EBO
QJSJNJEJO ;BU[BU JOJ EJQFSMVLBO TFM EBMBN KVNMBI ZBOH LVSBOH
MFCJI TBNB VOUVL QFNCFOUVLBO %/" EBO 3/" #JMB QVSJO
EJCFOUVL QVSJO NFOHIBNCBU FO[JN ZBOH EJCVUVILBO VOUVL
QFNCFOUVLBO QVSJO UBNCBIBO "LBO UFUBQJ QVSJO UFSTFCVU
UNIT I
NFOHBLUJGLBO FO[JNFO[JN VOUVL QFNCFOUVLBO QJSJNJEJO
4FCBMJLOZB QJSJNJEJO NFOHIBNCBU FO[JNOZB TFOEJSJ UFUBQJ
NFOHBLUJGLBO FO[JN QVSJO %FOHBO DBSB JOJ UFSEBQBU TVBUV
QSPTFT CFSLFMBOKVUBO ZBOH TBMJOH NFOVOKBOH BOUBSB TJTUFN
QFNCFOUVLBO VOUVL LFEVB [BU JOJ EBO NFOHIBTJMLBO KVNMBI
LFEVB[BUZBOHIBNQJSTBNBEJEBMBNTFMTFQBOKBOHXBLUV
Ringkasan 3JOHLBTBOOZB BEB EVB NFUPEF VUBNB CBHJ TFM

VOUVL NFOHFOEBMJLBO QSPQPSTJ EBO KVNMBI ZBOH UFQBU EBSJ
CFSCBHBJ VOTVS TFM ZBOH CFSCFEB
NFLBOJTNF QFOHBUVSBO
HFOFUJL EBO
NFLBOJTNF QFOHBUVSBO FO[JN (FO EBQBU
EJBLUJGLBOBUBVEJIBNCBUEBOTJTUFNFO[JNKVHBEBQBUEJBLUJGLBO
BUBVQVO EJIBNCBU .FLBOJTNF QFOHBUVSBO JOJ QBMJOH TFSJOH
CFSGVOHTJ TFCBHBJ TJTUFN QFOHFOEBMJBO VNQBO CBMJL ZBOH TFDBSB
UFSVTNFOFSVT NFOHBXBTJ LPNQPTJTJ CJPLJNJBXJ TFM EBO
NFNCVBU QFSCBJLBO ZBOH EJQFSMVLBO 5FUBQJ LBEBOH LBMB [BU
ZBOH CVLBO CFSBTBM EBSJ TFM UFSVUBNB CFCFSBQB IPSNPO ZBOH
EJCBIBT EBMBN CVLV JOJ
KVHB NFOHFOEBMJLBO SFBLTJ CJPLJNJB
JOUSBTFMVMBS EFOHBO NFOHBLUJGLBO BUBV NFOHIBNCBU TBUV BUBV
MFCJITJTUFNQFOHBUVSBOJOUSBTFMVMBS
Sistem Genetik DNA juga Mengendalikan Reproduksi Sel
3FQSPEVLTJ TFM NFSVQBLBO TVBUV DPOUPI MBJO EBSJ QFSBO ZBOH

EJNBJOLBO PMFI TJTUFN HFOFUJL %/" EJ TFMVSVI QSPTFT
LFIJEVQBO (FO EBO NFLBOJTNF QFOHBUVSBOOZB NFOFOUVLBO
LBSBLUFSJTUJL QFSUVNCVIBO TFM EBO KVHB XBLUV BUBV BQBLBI TFM
TJLMVT IJEVQ ZBOH CFSWBSJBTJ EBSJIBOZB TFLJUBS KBN VOUVL
BLBONFNCFMBIEJSJVOUVLNFNCFOUVLTFMTFMCBSV%FOHBODBSB
TFMTFM TVNTVN UVMBOH ZBOH TBOHBUUFSBOHTBOH TBNQBJTFMVSVI
JOJ TFNVB TJTUFN HFOFUJL ZBOH QFOUJOH EBQBU NFOHFOEBMJLBO NBTBIJEVQUVCVINBOVTJBVOUVLTFMTBSBG
TFUJBQ UBIBQ QFSLFNCBOHBO NBOVTJB NVMBJ EBSJ TFM UVOHHBM
PWVN ZBOH TVEBI EJCVBIJ TBNQBJ LFTFMVSVIBO UVCVI ZBOH Reproduksi Sel Dimulai dengan Replikasi DNA
CFSGVOHTJ+BEJ CJMBBEBUFNBEBTBSLFIJEVQBO NBLBUFNBEBTBS 4FQFSUJ IBMOZB IBNQJS TFNVB QFSJTUJXB QFOUJOH MBJO EBMBN TFM
JUVBEBMBITJTUFN%/"HFOFUJL SFQSPEVLTJCFSBXBMEBMBNJOUJJUVTFOEJSJ5BIBQQFSUBNBBEBMBI
Siklus Kehidupan Sel 4JLMVT LFIJEVQBO TFM BEBMBI QFSJPEF SFQMJLBTJ EVQMJLBTJ
TFNVB %/" EJ EBMBN LSPNPTPN )BOZB
EBSJ SFQSPEVLTJ TFM TBNQBJ SFQSPEVLTJ TFM CFSJLVUOZB #JMB TFM TFUFMBIUBIBQJOJEJMBMVJNJUPTJTEBQBUCFSMBOHTVOH
NBNBMJBUJEBLEJIBNCBUEBOEJQSPEVLTJTFDFQBULFNBNQVBOOZB %/" NVMBJ CFSEVQMJLBTJ TBNQBJ KBN TFCFMVN NJUPTJT
TJLMVT LFIJEVQBO JOJ EBQBU CFSMBOHTVOH TBNQBJ TFTJOHLBU EBO QSPTFT JOJ EJTFMFTBJLBO EBMBN XBLUV TBNQBJ KBN )BTJM
TBNQBJ KBN 4JLMVT LFIJEVQBO TFM JOJ EJIFOUJLBO PMFI BLIJS EBSJ QSPTFT JOJ BEBMBI EVB TBMJOBO ZBOH QFSTJT TBNB EBSJ
TFSBOHLBJBO LFKBEJBO GJTJL ZBOH LIBT ZBOH EJTFCVU NJUPTJT ZBOH TFNVB%/"4BMJOBOJOJTFMBOKVUOZBNFOKBEJ%/"EBMBNLFEVB
NFOZFCBCLBO QFNCBHJBO TFM NFOKBEJ EVB TFM BOBL CBSV TFMBOBLZBOHBLBOUFSCFOUVLTFXBLUVNJUPTJT4FUFMBISFQMJLBTJ
1FSJTUJXB NJUPTJT JOJ EJQFSMJIBULBO PMFI (BNCBS EBO BLBO %/" UFSEBQBUQFSJPEFTBNQBJKBNTFCFMVNNJUPTJTEJNVMBJ
EJKFMBTLBO LFNVEJBO "LBO UFUBQJ UBIBQ NJUPTJT ZBOH TFDBSB UJCBUJCB #BILBO TFMBNB QFSJPEF JOJ QFSVCBIBO
TFTVOHHVIOZB CFSMBOHTVOH IBOZB TFLJUBS NFOJU TFIJOHHB QFSVCBIBO BXBM ZBOH LBO NFOZFCBCLBO QSPTFT NJUPTJT TVEBI
MFCJI EBSJ QFSTFO TJLMVT LFIJEVQBO TFM ZBOH CBILBO NVMBJCFSMBOHTVOH
CFSFQSPEVLTJ EFOHBO DFQBU QVO EJXBLJMJ PMFI JOUFSWBM EJ BOUBSB Peristiwa Kimiawi dan Fisis pada Replikasi DNA %/"
NJUPTJT ZBOHEJTFCVUJOUFSGBTF EJSFQMJLBTJ EFOHBO DBSB IBNQJS TBNB EFOHBO USBOTLSJQTJ 3/"
,FDVBMJQBEBLFBEBBOLIVTVTSFQSPEVLTJTFMZBOHDFQBU GBLUPS TFCBHBJ SFTQPOT UFSIBEBQ %/" LFDVBMJ VOUVL CFCFSBQB
GBLUPS QFOHIBNCBU IBNQJS TFMBMV NFNQFSMBNCBU BUBV QFSCFEBBOQFOUJOH
NFOHIFOUJLBOTJLMVTIJTVQTFMZBOHUJEBLUFSIBNCBU0MFILBSFOB ,FEVBVOUBJ%/"EJTFUJBQLSPNPTPNEJSFQMJLBTJ UJEBLIBOZB
JUV CFSCBHBJTFMUVCVIZBOHCFSCFEBTFCFOBSOZBNFNJMJLJQFSJPEF TBUVVOUBJBOTBKB
37
. ,FEVBVOUBJIFMJLT%/"TFMVSVIOZBEJSFQMJLBTJEBSJVKVOHLF Kromosom dan Replikasinya

VKVOH EBO CVLBO IBOZB CFCFSBQB CBHBJBO EBSJ VOUBJBO )FMJLT%/"EBMBNOVLMFVTEJLFNBTEBMBNLSPNPTP4FMNBOVTJB
TFQFSUJZBOHUFSKBEJQBEBUSBOTLSJQTJ3/" NFOHBOEVOH LSPNPTPN ZBOH UFSEJSJ BUBT QBTBOH
. &O[JN VUBNB VOUVL SFQMJLBTJ %/" BEBMBI TFCVBI LPNQMFLT ,FCBOZBLBO HFO EBMBN LFEVB LSPNPTPN EBSJ TFUJBQ QBTBOH
EBSJ CFSCBHBJ FO[JN ZBOH EJTFCVU %/" QPMJNFSBTF ZBOH UFSTFCVU JEFOUJL BUBV IBNQJS JEFOUJL TBUV TBNB MBJOOZB TFIJOHHB
TFCBOEJOHEFOHBO3/"QPMJNFSBTF%/"QPMJNFSBTFNFMFLBU CJBTBOZB EJBOHHBQ CBIXB HFO ZBOH CFSCFEB KVHB UFSEBQBU EBMBN
EBO CFSHFSBL TFQBOKBOH VOUBJBO DFUBLBO %/" TFNFOUBSB QBTBOHBO XBMBVQVOLBEBOHLBEBOHQFSOZBUBBOJOJUJEBLUFQBU
FO[JN MBJO %/" MJHBTF NFOZFCBCLBO QFOHJLBUBO OVLMFPUJEB 4FMBJO%/"EBMBNLSPNPTPNUFSEBQBUTFKVNMBICFTBSQSPUFJO
%/"CFSJLVUOZBTBUVTBNBMBJO EFOHBONFOHHVOBLBOJLBUBO ZBOH UFSVUBNB UFSTVTVO BUBT CBOZBL NPMFLVM LFDJM CFSNVBUBO
GJTGBUCFSFOFSHJUJOHHJVOUVLNFNQFSLVBUQFSMFLBUBOUFSTFCVU QPTJUJGZBOHEJTFCVUIJTUPO)JTUPOJOJUFSTVTVONFOKBEJJOUJLFDJM
. 1FNCFOUVLBO TFUJBQ VOUBJ %/" CBSV UFSKBEJ TFDBSB ZBOH NFOZFSVQBJ LVNQBSBO 4FHNFO LFDJM TFUJBQ IFMJLT %/"
CFSTBNBBO EBMBN CFSBUVTSBUVT TFHNFO EJ TFQBOKBOH TFUJBQ EJMJMJUTFDBSBCFSVSVUBONFOHFMJMJOHJJOUJTBUVQFSTBUV
EVB VOUBJ IFMJLT TBNQBJ TFMVSVI VOUBJBO EJSFQMJLBTJ *OUJ IJTUPO NFNBJOLBO TFCVBI QFSBO QFOUJOH EBMBN
,FNVEJBO CBHJBOBLIJSTVCVOJUUFSTFCVUEJHBCVOHCFSTBNB QFOHBUVSBO BLUJWJUBT %/" LBSFOB TFMBNB %/" EJLFNBT EFOHBO
TBNBPMFIFO[JN%/"MJHBTF FSBU %/" UJEBL EBQBU CFSGVOHTJ TFCBHBJ DFUBLBO VOUVL
4FUJBQ VOUBJ %/" ZBOH CBSV EJCFOUVL UFUBQ EJMFLBULBO PMFI QFNCFOUVLBO 3/" BUBV SFQMJLBTJ %/" ZBOH CBSV -FCJI MBOKVU
JLBUBO IJESPHFO MPOHHBS EFOHBO VOUBJ %/" BTMJ ZBOH UFMBI CFCFSBQB QSPUFJO QFOHBUVS EBQBU NFSFOHHBOHLBO QFOHFNBTBO
EJHVOBLBO TFCBHBJ DFLBUBO %FOHBO EFNJLJBO LFEVB VOUBJ IJTUPO UFSIBEBQ %/" EBO NFNVOHLJOLBO TFHNFOTFHNFO LFDJM
IFMJLT%/"UFSJLBUCFSTBNB NFNCFOUVL3/"QBEBTBUVXBLUV
,BSFOB IFMJLT %/" EJ TFUJBQ LSPNPTPN CFSVLVSBO TFLJUBS
#FCFSBQBQSPUFJOOPOIJTUPOKVHBNFSVQBLBOLPNQPOFOVUBNB
DN QBOKBOHOZB EBO NFNJMJLJ CFSKVUBKVUB QVUBSBO IFMJLT
LSPNPTPN ZBOH CFSGVOHTJ CBJL TFCBHBJ QSPUFJO TUSVLUVSBM
LFEVBTQJSBM%/"ZBOHCBSVEJCFOUVLUJEBLNVOHLJOUFSVSBJ
LSPNPTPN EBO EBMBN IVCVOHBOOZB EFOHBO NFTJO QFOHBUVS
TBUV TBNB MBJO CJMB UJEBL NFOHHVOLBO NFLBOJTNF LIVTVT
HFOFUJL TFCBHBJQFOHBLUJG QFOHIBNCBUEBOFO[JN
1FOHVSBJBOJOJEBQBUEJDBQBJPMFIFO[JNZBOHTFDBSBQFSJPEJL
4FCVBI QSPTFT SFQMJLBTJ LSPNPTPN UFSKBEJ TFMBNB CFCFSBQB
NFNPUPOH TFUJBQ IFMJLT EJ TFQBOKBOH LFTFMVSVIBOOZB
NFOJUCFSJLVUOZBTFUFMBISFQMJLBTJVOUBJIFMJLT%/"TFMTBJIFMJLT
NFNVUBS TFUJBQ TFHNFO TFIJOHHB DVLVQ VOUVL NFOZFCBCLBO
%/" ZBOH CBSV NFOHVNQVMLBO NPMFLVMNPMFLVM QSPUFJO CBSV
QFNJTBIBO EBO LFNVEJBO NFOZBNCVOH LFNCBMJ IFMJLT
ZBOH EJCVUVILBO ,FEVB LSPNPTPN ZBOH CBSV UFSCFOUVL UFUBQ
UFSTFCVU +BEJ LFEVB IFMJLT ZBOH CBSV EJCFOUVL NFOKBEJ
NFMFLBUTBUVTBNBMBJO TBNQBJXBLUVNJUPTJT
QBEBUFNQBUZBOH
UFSVSBJ
EJTFCVU TFOUSPNFS ZBOH UFSMFUBL EJ EFLBU QVTBUOZB ,SPNPTPN
Perbaikan DNA, "Koreksi-Cetakan Percobaan" DNA, ZBOHTVEBINFOHBMBNJEVQMJLBTJXBMBVNBTJINFMFLBUJOJEJTFCVU
dan "Mutasi". 4FMBNBQFSJPEFTFLJUBSKBNEJBOUBSBSFQMJLBTJ
LSPNBUJE
%/" EBO EJNVMBJOZB NJUPTJT UFSEBQBU TVBUV NBTB UFSKBEJOZB
QFSCBJLBO BLUJG EBO LPSFLTJ DFUBLBO QFSDPCBBO QBEB VOUBJBO
Mitosis Sel
%/" "SUJOZB CJMB BEB OVLMFPUJEB %/" ZBOH EJQBTBOHLBO
1SPTFTQFNJTBIBOTFMNFOKBEJEVBTFMCBSVEJTFCVUTFCBHBJNJUPTJT
TFDBSBUJEBLUFQBUEFOHBOOVLMFPUJEBZBOHUFSEBQBUQBEBVOUBJBO
#FHJUV LSPNPTPN UFMBI CFSFQMJLBTJ NFNCFOUVL EVB LSPNBUJE EJ
BTMJ TVBUV FO[JN LIVTVT BLBO NFNPUPOH EBFSBI ZBOH DBDBU
CBOZBL TFM NJUPTJT BLBO UFSKBEJ TFDBSB PUPNBUJT EBMBN XBLUV
UFSTFCVU EBO NFOHHBOUJLBOOZB EFOHBO OVLMFPUJEB
TBNQBJKBN
LPNQMFNFOUFS ZBOH UFQBU 1SPTFT JOJ EJMBLVLBO PMFI %/"
QPMJNFSBTFEBO%/"MJHBTFZBOHTBNBZBOHEJQBLBJQBEBQSPTFT Aparatus Mitosis: Fungsi Sentriol. 4BMBITBUVQFSJTUJXBBXBM
SFQMJLBTJ 1SPTFT QFSCBJLBO JOJ EJTFCVU TFCBHBJ LPSFLTJ DFUBLBO EBSJ QSPTFT NJUPTJT ZBOH UFSKBEJ QBEB TJUPQMBTNB UFSKBEJ TFMBNB
QFSDPCBBO%/" CBHJBO BLIJS EBSJ JOUFSGBTF EJ EBMBN BUBV EJ TFLFMJMJOH TUSVLUVS
0MFI LBSFOB QFSCBJLBO EBO LPSFLTJ DFUBL JOJ QSPTFT
TUSVLUVS LFDJM ZBOH EJTFCVU TFCBHBJ TFOUSJPM 4FQFSUJ ZBOH
USBOTLSJQTJKBSBOHTFLBMJNFMBLVLBOLFTBMBIBO5FUBQJCJMBUFSKBEJ
EJQFSMJIBULBO PMFI (BNCBS EVB QBTBOH TFOUSJPM UFSMFUBL
LFTBMBIBO IBM JOJ EJTFCVU TFCBHBJ NVUBTJ .VUBTJ NFOZFCBCLBO
CFSEFLBUBOTBUVTBNBMBJOEFLBUTBMBITBUVLVUVCOVLMFVT4FOUSJPM
QFNCFOUVLBO CFCFSBQB QSPUFJO BCOPSNBM EJ EBMBN TFM EBO JOJ TFQFSUJ%/"EBOLSPNPTPN KVHBEJSFQMJLBTJTFMBNBJOUFSGBTF
CVLBO QFNCFOUVLBO QSPUFJO ZBOH EJCVUVILBO ZBOH TFSJOH LBMJ CJBTBOZB TFHFSB TFCFMVN SFQMJLBTJ %/" 4FUJBQ TFOUSJPM BEBMBI
NFOZFCBCLBOGVOHTJTFMZBOHBCOPSNBM EBOCBILBOLBEBOHLBMB
TVBUV CBEBO TJMJOESJT LFDJM EFOHBO QBOKBOH TFLJUBS MN EBO
NFOZFCBCLBO LFNBUJBO TFM /BNVO LBSFOB BEB BUBV
CFSEJBNFUFS TFLJUBS MN ZBOH UFSVUBNB UFSEJSJ EBSJ BUBT
MFCJIHFOEJEBMBNHFOPNNBOVTJBEBOCBIXBQFSJPEFEBSJTBUV TFNCJMBOTUSVLUVSUVCVMVTQBSBMFM EBOUFSTVTVONFNCFOUVLTVBUV
HFOFSBTJ NBOVTJB LF HFOFSBTJ MBJO LJSBLJSB UBIVO TFTFPSBOH TJMJOEFS ,FEVB TFOUSJPM EBSJ TFUJBQ QBTBOH LSPNPTPN UFSMFUBL
BLBO NFOEBQBULBO NVUBTJ TFCBOZBL LBMJ BUBV MFCJI EBMBN UFHBLMVSVTTBUVTBNBMBJO4FUJBQQBEBOHTFOUSJPM CFSTBNBEFOHBO
QFXBSJTBO HFOPN UFSTFCVU EBSJ PSBOH UVB LF BOBL "LBO UFUBQJ NBUFSJQFSJTFOUSJPMZBOHNFMFLBU EJTFCVUTFCBHBJTFOUSPTPN
LBSFOB NBTJI BEB QFSMJOEVOHBO MFCJI MBOKVU TFUJBQ HFOPN
4FHFSBTFCFMVNNJUPTJTCFSMBOHTVOH LFEVBQBTBOHTFOUSJPMNVMBJ
NBOVTJB EJXBLJMJ PMFI EVB TFU LSPNPTPN ZBOH UFSQJTBI EFOHBO
CFSHFSBL NFOKBVIJ TBUV TBNB MBJO )BM JOJ EJTFCBCLBO PMFI
HFO ZBOH IBNQJS JEFOUJL 0MFI LBSFOB JUV TBUV HFO GVOHTJPOBM
QPMJNFSBTJ QSPUFJO NJLSPUVCVMVT ZBOH UVNCVI EJ BOUBSB LFEVB
EBSJTFUJBQQBTBOHLSPNPTPNIBNQJSTFMBMVUFSTFEJBVOUVLBOBL
QBTBOHBOTFOUSJPMEBONFOEPSPOHLFEVBTFOUSJPMUFSTFCVUNFOKBVIJ
XBMBVQVOBEBNVUBTJ
38
TBUVTBNBMBJO1BEBXBLUVZBOHTBNB NJLSPUVCVMVTMBJOUVNCVI Pengendalian Pertumbuhan Sel dan Reproduksi Sel

TFDBSB SBEJBM NFOKBVIJ TFUJBQ QBTBOH TFOUSJPM NFNCFOUVL TVBUV ,JUB NFOHFUBIVJ CBIXB TFMTFM UFSUFOUV UVNCVI EBO
CJOUBOH CFSEVSJ EJTFCVU BTUFS EJ TFUJBQ VKVOH TFM #FCFSBQB EVSJ CFSFQSPEVLTJ TFUJBQ XBLUV TFQFSUJ TFMTFM QFNCFOUVL EBSBI
TUFS NFOFNCVT OVLMFVT EBO NFNJTBILBO LFEVB TFU LSPNBUJE QBEB TVNTVN UVMBH MBQJTBO HFSNJOBUJWVN LVMJU EBO FQJUFM
TFMBNB NJUPTJT ,PNQMFLT NJLSPUVCVMVT ZBOH NFNBOKBOH EJ VTVT "LBO UFUBQJ CBOZBL TFM MBJO TFQFSUJ TFM PUPU QPMPT UJEBL
BOUBSB LFEVB QBTBOH TFOUSJPM EJTFCVU HFMFOEPOH EBO TFMVSVI CFSFQSPEVLTJ TFMBNB CFSUBIVOUBIVO #FCFSBQB TFM TFQFSUJ
UNIT I
QFSBOHLBU NJLSPUVCVMVT EJUBNCBI EVB QBTBOH TFOUSJPM EJTFCVU OFVSPO EBO TFCBHJBO CFTBS TFM PUPU MVSJL UJEBL CFSFQSPEVLTJ
CBEBONJUPTJT TFQBOKBOH LFIJEVQBO TFTFPSBOH LFDVBMJ QBEB BXBM LFIJEVQBO
GFUVT
Profase. 5BIBQ QFSUBNB NJUPSJT ZBOH EJTFCVU QSPGBTF %J CFCFSBQB KBSJOHBO LFUJEBLDVLVQBO CFCFSBQB KFOJT TFM
EJQFSMJIBULBO PMFI (BNCBS " # EBO $ 4FXBLUV HFMFOEPOH NFOZFCBCLBO TFMTFM JOJ UVNCVI EBO CFSFQSPEVLTJ EFOHBO
TFEBOH EJCFOUVL LSPNPTPN EBMBN OVLMFVT ZBOH EBMBN GBTF DFQBU TBNQBJ KVNMBI TFM ZBOH TFTVBJ UFSTFEJB LFNCBMJ 4FCBHBJ
JOUFSGBTF UFSEJSJ BUBT VOUBJBO LVNQBSBO MPOHHBS
EJQBEBULBO DPOUPI QBEB CFCFSBQB IFXBO NVEB UVKVIQFSEFMBQBO IBUJ
NFOKBEJCFOUVLLSPNPTPNZBOHMFCJINBOUBQ EBQBUEJBOHLBUNFMBMVJQFNCFEBIBOEBOTFQFSEFMBQBOTFMZBOH
UFSTJTBBLBOUVNCVIEBONFNCFMBITBNQBJNBTTBIBUJLFNCBMJ
Prometafase. 4FMBNB GBTF JOJ MJIBU (BNCBS %
EVSJ NFOEFLBUJ OPSNBM )BM ZBOH TBNB UFSKBEJ QBEB CBOZBL TFM
EVSJ NJLSPUVCVMVT EBSJ BTUFS ZBOH TFEBOH UVNCVI NFNFDBI LFMFOKBS EBO TFCBHJBO CFTBS TFM TVNTVN UVMBOH KBSJOHBO
TFMVCVOHJOUJ1BEBXBLUVZBOHTBNB CFCFSBQBNJLSPUVCVMVTEBSJ TVCLVUBO FQJUFMJOUFTUJOBM EBOIBNQJSKBSJOHBOMBJONBOBQVO
BTUFSNFMFLBUQBEBLSPNBUJEEJTFOUSPNFS UFNQBULSPNBUJEZBOH LFDVBMJ TFM ZBOH CFSEJGFSFOTJBTJ UJOHHJ TFQFSUJ TFM TBSBG EBO TFM
CFSQBTBOHBO NBTJI CFSJLBUBO TBUV TBNB MBJO UVCVMVT LFNVEJBO PUPU
NFOBSJL TBUV LSPNBUJE EBSJ TFUJBQ QBTBOH LSPNBUJE NFOVKV TBUV ,JUB IBOZB NFOHFUBIVJ TFEJLJU NFOHFOBJ NFLBOJTNF ZBOH
LVUVCTFMEBOQTBOHBOOZBNFOVKVLVUVCZBOHCFSMBXBOBO NFNQFSUBIBOLBOKVNMBICFSCBHBJKFOJTTFMZBOHCFSCFEBEBMBN
UVCVIEFOHBOUFQBU"LBOUFUBQJ QFOFMJUJBOUFMBINFOVOKVLLBO
Metafase. 4FMBNBNFUBGBTF MJIBU(BNCBS&
LFEVBBTUFS TFUJEBLOZB UJHB DBSB NFOHFOEBMJLBO QFSUVNCVIBO 1FSUBNB
EBSJ BQBSBUVT NJUPTJT BLBO EJEPSPOH MFCJI KBVI MBHJ ,FBEBBO JOJ QFSUVNCVIBO TFSJOH EJLFOEBMJLBO PMFI GBLUPSGBLUPS
EJZBLJOJ UFSKBEJ LBSFOB EVSJEVSJ NJLSPUVCVMVT EBSJ LFEVB BTUFS QFSUVNCVIBO ZBOH CFSBTBM EBSJ CBHJBO UVCVI ZBOH MBJO
EJ UFNQBU EVSJEVSJ UFSTFCVU TBMJOH UFSLBJU TBUV TBNB MBJO VOUVL #FCFSBQB GBLUPS QFSUVNCVIBO JOJ CFSTJSLVMBTJ EBMBN EBSBI
NFNCFOUVL HFMFOEPOH NJUPTJT TFCFOBSOZB TBMJOH NFOEPSPOH UFUBQJ ZBOH MBJO CFSBTBM EBSJ KBSJOHBO ZBOH CFSEFLBUBO 4FCBHBJ
NFOKBVIJ TBUV TBNB MBJO "EB BMBTBO VOUVL NFNQFSDBZBJ CBIXB DPOUPI TFMFQJUFMEBSJCFCFSBQBLFMFOKBS TFQFSUJQBOLSFBT HBHBM
NPMFLVMNPMFLVMLFDJMQSPUFJOLPOUSBLUJMZBOHEJTFCVUQFOHHFSBL UVNCVI UBOQB GBLUPS QFSUVNCVIBO EBSJ KBSJOHBO JLBU ZBOH
NPMFLVMFS ZBOH NVOHLJO UFSTVTVO BUBT QSPUFJO PUPU BLUJO UFSMFUBL EJ CBXBI LFMFOKBS ,FEVB TFCBHJBO CFTBS TFM CFSIFOUJ
NFNBOKBOH EJ BOUBSB EVB EVSJ ZBOH CFSVSVUBO EBO EFOHBO UVNCVI CJMB TFM UFSTFCVU LFIBCJTBO SVBOH VOUVL UVNCVI
NFOHHVOBLBO LFSKB CFSUBIBQ TFQFSUJ EJ PUPU TFDBSB BLUJG ,FBEBBO JOJ UFSKBEJ TBBU TFM UVNCVI EBMBN LVMUVS KBSJOHBO TFM
NFOHHFTFS EVSJ LF BSBI ZBOH CFSMBXBOBO TBUV TBNB MBJO 4FDBSB UVNCVI TBNQBJ TFM CFSLPOUBL EFOHBO CFOEB QBEBU EBO
CFSTBNBBO LSPNBUJE EJUBSJL EFOHBO LVBU PMFI NJLSPUVCVMVT LF LFNVEJBO QFSUVNCVIBO UFSIFOUJ ,FUJHB TFM ZBOH UVNCVI
CBHJBO QVTBU TFM CFSCBSJT VOUVL NFNCFOUVL MFNQFOH FLVBUPSJBM EBMBN LVMUVS KBSJOHBO TFSJOH CFSIFOUJ UVNCVI CJMB TFKVNMBI
HFMFOEPOHNJUPTJT LFDJM TFLSFTJ TFM JUV TFOEJSJ UFSLVNQVM EBMBN NFEJVN LVMUVS
,FBEBBO JOJ KVHB EBQBU NFOKBEJ TVBUV DBSB VOUVL NFOHBUVS
Anafase. 1BEBGBTFJOJ MJIBU(BNCBS'
LFEVBLSPNBUJE QFSUVNCVIBONFMBMVJVNQBOCBMJLOFHBUJG
EBSJTFUJBQLSPNPTPNEJUBSJLUFSQJTBIQBEBTFOUSPNFS4FNVB Pengaturan Ukuran Sel. 6LVSBO TFM EJUFOUVLBO IBNQJS
QBTBOH LSPNBUJE EJQJTBILBO NFNCFOUVL EVB TFU LSPNPTPN TFMVSVIOZBPMFIKVNMBI%/"ZBOHCFSGVOHTJEJEBMBNOVLMFVT
BOBL ZBOH UFSQJTBI 4BMBI TBUV TFU JOJ EJUBSJL NFOVKV TBUV BTUFS #JMB SFQMJLBTJ %/" UJEBL UFSKBEJ TFM UVNCVI TBNQBJ VLVSBO
NJUPUJLEBOTFUMBJONFOVKVBTUFSZBOHMBJOTFXBLUVLFEVBLVUVC UFSUFOUV EBO TFMBOKVUOZB CFSUBIBO QBEB VLVSBO UFSTFCVU
TFMZBOHNFNCFMBIEJEPSPOHNFOKBVI TFCBMJLOZB EFOHBO NFOHHVOBLBO [BS LJNJB LPMLJTJO
QFODFHBIBO QFNCFOUVLBO HFMFOEPOH NJUPTJT EBQBU
Telofase. 1BEBUFMPGBTF MJIBU(BNCBS(EBO)
LFEVBTFU EJNVOHLJOLBO EBO PMFI LBSFOB JUV EBQBU NFODFHBI NJUPTJT
LSPNPTPN BOBL EJUBSJL NFOKBVI TFQFOVIOZB ,FNVEJBO XBMBVQVO SFQMJLBTJ %/" CFSMBOKVU UFSVT 1BEB LFKBEJBO JOJ
BQBSBUVTNJUPTJTNFOHIJMBOH EBOTFCVBINFNCSBOOVLMFVTZBOH OVLMFVT NFOHBOEVOH KVNMBI %/" ZBOH KBVI MFCJI CFTBS EBSJ
CBSV UFSCFOUVL EJ TFLJUBS TFUJBQ TFU LSPNPTPN .FNCSBO JOJ KVNMBI OPSNBM EBO TFDBSB QSPQPSTJPOBM TFM UVNCVI MFCJI
EJCFOUVLEBSJCBHJBOSFUJLVMVNFOEPQMBTNBZBOHTVEBIUFSEBQBU CFTBS %JEVHB CBIXB LFBEBBO JOJ TFNBUBNBUB UFSKBEJ BLJCBU
EJ EBMBN TJUPQMBTNB 4FHFSB TFUFMBI JUV TFM BLBO UFSKFQJU QBEB QFOJOHLBUBO QSPEVLTJ 3/" EBO QSPUFJO TFM ZBOH TFMBOKVUOZB
CBHBJO QFSUFOHBIBO EJ BOUBSB LFEVB OVLMFVT 1SPTFT JOJ BLBONFOZFCBCLBOTFMUVNCVIMFCJICFTBS
EJTFCBCLBO PMFI UFSCFOUVLOZB DJODJO LPOUSBLUJM NJLSPGJMBNFO Diferensiasi Sel
ZBOH UFSTVTVO BUBT BLUJO EBO NVOHLJO NJPTJO EVB QSPUFJO
LPOUSBLUJMPUPU
QBEBQFSTJNQBOHBOTFMZBOHCBSVUFSCFOUVL ZBOH 4JGBU LIVTVT QFSUVNCVIBO TFM EBO QFNCFMBIBO TFM BEBMBI
NFOKFQJUOVLMFVTEBONFNJTBILBOOZBTBUVTBNBMBJO EJGFSFOTJBTJTFM ZBOHNFOHBDVQBEBQFSVCBIBOTJGBUGJTJLEBO
39
GVOHTJ TFM TFJSJOH EFOHBO QSPMJGFSTJ TFM EBMBN FNCSJP VOUVL ,FCBMJLBO EFOHBO LFNUBJBO ZBOH UFSQSPHSBN TFM ZBOH NBUJ
NFNCFOUVL TUSVLUVS EBO PSHBO UVCVI ZBOH CFSCFEB BLJCBU KFKBT BLVU CJBTBOZB NFNCFOHLBL EBO QFDBI BLJCBU
CFEB1FOKFMBTBO EBSJ TVBUV QFSDPCBBO ZBOH NFOBSJL CFSJLVU IJMBOHOZBLFVUVIBONFNCSBO TVBUVQSPTFTZBOHEJTFCVUOFLSPTJT
BLBONFNCBOUVNFOKFMBTLBOQSPTFTUFSTFCVU TFM 4FM ZBOH OFLSPUJL EBQBU NFOHFMVBSLBO JTJ TFMOZB
,FUJLB JOUJ EBSJ TFCVBI TFM NVLPTB VTVT LPEPL EJJNQMBOUBTJ NFOZFCBCLBOJOGMBNBTJEBOKFKBTLFTFMZBOHCFSEFLBUBO/BNVO
NFMBMVJ QFNCFEBIBO LF EBMBN PWVN LPEPL EFOHBO JOUJ PWVN BQPQUPTJT BEBMBI LFNBUJBO TFM UFSBUVS ZBOH NFOHIBTJMLBO
BTMJ ZBOH UFMBI EJBOHLBU IBTJMOZB BEBMBI QFNCFOUVLBO LPEPL QFOHIBODVSBOEBOGBHPTJUPTJTTFMTFCFMVNUFSKBEJLFCPDPSBOJTJTFM
ZBOH OPSNBM )BM JOJ NFOVOKVLLBO CBIXB CBILBO TFM NVLPTB EBOTFMTFMZBOHCFSEFLBUBOCJBTBOZBNBTJIUFUBQTFIBU
VTVT ZBOH NFSVQBLBO TFM ZBOH CFSEJGFSFOTJBTJ CBJL NFNCBXB "QPQUPTJT EJBXBMJ PMFI BLUJWBTJ TFLFMPNQPL QSPUFBTF ZBOH
TFNVBJOGPSNBTJHFOFUJLZBOHEJCVUVILBOVOUVLQFSLFNCBOHBO EJTFCVU LBTQBTF &O[JN JOJ EJTJOUFTJT EBO EJTJNQBO EJ EBMBN TFM
TFNVBTUSVLUVSZBOHEJCVUVILBOEBMBNUVCVILPEPL TFCBHBJ QSPLBTQBTF JOBLUJG .FLBOJTNF BLUJWBTJ LBTQBTF TBOHBU
0MFI LBSFOB JUV TVEBI KFMBT CBIXB EJGFSFOTJBTJ UJEBL LPNQMFLT OBNVO TFLBMJ UFSBLUJWBTJ FO[JN BLBO NFNCFMBI EBO
EJIBTJMLBO EBSJ IJMBOHOZB HFO UFUBQJ EBSJ QFOFLBOBO TFDBSB NFOHBLUJWBTJ QSPLBTQBTF MBJOOZB NFODFUVTLBO LBTLBEF ZBOH
TFMFLUJG HFO QSPNPUPS ZBOH CFSCFEB ,FOZBUBBOOZB EFOHBO NFOHIBODVSLBO QSPUFJO EFOHBO DFQBU EJ EBMBN TFM 4FM UFSTFCVU
NJLSPTLPQ FMFLUSPO EBQBU EJEVHB CBIXB CFCFSBQB TFHNFO LFNVEJBO NFNCPOHLBS EJSJOZB TFOEJSJ EBO TJTBOZB EJDFSOB
VOUBJIFMJLT%/"ZBOHCFSHFMVOHEJTFLJUBSJOUJCJTUPONFOKBEJ EFOHBODFQBUPMFITFMGBHPTJUJLZBOHCFSEFLBUBO
CFHJUV QBEBU TFIJOHHB VOUBJBO IFMJLT %/" UJEBL BLBO UFSVSBJ 4FKVNMBI CFTBS BQPQUPTJT UFSKBEJ EJ KBSJOHBOKBSJOHBO ZBOH
MBHJVOUVLNFNCFOUVLNPMFLVM3/"4BUVQFOKFMBTBOVOUVLIBM TFEBOHNFOHBMBNJQFSVCBIBOCFOUVLTFMBNBNBTBQFSLFNCBOHBO
JOJ BEBMBI TFCBHBJ CFSJLVU %JEVHB CBIXB HFOPN TFM CFSBXBM #BILBO QBEB PSBOH EFXBTB NJMZBSBO TFM NBUJ TFUJBQ KBNOZB EJ
QBEB UBIBQ EJGFSFOTJBTJ TFM UFSUFOUV VOUVL NFOHIBTJMLBO TVBUV KBSJOHBOTFQFSUJVTVTEBOTVNTVNUVMBOH EBOEJHBOUJLBOPMFITFM
QSPUFJO QFOHBUVS ZBOH BLBO TFMBNBOZB NFOFLBO TFLFMPNQPL ZBOH CBSV /BNVO LFNBUJBO TFM UFSQSPHSBN CJBTBOZB EJJNCBOHJ
HFO0MFILBSFOBJUV HFOZBOHEJUFLBOUJEBLBLBOCFSGVOHTJMBHJ EFOHBOQFNCFOUVLBOTFMCBSVQBEBPSBOHEFXBTBTFIBU+JLBUJEBL
5BOQB NFNQFSIBUJLBO NFLBOJTNFOZB TFM NBOVTJB ZBOH KBSJOHBOUVCVIBLBONFOHFSVUBUBVUVNCVICFSMFCJIBO1FOFMJUJBO
NBUBOH NFOHIBTJMLBO NBLTJNBM TBNQBJ QSPUFJO UFSLJOJ NFOVOKVLLBO CBIXB LFMBJOBO QSPTFT BQPQUPTJT EBQBU
EBOCVLBOQSPUFJOBUBVMFCJICJMBTFMVSVIHFOBLUJG NFNBJOLBOQFSBOBOLVODJQBEBQFOZBLJUOFVSPEFHFOFSBUJGTFQFSUJ
1FOFMJUJBO FNCSJPMPHJT NFOVOKVLLBO CBIXB TFMTFM UFSUFOUV QFOZBLJU "M[IFJNFS KVHB LBOLFS TFSUB QFOZBLJU BVUPJNVO
EBMBN FNCSJP NFOHBUVS EJGFSFOTJBTJ TFM ZBOH CFSEFLBUBO #FCFSBQB PCBU ZBOH UFMBI CFSIBTJM EJHVOBLBO VOUVL LFNPUFSBQJ
4FCBHBJ DPOUPI LPSEBNFTPEFSN QSJNPSEJBM EJTFCVU TFCBHBJ UBNQBLOZBNFOHJOEVLTJBQPQUPTJTQBEBTFMLBOLFS
QFOHBUVS QSJNFS FNCSJP LBSFOB LPSEB UFSTFCVU NFNCFOUVL
TVBUV GPLVT UFNQBU TJTB FNCSJP MBJO EJ TFLFMJMJOHOZB CFS
LFNCBOH,PSEBNFTPEFSNQSJNPSEJBMJOJBLBOCFSEJGFSFOTJBTJ
Kanker
NFOKBEJ BLTJT NFTPEFSN CFSJTJ TPNJU ZBOH UFSTVTVO TFDBSB
TFHNFOUBM EBO TFCBHBJ IBTJM EBSJ JOEVLTJ EBSJ KBSJOHBO
4FNVB BUBV IBNQJS TFNVB LBTVT LBOLFS EJTFCBCLBO PMFI QSPTFT
TFLJUBSOZB NFOZFCBCLBOUFSCFOUVLOZBTFNVBPSHBOQFOUJOHEJ
NVUBTJ BUBV BLUJWBTJ BCOPSNBM HFO TFM ZBOH NFOHFOEBMJLBO
EBMBNUVCVI
QFSUVNCVIBO TFM EBO NJUPTJT TFM (FO BCOPSNBM JUV EJTFCVU
4FCVBI DPOUPI MBJO EBSJ JOEVLTJ CFSMBOHTVOH TBBM WFTJLFU
POLPHFO4FCBOZBLPOLPHFOZBOHCFSCFEBUFMBIEJUFNVLBO
NBUB ZBOH TFEBOH CFSLFNCBOH CFSLPOUBL EFOHBO FLUPEFSN
LFQBMB EBO NFOZFCBCLBO FLUPEFSN NFOFCBM NFOKBEJ MFNQFOH %J EBMBN TFNVB TFM KVHB EJUFNVLBO BOUJPOLPHFO ZBOH
MFOTBZBOHBLBONFMJQBULFEBMBNVOUVLNFNCFOUVLMFOTBNBUB NFOFLBO BLUJWBTJ POLPHFO UFSUFOUV 0MFI LBSFOB JUV IJMBOHOZB
0MFI LBSFOB JUV TFCBHJBO CFTBS QFSLFNCBOHBO FNCSJP BUBV JOBLUJWBTJ BOUJPOLPHFO EBQBU NFNVOHLJOLBO BLUJWBTJ
NFSVQBLBO IBTJM EBSJ JOEVLTJ TFNBDBN JUV ZBLOJ TBUV CBHJBO POLPHFOZBOHNFOZFCBCLBOLBOLFS
UVCVI NFNFOHBSVIJ CBHJBO ZBOH MBJO EBO CBHJBO ZBOH MBJO +BSBOH TFLBMJ TFKVNMBI LFDJM EBSJ TFM ZBOH CFSNVUBTJ EJ EBMBN
UFSTFCVUNFNFOHBSVIJCBHJBOZBOHMBJOMBHJ UVCVI EBQBU NFOZFCBCLBO LBOLFS "EB CFCFSBQB BMBTBO VOUVL
+BEJ XBMBVQVO QFNBIBNBO LJUB NFOHFOBJ EJGFSFOTJBTJ TFM LFBEBBO UFSTFCVU 1FSUBNB TFCBHJBO CFTBS TFM ZBOH CFSNVUBTJ
NBTJI UJEBL KFMBT LJUB NFOHFUBIVJ CBOZBL NFLBOJTNF NFNJMJLJ LFNBNQVBO CFSUBIBO IJEVQ ZBOH LVSBOH CBJL KJLB
QFOHFOEBMJBOZBOHNFNVOHLJOLBOUFSKBEJOZBEJGFSFOTJBTJ EJCBOEJOHLBO EFOHBO TFM OPSNBM EBO PMFI LBSFOB JUV BLBO NBUJ
,FEVB IBOZBTFCBHJBOEBSJTFMZBOHCFSNVUBTJEBOCFSUBIBOIJEVQ
Apoptosis-Kematian Sel yang Terprogram NFOKBEJ LBOLFS LBSFOB TFCBHJBO CFTBS TFM ZBOH CFSNVUBTJ QVO
4FSBUVT USJMJVO TFM EJ EBMBN UVCVI NFSVQBLBO BOHHPUB EBSJ NBTJI NFNJMJLJ LPOUSPM VNQBO CBMJL OPSNBM ZBOH NFODFHBI
LPNVOJUBT ZBOH TBOHBU UFSBUVS UFNQBU TFNVB TFM EJBUVS UJEBL QFSUVNCVIBOZBOHCFSMFCJIBO
IBOZB NFMBMVJ QFOHBUVSBO LFDFQBUBO QFNCFMBIBO TFM UFUBQJ ,FUJHB TFMTFM ZBOH CFSQPUFOTJ NFOKBEJ LBOLFS TFSJOH LBMJ
KVHBPMFIQFOHBUVSBOUJOHLBULFNBUJBOTFM,FUJLBTFMUJEBLMBHJ EJIBODVSLBOPMFITJTUFNJNVOUVCVITFCFMVNTFMUFSTFCVUUVNCVI
EJCVUVILBO BUBV NFOKBEJ TVBUV BODBNBO CBHJ PSHBOJTNF TFM NFOKBEJ LBOLFS )BM JOJ UFSKBEJ NFMBMVJ 4FCBHJBO CFTBS TFM ZBOH
TFM UFSTFCVU BLBO NFOHBMBNJ QSPTFT LFNBUJBO TFM UFSQSPHSBN CFSNVUBTJ NFNCFOUVL QSPUFJO BCOPSNBM EJ EBMBN CBEBO TFMOZB
BUBV BQPQUPTJT 1SPTFT JOJ NFMJCBULBO LBTLBEF QSPUFPMJUJL LBSFOB QFSVCBIBO ZBOH UFSKBEJ QBEB HFO EBO QSPUFJO JOJ
TQFTJGJL ZBOH NFOZFCBCLBO TFM NFOHFSVU EBO NFNBEBU NFOHBLUJGLBO TJTUFN JNVO UVCVI NFOZFCBCLBO UVCVI
NFNCPOHLBS TJUPTLFMFUPOOZB EBO NFOHVCBI QFSNVLBBO NFNCFOUVL BOUJCPEJ BUBV MJNGPTJU UFSTFOTJUJTBTJ ZBOH CFSFBLTJ
TFMOZBTFIJOHHBTFMGBHPTJUJLZBOHCFSEFLBUBO TFQFSUJNBLSPGBH NFMBXBO TFM LBOLFS ZBOH BLBO NFOHIBODVSLBO TFMTFM UFSTFCVU
EBQBUNFOFNQFMQBEBNFNCSBOTFMEBONFODFSOBTFMUFSTFCVU 'BLUBZBOHNFOEVLVOHIBMJOJBEBMBICBIXBQBEBPSBOHEFOHBO
40
TJTUFN JNVO ZBOH UFSUFLBO TFQFSUJ PSBOH ZBOH NFNJOVN PCBU MFCJI HFO LBOLFS TVEBI CFSNVUBTJ EBMBN HFOPN ZBOH
JNVOPTVQSFTBO TFUFMBI USBOTQMBOUBTJ HJOKBM BUBV KBOUVOH EJXBSJTJ 0MFI LBSFOB JUV NVUBTJ UBNCBIBO ZBOH IBSVT
LFNVOHLJOBOUJNCVMOZBLBOLFSQBEBPSBOHUFSTFCVUNFOJOHLBU UFSKBEJTFCFMVNLBOLFSNVMBJUVNCVIQBEBBOHHPUBLFMVBSHB
NFOKBEJMJNBLBMJMJQBU UFSTFCVUKBVIMFCJITFEJLJU
,FFNQBU CJBTBOZB CFCFSBQB POLPHFO BLUJG ZBOH CFSCFEB 5. 1BEB IFXBO QFSDPCBBO CFCFSBQB KFOJT WJSVT EBQBU
EJQFSMVLBO TFDBSB CFSTBNBBO VOUVL NFOJNCVMLBO LBOLFS NFOZFCBCLBO CFCFSBQB NBDBN LBOLFS UFSNBTVL MFVLFNJB
UNIT I
4FCBHBJ DPOUPI TBUV HFO NVOHLJO NFOJOHLBULBO SFQSPEVLTJ ,FBEBBO JOJ CJBTBOZB EJBLJCBULBO PMFI TBUV EBSJ EVB DBSB
TFCVBITFMEFOHBODFQBU UFUBQJUJEBLUFSKBEJLBOLFSLBSFOBUJEBL 1BEBLBTVTWJSVT%/" VOUBJ%/"WJSVTEBQBUNFOZJTJQLBO
BEB HFO NVUBO MBJO ZBOH QBEB TBBU CFSTBNBBO NFNCFOUVL EJSJOZB TFOEJSJ TFDBSB MBOHTVOH LF EBMBN TBMBI TBUV
QFNCVMVIEBSBIZBOHEJQFSMVLBO LSPNPTPN EBO PMFI LBSFOBOZB NFOZFCBCLBO TVBUV NVUBTJ
5FUBQJ BQB ZBOH NFOZFCBCLBO QFSVCBIBO QBEB HFO JOJ ZBOHNFOZFCBCLBOLBOLFS1BEBLBTVTWJSVT3/" CFCFSBQB
%FOHBO NFNQFSUJNCBOHLBO USJMJVOBO TFM ZBOH CBSV EJCFOUVL WJSVT NFNCBXB TVBUV FO[JN ZBOH EJTFCVU USBOTLSJQUBTF
TFUJBQ UBIVO EBMBN UVCVI NBOVTJB QFSUBOZBBO ZBOH MFCJI CBJL QFNCBMJL SFWFSTF USBOTDSJQUBTF
TFIJOHHB NFOZFCBCLBO
NVOHLJO BEBMBI NFOHBQB LJUB TFNVB UJEBL NFOHIBTJMLBO %/" EBQBU EJUSBOTLSJQTJ EBSJ 3/" ,FNVEJBO %/" ZBOH
CFSKVUBKVUB BUBV CFSUSJMJVOUSJMJVO TFM NVUBTJ ZBOH NFOKBEJ EJUSBOTLSJQTJLBO JOJ NFOZJTJQLBO EJSJOZB TFOEJSJ LF EBMBN
LBOLFS +BXBCBOOZB BEBMBI BEBOZB TVBUV LFUFMJUJBO ZBOH MVBS HFOPNTFMIFXBO EBONFOZFCBCLBOLBOLFS
CJBTB QBEB SFQMJLBTJ VOUBJ LSPNPTPN %/" EBMBN TFUJBQ TFM
TFCFMVN NJUPTJT EBQBU CFSMBOHTVOH EBO KVHB LBSFOB QSPTFT Sifat Invasif Sel Kanker. 1FSCFEBBO VUBNB BOUBSB TFM
LPSFLTJDFUBL ZBOH NFNPUPOH EBO NFNQFSCBJLJ TFUJBQ VOUBJ LBOLFS EBO TFM OPSNBM BEBMBI TFCBHBJ CFSJLVU
4FM
%/" BCOPSNBM TFCFMVN QSPTFT NJUPTJT EJJ[JOLBO CFSMBOKVU LBOLFSUJEBLNFNBUVIJCBUBTQFSUVNCVIBOTFMZBOHOPSNBM
/BNVO XBMBVQVOUFSEBQBUTFNVBVQBZBQFODFHBIBOQFXBSJTBO BMBTBO VOUVL IBM JOJ BEBMBI CBIXB TFM LBOLFS
TFMJOJ TBUVTFMZBOHCBSVEJCFOUVLEBMBNTFUJBQCFCFSBQBKVUBTFM NVOHLJO UJEBLNFNCVUVILBOTFNVBGBLUPSQFSUVNCVIBO
NVOHLJONBTJINFNJMJLJTJGBUNVUBOZBOHCFSNBLOB ZBOH TBNB TFQFSUJ ZBOH EJCVUVILBO VOUVL QFSUVNCVIBO TFM
+BEJ IBOZB QFMVBOHMBI ZBOH EJQFSMVLBO VOUVL UFSKBEJOZB OPSNBM
4FM LBOLFS TFSJOH LBMJ KBVI LVSBOH NFMFLBU TBUV
NVUBTJ TFIJOHHB LJUB EBQBU CFSBOHHBQBO CBIXB TFKVNMBI CFTBS TBNB MBJO EJCBOEJOHLBO TFM OPSNBM 0MFI LBSFOB JUV TFM
LBOLFS IBOZB NFSVQBLBO IBTJM EBSJ TVBUV LFKBEJBO ZBOH UJEBL LBOLFS NFNJMJLJ LFDFOEFSVOHBO VOUVL NFOHFNCBSB LF
NFOHVOUVOHLBO TFMVSVI KBSJOHBO NFNBTVLJ BMJSBO EBSBI EBO UFSBOHLVU
/BNVO LFNVOHLJOBO NVUBTJ EBQBU EJUJOHLBULBO CFSLBMJLBMJ LF TFMVSVI UVCVI UFNQBU TFM LBOLFS NFNCFOUVL OJEVT
MJQBU CJMB TFTFPSBOH UFSQBKBO PMFI GBLUPSGBLUPS LJNJB GJTJL BUBV VOUVLTFKVNMBIQFSUVNCVIBOLBOLFSZBOHCBSV
#FCFSBQB
CJPMPHJTUFSUFOUV UFSNBTVLIBMIBMCFSJLVUJOJ LBOLFS KVHB NFOHIBTJMLBO GBLUPS BOHJPHFOJL ZBOH
NFOZFCBCLBO QFSUVNCVIBO CBOZBL QFNCVMVI EBSBI CBSV LF
. 5FMBI EJLFUBIVJ TFDBSB MVBT CBIXB SBEJBTJ JPOJTBTJ TFQFSUJ
EBMBN KBSJOHBO LBOLFS TFIJOHHB NFOZFEJBLBO OVUSJTJ
TJOBS9 TJOBS HBNNB EBO QBSUJLFM SBEJBTJ EBSJ CBIBO
ZBOHEJQFSMVLBOVOUVLQFSUVNCVIBOTFMLBOLFS
SBEJPBLUJG EBO CBILBO TJOBS VMUSBWJPMFU QVO EBQBU NFOKBEJ
GBLUPS QSFEJTQPTJTJ CBHJ TFTFPSBOH VOUVL UFSLFOB LBOLFS *PO
Mengapa Sel Kanker Membunuh?
ZBOH UFSCFOUVL EBMBN TFMTFM KBSJOHBO EJ CBXBI QFOHBSVI
SBEJBTJ UFSTFCVU CFSTJGBU TBOHBU SFBLUJG EBO EBQBU NFSVTBL +BXBCBOVOUVLQFSUBOZBBOUFSTFCVUCJBTBOZBTFEFSIBOB+BSJOHBO
VOUBJBO%/" TFIJOHHBNFOZFCBCLBOCBOZBLNVUBTJ LBOLFSCFSLPNQFUJTJEFOHBOKBSJOHBOOPSNBMVOUVLNFNQFSPMFI
. ;BU LJNJB EBSJ CFCFSBQB KFOJT UFSUFOUV KVHB NFNJMJLJ [BUHJ[J0MFILBSFOBTFMLBOLFSUFSVTCFSQSPMJGFSBTJUBOQBCBUBT
LFDFOEFSVOHBOLVBUVOUVLNFOJNCVMLBONVUBTJ5FMBIMBNB KVNMBITFMLBOLFSCFSMJQBUHBOEBTFUJBQIBSJ EBOTFMLBOLFSBLBO
EJUFNVLBO CBIXB CFSCBHBJ UVSVOBO CBIBO QFXBSOB BOJMJO TFHFSB NFNCVUVILBO TFNVB [BU HJ[J ZBOH UFSTFEJB VOUVL UVCVI
DFOEFSVOH NFOZFCBCLBO LBOLFS TFIJOHHB QFLFSKB EJ QBCSJL BUBV VOUVL CBHJBO QFOUJOH UVCVI 4FCBHBJ BLJCBUOZB KBSJOHBO
LJNJB ZBOH NFOHIBTJMLBO CBIBO TFQFSUJ JUV CJMB UJEBL OPSNBMTFDBSBCFSUBIBQNFOHBMBNJLFNBUJBOBLJCBULFLVSBOHBO
EJMJOEVOHJ NFNJMJLJ QSFEJTQPTJTJ UFSLFOB LBOLFS ;BU LJNJB HJ[J
ZBOH EBQBU NFOZFCBCLBO NVUBTJ EJTFCVU LBSTJOPHFO
,BSTJOPHFO ZBOH TBBU JOJ NFOZFCBCLBO KVNMBI LFNBUJBO Daftar Pustaka
UFSCBOZBLBEBMBIBTBQSPLPL"TBQSPLPLNFOZFCBCLBOLJSB Alberts B, Johnson A, Lewis J, et al: Molecular Biology of the Cell, ed 5, New
LJSBTFQFSFNQBUEBSJTFNVBLFNBUJBOBLJCBULBOLFS York, 2008, Garland Science.
. #BIBO JSJUBO GJTJL KVHB EBQBU NFOHBSBI QBEB LBOLFS TFQFSUJ Aranda A, Pascal A: Nuclear hormone receptors and gene expression, Physiol
BCSBTJ ZBOH UFSVT CFSMBOKVU QBEB TBMVSBO QFODFSOBBO PMFI Rev 81:1269, 2001.
CFCFSBQB KFOJT NBLBOBO ,FSVTBLBO KBSJOHBO EBQBU Brodersen P, Voinnet O: Revisiting the pdetailples of microRNA target recog-
NFOZFCBCLBO QFOHHBOUJBO NJUPTJT ZBOH DFQBU QBEB TFM nition and mode of action, NatRevMol Cell Biol 10:141, 2009.
4FNBLJO DFQBU NJUPTJT TFNBLJO CFTBS LFNVOHLJOBO Cairns BR: The logic of chromatin architecture and remodetting at promoters,
UFSKBEJOZBNVUBTJ Nature 461:193, 2009.
. 1BEBCBOZBLLFMVBSHB BEBLFDFOEFSVOHBOIFSFEJUFSZBOHLVBU Carthew RW, Sontheimer EJ: Origins and mechanisms of miRNAs and siRNAs,
Cell 136:642, 2009.
UFSIBEBQ LBOLFS ,FBEBBO JOJ EJTFCBCLBO PMFI GBLUB CBIXB
Castanotto D, Rossi JJ:The promises and pitfalts of RNA-interference-based
TFCBHJBO CFTBS LBOLFS NFNCVUVILBO UJEBL IBOZB TBUV
therapeutics, Nature 457:426, 2009.
NVUBTJUFUBQJ EVB BUBV MFCJI NVUBTJ TFCFMVN UFSKBEJOZB Cedar H, Bergman Y: Linking DNA methylation and histone modification:
LBOLFS 1BEB LFMVBSHB UFSUFOUV ZBOH NFNJMJLJ patterns and paradigms, NatRevGenet 10:295, 2009.
LFDFOEFSVOHBOUFSIBEBQLBOLFS EJEVHBCBIXBTBUVBUBV
41
Unit l Pengantar Fisiologi: Fisiologi Sel dan Umum
Croce CM: Causes and consequences of microRNA dysregulation in Kim VN, Han J, Siomi MC: Biogenesis of small RNAs in animals,
cancer, Nat Rev Genet 10:704, 2009. NatRevMol Cell Biol 10:126, 2009.
Frazer KA, Murray SS, Schork NJ, et al: Human genetic variation and its Misteli T, Soutoglou E: The emerging role of nuclear architecture in DNA
contribution to complex traits, NatRevGenet 10:241, 2009. repair and genome maintenance, NatRevMol Cell Biol 10:243, 2009.
Fuda NJ, Ardehali MB, Lis JT: Defining mechanisms that regulate RNA Moazed D: Small RNAs in transcriptional gene silencing and genome
polymerase II transcription in vivo, Nature 461:186, 2009. defence, Nature 457:413, 2009.
Hahn S: Structure and mechanism of the RNA polymerase II Siller KH, Doe CQ: Spindle orientation during asymmetric cell division,
transcription machinery, Nat Struct Mol Biol 11:394, 2004. Nat Cell Biol 11:365, 2009.
Hastings PJ, Lupski JR, Rosenberg SM, et al: Mechanisms of change in Sims RJ 3rd, Reinberg D: ls there a code embedded in proteins that is
gene copy number, NatRevGenet 10:551, 2009. basedon post-transtational modifications? NatRevMol Cell Biol
Hoeijmakers JH: DNA damage, aging, and cancer, N Engl J Med 9:815, 2008.
361:1475, 2009. Stappenbeck TS, Miyoshi H: The role of stromal stem cells in tissue
Hotchkiss RS, Strasser A, McDunn JE, et at: Cell death, N Engl J Med regeneration and wound repair. Science 324:1666, 2009.
361:1570, 2009. Sutherland H, Bickmore WA: Transcription factories: gene expression in
Jinek M, Doudna JA:A three-dimensional view of the molecular unions?, NatRevGenet 10:457, 2009.
machinery of RNA interference, Nature 457:40, 2009.
Jockusch BM, Httetmaier S, Illenberger S: From the nucleus toward the
cell periphery: a guided tour for mRNAs, News Physiol Sci 18:7,
2003.
42
II
UNIT
'JTJPMPHJ.FNCSBO
4BSBG EBO0UPU
4. Transpor Zat melalui Membran-Membran
Sel
5. Potensial Membran dan Potensial Aksi
6. Kontraksi Otot Rangka
7. Eksitasi Otot Rangka: Penghantaran

Saraf-Otot dan Rangkaian Eksitasi-
Kontraksi
8. Eksitasi dan Kontraksi Otot Polos
BAB 4
UNIT II
5SBOTQPS;BUNFMBMVJ
.FNCSBO.FNCSBO4FM
(BNCBS NFOVOKVLLBO 1SPUFJO ZBOH CFSCFEB NFNQVOZBJ GVOHTJ ZBOH CFSCFEB QVMB
QFSLJSBBO LPOTFOUSBTJ FMFLUSPMJU #FCFSBQB QSPUFJO NFNQVOZBJ SVBOH ZBOH CFSBJS EJ TFQBOKBOH
EBO [BU MBJO ZBOH QFOUJOH EBMBN NPMFLVMUFSTFCVUEBONFNVOHLJOLBOBJSEBOJPOBUBVNPMFLVM
DBJSBO FLTUSBTFMVMBS EBO DBJSBO UFSUFOUVVOUVLCFSHFSBLCFCBTQSPUFJOJOJEJTFCVUQSPUFJOLBOBM
JOUSBTFMVMBS 1FSIBUJLBO CBIXB 1SPUFJO MBJOOZB ZBOH EJTFCVU QSPUFJO QFNCBXB CFSJLBUBO
DBJSBOFLTUSBTFMVMBSNFOHBOEVOH EFOHBONPMFLVMBUBVJPOZBOHBLBOEJUSBOTQPSEBOQFSVCBIBO
TFKVNMBI CFTBS OBUSJVN UFUBQJ IBOZB NFOHBOEVOH TFEJLJU CFOUVLQBEBNPMFLVMQSPUFJOLFNVEJBOBLBONFNJOEBILBO[BU
LBMJVN%BMBNDBJSBOJOUSBTFMVMBSLFBEBBOZBOHBEBTFCBMJLOZB NFMBMVJ DFMBI QSPUFJO UFSTFCVU LF TJTJ MBJO NFNCSBO 1SPUFJO
$BJSBO FLTUSBTFMVMBS KVHB CBOZBL NFOHBOEVOH JPO LMPSJEB LBOBM EBO QSPUFJO QFNCBXB CJBTBOZB TBOHBU TFMFLUJG TFIJOHHB
TFEBOHLBO DBJSBO JOUSBTFMVMBS NFOHBOEVOH TBOHBU TFEJLJU IBOZB JPO BUBV NPMFLVM KFOJT UFSUFOUV TBKB ZBOH EBQBU NFMBMVJ
LMPSJEB 5FUBQJ LPOTFOUSBTJ GPTGBU EBO QSPUFJO EBMBN DBJSBO NFNCSBO
JOUSBTFMVMBS KBVI MFCJI CFTBS EJCBOEJOHLBO EBMBN DBJSBO
FLTUSBTFMVMBS #FSCBHBJ QFSCFEBBO JOJ TBOHBU QFOUJOH VOUVL
LFIJEVQBO TFM 5VKVBO CBC JOJ BEBMBI VOUVL NFOHVSBJLBO "Difusi" versus "Transpor Aktif." 5SBOTQPS NFMBMVJ
CBHBJNBOB NFLBOJTNF USBOTQPS NFNCSBO TFM NFOJNCVMLBO NFNCSBO TFM CBJL TFDBSB MBOHTVOH NFMBMVJ MBQJTBO MJQJE HBOEB
QFSCFEBBOQFSCFEBBOUFSTFCVU NBVQVO NFMBMVJ QSPUFJO UFSKBEJ NFMBMVJ TBMBI TBUV EBSJ EVB
QSPTFTEBTBSEJGVTJBUBVUSBOTQPSBLUJG
Sawar Lipid Membran Sel dan Protein Transpor
Membran Sel
4USVLUVS NFNCSBO ZBOH NFOZFMVCVOHJ CBHJBO MVBS TFUJBQ TFM

UVCVIUFMBIEJCBIBTEJ#BCEBOEJUVOKVLLBOQBEB(BNCBS
/B N&R- N&R-
EBO .FNCSBO UFSTFCVU IBNQJS TFMVSVIOZB UFSEJSJ BUBT , N&R- N&R-
MBQJTBO MJQJE HBOEB OBNVO NFNCSBO TFM KVHB NFOHBOEVOH $B N&R- N&R-
TFKVNMBI CFTBS NPMFLVM QSPUFJO EBMBN MJQJE EBO CBOZBL EJ .H N&R- N&R-
$Mo N&R- N&R-
BOUBSBOZB ZBOH NFOFNCVT NFNCSBO TFQFOVIOZB TFQFSUJ )$0o N&R- N&R-
EJUVOKVLLBO(BNCBS N&R- N&R-
40 N&R- N&R-
-BQJTBO MJQJE HBOEB UJEBL UFSDBNQVS EFOHBO DBJSBO NHEM NHEM
FLTUSBTFMVMBS NBVQVO DBJSBO JOUSBTFMVMBS 0MFI LBSFOB JUV NHEM NHEM
MBQJTBO MJQJE HBOEB JOJ EBQBU CFSGVOHTJ TFCBHBJ TBXBS ZBOH
NFOHIBNCBU QFSHFSBLBO NPMFLVM BJS EBO [BU MBSVUBJS BOUBSB
LPNQBSUFNFODBJSBOFLTUSBTFMVMBSEBODBJSBOJOUSBTFMVMBS"LBO HEM HEM
UFUBQJ TFQFSUJZBOHEJUVOKVLLBOEBMBN(BNCBSPMFIQBOBI
TJTJQBMJOHLJSJ BEBCFCFSBQB[BUZBOHEBQBUNFOFNCVTMBQJTBO
MJQJE HBOEB JOJ ZBOH CFSEJGVTJ MBOHTVOH NFMBMVJ [BU MJQJE JUV
TFOEJSJ IBM JOJ UFSVUBNB UFSKBEJ QBEB [BU MBSVUMJQJE ZBOH BLBO 10 NN )H NN)H
1$0 NN )H NN)H
EJCBIBTLFNVEJBO Q)
.PMFLVM QSPUFJO EBMBN NFNCSBO NFNQVOZBJ TJGBU ZBOH HEM HEM
N&R-
N&R-
CFSCFEB TBNB TFLBMJ EBMBN NFOUSBOTQPS [BU[BU 4USVLUVS

NPMFLVMUFSTFCVUNFOFNCVTLFVUVIBOMBQJTBOMJQJEHBOEB ZBOH
NFNCFOUVL TVBUV KBMVS BMUFSOBUJG NFMBMVJ NFNCSBO TFM 0MFI
LBSFOB JUV TFCBHJBO CFTBS QSPUFJO ZBOH NFOFNCVT JOJ EBQBU
CFSGVOHTJTFCBHBJQSPUFJOUSBOTQPS
45
Unit II Fisiologi Membran, Saraf, dan Otot
HFSBLBO NPMFLVM " NFOKBEJ MBNCBU ZBOH NFOHBMBNJ LFIJMBOHBO

TFCBHJBOFOFSHJLJOFUJLOZB+BEJ TFQFSUJZBOHEJQFSMJIBULBOEBMBN
(BNCBS TBUV NPMFLVM EBMBN TVBUV MBSVUBO BLBO TBMJOH
CFSUVCSVLBO EJ BOUBSB NPMFLVMNPMFLVM MBJOOZB NVMBNVMB
EBMBN TBUV BSBI LFNVEJBO LF BSBI MBJO ZBOH MBJO MBHJ EBO
TFUFSVTOZB ZBOH CFSUVCSVLBO TFDBSB BDBL TFCBOZBL SJCVBO LBMJ
TFUJBQ EFUJL (FSBLBO NPMFLVM ZBOH UFSVTNFOFSVT JOJ EJ BOUBSB
NPMFLVMZBOHTBUVEFOHBOZBOHMBJOEBMBNDBJSBOBUBVEBMBNHBT
EJTFCVUEJGVTJ
*PO CFSEJGVTJ EFOHBO DBSB ZBOH TBNB TFQFSUJ NPMFLVM CBILBO
QBSUJLFM LPMPJE ZBOH UFSTVTQFOTJ CFSEJGVTJ EFOHBO DBSB ZBOH
TFSVQB LFDVBMJ CBIXB LPMPJE UFSTFCVU CFSEJGVTJ EFOHBO TBOHBU
MBNCBU EJCBOEJOHLBO EFOHBO [BU NPMFLVM BLJCBU VLVSBO QBSUJLFM
LPMPJEUFSTFCVUZBOHCFTBS
.FTLJQVO UFSEBQBU CBOZBL WBSJBTJ QBEB LFEVB NFLBOJTNF
EBTBSUFSTFCVU EJGVTJCFSBSUJHFSBLBOBDBLNPMFLVMEBSJ[BU[BU
NPMFLVM EFNJ NPMFLVM CBJL NFMBMVJ SVBOHSVBOH BOUBS
Difusi melalui Membran Sel
NPMFLVM EJ NFNCSBO BUBV CFSLPNCJOBTJ EFOHBO QSPUFJO %JGVTJNFMBMVJNFNCSBOTFMUFSCBHJBUBTEVBTVCUJQFZBOHEJTFCVU
QFNCBXB &OFSHJ ZBOH NFOZFCBCLBO EJGVTJ BEBMBI FOFSHJ EJGVTJ TFEFSIBOB EBO EJGVTJ UFSGBTJMJUBTJ %JGVTJ TFEFSIBOB CFSBSUJ
HFSBLBOLJOFUJLOPSNBMTVBUVNBUFSJ CBIXB HFSBLBO LJOFUJL NPMFLVM BUBV JPO UFSKBEJ NFMBMVJ TVBUV
#FSCFEB EFOHBO IBM JUV USBOTQPS BLUJG CFSBSUJ HFSBLBO JPO DFMBI NFNCSBO BUBV NFMBMVJ SVBOH BOUBS NPMFLVM UBOQB
BUBV[BUMBJOOZBNFOFNCVTNFNCSBOEBMBNCFOUVLLPNCJOBTJ CFSJOUFSBLTJEFOHBOQSPUFJOQFNCBXBEBMBNNFNCSBO,FDFQBUBO
EFOHBO QSPUFJO QFNCBXB TFEFNJLJBO SVQB TFIJOHHB QSPUFJO EJGVTJEJUFOUVLBOPMFIKVNMBI[BUZBOHUFSTFEJB LFDFQBUBOHFSBLBO
QFNCBXBNFOZFCBCLBO[BUCFSHFSBLNFMBXBOHSBEJFOFOFSHJ LJOFUJL EBO KVNMBI VLVSBO DFMBI QBEB NFNCSBO ZBOH EBQBU
TFQFSUJ EBSJ UFNQBU LPOTFOUSBTJ SFOEBI LF UFNQBU LPOTFOUSBTJ EJMBMVJPMFINPMFLVMBUBVJPO
UJOHHJ1FSHFSBLBOTFNBDBNJOJNFNCVUVILBOTVNCFSFOFSHJ %JGVTJ UFSGBTJMJUBTJ NFNCVUVILBO JOUFSBLTJ EFOHBO TVBUV
UBNCBIBO TFMBJO FOFSHJ LJOFUJL 1FNCBIBTBO CFSJLVU BLBO QSPUFJOQFNCBXB1SPUFJOQFNCBXBNFNCBOUVMFXBUOZBNPMFLVM
NFNCFSJLBO QFOKFMBTBO ZBOH MFCJI EFUBJM NFOHFOBJ EBTBS BUBV JPO NFMBMVJ NFNCSBO EFOHBO NFOHJLBU NPMFLVM BUBV JPO
EBTBSGJTJLBEBOLJNJBGJTJLEBSJLFEVBQSPTFTUFSTFCVU UFSTFCVU TFDBSB LJNJBXJ TFIJOHHB EBQBU LFMVBSNBTVL NFNCSBO
EFOHBODBSBJOJ
%JGVTJ TFEFSIBOB EBQBU UFSKBEJ NFMBMVJ NFNCSBO TFM EFOHBO
Difusi EVBDBSB
NFMBMVJDFMBIQBEBMBQJTBOMJQJEHBOEB KJLB[BUZBOH
CFSEJGVTJ MBSVU EBMBN MJQJE EBO
NFMBMVJ LBOBM CFSBJS ZBOH
4FNVBNPMFLVMEBOJPOEBMBNDBJSBOUVCVI UFSNBTVLNPMFLVM NFOFNCVT CFCFSBQB QSPUFJO USBOTQPS ZBOH CFTBS TFQFSUJ ZBOH
BJS EBO [BU[BU UFSMBSVU CFSBEB EBMBN HFSBLBO ZBOH LPOTUBO EJUVOKVLLBOEBMBN(BNCBSQBEBTJTJLJSJ
EBO TFUJBQ QBSUJLFM CFSHFSBL EFOHBO DBSBOZB NBTJOHNBTJOH
(FSBLBO QBSUJLFM JOJMBI ZBOH EJTFCVU QBSB BIMJ GJTJLB TFCBHBJ Difusi Zat Larut-Lipid melalui Lapisan Lipid Ganda. 4BMBI
QBOBTNBLJOCFTBSQFSHFSBLBOOZB NBLJOUJOHHJTVIVOZBEBO TBUV GBLUPS UFSQFOUJOH ZBOH NFOFOUVLBO LFDFQBUBO TVBUV [BU
HFSBLBOUFSTFCVUUJEBLQFSOBICFSIFOUJEBMBNLPOEJTJBQBQVO NFMBMVJ MBQJTBO MJQJE HBOEB BEBMBI TJGBU LFMBSVUBO MJQJE EBSJ [BU
LFDVBMJ QBEB TVIV OPM NVUMBL ,FUJLB TFCVBI NPMFLVM ZBOH UFSTFCVU $POUPI LFMBSVUBO PLTJHFO OJUSPHFO LBSCPO EJPLTJEB
CFSHFSBL " NFOEFLBUJ NPMFLVM ZBOH EJBN # EBZB FMFLUSP EBO BMLPIPM EBMBN MJQJE BEBMBI UJOHHJ TFIJOHHB TFNVB [BU JOJ
TUBUJLEBOEBZBJOUJZBOHMBJOEBSJNPMFLVM"BLBONFOEPSPOH EBQBU MBOHTVOH MBSVU EBMBN MBQJTBO MJQJE HBOEB EBO CFSEJGVTJ
NPMFLVM # ZBOH BLBO NFNJOEBILBO TFCBHJBO FOFSHJ NFMBMVJNFNCSBOTFMEFOHBODBSBZBOHTBNBTFQFSUJEJGVTJQBSUJLFM
QFSHFSBLBO NPMFLVM " LF NPMFLVM # "LJCBUOZB NPMFLVM # MBSVUBO ZBOH UFSKBEJ EBMBN MBSVUBO FODFS 0MFI TFCBC JUV
NFNQFSPMFIFOFSHJLJOFUJLVOUVLQFSHFSBLBOOZB TFEBOHLBO LFDFQBUBOEJGVTJTFUJBQ[BUUFSTFCVUNFMBMVJNFNCSBOCFSCBOEJOH
MBOHTVOH EFOHBO TJGBU LFMBSVUBO MJQJEOZB 4FKVNMBI CFTBS [BU
LIVTVTOZB PLTJHFO EBQBU EJBOHLVU EFOHBO DBSB JOJ PMFI LBSFOB
JUV PLTJHFO EBQBU EJIBOUBSLBO LF EBMBN TFM TFPMBIPMBI IBNQJS
UJEBLBEBNFNCSBOTFM
Difusi Air dan Molekul Tidak Larut-Lipid Lainnya melalui

Kanal Protein. .FTLJQVO BJS CFSTJGBU TBOHBU UJEBL MBSVU EBMBN
MJQJE NFNCSBO BJS EBQBU MFXBU EFOHBO NVEBI NFMBMVJ LBOBM EJ
EBMBN NPMFLVM QSPUFJO ZBOH TFQFOVIOZB NFOFNCVT NFNCSBO
,FDFQBUBO NPMFLVM BJS VOUVL NFOFNCVT LFCBOZBLBO NFNCSBO
TFMEBSBINFSBITFUJBQEFUJLLJSBLJSBTFCFTBSLBMJWPMVNFTFM
EBSBINFSBIJUVTFOEJSJ
46
Bab 4 Transpor Zat melalui Membran-Membran Sel
.PMFLVM UJEBL MBSVUMJQJE MBJOOZB EBQBU MFXBU NFMBMVJ LBOBM

QSPUFJO EFOHBO DBSB ZBOH TBNB TFQFSUJ NPMFLVM BJS KJLB NPMFLVM
UFSTFCVU MBSVU EBMBN BJS EBO CFSVLVSBO DVLVQ LFDJM /BNVO
TFNBLJO CFTBS VLVSBOOZB LFNBNQVBO QFOFUSBTJOZB NFOVSVO
ESBTUJT .JTBMOZB EJBNFUFS NPMFLVM VSFB IBOZB QFSTFO MFCJI
UNIT II
CFTBS EBSJQBEB EJBNFUFS NPMFLVM BJS UFUBQJ LFNBNQVBOOZB
CFSQFOFUSBTJ NFMBMVJ QPSJQPSJ NFNCSBO TFM LJSBLJSB TFSJCV LBMJ
MFCJI LFDJM EBSJQBEB LFNBNQVBO QFOFUSBTJ BJS .FTLJQVO
EFNJLJBO EFOHBO NFNQFSUJNCBOHLBO LFDFQBUBO QFOFUSBTJ BJS
ZBOH NFOHBHVNLBO KVNMBI QFOFUSBTJ VSFB ZBOH EJDBQBJ UFSTFCVU
NBTJI NFNVOHLJOLBO UFSKBEJOZB USBOTQPS VSFB ZBOH DFQBU
NFMBMVJNFNCSBOEBMBNXBLUVCFCFSBQBNFOJU
Difusi melalui Pori-pori dan Kanal Protein-Permeabilitas

Selektif dan Kanal-Kanal Berpintu
3FLPOTUSVLTJ UJHB EJNFOTJ TFDBSB LPNQVUFSJTBTJ QPSJQPSJ EBO
LBOBMLBOBM QSPUFJO UFMBI NFNQFSMJIBULBO TBMVSBO CFSCFOUVL
UBCVOH ZBOH UFSCFOUBOH EBSJ DBJSBO FLTUSBTFMVMBS LF DBJSBO
JOUSBTFMVMBS 0MFI LBSFOB JUV [BU EBQBU CFSHFSBL EFOHBO DBSB
EJGVTJ TFEFSIBOB MBOHTVOH NFMBMVJ QPSJQPSJ EBO LBOBMLBOBM JOJ
EBSJTBUVTJTJNFNCSBOLFTJTJZBOHMBJO
1PSJQPSJ UFSTVTVO EBSJ QSPUFJOQSPUFJO JOUFHSBM NFNCSBO TFM
ZBOH NFNCFOUVL UBCVOHUBCVOH UFSCVLB NFOFNCVT NFNCSBO
EBOTFMBMVUFSCVLB/BNVO EJBNFUFSQPSJEBONVBUBOMJTUSJLOZB
NFOZFCBCLBO TFMFLUJWJUBT ZBOH NFNVOHLJOLBO IBOZB NPMFLVM
NPMFLVM UFSUFOUV NFMFXBUJOZB .JTBMOZB QPSJ QSPUFJO EJTFCVU
BLVBQPSJO BUBV LBOBM BJS NFNVOHLJOLBO BMJSBO BJS ZBOH DFQBU
NFMBMVJNFNCSBONFNCSBOTFMUFUBQJUJEBLNFMFXBULBONPMFLVM
NPMFLVM MBJO 4FUJEBLOZB KFOJT BLVBQPSJO ZBOH CFSCFEB
UFSEBQBU EJ CFSCBHBJ TFM EBMBN UVCVI NBOVTJB "LVBQPSJO
NFNQVOZBJ QPSJ ZBOH TFNQJU ZBOH NFNVOHLJOLBO NPMFLVM BJS JEFOUJLZBOHNFOZFMVCVOHJTVBUVQPSJTFOUSBM (BNCBS
%J
CFSEJGVTJ NFMBMVJ NFNCSBO TBUV EFNJ TBUV 1PSJ UFSTFCVU QVODBL QPSJ LBOBM UFSEBQBU MFOHLVOH QPSJ ZBOH NFNCFOUVL
EFNJLJBO TFNQJU TFIJOHHB JPO UFSIJESBTJ UJEBL EBQBU GJMUFS TFMFLUJG ZBOH TFNQJU 'JMUFS TFMFLUJG UFSTFCVU EJMBQJTJ PMFI
NFOFNCVTOZB 4FCBHBJNBOB EJCBIBT EBMBN #BC EBO PLTJHFO LBSCPOJM ,FUJLB JPO LBMJVN UFSIJESBTJ NBTVL LF GJMUFS
LFQBEBUBO TFCBHJBO BLVBQPSJO NJTBMOZB BLVBQPSJO
EBMBN TFMFLUJG JPOJPO JUV BLBO CFSJOUFSBLTJ EFOHBO PLTJHFO LBSCPOJM
NFNCSBO TFM UJEBL CFSTJGBU TUBUJT NFMBJOLBO CFSVCBI EBMBN EBO NFMFQBTLBO TFCBHJBO CFTBS NPMFLVM BJS ZBOH UFSJLBU
CFSCBHBJLPOEJTJGJTJPMPHJT TFIJOHHB NFNVOHLJOLBO JPO LBMJVN ZBOH UFSEFIJESBTJ
NFMFXBUJ LBOBM /BNVO PLTJHFO LBSCPOJM UFSMFUBL TBOHBU
%VB LBSBLUFSJTUJL QFOUJOH ZBOH NFNCVBU LBOBM QSPUFJO
CFSKBVIBO TFIJOHHBUJEBLEBQBUCFSJOUFSBLTJTFDBSBFSBUEFOHBO
NFOKBEJ CFSCFEB BEBMBI
LBOBM UFSTFCVU TFSJOH CFSTJGBU
JPOJPO OBUSJVN ZBOH MFCJI LFDJM EFOHBO EFNJLJBO EJDFHBI
QFSNFBCFM TFMFLUJG UFSIBEBQ [BU UFSUFOUV EBO
CBOZBL LBOBM
TFDBSBFGFLUJGPMFIGJMUFSTFMFLUJGVOUVLNFMFXBUJQPSJ
UFSTFCVU EBQBU EJCVLB BUBV EJUVUVQ PMFC QJOUV ZBOH EJBUVS PMFI
TJOZBM MJTUSJL LBOBM CFSQJOUV MJTUSJL
BUBV [BU[BU LJNJB ZBOH 'JMUFS TFMFLUJG ZBOH CFSCFEB VOUVL CFSCBHBJ LBOBM JPO
CFSJLBUBOEFOHBOQSPUFJOLBOBM LBOBMCFSQJOUVMJHBO
EJZBLJOJ NFOFOUVLBO QBEB TFCBHJBO CFTBS LFLIVTVTBO LBOBM
Permeabilitas Selektif Berbagai Kanal Protein #BOZBL VOUVLLBUJPOBUBVBOJPO TFQFSUJ/B , EBO$BU ZBOHEBQBU
LBOBM QSPUFJO CFSTJGBU TBOHBU TFMFLUJG VOUVL NFMBLVLBO NFMBMVJLBOBM
USBOTQPS TBUV BUBV MFCJI JPO BUBV NPMFLVM TQFTJGJL *OJ BEBMBI 4BMBI TBUV LBOBM QSPUFJO UFSQFOUJOH ZBOH EJTFCVU LBOBM
BLJCBU LBSBLUFSJTUJL LBOBM JUV TFOEJSJ TFQFSUJ EJBNFUFSOZB OBUSJVN TPEJVN DIBOOFM
IBOZB CFSEJBNFUFS Y
CFOUVLOZB TFSUB KFOJT NVBUBO MJTUSJL EBO JLBUBO LJNJB EJ OBOPNFUFS UFUBQJ ZBOH MFCJI QFOUJOH QFSNVLBBO EBMBN EBSJ
TFQBOKBOH QFSNVLBBOEBMBNOZB LBOBM JOJ EJMBQJTJ PMFI BTBN BNJOP ZBOH NFNQVOZBJ NVBUBO
,BOBM LBMJVN NFNVOHLJOLBO MFXBUOZB JPOJPO LBMJVN OFHBUJGZBOHLVBU TFQFSUJZBOHEJMVLJTLBOEFOHBOUBOEBOFHBUJG
NFOFNCVT NFNCSBO TFM LBMJ MFCJI NVEBI EBSJQBEB EJ CBHJBO EBMBN LBOBM QSPUFJO EBMBN (BNCBS
TFCFMBI
MFXBUOZB JPOJPO OBUSJVN /BNVO TFMFLUJWJUBT ZBOH UJOHHJ JOJ BUBT .VBUBO OFHBUJG ZBOH LVBU JOJ EBQBU NFOBSJL JPO OBUSJVN
UJEBLEBQBUEJKFMBTLBOIBOZBCFSEBTBSLBOEJBNFUFSJPO LBSFOBJPO ZBOHUFSEFIJESBTJLFEBMBNLBOBM ZBOHTFCFOBSOZBNFOBSJLJPO
LBMJVN TFEJLJU MFCJI CFTBS EBSJQBEB JPO OBUSJVN #BHBJNBOB OBUSJVNEBSJNPMFLVMBJSZBOHNFOHIJESBTJJPOUFSTFCVU#FHJUV
NFLBOJTNF TFMFLUJWJUBT JPO ZBOH MVBS CJBTB JOJ 1FSUBOZBBO JOJ CFSBEBEBMBNLBOBM JPOOBUSJVNJOJLFNVEJBOCFSEJGVTJLFMVBS
UFSKBXBC TFCBHJBO LFUJLB TUSVLUVS TVBUV LBOBM LBMJVN CBLUFSJ NBTVL TFTVBJ EFOHBO BUVSBO EJGVTJ ZBOH CJBTB +BEJ LBOBM
EJUFNVLBO NFMBMVJ LSJTUBMPHSBGJ TJOBS9 ,BOBM LBMJVN UFSOZBUB OBUSJVN TFDBSB TQFTJGJL CFSTJGBU TFMFLUJG VOUVL MFXBUOZB JPO
NFNQVOZBJTUSVLUVSUFUSBNFSJLUFSEJSJBUBTFNQBUTVCVOJUQSPUFJO OBUSJVN
47
Na+ Na+ EBSJ QJOUV LJNJBXJ BEBMBI FGFL BTFUJMLPMJO UFSIBEBQ LBOBM ZBOH
EJTFCVULBOBMBTFUJMLPMJO"TFUJMLPMJOBLBONFNCVLBQJOUVLBOBM
–
–
– – ZBOH NFSVQBLBO TVBUV QPSJQPSJ CFSEJBNFUFS LJSBLJSB
– – – – OBOPNFUFS ZBOH CFSNVBUBO OFHBUJG TFIJOHHB NFNVOHLJOLBO
– – – – NPMFLVM ZBOH UJEBL CFSNVBUBO BUBV JPO CFSNVBUBO QPTJUJG ZBOH
– – – – CFSEJBNFUFS MFCJI LFDJM VOUVL EBQBU MFXBU 1JOUV JOJ TBOHBU
QFOUJOHVOUVLQFOHIBOUBSBOTJOZBMTBSBGEBSJTBUVTFMTBSBGLFTFM
TBSBG MBJOOZB MJIBU #BC
EBO EBSJ TFM TBSBG LF TFM PUPU VOUVL
NFOJNCVMLBOLPOUSBLTJPUPU MJIBU#BC

Pintu Kanal dalam Keadaan Terbuka versus Pintu Kanal
dalam Keadaan Tertutup. %BMBN (BNCBS " EJQFSMJIBULBO
LBSBLUFSJTUJLZBOHTBOHBUNFOBSJLEBSJLFCBOZBLBOLBOBMCFSQJOUV
MJTUSJL (BNCBS UFSTFCVU NFOVOKVLLBO EVB SFLBNBO BSVT MJTUSJL
ZBOH NFOHBMJS NFMBMVJ TFCVBI LBOBM OBUSJVN QBEB TBBU UFSEBQBU
HSBEJFO QPUFOTJBM NFNCSBO TFCFTBS LJSBLJSB NJMJWPMU
1FSIBUJLBO CBIXB LBOBM NFOHIBOUBSLBO BSVT MJTUSJL EFOHBO
K+ K+ QSJOTJQ HBHBM BUBV UVOUBT ZBJUV QJOUV LBOBM NFNCVLB EBO
NFOVUVQ EFOHBO DFQBU EBO TFUMBQ QFNCVLBBO CFSMBOHTVOH
TFQFSTFLJBO NJMJEFUJL TBNQBJ CFCFSBQB NJMJEFUJL ,FBEBBO JOJ
NFOVOKVLLBO DFQBUOZB QFSVCBIBO ZBOH EBQBU UFSKBEJ TFMBNB
QFNCVLBBO EBO QFOVUVQBO QJOUV NPMFLVM QSPUFJO 1BEB TVBUV
OJMBJ QPUFOTJBM MJTUSJL UFSUFOUV LBOBM EBQBU UFUBQ UFSUVUVQ
Pintu pada Kanal Protein. 1JOUV QBEB LBOBM QSPUFJO
TFQBOKBOH XBLUV BUBV IBNQJS TFMBMV UFSUVUVQ TFEBOHLBO QBEB
NFSVQBLBOTVBUVDBSBVOUVLNFOHBUVSQFSNFBCJMJUBTJPOQBEB
TVBUVOJMBJQPUFOTJBMMJTUSJLMBJOOZB LBOBMEBQBUUFSCVLBTFQBOKBOH
LBOBM UFSTFCVU ,FBEBBO JOJ EJUVOKVLLBO EBMBN (BNCBS
XBLUV BUBV IBNQJS TFMBMV EBMBN LFBEBBO UFSCVLB 1BEB OJMBJ
TFCFMBI BUBT EBO CBXBI ZBOH TFMFLUJG VOUVL JPO OBUSJVN EBO
QPUFOTJBM MJTUSJL BOUBSB LFEVB LFBEBBO UFSTFCVU TFQFSUJ ZBOH
LBMJVN 4FCBHMBO QJOUV JOJ EJZBLJOJ TFCFOBSOZB NFNQVOZBJ
EJQFSMJIBULBO EBMBN HBNCBS QJOUV DFOEFSVOH NFNCVLB EBO
QFSMVBTBOTUSVLUVSNJSJQQJOUVQBEBNPMFLVMQSPUFJOUSBOTQPS
NFOVUVQ TFDBSB CFSHBOUJBO ZBOH NFOHIBTJMLBO OJMBJ BSVT MJTUSJL
ZBOHEBQBUNFOVUVQJQFNCVLBBOLBOBMBUBVEBQBUEJUBSJLEBSJ
SBUBSBUBEJBOUBSBOJMBJNBLTJNVNEBONJOJNVN
LBOBM ZBOH UFSCVLB EFOHBO DBSB NFOHVCBI CFOUVL NPMFLVM
QSPUFJOJUVTFOEJSJ Metode Patch-Clamp untuk Merekam Aliran Arus lon
1FNCVLBBO EBO QFOVUVQBO QJOUV EJBUVS EFOHBO EVB DBSB melalui Kanal-kanal Tunggal. 4JBQBQVO NVOHLJO CFSUBOZB
VUBNBCFSJLVU UBOZB NFOHFOBJ DBSB ZBOH NVOHLJO TFDBSB UFLOJT EBQBU EJQBLBJ
VOUVL NFSFLBN BMJSBO MJTUSJL JPO ZBOH NFMBMVJ TFCVBI LBOBM
1. 1JOUVMJTUSJL%BMBNIBMJOJ QFSVCBIBOCFOUVLNPMFLVMBUBV TFQFSUJ ZBOH EJQFSMJIBULBO QBEB (BNCBS " )BM JOJ EBQBU
JLBUBO LJNJB QBEB QJOUV UJNCVM TFCBHBJ SFTQPOT UFSIBEBQ EJDBQBJ EFOHBO NFOHHVOBLBO NFUPEF QBUDIDMBNQ ZBOH
QPUFOTJBM MJTUSJL ZBOH NFOFNCVT NFNCSBO TFM .JTBMOZB EJJMVTUSBTJLBO QBEB (BNCBS # $BSBOZB TBOHBU TFEFSIBOB
TFQFSUJ ZBOH EJQFSMJIBULBO QBEB (BNCBS TFCFMBI BUBT TFCVBI NJLSPQJQFU ZBOH VKVOHOZB CFSEJBNFUFS IBOZB BUBV
QBEB TBBU UFSEBQBU NVBUBO OFHBUJG LVBU QBEB CBHJBO EBMBN VN EJUFNQFMLBOQBEBTJTJMVBSNFNCSBOTFM,FNVEJBOEJCBHJBO
NFNCSBO TFM QJOUV OBUSJVN EJ CBHJBO MVBS BLBO UFUBQ EBMBN QJQFU EJQBTBOH QFOHJTBQ VOUVL NFOHJTBQ NFNCSBO LF
UFSUVUVQ SBQBU TFCBMJLOZB CJMB CBHJBO EBMBN NFNCSBO EBMBN VKVOH QJQFU )BM JOJ BLBO NFNCFOUVL TVBUV TFLBU EJ
LFIJMBOHBONVBUBOOFHBUJGOZB QJOUVJOJBLBOUFSCVLBTFDBSB TFLFMJMJOH UFQJ QJQFU ZBOH NFOZFOUVI NFNCSBO TFM )BTJMOZB
UJCBUJCB TFIJOHHB NFNVOHLJOLBO TFKVNMBI CFTBS JPO BEBMBITVBUVQPUPOHBOLFDJMNFNCSBOQBEBVKVOHQJQFUUFNQBU
OBUSJVN NFOHBMJS NBTVL NFMBMVJ QPSJQPSJ OBUSJVN BSVTBMJSBOMJTUSJLEBQBUEJSFLBN
,FBEBBO JOJ NFSVQBLBO NFLBOJTNF EBTBS UJNCVMOZB $BSB MBJO TFQFSUJ ZBOH EJQFSMJIBULBO QBEB (BNCBS #
QPUFOTJBM BLTJ QBEB TBSBG ZBOH NFOHIBOUBSLBO TJOZBM TBSBG QPUPOHBOLFDJMNFNCSBOTFMZBOHUFSEBQBUQBEBVKVOHQJQFUEBQBU
1BEB (BNCBS TFCFMBI CBXBI QJOUV LBMJVN CFSBEB EJ EJBNCJM EBSJ TFM 1JQFU CFSTBNB QPUPOHBO ZBOH NFMFLBU QBEBOZB
VKVOH EBMBN QBEB LBOBM LBMJVN EBO QJOUV JOJ BLBO LFNVEJBO EJNBTVLLBO LF EBMBN TVBUV MBSVUBO CFCBT )BM JOJ
NFNCVLB CJMB CBHJBO EBMBN NFNCSBO TFM CFSNVBUBO NFNVOHLJOLBO LPOTFOUSBTJ JPO EJ LFEVB TJTJ ZBJUV EBMBN
QPTJUJG 1FNCVLBBO QJOUVQJOUV UFSTFCVU UVSVU CFSQFSBO NJLSPQJQFUEBOEJEBMBNMBSVUBO EBQBUEJVCBITFTVBJLFJOHJOBO
QBEB UFSKBEJOZB UFSNJOBTJ QPUFOTJBM BLTJ ZBOH BLBO +VHB UFHBOHBO MJTUSJL BOUBSB LFEVB TJTJ NFNCSBO EBQBU EJBUVS
EJCJDBSBLBOMFCJIEFUBJMEJ#BC TFTVBJ LFJOHJOBO ZBJUV DMBNQFE QBEB UFHBOHBO ZBOH TVEBI
2. 1JOUV LJNJBXJ MJHBO
#FCFSBQB QJOUV LBOBM BLBO UFSCVLB EJUFOUVLBO ,JUB EBQBU NFNCVBU QPUPOHBO TFNBDBN JOJ EFOHBO
LBSFOB QFOHJLBUBO TVBUV [BU LJNJB MJHBO
EFOHBO QSPUFJO VLVSBOZBOHDVLVQLFDJMTFIJOHHBIBOZBTBUVQSPUFJOLBOBMZBOH
LBOBM IBM JOJ NFOZFCBCLBO QFSVCBIBO CFOUVL BUBV EJUFNVLBO QBEB QPUPOHBO NFNCSBO ZBOH EJQFMBKBSJ %FOHBO
QFSVCBIBO JLBUBO LJNJB QBEB NPMFLVM QSPUFJO TFIJOHHB NFOHVCBIVCBI LPOTFOUSBTJ JPO EBO UFHBOHBO MJTUSJL ZBOH
QJOUV EBQBU NFNCVLB BUBV NFOVUVQ *OJMBI ZBOH EJTFCVU NFMJOUBTJNFNCSBO LJUBEBQBUNFOFOUVLBOLBSBLUFSJTUJLUSBOTQPS
QJOUVLJNJBXJBUBVQJOUVMJHBO4BMBITBUVDPOUPIUFSQFOUJOH EBOTJGBUQJOUVTFCVBILBOBM
48
UNIT II
SBTJ [BU ZBOH CFSEJGVTJ 1FSCFEBBO BOUBSB EJGVTJ TFEFSIBOB EBO
EJGVTJ UFSGBTJMJUBTJ JOJ EJQFSMJIBULBO QBEB (BNCBS (BNCBS
UFSTFCVUNFOVOKVLLBOCBIXBLFUJLBLPOTFOUSBTJ[BUNFOJOHLBU
LFDFQBUBO EJGVTJ TFEFSIBOB UFSVT NFOJOHLBU TFDBSB QSPQP
STJPOBM OBNVO QBEB EJGVTJ UFSGBTJMJUBTJ LFDFQBUBO EJGVTJ UBL
EBQBUNFMFCJIJOJMBJ7NBLT
"QBLBIZBOHNFNCBUBTJLFDFQBUBOEJGVTJUFSGBTJMJUBTJ +BXBC
BO ZBOH NVOHLJO BEBMBI NFLBOJTNF ZBOH EJJMVTUSBTJLBO QBEB
(BNCBS (BNCBS JOJ NFNQFSMJIBULBO QSPUFJO QFNCBXB
EFOHBOQPSJQPSJZBOHDVLVQCFTBSVOUVLNFOUSBOTQPSNPMFLVM
UFSUFOUV NFMBMVJ TFCBHJBO KBMVS (BNCBS JOJ KVHB NFN
QFSMJIBULBO SFTFQUPS QFOHJLBU EJ CBHJBO EBMBN QSPUFJO
QFNCBXB .PMFLVM ZBOH BLBO EJUSBOTQPS NFNBTVLJ QPSJQPSJ
EBONFOKBEJUFSJLBU,FNVEJBO EBMBNXBLUVTFQFSTFLJBOEFUJL
UFSKBEJQFSVCBIBOCFOUVLBUBVQFSVCBIBOLJNJBXJQBEBQSPUFJO
QFNCBXB TFIJOHHBQPSJQPSJTFLBSBOHUFSCVLBLFTJTJNFNCSBO
ZBOH CFSMBXBOBO 0MFI LBSFOB EBZB JLBU SFTFQUPS MFNBI
QFSHFSBLBO UFSNBM NPMFLVM ZBOH UFSJLBU BLBO NFOZFCBCLBO
NPMFLVM UFSTFCVU NFNJTBILBO EJSJ EBO EJMFQBT QBEB TJTJ NFN
CSBOZBOHCFSMBXBOBO,FDFQBUBOUSBOTQPSNPMFLVMNFMBMVJNF
Difusi Terfasilitasi
%JGVTJ UFSGBTJMJUBTJ EJTFCVU KVHB EJGVTJ ZBOH EJQFSBOUBSBJ QFNCBXB
DBSSJFSNFEJBUFEEJGGVTJPO
LBSFOB[BUZBOHEJUSBOTQPSEFOHBODBSB
JOJ CFSEJGVTJ NFMBMVJ NFNCSBO EFOHBO CBOUVBO QSPUFJO QFNCBXB
ZBOHTQFTJGJL"SUJOZB QFNCBXBBLBONFNGBTJMJUBTJEJGVTJ[BULFTJTJ
MBJO
%JGVTJ UFSGBTJMJUBTJ CFSCFEB EFOHBO EJGVTJ TFEFSIBOB EBMBN IBM
IBMQFOUJOHCFSJLVU8BMBVQVOLFDFQBUBOEJGVTJNFMBMVJLBOBMZBOH
UFSCVLB NFOJOHLBU TFDBSB QSPQPSTJPOBM EFOHBO LPOTFOUSBTJ [BU
ZBOHCFSEJGVTJ QBEBEJGVTJUFSGBTJMJUBTJ LFDFQBUBOEJGVTJNFOEFLBUJ
OJMBJ NBLTJNVN ZBOH EJTFCVU 7NBLT 4FMBNB BEB QFOJOHLBUBO
LPOTFOU
49
Unit ll Fisiologi Membran, Saraf, dan Otot
LBOJTNF JOJ UJEBL QFSOBI EBQBU NFMFCJIJ LFDFQBUBO QFSVCBIBO

NPMFLVM QSPUFJO QFNCBXB ZBOH CPMBLCBMJL BOUBSB LFEVB
LFBEBBO UFSTFCVU .FTLJQVO EFNJLJBO QFSIBUJLBO TFDBSB
TBLTBNB CBIXB NFLBOJTNF JOJ NFNVOHLJOLBO NPMFLVM ZBOH
EJUSBOTQPS EBQBU CFSHFSBL ZBJUV CFSEJGVTJ CPMBLCBMJL NFMBMVJ
NFNCSBO
;BU[BUUFSQFOUJOHZBOHNFMJOUBTJNFNCSBOTFMNFMBMVJQSPTFT
EJGVTJ UFSGBTJMJUBTJ EJ BOUBSBOZB BEBMBI HMVLPTB EBO TFCBHJBO
CFTBSBTBNBNJOP%BMBNIBMHMVLPTB TFUJEBLOZBMJNBNPMFLVM
QFOUSBOTQPS HMVLPTB UFMBI EJUFNVLBO EJ CFSCBHBJ KBSJOHBO – + – +
4FCBHJBO EBSJ QBEBOZB KVHB EBQBU NFOUSBOTQPS CFCFSBQB
NPOPTBLBSJEB MBJO ZBOH NFNQVOZBJ TUSVLUVS NJSJQ EFOHBO
HMVLPTB UFSNBTVL HBMBLUPTB EBO GSVLUPTB 4BMBI TBUV EBSJ
QBEBOZB QFOUSBOTQPS HMVLPTB (-65
EJHJBULBO PMFI
JOTVMJO ZBOH KVHB EBQBU NFOJOHLBULBO LFDFQBUBO EJGVTJ
UFSGBTJMJUBTJ VOUVL HMVLPTB TFCFTBS TBNQBJ LBMJ MJQBU EJ
KBSJOHBO QFLBJOTVMJO *OJMBI NFLBOJTNF EBTBS JOTVMJO EBMBN
NFOHBUVS QFNBLBJBO HMVLPTB EBMBN UVCVI ZBOH UFMBI EJCBIBT
EBMBN#BC
'aktor-Faktor yang Memengaruhi Kecepatan Neto Difusi
4BNQBJ TBBU JOJ TVEBI KFMBT CBIXB CBOZBL [BU EBQBU CFSEJGVTJ P1 P2
NFMBMVJ NFNCSBO TFM )BM ZBOH CJBTBOZB QFOUJOH BEBMBI
LFDFQBUBO OFUP EJGVTJ TVBUV [BU EBMBN BSBI ZBOH EJJOHJOLBO
,FDFQBUBOOFUPUFSTFCVUEJUFOUVLBOPMFICFCFSBQBGBLUPS
Kecepatan Difusi Neto Sebanding dengan Beda
Konsentrasi pada Membran. (BNCBS " NFNQFSMJIBULBO
TVBUVNFNCSBOTFMEFOHBO[BULPOTFOUSBTJUJOHHJEJCBHJBOMVBS
EBOLPOTFOUSBTJSFOEBIEJCBHJBOEBMBN,FDFQBUBOEJGVTJ[BULF
CBHJBOEBMBNTFCBOEJOHEFOHBOLPOTFOUSBTJNPMFLVMEJCBHJBO CFEBBO LPOTFOUSBTJ JPO UFSKBEJ EFOHBO BSBI ZBOH CFSMBXBOBO
MVBS LBSFOB LPOTFOUSBTJ UFSTFCVU NFOFOUVLBO CBOZBLOZB EFOHBO BSBI QFSCFEBBO QPUFOTJBM MJTUSJL 1BEB TBBU UFSTFCVU
NPMFLVM ZBOH NFNCFOUVS CBHJBO MVBS NFNCSBO TFUJBQ EFUJL QFSCFEBBO LPOTFOUSBTJ DFOEFSVOH NFOHHFSBLLBO JPO LF LJSJ
4FCBMJLOZB LFDFQBUBO EJGVTJ NPMFLVM LF CBHJBO MVBS TFCBOEJOH TFEBOHLBO QFSCFEBBO NVBUBO MJTUSJL DFOEFSVOH NFOHHFSBLLBO
EFOHBO LPOTFOUSBTJ NPMFLVM EJ CBHJBO EBMBN NFNCSBO 0MFI JPO LF LBOBO #JMB QFSCFEBBO LPOTFOUSBTJ NFOJOHLBU DVLVQ
LBSFOBJUV LFDFQBUBOEJGVTJOFUPLFEBMBNTFMTFCBOEJOHEFOHBO UJOHHJ LFEVBFGFLUFSTFCVUBLBOTBMJOHNFOHJNCBOHJ1BEBTVIV
LPOTFOUSBTJ CBHJBO MVBS EJLVSBOHJ LPOTFOUSBTJ CBHJBO EBMBN UVCVI OPSNBM ¡$
QFSCFEBBO NVBUBO MJTUSJL ZBOH NFOH
BUBV JNCBOHJ QFSCFEBBO LPOTFOUSBTJ JPO VOJWBMFOU TFQFSUJ JPO
%JGVTJOFUP $P$J
OBUSJVN /B
EBQBU EJUFOUVLBO EFOHBO SVNVT CFSJLVU ZBOH
$P BEBMBI LPOTFOUSBTJ CBHJBO MVBS EBO $ BEBMBI LPOTFOUSBTJ EJTFCVUQFSTBNBBO/FSOTU
CBHJBOEBMBN
&.' EBMBNNJMJWPMU
MPH$
Pengaruh Potensial Listrik Membran terhadap Difusi lon $
"Potensial Nernst". +JLB TVBUV QPUFOTJBM MJTUSJL NFOHBMJS &.' NFSVQBLBO FMFDUSPNPUJWF GPSDF WPMUBTF
BOUBSB TJTJ EBO
NFMJOUBTJ NFNCSBO TFQFSUJ ZBOH EJQFSMJIBULBO QBEB (BNCBS TJTJEBSJNFNCSBO TFEBOHLBO$M NFSVQBLBOLPOTFOUSBTJQBEB
# NVBUBO MJTUSJL JPO BLBO NFOZFCBCLBO JPO UFSTFCVU TJTJ EBO$NFSVQBLBOLPOTFOUSBTJQBEBTJTJ1FSTBNBBOJOJ
CFSHFSBLNFMBMVJNFNCSBONFTLJQVOUJEBLUFSEBQBUQFSCFEBBO TBOHBUQFOUJOHBSUJOZBEBMBNNFNBIBNJUSBOTNJTJJNQVMTTBSBG
LPOTFOUSBTJ VOUVL NFOJNCVMLBO QFSHFSBLBOOZB +BEJ QBEB EBOBLBOEJCBIBTKBVIMFCJINFOEBMBNEJ#BC
CBHJBO LJSJ (BNCBS # LPOTFOUSBTJ JPO OFHBUJG BEBMBI TBNB
QBEB LFEVB TJTJ NFNCSBO OBNVO QBEB TJTJ LBOBO NFNCSBO Pengaruh Perbedaan Tekanan antara Kedua Sisi
UFSEBQBU NVBUBO QPTJUJG EBO NVBUBO OFHBUJG QBEB TJTJ LJSJOZB Membran. ,BEBOHLBEBOH UJNCVM QFSCFEBBO UFLBOBO ZBOH
TFIJOHHB NFODJQUBLBO TVBUV HSBEJFO MJTUSJL EJ LFEVB TJTJ CFSNBLOB BOUBSB LFEVB TJTJ NFNCSBO ZBOH EBQBU NFOHBMBNJ
NFNCSBO.VBUBOQPTJUJGBLBONFOBSJLJPOOFHBUJG TFNFOUBSB EJGVTJ ,FBEBBO JOJ UFSKBEJ NJTBMOZB QBEB NFNCSBO LBQJMFS
NVBUBOOFHBUJGNFOPMBLOZB0MFILBSFOBJUV UFSKBEJEJGVTJOFUP EBSBIZBOHUFSEBQBUEJTFNVBKBSJOHBOUVCVI5FLBOBOEJCBHJBO
EBSJ LJSJ LF LBOBO 4FUFMBI CFCFSBQB XBLUV TFKVNMBI CFTBS JPO EBMBNLBQJMFSLJSBLJSBNN)HMFCJICFTBSEBSJQBEBEJCBHJBO
OFHBUJGUFMBICFSQJOEBILFLBOBO EBOUFSCFOUVLLPOEJTJTFQFSUJ MVBS 4FCFOBSOZB UFLBOBO CFSBSUJ QFOKVNMBIBO TFNVB HBZB EBSJ
ZBOHEJHBNCBSLBOQBEB(BNCBS#TFCFMBILBOBO ZBJUVQFS CFSCBHBJNPMFLVMZBOHNFNCFOUVSTBUVTBUVBOMVBSQFSNVLBBO
50
QBEBTBUVTBBUUFSUFOUV0MFILBSFOBJUV CJMBUFLBOBOQBEBTBMBI
TBUVTJTJNFNCSBOMFCJICFTBSEBSJQBEBUFLBOBOEJTJTJMBJOOZB JOJ
CFSBSUJ CBIXB KVNMBI TFNVB HBZB NPMFLVM ZBOH NFNCFOUVS
LBOBM QBEB TJTJ NFNCSBO UFSTFCVU MFCJI CFTBS EBSJQBEB KVNMBI
HBZB EJ TJTJ MBJOOZB 1BEB TFCBHJBO CFTBS LFBEBBO IBM JOJ
UNIT II
EJTFCBCLBOKVNMBINPMFLVMZBOHNFNCFOUVSNFNCSBOQFSEFUJL
MFCJI CFTBS QBEB TBMBI TBUV TJTJ EBSJQBEB UFLBOBO EJ TJTJ MBJOOZB
"LJCBUOZB QFOJOHLBUBOFOFSHJZBOHUFSTFEJBBLBONFOZFCBCLBO
QFSHFSBLBOOFUPNPMFLVMEBSJTJTJZBOHCFSUFLBOBOUJOHHJLFBSBI
TJTJZBOHCFSUFLBOBOSFOEBI1FOHBSVIQFSCFEBBOUFLBOBOJOJEJ
JMVTUSBTJLBO QBEB (BNCBS $ ZBOH NFNQFSMJIBULBO TFCVBI
QJTUPO ZBOH NFOJNCVMLBO UFLBOBO UJOHHJ QBEB TBMBI TBUV TJTJ
TVBUV QPSJQPSJ TFIJOHHB NFOZFCBCLBO MFCJI CBOZBL NPMFLVM
NFNCFOUVS QPSJQPSJ QBEB TJTJ UFSTFCVU EBO LBSFOB JUV MFCJI
CBOZBLNPMFLVMZBOHCFSEJGVTJLFTJTJMBJOOZB
r
Osmosis melalui Membran Permeabel Selektif "Difusi r
Neto" Air
4FMBNBJOJ [BUZBOHQBMJOHCBOZBLCFSEJGVTJNFMBMVJNFNCSBOTFM
BEBMBI BJS +VNMBI BJS ZBOH CFSEJGVTJ EJ TFUJBQ BSBI NFMBMVJ
NFNCSBO TFM EBSBI NFSBI QFS EFUJL TFCBOZBL LJSBLJSB LBMJ UFLBOBO ZBOH TFDBSB QBTUJ EJQFSMVLBO VOUVL NFOHIFOUJLBO
WPMVNFTFMJUVTFOEJSJ/BNVO QBEBLFBEBBOOPSNBM KVNMBIZBOH QSPTFT PTNPTJT BJS EJTFCVU UFLBOBO PTNPUJL MBSVUBO OBUSJVN
CFSEJGVTJ EBMBN EVB BSBI CFOBSCFOBS TFJNCBOH TFIJOHHB UJEBL LMPSJEB
UFSKBEJQFSHFSBLBOOFUPBJSTFEJLJUQVO0MFILBSFOBJUV WPMVNFTFM 1SJOTJQ TVBUV QFSCFEBBO UFLBOBO ZBOH NFMBXBO PTNPTJT
UFUBQ LPOTUBO "LBO UFUBQJ QBEB LFBEBBO UFSUFOUV EBQBU UFSKBEJ EJUVOKVLLBO EBMBN (BNCBS ZBOH NFNQFSMJIBULBO
QFSCFEBBO LPOTFOUSBTJ BJS BOUBSB LFEVB TJTJ NFNCSBO EFNJLJBO NFNCSBO QFSNFBCFM TFMFLUJG ZBOH NFNJTBILBO EVB LPMPN
QVMBIBMOZBEFOHBOLPOTFOUSBTJ[BUMBJO#JMBIBMJUVUFSKBEJ UJNCVM DBJSBO TBUV LPMPN NFOHBOEVOH BJS NVSOJ EBO LPMPN MBJO
QFSHFSBLBO OFUP BJS NFMBMVJ NFNCSBO ZBOH NFOHBLJCBULBO TFM NFOHBOEVOH MBSVUBO BJS EBO [BU UFSMBSVU ZBOH UJEBL BLBO
NFNCFOHLBL BUBV NFOHFSVU CFSHBOUVOH BSBI QFSHFSBLBO BJS NFOFNCVTNFNCSBO0TNPTJTBJSEBSJSVBOH#LFEBMBNSVBOH
1SPTFTQFSHFSBLBOOFUPBJSJOJEJTFCBCLBOPMFIBEBOZBQFSCFEBBO " NFOZFCBCLBO LFEVB UJOHLBU LPMPN DBJSBO UFSQJTBI TFNBLJO
LPOTFOUSBTJBJSZBOHEJTFCVUPTNPTJT KBVI TBNQBJ BLIJSOZB UJNCVM QFSCFEBBO UFLBOBO ZBOH DVLVQ
4FCBHBJ DPOUPI PTNPTJT NBSJMBI LJUB NFOHBTVNTJLBO TVBUV CFTBS EJ BOUBSB LFEVB TJTJ NFNCSBO VOUVL NFMBXBO FGFL
LFBEBBO TFQFSUJ ZBOH UBNQBL QBEB (BNCBS EFOHBO BJS PTNPUJL1FSCFEBBOUFLBOBOEJTFQBOKBOHNFNCSBOQBEBTBBU
NVSOJZBOHUFSEBQBUQBEBTBMBITBUVTJTJNFNCSBOTFMEBOMBSVUBO
OBUSJVN LMPSJEB QBEB TJTJ MBJOOZB .PMFLVM BJS EBQBU NFMBMVJ
NFNCSBOTFMEFOHBONVEBI TFEBOHLBOJPOOBUSJVNEBOLMPSJEB
TVMJU NFMBMVJOZB 0MFI LBSFOB JUV MBSVUBO OBUSJVN LMPSJEB
TFCFOBSOZB NFSVQBLBO DBNQVSBO EBSJ NPMFLVM BJS ZBOH CFSTJGBU
QFSNFBCFM EBO JPO OBUSJVN TFSUB JPO LMPSJEB ZBOH CFSTJGBU
OPOQFSNFBCFM BUBVEFOHBOLBUBMBJO NFNCSBOCFSTJGBUQFSNFBCFM
TFMFLUJG VOUVL BJS UBQJ UJEBL VOUVL JPO OBUSJVN EBO LMPSJEB
/BNVO BEBOZB OBUSJVN EBO LMPSJEB UFMBI NFOHHBOUJLBO
CFCFSBQB NPMFLVM BJS QBEB TJTJ NFNCSBO UFNQBU JPOJPO JOJ
CFSBEB EBO LBSFOB JUV NFOVSVOLBO LPOTFOUSBTJ NPMFLVM BJS
TFIJOHHBMFCJISFOEBIEBSJQBEBLPOTFOUSBTJBJSNVSOJ"LJCBUOZB
TFCBHBJNBOBZBOHEJQFSMJIBULBOQBEB(BNCBS MFCJICBOZBL
NPMFLVM BJS ZBOH NFNCFOUVS LBOBM QBEB TJTJ LJSJ UFNQBU BJS
NVSOJ CFSBEB EJCBOEJOHLBO QBEB TJTJ LBOBO ZBOH TVEBI
CFSLVSBOHLPOTFOUSBTJBJSOZB%FOHBOEFNJLJBO QFSHFSBLBOOFUP
BJSUFSKBEJEBSJLJSJLFLBOBOBSUJOZB PTNPTJTUFSKBEJEBOBJSNVSOJ
LFEBMBNMBSVUBOOBUSJVNLMPSJEB
Tekanan Osmotik
+JLB EBMBN LFBEBBO TFQFSUJ (BNCBS EJCFSJLBO UFLBOBO QBEB
MBSVUBO OBUSJVN LMPSJEB PTNPTJT BJS LF EBMBN MBSVUBO UFSTFCVU
BLBONFOKBEJMBNCBU UFSIFOUJ BUBVCBILBOCFSCBMJLBSBI#FTBSOZB u .
51
JOJTBNBEFOHBOUFLBOBOPTNPUJLMBSVUBOZBOHNFOHBOEVOH[BU BLJCBUOZB LFEVBJPOUFSTFCVUUJEBLEBQBUCFSHFSBLEFOHBOCFCBT

UFSMBSVUZBOHUBLEBQBUCFSEJGVTJ EBMBN DBJSBO UVCVI EBO UBL EBQBU NFOJNCVMLBO QPUFOTJBM
UFLBOBO PTNPUJL ZBOH TFTVOHHVIOZB 0MFI LBSFOB JUV OJMBJ
Pentingnya Jumlah Partikel Osmotik (Konsentrasi Molar)
UFLBOBOPTNPUJLDBJSBOUVCVIZBOHTFTVOHHVIOZBLJSBLJSB
dalam Menentukan Tekanan Osmotik. 5FLBOBO PTNPUJL LBMJOJMBJZBOHEJIJUVOH
ZBOHEJIBTJMLBOQBSUJLFMEBMBNMBSVUBOEJUFOUVLBOPMFIKVNMBI
QBSUJLFMQFSVOJUWPMVNFDBJSBOEBOCVLBOPMFINBTTBQBSUJLFM lstilah "Osmolaritas". 0TNPMBSJUBTBEBMBILPOTFOUSBTJPTNPMBS
UBL QFEVMJ QBSUJLFM UFSTFCVU CFSVQB NPMFLVM BUBV JPO "MBTBO ZBOH EJOZBUBLBO EFOHBO PTNPM QFS MJUFS MBSVUBO EBO CVLBO
VOUVLLFBEBBOJOJBEBMBICBIXBSBUBSBUBTFUJBQQBSUJLFMEBMBN PTNPM QFS LJMPHSBN BJS .FTLJQVO TVEBI EJUFOUVLBO CBIXB
MBSVUBO UBOQBNFNQFSIBUJLBONBTTBOZB NFOHIBTJMLBOKVNMBI PTNPMQFSLJMPHSBNBJS PTNPMBMJUBT
ZBOHNFOFOUVLBOUFLBOBO
UFLBOBO ZBOH TBNB UFSIBEBQ NFNCSBO 0MFI LBSFOB JUV PTNPUJL VOUVL MBSVUBO ZBOH FODFS TFQFSUJ ZBOH UFSEBQBU EBMBN
QBSUJLFMCFTBS ZBOHNFNQVOZBJNBTTB N
MFCJICFTBSEBSJQBEB UVCVI QFSCFEBBOLVBOUJUBUJGBOUBSBPTNPMBSJUBTEBOPTNPMBMJUBT
QBSUJLFMLFDJM CFSHFSBLEFOHBOLFDFQBUBO W
ZBOHMFCJISFOEBI BEBMBI LVSBOH EBSJ QFSTFO 0MFI LBSFOB KBVI MFCJI QSBLUJT
1BSUJLFM LFDJM CFSHFSBL EFOHBO LFDFQBUBO ZBOH MFCJI UJOHHJ VOUVL NFOHVLVS PTNPMBSJUBT EBSJQBEB PTNPMBMJUBT PTNPMBSJUBT
TFIJOHHB FOFSHJ LJOFUJL SBUBSBUBOZB L
ZBOH EJUFOUVLBO PMFI CJBTBEJQBLBJEJIBNQJSTFNVBTUVEJGBBM
QFSTBNBBO
"Transpor Aktif" Zat melalui Membran
mv 2
k=
2
,BEBOH TFKVNMBI CFTBS LPOTFOUSBTJ [BU EJCVUVILBO EJ EBMBN
BEBMBITBNBVOUVLTFUJBQQBSUJLFMLFDJM ZBOHCFSMBLVKVHBVOUVL DBJSBO JOUSBTFMVMBS XBMBVQVO DBJSBO FLTUSBTFMVMBS IBOZB
TFUJBQ QBSUJLFM CFTBS "LJCBUOZB GBLUPS ZBOH NFOFOUVLBO NFOHBOEVOH[BUEFOHBOLPOTFOUSBTJZBOHLFDJM)BMJOJUFSKBEJ
UFLBOBOPTNPUJLTVBUVMBSVUBOBEBMBILPOTFOUSBTJMBSVUBOZBOH NJTBMOZB VOUVLJPOLBMJVN4FCBMJLOZB LPOTFOUSBTJJPOMBJOOZB
EJUFOUVLBOPMFIKVNMBIQBSUJLFM ZBOHTBNBEFOHBOLPOTFOUSBTJ IBSVTEJQFSUBIBOLBOEBMBNKVNMBIZBOHTBOHBUSFOEBIEJEBMBN
NPMBSOZB KJLB MBSVUBO UFSTFCVU NFSVQBLBO NPMFLVM ZBOH UJEBL TFM XBMBVQVO LPOTFOUSBTJOZB EBMBN DBJSBO FLTUSBTFMVMBS CFTBS
UFSVSBJ
EBOCVLBOEJUFOUVLBOPMFINBTTB[BUUFSMBSVU )BMJOJLIVTVTOZBUFSKBEJVOUVLJPOOBUSJVN5BLTBUVQVOEBSJ
LFEVB LFBEBBO UFSTFCVU ZBOH EBQBU UFSXVKVE NFMBMVJ QSPTFT
"Osmotalitas" Osmol. 6OUVL NFOZBUBLBO LPOTFOUSBTJ EJGVTJ TFEFSIBOB LBSFOB EJGVTJ TFEFSIBOB QBEB BLIJSOZB BLBO
TVBUV MBSVUBO ZBOH EJUFOUVLBO PMFI KVNMBI QBSUJLFM EJHVOBLBO NFOZFUBSBLBO LPOTFOUSBTJ QBEB LFEVB TJTJ NFNCSBO 4FCBHBJ
TBUVBOZBOHEJTFCVUPTNPMTFCBHBJQFOHHBOUJTBUVBOHSBN HBOUJOZB CFCFSBQB TVNCFS FOFSHJ IBSVT NFOJNCVMLBO
4BUV PTNPM BEBMBI HSBN CFSBU NPMFLVM VOUVL [BU UFSMBSVU QFSHFSBLBO NBTJG JPO LBMJVN LF EBMBN TFM EBO NFOZFCBCLBO
ZBOH NFOHBMBNJ PTNPTJT BLUJG +BEJ HSBN HMVLPTB ZBOH QFSHFSBLBO NBTJG JPO OBUSJVN LF MVBS TFM 1SPTFT QBEB TBBU
NFSVQBLBO HSBN CFSBU NPMFLVM HMVLPTB TFUBSB EFOHBO NFNCSBO TFM NFOHHFSBLLBO NPMFLVM BUBV JPO NFOBOKBL OBJL
PTNPM HMVLPTB LBSFOB NPMFLVM HMVLPTB UJEBL UFSVSBJ NFOKBEJ NFMBXBO TVBUV HSBEJFO LPOTFOUSBTJ BUBV NFOBOKBL OBJL
JPO+JLBTVBUV[BUUFSMBSVUUFSVSBJNFOKBEJEVBJPO HSBNCFSBU NFMBXBOHSBEJFOMJTUSJLBUBVHSBEJFOUFLBOBO
EJTFCVUUSBOTQPS
NPMFLVM[BUUFSMBSVUBLBONFOHIBTJMLBOPTNPMLBSFOBKVNMBI BLUJG
QBSUJLFM PTNPUJL BLUJG TFLBSBOH BEBMBI EVB LBMJ MFCJI CFTBS #FSCBHBJ NBDBN [BU ZBOH EJUSBOTQPS TFDBSB BLUJG TFUJEBLOZB
EBSJQBEB [BU UFSMBSVU ZBOH UJEBL UFSVSBJ 0MFI LBSFOB JUV CJMB NFMBMVJ CFCFSBQB NFNCSBO TFM NFMJQVUJ JPO OBUSJVN JPO
/B$ UFSVSBJ TFQFOVIOZB HSBN CFSBU NPMFLVM OBUSJVN LBMJVN JPO LBMTJVN JPO CFTJ JPO IJESPHFO JPO LMPSJEB JPO
LMPSJEB HSBN BLBOTFUBSBEFOHBOPTNPM JPEJO JPO VSBU CFCFSBQB KFOJT HVMB EBO TFCBHJBO CFTBS BTBN
4VBUV MBSVUBO ZBOH NFOHBOEVOH PTNPM [BU ZBOH UFSMBSVU BNJOP
EBMBNLJMPHSBNBJSEJLBUBLBONFNQVOZBJPTNPMBMJUBTTFCFTBS
Transpor Aktif Primer dan Transpor Aktif Sekunder. 5SBO
PTNPMLH EBO MBSVUBO ZBOH NFOHBOEVOH PTNPM [BU
TQPS BLUJG UFSCBHJ EBMBN EVB UJQF CFSEBTBSLBO TVNCFS FOFSHJ
UFSMBSVUQFSLJMPHSBNNFNQVOZBJPTNPMBMJUBTN0TNLH/JMBJ
ZBOHEJQBLBJVOUVLNFOJNCVMLBOUSBOTQPSUSBOTQPSBLUJGQSJNFS
PTNPMBMJUBTOPSNBMDBJSBOFLTUSBTFMVMBSEBOJOUSBTFMBEBMBILJSB
EBO USBOTQPS BLUJG TFLVOEFS 1BEB USBOTQPS BLUJG QSJNFS FOFSHJ
LJSBN0TNLHBJS
TFDBSB MBOHTVOH EJQFSPMFI EBSJ QFNFDBIBO BEFOPTJO USJGPTGBU
Hubungan Osmotalitas dengan Tekanan Osmotik. 1BEB "51
BUBV CFCFSBQB TFOZBXB GPTGBU CFSFOFSHJUJOHHJ MBJOOZB
TVIV UVCVI OPSNBM ¡$ OJMBJ LPOTFOUSBTJ PTNPM- BLBO 1BEB USBOTQPS BLUJG TFLVOEFS FOFSHJ TFLVOEFS EJQFSPMFI EBSJ
NFOJNCVMLBO UFLBOBO PTNPUJL EBMBN MBSVUBO TFCFTBS FOFSHJZBOHUFSTJNQBOEBMBNCFOUVLQFSCFEBBOLPOTFOUSBTJJPO
NN )H %FNJLJBO QVMB LPOTFOUSBTJ N0TN- TFUBSB EFOHBO EBO NPMFLVM BUBV [BU JPO BOUBSB LFEVB TJTJ NFNCSBO ZBOH
UFLBOBOPTNPUJLTFCFTBS NN)H%FOHBONFOHBMJLBOOJMBJ EJUJNCVMLBO PMFI QSPTFT USBOTQPS BLUJG QSJNFS TFCFMVNOZB
JOJ EFOHBO OJMBJ LPOTFOUSBTJ DBJSBO UVCVI TFCFTBS N0TN ,FEVB KFOJT USBOTQPS BLUJG UFSTFCVU CFSHBOUVOH QBEB QSPUFJO
BLBO NFNCFSJ UPUBM QFSIJUVOHBO UFLBOBO PTNPUJL DBJSBO JOJ QFNCBXB ZBOH NFOFNCVT NFNCSBO TFM ZBOH KVHB UFSKBEJ QBEB
TFCFTBS NN )H "LBO UFUBQJ IBTJM QFOHVLVSBO ZBOH QSPTFTEJGVTJUFSGBTJMJUBTJ"LBOUFUBQJ QBEBQSPTFTUSBOTQPSBLUJG
EJQFSPMFI SBUBSBUB IBOZB TFLJUBS NN )H 1FSCFEBBO JOJ GVOHTJQSPUFJOQFNCBXBCFSCFEBEFOHBOQSPUFJOQFNCBXBQBEB
EJTFCBCLBO CBOZBLOZB JPO EBMBN DBJSBO UVCVI TFQFSUJ JPO QSPTFT EJGVTJ UFSGBTJMJUBTJ LBSFOB NBNQV NFNCFSJLBO FOFSHJ
OBUSJVNEBOLMPSJEB ZBOHUBSJLNFOBSJLEFOHBOTBOHBULVBU LFQBEB[BUZBOHEJUSBOTQPSVOUVLCFSHFSBLNFMBXBOHSBEJFOFMFL
52
USPLJNJB #FSJLVU BEBMBI CFCFSBQB DPOUPI USBOTQPS BLUJG QSJNFS 1BEB TBBU EVB JPO LBMJVN UFSJLBU QBEB CBHJBO MVBS QSPUFJO
EBO USBOTQPS BLUJG TFLVOEFS EJTFSUBJ QFOKFMBTBO ZBOH MFCJI EFUBJM QFNCBXBEBOUJHBJPOOBUSJVNUFSJLBUQBEBCBHJBOEBMBNOZB
NFOHFOBJQSJOTJQEBTBSLFEVBQSPTFTUFSTFCVU GVOHTJ "51BTF QBEB QSPUFJO BLBO NFOKBEJ BLUJG "51BTF ZBOH
BLUJGJOJLFNVEJBOBLBONFNFDBILBOTBUVNPMFLVM"51 ZBOH
Transpor Aktif Primer UFSVSBJ NFOKBEJ BEFOPTJO EJGPTGBU "%1
EBO NFNCFCBTLBO
UNIT II
FOFSHJ ZBOH CFSBTBM EBSJ TFCVBI JLBUBO GPTGBU CFSFOFSHJUJOHHJ
Pompa Natrium-Kalium &OFSHJZBOHEJCFCBTLBOJOJ LFNVEJBO EJZBLJOJNFOZFCBCLBO
;BU[BU ZBOH EJUSBOTQPS PMFI USBOTQPS BLUJG QSJNFS EJ BOUBSBOZB QFSVCBIBO CFOUVL EBO LJNJBXJ QBEB NPMFLVM QSPUFJO
BEBMBIOBUSJVN LBMJVN LBMTJVN IJESPHFO LMPSJEB EBOCFCFSBQB QFNCBXB ZBOH NFOEPSPOH UJHB JPO OBUSJVN LFMVBS EBO UJHB
JPOMBJOOZB JPOLBMJVNLFEBMBN
.FLBOJTNFUSBOTQPSBLUJGZBOHQBMJOHEFUBJMEJQFMBKBSJBEBMBI 4FQFSUJ FO[JNFO[JN MBJO QPNQB /B, "51BTF EBQBU
QPNQB OBUSJVNLBMJVN /B,
ZBJUV TVBUV QSPTFT USBOTQPS CFSGVOHTJEBMBNBSBIZBOHTFCBMJLOZB+JLBHSBEJFOFMFLUSPLJNJB
ZBOH NFNPNQB JPO OBUSJVN LFMVBS NFMBMVJ NFNCSBO ZBOH VOUVL JPO /B EBO , DVLVQ NFOJOHLBU TFDBSB FLTQFSJNFOUBM
UFSEBQBU EJ TFNVB TFM EBO QBEB TBBU ZBOH TBNB NFNPNQB JPO TFIJOHHB FOFSHJ ZBOH UFSTJNQBO EBMBN HSBEJFO UFSTFCVU MFCJI
LBMJVN EBSJ MVBS LF EBMBN 1PNQB JOJ CFSUBOHHVOH KBXBC VOUVL CFTBSEBSJQBEB FOFSHJ LJNJBXJZBOH EJIBTJMLBO EBSJQFNFDBIBO
NFOKBHB QFSCFEBBO LPOTFOUSBTJ OBUSJVN EBO LBMJVN EJ BOUBSB "51 LFEVB JPO UFSTFCVU BLBO CFSHFSBL NFOHJLVUJ HSBEJFO
LFEVB TJTJ NFNCSBO TFM EBO CFSQFSBO VOUVL NFODJQUBLBO LPOTFOUSBTJOZBEBOQPNQB/B,BLBONFOZJOUFTJT"51EBSJ
UFHBOHBO MJTUSJL ZBOH CFSTJGBU OFHBUJG EJ EBMBN TFM #BC BLBO "%1 EBO GPTGBU #FOUVL QPNQB /B, ZBOH UFSGPTGPSJMBTJ
NFOVOKVLLBO CBIXB QPNQB JOJ KVHB NFSVQBLBO EBTBS CBHJ LBSFOB JUV EBQBU NFOZVNCBOHLBO GPTGBUOZB QBEB "%1 VOUVL
GVOHTJ TBSBG ZBOH BLBO NFOHIBOUBSLBO TJOZBM LF TFMVSVI TJTUFN NFNQSPEVLTJ "51 BUBV NFOHHVOBLBO FOFSHJ ZBOH EJNJMJLJ
TBSBG VOUVLNFOHVCBICFOUVLQPNQBEBONFNPNQB/BLFMVBSTFM
EBO , LF EBMBN TFM ,POTFOUSBTJ SFMBUJG "51 "%1 EBO GPTGBU
(BNCBS NFNQFSMJIBULBO LPNQPOFO GJTJL EBTBS QPNQB
/B, 1SPUFJO QFNCBXB NFSVQBLBO TVBUV LPNQMFLT ZBOH TFSUB HSBEJFO FMFLUSPLJNJB VOUVL /B, BLBO NFOFOUVLBO
UFSEJSJBUBTEVBQSPUFJOHMPCVMVTZBOHUFSQJTBIQSPUFJOZBOHMFCJI BSBI SFBLTJ FO[JN 1BEB CFCFSBQB TFM NJTBMOZB TFM TBSBG ZBOH
CFTBS EJTFCVU TVCVOJU B EFOHBO CFSBU NPMFLVM LJSBLJSB NFNJMJLJ BLUJWJUBT MJTUSJL TBNQBJ QFSTFO EBSJ LFCVUVIBO
EBO QSPUFJO ZBOH MFCJI LFDJM EJTFCVU TVCVOJU EFOHBO CFSBU FOFSHJ TFM EJUVKVLBO VOUVL QFNPNQBBO /B LFMVBS EBO , LF
NPMFLVMTFLJUBS8BMBVQVOGVOHTJQSPUFJOZBOHMFCJILFDJM EBMBNTFM
CFMVN EJLFUBIVJ LFDVBMJ CBIXB QSPUFJO JOJ NVOHLJO NFOBIBO Pompa Na+-K+ Penting dalam Pengaturan Volume Sel.
LPNQMFLT QSPUFJO EBMBN NFNCSBO MJQJE
QSPUFJO ZBOH MFCJI 4BMBI TBUV GVOHTJ UFSQFOUJOH QPNQB /B, BEBMBI VOUVL
CFTBS NFNJMJLJ UJHB LFJTUJNFXBBO LIVTVT ZBOH QFOUJOH VOUVL NFOHBUVS WPMVNF TFUJBQ TFM 5BOQB GVOHTJ QPNQB JOJ
NFOKBMBOLBOGVOHTJQPNQBUFSTFCVU LFCBOZBLBO TFM UVCVI BLBO NFNCFOHLBL TBNQBJ QFDBI
.FLBOJTNF ZBOH NFOHPOUSPM WPMVNF UFSTFCVU BEBMBI TFCBHBJ
1. .FNJMJLJ UJHB SFTFQUPS UFNQBU QFOHJLBUBO JPO OBUSJVN QBEB CFSJLVU %J EBMBN TFM UFSEBQBU TFKVNMBI CFTBS QSPUFJO EBO
CBHJBOQSPUFJOZBOHNFOPOKPMLFEBMBNTFM NPMFLVM PSHBOJL MBJO ZBOH UJEBL EBQBU LFMVBS EBSJ TFM
2. .FNJMJLJ EVB SFTFQUPS VOUVL JPO LBMJVN QBEB CBHJBO MVBS ,FCBOZBLBOLPNQPOFOUFSTFCVUCFSNVBUBOOFHBUJGEBOLBSFOB
QSPUFJO JUV BLBO NFOBSJL TFKVNMBI CFTBS LBMJVN OBUSJVN EBO JPO
3. #BHJBO EBMBN QSPUFJO ZBOH UFSMFUBL EFLBU EFOHBO UFNQBU QPTJUJGMBJOOZB4FNVBNPMFLVMEBOJPOJOJBLBONFOZFCBCLBO
UFSKBEJOZB PTNPTJT BJS LF EBMBN TFM +JLB IBM JOJ UJEBL EJ
QFOHJLBUBOOBUSJVN NFNJMJLJBLUJWJUBT"51BTF
LFOEBMJLBO TFM BLBO NFNCFOHLBL TBNQBJ QFDBI .FLBOJTNF
OPSNBM ZBOH NFODFHBI IBM UFSTFCVU BEBMBI QPNQB /B,
1FSIBUJLBO TFLBMJ MBHJ CBIXB QPNQB JOJ BLBO NFNPNQB UJHB
JPO/BLFMVBSEBSJTFMTFUJBQUFSKBEJQFNBTVLBOEVBJPO,LF
EBMBN .FNCSBO TFM KVHB NFNJMJLJ QFSNFBCJMJUBT ZBOH KBVI
MFCJI SFOEBI UFSIBEBQ JPO OBUSJVN EJCBOEJOHLBO JPO LBMJVN
TFIJOHHBCFHJUVJPOOBUSJVNCFSBEBEJMVBS JPOUFSTFCVUTBOHBU
DFOEFSVOH VOUVL UFUBQ CFSBEB EJ TBOB +BEJ LFBEBBO JOJ
NFNVOHLJOLBO JPO VOUVL EBQBU LFMVBS EBSJ TFM EBO BLBO
NFODFUVTLBO QSPTFT PTNPTJT BJS ZBOH LFMVBS EBSJ TFM #JMB TFM
NVMBJ NFNCFOHLBL LBSFOB TVBUV TFCBC QPNQB /B, BLBO
NFOKBEJ BLUJG TFDBSB PUPNBUJT EBO BLBO NFOHFMVBSLBO MFCJI
CBOZBLJPOLFMVBSEBONFNCBXBBJSCFTFSUBOZB0MFILBSFOB
JUV QPNQB /B, NFOKBMBOLBO QFSBO QFNBOUBVBO ZBOH
CFSLFTJOBNCVOHBO VOUVL NFNQFSUBIBOLBO WPMVNF OPSNBM
TFM
4JGBU&MFLUSPHFOJL1PNQB/B,,FOZBUBBOCBIXBQPNQB
/B,NFNJOEBILBOUJHBJPO/BLFMVBSTFMVOUVLTFUJBQEVB
JPO,ZBOHNBTVLLFEBMBNCFSBSUJCBIXBBLIJSOZB BLBOBEB
TBUVNVBUBOQPTJUJGZBOHQJOEBIEBSJEBMBNTFMLFMVBSTFMQBEB
TFUJBQTJLMVTQPNQB)BMJOJNFOJNCVMLBOLFQPTJUJGBOEJMVBSTFM
53
TFEBOHLBO JPO QPTJJG CFSLVSBOH KVNMBIOZB EJ EBMBN TFM ZBOH EJ CVUVILBO FOFSHJ EVB LBMJ MFCJI CBOZBL EBO VOUVL NFNFLBU
CFSBSUJ CBHJBO EBMBN TFM CFSBEB EBMBN LFOFHBUJGBO 0MFI LBOOZBLBMJMJQBUEJCVUVILBOFOFSHJUJHBLBMJMFCJICBOZBL
LBSFOB JUV QPNQB /B, EJLBUBLBO CFSTJGBU FMFLUSPHFOJL %FOHBO LBUB MBJO FOFSHJ ZBOH EJCVUVILBO TFCBOEJOH EFOHBO
LBSFOB NFOJNCVMLBO QPUFOTJBM MJTUSJL EJ BOUBSB LFEVB TJTJ MPHBSJUNBEBSJLBEBS[BUZBOHEJQFLBULBO TFQFSUJZBOHEJOZBUBLBO
NFNCSBO TFM 4FQFSUJ ZBOH EJCBIBT #BC 1PUFOTJBM MJTUSJL PMFISVNVTCFSJLVU
UFSTFCVU NFSVQBLBO LFCVUVIBO EBTBS EJ EBMBN TFSBCVU TBSBG
Energi (dalam kalori per osmol) =1.400 log C1
EBOPUPUVOUVLNFOHIBOUBSLBOTJOZBMTBSBGEBOPUPU C2
+BEJ EBMBNTBUVBOLBMPSJ KVNMBIFOFSHJZBOHEJQFSMVLBOVOUVL
Transpor Aktif Primer untuk lon Kalsium NFNFLBULBO PTNPM [BU TFCBOZBL LBMJ MJQBU BEBMBI TFLJUBS
.FLBOJTNFUSBOTQPSBLUJGQSJNFSZBOHQFOUJOHMBJOOZBBEBMBI LBMPSJBUBVVOUVLTFCBOZBLLBMJMJQBU EJQFSMVLBOFOFSHJ
QPNQB LBMTJVN *PO LBMTJVN OPSNBMOZB EJQFSUBIBOLBO QBEB LBMPSJ ,JUB EBQBU NFOHFUBIVJ CBIXB FOFSHJ ZBOH
LPOTFOUSBTJ ZBOH TBOHBU SFOEBI EBMBN TJUPTPM JOUSBTFMVMBS EJ EJLFMVBSLBO VOUVL NFNFLBULBO [BU EJ EBMBN TFM BUBV VOUVL
IBNQJS TFNVB TFM UVCVI EFOHBO LPOTFOUSBTJ LJSBLJSB NFOHFMVBSLBO [BU EBSJ TFM EFOHBO NFMBXBO HSBEJFO LPOTFOUSBTJ
LBMJ MFCJI LFDJM EBSJQBEB LPOTFOUSBTJOZB EBMBN DBJSBO EBQBU CFSKVNMBI TBOHBU CFTBS #FCFSBQB TFM TFQFSUJ TFM ZBOH
FLTUSBTFMVMBS ,FBEBBO JOJ EJXVKVELBO UFSVUBNB NFMBMVJ EVB NFMBQJTJ UVCVMVT HJOKBM EBO CBOZBL TFM LFMFOKBS NFOHFMVBSLBO
QPNQBLBMTJVNUSBOTQPSBLUJGQSJNFS4FCVBIQPNQBUFSEBQBU TFCBOZBL QFSTFO FOFSHJOZB IBOZB VOUVL UFSDBQBJOZB GVOHTJ
EJ NFNCSBO TFM EBO NFNPNQB LBMTJVN LF MVBS TFM 1PNQB UFSTFCVU
MBJOOZB NFNPNQB JPO LBMTJVN LF EBMBN TBUV BUBV MFCJI
PSHBOFMJOUSBTFMZBOHCFSWFTJLFMTFQFSUJSFUJLVMVNTBSLPQMBTNB
Transpor Aktif Sekunder—Ko-Transpor dan Transpor-Tukar
TFMPUPUEBONJUPLPOESJBZBOHUFSEBQBUEJTFNVBTFM%JTFUJBQ #JMBJPOOBUSJVNEJUSBOTQPSLFMVBSEBSJTFMNFMBMVJUSBOTQPSBLUJG
QPNQB UFSTFCVU QSPUFJO QFNCBXB NFOFNCVT NFNCSBO EBO QSJNFS CJBTBOZB UJNCVM HSBEJFO LPOTFOUSBTJ ZBOH CFTBS EBSJ
CFSGVOHTJ TFCBHBJ TVBUV FO[JN "51BTF ZBOH NFNJMJLJ OBUSJVNEJLFEVBTJTJNFNCSBOTFMLPOTFOUSBTJZBOHUJOHHJEJMVBS
LFNBNQVBO ZBOH TBNB VOUVL NFNFDBILBO "51 TFQFSUJ TFMEBOLPOTFOUSBTJZBOHTBOHBUSFOEBIEJEBMBNOZB(SBEJFOJOJ
"51BTFQBEBQSPUFJOQFNCBXBOBUSJVN1FSCFEBBOOZBBEBMBI NFOBOEBLBO BEBOZB DBEBOHBO FOFSHJ LBSFOB OBUSJVN ZBOH
CBIXB QSPUFJO JOJ NFNJMJLJ UFNQBU QFOHJLBUBO ZBOH TBOHBU CFSMFCJI EJ MVBS NFNCSBO TFM TFMBMV CFSVTBIB VOUVL CFSEJGVTJ LF
TQFTJGJLVOUVLLBMTJVNEBOCVLBOVOUVLOBUSJVN EBMBN%BMBNLPOEJTJZBOHTFTVBJ FOFSHJEJGVTJOBUSJVNUFSTFCVU
EBQBU NFOBSJL [BU MBJO VOUVL JLVU CFSTBNB OBUSJVN NFMBMVJ
Transpor Aktif Primer untuk lon Hidrogen
NFNCSBOTFM'FOPNFOBJOJEJTFCVULPUSBOTQPSJOJBEBMBITBMBI
5SBOTQPS BLUJG QSJNFS VOUVL JPO IJESPHFO QFOUJOH EJ EVB TBUVCFOUVLUSBOTQPSBLUJGTFLVOEFS
UFNQBU EJ EBMBN UVCVI
EJ LFMFOKBS HBTUFS QBEB MBNCVOH
"HBS OBUSJVN EBQBU NFOBSJL [BU MBJO VOUVL JLVU CFSTBNB
EBO
EJ CBHJBO BLIJS UVCVMVT EJTUBM EBO EVLUVT LPMJHFOUFT
EFOHBOOZB EJCVUVILBOTVBUVNFLBOJTNFZBOHCFSQBTBOHBO)BM
LPSUJLBMJTQBEBHJOKBM
UFSTFCVU EJDBQBJ EFOHBO BEBOZB QSPUFJO QFNCBXB MBJO EBMBN
%J LFMFOKBS HBTUFS TFMTFM QBSJFUBM ZBOH UFSMFUBL EJ MBQJTBO NFNCSBO TFM %BMBN IBM JOJ QFNCBXB CFSUJOEBL TFCBHBJ UJUJL
EBMBN NFNJMJLJ NFLBOJTNF BLUJG QSJNFS ZBOH QBMJOH QPUFO QFOHJLBUBOVOUVLJPOOBUSJVNEBOVOUVL[BUZBOHJLVUEJUSBOTQPS
EBSJ CBHJBO UVCVI NBOBQVO VOUVL NFOUSBOTQPS JPO IJESP CFSTBNB OBUSJVN #FHJUV LFEVBOZB UFSJLBU HSBEJFO FOFSHJ JPO
HFO *OJ BEBMBI EBTBS UFSKBEJOZB TFLSFTJ BTBN IJESPLMPSJEB OBUSJVN BLBO NFOZFCBCLBO JPO OBUSJVN EBO [BU MBJO ZBOH JLVU
QBEB QSPTFT QFODFSOBBO EJ MBNCVOH 1BEB VKVOH TFLSFUPSJL EJUSBOTQPS NBTVLLFEBMBNTFM
TFMQBSJFUBM LPOTFOUSBTJJPOIJESPHFOEBQBUNFOJOHLBUTFKVUB
1BEB USBOTQPSUVLBS JPO OBUSJVN KVHB CFSVTBIB VOUVL CFS
LBMJ MJQBU EBO LFNVEJBO EJMFQBTLBO CFSTBNB EFOHBO JPO
EJGVTJ LF EBMBN TFM LBSFOB HSBEJFO LPOTFOUSBTJOZB ZBOH CFTBS
LMPSJEBVOUVLNFNCFOUVLBTBNIJESPLMPSJEB
/BNVO LBMJJOJ [BUZBOHEJUSBOTQPSCFSBEBEJEBMBNTFMEBOIBSVT
%J UVCVMVT SFOBM LIVTVTOZB JOUFSDBMBUFE DFMMT EJ CBHJBO EJUSBOTQPS LF MVBS 0MFI LBSFOB JUV JPO OBUSJVN BLBO CFSJLBUBO
BLIJS UVCVMVT EJTUBM EBO EVLUVT LPMJHFOUFT LPSUJLBMJT UFSKBEJ EFOHBO QSPUFJO QFNCBXB QBEB CBHJBO QSPUFJO ZBOH NFOPOKPM LF
KVHB QSPTFT USBOTQPS JPO IJESPHFO NFMBMVJ USBOTQPS BLUJG QFSNVLBBO MVBS NFNCSBO TFEBOHLBO [BU ZBOH BLBO EJUSBOTQPS
QSJNFS %BMBN IBM JOJ TFKVNMBI CFTBS JPO IJESPHFO BLBO CFSJLBUBO EFOHBO CBHJBO QSPUFJO QFNCBXB ZBOH NFOPOKPM LF
EJTFLSFTJLBO EBSJ EBSBI LF EBMBN VSJO ZBOH CFSUVKVBO VOUVL EBMBN 4FUFMBI LFEVBOZB UFSJLBU UFSKBEJ QFSVCBIBO CFOUVL EBO
NFNCVBOH JPO IJESPHFO IJESPHFO
ZBOH CFSMFCJIBO EBSJ FOFSHJ ZBOH EJCFCBTLBO PMFI QFSHFSBLBO JPO OBUSJVN LF EBMBN
DBJSBO UVCVI MPO IJESPHFO EBQBU EJTFLSFTJLBO LF EBMBN VSJO BLBONFOZFCBCLBO[BUZBOHEJUSBOTQPSUFSTFCVUCFSHFSBLLFMVBS
EFOHBONFMBXBOHSBEJFOLPOTFOUSBTJTFCFTBSLJSBLJSBLBMJ
MJQBU Ko-Transpor Glukosa dan Asam Amino Bersama lon Na-
trium
Aktivitas Energi Transpor Aktif Primer
(MVLPTB EBO CBOZBL BTBN BNJOP EJUSBOTQPS LF EBMBN TFCBHJBO
+VNMBI FOFSHJ ZBOH EJQFSMVLBO VOUVL NFOUSBOTQPS TVBUV [BU CFTBSTFMEFOHBONFMBXBOHSBEJFOLPOTFOUSBTJZBOHCFTBSNFLB
TFDBSB BLUJG NFMBMVJ NFNCSBO EJUFOUVLBO PMFI CBOZBLOZB [BU OJTNFVOUVLIBMJOJTFMVSVIOZBEJMBLVLBONFMBMVJNFLBOJTNFLP
ZBOHEBQBUEJQFLBULBOTFMBNBUSBOTQPS%JCBOEJOHLBOEFOHBO USBOTQPS ZBOH UBNQBL QBEB (BNCBS 1FSIBUJLBO CBIXB
FOFSHJ ZBOH EJQFSMVLBO VOUVL NFNFLBULBO [BU TFCBOZBL QSPUFJO QFNCBXB NFNJMJLJ EVB UFNQBU QFOHJLBUBO QBEB TJTJ
LBMJMJQBU NBLBVOUVLNFNFLBULBO[BUTFCBOZBLLBMJMJQBU MVBSOZB TBUVVOUVLOBUSJVNEBOTBUVMBHJVOUVLHMVLPTB,POTFOU
54
Bab 4 Transpor Zat metalui Membran-Membran Sel
UNIT II
EBSJEBMBNMVNFOLFEBMBNTFMUVCVMVT TFEBOHLBOJPOIJESPHFO
EJUSBOTQPS LF EBMBN MVNFO .FLBOJTNF JOJ UJEBL CFHJUV LVBU
EBMBN NFOHIBTJMLBO QFNFLBUBO JPO IJESPHFO EJCBOEJOHLBO
SBTJ JPO OBUSJVN KVHB UJOHHJ EJ MVBS EBO SFOEBI EJ EBMBN ZBOH EFOHBO NFLBOJTNF USBOTQPS BLUJG QSJNFS VOUVL JPO IJESPHFO
NFNCFSJ FOFSHJ VOUVL QSPTFT USBOTQPS ,FJTUJNFXBBO QSPUFJO ZBOHUFSKBEJEJCFCFSBQBCBHJBOUVCVMVTSFOBMZBOHMFCJIEJTUBM
UFSTFCVU BEBMBI CBIXB QFSVCBIBO CFOUVL ZBOH NFNVOHLJOLBO UFUBQJ NFLBOJTNF JOJ EBQBU NFOUSBOTQPS TFKVNMBI CFTBS JPO
QFSHFSBLBOOBUSJVNLFEBMBNUJEBLBLBOUFSKBEJTBNQBJNPMFLVM IJESPHFO ZBOH NFSVQBLBO LVODJ VOUVL QFOHBUVSBO JPO
HMVLPTB JLVU UFSJLBU #FHJUV LFEVBOZB UFSJLBU TFDBSB PUPNBUJT IJESPHFO EBMBN DBJSBO UVCVI ZBOH BLBO EJCBIBT TFDBSB EFUBJM
UFSKBEJ QFSVCBIBO CFOUVL EBO OBUSJVN TFSUB HMVLPTB EJUSBOTQPS EJ#BC
LF EBMBN TFM EBMBN XBLUV ZBOH CFSTBNBBO 0MFI LBSFOB JUVMBI Transpor Aktif melalui Lapisan-Lapisan Sel
NBLB IBM JOJ EJTFCVU TFCBHBJ TVBUV NFLBOJTNF LPUSBOTQPS
OBUSJVNHMVLPTB ,PUSBOTQPSUFS OBUSJVNHMVLPTB UFSVUBNB %J CBOZBL UFNQBU EJ EBMBN UVCVI [BU IBSVT EJUSBOTQPS
NFSVQBLBONFLBOJTNFZBOHTBOHBUQFOUJOHEBMBNNFOUSBOTQPS TFMVSVIOZB NFMBMVJ MBQJTBOMBQJTBO TFM EBO CVLBO NFMBMVJ
HMVLPTB NFMBMVJ TFMTFM FQJUFM HJOKBM EBO VTVT TFCBHBJNBOB UFMBI NFNCSBOTFM5SBOTQPSKFOJTJOJUFSKBEJNFMBMVJ
FQJUFMVTVT
EJCBIBTEBMBN#BCEBO
FQJUFMUVCVMVTHJOKBM
FQJUFMTFNVBLFMFOKBSFLTPLSJO

,PUSBOTQPS OBUSJVN VOUVL BTBN BNJOP UFSKBEJ EFOHBO DBSB FQJUFM LBOEVOH FNQFEV EBO
NFNCSBO QMFLTVT LPSPJEFVT
ZBOH TBNB TFQFSUJ VOUVL HMVLPTB LFDVBMJ CBIXB BTBN BNJOP PUBL TFSUBNFNCSBOMBJOOZB
NFOHHVOBLBO LFMPNQPL TFU
QSPUFJO USBOTQPS ZBOH CFSCFEB .FLBOJTNFEBTBSVOUVLUSBOTQPS[BUNFMBMVJMBQJTBOMBQJTBOTFM
"EB MJNB QSPUFJO USBOTQPS BTBN BNJOP ZBOH UFMBI EJLFOBMJ EBO BEBMBI
USBOTQPSBLUJGNFMBMVJNFNCSBOTFMQBEBTBMBITBUVTJTJ
NBTJOHNBTJOH CFSUBOHHVOH KBXBC VOUVL NFOUSBOTQPS TF TFM ZBOH UFSEBQBU EJ MBQJTBO UFSTFCVU EBO LFNVEJBO
EJGVTJ
LFMPNQPLBTBNBNJOPTFTVBJLBSBLUFSJTUJLNPMFLVMZBOHTQFTJGJL TFEFSIBOB BUBV EJGVTJ UFSGBTJMJUBTJ NFMBMVJ NFNCSBO QBEB TJTJ TFM
,PUSBOTQPS OBUSJVN QBEB HMVLPTB EBO BTBN BNJOP LIVTVT ZBOHCFSMBXBOBO
OZB UFSKBEJ NFMBMVJ TFM FQJUFM TBMVSBO DFSOB EBO TFM UVCVMVT SFOBM (BNCBS NFNQFSMJIBULBO TVBUV NFLBOJTNF VOUVL
QBEBHJOKBM ZBOHCFSUVKVBONFODFUVTLBOQSPTFTBCTPSQTJ[BU[BU USBOTQPS JPO OBUSJVN NFMBMVJ MBQJTBO FQJUFM VTVT LBOEVOH
UFSTFCVU LF EBMBN EBSBI ZBOH BLBO EJCBIBT EJ CBCCBC FNQFEV EBOUVCVMVTSFOBM(BNCBSJOJNFNQFSMJIBULBOCBIXB
CFSJLVUOZB TFM FQJUFM TBMJOH CFSIVCVOHBO FSBU QBEB VKVOH MVNJOBM TFM
.FLBOJTNF LPUSBOTQPS MBJO ZBOH QFOUJOH TFUJEBLOZB VOUVL UFSTFCVUNFMBMVJQFSUBVUBOZBOHEJTFCVULJTTFT#SVTICPSEFSEJ
CFCFSBQBTFMNFMJQVUJLPUSBOTQPSJPOLJPSJEB JPOJPEJO JPOCFTJ QFSNVLBBO TFM ZBOH NFOHIBEBQ LF MVNFO CFSTJGBU QFSNFBCFM
EBOJPOVSBU UFSIBEBQJPOOBUSJVNEBOBJS0MFILBSFOBJUV OBUSJVNEBOBJS
Transpor-Tukar Natrium untuk lon Kalsium dan lon
Hidrogen
%VBNFLBOJTNFUSBOTQPSUVLBS USBOTQPSZBOHUFSKBEJCFSMBXBO
BO BSBI EFOHBO JPO VUBNB
ZBOH QFOUJOH UFSVUBNB BEBMBI
USBOTQPSUVLBS OBUSJVNLBMTJVN EBO USBOTQPSUVLBS OBUSJVN
IJESPHFO (BNCBS

5SBOTQPSUVLBSLBMTJVNUFSKBEJEJTFMVSVIBUBVIBNQJSTFMVSVI
NFNCSBO TFM EFOHBO JPO OBUSJVN ZBOH CFSHFSBL LF EBMBN EBO
JPOLBMTJVNLFMVBS EBOLFEVBOZBUFSJLBUQBEBQSPUFJOUSBOTQPS
ZBOH TBNB OBNVO EJTFTVBJLBO VOUVL UVKVBO USBOTQPSUVLBS
5SBOTQPSUVLBSLBMTJVNJOJBEBMBIKFOJTUSBOTQPSUBNCBIBOTFMBJO /B /B
USBOTQPSBLUJGQSJNFSLBMTJVNZBOHUFSKBEJEJCFCFSBQBTFM
5SBOTQPSUVLBS OBUSJVNIJESPHFO UFSKBEJ EJ CFCFSBQB KBSJOH
BO$POUPIZBOHQFOUJOHLIVTVTOZBBEBMBIUSBOTQPSZBOHUFSKBEJ
EJEBMBNUVCVMVTQSPLTJNBMHJOKBMUFNQBUJPOOBUSJVNCFSHFSBL
55
CFSEJGVTJEFOHBONVEBILFEBMBNTFM,FNVEJBO QBEBCBHJBO tension, Hypertension 53:291, 2009.

BrOer S: Amino acid transport across mammalian intestinal and renal
CBTBM EBO MBUFSBM NFNCSBO TFM JPO OBUSJVN TFDBSB BLUJG
epithelia, Physiol Rev 88:249, 2008.
EJUSBOTQPS NBTVL LF EBMBN DBJSBO FLTUSBTFMVMBS EJ TFLJUBS DeCoursey TE: Voltage-gated proton channels: what's next? J Physiol
KBSJOHBOJLBUEBOQFNCVMVIEBSBI)BMJOJBLBONFODJQUBLBO 586:5305, 2008.
HSBEJFO LPOTFOUSBTJ JPO OBUSJVN ZBOH UJOHHJ EJ LFEVB TJTJ Decoursey TE: Voltage-gated proton channels and other proton transfer
pathways, Physiol Rev 83:475, 2003.
NFNCSBO UFSTFCVU ZBOH LFNVEJBO NFOZFCBCLBO UFSKBEJOZB
DiPolo R, Beau0 L: Sodium/calcium exchanger: influence of metabolic reg-
PTNPTJT BJS +BEJ USBOTQPS BLUJG JPO OBUSJVN QBEB TJTJ ulation on ion carrier interactions, Physiol Rev 86:155, 2006.
CBTPMBUFSBM TFM FQJUFM UJEBL TBKB NFOUSBOTQPS JPO OBUSJVN Drummond HA, Jernigan NL, Grifoni SC: Sensing tension: epithelial sodium
UFUBQJKVHBNFOUSBOTQPSBJS channel/acid-sensing ion channel proteins in cardiovascular homeostasis,
Hypertension 51:1265, 2008.
.FLBOJTNFJOJEJHVOBLBOIBNQJSTFNVB[BUNBLBOBO JPO Gadsby DC: lon channels versus ion pumps: the principal difference, in
EBO [BU MBJOOZB ZBOH EJBCTPSCTJ LF EBMBN EBSBI EBO VTVT principle,, Nat Rev Mol Cell Biol 10:344, 2009.
QSPTFT SFBCTPSCTJ [BU ZBOH TBNB EBO GJMUSBU HMPNFSVMVT PMFI Jentsch TJ, Stein V, Weinreich F, Zdebik AA: Molecular structure and
UVCVMVTSFOBMKVHBNFOHHVOBLBONFLBOJTNFUFSTFCVU physiological function of chloride channels,Physiol Rev 82:503, 2002.
Kaupp UB, Seifert R: Cyclic nucleotide-gated ion channels, Physiol Rev
4FMVSVI CBDBBO JOJ NFNBQBSLBO TFKVNMBI DPOUPI CFSCBHBJ 82:769, 2002.
KFOJTUSBOTQPSZBOHEJCBIBTEBMBNCBCJOJ King LS, Kozono D, Agre P: From structure to disease: the evolving tale of
aquaporin biology, Nat Rev Mol Cell Biol 5:687, 2004.
Kleyman TR, Carattino MD, Hughey RP: ENaC at the cutting edge:
Daftar Pustaka regulation of epithelial sodium channels by proteases, J Biol Chem
Agre P, Kozono D: Aquaporin water channels: molecular mechanisms for 284:20447, 2009.
human diseases, FEBS Lett 555:72, 2003. Mazzochi C, Benos DJ, Smith PR: interaction of epithelial ion channels with
Ashcroft FM: From molecule to malady, Nature 440:440, 2006. the actin-based cytoskeleton, Am J Physiol Rena! Physiol 291:F1113,
Benos DJ, Stanton BA: Functional domains within the degenerin/epithelial 2006.
sodium channel (Deg/ENaC) superfamily of ion channels, J Physiol Peres A, Giovannardi S, Bossi E, Fesce R: Electrophysiological insights into
520:631, 1999. the mechanism of ion-coupled cotransporters, News Physiol Sci 19:80,
Benziane B, Chibalin AV: Frontiers: skeletal muscle sodium pump 2004.
regulation: a translocation paradigm, Am J Physiol Endocrinol Metab Russell JM: Sodium-potassium-chloride cotransport, Physiol Rev 80:211,
295:E553, 2008. 2000.
Biel M, Wahl-Schott C, Michalakis S, Zong X: Hyperpolarization-activated Shin JM, Munson K, Vagin O, Sachs G: The gastric HK-ATPase: structure,
cation channels: from genes to function, Physiol Rev 89:847, 2009. function, and inhibition, Pflugers Arch 457:609, 2009.
Blaustein MP, Zhang J, Chen L, et The pump, the exchanger, and endog- Tian J, Xie ZJ: The Na-K-ATPase and calcium-signaling microdomains,
enous ouabain: signaling mechanisms that link satt retention to hyper- Physiology (Bethesda) 23:205, 2008.
56
BAB 5
UNIT II
1PUFOTJBM.FNCSBOEBO1PUFOTJBM"LTJ
%J IBNQJS TFNVB TFM UVCVI UFSIBEBQ JPO OBUSJVN UFUBQJ UJEBL QFSNFBCFM VOUVL TFNVB JPO
UFSEBQBU QPUFOTJBM MJTUSJL ZBOH MBJOOZB %JGVTJ JPO OBUSJVN CFSNVBUBO QPTJUJG LF CBHJBO EBMBN
NFMJOUBTJ NFNCSBO 4FMBJO JUV NFNCFOUVL QPUFOTJBM NFNCSBO EJ LVUVC ZBOH CFSMBXBOBO
QBEBCFCFSBQBTFM NJTBMOZBTFM TFQFSUJ QBEB (BNCBS " EFOHBO NVBUBO OFHBUJG EJ MVBS EBO
TBSBG EBO TFM PUPU NBNQV NVBUBO QPTJUJG EJ EBMBN 4FLBMJ MBHJ QPUFOTJBM NFNCSBO
NFNCBOHLJULBOTFOEJSJJNQVMT NFOJOHLBU DVLVQ UJOHHJ EBMBN CFCFSBQB NJMJEFUJL VOUVL
FMFLUSPLJNJB ZBOH DFQBU CFSVCBI QBEB NFNCSBOOZB EBO NFOHIBNCBU EJGVTJ JPO OBUSJVN TFMBOKVUOZB LF EBMBN OBNVO
JNQVMT JOJ EJHVOBLBO VOUVL NFOHIBOUBSLBO TJOZBM TFQBOKBOH TBBUJOJ QBEBTFSBCVUTBSBGNBNBMJB QPUFOTJBMOZBBEBMBITFLJUBS
NFNCSBO TBSBG EBO PUPU 1BEB UJQF TFM MBJOOZB TFQFSUJ TFM QPTJUJGNJMJWPMUEJEBMBNTFSBCVU
LFMFOKBS NBLSPGBH EBO TFM ZBOH CFSTJMJB QFSVCBIBO MPLBM QBEB +BEJ QBEB LFEVB CBHJBO (BNCBS LJUB NFOHFUBIVJ CBIXB
QPUFOTJBM NFNCSBO KVHB NFOHBLUJGLBO CBOZBL GVOHTJ TFM QFSCFEBBO LPOTFOUSBTJ JPO ZBOH NFMJOUBTJ NFNCSBO QFSNFBCFM
1FNCJDBSBBO LJUB TBBU JOJ CFSIVCVOHBO EFOHBO QPUFOTJBM ZBOH TFMFLUJG EBMBN LPOEJTJ UFSUFOUV NFOJNCVMLBO QPUFOTJBM
NFNCSBO ZBOH EJCBOHLJULBO CBJL QBEB LFBEBBO JTUJSBIBU NFNCSBO %J BLIJS CBC JOJ BLBO EJUVOKVLLBO CBIXB CBOZBL
NBVQVOQBEBTBBUTFMTBSBGEBOTFMPUPUCFSBLUJWJUBT QFSVCBIBO ZBOH DFQBU QBEB QPUFOTJBM NFNCSBO ZBOH EJBNBUJ
TFMBNB USBOTNJTJ JNQVMT TBSBG EBO PUPU CFSBTBM EBSJ UFSKBEJOZB
QFSVCBIBODFQBUQBEBQPUFOTJBMEJGVTJUFSTFCVU
Fisika Dasar Potensial Membran
Potensial Membran yang Disebabkan oleh Difusi Hubungan Potensial Difusi terhadap Perbedaan
Konsentrasi—Potensial Nernst. /JMBJQPUFOTJBMEJGVTJZBOH
"Potensial Difusi" yang Disebabkan Perbedaan
NFMJOUBTJ TVBUV NFNCSBO ZBOH CFSCBOEJOH UFSCBMJL EFOHBO
Konsentrasi lon pada Kedua Sisi Membran. 1BEB(BNCBS EJGVTJOFUTVBUVQBSUJLFMJPONFMBMVJNFNCSBOEJTFCVUQPUFOTJBM
" LPOTFOUSBTJLBMJVNEJCBHJBOEBMBNNFNCSBOTFSBCVUTBSBG /FSOTU VOUVL JPO UFSTFCVU ZBJUV TVBUV JTUJMBI ZBOH UFMBI
TBOHBUUJOHHJ TFEBOHLBOEJCBHJBOMVBSNFNCSBOTBOHBUSFOEBI EJQFSLFOBMLBOEBMBN#BC#FTBSOZBQPUFOTJBM/FSOTUJOJEJUFO
.BSJ LJUB BTVNTJLBO CBIXB NFNCSBO QBEB DPOUPI JOJ CFSTJGBU
QFSNFBCFMUFSIBEBQJPOLBMJVNUFUBQJUJEBLUFSIBEBQJPOMBJOOZB
0MFILBSFOBHSBEJFOLPOTFOUSBTJLBMJVNEBSJEBMBNTFMLFMVBSTFM
CFTBS UFSEBQBU LFDFOEFSVOHBO LVBU VOUVL TFKVNMBI CFTBS JPO
LBMJVN CFSEJGVTJ LF MVBS NFMBMVJ NFNCSBO ,FUJLB IBM UFSTFCVU + – – + – + + –
UFSKBEJ JPO LBMJVN NFNCBXB NVBUBO MJTUSJL QPTJUJG LF MVBS + – – + – + + –
TFIJOHHB NFNCFOUVM FMFLUSPQPTJUJWJUBT EJ MVBS NFNCSBO EBO + – – + – + + –
+ – – + – + + –
FMFLUSPOFHBUJWJUBTEJEBMBNBLJCBUBOJPOBOJPOOFHBUJGZBOHUFUBQ + – – + – + + –
UFSUJOHHBM EBO UJEBL CFSEJGVTJ LF MVBS CFSTBNB LBMJVN %BMBN + – – + – + + –
XBLUVTBUVNJMJEFUJMBUBVMFCJI QFSCFEBBOQPUFOTJBMBOUBSBCBHJBO + – – + – + + –
EBMBN EBO MVBS ZBOH EJTFCVU TFCBHBJ QPUFOTJBM EJGVTJ NFOKBEJ (–94 mV) – + (+61 mV) + –
+ – – + – + + –
DVLVQCFTBSVOUVLNFOHIBNCBUEJGVTJLBMJVNOFUPTFMBOKVUOZBLF + – – + – + + –
CBHJBO MVBS NFTLJQVO HSBEJFO LPOTFOUSBTJ JPO LBMJVN DVLVQ
UJOHHJ 1BEB TFSBCVU TBSBG NBNBMJB OPSNBM QFSCFEBBO QPUFOTJBM
ZBOH EJCVUVILBO BEBMBI TFLJUBS NJMJWPMU EFOHBO LFBEBBO
OFHBUJGEJEBMBNNFNCSBOTFSBCVU
(BNCBS#NFOKFMBTLBOGFOPNFOBZBOHTBNBTFQFSUJQBEB
(BNCBS" UFUBQJTFLBSBOHEFOHBOLPOTFOUSBTJJPOOBUSJVN
ZBOHUJOHHJEJMVBSNFNCSBOEBOSFOEBIEJEBMBNMPOJPOJOJ
KVHB CFSNVBUBO QPTJUJG 4FLBSBOH NFNCSBO NFOKBEJ TBOHBU
QFSNFBCFMUFSIBEBQJPONFNCSBONFOKBEJTBOHBUQFSNFBCFM
57
UVLBO PMFI QFSCBOEJOHBO LPOTFOUSBTJ JPO TQFTJGJL UFSTFCVU ,FUJHB HSBEJFO LPOTFOUSBTJ JPO QPTJUJG ZBOH CFSBTBM EBSJ TJTJ
QBEB LFEVB TJTJ NFNCSBO 4FNBLJO CFTBS QFSCBOEJOHBO JOJ EBMBNNFNCSBOUFSIBEBQTJTJMVBSNFOJNCVMLBOFMFLUSPOFHBUJWJUBT
TFNBLJO CFTBS LFDFOEFSVOHBO JPO UFSTFCVU CFSEJGVTJ LF TBUV EJ TJTJ EBMBN NFNCSBO )BM JOJ EJTFCBCLBO PMFI LFMFCJIBO JPO
BSBI EBOPMFILBSFOBJUV TFNBLJOCFTBSQVMBQPUFOTJBM/FSOTU QPTJUJGZBOHCFSEJGVTJLFMVBSCJMBLPOTFOUSBTJOZBEJTJTJEBMBNMFCJI
ZBOH EJCVUVILBO VOUVL NFODFHBI EJGVTJ OFUP UBNCBIBO CFTBS EBSJQBEB EJ TJTJ MVBS 1FSJTUJXB JOJ NFNCBXB NVBUBO QPTJUJG
1FSTBNBBO CFSJLVU ZBOH EJTFCVU QFSTBNBBO /FSOTU EBQBU LF TJTJ MVBS OBNVO NFOJOHHBMLBO BOJPO OFHBUJG ZBOH UJEBL EBQBU
EJQBLBJ VOUVL NFOHIJUVOH QPUFOTJBM /FSOTU VOUVL TFUJBQ JPO CFSEJGVTJEJTJTJEBMBN TFIJOHHBNFOJNCVMLBOFMFLUSPOFHBUJWJUBTEJ
VOJWBMFOQBEBTVIVUVCVIOPSNBM ¡' ¡$
EBMBN &GFL ZBOH CFSMBXBOBO UFSKBEJ CJMB EJEBQBUJ HSBEJFO VOUVL
JPOOFHBUJG%BMBNLPOUFLTJOJ HSBEJFOJPOLMPSJEBEBSJTJTJMVBSLF
Konsentrasi sisi dalam TJTJ EBMBN NFOZFCBCLBO LFBEBBO OFHBUJG EJ EBMBN TFM TFCBC
EMF (milivolt) =± 61 × log
Konsentrasi sisi luar LFMFCJIBOJPOLMPSJEBCFSNVBUBOOFHBUJGCFSEJGVTJLFEBMBN TBNCJM
NFOJOHHBMLBOJPOQPTJUJGZBOHUJEBLEBQBUCFSEJGVTJEJTJTJMVBS
EFOHBO&.'TFCBHBJHBZBQFOHHFSBLFMFLUSPO ,FFNQBU TFQFSUJ ZBOH BLBO EJKFMBTLBO OBOUJ QFSNFBCJMJUBT
#JMB NFOHHVOBLBO SVNVT JOJ CJBTBOZB UFMBI EJBTVNTJLBO LBOBM OBUSJVN EBO LBMJVN BLBO NFOHBMBNJ QFSVCBIBO DFQBU
CBIXB QPUFOTJBM QBEB DBJSBO FLTUSBTFMVMBS EJ MVBS NFNCSBO TFMBNB USBOTNJTJ JNQVMT TBSBG TFEBOHLBO QFSNFBCJMJUBT LBOBM
UFUBQQBEBQPUFOTJBMOPM EBOQPUFOTJBM/FSOTUBEBMBIQPUFOTJBM LMPSJEBUJEBLNFOHBMBNJCFHJUVCBOZBLQFSVCBIBOTFMBNBQSPTFT
EJEBMBNNFNCSBO+VHB UBOEBQPUFOTJBMBEBMBIQPTJUJG
KJLB UFSTFCVU 0MFI LBSFOB JUV QFSVCBIBO QFSNFBCJMJUBT UFSIBEBQ
JPO ZBOH CFSEJGVTJ EBSJ EBMBN LF MVBS NFSVQBLBO JPO OFHBUJG OBUSJVN EBO LBMJVN ZBOH DFQBU UFSVUBNB CFSUBOHHVOH KBXBC
EBO OFHBUJG
KJLB JPO JOJ NFSVQBLBO JPO QPTJUJG +BEJ CJMB VOUVL USBOTNJTJ TJOZBM EJ TBSBG ZBOH NFSVQBLBO TVCKFL EBSJ
LPOTFOUSBTJ JPO LBMJVN QPTJUJG EJ TJTJ EBMBN CFTBSOZB LBMJ TFCBHJBOCFTBSIBMZBOHEJCJDBSBLBOEBMBNTJTBCBCJOJ
LPOTFOUSBTJOZBEJTJTJMVBS NBLBMPHBEBMBI KBEJQPUFOTJBM
/FSOTU ZBOH EJIJUVOH NFOKBEJ NJMJWPMU EJ EBMBN
NFNCSBO Pengukuran Potensial Membran
Perhitungan Potensial Difusi bila Membran Bersifat .FUPEFVOUVLNFOHVLVSQPUFOTJBMNFNCSBOTFDBSBUFPSJCFSTJGBU
Permeabel terhadap Beberapa Macam lon TFEFSIBOB OBNVO TFSJOH LBMJ TVMJU TFDBSB QSBLUJL LBSFOB
#JMBNFNCSBOCFSTJGBUQFSNFBCFMUFSIBEBQCFCFSBQBNBDBNJPO LFCBOZBLBO TFSBCVU CFSVLVSBO LFDJM (BNCBS NFOVOKVLLBO
QPUFOTJBM EJGVTJ ZBOH UJNCVM CFSHBOUVOH QBEB UJHB GBLUPS
TFCVBI QJQFU LFDJM ZBOH EJJTJ EFOHBO TVBUV MBSVUBO FMFLUSPMJU
QPMBSJUBT NVBUBO MJTUSJL NBTJOHNBTJOH JPO
QFSNFBCJMJUBT 1JQFUUFSTFCVUEJUVTVLLBONFMBMVJNFNCSBOTFMLFCBHJBOEBMBN
NFNCSBO 1
UFSIBEBQNBTJOHNBTJOHJPO EBO
LPOTFOUSBTJ TFSBCVU ,FNVEJBO FMFLUSPEB MBJO ZBOH EJTFCVU FMFLUSPEB
$
NBTJOHNBTJOH JPO EJ TJTJ EBMBN J
EBO EJ TJTJ MVBS P
JOEJGGFSFO EJUFNQBULBO EJ EBMBN DBJSBO FLTUSBTFM EBO
NFNCSBO +BEJ QBEB SVNVT CFSJLVU ZBOH EJTFCVU QFSTBNBBO QFSCFEBBOQPUFOTJBMBOUBSBCBHJBOEBMBNEBOCBHJBOMVBSTFSBCVU
(PMENBO BUBV QFSTBNBBO (PMENBO)PEHLJO,BU[ EJIBTJMLBO EJVLVS EFOHBO NFOHHVOBLBO TFCVBI WPMUNFUFS ZBOH UFQBU
QFSIJUVOHBOQPUFOTJBMNFNCSBOEJTJTJEBMBNNFNCSBOCJMBEVB 7PMUNFUFS JOJ NFSVQBLBO BMBU FMFLUSPOJL ZBOH TBOHBU DBOHHJI
JPOQPTJUJGVOJWBMFO ZBLOJOBUSJVN /B
EBOLBMJVN ,
EBO EBO NBNQV NFOHVLVS WPMUBTF ZBOH SFOEBI XBMBVQVO BEB
TBUVJPOOFHBUJWFVOJWBMFO ZBLOJJPOLMPSJEB $*
JLVUUFSMJCBU UBIBOBO ZBOH TBOHBU CFTBS UFSIBEBQ BMJSBO MJTUSJL ZBOH NFMBMVJ
VKVOH NJLSPQJQFU CJBTBOZB NFNJMJLJ EJBNFUFS MVNFO LVSBOH
EMF (millivolt)
EBSJNEBOEFOHBOUBIBOBOMFCJIEBSJTFKVUBPIN"HBSEBQBU
CNa+i PNa+ + CK+i PK+ +CCl-o PCl-
= -61 × log NFSFLBNQFSVCBIBOZBOHDFQBUQBEBQPUFOTJBMNFNCSBOTFMBNB
CNa+o PNa+ + CK+o PK+ +CCl-i PCl- USBOTNJTJ JNQVMT TBSBG NJLSPFMFLUSPEB EJIVCVOHLBO EFOHBO
TFCVBIPTJMPTLPQ TFQFSUJZBOHEJKFMBTLBOOBOUJEBMBNCBCJOJ
.BSJLJUBQFMBKBSJLFHVOBBOEBONBLOBEBSJQFSTBNBBOJOJ
1FSUBNB JPO OBUSJVN LBMJVN EBO LMPSJEB TFCFOBSOZB #BHJBO CBXBI (BNCBS NFNQFSMJIBULBO QPUFOTJBM MJTUSJL
NFSVQBLBO JPO UFSQFOUJOH ZBOH UFSMJCBU EBMBN UJNCVMOZB ZBOH EJVLVS QBEB TFUJBQ UJUJL EJ EBMBN BUBV EJ EFLBU NFNCSBO
QPUFOTJBM NFNCSBO EBMBN TFSBU TBSBG EBO PUPU TFSUB EJ TFM TFSBUTBSBG ZBOHEJNVMBJQBEBTJTJLJSJHBNCBSEBOUFSVTLFLBOBO
OFVSPO QBEB TJTUFN TBSBG QVTBU (SBEJFO LPOTFOUSBTJ NBTJOH
NBTJOH JPO ZBOH NFMJOUBTJ NFNCSBO JOJ NFNCBOUV 0
NFOFOUVLBOWPMUBTFQPUFOTJBMNFNCSBO
,FEVB UJOHLBU LFHVOBBO UJBQUJBQ JPO EBMBN NFOFOUVLBO — +
WPMUBTF CFSCBOEJOH MVSVT EFOHBO QFSNFBCJMJUBT NFNCSBO
UFSIBEBQ JPO UFSUFOUV UFSTFCVU "SUJOZB KJLB NFNCSBO
NFNJMJLJ QFSNFBCJMJUBT OPM UFSIBEBQ JPO LBMJVN NBVQVO JPO
LMPSJEB QPUFOTJBM NFNCSBO TFMVSVIOZB BLBO EJEPNJOBTJ PMFI +++++++++++ +++++
–––––––––– –––––
HSBEJFO LPOTFOUSBTJ JPO OBUSJVN TBKB EBO QPUFOTJBM ZBOH
EJIBTJMLBO BLBO TBNB OJMBJOZB EFOHBO QPUFOTJBM /FSOTU VOUVL – – – – – – – – – (–90 – – – – – – –
OBUSJVN)BMJOJCFSMBLVKVHBVOUVLNBTJOHNBTJOHLFEVBJPO + + + + + + + + + mV) + + + + + + + +
ZBOHMBJOKJLBNFNCSBONFOKBEJQFSNFBCFMTFMFLUJGVOUVLTBMBI
TBUVJPOTBKB
58
Bab 5 Potensial Membran dan Potensial Aksi
Transpor Aktif lon Natrium dan Kalium melalui

–+–+–+–+–+–+–+– Membran—Pompa Natrium-Kalium (Na+-K+). 1FSUBNB
+–++––+–+––++–+ UBNB NBSJ LJUB JOHBU LFNCBMJ QFNCJDBSBBO QBEB #BC CBIXB
–+–+–+–+–+–+–+– TFNVB NFNCSBO TFM UVCVI NFNQVOZBJ QPNQB /B, ZBOH
+–++––+–+––++–+
–+–+–+–+–+–+–+– TBOHBU LVBU EBO TFDBSB UFSVTNFOFSVT NFOUSBOTQPS USBOTQPSUT
+–++––+–+––++–+ JPO OBUSJVN LFMVBS EBSJ TFSBCVU EBO JPO LBMJVN LF EBMBN
UNIT II
–+–+–+–+–+–+–+–
+–++––+–+––++–+ TFQFSUJ ZBOH EJHBNCBSLBO QBEB TJTJ LJSJ (BNCBS
–+–+–+–+–+–+–+– 4FMBOKVUOZB QFSIBUJLBO CBIXB JOJ BEBMBI QPNQB FMFLUSPHFOJL
+–++––+–+––++–+
TFCBC MFCJI CBOZBL NVBUBO QPTJUJG ZBOH EJQPNQB LFMVBS
EBSJQBEBLFEBMBN UJHBJPO/BLFMVBSVOUVLTFUJBQEVBJPO,
ZBOHLFEBMBN
ZBOHNFOJOHHBMLBOEFGJTJUJPOQPTJUJGEJEBMBN
IBMJOJNFOZFCBCLBOQPUFOTJBMOFHBUJGEJEBMBNNFNCSBOTFM
1PNQB /B, JOJ KVHB NFOJNCVMLBO HSBEJFO LPOTFOUSBTJ
ZBOH CFTBS VOUVML OBUSJVN EBO LBMJVN EJ LFEVB TJTJ NFNCSBO
TBSBGJTUJSBIBU(SBEJFOUFSTFCVUBEBMBITFCBHBJCFSJLVU
Na+ (di luar): 142 mEq/L
Na+ (di dalam): 14 mEq/L
K+ (di luar): 4 mEq/L

K+ (di dalam): 140 mEq/L
1FSCBOEJOHBOLFEVBJPOJOJNBTJOHNBTJOHEBSJEBMBNLFMVBS
4FMBNB FMFLUSPEB CFSBEB EJ TJTJ MVBS NFNCSBO TBSBG QPUFOTJBM ZBOH
BEBMBI
UFSFLBN BEBMBI OPM ZBOH NFSVQBLBO QPUFOTJBM EBSJ DBJSBO
FLTUSBTFMVMBS 4FMBOKVUOZB TBBU FMFLUSPEB QFSFLBN NFMFXBUJ BSFB Na+di dalam/Na+di luar= 0.1
QFSVCBIBO WPMUBTF QBEB NFNCSBO TFM ZBOH EJTFCVU MBQJTBO EJQPMBS
MJTUSJL
QPUFOTJBMBLBOUVSVOTFDBSBUJCBUJCBLFoNJMJWPMU,FUJLB K+di dalam/K+di luar = 35.0
CFSHFSBL NFMJOUBTJ QVTBU TFSBCVU QPUFOTJBM NFOFUBQ QBEB UJOHLBU
ZBOHTUBCJMEJOJMBJoNJMJWPMU UFUBQJTFHFSBCFSCBMJLLFNCBMJLFOPM Kebocoran Kalium melalui Membran Saraf. #BHJBO LBOBO
EBMBN TFLFUJLB TBBU CFSHFSBL NFMFXBUJ NFNCSBO QBEB TJTJ ZBOH (BNCBSNFOVOKVLLBOTVBUVQSPUFJOLBOBM LBEBOHEJTFCVU
CFSMBXBOBO EBFSBIQPSJCFSEVB LBOBMLBMJVN BUBVLBOBMCPDPSLBMJVN
6OUVLNFNCFOUVLQPUFOTJBMOFHBUJGEJEBMBNNFNCSBO IBOZB EBMBN NFNCSBO TBSBG ZBOH EBQBU EJMBMVJ PMFI JPOJPO LBMJVN
JPOJPO QPTJUJG TBKB ZBOH IBSVT EJBOHLVU LF MVBS EBMBN KVNMBI TFLBMJQVO QBEB TFM JTUJSBIBU 4USVLUVS EBTBS LBOBM LBMJVN UFMBI
TFDVLVQOZB BHBS EBQBU NFNCFOUVL MBQJTBO MJTUSJL EJQPMBS QBEB EJCBIBT EBMBN #BC (BNCBS
,BOBMLBOBM CPDPS , JOJ
NFNCSBOJUVTFOEJSJ4FNVBJPOZBOHUFSUJOHHBMEJEBMBNTFSBCVU KVHB EBQBU EJMFXBUJ TFEJLJU JPO OBUSJVN UFUBQJ KBVI MFCJI
TBSBGEBQBUCFSVQBJPOOFHBUJGEBOJPOQPTJUJG TFQFSUJEJUVOKVLLBO QFSNFBCFM UFSIBEBQ LBMJVN EBSJ QBEB UFSIBEBQ OBUSJVN
OPSNBMOZB TFLJUBS LBMJ MFCJI QFSNFBCFM 4FQFSUJ ZBOH BLBO
QBEB CBHJBO BUBT (BNCBS 0MFI LBSFOB JUV IBOZB EJQFSMVLBO
EJCBIBT OBOUJ QFSCFEBBO QFSNFBCJMJUBT JOJ BEBMBI GBLUPS LVODJ
TFEJLJU TFLBMJ JPO ZBOH IBSVT EJQJOEBILBO NFMBMVJ NFNCSBO BHBS
EBMBN NFOFOUVLBO OJMBJ QPUFOTJBM NFNCSBO JTUJSBIBU ZBOH
EBQBUNFNCFOUVLQPUFOTJBMJTUJSBIBUOPSNBMTFCFTBSoNJMJWPMU
EJ EBMBN TFSBU TBSBG EFOHBO LBUB MBJO IBOZB TFLJUBS OPSNBM
TBNQBJ NVBUBO QPTJUJG UPUBM EBMBN TFSBCVU ZBOH
QFSMV EJQJOEBILBO +VHB TFEJLJU JPO QPTJUJG EBMBN KVNMBI ZBOH
TBNB CFSHFSBL EBSJ MVBS LF EBMBN TFSBCVU TFIJOHHB EBQBU
NFNCBMJLLBO QPUFOTJBM EBSJ o NJMJWPMU NFOKBEJ TFCFTBS
NJMJWPU EBMBN XBLUV EFUJL 1PMB QFSVCBIBO JPO ZBOH
DFQBU JOJ NFOJNCVMLBO TJOZBM TBSBG ZBOH BLBO LJUB CJDBSBLBO
LFNVEJBOEBMBNCBCJOJ
Potensial Membran Istirahat Saraf
1PUFOTJBM NFNCSBO JTUJSBIBU QBEB TFSBU TBSBG CFTBS LFUJLB UJEBL

NFOUSBOTNJTJLBOTJOZBMTBSBGBEBMBITFLJUBSoNJMJWPMU"SUJOZB
QPUFOTJBMEJEBMBNTFSBUBEBMBINJMJWPMUMFCJIOFHBUJGEBSJQBEB
QPUFOTJBM EJ DBJSBO FLTUSBTFMVMBS EJ MVBS TFSBCVU 1BEB CFCFSBQB
QBSBHSBG CFSJLVU TJGBU USBOTQPS NFNCSBO TBSBG JTUJSBIBU CBHJ
OBUSJVN EBO LBMJVN TFSUB CFSCBHBJ GBLUPS ZBOH NFOFOUVLBO OJMBJ a
QPUFOTJBMJTUJSBIBUEJCBIBT
59
Asal Potensial Membran Istirahat Normal TFUBSB EFOHBO NJMJWPMU TFQFSUJ ZBOH EJQFSMJIBULBO QBEB
HBNCBS
(BNCBS NFOHHBNCBSLBO GBLUPSGBLUPS QFOUJOH QBEB
QFNCFOUVLBO QPUFOTJBM NFNCSBO JTUJSBIBU OPSNBM TFCFTBS
NJMJWPMU'BLUPSGBLUPSUFSTFCVUBEBMBITFCBHBJCFSJLVU Kontribusi Difusi Natrium melalui Membran Saraf. (BNCBS
# NFOKFMBTLBO TFEJLJU QFOBNCBIBO QFSNFBCJMJUBT NFNC
Kontribusi Potensial Difusi Kalium.1BEB(BNCBS" SBO TBSBG CBHJ JPO OBUSJVN ZBOH EJTFCBCLBO PMFI TFEJLJUEJGVTJ
LJUBNFNCVBUBTVNTJCBIXBQFSHFSBLBOJPONFMBMVJNFNCSBO JPO OBUSJVN NFMBMVJ LBOBM CPDPS ,/B 1FSCBOEJOHBO JPO
IBOZBMBIEJGVTJEBSJJPOLBMJVN TFQFSUJZBOHEJHBNCBSLBOPMFI OBUSJVNEBSJEBMBNLFMVBSNFNCSBOBEBMBI EBONFOHIBTJMLBO
LBOBMUFSCVLBBOUBSBTJNCPMLBMJVN ,
EJEBMBNEBOEJMVBS QFSIJUVOHBOQPUFOTJBM/FSOTUVOUVLTJTJEBMBNNFNCSBOTFCFTBS
NFNCSBO 0MFI LBSFOB UJOHHJOZB QFSCBOEJOHBO BOUBSB JPO NJMJWPMU /BNVO EBMBN (BNCBS # KVHB EJUVOKVLLBO
LBMJVNEJEBMBNEBOEJMVBS ZBLOJ QPUFOTJBM/FSOTUZBOH QPUFOTJBM /FSOTU VOUVL EJGVTJ LBMJVN TFCFTBS NJMJWPMU
TFTVBJ EFOHBO QFSCBOEJOHBO JOJ BEBMBI NJMJWPMU LBSFOB #BHBJNBOB IBM JOJ EBQBU TBMJOH NFNFOHBSVIJ EBO BQB ZBOH BLBO
MPHBSJUNB BEBMBI EBO IBTJM JOJ EJLBMJ EFOHBO NFOKBEJ QPUFOTJBM BLIJS 1FSUBOZBBO JOJ EBQBU EJKBXBC EFOHBO
NJMJWPMU TBNB EFOHBO NJMJWPMU 0MFI LBSFOB JUV KJLB JPO QFSTBNBBO (PMENBO ZBOH UFMBI EJKFMBTLBO TFCFMVNOZB 4FDBSB
LBMJVN BEBMBI TBUVTBUVOZB GBLUPS ZBOH NFOZFCBCLBO JOUVJTJ LJUB EBQBU NFOHFUBIVJ CBIXB CJMB NFNCSBO TBOHBU
QPUFOTJBMJTUJSBIBU QPUFOTJBMJTUJSBIBUEBMBNTFSBCVUJOJBLBO QFSNFBCFM UFSIBEBQ LBMJVN UFUBQJ IBOZB TFEJLJU QFSNFBCFM
UFSIBEBQOBUSJVN BEBMBIMPHJTCBIXBEJGVTJLBMJVNBLBOCFSQFSBO
KBVIMFCJICFTBSCBHJQPUFOTJBMNFNCSBOEBSJQBEBEJGVTJOBUSJVN
1BEB TFSBCVU TBSBG OPSNBM QFSNFBCJMJUBT NFNCSBO UFSIBEBQ
LBMJVN LJSBLJSB LBMJ MFCJI CFTBS EBSJQBEB QFSNFBCJMJUBTOZB
UFSIBEBQOBUSJVN%FOHBONFOHHVOBLBOOJMBJJOJQBEBQFSTBNBBO
(PMENBO BLBOLJUBEBQBULBOQPUFOTJBMEJEBMBNNFNCSBOTFCFTBS
140 mEq/L
NJMJWPMU ZBOH NFOEFLBUJ QPUFOTJBM LBMJVN TFQFSUJ ZBOH
UBNQBLQBEBHBNCBS
Kontribusi Pompa Na+-K+.1BEB(BNCBS$ QPNQB/B,

EJHBNCBSLBONFOZFEJBLBOQFOBNCBIBOLPOUSJCVTJQBEBQPUFOTJBM
JTUJSBIBU%BMBNHBNCBSJOJ QFNPNQBBOUJHBJPOOBUSJVNLFMVBS
UFSVTUFSKBEJVOUVLTFUJBQEVBJPOLBMJVNZBOHEJQPNQBNBTVLLF
CBHJBO EBMBN NFNCSBO ,FOZBUBBO CBIXB UFSEBQBU MFCJI CBOZBL
JPOOBUSJVNZBOHEJQPNQBLFMVBSEBSJQBEBLBMJVNLFEBMBNBLBO
NFOZFCBCLBO IJMBOHOZB NVBUBO QPTJUJG ZBOH UFSVTNFOFSVT EBSJ
CBHJBOEBMBNNFNCSBOIBMJOJNFODJQUBLBOQFOBNCBIBOEFSBKBU
B LFOFHBUJGBO QFOBNCBIBO TFLJUBS NJMJWPMU
EJ EBMBN
NFMBNQBVJ QFOBNCBIBO ZBOH EJEBQBULBO EBSJ EJGVTJ TBKB 0MFI
+ - - + LBSFOBJUV TFQFSUJZBOHEJQFSMJIBULBOQBEB(BNCBS$ QPUFOTJBM
+ - - + NFNCSBOOFUPCJMBTFNVBJOJCFLFSKBQBEBXBLUVZBOHCFSTBNBBO
- + BEBMBITFLJUBSoNJMJWPMU
+ - - +
- +
,FTJNQVMBOOZB QPUFOTJBM EJGVTJ TFOEJSJ ZBOH EJTFCBCLBO PMFI
+ - - + EJGVTJ LBMJVN EBO OBUSJVN BLBO NFNCFSJ QPUFOTJBM NFNCSBO
+ - - + TFLJUBS o NJMJWPMU EBO IBNQJS TFNVB IBM JOJ EJUFOUVLBO PMFI
+ - - + EJGVTJ LBMJVN 4FMBOKVUOZB QFOBNCBIBO QPUFOTJBM NFNCSBO
+ - - + TFCFTBS NJMJWPMU PMFI QPNQB FMFLUSPHFOJL NFOHIBTJMLBO
- +
- +
QPUFOTJBMNFNCSBOJTUJSBIBUOFUPTFCFTBSoNJMJWPMU
+ - - +
- +
+ - - +
+ - - + Potensial Aksi Saraf
+ - - +
+ - - +
+ - - +
4JOZBM TBSBG EJIBOUBSLBO PMFI QPUFOTJBM BLTJ ZBOH NFSVQBLBO
+ - - + QFSVCBIBO DFQBU QBEB QPUFOTJBM NFNCSBO ZBOH NFOZFCBS TFDBSB
C DFQBU EJ TFQBOKBOH NFNCSBO TFSBU TBSBG 4FUJBQ QPUFOTJBM BLTJ
EJNVMBJ EFOHBO QFSVCBIBO NFOEBEBL EBO QPUFOTJBM NFNCSBO
OFHBUJG JTUJSBIBU OPSNBM NFOKBEJ QPUFOTJBM QPTJUJG EBO LFNVEJBO
B CFSBLIJS EFOHBO LFDFQBUBO ZBOH IBNQJS TBNB EBO LFNCBMJ LF
C
QPUFOTJBMOFHBUJG6OUVLNFOHIBOUBSLBOTJOZBMTBSBG QPUFOTJBMBLTJ
CFSHFSBLEJTFQBOKBOHTFSBUTBSBGTBNQBJUJCBEJVKVOHTFSBU
60
Tahap Repolarisasi.%BMBNXBLUVTFQFSCFCFSBQBQVMVISJCV
0
EFUJL TFTVEBI NFNCSBO NFOKBEJ TBOHBU QFSNFBCFM UFSIBEBQ
— + JPO OBUSJVN LBOBM OBUSJVN NVMBJ UFSUVUVQ EBO LBOBM LBMJVN
UFSCVLBMFCJIEBSJCJBTBOZB4FMBOKVUOZB EJGVTJJPOLBMJVNZBOH
CFSMBOHTVOH DFQBU LF CBHJBO MVBS BLBO NFNCFOUVL LFNCBMJ
UNIT II
QPUFOTJBMNFNCSBOJTUJSBIBUOFHBUJGZBOHOPSNBM1FSJTUJXBJOJ
++++ –––– +++++ EJTFCVUSFQPMBSJTBTJNFNCSBO
–––– ++++ –––––
6OUVL NFOKFMBTLBO TFDBSB MFCJI MFOHLBQ GBLUPSGBLUPS ZBOH
–––– ++++ ––––––
NFOZFCBCLBO EFQPMBSJTBTJ EBO SFQPMBSJTBTJ LJUB BLBO
++++ –––– ++++++ NFOHVSBJLBOTJGBUTJGBULIVTVTEBSJLFEVBKFOJTLBOBMUSBOTQPS
MBJO ZBOH NFMBMVJ NFNCSBO TBSBG LBOBM OBUSJVN EBO LBMJVN
CFSHFSCBOHWPMUBTF
Kanal Natrium dan Kalium Berpintu Listrik

1FMBLV VUBNB ZBOH NFOZFCBCLBO QFSJTUJXB EFQPMBSJTBTJ EBO
0 SFQPMBSJTBTJ NFNCSBO TBSBG TFMBNB QPUFOTJBM BLTJ BEBMBI LBOBM
OBUSJVN CFSQJOUV MJTUSJL ,BOBM LBMJVN CFSQJOUV MJTUSJL KVHB
Re
CFSQFSBO QFOUJOH EBMBN NFOJOHLBULBO LFDFQBUBO SFQPMBSJTBTJ

NFNCSBO,FEVBLBOBMEFOHBOQJOUVMJTUSJLJOJBLBONFOVOKBOH
,FEVBLBOBMEFOHBOQJOUVMJTUSJLJOJBLBONFOVOKBOHQPNQB/B
,EBOLBOBMCPDPS/B,
Kanal Berpintu Listrik untuk Natrium—Aktivasi dan

lnaktivasi Kanal
0 0.1 0.2 0.3 0.4 0.5 0.6 0.7
#BHJBO BUBT (BNCBS NFOKFMBTLBO LBOBM CFSQJOUV
MJTUSJL VOUVL OBUSJVN VOUVL UJHB LFBEBBO CFSCFEB ,BOBM JOJ
NFNQVOZBJEVBQJOUV TBUVEJEFLBUTJTJMVBSLBOBMZBOHEJTFCVU
QJOUV BLUJWBTJ EBO ZBOH MBJO EJ EFLBU TJTJ EBMBN EJTFCVU
#BHJBO BUBT (BNCBS NFOKFMBTLBO QFSVCBIBO ZBOH UFSKBEJ QJOUV JOBLUJWBTJ 1BEB CBHJBO LJSJ BUBT EJQFSMJIBULBO TFDBSB
QBEB NFNCSBO TFMBNB QPUFOTJBM BLTJ EFOHBO QFOHIBOUBSBO TLFNBUJT
LFBEBBOLFEVBQJOUVJOJQBEBNFNCSBOJTUJSBIBUOPS
NVBUBOQPTJUJGLFCBHJBOEBMBNTFSBCVUQBEBNBTBNVMBJOZBEBO
LFNCBMJOZB NVBUBO QPTJUJG LF CBHJBO MVBS QBEB VKVOH NFNCSBO
#BHJBOCBXBIHBNCBSNFOVOKVLLBOTFDBSBHSBGJTQFSVCBIBOZBOH
UFSKBEJ CFSUVSVUUVSVU QBEB QPUFOTJBM NFNCSBO TFMBNB
TFQFSCFCFSBQB QVMVI SJCV EFUJL ZBOH NFOKFMBTLBO NVMB
UJNCVMOZB QPUFOTJBM BLTJ TFDBSB NFOEBEBL EBO QFOHFNCBMJBO
ZBOHIBNQJSTBNBDFQBUOZB
Urutan tahap potensial aksi adalah sebagai berikut.
5BIBQ Istirahat. *OJ BEBMBI QPUFOTJBM NFNCSBO JTUJSBIBU
TFCFMVN UFSKBEJOZB QPUFOTJBM BLTJ .FNCSBO EJLBUBLBO NFOKBEJ
UFSQPMBSJTBTJTFMBNBUBIBQJOJLBSFOBBEBOZBQPUFOTJBMNFNCSBO
OFHBUJGTFCFTBSoNJMJWPMU
Tahap Depolarisasi.1BEBTBBUJOJ NFNCSBOUJCBUJCBNFOKBEJ
QFSNFBCFM UFSIBEBQ JPO OBUSJVN TFIJOHHB TFKVNMBI CFTBS JPO
OBUSJVN CFSNVBUBO QPTJUJG CFSEJGVTJ LF EBMBN BLTPO ,FBEBBO
UFSQPMBSJTBTJ OPSNBM TFCFTBS o NJMJWPMU TFHFSB EJOFUSBMJTBTJ
PMFI JPO OBUSJVN CFSNVBUBO QPTJUJG ZBOH NFOHBMJS NBTVL EBO K+
QPUFOTJBM NFOJOHLBU EFOHBO DFQBU LF BSBI QPTJUJG ,FBEBBO JOJ
EJTFCVUEFQPMBSJTBTJ1BEBTFSBCVUTBSBGCFTBS TFKVNMBICFTBSJPO
OBUSJVNCFSNVBUBOQPTJUJGZBOHCFSHFSBLLFEBMBNNFOZFCBCLBO
QPUFOTJBM NFNCSBO TFDBSB OZBUB NFMBNQBVJ OJMBJ OPM EBO
NFOKBEJ TFEJLJU QPTJUJG 1BEB CFCFSBQB TFSBCVU ZBOH MFCJI LFDJM
EBO QBEB CBOZBL OFVSPO TJTUFN TBSBG QVTBU QPUFOTJBM IBOZB
NFOEFLBUJOJMBJOPMEBOUJEBLNFMBNQBVJTBNQBJLFBEBBOQPTJUJG
61
NBM CJMB QPUFOTJBM NFNCSBO TFCFTBS o NJMJWPMU 1BEB Metode Penelitian untuk Mengukur Pengaruh
LFBEBBOJOJ QJOUVBLUJWBTJUFSUVUVQ ZBOHNFODFHBINBTVLOZB Voltase terhadap Pembukaan dan Penutupan Kanal
TFUJBQ JPO OBUSJVN LF CBHJBO EBMBN TFSBCVU NFMBMVJ LBOBM Berpintu listrik—"Klem Voltase". 1FOFMJUJBO PSJTJOBM ZBOH
OBUSJVNJOJ NFNVODVMLBO QFOHFSUJBO LVBOUJUBUJG UFOUBOH LBOBM OBUSJVN EBO
LBMJVN CFHJUV KFOJVTOZB TFIJOHHB JMNVXBO ZBOH CFSIBTJM NFOFNVLBO
Aktivasi Kanal Natrium. +JLB QPUFOTJBM NFNCSBO NFOKBEJ JOJ ZBJUV )PEHLJO EBO )VYMFZ NFOEBQBULBO IBEJBI /PCFM *OUJTBSJ
LVSBOH OFHBUJG LFUJNCBOH QBEB LFBEBBO JTUJSBIBU NFOJOHLBU QFOZFMJEJLBOJOJEJUVOKVLLBOQBEB(BNCBSEBO
EBSJ o NJMJWPMU NFOKBEJ OPM EBO BLIJSOZB NFODBQBJ TVBUV (BNCBS NFOKFMBTLBO TVBUV BMBU QFSDPCBBO ZBOH EJTFCVU LMFN
WPMUBTF CJBTBOZB BOUBSB o EBO o NJMJWPMU ZBOH WPMUBTF ZBOH EJQBLBJ VOUVL NFOHVLVS BMJSBO JPO NFMBMVJ CFSNBDBN
NFOZFCBCLBO QFSVCBIBO CFOUVL ZBOH UJCBUJCB QBEB QJOUV NBDBNLBOBM,FUJLBNFOHHVOBLBOBMBUJOJ EVBFMFLUSPEBEJTJTJQLBOLF
BLUJWBTJ BLBO NFNCBMJLLBO QJOUV TFQFOVIOZB NFOKBEJ QPTJTJ EBMBN TFSUB TBSBG 4BMBI TBUVOZB EJQBLBJ VOUVL NFOHVLVS WPMUBTF
UFSCVLB,FBEBBOJOJEJTFCVULFBEBBOUFSBLUJWBTJQBEBLFBEBBO QPUFOTJBMNFNCSBO EBOZBOHMBJOOZBVOUVLNFOZBMVSLBOBMJSBOMJTUSJL
JOJ JPO OBUSJVN EBQBU UFSUVBOH LF EBMBN NFMBMVJ LBOBM ZBOH LFEBMBNBUBVLFMVBSTFSBUTBSBG"MBUJOJEJQBLBJEFOHBODBSBCFSJLVU
BLBO NFOJOHLBULBO QFSNFBCJMJUBT OBUSJVN NFNCSBO TFCFTBS 1FOFMJUJ NFOFOUVLBO CFSBQB WPMUBTF ZBOH JB JOHJOLBO VOUVL UJNCVM EJ
TBNQBJLBMJMJQBU EBMBNTFSBUTBSBG#BHJBOFMFLUSPOJLEBSJBMBUUFSTFCVULFNVEJBOEJBUVS
TBNQBJ WPMUBTF ZBOH EJJOHJOLBO EBO BMBU JOJ TFDBSB PUPNBUJT BLBO
Inaktivasi Kanal Natrium. #BHJBO LBOBO BUBT QBEB CBHJBO NFNBTVLLBO MJTUSJL QPTJUJG BUBV OFHBUJG NFMBMVJ FMFLUSPEB ZBOH EJBMJSJ
BUBT(BNCBSNFOVOKVLLBOUBIBQLFUJHBEBSJLBOBMOBUSJVN MJTUSJL EFOHBO TVBUV BSVT QBEB LFDFQBUBO ZBOH EJCVUVILBO VOUVL
NFOBIBOWPMUBTF TFQFSUJZBOHUFSCBDBQBEBFMFLUSPEBWPMUBTF QBEBOJMBJ
,FOBJLBO WPMUBTF ZBOH TBNB CFTBSOZB ZBOH NFNCVLB QJOUV
ZBOHEJBUVSPMFIPQFSBUPS#JMBQPUFOTJBMNFNCSBOTFDBSBUJCBUJCBOBJL
BLUJWBTJKVHBNFOVUVQQJOUVJOBLUJWBTJ8BMBVQVOCFHJUV QJOUV EBSJ NJMJWPMU NFOKBEJ OPM LBOBM OBUSJVN EBO LBMJVN CFSQJOUV
JOBLUJWBTJ NFOVUVQ EBMBN XBLUV TFQFSCFCFSBQB QVMVI SJCV MJTUSJL BLBO UFSCVLB EBO JPO OBUSJVN EBO LBMJVN NVMBJ CFSHFSBL
EFUJL TFTVEBI QJOUV BLUJWBTJ UFSCVLB %FOHBO LBUB MBJO NFMBMVJ LBOBM 6OUVL NFOHJNCBOHJ FGFL HFSBLBO JPO JOJ QBEB OJMBJ
QFSVCBIBOCFOUVLZBOHNFNCBMJLLBOQJOUVJOBLUJWBTJNFOKBEJ WPMUBTF JOUSBTFMVMBS ZBOH EJIBSBQLBO BMJSBO MJTUSJL EJNBTVLLBO TFDBSB
UFSUVUVQ NFSVQBLBO QSPTFT ZBOH MFCJI MBNCBU EBSJQBEB QSPTFT PUPNBUJTNFMBMVJFMFLUSPEBBSVTEBSJLMFNWPMUBTFVOUVLNFOKBHBBHBS
QFSVCBIBO CFOUVL ZBOH NFNCVLB QJOUV BLUJWBTJ 0MFI LBSFOB
JUV TFTVEBILBOBMOBUSJVNUFUBQUFSCVLBTFMBNBTFQFSCFCFSBQB
QVMVI SJCV EFUJL QJOUV JOBLUJWBTJ NFOVUVQ EBO JPO OBUSJVN
UJEBL MBHJ EBQBU UFSUVBOH LF EBMBN NFNCSBO 1BEB TBBU JOJ
QPUFOTJBM NFNCSBO NVMBJ QVMJI LFNCBMJ LF LFBEBBO NFNCSBO
JTUJSBIBU ZBOHNFSVQBLBOQSPTFTSFQPMBSJTBTJ Ele trod
4JGBU QFOUJOH MBJO EBO QSPTFT JOBLUJWBTJ LBOBM OBUSJVN

BEBMBI CBIXB QJOUV ZBOH JOBLUJG UJEBL BLBO UFSCVLB MBHJ
TBNQBJ QPUFOTJBM NFNCSBO LFNCBMJ LF BUBV NFOEFLBUJ OJMBJ
QPUFOTJBM NFNCSBO JTUJSBIBU BTBMOZB 0MFI LBSFOB JUV
CJBTBOZBUJEBLMBINVOHLJOCBHJLBOBMOBUSJVNVOUVLUFSCVLB
MBHJUBOQBMFCJIEVMVUFSKBEJSFQPMBSJTBTJQBEBTFSBCVUTBSBG
Kanal Kalium Berpintu Listrik dan Aktivasinya 30

#BHJBO CBXBI (BNCBS NFNQFSMJIBULBO EVB LFBEBBO LBOBM
20
LBMJVN CFSQJOUV MJTUSJL TFMBNB LFBEBBO JTUJSBIBU LJSJ
EBO
NFOVKV BLIJS QPUFOTJBM BLTJ LBOBO
4FMBNB LFBEBBO JTUJSBIBU 10
QJOUVLBOBMLBMJVNUFSUVUVQ EBOJPOLBMJVNUFSIBMBOHJNFMBMVJ 0
LBOBMJOJLFMVBS#JMBQPUFOTJBMNFNCSBONFOJOHLBUEBSJ EBO

–90 mV +10 mV –90 mV
NJMJWPMU NFOVKV OPM QFSVCBIBO WPMUBTF JOJ NFOZFCBCLBO
QFSVCBIBO CFOUVL ZBOH NFNCVLB QJOUV EBO NFNVEBILBO
QFOJOHLBUBO EJGVTJ LBMJVN LF MVBS NFMBMVJ LBOBM /BNVO 0 2 3
LBSFOB UFSKBEJ TFEJLJU QFSMBNCBUBO QBEB QFNCVLBBO LBOBM
LBMJVN JOJ QBEB CBOZBL CBHJBO LBOBM LBMJVN IBOZB UFSCVLB
QBEBTBBUZBOHCFSTBNBBOLFUJLBLBOBMOBUSJVNNVMBJNFOVUVQ
BLJCBU JOBLUJWBTJ +BEJ NFOVSVOOZB KVNMBI OBUSJVN ZBOH
NBTVL LF EBMBN TFM EBO QFOJOHLBUBO QFOHFMVBSBO LBMJVN ZBOH
CFSTBNBBO XBLUVOZB EBSJ TFM TFDBSB CFSTBNBTBNB
NFNQFSDFQBUQSPTFTSFQPMBSJTBTJ EBONFOJNCVMLBOQFNVMJIBO
TFNQVSOB QBEB QPUFOTJBM NFNCSBO JTUJSBIBU EBMBN XBLUV
TFQFSCFCFSBQBQVMVISJCVEFUJLLFNVEJBO
62
WPMUBTF JOUSBTFMVMBS UFUBQ QBEB OJMBJ OPM ZBOH EJQFSMVLBO 6OUVL

NFODBQBJLFBEBBOJOJ BMJSBOZBOHEJNBTVLLBOIBSVTTFUBSBEFOHBO +60
+40
BMJSBO BSVT OFUP ZBOH NFMBMVJ LBOBM NFNCSBO OBNVO EFOHBO +20
QPMBSJUBT ZBOH CFSMBXBOBO 6OUVL NFOHVLVS CFSBQB CFTBS BMJSBO 100 0
–20
BSVTZBOHUFSKBEJEJTFUJBQTBBU FMFLUSPEBBSVTEJIVCVOHLBOEFOHBO 10 –40
UNIT II
TVBUV PTJMPTLPQ ZBOH NFSFLBN BMJSBO BSVT TFQFSUJ ZBOH –60
–80
EJHBNCBSLBO QBEB MBZBS PTJMPTLPQ QBEB (BNCBS "LIJSOZB 1
–100
QFOFMJUJ NFOHBUVS LPOTFOUSBTJ JPO EFOHBO OJMBJ ZBOH MBJO EBSJ 0.1
OPSNBM CBJL EJ EBMBN EBO EJ MVBS TFSBU TBSBG EBO NFOHVMBOH
QFOHVKJBO )BM JOJ EBQBU EJMBLVLBO EFOHBO NVEBI CJMB EJHVOBLBO 0.01
TFSBU TBSBG CFTBS ZBOH EJBNCJM EBSJ CFCFSBQB IFXBO JOWFSUFCSBUB 0.001
LIVTVTOZB BLTPO DVNJDVNJ SBLTBTB ZBOH LBEBOH EJBNFUFSOZB 100
EBQBU TFCFTBS NM #JMB OBUSJVN BEBMBI TBUVTBUVOZB JPO ZBOH 10
QFSNFBCFM EJ *BSVUBO CBHJBO EBMBN EBO MVBS BLTPO DVNJDVNJ
Conductance
(mmho/cm2)
LMFN WPMUBTF IBOZB NFOHVLVS BMJSBO BSVT ZBOH NFMBMVJ LBOBM 1 K+
OBUSJVN #JMB LBMJVN BEBMBI TBUVTBUVOZB JPO ZBOH QFSNFBCFM 0.1
IBOZBBMJSBOBSVTZBOHNFMBMVJLBOBMLBMJVNZBOHUFSVLVS Na+
0.01
0.005
.BLOB MBJO EBSJ QFOFMJUJBO NFOHFOBJ BMJSBO JPO NFMBMVJ 0 0.5 1.0 1.5
NBTJOHNBTJOHKFOJTLBOBMJBMBIVOUVLNFOHIBNCBUTFKFOJTLBOBM
QBEB TVBUV TBBU .JTBMOZB LBOBM OBUSJVN EBQBU EJIBNCBU PMFI
UPLTJO ZBOH EJTFCVU UFUSPEPUPLTJO EFOHBO NFNCFSJLBOOZB EJ
CBHJBO MVBS NFNCSBO TFM UFNQBU QJOUV BLUJWBTJ OBUSJVN CFSBEB
4FCBMJLOZB JPO UFUSBFUJMBNPOJVN NFOHIBNCBU LBOBMLBOBM
LBMJVNCJMBCBIBOJOJEJCFSJLBOQBEBCBHJBOEBMBNTFSBUTBSBG
(BNCBS NFOKFMBTLBO QFSVCBIBO LIBT QBEB QFOHIBOUBSBO
LBOBMOBUSJVNEBOLBMJVNCFSQJOUVMJTUSJLLFUJLBUFSKBEJQFSVCBIBO
NFOEBEBL QBEB QPUFOTJBM NFNCSBO LBSFOB QFOHHVOBBO LMFN
WPMUBTF EBO NJMJWPMU NFOKBEJ NJMJWPMU EBO NJMJEFUJL
LFNVEJBO LFNCBMJ MBHJ NFOKBEJ NJMJWPMU 1FSIBUJLBO BEBOZB MJQBU 4FMBOKVUOZB EBMBN XBLUV TFQFSTFLJBO NJMJEFUJL BLBO
QFNCVLBBO LBOBM OBUSJVN ZBOH CFSMBOHTVOH NFOEBEBL UBIBQ UFSKBEJ QSPTFT JOBLUJWBTJ ZBOH NFOVUVQ LBOBM OBUSJVN
BLUJWBTJ
EBMBNXBLUVLVSBOHEBSJTFQFSNJMJEFUJLTFTVEBIQPUFOTJBM 5FSKBEJOZB QPUFOTJBM BLTJ KVHB NFOZFCBCLBO LBOBM LBMJVN
NFNCSBO NFOJOHLBU NFOKBEJ OJMBJ QPTJUJG 8BMBVQVO CFHJUV NFOKBEJ CFSQJOUV MJTUSJL TFIJOHHB LBOBM UFSTFCVU NVMBJ
TFMBNB CFCFSBQB NJMJEFUJL CFSJLVUOZB LBOBM OBUSJVN TFDBSB NFNCVLBMFCJIMBNCBUEBMBNTFQFSTFLJBONJMJEFUJLTFUFMBI
PUPNBUJTBLBOUFSUVUVQ UBIBQJOBLUJWBTJ
LBOBM OBUSJVN UFSCVLB 1BEB BLIJS QPUFOTJBM BLTJ
1FSIBUJLBO QFNCVLBBO BLUJWBTJ
LBOBM LBMJVN ,BOBM JOJ QFOHFNCBMJBO QPUFOTJBM NFNCSBO LF LFBEBBO OFHBUJG
UFSCVLBTFDBSBMBNCBUEBOUFSCVLBTFMVSVIOZBIBOZBTFUFMBILBOBM NFOZFCBCLBO LBOBM LBMJVN UFSUVUVQ LFNCBMJ LF LFBEBBO
OBUSJVN UFMBI IBNQJS UFSUVUVQ TFMVSVIOZB 4FMBOKVUOZB CFHJUV TFNVMB OBNVO TFLBMJ MBHJ IBOZB TFTVEBI NFOHBMBNJ
LBOBM LBMJVN UFSCVLB LBOBM BLBO UFUBQ UFSCVLB QBEB XBLUV QFSMBNCBUBOTFCFTBSTFQFSTFLJBONJMJEFUJLBUBVMFCJI
UFSKBEJOZB QPUFOTJBM NFNCSBO QPTJUJG EBO UJEBL BLBO UFSUVUVQ MBHJ #BHJBOUFOHBI(BNCBSNFOVOKVLLBOQFSCBOEJOH
TBNQBJTFUFMBIQPUFOTJBMNFNCSBONFOVSVOLFNCBMJNFOKBEJOJMBJ BOLPOEVLUBOTOBUSJVNUFSIBEBQLPOEVLUBOTLBMJVNQBEB
OFHBUJG TFUJBQ TBBU TFMBNB QPUFOTJBM BLTJ EBO EJ BUBTOZB BEBMBI
HBNCBS QPUFOTJBM BLTJOZB 1BEB CBHJBO BXBM QPUFOTJBM
Ringkasan Peristiwa-Peristiwa yang Menyebabkan Potensial BLTJ QFSCBOEJOHBO LPOEVLUBOT OBUSJVN UFSIBEBQ LBMJVN
Aksi NFOJOHLBU MFCJI EBSJ TFSJCV LBMJ MJQBU 0MFI LBSFOB JUV
(BNCBS NFOKFMBTLBO CFOUVL SJOHLBT VSVUBO QFSJTUJXB ZBOH MFCJICBOZBLJPOOBUSJVNZBOHNFOHBMJSLFEBMBNTFSBCVU
UFSKBEJ TFMBNB EBO TFHFSB TFTVEBI QPUFOTJBM BLTJ #BHJBO CBXBI EBSJQBEB JPO LBMJVN ZBOH LF MVBS MOJMBI ZBOH
HBNCBS NFOVOKVLLBO QFSVCBIBO QBEB LPOEVLUBOT NFNCSBO NFOZFCBCLBO QPUFOTJBM NFNCSBO NFOKBEJ QPTJUJG QBEB
VOUVL JPO OBUSJVN EBO LBMJVN 1BEB LFBEBBO JTUJSBIBU TFCFMVN TBBU UFSKBEJOZB QPUFOTJBM BLTJ ,FNVEJBO LBOBM OBUSJVN
QPUFOTJBM BLTJ EJNVMBJ LPOEVLUBOT JPO LBMJVN BEBMBI TBNQBJ NVMBJ NFOVUVQ EBO LBOBM LBMJVN NVMBJ NFNCVLB
LBMJ MFCJI CFTBS EBSJQBEB LPOEVLUBOT JPO OBUSJVN )BM JOJ TFIJOHHBQFSCBOEJOHBOLPOEVLUBOTCFSHFTFSKBVILFBSBI
EJTFCBCLBO PMFI NBLJO CBOZBLOZB JPO LBMJVN ZBOH NFOHBMBNJ LPOEVLUBOTLBMJVNZBOHUJOHHJ UFUBQJEFOHBOLPOEVLUBOT
LFCPDPSBO NFMBMVJ LBOBM CPDPS EBO NFMFCJIJ KVNMBI JPO OBUSJVN OBUSJVN ZBOH SFOEBI )BM JOJ BLBO TBOHBU NFNQFSDFQBU
ZBOHNFOHBMBNJLFCPDPSBO8BMBVQVOCFHJUV QBEBTBBUUFSKBEJOZB QFOHFMVBSBO JPO LBMJVN TFNFOUBSB JPO OBUSJVN ZBOH
QPUFOTJBM BLTJ LBOBM OBUSJVN TFHFSB NFOKBEJ BLUJG EBO NFOHBMJS NBTVL IBNQJS OPM "LJCBUOZB QPUFOTJBM BLTJ
NFNQFSNVEBIQFOJOHLBUBOLPOEVLUBOTOBUSJVNTBNQBJLBMJ EFOHBODFQBULFNCBMJLFOJMBJTFNVMB
63
Peran lon Lainnya Selama Potensial Aksi OPSNBMTFCFMVNUJNCVMQFMFQBTBONVBUBOTQPOUBOEJCBOZBLTBSBG

QFSJGFS ZBOH TFSJOH LBMJ NFOZFCBCLBO UFUBOJh )BM JOJ LBEBOH
4FKBVIJOJ LJUBIBOZBNFNQFSUJNCBOHLBOQFSBOJPOOBUSJVNEBO NFNBUJLBOBLJCBULPOUSBLTJUFUBOJLQBEBPUPUQFSOBQBTBO
LBMJVN TBKB QBEB QFNCFOUVLBO QPUFOTJBM BLTJ 4FCFOBSOZB .VOHLJO JPOLBMTJVNNFNFOHBSVIJLBOBMOBUSJVNEFOHBODBSB
TFEJLJUOZB BEB EVB NBDBN JPO MBHJ ZBOH IBSVT EJQFSUJNCBOHLBO CFSJLVU *POJPO JOJ UBNQBLOZB CFSJLBUBO EFOHBO QFSNVLBBO MVBS
BOJPOOFHBUJGEBOJPOLBMTJVN NPMFLVMQSPUFJOLBOBMOBUSJVN.VBUBOQPTJUJGJPOJPOLBMTJVNJOJ
lon-lon Bermuatan Negatif (Anion) yang Tidak Permeabel LFNVEJBONFOHVCBILFBEBBOMJTUSJLTPEJVNQSPUFJOLBOBMOBUSJVN
di Dalam Akson. %J EBMBN BLTPO UFSEBQBU CBOZBL JPO CFSNVBUBO JUV TFOEJSJ EFOHBO EFNJLJBO NFOHVCBI OJMBJ WPMUBTF ZBOH
EJCVUVILBOVOUVLNFNCVLBQJOUVOBUSJVN
OFHBUJGZBOHUJEBLEBQBUNFMFXBUJLBOBMNFNCSBO*POJPOJOJNFMJQVUJ
BOJPO EBSJ NPMFLVM QSPUFJO EBO CBOZBL LPNQPOFO GPTGBU PSHBOJL Inisiasi Potensial Aksi
TFOZBXB TVMGBU EBO TFCBHBJOZB 0MFI LBSFOB JPOJPO JOJ UJEBL EBQBU 4BNQBJ EJ TJOJ LJUB UFMBI NFNCBIBT NFOHFOBJ QFSVCBIBO
NFOJOHHBMLBO TJTJ EBMBN BLTPO TFUJBQ EFGJTJU JPO QPTJUJG EJ EBMBN
QFSNFBCJMJUBT NFNCSBO UFSIBEBQ OBUSJVN EBO LBMJVN KVHB
NFNCSBO BLBO NFOJNCVMLBO LFMFCJIBO BOJPO OFHBUJG ZBOH UJEBL
QFSNFBCFMJOJ0MFILBSFOBJUV JPOJPOOFHBUJGZBOHUJEBLQFSNFBCFMJOJ
QFNCFOUVLBO QPUFOTJBM BLTJ JUV TFOEJSJ OBNVO LJUB CFMVN
CFSUBOHHVOH KBXBC BUBT NVBUBO OFHBUJG EJ EBMBN TFSBCVU CJMB UFSEBQBU NFNCBIBT BQB ZBOH NFOHJOJTJBTJ QPUFOTJBM BLTJ +BXBCBO
LFLVSBOHBO OFUP JPO LBMJVN ZBOH CFSNVBUBO QPTJUJG EBO JPO QPTJUJG VOUVLQFSUBOZBBOUFSTFCVUTFCFOBSOZBDVLVQTFEFSIBOB
MBJOOZB
Siklus Umpan Balik Positif Membuka Kanal Natrium.
lon Kalsium. )BNQJS TFMVSVI NFNCSBO TFM UVCVI NFNQVOZBJ 1FSUBNB TFMBNB NFNCSBO TFSBCVU TBSBG UFUBQ UJEBL
QPNQB LBMTJVN ZBOH NJSJQ EFOHBO QPNQB OBUSJVN EBO LBMTJVN CFLFSKB UFSHBOHHV UJEBL BEB QPUFOTJBM BLTJ ZBOH UJNCVM QBEB TFSBU
CFSTBNB EFOHBO BUBV NFOHHBOUJLBO
OBUSJVN EJ CFCFSBQB TFU VOUVL TBSBG .FTLJQVO EFNJLJBO CJMB BEB QFSJTUJXB BQB QVO ZBOH
NFOHIBTJMLBOTFCBHJBOCFTBSQPUFOTJBMBLTJ4FQFSUJIBMOZBQPNQBOBUSJVN
NFOZFCBCLBO LFOBJLBO BXBM ZBOH DVLVQ UJOHHJ QBEB
QPNQB LBMTJVN BLBO NFOUSBOTQPS JPOJPO LBMTJVN EBSJ CBHJBO EBMBN LF
CBHJBOMVBSNFNCSBOTFM BUBVLFEBMBNSFUJLVMVNFOEPQMBTNBTFM
ZBOH
QPUFOTJBM NFNCSBO EBSJ o NJMJWPMU NFOKBEJ OJMBJ OPM
NFOJNCVMLBO HSBEJFO JPO LBMTJVN LJSBLJSB LBMJ MJQBU )BM JOJ QFOJOHLBUBO WPMUBTF JUV TFOEJSJ NFOZFCBCLBO CBOZBL LBOBM
NFOZFCBCLBO LPOTFOUSBTJ JPO LBMTJVN EJ CBHJBO EBMBN TFM LJSBLJSB OBUSJVN CFSQJOUV MJTUSJL NVMBJ UFSCVLB )BM JOJ BLBO
NPMBSZBOHCFSBEBEFOHBOLPOTFOUSBTJEJCBHJBOMVBSTFCFTBSLJSBLJSB NFNQFSDFQBU NBTVLOZB JPO OBUSJVN ZBOH NFOZFCBCLBO
NPMBS QFOJOHLBUBO QBEB QPUFOTJBM NFNCSBO TFIJOHHB NBLJO
4FMBJO JUV UFSEBQBU LBOBM LBMTJVN CFSQJOUV MJTUSJL 0MFI LBSFOB LBEBS NFNCVLB MBHJ LBOBM OBUSJVN CFSQJOUV MJTUSJL EBO MFCJI
JPO LBMTJVN LBMJ MFCJI CFTBS EJ DBJSBO FLTUSBTFMVMBS LFUJNCBOH CBOZBLBMJSBOJPOOBUSJVNZBOHNBTVLLFEBMBNTFSBU1SPTFT
JOUSBTFMVMBS UFSKBEJMBI HSBEJFO EJGVTJ ZBOH TBOHBU CFTBS VOUVL UFSKBEJOZB JOJNFSVQBLBOTJLMVTVNQBOCBMJLQPTJUJGZBOH LFUJLBVNQBO
BMJSBOQBTJGJPOLBMTJVNLFEBMBNTFM,BOBMJOJTFEJLJUQFSNFBCFMUFSIBEBQ CBMJL JOJ DVLVQ LVBU UFSVT CFSMBOKVU TBNQBJ TFMVSVI LBOBM
JPO OBUSJVN EBO JPO LBMTJVN UFUBQJ QFSNFBCJMJUBTOZB UFSIBEBQ LBMTJVN OBUSJVN CFSQJOUV MJTUSJL NFOKBEJ UFSBLUJWBTJ UFSCVLB

LJSBLJSB LBMJ MFCJI CFTBS LFUJNCBOH UFSIBEBQ OBUSJVN EBMBN ,FNVEJBO EBMBN TFQFSTFLJBO NJMJEFUJL QFOJOHLBUBO
LFBEBBO GJTJPMPHJT OPSNBM #JMB LBOBMLBOBM UFSTFCVU NFNCVLB TFCBHBJ QPUFOTJBMNFNCSBONFOZFCBCLBOQFOVUVQBOLBOBMOBUSJVN
SFTQPOT UFSIBEBQ SBOHTBOH ZBOH NFOEFQPMBSJTBTJ NFNCSBO TFM JPO EBO QFNCVLBBO LBOBM LBMJVN EBO QPUFOTJBM BLTJ TFHFSB
LBMTJVNBLBOEBONFOHBMJSNBTVLLFEBMBNTFM CFSBLIJS
'VOHTJ VUBNB LBOBM CFSQJOUV MJTUSJL JPO LBMTJVN BEBMBI CFSLPOUSJCVTJ
Nilai Ambang untuk Inisiasi Potensial Aksi. 4VBUV
EBMBNGBTFEFQPMBSJTBTJQPUFOTJBMBLTJEJCFCFSBQBTFM5FUBQJQFOHBLJUJGBO
QJOUVLBOBMLBMTJVNCFSMBOHTVOHMBNCBU NFNCVUVILBOXBLUVTBNQBJ
QPUFOTJBM BLTJ UJEBL BLBO UJNCVM TBNQBJ QFOJOHLBUBO BXBM
LBMJ MFCJI MBNB EBSJ XBLUV VOUVL NFOHBLUJGLBO LBOBM OBUSJVN 0MFI QBEB QPUFOTJBM NFNCSBO DVLVQ CFTBS VOUVL NFODJQUBLBO
LBSFOBJUVMBILBOBMLBOBMLBMTJVNJOJEJOBNBLBOLBOBMMBNCBU TFCBMJLOZB VNQBOCBMJLQPTJUJGTFQFSUJZBOHUFMBIEJKFMBTLBOEJQBSBHSBG
EBSJ LBOBM OBUSJVN ZBOH EJOBNBLBO LBOBM DFQBU %FOHBO EFNJLJBO TFCFMVNOZB )BM JOJ UFSKBEJ CJMB KVNMBI JPO /B ZBOH
QFNCVLBBO LBOBMLBOBM LBMTJVN NFOZFCBCLBO UFSKBEJOZB EFQPMBSJTBTJ NFNBTVLJ TFSBCVU NFOKBEJ MFCJI CFTBS EBSJQBEB KVNMBI JPO
ZBOH CFSMBOHTVOH MFCJI MBNB TFEBOHLBO LBOBMLBOBM OBUSJVN CFSQFSBO , ZBOH NFOJOHHBMLBO TFSBCVU #JBTBOZB EJCVUVILBO
QFOUJOHEBMBNNFOHJOJTJBTJQPUFOTJBMBLTJ QFOJOHLBUBO QPUFOTJBM NFNCSBO ZBOH CFSMBOHTVOH TFDBSB
,BOBM LBMTJVN EJKVNQBJCBOZBL TFLBMJ EJ PUPU KBOUVOH EBO PUPU QPMPT UJCBUJCB TFCFTBS TBNQBJ NJMJWPMU 0MFI LBSFOB JUV
5FSOZBUB QBEBCFCFSBQBNBDBNPUPUQPMPT IBNQJSIBNQJSUJEBLEJKVNQBJ QFOJOHLBUBO ZBOH CFSMBOHTVOH UJCBUJCB QBEB QPUFOTJBM
LBOBM OBUSJVN DFQBU TFIJOHHB QPUFOTJBM BLTJ IBNQJS TFMVSVIOZB NFNCSBO EBMBN TFSBCVU TBSBG CFTBS EBSJ o NJMJWPMU
EJTFCBCLBOPMFIBLUJWBTJLBOBMLBMTJVNMBNCBU NFOKBEJ TFLJUBS o NJMJWPMU CJBTBOZB BLBO NFOZFCBCLBO
Kenaikan Permeabilitas Kanal Natrium Bila Terdapat UJNCVMOZBTVBUVMFUVQBOQPUFOTJBMBLTJ/JMBJoNJMJWPMUJOJ
Kekurangan lon Kalsium ,POTFOUSBTJ JPO LBMTJVN EJ DBJSBO EJLBUBLBOTFCBHBJOJMBJBNCBOHVOUVLQFSBOHTBOHBO
FLTUSBTFMVMBS KVHB NFNQVOZBJ QFOHBSVI ZBOH CFTBS UFSIBEBQ OJMBJ WPMUBTF
ZBOH NFNCVBU LBOBM OBUSJVN NFOKBEJ UFSBLUJWBTJ %BMBN LFBEBBO
Penyebaran Potensial Aksi
LFLVSBOHBO JPO LBMTJVN LBOBM OBUSJVN BLBO UFSBLUJWBTJ UFSCVLB
PMFI
QFOJOHLBUBO ZBOH TBOHBU LFDJM QPUFOTJBM MJTUSJL NFNCSBO EBSJ OJMBJ %BMBN QBSBHSBG TFCFMVNOZB LJUB UFMBI NFNCJDBSBLBO
OPSNBMOZB ZBOHTBOHBUOFHBUJG0MFILBSFOBJUV TFSBUTBSBGNFOKBEJTBOHBU QPUFOTJBMBLTJZBOHUFSKBEJQBEBTBMBITBUVUJUJLEJNFNCSBO
NVEBI UFSFLTJUBTJ LBEBOH NFMFQBTLBO NVBUBO TFDBSB CFSVOUVO UBOQB /BNVO QPUFOTJBM BLTJ ZBOH UJNCVM QBEB TBMBI TBUV UJUJL
QSPWPLBTJ EBO CVLBO NFOFUBQ QBEB LFBEBBO JTUJSBIBU 5FSOZBUB NBOBQVOEJNFNCSBOZBOHNVEBIUFSBOHTBOHCJBTBOZBBLBO
LPOTFOUSBTJJPOLBMTJVNIBOZBQFSMVUVSVOTFCFTBSQFSTFOEJCBXBIOJMBJ NFOHFLTJUBTJCBHJBONFNCSBOZBOHEJEFLBUUJUJLUFSTFCVU
64
+++++++++++++++++++++++ Prinsip Semua atau Tidak Sama Sekali. #FHJUV TVBUV

––––––––––––––––––––––– QPUFOTJBM BLTJ UJNCVM QBEB UJUJL NBOB QVO EBMBN NFNCSBO
TFSBCVU OPSNBM QSPTFT EFQPMBSJTBTJ CFSKBMBO TFQBOKBOH
–––––––––––––––––––––––
A +++++++++++++++++++++++ NFNCSBO KJLB LPOEJTJOZB NFNVOHLJOLBO BUBV UJEBL CFSKBMBO
TBNB TFLBMJ KJLB LFBEBBO UJEBL NFNVOHLJOLBO ,FBEBBO JOJ
UNIT II
EJTFCVU QSJOTJQ HBHBM BUBV UVOUBT BMMPSOPUIJOHT
EBO QSJOTJQ
++++++++++++––+++++++++ UFSTFCVU CFSMBLV EJ TFNVB KBSJOHBO OPSNBM ZBOH NVEBI
––––––––––––++–––––––––
UFSFLTJUBTJ"EBLBMBOZB QPUFOTJBMBLTJNFODBQBJTVBUVUJUJLQBEB
––––––––––––++––––––––– NFNCSBO EJ NBOB UJUJL UFSTFCVU UJEBL NFOJNCVMLBO WPMUBTF
B ++++++++++++––+++++++++ ZBOH DVLVQ VOUVL NFSBOHTBOH EBFSBI NFNCSBO CFSJLVUOZB
#JMBIBMJOJUFSKBEJ QFOZFCBSBOEFQPMBSJTBTJBLBOUFSIFOUJ0MFI
++++++++++––––++++++++
LBSFOB JUV BHBS QFOKBMBSBO JNQVMT UFSKBEJ UFSVTNFOFSVT
––––––––––++++–––––––– QFSCBOEJOHBO QPUFOTJBM BLTJ UFSIBEBQ OJMBJ BNCBOH VOUVL
QFSBOHTBOHBOQBEBTFUJBQTBBUIBSVTMFCJIMFCJICFTBSEBSJ)BM
––––––––––++++–––––––– TFNBDBNMFCJICFTBSEBSJJOJEJTFCVUGBLUPSQFOHBNBOVOUVL
C ++++++++++––––++++++++
QFOZFCBSBO
Penetapan Kembali Gradien lon Natrium dan Kalium
++––––––––––––––––––++
––++++++++++++++++++––
sesudah Terjadinya Potensial Aksi—Arti Penting
Metabolisme Energi
––++++++++++++++++++––
++––––––––––––––––––++ 5SBOTNJTJ TFUJBQ QPUFOTJBM BLTJ EJ TFQBOKBOH TVBUV TFSBU TBSBG
BLBO TFEJLJU NFOHVSBOHJ QFSCFEBBO LPOTFOUSBTJ OBUSJVN EBO
LBMJVNEJTJTJEBMBNEBOTJTJMVBSNFNCSBO LBSFOBJPOOBUSJVN
CFSEJGVTJLFEBMBNTFMBNBEFQPMBSJTBTJEBOJPOLBMJVNCFSEJGVTJ
LFMVBSTFMBNBSFQPMBSJTBTJ6OUVLTBUVQPUFOTJBMBLTJ QFOHBSVI
JOJ CFHJUV LFDJM TFIJOHHB UBL EBQBU EJVLVS #BILBO
TFIJOHHB UFSKBEJ QFOZFCBSBO QPUFOTJBM BLTJ EJ TFQBOKBOH TBNQBJ KVUB JNQVMT EBQBU EJUSBOTNJTJLBO PMFI TFSBU TBSBG
NFNCSBO .FLBOJTNF JOJ EJQFSMJIBULBO QBEB (BNCBS CFTBS TFCFMVN QFSCFEBBO LPOTFOUSBTJ NFODBQBJ LF TVBUV OJMBJ
(BNCBS"NFOHHBNCBSLBOTVBUVTFSBUTBSBGOPSNBMEBMBN ZBOH NFOZFCBCLBO UFSIFOUJOZB LPOEVLTJ QPUFOTJBM BLTJ
LFBEBBO JTUJSBIBU EBO (BNCBS # NFNQFSMJIBULBO TFSBU 8BMBVQVO CFHJUV EFOHBO CFSKBMBOOZB XBLUV QFSCFEBBO
TBSBG ZBOH UFMBI UFSFLTJUBTJ EJ CBHJBO UFOHBIOZB TFIJOHHB QBEB LPOTFOUSBTJ OBUSJVN EBO LBMJVN QBEB NFNCSBO QFSMV
CBHJBOUFOHBIJOJUFSKBEJLFOBJLBONFOEBEBLQBEBQFSNFBCJMJUBT EJUFUBQLBOLFNCBMJ)BMJOJEBQBUEJDBQBJNFMBMVJLFSKBQPNQB
UFSIBEBQOBUSJVN"SBIQBOBINFOKFMBTLBOTJSLVJUMPLBMBMJSBO /B, EFOHBO DBSB TFQFSUJ ZBOH UFMBI EJKFMBTLBO TFCFMVNOZB
MJTUSJL EBSJ EBFSBI NFNCSBO ZBOH UFSEFQPMBSJTBTJ LF EBFSBI QFSJIBMQFOFUBQBOBXBMQPUFOTJBMJTUJSBIBU"SUJOZB JPOOBUSJVN
NFNCSBO ZBOH TFEBOH JTUJSBIBU EJ EFLBUOZB %FOHBO LBUB MBJO ZBOHUFMBICFSEJGVTJLFEBMBNTFMTFMBNBQPUFOTJBMBLTJEBOJPO
NVBUBO MJTUSJL QPTJUJG EJCBXB PMFI JPO OBUSJVN ZBOH CFSEJGVTJ LBMJVN ZBOH UFMBI CFSEJGVTJ LF MVBS IBSVT EJLFNCBMJLBO LF
LFEBMBN NFMFXBUJ NFNCSBO ZBOH UFSEFQPMBSJTBTJ EBO LFBEBBO TFNVMB PMFI QPNQB /B, 0MFI LBSFOB QPNQB JOJ
TFMBOKVUOZB CFCFSBQB NJMJNFUFS QBEB LFEVB BSBI EJ TFQBOKBOH NFNCVUVILBO FOFSHJ VOUVL CFLFSKB QFOHJTJBO LFNCBMJ TFSBU
JOUJ BLTPO .VBUBO QPTJUJG JOJ NFOJOHLBULBO WPMUBTF EJ EBMBN TBSBG JOJ NFSVQBLBO QSPTFT NFUBCPMJL BLUJG EFOHBO
TFSBCVU CFTBS CFSNJFMJO TBNQBJ CFSKBSBL TBNQBJ NJMJNFUFS NFOHHVOBLBO FOFSHJ ZBOH CFSBTBM EBSJ TJTUFN FOFSHJ BEFOPTJO
IJOHHB EJ BUBT OJMBJ BNCBOH WPMUBTF VOUVL NFNVMBJ QPUFOTJBM USJGPTGBU "51
EJ TFM (BNCBS NFNQFSMJIBULBO CBIXB
BLTJ0MFILBSFOBJUV LBOBMOBUSJVNQBEBUFNQBUZBOHCBSVJOJ TFSBU TBSBG NFOHIBTJMLBO QBOBT ZBOH CFSMFCJIBO TFMBNB
TFHFSB UFSCVLB TFQFSUJ ZBOH EJQFSMJIBULBO QBEB (BNCBS $ QFOHJTJBOLFNCBMJ ZBOHNFSVQBLBOVLVSBOQFSJHFMVBSBOFOFSHJ
EBO % EBO QPUFOTJBM BLTJ ZBOH NFMFUVQ NFOKBEJ UFSTFCBS LFUJLBGSFLVFOTJJNQVMTNFOJOHLBU
%BFSBI EFQPMBSJTBTJ ZBOH CBSV JOJ NFOHIBTJMLBO TJSLVJU MPLBM 4VBUV HBNCBSBO LIVTVT EBSJ QPNQB /B, "51BTF BEBMBI
BMJSBO MJTUSJL MFCJI MBOKVU EJ TFQBOKBOH NFNCSBO EBO CBIXB UJOHLBU BLUJWJUBTOZB UFSBOHTBOH EFOHBO TBOHBU LVBU CJMB
NFOJNCVMLBO EFQPMBSJTBTJ ZBOH QSPHSFTJG +BEJ QSPTFT UFSEBQBU LFMFCJIBO JPO OBUSJVN ZBOH CFSLVNQVM EJ EBMBN
EFQPMBSJTBTJ UFSKBEJ TFQBOKBOH LFTFMVSVIBO QBOKBOH TFSBCVU NFNCSBO TFM 5FSOZBUB BLUJWJUBT QFNPNQBBO NFOJOHLBU LJSB
5BOTNJTJ QSPTFT EFQPMBSJTBTJ TFQBOKBOH TFSBCVU PUPU BUBV TBSBG LJSB TFCBOEJOH EFOHBO QBOHLBU UJHB LPOTFOUSBTJ OBUSJVN
EJTFCVUJNQVMTTBSBGBUBVJNQVMTPUPU JOUSBTFMVMBS +BEJ CJMB LPOTFOUSBTJ OBUSJVN EJ EBMBN TFM
NFOJOHLBU EBSJ NFOKBEJ N&R- BLUJWJUBT QPNQB UJEBL
Arah Penyebaran. 4FQFSUJ ZBOH EJQFSMJIBULBO QBEB (BNCBS IBOZB NFOJOHLBU EVB LBMJ OBNVO NFOJOHLBU LJSBLJSB EFMBQBO
NFNCSBO ZBOH NVEBI UFSFLTJUBTJ UJEBL NFNQVOZBJ TBUV LBMJMJQBU0MFILBSFOBJUV NVEBIEJNFOHFSUJCBHBJNBOBQSPTFT
BSBIQFOZFCBSBO OBNVOQPUFOTJBMBLTJCFSKBMBOEBMBNTFNVBBSBI QFOHJTJBO LFNCBMJ TFSBCVU TBSBG EBQBU EJCVBU CFHJUV DFQBU
NFOKBVIJSBOHTBOHBOCBILBOTFQBOKBOHTFNVBDBCBOHTFSBUTBSBG NFOKBEJ TVBUV HFSBLBO LBQBO QVO QFSCFEBBO LPOTFOUSBTJ JPO
TBNQBJLFTFMVSVIBONFNCSBONFOKBEJUFSEFQPMBSJTBTJ OBUSJVNEBOLBMJVNZBOHNFMFXBUJNFNCSBONVMBJCFSLVSBOH
65
Unit Fisiologi Membran, Saraf, dan Otot
'BLUPS LFEVB ZBOH NVOHLJO CFSUBOHHVOH KBXBC TFCBHJBO

UFSIBEBQ UJNCVMOZB QFOEBUBSBO BEBMBI CBIXB LBOBM LBMJVN
CFSQJOUVMJTUSJLUFSCVLBMFCJIMBNCBUEBSJCJBTBOZB ZBOHTFSJOHLBMJ
UJEBLUFSMBMVNFNCVLBTBNQBJBLIJSQFOEBUBSBO,FBEBBOJOJBLBO
NFNQFSMBNCBU LFNCBMJOZB QPUFOTJBM NFNCSBO LF OJMBJ OFHBUJG
OPSNBMTFLJUBSTBNQBJNJMJWPMU
Irama pada Beberapa Jaringan Peka

Rangsang—Pelepasan Muatan Beruntun
0 100 200 300
1FMFQBTBO JNQVMT ZBOH EJJOEVLTJ TFOEJSJ CFSMBOHTVOH CFSVSVUBO
UFSKBEJTFDBSBOPSNBMEJKBOUVOH EJTFCBHJBOCFTBSPUPUQPMPT EBO
EJCBOZBLOFVSPOTJTUFNTBSBGQVTBU1FMFQBTBOZBOHCFSJSBNBJOJ
NFOZFCBCLBO
EFUBL ZBOH UFSBUVS QBEB KBOUVOH
HFSBL
QFSJTUBMTJT SJUNJL QBEB VTVT IBMVT EBO
QFSJTUJXB OFVSPOBM
TFQFSUJQFOHBUVSBOSJUNJLQBEBQFSOBQBTBO
Plateau (Garis Datar) pada Beberapa Potensial Aksi
4FMBJO JUV IBNQJS TFNVB KBSJOHBO MBJO ZBOH NVEBI UFSFLTJUBTJ
EBQBU NFOHBMBNJ QFMFQBTBO TFDBSB CFSVSVUBO KJLB BNCBOH
1BEBCFCFSBQBLFBEBBO NFNCSBOZBOHUFSFLTJUBTJUJEBLBLBO SBOHTBOH VOUVL TUJNVMBTJ TFM KBSJOHBO NFOVSVO TBNQBJ DVLVQ
TFHFSB NFOHBMBNJ SFQPMBSJTBTJ TFTVEBI EFQPMBSJTBTJ CBILBO SFOEBI 4FCBHBJ DPOUPI CBILBO QBEB TFSBCVU TBSBG ZBOH CFTBS
QPUFOTJBM UFUBQ QBEB LFBEBBO NFOEBUBS NFOEFLBUJ QVODBL TFLBMJQVOTFSUBTFSBCVUPUPUSBOHLB ZBOHOPSNBMOZBTBOHBUTUBCJM
TQJLF QPUFOUJBM TFMBNB CFCFSBQB NJMJEFUJL EBO LFNVEJBO NFOHBMBNJQFMFQBTBONVBUBOZBOHCFSVSVUBOCJMBTFSBCVUTFSBCVU
CBSV SFQPMBSJTBTJ EJNVMBJ 1MBUFBV HBSJT EBUBS
TFQFSUJ JOJ UFSTFCVU EJUFNQBULBO EJ EBMBN MBSVUBO ZBOH NFOHBOEVOH PCBU
EJQFSMJIBULBO QBEB (BNCBS LJUB EBQBU TFHFSB NFMJIBU WFSBUSJOFBUBVCJMBLPOTFOUSBTJJPOLBMTJVNNFOVSVOEJCBXBIOJMBJ
CBIXB QFOEBUBSBO TBOHBU NFNQFSQBOKBOH QFSJPEF LSJUJT EBO LFEVB LFBEBBO UFSTFCVU NFOJOHLBULBO QFSNFBCJMJUBT
EFQPMBSJTBTJ 1PUFOTJBM BLTJ UJQF JOJ UFSKBEJ EJ EBMBN TFSBCVU OBUSJVNQBEBNFNCSBO
PUPU KBOUVOH UFNQBU QFOEBUBSBO CFSMBOHTVOH TFMBNB Proses Re-eksitasi yang Diperlukan untuk Irama Spontan.
TBNQBJ EFUJL EBO NFOZFCBCLBO LPOUSBLTJ PUPU KBOUVOH "HBS UFSKBEJ JSBNB TQPOUBO NFNCSBO CBILBO EBMBN LFBEBBO
QBEBQFSJPEFXBLUVZBOHTBNB BMBNJOZB IBSVT DVLVQ QFSNFBCFM VOUVL JPO OBUSJVN BUBV VOUVL
1FOZFCBCQFOEBUBSBOJOJBEBMBIHBCVOHBOEBSJCFCFSBQB JPO LBMTJVN EBO OBUSJVN ZBOH NFMBMVJ LBOBM LBMTJVNOBUSJVN
GBLUPS 1FSUBNB QBEB PUPU KBOUVOH BEB EVB NBDBN LBOBM MBNCBU
BHBS EBQBU NFNQFSNVEBI UFSKBEJOZB EFQPMBSJTBTJ
ZBOH UFSMJCBU EBMBN QSPTFT EFQPMBSJTBTJ
LBOBM OBUSJVN NFNCSBO PUPNBUJT +BEJ (BNCBS NFOHHBNCBSLBO CBIXB
UFSBLUJWBTJWPMUBTF ZBOH CJBTB EJTFCVU LBOBM DFQBU EBO
QPUFOTJBM NFNCSBO JTUJSBIBU QBEB QVTBU QFOHFOEBMJBO JSBNB
LBOBM LBMTJVNOBUSJVN UFSBLUJWBTJWPMUBTF ZBOH NFNCVLB KBOUVOH IBOZB TFCFTBS TBNQBJ NJMJWPMU /JMBJ JOJ CVLBO
TFDBSB MBNCBU EBO LBSFOB JUV EJTFCVU LBOBM MBNCBU NFSVQBLBO WPMUBTF ZBOH DVLVQ OFHBUJG VOUVL NFNQFSUBIBOLBO
1FNCVLBBO LBOBM DFQBU NFOZFCBCLBO UJNCVMOZB CBHJBO LBOBMOBUSJVNEBOLBMTJVNBHBSUFSUVUVQTFDBSBUPUBM0MFILBSFOB
SVODJOH EBSJ QPUFOTJBM BLTJ TFEBOHLBO QFNCVLBBO LBOBM JUV UFSKBEJ VSVUBO QFSJTUJXB TFCBHBJ CFSJLVU
CFCFSBQB JPO
MBNCBU LBMTJVNOBUSJVN ZBOH CFSMBOHTVOH MBNB UFSVUBNB OBUSJVN EBO JPO LBMTJVN NFOHBMJS LF EBMBN
IBM JOJ
BLBO NFNCJBSLBO JPO LBMTJVN NFNBTVLJ TFSBCVU EBO NFOJOHLBULBO WPMUBTF NFNCSBO LF BSBI QPTJUJG ZBOH TFMBOKVUOZB
QBMJOHCFSUBOHHVOHKBXBCVOUVLUFSCFOUVLOZBQMBUFBVQBEB NFOJOHLBULBO QFSNFBCJMJUBT NFNCSBO
TFNBLJO CBOZBL JPO
QPUFOTJBMBLTJ ZBOH NFOHBMJS LF EBMBN EBO
QFSNFBCJMJUBT BLBO MFCJI
NFOJOHLBU EBOTFUFSVTOZB TBNQBJUFSCFOUVLQPUFOTJBMBLTJ
+60
+60 kali m o ensial aksi
+40
+40
+20
+20
0
0
–20
–20
–40 –40
–60 –60
–80
0 1 2 3
–100
0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9
66
4FMBOKVUOZB QBEB BLIJS QPUFOTJBM BLTJ NFNCSBO BLBO

NFOHBMBNJSFQPMBSJTBTJ4FUFMBIQFOVOEBBOMBJOTFMBNBCFCFSBQB
NJMJEFUJL BUBV EFUJL FLTJUBTJ TQPOUBO NFOZFCBCLBO EFQPMBSJTBTJ
LFNCBMJ EBO TFDBSB TQPOUBO UJNCVM QPUFOTJBM BLTJ ZBOH CBSV
4JLMVT JOJ BLBO CFSMBOHTVOH CFSVMBOHVMBOH TFIJOHHB UFSKBEJ
UNIT II
FLTJUBTJCFSJSBNBEJKBSJOHBOZBOHNVEBIUFSFLTJUBTJPMFIEJSJOZB
TFOEJSJ
.FOHBQB NFNCSBO QVTBU QFOHFOEBMJ KBOUVOH UJEBL
CFSEFQPMBSJTBTJ TFHFSB TFUFMBI JB UFSFQPMBSJTBTJ UFUBQJ NBMBI
UFSMBNCBUIBNQJSTBUVEFUJLTFCFMVNNVMBJUJNCVMQPUFOTJBMBLTJ
ZBOH CFSJLVU +BXBCBOOZB EBQBU EJKVNQBJ EFOHBO NFOHBNBUJ
LVSWB CFSUVMJTLBO LPOEVLUBOT LBMJVN QBEB (BNCBS
(BNCBS JOJ NFNQFSMJIBULBO CBIXB NFOVKV BLIJS TFUJBQ
QPUFOTJBM BLTJ EBO CFSMBOKVU TFMBNB NBTB TJOHLBU TFTVEBIOZB
NFNCSBO NFOKBEJ MFCJI QFSNFBCFM UFSIBEBQ JPO LBMJVN
1FOJOHLBUBO BMJSBO LFMVBS JPO LBMJVN BLBO NFNCBXB TFKVNMBI
CFTBS NVBUBO QPTJUJG LF MVBS NFNCSBO TFIJOHHB NFOJNCVMLBO
LFOFHBUJGBO ZBOH MFCJI CFTBS EJ CBHJBO EBMBN TFSBCVU EBSJQBEB
ZBOHTFIBSVTOZBUFSKBEJ)BMJOJCFSMBOHTVOHUFSVTTFMBNBIBNQJS
TBUV EFUJL TFTVEBI QPUFOTJBM BLTJ TFCFMVNOZB CFSBLIJS TFIJOHHB
NFOBSJL QPUFOTJBM NFNCSBO VOUVL NFOEFLBUJ QPUFOTJBM /FSOTU
VOUVL LBMJVN ,FBEBBO JOJ EJTFCVU IJQFSQPMBSJTBTJ ZBOH KVHB
EJUVOKVLLBOQBEB(BNCBS4FMBNBLFBEBBOJOJCFSMBOHTVOH
UJEBL BLBO UFSKBEJ SFFLTJUBTJ TFOEJSJ /BNVO QFOJOHLBUBO
LPOEVLUBOT LBMJVN EBO LFBEBBO IJQFSQPMBSJTBTJ
TFDBSB
CFSUBIBQ BLBO NFOHIJMBOH TFQFSUJ ZBOH UBNQBL QBEB HBNCBS
TFUFMBI TFUJBQ QPUFOTJBM BLTJ TFMFTBJ EBO EFOHBO EFNJLJBO
NFNQFSNVEBIQPUFOTJBMNFNCSBOTFLBMJMBHJNFOJOHLBUIJOHHB
NFODBQBJ OJMBJ BNCBOH VOUVL QFSBOHTBOHBO ,FNVEJBO TFDBSB
NFOEBEBL UJNCVM QPUFOTJBM BLTJ ZBOH CBSV EBO QSPTFT UFSTFCVU
UFSKBEJCFSVMBOHVMBOH
Aspek Khusus Transmisi Sinyal dalam

Batang Saraf
Serat Saraf Bermielin dan Tidak Bermielin. (BNCBS
NFNQFSMJIBULBO QPUPOHBO NFMJOUBOH TBSBG LFDJM VNVN EBO
NFNQFSMJIBULBO CBOZBL TFSBU TBSBG CFTBS ZBOH NFNCFOUVL TFCBHJBO
CFTBSEBFSBIQPUPOHBONFMJOUBOH/BNVOEFNJLJBO QFOHBNBUBOZBOH
DFSNBU NFOHVOHLBQ MFCJI CBOZBL MBHJ TFSBU ZBOH TBOHBU LFDJM EBO
UFSMFUBL EJ BOUBSB TFSBCVU CFTBS 4FSBU CFTBS UFSTFCVU CFSNJFMJO EBO
TFSBCVULFDJMUJEBLCFSNJFMJO3BUBSBUBCBUBOHTBSBGUFSEJSJBUBTEVBLBMJ
MFCJICBOZBLTFSBUZBOHUJEBLCFSNJFMJOEBSJQBEBTFSBUZBOHCFSNJFMJO
(BNCBS NFNQFSMJIBULBO TFSBCVU CFSNJFMJO ZBOH LIBT *OUJ
CBHJBO UFOHBI TFSBCVU EJTFCVU BLTPO EBO NFNCSBO BLTPO NFSVQBLBO
NFNCSBOZBOHTFCFOBSOZBNFOHIBOUBSLBOQPUFOTJBMBLTJ#BHJBOUFOHBI
BLTPOEJQFOVIJEFOHBOBLTPQMBTNB ZBOHNFSVQBLBODBJSBOJOUSBTFMVMBS
LFOUBM:BOHNFOHFMJMJOHJBLTPOBEBMBITFMVCVOHNJFMJO ZBOHTFSJOHLBMJ
TBOHBUMFCJIUFCBMEBSJQBEBBLTPOOZBTFOEJSJ,JSBLJSBTBUVLBMJTFUJBQ
TBNQBJ NN TFQBOKBOH BLTPO TFMVCVOH NJFMJO EJTFMJOHJ PMFI OPEVT
3BOWJFS
4FMVCVOH NJFMJO EJ TFLFMJMJOH BLTPO EJCFOUVL PMFI TFMTFM 4DIXBOO
EFOHBO DBSB CFSJLVU .VMBNVMB NFNCSBO TFM 4DIXBOO BLBO
NFOZFMVCVOHJ BLTPO 4FMBOKVUOZB TFM 4DIXBOO NFOHFMJMJOHJ BLTPO TFM4DIXBOOZBOHCFSVSVUBOEJTFQBOKBOHBLTPO UFSEBQBUEBFSBILFDJM
CDCFSBQBLBMJ EBONFNCVBUCBOZBLMBQJTBONFNCSBOTFM4DIXBOOZBOH ZBOHUJEBLUFSJTPMBTJEFOHBOQBOKBOHIBOZBTBNQBJNEJNBOBJPO
UFSEJSJ BUBT TVCTUBOTJ MJQJE TGJOHPNJFMJO 4VCTUBOTJ JOJ BEBMBI JOTVMBUPS JPO NBTJI EBQBU NFOHBMJS EFOHBO NVEBI NFMBMVJ NFNCSBO BLTPO
MJTUSJL ZBOH CBJL TFLBMJ EBO NFOHVSBOHJ BMJSBO JPO ZBOH NFMBMVJ EJBOUBSB DBJSBO FLTUSBTFMVMBS EBO DBJSBO JOUSBTFMVMBS EJ EBMBN BLTPO
NFNCSBOLJSBLJSBLBMJMJQBU1BEBTBNCVOHBOBOUBSBTFUJBQEVB %BFSBIJOJMBIZBOHEJTFCVUOPEVT3BOWJFS
67
UVCVI VOUVL NFODFUVTLBO QPUFOTJBM BLTJ TBSBG BUBV PUPU UFLBOBO

NFLBOJT VOUVL NFOHFLTJUBTJ VKVOHVKVOH TBSBG TFOTPSJL QBEB LVMJU
OFVSPUSBOTNJUFS LJNJB VOUVL NFOUSBOTNJTJLBO TJOZBMTJOZBM EBSJ
TBUV OFVSPO LF OFVSPO CFSJLVUOZB EJ PUBL EBO BSVT MJTUSJL VOUVL
NFOUSBOTNJTJLBO TJOZBM EJ BOUBSB TFMTFM PUPU ZBOH CFSVSVUBO EJ
KBOUVOH EBO VTVT 6OUVL EBQBU NFOHFSUJ QSPTFT QFSBOHTBOHBO JOJ
NBSJLJUBNVMBJNFNCBIBTQSJOTJQQSJOTJQTUJNVMBTJMJTUSJL
Eksitasi Serat Saraf oleh Elektroda Logam Bermuatan
Negatif. $BSB ZBOH CJBTB EJHVOBLBO VOUVL NFOHFLTJUBTJ TBSBG BUBV
PUPUEBMBNMBCPSBUPSJVNQFSDPCBBOBEBMBIEFOHBONFOHBMJSLBOMJTUSJL
LF QFSNVLBBO TBSBG BUBV PUPU MFXBU EVB FMFLUSPEB LFDJM ZBOH TBMBI
1 2 3 TBUVOZB CFSNVBUBO OFHBUJG EBO ZBOH MBJOOZB CFSNVBUBO QPTJUJG #JMB
IBM JOJ UFSKBEJ NFNCSBO ZBOH NVEBI UFSFLTJUBTJ NFOKBEJ UFSTUJNVMBTJ
QBEBFMFLUSPEBOFHBUJG
1FOZFCBC EBSJ FGFL JOJ BEBMBI TFCBHBJ CFSJLVU *OHBUMBI CBIXB
Konduksi "Melompat" pada Serabut Bermielin dari QPUFOTJBM BLTJ EJUJNCVMLBO PMFI UFSCVLBOZB LBOBM OBUSJVN
CFSHFSCBOH WPMUBTF 4FMBOKVUOZB LBOBM JOJ EJCVLB PMFI QFOVSVOBO
Nodus ke Nodus. 8BMBVQVO IBNQJS UJEBL BEB JPOJPO EBQBU
WPMUBTF MJTUSJL JTUJSBIBU OPSNBM ZBOH NFMJOUBTJ NFNCSBO "SUJOZB
NFOHBMJS NFMFXBUJ TFMVCVOH NJFMJO ZBOH UFCBM QBEB TBSBG CFSNJFMJO
BMJSBO OFHBUJG ZBOH CFSBTBM EBSJ FMFLUSPEB BLBO NFOHVSBOHJ WPMUBTF
JPOJPO JUV EBQBU NFOHBMJS EFOHBO NVEBI NFMFXBUJ OPEVT 3BOWJFS
EJ TJTJ MVBS NFNCSBO NFOKBEJ OJMBJ OFHBUJG ZBOH NFOEFLBUJ WPMUBTF
0MFI LBSFOB JUV QPUFOTJBM BLTJ UJNCVM IBOZB QBEB OPEVT /BNVO
QBEB QPUFOTJBM OFHBUJG EJ TJTJ EBMBN TFSBCVU )BM JOJ BLBO
QPUFOTJBM BLTJ UFSTFCVU EJLPOEVLTJLBO EBSJ OPEVT LF OPEVT TFQFSUJ
NFOHVSBOHJ WPMUBTF MJTUSJL ZBOH NFMJOUBTJ NFNCSBO EBO
ZBOH EJQFSMJIBULBO QBEB (BNCBS IBM JOJ EJTFCVU LPOEVLTJ
NFNVEBILBO LBOBM OBUSJVN UFSCVLB TFIJOHHB NFOJNCVMLBO
NFMPNQBU "SUJOZB BMJSBO BSVT MJTUSJL NFOHBMJS NFMBMVJ TFLFMJMJOH
QPUFOTJBMBLTJ4FCBMJLOZB QBEBFMFLUSPEBQPTJUJG NBTVLOZBNVBUBO
DBJSBOFLTUSBTFMVMBSEJMVBSTFMVCVOHNJFMJOEBONFMBMVJBLTPQMBTNBEJ
QPTJUJG EJ TJTJ MVBS NFNCSBO TBSBG BLBO NFOJOHLBULBO QFSCFEBBO
EBMBN BLTPO EBSJ OPEVT LF OPEVT ZBOH NFSBOHTBOH OPEVTOPEVT
WPMUBTF ZBOH NFMJOUBTJ NFNCSBO EBO CVLBO NFOVSVOLBOOZB )BM
TFDBSB CFSVSVUBO TBUV QFS TBUV +BEJ JNQVMT TBSBG NFMPNQBUMPNQBUJ
JOJ BLBO NFOZFCBCLBO LFBEBBO IJQFSQPMBSJTBTJ ZBOH BLBO
TFSBU ZBOHNFSVQBLBOBTBMEBOJTUJMBINFMPNQBU
NFOVSVOLBOLFNBNQVBOFLTJUBTJTFSBCVULFUJNCBOHNFOJNCVMLBO
1FOKBMBSBO TFDBSB NFMPNQBU JOJ NFNQVOZBJ NBLSJ UFSTFOEJSJ QPUFOTJBMBLTJ
CFSEBTBSLBO EVB BMBTBO CFSJLVU 1FSUBNB EFOHBO NFOZFCBCLBO
QSPTFTEFQPMBSJTBTJNFMPNQBUJJOUFSWBMZBOHDVLVQKBVIEJTFQBOKBOH Nilai Ambang untuk Eksitasi dan "Potensial
TVNCV TFSBU TBSBG NFLBOJTNF JOJ NFOJOHLBULBO LFDFQBUBO Lokal Akut".3BOHTBOHBOMJTUSJLZBOHMFNBINVOHLJOUJEBLNBNQV
QFOHIBOUBSBOTBSBGQBEBTFSBUCFSNJFMJOTFCFTBSTBNQBJLBMJMJQBU NFSBOHTBOHTVBUVTFSBCVU/BNVO CJMBWPMUBTFSBOHTBOHBOEJOBJLLBO
,FEVB LPOEVLTJ NFMPNQBU BLBO NFOHIFNBU FOFSHJ BLTPO LBSFOB UFSDBQBJMBITVBUVUJUJLUFSKBEJOZBTUJNVMBTJ(BNCBSNFOVOKVLLBO
IBOZB OPEVT TBKB ZBOH CFSEFQPMBSJTBTJ ZBOH NFNVOHLJOLBO FGFL QFNCFSJBO SBOHTBOHBO ZBOH CFSVMBOHVMBOH EFOHBO LFLVBUBO
LFIJMBOHBO JPOJPO TBNQBJ LBMJ MFCJI TFEJLJU EBSJQBEB ZBOH ZBOHTFNBLJOCFTBS3BOHTBOHBOZBOHMFNBIEJUJUJL"NFOZFCBCLBO
TFIBSVTOZB UFSKBEJ TFQFSUJ ZBOH EJQFSMVLBO EBO LBSFOB JUV IBOZB QPUFOTJBM NFNCSBO CFSVCBI EBSJ NFOKBEJ NJMJWPMU OBNVO
NFNCVUVILBO TFEJLJU NFUBCPMJTNF VOUVL NFOFUBQLBO LFNCBMJ QFSVCBIBO JOJ UJEBL DVLVQ VOUVL NFOJNCVMLBO QSPTFT SFHFOFSBUJG
QFSCFEBBOLPOTFOUSBTJOBUSJVNEBOLBMJVNEJBOUBSBNFNCSBOTFUFMBI PUPNBUJT QBEB QPUFOTJBM BLTJ 1BEB UJUJL # SBOHTBOHBO EJCVBU MFCJI
UJNCVMOZBTFSBOHLBJBOJNQVMTTBSBG CFTBS UBQJ TFLBMJ MBHJ JOUFOTJUBT NBTJI UFUBQ UJEBL DVLVQ /BNVO
(BNCBSBO MBJO EBO QFOKBMBSBO TFDBSB NFMPNQBU QBEB TFSBCVU SBOHTBOHBOUFSOZBUBNFOHHBOHHVQPUFOTJBMNFNCSBOTFUFNQBUTFMBNB
CFSNJFMJOZBOHCFTBSBEBMBITFCBHBJCFSJLVU*OTVMBTJZBOHCBJLTFLBMJ NJMJEFUJL BUBV MFCJI TFTVEBI LFEVB SBOHTBOHBO ZBOH MFNBI JOJ
ZBOH EJTFEJBLBO PMFI NFNCSBO NJFMJO EBO QFOVSVOBO LBQBTJUBOTJ 1FSVCBIBO QPUFOTJBM MPLBM JOJ EJTFCVU QPUFOTJBM MPLBM BLVU EBO CJMB
NFNCSBOTFCFTBSLBMJMJQBUNFNVOHLJOLBOUFSKBEJOZBSFQPMBSJTBTJ HBHBM VOUVL NFOJNCVMLBO QPUFOTJBM BLTJ QPUFOTJBM JOJ EJTFCVU
EFOHBOTBOHBUTFEJLJUQFNJOEBIBOJPO QPUFOTJBMTVCBNCBOHBLVU
Kecepatan Konduksi pada Serat Saraf. ,FDFQBUBO +60
LPOEVLTJQBEBTFSBUTBSBGCFSWBSJBTJEBSJ NEFUJLQBEBTFSBUUBL +40
CFSNJFMJO ZBOH TBOHBU LFDJM TBNQBJ TFCFTBS N EFUJL QBOKBOH +20
MBQBOHBOTFQBLCPMBEBMBNEFUJL
QBEBTFSBUCFSNJFMJOZBOHTBOHBU 0 di a a
CFTBS -20 nilai am ang
ak
-40
Perangsangan—Proses Pencetusan Potensial -60
Aksi
A B C D
0 1 2 3 4
1BEB EBTBSOZB TFUJBQ GBLUPS ZBOH NFOZFCBCLBO JPO OBUSJVN NVMBJ
CFSEJGVTJ LF EBMBN NFMBMVJ NFNCSBO EBMBN KVNMBI DVLVQ CBOZBL
EBQBU NFOJNCVMLBO QFNCVLBBO SFHFOFSBUJG LBOBM OBUSJVN TFDBSB
PUPNBUJT)BMJOJEBQBUNFSVQBLBOBLJCBUEBSJHBOHHVBONFLBOJTQBEB
NFNCSBO QFOHBSVILJNJBXJQBEBNFNCSBO BUBVBEBOZBBMJSBOMJTUSJL
EJTFMVSVINFNCSBO4FNVBGBLUPSJOJEJQBLBJEJCFSCBHBJUJUJLEBMBN
68
1BEB UJUJL $ EBMBN (BNCBS SBOHTBOHBO CBILBO MFCJI LVBU

4FLBSBOHQPUFOTJBMMPLBMUFMBINFODBQBJUJOHLBUZBOHEBQBUNFOJNCVMLBO
TVBUVQPUFOTJBMBLTJ ZBOHEJTFCVUOJMBJBNCBOHUFUBQJIBMJOJIBOZBUFSKBEJ
TFTVEBIQFSJPEFMBUFOZBOHTJOHLBU1BEBUJUJL% SBOHTBOHBONBTJIMFCJI
LVBU QPUFOTJBMMPLBMBLVUKVHBMFCJILVBU EBOQPUFOTJBMBLTJUFSKBEJTFUFMBI
UNIT II
TVBUVQFSJPEFMBUFOZBOHTJOHLBU
+BEJ HBNCBS UFSTFCVU NFNQFSMJIBULBO CBIXB CBILBO SBOHTBOHBO
ZBOHMFNBIQVOEBQBUNFOJNCVMLBOQFSVCBIBOQPUFOTJBMBLTJMPLBMQBEB
NFNCSBO UFUBQJ JOUFOTJUBT QPUFOTJBM MPLBM IBSVT NFOJOHLBU TBNQBJ OJMBJ
BNCBOHTFCFMVNQPUFOTJBMBLTJUFSKBEJ
"Periode Refrakter" setelah Potensial Aksi, Saat

Rangsangan yang Baru Tidak Dapat Dihasilkan
1BEBTFSBCVUZBOHNVEBIUFSFLTJUBTJ QPUFOTJBMBLTJZBOHCBSVUJEBLEBQBU
UFSKBEJ TFMBNB NFNCSBO NBTJI EBMBN LFBEBBO EFQPMBSJTBTJ BLJCBU
QPUFOTJBMBLTJTFCFMVNOZB"MBTBOOZBBEBMBICBIXBEBMBNXBLUVTJOHLBU
TFTVEBI QPUFOTJBM BLTJ NVMBJ UJNCVM LBOBM OBUSJVN BUBV LBOBM LBMTJVN
BUBV LFEVBOZB
NFOKBEJ UJEBL BLUJG EBO UJEBL BEB TFKVNMBI TJOZBM
QFSBOHTBOHBO ZBOH EJCFSJLBO LFQBEB LBOBM QBEB UBIBQ JOJ ZBOH BLBO
NFNCVLB QJOUV ZBOH UJEBL BLUJG 4BUVTBUVOZB LFBEBBO ZBOH EBQBU
NFNCVLB QJOUV JOJ LFNCBMJ BEBMBI LFNCBMJOZB QPUFOTJBM NFNCSBO LF TFDBSBMVBSCJBTBDFQBU6OUVLUVKVBOQSBLUJT TBUVTBUVOZBKFOJTBMBU
BUBV NFOEFLBUJ OJMBJ QPUFOTJBM NFNCSBO JTUJSBIBU TFNVMB 4FMBOKVUOZB VLVS ZBOH VNVN ZBOH NBNQV CFSFTQPOT TFDBSB BLVSBU UFSIBEBQ
EBMBNXBLUVTFQFSTFLJBOEFUJLCFSJLVUOZBQJOUVUJEBLBLUJGLBOBMJOJBLBO QFSVCBIBO QPUFOTJBM NFNCSBO ZBOH DFQBU BEBMBI PTJMPTLPQ TJOBS
UFSCVLB EBOQPUFOTJBMBLTJZBOHCBSVEBQBUEJNVMBJ LBUPEB
1FSJPEF LFUJLB QPUFOTJBM BLTJ ZBOH LFEVB UJEBL EBQBU EJDFUVTLBO (BNCBSNFNQFSMJIBULBOTVBUVLPNQPOFOEBTBSEBSJTFCVBI
CBILBO EFOHBO SBOHTBOHBO ZBOH LVBU EJTFCVU QFSJPEF SFGSBLUFS BCTPMVU PTJMPTLPQTJOBSLBUPEB5BCVOHTJOBSLBUPEBJUVTFOEJSJQBEBEBTBSOZB
1BEB TFSBU TBSBG CFSNJFMJO ZBOH CFTBS QFSJPEF JOJ CFSMBOHTVOH TFLJUBS UFSEJSJBUBTQFOFNCBLFMFLUSPOEBOMBZBSGMVPSFTFOZBOHBLBOEJUBCSBL
EFUJL 0MFI LBSFOB JUV LJUB EBQBU NFOHIJUVOH CBIXB TFSBU PMFI FMFLUSPO %J UFNQBU FMFLUSPOFMFLUSPO NFNCFOUVS MBZBS CBIBO
TFNBDBN JOJ EBQBU NFOUSBOTNJTJLBO JNQVMT EBMBN KVNMBI NBLTJNVN GMVPSFTFO BLBO CFSQFOEBS #JMB CFSLBT FMFLUSPO UFSTFCVU CFSHFSBL
TFLJUBSJNQVMTQFSEFUJL NFMJOUBTJ MBZBS CJOUJL DBIBZB ZBOH CFSQFOEBS KVHB BLBO
NFNJOEBILBOEBONFOBSJLHBSJTGMVPSFTFOQBEBMBZBS
4FMBJOQFOFNCBLFMFLUSPOEBOQFSNVLBBOGMVPSFTFO UBCVOHTJOBS
Inhibisi Eksitabilitas—"Stabilisator" dan Anestesi Lokal LBUPEBEJMFOHLBQJEFOHBOEVBTVTVOMFNQFOHCFSNVBUBOMJTUSJLTBMBI
.BTJI BEB GBLUPSGBLUPS MBJO ZBOH LFSKBOZB CFSMBXBOBO EFOHBO GBLUPS TBUVUFSMFUBLQBEBLFEVBTJTJCFSLBTFMFLUSPO EBOZBOHMBJOOZBUFSMFUBL
GBLUPS ZBOH EBQBU NFOJOHLBULBO FLTJUBCJMJUBT LBOBM EJTFCVU GBLUPS EJ BUBT EBO EJ CBXBI 4JSLVJU QFOHBUVS FMFLUSPOJL ZBOH TFTVBJ BLBO
TUBCJMJTBTJNFNCSBO ZBOH EBQBU NFOVSVOLBO FLTJUBCJMJUBT $POUPIOZB NFOHVCBI WPMUBTF QBEB MFNQFOH JOJ TFIJOHHB CFSLBT FMFLUSPO EBQBU
LPOTFOUSBTJ JPO LBMTJVN QBEB DBJSBO FLTUSBTFMVMBS ZBOH UJOHHJ BLBO NFNCFMPL LF BUBT EBO LF CBXBI TFCBHBJ SFTQPOTOZB UFSIBEBQ TJOZBM
NFOVSVOLBO QFSNFBCJMJUBT NFNCSBO UFSIBEBQ JPO OBUSJVN EBO TFDBSB MJTUSJL ZBOH EBUBOH EBSJ FMFLUSPEBFMFLUSPEB QFSFLBN QBEB TBSBG
CFSTBNBBO BLBO NFOHVSBOHJ FLTJUBCJMJUBT 0MFI LBSFOB JUV JPO LBMTJVN #FSLBT EBSJ FMFLUSPOFMFLUSPO JOJ KVHB CFSKBMBO TFDBSB IPSJ[POUBM
EJLBUBLBOTFCBHBJTUBCJMJTBUPSh NFMFXBUJMBZBSQBEBLFDFQBUBOXBLUVZBOHLPOTUBOPMFITJSLVJUMJTUSJL
Anestesi Lokal. %J BOUBSB BHFOBHFO TUBCJMJTBUPS ZBOH QBMJOH JOUFSOBM EBO PTJMPTLPQ )BM JOJ BLBO NFOHIBTJMLBO SFLBNBO ZBOH
QFOUJOH BEB CFSNBDBNNBDBN BHFO ZBOH EJQBLBJ EBMBN LMJOJL TFCBHBJ UBNQBL QBEB NVLB UBCVOH TJOBS LBUPEB QBEB HBNCBS ZBOH
BOFTUFTJ MPLBM UFSNBTVL QSPLBJO EBO UFUSBLBJO 4FCBHJBO CFTBS BHFO JOJ NFNCFSJLBOHBNCBSBOEBTBSXBLUVTFDBSBIPSJ[POUBMEBOQFSVCBIBO
CFLFSKB MBOHTVOH QBEB QJOUV BLUJWBTJ EBO LBOBM OBUSJVN ZBOH NFNCVBU WPMUBTF QBEB FMFLUSPEB TBSBG ZBOH EJQFSMJIBULBO TFDBSB WFSUJLBM
QJOUV JOJ NFOKBEJ KBVI MFCJI TVMJU VOUVL UFSCVLB EBO EFOHBO EFNJLJBO 1FSIBUJLBO QBEB VKVOH TJTJ LJSJ SFLBNBO UFSEBQBU BSUJGBL SBOHTBOHBO
NFOHVSBOHJ FLTJUBCJMJUBT NFNCSBO #JMB FLTJUBCJMJUBT NFOVSVO LFDJM ZBOH EJTFCBCLBO PMFI SBOHTBOHBO MJTUSJL ZBOH EJHVOBLBO VOUVL
TFEFNJLJBO SFOEBI TFIJOHHB QFSCBOEJOHBO LFLVBUBO QPUFOTJBM BLTJ NFODFUVTLBO QPUFOTJBM BLTJ TBSBG ,FNVEJBO TFNBLJO LF LBOBO
UFSIBEBQ OJMBJ BNCBOH FLTJUBCJMJUBT EJTFCVU GBLUPS QFOHBNBO
HBNCBSBOUFSTFCVUNFOKBEJSFLBNBOQPUFOTJBMBLTJJUVTFOEJSJ
CFSLVSBOHTBNQBJEJCBXBI NBLBJNQVMTJNQVMTTBSBGHBHBMNFMFXBUJ
TBSBGZBOHEJBOFTUFTJ Daftar Pustaka
Alberts B, Johnson A, Lewis J, et al: Molecular Biology of the Cell, ed 3, New
York, 2008, Garland Science.
Perekaman Potensial Membran dan Potensial Aksi Biel M, Wahl-Schott C, Michalakis S, Zong X: Hyperpolarization-activated
cation channels: from genes to function, Physiol Rev 89:847, 2009. Blaesse
P, Airaksinen MS, Rivera C, Kaila K: Cation-chloride cotransporters
Osiloskop Sinar Katoda.%JBXBMCBCJOJ LJUBNFOHFUBIVJCBIXB
and neuronal function, Neuron 61:820, 2009.
QPUFOTJBM NFNCSBO CFSVCBI TBOHBU DFQBU LFUJLB UFSKBEJ QPUFOTJBM BLTJ Dai S, Hall DD, Hell JW: Supramolecular assemblies and localized regulation
#BILBO TFCBHJBO CFTBS LPNQMFLT QPUFOTJBM BLTJ TFSBU TBSBG ZBOH CFTBS of voltage-gated ion channels, Physiol Rev 89:411, 2009.
CFSMBOHTVOHLVSBOHEBSJEFUJL1BEBCFCFSBQBHBNCBSEBMBNCBC Hodgkin AL, Huxley AF: Quantitative description of membrane current and
JOJ TVBUV QFOHVLVS MJTUSJL UFMBI NFNQFSMJIBULBO QFSFLBNBO QFSVCBIBO its application to conduction and excitation in nerve, J Physiol (Lond)
QPUFOTJBM JOJ /BNVO IBSVT EJNFOHFSUJ CBIXB TFUJBQ BMBU VLVS ZBOH 117:500, 1952.
NBNQVNFSFLBNTFCBHJBOCFTBSQPUFOTJBMBLTJQBTUJNBNQVCFSFTQPOT Kandel ER, Schwartz JH, Jessell TM: Principles of Neural Science, ed 4, New
York, 2000, McGraw-Hill.
69
Kleber AG, Rudy Y: Basic mechanisms of cardiac impulse propagation and Poliak S, Peles E: The local differentiation of myelinated axons at nodes of
associated arrhythmias, Physiol Rev 84:431, 2004. Ranvier, Nat Rev Neurosci 12:968, 2003.
R, Maylie J, Adelman JP: New sites of action for GIRK and SK channels, Schafer DP, Rasband MN: Glial regulation of the axonal membrane at
Nat Rev Neurosci 10:475, 2009. nodes of Ranvier, Curr Opin Neurobiol 16:508, 2006.
Mangoni ME, Nargeot J: Genesis and regulation of the heart automaticity, Vacher H, Mohapatra DP, Trimmer JS: Localization and targeting of
Physiol Rev 88:919, 2008. voltage-dependent ion channels in mammalian central neurons,
Perez-Reyes E: Molecular physiology of low-voltage-activated T-type Physiol Rev 88:1407, 2008.
calcium channels, Physiol Rev 83:117, 2003.
70
BAB 6
UNIT II
,POUSBLTJ0UPU3BOHLB
,JSBLJSB QFSTFO EBSJ TFMVSVI NPMFLVM QSPUFJO QPMJNFS CFTBS ZBOH CFSUBOHHVOH KBXBC VOUVL
UVCVIUFSEJSJBUBTPUPUSBOHLB EBO LPOUSBLTJ PUPU TFTVOHHVIOZB 'JMBNFOGJMBNFO JOJ EBQBU EJMJIBU
NVOHLJOQFSTFOMBJOOZBCFSVQB QBEB QBOEBOHBO MPOHJUVEJOBM EFOHBO NJLSPHSBG FMFLUSPO QBEB
PUPU QPMPT EBO PUPU KBOUVOH (BNCBSEBOEJHBNCBSLBOTFDBSBEJBHSBNQBEB(BNCBS
#FCFSBQB QSJOTJQ EBTBS ZBOH TBNB CBHJBO&TBNQBJ-'JMBNFOUFCBMEBMBNEJBHSBNBEBMBINJPTJO
NFOHFOBJLPOUSBLTJEBQBUEJUFSBQ EBOGJMBNFOUJQJTBEBMBIBLUJO
LBOQBEBLFUJHBKFOJTPUPUZBOHCFSCFEBJOJ%JCBCJOJ UFSVUBNB 1FSIBUJLBO QBEB (BNCBS & CBIXB GJMBNFO NJPTJO EBO
BLBO EJCBIBT GVOHTJ PUPU SBOHLB GVOHTJ LIVTVT PUPU QPMPT BLBO BLUJO TFCBHJBO TBMJOH CFSUBVUBO TFIJOHHB NJPGJCSJM NFNJMJLJ
EJCJDBSBLBOEJ#BC EBOPUPUKBOUVOHEJCJDBSBLBOEJ#BC QJUB UFSBOH EBO HFMBQ ZBOH CFSTFMBOHTFMJOH TFQFSUJ EJ
HBNCBSLBO QBEB (BNCBS 1JUBQJUB UFSBOH IBOZB NF
OHBOEVOH GJMBNFO BLUJO EBO EJTFCVU QJUB * LBSFOB CFSTJGBU
JTPUSPQJLUFSIBEBQDBIBZBZBOHEJQPMBSJTBTJLBO1JUBQJUBHFMBQ
Fisiotogi Anatomi Otot Rangka NFOHBOEVOH GJMBNFOGJMBNFO NJPTJO EBO VKVOHVKVOH
GJMBNFOBLUJOUFNQBUQJUBQJUBUFSTFCVUUVNQBOHUJOEJIEFOHBO
4FSBCVU0UPU3BOHLB
NJPTJO ZBOH EJTFCVU QJUB " LBSFOB CFSTJGBU BOJTPUSPQJL
(BNCBS NFOVOKVLLBO PSHBOJTBTJ PUPU SBOHLB ZBOH UFSIBEBQ DBIBZB ZBOH EJQPMBSJTBTJLBO 1FSIBUJLBO KVHB
NFNQFSMJIBULBO CBIXB TFNVB PUPU SBOHLB EJCFOUVL PMFI QFOPOKPMBOQFOPOKPMBO LFDJM EBSJ TBNQJOH GJMBNFO NJPTJO
TFKVNMBI TFSBCVU ZBOH EJBNFUFSOZB CFSLJTBS EBSJ TBNQBJ QBEB(BNCBS&EBO-1FOPOKPMBOJOJNFSVQBLBOKFNCBUBO
N .BTJOHNBTJOH TFSBCVU JOJ UFSCVBU EBSJ SBOHLBJBO TVCVOJU TJMBOH *OUFSBLTJ BOUBSB KFNCBUBO TJMBOH EBO GJMBNFO BLUJO
ZBOH MFCJI LFDJM ZBOH KVHB EJQFSMJIBULBO QBEB (BNCBS EBO UFSTFCVUBEBMBIQFSJTUJXBZBOHNFOZFCBCLBOLPOUSBLTJ
EJCJDBSBLBOEJQBSBHSBGCFSJLVU
(BNCBS & KVHB NFOVOKVLLBO CBIXB VKVOHVKVOH
4FCBHJBO CFTBS PUPU SBOHLB NBTJOHNBTJOH TFSBCVUOZB GJMBNFO BLUJO NFMFLBU QBEB MFNQFOH ; %BSJ MFNQFOH JOJ
NFNCFOUBOH EJ TFMVSVI QBOKBOH PUPU ,FDVBMJ QBEB TFLJUBS GJMBNFOGJMBNFO UFSTFCVU NFNBOKBOH EBMBN EVB BSBI VOUVL
QFSTFO TFSBCVU NBTJOHNBTJOH TFSBCVU CJBTBOZB IBOZB TBMJOH CFSUBVUBO EFOHBO GJMBNFO NJPTJO -FNQFOH ; ZBOH
EJQFSTBSBGJ PMFI TBUV VKVOH TBSBG ZBOH UFSMFUBL EJ EFLBU CBHJBO UFSEJSJ BUBT QSPUFJO GJMBNFOUPTB ZBOH CFSCFEB EBSJ GJMBNFO
UFOHBITFSBCVU BLUJO EBO NJPTJO CFSKBMBO NFOZJMBOH NFMFXBUJ NJPGJCSJM EBO
Sarkolema adalah Membran Tipis yang Membungkus KVHB NFOZJMBOH EBSJ TBUV NJPGJCSJM LF NJPGJCSJM MBJOOZB EBO
NFMFLBULBO NJPGJCSJM TBUV EFOHBO ZBOH MBJO EJ TFQBOKBOH
Serabut Otot. 4BSLPMFNB UFSEJSJ BUBT NFNCSBO TFM ZBOH
TFSBCVUPUPU0MFILBSFOBJUV TFMVSVITFSBCVUPUPUNFNQVOZBJ
TFCFOBSOZB ZBOH EJTFCVU NFNCSBO QMBTNB EBO TFCVBI MBQJTBO
QJUB UFSBOH EBO HFMBQ TFQFSUJ ZBOH UFSEBQBU QBEB UJBQUJBQ
MVBS ZBOH UFSEJSJ BUBT TBUV MBQJTBO UJQJT NBUFSJ QPMJTBLBSJEB ZBOH
NJPGJCSJM 1JUBQJUB JOJ NFNCFSJ DPSBL MVSJL QBEB PUPU SBOHLB
NFOHBOEVOHTFKVNMBIGJCSJMLPMBHFOUJQJT%JTFUJBQVKVOHTFSBCVU
PUPU MBQJTBO QFSNVLBBO TBSLPMFNB JOJ CFSTBUV EFOHBO TFSBCVU EBOPUPUKBOUVOH
UFOEPO EBOTFSBCVUUFOEPOLFNVEJBOCFSLVNQVMNFOKBEJCFSLBT #BHJBONJPGJCSJM BUBVTFSBCVUPUPUVUVI
ZBOHUFSMFUBLBOUBSB
VOUVL NFNCFOUVL UFOEPO PUPU EBO LFNVEJBO CFSJOTFSTJ LF EVB MFNQFOH ; ZBOH CFSVSVUBO EJTFCVU TBSLPNFS #JMB TFSBCVU
EBMBNUVMBOH PUPUCFSLPOUSBLTJ TFQFSUJZBOHEJUVOKVLLBOQBEBCBHJBOCBXBI
Miofibril Tersusun dari Filamen Aktin dan Miosin. 4FUJBQ (BNCBS QBOKBOH TBSLPNFS LJSB LJSB N 1BEB VLVSBO
TFSBCVU PUPU NFOHBOEVOH CFCFSBQB SBUVT TBNQBJ CFCFSBQB SJCV QBOKBOH JOJ GJMBNFO BLUJO UVNQBOH UJOEJI TFMVSVIOZB EFOHBO
NJPGJCSJM ZBOH EJQFSMJIBULBO TFCBHBJ CVMBUBOCVMBUBO LFDJM UFS GJMBNFONJPTJO EBOVKVOHGJMBNFOBLUJONVMBJUVNQBOHUJOEJI
CVLB QBEB QPUPOHBO NFMJOUBOH QBEB (BNCBS $ 4FUJBQ TBUV TBNB MBJO 4FQFSUJ ZBOH BLBO EJEJTLVTJLBO OBOUJ QBEB
NJPGJCSJM (BNCBS%EBO&
UFSTVTVOPMFITFLJUBSGJMBNFO VLVSBO QBOKBOH JOJ PUPU NBNQV NFOJNCVMLBO LFLVBUBO
NJPTJOZBOHCFSEFLBUBOEBOGJMBNFOBLUJO ZBOHNFSVQBLBO LPOUSBLTJUFSCFTBSOZB
71
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Bab 6 Kontraksi Otot Rangka
EJUBNCBICFSCBHBJFO[JNQSPUFJO+VHBUFSEBQBUTFKVNMBICFTBS
NJUPLPOESJBZBOHUFSMFUBLTFKBKBSEFOHBONJPGJCSJM.JUPLPOESJB
NFOZVQMBJ NJPGJCSJM ZBOH CFSLPOUSBLTJ TFKVNMBI CFTBS FOFSHJ
EBMBN CFOUVL BEFOPTJO USJGPTGBU "51
ZBOH EJCFOUVL PMFI
NJUPLPOESJB
UNIT II
Retikulum Sarkoplasma merupakan Retikulum
Endoplasma Khusus pada Otot Rangka. %J EBMBN
TBSLPQMBTNB KVHB UFSEBQBU CBOZBL SFUJLVMVN HBNCBS )
ZBOH NFOHFMJMJOHJ NJPGJCSJM TFUJBQ TFSBCVU PUPU EJTFCVU
SFUJLVMVN TBSLPQMBTNB 3FUJLVMVN JOJ NFNQVOZBJ TVTVOBO
LIVTVT ZBOH TBOHBU QFOUJOH QBEB QFOHBUVSBO LPOUSBLTJ PUPU
TFQFSUJ ZBOH EJCBIBT EJ #BC 4FNBLJO DFQBU UJQF LPOUSBLTJ
TVBUV TFSBCVU PUPU NBLB TFSBCVU UFSTFCVU NFNQVOZBJ NBLJO
CBOZBLSFUJLVMVNTBSLPQMBTNB
Mekanisme Umum Kontraksi Otot

Titin, Molekul Berbentuk Filamen, Menjaga Filamen Miosin
dan Aktin Tetap Berada di Tempat. )VCVOHBO CFSTFCFMBIBO 5JNCVM EBO CFSBLIJSOZB LPOUSBLTJ PUPU UFSKBEJ EBMBN VSVUBO
BOUBSB GJMBNFO NJPTJO EBO BLUJO TVMJU EJQFSUBIBOLBO )BM JOJ UBIBQUBIBQCFSJLVU
EJQFSUBIBOLBO PMFI TFKVNMBI CFTBS NPMFLVM QSPUFJO CFSCFOUVL 1. 4VBUV QPUFOTJBM BLTJ CFSKBMBO EJ TFQBOKBOH TFCVBI TBSBG
GJMBNFO ZBOH EJTFCVU UJUJO (BNCBS
4FUJBQ NPMFLVM UJUJO NPUPSJLTBNQBJLFVKVOHOZBQBEBTFSBCVUPUPU
NFNQVOZBJ CFSBU NPMFLVM TFLJUBS KVUB ZBOH NFOKBEJLBOOZB
QSPUFJO NPMFLVM UFSCFTBS EBMBN UVCVI +VHB LBSFOB CFSCFOUVL 2. %J TFUJBQ VKVOH TBSBG JOFOZFLSFTJ [BU OFVSPUSBOTNJUFS
GJMBNFO UJUJO KVHB TBOHBU FMBTUJT .PMFLVM UJUJO ZBOH FMBTUJT JOJ ZBJUVBTFUJMLPMJO EBMBNKVNMBITFEJLJU
CFSGVOHTJ TFCBHBJ LFSBOHLB ZBOH NFOBIBO GJMBNFO NJPTJO EBO 3. "TFUJMLPMJO CFLFSKB QBEB EBFSBI TFUFNQBU QBEB NFNCSBO
BLUJOBHBSUFUBQCFSBEBEJUFNQBUOZBTFIJOHHBQFSBOHLBULPOUSBLTJ TFSBCVUPUPUVOUVLNFNCVLBCBOZBLLBOBMLBUJPOCFSQJOUV
TBSLPNFSJOJEBQBUCFLFSKB4BMBITBUVVKVOHNPMFLVMUJUJOCFSTJGBU BTFUJMLPMJO NFMBMVJ NPMFLVM QSPUFJO ZBOH UFSBQVOH QBEB
FMBTUJT EBO UFSJLBU QBEB MFNQFOH ; CFLFSKB TFCBHBJ QFHBT EBO NFNCSBO
NFOHVCBI QBOKBOH TBSLPNFS TBBU CFSLPOUSBLTJ EBO SFMBLTBTJ
4. 5FSCVLBOZB LBOBM CFSQJOUV BTFUJMLPMJO NFNVOHLJOLBO
#BHJBONPMFLVMUJUJOMBJOOZBNFOBNCBULBOUJUJOQBEBGJMBNFOUJQJT
TFKVNMBICFTBSJPOOBUSJVNVOUVLCFSEJGVTJLFCBHJBOEBMBN
NJPTJO .PMFLVM UJUJO TFOEJSJ OBNQBLOZB KVHB CFSUJOEBL TFCBHBJ NFNCSBO TFSBCVU PUPU )BM JOJ NFOZFCBCLBO EFQPMBSJTBTJ
QPMBVOUVLQFNCFOUVLBOBXBMCBHJBOGJMBNFOLPOUSBLUJMTBSLPNFS TFUFNQBU ZBOH LFNVEJBO NFOZFCBCLBO QFNCVLBBO LBOBM
UFSVUBNBGJMBNFONJPTJO OBUSJVNCFSQJOUVMJTUSJL
Sarkoplasma merupakan Cairan Intraselular Myofibrils.

EJ BOUBSB .JPGJCSJM #BOZBL NJPGJCSJM TFUJBQ TFSBCVU PUPU UFSMFUBL
TBMJOHCFSTJTJBOEBMBNTFSBCVUPUPU3VBOHEJBOUBSBNJPGJCSJMEJJTJ
PMFI DBJSBO JOUSBTFMVMBS ZBOH EJTFCVU TBSLPQMBTNB ZBOH NF
NFOHBOEVOHTFKVNMBICFTBSLBMJVN NBHOFTJVN EBOGPTGBU
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WPMUBHFHBUFE TPEJVN DIBOOFMT

1FSJTUJXB JOJ BLBO UVNQBOH UJOEJI TBUV TBNB MBJO EFOHBO QFNBOKBOHBO ZBOH
NFOJNCVMLBOTVBUVQPUFOTJBMBLTJQBEBNFNCSBO NBLTJNBM -FNQFOH ; KVHB EJUBSJL PMFI GJMBNFO BLUJO TBNQBJ LF
5. 1PUFOTJBMBLTJBLBOCFSKBMBOEJTFQBOKBOHNFNCSBOTFSBCVU VKVOH GJMBNFO NJPTJO +BEJ LPOUSBLTJ PUPU UFSKBEJ EFOHBO
PUPUEFOHBODBSBZBOHTBNBTFQFSUJQPUFOTJBMBLTJCFSKBMBOEJ NFLBOJTNFQFSHFTFSBOGJMBNFO
TFQBOKBOHNFNCSBOTFSBUTBSBG 5FUBQJ BQB ZBOH NFOZFCBCLBO GJMBNFOGJMBNFO BLUJO CFSHFTFS
6. 1PUFOTJBM BLTJ BLBO NFOJNCVMLBO EFQPMBSJTBTJ NFNCSBO LF EBMBN EJ BOUBSB GJMBNFOGJMBNFO NJPTJO )BM JOJ EJTFCBCLBO
PUPU EBO CBOZBL BMJSBO MJTUSJL QPUFOTJBM BLTJ NFOHBMJS PMFI LFLVBUBO ZBOH EJCFOUVL PMFI JOUFSBLTJ KFNCBUBO TJMBOH EBO
NFMBMVJ QVTBU TFSBCVU PUPU %J TJOJ QPUFOTJBM BLTJ GJMBNFO NJPTJO EFOHBO GJMBNFO BLUJO 1BEB LFBEBBO JTUJSBIBU
NFOZFCBCLBOSFUJLVMVNTBSLPQMBTNBNFMFQBTLBOTFKVNMBI LFLVBUBO JOJ UJEBL BLUJG UFUBQJ CJMB TFCVBI QPUFOTJBM BLTJ CFSKBMBO
CFTBSJPOLBMTJVN ZBOHUFMBIUFSTJNQBOEJEBMBNSFUJLVMVN EJ TFQBOKBOH NFNCSBO TFSBCVU PUPU IBM JOJ BLBO NFOZFCBCLBO
JOJ SFUJLVMVN TBSLPQMBTNB NFMFQBTLBO JPO LBMTJVN EBMBN KVNMBI
7. *PO LBMTJVN NFOHJOJTJBTJ LFLVBUBO NFOBSJL BOUBSB GJMBNFO CFTBS ZBOH EFOHBO DFQBU NFOHFMJMJOHJ NJPGJCSJM *POJPO LBMTJVN
JOJLFNVEJBONFOHBLUJGLBOLFLVBUBOEJBOUBSBGJMBNFOBLUJOEBO
BLUJO EBO NJPTJO ZBOH NFOZFCBCLBO LFEVB GJMBNFO
NJPTJO EBONVMBJUFSKBEJLPOUSBLTJ5FUBQJFOFSHJKVHBEJQFSMVLBO
UFSTFCVU CFSHFTFS TBUV TBNB MBJO EBO NFOHIBTJMMBO QSPTFT
VOUVL CFSMBOHTVOHOZB QSPTFT LPOUSBLTJ &OFSHJ JOJ CFSBTBM EBSJ
LPOUSBLTJ
JLBUBO CFSFOFSHJ UJOHHJ QBEB NPMFLVM "51 ZBOH EJVSBJLBO
8. 4FUFMBI LVSBOH EBSJ TBUV EFUJL JPO LBMTJVN EJQPNQB NFOKBEJBEFOPTJOEJGPTGBU "%1
VOUVLNFNCFCBTLBOFOFSHJ
LFNCBMJ LF EBMBN SFUJLVMVN TBSLPQMBTNB PMFI QPNQB 1BEB CFCFSBQB CBHJBO CFSJLVU LJUB BLBO NFNCBIBT IBMIBM
NFNCSBO$B EBOJPOJOJUFUBQEJTJNQBOEBMBNSFUJLVMVN ZBOH UFMBI EJLFUBIVJ NFOHFOBJ QFSJODJBO QSPTFT NPMFLVMBS
TBNQBJ QPUFOTJBM BLTJ PUPU ZBOH CBSV EBUBOH MBHJ LPOUSBLTJ
QFOHFMVBSBO JPO LBMTJVN EBSJ NJPGJCSJM BLBO NFOZFCBCLBO
LPOUSBLTJPUPUUFSIFOUJ Sifat Molekular Filamen Kontraktil
,JUB TFLBSBOH NFNCBIBT QFSBOHLBU NPMFLVMBS QBEB QSPTFT Filamen Miosin Tersusun oleh Banyak Molekul Miosin.
LPOUSBLTJPUPU 4FUJBQ NPMFLVM NJPTJO ZBOH EJQFSMJIBULBO QBEB (BNCBS "
NFNQVOZBJ CFSBU NPMFLVM LJSBLJSB (BNCBS #
NFNQFSMJIBULBO TVTVOBO CFSCBHBJ NPMFLVM ZBOH NFNCFOUVL
Mekanisme Molekuler pada Kontraksi Otot TFCVBIGJMBNFONJPTJO TFSUBJOUFSBLTJGJMBNFOJOJQBEBTBMBITBUV
TJTJEFOHBOVKVOHVKVOHLFEVBGJMBNFOBLUJO
Mekanisme Pergeseran Filamen pada Kontraksi Otot. .PMFLVM NJPTJO (BNCBS "
UFSEJSJ BUBT FOBN SBOUBJ
(BNCBS NFOVOKVLLBO NFLBOJTNF EBTBS UFSKBEJOZB QPMJQFQUJEB EVB SBOUBJ CFSBU NBTJOHNBTJOH EFOHBO CFSBU
LPOUSBLTJ PUPU (BNCBS UFSTFCVU NFOVOKVLLBO LFBEBBO NPMFLVM LJSBLJSB EBO FNQBU SBOUBJ SJOHBO EFOHBO CFSBU
SFMBLTBTJTVBUVTBSLPNFS BUBT
EBOLFBEBBOLPOUSBLTJ CBXBI
NPMFLVM NBTJOHNBTJOH TFLJUBS %VB SBOUBJ CFSBU TBMJOH
1BEB LFBEBBO SFMBLTBTJ VKVOHVKVOH GJMBNFO BLUJO ZBOH NFMJMJU TBUV TBNB MBJO VOUVL NFNCFOUVL IFMJLT HBOEB ZBOH
NFNBOKBOH EBSJ EVB MFNQFOH ; ZBOH CFSVSVUBO TFEJLJU TBMJOH EJTFCVUTFCBHBJFLPSNPMFLVMNJPTJO4BMBITBUVVKVOHEBSJNBTJOH
UVNQBOH UJOEJI TBUV TBNB MBJO 4FCBMJLOZB QBEB LFBEBBO
LPOUSBLTJ GJMBNFOBLUJOJOJUFSUBSJLLFEBMBNEJBOUBSBGJMBNFO
NJPTJO TFIJOHHBVKVOHVKVOHOZBTFLBSBOHTBMJOH
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LFQBMB CFCBT QBEB NPMFLVM NJPTJO IFMJLT HBOEB &NQBU SBOUBJ
SJOHBOKVHBCBHJBOEBSJLFQBMBNJPTJO ZBJUVEVBEJTFUJBQLFQBMB
3BOUBJSBOUBJSJOHBOJOJNFNCBOUVNFOHBUVSGVOHTJLFQBMBTFMBNB
UNIT II
LPOUSBLTJPUPU F-
'JMBNFO NJPTJO EJCFOUVL PMFI BUBV MFCJI NPMFLVM NJPTJO

UVOHHBM #BHJBO UFOHBI EBO TBMBI TBUV GJMBNFOGJMBNFO JOJ
EJUVOKVMEDBO QBEB (BNCBS # ZBOH NFNQFSMJIBULBO CBHJBO
FLPS EBO NPMFLVM NJPTJO UFSJLBU CFSTBNB NFNCFOUVL CBHJBO
CBEBO GJMBNFO TFNFOUBSB CBOZBL LFQBMB EBSJ NPMFLVM
4FUJBQGJMBNFOBLUJOQBOKBOHOZBLVSBOHMFCJIN#BHJBO
NFOHHBOUVOH LFMVBS QBEB CBHJBO TBNQJOH CBEBO 4FCBHJBO EBSJ
EBTBSGJMBNFOBLUJOEJTJTJQLBOEFOHBOLVBULFEBMBNMFNQFOH
CBEBO EJ TFUJBQ NPMFLVM NJPTJO KVHB NFOHHBOUVOH LF TBNQJOH
; VKVOHVKVOH GJMBNFO UFSTFCVU NFOPOKPM QBEB LFEVB BSBI
CFSTBNBEFOHBOLFQBMB TFIJOHHBNFOZFEJBLBOTVBUVMFOHBOZBOH
VOUVL CFSBEB EBMBN SVBOHBO BOUBSB NPMFLVM NJPTJO TFQFSUJ
NFNQFSQBOKBOH LFQBMB LFMVBS EBSJ CBEBO TFQFSUJ ZBOH
ZBOHEJUVOKVLLBOQBEB(BNCBS
EJQFSMJIBULBO QBEB HBNCBS #BHJBO MFOHBO EBO LFQBMB ZBOH
NFOPOKPM CFSTBNBTBNB EJTFCVU KFNCBUBO TJMBOH .BTJOHNBTJOH Molekul Tropomiosin. 'JMBNFO BLUJO KVHB NFOHBOEVOH
KFNCBUBOTJMBOHJOJCFSTJGBUGMFLTJCFMEJEVBUJUJLZBOHEJTFCVUFOHTFM QSPUFJO MBJO ZBJUV USPQPNJPTJO 4FUJBQ NPMFLVM USPQPNJPTJO
TBMBI TBUV NFSVQBLBO UFNQBU MFOHBO NFOJOHHBMLBO CBEBO EBSJ NFNQVOZBJ CFSBU NPMFLVM EBO QBOKBOH OBOPNFUFS
GJMBNFO NJPTJO EBO ZBOH TBUVOZB UFNQBU LFQBMB NFMFLBU QBEB .PMFLVM UFSTFCVU UFSCVOHLVT TFDBSB TQJSBM NFOHFMJMJOHJ TJTJ
MFOHBO-FOHBOZBOHCFSFOHTFMBLBONFNQFSNVEBIMFOHBOVOUVL IFMJLT 'BLUJO 1BEB LFBEBBO JTUJSBIBU NPMFLVM USPQPNJPTJO
NFNBOKBOH KBVI LFMVBS EBSJ CBEBO GJMBNFO NJPTJO BUBV EJCBXB UFSMFUBL QBEB CBHJBO BUBT UFNQBU BLUJG VOUBJ BLUJO TFIJOHHB
NFOEFLBU LF BSBI CBEBO ,FQBMB ZBOH CFSFOHTFM TFMBOKVUOZB UJEBLEBQBUUFSKBEJQFOBSJLBOBOUBSBGJMBNFOBLUJOEBONJPTJO
CFSQBSUJTJQBTJQBEBQSPTFTLPOUSBLTJZBOHTFCFOBSOZB TFQFSUJZBOH VOUVLNFOJNCVMLBOLPOUSBLTJ
BLBOEJCBIBTEJCBHJBOCFSJLVU
Troponin dan Perannya pada Kontraksi Otot. .BTJI
1BOKBOH UPUBM TFUJBQ GJMBNFO NJPTJO BEBMBI TFSBHBN IBNQJS BEB NPMFLVM QSPUFJO MBJO ZBOH NFMFLBU EJ TFQBOKBOH TJTJ
UFQBU N 5FUBQJ QFSIBUJLBOMBI CBIXB UJEBL BEB LFQBMB NPMFLVM USPQPNJPTJO ZBOH EJTFCVU USPQPOJO .PMFLVM JOJ
KFNCBUBOTJMBOHEJCBHJBOUFOHBIGJMBNFONJPTJOTFQBOKBOHLJSB TFCFOBSOZBNFSVQBLBOMDPNQMFLTZBOHUFSEJSJBUBTUJHBTVCVOJU
LJSB N LBSFOB MFOHBO CFSFOHTFM NFNBOKBOH NFOKBVI EBSJ QSPUFJO ZBOH UFSJLBU TFDBSB MPOHHBS ZBOH NBTJOHNBTJOH
CBHJBOUFOHBI NFNJMJLJQFSBOTQFTJGJLQBEBQFOHBUVSBOLPOUSBLTJPUPU4BMBI
4FLBSBOH VOUVLNFMFOHLBQJHBNCBSBOJOJ GJMBNFONJPTJOJUV TBUV TVCVOJU USPQPOJO *
NFNQVOZBJ BGJOJUBT ZBOH LVBU
TFOEJSJUFSQVOUJSTFIJOHHBTFUJBQQBTBOHBOKFNCBUBOTJMBOHZBOH UFSIBEBQ BLUJO ZBOH MBJOOZB USPQPOJO 5
UFSIBEBQ
CFSVSVUBOBLBOEJQJOEBILBOQBEBQPSPTOZBEBSJUFNQBUTFNVMB USPQPNJPTJO EBO ZBOH LFUJHB USPQPOJO $
UFSIBEBQ JPOJPO
TBNQBJ EFSBKBU ,FBEBBO JOJ NFOKBNJO CBIXB KFNCBUBO LBMTJVN ,PNQMFLT JOJ EJEVHB VOUVL NFMFLBULBO USPQPNJPTJO
TJMBOHBLBONFNBOKBOHLFTFHBMBBSBIEJTFLJUBSGJMBNFO QBEB BLUJO "GJOJUBT USPQPOJO ZBOH LVBU UFSIBEBQ JPOJPO
Aktivitas ATPase di Kepala Miosin $JSJDJSJ MBJO EBSJ LBMTJVN EJEVHB NFODFUVTLBO QSPTFT LPOUSBLTJ TFQFSUJ ZBOH
LFQBMB NJPTJO ZBOH TBOHBU QFOUJOH VOUVL LPOUSBLTJ PUPU BEBMBI BLBOEJUFSBOHLBOEJCBHJBOCFSJLVU
CBIXB JB EBQBU CFSGVOHTJ TFQFSUJ FO[JN "51BTF 4FQFSUJ
EJKFMBTLBO OBOUJ LFNBNQVBO JOJ NFOZFCBCLBO LFQBMB NBNQV Interaksi Satu Filamen Miosin, Dua Filamen Aktin, dan
NFNFDBI"51EBONFOHHVOBLBOFOFSHJZBOHCFSBTBMEBSJJLBUBO lon Kalsium untuk Menimbulkan Kontraksi
GPTGBUCFSFOFSHJUJOHHJ"51VOUVLNFOKBMBOLBOQSPTFTLPOUSBLTJ
Filamen Aktin Tersusun oleh Aktin, Tropomiosin, dan Penghambatan Filamen Aktin oleh Kompleks troponin-
Troponin. LSBOHLB GJMBNFO BLUJO BEBMBI TVBUV NPMFLVM QSPUFJO Tropomiosin; Pengaktifan oleh lon Kalsium. 4FCVBI
'BLUJOVOUBJHBOEB ZBOHEJHBNCBSLBOPMFIEVBVOUBJCFSXBSOB GJMBNFO BLUJO NVSOJ UBOQB BEBOZB LPNQMFLT USPQPOJO
UFSBOH QBEB (BNCBS LFEVB VOUBJ NFNCFMJU EBMBN TVBUV USPQPNJPTJO UBQJEFOHBOLFIBEJSBOJPONBHOFTJVNEBO"51

IFMJLTEFOHBODBSBZBOHTBNBTFQFSUJNPMFLVMNJPTJO BLBO CFSJLBUBO TFDBSB DFQBU EBO LVBU EFOHBO LFQBMB NPMFLVM
4FUJBQVOUBJIFMJLTHBOEB'BLUJOUFSEJSJBUBTNPMFLVM(BLUJO NJPTJO -BMV KJLB LPNQMFLT USPQPOJOUSPQPNJPTJO EJUBNCBI
UFSQPMJNFSJTBTJ ZBOH NBTJOHNBTJOH NFNQVOZBJ CFSBU NPMFLVM LBO QBEB GJMBNFO BLUJO JLBUBO BOUBSB BLUJO EBO NJPTJO JOJ
TFLJUBS1BEBTFUJBQNPMFLVM(BLUJONFMFLBUTBUVNPMFLVM UJEBL BLBO UFSCFOUVL 0MFI LBSFOB JUV EJEVHB CBIXB CBHJBO
"%1%JQFSLJSBLBOCBIXBNPMFLVM"%1JOJBEBMBICBHJBOBLUJG BLUJGQBEBGJMBNFOBLUJOOPSNBMEBSJPUPUZBOHTFEBOHSFMBLTBTJ
QBEB GJMBNFO BLUJO ZBOH CFSJOUFSBLTJ EFOHBO KFNCBUBO TJMBOH BLBO EJIBNCBU BUBV TFDBSB GJTJL EJUVUVQJ PMFI LPNQMFLT
GJMBNFONJPTJOVOUVLNFOJNCVMLBOLPOUSBLTJPUPU#BHJBOBLUJG USPQPOJOUSPQPNJPTJO "LJCBUOZB UFNQBU JOJ UJEBL EBQBU
QBEB LFEVB VOUBJ 'BLUJO EBO IFMJLT HBOEB EJBUVS CFSHBOUJBO NFMFLBU QBEB LFQBMB GJMBNFO NJPTJO VOUVL NFOJNCVMLBO
NFNCFOUVL TBUV UFNQBU BLUJG EJ TFMVSVI GJMBNFO BLUJO LJSBLJSB LPOUSBLTJ 4FCFMVN UFSKBEJOZB LPOUSBLTJ FGFL QFOHIBNCBUBO
TFUJBQ OBOPNFUFS LPNQMFLTUSPQPOJOUSPQPNJPTJOJUVTFOEJSJIBSVTEJIBNCBU
75
Unit ll Fislologi Membran, Saraf, dan Otot
,FBEBBOUFSTFCVUNFNCBXBLJUBLFQBEBQFSBOJPOLBMTJVN PUPUCFSLPOUSBLTJ UJNCVMTVBUVLFSKBEBONFNCVUVILBOFOFSHJ

%FOHBO BEBOZB JPO LBMTJVN EBMBN KVNMBI CFTBS FGFL 4FKVNMBI CFTBS "51 EJQFDBI NFNCFOUVL "%1 TFMBNB QSPTFT
QFOHIBNCBUBO USPQPOJOUSPQPNJPTJO UFSIBEBQ GJMBNFO BLUJO LPOUSBLTJ TFNBLJO CFTBS KVNMBI LFSKB ZBOH EJMBLVLBO PMFI PUPU
JUV TFOEJSJ EJIBNCBU .FLBOJTNF QFOHIBNCBUBO JOJ UJEBL TFNBLJO CFTBS KVNMBI "51 ZBOH EJQFDBILBO ZBOH EJTFCVU FGFL
EJLFUBIVJ UFUBQJTBMBITBUVEVHBBOBEBMBITFCBHBJCFSJLVU#JMB 'FOO#FSJLVUJOJBEBMBIQFSLJSBBOSBOHLBJBOQFSJTUJXBCBHBJNBOB
JPOLBMTJVNCFSHBCVOHEFOHBOUSPQPOJO$ EBOTFUJBQNPMFLVM IBMUFSTFCVUEBQBUUFSKBEJ
USPQPOJO $ EBQBU CFSJLBUBO TFDBSB LVBU EFOHBO FNQBU JPO
LBMTJVN LPNQMFLT USPQPOJO JOJ EJEVHB BLBO NFOHBMBNJ 1. 4FCFMVN LPOUSBLTJ NVMBJ UFSKBEJ LFQBMB KFNCBUBO TJMBOH
QFSVCBIBO CFOUVL ZBOH NFOBSJL NPMFLVM USPQPNJPTJO EBO
CFSJLBUBO EFOHBO "51 "LUJWJUBT "51BTF EBSJ LFQBMB NJPTJO
NFNJOEBILBOOZB MFCJI EBMBN LF MFLVLBO BOUBSB EVB VOUBJ
TFHFSB NFNFDBI "51 UFUBQJ NFOJOHHBMLBO IBTJM
BLUJO,FBEBBOJOJNFNCVLBCBHJBOBLUJGEBSJBLUJO TFIJOHHB
QFNFDBIBOOZB "%1 EBO JPO GPTGBU ZBOH UFSJLBU QBEB LFQBMB
NFNVOHLJOLBO LPNQMFLT JOJ NFOBSJL LFQBMB KFNCBUBO TJMBOH
1BEBLFBEBBOJOJ CFOUVLLFQBMBNFNBOKBOHTFDBSBUFHBLMVSVT
NJPTJO EBO NFOZFCBCLBO UFSKBEJOZB LPOUSBLTJ 8BMBVQVO JOJ
LFBSBIGJMBNFOBLUJOUFUBQJNBTJICFMVNNFMFLBUQBEBBLUJO
NFSVQBLBO NFLBOJTNF ZBOH NBTJI CFSVQB IJQPUFTJT
2. #JMB LPNQMFLT USPQPOJOUSPQPNJPTJO CFSJLBUBO EFOHBO JPO
NFLBOJTNF JOJ NFOFLBOLBO CBIXB IVCVOHBO OPSNBM BOUBSB
LPNQMFLT USPQPOJOUSPQPNJPTJO EBO BLUJO EJVCBI PMFI JPO LBMTJVN CBHJBOBLUJGQBEBGJMBNFOBLUJONFOKBEJUFSCVLB EBO
LBMTJVN EBO NFNCFOUVL LPOEJTJ CBSV ZBOH NFOJNCVMLBO LFQBMB NJPTJO LFNVEJBO CFSJLBUBO EFOHBO CBHJBO JOJ TFQFSUJ
LPOUSBLTJ ZBOHUBNQBLQBEB(BNCBS
3. *LBUBO BOUBSB LFQBMB KFNCBUBO TJMBOH EBO CBHJBO BLUJG GJMBNFO
lnteraksi antara Filamen Aktin yang "Teraktivasi" dan
Jembatan Silang Miosin—Teori "Berjalan-bersama" BLUJO NFOZFCBCLBO QFSVCBIBO CFOUVL LFQBMB NFOZFCBCLBO
LFQBMB NFOFLVL LF BSBI MFOHBO KFNCBUBO TJMBOH ,FEVEVLBO
Kontraksi. 4FHFSB TFTVEBI GJMBNFO BLUJO NFOKBEJ UFSBLUJWBTJ
JOJ NFNCFSJLBO QPXFS TUSPLF VOUVL NFOBSJL GJMBNFO BLUJO
PMFI JPO LBMTJVN LFQBMB KFNCBUBO TJMBOH EBSJ GJMBNFO NJPTJO
&OFSHJ ZBOH NFOHBLUJGLBO QPXFS TUSPLF BEBMBI FOFSHJ ZBOH
NFOKBEJ UFSUBSJL LF CBHJBO BLUJG GJMBNFO BLUJO EBO IBM JOJ
UFMBI EJTJNQBO TFQFSUJ TFCVBI TFOKBUB ZBOH UFSLPLBOHh PMFI
EBMBNCFCFSBQBDBSB BLBONFOZFCBCLBOUFSKBEJOZBLPOUSBLTJ
QFSVCBIBO CFOUVL ZBOH UFSKBEJ QBEB LFQBMB TBBU NPMFLVM "51
.FTLJQVO JOUFSBLTJ BOUBSB KFNCBUBO TJMBOH EBO BLUJO ZBOH
UFMBIEJQFDBILBOTFCFMVNOZB
NFOJNCVMLBO LPOUSBLTJ JOJ TFCBHJBO NBTJI CFSTJGBU UFPSFUJT
TBMBI TBUV UFPSJ ZBOH CVLUJOZB UFMBI BEB ZBJUV UFPSJ CFSKBMBO 4. #FHJUV LFQBMB KFNCBUBO TJMBOH NFOFLVL LFBEBBO JOJ
CFSTBNB XBMLBMPOHUIFPSZ
LPOUSBLTJ NFOZFCBCLBOQFMFQBTBO"%1EBOJPOGPTGBUZBOHTFCFMVNOZB
NFMFLBU QBEB LFQBMB %J UFNQBU QFMFQBTBO "%1 UFSJLBU
(BNCBS NFOHHBNCBSLBO NFLBOJTNF CFSKBMBOCFSTBNB
NPMFLVM "51 ZBOH CBSV *LBUBO "51 CBSV JOJ LFNVEJBO
ZBOH UFMBI EJEBMJMLBO VOUVL LPOUSBLTJ (BNCBS JOJ NFOVOKVL
NFOZFCBCLBOUFSMFQBTOZBLFQBMBEBSJBLUJO
LBOLFQBMBEBSJEVBKFNCBUBOTJMBOHZBOHNFMFLBUEBOUFSMFQBT
EBSJ CBHJBO BLUJG GJMBNFO BLUJO 5FMBI EJEBMJMLBO CBIXB CJMB 5. 4FUFMBI LFQBMB UFSQJTBI EBSJ BLUJO NPMFLVM "51 ZBOH CBSV
TFCVBI LFQBMB NFMFLBU QBEB CBHJBO BLUJG QFSMFLBUBO JOJ TFDBSB EJQFDBI VOUVL NFNVMBJ TJLMVT CBSV ZBOH NFOJNCVMLBO TVBUV
TFSFOUBL NFOZFCBCLBO QFSVCBIBO CFTBS QBEB LFLVBUBO QPXFSTUSPLFZBOHCBSV"SUJOZB FOFSHJTFLBMJMBHJNFOHPLBOH
JOUSBNPMFLVMBS BOUBSB LFQBMB EBO MFOHBO KFNCBUBO TJMBOHOZB LFQBMB LFNCBMJ LF LFEVEVLBO UFHBL MVSVTOZB EBO TJBQ VOUVL
,FMPNQPL LFLVBUBO ZBOH CBSV JOJ NFOZFCBCLBO LFQBMB NFNVMBJTJLMVTQPXFSTUSPLFZBOHCBSV
NFOFLVL LF BSBI MFOHBO EBO NFOBSJL GJMBNFO BLUJO CFSTBNB 6. #JMB LFQBMB ZBOH UFSLPLBOH EJTFSUBJ EFOHBO FOFSHJ
EFOHBOOZB 1FOFLVLBO LFQBMB JOJ EJTFCVU QPXFS TUSPLF TJNQBOBOOZB ZBOH CFSBTBM EBSJ QFNFDBIBO "51
CFSJLBUBO
,FNVEJBO TFHFSB TFTVEBI NFOFLVL LFQBMB TFDBSB PUPNBUJT EFOHBO CBHJBO BLUJG ZBOH CBSV QBEB GJMBNFO BLUJO LFQBMB
UFSMFQBT EBSJ CBHJBO BLUJG 4FMBOKVUOZB LFQBMB LFNCBMJ LF BSBI NFOKBEJ UJEBL UFSLPLBOH EBO TFLBMJ MBHJ NFOZFEJBLBO QPXFS
NFNBOKBOHOZB 1BEB QPTJTJ JOJ LFQBMB CFSLPNCJOBTJ EFOHBO TUSPLF
CBHJBO BLUJG ZBOH CBSV CFSJLVUOZB EJ TFQBOKBOH GJMBNFO BLUJO
%FOHBOEFNJLJBO QSPTFTBLBOCFSMBOHTVOHUFSVTTBNQBJGJMBNFO
LFNVEJBO LFQBMB NFOFLVL MBHJ VOUVL NFOJNCVMLBO QPXFS
BLUJONFOBSJLNFNCSBO;NFOZFOUVIVKVOHBLIJSGJMBNFONJPTJO
TUSPLF ZBOH CBSV EBO GJMBNFO BLUJO NFOHHFSBLLBO UBIBQ
BUBV TBNQBJ CFCBO QBEB PUPU NFOKBEJ UFSMBMV CFTBS VOUVL UFSKBEJ
MBJOOZB +BEJ LFQBMB KFNCBUBO TJMBOH NFNCFMPL LF EFQBO EBO
UBSJLBOTFMBOKVUOZB
CFMBLBOH EBO TFUBQBL EFNJ TFUBQBL CFSKBMBO EJ TFQBOKBOH
GJMBNFO BLUJO TFSUB NFOBSJL VKVOH EVB GJMBNFO BLUJO ZBOH
CFSVSVUBOLFCBHJBOUFOHBIGJMBNFONJPTJO
4FUJBQ TBUV KFNCBUBO TJMBOH EJEVHB CFLFSKB TFDBSB Power
JOEFQFOEFO EBO NBTJOHNBTJOH NFMFLBU EBO NFOBSJL EBMBN stroke
TVBUVTJLMVTCFSVMBOHZBOHCFSLFTJOBNCVOHBO0MFILBSFOBJUV
TFNBLJO CBOZBL KVNMBI KFNCBUBO TJMBOH ZBOH CFSIVCVOHBO
EFOHBOGJMBNFOBLUJOQBEBTVBUVXBLUV TFNBLJOCFTBSLFLVBUBO
LPOUSBLTJOZB
ATP sebagai Sumber Energi untuk Kontraksi— Peris- (BNCBS.FLBOJTNFCFSKBMBOCFSTBNB 8BMLBMPOH
VOUVLLPOUSBL
tiwa Kimiawi pada Pergerakan Kepala Miosin#JMBTFCVBI TJPUPU
76
Jumlah Tumpang Tindih Filamen Aktin dan Miosin Menen-

tukan Tegangan yang Dihasilkan oleh Otot yang berkon-
raksi
(BNCBSNFNQFSMJIBULBOFGFLQBOKBOHTBSLPNFSEBOKVNMBI
Tension of muscle
UVNQBOH UJOEJI GJMBNFO BLUJONJPTJO UFSIBEBQ UFHBOHBO BLUJG
UNIT II
ZBOHEJUJNCVMLBOPMFITFSBCVUPUPUZBOHCFSLPOUSBLTJ%JTFCFMBI
LBOBO EJUVOKVLLBO EFOHBO XBSOB IJUBN NFSVQBLBO CFSCBHBJ
EFSBKBU UVNQBOH UJOEJI GJMBNFO NJPTJO EBO BLUJO QBEB CFSCBHBJ
QBOKBOH TBSLPNFS %J UJUJL % QBEB EJBHSBN GJMBNFO BLUJO UFMBI
UFSUBSJL LF VKVOH GJMBNFO NJPTJO UBOQB BEBOZB UVNQBOH UJOEJI
BLUJONJPTJO%JUJUJLJOJ UFHBOHBOZBOHEJCFOUVLPMFIPUPUZBOH
UFSBLUJWBTJ BEBMBI OPM ,FNVEJBO CJMB TBSLPNFS NFNFOEFL EBO 0
GJMBNFO BLUJO NVMBJ UVNQBOH UJOEJI EFOHBO GJMBNFO NJPTJO 1/2 Normal 2s
normal normal
UFHBOHBO NFOJOHLBU TFDBSB QSPHSFTJG TBNQBJ QBOKBOH TBSLPNFS
CFSLVSBOHNFOKBEJLJSBLJSB N1BEBTBBUJOJ GJMBNFOBLUJO
UFMBIUVNQBOHUJOEJIQBEBTFNVBKFNCBUBOTJMBOHGJMBNFONJPTJO
UFUBQJ NBTJI CFMVN NFODBQBJ QVTBU GJMBNFO NJPTJO %FOHBO
QFNFOEFLBO TFMBOKVUOZB TBSLPNFS UFUBQ UFHBOH TFQFOVIOZB
PUPU UJEBL TFMBMV CFSLPOUSBLTJ EBMBN KVNMBI ZBOH TBNB 0MFI
TBNQBJ UJUJL # UFSDBQBJ TBBU QBOKBOH TBSLPNFS TFLJUBS N
LBSFOB JUV LVSWB UFSTFCVU NFNJMJLJ CFCFSBQB QFSCFEBBO
1BEB TBBU JOJ VKVOHVKVOH LFEVB GJMBNFO BLUJO NVMBJ TBMJOH
EJNFOTJ EBSJLVSWBZBOHEJHBNCBSLBOVOUVLTBUVTFSBCVUPUPU
UVNQBOH UJOEJI TFMBJO UVNQBOH UJOEJI EFOHBO GJMBNFO NJPTJO
UFUBQJ IBM JUV NFOVOKVLLBO CFOUVL VNVN ZBOH TBNB VOUVL
1BEB XBLUV QBOKBOH TBSLPNFS CFSLVSBOH EBSJ N NFOKBEJ
MFSFOHQBEBSFOUBOHOPSNBMLPOUSBLTJ TFQFSUJZBOHUFSMJIBUQBEB
TFLJUBS N QBEB UJUJL " LFLVBUBO LPOUSBLTJ CFSLVSBOH
(BNCBS
EFOHBO DFQBU 1BEB UJUJL JOJ LFEVB MFNQFOH ; TBSLPNFS
CFSTFOUVIBOEFOHBOVKVOHVKVOHGJMBNFONJPTJO,FNVEJBO CJMB 1FSIBUJLBOQBEB(BNCBSCBIXBCJMBPUPUCFSBEBEBMBN
LPOUSBLTJ UFSVT CFSMBOHTVOH TFIJOHHB MFCJI NFNFOEFLLBO LFBEBBO QBOKBOH JTUJSBIBU OPSNBMOZB ZBJUV QBEB QBOKBOH
QBOKBOH TBSLPNFS VKVOHVKVOH GJMBNFO NJPTJO NFOKBEJ LVTVU TBSLPNFS TFLJUBS N JB BLBO CFSLPOUSBLTJ TBBU BLUJWBTJ
EBO TFQFSUJZBOHEJUVOKVLLBOEBMBNHBNCBS LFLVBUBOLPOUSBLTJ EFOHBO LFLVBUBO LPOUSBLTJ NFOEFLBUJ NBLTJNVN 5BQJ
NFODBQBJ OPM OBNVO TBSLPNFS TFLBSBOH CFSLPOUSBLTJ TBNQBJ QFOJOHLBUBO UFHBOHBO ZBOH NVODVM TFMBNB LPOUSBLTJ ZBOH
NFODBQBJVLVSBOUFSQFOEFLOZB EJTFCVU UFHBOHBO BLUJG BLBO NFOVSVO CJMB PUPU EJSFHBOHLBO
NFMFCJIJ QBOKBOH OPSNBMOZB ZBJUV IJOHHB QBOKBOH TBSLPNFS
Pengaruh Panjang Otot terhadap Kekuatan Kontraksi MFCJI EBSJ N )BM JOJ EJQFSMJIBULBO EFOHBO BEBOZB
pada Otot yang Utuh. ,VSWB BUBT QBEB (BNCBS NJSJQ QFOVSVOBO QBOKBOH QBOBI EBMBN HBNCBS QBEB QBOKBOH PUPU
EFOHBO LVSWB QBEB (BNCBS UFUBQJ LVSWB QBEB (BNCBS ZBOHNFMFCJIJOPSNBM
NFNQFSMJIBULBO UFHBOHBO PUPU ZBOH VUVI EBO MFOHMDBQ CVLBO Hubungan antara Kecepatan Kontraksi dan Beban
TBUV TFSBCVU PUPU TBKB 0UPU ZBOH MFOHLBQNFNJMJLJ CBOZBL TFLBMJ
4FCVBI PUPU SBOHLB BLBO CFSLPOUSBLTJ DFQBU CJMB JB
KBSJOHBOJLBUEJEBMBNOZBEFNJLJBOQVMB TBSLPNFSEJCFSCBHBJ
CFSLPOUSBLTJ UBOQB NFMBXBO CFCBO NFODBQBJ LFBEBBO
LPOUSBLTJQFOVILJSBLJSBEBMBN EFUJLVOUVLPUPUSBUBSBUB
D
B C #JMB CFCBO EJCFSJLBO LFDFQBUBO LPOUSBLTJ BLBO NFOVSVO
C
100 TFDBSB QSPHSFTJG TFJSJOH EFOHBO QFOBNCBIBO CFCBO TFQFSUJ
B
A
ZBOHEJUVOKVLLBOQBEB(BNCBS%FOHBOEFNJLJBO CJMB
A
30
50
20
D
0 10
0 1 2 3 4
0
0 1 2 3 4
77
Unit II fisiologi Membran, Saraf, dan Otot
CFCBO UFMBI EJUJOHLBULBO TBNQBJ TBNB EFOHBO LFLVBUBO LFNCBMJ "51 /BNVO KVNMBI UPUBM LSFBUJOGPTGBU QBEB TFSBCVU
NBLTJVN ZBOH EBQBU EJMBLVLBO PUPU UFSTFCVU LFDFQBUBO PUPUKVHBTBOHBULFDJMIBOZBTFLJUBSMJNBLBMJMFCJICFTBSEBSJQBEB
LPOUSBLTJNFOKBEJOPMEBOUJEBLUFSKBEJLPOUSBLTJTBNBTFLBMJ KVNMBI "51 0MFI LBSFOB JUV LPNCJOBTJ FOFSHJ EBSJ "51
XBMBVQVOUFSKBEJBLUJWJUBTTFSBCVUPUPU DBEBOHBO EBO LSFBUJOGPTGBU EJ EBMBN PUPU EBQBU NFOJNCVMLBO
1FOVSVOBO LFDFQBUBO LPOUSBLTJ EFOHBO CFCBO JOJ EJTFCBCLBO LPOUSBLTJPUPUNBLTJNBMIBOZBVOUVLTBNQBJEFUJL
PMFI LFOZBUBBO CBIXB CFCBO QBEB PUPU ZBOH CFSLPOUSBLTJ BEBMBI 4VNCFS FOFSHJ QFOUJOH LFEVB ZBOH EJHVOBLBO VOUVL
LFLVBUBOCFSMBXBOBOBSBIZBOHNFMBXBOLFLVBUBOLPOUSBLTJBLJCBU NFOZVTVO LFNCBMJ LSFBUJOGPTGBU EBO "51 BEBMBI HMJLPMJTJT EBSJ
LPOUSBLTJ PUPU 0MFI LBSFOB JUV LFLVBUBO OFUP ZBOH UFSTFEJB VOUVL
HMJLPHFO ZBOH TFCFMVNOZB UFSTJNQBO EBMBN TFM PUPU 1FNFDBIBO
NFOJNCVMLBOLFDFQBUBOQFNFOEFLBOBLBOCFSLVSBOHTFDBSBTFTVBJ
HMJLPHFO TFDBSB FO[JNBUJL NFOKBEJ BTBN QJSVWBU EBO BTBN MBLUBU
ZBOH CFSMBOHTVOH EFOHBO DFQBU BLBO NFNCFCBTLBO FOFSHJ ZBOH
Energetika Kontraksi Otot EJHVOBLBO VOUVL NFOHVCBI "%1 NFOKBEJ "51 "51 LFNVEJBO
EBQBU EJHVOBLBO TFDBSB MBOHTVOH VOUVL NFNCFSJ FOFSHJ CBHJ
Hasil Kerja Selama Kontraksi Otot LPOUSBLTJ PUPU UBNCBIBO EBO KVHB VOUVL NFNCFOUVL LFNCBMJ
#JMB TVBUV PUPU CFSLPOUSBLTJ NFMBXBO TVBUV CFCBO PUPU JOJ TJNQBOBOLSFBUJOGPTGBU
BLBO NFMBLVLBO LFSKB )BM JOJ CFSBSUJ CBIXB BEB FOFSHJ ZBOH .BLOB QFOUJOH NFLBOJTNF HMJLPMJTJT JOJ BEB EVB 1FSUBNB
EJQJOEBILBO EBSJ PUPU LF CFCBO FLTUFSOBM TFCBHBJ DPOUPI SFBLTJ HMJLPMJTJT JOJ EBQBU UFSKBEJ CBILBO CJMB UJEBL BEB PLTJHFO
VOUVLNFOHBOHLBUTVBUVPCKFLLFUFNQBUZBOHMFCJIUJOHHJBUBV TFIJOHHBLPOUSBLTJPUPUEBQBUUFUBQEJQFSUBIBOLBOVOUVLCFCFSBQB
VOUVLNFOHJNCBOHJUBIBOBOQBEBXBLUVNFMBLVLBOHFSBL EFUJLEBOLBEBOHTBNQBJMFCJIEBSJTBUVNFOJU CBILBOCJMBUJEBL
1BEB QFSIJUVOHBO NBUFNBUJT LFSKB JOJ EJEFGJOJTJLBO PMFI UFSTFEJB PLTJHFO ZBOH EJIBOUBSLBO MFXBU EBSBI ,FEVB LFDFQBUBO
QFSTBNBBOCFSJLVU W=L×D QFNCFOUVLBO "51 PMFI QSPTFT HMJLPMJTJT LJSBLJSB LBMJ
EFOHBO 8 BEBMBI IBTJM LFSKB - BEBMBI CFCBO EBO % BEBMBI LFDFQBUBO QFNCFOUVLBO "51 TFCBHBJ SFTQPOT UFSIBEBQ [BU
KBSBL QFSHFSBLBO UFSIBEBQ CFCBO &OFSHJ ZBOH EJCVUVILBO NBLBOBOTFMZBOHCFSFBLTJEFOHBOPLTJHFO/BNVO CFHJUVCBOZBL
VOUVL NFMBLVLBO LFSKB CFSBTBM EBSJ SFBLTJ LJNJB EJ TFM PUPU QSPEVL BLIJS HMJLPMJTJT CFSLVNQVM EBMBN TFM PUPU TFIJOHHB
TFMBNBLPOUSBLTJ ZBOHEJCJDBSBLBOEBMBNCBHJBOCFSJLVU HMJLPMJTJT LFIJMBOHBO LFNBNQVBOOZB VOUVL NFNQFSUBIBOLBO
LPOUSBLTJPUPUNBLTJNVNTFUFMBITFLJUBSNFOJU
Sumber Energi untuk Kontraksi Otot 4VNCFS FOFSHJ LFUJHB TFLBMJHVT ZBOH UFSBLIJS BEBMBI
NFUBCPMJTNF PLTJEBUJG )BM JOJ CFSBSUJ NFOHPNCJOBTJLBO PLTJHFO
,JUB UFMBI NFMJIBU CBIXB LPOUSBLTJ PUPU CFSHBOUVOH QBEB EFOHBO QSPEVL BLIJS HMJLPMJTJT EBO CFSCBHBJ [BU NBLBOBO TFM
FOFSHJ ZBOH EJTFEJBLBO PMFI "51 4FCBHJBO CFTBS FOFSHJ JOJ MBJOOZB VOUVL NFNCFCBTLBO "51 -FCJI EBSJ QFSTFO FOFSHJ
EJCVUVILBO VOUVL NFOKBMBOLBO NFLBOJTNF CFSKBMBO ZBOH EJHVOBLBO PMFI PUPU VOUVL LPOUSBLTJ KBOHLB QBOKBOH ZBOH
CFSTBNB XBMLBMPOH NFDIBOJTN
LFUJLB KFNCBUBO TJMBOH CFSLFTJOBNCVOHBO CFSBTBM EBSJ TVNCFS JOJ ;BU NBLBOBO ZBOH
NFOBSJL GJMBNFOGJMBNFO BLUJO UFUBQJ TFKVNMBI LFDJM FOFSHJ EJLPOTVNTJ BEBMBI LBSCPIJESBU MFNBL EBO QSPUFJO 6OUVL
EJCVUVILBO VOUVL
NFNPNQB JPO LBMTJVN EBO BLUJWJUBT PUPU NBLTJNBM ZBOH CFSMBOHTVOH TBOHBU MBNB MFCJI EBSJ
TBSLPQMBTNBLFEBMBNSFUJLVMVNTBSLPQMBTNBTFUFMBILPOUSBLTJ CFSKBNKBN QSPQPSTJ FOFSHJ ZBOH UFSCFTBS CFSBTBM EBSJ MFNBL
CFSBLIJS EBO
NFNPNQB JPOJPO OBUSJVN EBO LBMJVN UFUBQJ VOUVL QFSJPEF LPOUSBLTJ TFMBNB TBNQBJ KBN TFQBSVI
NFMBMVJ NFNCSBO TFSBCVU PUPU VOUVL NFNQFSUBIBOLBO FOFSHJOZBEBQBUCFSBTBMEBSJLBSCPIJESBU
MJOHLVOHBO JPOJL ZBOH DPDPL VOUVL QFNCFOUVLBO QPUFOTJBM
BLTJTFSBCVUPUPU .FLBOJTNFUFSQFSJODJQSPTFTFOFSHFUJLBJOJEJCJDBSBLBOEJ#BC
TBNQBJ 4FMBJO JUV NBLOB QFOUJOH CFSCBHBJ NFLBOJTNF
,POTFOUSBTJ "51 EJ EBMBN TFSBCVU PUPU LJSBLJSB QFMFQBTBO FOFSHJ TBBU NFMBLVLBO CFSNBDBNNBDBN PMBISBHB
NJMJNPMBS DVLVQ VOUVL NFNQFSUBIBOLBO LPOUSBLTJ QFOVI EJCJDBSBLBOEJ#BCQBEBGJTJPMPHJPMBISBHB
IBOZB TFMBNB TBNQBJ EFUJL "51 UFSTFCVU QFDBI VOUVL
NFNCFOUVL "%1 ZBOH NFNJOEBILBO FOFSHJ EBSJ NPMFLVM Efisiensi Kontraksi Otot. &GJTJFOTJ TFCVBI NFTJO BUBV NPUPS
"51 LF QFSBOHLBU LPOUSBLTJ TFSBCVU PUPU -BMV TFQFSUJ ZBOH EJIJUVOH TFCBHBJ QFSTFOUBTF NBTVLBO FOFSHJ ZBOH EJVCBI NFOKBEJ
TVEBIEJKFMBTLBOEJ#BC "%1NFOHBMBNJSFGPTGPSJMBTJVOUVL LFSKB CVLBO NFOKBEJ QBOBT 1FSTFOUBTF FOFSHJ ZBOH NBTVL LF PUPU
NFNCFOUVL "51 CBSV EBMBN TFQFSTFLJBO EFUJL MBHJ ZBOH FOFSHJ LJNJBXJ EBMBN [BU HJ[J
ZBOH EBQBU EJVCBI NFOKBEJ LFSKB
NFNCJBSLBO PUPU VOUVL NFMBOKVULBO LPOUSBLTJ 5FSEBQBU CBILBO EBMBN LPOEJTJ UFSCBJL BEBMBI LVSBOH EBSJ QFSTFO EBO
CFCFSBQBTVNCFSFOFSHJVOUVLQSPTFTSFGPTGPSJMBTJJOJ TJTBOZBNFOKBEJQBOBT1FOZFCBCEBSJFGJTJFOTJZBOHSFOEBIJOJLBSFOB
4VNCFS FOFSHJ QFSUBNB ZBOH EJHVOBLBO VOUVL NFOZVTVO LJSBLJSB TFQBSVI FOFSHJ EJ EBMBN [BU NBLBOBO BLBO IJMBOH QBEB
LFNCBMJ "51 BEBMBI TVCTUBOTJ LFSBUJOGPTGBU ZBOH NFNCBXB QFNCFOUVLBO "51 EBO LFNVEJBO IBOZB TBNQBJ QFSTFO FOFSHJ
JLBUBO GPTGBU CFSFOFSHJ UJOHHJ ZBOH TFSVQB EFOHBO JLBUBO "51 EBMBN"51JUVTFOEJSJZBOHLFNVEJBOEBQBUEJVCBINFOKBEJLFSKB
*LBUBOGPTGBUCFSFOFSHJUJOHHJEBSJLSFBUJOGPTGBUNFNJMJLJKVNMBI &GJTJFOTJ NBLTJNVN EBQBU EJXVKVELBO IBOZB CJMB PUPU CFSLPOUSBLTJ
FOFSHJ CFCBT ZBOH TFEJLJU MFCJI UJOHHJ EBSJQBEB ZBOH EJNJMJLJ EFOHBOLFDFQBUBOTFEBOH#JMBPUPUCFSLPOUSBLTJTFDBSBMBNCBUBUBVUBOQB
PMFI TFUJBQ JLBUBO "51 ZBOH EJCJDBSBLBO MFCJI NFOZFMVSVI EJ QFSHFSBLBOTBNBTFLBMJ TFKVNMBILFDJMQBOBTQFNFMJIBSBBO NBJOUFOBODF
#BCEBO0MFILBSFOBJUV LSFBUJOGPTGBUTFHFSBEJQFDBILBO IFBU
EJMFQBTLBOTFMBNBQSPTFTLPOUSBLTJ XBMBVQVOEFNJLJBOLFSKBZBOH
EBO QFMFQBTBO FOFSHJOZB NFOZFCBCLBO NFOZFCBCLBO EJMBLVLBOIBOZBTFEJLJUBUBVUJEBLBEBTBNBTFLBMJ TFIJOHHBNFOVSVOLBO
UFSJLBUOZBTFCVBIJPOGPTGBUCBSVQBEB"%1VOUVLNFOZVTVO FGJTJFOTJNFOKBEJOPM4FCBMJLOZB
78
CJMBLPOUSBLTJUFSMBMVDFQBU TFKVNMBICFTBSFOFSHJEJHVOBLBOVOUVL
NFMBXBO HFTFLBO WJTLPTJUBT EJ EBMBN PUPU JUV TFOEJSJ EBO IBM JOJ
KVHB BLBO NFOHVSBOHJ FGJTJFOTJ LPOUSBLTJ #JBTBOZB FGJTJFOTJ
NBLTJNVNUFSCFOUVLCJMBLFDFQBUBOLPOUSBLTJLJSBLJSBQFSTFO
OJMBJNBLTJNVN
UNIT II
Karakteristik Kontraksi Seberkas Otot
#BOZBL TJGBU LPOUSBLTJ PUPU EBQBU EJQFSMJIBULBO EFOHBO
NFOJNCVMLBOLFEVUBOUVOHHBMPUPU)BMJOJEBQBUEJDBQBJEFOHBO
NFNCFSJFLTJUBTJMJTUSJLTFDBSBUJCBUJCBQBEBTBSBGZBOHNFOZBSBGJ
0 40 80 120 160 200
PUPUBUBVEFOHBONFMFXBULBOSBOHTBOHBOMJTUSJLTJOHLBULFPUPUJUV
TFOEJSJ )BM JOJ BLBO NFOJNCVMLBO LPOUSBLTJ UVOHHBM ZBOH
NFOEBEBLEBOCFSMBOHTVOHTFQFSTFLJBOEFUJL
Kontraksi Isometrik versus Kontraksi Isotonik.

,POUSBLTJ PUPU EJLBUBLBO JTPNFUSJL CJMB PUPU UJEBL NFNFOEFL ZBOH NFNQVOZBJ MBNB LPOUSBLTJ JTPNFUSJL LVSBOH EBSJ
TFMBNB LPOUSBLTJ EBO EJLBUBLBO JTPUPOJL CJMB PUPU NFNFOEFL EFUJL PUPU HBTUSPLOFNJVT ZBOH NFNQVOZBJ MBNB LPOUSBLTJ LJSB
OBNVOUFHBOHBOQBEBPUPUUFUBQLPOTUBOTFMBNBLPOUSBLTJ4JTUFN LJSB EFUJMD EBO PUPU TPMFVT ZBOH NFNQVOZBJ MBNB LPOUSBLTJ
ZBOH NFODBUBU LFEVB KFOJT LPOUSBLTJ PUPU JOJ EJUVOKVLLBO QBEB LJSBLJSBEFUJL)BMZBOHNFOBSJLBEBMBICBIXBMBNBLPOUSBLTJ
(BNCBS JOJEJTFTVBJLBOEFOHBOGVOHTJPUPUUFSTFCVU1FSHFSBLBONBUBIBSVT
1BEB TJTUFN JTPNFUSJL PUPU CFSLPOUSBLTJ NFMBXBO USBOTEVTFS TBOHBUDFQBUBHBSEBQBUNFNQFSUBIBOLBOGJLTBTJNBUBQBEBPCKFL
LFLVBUBOUBOQBNFOHVSBOHJQBOKBOHPUPU TFQFSUJZBOHEJQFSMJIBU PCKFL EBO EJQFSPMFI QFOHMJIBUBO ZBOH BLVSBU 0UPU HBTUSPLOFNJVT
LBO QBEB CBHJBO LBOBO (BNCBS 1BEB TJTUFN JTPUPOJL PUPU IBSVT CFSLPOUSBLTJ DVLVQ DFQBU VOUVL NFOHIBTJMLBO LFDFQBUBO
NFNFOEFLNFMBXBOCFCBOZBOHUFUBQIBMJOJEJHBNCBSLBOQBEB ZBOHDVLVQQBEBQFSHFSBLBOUVOHLBJVOUVLCFSMBSJEBONFMPNQBU
CBHJBOLJSJEBMBNHBNCBS ZBOHNFNQFSMJIBULBOTVBUVPUPUZBOH EBO PUPU TPMFVT QBEB EBTBSOZB CFSIVCVOHBO EFOHBO LPOUSBLTJ
TFEBOH NFOHBOHLBU TFKVNMBI CFCBO (BNCBSBO LIBT LPOUSBLTJ MBNCBU VOUVL NFOZPLPOH UVCVI UFSIBEBQ HBZB HSBWJUBTJ EBMBN
JTPUPOJL CFSHBOUVOH QBEB CFCBO ZBOH EJMBXBO PMFI LPOUSBLTJ XBLUVZBOHMBNBTFDBSBLPOUJOV
PUPU TFSUB JOFSTJB CFCBO /BNVO TJTUFN JTPNFUSJL IBOZB Serabut Otot Cepat versus Serabut Otot Lambat.
NFSFLBN QFSVCBIBO QBEB LFLVBUBO LPOUSBLTJ PUPU JUV TFOEJSJ
4FQFSUJ ZBOH BLBO LJUB CJDBSBLBO MFCJI NFOEBMBN EJ #BC
TBKB 0MFI LBSFOB JUV TJTUFN JTPNFUSJL BEBMBI TJTUFN ZBOH QBMJOH
NFOHFOBJGJTJPMPHJPMBISBHB TFUJBQPUPUUVCVIUFSEJSJBUBTDBNQVSBO
TFSJOH EJHVOBLBOCJMB LJUB IFOEBL NFNCBOEJOHLBO LBSBLUFSJTUJL
TFSBCVU PUPU DFQBU EBO MBNCBU TFSUB TFSBCVU PUPU MBJO EFOHBO
GVOHTJPOBMCFSCBHBJKFOJTPUPU
LFDFQBUBO BOUBSB LFEVB LFDFQBUBO FLTUSFN EJ BUBT 0UPUPUPU ZBOH
Karakteristik Kedutan Isometrik yang Direkam dari CFSFBLTJ EFOHBO DFQBU UFSVUBNB PUPU UJCJBMJT BOUFSJPS UFSVUBNB
UFSEJSJ BUBT TFSBCVUTFSBCVU DFQBU EFOHBO IBOZB TFKVNMBI LFDJM
Berbagai Otot 5VCVI NBOVTJB NFNQVOZBJ PUPU SBOHLB
TFSBCVU KFOJT MBNCBU 4FCBMJLOZB PUPU TFQFSUJ PUPU TPMFVT ZBOH
EFOHBOCFSCBHBJVLVSBOEBSJPUPUTUBQFEJVTEBMBNUFMJOHBUFOHBI
CFSFBLTJMBNCBUUFUBQJEFOHBOLPOUSBLTJZBOHMBNBUFSVUBNBUFSEJSJ
TFQBOKBOH IBOZB CFCFSBQB NJMJNFUFS EBO CFSEJBNFUFS TBUV
BUBTTFSBCVUTFSBCVUMBNCBU1FSCFEBBOBOUBSBLFEVBKFOJTTFSBCVU
NJMJNFUFS IJOHHBPUPULVBESJTFQZBOHCFTBS ZBLOJTFUFOHBIKVUB
JOJBEBMBITFCBHBJCFSJLVU
LBMJ MFCJI CFTBS EBSJQBEB PUPU TUBQFEJVT 4FMBOKVUOZB TFSBCVU
TFSBCVU EBQBU CFSEJBNFUFS TFLFDJM N BUBV TFCFTBS N Serabut Lambat (Tipe I, Otot Merah)
4FSBCVUOZB
"LIJSOZB FOFSHFUJLB LPOUSBLTJ PUPU TBOHBU CFSWBSJBTJ EBSJ PUPU MFCJI LFDJM
+VHB EJQFSTBSBGJ PMFI TFSBUTFSBU TBSBG ZBOH MFCJI
ZBOH TBUV EFOHBO PUPU ZBOH MBJO 0MFI LBSFOB JUV UJEBL LFDJM
4JTUFNQFNCVMVIEBSBIEBOLBQJMFSZBOHMFCJIMVBTVOUVL
NFOHIFSBOLBOCJMBLBSBLUFSJTUJLNFLBOJTLPOUSBLTJPUPUCFSCFEB NFOZFEJBLBO TFKVNMBI PLTJHFO UBNCBIBO
1FOJOHLBUBO IFCBU
VOUVLNBTJOHNBTJOHPUPU QBEB KVNMBI NJUPLPOESJB KVHB VOUVL NFNCBOUV UJOHLBU NFUB
CPMJTNF PLTJEBUJG ZBOH UJOHHJ
4FSBCVUTFSBCVU NFOHBOEVOH
(BNCBSNFOVOKVLLBOSFLBNBOLPOUSBLTJJTPNFUSJLEBSJ TFKVNMBI CFTBS NJPHMPCJO ZBLOJ TVBUV QSPUFJO ZBOH NFOHBOEVOH
UJHBKFOJTPUPUSBOHLBPUPUNBUB CFTJ TFSVQB EFOHBO IFNPHMPCJO TFMTFM EBSBI NFSBI .JPHMPCJO
CFSHBCVOH EFOHBO PLTJHFO EBO NFOZJNQBO PLTJHFO UFSTFCVU
TBNQBJ EJQFSMVLBO IBM JOJ KVHB TBOHBU NFNQFSDFQBU USBOTQPS
PLTJHFO LF NJUPLPOESJB 1BEB PUPU MBNCBU NJPHMPCJO NFNCFSJ
XBSOBLFNFSBINFSBIBOTFIJOHHBEJOBNBLBOPUPUNFSBI
K mogra
Serabut Cepat (Tipe II , Otot Putih)
4FSBCVU CFTBS
VOUVL LFLVBUBO LPOUSBLTJ ZBOH CFTBS
3FUJLVMVN TBSLPQMBTNB
ZBOHMVBTTFIJOHHBEBQBUEFOHBODFQBUNFMFQBTLBOJPOJPOLBMTJVN
VOUVLNFNVMBJLPOUSBLTJ
4FKVNMBICFTBSFO[JNHMJLPMJTJTVOUVL
QFMFQBTBO FOFSHJ ZBOH DFQBU NFMBMVJ QSPTFT HMJLPMJTJT
4VQMBJ
EBSBI ZBOH UJEBL UFSMBMV MVBT LBSFOB NFUBCPMJTNF PLTJEBUJG UJEBL
CFHJUV QFOUJOH
-FCJI TFEJLJU NJUPLPOESJB KVHB LBSFOB
NFUBCPMJTNF PLTJEBUJG UJEBL CFHJUV QFOUJOH +VNMBI NJPHMPCJO
NFSBI ZBOH TFEJLJU QBEB PUPU DFQBU TFIJOHHB PUPU JOJ EJOBNBLBO
PUPUQVUJI
79
Unit ll Fislotogi Membran, Saraf, dan Otot
Mekanisme Kontraksi Otot Rangka

Unit Motorik-Seluruh Serabut otot Diinervasi oleh Serat
Saraf Tunggal 4FUJBQ NPUPOFVSPO ZBOH NFOJOHHBMLBO NFEVMB Tetanization
TQJOBMJT BLBO NFNQFSTBSBGJ CFSCBHBJ TFSBCVU PUPU EBO KVNMBIOZB
CFSHBOUVOHQBEBKFOJTPUPU4FNVBTFSBCVUPUPUZBOHEJQFSTBSBGJPMFI
TBUVTFSBUTBSBGEJTFCVUVOJUNPUPSJL1BEBVNVNOZB PUPUPUPULFDJM
ZBOH CFSFBLTJ EFOHBO DFQBU EBO ZBOH QFOHBUVSBOOZB IBSVT UFQBU
NFNQVOZBJ MFCJI CBOZBL TFSBU TBSBG VOUVL TFSBCVU PUPU ZBOH MFCJI
TFEJLJUKVNMBIOZB NJTBMOZB IBOZBEVBTBNQBJUJHBTFSBCVUPUPUQFS
VOJUNPUPSJLQBEBCFCFSBQBPUPUMBSJOH
4FCBMJLOZB PUPUCFTBSZBOH
UJEBL NFNFSMVLBO QFOHBUVSBO IBMVT TFQFSUJ PUPU TPMFVT NVOHLJO
NFNQVOZBJ CFCFSBQB SBUVT TFSBCVU PUPU EBMBN TBUV VOJU NPUPSJL 5 10 15 20 25 30 35 40 45 50 55
(BNCBSBO VNVN VOUVL TFNVB PUPU UVCVI NBTJI EJQFSUBOZBLBO
UFUBQJ EVHBBO LVBU BEBMBI TFLJUBS TBNQBJ TFSBCVU PUPU VOUVL
TBUVVOJUNPUPSJL
4FSBCVUTFSBCVU PUPU EBMBN TFUJBQ VOJU NPUPSJL UJEBL TFMVSVIOZB TFIJOHHB LPOUSBLTJLPOUSBLTJ UFSTFCVU CFOBSCFOBS CFSTBUV CFSTBNB
UFSLVNQVM CFSTBNBTBNB EBMBN TBUV PUPU UFUBQJ UVNQBOH UJOEJI TBNB EBO LPOUSBLTJ TFDBSB LFTFMVSVIBO OBNQBL IBMVT EBO
EFOHBOVOJUNPUPSJLMBJOEBMBNTVBUVCFSLBTNJLSPZBOHUFSEJSJBUBT CFSMBOHTVOH UFSVTNFOFSVT TFQFSUJ ZBOH UBNQBL EBMBN (BNCBS
TBNQBJ TFSBCVU 1FSUBVUBO JOJ NFOZFCBCLBO VOJU NPUPSJL ZBOH 1FSJTUJXB JOJ EJTFCVU UFUBOJTBTJ 1BEB GSFLVFOTJ ZBOH TFEJLJU MFCJI
UFSQJTBI BLBO CFSLPOUSBLTJ VOUVL NFNCBOUV VOJU ZBOH MBJO EBO UJOHHJ LFLVBUBO LPOUSBLTJ BLBO NFODBQBJ UJOHLBU NBLTJNVNOZB
CVLBOTFDBSBLFTFMVSVIBOTFCBHBJTFHNFOUFSTFOEJSJ TFIJOHHBUBNCBIBOQFOJOHLBUBOBQBQVOQBEBGSFLVFOTJEJBUBTUJUJL
JOJ UJEBL BLBO NFNCFSJ FGFL QFOJOHLBUBO LFLVBUBO LPOUSBLTJ MFCJI
Kontraksi Otot pada Kekuatan yang Berbeda-Beda MBOKVU )BM JOJ UFSKBEJ LBSFOB UFSEBQBU DVLVQ JPO LBMTJVN ZBOH
—Sumasi Kekuatan 4VNBTJ CFSBSUJ QFOKVNMBIBO TFUJBQ EJQFSUBIBOLBO EBMBN TBSLPQMBTNB PUPU CBILBO EJ BOUBSB QPUFOTJBM
LPOUSBLTJ LFEVUBO VOUVL NFOJOHLBULBO JOUFOTJUBT LFTFMVSVIBO BLTJ TFIJOHHB UFSKBEJ LFBEBBO LPOUSBLTJ QFOVI ZBOH CFSMBOHTVOH
LPOUSBLTJ PUPU 4VNBTJ UFSKBEJ EBMBN EVB DBSB
EFOHBO UFSVTNFOFSVT UBOQB NFNVOHLJOLBO BEBOZB SFMBLTBTJ BQB QVO EJ
NFOJOHLBULBO KVNMBI VOJU NPUPSJL ZBOH CFSLPOUSBLTJ TFDBSB BOUBSBQPUFOTJBMBLTJ
CFSTBNBTBNB ZBOH EJTFCVU TVNBTJ TFSBCVU NVMUJQFM EBO

EFOHBO NFOJOHLBULBO GSFLVFOTJ LPOUSBLTJ ZBOH EJTFCVU TVNBTJ Kekuatan Maksimum Kontraksi.,FLVBUBONBLTJNVNQBEB
GSFLVFOTJEBOEBQBUNFOJNCVMLBOUFUBOJTBTJ LPOUSBLTJUFUBOJTFCVBIPUPUZBOHCFLFSKBQBEBQBOKBOHPUPUOPSNBM
Sumasi Serabut Multipel. #JMB TJTUFN TBSBG QVTBU SBUBSBUBBOUBSBEBOLHQFSDNQFSTFHJPUPU BUBV40QPOQFSJODJ
QFSTFHJ 0MFI LBSFOB PUPU LVBESJTFQT EBQBU NFNJMJLJ CBHJBO QFSVU
NFOHJSJNLBO TJOZBM ZBOH MFNBI VOUVL NFOJNCVMLBO LPOUSBLTJ PUPU
PUPU TBNQBJ JODJ QFSTFHJ NBLB UFHBOHBO TFCFTBS QPO EBQBU
ZBOH MFCJI TFSJOH UFSBOHTBOH BEBMBI VOJU NPUPSJL EBMBN PUPU ZBOH
EJCFSJLBO QBEB UFOEP QBUFMB 0MFI LBSFOBOZB LJUB EBQBU NFOHFSUJ
NFOHBOEVOHTFSBCVUPUPUZBOHMFCJILFDJMEBSJQBEBVOJUNPUPSJLZBOH
CBIXBPUPUEBQBUNFOBSJLUFOEPOOZBLFMVBSEBOJOTFSTJOZBEJUVMBOH
MFCJI CFTBS ,FNVEJBO LFUJLB LFLVBUBO TJOZBM NFOJOHLBU VOJU
NPUPSJL ZBOH NVMBJ UFSBOHTBOH KVHB TFNBLJO CFTBS EFOHBO VOJU Perubahan Kekuatan Otot pada Onset Kontraksi—
NPUPSJLZBOHUFSCFTBSTFSJOHLBMJNFNJMJLJLFLVBUBOLPOUSBLTJ40LBMJ Efek Tangga (Treppe). #JMB TFCVBI PUPU NFNVMBJ LPOUSBLTJ
MFCJILVBUEBSJQBEBLFLVBUBOLPOUSBLTJVOJUZBOHQBMJOHLFDJM)BMJOJ TFTVEBIQFSJPEFJTUJSBIBUZBOHMBNB LFLVBUBOLPOUSBLTJQFSNVMBBO
EJTFCVU QSJOTJQ VLVSBO 1FSJTUJXB UFSTFCVU CFSTJGBU QFOUJOH LBSFOB OZB NVOHLJO IBOZB TFUFOHBI LFLVBUBO EBSJ TBNQBJ LFEVUBO
EBQBU NFOHIBTJMLBO HSBEBTJ LFLVBUBO PUPU VOUVL NFOJNCVMLBO TFTVEBIOZB "SUJOZB LFLVBUBO LPOUSBLTJ NFOJOHLBU TBNQBJ HBSJT
LPOUSBLTJ MFNBI QBEB UBIBQ LFDJM TFNFOUBSB UBIBQUBIBQ JOJ TFDBSB NFOEBUBS QMBUFBV
TVBUVGFOPNFOBZBOHEJTFCVUFGFLUBOHHB BUBV
QSPHSFTJGBLBONFOKBEJTFNBLJOCFTBSTBBUEJQFSMVLBOTFKVNMBICFTBS USFQQF
EBZB 1FOZFCBC QSJOTJQ VLVSBO JOJ BEBMBI VOJU NPUPSJL ZBOH MFCJI .FTLJQVO TFNVB LFNVOHLJOBO QFOZFCBC EBSJ FGFL UBOHHB JOJ
LFDJM EJSBOHTBOH PMFI TFSBCVU TBSBG NPUPSJL ZBOH LFDJM EBO CFMVN EJLFUBIVJ EJEVHB QFOZFCBC VUBNBOZB JBMBI QFOJOHLBUBO JPO
NPUPOFVSPO LFDJM EBMBN NFEVMB TQJOBMJT MFCJI NVEBI UFSBOHTBOH LBMTJVNEBMBNTJUPTPMBLJCBUQFMFQBTBOJPOZBOHTFNBLJOCBOZBLEBSJ
EBSJQBEBNPUPOFVSPOZBOHCFTBS TFIJOHHBTFDBSBBMBNJNPUPOFVSPO SFUJLVMVN TBSLPQMBTNB QBEB TFUJBQ QPUFOTJBM BLTJ PUPU ZBOH
LFDJMZBOHQFSUBNBLBMJBLBOUFSBOHTBOH CFSVSVUBO EBO LFHBHBMBO TBSLPQMBTNB VOUVL NFOHBNCJM LFNCBMJ
JPOJPOJOJEFOHBOTFHFSB
(BNCBSBO QFOUJOH MBJOOZB EBSJ TVNBTJ TFSBCVU NVMUJQFM BEBMBI
CBIXB CFSCBHBJ VOJU NPUPSJL EJSBOHTBOH TFDBSB UJEBL TJOLSPO PMFI Tonus Otot Rangka #BILBO CJMB PUPU CFSBEB EBMBN LFBEBBO
NFEVMB TQJOBMJT TFIJOHHB UFSKBEJ LPOUSBLTJZBOH TBMJOH CFSHBOUJBO EJ JTUJSBIBU CJBTBOZB TFKVNMBI UFHBOHBO NBTJI UFUBQ BEB 5FHBOHBO JOJ
BOUBSB TBUV VOJU NPUPSJL EBO VOJU NPUPSJL MBJOOZB TFIJOHHB EJTFCVU UPOVT PUPU 0MFI LBSFOB TFSBCVU PUPU SBOHLB OPSNBM UJEBL
NFOJNCVMLBOLPOUSBLTJZBOHIBMVTCBILBOQBEBGSFLVFOTJTJOZBMTBSBG BLBO CFSLPOUSBLTJ KJLB UJEBL BEB QPUFOTJBM BLTJ ZBOH NFSBOHTBOH
ZBOHSFOEBI TFSBCVU UFSTFCVU UPOVT PUPU SBOHLB TFDBSB LFTFMVSVIBO EJIBTJMLBO
Frekuensi Sumasi dan Tetanisasi (BNCBS EBSJ JNQVMT TBSBG CFSLFDFQBUBO SFOEBI ZBOH CFSBTBM EBSJ NFEVMB
NFNQFSMJIBULBO QSJOTJQQSJOTJQ GSFLVFOTJ TVNBTJ EBO UFUBOJTBTJ ,F TQJOBMJT*NQVMTTBSBGJOJ TFCBMJLOZB EJBUVSTFCBHJBOPMFITJOZBMZBOH
BSBI LJSJ UFSMJIBU NBTJOHNBTJOH LPOUSBLTJ LFEVUBO ZBOH UFSKBEJ TBUV EJKBMBSLBO EBSJ PUBL LF NPUPOFVSPO BOUFSJPS NFEVMB TQJOBMJT ZBOH
QFSTBUV QBEB GSFLVFOTJ QFSBOHTBOHBO ZBOH SFOEBI ,FNVEJBO LFUJLB TFTVBJ EBOTFCBHJBOMBHJPMFITJOZBMZBOHCFSBTBMEBSJHFMFOEPOHPUPU
GSFLVFOTJNFOJOHLBU TBNQBJMBIQBEBTVBUVUJUJLLFUJLBLPOUSBLTJZBOH ZBOH UFSEBQBU EJ EBMBN PUPU JUV TFOEJSJ ,FEVB IBM JOJ BLBO
CBSV UJNCVM TFCFMVN LPOUSBLTJ ZBOH UFSEBIVMV CFSBLIJS 4FCBHBJ EJEJTLVTJLBO EJ #BC EBMBN IVCVOHBOOZB EFOHBO GVOHTJ NFEVMB
BLJCBUOZB TFCBHJBO LPOUSBLTJ ZBOH LFEVB BLBO EJUBNCBILBO QBEB TQJOBMJTEBOHFMFOEPOHPUPU
LPOUSBLTJZBOHQFSUBNB TFIJOHHBLFLVBUBOLPOUSBLTJUPUBMNFOJOHLBU Kelelahan Otot. ,POUSBLTJ PUPU ZBOH LVBU EBO MBNB
TFDBSBQSPHSFTJGCFSTBNBEFOHBOQFOJOHLBUBOGSFLVFOTJ#JMBGSFLVFOTJ NFOHBLJCBULBO LFBEBBO ZBOH EJLFOBM TFCBHBJ LFMFMBIBO PUPU
NFODBQBJ UJUJL LSJUJT UFSKBEJOZB LPOUSBLTJ CFSJLVUOZB BLIJSOZB 1FOFMJUJBOQBEBBUMFUNFOVOKVLLBOCBIXBLFMFMBIBOPUPUNFOJOHLBU
NFOKBEJCFHJUVDFQBU IBNQJSCFSCBOEJOHMBOHTVOHEFOHBOLFDFQBUBOQFOHVSBOHBO
80
HMJLPHFO PUPU 0MFI LBSFOB JUV LFMFMBIBO UFSVUBNB EJTFCBCLBO 1PTJTJNBTJOHNBTJOHCBHJBOUVCVIZBOHUFSQJTBI TFQFSUJTBUV
LFUJEBLNBNQVBOQSPTFTLPOUSBLTJEBONFUBCPMJTNFTFSBCVUPUPUVOUVLUFSVT MFOHBOBUBVTBUVUVOHLBJ EJUFOUVLBOPMFIEFSBKBULPOUSBLTJSFMBUJG
NFNCFSJLBO IBTJM LFSKB ZBOH TBNB 5BQJ QFSDPCBBOQFSDPCBBO KVHB UFMBI EBSJ TFSBOHLBJBO PUPU BHPOJT EBO BOUBHPOJT $POUPI NBSJ LJUB
NFOVOKVLLBO CBIXB USBOTNJTJ TJOZBM TBSBG JOFMBMVJ UBVU TBSBG PUPU ZBOH BTVNTJLBO CBIXB TBUV MFOHBO BUBV TBUV UVOHLBJ EJUFNQBULBO
EJCJDBSBLBOEJ#BC EBQBUCFSLVSBOHTFUJEBLOZBEBMBNKVNMBILFDJMTFUFMBI QBEBQPTJTJUFOHBI6OUVLNFODBQBJIBMJOJ PUPUPUPUBHPOJTEBO
BLUJWJUBT PUPU ZBOH MBNB EBO JOUFOTJG TFIJOHHB NFOHVSBOHJ LPOUSBLTJ PUPU BOUBHPOJT UFSFLTJUBTJ LJSBLJSB TBNB LVBU JOHBUMBI CBIXB PUPU
UNIT II
MFCJI MBOKVU )BNCBUBO BMJSBO EBSBI ZBOH NFOVKV PUPU ZBOH TFEBOH ZBOH MFCJI QBOKBOH BLBO CFSLPOUSBLTJ EFOHBO LFLVBUBO ZBOH
CFSLPOUSBLTJNFOZFCBCLBOLFMFMBIBOPUPUIBNQJSTFNQVSOBEBMBNTBUVBUBV MFCJI CFTBS EBSJQBEB PUPU ZBOH QFOEFL ZBOH EJQFSMJIBULBO QBEB
NFOJULBSFOBLFIJMBOHBOTVQMBJNBLBOBO UFSVUBNBLFIJMBOHBOPLTJHFO (BNCBS OBNQBL CBIXB UFSEBQBU LFLVBUBO LPOUSBLTJ
NBLTJNVN QBEB QBOKBOH PUPU GVOHTJPOBM ZBOH MFOHLBQ EBO
Sistem Pengungkit Tubuh 0UPU CFLFSKB EFOHBO NFNCFSJLBO IBNQJS UJEBL BEB LFLVBUBO LPOUSBLTJ BQB QVO QBEB TFUFOHBI
UFHBOHBO QBEB UFNQBUUFNQBU JOTFSTJ EJ EBMBN UVMBOH EBO UVMBOHUVMBOH
QBOKBOHOPSNBM0MFILBSFOBJUV PUPUPUPUQBOKBOHQBEBTBUVTJTJ
LFNVEJBO NFNCFOUVL CFSCBHBJ KFOJT TJTUFN QFOHVOHLJU (BNCBS
TFOEJ EBQBU CFSLPOUSBLTJ EFOHBO LFLVBUBO ZBOH KBVI MFCJI CFTBS
NFMVLJTLBO TJTUFN QFOHVOHLJU ZBOH EJBLUJGLBO PMFI PUPU CJTFQT VOUVL
EBSJQBEB PUPU ZBOH MFCJI QFOEFL QBEB TJTJ ZBOH CFSMBXBOBO
NFOHBOHLBUMFOHBOCBXBI#JMBLJUBNFOHBOHHBQCBIXBTFCVBIPUPUCJTFQT
,FUJLBTFCVBIMFOHBOBUBVUVOHLBJCFSHFSBLLFBSBIQPTJTJUFOHBI
ZBOHCFTBSNFJOQVOZBJMVBTQPUPOHBONFMJOUBOHTFCFTBSJODJQFSTFHJ NBLB
LFLVBUBO PUPU ZBOH MFCJI QBOKBOH BLBO CFSLVSBOH TFNFOUBSB
LFLVBUBO LPOUSBLTJ NBLTJNBM BEBMBI TFLJUBS QPO #JMB MFOHBO CBXBI
LFLVBUBO PUPU ZBOH MFCJI QFOEFL BLBO NFOJOHLBU TBNQBJ LFEVB
CFSBEB UFQBU QBEB TVEVU TJLVTJLV EFOHBO MFOHBO BUBT QFSMFLBUBO UFOEP
LFLVBUBOTFUBSBTBUVTBNBMBJO1BEBUBIBQJOJ QFSHFSBLBOMFOHBO
CJTFQT LJSBLJSB JODJ EJ TFCFMBI BOUFSJPS EBSJ GVMLSVN TFOEJ TJLV EBO
BUBV UVOHLBJ BLBO CFSIFOUJ +BEJ EFOHBO NFMBLVLBO WBSJBTJ
QBOKBOHTFMVSVIQFOHVOHLJUMFOHBOCBXBILJSBLJSBJODJ0MFILBSFOBJUV
QFSCBOEJOHBO EFSBKBU BLUJWBTJ PUPUPUPU BHPOJT EBO BOUBHPOJT
KVNMBI EBZB BOHLBU CJTFQT QBEB UBOHBO IBOZB TBUV QFS UVKVI EBSJ QPO
TJTUFNTBSBGJOFOFOUVLBOQPTJTJMFOHBOBUBVUVOHLBJ
LFLVBUBO PUPU BUBV LJSBLJSB QPO #JMB MFOHBO EBMBN LFBEBBO FLTUFOTJ
QFOVI QFSMFLBUBO CJTFQT BLBO MFCJI QFOEFL EBSJ JODJ EJ TFCFMBI BOUFSJPS ,JUB BLBO NFOHFUBIVJ EJ 4BC CBIXB TJTUFN TBSBG NPUPSJL
GVMLSVN EBOLFLVBUBOZBOHEBQBUNFOHHFSBLLBOUBOHBOLFEFQBOKVHBMFCJI NFNJMJLJ NFLBOJTNF QFOUJOH UBNCBIBO VOUVL NFOHPNQFOTBTJ
LFDJMEBSJQPO CFSCBHBJCFCBOPUPULFUJLBNFOHBSBILBOQSPTFTQFOFNQBUBOQPTJTJ
JOJ
4FDBSB TJOHLBU TVBUV BOBMJTJT NFOHFOBJ TJTUFN QFOHVOHLJU UVCVI
CFSHBOUVOH QBEB QFOHFUBIVBO UFOUBOH
UFNQBUUFNQBU JOTFSTJ PUPU
Remodeling Otot untuk Penyesuaian Fungsi
KBSBLOZBEBSJGVMLSVNQFOHVOHLJU
QBOKBOHMFOHBOQFOHVOHLJU EBO
4FNVB PUPU UVCVI TFDBSB UFSVTNFOFSVT EJCFOUVL LFNCBMJ
QPTJTJ QFOHVOHLJU 5VCVI NFNCVUVILBO CBOZBL KFOJT QFSHFSBLBO EBO SFNPEFMFE
VOUVL NFOZFTVBJLBO GVOHTJGVOHTJ ZBOH EJCVUVILBO
CFCFSBQB EJ BOUBSBOZB NFNCVUVILBO LFLVBUBO ZBOH CFTBS TFSUB CFCFSBQB NFSFLB %JBNFUFSOZB EJVCBI QBOKBOHOZB EJVCBI LFLVBUBOOZB
ZBOH MBJO NFNCVUVILBO KBSBL QFSHFSBLBO ZBOH KBVI 0MFI LBSFOB JUV BEB EJVCBI TVQMBJQFNCVMVIEBSBIOZBEJVCBI EBOCBILBOUJQFTFSBCVU
CFSNBDBNNBDBNPUPUCFCFSBQBPUPUVLVSBOOZBQBOKBOHEBOCFSLPOUSBLTJ PUPUOZB EJVCBI TFUJEBLOZB IBOZB TFEJLJU 1SPTFT QFOHVCBIBO
MBNB EBO CFCFSBQB ZBOH MBJO VLVSBOOZB QFOEFL UFUBQJ NFNQVOZBJ MVBT CFOUVLJOJ SFNPEFMJOH
TFSJOHLBMJCFSMBOHTVOHDFQBU EBMBNXBLUV
QPUPOHBO NFMJOUBOH ZBOH CFTBS EBO EBQBU NFOHIBTJMLBO LFLVBUBO CFCFSBQB NJOHHV 5FSOZBUB QFSDPCBBO QBEB IFXBO UFMBI
LPOUSBLTJ ZBOH FLTUSFN QBEB KBSBL ZBOH QFOEFL 1FOFMJUJBO NFOHFOBJ NFOVOKVLLBO CBIXB QSPUFJO LPOUSBLUJM PUPU QBEB PUPU ZBOH MFCJI
CFSCBHBJ KFOJT PUPU TJTUFN QFOHVOHLJU EBO QFOHFSBLBOOZB EJTFCVU LFDJMEBOBLUJGEBQBUEJHBOUJTFTJOHLBUNJOHHV
LJOFTJPMPHJ EBO NFSVQBLBO LPNQPOFO JMNV QFOHFUBIVBO ZBOH TBOHBU
QFOUJOHQBEBGJTJPBOBUPNJNBOVTJB Hipertrofi Otot dan Atrofi Otot#JMBNBTTBUPUBMTVBUVPUPU
NFOJOHLBU QFSJUJXB JOJ EJTFCVU IJQFSUSPGJ PUPU #JMB NBTTBOZB
"Sikap Posisi suatu Bagian Tubuh Akibat Kontraksi Otot JOFOVSVO QSPTFTJOJEJTFCVUBUSPGJPUPU
Agonis dan Antagonis pada Sisi Sendi yang Berlawanan 4FCFOBSOZB TFNVB IJQFSUSPGJ PUPU BEBMBI BLJCBU EBSJ TVBUV
—"Koaktivasi" Otot Antagonis )BNQJS TFNVB HFSBLBO UVCVI QFOJOHLBUBO KVNMBI GJMBNFO BLUJO EBO NJPTJO EBMBN TFUJBQ
EJTFCBCLBO PMFI LPOUSBLTJ PUPU BHPOJT EBO BOUBHPOJT QBEB TJTJ TFOEJ ZBOH TFSBCVUPUPU NFOZFCBCLBOQFNCFTBSBONBTJOHNBTJOHTFSBCVU
CFSMBXBOBOZBOHCFSMBOHTVOHCFSTBNBTBNB,FBEBBOJOJEJTFCVULPBLUJWBTJ PUPU IBM JOJ TFDBSB TFEFSIBOB EJTFCVU IJQFSUSPGJ TFSBCVU
PUPUBHPOJTEBOBOUBHPOJT EBOEJLFOEBMJLBOPMFIQVTBULPOUSPMNPUPSJLPUBL )JQFSUSPGJZBOHTBOHBUMVBTEBQBUUFSKBEJCJMBPUPUPUPUEJCFSJLBO
EBONFEVMBTQJOBMJT CFCBO TFMBNB QSPTFT LPOUSBLTJ 6OUVL NFOHIBTJMLBO IJQFSUSPGJ
IBNQJS NBLTJNVN EBMBN XBLUV TBNQBJ NJOHHV IBOZB
EJCVUVILBOTFEJLJULPOUSBLTJLVBUTFUJBQIBSJOZB
#BHBJNBOB LPOUSBLTJ ZBOH TBOHBU LVBU JOJ EBQBU NFOJNCVMLBO
IJQFSUSPGJ NBTJI CFMVN EJLFUBIVJ /BNVO UFMBI EJLFUBIVJ CBIXB
TFMBNB UFSKBEJ IJQFSUSPGJ TJOUFTJT QSPUFJO LPOUSBLUJM PUPU
CFSMBOHTVOH KBVI MFCJI DFQBU TFIJOHHB KVHB NFOHIBTJMLBO KVNMBI
GJMBNFOBLUJOEBONJPTJOZBOHCFSUBNCBICBOZBLTFDBSBQSPHSFTJG
EJ EBMBN NJPGJCSJM ZBOH TFSJOH LBMJ NFOJOHLBU TBNQBJ QFSTFO
,FNVEJBO UFMBIEJBNBUJCBIXBCFCFSBQBNJPGJCSJMJUVTFOEJSJBLBO
NFNFDBI EJ EBMBN PUPU ZBOH NFOHBMBNJ IJQFSUSPGJ VOUVL
NFNCFOUVL NJPGJCSJM ZBOH CBSV OBNVO LFQFOUJOHBO IBM JOJ QBEB
IJQFSUSPGJPUPUCJBTBCFMVNEJLFUBIVJ
#FSTBNBEFOHBOQFOJOHLBUBOVLVSBONJPGJCSJM TJTUFNFO[JN
ZBOH NFOZFEJBLBO FOFSHJ KVHB CFSUBNCBI )BM JOJ UFSVUBNB
UFSKBEJ QBEB FO[JNFO[JN ZBOH EJQBLBJ VOUVL HMJLPMJTJT ZBOH
NFNVOHLJOLBOUFSKBEJOZBQFOZFEJBBOFOFSHJZBOHDFQBUTFMBNB
LPOUSBLTJPUPUZBOHLVBUEBOTJOHLBU
81
#JMB TVBUV PUPU UJEBL EJHVOBLBO TFMBNB CFSNJOHHV NJOHHV IBSJ BUBV EFOHBO NFOHHVOBLBO BMBUBMBU ZBOH NFNQFSUBIBOLBO
LFDFQBUBO QFOHIBODVSBO QSPUFJO LPOUSBLUJM BLBO CFSMBOHTVOH MFCJI PUPUPUPUBHBSUFUBQUFSFHBOHTFMBNBQSPTFTBUSPGJCFSMBOHTVOH
DFQBUEBSJQBEBLFDFQBUBOQFOHHBOUJBOOZB0MFILBSFOBJUV UFSKBEJBUSPGJ
PUPU +BMVS ZBOH NVODVM VOUVL NFOKFMBTLBO TFCBHJBO CFTBS EFHSBEBTJ Pemulihan Kontraksi Otot pada Poliomielitis Pembentukan
QSPUFJO QBEB PUPU ZBOH NFOHBMBNJ BUSPGJ BEBMBI KBMVS "51EFQFOEFOU
Unit Makromotor.#JMBCFCFSBQBOBNVOUBLTFNVBTFSBCVUTBSBGZBOH
VCJRVJUJOQSPUFBTPNF 1SPUFBTPNF BEBMBI LPNQMFLT QSPUFJO CFTBS ZBOH NFOVKV PUPU NFOHBMBNJ LFSVTBLBO TFQFSUJ ZBOH VNVNOZB UFSKBEJ QBEB
QPMJPNJFMJUJT TFSBCVU TBSBG ZBOH UFSTJTB BLBO CFSDBCBOH VOUVL
NFOEFHSBEBTJQSPUFJOSVTBLBUBVQSPUFJOZBOHUJEBLEJCVUVILBOEFOHBO
NFNCFOUVL BLTPOCBSV ZBOH LFNVEJBO NFNQFSTBSBGJ CBOZBL TFSBCVU
DBSB QSPUFPMJTJT SFBLTJ LJNJB ZBOH NFNFDBI JLBUBO QFQUJEB 6CJRVJUJO
PUPU ZBOH QBSBMJTJT 1FSJTUJXB JOJ BLBO NFOHIBTJMLBO VOJU NPUPSJL ZBOH
BEBMBI QSPUFJO QFOHBUVS ZBOH QBEB EBTBSOZB NFOBOEBJ TFM NBOB ZBOH
CFTBS ZBOH EJTFCVU VOJU NBLSPNPUPS ZBOH EBQBU NFOHBOEVOH TFSBCVU
BLBONFOKBEJUBSHFUEFHSBEBTJQSPUFPTPNBM
PUPU TFCBOZBL MJNB LBMJ KVNMBI OPSNBM VOUVL TFUJBQ NPUPOFVSPO ZBOH
CFSBTBM EBSJ NFEVMB TQJOBMJT )BM JOJ BLBO NFOHVSBOHJ LFIBMVTBO
Penyesuaian Panjang Otot #JMB PUPU EJSFHBOHLBO IJOHHB QFOHBUVSBO ZBOH LJUB NJMJLJ EJ TFMVSVI PUPU UFUBQJ NFNVOHLJOLBO PUPU
QBOKBOHOZBNFMFCJIJOPSNBM EBQBUUFSKBEJKFOJTIJQFSUSPGJZBOH PUPUNFNQFSPMFILFLVBUBOOZBEFOHBOEFSBKBULFLVBUBOZBOHCFSWBSJBTJ
MBJO 1FSJTUJXB JOJ NFOZFCBCLBO CFSUBNCBIOZB TBSLPNFS CBSV
QBEB VKVOH TFSBCVU PUPU UFNQBU PUPU NFMFLBU QBEB UFOEPO #FCFSBQBKBNTFUFMBILFNBUJBO TFNVBPUPUUVCVINBTVLEBMBNLFBEBBO
#BILBO TBSLPNFS EBQBU EJUBNCBILBO EFOHBO LFDFQBUBO LPOUSBLUVS ZBOH EJTFCVU SJHPS NPSUJT ZBJUV PUPUPUPU CFSLPOUSBLTJ EBO
CFCFSBQB TBSLPNFS QFS NFOJU QBEB PUPU ZBOH CBSV CFS NFOKBEJ LBLV NFTLJQVO UJEBL UFSEBQBU QPUFOTJBM BLTJ ,FLBLVBO JOJ
LFNCBOH ZBOHNFMVLJTLBOLFDFQBUBOKFOJTIJQFSUSPGJJOJ CFSBTBM EBSJ LFIJMBOHBO TFNVB "51 ZBOH EJCVUVILBO VOUVL
4FCBMJLOZB CJMB TVBUV PUPU TFDBSB UFSVTNFOFSVT UFUBQ NFOZFCBCLBOQFNJTBIBOKFNCBUBOTJMBOHEBSJGJMBNFOBLUJOTFMBNBQSPTFT
NFNFOEFLIJOHHBLVSBOHEBSJQBOKBOHOPSNBMOZB TBSLPNFS SFMBLTBTJ 0UPU UFUBQ CFSBEB EBMBN LFBEBBO LBLV TBNQBJ QSPUFJO PUPU
NFOHBMBNJ LFSVTBLBO TFUFMBI TBNQBJ KBN LFNVEJBO ZBOH
TBSLPNFS QBEB VKVOHVKVOH TFSBCVU PUPU EBQBU CFOBSCFOBS
EJBTVNTJLBO UFSKBEJ BLJCBU BVUPMJTJT PMFI FO[JNFO[JN ZBOH EJLFMVBSLBO
NFOHIJMBOH .FMBMVJ QSPTFT JOJMBI PUPU TFDBSB LPOUJOV EBSJ MJTPTPN 4FMVSVI QSPTFT JOJ CFSMBOHTVOH MFCJI DFQBU QBEB TVIV ZBOH
EJCFOUVL LFNCBMJ VOUVL NFODBQBJ QBOKBOH ZBOH TFTVBJ CBHJ MFCJIUJOHHJ
LPOUSBLTJPUPUUFSUFOUV
Daftar Pustaka
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EBSJ XBLUV UFSTFCVU CVMBO
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NFOKBEJTFNBLJOCFSLVSBOH EBOTFUFMBITBNQBJUBIVOUJEBL actin cytoskeleton in time and space, Physiol Rev 88:1, 2008.
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+BSJOHBO GJCSPTB ZBOH NFOHHBOUJLBO TFSBCVUTFSBCVU PUPU
anisms and impact on muscle force production, Physiol Rev 88:1243,
TFMBNB BUSPGJ BLJCBU EFOFSWBTJ KVHB NFNJMJLJ LFDFOEFSVOHBO 2008.
VOUVL UFSVT NFNFOEFL TFMBNB CFSCVMBOCVMBO ZBOH EJTFCVU Sandri M: Signaling in muscle atrophy and hypertrophy, Physiology
LPOUSBLUVS 0MFI LBSFOB JUV TBUV NBTBMBI ZBOH QBMJOH QFOUJOH (Bethesda) 160, 2008.
EBMBN NFMBLVLBO UFSBQJ GJTJL BEBMBI NFNQFSUBIBOLBO PUPU Sieck GC, Regnier M: Plasticity and energetic demands of contraction in
ZBOH TFEBOH NFOHBMBNJ BUSPGJ JOJ BHBS UJEBL NFOHBMBNJ skeletal and cardiac muscle, J Appl Physiol 90:1158, 2001.
Treves S, Vukcevic M, Maj M, et al: Minor sarcoplasmic reticulum mem-
LFMFNBIBO EFCJMJUBUJOH
EBOLPOUSBLUVSZBOHNFSVTBLCFOUVL brane components that modulate excitation-contraction coupling in striated
)BMJOJEJDBQBJEFOHBONFMBLVLBOQFSFHBOHBOPUPUPUPUTFUJBQ muscles, J Physiol 587:3071, 2009.
82
BAB 7
&LTJUBTJ0UPU3BOHLB
1FOHIBOUBSBO4BSBG0UPU
EBO3BOHLBJBO&LTJUBTJ,POUSBLTJ
Penghantarkan Impuls dari EFOHBO DFQBU EJBCTPSCTJ LF EBMBN TFKVNMBI WFTJLFM TJOBQT ZBOH
Saraf ke Serabut Otot LFDJM LJSBLJSB ZBOHEBMBNLFBEBBOOPSNBMUFSEBQBUEJ
Rangka: Taut Saraf-Otot CBHJBO UFSNJOBM FOE QMBUF UVOHHBM %J SVBOH TJOBQT UFSEBQBU
4FSBCVU PUPU SBOHLB EJQFSTBSBGJ TFKVNMBI CFTBS FO[JN BTFUJMLPMJOFTUFSBTF ZBOH NFSVTBL
PMFI TFSBU TBSBG CFTBS EBO BTFUJMLPMJO CFCFSBQB NJMJEFUJL TFUFMBI EJLFMVBSLBO EBSJ WFTJLFM
CFSNJFMJO ZBOH CFSBTBM EBSJ TJOBQT
NPUPOFVSPOCFTBSQBEBLPSOV Sekresi Asetilkolin oleh Terminal Saraf
BOUFSJPS NFEVMB TQJOBMJT 4FQFSUJ ZBOH EJUFLBOLBO EJ #BC #JMBTVBUVJNQVMTTBSBGUJCBEJUBVUTBSBGPUPU TFLJUBSWFTJLFM
TFUJBQ TFSBU TBSBG TFUFMBI NFNBTVLJ CBHJBO QFSVU PUPU BTFUJMLPMJOEJMFQBTLBOEBSJUFSNJOBMEBONBTVLLFEBMBNSVBOH
OPSNBMOZB CFSDBCBOH EBO NFSBOHTBOH UJHB TBNQBJ CFCFSBQB TJOBQT #FCFSBQB EFUBJM EBSJ NFLBOJTNF JOJ EBQBU EJMJIBU QBEB
SBUVTTFSBCVUPUPUSBOHLB.BTJOHNBTJOHVKVOHTBSBGNFNCVBU (BNCBS ZBOH NFNQFSMJIBULBO TVBUV QBOEBOHBO ZBOH
TVBUV UBVU ZBOH EJTFCVU UBVU TBSBGPUPU EFOHBO TFSBCVU PUPU EJQFSCFTBSEBSJSVBOHTJOBQTEFOHBONFNCSBOTBSBGEJBUBTOZB
EFLBUQFSUFOHBIBOTFSBCVUOZB1PUFOTJBMBLTJZBOHEJCBOHLJULBO EBONFNCSBOPUPUTFSUBDFMBITVCOFVSBMEJCBHJBOCBXBI
QBEBTFSBCVUPUPUPMFITJOZBMTBSBGNFOKBMBSNFOVKVEVBBSBILF 1BEB TJTJ EBMBN QFSNVLBBO NFNCSBO TBSBG UFSEBQBU MJOFBS
LFEVBVKVOHTFSBCVUPUPU%FOHBOQFOHFDVBMJBOTFLJUBSQFSTFO EFOTF CBS ZBOH EJQFSMJIBULBO EBMBN CFOUVL QPUPOHBO
TFSBCVUPUPU IBOZBBEBTBUVUBVUTFNBDBNJOJQFSTFSBCVUPUPU NFMJOUBOHQBEB(BNCBS%JTFUJBQTJTJEBSJTFUJBQEFOTFCBS
UFSEBQBU QBSUJLFM QSPUFJO ZBOH NFOFNCVT NFNCSBO TBSBG
QBSUJLFM QSPUFJO JOJ NFSVQBLBO LBOBM LBMTJVN CFSQJOUV MJTUSJL
WPMUBHFHBUFE DBMDJVN DIBOOFMT
#JMB TVBUV QPUFOTJBM BLTJ
Anatomi Fisiologis Taut Saraf-Otot—Motor End Plate. NFOZFCBS LF TFMVSVI UFSNJOBM LBOBM JOJ BLBO UFSCVLB EBO
NFNVOHLJOLBO TFKVNMBI JPO LBMTJVN VOUVL CFSEJGVTJ EBSJ
(BNCBS"EBO#NFNQFSMJIBULBOUBVUTBSBGPUPUEBSJTFSBU SVBOH TJOBQT LF CBHJBO EBMBN UFSNJOBM TBSBG *POJPO LBMTJVN
TBSBG CFSNJFMJO ZBOH CFTBS LF TBUV TFSBCVU PUPU SBOHLB 4FSBU JOJ LFNVEJBO EJEVHB NFNQVOZBJ QFOHBSVI UBSJLBO UFSIBEBQ
TBSBG NFNCFOUVL TVBUV LPNQMFLT UFSNJOBM DBCBOH TBSBG ZBOH WFTJLFM BTFUJMLPMJO EBO NFOBSJLOZB LF NFNCSBO TBSBG ZBOH
CFSJOWBHJOBTJ LF QFSNVLBBO NPUPS FOE QMBUF .PUPS FOE QMBUF CFSEFLBUBO EFOHBO EFOTF CBS 7FTJLFM UFSTFCVU MBMV CFSGVTJ
EJUVUVQJ PMFI TBUV BUBV MFCJI TFM 4DIXBOO ZBOH NFOZFLBUOZB EFOHBO NFNCSBO TBSBG EBO NFOHFMVBSLBO BTFUJMLPMJOOZB LF
EBSJDBJSBOEJTFLFMJMJOHOZB EBMBNSVBOHTJOBQTNFMBMVJQSPTFTFLTPTJUPTJT
(BNCBS $ NFNQFSMJIBULBO TVBUV TLFUTB NJLSPHSBGJL 8BMBVQVO CFCFSBQB EFUBJM ZBOH UFMBI EJTFCVU EJ BUBT NBTJI
FMFLUSPO UBVU BOUBSB UFSNJOBM BLTPO UVOHHBM EBO NFNCSBO NFSVQBLBO EVHBBO UFMBI EJLFUBIVJ CBIXB SBOHTBOHBO ZBOH
TFSBCVUPUPU.FNCSBOZBOHNFOHBMBNJJOWBHJOBTJJUVEJTFCVU FGFLUJG BHBS BTFUJMLPMJO EBQBU EJMFQBTLBO EBSJ WFTJLFM BEBMBI
QBSJU TJOBQT BUBV QBMVOH TJOBQT EBO SVBOHBO BOUBSB UFSNJOBM NBTVLOZB JPO LBMTJVN EBO BTFUJMLPMJO EBMBN WFTJLFM UFSTFCVU
EBO NFNCSBO TFSBCVU EJTFCVU DFMBI TJOBQT BUBV SVBOH TJOBQT LFNVEJBO EJLPTPOHLBO NFMBMVJ NFNCSBO TBSBG ZBOH CFSEFLBUBO
$FMBITJOBQTJOJMFCBSOZBTBNQBJOBOPNFUFS1BEBCBHJBO EFOHBOEFOTFCBS
EBTBS QBSJU UFSEBQBU CBOZBL MJQBUBO NFNCSBO PUPU ZBOH MFCJI Pengaruh Asetilkolin terhadap Membran Serabut otot
LFDJM ZBOH EJTFCVU DFMBI TVCOFVSBU ZBOH TBOHBU NFNQFSMVBT Pascasinaps untuk Membuka Kanal lon.
QFSNVLBBOEBFSBIUFNQBUUSBOTNJUFSTJOBQUJLCFLFSKB (BNCBS NFNQFSMJIBULBO CBOZBL SFTFQUPS BTFUJMLPMJO ZBOH
%J UFSNJOBM BLTPO UFSEBQBU CBOZBL NJUPLPOESJB ZBOH LFDJM EBMBN NFNCSBO TFSBCVU PUPU JOJ NFSVQBLBO
NFOZFEJBLBO BEFOPTJO USJGPTGBU "51
ZBJUV TVNCFS FOFSHJ BDFUZMDIPMJOFHBUFE JPO DIBOOFMT LBOBM JPO EFOHBO QJOUV
ZBOH EJHVOBLBO VOUVL TJOUFTJT CBIBO USBOTNJUFS QFOHFLTJUBTJ ZBOH EJBLUJGLBO PMFI BTFUJMLPMJO
EBO LBOBM JPO UFSTFCVU
ZBLOJBTFUJMLPMJO"TFUJMLPMJOLFNVEJBONFOHFLTJUBTJNFNCSBO UFSMFUBL IBNQJS TFMVSVIOZB EFLBU NVMVU DFMBI TVCOFVSBM ZBOH
"TFUJMLPMJOEJTJOUFTJTEBMBNTJUPQMBTNBCBHJBOUFSNJOBM OBNVO UFSMFUBL UFQBU EJ CBXBI EBFSBI EFOTF CBS UFNQBU BTFUJMLPMJO
EJMFQBTLBOLFEBMBNSVBOHTJOBQT
83
A B
NPMFLVM BTFUJMLPMJO NFMFLBU TFDBSB CFSVSVUBO QBEB EVB QSPUFJO

TVCVOJU BMGB )BM JOJ NFOZFCBCLBO QFSVCBIBO CFOUVL ZBOH BLBO
NFNCVLB LBOBM TFQFSUJ ZBOH EJQFSMJIBULBO PMFI CBHJBO # QBEB
HBNCBS
,BOBM CFSQJOUV BTFUJMLPMJO LBOBM EFOHBO QJOUV ZBOH EJBLUJGLBO
PMFI BTFUJMLPMJO
NFNJMJLJ EJBNFUFS TFLJUBS OBOPNFUFS ZBOH
DVLVQCFTBSVOUVLNFNVOHLJOLBOJPOQPTJUJGZBOHQFOUJOHTFQFSUJ
OBUSJVN /B
LBMJVN ,
EBO LBMTJVN $B
EBQBU CFSHFSBL
EFOHBO NVEBI NFMFXBUJ QJOUV ZBOH UFSCVLB 4FCBMJLOZB JPOJPO
OFHBUJG TFQFSUJJPOLMPSJEB UJEBLEBQBUMFXBULBSFOBEJEBMBNNVMVU
LBOBM UFSEBQBU NVBUBO OFHBUJG ZBOH LVBU EBO NFOPMBL JPOJPO
OFHBUJGJOJ
4JOHLBUOZB UFSEBQBU KBVI MFCJI CBOZBL JPO OBUSJVN
ZBOH NFOHBMJS NFMBMVJ LBOBM CFSQJOUV VTFUJMLPMJO EBSJQBEB
JPO MBJO NBOB QVO IBM JOJ UFSKBEJ LBSFOB EVB BMBTBO CFSJLVU
1FSUBNB IBOZBUFSEBQBUEVBJPOQPTJUJGEBMBNLPOTFOUSBTJCFTBSJPO
OBUSJVN EBMBN DBJSBO FLTUSBTFMVMBS EBO JPO LBMJVN EBMBN DBJSBO
JOUSBTFMVMBS ,FEVB OJMBJ QPUFOTJBM OFHBUJG QBEB CBHJBO EBMBN
NFNCSBO PUPU TBNQBJ NJMJWPMU BLBO NFOBSJL JPO
OBUSJVNZBOHCFSNVBUBOQPTJUJGLFEBMBNTFSBCVU TFNFOUBSBTFDBSB
TJNVMUBO BLBO NFODFHBI LFMVBSOZB JPO LBMJVN CFSNVBUBO QPTJUJG
CJMBJPOJOJCFSVTBIBLFMVBS
4FQFSUJ ZBOH EJQFSMJIBULBO QBEB (BNCBS # FGFL VUBNB
4FUJBQSFTFQUPSNFSVQBLBOLPNQMFLTQSPUFJOZBOHNFNJMJLJ QFNCVLBBO LBOBM CFSQJOUVBTFUJMLPMJO BEBMBI NFNVOHLJOLBO
CFSBU NPMFLVM UPUBM TFCFTBS ,PNQMFLT JOJ UFSEJSJ BUBT TFKVNMBICFTBSJPOOBUSJVNEBQBUNFOHBMJSNBTVLLFEBMBNTFSBCVU
MJNBQSPUFJOTVCVOJU ZBJUVEVBQSPUFJOBMGBEBONBTJOHNBTJOH ZBOH CFSTBNB JPO UFSTFCVU UFSCBXB TFSUB TFKVNMBI CFTBS NVBUBO
TBUV QSPUFJO CFUB EFMUB EBO HBNNB .PMFLVM QSPUFJO JOJ QPTJUJG 1FSJTUJXB JOJ BLBO NFOJNCVMLBO TVBUV QFSVCBIBO QPUFOTJBM
NFOFNCVT NFNCSBO UFSMFUBL TBMJOH CFSTJTJBO EBMBN TVBUV QPTJUJG TFUFNQBU EJ EBMBN NFNCSBO TFSBCVU PUPU ZBOH EJTFCVU
MJOHLBSBO NFNCFOUVL LBOBM UVCVMBS ZBOH EJHBNCBSLBO QBEB QPUFOTJBM FOE QMBUF ,FNVEJBO QPUFOTJBM FOE QMBUF JOJ BLBO
(BNCBS ,BOBM UFUBQ CFSBEB EBMBN LFBEBBO LPOTUSJLTJ NFOJNCVMLBO TVBUV QPUFOTJBM BLTJ ZBOH NFOZFCBS EJ TFQBOKBOH
TFQFSUJZBOHEJUVOKVLLBOPMFICBHJBO"QBEBHBNCBS TBNQBJ NFNCSBOPUPUEBOTFMBOKVUOZBNFOZFCBCLBOLPOUSBLTJPUPU
84
Bab 7 Eksitasi Otot Rangka: Penghantaran Saraf-Otot dan Rangkaian Eksitasi-Kontraksi
Potensial End Plate dan Perangsangan Serabut Otot

Rangka *PO OBUSJVN ZBOH UJCBUJCB NBTVL LF EBMBN
– –
– – TFSBCVU PUPU LFUJLB LBOBM CFSQJOUV BTFUJMLPMJO BDFUZMDIPMJOF
– – HBUFE DIBOOFMT
UFSCVLB BLBO NFOZFCBCLBO QPUFOTJBM MJTSJL EJ
EBMBN TFSBCVU QBEB EBFSBI TFUFNQBU EJ FOE QMBUF BLBO
UNIT II
CFSUBNCBI EBMBN BSBI QPTJUJG TFCFTBS TBNQBJ NJMJWPMU
EBONFNCFOUVLQPUFOTJBMTFUFNQBUZBOHEJTFCVUQPUFOTJBMFOE
QMBUF *OHBUMBI LFNCBMJ EJ #BC CBIXB LFOBJLBO QPUFOTJBM
NFNCSBOTBSBGZBOHCFSMBOHTVOHUJCBUJCBMFCJIEBSJTBNQBJ
NJMJWPMU OPSNBMOZB TVEBI DVLVQ VOUVL NFOJNCVMLBO
BLUJWBTJ LBOBM OBUSJVN MFCJI CBOZBL MBHJ TFIJOHHB
NFOJNCVMLBOQPUFOTJBMBLTJQBEBNFNCSBOTFSBCVUPUPU
(BNCBS NFOKFMBTLBO QSJOTJQ TVBUV QPUFOTJBM FOE QMBUF
ZBOH NFOJNCVMLBO QPUFOTJBM BLTJ (BNCBS JOJ NFOVOKVLLBO
A UJHBQPUFOTJBMFOEQMBUFZBOHUFSQJTBI1PUFOTJBMFOEQMBUF"EBO
Na+ Ach $CFHJUVMFNBIVOUVLNFOJNCVMLBOTVBUVQPUFOTJBMBLTJ UFUBQJ
LFEVB QPUFOTJBM UFSTFCVU NFOHIBTJMLBO QFSVCBIBO WPMUBTF FOE
QMBUF TFUFNQBU ZBOH MFNBI TFQFSUJ UFSFLBN EBMBN HBNCBS
– – 4FCBMJLOZB QPUFOTJBM FOE QMBUF # KBVI MFCJI LVBU EBO
– – NFOZFCBCLBO DVLVQ CBOZBL LBOBM OBUSJVN UFSCVLB TFIJOHHB
– – FGFL QFNVMJIBO TFOEJSJ EBSJ TFNBLJO CBOZBLOZB JPO OBUSJVN
ZBOH NFOHBMJS LF CBHJBO EBMBN TFSBCVU BLBO NFOJNCVMLBO
TVBUV QPUFOTJBM BLTJ 1PUFOTJBM FOE QMBUF ZBOH MFNBI EJ UJUJL "
EJTFCBCLBO QFSBDVOBO TFSBCVU PUPU EFOHBO NFOHHVOBLBO
LVSBSF TVBUVPCBUZBOHEBQBUNFNCMPLLFSKBQJOUVBTFUJMLPMJO
QBEB LBOBM BTFUJMLPMJO EFOHBO DBSB CFSTBJOH NFOFNQBUJ
SFTFQUPS BTFUJMLPMJO 1PUFOTJBM FOE QMBUF ZBOH MFNBI EJ UJUJL $
EJTFCBCLBO PMFI QFOHBSVI UPLTJO CPUVMJOVN ZBJUV SBDVO
CBLUFSJ ZBOH NFOHVSBOHJ KVNMBI BTFUJMLPMJO ZBOH EJMFQBTLBO
PMFIUFSNJOBMTBSBG
B Faktor Keamanan Transmisi di Taut Saraf-Otot;
Keletihan di Taut. #JBTBOZB TFUJBQ JNQVMT ZBOH UJCB EJ UBVU
TBSBGPUPU BLBO NFOZFCBCLBO LFCVUVIBO QPUFOTJBM FOE QMBUF
TFLJUBS UJHB LBMJ MFCJI CBOZBL EBSJQBEB LFCVUVIBO VOUVL
NFSBOHTBOHTFSBCVUPUPU0MFILBSFOBJUVEJLBUBLBOUBVUTBSBG
PUPU ZBOH OPSNBM NFNQVOZBJ GBLUPS LFBNBOBO ZBOH UJOHHJ
#JBSQVO CFHJUV SBOHTBOHBO QBEB TFSBCVU TBSBG EFOHBO
LFDFQBUBO NFMFCJIJ LBMJ QFS EFUJL TFMBNB CFCFSBQB NFOJU
1FOHIBODVSBO"TFUJMLPMJOZBOH%JMFQBTLBOPMFI TFSJOH LBMJ BLBO NFOHVSBOHJ KVNMBI WFTJLFM BTFUJMLPMJO CFHJUV
"TFUJMLPMJOFTUFSBTF "TFUJMLPMJO CFHJUV EJMFQBTLBO LF EBMBN CBOZBLTFIJOHHBJNQVMTLFNVEJBOHBHBMNFNBTVLJTFSBCVU
SVBOH TJOBQT BLBO UFSVT NFOHBLUJGLBO SFTFQUPS BTFUJMLPMJO
TFMBNBBTFUJMLPMJOUFSTFCVUNFOFUBQEBMBNSVBOHBO/BNVO +60
EFNJLJBO BTFUJMLPMJO JOJ TFDBSB DFQBU BLBO EJTJOHLJSLBO +40
NFMBMVJ EVB DBSB
4FCBHJBO CFTBS BTFUJMLPMJO BLBO +20
EJIBODVSLBO PMFI FO[JN BTFUJMLPMJOFTUFSBTF ZBOH UFSVUBNB 0
UFSMFLBUQBEBTVBUVMBQJTBOTFQFSUJCVTBEJKBSJOHBOJLBUIBMVT –20
ZBOH NFOHJTJ SVBOH TJOBQT BOUBSB UFSNJOBM TBSBG QSFTJOBQT –40
EBONFNCSBOPUPUQBTDBTJOBQT
4FKVNMBILFDJMBTFUJMLPMJO –60
MBJOOZB BLBO CFSEJGVTJ LFMVBS EBSJ SVBOH TJOBQT EBO –80
LFNVEJBO UJEBL MBHJ UFSTFEJB VOUVL CFLFSKB QBEB NFNCSBO A B C
–100
TFSBCVUPUPU 0 15 30 45 60 75
8BLUV ZBOH TJOHLBU TBBU BTFUJMLPMJO NFOFUBQ EBMBN SVBOH
TJOBQT QBMJOH MBNB CFCFSBQB NJMJEFUJL OPSNBMOZB IBNQJS
TFMBMV DVLVQ VOUVL NFOHFLTJUBTJ TFSBCVU PUPU ,FNVEJBO
QFOHIBODVSBO BTFUJMLPMJO ZBOH DFQBU BLBO NFODFHBI
CFSMBOKVUOZB QFSBOHTBOHBO PUPU LFNCBMJ TFUFMBI TFSBCVU PUPU
EJQVMJILBOEBSJQFSNVMBBOQPUFOTJBMBLTJ
85
PUPU ,FBEBBO JOJ EJTFCVU LFMFMBIBO GBUJHVF

EJ UBVU TBSBG Obat yang Meningkatkan atau Memblok
PUPU EBO IBM JOJ TBNB EFOHBO FGFL ZBOH NFOZFCBCLBO Penghantaran di Taut Saraf-Otot
LFMFMBIBO TJOBQTTJOBQT EBMBN TJTUFN TBSBG QVTBU KJLB TJOBQT
UFSTFCVU EJFLTJUBTJ TFDBSB CFSMFCJIBO #JMB GVOHTJ CFSKBMBO Obat yang Merangsang Serabut Otot melalui Kerja Mirip
OPSNBM LFMFMBIBOCFSNBLOBEJUBVUTBSBGPUPUKBSBOHUFSKBEJ Mirip Asetilkolin#BOZBLTFOZBXB BOUBSBMBJONFUBLPMJO LBSCBLPM EBO
EBO CBILBO IBOZB UFSKBEJ QBEB UJOHLBU BLUJWJUBT PUPU ZBOH OJLPUJO NFNQVOZBJ QFOHBSVI ZBOH TBNB QBEB TFSBCVU PUPU TFQFSUJ
QBMJOHNFMFMBILBO ZBOH EJMBLVLBO PMFI BTFUJMLPMJO 1FSCFEBBO BOUBSB PCBUPCBU JOJ EBO
BTFUJMLPMJO JBMBI CBIXB PCBU JOJ UJEBL EJSVTBL PMFI LPMJOFTUFSBTF BUBV
EJSVTBLEFOHBOTBOHBUMBNCBUTFIJOHHBEBZBLFSKBPCBUUFSTFCVUTFSJOH
Biologi Molekuler Pembentukan dan NFOFUBQ TFMBNB CFCFSBQB NFOJU IJOHHB CFCFSBQB KBN 0CBU JOJ
Pelepasan Asetilkolin CFLFSKB EFOHBO NFOJNCVMLBO EBFSBI EFQPMBSJTBTJ ZBOH UFSCBUBT QBEB
MFNQFOH BLIJS NPUPSJL EJ NFNCSBO TFSBCVU PUPU UFNQBU SFTFQUPS
0MFI LBSFOB VLVSBO UBVU TBSBGPUPU DVLVQ CFTBS TFIJOHHB BTFUJMLPMJO CFSBEB ,FNVEJBO TFUJBQ LBMJ TFSBCVU PUPU QVMJI EBSJ
NVEBI EJQFMBKBSJ TJOBQT JOJ BEBMBI TBMBI TBUV EBSJ CFCFSBQB LPOUSBLTJTFCFMVNOZB EBFSBIEFQPMBSJTBTJJOJ CFSEBTBSLBOLFCPDPSBO
TJOBQT QBEB TJTUFN TBSBG ZBOH TFCBHJBO CFTBS QFOKBMBSBO JPOOZB BLBO NFOJNCVMLBO QPUFOTJBM BLTJ CBSV TFIJOHHB UFSKBEJ
LJNJBXJOZB UFMBI EJQFMBKBSJ 1FNCFOUVLBO EBO QFMFQBTBO LFBEBBOTQBTNFPUPU
BTFUJMLPMJOEJUBVUJOJUFSKBEJNFMBMVJCFCFSBQBUBIBQ Obat yang Merangsang Taut Saraf-Otot melalui Inaktivasi
1. 7FTJLFM LFDJM ZBOH CFSVLVSBO LJSBLJSB OBOPNFUFS EJCFOUVL Asetilkolinesterase. "EB UJHB NBDBN PCBU ZBOH UFMBI EJLFOBM EFOHBO
PMFI CBEBO (PMHJ EBMBN CBEBO TFM OFVSPO NPUPSJL EJ NFEVMB CBJL ZBLOJ OFPTUJHNJO GJTPTUJHNJO EBO EJJTPQSPQJM GMVPSPGPTGBU ZBOH
TQJOBMJT 7FTJLFM JOJ LFNVEJBO EJBOHLVU PMFI BLTPQMBTNB ZBOH NFOHJOBLUJWBTJ BTFUJMLPMJOFTUFSBTF EJ TJOBQT TFIJOHHB FO[MN UFSTFCVU
NFOHBMJS NFMBMVJ JOUJ BLTPO EBSJ CBEBO TFM QVTBU EJ NFEVMB 6OBL MBHJ NFOHIJESPMJTJT BTFUJMLPMJO "LJCBUOZB QBEB TFUJBQ JNQVMT
TQJOBMJTNFOVKVUBVUTBSBGPUPUZBOHUFSMFUBLEJVKVOHTFSBCVUTBSBG TBSBG ZBOH CFSVSVUBO TFKVNMBI CFTBS BTFUJMLPMJO BLBO UFSUJNCVO EBO
QFSJGFS ,JSBLJSB WFTJLFMWFTJLFM LFDJM JOJ CFSLVNQVM EJ TFMBOKVUOZB CFSVMBOHVMBOH NFSBOHTBOH TFSBCVU PUPU ,FBEBBO JOJ
CBHJBOUFSNJOBMTBSBGEBSJTFCVBIFOEQMBUFPUPUSBOHLB NFOJNCVMLBOTQBTNFPUPUCBILBOLFUJLBJNQVMTTBSBGNFODBQBJPUPU
4BZBOHOZB LFBEBBO JOJ KVHB EBQBU NFOJNCVMLBO LFNBUJBO BLJCBU
2. "TFUJMLPMJO EJTJOUFTJT EBMBN TJUPTPM TFSBCVU TBSBG UFSNJOBM TQBTNFMBSJOH ZBOHBLBONFODFLJLPSBOHUFSTFCVU
OBNVOLFNVEJBOTFHFSBEJBOHLVUNFMBMVJNFNCSBOWFTJLFM /FPTUJHNJO EBO GJTPTPUJHNJO ZBOH CFSLPNCJOBTJ EFOHBO
NFOVKV CBHJBO EBMBNOZB UFNQBU BTFUJMLPMJO EJTJNQBO BTFUJMLPMJOFTUFSBTF BLBO NFOHJOBLUJWBTJ BTFUJMLPMJOFTUFSBTF TFMBNB
EBMBN CFOUVL ZBOH TBOHBU QFLBU ZBJUV TFLJUBS CFCFSBQB KBN TFTVEBI JUV OFPTUJHNJO EBO GJTPTPUJHNJO EJQJOEBILBO
NPMFLVMBTFUJMLPMJOEBMBNTFUJBQWFTJLFM EBSJBTFUJMLPMJOFTUFSBTFTFIJOHHBBTFUJMLPMJOFTUFSBTFTFLBMJMBHJNFOKBEJ
3. #JMBTVBUVQPUFOTJBMBLTJUJCBQBEBUFSNJOBMTBSBG QPUFOTJBMBLTJJOJ BLUJG4FCBMJLOZB EJJTPQSPQJMGMVPSPTGPTGBUZBOHNFSVQBLBOHBTSBDVO
BLBO NFNCVLB CBOZBL LBOBM LBMTJVN EBMBN NFNCSBO TBSBG TBSBG ZBOH LVBU NFOHJOBLUJWBTJ BTFUJMLPMJOFTUFSBTF TFMBNB
UFSNJOBM TFCBC UFSNJOBM JOJ NFNJMJLJ LBOBM LBMTJVN CFSQJOUV CFSNJOHHVNJOHHV TFIJOHHB NFOKBEJLBOOZB TFCBHBJ SBDVO
MJTUSJL ZBOH NFMJNQBI "LJCBUOZB LPOTFOUSBTJ JPO LBMTJVN EJ NFNBUJLBOZBOHVUBNB
EBMBN NFNCSBO UFSNJOBM NFOJOHLBU TFLJUBS LBMJ MJQBU ZBOH Obat yang Menghambat Penghantaran di Taut Saraf-Otot
LFNVEJBO NFOJOHLBULBO MBKV GVTJ WFTJLFM BTFUJMLPMJO EFOHBO
NFNCSBO UFSNJOBM LJSBLJSB LBMJ MJQBU 'VTJ JOJ NFNCVBU 4FLFMPNQPL PCBUPCBUBO ZBOH EJLFOBM TFCBHBJ PCBU LVSBSJGPSN EBQBU
CBOZBL WFTJLFM QFDBI EBO NFOJNCVMLBO FLTPTJUPTJT BTFUJMLPMJO LF NFODFHBINBTVLOZBJNQVMTEBSJVKVOHTBSBGLFPUPU4FCBHBJDPOUPI
EBMBNSVBOHTJOBQT1BEBTFUJBQQPUFOTJBMBLTJCJBTBOZBTFLJUBS %UVCPLVSBSJO NFNCMPL LFSKB BTFUJMLPMJO QBEB SFTFQUPS BTFUJMLPMJO EJ
WFTJLFM QFDBI -BMV TFUFMBI CFCFSBQB NJMJEFUJL BTFUJMLPUJO TFSBCVUPUPU TFIJOHHBNFODFHBIUFSKBEJOZBQFOJOHLBUBOQFSNFBCJMJUBT
EJVSBJLBO PMFI BTFUJMLPMJOFTUFSBTF NFOKBEJ JPO BTFUBU EBO LPMJO LBOBMNFNCSBOPUPUZBOHDVLVQVOUVLNFNVMBJQPUFOTJBMBLTJ
EBOLPMJOEJSFBCTPSCTJTFDBSBBLUJGLFEBMBNUFSNJOBMTBSBGVOUVL
EJHVOBLBO LFNCBMJ CBHJ QFNCFOUVLBO BTFUJMLPMJO ZBOH CBSV Miastenia Gravis Menyebabkan Ketumpuhan Otot
4FMVSVI SBOHLBJBO QFSJTUJXB JOJ UFSKBEJ EBMBN XBLUV TBNQBJ
NJMJEFUJL .JBTUFOJBHSBWJT ZBOHUFSKBEJQBEBLJSBLJSBEBSJTFUJBQPSBOH
4. +VNMBIWFTJLFMZBOHUFSTFEJBEBMBNVKVOHTBSBGIBOZBDVLVQVOUVL NFOZFCBCLBO LFMVNQVIBO PUPU BLJCBU LFUJEBLNBNQVBO UBVU TBSBG
NFNVOHLJOLBOQFOHIBOUBSBOCFCFSBQBSJCVJNQVMTTBSBGLFPUPU PUPU VOUVL NFOHIBOUBSLBO DVLVQ TJOZBM EBSJ TFSBU TBSBG LF TFSBCVU
0MFI LBSFOB JUV BHBS GVOHTJ UBVU TBSBGPUPU EBQBU CFSKBMBO UFSVT PUPU 4FDBSB QBUPMPHJT EBMBN EBSBI TFCBHJBO CFTBS QBTJFO NJBTUFOJB
WFTJLFMCBSVQFSMVTFHFSBEJCFOUVLLFNCBMJ%BMBNXBLUVCFCFSBQB HSBWJT EJUFNVLBO BOUJCPEJ ZBOH NFOZFSBOH SFTFQUPS BTFUJMLPMJO 0MFI
EFUJL TFTVEBI TFUJBQ QPUFOTJBM BLTJ TFMFTBJ QBEB NFNCSBO TBSBG TFCBC JUV EJQFSDBZB CBIXB NJBTUFOJB HSBWJT NFSVQBLBO QFOZBLJU
UFSNJOBM NVODVM UFSPXPOHBO CFSMBQJT ZBOH EJTFCBCLBO PMFI BVUPJNVO LBSFOB QBEB QBTJFO JOJ UFSCFOUVL BOUJCPEJ ZBOH NFNCMPL
BEBOZB QSPUFJO LPOUSBLUJM QBEB VKVOH TBSBG LIVTVTOZB QSPUFJO BUBV NFSVTBL SFTFQUPS BTFUJMLPMJOOZB TFOEJSJ QBEB UBVU TBSBG PUPU
LMBUSJO ZBOHNFMFLBUQBEBNFNCSBOEJEBFSBIWFTJLFMBTBM%BMBN QBTDBTJOBQT
XBLUV LJSBLJSB EFUJL QSPUFJOQSPUFJO CFSLPOUSBLTJ EBO 5BOQB NFNQFSIBUJLBO QFOZFCBCOZB QPUFOTJBM FOE QMBUF ZBOH
NFOZFCBCLBO UFSPXPOHBO QFDBI LF CBHJBO EBMBN NFNCSBO UJNCVMEJEBMBNTFSBCVUPUPUVNVNOZBUFSMBMVMFNBIVOUVLNFNCVLB
TFIJOHHB NFNCFOUVL WFTJLFM CBSV %BMBN XBLUV CFCFSBQB EFUJL LBOBMOBUSJVNCFSQJOUVMJTUSJLTFIJOHHBEFQPMBSJTBTJTFSBCVUPUPUUJEBL
CFSJLVUOZB BTFUJMLPMJO EJUSBOTQPS LF EBMBN WFTJLFM JOJ EBO UFSKBEJ #JMB QFOZBLJU UFSTFCVU DVLVQ QBSBI QBTJFO NFOJOHHBM BLJCBU
TFMBOKVUOZB TJBQ VOUVL NBTVL EBMBN TJLMVT QFMFQBTBO BTFUJMLPMJO QBSBMJTJT UFSVUBNB QBSBMJTJT PUPU QFSOBQBTBO #JBTBOZB QFOZBLJU EBQBU
ZBOHCBSV EJTFNCVILBOTFMBNBCFCFSBQBKBNEFOHBOQFNCFSJBOOFPTUJHNJOBUBV
86
CFCFSBQBPCBUBOUJLPMJOFTUFSBTFMBJOOZB ZBOHBLBONFNVEBILBO 3. ,FDFQBUBO QFOHIBOUBSBO TBNQBJ NFUFSEFUJL LJSB

KBVI MFCJI CBOZBL BTFUJMLPMJO VOUVL CFSLVNQVM EJ SVBOH TJOBQT LJSBLBMJLFDFQBUBOQFOHIBOUBSBOQBEBTFSBCVUTBSBG
%BMBN XBLUV CFCFSBQB NFOJU CFCFSBQB QBTJFO ZBOH QBSBMJTJT JOJ CFTBSCFSNJFMJOZBOHNFSBOHTBOHPUPUSBOHLB
EBQBU NVMBJ CFSGVOHTJ IBNQJS OPSNBM TBNQBJ TFKVNMBI EPTJT
OFPTUJHNJOCBSVEJCVUVILBOLFNCBMJCFCFSBQBKBNLFNVEJBO Penyebaran Potensial Aksi ke Bagian Dalam Serabut
UNIT II
Otot melalui "Tubulus Transversa"
Potensial Aksi Otot 4FSBCVUPUPUSBOHLBEFNJLJBOCFTBSOZBTFIJOHHBQPUFOTJBM
BLTJZBOHNFOZFCBSEJTFQBOKBOHNFNCSBOQFSNVLBBOOZB
)BNQJS TFNVB ZBOH EJCJDBSBLBO EJ #BC NFOHFOBJ QFSNVMBBO IBNQJS UJEBL NFOJNCVMLBO BMJSBO EJ EBMBN TFSBCVU +BEJ
EBO QFOHIBOUBSBO QPUFOTJBM BLTJ EBMBN TFSBCVU TBSBG EBQBU VOUVL NFOJNCVMLBO LPOUSBLTJ PUPU NBLTJNVN BSVT
EJUFSBQLBO QBEB TFSBCVU PUPU SBOHLB LFDVBMJ VOUVL QFSCFEBBO MJTUSJLJOJIBSVTNFOFNCVTLFEBMBNTFSBCVUPUPUEJTFLJUBS
KVNMBI #FCFSBQB BTQFL LVBOUJUBUJG EBSJ QPUFOTJBM PUPU BEBMBI NJPGJCSJMZBOHUFSQJTBI)BMJOJEJDBQBJNFMBMVJQFOZFCBSBO
TFCBHBJCFSJLVU QPUFOTJBM BLTJ TFQBOKBOH UVCVMVT USBOTWFSTB UVCVMVT 5

ZBOHNFOFNCVTTFQFOVIOZBNFMBMVJTFSBCVUPUPUEBSJTBUV
1. 1PUFOTJBMNFNCSBOJTUJSBIBUTFLJUBSoTBNQBJoNJMJWPMU TJTJ TFSBCVU LF TJTJ MBJO TFQFSUJ ZBOH EJHBNCBSLBO QBEB
QBEBTFSBCVUPUPUSBOHLBTBNBTFQFSUJZBOHUFSEBQBUQBEBTFSBU 1PUFOTJBM BLTJ UVCVMVT 5 NFOZFCBCLBO
TBSBGCFTBSCFSNJFMJO QFMFQBTBO JPO LBMTJVN EJ EBMBN TFSBCVU PUPU LF TFLJUBS
2. %VSBTJ QPUFOTJBM BLTJ TBNQBJ NJMJEFUJL EJ PUPU SBOHLB NJPGJCSJM EBO JPO LBMTJVN JOJ LFNVEJBO NFOJNCVMLBO
LJSBLJSB MJNB LBMJ MFCJI MBNB EBSJQBEB EJ TBSBG CFTBS LPOUSBLTJ 4FMVSVI QSPTFT JOJ EJTFCVU SBOHLBJBO FLTJUBTJ
CFSNJFMJO LPOUSBLTJ
87
(BNCBS EBO NFOVOKVLLBO CBIXB QPUFOTJBM BLTJ EBSJ

Rangkaian Eksitasi-Kontraksi UVCVMVT 5 NFOZFCBCLBO BMJSBO BSVT LF EBMBN TJTUFSOB SFUJLVMVN
TBSLPQMBTNBEJUFNQBUTJTUFSOBUFSTFCVUCFSCBUBTBOEFOHBOUVCVMVT
5 4BBU QPUFOTJBM BLTJ TBNQBJ QBEB UVCVMVT5 QFSVCBIBO WPMUBTF
Sistem Tubulus Transversa Retikulum Sarkoplasma
JOJEJUFSJNBPMFISFTFQUPSEJIJESPQJSJEJOZBOHUFSJLBUEFOHBOLBOBM
(BNCBS NFOHHBNCBSLBO NJPGJCSJM ZBOH EJLFMJMJOHJ PMFI ZBOH NFMFQBTLBO LBMTJVN ZBOH EJTFCVU KVHB SZBOPEJOF SFDFQUPS
TJTUFN UVCVMVT 5SFUJLVMVN TBSLPQMBTNB 5VCVMVT 5 DIBOOFMT ZBOHCFSEFLBUBOEFOHBOTJTUFSOBSFUJLVMVNTBSLPQMBTNB
VLVSBOOZBLFDJMEBOCFSKBMBONFMJOUBOHLFNJPGJCSJM5VCVMVT MJIBU (BNCBS
"LUJWBTJ SFTFQUPS EJIZESPQZSJEJOF
JOJCFSNVMBQBEBNFNCSBOTFMEBOUFSVTNFOFNCVTEBSJTBUV NFODFUVTLBO QFNCVLBBO LBOBM ZBOH NFMFQBTLBO LBMTJVN EBMBN
TJTJ TFSBCVU PUPU LF TJTJ EJ IBEBQBOOZB 5JEBL UFSMJIBU EBMBN TJTUFSOB TFQFSUJ KVHB EBMBN UVCVMVT MPOHJUVEJOBM ZBOH NFMFLBU
HBNCBS BEBMBI LFOZBUBBO CBIXB UVCVMVTUVCVMVT JOJ QBEBOZB ,BOBM JOJ UFUBQ UFSCVLB TFMBNB CFCFSBQB NJMJEFUJL
CFSDBCBOH EJ BOUBSB UVCVMVT JUV TFOEJSJ EBO NFNCFOUVL NFMFQBTLBO JPO LBMTJVN LF EBMBN TBSLPQMBTNB EJ TFLFMJMJOH
IBNQBSBO UVCVMVT 5 ZBOH TBMJOH NFOKBMJO EJ BOUBSB TFMVSVI NJPGJCSJMEBONFOJNCVMLBOLPOUSBLTJ TFQFSUJZBOHEJCJDBSBLBOEJ
NJPGJCSJM ZBOH UFSQJTBI %FNJLJBO QVMB LBSFOB UVCVMVT 5 #BC
CFSBTBM EBSJ NFNCSBO TFM UVCVMVT UFSTFCVU BLBO UFSCVLB LF
Pompa Kalsium untuk Membuang lon Kalsium dari
BSBI MVBS TFSBCVU PUPU 0MFI TFCBC JUV UVCVMVT UFSTFCVU
Cairan Miofibril Setelah Terjadinya Kontraksi. 4FHFSB TFUFMBI
CFSIVCVOHBO EFOHBO DBJSBO FLTUSBTFMVMBS ZBOH NFOHFMJMJOHJ
JPO LBMTJVN EJLFMVBSLBO EBSJ UVCVMVT TBSLPQMBTNB EBO UFMBI
TFSBCVU PUPU EBO UVCVMVT 5 UFSTFCVU NFOHBOEVOH DBJSBO
CFSEJGVTJ EJ BOUBSB NJPGJCSJM LPOUSBLTJ PUPU UFSVT CFSMBOHTVOH
FLTUSBTFM EJ EBMBN MVNFOOZB %FOHBO LBUB MBJO UVCVMVT 5
TFMBNBLPOTFOUSBTJJPOLBMTJVNUFUBQUJOHHJ/BNVO TFCVBIQPNQB
TFCFOBSOZBNFSVQBLBOQFSMVBTBOCBHJBOEBMBNNFNCSBOTFM
LBMTJVN ZBOH UFSVTNFOFSVT BLUJG ZBOH UFSMFUBL EJ EJOEJOH
0MFI LBSFOB JUV CJMB QPUFOTJBM BLTJ NFOZFCBS LF TFMVSVI
SFUJLVMVN TBSLPQMBTNB BLBO NFNPNQB JPO LBMTJVN LFMVBS EBO
NFNCSBO TFSBCVU PUPU TVBUV QFSVCBIBO QPUFOTJBM KVHB
NJPGJCSJM LFNCBMJ LF EBMBN UVCVMVT TBSLPQMBTNB MJIBU (BNCBS
NFOZFCBS EJ TFQBOKBOH UVCVMVT 5 LF CBHJBO EBMBN TFSBCVU

1PNQB JOJ EBQBU NFNFLBULBO JPO LBMTJVN LJSBLJSB
PUPU "SVT MJTUSJL ZBOH NFOHFMJMJOHJ UVCVMVT 5 JOJ LFNVEJBO
LBMJMJQBUEJEBMBNUVCVMVT4FMBJOJUV EJEBMBNSFUJLVMVNUFSEBQBU
NFOZFCBCLBOLPOUSBLTJPUPU
TFCVBI QSPUFJO ZBOH EJTFCVU DBMTFRVFTUSJO ZBOH EBQBU NFOHJLBU
(BNCBS KVHB NFOVOKVLLBO SFUJLVMVN TBSLPQMBTNB IJOHHBLBMJMFCJICBOZBLLBMTJVN
EBMBN XBSOB LVOJOH 3FUJLVMVN TBSLPQMBTNB UFSEJSJ BUBT EVB "Pulsasi" Eksitatorik lon Kalsium. ,POTFOUSBTJ LFBEBBO
CBHJBO VUBNB
SVBOHBO CFTBS ZBOH EJTFCVU TJTUFSOB JTUJSBIBU OPSNBM NPMBS
JPO LBMTJVN EBMBN TJUPTPM ZBOH
UFSNJOBMJTZBOHCFSCBUBTBOEFOHBOUVCVMVT5 EBO
UVCVMVT NFMJOHLVQJ NJPGJCSJM UFSMBMV TFEJLJU VOUVL NFOJNCVMLBO
MPOHJUVEJOBMZBOHQBOKBOHEBONFMJOHLVQJTFMVSVIQFSNVLBBO LPOUSBLTJ 0MFI TFCBC JUV LPNQMFLT USPQPOJOUSPQPNJPTJO
NJPGJCSJMZBOHCFOBSCFOBSCFSLPOUSBLTJ NFOKBHB BHBS GJMBNFO BLUJO UFUBQ UFSIBNCBU EBO
NFNQFSUBIBOLBOLFBEBBOSFMBLTBTJPUPU
Pelepasan lon Kalsium oleh Retikulum Sarkoplasma 4FCBMJLOZB QFSBOHTBOHBO QFOVI TJTUFN UVCVMVT 5 EBO TJTUFN
4BMBI TBUV DJSJ JTUJNFXB EBSJ SFUJLVMVN TBSLPQMBTNB JBMBI SFUJLVMVN TBSLPQMBTNB NFOZFCBCLBO DVLVQ CBOZBL JPO LBMTJVN
CBIXB EJ EBMBN UVCVMVT WFTJLVMBSOZB UFSEBQBU LFMFCJIBO JPO ZBOH EJMFQBTLBO VOUVL NFOJOHLBULBO LPOTFOUSBTJOZB EJ EBMBN
LBMTJVNEBMBNLPOTFOUSBTJUJOHHJ EBOCBOZBLEBSJJPOJOJBLBO DBJSBONJPGJCSJMTFCBOZBLYNPMBSLPOTFOUSBTJ ZBJUV
EJMFQBTLBOEBSJTFUJBQWFTJLFMCJMBTVBUVQPUFOTJBMBLTJUFSKBEJEJ
UVCVMVT5ZBOHCFSEFLBUBO
+
+
+
Ca++
+
+
+
Ca++
+
+ Ca++
+
+
+
+
+
88
UNIT II
ATP
++
QFOJOHLBUBO LBMJ MJQBU ZBOH LJSBLJSB LBMJ OJMBJ ZBOH Fagerlund MJ, Eriksson LI: Current concepts in neuromuscular transmission,
BrJ Anaesth 103:108, 2009.
EJCVUVILBO VOUVL NFOZFCBCLBO LPOUSBLTJ PUPU NBLTJNVN
Haouzi P, Chenuel B, Huszczuk A: Sensing vascular distension in skeletal
4FHFSB TFTVEBIOZB QPNQB LBMTJVN BLBO NFOHPTPOHLBO JPO muscle by slow conducting afferent fibers: neurophysiological basis and
LBMTJVN MBHJ -BNBOZB QVMTBTJ LBMTJVN JOJ EBMBN TFSBCVU PUPU implication for respiratory controldApp/ Physiol 96:407, 2004.
SBOHLB CJBTB CFSMBOHTVOH LJSBLJSB EFUJL NFTLJQVO QBEB Hirsch NP: Neuromuscular junction in health and disease, Br J Anaesth
CFCFSBQBTFSBCVUEBQBUCFSMBOHTVOHCFCFSBQBLBMJMFCJIMBNBEBO 99:132, 2007.
QBEB TFSBCVU MBJO MFCJI TJOHLBU %J PUPU KBOUVOH QVMTBTJ LBMTJVN Keesey JC: Clinical evaluation and management of myasthenia gravis, Muscle
CFSMBOHTVOHTFLJUBSTFQFSUJHBEFUJLLBSFOBMBNBOZBQPUFOTJBMBLTJ Nerve 29:484, 2004.
Muscle Nerve 29:484, 2004.
KBOUVOH
Korkut C, Budnik V: WNTs tune up the neuromuscular junction, Nat Rev
Neurosci 10:627, 2009.
4FMBNB QVMTBTJ LBMTJVN JOJ UFSKBEJMBI LPOUSBLTJ PUPU Leite JF, Rodrigues-Pinguet N, Lester HA: Insights into channel function via
#JMB LPOTFOUSBTJ CFSMBOHTVOH UFSVTNFOFSVT UBOQB KFEB TFMBNB channel dysfunction, J Clin Invest 111:436, 2003.
JOUFSWBM XBLUV ZBOH MBNB TFSBOHLBJBO QVMTBTJ LBMTJVN TFNBDBN Meriggioli MN, Sanders DB: Autoimmune myasthenia gravis: emerg-
JOJ IBSVT EJUJNCVMLBO PMFI TFSBOHLBJBO QPUFOTJBM BLTJ ZBOH ing clinical and biological heterogeneity, Lancet Neurol 8:475,
CFSVMBOHVMBOH EBO UFSVTNFOFSVT TFQFSUJ ZBOH EJCJDBSBLBO EJ 2009.
Rekling JC, Funk GD, Bayliss DA, et al: Synaptic control of motoneuronal
#BC excitability, Physiol Rev 80:767, 2000.
Rosenberg PB: Calcium entry in skeletal muscle, J Physiol 587:3149,
Daftar Pustaka 2009.
Lihat juga daftar pustaka pada Bab 5 dan 6. Toyoshima C, Nomura H, Sugita Y: Structural basis of ion pumping
Brown RH Jr: Dystrophin-associated proteins and the muscular dystrophies, by Ca 2+-ATPase of sarcoplasmic reticulum, FEBS Lett 555:106,
Annu Rev Med 48:457, 1997. 2003.
Chaudhuri A, Behan PO: Fatigue in neurological disorders, Lancet 363:978, 2004. Van der Kloot W, Molgo J: Quantal acetylcholine release at the vertebrate
Cheng H, Lederer WJ: Calcium sparks, Physiol Rev 88:1491, 2008 neuromuscular junction, Physiol Rev 74:899, 1994.
Engel AG, Ohno K, Shen XM, Sine SM: Congenital myasthenic syndromes Vincent A: Unraveling the pathogenesis of myasthenia gravis, Nat Rev
Immunol 10:797, 2002.
multiple molecular targets at the neuromuscular junction, Ann N Y Acad Sci
Vincent A, McConville J, Farrugia ME, et al: Antibodies in myasthenia gravis
998:138, 2003.
and related disorders, Ann N Y Acad Sci 998:324, 2003.
BAB 8
UNIT II
&LTJUBTJEBO,POUSBLTJ0UPU1PMPT
Kontraksi Otot Polos PUPUJSJTNBUB EBOPUPUQJMPFSFLUPSZBOHNFOZFCBCLBOUFHBLOZB

SBNCVUCJMBEJSBOHTBOHPMFITJTUFNTBSBGTJNQBUJT
%J #BC EBO QFNCJDBSBBO LJUB
EJGPLVTLBO QBEB PUPU SBOHLB Otot Polos Unit-Tunggal. 5JQF PUPU QPMPT JOJ KVHB
4FLBSBOH LJUB CFSBMJI LF PUPU QPMPT EJTFCVUPUPUQPMPTTJOTJUJBMBUBVPUPUQPMPTWJTFSBM*TUJMBIVOJU
ZBOHUFSEJSJBUBTTFSBCVUTFSBCVULFDJM UVOHHBM CFSTJGBU NFNCJOHVOHLBO LBSFOB JTUJMBI JOJ CVLBO
VNVNOZBCFSEJBNFUFSTBNQBJ CFSBSUJ TVBUV TFSBCVU PUPU UVOHHBM +VTUSV JTUJMBI JOJ CFSBSUJ
MNEBOQBOKBOHOZBIBOZBTBNQBJMN4FCBMJLOZB TFSBCVU TVBUVNBTTBZBOHUFSEJSJBUBTCFSBUVTSBUVTTBNQBJCFSJCVSJCV
PUPUSBOHLBCFSEJBNFUFSLBMJMFCJICFTBSEBOCFSBUVTSBUVTLBMJ TFSBCVU PUPU QPMPT ZBOH CFSLPOUSBLTJ CFSTBNB TFCBHBJ TVBUV
MFCJI QBOKBOH #BOZBL QSJOTJQ LPOUSBLTJ ZBOH TBNB EBO CFSMBLV VOJUUVOHHBM 4FSBCVUTFSBCVU CJBTBOZB UFSTVTVO EBMBN CFOUVL
CBHJ PUPU QPMPT KVHB CFSMBLV CBHJ PUPU SBOHLB :BOH QBMJOH MFNCBSBO BUBV CFSLBT EBO NFNCSBO TFMOZB CFSMFLBUBO TBUV
QFOUJOH QBEB EBTBSOZB UFSEBQBU LFLVBUBO NFOBSJL ZBOH TBNB TBNBMBJOQBEBCBOZBLUJUJLTFIJOHHBLFLVBUBOZBOHUFSCFOUVL
BOUBSB GJMBNFO NJPTJO EBO BLUJO VOUVL NFOZFCBCLBO LPOUSBLTJ EBMBNTBUVTFSBCVUPUPUEBQBUEJKBMBSLBOLFTFSBCVUCFSJLVUOZB
QBEBPUPUSBOHLB OBNVOTVTVOBOGJTJLCBHJBOEBMBNTFSBCVUPUPU 4FMBJO JUV NFNCSBO TFM EJIVCVOHLBO PMFI CBOZBL UBVU JNCBT
QPMPTCFSCFEB HBQKVODUJPO
ZBOHEBQBUEJMBMVJPMFIJPOTFDBSBCFCBTEBSJTBUV
TFM PUPU LF TFM PUPU CFSJLVUOZB TFIJOHHB QPUFOTJBM BLTJ BUBV
BMJSBO JPO ZBOH TFEFSIBOB UBOQB QPUFOTJBM BLTJ EBQBU CFSKBMBO
EBSJ TBUV TFSBCVU LF TFSBCVU CFSJLVUOZB EBO NFOZFCBCLBO
Tipe-Tipe Otot Polos TFSBCVU PUPU EBQBU CFSLPOUSBLTJ CFSTBNB +FOJT PUPU QPMPT JOJ
KVHB EJLFOBM TFCBHBJ PUPU QPMPT TJOTJUJBM LBSFOB TJGBU BOUBS
0UPU QPMPT EBSJ TFUJBQ PSHBO KFMBT CFSCFEB EFOHBO LFCBOZBLBO
IVCVOHBO TJOTJUJBMOZB EJ BOUBSB TFSBCVU 0UPU JOJ KVHB EJTFCVU
PSHBO MBJO EBMBN CFCFSBQB IBM
VLVSBO GJTJL
TVTVOBO
PUPU QPMPT WJTFSBM LBSFOB PUPU JOJ EJUFNVLBO QBEB EJOEJOH
VOUVL NFNCFOUVL CFSLBT BUBV MFNCBSBO
SFTQPOT UFSIBEBQ
TFCBHJBO CFTBS PSHBO WJTFSB UVCVI UFSNBTVL USBLUVT
CFSCBHBJ KFOJT SBOHTBOHBO
TJGBU QFSTBSBGBO EBO
GVOHTJ
HBTUSPJOUFTUJOBM EVLUVT CJMJBSJT VSFUFS VUFSVT EBO CBOZBL
/BNVO VOUVL UVKVBO QFOZFEFSIBOBBO QBEB VNVNOZB PUPU
QFNCVMVIEBSBI
QPMPTEBQBUEJCBHJNFOKBEJEVBUJQFVUBNB TFQFSUJEJHBNCBSLBO
QBEB (BNCBS PUPU QPMPT NVMUJVOJU EBO PUPU QPMPT VOJUBSZ
BUBVVOJUUVOHHBM

Otot Polos Multi-Unit . 5JQFPUPUQPMPTJOJUFSEJSJBUBTTFSBCVU
PUPU QPMPT UFSTFOEJSJ EBO UFSQJTBI 5JBQ TFSBCVU CFLFSKB UBOQB d en isia
CFSHBOUVOHQBEBTFSBCVUMBJOEBOTFSJOHLBMJEJQFSTBSBGJPMFIVKVOH
TBSBG UVOHHBM TFQFSUJ ZBOH UFSKBEJ QBEB TFSBCVU PUPU SBOHLB
4FMBOKVUOZB QFSNVLBBO MVBS TFSBCVU JOJ TFQFSUJ IBMOZB QBEB
TFSBCVU PUPU SBOHLB EJUVUVQJ PMFI MBQJTBO UJQJT ZBOH UFSEJSJ BUBT
TVCTUBOTJ TFQFSUJ NFNCSBO CBTBM ZBLOJ DBNQVSBO LPMBHFO IBMVT ea
oo
EBO HMJLPQSPUFJO ZBOH NFNCBOUV NFOZFLBU TFSBCVUTFSBCVU ZBOH mediasi
UFSQJTBITBUVTBNBMBJO
ndo el
4JGBU UFSQFOUJOH EBSJ TFSBCVU PUPU QPMPT NVMUJVOJU BEBMBI
CBIXB NBTJOHNBTJOH TFSBCVU EBQBU CFSLPOUSBLTJ EFOHBO UJEBL
CFSHBOUVOH QBEB ZBOH MBJO EBO QFOHBUVSBOOZB UFSVUBNB
e i ke il
EJMBLVLBO PMFI TJOZBM TBSBG 4FCBMJLOZB QFOHBUVSBO PUPU QPMPT
A o olos li i B o olos ni nggal
VOJUUVOHHBM TFCBHJBO CFTBS EJQFSPMFI EBSJ SBOHTBOHBO OPOTBSBG
#FCFSBQBDPOUPIPUPUQPMPTNVMUJVOJUBEBMBIPUPUTJMJBSJTNBUB Gambar 8-1 Otot polos multi-unit (A) dan unit-tunggal (B)
91
Mekanisme Kontraksi pada Otot Polos

Dasar Kimiawi untuk Kontraksi Otot Polos
0UPU QPMPT NFOHBOEVOH GJMBNFO BLUJO EBO NJPTJO ZBOH
NFNQVOZBJ TJGBU LJNJBXJ NJSJQ EFOHBO TJGBU LJNJBXJ GJMBNFO
ilamen ilamen
BLUJOEBONJPTJOEJPUPUSBOHLB0UPUQPMPTUJEBLNFOHBOEVOH ak in
LPNQMFLTUSPQPOJOOPSNBMZBOHEJCVUVILBOQBEBQFOHBUVSBO
LPOUSBLTJ PUPU SBOHLB TFIJOHHB NFLBOJTNF QFOHBUVSBO
LPOUSBLTJOZB CFSCFEB )BM JOJ OBOUJ EJCJDBSBLBO TFDBSB MFCJI
EFUBJMEBMBNCBCJOJ ense odies
1FOFMJUJBOLJNJBXJUFMBINFOVOKVLLBOCBIXBGJMBNFOBLUJO
EBO NJPTJO ZBOH CFSBTBM EBSJ PUPU QPMPT TBMJOH CFSJOUFSBLTJ
BOUBSB TBUV TBNB MBJO EFOHBO DBSB ZBOH IBNQJS TBNB EJ PUPU
SBOHLB 4FMBOKVUOZB QSPTFT LPOUSBLTJ EJBLUJGLBO PMFI JPO
LBMTJVN EBO BEFOPTJO USJGPTGBU "51
EJQFDBI NFOKBEJ
BEFOPTJO EJGPTGBU "%1
VOUVL NFNCFSJLBO FOFSHJ CBHJ ilamen miosin
LPOUSBLTJ
/BNVO UFSEBQBUQFSCFEBBOCFTBSBOUBSBTVTVOBOGJTJLPUPU
QPMPT EBO PUPU SBOHLB EFNJLJBO KVHB QFSCFEBBO QBEB
SBOHLBJBOFLTJUBTJLPOUSBLTJ QFOHBUVSBOQSPTFTLPOUSBLTJPMFI
JPO LBMTJVN MBNBOZB LPOUSBLTJ EBO KVNMBI FOFSHJ ZBOH
EJCVUVILBOVOUVLLPOUSBLTJ
Dasar Fisika Kontraksi Otot Polos em an sel
0UPUQPMPTUJEBLNFNQVOZBJHBNCBSBOMVSJLGJMBNFOBLUJOEBO
NJPTJO ZBOH TBNB TFQFSUJ ZBOH EJKVNQBJ EJ PUPU SBOHLB
/BNVO UFLOJLNJLSPHSBGJFMFLUSPONFNCFSJLBOLFTBOBEBOZB
TVTVOBO GJTJL TFQFSUJ ZBOH EJQFSMJIBULBO QBEB (BNCBS
(BNCBS JOJ NFOVOKVLLBO TFKVNMBI CFTBS GJMBNFO BLUJO ZBOH
UFSMFLBU QBEB TFTVBUV ZBOH EJTFCVU CBEBO QSPUFJO QBEBU EFOTF
CPEJFT
#FCFSBQB EBSJ CBEBO JOJ NFMFLBU QBEB NFNCSBO TFM
TFEBOHLBO ZBOH MBJOOZB UFSTFCBS EJ EBMBN TFM #FCFSBQB
NFNCSBO CBEBO QBEBU EBSJ TFMTFM ZBOH CFSEFLBUBO UFSJLBU
CFSTBNBTBNB PMFI KFNCBUBO QSPUFJO BOUBSTFM 5FSVUBNB
NFMBMVJJLBUBOJOJMBILFLVBUBOLPOUSBLTJEJKBMBSLBOEBSJTBUVTFM k isik o o olos ea di sisi ki i a as
LFTFMCFSJLVUOZB mem e li a kan ilamen ak in ang meman a da i e e o ie
%JBOUBSBGJMBNFOBLUJOEBMBNTFSBCVUPUPUUFSEBQBUGJMBNFO ea ang di ki i a a dan diag am ang di se ela kanan
NJPTJO ZBOH UFSMFUBL CFSUFCBSBO 'JMBNFO NJPTJO JOJ NFNJMJLJ mem e li a kan ngan an a a ilamen miosin dengan ilamen
EJBNFUFS EVB LBMJ MFCJI CFTBS EBSJQBEB GJMBNFO BLUJO 1BEB ak in
NJLSPHSBG FMFLUSPO LJUB CJBTBOZB EBQBU NFOFNVLBO GJMBNFO
BLUJO LJSBLJSBIJOHHBLBMJMFCJICBOZBLEBSJQBEBGJMBNFO TJTJ ZBOH MBJO ,FVOUVOHBO EBSJ TVTVOBO JOJ NFOZFCBCLBO PUPU
NJPTJO QPMPT EBQBU CFSLPOUSBLTJ IJOHHB QFSTFO EBSJ QBOKBOHOZB
%J TJTJ LBOBO (BNCBS UBNQBL TUSVLUVS ZBOH UFMBI EJCBOEJOH PUPU SBOHLB ZBOH LPOUSBLTJOZB UFSCBUBT ZBJUV LVSBOH
EJEBMJMLBO TFCBHBJ TVBUV VOJU LPOUSBLTJ UVOHHBM EJ EBMBN TVBUV EBSJQFSTFO
TFM PUPU QPMPT EBO UFSMJIBU TFKVNMBI CFTBS GJMBNFO BLUJO ZBOH
Perbandingan antara Kontraksi Otot Polos
NFNBODBSEBSJEVBEFOTFCPEJFTVKVOHEBSJGJMBNFOJOJUVNQBOH
dan Kontraksi Otot Rangka
UJOEJI EFOHBO GJMBNFO NJPTJO ZBOH UFSMFUBL EJ CBHJBO UFOHBI
BOUBSB CBEBO QBEBU 6OJU LPOUSBLTJ JOJ NJSJQ EFOHBO VOJU 8BMBVQVO TFCBHJBO CFTBS PUPU SBOHLB EBQBU CFSLPOUSBLTJ EBO
LPOUSBLTJ QBEB PUPU SBOHLB UFUBQJ UJEBL EJTFSUBJ EFOHBO CFSFMBLTBTJTFDBSBDFQBU UFUBQJTFCBHJBOCFTBSLPOUSBLTJPUPUQPMPT
LFUFSBUVSBO TFQFSUJ QBEB TUSVLUVS PUPU SBOHLB QBEB NFSVQBLBO LPOUSBLTJ UPOJL ZBOH EBQBU CFSMBOHTVOH MBNB EBO
LFOZBUBBOOZB CBEBO QSPUFJO QBEBU EFOTF CPEJFT
QBEB PUPU LBEBOHCFSMBOHTVOHIJOHHBCFSKBNKBNBUBVCBILBOCFSIBSJIBSJ
QPMPTNFMBLVLBOQFSBOZBOHTBNBTFQFSUJMFNQFOH;QBEBPUPU 0MFI LBSFOB JUV BEB EVHBBO CBIXB CBJL TJGBU GJTJL NBVQVO TJGBU
SBOHLB LJNJBXJ LPOUSBLTJ PUPU QPMPT WFSTVT LPOUSBLTJ PUPU SBOHLB BLBO
CFSCFEB#FCFSBQBEBSJQFSCFEBBOUFSTFCVUBEBMBITFCBHBJCFSJLVU
1FSCFEBBO MBJOOZB BEBMBI LFCBOZBLBO GJMBNFO NJPTJO
NFNQVOZBJ TFTVBUV ZBOH EJTFCVU KFNCBUBO TJMBOH TJEFQPMBS Siklus Lambat Jembatan Silang Miosin. ,FDFQBUBO TJLMVT
ZBOHUFSTVTVOTFIJOHHBKFNCBUBOQBEBTBUVTJTJCFSBZVOLFTBUV KFNCBUBO TJMBOH NJPTJO QBEB PUPU QPMPT ZBJUV QFSMFLBUBOOZB QBEB
BSBI EBO ZBOH MBJOOZB CFSBZVO LF BSBI TFCBMJLOZB )BM JOJ BLUJO LFNVEJBOMFQBTEBSJBLUJO EBOQFSMFLBUBOOZBLFNCBMJVOUVL
NFOZFCBCLBONJPTJONFOBSJLGJMBNFOBLUJOLFTBUVBSBIQBEB TJLMVTCFSJLVUOZBCFSMBOHTVOHKBVIMFCJIMBNCBUEBSJBLUJOEBOQFS
92
Bab 8 Eksitasi dan Kontraksi Otot Polos
QFSMFLBUBOOZB LFNCBMJ VOUVL TJLMVT CFSJLVUOZB CFSMBOHTVOH KBVI 4FMBOKVUOZB FOFSHJ ZBOH EJHVOBLBO VOUVL NFNQFSUBOLBO
MFCJIMBNCBUEBSJQBEBEJPUPUSBOHLBCBILBO GSFLVFOTJOZBTBNQBJ LPOUSBLTJTFSJOHTFEJLJUTFLBMJ LBEBOHIBOZBEBSJFOFSHJ
TFLFDJMTBNQBJGSFLVFOTJTJLMVTEJPUPUSBOHLB5FSOZBUB ZBOH EJCVUVILBO PMFI PUPU SBOHLB VOUVL NFNQFSUBIBOLBO
GSBLTJXBLUVTBBUKFNCBUBOTJMBOHUFUBQNFMFLBUQBEBGJMBNFOBLUJO LPOUSBLTJZBOHTBNB)BMJOJEJTFCVUNFLBOJTNFNFOHVODJh
ZBOH NFSVQBLBO GBLUPS VUBNB ZBOH NFOFOUVLBO LFLVBUBO .BLOB QFOUJOH EBSJ NFLBOJTNF NFOHVODJ BEBMBI CBIXB
UNIT II
LPOUSBLTJ EJEVHB TBOHBU NFOJOHLBU QBEB PUPU QPMPT NFLBOJTNF JOJ EBQBU NFNQFSUBIBOLBO LPOUSBLTJ UPOJL ZBOH
,FNVOHLJOBO BMBTBO UFSKBEJOZB TJLMVT ZBOH MBNCBU JOJ BEBMBI MBNBQBEBPUPUQPMPTTFMBNBCFSKBNKBNEFOHBONFOHHVOBLBO
LBSFOB LFQBMB KFNCBUBOTJMBOH NFNJMJLJ BLUJWJUBT "51BTF ZBOH TFEJLJU FOFSHJ 4FMBJO JUV EJCVUVILBO TFEJLJU TJOZBM FLTJUBUPSJL
KBVI MFCJI MFNBI EBSJQBEB BLUJWJUBT "51BTF QBEB PUPU SBOHLB CFSMBOKVUZBOHCFSBTBMEBSJTFSBUTBSBGBUBVTVNCFSIPSNPOBM
TFIJOHHB QFNFDBIBO "51 ZBOH NFNCFSJ FOFSHJ CBHJ QFSHFSBLBO Stres-Relaksasi Otot Polos. ,BSBLUFSJTUJL QFOUJOH MBJO
LFQBMB KFNCBUBO TJMBOH NFOKBEJ KBVI CFSLVSBOH TFTVBJ EFOHBO EBSJPUPUQPMPT LIVTVTOZBKFOJTPUPUQPMPTVOJUUVOHHBMWJTFSBM
MBNCBUOZBLFDFQBUBOTJLMVT QBEB CBOZBL PSHBO CFSPOHHB BEBMBI LFNBNQVBOOZB VOUVL
Kebutuhan Energi yang Rendah untuk Mempertahankan LFNCBMJ NFOEFLBUJ LFLVBUBO LPOUSBLTJ BTBMOZB EBMBN XBLUV
Kontraksi Otot Polos. )BOZB EJCVUVILBO FOFSHJ TFCFTBS CFCFSBQB EFUJL BUBV CFCFSBQB NFOJU TFUFMBI PUPU UFSTFCVU
IJOHHB VOUVL NFNQFSUBIBOLBO BHBS UFHBOHBO LPOUSBLTJ NFNBOKBOH BUBV NFNFOEFL 4FCBHBJ DPOUPI QFOJOHLBUBO
QBEBPUPUQPMPTNFOKBEJTBNBEFOHBOUFHBOHBOQBEBPUPUSBOHLB WPMVNF DBJSBO EBMBN LBOEVOH LFNJI ZBOH CFSMBOHTVOH UJCB
)BMJOJ KVHB EJEVHBCFSBTBMEBSJTJLMVTQFSMFLBUBOEBOQFMFQBTBO UJCB TFIJOHHBNFSFHBOHLBOPUPUQPMPTEBMBNEJOEJOHLBOEVOH
KFNCBUBOTJMBOHZBOHCFSMBOHTVOHMBNCBUEBOLBSFOBIBOZBTBUV LFNJI BLBO NFOZFCBCLBO QFOJOHLBUBO UFLBOBO ZBOH CFTBS
NPMFLVM "51 TBKB ZBOH EJCVUVILBO VOUVL TFUJBQ TJLMVT UBOQB EBODFQBUEBMBNLBOEVOHLFNJI/BNVO TFMBNBLJSBLJSB
NFNQFSIBUJLBOMBNBLFSKBOZB EFUJL IJOHHB TBUV NFOJU CFSJLVUOZB NFTLJQVO UFSVT UFSKBEJ
1FOHHVOBBOTFEJLJUFOFSHJPMFIPUPUQPMPTJOJ CFSTJGBUTBOHBU SFHBOHBOQBEBEJOEJOHLBOEVOHLFNJI UFLBOBOBLBOLFNCBMJ
QFOUJOH CBHJ LFTFMVSVIBO FLPOPNJ FOFSHJ UVCVI LBSFOB PSHBO IBNQJS UFQBU LF OJMBJ BTBMOZB ,FNVEJBO CJMB WPMVNF
PSHBO TFQFSUJ VTVT LBOEVOH LFNJI LBOEVOH FNQFEV EBO NFOJOHLBU MBHJ BLJCBU QFOZFCBC ZBOH MBJO FGFL ZBOH TBNB
PSHBO WJTFSB MBJOOZB TFSJOH IBSVT NFNQFSUBIBOLBO UPOJL LFNCBMJUFSKBEJ
LPOUSBLTJPUPUEBMBNXBLUVIBNQJSUBLUFSCBUBT 4FCBMJLOZB CJMBWPMVNFNFOVSVOTFDBSBUJCBUJCB NVMB
Kelambatan Onset Kontraksi dan Relaksasi Seluruh NVMB UFLBOBO BLBO NFOVSVO EFOHBO ESBTUJT UFUBQJ LFNVEJBO
EBMBN CFCFSBQB EFUJL BUBV CFCFSBQB NFOJU CFSJLVUOZB BLBO
Jaringan Otot Polos. +BSJOHBOPUPUQPMPTZBOHLIBTBLBONVMBJ
CFSLPOUSBLTJ TBNQBJ NJMJEFUJL TFUFMBI PUPU QPMPT NFOJOHLBU EBO NFOEFLBUJ BUBV LFNCBMJ LF OJMBJ BTBMOZB
EJSBOHTBOH MBMV NFODBQBJ LPOUSBLTJ QFOVI TFLJUBS EFUJL 'FOPNFOB JOJ EJTFCVU TUSFT SFMBLTBTJ EBO LFCBMJLBO TUSFT
LFNVEJBO EBO TFMBOKVUOZB LFLVBUBO LPOUSBLTJ PUPU JOJ SFMBLTBTJ .BLOB QFOUJOH IBM UFSTFCVU BEBMBI CBIXB LFDVBMJ
CFSLVSBOH EBMBN XBLUV IJOHHB EFUJL CFSJLVUOZB TFIJOHHB VOUVL XBLUV TJOHLBU NFNCVBU TVBUV PSHBO CFSPOHHB EBQBU
NFOHIBTJMLBOXBLUVLPOUSBLTJUPUBMIJOHHBEFUJL8BLUVJOJ NFNQFSUBIBOLBO UFLBOBO ZBOH LVSBOH MFCJI TBNB CFTBS EJ
TFLJUBSLBMJMFCJIMBNBEJCBOEJOHLBOEFOHBOLPOUSBLTJUVOHHBM EBMBN MVNFOOZB XBMBVQVO UFSEBQBU QFSVCBIBO WPMVNF ZBOH
SBUBSBUB QBEB TVBUV TFSBCVU PUPU SBOHLB /BNVO LBSFOB BEB CFTBSEBOCFSMBOHTVOHMBNB
CFHJUV CBOZBL KFOJT PUPU QPMPT LPOUSBLTJ QBEB CFCFSBQB UJQF Pengaturan Kontraksi oleh lon Kalsium
EBQBUCFSMBOHTVOHTFTJOHLBU EFUJLBUBVTFMBNBEFUJL 4FQFSUJ ZBOH UFSKBEJ EJ PUPU SBOHLB TUJNVMVT ZBOH NFNJDV
0OTFU LPOUSBLTJ ZBOH CFSMBOHTVOH MBNCBU QBEB PUPU QPMPT TFCBHJBOCFTBSLPOUSBLTJPUPUQPMPTBEBMBIBEBOZBQFOJOHLBUBO
EFNJLJBO KVHB NBTB LPOUSBLTJOZB ZBOH MBNB NVOHLJO JPO LBMTJVN JOUSBTFMVMBS 1FOJHLBUBO JOJ EBQBU EJUJNCVMLBO
EJTFCBCLBO PMFI MBNCBUOZB QFSMFLBUBO EBO QFMFQBTBO KFNCBUBO QBEB KFOJT PUPU QPMPT ZBOH CFSCFEB PMFI QFSBOHTBO TBSBG QBEB
TJMBOH EFOHBO GJMBNFO BLUJO 4FMBJO JUV UFSDFUVTOZB LPOUSBLTJ TFSBCVU PUPU QPMPT TUJNVMBTJ IPSNPO SFHBOHBO TFSBCVU BUBV
TFCBHBJ SFTQPOT UFSIBEBQ JPO LBMTJVN CFSMBOHTVOH KBVI MFCJI CBILBOQFSVCBIBOQBEBMJOHLVOHBOLJNJBXJ
MBNCBUCJMBEJCBOEJOHLBOEFOHBOQBEBPUPUSBOHLB TFQFSUJZBOH 5FUBQJPUPUQPMPTUJEBLNFOHBOEVOHUSPQPOJO ZBJUVQSPUFJO
BLBOEJCBIBTLFNVEJBO QFOHBUVSZBOHEJBLUJGLBOPMFIJPOLBMTJVNVOUVLNFOJNCVMLBO
Kekuatan Kontraksi Maksimum Otot Polos Sering Lebih LPOUSBLTJ PUPU SBOHLB +VTUSV LPOUSBLTJ PUPU QPMPT EJBLUJGLBO
Besar daripada Otot Rangka. 8BMBVQVO SFMBUJG UFSEBQBU PMFITVBUVNFLBOJTNFZBOHTFMVSVIOZBCFSCFEB ZBJUVTFCBHBJ
TFEJLJU GJMBNFO NJPTJO EBMBN PUPU QPMPT EBO NFTLJQVO CFSJLVU
UFSEBQBU XBLUV TJLMVT ZBOH MBNCBU QBEB KFNCBUBOTJMBOH Kombinasi Ion Kalsium dengan Kalmodulin
LFLVBUBO LPOUSBLTJ NBLTJNVN PUPU QPMPT TFSJOH LBMJ MFCJI CFTBS Menyebabkan—Aktivasi Miosin Kinase dan Fosforilasi
EBSJQBEB LFLVBUBO LPOUSBLTJ NBLTJNVN PUPU SBOHLB TFCFTBS Kepala Miosin. 4FCBHBJQFOHHBOUJUSPQPOJO TFMTFMPUPUQPMPT
TBNQBJLHDNJSJTBONFMJOUBOHVOUVLPUPUQPMPTEJCBOEJOHLBO NFOHBOEVOH TFKVNMBI CFTBS QSPUFJO QFOHBUVS MBJO ZBOH
EFOHBOTBNQBJLHVOUVLPUPUSBOHLB,FLVBUBOLPOUSBLTJPUPU EJTFCVU LBMNPEVMJO (BNCBS
8BMBVQVO QSPUFJO JOJ
QPMPTZBOHCFTBSJOJCFSBTBMEBSJNBTBQFSMFLBUBOKFNCBUBOTJMBOH TFSVQB EFOHBO USPQPOJO LBMNPEVMJO NFNQVOZBJ DBSB ZBOH
LFGJMBNFOBLUJOZBOHCFSMBOHTVOHMBNB CFSCFEBEBMBN NFNJDVLPOUSBLTJ,BMNPEVMJONFMBLVLBOIBM
Mekanisme "Mengunci (Latch)" Memudahkan JOJ EFOHBO NFOHBLUJGLBO KFNCBUBO TJMBOH NJPTJO 1SPTFT
Mempertahankan Kontraksi yang Lama pada Otot Polos. BLUJWBTJ JOJ EBO LPOUSBLTJ TFMBOKVUOZB UFSKBEJ EBMBN VSVUBO
#FHJUV PUPU QPMPT UFMBI NFOHBMBNJ LPOUSBLTJ TFNQVSOB KVNMBI TFCBHBJCFSJLVU
FLTJUBTJ ZBOH CFSMBOKVU CJBTBOZB EBQBU EJLVSBOHJ IJOHHB UJOHLBU 1. *POLBMTJVNCFSJLBUBOEFOHBOLBMNPEVMJO
ZBOHKBVIMFCJISFOEBIEBSJQBEBUJOHLBUQFSNVMBBO EBOUFSOZBUB 2. ,PNQMFLLBMNPEVMJOLBMTJVNLFNVEJBOCFSHBCVOHEFOHBO
PUPUNFNQFSUBIBOLBOLPOUSBLTJOZBEFOHBOLFLVBUBOQFOVI EBOTFLBMJHVTNFOHBLUJGLBOLJOBTFSBOUBJSJOHBONJPTJO
93
QFSUBIBOBOUPOVTKBOHLBQBOKBOHEJCBOZBLPSHBOPUPUQPMPTUBOQB
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QFNBLBJBO CBOZBL FOFSHJ UFMBI CBOZBL VTBIB ZBOH EJMBLVLBO
VOUVL NFOKFMBTLBO IBM JOJ %J BOUBSB CBOZBL NFLBOJTNF ZBOH
UFMBI EJEBMJMLBO TBMBI TBUV NFLBOJTNF ZBOH QBMJOH TFEFSIBOB
BEBMBITFCBHBJCFSJLVU
4BBU FO[JN NJPTJO LJOBTF EBO NJPTJO GPTGBUBTF EJBLUJGLBO
TFDBSB LVBU GSFLVFOTJ TJLMVT LFQBMB NJPTJO EBO LFDFQBUBO
Ca++ $B
LPOUSBLTJ NFOKBEJ UJOHHJ ,FNVEJBO LFUJLB BLUJWBTJ FO[JN
almod lin NFOVSVO GSFLVFOTJ TJLMVT KVHB NFOVSVO UFUBQJ QBEB TBBU ZBOH
CFSTBNBBO EFBLUJWBTJ FO[JNFO[JN JOJ BLBO NFOZFCBCLBO
LFQBMB NJPTJO UFUBQ NFMFLBU QBEB GJMBNFO BLUJO VOUVL XBLUV
a almod lin ZBOHNBLJO*BNBNBLJOQBOKBOHEBMBNNBTBTJLMVT0MFILBSFOB
JUV KVNMBI LFQBMB ZBOH NFMFLBU QBEB GJMBNFO BLUJO QBEB TVBUV
TBBU UFUBQ CFTBS 0MFI LBSFOB KVNMBI LFQBMB ZBOH NFMFLBU QBEB
ak i dak ak i BLUJO NFOFOUVLBO LFLVBUBO LPOUSBLTJ TUBUJL UFHBOHBO BLBO
EJQFSUBIBOLBO BUBVUFSLVODJ MBUDIFE
UFSOZBUBIBOZBTFEJLJU
os a FOFSHJ ZBOH EJHVOBLBO PMFI PUPU LBSFOB "51 UJEBL EJVSBJLBO
NFOKBEJ "%1 LFDVBMJ QBEB LFBEBBO ZBOH KBSBOH LFUJLB TFCVBI
os o ilasi e os o ilasi LFQBMBUFSMFQBT
Pengaturan Saraf dan Hormon pada Kontraksi Otot

Polos
ons aksi elaksasi
8BMBVQVO TFSBCVU PUPU SBOHLB EJSBOHTBOH TFDBSB FLTLMVTJG PMFI
onsen asi ion kalsi m a in asel la TJTUFNTBSBG PUPUQPMPTEBQBUEJSBOHTBOHVOUVLCFSLPOUSBLTJPMFI
meningka ke ika a memas ki sel melal i kanal kalsi m ada
mem an sel a a e ik l m sa ko lasma a e ika an CFSCBHBJ KFOJT TJOZBM PMFI TJOZBM TBSBG PMFI SBOHTBOHBO
dengan kalmod lin mem en k kom leks a kalmod lin ang IPSNPOBM PMFI SFHBOHBO PUPU EBO PMFI CFCFSBQB DBSB MBJOOZB
kem dian mengak i asi an ai ingan miosin kinase yo i lig 1FOZFCBCVUBNBEBSJQFSCFEBBOJOJBEBMBILBSFOBNFNCSBOPUPU
i i e mem os o ilasi an ai ingan miosin QPMPT NFOHBOEVOH CBOZBL KFOJT QSPUFJO SFTFQUPS ZBOH EBQBU
men e a kan kon aksi o o olos e ika konsen asi a NFOJNCVMLBO QSPTFT LPOUSBLTJ .BTJI BEB QSPUFJO SFTFQUPS MBJO
men n ka ena emom aan a kel a sel oses menjadi
e alik dan miosin os a ase mele askan os a da i ZBOHNFOHIBNCBULPOUSBLTJPUPUQPMPT ZBOHNFSVQBLBOCFOUVL
men e a kan elaksasi QFSCFEBBOZBOHMBJOMBHJEBSJPUPUSBOHLB0MFILBSFOBJUV QBEB
CBHJBOJOJ LJUBNFNCBIBTQFOHBUVSBOPMFITBSBGQBEBLPOUSBLTJ
NJPTJOJHIUDIBJOLJOBTF
ZBJUVTVBUVFO[JNGPTGPSJMBTJ PUPU QPMPT EJJLVUJ PMFI QFOHBUVSBO PMFI IPSNPO EBO DBSB
3. 4BMBITBUVSBOUBJSJOHBOEBSJTFUJBQLFQBMBNJPTJO ZBOHEJ QFOHBUVSBOMBJOOZB
TFCVU SBOUBJ QFOHBUVS NFOHBMBNJ GPTGPSJMBTJ TFCBHBJ SFTQPOT
Taut Saraf-Otot pada Otot Polos
UFSIBEBQ NJPTJO LJOBTF #JMB SBOUBJ JOJ UJEBL NFOHBMBNJ
GPTGPSJMBTJ TJLMVT QFSMFLBUBO QFMFQBTBO LFQBMB NJPTJO EFOHBO Anatomi Fisiologis Taut Saraf- Otot pada Otot Polos.
GJMBNFO BLUJO UJEBL BLBO UFSKBEJ 5FUBQJ CJMB SBOUBJ QFOHBUVS +FOJT UBVU TBSBGPUPU ZBOH TBOHBU UFSTUSVLUVS QBEB TFSBCVU PUPU
NFOHBMBNJ GPTGPSJMBTJ LFQBMB NFNJMJLJ LFNBNQVBO VOUVL SBOHLB UJEBL EJUFNVLBO QBEB PUPU QPMPT +VTUSV TFSBU TBSBG
CFSJLBUBO TFDBSB CFSVMBOH EFOHBO GJMBNFO BLUJO EBO CFLFSKB PUPOPN ZBOH NFNQFSTBSBGJ PUPU QPMPT VNVNOZB CFSDBCBOH
NFMBMVJ TFMVSVI QSPTFT TJLMVT UBSJLBO CFSLBUB TBNB TFQFSUJ TFDBSB EJGVT QBEB QVODBL MFNCBSBO TFSBCVU PUPU TFQFSUJ ZBOH
ZBOH UFSKBEJ QBEB PUPU SBOHLB TFIJOHHB NFOHIBTJMLBO EJKFMBTLBOEBMBN(BNCBS1BEBVNVNOZB TFSBCVUJOJUJEBL
LPOUSBLTJPUPU NFNCVBULPOUBLMBOHTVOHEFOHBONFNCSBOTFMTFSBCVUPUPU
Miosin Fosfatase Penting pada Penghentian
Kontraksi. #JMBLPOTFOUSBTJJPOLBMTJVNNFOVSVOEJCBXBIOJMBJ a im as
LSJUJT QSPTFT ZBOH UFMBI EJTFCVULBO EJ BUBT BLBO CFSMBOHTVOH
UFSCBMJL TFDBSB PUPNBUJT LFDVBMJ VOUVL GPTGPSJMBTJ LFQBMB NJPTJO
1FNCBMJLBO QSPTFT JOJ NFNCVUVILBO FO[JN MBJO ZBJUV NJPTJO
GPTGBUBTF MJIBU(BNCBS
ZBOHUFSMFUBLEJEBMBNTJUPTPMTFMPUPU
QPMPT NFOHVSBJLBOGPTGBUEBSJSBOUBJSJOHBOQFOHBUVS,FNVEJBO
TJLMVT CFSIFOUJ EBO LPOUSBLTJ CFSBLIJS 0MFI LBSFOB JUV XBLUV
ZBOH EJCVUVILBO VOUVL NFSFMBLTBTJLBO PUPU ZBOH CFSLPOUSBLTJ a ikosi as
TBOHBUEJUFOUVLBOPMFIKVNMBINJPTJOGPTGBUBTFBLUJGEJEBMBNTFM
Kemungkinan Mekanisme pada Pengaturan Fenomena
"Terkunci"
0MFI LBSFOB GFOPNFOB UFSLVODJ EBMBN PUPU QPMPT CFSTJGBU ise al li i
TBOHBUQFOUJOH EBOLBSFOBGFOPNFOBJOJNFNVOHLJOLBOUFSKBEJ e sa a an o o olos
94
QPMPTOBNVOTFCBMJLOZBNFNCFOUVLTFTVBUVZBOHEJTFCVUUBVU 3FTFQUPS JOJ BLBO EJCJDBSBLBO TFDBSB MFCJI EFUBJM EJ #BC
EJGVTZBOHNFOZFLSFTJTVCUBOTJUSBOTNJUFSOZBLFEBMBNNBUSJLT TFIVCVOHBOEFOHBOGVOHTJTJTUFNTBSBGPUPOPN
ZBOH NFNCVOHLVT PUPU QPMPT TFSJOH CFCFSBQB NJLSPNFUFS
N
KBVIOZB EBSJ TFM PUPU TVCUBOTJ USBOTNJUFS LFNVEJBO Potensial Membran dan Potensial Aksi di Otot Polos
CFSEJGVTJ LF EBMBN TFM 4FMBOKVUOZB EJ UFNQBU ZBOH CBOZBL Potensial Membran di Otot Polos. 7PMUBTF LVBOUJUBUJG
UNIT II
UFSEBQBU MBQJTBO TFM PUPU TFSBU TBSBG TFSJOH LBMJ IBOZB EBSJ QPUFOTJBM NFNCSBO PUPU QPMPT CFSHBOUVOH QBEB LFBEBBO
NFNQFSTBSBGJ MBQJTBO MVBS &LTJUBTJ PUPU LFNVEJBO NFOKBMBS PUPU TBBU JUV 1BEB LFBEBBO JTUJSBIBU ZBOH OPSNBM QPUFOTJBM
EBSJ MBQJTBO MVBS JOJ IJOHHB LF MBQJTBO EBMBN NFMBMVJ JOUSBTFMVMBS CJBTBOZB LJSBLJSB TBNQBJ NJMJWPMU ZBJUV
QFOHIBOUBSBO QPUFOTJBM BLTJ EJ NBTTB PUPU BUBV NFMBMVJ TFLJUBS NJMJWPMU LVSBOH OFHBUJG EBSJQBEB QPUFOTJBM ZBOH BEB
TFSBOHLBJBOEJGVTJTVCUBOTJUSBOTNJUFS EJPUPUSBOHLB
"LTPO ZBOH NFNQFSTBSBGJ TFSBCVU PUPU QPMPT UJEBL
NFNQVOZBJ KFOJT QFSDBCBOHBO LBLJ VKVOH ZBOH LIBT QBEB FOE Potensial Aksi di Otot Polos Unit-Tunggal. 1PUFOTJBM
QMBUFNPUPSJLEJTFSBCVUPUPUSBOHLB+VTUSVTFCBHJBOCFTBSBLTPO BLTJ UFSKBEJ EJ PUPU QPMPT VOJUUVOHHBM TFQFSUJ PUPU WJTFSBM

UFSNJOBM ZBOH IBMVT NFNQVOZBJ CBOZBL WBSJLPTJUBT ZBOH EFOHBODBSBZBOHTFSVQBEFOHBOZBOHUFSKBEJQBEBPUPUSBOHLB
NFOZFCBS EJ TFQBOKBOH TVNCVOZB %J UFNQBU JOJ TFM 4DIXBOO 1PUFOTJBMBLTJJOJCJBTBOZBUJEBLUFSKBEJQBEBCBOZBLPUPUQPMPT
ZBOH NFOZFMVCVOHJ BLTPO EJTFMBOHTFMJOHJ TFIJOHHB TVCTUBOTJ UJQFNVMUJVOJU TFQFSUJZBOHBLBOEJCJDBSBLBOEJCBHJBOCFSJLVU
USBOTNJUFS EBQBU EJTFLSFTJLBO NFMBMVJ EJOEJOH WBSJLPTJUBT %J 1PUFOTJBMBLTJEJPUPUQPMPTWJTFSBMUFSKBEJEBMBNEVBCFOUVL
EBMBN WBSJLPTJUBT UFSEBQBU WFTJLFM ZBOH NJSJQ EFOHBO WFTJLFM EJ
MPOKBLBO QPUFOTJBM TQJLF QPUFOUJBM
EBO
QPUFOTJBM BLTJ
FOE QMBUF PUPU SBOHLB ZBOH NFOHBOEVOH TVCTUBOTJ USBOTNJUFS EFOHBOQMBUFBV QFOEBUBSBO

/BNVO CFSMBJOBO EFOHBO WFTJLFM QBEB UBVU PUPU SBOHLB ZBOH
TFMBMV NFOHBOEVOH BTFUJMLPMJO WFTJLFM EJ VKVOH TFSBCVU TBSBG
Spike Potential 1PUFOTJBM BLTJ EFOHBO CFOUVL TQJLF ZBOH
PUPOPN NFOHBOEVOH BTFUJMLPMJO QBEB CFCFSBQB TFSBCVU EBO
LIBT TFQFSUJ ZBOH UBNQBL QBEB PUPU SBOHLB UJNCVM QBEB
OPSFQJOFGSJO QBEB TFSBCVU ZBOH MBJO EBO LBEBOHLBEBOH NBTJI
TFCBHJBO CFTBS UJQF PUPU QPMPT VOJUUVOHHBM -BNBOZB UJQF
NFOHBOEVOHTVCTUBOTJZBOHMBJOMBHJ QPUFOTJBM BLTJ JOJ TBNQBJ NJMJEFUJL TFQFSUJ ZBOH
1BEB CFCFSBQB DPOUPI UFSVUBNB QBEB PUPU QPMPT UJQF NVMUJ EJHBNCBSLBO QBEB (BNCBS " 1PUFOTJBM BLTJ TFNBDBN JOJ
VOJU WBSJLPTJUBTUFSQJTBIEBSJNFNCSBOTFMPUPUEFOHBOKBSBL EBQBUEJUJNCVMLBONFMBMVJCBOZBLDBSB NJTBMOZB NFMBMVJ
IJOHHB OBOPNFUFS KBSBL ZBOH TBNB TFQFSUJ DFMBI TJOBQT ZBOH
UFSCFOUVLEJUBVUPUPUSBOHLB)BMJOJEJTFCVUUBVULPOUBLEBOUBVU
UFSTFCVU CFSGVOHTJ IBNQJS TBNB TFQFSUJ UBVU TBSBGPUPU QBEB PUPU
SBOHLB LFDFQBUBO LPOUSBLTJ TFSBCVU PUPU QPMPT JOJ CFSMBOHTVOH 0
MFCJIDFQBUEBSJQBEBLFDFQBUBOLPOUSBLTJTFSBCVUZBOHEJSBOHTBOH
PMFIUBVUEJGVT
–20
Substansi Transmiter Perangsang dan Penghambat

yang Disekresi di Taut Saraf-Otot pada Otot Polos –40
4VCTUBOTJ USBOTNJUFS QBMJOH QFOUJOH ZBOH EJTFLSFTJ PMFI TBSBG
PUPOPN ZBOH NFNQFSTBSBGJ PUPU QPMPT BEBMBI BTFUJMLPMJO EBO
–60 Gelombang lambat
OPSFQJOFGSJO UFUBQJ LFEVBOZB UJEBL QFSOBI EJTFLSFTJ PMFI TFSBU
TBSBG ZBOH TBNB %J CFCFSBQB PSHBO BTFUJMLPMJO NFSVQBLBO
TVCTUBOTJ USBOTNJUFS QFSBOHTBOH VOUVL TFSBCVU PUPU QPMPT UFUBQJ 0 50 100 0 10 20 30
NFSVQBLBO USBOTNJUFS QFOHIBNCBU VOUVL PUPU QPMPT EJ PSHBO A B
MBJOOZB #JMB BTFUJMLPMJO NFSBOHTBOH TFCVBI TFSBCVU PUPU
OPSFQJOFGSJO CJBTBOZB NFOHIBNCBUOZB 4FCBMJLOZB CJMB
0
BTFUJMLPMJO NFOHIBNCBU TVBUV TFSBCVU OPSFQJOFGSJO CJBTBOZB
NFSBOHTBOHOZB
Millivolts
–25
/BNVO NFOHBQB TBNQBJ UFSKBEJ SFTQPOT ZBOH CFSCFEB JOJ
+BXBCBOOZB BEBMBI CBIXB DBSB BTFUJMLPMJO EBO OPSFQJOFGSJO –50
NFSBOHTBOH BUBV NFOHIBNCBU PUPU QPMPT BXBMOZB CFSJLBUBO
EFOHBO QSPUFJO SFTFQUPS QBEB QFSNVLBBO NFNCSBO TFM PUPU 0 0.1 0.2 0.3 0.4
C
#FCFSBQB QSPUFJO SFTFQUPS NFSVQBLBO SFTFQUPS QFSBOHTBOH Seconds
TFEBOHLBO ZBOH MBJO NFSVQBLBO SFTFQUPS QFOHIBNCBU %FOHBO , Potensial aksi otot polosyang khas (s e
EFNJLJBO KFOJT SFTFQUPS NFOFOUVLBO BQBLBI PUPU QPMPT BLBO o en al yang ditimbulkan oleh rangsangan eksternal. 8,
EJIBNCBU BUBV EJSBOHTBOH EBO KVHB NFOFOUVLBO BOUBSB LFEVB serangkaian spike o en al yang ditimbulkan oleh gelombang
listrik berirama lambat yang terjadi secara spontan di otot polos
USBOTNJUUFS UFSTFCVU BQBLBI BTFUJMLPMJO BUBV OPSFQJOFGSJO ZBOH dinding usus. C, Potensial aksi dengan plateau yang direkam
FGFLUJGEBMBNNFOJNCVMLBOQFSBOHTBOHBOBUBVQFOHIBNCBUBO dari suatu serabut otot polos uterus.
95
SBOHTBOH MJTUSJL NFMBMVJ LFSKB IPSNPO UFSIBEBQ PUPU QPMPT ZBJUV QPUFOTJBM NFNCSBO NFOKBEJ MFCJI OFHBUJG CJMB OBUSJVN
NFMBMVJ LFSKB TVCTUBOTJ USBOTNJUFS EBSJ TFSBU TBSBG NFMBMVJ EJQPNQB EFOHBO DFQBU EBO NFOKBEJ LVSBOH OFHBUJG CJMB QPNQB
QFSFHBOHBO BUBV TFCBHBJ IBTJM EBSJ QFNCFOUVLBO TQPOUBO OBUSJVN LVSBOH BLUJG "OHHBQBO MBJOOZB BEBMBI CBIXB
EBMBN TFSBCVU PUPU JUV TFOEJSJ TFQFSUJ ZBOH EJCJDBSBLBO LPOEVLUBOTJLBOBMJPONFOJOHLBUEBONFOVSVOTFDBSBCFSJSBNB
LFNVEJBO .BLOB QFOUJOH EBSJ HFMPNCBOH MBNCBU BEBMBI CBIXB LFUJLB
Potensial Aksi dengan Plateau. (BNCBS $ HFMPNCBOH UFSTFCVU NFOKBEJ DVLVQ LVBU HFMPNCBOH JOJ EBQBU
NFNQFSMJIBUBO TVBUV QPUFOTJBM BLTJ PUPU QPMPT EFOHBO NFODFUVTLBO QPUFOTJBM BLTJ (FMPNCBOH MBNCBU JUV TFOEJSJ UJEBL
QMBUFBV1FSNVMBBOQPUFOTJBMBLTJJOJNJSJQEFOHBOUJNCVMOZB EBQBUNFOJNCVMLBOLPOUSBLTJPUPU5FUBQJ CJMBQVODBLQPUFOTJBM
TQJLF QPUFOUJBM ZBOH LIBT /BNVO CFSCFEB EFOHBO HFMPNCBOHMBNCBUZBOHOFHBUJGEJEBMBNNFNCSBOTFMNFOJOHLBU
SFQPMBSJTBTJ DFQBU QBEB NFNCSBO TFSBU TBSBG SFQPMBSJTBTJ JOJ LF BSBI QPTJUJG EBSJ NFOKBEJ TFLJUBS NJMJWPMU BNCBOH
BLBO EJQFSMBNCBU TFMBNB CFCFSBQB SBUVT TBNQBJ CBUBT ZBOH NFOEFLBUJ OJMBJ VOUVL NFODFUVTLBO QPUFOTJBM BLTJ
NJMJEFUJL EFUJL
.BLOBEBSJQMBUFBVJBMBICBIXBJOJEBQBU QBEBTFCBHJBOCFTBSPUPUQPMPTWJTFSBM
TVBUVQPUFOTJBMBLTJBLBO
NFOVOKVLLBO QFSQBOKBOHBO LPOUSBLTJ ZBOH UFSKBEJ QBEB UJNCVM EBO NFOZFCBS LF TFMVSVI NBTTB PUPU EBO UFSKBEJMBI
CFCFSBQB UJQF PUPU QPMPT TFQFSUJ VSFUFS VUFSVT QBEB LFBEBBO LPOUSBLTJ (BNCBS # NFOVOKVLLBO QFOHBSVI JOJ ZBOH
UFSUFOUV EBO UJQF UFSUFOUV PUPU QPMPT QFNCVMVI EBSBI *OJ NFNQFSMJIBULBO CBIXB QBEB TFUJBQ QVODBL HFMPNCBOH MBNCBU
KVHBNFSVQBLBOKFOJTQPUFOTJBMBLTJZBOHUFSMJIBUQBEBTFSBCVU UFSKBEJ TBUV BUBV MFCJI QPUFOTJBM BLTJ 6SVUBO QPUFOTJBM BLTJ ZBOH
PUPUKBOUVOHZBOHNFNJMJLJNBTBLPOUSBLTJZBOHMBNB TFQFSUJ CFSVMBOH JOJ NFOJNCVMLBO LPOUSBLTJ NBTTB PUPU QPMPT ZBOH
ZBOHEJCJDBSBLBOEJ#BCEBO
CFSJSBNB0MFILBSFOBJUV HFMPNCBOHMBNCBUEJTFCVUHFMPNCBOH
QFNJDV QBDFNBLFS XBWFT
%J #BC LJUB BLBO NFOHFUBIVJ
Kanal Kalsium Penting dalam Mencetuskan Potensial CBIXBKFOJTBLUJWJUBTQBDFNBLFSJOJNFOHBUVSLPOUSBLTJVTVTZBOH
"LTJ 0UPU 1PMPT .FNCSBO TFM PUPU QPMPT NFNQVOZBJ KBVI CFSJSBNB
MFCJI CBOZBL LBOBM LBMTJVN CFSQJOUV MJTUSJL EBSJQBEB PUPU
SBOHLB OBNVO LBOBM OBUSJVN CFSQJOUV MJTUSJL MFCJI TFEJLJU Perangsangan Otot Polos Viseral oleh Peregangan. #JMB
0MFI TFCBC JUV QBEB TFCBHJBO CFTBS PUPU QPMPT QFSBO OBUSJVN PUPUQPMPTWJTFSBM VOJUUVOHHBM
EJSFHBOHTFDVLVQOZB CJBTBOZB
EBMBN NFODFUVTLBO QPUFOTJBM BLTJ MFCJI TFEJLJU +VTUSV BMJSBO BLBO UJNCVM QPUFOTJBM BLTJ TFDBSB TQPOUBO 1PUFOTJBM BLTJ JOJ
JPO LBMTJVN LF CBHJBO EBMBN TFSBCVU JUVMBI ZBOH UFSVUBNB BEBMBIIBTJMEBSJQFOHHBCVOHBO
QPUFOTJBMHFMPNCBOHMBNCBU
CFSUBOHHVOH KBXBC BUBT UFSKBEJOZB QPUFOTJBM BLTJ ,FBEBBO JOJ OPSNBMEBO
QFOVSVOBOEBOLFOFHBUJGBOQPUFOTJBMNFNCSBO
NJSJQ EFOHBO UFSKBEJOZB QSPTFT SFHFOFSBTJ TFOEJSJ TFQFSUJ ZBOH TFDBSBLFTFMVSVIBOZBOHEJTFCBCLBOPMFIQFSFHBOHBOJUVTFOEJSJ
UFSKBEJ EJ LBOBM OBUSJVN EBMBN TFSBCVU TBSBG EBO TFSBCVU PUPU 3FTQPOTUFSIBEBQQFSFHBOHBOJOJNFNVOHLJOLBOEJOEJOHVTVT
SBOHLB/BNVOEFNJLJBO QFNCVLBBOLBOBMLBMTJVNCFCFSBQB CJMB UFSFHBOH TFDBSB IFCBU VOUVL CFSLPOUSBLTJ TFDBSB PUPNBUJT
LBMJ MFCJI MBNCBU EBSJQBEB LBOBM OBUSJVN EBO UFSVT EBMBN EBOCFSJSBNB$POUPIOZB CJMBVTVTUFSJTJTFDBSBCFSMFCJIBOPMFI
LFBEBBO UFSCVLB MFCJI MBNB 1FNCVLBBO JOJ CFSQFSBO DVLVQ JTJ VTVT LPOUSBLTJ TFUFNQBU ZBOH PUPNBUJT TFSJOH LBMJ
CFTBS VOUVL NFOZFCBCLBO QPUFOTJBM BLTJ EFOHBO QMBUFBV ZBOH NFOJNCVMLBO TVBUV HFMPNCBOH QFSJTUBMUJL ZBOH NFOEPSPOH JTJ
MBNBQBEBCFCFSBQBTFSBCVUPUPUQPMPT VTVT NFOKBVIJ CBHJBO VTVT ZBOH TBOHBU UFSFHBOH UFSTFCVU
(BNCBSBO QFOUJOH MBJO NBTVLOZB JPO LBMTJVN LF EBMBN TFM CJBTBOZBLFBSBIBOVT
TFMBNBCFSMBOHTVOHOZBQPUFOTJBMBLTJBEBMBICBIXBJPOLBMTJVN
BLBO CFLFSKB TFDBSB MBOHTVOH QBEB NFLBOJTNF LPOUSBLTJ PUPU Depolarisasi Otot Polos Multi-Unit Tanpa Potensial Aksi
QPMPT VOUVL NFOZFCBCLBO LPOUSBLTJ +BEJ LBMTJVN NFMBLVLBO 1BEB LFBEBBO OPSNBM TFSBCVU PUPU QPMPT EBO PUPU QPMPT NVMUJ
EVBUVHBTTFLBMJHVT VOJU TFQFSUJ PUPU EJ JSJT NBUB BUBV PUPU QJMPFSFLUPS EJ TFUJBQ
SBNCVU
BLBO CFSLPOUSBLTJ UFSVUBNB TFCBHBJ SFTQPOT UFSIBEBQ
Potensial Gelembang Lambat di Otot Polos Unit- SBOHTBOH TBSBG 1BEB CFCFSBQB PUPU QPMPT NVMUJVOJU VKVOH TBSBG
Tunggal dapat Menyebabkan Pencetusan Potensial Aksi BLBO NFOHFMVBSLBO BTFUJMLPMJO EBO QBEB UJQF ZBOH MBJO
secara Spontan. #FCFSBQBPUPUQPMPTEBQBUUFSFLTJUBTJTFOEJSJ NFOHFMVBSLBO OPSFQJOFGSJO 1BEB LFEVB DPOUPI UFSTFCVU
"SUJOZB QPUFOTJBMBLTJEBQBUUJNCVMEFOHBOTFOEJSJOZBEJEBMBN TVCTUBOTJ USBOTNJUFS JOJ NFOJNCVMLBO EFQPMBSJTBTJ QBEB
PUPU QPMPT UBOQB SBOHTBOHBO EBSJ MVBS ,FBEBBO JOJ TFSJOH LBMJ NFNCSBO PUPU QPMPT EBO IBM JOJ LFNVEJBO BLBO NFODFUVTLBO
EJIVCVOHLBOEFOHBOBEBOZBJSBNBHFMPNCBOHMBNCBUEBTBSEBO LPOUSBLTJ1PUFOTJBMBLTJCJBTBOZBUJEBLUJNCVMBMBTBOOZBBEBMBI
QPUFOTJBMNFNCSBO(FMPNCBOHMBNCBUZBOHLIBTJOJQBEBPUPU LBSFOB TFSBCVU UFSMBMV LFDJM VOUVL NFODFUVTLBO TVBUV QPUFOTJBM
QPMPTWJTFSBMVTVTEJHBNCBSLBOQBEB(BNCBS#(FMPNCBOH BLTJ #JMBQPUFOTJBMBLTJEJDFUVTLBOEBMBNPUPUQPMPTWJTFSBMVOJU
MBNCBU JUV TFOEJSJ CVLBOMBI QPUFOTJBM BLTJ "SUJOZB CVLBO UVOHHBM TFCBOZBL TBNQBJ TFSBCVU PUPU QPMPT IBSVT
QSPTFT SFHFOFSBTJ TFOEJSJ ZBOH NFOZFCBS TFDBSB QSPHSFTJG EJ CFSEFQPMBSJTBTJTFDBSBTJNVMUBOHVOBNFOJNCVMLBOQPUFOTJBMBLTJ
TFMVSVI NFNCSBO TFSBCVU PUPU +VTUSV IBM UFSTFCVU NFSVQBLBO ZBOH NFOZFCBS TFOEJSJ
"LBO UFUBQJ QBEB TFM PUPU QPMPT LFDJM
TJGBUMPLBMEBSJTFSBCVUPUPUQPMPTZBOHNFNCFOUVLNBTTBPUPU CBILBO UBOQB BEBOZB QPUFOTJBM BLTJ EFQPMBSJTBTJ MPLBM EJTFCVU
1FOZFCBC UFSKBEJOZB JSBNB HFMPNCBOH MBNCBU CFMVN QPUFOTJBM UBVU
EJUJNCVMLBO PMFI TVCTUBOTJ USBOTNJUFS TBSBG JUV
EJLFUBIVJ "EB BOHHBQBO CBIXB HFMPNCBOH MBNCBU EJTFCBCLBO TFOEJSJZBOHLFNVEJBONFOZFCBSTFDBSBFMFLUSPUPOJLLFTFMVSVI
PMFI NFOJOHLBUOZB EBO CFSLVSBOHOZB QFNPNQBBO JPO QPTJUJG TFSBCVU EBO IBOZB IBM JOJMBI ZBOH EJQFSMVLBO VOUVL
NVOHLJOJPOOBUSJVN
LFMVBSNFMBMVJNFNCSBOTFSBCVUPUPU NFOJNCVMLBOLPOUSBLTJPUPU
96
Pengaruh Faktor Jaringan dan Hormon Setempat untuk 1FOHIBNCBUBO TFDBSBLPOUSBT KVTUSVUFSKBEJLFUJLBIPSNPO
Menimbulkan Kontraksi Otot Polos Tanpa Potensial Aksi BUBV GBLUPS KBSJOHBO MBJO
NFOVUVQ LBOBM JPO OBUSJVN EBO
.VOHLJO TFQBSVI EBSJ LPOUSBLTJ PUPU QPMPT EJDFUVTLBO PMFI LBMTJVN VOUVL NFODFHBI NBTVLOZB JPOJPO QPTJUJG JOJ
GBLUPS QFSBOHTBOH ZBOH CFLFSKB MBOHTVOH QBEB QFSBOHLBU QFOHIBNCBUBO KVHB UFSKBEJ KJLB LBOBM LBMJVN ZBOH OPSNBMOZB
LPOUSBLTJ PUPU QPMPT EBO UBOQB QPUFOTJBM BLTJ ,FEVB UJQF GBLUPS UFSUVUVQ KVTUSV UFSCVLB TFIJOHHB NFNCVBU JPO LBMJVN QPTJUJG
UNIT II
QFSBOHTBOH ZBOH CFSTJGBU OPOTBSBG EBO OPOQPUFOTJBM BLTJ ZBOH CFSEJGVTJ LF MVBS TFM ,FEVB LFKBEJBO JOJ NFOJOHLBULBO EFSBKBU
TFSJOH UFSMJCBU BEBMBI
GBLUPS LJNJBXJ KBSJOHBO TFUFNQBU EBO LFOFHBUJGBO EJ EBMBN TFM PUPU TVBUV LFBEBBO ZBOH EJTFCVU

CFSNBDBNNBDBNIPSNPO IJQFSQPMBSJTBTJ ZBOH TFDBSB LVBU BLBO NFOHIBNCBU LPOUSBLTJ
Kontraksi Otot Polos sebagai Respons terhadap Faktor PUPU
Kimiawi Jaringan Setempat. %J #BC LJUB NFNCBIBT ,BEBOHLPOUSBLTJBUBVQFOHIBNCBUBOPUPUQPMPTEJDFUVTLBO
QFOHBUVSBO LPOUSBLTJ BSUFSJPM NFUBBSUFSJPM EBO TGJOHUFS PMFI IPSNPO UBOQB TFDBSB MBOHTVOH NFOZFCBCLBO QFSVCBIBO
QSFLBQJMFS.BLJOLFDJMQFNCVMVIEBSBIJOJ NBLJOTFEJLJUTVQMBJ QBEB QPUFOTJBM NFNCSBO 1BEB LFBEBBO JOJ IPSNPO EBQBU
TBSBGOZB BUBV KVTUSV UJEBL BEB TBNB TFLBMJ /BNVO PUPU QPMPT NFOHBLUJGLBO TVBUV SFTFQUPS NFNCSBO ZBOH UJEBL NFNCVLB
CFSTJGBU TBOHBU LPOUSBLUJM ZBOH CFSFTQPOT DFQBU UFSIBEBQ LBOBM JPO NBOB QVO OBNVO KVTUSV NFOZFCBCLBO QFSVCBIBO
QFSVCBIBO LFBEBBO LJNJBXJ TFUFNQBU EBMBN DBJSBO JOUFSTUJTJBM JOUFSOBM QBEB TFSBCVU PUPU TFQFSUJ QFMFQBTBO JPO LBMTJVN EBO
TFLJUBSOZB SFUJLVMVN TBSLPQMBTNB JOUSBTFM JPO LBMTJVN LFNVEJBO
1BEBLFBEBBOJTUJSBIBUOPSNBM CBOZBLQFNCVMVIEBSBILFDJM NFOHJOEVLTJ UFSKBEJOZB LPOUSBLTJ 6OUVL NFOHIBNCBU
JOJ UFUBQ CFSLPOUSBLTJ /BNVO LFUJLB BMJSBO EBSBI UBNCBIBO LF UFSKBEJOZB LPOUSBLTJ NFLBOJTNF SFTFQUPS MBJO UFMBI EJLFUBIVJ
KBSJOHBO EJQFSMVLBO CFCFSBQB GBLUPS EBQBU NFSFMBLTBTJLBO EBQBUNFOHBLUJGLBOFO[JNBEFOJMBUTJLMBTFBUBVHVBOJMBUTJLMBTF
EJOEJOH QFNCVMVI EBSBI TFIJOHHB NFNCVBU KVNMBI BMJSBO EJ NFNCSBO TFM CBHJBO EBSJ SFTFQUPS ZBOH NFOFNCVT LF
CFSUBNCBI %FOHBO DBSB JOJ TJTUFN QFOHBUVS VNQBO CBMJL CBHJBO EBMBN TFM EJSBOHLBJ LF FO[JNFO[JN JOJ NFOZFCBCLBO
TFUFNQBU ZBOH TBOHBU LVBU BLBO NFOHBUVS BMJSBO EBSBI ZBOH UFSCFOUVLOZBBEFOPTJONPOPGPTGBUTJLMJL D".1
BUBVHVBOPTJO
NFOVKVLFEBFSBIKBSJOHBOTFUFNQBU#FCFSBQBGBLUPSQFOHFOEBMJ NPOPGPTGBU TJLMJL D(.1
ZBOH KVHB EJTFCVU TFCBHBJ DBSBLB
ZBOHLIBTBEBMBITFCBHBJCFSJLVU LFEVB TFDPOE NFTTFOHFS
D".1 BUBV D(.1 NFNCFSJLBO
1. ,VSBOHOZB PLTJHFO EJ KBSJOHBO TFUFNQBU NFOZFCBCLBO CBOZBL QFOHBSVI TBUV EJ BOUBSBOZB BEBMBI VOUVL NFOHVCBI
SFMBLTBTJ PUPU QPMPT EBO LBSFOB JUV NFOJNCVMLBO EFSBKBU GPTGPSJMBTJ CFCFSBQB FO[JN ZBOH TFDBSB UJEBL MBOHTVOH
WBTPEJMBUBTJ NFOHIBNCBU LPOUSBLTJ 1PNQB ZBOH NFNJOEBILBO JPO
2. ,FMFCJIBOLBSCPOEJPLTJEBNFOJNCVMMLBOWBTPEJMJUBTJ LBMTJVN EBSJ TBSLPQMBTNB LF EBMBN SFUJLVMVN TBSLPQMBTNB
3. 1FOJOHLBUBOLPOTFOUSBTJJPOIJESPHFONFOJNCVMLBO EJBLUJGLBO EFNJLJBO KVHB QPNQB NFNCSBO TFM ZBOH
WBTPEJMJUBTJ NFNJOEBILBOJPOLBMTJVNLFMVBSEBSJTFMJUVTFOEJSJQFOHBSVI
JOJNFOHVSBOHJLPOTFOUSBTJJPOLBMTJVNEJEBMBNTBSLPQMBTNB
"EFOPTJO BTBNMBLUBU QFOJOHLBUBOJPOLBMJVN CFSLVSBOHOZB
TFIJOHHBNFOHIBNCBULPOUSBLTJ
LPOTFOUSBTJJPOLBMTJVN EBOQFOJOHLBUBOTVIVUVCVI TFNVBIBM
UFSTFCVUEBQBUNFOJNCVMLBOWBTPEJMBUBTJTFUFNQBU 0UPU QPMPT NFNQVOZBJ CFSBHBN DBSB EBMBN NFODFUVTLBO
LPOUSBLTJ BUBV SFMBLTBTJ TFCBHBJ SFTQPOT UFSIBEBQ IPSNPO
Pengaruh Hormon terhadap Kontraksi Otot Polos. Banyak OFVSPUSBOTNJUFS EBO TVCTUBOTJ MBJO ZBOH CFSCFEB 1BEB
IPSNPO ZBOH CFTJSLVMBTJ EBMBN UVCVI NFNFOHBSVIJ LPOUSBLTJ
CFCFSBQB LFBEBBO TVCTUBOTJ ZBOH TBNB EBQBU NFOZFCBCLBO
PUPU QPMPT IJOHHB EFSBKBU UFSUFOUV EBO CFCFSBQB EJ BOUBSBOZB
SFMBLTBTJ BUBV LPOUSBLTJ PUPU QPMPT EJ CFSCBHBJ MPLBTJ
NFNQVOZBJ QFOHBSVI ZBOH TBOHBU CFTBS %J BOUBSB IPSNPO
$POUPIOZB OPSFQJOFGSJO NFOHIBNCBU LPOUSBLTJ PUPU QPMPT
EBMBNEBSBIZBOHQFOUJOHUFSTFCVUBEBMBIOPSFQJOFGSJO FQJOFGSJO
QBEB VTVT IBMVT OBNVO NFSBOHTBOH LPOUSBLTJ PUPU QPMPT QBEB
BTFUJMLPMJO BOHJPUFOTJO FOEPUFMJO WBTPQSFTJO PLTJUPTJO TFSPUPOJO
QFNCVMVIEBSBI
EBOIJTUBNJO
4VBUVIPSNPOEBQBUNFOJNCVMLBOLPOUSBLTJTVBUVPUPUQPMPT Sumber lon Kalsium yang Menyebabkan Kontraksi
CJMBNFNCSBOTFMPUPUNFOHBOEVOHSFTFQUPSQFSBOHTBOHCFSQJOUV melalui Membran Sel dan dari Retikulum Sarkoplasma
IPSNPO VOUVL IPSNPO UFSUFOUV 4FCBMJLOZB IPSNPO BLBO
8BMBVQVO QSPTFT LPOUSBLTJ QBEB PUPU QPMPT TFQFSUJ QBEB PUPU
NFOJNCVMLBO QFOHIBNCBUBO KJLB NFNCSBO NFOHBOEVOH
SBOHLB EJBLUJGLBO PMFI JPO LBMTJVN TVNCFS JPO LBMTJVNOZB
SFTFQUPS QFOHIBNCBU VOUVL IPSNPO UFSTFCVU LFUJNCBOH
CFSCFEB 1FSCFEBBO VUBNBOZB BEBMBI SFUJLVMVN TBSLPQMBTNB
NFOHBOEVOHSFTFQUPSQFSBOHTBOH
ZBOH NFOZFEJBLBO TFMVSVI JPO LBMTJVN VOUVL LPOUSBLTJ PUPU
Mekanisme Perangsangan atau Penghambatan Otot SBOHLB IBOZB TFEJLJU CFSLFNCBOH QBEB TFCBHJBO CFTBS PUPU
Polos oleh Hormon atau Faktor Jaringan Setempat QPMPT .BMBIBO IBNQJSTFNVBJPOLBMTJVNZBOHNFOZFCBCLBO
#FCFSBQB SFTFQUPS IPSNPO QBEB NFNCSBO PUPU QPMPT NFNCVLB LPOUSBLTJ NFNBTVLJ TFM PUPU EBO DBJSBO FLTUSBTFMVMBS QBEB TBBU
LBOBM JPO LBMTJVN EBO OBUSJVN TFSUB NFOJNCVMLBO EFQPMBSJTBTJ UJNCVMOZBQPUFOTJBMBLTJBUBVSBOHTBOHBOMBJO+BEJ LPOTFOUSBTJ
NFNCSBO TBNB TFQFSUJ TFTVEBI UFSKBEJ QFSBOHTBOHBO TBSBG JPO LBMTJVN EBMBN DBJSBO FLTUSBTFMVMBS MFCJI UJOHHJ EBSJ ¦
,BEBOHUJNCVMQPUFOTJBMBLTJ BUBVKVTUSVNVOHLJONFNQFSLVBU NPMBS CJMB EJCBOEJOHLBO EFOHBO OJMBJ ¦ NPMBS EJ EBMBN TFM
QPUFOTJBM BLTJ ZBOH UFMBI UFSKBEJ 1BEB LBTVT MBJO UFSKBEJ PUPUQPMPT IBMJOJNFOZFCBCLBOEJGVTJTFDBSBDFQBUJPOLBMTJVN
EFQPMBSJTBTJUBOQBEJTFSUBJEFOHBOQPUFOTJBMBLTJ EBOEFQPMBSJTBTJ ZBOHCFSBTBMEBSJDBJSBOFLTUSBTFMVMBSLFEBMBNTFMLFUJLBLBOBM
JOJNFNCVBUJPOLBMTJVNNBTVLLFEBMBNTFMTFIJOHHBUFSKBEJMBI LBMTJVN UFSCVLB 8BLUV ZBOH EJCVUVILBO VOUVL UFSKBEJOZB
LPOUSBLTJ EJGVTJJOJSBUBSBUBTFLJUBSIJOHHBNJMJEFUJLEBOEJTFCVU
97
QFSJPEFMBUFOTFCFMVNLPOUSBLTJNVMBJUFSKBEJQFSJPEFMBUFOJOJ Pompa Kalsium Dibutuhkan untuk Menimbulkan Relaksasi

VOUVL PUPU QPMPT TFLJUBS LBMJ MFCJI CFTBS EBSJQBEB VOUVL pada Otot Polos. 6OUVLNFOJNCVMLBOSFMBLTBTJQBEBPUPUQPMPT
LPOUSBLTJPUPUSBOHLB ZBOHUFMBICFSLPOUSBLTJ JPOLBMTJVNQFSMVEJLFMVBSLBOEBSJDBJSBO
JOUSBTFMVMBS 1FNJOEBIBO JOJ EJMBLVLBO PMFI QPNQB LBMTJVN ZBOH
Peran Retikulum Sarkoplasma. (BNCBSNFNQFSMJIBU NFNPNQBJPOLBMTJVNLFMVBSEBSJTFSBCVUPUPUQPMPTLFNCBMJLF
LBOUVCVMVTTBSLPQMBTNBZBOHTFEJLJUCFSLFNCBOH ZBOHUFSMFUBL EBMBN DBJSBO FLTUSBTFMVMBS BUBV KJLB BEB LF EBMBN SFUJLVMVN
EFLBU NFNCSBO TFM QBEB CFCFSBQB TFM PUPU QPMPT ZBOH MFCJI TBSLPQMBTNB1PNQBJOJCFLFSKBMBNCBUCJMBEJCBOEJOHLBOEFOHBO
CFTBS*OWBHJOBTJLFDJMQBEBNFNCSBOTFM ZBOHEJTFCVULBWFPMJ QPNQB SFUJLVMVN TBSLPQMBTNB QBEB PUPU SBOHLB ZBOH CFLFSKB
CFSCBUBTBO EFOHBO QFSNVLBBO UVCVMVT JOJ ,BWFPMJ EJEVHB DFQBU 0MFI LBSFOB JUV LPOUSBLTJ PUPU QPMPT UVOHHBM TFSJOH LBMJ
NFSVQBLBO CFOUVL SVEJNFOUFS ZBOH BOBMPH EFOHBO TJTUFN CFSMBOHTVOH EBMBN IJUVOHBO EFUJL EJCBOEJOHLBO EFOHBO XBLUV
UVCVMVTUSBOTWFSTBPUPUSBOHLB#JMBQPUFOTJBMBLTJEJKBMBSLBOLF LPOUSBLTJQBEBPUPUSBOHLBZBOHCFSMBOHTVOHQFSTFSBUVTBOTBNQBJ
EBMBN LBWFPMJ QPUFOTJBM BLTJ JOJ EJQFSDBZB BLBO NFSBOHTBOH QFSTFQVMVIBOEFUJL
QFMFQBTBO JPO LBMTJVN EBSJ UVCVMVT TBSLPQMBTNB ZBOH
CFSCBUBTBO EBO DBSB ZBOH EJMBLVLBO BEBMBI TBNB TFQFSUJ
QPUFOTJBM BLTJ EBMBN UVCVMVT USBOTWFSTB PUPU SBOHLB ZBOH Daftar Pustaka
NFOZFCBCLBO QFMFQBTBO JPO LBMTJVN EBO UVCVMVT TBSLPQMBTNB Also see references for Chapters 5 and 6.
MPOHJUVEJOBM PUPU SBOHLB 1BEB VNVNOZB TFNBLJO MVBT Andersson KE, Arner A: Pharmacology of the lower urinary tract: basis for
current and future treatments of urinary incontinence, Physiol Rev
SFUJLVMVNTBSLPQMBTNBEBMBNTFSBCVUPUPUQPMPT TFNBLJODFQBU
84:935, 2004.
PUPUJOJCFSLPOUSBLTJ Berridge MJ: Smooth muscle cell calcium activation mechanisms, J Physiol
586:5047, 2008.
Kontraksi Otot Polos Bergantung pada Konsentrasi Blaustein MP, Lederer WJ: Sodium/calcium exchange: its physiological
lon Kalsium Ekstraselular. 8BMBVQVONFOHVCBILPOTFOUSBTJ implications, Physiol Rev 79:763, 1999.
JPO LBMTJVN DBJSBO FLTUSBTFMVMBS EBSJ OJMBJ OPSNBMOZB IBOZB Cheng H, Lederer WJ: Calcium sparks, Physiol Rev 88:1491, 2008.
Davis MJ, Hill MA: Signaling mechanisms underlying the vascular myogenic
NFNJMJLJTFEJLJUFGFLUFSIBEBQLFLVBUBOLPOUSBLTJPUPUSBOHLB
response, Physiol Rev 79:387, 1999.
IBM JOJ UJEBL CFSMBLV VOUVL TFCBHJBO CFTBS PUPU QPMPT #JMB Drummond HA, Grifoni SC, Jernigan NLA: New trick for an old dogma:
LPOTFOUSBTJ JPO LBMTJVN DBJSBO FLTUSBTFMVMBS UVSVO IJOHHB ENaC proteins as mechanotransducers in vascular smooth muscle,
TFLJUBS LF EBSJ OJMBJ OPSNBM LPOUSBLTJ PUPU QPMPT Physiology (Bethesda) 23:23, 2008.
CJBTBOZBUJEBLUFSKBEJ0MFILBSFOBJUV LFLVBUBOLPOUSBLTJPUPU Harnett KM, Biancani P: Calcium-dependent and calcium-independent
contractions in smooth muscles, Am J Med 115(Suppl 3A):24S, 2003.
QPMPT CJBTBOZB TBOHBU CFSHBOUVOH QBEB LPOTFOUSBTJ JPO
Hilgers RH, Webb RC: Molecular aspects of arterial smooth muscle contrac-
LBMTJVNDBJSBOFLTUSBTFMVMBS tion: focus on Rho, Exp Biol Med (Maywood) 230:829, 2005.
House SJ, Potier M, Bisaillon J, Singer HA, Trebak M: The non-excitable
smooth muscle: calcium signaling and phenotypic switching during vas-
cular disease, Pflugers Arch 456:769, 2008.
Huizinga JD, Lammers WJ: Gut peristalsis is governed by a multitude of
cooperating mechanisms, Am J Physiol Gastrointest Liver Physiol 296:G1,
2009.
Kuriyama H, Kitamura K, Itoh T, Inoue R: Physiological features of visceral
smooth muscle cells, with special reference to receptors and ion chan-
nels, Physiol Rev 78:811, 1998.
Morgan KG, Gangopadhyay SS: Cross-bridge regulation by thin filament-
associated proteins, J Appl Physiol 91:953, 2001.
Somlyo AP, Somlyo AV: Ca2+ sensitivity of smooth muscle and nonmuscle
a eoli myosin II: modulated by G proteins, kinases, and myosin phosphatase,
Physiol Rev 83:1325, 2003.
Stephens NL: Airway smooth muscle, Lung 179:333, 2001.
Touyz RM: Transient receptor potential melastatin 6 and 7 channels, mag-
nesium transport, and vascular biology: implications in hypertension, Am J
Physiol Heart Circ Physiol 294:H1103, 2008.
e ik l m Walker JS, Wingard CJ, Murphy RA: Energetics of crossbridge phosphoryla-tion
sa ko lasmik and contraction in vascular smooth muscle, Hypertension 23:1106,
1994.
Wamhoff BR, Bowles DK, Owens GK: Excitation-transcription coupling in
l s sa ko lasma dalam se a o o olos arterial smooth muscle, Circ Res 98:868, 2006.
esa ang mem e li a kan ngann a dengan in aginasi di Webb RC: Smooth muscle contraction and relaxation, Adv Physiol Educ
mem an sel ang dise eoli 27:201, 2003.
98
III
UN IT
+BOUVOH
9. Otot Jantung; Jantung sebagai Pompa
dan Fungsi Katup-Katup Jantung
10. Eksitasi Ritmis pada Jantung
11. Elektrokardiogram Normal
12. Penafsiran Elektrokardiografi Kelainan
Otot Jantung dan Kelainan Aliran Darah
Koroner: Suatu Analisis Vektor
13. Aritmia Jantung dan Penafsiran
Elektrokardiogram
BAB 9
0UPU+BOUVOH+BOUVOHTFCBHBJ1PNQB
EBO'VOHTJ,BUVQLBUVQ+BOUVOH
1BEB CBC JOJ LJUB BLBO CJDBSBLBO TBNB EFOHBO QPMB QBEB PUPU SBOHLB 4FMBOKVUOZB PUPU KBOUVOH
KBOUVOH EBO TJTUFN TJSLVMBTJ NFNQVOZBJNJPGJCSJMNJPGJCSJMLIBTZBOHNFOHBOEVOHGJMBNFO
+BOUVOH TFQFSUJ UFSMJIBU QBEB BLUJO EBO NJPTJO ZBOH IBNQJS JEFOUJL EFOHBO GJMBNFO ZBOH
(BNCBS UFSEJSJ BUBT EVB EJKVNQBJ EJ EBMBN PUPU SBOHLB TFMBNB LPOUSBLTJ GJMBNFO
QPNQBZBOHUFSQJTBI ZBJUVKBOUVOH GJMBNFO JOJ UFSMFUBL CFSEBNQJOHBO EBO TBMJOH CFSHFTFS TBUV
LBOBO ZBOH NFNPNQBLBOEBSBI UFSIBEBQMBJOOZBTFQFSUJZBOHUFSKBEJQBEBPUPUSBOHLB MJIBU#BC
LFQBSV EBOKBOUVOH
/BNVO EJ MBJO IBM PUPU KBOUVOH DVLVQ CFSCFEB EBSJ PUPU
LJSJ ZBOH NFNPNQBLBO EBSBI LF PSHBOPSHBO QFSJGFS 4FMBOKVU SBOHLB TFQFSUJZBOHBLBOLJUBMJIBUTFMBOKVUOZB
OZB TFUJBQ CBHJBO KBOUVOH ZBOH UFSQJTBI NFSVQBLBO EVB SVBOH 0UPU+BOUVOHTFCBHBJ4VBUV4JOTJUJVN%BMBN(BNCBS
QPNQB ZBOH EBQBU CFSEFOZVU ZBJUV UFSEJSJ BUBT TBUV BUSJVN EBO UBNQBL EBFSBIEBFSBI HFMBQ ZBOH NFOZJMBOH TFSBUTFSBU PUPU
TBUVWFOUSJLFM4FUJBQBUSJVNBEBMBITVBUVQPNQBQFOEBIVMVZBOH KBOUVOHZBOHEJTFCVUTFCBHBJEJTLVTJOUFSLBMBUVTOBNVOEJTLVT
MFNBI CBHJ WFOUSJLFM ZBOH NFNCBOUV NFOHBMJSLBO EBSBI NBTVL JOUFSLBMBUVT TFCFOBSOZB NFSVQBLBO NFNCSBO TFM ZBOH NFNJ
LFEBMBNWFOUSJLFM7FOUSJLFMMBMVNFOZFEJBLBOUFOBHBQFNPNQB TBILBO NBTJOHNBTJOH TFM PUPU KBOUVOH TBUV TBNB MBJOOZB +BEJ
VUBNB ZBOH NFOEPSPOH EBSBI
LF TJSLVMBTJ QBSV NFMBMVJ TFSBUTFSBUPUPUKBOUVOHUFSEJSJBUBTCBOZBLTFMPUPUKBOUVOHZBOH
WFOUSJLFMLBOBOBUBV
LFTJSLVMBTJQFSJGFSNFMBMVJWFOUSJLFMLJSJ TBMJOH CFSIVCVOHBO EBMBN TVBUV SBOHLBJBO TFDBSB TFSJ EBO
4VBUV NFLBOJTNF LIVTVT QBEB KBOUVOH ZBOH NFOZFCBCLBO QBSBMFMTBUVEFOHBOMBJOOZB
SBOHLBJBO LPOUSBLTJ UFSVTNFOFSVT ZBOH EJTFCVU JSBNB KBOUVOH 1BEB TFUJBQ EJTLVT JOUFSLBMBUVT NFNCSBO TFMOZB TBMJOH
NFOKBMBSLBO QPUFOTJBM BLTJ LF TFMVSVI PUPU KBOUVOH TFIJOHHB CFSGVTJ TBUV EFOHBO ZBOH MBJO EFOHBO DBSB ZBOH TFEFNJLJBO
NFOJNCVMLBO EFOZVU KBOUVOH CFSJSBNB 4JTUFN ZBOH NFOHBUVS TFIJOHHB NFNCSBO TFM NFNCFOUVL UBVU LPNVOJLBTJ UBVU
JSBNBJOJEJKFMBTLBOQBEBCBC1BEBCBCJOJEJKFMBTLBOCBHBJNB JNCBTHBQKVODUJPO
ZBOHQFSNFBCFM ZBOHNFNVOHLJOLBOEJ
OB KBOUVOH CFLFSKB TFCBHBJ QPNQB EJBXBMJ EFOHBO HBNCBSBO EJGVTJJPOJPOZBOHDFQBU0MFILBSFOBJUV EJQBOEBOHEBSJTFHJ
LIVTVTPUPUKBOUVOHTFOEJSJ GVOHTJOZB JPOJPO JUV EFOHBO NVEBI CFSHFSBL EBMBN DBJSBO
JOUSBTFMVMBSTFQBOKBOHTVNCVMPOHJUVEJOBMTFSBUPUPUKBOUVOHTF
Fisiologi Otot Jantung
+BOUVOH UFSEJSJ BUBT UJHB UJQF PUPU KBOUVOH VUBNB ZBLOJ PUPU
BUSJVN PUPUWFOUSJLFM TFSUBTFSBUPUPUFLTJUBUPSJLEBOQFOHIBOUBS
LIVTVT5JQFPUPUBUSJVNEBOWFOUSJLFMCFSLPOUSBLTJEFOHBODBSB
ZBOHTBNBTFQFSUJPUPUSBOHLB IBOZBTBKBEVSBTJLPOUSBLTJPUPU
PUPU UFSTFCVU MFCJI MBNB /BNVO TFSBU FLTJUBUPSJL EBO
QFOHIBOUBSLIVTVTCFSLPOUSBLTJEFOHBOMFNBITFCBCTFSBUTFSBU
JOJ IBOZB NFOHBOEVOH TFEJLJU GJCSJM LPOUSBLUJM TFSBU JOJ NBMBI
NFNQFSMJIBULBOMFQBTBONVBUBOMJTUSJLCFSJSBNBPUPNBUJTEBMBN
CFOUVL QPUFOTJBM BLTJ NBVQVO QFOHIBOUBSBO QPUFOTJBM BLTJ
NFMBMVJKBOUVOH TFIJOHHBNFOKBEJTVBUVTJTUFNFLTJUBUPSJLZBOH
NFOHBUVSEFOZVUKBOUVOHCFSJSBNB
Anatomi Fisiologis Otot Jantung

(BNCBS NFNQFSMJIBULBO IJTUPMPHJ PUPU KBOUVOH NFOVOKVL
LBO TFSBUTFSBU PUPU KBOUVOH ZBOH UFSTVTVO TFQFSUJ LJTJLJTJ
EFOHBOTFSBUTFSBUZBOHNFNJTBI CFSHBCVOHLFNCBMJLFNVEJBO
NFOZFCBS LFNCBMJ %BSJ HBNCBS JOJ TFTFPSBOH EBQBU TFHFSB
NFMJIBUCBIXBPUPUKBOUVOHJUVCFSMVSJLMVSJLEFOHBOQPMBZBOH
101
Unit III Jantung
TFIJOHHBQPUFOTJBMBLTJEBQBUCFSKBMBOEFOHBONVEBIEBSJTBUV
TFM PUPU KBOUVOH LF TFM PUPU KBOUVOH ZBOH MBJO NFMFXBUJ EJTLVT
JOUFSLBMBUVT+BEJ PUPUKBOUVOHNFSVQBLBOTVBUVTJOTJUJVNEBSJ
CBOZBL TFMTFM PUPU KBOUVOH EJ NBOB UJBQ TFM PUPU KBOUVOH JUV
CFSIVCVOHBO EFOHBO TBOHBU FSBU TFIJOHHB CJMB TBMBI TBUV TFM QBEB PUPU SBOHLB UJEBL EFNJLJBO +BXBCBO CJPGJTJLB EBTBS EBSJ
PUPU JOJ UFSBOHTBOH QPUFOTJBM BLTJ BLBO NFOZFCBS LF TFMVSVI QFSUBOZBBO UFSTFCVU EJKFMBTLBO EBMBN #BC UFUBQJ IBM JOJ KVHB
KBOUVOH EBSJ TBUV TFM LF TFM ZBOH MBJO NFMBMVJ LJTJLJTJ ZBOH QBUVUEJLFNVLBLBOEJTJOJ
TBMJOHCFSIVCVOHBOUBEJ 1BMJOH TFEJLJU BEB EVB QFSCFEBBO VUBNB BOUBSB TJGBU NFN
+BOUVOHTFCFOBSOZBUFSEJSJBUBTEVBTJOTJUJVNTJOTJUJVNBUSJ CSBO PUPU KBOUVOH EFOHBO NFNCSBO PUPU SBOHLB EBMBN IBM
VN ZBOH NFOZVTVO EJOEJOH LFEVB BUSJVN EBO TJOTJUJVN QPUFOTJBMBLTJZBOHCFSMBOHTVOHMFCJIMBNBEBOBEBOZBQMBUFBV
WFOUSJLFMZBOHNFNCFOUVLEJOEJOHLFEVBWFOUSJLFM"USJVNEBO QBEB PUPU KBOUVOH 1FSUBNB QPUFOTJBM BLTJ QBEB PUPU SBOHLB
WFOUSJLFM EJQJTBILBO PMFI KBSJOHBO GJCSPTB ZBOH NFOHFMJMJOHJ IBNQJS TFMVSVIOZB EJUJNCVMLBO PMFI BEBOZB QFNCVLBBO ZBOH
MVCBOH LBUVQ BUSJPWFOUSJLVMBS "7
EJ BOUBSB BUSJVN EBO UJCBUJCB EBSJ LBOBM DFQBU OBUSJVN ZBOH NFOZFCBCLBO JPO
WFOUSJLFM #JBTBOZB QPUFOTJBM BLTJ UJEBL EJIBOUBSLBO EBSJ OBUSJVNEBSJDBJSBOFLTUSBTFMVMBSEBMBNKVNMBICFTBSNBTVLLF
TJOTJUJVNBUSJVNNFOVKVLFTJOTJUJVNWFOUSJLFMTFDBSBMBOHTVOH EBMBNTFSBUPUPUSBOHLB,BOBMJOJEJTFCVUTFCBHBJLBOBMDFQBU
NFMBMVJ KBSJOHBO GJCSPTB JOJ .FMBJOLBO JNQVMT IBOZB LBSFOB LBOBM JOJ UFUBQ UFSCVLB IBOZB TFMBNB TFQFSCFSBQBSJCV
EJIBOUBSLBO NFMBMVJ TJTUFN IBOUBSBO LIVTVT ZBOH EJTFCVU EFUJL EBO LFNVEJBO NFOVUVQ EFOHBO UJCBUJCB 1BEB BLIJS
CFSLBT "7 ZBJUV TFCVBI CFSLBT TFSBU IBOUBSBO EFOHBO QSPTFT QFOVUVQBO JOJ UFSKBEJ SFQPMBSJTBTJ EBO QPUFOTJBM BLTJ
EJBNFUFSCFCFSBQBNJMJNFUFS ZBOHBLBOEJCJDBSBLBOMFCJIEFUBJM CFSBLIJSEBMBNXBLUVTFQFSCFSBQBSJCVEFUJLCFSJLVUOZB
MBHJEBMBN#BC 1BEBPUPUKBOUVOHQPUFOTJBMBLTJEJUJNCVMLBOPMFIQFSNVLB
1FNCBHJBOPUPUKBOUVOHNFOKBEJEVBTJOTJUJVNGVOHTJPOBMJOJ BOEVBNBDBNLBOBM ZBJUV
LBOBMDFQBUOBUSJVNZBOHTBNB
NFNVOHLJOLBO BUSJVN CFSLPOUSBLTJ TFTBBU TFCFMVN LPOUSBLTJ EFOHBOZBOHUFSEBQBUQBEBPUPUSBOHLB EBO
LFMPNQPLLBOBM
WFOUSJLFM ZBOHQFOUJOHCBHJFGFLUJWJUBTQPNQBKBOUVOH MBNCBU LBMTJVN MBJO ZBOH TBOHBU CFSCFEB ZBOH KVHB EJTFCVU
TFCBHBJLBOBMLBMTJVNOBUSJVN,VNQVMBOLBOBMZBOHLFEVBJOJ
Potensial Aksi pada Otot Jantung CFSCFEBEFOHBOLBOBMDFQBUOBUSJVNLBSFOBMFCJIMBNCBUNFN
1PUFOTJBM BLTJ ZBOH EJSFLBN QBEB TFCVBI TFSBU PUPU WFOUSJLFM CVLBEBO ZBOHMFCJIQFOUJOH LBOBMJOJUFUBQUFSCVLBTFMBNBTF
EJQFSMJIBULBO QBEB (BNCBS SBUBSBUB CFTBSOZB NJMJWPMU QFSCFSBQBQVMVIEFUJL4FMBNBXBLUVJOJ TFKVNMBICFTBSJPOLBM
ZBOH CFSBSUJ CBIXB EJ BOUBSB EFOZVU KBOUVOH QPUFOTJBM JOUSBTFM TJVNEBOJPOOBUSJVNNFOHBMJSNFMBMVJLBOBMLBOBMJOJNBTVL
UFSTFCVUNFOJOHLBUEBSJTVBUVOJMBJZBOHTBOHBUOFHBUJG TFLJUBS LFEBMBNTFSBUPUPUKBOUVOH EBOIBMJOJBLBONFNQFSUBIBOLBO
NJMJWPMU NFOKBEJ TFEJLJU QPTJUJG LJSBLJSB NJMJWPMU TFQBOKBOH QFSJPEF EFQPMBSJTBTJ EBMBN XBLUV ZBOH MFCJI QBOKBOH NFOZF
EFOZVU KBOUVOH 4FUFMBI UFSKBEJ HFMPNCBOH QBLV TQJLF
ZBOH CBCLBO QMBUFBV QPUFOTJBM BLTJ -FCJI MBOKVU JPO LBMTJVN ZBOH
QFSUBNB NFNCSBOUFUBQEBMBNLFBEBBOEFQPMBSJTBTJTFMBNBLJSB NBTVLTFMBNBGBTFQMBUFBVJOJNFNCBOHLJULBOQSPTFTLPOUSBLTJ
LJSB EFUJL NFNQFSMJIBULBO TVBUV QMBUFBV HBSJT EBUBS
TFQFSUJ PUPU TFNFOUBSB JPO LBMTJVN ZBOH NFOZFCBCLBO LPOUSBLTJ PUPU
ZBOH EJUVOKVLLBO EBMBN HBNCBS ZBOH EJLVUJ EFOHBO SFQPMBSJTBTJ SBOHLBCFSBTBMEBSJSFUJLVMVNTBSLPQMBTNJLJOUSBTFM
UJCBUJCB QBEB CBHJBO BLIJS EBSJ QMBUFBV UFSTFCVU "EBOZB QMBUFBV 1FSCFEBBOGVOHTJPOBMVUBNBZBOHLFEVBBOUBSBPUPUKBOUVOH
QBEB QPUFOTJBM BLTJ JOJ NFOZFCBCLBO LPOUSBLTJ WFOUSJLFM CFSMBOH EBO PUPU SBOHLB ZBOH NFNCBOUV NFOFSBOHLBO QFNBOKBOHBO
TVOHTBNQBJLBMJMFCJIMBNBEBSJQBEBLPOUSBLTJPUPUSBOHLB QPUFOTJBM BLTJ EBO BEBOZB QMBUFBV JBMBI 4FHFSB TFTVEBI QPUFO
"QB ZBOH .FOZFCBCLBO 5FSKBEJOZB 1PUFOTJBM "LTJ ZBOH TJBM BLTJ UJNCVM QFSNFBCJMJUBT NFNCSBO PUPU KBOUVOH UFSIBEBQ
-BNBEBO1MBUFBV 1BEBUJUJLJOJ LJUBNFOHBKVLBOQFSUBOZBBO JPOLBMJVNNFOVSVOLJSBLJSBLBMJMJQBU ZBOHNFSVQBLBOTVB
.FOHBQB QPUFOTJBM BLTJ PUPU KBOUVOH CFSMBOHTVOH CFHJUV MBNB UVFGFLZBOHUJEBLUFSKBEJQBEBPUPUSBOHLB1FOVSVOBOQFSNFB
EBONFOHBQBQPUFOTJBMBLTJJOJNFNQVOZBJQMBUFBV TFEBOHLBO CJMJUBTUFSIBEBQLBMJVNJOJNVOHLJOEJTFCBCLBOPMFIUFSMBMVCB

Bab 9 Otot Jantung; Jantung sebagai Pompa dan Fungsi Katup-Katup Jantung
OZBLOZB QFNBTVLBO LBMTJVN NFMBMVJ LBOBM LBMTJVN "QBQVO Rangkaian (Coupling) Eksitasi-Kontraksi—Fungsi
U N I T I I I
QFOZFCBCOZB QFOVSVOBOQFSNFBCJMJUBTUFSIBEBQLBMJVNBLBOTB lon Kalsium dan Tubulus Transversus
OHBUNFOVSVOLBOQFOHFMVBSBOJPOLBMJVNZBOHCFSNVBUBOQPTJ *TUJMBI SBOHLBJBO FLTJUBTJLPOUSBLTJ NFSVKVL QBEB NFLBOJT
UJG TFMBNB UFSKBEJOZB QMBUFBV QPUFOTJBM BLTJ EBO PMFI LBSFOB JUV NF TBBU QPUFOTJBM BLTJ NFOZFCBCLBO NJPGJCSJM PUPU CFSLPO
NFODFHBILFNCBMJOZBWPMUBTFQPUFOTJBMBLTJZBOHEJOJLFUJOHLBU USBLTJ )BM JOJ UFMBI EJCJDBSBLBO EBMBN #BC NFOHFOBJ PUPU
JTUJSBIBU#JMBLBOBMMBNCBULBMTJVNOBUSJVNUFSUVUVQQBEBBLIJS SBOHLB 4FLBMJ MBHJ EJUFHBTLBO CBIXB BEB QFSCFEBBO EBMBN
EBSJ TBNQBJ EFUJL EBO QFNBTVLBO JPO LBMTJVN EBO NFLBOJTNF JOJ QBEB PUPU KBOUVOH ZBOH CFSEBNQBL QFOUJOH
OBUSJVNCFSIFOUJ QFSNFBCJMJUBTNFNCSBOVOUVLJPOLBMJVNKVHB QBEBTJGBUTJGBULPOUSBLTJPUPUKBOUVOH
BLBO NFOJOHLBU EFOHBO TBOHBU DFQBU EBO IJMBOHOZB JPO LBMJVN 4FQFSUJIBMOZBQBEBPUPUSBOHLB CJMBQPUFOTJBMBLTJNFOKB
ZBOH DFQBU EBSJ TFSBU TFHFSB BLBO NFOHFNCBMJLBO QPUFOTJBM MBS TFQBOKBOH NFNCSBO PUPU KBOUVOH QPUFOTJBM BLTJ BLBO
NFNCSBOLFLFBEBBOJTUJSBIBU EBONFOHBLIJSJQPUFOTJBMBLTJ NFOZFCBS LF CBHJBO EBMBN TFSBU PUPU KBOUVOH TFQBOKBOH
,FDFQBUBO ,POEVLTJ 4JOZBM EJ %BMBN 0UPU +BOUVOH ,F NFNCSBO UVCVMVT USBOTWFSTVT 5
1PUFOTJBM BLTJ UVCVMVT 5
DFQBUBOLPOEVLTJTJOZBMQPUFOTJBMBLTJFLTJUBUPSJLTFQBOKBOHTFSBU TFMBOKVUOZB CFLFSKB QBEB NFNCSBO UVCVMVT TBSLPQMBTNJL
PUPU BUSJVN EBO WFOUSJLFM LJSBLJSB TFCFTBS TBNQBJ NFUFS MPOHJUVEJOBMZBOHNFOZFCBCLBOQFMFQBTBOJPOJPOLBMTJVNLF
EFUJL BUBVTFLJUBSLFDFQBUBOLPOEVLTJEJEBMBNTFSBUTBSBG EBMBN TBSLPQMBTNB PUPU EBSJ SFUJLVMVN TBSLPQMBTNJL %BMBN
ZBOH TBOHBU CFTBS EBO LJSBLJSB LFDFQBUBO LPOEVLTJ EJ EB TFQFSCFSBQB SJCV EFUJL CFSJLVUOZB JPO LBMTJVN JOJ BLBO
MBNTFSBUPUPUSBOHLB,FDFQBUBOLPOEVLTJEJEBMBNTJTUFNLPO CFSEJGVTJ LF EBMBN NJPGJCSJM EBO NFOHBUBMJTBTJ SFBLTJ LJNBXJ
EVLTJ KBOUVOH LIVTVT QBEB TFSBCVU 1VSLJOKF BEBMBI TFCFTBS ZBOH NFNQFSNVEBI QFSHFTFSBO TMJEJOH
GJMBNFO BLUJO EBO
NFUFSEFUJL QBEB TFCBHJBO CFTBS TJTUFN UFSTFCVU ZBOH NFNVOH NJPTJO TBUV TBNB MBJO IBM JOJ BLBO NFOJNCVMLBO LPOUSBLTJ
LJOLBOLPOEVLTJTJOZBMFLTJUBUPSJLZBOHSFMBUJGDFQBULFCFCFSBQB PUPU
CBHJBOKBOUVOH TFQFSUJZBOHBLBOEJUFSBOHLBOEBMBN#BC 4BNQBJTFKBVIJOJ NFLBOJTNFSBOHLBJBOFLTJUBTJLPOUSBLTJ
1FSJPEF3FGSBLUFS0UPU+BOUVOH0UPUKBOUVOH TFQFSUJIBMOZB JOJ TBNB EFOHBO NFLBOJTNF ZBOH UFSKBEJ EBMBN PUPU SBOHLB
TFNVB KBSJOHBO QFLB SBOHTBOH UFSOZBUB CFSTJGBU SFGSBLUFS CJMB OBNVO BEB FGFL LFEVB ZBOH DVLVQ CFSCFEB %J TBNQJOH JPO
EJSBOHTBOH LFNCBMJ TFMBNB QFSJPEF QPUFOTJBM BLTJ CFSMBOHTVOH LBMTJVN ZBOH EJMFQBTLBO LF EBMBN TBSLPQMBTNB EBSJ TJTUFSOB
0MFI LBSFOB JUV QFSJPEF SFGSBLUFS KBOUVOH BEBMBI TFMBOH XBLUV SFUJLVMVN TBSLPQMBTNJL JPO LBMTJVN KVHB CFSEJGVTJ LF EBMBN
TFQFSUJ ZBOH UBNQBL QBEB TJTJ LJSJ (BNCBS TBBU JNQVMT TBSLPQMBTNBEBSJUVCVMVT5TFOEJSJ ZBJUVTBBUCFSMBOHTVOHOZB
KBOUVOH OPSNBM UJEBL EBQBU NFOHFLTJUBTJ LFNCBMJ TVBUV EBFSBI QPUFOTJBM BLTJ ZBOH NFNCVLB LBOBM LBMTJVN CFSQJOUV MJTUSJL
PUPU KBOUVOH ZBOH NFNBOH TVEBI UFSFLTJUBTJ UFSMFCJI EBIVMV QBEBNFNCSBOUVCVMVT5 (BNCBS
,BMTJVNZBOHNBTVL
1FSJPEFSFGSBLUFSWFOUSJLFMZBOHOPSNBMBEBMBI TBNQBJ LF EBMBN TFM TFMBOKVUOZB NFOHBLUJWBTJ LBOBM QFMFQBT LBMTJVN
EFUJL ZBOH LJSBLJSB TFTVBJ EFOHBO MBNBOZB QFNBOKBOHBO EJTFCVU KVHB SZBOPEJOF SFDFQUPS DIBOOFMT QBEB NFNCSBO
QMBUFBVQPUFOTJBMBLTJ%JTBNQJOHJUV BEBQFSJPEFSFGSBLUFSSFMBUJG SFUJLVMVNTBSLPQMBTNJL NFNJDVQFMFQBTBOLBMTJVNLFEBMBN
ZBOHXBLUVOZBLJSBLJSB EFUJL TBBUPUPUUFSTFCVUMFCJITVMJU TBSLPQMBTNB 4FMBOKVUOZB LBMTJVN EJ EBMBN TBSLPQMBTNB
UFSFLTJUBTJ EJCBOEJOHLBO LFUJLB EBMBN LFBEBBO OPSNBM UFUBQJ CFSJOUFSBLTJEFOHBOUSPQPOJOVOUVLNFOHBXBMJQFNCFOUVLBO
XBMBVQVO EFNJLJBO NBTJI EBQBU UFSFLTJUBTJ PMFI TJOZBM KFNCBUBOTJMBOHEBOLPOUSBLTJNFMBMVJNFLBOJTNFEBTBSZBOH
FLTJUBUPSJL ZBOH TBOHBU LVBU TFQFSUJ ZBOH EJQFSMJIBULBO TFCBHBJ TBNBTFQFSUJZBOHEJEJTLVTJLBOVOUVLPUPUSBOHLBQBEB#BC
LPOUSBLTJQSFNBUVSEJOJQBEBDPOUPILFEVBEBMBN(BNCBS 5BOQBLBMTJVNEBSJUVCVMVT5JOJ LFLVBUBOLPOUSBLTJPUPU
1FSJPEFSFGSBLUFSPUPUBUSJVNKBVIMFCJITJOHLBUEBSJQBEBQFSJPEF KBOUVOH JOJ BLBO TBOHBU NFOVSVO LBSFOB SFUJLVMVN
SFGSBLUFS PUPU WFOUSJLFM LJSBLJSB EFUJL VOUVL BUSJVN TBSLPQMBTNJL PUPU KBOUVOH LVSBOH CFHJUV CFSLFNCBOH
EJCBOEJOHLBOEFOHBOWFOUSJLFM ZBJUV TBNQBJ EFUJL
EJCBOEJOHLBO SFUJLVMVN TBSLPQMBTNJL PUPU SBOHLB EBO UJEBL
NFOZJNQBO LBMTJVN ZBOH DVLVQ VOUVL NFOJNCVMLBO
LPOUSBLTJ QFOVI /BNVO UVCVMVT 5 QBEB PUPU KBOUVOH
NFNQVOZBJ EJBNFUFS LBMJ MFCJI CFTBS EBSJQBEB UVCVMVT 5
QBEBPUPUSBOHLB ZBOHCFSBSUJWPMVNFOZBLBMJMFCJICFTBS
4FMBJO JUV EJ EBMBN UVCVMVT 5 EJUFNVLBO TFKVNMBI CFTBS
NVLPQPMJTBLBSJEB ZBOH CFSNVBUBO FMFLUSPOFHBUJG EBO
NFOHJLBUDBEBOHBOJPOLBMTJVNZBOHTBOHBUCBOZBL NFOKBHB
BHBS JPO LBMTJVN TFMBMV UFSTFEJB VOUVL CFSEJGVTJ LF CBHJBO
EBMBN TFSBU PUPU KBOUVOH TFXBLUV UFSKBEJ QPUFOTJBM BLTJ QBEB
UVCVMVT5
,FLVBUBO LPOUSBLTJ PUPU KBOUVOH TBOHBU CFSHBOUVOH QBEB
LPOTFOUSBTJ JPO LBMTJVN DBJSBO FLTUSBTFMVMBS ,FOZBUBBOOZB
KBOUVOHZBOHEJUFNQBULBOEBMBNMBSVUBOCFCBTLBMTJVN BLBO
TFHFSB CFSIFOUJ CFSEFOZVU 1FOZFCBCOZB JBMBI CBIXB DFMBI
DFMBI QBEB UVCVMVT 5 MBOHTVOH NFOFNCVT NFNCSBO TFM PUPU
KBOUVOH LF SVBOH FLTUSBTFM ZBOH NFOHFMJMJOHJ TFM TFIJOHHB
DBJSBO FLTUSBTFMVMBS ZBOH TBNB ZBOH UFSEBQBU EJ EBMBN
JOUFSTUJTJVNPUPUKBOUVOHKVHBNFMFXBUJUVCVMVT5"LJCBUOZB

Unit III Jantung
Ca++ Na+ K+
ATP
Ca++ Na+
Ca++
Ca++ ATP
Ca++
Ca++
KVNMBI JPO LBMTJVN ZBOH BEB EJ EBMBN TJTUFN UVCVMVT 5 ZBJUV KBOUVOH TFCFOBSOZB NFSVBQBLBO TVBUV GVOHTJ EBSJ MBNBOZB
UFSTFEJBOZB JPO LBMTJVN VOUVL NFOJNCVMLBO LPOUSBLTJ PUPU QPUFOTJBM BLTJ UFSNBTVL QMBUFBV LJSBLJSB EFUJL QBEB PUPU
KBOUVOH TBOHBU CFSHBOUVOH QBEB LPOTFOUSBTJ JPO LBMTJVN EJ BUSJVNEBO EFUJLQBEBPUPUWFOUSJLFM
EBMBNDBJSBOFLTUSBTFMVMBS
4FCBMJLOZB LFLVBUBO LPOUSBLTJ PUPU SBOHLB IBNQJS UJEBL
EJQFOHBSVIJPMFIQFSVCBIBOLPOTFOUSBTJJPOLBMTJVNZBOHUJEBL Siklus Jantung
UFSMBMVCFTBSEJEBMBNDBJSBOFLTUSBTFMVMBSLBSFOBLPOUSBLTJPUPU
SBOHLB IBNQJS TFMVSVIOZB EJTFCBCLBO PMFI JPO LBMTJVN ZBOH 1FSJTUJXB ZBOH UFSKBEJ QBEB KBOUVOH EJNVMBJ EBSJ BXBM TFCVBI
EJMFQBTLBO EBSJ SFUJLVMVN TBSLPQMBTNJL EJ EBMBN TFSBU PUPU EFOZVUKBOUVOHTBNQBJBXBMEFOZVUKBOUVOHCFSJLVUOZBEJTFCVU
SBOHLB TJLMVT KBOUVOH 4FUJBQ TJLMVT EJBXBMJ PMFI QFNCFOUVLBO
1BEB BLIJS QMBUFBV QPUFOTJBM BLTJ KBOUVOH QFNBTVLBO JPO QPUFOTJBMBLTJTQPOUBOEJEBMBNTJNQVMTJOVT TFQFSUJEJKFMBTLBO
LBMTJVNLFEBMBNTFSBUPUPUUJCBUJCBCFSIFOUJ EBOJPOLBMTJVN EBMBN#BC4JNQVMJOJUFSMFUBLQBEBEJOEJOHMBUFSBMTVQFSJPS
EJ EBMBN TBSLPQMBTNB EFOHBO DFQBU EJQPNQBLBO LFMVBS EBSJ BUSJVN LBOBO EFLBU NVBSB WFOB DBWB TVQFSJPS TFMBOKVUOZB
TFSBU PUPU LFNCBMJ LF EBMBN SFUJLVMVN TBSLPQMBTNJL EBO QPUFOTJBM BLTJ NFOKBMBS EBSJ TJOJ EFOHBO LFDFQBUBO UJOHHJ
UVCVMVT 5 SVBOH DBJSBO FLTUSBTFMVMBS 1FOHBOHLVUBO LBMTJVN NFMBMVJ LFEVB BUSJVN EBO LFNVEJBO NFMBMVJ CFSLBT "7 LF
LFNCBMJ LF EBMBN SFUJLVMVN TBSLPQMBTNJL EJKBMBOLBO EFOHBO WFOUSJLFM0MFILBSFOBBEBOZBQFOHBUVSBOLIVTVTEBMBNTJTUFN
CBOUVBO QPNQB LBMTJVN"51BTF MJIBU (BNCBS
*PO LPOEVLTJ EBSJ BUSJVN NFOVKV LF WFOUSJLFM EJUFNVLBO
LBMTJVN KVHB EJLFMVBSLBO EBSJ TFM PMFI QFOVLBS OBUSJVN QFSMBNCBUBOTFMBNBMFCJIEBSJ EFUJLLFUJLBJNQVMTKBOUVOH
LBMTJVN /BUSJVN ZBOH NBTVL TFM TFMBNB QFSUVLBSBO JOJ EJIBOUBSLBO EBSJ BUSJVN LF WFOUSJLFM ,FBEBBO JOJ
LFNVEJBOEJBOHLVULFMVBSEBSJTFMPMFIQPNQBOBUSJVNLBMJVN NFNVOHLJOLBO BUSJVN VOUVL CFSLPOUSBLTJ NFOEBIVMVJ
"51BTF "LJCBUOZB LPOUSBLTJ CFSIFOUJ TBNQBJ EBUBOH MBHJ LPOUSBLTJ WFOUSJLFM TFSUB NFNPNQBLBO EBSBI LF EBMBN
QPUFOTJBMBLTJZBOHCBSV WFOUSJLFM TFCFMVN UFSKBEJ LPOUSBLTJ WFOUSJLFM ZBOH LVBU +BEJ
-BNBOZB ,POUSBLTJ 0UPU KBOUVOH NVMBJ CFSLPOUSBLTJ BUSJVN JUV CFLFSKB TFCBHBJ QPNQB QFOEBIVMV CBHJ WFOUSJLFM
CFCFSBQB NJMJEFUJL TFTVEBI QPUFOTJBM BLTJ EJNVMBJ EBO BLBO EBOWFOUSJLFMTFMBOKVUOZBBLBONFOZFEJBLBOTVNCFSLFLVBUBO
UFSVT CFSLPOUSBLTJ TFMBNB CFCFSBQB NJMJEFUJL TFTVEBI VUBNB VOUVL NFNPNQBLBO EBSBI LF TJTUFN QFNCVMVI EBSBI
QPUFOTJBMBLTJCFSBLIJS0MFILBSFOBJUV MBNBLPOUSBLTJPUPU UVCVI
104
Sistolik dan Diastolik Hubungan antara Gambaran Elektrokardiogram dengan

4JLMVT KBOUVOH UFSEJSJ BUBT TBUV QFSJPEF SFMBLTBTJ ZBOH EJTFCVU Siklus Jantung
EJBTUPMJL ZBJUV QFSJPEF QFOHJTJBO KBOUVOH EFOHBO EBSBI ZBOH (FMPNCBOHHFMPNCBOH1 2 3 4 5ZBOHEJUVOKVLLBOPMFIFMFLUSP
EJJLVUJPMFITBUVQFSJPEFLPOUSBLTJZBOHEJTFCVUTJTUPMJL LBSEJPHSBNQBEB(BNCBSBLBOEJCJDBSBLBOEBMBN#BC
-BNBCFSMBOHTVOHOZBLFTFMVSVIBOTJLMVTKBOUVOHUFSNBTVL EBO (FMPNCBOHHFMPNCBOH JOJ NFSVQBLBO UFHBOHBO MJTUSJL
UNIT III
TJTUPMEBOEJBTUPM CFSCBOEJOHUFSCBMJLEFOHBOGSFLVFOTJEFOZVU ZBOHEJUJNCVMLBOPMFIKBOUVOHEBOEJSFLBNPMFIFMFLUSPLBSEJPHSBG
KKBOUVOH4FCBHBJDPOUPI CJMBGSFLVFOTJEFOZVUKBOUVOHBEBMBI EBSJQFSNVLBBOUVCVI
EFOZVUNFOJU MBNB TJLMVT KBOUVOH BEBMBI EFOZVU (FMPNCBOH1EJTFCBCLBOPMFIQFOZFCBSBOEFQPMBSJTBTJNFMFXBUJ
NFOJUoTFLJUBS NFOJU QFS EFOZVU BUBV EFUJL QFS BUSJVN ZBOH EJJLVUJ PMFI LPOUSBLTJ BUSJVN ZBOH NFOZFCBCLBO
EFOZVU LVSWB UFLBOBO BUSJVN OBJL TFEJLJU TFHFSB TFTVEBI HFMPNCBOH 1
(BNCBS NFNQFSMJIBULBO CFSCBHBJ QFSJTUJXB CFSCFEB QBEBFMFLUSPLBSEJPHSBN
ZBOHUFSKBEJTFMBNBTJLMVTKBOUVOHVOUVLTJTJLJSJKBOUVOH,FUJ ,JSBLJSB EFUJLTFTVEBIEJNVMBJOZBHFMPNCBOH1 NVODVM
HB LVSWB UFSBUBT TFDBSB CFSVSVUBO NFOVOKVLLBO QFSVCBIBO HFMPNCBOH 234 TFCBHBJ IBTJM EFQPMBSJTBTJ MJTUSJL QBEB WFOUSJLFM
QFQFSVCBIBOUFLBOBOEJEBMBNBPSUB WFOUSJLFMLJSJ EBOBUSJVN ZBOH NFOHBXBMJ LPOUSBLTJ WFOUSJLFM EBO NFOZFCBCLBO UFLBOBO
LJSJ ,VSWB LFFNQBU NFMVLJTLBO QFSVCBIBO WPMVNF WFOUSJLFM WFOUSJLFM NVMBJ NFOJOHLBU TFQFSUJ ZBOH EJUVOKVLLBO QVMB EBMBN
LJSJ LVSWBLFMJNBBEBMBIFMFLUSPLBSEJPHSBN EBOLVSWBLFFOBN HBNCBS 0MFI LBSFOB JUV LPNQMFLT 234 EJNVMBJ TFTBBU TFCFMVN
BEBMBI GPOPLBSEJPHSBN ZBOH NFSVQBLBO SFLBNBO CVOZJ ZBOH TJTUPMJLWFOUSJLFM
EJIBTJMLBO PMFI KBOUVOH UFSVUBNB PMFI LBUVQ KBOUVOH TFXBLUV "LIJSOZB NBSJMBILJUBMJIBUHFMPNCBOH5WFOUSJLFMQBEBFMFUSP
NFNPNQBLBO EBSBI ,JSBOZB TBOHBU QFOUJOH CBHJ NBIBTJTXB LBSEJPHSBN (FMPNCBOH 5 WFOUSJLFM NFXBLJMJ UBIBQ SFQPMBSJTBTJ
VOUVLNFNQFMBKBSJEJBHSBNEBMBNHBNCBSJOJTFDBSBMFCJIEF WFOUSJLFM LFUJLB TFSBUTFSBU PUPU WFOUSJLFM NVMBJ CFSFMBLTBTJ 0MFI
UBJMEBONFOHFSUJBLBOQFOZFCBCEBSJTFNVBQFSJTUJXBQFSJTUJXB LBSFOBJUV HFMPNCBOH5UFSKBEJTFTBBUTFCFMVNBLIJSEBSJLPOUSBLTJ
ZBOHEJHBNCBSLBOEJBUBT WFOUSJLFM
1FOHBSVI'SFLVFOTJ%FOZVU+BOUVOHUFSIBEBQ-BNB4JLMVT
+BOUVOH "QBCJMB GSFLVFOTJ EFOZVU KBOUVOH NFOJOHLBU MBNB
Fungsi Atrium sebagai Pompa Pendahuluan
CFSMBOHTVOHOZBTFUJBQTJLMVTKBOUVOHBLBOUVSVO UFSNBTVLGBTF
LPOUSBLTJ EBO SFMBLTBTJ -BNB QPUFOTJBM BLTJ EBO QFSJPEF 1BEB LFBEBBO OPSNBM EBSBI NFOHBMJS TFDBSB UFSVTNFOFSVT
LPOUSBLTJ TJTUPM
KVHB UVSVO OBNVO UJEBL TFCFTBS QFSTFOUBTF EBSJWFOBWFOBCFTBSNFOVKVLFBUSJVNLJSBLJSBQFSTFOEBSJ
GBTF SFMBLTBTJ EJBTUPM
1BEB GSFLVFOTJ EFOZVU KBOUVOH OPSNBM EBSBI UFSTFCVU BLBO NFOHBMJS MBOHTVOH NFMFXBUJ BUSJVN EBO
TFCFTBSEFOZVUNFOJU TJTUPMCFSMBOHTVOHTFLJUBS CBHJBO NBTVLLFEBMBNWFOUSJLFMCBILBOTFCFMVNBUSJVNCFSLPOUSBLTJ
EBSJ TFMVSVI TJLMVT KBOUVOH 1BEB GSFLVFOTJ UJHB LBMJ GSFLVFOTJ 4FMBOKVUOZB LPOUSBLTJ BUSJVN CJBTBOZB NFOZFCBCLBO UBNCB
EFOZVU OPSNBM TJTUPM CFSMBOHTVOH CBHJBO EBSJ TFMVSVI IBOQFOHJTJBOWFOUSJLFMTFCFTBSQFSTFO0MFILBSFOBJUV BUSJ
TJLMVT KBOUVOH )BM JOJ CFSBSUJ CBIXB KBOUVOH ZBOH CFSEFOZVU VN EJLBUBLBO CFSGVOHTJ TFCBHBJ QPNQB QSJNFS ZBOH NFOJOH
EFOHBO GSFLVFOTJ ZBOH TBOHBU DFQBU UJEBL NFNJMJLJ XBLUV LBULBOFGFLUJWJUBTQPNQBWFOUSJLFMTFCBOZBLQFSTFO/BNVO
SFMBLTBTJZBOHDVLVQVOUVLQFOHJTJBOTFNQVSOBSVBOHKBOUVOH KBOUVOHCBILBOEBQBUUFSVTCFLFSKBQBEBLFBEBBOUBOQBUBNCB
TFCFMVNLPOUSBLTJCFSJLVUOZB IBOFGFLUJWJUBTTFCFTBSQFSTFOUFSTFCVU LBSFOBTFDBSBOPSNBM
Aortic
pressure
105
Unit III Jantung
KBOUVOHNFNQVOZBJLFNBNQVBOVOUVLNFNPNQBLBOEBSBI QVMNPOBMJT 0MFI LBSFOB JUV TFMBNB QFSJPEF JOJ BLBO UFSKBEJ
TBNQBJQFSTFOMFCJICBOZBLEBSBIEBSJQBEBZBOHEJCVUVILBO LPOUSBLTJ EJ EBMBN WFOUSJLFM OBNVO CFMVN BEB QFOHPTPOHBO
PMFI UVCVI QBEB LFBEBBO JTUJSBIBU 0MFI LBSFOB JUV CJMB BUSJVN 1FSJPEF JOJ EJTFCVU TFCBHBJ QFSJPEF LPOUSBLTJ JTPNFUSJL BUBV
HBHBM CFSGVOHTJ QFSCFEBBO JOJ UJEBL UFSMBMV EJQFSIBUJLBO LFDVBMJ JTPWPMFNJL ZBOH CFSBSUJ BEB LFOBJLBO UFHBOHBO EJ EBMBN PUPU
LBMBVPSBOHUFSTFCVUCFSPMBISBHBNBLBBEBLBMBOZBUJNCVMHFKBMB OBNVO UJEBL BEB BUBV UFSKBEJ TFEJLJU QFNFOEFLBO TFSBUTFSBU
HFKBMBHBHBMKBOUVOHBLVU UFSVUBNBTFTBLOBQBT PUPU
1FSVCBIBO5FLBOBOEJ%BMBN"USJVN(FUPNCBOH(FMPNCBOH 1FSJPEF&KFLTJ#JMBUFLBOBOWFOUSJLFMLJSJNFOJOHLBUTFEJLJUEJ
B D EBO W 1BEB LVSWB UFLBOBO BUSJVN QBEB (BNCBS EBQBU BUBTNN)H EBOUFLBOBOWFOUSJLFMLBOBONFOJOHLBUTFEJLJU
EJMJIBU UJHB QFOJOHLBUBO UFLBOBO LFDJM ZBOH EJTFCVU HFMPNCBOH EJBUBTNN)H
NBLBUFLBOBOWFOUSJLFMJOJBLBONFOEPSPOH
UFLBOBOBUSJVNB D EBOW LBUVQ TFNJMVOBSJT TVQBZB UFSCVLB 4FHFSB TFUFMBI JUV EBSBI
(FMPNCBOH B EJTFCBCLBO PMFI LPOUSBLTJ BUSJVN #JBTBOZB TFMBNB NVMBJ NFOHBMJS LFMVBS EBSJ WFOUSJLFM TFLJUBS QFSTFO EBSJ
LPOUSBLTJBUSJVN UFLBOBOBUSJVNLBOBONFOJOHLBUTFCFTBSTBNQBJ QSPTFTQFOHPTPOHBOEBSBIUFSKBEJTFMBNBTFQFSUJHBQFSUBNBEBSJ
NN )H TFEBOHLBO UFLBOBO BUSJVN LJSJ NFOJOHLBU LJSBLJSB QFSJPEF FKFLTJ EBO QFSTFO TJTB QFOHPTPOHBO UFSKBEJ TFMBNB
TFCFTBSTBNQBJNN)H EVB QFSUJHB CFSJLVUOZB 0MFI LBSFOB JUV XBLUV TFQFSUJHB ZBOH
(FMPNCBOH D UFSKBEJ QBEB TBBU WFOUSJLFM NVMBJ CFSLPOUSBLTJ QFSUBNB EJTFCVU TFCBHBJ QFSJPEF FKFLTJ DFQBU EBO XBLUV
HFMPNCBOH JOJ TFCBHJBO EJTFCBCLBO PMFI BEBOZB TFEJLJU BMJSBO CBMJL
EVBQFSUJHBZBOHUFSBLIJSEJTFCVUTFCBHBJQFSJPEFFKFLTJMBNCBU
EBSBI LF EBMBN BUSJVN QBEB QFSNVMBBO LPOUSBLTJ WFOUSJLFM UFUBQJ
UFSVUBNB EJTFCBCLBO PMFI QFOPOKPMBO LBUVQ "7 LFNCBMJ LF BSBI
1FSJPEF 3FMBLTBTJ *TPWPMFNJL *TPNFUSJL
1BEB BLIJS TJTUP
BUSJVNBLJCBUBEBOZBQFOJOHLBUBOUFLBOBOEJEBMBNWFOUSJLFM MJL SFMBLTBTJ WFOUSJLFM NVMBJ UFSKBEJ TFDBSB UJCBUJCB TFIJOHHB
(FMPNCBOH W UFSKBEJ NFOKFMBOH BLIJS LPOUSBLTJ WFOUSJLFM HFMPN CBJL UFLBOBO JOUSBWFOUSJLFM LJSJ NBVQVO LBOBO NFOVSVO EF
CBOHJOJEJTFCBCLBOPMFIBMJSBOEBSBIZBOHMBNCBUEBSJWFOBLFEB OHBODFQBU1FOJOHHJBOUFLBOBOEJEBMBNBSUFSJCFTBSZBOHCFS
MBNBUSJVNTFNFOUBSBLBUVQ"7UFSUVUVQTFXBLUVLPOUSBLTJWFOUSJ EJMBUBTJ ZBOH CBSV TBKB EJJTJ EFOHBO EBSBI ZBOH CFSBTBM EBSJ
LFM ,FNVEJBO TFXBLUV LPOUSBLTJ WFOUSJLFM CFSBLIJS LBUVQ "7 WFOUSJLFM ZBOH CFSLPOUSBLTJ TFHFSB NFOEPSPOH EBSBI LFNCBMJ
NFNCVLB TFIJOHHBEBSBIBUSJVNZBOHUFSTJNQBOJOJEBQBUNFOHBMJS LFWFOUSJLFMTFIJOHHBBMJSBOEBSBIJOJBLBONFOVUVQLBUVQBPSUB
EFOHBO DFQBU LF EBMBN WFOUSJLFM EBO NFOZFCBCLBO IJMBOHOZB EBO LBUVQ QVMNPOBMJT EFOHBO LFSBT 4FMBNB TBNQBJ
HFMPNCBOHW EFUJL CFSJLVUOZB PUPU WFOUSJLFM UFSVT CFSFMBLTBTJ NFTLJQVO
WPMVNFWFOUSJLFMUJEBLCFSVCBI TFIJOHHBNFOZFCBCLBOQFSJPEF
Fungsi Ventrikel sebagai Pompa SFMBLTBTJ JTPWPMFNJL BUBV JTPNFUSJL 4FMBNB QFSJPEF JOJ UFLBOBO
1FOHJTJBO 7FOUSJLFM 4FMBNB %JBTUPM 4FMBNB GBTF TJTUPM JOUSBWFOUSJLFM NFOVSVO EFOHBO DFQBU TFLBMJ LF UFLBOBO EJBTUP
WFOUSJLFM TFKVNMBI CFTBS EBSBI CFSLVNQVM EBMBN BUSJVN LJSJ MJLOZBZBOHSFOEBI4FMBOKVUOZBLBUVQ"7BLBOUFSCVLBVOUVL
EBO LBOBO LBSFOB LBUVQ "7 UFSUVUVQ 0MFI LBSFOB JUV TFHFSB NFNVMBJTJLMVTQFNPNQBBOWFOUSJLFMZBOHCBSV
TFTVEBITJTUPMTFMFTBJEBOUFLBOBOWFOUSJLFMUVSVOMBHJTBNQBJLF 7PMVNF%JBTUPMJL"LIJS 7PMVNF4JTUPMJL"LIJS EBO$VSBI
OJMBJ EJBTUPMOZB ZBOH SFOEBI UFLBOBO ZBOH DVLVQ UJOHHJ ZBOH *TJ 4FLVODVQ 4FMBNB GBTF EJBTUPMJL QFOHJTJBO WFOUSJLFM ZBOH
UFMBI UFSCFOUVL EJ EBMBN BUSJVN TFMBNB GBTF TJTUPM WFOUSJLFM OPSNBM BLBO NFOJOHLBULBO WPMVNF TFUJBQ WFOUSJLFM TBN QBJ
TFHFSBNFOEPSPOHLBUVQ"7BHBSUFSCVLBTFIJOHHBEBSBIEBQBU LJSBLJSB IJOHHB NM 7PMVNF JOJ EJTFCVU WPMVNF EJBT
NFOHBMJS EFOHBO DFQBU LF EBMBN WFOUSJLFM TFQFSUJ ZBOH UPMJLBLIJS4FMBOKVUOZB TFXBLUVWFOUSJLFMNFOHPTPOHLBOJTJOZB
EJQFSMJIBULBOEFOHBOOBJLOZBLVSWBWPMVNFWFOUSJLFMLJSJEBMBN TFMBNB GBTF TJTUPMJL WPMVNF WFOUSJLFM BLBO NFOVSVO TBNQBJ
(BNCBS,FBEBBOJOJEJTFCVUTFCBHBJQFSJPEFQFOHJTJBODFQBU LJSBLJSBNM ZBOHEJTFCVUTFCBHBJDVSBIJTJTFLVODVQ7PMV
QBEBWFOUSJLFM NFZBOHNBTJIUFSUJOHHBMEBMBNTFUJBQWFOUSJLFM ZBLOJLJSBLJSB
1FSJPEFQFOHJTJBODFQBUCFSMBOHTVOHLJSBLJSBQBEBTFQFSUJHB TBNQBJ NM EJTFCVU TFCBHBJ WPMVNF TJTUPMJLBLIJS #BHJBO
QFSUBNB EBSJ EJBTUPMJL 4FMBNB TFQFSUJHB LFEVB EBSJ EJBTUPMJL EBSJ WPMVNF EJBTUPMJLBLIJS ZBOH EJTFNQSPULBO LFMVBS EJTFCVU
CJBTBOZB IBOZB BEB TFEJLJU EBSBI ZBOH NFOHBMJS LF EBMBN CBHJBOFKFLTJCJBTBOZBTBNBEFOHBOLJSBLJSBQFSTFO
WFOUSJLFMEBSBIJOJBEBMBIEBSBIZBOHUFSVTNFOHBMJSNBTVLLF #JMBKBOUVOHCFSLPOUSBLTJEFOHBOLVBU WPMVNFTJTUPMJLBLIJS
EBMBN BUSJVN EBSJ WFOBWFOB EBO EBSJ BUSJVN MBOHTVOH NBTVL EBQBUCFSLVSBOHIJOHHBNFODBQBJTBNQBJNM4FCBMJLOZB
LFWFOUSJLFM CJMB TFKVNMBI CFTBS EBSBI NFOHBMJS NBTVL LF EBMBN WFOUSJLFM
4FMBNBQFSJPEFTFQFSUJHBBLIJSEBSJEJBTUPMJL BUSJVNCFSLPO TFMBNB GBTF EJBTUPMJL WPMVNF EJBTUPMJL BLIJS WFOUSJLFM EBQBU
USBLTJ EBO NFNCFSJLBO EPSPOHBO UBNCBIBO UFSIBEBQ BMJSBO NFOKBEJ TBNQBJ NM QBEB KBOUVOH ZBOH TFIBU %FOHBO
EBSBIZBOHNBTVLLFEBMBNWFOUSJLFMEBONFSVQBLBOLJSBLJSB NFOBJLLBO WPMVNF EJBTUPMJLBLIJS EBO NFOVSVOLBO WPMVNF
QFSTFOEBSJQFOHJTJBOWFOUSJLFMQBEBTFUJBQTJLMVTKBOUVOH TJTUPMJLBLIJS DVSBIJTJTFLVODVQTFSJOHLBMJEBQBUEJUJOHLBULBO
TBNQBJLJSBLJSBMFCJIEBSJEVBLBMJWPMVNFOPSNBM
Pengosongan Ventrikel Selama Sistolik
1FSJPEF ,POUSBLTJ *TPWPMFNJL *TPNFUSJL
4FHFSB TFTVEBI Fungsi Katup
WFOUSJLFM NVMBJ CFSLPOUSBLTJ UFLBOBO WFOUSJLFM NFOJOHLBU EF ,BUVQ "USJPWFOUSJLFM ,BUVQ "7 LBUVQ USJLVTQJE EBO LBUVQ
OHBO UJCBUJCB TFQFSUJ ZBOH EJHBNCBSLBO EBMBN (BNCBS NJUSBM
NFODFHBI BMJSBO CBMJL EBSBI ZBOH CFSBTBM EBSJ WFOUSJLFM
TFIJOHHBNFOZFCBCLBOLBUVQ"7NFOVUVQ4FMBOKVUOZBEJCVUV NFOVKV LF BUSJVN TFMBNB GBTF TJTUPMJL EBO LBUVQ TFNJMVOBSJT
UVILBO UBNCBIBO XBLUV TFCBOZBL TBNQBJ EFUJL CBHJ ZBLOJ LBUVQ BPSUB EBO BSUFSJ QVMNPOBMJT
NFODFHBI BMJSBO CBMJL
WFOUSJLFM BHBS EBQBU NFOHIJNQVO UFLBOBO ZBOH DVLVQ VOUVL EBSBI ZBOH CFSBTBM EBSJ BPSUB EBO BSUFSJ QVMNPOBMJT LFNCBMJ LF
NFOEPSPOH LBUVQ TFNJMVOBSJT LBUVQ BPSUB EBO LBUVQ QVMNP WFOUSJLFMTFMBNBEJBTUPMJL,BUVQLBUVQJOJ TFQFSUJZBOHEJUVOKVL
OBMJT
BHBSUFSCVLBNFMBXBOUFLBOBOEJEBMBNBPSUBEBOBSUFSJ LBOEBMBN(BNCBSVOUVLWFOUSJLFMLJSJ NFOVUVQEBONFN

Bab 9 Otot jantung; Jantung sebagai Pompa dan Fungsi Katup-Katup Jantung
Kurva Tekanan Aorta
#JMBWFOUSJLFMLJSJCFSLPOUSBLTJ UFLBOBOWFOUSJLFMEFOHBODFQBU
NFOJOHLBU TBNQBJ LBUVQ BPSUB NFNCVLB 4FMBOKVUOZB TFUFMBI
LBUVQUFSCVLB UFLBOBOEJEBMBNWFOUSJLFMIBOZBBLBONFOJOH
LBUTFEJLJU TFQFSUJZBOHEJUVOKVLLBOEBMBN(BNCBS LBSFOB
UNIT III
EBSBI TFHFSB NFOHBMJS LF MVBS EBSJ WFOUSJLFM EBO NBTVL LF
EBMBNBPSUBMBMVNBTVLLFBSUFSJQFOZBMVSTJTUFNJL
.BTVLOZBEBSBILFEBMBNBSUFSJBLBONFOZFCBCLBOEJOEJOH
BSUFSJ UFSTFCVU NFSFHBOH EBO UFLBOBO NFOJOHLBU TFLJUBS
NN)H
4FMBOKVUOZB QBEB BLIJS TJTUPMJL TFUFMBI WFOUSJLFM CFSIFOUJ
NFOHFKFLTJLBO EBSBI EBO LBUVQ BPSUB UFSUVUVQ FMBTUJTJUBT
EJOEJOHBSUFSJBLBOUFUBQNFNQFSUBIBOLBOUFLBOBOZBOHUJOHHJ
EJEBMBNBSUFSJ CBILBOTFMBNBEJBTUPMJL
#JMB LBUVQ BPSUB NFOVUVQ QBEB LVSWB UFLBOBO BPSUB BLBO
UJNCVM TVBUV JOTJTVSB *OTJTVSB JOJ EJTFCBCLBO PMFI QFSJPEF
TJOHLBU BMJSBO CBMJL EBSBI TFHFSB TFCFMVN QFOVUVQBO LBUVQ
ZBOHTFMBOKVUOZBBLBOEJJLVUJEFOHBOQFOHIFOUJBOBMJSBOCBMJL
UFSTFCVUTFDBSBUJCBUJCB
4FTVEBILBUVQBPSUBNFOVUVQ UFLBOBOEJEBMBNBPSUBBLBO
CVLB TFDBSB QBTJG :BJUV LBUVQLBUVQ JOJ BLBO NFOVUVQ TFXBLUV CFSLVSBOH TFDBSB QFSMBIBOMBIBO TFQBOKBOH GBTF EJBTUPMJL LBSF
HSBEJFOUFLBOBOCBMJLNFOEPSPOHEBSBILFNCBMJLFCFMBLBOH EBO OBEBSBIZBOHEJTJNQBOEJEBMBNBSUFSJFMBTUJTZBOHCFSEJMBUBTJ
LBUVQLBUVQ JOJ NFNCVLB CJMB HSBEJFO UFLBOBO LF BSBI EFQBO BLBO NFOHBMJS TFDBSB UFSVTNFOFSVT NFMBMVJ QFNCVMVI EBSBI
NFOEPSPOH EBSBI LF EFQBO #FSLBJUBO EFOHBO BOBUPNJOZB QFSJGFS LFNCBMJ LF WFOB 4FCFMVN WFOUSJLFM CFSLPOUSBLTJ MBHJ
QFOVUVQBOLBUVQ"7ZBOHUJQJTEBONJSJQTFMBQVUJOJIBNQJSUJEBL CJBTBOZB UFLBOBO BPSUB UVSVO TBNQBJ LJSBLJSB NN )H
NFNCVUVILBO BMJSBO CBMJL EBSBI TFEBOHLBO LBUVQ TFNJMVOBSJT UFLBOBO EJBTUPMJL
ZBOH NFSVQBLBO EVB QFSUJHB EBSJ UFLBOBO
ZBOH KBVI MFCJI UFCBM NFNCVUVILBO BMJSBO CBMJL ZBOH BHBL DFQBU NBLTJNVN TFCFTBS NN )H UFLBOBO TJTUPMJL
ZBOH UFSKBEJ
TFMBNBCFCFSBQBNJMJEFUJLVOUVLNFOVUVQ EJEBMBNBPSUBTFMBNBLPOUSBLTJWFOUSJLFM
'VOHTJ 0UPU 1BQJMBSJT (BNCBS KVHB NFOVOKVLLBO PUPU ,VSWB UFLBOBO EJ EBMBN WFOUSJLFM LJSJ EBO BSUFSJ QVMNPOBMJT
QBQJMBSJTZBOHNFMFLBUQBEBEBVOEBVOLBUVQ"7NFMBMVJLPSEB NJSJQ EFOHBO LVSWB UFLBOBO ZBOH UFSEBQBU EJ EBMBN BPSUB IB
UFOEJOFB 0UPU QBQJMBSJT CFSLPOUSBLTJ CJMB EJOEJOH WFOUSJLFM OZBTBKBUFLBOBOUFSTFCVUCFTBSOZBLJSBLJSBTFQFSFOBNEBSJUF
CFSLPOUSBLTJ UFUBQJ CFSMBXBOBO EFOHBO BQB ZBOH EJQFSLJSBLBO LBOBO EJ EBMBN BPSUB TFQFSUJ ZBOH BLBO EJCJDBSBLBO EJ EBMBN
PUPU QBQJMBSJT JOJ UJEBL NFNCBOUV NFOVUVQ LBUVQ UFSTFCVU #BC
4FCBMJLOZB TFMBNB LPOUSBLTJ WFOUSJLFM PUPU QBQJMBSJT JOJ NFOBSJL
EBVOEBVO LBUVQ LF EBMBN NFOVKV LF BSBI WFOUSJLFM VOUVL Hubungan antara Bunyi Jantung dengan Pompa Jantung
NFODFHBIBHBSLBUVQUJEBLNFOPOKPMUFSMBMVKBVILFCFMBLBOH LF
4FXBLUVLJUBNFOEFOHBSLBOCVOZJKBOUVOHEFOHBOCBOUVBOTFCVBI
BSBI BUSJVN #JMB LPSEB UFOEJOFB SPCFL BUBV TBMBI TBUV PUPU
TUFUPTLPQ TFTFPSBOH UJEBL EBQBU NFOEFOHBSLBO QFNCVLBBO LBUVQ
QBQJMBSJT JOJ MVNQVI LBUVQ BLBO NFOPOKPM KBVI LF CFMBLBOH
KBOUVOH LBSFOB IBM JOJ NFSVQBLBO TVBUV QSPTFT ZBOH SFMBUJG MBNCBU
TFMBNB LPOUSBLTJ WFOUSJLFM CFHJUV KBVI TFIJOHHB LBEBOHLBEBOH TFIJOHHB OPSNBMOZB UJEBL NFOJNCVMLBO TVBSB "LBO UFUBQJ XBLUV
UFSKBEJ LFCPDPSBO ZBOH IFCBU EBO NFOHBLJCBULBO QBZBI KBOUVOH LBUVQ UFSUVUVQ EBVO LBUVQ EBO DBJSBO EJ TFLFMJMJOHOZB CFSHFUBS
ZBOHQBSBIBUBVZBOHNFNBUJLBO LBSFOB QFOHBSVI QFSVCBIBO UFLBOBO ZBOH UJCBUJCB TFIJOHHB
,BUVQ"PSUBEBO,BUVQ"SUFSJ1VMNPOBMJT$BSBLFSKBLBUVQ NFOHIBTJMLBOTVBSBZBOHNFOKBMBSNFMFXBUJEBEBLFTFNVBKVSVTBO
TFNJMVOBSJTBPSUBEBOBSUFSJQVMNPOBMJTDVLVQCFSCFEBEBSJLBUVQ
#JMB WFOUSJLFM CFSLPOUSBLTJ LJUB QFSUBNB LBMJ BLBO NFOEFOHBS
"7 1FSUBNB UFLBOBO ZBOH UJOHHJ EBMBN BSUFSJ QBEB BLIJS CVOZJ ZBOH EJTFCBCLBO PMFI QFOVUVQBO LBUVQ "7 (FUBSBO
TJTUPMJL BLBO NFOZFCBCLBO LBUVQ TFNJMVOBSJT UFSTFOUBL EBO UFSTFCVU OBEBOZB SFOEBI EBO SFMBUJG CFSUBIBO MBNB EBO EJLFOBM
NFOVUVQEFOHBOLFSBT CFSMBXBOBOEFOHBOQFOVUVQBOLBUVQ"7 TFCBHBJ CVOZJ KBOUVOH QFSUBNB 4FXBLUV LBUVQ BPSUB EBO LBUVQ
ZBOH MFCJI MFNCVU ,FEVB LBSFOB MVCBOHOZB ZBOH MFCJI LFDJM QVMNPOBMJT NFOVUVQ QBEB BLIJS TJTUPMJL LJUB EBQBU NFOEFOHBS
LFDFQBUBOFKFLTJEBSBINFMFXBUJLBUVQBPSUBEBOQVMNPOBMJTKBVI TVBUVCVOZJNFOZFOUBLZBOHDFQBU TFCBCLBUVQLBUVQJOJNFOVUVQ
MFCJI CFTBS EBSJQBEB LFDFQBUBO FKFLTJ ZBOH NFMFXBUJ LBUVQ "7 EFOHBODFQBU EBOTFLFMJMJOHOZBCFSHFUBSVOUVLXBLUVZBOHTJOHLBU
ZBOH KBVI MFCJI *FCBS +VHB LBSFOB QFOVUVQBO EBO FKFLTJ ZBOH #VOZJ JOJ EJTFCVU CVOZJ KBOUVOH LFEVB 1FOZFCBC CVOZJ KBOUVOH
CFSMBOHTVOH DFQBU UFQJ LBUVQ BPSUB EBO QVMNPOBMJT DFOEFSVOH ZBOH QBTUJ BLBO EJEJTLVTJLBO MFCJI NFOEBMBN EBMBN #BC
NFOEBQBU BCSBTJ NFLBOJT ZBOH MFCJI CFTBS EJCBOEJOHLBO EFOHBO TFIVCVOHBOEFOHBONFOEFOHBSLBOTVBSBEFOHBOTUFUPTLPQ
LBUVQ "7 "LIJSOZB LBUVQ "7 KVHB EJTPLPOH PMFI LPSEB
UFOEJOFB TFEBOHLBOLBUVQTFNJMVOBSJTUJEBLNFNJMJLJOZB)BMJOJ
Curah Kerja Jantung
UFSMJIBU OZBUB EBSJ BOBUPNJ LBUVQ BPSUB EBO QVMNPOBMJT TFQFSUJ
ZBOH UFSMJIBU QBEB CBHJBO CBXBI (BNCBS VOUVL LBUVQ BPSUB
$VSBI LFSKB TFLVODVQ KBOUVOH BEBMBI KVNMBI FOFSHJ ZBOH EJVCBI
CBIXBLBUVQLBUVQUFSTFCVUIBSVTUFSTVTVOEFOHBOEBTBSKBSJOHBO PMFI KBOUVOH NFOKBEJ LFSKB TFMBNB TFUJBQ EFOZVU KBOUVOH TFXBLUV
GJCSPTBZBOHTBOHBULVBUOBNVOTBOHBUMFOUVSVOUVLEBQBUNFOB NFNPNQBEBSBILFEBMBNBSUFSJ$VSBILFSKBTFNFOJUBEBMBIKVN
IBOUSBVNBGJTJLUBNCBIBO MBIUPUBMFOFSHJZBOHEJVCBINFOKBEJLFSKBEBMBNNFOJUKVNMBI
107
Unit III Jantung
JOJ TFCBOEJOH EFOHBO DVSBI LFSKB TFLVODVQ EJLBMJLBO EFOHBO EF 5FLBOBO EJBTUPMJL UJEBL BLBO OBJL CFHJUV CBOZBL CJMB WPMVNF
OZVUKBOUVOHQFSNFOJU WFOUSJLFMZBOHUJEBLCFSLPOUSBLTJCFMVNNFOJOHLBUEJBUBTLJSBLJSB
$VSBILFSKBKBOUVOHUFSCBHJEBMBNEVBCFOUVL1FSUBNB TFKBVI NM 0MFI LBSFOB JUV TBNQBJ WPMVNF JOJ EBSBI EBQBU EFOHBO
JOJ CBHJBO ZBOH VUBNB EJHVOBLBO VOUVL NFNJOEBILBO EBSBI EBSJ NVEBI NFOHBMJS EBSJ BUSJVN LF EBMBN WFOUSJLFM %J BUBT NM
WFOBWFOBCFSUFLBOBOSFOEBILFBSUFSJCFSUFLBOBOUJOHHJ#BHJBOJOJ UFLBOBOEJBTUPMJLWFOUSJLFMBLBONFOJOHLBUEFOHBODFQBU TFCBHJBO
EJTFCVUTFCBHBJLFSKBWPMVNFUFLBOBOBUBVLFSKBMVBS,FEVB CBHJBO LBSFOBKBSJOHBOJLBUGJCSPTBEJEBMBNKBOUVOHUJEBLBLBONFSFHBOH
ZBOHLFDJMEBSJFOFSHJUFSTFCVUEJHVOBLBOVOUVLNFNBDVLFDFQBUBO MFCJI CBOZBL MBHJ EBO TFCBHJBO MBHJ LBSFOB QFSJLBSEJVN ZBOH
FKFLTJEBSBINFMBMVJLBUVQBPSUBEBOQVMNPOBMJT#BHJBOJOJEJTFCVU NFOHFMJMJOHJKBOUVOHTVEBIUFSJTJTBNQBJNFOEFLBUJCBUBTOZB
LPNQPOFOFOFSHJLJOFUJLBMJSBOEBSBIEBODVSBILFSKB 4FMBNBLPOUSBLTJWFOUSJLFM UFLBOBOTJTUPMJLNFOJOHLBUCBILBO
$VSBI LFSKB MVBS WFOUSJLFM LBOBO CJBTBOZB TFLJUBS TFQFSFOBN QBEB WPMVNF WFOUSJLFM SFOEBI EBO BLBO NFODBQBJ NBLTJNVNOZB
DVSBI LFSKB WFOUSJLFM LJSJ LBSFOB BEBOZB QFSCFEBBO TFCFTBS FOBN QBEB WPMVNF WFOUSJLFM TFCFTBS TBNQBJ NM ,FNVEJBO
LBMJ MJQBU QBEB UFLBOBO TJTUPMJL EBSJ QFNPNQBBO LFEVB WFOUSJLFM TFJSJOH EFOHBO UFSVT NFOJOHLBUOZB WPMVNF UFSTFCVU EJ CBXBI
$VSBI LFSKB UBNCBIBO EBSJ UJBQ WFOUSJLFM ZBOH EJCVUVILBO VOUVL QFOHBSVICFCFSBQBLFBEBBO UFLBOBOTJTUPMJLNFOVSVO TFQFSUJZBOH
NFOHIBTJMLBOFOFSHJLJOFUJLBMJSBOEBSBIBEBMBITFCBOEJOHEFOHBO EJUVOKVLLBOEFOHBOUVSVOOZBLVSWBUFLBOBOTJTUPMJLQBEB(BNCBS
NBTTB EBSBI ZBOH EJFKFLTJLBO EJLBMJ EFOHBO LVBESBU LFDFQBUBO TFCBC QBEB WPMVNF ZBOH TBOHBU CFTBS JOJ GJMBNFO BLUJO EBO
FKFLTJ NJPTJO TFSBU PUPU KBOUVOH CFOBSCFOBS UFSFHBOH DVLVQ KBVI
#JBTBOZB DVSBI LFSKB WFOUSJLFM LJSJ ZBOH EJCVUVILBO VOUVL TFIJOHHBLFLVBUBOLPOUSBLTJKBOUVOHNFOKBEJLVSBOHPQUJNBM
NFOJNCVMLBO FOFSHJ LJOFUJL BMJSBO EBSBI IBOZB LJSBLJSB QFSTFO 1FSIBUJLBO UFSVUBNB QBEB (BNCBS CBIXB UFLBOBO TJTUPMJL
EBSJ TFMVSVI DVSBI LFSKB WFOUSJLFM EBO PMFI LBSFOB JUV EBQBU NBLTJNVN QBEB WFOUSJLFM LJSJ OPSNBM BEBMBI BOUBSB EBO
EJBCBJLBOEBMBNQFSIJUVOHBOKVNMBIUPUBMDVSBILFSKBJTJTFLVODVQ NN )H UFUBQJ OJMBJ JOJ TBOHBU CFSWBSJBTJ TFTVBJ EFOHBO LFLVBUBO
/BNVO QBEBLPOEJTJBCOPSNBMUFSUFOUV TFQFSUJTUFOPTJTBPSUBZBOH KBOUVOH NBTJOHNBTJOH PSBOH EBO EFSBKBU QFSBOHTBOHBO KBOUVOH
NFOHBMJSLBOEBSBIEFOHBOLFDFQBUBOZBOHCFTBSNFMBMVJLBUVQZBOH PMFI TBSBG KBOUVOH #BHJ WFOUSJLFM LBOBO OPSNBM UFLBOBO TJTUPMJL
NFOHBMBNJQFOZFNQJUBO NVOHLJOEJCVUVILBOMFCJIEBSJQFSTFO NBLTJNVNCFSBEBEJBOUBSBEBONN)H
KVNMBI UPUBM DVSBI LFSKB VOUVL EBQBU NFOJNCVMLBO FOFSHJ LJOFUJL %JBHSBN 7PMVNF5FLBOBO 4FMBNB 4JLMVT +BOUVOH $VSBI
BMJSBOEBSBI ,FSKB +BOUVOH 1BEB (BNCBS HBSJT ZBOH CFSXBSOB NFSBI
NFNCFOUVLTVBUVMFOHLVOHZBOHEJTFCVUTFCBHBJEJBHSBNWPMVNF
Ananlisis Grafik Pompa Ventrikel UFLBOBO TJLMVT KBOUVOH VOUVL GVOHTJ OPSNBM WFOUSJLFM LJSJ 7FSTJ
(BNCBS NFNQFSMJIBULBO TFCVBI EJBHSBN ZBOH TFDBSB LIVTVT MFOHLVOHJOJZBOHMFCJIEFUJMEJQFSMJIBULBOQBEB(BNCBS,VSWB
CFSHVOB VOUVL NFOKFMBTLBO NFLBOJTNF QFNPNQBBO EBSJ WFOUSJLFM JOJEJCBHJEBMBNFNQBUGBTF
LJSJ,PNQPOFOLPNQPOFOZBOHQBMJOHQFOUJOHEBSJEJBHSBNBEBMBI 'BTF*1FSJPEFQFOHJTJBO1BEBEJBHSBNWPMVNFUFLBOBO GBTFJOJ
EVBLVSWBZBOHEJCFSJMBCFMUFLBOBOEJBTUPMJLEBOUFLBOBOTJTUPMJLh EJNVMBJ QBEB WPMVNF WFOUSJLFM TFCBOZBL LJSBLJSB NM EBO
,FEVBLVSWBJOJBEBMBILVSWBWPMVNFUFLBOBO UFLBOBOEJBTUPMJLTFCFTBSTBNQBJNN)H4FKVNMBINMEBSBI
,VSWBUFLBOBOEJBTUPMJLEJUFOUVLBOEBSJQFOHJTJBOKBOUVOHEFOHBO ZBOH UFUBQ UJOHHBM EBMBN WFOUSJLFM TFTVEBI EFOZVU KBOUVOH ZBOH
TFKVNMBI EBSBI ZBOH WPMVNFOZB NBLJO MBNB NBLJO CBOZBL EBO UFSEBIVMVEJTFCVUTFCBHBJWPMVNFTJTUPMJLBLIJS4FXBLUVEBSBIWFOB
TFMBOKVUOZB EJMBLVLBO QFOHVLVSBO UFLBOBO EJBTUPMJL TFTBBU TFCFMVN ZBOHCFSBTBMEBSJBUSJVNLJSJNFNBTVLJWFOUSJLFM CJBTBOZBWPMVNF
UFSKBEJ LPOUSBLTJ WFOUSJLFM ZBOH NFSVQBLBO UFLBOBO EJBTUPMJLBLIJS WFOUSJLFM BLBO NFOJOHLBU TBNQBJ TFLJUBS NM EJTFCVU TFCBHBJ
WFOUSJLFM WPMVNFEJBTUPMJLBLIJS ZBOHNFSVQBLBOTVBUVLFOBJLBOTFCFTBS
NM 0MFI LBSFOB JUV EJBHSBN WPMVNFUFLBOBO TFMBNB GBTF *
,VSWBUFLBOBOTJTUPMJLEJUFOUVLBOPMFIQFSFLBNBOUFLBOBO
CFSMBOHTVOHTFQBOKBOHHBSJTZBOHEJCFSJMBCFM* EBSJUJUJL"LFUJUJL
TJTUPMJLZBOHEJQFSPMFITFMBNBLPOUSBLTJWFOUSJLFMQBEBTFUJBQ # EFOHBOWPMVNFZBOHNFOJOHLBUTBNQBJNMEBOQFOJOHLBUBO
WPMVNFQFOHJTJBO UFLBOBOEJBTUPMJLNFODBQBJTFLJUBSTBNQBJNN)H
'BTF ** 1FSJPEF LPOUSBLTJ JTPWPMFNJL 4FMBNB LPOUSBLTJ JTPWPMF
NJL WPMVNF WFOUSJLFM UJEBL NFOHBMBNJ QFSVCBIBO LBSFOB TFNVB
LBUVQUFSUVUVQ"LBOUFUBQJ UFLBOBOEJEBMBNWFOUSJLFMBLBONFOJ
OHLBU TBNQBJ TBNB EFOHBO UFLBOBO EJ EBMBN BPSUB ZBJUV UFLBOBO
TFCFTBSNN)H TFQFSUJZBOHEJHBNCBSLBOPMFIUJUJL$
'BTF***1FSJPEFFKFLTJ4FMBNBFKFLTJ UFLBOBOTJTUPMJLNFOJOHLBU
MFCJI UJOHHJ MBHJ TFCBC WFOUSJLFM NBTJI CFSLPOUSBLTJ 1BEB XBLUV
ZBOH TBNB WPMVNF WFOUSJLFM BLBO NFOVSVO LBSFOB LBUVQ BPSUB
TFLBSBOH UFMBI UFSCVLB EBO EBSBI NFOHBMJS LFMVBS EBSJ WFOUSJLFM
NBTVL LF EBMBN BPSUB 0MFI LBSFOB JUV LVSWB CFSMBCFM *** BUBV
QFSJPEF FKFLTJ NFODBUBU QFSVCBIBO WPMVNF EBO UFLBOBO TJTUPMJL
TFMBNBQFSJPEFFKFLTJJOJ
'BTF *7 1FSJPEF SFMBLTBTJ JTPWPMFNJL 1BEB BLIJS QFSJPEF FKFLTJ
UJUJL %
LBUVQ BPSUB NFOVUVQ EBO UFLBOBO WFOUSJLFM UVSVO
LFNCBMJ LF OJMBJ UFLBOBO EJBTUPMJL (BSJT CFSMBCFM *7 NFODBUBU
QFOVSVOBO UFLBOBO JOUSBWFOUSJLVMBS UBOQB EJTFSUBJ QFSVCBIBO
WPMVNF +BEJ WFOUSJLFM UFSTFCVU LFNCBMJ LF UJUJL BXBMOZB EFOHBO
LJSBLJSB NM EBSBI UFSUJOHHBM EJ EBMBN WFOUSJLFM EBO QBEB
UFLBOBOBUSJVNTFLJUBSTBNQBJNN)H
1FNCBDB ZBOH UFSMBUJI CBJL EBMBN QSJOTJQQSJOTJQ EBTBS JMNV
GJTJLB BLBO NFOHFOBMJ CBIXB EBFSBI ZBOH EJHBNCBSLBO PMFI EJBH
SBNGVOHTJWPMVNFUFLBOBOJOJ EBFSBIEFOHBOCBZBOHBODPLFMBU
108
ZBOHEJCFSJMBCFM&8
NFXBLJMJDVSBILFSKBMVBSOFUP OFUFYUFSOBMXPSL Energi Kimia yang Dibutuhkan untuk Kontraksi Jantung:
PVUQVU
EBO TFMBNB TJLMVT LPOUSBLTJOZB 1BEB TUVEJ FLTQFSJNFOUBM Penggunaan Oksigen oleh Jantung
LPOUSBLTJ KBOUVOH EJBHSBN JOJ EJQBLBJ VOUVL NFOHIJUVOH DVSBI LFSKB
KBOUVOH 0UPU KBOUVOH TFQFSUJ IBMOZB PUPU SBOHLB NFOHHVOBLBO FOFSHJ
#JMBKBOUVOHNFNPNQBEBSBIEBMBNKVNMBICBOZBL EBFSBIEJBHSBN LJNJB VOUVL NFOJNCVMLBO LPOUSBLTJ 1BEB LFBEBBO OPSNBM
LFSKBBLBONFOKBEJMFCJIMVBT:BJUV EJBHSBNJOJBLBONFMVBTKBVILF TFLJUBS TBNQBJ FOFSHJ JOJ EJIBTJMLBO EBSJ NFUBCPMJTNF
LBOBO TFCBC WFOUSJLFM UFSJTJ EFOHBO MFCJI CBOZBL EBSBI TFMBNB GBTF PLTJEBUJG BTBN MFNBL EBO TFLJUBS TBNQBJ EJQFSPMFI EBSJ
EJBTUPMJL EJBHSBN JOJ BLBO OBJL MFCJI UJOHHJ TFCBC WFOUSJLFM CBIBO NBLBOBO ZBOH MBJO LIVTVTOZB MBLUBU EBO HMVLPTB 0MFI
CFSLPOUSBLTJ EFOHBO UFLBOBO ZBOH MFCJI CFTBS EBO CJBTBOZB EJBHSBN LBSFOB JUV LFDFQBUBO QFNBLBJBO PLTJHFO PMFI KBOUVOH
JOJ BLBO NFMVBT KBVI LF LJSJ TFCBC WFOUSJLFM CFSLPOUSBLTJ EFOHBO NFSVQBLBOVLVSBOZBOHCBJLVOUVLFOFSHJLJNJBZBOHEJMFQBTLBO
WPMVNF ZBOH MFCJI TFEJLJU LIVTVTOZB CJMB WFOUSJLFM EJSBOHTBOH PMFI TFXBLUVKBOUVOHNFMBLVLBOLFSKBOZB#FSCBHBJSFBLTJLJNJBZBOH
TJTUFNTBSBGTJNQBUJTTFIJOHHBBLUJWJUBTOZBNFOJOHLBU NFMFQBTLBOFOFSHJJOJEJCBIBTEBMBN#BCEBO
1FOFMJUJBO FLTQFSJNFOUBM NFOVOKVLLBO CBIXB QFOHHVOBBO
,POTFQ 1SFMPBE EBO "GUFSMPBE %BMBN NFOJMBJ TJGBUTJGBU PLTJHFO PMFI KBOUVOH EBO FOFSHJ LJNJB ZBOH EJLFMVBSLBO TFMBNB
LPOUSBLTJ PUPU QFOUJOH LJSBOZB VOUVL NFOFUBQLBO EFSBKBU LPOUSBLTJ CFSIVCVOHBO MBOHTVOH EFOHBO UPUBM BSFB ZBOH EJCFSJ
CBZBOHBO QBEB (BNCBS #BHJBO ZBOH EJCFSJ CBZBOHBO JOJ
SFHBOHBO PUPU LFUJLB PUPU UFSTFCVU NVMBJ CFSLPOUSBLTJ ZBOH
UFSEJSJ BUBT LFSKB MVBS &8
TFQFSUJ ZBOH UFMBI EJKFMBTLBO
EJTFCVU TFCBHBJ QSFMPBE EBO KVHB NFOFUBQLBO CFCBO ZBOH
TFCFMVNOZB EBO CBHJBO UBNCBIBO ZBOH EJTFCVU FOFSHJ QPUFOTJBM
EJMBXBO PMFI LFLVBUBO LPOUSBLTJ PUPU ZBOH EJTFCVU TFCBHBJ ZBOH EJCFSJ MBCFM 1& &OFSHJ QPUFOTJBM NFOVOKVLLBO LFSKB
BGUFSMPBE UBNCBIBO ZBOH EBQBU EJTFMFTBJLBO PMFI LPOUSBLTJ WFOUSJLFM
1BEB LPOUSBLTJ KBOUVOH CJBTBOZBQSFMPBE JOJ EJOZBUBLBO BQBCJMB WFOUSJLFM NFOPHPTPOHLBO TFMVSVI EBSBI EJ EBMBN
TFCBHBJ UFLBOBO EJBTUPMJLBLIJS LFUJLB WFOUSJLFM TVEBI EBMBN SPOHHBOZBTFUJBQLBMJCFSLPOUSBLTJ
LFBEBBOUFSJTJ #FTBSOZB QFOHHVOBBO PLTJHFO KVHB NFOVOKVLLBO IBNQJS
"GUFSMPBE WFOUSJLFM BEBMBI UFLBOBO EJ EBMBN BPSUB ZBOH TFCBOEJOH EFOHBO UFHBOHBO ZBOH UFSKBEJ EJ EBMBN PUPU KBOUVOH
CFSBTBM EBSJ WFOUJLFM %BMBN (BNCBS BGUFSMPBE TFMBNB LPOUSBLTJ EJLBMJLBO EFOHBO MBNB XBLUV CFSMBOHTVOHOZB
CFSIVCVOHBO EFOHBO UFLBOBO TJTUPMJL ZBOH EJHBNCBSLBO PMFI LPOUSBLTJ EJTFCVU TFCBHBJ JOEFLT UFHBOHBO XBLUV 0MFI LBSFOB
LVSWB GBTF *** EBMBN EJBHSBN WPMVNFUFLBOBO ,BEBOH UFHBOHBOOZB UJOHHJ QBEB TBBU UFLBOBO TJTUPMJL UJOHHJ EFOHBO
TFOEJSJOZBMFCJICBOZBLPLTJHFOZBOHEJHVOBLBO5BNCBIBOQVMB
BGUFSMPBE EJOZBUBLBO TFDBSB CFCBT TFCBHBJ UBIBOBO EJ EBMBN
MFCJI CBOZBL FOFSHJ LJNJB ZBOH EJLFMVBSLBO XBMBVQVO UFLBOBO
TJSLVMBTJEBSJQBEBTFCBHBJUFLBOBO

TJTUPMJL OPSNBM BQBCJMB UFSEBQBU EJMBUBTJ WFOUSJLFM BCOPSNBM
.BLOB QFOUJOH EBSJ LPOTFQ QSFMPBE EBO BGUFSMPBE JBMBI LBSFOBUFHBOHBOPUPUKBOUVOHTFMBNBLPOUSBLTJCFSCBOEJOHMVSVT
QBEB CBOZBL LFBEBBO GVOHJ KBOUVOH BUBV TJSLVMBTJ ZBOH EFOHBO UFLBOBO EJLBMJLBO EJBNFUFS WFOUSJLFM )BM JOJ NFOKBEJ
BCOPSNBM UFLBOBO TFMBNB QFOHJTJBO WFOUSJLFM QSFMPBE
BUBV QFOUJOH QBEB HBHBM KBOUVOH EJ NBOB UFSEBQBU EJMBUBTJ WFOUSJLFM
UFLBOBO BSUFSJ ZBOH IBSVT EJMBXBO PMFI LPOUSBLTJ WFOUSJLFM EBO TFCBMJLOZB KVNMBI FOFSHJ LJNJB ZBOH EJCVUVILBO VOUVL
BGUFSMPBE
BUBV LFEVBOZB CBOZBL NFOHBMBNJ QFSVCBIBO DVSBI LFSKB UFSUFOUV BEBMBI MFCJI CFTBS EBSJ OPSNBM NFTLJQVO
EJCBOEJOHLBOLFBEBBOZBOHOPSNBM KBOUVOHUFMBINFOHBMBNJLFHBHBMBO
109
Unit III Jantung
&GJTJFOTJ ,POUSBLTJ +BOUVOH 4FMBNB PUPU KBOUVOH ZBOH CFSUBNCBI NFSVQBLBO LBSBLUFSJTUJL EBSJ TFNVB PUPU
CFSLPOUSBLTJ TFCBHJBO CFTBS FOFSHJ LJNJB ZBOH EJHVOBLBO MVSJL TFQFSUJZBOHEJKFMBTLBOEBMBN#BC EBOCVLBONFSVQB
EJVCBI NFOKBEJ QBOBT EBO TBUV CBHJBO ZBOH MFCJI LFDJM LBOLBSBLUFSJTUJLPUPUKBOUVOHTBKB
EJHVOBLBOVOUVLDVSBILFSKB1FSCBOEJOHBOBOUBSBDVSBILFSKB 4FMBJO QFOHBSVI QFOUJOH QFNBOKBOHBO PUPU KBOUVOH NBTJI
EFOHBOQFOHFMVBSBOFOFSHJLJNJBUPUBMEJTFCVUTFCBHBJFGJTJFOTJ BEB GBLUPS MBJO ZBOH EBQBU NFOJOHLBULBO EBZB QPNQB KBOUVOH
LPOUSBLTJ KBOUVOH BUBV IBOZB FGJTJFOTJ KBOUVOH &GJTJFOTJ CJMB WPMVNFOZB NFOJOHLBU 1FSFHBOHBO EJOEJOH BUSJVN LBOBO
NBLTJNVN KBOUVOH OPSNBM ZBJUV BOUBSB TBNQBJ QFSTFO TFDBSB MBOHTVOH BLBO NFOJOHLBULBO GSFLVFOTJ EFOZVU KBOUVOH
1BEB HBHBM KBOUVOH OJMBJ JOJ CJTB UVSVO NFOKBEJ TFSFOEBI TFCFTBS TBNQBJ QFSTFO LFBEBBO JOJ KVHB NFNCBOUV
TBNQBJQFSTFO NFOJOHLBULBO KVNMBI EBSBI ZBOH EJQPNQB TFUJBQ NFOJU
XBMBVQVOQFSBOBOOZBUJEBLTFCFTBSQFSBOBONFLBOJTNF'SBOL
Pengaturan Penompaan Jantung 4UBSMJOH
#JMB TFTFPSBOH EBMBN LFBEBBO JTUJSBIBU TFUJBQ NFOJUOZB Kurva fungsi Ventrikel
KBOUVOHIBOZBBLBONFNPNQBTBNQBJMJUFSEBSBI4FMBNB
CFLFSKB CFSBU KBOUVOH NVOHLJO QFSMV NFNPNQB EBSBI 4BMBI TBUV DBSB ZBOH UFSCBJL VOUVL NFOZBUBLBO LFNBNQVBO
TFCBOZBL FNQBU TBNQBJ UVKVI LBMJ MJQBU EBSJ KVNMBI JOJ %VB GVOHTJWFOUSJLFMEBMBNNFNPNQBEBSBIBEBMBIEFOHBONFOHHV
DBSB EBTBS QFOHBUVSBO WPMVNF EBSBI ZBOH EJQPNQBLBO PMFI OBLBO LVSWB GVOHTJ WFOUSJLFM TFQFSUJ ZBOH EJHBNCBSLBO EBMBN
KBOUVOH BEBMBI
QFOHBUVSBO JOUSJOTJL QFNPNQBBO KBOUVOH (BNCBS EBO (BNCBS NFNQFSMJIBULBO TVBUV
TFCBHBJ SFTQPOT UFSIBEBQ QFSVCBIBO WPMVNF EBSBI ZBOH KFOJT LVSWB GVOHTJ WFOUSJLFM ZBOH EJTFCVU TFCBHBJ LVSWB DVSBI
NFOHBMJS LF EBMBN KBOUVOH EBO
QFOHFOEBMJBO GSFLVFOTJ LFSKB TFLVODVQ TUSPLF XPSL PVUQVU DVSWF
1FSIBUJLBO CBIXB
EFOZVUKBOUVOHEBOLFLVBUBOQFNPNQBBOKBOUVOHPMFITJTUFN CFHJUV UFLBOBO BUSJVN VOUVL TFUJBQ TJTJ KBOUVOH NFOJOHLBU
TBSBGPUPOPN DVSBILFSKBTFLVODVQVOUVLTJTJUFSTFCVUBLBONFOJOHLBUTBNQBJ
NFODBQBJCBUBTLFNBNQVBOLPOUSBLTJWFOUSJLFM
Pengaturan Intrinsik Pompa Jantung—Mekanisme (BNCBS NFOHHBNCBSLBO LVSWB GVOHTJ WFOUSJLFM KFOJT
Frank-Starling MBJO ZBOH EJTFCVU TFCBHBJ LVSWB DVSBI JTJ WFOUSJLFM WFOUSJDVMBS
WPMVNF PVUQVU DVSWF
,FEVB LVSWB QBEB (BNCBS JOJ NFOVO
%BMBN #BC LJUB BLBO NFNQFMBKBSJ CBIXB QBEB CFSCBHBJ KVLLBOGVOHTJLFEVBWFOUSJLFMKBOUVOHNBOVTJBCFSEBTBSLBOEBUB
LPOEJTJ KVNMBIEBSBIZBOHEJQPNQBPMFIKBOUVOHTFUJBQNFOJU ZBOHEJFLTUSBQPMBTJLBOEBSJCJOBUBOHZBOHMFCJISFOEBI4FXBLUV
QBEB LFBEBBO OPSNBM IBNQJS TFMVSVIOZB EJUFOUVLBO PMFI UFLBOBO BUSJVN LJSJ EBO LBOBO NFOJOHLBU NBLB WPMVNF ZBOH
LFDFQBUBO BMJSBO EBSBI LF EBMBN KBOUVOH ZBOH CFSBTBM EBSJ EJLFMVBSLBO PMFI NBTJOHNBTJOH WFOUSJLFMOZB EBMBN TFUJBQ
WFOBWFOB EJTFCVU TFCBHBJ BMJSBO CBMJL WFOB 4FUJBQ KBSJOHBO NFOJUKVHBBLBONFOJOHLBU
QFSJGFSQBEBUVCVINFOHBUVSBMJSBOEBSBIEJUFNQBUOZBTFOEJSJ
EBO TFMVSVI BMJSBO TFUFNQBU KBSJOHBO UFSTFCVU BLBO CFSHBCVOH
EBO LFNCBMJ LF EBMBN BUSJVN LBOBO NFMBMVJ WFOBWFOB
+BOUVOH LFNVEJBO TFDBSB PUPNBUJT BLBO NFNPNQB EBSBI
ZBOHNBTVLJOJLFEBMBNBSUFSJ TFIJOHHBEBSBIUFSTFCVUEBQBU
NFOHBMJSLFNCBMJNFOHFMJMJOHJTJSLVMBTJ
,FNBNQVBOJOUSJOTJLKBOUVOHVOUVLCFSBEBQUBTJUFSIBEBQ
WPMVNF ZBOH NFOJOHLBU BLJCBU BMJSBO NBTVL EBSBI EJ TFCVU
TFCBHBJ NFLBOJTNF 'SBOL4UBSMJOH EBSJ KBOUVOH TFCBHBJ
QFOHIPSNBUBO UFSIBEBQ 0UUP 'SBOL EBO &SOFTU 4UBSMJOH EVB
BIMJ GJTJPMPHJ UFSLFOBM QBEB TBUV BCBE TJMBN 4FDBSB NFOEBTBS
NFLBOJTNF 'SBOL4UBSMJOH CFSBSUJ TFNBLJO CFTBS PUPU KBOUVOH
EJSFHBOHLBO TFMBNB QFOHJTJBO TFNBLJO CFTBS LFLVBUBO LPO
USBLTJ EBO TFNBLJO CFTBS QVMB KVNMBI EBSBI ZBOH EJQPNQB LF
EBMBN BPSUB "UBV EJOZBUBLBO EFOHBO DBSB MBJO %BMBN CBUBT
CBUBT GJTJPMPHJT KBOUVOH BLBO NFNPNQB TFNVB EBSBI ZBOH
LFNCBMJLFKBOUVOHNFMBMVJWFOB
"QB 1FOKFMBTBO EBSJ .FLBOJTNF 'SBOL4UBSMJOH #JMB
TFKVNMBI EBSBI UBNCBIBO NFOHBMJS LF EBMBN WFOUSJLFM PUPU
KBOUVOH TFOEJSJ BLBO MFCJI UFSFHBOH ,FBEBBO JOJ TFMBOKVUOZB
BLBO NFOZFCBCLBO PUPU CFSLPOUSBLTJ EFOHBO LFLVBUBO ZBOH
CFSUBNCBILBSFOBGJMBNFOBLUJOEBONJPTJOEJCBXBNFOEFLBUJ
UBIBQ UVNQBOH UJOEJI ZBOH PQUJNBM VOUVL NFNCBOHLJULBO
LFLVBUBO 0MFI LBSFOB JUV WFOUSJLFM LBSFOB QFOJOHLBUBO
QFNPNQBBO TFDBSBPUPNBUJTBLBONFNPNQBEBSBIUBNCBIBO
LFEBMBNBSUFSJ
,FNBNQVBO PUPU ZBOH EJSFHBOHLBO TBNQBJ NFODBQBJ
QBOKBOHZBOHPQUJNBM VOUVLCFSLPOUSBLTJEFOHBODVSBILFSKB
110
+BEJ LVSWB GVOHTJ WFOUSJLFM NFSVQBLBO DBSB MBJO VOUVL BLBO NFOVSVOLBO UJOHLBU QFNPNQBBO KBOUVOH TBNQBJ
NFOZBUBLBONFLBOJTNF'SBOL4UBSMJOHKBOUVOH:BLOJ TFXBLUV TFCFTBSQFSTFOEJCBXBIOPSNBM
WFOUSJLFM EJJTJ TFCBHBJ SFTQPOT UFSIBEBQ QFOJOHLBUBO UFLBOBO 1FSBOHTBOHBO1BSBTJNQBUJT 7BHVT
QBEB+BOUVOH1FSBOH
BUSJVN NBLB NBTJOHNBTJOH WPMVNF WFOUSJLFM EBO LFLVBUBO TBOHBO TFSBU TBSBG QBSBTJNQBUJT EJ EBMBSO OFSWVT WBHVT ZBOH
UNIT III
LPOUSBLTJ PUPU KBOUVOH KVHB NFOJOHLBU TFIJOHHB KBOUVOH BLBO LVBUQBEBKBOUVOHEBQBUNFOHIFOUJLBOEFOZVUKBOUVOHTFMBNB
NFNPNQBMFCJICBOZBLEBSBILFEBMBNBSUFSJ CFCFSBQB EFUJL UFUBQJ CJBTBOZB KBOUVOH BLBO NFOHBUBTJOZB
EBO CFSEFOZVU EFOHBO LFDFQBUBO TBNQBJ EFOZVUNFOJU
Pengaturan Jantung oleh Saraf Simpatis dan TFMBNB QFSBOHTBOHBO QBSBTJNQBUJT UFSVT CFSMBOKVU 4FMBJO JUV
Parasimpatis QFSBOHTBOHBO WBHVT ZBOH LVBU EBQBU NFOVSVOLBO LFLVBUBO
&GFLUJWJUBTQPNQBKBOUVOHKVHBEJLFOEBMJLBOPMFITBSBGTJNQBUJT LPOUSBLTJPUPUKBOUVOHTFCFTBSTBNQBJQFSTFO
EBO QBSBTJNQBUJT WBHVT
ZBOH NFNQFSTBSBGJ KBOUVOH EBMBN 4FSBUTFSBU WBHVT EJEJTUSJCVTJLBO UFSVUBNB LF BUSJVN EBO
KVNMBI CBOZBL TFQFSUJ ZBOH EJUVOKVLLBO QBEB (BNCBS UJEBL CFHJUV CBOZBL LF WFOUSJLFM UFNQBU UFSKBEJOZB UFOBHB
1BEB UFLBOBO BUSJVN UFSUFOUV KVNMBI EBSBI ZBOH EJQPNQB LPOUSBLTJ ZBOH TFCFOBSOZB )BM JOJ NFOKFMBTLBO QFOHBSVI
TFUJBQ NFOJUOZB DVSBI KBOUVOH
TFSJOH EBQBU EJUJOHLBULBO QFSBOHTBOHBO WBHVT ZBOH UFSVUBNB NFOHVSBOHJ GSFLVFOTJ
TBNQBJ MFCJI EBSJ QFSTFO NFMBMVJ QFSBOHTBOHBO TJNQBUJT EFOZVU KBOUVOH EBO CVLBO UFSVUBNB NFOHVSBOHJ LFLVBUBO
4FCBMJLOZB DVSBI KBOUVOH KVHB EBQBU EJUVSVOLBO TBNQBJ LPOUSBLTJ KBOUVOH .FTLJQVO EFNJLJBO QFOVSVOBO GSFLVFOTJ
TFSFOEBI OPM BUBV IBNQJS OPM NFMBMVJ QFSBOHTBOHBO WBHVT EFOZVU KBOUVOH ZBOH CFTBS EJHBCVOHLBO EFOHBO QFOVSVOBO
QBSBTJNQBUJT
LFLVBUBOLPOUSBLTJKBOUVOHZBOHLFDJMBLBOEBQBUNFOVSVOLBO
.FLBOJTNF&LTJUBTJ+BOUVOHPMFI4BSBG4JNQBUJT1FSBOH QFNPNQBBOWFOUSJLFMTFCFTBSQFSTFOBUBVMFCJI
TBOHBO TJNQBUJT ZBOH LVBU EBQBU NFOJOHLBULBO GSFLVFOTJ 1FOHBSVI 1FSBOHTBOHBO 4JNQBUJT BUBV 1BSBTJNQBUJT
EFOZVU KBOUVOH QBEB NBOVTJB EFXBTB NVEB EBSJ GSFLVFOTJ UFSIBEBQ,VSWB'VOHTJ+BOUVOH(BNCBSNFOVOKVLLBO
OPSNBMTFCFTBSEFOZVUNFOJUNFOKBEJTBNQBJEBO FNQBU LVSWB GVOHTJ KBOUVOH ,VSWBLVSWB JOJ NJSJQ EFOHBO
XBMBVQVO KBSBOH UFSKBEJ EFOZVUNFOJU %J TBNQJOH JUV LVSWB GVOHTJ WFOUSJLFM QBEB (BNCBS "LBO UFUBQJ LVSWB
QFSBOHTBOHBO TJNQBUJT NFOJOHLBULBO LFLVBUBO LPOUSBLTJ PUPU GVOHTJ KBOUVOH JOJ MFCJI NFOHHBNCBSLBO GVOHTJ TFMVSVI
KBOUVOH TBNQBJ EVB LBMJ OPSNBM TFIJOHHB BLBO NFOJOHLBULBO KBOUVOHEBSJQBEBGVOHTJTFCVBIWFOUSJLFMLVSWBLVSWBUFSTFCVU
WPMVNFEBSBIZBOHEJQPNQBEBONFOJOHLBULBOUFLBOBOFKFLTJ KVHB NFOVOKVLLBO IVCVOHBO BOUBSB UFLBOBO BUSJVN LBOBO
+BEJ QFSBOHTBOHBO TJNQBUJT TFSJOH EBQBU NFOJOHLBULBO DVSBI QBEB UFNQBU NBTVLOZB EJ KBOUVOH LBOBO EBO DVSBI KBOUVOH
KBOUVOHNBLTJNVNTFCBOZBLEVBTBNQBJUJHBLBMJMJQBU EJTBN EBSJWFOUSJLFMLJSJLFEBMBNBPSUB
QJOH QFOJOHLBUBO DVSBIBO ZBOH EJTFCBCLBO PMFI NFLBOJNF ,VSWBEBO(BNCBSNFOVOKVLLBOCBIXBQBEBTFUJBQ
'SBOL4UBSMJOHZBOHTVEBIEJCBIBTTFCFMVNOZB OJMBJ UFLBOBO BUSJVN LBOBO DVSBI KBOUVOH BLBO NFOJOHLBU
4FCBMJLOZB QFOHIBNCBUBO TBSBG TJNQBUJT LF KBOUVOH EBQBU LFUJLB UFSKBEJ QFOJOHLBUBO QFSBOHTBOHBO TJNQBUJT EBO
NFOVSVOLBOQFNPNQBBOKBOUVOHNFOKBEJTFEBOHEFOHBODBSB NFOVSVO LFUJLB UFSKBEJ QFOJOHLBUBO QFSBOHTBOHBO QBSB
TFCBHBJCFSJLVU1BEBLFBEBBOOPSNBM TFSBUTFSBUTBSBGTJNQBUJ TJNQBUJT 1FSVCBIBO DVSBI KBOUVOH ZBOH EJTFCBCLBO PMFI
LF KBOUVOH TFDBSB UFSVTNFOFSVT NFMFQBTLBO TJOZBM EFOHBO QFSBOHTBOHBO TJTUFN TBSBG PUPOPN JOJ NFSVQBLBO BLJCBU EBSJ
LFDFQBUBO SFOEBI VOUVL NFNQFSUBIBOLBO QFNPNQBBO LJSB QFSVCBIBO GSFLVFOTJ EFOZVU KBOUVOH EBO QFSVCBIBO LFLVBUBO
LJSB QFSTFO MFCJI UJOHHJ CJMB UBOQB QFSBOHTBOHBO TJNQBUJL LPOUSBLTJ KBOUVOH LBSFOB LFEVB QFSVCBIBO UFSTFCVU NFSVQB
0MFILBSFOBJUV CJMBBLUJWJUBTTJTUFNTBSBGTJNQBUJTEJUFLBOTBN LBOSFTQPOTUFSIBEBQQFSBOHTBOHBOTBSBG
QBJ EJ CBXBI OPSNBM LFBEBBO JOJ BLBO NFOVSVOLBO GSFLVFOTJ
EFOZVUKBOUVOHEBOLFLVBUBOLPOUSBLTJPUPUWFOUSJLFMTFIJOHHB
111
Unit III Jantung
Pengaruh ion Kalium dan Kalsium terhadap Funsi

jantung 5
%BMBNQFNCBIBTBONFOHFOBJQPUFOTJBMNFNCSBOQBEB#BC
4
UFMBI EJUFLBOLBO CBIXB JPO LBMJVN NFNJMJLJ QFOHBSVI ZBOH
CFSNBLOBUFSIBEBQQPUFOTJBMNFNCSBO EBOQBEB#BC KVHB 3
UFMBI EJUFLBOLBO CBIXB JPO LBMTJVN JUV NFNQVOZBJ QFSBO
2
ZBOH LIVTVT EBO QFOUJOH EBMBN NFOHBLUJWBTJ UJNCVMOZB
QSPTFT LPOUSBLTJ PUPU 0MFI LBSFOB JUVMBI EBQBU EJQFSLJSBLBO 1
CBIXB UJOHHJOZB LPOTFOUSBTJ NBTJOHNBTJOH LFEVB JPO JOJ EJ 0
EBMBNDBJSBOFLTUSBTFMVMBSTFIBSVTOZBKVHBNFNQVOZBJQFOHB 0 50 100 150 200 250
SVIZBOHQFOUJOHUFSIBEBQQPNQBKBOUVOH
1FOHBSVI MPO ,BMJVN ,FMFCJIBO JPO LBMJVN EBMBN DBJSBO
FLTUSBTFMVMBS BLBO NFOZFCBCLBO KBOUVOH NFOKBEJ NFOHFN
CBOH EBO MFNBT EBO KVHB NFNCVBU GSFLVFOTJ EFOZVU KBOUVOH
NFOKBEJ MBNCBU +VNMBI JPO LBMJVN ZBOH UFSMBMV CFTBS KVHB
BLBONFOHIBNCBULPOEVLTJJNQVMTKBOUVOHZBOHCFSBTBMEBSJ UFSKBEJ TBBU UVCVI CFSPMBISBHB UFUBQJ QFOJOHLBUBO TVIV ZBOH
BUSJVN NFOVKV LF WFOUSJLFM NFMBMVJ CFSLBT "o7 1FOJOHLBUBO MBNB BLBO NFMFNBILBO TJTUFN NFUBCPMJL KBOUVOH EBO BLIJSOZB
LPOTFOUSBTJ JPO LBMJVN IBOZB EBSJ NFOKBEJ N&R- ZBJUV NFOZFCBCLBO LFMFNBIBO 0MFI LBSFOB JUV GVOHTJ PQUJNBM KBO
EVB TBNQBJ UJHB LBMJ OJMBJ OPSNBM EBQBU NFOZFCBCLBO LFMF UVOHTBOHBUCFSHBOUVOHQBEBQFOHBUVSBOTVIVUVCVIPMFINFLB
NBIBO KBOUVOH ZBOH IFCBU EBO UJNCVMOZB JSBNB BCOPSNBM OJTNFQFOHBUVSBOTVIVZBOHUFMBIEJKFMBTLBOQBEB#BC
TFIJOHHBNFOHBLJCBULBOLFNBUJBO
4FNVBQFOHBSVIJOJTFCBHJBOCFSBTBMEBSJLFOZBUBBOCBIXB Peningkatan Beban Tekanan Arteri (Sampai ke Batasnya)
UJOHHJOZB LPOTFOUSBTJ LBMJVN EJ EBMBN DBJSBO FLTUSBTFMVMBS Tidak Menurunkan Curah Jantung
NFOVSVOLBOQPUFOTJBMNFNCSBOJTUJSBIBUEJEBMBNTFSBUTFSBU 1FSIBUJLBOQBEB(BNCBSCBIXBQFOJOHLBUBOQBEBUFLBOBO
PUPU KBOUVOH TFQFSUJ ZBOH EJKFMBTLBO EBMBN #BC %BMBN IBM BSUFSJ EJ EBMBN BPSUB UJEBL NFOVSVOLBO DVSBI KBOUVOH TBNQBJ
JOJ LPOTFOUSBTJ LBMJVN ZBOH UJOHHJ QBEB DBJSBO FLTUSBTFMVMBS UFLBOBO BSUFSJ SBUBSBUB NFOJOHLBU EJ BUBT TFLJUBS NN )H
NFOZFCBCLBO EFQPMBSJTBTJ QBSTJBM NFNCSBO TFM TFIJOHHB %FOHBO LBUB MBJO TFMBNB KBOUVOH CFSGVOHTJ OPSNBM QBEB UFLB
QPUFOTJBMNFNCSBONFOKBEJLVSBOHOFHBUJG4FXBLUVQPUFOTJBM OBO BSUFSJ TJTUPMJL ZBOH OPSNBM TBNQBJ NN )H
CFTBS
NFNCSBO UVSVO JOUFOTJUBT QPUFOTJBM KVHB NFOVSVO ZBOH DVSBI KBOUVOH EJUFOUVLBO IBNQJS TFMVSVIOZB PMFI LFNVEBIBO
NFNCVBULPOUSBLTJKBOUVOHTFDBSBQSPHSFTJGNFMFNBI BMJSBOEBSBINFMBMVJKBSJOHBOUVCVI ZBOHTFMBOKVUOZBNFOHBUVS
1FOHBSVI MPO ,BMTJVN ,FMFCJIBO JPO LBMTJVN BLBO BMJSBO CBMJL WFOB EBSBI LF KBOUVOH )BM JOJ NFSVQBLBO QPLPL
NFOJNCVMLBO BLJCBU ZBOH IBNQJS CFSMBXBOBO EFOHBO BLJCBU CBIBTBOVUBNB#BC
ZBOHEJUJNCVMLBOPMFIJPOLBMJVN ZBJUVNFOZFCBCLBOKBOUVOH
NFOHBMBNJ LPOUSBLTJ TQBTUJT )BM JOJ EJTFCBCLBO PMFI Daftar Pustaka
QFOHBSVI MBOHTVOH JPOJPO LBMTJVN EBMBN NFOHBXBMJ QSPTFT
Bers DM:Altered cardiac myocyte Ca regulation in heart faiture, Physiology (Be-
LPOUSBLTJ KBOUVOH TFQFSUJ ZBOH UFMBI EJKFMBTLBO UFSEBIVMV
thesda) 21:380, 2006.
EBMBNCBCJOJ Bers DM: Calcium cycling and signaling in cardiac myocytes, Annu Rev Physiol
4FCBMJLOZB LFLVSBOHBO JPO LBMTJVN BLBO NFOZFCBCLBO 70:23, 2008.
LFMFNBIBO KBOUVOH ZBOH NJSJQ EFOHBO QFOHBSVI JPO LBMJVN Brette F, Orchard C: T-tubule function in mammalian cardiac myocytes, Circ
6OUVOHOZB QBEBLFBEBBOOPSNBMLBEBSJPOLBMTJVNEJEBMBN Res 92:1182, 2003.
Chantler PD, Lakatta EG, Najjar SS:Arterial-ventricular coupling: mechanistic in-
EBSBIEJBUVSEBMBNLJTBSBOZBOHTBOHBUTFNQJU%FOHBOEFNJ isights into cardiovascular performance at rest and during exercise, J Appl
LJBO QFOHBSVI LPOTFOUSBTJ LBMTJVN ZBOH BCOPSNBM UFSIBEBQ Physiol 105:1342, 2008.
KBOUVOHTFSJOHUJEBLNFNQVOZBJBSUJLMJOJTZBOHQFOUJOH Cheng H, Lederer WJ: Calcium sparks, Physiol Rev 88:1491, 2008.
Clancy CE, Kass RS: Defective cardiac ion channels: from mutations to clinical
syndromes, J Clin Invest 110:1075, 2002.
Pengaruh Suhu terhadap Fungsi Jantung Couchonnal LF ,Anderson ME:The role of calmodulin kinase II in myocardial
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SBOH NFOEFSJUB EFNBN BLBO TBOHBU NFOJOHLBULBO GSFLVFOTJ Fuchs F, Smith SH: Calcium, cross-bridges, and the Frank-Starling r elationship,
EFOZVU KBOUVOH LBEBOHLBEBOH TBNQBJ EVB LBMJ GSFLVFOTJ EF News Physiol Sci 16:5, 2001.
Guyton AC: Determination of cardiac output by equating venous return curves
OZVU OPSNBM 1FOVSVOBO TVIV TBOHBU NFOVSVOLBO GSFLVFOTJ with cardiac response curves, Physiol Rev 35:123, 1955.
EFOZVU KBOUVOH IJOHHB UVSVO TBNQBJ TFSFOEBI CFCFSBQB EF Guyton AC, Jones CE, Coleman TG: Circulatory Physiology: Cardiac Output
OZVUQFSNFOJU TFQFSUJQBEBTFTFPSBOHZBOHNFOEFLBUJLFNB and its Regulation, 2nd ed, Philadelphia, 1973, WB Saunders.
UJBO BLJCBU IJQPUFSNJB TVIV UVCVI EBMBN LJTBSBO ¡ TBNQBJ Kang M, Chung KY, Walker JW: G-protein coupled receptor signaling in myocar-
dium: not for the faint of heart, Physiology (Bethesda) 22:174, 2007.
¡' ¡TBNQBJ ¡$
1FOZFCBCQFOHBSVIJOJLFNVOHLJ Knaapen P, Germans T, Knuuti J, et al: Myocardial energetic and efficiency: cur-
LJOBOLBSFOBQBOBTNFOJOHLBULBOQFSNFBCJMJUBTNFNCSBOPUPU rent status of the noninvasive approach, Circulation 115:918, 2007.
KBOUVOHUFSIBEBQJPOZBOHNFOHBUVSGSFLVFOTJEFOZVUKBOUVOH Mangoni ME, Nargeot J: Genesis and regulation of the heart automaticity, Physi-
NFOHIBTJMLBOQFOJOHLBUBOQSPTFTQFSBOHTBOHBOTFOEJSJ ol Rev 88:919, 2008.
Korzick DH: Regulation of cardiac excitation-contraction coupling: a cellular up-
,FLVBUBOLPOUSBLTJKBOUVOHTFSJOHEJQFSDFQBUTFDBSBUFNQP date, Adv Physiol Educ 27:192, 2003.
SFSNFMBMVJTVBUVQFOJOHLBUBOTVIVZBOHTFEBOH TFQFSUJZBOH Olson EN: A decade of discoveries in cardiac biology, Nat Med 10:467, 2004.
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basis of the Frank-Starling law, J Physiol 571:253, 2006.
UNIT III
113
BAB 10
UNIT III
&LTJUBTJ3JUNJTQBEB+BOUVOH
+BOUVOH EJMFOHLBQJ EFOHBO TVBUV EBSJBUSJVNLBOBOUFQBUEJCBXBIEBOTFEJLJUMBUFSBMEBSJMVCBOH

TJTUFNLIVTVTVOUVL
NFODFUVT WFOBDBWBTVQFSJPS4FSBUTFSBUOPEVTJOJIBNQJSUJEBLNFNJMJLJ
LBO JNQVMTJNQVMT MJTUSJL SJUNJT GJMBNFOPUPULPOUSBLUJMEBONBTJOHNBTJOHIBOZBCFSEJBNFUFS
ZBOH NFOZFCBCLBO UJNCVMOZB TBNQBJHNTBOHBUCFSCFEBEFOHBOEJBNFUFSTFSBUTFSBUPUPU
LPOUSBLTJ SJUNJT PUPU KBOUVOH EBO ZBOHUFSEBQBUEJTFLFMJMJOHBUSJVN ZBOHCFTBSOZBTBNQBJ

NFOHIBOUBSLBOJNQVMTJNQMVT HN /BNVO TFSBUTFSBU OPEVT TJOVT TFDBSB MBOHTVOH CFS
JOJ EFOHBO DFQBU LF KBOUVOH #JMB TJTUFN UFSTFCVU CFSGVOHTJ IVCVOHBO EFOHBO TFSBUTFSBU PUPU BUSJVN TFIJOHHB TFUJBQ
OPSNBM BUSJVNBLBOCFSLPOUSBLTJLJSBLJSBTFQFSFOBNEFUJLMFCJI QPUFOTJBM BLTJ ZBOH EJNVMBJ EJ EBMBN OPEVT TJOVT BLBO TFHFSB
BXBMEBSJLPOUSBLTJWFOUSJLFM TFIJOHHBNFNVOHLJOLBOQFOHJTJBO NFOZFCBSLFEBMBNEJOEJOHPUPUBUSJVN
WFOUSJLFM TFCFMVN WFOUSJLFM NFNPNQB EBSBI LF TJSLVMBTJ QBSV Irama Listrik Otomatis dari Serat-Serat Sinus
EBO QFSJGFS .BLOB QFOUJOH MBJO EBSJ TJTUFN UFSTFCVU BEBMBI
CBIXB TJTUFN JOJ NFNVOHLJOLBO TFNVB CBHJBO WFOUSJLFM #FCFSBQBTFSBUKBOUVOHNFNQVOZBJLFNBNQVBOFLTJUBTJTFOEJSJ
CFSLPOUSBLTJ TFDBSB IBNQJS CFSTBNBBO IBM JOJ QFOUJOH VOUVL TFMGFYDJUBUJPO
QSPTFT ZBOH EBQBU NFOZFCBCLBO MFQBTBO EBO
NFOJNCVMLBOUFLBOBOZBOHQBMJOHFGFLUJGEBMBNSVBOHWFOUSJLFM LPOUSBLTJ SJUNJT ZBOH PUPNBUJT )BM JOJ NFNBOH CFOBS VOUVL
TFSBUTFSBU TJTUFN LPOEVLTJ LIVTVT KBOUVOH UFSNBTVL TFSBU
/BNVO TJTUFNSJUNJTEBOLPOEVLTJEBMBNKBOUVOHJOJTBOHBU
TFSBU OPEVT TJOVT %FOHBO BMBTBO JOJMBI OPEVT TJOVT CJBTBOZB
SFOUBO UFSIBEBQ LFSVTBLBO BLJCBU QFOZBLJU KBOUVOH UFSVUBNB
NFOHBUVSLFDFQBUBOEFOZVUTFMVSVIKBOUVOH TFQFSUJZBOHBLBO
BLJCBU JTLFNJB KBSJOHBO KBOUVOH LBSFOB CVSVLOZB BMJSBO EBSBI
EJCJDBSBLBOMFCJIEFUBJMOBOUJEBMBNCBCJOJ1FSUBNB NBSJMBI
LPSPOFS 1FOHBSVIOZB TFSJOH LBMJ CFSVQB JSBNB KBOUVOH ZBOH
LJUBCJDBSBLBOJSBNBPUPNBUJTJOJ
BOFI BUBV TFSFOUFUBO LPOUSBLTJ ZBOH BCOPSNBM EBSJ SPOHHB
KBOUVOH EBO FGFLUJWJUBT QPNQB KBOUVOH TFSJOH TBOHBU UFS Mekanisme Irama Nodus Sinus (BNCBS NFOKFMBT
QFOHBSVI TBNQBJEBQBUNFOZFCBCLBOLFNBUJBO LBO QPUFOTJBM BLTJ ZBOH EJSFLBN EBSJ EBMBN TFSBU OPEVT TJOVT
TFMBNBUJHBEFOZVUKBOUVOH EFOHBOQFSCBOEJOHBO TBUVQPUFOTJBM
Sistem Eksitasi dan Konduksi Khusus pada BLTJTFSBUPUPUWFOUSJLFM1FSIBUJLBO CBIXBQPUFOTJBMNFNCSBO
Jantung JTUJSBIBU QBEB TFSBU OPEVT TJOVT EJ BOUBSB MFQBTBO NFNQVOZBJ
LFOFHBUJGBOTFLJUBSoTBNQBJoNJMJWPMU TFEBOHLBOTFSBUPUPU
(BNCBS NFOVOKVLLBO TJTUFN FLTJUBTJ EBO LPOEVLTJ LIVTVT WFOUSJLFMNFNQVOZBJQPUFOTJBMTFCFTBSoTBNQBJoNJMJWPMU
QBEBKBOUVOH ZBOHNFOHBUVSLPOUSBLTJKBOUVOH(BNCBSUFSTFCVU 1FOZFCBC EBSJ CFSLVSBOHOZB LFOFHBUJGBO JOJ BEBMBI CPDPSOZB
NFNQFSMJIBULBO OPEVT TJOVT KVHB EJTFCVU OPEVT TJOPBUSJBM BUBV NFNCSBO TFM TFSBU TJOVT TFDBSB BMBNJBI UFSIBEBQ JPOJPO
OPEVT4"
UFNQBUJNQVMTJNQVMTSJUNJTOPSNBMEJDFUVTLBOKBMVS OBUSJVN EBO LBMTJVN EBO NVBUBO QPTJUJG BLJCBU NBTVLOZB JPO
JOUFSOPEVT ZBOH NFOHIBOUBSLBO JNQVMTJNQVMT EBSJ OPEVT TJOVT OBUSJVN EBO LBMTJVN NFOFUSBMJTBTJ TFCBHJBO LFOFHBUJGBO
NFOVKV LF OPEVT BUSJPWFOUJLVMBS "7
OPEVT "7 UFNQBU JOUSBTFMVMBS
JNQVMTJNQVMT EBSJ BUSJVN NFOHBMBNJ QFSMBNCBUBO TFCFMVN 4FCFMVN LJUB NFODPCB NFNCBIBT JSBNB TFSBU OPEVT TJOVT
NBTVL LF WFOUSJLFM CFSLBT "7 ZBOH NFOHIBOUBSLBO JNQVMT NVMBNVMBLJUBJOHBULFNCBMJEBSJQFNCJDBSBBOQBEB#BCEBO
JNQVMT EBSJ BUSJVN LF WFOUSJLFM EBO DBCBOHDBCBOH CFSLBT ZBOH NFOKFMBTLBO CBIXB EJ EBMBN PUPU KBOUVOH BEB UJHB
TFSBCVUTFSBCVU 1VSLJOKF LJSJ EBO LBOBO ZBOH NFOHIBOUBSLBO NBDBNLBOBMJPONFNCSBOZBOHNFNBJOLBOQFSBOBOQFOUJOH
JNQVMTJNQVMTKBOUVOHLFTFMVSVICBHJBOWFOUSJLFM EBMBN NFOZFCBCLBO QFSVCBIBO WPMUBTF QPUFOTJBM BLTJ ,BOBM
LBOBM UFSTFCVU ZBJUV
LBOBM DFQBU OBUSJVN
LBOBM MBNCBU
Nodus Sinus (Sinoatrial) OBUSJVNLBMTJVN EBO
LBOBMLBMJVN
/PEVT TJOVT EJTFCVU KVHB OPEVT TJOPBUSJBM
NFSVQBLBO CBHJBO 1FNCVLBBO LBOBM DFQBU OBUSJVN ZBOH UFSKBEJ TFMBNB
PUPU KBOUVOH LIVTVT CFSVLVSBO LFDJM UJQJT EBO CFSCFOUVL FMJQT TFQFSCFCFSBQB QVMVI SJCV EFUJL EJBOHHBQ CFSUBOHHVOH KBXBC
EFOHBO MFCBS LJSBLJSB NN QBOKBOH NN EBO UFCBM NN VOUVLNVODVMOZBHBNCBSBOLBEVLKVMBOHQPUFOTJBMBLTJ TQJLF

/PEVTUFSTFCVUUFSMFUBLEJEBMBNEJOEJOHQPTUFSPMBUFSBMTVQFSJPS ZBOHTBOHBUDFQBU ZBOHEBQBUEJBNBUJEBMBNPUPUWFOUSJLFM LB
115
Unit III Jantung
UJNCVMOZB QPUFOTJBM BLTJ )BTJMOZB QFNCFOUVLBO QPUFOTJBM BLTJ

OPEVT BUSJVN NFOKBEJ MFCJI MBNCBU EBSJQBEB ZBOH UFSKBEJ QBEB
PUPU WFOUSJLFM 4FMBJO JUV TFUFMBI UFSKBEJ QPUFOTJBM BLTJ
QFOHFNCBMJBO QPUFOTJBM LF LFBEBBO OFHBUJG BLBO QVMJI EFOHBO
LFDFQBUBOZBOHMFCJIMBNCBULFUJNCBOHQPUFOTJBMBLTJEBMBNTFSBU
WFOUSJLFMZBOHQVMJIEFOHBOUJCBUJCB
Self-Excitation Serat-Serat Nodus Sinus 0MFI LBSFOB
UJOHHJOZBLPOTFOUSBTJJPOOBUSJVNEJEBMBNDBJSBOFLTUSBTFMVMBSEJ
MVBSTFSBUOPEVT CFHJUVKVHBEFOHBOTFKVNMBILBOBMOBUSJVNZBOH
TVEBI UFSCVLB JPOJPO OBUSJVN CFSNVBUBO QPTJUJG EBSJ MVBS TFSBU
CJBTBOZBDFOEFSVOHBLBONBTVLLFEBMBNTFSBU0MFILBSFOBJUV
NBTVLOZB JPOJPO OBUSJVN CFSNVBUBO QPTJUJG EJ BOUBSB EFOZVU
KBOUVOH NFOZFCBCLBO QFOJOHLBUBO QPUFOTJBM NFNCSBO JTUJSBIBU
LFBSBIQPTJUJGTFDBSBMBNCBU+BEJ TFQFSUJZBOHEJUVOKVLLBOQBEB
(BNCBS QPUFOTJBM JTUJSBIBU TFDBSB QFSMBIBOMBIBO BLBO
NFOJOHLBU EBO CFSLVSBOH LFOFHBUJGJUBTBOOZB EJ BOUBSB EVB
EFOZVU KBOUVOH 4BBU QPUFOTJBM NFODBQBJ BNCBOH CBUBT WPMUBTF
LJSBLJSB TFCFTBS o NJMJWPMU LBOBM OBUSJVNLBMTJVN NFOKBEJ
BLUJG TFIJOHHBNFOJNCVMLBOQPUFOTJBMBLTJ0MFILBSFOBJUV QBEB
EBTBSOZB TJGBUQFNCPDPSBOEBSJTFSBUTFSBUOPEVTTJOVTUFSIBEBQ
SFOB BEBOZB QFNBTVLBO DFQBU JPO OBUSJVN ZBOH CFSNVBUBO JPOJPO OBUSJVN EBO LBMTJVN NFOZFCBCLBO UJNCVMOZB TFMG
QPTJUJG LF CBHJBO EBMBN TFSBU UFSTFCVU 4FMBOKVUOZB HBNCBSBO FYDJUBUJPO
QMBUFBV EBSJ QPUFOTJBM BLTJ WFOUSJLFM JUV EJTFCBCLBO UFSVUBNB .FOHBQBCPDPSOZBJPOOBUSJVNEBOLBMTJVNUJEBLNFOZFCBC
PMFI MBNCBUOZB QFNCVLBBO LBOBM MBNCBU OBUSJVNLBMTJVN LBO TFSBUTFSBU OPEVT TJOVT UFUBQ EBMBN LFBEBBO EFQPMBSJTBTJ
ZBOH CFSMBOHTVOH TFMBNB TFLJUBS EFUJL "LIJSOZB TFQBOKBOHXBLUV +BXBCBOOZBJBMBICBIXBBEBEVBQFSJTUJXBZBOH
QFNCVLBBOLBOBMLBMJVNNFNVOHLJOLBOEJGVTJTFCBHJBOCFTBS UFSKBEJTFMBNBCFSMBOHTVOHOZBQPUFOTJBMBLTJVOUVLNFODFHBIIBM
JPOJPO LBMJVN ZBOH CFSNVBUBO QPTJUJG LF BSBI MVBS EBSJ UFSTFCVU 1FSUBNB LBOBM OBUSJVNLBMTJVN NFOKBEJ UJEBL BLUJG
NFNCSBOTFSBUUFSTFCVUEBONFOHFNCBMJLBOQPUFOTJBM NJTBMOZB LBOBMUFSTFCVUNFOKBEJUFSUVUVQ
EBMBNXBLUVLJSBLJSB
5FUBQJBEBTVBUVQFSCFEBBOGVOHTJEBSJLBOBMLBOBMJOJEBMBN TBNQBJ NJMJEFUJL TFUFMBI EJCVLB EBO LFEVB LJSBLJSB
TFSBU OPEVT TJOVT BLJCBU TBOHBU LVSBOHOZB LFOFHBUJGBO TFMBNB QBEB XBLUV ZBOH CFSTBNBBO TFKVNMBI LBOBM LBMJVN ZBOH
QPUFOTJBM JTUJSBIBU ZBLOJ IBOZB TFCFTBS o NJMJWPMU EJ TFSBU KVNMBIOZB TFNBLJO CBOZBL NFOKBEJ UFSCVLB 0MFI LBSFOB JUV
OPEVT EJCBOEJOHLBO EFOHBO o NJMJWPMU QBEB TFSBU PUPU NBTVLOZB JPO LBMTJVN EBO OBUSJVN CFSNVBUBO QPTJUJG NFMBMVJ
WFOUSJLFM 1BEB UJOHLBU o NJMJWPMU JOJ TFCBHJBO CFTBS LBOBM LBOBM OBUSJVNLBMTJVN BLBO CFSIFOUJ 4FNFOUBSB QBEB TBBU ZBOH
DFQBU OBUSJVN TVEBI NFOKBEJ JOBLUJG ZBOH CFSBSUJ CBIXB TBNBTFKVNMBICFTBSJPOLBMJVNCFSNVBUBOQPTJUJGBLBOCFSEJGVTJ
LBOBM JOJ TVEBI EJIBNCBU 1FOZFCBCOZB CBIXB TFUJBQ LBMJ LFMVBSEBSJTFSBU,FEVBIBMUFSTFCVUNFOHVSBOHJQPUFOTJBMJOUSBTFM
QPUFOTJBM NFNCSBO UFUBQ LVSBOH OFHBUJG EBSJ o NJMJWPMU TFIJOHHB LFNCBMJ LF UJOHLBU JTUJSBIBU ZBOH OFHBUJG TFIJOHHB
TFMBNB MFCJI EBSJ CFCFSBQB NJMJEFUJL HFSCBOH JOBLUJWBTJ EJ NFOHBLIJSJ QPUFOTJBM BLTJ -FCJI MBOKVU LBOBM LBMJVN BLBO UFUBQ
EBMBN NFNCSBO TFM ZBOH NFOVUVQ LBOBM DFQBU OBUSJVN BLBO UFSCVLB TFMBNB TFQFSCFCFSBQB QVMVI EFUJL NFOZFCBCLBO
NFOKBEJ UFSUVUVQ EBO BLBO UFUBQ EFNJLJBO 0MFI LBSFOB JUV CFSMBOKVUOZB QFSHFSBLBO NVBUBO QPTJUJG LF MVBS EBSJ TFM VOUVL
IBOZB LBOBM MBNCBU OBUSJVNLBMTJVN ZBOH EBQBU NFNCVLB TFNFOUBSBXBLUV TFIJOHHBUFSKBEJLFOFHBUJGBOZBOHCFSMFCJIBOEJ
ZBLOJZBOHEBQBUNFOKBEJBLUJG
TFIJOHHBEBQBUNFOZFCBCLBO EBMBN TFSBU LFBEBBO JOJ EJTFCVU TFCBHBJ IJQFSQPMBSJTBTJ 1BEB
BXBMOZB LFBEBBO IJQFSQPMBSJTBTJ BLBO NFOZFCBCLBO QPUFOTJBM
NFNCSBO JTUJSBIBU UVSVO TBNQBJ LJSBLJSB o IJOHHB o
NJMJWPMUQBEBBLIJSEBSJQPUFOTJBMBLTJ
.FOHBQB LFBEBBO IJQFSQPMBSJTBTJ ZBOH CBSV JOJ UJEBL
CFSMBOHTVOH UFSVTNFOFSVT "MBTBOOZB BEBMBI TFMBNB TFQFS
CFCFSBQB QVMVI EFUJL TFTVEBI QPUFOTJBM BLTJ CFSBLIJS TFDBSB
CFSUBIBQNBLJOMBNBNBLJOCBOZBLLBOBMLBMJVNZBOHNFOVUVQ
,FCPDPSBO ZBOH NFOZFCBCLBO NBTVLOZB JPOJPO OBUSJVN EBO
LBMTJVN ZBOH CFSNVBUBO QPTJUJG LF BSBI EBMBN TFLBMJ MBHJ BLBO
NFOHHBOHHV LFTFJNCBOHBO BMJSBO LFMVBS JPO LBMJVN TFIJOHHB
NFOZFCBCLBOQPUFOTJBMJTUJSBIBUBLBONFOZJNQBOHLFBUBTMBHJ
BLIJSOZBNFODBQBJOJMBJBNCBOHCBUBTVOUVLQFMFQBTBOQPUFOTJBM
BLTJ TFCFTBS LJSBLJSB o NJMJWPMU 4FMBOKVUOZB TFMVSVI QSPTFT
EJNVMBJ LFNCBMJ ZBLOJ TFMGFYDJUBUJPO VOUVL NFOZFCBCLBO
QPUFOTJBM BLTJ QFNVMJIBO EBO QPUFOTJBM BLTJ IJQFSQPMBSJTBTJ
TFTVEBIQPUFOTJBMBLTJCFSBLIJS QFOZJNQBOHBOLFBUBTEBOQPUF
116
Bab 10 Eksitasi Ritmis pada Jantung
OTJBM JTUJSBIBU LF OJMBJ BNCBOH EBO BLIJSOZB UFSKBEJ QSPTFT MBNCBUQFOKBMBSBOJNQVMTJOJLFWFOUSJLFM
FLTJUBTJLFNCBMJ SFFYDJUBUJPO
BHBSEBQBUUJNCVMTJLMVTZBOHMBJO /PEVT"7UFSMFUBLQBEBEJOEJOHQPTUFSJPSBUSJVNLBOBO
1SPTFT JOJ CFSMBOHTVOH UFSVT TFDBSB UJEBL UFSCBUBT TFMBNB UFQBU EJ CFMBLBOH LBUVQ USJLVTQJE TFQFSUJ ZBOH EJUVOKVLLBO
LFIJEVQBOTFTFPSBOH QBEB (BNCBS (BNCBS NFOHHBNCBSLBO CFSCBHBJ
UNIT III
Jalur Internodus dan Penjalaran Impuls Jantung melalui CBHJBO OPEVT ZBOH CFSCFEB EBO IVCVOHBOOZB EFOHBO
Atrium NBTVLOZB TFSBU KBMVS JOUFSOPEVT BUSJVN EBO LFMVBSOZB CFSLBT
"7 (BNCBS UFSTFCVU KVHB NFOVOKVLLBO QFSLJSBBO JOUFSWBM
6KVOH TFSBUTFSBU OPEVT TJOVT CFSIVCVOHBO MBOTVOH EFOHBO
XBLUVEBMBNTFQFSTFLJBOEFUJLBOUBSBBXBMEJNVMBJOZBJNQVMT
TFSBUTFSBUPUPUBUSJVNEJTFLFMJMJOHOZB0MFILBSFOBJUV QPUFOTJBM
KBOUVOH EJ EBMBN OPEVT TJOVT EBO QFNVODVMBO TFMBOKVUOZB
BLTJ ZBOH CFSBTBM EBSJ OPEVT TJOVT BLBO NFOKBMBS LFMVBS EBO
NBTVL LF EBMBN TFSBUTFSBU PUPU BUSJVN %FOHBO DBSB JOJMBI EBMBN TJTUFN OPEVT "7 1FSIBUJLBO CBIXB TFUFMBI CFSKBMBO
QPUFOTJBM BLTJ NFOZFCBS LF TFMVSVI NBTTB PUPU BUSJVN EBO NFMBMVJKBMVSKBMVSJOUFSOPEVT JNQVMTBLBONFODBQBJOPEVT"
BLIJSOZB LF OPEVT "7 ,FDFQBUBO LPOEVLTJ EJ TFCBHJBO CFTBS 7 LJSBLJSB EFUJL TFTVEBI LFMVBS EBSJ BTBMOZB ZBLOJ EBSJ
PUPU BUSJVN LJSBLJSB NEFUJL UFUBQJ LPOEVLTJ MFCJI DFQBU OPEVT TJOVT ,FNVEJBO QFOVOEBBO MBJO UFSKBEJ TFMBNB
TFLJUBS NEFUJL EJ CFCFSBQB QJUB TFSBU PUPU BUSJVN ZBOH LFDJM EFUJL EJ EBMBN OPEVT "7 TFOEJSJ TFCFMVN JNQVMT NBTVL LF
4BMBI TBUV EBSJ QJUB JOJ EJTFCVU QJUB BOUBS BUSJVN BOUFSJPS CBHJBO QFOFNCVTBO EBSJ CFSLBT "7 QFOFUSBUJOH QPSUJPO

BOUFSJPSJOUFSBUSJBMCBOE
CFSKBMBOEJTFQBOKBOHEJOEJOHBOUFSJPS UFNQBUJNQVMTNFNBTVLJWFOUSJLFM1FOVOEBBOUFSBLIJSTFMBNB
BUSJVN NFOVKV LF BUSJVN LJSJ 4FMBJO JUV BEB UJHB QJUB LFDJM MBJO EFUJLUFSKBEJUFSVUBNBEBMBNCBHJBOQFOFNCVTBOEJCFSLBT
ZBOH NFMBMVJ EJOEJOH BOUFSJPS MBUFSBM EBO QPTUFSJPS BUSJVN EBO "7JOJ ZBOHUFSEJSJBUBTGBTJLVMVTLFDJMNVMUJQFMZBOHNFMFXBUJ
CFSBLIJS EJ EBMBN OPEVT "7 TFQFSUJ ZBOH EJHBNCBSLBO QBEB KBSJOHBOGJCSPTBZBOHNFNJTBILBOBUSJVNEBOWFOUSJLFM
(BNCBS EBO ZBOH TFDBSB CFSVSVUBO EJTFCVU KBMVS %FOHBO EFNJLJBO UPUBM QFOVOEBBO EBMBN OPEVT "7 EBO
JOUFSOPEVT BOUFSJPS NFEJB EBO QPTUFSJPS 1FOZFCBC LFDFQBUBO TJTUFN CFSLBT "7 BEBMBI TFLJUBS EFUJL )BM UFSTFCVU
LPOEVLTJ ZBOH MFCJI UJOHHJ EBMBN QJUBQJUB JOJ BEBMBI BEBOZB EJUBNCBIQFOVOEBBOLPOEVLTJZBOHQFSUBNBTFMBNB EFUJL
TFSBUTFSBULPOEVLTJLIVTVT4FSBUTFSBUJOJNJSJQEFOHBOTFSBCVU EBSJ OPEVT TJOVT LF OPEVT "7 NFOZFCBCLBO KVNMBI
TFSBCVU LPOEVLTJ 1VSLJOKF EBMBN WFOUSJLFM CBILBO MFCJI DFQBU QFOVOEBBO TFMVSVIOZB BEBMBI EFUJL TFCFMVN BLIJSOZB
ZBOHEJCBIBTTFCBHBJCFSJLVU TJOZBMFLTJUBTJNFOZFCBCLBOLPOUSBLTJPUPUWFOUSJLFM
Nodus Atrioventrikular dan Penundaan Konduksi Impuls Penyebab Konduksi yang Lambat 1FOZFCBC VUBNB
dari Atrium ke Ventrikel LPOEVLTJ ZBOH TBOHBU MBNCBU QBEB TFSBU USBOTJTJPOBM TFSBU
4JTUFNLPOEVLTJBUSJVNEJBUVSTFEFNJLJBOSVQBTFIJOHHBJNQVMT OPEVT TJOVT EBO CBHJBO QFOFNCVTBO EJ TFSBU CFSLBT "7
KBOUVOH UJEBL NFOKBMBS UFSMBMV DFQBU EBSJ BUSJVN NFOVKV LF BEBMBI IJMBOHOZB TFKVNMBI HBQ KVODUJPO EJ BOUBSB TFMTFM ZBOH
WFOUSJLFM EFOHBO EFNJLJBO QFOVOEBBO JOJ BLBO NFNCFSJ XBLUV TBMJOH CFSEFSFU EBMBN KBMVS LPOEVLTJ TFIJOHHB UFSEBQBU
ZBOH DVLVQ CBHJ BUSJVN VOUVL NFOHPTPOHLBO EBSBI LF EBMBN UBIBOBO ZBOH TBOHBU CFTBS UFSIBEBQ LPOEVLTJ JPOJPO ZBOH
WFOUSJLFM TFCFMVN LPOUSBLTJ WFOUSJLFM EJNVMBJ /PEVT "7 EBO UFSFLTJUBTJEBSJTBUVTFSBULFTFSBUCFSJLVUOZB0MFILBSFOBJUV
TFSBUTFSBULPOEVLTJZBOHCFSEFLBUBOMBIZBOHUFSVUBNBNFNQFS EFOHBONVEBIEBQBUEJQBIBNJNFOHBQBTFUJBQTFMCFSJLVUOZB
MBNCBUUFSFLTJUBTJ
Penjalaran Cepat di Dalam Sistem Purkinje Ventrikel
4FSBCVU 1VSLJOKF LIVTVT CFSKBMBO EBSJ OPEVT "7 NFMBMVJ
CFSLBT "7 EBO NBTVL LF EBMBN WFOUSJLFM ,FDVBMJ VOUVL
CBHJBO BXBM TFSBU JOJ ZBOH NFOFNCVT TBXBS GJCSPTB "7
TFSBCVU 1VSLJOKF NFNJMJLJ LBSBLUFSJTUJL GVOHTJPOBM ZBOH
CFSMBXBOBO EFOHBO GVOHTJ TFSBU OPEVT "7 4FSBCVU 1VSLJOKF
NFSVQBLBO TFSBU ZBOH TBOHBU CFTBS CBILBO MFCJI CFTBS
EBSJQBEBTFSBUPUPUWFOUSJLFMOPSNBM EBOTFSBUJOJNFOKBMBSLBO
QPUFOTJBMBLTJEFOHBOLFDFQBUBO TBNQBJ NEFUJL ZBOH
LJSBLJSB LBMJ LFDFQBUBO EBMBN PUPU WFOUSJLFM CJBTBOZB EBO
LBMJ LFDFQBUBO EBMBN TFSBU OPEVT "7 ,FBEBBO JOJ
NFNVOHLJOLBO QFOKBMBSBO JNQVMT KBOUVOH TFDBSB DFQBU LF
TFMVSVIPUPUWFOUSJLFMZBOHUFSTJTB
1FOKBMBSBO QPUFOTJBM BLTJ ZBOH TBOHBU DFQBU PMFI TFSBCVU
1VSLJOKF EJZBLJOJ EJTFCBCLBO PMFI UJOHLBU QFSNFBCJMJUBT HBQ
KVODUJPO ZBOH TBOHBU UJOHHJ QBEB EJTLVT JOUFSLBMBUVT ZBOH
UFSEBQBU EJ BOUBSB TFMTFM ZBOH TBMJOH CFSEFSFU NFOZVTVO
TFSBCVUTFSBCVU1VSLJOKF0MFILBSFOBJUV JPOJPOEJIBOUBSLBO
EFOHBO NVEBI EBSJ TBUV TFM LF TFM ZBOH MBJO TFIJOHHB
NFOJOHLBULBO LFDFQBUBO QFOKBMBSBO 4FSBCVU 1VSLJOKF KVHB
NFNQVOZBJ TBOHBU TFEJLJU NJPGJCSJM ZBOH CFSBSUJ CBIXB TFSBU
JOJTFEJLJUBUBVUJEBLCFSLPOUSBLTJTBNBTFLBMJTFMBNBQFSKBMBO
BOQFOKBMBSBOJNQVMT
117
Unit III Jantung
,POEVLTJ 4BUV "SBI NFMBMVJ #FSLBT "7 4FCVBI LBSBLUFSJTUJL

LIVTVTEBSJCFSLBT"7BEBMBILFUJEBLNBNQVBOQPUFOTJBMBLTJ
VOUVL CFSKBMBO LFNCBMJ EBSJ WFOUSJLFM LF BUSJVN LFDVBMJ QBEB
LFBEBBO BCOPSNBM ,FBEBBO JOJ BLBO NFODFHBI NBTVLOZB
LFNCBMJ JNQVMT KBOUVOH NFMBMVJ KBMVS JOJ EBSJ WFOUSJLFM LF
BUSJVN TFIJOHHB ZBOH UFSKBEJ IBOZB LPOEVLTJ EBSJ BUSJVN LF
WFOUSJLFM
-FCJIKBVIMBHJ IFOEBLOZBEJJOHBULFNCBMJCBIXBEJNBOB
TBKBLFDVBMJQBEBCFSLBT"7 PUPUBUSJVNEJQJTBILBOEBSJPUPU
WFOUSJLFM PMFI TFCVBI TBXBS GJCSPTB CFSLFTJOBNCVOHBO ZBJUV
TFCVBICBHJBOZBOHEJUVOKVLLBOQBEB(BNCBS4BXBSJOJ
CJBTBOZB CFLFSKB TFCBHBJ TVBUV JOTVMBUPS VOUVL NFODFHBI
JNQVMTKBOUVOHMFXBUEJBOUBSBPUPUBUSJVNLFWFOUSJLFMNFMBMVJ
KBMVSMBJOTFMBJOLPOEVLTJNBKVNFMBMVJCFSLBT"7JUVTFOEJSJ
1BEBLBTVTZBOHKBSBOH TFCVBIKFNCBUBOPUPUZBOHBCOPSNBM
EBQBUNFOFNCVTTBXBSGJCSPTBEJNBOBTBKBTFMBJOQBEBCFSLBT
"7 1BEB LFBEBBO ZBOH EFNJLJBO JNQVMT KBOUVOH EBQBU
NBTVL LFNCBMJ LF BUSJVN EBSJ WFOUSJLFM EBO NFOZFCBCLBO
BSJUNJBKBOUVOHZBOHCFSBU
%istribusi Serabut-Serabut Purkinje di Dalam Ventrikel-

$abang Berkas Kiri dan Kanan.4FUFMBINFOFNCVTKBSJOHBO
GJCSPTB EJ BOUBSB PUPU BUSJVN EBO WFOUSJLFM CBHJBO EJTUBM EBSJ
CFSLBT"7BLBOCFSKBMBOLFCBXBIEJEBMBNTFQUVNWFOUSJLFM
TFQBOKBOHTBNQBJNNNFOVKVBQFLTKBOUVOH TFQFSUJZBOH
EJUVOKVLLBOQBEB(BNCBSEBO,FNVEJBOCFSLBT"
7JOJNFNCBHJEJSJNFOKBEJDBCBOHCFSLBTLJSJEBOLBOBOZBOH QFOKBMBSBO JNQVMT KBOUVOH EBSJ UFNQBU BXBM EJ DBCBOH CFSLBT
UFSMFUBL EJ CBXBI FOEPLBSEJVN QBEB LFEVB TJTJ TFQUVN IJOHHBLFCBHJBOBLIJSEBSJTFSBUPUPUWFOUSJLFMQBEBKBOUVOHZBOH
WFOUSJLFM 5JBQUJBQ DBCBOH NFOZFCBS LF CBXBI NFOVKV BQFLT OPSNBMBEBMBILJSBLJSB EFUJL
WFOUSJLFM EBO TFDBSB CFSUBIBQ BLBO NFNCBHJ EJSJ NFOKBEJ
Ringkasan Penyebaran Impuls Jantung ke Seluruh Jantung
DBCBOHDBCBOH MFCJI LFDJM $BCBOHDBCBOH JOJ TFMBOKVUOZB
CFSKBMBO NFOZBNQJOH NFOHFMJMJOHJ UJBQ SPOHHB WFOUSJLFM EBO (BNCBS NFOKFMBTLBO TFDBSB SJOHLBT QFOKBMBSBO JNQVMT
LFNCBMJNFOVKVCBTJTKBOUVOH6KVOHTFSBCVUTFSBCVU1VSLJOKF KBOUVOH QBEB KBOUVOH NBOVTJB "OHLBBOHLB EBMBN HBNCBS
NFOFNCVT QBEB LJSBLJSB TFQFSUJHB EBSJ QFSKBMBOBO LF EBMBN NFOVOKVLLBO JOUFSWBM XBLUV EBMBN TFQFSTFLJBO EFUJL ZBOH
NBTTBPUPUEBOBLIJSOZBCFSTJOBNCVOHEFOHBOTFSBUTFSBUPUPU EJCVUVILBOPMFIJNQVMTKBOUVOHEBSJUFNQBUBTBMEJEBMBNOPEVT
KBOUVOH TJOVT TBNQBJ NVODVM QBEB UJBQ UJUJL ZBOH TFTVBJ QBEB KBOUVOH
+VNMBI UPUBM XBLUV ZBOH EJQFSMVLBO TFKBL JNQVMT KBOUVOH 1FSIBUJLBO CBIXB JNQVMT NFOZFCBS EFOHBO LFDFQBUBO TFEBOH
NFNBTVLJ DBCBOH CFSLBT EJ EBMBN TFQUVN WFOUSJLFM TBNQBJ NFMBMVJBUSJVN UFUBQJJNQVMTJUVEJQFSMBNCBUMFCJIEBSJ EFUJL
NFODBQBJ BLIJS EBSJ TFSBCVU 1VSLJOKF SBUBSBUB IBOZB EJ EBFSBI OPEVT "7 TFCFMVN NVODVM QBEB CFSLBT "7 EJ
EFUJL 0MFI LBSFOB JUV TFLBMJ JNQVMT KBOUVOH JUV NBTVL LF TFQUVNWFOUSJLFM4FLBMJJNQVMTNBTVLLFEBMBNCFSLBTJOJ JNQVMT
EBMBN TJTUFN LPOEVLTJ 1VSLJOKF EJ WFOUSJLFM JNQVMT UFSTFCVU EFOHBO TBOHBU DFQBU NFOZFCBS NFMBMVJ TFSBCVUTFSBCVU 1VSLJOKF
TFHFSBBLBONFOZFCBSLFTFMVSVINBTTBPUPUWFOUSJLFM NFOVKV LF TFMVSVI QFSNVLBBO FOEPLBSEJVN WFOUSJLFM 4FMBOKVU
OZB JNQVMT UFSTFCVU TFLBMJ MBHJ NFOZFCBS EFOHBO LFDFQBUBO ZBOH
Penjalaran Impuls Jantung di Dalam Otot Ventrikel TFEJLJUMFCJIMBNCBUNFMBMVJPUPUWFOUSJLFMNFOVKVLFQFSNVLBBO
4FLBMJ JNQVMT NFODBQBJ VKVOH TFSBCVU 1VSLJOKF JNQVMT BLBO FQJLBSEJVN
EJIBOUBSLBO LF NBTTB PUPU WFOUSJLFM PMFI TFSBUTFSBU PUPU 1FOUJOHCBHJNBIBTJTXBVOUVLNFNQFMBKBSJTFDBSBMFCJIEFUBJM
WFOUSJLFMJUVTFOEJSJ,FDFQBUBOQFOKBMBSBOJUVTFLBSBOHIBOZB NFOHFOBJ QFOKBMBSBO JNQVMT KBOUVOH NFMBMVJ KBOUVOH EBO XBLUV
TBNQBJ NEFUJL ZBLOJTFQFSFOBNEBSJLFDFQBUBOEBMBN UFQBU ZBOH EJCVUVILBO BHBS JNQVMT UFSTFCVU EBQBU NVODVM QBEB
TFSBCVU1VSLJOKF UJBQ CBHJBO KBOUVOH TFCBC QFOHFUBIVBO ZBOH NFOZFMVSVI
0UPU KBOUVOH NFNCVOHLVT TFLFMJMJOH KBOUVOH EBMBN TVBUV NFOHFOBJQSPTFTJOJQFOUJOHVOUVLNFNBIBNJFMFLUSPLBSEJPHSBGJ
TQJSBM HBOEB EJTFSUBJ TFQUB GJCSPTB EJ BOUBSB MBQJTBOMBQJTBO ZBOHEJCBIBTEBMBN#BCTBNQBJ
CFSTQJSBMPMFILBSFOBJUV JNQVMTKBOUVOHUJEBLQFSMVMBOHTVOH
NFOKBMBSLFMVBSNFOVKVLFQFSNVLBBOKBOUVOHUFUBQJTFCBMJL
OZBCFSCFMPLNFOVKVLFQFSNVLBBOEJTFQBOKBOHTQJSBMTQJSBM Pengendalian Eksitasi dan Konduksi di Dalam Jantung
UFSTFCVU 0MFI LBSFOB IBM JOJ QFOKBMBSBO EBSJ QFSNVLBBO
FOEPLBSEJVNLFQFSNVLBBOFQJLBSEJVNWFOUSJLFMNFNCVUVI Nodus Sinus sebagai Picu Jantung
LBO XBLUV EFUJL LJSBLJSB IBNQJS TBNB EFOHBO XBLUV 1BEB QFNCBIBTBO LJUB TFKBVI JOJ NFOHFOBJ QFNCFOUVLBO EBO
ZBOHEJCVUVILBOVOUVLQFOKBMBSBOTJTUFN1VSLJOKFLFTFMVSVI QFOKBMBSBO JNQVMT KBOUVOH EJ KBOUVOH LJUB UFMBI NFMJIBU CBIXB
CBHJBOWFOUSJLFM4FIJOHHB UPUBMXBLUVZBOHEJCVUVILBOVOUVL OPSNBMOZBJNQVMTUJNCVMEJEBMBNOPEVTTJOVT1BEBCFCFSBQB
118
Bab 10 Eksitasi Ritmis pada Jantung
LPOEJTJ ZBOH BCOPSNBM IBM JOJ UJEBL CFSMBLV #BHJBO MBJO EBSJ USJOTJLOZBIJOHHBTBNQBJEFUJLLFNVEJBO LBSFOBTFCFMVN
KBOUVOH KVHB EBQBU NFODFUVTLBO FLTJUBTJ SJUNJT JOUSJOTJL EFOHBO QFOHIBNCBUBO TFSBCVU 1VSLJOKF UFMBI EJLFTBNQJOHLBO PMFI
DBSBZBOHTBNBTFQFSUJZBOHEJMBLVLBOPMFITFSBUOPEVTTJOVTIBM JNQVMT TJOVT ZBOH DFQBU EBO TFCBHBJ BLJCBUOZB TFSBCVU
JOJ UFSVUBNB UFSKBEJ EJ EBMBN TFSBU OPEVT "7 EBO TFSBCVU 1VSLJOKFBLBOCFSBEBEBMBNLFBEBBOUFSUFLBO%BMBNTBNQBJ
EFUJL JOJ WFOUSJLFM HBHBM NFNPNQBLBO EBSBI EBO PSBOH
UNIT III
1VSLJOKF
4FSBUTFSBU OPEVT "7 CJMB UJEBL NFOEBQBU SBOHTBOHBO EBSJ BLBO KBUVI QJOHTBO TFTVEBI TBNQBJ EFUJL QFSUBNB LBSFOB
TVNCFSEJMVBS BLBONFMFQBTLBOJNQVMTEFOHBOGSFLVFOTJSJUNJT PUBL NFOHBMBNJ LFLVSBOHBO BMJSBO EBSBI ,FBEBBO EFOZVU
JOUSJOTJL TFCFTBS TBNQBJ LBMJ QFS NFOJU EBO TFSBCVU KBOUVOH ZBOH UFSMBNCBU JOJ EJTFCVU TFCBHBJ TJOESPN 4UPLFT
1VSLJOKF BLBO NFMFQBTLBO JNQVMT EFOHBO GSFLVFOTJ TFCFTBS "EBNT #JMB XBLUV QFOVOEBBO JOJ UFSMBMV MBNB NBLB EBQBU
TBNQBJ LBMJ QFS NFOJU 'SFLVFOTJ JOJ CFSMBJOBO EFOHBO NFOJNCVMLBOLFNBUJBO
GSFLVFOTJ OPSNBM EBSJ OPEVT TJOVT ZBLOJ TBNQBJ LBMJ QFS Peranan Sistem Purkinje dalam Menyebabkan Kontraksi
NFOJU Otot Ventrikel yang Sinkron
.FOHBQB OPEVT TJOVT ZBOH NFOHBUVS JSBNB KBOUVOH EBO %BSJ VSBJBO UFSEBIVMV NFOHFOBJ TJTUFN 1VSLJOKF TVEBI KFMBT
CVLBO OPEVT "7 BUBV TFSBCVUTFSBCVU 1VSLJOKF +BXBCBOOZB CBIXB OPSNBMOZB JNQVMT KBOUVOH NFODBQBJ IBNQJS TFNVB
EJQFSPMFIEBSJLFOZBUBBOCBIXBGSFLVFOTJQFMFQBTBOJNQVMTEBSJ CBHJBO WFOUSJLFM EBMBN XBLUV ZBOH TBOHBU TJOHLBU EBO BLBO
OPEVTTJOVTKBVIMFCJIDFQBUEBSJQBEBGSFLVFOTJQFMFQBTBOBMBNJ NFSBOHTBOH TFSBU PUPU WFOUSJLFM QFSUBNB IBOZB EBMBN XBLUV
CBJL EBSJ OPEVT "7 BUBV TFSBCVU 1VSLJOKF 4FUJBQ LBMJ OPEVT TBNQBJ EFUJL TFCFMVN QFSBOHTBOHBO TFSBU PUPU
TJOVTNFMFQBTLBOJNQVMT JNQVMTOZBBLBOEJIBOUBSLBOLFOPEVT WFOUSJLFMUFSBLIJS,FBEBBOJOJBLBONFOZFCBCLBOTFNVBCBHJ
"7EBOTFSBCVU1VSLJOKF ZBOHKVHBBLBONFSBOHTBOHNFNCSBO BO PUPU WFOUSJLFM EJ LFEVB WFOUSJLFM BLBO NVMBJ CFSLPOUSBLTJ
OPEVT "7 EBO TFSBCVU 1VSLJOKF ZBOH NVEBI UFSFLTJUBTJ 5FUBQJ QBEBTBBUZBOHIBNQJSCFSTBNBBOEBOLFNVEJBONFMBOKVULBO
OPEVTTJOVTNFMFQBTLBOJNQVMTLFNCBMJTFCFMVNTBMBITBUV CBJL LPOUSBLTJTFMBNBTFLJUBS EFUJL
OPEVT "7 NBVQVO TFSBCVU 1VSLJOKF EBQBU NFODBQBJ OJMBJ
%BZB QPNQB FGFLUJG PMFI LFEVB SPOHHB WFOUSJLFM NFN
BNCBOHOZB VOUVL TFMGFYDJUBUJPO 0MFI LBSFOB JUV JNQVMT ZBOH
CVUVILBIKFOJTLPOUSBLTJTJOLSPOJOJ#JMBJNQVMTKBOUVOHIBSVT
CBSVEBSJOPEVTTJOVTBLBONFSBOHTBOHOPEVT"7EBOTFSBCVU
NFOKBMBSLFTFQBOKBOHWFOUSJLFMEFOHBOMBNCBU TFCBHJBOCFTBS
1VSLJOKFTFCFMVNUFSKBEJTFMGFYDJUBUJPOEJLFEVBCBHJBOUFSTFCVU
NBTTBWFOUSJLFMBLBOCFSLPOUSBLTJNFOEBIVMVJLPOUSBLTJZBOH
+BEJ OPEVT TJOVT NFOHBUVS EFOZVU KBOUVOH TFCBC GSFLVFOTJ
EJUJNCVMLBO PMFI NBTTB WFOUSJLFM TJTBOZB TFIJOHHB TFDBSB
QFMFQBTBOJNQVMTZBOHSJUNJTUFSTFCVUMFCJIDFQBUEBSJQBEBTFUJBQ
LFTFMVSVIBO EBZB QPNQB KBOUVOH BLBO TBOHBU UFSUFLBO 5FOUV
CBHJBO MBJO EJ KBOUVOH 0MFI LBSFOB JUV OPEVT TJOVT TFCFOBSOZB
TBKB QBEBCFCFSBQBNBDBNLFMFNBIBOKBOUVOH ZBOHCFCFSBQB
TFMBMVNFSVQBLBOQJDVKBOUVOHEBSJKBOUVOHOPSNBM
EJBOUBSBOZBBLBOEJCJDBSBLBOEBMBN#BCEBO QFOKBMBSBO
Picu Jantung Abnormal—Picu Jantung "Ektopik,BEBOH MBNCBU NFNBOH UFSKBEJ EBO FGFLUJWJUBT QFNPNQBBO WFOUSJLFM
LBEBOHCFCFSBQBCBHJBOMBJOEBSJKBOUVOHNFODFUVTLBOGSFLVFOTJ BLBONFOVSVOTFCBOZBLIJOHHBQFSTFO
SBOHTBOHBOSJUNJTZBOHMFCJIDFQBUEBSJQBEBZBOHEJDFUVTLBOPMFI Pengaturan Irama Jantung dan Konduksi Impuls oleh
OPEVTTJOVT)BMJOJLBEBOHUFSKBEJQBEBOPEVT"7BUBVTFSBCVU Saraf Jantung: Saraf Simpatis dan Parasimpatis
1VSLJOKF CJMB TBMBI TBUV EBSJ LFEVBOZB NFOKBEJ BCOPSNBM 1BEB
LFEVB LBTVT JOJ QJDV KBOUVOH BLBO CFSBMJI EBSJ OPEVT TJOVT LF 4FQFSUJ UFMBI EJUVOKVLLBO EBMBN (BNCBS QBEB #BC
OPEVT "7 BUBV LF TFSBCVU 1VSLJOKF ZBOH QFLB SBOHTBOH 1BEB KBOUVOH EJQFSTBSBGJ PMFI TBSBG TJNQBUJT EBO TBSBG QBSBTJNQBUJT
LFBEBBO ZBOH KBSBOH TBMBI TBUV UFNQBU EBMBN PUPU BUSJVN BUBV 4BSBGQBSBTJNQBUJT TBSBGWBHVT
UFSVUBNBUFSTFCBSEJOPEVT4"
PUPUWFOUSJLFMBLBONFOKBEJTBOHBUNVEBIEJSBOHTBOHEBOEBQBU EBO OPEVT "7 TFCBHJBO LFDJM UFSTFCBS EJ PUPU LFEVB BUSJVN
NFOKBEJQJDVKBOUVOH EBOTBOHBUTFEJLJUZBOHMBOHTVOHLFPUPUWFOUSJLFM4FCBMJLOZB
TBSBG TJNQBUJT UFSTFCBS EJ TFNVB CBHJBO KBOUVOH EFOHBO
1JDV KBOUVOH ZBOH UFSMFUBL EJ UFNQBU MBJO TFMBJO OPEVT TJOVT
QFOHBSVIZBOHLVBUUFSMJIBUQBEBPUPUWFOUSJLFMEFNJLJBOKVHB
EJTFCVUTFCBHBJQJDVKBOUVOHFLUPQJL4VBUVQJDVKBOUVOHFLUPQJL
EFOHBOTFNVBCBHJBOMBJO
EBQBU NFOZFCBCLBO UJNCVMOZB TFSBOHLBJBO LPOUSBLTJ BCOPSNBM
EBSJ CBHJBOCBHJBO CFSCFEB EBMBN KBOUVOH EBO EBQBU NFO Perangsangan Parasimpatis (Vagus) Dapat Memper-
ZFCBCLBONFMFNBIOZBQFNPNQBBOKBOUVOH lambat atau Bahkan Menghambat Irama Jantung dan
1FOZFCBC MBJO CFSBMJIOZB QJDV KBOUVOH BEBMBI CJMB UFSKBEJ Konduksi "Ventri-cular Escape" (Ventrikel Lepas). 1FSBO
QFOHIBNCBUBO QFOKBMBSBO JNQVMT KBOUVOH EBSJ OPEVT TJOVT LF HTBOHBO TBSBGTBSBG QBSB TJNQBUJT ZBOH NFOVKV LF KBOUVOH
CBHJBO MBJO EBSJ KBOUVOH 1JDV KBOUVOH ZBOH CBSV LFNVEJBO WBHVT
BLBONFOZFCBCLBOQFMFQBTBOIPSNPOBTFUJMLPMJOQBEB
UFSKBEJ QBMJOH TFSJOH QBEB OPEVT "7 BUBV EBMBN CBHJBO VKVOH TBSBG WBHVT )PSNPO JOJ NFNQVOZBJ EVB QFOHBSVI
QFOFNCVTBOEJCFSLBT"7EBMBNQFSKBMBOBONFOVKVWFOUSJLFM VUBNB QBEB KBOUVOH 1FSUBNB IPSNPO JOJ BLBO NFOVSVOLBO
#JMB UFSKBEJ CMPL "7 ZBJUV CJMB JNQVMT KBOUVOH HBHBM MFXBU GSFLVFOTJ JSBNB OPEVT TJOVT EBO LFEVB IPSNPO JOJ BLBO
EBSJ BUSJVN LF WFOUSJLFM NFMBMVJ OPEVT "7 EBO TJTUFN CFSLBT NFOVSVOLBO FLTJUBCJMJUBT TFSBUTFSBU QFOHIVCVOH "7 ZBOH
BUSJVNBLBOUFSVTCFSEFOZVUEFOHBOGSFLVFOTJJSBNBOPEVTTJOVT UFSMFUBL EJ BOUBSB PUPUPUPU BUSJVN EBO OPEVT "7 TFIJOHHB
OPSNBM TFEBOHLBO EJ TFSBCVU 1VSLJOKF EBMBN WFOUSJLFM CJBTBOZB BLBO NFNQFSMBNCBU QFOKBMBSBO JNQVMT KBOUVOH NFOVKV LF
UJNCVM TVBUV QJDV KBOUVOH CBSV EBO BLBO NFOHHFSBLLBO PUPU WFOUSJLFM
WFOUSJLFMEFOHBOTVBUVGSFLVFOTJCBSVZBLOJBOUBSBEBOLBMJ 1FSBOHTBOHBO MFNBI TBNQBJ TFEBOH TBSBG WBHVT BLBO
QFS NFOJU 4FUFMBI UFSKBEJ CMPL EJ CFSLBT "7 ZBOH UJCBUJCB NFNQFSMBNCBU LFDFQBUBO QFNPNQBBO KBOUVOH TFSJOH TBNQBJ
TJTUFN1VSLJOKFUJEBLBLBONVMBJNFNBODBSLBOJNQVMTSJUNJTJO TFUFOHBIEBSJOPSNBM1FSBOHTBOHBOLVBUTBSBGWBHVTEBQBUNF
119
Unit III Jantung
OHIFOUJLBO FLTJUBTJ SJUNJT EBSJ OPEVT TJOVT BUBV NFOHIBNCBU NFOJOHLBULBOGSFLVFOTJEFOZVUKBOUVOHTBNQBJUJHBLBMJMJQBUEBO

UPUBM QFOKBMBSBO JNQVMT KBOUVOH EBSJ BUSJVN LF WFOUSJLFM EBQBU NFOJOHLBULBO TFMVSVI LFLVBUBO LPOUSBLTJ KBOUVOH TBNQBJ
NFMBMVJ OPEVT "7 1BEB LFEVB LBTVT EJ BUBT TJOZBMTJOZBM EVBLBMJMJQBU
FLTJUBTJ SJUNJT JUV UJEBL MBHJ EJKBMBSLBO LF WFOUSJLFM 7FOUSJLFM
Mekanisme Pengaruh Simpatis1FSBOHTBOHBOTBSBGTJNQB
BLBO CFSIFOUJ CFSEFOZVU TFMBNB TBNQBJ EFUJL UBQJ LF
UJT BLBO NFMFQBTLBO IPSNPO OPSFQJOFGSJO QBEB VKVOH TBSBG
NVEJBOCFCFSBQBBSFBLFDJMEBMBNTFSBCVU1VSLJOKF VNVNOZB
TJNQBUJT /PSFQJOFGSJO TFMBOKVUOZB NFSBOHTBOH SFTFQUPS BESF
QBEBCBHJBOTFQUVNWFOUSJLFMEBSJCFSLBT"7 BLBONFODFUVT
OFSHJL CFUB ZBOH NFNFOHBSVIJ GSFLVFOTJ EFOZVU KBOUVOH
LBO JSBNBOZB TFOEJSJ EBO NFOZUIBCLBO LPOUSBLTJ WFOUSJLFM
4BNQBJTFLBSBOHNBTJICFMVNEJLFUBIVJEFOHBOKFMBTCBHBJNBOB
EFOHBO GSFLVFOTJ TBNQBJ EFOZVU QFS NFOJU 'FOPNFOB
NFLBOJTNF ZBOH UFQBU NFOHFOBJ LFSKB QFSBOHTBOHBO BESFOFSHJL
JOJEJTFCVUTFCBHBJWFOUSJLFMMFQBT WFOUSJDVMBSFTDBQF

CFUB QBEB TFSBUTFSBU PUPU KBOUVOH UFUBQJ EJZBLJOJ CBIXB
Mekanisme Pengaruh Vagus"TFUJMLPMJOZBOHEJMFQBTLBO SFTFQUPSJOJNFOJOHLBULBOQFSNFBCJMJUBTNFNCSBOTFSBUUFSIBEBQ
QBEB VKVOH TBSBG WBHVT TBOHBU NFOJOHLBULBO QFSNFBCJMJUBT JPO OBUSJVN EBO LBMTJVN %J EBMBN OPEVT TJOVT QFOJOHLBUBO
NFNCSBO TFSBU UFSIBEBQ JPO LBMJVN TFIJOHHB BLBO NFN QFSNFBCJMJUBT OBUSJVNLBMTJVN BLBO NFOZFCBCLBO QPUFOTJBM
QFSNVEBI UFSKBEJOZB LFCPDPSBO LBMJVN ZBOH DFQBU EBSJ TFSBU NFNCSBO JTUJSBIBU NFOKBEJ MFCJI QPTJUJG EBO KVHB NFOZFCBCLBO
TFSBU LPOEVLTJ )BM JOJ BLBO NFOZFCBCLBO QFOJOHLBUBO QFOJOHLBUBOLFDFQBUBOQFOZJNQBOHBOLFBUBTQPUFOTJBMNFNCSBO
LFOFHBUJGBO EJ EBMBN TFSBU EBO QFOHBSVI JOJ EJTFCVU TFCBHBJ EJBTUPMJL NFOVKV LF OJMBJ BNCBOH BHBS UJNCVM TFMGFYDJUBUJPO
IJQFSQPMBSJTBTJ ZBOHNFNCVBUKBSJOHBOZBOHNVEBIUFSFLTJUBTJ TFIJOHHB NFNQFSDFQBU TFMGFYDJUBUJPO EBO PMFI LBSFOB JUV BLBO
JOJNFOKBEJLVSBOHQFLB TFQFSUJUFMBIEJKFMBTLBOEBMBN#BC NFOJOHLBULBOGSFLVFOTJEFOZVUKBOUVOH
%J EBMBN OPEVT TJOVT LFBEBBO IJQFSQPMBSJTBTJ BLBO NF %J EBMBN OPEVT "7 EBO CFSLBT "7 QFOJOHLBUBO
OVSVOLBOQPUFOTJBMNFNCSBOJTUJSBIBUEBSJTFSBUOPEVTTJOVT QFSNFBCJMJUBT OBUSJVNLBMTJVN BLBO NFNCVBU QPUFOTJBM BLTJ
LF TVBUV OJMBJ ZBOH KBVI MFCJI OFHBUJG EBSJQBEB CJBTBOZB ZBJUV MFCJINVEBINFSBOHTBOHTFUJBQCFSLBTTFSBUCFSJLVUOZB TFIJOHHB
TBNQBJ QBEB TVBUV OJMBJ TFSFOEBI o TBNQBJ o NJMJWPMU BLBO NFOVSVOLBO XBLUV LPOEVLTJ EBSJ BUSJVN NFOVKV LF
EJCBOEJOH OJMBJ OPSNBM TFCFTBS o TBNQBJ o NJMJWPMU 0MFI WFOUSJLFM
LBSFOB JUV BXBM QFOJOHLBUBO QPUFOTJBM NFNCSBO OPEVT TJOVT
ZBOH EJTFCBCLBO PMFI NBTVLOZB OBUSJVN EBO LFCPDPSBO %JCBXBIQFOHBSVIQFSBOHTBOHBOTBSBGTJNQBUJT QFOJOHLBUBO
LBMTJVNNFNCVUVILBOXBLUVMFCJIMBNBVOUVLNFODBQBJOJMBJ QFSNFBCJMJUBT UFSIBEBQ JPO LBMTJVN QBMJOH UJEBL TFCBHJBOOZB
BNCBOH QPUFOTJBM VOUVL FLTJUBTJ ,FBEBBO JOJ BLBO TBOHBU CFSUBOHHVOH KBXBC BUBT QFOJOHLBUBO LFLVBUBO LPOUSBLTJ PUPU
NFNQFSMBNCBU JSBNB SJUNJT EBSJ TFSBUTFSBU OPEVT UFSTFCVU KBOUVOH TFCBC JPO LBMTJVN NFNQVOZBJ QFSBO ZBOH TBOHBU LVBU
+JLB QFSBOHTBOHBO TBSBG WBHVT JOJ DVLVQ LVBU NBLB NVOHLJO EBMBNNFSBOHTBOHQSPTFTLPOUSBLTJNJPGJCSJM
BLBO CFOBSCFOBS NFOHIFOUJLBO TFMVSVI JSBNB TFMGFYDJUBUJPO
EBSJOPEVTJOJ Daftar Pustaka
%J EBMBN OPEVT "7 LFBEBBO IJQFSQPMBSJTBTJ BLJCBU
Barbuti A, DiFrancesco D: Control of cardiac rate by "funny" channels in health
QFSBOHTBOHBO TBSBG WBHVT BLBO NFOZVMJULBO TFSBUTFSBU LFDJM and disease, Ann N Y Acad Sci 1123:213, 2008.
BUSJVNZBOHNFNBTVLJOPEVTVOUVLNFODFUVTLBOBMJSBOMJTUSJL Baruscotti M, Robinson RB: Electrophysiology and pacemaker function of the
EBMBN KVNMBI DVLVQ VOUVL NFSBOHTBOH TFSBUTFSBU OPEVT developing sinoatrial node, Am J Physiol Heart Circ Physiol 293:H2613, 2007.
0MFI LBSFOB JUV BLBO UFSKBEJ QFOVSVOBO GBLUPS LFBNBOBO Cheng H, Lederer WJ: Calcium sparks,Physiol Rev 88:1491, 2008.
Chien KR, Domian IJ, Parker KK: Cardiogenesis and the complex biology of
TBGFUZ GBDUPS
CBHJ QFOKBMBSBO JNQVMT KBOUVOH ZBOH NFMFXBUJ regenerative cardiovascular medicine, Science 322:1494, 2008.
TFSBUQFOHIVCVOHVOUVLNBTVLLFEBMBNTFSBUTFSBUOPEVT" Dobrzynski H, Boyett MR, Anderson RH: New insights into pacemaker activity:
7 1FOVSVOBO ZBOH EFSBKBUOZB TFEBOH IBOZB BLBO NFN promoting understanding of sick sinus syndrome, Circulation 115:1921, 2007.
QFSMBNCBULPOEVLTJJNQVMT UFUBQJQFOVSVOBOZBOHCFTBSBLBO James TN: Structure and function of the sinus node, AV node and His bundle of
the human heart: part 1—structure, Prog Cardiovasc Dis 45:235, 2002.
NFOHIBNCBULPOEVLTJTFDBSBLFTFMVSVIBO James TN: Structure and function of the sinus node, AV node and His bundle of
Pengaruh Perangsangan Simpatis pada Irama dan the human heart: part II—function, Prog Cardiovasc Dis 45:327, 2003.
Kiber AG, Rudy Y: Basic mechanisms of cardiac impulse propagation and
Konduksi Jantung. 1BEB EBTBSOZB QFSBOHTBOHBO TBSBG associated arrhythmias, Physiol Rev 84:431, 2004.
TJNQBUJT QBEB KBOUVOH BLBO NFOJNCVMLBO QFOHBSVI ZBOH Lakatta EG, Vinogradova TM, Maltsev VA: The missing link in the mystery of
CFSMBXBOBOEFOHBOQFOHBSVIZBOHEJUJNCVMLBOBLJCBUQFSBOH normal automaticity of cardiac pacemaker cells, Ann N Y Acad Sci 1123:41,
2008.
TBOHBOPMFITBSBGWBHVT TFQFSUJZBOHEJVSBJLBOTFCBHBJCFSJLVU
Leclercq C, Hare JM:Ventricular resynchronization: current state of the art,
1FSUBNB QFSBOHTBOHBO JOJ BLBO NFOJOHLBULBO LFDFQBUBO Circulation 109:296, 2004.
QFMFQBTBO JNQVMT EBSJOPEVT TJOVT ,FEVB QFSBOHTBOHBO JOJ Mangoni ME, Nargeot J: Genesis and regulation of the heart automaticity,
BLBONFOJOHLBULBOLFDFQBUBOLPOEVLTJEFNJLJBOKVHBEFOHBO Physiol Rev 88:919, 2008.
UJOHLBU FLTJUBCJMJUBT EJ TFNVB CBHJBO KBOUVOH ,FUJHB QFSBOH Mazgalev TN, Ho SY, Anderson RH: Anatomic-electrophysiological correlations
concerning the pathways for atrioventricular conduction, Circulation 103:2660,
TBOHBO JOJ BLBO TBOHBU NFOJOHLBULBO LFLVBUBO LPOUSBLTJ 2001.
TFNVB PUPUPUPU KBOUVOH CBJL PUPU BUSJVN NBVQVO PUPU Schram G, Pourrier M, Melnyk P, et Differential distribution of cardiac
WFOUSJLFM TFQFSUJZBOHUFMBIEJKFMBTLBOEBMBN#BC ion channel expression as a basis for regional specialization in electrical
function, Circ Res 90:939, 2002.
3JOHLBTOZB QFSBOHTBOHBOTBSBGTJNQBUJTBLBONFOJOHLBUL Yasuma F, Hayano J: Respiratory sinus arrhythmia: why does the heartbeat
BOTFMVSVIBLUJWJUBTKBOUVOH1FSBOHTBOHBONBLTJNBMEBQBU synchronize with respiratory rhythm? Chest 125:683, 2004.
120
BAB 11
UNIT III
&MFLUSPLBSEJPHSBN/PSNBM
4FXBLUV JNQVMT KBOUVOH NFMFXBUJ (FMPNCBOH 5 EJTFCBCLBO PMFI QPUFOTJBM MJTUSJL ZBOH
KBOUVOH BSVT MJTUSJL KVHB BLBO EJDFUVTLBOTFXBLUVWFOUSJLFMQVMJIEBSJLFBEBBOEFQPMBSJTBTJ%J
NFOZFCBS EBSJ KBOUVOH LF EBMBN EBMBN PUPU WFOUSJLFM QSPTFT JOJ OPSNBMOZB UFSKBEJ TBNQBJ
KBSJOHBO EJ EFLBUOZB EJ TFLFMJMJOH EFUJL TFTVEBI EFQPMBSJTBTJ EBO HFMPNCBOH 5 EJLFOBM
KBOUVOH 4FCBHJBO LFDJM EBSJ BSVT TFCBHBJHFMPNCBOHSFQPMBSJTBTJ
MJTUSJL JOJ BLBO NFOZFCBS LF TFHBMB +BEJ HBNCBSBO FUFLUSPLBSEJPHSBN UFSEJSJ BUBT HFMPNCBOH
BSBINFODBQBJQFSNVLBBOUVCVI EFQPMBSJTBTJ EBO HFMPNCBOH SFQPMBSJTBTJ 1SJOTJQQSJOTJQ
#JMB EJUFNQBULBO FMFLUSPEB QBEB LVMJU EJ TJTJ CFSMBXBOBO EBSJ EFQPMBSJTBTJEBOSFQPMBSJTBTJJOJUFMBIEJCJDBSBLBOEBMBN#BC
KBOUVOH NBLB QPUFOTJBM MJTUSJL ZBOH EJDFUVTLBO PMFI BSVT 1FSCFEBBO BOUBSB HFMPNCBOH EFQPMBSJTBTJ EBO HFMPNCBOH
UFSTFCVU BLBO EBQBU EJSFLBN SFLBNBO JOJ EJLFOBM TFCBHBJ SFQPMBSJTBTJCFHJUVQFOUJOHOZBEBMBNHBNCBSBOFMFLUSPLBSEJPH
FMFLUSPLBSEJPHSBN&MFLUSPLBSEJPHSBNOPSNBMZBOHEJEBQBULBO SBGJTFIJOHHBEJQFSMVLBOQFOKFMBTBOZBOHMFCJIMBOKVU
EBSJEVBEFOZVUKBOUVOHEJQFSMJIBULBOQBEB(BNCBS
Gelombang Depolarisasi vs Gelombang Repolarisasi
Karakteristik Elektrokardiogram (BNCBSNFOKFMBTLBOFNQBUUBIBQQSPTFTEFQPMBSJTBTJEBO
Normal SFQPMBSJTBTJ ZBOH UFSKBEJ QBEB TBUV TFSBU PUPU KBOUVOH 4FMBNB
CFSMBOHTVOHOZBQSPTFTEFQPMBSJTBTJ QPUFOTJBMOFHBUJGOPSNBMEJ
&MFLUSPLBSEJPHSBN OPSNBM MJIBU (BNCBS
UFSEJSJ BUBT EBMBN TFSBU BLBO NFNCBMJL TFIJOHHB NFOKBEJ TFEJLJU QPTJUJG EJ
TFCVBI HFMPNCBOH 1 TFCVBI LPNQMFLT 234 EBO TFCVBI TJTJEBMBNEBOTFEJLJUOFHBUJGEJTJTJMVBS
HFMPNCBOH 5 4FSJOH LBMJ UFUBQJ UJEBL TFMBMV LPNQMFLT 234 JUV 1BEB(BNCBS" QSPTFTEFQPMBSJTBTJEJQFSMJIBULBOTFCBHBJ
UFSEJSJ BUBT UJHB HFMPNCBOH ZBOH UFSQJTBI ZBLOJ HFMPNCBOH 2 NVBUBO QPTJUJG EJ TJTJ EBMBN EBO NVBUBO OFHBUJG EJ TJTJ MVBS
HFMPNCBOH3 EBOHFMPNCBOH4 TFEBOHCFSKBMBOEBSJLJSJLFLBOBO4FQBSVICBHJBOQFSUBNBEBSJ
(FMPNCBOH 1 EJTFCBCLBO PMFI QPUFOTJBM MJTUSJL ZBOH TFSBU TVEBI UFSEFQPMBSJTBTJ TFNFOUBSB TFQBSVI TJTBOZB NBTJI
EJDFUVTLBO TFXBLUV BUSJVN CFSEFQPMBSJTBTJ TFCFMVN LPOUSBLTJ EBMBN LFBEBBO QPMBSJTBTJ 0MFI LBSFOB JUV FMFLUSPEB LJSJ ZBOH
BUSJVNEJNVMBJ,PNQMFLT234EJTFCBCLBOPMFIQPUFOTJBMMJTUSJL UFSMFUBL EJ MVBS TFSBU CFSBEB QBEB EBFSBI LFOFHBUJGBO EBO
ZBOH EJDFUVTLBO TFXBLUV WFOUSJLFM CFSEFQPMBSJTBTJ TFCFMVN FMFLUSPEB LBOBO CFSBEB QBEB EBFSBI LFQPTJUJGBO LFBEBBO JOJ
CFSLPOUSBLTJ ZBJUV TFXBLUV HFMPNCBOH EFQPMBSJTBTJ NFOZFCBS BLBONFNCVBUSFLBNBOQBEBBMBUQFOHVLVSNFOKBEJQPTJUJG%J
NFMFXBUJWFOUSJLFM0MFILBSFOBJUV CBJLHFMPNCBOH1NBVQVO TFCFMBI LBOBO TFSBCVU TFSBCVU PUPU EJUVOKVLLBO SFLBNBO
LPNQPOFO LPNQPOFO LPNQMFLT 234 EJTFCVU TFCBHBJ QPUFOTJBMMJTUSJLBOUBSBLFEVBFMFLUSPEB TFQFSUJZBOHEJSFLBN
HFMPNCBOHEFQPMBSJTBTJ PMFIBMBUQFSFLBNCFSLFDFQBUBOUJOHHJ%BMBN(BNCBS"
+1.0 R
+0.5
T
P
0
Q
S
–0.5
0 0.2 0.4 0.6 0.8 1.0 1.2 1.4 1.6
121
Unit III Jantung
0

R

T
A
Q
S

B

C BOUBSB TBNQBJ EFUJL #BHJBO QVODBL QBEB (BNCBS
NFOVOKVLLBO TFCVBI SFLBNBO QPUFOTJBM BLTJ NPOPGBTJL ZBOH
CFSBTBMEBSJTFCVBINJLSPFMFLUSPEBZBOHEJTJTJQLBOEJCBHJBOEBMBN

TBUVTFSBUPUPUWFOUSJLFM#BHJBOQPUFOTJBMBLTJZBOHNFMFOHLVOHLF
BUBTEJTFCBCLBOPMFIEFQPMBSJTBTJ EBOLFNCBMJOZBQPUFOTJBMBLTJLF

D HBSJTEBTBSEJTFCBCLBOPMFISFQPMBSJTBTJ
Gambar 11-2 Rekaman gelombang depolarisasi (A dan B) dan 1FSIBUJLBO CBHJBO CBXBI HBNCBS ZBOH NFNQFSMJIBULBO TFCVBI
gelombang repolarisasi (C dan D) yang berasal dari serat otot jantung. SFLBNBO FMFLUSPLBSEJPHSBN TFDBSB TFSFOUBL EBSJ WFOUSJLFM ZBOH
TBNB ZBOH NFOVOKVLLBO CBIXB HFMPNCBOH 234 NVODVM QBEB
BXBMQPUFOTJBMNPOPGBTJLEBOHFMPNCBOH5NVODVMEJCBHJBOBLIJS
IFOEBLOZB EJQFSIBUJLBO CBIXB QBEB TBBU EFQPMBSJTBTJ UFMBI 1FSIBUJLBO UFSVUBNB TFXBLUV PUPU WFOUSJLFM EBMBN LFBEBBO
NFODBQBJ TFUFOHBI KBMBO SFLBNBO UFSTFCVU TVEBI OBJL TBNQBJ QPMBSJTBTJ MFOHLBQ BUBV EFQPMBSJTBTJ MFOHLBQ UFSOZBUB TBNB TFLBMJ
OJMBJQPTJUJGNBLTJNVN UJEBLBEBQPUFOTJBMZBOHUFSFLBNQBEBFMFLUSPLBSEJPHSBN1PUFOTJBM
1BEB (BNCBS # QSPTFT EFQPMBSJTBTJ UFMBI NFOZFCBS LF UFSTFCVU BLBO UFSFLBN IBOZB CJMB TFCBHJBO PUPU EBMBN LFBEBBO
TFMVSVITFSBUPUPU EBOSFLBNBOEJTFCFMBILBOBOTVEBILFNCBMJ QPMBSJTBTJ EBO TFCBHJBO MBHJ UFSEFQPMBSJTBTJ TFIJOHHB BMJSBO BSVT
LFHBSJTEBTBSOPMMBHJLBSFOBLFEVBFMFLUSPEBTFLBSBOHUFSMFUBL MJTUSJL UFSTFCVU NFOHBMJS EBSJ TBUV CBHJBO WFOUSJLFM NFOVKV LF
QBEBEBFSBIZBOHNFNJMJLJLFOFHBUJGBOZBOHTBNB(FMPNCBOH CBHJBOWFOUSJLFMZBOHMBJO EBOPMFILBSFOBJUVBSVTMJTUSJLKVHBBLBO
ZBOH UFMBI NFOHBLIJSJ QFOKBMBSBOOZB EJTFCVU HFMPNCBOH NFOHBMJS LF QFSNVLBBO UVCVI VOUVL NFOJNCVMLBO HBNCBSBO
EFQPMBSJTBTJ LBSFOB HFMPNCBOH JOJ UJNCVM EBSJ QFOZFCBSBO FMFLUSPLBSEJPHSBN
EFQPMBSJTBTJLFTFQBOKBOHNFNCSBOTFSBUPUPU Hubungan antara Kontraksi Atrium dan Kontraksi Ventrikel
(BNCBS $ NFOVOKVLLBO QSPTFT SFQPMBSJTBTJ QBEB terhadap Gelombang Elektrokardiogram
TFQBSVI CBHJBO ZBOH UFSKBEJ EJ EBMBN TFSBCVU PUPU ZBOH TBNB 4FCFMVN LPOUSBLTJ PUPU EBQBU UFSKBEJ QSPTFT EFQPMBSJTBTJ IBSVT
EFOHBOLFQPTJUJGBOLFNCBMJLFTJTJMVBSEBSJTFSBU1BEBUJUJLJOJ NFOZFCBS LF TFMVSVI PUPU VOUVL NFOHBXBMJ QSPTFT LJNJBXJ EBO
FMFLUSPEB LJSJ CFSBEB QBEB EBFSBI LFQPTJUJGBO EBO FMFLUSPEB LPOUSBLTJ .FSVKVL LFNCBMJ QBEB (BNCBS HFMPNCBOH 1
LBOBOCFSBEBQBEBEBFSBILFOFHBUJGBO,FBEBBOJOJCFSMBXBOBO UFSKBEJ QBEB QFSNVMBBO LPOUSBLTJ BUSJVN EBO HFMPNCBOH
EFOHBO QPMBSJUBT ZBOH UBNQBL EBMBN (BNCBS " LPNQMFLT 234 UFSKBEJ QBEB BXBM LPOUSBLTJ WFOUSJLFM 7FOUSJLFM
"LJCBUOZB SFLBNBO ZBOH EJUVOKVLLBO EJ TFCFMBI LBOBO BLBO BLBOUFUBQCFSLPOUSBLTJTBNQBJTFTVEBIQSPTFTSFQPMBSJTBTJUFSKBEJ
NFOKBEJOFHBUJG ZBLOJTBNQBJHFMPNCBOH5CFSBLIJS
%BMBN (BNCBS % TFSBCVU PUPU UFMBI TFMVSVIOZB "USJVN NFOHBMBNJ SFQPMBSJTBTJ TFLJUBS TBNQBJ EFUJL
NFOHBMBNJ SFQPMBSJTBTJ EBO LFEVB FMFLUSPEB TFLBSBOH CFSBEB TFUFMBIHFMPNCBOH1CFSBLIJS4BBUJOJCFSUFQBUBOEFOHBOUFSKBEJOZB
EBMBN EBFSBI LFQPTJUJGBO TFIJOHHB UJEBL BEB QFSCFEBBO LPNQMFLT 234 ZBOH EJSFLBN EBMBN FMFLUSPLBSEJPHSBN 0MFI
QPUFOTJBM MJTUSJL ZBOH EBQBU EJSFLBN EJ BOUBSB LFEVB FMFLUSPEB LBSFOB JUV HFMPNCBOH SFQPMBSJTBTJ BUSJVN ZBOH EJLFOBM EFOHBO
JOJ +BEJ QBEB SFLBNBO ZBOH EJ TFCFMBI LBOBO TFLBMJ MBHJ HFMPNCBOH 5 BUSJVN CJBTBOZB NFOKBEJ UFSUVUVQ PMFI CFTBSOZB
QPUFOTJBM LFNCBMJ NFOKBEJ OPM (FMPNCBOH OFHBUJG ZBOH UFMBI LPNQMFLT 234 0MFI LBSFOB BMBTBO UFSTFCVU HFMPNCBOH 5 BUSJVN
NFOHBLIJSJ QFSKBMBOBO EJTFCVU HFMPNCBOH SFQPMBSJTBTJ TFCBC KBSBOHEBQBUEJMJIBUEBMBNFMFLUSPLBSEJPHSBN
HFMPNCBOH JOJ CFSBTBM EBSJ QFOZFCBSBO QSPTFT SFQPMBSJTBTJ EJ %BMBNHBNCBSFMFLUSPLBSEJPHSBNOPSNBM HFMPNCBOH5BEBMBI
TFQBOKBOHNFNCSBOTFSBCVUPUPU HFMPNCBOH SFQPMBSJTBTJ WFOUSJLFM #JBTBOZB CFCFSBQB TFSBU PUPU
)VCVOHBO BOUBSB 1PUFOTJBM "LTJ .POPGBTJL QBEB WFOUSJLFM NVMBJ CFSFQPMBSJTBTJ LJSBLJSB EFUJL TFTVEBI
0UPU7FOUSJLFM EFOHBO (FMPNCBOH 234 EBO (FMPNCBOH 5 QFSNVMBBO HFMPNCBOH EFQPMBSJTBTJ LPNQMFLT 234
OBNVO QBEB
QBEB&MFLUSPLBSEJPHSBN 4UBOEBS 1PUFOTJBM BLTJ NPOPGBTJL LFCBOZBLBOTFSBUMBJOOZB QSPTFTSFQPMBSJTBTJNFNCVUVILBOXBLUV
ZBOH UFSEBQBU QBEB PUPU WFOUSJLFM TFQFSUJ ZBOH UFMBI TBNQBJ EFUJL +BEJ QSPTFT SFQPMBSJTBTJ WFOUSJLFM BLBO
EJCJDBSBLBOEBMBN#BC EBMBNLFBEBBOOPSNBMCFSMBOHTVOH NFNFSMVLBOXBLUVZBOHMBNB LJSBLJSB EFUJL%FOHBO
122
Bab 11 Elektrokardiogram Normal
BMBTBO JOJMBI HFMPNCBOH 5 EBMBN HBNCBS FMFLUSPLBSEJPHSBN CBOUVBO FMFLUSPLBSEJPHSBN TFCBC GSFLVFOTJ EFOZVU KBOUVOH
OPSNBM NFSVQBLBO HFMPNCBOH ZBOH NFNBOKBOH OBNVO WPMUBTF CFSCBOEJOH UFSCBMJL EFOHBO JOUFSWBM XBLUV EJ BOUBSB EVB
HFMPNCBOH 5 JUV TBOHBU LFDJM EJCBOEJOHLBO EFOHBO WPMUBTF EFOZVU KBOUVOH ZBOH CFSVSVUBO #JMB JOUFSWBM EJ BOUBSB EVB
LPNQMFLT 234 TFCBHJBO EJTFCBCLBO PMFI QFSQBOKBOHBO QSPTFT EFOZVU KBOUVOH TFQFSUJ ZBOH EJUFOUVLBO EFOHBO HBSJT LBMJCSBTJ
XBLUVBEBMBIEFUJL NBLBGSFLVFOTJEFOZVUKBOUVOHBEBMBI
UNIT III
SFQPMBSJTBTJUBEJ
LBMJNFOJU*OUFSWBMOPSNBMEJBOUBSBEVBLPNQMFLT234ZBOH
Kalibrasi Voltase dan Waktu pada Elektrokardiogram CFSVSVUBO QBEB PSBOH EFXBTB LJSBLJSB EFUJL +BEJ
4FNVB SFLBNBO FMFLUSPLBSEJPHSBN EJCVBU EFOHBO HBSJT LBMJCSBTJ GSFLVFOTJ EFOZVU KBOUVOH TFCFTBS LBMJ QFS NFOJU BUBV
ZBOH UFQBU QBEB LFSUBT SFLBNBO (BSJT LBMJCSBTJ JOJ EBQBU TVEBI LBMJNFOJU
EJHBSJTLBO QBEB TFCVBI LFSUBT TFQFSUJ CJMB NFNQFSHVOBLBO BMBU
QFOB SFLBNBO BUBV EBQBU KVHB EJCVBU EJ BUBT LFSUBT QBEB XBLUV Metode Perekaman Elektrokardiogram
ZBOHCFSTBNBBOEFOHBOQFSFLBNBOFMFLUSPLBSEJPHSBN ZBOHBLBO
EJUFNVLBOCJMBNFOHHVOBLBOFMFLUSPLBSEJPHSBGUJQFGPUPHSBGJL ,BEBOH BSVT MJTUSJL ZBOH EJDFUVTLBO PMFI PUPU KBOUVOH TFMBNB
4FQFSUJ ZBOH EJQFSMJIBULBO EBMBN (BNCBS HBSJT LBMJCSBTJ TBUVEFOZVUKBOUVOHEBQBUNFOHVCBICFTBSOZBQPUFOTJBMMJTUSJL
IPSJ[POUBMEJBUVSTFEFNJLJBOSVQBTFIJOHHBTFQVMVILPUBLLFDJMLF EBOQPMBSJUBTQBEBTJTJTJTJZBOHCFSVSVUBOEBSJKBOUVOHEBMBN
BUBTBUBVLFCBXBIEBMBNFMFLUSPLBSEJPHSBNTUBOEBSNFOVOKVLLBO XBLUVLVSBOHEBSJ EFUJL0MFILBSFOBJUV QFOUJOHLJSBOZB
WPMUBTF TFCFTBS NJMJWPMU EFOHBO LFQPTJUJGBO LF BSBI BUBT EBO EJUFLBOLBOCBIXBTFUJBQBMBUQFSFLBNFMFLUSPLBSEJPHSBNIBSVT
LFOFHBUJGBOLFBSBICBXBI NBNQV NFOBOHHBQJ EFOHBO DFQBU TFUJBQ QFSVCBIBO QPUFOTJBM
(BSJT WFSUJLBM ZBOH UFSEBQBU QBEB FMFLUSPLBSEJPHSBN MJTUSJLJOJ
NFOVOKVLLBO HBSJT LBMJCSBTJ XBLUV 4FCVBI FMFLUSPLBSEJPHSBN
MB[JNOZB EJKBMBOLBO QBEB LFSUBT EFOHBO LFDFQBUBO NJMJNFUFS Alat Perekam Elektrokardiograf
QFS EFUJL NFTLJQVO LBEBOHLBEBOH LFDFQBUBO ZBOH MFCJI UJOHHJ 4FCBHJBOCFTBSFMFLUSPLBSEJPHSBGLMJOJLNPEFSONFOHHVOBLBO
KVHB EJHVOBLBO 0MFI TFCBC JUV UJBQ NJMJNFUFS LF BSBI TJTUFNCFSCBTJTLPNQVUFSEBOHBNCBSBOFMFLUSPOJL TFNFOUBSB
IPSJ[POUBM BEBMBI TFCFTBS EFUJL EBO TFUJBQ NJMJNFUFS TFHNFO ZBOH MBJOOZB NFOHHVOBLBO TFCVBI QFOB QFSFLBN MBOHTVOH
EJUVOKVLLBOPMFIHBSJTWFSUJLBMUFCBM NFOVOKVLLBOXBLUVTFCFTBS ZBOH BLBO NFOVMJT HBNCBSBO FMFLUSPLBSEJPHSBN EFOHBO
EFUJL *OUFSWBM EFUJL JOJ JOJ EJCBHJ MBHJ NFOKBEJ MJNB TFCVBI QFOB MBOHTVOH QBEB MBQJTBO LFSUBT ZBOH CFSKBMBO
JOUFSWBM ZBOH MFCJI LFDJM PMFI HBSJT UJQJT EBO TFUJBQ JOUFSWBM ZBOH ,BEBOHLBEBOH QFOB NFSVQBLBO TFCVBI QJQB LFDJM ZBOH TBUV
LFDJMJOJCFTBSOZB EFUJL VKVOHOZB EJIVCVOHLBO EFOHBO UFNQBU QFOBNQVOHBO UJOUB
EBO VKVOH CBHJBO QFSFLBN EJIVCVOHLBO EFOHBO TJTUFN
Voltase Normal dalam Elektrokardiogram. 3FLBNBO
FMFLUSPNBHOFUJLLVBUZBOHNBNQVNFOHHFSBLLBOQFOBNBKV
CFTBSOZB WPMUBTF HFMPNCBOH ZBOH UFSEBQBU EBMBN
EBO NVOEVS QBEB LFDFQBUBO UJOHHJ 4FXBLUV LFSUBT CFSHFSBL
FMFLUSPLBSEJPHSBN OPSNBM CFSHBOUVOH LFQBEB DBSB QFNBTBOHBO
LFEFQBO QFOBBLBONFSFLBNFMFLUSPLBSEJPHSBN1FSHFSBLBO
FMFLUSPEB QBEB QFSNVLBBO UVCVI EBO KBSBL FMFLUSPEB LF KBOUVOH
QFOB EJLFOEBMJLBO EFOHBO QFOHVBU FMFLUSPOJL ZBOH TFTVBJ
#JMB TBMBI TBUV FMFLUSPEB EJQBTBOH UFQBU EJ BUBT WFOUSJLFM EBO
ZBOH EJIVCVOHLBO LF FMFLUSPEB FMFLUSPLBSEJPHSBGJL QBEB
FMFLUSPEBZBOHLFEVBEJUFNQBULBOEJCBHJBOUVCVIMBJOZBOHKBVI
QBTJFO
EBSJ KBOUVOH WPMUBTF LPNQMFLT 234 NVOHLJO TFCFTBS TBNQBJ
NJMJWPMU 7PMUBTF JOJ QVO NBTJI LFDJM CJMB EJCBOEJOHLBO EFOHBO 4JTUFN QFOB QFSFLBN MBJOOZB NFOHHVOBLBO LFSUBT LIVTVT
QPUFOTJBMBLTJNPOPGBTJLTFCFTBSNJMJWPMUZBOHEJSFLBNTFDBSB ZBOH UJEBL NFNCVUVILBO UJOUB EBMBN KBSVN QFSFLBNOZB
MBOHTVOH QBEB NFNCSBO PUPU KBOUVOH #JMB FMFLUSPLBSEJPHSBN ,FSUBT TFKFOJT JUV BLBO NFOKBEJ IJUBN CJMB UFSQBQBS EFOHBO
EJSFLBNEFOHBONFNBTBOHFMFLUSPEBQBEBLFEVBMFOHBOBUBVQBEB QBOBTKBSVNJUVTFOEJSJEJCVBUNFOKBEJTBOHBUQBOBTPMFIBSVT
TBUV MFOHBO EBO TBUV UVOHLBJ WPMUBTF LPNQMFLT 234 CJBTBOZB MJTUSJL ZBOH NFOHBMJS NFMBMVJ VKVOHOZB +FOJT LFSUBT ZBOH MBJO
TFCFTBS TBNQBJ NJMJWPMU NVMBJ EBSJ QVODBL HFMPNCBOH 3 BLBO NFOKBEJ IJUBN TFXBLUV BSVT MJTUSJL NFOHBMJS EBSJ VKVOH
TBNQBJLFEBTBSHFMPNCBOH4CFTBSOZBWPMUBTFHFMPNCBOH1BOUBSB KBSVN NFMBMVJ LFSUBT NFOVKV LF FMFLUSPEB ZBOH UFSEBQBU EJ
EBO NJMJWPMU EBO WPMUBTF HFMPNCBOH 5 BOUBSB EBO CBMJLLFSUBTJUV$BSBJOJBLBONFOJOHHBMLBOTVBUVHBSJTIJUBN
NJMJWPMU QBEBLFSUBTEJUFNQBUZBOHEJTFOUVIPMFIKBSVN
*OUFSWBM 12 BUBV *OUFSWBM 13 -BNB XBLUV BOUBSB QFSNVMBBO
HFMPNCBOH 1 EBO QFSNVMBBO LPNQMFLT 234 BEBMBI JOUFSWBM XBLUV Aliran Listrik di Seketiling Jantung Selama
BOUBSB QFSNVMBBO FLTJUBTJ MJTUSJL BUSJVN EBO QFSNVMBBO FLTJUBTJ Siklus Jantung
WFOUSJLFM1FSJPEFXBLUVJOJEJTFCVUTFCBHBJJOUFSWBM12*OUFSWBM1
2 OPSNBM BEBMBI LJSBLJSB EFUJL 4FSJOH LBMJ JOUFSWBM JOJ KVHB Perekaman Potensial Listrik dari Massa Sinsitium Otot
EJTFCVUTFCBHBJJOUFSWBM13TFCBCHFMPNCBOH2TFSJOHUJEBLBEB
Jantung yang Mengalami Depolarisasi Sebagian
*OUFSWBM 25 ,POUSBLTJ WFOUSJLFM CFSMBOHTVOH IBNQJS (BNCBSNFOVOKVLLBONBTTBTJOTJUJVNPUPUKBOUVOHZBOH
EBSJQFSNVMBBOHFMPNCBOH2 BUBVHFMPNCBOH3 KJLBHFMPNCBOH UFMBI UFSBOHTBOH QBEB UJUJL QVTBUOZB 4FCFMVN UFSBOHTBOH
2 UJEBL BEB
TBNQBJ BLIJS HFMPNCBOH 5 *OUFSWBM JOJ EJTFCVU TFNVB CBHJBO MVBS TFM PUPU JUV CFSNVBUBO QPTJUJG EBO CBHJBO
TFCBHBJ JOUFSWBM25EBOCJBTBOZBLJSBLJSB EFUJL1FOFOUVBO EBMBNCFSNVBUBOOFHBUJG0MFILBSFOBBMBTBOBMBTBOZBOHUFMBI
'SFLVFOTJ %FOZVU +BOUVOH EFOHBO &MFLUSPLBSEJPHSBN 'SFLVFOTJ EJKFMBTLBO EBMBN #BC TFXBLUV NFNCBIBT NFNCBIBT
EFOZVUKBOUVOHEBQBUEFOHBONVEBIEJUFOUVLBOEFOHBO QPUFOTJBMNFNCSBO CFHJUVTVBUVEBFSBITJOTJUJVNKBOUVOHUFS
123
Unit IlI Jantung
0 0 0

0

B
A

EFQPMBSJTBTJ NVBUBOOFHBUJGBLBOCPDPSLFMVBSEBSJTFSBCVUPUPU

ZBOH NFOHBMBNJ EFQPMBSJTBTJ TFIJOHHB EBFSBI QFSNVLBBO JOJ

NFOKBEJFMFLUSPOFHBUJG TFQFSUJZBOHEJUVOKVLLBOEBMBN(BNCBS
EFOHBOUBOEBOFHBUJG4JTBQFSNVLBBOKBOUVOHZBOHNBTJI
UFUBQ EBMBN LFBEBBO QPMBSJTBTJ EJUVOKVLLBO EFOHBO UBOEB
QPTJUJG 0MFI LBSFOB JUV CJMB BMBU QFOHVLVS ZBOH VKVOH
OFHBUJGOZBEJIVCVOHLBOLFEBFSBIZBOHNFOHBMBNJEFQPMBSJTBTJ
EBO VKVOH QPTJUJGOZB EJIVCVOHLBO LF EBFSBI ZBOH NBTJI
NFOHBMBNJQPMBSJTBTJ TFQFSUJZBOHEJUVOKVLLBOEJCBHJBOLBOBO
HBNCBSUFSTFCVU NBLBSFLBNBOZBOHEJEBQBUBLBOQPTJUJG
%BMBN (BNCBS KVHB EJHBNCBSLBO EVB UFNQBU ZBOH IBULBO PMFI BOBL QBOBI ZBOH NFMFOHLVOH EBMBN HBNCBS JOJ
EBQBU EJQBLBJ VOUVL NFOFNQBULBO FMFLUSPEB EBO QFNCBDBBO #JMB TFNVB HBSJT BMJSBO MJTUSJL EJSBUBSBUBLBO NFOVSVU
BMBU QFOHVLVS )BM JOJ IFOEBLOZB EJQFMBKBSJ TFDBSB UFMJUJ EBO QFSIJUVOHBO BMKBCBS KBMVS FMJQT
NBLB LJUB BLBO NFOKVNQBJ
QFNCBDBEJIBSBQLBOEBQBUNFOFSBOHLBOTFOEJSJQFOZFCBCEBSJ CBIXB BSVT MJTUSJL SBUBSBUB EFOHBO LFOFHBUJGBO NFOHBMJS LF CBTBM
BQB ZBOH UFSCBDB QBEB BMBU QFOHVLVS 0MFI LBSFOB QSPTFT KBOUVOHEBOBSVTMJTUSJLSBUBSBUBEFOHBOLFQPTJUJGBOBLBONFOHBMJS
EFQPMBSJTBTJNFOZFCBSLFTFHBMBBSBINFMBMVJKBOUVOH QFSCFEBBO LFCBHJBOBQFLT
QPUFOTJBM ZBOH UBNQBL EBMBN HBNCBS IBOZB NFOFUBQ TFMBNB 4FMBNB CFSMBOHTVOHOZB TFCBHJBO CFTBS TJTB QSPTFT EFQPMBSJTBTJ
TFQFSCFCFSBQB SJCV EFUJL EBO QFSIJUVOHBO WPMUBTF ZBOH BSVT KVHB UFUBQ NFOHBMJS NFOVSVU BSBI QFOZFCBSBO ZBOH TBNB
TFCFOBSOZB IBOZB EBQBU EJMBLVLBO EFOHBO BMBU QFSFLBN ZBOH TFNFOUBSB EFQPMBSJTBTJ NFOZFCBS EBSJ QFSNVLBBO FOEPLBSEJVN
CFSLFDFQBUBOUJOHHJ LFMVBS NFMBMVJ NBTTB PUPU WFOUSJLFM ,FNVEJBO TFTBBU TFCFMVN
Aliran Arus Listrik yang Mengelilingi Jantung pada Dada QSPTFTEFQPMBSJTBTJTFMFTBJNFMJOUBTJWFOUSJLFM TFMBNBLJSBLJSB
(BNCBS NFOVOKVLLBO PUPU WFOUSJLFM ZBOH UFSMFUBL EJ EFUJL SBUBSBUBBSBIBMJSBOBSVTMJTUSJLJOJBLBOUFSCBMJL ZBLOJBLBO
EBMBN EBEB #BILBO QBSV XBMBVQVO TFCBHJBO CFTBS UFSJTJ NFOHBMJSEBSJBQFLTWFOUSJLFMNFOVKVLFCBHJBOCBTBM TFCBCCBHJBO
EFOHBO VEBSB EBQBU NFOHIBOUBSLBO BSVT MJTUSJL ZBOH DVLVQ KBOUVOH ZBOH QBMJOH BLIJS UFSEFQPMBSJTBTJ BEBMBI EJOEJOH CBHJBO
CFTBS EBO DBJSBO ZBOH UFSEBQBU EBMBN KBSJOHBO MBJO EJ MVBSWFOUSJLFMZBOHEFLBUEFOHBOCBTBMKBOUVOH
TFLFMJMJOH KBOUVOH KVHB EBQBU NFOHIBOUBSLBO BMJSBO MJTUSJL %FOHBO EFNJLJBO QBEB WFOUSJLFM KBOUVOH ZBOH OPSNBM
EFOHBO NVEBI 0MFI LBSFOB JUV TFCFOBSOZB KBOUVOH UFSFOEBN TFMBNB IBNQJS TFMVSVI TJLMVT EFQPMBSJTBTJ BSVT NFOHBMJS EBSJ
EJ EBMBN NFEJB ZBOH LPOEVLUJG #JMB TBUV CBHJBO WFOUSJLFM OFHBUJG LF QPTJUJG UFSVUBNB EBSJ BSBI CBTBM KBOUVOH NFOVKV LF
NFOHBMBNJ EFQPMBSJTBTJ EBO PMFI LBSFOB JUV NFOKBEJ BQFLT LFDVBMJ QBEB CBHJBO QBMJOH BLIJS EBSJ QSPTFT EFQP
FMFLUSPOFHBUJG EJCBOEJOHLBO CBHJBO MBJOOZB BMJSBO MJTUSJL BLBO MBSJTBTJ #JMB BMBU QFOHVLVS EJIVCVOHLBO EFOHBO FMFLUSPEB EJ
NFOHBMJS EBSJ EBFSBI ZBOH UFSEFQPMBSJTBTJ NFOVKV LF EBFSBI QFSNVLBBO UVCVI TFQFSUJ ZBOH UFSEBQBU EBMBN (BNCBS
ZBOH UFSQPMBSJTBTJ NFMBMVJ KBMVS NFMJOHLBS ZBOH CFTBS TFQFSUJ FMFLUSPEBZBOHUFSMFUBLEFLBUEFOHBOCBHJBOCBTBMBLBONFOKBEJ
ZBOHEJMVLJTLBOEBMBNHBNCBSJOJ OFHBUJG TFEBOHLBO ZBOH EFLBU EFOHBO BQFLT BLBO NFOKBEJ
%BSJ QFNCJDBSBBO NFOHFOBJ TJTUFN 1VSLJOKF EBMBN #BC QPTJUJG EBO BMBU QFSFLBN BLBO NFNQFSMJIBULBO SFLBNBO ZBOH
EBQBU EJJOHBU LFNCBMJ CBIXB JNQVMT KBOUVOH NVMBNVMB BLBO QPTJUJGEBMBNFMFLUSPLBSEJPHSBN
TBNQBJ EJ CBHJBO TFQUVN WFOUSJLFM EBO TFMBOKVUOZB TFHFSB
Sadapan-Sadapan Elektrokardiografik
NFOZFCBS LF QFSNVLBBO EBMBN EBO TJTB WFOUSJLFM MBJOOZB
TFQFSUJ ZBOH EJHBNCBSLBO TFCBHBJ EBFSBI CFSBSTJS EBO EJCFSJ
UBOEB OFHBUJG EBMBN (BNCBS ,FBEBBO JOJ BLBO Ketiga Sadapan Anggota Badan Bipolar
NFOZFCBCLBOLFOFHBUJGBOEJCBHJBOEBMBNWFOUSJLFM TFEBOHLBO (BNCBS NFOHHBNCBSLBO IVCVOHBO MJTUSJL BOUBSB BOHHPUB
EJ CBHJBO MVBS EJOEJOH WFOUSJLFM BLBO NFOHBMBNJ LFQPTJUJGBO CBEBO EFOHBO BMBU FMFLUSPLBSEJPHSBG ZBOH EJQBLBJ VOUVL NFSFLBN
EFOHBOBSVTMJTUSJLBLBONFOHBMJSNFMFXBUJDBJSBOZBOHUFSEBQBU FMFLUSPLBSEJPHSBN ZBOH EJTFCVU TFCBHBJ TBEBQBO BOHHPUB CBEBO
EJTFLFMJMJOHWFOUSJLFMNFOVSVUKBMVSFMJQT TFQFSUJZBOHEJQFSMJ CJQPMBSTUBOEBSMTUJMBICJQPMBSCFSBSUJCBIXBFMFLUSPLBSEJPHSBN
124
Bab 11 Elektrokardiogram Norrnal
4BEBQBO *** 6OUVL NFSFLBN TBEBQBO BOHHPUB CBEBO ***

VKVOHOFHBUJGFMFLUSPLBSEJPHSBGEJIVCVOHLBOLFMFOHBOLJSJEBO
0 VKVOH QPTJUJGOZB EJIVCVOHLBO QBEB UVOHLBJ LJSJ *OJ CFSBSUJ
CBIXB SFLBNBO FMFLUSPLBSEJPHSBG BLBO NFOKBEJ QPTJUJG CJMB
MFOHBOLJSJCFSTJGBUOFHBUJGEJCBOEJOHEFOHBOUVOHLBJLJSJOZB
UNIT III
4FHJUJHB &JOUIPWFO %BMBN (BNCBS UBNQBL TFCVBI
TFHJUJHB ZBOH EJTFCVU TFCBHBJ TFHJUJHB &JOUIPWFO ZBOH
EJHBNCBSLBO NFOHFMJMJOHJ EBFSBI KBOUVOH 4FHJUJHB JOJ
NFOHJMVTUSBTJLBO CBIXB LFEVB MFOHBO EBO UVOHLBJ LJSJ
NFNCFOUVL QVODBL EBSJ TFCVBI TFHJUJHB ZBOH NFOHFMJMJOHJ
KBOUVOH,FEVBQVODBLEJCBHJBOBUBTTFHJUJHBJUVNFOVOKVLLBO
UJUJLUJUJL UFNQBU LFEVB MFOHBO CFSIVCVOHBO TFDBSB MJTUSJL
EFOHBO DBJSBO ZBOH UFSEBQBU EJ TFLFMJMJOH KBOUVOH EBO QVODBL
CBXBINFSVQBLBOUJUJLUFNQBUUVOHLBJLJSJCFSIVCVOHBOEFOHBO
DBJSBO
)VLVN &JOUIPWFO )VLVN &JOUIPWFO NFOZBUBLBO CBIXB
CJMB CFTBS QPUFOTJBM MJTUSJL EBQBU EJLFUBIVJ TFUJBQ TBBU QBEB EVB
EBSJ UJHB TBEBQBO BOHHPUB CBEBO CJQPMBS CFTBS QPUFOTJBM QBEB
TBEBQBOLFUJHBEBQBUEJUFOUVLBOTFDBSBNBUFNBUJLIBOZBEFOHBO
NFOKVNMBILBOCFTBSLFEVBQPUFOTJBMQFSUBNB/BNVO TFXBLUV
NFOKVNMBILBOIFOEBLOZBCFOBSCFOBSEJQFSIBUJLBOMFUBLUBOEB
0 .7 mV QPTJUJGEBOUBOEBOFHBUJGQBEBCFSCBHBJTBEBQBOZBOHCFSCFEB
4FCBHBJDPOUPI NBSJMBILJUBNFOHBOHHBQVOUVLTFNFOUBSB
0 0

TFQFSUJ ZBOH EJUVMJTLBO EBMBN (BNCBS CBIXB MFOHBO

LBOBO o NJMJWPMU OFHBUJG
EJCBOEJOHLBO EFOHBO QPUFOTJBM

SBUBSBUB EBMBN UVCVI MFOHBO LJSJ NJMJWPMU QPTJUJG
EBO
UVOHLBJ LJSJ NJMJWPMU QPTJUJG
#JMB LJUB QFSIBUJLBO BMBU
QFOHVLVS ZBOH UFSUFSB EBMBN HBNCBS UFSTFCVU UBNQBL CBIXB
TBEBQBO*BLBONFSFLBNQPUFOTJBMQPTJUJGTFCFTBS NJMJWPMU
TFCBC OJMBJ JOJ NFSVQBLBO TFMJTJI BOUBSB o NJMJWPMU ZBOH
UFSEBQBU QBEB MFOHBO LBOBO EBO NJMJWPMU ZBOH UFSEBQBU
QBEB MFOHBO LJSJ %FNJLJBO QVMB TBEBQBO *** NFSFLBN
QPUFOTJBMQPTJUJGTFCFTBS NJMJWPMU EBOTBEBQBO**NFSFLBN
QPUFOTJBM QPTJUJG TFCFTBS NJMJWPMU TFCBC OJMBJOJMBJ JOJ
ZBOH EJTFCVU TFCBHBJ TBEBQBO BOHHPUB CBEBO CJQPMBS TUBOEBS NFSVQBLBO TFMJTJI QPUFOTJBM ZBOH TFHFSB UFSKBEJ EJ BOUBSB
MTUJMBI CJQPMBS CFSBSUJ CBIXB FMFLUSPLBSEJPHSBN ZBOH EJSFLBN QBTBOHBOBOHHPUBCBEBOZBOHTFTVBJ
4FLBSBOH QFSIBUJLBO CBIXB KVNMBI WPMUBTF QBEB TBEBQBO *
JUV CFSBTBM EBSJ EVB FMFLUSPEB ZBOH UFSMFUBL QBEB CBHJBO KBOUVOH
EBOTBEBQBO***TFTVBJEFOHBOWPMUBTFQBEBTBEBQBO**ZBLOJ
ZBOH CFSCFEB EBMBN IBM JOJ QBEB BOHHPUB CBEBO +BEJ TFCVBI
EJUBNCBI TFTVBJ EFOHBO 4FDBSB NBUFNBUJL BTBT JOJ
TBEBQBO CVLBO NFSVQBLBO TFCVBI LBCFM UVOHHBM ZBOH
EJTFCVU TFCBHBJ IVLVN &JOUIPWFO EBO UFSOZBUB IVLVN JOJ
EJIVCVOHLBO EBSJ UVCVI UFUBQJ NFSVQBLBO HBCVOHBO EBSJ EVB
CFSMBLV QBEB TFUJBQ TBBU QFSFLBNBO FMFLUSPLBSEJPHSBN ZBOH
LBCFM EBO FMFLUSPEBOZB VOUVL NFNCFOUVL TFCVBI TJSLVJU ZBOH
NFOHHVOBLBOLFUJHBCJQPMBSTUBOEBSh
NFOZFMVSVI BOUBSB UVCVI EBO FMFLUSPLBSEJPHSBG 1BEB NBTJOH
NBTJOH DPOUPI EJ CBXBI JOJ FMFLUSPLBSEJPHSBG EJHBNCBSLBO
Gambaran Elektrokardiogram Normal yang Direkam dari
TFCBHBJ BMBU QFOHVLVS MJTUSJL EBMBN CFOUVL EJBHSBN XBMBVQVO Ketiga Sadapan Anggota Badan Bipolar Standar. (BNCBS
TFCFOBSOZB FMFLUSPLBSEJPHSBG NFSVQBLBO BMBU QFSFLBN NFNQFSMJIBULBOSFLBNBOFMFLUSPLBSEJPHSBNQBEBTBEBQBO
CFSLFDFQBUBOUJOHHJEFOHBOLFSUBTZBOHCFSKBMBO * ** EBO *** +FMBT CBIXB HBNCBSBO FMFLUSPLBSEJPHSBN QBEB
LFUJHB TBEBQBO TFSVQB TBUV TBNB MBJOOZB TFCBC TFNVB TBEBQBO
4BEBQBO * 4FXBLUV NFSFLBN TBEBQBO BOHHPUB CBEBO VKVOH UFSTFCVU NFSFLBN HFMPNCBOH 1 ZBOH QPTJUJG EBO HFMPNCBOH 5
OFHBUJG FMFLUSPLBSEJPHSBG EJIVCVOHLBO LF MFOHBO LBOBO EBO ZBOHQPTJUJG EBOCBHJBOVUBNBEBSJLPNQMFLT234KVHBEJSFLBN
VKVOHQPTJUJGOZBQBEBMFOHBOLJSJ0MFILBSFOBJUV LBMBVUJUJLZBOH QPTJUJGEBMBNTFUJBQFMFLUSPLBSEJPHSBN
NFOHIVCVOHLBO MFOHBO LBOBO EFOHBO EBEB CFSTJGBU 1BEB BOBMJTJT LFUJHB FMFLUSPLBSEJPHSBN EFOHBO DBSB
FMFLUSPOFHBUJG EJCBOEJOH EFOHBO UJUJL ZBOH NFOHIVCVOHLBO QFOHVLVSBO ZBOH UFMJUJ EBO QFOHBNBUBO QPMBSJUBT ZBOH DFSNBU
MFOHBO LJSJ NBLB SFLBNBO FMFLUSPLBSEJPHSBGOZB BLBO NFOKBEJ EBQBU EJUVOKVLLBO CBIXB QBEB TFUJBQ TBBU KVNMBI QPUFOTJBM
QPTJUJG ZBLOJ EJ BUBT HBSJT WPMUBTF OPM QBEB FMFLUSPLBSEJPHSBN EBMBN TBEBQBO * EBO *** TFTVBJ EFOHBO CFTBS QPUFOTJBM EBMBN
+JLBUFSKBEJTFCBMJLOZB SFLBNBOFMFLUSPLBSEJPHSBGOZBBLBOCFSBEB TBEBQBO ** TFIJOHHB NFOHHBNCBSLBO LFBCTBIBO EBSJ IVLVN
EJCBXBIHBSJTUFSTFCVU &JOUIPWFOUFSTFCVU
4BEBQBO ** 6OUVL NFSFLBN TBEBQBO BOHHPUB CBEBO VKVOH 0MFILBSFOBIBTJMSFLBNBOZBOHEJEBQBUEBSJTFNVBTBEBQBO
OFHBUJG FMFLUSPLBSEJPHSBG EJIVCVOHLBO LF MFOHBO LBOBO EBO BOHHPUB CBEBO CJQPMBS TBNB TBUV EFOHBO ZBOH MBJOOZB UJEBL
VKVOH QPTJUJGOZB QBEB UVOHLBJ LJSJ 0MFI LBSFOB JUV CJMB MFOHBO CFHJUVNFOKBEJNBTBMBITBEBQBOZBOHNBOBZBOHBLBOEJSFLBN
LBOBO CFSTJGBU OFHBUJG EJCBOEJOH EFOHBO UVOHLBJ LJSJ NBLB CJMBLJUBJOHJONFOEJBHOPTJTCFSNBDBNNBDBNBSJUNJBKBOUVOH
SFLBNBOFMFLUSPLBSEJPHSBGOZBBLBOQPTJUJG TFCBCEJBHOPTJTBSJUNJBKBOUVOHUFSVUBNBCFSHBOUVOHQBEB
125
Unit III Jantung
12
II 3 456
RA LA
III
0
XBLUVEJBOUBSBHFMPNCBOHZBOHCFSCFEBEBMBNTJLMVTKBOUVOH
5FUBQJ CJMB LJUB JOHJO NFOEJBHOPTJT LFSVTBLBO QBEB PUPU
WFOUSJLFMBUBVPUPUBUSJVNBUBVQBEBTJTUFNLPOEVLTJ1VSLJOKF
TBEBQBO ZBOH BLBO EJQBLBJ VOUVL NFSFLBN TBOHBU
NFOFOUVLBO TFCBC LFMBJOBO LPOUSBLTJ PUPU KBOUVOH BUBV
LPOEVLTJ JNQVMT KBOUVOH BLBO TBOHBU NFOHVCBI QPMB
FMFLUSPLBSEJPHSBN ZBOH UFSFLBN QBEB CFCFSBQB TBEBQBO
XBMBVQVO CJTB UJEBL NFNFOHBSVIJ TBEBQBO ZBOH MBJO
*OUFSQSFUBTJFMFLUSPLBSEJPHSBGJLQBEBLFEVBUJQFLPOEJTJCFSJLVU
JOJLBSEJPNJPQBUJEBOBSJUNJBKBOUVOHBLBOEJCJDBSBLBOTFDBSB
UFSQJTBIEBMBN#BCEBO
CBTBM KBOUVOH NFSVQBLBO BSBI LFOFHBUJGBO TFMBNB CFSMBOHTVOH
Sadapan Dada (Sadapan Prekordial) OZB TFCBHJBO CFTBS QSPTFT EFQPMBSJTBTJ WFOUSJLFM 4FCBMJLOZB
4FSJOH LBMJ HBNCBSBO FMFLUSPLBSEJPHSBN EJSFLBN EFOHBO DBSB
LPNQMFLT 234 EBMBN TBEBQBO 7 7 EBO 7 UFSVUBNB QPTJUJG
NFOFNQBULBOTFCVBIFMFLUSPEBQBEBQFSNVLBBOBOUFSJPSEBEB
TFCBC FMFLUSPEB EBEB EBMBN TBEBQBOTBEBQBO JOJ UFSMFUBL MFCJI
MBOHTVOH EJ BUBT KBOUVOH ZBLOJ QBEB TBMBI TBUV UJUJL ZBOH
EFLBU EFOHBO BQFLT KBOUVOH ZBOH NFSVQBLBO BSBI LFQPTJUJGBO
UBNQBL EBMBN (BNCBS &MFLUSPEB JOJ EJIVCVOHLBO
TFMBNBCFSMBOHTVOHOZBTFCBHJBOCFTBSQSPTFTEFQPMBSJTBTJ
EFOHBO VKVOH QPTJUJG QBEB FMFLUSPLBSEJPHSBG TFEBOHLBO
FMFLUSPEB OFHBUJG ZBOH EJTFCVU TFCBHBJ FMFLUSPEB JOEJGFSFO Sadapan Anggota Badan Unipolar yang Diperbesar
EJIVCVOHLBO NFMBMVJ UBIBOBO MJTUSJL ZBOH TBNB LF MFOHBO (Augmented)
LBOBO MFOHBOLJSJ EBOUVOHLBJLJSJ TFNVBOZBQBEBTBBUZBOH 4JTUFN TBEBQBO MBJO ZBOH QFNBLBJBOOZB TVEBI NFMVBTZBJUV
CFSTBNBBO TFQFSUJ ZBOH UBNQBL EBMBN HBNCBS UFSTFCVU TBEBQBO BOHHPUB CBEBO VOJQPMBS ZBOH EJQFSCFTBS
#JBTBOZB EBSJ EJOEJOH BOUFSJPS EBEB EBQBU EJSFLBN FOBN BVHNFOUFE VOJQPMBS MJNC MFBE
1BEB UJQF QFSFLBNBO JOJ
NBDBNTBEBQBOEBEBTUBOEBS TBUVQFSTBUV LFFOBNFMFLUSPEB LFEVB BOHHPUB CBEBO EJIVCVOHLBO NFMBMVJ UBIBOBO MJTUSJL
EBEBEJMFUBLLBOTFDBSBCFSVSVUBOQBEBFOBNUJUJLTFQFSUJEBMBN EFOHBOVKVOHOFHBUJGBMBU FMFLUSPLBSEJPHSBG TFEBOHLBOBOHHPUB
EJBHSBN .BDBNNBDBN SFLBNBO UFSTFCVU EJLFOBM TFCBHBJ CBEBO ZBOH LFUJHB EJIVCVOHLBO EFOHBO VKVOH QPTJUJG #JMB
TBEBQBO7 7 7 7 7EBO7 VKVOHQPTJUJGUFSMFUBLQBEBMFOHBO LBOBO NBLB TBEBQBOEJLFOBM
(BNCBS NFOHHBNCBSLBO FMFLUSPLBSEJPHSBN KBOUVOH TFCBHBJ TBEBQBO B73 CJMB QBEB MFOHBO LJSJ NBLB EJTFCVU
TFIBUZBOHEJSFLBNEFOHBOLFFOBNTBEBQBOEBEBTUBOEBSJOJ TFCBHBJ TBEBQBO B7- EBO CJMBQBEBUVOHLBJLJSJ NBLBEJTFCVU
0MFILBSFOBQFSNVLBBOKBOUVOHUFSMFUBLEFLBUEFOHBOEJOEJOH TFCBHBJTBEBQBOB7'
EBEB NBLB UJBQUJBQ TBEBQBO EBEB UFSVUBNB NFSFLBN
QPUFOTJBM MJTUSJL EBSJ PUPUPUPU KBOUVOH ZBOH UFQBU CFSBEB EJ
CBXBI FMFLUSPEB 0MFI LBSFOB JUV LFMBJOBOLFMBJOBO WFOUSJLFM
ZBOH SFMBUJG LFDJM UFSVUBNB TFLBMJ ZBOH BEB EJ EBMBN EJOEJOH
WFOUSJLFM BOUFSJPS EBQBU NFOZFCBCLBO QFSVCBIBOQFSVCBIBO
ZBOH OZBUB QBEB SFLBNBO FMFLUSPLBSEJPHSBN ZBOH EJSFLBN
EBSJNBTJOHNBTJOHTBEBQBOEBEBJOJ
1BEB TBEBQBO EBO 7 SFLBNBO 234 EBSJ KBOUVOH OPSNBM
UFSVUBNB OFHBUJG TFCBC TFQFSUJ ZBOH EJUVOKVLLBO EBMBN V1 V2 V3 V4 V5 V6
(BNCBS FMFLUSPEB EBEB QBEB TBEBQBOTBEBQBO JOJ
UFSMFUBLMFCJIEFLBUEFOHBOCBTBMKBOUVOHEBSJQBEBBQFLT EBO s.
126
Bab 11 Elektrokardiogram Norrnal
3FLBNBO ZBOH OPSNBM EBSJ TBEBQBO BOHHPUB CBEBO

VOJQPMBS ZBOH EJQFSCFTBS JUV EJUVOKVLLBO EBMBN (BNCBS
3FLBNBO JOJ TFSVQB EFOHBO SFLBNBO ZBOH EJEBQBU
EBSJ TBEBQBO BOHHPUB CBEBO ZBOH TUBOEBS LFDVBMJ CBIXB
UNIT III
SFLBNBO ZBOH CFSBTBM EBSJ TBEBQBO B73 UBNQBL UFSCBMJL
.FOHBQB UFSKBEJ JOWFSTJ TFQFSUJ JOJ 1FMBKBSJ UFOUBOH
IVCVOHBO QPMBSJUBT EFOHBO FMFLUSPLBSEJPHSBG VOUVL
aVR aVL aVF
NFOHFUBIVJIBMJOJ
Daftar Pustaka
Lihat daftar pustaka pada Bab 13.
127
BAB 12
1FOBGTJSBO&MFLUSPLBSEJPHSBGJ,FMBJOBO
UNIT III
0UPU+BOUVOHEBO,FMBJOBO"MJSBO
%BSBI,PSPOFS4VBUV"OBMJTJT7FLUPS
%BSJ QFNCBIBTBO QBEB #BC VOUVL QPUFOTJBM ZBOH EJCBOHLJULBO JOJ EJTFCVU TFCBHBJ WFLUPS
UFOUBOH QFOHIBOUBSBO JNQVMT EJ SBUBSBUBTFTBBU EJHBNCBSLBOEFOHBOBOBLQBOBIIJUBNQBOKBOH
KBOUVOH TVEBIKFMBTCBIXBTFUJBQ ZBOH EJUBSJL NFMBMVJ UFOHBIUFOHBI WFOUSJLFM EFOHBO BSBI EBSJ
QFSVCBIBO EBMBN QPMB QFOHIBO CBTJT NFOVKV BQFLT KBOUVOH -FCJI MBOKVU LBSFOB QFOKVNMBIBO
UBSBO JOJ EBQBU NFOJNCVMLBO BSVTJOJTBOHBUCFTBS QPUFOTJBMMJTUSJLKVHBCFTBS EBOWFLUPSOZB
QPUFOTJBM MJTUSJL ZBOH BCOPSNBM QBOKBOH
EJTFLFMJMJOHKBOUVOHEBO Arah Vektor Dinyatakan dalam Derajat
BLJCBUOZB EBQBU NFOHVCBI CFOUVL HFMPNCBOH FMFLUSP
LBSEJPHSBN %FOHBO BMBTBO JOJMBI TFCBHJBO CFTBS LFMBJOBO PUPU #JMBTFCVBIWFLUPSUFSMFUBLIPSJ[POUBMEBONFOHBSBILFTJTJLJSJ
KBOUVOH ZBOH TFSJVT EBQBU EJEJBHOPTJT EFOHBO NFOHBOBMJTJT PSBOH UFSTFCVU WFLUPS JUV EJLBUBLBO NFOVOKVL LF BSBI
LPOUVSHFMPNCBOHQBEBCFSCBHBJTBEBQBOFMFLUSPLBSEJPHSBGJ EFSBKBU TFQFSUJZBOHEJHBNCBSLBOQBEB(BNCBS%BSJUJUJL
OPM JOJ TLBMB WFLUPS CFSQVUBS TFBSBI KBSVN KBN CJMB WFLUPS
CFSBTBMEBSJBUBTMVSVTLFCBXBI WFLUPSUFSTFCVUNFOVOKVLLF
Prinsip-Prinsip Analisis Vektor pada
BSBI EFSBKBU CJMB WFLUPS JUV CFSKBMBO EBSJ TJTJ LJSJ LF TJTJ
Etektrokardiogram
LBOBO TVCKFL WFLUPS UFSTFCVU NFNQVOZBJ BSBI EFSBKBU
EBO CJMB WFLUPS CFSHFSBL LF BUBT WFLUPS UFSTFCVU NFNQVOZBJ
Penggunaan Vektor untuk Menggambarkan Potensial Listrik BSBI BUBV
EFSBKBU
6OUVL NFNBIBNJ CBHBJNBOB LFMBJOBO KBOUVOH NFNFOHBSVIJ
LPOUVSHFMPNCBOHFMFLUSPLBSEJPHSBN UFSMFCJIEBIVMVLJUBIBSVT 1BEB KBOUVOH ZBOH OPSNBM BSBI WFLUPS SBUBSBUB TFMBNB
NFOHFOBM EFOHBO CBJL QFOHFSUJBO UFOUBOH WFLUPS EBO BOBMJTJT QFOZFCBSBO HFMPNCBOH EFQPMBSJTBTJ NFMBMVJ WFOUSJLFM ZBOH
WFLUPS ZBOH CFSMBLV CBHJ QPUFOTJBM MJTUSJL EJ EBMBN EBO EJ EJTFCVU WFLUPS 234 SBUBSBUB CFTBSOZB LJSBLJSB EFSBKBU
TFLFMJMJOHKBOUVOH 7FLUPS JOJ EJUVOKVLLBO PMFI HBSJT WFLUPS " ZBOH NFMBMVJ UJUJL
%J EBMBN #BC TFCFOBSOZB CFCFSBQB LBMJ UFMBI EJUFLBOLBO QVTBU EFOHBO BSBI EFSBKBU QBEB (BNCBS "SUJOZB
CBIXBBSVTMJTUSJLKBOUVOHNFOKBMBSEFOHBOBSBIUFSUFOUVEJEBMBN QBEB TFCBHJBO CFTBS HFMPNCBOH EFQPMBSJTBTJ CBHJBO BQFLT
KBOUVOH EBMBN XBLUV TFLFKBQ QBEB TFUJBQ TJLMVT KBOUVOH 4FCVBI KBOUVOH UFUBQ QPTJUJG EJCBOEJOHLBO EFOHBO CBHBJO CBTJT
WFLUPS BEBMBI BOBL QBOBI ZBOH NFOVOKVLLBO BSBI QPUFOTJBM KBOUVOH TFQFSUJZBOHBLBOEJCJDBSBLBOLFNVEJBOEBMBNCBCJOJ
MJTUSJLZBOHEJCBOHLJULBOPMFIBSVTMJTUSJLUFSTFCVU EFOHBOLFQBMB
QBOBI NFOVOKVLLBO BSBI QPTJUJG +VHB TFTVBJ LFTFQBLBUBO
QBOKBOH QBOBI EJHBNCBSLBO TFUBSB EFOHBO UFHBOHBO QPUFOTJBM

MJTUSJLUFSTFCVU

Vektor "Resultan" di Jantung pada Sembarang Waktu

(BNCBSNFNQFSMJIBULBOEFQPMBSJTBTJTFQUVNWFOUSJLFMEBO

CBHJBOCBHJBO EJOEJOH FOEPLBSEJVN EJ BQFLT LFEVB WFOUSJLFM

EJQFSMJIBULBO NFMBMVJ CJEBOH CFSCBZBOH BCVBCV EBO UBOEB

OFHBUJG 1BEB FLTJUBTJ KBOUVOH TFTBBU JOJ BSVT MJTUSJL NFOHBMJS EJ

BOUBSB EBFSBI UFSEFQPMBSJTBTJ EJ EBMBN KBOUVOH EBO EBFSBI UBL

UFSEFQPMBSJTBTJ EJ MVBS KBOUVOH ZBOH EJUVOKVLLBO EFOHBO QBOBI

QBOKBOH CFSCFOUVL FMJQT 4FEJLJU BSVT MJTUSJL KVHB NFOHBMJS EJ
EBMBN SPOHHBSPOHHB KBOUVOH MBOHTVOH EBSJ EBFSBI
UFSEFQPMBSJTBTJNFOVKVLFEBFSBIZBOHNBTJIUFSQPMBSJTBTJ4FDBSB
LFTFMVSVIBO BSVT MJTUSJL ZBOH NFOHBMJS LF CBXBI EBSJ CBTJT
WFOUSJLFM NFOVKV LF BQFLT KBVI MFCJI CBOZBL EBSJQBEB ZBOH
NFOHBMJSLFBSBIBUBT0MFILBSFOBJUV QFOKVNMBIBOWFLUPSTFTBBU
129
Unit lll Jantung
90 TVNCVVOUVLTFNVBTBEBQBOJOJEJQFSMJIBULBOQBEB(BNCBS
270
ZBOH EJLFOBM TFCBHBJ TJTUFN SVKVLBO IFLTBHPOBM 1PMBSJUBT
FMFLUSPEBEJUVOKVLLBOEFOHBOUBOEBQMVTEBONJOVTQBEBHBNCBS
UFSTFCVU 1FNCBDB IBSVT NFNQFMBKBSJ TVNCVTVNCV JOJ EBO
QPMBSJUBTOZB UFSVUBNB UFOUBOH TBEBQBO BOHHPUB CBEBO CJQPMBS *
100 M* EBO TVQBZB EBQBU NFOHFSUJ BQB ZBOH BLBO EJUFSBOHLBO
TFMBOKVUOZBEBMBNCBCJOJ
180 0
A
+BEJ TBNQBJ TFLBSBOH LJUB UFMBI NFNCJDBSBLBO QFSUBNB
LFUFOUVBOLFUFOUVBO ZBOH EJQBLBJ VOUVL NFOVOKVLLBO
120 59 CFSCBHBJ QPUFOTJBM QBEB KBOUVOH EFOHBO CBOUVBO WFLUPS EBO
LFEVB TVNCVTVNCV TBEBQBO %FOHBO EFNJLJBO LJUB EBQBU
NFOHHVOBLBO LFEVBOZB VOUVL NFOFOUVLBO QPUFOTJBM TFTBBU ZBOH
90 BLBOUFSFLBNQBEBFMFLUSPLBSEJPHSBNTFUJBQTBEBQBOVOUVLTVBUV
WFLUPSUFSUFOUVEJEBMBNKBOUVOH TFCBHBJCFSJLVU
(BNCBS NFOHHBNCBSLBO KBOUVOH ZBOH UFSEFQPMBSJTBTJ
TFCBHJBOWFLUPS"NFXBLJMJBSBISBUBSBUBBSVTMJTUSJLTFLFUJLBEJ
EBMBN WFOUSJLFM %BMBJO DPOUPI JOJ BSBI WFLUPSOZB BEBMBI
EFSBKBU EBO UFHBOHBO QPUFOTJBMOZB ZBOH EJXBLJMJ PMFI QBOKBOH
%BMBN#BC UFMBIEJKFMBTLBOLFUJHBTBEBQBOCJQPMBSTUBOEBS WFLUPS" BEBMBINW1BEBEJBHSBNEJCBXBIKBOUVOH WFLUPS"
EBO UJHB TBEBQBO BOHHPUB CBEBO VOJQPMBS 4FUJBQ TBEBQBO JOJ EJQFSMJIBULBOMBHJ EBOTFCVBIHBSJTEJUBSJLVOUVLNFOHHBNCBSLBO
TFCFOBSOZB CFSVQB TFQBTBOH FMFLUSPEB ZBOH EJIVCVOHLBO LF TVNCVTBEBQBO*EFOHBOBSBIEFSBKBU6OUVLNFOFOUVLBOTFCF
CBEBOQBEBUFNQBUZBOHCFSTFCFSBOHBOUFSIBEBQKBOUVOH EBO SBQB CFTBS UFHBOHBO EJ EBMBN WFLUPS " ZBOH BLBO UFSFLBN QBEB
BSBI EBSJ FMFLUSPEB OFHBUJG LF FMFLUSPEB QPTJUJG JUV EJTFCVU TBEBQBO EJUBSJL TFCVBI HBSJT ZBOH UFHBL MVSVT UFSIBEBQ TVNCV
TVNCV TBEBQBO 4BEBQBO * EJSFLBN EBSJ EVB FMFLUSPEB ZBOH TBEBQBO * EBSJ VKVOH WFLUPS " NFOVKV TVNCV TBEBQBO * EBO
NBTJOHNBTJOH EJMFUBLLBO QBEB MFOHBO LJSJ EBO LBOBO 0MFI TFCVBI WFLUPS ZBOH EJTFCVU WFLUPS QSPZFLTJ #
EJHBNCBS EJ
LBSFOB LFEVB FMFLUSPEB JOJ UFSMFUBL UFQBU IPSJ[POUBM EBO TFQBOKBOH TVNCV TBEBQBO * UFSTFCVU ,FQBMB WFLUPS QSPZFLTJ JOJ
FMFLUSPEB QPTJUJG UFSMFUBL EJ TFCFMBI LJSJ TVNCV TBEBQBO * JUV NFOVOKVLLFBSBIQPTJUJGQBEBTVNCVTBEBQBO*CFSBSUJ SFLBNBO
BEBMBIEFSBKBU ZBOH UFSFLBN TFLFUJLB QBEB FMFLUSPLBSEJPHSBN TBEBQBO * BEBMBI
1BEBQFSFLBNBOTBEBQBO** FMFLUSPEBEJQBTBOHQBEBMFOHBO QPTJUJG 5FHBOHBO TFLFUJLB ZBOH UFSFLBN BLBO TBNB EFOHBO
LBOBO EBO UVOHLBJ LJSJ -FOHBO LBOBO CFSIVCVOHBO EFOHBO QBOKBOH WFLUPS # EJCBHJ QBOKBOH WFLUPS " EJLBMJLBO NJMJWPMU
CBUBOH UVCVI QBEB TVEVU LBOBO BUBT EBO UVOHLBJ LJSJ BUBVLJSBLJSBNJMJWPMU
CFSIVCVOHBO EFOHBO CBEBO QBEB TVEVU LJSJ CBXBI 0MFI (BNCBSNFOVOKVLLBODPOUPIMBJOUFOUBOHBOBMJTJTWFLUPS
LBSFOBJUV BSBITBEBQBOJOJLJSBLJSBEFSBKBU 1BEB DPOUPI JOJ WFLUPS " NFOHHBNCBSLBO QPUFOTJBM MJTUSJL EBO
%FOHBOBOBMJTJTZBOHTFSVQB EBQBUEJMJIBUCBIXBTBEBQBO*** TVNCVOZB QBEB TVBUV TBBU UFSUFOUV TFMBNB EFQPMBSJTBTJ WFOUSJLFM
NFNQVOZBJTVNCVLJSBLJSBEFSBKBUTBEBQBOB73 QBEB TFCVBI KBOUVOH ZBOH TJTJ LJSJOZB MFCJI DFQBU UFSEFQPMBSJTBTJ
EFSBKBUB7' EFSBKBUEBOB7- EFSBKBU"SBI EBSJQBEB TJTJ LBOBOOZB %BMBN DPOUPI JOJ WFLUPS TFLFUJLBOZB
NFNQVOZBJ BSBI EFSBKBU EBO UFHBOHBOOZB KVHB NJMJWPMU
–
–
6OUVL NFOFOUVLBO QPUFOTJBM ZBOH TFCFOBSOZB UFSFLBN QBEB
– aVF
III TBEBQBO* LJUBUBSJLTFCVBIHBSJTUFHBLMVSVTEBSJVKVOHWFLUPS"
LFTVNCVTBEBQBO*EBOEJQFSPMFIWFLUPSQSPZFLTJ#
+ aVR aVL +
210
30
A
I 0 I
– +
aVL aVR I B I
– +
– 60 –
III 120 90 II
A
+ +
+
130
Bab 12 Penafsiran Elektrokardiografi Ketainan Otot Jantung dan Kelainan Aliran Darah Koroner: Suatu Analisis Vektor
TBNBEFOHBOCFTBSQPUFOTJBMQBEBKBOUVOHEBOQBEBTBEBQBO
*** WFLUPS%
CFTBSOZBLJSBLJSBTFQFSUJHBEBSJCFTBSQPUFOTJBM
QBEBKBOUVOH
"OBMJTJT ZBOH TBNB EBQBU KVHB EJQFSHVOBLBO VOUVL
UNIT III
NFOFOUVLBO CFTBSOZB QPUFOTJBM ZBOH EJSFLBN QBEB TBEBQBO
BOHHPUB CBEBO EJQFSLVBU BVHNFOUFE MJNC MFBET
LFDVBMJ
I B I CBIXBNBTJOHNBTJOHTVNCVTBEBQBOEJQFSLVBU MJIBU(BNCBS
– +

EJQFSHVOBLBO TFCBHBJ QFOHHBOUJ TVNCVTVNCV TBEBQBO
A
BOHHPUB CBEBO CJQPMBS TUBOEBS ZBOH EJQFSHVOBLBO VOUVL
(BNCBS
Analisis Vektor pada Gambaran Elekrokardiogram
Normal
Vektor-Vektor yang Terbentuk pada Interval- Interval yang
7FLUPS#JOJTBOHBUQFOEFLEBOLBMJJOJNFOVOKVLLFBSBIOFHBUJG Berurutan Selama Depolarisasi Ventrikel—Kompleks QRS
NFOVOKVLLBOCBIXBEJEBMBNDPOUPILIVTVTJOJQFSFLBNBOEBMBN
,FUJLB JNQVMT KBOUVOH NBTVL LF WFOUSJLFM NFMBMVJ CFSLBT
TBEBQBO * BLBO OFHBUJG EJ CBXBI HBSJT OPM QBEB
BUSJPWFOUSJLVMBS CBHJBO WFOUSJLFM ZBOH QFSUBNB UFSEFQP
FMFLUSPLBSEJPHSBN
EBO UFHBOHBO ZBOH UFSFLBN JUV LFDJM TBKB
MBSJTBTJBEBMBIQFSNVLBBOFOEPLBSEJVNTFQUVNTFCFMBILJSJ
TFLJUBS NJMJWPMU(BNCBSJOJNFNQFSMJIBULBOCBIXBCJMBWFLUPS
,FNVEJBO EFQPMBSJTBTJ JOJ EFOHBO DFQBU NFOZFCBS EBO
EJ KBOUVOH NFNQVOZBJ BSBI IBNQJS UFHBL MVSVT UFSIBEBQ TVNCV
NFOHFOBJLFEVBQFSNVLBBOFOEPLBSEJVNTFQUVN EJQFSMJIB
TBEBQBO UFHBOHBO ZBOH UFSFLBN QBEB FMFLUSPLBSEJPHSBN TBEBQBO
EJQFSMJIBU QFSMJIBULBO EFOHBO CBHJBO WFOUSJLFM ZBOH BHBL
JOJ NFOKBEJ TBOHBU SFOEBI 4FCBMJLOZB CJMB BSBI WFLUPS KBOUVOH
HFMBQ QBEB (BNCBS " 4FMBOKVUOZB EFQPMBSJTBTJ BLBO
IBNQJS TBNB EFOHBO TVNCV TBEBQBO IBNQJS TFMVSVI UFHBOHBO
NFOZFCBSEJTFQBOKBOHQFSNVLBBOFOEPLBSEJBMTJTBOZBQBEB
EBMBNWFLUPSJUVBLBOUFSFLBN
LFEVB WFOUSJLFM TFQFSUJ UBNQBL QBEB (BNCBS # EBO $
Analisis Vektor untuk Potensial-Potensial pada Tiga "LIJS OZB EFQPMBSJTBTJ BLBO NFOZFCBS NFMFXBUJ PUPU
Sadapan Anggota Badan Bipolar Standar 1BEB (BNCBS WFOUSJLFM NFOVKV LF CBHJBO MVBS KBOUVOH TFQFSUJ UBNQBL
WFLUPS " NFOHHBNCBSLBO QPUFOTJBM MJTUSJL TFLFUJLB QBEB KBOUVOH TFDBSBCFSVSVUBOEBMBN(BNCBS$ % EBO&
ZBOH UFSEFQPMBSJTBTJ TFCBHJBO 6OUVL NFOFUBQLBO CFTBSOZB
1BEB TFUJBQ UBIBQ EBMBN (BNCBS CBHJBO " TBNQBJ
QPUFOTJBM ZBOH UFSFLBN TFLFUJLB QBEB FMFLUSPLBSEJPHSBN EBSJ
& QPUFOTJBM MJTUSJL SBUBSBUB TFLFUJLB EJ WFOUSJLFM EJXBLJMJ
NBTJOHNBTJOH LFUJHB TBEBQBO BOHHPUB CBEBO CJQPMBS TUBOEBS
PMFITFCVBIWFLUPSCFSCFOUVLQBOBIZBOHEJMFUBLLBOEJBUBT
EJUBSJLHBSJTHBSJTUFHBLMVSVT HBSJTQVUVTQVUVT
EBSJVKVOHWFLUPS
TVQFSJNQPTFE
WFOUSJLFM QBEB TFUJBQ HBNCBS UFSTFCVU
" NFOVKV LF LFUJHB HBSJT ZBOH NFXBLJMJ TVNCV LFUJHB TBEBQBO
4FUJBQ WFLUPS JOJ LFNVEJBO EJBOBMJTJT EFOHBO NFUPEF ZBOH
TUBOEBS JUV TFQFSUJ ZBOH EJUVOKVLLBO QBEB HBNCBS 7FLUPS
UFMBI EJKFMBTLBO EJ BUBT VOUVL NFOFUBQLBO CFTBSOZB
QSPZFLTJ#NFOFOUVLBOCFTBSOZBQPUFOTJBMZBOHUFSFLBNQBEBTBBU
UFHBOHBOZBOHBLBOUFSFLBNTFUJBQTBBUQBEBLFUJHBTBEBQBO
JUV QBEB WFLUPS QSPZFLTJ $ NFOHHBNCBSLBO CFTBSOZB QPUFOTJBM
FMFLUSPLBSEJPHSBGJ TUBOEBS 1BEB TJTJ LBOBO NBTJOHNBTJOH
QBEBTBEBQBO** EBOWFLUPSQSPZFLTJ%NFOHHBNCBSLBOQPUFOTJBM
HBNCBS EJQFSMJIBULBO QFSLFNCBOHBO QFNCFOUVLBO
QBEB TBEBQBO *** 1BEB NBTJOHNBTJOH WFLUPS JOJ SFLBNBO QBEB
LPNQMFLT234QBEBFMFLUSPLBSEJPHSBGJ)BSVTEJJOHBUCBIXB
FMFLUSPLBSEJPHSBN BEBMBI QPTJUJG ZBLOJ EJ BUBT HBSJT OPM TFCBC
TFCVBI WFLUPS QPTJUJG QBEB TBUV TBEBQBO BLBO NFOHIBTJMLBO
WFLUPSWFLUPS QSPZFLTJ JUV NFOVOKVL LF BSBI QPTJUJG QBEB TVNCV
SFLBNBO FMFLUSPLBSEJPHSBN EJ BUBT HBSJT OPM TFEBOHLBO
TFNVBTBEBQBOUFSTFCVU#FTBSOZBQPUFOTJBMQBEBTBEBQBO* WFLUPS
WFLUPS OFHBUJG BLBO NFOHIBTJMLBO SFLBNBO EJ CBXBI HBSJT
#
LJSBLJSB TFUFOHBI EBSJ QPUFOTJBM ZBOH TFCFOBSOZB NFMFXBUJ
OPM
KBOUVOH WFLUPS"
QBEBTBEBQBO** WFLUPS$
CFTBSOZBIBNQJS
4FCFMVN CFSMBOKVU QBEB QFOKFMBTBO MFCJI EBMBN UFOUBOH
– –
BOBMJTJT WFLUPS LJSBOZB QFOUJOH EJQBIBNJ MFCJI EBIVMV
II III BOBMJTJT WFLUPSWFLUPS OPSNBM CFSVSVUBO ZBOH EJTBKJLBO
EBMBN(BNCBSJOJ.BTJOHNBTJOHBOBMJTJTJOJIFOEBL
LOZB EJQFMBKBSJ TFDBSB MFCJI EFUBJM CFSEBTBSLBO DBSBDBSB
ZBOH EJCBIBT EJ TJOJ 3JOHLBTBO TJOHLBU NFOHFOBJ VSVU
VSVUBOUFSTFCVUBEBMBITFCBHBJCFSJLVU
I B I
– + 1BEB (BNCBS " PUPU WFOUSJLFM CBSV TBKB UFSEFQPMBSJTBTJ
D NFOHHBNCBSLBO TBBU LJSBLJSB EFUJL TFTVEBI NVMBJOZB
A
EFQPMBSJTBTJ 1BEB TBBU UFSTFCVU WFLUPSOZB QFOEFL TFCBC IBOZB
C TFCBHJBO LFDJM WFOUSJLFM ZBLOJ TFQUVN ZBOH UFSEFQPMBSJTBTJ 0MFI
LBSFOBJUV TFNVBUFHBOHBOFMFLSPLBSEJPHSBGJLOZBSFOEBI TFQFSUJ
II
ZBOH UFSFLBN VOUVL CBHJBO LBOBO PUPU WFOUSJLFM QBEB TFUJBQ
II
I+ TBEBQBO 5FHBOHBO QBEB TBEBQBO ** MFCJI CFTBS EBSJQBEB
+
UFHBOHBO EBMBN TBEBQBO * EBO *** LBSFOB WFLUPS KBOUVOH
UFSVUBNB CFSHFSBL EFOHBO BSBI ZBOH TBNB EFOHBO TVNCV
TBEBQBO**
131
Unit llI Jantung

II III II III
I I
I I I I

II II
III II III II

III III
A B

II III II III
I I
I I I I

II II
III II III II

III III
C D

II III I
I I

II
III II

III
E
1BEB (BNCBS # ZBOH NFXBLJMJ XBLUV LJSBLJSB TBNB OFHBUJG ZBLOJ EJ CBXBI HBSJT OPM TFNFOUBSB UFHBOHBO EJ
EFUJL TFTVEBI NVMBJOZB EFQPMBSJTBTJ WFLUPS KBOUVOH QBOKBOH TBEBQBO*UFUBQQPTJUJG
LBSFOB CBOZBL NBTTB WFOUSJLFM NFOHBMBNJ EFQPMBSJTBTJ 0MFI %BMBN (BNCBS & LJSBLJSB EFUJL TFTVEBI NVMBJOZB
LBSFOB JOJ UFHBOHBO QBEB TFNVB TBEBQBO FMFLUSPLBSEJPHSBGJL EFQPMBSJTBTJ TFMVSVI NBTTB PUPU WFOUSJLFM TVEBI UFSEFQPMBSJTBTJ
TVEBINFOJOHLBU TFIJOHHB UJEBL BEB BSVT MJTUSJL EJ TFLFMJMJOH KBOUVOH EBO UJEBL BEB
1BEB (BNCBS $ ZBOH UFSKBEJ LJSBLJSB EFUJL QPUFOTJBM MJTUSJL ZBOH EJCBOHLJULBO 7FLUPSOZB NFOKBEJ OPM EBO
TFTVEBINVMBJOZBEFQPMBSJTBTJ WFLUPSKBOUVOHNFNFOEFL EBO UFHBOHBOQBEBTFNVBTBEBQBONFOKBEJOPM
UFHBOHBO QBEB SFLBNBO &,( MFCJI SFOEBI LBSFOB CBHJBO MVBS %FOHBO EFNJLJBO MFOHLBQMBI LPNQMFLT 234 QBEB LFUJHB
BQFLT KBOUVOH TFLBSBOH NFOKBEJ FMFLUSPOFHBUJG TFIJOHHB TBEBQBOBOHHPUBCBEBOCJQPMBSTUBOEBS
NFOFUSBMLBOCBOZBLCBHJBOCFSNVBUBOQPTJUJGQBEBQFSNVLBBO
FQJLBSEJVNKBOUVOHMBJOOZB4VNCVWFLUPSKVHBNVMBJCFSHFTFS ,BEBOHLBEBOH QBEB CBHJBO BXBM LPNQMFLT 234 UFSEBQBU
LF TJTJ LJSJ EBEB LBSFOB WFOUSJLFM LJSJ TFEJLJU MFCJI MBNCBU TFEJLJU EFQSFTJ OFHBUJG QBEB TBUV BUBV CFCFSBQB TBEBQBO ZBOH
UFSEFQPMBSJTBTJ EBSJQBEB WFOUSJLFM LBOBO 0MFI LBSFOB JUV UJEBL UBNQBL EBMBN (BNCBS EFQSFTJ JOJ BEBMBI HFMPNCBOH
QFSCBOEJOHBOUFHBOHBOQBEBTBEBQBO*UFSIBEBQUFHBOHBOQBEB 2 #JMB UFSEBQBU HFMPNCBOH 2 QFOZFCBCOZB BEBMBI EFQPMBSJTBTJ
TBEBQBO***BLBONFOJOHLBU BXBM QBEB CBHJBO TJTJ LJSJ TFQUVN ZBOH NFOEBIVMVJ TJTJ LBOBO
TFIJOHHB NFOJNCVMLBO WFLUPS MFNBI EBSJ TJTJ LJSJ LF TJTJ LBOBO
1BEB (BNCBS % LJSBLJSB EFUJL TFTVEBI NVMBJOZB TFMBNB TFQFSTFLJBO EFUJL TFCFMVN NVODVM WFLUPS ZBOH CJBTB EBSJ
EFQPMBSJTBTJ WFLUPSKBOUVOHNFOVOKVLLFBSBICBTJTWFOUSJLFMLJSJ CBTJT LF BQFLT %FGMFLTJ QPTJUJG CFTBS ZBOH UBNQBL QBEB (BNCBS
EBO WFLUPS JOJ QFOEFL LBSFOB UJOHHBM TFEJLJU TBKB PUPU WFOUSJLFM BEBMBI HFMPNCBOH 3 EBO EFGMFLTJ OFHBUJG EJ CBHJBO BLIJS
ZBOH NBTJI QPTJUJG UFSQPMBSJTBTJ 0MFI LBSFOB BSBI WFLUPS QBEB BEBMBIHFMPNCBOH4
TBBUJOJ UFHBOHBOZBOHUFSFLBNEBMBNTBEBQBO**EBO***TBNB
132
Bab 12 Penafsiran Etektrokardiografi Kelainan Otot Jantung dan Ketainan Aliran Darah Koroner: Suatu Analisis Vektor
Elektrokardiogram Selama Repolarisasi— Gelombang T TFIJOHHBKVNMBILFTFMVSVIBOBMJSBOMJTUSJLZBOHNFOHBMJSNVMBJ

4FUFMBI PUPU WFOUSJLFM UFSEFQPMBSJTBTJ LJSBLJSB EFUJL NFOHFDJM 3BOHLBJBO QFSVCBIBO JOJ KVHB NFNQFSMJIBULBO
LFNVEJBO SFQPMBSJTBTJ EJNVMBJ EBO CFSMBOHTVOH TBNQBJ TFMFTBJ CBIXB WFLUPS UFSTFCVU QBMJOH CFTBS LFUJLB LJSBLJSB TFUFOHBI
LJSBLJSB EBMBN EFUJL 3FQPMBSJTBTJ JOJ NFOHIBTJMLBO CBHJBO KBOUVOH NFOHBMBNJ LFBEBBO QPMBSJTBTJ EBO LJSBLJSB
UNIT III
HFMPNCBOH5QBEBFMFLUSPLBSEJPHSBN TFUFOHBIOZBMBHJEBMBNLFBEBBOEFQPMBSJTBTJ
0MFI LBSFOB ZBOH QFSUBNB LBMJ UFSEFQPMBSJTBTJ BEBMBI TFQUVN 1FSVCBIBO QBEB HBNCBSBO FMFLUSPLBSEJPHSBN LFUJHB
EBO TJTJ FOEPLBSEJVN PUPU WFOUSJLFM UBNQBLOZB NBTVL BLBM TBEBQBO BOHHPUB CBEBO TUBOEBS TFMBNB QSPTFT SFQPMBSJTBTJ
CBIXB EBFSBI JOJ KVHB NFOHBMBNJ SFQPMBSJTBTJ UFSMFCJI EVMV CFSMBOHTVOH UFSMJIBU EJ CBXBI NBTJOHNBTJOH WFOUSJLFM
/BNVO CJBTBOZB ZBOH UFSKBEJ CVLBO EFNJLJBO LBSFOB TFQUVN NFMVLJTLBO SBOHLBJBO QSPHSFTJGJUBT TUBEJVN SFQPMBSJTBTJ
EBO EBFSBI FOEPLBSEJVN MBJOOZB NFNQVOZBJ QFSJPEF LPOUSBLTJ %FOHBO EFNJLJBO TFTVEBI LJSBLJSB EFUJL ZBJUV XBLUV
ZBOH MFCJI QBOKBOH EJCBOEJOHLBO TFCBHJBO CFTBS QFSNVLBBO ZBOH EJCVUVILBO VOUVL CFSMBOHTVOHOZB TFMVSVI QSPTFT
FLTUFSOBM KBOUVOH %FOHBO EFNJLJBO CBHJBO UFSCFTBS NBTTB PUPU SFQPMBSJTBTJ HFMPNCBOH5EBMBNFMFLUSPLBSEJPHSBNUFSCFOUVL
WFOUSJLFM ZBOH MFCJI EBIVMV UFSFQPMBSJTBTJ BEBMBI TFMVSVI Depolarisasi Atrium—Gelombang P
QFSNVLBBO MVBS WFOUSJLFM LIVTVTOZB EJ EFLBU BQFLT KBOUVOH %FQPMBSJTBTJ LFEVB BUSJVN NVMBJ EJ OPEVT TJOVT EBO NFOZFCBS
4FCBMJLOZB EBFSBI FOEPLBSEJVN CJBTBOZB UFSFQPMBSJTBTJ QBMJOH LF TFMVSVI QFOKVSV BUSJVN 0MFI LBSFOB JUV UJUJL FMFLUSPOFHBUJG
BLIJS 6SVUBO SFQPMBSJTBTJ JOJ EJQFSLJSBLBO EJTFCBCLBO PMFI BXBM EJ BUSJVN LJSBLJSB UFSMFUBL QBEB UFNQBU NBTVLOZB WFOB
UFLBOBO EBSBI ZBOH UJOHHJ EJ EBMBN WFOUSJLFM TFMBNB LPOUSBLTJ DBWB TVQFSJPS ZBOH NFSVQBLBO UFNQBU OPEVT TJOVT EBO BSBI
ZBOH TBOHBU NFOHVSBOHJ BMJSBO EBSBI LPSPOFS NFOVKV LF EFQPMBSJTBTJ BXBM EBQBU EJMJIBU TFCBHBJ WFLUPS IJUBN QBEB
FOEPLBSEJVN TFIJOHHB NFNQFSMBNCBU SFQPMBSJTBTJ EJ EBFSBI (BNCBS 4FMBOKVUOZB TFDBSB VNVN WFLUPS UFSTFCVU BLBO
FOEPLBSEJVN UFUBQ QBEB BSBI JOJ EJ TFQBOKBOH CFSMBOHTVOHOZB QSPTFT
0MFI LBSFOB QFSNVLBBO MVBS BQFLT WFOUSJLFM UFSFQPMBSJTBTJ EFQPMBSJTBTJ BUSJVN OPSNBM 0MFI LBSFOB BSBIOZB TBNB EFOHBO
TFCFMVN QFSNVLBBO EBMBN VKVOH QPTJUJG WFLUPS WFOUSJLFM TFDBSB BSBI QPTJUJG TVNCV LFUJHB TBEBQBO BOHHPUB CBEBO CJQPMBS
LFTFMVSVIBOTFMBNBSFQPMBSJTBTJNFOVKVLFBQFLTKBOUVOH4FCBHBJ TUBOEBS* ** EBO*** HBNCBSBOFMFLUSPLBSEJPHSBNZBOHUFSFLBN
BLJCBUOZB HFMPNCBOH 5 OPSNBM QBEB LFUJHB TBEBQBO BOHHPUB EBSJBUSJVNTFMBNBQSPTFTEFQPMBSJTBTJCJBTBOZBKVHBQPTJUJGQBEB
CBEBOCJQPMBSBEBMBIQPTJUJGZBOHKVHBNFSVQBLBOQPMBSJUBTQBEB LFUJHB TBEBQBO UFSTFCVU TFQFSUJ UFSMJIBU QBEB (BNCBS
TFCBHJBOCFTBSLPNQMFLT234OPSNBM 3FLBNBOEFQPMBSJTBTJBUSJVNJOJEJLFOBMTFCBHBJHFMPNCBOH1
%BMBN (BNCBS MJNB TUBEJVN SFQPMBSJTBTJ WFOUSJLFM Repolarisasi Atrium—Gelombang T Atrium. 1FOZFCBSBO
EJUVOKVLLBOEFOHBOTFNBLJONFMVBTOZBEBFSBICFSCBZBOHZBLOJ EFQPMBSJTBTJ NFMBMVJ PUPU BUSJVN KBVI MFCJI MBNCBU EBSJQBEB
EBFSBI SFQPMBSJTBTJ 1BEB TFUJBQ TUBEJVN WFLUPS CFSHFSBL EBSJ QFOZFCBSBOEJWFOUSJLFMLBSFOBBUSJVNUJEBLNFNQVOZBJTJTUFN
CBTJTKBOUVOHNFOVKVLFBQFLTTBNQBJBLIJSOZBNFOHIJMBOHQBEB 1VSLJOKF VOUVL QFOHIBOUBSBO TJOZBM EFQPMBSJTBTJ TFDBSB DFQBU
TUBEJVNBLIJS1BEBBXBMOZB WFLUPSJUVSFMBUJGLFDJMTFCBCEBFSBI 0MFI LBSFOB JUV PUPUPUPU EJ TFLFMJMJOH OPEVT TJOVT BLBO
ZBOH NFOHBMBNJ SFQPMBSJTBTJ KVHB LFDJM ,FNVEJBO WFLUPS UFSEFQPMBSJTBTJ KBVI TFCFMVN PUPUPUPU EJ CBHJBO EJTUBM BUSJVN
NFOKBEJ TFNBLJO LVBU LBSFOB EFSBKBU SFQPMBSJTBTJ TFNBLJO CFTBS 0MFILBSFOBJUVMBI EBFSBIEJEBMBNBUSJVNZBOHKVHBQFSUBNB
"LIJSOZB WFLUPS BLBO NFOKBEJ LFDJM LFNCBMJ LBSFOB EBFSBI LBMJUFSFQPMBSJTBTJBEBMBIEBFSBIOPEVTTJOVT ZBJUVEBFSBIZBOH
EFQPMBSJTBTJZBOHNBTJIBEBNFOKBEJTFEFNJLJBOTFEJLJU NFNBOH QFSUBNB LBMJ NFOHBMBNJ EFQPMBSJTBTJ +BEJ LFUJLB
SFQPMBSJTBTJ NVMBJ EBFSBI TFLJUBS OPEVT TJOVT NFOKBEJ QPTJUJG
EJCBOEJOHEFOHBOCBHJBOBUSJVNMBJOOZB0MFILBSFOBJUV
P T

II III
I

I I
SA

II
II III
III II

I I I III

II
III II
III
133
Unit llI Jantung
WFLUPSSFQPMBSJTBTJBUSJVNCFSKBMBOCFSMBXBOBOUFSIBEBQWFLUPS KBOUVOHUFSEFQPMBSJTBTJ WFLUPSNBLJOMBNBBLBONBLJOLVBU EBO

EFQPMBSJTBTJ 1FSIBUJLBOCBIXBIBMJOJCFSMBXBOBOEFOHBOFGFL CJBTBOZB TFEJLJU CFSHFTFS LF TBMBI TBUV TJTJ +BEJ WFLUPS QBEB
ZBOH UFSKBEJ QBEB WFOUSJLFM
0MFI LBSFOB JUV QBEB CBHJBO (BNCBS NFOVOKVLLBO LFBEBBO EFQPMBSJTBTJ ZBOH EJBMBNJ
LBOBO (BNCBS HFMPNCBOH ZBOH EJTFCVU TFCBHBJ WFOUSJLFMLJSBLJSB EFUJLTFTVEBIWFLUPS4FTVEBI EFUJL
HFMPNCBOH 5 BUSJVN BLBO NFOHJLVUJ LJSBLJSB EFUJL CFSJLVUOZB WFLUPSNFMVLJTLBOQPUFOTJBMMJTUSJLOZB EBOWFLUPS
TFUFMBI HFMPNCBOH 1 BUSJVN OBNVO HFMPNCBOH 5 JOJ UFSMFUBL UFSKBEJ EFUJL CFSJLVUOZB "LIJSOZB TFMVSVI WFOUSJLFM
QBEB TJTJ CFSMBXBOBO UFSIBEBQ HBSJT OPM EFOHBO HFMPNCBOH 1 UFSEFQPMBSJTBTJ EBO WFLUPSOZB NFOKBEJ OPM LFNCBMJ TFQFSUJ ZBOH
OPSNBMOZB HFMPNCBOHJOJOFHBUJGQBEBLFUJHBTBEBQBOBOHHPUB EJUVOKVLLBOQBEBUJUJL
CBEBOCJQPMBSTUBOEBS CVLBOQPTJUJG
(BNCBSBO FMJQT ZBOH UFSCFOUVL EBSJ VKVOH QPTJUJG WFLUPS
1BEB HBNCBSBO FMFLUSPLBSEJPHSBN OPSNBM HFMPNCBOH 5 WFLUPS JOJ EJTFCVU TFCBHBJ WFLUPSLBSEJPHSBN 234 %FOHBO
BUSJVN NVODVM LJSBLJSB QBEB XBLUV ZBOH CFSTBNBBO EFOHBO CBOUVBO TFCVBI PTJMPTLPQ WFLUPSLBSEJPHSBN EBQBU EJSFLBN
NVODVMOZB LPNQMFLT 234 WFOUSJLFM 0MFI LBSFOB JUV EFOHBO DBSB NFOHIVCVOHLBO FMFLUSPEBFMFLUSPEB QFSNVLBBO
HFMPNCBOH JOJ IBNQJS TFMBMV EJLBCVSLBO PMFI LPNQMFLT 234 UVCVI EBSJ MFIFS EBO BCEPNFO CBHJBO CBXBI EFOHBO MFNQFOH
WFOUSJLFM ZBOH CFTBS XBMBVQVO QBEB CFCFSBQB LFBEBBO ZBOH MFNQFOH WFSUJLBM PTJMPTLPQ EBO NFOHIVCVOHLBO FMFLUSPEB
TBOHBU BCOPSNBM HFMPNCBOH JOJ NVODVM KFMBT QBEB SFLBNBO FMFLUSPEB QFSNVLBBO EBEB EBSJ LFEVB TJTJ KBOUVOH EFOHBO
FMFLUSPLBSEJPHSBN MFNQFOHIPSJ[POUBM#JMBBEBQFSVCBIBOWFLUPS UJUJLMBNQVQBEB
PTJMPTLPQBLBONFOHJLVUJBSBIVKVOHQPTJUJGWFLUPSZBOHCFSVCBI
Vektorkardiogram JUV TFIJOHHB BLBO NFMVLJTLBO WFLUPSLBSEJPHSBN QBEB MBZBS
4BNQBJ EJ TJOJ UFMBI EJUFLBOLBO EBMBN QFNCJDBSBBO CBIXB PTJMPTLPQ
WFLUPS BMJSBO BSVT MJTUSJL ZBOH NFMFXBUJ KBOUVOH CFSVCBI
EFOHBO DFQBU LFUJLB JNQVMT NFOZFCBS NFMFXBUJ NJPLBSEJVN Sumbu Listrik Rata-Rata QRS Ventrikel— dan
1FSVCBIBO JOJ UFSKBEJ QBEB EVB BTQFL 1FSUBNB WFLUPS Maknanya
NFNBOKBOH EBO NFNFOEFL LBSFOB UFHBOHBO WFLUPS NFOJOHHJ
EBO NFOVSVO ,FEVB BSBI WFLUPS CFSVCBI LBSFOB BEB 7FLUPSLBSEJPHSBNVUVLEFQPMBSJTBTJWFOUSJLBM WFLUPSLBSHJPHSBN
QFSVCBIBO SBUBSBUB BSBI QPUFOTJBM MJTUSJL KBOUVOH 234
ZBOH EJQFSMJIBULBO QBEB (BNCBS BEBMBI WFLUPS
7FLUPSLBSEJPHSBN NFOHHBNCBSLBO QFSVCBIBOQFSVCBIBO LBSEJPHSBNQBEBKBOUVOHOPSNBM%BSJWFLUPSLBSEJPHSBNJOJEBQBU
WFLUPS JOJ QBEB TBBUTBBU CFSCFEB EJ TFQBOKBOH TJLMVT KBOUVOH EJDBUBU CBIXB BSBI WFLUPSWFLUPS WFOUSJLFM ZBOH QSFEPNJOBO
TFQFSUJEJQFSMJIBULBOQBEB(BNCBS OPSNBMOZB NFOVKV LF BQFLT KBOUVOH TFMBNB EFQPMBSJTBTJ #FSBSUJ
TFMBNBCFSMBOHTVOHOZBTFCBHJBOCFTBSTJLMVTEFQPMBSJTBTJWFOUSJLFM
1BEB WFLUPSLBSEJPHSBN CFTBS EJ (BNCBS UJUJL BSBIQPUFOTJBMMJTUSJL OFHBUJGLFQPTJUJG
BEBMBIEBSJCBTJTWFOUSJLFM
BEBMBIUJUJLSFGFSFOTJOPM EBOUJUJLJOJNFSVQBLBOVKVOHOFHBUJG NFOVKV LF BQFLT "SBI QPUFOTJBM MJTUSJL ZBOH QSFEPNJOBO TFMBNB
EBSJ TFNVB WFLUPS ZBOH CFSVSVUBO 4FMBNB PUPU KBOUVOH QSPTFT EFQPMBSJTBTJ JOJ EJTFCVU TVNCV MJTUSJL WFOUSJLFM SBUBSBUB
UFSQPMBSJTBTJ EJ BOUBSB EFOZVUEFOZVU KBOUVOH VKVOH QPTJUJG 4VNCV MJTUSJL SBUBSBUB QBEB WFOUSJLFM OPSNBM BEBMBI TFCFTBS
WFLUPSOZBNBTJICFSBEBEJUJUJLOPMLBSFOBUJEBLBEBQPUFOTJBM EFSBKBU 1BEB CBOZBL LPOEJTJ QBUPMPHJT KBOUVOH BSBI QPUFOTJBM
MJTUSJL WFLUPSJBM /BNVO TFHFSB TFTVEBI BSVT MJTUSJL NVMBJ MJTUSJLJOJCFSVCBITBNBTFLBMJLBEBOHLBEBOHCBILBOCFSCBMJLLF
NFOHBMJSJ WFOUSJLFM QBEB QFSNVMBBO EFQPMBSJTBTJ WFOUSJLFM BSBILVUVCKBOUVOHZBOHCFSMBXBOBO
VKVOHQPTJUJGWFLUPSBLBONFOJOHHBMLBOUJUJLSFGFSFOTJOPM
#JMB TFQUVN UFSEFQPMBSJTBTJ UFSMFCJI EBIVMV WFLUPS BLBO Menentukan Sumbu Listrik dan Elektrokardiogram
CFSKBMBOLFCBXBINFOVKVLFBQFLTKBOUVOH OBNVOWFLUPSJOJ Sadapan Standar
SFMBUJG MFNBI TFIJOHHB NFOJNCVMLBO CBHJBO BXBM QBEB 4FDBSB LMJOJT TVNCV MJTUSJL KBOUVOH CJBTBOZB EBQBU
HBNCBSBO WFLUPSLBSEJPHSBN WFOUSJLFM EJMVLJTLBO EFOHBO EJQFSLJSBLBO EBSJ FMFLUSPLBSEJPHSBN TBEBQBO BOHHPUB
VKVOHQPTJUJGWFLUPS*,FUJLBTFNBLJOCBOZBLMBHJCBHJBO CBEBOCJQPMBSTUBOEBS CVLBOEFOHBOWFLUPSLBSEJPHSBN(BNCBS
NFOKFMBTLBO TVBUV DBSB VOUVL NFMBLVLBO IBM JOJ 4FTVEBI
NFMBLVLBO QFSFLBNBO TBEBQBO TUBOEBS LJUB EBQBU NFOFOUVLBO
CFTBSOZBQPUFOTJBMEBOQPMBSJUBTOFUPSFLBNBOQBEBTBEBQBO*EBO
1 2 3 4 5 *** 1BEBTBEBQBO*(BNCBS SFLBNBOOZBQPTJUJG EBOQBEB
4 TBEBQBO *** SFLBNBOOZB TFCBHJBO CFTBS QPTJUJG OBNVO OFHBUJG
QBEBCBHJBOUFSUFOUVTJLMVT#JMBBEBCBHJBOSFLBNBOZBOHOFHBUJG
5 QPUFOTJBM OFHBUJG JOJ EJLVSBOHLBO UFSIBEBQ QPUFOTJBM QPTJUJG VOUVL
EBQBU NFOFUBQLBO CFTBSOZB QPUFOTJBM OFUP TBEBQBO UFSTFCVU
1
3
TFQFSUJ ZBOH EJUVOKVLLBO EFOHBO BOBL QBOBI EJ TFCFMBI LBOBO
LPNQMFLT234VOUVLTBEBQBO***,FNVEJBO TFUJBQQPUFOTJBMOFUP
VOUVLTBEBQBO*EBO***EJHBNCBSLBOQBEBNBTJOHNBTJOHTVNCV
TBEBQBOOZB EFOHBO QBOHLBM QPUFOTJBM QBEB UJUJL QFSQPUPOHBO
2 TVNCVTVNCVTBEBQBO TFQFSUJZBOHUFSMJIBUQBEB(BNCBS
T
134
Bab 12 Penafsiran Etektrokardiografi Kelainan Otot Jantung dan Ketainan Aliran Darah Koroner: Suatu Analisis Vektor
LBSFOB JTJ QFSVU BLBO NFOFLBO EJBGSBHNB LF BUBT EBO

TBOHBU TFSJOH QBEB PSBOH HFNVL ZBOH CJTBOZB EJBGSBHNBOZB
NFOFLBO KBOUVOH LF BUBT BLJCBU QFOBNCBIBO MFNBL PSHBO
III
– –60 WJTFSB
UNIT III
I
%FNJLJBO QVMB KBOUVOH ZBOH NFMFOHLVOH LF LBOBO
NFOZFCBCLBO TVNCV MJTUSJL SBUBSBUB WFOUSJLFM CFSHFTFS LF
LBOBO ,FBEBBO JOJ UFSKBEJ
QBEB BLIJS JOTQJSBTJ EBMBN
I
– +
LFUJLB PSBOH CFSEJSJ EBO CJBTBOZB QBEB PSBOH
I II
180 0 UJOHHJTFNBNQBJZBOHKBOUVOHOZBCFSHBOUVOHLFCBXBI
Hipertrofi Salah Satu Ventrikel.#JMBTBMBITBUVWFOUSJLFM
TBOHBUIJQFSUSPGJL TVNCVKBOUVOHCFSHFTFSNFOVKVLFWFOUSJLFM
III ZBOH IJQFSUSPGJ LBSFOB EVB BMBTBO 1FSUBNB KVNMBI PUPU QBEB
120 59
+ KBOUVOHZBOHIJQFSUSPGJLKBVIMFCJICFTBSEBSJQBEBTJTJMBJOOZB
III EBOLFBEBBOJOJNFNVOHLJOLBOQFNCBOHLJUBOBSVTMJTUSJLZBOH
CFSMFCJIBO QBEB TJTJ UFSTFCVU ,FEVB XBLUV ZBOH EJCVUVILBO
PMFIHFMPNCBOHEFQPMBSJTBTJVOUVLNFOKBMBSNFMFXBUJWFOUSJLFM
IJQFSUSPGJL MFCJI MBNB EBSJQBEB NFMFXBUJ WFOUSJLFM OPSNBM
#JMBQPUFOTJBMOFUPTBEBQBO*QPTJUJG QPUFOTJBMJUVEJHBNCBSLBO "LJCBUOZB WFOUSJLFM OPSNBM BLBO UFSEFQPMBSJTBTJ KBVI
EFOHBO BSBI QPTJUJG QBEB HBSJT ZBOH NFMVLJTLBO TBEBQBO * NFOEBIVMVJ WFOUSJLFM ZBOH IJQFSUSPGJ EBO LFBEBBO JOJ BLBO
4FCBMJLOZB CJMB OFHBUJG QPUFOTJBM JOJ EJHBNCBSLBO EFOHBO BSBI NFOHIBTJMLBOWFLUPSZBOHLVBUEBSJTJTJKBOUVOHOPSNBMNFOVKV
OFHBUJG %FNJLJBO KVHB VOUVL TBEBQBO *** QPUFOTJBM OFUP LF TJTJ IJQFSUSPGJL ZBOH NBTJI BNBU CFSNVBUBO QPTJUJG +BEJ
EJHBNCBSLBO EFOHBO QBOHLBM QBEB UJUJL QFSQPUPOHBO EBO CJMB TVNCVOZBNFOZJNQBOHLFBSBIWFOUSJLFMIJQFSUSPGJL
QPTJUJG EJHBNCBSLBO EFOHBO BSBI QPTJUJG QBEB HBSJT ZBOH
NFXBLJMJTBEBQBO***#JMBOFHBUJG QPUFOTJBMOFUPJOJEJHBNCBSLBO Analisis Vektor pada Penyimpangan Sumbu ke Kiri
EFOHBOBSBIOFHBUJG yang Di sebabkan oleh Hipertrofi Ventrikel Kiri. (BNCBS
NFNQFSMJIBULBO LFUJHB TBEBQBO BOHHPUB CBEBO CJQPMBS
6OUVL NFOFUBQLBO CFTBSOZB WFLUPS QPUFOTJBM MJTUSJL SBUBSBUB TUBOEBSQBEBTFCVBIFMFLUSPLBSEJPHSBN"OBMJTJTWFLUPSNFN
234 WFOUSJLFM UPUBM LJUB EBQBU NFOBSJL HBSJTHBSJT UFHBL MVSVT NFNQFSMJIBULBO QFOZJNQBOHBO TVNCV LF LJSJ EFOHBO TVNCV
HBSJT QVUVTQVUVT QBEB HBNCBS EBSJ NBTJOHNBTJOH VKVOH MJTUSJLSBUBNFOVOKVLLBOLFBSBI¦EFSBKBU&MFLSPLPSEJPHSBN
TBEBQBO*EBO***%FOHBOBOBMJTJTWFLUPS UJUJLQPUPOHLFEVBHBSJT JOJ NFSVQBLBO FMFLSPLBSEJPHSBN LIBT ZBOH EJTFCBCLBO PMFI
UFHBLMVSVTJOJBLBONFXBLJMJQVODBLWFLUPS234SBUBSBUBQBEB IJQFSUFOTJ UFLBOBO EBSBI BSUFSJ ZBOH UJOHHJ
NFOZFCBCLBO
WFOUSJLFM EBOUJUJLQPUPOHTVNCVTBEBQBO*EBO***NFOVOKVLLBO WFOUSJLFMLJSJNFOHBMBNJIJQFSUSPGJTFIJOHHBNBNQVNFNPNQB
VKVOH OFHBUJG WFLUPS SBUBSBUB 0MFI LBSFOB JUV WFLUPS 2HJ SBUB EBSBI VOUVL NFMBXBO UFLBOBO EBSBI TJTUFNJL ZBOH UJOHHJ
SBUB EBQBU EJUBSJL EJ BOUBSB LFEVB UJUJL JOJ 1FSLJSBBO QPUFOTJBM (BNCBSBO QFOZJNQBOHBO TVNCV LF LJSJ ZBOH TFSVQB EBQBU
SBUBSBUB ZBOH EJUJNCVMLBO PMFI WFOUSJLFM TFMBNB NFOHBMBNJ UFSKBEJCJMBWFOUSJLFMLJSJNFOHBMBNJ
EFQPMBSJTBTJ JUV EJUVOKVLLBO PMFI QBOKBOH WFLUPS 234 SBUBSBUB
JOJ EBO TVNCV MJTUSJL SBUBSBUB EJUVOKVLLBO PMFI BSBI WFLUPS
SBUBSBUB +BEJ PSJFOUBTJ TVNCV MJTUSJL SBUBSBUB QBEB WFOUSJLFM
ZBOHOPSNBM TFQFSUJZBOHEJUFOUVLBOQBEB(BNCBS BEBMBI
EFSBKBUQPTJUJG EFSBKBU

Kondisi-Kondisi Kelainan Ventrikel yang Dapat

Menyebabkan Penyimpangan Sumbu
8BMBVQVO TVNCV MJTUSJL SBUBSBUB WFOUSJLFM LJSBLJSB CFSLJTBS I II III
EFSBKBU QBEB KBOUVOH ZBOH OPSNBM QVO TVNCV JOJ EBQBU
III
NFOZJNQBOH EBSJ LJSBLJSB EFSBKBU TBNQBJ LJSBLJSB –
EFSBKBU1FOZFCBCUJNCVMOZBQFOZJNQBOHBOOPSNBMJOJUFSVUBNB
BEBMBI QFSCFEBBO BOBUPNJ QBEB TJTUFN EJTUSJCVTJ 1VSLJOKF BUBV
TVTVOBO PUPUOZB TFOEJSJ QBEB KBOUVOH ZBOH CFSCFEB 8BMBVQVO
CFHJUV TFKVNMBI LPOEJTJ LFMBJOBO KBOUVOH EBQBU NFOZFCBCLBO
I – +I
QFOZJNQBOHBO TVNCV LFMVBS EBSJ CBUBTCBUBT OPSNBM TFQFSUJ
CFSJLVU
+
Perubahan Kedudukan Jantung #JMB KBOUVOHOZB TFOEJSJ III
NFMFOHLVOHLFLJSJ TVNCVMJTUSJLSBUBSBUBKBOUVOHKVHBCFSHFTFS
LFLJSJ1FSHFTFSBOJOJUFSKBEJ
QBEBBLIJSFLTQJSBTJEBMBN

LFUJLBPSBOHCFSCBSJOH
135
Unit III Jantung
IJQFSUSPGJBLJCBUTUFOPTJTLBUVQBPSUB SFHVSHJUBTJLBUVQBPSUB "OBMJTJT7FLUPSVOUVL1FOZJNQBOHBO4VNCVLF,JSJQBEB

BUBV TFKVNMBI LFMBJOBO KBOUVOH LPOHFOJUBM ZBOH NFOZFCBC Blok Cabang Berkas Kiri. #JMB DBCBOH CFSLBT LJSJ UFSCMPL
LBO WFOUSJLFM LJSJ NFNCFTBS TFEBOHLBO WFOUSJLFM LBOBO EFQPMBSJTBTJKBOUVOHZBOHNFOZFCBSNFMFXBUJWFOUSJLFMLBOBOEVB
SFMBUJGCFSVLVSBOOPSNBM TBNQBJUJHBLBMJMFCJIDFQBUEBSJQBEBZBOHNFMFXBUJWFOUSJLFMLJSJ
"LJCBUOZB CBOZBLCBHJBOWFOUSJLFMLJSJUFUBQUFSQPMBSJTBTJTBNQBJ
Analisis Vektor pada Penyimpangan Sumbu ke Kanan TFMBNB EFUJL TFUFMBI TFMVSVI WFOUSJLFM LBOBO UFSEFQPMBSJTBTJ
yang Disebabkan oleh Hipertrofi Ventrikel Kanan.&MFLSP UPUBM %FOHBO EFNJLJBO WFOUSJLFM LBOBO NFOKBEJ FMFLUSPOFHBUJG
LBSEJPHSBN QBEB (BNCBS NFMVLJTLBO QFOZJNQBOBO TFNFOUBSB WFOUSJLFM LJSJ UFUBQ FMFLUSPQPTJUJG TFMBNB
TVNCV LF LBOBO ZBOH IFCBU TBNQBJ TVNCV MJTUSJL LJSBLJSB CFSMBOHTVOHOZB TFCBHJBO CFTBS QSPTFT EFQPMBSJTBTJ EBO UJNCVM
EFSBKBU ZBJUV CFSHFTFS EFSBKBU LF TFCFMBI LBOBO EBSJ WFLUPS EFOHBO LFLVBUBO ZBOH TBOHBU CFTBS EBSJ WFOUSJLFM LBOBO
TVNCV 234 WFOUSJLFM SBUBSBUB EFSBKBU ZBOH OPSNBM NFOHBSBI LF WFOUSJLFM LJSJ %FOHBO LBUB MBJO UFSKBEJ
1FOZJNQBOHBOTVNCVLFLBOBOZBOHUFSMJIBUQBEBHBNCBSJOJ QFOZJNQBOHBO LVBU TVNCV LF LJSJ TFLJUBS o EFSBKBU LBSFOB
EJTFCBCLBO PMFI IJQFSUSPGJ WFOUSJLFM LBOBO TFCBHBJ BLJCBU EBSJ VKVOH QPTJUJG WFLUPS NFOHBSBI LF WFOUSJLFM LJSJ )BM JOJ
TUFOPTJT LBUVQ QVMNPOBMJT LPOHFOJUBM 1FOZJNQBOHBO TVNCV EJQFSMJIBULBO EBMBN (BNCBS ZBOH NFOVOKVLLBO
LF LBOBO KVHB EBQBU UFSKBEJ QBEB LFMBJOBO KBOUVOH LPOHFOJUBM QFOZJNQBOHBOTVNCVLFLJSJZBOHLIBTBLJCBUCMPLQBEBDBCBOH
MBJO ZBOH NFOZFCBCLBO IJQFSUSPGJ WFOUSJLFM LBOBO TFQFSUJ CFSLBTLJSJ
UFUSBMPHJ'BMMPUEBOLFMBJOBOTFQUVNJOUFSWFOUSJLVMBS 0MFILBSFOBMBNCBUOZBQFOKBMBSBOJNQVMTCJMBBEBCMPLQBEB
Blok Cabang Berkas (Bundle Branch Block) TJTUFN 1VSLJOKF TFMBJO UFSKBEJ QFOZJNQBOHBO TVNCV EVSBTJ
Menyebabkan Penyimpangan Sumbu 1BEB VNVNOZB LPNQMFLT234NFOKBEJBNBUNFNBOKBOH LBSFOBEFQPMBSJTBTJEJ
EJOEJOH MBUFSBM LFEVB WFOUSJLFM UFSEFQPMBSJTBTJ QBEB TBBU TJTJ KBOUVOH ZBOH UFSCMPL CFSKBMBO BNBU MBNCBU ,JUB EBQBU
IBNQJSCFSTBNBBO TFCBCLFEVBDBCBOHCFSLBTLBOBOEBOLJSJ NFOHFUBIVJOZB EFOHBO NFOFNVLBO HFMPNCBOH 234 ZBOH
TJTUFN 1VSLJOKF NFOKBMBSLBO JNQVMT KBOUVOH NFOVKV EJOEJOH TBOHBUMFCBSQBEB(BNCBS)BMJOJBLBOEJCJDBSBLBOTFDBSB
LFEVB WFOUSJLFM QBEB TBBU IBNQJS CFSTBNBBO 4FCBHBJ MFCJI EFUBJM OBOUJ EBMBN CBC JOJ ,PNQMFLT 234 ZBOH TBOHBU
BLJCBUOZB QPUFOTJBM MJTUSJL ZBOH EJCBOHLJULBO PMFI LFEVB NFNBOKBOH JOJ NFNCFEBLBO CMPL DBCBOH CFSLBT EBSJ
WFOUSJLFM QBEBLFEVBTJTJKBOUVOH
IBNQJSTBMJOHNFOFUSBMLBO QFOZJNQBOHBOTVNCVBLJCBUIJQFSUSPGJ
/BNVO CJMBIBOZBTBMBITBUVDBCBOHCFSLBTVUBNBNFOHBMBNJ "OBMJTJT7FLUPSEBO1FOZJNQBOHBO4VNCVLF,BOBOQBEB
CMPLBEF JNQVMT KBOUVOH ZBOH NFOZFCBS NFMFXBUJ WFOUSJLFM Blok Cabang Berkas Kanan#JMBDBCBOHCFSLBTLBOBOUFSCMPL
OPSNBM BLBO CFSMBOHTVOH KBVI TFCFMVN JNQVMT JUV NFOZFCBS WFOUSJLFM LJSJ BLBO CFSEFQPMBSJTBTJ KBVI MFCJI DFQBU EBSJQBEB
NFMBMVJWFOUSJLFMZBOHMBJO0MFILBSFOBJUV EFQPMBSJTBTJLFEVB WFOUSJLFMLBOBOTFIJOHHBTJTJLJSJWFOUSJLFMNFOKBEJFMFLUSPOFHBUJG
WFOUSJLFM UJEBL CJTB UFSKBEJ TFDBSB CFSTBNBBO EBO QPUFOTJBM TFMBNB EFUJL NFOEBIVMVJ WFOUSJLFM LBOBO 0MFI LBSFOB JUV
EFQPMBSJTBTJOZB UJEBL TBMJOH NFOFUSBMLBO 4FCBHBJ BLJCBUOZB UJNCVMWFLUPSZBOHTBOHBUCFTBS EFOHBOVKVOHOFHBUJGNFOHBSBI
UFSKBEJQFOZJNQBOHBOTVNCVTFCBHBJCFSJLVU LFWFOUSJLFMLJSJEBOVKVOHQPTJUJGNFOHBSBILFWFOUSJLFMLBOBO
%FOHBO LBUB MBJO UFSKBEJMBI QFOZJNQBOHBO TVNCV LF LBOBO
ZBOH CFTBS 1FOZJNQBOHBO TVNCV LF LBOBO ZBOH EJTFCBCLBO
PMFICMPLQBEBDBCBOHCFSLBTLBOBOEJHBNCBSLBO EBOWFLUPSOZB
I II III
III I II III
–
III
–
I – +I
I – +I
+
III
+
III
136
Bab 12 Penafsiran Elektrokardiografi Kelainan Otot jantung dan Kelainan Atiran Darah Koroner: Suatu Analisis Vektor
III
I –
UNIT III
I– +I
II I II
III +
III
III
EJBOBMJTJT QBEB (BNCBS ZBOH NFNQFSMJIBULBO TFCVBI

TVNCVTFLJUBSEFSBKBU CVLBOTVNCVOPSNBMEFSBKBU EBO ZBOH TFSJOH EJKVNQBJ TFTVEBI JOGBSL KBOUVOH NVMUJQFM LFDJM
QFNBOKBOHBOLPNQMFLT234LBSFOBLPOEVLTJZBOHMBNCBU ZBOH TVEBI NFOJNCVMLBO QFSMBNCBUBO MPLBM QFOHIBOUBSBO
JNQVMTEBOQFOVSVOBOUFHBOHBOBLJCBULFIJMBOHBONBTTBPUPU
Kondisi-Kondisi yang Dapat Menyebabkan EJTFMVSVIWFOUSJLFM
Tegangan Abnormal pada Kompleks QRS
Penurunan Tegangan Akibat Kondisi-Kondisi di
Peningkatan Tegangan pada Sadapan Anggota Badan Sekeliling Jantung. 4BMBI TBUV QFOZFCBC UFSQFOUJOH ZBOH
Bipolar Standar EBQBU NFOVSVOLBO UFHBOHBO QBEB TBEBQBOTBEBQBO
FMFLUSPLBSEJPHSBGJL BEBMBI DBJSBO EJ EBMBN QFSJLBSEJVN 0MFI
#JBTBOZB UFHBOHBO QBEB LFUJHB TBEBQBO BOHHPUB CBEBO CJQPMBS LBSFOB DBJSBO FLTUSBTFM NVEBI TFLBMJ NFOKBMBSLBO BSVT MJTUSJL
TUBOEBS ZBOH EJVLVS EBSJ QVODBL HFMPNCBOH 3 LF CBHJBO QBMJOH TFCBHJBO CFTBS BSVT MJTUSJL ZBOH NFOHBMJS LF MVBS EBSJKBOUVOH
CBXBI HFMPNCBOH 4 CFSWBSJBTJ BOUBSB EBO NJMJWPMU BLBO EJIBOUBSLBO EBSJ TBUV CBHJBO KBOUVOH LF CBHJBO KBOUVOH
TBEBQBO***CJBTBOZBNFSFLBNUFHBOHBOUFSFOEBIEBOTBEBQBO** MBJOOZB MFXBU DBJSBO QFSJLBSEJVN +BEJ DBJSBO FGVTJ JOJ TFDBSB
UFSUJOHHJ /BNVO HBNCBSBO UFSTFCVU CVLBOOZB UJEBL EBQBU FGFLUJG JOFSVQBLBO KBMVS QFOEFL QPUFOTJBM MJTUSJL ZBOH
CFSVCBI CBILBOQBEBKBOUVOHOPSNBMTFLBMJQVO4FDBSBVNVN EJCBOHLJULBO PMFI KBOUVOH TFIJOHHB NFOVSVOLBO UFHBOHBO
CJMB QFOKVNMBIBO UFHBOHBO EBSJ TFMVSVI LPNQMFLT 234 QBEB FMFLUSPLBSEJPHSBGJL ZBOH NFODBQBJ QFSNVLBBO CBEBO &GVTJ
LFUJHB TBEBQBO TUBOEBS MFCJI CFTBS EBSJ NJMJWPMU QBTJFO EBQBU QMFVSB EFOHBO EFSBKBU ZBOH MFCJI SJOHBO KVHB EBQBU
EJBOHHBQNFNQVOZBJFMFLUSPLBSEJPHSBNEFOHBOUFHBOHBOUJOHHJ NFNJOUBTLBO BSVT MJTUSJL LF TFLFMJMJOH KBOUVOH TFIJOHHB
1FOZFCBCUFSTFSJOHUJNCVMOZBLPNQMFLT234UFHBOHBOUJOHHJ UFHBOHBO QBEB QFSNVLBBO CBEBO EBO FMFLUSPLBSEJPHSBN BLBO
BEBMBI CFSUBNCBIOZB NBTTB PUPU KBOUVOH ZBOH CJBTBOZB NFOVSVO
EJTFCBCLBO PMFI IJQFSUSPGJ PUPU TFCBHBJ SFTQPOT UFSIBEBQ &NGJTFNB QBSV EBQBU NFOVSVOLBO QPUFOTJBM FMFLSPLBSEJPH
LFMFCJIBO CFCBO QBEB TBMBI TBUV CBHJBO KBOUVOH $POUPIOZB SBGJL UFUBQJ EFOHBO BMBTBO ZBOH CFSCFEB EBSJQBEB FGVTJ
IJQFOUSPGJWFOUSJLFMLBOBOUFSKBEJLBMBVKBOUVOHIBSVTNFNPNQB QFSJLBSEJVN 1BEB FNGJTFNB QBSV QFOHIBOUBSBO BSVT MJTUSJL
EBSBI NFMBMVJ LBUVQ QVMNPOBMJT ZBOH TUFOPUJL EBO IJQFSUSPGJ NFMFXBUJ QBSV TBOHBU UFSUFLBO LBSFOB KVNMBI VEBSB EJ EBMBN
WFOUSJLFM LJSJ UFSKBEJ CJMB TFTFPSBOH NFOEFSJUB UFLBOBO EBSBI QBSVQBSV UFSMBMV CBOZBL 3POHHB EBEB KVHB NFNCFTBS EBO
UJOHHJ +VNMBI PUPU ZBOH NFOJOHLBU JOJ BLBO NFOZFCBCLBO QBSV DFOEFSVOH MFCJI NFOVUVQJ KBOUVOH EBSJQBEB CJBTBOZB
QFNCBOHLJUBO MJTUSJL ZBOH MFCJI CFTBS EJ TFLFMJMJOH KBOUVOH 0MFI LBSFOB JUV QBSVQBSV CFLFSKB TFCBHBJ JTPMBUPS ZBOH
4FCBHBJ BLJCBUOZB QPUFOTJBM MJTUSJL ZBOH UFSFLBN QBEB TBEBQBO NFOHIBNCBU QFOKBMBSBO UFHBOHBO MJTUSJL EBSJ KBOUVOH LF
FMFLUSPLBSEJPHSBGJL KBVI MFCJI CFTBS EBSJQBEB OPSNBM TFQFSUJ QFSNVLBBO UVCVI EBO IBM JOJ NFOZFCBCLBO QFOVSVOBO
ZBOHUBNQBLQBEB(BNCBSEBO QPUFOTJBMFMFLUSPLBSEJPHSBGJLQBEBCFSCBHBJNBDBNTBEBQBO
Penurunan Tegangan pada Elektrokardiogram
Penurunan Tegangan Akibat Kardiomiopati. 4BMBITBUV Pola-Pola Kompteks QRS yang Aneh
QFOZFCBC QFOVSVOBO UFHBOHBO QBEB LPNQMFLT 234 ZBOH QBMJOH (Bizarre) dan Memanjang
TFSJOH BEBMBI TFSBOHLBJBO JOGBSL NJPLBSEJVN MBNB ZBOH
NFOHBLJCBULBO CFSLVSBOHOZB NBTTB PUPU ,FBEBBO JOJ KVHB Pemanjangan Kompleks QRS Akibat Hipertrofi atau
NFOZFCBCLBO HFMPNCBOH EFQPMBSJTBTJ CFSHFSBL MBNCBU NFMBMVJ Dilatasi Jantung
WFOUSJLFM EBO NFODFHBI TFCBHJBO CFTBS KBOUVOH NFOHBMBNJ ,PNQMFLT 234 CFSMBOHTVOH TFMBNB EFQPMBSJTBTJ UFSVT
EFQPMBSJTBTJ TFDBSB CFSTBNBTBNB TFLBMJHVT "LJCBUOZB LPOEJTJ NFOZFCBS NFMFXBUJ WFOUSJLFM ZBLOJ TFMBNB TFCBHJBO WFOUSJLFM
JOJ BLBO NFOZFCBCLBO QFNBOKBOHBO TFEJLJU LPNQMFLT 234 UFSEFQPMBSJTBTJEBOCBHJBOMBJOOZBEBMBNLFBEBBOUFSQPMBSJTBTJ
CFSTBNB EFOHBO QFOVSVOBO UFHBOHBO (BNCBS 0MFI LBSFOB JUV QFNBOKBOHBO LPOEVLTJ JNQVMT NFMBMVJ
NFNQFSMJIBULBO FMFLUSPLBSEJPHSBN EFOHBO UFHBOHBO SFOEBI WFOUSJLFM TFMBMV NFOZFCBCLBO UJNCVMOZB QFNBOKBOHBO
LIBTEJTFSUBJQFNBOKBOHBOLPNQMFLT234 LPNQMFLT2341FNBOKBOHBOTFQFSUJJUVTFSJOHLBMJUFSKBEJCJMB
137
Unit lll Jantung
TBMBI TBUV BUBV LFEVB WFOUSJLFM NFOHBMBNJ IJQFSUSPGJ BUBV ZBOH TFKBVI JOJ NFSVQBLBO QFOZFCBC QBMJOH TFSJOH VOUVL BSVT
EJMBUBTJLBSFOBKBMBOZBOHIBSVTEJMFXBUJJNQVMTNFOKBEJMFCJI DFEFSBEJKBOUVOH1BEBJTLFNJB UJEBLUFSTFEJBDVLVQOVUSJFOCBHJ
QBOKBOH ,PNQMFLT 234 OPSNBM CFSMBOHTVOH TFMBNB KBOUVOH EBSJ TVQMBJ EBSBI LPSPOFS VOUVL NFNQFSUBIBOLBO
TBNQBJ EFUJL TFEBOHLBO QBEB IJQFSUSPGJ BUBV EJMBUBTJ QPMBSJTBTJNFNCSBOOPSNBM
WFOUSJLFM LJSJ BUBV LBOBO LPNQMFLT 234 EBQBU NFNBOKBOH
NFOKBEJ TBNQBJ EFUJL Pengaruh Arus-Cedera terhadap Kompleks QRS
%BMBN(BNCBS TVBUVEBFSBILFDJMEJCBTJTWFOUSJLFMLJSJCBSV
Pemanjangan Kompleks QRS Akibat Blok pada Sistem TBKB NFOHBMBNJ JOGBSL LFIJMBOHBO BMJSBO EBSBI LPSPOFS
0MFI
Purkinje LBSFOB JUV TFMBNB JOUFSWBM 51 ZBLOJ LFUJLB PUPU WFOUSJLFM
#JMB BEB CMPL QBEB TFSBUTFSBU 1VSLJOKF JNQVMT KBOUVOH IBSVT UFSQPMBSJTBTJ UPUBM NBTJI BEB BSVT OFHBUJG BCOPSNBM ZBOH NFOHBMJS
EJKBMBSLBO PMFI PUPU WFOUSJLFM EBO CVLBO NFMBMVJ TJTUFN EBSJ EBFSBI JOGBSL EJ CBTJT WFOUSJLFM LJSJ EBO NFOZFCBS LF CBHJBO
1VSLJOKF )BM JOJ NFOVSVOLBO LFDFQBUBO QFOKBMBSBO JNQVMT WFOUSJLFMMBJOOZB
TBNQBJ LJSBLJSB TFQFSUJHB LFDFQBUBO OPSNBM 0MFI LBSFOB JUV
7FLUPSVOUVLBSVTDFEFSBJOJ TFQFSUJZBOHEJHBNCBSLBOQBEB
CJMB BEB CMPL UPUBM QBEB TBMBI TBUV DBCBOH CFSLBT EVSBTJ
KBOUVOH QFSUBNB QBEB (BNCBS NFNQVOZBJ BSBI LJSBLJSB
LPNQMFLT 234 CJBTBOZB BLBO NFNBOKBOH TBNQBJ EFUJL
EFSBKBU EBOCBTJTWFLUPSOZB VKVOHOFHBUJGJOFOHBSBILFPUPU
BUBVMFCJI
ZBOHNFOHBMBNJDFEFSB4FQFSUJEJQFSMJIBULBOQBEBCBHJBOCBXBI
1BEB VNVNOZB LPNQMFLT 234 EJBOHHBQ BCOPSNBM
HBNCBS CBILBO TFCFMVN LPNQMFLT 234 EJNVMBJ WFLUPS JOJ
NFNBOKBOH CJMB CFSMBOHTVOH MFCJI EBSJ EFUJL CJMB
NFOJNCVMLBO SFLBNBO BXBM QBEB TBEBQBO * EJ CBXBI HBSET
LPNQMFLT JOJ CFSMBOHTVOH MFCJI EBSJ EFUJL QFNBOKBOHBO
QPUFOTJBM OPM LBSFOB WFLUPS ZBOH LFMVBS EBSJ EBFSBI DFEFSB QBEB
JUVIBNQJSQBTUJEJTFCBCLBOPMFICMPLQBUPMPHJTEJTVBUVUFNQBU
TBEBQBO * NFOVKV LF VKVOH OFHBUJG TVNCV TBEBQBO * 1BEB
QBEB TJTUFN LPOEVLTJ EJ EBMBN WFOUSJLFM TFQFSUJ ZBOH
TBEBQBO ** SFLBNBOOZB CFSBEB EJ BUBT HBSJT LBSFOB WFLUPS ZBOH
EJQFSMJIBULBO PMFI FMFLUSPLBSEJPHSBN VOUVL CMPL DBCBOH
LFMVBSMFCJINFOVKVLFVKVOHQPTJUJGTBEBQBO**1BEBTBEBQBO***
CFSLBTQBEB(BNCBSEBO
WFLUPS ZBOH LFMVBS NFNQVOZBJ BSBI ZBOH TBNB EFOHBO VKVOH
Kondisi-kondisi yang Dapat Menyebabkan Timbulnya QPTJUJG TBEBQBO *** TFIJOHHB SFLBNBOOZB QPTJUJG 4FMBOKVUOZB
Kompleks QRS yang Aneh LBSFOB WFLUPS UFSTFCVU UFSMFUBL IBNQJS TFBSBI EFOHBO TVNCV
TBEBQBO *** UFHBOHBO BSVTDFEFSB QBEB TBEBQBO ***KBVI MFCJI
1PMBQPMB BOFI LPNQMFLT 234 QBMJOH TFSJOH EJTFCBCLBO PMFI CFTBSEBSJQBEBUFHBOHBOQBEBTBEBQBO*BUBVTBEBQBO**
EVB LFBEBBO
LFSVTBLBO PUPU KBOUVOH EJ CFCFSBQB EBFSBI EJ
TFMVSVI TJTUFN WFOUSJLVMBS ZBOH EJTFSUBJ QFOHHBOUJBO PUPU ,FUJLB LFNVEJBO KBOUVOH UFSVT NFOKBMBOJ QSPTFT
EFOHBO KBSJOHBO QBSVU EBO
CMPL MPLBM LFDJM NVMUJQFM EJ EFQPMBSJTBTJOZB ZBOH OPSNBM TFQUVNMBI ZBOH NVMBNVMB
CBOZBL UFNQBU QBEB TJTUFN 1VSLJOKF 4FCBHBJ BLJCBUOZB UFSEFQPMBSJTBTJ LFNVEJBO EFQPMBSJTBTJ JOJ NFOZFCBS UVSVO LF
LPOEVLTJ JNQVMT KBOUVOH NFOKBEJ UJEBL UFSBUVS TFIJOHHB BQFLT EBO LFNCBMJ LF BSBI CBTJT WFOUSJLFM #BHJBO WFOUSJLFM
NFOZFCBCLBO QFSVCBIBO UFHBOHBO EFOHBO DFQBU EBO UFSBLIJS ZBOH NFOHBMBNJ EFQPMBSJTBTJ UPUBM BEBMBI CBTJT WFOUSJLFM
QFOZJNQBOHBO TVNCV ,FBEBBO JOJ TFSJOH NFOZFCBCLBO LBOBO LBSFOBCBTJTWFOUSJLFMLJSJTVEBITFMVSVIOZBUFSEFQPMBSJTBTJ
UFSEBQBUOZB EVB CBILBO UJHB LBMJ MJQBU QVODBL HFMPNCBOH QBEB TFDBSB QFSNBOFO %FOHBO BOBMJTJT WFLUPS VSVUBO UBIBQUBIBQ
CFCFSBQBTBEBQBOFMFLUSPLBSEJPHSBGJL TFQFSUJZBOHUFSMJIBUQBEB QFNCFOUVLBO FMFLUSPLBSEJPHSBN PMFI HFMPNCBOH EFQPMBSJTBTJ
(BNCBS ZBOH NFOKBMBS NFMFXBUJ WFOUSJLFM EBQBU EJCBOHVO TFDBSB HSBGJT
TFQFSUJZBOHEJQFSMJIBULBOEJCBHJBOCBXBI(BNCBS
Arus-Cedera (Current of Injury) #JMBKBOUVOHUFSEFQPMBSJTBTJUPUBM QBEBBLIJSQSPTFTEFQPMBSJTBTJ
TFQFSUJ ZBOH EJUVOKVLLBO QBEB TBUV UBIBQ TFCFMVN BLIJS QBEB
#BOZBLNBDBNLFMBJOBOKBOUVOH LIVTVTOZBZBOHNFSVTBLPUPU (BNCBS
TFNVB PUPU WFOUSJLFM CFSBEB EBMBN LFBEBBO
KBOUVOH TFSJOH LBMJ NFOZFCBCLBO TFCBHJBO KBOUVOH UFUBQ OFHBUJG0MFILBSFOBJUV EBMBNHBNCBSBOFMFLUSPLBSEJPHSBNTBBU
UFSEFQPMBSJTBTJTFQBOKBOHXBLUV UPUBMBUBVQBSTJBM#JMBLFBEBBO JOJ TBNBTFLBMJUJEBLBEBBSVTMJTUSJLZBOHNFOHBMJSEJWFOUSJLFMLF
JOJUFSKBEJ BSVTMJTUSJLNFOHBMJSEJBOUBSBEBFSBIUFSEFQPMBSJTBTJ FMFLUSPEB FMFLUSPLBSEJPHSBGJ LBSFOB TFLBSBOH PUPU KBOUVOH ZBOH
QBUPMPHJTEBOEBFSBIUFSQPMBSJTBTJOPSNBM CBILBOQBEBTFMBOH DFEFSB EBO PUPU ZBOH TFEBOH CFSLPOUSBLTJ EBMBN LFBEBBO
BOUBS EFOZVU KBOUVOH TFLBMJQVO ,FBEBBO JOJ EJTFCVU BSVT UFSEFQPMBSJTBTJ
DFEFSB DVSSFOU PG JOKVSZ
1FSIBUJLBO TFDBSB LIVTVT CBIXB
4FMBOKVUOZB TFXBLUV UFSKBEJ SFQPMBSJTBTJ BLIJSOZB TFMVSVI
EBFSBIKBOUVOHZBOHDFEFSBCFSTJGBUOFHBUJGLBSFOBCBHJBOJOJMBI
KBOUVOH NFOHBMBNJ SFQPMBSJTBTJ LFDVBMJ EBFSBI ZBOH NFOHBMBNJ
ZBOHNFOHBMBNJEFQPMBSJTBTJEBONFOHFMVBSLBONVBUBOOFHBUJG
EFQPMBSJTBTJQFSNBOFO ZBLOJCBTJTWFOUSJLFMLJSJZBOHDFEFSB+BEJ
LF DBJSBO EJ TFLJUBSOZB TFEBOHLBO EBFSBI KBOUVOH MBJOOZB
SFQPMBSJTBTJ NFOZFCBCLBO UJNCVMOZB LFNCBMJ BSVTDFEFSB QBEB
NFNQVOZBJQPMBSJUBTOFUSBMBUBVQPTJUJG
TFUJBQ TBEBQBO TFQFSUJ ZBOH EJHBNCBSLBO QBEB VKVOH LBOBO
#FCFSBQBLFMBJOBOZBOHEBQBUNFOJNCVMLBOBSVTDFEFSBJOJ (BNCBS
JBMBI
USBVNB NFLBOJT ZBOH NFNCVBU NFNCSBO UFUBQ
TFEFNJLJBOQFSNFBCFMTFIJOHHBUJEBLEBQBUUFSKBEJSFQPMBSJTBTJ Titik J—Potensial Rujukan Nol untuk Menganalisis Arus-
TFNQVSOB
QSPTFT JOGFLTJ ZBOH NFSVTBL NFNCSBO PUPU Cedera
EBO
IJTLFNJB EBFSBIEBFSBI TFUFNQBU QBEB PUPU KBOUVOH 4JBQB QVO BLBO NFOEVHB CBIXB NFTJO FMFLUSPLBSEJPHSBGJ VOUVL
ZBOHEJTFCBCLBOPMFIPLMVTJQFNCVMVIEBSBILPSPOFSTFUFNQBU NFSFLBNFMFLUSPLBSEJPHSBNEBQBUNFOFOUVLBOLBQBOUJEBLBEB
138
Bab 12 Penafsiran Elektrokardiografi Kelainan Otot Jantung dan Kelainan Aliran Darah Koroner: Suatu Analisis Vektor
UNIT III

II III
I I

III II

I
J
II
J
III
J
.
LBQBO UJEBL BEB BSVT NFOHBMJS EJ TFLFMJMJOH KBOUVOH /BNVO

TFCFOBSOZB EJ EBMBN UVCVI UFSEBQBU CBOZBL BSVT NFOZJNQBOH QBEB NBTJOHNBTJOH TBEBQBO NFSVQBLBO TFMJTJI BOUBSB
NJTBMOZBBSVTZBOHCFSBTBMEBSJQPUFOTJBMLVMJUEBOZBOHUJNCVM UFHBOHBO FMFLUSPLBSEJPHSBN UFQBU TFCFMVN POTFU HFMPNCBOH 1
BLJCBU QFSCFEBBO LPOTFOUSBTJ JPO QBEB CFSCBHBJ DBJSBO UVCVI EBOOJMBJUFHBOHBOOPMZBOHEJUFUBQLBOEBSJUJUJL+1BEBTBEBQBO
0MFILBSFOBJUV CJMBBEBEVBFMFLUSPEBZBOHUFSIVCVOHEJBOUBSB * UFHBOHBO QPUFOTJBM DFEFSB ZBOH UFSFLBN CFSBEB EJ BUBT OJMBJ
LFEVBMFOHBOBUBVBOUBSBMFOHBOEBOLBLJ BSVTBSVTNFOZJNQBOH QPUFOTJBM OPM NBLB OJMBJOZB QPTJUJG 4FCBMJLOZB QBEB TBEBQBO
JOJ UJEBL NFNVOHLJOLBO VOUVL NFOFUBQLBO OJMBJ SVKVLBO OPM *** QPUFOTJBMDFEFSBUFSMFUBLEJCBXBIHBSJTUFHBOHBOOPM NBLB
TFDBSBUFQBUQBEBFMFLUSPLBSEJPHSBN OJMBJOZBOFHBUJG
%FOHBO BMBTBO JOJ IBSVT EJQBLBJ QSPTFEVS CFSJLVU VOUVL %J CBHJBO CBXBI (BNCBS NBTJOHNBTJOH QPUFOTJBM
NFOFUBQLBO OJMBJ QPUFOTJBM OPM UFSTFCVU 1FSUBNB LJUB IBSVT DFEFSBQBEBTBEBQBO*EBO***EJHBNCBSLBOQBEBLPPSEJOBULF
NFOFOUVLBO MFCJI EBIVMV TFDBSB QBTUJ UJUJL ZBOH NFOVOKVLLBO EVB TBEBQBO JOJ EBO WFLUPS SFTVMUBO EBSJ QPUFOTJBM DFEFSB
CBIXB HFMPNCBOH EFQPMBSJTBTJ CBSV TBKB TFMFTBJ NFMFXBUJ TFMVSVI VOUVL EBSJ QPUFOTJBMDFEFSB VOUVL TFMVSVI NBTTB WFOUSJLFM
KBOUVOH ZBOHUFSEBQBUQBEBBLIJSLPNQMFLT2345FQBUQBEBUJUJL EBQBUEJUFUBQLBOEFOHBOBOBMJTJTWFLUPSZBOHUFMBIEJKFMBTLBO
JOJ TFMVSVI CBHJBO WFOUSJLFM UFMBI UFSEFQPMBSJTBTJ CBJL CBHJBO I
DFEFSBNBVQVOCBHJBOOPSNBM TFIJOHHBUJEBLBEBBSVTNFOHBMJS 0

0
EJTFLFMJMJOHKBOUVOH1BEBUJUJLJOJ BSVTDFEFSBQVOIJMBOH0MFI
LBSFOBJUV QPUFOTJBMFMFLUSPLBSEJPHSBNQBEBTBBUJOJBEBMBIQBEB
UFHBOHBO OPM 1BEB FMFLUSPLBSEJPHSBN UJUJL JOJ EJLFOBM TFCBHBJ
UJUJL+hTFQFSUJZBOHEJQFSMJIBULBOQBEB(BNCBS II
I
0 0
4FMBOKVUOZB VOUVL NFOHBOBMJTJT TVNCV MJTUSJL QPUFOTJBM
DFEFSB ZBOH EJTFCBCLBO PMFI BSVTDFEFSB QBEB
FMFLUSPLBSEJPHSBN EJUBSJL TFCVBI HBSJT IPSJ[POUBM VOUVL II

NBTJOHNBTJOH TBEBQBO TFUJOHHJ UJUJL + (BSJT JOJ TFMBOKVUOZB I
EJKBEJLBO OJMBJ QPUFOTJBM OPM EBMBN FMFLUSPLBSEJPHSBN ZBOH
BLBOEJQBLBJVOUVLNFOHVLVSTFNVBQPUFOTJBMZBOHEJIBTJMLBO
PMFIBSVTDFEFSB I I
Penggunaan Titik J untuk Menggambarkan Sumbu Potensial-

$FEFSB (BNCBS NFNQFSMJIBULBO FMFLUSPLBSEJPHSBN
TBEBQBO * EBO ***
EBSJ KBOUVOH ZBOH NFOHBMBNJ DFEFSB ,FEVB II
SFLBNBONFNQFSMJIBULBOQPUFOTJBMDFEFSB%FOHBOLBUBMBJO UJUJL
+ QBEB NBTJOHNBTJOH FMFLUSPLBSEJPHSBN JOJ UJEBL CFSBEB QBEB
HBSJT ZBOH TBNB EFOHBO TFHNFO 51 %BMBN HBNCBS JOJ EJUBSJL
TFCVBI HBSJT IPSJ[POUBM NFMBMVJ UJUJL + VOUVL NFOVOKVLLBO
OJMBJUFHBOHBOOPMQBEBNBTJOHNBTJOHSFLBNBO1PUFOTJBMDFEFSB
139
Unit lll Jantung
%BMBN DPOUPI JOJ WFLUPS SFTVMUBO CFSBTBM EBSJ TJTJ LBOBO

WFOUSJLFM NFOVKV LF LJSJ EBO TFEJLJU LF BUBT EFOHBO TVNCV
LJSBLJSB EFSBKBU #JMB LJUB MFUBLLBO WFLUPS QPUFOTJBM
DFEFSB JOJ MBOHTVOH EJ BUBT WFOUSJLFM VKVOH OFHBUJG WFLUPS
BLBO NFOHBSBI LF EBFSBI DFEFSB WFOUSJLFM ZBOH I II III V2
UFSEFQPMBSJTBTJ QFSNBOFO 1BEB DPOUPI ZBOH EJQFSMJIBULBO
QBEB (BNCBS EBFSBI DFEFSB CFSBEB QBEB EJOEJOH II III
– –
MBUFSBMWFOUSJLFMLBOBO
"OBMJTJT JOJ KFMBT LPNQMFLT /BNVO NBIBTJTXB IBSVT

NFNCBDBOZB CFSLBMJLBMJ TBNQBJ JB NFNBIBNJOZB EFOHBO
CBJL 5JEBL BEB BTQFL MBJO EBMBN BOBMJTJT FMFLUSPLBSEJPHSBGJ
ZBOHMFCJIQFOUJSJHEBSJQBEBIBMJOJ
Iskemia Koroner sebagai Penyebab Potensial- Cedera

,FLVSBOHBO BMJSBO EBSBI ZBOH NFOHBMJS LF PUPU KBOUVOH BLBO
NFOVSVOLBO NFUBCPMJTNF PUPU LBSFOB UJHB BMBTBO
+ +
LFLVSBOHBO PLTJHFO
BLVNVMBTJ LBSCPO EJPLTJEB ZBOH III II
CFSMFCJIBO EBO
LFLVSBOHBOOVUSJFOEBSJNBLBOBO4FCBHBJ
BLJCBUOZB UJEBLEBQBUUFSKBEJSFQPMBSJTBTJQBEBNFNCSBOPUPUEJ
EBFSBIZBOHNFOHBMBNJJTLFNJBNJPLBSECFSBU4FSJOHLBMJ PUPU
*OGBSL%JOEJOH"OUFSJPS"LVU(BNCBSNFNQFSMJIBULBO
KBOUVOH UJEBL NBUJ LBSFOB BMJSBO EBSBI NBTJI DVLVQ VOUVL
FMFLUSPLBSEJPHSBN QBEB UJHB TBEBQBO BOHHPUBOZB CBEBO EJQPMBS
NFNQFSUBIBOLBOLFIJEVQBOPUPU XBMBVQVOUJEBLDVLVQVOUVL
TUBOEBS EBO TBUV TBEBQBO EBEB TBEBQBO 7
ZBOH EJSFLBN EBSJ
NFOJNCVMLBO SFQPMBSJTBTJ NFNCSBO 4FMBNB LPOEJTJ JOJ NBTJI
TFPSBOH QBTJFO ZBOH NFOHBMBNJ JOGBSL EJOEJOH BOUFSJPS KBOUVOH
CFSMBOHTVOH QPUFOTJBMDFEFSB JOKVSZ QPUFOUJBM
UFSVT NFOHBMJS
BLVU (BNCBSBO EJBHOPTUJL QBMJOH QFOUJOH JBMBI QPUFOTJBMDFEFSB
QBEBCBHJBOEJBTUPMJL CBHJBO51
TFUJBQEFOZVUKBOUVOH
ZBOH TBOHBU LVBU QBEB TBEBQBO EBEB 7; #JMB LJUB UBSJL TFCVBI
*TLFNJB PUPU KBOUVOH ZBOH QBSBI UFSKBEJ TFTVEBI PLMVTJ
HBSJT QPUFOTJBM OPM IPSJ[POUBM NFMFXBUJ UJUJL + QBEB FMFLSPLBS
LPSPOFS EBO TFMBNB JOUFSWBM 51 BOUBS EFOZVU KBOUVOH BSVT
EJPHSBN JOJ EBQBU EJKVNQBJ QPUFOTJBMDFEFSB OFHBUJG ZBOH LVBU
DFEFSB ZBOH LVBU BLBO NFOHBMJS EBSJ EBFSBI WFOUSJLFM ZBOH
TFMBNB JOUFSWBM 51 ZBOH CFSBSUJ CBIXB FMFLUSPEB EBEB QBEB
NFOHBMBNJ JOGBSL TFQFSUJ UBNQBL QBEB (BNCBS EBO
CBHJBO EFQBO KBOUVOH CFSBEB QBEB TVBUV EBFSBI CFSQPUFOTJBM
0MFILBSFOBJUV TBMBITBUVHBNCBSBOEJBHOPTUJLQFOUJOH
OFHBUJG LVBU %FOHBO LBUB MBJO VKVOH OFHBUJG WFLUPS QPUFOTJBM
QBEB FMFLUSPLBSEJPHSBN ZBOH EJSFLBN TFTVEBI UFSKBEJ
DFEFSBQBEBKBOUVOHJOJNFOFNQFMQBEBEJOEJOHEFQBOEBEB)BM
USPNCPTJTLPSPOFSBLVUBEBMBIBSVTDFEFSB DVSSFOUPGJOKVSZ

JOJ CFSBSUJ CBIXB BSVTDFEFSB LF MVBS EBSJ EJOEJOH BOUFSJPS
JOJ
WFOUSJLFM ZBOH NFOFHBLLBO EJBHOPTJT LPOEJTJ JOJ TFCBHBJ JOGBSL
EJOEJOHBOUFSJPS
%FOHBONFMBLVLBOBOBMJTJTBSVTDFEFSBQBEBTBEBQBO*EBO***
LJUBEBQBUNFOKVNQBJTVBUVQPUFOTJBMOFHBUJGQBEBTBEBQBO*EBO
QPUFOTJBM QPTJUJG QBEB TBEBQBO *** )BM JOJ CFSBSUJ CBIXB WFLUPS
SFTVMUBO QPUFOTJBMDFEFSB QBEB KBOUVOH JOJ BEBMBI LJSBLJSB
EFSBKBU EFOHBO VKVOH OFHBUJG JOFOKVSVT LF WFOUSJLFM LJSJ EBO
VKVOH QPTJUJGOZB NFOKVSVT LF WFOUSJLFM LBOBO +BEJ QBEB
FMFLUSPLBSEJPHSBN ZBOH LIVTVT JOJ BSVTDFEFSB UFSVUBNB EBUBOH
EBSJWFOUSJLFMLJSJEBOEBSJEJOEJOHBOUFSJPSKBOUVOH0MFILBSFOB
I II III
JUV LJUB EBQBU NFOZJNQVMLBO CBIXB JOGBSL EJOEJOH BOUFSJPS JOJ
III IBNQJSQBTUJEJTFCBCLBOPMFIUSPNCPTJTDBCBOHEFTFOEFOBOUFSJPS
–
BSUFSJLPSPOBSJBLJSJ
*OGBSL%JOEJOH1PTUFSJPS(BNCBSNFNQFSMJIBULBOUJHB
TBEBQBO BOHHPUB CBEBO CJQPMBS TUBOEBS EBO TBUV TBEBQBO EBEB
I– +I TBEBQBO7
EBSJTFPSBOHQBTJFOZBOHNFOHBMBNJJOGBSLEJOEJOH
QPTUFSJPS (BNCBSBO EJBHOPTUJL VUBNB QBEB FMFLUSPLBSEJPHSBN
JOJ KVHB UFSEBQBU QBEB TBEBQBO EBEB #JMB EJUBSJL TFCVBI HBSJT
SVKVLBO QPUFOTJBM OPM NFMBMVJ UJUJL + QBEB TBEBQBO JOJ UBNQBL
+ KFMBTCBIXBTFMBNBJOUFSWBM51 QPUFOTJBMBSVTDFEFSBOZBQPTJUJG
III *OJ CFSBSUJ CBIXB VKVOH QPTJUJG WFLUPSOZB NFOHBSBI LF EJOEJOH
V2
EBEBBOUFSJPS EBOVKVOHOFHBUJG VKVOHDFEFSBWFLUPS
NFOKBVIJ
EJOEJOHEBEB%FOHBOLBUBMBJO BSVT
140
Bab 12 Penafsiran Elektrokardiografi Kelainan Otot jantung dan Kelainan Aliran Darah Koroner: Suatu Analisis Vektor
DFEFSB CFSBTBM EBSJ TJTJ KBOUVOH ZBOH CFSMBXBOBO EFOHBO EJOEJOH Anterior Posterior
EBEB BOUFSJPS EBO JOJ NFSVQBLBO BMBTBO NFOHBQB UJQF
FMFLUSPLBSEJPHSBN JOJ EJQBLBJ TFCBHBJ EBTBS VOUVL NFOEJBHOPTJT
JOGBSLEJOEJOHQPTUFSJPS
UNIT III
#JMBLJUBNFOHBOBMJTJTQPUFOTJBMDFEFSBQBEBTBEBQBO**EBO***
QBEB (BNCBS UBNQBL KFMBT CBIXB QPUFOTJBMDFEFSB Q Q
CFSNVBUBO OFHBUJG QBEB LFEVB TBEBQBO UFSTFCVU %FOHBO BOBMJTJT I III I III
WFLUPSJ TFQFSUJ ZBOH UBNQBL QBEB HBNCBS JOJ EBQBU EJLFUBIVJ
CBIXB WFLUPS SFTVMUBO QPUFOTJBMDFEFSB BEBMBI LJSBLJSB
EFSBKBU EFOHBO VKVOH OFHBUJG NFOKVSVT LF CBXBI EBO VKVOH
QPTJUJGOZB NFOKVSVT LF BUBT +BEJ LBSFOB JOGBSLOZB CFSBEB EJ
EJOEJOH QPTUFSJPS KBOUVOH ZBOH EJUVOKVLLBO PMFI TBEBQBO EBEB

EBO EJ CBHJBO BQFLT KBOUVOH ZBOH EJUVOKVLLBO PMFI QPUFOTJBM UFUBQJ LBMBV PUPU UJEBL NBUJ KBOUVOH JOJ BLBO UFSVT
DFEFSB QBEB TBEBQBO ** EBO TBEBQBO ***
LJUB EBQBU NFOEVHB NFNQFSMJIBULBOQPUFOTJBMDFEFSBTFMBNBJTLFNJOZBNBTJIBEB
CBIXB JOGBSL JOJ CFSBEB EJ EFLBU BQFLT QBEB EJOEJOH QPTUFSJPS LIVTVTOZB TFXBLUV BLUJWJUBT LFSKB GJTJL TBBU KBOUVOH TBOHBU
WFOUSJLFMLJSJ UFSCFCBOJ
Infark di Bagian Jantung Lainnya %FOHBO QSPTFEVS TBNB Infark Miokard-Pulih Lama. (BNCBS NFOBNQJMLBO
TFQFSUJ ZBOH UFMBI EJKFMBTLBO EBMBN QFNCBIBTBO UFSEBIVMV TBEBQBO*EBO***TFUFMBIJOGBSLBOUFSJPSTFSUBTBEBQBO*EBO***
NFOHFOBJ JOGBSL QBEB EJOEJOH QPTUFSJPS EBO EJOEJOH BOUFSJPS TFUFMBI JOGBSL QPTUFSJPS LJSBLJSB TFUBIVO TFTVEBI TFSBOHBO
UFNQBU EBFSBI JOGBSL ZBOH NFNBODBSLBO BSVT DFEFSB EBQBU KBOUVOH BLVU 3FLBNBO JOJ NFNQFSMJIBULBO BQB ZBOH EJTFCVU
EJUFOUVLBO UBOQBNFOHIJSBVLBOCBHJBOKBOUVOHNBOBZBOHTBLJU TFCBHBJ LPOGJHVSBTJ JEFBM LPNQMFLT 234 UJQFUJQF QFNVMJIBO
6OUVL NFNCVBU BOBMJTJT WFLUPS TFQFSUJ JUV IFOEBLOZB TFMBMV JOGBSL NJPLBSE JOJ #JBTBOZB TFCVBI HFMPNCBOH 2 TVEBI
EJJOHBU CBIXB VKVOH QPTJUJG WFLUPS QPUFOTJBMDFEFSB NFOKVSVT LF NVODVM QBEB BXBM LPNQMFLT 234 EJ TBEBQBO * QBEB JOGBSL
BSBIPUPUKBOUVOHOPSNBM EBOVKVOHOFHBUJGJOFOHBSBILFCBHJBO BOUFSJPS LBSFOB UFSKBEJ LFIJMBOHBO NBTTB PUPU QBEB EJOEJOH
KBOUVOHDFEFSBZBOHNFNBODBSLBOBSVTDFEFSB BOUFSJPS WFOUSJLFM LJSJ UFUBQJ QBEB JOGBSL QPTUFSJPS HFMPNCBOH
Pemulihan dari Trombosis Koroner Akut. (BNCBS 2TVEBIUJNCVMQBEBQFSNVMBBOLPNQMFLT234QBEBTBEBQBO
NFNQFSMJIBULBO TBEBQBO EBEB 7 EBSJ TFPSBOH QBTJFO EFOHBO *** LBSFOBUFSKBEJLFIJMBOHBOPUPUQBEBCBHJBOBQFLTQPTUFSJPS
JOGBSL EJOEJOH QPTUFSJPS BLVU ZBOH NFNQFSMJIBULBO QFSVCBIBO WFOUSJLFM
FMFLUSPLBSEJPHSBN EBSJ IBSJ QFSUBNB TFSBOHBO NJOHHV
5FOUVTBKB HBNCBSBOJOJUJEBLEJKVNQBJQBEBTFNVBLBTVT
LFNVEJBO NJOHHV LFNVEJBO TBNQBJ BLIJSOZB UBIVO
JOGBSL KBOUVOH MBNB ,FIJMBOHBO PUPU TFUFNQBU EBO UJUJLUJUJL
LFNVEJBO %BSJ FMFLUSPLBSEJPHSBN JOJ EBQBU UFSMJIBU CBIXB
MPLBM CMPL LPOEVLTJ TJOZBM KBOUVOH EBQBU NFOZFCBCLBO QPMB
QPUFOTJBMDFEFSBLVBUTFHFSBTFTVEBITFSBOHBOBLVU TFHNFO51
QPMB LPNQMFLT 234 ZBOH TBOHBU BOFI CJ[BSSF
LIVTVTOZB
CFSHFTFS EBSJ TFHNFO 45 LF BSBI QPTJUJG
/BNVO TFUFMBI LJSB
HFMPNCBOH 2 ZBOH NFODPMPL NJTBMOZB
QFOVSVOBO
LJSBNJOHHV QPUFOTJBMDFEFSBTBOHBUCFSLVSBOHEBO NJOHHV
UFHBOHBO EBOQFNBOKBOHBOLPNQMFLT234
TFTVEBIOZB CFOBSCFOBS IJMBOH TBNB TFLBMJ 4FTVEBI JUV
HBNCBSBO FMFLUSPLBSEJPHSBN UJEBL CFHJUV CFSVCBI TFQBOKBOH Arus-Cedera pada Angina Pektoris. h"OHJOB QFLUPSJT
UBIVO CFSJLVUOZB *OJMBI QPMB QFNVMJIBO ZBOH CJBTBOZB UFSKBEJ CFSBSUJSBTBOZFSJZBOHCFSBTBMEBSJKBOUVOHEBOEJSBTBLBOEJ
TFTVEBIJOGBSLNJPLBSEJVNBLVUEFOHBOEFSBKBUNFOFOHBI ZBOH EBFSBI QFLUPSBM EBEB CBHJBO BUBT 3BTB OZFSJ JOJ CJBTBOZB
NFNQFSMJIBULBOCBIXBBMJSBOEBSBILPSPOFSLPMBUFSBMCBSVDVLVQ NFOZFCBS LF EBFSBI MFIFS EBO UVSVO LF MFOHBO LJSJ /ZFSJ
CFSLFNCBOH VOUVL NFOZFEJBLBO LFNCBMJ LFCVUVIBO OVUSJTJ CJBTBOZBEJTFCBCLBOPMFIJTLFNJBKBOUVOHTFEBOH#JMBQBTJFO
TFCBHJBOCFTBSEBFSBIJOGBSL UFOBOH OZFSJ CJBTBOZB UJEBL UFSBTB UFUBQJ CFHJUV EJB CFLFSKB
4FCBMJLOZB QBEB CFCFSBQB QBTJFO JOGBSL NJPLBSEJVN EBFSBI NFNCFCBOJKBOUVOH OZFSJBLBOUJNCVMLFNCBMJ
JOGBSL UJEBL QFSOBI NFOEBQBU LFNCBMJ TVQMBJ EBSBI LPSPOFS ,BEBOHLBEBOH TVBUV QPUFOTJBMDFEFSB NVODVM QBEB
TFDBSBBEFLVBU4FSJOHLBMJ TFCBHJBOPUPUKBOUVOHBLBONBUJ FMFLUSPLBSEJPHSBN TFXBLUV UFSKBEJ TFSBOHBO BOHJOB QFLUPSJT
CFSBU LBSFOB JOTVGJTJFOTJ LPSPOFSOZB NFOKBEJ DVLVQ CFTBS
VOUVLNFOHIBNCBUSFQPMBSJTBTJCFCFSBQBEBFSBIKBOUVOHTFDBSB
BEFLVBUTFMBNBEJBTUPMJL
Kelainan Gelombang T
1BEBCBHJBOBXBMCBCJOJ UFMBIEJTFCVULBOCBIXBHFMPNCBOH5
OPSNBMOZB QPTJUJG QBEB TFNVB TBEBQBO BOHHPUB CBEBO CJQPMBS
1 3 1
TUBOEBS EBO HFMPNCBOH JOJ EJIBTJMLBO PMFI SFQPMBSJTBTJ QBEB
BQFLT EBO QFSNVLBBO MVBS WFOUSJLFM TFCFMVN SFQPMBSJTBTJ EJ
QFSNVLBBOEBMBN WFOUSJLFM %FOHBO EFNJLJBO (FMPNCBOH 5
NFOKBEJ BCOPSNBM CJMB UJEBL UFSKBEJ VSVUVSVUBO SFQPMBSJTBTJ
ZBOH OPSNBM #FCFSBQB GBLUPS EBQBU NFOHVCBI VSVUBO
SFQPMBSJTBTJJOJ
141
Unit lll Jantung
Pengaruh Perlambatan Penghantaran Gelombang

Depolarisasi Terhadap Gelombang T
#JMB EJMJIBU (BNCBS QFSIBUJLBO CBIXB LPNQMFLT 234 T T
TBOHBU NFNBOKBOH "MBTBO NFOHBQB UFSKBEJ QFNBOKBOHBO JOJ
BEBMBI QFSMBNCBUBO QFOHIBOUBSBO EJ EBMBN WFOUSJLFM LJSJ
TFCBHBJ BLJCBU EBSJ CMPL QBEB DBCBOH LJSJ CFSLBT 1FSMBNCBUBO
JOJ NFOZFCBCLBO WFOUSJLFM LJSJ UFSEFQPMBSJTBTJ LJSBLJSB
EFUJL TFTVEBI EFQPMBSJTBTJ WFOUSJLFM LBOBO TFIJOHHB BLBO
NFOHIBTJMLBO WFLUPS 234 SBUBSBUB ZBOH LVBU LF BSBI LJSJ
/BNVO QFSJPEF SFGSBLUFS NBTTB PUPU WFOUSJLFM LBOBO EBO LJSJ
TFCFOBSOZB UJEBL CBOZBL CFSCFEB TBUV TBNB MBJOOZB 0MFI
LBSFOB JUV WFOUSJLFM LBOBO JOVMBJ NFOHBMBNJ SFQPMBSJTBTJ KBVI 4FKBVI JOJ JTLFNJB SJOHBO NFSVQBLBO QFOZFCBC QBMJOH TFSJOH
TFCFMVN WFOUSJLFM LJSJ IBM JOJ NFOZFCBCLBO WFOUSJLFM LBOBO QFNFOEFLBO EFQPMBSJTBTJ PUPU KBOUVOH LBSFOB JTLFNJB SJOHBO
CFSNVBUBO QPTJUJG LVBU EBO WFOUSJLFM LJSJ CFSNVBUBO OFHBUJG NFOJOHLBULBO BMJSBO BSVT MJTUSJL NFMBMVJ LBOBM LBMJVN ,BMBV
QBEB TBBU TFEBOH UFSCFOUVL HFMPNCBOH 5 %FOHBO LBUB MBJO JTLFNJB IBOZB UFSKBEJ QBEB TBUV EBFSBI KBOUVOH QFSJPEF
TVNCVSBUBSBUBHFMPNCBOH5TFLBSBOHCFSHFTFSLFLBOBO ZBOH EFQPMBSJTBTJEJEBFSBIUFSTFCVUKBVINFNFOEFLEJCBOEJOHEFOHBO
CFSMBXBOBOEFOHBOBSBITVNCVMJTUSJLSBUBSBUBLPNQMFLT234 EBFSBI KBOUVOH MBJOOZB 4FCBHBJ BLJCBUOZB EBQBU UFSKBEJ
QBEB FMFLUSPLBSEJPHSBN ZBOH TBNB +BEJ CJMB QFOHIBOUBSBO QFSVCBIBOHFMPNCBOH5ZBOHOZBUB*TLFNJBEBQBUUFSKBEJBLJCBU
JNQVMT EFQPMBSJTBTJ ZBOH NFMFXBUJ WFOUSJLFM TBOHBU UFSMBNCBU PLMVTJ LPSPOFS QSPHSFTJG LSPOJL PLMVTJ LPSPOFS BLVU BUBV
HFMPNCBOH 5 IBNQJS TFMBMV NFNJMJLJ QPMBSJUBT CFSMBXBOBO JOTVGJTJFOTJLPSPOFSSFMBUJGZBOHUFSKBEJTFXBLUVLFSKBGJTJL
EFOHBOQPMBSJUBTLPNQMFLT234
4VBUV DBSB VOUVL NFOHFUBIVJ JOTVGJTJFOTJ LPSPOFS SJOHBO
Pemendekan Depolarisasi di Bagian Otot Ventrikel BEBMBI NFOZVSVI QBTJFO NFMBLVLBO LFSKB GJTJL EBO NFSFLBN
Sebagai Penyebab Kelainan Gelombang T FMFLUSPLBSEJPHSBN TBNCJM NFMJIBU BQBLBI BEB QFSVCBIBO QBEB
HFMPNCBOH 5 BUBV UJEBL 1FSVCBIBO QBEB HFMPNCBOH 5 UJEBL
#JMB CBTJT WFOUSJLFM TBNQBJ NFNQFSMJIBULBO QFSJPEF QFSMV TQFTJGJL TFCBC TFUJBQ QFSVCBIBO QBEB HFMPNCBOH 5 EJ
EFQPMBSJTBTJ ZBOH BNBU QFOEFL ZBLOJ QFNFOEFLBO QPUFOTJBM TBEBQBO NBOB QVO NJTBMOZB HFMPNCBOH JOWFSTJ BUBV CJGBTJL
BLTJ SFQPMBSJTBTJ WFOUSJLFM UJEBL BLBO EJNVMBJ EJ CBHJBO BQFLT TFSJOH LBMJ DVLVQ NFOKBEJ CVLUJ CBIXB CFCFSBQB CBHJBO PUPU
TFQFSUJ QBEB LFBEBBO OPSNBM 4FCBMJLOZB CBTJT WFOUSJLFM BLBO WFOUSJLFMNFNQVOZBJQFSJPEFEFQPMBSJTBTJZBOHKBVIMFCJIQFOEFL
NFOHBMBNJ SFQPMBSJTBTJ MFCJI EBIVMV EBSJQBEB CBHJBO BQFLT EBSJQBEB CBHJBO KBOUVOH MBJOOZB EBO JOJ NVOHLJO EJTFCBCLBO
EBO WFLUPS SFQPMBSJTBTJ BLBO NFOHBSBI EBSJ BQFLT NFOVKV LF PMFIJOTVGJTJFOTJLPSPOFSSJOHBOTBNQBJTFEBOH
CBTJT KBOUVOH CFSMBXBOBO EFOHBO WFLUPS SFQPMBSJTBTJ TUBOEBS Pengaruh Obat Digitalis terhadap Gelombang T 4FQFSUJ
4FCBHBJ BLJCBUOZB HFMPNCBOH 5 ZBOH UFSFLBN QBEB LFUJHB EJCBIBT EBMBN #BC EJHJUBMJT BEBMBI TFKFOJT PCBU ZBOH EBQBU
TBEBQBO TUBOEBS BLBO OFHBUJG EBO CVLBO QPTJUJG TFQFSUJ EJCFSJLBO QBEB JOTVGJTJFOTJ LPSPOFS VOUVL NFOJOHLBULBO
CJBTBOZB +BEJ GBLUB TFEFSIBOB CBIXB CBTJT WFOUSJLFM LFLVBUBOLPOUSBLTJPUPUKBOUVOH/BNVO LBMBVEJCFSJLBOEJHJUBMJT
NFNQVOZBJQFSJPEFEFQPMBSJTBTJZBOHNFNFOEFLTVEBIDVLVQ EBMBN EPTJT CFSMFCJI EVSBTJ EFQPMBSJTBTJ QBEB TBUV CBHJBO
VOUVL NFOZFCBCLBO QFSVCBIBO OZBUB QBEB HFMPNCBOH 5 WFOUSJLFMEBQBUNFOJOHLBUKBVIEJCBOEJOHEFOHBOCBHJBOMBJOOZB
CBILBO TBNQBJ NFOHVCBI QPMBSJUBT TFMVSVI HFMPNCBOH 5 4FCBHBJ BLJCBUOZB EBQBU UFSKBEJ QFSVCBIBO OPOTQFTJGJL NJTBMOZB
TFQFSUJEJQFSMJIBULBOQBEB(BNCBS JOWFSTJ HFMPNCBOH 5 BUBV HFMPNCBOH 5 CJGBTJL QBEB TBMBI TBUV
BUBV CFCFSBQB TBEBQBO FMFLUSPLBSEJPHSBGJL (FMPNCBOH 5 CJGBTJL
ZBOHEJTFCBCLBOPMFIQFNCFSJBOEJHJUBMJTCFSMFCJIBOEBQBUEJMJIBU
T T T T
QBEB(BNCBS0MFILBSFOBJUV QFSVCBIBOQFSVCBIBOQBEB
HFMPNCBOH 5 TFXBLUV QFNCFSJBO EJHJUBMJT TFSJOH LBMJ NFOKBEJ
UBOEBEJOJLFSBDVOBOEJHJUBMJT
Daftar Pustaka
Lihatdaftarpustaka pada Bab 13.
142
BAB 13
UNIT III
"SJUNJB+BOUVOHEBO1FOBGTJSBO
&MFLUSPLBSEJPHSBN
#FCFSBQB UJQF LFMBJOBO GVOHTJ EFOZVU QFS EFSBKBU $FMTJVT

TBNQBJ TVIV UVCVI LJSBLJSB
KBOUVOHZBOHQBMJOHCFSCBIBZBCVLBO NFODBQBJ ¡' ¡$
EJ BUBT TVIV JOJ GSFLVFOTJ EFOZVU
UFSKBEJ LBSFOB LFMBJOBO PUPU KBOUVOH KBOUVOHEBQBUNFOVSVOLBSFOBNFMFNBIOZBPUPUKBOUVOHTFDBSB
UFUBQJ LBSFOB JSBNB KBOUVOH QSPHSFTJG BLJCBU EFNBN %FNBN NFOZFCBCLBO UBLJLBSEJB
BCOPSNBM 4FCBHBJ DPOUPI LBEBOH LBSFOB LFOBJLBO TVIV BLBO NFOJOHLBULBO LFDFQBUBO
LBEBOH EFOZVU BUSJVN UJEBL NFUBCPMJTNF OPEVT TJOVT ZBOH TFMBOKVUOZB TFDBSB MBOHTVOH
UFSLPPSEJOBTJEFOHBOEFOZVUEFOHBO NFOJOHLBULBOFLTJUBCJMJUBTEBOGSFLVFOTJJSBNBKBOUVOH
EFOZVU WFOUSJLFM TFIJOHHB BUSJVN UJEBL MBHJ CFSGVOHTJ TFCBHBJ #FSCBHBJ GBLUPS ZBOH EBQBU NFOZFCBCLBO TJTUFN TBSBG
QPNQBQFOEBIVMVCBHJWFOUSJLFM TJNQBUJTNFSBOHTBOHKBOUVOH BLBOEJCJDBSBLBOQBEBCFCFSBQB
5VKVBO CBC JOJ BEBMBI VOUVL NFNCBIBT GJTJPMPHJ BSJUNJB UPQJLEBMBNCVLVUFLTJOJ4FCBHBJDPOUPI CJMBTFPSBOHQBTJFO
KBOUVOH ZBOH VNVN UFSKBEJ EBO QFOHBSVIOZB UFSIBEBQ EBZB LFIJMBOHBO EBSBI EBO CFSBEB EBMBN LFBEBBO TZPL BUBV TFNJ
QPNQB KBOUVOH KVHB DBSB NFOEJBHOPTJTOZB EFOHBO TZPL SBOHTBOHBOSFGMFLTTJNQBUJTQBEBKBOUVOHTFSJOHLBMJBLBO
FMFLUSPLBSEJPHSBN 1FOZFCBC BSJUNJB KBOUVOH CJBTBOZB NFOJOHLBULBOGSFLVFOTJEFOZVUKBOUVOHIJOHHBTBNQBJ
NFSVQBLBO TBUV BUBV HBCVOHBO EBSJ LFMBJOBO EBMBN TJTUFN EFOZVUNFOJU
JSBNBLPOEVLTJKBOUVOH TFQFSUJCFSJLVUJOJ ,FMFNBIBO SJOHBO QBEB NJPLBSEJVN CJBTBOZB BLBO
1. *SBNBQJDVKBOUVOHBCOPSNBM NFOJOHLBULBO GSFLVFOTJ EFOZVU KBOUVOH LBSFOB KBOUVOH ZBOH
2. 1FSHFTFSBO QJDV KBOUVOH EBSJ OPEVT TJOVT LF UFNQBU MBJO EJ MFNBI UJEBL EBQBU NFNPNQB EBSBI LF EBMBN TJTUFN BSUFSJ
KBOUVOH EBMBN KVNMBI OPSNBM EBO LFBEBBO JOJ NFOJNCVMLBO SFGMFLT
TJNQBUJTVOUVLNFOJOHLBULBOGSFLVFOTJEFOZVUKBOUVOH
. #MPL EJ CFCFSBQB UFNQBU CFSCFEB QBEB EBFSBI QFOZFCBSBO
JNQVMTEJKBOUVOH Bradikardia
4. +BMVSQFOKBMBSBOJNQVMTBCOPSNBMEJKBOUVOH *TUJMBI CSBEJLBSEJB CFSBSUJ GSFLVFOTJ EFOZVU KBOUVOH ZBOH
5. 1FNCFOUVLBO JNQVMT QBMTV TQPOUBO QBEB IBNQJS TFNVB MBNCBU CJBTBOZB EJUFUBQLBO LVSBOH EBSJ EFOZVUNFOJU
CBHJBOKBOUVOH (BNCBSBO FMFLUSPLBSEJPHSBN CSBEJLBSEJB EBQBU EJMJIBU QBEB
(BNCBS
Irama Sinus Abnormal Bradikardia pada Olahragawan. +BOUVOHPMBISBHBXBOKBVI
MFCJI LVBU EBO MFCJI CFTBS EBSJ QBEB PSBOH OPSNBM TFIJOHHB
Takikardia NFNVOHLJOLBOKBOUVOHPMBISBHBXBOVOUVLNFNPNQBJTJTF
*TUJMBI UBLJLBSEJB CFSBSUJ EFOZVU KBOUVOH DFQBU CJBTBOZB
EJEFGJOJTJLBO QBEB PSBOH EFXBTB TFCBHBJ MFCJI EBSJ EFOZVU
NFOJU &MFLUSPLBSEJPHSBN ZBOH EJSFLBN EBSJ TFPSBOH QBTJFO
EFOHBO UBLJLBSEJB EBQBU EJMJIBU QBEB (BNCBS (BNCBSBO
FMFLUSPLBSEJPHSBN JOJ OPSNBM LFDVBMJ QBEB GSFLVFOTJ EFOZVU
KBOUVOHOZB TFQFSUJZBOHEJUFOUVLBOEBSJJOUFSWBMXBLUVEJBOUBSB akika dia sin s sada an
LPNQMFLT 234 BEBMBI LJSBLJSB LBMJNFOJU EJCBOEJOHLBO
EFOHBOGSFLVFOTJOPSNBMTFCFTBSLBMJNFOJU
#FCFSBQB QFOZFCBC UBLJLBSEJB NFMJQVUJ LFOBJLBO TVIV UVCVI
SBOHTBOHBOKBOUVOHPMFITBSBGTJNQBUJT BUBVLFBEBBOUPLTJLQBEB
KBOUVOH
'SFLVFOTJEFOZVUKBOUVOHNFOJOHLBULJSBLJSBEFOZVUNFOJU
VOUVLTFUJBQLFOBJLBOTVIVUVCVITFCFTBSTBUVEFSBKBU'BISFOIFJU adika dia sin s sada an
143
Unit III Jantung
LVODVQ ZBOH MFCJI CFTBS EJ TFUJBQ EFOZVUOZB CBILBO TBBU lok
JTUJSBIBU 1BEB XBLUV PMBISBHBXBO EBMBN LFBEBBO JTUJSBIBU
UFSEBQBU LFMFCJIBO KVNMBI EBSBI ZBOH EJQPNQBLBO LF EBMBN
TJTUFN BSUFSJ QBEB TFUJBQ EFOZVUOZB TFIJOHHB IBM JOJ BLBO
NFSBOHTBOH SFGMFLT VNQBO CBMJL TJSLVMBTJ BUBV FGFLFGFL MBJO lok nod s sinoa i m dengan i ama nod s
VOUVLNFOZFCBCLBOCSBEJLBSEJB sada an
Rangsangan Saraf Vagus sebagai Penyebab Bradikardia.
4FUJBQ SFGMFLT TJSLVMBTJ ZBOH NFSBOHTBOH TBSBG WBHVT EBQBU EBEBL HFMPNCBOH 1 EFOHBO BLJCBU QFOHIFOUJBO BUSJVN "LBO
NFOZFCBCLBO QFMFQBTBO BTFUJMLPMJO QBEB VKVOH TBSBG WBHVT EJ UFUBQJ WFOUSJLFM BLBO NFOHBNCJM JSBNB CBSV ZBJUV JNQVMT ZBOH
KBOUVOH TFIJOHHB NFOZFCBCLBO FGFL QBSBTJNQBUJT .VOHLJO CJBTBOZBUJNCVMTQPOUBOEBSJOPEVTBUSJPWFOUSJLFM "7
TFIJOHHB
DPOUPI ZBOH QBMJOH OZBUB BEBMBI QBEB QBTJFO EFOHBO TJOESPN GSFLVFOTJLPNQMFLTWFOUSJLFM2345IBOZBNFMBNCBUUFUBQJUJEBL
TJOVT LBSPUJT 1BEB QBTJFO JOJ SFTFQUPS UFLBOBO CBSPSFTFQUPS
EJ NFOHVCBIIBMMBJOOZB
EBFSBITJOVTLBSPUJTQBEBEJOEJOHBSUFSJLBSPUJTTBOHBUQFLB0MFI
Blok Atrioventrikel
LBSFOB JUV CBILBO UFLBOBO ZBOH SJOHBO QBEB EBFSBI MFIFS BLBO
NFOJNCVMLBO SFGMFLT CBSPSFTFQUPS ZBOH LVBU TFIJOHHB +BMBO TBUVTBUVOZB ZBOH CJBTB EJMBMVJ JNQVMT EBSJ BUSJVN LF
NFOZFCBCLBOQFOHBSVIWBHVTBTFUJMLPMJOZBOHLVBUQBEBKBOUVOH WFOUSJLFM BEBMBI NFMBMVJ CFSLBT "7 ZBOH KVHB EJLFOBM TFCBHBJ
UFSNBTVL KVHB CSBEJLBSEJB IFCBU 5FOUV TBKB LBEBOHLBEBOH CFSLBT)JT #FSCBHBJLFBEBBOZBOHEBQBUNFOVSVOLBOLFDFQBUBO
SFGMFLT JOJ CFHJUV LVBU TFIJOHHB EBQBU NFOHIFOUJLBO KBOUVOH LPOEVLTJ JNQVMT EJ EBMBN CFSLBT JOJ BUBV ZBOH TBNB TFLBMJ
TFMBNBTBNQBJEFUJL NFNCMPLJNQVMT BEBMBITFCBHBJCFSJLVU
Aritmia Sinus 1. *TLFNJBQBEBOPEVT"7BUBVTFSBUTFSBUCFSLBT"7TFSJOHLBMJ
(BNCBS NFNQFSMJIBULBO SFLBNBO GSFLVFOTJ EFOZVU NFNQFSMBNCBU BUBV NFNCMPL LPOEVLTJ EBSJ BUSJVN LF
KBOUVOH QBEB LBSEJPUBLPNFUFS CBHJBO QFSUBNB EJMBLVLBO WFOUSJLFM *OTVGJTJFOTJ LPSPOFS EBQBU NFOZFCBCLBO JTLFNJB
TFMBNB SFTQJSBTJ OPSNBM EBO LFNVEJBO QBEB SFLBNBO CBHJBO QBEBOPEVT"7EBOKVHBCFSLBT"7EFOHBODBSBZBOHTBNB
LFEVB
EJMBLVLBO TFMBNB SFTQJSBTJ EBMBN ,BSEJPUBLPNFUFS TFQFSUJLFUJLBNFOZFCBCLBOJTLFNJBNJPLBSEJVN
NFSVQBLBOBMBUZBOHNFSFLBNMBNBOZBTFMBOHXBLUVEJBOUBSB 2. ,PNQSFTJ EJ CFSLBT "7 PMFI KBSJOHBO QBSVU BUBV PMFI CBHJBO
LPNQMFLT 234 ZBOH CFSVSVUBO EBMBN FMFLUSPLBSEJPHSBN KBOUVOH ZBOH NFOHBMBNJ LBMTJGJLBTJ EBQBU NFOFLBO BUBV
CFSEBTBSLBO UJOHHJ HFMPNCBOH QVODBL ZBOH CFSVSVUBO %BSJ NFNCMPLLPOEVLTJEBSJBUSJVNLFWFOUSJLFM
SFLBNBO JOJ EBQBU EJMJIBU CBIXB GSFLVFOTJ EFOZVU KBOUVOH 3. *OGMBNBTJ QBEB OPEVT "7 BUBV CFSLBT "7 EBQBU NFOFLBO
NFOJOHLBU EBO NFOVSVO UJEBL MFCJI EBSJ QFSTFO TFMBNB GBTF LPOEVLUJWJUBTEBSJBUSJVNTBNQBJLFWFOUSJLFM*OGMBNBTJTFSJOH
TJLMVT SFTQJSBTJ ZBOH UFOBOH TJTJ LJSJ SFLBNBO
,FNVEJBO EJTFCBCLBO PMFI KFOJT NJPLBSEJUJT ZBOH CFSCFEB NJTBMOZB
TFMBNB SFTQJSBTJ EBMBN GSFLVFOTJ EFOZVU KBOUVOH NFOJOHLBU EJGUFSJBUBVEFNBNSFVNBUJL
EBONFOVSVOQBEBTFUJBQTJLMVTSFTQJSBTJTFCBOZBLQFSTFO 4. 4UJNVMBTJLVBUQBEBKBOUVOHPMFIOFSWVTWBHVTQBEBLBTVTZBOH
"SJUNJBTJOVTEBQBUEJUJNCVMLBOPMFITBUVBUBVMFCJILFBEBBO
KBSBOH BLBO NFNCMPL LPOEVLTJ JNQVMT NFMBMVJ OPEVT "7
TJSLVMBTJ ZBOH NFOHVCBI LFLVBUBO TJOZBM TBSBG TJNQBUJT EBO
&LTJUBTJ WBHVT ZBOH EFNJLJBO LBEBOHLBEBOH EJTFCBCLBO PMFI
QBSBTJNQBUJT LF OPEVT TJOVT EJ KBOUVOH 1BEB BSJUNJB TJOVT UJQF
SBOHTBOHBO LVBU QBEB CBSPSFTFQUPS ZBOH EJUFNVLBO QBEB
SFTQJSBUPSJL TFQFSUJ ZBOH EJUVOKVLLBO QBEB (BNCBS
QBTJFO EFOHBO TJOESPN TJOVT LBSPUJT ZBOH UFMBI EJCJDBSBLBO
LFBEBBO JOJ UFSVUBNB EJTFCBCLBO PMFI UVNQBIOZB TJOZBM ZBOH
TFCFMVNOZBTFIVCVOHBOEFOHBOCSBEJLBSEJB
LFMVBS EBSJ QVTBU SFTQJSBTJ EJ NFEVMB LF EBMBN QVTBU WBTPNPUPS
ZBOHCFSEFLBUBO ZBOHUFSKBEJTFMBNBTJLMVTJOTQJSBTJEBOFLTQJSBTJ Blok Jantung Atrioventrikel Inkomplet
QFSOBQBTBO4JOZBMTJOZBMZBOHUVNQBILFMVBSBLBONFOZFCBCLBO Perpanjangan Interval. P-R (atau P-Q)—Blok Derajat
QFOJOHLBUBO EBO QFOVSVOBO KVNMBI JNQVMT ZBOH EJIBOUBSLBO
Pertama. #JMB KBOUVOH CFSEFOZVU EBMBN GSFLVFOTJ ZBOH OPSNBM
NFMBMVJTBSBGTJNQBUJTEBOWBHVTLFKBOUVOH
TFMBOHXBLUVZBOHCJBTBOZBUFSKBEJBOUBSBQFSNVMBBOHFMPNCBOH1
EBOQFSNVMBBOLPNQMFLT234BEBMBILJSBLJSB EFUJL*OUFSWBM
Irama Abnormal Akibat Blok pada Sinyal Jantung di UFSTFCVU ZBOH CJBTBOZB EJTFCVU EFOHBO JOUFSWBM 13 CJBTBOZB
Dalam Jalur Konduksi Intrakardiak NFNFOEFLQBEBEFOZVUKBOUVOHZBOHMFCJIDFQBUEBONFNBOKBOH
QBEB EFOZVU KBOUVOH ZBOH MFCJI MBNCBU 1BEB VNVNOZB CJMB
Blok Sinoatrium JOUFSWBM13NFOJOHLBUMFCJICFTBSEBSJ EFUJL NBLBJOUFSWBM1
3 EJLBUBLBO NFNBOKBOH EBO QBTJFO EJLBUBLBO NFOHBMBNJ CMPL
1BEBLFBEBBOZBOHKBSBOH JNQVMTEBSJOPEVTTJOVTEJIBNCBU
KBOUVOHJOLPNQMFUEFSBKBUQFSUBNB
TFCFMVN NFNBTVLJ PUPU BUSJVN 'FOPNFOB JOJ EJUVOKVLLBO
QBEB(BNCBS ZBOHNFNQFSMJIBULBOQFOHIFOUJBONFO (BNCBSNFOVOKVLLBOFMFLUSPLBSEJPHSBNEFOHBOJOUFSWBM
13ZBOHNFNBOKBOHJOUFSWBMQBEBLFBEBBOJOJLJSBLJSB
60
jan ng
70
80 P P P P P
en
100
120
i mia sin s ang di ekam ole

ka dio akome e isi ki i me akan ekaman ke ika e na as e anjangan in e al ang dise a kan ole
no mal sisi kanan ke ika e na as dalam lok de aja e ama sada an i
144
Bab 13 Aritmia Jantung dan Penafsiran Elektrokardiogram
EFUJL TFCBMJLOZBQBEBZBOHOPSNBM EFUJLBUBVLVSBOH+BEJ Sindrom Stokes-Adams—Ventricular Escape.

CMPLEFSBKBUQFSUBNBEJEFGJOJTJLBOTFCBHBJQFSMBNCBUBOLPOEVLTJ 1BEB CFCFSBQB QBTJFO EFOHBO CMPL "7 CMPL UPUBMEBUBOHEBO
EBSJ BUSJVN LF WFOUSJLFM UFUBQJ TFCFOBSOZB UJEBL NFNCMPL QFSHJZBJUVCBIXBJNQVMTEJIBOUBSLBOEBSJBUSJVNLFWFOUSJLFM
LPOEVLTJ*OUFSWBM13KBSBOHNFOJOHLBUEJBUBT TBNQBJ VOUVLXBLUVUFSUFOUV EBOLFNVEJBOUJCBUJCBUJEBLBEBJNQVMT
UNIT III
EFUJL LBSFOB QBEB TBBU JUV LPOEVLTJ NFMBMVJ CFSLBT "7 BLBO ZBOH EJIBOUBSLBO -BNBOZB CMPL EBQBU CFSMBOHTVOH TFMBNB
TBOHBU UFSUFLBO TFIJOHHB LPOEVLTJ BLBO CFSIFOUJ TBNB TFLBMJ CFCFSBQB EFUJL CFCFSBQB NFOJU CFCFSBQB KBN CBILBO
4BMBI TBUV DBSB VOUVL NFOFOUVLBO CFSBUOZB CFCFSBQB QFOZBLJU CFSNJOHHVNJOHHV BUBV MFCJI MBNB MBHJ TFCFMVN LPOEVLTJ
KBOUVOH TFQFSUJ QFOZBLJU KBOUVOH SFVNBUJL BLVU BEBMBI EFOHBO LFNCBMJ OPSNBM ,FBEBBO JOJ UFSKBEJ QBEB KBOUVOH EFOHBO
NFOFOUVLBOJOUFSWBM13 TJTUFNLPOEVLTJZBOHNFOHBMBNJJTLFNJBCPSEFSMJOF
Blok Derajat Dua. #JMB LPOEVLTJ ZBOH NFMBMVJ CFSLBT "7 4FUJBQ UFSKBEJ QFOHIFOUJBO LPOEVLTJ "7 WFOUSJLFM TFSJOH
EJQFSMBNCBU TFIJOHHB DVLVQ VOUVL NFOJOHLBULBO JOUFSWBM 13 LBMJ UJEBL NVMBJ CFSEFOZVU TFOEJSJ TBNQBJ TFUFMBI BEB
EBSJ TBNQBJ EFUJL LBEBOHLBEBOH QPUFOTJBM BLTJ DVLVQ QFSMBNCBUBOTFMBNBIJOHHBEFUJL)BMJOJBLJCBUGFOPNFOB
LVBUVOUVLNFMFXBUJCFSLBT"7NFOVKVLFEBMBNWFOUSJLFMEBO ZBOH EJTFCVU TVQSFTJ ZBOH CFSMFCJIBO )BM JOJ CFSBSUJ CBIXB
LBEBOHLBEBOH QPUFOTJBM BLTJ UFSTFCVU UJEBL DVLVQ LVBU 1BEB FLTJUBCJMJUBT WFOUSJLFM QBEB NVMBOZB EBMBN LFBEBBO UFSUFLBO
LFBEBBO JO BLBO UFSEBQBU HFMPNCBOH 1 BUSJVN UFUBQJ UJEBL LBSFOB WFOUSJLFM UFMBI EJLFOEBMJLBO PMFI BUSJVN QBEB TVBUV
UFSEBQBU HFMPNCBOH 2345 EBO EJLBUBLBO BEB EFOZVU ZBOH GSFLVFOTJ ZBOH MFCJI CFTBS EJCBOEJOHLBO GSFLVFOTJ BUBV JSBNB
IJMBOH ESPQQFE CFBUT
EBSJ WFOUSJLFM ,FBEBBO JOJ EJTFCVU CMPL WFOUSJLFM ZBOH BTMJ /BNVO EFNJLJBO TFUFMBI CFCFSBQB EFUJL
KBOUVOHEFSBKBUEVB CFCFSBQB CBHJBO EBSJ TJTUFN 1VSLJOKF EJ MVBS UFNQBU ZBOH
(BNCBS NFOVOKVLLBO JOUFSWBM 13 TFCFTBS EFUJL UFSCMPL CJBTBOZBQBEBCBHJBOEJTUBMOPEVT"7EJMVBSUFNQBU
EBO KVHB NFNQFSMJIBULBO TBUV EFOZVU WFOUSJLFM ZBOH IJMBOH ZBOH UFSCMPL EJ OPEVT BUBV EJ EBMBN CFSLBT "7 NVMBJ
TFCBHBJBLJCBULFHBHBMBOLPOEVLTJEBSJBUSJVNLFWFOUSJLFM NFMFQBTLBO JNQVMT TFDBSB SJUNJT EFOHBO GSFLVFOTJ TBNQBJ
"EB LBMBOZB TBUV EBSJ EVB EFOZVU WFOUSJLFM IJMBOH TFIJOHHB LBMJ NFOJU EBO CFSUJOEBL TFCBHBJ QJDV KBOUVOH WFOUSJLFM
UFSKBEJ JSBNB EJ NBOB BUSJVN CFSEFOZVU EVB LBMJ VOUVL )BMJOJEJTFCVUTFCBHBJWFOUSJDVMBSFTDBQF
TFUJBQ TBUV EFOZVU WFOUSJLFM 1BEB LFBEBBO ZBOH MBJO UJNCVM 0MFILBSFOBPUBLUJEB,EBQBUUFSVTBLUJGTFMBNBMFCJIEBSJ
JSBNBMBJO TFQFSUJBUBV TBNQBJEFUJLUBOQBTVQMBJEBSBI TFCBHJBOCFTBSQBTJFOBLBO
QJOHTBOTFMBNBCFCFSBQBEFUJLTFUFMBIUJNCVMCMPLUPUBM LBSFOB
Blok A-V Total (Blok Derajat Tiga). #JMB LFBEBBO ZBOH KBOUVOH UJEBL NFNPNQB EBSBI TFMBNB TBNQBJ EFUJL
NFOZFCBCLBO LPOEVLTJ CVSVL EBMBN OPEVT "7 BUBV CFSLBT TBNQBJ WFOUSJLFM MFQBT FTDBQF
"LBO UFUBQJ TFUFMBI MFQBT
"7 NFOKBEJ TBOHBU CFSBU NBLB EBQBU UFSKBEJ CMPL UPUBM WFOUSJLFM ZBOH CFSEFOZVU MBNCBU QVO CJBTBOZB NFNPNQB
UFSIBEBQ JNQVMT EBSJ BUSJVN LF WFOUSJLFM 1BEB LFBEBBO JOJ DVLVQCBOZBLEBSBITFIJOHHBEFOHBODFQBUQBTJFOEBQBUQVMJI
WFOUSJLFM TFDBSB TQPOUBO NFNCFOUVL TJOZBMOZB TFOEJSJ EBSJ LFBEBBO QJOHTBO EBO LFNVEJBO UFSVT NFNQFSUBIBOLBO
CJBTBOZBCFSBTBMEBSJOPEVT"7BUBVCFSLBT"70MFILBSFOB BHBS JB UFUBQ TBEBS 4FSBOHBO QJOHTBO QFSJPEJL JOJ EJLFOBM
JUV HFMPNCBOH 1 UBNQBL UFSQJTBI EBSJ LPNQMFLT 2345 TFCBHBJTJOESPN4UPLFT"EBNT
TFQFSUJ UFSMJIBU EBMBN (BNCBS 1FSIBUJLBO CBIXB ,BEBOHLBEBOH TFMBOH XBLUV QFOHIFOUJBO WFOUSJLFM QBEB
GSFLVFOTJ JSBNB BUSJVN EBMBN FMFLUSPLBSEJPHSBN JOJ LJSBLJSB QFSNVMBBO CMPL UPUBM CFHJUV MBNB TFIJOHHB NFSVHJLBO
LBMJNFOJU TFEBOHLBO GSFLVFOTJ EFOZVU WFOUSJLFM LVSBOH LFTFIBUBO QBTJFO BUBV CBILBO NFOZFCBCLBO LFNBUJBO
EBSJ LBMJNFOJU 4FMBJO JUV UJEBL BEB IVCVOHBO BQBQVO "LJCBUOZB TFCBHJBO CFTBS EBSJ QBTJFO JOJ EJMFOHLBQJ EFOHBO
BOUBSB JSBNB HFMPNCBOH 1 EFOHBO JSBNB LPNQMFLT 2345 BMBU QJDV KBOUVOH CVBUBO ZBJUV TFCVBI TUJNVMBUPS MJTUSJL LFDJM
LBSFOB WFOUSJLFM UFMBI MFQBT FTDBQF
EBSJ QFOHFOEBMJBO ZBOHEJPQFSBTJLBOEFOHBOCBUFSBJEBOEJUBOBNEJCBXBILVMJU
BUSJVN EBOWFOUSJLFMCFSEFOZVUEFOHBOLFDFQBUBOBMBNJBIOZB TFEBOHLBO FMFLUSPEBOZB CJBTBOZB EJIVCVOHLBO EFOHBO
TFSJOH LBMJ EJLFOEBMJLBO PMFI TJOZBMTJOZBM SJUNJT ZBOH WFOUSJLFM LBOBO "MBU QJDV KBOUVOH JOJ NFNCFSJLBO JNQVMT
EJDFUVTLBOEJOPEVT"7BUBVCFSLBT"7 SJUNJTEBOLPOUJOV NFOHBNCJMBMJILFOEBMJUFSIBEBQWFOUSJLFM
en ang ilang Blok Intraventrikel Inkomplet—Listrik Selang-seling

4FCBHJBO CFTBS GBLUPS ZBOH EBQBU NFOZFCBCLBO CMPL "7
EBQBUKVHBNFNCMPLLPOEVLTJJNQVMTEJUFQJTJTUFN1VSLJOKF
P P P P P P
WFOUSJLFM (BNCBS NFOHHBNCBSLBO LFBEBBO ZBOH
EJLFOBMTFCBHBJMJTUSJLTFMBOHTFMJOH FMFDUSJDBMBMUFSOBOT
ZBOH
UFSKBEJ BLJCBU CMPL JOUSBWFOUSJLFM QBSTJBM QBEB TFUJBQ TFMBOH
lok de aja d a kadang kadang TBUVEFOZVUKBOUVOH
men nj kkan kegagalan en ikel n k mene ima sin al sin al
e angsangan sada an .
P P P P P P P P P P
am a lok in a en ikel a sial lis ik olak

lok o al sada an alik sada an
145
Unit III Jantung
&MFLUSPLBSEJPHSBN JOJ KVHB NFNQFSMJIBULBO UBLJLBSEJB ,POUSBLTJ BUSJVN QSFNBUVS TFSJOH UJNCVM QBEB PSBOH TFIBU
GSFLVFOTJ EFOZVU KBOUVOH DFQBU
ZBOH NVOHLJO NFSVQBLBO #BILBO TFSJOH EJUFNVLBO QBEB BUMFU ZBOH KBOUVOHOZB KFMBT
QFOZFCBC UJNCVMOZB CMPL LBSFOB CJMB GSFLVFOTJ EFOZVU EBMBN LFBEBBO TBOHBU TFIBU ,FBEBBO UPLTJL SJOHBO TFCBHBJ
KBOUVOH TBOHBU DFQBU UJEBL NVOHLJO CBHJ CFCFSBQB CBHJBO BLJCBU EBSJ GBLUPSGBLUPS TFQFSUJ NFSPLPL LFLVSBOHBO UJEVS
TJTUFN1VSLJOKFVOUVLQVMJIEBSJQFSJPEFSFGSBLUFSTFCFMVNOZB UFSMBMV CBOZBL NJOVN LPQJ BMLPIPMJTNF TFSUB QFNBLBJBO
EFOHBO DVLVQ DFQBU BHBS EBQBU CFSFBLTJ EJ TFUJBQ EFOZVU CFSCBHBJ PCBUPCBUBO KVHB EBQBU NFOJNCVMLBO LPOUSBLTJ
KBOUVOH CFSJLVUOZB 4FMBJO JUV CFSCBHBJ LFBEBBO MBJO KVHB UFSTFCVU
EBQBU NFOFLBO KBOUVOH TFQFSUJ JTLFNJB NJPLBSEJUJT BUBV
Defisit Nadi #JMB KBOUVOH CFSLPOUSBLTJ MFCJI BXBM EBSJ
LFSBDVOBO EJHJUBMJT ZBOH EBQBU NFOZFCBCLBO CMPL
TFIBSVTOZB WFOUSJLFM UJEBL BLBO UFSJTJ PMFI EBSBI EBMBN KVNMBI
JOUSBWFOUSJLFMJOLPNQMFUTFIJOHHBNFOHBLJCBULBOBMJSBOMJTUSJL
OPSNBM EBO LFMVBSBO JTJ TFLVODVQ TFMBNB LPOUSBLTJ BLBO
CPMBLCBMJL
NFOHBMBNJ QFOFLBOBO BUBV LBEBOHLBEBOH IBNQJS UJEBL BEB
0MFI LBSFOB JUV HFMPNCBOH OBEJ ZBOH CFSKBMBO LF BSUFSJ QFSJGFS
Kontraksi Prematur TFTVEBI LPOUSBLTJ QSFNBUVS EBQBU CFHJUV MFNBI TFIJOHHB OBEJ
,POUSBLTJQSFNBUVSNFSVQBLBOLPOUSBLTJKBOUVOHZBOHUFSKBEJ UJEBL EBQBU EJSBCB TBNB TFLBMJ EJ BSUFSJ SBEJBMJT +BEJ KVNMBI
TFCFMVNXBLUVLPOUSBLTJOPSNBMEJQFSLJSBLBOUJNCVM,FBEBBO EFOZVU OBEJ ZBOH UFSBCB QBEB EFOZVU BSUFSJ SBEJBMJT MFCJI TFEJLJU
JOJ KVHB EJTFCVU FLTUSBTJTUPM EFOZVU QSFNBUVS BUBV EFOZVU CJMBEJCBOEJOHLBOEFOHBOKVNMBILPOUSBLTJKBOUVOHTFCFOBSOZB
FLUPQJL Kontraksi Prematur Nodus A-V atau Berkas A-V
Penyebab Kontraksi Prematur. 4FCBHJBOCFTBSLPOUSBLTJ (BNCBS NFNQFSMJIBULBO LPOUSBLTJ QSFNBUVS ZBOH
QSFNBUVS NFSVQBLBO BLJCBU GPLVT FLUPQJL EJ EBMBN KBOUVOH CFSBTBMEBSJEBMBNOPEVT"7BUBVCFSLBT"71BEBLPOUSBLTJ
ZBOH NFOHFMVBSLBO JNQVMT BCOPSNBM QBEB XBLUV UFSUFOUV QSFNBUVS HFMPNCBOH 1 BLBO IJMBOH EBSJ SFLBNBO
TFMBNB JSBNB KBOUVOH 1FOZFCBC GPLVT FLUPQJL ZBOH NVOHLJO FMFLUSPLBSEJPHSBGJL 4FCBMJLOZB HFMPNCBOH 1 CFSHBCVOH
BEBMBI
EBFSBI JTLFNJB MPLBM
QMBL LBMTJGJLBTJ LFDJM EJ TVQFSJNQPTFE
LF EBMBN LPNQMFLT 2345 LBSFOB JNQVMT
CFSCBHBJ CBHJBO KBOUVOH ZBOH NFOFLBO PUPU KBOUVOH EJ KBOUVOH CFSKBMBO CBMJL LF EBMBN BUSJVN QBEB XBLUV ZBOH
EFLBUOZB TFIJOHHB CFCFSBQB TFSBU NFOKBEJ UFSJSJUBTJ EBO
CFSTBNBBO EFOHBO JNQVMT ZBOH CFSKBMBO LF EBMBN WFOUSJLFM
JSJUBTJ UPLTJL QBEB OPEVT "7 TJTUFN 1VSLJOKF BUBV HFMPNCBOH 1 TFEJLJU NFOHVCBI CFOUVL LPNQMFLT 2345
NJPLBSEJVNEJTFCBCLBOPMFIPCBUPCBUBO OJLPUJO BUBVLBGFJO UFUBQJ HFMPNCBOH 1 TFOEJSJ UJEBL EBQBU EJMJIBU MBHJ 1BEB
5JNCVMOZB LPOUSBLTJ QSFNBUVS TFDBSB NFLBOJT KVHB TFSJOH VNVNOZB LPOUSBLTJ OPEVT "7 QSFNBUVS NFNQVOZBJ BLJCBU
UFSMJIBU TFMBNB LBUFUFSJTBTJ KBOUVOH TFKVNMBI CFTBS LPOUSBLTJ EBOQFOZFCBCZBOHTBNBEFOHBOLPOUSBLTJBUSJVNQSFNBUVS
QSFNBUVS TFSJOH LBMJ UJNCVM CJMB LBUFUFS NFNBTVLJ WFOUSJLFM Kontraksi Ventrikel Prematur
LBOBOEBONFOFLBOFOEPLBSEJVN
&MFLUSPLBSEJPHSBN QBEB (BNCBS NFNQFSMJIBULBO
LPOUSBLTJ WFOUSJLFM QSFNBUVS ,71
TFSJBM ZBOH CFSTFMBOHTFMJOH
Kontraksi Atrium Prematur
EFOHBO LPOUSBLTJ OPSNBM ,71 EBQBU NFOZFCBCLBO FGFLFGFL
(BNCBSNFNQFSMJIBULBOTBUVLPOUSBLTJBUSJVNQSFNBUVS ZBOHTQFTJGJLEBMBNFMFLUSPLBSEJPHSBN TFQFSUJCFSJLVUJOJ
(FMPNCBOH1QBEBEFOZVUJOJUFSKBEJUFSMBMVDFQBUEBMBNTJLMVT
KBOUVOH JOUFSWBM 13 NFNFOEFL ZBOH NFOVOKVLLBO CBIXB 1. ,PNQMFLT 234 CJBTBOZB TBOHBU NFNBOKBOH )BM JOJ
BTBM EFOZVU FLUPQJL UFSMFUBL EJ BUSJVN EFLBU EFOHBO OPEVT " EJLBSFOBLBO JNQVMT UFSVUBNB EJIBOUBSLBO NFMBMVJ PUPU
74FMBJOJUV JOUFSWBMBOUBSBLPOUSBLTJQSFNBUVSEBOLPOUSBLTJ WFOUSJLFM ZBOH CFSLPOEVLTJ MBNCBU EBSJQBEB NFMBMVJ TJTUFN
CFSJLVUOZB TFEJLJU MFCJI MBNB ZBOH EJTFCVU TFCBHBJ JTUJSBIBU 1VOLJOKF
LPNQFOTBUPSJ DPNQFOTBUPSZ QBVTF
4BMBI TBUV BMBTBO VOUVL 2. ,PNQMFLT 234 NFNQVOZBJ WPMUBTF ZBOH UJOHHJ LBSFOB BMBTBO
JOJBEBMBI CBIXBLPOUSBLTJQSFNBUVSZBOHCFSBTBMEBSJBUSJVN CFSJLVU CJMB JNQVMT ZBOH OPSNBM CFSKBMBO NFMBMVJ KBOUVOH
CFSBEB BHBL KBVI EBSJ OPEVT TJOVT EBO JNQVMT IBSVT CFSKBMBO JNQVMT UFSTFCVU BLBO NFMFXBUJ LFEVB WFOUSJLFM TFDBSB IBNQJS
NFMBMVJ TFKVNMBI PUPU BUSJVN TFCFMVN EBQBU NFOHBLUJGLBO CFSTBNBBO BLJCBUOZB QBEB KBOUVOH ZBOH OPSNBM HFMPNCBOH
OPEVT TJOVT "LJCBUOZB OPEVT TJOVT NFMFQBTLBO JNQVMT ZBOH EFQPMBSJTBTJEBSJLFEVBCBHJBOKBOUVOHVNVNOZBQBEBQPMBSJUBT
TBOHBU MBNCBU QBEB TJLMVT QSFNBUVS EBO IBM JOJ NFNCVBU ZBOH TBMJOH CFSMBXBOBO BOUBSB TBUV EFOHBO ZBOH MBJOOZB
MFQBTBOOPEVTTJOVTCFSJLVUOZBKVHBUFSMBNCBUNVODVM TFCBHJBO BLBO NFOFUSBMJTJS TBUV TBNB MBJO QBEB
FMFLUSPLBSEJPHSBN1BEB,71 JNQVMTIBNQJSTFMBMVCFSKBMBO
en ema
en ema
P T P T P T PT P T
en a i m ema sada an on aksi nod s ema sada an
146
EBQBUNFOFOUVLBOEBSJFMFLUSPLBSEJPHSBNQBEB(BNCBS
UJUJLBTBMEBSJ,71TFCBHBJCFSJLVU1FSIBUJLBOCBIXBQPUFOTJBM
LPOUSBLTJ QSFNBUVS QBEB TBEBQBO ** EBO *** LFEVBOZB BEBMBI
QPTJUJG %FOHBO NFNJOEBILBO QPUFOTJBM JOJ QBEB TVNCV
UNIT III
TBEBQBO**EBO***EBONFNFDBILBOOZBEFOHBONFOHHVOBLBO
BOBMJTJT WFLUPSJBM VOUVL WFLUPS 234 SBUBSBUB EJ KBOUVOH LJUB
BLBO NFOEBQBULBO CBIXB WFLUPS LPOUSBLTJ QSFNBUVS JOJ
NFNJMJLJVKVOH BTBM
OFHBUJGEJCBHJBOCBTBMKBOUVOHEBOVKVOH
QPTJUJGOZB LF BSBI BQFLT +BEJ CBHJBO QFSUBNB EBSJ KBOUVOH
II III ZBOH CFSEFQPMBSJTBTJ TFMBNB LPOUSBLTJ QSFNBUVS BEBMBI ZBOH

CFSEFLBUBOEFOHBOCBHJBOCBTBMKBOUVOH EBOPMFILBSFOBJUVMBI
UFNQBUUFSTFCVUNFSVQBLBOGPLVTFLUPQJL
Kelainan Repolarisasi Jantung —Sindroma
Perpanjangan QT. *OHBULFNCBMJCBIXBHFMPNCBOH2TFTVBJ
EFOHBO EFQPMBSJTBTJ WFOUSJLFM TFEBOHLBO HFMPNCBOH 5 TFTVBJ
EFOHBO SFQPMBSJTBTJ WFOUSJLFM*OUFSWBM 25 BEBMBI XBLUV EBSJ
UJUJL 2 TBNQBJ BLIJS HFMPNCBOH 5 ,FMBJOBO ZBOH
NFNQFSMBNCBUSFQPMBSJTBTJPUPUWFOUSJLFMTFUFMBIQPUFOTJBMBLTJ
III II
WFOUSJLFM CFSMBNHTVNH NFOZFCBCLBO QFSQBOKBOHBO QPUFOTJBM
am a on aksi en ikel ema digam a kan BLTJWFOUSJLFMEBOEFOHBOEFNJLJBOKVHBQFSQBOKBOHBOJOUFSWBM
ole kom leks a no mal dan esa sada an dan
25OZBUBQBEBFMFLUSPLBSEJPHSBN TVBUVLPOEJTJZBOHEJLFOBM
m kon aksi ema digam a kan dengan ga is e s
s ses ai dengan insi analisis ek o ang dijelaskan
TFCBHBJTJOESPNBQFNBOKBOHBO25 MPOH25TZOESPNF-254
dalam a gam a ini men nj kkan menga a asal "MBTBO VUBNB CBIXB TJOESPNB QFSQBOKBOHBO 25
deka dengan agisn asal en ikel NFSVQBLBO NBTBMBI BEBMBI CBIXB QFSMBNCBUBO SFQPMBSJTBTJ
PUPU WFOUSJLFM NFOJOHLBULBO LFSFOUBOBO TFTFPSBOH VOUVL
NFOHBMBNJ BSJUNJB WFOUSJLFM ZBOH EJTFCVU UPSTBEF EF QPJOUFT
IBOZB LF TBUV BSBI TFIJOHHB UJEBL UFSEBQBU FGFL OFUSBMJTBTJ
ZBOH TFDBSB IBSGJBI CFSBSUJ UJUJL QFSQVUBSBOh +FOJT BSJUNJB JOJ
EBOTBUVTJTJWFOUSJLFMTFDBSBLFTFMVSVIBOBUBVVKVOHWFOUSJLFM
NFNJMJLJ HBNCBSBO TFQFSUJ EJQFSMJIBULBO QBEB (BNCBS
UFSMFCJI EBIVMV NFOHBMBNJ EFQPMBSJTBTJ EJCBOEJOHLBO CBHJBO
#FOUVL LPNQMFLT 234 EBQBU CFSVCBI TFXBLUVXBLUV ZBJUV
ZBOH MBJO IBM JOJ BLBO NFOZFCBCLBO QPUFOTJBM MJTUSJL ZBOH
EFOHBO UJNCVMOZB BSJUNJB ZBOH VNVNOZB NFOHJLVUJ TVBUV
TBOHBU CFTBS TFQFSUJ ZBOH EJQFSMJIBULBO QBEB ,71 EBMBN
EFOZVU QSFNBUVS EJTFMJOH JTUJSBIBU LFNVEJBO TFCVBI EFOZVU
(BNCBS
EFOHBO JOUFSWBM 25 QBOKBOH ZBOH EBQBU NFNJDV BSJUNJB
3. 1BEB IBNQJS TFNVB ,71 ZBOH UFSKBEJ HFMPNCBOH 5
UBLJLBSEJB EBOQBEBCFCFSBQBLFBEBBOKVHBGJCSJMBTJWFOUSJLFM
NFNQVOZBJ QPMBSJUBT MJTUSJL CFSMBXBOBO EFOHBO LPNQMFLT
,FMBJOBO SFQPMBSJTBTJ KBOUVOH ZBOH NFOHBSBI LF -254
234 LBSFOBLPOEVLTJJNQVMTZBOHMBNCBUNFMBMVJPUPUKBOUVOH
NVOHLJO EJUVSVOLBO BUBV EJEBQBU BDRVJSFE
#FOUVL
NFOZFCBCLBO TFSBCVU PUPU ZBOH QFSUBNB LBMJ CFSEFQPMBSJTBTJ
LPOHFOJUBM-254BEBMBILFMBJOBOZBOHKBSBOH EJTFCBCLBOPMFI
KVHBNFOHBMBNJSFQPMBSJTBTJUFSMFCJIEBIVMV
NVUBTJ HFO LBOBM OBUSJVN BUBV LBMJVN 4FEJLJUOZB NVUBTJ
1FOHBSVICFCFSBQB,71UFSIBEBQQFNPNQBBOKBOUVOHTFDBSB HFO CFSCFEB UFMBI EJJEFOUJGJLBTJ ZBOH EBQBU NFOZFCBCLBO
LFTFMVSVIBO SFMBUJG UJEBL CFSCBIBZB ,71 EBQBU NFSVQBLBO CFSCBHBJEFSBKBUQFSQBOKBOHBO25
BLJCBUEBSJGBLUPSGBLUPSTFQFSUJSPLPL NJOVNLPQJCFSMFCJIBO
#FOUVL ZBOH MFCJI VNVN EJKVNQBJ BEBMBI CFOUVL -254
LVSBOH UJEVS CFSCBHBJ LFBEBBO UPLTJL SJOHBO EBO CBILBO
EJEBQBU EJLBJULBO EFOHBO HBOHHVBO FMFLUSPMJU QMBTNB TFQFSUJ
HBOHHVBOFNPTJPOBM4FCBMJLOZB TFKVNMBI,71MBJOOZBBEBMBI
IJQPNBHOFTFNJB IJQPLBMFNJBBUBVIJQPLBMTFNJB BUBVEFOHBO
BLJCBU EBSJ JNQVMT ZBOH UFSTFTBU BUBV TJOZBM ZBOH NBTVL
QFNCFSJBO PCBU BOUJBSJUNJB EBMBN KVNMBI CFSMFCJIBO TFQFSUJ
LFNCBMJ CFSBTBM EBSJ EBFSBI EJ TFLJUBS QFSCBUBTBO ZBOH
RVJOJEJO BUBV CFCFSBQB BOUJCJPUJL TFQFSUJ GMVPSPRVJOPMPO BUBV
NFOHBMBNJ JOGBSL BUBV JTLFNJB EJ KBOUVOH "EBOZB ,71 ZBOH
FSZUISPNZDJOZBOHNFNQFSQBOKBOHJOUFSWBM25
EFNJLJBOUJEBLCPMFIEJQBOEBOHSJOHBO4UBUJTUJLNFOVOKVLLBO
CBIXBPSBOHPSBOHEFOHBO,71EBMBNKVNMBIZBOHCFSNBLOB .FTLJQVO CFCFSBQB PSBOH EFOHBO -254 UJEBL
NFNQVOZBJLFNVOHLJOBOMFCJICFTBSVOUVLUJNCVMOZBGJCSJMBTJ NFOVOKVLLBO HFKBMB CFSBU TFMBJO QFSQBOKBOHBO JOUFSWBM 25

WFOUSJLFM TQPOUBO ZBOH NFNBUJLBO EJCBOEJOHLBO EFOHBO TFCBHJBO MBJO NFOHBMBNJ QJOHTBO EBO BSJUNJB WFOUSJLFM ZBOH
PSBOHPSBOHOPSNBM ZBOHTBMBITBUVOZBEJEVHBEJBXBMJEFOHBO EBQBU EJDFUVTLBO PMFI MBUJIBO GJTJL FNPTJ LVBU TFQFSUJ
,71 )BM JOJ UFSKBEJ CJMB ,71 UJNCVM TFMBNB QFSJPEF ZBOH LFUBLVUBO BUBV NBSBI BUBV EJLFKVULBO PMFI TVBSB LFSBT 1BEB
SFOUBO VOUVL UFSKBEJOZB GJCSJMBTJ ZBJUV UFQBU QBEB BLIJS CFCFSBQBLBTVT BSJUNJBWFOUSJLFMCFSLBJUBOEFOHBO-254EBQBU
HFMPNCBOH 5 EJTBBU WFOUSJLFM LFMVBS EBSJ LFBEBBO SFGSBLUFS NFNCVSVLNFOKBEJGJCSJMBTJWFOUSJLFMEBOLFNBUJBONFOEBEBL
TFQFSUJZBOHBLBOEJUFSBOHLBOLFNVEJBOEBMBNCBCJOJ 1FOHPCBUBO-254EBQBUNFODBLVQTVMGBUNBHOFTJVNVOUVL
Analisis Vektor mengenai Asal dari Kontraksi Ventrikel -254 BLVU TFSUB VOUVL QFOHPCBUBO BOUJBSJUNJB -254 KBOHLB
Prematur Ektopik. %BMBN#BCUFMBIEJUFSBOHLBOQSJOTJQQSJOTJQ QBOKBOH EJHVOBLBO QFOHIBNCBU BESFOFSHJLCFUB BUBV
BOBMJTJTWFLUPS%FOHBONFNBLBJQSJOTJQQSJOTJQUFSTFCVU LJUB JNQMBOUBTJEFGJCSJMBUPSKBOUVOHNFMBMVJQFNCFEBIBO
147
Unit III Jantung
e ola isasi ema e ola isasi ema e lang
o sades de oin es
s a a s a a
as a is a a QT as a is a a QT
e jadin a a i mia ada sind oma e anjangan ila e jadi e anjangan o ensial aksi se a o o en ikel se agai
aki a da i e lam a an e ola isasi de ola isasi ema g i g ii da a e jadi se el m e ola isasi
selesai ada keadaan e en de ola isasi ema e lang g da a menj s ke de ola isasi m l i e ada
o sades de oin es g den ema en ikel diik i is i a a e anjangan in e al as a is i a a dan a i mia
igam a lang da i a oden i o e o i e ol i io e lo g y o e alam a o d i a o
eds a diolog ondon os
Takikardia Paroksismal
#FCFSBQBLFMBJOBOEJCFSCBHBJCBHJBOKBOUVOH UFSNBTVLBUSJVN
TJTUFN 1VSLJOKF EBO WFOUSJLFM LBEBOHLBEBOH EBQBU akika dia a oksismal a i m onse e da a di
agian enga ekaman sada an
NFOJNCVMLBO MFQBTBO JNQVMT SJUNJT DFQBU ZBOH NFOZFCBS LF
TFHBMBBSBIEJKBOUVOH)BMJOJEJZBLJOJTFSJOHLBMJEJTFCBCLBOPMFI
JNQVMT ZBOH NBTVL LFNCBMJ ZBOH CFSHFSBL CFSQVUBS EJ KBMVS EBEBLEBSJLJSBLJSBNFOKBEJLBMJNFOJU1BEBQFOHBNBUBO
VNQBO CBMJL TFIJOHHB NFOJNCVMLBO TFMG SFFYDJUBUJPO ZBOH FMFLUSPLBSEJPHSBN TFMBNB EFOZVU KBOUVOH ZBOH DFQBU UJNCVM
CFSTJGBUMPLBMEBOCFSVMBOH0MFILBSFOBJSBNBOZBDFQBUEJUFNQBU HFMPNCBOH 1 UFSCBMJL TFCFMVN TFUJBQ LPNQMFLT 2345 EBO
ZBOHUFSJSJUBTJJOJ UFNQBUUFSTFCVUBLBONFOKBEJQJDVKBOUVOH HFMPNCBOH 1 JOJ TFCBHJBO CFSHBCVOH TVQFSJNQPTFE
EFOHBO
*TUJMBIQBSPLTJTNBMCFSBSUJCBIXBGSFLVFOTJEFOZVUKBOUVOH HFMPNCBOH 5 OPSNBM EBSJ EFOZVU TFCFMVNOZB )BM JOJ
NFOKBEJ TBOHBU DFQBU QBEB TBBU TFSBOHBO EFOHBO TFSBOHBO NFOBOEBLBO CBIXB BTBM EBSJ UBLJLBSEJB QBSPLTJTNBM JOJ BEBMBI
ZBOHNVMBJOZBNFOEBEBLEBOCFSMBOKVUTFMBNBCFCFSBQBEFUJL BUSJVN UFUBQJ LBSFOB CFOUVL HFMPNCBOH 1OZB BCOPSNBM NBLB
BTBMOZBUJEBLCFSEFLBUBOEFOHBOOPEVTTJOVT
CFCFSBQBNFOJU CFCFSBQBKBN BUBVMFCJIMBNBMBHJ,FNVEJBO
TFSBOHBOCJBTBOZBCFSBLIJSTFDBSBNFOEBEBLTFQFSUJQBEBTBBU Takikardia Paroksismal Nodus A-V. 5BLJLBSEJB
NVMBJOZB EBOQJDVKBOUVOHLFNVEJBOCFSBMJIEFOHBODFQBULF QBSPLTJTNBMTFSJOHLBMJEJTFCBCLBOPMFIJSBNBNFOZJNQBOH ZBOH
OPEVTTJOVT NFOHFOBJ OPEVT "7 ,FBEBBO JOJ CJBTBOZB NFOZFCBCLBO
5BLJLBSEJB QBSPLTJTNBM TFSJOH LBMJ EBQBU EJIFOUJLBO EFOHBO LPNQMFLT2345ZBOHIBNQJSOPSNBMUFUBQJUJEBLBEBHFMPNCBOH
NFOJNCVMLBO SFGMFLT WBHVT 4VBUV UJQF SFGMFLT WBHVT ZBOH 1TBNBTFLBMJ BUBVHFMPNCBOH1UJEBLKFMBT
LBEBOHLBEBOH EJUJNCVMLBO VOUVL LFQFSMVBO JOJ BEBMBI EFOHBO 5BLJLBSEJB QBSPLTJTNBM OPEVT "7 BUBV BUSJVN LFEVBOZB
NFOFLBO EBFSBI MFIFS EJ TJOVT LBSPUJT ZBOH NVOHLJO EBQBU EJTFCVU TFCBHBJ UBLJLBSEJB TVQSBWFOUSJLFM CJBTBOZB UFSKBEJ QBEB
NFOZFCBCLBO SFGMFLT WBHVT ZBOH DVLVQ VOUVL NFOHIFOUJLBO PSBOHNVEBTFIBUEBOCJBTBOZBUFSKBEJEJMVBSUFNQBUQSFEJTQPTJTJ
TFSBOHBO #FSCBHBJ PCBUPCBUBO EBQBU KVHB EJQBLBJ %VB NBDBN QBEB UBLJLBSEJB ZBOH NVODVM TFUFMBI EFXBTB 1BEB VNVNOZB
PCBU ZBOH TFSJOH LBMJ EJQBLBJ BEBMBI RVJOJEJO EBO MJEPLBJO UBLJLBSEJB TVQSBWFOUSJLFM TBOHBU NFOBLVULBO CBHJ PSBOH ZBOH
LFEVBOZBEBQBUNFOFLBOQFOJOHLBUBOOPSNBMEBOQFSNFBCJMJUBT CFSTBOHLVUBO EBO EBQBU NFOZFCBCLBO LFMFNBIBO TFMBNB
NFNCSBO PUPU KBOUVOH UFSIBEBQ OBUSJVN TFMBNB QFNCFOUVLBO TFSBOHBO UFUBQJKBSBOHNFOJNCVMLBOHBOHHVBONFOFUBQTFTVEBI
QPUFOTJBM BLTJ EFOHBO EFNJLJBO TFSJOH NFNCMPL MFQBTBO SJUNJT TFSBOHBOUFSTFCVU
EBSJUJUJLGPLVTZBOHNFOZFCBCLBOTFSBOHBOQBSPLTJTNBM Takikardia Paroksismal Ventrikel
Takikardia Paroksismal Atrium
(BNCBS NFOVOKVLLBO TFSBOHBO UBLJLBSEJB WFOUSJLFM LIBT
(BNCBS NFNQFSMJIBULBO CBIXB EJ CBHJBO UFOHBI EBO TJOHLBU (BNCBSBO FMFLUSPLBSEJPHSBN EBSJ UBLJLBSEJB
SFLBNBOUFSEBQBULFOBJLBOGSFLVFOTJEFOZVUKBOUVOHNFO QBSPLTJTNBMWFOUSJLFMCFSVQBTVBUVSBOHLBJBOEFOZVUQSFNBUVS
Fenomena Masuk-Kembali (Re-entry)—"Gerakan

Berputar" sebagai Dasar Timbulnya Fibrilasi Ventrikel
#JMB JNQVMT KBOUVOH OPSNBM QBEB KBOUVOH OPSNBM UFMBI
CFSKBMBO LF TFMVSVI WFOUSJLFM JNQVMT UFSTFCVUUJEBL
UNIT III
NFNQVOZBJ UFNQBU MBJO VOUVL EJUVKV MBHJ LBSFOB TFNVB PUPU
akika dia a oksismal en ikel sada an WFOUSJLFM EBMBN LFBEBBO SFGSBLUFS EBO UJEBL EBQBU
NFOHIBOUBSLBOJNQVMTMFCJIKBVIMBHJ0MFILBSFOBJUV JNQVMT
WFOUSJLFM ZBOH UJNCVM CFSUVSVUUVSVU UBOQB EJTFMJOHJ TBUV QVO BLBO CFSIFOUJ EBO KBOUVOH NFOVOHHV TFCVBI QPUFOTJBM BLTJ
EFOZVUOPSNBMEJBOUBSBOZB ZBOHCBSVVOUVLNFSBOHTBOHOPEVTTJOVTBUSJVNLFNCBMJ
5BLJLBSEJBQBSPLTJTNBMWFOUSJLFMCJBTBOZBNFSVQBLBOLFBEBBO /BNVO EFNJLJBO QBEB CFCFSBQB LFBEBBO SBOHLBJBO
TFSJVT LBSFOB EVB TFCBC 1FSUBNB UJQF UBLJLBSEJB JOJ CJBTBOZB LFKBEJBO OPSNBM JOJ UJEBL UFSKBEJ 0MFI LBSFOB JUV LJUB BLBO
UJEBL UJNCVM LFDVBMJ UFSEBQBU LFSVTBLBO JTLFNJB ZBOH TBOHBU NFNCBIBT TFDBSB MFCJI NFOEBMBN NFOHFOBJ MBUBS CFMBLBOH
CFSNBLOB EJ WFOUSJLFM ,FEVB UBLJLBSEJB WFOUSJLFM TFSJOH LBMJ GFOPNFOB NBTVLLFNCBMJ TFIJOHHB NFOZFCBCLBO HFSBLBO
NFOHBXBMJ LFBEBBO GJCSJMBTJ WFOUSJLFM ZBOH NFNBUJLBO LBSFOB CFSQVUBSZBOHTFMBOKVUOZBNFOHBLJCBULBOGJCSJMBTJWFOUSJLFM
UJNCVMOZB SBOHTBOHBO PUPU WFOUSJLFM ZBOH DFQBU EBO CFSVMBOH (BNCBS NFNQFSMJIBULBO CFCFSBQB QPUPOHBO PUPU
TFQFSUJZBOHBLBOLJUBCBIBTEBMBNCBHJBOCFSJLVUOZB KBOUVOH ZBOH LFDJM EBMBN CFOUVL MJOHLBSBO #JMB QPUPOHBO
*OUPLTJLBTJ BLJCBU QFNBLBJBO PCBUPCBUBO EJHJUBMJT QBEB UFSTFCVU EJSBOHTBOH QBEB QPTJTJ KBN TFIJOHHB JNQVMT BLBO
KBOUVOH LBEBOHLBEBOH NFOZFCBCLBO UFNQBU UFSUFOUV NFOKBEJ CFSKBMBN IBOZB EBMBN TBUV BSBI TBKB JNQVMT BLBO NFOZFCBS
UFSJSJUBTJ ZBOH BLIJSOZB NFOJNCVMLBO UBLJLBSEJB WFOUSJLFM EFOHBO DFQBU EJ TFLFMJMJOH MJOHLBSBO UFSTFCVU TBNQBJ JNQVMT
4FCBMJLOZB RVJOJEJO ZBOHNFOJOHLBULBOXBLUVSFGSBLUFSEBOKVHB LFNCBMJ QBEB QPTJTJ KBN #JMB TFSBCVUTFSBCVU PUPU ZBOH
NFOJOHLBULBOOJMBJBNCBOHSBOHTBOHVOUVLFLTJUBTJPUPUKBOUVOH NVMBNVMBEJSBOHTBOHNBTJIEBMBNLFBEBBOSFGSBLUFS JNQVMT
EBQBU EJQBLBJ VOUVL NFNCMPL UFNQBU ZBOH UFSJSJUBTJ QFOZFCBC BLBO CFSIFOUJ LBSFOB PUPU ZBOH SFGSBLUFS JUV UJEBL EBQBU
UBLJLBSEJBWFOUSJLFM NFOHIBOUBSLBO JNQVMT LFEVB 5FUBQJ UFSEBQBU UJHB LFBEBBO
CFSCFEB ZBOH EBQBU NFOZFCBCLBO JNQVMT UFSVT CFSKBMBO EJ
Fibrilasi Ventrikel TFLFMJMJOH MJOHLBSBO UFSTFCVU ZBJUV NFOZFCBCLBO JNQVMT
NBTVLLFNCBMJLFEBMBNPUPUZBOHTVEBIEJSBOHTBOH)BMJOJ
,FBEBBO QBMJOH TFSJVT EBSJ TFNVB BSJUNJB KBOUVOH BEBMBI EJTFCVUHFSBLBOCFSQVUBS
GJCSJMBTJ WFOUSJLFM ZBOH CJMB UJEBL EJIFOUJLBO EBMBN XBLUV 1FSUBNB CJMBKBMVSEJTFLFMJMJOHMJOHLBSBOJUVTBOHBUQBOKBOH
TBNQBJ NFOJU IBNQJS TFMBMV NFOJNCVMLBO LFBEBBO GBUBM QBEBTBBUJNQVMTLFNCBMJLFQPTJTJKBN PUPUZBOHNVMBOZB
'JCSJMBTJWFOUSJLFMUFSKBEJLBSFOBJNQVMTKBOUVOHZBOHUFSEBQBU TVEBI UFSBOHTBOH UJEBL MBHJ CFSBEB EBMBN LFBEBBO SFGSBLUFS
EJEBMBNNBTTBPUPUWFOUSJLFMUJNCVMEJMVBSLFOEBMJ*NQVMT EBOJNQVMTBLBOUFSVTNFOHFMJMJOHJMJOHLBSBOUFSTFCVU
UFSTFCVU BLBO NFSBOHTBOH TBMBI TBUV CBHJBO PUPU WFOUSJLFM ,FEVB CJMB QBOKBOH KBMVS UFUBQ LPOTUBO UFUBQJ LFDFQBUBO
LFNVEJBO NFSBOHTBOH CBHJBO MBJO LFNVEJBO ZBOH MBJO MBHJ LPOEVLTJ DVLVQ NFOVSVO BLBO UFSKBEJ QFSQBOKBOHBO TFMBOH
EBO BLIJNZB LFNCBMJ LF UFNQBU TFNVMB EBO NFSBOHTBOH XBLUVUFNQVITFCFMVNJNQVMTEBQBULFNCBMJLFQPTJTJKBN
LFNCBMJ PUPU WFOUSJLFM ZBOH TBNB CFSVMBOHVMBOH LBMJ EBO 1BEB TBBU JOJ PUPU ZBOH NVMBOZB TVEBI UFSBOHTBOH NVOHLJO
UJEBL QFSOBI CFSIFOUJ #JMB IBM JOJ UFSKBEJ CBOZBL CBHJBO PUPU UFMBI LFMVBS EBSJ LFBEBBO SFGSBLUFS EBO JNQVMT BLBO UFSVT
WFOUSJLFMZBOHLFDJMBLBOCFSLPOUSBLTJQBEBXBLUVCFSTBNBBO NFOHFMJMJOHJMJOHLBSBOUFSTFCVUCFSVMBOHLBMJ
TFNFOUBSB JUV CBOZBL CBHJBO MBJO EBMBN KVNMBI TBNB KVHB ,FUJHB QFSJPEF SFGSBLUFS PUPU CJTB NFOKBEJ TBOHBU
BLBO CFSFMBLTBTJ +BEJ UJEBL QFSOBI BEB LPOUSBLTJ NFNFOEFL 1BEB LFBEBBO JOJ JNQVMT KVHB BLBO UFSVT
UFSLPPSEJOBTJ EBSJ TFNVB PUPU WFOUSJLFM QBEB TBBU CFSTBNBBO NFOHFMJMJOHJMJOHLBSBOUFSTFCVU
ZBOH EJQFSMVLBO VOUVL TJLMVT QPNQB KBOUVOH 8BMBVQVO
UFSEBQBUBMJSBOTJOZBMTJOZBMQFSBOHTBOHBOZBOHTBOHBUCBOZBL
EJ TFMVSVI WFOUSJLFM SVBOHBO EJ EBMBN WFOUSJLFM UJEBL
NFNCFTBS UJEBL KVHB CFSLPOUSBLTJ UFUBQJ UFUBQ CFSUBIBO QBEB
UBIBQLPOUSBLTJQBSTJBMZBOHUJEBLEBQBUEJUFOUVLBO KVHBUJEBL
NFNPNQB EBSBI EBMBN KVNMBI CFSBSUJ 0MFI LBSFOB JUV
TFUFMBI GJCSJMBTJ EJNVMBJ PSBOH BLBO IJMBOH LFTBEBSBOOZB
EBMBN XBLUV TBNQBJ EFUJL LBSFOB UJEBL BEB EBSBI e ak e
NFOHBMJS LF PUBL EBO LFNBUJBO KBSJOHBO ZBOH UJEBL EBQBU ela i
EJDFHBINVMBJUFSKBEJEJTFMVSVIUVCVIEBMBNXBLUVCFCFSBQB e ak e
NFOJU a sol
#FSCBHBJ GBLUPS EBQBU NFODFUVTLBO BXBM EBSJ GJCSJMBTJ e ak e
a sol
WFOUSJLFM TFTFPSBOH EBQBU NFNJMJLJ EFOZVU KBOUVOH OPSNBM
VOUVL TFNFOUBSB UFUBQJ TBUV EFUJL LFNVEJBO WFOUSJLFM
NFOHBMBNJ GJCSJMBTJ )BMIBM UFSUFOUV ZBOH DFOEFSVOH
NFOJNCVMLBOGJCSJMBTJBEBMBI
LFKVUMJTUSJLKBOUVOHUJCBUJCB e akan e a mem e li a kan
BUBV
JTLFNJB PUPU KBOUVOH UFSVUBNB TJTUFN LPOEVLTJ BUBV eng ilangan im ls di dalam jal endek dan e am a an
LFEVBOZB im ls ang e s mene s di dalam jal anjang
149
Unit III Jantung
4FNVB LFBEBBO JOJ UFSKBEJ QBEB CFSCBHBJ LFBEBBO QBUPMPHJ QBEB KBOUVOH " JNQVMT UFSUFOUV CFSKBMBO VOUVL KBSBL QFOEFL
ZBOH CFSCFEB QBEB KBOUVOH NBOVTJB TFQFSUJ CFSJLVU JOJ
TBNQBJ JNQVMT NFODBQBJ EBFSBI KBOUVOH ZBOH SFGSBLUFS EBO
+BMVS ZBOH QBOKBOH CJBTBOZB UFSKBEJ QBEB KBOUVOH ZBOH UFMBI LFNVEJBO JNQVMT UFSTFCVU EJIBNCBU 5FUBQJ JNQVMTJNQVMT ZBOH
CFSEJMBUBTJ
1FOVSVOBO LFDFQBUBO LPOEVLTJ TFSJOH LBMJ MBJO MFXBU EJ BOUBSB EBFSBI ZBOH SFGSBLUFS EBO UFSVT CFSKBMBO LF
BLJCBU B
CMPLQBEBTJTUFN1VSLJOKF C
JTLFNJBPUPUKBOUVOH EBFSBI ZBOH EBQBU EJSBOHTBOH ,FNVEJBO CFCFSBQB QFSJTUJXB
D
LBEBS LBMJVN EBSBI ZBOH UJOHHJ BUBV E
GBLUPSGBLUPS CFSMBOHTVOH EBMBN SBOHLBJBO DFQBU TFNVBOZB UFSKBEJ TFDBSB
MBJOOZB
1FSJPEF SFGSBLUFS NFNFOEFL CJBTBOZB UFSKBEJ CFSTBNBBOEBOCFSBLIJSEBMBNLFBEBBOGJCSJMBTJ
TFCBHBJSFTQPOTUFSIBEBQCFSCBHBJPCBU TFQFSUJFQJOFGSJO BUBV 1FSUBNB IBNCBUBOJNQVMTLFCFCFSBQBBSBIUFUBQJCFSIBTJMOZB
TFUFMBI SBOHTBOHBO MJTUSJL CFSVMBOH +BEJ QBEB CFCFSBQB QFOKBMBSBO LF BSBI MBJO NFODJQUBLBO TBUV EBSJ LPOEJTJ ZBOH
HBOHHVBO KBOUVOH JNQVMT ZBOH NBTVLLFNCBMJ EBQBU EJCVUVILBO VOUVL NFOJNCVMLBO JNQVMT NBTVLLFNCBMJZBJUV
NFOZFCBCLBO QPMB LPOUSBLTJ KBOUVOH BCOPSNBM BUBV JSBNB QFOKBMBSBO CFCFSBQB HFMPNCBOH EFQPMBSJTBTJ EJ TFLJUBS KBOUVOH
KBOUVOH BCOPSNBM EFOHBO NFOHBCBJLBO QFOHBSVI QJDV IBOZBLFCFCFSBQBBSBIUFUBQJUJEBLLFBSBIZBOHMBJOOZB
KBOUVOHEBSJOPEVTTJOVT ,FEVB SBOHTBOHBOKBOUVOHZBOHDFQBUBLBONFOZFCBCLBOEVB
Mekanisme Reaksi Berantai Fibrilasi QFSVCBIBO EBMBN PUPU KBOUVOH JUV TFOEJSJ LFEVBOZB NFSVQBLBO
GBLUPS QSFEJTQPTJTJ UFSIBEBQ UJNCVMOZB HFSBLBO CFSQVUBS

1BEB GJCSJMBTJ WFOUSJLFM LJUB BLBO NFMJIBU CBOZBL HFMPNCBOH ,FDFQBUBO LPOEVLTJ NFMBMVJ PUPU KBOUVOH NFOVSVO ZBOH
LPOUSBLTJ ZBOH UFSQJTBIQJTBI EBO LFDJM NFOZFCBS QBEB TBBU NFNVOHLJOLBO TFMBOH XBLUV MFCJI QBOKBOH CBHJ JNQVMT VOUVL
CFSTBNBBOEBMBNBSBICFSCFEBEJTFMVSVIPUPUKBOUVOH*NQVMT EBQBU CFSKBMBO EJ TFLJUBS KBOUVOH
1FSJPEF SFGSBLUFS PUPU
ZBOH NBTVLLFNCBMJ QBEB LFBEBBO GJCSJMBTJ UJEBL IBOZB EJQFSTJOHLBU TFIJOHHB NFNVOHLJOLBO JNQVMT NBTVLLFNCBMJ LF
NFSVQBLBOTFCVBIJNQVMTUVOHHBMZBOHCFSHFSBLEBMBNTVBUV EBMBN PUPU KBOUVOH ZBOH TVEBI UFSBOHTBOH TFCFMVNOZB EBMBN
MJOHLBSBO TFQFSUJ EJQFSMJIBULBO QBEB (BNCBS XBLUVZBOHMFCJIQFOEFLEBSJXBLUVOPSNBM
.FMBJOLBO JNQVMT UFSTFCVU NFNCBOHLJULBO TFSBOHLBJBO ,FUJHB TBMBITBUVHBNCBSBOGJCSJMBTJZBOHQBMJOHQFOUJOHBEBMBI
HFMPNCBOH NVMUJQFM ZBOH NFNJMJLJ HBNCBSBO TFQFSUJ SFBLTJ QFNFDBIBOJNQVMT TFQFSUJZBOHEJHBNCBSLBOQBEBKBOUVOH"#JMB
CFSBOUBJh 4BMBI TBUV DBSB UFSCBJL VOUVL NFOKFMBTLBO QSPTFT HFMPNCBOH EFQPMBSJTBTJ NFODBQBJ EBFSBI SFGSBLUFS EJ EBMBN
GJCSJMBTJ JOJ BEBMBI EFOHBO NFOKFMBTLBO UFSCFOUVLOZB GJCSJMBTJ KBOUVOH HFMPNCBOH JUV BLBO CFSKBMBO QBEB LFEVB TJTJ EJ TFLJUBS
PMFILFKVUMJTUSJLZBOHEJTFCBCLBOPMFIBSVTMJTUSJLCPMBLCBMJL EBFSBI SFGSBLUFS UFSTFCVU +BEJ TFCVBI JNQVMT BLBO UFSQFDBI
TFCFTBSTJLMVT NFOKBEJ EVB JNQVMT ,FNVEJBO CJMB NBTJOHNBTJOH JNQVMT JOJ
Fibrilasi yang Disebabkan oleh Arus Listrik Bolak-Balik NFODBQBJ EBFSBI SFGSBLUFS ZBOH MBJO JNQVMT UFSTFCVU KVHB BLBO
Sebesar 60 Siklus. 1BEB UJUJL QVTBU WFOUSJLFM EJ KBOUVOH " EJQFDBI NFOKBEJ EVB JNQVMT MBHJ %FOHBO DBSB JOJ CBOZBL
QBEB (BNCBS TFCVBI SBOHTBOHBO MJTUSJL TFCFTBS HFMPNCBOHCBSVTFDBSBUFSVTNFOFSVTEJCFOUVLEJKBOUVOHNFMBMVJ
TJLMVT EJCFSJLBO NFMBMVJ TFCVBI FMFLUSPEB QFSBOHTBOH 4JLMVT SFBLTJ CFSBOUBJ ZBOH DFQBU TBNQBJ BLIJSOZB UFSEBQBU CBOZBL
QFSUBNB EBSJ SBOHTBOHBO MJTUSJL NFOZFCBCLBO HFMPNCBOH HFMPNCBOHEFQPMBSJTBTJLFDJMZBOHCFSKBMBOLFCFSCBHBJBSBIQBEB
EFQPMBSJTBTJ NFOZFCBS LF TFHBMB BSBI NFOJOHHBMLBO TFNVB TBBU CFSTBNBBO 4FMBOKVUOZB QPMB QFSKBMBOBO JNQVMT ZBOH UJEBL
PUPU ZBOH UFSEBQBU EJ CBXBI FMFLUSPEB EBMBN LFBEBBO UFSBUVS JOJ BLBO NFOZFCBCLBO CBOZBL KBMVS CFSQVUBS CBHJ
SFGSBLUFS 4FUFMBI LJSBLJSB EFUJL TFCBHJBO EBSJ PUPU JOJ QFSKBMBOBO JNQVMT ZBOH BLBO TBOHBU NFNQFSQBOKBOH MJOUBTBO
NVMBJ LFMVBS EBSJ LFBEBBO SFGSBLUFS #FCFSBQB CBHJBO LFMVBS LPOEVLTJ ZBOH NFSVQBLBO TBMBI TBUV LPOEJTJ VOUVL
EBSJ LFBEBBO SFGSBLUFS TFCFMVN CBHJBO MBJOOZB ,FBEBBO JOJ NFNQFSUBIBOLBO LFBEBBO GJCSJMBTJ 1PMB UFSTFCVU KVHB BLBO
EJHBNCBSLBO QBEB KBOUVOH " PMFI CFCFSBQB CFSDBL QVDBU NFOZFCBCLBO QPMB UJEBL UFSBUVS UFSVT CFSMBOKVU EJ EBFSBI CFSDBL
NFXBLJMJ PUPU KBOUVOH ZBOH TVEBI EJSBOHTBOH EBO CFCFSBQB KBOUVOHSFGSBLUFS
CFSDBL HFMBQ NFXBLJMJ PUPU ZBOH NBTJI EBMBN LFBEBBO ,JUB BLBO NFMJIBU EFOHBO NVEBI CBIXB CJMB TVBUV MJOHLBSBO
SFGSBLUFS 4BBU JOJ SBOHTBOHBO TFCFTBS TJLMVT ZBOH UFSVT TFUBO UFMBI EJNVMBJ -FCJI CBOZBL MBHJ JNQVMT BLBO EJCFOUVL
EJCFSJLBO EBSJ FMFLUSPEB NFOZFCBCLBO JNQVMT IBOZB CFSKBMBO NBLB MFCJI CBOZBL MBHJ CFSDBLCFSDBL PUPU ZBOH SFGSBLUFS EBO
EBMBNBSBIUFSUFOUVEJKBOUVOHUFUBQJUJEBLLFTFHBMBBSBI+BEJ CFSDBL PUPU SFGSBLUFS JOJ BLBO NFOZFCBCLBO MFCJI CBOZBL MBHJ
Titik
QFNFDBIBO JNQVMT 0MFI LBSFOB JUV LBQBO QVO EBFSBI PUPU
impuls Pemecahan KBOUVOHLFMVBSEBSJQFSJPEFSFGSBLUFS NBLBTFCVBIJNQVMTTVEBI
impuls CFHJUVEFLBUVOUVLNBTVLLFNCBMJLFEBFSBIUFSTFCVU
+BOUVOH # EBMBN (BNCBS NFNQFSMJIBULBO UBIBQ BLIJS
ZBOHUFSKBEJEBMBNGJCSJMBTJ%JTJOJLJUBEBQBUSOFMJIBUBEBCBOZBL
JNQVMT ZBOH CFSKBMBO LF TFHBMB BSBI CFCFSBQB EJ BOUBSBOZB
UFSQFDBI EBO NFOBNCBI KVNMBI JNQVMT TFEBOHLBO ZBOH MBJO
EJIBNCBU PMFI EBFSBI ZBOH SFGSBLUFS 4FCFOBSOZB LFKVU MJTUSJL
UVOHHBM ZBOH UFSKBEJ TFMBNB QFSJPEF SFOUBO JOJ TFSJOH LBMJ EBQBU
NFOZFCBCLBO QPMB JNQVMT ZBOH BOFI ZBOH NFOZFCBS LF TFHBMB
Blok BSBIEJTFLJUBSEBFSBIPUPUSFGSBLUFS TFIJOHHBBLBONFOZFCBCLBO
impuls QSPTFTGJCSJMBTJ
A B
Gambaran Elektrokardiogram pada Fibrilasi Ventrikel
Gambar 13-16 ,Awal dari fibrilasi dalam jantung saat
ditemukan bercak-bercak otot yang refrakter. B, Perambatan 1BEB GJCSJMBTJ WFOUSJLFM HBNCBSBO FMFLUSPLBSEJPHSBNOZB TBOHBU
impuls fibritasi terus-menenus pada fibrilasi ventrikel. BOFI (BNCBS
EBOCJBTBOZBUJEBLNFOVOKVLLBO
150
Bab 13 Aritmia Jantung dan Penafsiran Etektrokardiogram
Beberapa ribu volt

selama beberapa milivolt
Pegangan
untuk
UNIT III
melakukan
Fibrilasi ventrikel (sadapan ).
tekanan
LFDFOEFSVOHBOVOUVLLFNCBMJLFJSBNBOPSNBMEBSJKFOJTBQBQVO
4FMBNBCFCFSBQBEFUJLQFSUBNBGJCSJMBTJWFOUSJLFM TFKVNMBICFTBS
NBTTBPUPUBLBOCFSLPOUSBLTJSFMBUJGTFDBSBCFSTBNBBO EBOIBMJOJ
BLBO NFOZFCBCLBO HFMPNCBOH LBTBS EBO UJEBL UFSBUVS EBMBN
FMFLUSPLBSEJPHSBN 4FUFMBI CFCFSBQB EFUJL LFNVEJBO LPOUSBLTJ
WFOUSJLFM LBTBS JOJ NFOHIJMBOH EBO HBNCBSBO FMFLUSPLBSEJPHSBN Elektroda
BLBO CFSVCBI NFOKBEJ TFCVBI QPMB HFMPNCBOH CBSV ZBOH
CFSWPMUBTF SFOEBI EBO TBOHBU UJEBL UFSBUVS +BEJ UJEBL BEB QPMB
FMFLUSPLBSEJPHSBGJL CFSVMBOH ZBOH EBQBU EJMJIBU QBEB GJCSJMBTJ
WFOUSJLFM 4FCBMJLOZB PUPU WFOUSJLFM CFSLPOUSBLTJ TFCBOZBL Penggunaan arus listrik pada dada untuk
IJOHHB CFSDBL LFDJM PUPU QBEB TBUV XBLUV EBO QPUFOTJBM menghentikan fibrilasi ventrikel.
FMFLUSPLBSEJPHSBGJL CFSVCBI TFDBSB LPOTUBO EBO TQBTNPEJL
LBSFOBBSVTMJTUSJLEJEBMBNKBOUVOH QFSUBNBLBMJBLBONFOHBMJS WPMUZBOHCFSBTBMEBSJBSVTMBOHTVOH EJSFDUDVSSFOU
ZBOH
EBMBNTBUVBSBIEBOLFNVEJBOEBMBNBSBIZBOHMBJO EBOKBSBOH EJUFNQFMLBO TFMBNB TFQFSTFLJBO SJCV EFUJL #JMB EJUFNQFMLBO
CFSVMBOHQBEBTJLMVTTQFTJGJLNBOBQVO NFMBMVJ EVB FMFLUSPEB QBEB EJOEJOH EBEB TFQFSUJ ZBOH
EJUVOKVLLBOQBEB(BNCBS QSPTFEVSZBOHVNVNBEBMBI
7PMUBTF HFMPNCBOH EBMBN HBNCBSBO FMFLUSPLBSEJPHSBN QBEB
NFOHJTJ TFCVBI LBQBTJUPS MJTUSJL ZBOH CFTBS TBNQBJ CFCFSBQB
GJCSJMBTJ WFOUSJLFM CJBTBOZB TFLJUBS NJMJWPMU TBBU GJCSJMBTJ
SJCVWPMUEBOLFNVEJBONFOZFCBCLBOLBQBTJUPSJUVNFMFQBTLBO
WFOUSJLFM EJNVMBJ QFSUBNB LBMJ UFUBQJ WPMUBTF JUV BLBO NFOVSVO
NVBUBOOZB TFMBNB TFQFSTFLJBO SJCV EFUJL NFMBMVJ LFEVB
EFOHBODFQBUTFIJOHHBTFUFMBITBNQBJEFUJL WPMUBTFUFSTFCVU
FMFLUSPEBEBOKBOUVOH
CJBTBOZB IBOZB TBNQBJ NJMJWPMU 7PMUBTF LFDJM ZBOH
CFTBSOZB NJMJWPMU BUBV LVSBOH EBSJ JUV EBQBU UFSFLBN TFMBNB Pompa Jantung dengan Menggunakan Tangan
NFOJUBUBVMFCJITFUFMBIGJCSJMBTJWFOUSJLFMEJNVMBJ4FQFSUJUFMBI (Resusitasi Jantung Paru) sebagai Suatu Alat Bantu
EJKFMBTLBO TFCFMVNOZB LBSFOB UJEBL UFSK BEJ QFNPNQBBO EBSBI untuk Defibrilasi
TFMBNBGJCSJMBTJWFOUSJLFM LFBEBBOJOJCFSTJGBUNFNBUJLBOLFDVBMJ #JMB UJEBL EJEFGJCSJMBTJ EBMBN XBLUV NFOJU TFUFMBI GJCSJMBTJ
CJMB EJIFOUJLBO PMFI CFCFSBQB QFOHPCBUBO QFOZFMBNBUBO TFQFSUJ EJNVMBJ KBOUVOH CJBTBOZB UFSMBMV *FNBI VOUVL EBQBU
EFOHBOLFKVUMJTUSJLZBOHDFQBUQBEBKBOUVOH ZBOHBLBOEJKFMBTLBO EJCBOHLJULBO MBHJ EFOHBO EFGJCSJMBTJ LBSFOB KBOUVOH UFMBI
EBMBNCBHJBOCFSJLVUJOJ LFLVSBOHBO OVUSJTJ EBSJ BMJSBO EBSBI LPSPOFS "LBO UFUBQJ
KBOUVOHNBTJINVOHLJOEJCBOHLJULBOCJMBTFCFMVNOZBKBOUVOH
Defibrilasi Ventrikel dengan Kejut Listrik
EJQPNQB EFOHBO UBOHBO QFOFLBOBO TFDBSB JOUFSNJUFO
EBO
8BMBVQVO BSVT MJTUSJL CPMBLCBMJL EFOHBO WPMUBTF TFEBOH ZBOH LFNVEJBOKBOUVOHEJEFGJCSJMBTJ%FOHBODBSBJOJTFKVNMBILFDJM
EJMFUBLLBOMBOHTVOHLFWFOUSJLFMIBNQJSTFMBMVNFNCVBUWFOUSJLFM EBSBI BLBO EJIBOUBSLBO LF BPSUB EBO UFSCFOUVL TVQMBJ EBSBI
KBUVI LF EBMBN GJCSJMBTJ BSVT MJTUSJL CPMBLCBMJL EFOHBO WPMUBTF LPSPOFS ZBOH IBSV ,FNVEJBO TFUFMBI CFCFSBQB NFOJU
UJOHHJ ZBOH NFMFXBUJ WFOUSJLFM TFMBNB TFQFSTFLJBO EFUJL EBQBU NFNPNQB EFOHBO UBOHBO EFGJCSJMBTJ MJTUSJL TFSJOH EBQBU
NFOHIFOUJLBO GJCSJMBTJ EFOHBO NFNCVBU TFNVB PUPU WFOUSJLFM EJMBLVLBOMBHJ#BILBO QBEBKBOUVOHZBOHNFOHBMBNJGJCSJMBTJ
CFSBEB EBMBN LFBEBBO SFGSBLUFS TFDBSB CFSTBNBBO ,FBEBBO JOJ ZBOH UFMBI EJQPNQB EFOHBO UBOHBO TFMBNB NFOJU UFUBQ
EBQBU EJDBQBJ EFOHBO NFOHBMJSLBO BSVT LVBU NFMBMVJ FMFLUSPEB EBQBUEJJLVUJEFOHBOEFGJCSJMBTJZBOHTVLTFT
CFTBSZBOHEJMFUBLLBOQBEBLFEVBTJTJKBOUVOH"SVTBLBONBTVL 4FCVBI UFLOJL QFNPNQBBO KBOUVOH UBOQB NFNCVLB
LF EBMBN TFCBHJBO CFTBS TFSBCVU WFOUSJLFM QBEB TBBU ZBOH EJOEJOH EBEB UFSEJSJ BUBT EPSPOHBO UFLBOBO ZBOH JOUFSNJUFO
CFSTBNBBO TFIJOHHB QBEB EBTBSOZB NFSBOHTBOH TFNVB CBHJBO QBEB EJOEJOH EBEB CFSTBNB EFOHBO QFNCFSJBO QFSOBQBTBO
WFOUSJLFM TFDBSB CFSTBNBBO EBO NFOZFCBCLBO TFNVB CBHJBO CVBUBO5JOEBLBOUFSTFCVUEJUBNCBIEFOHBOEFGJCSJMBTJEJTFCVU
WFOUSJLFM NFOKBEJ SFGSBLUFS 4FNVB QPUFOTJBM BLTJ BLBO CFSIFOUJ TFCBHBJSFTVTJUBTJKBOUVOHQBSVBUBV3+1
EBO KBOUVOH UFUBQ UJEBL CFSEFOZVU TFMBNB TBNQBJ EFUJL ,FLVSBOHBOBMJSBOEBSBILFPUBLTFMBNBMFCJIEBOTBNQBJ
LFNVEJBO TFUFMBI JUV KBOUVOH BLBO NVMBJ CFSEFOZVU LFNCBMJ NFOJU CJBTBOZB BLBO NFOZFCBCLBO HBOHHVBO NFOUBM ZBOH
CJBTBOZBEFOHBO OPEVT TJOVT BUBV CFCFSBQB CBHJBO KBOUVOH MBJO QFSNBOFO BUBV CBILBO LFSVTBLBO QBEB KBSJOHBO PUBL
TFCBHBJ QJDV KBOUVOH "LBO UFUBQJ QBEB UFNQBU NBTVLLFNCBMJ 8BMBVQVOKBOUVOHEBQBUEJCBOHLJULBOLFNCBMJ PSBOHUFSTFCVU
ZBOH TBNB EFOHBO ZBOH BXBMOZB NFNCVBU WFOUSJLFM NBTVL LF CJTBNFOJOHHBMBLJCBULFSVTBLBOPUBL BUBVEBQBUIJEVQEFOHBO
EBMBN LFBEBBO GJCSJMBTJ TFSJOH LBMJ NBTJI EBQBU EJUFNVLBO QBEB LFSVTBLBONFOUBMZBOHQFSNBOFO
LBTVTJOJGJCSJMBTJEBQBUNVMBJLFNCBMJEFOHBOTFHFSB
#JMBFMFLUSPEBMBOHTVOHEJUFNQFMLBOQBEBLFEVBTJTJKBOUVOH Fibrilasi Atrium
GJCSJMBTJ CJBTBOZB EBQBU EJIFOUJLBO EFOHBO NFOHHVOBLBO WPMUBTF
TFCFTBS WPMU ZBOH CFSBTBM EBSJ BSVT CPMBLCBMJL TFCFTBS *OHBU CBIXB LFDVBMJ VOUVL IVCVOHBO KBMVS LPOEVLTJ NFMBMVJ
TJLMVT ZBOHEJUFNQFMLBOTFMBNB EFUJLBUBVEFOHBOWPMUBTF CFSLBT"7 NBTTBPUPUBUSJVNEJQJTBILBOEBSJNBTTBPUPU
151
Unit III Jantung
WFOUSJLFM PMFI KBSJOHBO GJCSPTB 0MFI LBSFOB JUV GJCSJMBTJ TFUFMBI JNQVMT QFSUBNB QBMJOH TFEJLJU IBSVT BEB TFMBOH XBLUV
WFOUSJLFM TFSJOH UFSKBEJ UBOQB GJCSJMBTJ BUSJVN %FNJLJBO KVHB EFUJL BOUBSB TBUV LPOUSBLTJ WFOUSJLFM EFOHBO LPOUSBLTJ
GJCSJMBTJ TFSJOH UFSKBEJ EJ EBMBN BUSJVN UBOQB EJTFSUBJ GJCSJMBTJ CFSJLVUOZB ,FNVEJBO UFSEBQBU UBNCBIBO TFMBOH XBLUV ZBOH
WFOUSJLFM EJUVOKVLLBOEJCBHJBOLBOBOQBEB(BNCBS
CFSWBSJBTJ EBSJ TBNQBJ EFUJL TFCFMVN TBUV JNQVMT EBSJ
.FLBOJTNF GJCSJMBTJ BUSJVN JEFOUJL EFOHBO NFLBOJTNF GJCSJMBTJBUSJVNZBOHUJEBLUFSBUVSUJCBEJOPEVT"7+BEJ TFMBOH
GJCSJMBTJ WFOUSJLFM LFDVBMJ CBIXB QSPTFTOZB UFSKBEJ IBOZB EJ XBLUV BOUBSB LPOUSBLTJWFOUSJLFM CFSJLVUOZB CFSWBSJBTJ EBSJ
NBTTB PUPU BUSJVN EBO CVLBO EJ NBTTB PUPU WFOUSJLFM QBMJOHTFEJLJUTFLJUBS EFUJLTBNQBJQBMJOHCBOZBLTFLJUBS
1FOZFCBC ZBOH TFSJOH NFOJNCVMLBO GJCSJMBTJ BUSJVN BEBMBI EFUJL ZBOH NFOZFCBCLBO EFOZVU KBOUVOH TBOHBU UJEBL UFSBUVS
QFNCFTBSBO BUSJVN BLJCBU MFTJ QBEB LBUVQ KBOUVOH ZBOH 4FCFOBSOZB LFUJEBLUFSBUVSBO JOJ ZBOH EJQFSMJIBULBO PMFI KBSBL
NFODFHBI BUSJVN NFOHPTPOHLBO JTJOZB TFDBSB BEFLVBU LF EFOZVU KBOUVOH ZBOH CFSWBSJBTJ EBMBN HBNCBSBO
EBMBN WFOUSJLFM BUBV LBSFOB LFHBHBMBO WFOUSJLFM ZBOH FMFLUSPLBSEJPHSBN QBEB (BNCBS BEBMBI TBMBI TBUV
EJBLJCBULBOPMFIQFNCFOEVOHBOEBSBIZBOHCBOZBLEJEBMBN UFNVBO LMJOJT ZBOH EBQBU EJHVOBLBO VOUVL NFOEJBHOPTJT
BUSJVN %JOEJOH BUSJVN ZBOH CFSEJMBUBTJ NFSVQBLBO LPOEJTJ LFBEBBOJOJ0MFILBSFOBGSFLVFOTJJNQVMTQBEBGJCSJMBTJBUSJVN
ZBOH JEFBM VOUVL NFOZFCBCLBO KBMVS LPOEVLTJ ZBOH QBOKBOH ZBOHDFQBU WFOUSJLFMKVHBEJLFOEBMJLBOEBMBNGSFLVFOTJEFOZVU
EFNJLJBOKVHBEFOHBOLPOEVLTJZBOHMBNCBU ZBOHLFEVBOZB KBOUVOHDFQBU CJBTBOZBBOUBSBEBOLBMJNFOJU
NFSVQBLBOGBLUPSQSFEJTQPTJTJGJCSJMBTJBUSJVN Pengobatan Kejut Listrik untuk Fibrilasi Atrium. %FOHBO
DBSB ZBOH TBNB CBIXB GJCSJMBTJ WFOUSJLFM EBQBU EJVCBI
Karakteristik Pemompaan Atrium Selama Fibrilasi
LFNCBMJ NFOKBEJ JSBNB OPSNBM EFOHBO NFOHHVOBLBO LFKVU
Atrium. %FOHBO BMBTBO ZBOH TBNB CBIXB WFOUSJLFM UJEBL
MJTUSJL EFNJLJBO KVHB GJCSJMBTJ BUSJVN EBQBU EJLFNCBMJLBO LF
BLBONFNPNQBEBSBITFMBNBGJCSJMBTJWFOUSJLFMCFSMBOHTVOH
JSBNB OPSNBM EFOHBO SOFOHHVOBLBO LFKVU MJTUSJL 1BEB
EFNJLJBO KVHB BUSJVN UJEBL BLBO NFNPNQB EBSBI TFMBNB
EBTBSOZB QSPTFEVSOZB TBNB TFQFSUJ QBEB QFOHVCBIBO
GJCSJMBTJ BUSJVN 0MFI LBSFOB JUV BUSJVN NFOKBEJ UJEBL
GJCSJMBTJ WFOUSJLFM CFSJLBO BMJSBO LFKVU MJTUSJL UVOHHBM LVBU
CFSHVOBTFCBHBJQPNQBQFOEBIVMVCBHJWFOUSJLFM8BMBVQVO
NFMBMVJ KBOUVOH ZBOH BLBO NFNCVBU TFMVSVI KBOUVOH EBMBN
EFNJLJBO EBSBI BLBO NFOHBMJS TFDBSB QBTJG EBSJ BUSJVN LF
LFBEBBO SFGSBLUFS TFMBNB CFCFSBQB EFUJL TFSJOH LBMJ JSBNB
EBMBN WFOUSJLFM EBO FGJTJFOTJ QPNQB WFOUSJLFM IBOZB BLBO
OPSNBMBLBONFOHJLVUJCJMBKBOUVOHNBNQVNFMBLVLBOOZB
NFOVSVO TFCBOZBL TBNQBJ QFSTFO 0MFI LBSFOB JUV
EJCBOEJOHLBO EFOHBO TJGBU ZBOH NFNBUJLBO EBSJ GJCSJMBTJ
Atrial Flutter
WFOUSJLFM PSBOH EBQBU IJEVQ TFMBNB CFCFSBQB CVMBO CBILBO
CFSUBIVOUBIVO EFOHBO GJCSJMBTJ BUSJVN XBMBVQVO UFSKBEJ "USJBM GMVUUFS NFSVQBLBO LFBEBBO MBJO ZBOH EJTFCBCLBO PMFI
QFOVSVOBOFGJTJFOTJEBSJTFMVSVIEBZBQPNQBKBOUVOH HFSBLBO CFSQVUBS EJ EBMBN BUSJVN "USJBM GMVUUFS CFSCFEB
Gambaran Elektrokardiogram pada Fibrilasi Atrium. EFOHBO GJCSJMBTJ BUSJVN LBSFOB TJOZBM MJTUSJL CFSKBMBO TFCBHBJ
(BNCBS NFNQFSMJIBULBO FMFLUSPLBSEJPHSBN TFMBNB TFCVBI HFMPNCBOH CFTBS ZBOH UFSVT NFOHFMJMJOHJ NBTTB PUPU
CFSMBOHTVOHOZB GJCSJMBTJ BUSJVN 4FKVNMBI HFMPNCBOH BUSJVN EBMBN TBUV BSBI TFQFSUJ ZBOH EJUVOKVLLBO QBEB CBHJBO
EFQPMBSJTBTJ LFDJM NFOZFCBS LF TFHBMB BSBI NFMBMVJ BUSJVN LJSJEBMBN(BNCBS"USJBMGMVUUFSNFOZFCBCLBOGSFLVFOTJ
TFMBNB GJCSJMBTJ BUSJVN 0MFI LBSFOB HFMPNCBOHHFMPNCBOH LPOUSBLTJ BUSJVN ZBOH DFQBU CJBTBOZB BOUBSB TBNQBJ
UFSTFCVU MFNBI EBO CBOZBL ZBOH NFNJMJLJ QPMBSJUBT EFOZVUNFOJU"LBOUFUBQJ LBSFOBTBUVTJTJBUSJVNCFSLPOUSBLTJ
CFSMBXBOBOEJTFUJBQXBLUV HFMPNCBOHHFMPNCBOHUFSTFCVU TFNFOUBSB TJTJ ZBOH MBJO CFSFMBLTBTJ KVNMBI EBSBI ZBOH
CJBTBOZB IBNQJS TFDBSB LFTFMVSVIBO TBMJOH NFOFUSBMLBO EJQPNQB PMFI BUSJVN TBOHBU TFEJLJU -FCJI MBOKVU TJOZBM ZBOH
TBUVTBNBMBJO0MFILBSFOBJUV EJEBMBNFMFLUSPLBSEJPHSBN NFODBQBJ OPEVT "7 UFSMBMV DFQBU VOUVL EJIBOUBSLBO LF
LJUBEBQBUNFMJIBUCBIXBUJEBLBEBHFMPNCBOH1EBSJBUSJVN WFOUSJLFM TFMVSVIOZB LBSFOB QFSJPEF SFGSBLUFS OPEVT "7 EBO
ZBOHEBQBUUFSFLBN BUBVIBOZBUFSFLBNTFCVBIHFMPNCBOH CFSLBT "7 UFSMBMV QBOKBOH VOUVL EBQBU SOFOHIBOUBSLBO MFCJI
IBMVT CFSGSFLVFOTJ UJOHHJ EFOHBO WPMUBTF TBOHBU SFOEBI EBSJ TBUV CBHJBO LFDJM TJOZBM EBSJ BUSJVN UFSTFCVU 0MFI LBSFOB
4FCBMJLOZB LPNQMFLT 2345 UFSMJIBU OPSNBM LFDVBMJ KJLB JUV CJBTBOZB BEB EVB TBNQBJ UJHB EFOZVU BUSJVN VOUVL TFUJBQ
UFSEBQBU LFMBJOBO WFOUSJLFM UFUBQJ XBLUVOZB UJEBL UFSBUVS EFOZVUWFOUSJLFM
TFQFSUJZBOHBLBOEJKFMBTLBOCFSJLVUJOJ (BNCBS NFOVOKVLLBO HBNCBSBO FMFLUSPLBSEJPHSBN
ZBOHLIBTQBEBBUSJBMGMVUUFS(FMPNCBOH1UBNQBLLVBUBLJCBU
Ketidakteraturan Irama Ventrikel Selama Fibrilasi
Atrium. #JMBBUSJVNNFOHBMBNJGJCSJMBTJ JNQVMTZBOHCFSBTBM
EBSJ PUPU BUSJVN BLBO UJCB QBEB OPEVT "7 EFOHBO DFQBU
UFUBQJ KVHB UJEBL UFSBUVS 0MFI LBSFOB OPEVT "7 UJEBL BLBO
NFOHIBOUBSLBOJNQVMTLFEVBTFMBNBLJSBLJSB EFUJL
Fibrilasi atrium (sadapan ). Gelombang yang Arial flutter Fibrilasi atrium

dapat ditihat adalah gelombang ventrikel RS dan gelombang T.
152
Bab 13 Aritmia Jantung dan Penafsiran Etektrokardiogram
Daftar Pustaka
Antzelevitch C: Role of spatial dispersion of repolarization in inherited
and acquired sudden cardiac death syndromes, Am J Physiol Heart Circ
Physiol 293:H2024, 2007.
ial l e e andingan i ama a i m dan
UNIT III
Awad MM, Calkins H, Judge DP: Mechanisms of disease: molecular genetics
en ikel dan sada am of arrhythmogenic right ventricular dysplasia/cardiomyopathy, Nat Clin
Pract Cardiovasc Med 5:258, 2008.
Barbuti A, DiFrancesco D: Control of cardiac rate by “funny” channels in
LPOUSBLTJ NBTTB PUPU ZBOH UFSLPPSEJOBTJ TFCBHJBO "LBO UFUBQJ health and disease, Ann N Y Acad Sci 1123:213, 2008.
QFSIBUJLBO KVHB EBMBN SFLBNBO CBIXB LPNQMFLT 2345 BLBO Cheng H, Lederer WJ: Calcium sparks, Physiol Rev 88:1491, 2008. Dobrzynski
NFOHJLVUJ HFMPNCBOH 1 BUSJVN IBOZB TFLBMJ VOUVL EVB TBNQBJ H, Boyett MR, Anderson RH: New insights into pacemaker
activity: promoting understanding of sick sinus syndrome, Circulation
UJHBEFOZVUBUSJVN TFIJOHHBNFOHIBTJMLBOJSBNBBUBV 115:1921, 2007.
Elizari MV, Acunzo RS, Ferreiro M: Hemiblocks revisited, Circulation
115:1154, 2007.
Henti Jantung Jalife J: Ventricular fibrillation: mechanisms of initiation and maintenance,
Annu Rev Physiol 62:25, 2000.
Lubitz SA, Fischer A, Fuster V: Catheter ablation for atrial fibrillation, BMJ
,FMBJOBO ZBOH QBMJOH BLIJS EBSJ TJTUFN JSBNBLPOEVLTJ KBOUVOH 336:819, 2008.
ZBOH CFSBU BEBMBI IFOUJ KBOUVOH )FOUJ KBOUVOH UJNCVM BLJCBU Maron BJ: Sudden death in young athletes, N Engl J Med 349:1064, 2003.
UFSIFOUJOZB TFNVB TJOZBM LFOEBMJ MJTUSJL EJ KBOUVOH :BJUV UJEBL Morita H, Wu J, Zipes DP: The QT syndromes: long and short, Lancet
BEBMBHJJSBNBZBOHTQPOUBO 372:750, 2008.
Murray KT, Roden DM: Disorders of cardiac repolarization: the long QT syn-
)FOUJKBOUVOHNVOHLJOUJNCVMTFXBLUVBOFTUFTJBZBOHEBMBN
dromes. In Crawford MG, DiMarco JP, editors: Cardiology, London, 2001,
LFUJLBCFCFSBQBQBTJFONFOHBMBNJIJQPLTJBCFSBUBLJCBUSFTQJSBTJ Mosby.
ZBOHUJEBLBEFLVBU)JQPLTJBBLBONFODFHBITFSBUTFSBUPUPUEBO Myerburg RJ: Implantable cardioverter-defibrillators after myocardial
TFSBUTFSBU LPOEVLTJ NFNQFSUBIBOLBO QFSCFEBBO LPOTFOUSBTJ infarction, N Engl J Med 359:2245, 2008.
FMFLUSPMJU ZBOH OPSNBM EJ TFLJUBS NFNCSBO EBO FLTJUBCJMJUBT Passman R, Kadish A: Sudden death prevention with implantable devices,
Circulation 116:561, 2007.
NFNCSBOCJTBTBOHBUEJQFOHBSVIJTFIJOHHBJSBNBPUPNBUJTBLBO
Roden DM: Drug-induced prolongation of the QT interval, N Engl J Med
IJMBOH 350:1013, 2004.
1BEB TFCBHJBO CFTBS LFBEBBO IFOUJ KBOUVOH BLJCBU BOFTUFTJ Sanguinetti MC: Tristani-Firouzi M: hERG potassium channels and cardiac
SFTVTJUBTJ KBOUVOH QBSV ZBOH EJQFSQBOKBOH DVLVQ CFSIBTJM arrhythmia, Nature 440:463, 2006.
CFCFSBQB NFOJU BUBV CBILBO KBN
EBMBN NFODJQUBLBO LFNCBMJ Swynghedauw B, Baillard C, Milliez P: The long QT interval is not only
inherited but is also linked to cardiac hypertrophy, J Mol Med 81:336,
JSBNB KBOUVOH ZBOH OPSNBM 1BEB CFCFSBQB QBTJFO QFOZBLJU
2003.
NJPLBSEJVN ZBOH CFSBU EBQBU NFOZFCBCLBO IFOUJ KBOUVOH ZBOH Wang K, Asinger RW, Marriott HJ: ST-segment elevation in conditions other
QFSNBOFO BUBV TFNJQFSNBOFO ZBOH EBQBU NFOZFCBCLBO than acute myocardial infarction, N Engl J Med 349:2128, 2003. Zimetbaum
LFNBUJBO6OUVL NFOHPCBUJ LFBEBBO JOJ JNQVMT MJTUSJL ZBOH PJ, Josephson ME: Use of the electrocardiogram in acute myo-
UFSBUVS EBSJ BMBU QJDV KBOUVOH FMFLUSPOJL ZBOH EJUBOBN UFMBI cardial infarction, N Engl J Med 348:933, 2003.
CFSIBTJM EJHVOBLBO VOUVL NFNQFSUBIBOLBO BHBS QBTJFO EBQBU
UFUBQIJEVQTFMBNBCFSCVMBOCVMBOBUBVCFSUBIVOUBIVO
153
IV
UNIT
4JSLVMBTJ
14. lkhtisar Sirkulasi; Biofisik Tekanan, Aliran,
dan Tahanan
15. Distensibilitas Vaskular serta Fungsi
Sistem Vena dan Arteri
16. Mikrosirkulasi dan Sistem Limfatik:
Pertukaran Cairan Kapiler, Cairan
Interstitial, dan Aliran Limfe
17. Pengendalian Lokal dan Humoral Aliran
Darah Jaringan
18. Pengaturan Sirkulasi oleh Saraf, dan
Pengendalian Cepat Tekanan Arteri
19. Peran Ginjal dalam Pengaturan Tekanan
Arteri Jangka Panjang dan Hipertensi:
Sistem Terintegrasi Pengaturan Tekanan
Arteri
20. Curah Jantung, Aliran Batik Vena, dan
Pengaturannya
21. Aliran Darah Otot dan Curah Jantung
Selama Kerja Fisik; Sirkulasi Koroner dan
Penyakit Jantung lskemik
22. Gagal Jantung
23. Katup Jantung dan Bunyi Jantung;
Kelainan Katup dan Jantung Bawaan
24. Syok Sirkulasi dan Pengobatannya
BAB 14
UNIT IV
*LIUJTBS4JSLVMBTJ#JPGJTJL
5FLBOBO "MJSBO EBO5BIBOBO
'VOHTJ TJSLVMBTJ BEBMBI BSUFSJEBO CFSGVOHTJTFCBHBJ TBMVSBOLFOEBMJ VOUVL NFOFOUVLBO

VOUVL NFNFOVIJ LFCVUVIBO EBOCFSGVOHTJTFCBHBJTBMVSBOLFOEBMJVOUVLNFOFOUVLBOEBSBI
KBSJOHBO UVCVI VOUVL ZBOHBLBOEJMFQBTLBOLFLBQJMFS"SUFSJPMNFNJMJLJEJOEJOHPUPU
NFOUSBOTQPS[BUNBLBOBOLF ZBOH LVBU TFIJOHHB EBQBU NFOVUVQ BSUFSJPM TFDBSB UPUBM BUBV
KBSJOHBO UVCVI VOUVL EFOHBO CFSFMBLTBTJ EBQBU NFOEJMBUBTJ QFNCVMVI IJOHHB
NFOUSBOTQPSQSPEVLQSPEVL CFCFSBQB LBMJ MJQBU TFIJOHHB NFNQVOZBJ LFNBNQVBO CFTBS
TJTB NFUBCPMJTNF LFMVBS VOUVL NFOUSBOTQPS IPSNPO EBSJ TBUV VOUVL NFOHVCBI BMJSBO EBSBI EJ UJBQ KBSJOHBO TFCBHBJ SFTQPOT
CBHJBOUVCVILFCBHJBOUVCVIZBOHMBJO EBOTFDBSBVNVN VOUVL UFSIBEBQLFCVUVIBOOZB
'VOHTJLBQJMFSBEBMBIVOUVLQFSUVLBSBODBJSBO [BUNBLBOBO
NFNQFSUBIBOLBOMJOHLVOHBOZBOHTFTVBJEJEBMBNTFMVSVIDBJSBO FMFLUSPMJU IPSNPO EBO CBIBOCBIBO MBJOOZB BOUBSB EBSBI EBO
KBSJOHBO UVCVI BHBS TFM CJTB CFSUBIBO IJEVQ EBO CFSGVOHTJ TFDBSB DBJSBO JOUFSTUJTJBM 6OUVL EBQBU NFMBLVLBO QFSBO JOJ EJOEJOH
PQUJNBM LBQJMFS CFSTJGBU TBOHBU UJQJT EBO NFNJMJLJ CBOZBL QPSJQPSJ
,FDFQBUBO BMJSBO EBSBI ZBOH NFMFXBUJ TFCBHJBO CFTBS
LBQJMFS LFDJM ZBOH QFSNFBCFM UFSIBEBQ BJS EBO [BU CFSNPMFLVM
KBSJOHBO EJLFOEBMJLBO UFSVUBNB TFCBHBJ SFTQPOT UFSIBEBQ
LFDJMMBJOOZB
LFCVUVIBO KBSJOHBO UFSIBEBQ [BU NBLBOBO 1BEB CFCFSBQB
7FOVMB NFOHVNQVMLBO EBSBI EBSJ LBQJMFS EBO TFDBSB
PSHBO TFQFSUJ HJOKBM TJSLVMBTJ NFOZFEJBLBO GVOHTJ UBNCBIBO
CFSUBIBQCFSHBCVOHNFOKBEJWFOBZBOHTFNBLJOCFTBS
"MJSBO EBSBI LF HJOKBM NJTBMOZB KBVI NFMFCJIJ LFCVUVIBO
7FOBCFSGVOHTJTFCBHBJTBMVSBOVOUVLNFOHBOHLVUEBSBIEBO
NFUBCPMJTNFOZB EBO EJLBJULBO EFOHBO GVOHTJ FLTLSFTJ ZBOH
WFOVMB LFNCBMJ LF KBOUVOH TBNB QFOUJOHOZB WFOB CFSQFSBO
NFOVOUVUWPMVNFEBSBIZBOHCFTBSVOUVLEJGJMUSBTJTFUJBQNFOJU
TFCBHBJQFOBNQVOHVUBNBEBSBIFLTUSB0MFILBSFOBUFLBOBOEJ
+BOUVOHEBOQFNCVMVIEBSBITFMBOKVUOZBEJLFOEBMJLBOVOUVL
TJTUFNWFOBTBOHBUSFOEBI EJOEJOHWFOBTBOHBUUJQJT.FTLJQVO
NFNFOVIJ DVSBI KBOUVOH EBO UFLBOBO BSUFSJ ZBOH TFTVBJ BHBS
EFNJLJBO EJOEJOHOZBNFNQVOZBJPUPUZBOHDVLVQVOUVLEBQBU
BMJSBO EBSBI NFOHBMJS EJ KBSJOHBO TFTVBJ EFOHBO KVNMBI ZBOH
CFSLPOUSBLTJBUBVNFMFCBS EBOEFOHBOEFNJLJBOEBQBUCFSQFSBO
EJCVUVILBO .FLBOJTNF BQB TBKB ZBOH EJHVOBLBO VOUVL
TFCBHBJ QFOBNQVOH EBSBI FLTUSB ZBOH EBQBU EJLFOEBMJLBO CBJL
QFOHBUVSBO WPMVNF EBSBI EBO BMJSBO EBSBI EBO CBHBJNBOB
EBMBN KVNMBI LFDJM BUBV CFTBS CFSHBOUVOH QBEB LFCVUVIBO
IVCVOHBO IBM JOJ EFOHBO TFMVSVI GVOHTJ TJSLVMBTJ MBJOOZB
TJSLVMBTJ
#FSJLVUBEBMBICFCFSBQBCBIBTBOEBOQFSUBOZBBOZBOHBLBOLJUB
EJTLVTJLBOEJCBCJOJNFOHFOBJTJSLVMBTJ Volume Darah di Berbagai Bagian Sirkulasi.
(BNCBS NFNCFSJLBO JLIUJTBS NFOHFOBJ TJSLVMBTJ EBO
Karakteristik Fisik Sirkulasi EBGUBS QFSTFOUBTF WPMVNF EBSBI UPUBM EJ CBHJBO VUBNB TJSLVMBTJ
4FCBHBJDPOUPI TFLJUBSQFSTFOEBSJTFMVSVIWPMVNFEBSBIEJ
EBMBN UVCVI UFSEBQBU EJ TJSLVMBTJ TJTUFNJL EBO QFSTFO EJ
4JSLVMBTJ EJQFSMJIBULBO QBEB (BNCBS EJCBHJ NFOKBEJ
EBMBNKBOUVOHEBOQBSV%BSJQFSTFOEJTJSLVMBTJTJTUFNJL
TJSLVMBTJ TJTUFNJL EBO TJSLVMBTJ QBSV 0MFI LBSFOB TJSLVMBTJ
QFSTFOOZB EJ WFOB QFSTFO EJ BSUFSJ EBO QFSTFO EJ BSUFSJPM
TJTUFNJL NFOZVQMBJ BMJSBO EBSBI LF TFMVSVI KBSJOHBO UVCVI
TJTUFNJL EBO LBQJMFS +BOUVOH NFOHBOEVOH QFSTFO EBSBI
LFDVBMJ QBSV EBQBU KVHB EJTFCVU TJSLVMBTJ CFTBS BUBV TJSLVMBTJ
TFEBOHLBOQFNCVMVIEBSBIQBSVNFOHBOEVOHQFSTFO
QFSJGFS
)BM ZBOH TBOHBU NFOHIFSBOLBO BEBMBI SFOEBIOZB WPMVNF
#BHJBO 'VOHTJPOBM 4JSLVMBTJ 4FCFMVN NFNCBIBT GVOHTJ EBSBI EJ LBQJMFS 1BEBIBM EJ TJOJMBI UFSKBEJOZB GVOHTJ ZBOH
TJSLVMBTJ TFDBSB MFCJI EFUBJM UFSMFCJI EBIVMV IBSVT EJQBIBNJ QBMJOH QFOUJOH EBSJ TJSLVMBTJ ZBJUV [BU[BU CFSEJGVTJ LFMVBS EBO
QFSBOTFUJBQCBHJBOTJSLVMBTJ NBTVL BOUBSB EBSBI EBO KBSJOHBO 'VOHTJ JOJ BLBO EJCJDBSBLBO
'VOHTJBSUFSJBEBMBIVOUVLNFOUSBOTQPSEBSBILFKBSJOHBOEJ TFDBSBMFCJIEFUBJMQBEB#BC
CBXBI UFLBOBO ZBOH UJOHHJ 0MFI LBSFOB BMBTBO JOJMBI BSUFSJ
Luas Penampang dan Kecepatan Aliran Darah.
NFNQVOZBJ EJOEJOH QFNCVMVI EBSBI ZBOH LVBU EBO EBSBI #JMB TFNVB QFNCVMVI TJTUFNJL EBSJ NBTJOHNBTJOH KFOJT
NFOHBMJSEFOHBOLFDFQBUBOUJOHHJEJBSUFSJ EJKBKBSLBO SBUBSBUB MVBT QFOBNQBOH UPUBMOZB QBEB NBOVTJB
"SUFSJPMNFSVQBLBODBCBOHDBCBOHLFDJMUFSBLIJSTJTUFN BLBONFOKBEJTFCBHBJCFSJLVU
157
Unit IV Sirkulasi
ZBOH TJOHLBU JOJ NFSVQBLBO GBLUB ZBOH NFOHIFSBOLBO

NFOHJOHBU TFNVB EJGVTJ [BU NBLBOBO EBO FMFLUSPMJU NFMBMVJ
EJOEJOHLBQJMFSIBSVTUFSKBEJEBMBNXBLUVTJOHLBUUFSTFCVU
Tekanan di Berbagai Bagian Sirkulasi.

0MFI LBSFOB KBOUVOH NFNPNQB EBSBI TFDBSB LPOUJOV LF EBMBN
BPSUB UFLBOBO SBUBSBUB EJ BPSUB NFOKBEJ UJOHHJ SBUBSBUB
TFLJUBS NN )H %FNJLJBO KVHB LBSFOB QFNPNQBBO PMFI
KBOUVOHCFSTJGBUQVMTBUJM UFLBOBOBSUFSJCFSHBOUJHBOUJBOUBSBOJMBJ
UFLBOBO TJTUPMJL NN )H EBO OJMBJ UFLBOBO EJBTUPMJL NN
)H TFQFSUJUFSMJIBUQBEBTJTJLJSJEBMBN(BNCBS
4FMBNBEBSBINFOHBMJSNFMBMVJTJSLVMBTJTJTUFNJL UFLBOBOSBUB
SBUB NFOVSVO TFDBSB QSPHSFTJG TBNQBJ LJSBLJSB NN )H QBEB
XBLUV NFODBQBJ VKVOH WFOB DBWB ZBOH NFSVQBLBO UFNQBU
Systemic NFOHPTPOHLBOEBSBILFEBMBNBUSJVNLBOBOKBOUVOH
vessels
5FLBOBOEBMBNLBQJMFSTJTUFNJLCFSWBSJBTJEBSJTFUJOHHJNN
)H EJ EFLBU VKVOH BSUFSJPM TBNQBJ TFSFOEBI NN )H EJ EFLBU
VKVOHWFOB UFUBQJUFLBOBOGVOHTJPOBMSBUBSBUBOZBQBEBTFCBHJBO
% CFTBS QFNCVMVI EBSBI BEBMBI NN )H NFSVQBLBO UFLBOBO
ZBOH DVLVQ SFOEBI TFIJOHHB IBOZB TFEJLJU QMBTNB BLBO CPDPS
LFMVBS EBSJ QPSJQPSJ LFDJM EJ EJOEJOH LBQJMFS XBMBVQVO [BU
NBLBOBO EBQBU CFSEJGVTJ EFOHBO NVEBI NFMBMVJ QPSJQPSJ ZBOH
TBNBLFTFMTFMKBSJOHBOZBOHMFCJIKBVI
1FSIBUJLBOQBEBTJTJLBOBO(BNCBS ZBOHNFNQFSMJIBULBO
UFLBOBOCFSVSVUBOQBEBCFSCBHBJCBHJBOTJSLVMBTJQBSV1BEBBSUFSJ
QVMNPOBMJT UFLBOBO CFSTJGBU QVMTBUJM TBNB TFQFSUJ QBEB BPSUB
UFUBQJ UFLBOBOOZB KBVI MFCJI SFOEBI UFLBOBO TJTUPMJL BSUFSJ
QVMNPOBMJT SBUBSBUB TFLJUBS NN )H EBO UFLBOBO EJBTUPMJL
NN)H EFOHBOUFLBOBOBSUFSJQVMNPOBMJTSBUBSBUBIBOZBNN
)H 5FLBOBO LBQJMFS QBSV SBUBSBUB IBOZB TFLJUBS NN )H
5FSOZBUB UPUBM BMJSBO EBSBI NFMBMVJ QBSV TFUJBQ NFOJUOZB TBNB
Pembuluh Luas penampang (cm2) EFOHBOZBOHNFMBMVJTJSLVMBTJTJTUFNJL5FLBOBOSFOEBIEJTJTUFN
Aorta 2.5 QBSV TFTVBJ EFOHBO LFCVUVIBO QBSV LBSFOB ZBOH EJQFSMVLBO
Arteri kecil 20 IBOZBBHBSEBSBIEJLBQJMFSQBSVUFSQBKBOEFOHBOPLTJHFOEBOHBT
Arteriol 40 HBTMBJOEBMBNBMWFPMJQBSV
Kapiler 2500
VenuLa 250
Vena kecil 80 Prinsip Dasar Fungsi Sirkulasi
Vena kecil 8
8BMBVQVO QFSJODJBO GVOHTJ TJSLVMBTJ CFSTJGBU LPNQMFLT UFSEBQBU

5FSVUBNB QFSIBUJLBO CBIXB MVBT QFOBNQBOH WFOB KBVI UJHBQSJOTJQEBTBSZBOHNFOEBTBSJLFTFMVSVIBOGVOHTJEBSJTJTUFN
MFCJI CFTBS EBSJQBEB BSUFSJ SBUBSBUB TFLJUBS FNQBU LBMJ EBSJ 1. ,FDFQBUBO BMJSBO EBSBI LF TFUJBQ KBSJOHBO UVCVI IBNQJS
BSUFSJ ZBOH TFQBEBO )BM JOJ NFOKFMBTLBO LBQBTJUBT TFMBMV EJLFOEBMJLBO TFTVBJ EFOHBO LFCVUVIBO KBSJOHBO #JMB
QFOZJNQBOBO EBSBI ZBOH MFCJI CFTBS EJ TJTUFN WFOB KBSJOHBO NFOKBEJ BLUJG KBSJOHBO JOJ NFNCVUVILBO KBVI MFCJI
EJCBOEJOHLBOEFOHBOEJTJTUFNBSUFSJ CBOZBL TVQMBJ [BU NBLBOBO EBO PMFI LBSFOB JUV BMJSBO EBSBI
0MFI LBSFOB TFKVNMBI WPMVNF BMJSBO EBSBI GMPX '
ZBOH BLBO MFCJI CBOZBL CJMB EJCBOEJOHLBO QBEB LFBEBBO JTUJSBIBU
TBNB IBSVT NFMFXBUJ TFUJBQ CBHJBO TJSLVMBTJ EBMBN TFUJBQ LBEBOHLBEBOH IJOHHB TBNQBJ LBMJ OJMBJ JTUJSBIBUOZB
NFOJUOZB LFDFQBUBO BMJSBO EBSBI WFMPDJUZ W
CFSCBOEJOH /BNVO KBOUVOH OPSNBMOZB UJEBL EBQBU NFOJOHLBULBO DVSBI
UFSCBMJL EFOHBO MVBT QFOBNQBOH QFNCVMVI EBSBI DSPTT KBOUVOHOZBMFCJIEBSJFNQBUTBNQBJUVKVILBMJMFCJICFTBSEBSJ
TFDUJPOBMBSFB"
OJMBJ JTUJSBIBU 0MFI TFCBC JUV TBOHBU UJEBL NVOHLJO VOUVL
v = F/A NFOJOHLBULBO BMJSBO EBSBI EJ TFMVSVI CBHJBO UVCVI LFUJLB
%FOHBO EFNJLJBO QBEB LFBEBBO JTUJSBIBU LFDFQBUBO SBUB KBSJOHBOUFSUFOUVNFNCVUVILBOQFOJOHLBUBOBMJSBO4FCBMJLOZB
SBUB TFLJUBS DNEFUJL EJ BPSUB UFUBQJ IBOZB QFNCVMVI NJLSP TFUJBQ KBSJOHBO UFSVTNFOFSVT NFOHBXBTJ
LFDFQBUBOOZB EJ LBQJMFS TFLJUBS NNEFUJL "LBO UFUBQJ LFCVUVIBO KBSJOHBO TFQFSUJ UFSTFEJBOZB PLTJHFO EBO [BU
LBSFOB LBQJMFS NFNQVOZBJ QBOKBOH IBOZB TBNQBJ NN NBLBOBO MBJO TFSUB BLVNVMBTJ LBSCPO EJPLTJEB EBO QSPEVL
EBSBIIBOZBCFSBEBEJLBQJMFSTFMBNBTBNQBJEFUJL8BLUV QSPEVLCVBOHBOMBJOOZB EBOIBMJOJMBIZBOHLFNVEJBO
158
Bab 14 Ikhtisar Sirkulasi; Biofisik Tekanan, Aliran, dan Tahanan
120
100
Pressure (mm Hg)
UNIT IV
80
60
40
20
0
0 Sistemik Paru-paru
NFOHBUVS BMJSBO EBSBI TFUFNQBU TFDBSB MBOHTVOH EFOHBO NVMBJ NFNCBIBT QFSJODJBO EBTBS QFOBUBMBLTBOBBO BMJSBO EBSBI
CFSEJMBUBTJ BUBV CFSLPOUSBLTJ VOUVL NFOHFOEBMJLBO BMJSBO KBSJOHBO TFSUBQFOHFOEBMJBODVSBIKBOUVOHEBOUFLBOBOBSUFSJ
EBSBI TFUFNQBU TFDBSB UFQBU IJOHHB NFODBQBJ OJMBJ ZBOH
EJQFSMVLBO VOUVL BLUJWJUBT KBSJOHBO 4FMBJO JUV
QFOHFOEBMJBO TBSBG UFSIBEBQ TJSLVMBTJ EBSJ TJTUFN TBSBG
QVTBU CFTFSUB IPSNPO NFNCFSJLBO CBOUVBO UBNCBIBO Hubungan Timbal Balik antara Tekanan,
EBMBNQFOHFOEBMJBOBMJSBOEBSBIKBSJOHBO Aliran, dan Tahanan
2. $VSBI KBOUVOH UFSVUBNB EJLFOEBMJLBO PMFI QFOKVNMBIBO
QFOKVNMBIBO TFMVSVI BMJSBO EBSBI TFUFNQBU #JMB EBSBI "MJSBO EBSBI NFMBMVJ QFNCVMVI EBSBI EJUFOUVLBO PMFI EVB
NFOHBMJSEJKBSJOHBO EBSBIJOJBLBOTFHFSBLFNCBMJNFMBMVJ GBLUPS
QFSCFEBBO UFLBOBO EBSBI EJ BOUBSB LFEVB VKVOH
WFOB LF KBOUVOH +BOUVOH CFSFTQPOT TFDBSB PUPNBUJT QFNCVMVI LBEBOHLBEBOH KVHB EJTFCVU HSBEJFO UFLBOBO EJ
UFSIBEBQ QFOJOHLBUBO BMJSBO EBSBI JOJ EFOHBO TFHFSB TFQBOKBOH QFNCVMVI EBSBI ZBJUV EBZB ZBOH NFOEPSPOH EBSBI
NFNPNQB EBSBI LFNCBMJ LF BSUFSJ +BEJ KBOUVOH CFLFSKB NFMBMVJQFNCVMVI EBO
SJOUBOHBOUFSIBEBQBMJSBOEBSBIZBOH
TFCBHBJNFTJOPUPNBUJT EFOHBODBSBNFSFTQPOTLFCVUVIBO NFMBMVJ QFNCVMVI EJTFCVU SF QFNCVMVI EBSBI (BNCBS
KBSJHBO /BNVO EFNJLJBO KBOUVOH TFSJOH LBMJ NFNFSMVLBO NFOHHBNCBSLBOIVCVOHBOJOJ UFSMJIBUCBHJBOQFNCVMVIEBSBI
CBOUVBO EBMBN CFOUVL TJOZBM TBSBG LIVTVT BHBS EBQBU ZBOHEBQBUUFSMFUBLEJCBHJBONBOBQVOEBMBNTJTUFNTJSLVMBTJ
NFNPNQB EBSBI TFTVBJ EFOHBO KVNMBI BMJSBO EBSBI ZBOH
EJCVUVILBO 1 NFXBLJMJ UFLBOBO QBEB QFSNVMBBO QFNCVMVI QBEB VKVOH
3. 1BEB VNVNOZB UFLBOBO BSUFSJ EJBUVS TFDBSB NBOEJSJ ZBOHMBJOUFLBOBOOZBBEBMBI15BIBOBOUFSKBEJLBSFOBHFTFLBO
CBJL NFMBMVJ QFOHFOEBMJBO BMJSBO EBSBI TFUFNQBU BUBV BOUBSB BMJSBO EBSBI EBO FOEPUFM EJ EBMBN QFNCVMVI EBSBI EJ
QFOHFOEBMJBO DVSBI KBOUVOH 4JTUFN TJSLVMBTJ EJMFOHLBQJ TFQBOKBOH CBHJBO EBMBN QFNCVMVI "MJSBO NFMBMVJ QFNCVMVI
EFOHBO TJTUFN QFOHFOEBMJBO ZBOH MVBT UFSIBEBQ UFLBOBO EBQBU EJIJUVOH EFOHBO SVNVT CFSJLVU ZBOH EJTFCVU )VLVN
EBSBIBSUFSJ4FCBHBJDPOUPI KJLBQBEBTBBUUFSUFOUVUFLBOBO 0IN
NFOKBEJ TBOHBU NFOVSVO EJ CBXBI OJMBJ OPSNBMOZB TFLJUBS DP
F=
NN)H EBMBNXBLUVCFCFSBQBEFUJLTFSFOUFUBOSFGMFLT R
TBSBG BLBO NFOJNCVMLBO TFSBOHLBJBO QFSVCBIBO TJSLVMBTJ 'BEBMBIBMJSBOEBSBI, $P BEBMBIQFSCFEBBOUFLBOBO (P1 − P 2)
VOUVL NFOJOHLBULBO UFLBOBO LFNCBMJ NFOVKV OPSNBM BOUBSB LFEVB VKVOH QFNCVMVI EBO 3 BEBMBI UBIBOBO 3VNVT
4JOZBMTJOZBM TBSBG JOJ UFSVUBNB B
NFOJOHLBULBO EBZB JOJ NFOZBUBLBO CBIXB BMJSBO EBSBI CFSCBOEJOH MVSVT EFOHBO
QFNPNQBBO KBOUVOH C
NFOZFCBCLBO LPOUSBLTJ QBEB QFSCFEBBOUFLBOBOUFUBQJCFSCBOEJOHUFSCBMJLEFOHBOUBIBOBO
TJTUFN WFOB QFOBNQVOH CFTBS BHBS NFOZFEJBLBO MFCJI
CBOZBLEBSBICBHJKBOUVOH EBO D
NFOZFCBCLBOLPOTUSJLTJ
VNVN QBEB TFCBHJBO CFTBS BSUFSJPM EJ TFMVSVI UVCVI
TFIJOHHB MFCJI CBOZBL EBSBI UFSBLVNVMBTJ EJ EBMBN BSUFSJ
BSUFSJCFTBSVOUVLNFOJOHLBULBOUFLBOBOBSUFSJ,FNVEJBO P1 P2
EBMBN KBOHLB XBLUV MFCJI MBNB CFCFSBQB KBN EBO CFSIBSJ Aliran darah
IBSJ HJOKBM NFNBJOLBO QFSBO VUBNB UBNCBIBO EBMBN
QFOHBUVSBOUFLBOBO CBJLEFOHBONFOZFLSFTJIPSNPOZBOH Tahanan
NFOHBUVSUFLBOBONBVQVOEFOHBONFOHBUVSWPMVNFEBSBI
+BEJ LFTJNQVMBOOZB LFCVUVIBO TFUJBQ KBSJOHBO EJTFEJBLBO
TFDBSBLIVTVTPMFITJSLVMBTJ4FMBOKVUOZBQBEBCBCJOJ LJUBBLBO
159
Unit IV Sirkulasi
1FSIBUJLBOCBIXBQFSCFEBBOUFLBOBOBOUBSBLFEVBVKVOH 1FOHVLVS"MJSBO&MFLUSPNBHOFUJL4BMBITBUVBMBUZBOHQBMJOH
QFNCVMVIMBI ZBOH NFOFOUVLBO LFDFQBUBO BMJSBO CVLBO QFOUJOHVOUVLNFOHVLVSBMJSBOEBSBIUBOQBNFNCVLBQFNCVMVI
UFLBOBO BCTPMVU EBMBN QFNCVMVI 4FCBHBJ DPOUPI CJMB BEBMBIQFOHVLVSBMJSBOFMFLUSPNBHOFUJL QSJOTJQOZBEJJMVTUSBTJLBO
UFLBOBO QBEB LFEVB VKVOH QFNCVMVI BEBMBI NN )H QBEB(BNCBS(BNCBS"NFNQFSMJIBULBOQFNCFOUVLBO
TFIJOHHBUJEBLBEBQFSCFEBBOUFLBOBOEJBOUBSBLFEVBVKVOH EBZB FMFLUSPNPUJG WPMUBTF MJTUSJL
QBEB TFCVBI LBXBU ZBOH
QFNCVMVIUFSTFCVU UJEBLBLBOBEBBMJSBONFTLJQVOUFSEBQBU EJHFSBLLBO TFDBSB DFQBU NFMJOUBTJ TVBUV MBQBOHBO NBHOFUJL *OJ
UFLBOBOTFCFTBSNN)H BEBMBI QSJOTJQ ZBOH UFMBI EJLFOBM VOUVL NFOHIBTJMLBO MJTUSJL
NFMBMVJ HFOFSBUPS MJTUSJL (BNCBS # NFOHHBNCBSLBO CBIXB
)VLVN 0IN TFQFSUJ EJJMVTUSBTJLBO QBEB 1FSTBNBBO
QSJOTJQZBOHTBNBCFSMBLVVOUVLQFNCFOUVLBOEBZBFMFLUSPNPUJG
NFOZBUBLBO IBM ZBOH QBMJOH QFOUJOH EBSJ IVCVOHBO
EBMBN EBSBI ZBOH CFSHFSBL NFMFXBUJ MBQBOHBO NBHOFUJL %BMBN
LFTFMVSVIBOOZB ZBOH QFSMV EJNFOHFSUJ QFNCBDB BHBS EBQBU
IBMJOJ QFNCVMVIEBSBIEJMFUBLLBOEJBOUBSBLFEVBLVUVCNBHOFU
NFNBIBNJ IFNPEJOBNJLB TJSLVMBTJ .FOHJOHBU TBOHBU
ZBOH LVBU EBO FMFLUSPEBFMFLUSPEB EJMFUBLLBO QBEB LFEVB TJTJ
QFOUJOHOZB SVNVT JOJ QFNCBDB KVHB IBSVT NFOHFUBIVJ LFEVB
QFNCVMVI UFHBL MVSVT UFSIBEBQ HBSJT EBZB NBHOFUJL #JMB EBSBI
CFOUVLBMKBCBSMBJOOZB
NFOHBMJSNFMBMVJQFNCVMVI WPMUBTFMJTUSJLBLBOTFCBOEJOHEFOHBO
DP = F R LFDFQBUBO BMJSBO EBSBI ZBOH EJUJNCVMLBO EJ BOUBSB LFEVB
DP FMFLUSPEB EBO EJDBUBU NFNBLBJ BMBU QFOHVLVS FMFLUSPOJL BUBV
R= WPMUNFUFS ZBOH TFTVBJ (BNCBS $ NFNQFSMJIBULBO
F
QSPCF TBUFMJU
TVOHHVIBOZBOHEJMFUBLLBOQBEBQFNCVMVIEBSBI
CFTBS VOUVL NFOHVLVS BMJSBO EBSBIOZB 1SPCF JOJ CFSJTJ NBHOFU
"MJSBO EBSBI CFSBSUJ KVNMBI EBSBI ZBOH NFOHBMJS NFMBMVJ LVBUEBOFMFLUSPEBFMFLUSPEB
TVBUVUJUJLUFSUFOUVEJTJSLVMBTJEBMBNQFSJPEFXBLUVUFSUFOUV 4VBUV LFVOUVOHBO LIVTVT EBSJ QFOHVLVS BMJSBO
#JBTBOZB BMJSBO EBSBI EJOZBUBLBO EBMBN NJMJMJUFS QFS NFOJU FMFLUSPNBHOFUJL JBMBI EBQBU NFODBUBU QFSVCBIBO BMJSBO EBMBN
BUBV MJUFS QFS NFOJU UFUBQJ EBQBU KVHB EJOZBUBLBO EBMBN XBLUV LVSBOH EBSJ EFUJL NFNVOHLJOLBO QFODBUBUBO
NJMJMJUFS QFS EFUJL BUBV TFUJBQ TBUVBO BMJSBO MBJOOZB EBO QFSVCBIBOBMJSBOZBOHUVSVOOBJLEBOBMJSBOZBOHLPOUJOV TFDBSB
XBLUV BLVSBU
4FDBSB LFTFMVSVIBO BMJSBO EBSBI QBEB TJSLVMBTJ UPUBM PSBOH 1FOHVLVS "MJSBO %PQQMFS 6MUSBTPOJL 5JQF QFOHVLVS BMJSBO
EFXBTBEBMBNLFBEBBOJTUJSBIBUBEBMBITFLJUBSNMNFOJU MBJOOZB ZBOH EBQBU EJQBTBOH EJ MVBS QFNCVMVI EBO NFNQVOZBJ
"MJSBO EBSBI JOJ EJTFCVU DVSBI KBOUVOH LBSFOB NFSVQBLBO CBOZBL LFVOUVOHBO TFSVQB EFOHBO QFOHVLVS BMJSBO
KVNMBI EBSBI ZBOH EJQPNQB LF BPSUB PMFI KBOUVOH TFUJBQ FMFLUSPNBHOFUJL BEBMBI QFOHVLVS BMJSBO %PQQMFS VMUSBTPOJL
NFOJUOZB TFQFSUJUFSMJIBUQBEB(BNCBS4VBUVLSJTUBMQJF[PFMFLUSJLZBOH
.FUPEF VOUVL 1FOHVLVSBO "MJSBO %BSBI 4FKVNMBI BMBU TBOHBU LFDJM EJQBTBOH EJ TBMBI TBUV VKVOH EJOEJOH BMBU UFSTFCVU
NFLBOJL BUBV FMFLUSPNFLBOJL EBQBU EJQBTBOH CFSBOHLBJ ,SJTUBM JOJ CJMB EJCFSJLBO FOFSHJ EFOHBO BMBU FMFLUSPOJL ZBOH
EFOHBO QFNCVMVI EBSBI BUBV QBEB CFCFSBQB LFBEBBO TFTVBJ BLBO NFOHJSJNLBO TVBSB VMUSBTPOJL EFOHBO GSFLVFOTJ CFC
EJMFUBLLBO EJ MVBS QFNCVMVI EBSBI VOUVL NFOHVLVS BMJSBO FSBQB SBUVT SJCV TJLMVT QFS EFUJL LF BSBI CBXBI NFOHJLVUJ BMJSBO
"MBUBMBUJUVEJTFCVUQFOHVLVSBMJSBO GMPXNFUFS
EBSBI4FCBHJBOTVBSBEJQBOUVMLBOPMFITFMTFMEBSBINFSBIZBOH

0 0
N S N S

A B
160
Bab 14 Ikhtisar Sirkulasi; Biofisik Tekanan, Aliran, dan Tahanan
UNIT IV
NFOHBMJS (FMPNCBOH TVBSB VMUSBTPOJL ZBOH EJQBOUVMLBO
LFNVEJBO CFSKBMBO LFNCBMJ EBSJ TFMTFM EBSBI NFSBI LF BSBI
LSJTUBM (FMPNCBOH ZBOH EJQBOUVMLBO JOJ NFNQVOZBJ GSFLVFOTJ
ZBOH MFCJI SFOEBI EBSJQBEB HFMPNCBOH ZBOH EJQBODBSLBO
LBSFOB TFMTFM EBSBI NFSBI CFSHFSBL NFOKBVIJ LSJTUBM
USBOTNJUFS *OJ EJTFCVU FGFL %PQQMFS )BM TBNB EJBMBNJ PMFI
TFTFPSBOH CJMB LFSFUB BQJ NFOEFLBUJOZB EBO NFMJOUBT TBNCJM
NFNCVOZJLBOQFMVJU4FHFSBTFUFMBITVBSBQFMVJUNFMFXBUJPSBOH
1FOZFCBC EBSJ CFOUVL QBSBCPMJL BEBMBI TFCBHBJ CFSJLVU
UFSTFCVU OBEBTVBSBQFMVJUJUVNFOEBEBLNFOKBEJMFCJISFOEBI
.PMFLVMDBJSBOZBOHNFOHFOBJEJOEJOHCFSHFSBLMBNCBULBSFOB
EBSJQBEBOBEBTVBSBTFXBLUVLFSFUBBQJNFOEFLBU
QFSMFLBUBO EFOHBO EJOEJOH QFNCVMVI -BQJTBO NPMFLVM

6OUVL QFOHVLVS BMJSBO ZBOH EJQFSMJIBULBO QBEB (BNCBS
CFSJLVUOZBUFSHFMJODJSEJBUBTMBQJTBOTFCFMVNOZB MBQJTBOLFUJHB
HFMPNCBOH VMUSBTPOJL CFSGSFLVFOTJ UJOHHJ EJQBODBSLBO TFDBSB
EJ BUBT MBQJTBO LFEVB MBQJTBO LFFNQBU EJ BUBT MBQJTBO LFUJHB
JOUFSNJUFO EBO HFMPNCBOH ZBOH EJQBOUVMLBO LFNCBMJ EJUFSJNB
CFHJUVTFUFSVTOZB0MFILBSFOBJUV DBJSBOZBOHCFSBEBEJCBHJBO
NBTVL LF EBMBN LSJTUBM EBO EJQFSLVBU TFDBSB MVBS CJBTB PMFI BMBU
UFOHBIQFNCVMVIEBQBUCFSHFSBLTFDBSBDFQBULBSFOBBEBCBOZBL
FMFLUSPOJL #BHJBO MBJO EBSJ BMBU FMFLUSPOJL JUV NFOFOUVLBO
MBQJTBONPMFLVMEJBOUBSBCBHJBOUFOHBIQFNCVMVIEBOEJOEJOH
QFSCFEBBO GSFLVFOTJ BOUBSB HFMPNCBOH ZBOH EJQBODBSLBO EBO
QFNCVMVI KBEJ TFUJBQ MBQJTBO ZBOH NFOVKV LF BSBI UFOHBI
HFMPNCBOH ZBOH EJQBOUVMLBO KBEJ NFOFOUVLBO LFDFQBUBO BMJSBO
TFDBSB QSPHSFTJG BLBO NFOHBMJS MFCJI DFQBU EBSJQBEB MBQJTBO EJ
EBSBI4FMBNBEJBNFUFSQFNCVMVIUJEBLCFSVCBI QFSVCBIBOBMJSBO
MVBS
EBSBI EBMBN QFNCVMVI CFSCBOEJOH MBOHTVOH EFOHBO QFSVCBIBO
LFDFQBUBOBMJSBO "MJSBO %BSBI 5VSCVMFO QBEB #FCFSBQB ,FBEBBO ,FUJLB
4FQFSUJ QFOHVLVS BMJSBO FMFLUSPNBHOFUJL QFOHVLVS BMJSBO LFDFQBUBO BMJSBO EBSBI NFOKBEJ UFSMBMV CFTBS CJMB BMJSBO EBSBI
%PQQMFS VMUSBTPOJL NBNQV NFODBUBU QFSVCBIBO BMJSBO ZBOH NFMFXBUJ TVBUV PCTUSVLTJ EJ QFNCVMVI CJMB BMJSBO CFSCFMPL
UVSVOOBJLEBOBMJSBOZBOHLPOUJOV TFDBSBDFQBU UBKBN BUBVCJMBEBSBINFOHBMJSNFMBMVJQFSNVLBBOLBTBS BMJSBO
"MJSBO %BSBI -BNJOBS EJ EBMBN 1FNCVMVI #JMB EBSBI EBSBIEBQBUNFOKBEJUVSCVMFOBUBVUFSHBOHHV EBOUJEBLMBNJOBS
NFOHBMJSEFOHBOLFDFQBUBOUFUBQNFMBMVJQFNCVMVIEBSBIZBOH MJIBU (BNCBS $
"MJSBO UVSCVMFO CFSBSUJ CBIXB EBSBI
QBOKBOHEBOMJDJO EBSBIBLBONFOHBMJSEBMBNBMJSBOTUSFBNMJOF NFOHBMJS NFMJOUBOH EJ QFNCVMVI NBVQVO EJ TFQBOKBOH
EFOHBO TFUJBQ MBQJTBO EBSBI UFUBQ CFSKBSBL TBNB EBSJ EJOEJOH QFNCVMVI CJBTBOZB NFNCFOUVL QVTBSBO EBMBN EBSBI ZBOH
QFNCVMVI EBSBI %FNJLJBO QVMB CBHJBO QBMJOH UFOHBI EBSJ EJTFCVU BSVT FEEZ "MJSBO JOJ TFSVQB EFOHBO QVTBSBO BJS ZBOH
EBSBICFSBEBEJCBHJBOUFOHBIQFNCVMVI5JQFBMJSBOJOJEJTFCVU TFSJOH LJUB MJIBU EJ TVOHBJ CFSBMJSBO DFQBU QBEB UFNQBU ZBOH
BMJSBOMBNJOBSBUBVBMJSBOTUSFBNMJOF EBOBMJSBOJOJCFSMBXBOBO UFSEBQBUIBNCBUBO
EFOHBO BMJSBO UVSCVMFO ZBLOJ EBSBI NFOHBMJS LF TFNVB BSBI #JMBUJNCVMBSVTFEEZ EBSBINFOHBMJSEFOHBOUBIBOBOZBOH
EBMBN QFNCVMVI EBO TFDBSB LPOUJOV CFSDBNQVS EJ EBMBN KBVI MFCJI CFTBS EBSJQBEB CJMB NFOHBMJS MBNJOBS LBSFOB BSVT
QFNCVMVI TFQFSUJZBOHBLBOEJCJDBSBLBOCFSJLVUJOJ FEEZ TBOHBU NFNQFSCFTBS TFMVSVI HFTFLBO BMJSBO EBMBN
#FOUVL ,FDFQBUBO 1BSBCPMJL 4FMBNB "MJSBO -BNJOBS #JMB QFNCVMVI
UJNCVM BMJSBO MBNJOBS LFDFQBUBO BMJSBO EJ UFOHBI QFNCVMVI ,FDFOEFSVOHBOVOUVLUJNCVMOZBBMJSBOUVSCVMFONFOJOHLBU
KBVI MFCJI CFTBS EBSJQBEB ZBOH LF BSBI EJOEJOH MVBS )BM JOJ CFSCBOEJOH MVSVT EFOHBO LFDFQBUBO BMJSBO EBSBI EJBNFUFS
UFSMJIBU QBEB (BNCBS 1BEB (BNCBS " EJ EBMBN QFNCVMVIEBSBIEBOCFSBUKFOJTEBSBI EBOCFSCBOEJOHUFSCBMJL
QDNCVMVI UFSEBQBU EVB NBDBN DBJSBO DBJSBO EJ CBHJBO LJSJ EFOHBOWJTLPTJUBTEBSBI TFTVBJEFOHBOQFSTBNBBOCFSJLVU
EJXBSOBJ PMFI [BU XBSOB EBO EJ CBHJBO LBOBO BEBMBI DBJSBO
KFSOJI UFUBQJUJEBLBEBBMJSBOEJQFNCVMVIJUV#JMBDBJSBOEJCVBU n. d . r
Re =
NFOHBMJS BLBO UFSCFOUVL CBUBT CFSCFOUVL QBSBCPMJL EJ BOUBSB h
DBJSBO UFSTFCVU TFQFSUJ ZBOH UFSMJIBU EFUJL LFNVEJBO EJ 3F BEBMBI CJMBOHBO 3FZOPME EBO NFSVQBLBO VLVSBO
(BNCBS # NFNQFSMJIBULBO CBIXB CBHJBO DBJSBO ZBOH LFDFOEFSVOHBO UFSKBEJOZB UVSCVMFOTJ W BEBMBI LFDFQBUBO SBUB
EFLBU EFOHBO EJOEJOH QFNCVMVI IBNQJS UJEBL CFSHFSBL TBNB SBUBBMJSBOEBSBI EBMBNDNEFUJL
EBEBMBIEJBNFUFSQFNCVMVI
TFLBMJ CBHJBO ZBOH TFEJLJU MFCJI KBVI EBSJ EJOEJOH CFSHFSBL EBMBNDN
QBEBMBINBTTBKFOJT EBOBEBMBIWJTLPTJUBT EBMBN
EFOHBOKBSBLQFOEFL EBODBJSBOZBOHCFSBEBEJCBHJBOUFOHBI QPJTF
7JTLPTJUBTEBSBIOPSNBMOZBTFLJUBS QPJTF EBONBTTB
QFNCVMVI UFMBI CFSHFSBL MFCJI KBVI MBHJ &GFL JOJ EJTFCVU KFOJTOZBIBOZBTFEJLJUMFCJICFTBSEBSJ#JMBCJMBOHBO3FZOPME
CFOUVLQBSBCPMJLVOUVLLFDFQBUBOBMJSBOEBSBI NFOJOHLBUEJBUBTTBNQBJ CJBTBOZBBLBOUJNCVMBMJSBO
161
Unit IV Sirkulasi
UVSCVMFO EJ CFCFSBQB QFSDBCBOHBO QFNCVMVI UFUBQJ BLBO

CFSIFOUJ EJ TFQBOKBOH QFNCVMVI ZBOH MJDJO /BNVO EFNJLBO
CJMB CJMBOHBO 3FZOPME NFOJOHLBU TBNQBJ IBNQJS BMJSBO A
UVSCVMFOBLBOUJNCVMCBILBOEJQFNCVMVIZBOHMVSVTEBOMJDJO
"HBSNFOHBMJSEJTJTUFNQFNCVMVIEBSBI CJMBOHBO3FZOPME
CBILBO OPSNBMOZB NFOJOHLBU IJOHHB TBNQBJ QBEB
BSUFSJCFTBSTFCBHBJBLJCBUOZB IBNQJSTFMBMVUFSEBQBUCFCFSBQB
BMJSBOUVSCVMFOEJQFSDBCBOHBOQFNCVMVI%JCBHJBOQSPLTJNBM B
BPSUBEBOBSUFSJQVMNPOBMJT CJMBOHBO3FZOPMEEBQBUNFOJOHLBU
IJOHHBCFCFSBQBSJCVTFMBNBGBTFDFQBUTBBUFKFLTJWFOUSJLFMIBM
JOJ NFOZFCBCLBO BMJSBO ZBOH TBOHBU UVSCVMFO EJ QSPLTJNBM
BPSUBEBOBSUFSJQVMNPOBMJTLBSFOBUFSEBQBUCFCFSBQBLFBEBBO
ZBOH CFSQFSBO NFOJNCVMLBO BMJSBO UVSCVMFO
LFDFQBUBO
BMJSBOEBSBIZBOHUJOHHJ
BMJSBOQVMTBUJMBMBNJ
QFSVCBIBO
EJBNFUFS QFNCVMVI NFOEBEBL EBO
EJBNFUFS QFNCVMVI
ZBOH CFTBS /BNVO EFNJLJBO QBEB QFNCVMVI LFDJM CJMBOHBO
3FZOPME IBNQJS UJEBL QFSOBI DVLVQ UJOHHJ VOUVL
NFOZFCBCLBOBMJSBOUVSCVMFO
4BUVBO 5FLBOBO 4UBOEBS 5FLBOBO EBSBI IBNQJS TFMBMV

EJOZBUBLBO EBMBN NJMJNFUFS BJS SBLTB NN )H
LBSFOB
NBOPNFUFS BJS SBLTB UFMBI EJQBLBJ TFCBHBJ SVKVLBO TUBOEBS
VOUVLQFOHVLVSBOUFLBOBOTFKBLEJDJQUBLBOQBEBUBIVO C
PMFI 1PJTFVJMMF 4FCFOBSOZB UFLBOBO EBSBI CFSBSUJ EBZB ZBOH
EJIBTJMLBO PMFI EBSBI UFSIBEBQ TFUJBQ TBUVBO MVBT EJOEJOH
QFNCVMVI #JMB TFTFPSBOH NFOHBUBLBO CBIXB UFLBOBO EBMBN
QFNCVMVIBEBMBINN)H IBMJUVCFSBSUJCBIXBEBZBZBOH
EJIBTJMLBODVLVQVOUVLNFOEPSPOHLPMPNBJSSBLTBNFMBXBO
1BEB (BNCBS " TFCVBI MFNQFOH NFUBM TFEFSIBOB
HSBWJUBTJTBNQBJTFUJOHHJNN#JMBUFLBOBOBEBMBINN
EJMFUBLLBO CFCFSBQB SBUVT TFOUJNFUFS EJ BUBT NFNCSBO #JMB
)H LPMPNBJSSBLTBBLBOEJEPSPOHTFUJOHHJNN NFNCSBONFOPOKPMLFMVBS NFNCSBONFOKBEJMFCJIEFLBUEFOHBO
,BEBOHLBEBOH UFLBOBO EJOZBUBLBO EBMBN TFOUJNFUFS BJS MFNQFOH TFIJOHHB NFOJOHLBULBO LBQBTJUBOTJ MJTUSJL EJ BOUBSB
LFEVBOZB EBO QFSVCBIBO LBQBTJUBOT JOJ EBQBU EJDBUBU EFOHBO
DN)0
5FLBOBOTFCFTBSDN)0CFSBSUJCBIXBUFLBOBO
NFOHHVOBLBOTJTUFNFMFLUSPOJLZBOHTFTVBJ
DVLVQ VOUVL NFOBJLLBO TBUV LPMPN BJS NFMBXBO HSBWJUBTJ
1BEB (BNCBS # TFCVBI MPHBN CFTJ LFDJM EJMFUBLLBO QBEB
TFUJOHHJDN4BUVNJMJNFUFSUFLBOBOBJSSBLTBTBNBEFOHBO NFNCSBO EBO EBQBU CFSHFTFS LF BUBT LF EBMBN QVTBU EJ EBMBN
DNUFLBOBOBJSLBSFOBCFSBUKFOJTBJSSBLTBBEBMBI LBMJ LVNQBSBO LBXBU MJTUSJL 1FSHFSBLBO CFTJ LF LVNQBSBO
EBSJBJS EBODNBEBMBILBMJNN NFOJOHLBULBOJOEVLUBOTJLVNQBSBO EBOIBMJOJKVHBEBQBUEJDBUBU
TFDBSBFMFLUSPOJL
.FUPEF 1FOHVLVSBO 5FLBOBO %BSBI EFOHBO ,FUFQBUBO "LIJSOZB QBEB(BNCBS$ TFCVBILBXBUUBIBOSFHBOHZBOH
5JOHHJ,FMFNCBNBOBJSSBLTBEJEBMBNNBOPNFUFSCFHJUVUJOHHJ TBOHBU UJQJT EJIVCVOHLBO EFOHBO NFNCSBO #JMB LBXBU JOJ TBOHBU
TFIJOHHB UJEBL EBQBU OBJL BUBV UVSVO TFDBSB DFQBU 0MFI LBSFOB UFSFHBOH SFTJTUBOTJOZB BLBO NFOJOHLBU CJMB LBXBU LVSBOH
BMBTBO JOJMBI NBOPNFUFS BJS SBLTB NFTLJQVO TBOHBU CBJL VOUVL UFSFHBOH SFTJTUBOTJOZB BLBO NFOVSVO 1FSVCBIBOQFSVCBIBO JOJ
QFOHVLVSBOUFLBOBOZBOHTUBCJM UJEBLEBQBUCFSFTQPOTUFSIBEBQ KVHBEBQBUEJDBUBUPMFITJTUFNFMFLUSPOJL
QFSVCBIBOUFLBOBOZBOHUFSKBEJMFCJIDFQBUEBSJTBNQBJEFUJL 4JOZBM MJTUSJL EBSJ USBOTEVTFS EJLJSJN LF BNQMJGJFS QFOHFSBT
QFOHVBU
LFNVEJBO LF BMBU QFSFLBN ZBOH TFTVBJ 1BEB CFCFSBQB
TFUJBQ TJLMVT #JMBNBOB EJLFIFOEBLJ VOUVL NFODBUBU UFLBOBO
UJQF TJTUFN QFODBUBU EFOHBO LFUFQBUBO UJOHHJ JOJ TJLMVT UFLBOBO
ZBOH CFSVCBI DFQBU EJQFSMVLBO CFCFSBQB KFOJT QFODBUBU UFLBOBO TBNQBJTJLMVTQFSEFUJLUFMBIEBQBUEJDBUBUTFDBSBBLVSBU1BEB
MBJOOZB (BNCBS NFNQFSMJIBULBO QSJOTJQ EBTBS UJHB QFNBLBJBO CJBTB EJHVOBLBO QFODBUBU ZBOH NBNQV NFODBUBU
USBOTEVTFSUFLBOBOFMFLUSPOJLZBOHCJBTBEJQBLBJVOUVLNFOHVCBI QFSVCBIBOUFLBOBOTFDFQBUTBNQBJTJLMVTQFSEFUJL EFOHBO
UFLBOBO EBSBI EBOBUBV QFSVCBIBO UFLBOBO ZBOH DFQBU NFOKBEJ DBSBZBOHEJQFSMJIBULBOQBEBLFSUBTQFODBUBUEBMBN(BNCBS$
TJOZBMMJTUSJLEBOLFNVEJBONFODBUBUTJOZBMMJTUSJLQBEBQFODBUBU
MJTUSJL CFSLFDFQBUBO UJOHHJ 4FUJBQ USBOTEVTFS JOJ NFOHHVOBLBO
NFNCSBO NFUBM ZBOH TBOHBU UJQJT EBO TBOHBU UFSFHBOH ZBOH
Tahanan Aliran Darah
NFNCFOUVL TBMBI TBUV EJOEJOH SVBOH DBJSBO 3VBOH DBJSBO
LFNVEJBO EJIVCVOHLBO EFOHBO QFNCVMVI EBSBI ZBOH BLBO 4BUVBO5BIBOBO5BIBOBONFSVQBLBOIBNCBUBOBMJSBOEBSBI
EJVLVS UFLBOBOOZB NFMBMVJ TFCVBI KBSVN BUBV LBUFUFS ZBOH EBMBN QFNCVMVI UFUBQJ UJEBL EBQBU EJVLVS TFDBSB MBOHTVOH
EFOHBO DBSB BQBQVO 4FCBMJLOZB UBIBOBO IBSVT EJIJUVOH EBSJ
EJNBTVLLBO LF EBMBN QFNCVMVI #JMB UFLBOBOOZB UJOHHJ
QFOHVLVSBOBMJSBOEBSBIEBOQFSCFEBBOUFLBOBOBOUBSBEVBUJUJL
NFNCSBOTFEJLJUNFOPOKPMLFMVBS EBOCJMBUFLBOBOOZBSFOEBI
NFNCSBOBLBOLFNCBMJLFQPTJTJJTUJSBIBU
162
Bab 14 lkhtisar Sirkulasi; Biofisik Tekanan, Aliran, dan Tahanan
EJ EBMBN QFNCVMVI #JMB QFSCFEBBO UFLBOBO BOUBSB EVB UJUJL d=1
BEBMBI NN )H EBO BMJSBO BEBMBI NMEFUJL UBIBOBOOZB
d=2
EJLBUBLBOTFCFTBSTBUVBOUBIBOBOQFSJGFS CJBTBOZBEJTJOHLBU
136 QFSJQIFSBMSFTJTUBODFVOJU
d=4
UNIT IV
1FSOZBUBBO5BIBOBOEBMBN4BUVBO$(4,BEBOHLBEBOH TBUVBOGJTJL
EBTBS EJTFCVU TBUVBO $(4 DFOUJNFUFST HSBNT TFDPOET TFOUJNFUFS
HSBN EFUJL
EJQBLBJ VOUVL NFOZBUBLBO UBIBOBO 4BUVBO JOJ BEBMBI
EZOF EFUJLDN 5BIBOBO EBMBN TBUVBO JOJ EBQBU EJIJUVOH EFOHBO
SVNVTCFSJLVU
dyne detik 1333 mm Hg

R dalam =
cm5 ml/det
Tahanan Pembuluh Darah Periter Total dan

Tahanan Pembuluh Darah Paru Total. ,FDFQBUBO BMJSBO
EBSBINFMBMVJTFMVSVITJTUFNTJSLVMBTJTBNBEFOHBOLFDFQBUBO
QPNQBEBSBIPMFIKBOUVOHZBLOJ TBNBEFOHBODVSBIKBOUVOH
1BEB PSBOH EFXBTB LFDFQBUBOOZB TFLJUBS NMEFU
)BM JOJ EJHBNCBSLBO MFXBU QFSDPCBBO ZBOH EJJMVTUSBTJLBO
1FSCFEBBO UFLBOBO EBSJ BSUFSJ TJTUFNJL TBNQBJ WFOB TJTUFNJL
QBEB (BNCBS " NFNQFSMJIBULBO UJHB QFNCVMVI
BEBMBI TFLJUBS NN )H 0MFI LBSFOB JUV UBIBOBO EJ
UFSQJTBI EFOHBO EJBNFUFS SFMBUJG TFCFTBS EBO UFUBQJ
TFMVSVI TJSLVMBTJ TJTUFNJL ZBOH EJTFCVU UBIBOBO QFSJGFS UPUBM
EFOHBO QFSCFEBBO UFLBOBO ZBOH TBNB BOUBSB LFEVB VKVOH
BEBMBITFLJUBS BUBVTBUVBOUBIBOBOQFSJGFS 136

QFNCVMVI UFSTFCVU ZBJUV NN )H .FTLJQVO EJBNFUFS
1BEB LFBEBBO LFUJLB TFNVB QFNCVMVI EBSBI EJ TFMVSVI QFNCVMVIQFNCVMVIJOJNFOJOHLBUIBOZBFNQBULBMJMJQBU
UVCVI CFSLPOTUSJLTJ LVBU SFTJTUBOTJ QFSJGFS UPUBM LBEBOH BMJSBO EJ EBMBN QFNCVMVI NBTJOHNBTJOH NFOKBEJ
LBEBOH NFOJOHLBU NFOKBEJ TFCFTBS 136 4FCBMJLOZB CJMB EBO NMNFOJU BUBV UFSEBQBU LFOBJLBO BMJSBO TFCFTBS
TFNVB QFNCVMVI CFSEJMBUBTJ LVBU SFTJTUBOTJ JOJ EBQBU UVSVO LBMJ MJQBU +BEJ LPOEVLUBOT QFNCVMVI NFOJOHLBU
TBNQBJTFLFDJM 136 TFCBOEJOH EFOHBO QBOHLBU FNQBU EJBNFUFSOZB TFTVBJ
%BMBN TJTUFN QBSV UFLBOBO BSUFSJ QVMNPOBMJT SBUBSBUB EFOHBOSVNVTCFSJLVU
BEBMBINN)HEBOUFLBOBOBUSJVNLJSJSBUBSBUBBEBMBI Konduktans µ Diameter4
NN )H TFIJOHHB TFMJTJI UFLBOBO BEBMBI NN )H 0MFI
)VLVN 1PJTFVJMMF 1FOZFCBC LFOBJLBO LPOEVLUBOT ZBOH CFTBS
LBSFOB JUV CJMB DVSBI KBOUVOH OPSNBM ZBLOJ TFLJUBS NM
LFUJLB EJBNFUFS NFOJOHLBU JOJ EBQBU EJUFSBOHLBO EFOHBO NFMJIBU
EFUJL UBIBOBO QFNCVMVI EBSBI QBSV UPUBM EJQFSIJUVOHLBO (BNCBS# NFNQFSMJIBULBOQFOBNQBOHNFMJOUBOHQFNCVMVI
LJSBLJSB TFCFTBS 136 TFLJUBS TFQFSUVKVI TJSLVMBTJ CFTBS EBO QFNCVMVI LFDJM -JOHLBSBO LPOTFOUSJL EJ EBMBN
TJTUFNJL
QFNCVMVI NFOBOEBLBO CBIXB LFDFQBUBO BMJSBO EBMBN TFUJBQ
MJOHLBSBO CFSCFEB EFOHBO MJOHLBSBO EJEFLBUOZB BLJCBU BMJSBO
MBNJOBS TFQFSUJZBOHUFMBIEJCJDBSBLBOTFCFMVNOZBEBMBNCBCJOJ
"Konduktans" Darah dalam Pembuluh dan :BJUV EBSBI ZBOH BEB EJ MJOHLBSBO ZBOH NFOZFOUVI EJOEJOH
Hubungannya dengan Tahanan. ,POEVLUBOTNFSVQBLBO QFNCVMVI IBNQJS UJEBL NFOHBMJS LBSFOB NFMFLBU QBEB FOEPUFM
VLVSBO BMJSBO EBSBI NFMBMVJ QFNCVMVI QBEB UFLBOBO QFNCVMVI EBSBI -JOHLBSBO EBSBI CFSJLVUOZB ZBOH NFOVKV LF
UFSUFOUV1BEBVNVNOZBEJOZBUBLBOEBMBNNJMJMJUFSQFSEFUJL QVTBU QFNCVMVI BLBO UFSHFMJODJS EJ BUBT MJOHLBSBO QFSUBNB EBO
QFSNJMJNFUFSUFLBOBOBJSSBLTB UFUBQJKVHBEBQBUEJOZBUBLBO LBSFOB JUV NFOHBMJS MFCJI DFQBU -JOHLBSBO ZBOH LFUJHB LFFNQBU
EBMBN MJUFS QFS EFUJL QFS NJMJNFUFS BJS SBLTB BUBV EBMBN LFMJNB EBO LFFOBN EFNJLJBO QVMB BLBO NFOHBMJS EFOHBO
TBUVBOBMJSBOEBSBIEBOUFLBOBOMBJOOZB LFDFQBUBO ZBOH NBLJO NFOJOHLBU +BEJ EBSBI ZBOH CFSBEB EFLBU
EFOHBO EJOEJOH QFNCVMVI NFOHBMJS MBNCBU TFEBOHLBO ZBOH EJ
+BEJ KFMBT CBIXB LPOEVLUBOT UFQBUOZB NFSVQBLBO UFOHBIQFNCVMVINFOHBMJSMFCJIDFQBU
LFCBMJLBOEBSJUBIBOBOTFTVBJEFOHBOQFSTBNBBOCFSJLVU
%JQFNCVMVILFDJM QBEBEBTBSOZBTFNVBEBSBICFSBEBEJEFLBU
EJOEJOH TFIJOHHB BMJSBO TFOUSBM ZBOH CFSKBMBO TBOHBU DFQBU UJEBL
QFSOBIBEB%FOHBONFOHHBCVOHLBOLFDFQBUBOTFMVSVIMJOHLBSBO
Konduktans = 1 LPOTFOUSJL EBSJ BMJSBO EBSBI EBO NFOHBMJLBOOZB EFOHBO MVBT
Resistensi EBFSBI MJOHLBSBO LJUB NFOEBQBULBO SVNVT ZBOH EJLFOBM TFCBHBJ
IVLVN1PJTFVJMMF
pD Pr4
Sedikit Saja Perubahan pada Diameter Pembuluh F=
8 h1
akan Sangat Mengubah Konduktansnya1FSVCBIBOLFDJM
QBEB EJBNFUFS QFNCVMVI BLBO NFOZFCBCLBO QFSVCBIBO ' BEBMBI LFDFQBUBO BMJSBO EBSBI $P BEBMBI QFSCFEBBO UFLBOBO
MVBS CJBTB UFSIBEBQ LFNBNQVBO QFNCVMVI VOUVL BOUBSB VKVOHVKVOH QFNCVMVI r SBEJVTQFNCVMVI, l iBEBMBI BEBMBI
NFOHIBOUBSLBOEBSBICJMBBMJSBOEBSBICFSTJGBUMBNJOBS QBOKBOHQFNCVMVI EBO H BEBMBIWJTLPTJUBTEBSBI
163
Unit IV Sirkulasi
1FSIBUJLBOEBMBNQFSTBNBBOJOJCBIXBLFDFQBUBOBMJSBO " UBIBOBO QFNCVMVI EBSBI UPUBM BEBMBI TBNB EFOHBO

EBSBI CFSCBOEJOH MVSVT EFOHBO QBOHLBU FNQBU SBEJVT QFKVNMBIBO3MEBO3
QFNCVMVI NFOHHBNCBSLBO TFLBMJ MBHJ CBIXB EJBNFUFS 1FNCVMVI EBSBI CFSDBCBOH TBOHBU MVBT VOUVL NFNCFOUVL
QFNCVMVIEBSBI TBNBEFOHBOEVBLBMJSBEJVT
NFNBJOLBO TJSLVJU QBSBMFM ZBOH NFOZVQMBJ EBSBI LF CFCFSBQB PSHBO KBSJOHBO
QFSBOBO QBMJOH CFTBS EBSJ TFNVB GBLUPS MBJOOZB EBMBN UVCVI 1FOHBUVSBO QBSBMFM JOJ NFNCVBU KBSJOHBO EBQBU NFOHBUVS
NFOFOUVLBOLFDFQBUBOBMJSBOEBSBINFMBMVJQFNCVMVI BMJSBOEBSBIOZBTFOEJSJ MFCJIKBVIMBHJ NFOHBUVSTFOEJSJBMJSBOLF
KBSJOHBOMBJO
Makna dan "Hukum Pangkat Empat" Diameter
Pembuluh dalam Menentukan Tahanan Arteriol. TJTUFNJL #BHJQFNCVMVIEBSBIZBOHEJBUVSTFDBSBQBSBMFM(BNCBS#
UPUBM QBEB BMJSBO EBSBI BEBMBI UBIBOBO BSUFSJPM EJ EBMBN UBIBOBOUPUBMEBSJBMJSBOEBSBITFQFSUJ
BSUFSJPM LFDJM %JBNFUFS JOUFSOB QFNCVMVI BSUFSJPM CFSLJTBS 1 1 1 1 1 ...
= + + +
EBSJ N TBNQBJ TFCFTBS N /BNVO BSUFSJPM NFNJMJLJ Rtotal R1 R2 R3 R4
EJOEJOHQFNCVMVIEBSBIZBOHLVBU TFIJOHHBNFNVOHLJOLBO
EJBNFUFS JOUFSOB NFOKBEJ TBOHBU CFSVCBI TFSJOH LBMJ TBNQBJ +FMBTCBIXBQBEBHSBEJFOUFLBOBOUFSUFOUV KVNMBIEBSBIZBOH
TFCFTBSFNQBULBMJMJQBUOZB%BSJIVLVNQBOHLBUFNQBUZBOH NFOHBMJS NFMBMVJ TJTUFN QBSBMFM BLBO KBVI MFCJI CFTBS
UFMBI EJEJTLVTJLBO TFCFMVNOZB ZBOH NFOHIVCVOHLBO BMJSBO EJCBOEJOHLBOZBOHNFMBMVJNBTJOHNBTJOHQFNCVMVIEBSBI0MFI
EBSBI EFOHBO EJBNFUFS QFNCVMVI LJUB EBQBU NFMJIBU CBIXB LBSFOB JUV UBIBOBO UPUBM KBVI MFCJI LFDJM EBSJQBEB UBIBOBO EJ
QFOJOHLBUBO EJBNFUFS QFNCVMVI TFCFTBS FNQBU LBMJ MJQBU TFUJBQ QFNCVMVI EBSBI "MJSBO ZBOH NFMBMVJ QFNCVMVI QBSBMFM
EBQBUNFOJOHLBULBOBMJSBOIJOHHBTFCFTBSLBMJMJQBU+BEJ EBMBN (BNCBS # EJUFOUVLBO PMFI HSBEJFO UFLBOBO EBO
IVLVN QBOHLBU FNQBU JOJ NFNCVBU IBM UFSTFCVU NVOHLJO UBIBOBOOZB CVLBOPMFIUBIBOBOQFNCVMVIEBSBIQBSBMFMMBJOOZB
UFSKBEJ QBEB BSUFSJPM #JMB UFSEBQBU TJOZBM TBSBG BUBV TJOZBM /BNVO EFNJLJBO QFOJOHLBUBO UBIBOBO TFUJBQ QFNCVMVI EBSBI
LJNJB EJ KBSJOHBO TFUFNQBU TFIJOHHB NFOZFCBCLBO IBOZB BLBONFOJOHLBULBOUBIBOBOQFNCVMVIEBSBIUPUBM
TFEJLJU QFSVCBIBO QBEB EJBNFUFS BSUFSJPM SFTQPOT ZBOH .VOHLJOUFSMJIBUCFSMBXBOBOCBIXBNFOBNCBILBOQFNCVMVI
EJCFSJLBO EBQBU CFSVQB NFOHIFOUJLBO BMJSBO EBSBI LF EBSBILFTJSLVJUBLBONFOVSVOLBOUBIBOBOQFNCVMVIEBSBIUPUBM
KBSJOHBO TFDBSB UPUBM BUBV NFOJOHLBULBO BMJSBO EBSBI EFOHBO /BNVO EFNJLJBO CBOZBLOZB QFNCVMVI EBSBI QBSBMFM NFNCVBU
TBOHBUIFCBU4FCFOBSOZB QFSOBIUFSDBUBULJTBSBOBMJSBOEBSBI EBSBINFOKBEJMFCJINVEBIVOUVLEJBMJSLBONFMBMVJTJSLVJULBSFOB
MFCJI EBSJ LBMJ MJQBU QBEB EBFSBI KBSJOHBO ZBOH UFSQJTBI TFUJBQQFNCVMVIQBSBMFMNFOZFEJBLBOKBMVSMBJO BUBVLPOEVLUBOT
BOUBSBCBUBTLPOTUSJLTJBSUFSJPMNBLTJNVNEBOEJMBUBTJBSUFSJPM VOUVL NFOHBMJSLBO EBSBI ,POEVLUBOT UPUBM ($UPUBM) VOUVL
NBLTJNVN NFOHBMJSLBOEBSBINFSVQBLBOQFOKVNMBIBOLPOEVLUBOTEJTFUJBQ
Tahanan Aliran Darah dalam Sirkuit Pembuluh Darah KBMVSQBSBMFM
Paralel dan Serial. %BSBI ZBOH EJQPNQB PMFI KBOUVOH Ctotal = C1 + C2 + C3 + C4 . . .
NFOHBMJS EBSJ CBHJBO CFSUFLBOBO UJOHHJ EJ TJSLVMBTJ TJTUFNJL
ZBJUV BPSUB
LF CBHJBO CFSUFLBOBO SFOEBI ZBJUV WFOB DBWB
4FCBHBJ DPOUPI PUBL HJOKBM PUPU TBMVSBO DFSOB LVMJU EBO
NFMJOUBTJ KBSBL KBVI EJ EBMBN QFNCVMVI EBSBI ZBOH EJBUVS TJSLVMBTJLPSPOFSEJBUVSTFDBSBQBSBMFM EBONBTJOHNBTJOHKBSJOHBO
TFDBSB TFSJBM EBO QBSBMFM "SUFSJ BSUFSJPM LBQJMFS WFOVMB EBO NFNCFSJLBO LPOUSJCVTJ UFSIBEBQ LFTFMVSVIBO LPOEVLUBOT EJ
WFOB EJLVNQVMLBO TFDBSB TFSJBM #JMB QFNCVMVI EBSBI EJBUVS TJSLVMBTJTJTUFNJL"MJSBOEBSBINFMBMVJTFUJBQKBSJOHBONFSVQBLBO
TFDBSB TFSJBM BMJSBO EJ TFUJBQ QFNCVMVI EBSBI TBNB EBO CBHJBOEBSJUPUBMBMJSBOEBSBI DVSBIKBOUVOH
EBOEJUFOUVLBOPMFI
UBIBOBO UPUBM BMJSBO EBSBI (3UPUBM) TBNB EFOHBO QFOKVNMBIBO UBIBOBO SFTJQSPLBM LPOEVLUBOT
BMJSBO EBSBI EJ KBSJOHBO CFHJUV
UBIBOBOEJTFUJBQQFNCVMVI KVHB HSBEJFO UFLBOBO 0MFI LBSFOB JUV UJOEBLBO BNQVUBTJ QBEB
BOHHPUBCBEBOBUBVQFOHBOHLBUBOHJOKBMNFMBMVJQFNCFEBIBOKVHB
R =R +R +R +R . . . NFOHIJMBOHLBO TJSLVJU QBSBMFM EBO NFOVSVOLBO LPOEVLUBOT
total 1 2 3 4
QFNCVMVIEBSBIUPUBMBMJSBOEBSBIUPUBM DVSBIKBOUVOH
TFNFOUBSB
0MFILBSFOBJUV UBIBOBOQFNCVMVIEBSBIQFSJGFSUPUBMTBNB NFOJOHLBULBOUBIBOBOQFNCVMVIEBSBIQFSJGFSUPUBM
EFOHBOQFOKVNMBIBOUBIBOBOEJBSUFSJ BSUFSJPM LBQJMFS WFOVMB
EBOWFOB1BEBDPOUPIZBOHEJQFSMJIBULBOEBMBN(BNCBS
Pengaruh Hematokrit Darah dan Viskositas Darah terhadap
Tahanan Pembuluh Darah dan Aliran Darah
1FSIBUJLBO LIVTVTOZB CBIXB TBMBI TBUV GBLUPS QFOUJOH EBMBN
QFSTBNBBO 1PJTFVJMMF BEBMBI WJTLPTJUBT EBSBI 4FNBLJO CFTBS
WJTLPTJUBT BMJSBO EBMBN QFNCVMVI TFNBLJO LFDJM KJLB TFMVSVI
GBLUPSMBJOOZBCFSTJGBULPOTUBO4FMBOKVUOZB WJTLPTJUBTQBEBEBSBI
OPSNBMBEBMBITFLJUBSUJHBLBMJMFCJICFTBSEBSJQBEBWJTLPTJUBTBJS
5FUBQJ BQB ZBOH NFNCVBU EBSBI CFHJUV LFOUBM )BM JOJ
UFSVUBNBLBSFOBTFCBHJBOCFTBSTFMEBSBINFSBIUFSTVTQFOTJEBMBN
EBSBI NBTJOHNBTJOHGBLUPSJOJNFOJNCVMLBOQFSHFTFLBOBOUBSB
TFMTFMZBOHCFSEFLBUBOEBOUFSIBEBQEJOEJOHQFNCVMVIEBSBI
164
Bab 14 lkhtisar Sirkulasi; Biofisik Tekanan, Aliran, dan Tahanan
7JTLPTJUBT EBSBI MFOHLBQ QBEB IFNBUPLSJU OPSNBM BEBMBI

TFLJUBS IBM JOJ CFSBSUJ CBIXB EJQFSMVLBO UFLBOBO UJHB LBMJ
MFCJI CFTBS VOUVL NFOEPSPOH EBSBI MFOHLBQ EJCBOEJOHLBO
NFOEPSPOH BJS NFMBMVJ QFNCVMVI EBSBI ZBOH TBNB #JMB
UNIT IV
IFNBUPLSJU NFOJOHLBU TBNQBJ BUBV ZBOH TFSJOH LBMJ
UFSKBEJ QBEB QPMJTJUFNJB WJTLPTJUBT EBSBI EBQBU NFOJOHLBU
NFOKBEJLBMJMFCJICFTBSEBSJQBEBBJS EBOBMJSBOOZBEBMBN
QFNCVMVIEBSBINFOKBEJTBOHBUUFSIBNCBU
'BLUPS MBJO ZBOH NFNFOHBSVIJ WJTLPTJUBT EBSBI BEBMBI
LPOTFOUSBTJ QSPUFJO QMBTNB EBO KFOJT QSPUFJO EBMBN QMBTNB
UFUBQJ QFOHBSVIOZB LVSBOH CFHJUV QFOUJOH EJCBOEJOHLBO
EFOHBOQFOHBSVIIFNBUPLSJU TFIJOHHBUJEBLEJQFSUJNCBOHLBO
TFDBSB TFSJVT QBEB LFCBOZBLBO QFOFMJUJBO IFNPEJOBNJL
7JTLPTJUBTQMBTNBEBSBIBEBMBITFLJUBS LBMJWJTLPTJUBTBJS
Pengaruh Tekanan terhadap Tahanan Pembuluh

Darah dan Aliran Darah Jaringan
"Autoregulasi" Mengurangi Pengaruh Tekanan Arteri
Terhadap Aliran Darah Jaringan". %BSJ EJTLVTJ TFKBVI JOJ
0 LJUB NVOHLJO NFNQFSLJSBLBO CBIXB LFOBJLBO UFLBOBO BSUFSJ
Normal BLBONFOZFCBCLBOLFOBJLBOZBOHTFCBOEJOHQBEBBMJSBOEBSBI
NFMBMVJ CFSCBHBJ KBSJOHBO UVCVI "LBO UFUBQJ QFOHBSVI
UFLBOBOBSUFSJUFSIBEBQBMJSBOEBSBIEJTFCBHJBOCFTBSKBSJOHBO
CJBTBOZBKBVIMFCJILFDJMEBSJQBEBZBOHLJUBQFSLJSBLBO TFQFSUJ
UFSMJIBUQBEB(BNCBS"MBTBOVOUVLIBMUFSTFCVUBEBMBI
)FNBUPLSJU #BHJBO EBSBI ZBOH CFSVQB TFM EBSBI NFSBI
CBIXB LFOBJLBO UFLBOBO BSUFSJ UJEBL IBOZB NFOBJLLBO
EJTFCVUIFNBUPLSJU+BEJ CJMBTFTFPSBOHNFNQVOZBJIFNBUPLSJU
LFLVBUBO ZBOH NFOEPSPOH EBSBI NFMBMVJ QFNCVMVI UFUBQJ
IBM JOJ CFSBSUJ QFSTFO WPMVNF EBSBI BEBMBI TFM EBO
KVHB NFOJNCVMLBO QFOJOHLBUBO LPNQFOTBUPSJL QBEB UBIBOBO
TJTBOZB BEBMBI QMBTNB )FNBUPLSJU QBEB MBLJMBLJ EFXBTB
QFNCVMVI EBMBN XBLUV CFCFSBQB EFUJL NFMBMVJ BLUJWBTJ
OPSNBM SBUBSBUB TFLJUBS TFEBOHLBO QBEB XBOJUB OPSNBM
NFLBOJTNFQFOHFOEBMJBOTFUFNQBUZBOHEJCBIBTQBEB#BC
SBUBSBUB TFLJUBS "OHLB JOJ TBOHBU CFSWBSJBTJ CFSHBOUVOH
4FCBMJLOZB EFOHBO CFSLVSBOHOZB UFLBOBO BSUFSJ TFCBHJBO
BQBLBITFTFPSBOHNFOEFSJUBBOFNJBBUBVUJEBL EFSBKBUBLUJWJUBT
CFTBS UBIBOBO WBTLVMFS EJ TFCBHJBO CFTBS KBSJOHBO TFHFSB
UVCVIOZB EBO LFUJOHHJBO MPLBTJ UFNQBU TFTFPSBOH CFSBEB
EJUVSVOLBO EBO BMJSBO EBSBI EJQFSUBIBOLBO SFMBUJG LPOTUBO
1FSVCBIBOQFSVCBIBO IFNBUPLSJU JOJ UFMBI EJCJDBSBLBO EBMBN ,FNBNQVBO TFUJBQ KBSJOHBO VOUVL NFOZFTVBJLBO UBIBOBO
IVCVOHBOOZBEFOHBOTFMTFMEBSBINFSBIEBOGVOHTJOZBEBMBN WBTLVMFS EBO NFNQFSUBIBOLBO BMJSBO EBSBI OPSNBM TFXBLUV
USBOTQPSPLTJHFOQBEB#BC UFSEBQBUQFSVCBIBOUFLBOBOBSUFSJBOUBSBLVSBOHMFCJIEBO
)FNBUPLSJU EJUFOUVLBO EFOHBO NFNVTJOHLBO EBSBI EBMBN NN)HEJTFCVUBVUPSFHVMBTJBMJSBOEBSBI
UBCVOH CFSLBMJCSBTJ TFQFSUJ UFSMJIBU QBEB (BNCBS
,BMJCSBTJJOJMBOHTVOHNFOZBUBLBOCFTBSOZBQFSTFOUBTFTFM 2.5
1FOHBSVI )FNBUPLSJU UFSIBEBQ 7JTLPTJUBT %BSBI
7JTLPTJUBT EBSBI NFOJOHLBU TFDBSB ESBTUJT EFOHBO 2.0
NFOJOHLBUOZBIFNBUPLSJU TFQFSUJUFSMJIBUQBEB(BNCBS
1.5
10
1.0
9
8
0.5
7
6
0
5 0 50 100 150 200
4 Mean arterial pressure (mm Hg)
3
2
1
0
0 10 20 30 40 50 60 70
165
Unit IV Sirkulasi
1FSIBUJLBOKVHBQBEB(BNCBS QFSVCBIBOQBEBBMJSBO
7
EBSBI EBQBU EJTFCBCLBO PMFI SBOHTBOHBO TBSBG TJNQBUJT LVBU
NFOJNCVMLBO LPOTUSJLTJ QFNCVMVI EBSBI %FNJLJBO QVMB 6
IPSNPO WBTPLPOTUSJLUPS TFQFSUJ OPSFQJOFGSJO BOHJPUFOTJO **
5
WBTPQSFTJO BUBV FOEPUFMJO EBQBU NFOVSVOLBO BMJBO EBSBI
TFUJEBLOZBVOUVLTFNFOUBSB 4
1FSVCBIBO BMJSBO EBSBI LF KBSJOHBO KBSBOH CFSMBOHTVOH 3

MFCJIEBSJCFCFSBQBKBNNFTLJQVOQFOJOHLBUBOUFLBOBOBSUFSJ
2
BUBVQFOJOHLBUBOLBEBSWBTPLPOTUSJLUPSEJQFSUBIBOLBO"MBTBO
UFSEBQBUOZB BMJSBO EBSBI ZBOH EJQFSUBIBOLBO SFMBUJG LPOTUBO 1
BEBMBI LBSFOB BEBOZB NFLBOJTNF BVUPSFHVMBTJ TFUFNQBU 0
KBSJOHBO ZBOH BLIJSOZB NFOHIJMBOHLBO TFCBHJBO CFTBS 0 20 40 60 80 100 120 140 160 180 200
QFOHBSVI WBTPLPOTUSJLUPS EBMBN VQBZB NFOZFEJBLBO BMJBO
EBSBIZBOHTFTVBJEFOHBOLFCVUVIBOKBSJOHBO
Hubungan Tekanan-Aliran pada Jalinan Vaskuler

Pasif1BEBQFNCVMVIEBSBIUFSJTPMBTJBUBVKBSJOHBOZBOHUJEBL
NFNQFSMJIBULBO BVUPSFHVMBTJ QFSVCBIBO UFLBOBO BSUFSJ EBQBU
NFNQVOZBJ QFOHBSVI QFOUJOH QBEB BMJSBO EBSBI
TJNQBUJT TBOHBU NFOEJMBUBTJ QFNCVMVI EBO EBQBU NFOJOHLBULBO
,FOZBUBBOOZB QFOHBSVI UFLBOBO UFSIBEBQ BMJSBO EBSBI EBQBU
BMJSBOEBSBITBNQBJEVBLBMJMJQBUBUBVMFCJI4FCBMJLOZB SBOHTBOH
MFCJI CFTBS EBSJ ZBOH EJQSFEJLTJ NFOHHVOBLBO QFSTBNBBO
TJNQBUJT ZBOH TBOHBU LVBU EBQBU NFOJNCVMLBO LPOTUSJLTJ
1PJTFVJMMF TFQFSUJEJQFSMJIBULBOHBSJTNFMFOHLVOHLFBUBTQBEB
QFNCVMVI TFEFNJLJBO IFCBUOZB TFIJOHHB BMJSBO EBSBI LBEBOH
(BNCBS "MBTBOOZB BEBMBI CBIXB QFOJOHLBUBO UFLBOBO
LBEBOH UVSVO TBNQBJ TFSFOEBI OPM TFMBNB CFCFSBQB EFUJL
BSUFSJUJEBLIBOZBNFOJOHLBULBOEBZBZBOHNFOEPSPOHEBSBI
NFTLJQVOUFSEBQBUUFLBOBOBSUFSJZBOHUJOHHJ
NFMBMVJ QFNCVMVI UFUBQJ KVHB NFOJNCVMLBO QFSFHBOHBO
QFNCVMVI FMBTUJL TFIJOHHB NFOVSVOLBO UBIBOBO WBTLVMFS 1BEB LFOZBUBBOOZB IBOZB BEB CFCFSBQB LPOEJTJ GJTJPMPHJL
4FCBMJLOZB QFOVSVOBO UFLBOBO BSUFSJ QBEB QFNCVMVI EBSBI KBSJOHBO NFNQFSMJIBULBO IVCVOHBO UFLBOBOBMJSBO QBTJG TFQFSUJ
QBTJGBLBONFOJOHLBULBOUBIBOBOBLJCBULPMBQTOZBQFNCVMVI UFSMJIBU QBEB (BNCBS #BILBO QBEB KBSJOHBO ZBOH UJEBL
FMBTUJL TFDBSB CFSUBIBQ PMFI QFOVSVOBO UFLBOBO QFSFHBOHBO TFDBSBFGFLUJGNFOKBMBOJBVUPSFHVMBTJQFNCVMVIEBSBIOZBTFXBLUV
4BBU UFLBOBO UVSVO EJ CBXBI UJOHLBU LSJUJT EJTFCVU UFLBOBO UFSKBEJ QFSVCBIBO UFLBOBO BSUFSJ BLVU BMJSBO EBSBI EJBUVS TFTVBJ
QFOVUVQBO LSJUJT BMJSBO CFSIFOUJ BLJCBU LPMBQT TFNQVSOB EFOHBO LFCVUVIBO KBSJOHBO LFUJLB QFSVCBIBO UFLBOBO UFSTFCVU
QFNCVMVIEBSBI EJQFSUBIBOLBO TFQFSUJEJCBIBTQBEB#BC
3BOHTBOH TJNQBUJT EBO WBTPLPOTUSJLUPS MBJO EBQBU
Daftar Pustaka
NFOHVCBI IVCVOHBO UFLBOBOBMJSBO QBTJG TFQFSUJ
EJQFSMJIBULBOQBEB(BNCBS+BEJ JOIJCJTJBLUJWJUBT -JIBUEBGUBSQVTUBLBQBEB#BC
166
BAB 15
UNIT IV
%JTUFOTJCJMJUBT7BTLVMBSTFSUB
'VOHTJ4JTUFNEBO"SUFSJ
NBUJL EBO LBSFOB JUV EJTUFOTJCJMJUBTOZB LJSBLJSB FOBN LBMJ

Distensibilitas
MFCJICFTBSEBSJQBEBBSUFSJTJTUFNJL
Vaskular
Komplians Vaskular (atau Kapasitansi Vaskular)
,BSBLUFSJTUJL TJTUFN WBTLVMBS
ZBOHQFOUJOHBEBMBICBICBIXB 1BEB TUVEJ IFNPEJOBNJL CJBTBOZB KBVI MFCJI QFOUJOH VOUVL
TFNVBQFNCVMVIEBSBICFSTJGBU NFOHFUBIVJ KVNMBI UPUBM EBSBI ZBOH EBQBU EJUBNQVOH EJ
EJTUFOTJCMF NVEBINFSFHBOH
TJGBUEJTUFOTJCJMJUBTBSUFSJNFNVOH CBHJBO TJSLVMBTJ UFSUFOUV VOUVL TFUJBQ NN )H LFOBJLBO
LJOLBO BSUFSJ UFSTFCVU VOUVL NFOZBMVSLBO DVSBI KBOUVOH ZBOH UFLBOBO EBSJQBEB NFOHFUBIVJ EJTUFOTJCJMJUBT NBTJOHNBTJOH
CFSTJGBU QVMTBUJM EBO NFOJNCVMLBO QVMBTJ UFLBOBO SBUBSBUB )BM QFNCVMVI /JMBJ JOJ EJTFCVU LPNQMJBOT DPNQMJBODF
BUBV
JOJ BLBO NFOZFCBCLBO BMJSBO EBSBI UFSVTNFOFSVT EBO MBODBS LBQBTJUBOTSBOHLBJBOQFNCVMVIEBSBI:BJUV
NFMBMVJQFNCVMVIEBSBIZBOHTBOHUBLFDJMEJEBMBNKBSJOHBO
Peningkatan Volume
7FOB BEBMBI ZBOH QBMJOH EJTUFOTJCFM EBSJ TFMVSVI QFNCVMVI Komplians vaskular =
Peningkatan Tekanan
#BILBO EFOHBO TFEJLJU QFOJOHLBUBO UFLBOBO WFOB TVEBI EBQBU
NFOBNQVOH TBNQBJ -EBSBIUBNCBIBO0MFILBSFOBJUV ,PNQMJBOT EBO EJTUFOTJCJMJUBT TBOHBU CFSCFEB TBUV TBNB MBJO
WFOB NFOZFEJBLBO TVBUV GVOHTJ QFOBNQVOHBO SFTFSWPJS
VOUVL 1FNCVMVIZBOHTBOHBUEJTUFOTJCFMEFOHBOTFEJLJUWPMVNFEBQBU
NFOZJNQBO TFKVNMBI CFTBS EBTBS UBNCBIBO ZBOH EBQBU EJHV NFNQVOZBJ LPNQMJBOT KBVI MFCJI TFEJLJU EBSJQBEB QFNCVMVI
OBLBOTFUJBQTBBUEJCVUVILBOEJNBOBQVOEBMBNTJSLVMBTJ LVSBOH EJTUFOTJCFM ZBOH NFNQVOZBJ WPMVNF CFTBS LBSFOB
4BUVBO %JTUFOTJCJMJUBT 7BTLVMBS %JTUFOTJCJMJUBT WBTLVMBS LPNQMJBOTTBNBEFOHBOEJTUFOTJCJMJUBTEJLBMJWPMVNF
CJBTBOZB EJOZBUBLBO TFCBHBJ GSBLTJ LFOBJLBO WPMVNF QBEB TFUJBQ ,PNQMJBOT TFCVBI WFOB TJTUFNJL CFTBSOZB TFLJUBS LBMJ
QFOJOHLBUBO UFLBOBO EBMBN NJMJNFUFS BJS SBLTB TFTVBJ EFOHBO LPNQMJBOTBSUFSJCFSVLVSBOTFCBOEJOHLBSFOBWFOBLJSBLJSB
SVNVT LBMJ MFCJI EJTUFOTJCFM EBO NFNQVOZBJ WPMVNF LJSBLJSB LBMJ
MFCJICFTBS Y

Peningkatan Volume
Distensibilitas Vaskular =
Peningkatan Tekanan Volume Awal Kurva Volume-Tekanan dan Sirkulasi
Arteri dan Vena
:BJUV CJMB NN )H NFOZFCBCLBO QFOJOHLBUBO WPMVNF TVBUV $BSBNVEBIVOUVLNFOZBUBLBOIVCVOHBOBOUBSBUFLBOBOEBO
QFNCVMVITFCBOZBLNM ZBOHBXBMOZBCFSJTJNMEBSBI OJMBJ WPMVNFEJEBMBNQFNCVMVIBUBVEJCBHJBOTJSLVMBTJNBOBTBKB
EJTUFOTJCJMJUBTOZB BLBO NFOKBEJ QFS NN )H BUBV QFSTFO BEBMBI EFOHBO LVSWB ZBOH EJTFCVU LVSWB WPMVNFUFLBOBO
QFSNN)H ,VSWB EFOHBO HBSJT VUVI EJ TFCFMBI LJSJ EBO LBOBO QBEB
(BNCBS CFSUVSVUUVSVU NFSVQBLBO LVSWB WPMVNF
Perbedaan Distensibilitas Arteri dan Vena. UFLBOBO TJTUFN BSUFSJ EBO TJTUFN WFOB TJTUFNJL OPSNBM
4FDBSB BOBUPNJT EJOEJOH BSUFSJ KBVI MFCJI LVBU EBSJQBEB NFNQFSMJIBULBOCBIXBCJMBTJTUFNBSUFSJQBEBTFPSBOHEFXBTB
EJOEJOH WFOB "LJCBUOZB SBUBSBUB EJTUFOTJCJMJUBT WFOB LJSB SBUBSBUB NFMJQVUJTFNVBBSUFSJCFTBS BSUFSJLFDJM EBOBSUFSJPM

LJSB EFMBQBO LBMJMFCJI CFTBS EJCBOEJOHLBO BSUFSJ "SUJOZB UFSJTJEFOHBOTFLJUBSNMEBSBI UFLBOBOBSUFSJSBUBSBUBOZB
EFOHBO LFOBJLBO UFLBOBO UFSUFOUV BLBO NFOZFCBCLBO BEBMBI NN )H UFUBQJ CJMB IBOZB UFSJTJ EFOHBO NM
QFOJOHLBUBO WPMVNF EBSBI EJ TFCVBI WFOB LJSBLJSB TFCBOZBL UFLBOBOOZBNFOVSVOTBNQBJOPM
EFMBQBOLBMJEBSJQBEBEJBSUFSJZBOHCFSVLVSBOTFCBOEJOH %J TFMVSVI TJTUFN WFOB TJTUFNJL WPMVNF EBSBI CJBTBOZB
%JTUFOTJCJMJUBT WFOB EJ TJSLVMBTJ QBSV TFSVQB EFOHBO WFOB CFSLJTBSEBSJTBNQBJNM EBOQFSVCBIBO WPMVNF
TJSLVMBTJTJTUFNJL"LBOUFUBQJ BSUFSJQVMNPOBMJTCJBTBOZBCFLFSKB TFCBOZBL CFCFSBQB SBUVT NJMJNFUFS EJQFSMVLBO VOUVL NFOHV
QBEBUFLBOBOTFLJUBSTFQFSFOBNUFLBOBOBSUFSJTJTUFNBSUFSJTJTUF CBI UFLBOBO WFOB IBOZB TFCFTBS TBNQBJ NN )H )BM UFS
TFCVUNFOKFMBTLBOCBIXBTFCBOZBLTFUFOHBIMJUFSEBSBIEBQBU
167
Unit IV Sirkulasi
(mm Hg)
volume
(mm Hg)
Volume (ml)
(BNCBS
SB NFOZFCBCLBO EJTUFOTJ FMBTUJT QBEB WFOB OBNVO LFNVEJBO

EJUSBOTGVTJLBO LF PSBOH TFIBU IBOZB EBMBN XBLUV CFCFSBQB TFSBUPUPUQPMPTWFOBNVMBJNFOKVMVSNFOKBEJMFCJIQBOKBOH EBO
NFOJUUBOQBCBOZBLNFOHVCBIGVOHTJTJSLVMBTJOZB TFIVCVOHBO EFOHBO JUV UFHBOHBOOZB JLVU NFOVSVO &GFL JOJ
NFSVQBLBO LBSBLUFSJTUJL TFNVB KBSJOHBO PUPU QPMPT EBO EJTFCVU
Pengaruh Rangsangan Simpatis atau Inhibisi TUSFTSFMBLTBTJ ZBOHTVEBIEJKFMBTLBOEJ#BC
Simpatis Terhadap Hubungan Volume-Tekanan ,PNQMJBOT MBNCBU BEBMBI TVBUV NFLBOJTNF QFOUJOH ZBOH
Sistem Arteri dan Vena. 1BEB (BNCBS KVHB UFSMJIBU NFOZFCBCLBO TJSLVMBTJ EBQBU NFOBNQVOH UBNCBIBO EBSBI CJMB
QFOHBSVI SBOHTBOHBO BUBV JOIJCJTJ TBSBG TJNQBUJT WBTLVMBS EJQFSMVLBO NJTBMOZB TFTVEBI USBOTGVTJ EBMBN KVNMBI CFTBS
UFSIBEBQLVSWBWPMVNFUFLBOBO1FOJOHLBUBOUPOVTPUPUQPMPT ,PNQMJBOTMBNCBUEBMBNBSBICFSMBXBOBOBEBMBITBMBITBUVDBSB
WBTLVMBS ZBOH EJTFCBCLBO PMFI SBOHTBOHBO TJNQBUJT UFMBI UFSKBEJOZBQFOZFTVBJBOTJSLVMBTJTFDBSBPUPNBUJTTFMBNBCFSNFOJU
UFSCVLUJBLBONFOJOHLBULBOUFLBOBOQBEBTFUJBQWPMVNFBSUFSJ NFOJU BUBV CFSKBNKBN UFSIBEBQ QFOHVSBOHBO WPMVNF EBSBI
BUBV WFOB TFEBOHLBO JOIJCJTJ TJNQBUJT BLBO NFOVSVOLBO TFUFMBIUFSKBEJOZBQFSEBSBIBOTFSJVT
UFLBOBO QBEB TFUJBQ WPMVNF 1FOHFOEBMJBO QFNCVMVI PMFI
TJNQBUJT TFQFSUJ JOJ NFSVQBLBO DBSB CFSIBSHB VOUVL
NFOHVSBOHJ VLVSBO TVBUV TFHNFO TJSLVMBTJ ZBJUV EBQBU Pulsasi Tekanan Arteri
NFNJOEBILBOEBSBILFTFHNFOMBJO$POUPIOZB QFOJOHLBUBO
4FUJBQ LBMJ KBOUVOH CFSEFOZVU UFSEBQBU HFMPNCBOH EBSBI CBSV
UPOVTWBTLVMBSEJTFMVSVITJSLVMBTJTJTUFNJLTFSJOHLBMJNFOZF
NFOHJTJ BSUFSJ #JMB UJEBL BEB EJTUFOTJCJMJUBT TJTUFN BSUFSJ TFNVB
CBCLBO TFKVNMBI CFTBS WPMVNF EBSBI CFSQJOEBI EBMBN
EBSBI UFSTFCVU BLBO TFHFSB NFOHBMJS NFMBMVJ QFNCVMVI EBSBI
KBOUVOH IBM JOJ NFSVQBLBO TBMBI TBUV DBSB VUBNB ZBOH
QFSJGFS IBOZB TFMBNB QFSJPEF TJTUPM EBO UJEBL BLBO BEB EBSBI
EJHVOBLBO PMFI UVCVI VOUVL NFOJOHLBULBO QFNPNQBBO
NFOHBMJSTFMBNBEJBTUPM/BNVOQBEBLFBEBBOOPSNBM LPNQMJBOT
KBOUVOH
QFSDBCBOHBO BSUFSJ BLBO NFOVSVOLBO QVMTBTJ UFLBOBO TBNQBJ
1FOHBUVSBO LBQBTJUBOTJ WBTLVMBS EFOHBO DBSB TJNQBUJTKVHB IBNQJS UJEBL CFSQVMTBTJ QBEB TBBU EBSBI NFODBQBJ LBQJMFS PMFI
TBOHBUQFOUJOHTFXBLUVQFSEBSBIBO1FOHVBUBOUPOVTTJNQBUJT LBSFOB JUV BMJSBO EBSBI KBSJOHBO CFSMBOHTVOH UFSVUBNB TFDBSB
QFNCVMVI UFSVUBNB UFSIBEBQ WFOB BLBO NFOHVSBOHJ UFSVTNFOFSVTEFOHBOQVMTBTJZBOHTBOHBULFDJM
VLVSBO QFNCVMVI TFIJOHHB TJTUFN TJSLVMBTJ EBQBU UFSVT
CFSKBMBO NFOEFLBUJ OPSNBM NFTLJQVO EBSBI UFMBIUFSCVBOH 4FCVBI SFLBNBO LIBT QVMTBTJ UFLBOBO QBEB CBHJBO QSPLTJNBM
TFCBOZBLQFSTFOEBSJWPMVNFEBSBIUPUBM BPSUBEJQFSMJIBULBOQBEB(BNCBS1BEBPSBOHEFXBTBTFIBU
UFLBOBO QBEB QVODBL TFUJBQ QVMTBTJ EJTFCVU UFLBOBO TJTUPMJL
Komplians Pembuluh Tertunda (Stres-Relaksasi) MTUJMBI BEBMBI TFLJUBS NN )H 1BEB UJUJL UFSFOEBI TFUJBQ QVMTBTJ
LPNQMJBOTUFSUVOEBCFSBSUJCBIXBQFNCVMVIZBOHNFOHBMBNJ EJTFCVU UFLBOBO EJBTUPMJL OJMBJOZB TFLJUBS NN )H 1FSCFEBBO
QFOJOHLBUBO WPMVNF NVMBNVMB BLBO NFNQFSMJIBULBO OJMBJBOUBSBLFEVBUFLBOBOJOJTFLJUBSNN)H EJTFCVUUFLBOBO
QFOJOHLBUBO UFLBOBO CFTBS UFUBQJ SFHBOHBO PUPU QPMPT ZBOH OBEJ
MBNCBU EBO QSPHSFTJG QBEB EJOEJOH QFNCVMVI NFNVOHLJOLBO %VBGBLUPSVUBNBZBOHNFNFOHBSVIJUFLBOBOOBEJ
DVSBI
UFLBOBOVOUVLLFNCBMJOPSNBMTFUFMBICFSNFOJUNFOJUTBNQBJ JTJ TFLVODVQ KBOUVOH EBO
LPNQMJBOT EJTUFOTJCJMJUBT UPUBM

CFSKBNKBN &GFL UFSTFCVU EJQFSMJIBULBO QBEB (BNCBS QFSDBCBOHBOBSUFSJ'BLUPSLFUJHB UFUBQJLVSBOHQFOUJOHCFSQFSBO
1BEB HBNCBS JOJ UFLBOBO EJDBUBU QBEB TVBUV TFHNFO LFDJM EJ BEBMBITJGBUFKFLTJEBSJKBOUVOHTFMBNBQFSJPEFTJTUPM
TFCVBIWFOBZBOHLFEVBVKVOHOZBEJTVNCBU4FKVNMBIWPMVNF
EBSBIUBNCBIBOTFDBSBNFOEBEBLEJTVOUJLLBOTBNQBJUFLBOBO 1BEBVNVNOZB NBLJOCFTBSDVSBIJTJTFLVODVQ NBLJOCFTBS
NFOJOHLBU EBSJ NFOKBEJ NN )H .FTLJQVO UJEBL BEB QVMB KVNMBI EBSBI ZBOH IBSVT EJUBNQVOH EJ QFSDBCBOHBO BSUFSJ
EBSBI QJOEBI TFUFMBI QFOZVOUJLBO UFLBOBO TFHFSB NFOVSVO QBEB TFUJBQ EFOZVU KBOUVOH EBO PMFI LBSFOB JUV NBLJO CFTBS
EBO NFOEFLBUJ OJMBJ TFLJUBS NN )H TFUFMBI CFCFSBQB NFOJU QFOJOHLBUBO EBO QFOVSVOBO UFLBOBO TFMBNB TJTUPM EBO EJBTUPM
%FOHBOLBUBMBJO WPMVNFEBSBIZBOHEJTVOUJLLBOTFHF BLBONFOZFCBCLBONBLJOCFTBSOZBUFLBOBOOBEJ4FCBMJLOZB NB
168
Bab 15 Distensbilitas Vaskular sena Fungsi Sistem Vena dan Arteri
1BEB EVLUVT BSUFSJPTVT NFOFUBQ TFQBSVI BUBV MFCJI EBSBI

ZBOH EJQPNQB LF EBMBN BPSUB PMFI WFOUSJLFM LJSJ TFHFSB
NFOHBMJSLFNCBMJNFMBMVJEVLUVTZBOHUFSCVLBMFCBSLFEBMBN
BSUFSJ QVMNPOBMJT EBO QFNCVMVI EBSBI QBSV TFIJOHHB
UNIT IV
120
NFNVOHLJOLBOUFLBOBOEJBTUPMJLVOUVLUVSVOESBTUJTTFCFMVN
EFOZVUKBOUVOHCFSJLVUOZB
1BEB SFHVSHJUBTJ BPSUB LBUVQ BPSUB UJEBL BEB BUBV UJEBL
(mm Hg)
EBQBU NFOVUVQ TFQFOVIOZB 0MFI LBSFOB JUV TFUFMBI TFUJBQ

80
LBMJ KBOUVOH CFSEFOZVU EBSBI ZBOH CBSV TBKB EJQPNQB LF
EBMBNBPSUBBLBOTFHFSBNFOHBMJSLFNCBMJLFEBMBNWFOUSJLFM
LJSJ "LJCBUOZB UFLBOBO BPSUB EBQBU UVSVO NFOKBEJ OPM EJ
60
BOUBSB EFOZVU KBOUVOH +VHB UJEBL UFSEBQBU UBLJL QBEB
HBNCBSBO QVMTBTJ BPSUB LBSFOB UJEBL UFSEBQBU LBUVQ BPSUB
VOUVLNFOVUVQ
40
0 0.2 0.4 0.6 0.8 1.0 1.2 1.4 1.6 1.8 2.0
1BEB TBBU KBOUVOH NFNPNQB EBSBI LF EBMBN BPSUB TFMBNB

NBLJO LFDJM LPNQMJBOT TJTUFN BSUFSJ NBLJO CFTBS LFOBJLBO TJTUPM NVMBNVMB IBOZB CBHJBO QSPLTJNBM BPSUB ZBOH NFOHB
UFLBOBO ZBOH BLBO UFSKBEJ BLJCBU JTJ TFLVODVQ EBSBI ZBOH MBNJ EJTUFOTJ LBSFOB TJGBU JOFSTJB EBSBI BLBO NFODFHBI QFSHF
EJQPNQB LF EBMBN BSUFSJ .JTBMOZB TFQFSUJ ZBOH EJQFSMJIBULBO SBLBOEBSBIZBOHUJCBUJCBLFQFSJGFS"LBOUFUBQJ QFOJOHLBUBO
PMFILVSWBQBMJOHBUBTCBHJBOUFOHBIQBEB(BNCBS UFLBOBO UFLBOBO EJ BPSUB QSPLTJNBM EFOHBO DFQBU BLBO NFOHJNCBOHJ
OBEJ QBEB PSBOH MBOKVU VTJB LBEBOHLBEBOH NFOJOHLBU TBNQBJ TJGBUJOFSTJBUFSTFCVUEBOCBHJBONVLBHFMPNCBOHEJTUFOTJBLBO
EVB LBMJ OJMBJ OPSNBM LBSFOB BSUFSJ NFOKBEJ MFCJI LBLV BLJCBU NFOZFCBS TFNBLJO KBVI EJ TFQBOKBOH BPSUB TFQFSUJ EJQFSMJ
BSUFSJPTLMFSPTJTEBOLBSFOBOZB BSUFSJSFMBUJGUJEBLMFOUVS IBULBO QBEB (BNCBS )BM JOJ EJTFCVU USBOTNJTJ QVMTBTJ
,FOZBUBBOOZB UFLBOBO OBEJ EJUFOUVLBO LJSBLJSB PMFI SBTJP UFLBOBOEJEBMBNBSUFSJ
DVSBI JTJ TFLVODVQ UFSIBEBQ LPNQMJBOT QFSDBCBOHBO BSUFSJ 4F ,FDFQBUBOUSBOTNJTJQVMTBTJUFLBOBOEJBPSUBOPSNBMBEBMBI
UJBQ LPOEJTJ TJSLVMBTJ ZBOH NFNFOHBSVIJ TBMBI TBUV BUBV LFEVB TBNQBJ NEFUJL EJ DBCBOH BSUFSJ CFTBS TBNQBJ N
GBLUPSUFSTFCVUKVHBBLBONFNFOHBSVIJUFLBOBOOBEJ EFUJL EBO EJ BSUFSJ LFDJM TBNQBJ NEFUJL 1BEB VNVN
5FLBOBOOBEJ ª WPMVNFJTJTFLVODVQLPNQMJBOTBSUFSJ OZB NBLJO CFTBS LPNQMJBOT TFUJBQ TFHNFO WBTLVMBS NBLJO
MBNCBU LFDFQBUBO USBOTNJTJOZB ZBOH NFOKFMBTLBO MBNCBUOZB
(BNCBSBO1VMTBTJ5FLBOBOZBOH"COPSNBM USBOTNJTJEJBPSUBEBOMFCJIDFQBUOZBUSBOTNJTJEJBSUFSJEJTUBM
#FCFSBQB LPOEJTJ TJSLVMBTJ KVHB NFOZFCBCLBO HBNCBSBO BCOPS CFSVLVSBO LFDJM EFOHBO LPNQMJBOT MFCJI LFDJM %J BPSUB LFDF
NBM QBEB HFMPNCBOH QVMTBTJ UFLBOBO TFMBJO QFSVCBIBO UFLBOBO QBUBOUSBOTNJTJQVMTBTJUFLBOBOTFCFTBSLBMJBUBVMFCJIEBSJ
OBEJ:BOHTBOHBUNFOPOKPMEJBOUBSBOZBUFSEBQBUQBEBTUFOPTJT LFDFQBUBOBMJSBOEBSBILBSFOBUFLBOBOQVMTBTJIBOZBMBITVBUV
BPSUB EVLUVTBSUFSJPTVTNFOFUBQ EBOSFHVSHJUBTJBPSUB NBTJOH
NBTJOHEJQFSMJIBULBOQBEB(BNCBS
1BEB TUFOPTJT LBUVQ BPSUB EJBNFUFS QFNCVLBBO LBUVQ BPSUB Wave fronts
CFSLVSBOH TFDBSB CFSNBLOB EBO QVMTBTJ UFLBOBO BPSUB TBOHBU
NFOVSVO BLJCBU QFOVSVOBO BMJSBO EBSBI LFMVBS NFMBMVJ LBUVQ
ZBOHTUFOPUJL
160
120
80
Normal Arterios lerosis Aortic stenosis
(mm Hg)
160
120
80
Normal
40
0
Figure 15-5 Progressive stages in transmission of the
pressure pulse along the aorta.
169
Unit IV Sirkulasi
QFSHFSBLBO HFMPNCBOH UFLBOBO EBO NFMJCBULBO TFEJLJU

QFSHFSBLBOUPUBMWPMVNFEBSBILFBSBIEFQBO
Peredaman Pulsasi Tekanan dalam Arteri Kecil, Cara Auskultasi. (BNCBS NFNQFSMJIBULBO DBSB
Arteriol, dan Kapiler. (BNCBS NFNQFSMJIBULBO BVTLVMUBTJVOUVLNFOFOUVLBOUFLBOBOBSUFSJTJTUPMJLEBOEJBTUPMJL
QFSVCBIBO HBNCBSBO QVMTBTJ UFLBOBO LIBT LFUJLB QVMTBTJ 4FCVBI TUFUPTLPQ EJMFUBLLBO EJ BUBT BSUFSJ EJ CBHJBO MJQBU TJLV
CFSKBMBO LF QFNCVMVI QFSJGFS 1FSIBUJLBO UFSVUBNB QBEB BOUFLVCJUJ
EBOEJTFLFMJMJOHMFOHBOBUBTEJQBTBOHTFCVBINBOTFU
LFUJHB LVSWB CBHJBO CBXBI ZBJUV JOUFOTJUBT QVMTBTJ NFOKBEJ UFLBOBO EBSBI ZBOH EJHFNCVOHLBO 4FMBNB NBOTFU NFOFLBO
CFSLVSBOH TFDBSB QSPHSFTJG EJ BSUFSJ LFDJM BSUFSJPM EBO MFOHBOEFOHBOUFLBOBOZBOHUFSMBMVLFDJMVOUVLNFOZVNCBUBSUFSJ
UFSVUBNB LBQJMFS 1BEB LFOZBUBBOOZB QVMTBTJ EBQBU UFSMJIBU CSBLJBMJT UJEBL BLBO UFSEFOHBS CVOZJ BSUFSJ UFSTFCVU NFMBMVJ
QBEBLBQJMFSIBOZBCJMBQVMTBTJBPSUBTBOHBUCFTBSBUBVBSUFSJPM TUFUPTLPQ /BNVO CJMB UFLBOBO EBMBN NBOTFU JUV DVLVQ CFTBS
TBOHBUCFSEJMBUBTJ VOUVL NFOZVNCBU BSUFSJ TFMBNB TFCBHJBO TJLMVT UFLBOBO BSUFSJ
1FOVSVOBO QSPHSFTJG QVMTBTJ EJ QFSJGFS EJTFCVU QFSFEBNBO CVOZJBLBOUFSEFOHBSQBEBTFUJBQQVMTBTJ #VOZJCVOZJJOJEJTFCVU
QVMTBTJ UFLBOBO 1FOZFCBC IBM JOJ UFSCBHJ EVB
UBIBOBO CVOZJ ,PSPULPGG EJOBNBLBO TFTVBJ /JLPMBJ ,PSPULPGG TFPSBOH
UFSIBEBQ QFSHFSBLBO EBSBI EBMBN QFNCVMVI EBO
EPLUFS3VTJBZBOHNFOEFTLSJQTJLBOOZBQBEBUBIVO
LPNQMJBOTQFNCVMVI5BIBOBOBLBONFSFEBNQVMTBTJLBSFOB
TFKVNMBILFDJMEBSBIIBSVTNFOHBMJSNBKVQBEBCBHJBOEFQBO
HFMPNCBOH QVMTBTJ VOUVL NFSFHBOHLBO TFHNFO CFSJLVUOZB
(mm Hg)
EBSJ QFNCVMVI TFNBLJO CFTBS UBIBOBO TFNBLJO TVMJU IBM JOJ
UFSKBEJ,PNQMJBOTBLBONFSFEBNQVMTBTJLBSFOBNBLJOMFOUVS
TVBUVQFNCVMVI NBLJOCBOZBLKVNMBIEBSBIEJQFSMVLBOQBEB
CBHJBO EFQBO HFMPNCBOH QVMTBTJ VOUVL NFOJNCVMLBO
LFOBJLBOUFLBOBO0MFILBSFOBJUV EFSBKBUQFSFEBNBOIBNQJS
CFSCBOEJOHMBOHTVOHEFOHBOIBTJMUBIBOBOEJLBMJLPNQMJBOT
Metode Minis untuk Mengukur Tekanan Sistolik dan

Tekanan Diastolik.
1FOHHVOBBOBMBUQFSFLBNUFLBOBOZBOHNFOHIBSVTLBOKBSVN
NBTVLLFEBMBNBSUFSJVOUVLQFOHVLVSBOSVUJOUFLBOBOEBSBI
BSUFSJQBEBQBTJFONBOVTJBUJEBLQBOUBTEJMBLVLBO XBMBVQVO
DBSB UFSTFCVU LBEBOHLBEBOH EJQFSMVLBO QBEB TUVEJ LIVTVT
4FCBHBJHBOUJOZB QBSBLMJOJTJNFOFOUVLBOUFLBOBOTJTUPMJL
S stol Diastol In isura

160
120
80 240
20
mmHg
Arteriol
0 1 2
Gambar 15-6 Perubahan gambaran tekanan nadi seiring

dengan perjalanan gelombang pulsasi ke pembuluh yang lebih olik.
kecil.
170
#VOZJ ,PSPULPGG EJTFCBCLBO UFSVUBNB PMFI TFNCVSBO EBSBI

NFMFXBUJ QFNCVMVI EFOHBO IBNCBUBO QBSTJBM TFSUB PMFI HFUBSBO
S stoli
(mm Hg)
EJOEJOH QFNCVMVI 4FNCVSBO EBSBI JOJ NFOJNCVMLBO BMJSBO
UVSCVMFOEJEBMBNQFNCVMVIEJMVBSEBFSBINBOTFU EBOLFBEBBO
UNIT IV
JOJBLBONFOJNCVMLBOHFUBSBOZBOHUFSEFOHBSNFMBMVJTUFUPTLPQ
%BMBN NFOFOUVLBO UFLBOBO EBSBI EFOHBO DBSB BVTLVMUBTJ Diastoli
UFLBOBO EBMBN NBOTFU NVMBNVMB EJOBJLLBO TBNQBJ EJ BUBT
UFLBOBO TJTUPMJL BSUFSJ 4FMBNB UFLBOBO NBOTFU MFCJI UJOHHJ
EBSJQBEB UFLBOBO TJTUPMJL BSUFSJ CSBLJBMJT BLBO UFUBQ LPMBQT EBO
UJEBL BLBO BEB EBSBI NFOHBMJS LF EBMBN BSUFSJ ZBOH MFCJI EJTUBM
TFMBNB TJLMVT QFOFLBOBO 0MFI LBSFOB JUV UJEBL BLBO UFSEFOHBS
CVOZJ,PSPULPGGEJBSUFSJEJTUBM/BNVOLFNVEJBOUFLBOBOEBMBN
NBOTFUTFDBSBCFSUBIBQEJLVSBOHJ#FHJUVUFLBOBOEBMBNNBOTFU
UVSVO EJ CBXBI UFLBOBO TJTUPMJL UJUJL # (BNCBS
EBSBI
NVMBJ NFOHBMJS NFMBMVJ BSUFSJ EJ EJTUBM NBOTFU TFMBNB QVODBL
UFLBOBOTJTUPMJL EBOLJUBNVMBJNFOEFOHBSCVOZJCFSEFUBLBSUFSJ
NFNQFSMJIBULBO QFSVCBIBO OZBUB TFJSJOH EFOHBO CFSKBMBOOZB
BOUFLVCJUJZBOHTJOLSPOEFOHBOEFOZVUKBOUVOH#FHJUVCVOZJJOJ
VTJB UFSVUBNB TFUFMBI VTJB UBIVO TVEBI EJLFUBIVJ EFOHBO
NVMBJUFSEFOHBS OJMBJUFLBOBOZBOHEJUVOKVLLBOPMFINBOPNFUFS
KFMBT
ZBOH UFSIVCVOH EFOHBO NBOTFU LJSBLJSB TBNB EFOHBO UFLBOBO
4FEJLJU QFOJOHLBUBO UBNCBIBO EBSJ UFLBOBO TJTUPMJL CJBTBOZB
TJTUPMJL
UFSKBEJ TFUFMBI VTJB UBIVO )BM JOJ EJTFCBCLBO PMFI QFOVSV
#JMB UFLBOBO EBMBN NBOTFU EJUVSVOLBO MFCJI MBOKVU UFSKBEJ OBO EJTUFOTJCJMJUBT BUBV QFOHFSBTBO BSUFSJ TFSJOH EJTFCBCLBO
QFSVCBIBO LVBMJUBT CVOZJ ,PSPULPGG LVBMJUBT EFUBLOZB NFOKBEJ PMFI BUFSPTLMFSPTJT %BNQBL BLIJSOZB BEBMBI UFLBOBO TJTUPMJL
CFSLVSBOHEBOCVOZJOZBNFOKBEJMFCJICFSJSBNBEBOMFCJILBTBS MFCJI UJOHHJ EFOHBO QFOJOHLBUBO UFLBOBO OBEJ ZBOH CFTBS
,FNVEJBO BLIJSOZB TFXBLUV UFLBOBO NBOTFU UVSVO NFOEFLBUJ TFQFSUJZBOHEJKFMBTLBOTFCFMVNOZB
UFLBOBO EJBTUPM LVBMJUBT CVOZJ UJCBUJCB CFSVCBI NFOKBEJ SFEVQ
UJUJL$ (BNCBS
)FOEBLOZBEJTJNBLUFLBOBONBOPNFUFS
TBBU CVOZJ ,PSPULPGG CFSVCBI LVBMJUBTOZB NFOKBEJ SFEVQ EBO Tekanan Arteri Rata-rata.5FLBOBOBSUFSJSBUBSBUBBEBMBI
UFLBOBO JOJ LVSBOH MFCJI TBNB EFOHBO UFLBOBO EJBTUPMJL NFT OJMBJ SBUBSBUB EBSJ UFLBOBO BSUFSJ ZBOH EJVLVS NJMJEFUJL QFS
LJQVO TFEJLJU MFCJI UJOHHJ EBSJ QFOFUBQBO UFLBOBO EJBTUPMJL NJMJEFUJL TFMBNB QFSJPEF XBLUV UFSUFOUV /JMBJ JOJ UJEBL TBNB
MBOHTVOH NFOHHVOBLBO LBUFUFS JOUSBBSUFSJBM 4BBU UFLBOBO EFOHBO SBUBSBUB UFLBOBO TJTUPMJL EBO EJBTUPMJL LBSFOB QBEB
NBOTFU UVSVO CFCFSBQB NN )H MBHJ BSUFSJ UFSTFCVU UJEBL GSFLVFOTJ KBOUVOH OPSNBM CBHJBO TJLMVT KBOUVOH ZBOH MFCJI
UFSTVNCBU MBHJ TFMBNB EJBTUPM CFSBSUJ CBIXB GBLUPS EBTBS ZBOH CFTBS EJMVBOHLBO TFXBLUV EJBTUPM EBO CVLBO TJTUPM TFIJOHHB
NFOZFCBCLBO UJNCVMOZB CVOZJ ZBJUV TFNCVSBO EBSBI NFMFXBUJ UFLBOBOBSUFSJMFCJINFOEFLBUJOJMBJUFLBOBOEJBTUPMJLEBSJQBEB
BSUFSJ ZBOH UFSUFLBO
UJEBL BEB MBHJ 0MFI LBSFOB JUV CVOZJ UFLBOBO TJTUPMJL QBEB TFCBHJBO CFTBS TJLMVT KBOUVOH 0MFI
UFSTFCVU NFOHIJMBOH TFMVSVIOZB #BOZBL BIMJ LMJOJL NFZBLJOJ LBSFOBJUV UFLBOBOBSUFSJSBUBSBUBEJUFUBQLBOTFLJUBSQFSTFO
CBIXB UFLBOBO TBBU CVOZJ ,PSPULPGG NFOHIJMBOH TBNB TFLBMJ EBSJ UFLBOBO EJBTPMJL EBO QFSTFO EBSJ UFLBOBO TJTUPMJL
TFZPHZBOZB EJUFUBQLBO TFCBHBJ UFLBOBO EJBTUPM LFDVBMJ QBEB 1FSIBUJLBO QBEB (BNCBS CBIXB UFLBOBO SBUBSBUB ZBOH
LFBEBBO EJ NBOB NFOHIJMBOHOZB CVOZJ UJEBL EBQBU EJUFUBQLBO EJUVOKVLLBO PMFI HBSJT VUVI EJ UFOHBI
QBEB TFNVB VTJB MFCJI
EFOHBO QBTUJ LBSFOB CVOZJ UFSTFCVU UFUBQ UFSEFOHBS NFTLJQVO NFOEFLBUJUFLBOBOEJBTUPMJLEBSJQBEBUFLBOBOTJTUPMJL/BNVO
NBOTFU UFMBI UFSEFGMBTJ TFNQVSOB 4FCBHBJ DPOUPI QBEB QBTJFO QBEB GSFLVFOTJ KBOUVOH ZBOH TBOHBU UJOHHJ EJBTUPM NFOFNQBUJ
EFOHBO GJTUVMB BSUFSJWFOB VOUVL IFNPEJBMJTJT BUBV EFOHBO GSBLTJMFCJILFDJMEBMBNTJLMVTKBOUVOHEBOUFLBOBOBSUFSJSBUB
JOTVGJTJFOTJBPSUB CVOZJ,PSPULPGGEBQBUUFSEFOHBSTFUFMBIEFGMBTJ SBUBMFCJINFOEFLBUJSBUBSBUBUFLBOBOTJTUPMEBOEJBTUPM
NBOTFUTFNQVSOB
$BSB BVTLVMUBTJ VOUVL NFOFOUVLBO UFLBOBO TJTUPMJL EBO
EJBTUPMJL JOJ UJEBL TFMVSVIOZB BLVSBU OBNVO CJBTBOZB IBOZB Vena dan Fungsinya
CFSCFEBQFSTFOEBSJOJMBJZBOHEJQFSPMFIEFOHBOQFOHVLVSBO
LBUFUFSJTBTJMBOHTVOHEBSJEBMBNBSUFSJ 4FMBNB CFSUBIVOUBIVO WFOB EJBOHHBQ UJEBL MFCJI EBSJQBEB
MJOUBTBO VOUVL BMJSBO EBSBI LF EBMBN KBOUVOH BLBO UFUBQJ
Tekanan Arteri Normal Seperti Diukur dengan Cara TFNBLJO KFMBT CBIXB WFOB NFMBLVLBO GVOHTJ LIVTVT MBJO ZBOH
Auskultasi. (BNCBSNFNQFSMJIBULBOQFSLJSBBOOJMBJOPSNBM EJQFSMVLBO BHBS TJSLVMBTJ EBQBU CFSKBMBO :BOH QFOUJOH
UFLBOBO BSUFSJ TJTUPMJL EBO EJBTUPMJL QBEB CFSCBHBJ VNVS UFSVUBNB WFOB NBNQV CFSLPOTUSJLTJ EBO CFSEJMBUBTJ EBO
1FOJOHLBUBO UFLBOBO QSPHSFTJG TFJSJOH EFOHBO CFSKBMBOOZB VTJB EFOHBOEFNJLJBOEBQBUNFOZJNQBOEBSBIEBMBNKVNMBICFTBS
BEBMBI BLJCBU EBSJ QFOHBSVI QFOVBBO UFSIBEBQ NFLBOJTNF NBVQVO LFDJM TFSUB NFOZFEJBLBOOZB LFNCBMJ CJMB EJQFSMVLBO
LFOEBMJ UFLBOBO EBSBI ,JUB BLBO NFOHFUBIVJ EJ #BC CBIXB PMFI CBHJBO MBJO EBSJ TJSLVMBTJ 7FOB QFSJGFS KVHB EBQBU
HJOKBM UFSVUBNB CFSUBOHHVOH KBXBC VOUVL QFOHBUVSBO KBOHLB NFOEPSPOHEBSBINBKVEFOHBODBSBZBOHEJTFCVUQPNQBWFOB
QBOKBOHUFSIBEBQUFLBOBOBSUFSJEBOGBLUBCBIXBHJOKBMNFNQFS EBO CBILBO EBQBU NFNCBOUV NFOHBUVS DVSBI KBOUVOH TVBUV
GVOHTJZBOHTBOHBUQFOUJOHZBOHEJKFMBTLBOTFDBSBEFUBJMEJ#BC

171
Unit IV Sirkulasi
Tekanan Vena—Tekanan Atrium Kanan (Tekanan Vena

Sentral) dan Tekanan Vena Perifer
6OUVL EBQBU NFNBIBNJ CFSCBHBJ GVOHTJ WFOB QFSUBNBUBNB
QFSMV EJLFUBIVJ TFTVBUV NFOHFOBJ UFLBOBO EBMBN WFOB EBO
IBMIBMZBOHEBQBUNFOHBUVSOZB
%BSBIEBSJTFNVBWFOBTJTUFNJLNFOHBMJSLFEBMBNBUSJVN
LBOBOPMFILBSFOBJUV UFLBOBOEJEBMBNBUSJVNLBOBOEJTFCVU
UFLBOBOWFOBDFOUSBM
5FLBOBO BUSJVN LBOBO EJLFOEBMJLBO PMFI TVBUV LFTFJN
CBOHBOBOUBSB
LFNBNQVBOKBOUVOHNFNPNQBEBSBILFMV
BSEBSJBUSJVNLBOBOEBOEBSJWFOUSJLFMLFEBMBNQBSVEBO

LFDFOEFSVOHBO EBSBI VOUVL NFOHBMJS EBSJ WFOB QFSJGFS LF EB = 4 mm Hg
MBN BUSJVN LBOBO #JMB KBOUVOH TFCFMBI LBOBO NFNPNQB EF
OHBOLVBU UFLBOBOBUSJVNLBOBOBLBONFOVSVO4FCBMJLOZB LFMF
MBIBOKBOUVOHBLBONFOJOHLBULBOUFLBOBOBUSJVNLBOBO#FHJUV
QVMB TFUJBQQFOHBSVIZBOHNFOZFCBCLBOEBSBINBTVLTFDBSBDF
QBUEBSJWFOBQFSJGFSLFEBMBNBUSJVNLBOBOBLBONFOJOHLBULBO
UFLBOBOBUSJVNLBOBO#FCFSBQBGBLUPSZBOHEBQBUNFOJOHLBULBO Gambar 15-9 Titik-titik kompresi yang cenderung menyebabkan
BMJSBOCBMJLWFOBJOJ EBOEBQBUNFOJOHLBULBOUFLBOBOBUSJVNLB kotaps pada vena yang memasuki toraks.
OBO
BEBMBI
QFOJOHLBUBOWPMVNFEBSBI
QFOJOHLBUBOUPOVT OBZBOHNFMBMVJBCEPNFOTFSJOHLBMJUFSLPNQSFTJPMFICFSCBHBJ
QFNCVMVICFTBSEJTFMVSVIUVCVIZBOHCFSBLJCBUOBJLOZBUFLBOBO PSHBO EBO PMFI UFLBOBO JOUSBBCEPNFO TFIJOHHB WFOBWFOB JOJ
WFOBQFSJGFS EBO
EJMBUBTJBSUFSJPM ZBOHNFOVSVOLBOUBIBOBO CJBTBOZB QBMJOH UJEBL NFOHBMBNJ LPMBQT QBSTJBM NFOKBEJ CFOUVL
QFSJGFSEBONFNVOHLJOLBOEBSBINFOHBMJSEFOHBODFQBUEBSJBS PWPJE BUBV NFOZFSVQBJ DFMBI 0MFI TFCBC JUV WFOBWFOB CFTBS
UFSJLFEBMBNWFOB CJBTBOZB NFNCFSJLBO TFCBHJBO UBIBOBO UFSIBEBQ BMJSBO EBSBI
'BLUPSGBLUPSTBNBZBOHNFOHBUVSUFLBOBOBUSJVNLBOBOKVHB EBO LBSFOBOZB UFLBOBO EJ WFOBWFOB LFDJM ZBOH MFCJI QFSJGFS
JLVUTFSUBNFOHBUVSDVSBIKBOUVOHLBSFOBKVNMBIEBSBIZBOHEJ QBEBTFTFPSBOHZBOHCFSCBSJOHUFSMFOUBOHCJBTBOZB TBNQBJ
QPNQBPMFIKBOUVOHCFSHBOUVOHQBEBLFNBNQVBOKBOUVOHVOUVL NN)HMFCJICFTBSEBSJQBEBUFLBOBOBUSJVNLBOBO
NFNPNQB EBO LFDFOEFSVOHBO EBSBI VOUVL NFOHBMJS LF EBMBN
KBOUVOHEBSJQFNCVMVIQFSJGFS0MFILBSFOBJUV LJUBBLBONFN Pengaruh Tekanan Atrium Kanan yang Tinggi terhadap
CBIBTQFOHBUVSBOUFLBOBOBUSJVNLBOBOTFDBSBMFCJINFOEBMBNEJ Tekanan Vena Perifer.,FUJLBUFLBOBOBUSJVNLBOBONFOJOHLBU
#BCZBOHCFSIVCVOHBOEFOHBOQFOHBUVSBODVSBIKBOUVOH NFMFCJIJOJMBJOPSNBMNN)H EBSBINVMBJUFSCFOEVOHEJWFOB
5FLBOBOBUSJVNLBOBOOPSNBMBEBMBITFLJUBSNN)H TBNB CFTBS )BM UFSTFCVU BLBO NFNCVBU WFOB NFOKBEJ MFCBS EBO CBI
EFOHBOUFLBOBOBUNPTGJSEJTFLJUBSUVCVI5FLBOBOJOJEBQBUOBJL LBO UJUJLUJUJL SBXBO LPMBQT EJ WFOB BLBO UFSCVLB CJMB UFLBOBO
NFOKBEJTBNQBJNN)HQBEBLFBEBBOZBOHTBOHBUBCOPS BUSJVN LBOBO NFOJOHLBU NFMFCJIJ TBNQBJ NN )H ,FNV
NBM TFQFSUJ
HBHBM KBOUVOH TFSJVT BUBV
TFTVEBI USBOTGVTJ EJBO CJMB UFLBOBO BUSJVN LBOBO NBTJI UFSVT NFOJOHLBU UBNCB
EBSBINBTJG ZBOHBLBOTBOHBUNFOJOHLBULBOWPMVNFEBSBIUPUBM IBO LFOBJLBO UFLBOBO NFOJNCVMLBO LFOBJLBO ZBOH TFTVBJ QBEB
EBO NFOZFCBCLBO BMJSBO EBSBI EFOHBO KVNMBI CFSMFCJIBO CFSV UFLBOBO WFOB QFSJGFS EJ UVOHLBJ EBO WFOB MBJOOZB 0MFI LBSFOB
TBIBNBTVLLFEBMBNKBOUVOHEBSJQFNCVMVIQFSJGFS IBSVTUFSEBQBULFMFNBIBOKBOUVOHVOUVLNFOJNCVMLBOLFOBJLBO
#BUBTCBXBIVOUVLUFLBOBOBUSJVNLBOBOCJBTBOZBTFLJUBSo UFLBOBO BUSJVN LBOBO TFUJOHHJ TBNQBJ NN )H LJUB TFSJOH
TBNQBJoNN)HEJCBXBIUFLBOBOBUNPTGFS5FLBOBOJOJKVHB NFOFNVLBOCBIXBUFLBOBOWFOBQFSJGFSUJEBLUFSMJIBUOBJLCBI
NFSVQBLBO UFLBOBO EBMBN SPOHHB EBEB ZBOH NFOHFMJMJOHJ KBO LBOQBEBTUBEJVNHBHBMKBOUVOHEJOJTFLBMJQVO
UVOH5FLBOBOBUSJVNLBOBONFOEFLBUJOJMBJCBUBTCBXBIUFSTFCVU
CJMBKBOUVOHNFNPNQBEFOHBOTBOHBULVBUBUBVBMJSBOEBSBIZBOH Pengaruh Tekanan Intra-Abdomen terhadap Tekanan
NBTVLLFEBMBNKBOUVOHEBSJQFNCVMVIQFSJGFSTBOHBUNFOVSVO Vena Tungkai. 5FLBOBOOPSNBMEJEBMBNSPOHHBBCEPNFOQBEB
NJTBMOZB TFTVEBIQFSEBSBIBOIFCBU TFTFPSBOH ZBOH UFSMFOUBOH SBUBSBUB TFLJUBS NN )H UFUBQJ
EBQBU NFOJOHLBU NFOKBEJ TBNQBJ NN )H BLJCBU
Tahanan Vena dan Tekanan Vena Perifer LFIBNJMBO UVNPSCFTBS PCFTJUBTBCEPNFOBUBVLFMFCJIBODBJSBO
EJTFCVUBTJUFT
EJSPOHHBBCEPNFO#JMBUFLBOBOJOUSBBCEPNFO
7FOB CFTBS NFNQVOZBJ UBIBOBO ZBOH CFHJUV LFDJM UFSIBEBQ
NFOJOHLBU UFLBOBO EJ WFOB UVOHLBJ IBSVT OBJL EJ BUBT UFLBOBO
BMJSBOEBSBILFUJLBWFOBNFOHBMBNJEJTUFOTJTFIJOHHBUBIBOBO
BCEPNFOBHBSWFOBBCEPNFOUFSCVLBEBONFNVOHLJOLBOEBSBI
NFOKBEJ IBNQJS OPM EBO IBNQJS UJEBL CFSQFOHBSVI "LBO
NFOHBMJS EBSJ UVOHLBJ LF KBOUVOH +BEJ CJMB UFLBOBO JOUSB
UFUBQJ TFQFSUJ UFSMJIBU QBEB (BNCBS LFCBOZBLBO WFOB
BCEPNFO BEBMBI NN )H UFLBOBO ZBOH NVOHLJO QBMJOH
CFTBSZBOHNFNBTVLJUPSBLTNFOHBMBNJLPNQSFTJQBEBTFKVN
SFOEBIEJWFOBGFNPSBMJTKVHBTFLJUBSNN)H
MBIUJUJLPMFIKBSJOHBOTFLJUBSOZB TFIJOHHBBMJSBOEBSBINFOKB
EJ UFSIBNCBU QBEB UJUJLUJUJL UFSTFCVU $POUPIOZB WFOB EBSJ Pengaruh Tekanan Gravitasi terhadap Tekanan Vena
MFOHBO UFSLPNQSFTJ PMFI MFOHLVOHBO UBKBNOZB NFMFXBUJ UVMB %J TFNVB CBHJBO BJS ZBOH UFSQBQBS PMFI VEBSB UFLBOBO QBEB
OHSVTVLQFSUBNB+VHB UFLBOBOEJWFOBMFIFSTFSJOHLBMJUVSVO QFSNVLBBO BJS BEBMBI TBNB EFOHBO UFLBOBO BUNPTGFS OBNVO
CFHJUVSFOEBITFIJOHHBUFLBOBOBUNPTGJSEJMVBSMFIFSNFOZF UFLBOBONFOJOHLBUNN)HVOUVLTFUJBQQFOVSVOBO NN
CBCLBOWFOBWFOBUFSTFCVUNFOKBEJLPMBQT5FSBLIJS WFOBWF
172
EBSJ QFSNVLBBO 5FLBOBO JOJ EJBLJCBULBO PMFI CFSBU BJS EBO OKBOHQFSKBMBOBOOZB"MBTBOVOUVLIBMJOJBEBMBICBIXBTFUJBQ
LBSFOBJUVEJTFCVUUFLBOBOHSBWJUBTJBUBVUFLBOBOIJESPTUBUJL LFDFOEFSVOHBO UFLBOBO VOUVL OBJL EJ BUBT OJMBJ UFSTFCVU BLBO
NFNCVLBWFOBEBONFNVOHLJOLBOUFLBOBOUVSVOLFNCBMJLF
5FLBOBO HSBWJUBTJ KVHB UJNCVM EJ TJTUFN WBTLVMBS NBOVTJB
OPM BLJCBU BMJSBO EBSBI 4FCBMJLOZB TFUJBQ LFDFOEFSVOHBO
BLJCBU CFSBU EBSBI EJ EBMBN QFNCVMVI TFQFSUJ UFSMJIBU QBEB
UFLBOBO VOUVL UVSVO EJ CBXBI OPM BLBO NFOZFCBCLBO WFOB
UNIT IV
(BNCBS #JMB TFTFPSBOH CFSEJSJ UFLBOBO EJ BUSJVN LBOBO
TFNBLJO LPMBQT ZBOH TFMBOKVUOZB NFOJOHLBULBO UBIBOBOOZB
UFUBQTFLJUBSNN)HLBSFOBKBOUVOHNFNPNQBLFEBMBNBSUFSJ
EBONFOHFNCBMJLBOUFLBOBOWFOBNFOKBEJOPMMBHJ
TFUJBQLFMFCJIBOEBSBIZBOHCFSVTBIBNFOVNQVLEJUFNQBUJOJ
"LBOUFUBQJ QBEBTFPSBOHEFXBTBZBOHCFSEJSJEJBNTBNBTFLBMJ %J QJIBL MBJO WFOBWFOB EBMBN UFOHLPSBL CFSBEB EJ EBMBN
UFLBOBO EJ WFOB LBLJ TFLJUBS NN )H BLJCBU CFSBU HSBWJUBTJ SVBOHBO ZBOH UJEBL EBQBU LPMBQT SPOHHB UFOHLPSBL
TFIJOHHB
EBSBI EJ WFOB BOUBSB KBOUVOH EBO LBLJ 5FLBOBO WFOB QBEB WFOBWFOB UFSTFCVU UJEBL EBQ BU LPMBQT "LJCBUOZB UFLBOBO
LFUJOHHJBO UVCVI MBJOOZB TFDBSB QSPQPSTJPOBM CFTBSOZB BOUBSB OFHBUJG EBQBU UJNCVM EJ TJOVTTJOVT EVSBM LFQBMB QBEB QPTJTJ
EBONN)H CFSEJSJ UFLBOBO WFOB EJ TJOVT TBHJUBMJT ZBOH CFSBEB EJ QVODBL
LFQBMB CFTBSOZB TFLJUBS NN )H BLJCBU QFOHJTBQBO
%J WFOB MFOHBO UFLBOBO QBEB UJUJL TFUJOHHJ UVMBOH SVTVL IJESPTUBUJLBOUBSBQVODBLUFOHLPSBL
UFSBUBT CJBTBOZB TFLJUBS NN )H BLJCBU LPNQSFTJ WFOB
EBOEBTBSUFOHLPSBL0MFILBSFOBJUV CJMBTJOVTTBHJUBMJTEJ
TVCLMBWJB TFXBLUV NFMFXBUJ UVMBOH SVTVL UFSTFCVU 5FLBOBO
CVLB TFMBNB UJOEBLBO PQFSBTJ VEBSB EBQBU TFHFSB UFSJTBQ LF
HSBWJUBTJ EJ TFQBOKBOH MFOHBO LFNVEJBO EJUFOUVLBO PMFI
EBMBN TJTUFN WFOB VEBSB CBILBO EBQBU UFSVT CFSKBMBO LF
KBSBLOZBEBSJUVMBOHSVTVLJOJ+BEJ CJMBTFMJTJIHSBWJUBTJQBEB
CBXBI NFOJNCVMLBO FNCPMJ VEBSB EJ KBOUVOH EBO EBQBU
UJUJL BOUBSB UVMBOH SVTVL EBO UBOHBO BEBMBI NN )H
UFSKBEJLFNBUJBO
UFLBOBO HSBWJUBTJ JOJ EJUBNCBI EFOHBO NN )H ZBOH
EJTFCBCLBOPMFILPNQSFTJWFOBLFUJLBNFMFXBUJUVMBOHSVTVL
TFIJOHHB CFTBS UFLBOBO UPUBM EJ WFOB UBOHBO BEBMBI NN Pengaruh Faktor Gravitasi terhadap Tekanan Arteri dan
)H Tekanan Lainnya. 'BLUPS HSBWJUBTJ KVHB NFNFOHBSVIJ
7FOBWFOB MFIFS QBEB PSBOH ZBOH CFSEJSJ UFHBL IBNQJS UFLBOBO EJ BSUFSJ QFSJGFS EBO LBQJMFS TFMBJO QFOHBSVIOZB QBEB
TFQFOVIOZB LPMBQT TFQBOKBOH QFSKBMBOBOOZB LF UFOHLPSBL WFOB$POUPIOZB QBEBTFTFPSBOHZBOHCFSEJSJEBONFNQVOZBJ
BLJCBU UFLBOBO BUNPTGFS EJ MVBS MFIFS ,PMBQTOZB WFOB JOJ UFLBOBO BSUFSJ SBUBSBUB NN )H QBEB UJOHLBUBO TFUJOHHJ
NFOZFCBCLBOUFLBOBOEJWFOBWFOBUFSTFCVUUFUBQOPMEJTFQB KBOUVOHBLBONFNQVOZBJUFLBOBOBSUFSJEJLBLJTFLJUBSNN
)H0MFILBSFOBJUV CJMBTFTFPSBOHNFOZBUBLBOCBIXBUFLBOBO
BSUFSJOZBTFCFTBSNN)H IBMJOJVNVNOZBCFSBSUJCBIXB
UFLBOBO UFSTFCVU NFSVQBLBO UFLBOBO QBEB UJOHLBUBO HSBWJUBTJ
TFUJOHHJ KBOUVOH UFUBQJ UJEBL CFSMBLV QBEB QFNCVMVI BSUFSJ EJ
UFNQBUMBJO
Katup Vena dan "Pornpa Vena": Pengaruhnya

terhadap Tekanan Vena
+JLB UJEBL BEB LBUVQ EBMBN WFOB FGFL UFLBOBO HSBWJUBTJ BLBO
NFOZFCBCLBOUFLBOBOWFOBEJLBLJTFMBMVTFCFTBSLJSBLJSB
NN)HQBEBTFPSBOHEFXBTBZBOHCFSEJSJ"LBOUFUBQJ TFUJBQ
LBMJ TFTFPSBOH NFOHHFSBLLBO UVOHLBJ JT BLBO NFOFHBOHLBO
PUPUOZBEBONFOFLBOWFOBEFLBUPUPUUFSTFCVUBUBVEBFSBITF
LJUBSOZB EBOJOJBLBONFNFSBTEBSBILFMVBSEBSJWFOB/BNVO
LBUVQWFOB ZBOHUBNQBLQBEB(BNCBS UFSTVTVOTFEFNJ
LJBO SVQB TFIJOHHB BSBI BMJSBO EBSBI WFOB IBOZB UFSUVKV LF
KBOUVOH "LJCBUOZB TFUJBQ LBMJ TFTFPSBOH NFOHHFSBLLBO UVOH
LBJBUBVCBILBONFOFHBOHLBOPUPU TFKVNMBIEBSBIWFOBEJEP
SPOH LF BSBI KBOUVOH 4JTUFN QFNPNQBBO JOJ EJLFOBM TFCBHBJ
QPNQBWFOBBUBVQPNQBPUPU EBOQPNQBJOJDVLVQFGJTJFO
TFIJOHHBEBMBNLFBEBBOZBOHCJBTB UFLBOBOWFOBEJLBLJTFP
SBOH EFXBTB ZBOH TFEBOH CFSKBMBO UFUBQ LVSBOH EBSJ NN
)H
#JMBNBOVTJBCFSEJSJEJBNTFNQVSOB QPNQBWFOBUJEBLBLBO
CFLFSKB EBO UFLBOBO WFOB EJ CBHJBO CBXBI UVOHLBJ BLBO
NFOJOHLBUTBNQBJOJMBJHSBWJUBTJQFOVINN)HEBMBNXBL
UVLJSBLJSBEFUJL5FLBOBOEJEBMBNLBQJMFSKVHBTBOHBUNF
OJOHLBU NFOZFCBCLBOCPDPSOZBDBJSBOEBSJTJTUFNTJSLVMBTJLF
EBMBN SVBOH KBSJOHBO "LJCBUOZB UVOHLBJ NFNCFOHLBL EBO
WPMVNF EBSBI CFSLVSBOH 4FTVOHHVIOZB TBNQBJ QFSTFO
WPMVNFEBSBIEBQBUIJMBOHEBSJTJTUFNTJSLVMBTJEBMBNXBLUV
173
Unit IV Sirkulasi
LBOBO NFOJOHLBU TFCBOZBL NN )H WFOB MFIFS EJ CBHJBO

CBXBINVMBJNFOPOKPMEBOQBEBUFLBOBOBUSJVNNN)H
TFNVBWFOBEJMFIFSSOFOHBMBNJEJTUFOTJ
Pengukuran Langsung Tekanan Vena dan Tekanan Atrium Kanan
5FLBOBO WFOB EBQBU KVHB EJVLVS TFDBSB NVEBI EFOHBO
NFNBTVLLBO TFCVBI KBSVN TFDBSB MBOHTVOH LF EBMBN WFOB EBO
NFOHIVCVOHLBOOZB EFOHBO TVBUV BMBU QFOHVLVSUFLBOBO4BUV
TBUVOZB DBSB VOUVL NFOHVLVS UFLBOBOBUSJVNLBOBO TFDBSB BLVSBU
BEBMBI EFOHBO NFNBTVLLBOLBUFUFSNFMBMVJ WFOB QFSJGFS LF EBMBN
BUSJVN LBOBO 5FLBOBO ZBOH EJVLVS NFMBMVJ LBUFUFS WFOB TFOUSBM
TFQFSUJ JOJ IBNQJS TFMBMV EJLFSKBLBO TFDBSB SVUJO QBEB CFCFSBQB
UJQF QBTJFO TBLJU KBOUVOH ZBOH EJSBXBU VOUVL NFOEBQBULBO
QFOJMBJBO LPOTUBO NFOHFOBJ LFNBNQVBO QFNPNQBBO KBOUVOH
Tingkat Patokan Tekanan untuk Pengukuran Tekanan Vena dan
Tekanan Sirkulasi Lainnya
4BNQBJ EJ TJOJ LJUB TFSJOH LBMJ NFOZBUBLBO CBIXB UFLBOBO
BUSJVN LBOBO BEBMBI NN )H EBO UFLBOBO BSUFSJ BEBMBI
NN )H UFUBQJ LJUB CFMVN NFOFUBQLBO UJOHLBUBO HSBWJUBTJ EJ
TJTUFNTJSLVMBTJEFOHBOUFLBOBOJOJTFCBHBJQBUPLBO5FSEBQBU
TBUV UJUJL EJ TJTUFN TJSLVMBTJ UFNQBU GBLUPS UFLBOBO HSBWJUBTJ
ZBOH EJTFCBCLBO PMFI QFSVCBIBO QPTJTJ UVCVI TFTFPSBOH ZBOH
TBNQBJ NFOJU TFKBL CFSEJSJ EJBN TFNQVSOB TFQFSUJ ZBOH TFIBU CJBTBOZB UJEBL BLBO NFNFOHBSVIJ QFOHVLVSBO UFLBOBO
TFSJOH UFSKBEJ CJMB TFPSBOH QSBKVSJU CFSEJSJ EFOHBO QPTJTJ ZBOH MFCJI EBSJ TBNQBJ NN )H 5JUJL JOJ CFSBEB TFUJOHHJ BUBV
LBLV EFLBU EFOHBO LBUVQ USJLVTQJE TFQFSUJ EJQFSMJIBULBO PMFI
QFSQPUPOHBOHBSJTTVNCVQBEB(BNCBS0MFILBSFOBJUV
Kegagalan Katup Vena yang Menyebabkan "Varises". TFNVB QFOHVLVSBO UFLBOBO TJSLVMBTJ ZBOH UFMBI EJCJDBSBLBO
,BUVQLBUVQ QBEB TJTUFN WFOB TFSJOH LBMJ NFOKBEJ UJEBL EBMBN UFLT JOJ NFSVKVL LF UJOHLBUBO UFSTFCVU ZBOH EJTFCVU
NBNQV CFSGVOHTJ BUBV LBEBOHLBEBOH NBMBI SVTBL )BM JOJ UJOHLBUQBUPLBOVOUVLQFOHVLVSBOUFLBOBO
UFSVUBNB UFSKBEJ CJMB WFOB UFSFHBOH CFSMFCJIBO BLJCBU UFLBOBO
WFOB UJOHHJ TFMBNB CFSNJOHHVNJOHHV BUBV CFSCVMBOCVMBO ,VSBOHOZB QFOHBSVI HSBWJUBTJ EJ LBUVQ USJLVTQJE
TFQFSUJZBOHUFSKBEJQBEBLFIBNJMBOBUBVCJMBTFTFPSBOHCFSEJSJ EJLBSFOBLBO KBOUVOH TFDBSB PUPNBUJT NFODFHBI QFSVIBIBO
UFSMBMV MBNB 1FSFHBOHBO WFOB BLBO NFOJOHLBULBO MVBT HSBWJUBTJ ZBOH CFSNBLOB QBEB UFLBOBO EJ UFNQBU JOJ EFOHBO
QFOBNQBOH UFUBQJ UJEBL NFOJOHLBULBO VLVSBO EBVO LBUVQ DBSBTFCBHBJCFSJLVU
0MFILBSFOBJUV EBVOLBUVQUJEBLEBQBUMBHJNFOVUVQSBQBU#JMB +JLB UFLBOBO EJ LBUVQ USJLVTQJE TFEJLJU NFOJOHLBU EJ BUBT
IBMJOJUFSKBEJ UFLBOBOEJWFOBUVOHLBJBLBONFOJOHLBUUBKBN OPSNBM WFOUSJLFM LBOBO NFOHJTJ EBSBI MFCJI CBOZBL EBSJ
BLJCBU LFHBHBMBO QPNQB WFOB IBM JOJ TFMBOKVUZB BLBO CJBTBOZB TFIJOHHB KBOUVOH NFNPNQB EBSBI MFCJI DFQBU EBO
NFOJOHLBULBO VLVSBO WFOB EBO BLIJSOZB NFSVTBL TFMVSVI
LBSFOB JUV BLBO NFOVSVOLBO UFLBOBO EJ LBUVQ USJLVTQJE
GVOHTJ LBUVQ +BEJ PSBOH UFSTFCVU BLBO NFOHBMBNJ WBSJTFT
LFNCBMJ LF LJTBSBO OJMBJ OPSNBM 4FCBMJLOZB KJLB UFLBOBO
ZBOHEJUBOEBJEFOHBOQFOPOKPMBOCFTBSEBSJWFOBEJCBXBILVMJU
NFOVSVO WFOUSJLFM LBOBO HBHBM UFSJTJ TFDBSB BEFLVBU EBZB
TFMVSVIUVOHLBJ UFSVUBNBUVOHLBJCBXBI
QPNQBOZB NFOVSVO EBO EBSBI UFSCFOEVOH EJ TJTUFN WFOB
,BQBOQVOPSBOHEFOHBOWBSJTFTCFSEJSJMFCJIEBSJCFCFSBQB TBNQBJUFLBOBOEJUJOHLBUBOLBUVQUSJLVTQJENFOJOHLBUMBHJ
NFOJU UFLBOBO WFOB EBO LBQJMFS BLBO NFOKBEJ TBOHBU UJOHHJ
EBO LFCPDPSBO DBJSBO EBSJ LBQJMFS NFOZFCBCLBO FEFNB ZBOH
UFSVTNFOFSVTEJUVOHLBJ4FMBOKVUOZB FEFNBNFODFHBIEJGVTJ
[BU OVUSJTJ ZBOH BEFLVBU EBSJ LBQJMFS LF PUPU EBO TFMTFM LVMJU
TFIJOHHBPUPUNFOKBEJUFSBTBOZFSJEBOMFNBITFSUBLVMJUTFSJOH
LBMJNFOHBMBNJHBOHSFOEBOVMLVT1FOHPCBUBOUFSCBJLVOUVL
LFBEBBO TFQFSUJ JOJ BEBMBI NFOBJLLBO UVOHLBJ TBNQBJ
TFEJLJUOZBTFUJOHHJKBOUVOHTFDBSBCFSVMBOHVMBOH#FCBUZBOH
LFUBU QBEB UVOHLBJ KVHB EBQBU NFNCBOUV EBMBN NFODFHBI
FEFNBEBOHFKBMBTJTBOZB
Perkiraan Tekanan Vena secara Klinis 5FLBOBO WFOB TFSJOH LBMJ
EBQBUEJQFSLJSBLBOTFDBSBNVEBIEFOHBONFMJIBUEFSBKBUEJTUFOTJ
EBSJ WFOBWFOB QFSJGFS UFSVUBNB WFOBWFOB MFIFS $POUPIOZB
QBEB QPTJTJ EVEVL WFOBWFOB MFIFS UJEBL QFSOBI NFOHBMBNJ
EJTUFOTJ QBEB PSBOH OPSNBM ZBOH TFEBOH JTUJSBIBU "LBO UFUBQJ
CJMBUFLBOBOBUSJVN
174
LFOJMBJOPSNBM%FOHBOLBUBMBJO KBOUVOHCFSUJOEBL
TFCBHBJQFOHBUVSUFLBOBOTFDBSBVNQBOCBMJLEJLBUVQ
USJLVTQJE
#JMB TFTFPSBOH EBMBN QPTJTJ CFSCBSJOH MFUBL LBUVQ
UNIT IV
USJLVTQJEIBNQJSQFSTJTQFSTFOEBSJLFUFCBMBOEBEBEJ
CBHJBO EFQBO QVOHHVOH 5FNQBU JOJ BEBMBI UJOHLBU
QBUPLBO UFLBOBO OPM VOUVL TFTFPSBOH ZBOH CFSCBSJOH
UFSMFOUBOH
Fungsi Penampungan Darah dari Vena

4FQFSUJ ZBOH UFMBI EJUFLBOLBO EJ #BC MFCJI EBSJ QFSTFO
TFMVSVI EBSBI EJ TJTUFN TJSLVMBTJ CJBTBOZB CFSBEB EBMBN WFOB
0MFI LBSFOB BMBTBO UFSTFCVU EBO LBSFOB WFOB CFHJUV MFOUVS
TJTUFN WFOB EJLBUBLBO CFSGVOHTJ TFCBHBJ UFNQBU QFOBNQVOHBO
EBSBICBHJTJSLVMBTJ
,FUJLB UVCVI LFIJMBOHBO EBSBI EBO UFLBOBO BSUFSJ NVMBJ
NFOVSVO TJOZBM TBSBG EJMFQBTLBO EBSJ TJOVT LBSPUJLVT EBO BSFB
QFLBUFLBOBOMBJOOZBEBMBNTJSLVMBTJ TFQFSUJZBOHEJCBIBTEJ#BC
)BM JOJ TFMBOKVUOZB NFOZFCBCLBO QFMFQBTBO TJOZBM TBSBG EBSJ UFNJL "LJCBUOZB QVMQB NFSBI EBSJ MJNQB NFOKBEJ QFOBN
PUBLEBONFEVMBTQJOBMJTUFSVUBNBNFMBMVJTBSBGTJNQBUJTNFOVKV QVOHLIVTVTZBOHNFOHBOEVOHTFKVNMBICFTBSTFMEBSBINFSBI
LF WFOB TFIJOHHB WFOB NFOHBMBNJ LPOTUSJLTJ ,FBEBBO UFSTFCVU UFSLPOTFOUSBTJ4FMEBSBINFSBIUFSTFCVUEBQBUEJEFTBLLFMVBS
BLBO NFOHJNCBOHJ LVSBOHOZB EBSBI EBMBN TJTUFN TJSLVMBTJ LF EBMBN TJSLVMBTJ TJTUFNJL CJMB TJTUFN TBSBG TJNQBUJT UFS
#BILBOTFUFMBIUFSKBEJLFIJMBOHBOEBSBITFCBOZBLQFSTFOEBSJ BOHTBOH EBO NFOZFCBCLBO MJNQB CFTFSUB QFNCVMVIOZB CFS
WPMVNF UPUBM TFLBMJQVO TJTUFN TJSLVMBTJ TFSJOH LBMJ EBQBU LPOUSBLTJ4FCBOZBLNMEBSJTFMEBSBINFSBIUFSLPOTFOUSBTJ
CFSGVOHTJ NFOEFLBUJ OPSNBM LBSFOB GVOHTJ QFOBNQVOHBO WFOB EBQBU EJMFQBTLBO LF EBMBN TJSLVMBTJ ZBOH BLBO NFOJOHLBULBO
ZBOHEBQBUCFSVCBIVCBI OJMBJIFNBUPLSJUTFCFTBSTBNQBJQFSTFO
%J BSFB MBJO QVMQB MJNQB BEBMBI QVMBVQVMBV TFMTFM EBSBI
Penampung Darah yang Spesifik. #FCFSBQB CBHJBO EBSJ QVUJI ZBOHTFDBSBLFTFMVSVIBOEJTFCVUQVMQBQVUJI%JTJOJTFM
TJTUFNTJSLVMBTJCFHJUVFLTUFOTJGEBOBUBVCFHJUVMFOUVSTFIJOHHB TFM MJNGPJE EJCFOUVL TFSVQB EFOHBO ZBOH EJCFOUVL EJ LFMFOKBS
CBHJBOCBHJBO JOJ EJTFCVU QFOBNQVOH EBSBI ZBOH TQFTJGJLh MJNGF 4FMTFM UFSTFCVU BEBMBI CBHJBO EBSJ TJTUFN JNVO UVCVI
0SHBOPSHBO JOJ NFMJQVUJ
MJNQB ZBOH LBEBOHLBEBOH EBQBU
ZBOHBLBOEJKFMBTLBOEJ#BC
NFOHVSBOHJ VLVSBOOZB VOUVL NFMFQBTLBO TFCBOZBL NM
EBSBI LF EBFSBI MBJO EBSJ TJSLVMBTJ
IBUJ TJOVT IBUJ EBQBU
NFNCFCBTLBOCFCFSBQBSBUVTNJMJMJUFSEBSBILFCBHJBOMBJOEBSJ Fungsi Limpa sebagai Pembersih Darah—
TJSLVMBTJ
WFOBWFOB CFTBS EJ BCEPNFO EBQBU NFMFQBTLBO Penghancuran Sel-Sel yang Tua
EBSBI TFCBOZBL NM EBO
QMFLTVT WFOPTVT EJ CBXBI LVMJU 4FCFMVN NBTVL LF EBMBN TJOVT TFM EBSBI ZBOH NFMFXBUJ
ZBOH EBQBU KVHB NFOHFMVBSLBO CFCFSBQB SBUVT NJMJMJUFS +BOUVOH QVMQB MJNQB BLBO EJQFSBT TFMVSVIOZB 0MFI LBSFOB JUV TFMTFM
EBOQBSV NFTLJQVOCVLBOCBHJBOEBSJTJTUFNQFOBNQVOHWFOB EBSBI NFSBI ZBOH SBQVI EJQFSLJSBLBO UJEBL BLBO UBIBO
TJTUFNJL IBSVT KVHB EJBOHHBQ TFCBHBJ QFOBNQVOH EBSBI UFSIBEBQ USBVNB UFSTFCVU 0MFI LBSFOB BMBTBO JOJMBI CBOZBL
+BOUVOH DPOUPIOZB BLBO NFOHFDJM TFMBNB SBOHTBOHBO TJNQBUJT TFM EBSBI NFSBI ZBOH SVTBL EJ EBMBN UVCVI BLBOEJBLIJSJ
IJEVQOZB EJ EBMBN MJNQB 4FUFMBI TFM UFSTFCVU QFDBI
EBOEFOHBODBSBJOJEBQBUNFOBNCBILJSBLJSBTBNQBJNM
IFNPHMPCJO EBO TUSPNB TFM ZBOH UFSMFQBT BLBO EJDFSOBPMFI
EBSBI EBO QBSV EBQBU NFOZVNCBOH TBNQBJ NM EBSBI
TFMTFM SFUJLVMPFOEPUFMJBM MJNQB EBO IBTJM QSPTFT QFODFSOBBO
UBNCBIBO CJMB UFLBOBO QVMNPOBM UVSVO TBNQBJ LF OJMBJ ZBOH UFSTFCVU UFSVUBNB BLBO EJHVOBLBO LFNCBMJ PMFI UVCVI
SFOEBI TFCBHBJ [BU OVUSJTJ ZBOH TFSJOH LBMJ EJUVKVLBOVOUVLNFNCVBU
TFMEBSBIZBOHCBSV
Limpa sebagai Penampung untuk Menyimpan Sel Darah
Sel-Set Retikutoendotelial Limpa
Merah. (BNCBS NFNQFSMJIBULBO CBIXB MJNQB NFNJMJLJ
1VMQB MJNQB NFOHBOEVOH CBOZBL TFM SFUJLVMPFOEPUFMJBM GBHPTJUJL
EVBEBFSBIUFSQJTBIVOUVLNFOZJNQBOEBSBITJOVTWFOPTVTEBO
ZBOHCFTBS EBOTJOVTWFOPTVTOZBEJMBQJTJPMFITFMTFMTFSVQB4FM
QVMQB 4JOVT EBQBU NFNCFOHLBL TBNB IBMOZB EFOHBO TFNVB TFM JOJ CFSGVOHTJ TFCBHBJ CBHJBO EBSJ TJTUFN QFNCFSTJI VOUVL
CBHJBO MBJO EBSJ TJTUFN WFOB EBO EBQBU NFOZJNQBO EBSBI EBSBI CFLFSKBTBNBEFOHBOTJTUFNTFSVQBTFMTFMSFUJLVMPFOEPUFMJBM
MFOHLBQ EJ EBMBN TJOVT WFOPTVT IBUJ #JMB EBSBI EJTFSBOH PMFI CBIBO
JOGFLTJVT TFMTFM SFUJLVMPFOEPUFMJBM MJNQB EFOHBO DFQBU BLBO
1BEB QVMQB MJNQB LBQJMFS CFHJUV QFSNFBCFM TFIJOHHB EBSBI
NFOHIBODVSLBO EFCSJT CBLUFSJ QBSBTJU EBO MBJOMBJO +VHB QBEB
MFOHLBQ ZBOHNFMJQVUJTFMEBSBINFSBI QFSMBIBOMBIBONFOHBMJS CBOZBL QSPTFT JOGFLTJ LSPOJT MJNQB NFNCFTBS EFOHBO DBSB TBNB
LFMVBS NFMBMVJ EJOEJOH LBQJMFS NBTVL LF EBMBN KBSJOHBO TFQFSUJ QBEB LFMFOKBS MJNGF ZBOH NFNCFTBS EBO LFNVEJBO
USBCFLVMB ZBOH NFNCFOUVL QVMQB NFSBI 4FM EBSBI NFSBI NFMBLVLBOGVOHTJQFNCFSTJIBOOZBCBILBOMFCJIHJBUMBHJ
UFSQFSBOHLBQ EJ USBCFLVMB TFEBOHLBO QMBTNB UFUBQ NFOHBMJS LF
EBMBNTJOVTWFOPTVTEBOLFNVEJBONBTVLLFEBMBNTJSLVMBTJTJT
175
Unit IV Sirkulasi
Daftar Pustaka pressure measurement in experimental animals: a statement for pro-fessionals

from the Subcommittee of Professional and Public Education of the American
Badeer HS: Hemodynamics for medical students, AmJ Physiol (Adv Heart Association Council on High Blood Pressure Research, Hypertension
Physiol Educ) 25:44, 2001. 45:299, 2005.
Guyton AC: Arterial pressure and hypertension, Philadelphia, 1980, WB O'Rourke MF, Nichols WW:Aortic diameter, aortic stiffness, and wave
Saunders. reflection increase with age and isolated systolic hypertension,
Guyton AC, Jones CE: Central venous pressure: physiological significance Hypertension 45:652, 2005.
and clinical implications, Am HeartJ 86:431, 1973. Laurent S, Boutouyrie P, Lacolley P: Structural and genetic bases of arteria
Guyton AC, Jones CE, Coleman TG: Circulatory physiology: cardiac stiffness, Hypertension 45:1050, 2005.
output and its regulation, Philadelphia, 1973, WB Saunders. Pickering TG, Hall JE, Appel LJ, et al: Recommendations for blood pressure
Hall JE: Integration and regulation of cardiovascular function, AmJ Physiol measurement in humans and experimental animals: Part 1: blood pressure
(Adv Physiol Educ) 22:5174, 1999. measurement in humans: a statement for professionals from the Subcommittee
Hicks JW, Badeer HS: Gravity and the circulation: "open" vs. "closed" system of Professional and Public Education of the American Heart Association
AmJ Physiol 262:R725—R732, 1992. Council on High Blood Pressure Research, Hypertension 45:142, 2005.
Jones DW, Appel LJ, Sheps SG, et al: Measuring blood pressure accurately: Wilkinson IB, Franklin SS, Cockcroft JR: Nitric oxide and the regulation
New and persistent challenges, JAMA 289:1027, 2003. large artery stiffness: from physiology to pharmacology, Hypertension 44:112,
Kass DA: Ventricular arterial stiffening: integrating the pathophysiology, 2004.
Kurtz 1W, Griffin KA, Bidani AK, et al: Recommendations for blood pressure
measurement in humans and experimental animals. Part 2: Blood
176
BAB 16
.JLSPTJSLVMBTJEBO4JTUFN-JNGBUJL
UNIT IV
1FSUVLBSBO$BJSBO,BQJMFS $BJSBO
*OUFSTUJTJBM EBO"MJSBO-JNGF
'VOHTJ UFSQFOUJOH TJSLVMBTJ UFSKBEJ CVLBEBONFOVUVQKBMBONBTVLLFLBQJMFS

EJ EBMBN NJLSPTJSLVMBTJ #FSVQB 7FOVMBMFCJICFTBSEBSJQBEBBSUFSJPMEBONFNQVOZBJMBQJTBO
USBOTQPS[BUOVUSJTJLFKBSJOHBOEBO PUPU MFCJI MFNBI /BNVO UFLBOBO EJ EBMBN WFOVMB KBVI MFCJI
QFNCVBOHBO FLTLSFUB TFM "SUFSJPM LFDJM EJCBOEJOHLBO UFLBOBO EJ EBMBN BSUFSJPM TFIJOHHB WFOVMB
LFDJM NFOHFOEBMJLBO BMJSBO EBSBI UFUBQNBTJIEBQBUCFSLPOUSBLTJNFTLJQVOPUPUOZBMFNBI
LF TFUJBQ KBSJOHBO EBO LPOEJTJ
TFUFNQBUEJKBSJOHBOUFSTFCVUTFMBO 4VTVOBOLIVTVTKBMJOBOLBQJMFSJOJUJEBLEJKVNQBJEJTFNVB
CBHJBO UVCVI NFTLJQVO CFHJUV BEB CFCFSBQB TVTVOBO TFSVQB
KVUOZB NFOHFOEBMJLBO EJBNFUFS BSUFSJPM +BEJ TFUJBQ KBSJOHBO
ZBOH CFLFSKB EFOHBO UVKVBO TBNB :BOH QBMJOH QFOUJOH
QBEB TFCBHJBO CFTBS LFBEBBO BLBO NFOHFOEBMJLBO BMJSBO
NFUBSUFSJPMEBOTGJOHUFSQSFLBQJMFSCFSIVCVOHBOEFLBUEFOHBO
EBSBIOZB TFOEJSJ TFTVBJ EFOHBO LFCVUVIBOOZB NBTJOHNBTJOH
KBSJOHBO ZBOH EJMBZBOJOZB 0MFI LBSFOB JUV LPOEJTJ KBSJOHBO
)BMUFSTFCVUBLBOEJCBIBTEJ#BC
TFUFNQBU ZBJUV LPOTFOUSBTJ [BU OVUSJTJ QSPEVL BLIJS
%JOEJOH LBQJMFS TBOHBUMBI UJQJT UFSTVTVO EBSJ TBUV MBQJT TFM NFUBCPMJTNF JPOJPO IJESPHFO EBO TFCBHBJOZB EBQBU CFS
FOEPUFM ZBOH TBOHBU QFSNFBCFM 0MFI LBSFOB JUV BJS [BU OVUSJTJ QFOHBSVI MBOHTVOH UFSIBEBQ QFNCVMVI UFSTFCVU EBMBN IBM
EBOFLTLSFUBTFMTFNVBOZBEBQBUCFSUVLBSUFNQBUEFOHBONVEBI QFOHFOEBMJBOBMJSBOEBSBITFUFNQBUEJTFUJBQBSFBKBSJOHBOZBOH
EBODFQBUBOUBSBKBSJOHBOEBOEBSBIZBOHCFSTJSLVMBTJ LFDJM
4JSLVMBTJ QFSJGFS EJ TFMVSVI UVCVI NFNJMJLJ LBQJMFS TFCBOZBL
LJSBLJSB NJMJBS EFOHBO UPUBM MVBT QFSNVLBBO LJSBLJSB Struktur Dinding Kapiler (BNCBS NFMVLJTLBO
TBNQBJ N LVSBOH MFCJI TFQFSEFMBQBO MVBT MBQBOHBO TFQBL TUSVLUVS VMUSBNJLSPTLPQJL TFM FOEPUFM LIBT EJ EJOEJOH LBQJMFS
CPMB
#BILBO KBSBOHEJKVNQBJTFCVBITFMGVOHTJPOBMUVCVIZBOH TFQFSUJ EJKVNQBJ EJ TFCBHJBO CFTBS PSHBO UVCVI LIVTVTOZB EJ
MFUBLOZBMFCJIEBSJTBNQBJNJLSPNFUFS EBSJTFCVBILBQJMFS PUPU EBO KBSJOHBO JLBU 1FSIBUJLBO CBIXB EJOEJOH UFSTFCVU
UFSTVTVO EBSJ TBUV MBQJTBO VOJTFMVMBS TFMTFM FOEPUFM EBO
EJLFMJMJOHJ PMFI TVBUV NFNCSBO CBTBM ZBOH UJQJT EJ TJTJ MVBS
Struktur Mikrosirkulasi dan Sistem Kapiler LBQJMFS 5PUBM LFUFCBMBO EJOEJOH LBQJMFS IBOZB TFLJUBS
NJLSPNFUFS %JBNFUFS JOUFSOB LBQJMFS CFTBSOZB TBNQBJ
NJLSPNFUFS VLVSBOOZBSJTDVLVQCFTBSVOUVLNFMFXBULBOTFM
.JLSPTJSLVMBTJ TFUJBQ PSHBO EJTVTVO TFDBSB LIVTVT VOUVL
EBSBINFSBIEBOTFMEBSBIMBJOOZB
NFNFOVIJ LFCVUVIBO PSHBO UFSTFCVU 1BEB VNVNOZB TFUJBQ
BSUFSJ QFNCFSJ NBLBOBO ZBOH NFNBTVLJ PSHBO BLBO CFSDBCBOH "Pori-Pori" pada Membran Kapiler. (BNCBS
TFCBOZBL FOBN TBNQBJ EFMBQBO LBMJ TFCFMVN BSUFSJ UFSTFCVU NFNQFSMJIBULBO EVB KBMVS LFDJM ZBOH NFOHIVCVOHLBO CBHJBO
NFOKBEJ DVLVQ LFDJM VOUVL EJTFCVU BSUFSJPM VNVNOZB CFSEJB EBMBN LBQJMFS EFOHBO CBHJBO MVBS 4BMBI TBUV EBSJ KBMVS JOJ
NFUFS JOUFSOB IBOZB TBNQBJ NJLSPNFUFS 4FMBOKVUOZB BEBMBIDFMBIBOUBSTFM ZBOHNFSVQBLBODFMBIUJQJTEBOCFSCFMPL
BSUFSJPM JUV TFOEJSJ BLBO CFSDBCBOH EVB TBNQBJ MJNB LBMJ UFSMFUBL EJ BOUBSB TFMTFM FOEPUFM ZBOH TBMJOH CFSTFCFMBIBO
NFODBQBJ EJBNFUFS LJSBLJSB TBNQBJ NJLSPNFUFS QBEB 4FUJBQDFMBIJOJEJTFMBOHJTFDBSBQFSJPEJLPMFICVCVOHBO SJEHF

VKVOHOZBUFNQBUBSUFSJPMUFSTFCVUNFNBTPLEBSBILFLBQJMFS QFSMFLBUBO QSPUFJO ZBOH QFOEFL ZBOH NFOZBOHHB TFMTFM
"SUFSJPM TBOHBU CFSPUPU EBO EJBNFUFSOZB EBQBU CFSVCBI FOEPUFMCFSTBNBBO UFUBQJEJBOUBSBCVCVOHBOJOJ DBJSBOEBQBU
CFCFSBQB LBMJ MJQBU .FUBSUFSJPM BSUFSJPM UFSNJOBM
UJEBL NFN MFXBU EFOHBO CFCBT NFMBMVJ DFMBI /PSNBMOZB DFMBI NFNJMJLJ
QVOZBJ MBQJTBO PUPU LPOUJOV OBNVO NFNQVOZBJ TFSBCVU PUPU KBSBL ZBOH TFSBHBN EFOHBO MFCBS LJSBLJSB TBNQBJ OBOP
QPMPT ZBOH NFOHFMJMJOHJ QFNCVMVI QBEB UJUJLUJUJL JOUFSNJUFO NFUFS TBNQBJ BOHTUSPN
TFEJLJU MFCJI LFDJM EBSJQBEB
TFQFSUJ EJMVLJTLBO QBEB (BNCBS PMFI UJUJLUJUJL IJUBN QBEB EJBNFUFSTFCVBINPMFLVMQSPUFJOBMCVNJO
TJTJNFUBSUFSJPM 0MFILBSFOBDFMBIDFMBIBOUBSTFMJOJIBOZBUFSMFUBLQBEBUFQJ
%J UJUJL UFNQBU BTBM UJBQ LBQJMFS TFKBUJ QBEB TFCVBI NFUBSUFSJPM TFMFOEPUFM NBLBMVBTQFSNVLBBOOZBCJBTBOZBUJEBLMFCJIEBSJ
UFSEBQBU TFSBU PUPU QPMPT ZBOH CJBTBOZB NFOHFMJMJOHJ LBQJMFS UPUBMMVBTQFSNVLBBOUPUBMEJOEJOHLBQJMFS.FTLJQVO
4FSBCVUJOJEJTFCVUTGJOHUFSQSFLBQEFS4GJOHUFSJOJEBQBUNFN EFNJLJBO LFDFQBUBOQFSHFSBLBOUFSNBMNPMFLVMTFMVSVIOZBCFS
177
Unit IV Sirkulasi
7FTJLFM UFSTFCVU EBQBU CFSHFSBL TFDBSB MBNCBU NFMBMVJ TFM

FOEPUFM #FCFSBQB WFTJLFM JOJ EBQBU CFSHBCVOH NFNCFOUVL
LBOBM WFTJLFM ZBOH NFOFNCVT TFM FOEPUFM EJQFSMJIBULBO QBEB
(BNCBS
Tipe Khusus "Pori-Pori" yang Terdapat di Kapiler Organ

Tertentu. 1PSJQPSJ LBQJMFS EJ CFCFSBQB PSHBO NFNQVOZBJ
LBSBLUFSJTUJLUFSUFOUVTFTVBJEFOHBOLFCVUVIBOPSHBOUFSTFCVU
#FCFSBQBLBSBLUFSJTUJLJOJBEBMBI
1. %J EBMBN PUBL QFSUBVUBO BOUBSB TFMTFM FOEPUFM LBQJMFS

UFSVUBNB NFSVQBLBO QFSUBVUBO ZBOH SBQBU TFIJOHHB IBOZB
NPMFLVM ZBOH TBOHBU LFDJM TFQFSUJ BJS PLTJHFO EBO LBSCPO
EJGVTJ EFOHBO NVEBI BOUBSB CBHJBO EBMBN EBO CBHJBO MVBS EJPLTJEB ZBOH EBQBU MFXBU NBTVL BUBV LFMVBS EBSJ KBSJOHBO
LBQJMFSNFMBMVJDFMBIQPSJJOJ DFMBIBOUBSTFM PUBL
%J TFM FOEPUFM KVHB UFSEBQBU CBOZBL WFTJLFM QMBTNB MFNBM 2. %J EBMBN IBUJ UFSKBEJ LFCBMJLBOOZB $FMBI BOUBS TFMTFM
LFDJM EJTFCVU KVHB LBWFPMB DBWFPMBFHPB LFDJM
7FTJLFM JOJ FOEPUFMLBQJMFSCFHJUVMFCBSUFSCVLB TFIJOHHBIBNQJSTFNVB
EJCFOUVL EBSJ PMJHPNFS QSPUFJO CFSOBNB LBWFPMJO ZBOH [BU UFSMBSVU EBMBN QMBTNB UFSNBTVL QSPUFJO QMBTNB EBQBU
EJLBJULBO EFOHBO NPMFLVM LPMFTUFSPM EBO TGJOHPMJQJE .FTLJQVO MFXBUEBSJEBSBINBTVLLFEBMBNKBSJOHBOIBUJ
GVOHTJ UFQBUOZB CFMVN KFMBT EJEVHB LBWFPMB CFSQFSBO QBEB 3. ,BSBLUFSJTUJLQPSJQPSJNFNCSBOLBQJMFSHBTUSPJOUFTUJOBMBEB
FOEPTJUPTJT QSPTFTEJNBOBTFMNFOFMBONBUFSJEBSJMVBSTFM
EBO
EJ QFSUFOHBIBO BOUBSB LBSBLUFSJTUJL QPSJQPSJ PUPU EBO QPSJ
USBOTJUPTJTNBLSPNPMFLVMNFOFNCVTTFMFOEPUFM,BWFPMBQBEB
QPSJIBUJ
QFSNVLBBO TFM OBNQBLOZB NFOZFSBQ TFKVNMBI LFDJM QBLFU
QMBTNBBUBVDBJSBOFLTUSBTFMZBOHNFOHBOEVOHQSPUFJOQMBTNB 4. %JEBMBNLBQJMFSHMPNFSVMVTHJOKBM BEBCFCFSBQBKFOEFMBLFDJM
CFSCFOUVL PWBM ZBOH EJTFCVU GFOFTUSBF ZBOH MBOHTVOH
NFOFNCVT NFMBMVJ CBHJBO UFOHBI TFM FOEPUFM TFIJOHHB
TFKVNMBICFTBS[BUNPMFLVMEBOJPOZBOHTBOHBULFDJM OBNVO
CVLBO NPMFLVM QSPUFJO QMBTNB CFSVLVSBO CFTBS
EBQBU
NFMFXBUJ HMPNFSVMVT UBOQB IBSVT NFMFXBUJ DFMBI BOUBSTFM
FOEPUFM
Aliran Darah dalam Kapiler—Vasomotion
%BSBI VNVNOZB UJEBL NFOHBMJS TFDBSB UFSVTNFOFSVT NFMBMVJ

LBQJMFS .BMBIBO QFOHBMJSBOOZB TFDBSB JOUFSNJUFO ZBJUV
NFOHBMJS EBO CFSIFOUJ TFUJBQ CFCFSBQB EFUJL BUBV CFCFSBQB
NFOJU 1FOZFCBC UJNCVMOZB BMJSBO JOUFSNJUFO JOJ BEBMBI TVBUV
GFOPNFOB ZBOH EJTFCVU WBTPNPUJPO ZBOH CFSBSUJ LPOUSBLTJ
JOUFSNJUFO NFUBSUFSJPM EBO TGJOHUFS QSBLBQJMFS EBO CBILBO
LBEBOHLBEBOHQBEBBSUFSJPMCFSVLVSBOTBOHBULFDJM

Pengaturan Vasomotion. 'BLUPS UFSQFOUJOH ZBOH EJUFNV
LBO EBQBU NFNFOHBSVIJ EFSBKBU QFNCVLBBO EBO QFOVUVQBO
NFUBSUFSJPM EBO GJTOHUFS QSBLBQJMFS BEBMBI LPOTFOUSBTJ PLTJHFO
EBMBNKBSJOHBO#JMBLFDFQBUBOQFNBLBJBOPLTJHFOPMFIKBSJOHBO
DVLVQ CFTBS TFIJOHHB LPOTFOUSBTJ PLTJHFO KBSJOHBO UVSVO EJ
CBXBIOPSNBM BMJSBOEBSBILBQJMFSJOUFSNJUFOBLBOMFCJITFSJOH
UFSKBEJ EBO QFSJPEF TFUJBQ BMJSBO NFOKBEJ MFCJI MBNB EFOHBO
EFNJLJBO NFNVOHLJOLBO EBSBI LBQJMFS VOUVL NFNCBXB MFCJI
IBOZBL MBHJ PLTJHFO EBO [BU NBLBOBO MBJOOZB
LF KBSJOHBO
1FOHBSVIPLTJHFOJOJ CFSTBNBEFOHBOCFSCBHBJGBLUPSMBJOZBOH
NFOHBUVS BMJSBO EBSBI KBSJOHBO TFUFNQBU BLBO EJCBIBT EJ #BC

178
Bab 16 Mikrosirkulasi dan Sistem Limfatik: Pertukaran Cairan Kapiler, Cairan Interstisial, dan Aliran Limfe
Fungsi Rata-Rata Sistem Kapiler NCSBOTFMLBQJMFSUBOQBIBSVTNFMFXBUJQPSJQPSJ;BUUFSTFCVU

.FTLJQVO BMJSBO EBSBI NFMFXBUJ UJBQ LBQJMFS CFSMBOHTVOH NFMJQVUJ PLTJHFO EBO LBSCPO EJPLTJEB 0MFI LBSFOB [BU[BU JOJ
JOUFSNJUFO UFSEBQBU CFHJUV CBOZBL LBQJMFS EBMBN KBSJOHBO EBQBU NFOFNCVT TFNVB BSFB NFNCSBO LBQJMFS LFDFQBUBO
TFIJOHHB GVOHTJ LFTFMVSVIBOOZB EBQBU EJSBUBSBUBLBO :BLOJ USBOTQPSOZBNFMBMVJNFNCSBOLBQJMFSCFCFSBQBLBMJMFCJICFTBS
UNIT IV
UFSEBQBU LFDFQBUBO SBUBSBUB BMJSBO EBSBI NFMBMVJ TFUJBQ EBSJQBEBLFDFQBUBOUSBOTQPS[BUZBOHUJEBLMBSVUEBMBNMFNBL
SBOHLBJBO LBQJMFS KBSJOHBO UFLBOBO LBQJMFS SBUBSBUB EBMBN NJTBMOZB JPO OBUSJVN EBO HMVLPTB ZBOH IBOZB EBQBU MFXBU
LBQJMFS EBO LFDFQBUBO SBUBSBUB QFNJOEBIBO [BU BOUBSB EBSBI NFMBMVJQPSJQPSJ
LBQJMFS EBO DBJSBO JOUFSTUJTJBM EJ TFLFMJMJOHOZB %BMBN CBC JOJ
TFMBOKVUOZB LJUB BLBO NFNCJDBSBLBO OJMBJ SBUBSBUB UFSTFCVU Zat Larut-Lemak Dapat Berdifusi secara Langsung
XBMBVQVOIBSVTLJUBJOHBUCBIXBQBEBLFOZBUBBOOZBGVOHTJSBUB melalui Membran Sel Endotel Kapiler. #BOZBL [BU ZBOH
SBUB JOJ NFSVQBLBO GVOHTJ CFSNJMJBSNJMJBS LBQJMFS EBO NBTJOH EJCVUVILBO PMFI KBSJOHBO EBQBU MBSVU EBMBN BJS OBNVO UJEBL
NBTJOH CFLFSKB TFDBSB JOUFSNJUFO TFCBHBJ SFTQPOTOZB UFSIBEBQ EBQBUNFOFNCVTNFNCSBOMJQJETFMFOEPUFM[BU[BUJOJBOUBSB
LPOEJTJTFUFNQBUEBMBNKBSJOHBO MBJO NPMFLVM BJS JUV TFOEJSJ JPO OBUSJVN JPO LMPSJEB EBO
HMVLPTB .FTLJQVO UJEBL MFCJI EBSJ MVBT QFSNVLBBO
LBQJMFS EJUFNQBUJ PMFI DFMBI BOUBSTFM EJ BOUBSB TFM FOEPUFM
Pertukaran Air, Zat Nutrisi, serta Zat-Zat Lainnya
LFDFQBUBO QFSHFSBLBO UFSNBM NPMFLVM EBMBN DFMBI CFHJUV
antara Darah dan Cairan Interstisial
CFTBSOZB TFIJOHHB EFOHBO EBFSBI LFDJM JOJ TBKB TVEBI DVLVQ
VOUVL NFNVOHLJOLBO TFKVNMBI CFTBS EJGVTJ BJS EBO [BU MBSVU
Difusi melalui Membran Kapiler BJS NFMBMVJ DFMBIQPSJ JOJ 6OUVL NFNCFSJLBO HBNCBSBO
4FKBVI JOJ DBSB UFSQFOUJOH VOUVL NFNJOEBILBO [BU[BU BOUBSB NFOHFOBJ LFDFQBUBO EJGVTJ [BU[BU UFSTFCVU LFDFQBUBO EJGVTJ
QMBTNB EBO DBJSBO JOUFSTUJTJBM BEBMBI EJGVTJ (BNCBS NPMFLVM BJS NFMFXBUJ NFNCSBO LBQJMFS LJSBLJSB LBMJ MFCJI
NFMVLJTLBO QSPTFT JOJ NFOVOKVLLBO CBIXB TFXBLUV EBSBI DFQBU EBSJQBEB LFDFQBUBO BMJSBO MJOFBS QMBTNB JUV TFOEJSJ EJ
NFOHBMJSEJTFQBOKBOHMVNFOLBQJMFS TFKVNMBICFTBSNPMFLVMBJS TFQBOKBOHLBQJMFS+BEJ BJSZBOHUFSEBQBUEBMBNQMBTNBEJUVLBS
EBO QBSUJLFM UFSMBSVU CFSEJGVTJ CPMBLCBMJL NFMBMVJ EJOEJOH EFOHBOBJSZBOHUFSEBQBUEBMBNDBJSBOJOUFSTUJTJBMTFCBOZBL
LBQJMFS TFIJOHHB UFSKBEJ QFSDBNQVSBO UFSVTNFOFSVT BOUBSB LBMJ TFCFMVN QMBTNB EBQBU NFOHBMJS NFMBMVJ LBQJMFS TFQFOVI
DBJSBOJOUFSTUJTJBMEBOQMBTNB%JGVTJEJTFCBCLBOPMFIQFSHFSBLBO OZB
UFSNBM NPMFLVM BJS EBO [BU UFSMBSVU EBMBN DBJSBO ZBJUV CFSCBHBJ
NPMFLVM EBO JPO NVMBNVMB CFSHFSBL EBMBN TBUV BSBI EBO Pengaruh Ukuran Molekul pada Perjalanan Melewati
LFNVEJBO LF BSBI MBJOOZB CFSUVNCVLBO TFDBSB BDBL EJ TFUJBQ Pori-Pori -FCBSDFMBIQPSJBOUBSTFMLBQJMFS TFCFTBSTBNQBJ
BSBI OBOPNFUFS LJSBLJSB LBMJ EJBNFUFS NPMFLVM BJS ZBOH
NFSVQBLBO NPMFLVM UFSLFDJM ZBOH QBEB LFBEBBO OPSNBM
Zat Larut-Lemak Dapat Berdifusi secara Langsung me- NFMFXBUJ QPSJQPSJ LBQJMFS 4FCBMJLOZB EJBNFUFS NPMFLVM
lalui Membran Sel Endotel Kapiler #JMB TVBUV [BU EBQBU MBSVU QSPUFJOQMBTNBTFEJLJUMFCJICFTBSEBSJQBEBMFCBSQPSJQPSJ;BU
EBMBNMFNBL [BUJUVEBQBUCFSEJGVTJTFDBSBMBOHTVOHNFMBMVJNF [BUMBJOOZB TFQFSUJJPOOBUSJVN JPOLMPSJEB HMVLPTBEBOVSFB
NFNQVOZBJ VLVSBO EJBNFUFS TFEBOH 0MFI LBSFOB JUV
QFSNFBCJMJUBT QPSJQPSJ LBQJMFS VOUVL CFSNBDBNNBDBN [BU
CFSWBSJBTJTFTVBJEFOHBOEJBNFUFSNPMFLVMOZB
5BCFM NFOHHBNCBSLBO QFSNFBCJMJUBT SFMBUJG QPSJQPSJ
LBQJMFS EJ PUPU SBOHLB UFSIBEBQ [BU[BU ZBOH VNVNOZB
EJKVNQBJ DPOUPIOZB QFSNFBCJMJUBT VOUVL NPMFLVM HMVLPTB
CFTBSOZB LBMJ EBSJQBEB QFSNFBCJMJUBT VOUVL NPMFLVM BJS
TFEBOHLBO QFSNFBCJMJUBT VOUVL NPMFLVM BMCVNJO BNBU TBOHBU
LFDJM ZBJUVIBOZBQFSNFBCJMJUBTNPMFLVMBJS
"EB TBUV IBM ZBOH IBSVT EJQFSIBUJLBO ZBLOJ CBIXB LBQJMFS
QBEB CFSCBHBJ KBSJOHBO NFNQVOZBJ QFSCFEBBO QFSNFBCJMJUBT
ZBOH TBOHBU CFTBS $POUPIOZB NFNCSBO TJOVTPJE LBQJMFS IBUJ
CFHJUV QFSNFBCFM TFIJOHHB QSPUFJO QMBTNB NFOHBMJS TFDBSB
CFCBTNFMBMVJEJOEJOHTJOVTPJEJOJIBNQJSTFNVEBIBJSEBO[BU
MBJO+VHB QFSNFBCJMJUBTNFNCSBOHMPNFSVMVTHJOKBMVOUVLBJS
EBO FMFLUSPMJU LJSBLJSB LBMJ QFSNFBCJMJUBT LBQJMFS PUPU
UFUBQJ UJEBL CFSMBLV VOUVL QSPUFJO QMBTNB QFSNFBCJMJUBT
HMPNFSVMVT TBOHBU LFDJM VOUVL QSPUFJO QMBTNB TFQFSUJ QBEB
KBSJOHBOEBOPSHBOMBJO
179
Unit IV Sirkulasi
Tabel 16-1 Permeabilitas Relatif Pori-Pori Kapiler Otot Rangka Interstisium dan Cairan Interstisial
terhadap Berbagai Ukuran Molekul
,VSBOH MFCJI TFQFSFOBN EBSJ UPUBM WPMVNF UVCVI UFSEJSJ BUBT

Zat Berat Molekuk Permeablitas
SVBOHSVBOH BOUBS TFM ZBOH TFDBSB LFTFMVSVIBO EJTFCVU JOUFST
Air 18 1.00 UJTJVN $BJSBO ZBOH UFSEBQBU EJ EBMBN SVBOH JOJ EJTFCVU DBJSBO
NaCI 58.5 0.96
JOUFSTUJTJBM
Urea 60 0.8
4USVLUVS JOUFSTUJTJVN EJQFSMJIBULBO QBEB (BNCBS
4USVLUVSJOJUFSEJSJBUBTEVBUJQFVUBNBTUSVLUVSQBEBU
CFSLBT
Glukosa 180 0.6 TFSBU LPMBHFO EBO
GJMBNFO QSPUFPHMJLBO #FSLBT TFSBU LPMBHFO
Sukrosa 342 0.4 UFSCFOUBOH QBOKBOH EJ EBMBN JOUFSTUJTJVN #FSLBT JOJ TBOHBU LVBU
Inulin 5,000 0.2 EBOLBSFOBJUVQBMJOHCBOZBLNFNCFSJEBZBUFHBOHQBEBKBSJOHBO
Mioglobin 17,600 0.03
/BNVO GJMBNFO QSPUFPHMJLBO NFSVQBLBO NPMFLVM TBOHBU UJQJT
ZBOHUFSKBMJOBUBVUFSUFLVLEBOTFLJUBSQFSTFOUFSEJSJBUBTBTBN
Hemoglobin 68,000 0.01 IJBMVSPOBU EBO QFSTFO QSPUFJO .PMFLVM UFSTFCVU CFHJUV UJQJT
Albumin 69,000 0.001 TFIJOHHBUJEBLEBQBUEJMJIBUEFOHBONJLSPTLPQDBIBZBEBOTVLBS
VOUVL EJQFSMJIBULBO CBILBO EFOHBO NJLSPTLPQ FMFLUSPO
Data dari Pappenheimer JR:"Passage of molecules through capillary Physiol
.FTLJQVO CFHJUV NPMFLVMNPMFLVM JOJ NFNCFOUVL BMBT GJMBNFO
Rev. 33:387, 1953.
SFUJLVMBS ZBOH TBOHBU IBMVT EJTFCVU TFCBHBJ UVNQVLBO
TJLBU CSVTIQJMF

,FUJLB LJUB NFNQFMBKBSJ CFSCBHBJ PSHBO UFSTFCVU ZBOH BLBO
EJKFMBTLBO OBOUJ EBMBN CBC JOJ BLBO KFMBTMBI NFOHBQB
"Gel" dalam Interstisium. $BJSBO EBMBN JOUFSTUJTJVN
CFCFSBQB KBSJOHBO DPOUPIOZB IBUJ NFNCVUVILBO EFSBKBU
EJIBTJMLBOEBSJGJMUSBTJEBOEJGVTJLBQJMFS$BJSBOJOJNFOHBOEVOH
QFSNFBCJMJUBT LBQJMFS MFCJI CFTBS EJCBOEJOHLBO KBSJOHBO MBJO
CBIBOCBIBO ZBOH IBNQJS TBNB EFOHBO QMBTNB LFDVBMJ CBIXB
ZBOHCFSUVKVBOVOUVLNFNJOEBILBOTFKVNMBICFTBS[BUOVUSJTJ
LPOTFOUSBTJ QSPUFJOOZB KBVI MFCJI SFOEBI LBSFOB QSPUFJO UJEBL
BOUBSB EBSBI EBO TFM QBSFOLJN IBUJ TFSUB HJOKBM BHBS EBQBU
EBQBU LFMVBS EFOHBO NVEBI NFMBMVJ QPSJQPSJ LBQJMFS $BJSBO
UFSKBEJGJMUSBTJTFKVNMBICFTBSDBJSBOVOUVLQFNCFOUVLBOVSJOF
JOUFSTUJTJBM UFSQFSBOHLBQ UFSVUBNB EBMBN SVBOH LFDJM ZBOH
UFSEBQBUEJBOUBSBGJMBNFOGJMBNFOQSPUFPHMJLBO(BCVOHBOBOUBSB
Pengaruh Perbedaan Konsentrasi terhadap Kecepat- GJMBNFO QSPUFPHMJLBO EBO DBJSBO ZBOH UFSQFSBOHLBQ EJ EBMBNOZB
an Neto Difusi melalui Membran Kapiler,FDFQBUBOOFUP NFNQVOZBJ LBSBLUFSJTUJL TFQFSUJ HFM BHBSBHBS
EBO LBSFOB JUV
EJGVTJ TVBUV [BU NFMBMVJ TFUJBQ NFNCSBO TFCBOEJOH EFOHBO EJTFCVUHFMKBSJOHBO
QFSCFEBBO LPOTFOUSBTJ [BU BOUBSB LFEVB TJTJ NFNCSBO +BEJ
0MFILBSFOBKVNMBIGJMBNFOQSPUFPHMJLBOTBOHBUCBOZBL NBLB
NBLJOCFTBSQFSCFEBBOLPOTFOUSBTJTVBUV[BUBOUBSBLFEVBTJTJ
DBJSBO TVMJU VOUVL NFOHBMJS EFOHBO NVEBI NFMBMVJ HFM KBSJOHBO
NFNCSBO LBQJMFS NBLJO CFTBS QFSHFSBLBO OFUP [BU UFSTFCVU
4FCBHBJHBOUJOZB DBJSBOJUVUFSVUBNBCFSEJGVTJNFMBMVJHFMKBSJOHB
NFOFNCVT NFNCSBO EBMBN TBUV BSBI .JTBMOZB LPOTFOUSBTJ
PLTJHFO EBMBN EBSBI LBQJMFS OPSNBMOZB MFCJI CFTBS EBSJQBEB
LPOTFOUSBTJOZBEJDBJSBOJOUFSTUJTJBM6OUVLJUV TFKVNMBICFTBS
PLTJHFO OPSNBMOZB CFSHFSBL EBSJ EBSBI NFOVKV LF KBSJOHBO
4FCBMJLOZB LPOTFOUSBTJ LBSCPO EJPLTJEB EJ EBMBN KBSJOHBO
MFCJI CFTBS EBSJQBEB EJ EBMBN EBSBI NFOZFCBCLBO LBSCPO
EJPLTJEBCFSMFCJICFSHFSBLLFEBMBNEBSBIVOUVLEJCBXBQFSHJ
EBSJKBSJOHBO
,FDFQBUBO EJGVTJ TFCBHJBO CFTBS [BU ZBOH QFOUJOH VOUVL
OVUSJTJ TFXBLUV NFMFXBUJ NFNCSBO LBQJMFS CFHJUV CFTBS
TFIJOHHBIBOZBEFOHBOQFSCFEBBOLPOTFOUSBTJLFDJMTBKBTVEBI
EBQBUNFOZFCBCLBOQFOHBOHLVUBO[BUMFCJIEBSJDVLVQBOUBSB
QMBTNBEBODBJSBOJOUFSTUJTJBM$POUPIOZB LPOTFOUSBTJPLTJHFO
EBMBN DBJSBO JOUFSTUJTJBM UFQBU EJ TJTJ MVBS LBQJMFS IBOZB
CFCFSBQB QFSTFO MFCJI SFOEBI EBSJ LPOTFOUSBTJ EBMBN QMBTNB
EBSBI OBNVO QFSCFEBBO LPOTFOUSBTJ LFDJM JOJ EBQBU NFO
ZFCBCLBOPLTJHFOCFSHFSBLEBMBNKVNMBIDVLVQEBSJEBSBILF
EBMBNSVBOHJOUFSTUJTJBMVOUVLNFOZFEJBLBOTFNVBLFCVUVIBO
PLTJHFO VOUVL NFUBCPMJTNF KBSJOHBO TFSJOH LBMJ TFCBOZBL
CFCFSBQB MJUFS PLTJHFO QFS NFOJU TFMBNB UVCVI CFSBEB EBMBN
LFBEBBOTBOHBUBLUJG
180
BOZBLOJ NPMFLVMQFSNPMFLVMDBJSBOCFSHFSBLEBSJTBUVUFNQBU
LFUFNQBUZBOHMBJONFMBMVJQFSHFSBLBOUFSNBMLJOFUJLEBOCVLBO
CFSHFSBLCFSTBNBBOEBMBNKVNMBICFTBS 0
%JGVTJZBOHNFMFXBUJHFMLJSBLJSBTFDFQBUTBNQBJQFSTFO
UNIT IV
EJGVTJZBOHNFMBMVJDBJSBOCFCBT0MFILBSFOBKBSBLBOUBSBLBQJMFS
EBO TFM KBSJOHBO DVLVQ QFOEFL EJGVTJ JOJ NFNVOHLJOLBO USBO
TQPSU ZBOH DFQBU NFMBMVJ JOUFSTUJTJVN UJEBL IBOZB CBHJ NPMFLVM
BJS UFUBQJ KVHB CBHJ FMFLUSPMJU [BU OVUSJTJ EFOHBO CFSBU NPMFLVM
LFDJM FLTLSFUBTFM PLTJHFO LBSCPOEJPLTJEB EBOTFCBHBJOZB 0
Cairan "Bebas" dalam Interstisium. 8BMBVQVO IBNQJS

TFMVSVIDBJSBOEBMBNJOUFSTUJTJVNOPSNBMOZBUFSQFSBOHLBQEBMBN
HFMKBSJOHBO BEBLBMBOZBKVHBUFSEBQBUTVOHBJLFDJMDBJSBOCFCBT
EBO WFTJLFM LFDJM DBJSBO CFCBT CFSBSUJ UFSEBQBU DBJSBO ZBOH CFCBT 1. 5FLBOBO LBQJMFS 1D
DFOEFSVOH NFOEPSPOH DBJSBO LF MVBS
EBSJ NPMFLVM QSPUFPHMJLBO EBO PMFI LBSFOB JUV EBQBU NFOHBMJS NFMBMVJNFNCSBOLBQJMFS
EFOHBO CFCBT #JMB TVBUV [BU XBSOB EJTVOUJLLBO LF EBMBN EBSBI
2. 5FLBOBO DBJSBO JOUFSTUJTJBM 1JG
DFOEFSVOH NFOEPSPOH
TJSLVMBTJ TFSJOH LBMJ [BU XBSOB UFSTFCVU EBQBU UFSMJIBU NFOHBMJS
DBJSBOLFEBMBNNFMBMVJNFNCSBOLBQJMFSCJMBOJMBJ1JGQPTJUJG
NFMBMVJ JOUFSTUJTJVN EJ EBMBN TVOHBJ LFDJM CJBTBOZB NFOHBMJS EJ
UFUBQJLFMVBSCJMBOJMBJ1JGOFHBUJG
TFQBOKBOHQFSNVLBBOTFSBCVULPMBHFOBUBVQFSNVLBBOTFM
3. 5FLBOBO PTNPUJL LPMPJE QMBTNB LBQJMFS ͑Q
DFOEFSVOH
+VNMBIDBJSBOCFCBTZBOHUFSEBQBUEJKBSJOHBOOPSNBMIBOZB NFOJNCVMLBO PTNPTJT DBJSBO LF EBMBN NFMBMVJ NFNCSBO
TFEJLJU CJBTBOZB LVSBOH EBSJ QFSTFO 4FCBMJLOZB CJMB KBSJOHBO LBQJMFS
NFOHBMBNJFEFNB LBOUVOHLBOUVOHEBOTVOHBJLFDJMDBJSBOCFCBT 4. 5FLBOBO PTNPUJL LPMPJE DBJSBO JOUFSTUJTJBM ͑JG
DFOEFSVOH
JOJ NFOHFNCBOH EFOHBO IFCBU TBNQBJ TFQBSVI BUBV MFCJI DBJSBO
NFOJNCVMLBO PTNPTJT DBJSBO LF MVBS NFMBMVJ NFNCSBO
FEFNBNFOKBEJDBJSBOZBOHNFOHBMJSCFCBTEBOUJEBLUFSQFSBOH
LBQJMFS
LBQEJGJMBNFOQSPUFPHMJLBO
+JLBKVNMBILFFNQBUEBZBJOJ ZBJUVUFLBOBOGJMUSBTJOFUP OFU
GJMUSBUJPO QSFTTVSF/'1
CFSOJMBJ QPTJUJG UFSKBEJ GJMUSBTJ DBJSBO
Filtrasi Cairan Melewati Kapiler Ditentukan oteh OFUP NFMBMVJ LBQJMFS +JLB KVNMBI EBZB 4UBSMJOH CFSOJMBJ OFHBUJG
Tekanan Hidrostatik dan Osmotik Koloid, serta BLBO UFSKBEJ BCTPSQTJ DBJSBO EBSJ SVBOH JOUFSTUJTJBM LF EBMBN
Koefisien Filtrasi Kapiler LBQJMFS 5FLBOBO GJMUSBTJ OFUP /'1
EBQBU EJIJUVOH TFCBHBJ
CFSJLVU
NFP = Pc – Pif – ͑p + ͑if
5FLBOBOIJESPTUBUJLEBMBNLBQJMFSDFOEFSVOHVOUVLNFOEPSPOH
DBJSBOEBO[BU[BUUFSMBSVUOZBNFMFXBUJQPSJQPSJLBQJMFSLFEBMBN 4FQFSUJ ZBOH BLBO EJKFMBTLBO OBOUJ OJMBJ /'1 TFEJLJU QPTJUJG
SVBOHJOUFSTUJTJBM4FCBMJLOZB UFLBOBOPTNPUJLZBOHEJUJNCVMLBO QBEBLFBEBBOOPSNBM TFIJOHHBNFOZFCBCLBOUFSKBEJOZBGJMUSBTJ
PMFI QSPUFJO QMBTNB ZBOH EJTFCVU UFLBOBO PTNPUJL LPMPJE
DBJSBO OFUP NFMBMVJ LBQJMFS LF EBMBN SVBOH JOUFSTUJTJBM EJ
DFOEFSVOHVOUVLNFOJNCVMLBOQFSHFSBLBODBJSBOTFDBSBPTNPTJT LFCBOZBLBO PSHBO ,FDFQBUBO GJMUSBTJ DBJSBO EJ TVBUV KBSJOHBO
EBSJ SVBOH JOUFSTUJTJBM LF EBMBN EBSBI 5FLBOBO PTNPUJL ZBOH KVHB EJUFOUVLBO PMFI KVNMBI EBO VLVSBO QPSJQPSJ EJ TFUJBQ
EJUJNCVMLBO PMFI QSPUFJO QMBTNB JOJ QBEB LFBEBBO OPSNBM LBQJMFS EBO KVNMBI LBQJMFS UFNQBU EBSBI NFOHBMJS 'BLUPS
NFODFHBI IJMBOHOZB WPMVNF DBJSBO ZBOH DVLVQ CFSNBLOB EBSJ GBLUPS UFSTFCVU CFSTBNBTBNB EJOZBUBLBO TFCBHBJ LPFGJTJFO
EBSBILFEBMBNSVBOHJOUFSTUJTJBM GJMUSBTJ LBQJMFS ,G
0MFI LBSFOB JUV ,G NFSVQBLBO TVBUV
VLVSBOLBQBTJUBTNFNCSBOLBQJMFSEBMBNNFNGJMUSBTJBJSVOUVL
+VHBQFOUJOHBEBMBITJTUFNMJNGBUJL ZBOHBLBONFOHFNCBMJLBO
TFUJBQ OJMBJ /'1 EBO CJBTBOZB EJOZBUBLBO TFCBHBJ NJMJMJUFS QFS
TFKVNMBI LFDJM EBSJ LFMFCJIBO QSPUFJO EBO BJS ZBOH CPDPS EBSJ
NFOJUQFSNN)HOJMBJUFLBOBOGJMUSBTJOFUP
EBSBI LF EBMBN SVBOH JOUFSTUJTJBM BHBS EBQBU CBMJL LF TJSLVMBTJ
,FDFQBUBO GJMUSBTJ DBJSBO LBQJMFS LBSFOB JUV EJUFOUVLBO PMFI
%BMBNCBCJOJTFMBOKVUOZB LJUBBLBONFNCBIBTNFLBOJTNFZBOH
QFSTBNBBOCFSJLVU
NFOHFOEBMJLBO GJMUSBTJ LBQJMFS EBO GVOHTJ BMJSBO MJNGF EBMBN
NFOHBUVSWPMVNFQMBTNBEBODBJSBOJOUFSTUJTJBMTFDBSBCFSTBNB Filtrasi = Kf × NFP
%BMBN QBSBHSBGQBSBHSBG CFSJLVU LJUB BLBO NFNCBIBT TFD

Daya Osmotik Koloid dan Hidrostatik Menentukan BSBEFUBJMTFUJBQEBZBZBOHNFOFOUVLBOLFDFQBUBOGJMUSBTJDBJSBO
Pergerakan Cairan melalui Membran Kapiler. (BNCBS LBQJMFS
NFOHHBNCBSLBO FNQBU EBZB VUBNB ZBOH NFOFOUVLBO BQBLBI
DBJSBO BLBO CFSHFSBL LFMVBS EBSJ EBSBI NBTVL LF EBMBN DBJSBO Tekanan Hidrostatik Kapiter
JOUFSTUJTJBM BUBV LF BSBI CFSMBXBOBO %BZB JOJ EJTFCVU EBZB
#FSCBHBJ NFUPEF QFSDPCBBO EJQBLBJ VOUVL NFOJMBJ UFLBOBO
4UBSMJOH VOUVL NFOHIPSNBUJ BIMJ GBBM ZBOH QFSUBNB LBMJ
LBQJMFS
LBOVMBTJ NJLSPQJQFU LBQJMFS TFDBSB MBOHTVOH ZBOH
NFNQFSMJIBULBOQFOUJOHOZBLFFNQBUEBZBCFSJLVU
NFNCFSJOJMBJUFLBOBOLBQJMFSSBUBSBUBTFCFTBSNN)HQBEB
CFCFSBQBKBSJOHBOTFQFSUJPUPUSBOHLBEBOVTVT EBO
QFOHV
181
Unit IV Sirkulasi
VLVSBOGVOHTJPOBMUFLBOBOLBQJMFSTFDBSBUJEBLMBOHTVOH ZBOH
NFNCFSJ OJMBJ UFLBOBO LBQJMFS SBUBSBUB TFLJUBS NN )H
QBEBKBSJOHBOUFSTFCVU
Metode Mikropipet untuk Mengukur Tekanan Kapiler.

6OUVLNFOHVLVSUFLBOBOEBMBNLBQJMFSEFOHBODBSBLBOVMBTJ
TFCVBIQJQFULBDBNJLSPTLPQJLMBOHTVOHEJUVTVLLBOLFEBMBN
LBQJMFS EBO UFLBOBO EJVLVS EFOHBO TJTUFN NJLSPNBOPNFUFS
ZBOH TFTVBJ %FOHBO NFOHHVOBLBO DBSB JOJ UFLBOBO LBQJMFS
UFMBI UFSVLVS EJ LBQJMFS QBQBSBO KBSJOHBO CJOBUBOH EBO EJ
MFOHLVOHBO LBQJMFS CFTBS FQPOJLJVN QBEB QBOHLBM LVLV KBSJ
NBOVTJB 1FOHVLVSBO JOJ NFNCFSJ OJMBJ UFLBOBO QBEB VKVOH
BSUFSJ LBQJMFS TFCFTBS TBNQBJ NN )H QBEB VKVOH WFOB
TFCFTBS TBNQBJ NN )H EBO LJSBLJSB NN )H QBEB
CBHJBOUFOHBILBQJMFS
1BEB CFCFSBQB LBQJMFS TFQFSUJ LBQJMFS HMPNFSVMVT HJOKBM
IBTJMQFOHVLVSBONFOHHVOBLBONFUPEFNJLSPQJQFUKBVIMFCJI
UJOHHJ EFOHBO SBUBSBUB TFLJUBS NN )H 4FCBMJLOZB QBEB
LBQJMFS QFSJUVCVMVT HJOKBM SBUBSBUB UFLBOBO IJESPTUBUJL IBOZB
TFLJUBS NN )H %FOHBO EFNJLJBO UFLBOBO IJESPTUBUJL
LBQJMFS QBEB KBSJOHBO CFSCFEB TBOHBU CFSWBSJBTJ CFSHBOUVOH
LFQBEBKBSJOHBOUFSUFOUVTFSUBLPOEJTJGJTJPMPHJTOZB
Metode Isogravimetrik untuk Mengukur Tekanan Kapiler

"Fungsional" secara Tidak Langsung (BNCBS
NFOKFMBTLBO NFUPEF JTPHSBWJNFUSJL VOUVL NFOJMBJ UFLBOBO = 17 mm Hg
LBQJMFS TFDBSB UJEBL *BOHTVOH (BNCBS JOJ NFNQFSMJIBULBO
TFCVBI QPUPOHBO VTVT ZBOH EJUFNQBULBO QBEB TBMBI TBUV
MFOHBO UJNCBOHBO HSBWJNFUSJL UJNCBOHBO QFOHVLVS CFSBU

4FMBOKVUOZB TFKVNMBI EBSBI EJTVOUJLLBO LF EBMBN QFNCVMVI
–
EBSBI EJOEJOH VTVT UFSTFCVU #JMB UFLBOBO BSUFSJ EJUVSVOLBO
QFOVSVOBO UFLBOBO LBQJMFS ZBOH EJIBTJMLBO BLBO NFNCVBU
UFLBOBOPTNPUJLQSPUFJOQMBTNBNFOJNCVMLBOBCTPSQTJDBJSBO
LFMVBS EBSJ EJOEJOH VTVT EBO NFOHBLJCBULBO CFSBU VTVT
CFSLVSBOH,FBEBBOJOJTFHFSBNFOZFCBCLBOQFSVCBIBOQPTJTJ QBEB TFCBHJBO CFTBS KBSJOHBO GJMUSBTJ DBJSBO LBQJMFS UJEBL
MFOHBO UJNCBOHBO 6OUVL NFODFHBI QFOVSVOBO CFSBU JOJ TFQFOVIOZB EJJNCBOHJ PMFI BCTPSCTJ DBJSBO 1BEB TFCBHJBO CFTBS
UFLBOBO WFOB EJOBJLLBO VOUVL NFOHJNCBOHJ FGFL QFOVSVOBO KBSJOHBO DBJSBO ZBOH EJGJMUSBTJ NFMFCJIJ SFBCTPSCTJOZB EJBOHLVU
UFLBOBO BSUFSJ %FOHBO LBUB MBJO UFLBOBO LBQJMFS EJ PMFI QFNCVMVI MJNGF 1BEB LBQJMFS HMPNFSVMVT HJOKBM TFKVNMBI
QFSUBIBOLBO UFUBQ LPOTUBO NFMBMVJ
QFOVSVOBO UFLBOBO CFTBSDBJSBO TFLJUBSNMNFOJUEJGJMUSBTJTFDBSBLPOUJOV
BSUFSJEBO
NFOJOHLBULBOUFLBOBOWFOB
(SBGJLEJCBHJBOCBXBIHBNCBSNFNQFSMJIBULBOQFSVCBIBO Tekanan Hidrostatik Cairan Interstisial
UFLBOBO BSUFSJ EBO UFLBOBO WFOB ZBOH TBMJOH NFOJBEBLBO 5FSEBQBU CFCFSBQB NFUPEF VOUVL NFOHVLVS UFLBOBO DBJSBO
TFMVSVI QFSVCBIBO CFSBU (BSJT BSUFSJ EBO HBSJT WFOB TBMJOH JOUFSTUJTJBM EBO TFUJBQ NFUPEF JOJ NFNCFSJ OJMBJ ZBOH TFEJLJU
CFSUFNV QBEB OJMBJ NN )H 0MFI LBSFOB JUV UFLBOBO CFSCFEB CFSHBOUVOH NFUPEF ZBOH EJHVOBLBO EBO KBSJOHBO ZBOH
LBQJMFS IBSVT UFUBQ QBEB UFLBOBO NN )H TFMBNB TFMVSVI EJVLVS UFLBOBOOZB 1BEB KBSJOHBO MPOHHBS TVCLVUBO UFLBOBO
NBOVWFSUFSTFCVUBQBCJMBUJEBL CBJLGJMUSBTJNBVQVOBCTPSQTJ DBJSBO JOUFSTUJTJBM ZBOH EJVLVS NFOHHVOBLBO NFUPEF CFSCFEB
DBJSBO BLBO UFSKBEJ NFMBMVJ EJOEJOH LBQJMFS +BEJ TFDBSB UJEBL VNVNOZB CFCFSBQB NJMJNFUFS BJS SBLTB TFEJLJU MFCJI SFOEBI
MBOHTVOH UFLBOBO LBQJMFS GVOHTJPOBM ZBOH UFSVLVS QBEB EBSJQBEB UFLBOBO BUNPTGFS ZBJUV OJMBJ ZBOH EJTFCVU UFLBOBO
KBSJOHBOJOJCFTBSOZBTFLJUBSNN)H OFHBUJG DBJSBO JOUFSTUJTJBM 1BEB KBSJOHBO MBJO ZBOH EJLFMJMJOHJ
5FMBI KFMBT CBIXB NFUPEF JTPHSBWJNFUSJL ZBOH EBQBU LBQTVM TFQFSUJ HJOKBM UFLBOBO JOUFSTUJTJBM VNVNOZB QPTJUJG MFCJI
NFOFOUVLBOUFLBOBOLBQJMFSTFDBSBUFQBUEFOHBONFOHJNCBOHJ UJOHHJ EBSJ UFLBOBO BUNPTGFS
.FUPEF ZBOH QBMJOH MB[JN
TFNVB EBZB ZBOH DFOEFSVOH VOUVL NFOHHFSBLLBO DBJSBO LF EJHVOBLBO BEBMBI
LBOVMBTJ MBOHTVOH QBEB KBSJOHBO EFOHBO
EBMBNBUBVLFMVBSEBSJLBQJMFS NFOHIBTJMLBOOJMBJMFCJISFOEBI NJLSPQJQFU
QFOHVLVSBO UFLBOBO NFMBMVJ JNQMBOUBTJ LBQTVM
EJCBOEJOHLBO UFLBOBO LBQJMFS ZBOH EJVLVS TFDBSB MBOHTVOH EBO
QFOHVLVSBO UFLBOBO QBEB TVNCV LBQBT ZBOH EJTJTJQLBO
NFOHHVOBLBONJLSPQJQFU)BMJOJUFSVUBNBEJTFCBCLBOLBSFOB LFEBMBNKBSJOHBO
182
Bab 16 Mikrosirkulasi dan Sistem Limfaik: Pertukaran Cairan Kapiler, Cairan Interstisial dan Aliran Limfe
Pengukuran Tekanan Cairan Interstisial dengan Menggunakan 1. #JMB TFCVBI DBOHLPLBO LVMJU EJMFUBLLBO QBEB QFSNVLBBO
Mikropipet. 1FOHHVOBBO KFOJT NJLSPQJQFU ZBOH TBNB VOUVL DFLVOH EJ UVCVI NJTBMOZB QBEB MFLVLBO NBUB TFTVEBI CPMB
NFOHVLVS UFLBOBO LBQJMFS EBQBU KVHB EJHVOBLBO EJ CFCFSBQB
NBUB EJLFMVBSLBO ZBJUV TFCFMVN LVMJU NFMFLBU QBEB MFLVLBO
KBSJOHBO VOUVL NFOHVLVS UFLBOBO DBJSBO JOUFSTUJTJBM 6KVOH
NJLSPQJQFU NFNJMJLJ EJBNFUFS TFLJUBS NJLSPNFUFS UFUBQJ ZBOH NFOEBTBSJOZB DBJSBO DFOEFSVOH VOUVL CFSLVNQVM EJ
UNIT IV
VLVSBO JOJ QVO TVEBI LBMJ MFCJI CFTBS BUBV MFCJI EBSJQBEB CBXBI LVMJU ZBOH EJDBOHLPL ,VMJU KVHB CFSVTBIB VOUVL
VLVSBO SVBOHBO BOUBSB GJMBNFOGJMBNFO QSPUFPHMJLBO JOUFS NFOHFSVU DFOEFSVOHVOUVLNFOBSJLLFMVBSLVMJUEBSJDFLVOH
TUJTJVN 0MFI LBSFOB JUV UFLBOBO ZBOH EJVLVS LFNVOHLJOBO BO.FTLJQVOCFHJUV CFCFSBQBEBZBOFHBUJGEJCBXBILVMJUBLBO
BEBMBIUFLBOBOEJEBMBNLBOUVOHDBJSBOCFCBT NFOZFCBCLBO BCTPSQTJ DBJSBO EBO CJBTBOZB CFOBSCFOBS BLBO
5FLBOBO ZBOH QFSUBNBUBNB UFSVLVS EFOHBO NFOHHVOBLBO NFOBSJLLVMJULFNCBMJLFCFOUVLDFLVOHOZB
NFUPEF NJLSPQJQFU CFSLJTBS EBSJ TBNQBJ NN )H UFUBQJ 2. 6OUVL NFOZVOUJLLBO TFKVNMBI CFTBS WPMVNF DBJSBO LF EBMBN
CJBTBOZBTFEJLJUQPTJUJG%FOHBOQFOHBMBNBOEBOQFSBMBUBOZBOH
KBSJOHBO TVCLVUBO MPOHHBS NJTBMOZB EJ CBXBI LFMPQBL NBUB
TVEBI EJQFSCBSVJ VOUVL NFOHVLVS UFLBOBO UFSTFCVU UFLBOBO
UFSLJOJ NFNJMJLJ OJMBJ SBUBSBUB TFLJUBS NN )H ZBOH
CBXBI EBMBN SVBOH LFUJBL EBO EJ EBMBN TLSPUVN EJCVUVI
NFNCFSJLBO OJMBJ UFLBOBO SBUBSBUB EBMBN KBSJOHBO MPOHHBS LBOUFLBOBOQPTJUJGLVSBOHEBSJNN)H+VNMBIDBJSBOZBOH
NJTBMOZB LVMJU ZBOH TFEJLJU MFCJI LFDJM EBSJQBEB UFLBOBO EJQFSIJUVOHLBO LBMJ MFCJI CFTBS EBSJQBEB KVNMBI DBJSBO
BUNPTGFS ZBOH CJBTBOZB UFSEBQBU EBMBN SVBOH JOUFSTUJTJBM CJMB
Pengukuran Tekanan Cairan Bebas Interstisial melalui Implan- EJTVOUJLLBOLFEBMBNBSFBUFSTFCVUEJBUBT BLBONFOJNCVMLBO
tasi Kapsul 5FLBOBO DBJSBO CFCBT JOUFSTUJTJBM ZBOH EJVLVS UFLBOBO QPTJUJG ZBOH CFTBSOZB UJEBL MFCJI EBSJ NN )H
EFOHBO DBSB JOJ NFOHHVOBLBO LBQTVM CFSEJBNFUFS DN QBEB *OUJTBSJEBSJQFOHBNBUBOJOJBEBMBICBIXBKBSJOHBOTFQFSUJJOJ
KBSJOHBOMPOHHBSTVCLVUBOOPSNBMNFNCFSJOJMBJTFLJUBSNN UJEBL NFNQVOZBJ TFSBU LVBU ZBOH EBQBU NFODFHBI QFOVNQV
)H UFUBQJEFOHBOLBQTVMZBOHMFCJILFDJM OJMBJOZBUJEBLCFSCFEB LBO DBJSBO 0MFI LBSFOB JUV CFCFSBQB NFLBOJTNF MBJO TFQFSUJ
KBVIEBSJNN)HZBOHEJVLVSNFOHHVOBLBONJLSPQJQFU TJTUFN LPNQMBJOT DPNQMJBODF LFNVEBIBO VOUVL EJSFHBOH
SFOEBI IBSVT UFSTFEJB VOUVL NFODFHBI QFOVNQVLBO DBJSBO

Tekanan Cairan Interstisial dalam Jaringan yang Ter- TFQFSUJJOJ
tutup Rapat 3. %J TFCBHJBO CFTBS SPOHHB BMBNJBI UVCVI UFNQBU UFSEBQBUOZB
#FCFSBQB KBSJOHBO UVCVI EJLFMJMJOHJ PMFI QFSJTBJ ZBOH DBJSBO CFCBT EBMBN LFTFJNCBOHBO EJOBNJL EFOHBO DBJSBO
NFOVUVQ SBQBU NJTBMOZB UFNQVSVOH LFQBMB ZBOH JOUFSTUJTJBM EJ TFLFMJMJOHOZB UFLBOBO ZBOH EJVLVS CFSOJMBJ
NFOHFMJMJOHJ PUBL LBQTVM GJCSPTB LVBU ZBOH NFOHFMJMJOHJ OFHBUJG#FCFSBQBSPOHHBJOJBEBMBITFCBHBJCFSJLVU
HJOKBM MBQJTBO GJCSPTB ZBOH NFOHFMJMJOHJ PUPU EBO TLMFSB EJ 3POHHBJOUSBQMFVSBoNN)H
TFLFMJMJOH NBUB %J TFCBHJBO CFTBS KBSJOHBO JOJ UBOQB 3POHHBTJOPWJBTFOEJoTBNQBJoNN)H
NFOHIJSBVLBO NFUPEF ZBOH EJQBLBJ VOUVL NFOHVLVS OJMBJ 3POHHBFQJEVSBM oTBNQBJoNN)H
UFLBOBO DBJSBO JOUFOTUJTJBMOZB QPTJUJG /BNVO UFLBOBO 4. .FUPEF JNQMBOUBTJ LBQTVM VOUVL NFOHVLVS UFLBOBO DBJSBO
DBJSBO JOUFOTUJTJBM JOJ IBNQJS TFMBMV NBTJI MFCJI LFDJM JOUFSTUJTJBM EBQBU EJQBLBJ VOUVL NFSFLBN QFSVCBIBO EJOBNJL
EBSJQBEB UFLBOBO ZBOH UFSCFOUVL EJ TJTJ MVBS KBSJOHBO PMFI EBSJ UFLBOBO JOJ 1FSVCBIBO UFSTFCVU LJSBLJSB EJQFSIJUVOHLBO
QFSJTBJOZB 4FCBHBJ DPOUPI UFLBOBO DBJSBO TFSFCSPTQJOBM EJ EBQBUUFSKBEJ
CJMBUFLBOBOBSUFSJNFOJOHLBUBUBVNFOVSVO
TFLFMJMJOH PUBL TFFLPS CJOBUBOH ZBOH CFSCBSJOH SBUBSBUB
CJMBDBJSBOEJTVOUJLLBOLFEBMBNSVBOHKBSJOHBOTFLJUBSOZB
TFLJUBS NN )H TFEBOHLBO UFLBOBO DBJSBO JOUFSTUJTJBM BUBV
CJMBEJTVOUJLLBOCBIBOPTNPUJLLPMPJECFSLPOTFOUSBTJ
PUBLSBUBSBUBTFLJUBSTBNQBJNN)H%JEBMBNHJOKBM UJOHHJ LF EBMBN EBSBI VOUVL NFOHBCTPSQTJ DBJSBO EBSJ SVBOH
UFLBOBO LBQTVM ZBOH NFOHFMJMJOHJ HJOKBM SBUBSBUB NN KBSJOHBO#JBTBOZBQFSVCBIBOEJOBNJLJOJUJEBLEBQBUEJSFLBN
)H TFEBOHLBO UFLBOBO DBJSBO JOUFSTUJTJBM HJOKBM ZBOH TFDBSB BLVSBU LFDVBMJ KJLB UFLBOBO LBQTVM TBOHBU NFOEFLBUJ
EJMBQPSLBOSBUBSBUBTFLJUBSNN)H+BEJ CJMBLJUBJOHBU UFLBOBOJOUFSTJUJTJBMZBOHTFTVOHHVIOZB
CBIXB UFLBOBO ZBOH NFOEFTBL LVMJU BEBMBI TBNB EFOHBO
UFLBOBO BUNPTGFS ZBOH EJBOHHBQ UFLBOBO OPM LJUB EBQBU
NFSVNVTLBO BUVSBO VNVN ZBOH NFOZBUBLBO CBIXB
Ringkasan—Nilai Rata-Rata untuk Tekanan Negatif Cairan
UFLBOBO DBJSBO JOUFSTUJTJBM OPSNBM CJBTBOZB CFCFSBQB Interstisial dalam Jaringan Longgar Subkutan. 8BMBVQVO
NJMJNFUFS BJS SBLTB MFCJI OFHBUJG EBSJQBEB UFLBOBO ZBOH CFSCBHBJ NFUPEF ZBOH EJUVOKVLLBO EJ BUBT NFNCFSJ IBTJM ZBOH
TFEJLJU CFSCFEB VOUVL UFLBOBO DBJSBO JOUFSTUJTJBM BLIJSBLIJS JOJ
NFOHFMJMJOHJUJBQKBSJOHBO
UFSEBQBU BOHHBQBO VNVN EJ BOUBSB QBSB BIMJ GBBM CBIXB UFLBOBO
Apakah Nilai Tekanan Cairan Interstisial yang DBJSBO JOUFSTUJTJBM ZBOH TFTVOHHVIOZB EBMBN KBSJOHBO MPOHHBS
Sesungguhnya di Jaringan Subkutan Longgar Lebih TVCLVUBOTFEJLJUMFCJISFOEBIEBSJQBEBUFLBOBOTVCBUNPTGFS SBUB
Rendah daripada Tekanan Atmosfer (Subatmosfer)? SBUBTFLJUBSoNN)H
,POTFQCBIXBUFLBOBODBJSBOJOUFSTUJTJBMEJCFCFSBQBKBSJOHBO
UVCVI CFSTJGBU TVCBUNPTGFS UFMBI MBNB EJBNBUJ NFMBMVJ Pemompaan oleh Sistem Limfatik adalah Dasar Penyebab
PCTFSWBTJ LMJOJT IBM JOJ UJEBL EBQBU EJUFSBOHLBO PMFI LPOTFQ Tekanan Negatif Cairan Interstisial
UFSEBIVMVZBOHNFOZBUBLBOCBIXBUFLBOBODBJSBOJOUFSTUJTJBM 4JTUFN MJNGBUJL BLBO EJCBIBT LFNVEJBO EBMBN CBC JOJ UFUBQJ LJUB
TFMBMV QPTJUJG #FCFSBQB QFOHBNBUBO ZBOH CFSLBJUBO BEBMBI QFSMVNFOHFSUJEJTJOJNFOHFOBJQFSBOEBTBSZBOHEJKBMBOLBOPMFI
TFCBHBJCFSJLVU TJTUFNJOJEBMBNNFOFOUVLBOUFLBOBODBJSBOJOUFSTUJTJBM4JTUFN
183
Unit IV Sirkulasi
MJNGBUJL BEBMBI TJTUFN TDBWFOHFS QFNCFSTJI

ZBOH NFO TVEVU QBOEBOH EJOBNJLB LBQJMFS EBO DBJSBO KBSJOHBO QSPUFJO
HFMVBSLBOLFMFCJIBODBJSBO LFMFCJIBONPMFLVMQSPUFJO EFCSJT QMBTNBZBOHQFOUJOHUFSVUBNBBEBMBIBMCVNJO
EBO CBIBO MBJO EBSJ SVBOH KBSJOHBO /PSNBMOZB LFUJLB DBJSBO
NFNBTVLJ LBQJMFS MJNGBUJL UFSNJOBM EJOEJOH QFNCVMVI MJNGF Tekanan Osmotik Koloid Cairan Interstisial
TFDBSB PUPNBUJT BLBO CFSLPOUSBLTJ TFMBNB CFCFSBQB EFUJL EBO 8BMBVQVO VLVSBO QPSJQPSJ LBQJMFS CJBTB MFCJI LFDJM EBSJQBEB
NFNPNQBDBJSBOLFEBMBNTJSLVMBTJEBSBI,FTFMVSVIBOQSPTFT VLVSBO NPMFLVM QSPUFJO QMBTNB IBM JOJ UJEBL CFSMBLV VOUVL
UFSTFCVU NFODJQUBLBO UFLBOBO OFHBUJG TFEJLJU ZBOH UFMBI TFNVB QPSJQPSJ 0MFI LBSFOB JUV TFKVNMBI LFDJM QSPUFJO QMBTNB
UFSVLVSEJSVBOHJOUFSTUJTJBM CPDPS NFMBMVJ QPSJQPSJ NBTVL LF EBMBN SVBOH JOUFSTUJTJBM
NFMBMVJQPSJEBOUSBOTJUPTJTQBEBWFTJLFMLFDJM
Tekanan Osmotik Koloid Plasma
+VNMBI UPUBM QSPUFJO EBMBN TFMVSVI MJUFS DBJSBO JOUFSTUJTJBM
Protein dalam Plasma Menyebabkan Tekanan Osmo-
UVCVI TFEJLJU MFCJI CFTBS EBSJQBEB KVNMBI UPUBM QSPUFJO EBMBN
tik Koloid. 1BEB #BC ZBOH NFNCBIBT EBTBS UFSCFOUVLOZB QMBTNB TFOEJSJ UFUBQJ LBSFOB WPMVNF JOJ FNQBU LBMJ MFCJI CFTBS
UFLBOBOPTNPUJL UFMBIEJUFLBOLBOCBIXBIBOZBNPMFLVMBUBV EBSJ WPMVNF QMBTNB LPOTFOUSBTJ QSPUFJO SBUBSBUB EBMBN DBJSBO
JPOZBOHUBLEBQBUNFMBMVJQPSJQPSJNFNCSBOTFNJQFSNFBCFM JOUFSTUJTJBM CJBTBOZB IBOZB QFSTFO EBSJ ZBOH UFSEBQBU EBMBN
ZBOH BLBO NFOJNCVMLBO UFLBOBO PTNPUJL 0MFI LBSFOB QMBTNB BUBV TFLJUBS HEM 4FDBSB LVBOUJUBUJG LJUB EBQBU NFMJIBU
QSPUFJO NFSVQBLBO TBUVTBUVOZB CBIBO UFSMBSVU EBMBN QMBTNB CBIXB UFLBOBO PTNPUJL LPMPJE SBUBSBUB DBJSBO JOUFSTUJTJBM VOUVL
EBO DBJSBO JOUFSTUJTJBM ZBOH UJEBL EBQBU NFMBMVJ QPSJQPSJ LPOTFOUSBTJQSPUFJOJOJBEBMBITFLJUBSNN)H
LBQJMFS EFOHBO NVEBI QSPUFJO QMBTNB EBO QSPUFJO DBJSBO
JOUFSTUJTJBM CFSUBOHHVOH KBXBC BUBT UFSCFOUVLOZB UFLBOBO Pertukaran Volume Cairan melalui Membran Kapiler
PTNPUJL QBEB LFEVB TJTJ NFNCSBO LBQJMFS 6OUVL NFNCFEB
LBOUFLBOBOPTNPUJLJOJEFOHBOUFLBOBOPTNPUJLZBOHUFSKBEJ 0MFI LBSFOB LJUB UFMBI NFNCBIBT CFSCBHBJ GBLUPS ZBOH
QBEB NFNCSBO TFM EJHVOBLBO JTUJMBI UFLBOBO PTNPUJL LPMPJE NFNFOHBSVIJ QFSHFSBLBO DBJSBO NFMBMVJ NFNCSBO LBQJMFS LJUB
BUBVUFLBOBOPOLPUJLMTUJMBIUFLBOBOPTNPUJLLPMPJECFSBTBM EBQBU NFOJOKBV TFMVSVI GBLUPS JOJ CFSTBNBTBNB VOUVL
EBSJ GBLUB CBIXB TVBUV MBSVUBO QSPUFJO NFOZFSVQBJ MBSVUBO NFOHFUBIVJDBSBZBOHEJHVOBLBOLBQJMFSVOUVLNFNQFSUBIBOLBO
LPMPJE XBMBVQVO QBEB LFOZBUBBOOZB MBSVUBO QSPUFJO UFSTFCVU EJTUSJCVTJ OPSNBM WPMVNF DBJSBO BOUBSB QMBTNB EBO DBJSBO
CFOBSCFOBSTVBUVMBSVUBONPMFLVM JOUFSTUJTJBM
5FLBOBO LBQJMFS SBUBSBUB EJ VKVOH BSUFSJ LBQJMFS CFTBSOZB
Nilai Normal untuk Tekanan Osmotik Koloid Plasma.
TBNQBJ NN )H MFCJI CFTBS EBSJ EJ VKVOH WFOB 0MFI LBSFOB
/JMBJ SBUBSBUB UFLBOBO PTNPUJL LPMPJE QBEB QMBTNB NBOVTJB
QFSCFEBBO JOJ DBJSBO NFSFNCFT LFMVBS EBSJ LBQJMFS QBEB VKVOH
OPSNBMLJSBLJSBNN)HNNEBSJOJMBJJOJEJUJNCVMLBO
BSUFSJOZB OBNVO EJ VKVOH WFOBOZB DBJSBO EJBCTPSQTJ LFNCBMJ LF
PMFIFGFLNPMFLVMFSEBOQSPUFJOZBOHMBSVUEBONNPMFIFGFL
EBMBN LBQJMFS +BEJ TFCFOBSOZB BEB TFKVNMBI LFDJM DBJSBO ZBOH
%POOBO ZBJUV UFLBOBO PTNPUJL UBNCBIBO ZBOH EJUJNCVMLBO
NFOHBMJS NFMBMVJ KBSJOHBO EBSJ VKVOH BSUFSJ LBQJMFS NFOVKV LF
PMFI OBUSJVN LBMJVN EBO LBUJPO MBJOOZB ZBOH EJUBIBO EJ
VKVOHWFOB%JOBNJLBBMJSBOJOJBEBMBITFCBHBJCFSJLVU
EBMBNQMBTNBPMFIQSPUFJO
Pengaruh Macam-Macam Protein Plasma terhadap Tekanan

Analisis Daya yang Menyebabkan Filtrasi di Ujung Arteria
Osmotik Koloid. 1SPUFJO QMBTNB NFSVQBLBO TVBUV DBNQVSBO Kapiler. %BZBSBUBSBUBZBOHCFLFSKBEJVKVOHBSUFSJLBQJMFSZBOH
NFOHBOEVOH BMCVNJO EFOHBO CFSBU NPMFLVM SBUBSBUB NFOZFCBCLBOQFSHFSBLBONFMBMVJNFNCSBOLBQJMFSEJQFSMJIBULBO
HMPCVMJO EBO GJCSJOPHFO +BEJ HSBN HMPCVMJO TFCBHBJCFSJLVU
IBOZB NFOHBOEVOH TFUFOHBI KVNMBI NPMFLVM HSBN BMCVNJO
EBO HSBN GJCSJOPHFO IBOZB NFOHBOEVOH TFQFSFOBN KVNMBI
mm Hg
NPMFLVM HSBN BMCVNJO *OHBU LFNCBMJ QFNCJDBSBBO UFOUBOH
UFLBOBO PTNPUJL QBEB #BC ZBOH NFOZBUBLBO CBIXB UFLBOBO Daya yang cenderung menggerakkan cairan ke luar:
PTNPUJL MFCJI EJUFOUVLBO PMFI KVNMBI NPMFLVM ZBOH MBSVU EBMBN Tekanan kapiler (ujung arteri kapiler) 30
DBJSBO EBSJQBEB PMFI NBTTB NPMFLVMOZB 0MFI LBSFOB JUV CJMB Tekanan negatif cairan bebas interstisial 3
EJLPSFLTJ NFOKBEJ KVNMBI NPMFLVM CVLBOOZB NBTTB CBHBO Tekanan osmotik koloid cairan interstisial 8
CFSJLVU NFODBOUVNLBO LPOTFOUSBTJ NBTTB SFMBUJG HEM
EBSJ TOTAL DAYA KE LUAR 41
CFSCBHBJ KFOJT QSPUFJO EBMBN QMBTNB OPSNBM EBO LPOUSJCVTJOZB Daya yang cenderung menggerakkan cairan ke dalam:
UFSIBEBQUFLBOBOPTNPUJLLPMPJEQMBTNBUPUBM *1
Tekanan osmotik koloid plasma 28
TOTAL DAYA KE DALAM 28
g/dl ’p (mm Hg)
Albumin 4.5 21.8 Jumlah daya di atas:
Globulin 2.5 6.0 Ke luar 41
Ke dalam 28
Fibrinogen 0.3 0.2 NETO DAYA KE LUAR (DI UJUNG ARTERI) 13
Total 7.3 28.0
+BEJ LJSBLJSB QFSTFO EBSJ UFLBOBO PTNPUJL LPMPJE UPUBM +BEJ QFOKVNMBIBO EBZB EJ VKVOH BSUFSJ LBQJMFS NFOVOKVLLBO
EBMBNQMBTNBCFSBTBMEBSJGSBLTJBMCVNJO QFSTFOEBSJHMPCVMJO TVBUV UFLBOBO GJMUSBTJ OFUP TFCFTBS NN )H ZBOH DFOEFSVOH
EBOIBNQJSUJEBLBEBEBSJGJCSJOPHFO0MFILBSFOBJUV EJMJIBUEBSJ NFOEPSPOHDBJSBOLFMVBSNFMBMVJQPSJQPSJLBQJMFS
184
Bab 16 Mikrosirkutasi dan Sistem Limfatik: Pertukaran Cairan Kapiler, Cairan Interstisial dan Aliran Life
5FLBOBO GJMUSBTJ TFCFTBS NN )H JOJ BLBO NFOZFCBCLBO mm Hg

OJMBJ SBUBSBUB TFLJUBS QMBTNB EJ EBMBN EBSBI ZBOH Daya rata-rata yang cenderung menggerakkan
NFOHBMJSVOUVLNFSFNCFTLFMVBSEBSJVKVOHBSUFSJLBQJMFSNBTVL cairan ke luar:
LFEBMBNSVBOHJOUFSTUJTJBMTFUJBQLBMJEBSBIMFXBUNFMBMVJLBQJMFS Tekanan kapiler rata-rata 17.3
UNIT IV
Tekanan negatif cairan bebas interstisial 3.0
Analisis Reabsorpsi di Ujung Vena Kapiler. 5FLBOBO Tekanan osmotik koloid cairan interstisial 8.0
EBSBIZBOHSFOEBIEJVKVOHWFOBLBQJMFSNFOHVCBILFTFJNCBOH TOTAL DAYA KE LUAR 28.3
BOEBZBEBZBZBOHNFNCBOUVBCTPSQTJTFQFSUJCFSJLVU Daya rata-rata yang cenderung menggerakkan
cairan ke dalam:
Tekanan osmotik koloid plasma 28.0
mm Hg TOTAL DAYA KE DALAM 28.0
Daya yang cenderung menggerakkan cairan ke dalam:
Tekanan osmotik koloid plasma 28 Penjumlahan daya rata-rata:
TOTAL DAYA KE DALAM 28 Ke luar 28.3
Ke dalam 28.0
Daya yang cenderung menggerakkan cairan ke luar: NETO DAYA KE LUAR 0.3
Tekanan kapiler (ujung arteri kapiler) 10
Tekanan negatif cairan bebas interstisial 3
Tekanan osmotik koloid cairan interstisial 8 LBO GJMUSBTJ DBJSBO LF EBMBN SVBOH JOUFSTUJTJBM TFEJLJU MFCJI
TOTAL DAYA KE LUAR 21 CBOZBLEBSJQBEBQSPTFTSFBCTPSQTJ4FEJLJULFMFCJIBOGJMUSBTJJOJ
Penjumlahan daya di atas EJTFCVU GJMUSBTJ CFSTJI OFU GJMUSBUJPO
EBO DBJSBO JOJMBI ZBOH
Ke dalam 28 IBSVT LFNCBMJ LF TJSLVMBTJ NFMBMVJ TJTUFN MJNGBUJL ,FDFQBUBO
Ke luar 21 OPSNBM EBSJ GJMUSBTJ CFSTJI EJ TFMVSVI UVCVI UJEBL UFSNBTVL
NETO DAYA KE DALAM 7 HJOKBM LJSBLJSBIBOZBNMNFOJU
Koefisien Filtrasi. 1BEB DPOUPI TFCFMVNOZB EBZB LFUJEBL
%FOHBOEFNJLJBO EBZBZBOHNFOZFCBCLBODBJSBOCFSHFSBLLF TFJNCBOHBOCFSTJISBUBSBUBQBEBNFNCSBOLBQJMFSTFCFTBS
EBMBN LBQJMFS ZBJUV NN )H MFCJI CFTBS EBSJQBEB EBZB ZBOH NN )H BLBO NFOZFCBCLBO UFSKBEJOZB GJMUSBTJ CFSTJI DBJSBO EJ
NFMBXBO SFBCTPSQTJ ZBLOJ NN )H 1FSCFEBBO NN )H TFMVSVI UVCVI TFCFTBS NMNFOJU #JMB LJUB OZBUBLBO OJMBJ JOJ
BEBMBIUFLBOBOSFBCTPSQTJOFUPQBEBVKVOHWFOBLBQJMFS5FLBOBO QFS NJMJNFUFS BJS SBLTB LJUB EBQBULBO LFDFQBUBO GJMUSBTJ CFSTJI
SFBCTPSQTJJOJMFCJILFDJMEBSJQBEBUFLBOBOGJMUSBTJEJVKVOHBSUFSJ TFCFTBS NMNFOJU DBJSBO QFS NN )H EJ TFMVSVI UVCVI
LBQJMFS UFUBQJ JOHBUMBI CBIXB LBQJMFS WFOB KVNMBIOZB MFCJI 1FSOZBUBBO JOJ EJTFCVU TFCBHBJ LPFGJTJFO GJMUSBTJ LBQJMFS TFMVSVI
CBOZBL EBO MFCJI QFSNFBCFM EBSJQBEB LBQJMFS BSUFSJ TFIJOHHB UVCVI
IBOZB EJCVUVILBO MFCJI TFEJLJU UFLBOBO SFBCTPSQTJ VOUVL EBQBU ,PFGJTJFOGJMUSBTJEBQBUKVHBEJOZBUBLBOVOUVLCBHJBOCBHJBO
NFOZFCBCLBOQFSHFSBLBODBJSBOLFSBIEBMBN UFSQJTBI EJ UVCVI EBMBN JTUJMBI MBKV GJMUSBTJ QFS NFOJU QFS NN
5FLBOBO SFBCTPSQTJ NFOZFCBCLBO TFLJUBS TFNCJMBO QFS )H QFS HSBN KBSJOHBO %BMBN IBM JOJ LPFGJTJFO GJMUSBTJ
TFQVMVIDBJSBOZBOHUFMBIEJGJMUSBTJLFMVBSEBSJVKVOHBSUFSJLBQJMFS KBSJOHBO SBUBSBUB BEBMBI TFLJUBS NM NFOJUNN )H H
EJBCTPSQTJLFNCBMJEJVKVOHWFOB4FQFSTFQVMVITJTBOZBNFOHBMJS KBSJOHBO /BNVO BLJCBU QFSCFEBBO ZBOH FLTUSFN QBEB
LFEBMBNQFNCVMVIMJNGFEBOLFNCBMJLFEBSBIZBOHCFSTJSLVMBTJ QFSNFBCJMJUBT TJTUFN LBQJMFS EJ CFSCBHBJ KBSJOHBO LPFGJTJFO JOJ
CFSWBSJBTJMFCJIEBSJLBMJMJQBUBOUBSKBSJOHBOZBOHCFSCFEB
Keseimbangan Starling bagi Pertukaran melalui Kapiler CFEB ,PFGJTJFO JOJ TBOHBU LFDJM EJ EBMBN PUBL EBO PUPU DVLVQ
CFTBS EJ KBSJOHBO TVCMDVUBO CFTBS EJ VTVT EBO TBOHBU CFTBS EJ
-FCJI EBSJ TBUV BCBE ZBOH MBMV &SOFTU ) 4UBSMJOH NFOZBUBLBO
IBUJ EBO HMPNFSVMVT HJOKBM ZBOH NFNQVOZBJ CBOZBL QPSJQPSJ
CBIXB QBEB LPOEJTJ OPSNBM UFSEBQBU TVBUV LFBEBBO NFOEFLBUJ
BUBVQPSJQPSJZBOHUFSCVLBMFCBS%FOHBODBSBZBOHTBNB EBZB
LFTFJNCBOHBO EJ NFNCSBO LBQJMFS TFCBHJBO CFTBS LBQJMFS ZBJUV
UFNCVTQSPUFJONFMBMVJNFNCSBOLBQJMFSKVHBTBOHBUCFSWBSJBTJ
KVNMBI DBJSBO ZBOH EJGJMUSBTJ LFMVBS EBSJ VKVOH BSUFSJ CFCFSBQB
,POTFOUSBTJ QSPUFJO EJ EBMBN DBJSBO JOUFSTUJTJBM PUPU LJSBLJSB
LBQJMFS IBNQJS TFUBSB EFOHBO KVNMBI DBJSBO ZBOH LFNCBMJ LF
HEMEJEBMBNKBSJOHBOTVCLVUBOHEMEJEBMBNVTVTH
TJSLVMBTJNFMBMVJQSPTFTBCTPSQTJ4FEJLJULFUJEBLTFJNCBOHBOZBOH
EMEBOEJEBMBNIBUJHEM
UFSKBEJ NFSVQBLBO TFKVNMBI LFDJM DBJSBO ZBOH QBEB BLIJSOZB
EJLFNCBMJLBOLFTJSLVMBTJNFMBMVJTJTUFNMJNGBUJL
Pengaruh Ketidakseimbangan Daya Abnormal di
#BHBOCFSJLVUNFNQFSMJIBULBOQSJOTJQQSJOTJQLFTFJNCBOHBO Membran Kapiler
4UBSMJOH1BEBCBHBOJOJ UFLBOBOEBMBNLBQJMFSBSUFSJEBOLBQJMFS
#JMB UFLBOBO LBQJMFS SBUBSBUB NFOJOHLBU EJ BUBT NN )H
WFOB UFMBI EJSBUBSBUBLBO NFOKBEJ UFLBOBO LBQJMFS GVOHTJPOBM
EBZB OFUP ZBOH DFOEFSVOH NFOZFCBCLBO GJMUSBTJ DBJSBO LF
SBUBSBUB/JMBJJOJUFMBIEJIJUVOH CFTBSOZB NN)H
EBMBN SVBOH KBSJOHBO BLBO NFOJOHLBU +BEJ LFOBJLBO UFLBOBO
+BEJ VOUVL TJSLVMBTJ LBQJMFS UPUBM LJUB KVNQBJ TVBUV LFBEBBO LBQJMFSSBUBSBUBTFCFTBSNN)HNFOZFCBCLBOQFOJOHLBUBO
ZBOH NFOEFLBUJ LFTFJNCBOHBO BOUBSB UPUBM EBZB LFMVBS TFCFTBS UFLBOBO GJMUSBTJ OFUP EBSJ NN )H NFOKBEJ NN )H
NN )H EBO UPUBM EBZB LF EBMBN TFCFTBS NN )H NFOHIBTJMLBOGJMUSBTJOFUPDBJSBOLFEBMBNSVBOHJOUFSTUJTJBM
4FEJLJUEBZBLFUJEBLTFJNCBOHBOJOJ ZBJUV NN)H NFOZFCBC LBMJMFCJICFTBSEJCBOEJOHLBOLFBEBBOOPSNBM6OUVLNFO
185
Unit IV Sirkulasi
DFHBI BLVNVMBTJ DBJSBO CFSMFCJIBO EJ EBMBN SVBOH UFSTFCVU Saluran Limfe Tubuh
EJCVUVILBOLBMJBMJSBODBJSBOOPSNBMLFEBMBNTJTUFNMJNGF
)BNQJSTFMVSVIKBSJOHBOUVCVINFNQVOZBJTBMVSBOMJNGF
TVBUV KVNMBI ZBOH CFTBSOZB TBNQBJ LBMJ UFSMBMV CBOZBL
LIVTVT ZBOH NFOHBMJSLBO LFMFCJIBO DBJSBO TFDBSB
VOUVL EJBOHLVU PMFI TBMVSBO MJNGF "LJCBUOZB DBJSBO BLBO
MBOHTVOH EBSJ SVBOH JOUFSTUJTJBM #FCFSBQB QFOHFDVBMJBO
NVMBJNFOVNQVLEJEBMBNSVBOHJOUFSTUJTJBMEBONFOJNCVMLBO
BOUBSB MBJO CBHJBO QFSNVLBBO LVMJU TJTUFN TBSBG QVTBU
FEFNB
FOEPNJTJVN PUPU EBO UVMBOH /BNVO CBILBO KBSJOHBO
4FCBMJLOZB CJMBUFLBOBOLBQJMFSUVSVOTBOHBUSFOEBI UFSKBEJ KBSJOHBO UFSTFCVU NFNQVOZBJ QFNCVMVI JOUFSTUJTJBM LFDJM
SFBCTPSQTJ OFUP DBJSBO LF EBMBN LBQJMFS TFCBHBJ QFOHHBOUJ EJTFCVU TBMVSBO QSBMJNGBUJL ZBOH EBQBU EJBMJSJ PMFI DBJSBO
GJMUSBTJ OFUP EBO WPMVNF EBSBI BLBO NFOJOHLBU LBSFOB
JOUFSTUJTJBM QBEB BLIJSOZB DBJSBO JOJ NFOHBMJS LF EBMBN
QFOHFMVBSBOWPMVNFDBJSBOJOUFSTUJTJBM&GFLLFUJEBLTFJNCBOHBO
QFNCVMVIMJNGFBUBV QBEBPUBL NFOHBMJSLFEBMBNDBJSBO
EJ NFNCSBO LBQJMFS EBMBN IVCVOHBOOZB EFOHBO CFSCBHBJ
TFSFCSPTQJOBM EBO LFNVEJBO MBOHTVOH LFNCBMJ LF EBMBN
CFOUVLFEFNBBLBOEJCJDBSBLBOEJ#BC
EBSBI
1BEBEBTBSOZBTFMVSVIQFNCVMVIMJNGFEBSJCBHJBOCBXBI
Sistem Limfatik UVCVI QBEB BLIJSOZB BLBO CFSNVBSB LF EVLUVT UPSBLTJLVT
ZBOHTFMBOKVUOZBCFSNVBSBLFEBMBNTJTUFNEBSBIWFOBQBEB
4JTUFNMJNGBUJLNFSVQBLBOTVBUVKBMVSUBNCBIBOUFNQBUDBJSBO QFSUFNVBO BOUBSB WFOB KVHVMBSJT JOUFSOB LJSJ EBO WFOB
EBQBUNFOHBMJSEBSJSVBOHJOUFSTUJTJBMLFEBMBNEBSBI)BMZBOH TVCLMBWJBLJSJ TFQFSUJZBOHEJJMVTUSBTJLBOQBEB(BNCBS
UFSQFOUJOH TJTUFN MJNGBUJL EBQBU NFOHBOHLVU QSPUFJO EBO [BU
$BJSBOMJNGFEBSJTJTJLJSJLFQBMB MFOHBOLJSJ EBOTFCBHJBO
[BU CFSQBSUJLFM CFTBS LFMVBS EBSJ SVBOH KBSJOHBO ZBOH UJEBL
EBFSBI UPSBLT KVHB NFNBTVLJ EVLUVT UPSBLTJLVT TFCFMVN
EBQBU EJQJOEBILBO EFOHBO QSPTFT BCTPSQTJ MBOHTVOH LF EBMBN
CFSNVBSBLFEBMBNWFOB
LBQJMFSEBSBI1FOHFNCBMJBOQSPUFJOLFEBMBNEBSBIEBOSVBOH
$BJSBO MJNGF EBSJ TJTJ LBOBO MFIFS EBO LFQBMB MFOHBO
JOUFSTUJTJBM JOJ NFSVQBLBO GVOHTJ QFOUJOH EBO UBOQB BEBOZB
LBOBO EBOCBHJBOLBOBOUPSBLTNFNBTVLJEVLUVTMJNGBUJLVT
GVOHTJUFSTFCVU LJUBBLBONFOJOHHBMEBMBNXBLUVKBN
LBOBO KBVI MFCJI LFDJM EBSJQBEB EVLUVT UPSBLTJLVT
ZBOH
BLBOCFSNVBSBLFEBMBNTJTUFNEBSBIWFOBQBEBQFSUFNVBO
BOUBSBWFOBTVCLMBWJBLBOBOEBOWFOBKVHVMBSJTJOUFSOB
Gambar 16-7 Sistem limfatik.
186
Bab 16 Mikrosirkulasi dan Sistem Limfatik: Pertukaran Cairan Kapiler, Cairan InterstisiaL dan Abran Limfe
Kapiler Limfe Terminal dan Permeabilitasnya. 4FCBHJBO IFQBS DBJSBO MJNGF ZBOH UFSCFOUVL NFNQVOZBJ LPOTFOUSBTJ
CFTBS DBJSBO ZBOH NFSFNCFT EBSJ VKVOH BSUFSJ LBQJMFS EBSBI QSPUFJOTFUJOHHJHEM EBODBJSBOMJNGFZBOHEJCFOUVLEJVTVT
NFOHBMJS EJ BOUBSB TFMTFM EBO BLIJSOZB EJSFBCTPSQTJ LFNCBMJ LF NFNJMJLJ LPOTFOUSBTJ QSPUFJO TFUJOHHJ TBNQBJ HEM 0MFI
EBMBN VKVOH WFOB EBSJ LBQJMFS EBSBI UFUBQJ SBUBSBUB TFLJUBS LBSFOB LVSBOH MFCJI EVB QFSUJHB EBSJ TFMVSVI DBJSBO MJNGF
UNIT IV
TFQFSTFQVMVI DBJSBO UFSTFCVU NBMBI NFNBTVLJ LBQJMFS MJNGF EBO OPSNBMOZB CFSBTBM EBSJ IBUJ EBO VTVT DBJSBO MJNGF EVLUVT
LFNCBMJ LF EBSBI NFMBMVJ TJTUFN MJNGBUJL EBO CVLBO NFMBMVJ UPSBLTJLVT ZBOH NFSVQBLBO DBNQVSBO DBJSBO MJNGF EBSJ
LBQJMFSWFOB+VNMBIUPUBMDBJSBOMJNGFZBOHLFNCBMJJOJOPSNBM TFMVSVI UVCVI CJBTBOZB NFNQVOZBJ LPOTFOUSBTJ QSPUFJO
OZBIBOZBTBNQBJ-IBSJ TBNQBMHEM
$BJSBOZBOHLFNCBMJLFTJSLVMBTJNFMBMVJTJTUFNMJNGBUJLTBOHBU 4JTUFN MJNGBUJL KVHB NFSVQBLBO TBMBI TBUV KBMVS VUBNB
QFOUJOH LBSFOB [BU[BU EFOHBO CFSBU NPMFLVM UJOHHJ TFQFSUJ VOUVL BCTPSQTJ [BU OVUSJTJ EBO TBMVSBO DFSOB UFSVUBNB VOUVL
QSPUFJO UJEBL EBQBU EJBCTPSQTJ EFOHBO DBSB MBJO NFTLJQVO BCTPSQTJIBNQJSTFNVBMFNBLUVCVI ZBOHBLBOEJCJDBSBLBOEJ
QSPUFJO UFSTFCVU EBQBU NFNBTVLJ LBQJMFS MJNGF IBNQJS UBOQB #BC .BMBIBO TFUFMBI NFOZBOUBQ NBLBOBO CFSMFNBL
IBNCBUBO 1FOZFCBC IBM UFSTFCVU JBMBI BEBOZB TUSVLUVS LIVTVT DBJSBO MJNGF EJ EBMBN EVLUVT UPSBLTJLVT LBEBOHLBEBOH
QBEBLBQJMFSMJNGF TFQFSUJZBOHEJJMVTUSBTJLBOQBEB(BNCBS NFOHBOEVOHTBNQBJQFSTFOMFNBL
(BNCBS JOJ NFNQFSMJIBULBO TFMTFM FOEPUFM LBQJMFS MJNGF ZBOH "LIJSOZB CBILBO QBSUJLFMQBSUJLFM CFTBS TFQFSUJ CBLUFSJ
EJSFLBULBO PMFI GJMBNFO QFOBNCBU LF KBSJOHBO JLBU TFLJUBSOZB EBQBUNFNBTVLJTBMVSBOMJNGFEJBOUBSBTFMTFMFOEPUFMLBQJMFS
1BEBQFSUBVUBOBOUBSTFMTFMFOEPUFMZBOHCFSTFCFMBIBO UFQJEBSJ MJNGFEBOEFOHBODBSBUFSTFCVU NBTVLLFDBJSBOMJNGF,FUJLB
TBUVTFMFOEPUFMNFOVUVQJUFQJTFMEJTFCFMBIOZB TFEFNJLJBOSVQB DBJSBO MJNGF NFMFXBUJ LFMFOKBS MJNGF QBSUJLFMQBSUJLFM JOJ
TFIJOHHB UFQJ ZBOH NFOVUVQJ UFSTFCVU CFCBT NFOVUVQ LF EBMBN IBNQJS TFMVSVIOZB BLBO EJLFMVBSLBO EBO EJIBODVSLBO ZBOH
NFNCFOUVL TVBUV LBUVQ LFDJM ZBOH NFNCVLB LF CBHJBO EBMBN BLBOEJCJDBSBLBOEJ#BC
LBQJMFS MJNGF $BJSBO JOUFSTUJTJBM CFSTBNB EFOHBO QBSUJLFM
UFSTVTQFOTJOZB EBQBU NFOEPSPOH LBUVQ VOUVL NFNCVLB EBO
Kecepatan Aliran Limfe
NFOHBMJS MBOHTVOH LF EBMBN LBQJMFS MJNGF 5FUBQJ DBJSBO JOJ TVMJU $BJSBOMJNGFNFOHBMJSLJSBLJSBNMQFSKBN NFMBMVJEVLUVT
VOUVL NFOJOHHBMLBO LBQJMFS CFHJUV TVEBI NBTVL LBSFOB TFUJBQ UPSBLTJLVT QBEB PSBOH ZBOH TFEBOH CFSJTUJSBIBU EBO LJSBLJSB
BMJSBO CBMJL BLBO NFOVUVQ LBUVQ +BEJ TJTUFN MJNGBUJL NFN NM MBJOOZB UJBQ KBN NFOHBMJS LF EBMBN TJSLVMBTJ NFMBMVJ
QVOZBJ LBUVQ EJ CBHJBO QBMJOH VKVOH EBSJ LBQJMFS MJNGF UFSNJOBM TBMVSBO MBJO TFIJOHHB NFNCVBU QFSLJSBBO UPUBM BMJSBO MJNGF
EBO NFNQVOZBJ LBUVQ EJ TFQBOKBOH QFNCVMVI MJNGF ZBOH TFLJUBSNMKBN BUBVTBNQBJ-IBSJ
CFSVLVSBO MFCJI CFTBS TBNQBJ QBEB UJUJL UFNQBU TJTUFN UFSTFCVU
CFSNVBSBLFEBMBNTJSLVMBTJEBSBI Pengaruh Tekanan Cairan Interstisial terhadap Aliran
Cairan Limfe. (BNCBS NFNQFSMJIBULBO FGFL CFSCBHBJ
Pembentukan Cairan Limfe OJMBJ UFLBOBO DBJSBO JOUFSTUJTJBM UFSIBEBQ BMJSBO MJNGF TFQFSUJ
ZBOH EJVLVS QBEB UVOHLBJ TFFLPS BOKJOH 1FSIBUJLBO CBIXB
$BJSBO MJNGF CFSBTBM EBSJ DBJSBO JOUFSTUJTJBM ZBOH NFOHBMJS LF BMJSBOMJNGFOPSNBMTBOHBULFDJMQBEBUFLBOBODBJSBOJOUFSTUJTJBM
EBMBN TJTUFN MJNGBUJL 0MFI LBSFOB JUV DBJSBO MJNGF ZBOH ZBOHMFCJIOFHBUJGEBSJOJMBJOPSNBMZBOHCFTBSOZBNN)H
NFNBTVLJ QFNCVMVI MJNGF UFSNJOBM NFNQVOZBJ LPNQPTJTJ ,FNVEJBO LFUJLB UFLBOBO NFOJOHLBU TBNQBJ NN )H
IBNQJSTBNBEFOHBOLPNQPTJTJDBJSBOJOUFSTUJTJBM UFLBOBOBUNPTGFS
KVNMBIBMJSBOBLBONFOJOHLBUMFCJIEBSJ
,POTFOUSBTJQSPUFJOEBMBNDBJSBOJOUFSTUJTJBMEJTFCBHJBOCFTBS LBMJMJQBU0MFILBSFOBJUV GBLUPSBQBQVOZBOHNFOJOHLBULBO
KBSJOHBO SBUBSBUB TFLJUBS HEM EBO LPOTFOUSBTJ QSPUFJO DBJSBO
MJNGFZBOHNFOHBMJSEBSJKBSJOHBOUFSTFCVUNFOEFLBUJOJMBJJOJ%J
2
mm Hg mm Hg
1
6 4 2 0 2 4
PT (mm Hg)
187
Unit IV Sirkulasi
UFLBOBODBJSBOJOUFSTUJTJBMBLBOKVHBNFOJOHLBULBOBMJSBOMJNGF MJNGF CFSJLVUOZB )BM UFSTFCVU BLBO NFOHJTJ TFHNFO CFSJLVUOZB

KJLB QFNCVMVI MJNGF CFSGVOHTJ TFDBSB OPSNBM 'BLUPSGBLUPS EBOCFCFSBQBEFUJLLFNVEJBO TFHNFOUFSTFCVUKVHBCFSLPOUSBLTJ
UFSTFCVUNFMJQVUJ QSPTFT JOJ CFSMBOKVU UFSVT EJ TFQBOKBOH QFNCVMVI MJNGF TBNQBJ
t DBJSBO MJNGF UFSTFCVU CFSNVBSB LF EBMBN TJSLVMBTJ EBSBI 1BEB
1FOJOHLBUBOUFLBOBOIJESPTUBUJLLBQJMFS
QFNCVMVI MJNGF ZBOH TBOHBU CFTBS TFQFSUJ EVLUVT UPSBLTJLVT
t 1FOVSVOBOUFLBOBOPTNPUJLLPMPJEQMBTNB QPNQB MJNGF JOJ EBQBU NFOHIBTJMLBO UFLBOBO TFCFTBS TBNQBJ
t 1FOJOHLBUBOUFLBOBOPTNPUJLLPMPJEDBJSBOJOUFSTUJTJBM NN)H
t 1FOJOHLBUBOQFSNFBCJMJUBTLBQJMFS Pemompaan yang Disebabkan oleh Kompresi Intermiten
4FNVB GBLUPS JOJ NFOZFCBCLBO UFSKBEJOZB TVBUV JNCBOHBO Eksternal pada Sistem Limfatik. 4FMBJO QFNPNQBBO ZBOH
QFSUVLBSBODBJSBOEJNFNCSBOLBQJMFSEBSBIVOUVLNFNCBOUV EJTFCBCLBO PMFI LPOUSBLTJ JOUSJOTJL EJOEJOH QFNCVMVI MJNGF
QFSHFSBLBO DBJSBO LF EBMBN JOUFSTUJTJVN ZBOH BLBO NFOJOH GBLUPSMVBSZBOHTFDBSBJOUFSNJUFONFOFLBOQFNCVMVIMJNGFKVHB
LBULBO WPMVNF DBJSBO JOUFSTUJTJBM UFLBOBO DBJSBO JOUFSTUJTJBM EBQBU NFOZFCBCLBO QFNPNQBBO .FOVSVU VSVUBO BSUJ QFOUJOH
EBOBMJSBOMJNGFQBEBTBBUCFSTBNBBO OZB GBLUPSGBLUPSUFSTFCVUBEBMBI
/BNVO QFSIBUJLBO QBEB (BNCBS LFUJLB UFLBOBO t ,POUSBLTJPUPUSBOHLBEJTFLJUBSTBMVSBOMJNGF
DBJSBO JOUFSTUJTJBM NFOKBEJ BUBV NN )H MFCJI CFTBS EBSJ t 1FSHFSBLBOCBHJBOCBHJBOUVCVI
UFLBOBO BUNPTGFS NN )H
BMJSBO MJNGF UJEBL EBQBU
NFOJOHLBUMFCJIMBOKVUQBEBOJMBJUFLBOBOMFCJIUJOHHJ)BMNJ t 1VMTBTJBSUFSJZBOHCFSEFLBUBOEFOHBOTBMVSBOMJNGF
UFSKBEJ LBSFOB QFOJOHLBUBO UFLBOBO KBSJOHBO UJEBL IBOZB t 1FOFLBOBOKBSJOHBOPMFICFOEBCFOEBEJMVBSUVCVI
NFOJOHLBULBOQFNBTVLBODBJSBOLFEBMBNLBQJMFSMJNGF UFUBQJ 1PNQB MJNGF NFOKBEJ TBOHBU BLUJG TFMBNB CFSPMBISBHB ZBOH
KVHB BLBO NFOFLBO TJTJ MVBS QFSNVLBBO TBMVSBO MJNGF ZBOH TFSJOH NFOJOHLBULBO BMJSBO MJNGF TBNQBJ LBMJ MJQBU
CFSVLVSBO MFCJI CFTBS TFIJOHHB BMJSBO MJNGF NFOKBEJ 4FCBMJLOZB EBMBN LFBEBBO JTUJSBIBU BMJSBO MJNGF NFOKBEJ TBOHBU
UFSIBNCBU1BEBOJMBJUFLBOBOMFCJIUJOHHJ EVBGBLUPSUFSTFCVU MBNCBU IBNQJSUBLBEBTBNBTFLBMJ
TBMJOH NFOHJNCBOHJ TBUV TBNB MBJO IBNQJS TFDBSB UFQBU
TFIJOHHB BMJSBO MJNGF TBNQBJ QBEB UBIBQ ZBOH EJTFCVU Pompa Kapiler Limfe. ,BQJMFS MJNGF UFSNJOBM KVHB NBNQV
LFDFQBUBONBLTJNVNBMJSBOMJNGF,FDFQBUBONBLTJNVNJOJ NFNPNQBDBJSBOMJNGF TFMBJOQFNPNQBBOMJNGFPMFIQFNCVMVI
EJMVLJTLBOTFCBHBJHBSJTNFOEBUBS QMBUFBV
QBEB(BNCBS MJNGF CFTBS 4FQFSUJ UFMBI EJKFMBTLBO MFCJI BXBM EBMBN CBC JOJ
EJOEJOHLBQJMFSMJNGFNFMFLBUFSBUQBEBTFMTFMKBSJOHBOTFLJUBSOZB
Pompa Limfe Meningkatkan Aliran Cairan Limfe. NFMBMVJ GJMBNFOGJMBNFO QFOBNCBUOZB 0MFI LBSFOB JUV TFUJBQ
,BUVQLBUVQ UFSEBQBU EJ TFMVSVI TBMVSBO MJNGF LBUVQLBUVQ LBMJ LFMFCJIBO DBJSBO NFNBTVLJ KBSJOHBO EBO NFOZFCBCLBO
LIBT EJJMVTUSBTJLBO QBEB (BNCBS ZBOH UFSEBQBU EJ KBSJOHBO NFNCFOHLBL GJMBNFO QFOBNCBU BLBO NFOBSJL LBQJMFS
TBMVSBO MJNGF QFOHVNQVM UFNQBU CFSNVBSBOZB LBQJMFSLBQJMFS MJNGF EBO DBJSBO BLBO NFOHBMJS LF EBMBN LBQJMFS MJNGF
MJNGF UFSNJOBM NFMBMVJ QFSUBVUBO EJ BOUBSB TFMTFM FOEPUFM ,FNVEJBO
(BNCBS IJEVQ ZBOH EJBNCJM EBSJ QFNCVMVI MJNGF ZBOH LFUJLBKBSJOHBOUFSUFLBO UFLBOBOEJEBMBNLBQJMFSNFOJOHLBUEBO
UFSCVLB CBJL QBEB NBOVTJB NBVQVO QBEB CJOBUBOH NFOZFCBCLBOUFQJUFQJTFMFOEPUFMZBOHUVNQBOHUJOEJINFOVUVQ
NFNQFSMJIBULBO CBIXB LFUJLB TBMVSBO MJNGF QFOHVNQVM BUBV TFQFSUJ LBUVQ 0MFI LBSFOB JUV UFLBOBO BLBO NFOEPSPOH DBJSBO
QFNCVMVI MJNGF CFSVLVSBO MFCJI CFTBS EJSFHBOHLBO PMFI MJNGF NBTVL LF EBMBN TBMVSBO MJNGF QFOHVNQVM EBO CVLBO
DBJSBO PUPU QPMPT QBEB EJOEJOH QFNCVMVI UFSTFCVU BLBO CFSHFSBLNVOEVSNFMBMVJQFSUBVUBOTFM
CFSLPOUSBLTJ TFDBSB PUPNBUJT 4FMBOKVUOZB TFUJBQ TFHNFO 4FMTFM FOEPUFM LBQJMFS MJNGF KVHB NFOHBOEVOH CFCFSBQB
QFNCVMVI MJNGF EJ BOUBSB LBUVQ BLBO CFSGVOHTJ TFCBHBJ TVBUV GJMBNFO LPOUSBLUJM BLUPNJPTJO %J CFCFSBQB KBSJOHBO IFXBO
QPNQBPUPNBUJTUFSTFOEJSJ:BJUV QFOHJTJBOTVBUVTFHNFOBLBO DPOUPIOZB TBZBQ LFMFMBXBS
GJMBNFO BLUPNJPTJO JOJ EJBNBUJ
BLBONFOZFCBCLBOLPOUSBLTJTFHNFOUFSTFCVU EBODBJSBOBLBO EBQBU NFOJNCVMLBO LPOUSBLTJ SJUNJT LBQJMFS MJNGF EFOHBO DBSB
EJQPNQBNFMBMVJLBUVQCFSJLVUOZBLFEBMBNTFHNFOQFNCVMVI TBNBZBJUVCBOZBLQFNCVMVIEBSBILFDJMEBOQFNCVMVIMJNGF
188
CFSLPOUSBLTJ TFDBSB SJUNJT 0MFI LBSFOB JUV TFCBHJBO LFDJM EBSJ 0MFI LBSFOB JUV OJMBJ LVBOUJUBUJG EBSJ TFNVB GBLUPS JOJ BLBO
QFNPNQBBO MJNGF EBQBU EJTFCBCLBO PMFI LPOUSBLTJ TFM FOEPUFM NFODBQBJ LFBEBBO ZBOH NBOUBQ GBLUPSGBLUPS UFSTFCVU BLBO
LBQJMFSMJNGFTFMBJOLPOUSBLTJPUPUTBMVSBOMJNGFCFSVLVSBOMFCJI UFUBQ TFJNCBOH QBEB OJMBJ JOJ TBNQBJ UFSKBEJ QFSVCBIBO QBEB
CFTBS LFDFQBUBOCPDPSOZBQSPUFJOEBODBJSBOEBSJLBQJMFSEBSBI
UNIT IV
Ringkasan Faktor-Faktor yang Menentukan Aliran Limfe. Arti PentingTekanan Negatif Cairan Interstisial sebagai
#FSEBTBSLBO QFNCJDBSBBO TFCFMVNOZB LJUB EBQBU NFOHFUBIVJ Suatu Cara untuk Menjaga Kesatuan Jaringan Tubuh
CBIXB EVB GBLUPS VUBNB ZBOH NFOFOUVLBO BMJSBO MJNGF BEBMBI 4FKBL EVMV UFMBI EJBOHHBQ CBIXB CFSCBHBJ KBSJOHBO UVCVI

UFLBOBO DBJSBO JOUFSTUJTJBM EBO
BLUJWJUBT QPNQB MJNGF CFSCFEB EJTBUVLBO PMFI TFSBU KBSJOHBO JLBU /BNVO EJ CBOZBL
0MFILBSFOBJUV EBQBUEJLBUBLBOCBIXBTFDBSBLBTBS LFDFQBUBO UFNQBU EBMBN UVCVI TFSBU KBSJOHBO JLBU UFSTFCVU TBOHBU MFNBI
BMJSBO MJNGF EJUFOUVLBO PMFI IBTJM QFSLBMJBO UFLBOBO DBJSBO BUBV CBILBO UJEBL BEB )BM JOJ UFSKBEJ LIVTVTOZB EJ TFKVNMBI
JOUFSTUJTJBMEFOHBOBLUJWJUBTQPNQBMJNGF BSFB UFNQBU KBSJOHBO UFSTFCVU TBMJOH NFOVUVQJ TBUV TBNB MBJO
TFQFSUJ LVMJU ZBOH NFOVUVQJ QVOHHVOH UBOHBO BUBV LVMJU ZBOH
Peran Sistem Limfatik dalam Mengatur Konsentrasi
NFOZFMJNVUJ XBKBI /BNVO CBILBO QBEB UFNQBUUFNQBU JOJ
Protein Cairan Interstisial, Volume Cairan Interstisial, dan
KBSJOHBOKBSJOHBO EJQFSTBUVLBO PMFI UFLBOBO OFHBUJG DBJSBO
Tekanan Cairan Interstisial
JOUFSTUJTJBM ZBOH TFCFOBSOZB NFSVQBLBO SVBOH IBNQB QBSTJBM
4VEBIKFMBTCBIXBTJTUFNMJNGBUJLCFSGVOHTJTFCBHBJNFLBOJTNF #JMB KBSJOHBO UFSTFCVU LFIJMBOHBO UFLBOBO OFHBUJGOZB DBJSBO
VOUVL LFMFCJIBO BMJSBO PWFSGMPX NFDIBOJTN
VOUVL NFO BLBO UFSBLVNVMBTJ EBMBN SVBOH UFSTFCVU EBO LFBEBBO JOJ
HFNCBMJLBO LFMFCJIBO QSPUFJO EBO LFMFCJIBO WPMVNF DBJSBO LF EJLFOBM TFCBHBJ UJNCVMOZB FEFNB )BM JOJ BLBO EJCBIBT EJ #BC
TJSLVMBTJ EBSJ SVBOH KBSJOHBO 0MFI LBSFOB JUV TJTUFN MJNGBUJL
KVHB NFNJMJLJ QFSBO TFOUSBM EBMBN NFOHBUVS
LPOTFOUSBTJ
QSPUFJO EBMBN DBJSBO JOUFSTUJTJBM
WPMVNF DBJSBO JOUFSTUJTJBM
EBO
UFLBOBODBJSBO JOUFSTUJTJBM.BSJ LJUBCBIBT DBSB GBLUPS
GBLUPSJOJCFSJOUFSBLTJ Daftar Pustaka
1FSUBNB JOHBUMBI CBIXB TFKVNMBI LFDJM QSPUFJO UFSVT LFMVBS Dejana E: Endothelial junctions: happy together, Nat Rev Mol Cell
EBSJLBQJMFSEBSBINBTVLLFEBMBNJOUFSTUJTJVN)BOZBTFKVNMBI Biol 5:261, 2004.
LFDJM QSPUFJO ZBOH CPDPS KJLB BEB LFNCBMJ LF TJSLVMBTJ NFMBMVJ Gashev AA: Physiologic aspects of lymphatic contractile function: current
perspectives, Ann N Y Acad Sci 979:178, 2002.
VKVOHVKVOH WFOB EBSJ LBQJMFS EBSBI 0MFI LBSFOB JUV QSPUFJO
Gratton JP, Bernatchez P, Sessa WC: Caveolae and caveolins in the
QSPUFJO JOJ DFOEFSVOH CFSBLVNVMBTJ EJ DBJSBO JOUFSTUJTJBM EBO cardiovascular system, Circ Res 94:1408, 2004.
IBM JOJ LFNVEJBO BLBO NFOJOHLBULBO UFLBOBO PTNPUJL LPMPJE Guyton AC: Concept of negative interstitial pressure based on pressures in
DBJSBOJOUFSTUJTJBM implanted perforated capsules, Circ Res 12:399, 1963.
Guyton AC: Interstitial fluid pressure: II. Pressure-volume curves of
,FEVB QFOJOHLBUBO UFLBOBO PTNPUJL LPMPJE EBMBN DBJSBO
interstitial space, Circ Res 16:452, 1965.
JOUFSTUJTJBM BLBO NFHHFTFS LFTFJNCBOHBO EBZB QBEB NFNCSBO Guyton AC, Granger HJ, Taylor AE: Interstitial fluid pressure, Physiol Rev
LBQJMFS EBSBI EBMBN NFNCBOUV GJMUSBTJ DBJSBO LF EBMBN JOUFS 51:527, 1971.
TUJTJVN0MFILBSFOBJUV DBJSBOCFSUVLBSUFNQBUTFDBSBPTNPTJT Michel CC, Curry FE: Microvascular permeability, Physiol Rev 79:703, 1999.
LFMVBS NFMBMVJ EJOEJOH LBQJMFS NBTVL LF EBMBN JOUFSTUJTJVN Mehta D, Malik AB: Signaling mechanisms regulating endothelial permeability,
Physiol Rev 86:279, 2006.
BLJCBU QSPUFJO TFIJOHHB NFOJOHLBULBO WPMVNF DBJSBO JOUFS
Miyasaka M, Tanaka T: Lymphocyte trafficking across high endothelial
TUJTJBMEBOUFLBOBODBJSBOJOUFSTJUJTJBM venules: dogmas and enigmas, Nat Rev Immunol 4:360, 2004.
,FUJHB QFOJOHLBUBO UFLBOBO DBJSBO JOUFSTJUJTJBM BLBO TBOHBU Parker JC: Hydraulic conductance of lung endothelial phenotypes and
NFOJOHLBULBO LFDFQBUBO BMJSBO MJNGF TFQFSUJ UFMBI EJKFMBTLBO Starling safety factors against edema, Am J Physiol Lung Cell Mol
Physiol 292:L378, 2007.
TFCFMVNOZB)BMUFSTFCVULFNVEJBONFNCBXBLFMVBSLFMFCJIBO
Parker JC, Townsley MI: Physiological determinants of the pulmonary
WPMVNF DBJSBO JOUFSTUJTJBM EBO LFMFCJIBO QSPUFJO ZBOH UFMBI filtration coefficient, Am J Physiol Lung Cell sMol Physiol 295:L235, 2008.
UFSBLVNVMBTJEJEBMBNSVBOHJOUFSTUJTJBM Predescu SA, Predescu DN, Malik AB: Molecular determinants of endothelial
%FOHBO EFNJLJBO CFHJUV LPOTFOUSBTJ QSPUFJO DBJSBO JOUFS transcytosis and their role in endothelial permeabitity, Am J Physiol
Lung Cell Mol Physiol 293:L823, 2007.
TUJTJBM NFODBQBJ OJMBJ UFSUFOUV EBO NFOZFCBCLBO QFOJOHLBUBO
Oliver G: Lymphatic vasculature development, Nat Rev Immunol 4:35,
WPMVNF DBJSBO JOUFSTJUJTJBM EBO UFLBOBO DBJSBO JOUFSTUJTJBM ZBOH 2004.
TFUBSB QFOHFNCBMJBOQSPUFJOEBODBJSBONFMBMVJTJTUFNMJNGBUJL Taylor AE, Granger DN: Exchange of macromolecules across the
NFOKBEJ DVLVQ CFTBS VOUVL NFOHJNCBOHJ TFDBSB UFQBU microcirculation. ln Renkin EM, Michel CC, editors: Handbook of
LFDFQBUBO CPDPSOZB QSPUFJO EBO DBJSBO LF EBMBN JOUFSTUJTJVN Physiology, Sec 2, vol IV, Bethesda, MD, 1984, American Physiological
Society, pp 467.
EBSJLBQJMFSEBSBI
189
BAB 17
UNIT IV
1FOHFOEBMJBO-PLBMEBO)VNPSBM
"MJSBO%BSBI+BSJOHBO
Pengendalian Lokal Aliran NFNCFSTJILBOEBSBIEBSJQSPEVLTJTBNFUBCPMJTNF

Darah sebagai Respons 4FCBMJLOZB QBMJOH NFOBLKVCLBO BEBMBI BMJSBO EBSBI ZBOH
terhadap Kebutuhan SFOEBI LF TFNVB PUPU UVCVI JOBLUJG EFOHBO KVNMBI UPUBM IBOZB
Jaringan NMNFOJU XBMBVQVO PUPUPUPU UFSTFCVU NFSVQBLBO
TBNQBJQFSTFOEBSJUPUBMNBTTBUVCVI1BEBLFBEBBOJTUJSBIBU
4BMBI TBUV QSJOTJQ QBMJOH BLUJWJUBTNFUBCPMJLPUPUTBOHBUSFOEBI EBOEFNJLJBOQVMBBMJSBO
NFOEBTBS GVOHTJ TJSLVMBTJ BEBMBI LFNBNQVBO TFUJBQ KBSJOHBO EBSBIOZB IBOZB NM NFOJU H /BNVO TFMBNB BLUJWJUBT
VOUVL NFOHBUVS BMJSBO EBSBI MPLBMOZB TFOEJSJ TFTVBJ EFOHBO CFSBU BLUJWJUBTNFUBCPMJLPUPUEBQBUNFOJOHLBUMFCJIEBSJLBMJ
LFCVUVIBONFUBCPMJLOZB MJQBU EBO BMJSBO EBSBI NFOJOHLBU TFCBOZBL LBMJ MJQBU
"QBTBKBLBILFCVUVIBOTQFTJGJLKBSJOHBOZBOHNFNFSMVLBO NFOJOHLBU TBNQBJ TFUJOHHJ NMNFOJU EJ TFNVB KBMJOBO
BMJSBO EBSBI +BXBCBO QFSUBOZBBO UFSTFCVU EBQBU CFSCBHBJ WBTLVMBSPUPUUVCVI BUBVNMNFOJUHPUPU

NBDBN BOUBSBMBJONFMJQVUJ Pentingnya Pengendalian Aliran Darah oleh Jaringan
1. 1FOHIBOUBSBOPLTJHFOLFKBSJOHBO Setempat. ,JUB EBQBU NFOHBKVLBO QFSUBOZBBO TFEFSIBOB
.FOHBQB UJEBL EJCJBSLBO UFSKBEJOZB BMJSBO EBSBI CFTBS LF TFUJBQ
2. 1FOHIBOUBSBO [BU OVUSJTJ MBJOOZB TFQFSUJ HMVLPTB BTBN KBSJOHBO UVCVI TFUJBQ TBBU ZBOH TFMBMV DVLVQ VOUVL NFNFOVIJ
BNJOP EBOBTBNMFNBL LFCVUVIBOKBSJOHBOUBOQBNFOHIJSBVLBOCFSBUSJOHBOOZBBLUJWJUBT
3. 1FNCVBOHBOLBSCPOEJPLTJEBEBSJKBSJOHBO KBSJOHBO UFSTFCVU +BXBCBO VOUVL QFSUBOZBBO JOJ KVHB TFEFSIBOB
4. 1FNCVBOHBOJPOIJESPHFOEBSJKBSJOHBO 6OUVL NFMBLVLBO IBM UFSTFCVU EJCVUVILBO KVNMBI BMJSBO EBSBI
CFSMJQBUHBOEBEBSJKVNMBIBMJSBOEBSBIZBOHEBQBUEJQPNQBPMFI
5. .FNQFSUBIBOLBO LPOTFOUSBTJ JPOJPO MBJO EJ KBSJOHBO
KBOUVOH
EFOHBOUFQBU 1FSDPCBBO UFMBI NFOVOKVLLBO CBIXB BMJSBO EBSBI LF TFUJBQ
6. 1FOHBOHLVUBO CFSCBHBJ IPSNPO EBO [BU MBJOOZB LF KBSJOHBO CJBTBOZB EJBUVS QBEB UJOHLBU NJOJNBM ZBOH EBQBU
CFSCBHBJKBSJOHBO NFNFOVIJ LFQFSMVBO KBSJOHBO UJEBL MFCJI UJEBL LVSBOH
0SHBOPSHBO UFSUFOUV NFNQVOZBJ LFQFSMVBO ZBOH LIVTVT .JTBMOZB EJ KBSJOHBO EFOHBO QFOHIBOUBSBO PLTJHFO TFCBHBJ
$POUPIOZB BMJSBO EBSBI LF LVMJU NFOFOUVLBO QBOBT ZBOH LFCVUVIBO UFSQFOUJOH BMJSBO EBSBI TFMBMV EJBUVS QBEB UJOHLBU
IJMBOH EBSJ UVCVI EBO EFOHBO DBSB UFSTFCVU BLBO NFNCBOUV TFEJLJU EJ BUBT KVNMBI ZBOH EJQFSMVLBO VOUVL NFNQFSUBIBOLBO
NFOHFOEBMJLBOTVIVUVCVI1FOHIBOUBSBOQMBTNBEBSBIEBMBN PLTJHFOBTJ KBSJOHBO TFQFOVIOZB UFUBQJ UJEBL CJTB MFCJI EBSJ JUV
KVNMBI BEFLVBU LF HJOKBM NFNVOHLJOLBO HJOKBM VOUVL %FOHBO NFOHBUVS BMJSBO EBSBI TFUFNQBU EFOHBO DBSB ZBOH
NFOHFLTLSFTJ QSPEVL TJTB NFUBCPMJTNF UVCVI TFSUB NFOHBUVS EFNJLJBO UFQBU KBSJOHBO IBNQJS UJEBL QFSOBI NFOHBMBNJ
WPMVNFDBJSBOUVCVIEBOFMFLUSPMJU EFGJTJFOTJ OVUSJTJ PLTJHFO EBO CFCBO LFSKB KBOUVOH EBQBU
,JUB BLBO TJNBL CBIXB GBLUPSGBLUPS UFSTFCVU BLBO TBOHBU EJQFSUBIBOLBOQBEBUJOHLBUZBOHNJOJNVN
CFSQFSBO QBEB QFOHBUVSBO BMJSBO EBSBI MPLBM EBO CBIXB
KBSJOHBO CFSCFEB NFNJMJLJ UJOHLBU LFQFOUJOHBO ZBOH CFSCFEB Mekanisme Pengendalian Aliran Darah
QVMBQBEBGBLUPSGBLUPSJOJEBMBNNFOHFOEBMJLBOBMJSBOEBSBI
1FOHFOEBMJBOBMJSBOEBSBIMPLBMEBQBUEJCBHJEBMBNEVBGBTF

Variasi Aliran Darah di Berbagai Jaringan dan Organ. QFOHBUVSBOBLVUEBO
QFOHBUVSBOKBOHLBQBOKBOH
1FSIBUJLBO QBEB 5BCFM BEBOZB BMJSBO EBSBI ZBOH TBOHBU 1FOHBUVSBO BLVU EJDBQBJ NFMBMVJ QFSVCBIBO DFQBU QBEB
CFTBS EJ CFCFSBQB PSHBO DPOUPIOZB CFCFSBQB SBUVT NM QFS WBTPEJMBUBTJBUBVWBTPLPOTUSJLTJBSUFSJPM NFUBSUFSJPM EBOTGJOHUFS
NFOJUQFSHKBSJOHBOLFMFOKBSUJSPJEBUBVBESFOBMEBOBMJSBO QSFLBQJMFS TFUFNQBU UFSKBEJ EBMBN XBLUV CFCFSBQB EFUJL TBNQBJ
EBSBI UPUBM TFCBOZBL NMNFOJU EJ IBUJ BUBV NM CFCFSBQBNFOJUBHBSEBQBUEFOHBODFQBUNFNQFSUBIBOLBOBMJSBO
NFOJUHKBSJOHBOIBUJ EBSBIKBSJOHBOTFUFNQBUZBOHNFNBEBJ
1FSIBUJLBO KVHB BMJSBO EBSBI ZBOH MVBS CJBTB CFTBSOZB 4FNFOUBSB QFOHBUVSBO KBOHLB QBOKBOH CFSBSUJ QFSVCBIBO
NFMBMVJ HJOKBM NMNFOJU +VNMBI BMJSBO ZBOH CFTBS JOJ BMJSBO ZBOH MBNCBU EBO UFSLFOEBMJ EBMBN KBOHLB XBLUV CFSIBSJ
EJQFSMVLBOHJOKBMVOUVLNFMBLTBOBLBOGVOHTJOZB IBSJ CFSNJOHHVNJOHHV BUBVCBILBOCFSCVMBOCVMBO
191
Unit IV Sirkulasi
Tabel 17-1 "MJSBO%BSBILF#FSCBHBJ0SHBOEBO+BSJOHBOQBEB SBOHLB1FSIBUJLBOCBIXBLFOBJLBONFUBCPMJTNFTBNQBJEFMBQBOLBMJ

,POEJTJ#BTBM
LFBEBBO OPSNBM BLBO NFOJOHLBULBO BMJSBO EBSBI LJSBLJSB FNQBU
LBMJMJQBUTFDBSBBLVU
1FSTFO $VSBI NMNFOJU NMNFOJU
BOUVOH =HCFSBU Pengaturan Akut Aliran Darah Lokal Ketika Terjadi Perubahan
KBSJOHBO Ketersediaan Oksigen. 4BMBITBUV[BUOVUSJTJNFUBCPMJLUFSQFOUJOH
BEBMBI PLTJHFO #JMBNBOB LFUFSTFEJBBO PLTJHFO KBSJOHBO NFOVSVO
Otak 14 700 50 TFQFSUJ
EJEBUBSBOUJOHHJEJQVODBLHVOVOH
QBEBQOFVNPOJB
Hati 4 200 70
QBEBLFSBDVOBOLBSCPONPOPLTJEB ZBOHNFSBDVOJLFNBNQVBO
Bronkus 2 100 25 IFNPHMPCJO NFOHBOHLVU PLTJHFO
BUBV
QBEB LFSBDVOBO TJBOJEB
ZBOHNFSBDVOJLFNBNQVBOKBSJOHBONFOHHVOBLBOPLTJHFO
BMJSBO
Ginjal 22 1100 360
EBSBINFMBMVJKBSJOHBOBLBONFOJOHLBUEFOHBOOZBUB(BNCBS
Hati 27 1350 95 NFNQFSMJIBULBO CBIXB TFJSJOH EFOHBO QFOVSVOBO TBUVSBTJ PLTJHFO
Portat (21) 1050 BSUFSJTBNQBJNFODBQBJQFSTFOOJMBJOPSNBM BMJSBOEBSBINFMBMVJ
Arterial (6) 300
UVOHLBJ ZBOH UFSJTPMBTJ NFOJOHLBU LJSBLJSB UJHB LBMJ MJQBU ZBJUV
BMJSBO EBSBI NFOJOHLBU IBNQJS DVLVQ UFUBQJ UJEBL DVLVQ VOUVL
Otot (keadaan 15 750 4 NFOHPNQFOTBTJ QFOVSVOBO KVNMBI PLTJHFO EJ EBMBN EBSBI KBEJ
inaktif)
OZBSJTNFNQFSUBIBOLBOQFOZFEJBBOPLTJHFOZBOHSFMBUJGLPOTUBOLF
Tulang 5 250 3 KBSJOHBO
Kulit (hawa 6 300 3 ,FSBDVOBO TJBOJEB UPUBM UFSIBEBQ QFOHHVOBBO PLTJHFO PMFI BSFB
sejuk) KBSJOHBO MPLBM EBQBU NFOZFCBCLBO LFOBJLBO BMJSBO EBSBI TFUFNQBU
Ketenjar tiroid 1 50 160 TFCBOZBLUVKVILBMJMJQBU NFOVOKVLLBOQFOHBSVIFLTUSFNEFGJTJFOTJ
Ketenjar adrenalin 0.5 25 300 PLTJHFOUFSIBEBQQFOJOHLBUBOBMJSBOEBSBI
5FSEBQBU EVB UFPSJ EBTBS QFOHBUVSBO BMJSBO EBSBI MPLBM ZBOH
Kelenjar lain 3.5 175 1.3
UFSKBEJ LFUJLB LFDFQBUBO NFUBCPMJTNF KBSJOHBO CFSVCBI BUBV
Total 100.0 5000 LFUFSTFEJBBO PLTJHFO CFSVCBI ,FEVB UFPSJ UFSTFCVU ZBJUV
UFPSJ
WBTPEJMBUPSEBO
UFPSJLFLVSBOHBOPLTJHFO
1BEB VNVNOZB QFSVCBIBOQFSVCBIBO KBOHLB Teori Vasodilator untuk Pengaturan Akut Aliran Darah
QBOKBOH JOJ NFOHIBTJMLBO QFOHFOEBMJBO BMJSBO ZBOH
Lokal—Kemungkinan Peran Khusus Adenosin.
MFCJI CBJL TFTVBJ EFOHBO LFCVUVIBO KBSJOHBO
1FSVCBIBO JOJUFSKBEJ TFCBHBJ BLJCBU EBSJ QFOJOHLBUBO .FOVSVU UFPSJ JOJ NBLJO DFQBU NFUBCPMJTNF BUBV NBLJO LVSBOH
BUBVQFOVSVOBOVLVSBO EBO KVNMBI QFNCVMVI EBSBI QFOZFEJBBOPLTJHFOBUBV[BUOVUSJTJMBJOOZBLFTVBUVKBSJOHBO NBLJO
ZBOH NFNBTPLKBSJOHBO CFTBS LFDFQBUBO QFNCFOUVLBO [BU WBTPEJMBUPS EJ EBMBN TFM KBSJOHBO
UFSTFCVU ;BU WBTPEJMBUPS LFNVEJBO EJZBLJOJ CFSEJGVTJ NFMBMVJ
Pengendalian Akut Aliran Darah Lokal
KBSJOHBO LF TGJOHUFS QSFLBQJMFS NFUBSUFSJPM EBO BSUFSJPM VOUVL
Pengaruh Metabolisme Jaringan terhadap Aliran NFOJNCVMLBO WBTPEJMBUBTJ 4FCBHJBO EBSJ CFSCBHBJ NBDBN [BU
Darah Lokal. (BNCBS NFNQFSMJIBULBO QFSLJSBBO WBTPEJMBUPS ZBOH UFMBI EJLFNVLBLBO BEBMBI BEFOPTJO LBSCPO
QFOHBSVI BLVU QFOJOHLBUBO LFDFQBUBO NFUBCPMJTNF EJ EJPLTJEB TFOZBXB GPTGBU BEFOPTJO IJTUBNJO JPO LBMJVN EBO JPO
KBSJOHBOTFUFNQBUUFSIBEBQBMJSBOEBSBI TFQFSUJEJPUPU IJESPHFO
192
Bab 17 Pengendalian Lokal dan Humoral Aliran Darah Jaringan
;BU WBTPEJMBUPS NVOHLJO EJCFCBTLBO EBSJ KBSJOHBO TFCBHBJ TFUFNQBU )BM UFSTFCVU KVHB BLBO NFOZFCBCLBO WBTPEJMBUBTJ
SFBLTJ UFSIBEBQ EFGJTJFOTJ PLTJHFO $POUPIOZB QFSDPCBBO TFUFNQBU
QFSDPCBBOUFMBINFNQFSMJIBULBOCBIXBQFOVSVOBOLFUFSTFEJBBO 4VBUV NFLBOJTNF ZBOH NFOFSBOHLBO LFSKBOZB UFPSJ
PLTJHFO EBQBU NFOZFCBCLBO CBJL BEFOPTJO NBVQVO BTBN MBLUBU LFLVSBOHBOPLTJHFOEJUVOKVLLBOQBEB(BNCBS(BNCBSJOJ
UNIT IV
ZBOHNFOHBOEVOHJPOIJESPHFO
EJCFCBTLBOLFEBMBNSVBOHEJ NFNQFSMJIBULBO TFCVBI VOJU KBSJOHBO ZBOH UFSEJSJ BUBT
BOUBSB TFMTFM KBSJOHBO [BU UFSTFCVU LFNVEJBO NFOZFCBCLBO NFUBSUFSJPM EFOHBO TFCVBI MFOHBO TJTJ LBQJMFS EBO KBSJOHBO EJ
WBTPEJMBUBTJ BLVU ZBOH IFCBU EBO LBSFOB JUV CFSUBOHHVOH KBXBC TFLJUBSOZB %J UFNQBU BTBM LBQJMFS UFSTFCVU UFSEBQBU TGJOHUFS
TFQFOVIOZB BUBV TFCBHJBO UFSIBEBQ QFOHBUVSBO BMJSBO EBSBI QSFLBQJMFS EBO EJ TFLFMJMJOH NFUBSUFSJPM UFSEBQBU CFCFSBQB TFSBU
TFUFNQBU ;BU WBTPEJMBUPS TFQFSUJ LBSCPO EJPLTJEB BTBN MBLUBU PUPUQPMPTMBJOOZB1FOHBNBUBOKBSJOHBOJOJEJCBXBINJLSPTLPQ
EBO JPO LBMJVN DFOEFSVOH NFOJOHLBU EJ KBSJOHBO BQBCJMB BMJSBO DPOUPIOZB QBEB TBZBQ LFMFMBXBS UFSMJIBU CBIXB TGJOHUFS
EBSBI CFSLVSBOH EBO NFUBCPMJTNF TFM CFSKBMBO EFOHBO MBKV ZBOH QSFLBQJMFSOPSNBMOZBEBMBNLFBEBBOUFSCVLBUPUBMBUBVUFSUVUVQ
TBNB BUBV BQBCJMB NFUBCPMJTNF TFM NFOEBEBL NFOJOHLBU UPUBM +VNMBI TGJOHUFS QSFLBQJMFS ZBOH UFSCVLB TFUJBQ TBBU TFDBSB
%FOHBO NFOJOHLBUOZB LPOTFOUSBTJ NFUBCPMJU WBTPEJMBUPS UFSKBEJ LBTBS TFCBOEJOH EFOHBO LFCVUVIBO KBSJOHBO BLBO [BU OVUSJTJ
WBTPEJMBUBTJBSUFSJPMZBOHNFOJOHLBULBOBMJSBOEBSBIKBSJOHBOEBO 4GJOHUFS QSFLBQJMFS EBO NFUBSUFSJPM NFNCVLB EBO NFOVUVQ
NFOHFNCBMJLBOLPOTFOUSBTJNFUBCPMJUKBSJOHBONFOVKVOPSOBM TFDBSB CFSJSBNB CFCFSBQB LBMJ QFS NFOJU EFOHBO MBNB GBTF
#BOZBL BIMJ GBBM NFZBLJOJ CBIXB BEFOPTJO NFSVQBLBO QFNCVLBBO ZBOH TFCBOEJOH EFOHBO LFCVUVIBO NFUBCPMJL
WBTPEJMBUPS MPLBM QFOUJOH VOUVL QFOHBUVSBO BMJSBO EBSBI MPLBM KBSJOHBO BLBO PLTJHFO 4JLMVT QFNCVLBBO EBO QFOVUVQBO JOJ
$POUPIOZB TFKVNMBILFDJMWBTPEJMBUPSBEFOPTJOEJCFCBTLBOEBSJ EJTFCVUWBTPNPUJPO
TFMPUPUKBOUVOHCJMBBMJSBOEBSBILPSPOFSTBOHBULVSBOH EBOIBM .BSJ LJUB CBIBT CBHBJNBOB LPOTFOUSBTJ PLTJHFO EJ KBSJOHBO
UFSTFCVU NFOZFCBCLBO WBTPEJMBUBTJ MPLBM ZBOH DVLVQ VOUVL TFUFNQBU NFOHBUVS BMJSBO EBSBI NFMBMVJ BSFB UFSTFCVU 0MFI
NFOHFNCBMJLBOBMJSBOEBSBILPSPOFSLFLFBEBBOOPSNBM4FMBJO LBSFOB PUPU QPMPT NFNFSMVLBO PLTJHFO VOUVL UFUBQ
JUV TFUJBQ LBMJ KBOUVOH NFOKBEJ MFCJI BLUJG EBSJ LFBEBBO OPSNBM CFSLPOUSBLTJ LJUBEBQBUNFOHBOHHBQCBIXBLFLVBUBOLPOUSBLTJ
EBO NFUBCPMJTNF KBOUVOH TBOHBU NFOJOHLBU IBM JOJ KVHB BLBO TGJOHUFS QSFLBQJMFS BLBO NFOJOHLBU CFSTBNB EFOHBO LFOBJLBO
NFOZFCBCLBO QFOJOHLBUBO QFNBLBJBO PLTJHFO EJJLVUJ PMFI
LPOTFOUSBTJ PLTJHFO "LJCBUOZB LFUJLB LPOTFOUSBTJ PLTJHFO EJ
QFOVSVOBOLPOTFOUSBTJPLTJHFOEJTFMPUPUKBOUVOHEFOHBOBLJCBU KBSJOHBO NFOJOHLBU TBNQBJ EJ BUBT OJMBJ UFSUFOUV TGJOHUFS

EFHSBEBTJ BEFOPTJO USJGPTGBU "51
ZBOH BLBO
QSFLBQJMFSEBONFUBSUFSJPMEJEVHBBLBONFOVUVQTBNQBJTFMTFM
NFOJOHLBULBO QFMFQBTBO BEFOPTJO %JZBLJOJ CBIXB CBOZBL KBSJOHBO NFOHHVOBLBO LFMFCJIBO PLTJHFO /BNVO LFUJLB
BEFOPTJO UFSTFCVU LFMVBS EBSJ TFM PUPU KBOUVOH VOUVL LFMFCJIBOPLTJHFOTVEBIIBCJTUFSQBLBJEBOLPOTFOUSBTJPLTJHFO
NFOJNCVMLBO WBTPEJMBUBTJ LPSPOFS NFOZFCBCLBO QFOJOHLBUBO NFOVSVO DVLVQ CBOZBL TGJOHUFS BLBO NFNCVLB MBHJ VOUVL
BMJSBOEBSBILPSPOFSHVOBNFNFOVIJLFCVUVIBO[BUOVUSJTJZBOH NFNVMBJTJLMVTLFNCBMJ
NFOJOHLBUQBEBKBOUVOHBLUJG +BEJ CFSEBTBSLBO EBUB ZBOH UFSTFEJB CBJL UFPSJ [BU
.FTLJQVOCVLUJQFOFMJUJBONBTJILVSBOHKFMBT CBOZBLBIMJGBBM WBTPEJMBUPS NBVQVO UFPSJ LFLVSBOHBO PLTJHFO EBQBU
KVHB NFOHFNVLBLBO CBIXB NFLBOJTNF BEFOPTJO ZBOH TBNB NFOKFMBTLBO QFOHBUVSBO BLVU BMJSBO EBSBI MPLBM TFCBHBJ
NFSVQBLBOQFOHFOEBMJBMJSBOEBSBIQFOUJOHEJPUPUSBOHLBEBOEJ SFTQPOT UFSIBEBQ LFCVUVIBO NFUBCPMJL KBSJOHBO ,FCFOBSBO
CBOZBLKBSJOHBOMBJOOZB EFNJLJBOQVMBEJKBOUVOH/BNVO TVMJU NVOHLJO UFSMFUBL QBEB LPNCJOBTJ EBSJ LFEVB NFLBOJTNF
VOUVL NFNCVLUJLBO CBIXB TBUV [BU WBTPEJMBUPS BQBQVO UFSTFCVU
UFSNBTVL BEFOPTJO
EBMBN KVNMBI DVLVQ NFNBOH EJCFOUVL EJ
KBSJOHBOVOUVLNFOJNCVMLBOTFMVSVILFOBJLBOBMJSBOEBSBIZBOH
UFSVLVS -FCJI NFNVOHLJOLBO CBIXB LPNCJOBTJ EBSJ CFCFSBQB
WBTPEJMBUPS ZBOH EJMFQBT PMFI KBSJOHBO CFSQFSBO TFSUB EBMBN
QFOHBUVSBOBMJSBOEBSBI
Teori Kekurangan Oksigen untuk Pengaturan Aliran
Darah Lokal. .FTLJQVO UFPSJ WBTPEJMBUPS EJUFSJNB TFDBSB MVBT
CFCFSBQB GBLUB LSJUJT UFMBI NFOZFCBCLBO BIMJ GBBM MBJO MFCJI
NFOZVLBJ UFPSJ MBJOOZB ZBOH EBQBU EJTFCVU TFCBHBJ UFPSJ
LFLVSBOHBO PLTJHFO BUBV MFCJI UFQBUOZB UFPSJ LFLVSBOHBO [BU
OVUSJTJ LBSFOB TFMBJO PLTJHFO [BU OVUSJTJ MBJO KVHB UFSMJCBU

0LTJHFO EBO [BU OVUSJTJ MBJOOZB
EJQFSMVLBO TFCBHBJ [BU OVUSJTJ
NFUBCPMJL VOUVL NFOJNCVMLBO LPOUSBLTJ PUPU WBTLVMBS 0MFI
LBSFOB JUV CJMB PLTJHFO UJEBL DVLVQ UFSTFEJB DVLVQ CFSBMBTBO
VOUVL NFOHBOHHBQ CBIXB QFNCVMVI EBSBI BLBO NFOHBMBNJ
SFMBLTBTJ EBO LBSFOB JUV TFDBSB BMBNJBI BLBO CFSEJMBUBTJ 4FMBJO
JUV QFOJOHLBUBO QFOHHVOBBO PLTJHFO EJ KBSJOHBO TFCBHBJ BLJCBU
QFOJOHLBUBO NFUBCPMJTNF TFDBSB UFPSFUJT EBQBU NFOVSVOLBO
LFUFSTFEJBBOPLTJHFOLFTFSBUPUPUQPMPTEJQFNCVMVIEBSBI
193
Unit IV Sirkulasi
Kemungkinan Peran Zat Nutrisi selain Oksigen pada EJQFSMVLBO VOUVL NFNQFSUBIBOLBO UJOHLBUBO GVOHTJOZB ZBOH
Pengendalian Aliran Darah Lokal. 1BEB LFBEBBO UFSUFOUV CBSV4FQFSUJEJUFLBOLBOEJBXBM IJQFSFNJBBLUJGQBEBPUPUSBOHLB
UFMBIEJQFSMJIBULBOCBIXBLFLVSBOHBOHMVLPTBEJEBMBNEBSBI EBQBU NFOJOHLBULBO BMJSBO EBSBI PUPU TFUFNQBU TBNQBJ LBMJ
QFSGVTJ EBQBU NFOZFCBCLBO WBTPEJMBUBTJ KBSJOHBO TFUFNQBU MJQBUTFXBLUVCFSPMBISBHBEFOHBOJOUFOTJG
4FMBJO JUV FGFL ZBOH TBNB EBQBU UJNCVM CJMB UFSKBEJ EFGJTJFOTJ
[BUOVUSJTJMBJO TFQFSUJBTBNBNJOPBUBVBTBNMFNBL XBMBVQVO
"Autoregulasi" Aliran Darah Ketika Tekanan Arteri Berubah
IBM JOJ CFMVN QFSOBI EJUFMJUJ TFDBSB BEFLVBU 4FMBJO JUV
dari Normal—Mekanisme "Metabolik" dan "Miogenik"
WBTPEJMBUBTJ UFSKBEJ QBEB QFOZBLJU EFGJTJFOTJ WJUBNJO ZBOH %J TFUJBQ KBSJOHBO UVCVI LFOBJLBO UFLBOBO BSUFSJ ZBOH DFQBU
EJTFCVU CFSJCFSJ ZBJUV QBTJFO NFOHBMBNJ LFLVSBOHBO [BU[BU NFOZFCBCLBO QFOJOHLBUBO BMJSBO EBSBI TFHFSB "LBO UFUBQJ
WJUBNJO#TFQFSUJUJBNJO OJBTJO EBOSJCPGMBWJO1BEBQFOZBLJU EBMBNXBLUVLVSBOHEBSJTFNFOJU BMJSBOEBSBIEJTFCBHJBOCFTBS
JOJ BMJSBO EBSBI QFNCVMVI QFSJGFS EJ IBNQJS TFUJBQ CBHJBO KBSJOHBO LFNCBMJ IBNQJS LF UJOHLBU OPSNBM NFTLJQVO UFLBOBO
UVCVI TFSJOH LBMJ NFOJOHLBU EVB TBNQBJ UJHB LBMJ MJQBU 0MFI BSUFSJ UFUBQ UJOHHJ ,FNCBMJOZB BMJSBO JOJ LF UJOHLBU OPSNBM
LBSFOBWJUBNJOWJUBNJOJOJTFNVBOZBEJCVUVILBOQBEBQSPTFT EJTFCVU BVUPSFHVMBTJ BMJSBO EBSBI 4FUFMBI UFSKBEJ BVUPSFHVMBTJ
GPTGPSJMBTJZBOHEJJOEVLTJPLTJHFOVOUVLNFOHIBTJMLBO"51EJ BMJSBO EBSBI MPLBM EJ TFCBHJBO CFTBS KBSJOHBO UVCVI EBQBU
TFM KBSJOHBO LJUB EBQBU NFOHFSUJ CBIXB EFGJTJFOTJ WJUBNJO EJLBJULBO EFOHBO UFLBOBO BSUFSJ ZBOH LJSBLJSB TFTVBJ EFOHBO
UFSTFCVU EBQBU NFOJNCVMLBO QFOVSVOBO LFNBNQVBO LVSWB BLVU EFOHBO HBSJT VUVI QBEB (BNCBS 1FSIBUJLBO
LPOUSBLUJMJUBTPUPUQPMPTEBOKVHBWBTPEJMBUBTJMPLBM CBIXBQBEBOJMBJUFLBOBOBSUFSJBOUBSBTFLJUBSNN)HEBO
NN )H BMJSBO EBSBI IBOZB NFOJOHLBU TBNQBJ QFSTFO
Contoh-Contoh Khusus Pengendatian "Metabolik" Akut XBMBVQVOUFLBOBOBSUFSJNFOJOHLBUTFCBOZBLQFSTFO
terhadap Aliran Darah Lokal 4FMBNB IBNQJS TFBCBE UFMBI EJLFNVLBLBO EVB QFOEBQBU
.FLBOJTNFZBOHUFMBILJUBCBIBTTFKBVIJOJVOUVLQFOHBUVSBO VOUVL NFOFSBOHLBO NFLBOJTNF BVUPSFHVMBTJ BLVU UFSTFCVU %VB
BMJSBO EBSBI MPLBM EJTFCVU NFLBOJTNF NFUBCPMJL LBSFOB QFOEBQBUJOJEJTFCVU
UFPSJNFUBCPMJLEBO
UFPSJNJPHFOJL
TFNVBNFLBOJTNFUFSTFCVUCFSGVOHTJTFCBHBJSFTQPOTUFSIBEBQ
LFCVUVIBO NFUBCPMJL KBSJOHBO %VB DPOUPI LIVTVT UBNCBIBO 5FPSJ NFUBCPMJL EBQBU EJQBIBNJ TFDBSB NVEBI EFOHBO
QFOHBUVSBO NFUBCPMJL BMJSBO EBSBI MPLBM BEBMBI IJQFSFNJB NFOFSBQLBO QSJOTJQ EBTBS QFOHBUVSBO BMJSBO EBSBI MPLBM ZBOH
SFBLUJGEBOIJQFSFNJBBLUJG UFMBI EJCJDBSBLBO TFCFMVNOZB +BEJ CJMB UFLBOBO BSUFSJ NFOKBEJ
UFSMBMV UJOHHJ LFMFCJIBO BMJSBO BLBO NFNCFSJLBO UFSMBMV CBOZBL
)JQFSFNJB 3FBLUJG #JMB QFOZFEJBBO EBSBI LF KBSJOHBO
PLTJHFO EBO [BU OVUSJTJ MBJO LF KBSJOHBO TFSUB NFNCFSTJILBO
UFSIBNCBU TFMBNB CFCFSBQB EFUJL TBNQBJ TBUV KBN BUBV MFCJI
WBTPEJMBUPSZBOHEJMFQBTPMFIKBSJOHBO;BUNBLBOBOJOJ UFSVUBNB
EBOLFNVEJBOIBNCBUBOOZBEJIJMBOHLBO BMJSBOEBSBINFMBMVJ
PLTJHFO
EBO QFOVSVOBO LBEBS WBTPEJMBUPS KBSJOHBO LFNVEJBO
KBSJOHBOCJBTBOZBBLBOTFHFSBNFOJOHLBUTFCFTBSFNQBUTBNQBJ
NFOZFCBCLBO QFNCVMVI EBSBI CFSLPOTUSJLTJ EBO BMJSBO LFNCBMJ
UVKVI LBMJ OPSNBM LFOBJLBO BMJSBO JOJ BLBO CFSMBOKVU TFMBNB
NFOEFLBUJOPSNBMNFTLJQVOUFLBOBOUFSVTNFOJOHHJ
CFCFSBQB EFUJL CJMB IBNCBUBO CFSMBOHTVOH IBOZB CFCFSBQB
EFUJL UFUBQJ LBEBOHLBEBOH CFSMBOKVU TBNQBJ CFSKBNKBN CJMB /BNVO UFPSJ NJPHFOJL NFOVOKVLLBO CBIXB NBTJI BEB
BMJSBOEBSBIUFSIFOUJTFMBNBTBUVKBNBUBVMFCJI'FOPNFOBJOJ NFLBOJTNF MBJO ZBOH UJEBL CFSIVCVOHBO EFOHBO NFUBCPMJTNF
EJTFCVUIJQFSFNJBSFBLUJG KBSJOHBO ZBOH NFOKFMBTLBO GFOPNFOB BVUPSFHVMBTJ 5FPSJ JOJ
)JQFSFNJB SFBLUJG BEBMBI NBOJGFTUBTJ MBJO NFLBOJTNF EJEBTBSLBO QBEB QFOHBNBUBO CBIXB SFHBOHBO UJCBUJCB QBEB
QFOHBUVSBO BMJSBO EBSBI NFUBCPMJL MPLBM ZBJUV LVSBOHOZB QFNCVMVIEBSBILFDJMNFOZFCBCLBOLPOUSBLTJPUPUQPMPTEJOEJOH
BMJSBO EBSBI BLBO NFOHBLUJGLBO TFNVB GBLUPS ZBOH QFNCVMVI
NFOZFCBCLBO WBTPEJMBUBTJ 4FTVEBI TVBUV QFSJPEF TJOHLBU
QFOZVNCBUBO WBTLVMBS BMJSBO EBSBI UBNCBIBO TFMBNB GBTF
IJQFSFNJB SFBLUJG BLBO CFSMBOHTVOH DVLVQ MBNB VOUVL
NFOHHBOUJ IBNQJS TFNVB LFLVSBOHBO PLTJHFO KBSJOHBO ZBOH
UFSIVUBOH TFMBNB QFSJPEF QFOZVNCBUBO .FLBOJTNF JOJ
NFOFLBOLBO IVCVOHBO FSBU BOUBSB QFOHBUVSBO BMJSBO EBSBI
MPLBM EFOHBO QFOHIBOUBSBO PLTJHFO EBO [BU OVUSJTJ MBJO LF
KBSJOHBO
)JQFSFNJB"LUJG#JMBKBSJOHBONFOKBEJTBOHBUBLUJG TFQFSUJ
PUPU ZBOH TFEBOH EJMBUJI LFMFOKBS HBTUSPJOUFTUJOBM TFMBNB
QFSJPEFIJQFSTFLSFTJ BUBVCBILBOPUBLTFMBNBBLUJWJUBTNFOUBM
DFQBU MBKVBMJSBOEBSBINFMBMVJKBSJOHBOBLBONFOJOHLBU4FLBMJ
MBHJ IBOZBEFOHBONFNBLBJQSJOTJQEBTBSQFOHFOEBMJBOBMJSBO
EBSBI MPLBM LJUB EFOHBO NVEBI EBQBU NFNBIBNJ IJQFSFNJB
BLUJG,FOBJLBONFUBCPMJTNFMPLBMNFOZFCBCLBOTFMTFMEFOHBO
DFQBU NFMBIBQ [BU OVUSJTJ EJ DBJSBO KBSJOHBO EBO KVHB
NFOHFMVBSLBO TFKVNMBI CFTBS [BU WBTPEJMBUPS "LJCBUOZB BLBO
UFSKBEJEJMBUBTJQFNCVMVIEBSBITFUFNQBUEBOLBSFOBJUV BMJSBO
EBSBI MPLBM BLBO NFOJOHLBU %FOHBO DBSB UFSTFCVU KBSJOHBO
ZBOHBLUJGBLBONFOFSJNB[BUOVUSJTJUBNCBIBOZBOH
194
Bab 17 Pengendalian Lokal dan Humorat Aliran Darah Jaringan
0MFI LBSFOB JUV BEB BOHHBQBO CBIXB CJMB UFLBOBO BSUFSJ UJOHHJ 2. %JPUBL TFMBJOLPOTFOUSBTJPLTJHFOKBSJOHBOZBOHCFSGVOHTJ
NFSFHBOH QFNCVMVI IBM JOJ BLBO NFOZFCBCLBO LPOTUSJLTJ VOUVL NFOHFOEBMJLBO BMJSBO EBSBI LPOTFOUSBTJ LBSCPO
WBTLVMBS SFBLUJG ZBOH NFOVSVOLBO BMJSBO EBSBI IBNQJS EJPLTJEB EBO JPO IJESPHFO KVHB CFSQFSBO QFOUJOH
NFOEFLBUJ OPSNBM 4FCBMJLOZB QBEB UFLBOBO SFOEBI EFSBKBU 1FOJOHLBUBOTBMBITBUVBUBVLFEVBJPOUFSTFCVUNFOEJMBUBTJ
UNIT IV
SFHBOHBO QFNCVMVI CFSLVSBOH TFIJOHHB PUPU QPMPT CFSFMBLTBTJ QFNCVMVI TFSFCSBM EBO NFNVOHLJOLBO QFNCFSTJIBO DFQBU
NFOHVSBOHJ UBIBOBO WBTLVMBS EBO NFNCBOUV NFOHFNCBMJLBO LFMFCJIBO LBSCPO EJPLTJEB BUBV JPO IJESPHFO EJ KBSJOHBO
BMJSBONFOVKVOPSNBM PUBL)BMJOJQFOUJOHLBSFOBUJOHLBULFQFLBBOSBOHTBOHPUBL
3FTQPOTNJPHFOJLNFSVQBLBOTJGBUBMBNJBIZBOHEJNJMJLJPMFI JUVTFOEJSJTBOHBUCFSHBOUVOHQBEBQFOHFOEBMJBODFSNBUPMFI
PUPUQPMPTWBTLVMBSEBOEBQBUUFSKBEJEJMVBSQFOHBSVITBSBGBUBV LPOTFOUSBTJ LBSCPO EJPLTJEB EBO LPOTFOUSBTJ JPO IJESPHFO
IPSNPO)BMUFSTFCVUUFSVUBNBUFSKBEJEJBSUFSJPMUFUBQJEBQBUKVHB .FLBOJTNFLIVTVTVOUVLQFOHBUVSBOBMJSBOEBSBITFSFCSBM
EJKVNQBJ EJ BSUFSJ WFOVMB WFOB EBO CBILBO EJ QFNCVMVI MJNGF JOJEJCBIBTEJ#BC
,POUSBLTJ NJPHFOJL EJBXBMJ EFOHBO EFQPMBSJTBTJ WBTLVMBS ZBOH 3. 1BEBLVMJU QFOHFOEBMJBOBMJSBOEBSBICFSLBJUBOFSBUEFOHBO
EJJOEVLTJ PMFI SFHBOHBO ZBOH LFNVEJBO BLBO NFOJOHLBULBO QFOHBUVSBO TVIV UVCVI "MJSBO LVUBOFVT EBO TVCLVUBOFVT
NBTVLBO JPO LBMTJVN EBSJ DBJSBO FLTUSBTFM LF EBMBN TFM NFOHBUVSQFOHFMVBSBOQBOBTUVCVIEFOHBODBSBNFOHVLVS
NFOHBLJCBULBO QFNCVMVIQFNCVMVI UFSTFCVU CFSLPOUSBLTJ QFOHIBOUBSBO QBOBT EBSJ JOUJ UVCVI LF QFSNVLBBO UVCVI
1FSVCBIBO QBEB UFLBOBO WBTLVMBS KVHB EBQBU NFNCVLB BUBV UFNQBU QBOBT EJMFQBT LF MJOHLVOHBO "MJSBO EBSBI LVMJU
NFOVUVQ LBOBM JPO MBJO ZBOH NFNFOHBSVIJ LPOUSBLTJ WBTLVMBS TFCBHJBOCFTBSEJLFOEBMJLBOPMFITJTUFNTBSBGQVTBUNFMBMVJ
.FLBOJTNF ZBOH EJHVOBLBO QFSVCBIBO UFLBOBO VOUVL EBQBU TBSBGTJNQBUJT TFQFSUJEJCBIBTQBEB#BC.FTLJQVOBMJSBO
NFOVUVQBUBVNFNCVLBLBOBMJPONBTJICFMVNEJLFUBIVJEFOHBO EBSBILFLVMJUIBOZBTFLJUBSNMNFOJUHKBSJOHBOQBEB
QBTUJ OBNVOBHBLOZBNFMJCBULBOFGFLNFLBOJLUFLBOBOUFSIBEBQ TVIVTFKVL BQBCJMBEJQFSMVLBO QFSVCBIBOOJMBJDVLVQCFTBS
QSPUFJO FLTUSBTFM ZBOH UFSJLBU QBEB FMFNFO TJUPTLFMFUPO EJOEJOH EBQBU UFSKBEJ "QBCJMB NBOVTJB EJQBQBSLBO UFSIBEBQ
WBTLVMBSBUBVQBEBLBOBMJPOJUVTFOEJSJ QFNBOBTBO UVCVI BMJSBO EBSBI LVMJU EBQBU NFOJOHLBU
.FLBOJTNF NJPHFOJL UBNQBLOZB QFOUJOH EBMBN NFODFHBI CFSMJQBUHBOEB NFODBQBJTBNQBJ-NFOJUVOUVLTFMVSVI
SFHBOHBO QFNCVMVI EBSBI CFSMFCJIBO LFUJLB UFLBOBO EBSBI UVCVI "QBCJMB TVIV UVCVI EJUVSVOLBO BMJSBO EBSBI LVMJU
NFOJOHLBU /BNVO QFSBO NFLBOJTNF NJPHFOJL EBMBN CFSLVSBOH UVSVOTBNQBJTFEJLJUEJBUBTOPMQBEBTVIVZBOH
QFOHBUVSBO BMJSBO EBSBI NBTJI CFMVN KFMBT LBSFOB NFLBOJTNF TBOHBUSFOEBI.FTLJQVOUFSKBEJWBTPLPOTUSJLTJIFCBU BMJSBO
QFOEFUFLTJ UFLBOBO JOJ UJEBL EBQBU TFDBSB MBOHTVOH NFOEFUFLTJ EBSBILVMJUNBTJIDVLVQCFTBSVOUVLNFNFOVIJLFCVUVIBO
BEBOZB QFSVCBIBO BMJSBO EBSBI EJ KBSJOHBO #BILBO GBLUPS EBTBSNFUBCPMJLLVMJU
NFUBCPMJL UBNQBLOZB NFOHFOZBNQJOHLBO NFLBOJTNF NJPHFOJL Pengendalian Aliran Darah Jaringan oleh Faktor
QBEB LFBEBBOLFBEBBO TBBU LFCVUVIBO NFUBCPMJL KBSJOHBO Relaksasi atau Konstriksi Asal-Endotel (Endothelial-
NFOJOHLBUTFDBSBCFSNBLOB NJTBMOZBTFMBNBMBUJIBOPUPUJOUFOTJG Derived Relaxing or Constricting Factors)
ZBOH EBQBU NFOJNCVMLBO QFOJOHLBUBO BMJSBO EBSBI PUPU SBOHLB 4FMTFM FOEPUFM ZBOH NFMBQJTJ QFNCVMVI EBSBI NFOTJOUFTJT
ESBNBUJT CFSCBHBJTVCTUBOTJ ZBOHCJMBEJMFQBTLBO EBQBUNFNFOHBSVIJ
EFSBKBULPOTUSBLTJBUBVSFMBLTJEJOEJOHBSUFSJ1FSBOGJTJPMPHJT
Mekanisme Khusus Pengendalian Akut Aliran Darah di CFSCBHBJGBLUPSSFMBLTBTJBUBVLPOTUSJLTJBTBMFOEPUFMJOJCBSV
Jaringan Tertentu NVMBJEJNFOHFSUJEBOBQMJLBTJLMJOJTOZB QBEBTFCBHJBOCFTBS
8BMBVQVO NFLBOJTNF VNVN QFOHFOEBMJBO BMJSBO EBSBI MPLBM LBTVT CFMVNEJLFNCBOHLBO
ZBOHUFMBIEJCBIBTTFKBVIJOJUFSEBQBUEJIBNQJSTFMVSVIKBSJOHBO Oksida Nitrat—Vasodilator yang Dilepas Sel Endotel
UVCVI UFSEBQBU NFLBOJTNF ZBOH DBSB LFSKBOZB CFSCFEB TBNB Sehat.'BLUPSSFMBLTBTJBTBMFOEPUFMUFSQFOUJOHBEBMBIPLTJEB
TFLBMJ EJ CFCFSBQB BSFB LIVTVT 4FMVSVI NFLBOJTNF EJCBIBT EJ OJUSBU OJUSJDPYJEF/0
HBT*JQPGJMJLZBOHEJMFQBTTFMFOEPUFM
TFNVB CBHJBO CBC JOJ EBMBN LBJUBOOZB EFOHBO PSHBOPSHBO TFCBHBJSFTQPOTUFSIBEBQCFSCBHBJSBOHTBOHLJNJBBUBVGJTJL
TQFTJGJL UFUBQJEVBPSHBOUFSQFOUJOHBEBMBITFCBHBJCFSJLVU &O[JN PLTJEB OJUSBU TJOUBTF OJUSJD PYJEF TZOUIBTF/04
QBEB
1. %J HJOKBM QFOHBUVSBO BMJSBO EBSBI TFCBHBJO CFTBS EJKBMBOLBO TFM FOEPUFM NFOZJTUFTJT /0 EBSJ BSHJOJO EBO PLTJHFO NFMBMVJ
NFMBMVJ NFLBOJTNF ZBOH EJTFCVU VNQBO CBMJL UVCVMPHMPNF SFEVLTJOJUSBUBOPSHBOJL4FUFMBICFSEJGVTJLFMVBSTFMFOEPUFM
SVMVT EJNBOBLPNQPTJTJDBJSBOEJCBHJBOBXBMUVCVMVTEJTUBM EJ EBMBN EBSBI /0 IBOZB NFNJMJLJ XBLUV QBSVI TFLJUBS
EJEFUFLTJ PMFI TUSVLUVS FQJUFM UVCVMVT ZBOH EJTFCVU NBLVMB EFUJL EBO CFLFSKB UFSVUBNB EJ KBSJOHBO TFUFNQBU UFNQBU JB
EFOTB QBEB UVCVMVT EJTUBM JUV TFOEJSJ 4USVLUVS UFSTFCVU EJMFQBT /0 NFOHBLUJWBTJ HVBOJMBU TJLMBTF UFSMBSVU EJ EBMBN
UFSEBQBU EJ UVCVMVT EJTUBM ZBOH UFSMFUBL CFSTFCFMBIBO EFOHBO PUPU QPMPT WBTLVMBS (BNCBS
NFOZFCBCLBO LPOWFSTJ
BSUFSJPMBGFSFOEBOBGFSFOQBEBOFGSPOBQBSBUVTKVLTUBHMPNF HVBOPTJOUSJGPTGBUTJLMJL DZDMJDHVBOZMBUFUSPQIPTQIBUFD(51
SVMVT "QBCJMB UFSMBMV CBOZBL DBJSBO EJGJMUSBTJ EBSJ EBSBI NFOKBEJHVBOPTJONPOPGPTGBUTJLMJL DZDMJDHVBOPTJOFNPOPQ
NFMBMVJ HMPNFSVMVT LF EBMBN TJTUFN UVCVMVT TJOZBM VNQBO IPTQIBUFMD(.1
TFSUBBLUJWBTJD(.1EFQBOEFOUQSP
CBMJL EBSJ NBLVMB EFOTB NFOZFCBCLBO LPOTUSJLTJ BSFUFSJPM UFJO LJOBTF 1,(
ZBOH NFNJMJLJ CFCFSBQB LFHJBUBO ZBOH
BGFSFO EBMBN IBM JOJ BLBO NFOVSVOLBO CBJL BMJSBO EBSBI LF NFOZFCBCLBOSFMBLTBTJQFNCVMVIEBSBI
HJOKBM NBVQVO MBKV GJMUSBTJ HMPNFSVMVT LFNCBMJ LF BUBV 4BBUEBSBINFOHBMJSNFMBMVJBSUFSJEBOBSUFSJPM UFSKBEJTUSFT
NFOEFLBUJ OPSNBM 3JODJBO NFLBOJTNF JOJ EJCBIBT EJ #BC HFTFLBO TIFBSTUSFT
QBEBTFMFOEPUFMBLJCBUUBSJLBOWJTLPTJUBT

195
Unit IV Sirkulasi
EJOEJOHWBTLVMBS4USFTJOJNFMJVLLBOTFMFOEPUFMNFOVKVBSBI 1%&
TVBUV FO[JN ZBOH NFOHIBODVSLBO D(.1 %FOHBO
BMJSBO EBO NFOZFCBCLBO QFOJOHLBUBO QFMFQBTBO /0 ZBOH NFOHIBNCBU QFOHIBODVSBO D(.1 JOIJCJUPS 1%& TFDBSB
CFSNBLOB /0 TFMBOKVUOZB NFSFMBLTBTJ QFNCVMVI EBSBI )BM FGFLUJG NFNQFSQBOKBOH LFSKB /0 VOUVL NFOJNCVMLBO
JOJ NFOHVOUVOHLBO LBSFOB QFOHFOEBMJBO BMJSBO EBSBI WBTPEJMBUBTJ1FOHHVOBBOVUBNBJOIJCJUPS1%&EJLMJOJLBEBMBI
KBSJOHBO NFMBMVJ NFLBOJTNF NFUBCPMJL TFUFNQBU UFSVUBNB VOUVL NFOHPCBUJ EJTGVOHTJ FSFLTJ &SFLTJ QFOJT EJTFCBCLBO PMFI
NFOEJMBUBTJ BSUFSJ EBO BSUFSJPM ZBOH TBOHBU LFDJM EJ TFUJBQ JNQVMT TBSBG QBSBTJNQBUJT NFMBMVJ TBSBG QFMWJT NFOVKV QFOJT
KBSJOHBO/BNVO TBBUUFSKBEJQFOJOHLBUBOBMJSBOEBSBINFMBMVJ UFNQBU OFVSPUSBOTNJUFS BTFUJMLPMJO EBO /0 EJMFQBTLBO %FOHBO
CBHJBONJLSPWBTLVMBSTJSLVMBTJ UFSKBEJQFSBOHTBOHBOTFLVOEFS NFODFHBI QFOHIBODVSBO /0 JOIJCJUPS 1%& NFOJOHLBULBO
CFSVQB QFMFQBTBO /0 EBSJ QFNCVMVI ZBOH MFCJI CFTBS BLJCBU EJMBUBTJ QFNCVMVI EBSBI QFOJT EBO NFNCBOUV FSFLTJ TFQFSUJ
QFOJOHLBUBOBMJSBOEBOTUSFTHFTFLBOQBEBQFNCVMVIUFSTFCVU EJCBIBTQBEB#BC
/0 ZBOH EJMFQBT BLBO NFOJOHLBULBO EJBNFUFS QFNCVMVI Endotelin—Vasokonstriktor Kuat yang Dilepas Endotel
EBSBI LF IVMV QSPLTJNBM
ZBOH MFCJI CFTBS TFUJBQ LBMJ BMJSBO Rusak. 4FMFOEPUFMKVHBNFMFQBT[BUWBTPLPOTUSJLUPS;BUZBOH
EBSBI NJLSPWBTLVMBS LF BSBI IJMJS EJTUBM
NFOJOHLBU 5BOQB QBMJOH QFOUJOH BEBMBI FOEPUFMJO TVBUV QFQUJEB CFTBS EFOHBO
SFTQPOT ZBOH EFNJLJBO FGFLUJWJUBT QFOHFOEBMJBO BMJSBO EBSBI QFQUJEB BTBN BNJOP ZBOH IBOZB EBMBN KVNMBI OBOPHSBN
TFUFNQBU BLBO NFOVSVO LBSFOB UFSKBEJ UBIBOBO ZBOH NFOJNCVMLBO WBTPLPOTUSJLTJ LVBU 4VCTUBOTJ JOJ UFSEBQBU EJ
CFSNBLOB UFSIBEBQ BMJSBO EBSBI EJ BSUFSJ LFDJM CBHJBO IVMV EBMBN TFM FOEPUFM TFNVB BUBV IBNQJS TFNVB QFNCVMVI EBSBI
QSPLTJNBM
UFUBQJ TBOHBU NFOJOHLBU BQBCJMB QFNCVMVI UFSMVLB 6NVNOZB
4JOUFTJT EBO QFMFQBTBO /0 EBSJ TFM FOEPUFM KVHB EJSBOHTBOH SBOHTBOH VOUVL QFMFQBTBOOZB BEBMBI LFSVTBLBO FOEPUFM TFQFSUJ
PMFI CFCFSBQB WBTPLPOTUSJLUPS TFQFSUJ BOHJPUFOTJO ** ZBOH ZBOHEJTFCBCLBOPMFILFIBODVSBOKBSJOHBOBUBVQFOZVOUJLBO[BU
CFSJLBUBOEFOHBOSFTFQUPSTQFTJGJLQBEBTFMFOEPUFM1FOJOHLBUBO LJNJB QFSVTBL LF EBMBN QFNCVMVI EBSBI 4FUFMBI LFSVTBLBO
QFMFQBTBO/0NFMJOEVOHJUFSIBEBQWBTPLPOTUSJLTJCFSMFCJIBO IFCBU QBEB QFNCVMVI EBSBI QFMFQBTBO FOEPUFMJO TFUFNQBU EBO
"QBCJMBUFSKBEJLFSVTBLBOTFMFOEPUFMBLJCBUIJQFSUFOTJLSPOJT WBTPLPOTUSJLTJ ZBOH NFOZVTVM BLBO NFNCBOUV NFODFHBI
BUBV BUFSPTLMFSPTJT HBOHHVBO TJOUFTJT /0 EBQBU UVSVU QFSEBSBIBO CFSMFCJIBO BSUFSJ CFSEJBNFUFS TBNQBJ TFCFTBS NN
CFSLPOUSJCVTJ QBEB UFSKBEJOZB WBTPLPOTUSJLTJ IFCBU EBO ZBOHNVOHLJOUFSMVLBBLJCBUDFEFSB
NFNQFSCFSBU IJQFSUFOTJ NBVQVO LFSVTBLBO FOEPUFM ZBOH CJMB 1FOJOHLBUBO QFMFQBTBO FOEPUFMJO KVHB EJZBLJOJ CFSLPOUSJCVTJ
UJEBLEJPCBUJ BLIJSOZBEBQBUNFOZFCBCLBODFEFSBWBTLVMBSEBO QBEB WBTPLPOTUSJLTJ BQBCJMB TFM FOEPUFM SVTBL BLJCBU IJQFSUFOTJ
LFSVTBLBOKBSJOHBOZBOHSFOUBOTFQFSUJKBOUVOH HJOKBM EBOPUBL 0CBU ZBOH NFOHIBNCBU SFTFQUPS FOEPUFMJO UFMBI EJHVOBLBO
#BILBOTFCFMVNEJUFNVLBOOZB/0 QBSBLMJOJTJNFOHHVOBLBO VOUVL NFOHPCBUJ IJQFSUFOTJ QVMNPOBM OBNVO CFMVN TFDBSB
OJUSPHMJTFSJO BNJM OJUSBU EBO EFSJWFU OJUSBU MBJOOZB VOUVL VNVN EJHVOBLBO VOUVL NFOVSVOLBO UFLBOBO EBSBI QBTJFO
NFOHPCBUJ QBTJFO EFOHBO BOHJOB QFLUPSJT ZBJUV OZFSJ EBEB EFOHBOIJQFSUFOTJBSUFSJTJTUFNJL
IFCBUZBOHEJTFCBCLBOJTLFNJBPUPUKBOUVOH0CBUPCBUJOJ CJMB
Pengaturan Aliran Darah Jangka Panjang
EJQFDBI TFDBSB LJNJB NFMFQBT /0 EBO NFOJNCVMLBO EJMBUBTJ
4FKBVI JOJ TFCBHJBO CFTBS NFLBOJTNF QFOHBUVSBO BMJSBO EBSBI
QFNCVMVI EBSBI EJ TFMVSVI UVCVI UFSNBTVL QFNCVMVI EBSBI
MPLBMZBOHUFMBILJUBCBIBT CFLFSKBEBMBNXBLUVCFCFSBQBEFUJL
LPSPOFS
TBNQBJ CFCFSBQB NFOJU TFUFMBI LPOEJTJ KBSJOHBO TFUFNQBU
1FOFSBQBOQFOUJOHMBJOGJTJPMPHJEBOGBSNBLPMPHJ/0BEBMBI CFSVCBI /BNVO NFTLJQVO NFLBOJTNF BLVU JOJ TVEBI
QFOHFNCBOHBOEBOQFOHHVOBBOLMJOJTPCBU TFQFSUJTJMEFOBGJM
UFSBLUJWBTJ QFOVI BMJSBO EBSBI CJBTBOZB IBOZB EJTFTVBJLBO
ZBOHNFOHIBNCBUD(.1TQFDJGJDQIPTQIPEJFTUFSBTF TFLJUBSUJHBQFSFNQBULFCVUVIBOUBNCBIBOKBSJOHBOZBOH
196
TFTVOHHVIOZB .JTBMOZB CJMB UFLBOBO BSUFSJ NFOEBEBL

NFOJOHLBU EBSJ NN )H NFOKBEJ NN )H BMJSBO EBSBI
BLBONFOJOHLBUIBNQJSTFLFUJLBLJSBLJSBQFSTFO,FNVEJBO
EBMBN XBLUV EFUJL TBNQBJ NFOJU BMJSBO NFOVSVO TBNQBJ
UNIT IV
LJSBLJSBTBNQBJQFSTFOEJBUBTOJMBJLPOUSPMTFNVMB)BMJOJ
NFOHHBNCBSLBO LFDFQBUBO NFLBOJTNF BLVU VOUVL QFOHBUVSBO
BMJSBO EBSBI TFUFNQBU UFUBQJ QBEB XBLUV ZBOH CFSTBNBBO KVHB
NFNQFSMJIBULBO CBIXB QFOHBUVSBO JOJ NBTJI LVSBOH MFOHLBQ
LBSFOB NBTJI BEB LFMFCJIBO TBNQBJ QFSTFO QBEB BMJSBO
EBSBI
"LBO UFUBQJ EBMBN XBLUV CFCFSBQB KBN IBSJ BUBV NJOHHV
TVBUVKFOJTQFOHBUVSBOBMJSBOEBSBIMPLBMKBOHLBQBOKBOHNVODVM
TFCBHBJ UBNCBIBO UFSIBEBQ QFOHFOEBMJBO BLVU 1FOHBUVSBO
KBOHLB QBOKBOH JOJ NFSVQBLBO QFOHFOEBMJBO BMJSBO EBSBI ZBOH
1µm
KBVI MFCJI MFOHLBQ $POUPIOZB TFQFSUJ QBEB LBTVT EJ BUBT CJMB A
UFLBOBO BSUFSJ TFUFSVTOZB UFUBQ CFSBEB QBEB NN )H EBMBN
XBLUV CFCFSBQB NJOHHV BMJSBO EBSBI ZBOH NFMBMVJ KBSJOHBO
TFDBSB CFSUBIBQ BLBO LFNCBMJ NFOEFLBUJ LFBEBBO OPSNBM
(BNCBS NFOHHBNCBSLBO LFFGFLUJGBO ZBOH MVBS CJBTB
QFOHBUVSBOBMJSBOEBSBIMPLBMKBOHLBQBOKBOHPMFILVSWBEFOHBO
HBSJT QVUVTQVUVT 1FSIBUJLBO CBIXB CFHJUV QFOHBUVSBO KBOHLB
QBOKBOH NVODVM QFSVCBIBO KBOHLB QBOKBOH UFSIBEBQ UFLBOBO
BSUFSJBOUBSBOJMBJEBONN)HIBOZBTFEJLJUCFSQFOHBSVI
UFSIBEBQLFDFQBUBOBMJSBOEBSBITFUFNQBU
1FOHBUVSBO KBOHLB QBOKBOH BMJSBO EBSBI UFSVUBNB QFOUJOH
LFUJLB LFCVUVIBO NFUBCPMJL KBSJOHBO CFSVCBI +BEJ CJMB TVBUV
KBSJOHBO NFOKBEJ UFSMBMV BLUJG TFDBSB LSPOJT EBO LBSFOB JUV
NFNCVUVILBO LFOBJLBO KVNMBI PLTJHFO EBO [BU OVUSJTJ MBJO
KVNMBI EBO VLVSBO BSUFSJPM EBO LBQJMFS CJBTBOZB NFOJOHLBU
EBMBN XBLUV CFCFSBQB NJOHHV VOUVL NFNFOVIJ LFCVUVIBO
KBSJOHBOLFDVBMJKJLBTJTUFNTJSLVMBTJUFMBINFOKBEJQBUPMPHJTBUBV B
UFSMBMVUVBVOUVLNFNCFSJSFTQPOT
Mekanisme Pengaturan Jangka Panjang—Perubahan
"Vaskularitas Jaringan"
.FLBOJTNF QFOHBUVSBO BMJSBO EBSBI MPLBM KBOHLB QBOKBOH QBEB
EBTBSOZB BEBMBI QFOHVCBIBO KVNMBI WBTLVMBSJUBT KBSJOHBO
$POUPIOZB KJLBNFUBCPMJTNFEJTVBUVKBSJOHBONFOJOHLBUVOUVL
KBOHLB XBLUV MBNB WBTLVMBSJUBT BLBO NFOJOHLBU TVBUV QSPTFT
ZBOH VNVNOZB EJTFCVU BOHJPHFOFTJT KJLB NFUBCPMJTNF KBSJOHBO
UFSTFCVU NFOVSVO WBTLVMBSJUBT BLBO NFOVSVO (BNCBS UVB WBTLVMBSJUBTTFSJOHLBMJUFSUJOHHBMKBVIEJCBXBILFCVUVIBO
NFNQFSMJIBULBO QFOJOHLBUBO CFTBS EBMBN KVNMBI LBQJMFS PUPU KBSJOHBO
UJCJBMJT BOUFSJPS UJLVT ZBOH EJCFSJ SBOHTBOH MJTUSJL BHBS Peran Oksigen dalam Pengaturan Jangka Panjang
CFSLPOUSBLTJTJOHLBUTFDBSBQFSJPEJL TFUJBQIBSJTFMBNBIBSJ 0LTJHFOUJEBLIBOZBQFOUJOHCBHJQFOHBUVSBOBLVUBMJSBOEBSBI
EJCBOEJOHLBOPUPUUVOHLBJMBJOOZBZBOHUJEBLEJCFSJSBOHTBOH MPLBM UFUBQJ KVHB VOUVL QFOHBUVSBO KBOHLB QBOKBOH 4BMBI TBUV
+BEJ UFSEBQBU SFLPOTUSVLTJ WBTLVMBSJUBT KBSJOHBO ZBOH OZBUB DPOUPIOZB BEBMBI NFOJOHLBUOZB WBTLVMBSJUBT KBSJOHBO QBEB
VOUVL NFNFOVIJ LFCVUVIBO KBSJOHBO 3FLPOTUSVLTJ JOJ UFSKBEJ IFXBO ZBOH IJEVQ EJ UFNQBU LFUJOHHJBO IJHI BMUJUVEF
EFOHBO
TBOHBU DFQBU EBMBN CFCFSBQB IBSJ
QBEB IFXBO NVEB )BM JOJ LBEBS PLTJHFO BUNPTGFS SFOEBI $POUPI LFEVB BEBMBI FNCSJP
KVHB DFQBU UJNCVM QBEB KBSJOHBO ZBOH CBSV UVNCVI TFQFSUJ BZBN ZBOH EJUFUBTLBO EBMBN MJOHLVOHBO LBEBS PLTJHFO SFOEBI
KBSJOHBO QBSVU EBO KBSJOHBO LBOLFS OBNVO UJNCVM TBOHBU NFNQVOZBJ LPOEVLUJWJUBT QFNCVMVI EBSBI KBSJOHBO EVB LBMJ
MBNCBU QBEB KBSJOHBO ZBOH TVEBI DVLVQ MBNB UFSCFOUVL 0MFI MFCJI CFTBS EJCBOEJOHLBO QBEB LFBEBBO OPSNBM 1FOHBSVI
LBSFOB JUV XBLUV ZBOH EJCVUVILBO VOUVL QFOHBUVSBO KBOHLB PLTJHFOJOJKVHBEJUVOKVLLBOTFDBSBESBNBUJTQBEBCBZJNBOVTJB
QBOKBOH NVOHLJO IBOZB CFSMBOHTVOH CFCFSBQB IBSJ QBEB QSFNBUVS ZBOH EJNBTVLLBO LF EBMBN UFOEB PLTJHFO VOUVL
OFPOBUVT BUBV TFMBNB CFSCVMBOCVMBO QBEB PSBOHUVB UVKVBO UFSBQFVUJL ,FMFCJIBO PLTJHFO IBNQJS TFHFSB
4FMBOKVUOZB EFSBKBUBLIJSSFTQPOTKBVIMFCJICBJLQBEBKBSJOHBO NFOZFCBCLBOUFSIFOUJOZBQFSUVNCVIBOWBTLVMBSCBSVEJSFUJOB
NVEB EJCBOEJOHLBO KBSJOHBO UVB TFIJOHHB QBEB OFPOBUVT NBUB CBZJ QSFNBUVS EBO CBILBO NFOZFCBCLBO EFHFOFSBTJ
WBTLVMBSJUBTBLBONFOZFTVBJLBOEJSJIBNQJSUFQBUTFTVBJEFOHBO CFCFSBQBQFNCVMVIEBSBILFDJMZBOHTVEBIUFSCFOUVL#JMBCBZJ
LFCVUVIBOKBSJOHBOBLBOBMJSBOEBSBI TFEBOHLBOQBEBKBSJOHBO LFNVEJBOEJLFMVBSLBOEBSJUFOEBELTJHFO UJNCVMQFSUVNCVIBO
197
Unit IV Sirkulasi
CFSMFCJIBO ZBOH QFTBU QFNCVMVI CBSV VOUVL NFOHPNQFOTBTJ PMFI LFCVUVIBO NBLTJNVN BMJSBO EBSBI EBO CVLBO PMFI
QFOVSVOBO NFOEBEBL LFUFSTFEJBBO PLTJHFO CBILBO TFSJOH LFCVUVIBO SBUBSBUB $POUPIOZB TFMBNB PMBI SBHB CFSBU
LBMJ UFSEBQBU QFSUVNCVIBO CFSMFCJIBO EBMBN KVNMBI TBOHBU LFCVUVIBO BMJSBO EBSBI EJ TFMVSVI UVCVI TFSJOH LBMJ NFOJOHLBU
CBOZBL TFIJOHHB QFNCVMVI EBSBI SFUJOB UVNCVI NBTVL EBSJ FOBN TBNQBJ EFMBQBO LBMJ BMJSBO EBSBI JTUJSBIBU ,FMFCJIBO
SFUJOBLFEBMBNWJUSFVTIVNPSNBUBEBOIBMJOJQBEBBLIJSOZB BMJSBOJOJNVOHLJOUBLEJCVUVILBOMFCJIEBSJCFCFSBQBNFOJUQFS
BLBO NFOZFCBCLBO LFCVUBBO ,FBEBBO JOJ EJTFCVUGJCSPQMBTJB IBSJ /BNVO CBILBO QBEB LFCVUVIBO ZBOH TFTJOHLBU JUV QVO
SFUSPMFOUBM
EBQBUNFOZFCBCLBOUFSCFOUVLOZB7&('EBMBNKVNMBIDVLVQEJ
Pentingnya Faktor Pertumbuhan Endotel Vaskular dalam PUPU VOUVL NFOJOHLBULBO WBTLVMBSJTBTJOZB TFTVBJ LFCVUVIBO
Pembentukan Pembuluh Darah Baru +JLB UJEBL BEB LFNBNQVBO JOJ TFUJBQ LBMJ TFTFPSBOH NFODPCB
5FMBIEJUFNVLBOTFMVTJOBUBVMFCJIGBLUPSZBOHNFOJOHLBULBO NFMBLVLBO PMBI SBHB CFSBU PUPU UBL BLBO CJTB NFNQFSPMFI [BU
QFSUVNCVIBO QFNCVMVI EBSBI CBSV ZBOH IBNQJS TFMVSVIOZB OVUSJTJ ZBOH EJCVUVILBO UFSVUBNB PLTJHFO TFIJOHHB PUPU BLBO
CFSVQB QFQUJEB LFDJM 5JHB EBSJ GBLUPSGBLUPS UFSTFCVU ZBOH HBHBMCFSLPOUSBLTJ
UFMBIEJLFOBMJEFOHBOCBJLBEBMBIGBLUPSQFSUVNCVIBOFOEPUFM "LBO UFUBQJ TFUFMBI UFSCFOUVL WBTLVMBSJTBTJ UBNCBIBO
WBTLVMBS WBTDVMBS FOEPUIFMJBM HSPXUI GBDUPST7&('
GBLUPS QFNCVMVI EBSBI UBNCBIBO UFSTFCVU OPSNBMOZB BLBO UFUBQ
QFSUVNCVIBO GJCSPCMBT EBO BOHJPHFOJO NBTJOHNBTJOH UFMBI CFSLPOTUSJLTJ EBO UFSCVLB VOUVL NFMFXBULBO BMJSBO EBSBI
EJJTPMBTJLBO EBSJ KBSJOHBO EFOHBO TVQMBJ EBSBI ZBOH UJEBL UBNCBIBO IBOZB KJLB UFSEBQBU SBOHTBOH TFUFNQBU ZBOH TFTVBJ
BEFLVBU %JQFSLJSBLBO EFGJTJFOTJ PLTJHFO KBSJOHBO BUBV TFQFSUJ LFLVSBOHBO PLTJHFO SBOHTBOH WBTPEJMBUPS TBSBG BUBV
OVUSJFO MBJOOZB BUBV LFEVBEVBOZB ZBOH NFOHBSBI SBOHTBOHMBJOOZBZBOHNFNCVUVILBOBMJSBOUBNCBIBO
QFNCFOUVLBO GBLUPS QFSUVNCVIBO WBTLVMBS EJTFCVU KVHB Pembentukan Sirkulasi Kolateral-Suatu Fenomena
GBLUPSBOHJPHFOJL
Pengaturan Aliran Darah Lokal Jangka Panjang
1BEB EBTBSOZB TFNVB GBLUPS BOHJPHFOJL NFOJNCVMLBO #JMB TFCVBI BOUFSJ BUBV WFOB EJ IBNQJS TFNVB KBSJOHBO UVCVI
QFSUVNCVIBO QFNCVMVI CBSV EFOHBO DBSB TBNB 'BLUPSGBLUPS NBOBQVOEJTVNCBU TVBUVTBMVSBOQFNCVMVIEBSBICBSVCJBTBOZB
UFSTFCVUNFOZFCBCLBOQFNCVMVICBSVUVNCVIEBSJQFNCVMVI BLBOUJNCVMEJTFLJUBSTVNCBUBOEBONFNVOHLJOLBOLFNCBMJOZB
QFNCVMVI LFDJM MBJOOZB -BOHLBI QFSUBNB BEBMBI EJTPMVTJ TVQMBJEBSBITFUJEBLOZBTFDBSBQBSTJBMLFKBSJOHBOUFSTFCVU5BIBQ
NFNCSBO CBTBM TFM FOEPUFM EJ UFNQBU QFSUVNCVIBO )BM JOJ QFSUBNB EBMBN QSPTFT UFSTFCVU BEBMBI EJMBUBTJ EBSJ MFOHLVOH
EJJLVUJPMFISFQSPEVLTJDFQBUTFMTFMFOEPUFMCBSVZBOHLFNVEJBO WBTLVMBS LFDJM ZBOH TVEBI NFOHIVCVOHLBO QFNCVMVI EJ BUBT
NFOHBMJS LFMVBS NFMBMVJ EJOEJOH QFSQBOKBOHBO QFNCVMVI LF TVNCBUBO EFOHBO QFNCVMVI EJ CBXBIOZB %JMBUBTJ JOJ UFSKBEJ
BSBITVNCFSGBLUPSBOHJPHFOJL4FMTFMEJTFUJBQQFNCVMVIUFSVT EBMBN XBLUV TBUV BUBV EVB NFOJU ZBOH NFOVOKVLLBO CBIXB
NFOFSVT NFNCFMBI EJSJ EBO EFOHBO DFQBU NFMJQBU NFOKBEJ EJMBUBTJ UFSTFCVU UBNQBLOZB EJQFSBOUBSBJ PMFI GBLUPS NFUBCPMJL
TVBUV UBCVOH 4FMBOKVUOZB UBCVOH UFSTFCVU UFSIVCVOH EFOHBO ZBOHNFSFMBLTBTJTFSBUPUPUQFNCVMVILFDJMCFSTBOHLVUBO4FUFMBI
UBCVOH MBJO ZBOH CFSUVOBT EBSJ QFNCVMVI EPOPS MBJO BSUFSJPM UBIBQ QFNCVLBBO BXBM QFNCVMVI LPMBUFSBM JOJ BMJSBO EBSBI
BUBVWFOVMBMBJO
EBONFNCFOUVLTVBUVMFOHLVOHLBQJMFSUFNQBU TFSJOH LBMJ NBTJI LVSBOH EBSJ TFQFSFNQBU ZBOH EJQFSMVLBO VOUVL
EBSBINVMBJNFOHBMJS+JLBBMJSBODVLVQCFTBS TFMTFMPUPUQPMPT NFNFOVIJ TFNVB LFCVUVIBO KBSJOHBO 1FNCVLBBO TFMBOKVUOZB
BLIJSOZBNBTVLLFEBMBNEJOEJOH TFIJOHHBCFCFSBQBQFNCVMVI UFSKBEJ EBMBN XBLUV KBNKBN CFSJLVUOZB TFIJOHHB TFUFMBI IBSJ
CBSV BLIJSOZB UVNCVI NFOKBEJ BSUFSJPM CBSV BUBV WFOVMB BUBV TFQBSVI LFCVUVIBO KBSJOHBO NVOHLJO EBQBU UFSQFOVIJ EBO
NVOHLJO QFNCVMVI CFSVLVSBO MFCJI CFTBS +BEJ BOHJPHFOFTJT EBMBN XBLUV CFCFSBQB IBSJ BMJSBO EBSBI VNVNOZB DVLVQ
NFOKFMBTLBO DBSB GBLUPS NFUBCPMJL EJ KBSJOHBO MPLBM EBQBU NFNBEBJVOUVLNFNFOVIJLFCVUVIBOKBSJOHBO
NFOZFCBCLBOQFSUVNCVIBOQFNCVMVICBSV 4FMBNB CFCFSBQB CVMBO CFSJLVUOZB QFNCVMVI LPMBUFSBM UFSVT
;BU UFSUFOUV MBJOOZB TFQFSUJ CFCFSBQB IPSNPO TUFSPJE NFOFSVTUVNCVI ZBOHIBNQJSTFMBMVNFNCFOUVLCBOZBLTBMVSBO
NFNJMJLJ FGFL ZBOH CFSMBXBOBO UFSIBEBQ QFNCVMVI EBSBI LPMBUFSBM LFDJM EBO CVLBO TBUV QFNCVMVI UVOHHBM CFTBS 1BEB
LFDJM LBEBOHLBEBOH CBILBO NFOZFCBCLBO EJTPMVTJ TFMTFM LFBEBBO JTUJSBIBU BMJSBO EBSBI CJBTBOZB LFNCBMJ NFOEFLBUJ
WBTLVMBS EBO IJMBOHOZB QFNCVMVI 0MFI LBSFOB JUV OPSNBM UFUBQJ TBMVSBO ZBOH CBSV KBSBOH CFSVLVSBO DVLVQ CFTBS
QFNCVMVI EBSBI EBQBU EJCVBU NFOHIJMBOH CJMB UJEBL VOUVLNFOZFEJBLBOBMJSBOEBSBIZBOHEJQFSMVLBOTFMBNBBLUJWJUBT
EJCVUVILBO 1FQUJEB ZBOH EJIBTJMLBO KBSJOHBO EBQBU KBSJOHBOCFSBU+BEJ QFNCFOUVLBOQFNCVMVILPMBUFSBMNFOHJLVUJ
NFOHIBNCBU QFSUVNCVIBO QFNCVMVI EBSBI CBSV QSJOTJQVNVNEBSJQFOHBUVSBOBMJSBOEBSBIMPLBMBLVUEBOKBOHLB
$POUPIOZB BOHJPTUBUJO GSBHNFO QSPUFJO QMBTNJOPHFO QBOKBOH ZBJUV QFOHBUVSBO BLVU NFOJNCVMLBO EJMBUBTJ NFUBCPMJL
BEBMBI TVBUV JOIJCJUPS BOHJPHFOFTJT BMBNJ &OEPTUBUJO ZBOH DFQBU EJJLVUJ TFDBSB LSPOJT PMFI QFSUVNCVIBO EBO
BEBMBI BOUJBOHJPHFOJL MBJO ZBOH CFSBTBM EBSJ QFNFDBIBO QFNCFTBSBO QFNCVMVI CBSV TFMBNB CFSNJOHHVNJOHHV EBO
LPMBHFO UJQF 97** .FTLJQVO GVOHTJ GJTJPMPHJL TVCTUBOTJ CFSCVMBOCVMBO
BOUJBOHJPHFOJL UFQBUOZB NBTJI CFMVN EJLFUBIVJ NFOKBEJ $POUPI UFSQFOUJOH QFNCFOUVLBO QFNCVMVI EBSBI LPMBUFSBM
NJOBU ZBOH CFTBS NFOHFOBJ QPUFOTJ QFOHHVOBBOZB EBMBN EJKVNQBJ TFUFMBI UFSKBEJOZB USPNCPTJT EJ TBMBI TBUV BSUFSJ
NFOHIFOUJLBO QFSUVNCVIBO QFNCVMVI EBSBI QBEB UVNPS LPSPOFS )BNQJS TFNVB PSBOH ZBOH CFSVNVS UBIVO UFMBI
HBOBT EBO EFOHBO EFNJLJBO NFODFHBI QFOJOHLBUBO BMJSBO NFNJMJLJ TFEJLJUOZB TBUV DBCBOH QFNCVMVI LPSPOFS LFDJM ZBOH
EBSBIZBOHEJQFSMVLBOVOUVLNFOVOKBOHLFCVUVIBOOVUSJFO UFSUVUVQ BUBV TFUJEBLOZB TFCBHJBO UFSTVNCBU /BNVO TFCBHJBO
QBEBQFSUVNCVIBOUVNPSZBOHQFTBU CFTBSPSBOHUJEBLNFOHFUBIVJCBIXBIBMJOJUFMBIUFSKBEJLBSFOB
LPMBUFSBM UFMBI UFSCFOUVL DVLVQ DFQBU VOUVL NFODFHBI
Vaskularitas Ditentukan oleh Kebutuhan Maksimum LFSVTBLBO NJPLBSEJVN MOJMBI ZBOH UFSKBEJ QBEB LBTVTLBTVT
Aliran Darah, dan Bukan oleh Kebutuhan Rata-rata. 4BUV MBJOOZBTBBUJOTVGJTJFOTJLPSPOFSUJNCVMUFSMBMVDFQBUBUBVUFSMBMV
LBSBLUFSJTUJL QFOUJOH ZBOH EJNJMJLJ PMFI QFOHBUVSBO WBTLVMBS QBSBI VOUVL UFSCFOUVLOZB LPMBUFSBM TFIJOHHB UFSKBEJ TFSBOHBO
KBOHLBQBOKBOHZBJUVCBIXBWBTLVMBSJUBTUFSVUBNBEJUFOUVLBO KBOUVOHZBOHTFSJVT
198
Pengendalian Sirkulasi secara Humoral NFOJOHLBU DVLVQ UJOHHJ VOUVL NFOJOHLBULBO UFLBOBO BSUFSJ
TFCBOZBLNN)H
1FOHFOEBMJBO TJSLVMBTJ TFDBSB IVNPSBM CFSBSUJ QFOHFOEBMJBO PMFI
[BU[BUZBOHEJTFLSFTJBUBVZBOHEJBCTPSCTJLFEBMBNDBJSBOUVCVI 7BTPQSFTJO NFNJMJLJ GVOHTJ VUBNB NFOJOHLBULBO
UNIT IV
TFQFSUJIPSNPOEBOGBLUPSZBOHEJIBTJMLBOTFUFNQBU#FCFSBQB[BU SFBCTPSQTJ BJS EBSJ UVCVMVT SFOBM LFNCBMJ LF EBMBN EBSBI
JOJEJCFOUVLPMFILFMFOKBSLIVTVTEBOEJCBXBEJEBMBNEBSBILF EJCBIBTEJ#BC
EBOLBSFOBJUVBLBONFNCBOUVNFOHBUVS
TFMVSVIUVCVI;BUMBJOOZBEJCFOUVLEJEBFSBIKBSJOHBOTFUFNQBU WPMVNFDBJSBOUVCVI*UVTFCBCOZBNFOHBQBIPSNPOJOJKVHB
EBO IBOZB NFOJNCVMLBO QFOHBSVI TJSLVMBTJ TFUFNQBU 'BLUPS EJOBNBLBOIPSNPOBOUJEJVSFUJL
GBLUPSIVNPSBMUFSQFOUJOHZBOHNFNFOHBSVIJGVOHTJTJSLVMBTJEJ Zat Vasodilator
BOUBSBOZBBEBMBITFCBHBJCFSJLVU Bradikinin #FCFSBQB [BU ZBOH EJTFCVU LJOJO EBQBU
Zat Vasokonstriktor NFOZFCBCLBOWBTPEJMBUBTJLVBULFUJLBEJCFOUVLEJEBMBNEBSBI
EBODBJSBOKBSJOHBOCFCFSBQBPSHBO
Norepinefrin dan Epinefrin. /PSFQJOFGSJO UFSVUBNB BEBMBI ,JOJO NFSVQBLBO QPMJQFQUJEB LFDJM ZBOH EJQJTBILBO PMFI
IPSNPO WBTPLPOTUSJLUPS ZBOH BNBU LVBU FQJOFGSJO UJEBL CFHJUV FO[JNQSPUFPMJUJLEBSJBMGBHMPCVMJOEBMBNQMBTNBBUBVDBJSBO
LVBUEBOEJCFCFSBQBKBSJOHBO CBILBONFOZFCBCLBOWBTPEJMBUBTJ KBSJOHBO 4VBUV FO[JN QSPUFPMJUJL QFOUJOH VOUVL UVKVBO
SJOHBO $POUPI LIVTVT WBTPEJMBUBTJ BLJCBU FQJOFGSJO EJKVNQBJ UFSTFCVU BEBMBI LBMJLSFJO ZBOH UFSEBQBU EBMBN EBSBI EBO
QBEB KBOUVOH VOUVL NFOEJMBUBTJLBO BSUFSJ LPSPOFS TFMBNB DBJSBOKBSJOHBOEBMBNCFOUVLUJEBLBLUJG,BMJLSFJOZBOHCFMVN
QFOJOHLBUBOBLUJWJUBTKBOUVOH
BLUJG JOJ EBQBU EJBLUJGLBO PMFI NBTFSBTJ EBSBI QFSBEBOHBO
,FUJLBTJTUFNTBSBGTJNQBUJTEJSBOHTBOHEJTFCBHJBOCFTBSBUBV KBSJOHBO BUBV PMFI QFOHBSVI GJTJL BUBV LJNJBXJ ZBOH TFSVQB
EJTFMVSVICBHJBOUVCVITFMBNBUFSKBEJTUSFTBUBVPMBISBHB VKVOH QBEB EBSBI BUBV KBSJOHBO #FHJUV LBMJLSFJO NFOKBEJ BLUJG [BU
TBSBG TJNQBUJT QBEB NBTJOHNBTJOH KBSJOHBO BLBO NFMFQBTLBO UFSTFCVU BLBO TFHFSB CFLFSKB QBEB BMGBHMPCVMJO VOUVL
OPSFQJOFGSJO ZBOH NFSBOHTBOH KBOUVOH EBO NFOHPOTUSJLTJ WFOB NFNCFCBTLBO TVBUV LJOJO ZBOH EJTFCVU LBMJEJO ZBOH
TFSUBBOUFSJPM4FMBJOJUV TBSBGTJNQBUJTQBEBNFEVMBBESFOBMKVHB LFNVEJBO EJVCBI PMFI FO[JN KBSJOHBO NFOKBEJ CSBEJLJOJO
NFOZFCBCLBO LFMFOKBS JOJ NFOTFLSFTJ OPSFQJOFGSJO EBO FQJOFGSJO #FHJUV UFSCFOUVL CSBEJLJOJO IBOZB CFSUBIBO CFCFSBQB NFOJU
LF EBMBN EBSBI )PSNPOIPSNPO JOJ LFNVEJBO CFSTJSLVMBTJ LF LBSFOB BLBO EJJOBLUJWBTJ PMFI FO[JN LBSCPLTJQFQUJEBTF BUBV
TFMVSVI CBHJBO UVCVI EBO NFOZFCBCLBO FGFL QFSBOHTBOHBO ZBOH PMFI FO[JN QFOHVCBI DPOWFSUJOH FO[ZNF
ZBJUV FO[JN ZBOH
IBNQJS TBNB EFOHBO QFSBOHTBOHBO TJNQBUJT MBOHTVOH UFSIBEBQ KVHB CFSQFSBO QFOUJOH EBMBN NFOHBLUJGLBO BOHJPUFOTJO
TJSLVMBTJ TFIJOHHB UFSTFEJB EVB TJTUFN QFOHBUVSBO
TFQFSUJ EJCBIBT EJ #BC &O[JN LBMJLSFJO ZBOH UFSBLUJWBTJ
QFSBOHTBOHBO TBSBG TFDBSB MBOHTVOH EBO
FGFL UJEBL MBOHTVOH BLBO EJIBODVSLBO PMFI TVBUV JOIJCJUPS LBMJLSFJO ZBOH KVHB
EBSJ OPSFQJOFGSJO EBOBUBV FQJOFGSJO EJ EBMBN EBSBI ZBOH UFSEBQBUEJDBJSBOUVCVI
CFSTJSLVMBTJ #SBEJLJOJO NFOZFCBCLBO EJMBUBTJ LVBU BSUFSJPM EBO
Angiotensin II"OHJPUFOTJO ** BEBMBI [BU WBTPLPOTUSJLUPS LVBU QFOJOHLBUBO QFSNFBCJMJUBT LBQJMFS $POUPIOZB JOKFLTJ
MBJOOZB 4FCBOZBL TFQFSTFKVUB HSBN EBQBU NFOJOHLBULBO NJLSPHSBN CSBEJLJOJO LF EBMBN BSUFSJ CSBLIJBMJT TFTFPSBOH
UFLBOBOBSUFSJNBOVTJBNN)HBUBVMFCJI BLBO NFOJOHLBULBO BMJSBO EBSBI NFMBMVJ MFOHBO TFCBOZBL
1FOHBSVI BOHJPUFOTJO ** BEBMBI VOUVL NFOHPOTUSJLTJ BOUFSJ FOBN LBMJ EBO CBILBO EBMBN KVNMBI MFCJI TFEJLJU CJMB
LFDJMEFOHBOLVBU+JLBIBMJOJUFSKBEJEJTVBUVCBHJBOKBSJOHBOZBOH EJTVOUJLLBO TFDBSB MPLBM LF EBMBN KBSJOHBO EBQBU
UFSJTPMBTJ BMJSBOEBSBILFCBHJBOUFSTFCVUEBQBUTBOHBUCFSLVSBOH NFOZFCBCLBOFEFNBTFUFNQBUZBOHIFCBUBLJCBUQFOJOHLBUBO
/BNVO LFQFOUJOHBO OZBUB EBSJ BOHJPUFOTJO ** BEBMBI CBIXB VLVSBOQPSJQPSJLBQJMFS
BOHJPUFOTJOTFDBSBOPSNBMCFLFSKBTFDBSBCFSTBNBBOQBEBCBOZBL 5FSEBQBU BMBTBO VOUVL NFZBLJOJ CBIXB LJOJO CFSQFSBO
BSUFSJPM UVCVI VOUVL NFOJOHLBULBO UBIBOBO QFSJGFS UPUBM ZBOH LIVTVT EBMBN QFOHBUVSBO BMJSBO EBSBI EBO CPDPSOZB DBJSBO
EFOHBO EFNJLJBO BLBO NFOJOHLBULBO UFLBOBO BOUFSJ +BEJ EBSJ LBQJMFS QBEB KBSJOHBO ZBOH NFSBEBOH %JZBLJOJ KVHB
IPSNPO JOJ CFSQFSBO TFDBSB JOUFHSBM EBMBN QFOHBUVSBO UFLBOBO CBIXB CSBEJLJOJO CFSQFSBO OPSNBM EBMBN QFOHBUVSBO BMJSBO
BSUFSJ TFQFSUJEJEJTLVTJLBOTFDBSBEFUBJMEJ#BC EBSBI EJ LVMJU EBO EJ LFMFOKBS MJVS TFSUB LFMFOKBS
Vasopresin. 7BTPQSFTJO ZBOH KVHB EJTFCVU IPSNPO HBTUSPJOUFTUJOBM
BOUJEJVSFUJL CBILBO MFCJI LVBU EBSJQBEB BOHJPUFOTJO ** TFCBHBJ Histamin. 1BEB EBTBNZB IJTUBNJO EJLFMVBSLBO EJ TFUJBQ
WBTPLPOTUSJLUPS TFIJOHHB NFOKBEJLBOOZB TFCBHBJ TBMBI TBUV [BU KBSJOHBO UVCVI KJLB KBSJOHBO UFSTFCVU NFOHBMBNJ LFSVTBLBO
WBTPLPOTUSJLUPS UFSLVBU UVCVI ;BU JOJ EJCFOUVL EJ TFM TBSBG EJ BUBV QFSBEBOHBO BUBV CFSQFSBO QBEB SFBLTJ BMFSHJ 4FCBHJBO
EBMBN IJQPUBMBNVT PUBL MJIBU #BC EBO
OBNVO LFNVEJBO CFTBSIJTUBNJOCFSBTBMEBSJTFMNBTUEBMBNKBSJOHBOZBOHSVTBL
EJBOHLVULFCBXBIPMFIBLTPOTBSBGLFLFMFOKBSIJQPGJTJTQPTUFSJPS EBOEBSJCBTPGJMEBMBNEBSBI
VOUVLBLIJSOZBEJTFLSFTJLFEBMBNEBSBI )JTUBNJO NFNJMJLJ FGFL WBTPEJMBUPS LVBU UFSIBEBQ BSUFSJPM
EBO TFQFSUJ CSBEJLJOJO NFNJMJLJ LFNBNQVBO VOUVL
+FMBTMBI CBIXB WBTPQSFTJO EBQBU NFNCFSJLBO QFOHBSVI
NFOJOHLBULBO QPSPTJUBT LBQJMFS EFOHBO IFCBU TFIJOHHB UJNCVM
TBOHBU CFTBS UFSIBEBQ GVOHTJ TJSLVMBTJ /BNVO EBMBN LFBEBBO
LFCPDPSBO DBJSBO EBO QSPUFJO QMBTNB LF EBMBN KBSJOHBO 1BEB
OPSNBM IBOZB TFKVNMBI LFDJM WBTPQSFTJO EJTFLSFTJLBO TFIJOHHB
CBOZBL LPOEJTJ QBUPMPHJT EJMBUBTJ BSUFSJPM TFSUB LFOBJLBO
CBOZBL BIMJ GBBM NFOHBOHHBQ CBIXB WBTPQSFTJO CFSQFSBO LFDJM
QPSPTJUBT LBQJMFS IFCBU BLJCBU IJTUBNJO EBQBU NFOZFCBCLBO
EBMBN QFOHBUVSBO WBTLVMBS "LBO UFUBQJ CFCFSBQB QFSDPCBBO
TFKVNMBI CFTBS DBJSBO CPDPS EBSJ TJSLVMBTJ NBTVL LF EBMBN
UFMBI NFNQFSMJIBULBO CBIXB LPOTFOUSBTJ WBTPQSFTJO EBMBN
KBSJOHBOEBONFNJDVUFSKBEJOZBFEFNB&GFLIJTUBNJOEBMBN
TJSLVMBTJEBSBITFUFMBIUFSKBEJOZBQFSEBSBIBOIFCBUEBQBU
199
Unit IV Sirkulasi
NFOJNCVMLBOWBTPEJMBUBTJMPLBMEBOFEFNBLIVTVTOZBNFOZPMPL 6OUVL NFOKBXBC QFSUBOZBBO JOJ LJUB IBSVT LFNCBMJ LFQBEB

TFMBNBCFSMBOHTVOHSFBLTJBMFSHJEBOBLBOEJCBIBTEJ#BC TBUVQSJOTJQEBTBSGVOHTJTJSLVMBTJZBOHUFMBIEJCBIBTTFCFMVNOZB
Pengendalian Vaskular oleh lon dan LFNBNQVBO BVUPSFHVMBTJ BMJSBO EBSBI KBSJOHBO TFTVBJ EFOHBO
Faktor Kimiawi Lainnya LFCVUVIBO NFUBCPMJL EBO GVOHTJ KBSJOHBO MBJOOZB 1FNCFSJBO
WBTPLPOTUSJLUPSLVBU TFQFSUJBOHJPUFOTJO** EBQBUNFOZFCBCLBO
#FSCBHBJ JPO EBO GBLUPS LJNJB MBJOOZB EBQBU NFOZFCBCLBO QFOVSVOBO TFNFOUBSB BMJSBO EBSBI KBSJOHBO EBO DVSBI KBOUVOH
EJMBUBTJ BUBV LPOTUSJLTJ QFNCVMVI EBSBI MPLBM 4FCBHJBO CFTBS UFUBQJ VNVNOZB IBOZB TFEJLJU NFNCFSJ QFOHBSVI KBOHLB
[BU[BUJOJNFNJMJLJQFSBOLFDJMEBMBNLFTFMVSVIBOQFOHBUVSBO QBOKBOH BQBCJMB UJEBL NFOZFCBCLBO QFSVCBIBO MBKV NFUBCPMJL
TJSLVMBTJ OBNVOCFCFSBQBQFOHBSVITQFTJGJLBEBMBI KBSJOHBO %FNJLJBO QVMB LFCBOZBLBO WBTPEJMBUPS IBOZB
1. 1FOJOHLBUBOLPOTFOUSBTJJPOLBMTJVNNFOZFCBCLBOWBTP NFOJNCVMLBO QFSVCBIBO BMJSBO EBSBI KBSJOHBO EBO DVSBI
LPOTUSJLTJ )BM JOJ BLJCBU QFOHBSVI VNVN LBMTJVN VOUVL KBOUVOH KBOHLB QFOEFL BQBCJMB UJEBL NFOZFCBCLBO QFSVCBIBO
NFSBOHTBOH LPOUSBLTJ PUPU QPMPT TFQFSUJ ZBOH EJCBIBT EJ MBKV NFUBCPMJL KBSJOHBO %FOHBO EFNJLJBO VNVNOZB BMJSBO
#BC EBSBI EJBUVS TFTVBJ LFCVUVIBO TQFTJGJL KBSJOHBO TFMBNB UFLBOBO
2. 1FOJOHLBUBO LPOTFOUSBTJ JPO LBMJVN EBMBN CBUBT GJTJPMPHJT BSUFSJNFNBEBJVOUVLQFSGVTJKBSJOHBO
NFOZFCBCLBO WBTPEJMBUBTJ )BM JOJ BLJCBU LFNBNQVBO JPO Daftar Pustaka
LBMJVNVOUVLNFOHIBNCBULPOUSBLTJPUPUQPMPT Adair TH: Growth regulation of the vascular system: an emerging role for
adenosine, Am J Physiol Regul Integr Comp Physiol 289:R283, 2005.
3. 1FOJOHLBUBO LPOTFOUSBTJ JPO NBHOFTJVN NFOZFCBCLBO Campbell WB, Falck JR: Arachidonic acid metabolites as endothelium-
WBTPEJMBUBTJ IFCBU LBSFOB JPO NBHOFTJVN VNVNOZB derived hyperpolarizing factors, Hypertension 49:590, 2007.
NFOHIBNCBULPOUSBLTJPUPUQPMPT Drummond HA, Grifoni SC, Jernigan NL: A new trick for an old dogma:
4. 1FOJOHLBUBO LPOTFOUSBTJ JPO IJESPHFO QFOVSVOBO Q)
ENaC proteins as mechanotransducers in vascular smooth muscle,
Physiology (Bethesda) 23:23, 2008.
NFOZFCBCLBO EJMBUBTJ BSUFSJPM 4FCBMJLOZB TFEJLJU Dhaun N, Goddard J, Kohan DE, et al: Role of endothelin-1 in clinical hyper-
QFOVSVOBO EBMBN LPOTFOUSBTJ JPO IJESPHFO NFOZFCBCLBO tension: 20 years on, Hypertension 52:452, 2008.
LPOTUSJLTJBSUFSJBM Ferrara N, Gerber HP, LeCouter J: The biology of VEGF and its receptors, Nat
Med 9:669, 2003.
5. "OJPO ZBOH NFNJMJLJ QFOHBSVI CFSNBLOB UFSIBEBQ
Folkman J: Angiogenesis, Annu Rev Med 57:1, 2006.
QFNCVMVI EBSBI BEBMBI BTFUBU EBO TJUSBU ,FEVBOZB Folkman J: Angiogenesis: an organizing principle for drug discovery? Nat
NFOJNCVMLBOWBTPEJMBUBTJSJOHBO Rev Drug Discov 6:273, 2007.
6. 1FOJOHLBUBO LPOTFOUSBTJ LBSCPO EJPLTJEB NFOJNCVMLBO Guyton AC, Coleman TG, Granger HJ: Circulation: overall regulation, Annu
Rev Physiol 34:13, 1972.
WBTPEJMBUBTJ TFEBOH EJ TFCBHJBO CFTBS KBSJOHBO OBNVO Hall JE, Brands MW, Henegar JR: Angiotensin II and long-term arterial
NFOJNCVMLBO WBTPEJMBUBTJ IFCBU EJ PUBL ,BSCPO EJPLTJEB pressure regulation: the overriding dominance of the kidney, J Am Soc
EJ EBMBN EBSBI ZBOH CFLFSKB QBEB QVTBU WBTPNPUPS PUBL Nephrol 10(Suppl 12):S258, 1999.
KVHB NFNJMJLJ FGFL UJEBL MBOHTVOH ZBOH TBOHBU LVBU &GFL Heerkens EH, Izzard AS, Heagerty AM: Integrins, vascular remodeling, and
hypertension, Hypertension 49:1, 2007.
UFSTFCVU EJIBOUBSLBO NFMBMVJ TJTUFN WBTPLPOTUSJLUPS TBSBG
Hester RL, Hammer LW: Venular-arteriolar communication in the regulation
TJNQBUJT VOUVL NFOJNCVMLBO WBTPLPOTUSJLTJ MVBT EJ of blood flow, Am J Physiol Regul Integr Comp Physiol 282:R1280, 2002.
TFMVSVIUVCVI Hodnett BL, Hester RL: Regulation of muscle blood flow in obesity,
Microcirculation 14:273, 2007.
Kebanyakan Vasodilator dan Vasokonstritor Berpengaruh Horowitz A, Simons M: Branching morphogenesis, Circ Res 103:784, 2008.
Kecil pada Aliran Darah Jangka-Panjang, Kecuali Apabila Humphrey JD: Mechanisms of arterial remodeling in hypertension: coupled
Mengubah Laju Metabolik Jaringan. 1BEB TFCBHJBO CFTBS roles of wall shear and intramural stress, Hypertension 52:195, 2008.
LBTVT BMJSBOEBSBIKBSJOHBOEBODVSBIKBOUVOH KVNMBIBMJSBOLF Jain RK, di Tomaso E, Duda DG, et al: Angiogenesis in brain tumours, Nat
Rev Neurosci 8:610, 2007.
TFMVSVI KBSJOHBO UVCVI
UJEBL UFSMBMV CFSVCBI LFDVBMJ TFMBNB Keeley EC, Mehrad B, Strieter RM: Chemokines as mediators of neovascu-
TBUVBUBVEVBIBSJQBEBTUVEJFLTQFSJNFOUBM TBBUEJCFSJJOGVTLSP larization, Arterioscler Thromb Vasc Biol 28:1928, 2008.
OJT TFKVNMBI CFTBS WBTPLPOTUSJLUPS LVBU TFQFSUJ BOHJPUFOTJO ** Renkin EM: Control of microcirculation and blood-tissue exchange. In
BUBV WBTPEJMBUPS TFQFSUJ CSBEJLJOJO .FOHBQB BMJSBO EBSBI Renkin EM, Michel CC (eds.): Handbook of Physiology, Sec 2, vol IV,
TFCBHJBO CFTBS KBSJOHBO UJEBL CFSVCBI TFDBSB CFSNBLOB Bethesda, 1984, American Physiological Society, pp 627.
Roman RJ: P-450 metabolites of arachidonic acid in the control of cardio-
NFTLJQVOUFSEBQBUTFKVNMBICFTBS[BUWBTPBLUJGJOJ vascular function, Physiol Rev 82:131, 2002.
200
BAB 18
UNIT IV
1FOHBUVSBO 4JSLVMBTJ PMFI 4BSBG EBO
1FOHFOEBMJBO$FQBU5FLBOBO"SUFSJ
EJQFSTBSBGJ TFQFSUJ QFNCVMVI EBSBI NFTFOUFSJLB NFTLJQVO

Pengaturan Sirkulasi
QFSTBSBGBOTJNQBUJTOZBVNVNOZBUJEBLTFQBEBUEJBSUFSJLFDJM
oleh Saraf
BSUFSJPMBEBOWFOB
4FQFSUJ ZBOH UFMBI EJCBIBT EJ 1FSTBSBGBOOZBQBEBBSUFSJLFDJMEBOBSUFSJPMNFNVOHLJOLBO
#BC QFOZFTVBJBO BMJSBO SBOHTBOHBO TJNQBUJT VOUVL NFOJOHLBULBO UBIBOBO BMJSBO
EBSBIEJKBSJOHBOEBOPSHBO EBSBI EBO EFOHBO EFNJLJBO NFOVSVOLBO MBKV BMJSBO EBSBI
UVCVI NFSVQBLBO GVOHTJ NFLBOJTNF QFOHBUVSBO KBSJOHBO NFMBMVJKBSJOHBO
TFUFNQBU 1BEB CBC JOJ LJUB CBIBT CBHBJNBOB QFOHBUVSBO TBSBG 1FSTBSBGBO QFNCVMVI EBSBI CFTBS UFSVUBNB WFOB
UFSIBEBQ TJSLVMBTJ NFNJMJLJ GVOHTJ ZBOH *FCJI VNVN TFQFSUJ NFNVOHLJOLBO SBOHTBOHBO TJNQBUJT VOUVL NFOVSVOLBO
SFEJTUSJCVTJBMJSBOEBSBILFCFSCBHBJEBFSBIUVCVI NFOJOHLBULBO WPMVNF QFNCVMVI EBSBI JOJ ,FBEBBO JOJ EBQBU NFOEPSPOH
BUBVNFOVSVOLBOBLUJWJUBTQPNQBKBOUVOH EBONFOHBUVSUFLBOBO EBSBI NBTVL LF KBOUVOH EBO EFOHBO EFNJLJBO CFSQFSBO
BSUFSJEFOHBODFQBU QFOUJOH EBMBN QFOHBUVSBO QPNQB KBOUVOH TFQFSUJ ZBOH BLBO
4JTUFN TBSBG NFOHBUVS TJSLVMBTJ IBNQJS TFMVSVIOZB NFMBMVJ LJUBKFMBTLBOEBMBNCBCJOJEBOCBCCBCCFSJLVUOZB
TJTUFNTBSBGPUPOPN'VOHTJLFTFMVSVIBOTJTUFNJOJEJCJDBSBLBOEJ
#BC EBO UPQJL JOJ KVHB EJQFSLFOBMLBO EBMBN #BC 6OUVL Serat Saraf Simpatis Jantung 4FSBU TJNQBUJT KVHB MBOHTVOH
EJTLVTJ QBEB CBC JOJ LJUB BLBO NFOJOKBV LBSBLUFSJTUJL BOBUPNJ NFOVKV KBOUVOH TFQFSUJ ZBOH EJUVOKVLLBO QBEB (BNCBS
EBOGVOHTJPOBMLIVTVTUBNCBIBOMBJOOZB ZBJUVTFCBHBJCFSJLVU EBO TFCBHBJNBOB EJCJDBSBLBO EBMBN #BC 1FSMV EJJOHBU
LFNCBMJ CBIXB SBOHTBOHBO TJNQBUJT KFMBT NFOJOHLBULBO
BLUJWJUBT KBOUVOH NFOJOHLBULBO GSFLVFOTJ KBOUVOH EBO
Sistem Saraf Otonom NFOBNCBILFLVBUBOTFSUBWPMVNFQPNQBKBOUVOH
4FKBVIJOJCBHJBOUFSQFOUJOHTJTUFNTBSBGPUPOPNCBHJQFOHBUVSBO
TJSLVMBTJ BEBMBI TJTUFN TBSBG TJNQBUJT /BNVO TJTUFN TBSBG Pengendalian Parasimpatis terhadap Fungsi Jantung,
QBSBTJNQBUJT KVHB CFSQFSBO QFOUJOH EBMBN QFOHBUVSBO GVOHTJ Terutama Frekuensi Jantung. .FTLJQVO TJTUFN TBSBG
KBOUVOH TFQFSUJZBOHEJKFMBTLBOLFNVEJBOEBMBNCBCJOJ QBSBTJNQBUJT TBOHBU QFOUJOH CBHJ CBOZBL GVOHTJ PUPOPN
MBJOOZB TFQFSUJ VOUVL NFOHFOEBMJLBO CFSCBHBJ BLUJWJUBT
Sistem Saraf Simpatis (BNCBS NFNQFSMJIBULBO BOBUPNJ HBTUSPJOUFTUJOBM UFUBQJIBOZBCFSQFSBOLFDJMEBMBNQFOHBUVSBO
TBSBGTJNQBUJTZBOHNFOHBUVSTJSLVMBTJ4FSBUTFSBUTBSBGWBTPNPUPS GVOHTJ WBTLVMBS EJ TFCBHJBO CFTBS KBSJOHBO 1FOHBSVIOZB QBEB
TJNQBUJTNFOJOHHBMLBONFEVMBTQJOBMJTNFMBMVJTFMVSVITBSBGTQJOBM TJSLVMBTJ ZBOH QBMJOH QFOUJOH BEBMBI QFOHBUVSBO GSFLVFOTJ
UPSBLBM EBO NFMBMVJ TBUV BUBV EVB TBSBG TQJOBM MVNCBM QFSUBNB KBOUVOH NFMBMVJ TFSBUTFSBU TBSBG QBSBTJNQBUJT ZBOH NFOVKV
4FSBCVUTFSBCVU JOJ TFHFSB NBTVL LF EBMBN SBOUBJ TJNQBUJT ZBOH KBOUVOH NFMBMVJ OFSWVT WBHVT UFSMJIBU QBEB (BNCBS
CFSBEB EJ UJBQ TJTJ LPSQVT WFSUFCSB ,FNVEJBO TFSBU JOJ NFOVKV TFCBHBJ HBSJT NFSBI QVUVTQVUVT EBSJ NFEVMB PUBL MBOHTVOH
TJSLVMBTJ NFMBMVJ EVB KBMBO
NFMBMVJ TBSBG TJNQBUJT TQFTJGJL ZBOH NFOVKVKBOUVOH
UFSVUBNB NFNQFSTBSBGJ QFNCVMVI EBSBI PSHBO WJTFSB JOUFSOB EBO
KBOUVOH TFQFSUJ UFSMJIBU QBEB (BNCBS TFCFMBI LBOBO EBO
1FOHBSVI SBOHTBOHBO QBSBTJNQBUJT UFSIBEBQ GVOHTJ KBOUVOH
IBNQJSTFHFSBNFNBTVLJOFSWVTTQJOBMJTQFSJGFSZBOHNFNQFSTBSBGJ UFMBIEJCBIBTTFDBSBEFUBJMEJ#BC1BEBEBTBSOZB SBOHTBOHBO
QFNCVMVI EBSBI QFSJGFS +BMVS UFQBUOZB TFSBUTFSBU JOJ EJ NFEVMB QBSBTJNQBUJT NFOZFCBCLBO QFOVSVOBO GSFLVFOTJ KBOUVOH ZBOH
TQJOBMJTEBOEJSBOUBJTJNQBUJTBLBOEJCJDBSBLBOEJ#BC OZBUBEBOTFEJLJUQFOVSVOBOLPOUSBLUJMJUBTPUPUKBOUVOH
Persarafan Simpatis Pembuluh Darah. Sistem Vasokonstriktor Simpatis dan

Pengendaliannya oleh Sistem Saraf Pusat
(BNCBSNFNQFSMJIBULBOEJTUSJCVTJTFSBUTFSBUTBSBGTJNQBUJT
LF QFNCVMVI EBSBI EBO NFOVOKVLLBO CBIXB EJ TFCBHJBO CFTBS 4BSBG TJNQBUJT NFNCBXB TFSBU TBSBG WBTPLPOTUSJLUPS EBMBN
KBSJOHBO TFNVB QFNCVMVI EBSBI LFDVBMJ LBQJMFS EJQFSTBSBGJOZB KVNMBICBOZBLTFLBMJEBOIBOZBTFEJLJUTFSBUWBTPEJMBUPS4FSBU
1BEBCFCFSBQBKBSJOHBO TGJOHUFSQSFLBQJMFS EBONFUBSUFSJPM WBTPLPOTUSJLUPSQBEBEBTBSOZBEJEJTUSJCVTJLBOLFTFMVSVI
201
Unit IV Sirkulasi
TFHNFO TJSLVMBTJ %JTUSJCVTJ JOJ MFCJI CFTBS EJ TFCBHJBO KBSJOHBO Pusat Vasomotor di Otak dan Pengendaliannya
EBSJQBEB KBSJOHBO MBJOOZB &GFL WBTPLPOTUSJLUPS TJNQBUJT JOJ terhadap Sistem Vasokonstriktor.%BFSBIZBOHEJTFCVUQVTBU
UFSVUBNB TBOHBU LVBU EJ HJOKBM VTVT MJNQB EBO LVMJU UFUBQJ WBTPNPUPS UFSMFUBL CJMBUFSBM UFSVUBNB EJ TVCTUBOTJB SFUJLVMBSJT
LVSBOHLVBUEJPUPUSBOHLBEBOPUBL NFEVMB EBO TFQFSUJHB CBXBI QPOT TFQFSUJ UFSMJIBU QBEB (BNCBS
EBO 1VTBU JOJ NFOHJSJNLBO JNQVMT QBSBTJNQBUJT
NFMBMVJ OFSWVT WBHVT LF KBOUVOH EBO NFOHIBOUBSLBO JNQVMT
TJNQBTUJT NFMBMVJ NFEVMB TQJOBMJT EBO TBSBG TJNQBUJT QFSJGFS LF
IBNQJSTFNVBBSUFSJ BSUFSJPM EBOWFOBEBMBNUVCVI
.FTLJQVO PSHBOJTBTJ LFTFMVSVIBO QVTBU WBTPNPUPS NBTJI
CFMVN KFMBT UFUBQJ EBSJ QFSDPCBBO ZBOH UFMBI EJCVBU
NFNVOHLJOLBO LJUB VOUVL NFOHJEFOUJGJLBTJ CFCFSBQB EBFSBI
QFOUJOHUFSUFOUV ZBJUVTFCBHBJCFSJLVU
1. %BFSBI WBTPLPOTUSJLUPS UFSMFUBL CJMBUFSBM EJ CBHJBO
BOUFSPMBUFSBM NFEVMB CBHJBO BUBT /FVSPO ZBOH CFSBTBM EBSJ
EBFSBIJOJNFOEJTUSJCVTJLBOTFSBUTFSBUOZBLFTFMVSVIUJOHLBU
NFEVMB TQJOBMJT UFNQBU TFSBUTFSBU UFSTFCVU NFOHFLTJUBTJ
OFVSPO QSFHBOHMJPO WBTPLPOTUSJLUPS QBEB TJTUFN TBSBG
TJNQBUJT
202
Bab 18 Pengaturan Sirkulasi oleh Saraf, dan Pengendalian Cepat Tekanan Arteri
2. %BFSBI WBTPEJMBUPS UFSMFUBL CJMBUFSBM EJ CBHJBO BOUFSPMBUFSBM Pengendalian Pusat Vasomotor oleh Pusat-Pusat
QBEB TFQBSVI CBXBI NFEVMB 4FSBUTFSBU OFVSPO JOJ Saraf yang Lebih Tinggi. 4FKVNMBICFTBSOFVSPOOFVSPOLFDJM
CFSQSPZFLTJ LF BUBT LF EBFSBI WBTPLPOTUSJLUPS ZBOH CBSV ZBOH UFSMFUBL EJ TFMVSVI TVCTUBOTJB SFUJLVMBSJT QPOT
EJKFMBTLBO NFOHIBNCBU BLUJWJUBT WBTPLPOTUSJLUPS EJ BSFB NFTFOTFGBMPO EBO EJFOTFGBMPO EBQBU NFOHFLTJUBTJ BUBV
NFOHJOIJCJTJ QVTBU WBTPNPUPS 4VCTUBOTJB SFUJLVMBSJT
UNIT IV
UFSTFCVU TFIJOHHBNFOZFCBCLBOWBTPEJMBUBTJ
EJQFSMJIBULBO QBEB (BNCBS CFSVQB EBFSBI CFSCBZBOH
3. %BFSBI TFOTPSJL UFSMFUBL CJMBUFSBM EJ USBLUVT TPMJUBSJVT EJ 1BEB VNVNOZB OFVSPOOFVSPO EJ TVCTUBOTJB SFUJLVMBSJT
CBHJBO QPTUFSPMBUFSBM NFEVMB EBO QPOT CBHJBO CBXBI ZBOH MFUBLOZB MFCJI MBUFSBM EBO TVQFSJPS BLBO NFOZFCBCLBO
/FVSPO EJ EBFSBI JOJ NFOFSJNB TJOZBM TBSBG TFOTPSJT EBSJ FLTJUBTJ TFEBOHLBO CBHJBO ZBOH MFCJI NFEJBM EBO JOGFSJPS
TJTUFN TJSLVMBTJ UFSVUBNB NFMBMVJ OFSWVT WBHVT EBO OFSWVT BLBONFOZFCBCLBOJOIJCJTJ
HMPTPGBSJOHFVT EBOTJOZBMZBOHLFMVBSEBSJEBFSBITFOTPSJLJOJ
LFNVEJBO NFNCBOUV NFOHFOEBMJLBO BLUJWJUBT EBFSBI )JQPUBMBNVT CFSQFSBO LIVTVT EBMBN NFOHFOEBMJLBO
WBTPLPOTUSJLUPS NBVQVO WBTPEJMBUPS TFIJOHHB NFSVQBLBO TJTUFN WBTPLPOTUSJLUPS LBSFOB EBQBU NFOHIBTJMLBO FGFL
SFGMFLTLFOEBMJUFSIBEBQCBOZBLGVOHTJTJSLVMBTJ$POUPIOZB FLTJUBTJ BUBV JOIJCJTJ LVBU QBEB QVTBU WBTPNPUPS #BHJBO
BEBMBI SFGMFLT CBSPSFTFQUPS VOUVL NFOHFOEBMJLBO UFLBOBO QPTUFSPMBUFSBM IJQPUBMBNVT UFSVUBNB NFOZFCBCLBO FLTJUBTJ
BSUFSJ ZBOHLJUBCBIBTLFNVEJBOEBMBNCBCJOJ TFEBOHLBOCBHJBOBOUFSJPSEBQBUNFOZFCBCLBOFLTJUBTJBUBV
JOIJCJTJ SJOHBO CFSHBOUVOH QBEB CBHJBO IJQPUBMBNVT
Konstriksi Parsial Pembuluh Darah Terus-Menerus BOUFSJPSZBOHEJSBOHTBOH
Normalnya Disebabkan oleh Tonus Vasokonstriktor
Simpatis. %BMBN LFBEBBO OPSNBM EBFSBI WBTPLPOTUSJLUPS EJ #BOZBL CBHJBO EJ LPSUFLT TFSFCSJ KVHB EBQBU NFSBOHTBOH
QVTBUWBTPNPUPSUFSVTNFOFSVTNFOHJSJNLBOTJOZBMLFTFSBUTBSBG BUBV NFOHIBNCBU QVTBU WBTPNPUPS 1FSBOHTBOHBO LPSUFLT
WBTPLPOTUSJLUPS TJNQBUJT TFMVSVI UVCVI NFOZFCBCLBO TFSBU JOJ NPUPSJL TFCBHBJDPOUPI BLBONFOHFLTJUBTJQVTBUWBTPNPUPS
NFMFQBTLBOJNQVMTMBNCBUEFOHBOGSFLVFOTJTFLJUBSTBUVTFUFOHBI LBSFOB JNQVMT BLBO EJIBOUBSLBO LF CBXBI LF EBMBN
TBNQBJ EVB JNQVMT QFS EFUJL *NQVMT LPOUJOV JOJ EJTFCVU UPOVT IJQPUBMBNVT EBO LFNVEJBO LF QVTBU WBTPNPUPS
WBTPLPOTUSJLUPS TJNQBUJT *NQVMT JOJ CJBTBOZB NFNQFSUBIBOLBO 1FSBOHTBOHBO MPCVT UFNQPSBMJT BOUFSJPS BSFB PSCJUB QBEB
LFBEBBO LPOUSBLTJ QBSTJBM QFNCVMVI EBSBI ZBOH EJTFCVU UPOVT LPSUFLT GSPOUBMJT CBHJBO BOUFSJPS HJSVT TJOHVMBUB BNJHEBMB
WBTPNPUPS TFQUVN EBOIJQPLBNQVTTFMVSVIOZBEBQBUKVHBNFOHFLTJUBTJ
BUBVNFOHIBNCBUQVTBUWBTPNPUPS CFSHBOUVOHQBEBCBHJBO
(BNCBS NFNQFSMJIBULBO BSUJ QFOUJOH UPOVT WBTPNPUPS
EBSJ BSFB JOJ ZBOH EJSBOHTBOH EBO JOUFOTJUBT QFSBOHTBOHBO
1BEB QFSDPCBBO JOJ EJMBLVLBO BOFTUFTJ TQJOBM UPUBM QBEB TFFLPS
+BEJ EBFSBI CBTBM ZBOH MVBT QBEB PUBL EBQBU TBOHBU
IFXBO ZBOHNFNCMPLTFNVBUSBOTNJTJJNQVMTTBSBGTJNQBUJTEBSJ
CFSQFOHBSVIUFSIBEBQGVOHTJLBSEJPWBTLVMBS
NFEVMB TQJOBMJT LF QFSJGFS "LJCBUOZB UFLBOBO BSUFSJ NFOVSVO
EBSJ NFOKBEJ NN )H NFOVOKVLLBO QFOHBSVI IJMBOHOZB
UPOVT WBTPLPOTUSJLUPS EJ TFMVSVI UVCVI #FCFSBQB NFOJU
LFNVEJBO TFKVNMBI LFDJM IPSNPO OPSFQJOFGSJO EJTVOUJLLBO LF
EBMBN EBSBI OPSFQJOFGSJO BEBMBI [BU IPSNPOBM WBTPLPOTUSJLUPS
VUBNB ZBOH EJTFLSFTJLBO QBEB VKVOH TFSBU TBSBG WBTPLPOTUSJLUPS
TJNQBUJT EJ TFMVSVI UVCVI
0MFI LBSFOB IPSNPO ZBOH
EJTVOUJLLBO JOJ EJCBXB EBMBN EBSBI LF QFNCVMVI EBSBI Motor Substansia
QFNCVMVI EBSBI TFLBMJ MBHJ NFOHBMBNJ LPOTUSJLTJ EBO UFLBOBO Singulata retikularis
BSUFSJ NFOJOHLBU CBILBO IJOHHB EJ BUBT OJMBJ OPSNBM TFMBNB
Mesensefalon
TBNQBJNFOJUTBNQBJOPSFQJOFGSJOJUVEJIBODVSLBO Orbita
Pengendalian Aktivitas Jantung oleh Pusat Vasomotor.

1BEB XBLUV ZBOH CFSTBNBBO TBBU QVTBU WBTPNPUPS NFOHBUVS
EFSBKBULPOTUSJLTJWBTLVMFS QVTBUJOJKVHBNFOHFOEBMJLBOBLUJWJUBT
KBOUVOH #BHJBO MBUFSBM QVTBU WBTPNPUPS NFOHJSJNLBO JNQVMT
FLTJUBTJNFMBMVJTFSBCVUTBSBGTJNQBUJTLFKBOUVOHCJMBUVCVIQFSMV
NFOBJLLBO GSFLVFOTJ TFSUB LPOUSBLUJMJUBT KBOUVOH 4FCBMJLOZB CJMB
UVCVI QFSMV NFOVSVOLBO QPNQB KBOUVOH CBHJBO NFEJBM QVTBU Temporal
WBTPNPUPSNFOHJSJNLBOTJOZBMLFOVLMFVTNPUPSJLEPSTBMJTOFSWVT
WBHVT EJ EFLBUOZB ZBOH LFNVEJBO NFOHJSJNLBO JNQVMT
QBSBTJNQBUJTNFMBMVJOFSWVTWBHVTLFKBOUVOHVOUVLNFOVSVOLBO Pons
GSFLVFOTJ EBO LPOUSBLUJMJUBT KBOUVOH 0MFI LBSFOB JUV QVTBU Medulla {
PUSAT
WBTPNPUPS EBQBU NFOJOHLBULBO BUBV NFOVSVOLBO BLUJWJUBT VASODILATOR
VASOMOTOR
KBOUVOH 'SFLVFOTJ KBOUVOH EBO LVBU LPOUSBLTJ KBOUVOH CJBTBOZB VASOKONSTRIKTOR
NFOJOHLBUTBBUUFSKBEJWBTPLPOTUSJLTJEBOCJBTBOZBNFOVSVOTBBU
WBTPLPOTUSJLTJEJIBNCBU
203
Unit IV Sirkulasi
150
125
100
75
50
25
0
0 5 10 15 20 25
Norepinefrin—Substansi Transmiter Vasokonstriktor PUPU VOUVL NFOHBUVS BMJSBO EBSBIOZB TFOEJSJ TFCBHBJ SFTQPOT
Simpatis. 4VCTUBOTJ ZBOH EJTFLSFTJLBO EJ VKVOHVKVOH UFSIBEBQ LFCVUVIBOOZB /BNVO CFCFSBQB QFOFMJUJBO
TBSBG WBTPLPOTUSJLUPS IBNQJS TFMVSVIOZB BEBMBI OPSFQJOFGSJO NFOVOKVLLBO CBIXB QBEB TBBU EJNVMBJOZB MBUJIBO GJTJL TJTUFN
ZBOH CFLFSKB MBOHTVOH QBEB SFTFQUPS BESFOFSHJL BMGB PUPU WBTPEJMBUPS TJNQBUJT EBQBU NFOZFCBCLBO WBTPEJMBUBTJ BXBM QBEB
QPMPT WBTLVMBS VOUVL NFOZFCBCLBO WBTPLPOTUSJLTJ TFQFSUJ PUPUPUPU SBOHLB VOUVL NFOHBOUJTJQBTJ QFOJOHLBUBO BMJSBO EBSBI
EJCJDBSBLBOEJ#BC CBILBOTFCFMVNPUPUPUPUNFNCVUVILBOQFOJOHLBUBOOVUSJTJ
Medula Adrenal dan Hubungannya dengan Sistem Pingsan Emosional—Sinkop Vasovagal. ,FKBEJBO ZBOH
Vasokonstriktor Simpatis. *NQVMT TJNQBUJT EJLJSJN LF NFEVMB TBOHBUNFOBSJLBEBMBIUJNCVMOZBSFBLTJWBTPEJMBUBTJQBEBPSBOH
BESFOBMQBEBXBLUVZBOHCFSTBNBBOEFOHBOEJLJSJNLBOOZBJNQVMTLF PSBOH ZBOH NFOHBMBNJ HBOHHVBO FNPTJPOBM IFCBU TFIJOHHB
QFNCVMVI EBSBI *NQVMT JOJ NFOZFCBCLBO NFEVMB NFOZFLSFTJLBO NFOZFCBCLBO PSBOH UFSTFCVU QJOHTBO 1BEB LFBEBBO JOJ TJTUFN
FQJOFGSJO EBO OFSPQJOFGSJO LF EBMBN TJSLVMBTJ EBSBI ,FEVB IPSNPO WBTPEJMBUPSPUPUUFSBLUJWBTJ EBOQBEBTBBUZBOHCFSTBNBBO QVTBU
JOJ EJCBXB EBMBN BMJSBO EBSBI LF TFNVB CBHJBO UVCVI LFEVBOZB
QFOHIBNCBUKBOUVOHWBHBMNFOHIBOUBSLBOTJOZBMLVBULFKBOUVOH
CFLFSKB TFDBSB MBOHTVOH QBEB TFMVSVI QFNCVMVI EBSBI EBO CJBTBOZB
NFOZFCBCLBO WBTPLPOTUSJLTJ 1BEB CFCFSBQ KBSJOHBO FQJOFGSJO VOUVLNFNQFSMBNCBUGSFLVFOTJEFOZVUKBOUVOHTFDBSBCFSNBLOB
NFOZFCBCLBO WBTPEJMUBTJ LBSFOB FQJOFGSJO KVHB NFNQVOZBJ FGFL 5FLBOBO BSUFSJ NFOVSVO EFOHBO DFQBU ZBOH NFOVSVOLBO BMJSBO
QFSBOHTBOHBO SFTFQUPS BESFOFSHJL CFUB ZBOH NFOZFCBCLBO EBSBI LF PUBL EBO NFOZFCBCLBO PSBOH UFSTFCVU LFIJMBOHBO
QFNCVMVI EBSBI UFSUFOUV CFSEJMBUBTJ LFUJNCBOH LPOTUSJLTJ TFQFSUJ LFTBEBSBO 4FMVSVI FGFL JOJ EJTFCVU TJOLPQ WBTPWBHBM 1JOHTBO
EJCJDBSBLBOEJ#BC FNPTJPOBMEJBXBMJEFOHBOHBOHHVBOCFSQJLJSQBEBLPSUFLTTFSFCSJ
Sistem Vasodilator Simpatis dan Pengendaliannya oleh ,FNVEJBOKBMVSJOJLFNVOHLJOBOCFSMBOKVULFQVTBUWBTPEJMBUPSEJ
Sistem Saraf Pusat. 4BSBG TJNQBUJT LF PUPU SBOHLB NFNCBXB IJQPUBMBNVT BOUFSJPS MBMV LF QVTBU WBHBM EJ NFEVMB NFOVKV
TFSBU WBTPEJMBUPS TJNQBUJT NBVQVO TFSBCVU WBTPLPOTUSJLUPS 1BEB KBOUVOHNFMBMVJOFSWVTWBHVT EBOKVHBNFMBMVJUVMBOHCFMBLBOHLF
CFCFSBQB IFXBO TFQFSUJ LVDJOH TFSBCVU EJMBUPS JOJ NFMFQBTLBO TBSBGWBTPEJMBUPSTJNQBUJTPUPU
BTFUJMLPMJO CVLBO OPSFQJOFGSJO QBEB VKVOHOZB NFTLJQVO QBEB Peran Sistem Saraf dalam Pengaturan
HPMPOHBO QSJNBUB FGFL WBTPEJMBUPS EJEVHB BLJCBU FQJOFGSJO ZBOH Tekanan Arteri yang Cepat
NFOHFLTJUBTJSFTFQUPSBESFOFSHJLCFUBEJQFNCVMVIEBSBIPUBL
+BMVS QFOHFOEBMJBO TJTUFN TBSBG QVTBU UFSIBEBQ TJTUFN 4BMBITBUVGVOHTJZBOHQBMJOHQFOUJOHQFOHBUVSBOTJSLVMBTJPMFI
WBTPEJMBUPSEJQFSMJIBULBOTFCBHBJHBSJTQVUVTQVUVTQBEB(BNCBS TBSBGBEBMBILFNBNQVBOOZBVOUVLNFOJNCVMLBOQFOJOHLBUBO
%BFSBI PUBL VUBNB ZBOH NFOHFOEBMJLBO TJTUFN JOJ BEBMBI UFLBOBO BSUFSJ TFDBSB DFQBU 6OUVL UVKVBO JOJ TFMVSVI GVOHTJ
IJQPUBMBNVTBOUFSJPS WBTPLPOTUSJLUPS EBO LBSEJPBLTFMFSBUPS TJTUFN TBSBG TJNQBUJT
EJSBOHTBOH CFSTBNBBO 1BEB TBBU ZBOH TBNB UFSKBEJ JOIJCJTJ
Kemungkinan Arti Tidak Penting Sistem Vasodilator SFTJQSPLBM TJOZBM QFOHIBNCBU WBHBM QBSBTJNQBUJT LF KBOUVOH
Simpatis. .BTJI EJSBHVLBO BQBLBI TJTUFN WBTPEJMBUPS TJNQBUJT "LJCBUOZB UJNCVMUJHBQFSVCBIBOVUBNBTFDBSBTFSFOUBL ZBOH
NFNBJOLBO QFSBO CFTBS EBMBN NFOHFOEBMJLBO TJSLVMBTJ QBEB NBTJOHNBTJOH NFNCBOUV NFOJOHLBULBO UFLBOBO BSUFSJ
NBOVTJB LBSFOB IBNCBUBO TFNQVSOB QBEB TBSBG TJNQBUJT ,FUJHBQFSVCBIBOUFSTFCVUBEBMBITFCBHBJCFSJLVU
NFOVKVLFPUPUPUPUIBNQJSUJEBLNFNFOHBSVIJLFNBNQVBO
204
1. 4FCBHJBO CFTBS BSUFSJPM EBMBN TJSLVMBTJ TJTUFNJL BLBO EFOHBOTFHFSBVOUVLNFOZFUBSBLBOCFTBSOZBQFOJOHLBUBO

CFSLPOTUSJLTJ )BM JOJ BLBO TBOHBU NFOJOHLBULBO UBIBOBO BLUJWJUBTPUPU
QFSJGFS UPUBM EBO EFOHBO EFNJLJBO NFOJOHLBULBO UFLBOBO 1BEB CBOZBL KFOJT TUSFT MBJO EJ TBNQJOH LFSKB PUPU
BSUFSJ QFOJOHLBUBO UFLBOBO EBSBI ZBOH TFSVQB KVHB EBQBU UFSKBEJ
UNIT IV
2. 1FNCVMVI CFTBS MBJO EBMBN TJSLVMBTJ UFSVUBNB WFOB BLBO 4FCBHBJ DPOUPI QBEB LFUBLVUBO ZBOH BNBU TBOHBU UFLBOBO
CFSLPOTUSJLTJ EFOHBO LVBU ,FBEBBO JOJ BLBO NFNJOEBILBO BSUFSJ LBEBOHLBEBOH NFOJOHLBU TBNQBJ TFUJOHHJ IJOHHB
EBSBI LFMVBS EBSJ QFNCVMVI EBSBI CFTBS EJ QFSJGFS NFOVKV NN)HEBMBNXBLUVCFCFSBQBEFUJL,FBEBBOJOJEJTFCVU
KBOUVOH TFIJOHHB NFOJOHLBULBO WPMVNF EBSBI EBMBN SPOHHB SFBLTJ BMBSN EBO IBM JOJ NFOJOHLBULBO UFLBOBO BSUFSJ ZBOH
KBOUVOH1FSFHBOHBOKBOUVOHLFNVEJBONFOZFCBCLBOKBOUVOH EBQBU EFOHBO TFHFSB NFOZFEJBLBO EBSBI CBHJ PUPU UVCVI
CFSEFOZVU EFOHBO LFLVBUBO MFCJI CFTBS TFIJOHHB NFNPNQB ZBOH NVOHLJO IBSVT NFNCFSJ SFTQPOT TFHFSB VOUVL
EBSBI EBMBN KVNMBI MFCJI CFTBS QVMB )BM JOJ KVHB NFOJNCVMLBOHFSBLBOMBSJNFOKBVIEBSJCBIBZB
NFOJOHLBULBOUFLBOBOBSUFSJ Mekanisme Refleks untuk Mempertahankan Tekanan
3. "LIJSOZB KBOUVOH TFDBSB MBOHTVOH EJSBOHTBOH PMFI TJTUFN Arteri Normal
TBSBGPUPOPN ZBOHTFMBOKVUOZBNFNQFSLVBUQPNQBKBOUVOH 4FMBJO LFSKB GJTJL EBO TUSFT ZBOH EBQBU NFOJNCVMLBO
,FBEBBO JOJ TFCBHJBO CFTBS EJTFCBCLBO PMFI QFOJOHLBUBO SBOHTBOHBO TJTUFN TBSBG PUPOPN VOUVL NFOJOHLBULBO
GSFLVFOTJ EFOZVU KBOUVOH LBEBOHLBEBOH TBNQBJ TFCFTBS UFLBOBO BSUFSJ UFSEBQBU CBOZBL NFLBOJTNF QFOHBUVS TBSBG
UJHBLBMJOPSNBM4FMBJOJUV TJOZBMTBSBGTJNQBUJTNFNQVOZBJ LIVTVT EJ CBXBI TBEBS ZBOH CFLFSKB TFQBOKBOH XBLUV VOUVL
QFOHBSVI MBOHTVOH ZBOH TJHOJGJLBO VOUVL NFOJOHLBULBO NFNQFSUBIBOLBO UFLBOBO BSUFSJ QBEB BUBV NFOEFLBUJ
LFLVBUBO LPOUSBLUJMJUBT PUPU KBOUVOH IBM JOJ KVHB BLBO OPSNBM )BNQJS TFMVSVIOZB NFSVQBLBO NFLBOJTNF SFGMFLT
NFOJOHLBULBO LFNBNQVBO KBOUVOH VOUVL NFNPNQB VNQBO CBMJL OFHBUJG ZBOH BLBO LJUB CBIBT EJ CBHJBO
WPMVNF EBSBI ZBOH MFCJI CFTBS 4FMBNB QFSBOHTBOHBO CFSJLVUOZB
TJNQBUJT ZBOH LVBU KBOUVOH EBQBU NFNPNQB EBSBI TFLJUBS
EVBLBMJMFCJICBOZBLEJCBOEJOHLBOLFEBBOOPSNBM)BMJOJ Sistem Pengaturan Tekanan Arteri oleh Baroreseptor—
UVSVU CFSQFSBO EBMBN NFOJNCVMLBO QFOJOHLBUBO BLVU Refleks-Refleks Baroreseptor
UFLBOBOBSUFSJZBOHMFCJIUJOHHJMBHJ 4FKBVI JOJ NFLBOJTNF TBSBG VOUVL NFOHBUVS UFLBOBO BSUFSJ
ZBOH QBMJOH EJLFUBIVJ BEBMBI SFGMFLT CBSPSFTFQUPS 1BEB
Kecepatan Pengaturan Tekanan Arteri oleh Saraf. EBTBSOZB SFGMFLT JOJ EJNVMBJ PMFI SFTFQUPS SFHBOH EJTFCVU
$JSJLIBTZBOHTBOHBUQFOUJOHEBSJQFOHBUVSBOUFLBOBOBSUFSJPMFI CBSPSFTFQUPS BUBV QSFTPSFTFQUPS ZBOH UFSMFUBL QBEB UJUJLUJUJL
TBSBGBEBMBILFDFQBUBOOZBEBMBNNFNCFSJSFTQPOT ZBOHEJNVMBJ TQFTJGJL EJ EJOEJOH CFCFSBQB BSUFSJ TJTUFNJL CFTBS
EBMBN XBLUV CFCFSBQB EFUJL EBO TFSJOH LBMJ NFOJNCVMLBO 1FOJOHLBUBO UFLBOBO BSUFSJ BLBO NFSFHBOHLBO CBSPSFTFQUPS
QFOJOHLBUBO UFLBOBO IJOHHB EVB LBMJ OPSNBM EBMBN XBLUV EBONFOZFCBCLBOUSBOTNJTJTJOZBMNFOVKVTJTUFNTBSBGQVTBU
TBNQBJ EFUJL 4FCBMJLOZB QFOHIBNCBUBO ZBOH CFSMBOHTVOH 4JOZBM VNQBO CBMJL LFNVEJBO EJLJSJN LFNCBMJ NFMBMVJ
UJCBUJCB QBEB QFSBOHTBOHBO LBSEJPWBTLVMBS PMFI TBSBG EBQBU TJTUFN TBSBG PUPOPN LF TJSLVMBTJ VOUVL NFOHVSBOHJ UFLBOBO
NFOVSVOLBOUFLBOBOBSUFSJTBNQBJTFSFOEBITFQBSVIOJMBJOPSNBM BSUFSJLFNCBMJLFOJMBJOPSNBM
EBMBN XBLUV TBNQBJ EFUJL 0MFI LBSFOB JUV QFOHBUVSBO
UFLBOBOBSUFSJPMFITBSBGTFKBVIJOJNFSVQBLBOZBOHQBMJOHDFQBU Anatomi Fisiologis Baroreseptor dan Persarafannya.
EBSJTFMVSVINFLBOJTNFVOUVLNFOHBUVSUFLBOBO #BSPSFTFQUPS NFSVQBLBO VKVOH TBSBG UJQF NFNBODBS TQSBZ
UJQF
ZBOH UFSMFUBL EJ EBMBN EJOEJOH BSUFSJ CBSPSFTFQUPS
Peningkatan Tekanan Arteri Selama Kerja Otot dan UFSBOHTBOH CJMB UFSFHBOH 1BEB IBNQJS TFNVB BSUFSJ CFTBS
Jenis Stres Lainnya ZBOH UFSMFUBL EJ EBFSBI UPSBLT EBO MFIFS EBQBU EJKVNQBJ
$POUPI QFOUJOH LFNBNQVBO TJTUFN TBSBG VOUVL NFOJOHLBULBO TFKVNMBILFDJMCBSPSFTFQUPSUFUBQJ TFQFSUJZBOHUFSMVLJTQBEB
UFLBOBO BSUFSJ BEBMBI QFOJOHLBUBO UFLBOBO TFMBNB MBUJIBO PUPU (BNCBS KVNMBI CBSPSFTFQUPS TBOHBU CFSMJNQBI EJ
4FMBNB PMBISBHB CFSBU PUPUPUPU TBOHBU NFNCVUVILBO EBMBN
EJOEJOH TFUJBQ BSUFSJ LBSPUJT JOUFSOB ZBOH UFSMFUBL
QFOJOHLBUBO BMJSBO EBSBI 4FCBHJBO QFOJOHLBUBO JOJ BLJCBU TFEJLJU EJ BUBT CJGVSLBTJP LBSPUJT TVBUV EBFSBI ZBOH EJLFOBM
WBTPEJMBUBTJ MPLBM QBEB WBTLVMBSJTBTJ PUPU ZBOH EJTFCBCLBO PMFI TFCBHBJTJOVTLBSPUJT EBO
EJOEJOHBSLVTBPSUB
QFOJOHLBUBONFUBCPMJTNFTFMTFMPUPU TFQFSUJEJKFMBTLBOEJ#BC (BNCBS NFOVOKVLLBO CBIXB TJOZBM EBSJ
4FCBHJBO QFOJOHLBUBO MBJOOZB BLJCBU QFOJOHLBUBO TFSFOUBL CBSPSFTFQUPS LBSPUJT EJKBMBSLBO NFMBMVJ TBSBG )FSJOH ZBOH
UFLBOBOBSUFSJZBOHEJTFCBCLBOPMFIQFSBOHTBOHBOTJNQBUJTQBEB LFDJM NFOVKV TBSBG HMPTPGBSJOHFVT EJ MFIFS CBHJBO BUBT EBO
TJSLVMBTJ TFDBSB LFTFMVSVIBO TFMBNB LFSKB GJTJL 1BEB LFSKB GJTJL LFNVEJBOLFUSBLUVTTPMJUBSJVTEJEBFSBINFEVMBCBUBOHPUBL
ZBOHQBMJOHCFSBU UFLBOBOBSUFSJNFOJOHLBUTFLJUBSTBNQBJ 4JOZBM EBSJ CBSPSFTFQUPS BPSUB EJ BSLVT BPSUB EJKBMBSLBO
QFSTFO ZBOHBLBONFOJOHLBULBOBMJSBOEBSBITBNQBJTFCFTBSEVB NFMBMVJOFSWVTWBHVTNFOVKVUSBLUVTTPMJUBSJVTZBOHTBNBEJ
LBMJMJQBUMFCJICBOZBL NFEVMB
1FOJOHLBUBO UFLBOBO BSUFSJ TFMBNB LFSKB GJTJL UFSVUBNB BLJCBU Respons Baroreseptor terhadap Tekanan Arteri.
EBSJ FGFL CFSJLVU ,FUJLB BSFB NPUPSJL PUBL NFOKBEJ UFSBLUJWBTJ (BNCBS NFNQFSMJIBULBO QFOHBSVI CFSCBHBJ OJMBJ
VOUVL NFOZFCBCLBO LFSKB GJTJL QBEB TBBU ZBOH CFSTBNBBO UFLBOBOBSUFSJUFSIBEBQMBKVQFOKBMBSBOJNQVMTEBMBNTFCVBI
TFCBHJBOCFTBSTJTUFNQFOHBLUJWBTJSFUJLVMBSQBEBCBUBOHPUBLKVHB TBSBG TJOVT LBSPUJT )FSJOH 1FSIBUJLBO CBIXB EJ BOUBSB
UFSBLUJWBTJ ZBOH NFMJCBULBO QFOJOHLBUBO QFSBOHTBOHBO ZBOH UFLBOBO EBO TBNQBJ NN )H CBSPSFTFQUPS TJOVT
TBOHBU CFTBS EJ BSFB WBTPLPOTUSJLUPS EBO LBSEJPBLTFMFSBUPS EJ LBSPUJT UJEBL UFSBOHTBOH TBNB TFLBMJ UFUBQJ EJ BUBT OJMBJ JOJ
QVTBUWBTPNPUPS,FBEBBOJOJBLBONFOJOHLBULBOUFLBOBOBSUFSJ CBSPSFTFQUPSNFNCFSJSFTQPOTZBOHNBLJOMBNBNBLJODFQBU
205
Unit IV Sirkulasi
#BSPSFTFQUPS NFNCFSJ SFTQPOT DFQBU UFSIBEBQ QFSVCBIBO

UFLBOBO BSUFSJ QBEB LFOZBUBBOOZB LFDFQBUBO QFMFQBTBO JNQVMT
NFOJOHLBU EBMBN IJUVOHBO EFUJL TFMBNB TJTUPM EBO NFOVSVO MBHJ
TFMBNB EJBTUPM 4FMBOKVUOZB CBSPSFTFQUPS MFCJI CBOZBL CFSFTQPOT
UFSIBEBQ UFLBOBO ZBOH CFSVCBI DFQBU EBSJQBEB UFLBOBO ZBOH
NFOFUBQ+BEJ CJMBUFLBOBOBSUFSJSBUBSBUBCFTBSOZBNN)H
OBNVO QBEB TBBU UFSUFOUV NFOJOHLBU EFOHBO DFQBU LFDFQBUBO
QFOKBMBSBO JNQVMT EBQBU NFOJOHLBU EVB LBMJ MJQBU EBSJQBEB CJMB
UFLBOBONFOFUBQQBEBNN)H
Refleks Sirkulasi yang diawali oleh Baroreseptor. 4FUFMBI
TJOZBM CBSPSFTFQUPS NFNBTVLJ USBLUVT TPMJUBSJVT NFEVMB TJOZBM
TFLVOEFS NFOHIBNCBU QVTBU WBTPLPOTUSJLUPS EJ NFEVMB EBO
NFSBOHTBOH QVTBU QBSBTJNQBUJT WBHVT &GFL BLIJSOZB BEBMBI

WBTPEJMBUBTJWFOBEBOBSUFSJPMEJTFMVSVITJTUFNTJSLVMBTJQFSJGFSEBO

CFSLVSBOHOZBGSFLVFOTJEFOZVUKBOUVOHEBOLFLVBUBOLPOUSBLTJ
KBOUVOH 0MFI LBSFOB JUV QFSBOHTBOHBO CBSPSFTFQUPS BLJCBU
UFLBOBO UJOHHJ EJ EBMBN BSUFSJ TFDBSB SFGMFLT NFOZFCBCLBO
QFOVSVOBO UFLBOBO BSUFSJ BLJCBU QFOVSVOBO UBIBOBO QFSJGFS EBO
QFOVSVOBODVSBIKBOUVOH4FCBMJLOZB UFLBOBOSFOEBINFNQVOZBJ
FGFL CFSMBXBOBO ZBOH TFDBSB SFGMFLT NFOZFCBCLBO UFLBOBO
NFOJOHLBULFNCBMJNFOKBEJOPSNBM
(BNCBS NFNQFSMJIBULBO TVBUV QFSVCBIBO SFGMFLT ZBOH
LIBTQBEBUFLBOBOBSUFSJZBOHEJTFCBCLBOPMFIQFOZVNCBUBOEVB
BSUFSJ LBSPUJT LPNVOJT )BM JOJ NFOVSVOLBO UFLBOBO TJOVT
LBSPUJT BLJCBUOZB TJOZBM EBSJ CBSPSFTFQUPS CFSLVSBOH EBO
NFOZFCBCLBO CFSLVSBOHOZB FGFL JOIJCJTJ UFSIBEBQ QVTBU
WBTPNPUPS 1VTBU WBTPNPUPS MBMV NFOKBEJ KBVI MFCJI BLUJG
EBO NFODBQBJ NBLTJNVN LJSBLJSB QBEB UFLBOBO NN )H EBSJQBEB CJBTBOZB TFIJOHHB UFLBOBO BSUFSJ BPSUB NFOJOHLBU EBO
3FTQPOTZBOHEJLFMVBSLBOPMFICBSPSFTFQUPSBPSUBNJSJQEFOHBO UFUBQ NFOJOHLBU TFMBNB NFOJU TFKBL BSUFSJ LBSPUJT UFSTVNCBU
ZBOHUFSKBEJQBEBSFTFQUPSLBSPUJTLFDVBMJCBIXBQBEBVNVNOZB 1FOZJOHLJSBO TVNCBUBO NFOZFCBCLBO QFOJOHLBUBO UFLBOBO
CBSPSFTFQUPSJOJCFLFSKBQBEBOJMBJUFLBOBOBSUFSJTFLJUBSNN EBMBN TJOVT LBSPUJT EBO TFLBSBOH SFGMFLT TJOVT LBSPUJT
)HMFCJIUJOHHJ NFOZFCBCLBO UFLBOBO BPSUB TFHFSB NFOVSVO TBNQBJ TFEJLJU EJ
4FDBSB LIVTVT IFOEBLOZB EJQFSIBUJLBO CBIXB QBEB LJTBSBO CBXBI OPSNBM TFCBHBJ LPNQFOTBTJ CFSMFCJIBO ZBOH CFSTJGBU
UFLBOBO BSUFSJ OPSNBM TFLJUBS NN )H QFSVCBIBO UFLBOBO TFNFOUBSB MBMVLFNCBMJOPSNBMEBMBNNFOJUCFSJLVUOZB
LFDJMTBKBTVEBIBLBONFOJNCVMLBOQFSVCBIBOCFTBSQBEBTJOZBM
CBSPSFTFQUPS VOUVL NFOHFNCBMJLBO UFLBOBO BSUFSJ LF OJMBJ Fungsi Baroreseptor Selama Perubahan Sikap Tubuh.
OPSNBM+BEJ NFLBOJTNFVNQBOCBMJLCBSPSFTFQUPSJOJCFSGVOHTJ ,FNBNQVBOCBSPSFTFQUPSVOUVLNFOKBHBUFLBOBOBSUFSJEJUVCVI
QBMJOH FGFLUJG CJMB NBTJI CFSBEB EBMBN LJTBSBO UFLBOBO ZBOH CBHJBO BUBT BHBS SFMBUJG LPOTUBO TBOHBUMBI QFOUJOH QBEB XBLUV
QBMJOHEJQFSMVLBO TFTFPSBOHCBOHLJUCFSEJSJTFUFMBIJBCFSCBSJOH4FHFSBTFTVEBI
150
100
DI =
DP
50
0
0 80 160 240 0 2 4 6 8 10 12 14
$I ,
$P ,
206
PSBOHUFSTFCVUCFSEJSJ UFLBOBOBSUFSJEJLFQBMBEBOUVCVICBHJBO
BUBT DFOEFSVOH NFOVSVO EBO CFSLVSBOHOZB UFLBOBO ZBOH OZBUB
JOJEBQBUNFOZFCBCLBOIJMBOHOZBLFTBEBSBO/BNVO QFOVSVOBO
UFLBOBOQBEBCBSPSFTFQUPSBLBONFOJNCVMLBOSFGMFLTTFHFSBZBOH
UNIT IV
NFOHIBTJMLBOSBOHTBOHBOTJNQBUJTLVBUEJTFMVSVIUVCVI EBOIBM
JOJ BLBO NFNQFSLFDJM QFOVSVOBO UFLBOBO EJ LFQBMB EBO UVCVI
CBHJBOBUBT
Fungsi "Penyangga (Buffer)" Sistem Pengendalian
Baroreseptor. 0MFI LBSFOB TJTUFN CBSPSFTFQUPS NFMBXBO
QFOJOHLBUBO EBO QFOVSVOBO UFLBOBO BSUFSJ TJTUFN JOJ EJTFCVU
TJTUFN QFOZBOHHB SFLBNBO EBO TBSBGTBSBG ZBOH CFSBTBM EBSJ
CBSPSFTFQUPSEJTFCVUTBSBGTBSBGQFOZBOHHB
(BNCBS NFOVOKVLLBO NBLOB QFOUJOH GVOHTJ QFOZBOHHB
EBSJ CBSPSFTFQUPS JOJ 3FLBNBO QBEB HBNCBS CBHJBO BUBT 0
NFOVOKVLLBO SFLBNBO UFLBOBO BSUFSJ ZBOH EJMBLVLBO TFMBNB
KBN QBEB TFFLPS BOKJOH OPSNBM EBO SFLBNBO CBXBI
NFNQFSMJIBULBO SFLBNBO UFLBOBO BSUFSJ EBSJ TFFLPS BOKJOH ZBOH
TBSBGTBSBG CBSPSFTFQUPS QBEB TJOVT LBSPUJT EBO BPSUBOZB TVEBI
EJBOHLBU 5FSOZBUB QBEB BOKJOH ZBOH UFMBI NFOHBMBNJ
QFNCVBOHBO TBSBG UBEJ UFSKBEJ WBSJBTJ UFLBOBO FLTUSFN ZBOH
EJTFCBCLBOPMFIQFSJTUJXBTFIBSJIBSJZBOHTFEFSIBOBTBKB TFQFSUJ
CFSCBSJOH CFSEJSJ SBTBHFNCJSB NBLBO EFGFLBTJ EBOHBEVI
(BNCBS NFMVLJTLBO GSFLVFOTJ EJTUSJCVTJ UFLBOBO BSUFSJ
SBUBSBUB ZBOH EJSFLBN TFMBNB KBN QFOVI CBJL QBEB BOKJOH BOUBSB EBO NN )H TFTVOHHVIOZB IBNQJS TFQBOKBOH
OPSNBMNBVQVOBOKJOHZBOHUFMBINFOHBMBNJEFOFSWBTJ5FSOZBUB IBSJ QBEB OJMBJ TFCFTBS NN )H 4FCBMJLOZB TFTVEBI
CJMBCBSPSFTFQUPSOZBCFSGVOHTJTFDBSBOPSNBM UFLBOBOBSUFSJSBUB CBSPSFTFQUPS EJEFOFSWBTJ LVSWB EJTUSJCVTJ GSFLVFOTJ NFOKBEJ
SBUBBLBONFOFUBQTFQBOKBOHIBSJEBMBNLJTBSBOTFNQJU ZBLOJ MFCJI MFCBS ZBJUV LVSWB CBXBI QBEB HBNCBS UFSTFCVU
NFOKFMBTLBO CBIXB LJTBSBO UFLBOBO NFOJOHLBU LBMJ MJQBU
TFSJOH LBMJ NFOVSVO TBNQBJ TFSFOEBI NN )H BUBV
NFOJOHLBUTBNQBJNFMFCJIJNN)H+BEJ LJUBEBQBUNFMJIBU
BEBOZB WBSJBTJ ZBOH FLTUSFN QBEB UFLBOBO UFSTFCVU CJMB TJTUFN
CBSPSFTFQUPSBSUFSJUJEBLBEB
4JOHLBUOZB UVKVBOVUBNBTJTUFNCBSPSFTFQUPSBSUFSJBEBMBI
VOUVL NFOHVSBOHJ WBSJBTJ UFLBOBO BSUFSJ EBSJ NFOJULFNFOJU
TBNQBJLJSBLJSBTFQFSUJHBEBSJBQBZBOHBLBOUFSKBEJCJMBUJEBL
BEBTJTUFNCBSPSFTFQUPS
Apakah Baroreseptor Penting untuk Pengaturan
0 Tekanan Arteri Jangka Panjang? .FTLJQVO CBSPSFTFQUPS
BSUFSJ NFOHIBTJMLBO QFOHFOEBMJBO UFLBOBO BSUFSJ EBSJ XBLUV LF
XBLUVZBOH LVBU LFQFOUJOHBOOZB EBMBN QFOHFOEBMJBO UFLBOBO
EBSBI KBOHLB QBOKBOH NBTJI LPOUSPWFSTJBM 4BUV BMBTBO
NFOHBQB CFCFSBQB BIMJ GJTJPMPHJ NFNQFSLJSBLBO CBIXB
CBSPSFTFQUPS SFMBUJG UJEBL QFOUJOH EBMBN QFOHBUVSBO LSPOJT
UFLBOBO BSUFSJ BEBMBI LFDFOEFSVOHBOOZB VOUVL CFSBOKBL
LFNCBMJ SFTFU
LF UJOHLBU QBQBSBO UFLBOBO TFNVMB EBMBN
XBLUV TBNQBJ IBSJ :BJUV CJMB UFLBOBO BSUFSJ NFOJOHLBU
EBSJ OJMBJ OPSNBM TFCFTBS NN )H NFOKBEJ NN )H
NVMBNVMB BLBO EJQBODBSLBO JNQVMT CBSPSFTFQUPS EFOHBO
LFDFQBUBO TBOHBU UJOHHJ 4FMBNB CFCFSBQB NFOJU CFSJLVUOZB
LFDFQBUBO QFMFQBTBO BLBO TBOHBU CFSLVSBOH LFNVEJBO
0
TFMBNB TBNQBJ IBSJ CFSJLVUOZB LFDFQBUBO QFMFQBTBO
BLBO NFOKBEJ TBOHBU MBNCBU EBO QBEB BLIJSOZB LFDFQBUBO
UFSTFCVU BLBO LFNCBMJ NFOEFLBUJ OPSNBM XBMBVQVO
LFOZBUBBOOZB UFLBOBO BSUFSJ SBUBSBUB UFUBQ TFUJOHHJ NN
)H 4FCBMJLOZB CJMB UFLBOBO BSUFSJ NFOVSVO TBNQBJ OJMBJ
ZBOH TBOHBU SFOEBI NVMBNVMB CBSPSFTFQUPS UJEBL
NFNBODBSLBO JNQVMT OBNVO TFUFMBI TBUV TFDBSB CFSUBIBQ
LFDFQBUBO QFMFQBTBO CBSPSFTFQUPS LFNCBMJ MBHJ LF OJMBJ LPOUSPM
TFNVMB
207
Unit IV Sirkulasi
"EBQUBTJ CBSPSFTFQUPS JOJ EBQBU NFMFNBILBO QPUFOTJOZB OBO SFOEBI 3FTFQUPS JOJ NJSJQ EFOHBO SFTFQUPS SFHBOH
TFCBHBJ TJTUFN LPOUSPM VOUVL QBEB TVBUV XBLUV NFNQFSCBJLJ CBSPSFTFQUPSEJBSUFSJTJTUFNJLCFTBS3FTFQUPSUFLBOBOSFOEBIJOJ
HBOHHVBOHBOHHVBO ZBOH DFOEFSVOH NFOHVCBI UFLBOBO BSUFSJ CFSQFSBOQFOUJOHUFSVUBNBVOUVLNFNQFSLFDJMQFSVCBIBOUFLBOBO
TFMBNB MFCJI EBSJ CFCFSBQB IBSJ /BNVO CFCFSBQB TUVEJ BSUFSJ TFCBHBJ SFTQPOT UFSIBEBQ QFSVCBIBO WPMVNF EBSBI 4FCBHBJ
FLTQFSJNFOUBM NFOVOKVLLBO CBIXB CBSPSFTFQUPS UJEBL DPOUPI KJLB QBEB TFFLPS BOKJOH ZBOH TFNVB SFTFQUPSOZB VUVI
TFQFOVIOZB CFSBEBQUBTJ TFIJOHHB EBQBU CFSQFSBO EBMBN EJCFSJ JOGVT NM EBSBI TFDBSB UJCBUJCB UFLBOBO BSUFSJ BLBO
QFOHBUVSBOUFLBOBOEBSBIKBOHLBQBOKBOH UFSVUBNBEFOHBODBSB NFOJOHLBU IBOZB TFLJUBS NN )H #JMB CBSPSFTFQUPS BSUFSJ
NFNFOHBSVIJ BLUJWJUBT TBSBG TJNQBUJT HJOKBM $POUPIOZB QBEB EJEFOFSWBTJ UFLBOBO BLBO NFOJOHLBU TFLJUBS NN )H +JLB
QFOJOHLBUBOUFLBOBOBSUFSJZBOHMBNB SFGMFLTCBSPSFTFQUPSBLBO SFTFQUPS UFLBOBO SFOEBI KVHB EJEFOFSWBTJ UFLBOBO BSUFSJ BLBO
NFNQFSBOUBSBJ QFOVSVOBO BLUJWJUBT TBSBG TJNQBUJT HJOKBM ZBOH NFOJOHLBUTFLJUBSNN)H
NFOZFCBCLBO QFOJOHLBUBO FLTLSFTJ OBUSJVN EBO BJS PMFI HJOKBM +BEJ LJUB EBQBU NFMJIBU CBIXB XBMBVQVO SFTFQUPS UFLBOBO
)BM JOJ NFOZFCBCLBO QFOVSVOBO WPMVNF EBSBI TFDBSB CFSUBIBQ SFOEBI EBMBN BSUFSJ QVMNPOBMJT EBO BUSJVN UJEBL EBQBU
ZBOHNFNCBOUVNFOHFNCBMJLBOUFLBOBOEBSBINFOVKVOPSNBM NFOEFUFLTJ UFLBOBO BSUFSJ TJTUFNJL SFTFQUPSSFTFQUPS JOJ EBQBU
%FOHBO EFNJLJBO QFOHBUVSBO UFLBOBO BSUFSJ SBUBSBUB ZBOH NFOEFUFLTJBEBOZBLFOBJLBOUFLBOBOTFSFOUBLEJEBFSBITJSLVMBTJ
CFSMBOHTVOH MBNB NFNCVUVILBO JOUFSBLTJ EFOHBO TJTUFN MBJO CFSUFLBOBO SFOEBI ZBOH EJTFCBCLBO PMFI QFOJOHLBUBO WPMVNF
UFSVUBNB TJTUFN QFOHBUVS UFLBOBO HJOKBM DBJSBO UVCVI CFSTBNB EBOSFTFQUPSSFTFQUPSUFSTFCVUNFOJNCVMLBOSFGMFLTZBOHCFSKBMBO
EFOHBO NFLBOJTNF IPSNPOBM EBO TBSBG UFSLBJU
ZBOH BLBO TFKBKBSEFOHBOSFGMFLTCBSPSFTFQUPSVOUVLNFNCVBUTFMVSVITJTUFN
EJCJDBSBLBOEJ#BCEBO SFGMFLTNFOKBEJKBVIMFCJILVBUEBMBNNFOHBUVSUFLBOBOBSUFSJ
Pengendalian Tekanan Arteri oleh Kemoreseptor
Refleks Atrium yang Mengaktivasi Ginjal——"Refleks Volume"
Karotis dan Aorta—Pengaruh Kadar Oksigen Rendah
3FHBOHBO BUSJVN KVHB NFOJNCVMLBO SFGMFLT EJMBUBTJ CFSNBLOB
terhadap Tekanan Arteri. 3FGMFLT ZBOH CFSLBJUBO FSBU EFOHBO QBEB BSUFSJPM BGFSFO EBMBN HJOKBM 4JOZBMTJOZBM KVHB TFSFOUBL
TJTUFN QFOHFOEBMJBO UFLBOBO CBSPSFTFQUPS BEBMBI SFGMFLT EJUSBOTNJTJLBO EBSJ BUSJVN LF IJQPUBMBNVT VOUVL NFOHVSBOHJ
LFNPSFTFQUPS ZBOH CFLFSKB IBNQJS TBNB TFQFSUJ SFGMFLT TFLSFTJ IPSNPO BOUJEJVSFUJL BOUJEJVSFUJD IPSNPOF <"%)>

CBSPSFTFQUPS LFDVBMJ CBIXB LFNPSFTFQUPS TFCBHBJ QFOHHBOUJ 1FOVSVOBO UBIBOBO BSUFSJPM BGFSFO EBMBN HJOKBM NFOZFCBCLBO
SFTFQUPSSFHBOH NFOHBXBMJSFTQPOT UFLBOBO LBQJMFS HMPNFSVMVT NFOJOHLBU EFOHBO EFNJLJBO
,FNPSFTFQUPS NFSVQBLBO TFMTFM LFNPTFOTJUJG ZBOH QFLB NFOHIBTJMLBOQFOJOHLBUBOGJMUSBTJDBJSBOLFEBMBNUVCVMVTHJOKBM
UFSIBEBQ LFLVSBOHBO PLTJHFO LBSCPO EJPLTJEB CFSMFCJIBO EBO 1FOHVSBOHBO "%) BLBO NFOHVSBOHJ SFBCTPSQTJ BJS EBSJ UVCVMVT
JPO IJESPHFO CFSMFCJIBO 4FMTFM JOJ UFSMFUBL EJ CFCFSBQB PSHBO ,PNCJOBTJ LFEVB FGFL JOJ QFOJOHLBUBO GJMUSBTJ HMPNFSVMVT EBO
LFNPSFTFQUPS LFDJM CFSVLVSBO TFLJUBS NJMJNFUFS EVB CVBI QFOVSVOBO SFBCTPSQTJ DBJSBO NFOJOHLBULBO QFOHFMVBSBO DBJSBO
CBEBOLBSPUJT TBMBITBUVEJBOUBSBOZBUFSMFUBLEJCJGVSLBTJPTFUJBQ PMFI HJOKBM EBO NFOHVSBOHJ QFOJOHLBUBO WPMVNF EBSBI BHBS
BSUFSJLBSPUJTLPNVOJT EBOCJBTBOZBTBUVIJOHHBUJHBCVBICBEBO LFNCBMJ NFOVKV OPSNBM ,JUB KVHB BLBO MJIBU EJ #BC CBIXB
BPSUB ZBOH UFSMFUBL CFSEFLBUBO EFOHBO BPSUB
,FNPSFTFQUPS JOJ SFHBOHBOBUSJVNZBOHEJTFCBCLBOPMFIQFOJOHLBUBOWPMVNFEBSBI
NFSBOHTBOH TFSBU TBSBG EBO CFSTBNB EFOHBO TFSBCVU KVHB NFOHIBTJMLBO FGFL IPSNPOBM QBEB HJOKBM QFMFQBTBO QFQUJEB
CBSPSFTFQUPS NFMFXBUJ TBSBG )FSJOH EBO OFSWVT WBHVT NFOVKV OBUSJVSFUJL BUSJVN ZBOH NFOBNCBI FLTLSFTJ DBJSBO MFCJI MBOKVU
QVTBUWBTPNPUPSEJCBUBOHPUBL EBMBNVSJOFEBONFOHFNCBMJLBOWPMVNFEBSBINFOKBEJOPSNBM

4FUJBQCBEBOLBSPUJTBUBVCBEBOBPSUBEJTVQMBJPMFIWBTLVMBSJTBTJ 4FNVB NFLBOJTNF ZBOH DFOEFSVOH NFOHFNCBMJLBO WPMVNF
CFSMJNQBI NFMBMVJ BSUFSJ LFDJM ZBOH NFNCBXB OVUSJTJ TFIJOHHB EBSBI LFNCBMJ LF OJMBJ OPSNBM TFUFMBI CFCBO WPMVNF CFSMFCJIBO
LFNPSFTFQUPSTFMBMVCFSIVCVOHBOFSBUEFOHBOEBSBIBSUFSJ#JMB CFLFSKB TFDBSB UJEBL MBOHTVOH TFCBHBJ QFOHFOEBMJ UFLBOBO EBO
UFLBOBO BSUFSJ NFOVSVO TBNQBJ EJ CBXBI OJMBJ LSJUJT QFOHFOEBMJ WPMVNF EBSBI TFCBC WPMVNF ZBOH CFSMFCJIBO BLBO
LFNPSFTFQUPS NFOKBEJ UFSBOHTBOH LBSFOB NFOVSVOOZB BMJSBO NFNBDVQFOJOHLBUBODVSBIKBOUVOHEBOLBSFOBJUV NFOHIBTJMLBO
EBSBI NFOZFCBCLBO QFOVSVOBO PLTJHFO TFSUB QFOJNCVOBO UFLBOBO BSUFSJ MFCJI CFTBS QVMB .FLBOJTNF SFGMFLT WPMVNF JOJ
LBSCPO EJPLTJEB EBO JPOJPO IJESPHFO CFSMFCJIBO ZBOH UJEBL EJCJDBSBLBO MBHJ EJ #BC CFSTBNB EFOHBO NFLBOJTNF
EBQBUEJCVBOHPMFIBMJSBOEBSBIZBOHMBNCBU QFOHBUVSBOWPMVNFEBSBI
4JOZBM ZBOH EJUSBOTNJTJLBO EBSJ LFNPSFTFQUPS NFSBOHTBOH Refleks Atrium terhadap Pengendalian Frekuensi
QVTBU WBTPNPUPS EBO IBM JOJ BLBO NFOJOHLBULBO UFLBOBO BSUFSJ
Jantung (Refleks Bainbridge). 1FOJOHLBUBO UFLBOBO BUSJVN
LFNCBMJ LF OPSNBM /BNVO SFGMFLT LFNPSFTFQUPS JOJ CVLBO
KVHB NFOZFCBCLBO QFOJOHLBUBO UFLBOBO BUSJVN KVHB
NFSVQBLBOQFOHFOEBMJUFLBOBOBSUFSJZBOHLVBUTFCFMVNUFLBOBO
NFOZFCBCLBO QFOJOHLBUBO GSFLVFOTJ KBOUVOH LBEBOHLBEBOH
BSUFSJ UVSVO EJ CBXBI NN )H 0MFI LBSFOB JUV CBSV QBEB
QFOJOHLBUBO UFSTFCVU EBQBU NFODBQBJ QFSTFO 4FCBHJBO LFDJM
UFLBOBO ZBOH MFCJI SFOEBI SFGMFLT JOJ NFOKBEJ QFOUJOH VOUVL
LFOBJLBOJOJEJTFCBCLBOPMFIFGFLMBOHTVOHQFOJOHLBUBOWPMVNF
NFNCBOUVNFODFHBIQFOVSVOBOUFLBOBOBSUFSJMFCJIMBOKVU
BUSJVN VOUVL NFSFHBOHLBO OPEVT TJOVT IBM JOJ UFMBI
1FSJIBM LFNPSFTFQUPS BLBO EJCJDBSBLBO MFCJI EFUBJM QBEB #BC
EJUFLBOLBO EJ #BC CBIXB SFHBOHBO MBOHTVOH TFNBDBN JOJ
TFIVCVOHBO EFOHBO QFOHFOEBMJBO QFSOBQBTBO LBSFOB QFSBO
EBQBU NFOJOHLBULBO GSFLVFOTJ KBOUVOH TFCBOZBL QFSTFO
LFNPSFTFQUPS EJ TJOJ MFCJI QFOUJOH EBSJQBEB QFSBOOZB EBMBN
5BNCBIBO LFOBJLBO GSFLVFOTJ KBOUVOH TFCFTBS TBNQBJ
QFOHBUVSBOUFLBOBOEBSBI
QFSTFO EJTFCBCLBO PMFI SFGMFLT TBSBG ZBOH EJTFCVU SFGMFLT
Refleks Atrium dan Arteri Pulmonalis Mengatur Tekanan #BJOCSJEHF 3FTFQUPS SFHBOH QBEB BUSJVN ZBOH NFOZFCBCLBO
Arteri. #BJL BUSJVN NBVQVO BSUFSJ QVMNPOBMJT NFNQVOZBJ SFGMFLT #BJOCSJEHF NFOKBMBSLBO TJOZBMTJOZBM FGFSFOOZB
SFTFQUPSSFHBOHEJEBMBNEJOEJOHOZBZBOHEJTFCVUSFTFQUPSUFLB EJKBMBSLBOLFNCBMJNFMBMVJOFSWVTWBHVTEBOTBSBGTJNQBUJT
208
VOUVL NFOJOHLBULBO GSFLVFOTJ KBOUVOH EBO NFNQFSLVBU ZBOHNFOHFOEBMJLBOUFLBOBO

LPOUSBLTJ KBOUVOH +BEJ SFGMFLT JOJ NFNCBOUV NFODFHBI Reaksi Cushing untuk Meningkatkan Tekanan di
QFNCFOEVOHBOEBSBIEBMBNWFOB BUSJVN EBOTJSLVMBTJQBSV Sekeliling Otak. 3FBLTJ $VTIJOH BEBMBI TVBUV KFOJT
Respons Iskemik Sistem Saraf Pusat Pengendalian SFTQPOT JTLFNJL 441 LIVTVT ZBOH EJTFCBCLBO PMFI
UNIT IV
Tekanan Arteri oleh Pusat Vasomotor Otak sebagai QFOJOHLBUBO UFLBOBO DBJSBO TFSFCSPTQJOBM EJ TFLFMJMJOH
Respons terhadap Pengurangan Aliran Darah Otak PUBL EBMBN SPOHHB UFOHLPSBL .JTBMOZB CJMB UFLBOBO
DBJSBO TFSFCSPTQJOBM NFOJOHLBU TBNQBJ TFUJOHHJ UFLBOBO
4FCBHJBO CFTBS QFOHBUVSBO UFLBOBO EBSBI PMFI TBSBG EJDBQBJ
BSUFSJ UFLBOBO JOJ NFOFLBO TFMVSVI PUBL UFSNBTVL BSUFSJ
NFMBMVJSFGMFLTZBOHCFSBTBMEBSJCBSPSFTFQUPS LFNPSFTFQUPS EBO
EBMBNPUBLEBONFNVUVTLBOTVQMBJEBSBILFPUBL)BMJOJ
SFTFQUPS UFLBOBO SFOEBI ZBOH TFNVBOZB UFSMFUBL EJ TJSLVMBTJ BLBO NFOHBXBMJ TVBUV SFTQPOT JTLFNJL 441 ZBOH
QFSJGFSEJMVBSPUBL#JMBBMJSBOEBSBINFOVKVLFQVTBUWBTPNPUPS NFOZFCBCLBO QFOJOHLBUBO UFLBOBO BSUFSJ #JMB UFLBOBO
EBMBN CBUBOH PUBL CBHJBO CBXBI TBOHBU CFSLVSBOH TFIJOHHB BSUFSJ UFMBI NFOJOHLBU TBNQBJ OJMBJ ZBOH MFCJI UJOHHJ
NFOZFCBCLBO EFGJTJFOTJ OVUSJTJ ZBOH NFOZFCBCLBO JTLFNJB EBSJQBEB UFLBOBO DBJSBO TFSFCSPTQJOBM EBSBI BLBO
TFSFCSBM OFVSPOOFVSPO WBTPLPOTUSJLUPS EBO BLTFMFSBUPS EJ QVTBU NFOHBMJS LFNCBMJ LF EBMBN QFNCVMVI EBSBI PUBL VOUVL
WBTPNPUPS BLBO CFSFTQPOT TFDBSB MBOHTVOH UFSIBEBQ LFBEBBO NFNVMJILBO JTLFNJB PUBL #JBTBOZB UFLBOBO EBSBI BLBO
JTLFNJB EBO NFOKBEJ TBOHBU UFSBOHTBOHBO #JMB LFBEBBO JOJ NFODBQBJ OJMBJ LFTFJNCBOHBO CBSV ZBOH TFEJLJU MFCJI
UFSKBEJ UFLBOBOBSUFSJTJTUFNJLTFSJOHLBMJNFOJOHLBUTBNQBJOJMBJ UJOHHJ EBSJQBEB UFLBOBO DBJSBO TFSFCSPTQJOBM TFIJOHHB
ZBOH EBQBU EJDBQBJ PMFI QPNQB KBOUVOH &GFL JOJ EJBOHHBQ NFNVOHLJOLBO EBSBI NVMBJ NFOHBMJS MBHJ NFOVKV PUBL
EJTFCBCLBO PMFI LFHBHBMBO EBSBI ZBOH NFOHBMJS MBNCBU VOUVL 3FBLTJ $VTIJOH NFNCBOUV NFMJOEVOHJ QVTBUQVTBU WJUBM
NFNCVBOH LBSCPO EJPLTJEB EBSJ QVTBU WBTPNPUPS CBUBOH PUBL EBMBN PUBL EBSJ LFIJMBOHBO OVUSJTJ KJLB QBEB TVBUV TBBU
QBEBTBBUEBSBIZBOHNFOHBMJSLFQVTBUWBTPNPUPSIBOZBTFEJLJU UFLBOBO DBJSBO TFSFCSPTQJOBM NFOJOHLBU DVLVQ UJOHHJ
LPOTFOUSBTJ LBSCPO EJPLTJEB TFUFNQBU TBOHBU NFOJOHLBU EBO VOUVLNFOFLBOBSUFSJBSUFSJTFSFCSBM
NFNQVOZBJ FGFL ZBOH TBOHBU LVBU VOUVL NFSBOHTBOH BSFB
QFOHFOEBMJTBSBGWBTPNPUPSTJNQBUJTEJNFEVMBPUBL
.VOHLJO TBKB CBIXB GBLUPSGBLUPS MBJO TFQFSUJ QFOVNQVLBO
BTBNMBLUBUEBOTVCTUBOTJBTBNMBJOOZBEJQVTBUWBTPNPUPS KVHB
NFNQFSLVBU QFSBOHTBOHBO EBO QFOJOHLBUBO UFLBOBO BSUFSJ Sifat Khusus Pengendalian Tekanan
1FOJOHLBUBO UFLBOBO BSUFSJ TFCBHBJ SFTQPOT UFSIBEBQ JTLFNJB Arteri melalui Saraf
TFSFCSBM JOJ EJLFOBM TFCBHBJ SFTQPOT JTLFNJL TJTUFN TBSBG QVTBU
441
Peran Saraf Rangka dan Otot Rangka dalam
1FOHBSVI JTLFNJB UFSIBEBQ BLUJWJUBT WBTPNPUPS EBQBU Meningkatkan Curah Jantung dan Tekanan Arteri
NFOJOHLBULBO UFLBOBO BSUFSJ SBUBSBUB TFDBSB ESBNBUJT LBEBOH 8BMBVQVOTFCBHJBOCFTBSQFOHFOEBMJBOTJSLVMBTJPMFITBSBG
LBEBOH NFODBQBJ TFUJOHHJ NN )H IJOHHB TFMBNB NFOJU EJQFOHBSVIJ NFMBMVJ TJTUFN TBSBG PUPOPN TFUJEBLUJEBLOZB
%FSBKBU WBTPLPOTUSJLTJ TJNQBUJT ZBOH EJTFCBCLBO PMFI JTLFNJB BEBEVBLPOEJTJZBOHNFOVOKVLLBOCBIXBTBSBGSBOHLBEBO
TFSFCSBM IFCBU TFSJOH LBMJ CFHJUV CFTBSOZB TFIJOHHB CFCFSBQB PUPU SBOHLB KVHB NFNFHBOH QFSBO CFTBS EBMBN SFTQPOT
QFNCVMVI QFSJGFS TFMVSVIOZB BUBV IBNQJS TFMVSVIOZB UFSTVNCBU TJSLVMBTJTFCBHBJCFSJLVU
(JOKBM TFCBHBJ DPOUPI TFSJOH LBMJ NFOHIFOUJLBO TFMVSVI
Refleks Kompresi Abdomen.#JMBSFGMFLTCBSPSFTFQUPS
QSPEVLTJ VSJOFOZB BLJCBU LPOTUSJLTJ BSUFSJPMBS HJOKBM TFCBHBJ
BUBV LFNPSFTFQUPS UFSBOHTBOH TJOZBMTJOZBM TBSBG KVHB
SFTQPOTUFSIBEBQQFSBOHTBOHBOTJNQBUJT0MFILBSFOBJUV SFTQPOT
EJKBMBSLBO TFDBSB TFSFOUBL NFMBMVJ TBSBG SBOHLB NFOVKV
JTLFNJL 441 BEBMBI TBMBI TBUV BLUJWBUPS TJTUFN WBTPLPOTUSJLUPS
PUPUPUPU SBOHLB UVCVI UFSVUBNB PUPUPUPU BCEPNFO
TJNQBUJTZBOHLVBU
,FBEBBO JOJ BLBO NFOFLBO TFMVSVI UFNQBU QFOZJNQBOBO
Makna Penting Respons Iskemik SSP sebagai Pengatur WFOBEJBCEPNFO NFNCBOUVNFNJOEBILBOEBSBILFMVBS
Tekanan Arteri. .FTLJQVO SFTQPOT JTLFNJL 441 TBOHBU LVBU EBSJ UFNQBU QFOZJNQBOBO WBTLVMBS EJ BCEPNFO NFOVKV
UFSOZBUB SFTQPOT JOJ UJEBLMBI CFSNBLOB TBNQBJ UFLBOBO BSUFSJ KBOUVOH"LJCBUOZB UFSKBEJQFOJOHLBUBOKVNMBIEBSBIZBOH
UVSVOKBVIEJCBXBIOPSNBM ZBLOJUVSVOTBNQBJNN)HEBO UFSTFEJBCBHJKBOUVOHVOUVLEJQPNQB,FTFMVSVIBOSFTQPOT
MFCJI SFOEBI MBHJ EBO NFODBQBJ EFSBKBU QFSBOHTBOHBO JOJ EJTFCVU SFGMFLT LPNQSFTJ BCEPNFO &GFL ZBOH UFSKBEJ
UFSUJOHHJOZBQBEBUFLBOBOTBNQBJNN)H0MFILBSFOBJUV QBEB TJSLVMBTJ TBNB EFOHBO FGFL ZBOH EJTFCBCLBO PMFI
NFLBOJTNF JOJ CVLBOMBI NFLBOJTNF OPSNBM VOUVL QFOHBUVSBO JNQVMT WBTPLPOTUSJLUPS TJNQBUJT LFUJLB JNQVMT UFSTFCVU
UFLBOBO BSUFSJ 4FCBMJLOZB NFLBOJTNF JOJ UFSVUBNB CFLFSKB NFOZFCBCLBO LPOTUSJLTJ WFOB QFOJOHLBUBO DVSBI KBOUVOH
TFCBHBJ TJTUFN QFOHFOEBMJBO UFLBOBO BSUFSJ EBMBN LFBEBBO EBO UFLBOBO BSUFSJ 3FGMFLT LPNQSFTJ BCEPNFO NVOHLJO
EBSVSBU ZBOH CFLFSKB EFOHBO DFQBU EBO TBOHBU LVBU VOUVL KBVI MFCJI QFOUJOH EBSJQBEB ZBOH UFMBI EJLFUBIVJ
NFODFHBI QFOVSVOBO UFLBOBO BSUFSJ MFCJI MBOKVU CJMBNBOB BMJSBO TFCFMVNOZB TFCBC UFMBI EJLFUBIVJ EFOHBO CBJL CBIXB
EBSBILFPUBLNFOVSVOIJOHHBLFPUBLNFOVSVOIJOHHBNFOEFLBUJ PSBOHPSBOH ZBOH NFOHBMBNJ LFMVNQVIBO PUPU SBOHLB
UJOHLBU ZBOH NFNBUJLBO .FLBOJTNF JOJ LBEBOHLBMB EJTFCVU TBOHBU DFOEFSVOH NFOHBMBNJ FQJTPEF IJQPUFOTJ EBSJQBEB
NFLBOJTNFQBOHLBMBOQFNCVBOHBOUFSBLIJS MBTUEJUDITUBOE
PSBOHPSBOHEFOHBOPUPUSBOHLBOPSNBM
209
Unit IV Sirkulasi
Peningkatan Curah Jantung dan Tekanan Arteri Akibat

Kontraksi Otot Rangka Selama Latihan Fisik.
4FXBLUVPUPUPUPUSBOHLBCFSLPOUSBLTJTFMBNBMBUJIBOGJTJL PUPU
PUPUUFSTFCVUNFOFLBOQFNCVMVIEBSBIEJTFMVSVIUVCVI#BILBO
QFSTJBQBO VOUVL MBUJIBO GJTJL TBKB TVEBI NFOHFODBOHLBO PUPU
PUPU TFIJOHHB UFSKBEJ LPNQSFTJ QFNCVMVI EBSBI EBMBN PUPU EBO
BCEPNFO "LJCBUOZB BEBMBI UFSKBEJ QFNJOEBIBO EBSBI EBSJ
QFNCVMVI QFSJGFS LF KBOUVOH EBO QBSV EBO EFOHBO EFNJLJBO
BLBO NFOJOHLBULBO DVSBI KBOUVOH ,FBEBBO JOJ NFSVQBLBO FGFL Gambar 18-10 A, Gelombang vasomotor akibat osilasi respons
iskemik SSP. B, Gelombang vasomotor akibat osilasi refleks
ZBOH QFOUJOH EBMBN NFNCBOUV NFOJOHLBULBO DVSBI KBOUVOH baroreseptor.
TFCFTBS MJNB TBNQBJ UVKVI LBMJ MJQBU ZBOH LBEBOHLBEBOH UFSKBEJ
TFMBNB MBUJIBO GJTJL CFSBU 4FMBOKVUOZB LFOBJLBO DVSBI KBOUVOH
NFSVQBLBO CBIBO QFOUJOH VOUVL NFOJOHLBULBO UFLBOBO BSUFSJ 1FOZFCBC UFSKBEJOZB HFMPNCBOH WBTPNPUPS BEBMBI SFGMFLT
TFMBNB MBUJIBO GJTJL CJBTBOZB UFSKBEJ QFOJOHLBUBO EBSJ UFLBOBO PTJMBTJ EBSJ TBMBI TBUV BUBV MFCJI NFLBOJTNF QFOHFOEBMJ UFLBOBO
SBUBSBUBOPSNBM NN)H
IJOHHBNFODBQBJTBNQBJ PMFITBSBG CFCFSBQBEJBOUBSBOZBBEBMBITFCBHBJCFSJLVU
NN)H
Osilasi Refleks-Refleks Baroreseptor dan Kemoreseptor.
Gelombang Respiratorik pada Tekanan Arteri (FMPNCBOH WBTPNPUPS QBEB (BNCBS # TFSJOH UFSMJIBU QBEB
%J TFUJBQ TJLMVT SFTQJSBTJ UFLBOBO BSUFSJ CJBTBOZB NFOHBMBNJ SFLBNBO UFLBOBO QFSDPCBBO XBMBVQVO CJBTBOZB LVSBOH CFHJUV
QFOJOHLBUBO EBO QFOVSVOBO TBNQBJ NN )H EBMBN LVBU CJMB EJCBOEJOHLBO EFOHBO ZBOH UBNQBL EBMBN HBNCBS
HBNCBSBO TFQFSUJ HFMPNCBOH EBO HFMPNCBOH JUV EJTFCVU (FMPNCBOH JOJ UFSVUBNB EJTFCBCLBO PMFI PTJMBTJ SFGMFLT
HFMPNCBOH SFTQJSBUPSJL QBEB UFLBOBO BSUFSJ (FMPNCBOH JOJ CBSPSFTFQUPS:BJUV CJMBUFLBOBOUJOHHJNFSBOHTBOHCBSPSFTFQUPS
EJIBTJMLBO EBSJ CFSCBHBJ QFOHBSVI CFCFSBQB EJ BOUBSBOZB LFBEBBO JOJ LFNVEJBO NFOHIBNCBU TJTUFN TBSBG TJNQBUJT EBO
CFSTJGBUTFCBHBJSFGMFLT ZBLOJ NFOVSVOLBO UFLBOBO CFCFSBQB EFUJL LFNVEJBO 1FOVSVOBO
1. #BOZBLTJOZBMQFSOBQBTBOZBOHUJNCVMEJQVTBUSFTQJSBUPSJL UFLBOBO BLBO NFOHVSBOHJ QFSBOHTBOHBO QBEB CBSPSFTFQUPS EBO
EJ NFEVMB BLBO UVNQBI LF EBMBN QVTBU WBTPNPUPS QBEB NFOHBLJCBULBO QVTBU WBTPNPUPS NFOKBEJ BLUJG MBHJ ZBOH BLBO
TFUJBQTJLMVTSFTQJSBUPSJL NFOBJLLBO UFLBOBO IJOHHB LF OJMBJ UJOHHJ 3FTQPOTOZB UJEBL
2. 4FUJBQ LBMJ TFTFPSBOH NFMBLVLBO JOTQJSBTJ UFLBOBO EJ EBMBN TFHFSB NVODVM EBO SFTQPOT JOJ UFSUVOEB IJOHHB CFCFSBQB EFUJL
SPOHHB UPSBLT NFOKBEJ MFCJI OFHBUJG EBSJQBEB CJBTBOZB ZBOH LFNVEJBO 5FLBOBO UJOHHJ JOJ TFMBOKVUOZB BLBO NFNVMBJ TJLMVT
NFOZFCBCLBO QFNCVMVI EBSBI EBMBN EBEB NFOHFNCBOH MBJO EBOQFSJTUJXBPTJMBTJUFSKBEJMBHJEBOCFHJUVTFUFSVTOZB
,FBEBBO JOJ NFOHVSBOHJ KVNMBI EBSBI ZBOH LFNCBMJ LF 3FGMFLT LFNPSFTFQUPS KVHB EBQBU NFOHPTJMBTJ EBO NFNCFSJLBO
CBHJBOLJSJKBOUVOHEBOVOUVLTFNFOUBSBXBLUVNFOVSVOLBO UJQF HFMPNCBOH ZBOH TBNB #JBTBOZB SFGMFLT JOJ CFSPTJMBTJ TFDBSB
DVSBIKBOUVOHEBOUFLBOBOBSUFSJ TFSFOUBL EFOHBO SFGMFLT CBSPSFTFQUPS 3FGMFLT JOJ NVOHLJO
3. 1FSVCBIBO UFLBOBO EBMBN QFNCVMVI EBSBI UPSBLT ZBOH NFNQVOZBJ QFSBO VUBNB EBMBN NFOJNCVMLBO HFMPNCBOH
EJTFCBCLBOPMFISFTQJSBTJEBQBUNFOHFLTJUBTJSFTFQUPSSFHBOH WBTPNPUPSTFXBLUVUFLBOBOBSUFSJCFSBEBQBEBLJTBSBOTBNQBJ
EJQFNCVMVIEBSBIEBOBUSJVN NN )H LBSFOB EBMBN LJTBSBO SFOEBI JOJ LFNPSFTFQUPS
8BMBVQVO TVMJU VOUVL NFOHBOBMJTJT IVCVOHBO ZBOH QFOHFOEBMJ TJSLVMBTJ NFOKBEJ CFHJUV LVBU TFEBOHLBO QFOHBUVS
TFCFOBSOZB BOUBSB TFNVB GBLUPSGBLUPS JOJ EBMBN NFOZFCBCLBO CBSPSFTFQUPSNFOKBEJMFCJIMFNBI
UFSKBEJOZB HFMPNCBOH UFLBOBO SFTQJSBUPSJL IBTJM OFUUP TFMBNB Osilasi Respons Iskemik SSP. 3FLBNBO ZBOH UBNQBL
SFTQJSBTJOPSNBMCJBTBOZBBEBMBILFOBJLBOUFLBOBOBSUFSJTFMBNB EBMBN (BNCBS " EJTFCBCLBO PMFI PTJMBTJ NFLBOJTNF
NBTB QFSNVMBBO FLTQJSBTJ EBO QFOVSVOBO UFLBOBO TFMBNB TJTB QFOHBUVSBO UFLBOBO JTLFNJL 441 1BEB QFSDPCBBO JOJ UFLBOBO
TJLMVTSFTQJSBUPSJL4FMBNBSFTQJSBTJEBMBN UFLBOBOEBSBIEBQBU DBJSBO TFSFCSPTQJOBM EJOBJLLBO NFOKBEJ NN )H ZBOH
NFOJOHLBU EBO NFOVSVO TFCFTBS NN )H QBEB TFUJBQ TJLMVT NFOFLBO QFNCVMVI EBSBI TFSFCSBM EBO NFNVMBJ UFSKBEJOZB
SFTQJSBUPSJL SFTQPOT UFLBOBO JTLFNJL 441 IJOHHB NN )H #JMB UFLBOBO
Gelombang "Vasomotor"Tekanan Arteri Osilasi pada BSUFSJ NFOJOHLBU TBNQBJ EFOHBO OJMBJ UJOHHJ UFSTFCVU LFBEBBO
Sistem Pengendali Refleks Tekanan JTLFNJB PUBL BLBO CFSLVSBOH EBO TJTUFN TBSBG TJNQBUJT NFOKBEJ
4FSJOHLBMJTBBUQFSFLBNBOUFLBOBOBSUFSJQBEBTFFLPSCJOBUBOH JOBLUJG "LJCBUOZB UFLBOBO BSUFSJ EFOHBO DFQBU BLBO UVSVO
TFMBJO BEBOZB HFMPNCBOH UFLBOBO LFDJM ZBOH EJTFCBCLBO PMFI LFNCBMJ LF OJMBJ MFCJI SFOEBI EBO NFOZFCBCLBO JTLFNJB PUBL
SFTQJSBTJ UFSOZBUB EBQBU EJDBUBU BEBOZB CFCFSBQB HFMPNCBOH MBHJ ,FNVEJBO LFBEBBO JTLFNJL JOJ BLBO NFNJDV LFOBJLBO
ZBOH MFCJI CFTBS TFCFTBS TBNQBJ NN )H QBEB TVBUV TBBU UFLBOBO 4FLBMJ MBHJ JTLFNJB CFSLVSBOH EBO UFLBOBO UVSVO
ZBOH OBJL EBO UVSVOOZB MFCJI MBNCBU EBSJQBEB HFMPNCBOH ,FBEBBO JOJ BLBO UFSVTNFOFSVT UFSKBEJ CFSVMBOHVMBOH TFMBNB
SFTQJSBUPSJL -BNB TFUJBQ TJLMVT CFSWBSJBTJ EBSJ EFUJL QBEB UFLBOBODBJSBOTFSFCSPTQJOBMUFUBQNFOJOHLBU
BOKJOHZBOHEJCJVTTBNQBJIJOHHBEFUJLQBEBNBOVTJBZBOH
UJEBL EJCJVT (FMPNCBOHHFMPNCBOH JOJ EJTFCVU HFMPNCBOH +BEJ SFGMFLT NFLBOJTNF QFOHBUVSBO UFLBOBO NBOBQVO EBQBU
WBTPNPUP SBUBV HFMPNCBOH .BZFS 3FLBNBO HFMPNCBOH CFSPTJMBTJ KJLB LFLVBUBO VNQBO CBMJLOZB DVLVQ LVBU EBO
UFSTFCVU EJQFSMJIBULBO EBMBN (BNCBS ZBOH UFSEBQBUQFOVOEBBOBOUBSBFLTJUBTJSFTFQUPSUFLBOBOEBOSFTQPOT
NFNQFSMJIBULBO BEBOZB LFOBJLBO EBO QFOVSVOBO TJLMJL EBMBN UFLBOBO TFMBOKVUOZB 4FDBSB UFPSFUJT HFMPNCBOH WBTPNPUPS
UFLBOBOBSUFSJ TBOHBUMBIQFOUJOHTFCBCHFMPNCBOHJOJNFOVOKVLLBOCBIXB
210
SFGMFLT TBSBG ZBOH NFOHFOEBMJLBO UFLBOBO BSUFSJ NFOHJLVUJ Goldstein DS, Robertson D, Esler M, et al: Dysautonomias: clinical
disorders
QSJOTJQQSJOTJQ ZBOH TBNB EFOHBO QSJOTJQ ZBOH EJUFSBQLBO
of the autonomic nervous system, Ann Intern Med 137:753, 2002.
QBEB TJTUFN QFOHFOEBMJ NFLBOJL EBO MJTUSJL 4FCBHBJ DPOUPI Guyton AC: Arterial pressure and hypertension, Philadelphia, 1980, WB
KJLB QFSPMFIBO VNQBO CBMJL UFSMBMV CFTBS QBEB NFLBOJTNF Saunders.
UNIT IV
QFNBOEV LFNVEJ PUPNBUJT EJ TFCVBI QFTBXBU UFSCBOH EBO Guyenet PG: The sympathetic control of blood pressure, Nat Rev Neurosci
UFSEBQBUKVHBQFOVOEBBOXBLUVSFTQPOTNFLBOJTNFQFNBOEV 7:335, 2006.
Joyner MJ: Baroreceptor function during exercise: resetting the record, Exp
UFSTFCVU NBLBQFTBXBUUFSCBOHBLBOCFSPTJMBTJEBSJTBUVTJTJLF
Physiol 91:27, 2006.
TJTJMBJOEBOUJEBLUFSCBOHNFOVSVUBSBIZBOHMVSVT Lohmeier TE, Dwyer TM, Irwin ED, et al: Prolonged activation of the barore-
flex abolishes obesity-induced hypertension, Hypertension 49:1307,
2007.
Lohmeier TE, Hildebrandt DA, Warren S, et al: Recent insights into the inter-
actions between the baroreflex and the kidneys in hypertension, Am J
Physiol Regul Integr Comp Physiol 288:R828, 2005.
Ketch T, Biaggioni I, Robertson R, Robertson D: Four faces of baroreflex
Daftar Pustaka failure: hypertensive crisis, volatile hypertension, orthostatic
Cao WH, Fan W, Morrison SF: Medullary pathways mediating specific tachycardia, and malignant vagotonia, Circulation 105:2518, 2002.
sympathetic responses to activation of dorsomedial hypothalamus, Mifflin SW: What does the brain know about blood pressure? News Physiol
Neuroscience 126:229, 2004. Sci 16:266, 2001.
Cowley AW Jr: Long-term control of arterial blood pressure, Physiol Rev Olshansky B, Sabbah HN, Hauptman PJ, et al: Parasympathetic
72:231, 1992. nervous
DiBona GF: Physiology in perspective: the wisdom of the body. Neural con-trol system and heart failure: pathophysiology and potential implications
of the kidney, Am J Physiol Regul Integr Comp Physiol 289:R633, 2005 for therapy, Circulation 118:863, 2008.
Esler M, Lambert G, Brunner-La Rocca HP, et al: Sympathetic nerve activty Schultz HD, Li YL, Ding Y: Arterial chemoreceptors and sympathetic nerve
and neurotransmitter release in humans: translation from pathophysiology activity: implications for hypertension and heart failure, Hypertension
into clinical practice, Acta Physiol Scand 177:275, 2003. Freeman R: 50:6, 2007.
Clinical practice. Neurogenic orthostatic hypotension, N Engl J Zucker IH: Novel mechanisms of sympathetic regulation in chronic heart
Med 358:615, 2008. failure, Hypertension 48:1005, 2006.
211
BAB 19
1FSBO(JOKBMEBMBN1FOHBUVSBO5FLBOBO"SUFSJ
UNIT IV
+BOHLB1BOKBOHEBO)JQFSUFOTJ4JTUFN
5FSJOUFHSBTJ1FOHBUVSBO5FLBOBO"SUFSJ
1FOHBUVSBO UFLBOBO BSUFSJ 0MFILBSFOBIBHGJTINJOVNTFDBSBUFSVTNFOFSVT WPMVNFDBJSBO

KBOHLB QFOEFL PMFI TJTUFN FLTUSBTFMVMBS WPMVNF EBSBI EBO UFLBOBO TFNVBOZB LFNCBMJ
TBSBG TJNQBUJT TFQFSUJ ZBOH NFOJOHLBULFOJMBJZBOHMFCJIUJOHHJ
EJCBIBT EJ #BC UFSVUBNB 4FQBOKBOH [BNBO NFLBOJTNF QFOHBUVSBO UFLBOBO ZBOH
UFSKBEJ NFMBMVJ QFOHBSVI QSJNJUJGJOJCFSUBIBOIBNQJSTFQFSUJZBOHCFSGVOHTJQBEBIBHGJTI
TJTUFN TBSBG QBEB UBIBOBO QBEB NBOVTJB LFMVBSBO HJOKBM VOUVL BJS EBO HBSBN TBNB
QFSJGFSUPUBMQFNCVMVIEBSBI QFLBOZB UFSIBEBQ QFSVCBIBO UFLBOBO TFQFSUJ IBHGJTI CBILBO
EBOLBQBTJUBOT TFMBJOKVHBQBEBEBZBQPNQBKBOUVOH NVOHLJO MFCJI QFLB .FNBOH QBEB NBOVTJB QFOJOHLBUBO
/BNVO UVCVIKVHBNFNJMJLJNFLBOJTNFLVBUZBOHNFOHBUVS UFLBOBO BSUFSJ ZBOH IBOZB CFCFSBQB NN )H TBKB EBQBU
UFLBOBO BSUFSJ EBSJ NJOHHV LF NJOHHV EBO EBSJ CVMBO LF CVMBO NFOJOHLBULBO LFMVBSBO BJS PMFI HJOKBM TFCBOZBL EVB LBMJ MJQBU
1FOHBUVSBOUFLBOBOBSUFSJKBOHLBQBOKBOHJOJ FSBUUFSKBMJOEFOHBO ZBOH EJTFCVU EJVSFTJT UFLBOBO EBO KVHB NFOJOHLBULBO LFMVBSBO
IPNFPTUBTJT WPMVNF DBJSBO UVCVI ZBOH EJUFOUVLBO PMFI HBSBNTFCBOZBLEVBLBMJMJQBU ZBOHEJTFCVUOBUSJVSFTJTUFLBOBO
LFTFJNCBOHBO BOUBSB BTVQBO EBO LFMVBSBO DBJSBO 6OUVL 1BEB NBOVTJB TJTUFN DBJSBO UVCVI HJOKBM VOUVL QFOHBUVSBO
LFMBOHTVOHBO IJEVQ KBOHLB QBOKBOH LFTFJNCBOHBO BTVQBO EBO UFLBOBOBSUFSJ TFQFSUJKVHBQBEBIBHGJTI NFSVQBLBONFLBOJTNF
LFMVBSBO DBJSBO IBSVT UFQBU TVBUV UVHBT ZBOH EJMBLVLBO PMFI EBTBS VOUVL QFOHBUVSBO UFLBOBO BSUFSJ KBOHLB QBOKBOH /BNVO
CFSCBHBJ LFOEBMJ TBSBG EBO IPSNPO EBO PMFI TJTUFN QFOHBUVSBO EFNJLJBO TFUFMBI NFMBMVJ CFSCBHBJ UBIBQ FWPMVTJ CFSCBHBJ
MPLBM EBMBN HJOKBM ZBOH NFOHBUVS FLTLSFTJ HBSBN EBO BJS 1BEB QFSCBJLBOUFMBIEJUBNCBILBOZBOHNFNCVBUTJTUFNJOJNFOKBEJ
CBC JOJ LJUB BLBO NFNCBIBT TJTUFN DBJSBO UVCVI HJOKBM ZBOH KBVIMFCJIUFQBUEBMBNNFMBLVLBOQFOHBUVSBOOZBQBEBNBOVTJB
NFNQVOZBJ QFSBO EPNJOBO EBMBN QFOHBUVSBO UFLBOBO EBSBI 1FSCBJLBO QFOUJOH LIVTVT ZBOH OBOUJ BLBO EJCBIBT CFSVQB
KBOHLBQBOKBOH QFOBNCBIBONFLBOJTNFSFOJOBOHJPUFOTJO
Jumlah Diuresis Tekanan sebagai Dasar Pengaturan
Sistem Cairan Tubuh Ginjal untuk Pengaturan Tekanan Arteri
Tekanan Arteri (BNCBSNFOVOKVLLBOQFSLJSBBOFGFLSBUBSBUBCFSCBHBJOJMBJ
UFLBOBO BSUFSJ QBEB LFMVBSBO WPMVNF VSJOF HJOKBM ZBOH EJJTPMBTJ
4JTUFN DBJSBO UVCVI HJOKBM VOUVL QFOHBUVSBO UFLBOBO BSUFSJ ZBOH NFNQFSMJIBULBO QFOJOHLBUBO WPMVNF VSJOF ZBOH KFMBT
CFLFSKBMBNCBUOBNVOEFOHBOLVBU TFCBHBJCFSJLVU#JMBWPMVNF EFOHBO NFOJOHLBUOZB UFLBOBO 1FOJOHLBUBO LFMVBSBO VSJOF JOJ
EBSBICFSUBNCBIEBOLBQBTJUBOTQFNCVMVIEBSBIUJEBLCFSVCBI NFSVQBLBO GFOPNFOB EJVSFTJT UFLBOBO ,VSWB EBMBN HBNCBS JOJ
UFLBOBO BSUFSJ KVHB BLBO NFOJOHLBU 1FOJOHLBUBO UFLBOBO JOJ EJTFCVU LVSWB LFMVBSBO VSJOF PMFI HJOKBM BUBV LVSWB GVOHTJ HJOKBM
TFMBOKVUOZB BLBO NFOZFCBCLBO HJOKBM NFOHFLTLSFTJ LFMFCJIBO %J NBOVTJB QBEB UFLBOBO BSUFSJ TFCFTBS NN )H LFMVBSBO
WPMVNF TFIJOHHBNFOHFNCBMJLBOUFLBOBOLFOJMBJOPSNBM VSJOF IBNQJS OPM 1BEB UFLBOBO NN )H LFMVBSBO VSJOF
%BMBNSJXBZBUGJMPHFOFUJLQFSLFNCBOHBOIFXBO TJTUFNDBJSBO OPSNBMEBOQBEBNN)H LFMVBSBOOZBLJSBLJSBFOBNTBNQBJ
UVCVI HJOKBM VOUVL QFOHBUVSBO UFLBOBO JOJ NFSVQBLBO TJTUFN EFMBQBOLBMJOPSNBM4FMBJOJUV QFOJOHLBUBOUFLBOBOUJEBLIBOZB
ZBOHQSJNJUJG4JTUFNJOJCFLFSKBTFDBSBTFNQVSOBQBEBTBMBITBUV NFOJOHLBULBO LFMVBSBO WPMVNF VSJOF UFUBQJ KVHB NFOZFCBCLBO
KFOJT WFSUFCSBUB ZBOH QBMJOH SFOEBI ZBJUV IBHGJTI )FXBO JOJ UFSKBEJOZBQFOJOHLBUBOLFMVBSBOOBUSJVNZBOHIBNQJSTBNBCFTBS
NFNJMJLJUFLBOBOBSUFSJZBOHSFOEBI IBOZBTBNQBJNN)H ZBOHNFSVQBLBOGFOPNFOBOBUSJVSFTJTUFLBOBO
EBO UFLBOBO JOJ NFOJOHLBU IBNQJS TFDBSB MBOHTVOH TFCBOEJOH Percobaan yang Mendemonstrasikan Sistem Cairan
EFOHBOWPMVNFEBSBIOZB)BHGJTIUFSVTNFOFSVTNJOVNBJSMBVU Tubuh–Ginjal untuk Pengaturan Tekanan Arteri. (BNCBS
ZBOH EJBCTPSCTJ LF EBMBN EBSBIOZB TFIJOHHB NFOJOHLBULBO NFOHHBNCBSLBOIBTJMTVBUVFLTQFSJNFOQBEBBOKJOHZBOH
WPMVNF EBO UFLBOBO EBSBI /BNVO CJMB UFLBOBO NFOJOHLBU TFNVB NFLBOJTNF SFGMFLT TBSBGOZB VOUVL QFOHBUVSBO UFLBOBO
UFSMBMV UJOHHJ HJOKBM NFOHFLTLSFLTJ TBKB LFMFCJIBO WPMVNF LF EBSBI UFMBI EJIBNCBU UFSMFCJI EBIVMV ,FNVEJBO UFLBOBO
EBMBN VSJOF EBO NFOVSVOLBO UFLBOBO 1BEB UFLBOBO ZBOH BSUFSJOZBUJCBUJCBEJOBJLLBOEFOHBONFOHJOGVTBOKJOHUFSTFCVU
SFOEBI HJOKBM NFOHFLTLSFTJ DBJSBO EBMBN KVNMBI ZBOH MFCJI EFOHBOTFLJUBSNMEBSBIJOUSBWFOB1FSIBUJLBOQFOJOHLBUBO
DBJSBOEBMBNKVNMBIZBOHMFCJITFEJLJUEBSJQBEBZBOHEJNJOVN DVSBIKBOUVOHDFQBUZBOHIBNQJSNFODBQBJEVBLBMJOPSNBMEBO
213
Unit IV Sirkulasi
8 8
Keluaran air dan
7 garam oleh ginjal
6 6
5
4
4
3 Titik keseimbangan Asupan air
2
dan garam
2
1 0
0 0 50 100 150 200
0 20 40 60 80 100 120 140 160 180 200
Analisis pengaturan tekanan arteri dengan
Kurva keluaran volume urine khas yang terukur menyetarakan kurva keluaran ginjal dengan kurva asupan
pada ginjal isolasi yang diperfusi, menunjukkan adanya diuresis garam dan air. Titik keseimbangan menunjukkan tingkat saat
tekanan bila tekanan arteri meningkat melebihi normal. pengaturan tekanan arteri dapat dilakukan. (Sebagian kecil
asupan garam dan air yang hilang dari tubuh lewat jalur selain
ginjal diabaikan pada kurva ini dan gambar sejenis dalam bab ini.)
4000
3000
ZBOHEBQBUEJQBLBJVOUVLNFOHBOBMJTJTQFOHBUVSBOUFLBOBOBSUFSJ
2000 PMFI TJTUFN DBJSBO UVCVI HJOKBM "OBMJTJT JOJ CFSEBTBSLBO EVB
LVSWBUFSQJTBIZBOHTBMJOHCFSQPUPOHBO
LVSWBLFMVBSBOHJOKBM
1000
VOUVL BJS EBO HBSBN TFCBHBJ SFTQPOT UFSIBEBQ QFOJOHLBUBO
4 UFLBOBOBSUFSJ ZBOHNFSVQBLBOLVSWBLFMVBSBOHJOKBMZBOHTBNB
3 TFQFSUJZBOHEJQFSMJIBULBOQBEB(BNCBS EBO
HBSJTZBOH
2 NFOVOKVLLBOKVNMBIOFUUPBTVQBOBJSEBOHBSBN
1
0 4FUFMBI QFSJPEF XBLUV ZBOH MBNB LFMVBSBO BJS EBO HBSBN
IBSVTTFUBSBEFOHBOBTVQBOOZB4FMBOKVUOZB TBUVTBUVOZBUFNQBU
225 QBEB HSBGJL EJ (BNCBS ZBOH NFOVOKVLLBO LFMVBSBO TBNB
200
EFOHBO BTVQBO BEBMBI TBBU LFEVB LVSWB UFSTFCVU CFSQPUPOHBO
175
ZBOH EJTFCVU UJUJL LFTFJNCBOHBO 4FLBSBOH NBSJ LJUB MJIBU BQB
150
125
ZBOHUFSKBEJCJMBUFLBOBOBSUFSJNFOJOHLBUEJBUBT BUBVNFOVSVO
100 EJCBXBI UJUJLLFTFJNCBOHBO
75 1FSUBNB NJTBMOZB UFLBOBO BSUFSJ NFOJOHLBU TBNQBJ NN
50
Lama infus )H1BEBOJMBJJOJ LFMVBSBOBJSEBOHBSBNHJOKBMLJSBLJSBUJHBLBMJ
MFCJI CFTBS EBSJQBEB BTVQBO 0MFI LBSFOB JUV UVCVI LFIJMBOHBO
0 1 02030405060 120
DBJSBO WPMVNF EBSBI CFSLVSBOH EBO UFLBOBO BSUFSJ NFOVSVO
4FMBOKVUOZB LFTFJNCBOHBOOFHBUJGDBJSBOJOJUJEBLBLBOCFSIFOUJ
Peningkatan curah jantung, keluaran urine, dan
TBNQBJ UFLBOBO UVSVO TFQFOVIOZB LFNCBMJ UFQBU LF UJUJL
tekanan arteri yang disebabkan oleh peningkatan volume darah
pada anjing yang mekanisme pengaturan tekanan oleh saraf LFTFJNCBOHBO#BILBOCJMBUFLBOBOBSUFSJIBOZBNN)HMFCJI
diblok. Gambar ini menunjukkan kembalinya tekanan arteri ke UJOHHJ EBSJ UJUJL LFTFJNCBOHBO UFUBQ BEB QFOHFMVBSBO BJS EBO
normal setelah kehilangan cairan selama kira-kira satu jam HBSBNZBOHTFEJLJUMFCJICFTBSEBSJQBEBBTVQBO TFIJOHHBUFLBOBO
melalui urine. (Sumbangan Dr. William Dobbs.) UFSVTNFOVSVOIJOHHBNN)HTBNQBJUFLBOBOLFNCBMJUFQBULF
QFOJOHLBUBO UFLBOBO BSUFSJ SBUBSBUB ZBOH NFODBQBJ NN UJUJLLFTFJNCBOHBO
)H NN )H EJ BUBT OJMBJ JTUJSBIBUOZB 1BEB CBHJBO UFOHBI #JMB UFLBOBO BSUFSJ NFOVSVO EJ CBXBI UJUJL LFTFJNCBOHBO
LVSWB UBNQBL QFOHBSVI QFOJOHLBUBO UFLBOBO BSUFSJ JOJ BTVQBOBJSEBOHBSBNBLBOMFCJICFTBSEBSJQBEBLFMVBSBOOZB0MFI
UFSIBEBQLFMVBSBOVSJOF ZBOHNFOJOHLBULBMJMJQBU#FSTBNB LBSFOB JUV WPMVNF DBJSBO UVCVI NFOJOHLBU WPMVNF EBSBI
EFOHBOIJMBOHOZBDBJSBOEBMBNKVNMBIZBOHCBOZBLJOJNFMBMVJ NFOJOHLBU EBO UFLBOBO BSUFSJ NFOJOHLBU LFNCBMJ UFQBU LF UJUJL
VSJOF CBJL DVSBI KBOUVOH NBVQVO UFLBOBO BSUFSJ LFNCBMJ LFTFJNCBOHBO 1FOHFNCBMJBO UFLBOBO BSUFSJ ZBOH TFMBMV LF UJUJL
OPSNBMQBEBKBNCFSJLVUOZB+BEJ LJUBMJIBULFNBNQVBOHJOKBM LFTFJNCBOHBO JOJ NFSVQBLBO TVBUV QSJOTJQ VNQBO CBMJL ZBOH
ZBOH TBOHBU IFCBU VOUVL NFOHFMVBSLBO WPMVNF DBJSBO EBSJ IBNQJS UJEBL UFSCBUBT VOUVL QFOHBUVSBO UFLBOBO BSUFSJ NFMBMVJ
UVCVITFCBHBJSFTQPOTUFSIBEBQUFLBOBOBSUFSJZBOHUJOHHJEBO NFLBOJTNFDBJSBOUVCVIHJOKBM
EFOHBO EFNJLJBO NFOHFNCBMJLBO UFLBOBO BSUFSJ LF OJMBJ
OPSNBM Dua Faktor Penentu Tekanan Arteri Jangka Panjang.
Pengaturan Tekanan Arteri oleh Mekanisme Cairan 1BEB (BNCBS LJUB KVHB EBQBU NFMJIBU CBIXB BEB EVB GBLUPS
Tubuh Ginjal Ciri "Umpan Balik yang Hampir Tidak KBOHLB QBOKBOH EBTBS ZBOH NFOFOUVLBO UFLBOBO BSUFSJ KBOHLB
Terbatas". (BNCBSNFOVOKVLLBOTVBUVNFUPEFHSBGJT QBOKBOH)BMJOJEBQBUEJKFMBTLBOTFCBHBJCFSJLVU
214
Bab 19 Peran Ginjal dalam Pengaturan Tekanan Arteri Jangka Panjang dan Hipertensi: Sistem Terintegrasi Pengaturan Tekanan Arteri
4FMBNBLFEVBLVSWBZBOHNFOHHBNCBSLBO
LFMVBSBOHBSBN 0MFI LBSFOB JUV UJEBL NVOHLJO NFOHVCBI OJMBJ UFLBOBO
EBO BJS PMFI HJOKBM EBO
BTVQBO HBSBN EBO BJS UFUBQ UFQBU BSUFSJSBUBSBUBKBOHLBQBOKBOHNFOKBEJOJMBJZBOHCBSVUBOQB
TFQFSUJ ZBOH EJHBNCBSLBO EBMBN (BNCBS UFLBOBO BSUFSJ NFOHVCBI TBMBI TBUV BUBV LFEVB GBLUPS QFOFOUV EBTBS
SBUBSBUBBLIJSOZBBLBONFOZFTVBJLBOEJSJLFNCBMJQBEBNN UFLBOBO BSUFSJ KBOHLB QBOKBOH BQBLBI
UJOHLBU BTVQBO
UNIT IV
)H ZBOH NFSVQBLBO UFLBOBO ZBOH EJHBNCBSLBO PMFI UJUJL HBSBN EBO BJS BUBV
CFTBS QFSHFTFSBO LVSWB GVOHTJ HJOKBM
LFTFJNCBOHBO QBEB HBNCBS JOJ 4FMBJO JUV IBOZB BEB EVB DBSB TFQBOKBOH TVNCV UFLBOBO /BNVO CJMB TBMBI TBUV GBLUPS
ZBOHEBQBUNFOHVCBIUJUJLLFTFJNCBOHBOEBSJNN)H4BMBI CFSVCBI QFOHBUVSBO UFLBOBO BSUFSJ TFMBOKVUOZB UFSKBEJ QBEB
TBUV DBSB BEBMBI EFOHBO NFOHHFTFS OJMBJ UFLBOBO QBEB LVSWB OJMBJ UFLBOBO ZBOH CBSV ZBJUV QBEB UFLBOBO BSUFSJ EJ
LFMVBSBO HJOKBM VOUVL HBSBN EBO BJS EBO DBSB ZBOH MBJO BEBMBI QFSQPUPOHBOLFEVBLVSWB
EFOHBO NFOHVCBI UJOHLBU HBSJT BTVQBO BJS EBO HBSBN 0MFI
Kurva Keluaran Ginjal Kronis lebih Curam daripada
LBSFOB JUV TFDBSB TFEFSIBOB EVB GBLUPS QFOFOUV VUBNB UFLBOBO
BSUFSJKBOHLBQBOKBOHBEBMBITFCBHBJCFSJLVU
Kurva Akut. $JSJLIBTQBEBOBUSJVSFTJTUFLBOBO EBOEJVSFTJT
UFLBOBO
JBMBI QFSVCBIBO UFLBOBO BSUFSJ ZBOH CFSMBOHTVOH
1. #FTBSQFSHFTFSBOUFLBOBOQBEBLVSWBLFMVBSBOHJOKBMVOUVLBJS CFCFSBQB IBSJ BUBV CVMBO NFNQVOZBJ QFOHBSVI ZBOH MFCJI
EBOHBSBN CFTBSQBEBLFMVBSBOHBSBNEBOBJSPMFIHJOKBMEBSJQBEBZBOH
2. #FTBSBTVQBOBJSEBOHBSBN EJPCTFSWBTJ TFMBNB QFSVCBIBO UFLBOBO BLVU (BNCBS

+BEJ CJMB HJOKBM CFSGVOHTJ OPSNBM LVSWB LFMVBSBO HJOKBM
$BSBLFSKBLFEVBGBLUPSQFOFOUVJOJEBMBNQFOHBUVSBO LSPOJTMFCJIDVSBNEBSJQBEBLVSWBBLVU
UFLBOBOBSUFSJEJQFSMJIBULBOQBEB(BNCBS"1BEB(BNCBS
1FOHBSVI IFCBU QFOJOHLBUBO UFLBOBO BSUFSJ LSPOJT QBEB
" CFCFSBQB LFMBJOBO EJ HJOKBM UFMBI NFOZFCBCLBO LVSWB
LFMVBSBOVSJOFBLJCBUQFOJOHLBUBOUFLBOBOUJEBLIBOZBPMFI
LFMVBSBO HJOKBM CFSHFTFS TFCFTBS NN )H LF BSBI UFLBOBO
QFOHBSVI IFNPEJOBNJL MBOHTVOH QBEB HJOKBM VOUVL
UJOHHJ LF LBOBO
1FSIBUJLBO UJUJL LFTFJNCBOHBO KVHB UFMBI
NFOJOHLBULBO FLTLSFTJ UFUBQJ KVHB PMFI QFOHBSVI UJEBL
CFSHFTFS TFCFTBS NN )H MFCJI UJOHHJ EBSJ OPSNBM 0MFI
MBOHTVOH ZBOH EJQFSBOUBSBJ PMFI QFSVCBIBO QFOHBSVI TBSBG
LBSFOB JUV CJMB LVSWB LFMVBSBO HJOKBM CFSHFTFS LF OJMBJ UFLBOBO
EBO IPSNPO ZBOH UFSKBEJ CJMB UFLBOBO EBSBI NFOJOHLBU
ZBOH CBSV UFLBOBO BSUFSJ BLBO NFOHJLVUJ NFOVKV LF UFLBOBO
.JTBMOZB QFOJOHLBUBOUFLBOBOBSUFSJNFOVSVOLBOLFHJBUBO
ZBOHCBSVEBMBNCFCFSBQBIBSJ
TJTUFN TBSBG TJNQBUJT EBO CFSCBHBJ IPSNPO TFQFSUJ
(BNCBS # NFMVLJTLBO CBHBJNBOB QFSVCBIBO BTVQBO BOHJPUFOTJO**EBOBMEPTUFSPOZBOHDFOEFSVOHNFOVSVOLBO
HBSBNEBOBJSKVHBEBQBUNFOHVCBIUFLBOBOBSUFSJ1BEBLFBEBBO FLTLSFTJ HBSBN EBO BJS PMFI HJOKBM 1FOVSVOBO LFHJBUBO
JOJ BTVQBO NFOJOHLBU FNQBU LBMJ EBO UJUJL LFTFJNCBOHBO UFMBI TJTUFN BOUJOBUSJVSFUJL JOJ BLBO NFNQFSCFTBS FGFLUJWJUBT
CFSHFTFSLFUFLBOBOTFCFTBSNN)H ZBLOJNN)HEJBUBT OBUSJVSFTJT EBO EJVSFTJT UFLBOBO VOUVL NFOJOHLBULBO
OPSNBM 4FCBMJLOZB QFOVSVOBO BTVQBO BLBO NFOVSVOLBO FLTLSFTJ HBSBN EBO BJS TFMBNB UFSKBEJ QFOJOHLBUBO UFLBOBO
UFLBOBOBSUFSJ BSUFSJ LSPOJT MJIBU #BC EBO VOUVL QFNCBIBTBO
NFOEBMBN

8
4
8
Kronis Akut
Normal Peningkatan
2 tekanan
Asupan tinggi
6
B
0
A 0 50 100 150 200 250 4
8 2
asupan normal
Peningkatan A
6 0
tekanan 0 50 100 150 200
4
Kurva keluaran ginjal akut dan kronis. Pada
Normal
2 keadaan steady state, keluaran garam dan air ginjal sama
dengan asupan garam dan air. A dan B menggambarkan titik
keseimbangan untuk pengaturan jangka panjang tekanan arteri
0
B 0 50 100 150 200 250
masing-masing untuk asupan garam normal atau enam kali
normal. Oleh karena curamnya kurva keluaran ginjal kronis,
Arterial pressure (mm Hg) peningkatan asupan garam hanya akan mengakibatkan
Dua cara untuk meningkatkan tekanan arteri: A, perubahan kecil pada tekanan arteri. Pada orang-orang dengan
dengan menggeser kurva keluaran ginjal ke kanan ke arah gangguan fungsi ginjal, kecuraman kurva keluaran ginjal
tekanan yang lebih tinggi atau B, dengan meningkatkan asupan berkurang, menyerupai kurva akut, sehingga meningkatkan
garam dan air. kepekaan tekanan arteri terhadap perubahan asupan garam.
215
Unit IV Sirkulasi
4FCBMJLOZB CJMB UFLBOBO EBSBI NFOVSVO TJTUFN TBSBG UFLBOBO BSUFSJ UFOUV TBKB CJMB UBIBOBO QFSJGFS UPUBM NFOJOHLBU
TJNQBUJT UFSBOHTBOH EBO QFOJOHLBUBO QFNCFOUVLBO IPSNPO TFDBSB BLVU UFLBOBO BSUFSJ BLBO TFHFSB NFOJOHLBU 5FUBQJ CJMB
BOUJOBUSJVSFUJL ZBOH BLBO NFOBNCBI QFOHBSVI MBOHTVOH HJOKBM UFUBQ CFSGVOHTJ TFDBSB OPSNBM QFOJOHLBUBO UFLBOBO BSUFSJ
QFOVSVOBOUFLBOBOVOUVLNFOHVSBOHJLFMVBSBOHBSBNEBOBJS NFOEBEBL UJEBL EJQFSUBIBOLBO 4FCBMJLOZB UFLBOBO BSUFSJ
HJOKBM (BCVOHBO QFOHBSVI MBOHTVOH UFLBOBO QBEB HJOKBM EBO UFSTFCVU EBMBN XBLUV TBUV IBSJ BUBV MFCJI BLBO LFNCBMJ
QFOHBSVI UJEBL MBOHTVOH UFLBOBO QBEB TJTUFN TBSBG TJNQBUJT TFQFOVIOZBLFOJMBJOPSNBM.FOHBQB
EBOCFSCBHBJTJTUFNIPSNPOMBJOOZBBLBONFNCVBUOBUSJVSFTJT +BXBCBOOZB BEBMBI TFCBHBJ CFSJLVU 1FOJOHLBUBO UBIBOBO
EBO EJVSFTJT UFLBOBO TBOHBU CFSQFOHBSVI QBEB QFOHBUVSBO QFNCVMVI EBSBI UVCVI TFMBJO EJ HJOKBM UJEBL NFOHVCBI UJUJL
UFLBOBOBSUFSJEBOWPMVNFDBJSBOUVCVIKBOHLBQBOKBOH LFTFJNCBOHBO QFOHBUVSBO UFLBOBO EBSBI ZBOH EJMBLVLBO PMFI
1FOUJOHOZB QFOHBSVI QFSTBSBGBO EBO IPSNPOBM QBEB HJOKBM MJIBU LFNCBMJ (BNCBS EBO
4FCBMJLOZB HJOKBM
OBUSJVSFTJT UFLBOBO MFCJI KFMBT UFSMJIBU TFMBNB QFSVCBIBO TFHFSB NVMBJ NFNCFSJLBO SFTQPOT UFSIBEBQ UFLBOBO BSUFSJ ZBOH
BTVQBOOBUSJVNLSPOJT#JMBHJOKBMTFSUBNFLBOJTNFQFSTBSBGBO UJOHHJ ZBOHNFOZFCBCLBOOBUSJVSFTJTEBOEJVSFTJTUFLBOBO%BMBN
EBO IPSNPOBM CFSGVOHTJ OPSNBM QFOJOHLBUBO BTVQBO HBSBN XBLUV CFCFSBQB KBN BLBO UFSKBEJ LFIJMBOHBO HBSBN EBO BJS EBSJ
EBOBJSZBOHLSPOJT TBNQBJTFUJOHHJFOBNLBMJOPSNBMCJBTBOZB UVCVIEBMBNKVNMBIZBOHCBOZBL ZBOHUFSVTCFSMBOHTVOHTBNQBJ
EJIVCVOHLBO IBOZB EFOHBO QFOJOHLBUBO UFLBOBO BSUFSJ LFDJM UFLBOBO BSUFSJ LFNCBMJ LF UFLBOBO TFTVBJ EFOHBO UJUJL
TBKB 1FSIBUJLBO UJUJL LFTFJNCBOHBO UFLBOBO EBSBI # QBEB LFTFJNCBOHBO 1BEB TBBU JOJ UFLBOBO EBSBI NFOKBEJ OPSNBM EBO
LVSWB IBNQJS TBNB EFOHBO UJUJL " UJUJL LFTFJNCBOHBO QBEB WPMVNF DBJSBO FLTSBTFM EBO WPMVNF EBSBI CFSLVSBOH TBNQBJ EJ
BTVQBO HBSBN ZBOH OPSNBM 4FCBMJLOZB QFOVSVOBO BTVQBO CBXBIOPSNBM
HBSBN EBO BJS TFSFOEBI TFQFSFOBN EBSJ OPSNBM CJBTBOZB 4FCBHBJCVLUJEBSJQSJOTJQQFSVCBIBOUBIBOBOQFSJGFSUPUBMUJEBL
IBOZB NFNCFSJLBO QFOHBSVI ZBOH LFDJM TBKB QBEB UFLBOBO NFNFOHBSVIJ UFLBOBO BSUFSJ KBOHLB QBOKBOH BQBCJMB GVOHTJ HJOKBM
BSUFSJ +BEJ CBOZBL PSBOH EBQBU EJLBUBLBO UJEBL QFLB HBSBN NBTJIOPSNBM QFMBKBSJMBI(BNCBSEFOHBOTBLTBNB(BNCBS
LBSFOB QFSVCBIQFSVCBIBO EBMBN BTVQBO HBSBN UJEBL JOJ NFNQFSMJIBULBO QFSLJSBBO DVSBI KBOUVOH EBO UFLBOBO BOUFSJ
NFOHVCBIUFLBOBOEBSBIMFCJIEBSJCFCFSBQBNN)H QBEBCFSNBDBNNBDBNLFBEBBOLMJOJTZBOHUBIBOBOQFSJGFSUPUBM
0SBOHPSBOH EFOHBO LFSVTBLBO HJOKBM BUBV TFLSFTJ IPSNPO KBOHLB QBOKBOHOZB MFCJI LFDJM BUBV MFCJI CFTBS EBSJ OPSNBM UBQJ
BOUJOBUSJVSFUJL TFQFSUJ BOHJPUFOTJO ** BUBV BMEPTUFSPO ZBOH FLTLSFTJHBSBNEBOBJSPMFIHJOKBMOZBOPSNBM1FSIBUJLBOMBIQBEB
CFSMFCJIBO NVOHLJO CFSTJGBU QFLB HBSBN EFOHBO LVSWB CFSCBHBJLPOEJTJLMJOJTJOJ UFLBOBOBSUFSJOZBKVHBUFQBUOPSNBM
LFMVBSBOHJOKBMZBOHEJMFNBILBONJSJQEFOHBOLVSWBBLVUQBEB 1BEB QFNCBIBTBO LJUB TBBU JOJ QFSMV BEB LFIBUJIBUJBO 4FSJOH
(BNCBS1BEBLBTVTJOJ QFOJOHLBUBOBTVQBOHBSBN ZBOH LBMJCJMBUFSKBEJQFOJOHLBUBOUBIBOBOQFSJGFSUPUBM QBEBTBBUZBOH
TFEBOH EBQBU NFOZFCBCLBO QFOJOHLBUBO UFLBOBO BSUFSJ ZBOH CFSTBNBBO KVHB UFSKBEJ QFOJOHLBUBO UBIBOBO WBTLVMBS JOUSBSFOBM
CFSBSUJ ZBOH BLBO NFOHVCBI GVOHTJ HJOKBM EBO EBQBU NFOZFCBCLBO
#FCFSBQB GBLUPS BOUBSB MBJO IJMBOHOZB OFGSPO GVOHTJPOBM IJQFSUFOTJEFOHBONFOHHFTFSLVSWBGVOHTJHJOKBMLFOJMBJUFLBOBO
BLJCBULFSVTBLBOHJOKBM BUBVQFNCFOUVLBOCFSMFCJIBOIPSNPO
BOUJOBUSJVSFUJLTFQFSUJBOHJPUFOTJO**BUBVBMEPTUFSPO.JTBMOZB
QFOHVSBOHBO NBTTB HJOKBM BLJCBU QFNCFEBIBO BUBV LFSVTBLBO
Hipertiroidisme
Amputasi empat ektremitas

Beriberi
HJOKBM BLJCBU IJQFSUFOTJ EJBCFUFT EBO CFSCBHBJ QFOZBLJU HJOKBM

Pirau AV
BLBO NFOZFCBCLBO UFLBOBO EBSBI MFCJI QFLB UFSIBEBQ

Penyakit Paget
QFSVCBIBOBTVQBOHBSBN1BEBDPOUPIDPOUPIJOJ EJQFSMVLBO 200

Penyakit paru
QFOJOHLBUBO UFLBOBO BSUFSJ ZBOH MFCJI CFTBS EBSJQBEB OPSNBM

Hipotiroidisme
VOUVL NFOJOHLBUBLO LFMVBSBO HJOKBM ZBOH DVLVQ VOUVL Cu
Normal
ra
NFNQFSUBIBOLBOJNCBOHBOBOUBSBBTVQBOEBOLFMVBSBOHBSBN 150 h
Anemia
EBOBJS
"EB CFCFSBQB CVLUJ BTVQBO HBSBN KBOHLB QBOKBOH TFMBNB
100
CFCFSBQB UBIVO EBQBU NFSVTBL HJOKBM EBO BLIJSOZB Tekanan arteri
jant
ung
NFOZFCBCLBO UFLBOBO EBSBI NFOKBEJ MFCJI QFLB UFSIBEBQ
HBSBN,JUBBLBONFNCBIBTLFQFLBBOUFLBOBOEBSBIUFSIBEBQ 50
HBSBN QBEB QFOEFSJUB EFOHBO IJQFSUFOTJ EJ CBHJBO BLIJS CBC
JOJ
Kegagalan Peningkatan Tahanan Perifer Total untuk 0
40 60 80 100 120 140 160
Meningkatkan Tekanan Arteri Jangka Panjang bila
Asupan Garam dan Fungsi Ginjal Tidak Mengalami
Perubahan Hubungan tahanan perifer total dengan tekanan
4FLBSBOH LFTFNQBUBO CBHJ QFNCBDB VOUVL NFMJIBU BQBLBI arteri dan curah jantung jangka panjang pada berbagai kelainan
NFOHFSUJ NFOHFOBJ NFLBOJTNF DBJSBO UVCVI HJOKBM VOUVL ktinis. Pada keadaan ini, ginjal masih berfungsi normal. Perhatikan
QFOHBUVSBO UFLBOBO BSUFSJ %FOHBO NFOHJOHBU LFNCBMJ perubahan tahanan perifer total seturuh tubuh akan menyebabkan
perubahan yang sama tetapi berlawanan pada curah jantung
QFSTBNBBO EBTBS VOUVL UFLBOBO BSUFSJ UFLBOBO BSUFSJ TBNB namun tidak memengaruhi tekanan arteri. (Digambar kembali dari
EFOHBO DVSBI KBOUVOH EJLBMJLBO UBIBOBO QFSJGFS UPUBM NBLB Guyton AC: r er a ress re an y er en on. Philadelphia: WB
KFMBTQFOJOHLBUBOUBIBOBOQFSJGFSUPUBMBLBONFOJOHLBULBO Saunders, 1980.)
216
ZBOH MFCJI UJOHHJ TFQFSUJ ZBOH EJUVOKVLLBO QBEB (BNCBS " BMJSBO EBSBI 1FOHBSVI ZBOH LFEVB JOJ EBQBU EJKFMBTLBO
,JUB BLBO NFMJIBU DPOUPI TFQFSUJ JOJ EJ BLIJS CBC TBBU LJUB TFCBHBJCFSJLVU
NFNCBIBT IJQFSUFOTJ ZBOH EJTFCBCLBO PMFI NFLBOJTNF .FSVKVLLF#BC NBSJLJUBNFOHJOHBULFNCBMJCJMBEBSBI
WBTPLPOTUSJLUPS /BNVO JOJ NFSVQBLBO QFOJOHLBUBO UBIBOBO NFOHBMJS CFSMFCJIBO NFMBMVJ TVBUV KBSJOHBO NBLB QFNCVMVI
UNIT IV
HJOKBM CVLBO QFOJOHLBUBO UBIBOBO QFSJGFS UPUBM TVBUV QFSCFEBBO EBSBIKBSJOHBOTFUFNQBUBLBOCFSLPOTUSJLTJEBONFOVSVOLBO
ZBOHQFOUJOH BMJSBO EBSBIOZB LFNCBMJ OPSNBM 'FOPNFOB JOJ EJTFCVU
BVUPSFHVMBTJ ZBOH TFCFOBSOZB IBOZB CFSBSUJ QFOHBUVSBO
Peningkatan Volume Cairan Dapat Meningkatkan Tekanan BMJSBO EBSBI PMFI KBSJOHBO JUV TFOEJSJ #JMB QFOJOHLBUBO
Arteri dengan Meningkatkan Curah Jantung atau Tahanan WPMVNF EBSBI NFOJOHLBULBO DVSBI KBOUVOH BMJSBO EBSBI EJ
Perifer Total TFMVSVI KBSJOHBO UVCVI BLBO NFOJOHLBU TFIJOHHB NFLBOJTNF
.FLBOJTNF LFTFMVSVIBO ZBOH NFOJOHLBULBO WPMVNF DBJSBO BVUPSFHVMBTJ JOJ BLBO NFOZFCBCLBO LPOTUSJLTJ QFNCVMVI
FLTUSBTFMVMBS EBQBU NFOJOHLBULBO UFLBOBO BSUFSJ CJMB LBQBTJUBT EBSBI EJ TFMVSVI UVCVI ,FBEBBO JOJ TFMBOKVUOZB BLBO
QFNCVMVI EBSBI UJEBL TFLBMJHVT NFOJOHLBU TFQFSUJ ZBOH NFOJOHLBULBOUBIBOBOQFSJGFSUPUBM
EJQFSMJIBULBO QBEB (BNCBS 6SVUBO QFSJTUJXBOZB BEBMBI
"LIJSOZB LBSFOB UFLBOBO BSUFSJ TBNB EFOHBO DVSBI
QFOJOHLBUBOWPMVNFDBJSBOFLTUSBTFMVMBS
NFOJOHLBULBOWPMVNF KBOUVOH EJLBMJLBO UBIBOBO QFSJGFS UPUBM NBLB QFOJOHLBUBO
EBSBI ZBOH
NFOJOHLBULBOUFLBOBOQFOHJTJBOTJSLVMBTJSBUBSBUB TFLVOEFSUBIBOBOQFSJGFSUPUBMBLJCBUNFLBOJTNFBVUPSFHVMBTJ
ZBOH
NFOJOHLBULBO BMJSBO CBMJL WFOB LF KBOUVOH ZBOH
TBOHBU NFNCBOUV NFOJOHLBULBO UFLBOBO BSUFSJ 4FCBHBJ
NFOJOHLBULBO DVSBI KBOUVOH ZBOH
NFOJOHLBULBO UFLBOBO DPOUPI QFOJOHLBUBO DVSBI KBOUVOH ZBOH IBOZB TFCFTBS
BSUFSJ 1FOJOHLBUBO UFLBOBO BSUFSJ TFMBOKVUOZB NFOJOHLBULBO IJOHHB QFSTFO EBQBU NFOJOHLBULBO UFLBOBO BSUFSJ EBO
FLTLSFTJ HBSBN EBO BJS EBO EBQBU NFOHFNCBMJLBO WPMVNF DBJSBO UFLBOBO BSUFSJ SBUBSBUB OPSNBM TFCFTBS NN )H NFOKBEJ
FLTUSBTFMVMBS LF UJOHLBU ZBOH IBNQJS OPSNBM CJMB GVOHTJ HJOKBM NN )H 4FCFOBSOZB QFOJOHLBUBO DVSBI KBOUVOH ZBOH
OPSNBM TFEJLJUJOJTFSJOHUJEBLEBQBUEJVLVS
1FSIBUJLBO EFOHBO TBLTBNB QBEB TLFNB JOJ EVB DBSB ZBOH Pentingnya Garam (NaCE) dalam Skema Cairan
EBQBU NFOJOHLBULBO UFLBOBO BSUFSJ NFMBMVJ QFOJOHLBUBO DVSBI Tubuh–Ginjal untuk Pengaturan Tekanan Arteri
KBOUVOH 4BMBI TBUV DBSB UFSTFCVU BEBMBI QFOHBSVI MBOHTVOH 8BMBVQVO QFNCJDBSBBO LJUB TFMBNB JOJ UFMBI
QFOJOHLBUBO DVSBI KBOUVOH QBEB QFOJOHLBUBO UFLBOBO EBO ZBOH NFOFLBOLBO QFOUJOHOZB WPMVNF EBMBN QFOHBUVSBO UFLBOBO
NFOJOHLBULBOUBIBOBOWBTLVMBSQFSJGFSUPUBMNFMBMVJBVUPSFHVMBTJ BSUFSJ QFOFMJUJBO FLTQFSJNFOUBM NFOVOKVLLBO QFOJOHLBUBO
BTVQBO HBSBN MFCJI CFSQFSBO EBMBN NFOJOHLBULBO
Peningkatan volume cairan ekstrasel UFLBOBO BSUFSJ EBSJQBEB QFOJOHLBUBO BTVQBO BJS )BM JOJ
LBSFOB EBMBN LFBEBBO OPSNBM BJS NVSOJ MBOHTVOH
EJFLTLSFTJLBO PMFI HJOKBM IBNQJS TFDFQBU BTVQBOOZB UFUBQJ
Peningkatan volume darah HBSBN UJEBL TFNVEBI JUV EJFLTLSFTJLBO "LJCBUOZB UFSKBEJ
QFOVNQVLBO HBSBN EBMBN UVCVI ZBOH KVHB TFDBSB UJEBL
MBOHTVOH NFOJOHLBULBO WPMVNF DBJSBO FLTUSBTFMVMBS LBSFOB
Peningkatan tekanan pengisian sirkulasi rata-rata EVBBMBTBOEBTBSCFSJLVU
1. #JMB UFSEBQBU LFMFCJIBO HBSBN EJ DBJSBO FLTUSBTFMVMBS
PTNPMBMJUBT DBJSBO BLBO NFOJOHLBU EBO LFBEBBO JOJ BLBO
eningka an ali an alik da a ena ke jan ng NFSBOHTBOH QVTBU IBVT EJ PUBL ZBOH NFNCVBU TFTFPSBOH
NJOVN MFCJI CBOZBL BJS VOUVL NFOHFNCBMJLBO LBEBS
HBSBN FLTUSBTFM LFNCBMJ OPSNBM )BM JOJ BLBO
eningka an a jan ng NFOJOHLBULBOWPMVNFDBJSBOFLTUSBTFMVMBS
2. 1FOJOHLBUBO PTNPMBMJUBT ZBOH EJTFCBCLBO PMFI LFMFCJIBO
o eg lasi HBSBN EBMBN DBJSBO FLTUSBTFMVMBS KVHB NFSBOHTBOH
NFLBOJTNFTFLSFTJLFMFOKBSIJQPUBMBNVTIJQPGJTJTQPTUFSJPS
VOUVL NFOZFLSFTJLBO MFCJI CBOZBL IPSNPO BOUJEJVSFUJL
eningka an
esis ansi e i e o al
IBMJOJEJCBIBTEJ#BC
)PSNPOBOUJEJVSFUJLLFNVEJBO
NFOZFCBCLBO HJOKBM NFSFBCTPSCTJ BJS EBMBN KVNMBI CFTBS
EBSJ DBJSBO UVCVMVT HJOKBM EFOHBO EFNJLJBO NFOHVSBOHJ
eningka an ekanan da a WPMVNF VSJOF ZBOH EJFLTLSFTJLBO UFUBQJ NFOJOHLBULBO
WPMVNFDBJSBOFLTUSBTFMVMBS
%FOHBO EFNJLJBO LBSFOB BMBTBOBMBTBO ZBOH QFOUJOH
eningka an a ine
JOJMBI KVNMBI HBSBN ZBOH NFOVNQVL EJ EBMBN UVCVI
NFSVQBLBOQFOFOUVVUBNBWPMVNFDBJSBOFLTUSBTFMVMBS0MFI
an langka langka eningka an ol me ai an LBSFOB QFOJOHLBUBO TFEJLJU TBKB QBEB WPMVNF DBJSBO
eks asel la ang men e a kan eningka an ekanan a e i FLTUSBTFMVMBSEBOEBSBITFSJOHLBMJEBQBUTBOHBUNFOJOHLBULBO
e a ikan dengan saksama eningka an a jan ng UFLBOBO BSUFSJ CJMB LBQBTJUBT WBTLVMBS UJEBL TFLBMJHVT
mem n ai enga langs ng n k meningka kan ekanan a e i
dan enga idak langs ng dengan a a meningka kan
NFOJOHLBUKVHBNBLBQFOVNQVLBOHBSBNFLTUSBEBMBNUVCVI
esis ansi e i e o al e le i da l TFEJLJU TBKB TVEBI EBQBU NFOJOHLBULBO UFLBOBO BSUFSJ ZBOH
DVLVQCFSNBLOB
217
Unit IV Sirkulasi
4FQFSUJ ZBOH UFMBI EJCBIBT TFCFMVNOZB QFOJOHLBUBO PUBL NBOB ZBOH UFSLFOB TUSPLF EBQBU NFOZFCBCLBO
BTVQBO HBSBN UBOQB HBOHHVBO GVOHTJ HJOKBM BUBV LFMVNQVIBO EFNFOTJB LFCVUBBO BUBV CFSCBHBJ HBOHHVBO
QFNCFOUVLBO IPSNPO BOUJOBUSJVSFUJL ZBOH CFSMFCJIBO PUBLCFSBUMBJOOZB
CJBTBOZB UJEBL CFHJUV NFOJOHLBULBO UFLBOBO BSUFSJ LBSFOB 3. 5FLBOBOZBOHUJOHHJIBNQJSTFMBMVNFOZFCBCLBOLFSVTBLBOEJ
HJOKBM BLBO TFDBSB DFQBU NFNCVBOH LFMFCJIBO HBSBN EBO HJOKBM ZBOHNFOJNCVMLBOLFSVTBLBOCBOZBLEBFSBIEJHJOKBM
WPMVNFEBSBIIBNQJSUJEB,CFSVCBI ZBOH BLIJSOZB NFOZFCBCLBO HBHBM HJOKBM VSFNJB EBO
LFNBUJBO
Hipertensi Kronis (Tekanan Darah Tinggi) Disebabkan
oleh Gangguan Ekskresi Cairan Ginjal 1FOHFUBIVBOZBOHEJQFMBKBSJEBSJKFOJTIJQFSUFOTJZBOHEJTFCVU
IJQFSUFOTJ CFCBO WPMVNF QFOUJOH EBMBN NFNBIBNJ QFSBO
#JMB TFTFPSBOH EJLBUBLBO NFOEFSJUB IJQFSUFOTJ LSPOJT BUBV NFLBOJTNF WPMVNF DBJSBO UVCVI EJ HJOKBM EBMBN QFOHBUVSBO
UFLBOBOEBSBIUJOHHJ
CFSBSUJCBIXBUFLBOBOBSUFSJSBUBSBUB UFLBOBO BSUFSJ )JQFSUFOTJ CFCBO WPMVNF CFSBSUJ IJQFSUFOTJ ZBOH
ZBOH MFCJI UJOHHJ EBSJQBEB CBUBT BUBT ZBOH EJBOHHBQ OPSNBM EJTFCBCLBO PMFI QFOVNQVLBO DBJSBO FLTUSBTFMVMBS TFDBSB
5FLBOBO BSUFSJ SBUBSBUB ZBOH MFCJI UJOHHJ EBSJ NN )H CFSMFCJIBOEBMBNUVCVI CFCFSBQBDPOUPITFCBHBJCFSJLVU
OPSNBM TFLJUBS NN )H
EJBOHHBQ IJQFSUFOTJ 5FLBOBO
SBUBSBUB UJOHHJ JOJ UFSKBEJ CJMB UFLBOBO EBSBI EJBTUPMJL MFCJI
CFTBSEBSJNN)HEBOUFLBOBOTJTUPMJLMFCJICFTBSEBSJLJSB Hipertensi Beban Volume Percobaan Disebabkan oleh
LJSBNN)H
1BEBIJQFSUFOTJCFSBU UFLBOBOBSUFSJSBUBSBUB Berkurangnya Massa Ginjal yang Terjadi secara Bersamaan
EBQBU NFOJOHLBU NFOKBEJ TBNQBJ NN )H EFOHBO dengan Naiknya Asupan Garam. (BNCBS NFOVOKVLLBO
UFLBOBO EJBTUPMJLOZB TFUJOHHJ NN )H EBO UFLBOBO TVBUV QFSDPCBBO LIBT ZBOH NFNQFSMJIBULBO IJQFSUFOTJ CFCBO
TJTUPMJLOZBLBEBOHLBEBOHTBNQBJTFUJOHHJNN)H WPMVNF QBEB TFLFMPNQPL BOKJOH ZBOH QFSTFO NBTTB HJOKBMOZB
EJCVBOH %J UJUJL QFSUBNB ZBOH EJMJOHLBSJ QBEB LVSWB UFSTFCVU
1FOJOHLBUBOTFEBOHUFLBOBOBSUFSJTBKBTVEBINFOJNCVMLBO
LFEVBLVUVCEBSJTBMBITBUVHJOKBMEJCVBOH EBOQBEBUJUJLLFEVB
QFNFOEFLBO IBSBQBO IJEVQ 1BEB UFLBOBO ZBOH TBOHBU UJOHHJ
ZBOH EJMJOHLBSJ TFMVSVI HJOKBM QBEB TJTJ ZBOH MBJO EJCVBOH
UFLBOBO BSUFSJ SBUBSBUB QFSTFO BUBV MFCJI EJ BUBT OPSNBM
TFIJOHHBQBEBIFXBOUFSTFCVUIBOZBUFSTJTBQFSTFONBTTBHJOKBM
TFTFPSBOH NVOHLJO EBQBU CFSIBSBQ IJEVQ UJEBL MFCJI EBSJ
ZBOH OPSNBM 1FSIBUJLBO CBIXB QFNCVBOHBO TFKVNMBI NBTTB
CFCFSBQB UBIVO MBHJ LBMBV UJEBL EJUBOHBOJ TFDBSB CFOBS &GFL
HJOKBMJOJIBOZBNFOZFCBCLBOQFOJOHLBUBOUFLBOBOBSUFSJLVSBOH
NFNBUJLBO IJQFSUFOTJ UFSVUBNB EJUJNCVMLBO NFMBMVJ UJHB DBSB
MFCJI NN )H ,FNVEJBO BOKJOHBOKJOH UFSTFCVU EJCFSJ NJOVN
CFSJLVU
MBSVUBO HBSBN EBO CVLBO BJS 0MFI LBSFOB MBSVUBO HBSBN UJEBL
1. ,FMFCJIBOCFCBOLFSKBEJKBOUVOH ZBOHNFOJNCVMLBOHBHBM
CFSIBTJMNFNVBTLBOSBTBIBVTOZB BOKJOHBOKJOHUFSTFCVUNJOVN
KBOUVOH EJOJ EBO QFOZBLJU KBOUVOH LPSPOFS TFSJOH LBMJ EVB TBNQBJ FNQBU LBMJ KVNMBI WPMVNF OPSNBM EBO EBMBN
CFSBLIJSEFOHBOLFNBUJBOBLJCBUTFSBOHBOKBOUVOH CFCFSBQB IBSJ UFLBOBO BSUFSJ NFOJOHLBU NFOKBEJ TFLJUBS NN
2. 5FLBOBO ZBOH UJOHHJ TFSJOH LBMJ NFSVTBL QFNCVMVI EBSBI )H EJ BUBT OPSNBM 4FTVEBI EVB NJOHHV BOKJOHBOKJOH UFSTFCVU
VUBNBEJPUBL ZBOHNFOHBLJCBULBOLFNBUJBOQBEBTFCBHJBO EJCFSJ NJOVN BJS LSBO EBO CVLBO MBSVUBO HBSBN UFLBOBOOZB
CFTBSPUBLLFBEBBOJOJEJTFCVUJOGBSLTFSFCSBM4FDBSBLMJOJT LFNCBMJ OPSNBM EBMBN XBLUV IBSJ "LIJSOZB EJ VKVOH
LFBEBBOJOJEJLFOBMEFOHBOTUSPLFh#FSHBOUVOHQBEBCBHJBO QFSDPCBBO BOKJOHBOKJOHUFSTFCVUEJCFSJLBONJOVNMBSVUBOHBSBN
a l i ke an a l
150
140
130
120
35–45% ginjal ki i el ginjal

diangka diangka
110
100
0
0 20 40 60 80 100
a a a a enga min m la an ga am e sen di anding min m ai ada ekanan a e i em a anjing ang

e sen ja ingan ginjaln a diangka igam a kem ali da i angs on on o glas H dkk e o ge i l i e
o ei l e e e l io i i lly e e o i e og Ci e ei in me i an Hea sso ia ion n
218
MBHJ EBOLBMJJOJUFLBOBOOZBNFOJOHLBUKBVIMFCJIDFQBUNFOKBEJ LFNCBMJLFEBMBNEBSBI,FEVB QFOJOHLBUBOUFLBOBOBSUFSJ

MFCJI UJOHHJ MBHJ TFCBC BOKJOHBOKJOH UFSTFCVU TVEBI CFMBKBS TFLBSBOH NFOZFCBCLBO HJOKBM NFOHFLTLSFTJ LFMFCJIBO
NFOUPMFSBOTJ MBSVUBO HBSBN TFIJOHHB BOKJOHBOKJOH UFSTFCVU WPMVNFDBJSBOZBOHTFNVMBEJBLVNVMBTJEBMBNUVCVI
NJOVN MFCJI CBOZBL MBHJ +BEJ QFSDPCBBO JOJ "LIJSOZB NBSJMBI LJUB NFOFMJUJ LFBEBBO BLIJS TJSLVMBTJ
UNIT IV
NFOEFNPOTUSBTJLBOLFBEBBOIJQFSUFOTJCFCBOWPMVNF CFCFSBQB NJOHHV TFUFMBI UFSKBEJOZB CFCBO WPMVNF ,JUB
+JLBQFNCBDBNFOHJOHBULFNCBMJGBLUPSGBLUPSEBTBSQFOFOUV UFNVLBOIBTJMIBTJMCFSJLVUJOJ
QFOHBUVSBO UFLBOBO BSUFSJ KBOHLB QBOKBOH NBLB EBQBU TFHFSB 1. )JQFSUFOTJ
NFOHFSUJ NFOHBQB UJNCVM IJQFSUFOTJ QBEB QFSDPCBBO CFCBO
2. 1FOJOHLBUBOUBIBOBOQFSJGFSUPUBMZBOHKFMBT
WPMVNF ZBOH EJUVOKVLLBO QBEB (BNCBS 1FSUBNB
QFOVSVOBO NBTTB HJOKBM TBNQBJ QFSTFO OPSNBM TBOHBU 3. 1FOHFNCBMJBO IBNQJS TFMVSVI WPMVNF DBJSBO
NFOVSVOLBOLFNBNQVBOHJOKBMVOUVLNFOHFLTLSFTJHBSBNEBO FLTUSBTFMVMBS WPMVNFEBSBI EBODVSBIKBOUVOHLFOPSNBM
BJS0MFILBSFOBJUV HBSBNEBOBJSNFOVNQVLEBMBNUVCVIEBO 0MFI LBSFOB JUV LJUB EBQBU NFNCBHJ IJQFSUFOTJ CFCBO
EBMBN CFCFSBQB IBSJ NFOJOHLBU DVLVQ UJOHHJ VOUVL WPMVNF NFOKBEJ EVB UBIBQ CFSVSVUBO ZBOH UFSQJTBI TFCBHBJ
NFOZFCBCLBOFLTLSFTJLFMFCJIBOBTVQBOHBSBNEBOBJS CFSJLVU5BIBQQFSUBNBEJTFCBCLBOPMFIQFOJOHLBUBOWPMVNF
DBJSBO ZBOH NFOJNCVMLBO QFOJOHLBUBO DVSBI KBOUVOH
Urutan Perubahan pada Fungsi Sirkulasi Selama 1FOJOHLBUBO DVSBI KBOUVOH JOJMBI ZBOH NFNQFSBOUBSBJ
Timbulnya Hipertensi Beban Volume. 4BOHBU CBJL UFSKBEJOZBIJQFSUFOTJ5BIBQLFEVBIJQFSUFOTJCFCBOWPMVNF
NFNQFMBKBSJ VSVUBO QFSVCBIBO EBMBN GVOHTJ TJSLVMBTJ TFMBNB EJUBOEBJPMFIUJOHHJOZBUFLBOBOEBSBIEBOUJOHHJOZBUBIBOBO
CFSLFNCBOHOZB IJQFSUFOTJ CFCBOWPMVNF (BNCBS QFSJGFS UPUBM UFUBQJ LFNCBMJOZB DVSBI KBOUVOH TBOHBU
NFOVOKVLLBO VSVUBO QFSVCBIBO JOJ ,JSBLJSB TBUV NJOHHV
NFOEFLBUJ OPSNBM TFIJOHHB UFLOJL QFOHVLVSBO ZBOH CJBTB
TFCFMVN UJUJL IBSJ LF NBTTB HJOKBM UFMBI EJLVSBOHJ TBNQBJ
IBOZB QFSTFO OPSNBM 4FMBOKVUOZB QBEB UJUJL JOJ BTVQBO TFSJOH LBMJ UBL EBQBU NFOEFUFLTJ DVSBI KBOUVOH ZBOH
HBSBN EBO BJS EJUJOHLBULBO TBNQBJ LJSBLJSB FOBN LBMJ OPSNBM NFOJOHLBUTFDBSBBCOPSNBMJOJ
EBO EJQFSUBIBOLBO UFUBQ TFUJOHHJ JOJ 1FOHBSVI BLVUOZB BEBMBI
QFOJOHLBUBO WPMVNF DBJSBO FLTUSBTFMVMBS WPMVNF EBSBI EBO
DVSBI KBOUVOH NFOKBEJ TBNQBJ QFSTFO EJ BUBT OPSNBM 20
4FDBSBCFSTBNBBO UFLBOBOBSUFSJNVMBJNFOJOHLBUKVHB OBNVO 19 33%
18
BXBMOZB UJEBL TFCFTBS QFOJOHLBUBO WPMVNF DBJSBO EBO DVSBI 17
KBOUVOH 1FOZFCBC QFOJOHLBUBO UFLBOBO ZBOH MFCJI MBNCBU JOJ 4%
16
EBQBUEJLFUBIVJEFOHBONFNQFMBKBSJLVSWBUBIBOBOQFSJGFSUPUBM 15
ZBOHNFOVOKVLLBOTVBUVQFOVSVOBOQBEBUBIBOBOQFSJGFSUPUBM
BXBM 1FOVSVOBO JOJ EJTFCBCLBO PMFI NFLBOJTNF CBSPSFTFQUPS 6.0
5.5 20% 5%
ZBOH UFMBI EJCBIBT EBMBN #BC ZBOH NFODPCB NFODFHBI
NFOJOHLBUOZB UFLBOBO 5FUBQJ TFTVEBI IJOHHB IBSJ 5.0
CBSPSFTFQUPS CFSBEBQUBTJ EJTFU LFNCBMJ
EBO UJEBL MBHJ EBQBU 7.0 40%
NFODFHBI OBJLOZB UFLBOBO 1BEB TBBU JOJ UFLBOBO BSUFSJ UFMBI 6.5
NFOJOHLBU IBNQJS NFODBQBJ NBLTJNBM LBSFOB BEBOZB
6.0
QFOJOHLBUBO DVSBI KBOUVOH NFTLJQVO UBIBOBO QFSJGFS UPUBM
5.5 5%
IBNQJSUFUBQQBEBUJOHLBUOPSNBM 5.0
4FTVEBI UFSKBEJ QFSVCBIBO BLVU EJOJ WBSJBCFM TJSLVMBTJ
28
UFSTFCVU UFSKBEJ QFSVCBIBO TFLVOEFS ZBOH MFCJI MBNB TFMBNB 26 33%
CFCFSBQB NJOHHV CFSJLVUOZB 1FSVCBIBO QFOUJOH JOJ BEBMBI 24
22
QFOJOHLBUBO QSPHSFTJG UBIBOBO QFSJGFS UPUBM TFNFOUBSB QBEB TBBU 20
18 13%
ZBOH CFSTBNBBO DVSBI KBOUVOH UVSVO IBNQJS LF OJMBJ OPSNBM
UFSVUBNB LBSFOB NFLBOJTNF BVUPSFHVMBTJ BMJSBO EBSBI KBOHLB 150 40%
30%
QBOKBOHTFQFSUJZBOHUFMBIEJCBIBTTFDBSBUFSQFSJODJEBMBN#BC 140
130
EBOEJBXBMCBCJOJ4FTVEBIDVSBIKBOUVOHNFOJOHLBUUJOHHJEBO
120
NFOZFCBCLBO UFSKBEJOZB IJQFSUFOTJ LFMFCJIBO BMJSBO EBSBI EJ 110
KBSJOHBOLFNVEJBONFOZFCBCLBOLPOTUSJLTJQSPHSFTJGEJBSUFSJPMB 0
TFUFNQBU TFIJOHHBNFOHFNCBMJLBOBMJSBOEBSBIMPLBMEJTFMVSVI 0 2 4 6 8 10 12 14
UVCVIEBOKVHBDVSBIKBOUVOHVOUVLLFNCBMJOPSNBM EBOTFDBSB
CFSTBNBBO NFOZFCBCLBO UFSKBEJOZB QFOJOHLBUBO TFLVOEFS e a an og esi ada a ia el a ia el
UBIBOBOQFSJGFSUPUBM en ing sis em si k lasi se ama mingg mingg e ama
i e e i i e i g ol e e ama e a ikan
1FSIBUJLBOKVHBWPMVNFDBJSBOFLTUSBTFMVMBSEBOWPMVNFEBSBI eningka an a al a jan ngse agai en e a dasa
IBNQJS TFQFOVIOZB LFNCBMJ OPSNBM EJTFSUBJ QFOVSVOBO DVSBI i e ensi elanj n a mekanisme a o eg lasi mengem alikan
a jan ng am i ke a a no mal semen a a se a a
KBOUVOH )BM JOJ EJTFCBCLBO PMFI EVB GBLUPS 1FSUBNB e samaan men e a kan e i g e i i eie o l
QFOJOHLBUBO UBIBOBO BSUFSJPMB BLBO NFOVSVOLBO UFLBOBO e e odi ikasi da i on ei l e e
LBQJMFS TFIJOHHBNFNVOHLJOLBODBJSBOEJKBSJOHBOEJBCTPSCTJ y e e io iladel ia a nde s
219
Unit IV Sirkulasi
%FOHBO EFNJLJBO QFOJOHLBUBO UBIBOBO QFSJGFS UPUBM QBEB NFOJOHLBULBO UFLBOBO BSUFSJ NFMBMVJ CFCFSBQB DBSB VOUVL
IJQFSUFOTJCFCBOWPMVNFUFSKBEJTFUFMBIIJQFSUFOTJTVEBIUJNCVM NFNCBOUVNFOHPSFLTJQFOVSVOBOBXBMUFLBOBO
EBO PMFILBSFOBJUV QFOJOHLBUBOJOJUFSKBEJTFLVOEFSUFSIBEBQ
IJQFSUFOTJEBOCVLBOTFCBHBJQFOZFCBCIJQFSUFOTJ Komponen-Komponen Sistem Renin-Angiotensin
(BNCBSNFNQFSMJIBULBOMBOHLBIMBOHLBIGVOHTJPOBMQBEB
Hipertensi Beban-Volume pada Pasien yang Tidak TJTUFN SFOJOBOHJPUFOTJO EBMBN NFNCBOUV NFOHFOEBMJLBO
Mempunyai Ginjal tetapi Dipertahankan oleh Ginjal UFLBOBOBSUFSJ
Buatan
3FOJO EJTJOUFTJT EBO EJTJNQBO EBMBN CFOUVL JOBLUJG ZBOH
#JMBTFPSBOHQBTJFOEJQFSUBIBOLBOIJEVQEFOHBOHJOKBMCVBUBO EJTFCVU QSPSFOJO EJ TFMTFM KVLTUBHMPNFSVMBS TFM +(
HJOKBM 4FM +(
TBOHBUMBIQFOUJOHNFOKBHBBHBSWPMVNFDBJSBOUVCVIOZBQBEB NFSVQBLBO NPEJGJLBTJ TFMTFM PUPU QPMPT ZBOH UFSMFUBL EJ EJOEJOH
UJOHLBU OPSNBM ZBJUV EFOHBO NFOHFMVBSLBO BJS EBO HBSBN BSUFSJPMBBGFSFO UFQBUEJTFCFMBIQSPLTJNBMHMPNFSPMJ#JMBUFLBOBO
EBMBN KVNMBI ZBOH TFTVBJ TFUJBQ LBMJ QBTJFO EJEJBMJTJT +JLB IBM BSUFSJ UVSVO SFBLTJ JOUSJOTJL EJ HJOKBM JUV TFOEJSJ NFOZFCBCLBO
JOJ UJEBL EJMBLVLBO EBO WPMVNF DBJSBO FLTUSBTFMVMBS EJCJBSLBO CBOZBL NPMFLVM QSPSFOJO EJ TFM +( NFNCFMBI EBO NFMFQBTLBO
NFOJOHLBU NBLBIJQFSUFOTJIBNQJSTFMBMVUJNCVMTFQFSUJZBOH SFOJO 4FCBHJBO CFTBS SFOJO NFNBTVLJ BMJSBO EBSBI HJOKBM EBO
EJQFSMJIBULBO EJ (BNCBS 1BEB BXBMOZB DVSBI KBOUVOH LFNVEJBO NFOJOHHBMLBO HJOKBM VOUVL CFSFEBS LF TFMVSVI UVCVI
NFOJOHLBU EBO NFOZFCBCLBO IJQFSUFOTJ 4FMBOKVUOZB 5FUBQJ TFKVNMBILFDJMSFOJOUFUBQCFSBEBEBMBNDBJSBOMPLBMHJOKBM
NFLBOJTNF BVUPSFHVMBTJ BLBO NFOHFNCBMJLBO DVSBI KBOUVOH EBONFNJDVCFCFSBQBGVOHTJJOUSBSFOBM
LFOPSNBMUFUBQJUFSKBEJQFOJOHLBUBOTFLVOEFSUBIBOBOQFSJGFS 3FOJO JUV TFOEJSJ NFSVQBLBO FO[JN CVLBO CBIBO WBTPBLUJG
UPUBM 0MFI LBSFOB JUV QBEB BLIJSOZB IJQFSUFOTJ ZBOH UJNCVM 4FQFSUJ ZBOH EJQFSMJIBULBO QBEB TLFNB EJ (BNCBS SFOJO
KFOJTIJQFSUFOTJEFOHBOUBIBOBOQFSJGFSUJOHHJ CFLFSKB TFDBSB FO[JNBUJL QBEB QSPUFJO QMBTNB MBJO ZBJUV TVBUV
HMPCVMJOZBOHEJTFCVUTVCTUSBUSFOJO BUBVBOHJPUFOTJOPHFO
VOUVL
Hipertensi Akibat Aldosteronisme Primer NFMFQBTLBO QFQUJEB BTBN BNJOP ZBJUV BOHJPUFOTJO *
+FOJT MBJO EBSJ IJQFSUFOTJ CFCBOWPMVNF EJTFCBCLBO PMFI "OHJPUFOTJO * NFNJMJLJ TJGBU WBTPLPOTUSJLUPS SJOHBO UFUBQJ UJEBL
LFMFCJIBO BMEPTUFSPO EBMBN UVCVI BUBV LBEBOHLBEBOH PMFI DVLVQ VOUVL NFOZFCBCLBO QFSVCBIBO CFSNBLOB QBEB GVOHTJ
LFMFCJIBO KFOJT TUFSPJE ZBOH MBJO 5VNPS LFDJM EJ TBMBI TBUV TJSLVMBTJ 3FOJO CFSBEB EBMBN EBSBI TFMBNB NFOJU TBNQBJ
LFMFOKBS BESFOBM LBEBOHLBEBOH NFOZFLSFTJLBO CBOZBL TFLBMJ KBN EBO UFSVT NFOZFCBCLBO QFNCFOUVLBO BOHJPUFOTJO * ZBOH
BMEPTUFSPO LFBEBBO JOJ EJTFCVU BMEPTUFSPOJTNF QSJNFSh MFCJICBOZBLMBHJTFMBNBXBLUVUFSTFCVU
4FQFSUJ ZBOH BLBO EJCBIBT EJ #BC EBO BMEPTUFSPO %BMBN CFCFSBQB EFUJL IJOHHB CFCFSBQB NFOJU TFUFMBI
NFOJOHLBULBOLFDFQBUBOSFBCTPSCTJHBSBNEBOBJSPMFIUVCVMVT QFNCFOUVLBOBOHJPUFOTJO* UFSEBQBUEVBBTBNBNJOPUBNCBIBO
HJOKBM TFIJOHHB NFOHVSBOHJ IJMBOHOZB HBSBN EBO BJS EBMBN
VSJOF OBNVO QBEB TBBU ZBOH TBNB NFOZFCBCLBO QFOJOHLBUBO
en nan
WPMVNF EBSBI EBO WPMVNF DBJSBO FLTUSBTFMVMBS "LJCBUOZB ekanan a e i
UFSKBEJIJQFSUFOTJ%BOCJMBBTVQBOHBSBNEJOBJLLBOQBEBTBBU
ZBOHCFSTBNBBO IJQFSUFOTJNFOKBEJMFCJICFSBU4FMBJOJUV CJMB
LFBEBBO JOJ NFOFUBQ TFMBNB CFSCVMBOCVMBO BUBV CFSUBIVO enin ginjal
UBIVO UFLBOBO BSUFSJ ZBOH CFSMFCJIBO TFSJOH NFOZFCBCLBO
QFSVCBIBO QBUPMPHJT QBEB HJOKBM TFIJOHHB NFNCVBU HJOKBM a a enin
NFSFUFOTJMFCJICBOZBLMBHJHBSBNEBOBJSTFMBJOZBOHMBOHTVOH (angio ensinogen)
PMFIBMEPTUFSPO"LIJSOZBIJQFSUFOTJTFSJOHLBMJNFOKBEJCFSBU
ngio ensin
EBONFNBUJLBO
%JTJOJ KVHB QBEB UBIBQ BXBM IJQFSUFOTJ JOJ DVSBI KBOUVOH n im
BLBONFOJOHLBU OBNVOQBEBUBIBQMFCJIMBOKVU DVSBIKBOUVOH kon e e
( a a )
VNVNOZB LFNCBMJ IBNQJS LF OPSNBM TFEBOHLBO UBIBOBO
QFSJGFSUPUBMBLBONFOJOHLBUTFLVOEFS TFCBHBJNBOBEJKFMBTLBO
ngio ensin
TFCFMVNOZBEJCBCIJQFSUFOTJCFCBOWPMVNFQSJNFS
ngio ensinase
Sistem Renin-Angiotensin: Perannya dalam (mengalami inak i i as)

Pengaturan Tekanan Arteri e ensi ga am asokons iksi
dan ai ole ginjal
4FMBJOLFNBNQVBOHJOKBMVOUVLNFOHFOEBMJLBOUFLBOBOBSUFSJ
NFMBMVJ QFSVCBIBO WPMVNF DBJSBO FLTUSBTFMVMBS HJOKBM KVHB
NFNJMJLJ NFLBOJTNF LVBU MBJOOZB VOUVL NFOHFOEBMJLBO
UFLBOBO.FLBOJTNFJOJBEBMBITJTUFNSFOJOBOHJPUFOTJO eningka an ekanan a e i
3FOJOBEBMBITVBUVFO[JNQSPUFJOZBOHEJTFLSFTJPMFIHJOKBM ekanisme asokons ik o enin angio ensin
CJMBUFLBOBOBSUFSJUVSVOTBOHBUSFOEBI,FNVEJBO FO[JNJOJ n k enga an ekanan a e i

EJQFDBI EBSJ BOHJPUFOTJO * VOUVL NFNCFOUVL BOHJPUFOTJO ** NFOJOHLBUNFOKBEJNN)HCJMBTJTUFNSFOJOBOHJPUFOTJO

QFQUJEB BTBN BNJOP 1FSVCBIBO JOJ UFSVUBNB UFSKBEJ EJ QBSV CFSGVOHTJ 4FCBMJLOZB UFLBOBO BSUFSJ IBOZB BLBO NFOJOHLBU
LFUJLBEBSBIZBOHNFMBMVJQFNCVMVILFDJMEJQBSV EBOEJLBUBMJTJT TBNQBJ NN )H CJMB TJTUFN SFOJOBOHJPUFOTJO EJIBNCBU
PMFI TVBUV FO[JN ZBJUV BOHJPUFOTJODPOWFSUJOH FO[ZNF ZBOH ,FBEBBO JOJ NFOVOKVLLBO CBIXB TJTUFN SFOJO BOHJPUFOTJO
UNIT IV
UFSEBQBU EJ FOEPUFM QFNCVMVI QBSV +BSJOHBO MBJO TFQFSUJ HJOKBM DVLVQ LVBU VOUVL TFUJEBLOZB NFOHFNCBMJLBO UFLBOBO BSUFSJ
EBO QFNCVMVI EBSBI KVHB NFOHBOEVOH BOHJPUFOTJODPOWFSUJOH TFQBSVI KBMBO NFOVKV OPSNBM EBMBN XBLUV CFCFSBQB NFOJU
FO[ZNFTFIJOHHBEBQBUNFNCFOUVLBOHJPUFOTJO**TFDBSBMPLBM TFUFMBI UFSKBEJ QFSEBSBIBO 0MFI LBSFOB JUV TJTUFN JOJ BLBO
"OHJPUFOTJO ** BEBMBI WBTPLPOTUSJLUPS ZBOH TBOHBU LVBU EBO NFOZFMBNBULBOUVCVI LIVTVTOZBQBEBTZPLTJSLVMBTJ
KVHB NFNFOHBSVIJ GVOHTJ TJSLVMBTJ NFMBMVJ DBSB MBJO /BNVO 1FSIBUJLBO KVHB TJTUFN WBTPLPOTUSJLUPS SFOJOBOHJPUFOTJO
BOHJPUFOTJO ** CFSBEB EBMBN EBSBI IBOZB TFMBNB BUBV NFOJU NFNCVUVILBO XBLUV LJSBLJSB NFOJU VOUVL CFUVMCFUVM
LBSFOB BOHJPUFOTJO ** TFDBSB DFQBU EJJOBLUJWBTJ PMFI CFSCBHBJ BLUJG 0MFI LBSFOB JUV TJTUFN JOJ CFSFBLTJ BHBL MFCJI MBNCBU
FO[JN EBSBI EBO KBSJOHBO ZBOH TFDBSB LPMFLUJG EJTFCVU EBMBNQFOHBUVSBOUFLBOBOEBSBIEJCBOEJOHLBOSFGMFLTSFGMFLT
BOHJPUFOTJOBTF TBSBGEBOTJTUFNOPSFQJOFGSJOFQJOFGSJOTJNQBUJT
4FMBNB CFSBEB EBMBN EBSBI BOHJPUFOTJO ** NFNQVOZBJ EVB
Efek Angiotensin II di Ginjal untuk Menimbulkan Retensi
QFOHBSVI VUBNB ZBOH BLBO NFOJOHLBULBO UFLBOBO BSUFSJ
Garam dan Air Ginjal Cara Penting untuk Pengaturan
1FSUBNB WBTPLPOTUSJLTJEJCFSCBHBJEBFSBIEJUVCVI ZBOHUJNCVM
Tekanan Arteri Jangka-Panjang
TFDBSB DFQBU 7BTPLPOTUSJLTJ LVBU UFSVUBNB UFSKBEJ EJ BSUFSJPMB
TFEBOHLBO KBVI MFCJI MFNBI EJ WFOB ,POTUSJLTJ EJ BSUFSJPMB BLBO "OHJPUFOTJO**NFOZFCBCLBOHJOKBMNFSFUFOTJCBJLHBSBNEBO
NFOJOHLBULBO UBIBOBO QFSJGFS UPUBM TFIJOHHB NFOJOHLBULBO BJSNFMBMVJEVBDBSBVUBNB
UFLBOBOBSUFSJ TFQFSUJZBOHEJHBNCBSLBOEJCBHJBOCBXBITLFNB 1. "OHJPUFOTJO ** CFLFSKB MBOHTVOH QBEB HJOKBM VOUVL
(BNCBS 4FMBJO JUV LPOTUSJLTJ SJOHBO EJ WFOBWFOB BLBO NFOJNCVMLBOSFUFOTJHBSBNEBOBJS
NFOJOHLBULBO BMJSBO CBMJL EBSBI WFOB LF KBOUVOH TFIJOHHB 2. "OHJPUFOTJO ** NFOZFCBCLBO LFMFOKBS BESFOBM
NFNCBOUVQPNQBKBOUVOHVOUVLNFMBXBOQFOJOHLBUBOUFLBOBO NFOZFLSFTJLBO BMEPTUFSPO EBO LFNVEJBO BMEPTUFSPO
$BSBVUBNBLFEVBBOHJPUFOTJO**NFOJOHLBULBOUFLBOBOBSUFSJ NFOJOHLBULBOSFBCTPSQTJHBSBNEBOBJSPMFIUVCVMVTHJOKBM
BEBMBI EFOHBO NFOVSVOLBO FLTLSFTJ HBSBN EBO BJS PMFI HJOKBM +BEJ CJMB UFSEBQBU BOHJPUFOTJO ** EBMBN KVNMBI ZBOH CFS
)BM JOJ QFSMBIBOMBIBO BLBO NFOJOHLBULBO WPMVNF DBJSBO MFCJIBO CFSTJSLVMBTJ EBMBN EBSBI TFMVSVI NFLBOJTNF DBJSBO
FLTUSBTFMVMBS ZBOHLFNVEJBONFOJOHLBULBOUFLBOBOBSUFSJTFMBNB UVCVI HJOKBM VOUVL QFOHBUVSBO UFLBOBO BSUFSJ KBOHLB QBOKBOH
CFSKBNKBN EBO CFSIBSJIBSJ CFSJLVUOZB 1FOHBSVI KBOHLB MBOHTVOH EJTFU EJ UJOHLBU UFLBOBO BSUFSJ ZBOH MFCJI UJOHHJ
QBOKBOH JOJ ZBOH CFLFSKB NFMBMVJ NFLBOJTNF WPMVNF DBJSBO EBSJQBEBOPSNBM
FLTUSBTFMVMBS MFCJI LVBU EBSJQBEB NFLBOJTNF WBTPLPOTUSJLUPS
BLVUEBMBNNFOZFCBCLBOQFOJOHLBUBOUFLBOBOBSUFSJ Mekanisme Pengaruh Langsung Angiotensin II pada
Ginjal untuk Menyebabkan Retensi Garam dan Air oleh
Kecepatan dan Intensitas Respons Tekanan Ginjal. "OHJPUFOTJONFNQVOZBJCFCFSBQBQFOHBSVIMBOHTVOH
Vasokonstriktor pada Sistem Renin-Angiotensin QBEBHJOKBMZBOHNFOZFCBCLBOHJOKBMNFSFUFOTJHBSBNEBOBJS
(BNCBS NFNQFSMJIBULBO TVBUV QFOFMJUJBO LIBT ZBOH 1FOHBSVI ZBOH VUBNB BEBMBI LPOTUSJLTJ BSUFSJPMB HJOKBM
NFOVOKVLLBOQFOHBSVIQFSEBSBIBOQBEBUFLBOBOBSUFSJQBEBEVB TFIJOHHB NFOHVSBOHJ BMJSBO EBSBI ZBOH NFMBMVJ HJOKBM "MJSBO
LFBEBBO CFSCFEB
EFOHBO TJTUFN SFOJOBOHJPUFOTJO ZBOH EBSBI ZBOH MBNCBU NFOVSVOLBO UFLBOBO EJ LBQJMFS
CFSGVOHTJ EBO
UBOQBTJTUFNZBOHCFSGVOHTJ TJTUFNJOJEJQVUVT QFSJUVCVMVT ZBOHNFOZFCBCLBOSFBCTPSQTJDBJSBOTFDBSBDFQBU
PMFI BOUJCPEJ ZBOH NFOHIBNCBU SFOJO
1FSIBUJLBO TFUFMBI EBSJ UVCVMVT "OHJPUFOTJO ** KVHB NFNQVOZBJ QFOHBSVI
QFSEBSBIBOZBOHDVLVQNFOZFCBCLBOQFOVSVOBOUFLBOBOBSUFSJ MBOHTVOH QFOUJOH UFSIBEBQ TFM UVCVMVT JUV TFOEJSJ VOUVL
TFLFUJLBNFOKBEJNN)HUFLBOBOBSUFSJLFNCBMJ NFOJOHLBULBO SFBCTPSQTJ OBUSJVN EBO BJS PMFI UVCVMVT
1FOHBSVI TFNVB JOJ TVOHHVI CFSNBLOB LBEBOHLBEBOH
NFOVSVOLBO LFMVBSBO VSJOF TBNQBJ LVSBOH EBSJ TFQFSMJNB
100
OPSNBM
engan
sis em enin angio ensin Perangsangan Sekresi Aldosteron oleh Angiotensin II
75 serta Pengaruh Aldosteron dalam Meningkatkan Retensi
Garam dan Air oleh Ginjal. "OHJPUFOTJO**KVHBNFSVQBLBO
50 an a TBMBI TBUV QFSBOHTBOH LVBU TFLSFTJ BMEPTUFSPO PMFI LFMFOKBS
sis em enin angio ensi BESFOBM TFQFSUJ ZBOH BLBO LJUB CBIBT EBMBN IVCVOHBOOZB
25 enda a an
EFOHBO QFOHBUVSBO DBJSBO UVCVI EJ #BC EBO EBMBN
IVCVOHBOOZBEFOHBOGVOHTJLFMFOKBSBESFOBMEJ#BC0MFI
0 LBSFOBJUV CJMBTJTUFNSFOJOBOHJPUFOTJOUFSBOHTBOH LFDFQBUBO
0 10 20 30 40 TFLSFTJ BMEPTUFSPO CJBTBOZB KVHB NFOJOHLBU EBO GVOHTJ
BMEPTUFSPO QFOUJOH TFMBOKVUOZB BEBMBI NFOZFCBCLBO
ek kom ensasi ekanan sis em asokons ik o QFOJOHLBUBO SFBCTPSQTJ OBUSJVN ZBOH CFSBSUJ PMFI UVCVMVT
enin angio ensin se ela e da a an e a igam a da i HJOKBM TFIJOHHB NFOJOHLBULBO KVNMBI UPUBM OBUSJVN DBJSBO
e o aan ole o e o g FLTUSBTFMVMBSUVCVI
221
Unit IV Sirkulasi
1FOJOHLBUBO OBUSJVN JOJ LFNVEJBO NFOZFCBCLBO SFUFOTJ BJS Peran Sistem Renin-Angiotensin dalam
TFQFSUJ UFMBI EJKFMBTLBO ZBOH NFOJOHLBULBO WPMVNF DBJSBO Mempertahankan Tekanan Arteri Normal Meskipun
FLTUSBTFMVMBS EBO TFMBOKVUOZB NFOZFCBCLBO QFOJOHLBUBO Terdapat Variasi yang Besar pada Asupan Garam
TFLVOEFSUFLBOBOBSUFSJKBOHLBQBOKBOH
4BMBI TBUV GVOHTJ TJTUFN SFOJOBOHJPUFOTJO ZBOH UFSQFOUJOH
+BEJ CBJL QFOHBSVI MBOHTVOH BOHJPUFOTJO QBEB HJOKBM NBVQVO
BEBMBI NFNVOHLJOLBO TFTFPSBOH EBQBU NBLBO TBOHBU TFEJLJU
QFOHBSVIOZBNFMBMVJBMEPTUFSPOBEBMBIQFOUJOHEBMBNQFOHBUVSBO
BUBVTBOHBUCBOZBLHBSBNUBOQBNFOHBLJCBULBOQFSVCBIBOCFTBS
UFLBOBO BSUFSJ KBOHLB QBOKBOH /BNVO EFNJLJBO QFOFMJUJBO EJ
CBJLQBEBWPMVNFDBJSBOFLTUSBTFMVMBSBUBVUFLBOBOBSUFSJ'VOHTJ
MBCPSBUPSJVN NFOVOKVLLBO QFOHBSVI MBOHTVOH BOHJPUFOTJO QBEB
JOJ EJKFMBTLBO PMFI TLFNB (BNCBS ZBOH NFNQFSMJIBULBO
HJOKBMNVOHLJOUJHBLBMJBUBVMFCJI MFCJILVBUEBSJQBEBQFOHBSVI
QFOHBSVI BXBM QFOJOHLBUBO BTVQBO HBSBN BEBMBI UJNCVMOZB
UJEBL MBOHTVOH ZBOH CFLFSKB NFMBMVJ BMEPTUFSPO XBMBVQVO
QFOJOHLBUBO WPMVNF DBJSBO FLTUSBTFMVMBS EBO TFMBOKVUOZB
TFCFOBSOZB QFOHBSVI UJEBL MBOHTVOH NFSVQBLBO QFOHBSVI ZBOH
NFOJOHLBULBO UFLBOBO BSUFSJ ,FNVEJBO QFOJOHLBUBO UFLBOBO
UFMBIEJLFOBMTFDBSBMVBT
BSUFSJ BLBO NFOZFCBCLBO NFOJOHLBUOZB BMJSBO EBSBI ZBOH
Analisis Kuantitatif Perubahan Tekanan Arteri yang NFMBMVJ HJOKBM EBO FGFL MBJOOZB TFMBOKVUOZB NFOHVSBOHJ
Disebabkan Angiotensin II. (BNCBS NFNQFSMJIBULBO LFDFQBUBOTFLSFTJSFOJO TBNQBJLFUBSBGZBOHTBOHBUSFOEBIEBO
BOBMJTJT LVBOUJUBUJG QFOHBSVI BOHJPUFOTJO QBEB QFOHBUVSBO UFLBOBO NFMBMVJ MBOHLBIMBOHLBI ZBOH CFSVSVUBO BLBO NFOVSVOLBO
BSUFSJ (BNCBS JOJ NFNQFSMJIBULBO EVB LVSWB LFMVBSBO HJOKBM EBO SFUFOTJHBSBNEBOBJSPMFIHJOKBM NFOHFNCBMJLBOWPMVNFDBJSBO
KVHB HBSJT ZBOH NFOHHBNCBSLBO UJOHLBU BTVQBO OBUSJVN OPSNBM FLTUSBTFMVMBS IBNQJS LF UJOHLBU NFOEFLBUJ OPSNBM EBO
,VSWB LFMVBSBO HJOKBM EJ TFCFMBI LJSJ EJVLVS EBSJ BOKJOHBOKJOH ZBOH
BLIJSOZB QFOHFNCBMJBO UFLBOBO BSUFSJ LF UBSBG IBNQJS OPSNBM
TJTUFN SFOJOBOHJPUFOTJOOZB UFMBI EJIBNCBU PMFI PCBU JOIJCJUPS
BOHJPUFOTJODPOWFSUJOH FO[ZNF ZBOH NFOHIBNCBU BOHJPUFOTJO * +BEJ TJTUFN SFOJOBOHJPUFOTJO NFSVQBLBO NFLBOJTNF VNQBO
NFOKBEJ BOHJPUFOTJO ** ,VSWB ZBOH EJ TFCFMBI LBOBO EJVLVS EBSJ CBMJL PUPNBUJT ZBOH NFNCBOUV NFNQFSUBIBOLBO UFLBOBO BSUFSJ
BOKJOHBOKJOHZBOHUFSVTNFOFSVTEJJOGVTBOHJPUFOTJO**LVSBOHMFCJI QBEB UJOHLBU OPSNBM BUBV NFOEFLBUJ OPSNBM CJMB BTVQBO HBSBN
LBMJ LFDFQBUBO OPSNBM QFNCFOUVLBO BOHJPUFOTJO EBMBN EBSBI NFOJOHLBU "UBV CJMB BTVQBO HBSBN NFOVSVO IJOHHB EJ CBXBI
1FSIBUJLBO QFSHFTFSBO LVSWB LFMVBSBO HJOKBM LF BSBI UFLBOBO ZBOH OPSNBM BLBOUFSKBEJFGFLZBOHCFSMBXBOBO
MFCJI UJOHHJ EJ CBXBI QFOHBSVI BOHJPUFOTJO ** 1FSHFTFSBO JOJ
EJTFCBCLBO CBJL PMFI QFOHBSVI MBOHTVOH BOHJPUFOTJO ** QBEB HJOKBM 6OUVL NFOFLBOLBO LFCFSIBTJMBO QFOHBSVI TJTUFN SFOJO
NBVQVO QFOHBSVI UBL MBOHTVOH ZBOH CFLFSKB NFMBMVJ TFLSFTJ BOHJPUFOTJO EBMBN NFOHBUVS UFLBOBO BSUFSJ CJMB TJTUFN JOJ
BMEPTUFSPO TFQFSUJZBOHEJKFMBTLBOTFCFMVNOZB CFSGVOHTJ OPSNBM NBLB BLBO UFSKBEJ QFOJOHLBUBO UFLBOBO BSUFSJ
"LIJSOZB QFSIBUJLBO EVB UJUJL LFTFJNCBOHBO TBUV VOUVL LBEBS ZBOHUJEBLMFCJIEBSJTBNQBJNN)HTFCBHBJSFTQPOTUFSIBEBQ
BOHJPUFOTJO OPM ZBOH NFOVOKVLLBO UFLBOBO BSUFSJ TFCFTBS NN QFOJOHLBUBOBTVQBOHBSBNTFCBOZBLLBMJMJQBU4FCBMJLOZB CJMB
)H EBO TBUV VOUVL LBEBS BOHJPUFOTJO ZBOH NFOJOHLBU ZBOH TJTUFN SFOJOBOHJPUFOTJO EJIBNCBU QFOJOHLBUBO BTVQBO HBSBN
NFOVOKVLLBO UFLBOBO TFCFTBS NN )H 0MFI LBSFOB JUV EBMBN KVNMBI ZBOH TBNB NVOHLJO NFOZFCBCLBO QFOJOHLBUBO
QFOHBSVIBOHJPUFOTJOZBOHNFOZFCBCLBOSFUFOTJHBSBNEBOBJSPMFI UFLBOBO TFLJUBS LBMJ EBSJ QFOJOHLBUBO OPSNBM TFSJOH LBMJ
HJOKBM EBQBU NFNQVOZBJ QFOHBSVI ZBOH LVBU VOUVL NFOZFCBCLBO NFODBQBJIJOHHBNN)H
QFOJOHLBUBOUFLBOBOBSUFSJZBOHLSPOJT
ada angio ensin dalam

da a dikali no mal eningka an as an ga am
0 2.5
10
eningka an ol me eks asel
8
eningka an ekanan a e i
6
en nan enin dan angio ensin

4
i ik
keseim angan
en nan e ensi ga am dan ai ole ginjal
2
o mal s an
em alin a ol me eks asel am i ke a a no mal
0
0 60 80 100 120 140 160
em alin a ekanan a e i am i ke a a no mal

ek d a kada angio ensin ada k a
kel a an ginjal ang men nj kkan enga an ekanan a e i an kejadian ang meningka kan ekanan a e i
ada i ik keseim angan se esa mm Hg saa kada aki a eningka an as an ga am nam n en nan kegia an
angio ensin enda dan ada i ik keseim angan mm Hg m an alik sis em enin angio ensin akan mengem alikan
saa kada angio ensin inggi ekanan a e i am i ke ingka no mal
222
Jenis-Jenis Hipertensi yang Melibatkan Angiotensin:

Hipertensi yang Disebabkan oleh Tumor yang
Menyekresi Renin atau oleh Infus Angiotensin II
,BEBOHLBEBOH UJNCVMUVNPSTFMTFMKVLTUBHMPNFSVMBS TFMTFM+(
UNIT IV
QFOZFLSFTJ SFOJO EBO NFOZFLSFTJLBO SFOJO EBMBNKVNMBIZBOH
CFTBS ZBOH NFOZFCBCLBO QFNCFOUVLBO BOHJPUFOTJO ** EBMBN
KVNMBI ZBOH TBNB CFTBS 1BEB TFNVB QBTJFO ZBOH NFOEFSJUB
UVNPS JOJ UJNCVM IJQFSUFOTJ CFSBU %FNJLJBO QVMB CJMB QBEB
TFFLPSIFXBOEJJOGVTEFOHBOTFKVNMBICFTBSBOHJPUFOTJO**TFDBSB
UFSVTNFOFSVTTFMBNBCFSIBSJIBSJBUBVCFSNJOHHVNJOHHV BLBO
UJNCVMIJQFSUFOTJCFSBUKBOHLBQBOKBOHZBOHTFSVQB ons iksi a e i enalis e asn a kons iksi
,JUBUFMBINFODBUBUCBIXBBOHJPUFOTJO**EBQBUNFOJOHLBULBO
UFLBOBOBSUFSJNFMBMVJEVBDBSB ekanan a e i sis emik
1. %FOHBO NFOJNCVMLBO LPOTUSJLTJ BSUFSJPMB EJ TFMVSVI UVCVI 200

TFIJOHHB NFOJOHLBULBO UBIBOBO QFSJGFS UPUBM EBO UFLBOBO
BSUFSJ QFOHBSVI JOJ UJNCVM CFCFSBQB EFUJL TFUFMBI JOGVT
150
BOHJPUFOTJOEJNVMBJ
2. %FOHBO NFOZFCBCLBO HJOKBM NFSFUFOTJ HBSBN EBO BJS TFMBOH ekanan a e i
CFCFSBQB IBSJ IBM JOJ KVHB BLBO NFOZFCBCLBO IJQFSUFOTJ EBO 100 enalis dis al
NFSVQBLBOQFOZFCBCVUBNBCFSUBIBOOZBQFOJOHLBUBOUFLBOBO
KBOHLBQBOKBOH
50
Hipertensi Goldblatt "Satu Ginjal". #JMB TBMBI TBUV HJOKBM
EJCVBOH EBO TFCVBI LPOTUSJLUPS EJUFNQBULBO QBEB BSUFSJ SFOBMJT
HJOKBMZBOHUFSTJTB TFQFSUJZBOHEJQFSMJIBULBOQBEB(BNCBS 7
FGFLTFHFSBBEBMBIUFLBOBOBSUFSJSFOBMJTZBOHTBOHBUNFOVSVOEJ
TFCFMBI EJTUBM LPOTUSJLUPS TFQFSUJ ZBOH EJQFSMJIBULBO PMFI LVSWB ek esi ine
EFOHBO HBSJT QVUVTQVUVT QBEB HBNCBS UFSTFCVU ,FNVEJBO
EBMBN XBLUV CFCFSBQB EFUJL BUBV NFOJU UFLBOBO BSUFSJ TJTUFNJL 1
NVMBJ NFOJOHLBU EBO UFSVT NFOJOHLBU TFMBNB CFCFSBQB IBSJ 0
0 4 8 12
5FLBOBO CJBTBOZB NFOJOHLBU EFOHBO DFQBU QBEB KBN QFSUBNB
BUBV TFMBOKVUOZB EBO LFBEBBO JOJ EJJLVUJ PMFI QFOJOHLBUBO
UBNCBIBO ZBOH QFSMBIBO*BIBO TFMBNB CFCFSBQB IBSJ #JMB enga emasangan klem kons iksi ada
UFLBOBO BSUFSJ TJTUFNJL NFODBQBJ UFLBOBO CBSVOZB ZBOH TUBCJM a e i enalis sa ginjal se ela engangka an ginjal lainn a
e a ikan e a an ekanan a e i sis emik ekanan a e i
UFLBOBO BSUFSJ SFOBMJT LVSWB EFOHBO HBSJT QVUVTQVUVT QBEB enalis se ela dis al klem dan ke e a an sek esi enin
HBNCBS
BLBO LFNCBMJ IBNQJS NFOEFLBUJ OPSNBM )JQFSUFOTJ Hi e ensi ang e jadi dise i e ensi old la sa
ZBOH EJUJNCVMLBO EFOHBO DBSB JOJ EJTFCVU IJQFSUFOTJ (PMECMBUU ginjal
TBUV HJOKBM TFCBHBJ QFOHIPSNBUBO LFQBEB %S )BSSZ (PMECMBUU
ZBOH QFSUBNBUBNB NFNQFMBKBSJ HBNCBSBO LVBOUJUBUJG ZBOH
QFOUJOH QBEB IJQFSUFOTJ ZBOH EJTFCBCLBO PMFI LPOTUSJLTJ BSUFSJ TBNQBJ IBSJ WPMVNF DBJSBO UVCVI BLBO NFOJOHLBU DVLVQ
SFOBMJT UJOHHJTFIJOHHBNFOJOHLBULBOUFLBOBOBSUFSJNFOKBEJOJMBJCBSV
1FOJOHLBUBO BXBM UFLBOBO BSUFSJ QBEB IJQFSUFOTJ (PMECMBUU ZBOH EJQFSUBIBOLBO /JMBJ LVBOUJUBUJG UFLBOBO ZBOH
EJTFCBCLBO PMFI NFLBOJTNF WBTPLPOTUSJLUPS SFOJOBOHJPUFOTJO EJQFSUBIBOLBO JOJ EJUFOUVLBO PMFI EFSBKBU LPOTUSJLTJ BSUFSJ
0MFI LBSFOB BMJSBO EBSBI ZBOH NFMBMVJ HJOKBM NFOKBEJ CVSVL SFOBMJT +BEJ UFLBOBO BPSUB IBSVT NFOJOHLBU DVLVQ UJOHHJ
TFTVEBI LPOTUSJLTJ BLVU BSUFSJ SFOBMJT CBOZBL TFLBMJ SFOJO ZBOH TFIJOHHB UFLBOBO BSUFSJ SFOBMJT EJ TFCFMBI EJTUBM LPOTUSJLUPS
EJTFLSFTJ PMFI HJOKBM TFQFSUJ ZBOH EJHBNCBSLBO PMFI LVSWB DVLVQVOUVLNFOZFCBCLBOLFMVBSBOVSJOFZBOHOPSNBM
UFSCBXBIQBEB(BNCBS ZBOHNFOJOHLBULBOBOHJPUFOTJO** 4LFOBSJP ZBOH TBNB KVHB UFSKBEJ QBEB QFOEFSJUB EFOHBO
EBO BMEPTUFSPO EBMBN EBSBI "OHJPUFOTJO JOJ TFMBOKVUOZB TUFOPTJT BSUFSJ SFOBMJT HJOKBM ZBOH UFSTJTB ZBOH EBQBU UFSKBEJ
NFOJOHLBULBO UFLBOBO BSUFSJ TFDBSB NFOEBEBL 4FLSFTJ SFOJO TFUFMBI TFPSBOH NFOEBQBU USBOTQMBOUBTJ HJOKBM 4FMBJO JUV
NFOJOHLBU NFODBQBJ QVODBLOZB LVSBOH MFCJI EBMBN TBUV KBN QFOJOHLBUBO UBIBOBO GVOHTJPOBM BUBVQVO QBUPMPHJT BSUFSJPMB
UFUBQJ LFNCBMJ IBNQJS LF OPSNBM EBMBN XBLUV TBNQBJ IBSJ SFOBMJT BLJCBU BUFSPTLMFSPTJT BUBV LBEBS WBTPLPOTUSJLUPS ZBOH
LBSFOB QBEB TBBU JUV UFLBOBO BSUFSJ SFOBMJT KVHB NFOJOHLBU CFSMFCJIBO EBQBUNFOZFCBCLBOIJQFSUFOTJNFMBMVJNFLBOJTNF
LFNCBMJ LF OPSNBM TFIJOHHB HJOKBM UJEBL MBHJ EBMBN LFBEBBO ZBOHTBNBTFQFSUJLPOTUSJLTJBSUFSJSFOBMJTVUBNB
JTLFNJL
1FOJOHLBUBOLFEVBQBEBUFLBOBOBSUFSJEJTFCBCLBOPMFISFUFOTJ Hipertensi Goldblatt "Dua Ginjal". )JQFSUFOTJKVHBEBQBU
HBSBN EBO BJS PMFI HJOKBM ZBOH NFOHBMBNJ LPOTUSJLTJ ZBOH KVHB UJNCVM CJMB BSUFSJ ZBOH NFOVKV LF TBMBI TBUV HJOKBM
EJSBOHTBOHPMFIBOHJPUFOTJO**EBOBMEPTUFSPO
%BMBNXBLUV EJLPOTUSJLTJLBO TFEBOHLBOBSUFSJZBOHLFHJOKBMMBJOOPSNBM
223
Unit IV Sirkulasi
)JQFSUFOTJJOJEBQBUUJNCVMLBSFOBNFLBOJTNFCFSJLVU(JOKBM Peran Autoregulasi pada Hipertensl yang Disebabkan

ZBOH NFOHBMBNJ LPOTUSJLTJ NFOZFLSFTJ SFOJO EBO KVHB oleh Koarktasio Aorta. $JSJ QFOUJOH IJQFSUFOTJ ZBOH EJTFCBCLBO
NFSFUFOTJ HBSBN EBO BJS BLJCBU NFOVSVOOZB UFLBOBO BSUFSJ PMFI LPBSLUBTJP BPSUB BEBMBI BMJSBO EBSBI EJ MFOHBO ZBOH UFLBOBOOZB
SFOBMJT QBEB HJOKBM UFSTFCVU ,FNVEJBO HJOKBM ZBOH OPSNBM EBQBUNFODBQBJIJOHHBQFSTFOEJBUBTOPSNBM IBNQJSNFOEFLBUJ
NFSFUFOTJ HBSBN EBO BJS BLJCBU SFOJO ZBOH EJIBTJMLBO PMFI OPSNBM %FNJLJBO QVMB BMJSBO EBSBI QBEB UVOHLBJ ZBOH UFLBOBOOZB
HJOKBM ZBOH JTLFNJL 3FOJO JOJ NFOZFCBCLBO UFSCFOUVLOZB UJEBL NFOJOHLBU IBNQJS NFOEFLBUJ OPSNBM #BHBJNBOB IBM JOJ EBQBU
BOHJPUFOTJO**EBOBMEPTUFSPO ZBOHLFEVBOZBCFSTJSLVMBTJLF UFSKBEJ EFOHBO UFLBOBO QBEB UVCVI CBHJBO BUBT IJOHHB QFSTFO
MFCJI CFTBS EBSJQBEB UVCVI CBHJBO CBXBI +BXBCBOOZB CVLBO LBSFOB
HJOKBMZBOHCFSCFEBEBONFOZFCBCLBOSFUFOTJHBSBNEBOBJS
UFSEBQBU QFSCFEBBO [BU WBTPLPOTUSJLUPS EBMBN EBSBI EJ UVCVI CBHJBO
QVMB+BEJ EFOHBOBMBTBOZBOHCFSCFEB LFEVBHJOKBMNFSFUFOTJ BUBT EBO UVCVI CBHJBO CBXBI LBSFOB EBSBI ZBOH NFOHBMJS LF LFEVB
HBSBNEBOBJS"LJCBUOZB UJNCVMIJQFSUFOTJ EBFSBI UFSTFCVU BEBMBI EBSBI ZBOH TBNB %FNJLJBO QVMB TJTUFN TBSBG
#FOUVLLMJOJT(PMECMBUUEVBHJOKBMUFSKBEJCJMBBEBTUFOPTJT ZBOH NFOHJOFSWBTJ LFEVB EBFSBI TJSLVMBTJ UFSTFCVU TFSVQB TFIJOHHB
TBUV BSUFSJ SFOBMJT NJTBMOZB ZBOH EJTFCBCLBO PMFI UJEBL BEB QFSCFEBBO EBMBN QFOHBUVSBO TBSBG VOUVL QFNCVMVI EBSBI
BUFSPTLMFSPTJT QBEBPSBOHEFOHBOEVBHJOKBM UFSTFCVU 4BUVTBUVOZB KBXBCBO ZBOH NBTVL BLBM BEBMBI UFSKBEJ
BVUPSFHVMBTJ KBOHLB QBOKBOH ZBOH IBNQJS TFNQVSOB TFIJOHHB
NFLBOJTNF QFOHBUVSBO BMJSBO EBSBI TFUFNQBU UFSLPNQFOTBTJ IBNQJS
Hipertensi Akibat Penyakit Ginjal yang Menyekresi QFSTFO NFTLJQVO BEB QFSCFEBBO UFLBOBO "LJCBUOZB QBEB LFEVB
Renin secara Menahun. 4FSJOH LBMJ TFCBHJBO EBFSBI TBMBI EBFSBIUFSTFCVU CBJLZBOHCFSUFLBOBOUJOHHJNBVQVOZBOHCFSUFLBOBO
TBUV HJOKBM BUBV LFEVB HJOKBM NFOHBMBNJ TBLJU EBO NFOKBEJ SFOEBI BMJSBO EBSBI TFUFNQBUOZB EJBUVS IBNQJS TFTVBJ EFOHBO
JTLFNJL BLJCBU WBTPLPOTUSJLTJ WBTLVMBS MPLBM TFEBOHLBO LFCVUVIBO KBSJOHBO EBO CVLBO EJTFTVBJLBO EFOHBO UJOHLBU UFLBOBO
EBFSBIHJOKBMMBJOOZBUFUBQOPSNBM#JMBIBMJOJUFSKBEJ UJNCVM 4BMBI TBUV BMBTBO NFOHBQB QFOHBNBUBO JOJ TBOHBU QFOUJOH BEBMBI
FGFLFGFL ZBOH IBNQJS TFSVQB EFOHBO ZBOH UFSKBEJ QBEB CBHBJNBOB IBNQJS TFNQVSOBOZB QSPTFT BVUPSFHVMBTJ KBOHLB QBOKBOH
IJQFSUFOTJ (PMECMBUU EVB HJOKBM #BHJBO KBSJOHBO HJOKBM ZBOH ZBOHUFSKBEJ
JTLFNJL BLBO NFOZFLSFTJ SFOJO EBO TFMBOKVUOZB Hipertensi pada Preeklampsia (Toksemia Gravidarum).
QFNCFOUVLBOBOHJPUFOTJO** NFOZFCBCLBONBTTBHJOKBMZBOH ,VSBOHMFCJIIJOHHBQFSTFOJCVIBNJMNFOHBMBNJTVBUVTJOESPN
UFSTJTB KVHB NFSFUFOTJ HBSBN EBO BJS 4BMBI TBUV QFOZFCBC ZBOHEJTFCVUQSFFLMBNQTJB KVHBEJLFOBMTFCBHBJUPLTFNJBHSBWJEBSVN

QBMJOH VNVN EBSJ IJQFSUFOTJ SFOBM LIVTVTOZB QBEB PSBOH 4BMBI TBUV NBOJGFTUBTJ QSFFLMBNQTJB BEBMBI IJQFSUFOTJ ZBOH CJBTBOZB
PSBOH ZBOH CFSVTJB UVB BEBMBI LFMBJOBO ZBOH NFOZFCBCLBO NFOVSVO TFUFMBI LFMBIJSBO CBZJ 8BMBVQVO QFOZFCBC QBTUJ
TFCBHJBOHJOKBMJTLFNJLTFQFSUJJOJ QSFFLMBNQTJB UJEBL TFQFOVIOZB EJQBIBNJ JTLFNJB QMBTFOUB ZBOH
NFOHJLVUJ EJEVHB CFSQFSBO EBMBN NFOZFCBCLBO CFSCBHBJ HFKBMB
QFOZBLJU JOJ UFSNBTVL IJQFSUFOTJ QBEB JCV ;BU[BU ZBOH EJMFQBTLBO
Jenis-Jenis Hipertensi Lainnya yang Disebabkan oleh PMFI QMBTFOUB ZBOH JTLFNJL LFNVEJBO NFOZFCBCLBO EJTGVOHTJ TFMTFM
Gabungan Beban Volume dan Vasokonstriksi FOEPUFM WBTLVMBS EJ TFMVSVI UVCVI UFSNBTVL QFNCVMVI EBSBI HJOKBM
Hipertensi pada Bagian Atas Tubuh yang Disebabkan oleh %JTGVOHTJFOEPUFMJOJNFOVSVOLBOQFMFQBTBOOJUSBUPLTJEBEBO[BU[BU
Koarkstaio Aorta. 4BUV EBSJ TFUJBQ TFSBUVT SJCV CBZJ EJMBIJSLBO WBTPEJMBUPS MBJOOZB TFIJOHHB UFSKBEJ WBTPLPOTUSJLTJ QFOVSVOBO MBKV
EFOHBO LPOTUSJLTJ QBUPMPHJT BUBV TVNCBUBO BPSUB EJTUBM GJMUSBTJ DBJSBO EBSJ HMPNFSVMVT LF EBMBN UVCVMVT HJOKBM HBOHHVBO
QFSDBCBOHBOBPSUBEFOHBOBSUFSJZBOHNFOVKVLFQBMBEBOMFOHBO OBUSJVSFTJTUFLBOBOPMFIHJOKBMEBOUJNCBMOZBIJQFSUFOTJ
UFUBQJ QSPLTJNBM BSUFSJ SFOBMJT LFBEBBO ZBOH EJTFCVU LPBSLUBTJP ,FMBJOBO QBUPMPHJT MBJOOZB ZBOH EBQBU NFOZFCBCLBO IJQFSUFOTJ
BPSUB #JMB IBM JOJ UFSKBEJ EBSBI ZBOH NFOHBMJS LF UVCVI CBHJBO QBEB QSFFLMBNQTJB BEBMBI QFOFCBMBO NFNCSBO HMPNFSVMVT HJOKBM
CBXBI BLBO EJCBXB PMFI CFCFSBQB BSUFSJ LPMBUFSBM ZBOH LFDJM NVOHLJO EJTFCBCLBO PMFI QSPTFT BVUPJNVO
ZBOH KVHB
QBEBEJOEJOHUVCVI EFOHBOUBIBOBOWBTLVMBSZBOHCFTBSBOUBSB NFOVSVOLBO MBKV GJMUSBTJ DBJSBO HMPNFSVMVT +FMBT UJOHLBU UFLBOBO
CBHJBO BUBT BPSUB EBO CBHJBO CBXBI BPSUB "LJCBUOZB UFLBOBO BSUFSJZBOHEJQFSMVLBOVOUVLNFOZFCBCLBOQFNCFOUVLBOVSJOFZBOH
BSUFSJEJUVCVICBHJBOBUBTEBQBUNFODBQBJTBNQBJQFSTFO OPSNBM BLBO NFOJOHLBU EBO UJOHLBU UFLBOBO BSUFSJ KBOHLB QBOKBOH
MFCJIUJOHHJEBSJQBEBUFLBOBOEJUVCVICBHJBOCBXBI KVHB UVSVU NFOJOHLBU 1BTJFOQBTJFO JOJ DFOEFSVOH NFOEFSJUB
.FLBOJTNF IJQFSUFOTJ ZBOH UFSKBEJ EJ UVCVI CBHJBO BUBT JOJ CFSCBHBJ EFSBKBU IJQFSUFOTJ KJLB NFOHLPOTVNTJ HBSBN TFDBSB
IBNQJS TBNB EFOHBO NFLBOJTNF ZBOH UFSKBEJ QBEB IJQFSUFOTJ CFSMFCJIBO
(PMECMBUU TBUV HJOKBM #JMB TVBUV LPOTUSJLUPS EJUFNQBULBO QBEB Hipertensi Neurogenik )JQFSUFOTJ OFVSPHFOJL BLVU EBQBU
BPSUB EJ BUBT BSUFSJ SFOBMJT UFLBOBO EBSBI EJ LFEVB HJOKBM QBEB
EJTFCBCLBO PMFI QFSBOHTBOHBO ZBOH LVBU QBEB TJTUFN TBSBG
NVMBOZB BLBO NFOVSVO UFSKBEJ TFLSFTJ SFOJO QFNCFOUVLBO
BOHJPUFOTJO EBO BMEPTUFSPO EBO UJNCVM IJQFSUFOTJ EJ UVCVI
TJNQBUJT 4FCBHBJ DPOUPI CJMB TFTFPSBOH NFOKBEJ UFSBOHTBOH PMFI
CBHJBOBUBT5FLBOBOBSUFSJEJUVCVICBHJBOCBXBITFUJOHHJHJOKBM LBSFOBBMBTBOBQBQVOBUBVQBEBTBBUTFEBOHHFMJTBI NBLBTJTUFN
BLBO NFOJOHLBU LVSBOH MFCJI NFOKBEJ OPSNBM OBNVO UFLBOBO TJNQBUJT EJSBOHTBOH TFDBSB CFSMFCJIBO NFOJNCVMLBO
ZBOHUJOHHJBLBONFOFUBQEJUVCVICBHJBOBUBT(JOKBMUJEBL MBHJ WBTPLPOTUSJLTJQFSJGFSEJTFMVSVIUVCVI EBOUJNCVMIJQFSUFOTJBLVU
NFOHBMBNJ JTLFNJB TFIJOHHB TFLSFTJ SFOJO EBO QFNCFOUVLBO Hipertensi Neurogenik Akut yang Disebabkan oleh
BOHJPUFOTJO EBO BMEPTUFSPO LFNCBMJ OPSNBM 4FMBJO JUV QBEB Pemotongan Saraf Baroreseptor. #FOUVL IJQFSUFOTJ
LPBSLUBTJP BPSUB UFLBOBO BSUFSJ EJ UVCVI CBHJBO CBXBI CJBTBOZB OFVSPHFOJL BLVU MBJOOZB BLBO UFSKBEJ CJMB TBSBGTBSBG ZBOH CFSBTBM
IBNQJS OPSNBM TFEBOHLBO UFLBOBO EJ UVCVI CBHJBO BUBT KBVI EBSJCBSPSFTFQUPSEJQPUPOHBUBVCJMBUSBLUVTTPMJUBSJVTZBOHUFSEBQBU
MFCJIUJOHHJEBSJQBEBOPSNBM QBEBTFUJBQTJTJ
224
NFEVMB PCMPOHBUB EJSVTBL JOJMBI UFNQBU TBSBG ZBOH CFSBTBM EBSJ ,FCBOZBLBO QBTJFO IJQFSUFOTJ NFNJMJLJ CFSBU CBEBO ZBOH
CBSPSFTFQUPS LBSPUJT EBO BPSUB CFSIVCVOHBO EJ CBUBOH PUBL
CFSMFCJI EBOQFOFMJUJBOQBEBCFSCBHBJQPQVMBTJNFOVOKVLLBO
)JMBOHOZB TJOZBMTJOZBM TBSBG OPSNBM ZBOH CFSBTBM EBSJ CBIXB LFOBJLBO CFSBU CBEBO ZBOH CFSMFCJI EBO PCFTJUBT
CBSPSFTFQUPS TFDBSB NFOEBEBL NFNQVOZBJ FGFL ZBOH TBNB QBEB NFNQVOZBJ SJTJLP TBNQBJ QFSTFO VOUVL UFSLFOB
NFLBOJTNF QFOHBUVSBO UFLBOBO PMFI TBSBG TFQFSUJ QBEB
UNIT IV
IJQFSUFOTJ QSJNFS 1FOFMJUJBO LMJOJT KFMBT NFOVOKVLLBO
QFOVSVOBO UFLBOBO BSUFSJ EBMBN BPSUB EBO BSUFSJ LBSPUJT TFDBSB
QFOUJOHOZB QFOVSVOBO CFSBU CBEBO VOUVL NFOVSVOLBO
NFOEBEBL &GFL ZBOH UFSKBEJ BEBMBI IJMBOHOZB JOIJCJTJ OPSNBM
QVTBU WBTPNPUPS ZBOH EJUJNCVMLBO PMFI TJOZBMTJOZBM TBSBG UFLBOBOEBSBIQBEBTFCBHJBOCFTBSQBTJFOIJQFSUFOTJ#BILBO
CBSPSFTFQUPS OPSNBM TFIJOHHB QVTBU WBTPNPUPS TFDBSB UJCBUJCB QBOEVBO LMJOJT VOUVL QFOHPCBUBO IJQFSUFOTJ NFOHBOKVSLBO
NFOKBEJ TBOHBU BLUJG EBO UFLBOBO BSUFSJ SBUBSBUB NFOJOHLBU EBSJ QFOJOHLBUBOBLUJWJUBTGJTJLEBOQFOVSVOBOCFSBUCBEBOTFCBHBJ
NN)HTBNQBJTFUJOHHJNN)H,JSBLJSBEBMBNXBLUV MBOHLBIQFSUBNBEBMBNNFOHFMPMBQBTJFOIJQFSUFOTJ
IBSJ UFLBOBO LFNCBMJ NFOKBEJ IBNQJS OPSNBM TFCBC SFTQPOT #FCFSBQBTJGBULIBTIJQFSUFOTJQSJNFSZBOHEJTFCBCLBOPMFI
QVTBUWBTPNPUPSUFSIBEBQUJEBLBEBOZBTJOZBMTJOZBMZBOHCFSBTBM
LFOBJLBOCFSBUCBEBOZBOHCFSMFCJIEBOPCFTJUBTNFMJQVUJ
EBSJ CBSPSFTFQUPS BLBO NFOHIJMBOH ZBOH EJTFCVU QFOZFTVBJBO
LFNCBMJ NFLBOJTNF QFOHBUVSBO UFLBOBO CBSPSFTFQUPS TFDBSB 1. $VSBI KBOUVOH NFOJOHLBU TFCBHJBO LBSFOB BMJSBO EBSBI
TFOUSBM 0MFI LBSFOB JUV IJQFSUFOTJ OFVSPHFOJL ZBOH EJTFCBCLBO UBNCBIBO ZBOH EJCVUVILBO VOUVL KBSJOHBO BEJQPTB FLTUSB
PMFI UFSQPUPOHOZB TBSBGTBSBG CBSPSFTFQUPS UFSVUBNB NFSVQBLBO 8BMBVQVO CFHJUV BMJSBO EBSBI EJ KBOUVOH HJOKBM USBLUVT
TVBUVKFOJTIJQFSUFOTJBLVU CVLBOKFOJTIJQFSUFOTJLSPOJT HBTUSPJOUFTUJOBM EBO PUPU TLFMFU KVHB NFOJOHLBU TFJSJOH
Hipertensi Genetik. 5FMBI EJLFUBIVJ BEBOZB IJQFSUFOTJ QFOJOHLBUBOCFSBUCBEBOEJTFCBCLBOPMFINFOJOHLBUOZBMBKV
IFSFEJUFS TQPOUBO QBEB CFCFSBQB HBMVS IFXBO UFSNBTVL CFCFSBQB NFUBCPMJL EBO QFSUVNCVIBO PSHBOPSHBO EBO KBSJOHBO
HBMVS UJLVT LFMJODJ EBO QBMJOH UJEBL TBUV HBMVS BOKJOH 1BEB HBMVS TFCBHBJ SFQPO UFSIBEBQ QFOJOHLBUBO LFCVUVIBO
UJLVT ZBOH UFMBI EJUFMJUJ TFDBSB MVBT ZBLOJ HBMVS UJLVT IJQFSUFOTJ NFUBCPMJLOZB %FOHBO LFBEBBO IJQFSUFOTJ ZBOH NFOFUBQ
TQPOUBO 0LBNPUP BEB CVLUJ QBEB QFSLFNCBOHBO BXBM UFSKBEJOZB TFMBNB CFSCVMBOCVMBO EBO CFSUBIVOUBIVO UBIBOBO
IJQFSUFOTJ TJTUFN TBSBG TJNQBUJTOZB NFOKBEJ KBVI MFCJI BLUJG WBTLVMBSQFSJGFSUPUBMKVHBEBQBUNFOJOHLBU
EBSJQBEB UJLVT OPSNBM 1BEB UBIBQ *BOKVU KFOJT IJQFSUFOTJ JOJ 2. "LUJWJUBT TBSBG TJNQBUJT UFSVUBNB EJ HJOKBM NFOJOHLBU QBEB
UFSMJIBUBEBOZBQFSVCBIBOTUSVLUVSBMQBEBOFGSPOOFGSPOHJOKBM

PSBOHPSBOH EFOHBO CFSBU CBEBO ZBOH CFSMFCJI 1FOZFCBC
QFOJOHLBUBO UBIBOBO BSUFSJ SFOBMJT QSFHMPNFSVMVT EBO

QFOVSVOBO QFSNFBCJMJUBT NFNCSBO HMPNFSVMVT 1FSVCBIBO
NFOJOHLBUOZBBLUJWJUBTTJNQBUJTQBEBLFBEBBOPCFTJUBTUJEBL
QFSVCBIBO TUSVLUVSBM JOJ BLBO NFNCBOUV CFSMBOKVUOZB IJQFSUFOTJ TFQFOVIOZB EJQBIBNJ OBNVO QFOFMJUJBO UFSBLIJS
KBOHLB QBOKBOH 1BEB HBMVS UJLVT ZBOH KVHB NFOHBMBNJ IJQFSUFOTJ NFOVOKVLLBOCBIXBIPSNPO TFQFSUJMFQUJO ZBOHEJMFQBTLBO
UFSEBQBUHBOHHVBOGVOHTJHJOKBM TFMTFM MFNBL EBQBU MBOHTVOH NFSBOHTBOH CFSCBHBJ EBFSBI
1BEB NBOVTJB NVUBTJ CFCFSBQB HFO ZBOH CFSCFEB UFMBI IJQPUBMBNVT ZBOHLFNVEJBO NFNQVOZBJQFOHBSVIFLTJUBTJ
EJJEFOUJGJLBTJ EBQBU NFOJNCVMLBO IJQFSUFOTJ #FOUVL IJQFSUFOTJ JOJ UFSIBEBQQVTBUWBTPNPUPSEJNFEVMBPUBL
EJTFCVU IJQFSUFOTJ NPOPHFOJL LBSFOB EJTFCBCLBO PMFI NVUBTJ HFO 3. ,BEBS BOHJPUFOTJO ** EBO BMEPTUFSPO NFOJOHLBU EVB TBNQBJ
UVOHHBM $JSJ NFOBSJL HBOHHVBO HFOFUJL JOJ BEBMBI TFNVB UJHB LBMJ QBEB CBOZBL QBTJFO EFOHBO PCFTJUBT )BM JOJ
NFOZFCBCLBOSFBCTPSQTJHBSBNEBOBJSZBOHCFSMFCJIBOPMFIUVCVMVT TFCBHJBO NVOHLJO EJTFCBCLBO PMFI NFOJOHLBUOZB
HJOKBM1BEBCFCFSBQBLBTVT QFOJOHLBUBOSFBCTPSQTJEJTFCBCLBOPMFI QFSBOHTBOHBO TBSBG TJNQBUJT ZBOH NFOJOHLBULBO QFMFQBTBO
NVUBTJ HFO ZBOH MBOHTVOH NFOJOHLBULBO USBOTQPSU OBUSJVN BUBV SFOJOPMFIHJOKBMEBOKVHBQFNCFOUVLBOBOHJPUFOTJO** ZBOH
LIMPSJEB EJ TFM FQJUFM UVCVMVT HJOKBM 1BEB DPOUPI MBJO NVUBTJ HFO
LFNVEJBO NFSBOHTBOH LFMFOKBS BESFOBM VOUVL NFOZFLSFTJ
NFOZFCBCLBO QFOJOHLBUBO TJOUFTJT BUBV BLUJWJUBT IPSNPO ZBOH
BMEPTUFSPO
NFSBOHTBOHSFBCTPSQTJBJSEBOHBSBNPMFIUVCVMVTHJOKBM+BEJ QBEB
TFNVBHBOHHVBOIJQFSUFOTJNPOPHFOJLZBOHUFMBIEJUFNVLBOTFMBNB
4. .FLBOJTNF OBUSJVSFTJT UFLBOBO HJOKBM UFSHBOHHV EBO HJOKBM
JOJ GJOBM DPNNPO QBUIXBZ NFOVKV IJQFSUFOTJ OBNQBLOZB BEBMBI UJEBLBLBONFOHFLTLSFTJHBSBNEBOBJSEBMBNKVNMBIZBOH
QFOJOHLBUBO SFBCTPSQTJ HBSBN EBO QFOJOHLBUBO WPMVNF DBJSBO DVLVQ LFDVBMJ UFLBOBO BSUFSJ UJOHHJ BUBV GVOHTJ HJOKBM
FLTUSBTFMVMBS/BNVOIJQFSUFOTJNPOPHFOJLTBOHBUKBSBOHEBOTFNVB NFNCBJLEFOHBOTFOEJSJOZB%FOHBOLBUBMBJO KJLBUFLBOBO
CFOUVL ZBOH EJLFUBIVJ IBOZB NFSVQBLBO IJQFSUFOTJ QBEB BSUFSJSBUBSBUBQBEBQBTJFOIJQFSUFOTJFTFOTJBMNN)H
NBOVTJB QFOHVSBOHBO BLVU UFLBOBO BSUFSJ SBUBSBUB TFDBSB CVBUBO
NFOKBEJOPSNBMNN)H UFUBQJUBOQBNFOHVCBIGVOHTJ
"Hipertensi Primer (Esensial)" HJOKBM LFDVBMJ CJMB UFLBOBOOZB CFSLVSBOH
BLBO
,JSBLJSB TBNQBJ QFSTFO PSBOH ZBOH NFOEFSJUB IJQFSUFOTJ NFOZFCBCLBO BOVSJB ZBOH IBNQJS UPUBM EBO QBTJFO BLBO
EJLBUBLBONFOEFSJUBIJQFSUFOTJQSJNFS ZBOHKVHBEJLFOBMTFDBSB NFSFUFOTJ HBSBN EBO BJS TBNQBJ UFLBOBOOZB OBJL LFNCBMJ
MVBT TFCBHBJ IJQFSUFOTJ FTFOTJBM PMFI CBOZBL LMJOJTJ *TUJMBI JOJ LFUFLBOBOTFNVMB NN)H1FOVSVOBOUFLBOBOBSUFSJ
TFDBSB TFEFSIBOB CFSBSUJ IJQFSUFOTJ EFOHBO QFOZFCBC ZBOH UJEBL LSPOJT EFOHBO UFSBQJ BOUJIJQFSUFOTJ ZBOH FGFLUJG CJBTBOZB
EJLFUBIVJ CFSCFEB EFOHBO CFOUVL IJQFSUFOTJ TFLVOEFS ZBOH UJEBL NFOZFCBCLBO SFUFOTJ HBSBN EBO BJS ZBOH CFSNBLOB
EJLFUBIVJQFOZFCBCOZB TFQFSUJTUFOPTJTBSUFSJSFOBMJTBUBVCFOUVL PMFI HJOKBM LBSFOB UFSBQJ JOJ KVHB NFNQFSCBJLJ OBUSJVSFTJT
NPOPHFOJLIJQFSUFOTJ UFLBOBOPMFIHJOKBM TFQFSUJEJCBIBTOBOUJ
1FOFMJUJBO FLTQFSJNFOUBM QBEB IFXBO EBO QBTJFO PCFT
1BEB TFCBHJBO CFTBS QBTJFO QFOJOHLBUBO CFSBU CBEBO ZBOH NFOVOKVLLBO LFDFOESVOHBO UFSHBOHHVOZB OBUSJVSFTJT UFLBOBO
CFSMFCJI EBO HBZB IJEVQ TFEFOUFS UBNQBLOZB NFNJMJLJ QFSBO PMFIHJOKBMQBEBIJQFSUFOTJEFOHBOPCFTJUBTUFSVUBNBEJTFCBCLBO
VUBNBEBMBNNFOZFCBCLBOIJQFSUFOTJ PMFINFOJOHLBUOZBSFBCTPSQTJHBSBNEBOBJSPMFIUVCVMVTHJOKBM
225
Unit IV Sirkulasi
QBEB IJQFSUFOTJ EFOHBO PCFTJUBT UFSVUBNB EJTFCBCLBO PMFI 4FCBMJLOZB QBEB QBTJFO IJQFSUFOTJ FTFOTJBM ZBOH TFOTJUJG HBSBN
NFOJOHLBUOZB SFBCTPSQTJ HBSBN EBO BJS PMFI UVCVMVT HJOKBM BTVQBO HBSBN ZBOH UJOHHJ TFDBSB CFSNBLOB NFNQFSCVSVL
BLJCBU NFOJOHLBUOZB BLUJWJUBT TBSBG TJNQBUJT EBO LBEBS IJQFSUFOTJ
BOHJPUFOTJO ** EBO BMEPTUFSPO 8BMBVQVO EFNJLJBO KJLB
%VB IBM UBNCBIBO ZBOH IBSVT EJUFLBOLBO
4FOTJUJWJUBT
IJQFSUFOTJUJEBLEJPCBUJTFDBSBFGFLUJG LFNVOHLJOBOKVHBUFSKBEJ
UFLBOBO EBSBI UFSIBEBQ HBSBN UJEBL CFSTJGBU HBHBM BUBV UVOUBT
LFSVTBLBOWBTLVMBSEJHJOKBMZBOHEBQBUNFOVSVOLBOMBKVGJMUSBTJ
OBNVO CFSTJGBU LVBOUJUBUJG EFOHBO TFKVNMBI PSBOH MFCJI TFOTJUJG
HMPNFSVMVT EBO NFNQFSCFSBU EFSBKBU IJQFSUFOTJ 1BEB BLIJNZB
UFSIBEBQHBSBNEBSJQBEBZBOHMBJO
4FOTJUJWJUBTUFLBOBOEBSBI
IJQFSUFOTJ UJEBL UFSLPOUSPM ZBOH UFSLBJU EFOHBO PCFTJUBT EBQBU
UFSIBEBQHBSBNUJEBLCFSTJGBUUFUBQKVTUSVUFLBOBOEBSBICJBTBOZB
NFOZFCBCLBO LFSVTBLBO WBTLVMBS ZBOH CFSBU EBO IJMBOHOZB
NFOKBEJ MFCJI TFOTJUJG UFSIBEBQ HBSBN CFSTBNBBO EFOHBO
GVOHTJHJOKBMTFQFOVIOZB
CFSUBNCBIOZBVTJB UFSVUBNBTFUFMBIVTJBBUBVUBIVO
"MBTBONFOHBQBBEBQFSCFEBBOBOUBSBIJQFSUFOTJFTFOTJBMZBOH
Analisis Grafis Pengaturan Tekanan Arteri pada
UJEBL TFOTJUJG HBSBN EBO IJQFSUFOTJ ZBOH TFOTJUJG HBSBN EJEVHB
Hipertensi Esensiat. (BNCBS BEBMBI BOBMJTJT HSBGJT
CFSLBJUBO EFOHBO QFSCFEBBO TUSVLUVSBM BUBV GVOHTJPOBM HJOKBM
IJQFSUFOTJFTFOTJBM,VSWBQBEBHBNCBSJOJEJTFCVULVSWBGVOHTJ
QBTJFOLFEVBKFOJTIJQFSUFOTJUFSTFCVU4FCBHBJDPOUPI IJQFSUFOTJ
HJOKBMCFCBOOBUSJVNLBSFOBUFLBOBOBSUFSJQBEBTFUJBQLFBEBBO
ZBOH TFOTJUJG HBSBN EBQBU UFSKBEJ QBEB CFSCBHBJ KFOJT QFOZBLJU
NFOJOHLBU TFDBSB QFSMBIBOMBIBO TFMBNB CFSIBSJIBSJ BUBV
HJOKBM LSPOJT ZBOH EJTFCBCLBO PMFI IJMBOHOZB VOJU GVOHTJPOBM
CFSNJOHHVNJOHHV NFOJOHLBULBO LBEBS BTVQBO OBUSJVN
HJOKBM OFGSPO
TFDBSB QFSMBIBOMBIBO BUBV PMFI QFOVBBO OPSNBM
TFDBSB CFSUBIBQ ,VSWB UJQF CFCBO OBUSJVN EBQBU EJUFOUVLBO
TFQFSUJZBOHEJCBIBTQBEB#BC'VOHTJTJTUFNSFOJOBOHJPUFOTJO
EFOHBO NFOJOHLBULBO LBEBS BTVQBO OBUSJVN NFOKBEJ LBEBS
ZBOH BCOPSNBM EBQBU KVHB NFOZFCBCLBO UFLBOBO EBSBI NFOKBEJ
ZBOHCBSVTFUJBQCFCFSBQBIBSJ LFNVEJBONFOVOHHVLFMVBSBO
TFOTJUJG UFSIBEBQ HBSBN TFQFSUJ ZBOH EJCBIBT TFCFMVNOZB EJ
OBUSJVNPMFIHJOKBMNFOKBEJTFJNCBOHEFOHBOBTVQBO EBOQBEB
EBMBNCBCJOJ
TBBUZBOHTBNBNFODBUBUQFSVCBIBOUFLBOBOBSUFSJ
Pengobatan Hipertensi Esensial. 1BOEVBO NVUBLIJS VOUVL
#JMBQSPTFEVSJOJEJUFSBQLBOQBEBQBTJFOIJQFSUFOTJFTFOTJBM
QFOHPCBUBO IJQFSUFOTJ NFOHBOKVSLBO TFCBHBJ MBOHLBI QFSUBNB
EVBUJQFLVSWB ZBOHEJUVOKVLLBOEJTFCFMBILBOBOQBEB(BNCBS
NPEJGJLBTJ HBZB IJEVQ ZBOH CFSUVKVBO NFOJOHLBULBO BLUJWJUBT
EBQBUEJSFLBNQBEBQBTJFOIJQFSUFOTJFTFOTJBM ZBOHTBUV
GJTJL EBO QFOVSVOBO CFSBU CBEBO QBEB TFCBHJBO CFTBS QBTJFO
EJTFCVU
IJQFSUFOTJZBOHUJEBLTFOTJUJGHBSBNEBOZBOHMBJOOZB
4BZBOHOZB CBOZBL QBTJFO ZBOH UJEBL EBQBU NFOVSVOLBO CFSBU

IJQFSUFOTJ TFOTJUJG HBSBN 1FSIBUJLBO LFEVB DPOUPI EJ BUBT
CBEBOOZB EBO UFSBQJ EFOHBO PCBUPCBUBO BOUJ IJQFSUFOTJ IBSVT
UFSOZBUB LVSWB CFSHFTFS LF LBOBO LF UFLBOBO ZBOH MFCJI UJOHHJ
NVMBJEJCFSJLBO
EJCBOEJOHLBOQBEBPSBOHOPSNBM4FLBSBOH NBSJLJUBUFSBQLBO
5FSEBQBUEVBLFMBTVNVNPCBUPCBUBOZBOHEJHVOBLBOVOUVL
QBEBHSBGJLZBOHTBNB B
OJMBJBTVQBOHBSBNZBOHOPSNBMEBO
NFOHFMPMB IJQFSUFOTJ
PCBUPCBU WBTPEJMBUPS ZBOH
C
OJMBJBTVQBOHBSBNZBOHUJOHHJ ZBJUV LBMJBTVQBOOPSNBM
NFOJOHLBULBOBMJSBOEBSBIEJHJOKBMEBO
PCBUPCBUOBUSJVSFUJL
1BEBLBTVTQBTJFOIJQFSUFOTJFTFOTJBMZBOHUJEBLTFOTJUJGHBSBN
BUBV EJVSFUJL ZBOH NFOVSVOLBO SFBCTPSQTJ HBSBN EBO BJS PMFI
UFLBOBO BSUFSJ UJEBL NFOJOHLBU TFDBSB CFSNBLOB TBBU KVNMBI
UVCVMVTHJOKBM
BTVQBOHBSBNZBOHOPSNBMCFSVCBINFOKBEJUJOHHJ
0CBUPCBU WBTPEJMBUPS CJBTBOZB NFOZFCBCLBO WBTPEJMBTJ QBEB
CBOZBLKBSJOHBOUVCVIMBJOOZBEBOKVHBQBEBHJOKBM0CBUPCBUJOJ
CFLFSKB NFMBMVJ TBMBI TBUV DBSB CFSJLVU
EFOHBO NFOHJOIJCJTJ
o mal
TJOZBMTBSBGTJNQBUJTLFHJOKBMBUBVEFOHBONFOHIBNCBULFSKB[BU
idak sensi i ga am
USBOTNJUFS TJNQBUJT QBEB WBTLVMBS HJOKBM EBO UVCVMVT HJOKBM

6 ensi i ga am
TFDBSB MBOHTVOH NFSFMBLTBTJ PUPUPUPU QPMPT WBTLVMBS HJOKBM BUBV
5
EFOHBO NFOHIBNCBU LFSKB TJTUFN SFOJOBOHJPUFOTJO QBEB
WBTLVMBSHJOKBMBUBVUVCVMVTHJOKBM
4 s an inggi a 0CBUPCBU ZBOH NFOVSVOLBO SFBCTPSQTJ HBSBN EBO BJS PMFI
3
UVCVMVT HJOKBM LIVTVTOZB NFMJQVUJ PCBUPCBU ZBOH NFOHIBNCBU
Hi e ensi USBOTQPS BLUJG OBUSJVN NFMBMVJ EJOEJOH UVCVMVT QFOHIBNCBUBO
o mal
2 esensial JOJTFMBOKVUOZBKVHBNFODFHBISFBCTPSQTJBJS TFQFSUJZBOHUFMBI
s an no mal D A EJKFMBTLBOTFCFMVNOZBEBMBNCBCJOJ0CBUPCBUOBUSJVSFUJLBUBV
1 EJVSFUJLJOJBLBOEJCBIBTMFCJIUFSQFSJODJQBEB#BC
C
0 Rangkuman Sistem yang Terintegrasi dan
0 50 100 150
Multifaset untuk Pengaturan Tekanan Arteri
nalisis enga an ekanan a e i ada 4FLBSBOH UFMBI KFMBT CBIXB UFLBOBO BSUFSJ EJBUVS CVLBO IBOZB
i e ensi esensial ang idak sensi i ga am dan i e ensi PMFI TBUV TJTUFN QFOHFOEBMJ UFLBOBO BSUFSJ NFMBJOLBO PMFI
ang sensi i ga am igam a kem ali da i on oleman CFCFSBQB TJTUFN ZBOH TBMJOH UFSLBJU UJBQ TJTUFN NFNQVOZBJ
o ng dkk l l e lo g e loo e e
GVOHTJ ZBOH TQFTJGJL 4FCBHBJ DPOUPI CJMB TFTFPSBOH NFOHBMBNJ
o ol e e as i in da i e nn al
e ie o edi ine ole nn al e ie s QFSEBSBIBO IFCBU TFIJOHHB UFLBOBO EBSBIOZB UVSVO TFDBSB UJCB
l e ie og UJCB BEBEVBNBTBMBIZBOHBLBOEJIBEBQJPMFITJTUFNQFOHFOEBMJ
226
UFLBOBO 1FSUBNB VOUVL CFSUBIBO IJEVQ ZBJUV NFOHFNCBMJLBO UFSTFCVU BEBMBI

NFLBOJTNF VNQBO CBMJL CBSPSFTFQUPS

UFLBOBO BSUFSJ TFHFSB LF OJMBJ ZBOH DVLVQ UJOHHJ TFIJOHHB QBTJFO NFLBOJTNF JTLFNJL TJTUFN TBSBG QVTBU EBO
NFLBOJTNF
EBQBUCFSUBIBONFMBMVJNBTBBLVU,FEVBBEBMBINFOHFNCBMJLBO LFNPSFTFQUPS .FLBOJTNFNFLBOJTNF JOJ UJEBL IBOZB NVMBJ
WPMVNFEBSBIQBEBBLIJSOZBLFOJMBJOPSNBMOZB TFIJOHHBTJTUFN CFSFBLTJ EBMBN CFCFSBQB EFUJL UFUBQJ KVHB TBOHBULVBU 4FUFMBI
UNIT IV
TJSLVMBTJ EBQBU LFNCBMJ OPSNBM TFMVSVIOZB UFSNBTVL TFUJBQQFOVSVOBOUFLBOBOZBOHCFSMBOHTVOHBLVU TFQFSUJZBOH
QFOHFNCBMJBO UFLBOBO BSUFSJ TFQFOVIOZB LF OJMBJ OPSNBM UJEBL EJTFCBCLBO PMFI QFSEBSBIBO IFCBU NFLBOJTNF TBSBG
IBOZBLFNCBMJLFOJMBJUFLBOBOZBOHEJCVUVILBOVOUVLCFSUBIBO CFSLPNCJOBTJ
VOUVL NFOZFCBCLBO LPOTUSJLTJ WFOB EBO
IJEVQ USBOTGFS EBSBI LF EBMBN KBOUVOH
VOUVL NFOJNCVMLBO
1BEB#BC LJUBMJIBUCBIXBHBSJTQFSUBIBOBOQFSUBNBVOUVL QFOJOHLBUBO GSFLVFOTJ EFOZVU KBOUVOH EBO LPOUSBLUJMJUBT
NFOHIBEBQJ QFSVCBIBO BLVU QBEB UFLBOBO BSUFSJ BEBMBI TJTUFN KBOUVOH TFIJOHHB LBQBTJUBT QFNPNQBBO KBOUVOH MFCJI CFTBS
QFOHBUVSBO TBSBG 1BEB CBC JOJ LJUB UFMBI NFOFLBOLBO HBSJT EBO
VOUVLNFOJNCVMLBOLPOTUSJLTJTFCBHJBOCFTBSBOUFSJPMB
QFSUBIBOBOLFEVBZBOHEJQFSPMFIUFSVUBNBEBSJNFLBOJTNFHJOKBM QFSJGFS VOUVL NFOHIBMBOHJ BMJSBO EBSBI LFMVBS EBSJ BSUFSJPMB
VOUVL QFOHBUVSBO UFLBOBO BSUFSJ KBOHLB QBOKBOH 8BMBVQVO QFSJGFS TFNVB FGFL JOJ UFSKBEJ IBNQJS TFDBSB TFHFSB VOUVL
EFNJLJBO NBTJI BEB CBHJBOCBHJBO MBJO ZBOH NFMFOHLBQJ LFEVB NFOJOHLBULBOUFLBOBOBSUFSJLFNCBMJLFEBMBNTVSWJWBMSBOHF
HBSJT QFSUBIBOBO JOJ (BNCBS NFNCBOUV NFSBOHLVN #JMB UFLBOBO TFDBSB UJCBUJCB NFOJOHLBU UFSMBMV UJOHHJ
TFDBSBCFSTBNBTBNB TFQFSUJ ZBOH NVOHLJO UFSKBEJ QBEB SFTQPOT UFSIBEBQ USBOTGVTJ
(BNCBSNFNQFSMJIBULBOQFSLJSBBOSFTQPOTQFOHBUVSBO DFQBU EBSBI ZBOH CFSMFCJIBO NFLBOJTNF ZBOH TBNB CFLFSKB
ZBOH CFSMBOHTVOH TFHFSB CFCFSBQB EFUJL EBO NFOJU
EBO EBMBN EBMBN BSBI ZBOH CFSMBXBOBO VOUVL NFOHFNCBMJLBO UFLBOBO
KBOHLB QBOKBOH CFSKBNKBN EBO CFSIBSJIBSJ
ZBOH EJOZBUBLBO LFOPSNBM
TFCBHBJ IBTJM VNQBO CBMJL EBSJ EFMBQBO NFLBOJTNF QFOHBUVSBO Mekanisme Pengaturan Tekanan yang Bekerja
UFLBOBO BSUFSJ .FLBOJTNFNFLBOJTNF JOJ EBQBU EJCBHJ NFOKBEJ Setelah Bermenit-menit. #FCFSBQB NFLBOJTNF QFOHBUVSBO
UJHB LFMPNQPL
ZBOH CFSFBLTJ DFQBU EBMBN XBLUV CFCFSBQB UFLBOBO NFNCFSJ SFTQPOT ZBOH CFSNBLOB IBOZB TFUFMBI
EFUJL BUBV CFCFSBQB NFOJU
ZBOH NFNCFSJ SFTQPOT EBMBN CFCFSBQBNFOJUTFTVEBIUFSKBEJQFSVCBIBOUFLBOBOBSUFSJZBOH
QFSJPEF XBLUV TFEBOH TFMBNB CFSNFOJUNFOJU BUBV CFSKBNKBN CFSMBOHTVOH BLVU 5JHB SFTQPOT UFSTFCVU ZBOH EJQFSMJIBULBO
EBO
ZBOHNFNCFSJQFOHBUVSBOUFLBOBOBSUFSJKBOHLBQBOKBOH QBEB (BNCBS BEBMBI
NFLBOJTNF WBTPLPOTUSJLUPS
TFMBNB CFSIBSJIBSJ CFSCVMBOCVMBO EBO CFSUBIVOUBIVO .BSJ SFOJOBOHJPUFOTJO
SFMBLTBTJTUSFTQBEBTJTUFNTJSLVMBTJ EBO
LJUB MJIBU CBHBJNBOB LFUJHB NFLBOJTNF JOJ CFLFSKB TBNB TFCBHBJ
QFSHFTFSBO DBJSBO NFMBMVJ EJOEJOH LBQJMFS KBSJOHBO LF
TJTUFN ZBOH UFSJOUFHSBTJ VOUVL QFOHBUVSBO UFLBOBO TFDBSB EBMBN EBO LF MVBS TJSLVMBTJ VOUVL NFOZFTVBJLBO LFNCBMJ
NFOZFMVSVI WPMVNFEBSBITFCBHBJNBOBZBOHEJCVUVILBO
Mekanisme Pengaturan Tekanan yang Bekerja Cepat, ,JUBUFMBINFNCBIBTTFDBSBQBOKBOHMFCBSNFOHFOBJQFSBO
dalam Waktu Beberapa Detik atau Beberapa Menit. TJTUFN WBTPLPOTUSJLUPS SFOJOBOHJPUFOTJO VOUVL DBSB ZBOH
.FLBOJTNF QFOHBUVSBO UFLBOBO ZBOH CFLFSKB DFQBU IBNQJS TFNJBLVUEBMBNNFOJOHLBULBOUFLBOBOBSUFSJCJMBEJCVUVILBO
TFMVSVIOZB NFSVQBLBO SFGMFLT TBSBG BLVU BUBV SFTQPOT TBSBG .FLBOJTNF SFMBLTBTJTUSFT EJEFNPOTUSBTJLBO PMFI DPOUPI
MBJOOZB 1FSIBUJLBO QBEB (BNCBS UFSEBQBU UJHB NFLBOJTNF DPOUPI CFSJLVU #JMB UFLBOBO EBMBN QFNCVMVI EBSBI NFOKBEJ
ZBOHNFNQFSMJIBULBOSFTQPOTEBMBNCFCFSBQBEFUJL.FLBOJTNF UFSMBMV UJOHHJ QFNCVMVI EBSBI NFOKBEJ UFSFHBOH EBO UFSVT
asokons iksi enin angio ensin
MFCJI NFSFHBOH MBHJ TFMBNB CFSNFOJUNFOJU BUBV CFSKBNKBN
§
BLJCBUOZB UFLBOBOEBMBNQFNCVMVIUVSVOLFNCBMJLFOPSNBM
1FSFHBOHBO QFNCVMVI EBSBI TFDBSB UFSVTNFOFSVT JOJ ZBOH
ada ekanan saa ini
EJTFCVUSFMBLTBTJTUSFT EBQBUCFSUJOEBLTFCBHBJCVGFSUFLBOBO
nan
da a
es o
EBMBNKBOHLBXBLUVTFEBOH
an eka
11 ns i
s ke
10 m .FLBOJTNF QFSHFTFSBO DBJSBO LBQJMFS IBOZB CFSBSUJ TFUJBQ
ol me
ik
9 LBMJUFLBOBOLBQJMFSUVSVOUFSMBMVSFOEBI DBJSBOEJBCTPSCTJEBSJ
8 KBSJOHBO NFMBMVJ NFNCSBO LBQJMFS EBO LF EBMBN TJSLVMBTJ
enga
a o ese o
ginjal
7 TFIJOHHB NFNQFSCBOZBL WPMVNF EBSBI EBO NFOJOHLBULBO

6
UFLBOBO EBMBN TJSLVMBTJ 4FCBMJLOZB CJMB UFLBOBO LBQJMFS
5
a aan ak
4
emo ese
n
NFOJOHLBU UFSMBMV UJOHHJ DBJSBO IJMBOH LFMVBS EBSJ TJSLVMBTJ
o
seo NBTVLLFEBMBNKBSJOHBO TFIJOHHBNFOVSVOLBOWPMVNFEBSBI
3 an Aldo
s ess se EBOKVHBTFMVSVIUFLBOBOEJTFMVSVITJSLVMBTJTFDBSBCFSNBLOB
2 asi ge n
ks e
1 ela ile a ,FUJHB NFLBOJTNF KBOHLB TFEBOH JOJ UFSBLUJWBTJ EBMBN
ai
e
ap
0 XBLUV NFOJU TBNQBJ CFCFSBQB KBN 4FMBNB XBLUV JOJ
0 15 30 1 2 4 8 1632 1 2 4 816 1 2 4 8 16 §
NFLBOJTNF TBSBG LFMFMBIBO EBO NFOKBEJ TFNBLJO LVSBOH
e ik eni am Ha i FGFLUJG ZBOHNFOKFMBTLBOQFOUJOHOZBDBSBQFOHBUVSBOUFLBOBO
OPOTBSBGZBOHCFSMBOHTVOHEBMBNKBOHLBXBLUVTFEBOHJOJ
Mekanisme Pengaturan Tekanan Arteri Jangka
Panjang. 5VKVBOBLIJSCBCJOJNFOKFMBTLBOQFSBOHJOKBMQBEB
QFOHBUVSBOUFLBOBOBSUFSJKBOHLBQBOKBOH#BHJBOZBOHQBMJOH
LBOBO QBEB (BNCBS NFNQFSMJIBULBO NFLBOJTNF
QFOHBUVSBOUFLBOBOWPMVNFEBSBIEJHJOKBM ZBOHTBNBEFOHBO
227
Unit IV Sirkulasi
QFOHBUVSBO UFLBOBO DBJSBO UVCVI HJOKBM

ZBOH NFOVOKVLLBO .FLBOJTNF KBOHLB QBOKBOH JOJ LFNVEJBO NFOJNCVMLBO
NFLBOJTNFJOJNFNFSMVLBOXBLUVCFCFSBQBKBNVOUVLNVMBJ CFSCBHBJ JOUFSBLTJ QBEB TJTUFN SFOJOBOHJPUFOTJOBMEPTUFSPO
NFNCFSJLBO SFTQPOT ZBOH CFSNBLOB 8BMBVQVO EFNJLJBO TJTUFN TBSBG EBO CFCFSBQB GBLUPS MBJO ZBOH NFNCFSJLBO
QBEBBLIJNZBNFLBOJTNFJOJNFOHIBTJMLBOIBTJMVNQBOCBMJL LFNBNQVBO QFOHBUVSBO UFLBOBO EBSBI LIVTVT VOUVL UVKVBO
VOUVL QFOHBUVSBO UFLBOBO BSUFSJ ZBOH IBNQJS UJEBL UFSCBUBT ZBOHLIVTVTQVMB
)BM JOJ CFSBSUJ NFLBOJTNF UFSTFCVU QBEB BLIJSOZB EBQBU
NFOHFNCBMJLBO UFLBOBO BSUFSJ IBNQJS TFQFOVIOZB UJEBL
Daftar Pustaka
IBOZB NFOHFNCBMJLBO TFCBHJBO LF UJOHLBU UFLBOBO ZBOH
NFOHIBTJMLBOLFMVBSBOHBSBNEBOBJSZBOHOPSNBMPMFIHJOKBM Chobanian AV, Bakris GL, Black HR, et al: Joint National Committee on
Prevention, Detection, Evaluation, and Treatment of High Blood Pressure.
4FLBSBOH QFNCBDB IFOEBLOZB TVEBI NFOHFOBM LPOTFQ JOJ National High Blood Pressure Education Program Coordinating Committee.
ZBOHNFSVQBLBOQPLPLCBIBTBOVUBNBCBCJOJ Seventh Report of the Joint National Committee on pre-vention, detection,
#BOZBL GBLUPS ZBOH EBQBU NFNFOHBSVIJ UJOHLBU evaluation, and treatment of high blood pressure, Hypertension 42:1206, 2003.
QFOHBUVSBO UFLBOBO EBSJ NFLBOJTNF DBJSBO UVCVI HJOKBM Coffman TM, Crowley SD: Kidney in hypertension: Guyton redux,
4BMBITBUVOZB ZBOHEJQFSMJIBULBOQBEB(BNCBS BEBMBI Hypertension 51:811, 2008.
Cowley AW Jr: Long-term control of arterial blood pressure, Physiol Rev
BMEPTUFSPO 1FOVSVOBO UFLBOBO BSUFSJ NFOZFCBCLBO
72:231, 1992.
QFOJOHLBUBO TFLSFTJ BMEPTUFSPO EBMBN CFCFSBQB NFOJU EBO Guyton AC: Arterial pressure and hypertension, Philadelphia, 1980, WB
TFMBNB CFCFSBQB KBN BUBV IBSJ LFNVEJBO IBM JOJ CFSQFSBO Saunders.
QFOUJOH EBMBN NFNPEJGJLBTJ DJSJ LIBT QFOHBUVSBO UFLBOBO Guyton AC: Blood pressure control—special role of the kidneys and body
ZBOHEJMBLVLBOPMFINFLBOJTNFDBJSBOUVCVIHJOKBM fluids, Science 252:1813, 1991.
Hall JE: The kidney, hypertension, and obesity, Hypertension 41:625, 2003. Hall
)BM ZBOH TBOHBU QFOUJOH BEBMBI JOUFSBLTJ BOUBSB TJTUFN JE, Brands MW, Henegar JR: Angiotensin II and long-term arterial
SFOJOBOHJPUFOTJO EFOHBO NFLBOJTNF DBJSBO HJOKBM 4FCBHBJ pressure regulation: the overriding dominance of the kidney, J Am Soc
DPOUPI BTVQBO HBSBN TFTFPSBOH TBOHBU CFSWBSJBTJ TFUJBQ Nephrol 10(Suppl 12):S258, 1999.
IBSJOZB,JUBUFMBINFMJIBUEBMBNCBCJOJCBIXBBTVQBOHBSBN Hall JE, Granger JP, Hall ME, et al: Pathophysiology of hypertension. In
EBQBU NFOVSVO NFODBQBJ TFQFSTFQVMVI OPSNBM BUBV EBQBU Fuster V, O’Rourke RA, Walsh RA, et al, eds.: Hurst’s The Heart, ed 12,
New York, 2008, McGraw-Hill Medical, pp 1570.
NFOJOHLBU TBNQBJ IJOHHB LBMJ OPSNBM EBO XBMBVQVO
Hall JE, da Silva AA, Brandon E, et al: Pathophysiology of obesity hyperten-
CFHJUV UJOHLBU QFOHBUVSBO UFSIBEBQ UFLBOBO BSUFSJ SBUBSBUB sion and target organ injury. In Lip GYP, Hall JE, eds.: Comprehensive
IBOZB BLBO CFSVCBI CFCFSBQB NN )H TBKB KJLB TJTUFN SFOJO Hypertension, New York, 2007, Elsevier, pp 447.
BOHJPUFOTJOBMEPTUFOPO CFLFSKB TFNQVSOB 5FUBQJ UBOQB LaMarca BD, Gilbert J, Granger JP: Recent progress toward the under-
TJTUFNSFOJOBOHJPUFOTJOBMEPTUFOPOZBOHGVOHTJPOBM UFLBOBO standing of the pathophysiology of hypertension during preeclampsia,
EBSBI NFOKBEJ TBOHBU TFOTJUJG UFSIBEBQ QFSVCBIBO BTVQBO
Lohmeier TE, Hildebrandt DA, Warren S, et al: Recent insights into the inter-
HBSBN actions between the baroreflex and the kidneys in hypertension, Am J
+BEJ QFOHBUVSBOUFLBOBOBSUFSJEJNVMBJEFOHBOQFOHBUVSBO Physiol Regul Integr Comp Physiol 288:R828, 2005.
UFLBOBO PMFI TBSBG VOUVL NFODBQBJ UJOHLBU ZBOH CFSTJGBU Oparil S, Zaman MA, Calhoun DA: Pathogenesis of hypertension, Ann Intern
NFOZFMBNBULBO KJXB LFNVEJBO EJUFSVTLBO EFOHBO TJGBUTJGBU Med 139:761, 2003.
Reckelhoff JF, Fortepiani LA: Novel mechanisms responsible for postmeno-
LIBT QFOHBUVSBO UFLBOBO KBOHLB TFEBOH EBO BLIJSOZB pausal hypertension, Hypertension 43:918, 2004.
EJTUBCJMLBO QBEB UJOHLBU UFLBOBO KBOHLB QBOKBOH PMFI Rossier BC, Schild L: Epithelial sodium channel: mendelian versus essential
NFLBOJTNFDBJSBOUVCVIHJOKBM hypertension, Hypertension 52:595, 2008.
228
BAB 20
UNIT IV
$VSBI+BOUVOH "MJSBO#BMJL
7FOB EBO1FOHBUVSBOOZB
$VSBIKBOUVOHBEBMBIKVNMBIEBSBI Pengaruh Usia terhadap Curah Jantung. (BNCBS
ZBOHEJQPNQBLFEBMBSOBPSUBPMFI NFNQFSMJIBULBO DVSBI KBOUVOH ZBOH EJOZBUBLBO
KBOUVOH TFUJBQ NFOJU +VHB TFCBHBJJOEFLTKBOUVOHQBEBCFSCBHBJVNVS5BNQBLJOEFLT
NFSVQBLBO KVNMBI EBSBI ZBOH KBOUVOHNFOJOHLBUDFQBUTBNQBJOJMBJZBOHNFMBNQBVJ-
NFOHBMJS NFMBMVJ TJSLVMBTJ $VSBI NFOJUNQBEBVTJBUBIVO EBOLFJOVEJBOUVSVOTBNQBJ
KBOUVOH NFSVQBLBO TBMBI TBUV TFLJUBS -NFOJUN QBEB VTJB UBIVO ,JUB BLBO
GBLUPSUFSQFOUJOHZBOHIBSVTLJUB KFMBTLBO MFCJI MBOKVU EJ CBC JOJ CBIXB QFOHBUVSBO DVSBI
QFSUJNCBOHLBO EBMBN IVCVOHBOOZB EFOHBO TJSLVMBTJ LBSFOB KBOUVOHTFQBOKBOHIJEVQIBNQJSTFDBSBMBOHTVOHTFCBOEJOH
NFSVQBLBO KVNMBI BMJSBO EBSBI NFOVKV LF TFMVSVI KBSJOHBO EFOHBOTFMVSVIBLUJWJUBTNFUBCPMJLUVCVI0MFILBSFOBJUV
UVCVI QFOVSVOBO JOEFLT KBOUVOH BEBMBI QFUVOKVL BEBOZB
QFOVSVOBO BLUJWJUBT BUBV QFOVSVOBO NBTTB PUPU TFJSJOH
"MJSBO CBMJL WFOB BEBMBI KVNMBI EBSBI ZBOH NFOHBMJS EBSJ EFOHBOVTJB
CFSCBHBJ WFOB LF EBMBN BUSJVN LBOBO TFUJBQ NFOJU "MJSBO
CBMJL WFOB EBO DVSBI KBOUVOH IBSVT TFUBSB TBUV TBNB MBJO
LFDVBMJ VOUVL CFCFSBQB EFOZVU KBOUVOH QBEB XBLUV EBSBI
Pengaturan Curah Jantung oleh Aliran Balik
VOUVL TFNFOUBSB EJTJNQBO BUBV EJLFMVBSLBO EBSJ KBOUVOH EBO
Vena—Peran Mekanisme Frank-Starling pada
QBSV
Jantung
#JMB LJUB NFOZBUBLBO CBIXB DVSBI KBOUVOH EJBUVS PMFI BMJSBO
Nilai Normal Curah Jantung Saat Istirahat dan CBMJL WFOB ZBOH EJNBLTVE BEBMBI CVLBO KBOUVOH JUV TFOEJSJ
Selama Beraktivitas ZBOH OPSNBMOZB CFSUJOEBL TFCBHBJ QFOHBUVS VUBNB DVSBI
KBOUVOH NFMBJOLBO UFSEBQBU CFSCBHBJ GBLUPS TJSLVMBTJ QFSJGFS
$VSBI KBOUVOH TBOHBU CFSWBSJBTJ CFSHBOUVOH QBEB UJOHLBU ZBOHNFNFOHBSVIJBMJSBOEBSBILFEBMBNKBOUVOHZBOHCFSBTBM
BLUJWJUBT UVCVI 'BLUPSGBLUPS CFSJLVU JOJ BOUBSB MBJO EBSJ WFOB ZBOH EJTFCVU BMJSBO CBMJL WFOB ZBOH NFSVQBLBO
NFSOFOHBSVIJ DVSBI KBOUVOH TFDBSB MBOHTVOH
NFUBCPMJTNF QFOHBUVSVUBNB
CBTBM UVCVI
BQBLBI PSBOH UFSTFCVU TFEBOH NFMBLVLBO LFSKB "MBTBO VUBNB NFOHBQB GBLUPSGBLUPS QFSJGFS CJBTBOZB MFCJI
GJTJL
VTJB EBO
VLVSBOUVCVI QFOUJOH EBSJQBEB KBOUVOH JUV TFOEJSJ EBMBN NFOHBUVS DVSBI
6OUVLTFPSBOHMBLJMBLJEFXBTBNVEBZBOHTFIBUCFTBSDVSBI KBOUVOH BEBMBI LBSFOB KBOUVOH NFNJMJLJ NFLBOJTNF EJ EBMBN
KBOUVOH SBUBSBUB TBBU JTUJSBIBU TFLJUBS - NFOJU 6OUVL KBOUVOH JUV TFOEJSJ ZBOH CJBTBOZB NFNVOHLJOLBO KBOUVOH
XBOJUB OJMBJ JOJ TFLJUBS -NFOJU #JMB LJUB KVHB VOUVL NFNPNQB TFDBSB PUPNBUJT CFSBQBQVO KVNMBI EBSBI
NFNQFSUJNCBOHLBO GBLUPS VTJB LBSFOB EFOHBO NFOJOHLBUOZB ZBOH NFOHBMJS LF EBMBN BUSJXO LBOBO ZBOH CFSBTBM EBO WFOB
VTJB BLUJWJUBTUVCVIEBONBTTBCFCFSBQBKBSJOHBO NJTBMOZBPUPU .FLBOJTNF JOJ ZBOH EJTFCVU IVLVN 'SBOL4UBSMJOH QBEB
SBOHLB
CFSLVSBOH CFTBS DVSBI KBOUVOH SBUBSBUB TBBU JTUJSBIBU KBOUVOH EJCBIBT EJ #BC 1BEB EBTBSOZB IVLVN UFSTFCVU
VOUVL PSBOH EFXBTB EBMBN BOHLB ZBOH EJCVMBULBO TFSJOH LBMJ NFOZBUBLBO CBIXB CJMB KVNMBI EBSBI ZBOH NFOHBMJS LF EBMBN
EJUFUBQLBOTFLJUBS-NFOJU KBOUVOH NFOHBMBNJ QFOJOHLBUBO IBM JOJ BLBO NFSFHBOHLBO
Indeks Jantung EJOEJOH SPOHHB KBOUVOH "LJCBU EBSJ QFSFHBOHBO JOJ PUPU
1FOFMJUJBO UFMBI NFOVOKVLLBO CBIXB DVSBI KBOUVOH KBOUVOH BLBO CFSLPOUSBLTJ EFOHBO LFLVBUBO ZBOH MFCJI CFTBS
NFOJOHLBULJSBLJSBTFCBOEJOHEFOHBOMVBTQFSNVLBBOUVCVI EBO BLBO NFOHPTPOHLBO EBSBI UBNCBIBO ZBOH UFMBI NBTVL
0MFI LBSFOB JUV DVSBI KBOUVOH TFSJOH EJOZBUBLBO EFOHBO EBSJTJSLVMBTJTJTUFNJL0MFILBSFOBJUV EBSBIZBOHNFOHBMJSLF
JTUJMBI JOEFLT KBOUVOH ZBJUV DVSBI KBOUVOH QFS NFUFS QFSTFHJ EBMBNKBOUVOHTFDBSBPUPNBUJTBLBOEJQPNQBUBOQBQFOVOEBBO
MVBT QFSNVLBBO UVCVI .BOVTJB OPSNBM EFOHBO CFSBU CBEBO LFEBMBNBPSUBEBOLFNVEJBONFOHBMJSMBHJNFMBMVJTJSLVMBTJ
LH NFNQVOZBJ MVBT QFSNVLBBO UVCVI LJSBLJSB NFUFS 'BLUPS QFOUJOH MBJOOZB ZBOH UFMBI EJCBIBT EJ #BC
QFSTFHJ ZBOH CFSBSUJ CBIXB JOEFLT KBOUVOH SBUBSBUB OPSNBM BEBMBI QFSFHBOHBO KBOUVOH BLBO NFOZFCBCLBO KBOUVOH
QBEB PSBOH EFXBTB LJSBLJSB -NFOJUN MVBT QFNVLBBO NFNPNQBMFCJIDFQBUQBEBGSFLVFOTJEFOZVUKBOUVOHZBOHMF
UVCVI
229
Unit IV Sirkulasi
4FCBHBJLFTJNQVMBO DVSBIKBOUVOHUFSVUBNBEJUFOUVLBOPMFI
QFOKVNMBIBO CFSCBHBJ GBLUPS EJ TFMVSVI UVCVI ZBOH NFOHBUVS
BMJSBO EBSBI MPLBM 4FNVB BMJSBO EBSBI MPLBM CFSLVNQVM
NFNCFOUVL BMJSBO CBMJL WFOB EBO KBOUVOH TFDBSB PUPNBUJT
NFNPNQB EBSBI ZBOH CBMJL JOJ VOUVL EJLFNCBMJLBO LF EBMBN
CJIUJOHHJ+BEJ QFSFHBOHBOOPEVTTJOVTQBEBEJOEJOHBUSJVN BSUFSJEBONFOHBMJSNFOHFMJMJOHJTJTUFNMBHJ
LBOBO CFSQFOHBSVI MBOHTVOH UFSIBEBQ JSBNB OPEVT JUV
TFOEJSJ VOUVL NFOJOHLBULBO GSFLVFOTJ KBOUVOH TFCBOZBL Pengaruh Tahanan Perifer Total terhadap Tingkat Curah
TBNQBJ QFSTFO 4FMBJO JUV BUSJVN LBOBO ZBOH UFSFHBOH Jantung Jangka Panjang. (BNCBS TBNB TFQFSUJ (BNCBS
BLBO NFNJDV SFGMFLT TBSBG ZBOH EJTFCVU SFGMFLT #BJOCSJEHF (BNCBS JOJ EJVMBOH EJ TJOJ VOUVL NFOHJMVTUSBTJLBO QSJOTJQ
ZBOH NVMBNVMB CFSKBMBO LF QVTBU WBTPNPUPS EJ PUBL EBO ZBOH TBOHBU QFOUJOH EBMBN QFOHBUVSBO DVSBI KBOUVOH 1BEB
LFNVEJBOLFNCBMJLFKBOUVOHNFMBMVJTBSBGTJNQBUJTEBOTBSBG CFSCBHBJ LFBEBBO OJMBJ DVSBI KBOUVOH KBOHLB QBOKBOH CFSWBSJBTJ
WBHVTVOUVLNFOJOHLBULBOGSFLVFOTJKBOUVOH TFDBSB UFSCBMJL EFOHBO QFSVCBIBO UBIBOBO QFSJGFS UPUBM TFMBNB
1BEB LPOEJTJ ZBOH QBMJOH SUPSNBM UBOQB EJTFSUBJ TUSFT UFLBOBO BSUFSJ UJEBL CFSVCBI 1FSIBUJLBO QBEB (BNCBS
DVSBI KBOUVOH EJBUVS IBNQJS TFMVSVIOZB PMFI GBLUPS QFSJGFS CBIXB CJMB UBIBOBO QFSJGFS UPUBM UFQBU OPSNBM QBEB UBOEB
ZBOHNFOFOUVLBOBMJSBOCBMJLWFOB/BNVO LJUBBLBOCBIBT QFSTFOEBMBNHBNCBS

MFCJI MBOKVU EJ CBC JOJ CBIXB CJMB EBSBI ZBOH LFNCBMJ MFCJI
CBOZBL EBSJQBEB ZBOH EBQBU EJQPNQB PMFI KBOUVOH NBLB
KBOUVOH LFNVEJBO NFOKBEJ GBLUPS QFNCBUBT ZBOH
NFOFOUVLBODVSBIKBOUVOH
Pengaturan Curah Jantung merupakan Penjumlahan

Pengaturan Aliran Darah di Seluruh Jaringan Tubuh
Lokal—Metabolisme Jaringan Mengatur Sebagian
BesarAliran Darah Lokal
"MJSBO CBMJL WFOB LF KBOUVOH BEBMBI QFOKVNMBIBO TFMVSVI
BMJSBOEBSBIMPLBMZBOHNFMBMVJTFMVSVITFHNFOKBSJOHBOQBEB
TJSLVMBTJ QFSJGFS 0MFI LBSFOB JUV EBQBU EJOZBUBLBO CBIXB
QFOHBUVSBO DVSBI KBOUVOH BEBMBI QFOKVNMBIBO TFMVSVI
QFOHBUVSBOBMJSBOEBSBIMPLBM
.FLBOJTNF QFOHBUVSBO BMJSBO EBSBI MPLBM EJCBIBT EJ #BC
%J TFCBHJBO CFTBS KBSJOHBO BMJSBO EBSBI UFSVUBNB
NFOJOHLBU TFCBOEJOH EFOHBO NB TJOHNBTJOH NFUBCPMJTNF
KBSJOHBO UFSTFCVU 4FCBHBJ DPOUPI BMJSBO EBSBI MPLBM IBNQJS
TFMBMV NFOJOHLBU CJMB LPOTVNTJ PLTJHFO KBSJOHBO KVHB
NFOJOHLBU FGFL JOJ EJQFSMJIBULBO QBEB (BNCBS VOUVL
CFSCBHBJ UJOHLBU LFSKB GJTJL 1FSIBUJLBO CBIXB TFUJBQ
QFOJOHLBUBO IBTJM LFMVBSBO PVUQVU
TFMBNB LFSKB GJTJL
LPOTVNTJ PLTJHFO EBO DVSBI KBOUVOH NFOJOHLBU EBMBN
KVNMBIZBOHTFCBOEJOH
230
Bab 20 Curah Jantung, Aliran Balik Vena, dan Pengaturannya
DVSBI KBOUVOH KVHB OPSNBM ,FNVEJBO CJMB UBIBOBO QFSJGFS UPUBM Faktor-Faktor yang Menyebabkan Jantung Hiperefektif
NFOJOHLBU EJ BUBT OPSNBM DVSBI KBOUVOH NFOVSVO TFCBMJLOZB %VBGBLUPSZBOHEBQBUNFNCVBUKBOUVOHNFNPNQBMFCJICBJL
CJMB UBIBOBO QFSJGFS UPUBM NFOVSVO DVSBI KBOUVOH NFOJOHLBU EBSJQBEBOPSNBM
QFSBOHTBOHBOTBSBGEBO
IJQFSUSPGJPUPU
* JUB EFOHBO NVEBI EBQBU NFNBIBNJ IBM JOJ EFOHBO NFOHJOHBU KBOUVOH
UNIT IV
LFNCBMJTBMBITBUVCFOUVLIVLVN0IN TFQFSUJZBOHEJOZBUBLBO Pengaruh Perangsangan Saraf terhadap Peningkatan
EJ#BC 1PNQB+BOUVOH%J#BC LJUBMJIBUCBIXBLPNCJOBTJEBSJ

Tekanan Arteri QFSBOHTBOHBO TJNQBUJT EBO
QFOHIBNCBUBO QBSBTJNQBUJT
Curah Jantung =
Tahanan Perifer Total BEBMBI EVB IBM ZBOH NFOJOHLBULBO FGFLUJWJUBT QPNQB KBOUVOH

IBM JOJ BLBO TBOHBU NFOJOHLBULBO GSFLVFOTJ KBOUVOH
"SUJEBSJSVNVTJOJEBO(BNCBSBEBMBITFCBHBJCFSJLVU
LBEBOHLBEBOH QBEB PSBOH NVEB NVMBJ EBSJ OJMBJ OPSNBM
4FUJBQ LBMJ OJMBJ UBIBOBO QFSJGFS UPUBM KBOHLB QBOKBOH CFSVCBI
EFOZVUNFOJU TBNQBJ EFOHBO IJOHHB EFOZVUNFOJU
UFUBQJ GVOHTJ TJSLVMBTJ MBJOOZB UJEBL CFSVCBI
CFTBS DVSBI
EBO
NFOJOHLBULBO LFLVBUBO LPOUSBLTJ KBOUVOH ZBOH
KBOUVOHBLBOCFSVCBIUFQBULFBSBIZBOHCFSMBXBOBO
EJTFCVUQFOJOHLBUBOLPOUSBLUJMJUBT
TBNQBJEVBLBMJLFLVBUBO
OPSNBMOZB %FOHBO NFOHHBCVOHLBO LFEVB FGFL JOJ
Jantung Memiliki Keterbatasan untuk Menghasilkan Curah
QFSBOHTBOHBO NBLTJNBM TBSBG QBEB KBOUVOH EBQBU
Jantung yang Dapat Dicapai
NFOJOHLBULBO OJMBJ HBSJT NFOEBUBS EBSJ LVSWB DVSBI KBOUVOH
TBNQBJIBNQJSEVBLBMJOJMBJHBSJTNFOEBUBSEBSJLVSWBOPSNBM
/ZBUB BEB LFUFSCBUBTBO NFOHFOBJ KVNMBI EBSBI ZBOH EBQBU
TFQFSUJ ZBOH EJQFSMJIBULBO PMFI OJMBJ -NFOJU QBEB LVSWB
EJQPNQB PMFI KBOUVOH ZBOH CBOZBLOZB EBQBU EJOZBUBLBO EBMBN
QBMJOHBUBT(BNCBS
CFOUVLLVSWBDVSBIKBOUVOH
(BNCBS NFNQFSMJIBULBO LVSWB DVSBI KBOUVOH OPSNBM
Peningkatan Efektivitas Pemompaan yang Disebabkan
NFOVOKVLLBODVSBIKBOUVOHQFSNFOJUQBEBTFUJBQOJMBJUFLBOBO oleh Hipertrofi Jantung. 1FOJOHLBUBO CFCBO LFSKB KBOHLB
BUSJVNLBOBO*OJBEBMBITBMBITBUVUJQFLVSWBGVOHTJKBOUVOHZBOH QBOKBOH UFUBQJ UJEBL TBNQBJ CFSMFCJIBO IJOHHB EBQBU NFSVTBL
EJCBIBT EJ #BC 1FSIBUJLBO CBIXB OJMBJ QBEB HBSJT NFOEBUBS KBOUVOH NFOZFCBCLBO NBTTB EBO LFLVBUBO LPOUSBLUJM PUPU
LVSWBDVSBIKBOUVOHOPSNBMJOJTFLJUBS-NFOJU ZBJUV LBMJ KBOUVOH NFOJOHLBU EFOHBO DBSB ZBOH TBNB TFQFSUJ LFSKB GJTJL
DVSBI KBOUVOH OPSNBM ZBOH CFTBSOZB TFLJUBS -NFOJU )BM JOJ CFSBU NFOZFCBCLBO PUPU SBOHLB NFOKBEJ IJQFSUSPGJ 4FCBHBJ
CFSBSUJ CBIXB KBOUVOH NBOVTJB OPSNBM ZBOH CFSGVOHTJ UBOQB DPOUPI VNVNOZB QBEB KBOUVOH TFPSBOH QFMBSJ NBSBUPO
QFSBOHTBOHBO TBSBG LIVTVT BQB QVO EBQBU NFNPNQB TFKVNMBI UFSEBQBU QFOJOHLBUBO NBTTB TFCFTBS IJOHHB QFSTFO
BMJSBOCBMJLWFOBTBNQBJTFLJUBS LBMJBMJSBOCBMJLWFOBOPSNBM LFBEBBO JOJ BLBO NFOJOHLBULBO OJMBJ HBSJT NFOEBUBS QBEB
TFCFMVN KBOUVOH NFOKBEJ GBLUPS QFNCBUBT EBMBN QFOHBUVSBO LVSWBDVSBIKBOUVOH LBEBOHLBEBOHTBNQBJQFSTFO EBO
DVSBIKBOUVOH PMFILBSFOBJUVNFNVOHLJOLBOKBOUVOHVOUVLNFNPNQBKBVI
MFCJICBOZBLEBSBIEBSJQBEBKVNMBIDVSBIKBOUVOHZBOHCJBTB
%JQFSMJIBULBO QBEB (BNCBS BEBMBI CFCFSBQB LVSWB #JMB LJUB NFOHHBCVOHLBO QFSBOHTBOHBO TBSBG KBOUVOH
DVSBI KBOUVOH MBJO VOUVL KBOUVOH ZBOH UJEBL EBQBU NFNPNQB EFOHBO IJQFSUSPGJ TFQFSUJ ZBOH UFSKBEJ QBEB QFMBSJ NBSBUPO
TFDBSB OPSNBM ,VSWB ZBOH QBMJOH BUBT BEBMBI VOUVL KBOUVOH NBLB QFOHBSVIOZB NFNVOHLJOLBO KBOUVOH VOUVL NFNPNQB
IJQFSFGFLJGZBOHNFNPNQBMFCJILVBUEBSJQBEBOPSNBM,VSWB TBNQBJ -NFOJU TFLJUBS LBMJ UJOHLBU ZBOH EBQBU
ZBOH QBMJOH CBXBI BEBMBI VOUVL KBOUVOH IJQPFGFLUJG ZBOH EJDBQBJ SBUBSBUB PSBOH LFOBJLBO UJOHLBU QFNPNQBBO JOJ
LFLVBUBOQFNPNQBBOOZBEJCBXBIOPSNBM NFSVQBLBO TBMBI TBUV GBLUPS UFSQFOUJOH ZBOH NFOFOUVLBI
XBLUVMBSJTFPSBOHQFMBSJ
Faktor-Faktor yang Menyebabkan Jantung Hipoefektif

4FUJBQ GBLUPS ZBOH NFOVSVOLBO LFNBNQVBO KBOUVOH VOUVL
NFNPNQBEBSBIEBQBUNFOZFCBCLBOIJQPFGFLUJWJUBT#FCFSBQB
GBLUPSUFSTFCVUBEBMBITFCBHBJCFSJLVU
t 1FOJOHLBUBOUFLBOBOBSUFSJZBOHIBSVTEJMBXBOPMFIQPNQB
KBOUVOH TFQFSUJIJQFSUFOTJ
t 1FOHIBNCBUBOQFSBOHTBOHBOTBSBGKBOUVOH
t 'BLUPSGBLUPSQBUPMPHJTZBOHNFOZFCBCLBOJSBNBBUBV
GSFLVFOTJEFOZVUKBOUVOHZBOHBCOPSNBM
t 4VNCBUBOBSUFSJLPSPOBSJB NFOZFCBCLBOTFSBOHBOKBOUVOH
t 1FOZBLJULBUVQKBOUVOH

t 1FOZBLJUKBOUVOHLPOHFOJUBM
t .JPLBSEJUJT QFSBEBOHBOPUPUKBOUVOH
t )JQPLTJBKBOUVOH
231
Unit IV Sirkulasi
Peran Sistem Saraf dalam Mengatur Curah Jantung NFOZFCBCLBO SFMBLTBTJ BSUFSJPM PUPU TFIJOHHB NFNVOHLJOLBO
UFSQFOVIJOZB PLTJHFO EBO OVUSJTJ ZBOH DVLVQ VOUVL NFN
Makna Penting Sistem Saraf dalam Mempertahankan QFSUBIBOLBO LPOUSBLTJ PUPU +FMBTMBI CBIXB IBM JOJ BLBO TBOHBU
Tekanan Arteri Bila Pembuluh Darah Perifer Berdilatasi NFOVSVOLBOUBIBOBOQFSJGFSUPUBM ZBOHTFDBSBOPSNBMKVHBBLBO
dan Aliran Balik Vena serta Curah Jantung Meningkat NFOVSVOLBO UFLBOBO BSUFSJ /BNVO TJTUFN TBSBG BLBO TFHFSB
NFMBLVLBO LPNQFOTBTJ "LUJWJUBT PUBL ZBOH TBNB ZBOH
NFOHJSJNLBO TJOZBM NPUPSJL LF PUPU KVHB NFOHJSJNLBO TJOZBM
(BNCBS NFNQFSMJIBULBO QFSCFEBBO QFOUJOH QBEB TFDBSBTFSFOUBLLFEBMBNQVTBUTBSBGPUPOPNVOUVLNFSBOHTBOH
QFOHBUVSBO DVSBI KBOUVOH EFOHBO NBVQVO UBOQB GVOHTJ BLUJWJUBT TJSLVMBTJ TFIJOHHB NFOZFCBCLBO LPOTUSJLTJ WFOB CFTBS
TJTUFNTBSBGPUPOPN,VSWBEFOHBOHBSJTVUVINFNQFSUBIBO NFOJOHLBULBO GSFLVFOTJ KBOUVOH EBO NFOJOHLBULBO LPOUSBL
LBO QFOHBSVI QBEB BOKJOH OPSNBM ZBOH NFOHBMBNJ EJMBUBTJ UJMJUBTKBOUVOH4FNVBQFSVCBIBOJOJCFLFSKBCFSTBNBTBNBVOUVL
IFCBUQBEBQFNCVMVIEBSBIQFSJGFSOZBBLJCBUQFNCFSJBOPCBU NFOJOHLBULBO UFLBOBO BSUFSJ EJ BUBT OPSSOBM ZBOH LFNVEJBO
EJOJUSPGFOPM ZBOH NFOJOHLBULBO NFUBCPMJTNF EJ TFMVSVI NFOEPSPOHMFCJICBOZBLBMJSBOEBSBINFMBMVJPUPUZBOHBLUJG
KBSJOHBO UVCVI TFLJUBS FNQBU LBMJ MJQBU 1FSIBUJLBO CBIXB
QFOHBUVSBO TBSBG EBQBU NFNQFSUBIBOLBO UFLBOBO BSUFSJ BHBS ,FTJNQVMBOOZB CJMBQFNCVMVIEBSBIKBSJOHBOMPLBMCFSEJMBUBTJ
UJEBL NFOVSVO TFIJOHHB EJMBUBTJ TFMVSVI QFNCVMVI EBSBI EBO EFOHBO EFNJLJBO BLBO NFOJOHLBULBO BMJSBO CBMJL WFOB EBO
QFSJGFS IBNQJS UJEBL NFOZFCBCLBO QFSVCBIBO QBEB UFLBOBO DVSBI KBOUVOH EJ BUBT OPSNBM TJTUFN TBSBG CFSQFSBO TBOHBU
BSUFSJ UFUBQJ NFOJOHLBULBO DVSBI KBOUVOH IBNQJS FNQBU LBMJ QFOUJOHEBMBNNFODFHBIQFOVSVOBOUFLBOBOBSUFSJLFOJMBJZBOH
MJQBU /BNVO TFUFMBI QFOHBUVSBO PUPOPNJL TJTUFN TBSBG TBOHBUSFOEBI1BEBLFOZBUBBOOZB TFMBNBLFSKBGJTJL TJTUFNTBSBG
EJIBNCBU SFGMFLT TJSLVMBTJ OPSNBM VOUVL NFNQFSUBIBOLBO UFSVT CFLFSKB NFOZFEJBLBO TJOZBM UBNCBIBO VOUVL NFOJOHLBU
UFLBOBO BSUFSJ UJEBL EBQBU CFSGVOHTJ 7BTPEJMBUBTJ QFNCVMVI LBO UFLBOBO BSUFSJ IJOHHB EJ BUBT OPSNBM ZBOH CFSGVOHTJ VOUVL
EBSBI BLJCBU EJOJUSPGFOPM LVSWB EFOHBO HBSJT QVUVTQVUVT
NFOJOHLBULBO DVSBI KBOUVOH UBNCBIBO TFCBOZBL TBNQBJ
LFNVEJBO NFOZFCBCLBO QFOVSVOBO ZBOH OZBUB QBEB UFLBOBO QFSTFO
BSUFSJ TBNQBJ TFLJUBS TFQBSVI OPSNBM TFEBOHLBO DVSBI
KBOUVOHNFOJOHLBUIBOZB LBMJMJQBUEBOCVLBOLBMJMJQBU
+BEJ NFNQFSUBIBOLBO UFLBOBO BSUFSJ OPSNBM PMFI SFGMFLT 4VOHHVINFOHIFSBOLBOCBIXBQBEBNBOVTJBZBOHTFIBU SBUB
TBSBG NFMBMVJ NFLBOJTNF ZBOH EJKFMBTLBO EJ #BC QFOUJOH SBUBDVSBIKBOUVOHOZBCFSTJGBULPOTUBOEBSJTBUVPSBOHLFPSBOH
VOUVL NFODBQBJ DVSBI KBOUVOH ZBOH UJOHHJ CJMB KBSJOHBO QFSJGFS MBJO /BNVO EFNJLJBO CFSCBHBJ LFMBJOBO LMJOJT EBQBU
NFOEJMBUBTJLBOQFNCVMVIEBSBIOZBVOUVLNFOJOHLBULBOBMJSBO NFOZFCBCLBO DVSBI KBOUVOH NFOKBEJ UJOHHJ BUBVQVO SFOEBI
CBMJLWFOB #FCFSBQB QFOZBLJU QFOUJOH ZBOH NFOZFCBCLBO LFBEBBO JOJ
EJQFSMJIBULBOQBEB(BNCBS
Pengaruh Sistem Saraf untuk Meningkatkan tekanan Curah Jantung Tinggi yang Disebabkan oleh Penurunan
Arteri Selama Kerja Fisik. 4FMBNB LFSKB GJTJL QFOJOHLBUBO Tahanan Perifer Total
NFUBCPMJTNFIFCBUQBEBPUPUSBOHLBZBOHBLUJGTFDBSBMBOHTVOH 4JTJ LJSJ (BNCBS NFOVOKVLLBO LPOEJTJLPOEJTJ ZBOH CJBTBOZB
NFOZFCBCLBO DVSBI KBOUVOH MFCJI UJOHHJ EBSJQBEB OPSNBM 4BUV DJSJ
LIVTVT LPOEJTJLPOEJTJ EJ BUBT BEBMBI CBIXB TFNVBOZB BLJCBU EBSJ
QFOVSVOBO UBIBOBO QFSJGFS UPUBM ZBOH LSPOJT 5JEBL TBUV QVO
NFSVQBLBO BLJCBU EBSJ LFMFCJIBO QFSBOHTBOHBO KBOUVOH JUV TFOEJSJ
ZBOH BLBO LJUB CBIBT LFNVEJBO 6OUVL TFNFOFUBSB NBSJ LJUB MJIBU
CFCFSBQBLPOEJTJZBOHEBQBUNFOVSVOLBOUBIBOBOQFSJGFSEBOQBEB
TBBUZBOHCFSTBNBBONFOJOHLBULBODVSBIKBOUVOHEJBUBTOPSNBM
1. #FSJCFSJ MOJ BEBMBI QFOZBLJU ZBOH EJTFCBCLBO PMFI LFLVSBOHBO
WJUBNJO UJBNJO WJUBNJO #
EBMBN LPOTVNTJ NBLBOBOOZB
LFLVSBOHBO WJUBNJO JOJ NFOZFCBCLBO QFOVSVOBO LFNBNQVBO
KBSJOHBO VOUVL NFOHHVOBLBO CFCFSBQB OVUSJTJ TFMVMFS EBO
NFLBOJTNF BMJSBO EBSBI KBSJOHBO TFUFNQBU LFNVEJBO
NFOZFCBCLBO WBTPEJMBUBTJ QFSJGFS ZBOH NFOZPMPL TFCBHBJ
LPNQFOTBTJ LBEBOHLBEBOH UBIBOBO QFSJGFS UPUBM NFOVSVO
TBNQBJ TFUFOHBI EBSJ OPSNBM "LJCBUOZB EFSBKBU BMJSBO CBMJL
WFOB EBO DVSBI KBOUVOH KBOHLB QBOKBOH KVHB TFSJOH LBMJ
NFOJOHLBUTBNQBJEVBLBMJOPSNBM
2. 'JTUVMB BSUFSJPWFOPTB QJSBVTIVOU
1BEB QFSNVMBBO CBC JOJ LJUB
UFMBINFOFLBOLBOCBIXBCJMBTVBUVGJTUVMB KVHBEJTFCVU"7TIVOU
UFSKBEJ EJ BOUBSB TFCVBI BSUFSJ VUBNB EBO WFOB VUBNB TFKVJOMBI
CFTBSEBSBINFOHBMJSTFDBSBMBOHTVOHEBSJBSUFSJLFWFOBLFBEBBO
JOJKVHBBLBOTBOHBUNFOVSVOLBOUBIBOBOQFSJGFSUPUBMEBO EFOHBO
EFNJLJBONFOJOHLBULBOBMJSBOCBMJLWFOBEBODVSBIKBOUVOH
232
UNIT IV
3. )JQFSUJSPJEJTNF1BEBIJQFSUJSPJEJTNF NFUBCPMJTNFTFCBHJBOCFTBS CBHJBO LBOBO (BNCBS ZBOH NFOVOKVLLBO QFOVSVOBO
KBSJOHBO UVCVI NFOKBEJ TBOHBU NFOJOHLBU 1FNBLBJBO PLTJHFO DVSBIKBOUVOHTFCBHBJBLJCBUOZB
NFOJOHLBUEBOQSPEVLWBTPEJMBUPSEJMFQBTLBOEBSJKBSJOHBO0MFI
#JMBDVSBIKBOUVOHUVSVOTBOHBUSFOEBITFIJOHHBKBSJOHBOEJ
LBSFOBJUV UBIBOBOQFSJGFSUPUBMNFOVSVOEFOHBONFOZPMPLBLJCBU
TFMVSVIUVCVINVMBJNFOEFSJUBLFLVSBOHBOOVUSJTJ LPOEJTJJOJ
SFBLTJQFOHBUVSBOBMJSBOEBSBIKBSJOHBOTFUFNQBUEJTFMVSVIUVCVI
BLJCBUOZB BMJSBO CBMJL WFOB EBO DVSBI KBOUVOH TFSJOH NFOJOHLBU EJTFCVU TZPL LBSEJPHFOJL ,FBEBBO JOJ BLBO EJCJDBSBLBO TFDBSB
TBNQBJIJOHHBQFSTFOEJBUBTOPSNBM MFOHLBQQBEB#BCEBMBNIVCVOHBOOZBEFOHBOHBHBMKBOUVOH
4. "OFNJB 1BEB BOFNJB UFSEBQBU EVB FGFL QFSJGFS ZBOH TBOHBU
Penurunan Curah Jantung yang Disebabkan oleh
NFOVSVOLBO UBIBOBO QFSJGFS UPUBM 4BUV EJ BOUBSBOZB BEBMBI
CFSLVSBOHOZBWJTLPTJUBTEBSBI BLJCBUEBSJQFOVSVOBOLPOTFOUSBTJ
Faktor-Faktor Perifer di Luar Jantung—Penurunan Aliran
TFMTFMEBSBINFSBI&GFLMBJOOZBBEBMBICFSLVSBOHOZBQFOHJSJNBO Balik Vena 4FUJBQ GBLUPS ZBOH NFOHHBOHHV BMJSBO CBMJL WFOB
PLTJHFO LF KBSJOHBO ZBOH NFOZFCBCLBO WBTPEJMBUBTJ MPLBM KVHB EBQBU NFOZFCBCLBO QFOVSVOBO DVSBI KBOUVOH
"LJCBUOZB DVSBIKBOUVOHBLBOTBOHBUNFOJOHLBU #FCFSBQBEJBOUBSBOZBBEBMBITFCBHBJCFSJLVU
4FNVBGBLUPSMBJOZBOHNFOVSVOLBOUBIBOBOQFSJGFSUPUBMTFDBSB 1. 1FOVSVOBO WPMVNF EBSBI 4FKBVI JOJ GBLUPS QFSJGFS EJ MVBS
LSPOJTKVHBBLBONFOJOHLBULBODVSBIKBOUVOH KBOUVOH ZBOH QBMJOH VNVN NFOZFCBCLBO QFOVSVOBO DVSBI
KBOUVOHBEBMBIQFOVSVOBOWPMVNFEBSBI ZBOHQBMJOHTFSJOH
Curah Jantung yang Rendah EJTFCBCLBO PMFI QFSEBSBIBO "MBTBO NFOHBQB LFBEBBO JOJ
NFOVSVOLBO DVSBI KBOUVOH ,FIJMBOHBO EBSBI BLBO
(BNCBS TFCFMBI LBOBO NFOVOKVLLBO CFCFSBQB LPOEJTJ ZBOH NFOVSVOLBOQFOHJTJBOTJTUFNWBTLVMBSLFOJMBJZBOHSFOEBI
NFOZFCBCLBO DVSBI KBOUVOH NFOKBEJ SFOEBI TFDBSB BCOPSNBM TFIJOHHBUJEBLUFSEBQBUDVLVQEBSBIEBMBNQFNCVMVIEBSBI
,POEJTJ JOJ EJCFEBLBO EBMBN EVB LBUFHPSJ
LFMBJOBO ZBOH QFSJGFS VOUVL NFOJNCVMLBO UFLBOBO WBTLVMBS QFSJGFS ZBOH
NFOZFCBCLBO FGFLUJWJUBT QPNQB KBOUVOH UVSVO SFOEBI TFLBMJ EBO DVLVQUJOHHJVOUVLNFOEPSPOHEBSBILFNCBMJLFKBOUVOH

LFMBJOBO ZBOH NFOZFCBCLBO BMJSBO CBMJL WFOB UVSVO TBOHBU
SFOEBI 2. %JMBUBTJ WFOB BLVU 1BEB CFCFSBQB LFBEBBO WFOBWFOB
QFSJGFS CFSEJMBUBTJ TFDBSB BLVU )BM JOJ QBMJOH TFSJOH UFSKBEJ
Penurunan Curah Jantung yang Disebabkan oleh Faktor- LFUJLB TJTUFN TBSBG TJNQBUJT UJCBUJCB NFOKBEJ UJEBL BLUJG
Faktor Jantung. #JMB KBOUVOH SVTBL CFSBU BQB QVO QFOZFCBCOZB 4FCBHBJ DPOUPI QJOHTBO TFSJOH EJTFCBCLBO PMFI IJMBOHOZB
CBUBT LFNBNQVBO QFNPNQBBOOZB EBQBU UVSVO IJOHHB EJ CBXBI BLUJWJUBT TJTUFN TBSBG TJNQBUJT TFDBSB NFOEBEBL ZBOH
UJOHLBU ZBOH EJQFSMVLBO VOUVL NFOHBMJSLBO EBSBI TFDBSB BEFLVBU NFOZFCBCLBO QFNCVMVI EBSBI LBQBTJUBUJG QFSJGFS UFSVUBNB
LFKBSJOHBO#FCFSBQBDPOUPILFBEBBOJOJBEBMBI
CMPLQFNCVMVI WFOB CFSEJMBUBTJ TFDBSB OZBUB ,FBEBBO JOJ NFOVSVOLBO
EBSBI EBSBI LPSPOFS CFSBU ZBOH EBQBU NFOZFCBCLBO JOGBSL UFLBOBO QFOHJTJBO TJTUFN WBTLVMBS LBSFOB WPMVNF EBSBI
NJPLBSE
QFOZBLJULBUVQKBOUVOHZBOHCFSBU
NJPLBSEJUJT
UJEBL EBQBU MBHJ NFNCVBU UFLBOBO ZBOH BEFLVBU EJ EBMBN
UBNQPOBEF KBOUVOH EBO
LFLBDBVBO NFUBCPMJTNF KBOUVOH &GFL QFNCVMVI EBSBI QFSJGFS ZBOH TVEBI MFNBI 4FCBHBJ
EBSJCFCFSBQBLFBEBBOEJBUBTEJMVLJTLBOQBEB BLJCBUOZB EBSBIUFSLVNQVMEJEBMBNQFNCVMVIEBSBIEBO
UJEBLEBQBULFNCBMJLFKBOUVOH
233
Unit lV Sirkulasi
3. 1FOZVNCBUBO WFOBWFOB CFTBS 1BEB LFBEBBO ZBOH KBSBOH

UFSKBEJ WFOB CFTBS ZBOH NFOHBSBI LF KBOUVOH NFOKBEJ
UFSTVNCBU TFIJOHHB EBSBI EBMBN QFNCVMVI EBSBI QFSJGFS
UJEBL EBQBU NFOHBMJS LFNCBMJ LF KBOUVOH "LJCBUOZB DVSBI
KBOUVOHUVSVOEFOHBOOZBUB
4. #FSLVSBOHOZB NBTTB KBSJOHBO UFSVUBSOB CFSLVSBOHOZB
NBTTB PUPU SBOHLB 1BEB QSPTFT QFOVBBO ZBOH OPSNBM BUBV
QBEB PSBOH EFOHBO GJTJL ZBOH MBNB UJEBL BLUJG CJBTBOZB
UFSKBEJ QFOHVSBOHBO VLVSBO PUPU SBOHLB ,FBEBBO JOJ
LFNVEJBO BLBO NFOVSVOLBO LPOTVNTJ PLTJHFO UPUBM EBO
BMJSBO EBSBI ZBOH EJCVUVILBO PMFI PUPU BLJCBUOZB UFSKBEJ
QFOVSVOBOBMJSBOEBSBIPUPUSBOHLBEBODVSBIKBOUVOH
5. 1FOVSVOBO MBKV NFUBCPMJTNF KBSJOHBO #JMB LFDFQBUBO
NFUBCPMJTNF KBSJOHBO UVSVO TFQFSUJ ZBOH UFSKBEJ QBEB PUPU
SBOHLB BLJCBU JTUJSBIBU CBSJOH ZBOH CFSLFQBOKBOHBO
LPOTVNTJPLTJHFOEBOLFCVUVIBOKBSJOHBOBLBOOVUSJFOKVHB
UVSVO )BM JOJ NFOVSVOLBO BMJSBO EBSBI LF KBSJOHBO KBOUVOH TFQFSUJEJKFMBTLBOEJCBHJBOCFSJLVU
NFOZFCBCLBO DVSBI KBOUVOH KVHB CFSLVSBOH ,POEJTJ MBJO
Pengaruh Tekanan Eksternal di Luar Jantung terhadap
TFQFSUJ IJQPUJSPJEJTNF KVHB EBQBU NFOVSVOLBO MBKV
Kurva Curah Jantung. (BNCBS NFOVOKVLLBO FGFL
NFUBCPMJTNF EBO EFOHBO EFNJLJBO KVHB BMJSBO EBSBI EBO
QFSVCBIBO UFLBOBO FLTUSBLBSEJBM UFSIBEBQ LVSWB DVSBI KBOUVOH
DVSBIKBOUVOH
5FLBOBO FLTUFSOBM ZBOH OPSNBM BEBMBI TBNB EFOHBO UFLBOBO
"QBQVOQFOZFCBCQFOVSVOBODVSBIKBOUVOH BQBLBIJUV
JOUSBQMFVSBOPSNBM UFLBOBOEBMBNSPOHHBEBEB
TFCFTBSoNN
GBLUPS QFSJGFS BUBV GBLUPS KBOUVOH KJLB DVSBI KBOUVOH UVSVO EJ )H 1FSIBUJLBO EBMBN HBNCBS CBIXB QFOJOHLBUBO UFLBOBO
CBXBI CBUBT ZBOH EJQFSMVLBO VOUVL QFNCFSJBO OVUSJTJ ZBOH JOUSBQMFVSB TBNQBJ o NN )H BLBO NFOHHFTFS LFTFMVSVIBO
BEFLVBUQBEBKBSJOHBO PSBOHUFSTFCVUEJLBUBLBONFOEFSJUBTZPL LVSWB DVSBI KBOUVOH LF LBOBO EFOHBO KVNMBI ZBOH TBNB
TJSLVMBTJ ,FBEBBO JOJ EBQBU NFOJNCVMLBO LFNBUJBO EBMBN 1FSHFTFSBOJOJUFSKBEJLBSFOBQFOHJTJBOSPOHHBKBOUVOHPMFIEBSBI
CFCFSBQB NFOJU TBNQBJ CFCFSBQB KBN 4ZPL TJSLVMBTJ BEBMBI NFNCVUVILBO UFLBOBO UBNCBIBO NN )H EBSJ BUSJVN LBOBO
NBTBMBI LMJOJL ZBOH QFOUJOH ZBOH BLBO EJCJDBSBLBO TFDBSB VOUVL NFMBNQBVJ QFOJOHLBUBO UFLBOBO EJ CBHJBO MVBS KBOUVOH
UFSQFSJODJEJ#BC %FNJLJBOKVHB QFOJOHLBUBOUFLBOBOJOUSBQMFVSBTBNQBJNN
)HNFNFSMVLBOQFOJOHLBUBOUFLBOBOBUSJVNLBOBOIJOHHBNN
Analisis Pengaturan Curah Jantung yang Lebih Kuantitatif )HEBSJOPSNBM NN)H
ZBOHNFOHHFTFSLFTFMVSVIBOLVSWB
1FNCJDBSBBO LJUB NFOHFOBJ QFOHBUVSBO DVSBI KBOUVOH TFKBVI DVSBIKBOUVOHNN)HLFLBOBO
JOJTVEBIDVLVQVOUVLNFNBIBNJGBLUPSGBLUPSZBOHNFOHBUVS
DVSBI KBOUVOH QBEB LPOEJTJLPOEJTJ ZBOH QBMJOH TFEFSIBOB #FCFSBQBGBLUPSZBOHEBQBUNFOHVCBIUFLBOBOFLTUFSOBMQBEB
/BNVO VOUVL NFOHFSUJ NFOHFOBJ QFOHBUVSBO DVSBI KBOUVOH KBOUVOH EBO NFOHHFTFS LVSWB DVSBI KBOUVOH BEBMBI
LIVTVTOZB EBMBN TJUVBTJ ZBOH QFOVI TUSFT TFQFSUJ LFSKB GJTJL TFCBHBJCFSJLVU
ZBOH FLTUSFN HBHBM KBOUVOH EBO TZPL TJSLVMBTJ BOBMJTJT 1. 1FSVCBIBO TJLMJL UFLBOBO JOUSBQMFVSB TFMBNB SFTQJSBTJ ZBOH
LVBOUJUBUJGZBOHMFCJILPNQMFLTEJQFSMJIBULBOEJCBHJBOCFSJLVU LJSBLJSB TFCFTBS NN )H TFMBNB CFSOBQBT OPSNBM UFUBQJ
JOJ EBQBUNFODBQBJNN)HTFMBNBCFSOBQBTLVBU
6OUVL NFMBLVLBO BOBMJTJT ZBOH MFCJI LVBOUJUBUJG QFSMV
EJCFEBLBO TFDBSB UFSQJTBI EVB GBLUPS QSJNFS ZBOH CFSLBJUBO 2. #FSOBQBT NFMBXBO UFLBOBO OFHBUJG ZBOH NFOHHFTFS LVSWB LF
EFOHBO QFOHBUVSBO DVSBI KBOUVOH
LFNBNQVBO QPNQB BSBIUFLBOBOBUSJVNLBOBOZBOHMFCJIOFHBUJG LFLJSJ

KBOUVOH TFQFSUJ ZBOH EJQFSMJIBULBO PMFI LVSWB DVSBI KBOUVOH 3. #FSOBQBT EFOHBO UFLBOBO QPTJUJG ZBOH NFOHHFTFS LVSWB LF
EBO
GBLUPSGBLUPS QFSJGFS ZBOH NFNFOHBSVIJ BMJSBO EBSBI LBOBO
WFOB LF KBOUVOH TFQFSUJ ZBOH EJQFSMJIBULBO PMFI LVSWB BMJSBO 4. 1FNCVLBBO SPOHHB EBEB ZBOH NFOJOHLBULBO UFLBOBO
CBMJL WFOB ,FNVEJBO LJUB EBQBU NFMFUBLLBO LFEVB LVSWB JOJ
JOUSBQMFVSB TBNQBJ NN )H EBO NFOHHFTFS LVSWB DVSBI
CFSTBNBTBNB TFDBSB LVBOUJUBUJG VOUVL NFNQFSMJIBULBO
KBOUVOHLFLBOBONN)H
CBHBJNBOBLFEVBLVSWBUFSTFCVUTBMJOHNFNFOHBSVIJTBUVTBNB
MBJO VOUVL NFOFOUVLBO DVSBI KBOUVOH BMJSBO CBMJL WFOB EBO 5. 5BNQPOBEF KBOUVOH ZBOH CFSBSUJ QFOHVNQVMBO TFKVNMBI
UFLBOBOBUSJVNLBOBOQBEBTBBUZBOHCFSTBNBBO CFTBS DBJSBO EJ EBMBN SPOHHB QFSJLBSEJVN EJ TFLFMJMJOH
KBOUVOHEFOHBOBLJCBUQFOJOHLBUBOUFLBOBOFLTUSBLBSEJBMEBO
Kurva Curah Jantung yang Digunakan dalam Analisis NFOHHFTFS LVSWB LF LBOBO 1FSIBUJLBO QBEB (BNCBS
Kuantitatif CBIXBUBNQPOBEFKBOUVOHNFOHHFTFSCBHJBOBUBTLVSWBMFCJI
#FCFSBQB LVSWB DVSBI KBOUVOH ZBOH EJHVOBLBO VOUVL KBVI LF LBOBO EBSJQBEB CBHJBO CBXBI LVSWB LBSFOB UFLBOBO
NFOHHBNCBSLBO FGFLUJWJUBT QPNQB KBOUVOH TFDBSB LVBOUJUBUJG UBNQPOBEFFLTUFSOBMNFOJOHLBUMFCJIUJOHHJTFXBLUVSPOHHB
UFMBI EJQFSMJIBULBO QBEB (BNCBS /BNVO EJCVUVILBO KBOUVOHUFSJTJWPMVNFMFCJICBOZBLTFMBNBDVSBIKBOUVOHZBOH
TFSBOHLBJBO LVSWB UBNCBIBO VOUVL NFOHHBNCBSLBO FGFL UJOHHJ
DVSBIKBOUVOHBLJCBUQFSVCBIBOUFLBOBOFLTUFSOBMEJMVBS
234
'BLUPSGBLUPS JOJ TFNVBOZB EBQBU EJOZBUBLBO TFDBSB

LVBOUJUBUJG EFOHBO LVSWB BMJSBO CBMJL WFOB TFQFSUJ ZBOH BLBO
LJUBCBIBTQBEBCBHJBOCFSJLVU
Kurva Aliran Balik Vena yang Normal
UNIT IV
4BNB IBMOZB EFOHBO LVSWB DVSBI KBOUVOH ZBOH
NFOHIVCVOHLBO QPNQB EBSBI PMFI KBOUVOH EFOHBO UFLBOBO
BUSJVN LBOBO NBLB LVSWB BMJSBO CBMJL WFOB NFOHIVCVOHLBO
BMJSBO CBMJL WFOB KVHB EFOHBO UFLBOBO BUSJVN LBOBO ZBJUV
BMJSBOEBSBIWFOBLFEBMBNKBOUVOHEBSJTJSLVMBTJTJTUFNJLQBEB
CFSCBHBJOJMBJUFLBOBOBUSJVNLBOBO
,VSWB QBEB (BNCBS BEBMBI LVSWB BMJSBO CBMJL WFOB
ZBOH OPSNBM ,VSWB JOJ NFNQFSMJIBULBO CBIXB CJMB
LFNBNQVBO QPNQB KBOUVOH NFOVSVO EBO NFOZFCBCLBO
UFLBOBO BUSJVN LBOBO NFOJOHLBU LFLVBUBO ZBOH NFOEPSPOH
NVOEVS BLJCBU UFLBOBO BUSJVN ZBOH NFOJOHLBU JOJ UFSIBEBQ
WFOBWFOBTJSLVMBTJTJTUFNJLBLBONFOVSVOLBOBMJSBOCBMJLWFOB
LF KBOUVOH #JMB TFNVB SFGMFLT TJSLVMBTJ PMFI TBSBG EJIBMBOH
IBMBOHJVOUVLCFLFSKB BMJSBOCBMJLWFOBUVSVOTBNQBJOPMLFUJLB
Kombinasi Berbagai Pola Kurva Curah Jantung. (BNCBS UFLBOBO BUSJVN LBOBO NFOJOHLBU TBNQBJ TFLJUBS NN )H
NFOVOKVLLBO CBIXB LVSWB DVSBI KBOUVOH BLIJS EBQBU
4FEJLJU QFOJOHLBUBO UFLBOBO BUSJVN LBOBO TFQFSUJ JUV BLBO
CFSVCBI TFCBHBJ BLJCBU QFSVCBIBOQFSVCBIBO TFSFOUBL QBEB
NFOZFCBCLBO QFOVSVOBO BMJSBO CBMJL WFOB ZBOH MVBS CJBTB
B
UFLBOBO FLTUSBLBSEJBM EBO C
FGFLUJWJUBT KBOUVOH TFCBHBJ
LBSFOB TJSLVMBTJ TJTUFNJL NFSVQBLBO TVBUV LBOUPOH ZBOH
QPNQB 4FCBHBJ DPOUPI HBCVOHBO KBOUVOH IJQFSFGFLUJG EFOHBO
NVEBI NFOHFNCBOH TFIJOHHB TFUJBQ QFOJOHLBUBO UFLBOBO
QFOJOHLBUBO UFLBOBO JOUSBQMFVSB BLBO NFOKVSVT LF QFOJOHLBUBO
CBMJLBLBONFOZFCBCLBOEBSBICFSLVNQVMEJEBMBNLBOUPOHJOJ
UBSBG DVSBI KBOUVOH NBLTJNBM BLJCBU QFOJOHLBUBO LFNBNQVBO
EBOUJEBLLFNCBMJLFKBOUVOH
QFNPNQBBOKBOUVOHUFUBQJLVSWBDVSBIKBOUVOHBLBOCFSHFTFSLF
1BEBTBBUZBOHTBNBLFUJLBUFLBOBOBUSJVNLBOBONFOJOHLBU
LBOBO NFOVKV UFLBOBO BSUFSJBM ZBOH MFCJI UJOHHJ
BLJCBU
EBONFOZFCBCLBOTUBTJTWFOB QSPTFTQFNPNQBBOPMFIKBOUVOH
QFOJOHLBUBO UFLBOBO JOUSBQMFVSB +BEJ EFOHBO NFOHFUBIVJ BQB
KVHB NFOEFLBUJ OPM LBSFOB QFOVSVOBO BMJSBO CBMJL WFOB +BEJ
ZBOHUFSKBEJQBEBUFLBOBOFLTUFSOBMEBOKVHBLFNBNQVBOKBOUVOH
UFLBOBO BSUFSJ EBO UFLBOBO WFOB NFOKBEJ TFJNCBOH CJMB TFNVB
TFCBHBJ QPNQB LJUB EBQBU NFOZBUBLBO LFNBNQVBO TFNFOUBSB
BMJSBOEBMBNTJSLVMBTJTJTUFNJLCFSIFOUJQBEBUFLBOBONN)H
KBOUVOHVOUVLNFNPNQBEBSBINFMBMVJTBUVLVSWBDVSBIKBOUVOH
ZBOH NFOVSVU EFGJOJTJ BEBMBI UFLBOBO QFOHJTJBO TJTUFNJL
TZTUFNJDGJMMJOHQSFTTVSF1TG
SBUBSBUB
Kurva Aliran Balik Vena
4FMVSVI TJSLVMBTJ TJTUFNJL UFUBQ IBSVT EJQFSUJNCBOHLBO TFCFMVN Garis Mendatar pada Kurva Aliran Balik Vena dengan
NFMBLVLBOBOBMJTJTUPUBMQFOHBUVSBOKBOUVOH6OUVLNFOHBOBMJTJT Tekanan Atrium Negatif Disebabkan Kolapsnya Vena-
GVOHTJ TJSLVMBTJ TJTUFNJL LBNJ NVMBNVMB NFOHBOHLBU KBOUVOH Vena Besar. #JMB UFLBOBO BUSJVN LBOBO UVSVO EJ CBXBI OPM
EBOQBSVEBSJTJSLVMBTJTFFLPSCJOBUBOHEBONFOHHBOUJOZBEFOHBO ZBJUV EJCBXBIUFLBOBOBUNPTGFSQFOJOHLBUBOBMJSBOCBMJLWFOB
TFCVBI QPNQB EBO TJTUFN PLTJHFOBUPS CVBUBO ,FNVEJBO TFMBOKVUOZB IBNQJS CFSIFOUJ %BO QBEB TBBU UFLBOBO BUSJVN
CFSCBHBJ GBLUPS TFQFSUJ WPMVNF EBSBI UBIBOBO WBTLVMBS EBO LBOBO UVSVO TBNQBJ TFLJUBS o NN )H BMJSBO CBMJL WFOB BLBO
UFLBOBO WFOB TFOUSBM QBEB BUSJVN LBOBO EJVCBI VOUVL NFODBQBJ HBSJT ZBOH NFOEBUBS QMBUFBV
,FNVEJBO BLBO
NFOFOUVLBO CBHBJNBOB TJSLVMBTJ TJTUFNJL CFLFSKB QBEB CFSCBHBJ NFOFUBQ QBEB HBSJT JOJ XBMBVQVO UFLBOBO BUSJVN LBOBO UVSVO
LFBEBBO TJSLVMBTJ %BMBN QFOFMJUJBO JOJ EJUFNVLBO UJHB GBLUPS TBNQBJ o NN )H o NN )H BUBV CBILBO MFCJI SFOEBI
VUBNB ZBOH NFNFOHBSVIJ BMJSBO CBMJL WFOB LF KBOUVOH EBSJ MBHJ(BSJTNFOEBUBSJOJEJTFCBCLBOPMFILPMBQTOZBWFOBWFOB
TJSLVMBTJTJTUFNJL'BLUPSGBLUPSJUVBEBMBITFCBHBJCFSJLVU
1. 5FLBOBO BUSJVN LBOBO ZBOH NFOHIBTJMLBO EPSPOHBO CBMJL

QBEBWFOBVOUVLNFOHIBMBOHJBMJSBOEBSBIEBSJWFOBLFEBMBN
BUSJVNLBOBO
2. %FSBKBUQFOHJTJBOTJSLVMBTJTJTUFNJL ZBOHEJVLVSEFOHBOUFLBOBO
QFOHJTJBOTJTUFNJLSBUBSBUB
ZBOHNFOEPSPOHEBSBITJTUFNJLLF
BSBI KBOUVOH JOJ BEBMBI UFLBOBO ZBOH EJVLVS EJ TFUJBQ UFNQBU
EBMBNTJSLVMBTJTJTUFNJLCJMBTFMVSVIBMJSBOEBSBIEJIFOUJLBOEBO
BLBOEJCBIBTMFCJIEFUBJMLFNVEJBO

3. 5BIBOBOUFSIBEBQBMJSBOEBSBIBOUBSBQFNCVMVIQFSJGFSEBO
BUSJVNLBOBO
235
Unit lV Sirkulasi
ZBOH NFNBTVLJ SPOHHB EBEB 5FLBOBO BUSJVN LBOBO ZBOH BLUJWJUBT SBOHTBOHBO TJNQBUJT ZBOH LVBU EBO MFNBI UFSIBEBQ
OFHBUJG BLBO NFOHJTBQ EJOEJOH WFOB LFUJLB BMJSBO EBSBI UFLBOBO QFOHJTJBO TJSLVMBTJ SBUBSBUB 3BOHTBOHBO TJNQBUJT ZBOH
NFNBTVLJ SPOHHB EBEB ZBOH NFODFHBI TFUJBQ BMJSBO EBSBI LVBU BLBO NFOJNCVMLBO LPOTUSJLTJ EJ TFMVSVI QFNCVMVI EBSBI
UBNCBIBO EBSJ WFOBWFOB QFSJGFS "LJCBUOZB XBMBVQUUO TJTUFNJL EFNJLJBO KVHB QBEB QFNCVMVI EBSBI QBSV ZBOH MFCJI
UFLBOBO BUSJVN LBOBO NFOKBEJ TBOHBU OFHBUJG UFUBQ UJEBL CFTBS EBO CBILBO SPOHHB KBOUVOH 0MFI LBSFOB JUV LBQBTJUBT
EBQBUNFOJOHLBULBOBMJSBOCBMJLWFOBTFDBSBCFSNBLOBEJBUBT TJTUFN NFOKBEJ NFOVSVO TFIJOHHB QBEB TFUJBQ KVNMBI WPMVNF
OJMBJZBOHTVEBIBEBQBEBUFLBOBOBUSJVNOPSNBMNN)H EBSBI UFLBOBOQFOHJTJBOTJSLVMBTJSBUBSBUBBLBONFOJOHLBU1BEB
WPMVNF EBSBI ZBOH OPSNBM SBOHTBOHBO TJNQBUJT ZBOH NBLTJNBM
Tekanan Pengisian Sirkulasi Rata-Rata dan Tekanan BLBO NFOJOHLBULBO UFLBOBO QFOHJTJBO TJSLVMBTJ SBUBSBUB EBSJ
Pengisian Sistemik Rata-Rata, serta Pengaruhnya NN)HNFOKBEJTFLJUBS LBMJOJMBJJOJ BUBVTFLJUBSNN)H
terhadap Aliran Balik Vena
4FCBMJLOZB QFOHIBNCBUBO UPUBM QBEB TJTUFN TBSBG TJNQBUJT
#JMB QFNPNQBBO KBOUVOH UFSIFOUJ BLJCBU LFKVU KBOUVOH MJTUSJL BLBO NFSFMBLTBTJLBO QFNCVMVI EBSBI NBVQVO KBOUVOH
ZBOH NFOZFCBCLBO GJCSJMBTJ WFOUSJLFM BUBV UFSIFOUJ LBSFOB NFOVSVOLBO UFLBOBO QFOHJTJBO TJSLVMBTJ SBUBSBUB EBSJ OJMBJ
TFCBC MBJO BMJSBO EBSBI EJ NBOB TBKB EBMBN TJSLVMBTJ BLBO OPSNBM NN )H NFOKBEJ TFLJUBS NN )H 4FCFMVN
UFSIFOUJ CFCFSBQB EFUJL LFNVEJBO 5BOQB BMJSBO EBSBI NFOJOHHBMLBO(BNCBS QFSIBUJLBOLIVTVTOZBCBHBJNBOB
UFLBOBOEJNBOBTBKBEBMBNTJSLVMBTJNFOKBEJTFUBSB5FLBOBO DVSBNOZB LVSWB JOJ ,VSWB UFSTFCVU NFNQFSMJIBULBO CBIXB
ZBOH UFMBI TFJNCBOH JOJ EJTFCVU UFLBOBO QFOHJTJBO TJSLVMBTJ EFOHBO TFEJLJU QFSVCBIBO QBEB WPMVNF EBSBI BUBV TFEJLJU
SBUBSBUB QFSVCBIBOQBEBLBQBTJUBTTJTUFNZBOHEJTFCBCLBOPMFICFSCBHBJ
Pengaruh Volume Darah Terhadap Tekanan Pengisian UJOHLBUBLUJWJUBTTJNQBUJT EBQBUNFNCFSJFGFLZBOHDVLVQCFTBS
Sirkulasi Rata-Rata. 4FNBLJO CFTBS WPMVNF EBSBI EBMBN QBEBUFLBOBOQFOHJTJBOTJSLVMBTJSBUBSBUB
TJSLVMBTJ TFNBLJO CFTBS UFLBOBO QFOHJTJBO TJSLVMBTJ SBUB Tekanan Pengisian Sistemik Rata-Rata dan Hubungannya
SBUB LBSFOB WPMVNF EBSBI UBNCBIBO NFOFLBO EJOEJOH dengan Tekanan Pengisian Sirkulasi Rata-Rata. 5FLBOBO
QFNCVMVI EBSBI ,VSWB BCVBCV HBSJT QVUVTQVUVT QBEB QFOHJTJBO TJTUFNJL SBUBSBUB 1TG TFEJLJU CFSCFEB EBSJ UFLBOBO
(BNCBS NFNQFSMJIBULBO QFOHBSVI OPSNBM CFSCBHBJ QFOHJTJBOTJSLVMBTJSBUBSBUB1TGBEBMBIUFLBOBOZBOHEJVLVSEJ
UJOHLBU WPMVNF EBSBI UFSIBEBQ UFLBOBO QFOHJTJBO TJSLVMBTJ NBOB TBKB EJ EBMBN TJSLVMBTJ TJTUFNJL TFUFMBI BMJSBO EBSBI
SBUBSBUB 1FSIBUJLBO CBIXB CJMB WPMVNF EBSBI CFSKVNMBI EJIFOUJLBO EFOHBO DBSB NFOKFQJU QFNCVMVI EBSBI CFTBS EJ
TFLJUBS NM UFLBOBO QFOHJTJBO TJSLVMBTJ SBUBSBUB BLBO KBOUVOH TFIJOHHB UFLBOBO EBMBN TJSLVMBTJ TJTUFNJL EBQBU
NFOEFLBUJ OPM LBSFOB LFBEBBO JOJ BEBMBI WPMVNF UBOQB EJIJUVOH TFDBSB UFSTFOEJSJ UJEBL UFSQFOHBSVI PMFI UFLBOBO
CFCBO VOTUSFTTFE WPMVNF
QBEB TJSLVMBTJ UFUBQJ QBEB EBMBN TJSLVMBTJ QBSV 5FLBOBO TJTUFNJL SBUBSBUB XBMBVQVO
WPMVNF NM UFLBOBO QFOHJTJBO CFSBEB QBEB OJMBJ IBNQJS NVTUBIJM VOUVL EJVLVS QBEB IFXBO IJEVQ BEBMBI
OPSNBM NN )H %FNJLJBO KVHB CJMB WPMVNF MFCJI CFTBS UFLBOBO ZBOH QFOUJOH VOUVL NFOFOUVLBO BMJSBO CBMJL WFOB
MBHJ UFLBOBO QFOHJTJBO TJSLVMBTJ SBUBSBUB NFOJOHLBU TFDBSB /BNVO UFLBOBO QFOHJTJBO TJTUFNJL SBUBSBUB IBNQJS TFMBMV
IBNQJSMJOFBS NFOEFLBUJOJMBJZBOHTBNBEFOHBOUFLBOBOQFOHJTJBOTJSLVMBTJ
Pengaruh Perangsangan Saraf Simpatis pada SBUBSBUBLBSFOBTJSLVMBTJQBSVNFNJMJLJEBZBUBNQVOHLVSBOH
Sirkulasi terhadap Tekanan Pengisian Sirkulasi EBSJ TFQFSEFMBQBO EBZB UBNQVOH TJSLVMBTJ TJUFNJL EBO IBOZB
Rata-Rata ,VSWB HBSJT BCVBCV EBO LVSWB HBSJT IJUBN TFLJUBSTFQFSTFQVMVIWPMVNFEBSBI
QBEB (BNCBS NFNQFSMJIBULBO QFOHBSVI TFDBSB Pengaruh PerubahanTekanan Pengisian Sistemik Rata-Rata
CFSUVSVUUVSVU UFSIBEBQ ,VSWB "MJSBO #BMJL 7FOB (BNCBS NFMVLJTLBO
QFOHBSVI EBSJ QFOJOHLBUBO BUBV QFOVSVOBO UFLBOBO QFOHJTJBO
TJTUFNJL 1TG
SBUBSBUB UFSIBEBQ LVSWB BMJSBO CBMJL WFOB
1FSIBUJLBOQBEB(BNCBSCBIXBUFLBOBOQFOHJTJBOTJTUFNJL
236
SBUBSBUBZBOHOPSNBMBEBMBI NN)H6OUVLLVSWBQBMJOHBUBT "MJSBOCBMJLWFOBEBQBUEJIJUVOHEFOHBONFOHHVOBLBO

QBEB HBNCBS UFSTFCVU UFLBOBO QFOHJTJBO TJTUFNJL SBUBSBUB SVNVTCFSJLVU
NFOJOHLBU NFOKBEJ NN )H EBO VOUVL LVSWB ZBOH QBMJOH
Psf-PRA
CBXBI BEBMBI NN )H ,VSWBLVSWB JOJ NFNQFSMJIBULBO VR =
RVR
UNIT IV
CBIXB TFNBLJO CFTBS UFLBOBO QFOHJTJBO TJTUFNJL SBUBSBUB ZBOH
KVHB CFSBSUJ TFNBLJO CFTBS LFLFUBUBO ZBOH UFSKBEJ LFUJLB TJTUFN 73 BEBMBI BMJSBO CBMJL WFOB 1TG BEBMBI UFLBOBO QFOHJTJBO
TJSLVMBTJ UFSJTJ EFOHBO EBSBI
LVSWB BMJSBO CBMJL WFOB BLBO TJTUFNJL SBUBSBUB 13" BEBMBI UFLBOBO BUSJVN LBOBO EBO
TFNBLJOCFSHFTFSLFBSBIBUBTEBOLFLBOBO4FCBMJLOZB TFNBLJO 373 BEBMBI UBIBOBO QBEB BMJSBO CBMJL WFOB 1BEB NBOVTJB
SFOEBI UFLBOBO QFOHJTJBO TJTUFNJL SBUBSBUB LVSWB TFNBLJO EFXBTBZBOHTFIBU OJMBJVOUVLTFNVBGBLUPSJOJBEBMBIBMJSBO
CFSHFTFSLFCBXBIEBOLFLJSJ CBMJLWFOBTFCFTBS-NFOJU UFLBOBOQFOHJTJBOTJTUFNJLSBUB
SBUBNN)H UFLBOBOBUSJVNLBOBONN)H EBOUBIBOBO
%FOHBO QFSLBUBBO MBJO TFNBLJO CBOZBL TJTUFN JOJ UFSJTJ QBEBBMJSBOCBMJLWFOB NN)H-NFOJUBMJSBOEBSBI
TFNBLJO NVEBI CBHJ EBSBI VOUVL NFOHBMJS LF EBMBN KBOUVOH
4FNBLJO TFEJLJU QFOHJTJBO TFNBLJO TVMJU CBHJ EBSBI VOUVL Pengaruh Tahanan pada Aliran Balik Vena terhadap
NFOHBMJSLFEBMBNKBOUVOH ,VSWB "MJSBO #BMJL 7FOB (BNCBS NFOVOKVLLBO
"Selisih Tekanan untuk Aliran Balik Vena"—Bila Nilai QFOHBSVIEBSJCFSCBHBJUBIBOBOQBEBBMJSBOCBMJLWFOBUFSIBEBQ
JOJ /PM 5JEBL 5FSKBEJ "MJSBO #BMJL 7FOB #JMB UFLBOBO BUSJVN LVSWBBMJSBOCBMJLWFOB ZBOHNFNQFSMJIBULBOCBIXBQFOVSVOBO
LBOBO OBJL NFOKBEJ TBNB EFOHBO UFLBOBO QFOHJTJBO TJTUFNJL UBIBOBOJOJTBNQBJTFQBSVIOPSNBMBLBONFNVOHLJOLBOEBSBI
SBUBSBUB UJEBL BEB MBHJ QFSCFEBBO UFLBOBO BOUBSB QFNCVMVI NFOHBMJS EVB LBMJ MFCJI CBOZBL EBO PMFI LBSFOB JUV BLBO
EBSBI QFSJGFS EBO BUSJVN LBOBO "LJCBUOZB UJEBL UFSKBEJ MBHJ NFNVUBSLVSWBLFBUBTTBNQBJEVBLBMJMFCJIDVSBN4FCBMJLOZB
BMJSBOEBSJQFNCVMVIQFSJGFSLFNCBMJLFBUSJVNLBOBO.FTLJQVO QFOJOHLBUBOUBIBOBOJOJTBNQBJEVBLBMJMJQBUOJMBJOPNBMBLBO
EFNJLJBO CJMB UFLBOBO BUSJVN LBOBO UVSVO TFDBSB QSPHSFTJG NFNVUBSLVSWBLFCBXBITBNQBJTFQBSVIDVSBN
TBNQBJ MFCJI SFOEBI EBSJ UFLBOBO QFOHJTJBO TJTUFNJL SBUBSBUB 1FSIBUJLBOKVHBCBIXBCJMBUFLBOBOBUSJVNLBOBONFOJOHLBU
BMJSBO LF KBOUVOH BLBO OBJL TFDBSB TFCBOEJOH TFQFSUJ ZBOH LJUB IJOHHB TBNB EFOHBO UFLBOBO QFOHJTJBO TJTUFNJL SBUBSBUB
MJIBU EFOHBO NFNQFMBKBSJ LVSWB BMJSBO CBMJL WFOB QBEB (BNCBS BMJSBO CBMJL WFOB NFOKBEJ OPM QBEB TFNVB OJMBJ UBIBOBO BMJSBO
%FOHBO EFNJLJBO TFNBLJO CFTBSQFSCFEBBO BOUBSB CBMJL WFOB LBSFOB CJMB UJEBL BEB TFMJTJI UFLBOBO VOUVL
UFLBOBO QFOHJTJBO TJTUFNJL SBUBSBUB EBO UFLBOBO BUSJVN LBOBO NFOZFCBCLBO BMJSBO EBSBI UJEBL QFEVMJ CFSBQB QVO OJMBJ
TFNBLJO CFTBS BMJSBO CBMJL WFOBOZB 0MFI LBSFOB JUV QFSCFEBBO UBIBOBOEBMBNTJSLVMBTJBMJSBOUFUBQOPM0MFILBSFOBJUV OJMBJ
BOUBSBLFEVBUFLBOBOEJBUBTEJTFCVUTFMJTJIUFLBOBOVOUVLBMJSBO QBMJOH UJOHHJ ZBOH EBQBU EJDBQBJ PMFI QFOJOHLBUBO UFLBOBO
CBMJLWFOB BUSJVN LBOBO UBOQB NFNQFSIBUJLBO TFCFSBQB CFTBS KBOUVOH
EBQBU HBHBM BEBMBI TFUBSB EFOHBO UFLBOBO QFOHJTJBO TJTUFNJL
Tahanan pada Aliran Balik Vena SBUBSBUB
4FQFSUJ IBMOZB UFLBOBO QFOHJTJBO TJTUFNJL SBUBSBUB BEBMBI
UFLBOBO ZBOH NFOEPSPOH EBSBI EBMBN WFOB EBSJ QFSJGFS LF BSBI Kombinasi Pola Kurva Aliran Balik Vena. (BNCBS
KBOUVOH UFSEBQBUKVHBUBIBOBOUFSIBEBQBMJSBOEBSBIEBMBNWFOB NFNQFSMJIBULBOFGFLZBOHUFSKBEJQBEBLVSWBBMJSBOCBMJLWFOB
JOJ5BIBOBOJOJEJTFCVUUBIBOBOQBEBBMJSBOCBMJLWFOB4FCBHJBO BLJCBU QFSVCBIBOQFSVCBIBO TFSFOUBL QBEB UFLBOBO TJTUFNJL
CFTBS UBIBOBO QBEB BMJSBO CBMJL WFOB JOJ UFSKBEJ EJ EBMBN WFOB SBUBSBUB 1TG
EBO UBIBOBO UFSIBEBQ BMJSBO CBMJL WFOB
XBMBVQVOTFCBHJBOUFSKBEJKVHBEJBSUFSJPMEBOBSUFSJLFDJM NFOVOKVLLBOCBIXBLFEVBGBLUPSJOJEBQBUCFLFSKBTFSFOUBL
.FOHBQB UBIBOBO WFOB CFHJUV QFOUJOH EBMBN NFOFOUVLBO

UBIBOBOQBEBBMJSBOCBMJLWFOB +BXBCBOOZBBEB*BICJMBUBIBOBO
EBMBN WFOB NFOJOHLBU EBSBI NVMBJ UFSCFOEVOH UFSVUBNB EJ
EBMBNWFOB5FUBQJUFLBOBOWFOBNFOJOHLBUTBOHBUTFEJLJULBSFOB
WFOB CFSTJGBU TBOHBU NVEBI UFSFHBOH 0*FI LBSFOB JUV
QFOJOHLBUBO UFLBOBO WFOB JOJ UJEBL UFSMBMV FGFLUJG VOUVL
NFOHJNCBOHJ UBIBOBO EBO BMJSBO EBSBI LF EBMBN BUSJVN LBOBO
ZBOH NFOVSVO TFDBSB ESBTUJT 4FCBMJLOZB CJMB UBIBOBO BSUFSJPM
EBO BSUFSJ LFDJM NFOJOHLBU EBSBI CFSLVNQVM EJ EBMBN BSUFSJ
ZBOH NFNJMJLJ EBZB UBNQVOH IBOZB TFQFSUJHBQVMVI EBSJ ZBOH

EJNJMJLJ WFOB 0MFI LBSFOB JUV CJMB UFSKBEJ TFEJLJU TBKB
QFOHVNQVMBO EBSBI EJ EBMBN BSUFSJ BLBO UFSKBEJ QFOJOHLBUBO
UFLBOBOBSUFSJZBOHTBOHBUCFTBSLBMJMFCJICFTBSEBSJQBEBWFOB
EBO UFLBOBO ZBOH UJOHHJ JOJ EBQBU NFOHJNCBOHJ TFCBHJBO CFTBS
QFOJOHLBUBOUBIBOBO4FDBSBNBUFNBUJT EBQBUEJOZBUBLBOCBIXB
TFLJUBS EVB QFSUJHB UBIBOBO QBEB BMJSBO CBMJL WFOB EJUFOUVLBO
PMFI UBIBOBO WFOB EBO TFLJUBS TFQFSUJHB TJTBOZB PMFI UBIBOBO
BSUFSJPMEBOBSUFSJLFDJM
237
Unit lV Sirkulasi
20

15
B
10
5 A Psf = 7 Psf = 16
0
4 0 4 8 12 16
Analisis Curah Jantung dan Tekanan Atrium Kanan

Menggunakan Kurva Curah Jantung dan Kurva Aliran CFSTBNBBO QFOJOHLBUBO WPMVNF EBSBI BLBO NFOHFNCBOHLBO
Balik Vena secara Bersamaan QFNCVMVI EBSBI TFIJOHHB NFOHVSBOHJ UBIBOBOOZB EBO
NFOVSVOLBOUBIBOBOQBEBBMJSBOCBMJLWFOB ZBOHNFNVUBSLVSWB
1BEB TJSLVMBTJ ZBOH MFOHLBQ KBOUVOH EBO TJSLVMBTJ TJTUFNJL
LF BUBT "LJCBU EVB QFOHBSVI UBEJ LVSWB BMJSBO CBMJL WFOB QBEB
IBSVTCFLFSKBCFSTBNBTBNB*OJCFSBSUJCBIXB
BMJSBOCBMJL
(BNCBS CFSHFTFS LF LBOBO ,VSWB ZBOH CBSV JOJ TBNB
WFOB EBSJ TJSLVMBTJ TJTUFNJL IBSVT TBNB EFOHBO DVSBI KBOUVOH
EFOHBO LVSWB DVSBI KBOUVOH EJ UJUJL # ZBOH NFNQFSMJIBULBO
EBSJKBOUVOHEBO
UFLBOBOBUSJVNLBOBOBEBMBI
CBIXBDVSBIKBOUVOHEBOBMJSBOCBMJLWFOBNFOJOHLBU TBNQBJ
%FOHBO EFNJLJBO LJUB EBQBU NFSBNBMLBO DVSBI KBOUVOH LBMJMJQBU EBOUFLBOBOBUSJVNLBOBONFOJOHLBUTBNQBJLJSBLJSB
EBO UFLBOBO BUSJVN LBOBO EFOHBO DBSB CFSJLVU
5FOUVLBO NN)H
LFNBNQVBO QPNQB KBOUVOH TFTBBU EBO HBNCBSLBO EBMBN
CFOUVL TFCVBI LVSWB DVSBI KBOUVOH
UFOUVLBO LFBEBBO Efek Kompensasi Lain sebagai Respons terhadap
BMJSBO EBO TJSLVMBTJ TJTUFNJL LF KBOUVOH TFTBBU EBO HBNCBSLBO Meningkatnya Volume Darah. 1FOJOHLBUBODVSBIKBOUVOHZBOH
EBMBN CFOUVL TFCVBI LVSWB BMJSBO CBMJL WFOB EBO
EJTFCBCLBO PMFI QFOJOHLBUBO WPMVNF EBSBI IBOZB CFSMBOHTVOH
TBNBLBOMBI LFEVB LVSWB JOJ TBUV TBNB MBJO TFQFSUJ ZBOH CFCFSBQB NFOJU LBSFOB CFCFSBQB FGFL LPNQFOTBTJ NVMBJ TFHFSB
EJQFSMJIBULBOQBEB(BNCBS UFSKBEJ
1FOJOHLBUBO DVSBI KBOUVOH NFOJOHLBULBO UFLBOBO
LBQJMFSTFIJOHHBDBJSBONVMBJLFMVBSEBSJLBQJMFSNBTVLLFEBMBN
,FEVBLVSWBQBEBHBNCBSUFSTFCVUNFMVLJTLBOLVSWBDVSBI
KBSJOHBO EFOHBO EFNJLJBO NFOHFNCBMJLBO WPMVNF EBSBI
KBOUVOH OPSNBM HBSJT BCVBCV UFSBOH
EBO LVSWB BMJSBO CBMJL
NFOKBEJ OPSNBM
1FOJOHLBUBO UFLBOBO EJ EBMBN WFOB
WFOB OPSNBM HBSJT BCVBCV HFMBQ
)BOZB UFSEBQBU TBUV UJUJL
NFOZFCBCLBO WFOBWFOB UFSVT NFOHFNCBOH TFDBSB CFSUBIBQ
QBEB HSBGJL UFSTFCVU ZBJUV UJUJL " UFNQBU BMJSBO CBMJL WFOB
NFMBMVJ NFLBOJTNF ZBOH EJTFCVU TUSFTSFMBLTBTJ UFSVUBNB
TBNB EFOHBO DVSBI KBOUVOHEBO UFLBOBOBUSJVN LBOBOBEBMBI
NFOZFCBCLBO UFNQBU QFOZJNQBOBO EBSBI WFOB TFQFSUJ IBUJ EBO
TBNB VOUVL KBOUVOH NBVQVO TJSLVMBTJ TJTUFNJL 0MFI LBSFOB
MJNQB
NFNCFTBS TFIJOHHB NFOVSVOLBO UFLBOBO TJTUFNJL SBUB
JUV EBMBN TJSLVMBTJ OPSNBM UFLBOBO BUSJVN LBOBO DVSBI
SBUB
,FMFCJIBO BMJSBO EBSBI ZBOH NFMBMVJ KBSJOHBO QFSJGFS
KBOUVOH EBOBMJSBOCBMJLWFOBTFNVBOZBEJMVLJTLBOPMFIUJUJL"
NFOZFCBCLBO QFOJOHLBUBO UBIBOBO WBTLVMFS QFSJGFS NFMBMVJ
ZBOH EJTFCVU UJUJL LFTFJNCBOHBO NFOHIBTJMLBO OJMBJ OPSNBM
NFLBOJTNF QFOHBUVSBO TFOEJSJ BVUPSFHVMBTJ
TFIJOHHB
VOUVL DVSBI KBOUVOH TFCFTBS -NFOJU EBO UFLBOBO BUSJVN
NFOJOHLBULBO UBIBOBO BMJSBO CBMJL WFOB 'BLUPSGBLUPS JOJ
LBOBOTFCFTBSNN)H
NFOZFCBCLBO UFLBOBO QFOHJTJBO TJTUFNJL SBUBSBUB LFNCBMJ
Pengaruh Peningkatan Volume Darah terhadap Curah OPSNBM EBO UBIBOBO QFNCVMVI EBSBI EJ TJSLVMBTJ TJTUFNJL
Jantung. 1FOJOHLBUBOUJCBUJCBWPMVNFEBSBITFLJUBSQFSTFO CFSLPOTUSJLTJ0MFILBSFOBJUV TFDBSBCFSUBIBQ TFUFMBITBNQBJ
BLBO NFOJOHLBULBO DVSBI KBOUVOH TFLJUBS TBNQBJ LBMJ NFOJU DVSBIKBOUVOHLFNCBMJ mendekati normal.
OPSNBM"OBMJTJTFGFLJOJEJMVLJTLBOQBEB(BNCBS4FHFSB
TFUFMBI QFNCFSJBO JOGVT TFKVNMBI CFTBS EBSBI UBNCBIBO Pengaruh Perangsangan Simpatis terhadap Curah Jantung.
QFOJOHLBUBOQFOHJTJBOTJTUFNNFOZFCBCLBOUFLBOBOQFOHJTJBO 1FSBOHTBOHBOTJNQBUJTNFNFOHBSVIJKBOUVOHEBOTJSLVMBTJ
TJTUFNJL SBUBSBUB 1TG
OBJL TBNQBJ NN )H ZBOH TJTUFNJL
NFNCVBUKBOUVOHNFOKBEJQPNQBZBOHMFCJILVBU

NFOHHFTFSLVSWBBMJSBOCBMJLWFOBLFLBOBO1BEBXBLUV %BMBNTJSLVMBTJTJTUFNJL QFSBOHTBOHBOTJNQBUJTNFOJOHLBULBO
UFLBOBOQFOHJTJBOTJTUFNJLSBUBSBUBBLJCBU
238
Bab 20 Curah Jantung, Aliran Balik Vena, dan Pengaturannyan
UNIT IV

LPOUSBLTJ QFNCVMVI EBSBI QFSJGFS UFSVUBNB WFOBWFOB EBO

NFOJOHLBULBOUBIBOBOUFSIBEBQBMJSBOCBMJLWFOB
1BEB(BNCBS EJMVLJTLBOLVSWBDVSBIKBOUVOHEBOLVSWB
BMJSBO CBMJL WFOB OPSNBM LVSWBLVSWB JOJ TBMJOH NFOZFTVBJLBO Pengaruh Terbukanya Fistula Arteriovenosus Besar.
QBEBUJUJL" ZBOHNFOVOKVLLBOTVBUVBMJSBOCBMJLWFOBEBODVSBI
(BNCBS NFNQFSMJIBULBO CFSCBHBJ EFSBKBU QFSVCBIBO
KBOUVOH ZBOH OPSNBM TFCFTBS -NFOJU EBO UFLBOBO BUSJVN
TJSLVMBTJZBOHUFSKBEJTFUFMBIUFSCVLBOZBGJTUVMBBSUFSJPWFOPTVT
LBOBO NN )H 1FSIBUJLBO CBIXB QFSBOHTBOHBO TJNQBUJT
CFTBS ZBJUV TFUFMBI UFSKBEJ IVCVOHBO MBOHTVOH BOUBSB BSUFSJ
NBLTJNBM LVSWBIJKBV
NFOJOHLBULBOUFLBOBOQFOHJTJBOTJTUFNJL
CFTBSEBOWFOBCFTBS
SBUBSBUB TBNQBJ NN )H EJMVLJTLBO PMFI UJUJL UFNQBU LVSWB
BMJSBO CBMJL WFOB NFODBQBJ UJOHLBU BMJSBO CBMJL WFOB OPM
1. %VB LVSWB NFSBI ZBOH CFSTJMBOHBO QBEB UJUJL " NFNQFS
1FSBOHTBOHBO TJNQBUJT KVHB NFOJOHLBULBO FGFLUJWJUBT MJIBULBOLPOEJTJOPSNBM
QFNPNQBBO KBOUVOH IBNQJS QFSTFO "LJCBUOZB DVSBI 2. ,VSWBLVSWBZBOHCFSTJMBOHBOQBEBUJUJL#NFNQFSMJIBULBO
KBOUVOH OBJL EBSJ OJMBJ OPSNBM EJ UJUJL LFTFJNCBOHBO " NFOKBEJ LPOEJTJ TJSLVMBTJ ZBOH TFHFSB UFSKBEJ TFUFMBI QFNCVLBBO
LJSBLJSBEVBLBMJMJQBUOJMBJOPSNBMEJUJUJLLFTFJNCBOHBO%EBO GJTUVMB CFTBS &GFLFGFL VUBNBOZB BEBMBI
SPUBTJ LVSWB
UFSOZBUB UFLBOBO BUSJVN LBOBO IBNQJS UJEBL CFSVCBI +BEJ BMJSBOCBMJLWFOBLFBSBIBUBTZBOHUJCBUJCBEBOCFSMBOHTVOH
CFSCBHBJ EFSBKBU QFSBOHTBOHBO TJNQBUJT EBQBU NFOJOHLBULBO DFQBU BLJCBU QFOVSVOBO UBIBOBO BMJSBO CBMJL WFOB ZBOH
DVSBI KBOUVOH TFDBSB QSPHSFTJG TBNQBJ LJSBLJSB EVB LBMJ OPSNBM ESBTUJTCJMBEBSBIEJCJBSLBONFOHBMJSEFOHBOIBNQJSUBOQB
VOUVLXBLUVZBOHTJOHLBUTBNQBJUFSKBEJFGFLLPNQFOTBTJEBMBN IBNCBUBOTFDBSBMBOHTVOHEBSJBSUFSJCFTBSLFEBMBNTJTUFN
XBLUVCFCFSBQBEFUJLBUBVNFOJU WFOB NFNJOUBT TFCBHJBO CFTBS FMFNFO UBIBOBO TJSLVMBTJ
Pengaruh Penghambatan Simpatis terhadap Curah QFSJGFS EBO
TFEJLJU QFOJOHLBUBO LVSWB DVSBI KBOUVOH
Jantung.4JTUFNTBSBGTJNQBUJTEBQBUEJCMPLJSEFOHBONFMBLVLBO LBSFOBUFSCVLBOZBGJTUVMBBLBONFOVSVOLBOUBIBOBOQFSJGFS
BOFTUFTJTQJOBMUPUBMBUBVEFOHBONFNBLBJ CFCFSBQBPCBU TFQFSUJ EBO NFNVOHLJOLBO QFOVSVOBO UFLBOBO BSUFSJ ZBOH BLVU
IFLTBNFUPOJVN ZBOH NFOZFLBU USBOTNJTJ JNQVMTJNQVMT TBSBG TFIJOHHB KBOUVOH EBQBU NFNPNQB EFOHBO MFCJI NVEBI
JOFMBMVJ HBOHMJB PUPOPNJL ,VSWBLVSWB ZBOH MFUBLOZB QBMJOH )BTJM BLIJSOZB ZBOH EJMVLJTLBO PMFI UJUJL # BEBMBI
CBXBI QBEB (BNCBS NFNQFSMJIBULBO QFOHBSVI QFOJOHLBUBO DVSBI KBOUVOH EBSJ -NFOJU NFOKBEJ -
QFOHIBNCBUBO TJNQBUJT ZBOH EJTFCBCLBO PMFI BOFTUFTJ TQJOBM NFOJU EBO QFOJOHLBUBO UFLBOBO BUSJVN LBOBO TBNQBJ
UPUBM NFOVOKVLLBO CBIXB
UFLBOBO QFOHJTJBO TJTUFNJL SBUB TFLJUBSNN)H
SBUB UVSVO NFOKBEJ TFLJUBS NN )H EBO
FGFLUJWJUBT KBOUVOH 3. 5JUJL $ NFOVOKVLLBO FGFLOZB TFLJUBS NFOJU LFNVEJBO
TFCBHBJ QPNQB UVSVO NFOKBEJ TFLJUBS QFSTFO OPSNBM $VSBI TFUFMBI SFGMFLT TBSBG TJNQBUJT NFNVMJILBO UFLBOBO BSUFSJ
KBOUVOHUVSVOEBSJUJUJL"LFUJUJL# ZBOHNFSVQBLBOQFOVSVOBO TBNQBJIBNQJSOPSNBMEBONFOZFCBCLBOEVBFGFLMBJO
TFCFTBSLJSBLJSBQFSTFOOPSNBM QFOJOHLBUBO UFLBOBO QFOHJTJBO TJTUFNJL SBUBSBUB BLJCBU

LPOTUSJLTJTFNVBWFOBEBOBSUFSJ
EBSJNFOKBEJNN)H
239
UnitlV Sirkulasi
TFIJOHHB NFOHHFTFS LVSWB BMJSBO CBMJL WFOB NN )H LF

LBOBO EBO
QFOJOHLBUBO MFCJI MBOKVU QBEB LVSWB DVSBI
KBOUVOHBLJCBUQFSBOHTBOHBOTBSBGTJNQBUJTKBOUVOH$VSBI
KBOUVOH TFLBSBOH NFOJOHLBU IJOHHB IBNQJS -NFOJU
EBOUFLBOBOBUSJVNLBOBONFOKBEJTFLJUBSNN)H
4. 5JUJL % NFNQFSMJIBULBO FGFL TFUFMBI CFCFSBQB NJOHHV
LFNVEJBO 1BEB TBBU JOJ WPMVNF EBSBI UFMBI NFOJOHLBU
LBSFOB TFEJLJU QFOVSVOBO QBEB UFLBOBO BSUFSJ EBO
QFSBOHTBOHBOTJNQBUJTLFEVBOZBNFOVSVOLBOLFMVBSBOVSJO
PMFI HJOKBM 5FLBOBO QFOHJTJBO TJTUFNJL SBUBSBUB TFLBSBOH
UFMBI NFOJOHLBU NFOKBEJ NN )H NFOHHFTFS LVSWB
BMJSBOCBMJLWFOBNN)HMBHJLFLBOBO1FOJOHLBUBOCFCBO
LFSKB ZBOH CFSLFQBOKBOHBO QBEB KBOUVOH KVHB UFMBI
Pengukuran Curah Jantung Menggunakan Asas Fick
NFOZFCBCLBO PUPU KBOUVOH NFOKBEJ IJQFSUSPGJ TFIJOHHB
Oksigen
NFOJOHLBULBO OJMBJ LVSWB DVSBI KBOUVOH MFCJI MBOKVU 0MFI "[BT 'JDL EJKFMBTLBO QBEB (BNCBS (BNCBS JOJ
LBSFOB JUV TFLBSBOH UJUJL % NFNQFSMJIBULBO DVSBI KBOUVOH NFNQFSMJIBULBO CBIXB NM PLTJHFO EJBCTPSQTJ EBSJ QBSV LF
ZBOHCFTBSOZBIBNQJS-NFOJUEBOUFLBOBOBUSJVNLBOBO EBMBNEBSBIQVMNPOBMTFUJBQNFOJUOZB$BSBJOJKVHBNFMVLJTLBO
TFLJUBSNN)H CBIXB EBSBI ZBOH NFNBTVLJ CBHJBO LBOBO KBOUVOH NFNQVOZBJ
Analisis Pengaturan Curah Jantung Lainnya.%J#BC LPOTFOUSBTJ PLTJHFO NM- EBSBI TFEBOHLBO ZBOH
EJQFSMJIBULBO BOBMJTJT QFOHBUVSBO DVSBI KBOUVOH TFMBNB LFSKB NFOJOHHBMLBO CBHJBO LJSJ KBOUVOH NFNQVOZBJ LPOTFOUSBTJ
GJTJL EBO EJ #BC EJQFSMJIBULBO BOBMJTJT FOHBUVSBO DVSBI PLTJHFO NM- EBSBI %BSJ EBUB JOJ LJUB EBQBU NFOHIJUVOH
KBOUVOHQBEBCFSCBHBJTUBEJVNHBHBMKBOUVOHLPOHFTUJG CBIXB TFUJBQ MJUFS EBSBI ZBOH NFMFXBUJ QBSV NFOHBNCJ NM
PLTJHFO
Metode-Metode untuk Mengukur Curah Jantung
,BSFOB KVNMBI UPUBM PLTJHFO ZBOH EJBCTPSQTJ LF EBMBN EBSBI
1BEB CJOBUBOH QFSDPCBBO EBQBU EJQBTBOH LBOVMB QBEB BPSUB EBSJ QBSV TFUJBQ NFOJUOZB BEBMBI NM EJCBHJ IBTJMOZB
BSUFSJQVMNPOBMJT BUBVWFOBWFOBCFTBSZBOHNFNBTVLJKBOUVOH BEBMBI MJNB LBMJ - EBSBI ZBOH IBSVT NFMFXBUJ TJSLVMBTJ QBSV
EBO DVSBI KBOUVOH EBQBU EJVLVS EFOHBO NFNBLBJ BMBU VLVS TFUJBQNFOJUOZBVOUVLNFOHBCTPSQTJTFKVNMBIPLTJHFOUBEJ0MFI
BMJSBO GMPXNFUFS
KFOJT BQB TBKB 4FCVBI QFOHVLVS BMJSBO KFOJT LBSFOB JUV KVNMBI BMJSBO EBSBI ZBOH NFMFXBUJ QBSVQBSV TFUJBQ
FMFLUSPNBHOFUJL BUBV VMUSBTPOJL KVHB EBQBU EJUFNQBULBO QBEB NFOJU BEBMBI - ZBOH KVHB NFSVQBLBO VLVSBO EBSJ DVSBI
BPSUBBUBVBSUFSJQVMNPOBMJTVOUVLNFOHVLVSDVSBIKBOUVOH KBOUVOH +BEJ DVSBI KBOUVOH EBQBU EJIJUVOH EFOHBO SVNVT
CFSJLVU
1BEB NBOVTJB LFDVBMJ QBEB LFBEBBOLFBEBBO ZBOH KBSBOH
DVSBI KBOUVOH EJVLVS TFDBSB UJEBL MBOHTVOH EFOHBO NFUPEF
ZBOH UJEBL NFNFSMVLBO QFNCFEBIBO %VB EJ BOUBSB NFUPEF
ZBOHEJHVOBLBOVOUVLTUVEJFLTQFSJNFOUBMBEBMBINFUPEF'JDL
PLTJHFO PYZHFO 'JDL NFUIPE
EBO NFUPEF QFOHFODFSBO
JOEJLBUPS 1BEB QFOFSBQBO NFUPEF 'JDL VOUVL NFOHVLVS DVSBI KBOUVOH
$VSBI KBOUVOH KVHB EBQBU EJQFSLJSBLBO NFOHHVOBLBO NBOVTJB EBSBIWFOBDBNQVSBOCJBTBOZBEJQFSPMFINFMBMVJLBUFUFS
FLIPLBSEJPHSBN TBUV NFUPEB NFOHHVOBLBO HFMPNCBOH ZBOH EJTJTJQLBO LF EBMBN WFOB CSBLJBMJT EJ MFOHBO BUBT NFMFXBUJ
VMUSBTPVOEZBOHEJMFQBTEBSJUSBOTEVTFSZBOHEJUFNQBULBOQBEB WFOB TVCLMBWJB UVSVO LF BUSJVN LBOBO EBO BLIJSOZB LF EBMBN
EJOEJOH EBEB BUBV EJMFXBULBO NFMBMVJ FTPGBHVT QBTJFO VOUVL WFOUSJLFM LBOBO BUBV BSUFSJ QVMNPOBMJT %BSBI BSUFSJ TJTUFNJL
NFOHVLVS CFTBS SPOHHB KBOUVOH TFSUB LFDFQBUBO BMJSBO EBSBI LFNVEJBOEBQBUEJQFSPMFIEBSJBSUFSJTJTUFNJLNBOBQVOEBMBN
EBSJ WFOUSJLFM LJSJ LF BPSUB 7PMVNF TFLVODVQ EJIJUVOH EBSJ
LFDFQBUBO BMJSBO EBSBI LF EBMBN BPSUB EBO MVBT QFOBNQBOH
BPSUBEJUFUBQLBOEBSJEJBNFUFSBPSUBZBOHEJVLVSNFOHHVOBLBO
QFODJUSBBOVMUSBTPVOE4FMBOKVUOZBDVSBIKBOUVOHEJIJUVOHEBSJ
QSPEVLWPMVNFTFLVODVQEBOGSFLVFOTJEFOZVUKBOUVOH
Denyut Curah Jantung Seperti yang Diukur mengguna-
kan Pengukur Aliran (Flowmeter) Elektromagnetik atau
Ultrasonik
(BNCBS NFMVLJTLBO TVBUV SFLBNBO BMJSBO EBSBI EJ
QBOHLBMBPSUBTFFLPSBOKJOHZBOHEJCVBUEFOHBONFOHHVOBLBO Cardiac output =
QFOHVLVS BMJSBO FMFLUSPNBHOFUJL 1FOHVLVS BMJSBO JOJ 5000 ml/min
NFNQFSMJIBULBO CBIXB BMJSBO EBSBI NFOJOHLBU EFOHBO DFQBU
NFODBQBJQVODBLTFMBNBTJTUPM EBOLFNVEJBOQBEBBLIJSTJTUPM
CFSCBMJL EBMBN XBLUV TFQFSTFLJBO EFUJL "MJSBO CBMJL JOJ
NFOZFCBCLBO LBUVQ BPSUB NFOVUVQ EBO BMJSBO LFNCBMJ LF
BOHLBOPM
240
UVCVI ,FDFQBUBO BCTPSQTJ PLTJHFO PMFI QBSV EJIJUVOH NFMBMVJ 4FUFMBI LVSWB FLTUSBQPMBTJ XBLUVLPOTFOUSBTJ EJUFUBQLBO
LFDFQBUBO IJMBOHOZB PLTJHFO EBSJ VEBSB SFTQJSBTJ EFOHBO LFNVEJBO LJUB EBQBU NFOHIJUVOH LPOTFOUSBTJ SBUBSBUB [BU
NFOHHVOBLBOQFOHVLVSPLTJHFO PYZHFONFUFS
KFOJTBQBQVO XBSOB EJ EBMBN EBSBI BSUFSJ TFMBNB XBLUV ZBOH EJCVUVILBO
PMFI LVSWB UFSTFCVU 1BEB DPOUPI QBMJOH BUBT (BNCBS
UNIT IV
Metode Pengenceran Indikator untuk Mengukur Curah QFOHIJUVOHBOJOJUFMBIEJMBLVLBOEFOHBONFOHVLVSEBFSBIEJ
Jantung CBXBI TFMVSVI LVSWB LVSWB SBUBLBO LPOTFOUSBTJ [BU XBSOB
TFMBNBEVSBTJLVSWBUFSTFCVULJUBEBQBUNFMJIBUQBEBQFSTFHJ
QBOKBOHLVSWBCBHJBOBUBTHBNCBSUFSTFCVUCBIXBLPOTFOUSBTJ
6OUVL NFOHVLVS DVSBI KBOUVOH EFOHBO NFUPEF QFOHFODFSBO SBUBSBUB [BU XBSOB LJSBLJSB NHEM EBSBI EBO MBNBOZB
JOEJLBUPShh TFKVNMBI LFDJM JOEJLBUPS TFQFSUJ [BU XBSOB OJMBJ SBUBSBUB JOJ BEBMBI EFUJL 4FKVNMBI UPUBM NH [BU
EJTVOUJLLBOLFEBMBNTFCVBIWFOBTJTUFNJLCFTBSBUBV MFCJICBJL XBSOB UFMBI EJTVOUJLLBO QBEB BXBM QFSDPCBBO JOJ %BSBI
MBHJ LFBUSJVNLBOBO*OEJLBUPSJOJCFSKBMBOEFOHBODFQBUNFMBMVJ IBOZB EBQBU NFNCBXB NH [BU XBSOB EBMBN TFUJBQ
KBOUVOH LBOBO LFNVEJBO NFMFXBUJ QFNCVMVI EBSBI QBSV LF NM TFIJOHHBVOUVLNFNCBXBTFMVSVINH[BUXBSOBNFMBMVJ
KBOUVOH LJSJ EBO BLIJSOZB LF EBMBN TJTUFN BSUFSJ TJTUFNJL KBOUVOH EBO QBSVQBSV EBMBN XBLUV EFUJL EJQFSMVLBO
,POTFOUSBTJ [BU XBSOB UFSTFCVU EJSFLBN LFUJLB NFMFXBUJ TBMBI TFKVNMBI CBHJBO TFCFTBS NBTJOHNBTJOH NM EBSBI
TBUV BSUFSJ QFSJGFS NFOHIBTJMLBO LVSWB TFQFSUJ ZBOH EJMVLJTLBO VOUVL CFSKBMBO NFMBMVJ KBOUVOH TFMBNB XBLUV JOJ EFUJL

QBEB (BNCBS 1BEB UJBQUJBQ DPOUPI JOJ NH [BU XBSOB ZBOHCFSBSUJTBNBEFOHBODVSBIKBOUVOHTFCFTBS-EFUJL
$BSEJP(SFFO UFMBI EJTVOUJLLBO QBEB XBLUV OPM 1BEB SFLBNBO BUBV -NFOJU 4FLBSBOH QFNCBDB EJQFSTJMBLBO VOUVL
QBMJOH BUBT UJEBL BEB [BU XBSOB ZBOH NBTVL LF EBMBN NFOHIJUVOH DVSBI KBOUVOH EBO LVSWB FLTUSBQPMBTJ CBHJBO
QFSDBCBOHBO BSUFSJ TBNQBJ LJSBLJSB EFUJL TFTVEBI CBXBI QBEB (BNCBS 3JOHLBTOZB DVSBI KBOUVOH EBQBU
QFOZVOUJLBO UFUBQJ LFNVEJBO LPOTFOUSBTJ [BU XBSOB EJ EBMBN EJUFOUVLBOEFOHBONFOHHVOBLBOSVNVTCFSJLVUJOJ
BSUFSJ NFOJOHLBU EFOHBO DFQBU IJOHHB NFODBQBJ NBLTJNVN
EBMBNXBLUVLJSBLJSBIJOHHBEFUJL4FTVEBIJUV LPOTFOUSBTJ
NFOVSVO EFOHBO DFQBU 5FUBQJ TFCFMVN LPOTFOUSBTJ NFODBQBJ
UJUJL OPM TFCBHJBO [BU XBSOB UFMBI CFSTJSLVMBTJ TFQFOVIOZB
NFMBMVJ CFCFSBQB QFNCVMVI EBSBI TJTUFNJL QFSJGFS EBO LFNCBMJ
LF KBOUVOH VOUVL LFEVB LBMJOZB "LJCBUOZB LPOTFOUSBTJ [BU
XBSOB EJ EBMBN BSUFSJ NVMBJ NFOJOHLBU LFNCBMJ 6OUVL UVKVBO
QFOHIJUVOHBO IBSVT EJMBLVLBO FLTUSBQPMBTJ QBEB LFNJSJOHBO
LVSWB ZBOH NFOVSVO QFSUBNB LBMJ LF UJUJL OPM TFQFSUJ ZBOH
EJQFSMJIBULBOPMFIHBSJTQVUVTQVUVTQBEBNBTJOHNBTJOHLVSWB Daftar Pustaka
%FOHBO DBSB JOJ LVSWB FLTUSBQPMBTJ XBLUVLPOTFOUSBTJ
Gaasch WH, Zile MR: Left ventricular diastolic dysfunction and diastolic
FYUSBQPMBUFEUJNFDPODFOUSBUJPODVSWF
ZBOHEJIBTJMLBOPMFI[BU heart failure, Annu Rev Med 55:373, 2004.
XBSOB EJ EBMBN BSUFSJ TJTUFNJL UBOQB SFTJSLVMBTJ EBQBU EJVLVS Guyton AC: Venous return. In Hamilton WF, editor: Handbook of Physiology,
QBEB CBHJBO QFSUBNBOZB EBO EJUBLTJS EFOHBO DVLVQ UFQBU EJ Sec 2, vol 2, Baltimore, 1963, Williams & Wilkins, p 1099.
CBHJBOCFSJLVUOZB Guyton AC: Determination of cardiac output by equating venous return
curves with cardiac response curves, Physiol Rev 35:123, 1955. Guyton AC,
Jones CE, Coleman TG: Circulatory physiology: cardiac output
and its regulation, Philadelphia, 1973, WB Saunders.
Guyton AC, Lindsey AW, Kaufmann BN: Effect of mean circulatory filling
pressure and other peripheral circulatory factors on cardiac output, Am
J Physiol 180:463–468, 1955.
Hall JE: Integration and regulation of cardiovascular function, Am J Physiol
277:S174, 1999.
Hall JE: The pioneering use of systems analysis to study cardiac output reg-
ulation, Am J Physiol Regul Integr Comp Physiol 287:R1009, 2004. Klein I,
Danzi S: Thyroid disease and the heart, Circulation 116:1725, 2007. Koch WJ,
Lefkowitz RJ, Rockman HA: Functional consequences of altering
myocardial adrenergic receptor signaling, Annu Rev Physiol 62:237, 2000.
Mathews L, Singh RK: Cardiac output monitoring, Ann Card Anaesth 11:56,
2008.
Rothe CF: Mean circulatory filling pressure: its meaning and measurement,
J Appl Physiol 74:499, 1993.
Rothe CF: Reflex control of veins and vascular capacitance, Physiol Rev
63:1281, 1983.
Sarnoff SJ, Berglund E: Ventricular function. 1. Starling’s law of the heart,
studied by means of simultaneous right and left ventricular function
curves in the dog, Circulation 9:706–718, 1953.
Uemura K, Sugimachi M, Kawada T, et al: A novel framework of circulatory
equilibrium, Am J Physiol Heart Circ Physiol 286:H2376, 2004.
Vatner SF, Braunwald E: Cardiovascular control mechanisms in the con-
scious state, N Engl J Med 293:970, 1975.
241
BAB 21
"MJSBO%BSBI0UPUEBO$VSBI+BOUVOH
UNIT IV
4FMBNB,FSKB'JTJL4JSLVMBTJ,PSPOFS
EBO1FOZBLJU+BOUVOH*TLFNJL
1BEBCBCJOJLJUBNFNCBIBT
1FOZFCBC CFSLVSBOHOZB BMJSBO EBSBI TFMBNB GBTF LPOUSBLTJ
BMJSBOEBSBILFPUPUSBOHLBEBO PUPU TBBU LFSKB GJTJL BEBMBI UFSUFLBOOZB QFNCVMVI EBSBI PMFI

BMJSBOEBSBILPSPOFSLFKBO PUPU ZBOH CFSLPOUSBLTJ 4FMBNB LPOUSBLTJ UFUBOJL ZBOH LVBU
UVOH1FOHBUVSBOLFEVBOZBUFS ZBOHNFOZFCBCLBOQFOFLBOBONFOFUBQQBEBQFNCVMVIEBSBI
VUBNB EJDBQBJ NFMBMVJ QFOHB BMJSBO EBSBI EBQBU IBNQJS CFSIFOUJ UFUBQJ IBM JOJ KVHB
UVSBO UBIBOBO WBTLVMBS TFUFN NFOZFCBCLBONFMFNBIOZBLPOUSBLTJEFOHBODFQBU
QBUTFCBHBJSFTQPOTUFSIBEBQ Peningkatan Aliran Darah di Kapiler Otot Selama Kerja
LFCVUVIBONFUBCPMJLKBSJOHBOPUPU Fisik. 4FMBNB JTUJSBIBU BMJSBO EBSBI EJ CFCFSBQB LBQJMFS PUPU
,JUBKVHBBLBONFNCBIBTGJTJPMPHJCFSCBHBJIBMUFSLBJU TFQFSUJ IBOZB TFEJLJU BUBV UJEBL BEB TBNB TFLBMJ /BNVO TFMBNB LFSKB

QFOHBUVSBO DVSBI KBOUVOH TFMBNB LFSKB GJTJL
DJSJ LIBT GJTJL ZBOH CFSBU TFMVSVI LBQJMFS UFSCVLB 5FSCVLBOZB LBQJMFS
TFSBOHBOKBOUVOH EBO
OZFSJBOHJOBQFLUPSJT ZBOH UJEBL BLUJG JOJ NFOHVSBOHJ KBSBL EJGVTJ PLTJHFO EBO [BU
NBLBOBO MBJOOZB EBSJ LBQJMFS LF TFSBUTFSBU PUPU ZBOH
CFSLPOUSBLTJ EBO LBEBOHLBEBOH NFOZFCBCLBO QFSMVBTBO
EBFSBI QFSNVLBBO LBQJMFS UFNQBU PLTJHFO EBO [BU NBLBOBO
Pengaturan Aliran Darah Otot Rangka EBQBUCFSEJGVTJEBSJEBSBILFKBSJOHBO TFCFTBSEVBTBNQBJUJHB
Selama Istirahat dan Kerja Fisik LBMJMJQBU
,FSKBGJTJLZBOHTBOHBUCFSBUNFSVQBLBOTBMBITBUVLPOEJTJQFOVI
TUSFTZBOHEJIBEBQJPMFITJTUFNTJSLVMBTJOPSNBM)BMJOJNFNBOH Pengaturan Aliran Darah Otot Rangka
CFOBSLBSFOBUFSEBQBUCBOZBLTFLBMJNBTTBPUPUSBOHLBEJEBMBN Pengaturan Lokal-Penurunan Oksigen di Otot Akan
UVCVI ZBOH TFMVSVIOZB NFNCVUVILBO TFKVNMBI CFTBS BMJSBO Sangat Memperkuat Aliran. 1FOJOHLBUBO IFCBU BMJSBO EBSBI
EBSBI 4FMBJO JUV DVSBI KBOUVOH TFSJOH LBMJ IBSVT NFOJOHLBU EJ PUPU ZBOH UFSKBEJ TFMBNB BLUJWJUBT PUPU SBOHLB UFSVUBNB
TFCBOZBL FNQBU TBNQBJ MJNB LBMJ OPSNBM QBEB TFTFPSBOH ZBOH EJTFCBCLBO PMFI [BU LJNJB ZBOH CFLFSKB MBOHTVOH QBEB BSUFSJPM
CVLBO BUMFU BUBV TFCBOZBL FOBN TBNQBJ UVKVI LBMJ OPSNBM QBEB PUPU VOUVL NFOJNCVMLBO EJMBUBTJ 4BMBI TBUV QFOHBSVI LJNJB
TFPSBOH BUMFU ZBOH UFSMBUJI CBJL VOUVL NFNFOVIJ LFCVUVIBO ZBOH QBMJOH QFOUJOH BEBMBI CFSLVSBOHOZB PLTJHFO EJ KBSJOHBO
NFUBCPMJLPUPUZBOHCFLFSKB PUPU "QBCJMB PUPU BLUJG QFOHHVOBBO PLTJHFO NFOKBEJ DFQBU
TFIJOHHB NFOVSVOLBO LPOTFOUSBTJ PLTJHFO EBMBN DBJSBO
Kecepatan Aliran Darah melalui Otot KBSJOHBO )BM JOJ TFMBOKVUOZB NFOZFCBCLBO WBTPEJMBUBTJ BSUFSJPM
MPLBM LBSFOB EJOEJOH BSUFSJPM UJEBL EBQBU NFNQFSUBIBOLBO
4FMBNBJTUJSBIBU SBUBSBUBBMJSBOEBSBINFMBMVJPUPUSBOHLBBEBMBI
LPOUSBLTJOZB QBEB LFBEBBO UJEBL BEB PLTJHFO EBO LBSFOB
BOUBSBTBNQBJNMNFOJUHSBNPUPU4FMBNBLFSKBGJTJLCFSBU
LFLVSBOHBO PLTJHFO NFOZFCBCLBO QFMFQBTBO CFSCBHBJ [BU
QBEBBUMFUUFSMBUJI BMJSBOEBSBIJOJEBQBUNFOJOHLBUTBNQBJ
WBTPEJMBUPS "EFOPTJO NVOHLJO NFSVQBLBO [BU WBTPEJMBUPS
LBMJ MJQBU NFODBQBJ TBNQBJ NMNFOJU HSBN PUPU
QFOUJOH OBNVO QFOFMJUJBO UFMBI NFOVOKVLLBO CBIXB CBILBO
"MJSBOEBSBIUFSUJOHHJ QFBLGMPX
TFCFTBSNMNFOJUHSBN
CJMB TFKVNMBI CFTBS BEFOPTJO EJJOGVT TFDBSB MBOHTVOH LF EBMBN
PUPU UFMBI EJMBQPSLBO UFSKBEJ QBEB PUPU QBIB BUMFU LFUBIBOBO
BSUFSJ PUPU QFOJOHLBUBO BMJSBO EBSBI UJEBL NFODBQBJ TFCFTBS
FOEVSBODF
UFSMBUJI
LFUJLB NFMBLVLBO LFSKB GJTJL CFSBU EBO WBTPEJMBUBTJ PUPU SBOHLB
Aliran Darah Selama Kontraksi Otot. (BNCBS UJEBLEBQBUEJQFSUBIBOLBOMFCJIEBSJTFLJUBSKBN
NFNQFSMJIBULBOSFLBNBOQFSVCBIBOBMJSBOEBSBIQBEBPUPUCFUJT
6OUVOHOZB CBILBO TFTVEBI QFNCVMVI EBSBI PUPU NFOKBEJ
UVOHLBJ NBOVTJB TFMBNB LFSKB PUPU ZBOH LVBU EBO CFSJSBNB
UJEBLQFLBUFSIBEBQQFOHBSVIWBTPEJMBUPSEBOBEFOPTJO GBLUPS
1FSIBUJLBO CBIXB BMJSBO EBSBI NFOJOHLBU EBO NFOVSVO TFUJBQ
WBTPEJMBUPS MBJOOZB UFUBQ NFNQFSUBIBOLBO QFOJOHLBUBO BMJSBO
LBMJ PUPU CFSLPOUSBLTJ 1BEB BLIJS LPOUSBLTJ BMJSBO EBSBI UFUBQ
EBSBI LBQJMFS TFMBNB LFSKB GJTJL NBTJI CFSMBOHTVOH 'BLUPS
UJOHHJ TFMBNB CFCFSBQB EFUJL UFUBQJ LFNVEJBO LFNCBMJ OPSNBM
GBLUPS JOJ BEBMBI
JPO LBMJVN
BEFOPTJO USJGPTGBU "51

TFUFMBICFCFSBQBNFOJUCFSJLVUOZB

BTBNMBLUBU EBO
LBSCPOEJPLTJEB,JUBUFUBQUJEBLUBIV
243
Unit IV Sirkulasi
Pengaruh Perangsangan Simpatis Menyeluruh

40
1BEB BXBM LFSKB GJTJL TJOZBM UJEBL IBOZB EJIBOUBSLBO EBSJ PUBL
NFOVKV PUPU VOUVL NFOJNCVMLBO LPOUSBLTJ PUPU UFUBQJ KVHB LF
QVTBU WBTPNPUPS VOUVL NFNVMBJ QFSBOHTBOHBO TJNQBUJT EJ
TFMVSVIUVCVI4FDBSBCFSTBNBBO TJOZBMQBSBTJNQBUJTLFKBOUVOH
20
NFOKBEJ TBOHBU MFNBI 0MFI LBSFOB JUV UJNCVM UJHB FGFL VUBNB
TJSLVMBTJ
1FSUBNB KBOUVOH EJSBOHTBOH TFIJOHHB LFDFQBUBO EFOZVU
KBOUVOHEBOLFLVBUBOQFNPNQBBOOZBNFOKBEJTBOHBUNFOJOHLBU
0
0 10 16 18 TFCBHBJ BLJCBU SBOHTBOHBO TJNQBUJT LF KBOUVOH EBO UFSCFCBTOZB
KBOUVOHEBSJIBNCBUBOQBSBTJNQBUJTOPSNBM
,FEVB TFCBHJBO CFTBS BSUFSJPM TJSLVMBTJ QFSJGFS CFSLPOUSBLTJ
EFOHBO LVBU LFDVBMJ BSUFSJPMBSUFSJPM EBMBN PUPU ZBOH BLUJG ZBOH
CFSEJMBUBTJ BLJCBU QFOHBSVI WBTPEJMBUPS MPLBM LVBU EBMBN PUPU
TFQFSUJ ZBOH EJKFMBTLBO TFCFMVNOZB +BEJ KBOUVOH EJSBOHTBOH
VOUVLNFOJOHLBULBOBMJSBOEBSBIZBOHNFNBOHEJCVUVILBOPMFI
TFCFSBQBCFTBSQFSBONBTJOHNBTJOHGBLUPSJOJEBMBNNFOJOH PUPU EBO QBEB TBBU ZBOH CFSTBNBBO BMJSBO EBSBI ZBOH NFMBMVJ
LBULBO BMJSBO EBSBI PUPU TFMBNB BLUJWJUBT PUPU QFSTPBMBO JOJ TFCBHJBOCFTBSEBFSBIUVCVIZBOHUJEBLCFSPUPUVOUVLTFNFOUBSB
UFMBIEJCJDBSBLBOTFDBSBMFCJIEFUBJMEJ#BC BLBOCFSLVSBOH TFIJOHHBNFNJOKBNLBOQFSTFEJBBOEBSBICBHJ
PUPU "MJSBO EBSBI UBNCBIBO NFOVKV LF PUPU JOJ CFTBSOZB LJSB
Pengaturan Aliran Darah Otot oleh Saraf. 4FMBJO
LJSB -NFOJU ZBOH TBOHBU QFOUJOH CJMB LJUB NFNJLJSLBO CBHBJ
NFLBOJTNF WBTPEJMBUPS KBSJOHBO TFUFNQBU PUPU SBOHLB
NBOB TFTFPSBOH EBQBU MBSJ VOUVL NFOZFMBNBULBO IJEVQOZB
EJQFSTBSBGJPMFITBSBGTBSBGWBTPLPOTUSJLUPSTJNQBUJTEBO QBEB
CBILBO QFOJOHLBUBO TFEJLJU TBKB LFDFQBUBO MBSJ PSBOH JUV TVEBI
CFCFSBQB TQFTJFT CJOBUBOH
KVHB EJQFSTBSBGJ PMFI TBSBG WBTP
EJMBUPSTJNQBUJT EBQBU NFNCVBU QFSCFEBBO BOUBSB IJEVQ EBO NBUJ %VB TJTUFN
TJSLVMBTJ QFSJGFS ZBLOJ TJTUFN LPSPOFS EBO TJTUFN TFSFCSBM
Saraf-Saraf Vasokonstriktor Simpatis. 4FSBCVU TBSBG UFSIJOEBS EBSJ QFOHBSVI WBTPLPOTUSJLUPS JOJ LBSFOB QFSTBSBGBO
WBTPLPOTUSJLUPS TJNQBUJT NFOZFLSFTJLBO OPSFQJOFGSJO QBEB WBTPLPOTUSJLUPSLFEVBEBFSBITJSLVMBTJJOJTBOHBUTFEJLJUVOUVOH
VKVOHVKVOH TBSBGOZB #JMB TBSBG JOJ EJSBOHTBOH TFDBSB NBL MBI CFHJUV LBSFOB KBOUVOH EBO PUBL QFOUJOH VOUVL LFSKB GJTJL
TJNBM EBQBUNFOVSVOLBOBMJSBOEBSBIZBOHNFMBMVJPUPUZBOH TFQFSUJIBMOZBPUPUPUPUSBOHLB
TFEBOH JTUJSBIBU SFTUJOH NVTDMF
TFCBOZBL TFUFOHBI IJOHHB
TFQFSUJHBEBSJOPSNBM7BTPLPOTUSJLTJJOJNFSVQBLBOLFBEBBO ,FUJHB EJOEJOHPUPUWFOBEBOEBFSBILBQBTJUBUJGMBJOOZBQBEB
GJTJPMPHJTZBOHQFOUJOHQBEBTZPLTJSLVMBTJEBOTFMBNBQFSJPEF TJSLVMBTJ CFSLPOUSBLTJ TFDBSB LVBU ZBOH BLBO TBOHBU NFOJOHLBU
TUSFT MBJOOZB TFXBLUV LJUB NFOHJOHJOLBO UFLBOBO BSUFSJ UFUBQ LBO UFLBOBO QFOHJTJBO TJTUFNJL SBUBSBUB 4FQFSUJ ZBOH LJUB
OPSNBMCBILBOMFCJIUJOHHJ QFMBKBSJ EJ #BC JOJ NFSVQBLBO TBMBI TBUV GBLUPS ZBOH QBMJOH
QFOUJOH EBMBN NFOJOHLBULBO BMJSBO CBMJL EBSBI WFOB LF KBOUVOH
/PSFQJOFGSJO TFMBJO EJTFLSFTJLBO QBEB VKVOH TBSBG TJNQBUJT EBO LBSFOBJUV NFOJOHLBULBODVSBIKBOUVOH
WBTPLPOTUSJLUPS TFMBNB NFMBLVLBO LFSKB GJTJL ZBOH CFSBU
NFEVMB LFEVB LFMFOKBS BESFOBM KVHB NFOZFLSFTJLBO TFKVNMBI
Peningkatan Tekanan Arteri Selama Kerja Fisik
CFTBSOPSFQJOFGSJOEBOCBILBOMFCJICBOZBLFQJOFGSJOLFEBMBN
Akibat Rangsang Simpatis
EBSBI TJSLVMBTJ /PSFQJOFGSJO EBMBN TJSLVMBTJ CFLFSKB EJ
QFNCVMVI EBSBI PUPU TFIJOHHB UFSKBEJ FGFL WBTPLPOTUSJLTJ &GFL QFOUJOH EBSJ QFOJOHLBUBO BLUJWJUBT TJNQBUJT TBBU LFSKB GJTJL
TFQFSUJIBMOZBCJMBEJMBLVLBOQFSBOHTBOHBOMBOHTVOHQBEBTBSBG BEBMBI VOUVL NFOJOHLBULBO UFLBOBO BSUFSJ )BM JOJ EJBLJCBULBO
TJNQBUJT 4FCBMJLOZB FQJOFGSJO TFSJOH NFNCFSJ QFOHBSVI PMFI CFSCBHBJ FGFL QFSBOHTBOHBO BOUBSB MBJO
WBTPLPOTUSJLTJ
WBTPEJMBUPS SJOHBO LBSFOB FQJOFGSJO MFCJI CBOZBL NFSBOHTBOH BSUFSJPM EBO BSUFSJ LFDJM QBEB TFCBHJBO CFTBS KBSJOHBO UVCVI
SFTFQUPS BESFOFSHJL CFUB QBEB QFNCVMVI EBSBI ZBOH LFDVBMJ QBEB PUPUPUPU ZBOH BLUJG
QFOJOHLBUBO BLUJWJUBT
NFSVQBLBO SFTFQUPS WBTPEJMBUPS CFSCFEB EFOHBO OPSFQJOFGSJO QFNPNQBBO PMFI KBOUVOH EBO
QFOJOHLBUBO IFCBU UFLBOBO
ZBOH UFSVUBNB NFSBOHTBOH SFTFQUPS BMGB ZBOH CFSTJGBU WBTP QFOHJTJBO TJTUFNJL SBUBSBUB ZBOH UFSVUBNB EJTFCBCLBO PMFI
LPOTUSJLUPS3FTFQUPSSFTFQUPSJOJBLBOEJCJDBSBLBOEJ#BC LPOUSBLTJ WFOB ,FSKB TBNB CFSCBHBJ FGFL BLIJSOZB TFMBMV
NFOJOHLBULBO UFLBOBO BSUFSJ TFMBNB LFSKB GJTJL ,FOBJLBO JOJ
Penyesuaian Sirkulasi Totat Tubuh Selama Kerja Fisik EBQBUTFLFDJMNN)HBUBVTFCFTBSNN)H CFSHBOUVOHQBEB
LFBEBBOTFXBLUVNFMBLVLBOLFSKBGJTJL#JMBTFTFPSBOHNFMBLVLBO
4FMBNB LFSKB GJTJL UFSKBEJ UJHB FGFL VUBNB ZBOH QFOUJOH CBHJ LFSKB GJTJL EBMBN LFBEBBO UFHBOH UFUBQJ IBOZB NFOHHVOBLBO
TJTUFN TJSLVMBTJ VOUVL NFOZFEJBLBO LFCVUVIBO BMJSBO EBSBI TFEJLJU PUPU TBKB SFTQPOT TJNQBUJT UFUBQ UFSKBEJ EJ TFMVSVI UVCVI
PUPU ZBOH UJOHHJ &GFLFGFL JOJ BEBMBI
QFSBOHTBOHBO LVBU 1BEB CFCFSBQB PUPU ZBOH BLUJG UFSKBEJ WBTPEJMBUBTJ UFUBQJ QBEB
TJTUFN TBSBG TJNQBUJT EJ TFMVSVI UVCVI EFOHBO BLJCBU FGFL TFNVBUFNQBUMBJOEJUVCVIFGFLVUBNBOZBBEBMBIWBTPLPOTUSJLTJ
QFSBOHTBOHBOQBEBTFMVSVITJSLVMBTJ
QFOJOHLBUBOUFLBOBO ZBOH TFSJOH LBMJ NFOJOHLBULBO UFLBOBO BSUFSJ SBUBSBUB TBNQBJ
BSUFSJ EBO
QFOJOHLBUBODVSBIKBOUVOH TFUJOHHJNN)H,FBEBBOTFSVQBEBQBUUFSKBEJQBEBTFTF
244
Bab 21 Aliran Darah Otot dan Curah Jantung Selama Kerja Fisik; SirkuEasi Koroner dan Penyakit Jantung Iskemik
PSBOHZBOHTFEBOHCFSEJSJEJUBOHHBEBONFNBTBOHQBLVEFOHBO 25
QBMV QBEB MBOHJUMBOHJU SVNBIOZB ,FUFHBOHBO TJUVBTJ JOJ KFMBT B
TFLBMJ 20
4FCBMJLOZB CJMB TFTFPSBOH NFMBLVLBO LFSKB GJTJL EFOHBO 15
UNIT IV
TFMVSVI UVCVIOZB NJTBMOZB CFSMBSJ BUBV CFSFOBOH LFOBJLBO
UFLBOBOBSUFSJOZBTFSJOHLBMJIBOZBTFCFTBSTBNQBJNN)H 10
5JEBL BEBOZB LFOBJLBO UFLBOBO ZBOH IFCBU JUV EJTFCBCLBO PMFI
5 A
WBTPEJMBUBTJIFCBUZBOHUFSKBEJTFDBSBTFSFOUBLEJTFKVNMBICFTBS
PUPUZBOHBLUJG
0
Mengapa Peningkatan Tekanan Arteri Selama Kerja Fisik 4 0 +4 +8 +12 +16 +20 +24
Penting? #JMB PUPUPUPU EJSBOHTBOH TFDBSB NBLTJNBM EJ MBCPSB
UPSJVN QFSDPCBBO UFUBQJ UBOQB NFNCJBSLBO UFLBOBO BSUFSJ
NFOJOHLBU BMJSBOEBSBIEBMBNPUPUKBSBOHNFOJOHLBUMFCJIEBSJ
TFLJUBSEFMBQBOLBMJMJQBU4FNFOUBSBJUV LJUBUBIVEBSJQFOFMJUJBO
UFSIBEBQ TFPSBOH QFMBSJ NBSBUPO CBIXB BMJSBO EBSBI ZBOH
NFMBMVJ PUPU EBQBU NFOJOHLBU EBSJ -NFOJU VOUVL TFMVSVI QFOJOHLBUBO GSFLVFOTJ KBOUVOH TFSJOH LBMJ NFOJOHLBU TBNQBJ
UVCVI TFMBNB LFBEBBO JTUJSBIBU NFOKBEJ MFCJI EBSJ -NFOJU IJOHHB LBMJNFOJU EBO
QFOJOHLBUBO LFLVBUBO
TFMBNBBLUJWJUBTNBLTJNBM0MFILBSFOBJUV KFMBTMBICBIXBBMJSBO LPOUSBLTJ KBOUVOH TFSJOH LBMJ TBNQBJ TFCFTBS EVB LBMJ OPSNBM
EBSBI LF PUPU EBQBU NFOJOHLBU KBVI MFCJI CFTBS EBSJQBEB ZBOH 5BOQB QFOJOHLBUBO OJMBJ GVOHTJ KBOUVOH NBLB QFOJOHLBUBO
UFSKBEJ QBEB QFSDPCBBO MBCPSBUPOJVN TFEFSIBOB "QB CFEBOZB DVSBI KBOUVOH BLBO UFSCBUBT EJ UJOHLBU HBSJT NFOEBUBS QBEB
1FSCFEBBO VUBNB BEBMBI CBIXB UFLBOBO BSUFSJ NFOJOHLBU QBEB KBOUVOH OPSNBM ZBOH CFSBSUJ QFOJOHLBUBO DVSBI KBOUVOH
LFSKB GJTJL OPSNBM .BSJ LJUB BTVNTJLBO TFCBHBJ DPOUPI CBIXB NBLTJNBM IBOZB TFLJUBS LBMJ MJQBU EBO CVLBO LBMJ MJQBU
UFLBOBO BSUFSJ NFOJOHLBU TFCFTBS QFSTFO TVBUV QFOJOHLBUBO TFQFSUJ ZBOH CJBTBOZB EBQBU EJDBQBJ PMFI QFMBSJ ZBOH UJEBL
ZBOHVNVNTFMBNBLFSKBGJTJLCFSBU1FOJOHLBUBOTFCFTBSJOJ UFSMBUJIBUBVLBMJMJQBUZBOHEBQBUEJDBQBJPMFITFPSBOHQFMBSJ
NFOZFCBCLBO LFLVBUBO CFSUBNCBI TFCBOZBL VOUVL NBSBUPO
NFOEPSPOHEBSBINFMBMVJQFNCVMVIEBSBIKBSJOHBOPUPU5FUBQJ 4FLBSBOH QFMBKBSJ LVSWB BMJSBO CBMJL WFOB +JLB UJEBL UFSKBEJ
IBM JOJ CVLBOMBI TBUVTBUVOZB FGFL ZBOH QFOUJOH QFOJOHLBUBO QFSVCBIBOBQBQVOQBEBLVSWBBMJSBOCBMJLWFOBOPSNBM DVSBI
UFLBOBOKVHBBLBOTBOHBUNFSFHBOHLBOEJOEJOHQFNCVMVIEBSBI KBOUVOH IBNQJS UJEBL EBQBU CFSVCBI TBNB TFLBMJ TFMBNB LFSKB
EBO FGFL JOJ CFSTBNB EFOHBO QFMFQBTBO WBTPEJMBUPS MPLBM EBO GJTJL LBSFOB OJMBJ EJ BUBT HBSJT NFOEBUBS QBEB LVSWB OPSNBM
QFOJOHLBUBO UFLBOBO EBSBI EBQBU NFOJOHLBULBO BMJSBO UPUBM EJ IBOZBMBI-NFOJU/BNVO UFSKBEJEVBQFSVCBIBOQFOUJOH
EBMBNPUPUMFCJIEBSJLBMJOJMBJOPSNBM
1. 5FLBOBOQFOHJTJBOTJTUFNJLSBUBSBUBNFOJOHLBUTFDBSBMVBS
CJBTB QBEB QFSNVMBBO LFSKB GJTJL CFSBU )BTJM JOJ TFCBHJBO
Arti Penting Peningkatan Curah Jantung Selama Kerja Fisik
CFSBTBM EBSJ QFSBOHTBOHBO TJNQBUJT ZBOH NFOZFCBCLBO
#BOZBL FGFL GJTJPMPHJT CFSCFEB UFSKBEJ QBEB TBBU CFSTBNBBO LPOUSBLTJ WFOB EBO CBHJBO LBQBTJUBUJG TJSLVMBTJ MBJOOZB
TFMBNBLFSKBGJTJLVOUVLNFOJOHLBULBODVSBIKBOUVOHBHBSTFTVBJ 4FMBJO JUV UFHBOHBO PUPUPUPU QFSVU EBO PUPUPUPU SBOHLB
EFOHBO UJOHLBU LFSKB GJTJL 1BEB LFOZBUBBOOZB LFNBNQVBO MBJOOZB EBMBN UVCVI BLBO NFOFLBO CBOZBL QFNCVMVI
TJTUFN TJSLVMBTJ NFOJOHLBULBO DVSBI KBOUVOH VOUVL NFOHJSJN EBSBI JOUFSOBM TFIJOHHB BLBO TFNBLJO NFOFLBO TFMVSVI
LBO PLTJHFO EBO [BU OVUSJTJ MBJOOZB LF PUPU TFMBNB LFSKB GJTJL TJTUFNWBTLVMBSLBQBTJUBUJG NFOZFCBCLBOQFOJOHLBUBOZBOH
TBNB QFOUJOHOZB EFOHBO LFLVBUBO PUPU JUV TFOEJSJ EBMBN MFCJI CFTBS MBHJ QBEB UFLBOBO QFOHJTJBO TJTUFNJL SBUBSBUB
NFOFOUVLBOCBUBTLFNBNQVBOPUPUVOUVLUFSVTCFLFSKB4FCBHBJ 1BEBLFSKBGJTJLZBOHNBLTJNBM EVBFGFLJOJCFSTBNBTBNB
DPOUPI TFPSBOHQFMBSJNBSBUPOZBOHEBQBUNFOJOHLBULBODVSBI EBQBU NFOJOHLBULBO UFLBOBO QFOHJTJBO TJTUFNJL SBUBSBUB
KBOUVOHOZB QBMJOH UJOHHJ VNVNOZB BEBMBI PSBOH TBNB ZBOH EBSJOJMBJOPSNBMNN)HNFOKBEJTFUJOHHJNN)H
NFNJMJLJQFNFDBISFLPSXBLUVMBSJ
2. ,FNJSJOHBOLVSWBBMJSBOCBMJLWFOBCFSQVUBSLFBUBT)BMJOJ
Analisis Grafik Perubahan Curah Jantung Selama Kerja EJTFCBCLBO PMFI QFOVSVOBO UBIBOBO ZBOH UFSKBEJ QBEB
Fisik Berat. (BNCBS NFNQFSMJIBULBO BOBMJTJT HSBGJL IBNQJS TFMVSVI QFNCVMVI EBSBI EJ EBMBN KBSJOHBO PUPU
QFOJOHLBUBODVSBIKBOUVOHCFTBSZBOHUFSKBEJTFMBNBLFSKBGJTJM ZBOHBLUJG ZBOHKVHBNFOZFCBCLBOUBIBOBOUFSIBEBQBMJSBO
CFSBU ,VSWB DVSBI KBOUVOH EBO BMJSBO CBMJL WFOB ZBOH CBMJLWFOBNFOVSVO
CFSTJMBOHBOEJUJUJL"NFSVQBLBOBOBMJTJTVOUVLTJSLVMBTJOPSNBM
TFEBOHLBOLVSWBZBOHCFSTJMBOHBOEJUJUJL#NFSVQBLBOBOBMJTJT 0MFI LBSFOB JUV LPNCJOBTJ QFOJOHLBUBO UFLBOBO QFOHJTJBO
LFSKB GJTJL CFSBU 1FSIBUJLBO CBIXB QFOJOHLBUBO DVSBI KBOUVOH TJTUFNJL SBUBSBUB EBO CFSLVSBOHOZB UBIBOBO UFSIBEBQ BMJSBO
CFTBS NFNCVUVILBO QFSVCBIBO CFSNBLOB QBEB LVSWB DVSBI CBMJL WFOB BLBO NFOJOHLBULBO TFMVSVI OJMBJ LVSWB BMJSBO CBMJL
KBOUVOHNBVQVOLVSWBBMJSBOCBMJLWFOB TFCBHBJCFSJLVU WFOB
1FOJOHLBUBO OJMBJ LVSWB DVSBI KBOUVOH EBQBU EJNFOHFSUJ 4FCBHBJSFTQPOTUFSIBEBQQFSVCBIBOLVSWBBMJSBOCBMJLWFOB

EFOHBONVEBI*OJBEBMBIIBTJMZBOHIBNQJSTFMVSVIOZBCFSBTBM EBO LVSWB DVSBI KBOUVOH UJUJL LFTFJNCBOHBO CBSV QBEB
EBSJSBOHTBOHBOTJNQBUJTQBEBKBOUVOHZBOHNFOZFCBCLBO
(BNCBS VOUVL DVSBI KBOUVOH EBO UFLBOBO BUSJVN LBOBO
TFLBSBOHCFSBEBEJUJUJL# TFEBOHLBOOJMBJOPSNBMCFSBEBEJ
245
Unit IV Sirkulasi
UJUJL " 1FSIBUJLBO LIVTVTOZB CBIXB UFLBOBO BUSJVN LBOBO NFOHBMJSLFNCBMJLFKBOUVOHNFMBMVJWFOBUIFCFTJBOZBOHTBOHBU

IBNQJS UJEBL CFSVCBI IBOZB NFOJOHLBU TFCFTBS NN )H LFDJM ZBOH NFOHPTPOHLBO EBSBIOZB MBOHTVOH LF TFNVB SVBOH
1BEBLFOZBUBBOOZB QBEBTFTFPSBOHEFOHBOKBOUVOHZBOHLVBU KBOUVOH
UFLBOBOBUSJVNLBOBOTFSJOHUVSVOEJCBXBIOPSNBMQBEBLFSKB
GJTJLZBOHTBOHBUCFSBUBLJCBUQFOJOHLBUBOSBOHTBOHBOTJNQBUJT Aliran Darah Koroner Normal-Sekitar 5% Curah Jantung
ZBOHCFTBSQBEBKBOUVOHTFMBNBLFSKBGJTJL
"MJSBO EBSBI LPSPOFS SBUBSBUB QBEB NBOVTJB TFXBLUV JTUJSBIBU
BEBMBI NMNFOJU H CFSBU KBOUVOH BUBV TFLJUBS NM
Sirkulasi Koroner NFOJU ZBJUVLJSBLJSBTBNQBJQFSTFODVSBIKBOUVOHUPUBM
,JSBLJSBTFQFSUJHBEBSJTFMVSVILFNBUJBOQBEBOFHBSBJOEVTUSJ 4FMBNB LFSKB GJTJL ZBOH CFSBU KBOUVOH TFPSBOH EFXBTB NVEB
EJEVOJB#BSBUBEBMBIBLJCBUEBSJQFOZBLJUBSUFSJLPSPOFS EBO BLBO NFOJOHLBULBO DVSBI KBOUVOHOZB FNQBU TBNQBJ UVKVI LBMJ
IBNQJS TFNVB PSBOH MBOKVU VTJB NFNQVOZBJ QBMJOH TFEJLJU MJQBU EBONFNPNQBEBSBIJOJNFMBXBOUFLBOBOBSUFSJZBOHMFCJI
CFCFSBQB HBOHHVBO TJSLVMBTJ BSUFSJ LPSPOFS 0MFI LBSFOB UJOHHJ EBSJQBEB OPSNBM "LJCBUOZB IBTJM LFSKB KBOUVOH QBEB
BMBTBO JOJ QFNBIBNBO GJTJPMPHJ OPSNBM EBO QBUPGJTJPMPHJ LFBEBBO FLTUSFN EBQBU NFOJOHLBU FOBN TBNQBJ TFNCJMBO LBMJ
TJSLVMBTJ LPSPOFS NFSVQBLBO TBMBI TBUV TVCKFL ZBOH QBMJOH MJQBU 1BEB TBBU CFSTBNBBO BMJSBO EBSBI LPSPOFS NFOJOHLBU UJHB
QFOUJOHEBMBNLFEPLUFSBO TBNQBJ FNQBU LBMJ MJQBU HVOB NFOZFEJBLBO NBLBOBO UBNCBIBO
ZBOH EJQFSMVLBO PMFI KBOUVOH ,FOBJLBO JOJ UJEBL TFCFTBS
LFOBJLBOCFCBOLFSKB ZBOHCFSBSUJCBIXBSBTJPQFNBLBJBOFOFSHJ
Anatomi Fisiologis Suplai Darah Koroner
PMFI KBOUVOH UFSIBEBQ BMJSBO EBSBI LPSPOFS NFOJOHLBU %FOHBO
(BNCBS NFNQFSMJIBULBO KBOUVOH EFOHBO TVQMBJ EBSBI EFNJLJBO FGJTJFOTJ QFNBLBJBO FOFSHJ PMFI KBOUVOH NFOJOHLBU
LPSPOFSOZB 1FSIBUJLBO CBIXB BSUFSJ LPSPOBSJB VUBNB HVOBNFOVUVQLFLVSBOHBOTVQMBJEBSBILPSPOFSSFMBUJG
UFSMFUBL QBEB QFSNVLBBO KBOUVOH EBO BSUFSJBSUFSJ ZBOH
MFCJI LFDJM NFOFNCVT EBSJ QFSNVLBBO NBTVL LF EBMBN Perubahan Fasik aliran Darah Koroner Selama Sistol dan
NBTTB PUPU KBOUVOH 4VQMBJ EBSBI LF KBOUVOH ZBOH NFOHBO Diastol-Pengaruh Kompresi Otot Jantung.(BNCBSNFN
EVOH OVUSJTJ IBNQJS TFMVSVIOZB NFMBMVJ BSUFSJBSUFSJ JOJ QFSMJIBULBOQFSVCBIBOBMJSBOEBSBINFMBMVJLBQJMFSOVUSJTJGTJTUFN
)BOZB NN QFSNVLBBO EBMBN FOEPLBSEJVN EBQBU LPSPOFS WFOUSJLFM LJSJ EBMBN NMNFOJU QBEB KBOUVOH NBOVTJB
NFNQFSPMFINBLBOBOEBMBNKVNMBIDVLVQTFDBSBMBOHTVOH TFMBNB TJTUPM EBO EJBTUPM TFQFSUJ ZBOH EJFLTUSBQPMBTJ EBSJ
EBSJEBSBIEJEBMBNSVBOHKBOUVOH TFIJOHHBTVNCFSOVUSJTJ QFOFMJUJBO QBEB IFXBO DPCB 1FSIBUJLBO QBEB EJBHSBN JOJ CBIXB
PUPUJOJCFSTJGBULFDJMTFLBMJ BMJSBOEBSBIEBMBNLBQJMFSLPSPOFSEJPUPUWFOUSJLFMLJSJNFOVSVO
IJOHHB LF OJMBJ ZBOH SFOEBI TFMBNB TJTUPM ZBOH CFSMBXBOBO
1BEB TBNQBJ QFSTFO QPQVMBTJ BSUFSJ LPSPOBSJB LJSJ EFOHBOBMJSBOEJSBOHLBJBOQFNCVMVIEBSBIMBJOEBMBNUVCVI)BM
UFSVUBNB NFOZVQMBJ CBHJBO BOUFSJPS EBO MBUFSBM LJSJ WFOUSJLFM UFSTFCVU EJTFCBCLBO PMFI LPNQSFTJ LVBU PUPU WFOUSJLFM LJSJ EJ
LJSJ TFEBOHLBO BSUFSJ LPSPOBSJB LBOBO NFOZVQMBJ TFCBHJBO TFLFMJMJOHQFNCVMVIEBSBIJOUSBNVTLVMBSTFMBNBLPOUSBLTJTJTUPM
CFTBSWFOUSJLFMLBOBOTFSUBCBHJBOQPTUFSJPSWFOUSJLFMLJSJ
4FMBNB EJBTUPM PUPU KBOUVOH CFSFMBLTBTJ EBO UJEBL MBHJ
4FCBHJBO CFTBS BMJSBO EBSBI WFOB LPSPOBSJB EBSJ PUPU NFOHIBNCBUBMJSBOEBSBIZBOHNFMBMVJLBQJMFSPUPUWFOUSJLFMLJSJ
WFOUSJLFM LJSJ LFNCBMJ LF BUSJVN LBOBO NFMBMVJ TJOVT LPSP TFIJOHHBEBSBINFOHBMJSEFOHBODFQBUTFMBNBEJBTUPM
OBSJVT ZBOHNFSVQBLBOQFSTFOBMJSBOEBSBILPSPOFSUPUBM
4FCBHJBO CFTBS EBSBI EBMBN WFOB LPSPOBSJB PUPU WFOUSJLFM "MJSBO EBSBI ZBOH NFMBMVJ LBQJMFS LPSPOFS WFOUSJLFM LBOBO
LBOBO LFNCBMJ NFMBMVJ WFOB DPSEJT BOUFSJPS LFDJM ZBOH KVHB NFOHBMBNJ QFSVCBIBO GBTJL TFMBNB TJLMVT KBOUVOH UFUBQJ
NFOHBMJS MBOHTVOH LF EBMBN BUSJVN LBOBO UJEBL NFMFXBUJ LBSFOBLFLVBUBOLPOUSBLTJPUPUWFOUSJLFMLBOBOKBVIMFCJILFDJM
TJOVTLPSPOBSJVT4FCBHJBOLFDJMEBSBIWFOBLPSPOFSKVHB EJCBOEJOHLBO PUPU WFOUSJLFM LJSJ NBLB QFSVCBIBO GBTJL ZBOH
UFSCBMJM JOJ IBOZB CFSMBOHTVOH QBSTJBM CFSCFEB EFOHBO ZBOH
UFSKBEJEJPUPUWFOUSJLFMLJSJ
300
200
100
246
Bab 21 Aliran Darah Otot dan Curah jantung Selama Kerja Fisik; Sirkulasi Koroner dan Penyakit jantung Iskemik
Aliran Darah Koroner Epikardial dan Subendokardial- BEFOPTJO %FOHBO BEBOZB LPOTFOUSBTJ PLTJHFO ZBOH TBOHBU
Pengaruh Tekanan Intramiokardial (BNCBS NFNQFS SFOEBI EJ EBMBN TFMTFM PUPU NBLB TFCBHJBO CFTBS "51 TFM
MJIBULBOTVTVOBOLIVTVTQFNCVMVIEBSBILPSPOFSQBEBCFSCBHBJ EJQFDBI NFOKBEJ BEFOPTJO NPOPGPTGBU LFNVEJBO TFCBHJBO
LFEBMBNBOPUPUKBOUVOH UBNQBLBSUFSJLPSPOBSJBFQJLBSEJBMQBEB LFDJM NFOHBMBNJ QFOHVSBJBO MFCJI MBOKVU HVOB NFNCFCBTLBO
UNIT IV
QFSNVLBBO MVBS PUPU KBOUVOH ZBOH NFOZFEJBLBO EBSBI VOUVL BEFOPTJO LF EBMBN DBJSBO KBSJOHBO PUPU KBOUVOH 4FTVEBI
TFCBHJBO CFTBS PUPU KBOUVOH "SUFSJ JOUSBNVTLVMBS ZBOH MFCJI BEFOPTJONFOJNCVMLBOWBTPEJMBUBTJ TFCBHJBOCFTBSEJBCTPSCTJ
LFDJM CFSBTBM EBSJ BSUFSJ FQJLBSEJBM
NFOFNCVT PUPU KBOUVOH LFEBMBNTFMTFMKBOUVOHVOUVLEJHVOBLBOLFNCBMJ
NFOZFEJBLBO LFCVUVIBO NBLBOBO 1FNCVMVI EBSBI ZBOH "EFOPTJO CVLBOMBI TBUVTBUVOZB QSPEVL WBTPEJMBUPS ZBOH
MFUBLOZBUFQBUEJCBXBIFOEPLBSEJVNBEBMBIQMFLTVTBSUFSJBSUFSJ UFMBI EJLFOBMJ 1SPEVL WBTPEJMBUPS MBJOOZB BEBMBI TFOZBXB
TVCFOEPLBSEJBM 4FMBNB TJTUPM EBSBI ZBOH NFOHBMJS NFMBMVJ BEFOPTJO GPTGBU JPO LBMJVN JPO IJESPHFO LBSCPO EJPLTJEB
QMFLTVTTVCFOEPLBSEJBMEBSJWFOUSJLFMLJSJDFOEFSVOHCFSLVSBOH QSPTUBHMBOEJO EBO OJUSJU PLTJEB /BNVO NFLBOJTNF WBTPEJMB
LBSFOBQFOFLBOBOQBEBQFNCVMVIEBSBILPSPOFSJOUSBNVTLVMBS UBTJ LPSPOFS TFMBNB QFOJOHLBUBO BLUJWJUBT KBOUVOH UJEBL TFQF
BLJCBU LPOUSBLTJ PUPU WFOUSJLFM 5FUBQJ QFNCVMVI EBSBI OVIOZB EBQBU EJKFMBTLBO NFMBMVJ BEFOPTJO ;BU GBSNBLPMPHJT
QFNCVMVI EBSBI QBEB QMFLTVT TVCFOEPLBSEJBM CJBTBOZB BLBO ZBOH NFNCMPLJS BUBV NFNCMPLJS TFCBHJBO FGFL WBTPEJMBUBTJ
NFOHLPNQFOTBTJLFBEBBOJOJ1BEBCBHJBOTFMBOKVUOZBEBSJCBC BEFOPTJO UJEBL EBQBU NFODFHBI WBTPEJMBUBTJ LPSPOFS ZBOH
JOJ LJUB BLBO KFMBTLBO CBHBJNBOB QFSCFEBBO ZBOH LIBT BOUBSB EJTFCBCLBOPMFIQFOJOHLBUBOBLUJWJUBTPUPUKBOUVOH1FOFMJUJBO
BMJSBO EBSBI EJ BSUFSJ FQJLBSEJBM EBO BSUFSJ TVCFOEPLBSEJBM JOJ
QBEB PUPU SBOHLB UFMBI NFOVOKVLLBO CBIXB JOGVT BEFOPTJO
CFSQFSBOQFOUJOHQBEBKFOJTJTLFNJBLPSPOFSUFSUFOUV
UFSVTNFOFSVT IBOZB NFNQFSUBIBOLBO EJMBUBTJ WBTLVMBS
TFMBNB TBNQBJ KBN EBO UFSOZBUB BLUJWJUBT PUPU BLBO UFUBQ
Pengaturan Aliran Darah Koroner NFOEJMBUBTJ QFNCVMVI EBSBI MPLBM NFTLJQVO BEFOPTJO UJEBL
Metabolisme Otot Lokal sebagai Pengatur Utama MBHJ EBQBU NFOEJMBUBTJ QFNCVMVI EBSBI UFSTFCVU 0MFI LBSFOB
Aliran Koroner JUV NFLBOJTNF WBTPEJMBUPS MBJOOZB TFQFSUJ ZBOH UFSUVMJT EJ
BUBT IBSVTEJJOHBU
"MJSBOEBSBIZBOHNFMBMVJTJTUFNLPSPOFSEJBUVSIBNQJSTFMVSVI
OZBPMFIWBTPEJMBUBTJBSUFSJPMTFUFNQBUTFCBHBJSFTQPOTUFSIBEBQ
LFCVUVIBO OVUSJTJ PUPU KBOUVOH "QBCJMB LFLVBUBO LPOUSBLTJ Pengaturan Aliran Darah Koroner oleh Saraf
KBOUVOH NFOJOHLBU LFDFQBUBO BMJSBO EBSBI LPSPOFS KVHB BLBO 1FSBOHTBOHBO TBSBG PUPOPN LF KBOUVOH EBQBU NFNQFOHBSVIJ
NFOJOHLBU 4FCBMJLOZB QFOVSVOBO BLUJWJUBT KBOUVOH EJTFSUBJ BMJSBO EBSBI LPSPOFS CBJL TFDBSB MBOHTVOH NBVQVO UJEBL
EFOHBOQFOVSVOBOBMJSBOLPSPOFS1FOHBUVSBOMPLBMBMJSBOEBSBI MBOHTVOH1FOHBSVIMBOHTVOHNFSVQBLBOIBTJMLFSKBMBOHTVOH
LPSPOFS JOJ IBNQJS JEFOUJL EFOHBO ZBOH UFSKBEJ EJ CBOZBL [BU[BU OFVSPUSBOTNJUFS BTFUJMLPMJO EBSJ OFSWVT WBHVT TFSUB
KBSJOHBOUVCVIMBJOOZB UFSVUBNBPUPUSBOHLB OPSFQJOFGSJOEBOFQJOFGSJOEBSJTBSBGTJNQBUJTQBEBQFNCVMVI
Kebutuhan Oksigen sebagai Faktor Utama dalam EBSBI LPSPOFS JUV TFOEJSJ 1FOHBSVI UJEBL MBOHTVOH UFSKBEJ
Pengaturan Lokal Aliran Darah Koroner. "MJSBO EBSBI EJ BLJCBUQFSVCBIBOTFLVOEFSQBEBBMJSBOEBSBILPSPOFSZBOHEJ
BSUFSJ LPSPOFS CJBTBOZB EJBUVS IBNQJS TFCBOEJOH EFOHBO TFCBCLBOPMFIQFOJOHLBUBOBUBVQFOVSVOBOBLUJWJUBTKBOUVOH
LFCVUVIBO PLTJHFO PUPU KBOUVOH /PSNBMOZB TFLJUBS QFSTFO 1FOHBSVI UJEBL MBOHTVOH ZBOH LFCBOZBLBO CFSMBXBOBO
PLTJHFOEJEBMBNEBSBIBSUFSJLPSPOFSEJQJOEBILBOTFMBHJEBSBI EFOHBOQFOHBSVIMBOHTVOH CFSQFSBOKBVIMFCJIQFOUJOHEBMBN
NFOHBMJSNFMBMVJPUPUKBOUVOH0MFILBSFOBUJEBLCBOZBLPLTJHFO QFOHBUVSBO BMJSBO EBSBI LPSPOFS OPSNBM +BEJ SBOHTBOHBO
ZBOH UFSTJTB NBLB UJEBL CBOZBL MBHJ PLTJHFO ZBOH EBQBU TJNQBUJT ZBOH NFMFQBTLBO OPSFQJOFGSJO EBO FQJOFGSJO NFOJ
EJUBNCBILBO LF PUPU KBOUVOH LFDVBMJ CJMB BMJSBO EBSBI LPSPOFS OHLBULBOGSFLVFOTJEBOLPOUSBLUJMJUBTKBOUVOHTFSUBNFOJOHLBU
NFOJOHLBU6OUVOHOZB BMJSBOEBSBILPSPOFSNFOJOHLBUIBNQJS LBOLFDFQBUBONFUBCPMJTNFKBOUVOH4FMBOKVUOZB QFOJOHLBUBO
CFSCBOEJOH MVSVT EFOHBO TFUJBQ UBNCBIBO LPOTVNTJ PLTJHFO NFUBCPMJTNF KBOUVOH BLBO NFOHBLUJGLBO NFLBOJTNF QFOHB
CBHJQSPTFTNFUBCPMJLEJKBOUVOH UVSBOBMJSBOEBSBIMPLBMHVOBNFOEJMBUBTJLBOQFNCVMVIEBSBI
/BNVO DBSB ZBOH QBTUJ CBHBJNBOB QFOJOHLBUBO LPOTVNTJ LPSPOFS EBO BMJSBO EBSBI NFOJOHLBU IBNQJS TFCBOEJOH
PLTJHFOEBQBUNFOZFCBCLBOEJMBUBTJLPSPOFSNBTJICFMVNEBQBU EFOHBOLFCVUVIBONFUBCPMJLPUPUKBOUVOH4FCBMJLOZB QFSBOH
EJUFOUVLBO #BOZBL QFOFMJUJ NFNQFSLJSBLBO CBIXB QFOVSVOBO TBOHBO WBHVT ZBOH NFMFQBTLBO BTFUJMLPMJO BLBO NFNQFS
LPOTFOUSBTJPLTJHFOEJKBOUVOHNFOZFCBCLBOEJMFQBTLBOOZB[BU MBNCBU KBOUVOH EBO NFNCFSJ TFEJLJU FGFL QFOFLBOBO QBEB
[BU WBTPEJMBUPS EBSJ TFMTFM PUPU EBO IBM JOJ BLBO NFOJNCVMLBO LPOUSBLUJMJUBT KBOUVOH ,FEVB FGFL JOJ BLBO NFOVSVOLBO
EJMBUBTJBSUFSJPM;BUEFOHBOQPUFOTJWBTPEJMBUPSZBOHCFTBSBEBMBI LPOTVNTJ PLTJHFO KBOUVOH EBO LBSFOB JUV TFDBSB UJEBL
MBOHTVOHNFOZFCBCLBOLPOTUSJLTJBSUFSJLPSPOFS
Pengaruh Langsung Perangsangan Saraf pada
Pembutuh Darah Koroner. %JTUSJCVTJ TFSBCVU TBSBG
QBSBTJNQBUJT WBHVT
EJ TJTUFN LPSPOFS WFOUSJLFM UJEBL UFSMBMV
CBOZBL /BNVO BTFUJMLPMJO ZBOH EJMFQBTLBO BLJCBU QFSBOH
TBOHBO QBSBTJNQBUJT NFNJMJLJ FGFL MBOHTVOH VOUVL NFOEJ
MBUBTJLBOBSUFSJLPSPOFS
247
Unit IV Sirkulasi
5FSEBQBU QFSTBSBGBO TJNQBUJT ZBOH KBVI MFCJI MVBT EJ ZBOHCFSBU TFQFSUJZBOHUFSKBEJTFUFMBIJOGBSLNJPLBSEJVN LJSB
QFNCVMVI EBSBI LPSPOFS 1BEB #BC LJUB MJIBU CBIXB [BU LJSB TFUFOHBI EBSJ CBTB BEFOJO EBQBU IJMBOH EBSJ TFMTFM PUPU
USBOTNJUFSTJNQBUJTOPSFQJOFGSJOEBOFQJOFGSJOEBQBUNFNCFSJ KBOUVOH ZBOH UFSLFOB 4FMBOKVUOZB LFIJMBOHBO JOJ EBQBU EJHBOUJ
FGFL EJMBUPS BUBV LPOTUSJLUPS QBEB QFNCVMVI EBSBI CFSHBO PMFITJOUFTJTBEFOPTJOCBSVEFOHBOLFDFQBUBOIBOZBQFSTFOQFS
UVOH QBEB BEB BUBV UJEBLOZB SFTFQUPS LPOTUSJLUPS BUBV EJMBUPS KBN 0MFI LBSFOB JUV CJMB TFSBOHBO JTLFNJB ZBOH TFSJVT UFMBI
EJ EJOEJOH QFNCVMVI EBSBI 3FTFQUPS LPOTUSJLUPS EJTFCVU CFSMBOHTVOH TFMBNB NFOJU BUBV MFCJI NBLB VTBIB VOUVL
SFTFQUPS BMGB EBO SFTFQUPS EJMBUPS EJTFCVU SFTFQUPS CFUB NFOHIJMBOHLBOJTLFNJBLPSPOFSNVOHLJOTVEBIUFSMBNCBUVOUVL
3FTFQUPS BMGB EBO CFUB BEB EJ QFNCVMVI EBSBI LPSPOFS 1BEB NFODFHBI DFEFSB EBO LFNBUJBO TFMTFM KBOUVOH )BM JOJ IBNQJS
VNVNOZB QFNCVMVI EBSBI LPSPOFS FQJLBSEJBM NFNQVOZBJ QBTUJNFOKBEJTBMBITBUVQFOZFCBCVUBNBLFNBUJBOTFMTFMKBOUVOH
SFTFQUPS BMGB ZBOH MFCJI CBOZBL TFEBOHLBO BSUFSJ JOUSBNVT TFMBNBJTLFNJBNJPLBSEJVN
LVMBS NFNJMJLJ MFCJI CBOZBL SFTFQUPS CFUB 0MFI LBSFOB JUV
QFSBOHTBOHBO TJNQBUJT TFUJEBLOZB TFDBSB UFPSFUJT EBQBU Penyakit Jantung Iskemik
NFOZFCBCLBO TFEJLJU LPOTUSJLTJ BUBV EJMBUBTJ LPSPOFS ZBOH
1FOZFCBC LFNBUJBO ZBOH QBMJOH VNVN EJ EVOJB #BSBU BEBMBI
NFOZFMVSVI UFUBQJ CJBTBOZB MFCJI CBOZBL LPOTUSJLTJ 1BEB
QFOZBLJU KBOUVOH JTLFNJL ZBOH NFSVQBLBO BLJCBU EBSJ JOTVGJ
CFCFSBQBPSBOH FGFLWBTPLPOTUSJLUPSBMGBUBNQBLTBOHBUUJEBL
TJFOTJ BMJSBO EBSBI LPSPOFS ,JSBLJSB QFSTFO EBSJ TFNVB
TFJNCBOH EBO PSBOHPSBOH JOJ EBQBU NFOHBMBNJ JTLFNJB
QFOEVEVL "NFSJLB 4FSJLBU NFOJOHHBM LBSFOB QFOZBLJU JOJ
NJPLBSEJVNWBTPTQBTUJLTFMBNBQFSJPEFQFSBOHTBOHBOTJNQB
#FCFSBQBLFNBUJBOUFSKBEJTFDBSBNFOEBEBLBLJCBUQFOZVNCBUBO
UJTZBOHCFSMFCJIBO TFSJOHLBMJNFOZFCBCLBOOZFSJBOHJOB
LPSPOFS BLVU BUBV LBSFOB GJCSJMBTJ KBOUVOH TFEBOHLBO ZBOH
'BLUPSNFUBCPMJL UFSVUBNBLPOTVNTJPLTJHFONJPLBSEJVN MBJOOZBUFSKBEJTFDBSBMBNCBUTFUFMBIQFOJPEFCFSNJOHHVNJOHHV
NFSVQBLBOQFOHFOEBMJVUBNBBMJSBOEBSBINJPLBSEJVN#JMB TBNQBJ CFSUBIVOUBIVO BLJCBU LFMFNBIBO QSPTFT QFNPNQBBO
NBOB FGFL MBOHTVOH QFSBOHTBOHBO TBSBG NFOHVCBI BMJSBO KBOUVOH ZBOH QSPHSFTJG %BMBN CBC JOJ LJUB CJDBSBLBO NBTBMBI
EBSBI LPSPOFS LF BSBI ZBOH TBMBI QFOHBUVSBO NFUBCPMJL UFS JTLFNJB LPSPOFS BLVU ZBOH EJTFCBCLBO PMFI QFOZVNCBUBO
IBEBQBMJSBOLPSPOFSCJBTBOZBBLBONFOHIJMBOHLBOQFOHBSVI LPSPOFSBLVUEBOJOGBSLNJPLBSEJVN1BEB#BC LJUBCJDBSBLBO
TBSBGZBOHCFLFSKBMBOHTVOHEBMBNXBLUVCFCFSBQBEFUJL NFOHFOBJ HBHBM KBOUVOH LPOHFTUJG EFOHBO QFOZFCBC UFSTFSJOH
ZBJUVJTLFNJBLPSPOFSQSPHSFTJGEBOLFMFNBIBOPUPUKBOUVOH
Gambaran Khusus Metabolisme Otot Jantung Aterosklerosis sebagai Penyebab Penyakit Jantung
1SJOTJQEBTBSNFUBCPMJTNFTFMVMFS ZBOHEJCJDBSBLBOEJ#BC Iskemik.1FOZFCBCUFSTFSJOHCFSLVSBOHOZBBMJSBOEBSBILPSPOFS
TBNQBJ EBQBU EJUFSBQLBO QBEB PUPU KBOUVOH TBNB TFQFSUJ BEBMBI BUFSPTLMFSPTJT 1SPTFT BUFSPTLMFSPUJL EJCJDBSBLBO EBMBN
QBEB KBSJOHBO MBJOOZB UFUBQJ UFSEBQBU CFCFSBQB QFSCFEBBO IVCVOHBOOZBEFOHBONFUBCPMJNFMJQJEEJ#BC4FDBSBTJOHLBU
LVBOUJUBUJG:BOHQBMJOHQFOUJOH EBMBNLFBEBBOJTUJSBIBU PUPU QSPTFTOZBBEBMBITFCBHBJCFSJLVU
KBOUVOHCJBTBOZBNFOHHVOBLBOBTBNMFNBLVOUVLNFOZVQMBJ 1BEBPSBOHPSBOHUFSUFOUVZBOHNFNJMJLJQSFEJTQPTJTJHFOFUJL
TFCBHJBO CFTBS FOFSHJOZB EBO CVLBO LBSCPIJESBU TFLJUBS UFSIBEBQ BUFSPTLMFSPTJT NFNQVOZBJ CFSBU CBEBO CFSMFCJI BUBV
QFSTFO FOFSHJ CFSBTBM EBSJ BTBN MFNBL
/BNVO TFQFSUJ KVHB PCFTJUBTEBONFNJMJLJQPMBIJEVQZBOHMFCJICBOZBLEVEVLBUBV
QBEB KBSJOHBO MBJOOZB QBEB LFBEBBO BOBFSPCJL BUBV JTLFNJL NFNQVOZBJ UFLBOBO EBSBI UJOHHJ EBO LFSVTBLBO TFM FOEPUFMJBM
NFUBCPMJTNF KBOUVOH IBSVT NFNBLBJ NFLBOJTNF HMJLPMJTJT QFNCVMVI EBSBI LPSPOFS TFKVNMBI CFTBS LPMFTUFSPM MBNCBU MBVO
BOBFSPCJL VOUVL FOFSHJOZB /BNVO HMJLPMJTJT NFNBLBJ BLBO UFSUJNCVO EJ CBXBI FOEPUFM EJ CBOZBL UFNQBU QBEB BSUFSJ
HMVLPTB EBSBI EBMBN KVNMBI ZBOH CBOZBL TFLBMJ EBO QBEB TFMVSVI UVCVI 4FDBSB CFSUBIBQ EBFSBI UJNCVOBO JOJ EJJOWBTJ
XBLUVZBOHCFSTBNBBONFNCFOUVLTFKVNMBICFTBSBTBNMBLUBU PMFIKBSJOHBOGJCSPTBEBOTFSJOHLBMJNFOHBMBNJLBMTJGJLBTJ)BTJM
EJ KBSJOHBO KBOUVOH ZBOH NVOHLJO NFSVQBLBO TBMBI TBUV BLIJSOZBBEBMBIQFNCFOUVLBOMFNQFOHBO QMBRVF
BUFSPTLMFSPUJL
QFOZFCBCOZFSJKBOUVOHQBEBLFBEBBOJTLFNJLKBOUVOH TFQFSUJ ZBOH NFOPOKPM LF EBMBN MVNFO QFNCVMVI EBSBI EBO
ZBOHEJCJDBSBLBOEBMBNCBCJOJLFNVEJBO NFOHIBNCBU TFMVSVI BUBV TFCBHJBO BMJSBO EBSBI 5FNQBU
4FQFSUJ ZBOH UFSKBEJ QBEB KBSJOHBO MBJOOZB MFCJI EBSJ QFNCFOUVLBOMFNQFOHBUFSPTLMFSPUJLZBOHMB[JNBEBMBICFCFSBQB
QFSTFOFOFSHJNFUBCPMJLZBOHEJMFQBTLBOEBSJNBLBOBOEJQBLBJ TFOUJNFUFSQFSUBNBEBSJBSUFSJLPSPOBSJBVUBNB
VOUVL NFNCFOUVL "51 EJ EBMBN NJUPLPOESJB "51 JOJ
LFNVEJBO CFLFSKB TFCBHBJ QFNCBXB FOFSHJ VOUVL LPOUSBLTJ Sumbatan Koroner Akut
PUPUKBOUVOHEBOGVOHTJTFMVMFSMBJOOZB1BEBJTLFNJBLPSPOFS 4VNCBUBO BLVU QBEB BSUFSJ LPSPOBSJB QBMJOH TFSJOH UFSKBEJ QBEB
ZBOHCFSBU "51NVMBNVMBUFSVSBJNFOKBEJBEFOPTJOEJGPTGBU PSBOH ZBOH UFMBI NFOEFSJUB QFOZBLJU KBOUVOH LPSPOFS BUFSPT
LFNVEJBO NFOKBEJ BEFOPTJO NPOPGPTGBU EBO BEFOPTJO 0MFI LMFSPUJL UFUBQJ IBNQJS UJEBL QFSOBI UFSKBEJ QBEB PSBOH ZBOH
LBSFOB NFNCSBO TFM PUPU KBOUVOH CFSTJGBU TFEJLJU QFSNFBCFM NFNQVOZBJ TJSLVMBTJ LPSPOFS OPSNBM 4VNCBUBO BLVU EBQBU
CBHJ BEFOPTJO NBLB CBOZBL BEFOPTJO EBQBU CFSEJGVTJ EBSJ TFM EJTFCBCLBO PMFI TBMBI TBUV EBSJ CFSCBHBJ QFOHBSVI EBO EVB EJ
PUPUNBTVLLFEBMBNTJSLVMBTJEBSBI BOUBSBOZBBEBMBITFCBHBJCFSJLVU
"EFOPTJO ZBOH UFSMFQBT JOJ EJBOHHBQ TFCBHBJ TBMBI TBUV [BU 1. -FNQFOH BUFSPTLMFSPUJL EBQBU NFOZFCBCLBO CFLVBO EBSBI
ZBOH NFOZFCBCLBO EJMBUBTJ BSUFSJPM LPSPOFS TFMBNB IJQPLTJB MPLBM ZBOH EJTFCVU USPNCVT ZBOH TFMBOKVUOZB NFOZVNCBU
LPSPOFS TFQFSUJ ZBOH EJUFSBOHLBO TFCFMVNOZB /BNVO IJMB BSUFSJ #JBTBOZB USPNCVT UJNCVM CJMB MFNQFOH BSUFSPTLMFSPUJL
OHOZBBEFOPTJOJOJKVHBNFNCBXBBLJCBUZBOHTFSJVTQBEBTFM UFMBI NFOFNCVT FOEPUFM KBEJ CFSIVCVOHBO MBOHTVOH EFOHBO
%BMBNXBLUVQBMJOHTFEJLJUNFOJUTFUFMBIJTLFNJBLPSPOFS EBSBIZBOHNFOHBMJS0MFILBSFOBMFNQFOHNFOZFCBCLBO
248
Bab 21 Aliran Darah Otot dan Curah Jantung Selama Kerja Fisik; Sirkulasi Koroner dan Penyakit Jantung Iskemik
QFSNVLBBO QFNCVMVI EBSBI NFOKBEJ UJEBL SBUB NBLB LPMBUFSBMNVMBJNFOJOHLBU EVBLBMJMJQBUQBEBIBSJLFEVBBUBV

USPNCPTJU NVMBJ NFMFLBU QBEBOZB GJCSJO NVMBJ UFSUJNCVO LFUJHB EBO TFSJOH LBMJ NFODBQBJ BMJSBO LPSPOFS ZBOH OPSNBM
EBO TFMTFM EBSBI NFSBI UFSQFSBOHLBQ VOUVL NFNCFOUVL BUBVIBNQJSOPSNBMEBMBNXBLUVCVMBO"LJCBUQFNCFOUVL
CFLVBO EBSBI ZBOH TFNBLJO CFTBS TBNQBJ NFOZVNCBU BOTBMVSBOTBMVSBOLPMBUFSBMJOJ CBOZBLQBTJFOZBOHEBQBUQVMJI
UNIT IV
QFNCVMVI EBSBI UFSTFCVU "UBV LBEBOHLBEBOH CFLVBO JUV IBNQJSTFDBSBUPUBMEBSJCFSCBHBJNBDBNEFSBKBUQFOZVNCBUBO
NFMFQBTLBO EJSJ EBSJ QFSMFLBUBOOZB EFOHBO MFNQFOH LPSPOFSCJMBEBFSBIPUPUZBOHUFSLFOBUJEBLUFSMBMVMVBT
BUFSPTLMFSPUJLEBONFOHBMJSLFDBCBOHZBOHMFCJIQFSJGFSEBSJ #JMBBUFSPTLMFSPTJTNFOJNCVMLBOLPOTUSJLTJBSUFSJLPSPOBSJB
BSUFSJ LPSPOBSJB NFOZVNCBU BSUFSJ EJ UFNQBU UFSTFCVU TFDBSB *BNCBU TFMBNB XBLUV CFSUBIVOUBIVO EBO UJEBL TFDBSB
5SPNCVT ZBOH NFOHBMJS EJ TFQBOKBOH BSUFSJ EBO NFOZVNCBU NFOEBEBL NBLBQFNCVMVIEBSBILPMBUFSBMEBQBUUVNCVIQBEB
QFNCVMVIEBSBIZBOHMFCJIEJTUBMEJTFCVUFNCPMVTLPSPOFS XBLUV ZBOH CFSTBNBBO EFOHBO UFSCFOUVLOZB BUFSPTLMFSPTJT
2. #BOZBL LMJOJLVT NFOEVHB CBIXB TQBTNF MPLBM PUPU BSUFSJ 0MFI LBSFOB JUV PSBOH UFSTFCVU NVOHLJO UJEBL QFSOBI
LPSPOBSJBKVHBEBQBUUFSKBEJ4QBTNFJOJNVOHLJOEJTFCBCLBO NFOHBMBNJ FQJTPEF EJTGVOHTJ KBOUVOH ZBOH BLVU 5FUBQJ QBEB
PMFI JSJUBTJ MBOHTVOH QBEB PUPU QPMPT EJOEJOH BSUFSJ PMFI UFQJ BLIJSOZB QSPTFT TLMFSPUJL JUV UFUBQ UFSKBEJ KVHB XBMBVQVO
MFNQFOH BUFSPTLMFSPUJL BUBV NVOHLJO BLJCBU SFGMFLT TBSBG QFNCVMVI EBSBI LPMBUFSBM EBQBU NFNFOVIJ LFCVUVIBO BMJSBO
MPLBM ZBOH NFOZFCBCLBO LPOUSBLTJ EJOEJOH QFNCVMVI EBSBI EBSBI EBO LBEBOHLBEBOH QFNCVMVI EBSBI LPMBUFSBM JUV
LPSPOFS TFDBSB CFSMFCJIBO 4QBTNF JOJ LFNVEJBO NFOJNCVM TFOEJSJEBQBUNFOHBMBNJBUFSPTLMFSPTJT#JMBIBMJOJUFSKBEJ PUPU
LBOUSPNCPTJTTFLVOEFSQBEBQFNCVMVIEBSBIUFSTFCVU KBOUVOH BLBO TBOHBU EJCBUBTJ EBMBN NFMBLTBOBLBO UVHBTOZB
Makna Sirkulasi Kolateral di Jantung Bagi Kelangsungan TFSJOH LBMJ CFHJUV UFSCBUBT TFIJOHHB KBOUVOH UJEBL EBQBU
Hidup. %FSBKBU LFSVTBLBO PUPU KBOUVOH ZBOH EJTFCBCLBO PMFI NFNPNQB TFKVNMBI BMJSBO EBSBI ZBOH CJBTBOZB EJCVUVILBO
LPOTUSJLTJBUFSPTLMFSPUJLBSUFSJLPSPOBSJBZBOHQSPHSFTJGBUBVQVO )BM JOJ NFSVQBLBO TBMBI TBUV QFOZFCBC HBHBM KBOUVOH ZBOH
QFOZVNCBUBO LPSPOFS BLVU EJUFOUVLBO PMFI EFSBKBU TJSLVMBTJ QBMJOHVNVNUFSKBEJQBEBCBOZBLPSBOHMBOKVUVTJB
LPMBUFSBMZBOHTVEBIUJNCVMBUBVZBOHBLBOUJNCVMEBMBNXBLUV
CFCFSBQBNFOJUTFUFMBIQFOZVNCBUBO Infark Miokardium
1BEBKBOUVOHOPSNBM IBNQJSUJEBLBEBIVCVOHBOZBOHMVBTEJ 4FHFSB TFUFMBI UFSKBEJ TVNCBUBO LPSPOFS BLVU BMJSBO EBSBI EJ
BOUBSBBSUFSJBSUFSJLPSPOBSJBCFTBS5FUBQJCBOZBLUFSEBQBUBOBT QFNCVMVI EBSBI LPSPOFS EJ CFMBLBOH TVNCBUBO NFOKBEJ
UPNPTJT EJ BOUBSB BSUFSJBSUFSJ ZBOH MFCJI LFDJM EFOHBO EJBNFUFS UFSIFOUJ LFDVBMJ TFKVNMBI LFDJM BMJSBO LPMBUFSBM EBSJ QFNCVMVI
TBNQBJTFQFSUJUFSMJIBUQBEB(BNCBS EBSBI EJ TFLJUBSOZB %BFSBI PUPU ZBOH TBNB TFLBMJ UJEBL NFO
#JMBUFSKBEJTVNCBUBONFOEBEBLEJTBMBITBUVBSUFSJLPSPOBSJB EBQBUBMJSBOBUBVBMJSBOOZBTBOHBUTFEJLJUTFIJOHHBUJEBLEBQBU
CFTBS NBLB BOBTUPNPTJT LFDJM BLBO NVMBJ CFSEJMBUBTJ EBMBN NFNQFSUBIBOLBO GVOHTJ PUPU KBOUVOH EJLBUBLBO NFOHBMBNJ
XBLUV CFCFSBQB EFUJL 5FUBQJ EBSBI ZBOH NFOHBMJS NFMBMVJ JOGBSL4FMVSVIQSPTFTJOJEJTFCVUJOGBSLNJPLBSEJVN
LPMBUFSBM LFDJM JOJ CJBTBOZB LVSBOH EBSJ TFQBSVI LFCVUVIBO 4FHFSB TFUFMBI JOGBSL TFKVNMBI LFDJM EBSBI LPMBUFSBM NVMBJ
TFCBHJBOCFTBSPUPUKBOUVOHZBOHTFLBSBOHEJTVQMBJOZBBHBSEBQBU NFSFNCFTLFEBMBNEBFSBIJOGBSL EBOIBMJOJ CFSTBNBEFOHBO
UFUBQ IJEVQ EJBNFUFS QFNCVMVI EBSBI LPMBUFSBM UJEBL NFMFCBS EJMBUBTJ QSPHSFTJG QFNCVMVI EBSBI MPLBM NFOZFCBCLBO EBFSBI
MFCJIMBOKVUVOUVLTBNQBJKBNCFSJLVUOZB5FUBQJLFNVEJBO UFSTFCVU EJQFOVIJ PMFI EBSBI ZBOH UFSHFOBOH 4FDBSB CFS
TBNBBO TFSBCVUPUPUNFNBLBJTJTBBLIJSPLTJHFOEBMBNEBSBI
TFIJOHHB IFNPHMPCJO NFOKBEJ UFSFEVLTJ TFDBSB UPUBM 0MFI
LBSFOB JUV EBFSBI ZBOH NFOHBMBNJ JOGBSL CFSXBSOB DPLFMBU
LFCJSVBO EBO QFNCVMVI EBSBI EJ EBFSBI UFSTFCVU UBNQBL
NFOHFNCBOH XBMBVQVO BMJSBO EBSBIOZB LVSBOH 1BEB UBIBQ
TFMBOKVUOZB EJOEJOH QFNCVMVI EBSBI NFOKBEJ TBOHBU QFS
NFBCFM EBO NFNCPDPSLBO DBJSBO KBSJOHBO PUPU MPLBM NFOKBEJ
FEFN EBO TFM PUPU KBOUVOH NVMBJ NFNCFOHLBL BLJCBU CFS
LVSBOHOZB NFUBCPMJTNF TFMVMFS %BMBN XBLUV CFCFSBQB KBN
IBNQJSUBOQBTVQMBJEBSBI TFMTFMPUPUKBOUVOHBLBONBUJ
0UPU KBOUVOH NFNFSMVLBO LJSBLJSB NM PLTJHFO QFS
HSBNKBSJOHBOPUPUQFSNFOJUIBOZBBHBSUFUBQIJEVQ/JMBJJOJ
TFCBOEJOH EFOHBO LJSBLJSB NM PLTJHFO QFS HSBN ZBOH
EJLJSJNLBO LF WFOUSJLFM LJSJ EBMBN LFBEBBO JTUJSBIBU OPSNBM
TFUJBQNFOJUOZB0MFILBSFOBJUV CJMBUFUBQUFSEBQBUTBNQBJ
QFSTFOBMJSBOEBSBILPSPOFSOPSNBMEBMBNLFBEBBOJTUJSBIBU
NBLB PUPU UJEBL BLBO NBUJ /BNVO EJ CBHJBO TFOUSBM EBFSBI
JOGBSL ZBOH CFTBS ZBOH IBNQJS UJEBL UFSEBQBU BMJSBO EBSBI
LPMBUFSBM PUPUBLBONBUJ
Infark Subendokardium. 0UPU TVCFOEPLBSEJVN TFSJOH
NFOHBMBNJJOGBSLCBILBOUBOQBCVLUJCVLUJUFSKBEJOZBJOGBSL
249
Unit IV Sirkulasi
EJCBHJBOQFSNVLBBOMVBSKBOUVOH"MBTBOVOUVLIBMJOJLBSFOB #JMB KBOUVOH UJEBL EBQBU CFSLPOUSBLTJ EFOHBO LFLVBUBO ZBOH

PUPU TVCFOEPLBSEJVN OPSNBMOZB MFCJI TVMJU VOUVL NFN DVLVQ VOUVL NFNPNQB DVLVQ EBSBI LF EBMBN QFSDBCBOHBO
QFSPMFI BMJSBO EBSBI ZBOH BEFLVBU LBSFOB QFNCVMVI EBSBI EJ BSUFSJQFSJGFS UFSKBEJHBHBMKBOUVOHEBOLFNBUJBOKBSJOHBOQFSJGFS
TVCFOEPLBSEJVN CFHJUV LVBU UFSLPNQSFTJ PMFI LPOUSBLTJ TFCBHBJ BLJCBU EBSJ JTLFNJB QFSJGFS ,FBEBBO JOJ EJTFCVU TZPL
TJTUPMJLKBOUVOH TFQFSUJZBOHUFMBIEJKFMBTLBOTFCFMVNOZB0MFI LPSPOFS TZPLLBSEJPHFOJL TZPLKBOUVOH BUBVHBHBMDVSBIKBOUVOH
LBSFOB JUV TFUJBQ LPOEJTJ ZBOH NFOHHBOHHV BMJSBO EBSBI LF SFOEBI)BMJOJBLBOEJCJDBSBLBOMFCJIMFOHLBQEJCBCCFSJLVUOZB
EBFSBI KBOUVOH NBOBQVO CJBTBOZB NFOZFCBCLBO LFSVTBLBO 4ZPL KBOUVOH IBNQJS TFMBMV UFSKBEJ CJMB MFCJI EBSJ QFSTFO
QFSUBNB LBMJ EJ EBFSBI TVCFOEPLBSEJVN EBO LFNVEJBO LFSV WFOUSJLFMLJSJNFOHBMBNJJOGBSL,FNBUJBOUFSKBEJQBEBMFCJIEBSJ
TBLBOUFSTFCVUNFOZFCBSLFMVBSLFBSBIFQJLBSEJVN QFSTFOQBTJFOZBOHNFOHBMBNJTZPLKBOUVOH
Pembendungan Darah di Sistem Vena Tubuh. #JMBKBOUVOH
Penyebab Kematian setelah Penyumbatan Koroner Akut UJEBL NFNPNQB EBSBI LF BSBI EFQBO NBLB EBSBI BLBO
1FOZFCBC LFNBUJBO ZBOH QBMJOH VNVN TFUFMBI UFSKBEJ JOGBSL UFSCFOEVOH EJ BUSJVN EBO EJ EBMBN QFNCVMVI EBSBI QBSV BUBV
NJPLBSE BLVU BEBMBI
QFOVSVOBO DVSBI KBOUVOH
QFN TJSLVMBTJTJTUFNJL)BMJOJBLBONFOJNCVMLBOQFOJOHLBUBOUFLBO
CFOEVOHBO EBSBI EJ QFNCVMVI EBSBI QBSV EJTFSUBJ LFNBUJBO BOLBQJMFS LIVTVTOZBEJQBSVQBSV
BLJCBU FEFNB QBSV
GJCSJMBTJ KBOUVOH EBO LBEBOHLBEBOH 1FNCFOEVOHBO EBSBI EBMBN WFOB JOJ TFSJOH NFOZFCBCLBO

SVQUVSKBOUVOH TFEJLJU NBTBMBI TFMBNB CFCFSBQB KBN QFSUBNB TFUFMBI UFSKBEJ
Penurunan Curah Jantung Peregangan Sistolik dan Syok JOGBSLNJPLBSE/BNVO HFKBMBHFKBMBCBSVUJNCVMCFCFSBQBIBSJ
LFNVEJBO LBSFOB BMBTBO CFSJLVU 1FOVSVOBO DVSBI KBOUVOH
Kardiogenik. #JMB TFCBHJBO TFSBCVU PUPU KBOUVOH TBNB TFLBMJ
TFDBSB BLVU NFOZFCBCLBO CFSLVSBOHOZB BMJSBO EBSBI LF HJOKBM
UJEBL CFSGVOHTJ EBO ZBOH MBJOOZB UFSMBMV MFNBI VOUVL
%BO LBSFOB BMBTBO ZBOH EJCJDBSBLBO EJ #BC HJOKBM LFNVEJBO
CFSLPOUSBLTJ EFOHBO LVBU NBLB TFMVSVI LFNBNQVBO QFN
PNQBBO WFOUSJLFM ZBOH UFSQFOHBSVI BLBO CFSLVSBOH TFDBSB HBHBM NFOHFLTLSFTJLBO DVLVQ VSJO )BM JOJ TFDBSB QSPHSFTJG
TFCBOEJOH .FNBOH LFLVBUBO QFNPNQBBO LFTFMVSVIBO QBEB NFOBNCBI WPMVNF EBSBI UPUBM EBO PMFI LBSFOB JUV NFOJNCVM
KBOUVOH ZBOH JOGBSL TFSJOH NFOVSVO MFCJI CFTBS EBSJ ZBOH LJUB LBO HFKBMBHFKBMB LPOHFTUJG "LJCBUOZB CBOZBL QBTJFO ZBOH
EVHB BLJCBU BEBOZB GFOPNFOB ZBOH EJTFCVU SFHBOH TJTUPMJL UBNQBL NFNCBJL CFCFSBQB IBSJ QFSUBNB TFUFMBI UFSKBEJ HBHBM
TZTUPMJD TUSFUDI
ZBOH EJQFSMJIBULBO QBEB (BNCBS #JMB KBOUVOH UJCBUJCB NFOHBMBNJ FEFNB QBSV BLVU EBO TFSJOH LBMJ
CBHJBO OPSNBM PUPU WFOUSJLFM CFSLPOUSBLTJ NBLB CBHJBO PUPU NFOJOHHBM EBMBN XBLUV CFCFSBQB KBN TFUFMBI UJNCVM HFKBMB
ZBOH JTLFNJL BQBLBI PUPU JOJ NBUJ BUBV UJEBL CFSGVOHTJ UJEBL FEFNBBXBM
BLBO CFSLPOUSBLTJ NFMBJOLBO UFSEPSPOH LFMVBS PMFI UFLBOBO Fibrilasi Ventrikel Setelah Infark Miokard. #BOZBLLFNBUJBO
ZBOH UJNCVM EBSJ EBMBN WFOUSJLFM 0MFI LBSFOB JUV CBOZBL QBTJFO EFOHBO TVNCBUBO LPSPOFS EJTFCBCLBO PMFI GJCSJMBTJ WFO
LFLVBUBO QFNPNQBBO WFOUSJLFM ZBOH IJMBOH BLJCBU QFOPOKPMBO USJLFM NFOEBEBL 'JCSJMBTJ TBOHBU NVOHLJO UFSKBEJ TFUFMBI JOGBSL
BSFBPUPUKBOUVOHZBOHUJEBLCFSGVOHTJ ZBOH MVBT OBNVO GJCSJMBTJ LBEBOHLBEBOH EBQBU KVHB UFSKBEJ
TFUFMBI QFOZVNCBUBO ZBOH LFDJM .FNBOH CFCFSBQB QBTJFO
EFOHBO JOTVGJTJFOTJ LPSPOFS LSPOJL NFOJOHHBM UJCBUJCB LBSFOB
GJCSJMBTJUBOQBBEBOZBJOGBSLBLVU
5FSEBQBU EVB QFSJPEF ZBOH TBOHBU CFSCBIBZB TFUFMBI JOGBSL
LPSPOFS ZBJUV TBBU GJCSJMBTJ TFSJOH TFLBMJ UFSKBEJ 1FSUBNB BEBMBI
TFMBNB NFOJU QFSUBNB TFUFMBI UJNCVM JOGBSL ,FNVEJBO
UFSEBQBU QFSJPEF QFOEFL ZBOH SFMBUJG BNBO EJJLVUJ PMFI QFSJPEF
JSJUBCJMJUBT KBOUVOH LFEVB ZBOH EJNVMBJ KBN LFNVEJBO BUBV
MFCJIEBOCFSMBOHTVOHTFMBNBCFCFSBQBKBNCFSJLVUOZB'JCSJMBTJ
EBQBUKVHBUFSKBEJCFCFSBQBIBSJTFUFMBIJOGBSLUFUBQJIBMJOJKBSBOH
EJUFNVJ
4FEJLJUOZB UFSEBQBU FNQBU GBLUPS ZBOH NFOJNCVMLBO LFDFO
EFSVOHBOKBOUVOHVOUVLCFSGJCSJMBTJ
1. )JMBOHOZB TVQMBJ EBSBI CBHJ PUPU KBOUVOH ZBOH CFSMBOHTVOH
BLVU NFOZFCBCLBO QFOVSVOBO LBMJVN EFOHBO DFQBU EBSJ
PUPUPUPUZBOHJTLFNJL,FBEBBOJOJKVHBNFOJOHLBULBOLPO
TFOUSBTJ LBMJVN EBMBN DBJSBO FLTUSBTFM EJ TFLJUBS TFSBU PUPU
KBOUVOH 1FSDPCBBO EFOHBO QFOZVOUJLBO LBMJVN LF EBMBN
TJTUFNLPSPOFSNFNQFSMJIBULBOCBIXBLFOBJLBOLPOTFOUSBTJ
LBMJVNFLTUSBTFMBLBONFOJOHLBULBO JSJUBCJMJUBT PUPU KBOUVOH
EBO PMFILBSFOBJUV NFOJNCVMLBOLFDFOEFSVOHBOGJCSJMBTJ
2. *TLFNJB PUPU NFOZFCBCLBO TVBUV BSVT DFEFSB JOKVSZ
DVSSFOU
ZBOH UFMBI EJKFMBTLBO EJ #BC TFIVCVOHBO EFOHBO
FMFLUSPLBSEJPHSBNQBEBQBTJFOJOGBSLNJPLBSEJVNBLVU0UPU
250
ZBOH JTLFNJL TFSJOH LBMJ UJEBL EBQBU NFSFQPMBSJTBTJLBO NFN

CSBOOZB EFOHBO TFNQVSOB TFUFMBI KBOUVOH CFSEFOZVU TF
IJOHHB QFSNVLBBO MVBS PUPU JOJ UFUBQ OFHBUJG EJCBOEJOHLBO
EFOHBOQPUFOTJBMNFNCSBOPUPUKBOUVOHOPSNBMEJNBOBQVO
UNIT IV
EBMBN KBOUVOH 0MFI LBSFOB JUV BMJSBO MJTUSJL NFOHBMJS EBSJ
EBFSBI JTLFNJL KBOUVOH JOJ LF EBFSBI OPSNBM EBO EBQBU
NFOJNCVMLBO JNQVMT BCOPSNBM ZBOH EBQBU NFOZFCBCLBO
GJCSJMBTJ
3. 3FGMFLT TJNQBUJT ZBOH TBOHBU LVBU TFSJOH LBMJ UJNCVM TFUFMBI
JOGBSLNBTJG UFSVUBNBLBSFOBKBOUVOHUJEBLNFNPNQBWPMVNF
EBSBI ZBOH DVLVQ LF EBMBN TJTUFN BSUFSJ ZBOH TFMBOKVUOZB
NFOVSVOLBO UFLBOBO EBSBI 3BOHTBOHBO TJNQBUJT KVHB
NFOJOHLBULBO JSJUBCJMJUBT PUPU KBOUVOH EBO EFOHBO EFNJLJBO
NFNQFSNVEBIUJNCVMOZBGJCSJMBTJ
4. ,FMFNBIBO PUPU KBOUVOH BLJCBU JOGBSL NJPLBSEJVN TFSJOH
NFOZFCBCLBO WFOUSJLFM CFSEJMBUBTJ TFDBSB CFSMFCJIBO )BM JOJ
BLBO NFOJOHLBULBO QBOKBOH MJOUBTBO LPOEVLTJ JNQVMT EJ
KBOUVOH EBO TFSJOH NFOZFCBCLBO MJOUBTBO LPOEVLTJ ZBOH
BCOPSNBMEJTFLJUBSEBFSBIJOGBSLQBEBPUPUKBOUVOH,FEVBFGFL TFLJUBSEBFSBIZBOHNBUJUFSEBQBUEBFSBIZBOHUJEBLCFSGVOHTJ
JOJ NFNQFSNVEBI UJNCVMOZB HFSBLBO TJSLVMBS LBSFOB TFQFSUJ ZBOH NFOHBMBNJ LFHBHBMBO LPOUSBLTJ EBO CJBTBOZB KVHB
ZBOHEJCJDBSBLBOEJ#BC QFNBOKBOHBOZBOHCFSMFCJIBOQBEB LFHBHBMBOLPOEVLTJJNQVMT,FNVEJBO EJEBFSBIZBOHNFMVBT
KBSBT LPOEVLTJ EJ WFOUSJLFM BLBO NFNVOHLJOLBO JNQVMT VOUVL TFDBSB NFMJOHLBS EJ TFLJUBS EBFSBI ZBOH UJEBL CFSGVOHTJ
LFNCBMJNFNBTVLJPUPUZBOHUFMBIQVMJIEBSJLFBEBBOSFGSBLUFS UFSTFCVUUFSEBQBUEBFSBIZBOHNBTJIUFUBQCFSLPOUSBLTJOBNVO
EFOHBO EFNJLJBO NFNVMBJ TVBUV TJLMVT FLTJUBTJ HFSBLBO TBOHBUMFNBIBLJCBUBEBOZBJTLFNJBSJOHBO
TJSLVMBS CFSJLVUOZB EBO NFOZFCBCLBO QSPTFT JOJ CFSMBOHTVOH Penggantian Otot Mati dengan Jaringan Parut. %J
UFSVTNFOFSVT CBHJBO CBXBI (BNCBS UFSMJIBU CFSCBHBJ UJOHLBU
Ruptur Daerah Infark. 4FMBNB IBSJIBSJ QFSUBNB TFUFMBI QFNVMJIBOTFUFMBIJOGBSLNJPLBSEJVNZBOHMVBT4FHFSBTFUFMBI
JOGBSL BLVU CBIBZB UFSKBEJOZB SVQUVS QBEB CBHJBO KBOUVOH ZBOH UFSKBEJ TVNCBUBO TFSBUTFSBU PUPU EJ QVTBU EBFSBI JTLFNJL
JTLFNJLNBTJILFDJM OBNVOCFCFSBQBIBSJLFNVEJBO TFSBUPUPU NFOKBEJ NBUJ ,FNVEJBO TFMBNB IBSJIBSJ CFSJLVUOZB EBFSBI
ZBOH NBUJ NVMBJ CFSEFHFOFSBTJ EBO EJOEJOH KBOUVOH NFOKBEJ EFOHBOTFSBUTFSBUNBUJUFSTFCVUNFMVBTLBSFOBCBOZBLTFSBCVU
TBOHBU UJQJT PMFI SFHBOHBO #JMB IBM JOJ UFSKBEJ PUPU ZBOH NBUJ NBSHJOBMBLIJSOZBNBUJBLJCBUJTLFNJBZBOHCFSMBOHTVOHMBNB
BLBO TBOHBU NFOPOKPM LFMVBS TFUJBQ LBMJ LPOUSBLTJ KBOUVOH EBO 1BEB XBLUV ZBOH CFSTBNBBO LBSFOB QFMFCBSBO TBMVSBO BSUFSJ
SFHBOHBO TJTUPMJL NFOKBEJ TFNBLJO NFNCFTBS TBNQBJ BLIJSOZB LPMBUFSBMZBOHNFOZVQMBJCBUBTMVBSEBFSBIJOGBSL CBOZBLPUPU
UJNCVMSVQUVSKBOUVOH1BEBLFOZBUBBOOZB TBMBITBUVDBSBZBOH ZBOHUJEBLCFSGVOHTJNFOKBEJQVMJILFNCBMJ4FTVEBICFCFSBQB
EJQBLBJVOUVLNFOJMBJQFSLFNCBOHBOJOGBSLNJPLBSEZBOHCFSBU IBSJTBNQBJNJOHHV TFCBHJBOCFTBSPUPUZBOHUJEBLCFSGVOHTJ
BEBMBI EFOHBO NFSFLBN NFOHHVOBLBO BMBU QFODJUSBBO KBOUVOH NFOKBEJ CFSGVOHTJ LFNCBMJ BUBV NBUJ 4FNFOUBSB JUV KBSJOHBO
ZBJUV TJOBSY
VOUVL NFOHFUBIVJ BQBLBI EFSBKBU SFHBOHBO GJCSPTB NVMBJ UVNCVI EJ BOUBSB TFSBCVUTFSBCVU ZBOH NBUJ
TJTUPMJLTFNBLJONFNCVSVLBUBVUJEBL LBSFOB JTLFNJB NFSBOHTBOH QFSUVNCVIBO GJCSPCMBT EBO
NFSBOHTBOHQFSUVNCVIBOKBSJOHBOGJCSPTBEBMBNKVNMBIZBOH
#JMB UFSKBEJ SVQUVS WFOUSJLFM IJMBOHOZB EBSBI LF EBMBN SVBOH
MFCJI CBOZBL EBSJQBEB OPSNBM 0MFI LBSFOB JUV KBSJOHBO PUPU
QFSJLBSEJBM NFOZFCBCLBO UJNCVMOZB UBNQPOBEF KBOUVOH EFOHBO
NBUJMBNCBUMBVOEJHBOUJLBOPMFIKBSJOHBOGJCSPTB,FNVEJBO
DFQBUZBJUV LPNQSFTJKBOUVOHEBSJMVBSPMFIEBSBIZBOHNFOHVN
LBSFOB JOJ BEBMBI TJGBU VNVN KBSJOHBO GJCSPTB VOUVL
QVM EJ SPOHHB QFSJLBSEJBM "LJCBU LPNQSFTJ KBOUVOH JOJ EBSBI
NFOHBMBNJ LPOUSBLTJ EBO QFMFCVSBO ZBOH QSPHSFTJG KBSJOHBO
UJEBLEBQBUNFOHBMJSLFEBMBNBUSJVNLBOBO EBOQBTJFONFOJOH QBSVU GJCSPTB BLBO NFOHFDJM TFUFMBI CFCFSBQB CVMBO TBNQBJ
HBMBLJCBUQFOVOVOBODVSBIKBOUVOHZBOHNFOEBEBL TFUBIVO
Stadium Pemulihan Infark Miokardium Akut "LIJSOZB EBFSBI OPSNBM KBOUVOH MBNCBU MBVO NFOHBMBNJ
IJQFSUSPGJ VOUVL NFOHLPNQFOTBTJ TFEJLJUOZB TFCBHJBO EBSJ
#BHJBO LJSJ BUBT (BNCBS NFNQFSMJIBULBO FGFL TVNCBUBO PUPU KBOUVOH ZBOH NBUJ %FOHBO DBSB JOJ KBOUVOH EBQBU QVMJI
LPSPOFSBLVUQBEBQBTJFOEFOHBOEBFSBIJTLFNJBPUPUZBOHLFDJM LFNCBMJ TFCBHJBO BUBV IBNQJS TFNQVSOB EBMBN XBLUV
EBO (BNCBS EJ TFCFMBI LBOBO NFNQFSMJIBULBO KBOUVOH EFOHBO CFCFSBQBUBIVO
EBFSBI JTLFNJB ZBOH MVBT #JMB EBFSBI JTLFNJL JOJ LFDJM EBQBU
UFSKBEJTFEJLJULFNBUJBOTFMPUPUBUBVUJEBLBEBTBNBTFLBMJ UFUBQJ Pentingnya Istirahat pada Pengobatan Infark Miokard.
TFCBHJBO PUPU TFSJOH LBMJ UJEBL CFSGVOHTJ VOUVL TFNFOUBSB BLJCBU 5JOHLBU LFNBUJBO TFMVMFS KBOUVOH EJUFOUVLBO PMFI EFSBKBU
LVSBOHOZBOVUSJTJVOUVLNFNCBOUVLPOUSBLTJPUPU JTLFNJB EBO CFCBO LFSKB PUPU KBOUVOH #JMB CFCBO LFSKB PUPU
KBOUVOH TBOHBU NFOJOHLBU TFQFSUJ TFMBNB LFSKB GJTJL QBEB
#JMBEBFSBIJTLFNJBJOJMVBT CFCFSBQBTFSBUPUPUEJQVTBUEBFSBI LFUFHBOHBO FNPTJ ZBOH IFCBU BUBV BLJCBU LFMFMBIBO NBLB
JUVNBUJEFOHBODFQBU EBMBNXBLUVTBNQBJKBNQBEBEBFSBI KBOUVOH NFNCVUVILBO UBNCBIBO PLTJHFO EBO [BU NBLBOBO
ZBOHNFOHBMBNJQFOHIFOUJBOUPUBMTVQMBJEBSBILPSPOFS5FQBUEJ MBJOOZBVOUVLNFMBOHTVOHLBOIJEVQOZB-BHJQVMB QFNCVMVI
251
Unit IV Sirkulasi
EBSBI BOBTUPNPTJT ZBOH NFOZVQMBJ EBSBI LF EBFSBI JTLFNJL TFQFSUJ KVHB MFOHBO 0MFI LBSFOB JUV LFEVB TUSVLUVS JOJ KBOUVOH
KBOUVOH KVHB IBSVT UFUBQ NFOZFEJBLBO EBSBI CBHJ EBFSBI EBOEBFSBIQFSNVLBBOUVCVI
NFOFSJNBTFSBCVUTBSBGOZFSJEBSJ
KBOUVOHZBOHCJBTBEJBMJSJPMFIQFNCVMVIEBSBIUFSTFCVU#JMB TFHNFONFEVMBTQJOBMJTZBOHTBNB
KBOUVOH NFOKBEJ MVBS CJBTB BLUJG QFNCVMVI EBSBI QBEB PUPU
4FCBHJBOCFTBSPSBOHEFOHBOBOHJOBQFLUPSJTLSPOJLNFSBTB
OPSNBM BLBO TBOHBU CFSEJMBUBTJ )BM JOJ NFNVOHLJOLBO
OZFSJCJMBNFMBLVLBOLFSKBGJTJLBUBVCJMBNFOHBMBNJQFSVCBIBO
TFCBHJBOCFTBSEBSBIZBOHNFOHBMJSLFEBMBNQFNCVMVIEBSBI
FNPTJ ZBOH BLBO NFOJOHLBULBO NFUBCPMJTNF KBOUVOH BUBV
LPSPOFS VOUVL NFOHBMJS NFMBMVJ KBSJOHBO PUPU OPSNBM KBEJ
NFOHLPOTUSJLTJLBO QFNCVMVI EBSBI LPSPOFS VOUVL TFNFOUBSB
IBOZB NFOZJTBLBO TFEJLJU EBSBI VOUVL EJBMJSLBO NFMBMVJ
XBLUV BLJCBU TJOZBM TBSBG WBTPLPOTUSJLUPS TJNQBUJT /ZFSJ
TBMVSBO BOBTUPNPTJT LFDJM LF EBMBN EBFSBI JTLFNJL TFIJOHHB
BOHJOB KVHB EJQFSCVSVL PMFI TVIV EJOHJO BUBV MBNCVOH ZBOH
LFBEBBO JTLFNJL TFNBLJO NFNCVSVL ,FBEBBO JOJ EJTFCVU
QFOVI EVB LFBEBBO ZBOH NFOJOHLBULBO CFCBO LFSKB KBOUVOH
TJOESPN DPSPOBSZ TUFBM "LJCBUOZB TBMBI TBUV GBLUPS QBMJOH
#JBTBOZBOZFSJCFSMBOHTVOHIBOZBCFCFSBQBNFOJU"LBOUFUBQJ
QFOUJOH EBMBN QFOHPCBUBO QBTJFO JOGBSL NJPLBSEJVN BEBMBI
CFCFSBQB QBTJFO NFOHBMBNJ JTLFNJB IFCBU EBO MBNB ZBOH SBTB
LFUBBUBO QBTJFO UFSTFCVU EBMBN NFMBLVLBO JTUJSBIBU UPUBM
OZFSJOZB UFSBTB TFQBOKBOH XBLUV /ZFSJ TFSJOH EJKBCBSLBO
TFMBNBQSPTFTQFNVMJIBO
TFCBHBJ SBTB QBOBT NFOFLBO EBO NFSFNBT LVBMJUBT OZFSJ JOJ
TFEFNJLJBO SVQB TFIJOHHB CJBTBOZB QBTJFO NFOHIFOUJLBO
Fungsi Jantung Setelah Pulih dari Infark Miokard TFMVSVIBLUJWJUBTUVCVIZBOHUJEBLQFSMVEBOIBSVTCFSJTUJSBIBU
,BEBOHLBEBOH KBOUVOHZBOHUFMBIQVMJIEBSJJOGBSLNJPLBS UPUBM
EJVN ZBOH MVBT LFNCBMJ CFSGVOHTJ TFDBSB IBNQJS QFOVI
Penatalaksanaan dengan Obat. #FCFSBQBPCBUWBTPEJMBUPS
UFUBQJMFCJITFSJOHLFNBNQVBONFNPNQBOZBUFUBQNFOVSVO
CJMB EJCFSJLBO TFMBNB TFSBOHBO BOHJOB BLVU TFSJOH LBMJ EBQBU
EJ CBXBI KBOUVOH ZBOH TFIBU )BM JOJ UJEBL CFSBSUJ CBIXB
TFHFSB NFSJOHBOLBO SBTB OZFSJ 7BTPEJMBUPS LFSKB DFQBU ZBOH
PSBOH JUV NFOKBEJ DBDBU KBOUVOH BUBV CBIXB DVSBI KBOUVOH TFSJOH EJHVOBLBO BEBMBI OJUSPHMJTFSJO EBO PCBU OJUSBU MBJOOZB
EBMBN LFBEBBO JTUJSBIBU NFOVSVO EJ CBXBI OPSNBM LBSFOB 7BTPEJMBUPS MBJO TFQFSUJ QFOHIBNCBU BOHJPUFOTJO DPOWFSUJOH
KBOUVOH ZBOH OPSNBM NBNQV NFNPNQB TBNQBJ FO[ZNF QFOHIBNCBU SFTFQUPS BOHJPUFOTJO QFOHIBNCBU LBOBM
QFSTFO MFCJI CBOZBL EBSBI QFSNFOJU EBSJQBEB ZBOH EJCVUVI LBMTJVN EBO SBOPMB[JO EBQBU NFOHVOUVOHLBO EBMBN NFOHPCBUJ
LBO UVCVI TFMBNB JTUJSBIBU BSUJOZB TFTFPSBOH ZBOH OPSNBM BOHJOBQFDUPSJTLSPOJTZBOHTUBCJM
NFNQVOZBJ DBEBOHBO KBOUVOH TFCBOZBL TBNQBJ
QFSTFO #BILBO CJMB DBEBOHBO KBOUVOH NFOVSVO TBNQBJ ,FMPNQPLPCBUMBJOZBOHEJHVOBLBOVOUVLQFOHPCBUBOBOHJOB
TFSFOEBIQFSTFO PSBOHUFSTFCVUNBTJIEBQBUNFMBLVLBO QFLUPSJT KBOHLB QBOKBOH BEBMBI QFOHIBNCBU CFUB TFQFSUJ
TFCBHJBOCFTBSBLUJWJUBTOPSNBMTFIBSJIBSJ UFUBQJUJEBLEBMBN QSPQSBOPMPM 0CBU JOJ NFOHIBNCBU SFTFQUPS BESFOFSHJL CFUB
LFBEBBO LFSKB GJTJL CFSBU ZBOH BLBO NFNCFCBOJ KBOUVOH TJNQBUJT ZBOH NFODFHBI QFSBOHTBOHBO TJNQBUJT UFSIBEBQ
TFDBSBCFSMFCJIBO GSFLVFOTJ KBOUVOH EBO NFUBCPMJTNF KBOUVOH TFMBNB LFSKB GJTJL
BUBV FQJTPEF FNPTJPOBM 0MFI LBSFOB JUV UFSBQJ EFOHBO CFUB
CMPLFS NFOVSVOLBO LFCVUVIBO KBOUVOH BLBO PLTJHFO NFUBCPMJL
Nyeri pada Penyakit Jantung Koroner
UBNCBIBO TFMBNB LPOEJTJ ZBOH QFOVI TUSFT 6OUVL BMBTBO ZBOH
%BMBN LFBEBBO OPSNBM TFTFPSBOH UJEBL EBQBU NFSBTBLBO KFMBT IBMJOJKVHBEBQBUNFOHVSBOHJKVNMBITFSBOHBOBOHJOBTFSUB
KBOUVOHOZB UFUBQJ PUPU KBOUVOH ZBOH JTLFNJL TFSJOH NFOHVSBOHJUJOHLBULFQBSBIBOOZB
NFOJNCVMLBOTFOTBTJOZFSJ1FOZFCBCQBTUJSBTBOZFSJJOJUJEBL
EJLFUBIVJ UFUBQJ EJBOHHBQ CBIXB JTLFNJB NFOZFCBCLBO PUPU Terapi Pembedahan pada Penyakit Arteri Koroner
NFNCFCBTLBO[BU[BUBTBN TFQFSUJBTBNMBLUBU BUBVQSPEVL Bedah Pintas Aorta-Koroner (Aortic-Coronaty Bypass
QSPEVL ZBOH NFOJNCVMLBO OZFSJ MBJOOZB TFQFSUJ IJTUBNJO
LJOJO BUBVFO[JNQSPUFPMJUJLTFMVMFS ZBOHUJEBLDFQBUEJCBXB Surgery). 1BEB CBOZBL QBTJFO EFOHBO JTLFNJB LPSPOFS EBFSBI
QFSHJ PMFI BMJSBO EBSBI LPSPOFS ZBOH CFSHFSBL MBNCBU EFOHBO BSUFSJ LPSPOFS ZBOH UFSLPOTUSJLTJ IBOZB UFSMFUBL EJ
,POTFOUSBTJ ZBOH UJOHHJ EBSJ QSPEVL BCOPSNBM JOJ BLBO CFCFSBQB UJUJL UFSUFOUV ZBOH UFSTVNCBU BLJCBU BEBOZB QFOZBLJU
NFSBOHTBOH VKVOHVKVOH TBSBG OZFSJ EJ PUPU KBOUVOH ZBOH BUFSPTLMFSPUJL EBO QFNCVMVI LPSPOFS EJ UFNQBU MBJO CFSVLVSBO
NFOHIBOUBSLBO JNQVMT OZFSJ NFMBMVJ TFSBCVU TBSBG BGFSFO OPSNBM BUBV IBNQJS OPSNBM 4VBUV QSPTFEVS QFNCFEBIBO UFMBI
TFOTPSJLLFEBMBNTJTUFNTBSBGQVTBU EJLFNCBOHLBO QBEB UBIVO BO ZBOH EJTFCVU QJOUBT BPSUB
LPSPOFS BPSUJDDPSPOBSZ CZQBTT
EFOHBO DBSB NFNPUPOH
TFCBHJBO WFOB TVCLVUBO EBSJ MFOHBO BUBV UVOHLBJ EBO LFNVEJBO
Angina Pektoris NFODBOHLPLWFOBJOJNVMBJEBSJBLBSBPSUBNFOVKVLFTJTJBSUFSJ
1BEBTFCBHJBOCFTBSPSBOHEFOHBOLPOTUSJLTJBSUFSJLPSPOBSJB LPSPOFS QFSJGFS EJ CFMBLBOH UJUJL TVNCBUBO BUFSPTLMFSPUJL
ZBOH QSPHSFTJG OZFSJ KBOUVOH ZBOH EJTFCVU BOHJOB QFLUPSJT #JBTBOZB EJMBLVLBO TBUV TBNQBJ MJNB DBOHLPLBO TFNBDBN JOJ
NVMBJ NVODVM CJMB CFCBO KBOUVOH NFOKBEJ UFSMBNQBV CFSBU ZBOH NBTJOHNBTJOH NFOZVQMBJ EBSBI VOUVL BSUFSJ LPSPOFS
TFIVCVOHBOEFOHBOBMJSBOEBSBILPSPOFSZBOHUFSTFEJB/ZFSJ QFSJGFSZBOHCFSMPLBTJEJCFMBLBOHTVNCBUBO
JOJ CJBTBOZB UFSBTB EJ CBXBI TUFSOVN CBHJBO BUBT EBO TFSJOH 1BEBTFCBHJBOCFTBSQBTJFO OZFSJBOHJOBOZBEBQBUCFSLVSBOH
NFOZFCBS LF EBFSBI QFSNVLBBO UVCVI ZBOH KBVI QBMJOH 4FMBJO JUV QBEB QBTJFO ZBOH KBOUVOHOZB CFMVN UFSMBMV SVTBL
TFSJOHLFMFOHBOLJSJEBOCBIVLJSJUFUBQJKVHBTFSJOHLFMFIFS TFCFMVN PQFSBTJ QSPTFEVS QJOUBT CZQBTT
LPSPOFS EBQBU
EBOCBILBOLFTJTJXBKBI1FOZFCBCEJTUSJCVTJOZFSJJOJBEBMBI NFOZFCBCLBO QBTJFO NFNQVOZBJ IBSBQBO IJEVQ ZBOH OPSNBM
LBSFOBKBOUVOHQBEBLFIJEVQBOFNCSJPOBMCFSNVMBEJMFIFS /BNVOKJLBLFSVTBLBOKBOUVOHTVEBITBOHBUQBSBI PQFSBTJQJOUBT
252
CZQBTT
JOJNVOHLJOUJEBLCBOZBLBSUJOZB Daftar Pustaka
Angioplasti Koroner. 4FKBLUBIVOBO UFMBIEJHVOBLBO Cohn PF, Fox KM, Daly C: Silent myocardial ischemia, Circulation
TVBUV QSPTFEVS VOUVL NFNCVLB QFNCVMVI LPSPOFS ZBOH 108:1263, 2003.
UFSTVNCBU TFCBHJBO TFCFMVN UFSKBEJ TVNCBUBO UPUBM 1SPTFEVS Dalal H, Evans PH, Campbell JL: Recent developments in secondary
UNIT IV
OZB EJTFCVUBOHJPQMBTUJBSUFSJLPSPOBSJB BEBMBITFCBHBJCFSJLVU prevention and cardiac rehabilitation after acute myocardial infarction,
4VBUV LBUFUFS ZBOH EJ CBHJBO VKVOHOZB UFSEBQBU TFCVBI CBMPO BMJ 328:693, 2004.
LFDJM LJSBLJSB CFSEJBNFUFS NN EFOHBO CJNCJOHBO SBEJP Duncker DJ, Bache RJ: Regulation of coronary blood flow during
HSBGJL EJNBTVLLBO LF EBMBN TJTUFN LPSPOFS EBO EJEPSPOH exercise, Physiol Rev 88:1009, 2008.
NFMBMVJ BSUFSJ ZBOH UFSTVNCBU TFCBHJBO TBNQBJ CBMPO LBUFUFS Freedman SB, Isner JM: Therapeutic angiogenesis for coronary artery
disease, Ann lntern Med 136:54, 2002.
UFSKFSBU EJ UFNQBU ZBOH UFSTVNCBU TFCBHJBO UFSTFCVU ,FNVEJBO
Gehlbach BK, Geppert E:The pulmonary manifestations of left heart
CBMPO EJUJVQ EFOHBO UFLBOBO UJOHHJ TFIJOHHB BLBO TBOHBU
failure, Chest 125:669, 2004.
NFSFHBOHLBO BSUFSJ ZBOH UFSTVNCBU JUV 4FUFMBI QSPTFEVS JOJ
GonzMez-Alonso J, Crandall CG, Johnson JM: The cardiovascular
EJMBLVLBO BMJSBO EBSBI ZBOH NFMFXBUJ QFNCVMVI TFSJOH challenge of exercising in the heat,JPhysiol 586:45, 2008.
NFOJOHLBUUJHBTBNQBJFNQBULBMJMJQBU EBOMFCJIEBSJQFSTFO Guyton AC, Jones CE, Coleman TG: Circulatory pathology: Cardiac
QBTJFO ZBOH NFOKBMBOJ QSPTFEVS JOJ NFSBTB CFCBT EBSJ HFKBMB output and its regulation, Philadelphia, 1973, WB Saunders.
JTLFNJL LPSPOFS TFMBNB TFEJLJUOZB CFCFSBQB UBIVO NFTLJQVO Hester RL, Hammer LW: Venular-arteriolar communication in the
CBOZBL QBTJFO QBEB BLIJSOZB UFUBQ NFNFSMVLBO CFEBI QJOUBT regulation of blood flow, AmJ Physiol 282:R1280, 2002.
CZQBTT
LPSPOFS Joyner M J, Wilkins BW: Exercise hyperaemia: is anything obligatory but
the hyperaemia? J Physiol 583:855, 2007.
5BCVOH LFDJM UFSCVBU EBSJ KBMJOBO CBKB BOUJ LBSBU ZBOH EJTFCVU
Koerselman J, van der Graaf Y, de Jaegere PP, et Coronary collaterals:
TUFOULBEBOHLBEBOHEJUFNQBULBOEJEBMBNBSUFSJLPSPOBSJBZBOH an important and underexposed aspect of coronary artery disease,
EJEJMBUBTJNFMBMVJBOHJPQMBTUJ VOUVLNFNQFSUBIBOLBOBSUFSJUFUBQ Circulation 107:2507, 2003.
UFSCVLB KBEJ NFODFHBI TUFOPTJT VMBOH %BMBN CFCFSBQB NJOHHV Levine BD: VO2max: what do we know, and what do we still need to
TFUFMBIQFNBTBOHBOTUFOUQBEBBSUFSJLPSPOBSJB VNVNOZBUVNCVI know? J Physiol 586:25, 2008.
FOEPUFMJVN NFOVUVQJ QFSNVLBBO MPHBN TUFOU NFNVOHLJOLBO Reynolds HR, Hochman J: Cardiogenic shock: current concepts and
EBSBI NFOHBMJS EFOHBO NVMVT NFMBMVJ TUFOU /BNVO QFOVUVQBO improving outcomes, Circulation 117:686, 2008.
LFNCBMJ SFTUFOPTJT
BSUFSJ LPSPOBSJB ZBOH UFSTVNCBU UFSKBEJ QBEB Richardson RS: Oxygen transport and utilization: an integration of the
TFLJUBS TBNQBJ QFSTFO QBTJFO ZBOH EJUBOHBOJ EFOHBO muscle systems, Adv Physiol Educ 27:183, 2003.
BOHJPQMBTUJ VNVNOZB UFSKBEJ EBMBN XBLUV CVMBO TFUFMBI Renault MA, Losordo DW: Therapeutic myocardial angiogenesis,
Microvasc Res 74:159, 2007.
UJOEBLBO BXBM )BM JOJ VNVNOZB EJTFCBCLBO PMFI QFNCFOUVLBO
KBSJOHBO QBSVU CFSMFCJIBO EJ CBXBI FOEPUFMJVN CBSV ZBOH TFIBU Saltin B: Exercise hyperaemia: magnitude and aspects on regulation in
humans,JPhysiol 583:819, 2007.
ZBOH UVNCVI NFOVUVQJ TUFOU 4UFOU ZBOH TFDBSB MBNCBU
Tsai AG, Johnson PC, Intaglietta M: Oxygen gradients in the
NFMFQBTLBOPCBU ESVHFMVUJOHTUFOUT
EBQBUNFNCBOUVNFODFHBI microcircula¬tion, Physiol Rev 83:933, 2003.
QFSUVNCVIBOKBSJOHBOQBSVUCFSMFCJIBO
Yellon DM, Downey JM: Preconditioning the myocardium: from cellular
1SPTFEVSUFSCBSVVOUVLNFNCVLBBSUFSJLPSPOFSNBTJIEBMBN physiology to clinical cardiology, Physiol Rev 83:1113, 2003.
QSPTFT QFOFMJUJBO 4BMBI TBUVOZB NFOHHVOBLBO TJOBS MBTFS QBEB
VKVOHLBUFUFSBSUFSJLPSPOFSZBOHEJUVKVLBOLFMFTJLPSPOFS4JOBS
MBTFSNFOHIJMBOHLBOTVNCBUBOUBOQBNFSVTBLEJOEJOHBSUFSJ
253
BAB 22
UNIT IV
(BHBM+BOUVOH
4BMBI TBUV QFOZBLJU QBMJOH QFOUJOH NFOJOHLBUTBNQBJNN)HLBSFOBQFOHFNCBMJBOEBSBIEBSJ

ZBOH IBSVT EJPCBUJ PMFI TFPSBOH UVCVI NFMBMVJ WFOB NFOVKV LF KBOUVOH UFSCFOEVOH EJ BUSJVN
EPLUFS BEBMBI HBHBM KBOUVOH LBOBO $VSBI KBOUVOH SFOEBI JOJ NBTJI DVLVQ VOUVL
,FBEBBO UFSTFCVU EBQBU UFSKBEJ NFNQFSUBIBOLBOIJEVQCBSBOHLBMJTFMBNBCFCFSBQBKBN UFUBQJ
BLJCBU TFNVB LPOEJTJ KBOUVOH ZBOH CJBTBOZBEJTFSUBJEFOHBOLFBEBBOQJOHTBO6OUVOHOZB TUBEJVN
NFOVSVOLBOLFNBNQVBOKBOUVOH BLVU JOJ CJBTBOZB IBOZB CFSMBOHTVOH TFMBNB CFCFSBQB EFUJL
UFLBOBO FLTUFSOBM EJ TFLJUBS KBOUVOH EFGJTJFOTJ WJUBNJO # LBSFOBTFHFSBUJNCVMSFGMFLTTBSBGTJNQBUJT EBONFOHPNQFOTBTJ
QFOZBLJU PUPU KBOUVOH QSJNFS BUBV TFHBMB LFMBJOBO MBJO ZBOH TFDBSB TBOHBU MVBT LFSVTBLBO KBOUVOH TFQFSUJ ZBOH BLBO
EBQBUNFNCVBUQFNPNQBBOKBOUVOHNFOKBEJLVSBOHFGFLUJG EJVSBJLBOCFSJLVUJOJ
%BMBN CBC JOJ LJUB UFSVUBNB NFNCJDBSBLBO NFOHFOBJ HBHBM Kompensasi untuk Gagal Jantung Akut oleh Refleks
KBOUVOH ZBOH EJTFCBCLBO PMFI QFOZBLJU KBOUVOH JTLFNJL ZBOH Saraf Simpatis. #JMB DVSBI KBOUVOH NFOVSVO TBNQBJ EFSBKBU
EJBLJCBULBO PMFI TVNCBUBO QBSTJBM EJ QFNCVMVI EBSBI LPSPOFS ZBOH NFNCBIBZBLBO CFSCBHBJ SFGMFLT TJSLVMBTJ TFQFSUJ ZBOH
QFOZFCBC UFSTFSJOH UFSKBEJOZB HBHBM KBOUVOH %BMBN CBC LJUB EJCJDBSBLBO EJ #BC EFOHBO DFQBU EJBLUJGLBO 3FGMFLT ZBOH
BLBO NFNCJDBSBLBO NFOHFOBJ QFOZBLJU LBUVQ KBOUVOH EBO QBMJOHUFSLFOBMBEBMBISFGMFLTCBSPSFTFQUPS ZBOHEJBLUJGLBOPMFI
QFOZBLJUKBOUVOHLPOHFOJUBM QFOVSVOBO UFLBOBO BSUFSJ 3FGMFLT LFNPSFTFQUPS SFTQPOT
Definisi Gagal Jantung. *TUJMBI HBHBM KBOUVOH TFDBSB JTLFNJL QBEB TJTUFN TBSBG QVTBU CBILBO SFGMFLT ZBOH CFSBTBM
TFEFSIBOB CFSBSUJ LFHBHBMBO KBOUVOH VOUVL NFNPNQB EBSBI EBSJ KBOUVOH ZBOH SVTBL JUV TFOEJSJ LFNVOHLJOBO KVHB NFN
EBMBNKVNMBIZBOHDVLVQVOUVLNFNFOVIJLFCVUVIBOUVCVI CBOUVNFOHBLUJGLBOTJTUFNTBSBGTJNQBUJT0MFITFCBCJUV TBSBG
TJNQBUJTNFOKBEJUFSBOHTBOHEFOHBOTBOHBULVBUEBMBNXBLUV
CFCFSBQB EFUJL EBO QBEB TBBU ZBOH CFSTBNBBO TJOZBM TBSBG
Dinamika Sirkulasi pada Gagal Jantung QBSBTJNQBUJTNFOVKVLFKBOUVOHEJIBNCBUTFDBSBSFTJQSPLBM
1FSBOHTBOHBO TJNQBUJT LVBU NFOZFCBCLBO QFOHBSVI CFTBS
Efek Akut Gagal Jantung Derajat Sedang QBEB KBOUVOH EBO WBTLVMBSJTBTJ QFSJGFS #JMB TFNVB PUPU
WFOUSJLFM NFOHBMBNJ LFSVTBLBO MVBT UFUBQJ NBTJI EBQBU
#JMB KBOUVOH NFOEBEBL NFOKBEJ SVTBL CFSBU TFQFSUJ QBEB JOGBSL
CFSGVOHTJ SBOHTBOHBO TJNQBUJT BLBO NFNQFSLVBU PUPU ZBOH
NJPLBSE LFNBNQVBO QFNPNQBBO KBOUVOH BLBO TFHFSB
SVTBL JOJ +JLB TFCBHJBO PUPU UJEBL CFSGVOHTJ TBNB TFLBMJ EBO
NFOVSVO 4FCBHBJ BLJCBUOZB BLBO UJNCVM EVB FGFL VUBNB

TFCBHJBOMBJOOZBUFUBQOPSNBM PUPUZBOHOPSNBMUFSTFCVUBLBO
QFOVSVOBODVSBIKBOUVOHEBO
QFNCFOEVOHBOEBSBIEJWFOB
EJSBOHTBOH EFOHBO LVBU PMFI QFSBOHTBOHBO TJNQBUJT EFOHBO
ZBOHNFOJNCVMLBOLFOBJLBOUFLBOBOWFOB
DBSB JOJ BLBO NFOHPNQFOTBTJ TFCBHJBO PUPU ZBOH UJEBL
1FSVCBIBO QSPHSFTJG LFFGFLUJGBO QFNPNQBBO KBOUVOH EJ CFSGVOHTJ +BEJ KBOUVOH BLBO NFOKBEJ QPNQB ZBOH MFCJI LVBU
CFSCBHBJ XBLUV TFUFMBI UFSKBEJ JOGBSL NJPLBSE EJHBNCBSLBO TFCBHBJBLJCBUQFSBOHTBOHBOTJNQBUJT1FOHBSVIJOJEJMVLJTLBO
EFOHBOHSBGJLQBEB(BNCBS,VSWBZBOHUFSMFUBLQBMJOHBUBT QBEB (BNCBS ZBOH NFNQFSMJIBULBO CBIXB TFUFMBI
QBEB HBNCBS JOJ NFNQFSMJIBULBO LVSWB DVSBI KBOUVOH ZBOH LPNQFOTBTJTJNQBUJTUFSKBEJLFOBJLBOTFLJUBSEVBLBMJMJQBUEBSJ
OPSNBM 5JUJL " QBEB LVSWB JOJ NFOBOEBLBO UJUJL LFSKB OPSNBM LVSWBDVSBIKBOUVOHZBOHSFOEBI
NFNQFSMJIBULBO DVSBI KBOUVOH OPSNBM EBMBN LFBEBBO JTUJSBIBU 1FSBOHTBOHBOTJNQBUJTKVHBNFOJOHLBULBOBMJSBOCBMJLWFOB
BEBMBI-NFOJUEBOUFLBOBOBUSJVNLBOBOTFCFTBSNN)H LBSFOB QFSBOHTBOHBO UFSTFCVU NFOBJLLBO UPOVT EJ TFCBHJBO
4FHFSB TFUFMBI KBOUVOH NFOHBMBNJ LFSVTBLBO LVSWB DVSBI CFTBS QFNCVMVI EBSBI TJSLVMBTJ UFSVUBNB WFOB TFIJOHHB
KBOUVOH NFOKBEJ TBOHBU NFOVSVO UVSVO TBNQBJ LVSWB QBMJOH UFLBOBO QFOHJTJBO TJTUFNJL SBUBSBUB NFOJOHLBU IJOHHB
CBXBI QBEB HSBGJL QBMJOH EBTBS %BMBN XBLUV CFCFSBQB EFUJL TBNQBJNN)H IBNQJSQFSTFOEJBUBTOPSNBM4FQFSUJ
UFSCFOUVLLFBEBBOTJSLVMBTJZBOHCBSVEJUJUJL# ZBOHNFOVOKVL ZBOHEJCBIBTEJ#BC QFOJOHLBUBOUFLBOBOQFOHJTJBOTBOHBU
LBOCBIXBDVSBIKBOUVOHUFMBINFOVSVOTBNQBJ-NFOJU LJSB NFOJOHLBULBOLFDFOEFSVOHBOEBSBIVOUVLNFOHBMJSEBSJWFOB
LJSBEVBQFSMJNBEBSJOPSNBM TFEBOHLBOUFLBOBOBUSJVNLBOBO LFNCBMJLFKBOUVOH0MFILBSFOBJUV KBOUVOHZBOHSVTBLNFO
255
Unit IV Sirkulasi
Retensi Cairan Tingkat Sedang pada Gagal Jantung

Dapat Bermanfaat. #BOZBL BIMJ QFOZBLJU KBOUVOH NFOHBOHHBQ
CBIXB SFUFOTJ DBJSBO TFMBMV CFSQFOHBSVI CVSVL QBEB HBHBM
KBOUVOH 5FUBQJ TBBU JOJ EJLFUBIVJ CBIXB LFOBJLBO DBJSBO UVCVI
EBO WPMVNF EBSBI EBMBN KVNMBI TFEBOH NFSVQBLBO GBLUPS
QFOUJOHEBMBNNFNCBOUVNFOHPNQFOTBTJQFOVSVOBOLFNBNQV
)
BO QFNPNQBBO KBOUVOH EFOHBO DBSB NFOJOHLBULBO BMJSBO CBMJL

(L/m
WFOB1FOJOHLBUBOWPMVNFEBSBIBLBONFOJOHLBULBOBMJSBOCBMJL
WFOB NFMBMVJ EVB DBSB 1FSUBNB LFBEBBO UFSTFCVU BLBO
NFOJOHLBULBO UFLBOBO QFOHJTJBO TJTUFNJL SBUBSBUB ZBOH BLBO
NFOBJLLBO HSBEJFO UFLBOBO BHBS BMJSBO EBSBI EJ QFNCVMVI WFOB
NFOVKV LF KBOUVOH ,FEVB QFOJOHLBUBO JOJ NFMFCBSLBO WFOB
ZBOH NFOVSVOLBO SFTJTUBOTJ WFOB TFIJOHHB MFCJI NFNVEBILBO
BMJSBOEBSBILFKBOUVOH
+JLB KBOUVOH UJEBL NFOHBMBNJ LFSVTBLBO ZBOH TBOHBU CFSBU
QFOJOHLBUBO BMJSBO CBMJL WFOB JOJ TFSJOH LBMJ UFUBQ EBQBU
TFQFOVIOZB NFOHPNQFOTBTJ LVSBOHOZB LFNBNQVBO QFNPNQB
BO KBOUVOH DVLVQ CBOZBL CBILBO CJMB LFNBNQVBO QFNPNQBBO
KBOUVOH CFSLVSBOH TBNQBJ TFSFOEBI IJOHHB QFSTFO EBSJ
OPSNBM QFOJOHLBUBO BMJSBO CBMJL WFOB TFSJOH LBMJ EBQBU
NFOHIBTJMLBO DVSBI KBOUVOH ZBOH TFDBSB LFTFMVSVIBO NFOEFLBUJ
OPSNBM TFMBNBQBTJFOUFUBQEBMBNLFBEBBOJTUJSBIBUUFOBOH
KBEJUFSQBKBOEFOHBONBTVLOZBBMJSBOEBSBIZBOHMFCJICBOZBL #JMB LFNBNQVBO QFNPNQBBO KBOUVOH TFNBLJO CFSLVSBOH
EBSJ CJBTBOZB EBO UFLBOBO BUSJVN LBOBO BLBO UFSVT NFOJOH BMJSBOEBSBILFHJOKBMBLIJSOZBNFOKBEJUFSMBMVSFOEBICBHJHJOKBM
LBU ZBOH BLBO NFNCBOUV KBOUVOH VOUVL NFNPNQB KVNMBI VOUVLEBQBUNFOTFLSFTJHBSBNEBOBJSEBMBNKVNMBIZBOHTFTVBJ
EBSBI ZBOH MFCJI CBOZBL +BEJ LFBEBBO TJSLVMBTJ ZBOH CBSV EFOHBO BTVQBOOZB 0MFI LBSFOB JUV NVMBJMBI UFSKBEJ SFUFOTJ
EJMVLJTLBO PMFI UJUJL $ QBEB (BNCBS NFNQFSMJIBULBO DBJSBO EBO BLBO CFSMBOHTVOH UFSVT TFDBSB UJEBL UFSCBUBT LFDVBMJ
DVSBI KBOUVOH TFCFTBS -NFOJU EBO UFLBOBO BUSJVN LBOBO CJMBEJMBLVLBOUJOEBLBOUFSBQFVUJLLIVTVTVOUVLNFODFHBIIBMJOJ
TFCFTBSNN)H UFSKBEJ4FMBOKVUOZB LBSFOBKBOUVOHUFMBINFNPNQBTBNQBJQBEB
3FGMFLT TJNQBUJT CFLFSKB NBLTJNBM EBMBN XBLUV TFLJUBS LFNBNQVBO QFNPNQBBO NBLTJNVNOZB DBJSBO ZBOH CFSMFCJIBO
EFUJL 0MFI LBSFOB JUV TFTFPSBOH ZBOH UJCBUJCB NFOHBMBNJ JOJ UJEBL MBHJ NFNCFSJ QFOHBSVI ZBOH CFSNBOGBBU QBEB TJSLVMBTJ
TFSBOHBO KBOUVOH EFSBKBU TFEBOH NVOHLJO IBOZB NFSBTBLBO 4FCBMJLOZB SFUFOTJDBJSBONFOJOHLBULBOCFCBOLFSKBKBOUVOHZBOH
OZFSJ KBOUVOH EBO QJOHTBO TFMBNB CFCFSBQB EFUJL 4FHFSB TVEBI SVTBL EBO NFOHBLJCBULBO FEFNB CFSBU EJ TFMVSVI UVCVI
TFUFMBIJUV EFOHBOCBOUVBOLPNQFOTBTJSFGMFLTTJNQBUJT DVSBI TVBUVLFBEBBONFSVHJLBOEBOEBQBUNFOZFCBCLBOLFNBUJBO
KBOUVOHEBQBULFNCBMJLFUJOHLBUBEFLVBUVOUVLNFNVOHLJO
LBOQBTJFOUFUBQUFOBOH NFTLJQVOOZFSJNVOHLJOUFUBQBEB Efek Merugikan Retensi Cairan Berlebihan pada Gagal
Jantung Derajat Berat. #FSMBXBOBO EFOHBO FGFL CFSNBOGBBU
Stadium Kronis Gagal Jantung—Retensi Cairan dan EBSJSFUFOTJDBJSBOUJOHLBUTFEBOHQBEBHBHBMKBOUVOH NBLBQBEB
Curah Jantung Terkompensasi HBHBM KBOUVOH CFSBU DBJSBO ZBOH TBOHBU CFSMFCJIBO EBQBU
#FCFSBQB NFOJU QFSUBNB TFUFMBI TFSBOHBO KBOUVOH BLVU NFOJNCVMLBOBLJCBUGJTJPMPHJTZBOHTFSJVT"LJCBUOZBBOUBSBMBJO
EJNVMBJMBI TUBEJVN TFNJLSPOJT QBOKBOH ZBOH UFSVUBNB
NFOJOHLBULBOCFCBOLFSKBKBOUVOHZBOHSVTBL
QFSFHBOHBO
EJUBOEBJ PMFI EVB LFBEBBO
SFUFOTJ DBJSBO PMFI HJOKBM EBO CFSMFCJIBO KBOUVOH TFIJOHHB MFCJI NFMFNBILBO KBOUVOH

CFSCBHBJ EFSBKBU QFNVMJIBO PMFI KBOUVOH TFOEJSJ TFUFMBI GJMUSBTJ DBJSBO LF EBMBN QBSV NFOZFCBCLBO FEFNB QBSV EBO
CFCFSBQB NJOHHV BUBV CVMBO TFQFSUJ EJHBNCBSLBO PMFI LVSWB BLJCBUOZB UFSKBEJ EFPLTJHFOBTJ EBSBI EBO
QFNCFOUVLBO
UJUJLUJUJLBCVBCVQBEB(BNCBSZBOHKVHBEJCBIBTEJ#BC FEFNB ZBOH MVBT EJ TFCBHJBO CFTBS CBHJBO UVCVI &GFL ZBOH
NFSVTBL BLJCBU DBJSBO ZBOH CFSMFCJIBO JOJ BLBO EJCJDBSBLBO EJ
CBHJBOTFMBOKVUOZBEBSJCBCJOJ
Retensi Cairan oleh Ginjal dan Peningkatan Volume
Darah Terjadi Selama Beberapa Jam sampai Hari Pemulihan Miokardium Setelah Infark Miokard
$VSBIKBOUVOHZBOHSFOEBIBLBONFNCFSJLBOQFOHBSVIZBOH 4FUFMBI LFSVTBLBO KBOUVOH NFOEBEBL BLJCBU JOGBSL NJPLBSE
MVBT UFSIBEBQ GVOHTJ HJOKBM LBEBOHLBEBOH NFOZFCBCLBO QSPTFT QFSCBJLBO BMBNJ EBSJ EBMBN UVCVI EJNVMBJ VOUVL
BOVSJB CJMB DVSBI KBOUVOH UVSVO NFODBQBJ TBNQBJ NFNCBOUV NFNVMJILBO GVOHTJ KBOUVOH ZBOH OPSNBM .JTBMOZB
QFSTFO OPSNBM 1BEB VNVNOZB LFMVBSBO VSJOF UFUBQ EJ BLBOUFSCFOUVLTVQMBJEBSBILPMBUFSBMCBSVZBOHEJNVMBJEJCBHJBO
CBXBIOPSNBMTFMBNBDVSBIKBOUVOHEBOUFLBOBOBSUFSJUFUBQ UFQJ EBFSBI KBOUVOH ZBOH NFOHBMBNJ JOGBSL TFSJOH LBMJ
LVSBOH EBSJ OPSNBM TFDBSB CFSNBLOB TFUFMBI TFSBOHBO NFOZFCBCLBOTFCBHJBOCFTBSPUPUKBOUVOHEJEBFSBIUFQJLFNCBMJ
KBOUVOHBLVU LFMVBSBOVSJOFCJBTBOZBUJEBLLFNCBMJOPSNBM CFSGVOHTJ %FNJLJBO QVMB CBHJBO PUPU KBOUVOH ZBOH UJEBL SVTBL
TBNQBJDVSBIKBOUVOHEBOUFLBOBOBSUFSJNFOJOHLBULFNCBMJ BLBO NFOHBMBNJ IJQFSUSPGJ TFIJOHHB NBNQV NFOHJNCBOHJ
LFUJOHLBUNFOEFLBUJOPSNBM TFCBHJBOCFTBSLFSVTBLBOKBOUVOH
256
Bab 22 Gagal jantung
%FSBKBUQFNVMJIBOCFSHBOUVOHQBEBKFOJTLFSVTBLBOKBOUVOH EBO NVNQBEBKBOUVOHZBOHQVMJITFCBHJBOUFUBQNFOVSVOTBNQBJ

EFSBKBU UFSTFCVU CFSWBSJBTJ NVMBJ EBSJ UBOQB QFNVMJIBO TBNQBJ LVSBOH EBSJ TFUFOHBI OPSNBM TFQFSUJ ZBOH EJHBNCBSLBO PMFI
IBNQJS QVMJI TFNQVSOB 4FTVEBI JOGBSL NJPLBSE BLVU KBOUVOH HBSJT NFOEBUBS QBEB LVSWB UJUJLUJUJL BCVBCV )BM JOJ
CJBTBOZB QVMJI EFOHBO DFQBU TFMBNB CFCFSBQB IBSJ BUBV NJOHHV NFOHHBNCBSLBO CBIXB QFOJOHLBUBO UFLBOBO BUSJVN LBOBO
UNIT IV
QFSUBNBEBOTFCBHJBOCFTBSNFODBQBJUBIBQBLIJSQFNVMJIBOOZB EBQBU NFNQFSUBIBOLBO DVSBI KBOUVOH QBEB OJMBJ OPSNBM
EBMBNXBLUVTBNQBJNJOHHV NFTLJQVOQFNVMJIBOUBNCBIBO NFTLJQVO KBOUVOH TFNBLJO MFNBI +BEJ QBEB TFCBHJBO CFTBS
EFSBKBUSJOHBOEBQBUCFSMBOKVUTBNQBJCFSCVMBOCVMBO PSBOH UFSVUBNB QBEB PSBOH ZBOH MFCJI UVB BLBO NFNQVOZBJ
DVSBI KBOUVOH OPSNBM EBMBN LFBEBBO JTUJSBIBU UFUBQJ EFOHBO
Kurva Curah Jantung Setelah Pemulihan Parsial.
LFOBJLBO UFLBOBO BUSJVN LBOBO SJOHBO TBNQBJ TFEBOH LBSFOB
(BNCBS NFNQFSMJIBULBO GVOHTJ KBOUVOH ZBOH UFMBI QVMJI
CFSCBHBJ EFSBKBU HBHBM KBOUVOH UFSLPNQFOTBTJh 0SBOHPSBOH
TFCBHJBO EBMBN XBLUV NJOHHV BUBV MFCJI TFTVEBI JOGBSL
JOJ NVOHLJO UJEBL NFOHFUBIVJ CBIXB EJSJOZB NFOHBMBNJ
NJPLBSEBLVU1BEBTBBUJOJ CBOZBLTFLBMJDBJSBOEJSFUFOTJEBMBN
LFSVTBLBO KBOUVOH LBSFOB LFSVTBLBO UFSTFCVU TFSJOH LBMJ
UVCVI EBO KVHB LFDFOEFSVOHBO BMJSBO CBMJL WFOB NFOJOHLBU
UFSKBEJTFEJLJUEFNJTFEJLJU EBOLPNQFOTBTJUFSKBEJCFSTBNBBO
EFOHBO OZBUB PMFI LBSFOB JUV UFLBOBO BUSJVN LBOBO BLBO
EFOHBOLFNBKVBOUJOHLBULFSVTBLBO
NFOJOHLBUMFCJIUJOHHJMBHJ"LJCBUOZB LFBEBBOTJSLVMBTJTFLBSB
OH CFSVCBI EBSJ UJUJL $ LF UJUJL % ZBOH NFNQFSMJIBULBO DVSBI #JMB TFTFPSBOH BEB EBMBN LFBEBBO HBHBM KBOUVOH UFSLPN
KBOUVOH OPSNBM TFCFTBS -NFOJU UFUBQJ UFLBOBO BUSJVN LBOBO QFOTBTJ TFUJBQ VTBIB VOUVL NFMBLVLBO LFSKB GJTJL ZBOH CFSBU
NFOJOHLBUNFOKBEJNN)H CJBTBOZB BLBO NFOZFCBCLBO LFNCBMJOZB HFKBMBHFKBMB HBHBM
BLVU ZBOH UJNCVM TFHFSB LBSFOB KBOUVOH UJEBL NBNQV MBHJ
0MFI LBSFOB DVSBI KBOUVOH UFMBI LFNCBMJ OPSNBM LFMVBSBO
NFOJOHLBULBO LFNBNQVBO QFNPNQBBOOZB LF UJOHLBU ZBOH
DBJSBOHJOKBMKVHBLFNCBMJOPSNBM EBOUJEBLUFSKBEJSFUFOTJDBJSBO
EJQFSMVLBOVOUVLLFSKBGJTJL0MFILBSFOBJUV EJLBUBLBOCBIXB
MFCJI MBOKVU LFDVBMJ SFUFOTJ DBJSBO ZBOH UFMBI UFSKBEJ UFSVT
QBEBHBHBMKBOUVOHUFSLPNQFOTBTJDBEBOHBOKBOUVOHNFOVSVO
CFSMBOKVUVOUVLNFNQFSUBIBOLBOLFMFCJIBODBJSBOEBMBNKVNMBI
,POTFQDBEBOHBOKBOUVOHUFSTFCVUBLBOEJCBIBTMFCJIMBOKVUEJ
TFEBOH 0MFI LBSFOB JUV LFDVBMJ UFLBOBO BUSJVN LBOBO ZBOH
CBCJOJ
UJOHHJ ZBOH EJUVOKVLLBO PMFI UJUJL % QBEB HBNCBS JOJ PSBOH
UFSTFCVU TFLBSBOH QBEB EBTBSOZB NFNJMJLJ EJOBNJLB LBSEJP Dinamika Gagal Jantung Derajat Berat—Gagal Jantung
WBTLVMBSZBOHOPSNBMTFMBNBJBUFUBQEBMBNLFBEBBOJTUJSBIBU Dekompensasi
+JLB QFNVMJIBO KBOUVOH DVLVQ MVBT EBO CJMB SFUFOTJ WPMVNF +JLBKBOUVOHNFOHBMBNJLFSVTBLBOCFSBU UJEBLBEBLPNQFOTBTJ
DBJSBO UFMBI DVLVQ SBOHTBOHBO TJNQBUJT MBNCBU MBVO CFSLVSBOH ZBOH EBQBU NFNCVBU QPNQB KBOUVOH ZBOH TBOHBU MFNBI JOJ
TBNQBJOPSNBMLBSFOBBMBTBOCFSJLVU1FNVMJIBOKBOUVOHQBSTJBM NFOHIBTJMLBODVSBIKBOUVOHOPSNBM CBJLNFMBMVJSFGMFLTTBSBG
EBQBU NFOJOHLBULBO LVSWB DVSBI KBOUVOH TBNB TFQFSUJ LBSFOB TJNQBUJTNBVQVOPMFISFUFOTJDBJSBO"LJCBUOZB DVSBIKBOUVOH
QFSBOHTBOHBO TJNQBUJT 0MFI LBSFOB JUV TFMBNB KBOUVOH EBQBU UJEBL EBQBU OBJL DVLVQ UJOHHJ VOUVL NFNCVBU HJOKBM NFOTF
QVMJI XBMBVQVO IBOZB TFEJLJU BLJCBU EBSJ SBOHTBOHBO TJNQBUJT LSFTJLBO DBJSBO EBMBN KVNMBI ZBOH OPSNBM 0MFI LBSFOB JUV
QBEBHBHBMKBOUVOHUBIBQBLVUTFQFSUJGSFLVFOTJEFOZVUOBEJZBOH DBJSBO BLBO UFSVT EJSFUFOTJ TFIJOHHB QBTJFO TFNBLJO FEFNB
DFQBU LVMJU NFOKBEJ EJOHJO EBO QVDBU MBNCBU MBVO BLBO NFOH EBO LFBEBBO JOJ BLIJSOZB NFOJNCVMLBO LFNBUJBO ,FBEBBO
IJMBOH UFSTFCVU EJLFOBM EFOHBO HBHBM KBOUVOH EFLPNQFOTBTJ +BEJ
QFOZFCBCVUBNBHBHBMKBOUVOHEFLPNQFOTBTJBEBMBILFHBHBMBO
Ringkasan Berbagai Perubahan yang Terjadi Setelah Gagal
KBOUVOH VOUVL NFNPNQB DVLVQ EBSBI BHBS HJOKBM EBQBU
jantung Akut—"Gagal Jantung Terkompensasi"
NFOTFLSFTJDBJSBOEBMBNKVNMBIZBOHTFTVBJTFUJBQIBSJOZB
6OUVL NFSJOHLBT CFSCBHBJ LFKBEJBO ZBOH UFMBI LJUB CJDBSBLBO
Analisis Grafik Gagal Jantung Dekompensasi.(BNCBS
TFCFMVNOZB ZBOH NFOKFMBTLBO EJOBNJLB QFSVCBIBO TJSLVMBTJ
NFOHHBNCBSLBO LVSWB DVSBI KBOUVOH ZBOH TBOHBU
TFUFMBITFSBOHBOKBOUVOHBLVUEFSBKBUTFEBOH LJUBEBQBUNFNCBHJ
NFOVSVOEJCFSCBHBJXBLUV 5JUJL"TBNQBJ'
TFUFMBIKBOUVOH
CFSCBHBJ QFSVCBIBO NFOKBEJ CFCFSBQB UBIBQ ZBJUV
FGFL ZBOH
NFOKBEJTBOHBUMFNBI5JUJL"QBEBLVSWBJOJNFOHHBNCBSLBO
UJNCVM TFHFSB TFUFMBI UFSKBEJ LFSVTBLBO KBOUVOH
LPNQFOTBTJ
LFBEBBO TJSLVMBTJ TFCFMVN UJNCVM LPNQFOTBTJ BQBQVO EBO
PMFITJTUFNTBSBGTJNQBUJT ZBOHUFSVUBNBUJNCVMEBMBNXBLUV UJUJL# NFOHHBNCBSLBOLFBEBBOCFCFSBQBNFOJULFNVEJBOTF
EFUJL TBNQBJ NFOJU QFSUBNB EBO
LPNQFOTBTJ LSPOJT ZBOH
CFSBTBM EBSJ QFNVMJIBO KBOUVOH QBSTJBM EBO SFUFOTJ DBJSBO PMFI
HJOKBM 4FNVB QFSVCBIBO JOJ EJHBNCBSLBO EFOHBO HSBGJL PMFI
HBSJT IJUBN QBEB (BNCBS 1FSLFNCBOHBO HBSJT JOJ
NFNQFSMJIBULBOLFBEBBOTJSLVMBTJZBOHOPSNBM UJUJL"
LFBEBBO
CFCFSBQB EFUJL TFUFMBI TFSBOHBO KBOUVOH OBNVO TFCFMVN UJNCVM
SFGMFLT TJNQBUJT UJUJL #
QFOJOHLBUBO DVSBI KBOUVOH LF BSBI
OPSNBMZBOHEJTFCBCLBOPMFIQFSBOHTBOHBOTJNQBUJT UJUJL$
EBO
UFSBLIJS LFNCBMJOZB DVSBI KBOUVOH ZBOH IBNQJS OPSNBM EBMBN
XBLUV CFCFSBQB IBSJ TBNQBJ CFCFSBQB NJOHHV TFUFMBI UFSKBEJ
QFNVMJIBO KBOUVOH QBSTJBM EBO SFUFOTJ DBJSBO UJUJL %
,FBEBBO
UFSBLIJSJOJEJTFCVUHBHBMKBOUVOHUFSLPNQFOTBTJ
Gagal Jantung Terkompensasi. 1FSIBUJLBO UFSVUBNB QBEB

(BNCBS CBIXBLFNBNQVBOQFNPNQBBOKBOUVOHNBLTJ
257
Unit IV Sirkulasi
UFMBIQFSBOHTBOHBOTJNQBUJTZBOHUFMBINFOHPNQFOTBTJTFTVBJ TBNQBJ LF OJMBJ LSJUJT ZBOH EJCVUVILBO BHBS GVOHTJ HJOKBM
LFNBNQVBO KBOUVOH UFUBQJ TFCFMVN SFUFOTJ DBJSBO EJNVMBJ CFSMBOHTVOH OPSNBM NFOHBLJCBULBO
SFUFOTJ DBJSBO TFNBLJO
1BEBTBBUJOJ DVSBIKBOUVOHNFOJOHLBUTBNQBJ-NFOJUEBO CBOZBL ZBOH NFOZFCBCLBO
UFLBOBO QFOHJTJBO TJTUFNJL SBUB
UFLBOBO BUSJVN LBOBO NFOJOHLBU TBNQBJ NN )H 4BBU JOJ SBUBTFNBLJONFOJOHLBU EBO
UFLBOBOBUSJVNLBOBOTFNBLJO
QBTJFO TFQFSUJOZB CFSBEB EBMBN LFBEBBO DVLVQ CBJL UFUBQJ NFOJOHLBU TBNQBJ BLIJSOZB KBOUVOH NFOHBMBNJ QFSFHBOHBO
LFBEBBO JOJ UJEBL BLBO NFOFUBQ MBNB LBSFOB DVSBI KBOUVOH CFSMFCJIBO BUBV NFOKBEJ TBOHBU FEFNB TFIJOHHB UJEBL NBNQV
CFMVN NFOJOHLBU DVLVQ UJOHHJ HVOB NFOJNCVMLBO FLTLSFTJ NFNPNQB EBSBI EBMBN KVNMBI ZBOH DVLVQ TFLBMJQVO EBO
DBJSBO ZBOH DVLVQ PMFI HJOKBM LBSFOB JUV SFUFOTJ DBJSBO UFSVT LBSFOB JUV HBHBM TFDBSB UPUBM 4FDBSB LMJOJT LJUB NFOEFUFLTJ
CFSMBOHTVOH EBO BLIJSOZB EBQBU NFOZFCBCLBO LFNBUJBO LFBEBBOEFLPNQFOTBTJTFSJVTJOJUFSVUBNBEBSJUFSKBEJOZBFEFNB
,FBEBBO JOJ EBQBU EJUFSBOHLBO TFDBSB LVBOUJUBUJG TFCBHBJ QSPHSFTJG LIVTVTOZB FEFNB QBSV ZBOH NFOZFCBCLBO UJNCVMOZB
CFSJLVU CVOZJ SPOLJ CBTBI B DSBDLMJOH TPVOE
EJ QBSV EBO EJTQOFB BJS
1FSIBUJLBOHBSJTMVSVTQBEB(BNCBS QBEBOJMBJDVSBI IVOHFS
,FHBHBMBO QFOBUBMBLTBOBBO ZBOH UFQBU CJMB LFBEBBO
KBOUVOH -NFOJU /JMBJ JOJ IBNQJS NFSVQBLBO OJMBJ DVSBI UFSTFCVUUJNCVMBLBOTFHFSBNFOKVSVTLFLFNBUJBO
KBOUVOH ZBOH LSJUJT ZBOH EJQFSMVLBO PSBOH EFXBTB OPSNBM Pengobatan Dekompensasi. 1SPTFT EFLPNQFOTBTJ TFSJOH
VOUVL NFNCVBU HJOKBM NFOFUBQLBO LFNCBMJ LFTFJNCBOHBO LBMJ EBQBU EJIFOUJLBO EFOHBO
NFOHVBULBO KBOUVOH EFOHBO
DBJSBO ZBOH OPSNBM ZBJUV BHBS LFMVBSBO HBSBN EBO BJS TBMBITBUVEBSJCFCFSBQBDBSBCFSJLVU UFSVUBNBEFOHBOQFNCFSJBO
TFJNCBOH EFOHBO BTVQBOOZB 4FUJBQ DVSBI KBOUVOH ZBOH PCBU LBSEJPUPOJL TFQFSUJ EJHJUBMJT TFIJOHHB KBOUVOH NFOKBEJ
CFSBEB EJ CBXBI OJMBJ JOJ TFNVB NFLBOJTNF SFUFOTJ DBJSBO DVLVQ LVBU VOUVL NFNPNQB EBSBI EBMBN KVNMBI DVLVQ TFTVBJ
ZBOHUFMBIEJCJDBSBLBOTFCFMVNOZBUFUBQCFSQFSBOEBOWPMVNF EFOHBOLFCVUVIBOBHBSGVOHTJHJOKBMEBQBUOPSNBMLFNCBMJ BUBV
DBJSBO UVCVI BLBO NFOJOHLBU TFDBSB QSPHSFTJG 0MFI LBSFOB
EFOHBOQFNCFSJBOPCBUEJVSFUJLBVOUVLNFOJOHLBULBOTFLSFTJ
QFOJOHLBUBO WPMVNF DBJSBO ZBOH QSPHSFTJG JOJ UFLBOBO HJOKBM TFNFOUBSB QBEB TBBU ZBOH CFSTBNBBO NFOHVSBOHJ BTVQBO
QFOHJTJBOTJTUFNJLSBUBSBUBEJTJSLVMBTJBLBOUFSVTNFOJOHLBU BJS EBO HBSBN ZBOH BLBO NFOJNCVMLBO LFTFJNCBOHBO BOUBSB
UFLBOBOJOJTFDBSBQSPHSFTJGBLBONFOBJLLBOKVNMBIEBSBIEBSJ BTVQBOEBOLFMVBSBODBJSBONFTLJQVODVSBIKBOUVOHSFOEBI
WFOB QFSJGFS LF EBMBN BUSJVN LBOBO TFIJOHHB NFOJOHLBULBO
,FEVBDBSBUFSTFCVUNFOHIFOUJLBOQSPTFTEFLPNQFOTBTJEFOH
UFLBOBO BUSJVN LBOBO 4FUFMBI LVSBOH MFCJI TFIBSJ LFBEBBO
BO NFOFUBQLBO LFNCBMJ LFTFJNCBOHBO DBJSBO OPSNBM TFIJOHHB
TJSLVMBTJCFSVCBIEBSJUJUJL#LF$QBEB(BNCBSUFLBOBO
DBJSBOLFMVBSQBMJOHUJEBLTBNBEFOHBODBJSBONBTVL
BUSJVN LBOBO OBJL NFOKBEJ NN )H EBO DVSBI KBOUVOH
NFOKBEJ -NFOJU 1FSIBUJLBO TFLBMJ MBHJ CBIXB DVSBI Mekanisme Kerja Obat Kardiotonik Seperti Digitalis.0CBU
KBOUVOH CFMVNMBI OBJL DVLVQ UJOHHJ HVOB NFOJNCVMLBO LBSEJPUPOJL TFQFSUJEJHJUBMJT CJMBEJCFSJLBOLFQBEBPSBOHEFOHBO
LFMVBSBO DBJSBO HJOKBM ZBOH OPSNBM LBSFOB JUV UFSVT UFSKBEJ KBOUVOHTFIBU IBOZBTFEJLJUNFNFOHBSVIJQFOJOHLBUBOLFLVBUBO
SFUFOTJ DBJSBO 4FUFMBI TBUV IBSJ BUBV MFCJI UFLBOBO BUSJVN LPOUSBLUJMJUBT PUPU KBOUVOH /BNVO EFNJLJBO CJMB EJCFSJLBO
LBOBOOBJLNFOKBEJNN)H EBOLFBEBBOTJSLVMBTJNFOKBEJ LFQBEBQBTJFOHBHBMKBOUVOHLSPOJT PCBUJOJLBEBOHLBEBOHEBQBU
TFQFSUJ ZBOH EJUVOKVLLBO PMFI UJUJL % 5FUBQJ DVSBI KBOUVOH NFOJOHLBULBOLFLVBUBONJPLBSEJVNZBOHHBHBMIJOHHBTFCBOZBL
UFUBQCFMVNDVLVQVOUVLNFODBQBJLFTFJNCBOHBODBJSBOZBOH TBNQBJQFSTFO0MFILBSFOBJUV PCBUPCBUJOJNFSVQBLBO
OPSNBM TBMBITBUVUFSBQJVUBNBQBEBHBHBMKBOUVOHLSPOJT
4FUFMBICFCFSBQBIBSJUFSKBEJSFUFOTJDBJSBO UFLBOBOBUSJVN %JHJUBMJT EBO HMJLPTJEB LBSEJPUPOJL MBJO EJZBLJOJ EBQBU NFN
LBOBO NBTJI UFSVT NFOJOHLBU UFUBQJ TFLBSBOH GVOHTJ KBOUVOH QFSLVBU LPOUSBLTJ KBOUVOH EFOHBO NFOJOHLBULBO KVNMBI JPO
NVMBJ NFOVSVO LF UJOHLBU ZBOH MFCJI SFOEBI 1FOVSVOBO JOJ LBMTJVN EBMBN TFSBU PUPU 1FOHBSVI JOJ DFOEFSVOH NFOHIBNCBU
EJTFCBCLBO PMFI QFSFHBOHBO KBOUVOH ZBOH CFSMFCJIBO FEFNB OBUSJVNLBMJVN "51BTF QBEB NFNCSBO TFM KBOUVOH )BNCBUBO
QBEB PUPU KBOUVOH EBO GBLUPSGBLUPS MBJO ZBOH NFOVSVOLBO QPNQBOBUSJVNLBMJVNNFOJOHLBULBOLBEBSOBUSJVNJOUSBTFMVMBS
GVOHTJQFNPNQBBOKBOUVOH4FLBSBOHUFMBIKFMBTCBIXBSFUFOTJ EBO NFNQFSMBNCBU QPNQB QFSUVLBSBO OBUSJVNLBMTJVN ZBOH
DBJSBO MFCJI MBOKVU BLBO MFCJI NFOJNCVMLBO LFSVTBLBO NFOHFMVBSLBOLBMTJVNEBSJEBMBNTFMTFCBHBJQFSUVLBSBOEFOHBO
EBSJQBEB NFNCFSJLBO NBOGBBU CBHJ TJSLVMBTJ 5FSOZBUB DVSBI OBUSJVN 0MFI LBSFOB QPNQB QFSUVLBSBO OBUSJVNLBMTJVN CFS
KBOUVOH UFUBQ UJEBL DVLVQ UJOHHJ VOUVL NFOHIBTJMLBO GVOHTJ HBOUVOH LFQBEB HSBEJFO OBUSJVN ZBOH UJOHHJ QBEB NFNCSBO TFM
HJOKBM ZBOH OPSNBM TFIJOHHB SFUFOTJ DBJSBO UJEBL IBOZB QFOVNQVLBOOBUSJVNJOUSBTFMVMBSNFOVSVOLBOBLUJWJUBTQPNQB
CFSMBOKVUUFUBQJTFNBLJODFQBUUFSKBEJLBSFOBQFOVSVOBODVSBI 1BEB LFHBHBMBO PUPU KBOUVOH SFUJLVMVN TBSLPQMBTNB HBHBM
KBOUVOH EBO KVHB UFSKBEJ QFOVSVOBO UFLBOBO BSUFSJ
NFOHVNQVMLBO LBMTJVN EBMBN KVNMBI OPSNBM EBO LBSFOB JUV
"LJCBUOZB EBMBN CFCFSBQB IBSJ LFBEBBO TJSLVMBTJ UFMBI UJEBL EBQBU NFMFQBTLBO DVLVQ JPO LBMTJVN LF EBMBN LPNQBS
NFODBQBJ UJUJL ' QBEB LVSWB EFOHBO DVSBI KBOUVOH TBBU JOJ UFNFO CFCBT DBJSBO EJ TFSBU PUPU VOUVL NFOJNCVMLBO LPOUSBLTJ
LVSBOHEBSJ -NFOJUEBOUFLBOBOBUSJVNLBOBONN)H PUPUNFOZFMVSVI&GFLEJHJUBMJTZBOHNFOFLBOQPNQBQFSUVLBSBO
,FBEBBO JOJ NFOEFLBUJ BUBV UFMBI NFODBQBJ UJOHLBU LFUJEBL OBUSJVNLBMTJVN EBO NFOJOHLBULBO LBEBS JPO LBMTJVN EJ EBMBN
TFTVBJBO EFOHBO LFIJEVQBO EBO QBTJFO BLBO NFOJOHHBM TFMPUPUKBOUVOHNFNCFSJLBOUBNCBIBOLBMTJVNZBOHEJQFSMVLBO
LFDVBMJ CJMB SBOHLBJBO QFSJTUJXB EJ BUBT EBQBU EJQVUBS CBMJL VOUVL NFOJOHLBULBO LFLVBUBO LPOUSBLUJM PUPU 0MFI LBSFOB JUV
,FBEBBO HBHBM KBOUVOH ZBOH UFSVT CFSMBOKVU EBO TFNBLJO QFOFLBOBO NFLBOJTNF QFNPNQBBO LBMTJVN TFDBSB NPEFSBU
NFNCVSVLEJTFCVUHBHBMKBOUVOHEFLPNQFOTBTJ NFOHHVOBLBO EJHJUBMJT VNVNOZB NFOHVOUVOHLBO LBSFOB NF
%FOHBOEFNJLJBO EBSJBOBMJTBJOJLJUBEBQBUNFMJIBU CBIXB NVOHLJOLBOQFOJOHLBUBOTFEJLJUKVNMBILBMTJVNJOUSBTFMEJTFSBU
LFHBHBMBODVSBIKBOUVOH EBOUFLBOBOBSUFSJ
VOUVLNFOJOHLBU PUPU
258
Bab 22 Gagal jantung
UFSTFCVU NFOZFCBCLBO KBOUVOH NFOKBEJ TFNBLJO MFNBI ZBOH

Gagat jantung Kiri Unitateral
NFNCVBU UFLBOBO BSUFSJ TFNBLJO NFOVSVO TFIJOHHB
NFOZFCBCLBO TZPL NFOKBEJ MFCJI CVSVL TFDBSB QSPHSFTJG
4BNQBJTFKBVIJOJ LJUBNFOHBOHHBQCBIXBHBHBMKBOUVOHUFSKBEJ
QSPTFTJOJBLIJSOZBNFOKBEJMJOHLBSBOTFUBOZBOHUFSKBEJBLJCBU
TFCBHBJ TVBUV LFTFMVSVIBO /BNVO QBEB TFCBHJBO CFTBS QBTJFO
UNIT IV
LFSVTBLBO KBOUVOH 1BEB TZPL LBSEJPHFOJL ZBOH EJTFCBCLBO
UFSVUBNB ZBOH NFOEFSJUB HBHBM KBOUVOH BLVU EJOJ HBHBM KBOUVOH
PMFI JOGBSL NJPLBSE NBTBMBI JOJ NFOKBEJ MFCJI LPNQMFLT
TFCFMBI LJSJ NFOEPNJOBTJ HBHBM KBOUVOH LBOBO EBO EBMBN
LBSFOBTVEBIBEBTVNCBUBOEJQFNCVMVILPSPOFSTFCFMVNOZB
LFBEBBOZBOHKBSBOH UFSEBQBUHBHBMKBOUVOHLBOBOUBOQBEJTFSUBJ
4FCBHBJ DPOUPI QBEB KBOUVOH ZBOH TFIBU UFLBOBO BSUFSJ
HBHBM KBOUVOH LJSJ ZBOH OZBUB 0MFI LBSFOB JUV LJUB QFSMV NFN
CJBTBOZB IBSVT UVSVO IJOHHB LJSBLJSB EJ CBXBI NN )H
CJDBSBLBOCFCFSBQBHBNCBSBOLIVTVTHBHBMKBOUVOHVOJMBUFSBM
TFCFMVNUFSKBEJLFSVTBLBOKBOUVOH"LBOUFUBQJ QBEBKBOUVOH
#JMBUFSKBEJHBHBMKBOUVOHLJSJUBOQBEJTFSUBJEFOHBOLFHBHBMBO ZBOHQFNCVMVILPSPOFSVUBNBOZBUFMBIUFSIBNCBU LFSVTBLBO
EJ CBHJBO LBOBO EBSBI UFUBQ EJQPNQB LF EBMBN QBSV EFOHBO UFSKBEJ CJMB UFLBOBO BSUFSJ LPSPOFS UVSVO EJ CBXBI TBNQBJ
LFLVBUBOKBOUVOHLBOBOZBOHCJBTB UFUBQJEBSBIZBOHLFMVBSEBSJ NN)H%FOHBOLBUBMBJO CJMBUFSKBEJQFOVSVOBOUFLBOBO
QBSV UJEBL EBQBU EJQPNQB TFDBSB BEFLVBU PMFI KBOUVOH LJSJ LF BSUFSJTFEJLJUTBKB IBMJOJEBQBUNFOJNCVMLBOMJOHLBSBOTFUBO
EBMBNTJSLVMBTJTJTUFNJL"LJCBUOZB UFLBOBOQFOHJTJBOQBSVSBUB ZBOHUFSKBEJBLJCBULFSVTBLBOKBOUVOH0MFILBSFOBBMBTBOJOJ
SBUBNFOJOHLBULBSFOBUFSKBEJQFSQJOEBIBOTFCBHJBOCFTBSEBSBI EBMBN NFOHPCBUJ JOGBSL NJPLBSE TBOHBU QFOUJOH VOUVL
EBSJTJSLVMBTJTJTUFNJLLFEBMBNTJSLVMBTJQBSV NFODFHBIUJNCVMOZBIJQPUFOTJXBMBVIBOZBEBMBNXBLUVZBOH
4FJSJOH NFOJOHLBUOZB WPMVNF EBSBI EJ EBMBN QBSV UFLBOBO TJOHLBUTFLBMJQVO
LBQJMFSQBSVBLBONFOJOHLBU EBOKJLBUFLBOBOJOJNFOJOHLBUEJ Fisiologi Pengobatan. 4FSJOH LBMJ QBTJFO NFOJOHHBM
BUBTOJMBJZBOHLVSBOHMFCJITBNBEFOHBOUFLBOBOPTNPUJLLPMPJE LBSFOBTZPLLBSEJPHFOJLTFCFMVNCFSCBHBJQSPTFTLPNQFOTBTJ
QMBTNB ZBJUV TFLJUBS NN )H DBJSBO NVMBJ NFSFNCFT LFMVBS ZBOH EJMBLVLBO EBQBU NFOHFNCBMJLBO DVSBI KBOUVOH EBO
EBSJ LBQJMFS LFNVEJBO NBTVL LF EBMBN SVBOH JOUFSTUJTJBM QBSV UFLBOBOBSUFSJ
TBNQBJLFUJOHLBUZBOHEBQBUNFNQFSUBIBOLBO
EBOBMWFPMJ TFIJOHHBNFOJNCVMLBOFEFNBQBSV LFMBOHTVOHBOIJEVQ0MFILBSFOBJUV QFOHPCBUBOLFBEBBOJOJ
%FOHBOEFNJLJBO EJBOUBSBNBTBMBIZBOHQBMJOHQFOUJOHEBSJ NFSVQBLBO TBMBI TBUV NBTBMBI QBMJOH QFOUJOH QBEB QFOBUB
HBHBM KBOUVOH LJSJ BEBMBI LPOHFTUJ QFNCVMVI EBSBI QBSV EBO MBLTBOBBOTFSBOHBOKBOUVOHBLVU
FEFNB QBSV 1BEB HBHBM KBOUVOH LJSJ BLVU ZBOH CFSBU LBEBOH 1FNCFSJBO EJHJUBMJT TFHFSB TFSJOH LBMJ EJHVOBLBO VOUVL
LBEBOH UFSKBEJ FEFNB QBSV TFEFNJLJBO DFQBU TFIJOHHB EBQBU NFOHVBULBO KBOUVOH KJLB PUPU WFOUSJLFM NFNQFSMJIBULBO
NFOZFCBCLBO LFNBUJBO LBSFOB LFLVSBOHBO OBQBT EBMBN XBLUV UBOEBUBOEB LFSVTBLBO %FNJLJBO KVHB QFNCFSJBO EBSBI
TBNQBJNFOJU ZBOHBLBOLJUBCBIBTMFCJIMBOKVUEJCBCJOJ MFOHLBQ QMBTNB BUBV PCBU VOUVL NFOBJLLBO UFLBOBO EBSBI
EJQBLBJ VOUVL NFNQFSUBIBOLBO UFLBOBO BSUFSJ #JMB UFLBOBO
BSUFSJ EBQBU EJOBJLLBO DVLVQ UJOHHJ BMJSBO EBSBI LPSPOFS
Gagal jantung dengan Curah jantung Rendah— TFSJOH LBMJ BLBO NFOJOHLBU DVLVQ UJOHHJ VOUVL NFODFHBI
Syok Kardiogenik MJOHLBSBO TFUBO ZBOH UFSKBEJ LBSFOB LFSVTBLBO %BO IBM JOJ
NFNCFSJLBO XBLUV ZBOH DVLVQ BHBS UFSKBEJ NFLBOJTNF
1BEB TFCBHJBO CFTBS LFBEBBO TFUFMBI UFSKBEJ TFSBOHBO KBOUVOH
LPNQFOTBTJZBOHTFTVBJEJTJTUFNTJSLVMBTJVOUVLNFNQFSCBJLJ
BLVU EBO TFSJOH LBMJ TFUFMBI UFSKBEJ LFSVTBLBO KBOUVOH ZBOH
LFBEBBOTZPL
CFSMBOHTVOH MBNCBU EBO CFSLFQBOKBOHBO KBOUVOH NFOKBEJ UJEBL
NBNQVMBHJVOUVLNFNPNQBCBILBOVOUVLKVNMBIBMJSBOEBSBI 4FEJLJU CBOZBL LFCFSIBTJMBO NFOPMPOH IJEVQ QBTJFO TZPL
ZBOH LFDJM TFLBMJQVO ZBOH EJCVUVILBO VOUVL NFNQFSUBIBOLBO LBSEJPHFOJL EJDBQBJ NFMBMVJ TBMBI TBUV QSPTFEVS CFSJLVU

BHBS UVCVI UFUBQ IJEVQ "LJCBUOZB KBSJOHBO UVCVI NVMBJ NFNCVBOH CFLVBO EJ BSUFSJ LPSPOFS NFMBMVJ QFNCFEBIBO
NFOHBMBNJ LFSVTBLBO EBO CBILBO NFNCVSVL TFSJOH LBMJ TFSJOH LBMJ EJLPNCJOBTJ EFOHBO QFNBTBOHBO QJOUBT LPSPOFS
NFOKVSVT LF LFNBUJBO EBMBN XBLUV CFCFSBQB KBN TBNQBJ DPSPOBSZ CZQBTT
BUBV
LBUFUFSJTBTJ BSUFSJ LPSPOFS ZBOH
CFCFSBQBIBSJ(BNCBSBOTFMBOKVUOZBBEBMBITBMBITBUVEBSJTZPL UFSTVNCBU EBO QFNCFSJBO FO[JNFO[JN TUSFQUPLJOBTF BUBV
TJSLVMBTJ TFQFSUJZBOHEJKFMBTLBOEJ#BC4JTUFNLBSEJPWBTLVMBS BLUJWBUPS QMBTNJOPHFO KBSJOHBO NFMBMVJ DBJSBO JOGVT ZBOH
QVO NFOHBMBNJ LFSVTBLBO LBSFOB LVSBOHOZB [BU NBLBOBO EBO NFOZFCBCLBO MBSVUOZB CFLVBO )BTJMOZB LBEBOHLBEBOH
KVHB CFSTBNB EFOHBO CBHJBO UVCVI MBJOOZB
NFNCVSVL NFOBLKVCLBO CJMB TBMBI TBUV QSPTFEVS JOJ EJMBLVLBO EBMBN
TFIJOHHB NFNQFSDFQBU LFNBUJBO 4JOESPN TZPL TJSLVMBTJ ZBOH XBLUVTBUVKBNQFSUBNBTFUFMBITZPLLBSEJPHFOJL UFUBQJTBNB
EJTFCBCLBOPMFIQFNPNQBBOKBOUVOHUJEBLBEFLVBUEJTFCVUTZPL TFLBMJ UJEBL CFSBSUJ BUBV IBOZB TFEJLJU CFSNBOGBBU CJMB EJ
LBSEJPHFOJLBUBVTFDBSBTFEFSIBOBTZPLKBOUVOH4FLBMJTFTFPSBOH MBLVLBOTFUFMBIUJHBKBN
NFOHBMBNJ TZPL LBSEJPHFOJL BOHLB IBSBQBO IJEVQOZB TFSJOH
LBMJ LVSBOH EBSJ QFSTFO NFTLJQVO EJCFSJ QFSBXBUBO NFEJT Edema pada Pasien Gagal Jantung
ZBOHUFQBU Ketidakmampuan Gagal Jantung Akut untuk Menimbul-
Lingkaran Setan Akibat Kerusakan Jantung pada Syok kan Edema Perifer. (BHBM KBOUVOH LJSJ BLVU EBQBU
Kardiogenik. 1FNCJDBSBBO NFOHFOBJ TZPL TJSLVMBTJ EJ #BC NFOJNCVMLBO QFNCFOEVOHBO DFQBU EJ QBSV EFOHBO QFN
NFOFLBOLBOCBIXBKBOUVOHDFOEFSVOHBLBONFOHBMBNJLFSVTB CFOUVLBO FEFNB QBSV EBO CBILBO NFOJNCVMLBO LFNBUJBO
LBOZBOHMFCJIQSPHSFTJGCJMBTVQMBJEBSBILPSPOFSOZBCFSLVSBOH EBMBNCFCFSBQBNFOJUTBNQBJCFCFSBQBKBN
TFMBNB UFSKBEJ TZPL "SUJOZB UFLBOBO BSUFSJ SFOEBI ZBOH UJNCVM /BNVO EFNJLJBO CBJL HBHBM KBOUVOH LJSJ NBVQVO LBOBO
TFMBNBTZPLBLBOTFNBLJONFOHVSBOHJTVQMBJEBSBILPSPOFS)BM TBOHBUMBNCBUNFOZFCBCLBOFEFNBQFSJGFS)BMJOJEJUFSBOH
259
Unit IV Sirkulasi
KBOUVOHNFOVSVOIJOHHBTFLJUBSTFQBSVIEBSJOPSNBM IBMJOJ
EBQBUNFOJNCVMLBOBOVSJBZBOHIBNQJSUPUBM
2. Aktivasi sistem renin-angiotensin dan peningkatan
reabsorpsi garam dan air oleh tubulus ginjal. 1FOVSVOBO
BMJSBOEBSBILFHJOKBMNFOZFCBCLBOQFOJOHLBUBOTFLSFTJSFOJO
PMFI HJOKBM ZBOH OZBUB EBO IBM JOJ LFNVEJBO NFOJOHLBULBO
QFNCFOUVLBOBOHJPUFOTJO** TFQFSUJZBOHEJVSBJLBOEJ#BC
"OHJPUFOTJO TFMBOKVUOZB NFNJMJLJ QFOHBSVI MBOHTVOH QBEB
BSUFSJPM HJOKBM VOUVL MFCJI NFOVSVOLBO BMJSBO EBSBI NFMBMVJ
HJOKBM NFOJNCVMLBO QFOVSVOBO UFLBOBO LBQJMFS QFSJUVCVMFS
TFLJUBS UVCVMVT HJOKBM TFIJOHHB TBOHBU NFOJOHLBULBO SFBC
0 TPSQTJ BJS EBO HBSBN EBSJ UVCVMVT "OHJPUFOTJO KVHB CFLFSKB
MBOHTVOH QBEB TFM FQJUFM UVCVMVT HJOKBM VOUVL NFSBOHTBOH
SFBCTPSQTJ HBSBN EBO BJS 0MFI LBSFOB JUV KVNMBI BJS EBO
HBSBN ZBOH IJMBOH LF EBMBN VSJOF TBOHBU NFOVSVO EBO
TFCBHJBOCFTBSHBSBNEBOBJSUFSBLVNVMBTJEJEBSBIEBODBJSBO
JOUFSTUJTJBMEJTFNVBCBHJBOUVCVI
LBO EFOHBO CBJL TFLBMJ PMFI (BNCBS #JMB KBOUVOH ZBOH 3. Peningkatan sekresi aldosteron. 1BEB HBHBM KBOUVOH
TFCFMVNOZBTFIBUUJCBUJCBNFOHBMBNJLFHBHBMBOQFNPNQBBO TUBEJVN LSPOJT TFKVNMBI CFTBS BMEPTUFSPO EJTFLSFTJLBO PMFI
UFLBOBO BPSUB BLBO NFOVSVO EBO UFLBOBO BUSJVN LBOBO LPSUFLT BESFOBM )BM JOJ UFSVUBNB CFSBTBM EBSJ QFOHBSVI
NFOJOHLBU4BBUDVSBIKBOUVOHNFOEFLBUJOPM LFEVBUFLBOBO BOHJPUFOTJO ZBOH NFSBOHTBOH TFLSFTJ BMEPTUFSPO PMFI LPSUFLT
JOJ TBMJOH NFOEFLBU TBUV TBNB MBJO QBEB OJMBJ LFTFJNCBOHBO BESFOBM 5FUBQJ TFEJLJU CBOZBL QFOJOHLBUBO TFLSFTJ BMEPTUFSPO
TFLJUBS NN )H 5FLBOBO LBQJMFS KVHB UVSVO EBSJ OJMBJ TFSJOHLBMJCFSBTBMEBSJQFOJOHLBUBOLBMJVNQMBTNB,FMFCJIBO
OPSNBMNN)HNFOKBEJUFLBOBOLFTFJNCBOHBOZBOHCBSV LBMJVN NFSVQBLBO TBMBI TBUV EBSJ TFLJBO CBOZBL SBOHTBOHBO
TFCFTBS NN )H +BEJ HBHBM KBOUVOH BLVU ZBOH CFSBU TFSJOH LVBU ZBOH EBQBU NFOJNCVMLBO TFLSFTJ BMEPTUFSPO EBO QBEB
LBMJ NFOZFCBCLBO QFOVSVOBO UFLBOBO LBQJMFS QFSJGFS EBO HBHBMKBOUVOH LPOTFOUSBTJLBMJVNZBOHNFOJOHLBUNFSVQBLBO
CVLBO KVTUSV NFOBJLLBO 0MFI LBSFOB JUV QFSDPCBBO ZBOH SFTQPOTUFSIBEBQQFOVSVOBOGVOHTJHJOKBM1FOJOHLBUBOLBEBS
EJMBLVLBO QBEB IFXBO NBVQVO QBEB NBOVTJB NFNQFSMJIBU BMEPTUFSPOTFMBOKVUOZBBLBONFOJOHLBULBOSFBCTPSQTJOBUSJVN
LBO CBIXB HBHBM KBOUVOH BLVU IBNQJS UJEBL QFSOBI EFOHBO EBSJUVCVMVTSFOBM)BMJOJLFNVEJBONFOJNCVMLBOQFOJOHLB
TFHFSBNFOJNCVMLBOFEFNBQFSJGFS UBOTFLVOEFSSFBCTPSQTJBJSLBSFOBEVBBMBTBO1FSUBNB LFUJLB
OBUSJVN EJSFBCTPSCTJ UFLBOBO PTNPUJL EJ UVCVMVT NFOVSVO
Retensi Cairan Jangka Panjang oleh Ginjal-Penyebab UFUBQJUFLBOBOPTNPUJLEJDBJSBOJOUFSTUJTJBMHJOKBMNFOJOHLBU
Edema Perifer pada Gagal Jantung yang Menetap QFSVCBIBOJOJBLBONFOJOHLBULBOPTNPTJTBJSLFEBMBNEBSBI
,FEVB OBUSJVNZBOHEJBCTPSCTJEBOBOJPOZBOHJLVUUFSCBXB
4FUFMBI TFIBSJ BUBV MFCJI TFKBL UFSKBEJ HBHBM KBOUVOH TFDBSB
EFOHBO OBUSJVN UFSVUBNB JPO LMPSJEB BLBO NFOJOHLBULBO
LFTFMVSVIBOBUBVHBHBMKBOUVOHWFOUSJLFMLBOBO FEFNBQFSJGFS
LPOTFOUSBTJ PTNPUJL DBJSBO FLTUSBTFM EJ EBMBN UVCVI )BM JOJ
NVMBJUJNCVMZBOHQBEBEBTBSOZBUFSKBEJBLJCBUSFUFOTJDBJSBO
NFOJNCVMLBOTFLSFTJIPSNPOBOUJEJVSFUJLPMFITJTUFNLFMFOKBS
PMFI HJOKBM 3FUFOTJ DBJSBO NFOJOHLBULBO UFLBOBO QFOHJTJBO
IJQPGJTJT QPTUFSJPS IJQPUBMBNVT EJCJDBSBLBO EJ #BC

TJTUFNJLSBUBSBUB ZBOHNFOHBLJCBULBOQFOJOHLBUBOLFDFOEFS
)PSNPO BOUJEJVSFUJL TFMBOKVUOZB NFOJNCVMLBO QFOJOHLBUBO
VOHBOBMJSBOEBSBILFNCBMJLFKBOUVOH)BMJOJNFOJOHLBULBO
ZBOHMFCJICFTBSMBHJEBMBNSFBCTPSQTJBJSPMFIUVCVMVT
UFLBOBO BUSJVN LBOBO LF OJMBJ ZBOH MFCJI UJOHHJ EBO
NFOHFNCBMJLBO UFLBOBO BSUFSJ LF OJMBJ OPSNBM 0MFI LBSFOB 4. Aktivasi sistem saraf simpatis. 4FQFSUJ UFMBI EJCBIBT
JUV UFLBOBO LBQJMFS TFLBSBOH KVHB NFOJOHLBU EFOHBO OZBUB TFCFMVNOZB HBHBMKBOUVOHNFOJNCVMLBOBLUJWBTJOZBUBTJTUFN
TFIJOHHB NFOZFCBCLBO NBTVLOZB DBJSBO LF EBMBN KBSJOHBO TBSBG TJNQBUJT ZBOH TFMBOKVUOZB NFNCFSJLBO CFCFSBQB FGFL
EBONFOJNCVMLBOFEFNBZBOHIFCBU NFOKVSVT LF SFUFOTJ HBSBN EBO BJS PMFI HJOKBM
LPOTUSJLTJ
5FMBI EJLFUBIVJ CFCFSBQB QFOZFCBC QFOVSVOBO LFMVBSBO BSUFSJPMB BGFSFO HJOKBM ZBOH NFOVSVOLBO MBKV GJMUSBTJ
VSJOFPMFIHJOKBMTFMBNBHBHBMKBOUVOH HMPNFSVMVT
BLUJWBTJ SFTFQUPS BMGBBESFOFSHJL TFM FQJUFM
UVCVMVT ZBOH NFSBOHTBOH SFBCTPSQTJ HBSBN EBO BJS PMFI
1. Penurunan laju filtrasi glomerulus. 1FOVSVOBO DVSBI UVCVMVT HJOKBM
QFSBOHTBOHBO QFMFQBTBO SFOJO EBO QFN
KBOUVOH NFNJMJLJ LFDFOEFSVOHBO VOUVL NFOVSVOLBO CFOUVLBO BOHJPUFOTJ ** ZBOH NFOJOHLBULBO SFBCTPQTJ UVCVMVT
UFLBOBOHMPNFSVMVTEJHJOKBMLBSFOB
QFOVSVOBOUFLBOBO HJOKBM EBO
QFSBOHTBOHBO QFMFQBTBO IPSNPO BOUJ EJVSFUJL
BSUFSJ EBO
LPOTUSJLTJ TJNQBUJL ZBOH LVBU EJ BSUFSJPM EBSJIJQPGJTJTQPTUFSJPS ZBOHNFOJOHLBULBOSFBCTPSQTJBJSPMFI
BGFSFOHJOKBM4FCBHBJBLJCBUOZB LFDVBMJQBEBHBHBMKBOUVOH UVCVMVT HJOKBM 1FOHBSVI QFSBOHTBOHBO TJNQBUJT JOJ EJCBIBT
EFOHBO EFSBKBU ZBOH QBMJOH SJOHBO MBKV GJMUSBTJ HMPNFSVMVT MFCJIEFUBJMQBEB#BCEBO
NFOKBEJ LVSBOH EBSJ OPSNBM %BSJ QFNCBIBTBO NFOHFOBJ
GVOHTJ HJOKBM EJ #BC TBNQBJ UFMBI KFMBT CBIXB CJMB Peran Peptida Natriuretik Atrium untuk Memperlambat
UFSKBEJ QFOVSVOBO TFEJLJU TBKB QBEB GJMUSBTJ HMPNFSVMVT Awat Timbulnya Dekompensasi Jantung. 1FQUJEB /BUSJVSFUJL
TFSJOHLBMJBLBOTBOHBUNFOVSVOLBOLFMVBSBOVSJOF#JMB "USJVN "USJBM/BUSJVSFUJD1FQUJEFM"/1
BEBMBIIPSNPOZBOHEJ
260
Bab 22 Gagal Jantung
MFQBTLBO PMFI EJOEJOH BUSJVN KBOUVOH LFUJLB EJOEJOH JOJ 4. #FSJLBO PCBU LBSEJPUPOJL ZBOH CFLFSKB DFQBU TFQFSUJ
NFSFHBOH 0MFI LBSFOB HBHBM KBOUVOH IBNQJS TFMBMV NFOJOHLBU EJHJUBMJT HVOBNFOHVBULBOKBOUVOH
LBO UFLBOBO BUSJVN LBOBO NBVQVO LJSJ ZBOH NFSFHBOHLBO -JOHLBSBOTFUBOBLJCBUFEFNBQBSVBLVUEBQBUCFSMBOKVUCFHJUV
EJOEJOH BUSJVN LBEBS "/1 EBMBN TJSLVMBTJ EBSBI EBQBU DFQBU TFIJOHHB LFNBUJBO EBQBU UJNCVM EBMBN XBLUV NFOJU
NFOJOHLBU TBNQBJ LBMJ MJQBU QBEB HBHBM KBOUVOH CFSBU
UNIT IV
TBNQBJ KBN 0MFI LBSFOB JUV BHBS CFSIBTJM TFUJBQ QSPTFEVS
4FMBOKVUOZB "/1 MBOHTVOH NFNFOHBSVIJ HJOKBM EFOHBO TBOHBU IBSVTEJMBLVLBOEFOHBOTFHFSB
NFOJOHLBULBOFLTLSFTJHBSBNEBOBJSOZB0MFILBSFOBJUV QFSBO
EBTBS "/1 BEBMBI VOUVL NFNCBOUV NFODFHBI HFKBMBHFKBMB
LPOHFTUJG ZBOH FLTUSFN TFMBNB HBHBM KBOUVOH 1FOHBSVI "/1 Cadangan Jantung
UFSIBEBQHJOKBMEJCJDBSBLBOEJ#BC
1FSTFOUBTF LFOBJLBO DVSBI KBOUVOH EJ BUBT OJMBJ OPSNBM ZBOH
NBTJI EBQBU EJDBQBJ TBNQBJ CBUBT NBLTJNVN EJTFCVU
Edema Paru Akut pada Gagal Jantung Stadium Lanjut— DBEBOHBO KBOUVOH +BEJ QBEB PSBOH EFXBTB NVEB ZBOH TFIBU
Lingkaran Setan Lain yang Mematikan CFTBS DBEBOHBO KBOUVOH BEBMBI TBNQBJ QFSTFO 1BEB
1FOZFCBCLFNBUJBOZBOHTFSJOHUFSKBEJQBEBHBHBMKBOUVOHBEBMBI PMBISBHBXBOZBOHUFSMBUJI DBEBOHBOKBOUVOHOZBNFODBQBJ
FEFNB QBSV BLVU UFSKBEJ QBEB QBTJFO ZBOH TFCFMVNOZB UFMBI TBNQBJQFSTFOBUBVMFCJI5FUBQJQBEBHBHBMKBOUVOH UJEBL
NFNQVOZBJ HBHBM KBOUVOH LSPOJT VOUVL KBOHLB XBLUV MBNB #JMB UFSEBQBUDBEBOHBOKBOUVOH4FCBHBJDPOUPIDBEBOHBOOPSNBM
UFSKBEJ QBEB TFTFPSBOH UBOQB EJTFSUBJ LFSVTBLBO CBSV EJ KBOUVOH DVSBI KBOUVOH QBEB PSBOH EFXBTB NVEB TFIBU TFMBNB
IBM JOJ VNVNOZB EJQJDV PMFI QFNCFCBOBO CFSMFCJIBO QBEB NFMBLVLBO LFSKB GJTJL CFSBU EBQBU NFOJOHLBU IJOHHB LJSBLJSB
KBOUVOHZBOHTJGBUOZBTFNFOUBSB NJTBMOZBEJTFCBCLBOPMFILFSKB MJNB LBMJ EBSJ OPSNBM LFOBJLBO JOJ NFSVQBLBO QFSTFO EJ
GJTJL CFSBU ZBOH EJMBLVLBO EBMBN XBLUV TJOHLBU CFCFSBQB BUBT OPSNBM KBEJ NFNQVOZBJ DBEBOHBO KBOUVOH TFCFTBS
QFOHBMBNBO FNPTJPOBM BUBV CBILBO GMV CFSBU &EFNB QBSV BLVU QFSTFO
JOJEJEVHBCFSBTBMEBSJMJOHLBSBOTFUBOCFSJLVU 4FUJBQ GBLUPS ZBOH NFODFHBI KBOUVOH VOUVL NFNPNQB
1. 1FOJOHLBUBOCFCBOTFNFOUBSBQBEBWFOUSJLFMLJSJZBOHTVEBI EBSBI EFOHBO NFNVBTLBO BLBO NFOVSVOLBO DBEBOHBO
KBOUVOH)BMJOJEBQBUUFSKBEJBLJCBUQFOZBLJUKBOUVOHJTLFNJL
MFNBI NFNVMBJ MJOHLBSBO TFUBO 0MFI LBSFOB LFNBNQVBO
QFOZBLJU NJPLBSE QSJNFS EFGJTJFOTJ WJUBNJO ZBOH
QPNQBKBOUVOHLJSJUFSCBUBT EBSBINVMBJUFSCFOEVOHEJQBSV
NFNFOHBSVIJPUPUKBOUVOH LFSVTBLBOGJTJLQBEBNJPLBSEJVN
2. 1FOJOHLBUBO EBSBI EJ QBSV NFOJOHLBULBO UFLBOBO LBQJMFS QFOZBLJU LBUVQ KBOUVOH EBO CBOZBL GBLUPS MBJOOZB CFCFSBQB
QBSV EBO TFKVNMBI LFDJM DBJSBO NVMBJ NFOHBMBNJ USBOTVEBTJ EJBOUBSBOZBUFSMJIBUQBEB(BNCBS
LFEBMBNKBSJOHBOEBOBMWFPMJQBSV
Diagnosis Cadangan Jantung Rendah Uji Kerja Fisik.
3. 1FOJOHLBUBODBJSBOEJEBMBNQBSVNFOHVSBOHJEFSBKBUPLTJHF
4FMBNB TFTFPSBOH EFOHBO DBEBOHBO KBOUVOH SFOEBI UFUBQ
OBTJEBSBI
EBMBN LFBEBBO JTUJSBIBU CJBTBOZB JB UJEBL BLBO NFOHBMBNJ
4. 1FOVSVOBO PLTJHFO EBMBN EBSBI TFNBLJO NFMFNBILBO HFKBMB VUBNB QFOZBLJU KBOUVOH /BNVO EFNJLJBO EJBHOPTJT
KBOUVOH EBO KVHB NFMFNBILBO BSUFSJPM EJ EBMBN UVCVI DBEBOHBO KBOUVOH SFOEBI CJBTBOZB EBQBU EJUFOUVLBO EFOHBO
TFIJOHHBNFOZFCBCLBOWBTPEJMBUBTJQFSJGFS NVEBI EFOHBO NFNJOUB PSBOH UFSTFCVU VOUVL NFMBLVLBO
5. 7BTPEJMBUBTJ QFSJGFS NFOJOHLBULBO MFCJI CBOZBL BMJSBO EBSBI PMBISBHB NFNBLBJ KFOUFSB CFSKBMBO USFBENJMM
BUBV EFOHBO
CBMJLWFOBEBSJTJSLVMBTJQFSJGFS CFSKBMBOOBJLUVSVOUBOHHB BUBVIBMMBJOOZBZBOHNFNFSMVLBO
QFOJOHLBUBO DVSBI KBOUVOH ZBOH TBOHBU CFTBS ,FOBJLBO
6. ,FOBJLBO BMJSBO CBMJL WFOB BLBO TFNBLJO NFOJOHLBULBO
QFNCFCBOBOKBOUVOHZBOHUJNCVMEFOHBODFQBUBLBONFNBLBJ
QFNCFOEVOHBO EBSBI EJ QBSV TFIJOHHB UJNCVM MFCJI CBOZBL
TFKVNMBI LFDJM DBEBOHBO KBOUVOH ZBOH UFSTFEJB EBO TFHFSB
USBOTVEBTJ DBJSBO MFCJI CBOZBL EFTBUVSBTJ PLTJHFO EJ BSUFSJ
UFSKBEJ LFHBHBMBO QFOJOHLBUBO DVSBI KBOUVOH VOUVL NFODBQBJ
MFCJI CBOZBL BMJSBO CBMJL WFOB EBO TFUFSVTOZB 4FIJOHHB
UJOHLBU ZBOH DVLVQ UJOHHJ HVOB NFNQFSUBIBOLBO UJOHLBU
UJNCVMTVBUVMJOHLBSBOTFUBO
BLUJWJUBTUVCVIZBOHCBSV&GFLBLVUJOJBEBMBITFCBHBJCFSJLVU
4FLBMJ MJOHLBSBO TFUBO UFMBI CFSMBOKVU TBNQBJ UJUJL LSJUJT UFS
UFOUV LFBEBBOJOJBLBOUFSVTCFSMBOKVUTBNQBJQBTJFONFOJOHHBM
LFDVBMJ CJMB EJMBLVLBO UJOEBLBO QFOHPCBUBO ZBOH IFSPJL EBMBN
IJUVOHBO NFOJU #FOUVL UFSBQJ ZBOH EBQBU NFOPMPOH IJEVQ
QBTJFO EBONFNCBMJLLBOQSPTFTUFSTFCVUBEBMBITFCBHBJCFSJLVU
1. 1BTBOHUPSOJLFUQBEBMFOHBOEBOUVOHLBJHVOBNFOBIBOMFCJI
CBOZBLEBSBIEJWFOB TFIJOHHBBLBONFOVSVOLBOCFCBOLFSKB
KBOUVOHLJSJ
2. #FSJLBOEJVSFUJLZBOHCFLFSKBDFQBU TFQFSUJGVSPTFNJE VOUVL
NFNQFSDFQBUIJMBOHOZBDBJSBOUVCVI
3. #FSJLBO PLTJHFO NVSOJ LFQBEB QBTJFO VOUVL CFSOBQBT HVOB
NFNVMJILBOEFTBUVSBTJPLTJHFOEBSBI LFSVTBLBOKBOUVOH EBO
WBTPEJMBUBTJQFSJGFS
261
Unit IV Sirkulasi
1. 4FTBL OBQBT EJTQOFB

ZBOH UJNCVM EFOHBO TFHFSB EBO CFSVCBI LBSFOB TJTUFN TJSLVMBTJ QFSJGFS NBTJI CFLFSKB TFDBSB
LBEBOHLBEBOH DVLVQ CFSBU BLJCBU LFHBHBMBO KBOUVOH OPSNBM 0MFI LBSFOB JUV LFBEBBO TJSLVMBTJ ZBOH CBSV EJUBOEBJ
VOUVL NFNPNQB EBSBI EBMBN KVNMBI ZBOH DVLVQ TF EFOHBO UJUJL # UFNQBU EJ TBBU LVSWB DVSBI KBOUVOH ZBOH CBSV
IJOHHB UFSKBEJ JTLFNJB KBSJOHBO EBO NFOJNCVMLBO TFOTBTJ NFNPUPOH LVSWB BMJSBO CBMJL WFOB OPSNBM +BEJ UFLBOBO BUSJVN
MBQBSVEBSB LBOBO TFHFSB NFOJOHLBU NFOKBEJ NN )H TFEBOHLBO DVSBI
2. ,FMFMBIBOPUPUZBOHMVBSCJBTBTFCBHBJBLJCBUJTLFNJBPUPU KBOUVOHNFOVSVOIJOHHB-NFOJU
TFIJOHHBNFNCBUBTJLFNBNQVBOTFTFPSBOHVOUVLNFMBLV Efek Refleks Simpatis. %BMBN XBLUV EFUJL CFSJLVUOZB
LBOLFSKBGJTJL SFGMFLT TJNQBUJT NFOKBEJ TBOHBU BLUJG 3FGMFLT JOJ NFOJOHLBULBO
3. ,FOBJLBO GSFLVFOTJ KBOUVOH ZBOH MVBS CJBTB LBSFOB SFGMFLT LVSWB DVSBI KBOUVOH EBO LVSWB BMJSBO CBMJL WFOB 1FSBOHTBOHBO
TBSBG LF KBOUVOH CFLFSKB TFDBSB CFSMFCJIBO TFCBHBJ VTBIB TJNQBUJT EBQBU NFOJOHLBULBO OJMBJ HBSJT NFOEBUBS LVSWB DVSBI
VOUVLNFOBOHHVMBOHJDVSBIKBOUVOHZBOHUJEBLBEFLVBU KBOUVOHIJOHHBTFCBOZBLTBNQBJQFSTFO1FSBOHTBOHBOJOJ
KVHB EBQBU NFOJOHLBULBO UFLBOBO QFOHJTJBO TJTUFNJL SBUBSBUB
6KJLFSKBGJTJLNFSVQBLBOCBHJBOEBSJLFMFOHLBQBOTFPSBOH
EJUBOEBJPMFIUJUJLUFNQBUQFSQPUPOHBOBOUBSBLVSWBBMJSBOCBMJL
BIMJ LBSEJPMPHJ 6KJVKJ JOJ NFOHHBOUJLBO QFOHVLVSBO DVSBI
WFOB EFOHBO TVNCV OPM BMJSBO CBMJL WFOB
IJOHHB CFCFSBQB
KBOUVOH ZBOH UJEBL EBQBU EJMBLVLBO EFOHBO NVEBI EJ
NJMJNFUFSBJSSBLTBQBEBHBNCBSJOJ EBSJOJMBJOPSNBMNN)H
LFCBOZBLBOLMJOJL
OBJLNFOKBEJNN)H1FOJOHLBUBOUFLBOBOQFOHJTJBOTJTUFNJL
Metode Grafik Kuantitatif untuk Analisis Gagal Jantung SBUBSBUB JOJ NFOHHFTFS LFTFMVSVIBO LVSWB BMJSBO CBMJL WFOB LF
LBOBO EBO LF BUBT ,VSWB DVSBI KBOUVOH EBO BMJSBO CBMJL WFOB
.FTLJQVO LJUB NVOHLJO NFNBIBNJ TFCBHJBO CFTBS QSJOTJQ ZBOH CBSV TFLBSBOH CFSBEB EBMBN LFTFJNCBOHBO EJ UJUJL $ ZBJUV
VNVN HBHBM KBOUVOH UFSVUBNB EFOHBO NFNBLBJ MPHJLB QBEBUFLBOBOBUSJVNLBOBOTFCFTBSNN)HEBODVSBIKBOUVOH
LVBMJUBUJG TFQFSUJ ZBOH UFMBI LJUB MBLVLBO EJ CBC JOJ NFMBMVJ -NFOJU
QFOEFLBUBOLVBOUJUBUJGLJUBEBQBUNFMJIBUNBLOBQFOUJOHEBSJ
CFSCBHBJ GBLUPS QBEB HBHBM KBOUVOH TFDBSB KBVI MFCJI Kompensasi Selama Beberapa Hari Berikutnya. 4FMBNB
NFOEBMBN 4BMBI TBUV QFOEFLBUBOOZB BEBMBI NFUPEF HSBGJL NJOHHV CFSJLVUOZB LVSWB DVSBI KBOUVOH EBO LVSWB BMJSBO CBMJL
VOUVL BOBMJTJT QFOHBUVSBO DVSBI KBOUVOH ZBOH EJQFSLFOBMLBO WFOB BLBO TFNBLJO NFOJOHLBU LBSFOB
UFSEBQBU TFEJLJU
EJ #BC 1BEB VSBJBO CFSJLVU LJUB BLBO NFOHBOBMJTJT QFNVMJIBOQBEBKBOUVOHEBO
SFUFOTJHBSBNEBOBJSPMFIHJOKBM
CFCFSBQB BTQFL NFOHFOBJ HBHBM KBOUVOH EFOHBO NFNBLBJ ZBOHTFNBLJONFOJOHLBULBOUFLBOBOQFOHJTJBOTJTUFNJLSBUBSBUB
UFLOJLHSBGJLUFSTFCVU LBMJ JOJ NFOJOHLBU IJOHHB NN )H ,FEVB LVSWB ZBOH CBSV
TFLBSBOH CFSBEB EBMBN LFTFJNCBOHBO EJ UJUJL % +BEJ DVSBI
Analisis Grafik Gagal Jantung Akut dan Kompensasi KBOUVOH TFLBSBOH UFMBI LFNCBMJ OPSNBM /BNVO UFLBOBO BUSJVN
Kronis LBOBO NBTJI NFOJOHLBU IJOHHB NN )H 0MFI LBSFOB DVSBI
(BNCBSNFNQFSMJIBULBOLVSWBDVSBIKBOUVOHEBOLVSWB KBOUVOH TFLBSBOH UFMBI OPSNBM LFMVBSBO HJOKBM KVHB OPSNBM
BMJSBO CBMJL WFOB EJ CFSCBHBJ LFBEBBO KBOUVOH EBO TJSLVMBTJ TFIJOHHBUFSDBQBJTVBUVLFBEBBOLFTFJNCBOHBODBJSBOZBOHCBSV
QFSJGFS ,FEVB LVSWB ZBOH NFMBMVJ 5JUJL " BEBMBI
LVSWB 4JTUFN TJSLVMBTJ BLBO UFSVT CFSGVOHTJ EJ UJUJL % EBO BLBO UFUBQ
DVSBIKBOUVOHOPSNBMEBO
LVSWBBMJSBOCBMJLWFOBOPSNBM TUBCJM EFOHBO DVSBI KBOUVOH ZBOH OPSNBM EBO UFLBOBO BUSJVN
4FQFSUJ ZBOH UFSDBOUVN EJ #BC IBOZB UFSEBQBU TBUV UJUJL LBOBO ZBOH NFOJOHLBU TBNQBJ CFCFSBQB GBLUPS FLTUSJOTJL
QBEBNBTJOHNBTJOHLFEVBLVSWBJOJ ZBOHNFSVQBLBOUFNQBU UBNCBIBONFOHVCBILVSWBDVSBIKBOUVOHBUBVLVSWBBMJSBOCBMJL
TJTUFN TJSLVMBTJ EBQBU CFLFSKB UJUJL " BEBMBI UFNQBU LFEVB WFOB
LVSWB TBMJOH CFSQPUPOHBO 0MFI LBSFOB JUV LFBEBBO TJSLVMBTJ %FOHBO NFNBLBJ UFLOJL JOJ VOUVL NFOHBOBMJTJT LJUB EBQBU
OPSNBM BEBMBI EJTBBU DVSBI KBOUVOH EBO BMJSBO CBMJL WFOB NFMJIBU UFSVUBNB NFOHFOBJ QFOUJOHOZB SFUFOTJ DBJSBO EBMBN
TFCFTBS-NFOJUEBOUFLBOBOBUSJVNLBOBONN)H KVNMBI TFEBOH EBO CBHBJNBOB IBM JOJ BLIJSOZB NFOJNCVMLBO
Efek Serangan Jantung Akut. 4FMBNB CFCFSBQB EFUJL LFBEBBOTJSLVMBTJZBOHCBSVEBOTUBCJMQBEBHBHBMKBOUVOHEFSBKBU
SJOHBOEBOTFEBOH%BOLJUBKVHBEBQBUNFMJIBUIVCVOHBOBOUBSB
QFSUBNBTFUFMBIUFSKBEJTFSBOHBOKBOUVOHEFSBKBUTFEBOH LVSWB
UFLBOBO QFOHJTJBO TJTUFNJL SBUBSBUB EBO QFNPNQBBO KBOUVOH
DVSBI KBOUVOH NFOVSVO IJOHHB LF LVSWB ZBOH QBMJOH CBXBI
QBEBCFSCBHBJEFSBKBULFHBHBMBOKBOUVOH
4FMBNBCFCFSBQBEFUJLJOJ LVSWBBMJSBOCBMJLWFOBNBTJICFMVN
1FSIBUJLBOCBIXBLFBEBBOLFBEBBOZBOHUFSMJIBUQBEB(BNCBS
NFSVQBLBO IBM ZBOH TBNB EFOHBO ZBOH EJQFSMJIBULBO QBEB
(BNCBS UFUBQJQBEB(BNCBS EJUBNQJMLBOEFOHBODBSB
ZBOHMFCJILVBOUJUBUJG
Analisis Grafik Gagal Jantung "Dekompensasi"
,VSWB DVSBI KBOUVOH CFSXBSOB IJUBN QBEB (BNCBS
NFSVQBLBOLVSWBTBNBEFOHBOZBOHEJQFSMJIBULBOQBEB(BNCBS
TVBUV LVSWB ZBOH TBOHBU UFSUFLBO ZBOH UFMBI NFODBQBJ
EFSBKBUQFNVMJIBOTFCFTBSZBOHEBQBUEJDBQBJPMFIKBOUVOH1BEB
HBNCBSJOJ LJUBUFMBINFOBNCBILBOLVSWBBMJSBOCBMJLWFOBZBOH
UJNCVM TFMBNB IBSJIBSJ CFSJLVUOZB TFUFMBI UFSKBEJ QFOVSVOBO
LVSWBDVSBIKBOUVOHZBOHBLVUIJOHHBLFOJMBJZBOHSFOEBIJOJ
262
Bab 22 Gagal Jantung
e era
UNIT IV
e
ODBQBJ UJUJL & QBEB (BNCBS EBO LJUB UFSVTLBO LF UJUJL &
ZBOHTBNBQBEB(BNCBS1BEBTBBUJOJ EJHJUBMJTEJCFSJLBO
VOUVLNFOHVBULBOKBOUVOH)BMJOJBLBONFOJOHLBULBOLVSWB
5JUJL " NFSVQBLBO LVSWB QBEB XBLUV OJMBJ OPM CFSJNCBOH DVSBI KBOUVOH LF UJOHLBU ZBOH EJQFSMJIBULBO QBEB (BNCBS
EFOHBOLVSWBBMJSBOCBMJLWFOBOPSNBMHVOBNFOHIBTJMLBODVSBI UFUBQJ UJEBL UJNCVM QFSVCBIBO ZBOH TFHFSB QBEB LVSWB
KBOUVOHLJSBLJSB-NFOJU"LBOUFUBQJ SBOHTBOHBOTJTUFNTBSBG BMJSBO CBMJL WFOB 0MFI LBSFOB JUV LVSWB DVSBI KBOUVOH ZBOH
TJNQBUJT ZBOH EJTFCBCLBO PMFI DVSBI KBOUVOH ZBOH SFOEBI JOJ CBSVBLBOCFSJNCBOHEFOHBOLVSWBBMJSBOCBMJLWFOBEJUJUJL(
NFOJOHLBULBOUFLBOBOQFOHJTJBOTJTUFNJLSBUBSBUBEBMBNXBLUV $VSBI KBOUVOH TBBU JOJ BEBMBI -NFOJU ZBJUV OJMBJ ZBOH
EFUJL EBSJ NFOKBEJ NN )H ,FBEBBO JOJ BLBO NFOH MFCJI CFTBS EBSJQBEB OJMBJ LSJUJT TFCFTBS - ZBOH EJQFSMVLBO
HFTFS LVSWB BMJSBO CBMJL WFOB LF BUBT EBO LF LBOBO HVOB BHBSHJOKBMEBQBUNFOHFLTLSFTJLBOVSJOFEBMBNKVNMBIOPSNBM
NFOHIBTJMLBO LVSWB ZBOH CFSUBOEB LPNQFOTBTJ PUPOPN +BEJ 0MFI LBSFOB JUV HJOKBM NFOHFMVBSLBO MFCJI CBOZBL DBJSBO
LVSWBBMJSBOCBMJLWFOBCBSVBLBOCFSJNCBOHEFOHBOLVSWBDVSBI EJCBOEJOH LFBEBBO OPSNBM TFIJOHHB NFOJNCVMLBO EJVSFTJT
KBOUVOHEJUJUJL#$VSBIKBOUVOHUFMBIQVMJILFUJOHLBU-NFOJU ZBOH NFSVQBLBO FGFL QFOHPCBUBO EJHJUBMJT ZBOH UFMBI TBOHBU
UFUBQJEFOHBONFOHPSCBOLBOQFOBNCBIBOUFLBOBOBUSJVNLBOBO EJLFOBM
IJOHHBNN)H ,FIJMBOHBODBJSBOTFDBSBQSPHSFTJGTFMBNBCFCFSBQBIBSJBLBO
$VSBI KBOUVOH -NFOJU NBTJI UFSMBMV SFOEBI VOUVL NFOVSVOLBO UFLBOBO QFOHJTJBO TJTUFNJL SBUBSBUB LFNCBMJ LF
NFNCVBUHJOKBMCFSGVOHTJTFDBSBOPSNBM0MFILBSFOBJUV DBJSBO NN )H EBO LVSWB BMJSBO CBMJL WFOB CBSV NFOKBEJ LVSWB
BLBO UFSVT EJSFUFOTJ EBO UFLBOBO QFOHJTJBO TJTUFNJL SBUBSBUB CFSUBOEB CFCFSBQB IBSJ LFNVEJBO ,VSWB JOJ CFSJNCBOH
NFOJOHLBUEBSJ NFOKBEJIBNQJSNN)H4BBUJOJ LVSWB EFOHBO LVSWB DVSBI KBOUVOH EBSJ KBOUVOH ZBOH NFOHBMBNJ
BMJSBO CBMJL WFOB NFOKBEJ LVSWB ZBOH CFSUBOEB IBSJ LFEVB EBO EJHJUBMJTBTJEJUJUJL) ZBLOJQBEBDVSBIKBOUVOHTFCFTBS-NFOJU
CFSJNCBOHEFOHBOLVSWBDVSBIKBOUVOHEJUJUJL$$VSBIKBOUVOH EBO UFLBOBO BUSJVN LBOBO TFCFTBS NN )H $VSBI KBOUVOH
NFOJOHLBU NFOKBEJ -NFOJU EBO UFLBOBO BUSJVN LBOBO JOJMBIZBOHUFQBUEJCVUVILBOBHBSUFSDJQUBLFTFJNCBOHBODBJSBO
NFOKBEJNN)H OPSNBM 0MFI LBSFOB JUV UJEBL BEB DBJSBO UBNCBIBO ZBOH BLBO
IJMBOH EBO UJEBL BLBO BEB QFOBNCBIBO DBJSBO "LJCBUOZB
4FMBNBIBSJIBSJCFSJLVUOZB DVSBIKBOUVOHUJEBLQFSOBIOBJL
TJTUFN TJSLVMBTJ TFLBSBOH UFMBI TUBCJM BUBV EFOHBO LBUB MBJO
DVLVQ UJOHHJ VOUVL NFODJQUBLBO LFNCBMJ GVOHTJ HJOKBM ZBOH
EFLPNQFOTBTJ HBHBM KBOUVOH UFMBI NFOHBMBNJ LPNQFOTBTJ
OPSNBM $BJSBO BLBO UFSVT EJSFUFOTJ UFLBOBO QFOHJTJBO TJTUFNJL
%FOHBODBSBMBJOEBQBUKVHBEJOZBUBLBOTFCBHBJCFSJLVU LFBEBBO
SBUBSBUBUFSVTNFOJOHLBU LVSWBBMJSBOCBMJLWFOBUFSVTCFSHFTFS
BLIJS TJSLVMBTJ ZBOH NBOUBQ EJUFHBTLBO PMFI UJUJL QFSTJMBOHBO
LFLBOBO EBOUJUJLLFTFJNCBOHBOBOUBSBLVSWBBMJSBOCBMJLWFOB
EBSJLFUJHBLVSWBLVSWBDVSBIKBOUVOH LVSWBBMJSBOCBMJLWFOB
EBOLVSWBDVSBIKBOUVOHKVHBCFSHFTFSTFDBSBQSPHSFTJGLFUJUJL%
EBO OJMBJ LSJUJT LFTFJNCBOHBO DBJSBO OPSNBM .FLBOJTNF
LFUJUJL& EBO BLIJSOZB LFUJUJL'1SPTFTLFTFJNCBOHBOTFLBSBOH
LPNQFOTBTJ TFDBSB PUPNBUJT BLBO NFOTUBCJMLBO TJSLVMBTJ CJMB
CFSBEB QBEB CBHJBO NFOVSVO LVSWB DVSBI KBOUVOH TFIJOHHB
LFUJHBLVSWBUFSTFCVUNFOZJMBOHEJUJUJLZBOHTBNB
SFUFOTJ DBJSBO MFCJI MBOKVU BLBO NFOZFCBCLBO FEFNB KBOUVOH
ZBOH TFNBLJO CFSBU EBO NFNCFSJLBO QFOHBSVI NFSVHJLBO QBEB Analisis Grafik Gagal Jantung dengan Curah Jantung
DVSBI KBOUVOH ,FBEBBO JOJ UFSVT NFOVSVO TBNQBJ UJNCVM
yang Tinggi
LFNBUJBO
%FOHBOEFNJLJBO EFLPNQFOTBTJUFSKBEJBLJCBUEBSJLFOZBUBO (BNCBS NFNCFSJLBO BOBMJTJT EBSJ EVB CFOUVL HBHBM
CBIXB LVSWB DVSBI KBOUVOH UJEBL QFSOBI NFOJOHLBU TBNQBJ LF KBOUVOH LBSFOB DVSBI KBOUVOH UJOHHJ 4BMBI TBUV EJ BOUBSBOZB
OJMBJ LSJUJT -NFOJU ZBLOJ OJMBJ ZBOH EJQFSMVLBO VOUVL EJTFCBCLBOPMFIGJTUVMBBSUFSJPWFOPTBZBOHNFNCFCBOJKBOUVOH
NFODJQUBLBO LFNCBMJ FLTLSFTJ DBJSBO PMFI HJOKBM EBMBN KVNMBI TFDBSBCFSMFCJIBOBLJCBUBMJSBOCBMJLWFOBZBOHCFTBS NFTLJQVO
OPSNBM BHBS UFSDJQUB LFTFJNCBOHBO BOUBSB BTVQBO EFOHBO LFNBNQVBO QFNPNQBBO KBOUVOH UJEBL NFOVSVO 1FOZFCBC
LFMVBSBODBJSBO MBJOOZB BEBMBI QFOZBLJU CFSJCFSJ ZBOH NFOZFCBCLBO BMJSBO
CBMJLWFOBTBOHBUNFOJOHLBULBSFOBQFOVSVOBOUBIBOBOQFN
Pengobatan Penyakit Jantung Dekompensasi dengan CVMVITJTUFNJL UFUBQJQBEBTBBUZBOHCFSTBNBBO LFNBNQVBO
Digitalis..BSJLJUBBOHHBQCBIXBUBIBQEFLPNQFOTBTJUFMBINF QFNPNQBBOKBOUVOHNFOVSVO
263
Unit IV Sirkulasi
OJMBJ OPSNBM TFCFTBS NN )H OBJL NFOKBEJ NN )H )BM JOJ
BLBONFOHHFTFSLVSWBBMJSBOCBMJLWFOBLFLBOBO"LIJSOZB LVSWB
BMJSBO CBMJL WFOB CFSQVUBS LF BUBT EBSJ LVSWB OPSNBM LBSFOB
BWJUBNJOPTJTUFMBINFOZFCBCLBOEJMBUBTJQFNCVMVIEBSBIQFSJGFS
TFQFSUJZBOHEJKFMBTLBOQBEB#BC
,FEVB LVSWB ZBOH CFSXBSOB BCVBCV LVSWB BMJSBO CBMJL WFOB
EBO LVSWB DVSBI KBOUVOH
TBMJOH NFOZJMBOH EJ UJUJL $ ZBOH
NFOHHBNCBSLBOLFBEBBOTJSLVMBTJQBEBCFSJCFSJ EFOHBOUFLBOBO
BUSJVN LBOBO QBEB LFBEBBO JOJ TFCFTBS NN )H EBO DVSBI
KBOUVOH LJSBLJSB QFSTFO EJ BUBT OPSNBM DVSBI KBOUVOH ZBOH
UJOHHJ JOJ UFUBQ UJNCVM NFTLJQVO KBOUVOH EBMBN LFBEBBO MFNBI
TFQFSUJZBOHEJHBNCBSLBOPMFIHBSJTNFOEBUBSEFOHBOOJMBJZBOH
NFOVSVOEBSJLVSWBDVSBIKBOUVOH
Daftar Pustaka
Abraham WT, Greenberg BH, Yancy CW: Pharmacologic therapies across the
Fistula Arteriovenosa ,VSWB OPSNBM QBEB (BNCBS continuum of left ventricular dysfunction, Am J Cardiol 102:21G-28G, 2008.
NFOBOEBLBO LVSWB DVSBI KBOUVOH OPSNBM EBO LVSWB BMJSBO Andrew P: Diastolic heart failure demystified, Chest 124:744, 2003.
CBMJLWFOBOPSNBM,FEVBLVSWBJOJTBMJOHCFSJNCBOHEJUJUJL" Bers DM: Altered cardiac myocyte Ca regulation in heart failure, Physiology
(Bethesda ) 21:380, 2006.
ZBOHNFOHHBNCBSLBODVSBIKBOUVOHOPSNBMTFCFTBS-NFOJU Braunwald E: Biomarkers in heart failure, N Engl J Med 358:2148, 2008. Dorn GW
EBOUFLBOBOBUSJVNLBOBOOPSNBMTFCFTBSNN)H 2nd, Molkentin JD: Manipulating cardiac contractility in heart
4FLBSBOH NBSJ LJUB BOHHBQ CBIXB SFTJTUBOTJ BUBV UBIBOBO failure: data from mice and men, Circulation 109:150, 2004.
QFNCVMVI TJTUFNJL UBIBOBO QFNCVMVI QFSJGFS UPUBM
NFOKBEJ Floras JS: Sympathetic activation in human heart failure: diverse mecha-nisms,
therapeutic opportunities, Acta Physiol Scand 177:391, 2003.
TBOHBU NFOVSVO BLJCBU QFNCVLBBO GJTUVMB BSUFSJPWFOPTB ZBOH Guyton AC, Jones CE, Coleman TG: Circulatory physiology: cardiac output and
TBOHBU CFTBS QFNCVLBBO MBOHTVOH EJ BOUBSB BSUFSJ CFTBS EBO its regulation, Philadelphia, 1973, WB Saunders.
WFOB CFTBS
,VSWB BMJSBO CBMJL WFOB NFNVUBS LF BUBT EBO Haddad F, Doyle R, Murphy DJ, et Right ventricular function in cardiovas-
NFOKBEJLVSWBZBOHCFSUBOEBGJTUVMB"7,VSWBBMJSBOCBMJL cular disease, part II: pathophysiology, clinical importance, and management of
WFOB JOJ CFSJNCBOH EFOHBO LVSWB DVSBI KBOUVOH OPSNBM EJ right ventricular failure, Circulation 117:1717, 2008.
Ikeda Y, Hoshijima M, Chien KR: Toward biologically targeted therapy of calcium
UJUJL # EFOHBO DVSBI KBOUVOH TFCFTBS -NFOJU EBO cycling defects in heart failure, Physiology (Bethesda) 23:6, 2008. Lohmeier TE:
UFLBOBO BUSJVN LBOBO TFCFTBS NN )H +BEJ DVSBI KBOUVOH Neurohumoral regulation of arterial pressure in hemorrhage and
NFOKBEJTBOHBUNFOJOHLBU UFLBOBOBUSJVNLBOBOTFEJLJUOBJL heart failure, Am J Physiol Regul lntegr Comp Physiol 283:R810, 2002.
EBOUFSEBQBUUBOEBUBOEBCFOEVOHBOQFSJGFSZBOHSJOHBO+JLB Mehra MR, Gheorghiade M, Bonow RO: Mitrat regurgitation in chronic heart
PSBOH UFSTFCVU CFSVTBIB VOUVL CFSPMBISBHB JB IBOZB failure: more questions than answers? Curr Cardiol Rep 6:96, 2004.
McMurray J, Pfeffer MA: New therapeutic options in congestive heart failure: Part
NFNQVOZBJ TFEJLJU DBEBOHBO KBOUVOH LBSFOB KBOUVOH UFMBI
I, Circulation 105:2099, 2002.
NFOEFLBUJ LBQBTJUBT NBLTJNVNOZB VOUVL NFNPNQB EBSBI McMurray J, Pfeffer MA: New therapeutic options in congestive heart failure: Part
UBNCBIBO NFMBMVJ GJTUVMB BSUFSJPWFOPTB ,FBEBBO JOJ II, Circulation 105:2223, 2002.
NFOZFSVQBJ LPOEJTJ HBHBM KBOUVOH EBO EJTFCVU HBHBM LBSFOB Morita H, Seidman J, Seidman CE: Genetic causes of human heart failure, J Clin
DVSBI KBOUVOH UJOHHJ UFUBQJ EBMBN LFOZBUBBOOZB KBOUVOH Invest 115:518, 2005.
EJCFCBOJTFDBSBCFSMFCJIBOLBSFOBBMJSBOCBMJLWFOBZBOHCFTBS Pfisterer M: Right ventricular involvement in myocardial infarction and cardiogenic
shock, Lancet 362:392, 2003.
Beriberi. (BNCBS NFNQFSMJIBULBO QFSVCBIBO QBEB Pitt B: Aldosterone blockade in patients with chronic heart faiture, Cardiol Clin
LVSWB DVSBI KBOUVOH EBO LVSWB BMJSBO CBMJL WFOB LBSFOB 26:15, 2008.
CFSJCFSJ 5JOHLBU QFOVSVOBO LVSWB DVSBI KBOUVOH EJTFCBCLBO Reynolds HR, Hochman JS: Cardiogenic shock: Current concepts and improving
PMFI NFMFNBIOZB KBOUVOH BLJCBU BWJUBNJOPTJT UFSVUBNB outcomes, Circulation 117:686, 2008.
Spodick DH: Acute cardiac tamponade, N Engl J Med 349:684, 2003.
LFLVSBOHBO UIJBNJO
ZBOH NFOZFCBCLBO TJOESPN CFSJCFSJ Zile MR, Brutsaert DL: New concepts in diastolic dysfunction and diastolic heart
.FMFNBIOZBKBOUVOHUFMBINFOVSVOLBOBMJSBOEBSBILFHJOKBM failure: Part I: diagnosis, prognosis, and measurements of diastolic
0MFI LBSFOB JUV HJOKBM BLBO NFSFUFOTJ TFKVNMBI CFTBS DBJSBO function, Circulation 105:1387, 2002.
UVCVI UBNCBIBO ZBOH TFMBOKVUOZB NFOJOHLBULBO UFLBOBO Zucker IH: Novel mechanisms of sympathetic regulation in chronic heart failure,
QFOHJTJBO TJTUFNJL SBUBSBUB EJUBOEBJ PMFI UJUJL QFSTJMBOHBO Hypertension 48:1005, 2006.
BOUBSBLVSWBBMJSBOCBMJLWFOBEBOOJMBJDVSBIKBOUVOHOPM
EBO
264
BAB 23
UNIT IV
,BUVQ+BOUVOHEBO#VOZJ+BOUVOH
,FMBJOBO,BUVQEBO+BOUVOH#BXBBO
'VOHTJ LBUVQ KBOUVOH UFMBI NFOEPSPOH BMJSBO EBSBI CBMJL UFSTFCVU LFNCBMJ LF TFUJBQ
EJCBIBT EJ #BC EJOZBUBLBO WFOUSJLFM )BM JOJ NFOZFCBCLBO EBSBI EBO EJOEJOH WFOUSJLFM
CBIXB QFOVUVQBO LBUV NFOZF TFSUB LBUVQ ZBOH UFHBOH CFSHFUBS EBO NFOJNCVMLBO HFUBSBO
CBCLBO CVOZJ ZBOH EBQBU EJ UVSCVMFOTJEBMBNEBSBI(FUBSBOLFNVEJBONFSBNCBUNFMBMVJ
EFOHBS #JBTBOZB UJEBL BEB KBSJOHBO EJ EFLBUOZB LF EJOEJOH EBEB TFIJOHHB EBQBU UFSEF
CVOZJZBOHEBQBUEJEFOHBSTBBU OHBSTFCBHBJCVOZJEFOHBONFOHHVOBLBOTUFUPTLPQ
LBUVQNFNCVLB #VOZJ KBOUVOH LFEVB EJUJNCVMLBO PMFI QFOVUVQBO LBUVQ
%BMBN CBC JOJ LJUB NVMBNVMB BLBO NFNCBIBT GBLUPSGBLUPS TFNJMVOBSJT ZBOH UJCBUJCB QBEB BLIJS TJTUPM ,FUJLB LBUVQ
ZBOH NFOJNCVMLBO CVOZJ KBOUVOH CBJL EBMBN LFBEBBO OPSNBM TFNJMVOBSJT NFOVUVQ LBUVQ JOJ NFOPOKPM LF BSBI WFOUSJLFM
NBVQVO BCOPSNBM ,FNVEJBO LJUB BLBO NFNCBIBT QFSVCBIBO EBO SFHBOHBO FMBTUJT LBUVQ BLBO NFMFOUJOHLBO EBSBI LFNCBMJ
ZBOH UFSKBEJ QBEB TJTUFN TJSLVMBTJ TFDBSB LFTFMVSVIBO TBBU LFBSUFSJ ZBOHNFOZFCBCLBOEBSBINFNBOUVMCPMBLCBMJLVO
UFSEBQBULFMBJOBOLBUVQEBOLFMBJOBOKBOUVOHCBXBBO UVLTFTBBUBOUBSBEJOEJOHBSUFSJEBOLBUVQTFNJMVOBSJTEBOKVHB
BOUBSB LBUVQ EBO EJOEJOH WFOUSJLFM (FUBSBO ZBOH UFSKBEJ EJ
EJOEJOH BSUFSJ LFNVEJBO EJIBOUBSLBO UFSVUBNB EJ TFQBOKBOH
Bunyi Jantung BSUFSJ #JMB HFUBSBO EBSJ QFNCVMVI BUBV WFOUSJLFM NFOHFOBJ
EJOEJOHTVBSB NJTBMOZBEJOEJOHEBEB HFUBSBOJOJNFOJNCVM
Bunyi Jantung Normal LBOTVBSBZBOHEBQBUEJEFOHBS
%FOHBO TUFUPTLPQ LJUB EBQBU NFOEFOHBS CVOZJ KBOUVOH OPSNBM
ZBOH CJBTBOZB EJEFTLSJQTJLBO TFCBHBJ MVC EVC MVC EVCh #VOZJ Tinggi Nada dan Durasi Bunyi Jantung Pertama dan
MVC EJLBJULBO EFOHBO QFOVUVQBO LBUVQ BUSJPWFOUSJLFM "7
Kedua. %VSBTJ TFUJBQ CVOZJ KBOUVOH TFEJLJU MFCJI EBSJ
QBEB QFSNVMBBO TJTUPM EBO CVOZJ EVC EJLBJULBO EFOHBO EFUJLCVOZJQFSUBNBLJSBLJSB EFUJLEBOZBOHLFEVBLJSB
QFOVUVQBOLBUVQTFNJMVOBSJT BPSUBEBOQVMNPOBSJT
QBEBBLIJS LJSB EFUJL1FOZFCBCMFCJITJOHLBUOZBCVOZJLFEVBBEBMBI
TJTUPM #VOZJ MVC EJTFCVU CVOZJ KBOUVOH QFSUBNB EBO EVC LBSFOB LBUVQ TFNJMVOBSJT MFCJI UFHBOH EBSJQBEB LBUVQ "7
EJTFCVU CVOZJ KBOUVOH LFEVB LBSFOB TJLMVT QPNQB KBOUVOH TFIJOHHB LBUVQLBUVQ JOJ CFSHFUBS VOUVL NBTB XBLUV ZBOH
OPSNBM EJBOHHBQ EJNVMBJ TBBU QFOVUVQBO LBUVQ "7 QBEB MFCJIQFOEFLEBSJQBEBLBUVQ"7
QFSNVMBBOTJTUPMWFOUSJLFM ,JTBSBO GSFLVFOTJ ZBOH EBQBU EJEFOHBS UJOHHJ OBEB
QBEB
CVOZJ KBOUVOH QFSUBNB EBO LFEVB TFQFSUJ ZBOH EJQFSMJIBULBO
Penyebab Bunyi Jantung Pertama dan Kedua. 4FNVMBEJ QBEB(BNCBS EJNVMBJQBEBGSFLVFOTJZBOHQBMJOHSFOEBI
EVHB CBIXB QFOZFCBC CVOZJ KBOUVOH BEBMBI CFOUVSBO TMBQQJ ZBOHEBQBUEJEFUFLTJPMFIUFMJOHB LJSBLJSBTJLMVTEFUJL EBO
OH
EBSJEBVOEBVOLBUVQTFDBSBCFSTBNBTBNBTFIJOHHBNFOJN UFSVTOBJLTBNQBJTFLJUBSTJLMVTEFUJL#JMBEJHVOBLBOBMBU
CVMLBOHFUBSBO/BNVO HFUBSBOJOJUFSOZBUBIBOZBNFOJNCVMLBO FMFLUSPOJLLIVTVTVOUVLNFSFLBNCVOZJ CBHJBOUFSCFTBSSFLB
TVBSB ZBOHLBMBVQVOBEB IBOZBLFDJMTBKBLBSFOBEBSBIZBOHUFS NBOCVOZJUFSMFUBLQBEBGSFLVFOTJEBOUJOHLBUTVBSBEJCBXBI
EBQBUEJBOUBSBEBVOLBUVQNFSFEBNFGFLCFOUVSBOEBONFODF LJTBSBOCVOZJZBOHEBQBUEJEFOHBS UFSFOEBIQBEBTBNQBJ
HBIUJNCVMOZBCVOZJZBOHKFMBT5FSOZBUB QFOZFCBCCVOZJJBMBI TJLMVTEFUJLEBONFNVODBLQBEBTFLJUBSTJLMVTEFUJL TFQFS
HFUBSBO QBEB LBUVQ ZBOH UFHBOH TFHFSB TFUFMBI QFOVUVQBO CFS UJEJJMVTUSBTJLBOQBEBEBFSBICFSCBZBOHCBHJBOCBXBI (BNCBS
TBNB EFOHBO HFUBSBO EJOEJOH KBOUVOH ZBOH CFSEFLBUBO EBO 6OUVLBMBTBOJOJ CBHJBOVUBNBCVOZJKBOUVOHEBQBUEJSF
QFNCVMVIQFNCVMVI VUBNB TFLJUBS KBOUVOH +BEJ VOUVL NFODF LBN TFDBSB FMFLUSPOJL NFOHHVOBLBO GPOPLBSEJPHSBN NFTLJ
UVTLBO CVOZJ KBOUVOH QFSUBNB LPOUSBLTJ WFOUSJLFM NVMBNVMB QVOCVOZJKBOUVOHUFSTFCVUUJEBLEBQBUEJEFOHBSEFOHBOTUFUP
NFOZFCBCLBO BMJSBO CBMJL EBSBI TFDBSB UJCBUJCB ZBOH NFOHFOBJ TLPQ
LBUVQ"7 LBUVQNJUSBMEBOLBUVQUSJLVTQJE
TFIJOHHBLBUVQJOJ #VOZJ KBOUVOH LFEVB OPSNBMOZB NFNJMJLJ GSFLVFOTJ MFCJI
NFOVUVQ EBO NFOHFNCVOH LF BSBI BUSJVN TBNQBJ LPSEB UJOHHJ EBSJQBEB CVOZJ KBOUVOH QFSUBNB LBSFOB EVB BMBTBO
UFOEJOFB TFDBSB UJCBUJCB NFOHIJMBOHLBO QFOHFNCVOHBO JOJ CFSJLVU
LFUFHBOHBO LBUVQ TFNJMVOBSJT KBVI MFCJI CFTBS
&MBTUJTJUBTLPSEBUFOEJOBFEBOLBUVQZBOHUFHBOHLFNVEJBOBLBO EJCBOEJOHLBOEFOHBOLBUVQ"7EBO
MFCJICFTBSOZBLPFGJ
265
Unit IV Sirkulasi
Dynes/cm2
TJFO FMBTUJTJUBT LFUFHBOHBO EJOEJOH BSUFSJ ZBOH NFSVQBLBO

SVBOH HFUBS VUBNB VOUVL CVOZJ LFEVB EJCBOEJOHLBO EFOHBO
CFEBCFEB .FTLJQVO CVOZJ EBSJ TFMVSVI LBUVQ EBQBU EJEFOHBS
SVBOH WFOUSJLFM ZBOH KBVI MFCJI MPOHHBS EBO LVSBOH FMBTUJT
EBSJ TFMVSVI EBFSBI JOJ QBSB BIMJ KBOUVOH NFOHFOBMJ CVOZJ EBSJ
ZBOH NFSVQBLBO TJTUFN HFUBS CVOZJ KBOUVOH QFSUBNB 1BSB
CFSCBHBJ LBUVQ NFMBMVJ QSPTFT FMJNJOBTJ ZBJUV EFOHBO NFNJO
LMJOJTJNFOHHVOBLBOQFSCFEBBOCVOZJJOJVOUVLNFNCFEBLBO
EBILBOTUFUPTLPQEBSJTVBUVUFNQBULFUFNQBUMBJOOZB NFNQFS
TJGBUTJGBULIVTVTQBEBLFEVBCVOZJUFSTFCVU
IBUJLBOLFLFSBTBOTVBSBEJUFNQBUZBOHCFSCFEBEBOTFDBSBCFSUB
IBQNFNJMJILPNQPOFOLPNQPOFOTVBSBEBSJTFUJBQLBUVQ
Bunyi Jantung Ketiga. ,BEBOHLBEBOH UFSEFOHBS CVOZJ
5FNQBU VOUVL NFOEFOHBSLBO CFSCBHBJ CVOZJ KBOUVOH UJEBL
KBOUVOH LFUJHB ZBOH MFNBI EBO CFSHFNVSVI QBEB BXBM TFQFS
UFQBU EJ BUBT LBUVQ ZBOH BLBO EJEFOHBSLBO 5FNQBU NFOEFOHBS
UJHBCBHJBOUFOHBIEJBTUPM,FUFSBOHBOMPHJTOBNVOCFMVNUFS
LBOCVOZJLBUVQBPSUBUFSMFUBLEJBUBTBPSUBLBSFOBQFOHIBOUBSBO
CVLUJNFOHFOBJCVOZJJOJJBMBIPTJMBTJEBSBICPMBLCBMJLBOUBSB
TVBSB OBJL LF BPSUB EBO EBFSBI QVMNPOBM UFSMFUBL EJ BUBT BSUFSJ
EJOEJOHEJOEJOHWFOUSJLFMZBOHEJDFUVTLBOPMFINBTVLOZBEB
QVMNPOBMJT%BFSBIUSJLVTQJECFSBEBEJBUBTWFOUSJLFMLBOBO EBO
SBI EFOHBO DFQBU EBSJ BUSJVN ,FBEBBO JOJ BOBMPH EFOHBO BJS
EBFSBINJUSBMEJBUBTBQFLTWFOUSJLFMLJSJ ZBOHNFSVQBLBOCBHJBO
LSBO ZBOH NFOHBMJS NBTVL LF EBMBN TFCVBI LBOUPOH LFSUBT
KBOUVOHUFSEFLBUEFOHBOEJOEJOHEBEBKBOUVOHCFSQVUBSTFEFNJ
"MJSBO BJS JOJ BLBO CFSHFUBS CPMBLCBMJL BOUBSB EJOEJOHEJO
LJBO SVQB TFIJOHHB TFCBHJBO CFTBS WFOUSJLFM LJSJ UFSMFUBL MFCJI EJ
EJOH LBOUPOH TFIJOHHB EJOEJOH LBOUPOH KVHB JLVU CFSHFUBS
CFMBLBOH
"MBTBOCVOZJKBOUVOHLFUJHBCBSVUFSEFOHBSQBEBTFQFSUJHBCB
HJBO UFOHBI EJBTUPM JBMBI NVOHLJO LBSFOB QBEB QFSNVMBBO
EJBTUPM WFOUSJLFM CFMVN DVLVQ UFSJTJ TFIJOHHB CFMVN UFSEBQBU Fonokardiogram
UFHBOHBOFMBTUJLZBOHDVLVQEBMBNWFOUSJLFMVOUVLNFOJNCVM +JLBTVBUVNJLSPGPOZBOHEJCVBULIVTVTVOUVLNFOEFUFLTJTVBSB
LBOMFOUJOHBO'SFLVFOTJCVOZJJOJCJBTBOZBCFHJUVSFOEBITF CFSGSFLVFOTJ SFOEBI EJUFNQBULBO EJ EBEB CVOZJ KBOUVOH EBQBU
IJOHHB UFMJOHB LJUB UJEBL EBQBU NFOEFOHBSOZB OBNVO CVOZJ EJQFSLFSBT EBO EJSFLBN PMFI BMBU QFSFLBN CFSLFDFQBUBO UJOHHJ
TFSJOHLBMJEBQBUEJSFLBNQBEBGPOPLBSEJPHSBN 1FSFLBN JOJ EJTFCVU GPOPLBSEJPHSBN EBO CVOZJ KBOUVOH UBNQBL
TFCBHBJ HFMPNCBOH TFQFSUJ ZBOH UFSMJIBU TFDBSB TLFNBUJT QBEB
(BNCBS3FLBNBO"NFSVQBLBODPOUPICVOZJKBOUVOHOPS
Bunyi Atrium (Bunyi Jantung Keempat). #VOZJ BUSJVN
NBM NFNQFSMJIBULBOHFUBSBOCVOZJKBOUVOHQFSUBNB LFEVB EBO
LBEBOHLBEBOH EBQBU UFSFLBN QBEB GPOPLBSEJPHSBN UFUBQJ
LFUJHB CBILBOCVOZJBUSJVNZBOHTBOHBUMFNBI,IVTVTOZBQFS
EFOHBOTUFUPTLPQIBNQJSUJEBLEBQBUUFSEFOHBSLBSFOBGSFLVF
IBUJLBO CVOZJ KBOUVOH LFUJHB EBO CVOZJ BUSJVN NBTJOHNBTJOH
OTJOZB ZBOH SFOEBI EBO MFNBI CJBTBOZB TJLMVTEFUJL BUBV
NFSVQBLBO CVOZJ HFNVSVI CFSGSFLVFOTJ TBOHBU SFOEBI #VOZJ
LVSBOH#VOZJJOJUJNCVMTBBUBUSJVNCFSLPOUSBLTJ EBOLFNV
KBOUVOH LFUJHB IBOZB EBQBU EJSFLBN QBEB TFQFSUJHB TBNQBJ
OHLJOBOEJTFCBCLBOPMFINFMVODVSOZBEBSBILFEBMBNWFOUSJ
LFM TFIJOHHB NFOJNCVMLBO HFUBSBO TFQFSUJ ZBOH UFSKBEJ QBEB TFUFOHBI EBSJ TFMVSVI NBOVTJB TFEBOHLBO CVOZJ BUSJVN EBQBU
CVOZJKBOUVOHLFUJHB EJSFLBNNVOHLJOQBEBTFQFSFNQBUEBSJTFMVSVINBOVTJB
Kelainan Katup
Tempat di Permukaan Dada untuk Melakukan
Kelainan Katup Reumatik
Auskultasi Bunyi Jantung Normal.
4BNQBJ TFKBVI JOJ KVNMBI UFSCFTBS LFMBJOBO LBUVQ BEBMBI BLJCBU
6OUVL NFOEFOHBSLBO TVBSBTVBSB EBMBN UVCVI CJBTBOZB EFNBN SFVNBUJL %FNBN SFVNBUJL BEBMBI QFOZBLJU BVUPJNVO
NFNBLBJTUFUPTLPQ EJTFCVUBVTLVMUBTJ(BNCBSNFNQFS ZBOHNFSVTBLBUBVNFOHIBODVSLBOLBUVQLBUVQKBOUVOH1FSJTUJ
MJIBULBO UFNQBUUFNQBU QBEB EJOEJOH EBEB ZBOH NFSVQBLBO XBJOJCJBTBOZBEJDFUVTLBOPMFIUPLTJOTUSFQUPLPLVTEFOHBODBSB
UFNQBUUFSCBJLVOUVLNFOHFOBMJCVOZJLBUVQKBOUVOHZBOHCFS TFCBHBJCFSJLVU
266
Bab 23 Katup jantung dan Bunyi Jantung; Kelainan Katup dan Jantung Bawaan
,BUVQZBOHEBVOEBVOOZBTBMJOHNFMFLBUEFNJLJBOIFCBU
TFIJOHHBEBSBIUJEBLEBQBUNFMBMVJOZBCJBTBOZBEJLBUBLBO
NFOHBMBNJTUFOPTJT4FCBMJLOZB CJMBUFQJUFQJLBUVQCBOZBL
NFOHBMBNJ LFSVTBLBO PMFI KBSJOHBO QBSVU TFIJOHHB LBUVQ
UNIT IV
JUV UJEBL EBQBU NFOVUVQ LFUJLB WFOUSJLFM CFSLPOUSBLTJ
NBLB UFSKBEJ SFHVSHJUBTJ BMJSBO CBMJL
EBSBI LUFJLB LBUVQ
TBSVTOZBUFSUVUVQ#JBTBOZBUJEBLBEBTUFOPTJTZBOHUFSKBEJ
UBOQBEJTFSUBJPMFITFEJLJUOZBCFCFSBQBEFSBKBUSFHVSHJUBTJ
EFNJLJBOQVMBTFCBMJLOZB
Penyebab Lain Klainan Katup. 4UFOPTJT BUBV UJEBL
BEBOZB TBUV BUBV MFJI EBVO LBUVQ LBEBOHLBEBOH KVHB
UFSKBEJTFCBHBJLFMBJOBOLPOHFOJUBM,FBEBBOUJEBLBEBOZB
EBVOLBUVQTBNBTFLBMJKBSBOHUFSKBEJTUFOPTJTLPOHFOJUBM
CFSTJGBUMFCJITFSJOH EBOJOJBLBOEJVSBJLBOLFNVEJBOEJ
CBCJOJ
Murmur Jantung yang Disebabkan oleh Kelainan Katup
1BEB GPOPLBSEJPHSBN EBMBN (BNCBS UFSMJIBU CFSCBHBJ
CVOZJ KBOUVOH BCOPSNBM ZBOH EJLFOBM TFCBHBJ NVSNVS
KBOUVOH ZBOH UFSKBEJ CJMB UFSEBQBU LFMBJOBO LBUVQ TFCBHBJ
CFSJLVU
6SVUBO LFKBEJBO IBNQJS TFMBMV EJNVMBJ EFOHBO JOGFLTJ
TUSFQUPLPLVT ZBOH EJTFCBCLBO TFDBSB TQFTJGJL PMFI TUSFQUPLPLVT Murmur Sistolik pada Stenosis Katup Aorta. 1BEB TUFOPTJT
IFNPMJUJL HSVQ " #BLUFSJ JOJ QBEB BXBMOZB NFOZFCBCLBO OZFSJ BPSUB EBSBI EJTFNCVSLBO EBSJ WFOUSJLFM LJSJ NFMBMVJ TFCVBI
UFOHHPSPLBO TDBSMFU GFWFS BUBV JOGFLTJ UFMJOHB UFOHBI 5FUBQJ MVCBOH EFOHBO KBSJOHBO GJCSPTB ZBOH TFNQJU EJ LBUVQ BPSUB
TUSFQUPLPLVT KVHB NFMFQBTLBO CFCFSBQB QSPUFJO CFSCFEB VOUVL "LJCBU BEBOZB UBIBOBO UFSIBEBQ FKFLTJ LBEBOHLBEBOH UFLB
NFMBXBO BOUJCPEJ ZBOH UFSCFOUVL PMFI TJTUFN SFUJLVMPFOEPUFMJBM OBOEBSBIEBMBNWFOUSJLFMLJSJNFOJOHLBUTBNQBJTFUJOHHJ
NBOVTJB"OUJCPEJCFSFBLTJUJEBLIBOZBEFOHBOQSPUFJOTUSFQUP NN)H TFNFOUBSBUFLBOBOEJBPSUBUFUBQOPSNBM+BEJ UFSCFO
LPLVTUFUBQJKVHBEFOHBOQSPUFJOKBSJOHBOUVCVIMBJO TFSJOHLBMJ UVLFGFLQJQBTFNQSPU OP[[MFFGGFDU
ZBOHUFSKBEJTFMBNBTJTUPM
NFOJNCVMLBO LFSVTBLBO JNVOPMPHJT ZBOH CFSBU 3FBLTJ JOJ CFS EFOHBOEBSBIZBOHEJTFNCVSLBOEFOHBOLFDFQBUBOTBOHBUUJO
MBOKVU UFSVT TFMBNB BOUJCPEJ NFOFUBQ EBMBN EBSBI UBIVO BUBV HHJ NFMBMVJ MVCBOH LFDJM EJ LBUVQ ,FBEBBO JOJ NFOZFCBCLBO
MFCJI UVSCVMFOTJ IFCBU QBEB EBSBI EJ QBOHLBM BPSUB %BSBI UVSCVMFO
%FNBN SFVNBUJL NFOZFCBCLBO LFSVTBLBO UFSVUBNB EJ EBF ZBOH NFOHFOBJ EJOEJOH BPSUB NFOJNCVMLBO HFUBSBO ZBOH IF
SBI ZBOH QFLB TFQFSUJ LBUVQ KBOUVOH %FSBKBU LFSVTBLBO LBUVQ CBU TFIJOHHB UJNCVM NVSNVS ZBOH LFSBT MJIBU SFLBNBO #
KBOUVOH CFSCBOEJOH MBOHTVOH EFOHBO LBEBS EBO MBNBOZB BOUJ (BNCBS
TBBU TJTUPM EBO EJIBOUBSLBO EJ TFQBOKBOH BPSUB
CPEJ JOJ CFSBEB EBMBN UVCVI 1SJOTJQQSJOTJQ JNVOJUBT ZBOH TVQFSJPS EBO CBILBO LF EBMBN BSUFSJBSUFSJ CFTBS EJ MFIFS
CFSLBJUBOEFOHBOKFOJTSFBLTJJOJEJCBIBTEJ#BC EBOEJ#BC 4VBSB JOJ LBTBS EBO QBEB TUFOPTJT CFSBU LBEBOHLBEBOH EFNJ
LBSFOB HMPNFSVMPOFGSJUJT BLVU HJOKBM NFNQVOZBJ EBTBS JNVOPMP LJBO LFSBTOZB TFIJOHHB EBQBU UFSEFOHBS QBEB KBSBL CFCFSBQB
HJTZBOHTBNB LBLJ EBSJ QBTJFO 4FMBJO JUV HFUBSBO TVBSB TFSJOH EBQBU UFSBCB
PMFIUBOHBOZBOHEJMFUBLLBOEJEBEBCBHJBOBUBTEBOMFIFSCBHJ
1BEB EFNBN SFVNBUJL UFSKBEJ QFSUVNCVIBO MFTJ CFSCFOKPM
BOCBXBI QFSJTUJXBJOJEJLFOBMTFCBHBJUISJMM
ZBOH NFOHBOEVOH GJCSJO EBO EJTFSUBJ QFSEBSBIBO MVBT EJ
TFQBOKBOHUFQJLBUVQKBOUVOHZBOHNFSBEBOH0MFILBSFOBLBUVQ Murmur Diastolik pada Regurgitasi Katup Aorta. 1BEB
NJUSBM NFOFSJNB MFCJI CBOZBL USBVNB TFXBLUV LFSKB EJCBOEJOH SFHVSHJUBTJ BPSUB UJEBL UFSEFOHBS TVBSB BCOPSNBM TFMBNB TJT
LBUVQLBUVQMBJOOZB NBLBLBUVQJOJZBOHQBMJOHTFSJOHNFOHBMB UPM UFUBQJTFMBNBEJBTUPM EBSBINFOHBMJSCBMJLEBSJBPSUBCFSUF
NJ LFSVTBLBO TFSJVT TFEBOHLBO LBUVQ BPSUB NFSVQBLBO LBUVQ LBOBOUJOHHJ LF WFOUSJLFM LJSJ NFOJNCVMLBO NVSNVS TFQFSUJ
LFEVB ZBOH TFSJOH NFOHBMBNJ DFEFSB #JMB LBUVQ KBOUVOH LBOBO TVBSB NFOJVQ ZBOH SFMBUJG CFSOBEB UJOHHJ EFOHBO EFTJT ZBOH
ZBOHUFSLFOB ZBJUVLBUVQUSJLVTQJEEBOQVMNPOBM CJBTBOZBUJEBL UFSEFOHBS NBLTJNBM EJ BUBT WFOUSJLFM LJSJ MJIBU SFLBNBO %
CFHJUV CFSBU LFNVOHLJOBO LBSFOB UFLBOBO TUSFT SFOEBI ZBOH (BNCBS
.VSNVS JOJ EJBLJCBULBO PMFI UVSCVMFOTJ EBSBI
CFLFSKB QBEB LBUVQLBUVQ JOJ MFCJI LFDJM EJCBOEJOH EFOHBO UFLB ZBOHNFOZFNCVSCBMJLEBOCFSUFNVEFOHBOEBSBIZBOHUFMBI
OBOTUSFTUJOHHJZBOHCFLFSKBQBEBLBUVQLBUVQKBOUVOHLJSJ CFSBEBEBMBNUFLBOBOEJBTUPMJLWFOUSJLFMLJSJZBOHSFOEBI
Murmur Sistolik pada Regurgitasi Katup Mitral. 1BEB
Parut pada Katupa -FTJ QBEB EFNBN SFVNBUJL BLVU TFSJOH SFHVSHJUBTJNJUSBM EBSBINFOHBMJSCBMJLNFMBMVJLBUVQNJUSBMLF
LBMJUFSKBEJTFDBSBCFSTBNBBOQBEBEBVOLBUVQZBOHCFSEFLBUBO EBMBNBUSJVNLJSJTFMBNBTJTUPM,FBEBBOJOJKVHBNFOJNCVMLBO
TFIJOHHBUFQJUFQJEBVONFMFLBUNFOKBEJTBUV#FCFSBQBNJOHHV TVBSB TFQFSUJ UJVQBO CFSGSFLVFOTJ UJOHHJ EBO TVBSB NFOEF
CVMBO BUBV UBIVO LFNVEJBO MFTJ NFOKBEJ KBSJOHBO QBSVU ZBOH TJT MJIBUSFLBNBO$ (BNCBS
ZBOHTFSVQBEFOHBOCVOZJ
TFDBSB QFSNBOFO NFOZBUVLBO CBHJBOCBHJBO EBVO LBUVQ ZBOH QBEBSFHVSHJUBTJLBUVQBPSUBUFUBQJUFSKBEJTBBUTJTUPM4VBSBJOJ
CFSEFLBUBO 4FMBJO JUV CBHJBO UFQJ EBVO ZBOH CFCBT ZBOH QBEB UFSVUBNB EJIBOUBSLBO EFOHBO LFSBT LF BUSJVN LJSJ /BNVO
LFBEBBO OPSNBM CFSTJGBU TFQFSUJ MFNCBSBO GJMN EBO CFSLJCBS BUSJVNLJSJUFSMFUBLEBMBNTFLBMJEJSPOHHBEBEBTFIJOHHBTVLBS
CFCBT TFSJOHLBMJNFOKBEJNBTTBQBSVUZBOHLBLV VOUVLNFOEFOHBSLBOTVBSBJOJUFQBUEJBUBTBUS
267
Unit IV Sirkulasi
JVN"LJCBUOZB TVBSBQBEBSFHVSHJUBTJNJUSBMEJIBOUBSLBOLF 1BEB SFHVSHJUBTJ SVBOH WFOUSJLFM LJSJ KVHB NFNCFTBS VOUVL
EJOEJOHEBEBUFSVUBNBNFMBMVJWFOUSJLFMLJSJLFBQFLTKBOUVOH NFOBNQVOH TFMVSVI EBSBI ZBOH LFNCBMJ EBSJ BPSUB ,BEBOH
Murmur Diastolik pada Stenosis Katup Mitral. 1BEBTUFOPTJT LBEBOH NBTTB PUPU WFOUSJLFM LJSJ CFSUBNCBI FNQBU TBNQBJ MJNB
LBUVQ NJUSBM EBSBI NFOHBMJS EBSJ BUSJVN LJSJ LF WFOUSJLFM LJSJ LBMJMJQBU NFNCVBUKBOUVOHLJSJTBOHBUCFTBS
NFMBMVJ LBUVQ NJUSBM ZBOH NFOHBMBNJ TUFOPTJT EFOHBO TVTBI #JMB LBUVQ BPSUB NFOHBMBNJ TUFOPTJT CFSBU PUPU ZBOH IJQFSUSPGJ
QBZBI EBOLBSFOBUFLBOBOEBMBNBUSJVNLJSJKBSBOHNFOJOHLBU JOJ NFNVOHLJOLBO WFOUSJLFM LJSJ VOUVL NFOJNCVMLBO UFLBOBO
EJ BUBT NN )H TFMJTJI UFLBOBO ZBOH CFTBS VOUVL NFOEP JOUSBWFOUSJLFMTFCFTBSNN)HQBEBQVODBLTJTUPMJL
SPOH EBSBI EBSJ BUSJVN LJSJ LF WFOUSJLFM LJSJ UJEBL UFSKBEJ 1BEB SFHVSHJUBTJ LBUVQ BPSUB ZBOH CFSBU PUPU ZBOH IJQFSUSPGJ
"LJCBUOZB CVOZJ BCOPSNBM ZBOH UFSEFOHBS QBEB TUFOPTJT LBEBOHLBEBOH NFNVOHLJOLBO WFOUSJLFM LJSJ VOUVL
LBUVQ NJUSBM MJIBU SFLBNBO & (BNCBS
CJBTBOZB MFNBI
NFNPNQBLBODVSBIWPMVNFTFLVODVQTFCFTBSNM XBMBVQVO
EBO EFOHBO GSFLVFOTJ TBOHBU SFOEBI TFIJOHHB TFCBHJBO CFTBS
UJHB QFSFNQBU EBSJ KVNMBI EBSBI JOJ LFNCBMJ LF WFOUSJLFM TFMBNB
TQFLUSVN TVBSB CFSBEB EJ CBXBI GSFLVFOTJ UFSFOEBI EBSJ
EJBTUPM EBOIBOZBTFQFSFNQBUOZBNFOHBMJSUFSVTLFBPSUBNFOVKV
QFOEFOHBSBONBOVTJB
TFMVSVIUVCVI
4FMBNB CBHJBO BXBM EJBTUPM WFOUSJLFM LJSJ EFOHBO LBUVQ
NJUSBMZBOHTUFOPTJTNFOHBOEVOHTFEJLJUTFLBMJEBSBIEBOEJO
Peningkatan Volume Darah. &GFL MBJO ZBOH NFNCBOUV
EJOHOZBEFNJLJBOMVOBLTFIJOHHBEBSBIUJEBLNFNBOUVMCPMBL
NFOHPNQFOTBTJ QFOVSVOBO IBTJM CFSTJI QFNPNQBBO WFOUSJLFM
CBMJL EJ BOUBSB EJOEJOHEJOEJOH WFOUSJLFM 0MFI LBSFOB BMBTBO
LJSJ JBMBI QFOJOHLBUBO WPMVNF EBSBI *OJ UFSKBEJ BLJCBU EBSJ

JOJ CBILBO QBEB TUFOPTJT LBUVQ NJUSBM ZBOH IFCBU TFLBMJ QVO
TFEJLJU QFOVSVOBO UFLBOBO BSUFSJ QBEB BXBMOZB EJUBNCBI

TBNBTFLBMJUJEBLUFSEFOHBSNVSNVSTFMBNBTFQFSUJHBBXBMEJB
SFGMFLT TJSLVMBTJ QFSJGFS ZBOH EJJOEVLTJ PMFI QFOVSVOBO UFLBOBO
TUPM ,FNVEJBO TFUFMBI UFSJTJ TFCBHJBO WFOUSJLFM UFMBI DVLVQ
UFSTFCVU ,FEVB IBM JOJ NFOHVSBOHJ QFNCFOUVLBO VSJOF PMFI
UFSFHBOH TFIJOHHB EBSBI EJQBOUVMLBO CPMBLCBMJL EBO NVMBJ
HJOKBM TFIJOHHBWPMVNFEBSBINFOJOHLBUEBOUFLBOBOBSUFSJSBUB
UFSKBEJNVSNVSZBOHCFSHFNVSVISFOEBI
SBUB LFNCBMJ OPSNBM 4FMBJO JUV NBTTB TFM EBSBI NFSBI BLIJSOZB
Fonokardiogram Murmur Katup. 'POPLBSEJPHSBN # $ % NFOJOHLBUBLJCBUIJQPLTJBSJOHBOQBEBKBSJOHBO
EBO & QBEB (BNCBS NFNQFSMJIBULBO TFDBSB CFSUVSVU 1FOJOHLBUBO WPMVNF EBSBI DFOEFSVOH NFOJOHLBULBO BMJSBO
UVSVU SFLBNBO JEFBM EBSJ QBTJFO TUFOPTJT LBUVQ BPSUB SFHVSHJ CBMJLWFOBLFKBOUVOH)BMJOJTFMBOKVUOZBNFOZFCBCLBOWFOUSJLFM
UBTJ LBUVQ NJUSBM SFHVSHJUBTJ LBUVQ BPSUB EBO TUFOPTJT LBUVQ LJSJNFNPNQBLBOEBSBIEFOHBOUFLBOBOFLTUSBZBOHEJCVUVILBO
NJUSBM +FMBT UFSMJIBU EBSJ GPOPLBSEJPHSBN JOJ CBIXB MFTJ QBEB VOUVLNFOHJNCBOHJBCOPSNBMJUBTEJOBNJLBQFNPNQBBO
TUFOPTJTLBUVQBPSUBNFOJNCVMLBOCVOZJNVSNVSQBMJOHLFSBT
TFEBOHLBOMFTJQBEBTUFOPTJTLBUVQNJUSBMNFOJNCVMLBOCVOZJ
UFSMFNBI 'POPLBSEJPHSBN NFNQFSMJIBULBO CBHBJNBOB JOUFO
Pada Akhirnya Terjadi Gagal Ventrikel Kiri, dan Timbul
TJUBTNVSNVSCFSWBSJBTJTFMBNBCFSCBHBJCBHJBOTJTUPMEBOEJBT
Edema Paru
UPM EBOMBNBOZBTFUJBQNVSNVSSFMBUJGKVHBUFSMJIBUKFMBT1FS 1BEB TUBEJVN BXBM TUFOPTJT BPSUB BUBV SFHVSHJUBTJ BPSUB
IBUJLBOUFSVUBNBCBIXBNVSNVSQBEBTUFOPTJTLBUVQBPSUBEBO LFNBNQVBO JOUSJOTJL WFOUSJLFM LJSJ VOUVL CFSBEBQUBTJ UFSIBEBQ
SFHVSHJUBTJLBUVQNJUSBMIBOZBUFSKBEJTFMBNBTJTUPM TFEBOHLBO QFOJOHLBUBOCFCBOEBQBUNFOHIJOEBSJUFSKBEJOZBHBOHHVBOZBOH
NVSNVSQBEBSFHVSHJUBTJLBUVQBPSUBEBOTUFOPTJTLBUVQNJUSBM CFSBSUJQBEBGVOHTJTJSLVMBTJTFTFPSBOHTFMBNBCFSJTUJSBIBU EJMVBS
IBOZBUFSKBEJTFMBNBEJBTUPM+JLBQFNCBDBUJEBLNFOHFSUJNF QFOJOHLBUBOIBTJMLFSKBZBOHEJCVUVILBOPMFIWFOUSJLFMLJSJ0MFI
OHFOBJTBBUTBBUUFSKBEJOZBNVSNVSJOJTFCBJLOZBCBDBLFNCBMJ TFCBCJUV TFSJOHUFMBIUFSKBEJTUFOPTJTBPSUBBUBVSFHVSHJUBTJBPSUB
TBNQBJBLIJSOZBEBQBUNFOHFSUJ ZBOH TBOHBU CFSBU TFCFMVN QBTJFO NFOHFUBIVJ CBIXB JB
NFOEFSJUB QFOZBLJU KBOUVOH CFSBU NJTBMOZB UFLBOBO TJTUPMJL
Dinamika Sirkulasi Abnormal pada Penyakit
EBMBNWFOUSJLFMLJSJQBEBTBBUJTUJSBIBUTFUJOHHJNN)HQBEB
Katup Jantung
TUFOPTJT BPSUB BUBV DVSBI WPMVNF TFLVODVQ WFOUSJLFM LJSJ UFMBI
Dinamika Sirkulasi pada Stenosis Katup Aorta dan NFOKBEJEVBLBMJMJQBUOPSNBMQBEBSFHVSHJUBTJBPSUB

Regurgitasi Katup Aorta %J BUBT UJOHLBU LSJUJT LFMBJOBO LBUVQ BPSUB JOJ WFOUSJLFM LJSJ
1BEBTUFOPTJTLBUVQBPSUB WFOUSJLFMLJSJZBOHCFSLPOUSBLTJUJEBL BLIJSOZB UJEBL EBQBU NFOZFTVBJLBO EJSJ MBHJ EFOHBO CFCBO LFSKB
EBQBU NFOHPTPOHLBO EJSJ TFDBSB BEFLVBU TFEBOHLBO QBEB "LJCBUOZB WFOUSJLFMLJSJNFMFCBSEBODVSBIKBOUVOHNVMBJUVSVO
SFHVSHJUBTJ LBUVQ BPSUB EBSBI NFOHBMJS LFNCBMJ LF WFOUSJLFM EBSBI QBEB TBBU ZBOH CFSTBNBBO UFSUJNCVO EJ BUSJVN LJSJ EBO EJ
EBSJBPSUBTFUFMBIWFOUSJLFMNFNPNQBLBOEBSBILFBPSUB0MFI QBSV EJ CFMBLBOH WFOUSJLFM LJSJ ZBOH LFQBZBIBO 5FLBOBO BUSJVN
LBSFOBJUV QBEBLBTVTZBOHNBOBQVO DVSBIWPMVNFTFLVODVQ LJSJNFOJOHLBUTFDBSBQSPHSFTJG EBOQBEBUFLBOBOBUSJVNLJSJSBUB
OFUUPKBOUVOHCFSLVSBOH SBUBEJBUBTTBNQBJNN)H NVODVMFEFNBEJQBSV TFQFSUJ
5FSKBEJCFCFSBQBLPNQFOTBTJQFOUJOHZBOHEBQBUNFOHVSB ZBOHEJVSBJLBOTFDBSBEFUBJMEJ#BC
OHJLFQBSBIBOLFMBJOBOTJSLVMBTJJOJ#FCFSBQBLPNQFOTBTJUFS
TFCVUJBMBITFCBHBJCFSJLVU Dinamika Stenosis Katup Mitral dan Regurgitasi Katup
Mitral
Hipertrofi Ventrikel Kiri. 1BEB TUFOPTJT BPSUB EBO 1BEBTUFOPTJTNJUSBM BMJSBOEBSBIEBSJBUSJVNLJSJLFWFOUSJLFMLJSJ
SFHVSHJUBTJ BPSUB PUPU WFOUSJLFM LJSJ NFOHBMBNJ IJQFSUSPGJ UFSIBNCBU TFEBOHLBOQBEBSFHVSHJUBTJNJUSBM CBOZBLEBSBIZBOH
BLJCBUQFOJOHLBUBOCFCBOLFSKBWFOUSJLFM UFMBINFOHBMJSLFWFOUSJLFMLJSJCPDPSLFNCBMJLFBUSJVNLJSJTFMB
268
NB TJTUPM EBO CVLBO EJQPNQBLBO LF BPSUB 0MFI LBSFOB JUV FO QFOZBLJU LBUVQ NJUSBM LFSKB GJTJL EBQBU NFOZFCBCLBO
TFUJBQLPOEJTJJOJNFOHVSBOHJKVNMBIOFUUPEBSBIZBOHNFOHBMJS QFOJNCVOBO EBSBI ZBOH CFHJUV CBOZBL EBMBN QBSV
EBSJBUSJVNLJSJLFWFOUSJLFMLJSJ TFIJOHHBFEFNBQBSVZBOHTFSJVTCBILBONFNBUJLBOEBQBU
UJNCVMEBMBNXBLUVNFOJU
UNIT IV
Edema Paru pada Penyakit Katup Mitral. 1FOJNCVOBOEBSBI 1BEB LBTVTLBTVT QFOZBLJU LBUVQ ZBOH SJOHBO TBNQBJ
EBMBN BUSJVN LJSJ NFOZFCBCLBO QFOJOHLBUBO QSPHSFTJG QBEB TFEBOH DBEBOHBO KBOUVOH QBTJFO CFSLVSBOH TFCBOEJOH
UFLBOBOBUSJVNLJSJ EBOJOJBLIJSOZBEBQBUNFOJNCVMLBOFEFNB EFOHBO CFSBUOZB LFMBJOBO GVOHTJ LBUVQ "SUJOZB DVSBI
QBSV TFSJVT #JBTBOZB FEFNB MFUBM UJEBL BLBO UFSKBEJ TBNQBJ KBOUVOHUJEBLNFOJOHLBUTFCFTBSZBOHTFIBSVTOZBTFMBNB
UFLBOBOSBUBSBUBBUSJVNLJSJOBJLEJBUBTNN)HEBOLBEBOH LFSKB GJTJL 0MFI LBSFOB JUV PUPUPUPU UVCVI BLBO DFQBU
LBEBOH TBNQBJ TFUJOHHJ NN )H LBSFOB UFSKBEJ QFMFCBSBO NFOHBMBNJ LFMFMBIBO LBSFOB QFOJOHLBUBO BMJSBO EBSBI
QFNCVMVI MJNGF QBSV CFCFSBQB LBMJ MJQBU TFIJOHHB EBQBU PUPUZBOHTFEJLJU
NFNCBXBDBJSBOEBSJKBSJOHBOQBSVEFOHBODFQBU
Pembesaran Atrium Kiri dan Fibrilasi Atrium. 5FLBOBOBUSJVN

LJSJZBOHUJOHHJKVHBNFOZFCBCLBOQFNCFTBSBOQSPHSFTJGBUSJVN
LJSJ NFOJOHLBULBO KBSBL ZBOH IBSVT EJUFNQVI PMFI JNQVMT Kelainan Dinamika Sirkulasi pada Kelainan
FLTJUBTJ FMFLUSJT KBOUVOH EJ EJOEJOH BUSJVN +BSBL JOJ BLIJSOZB Katup Kongenital
EBQBU NFNBOKBOH TFEFNJLJBO SVQB TFIJOHHB NFOKBEJ
QSFEJTQPTJTJ VOUVL UFSKBEJOZB HFSBL NFMJOHLBS TJOZBM FLTJUBTJ ,BEBOHLBEBOH KBOUVOH BUBV QFNCVMVIQFNCVMVI EBSBI EJ
TFQFSUJ ZBOH EJCBIBT EJ #BC 0MFI LBSFOB JUV QBEB TUBEJVN TFLJUBS KBOUVOH NFOHBMBNJ LFMBJOBO QFNCFOUVLBO TFMBNB
BLIJS QFOZBLJU LBUVQ NJUSBM UFSVUBNB QBEB TUFOPTJT NJUSBM LFIJEVQBO KBOJO LFMBJOBO JOJ EJTFCVU BOPNBMJ LPOHFOJUBM
CJBTBOZB UFSKBEJ GJCSJMBTJ BUSJVN )BM JOJ BLBO MFCJI NFOHVSBOHJ 5FSEBQBUUJHBKFOJTLFMBJOBOVUBNBBOPNBMJLPOHFOJUBMKBOUVOH
FGFLUJWJUBT QFNPNQBBO KBOUVOH EBO NFOZFCBCLBO LFBEBBO EBSJ QFNCVMVIQFNCVMVI EJ TFLJUBS KBOUVOH
TUFOPTJT
KBOUVOHZBOHMFCJICVSVL TBMVSBOEBSBIEJCFCFSBQBUFNQBUEJKBOUVOHBUBVEJQFNCVMVI
EBSBIVUBNBZBOHCFSIVCVOHBOFSBUEFOHBOKBOUVOH
TVBUV
Kompensasi pada Penyakit Katup Mitral Tahap Awal.4FQFSUJ BOPNBMJ ZBOH NFOHBLJCBULBO EBSBI NFOHBMJS LFNCBMJ EBSJ
ZBOH KVHB UFSKBEJ QBEB QFOZBLJU LBUVQ BPSUB EBO QBEB CBOZBL KBOUVOHLJSJBUBVBPSUBLFKBOUVOHLBOBOBUBVBSUFSJQVMNPOBM
KFOJTQFOZBLJUKBOUVOHLPOHFOJUBM WPMVNFEBSBINFOJOHLBUQBEB KBEJ UJEBL NFOHBMJS NFMBMVJ TJSLVMBTJ TJTUFNJL EJTFCVU QJSBV
QFOZBLJULBUVQNJUSBM UFSVUBNBBLJCBUCFSLVSBOHOZBFLTLSFTJBJS TIVOU
LJSJ LF LBOBO EBO
BOPNBMJ LFMBJOBO ZBOH
EBO HBSBN PMFI HJOKBM 1FOJOHLBUBO WPMVNF EBSBI JOJ BLBO NFOHBLJCBULBO EBSBI NFOHBMJS TFDBSB MBOHTVOH EBSJ KBOUVOH
NFOJOHLBULBO BMJSBO CBMJL WFOB LF KBOUVOH EFOHBO EFNJLJBO LBOBOLFKBOUVOHLJSJ KBEJUJEBLNFOHBMJSNFMBMVJQBSVEJTFCVU
NFNCBOUV NFOHBUBTJ FGFL LFSVTBLBO KBOUVOH 0MFI LBSFOB JUV QJSBVLBOBOLFLJSJ
TFUFMBILPNQFOTBTJ DVSBIKBOUVOHIBOZBUVSVONJOJNBMTBNQBJ 1FOHBSVI CFSCBHBJ MFTJ TUFOPUJL ZBOH CFSCFEB EBQBU
TUBEJVN BLIJS QFOZBLJU LBUVQ NJUSBM XBMBVQVO UFLBOBO BUSJVN EJNFOHFSUJ EFOHBO NVEBI 4FCBHBJ DPOUPI TUFOPTJT LBUVQ
LJSJNFOJOHLBU BPSUB LPOHFOJUBM BLBO NFOZFCBCLBO FGFL EJOBNJL ZBOH TBNB
0MFI LBSFOB UFLBOBO BUSJVN LJSJ NFOJOHLBU EBSBI NVMBJ TFQFSUJ TUFOPTJT LBUVQ BPSUB BLJCBU MFTJ LBUVQ MBJO ZBJUV
UFSUJNCVO EJ QBSV BLIJSOZB TFNVB NFOHBMJS CBMJL LF BSUFSJ LFDFOEFSVOHBO VOUVL UJNCVMOZB FEFNB QBSV CFSBU EBO
QVMNPOBMJT 4FMBJO JUV FEFNB QBSV ZBOH CBSV UFSKBEJ BLBO QFOVSVOBODVSBIKBOUVOH
NFOZFCBCLBO LPOTUSJLTJ BSUFSJPMBSUFSJPM QBSV ,FEVB IBM JOJ +FOJTMBJOTUFOPTJTLPOHFOJUBMBEBMBILPBSLUBTJPBPSUB TFSJOH
TFDBSB CFSTBNBTBNB BLBO NFOJOHLBULBO UFLBOBO BSUFSJ QVM UJNCVM IBNQJS TFUJOHHJ EJBGSBHNB )BM JOJ NFOZFCBCLBO
NPOBMJT TJTUPMJL EBO KVHB UFLBOBO WFOUSJLFM LBOBO LBEBOH UFLBOBOBSUFSJEJCBHJBOBUBTUVCVI EJBUBTUJOHLBULPBSLUBTJP

LBEBOHTBNQBJTFUJOHHJNN)H ZBOHCFSBSUJMFCJIEBSJEVB NFOKBEJ MFCJI CFTBS EBSJQBEB UFLBOBO EJ UVCVI CBHJBO CBXBI
LBMJOPSNBM,FBEBBOJOJTFMBOKVUOZBBLBONFOZFCBCLBOIJQFS BLJCBUBEBOZBUBIBOBOZBOHCFTBSUFSIBEBQBMJSBOEBSBIMFXBU
USPGJ KBOUVOH LBOBO ZBOH TFCBHJBO NFOHPNQFOTBTJ QFOJOH LPBSLUBTJP LF UVCVI CBHJBO CBXBI TFCBHJBO EBSBI IBSVT
LBUBOCFCBOLFSKBOZB NFOHBMJS NFOHFMJMJOHJ LPBSLUBTJP NFMBMVJ BSUFSJ LPMBUFSBM ZBOH
LFDJM TFQFSUJZBOHEJCBIBTEJ#BC
Dinamika Sirkulasi Selama Kerja Fisik pada Pasien dengan
Kelainan Katup Paten Duktus Arteriosus—Pirau Kiri ke Kanan
1BEB XBLUV LFSKB GJTJL TFKVNMBI CFTBS EBSBI WFOB LFNCBMJ LF 4FMBNB LFIJEVQBO KBOJO QBSV CFSBEB EBMBN LFBEBBO LPMBQT
KBOUVOH EBSJ TJSLVBTJ QFSJGFS 0MFI LBSFOB JUV TFNVB LFMBJOBO EBOGBLUPSGBLUPSLPNQSFTJFMBTUJLQBSVZBOHNFNQFSUBIBOLBO
EJOBNJLZBOHUFSKBEJQBEBCFSCBHBJKFOJTQFOZBLJULBUVQKBOUVOH BMWFPMJBHBSUFUBQLPMBQTKVHBNFNQFSUBIBOLBOTFCBHJBOCFTBS
UJNCVM LFNCBMJ TFDBSB MVBS CJBTB #BILBO QBEB QFOZBLJU LBUVQ QFNCVMVI EBSBI QBSV UFUBQ LPMBQT 0MFI LBSFOB JUV UBIBOBO
KBOUVOHSJOHBO ZBOHQBEBLFBEBBOJTUJSBIBUUJEBLNFOVOKVLLBO UFSIBEBQ BMJSBO EBSBI NFMBMVJ QBSV CFHJUV CFTBSOZB TFIJOHHB
HFKBMBTBNBTFLBMJ BLBOUJNCVMHFKBMBHFKBMBIFCBUTFXBLUVLFSKB UFLBOBOBSUFSJQVMNPOBMJTQBEBKBOJOUJOHHJ4FMBJOJUV LBSFOB
GJTJL SJOHBO 4FCBHBJ DPOUPI QBEB QBTJFO LFMBJOBO LBUVQ BPSUB UBIBOBOZBOHSFOEBIUFSIBEBQBMJSBOEBSBIEBSJBPSUBNFMBMVJ
LFSKBGJTJLEBQBUNFOZFCBCLBOUFSKBEJOZBHBHBMWFOUSJLFMLJSJBLVU QFNCVMVI CFTBS QMBTFOUB NBLB UFLBOBO EBMBN BPSUB KBOJO
ZBOHEJTVTVMEFOHBOFEFNBQBSVBLVU%FNJLJBOQVMBQBEBQBTJ MFCJISFOEBIEBSJQBEBOPSNBMCBILBOMFCJISFOEBIEBSJQBEB
269
Unit IV Sirkulasi
BSUFSJ QVMNPOBMJT )BM JOJ NFOHBLJCBULBO IBNQJS TFMVSVI Dinamika Sirkulasi pada Duktus Arteriosus Menetap
EBSBI BSUFSJ QVMNPOBMJT NFOHBMJS NFMBMVJ BSUFSJ LIVTVT ZBOH yang Persisten. 4FMBNB CVMBOCVMBO BXBM EBSJ LFIJEVQBO CBZJ
UFSEBQBUEBMBNKBOJOZBOHNFOHIVCVOHLBOBSUFSJQVMNPOBMJT EVLUVTBSUFSJPTVTNFOFUBQCJBTBOZBUJEBLNFOJNCVMLBOLFMBJOBO
EFOHBO BPSUB (BNCBS
ZBJUV EVLUVT BSUFSJPTVT KBEJ GVOHTJ ZBOH CFSBU 5BQJ TFJSJOH EFOHBO CFSUBNCBIOZB VTJB BOBL
NFNJOUBTQBSV,FBEBBOJOJNFNVOHLJOLBOSFTJSLVMBTJEBSBI QFSCFEBBO BOUBSB UFLBOBO UJOHHJ EJ BPSUB EBO UFLBOBO MFCJI
EFOHBO DFQBU NFMBMVJ BSUFSJ TJTUFNJL KBOJO UBOQB IBSVT SFOEBI EJ BSUFSJ QVMNPOBMJT NFOJOHLBU TFDBSB QSPHSFTJG EBO
NFMFXBUJ QBSV ,VSBOHOZB BMJSBO EBSBI NFMBMVJ QBSV UJEBL TFJSJOH EFOHBO JUV NFOJOHLBULBO KVNMBI EBSBI ZBOH NFOHBMJS
NFOJNCVMLBO LFSVHJBO CBHJ KBOJO LBSFOB EBSBI EJPLTJHFOBTJ CBMJL EBSJ BPSUB LF EBMBN BSUFSJ QVMNPOBMJT 4FMBJO JUV UFLBOBO
PMFIQMBTFOUB EBSBI BPSUB ZBOH UJOHHJ CJBTBOZB NFOZFCBCLBO EJBNFUFS EVLUVT
ZBOH UFSCVLB TFCBHJBO KVHB CFSUBNCBI CFTBS NFOHBLJCBULBO
Penutupan Duktus Arteriosus setelah Lahir. 4FHFSB LFBEBBOCFSUBNCBICVSVL
TFUFMBI CBZJ MBIJS EBO NVMBJ CFSOBQBT QBSVOZB NFOHFNCBOH Resirkulasi melalui Paru. 1BEB TFPSBOH BOBL MFCJI CFTBS
UJEBL IBOZB UFSKBEJ QFOHJTJBO BMWFPMJ PMFI VEBSB UFUBQJ KVHB ZBOHNFOHBMBNJEVLUVTBSUFSJPTVTNFOFUBQ TFUFOHBITBNQBJEVB
UBIBOBOUFSIBEBQBMJSBOEBSBIZBOHNFMBMVJWBTLVMBSJTBTJQBSV QFSUJHB BMJSBO EBSBI BPSUBOZB LFNCBMJ NFMBMVJ EVLUVT NBTVL LF
NFOHBMBNJ QFOVSVOBO IFCBU TFIJOHHB UFLBOBO BSUFSJ EBMBN BSUFSJ QVMNPOBMJT LFNVEJBO NFMBMVJ QBSV EBO BLIJSOZB
QVMNPOBMJT UVSVO #FSTBNBBO EFOHBO JUV UFLBOBO BPSUB OBJL LFNCBMJLFEBMBNWFOUSJLFMLJSJEBOBPSUB CFSKBMBONFMBMVJQBSV
BLJCBU UFSIFOUJOZB BMJSBO EBSBI EBSJ BPSUB LF QMBTFOUB TFDBSB EBO KBOUVOH LJSJ TFCBOZBL EVB LBMJ BUBV MFCJI VOUVL TFUJBQ LBMJ
NFOEBEBL+BEJ UFLBOBOEJBSUFSJQVMNPOBMJTUVSVO TFNFOUBSB EBSBINFMBMVJTJSLVMBTJTJTUFNJL0SBOHJOJUJEBLUFSMJIBUTJBOPTJT
UFLBOBOEJBPSUBOBJL4FCBHBJBLJCBUOZB BMJSBOEBSBILFEFQBO TBNQBJ BLIJS IJEVQOZB TBBU KBOUVOH NFOHBMBNJ LFHBHBMBO BUBV
NFMBMVJ EVLUVT UFSIFOUJ TFDBSB UJCBUJCB QBEB TBBU MBIJS EBO UFSKBEJCFOEVOHBOQBSV1BEBNBTBBXBMLFIJEVQBO EBSBIBSUFSJ
TFLBSBOH EBSBI NVMBJ NFOHBMJS UFSCBMJL EBSJ BPSUB LF BSUFSJ TFSJOH LBMJ UFSPLTJHFOBTJ MFCJI CBJL EBSJQBEB LFBEBBO OPSNBM
QVMNPOBMJTNFMBMVJEVLUVT,FBEBBOBMJSBOEBSBIUFSCBMJLZBOH BLJCBUBEBOZBXBLUVUBNCBIBOEBSBINFMFXBUJQBSV
CBSV JOJ NFOZFCBCLBO EVLUVT BSUFSJPTVT NFOVUVQ EBMBN
XBLUV CFCFSBQB KBN TBNQBJ CFCFSBQB IBSJ QBEB LFCBOZBLBO Penurunan Cadangan Jantung dan Respiratorik. &GFL
CBZJ TFIJOHHBBMJSBOEBSBIZBOHNFMBMVJEVLUVTUJEBLBEBMBHJ VUBNB EVLUVT BSUFSJPTVT NFOFUBQ UFSIBEBQ QBTJFO JBMBI
NFOVSVOOZB DBEBOHBO KBOUVOH EBO SFTQJSBUPSJL 7FOUSJLFM LJSJ
%VLUVT EJEVHB NFOVUVQ LBSFOB EBSBI BPSUB ZBOH TFLBSBOH
NFNPNQBLJSBLJSBEVBLBMJBUBVMFCJIDVSBIKBOUVOHOPSNBM EBO
NFOHBMJS NFMBMVJ EVLUVT NFNQVOZBJ LBEBS PLTJHFO EVB LBMJ
LFNBNQVBONBLTJNVNWFOUSJLFMVOUVLNFNPNQBTFUFMBIUFSKBEJ
MFCJI UJOHHJ EBSJQBEB EBSBI ZBOH NFOHBMJS EBSJ BSUFSJ
IJQFSUSPGJKBOUVOHBEBMBITFLJUBSFNQBUTBNQBJUVKVILBMJOPSNBM
QVMNPOBMJT LF EVLUVT TFMBNB LFIJEVQBO KBOJO ,FNVOHLJOBO
0MFI LBSFOB JUV TFMBNB LFSKB GJTJL KVNMBI OFUUP BMJSBO EBSBI LF
PLTJHFONFOZFCBCLBOLPOTUSJLTJPUPUEJOEJOHEVLUVT)BMJOJ
CBHJBOTJTBUVCVIZBOHMBJOUJEBLQFSOBIEBQBUNFOJOHLBUTBNQBJ
EJCBIBTMFCJIMBOKVUEJCBC
LF OJMBJ ZBOH EJCVUVILBO VOUVL BLUJWJUBT CFSBU 1BEB LFSKB GJTJL
ZBOH BHBL CFSBU QBTJFO UBNQBL NFOKBEJ MFNBI CBILBO QJOHTBO
LBSFOBHBHBMKBOUVOH
5FLBOBO ZBOH UJOHHJ EJ QFNCVMVI QBSV BLJCBU BMJSBO
CFSMFCJIBO NFMBMVJ QBSV TFSJOH LBMJ KVHB NFOJNCVMLBO
CFOEVOHBO QBSV EBO FEFNB QBSV 4FCBHBJ BLJCBU EBSJ CFCBO
CFSMFCJIBO QBEB KBOUVOH EBO LIVTVTOZB LBSFOB LPOHFTUJ
QVMNPOFS ZBOH TFDBSB CFSUBIBQ NFOKBEJ MFCJI CFSBU TFKBMBO
EFOHBOVTJB TFCBHJBOCFTBSQBTJFOEVLUVTNFOFUBQZBOHUJEBL
EJLPSFLTJBLBONFOJOHHBMBOUBSBVTJBEBOUBIVO
Bunyi Jantung: Murmur Suara Mesin. 1BEBCBZJCBSVMBIJS
EFOHBO EVLUVT BSUFSJPTVT NFOFUBQ LBEBOHLBEBOH UJEBL
UFSEFOHBS CVOZJ KBOUVOH BCOPSNBM LBSFOB KVNMBI BMJSBO EBSBI
ZBOH NFOHBMJS CBMJL NFMBMVJ EVLUVT CFMVN DVLVQ NFOJNCVMLBO
NVSNVS KBOUVOH 5BQJ EFOHBO CFSUBNCBIOZB VNVS CBZJ QBEB
VTJB TBNQBJ UBIVO NVMBJ UFSEFOHBS NVSNVS LBTBS TFQFSUJ
TVBSBCFSUJVQEJEBFSBIBSUFSJQVMNPOBMJTQBEBEBEB TFQFSUJZBOH
EJUVOKVLLBO QBEB SFLBNBO ' (BNCBS #VOZJ JOJ KBVI MFCJI
LFSBT TFMBNB TJTUPM LFUJLB UFLBOBO BPSUB UJOHHJ EBO UJEBL CFHJUV
LFSBTTFMBNBEJBTUPMLFUJLBUFLBOBOBPSUBUVSVOSFOEBI TFIJOHHB
CVOZJ JUV NFOHFSBT EBO NFMFNBI TFTVBJ EFOHBO EFOZVU KBOUVOH
NFNCFOUVLTVBSBZBOHEJTFCVUNVSNVSTVBSBNFTJO
270
Terapi Pembedahan. 5FSBQJ QFNCFEBIBO QBEB EVLUVT TJHFOBTJ 4FCBOZBL QFSTFO EBSBI WFOB ZBOH LFNCBMJ LF
BSUFSJPTVT NFOFUBQ TBOHBU TFEFSIBOB ZBOH QFSMV EJLFSKBLBO KBOUVOH NFNJOUBT MBOHTVOH EBSJ WFOUSJLFM LBOBO LF BPSUB
IBOZB NFOHJLBU EVLUVT ZBOH UFSCVLB BUBV NFNPUPOHOZB EBO UBOQBNFOHBMBNJPLTJHFOBTJ
NFOKBIJU LFEVB VKVOHOZB #BILBO QFNCFEBIBO JOJ NFSVQBLBO %JBHOPTJT UFUSBMPHJ 'BMMPU CJBTBOZB CFSEBTBSLBO BUBT
UNIT IV
TBUVPQFSBTJKBOUVOHZBOHQFSUBNBLBMJCFSIBTJMEJMBLVLBO LVMJU CBZJ NFOHBMBNJ TJBOPTJT CJSV

UFLBOBO TJTUPMJL
WFOUSJLFM LBOBO UJOHHJ TFXBLUV EJMBLVLBO QFSFLBNBO
Tetralogi Fallot—Pirau Kanan ke Kiri EFOHBO LBUFUFSJTBTJ
UFSEBQBU QFSVCBIBO LIBT QBEB
5FUSBMPHJ 'BMMPU EJQFSMJIBULBO QBEB (BNCBS JOJ BEBMBI HBNCBSBOSBEJPMPHJTCBZBOHBOKBOUVOHZBOHNFOVOKVLLBO
QFOZFCBC QBMJOH TFSJOH CBZJ CJSVh 4FCBHJBO CFTBS EBSBI QFNCFTBSBOWFOUSJLFMLBOBO EBO
BOHJPHSBN HBNCBSBO
NFNJOUBT QBSV TFIJOHHB EBSBI BPSUB NBTJI NFSVQBLBO EBSBI TJOBSY
NFOVOKVLLBO BMJSBO EBSBI BCOPSNBM NFMBMVJ
WFOB ZBOH UJEBL UFSPLTJHFOBTJ %BMBN LPOEJTJ TFQFSUJ JOJ FNQBU MVCBOH TFQUVN JOUFSWFOUSJLFM EBO NBTVL LF EBMBN BPSUB
NBDBNLFMBJOBOKBOUVOHUFSKBEJTFDBSBCFSTBNBBO UBQJ UFSEBQBU BMJSBO ZBOH KBVI MFCJI TFEJLJU NFMBMVJ BSUFSJ
QVMNPOBMJTZBOHTUFOPTJT
1. "PSUB CFSBTBM EBSJ WFOUSJLFM LBOBO CVLBO EBSJ LJSJ BUBV EBSJ
TFCVBI MVCBOH QBEB TFQUVN TFQFSUJ UFSMJIBU EBMBN (BNCBS Terapi Pembedahan. 5FUSBMPHJ 'BMMPU CJBTBOZB EBQBU
TFIJOHHBNFOFSJNBEBSBIEBSJLFEVBWFOUSJLFM EJUFSBQJEFOHBOTVLTFTNFMBMVJQFNCFEBIBO0QFSBTJZBOH
CJBTBEJMBLVLBOJBMBIEFOHBONFNCVLBTUFOPTJTQVMNPOBM
2. "SUFSJ QVMNPOBMJT NFOHBMBNJ TUFOPTJT TFIJOHHB EBSBI ZBOH
NFOVUVQ TFQUVN ZBOH CFSMVCBOH EBO NFMBLVLBO
NFOHBMJS EBSJ WFOUSJLFM LBOBO LF QBSV KBVI CFSLVSBOH EBSJ SFLPOTUSVLTJUFSIBEBQKBMVSEBSBIZBOHNFOVKVBPSUB#JMB
OPSNBM KVTUSV TFCBHJBO CFTBS EBSBI MBOHTVOH NBTVL LF QFNCFEBIBO CFSIBTJM IBSBQBO IJEVQ SBUBSBUB NFOJOHLBU
BPSUB EFOHBOEFNJLJBONFNJOUBTQBSV EBSJIBOZBTBNQBJUBIVONFOKBEJUBIVOBUBVMFCJI
3. %BSBIEBSJWFOUSJLFMLJSJNFOHBMJSLFWFOUSJLFMLBOBONFMBMVJ
MVCBOH TFQUVN WFOUSJLFM EBO LFNVEJBO LF BPSUB BUBV Penyebab Anomali Kongenital
MBOHTVOHLFBPSUBZBOH NFMBMVJMVCBOHJOJ 1FOZBLJUKBOUVOHLPOHFOJUBMCVLBOIBMZBOHKBSBOH UFSKBEJ
QBEB TFLJUBS EBSJ LFMBIJSBO IJEVQ 4BUV QFOZFCBC
4. 0MFILBSFOBKBOUVOHCBHJBOLBOBOIBSVTNFNPNQBTFKVNMBI
CFTBS EBSBI LF EBMBN BPSUB ZBOH CFSUFLBOBO UJOHHJ PUPU DBDBU KBOUVOH LPOHFOJUBM ZBOH QBMJOH TFSJOH BEBMBI JOGFLTJ
PUPUOZB BLBO TBOHBU CFSLFNCBOH TFIJOHHB UFSKBEJ WJSVT QBEB JCV TFMBNB USJNFTUFS QFSUBNB LFIBNJMBO ZBJUV
QFNCFTBSBOWFOUSJLFMLBOBO LFUJLB KBOUVOH KBOJO NVMBJ UFSCFOUVL $BDBU JOJ UFSVUBNB
UJNCVM CJMB JCV IBNJM UFSLFOB DBDBS +FSNBO TFIJOHHB BIMJ
%JOBNJLB 4JSLVMBTJ "COPSNBM 5FMBI KFMBT UFSMJIBU LBOEVOHBO NVOHLJO NFOHBOKVSLBO VOUVL NFOHBLIJSJ
CBIXB LFTVMJUBO GJTJPMPHJT VUBNB BLJCBU UFUSBMPHJ 'BMMPU BEBMBI LFIBNJMBO KJLB UFSKBEJ DBDBS +FSNBO QBEB USJNFTUFS
LBSFOBEBSBIUJEBLNFMFXBUJQBSVTFIJOHHBUJEBLNFOHBMBNJPL QFSUBNB
#FCFSBQB DBDBU LPOHFOJUBM KBOUVOH CFSTJGBU IFSFEJUFS
LBSFOBCFCFSBQBDBDBUUFMBIEJLFUBIVJUFSKBEJQBEBLFNCBS
JEFOUJLEFNJLJBOKVHBQBEBHFOFSBTJTFMBOKVUOZB"OBLEBSJ
QBTJFOQBTJFO ZBOH EJPCBUJ TFDBSB QFNCFEBIBO VOUVL
QFOZBLJU KBOUVOH LPOHFOJUBM NFNQVOZBJ SJTJLP NFOEFSJUB
QFOZBLJU KBOUVOH LPOHFOJUBM TFLJUBS LBMJ MFCJI CBOZBL
EJCBOEJOHLBO EFOHBO BOBLBOBL MBJO $BDBU KBOUVOH
LPOHFOJUBM KVHB TFSJOH EJTFSUBJ EFOHBO DBDBU UVCVI CBZJ
LPOHFOJUBMMBJOOZB
Penggunaan Sirkulasi Ekstrakorporeal

Selama Bedah Jantung
)BNQJS UJEBL NVOHLJO VOUVL NFNQFSCBJLJ LFMBJOBO KBOUVOH

EFOHBOQFNCFEBIBOTFXBLUVKBOUVOHNBTJINFNPNQB0MFI
LBSFOB JUV UFMBI EJCVBU CFCFSBQB NBDBN NFTJO KBOUVOHQBSV
CVBUBO VOUVL NFOHHBOUJLBO KBOUVOH EBO QBSV TFMBNB KBMBO
OZB QFNCFEBIBO 4JTUFN TFQFSUJ JUV EJTFCVU TJSLVMBTJ FLTUSB
LPSQPSFBM 1SJOTJQOZB TJTUFN JOJ UFSEJSJ BUBT TFCVBI QPNQB
EBO BMBU VOUVL PLTJHFOBTJ )BNQJS TFUJBQ KFOJT QPNQB ZBOH
UJEBLNFOJNCVMLBOIFNPMJTJTEBSBIUBNQBLOZBEBQBUEJQBLBJ
#FCFSBQB NFUPEF ZBOH EJUFSBQLBO VOUVL PLTJHFOBTJ EBSBI
JBMBI
NFNBTVLLBO HFMFNCVOHHFMFNCVOH PLTJHFO LF EB
MBN EBSBI EBO NFOHIJMBOHLBO MBHJ HFMFNCVOHHFMFNCVOH JUV
EBSJ EBSBI TFCFMVN EBSBI LFNCBMJ LF UVCVI QBTJFO

NFOFUFTLBOEBSBILFBUBTQFSNVLBBOMFNCBSBOQMBTUJLZBOHMV
271
Unit IVSirkulasi
BT EBMBN MJOHLVOHBO CFSPLTJHFO

NFMFXBULBO EBSBI EJ IBO EBQBU NFOKVSVT LF LFHBHBMBO KBOUVOH 4BMBI TBUV BMBTBOOZB
BUBTQFSNVLBBODBLSBNCFSPUBTJ EBO
NFMFXBULBOEBSBIEJ BEBMBI LBSFOB QFOJOHLBUBO WBTLVMBSJTBTJ LPSPOFS LIVTVTOZB
BOUBSBNFNCSBOUJQJTBUBVNFMBMVJQJQBQJQBUJQJTZBOHCFSTJGBU UJEBLMBI TFCBOEJOH EFOHBO QFOJOHLBUBO NBTTB PUPU KBOUVOH
QFSNFBCFMUFSIBEBQPLTJHFOEBOLBSCPOEJPLTJEB "MBTBO LFEVB BEBMBI LBSFOB TFSJOH UFSKBEJ QFNCFOUVLBO GJCSPTJT
QBEB PUPU LIVTVTOZB QBEB PUPU TVCFOEPLBSEJVN ZBOH BMJSBO
#FSCBHBJTJTUFNZBOHCFSCFEBTFNVBOZBNFNJMJLJQFOZVMJU EBSBI LPSPOFSOZB SFOEBI TFIJOHHB KBSJOHBO GJCSPTB NFOHHBO
UFSNBTVL IFNPMJTJT EBSBI QFNCFOUVLBO CFLVBO LFDJM EBMBN UJLBO PUPU KBOUVOH ZBOH NFOHBMBNJ EFHFOFSBTJ "EBOZB EJTQSP
EBSBI LFNVOHLJOBOHFMFNCVOHHFMFNCVOHLFDJMPLTJHFOBUBV QPSTJSFMBUJGBOUBSBQFOJOHLBUBONBTTBPUPUUFSIBEBQBMJSBOEBSBI
FNCPMJ LFDJM EBSJ [BU QFODFHBI QFNCFOUVL CVTB NBTVL LF LPSPOFSEBQBUNFOJNCVMLBOJTLFNJBSFMBUJGBQBCJMBUFSKBEJIJQFS
EBMBN BSUFSJ QBTJFO EJQFSMVLBOOZB TFKVNMBI CFTBS EBSBI USPGJKBOUVOHEFOHBOJOTVGJTJFOTJBMJSBOLPSPOFSZBOHUJNCVMLBSF
VOUVL LFCFSIBTJMBO TFMVSVI TJTUFN LFHBHBMBO VOUVL NFOVLBS OBOZB0MFILBSFOBJUV OZFSJBOHJOBTFSJOHNFOZFSUBJIJQFSUSPGJ
PLTJHFO EBMBN KVNMBI ZBOH DVLVQ EBO EJQFSMVLBOOZB KBOUVOH ZBOH EJLBJULBO EFOHBO QFOZBLJU LBUVQ BUBV KBOUVOH
QFOHHVOBBO IFQBSJO VOUVL NFODFHBI UFSKBEJOZB QFNCFLVBO CBXBBO1FNCFTBSBOKBOUVOHKVHBEJLBJULBOEFOHBOQFOJOHLBUBO
EBSBI QBEB TJTUFN MVBS UVCVI )FQBSJO KVHB NFOHIBMBOHJ SJTJLP UFSKBEJOZB BSJUNJB ZBOH LFNVEJBO EBQBU NFOKVSVT LF
UFSKBEJOZB QFNCFLVBO ZBOH BEFLVBU TFMBNB QSPTFT HBOHHVBO GVOHTJ KBOUVOH MFCJI MBOKVU EBO LFNBUJBO NFOEBEBL
QFNCFEBIBO /BNVO XBMBVQVO UFSEBQBU LFTVMJUBOLFTVMJUBO BLJCBUGJCSJMBTJ
JOJ EJ UBOHBO QBSB BIMJ QBTJFO EBQBU CFSUBIBO IJEVQ TFMBNB
CFCFSBQB KBN EFOHBO NFOHHVOBLBO NFTJO KBOUVOHQBSV
TFMBNBQFNCFEBIBOEBMBNKBOUVOHEJMBLTBOBLBO
Daftar Pustaka
Hipertrofi Jantung pada Penyakit Katup dan #SBVOXBME& 4FJENBO$& 4JHXBSU6$POUFNQPSBSZFWBMVBUJPOBOE
Penyakit Jantung Kongenital NBOBHFNFOUPGIZQFSUSPQIJDDBSEJPNZPQBUIZ $JSDVMBUJPO
$BSBCFMUP#"5IFDVSSFOUUIFSBQZGPSNJUSBMSFHVSHJUBUJPO +"N$PMM
)JQFSUSPGJPUPUKBOUVOHNFSVQBLBOTBUVNFLBOJTNFUFSQFOUJOH $BSEJPM
CBHJ KBOUVOH VOUVL NFOZFTVBJLBO EJSJ UFSIBEBQ CFCBO LFSKB %BM#JBODP+1 ,IBOEIFSJB#, .PPLBEBN' FU.BOBHFNFOUPG
ZBOH NFOJOHLBU BQBLBI CFCBO JOJ EJTFCBCLBO PMFI UJOHHJOZB BTZNQUPNBUJDTFWFSFBPSUJDTUFOPTJT +"N$PMM$BSEJPM
%PSO(8OE5IFGV[[ZMPHJDPGQIZTJPMPHJDBMDBSEJBDIZQFSUSPQIZ
UFLBOBOZBOHIBSVTEJIBEBQJPMFILPOUSBLTJPUPUKBOUVOHBUBV )ZQFSUFOTJPO
PMFI NFOJOHLBUOZB DVSBI KBOUVOH ZBOH IBSVT EJQPNQBLBO )PGGNBO+* ,BQMBO45IFJODJEFODFPGDPOHFOJUBMIFBSUEJTFBTF +"N$PMM
#FCFSBQB EPLUFS NFZBLJOJ CBIXB QFOJOHLBUBO LFLVBUBO LPO $BSEJPM
USBLTJPUPUKBOUVOHZBOHNFOZFCBCLBOIJQFSUSPGJZBOHMBJOOZB +FOLJOT,+ $PSSFB" 'FJOTUFJO+" FUBU/POJOIFSJUFESJTLGBDUPSTBOE
NFZBLJOJCBIXBUJOHLBUNFUBCPMJLPUPUZBOHNFOJOHLBUNFSV DPOHFOJUBM DBSEJPWBTDVMBS EFGFDUT DVSSFOU LOPXMFEHF B TDJFOUJGJD TUBUFNFOU
GSPN UIF "NFSJDBO )FBSU "TTPDJBUJPO $PVODJM PO $BSEJPWBTDVMBS %JTFBTF JO
QBLBO SBOHTBOHBO VUBNB 5JEBL QFEVMJ NBOB ZBOH CFUVM LJUB UIF :PVOH FOEPSTFE CZ UIF "NFSJDBO "DBEFNZ PG 1FEJBUSJDT $JSDVMBUJPO
EBQBUNFOHIJUVOHLJSBLJSBCFSBQBCFTBSIJQFSUSPGJZBOHBLBO
UFSKBEJEJTFUJBQSPOHHBKBOUVOHEFOHBODBSBNFOHBMJLBODVSBI .BSPO#+)ZQFSUSPQIJDDBSEJPNZPQBUIZBTZTUFNBUJDSFWJFX +"."
WFOUSJLFM EFOHBO UFLBOBO ZBOH IBSVT EJMBXBO PMFI LFSKB
WFOUSJLFM EFOHBOUJUJLCFSBUQBEBUFLBOBO+BEJ IJQFSUSPGJUFS .D%POBME. $VSSJF#+ $BSBQFUJT+3"DVUFSIFVNBUJDGFWFSBDIJOLJOUIF
DIBJO UIBU MJOLT UIF IFBSU UP UIF UISPBU -BODFU *OGFDU %JT
KBEJ QBEB TFCBHJBO CFTBS QFOZBLJU LBUVQ EBO QFOZBLJU LPOHF /JTIJNVSB3" )PMNFT%3+S$MJOJDBMQSBDUJDFIZQFSUSPQIJDPCTUSVDUJWF
OJUBM LBEBOHLBEBOHNFOZFCBCLBOCFSBUKBOUVOHNFOKBEJTF DBSEJPNZPQBUIZ /&OH+.FE
CFTBS HSBN EJCBOEJOHLBO EFOHBO CFSBU OPSNBMOZB 3FJNPME4$ 3VUIFSGPSE+%$MJOJDBMQSBDUJDFWBMWVMBSIFBSUEJTFBTFJO
HSBN QSFHOBODZ /&OH*+.FE
Efek Merugikan Hipertrofi Jantung Stadium Lanjut. 3IPEFT+' )JKB[J;. 4PNNFS3+1BUIPQIZTJPMPHZPGDPOHFOJUBMIFBSU
EJTFBTFJOUIFBEVMU QBSU**4JNQMFPCTUSVDUJWFMFTJPOT $JSDVMBUJPO
.FTLJQVO IJQFSUFOTJ NFSVQBLBO QFOZFCBC VNVN UFSKBEJOZB
IJQFSUSPGJ KBOUVOH IBNQJS TFNVB CFOUVL QFOZBLJU KBOUVOH 4DIPFO'+&WPMWJOHDPODFQUTPGDBSEJBDWBMWFEZOBNJDTUIFDPOUJOVVNPG
UFSNBTVL QFOZBLJU LBUVQ EBO KBOUVOH LPOHFOJUBM EBQBU EFWFMPQNFOU GVODUJPOBM TUSVDUVSF QBUIPCJPMPHZ BOE UJTTVF FOHJOFFSJOH
NFSBOHTBOHQFNCFTBSBOKBOUVOH $JSDVMBUJPO
4PNNFS3+ )JKB[J;. 3IPEFT+'+S1BUIPQIZTJPMPHZPGDPOHFOJUBMIFBSU
)JQFSUSPGJ KBOUVOH GJTJPMPHJT VNVNOZB EJBOHHBQ TFCBHBJ EJTFBTFJOUIFBEVMUQBSU*TIVOUMFTJPOT $JSDVMBUJPO 4PNNFS3+
SFTQPOT LPNQFOTBTJ KBOUVOH UFSIBEBQ QFOJOHLBUBO CFCBO )JKB[J;. 3IPEFT+'1BUIPQIZTJPMPHZPGDPOHFOJUBMIFBSU
LFSKBKBOUVOH EBOVNVNOZBCFSHVOBVOUVLNFNQFSUBIBOLBO EJTFBTF JO UIF BEVMU QBSU *** DPNQMFY DPOHFOJUBM IFBSU EJTFBTF $JSDVMBUJPO
DVSBI KBOUVOH NFOHIBEBQJ LFMBJOBO ZBOH NFOHHBOHHV
FGFLUJWJUBTQPNQBKBOUVSJH/BNVO IJQFSUSPGJEFSBKBUCFSMFCJ
272
BAB 24
UNIT IV
4ZPL4JSLVMBTJEBO1FOHPCBUBOOZB
4ZPL TJSLVMBTJ CFSBSUJ LFUJEBL Syok Sirkulasi yangTerjadi tanpa

DVLVQBOBMJSBOEBSBIEJTFMVSVI Pengurangan Curah Jantung
UVCVI TFIJOHHB KBSJOHBO UVCVI ,BEBOHLBEBOH DVSBI KBOUVOH CFTBSOZB OPSNBM BUBV CBILBO
NFOHBMBNJLFSVTBLBOUFSVUBNB NFMFCJIJOPSNBM QBEBIBMQBTJFOEBMBNLFBEBBOTZPLTJSLVMBTJ
LBSFOB UFSMBNQBV TFEJLJUOZB )BMJOJEBQBUEJBLJCBULBOPMFI
MBKVNFUBCPMJTNFZBOHCFSMF
PLTJHFO EBO [BU NBLBOBO MBJO CJIBO TFIJOHHB CBILBO DVSBI KBOUVOH ZBOH OPSNBM QVO UJEBL
OZBZBOHEJLJSJNLBOLFTFMTFM NFODVLVQJ BUBV
QPMBQFSGVTJKBSJOHBOZBOHBCOPSNBM TFIJ
KBSJOHBO #BILBO TJTUFN LBSEJPWBTLVMBS JUV TFOEJSJ PUPU KBOUVOH OHHB TFCBHJBO CFTBS DVSBI KBOUVOH NFOHBMJS NFMBMVJ QFNCVMVI
EJOEJOH QFNCVMVI EBSBI TJTUFN WBTPNPUPS EBO CBHJBOCBHJBO EBSBITFMBJOQFNCVMVIZBOHNFOZFEJBLBOOVUSJTJCBHJKBSJOHBO
TJSLVMBTJ MBJOOZB NVMBJ SVTBL TFIJOHHB TZPL TFLBMJ UFSKBEJ MPLBM
DFOEFSVOHNFNCVSVLTFDBSBQSPHSFTJG 1FOZFCBC TQFTJGJL TZPL BLBO EJCBIBT LFNVEJBO EJ CBC JOJ
6OUVLTFNFOUBSBXBLUV QFSMVEJDBUBUCBIXBTFNVBJOJNFOHB
LJCBULBO LVSBOHOZB QFOHJSJNBO [BU NBLBOBO LF KBSJOHBO EBO
PSHBO QFOUJOH EBO KVHB NFOZFCBCLBO LVSBOHOZB QFNCVBOHBO
Penyebab Fisiologis Syok QSPEVLCVBOHBOTFMEBSJKBSJOHBO
Apa yangTerjadi dengan Tekanan Arteri pada Syok
Syok Sirkulasi Akibat Penurunan Curah Jantung Sirkulasi?
#BOZBL EPLUFS CFSQFOEBQBU CBIXB OJMBJ UFLBOBO BSUFSJ
4ZPLCJBTBOZBEJTFCBCLBOPMFIDVSBIKBOUVOHZBOHUJEBLBEFLVBU NFSVQBLBOVLVSBOVUBNBGVOHTJTJSLVMBTJZBOHBEFLVBU"LBO
0MFILBSFOBJUV TFUJBQLFBEBBOZBOHNFOVSVOLBODVSBIKBOUVOH UFUBQJ UFLBOBO BSUFSJ TFSJOH LBMJ EBQBU TBOHBU NFOZFTBULBO
KBVI EJ CBXBI OPSNBM BLBO NVOHLJO NFOZFCBCLBO TZPL ,BEBOHLBEBOH TFTFPSBOH CFSBEB EBMBN TZPL CFSBU OBNVO
TJSLVMBTJ "EB EVB NBDBN GBLUPS ZBOH EBQBU NFNQFSCFSBU UFUBQ NFNQVOZBJ UFLBOBO BSUFSJ ZBOH IBNQJS OPSNBM LBSFOB
QFOVSVOBODVSBIKBOUVOH SFGMFLT TBSBG ZBOH TBOHBU LVBU NFODFHBI UVSVOOZB UFLBOBO
1BEB LFBEBBO MBJO UFLBOBO BSUFSJ EBQBU NFOVSVO TBNQBJ
1. ,FMBJOBO KBOUVOH ZBOH NFOVSVOLBO LFNBNQVBO KBOUVOH
TFQBSVI OPSNBM OBNVO PSBOH UFSTFCVU NBTJI NFNQVOZBJ
VOUVL NFNPNQB EBSBI ,FMBJOBO JOJ NFMJQVUJ LIVTVTOZB QFSGVTJKBSJOHBOOPSNBMEBOUJEBLEBMBNLFBEBBOTZPL
JOGBSL NJPLBSE UFUBQJ KVHB LFBEBBO UPLTJL KBOUVOH EJTGVOHTJ
LBUVQ KBOUVOH ZBOH CFSBU BSJUNJB KBOUVOH EBO LFBEBBO 1BEB TFCBHJBO CFTBS KFOJT TZPL UFSVUBNB TZPL ZBOH EJTF
MBJOOZB 4ZPL TJSLVMBTJ ZBOH EJTFCBCLBO PMFI QFOVSVOBO CBCLBOPMFILFIJMBOHBOCBOZBLEBSBI UFLBOBOBSUFSJNFOVSVO
LFNBNQVBO QFNPNQBBO KBOUVOH EJTFCVU TZPL LBSEJPHFOJL QBEB TBBU ZBOH CFSTBNBBO EFOHBO QFOVSVOBO DVSBI KBOUVOH
,FBEBBO UFSTFCVU UFMBI EJCBIBT TFDBSB UFSQFSJODJ EJ #BC NFTLJQVOCJBTBOZBUJEBLTFCBOZBLQFOVSVOBODVSBIKBOUVOH
EBO EJOZBUBLBO CBIXB TFCBOZBL QFSTFO QBTJFO TZPL Kerusakan Jaringan merupakan Hasil Akhir Syok
LBSEJPHFOJLUJEBLBLBOCFSUBIBOIJEVQ Sirkulasi
2. 'BLUPSGBLUPSZBOHNFOVSVOLBOBMJSBOCBMJLWFOBKVHBNFOV 4FLBMJTZPLTJSLVMBTJNFODBQBJTVBUVLFBEBBOCFSBUZBOHLSJUJT
SVOLBODVSBIKBOUVOHLBSFOBKBOUVOHUJEBLEBQBUNFNPNQB UJEBLQFEVMJBQBQFOZFCBCOZB TZPLJUVTFOEJSJBLBONFOZFCBC
EBSBI ZBOH UJEBL NFOHBMJS LF EBMBNOZB 1FOZFCBC QBMJOH LBOTZPLNFOKBEJMFCJICFSBU"SUJOZB BMJSBOEBSBIZBOHUJEBL
TFSJOHQFOVSVOBOBMJSBOCBMJLWFOBBEBMBIQFOVSVOBOWPMVNF BEFLVBU NFOZFCBCLBO KBSJOHBO UVCVI NVMBJ NFOHBMBNJ LF
EBSBI UFUBQJ BMJSBO CBMJL WFOB KVHB EBQBU CFSLVSBOH TFCBHBJ SVTBLBO UFSNBTVL KBOUVOH EBO TJTUFN TJSLVMBTJ JUV TFOEJSJ
BLJCBU QFOVSVOBO UPOVT WBTLVMBS UFSVUBNB QBEB TBMVSBO ,FBEBBO JOJ NFOZFCBCLBO DVSBI KBOUVOH TFNBLJO NFOVSVO
QFOBNQVOH EBSBI WFOB BUBV PCTUSVLTJ BMJSBO EBSBI QBEB MBMV UJNCVMMBI MJOHLBSBO TFUBO EFOHBO QFSLFNCBOHBO TZPL
CFCFSBQBUFNQBUEJTJSLVMBTJ UFSVUBNBEJMJOUBTBOBMJSBOCBMJL TJSLVMBTJ ZBOH TFNBLJO QSPHSFTJG QFSGVTJ KBSJOHBO NFOKBEJ
WFOBLFKBOUVOH TFNBLJOLVSBOH TZPLNFOKBEJTFNBLJOIFCBU EBOEFNJLJBO
273
Unit IV Sirkulasi
TFUFSVTOZBTBNQBJQBTJFONFOJOHHBM,FBEBBOQBEBUBIBQBLIJS UBNB NFOHVSBOHJ DVSBI KBOUVOH EBO TFMBOKVUOZB UFLBOBO BSUFSJ

TZPL TJSLVMBTJ JOJMBI ZBOH NFOKBEJ QFSIBUJBO LJUB LBSFOB LFEVBOZB UVSVO TBNQBJ OPM CJMB TBNQBJ QFSTFO WPMVNF
QFOHPCBUBO GJTJPMPHJT ZBOH TFTVBJ TFSJOH LBMJ EBQBU NFNCBMJL EBSBIUPUBMEJLFMVBSLBO
LBOLFBEBBOEFOHBODFQBUEBSJBSBILFNBUJBO Kompensasi Refleks Simpatis pada Syok-Manfaat Khusus
dalam Mempertahankan Tekanan Arteri. 1FOVSVOBO UFLBOBO
Tahap-Tahap Syok BSUFSJ TFUFMBI UFSKBEJOZB QFSEBSBIBO TFQFSUJ KVHB QFOVSVOBO
0MFI LBSFOB TJGBUTJGBU LIBT TZPL TJSLVMBTJ EBQBU CFSVCBI QBEB UFLBOBO QBEB BSUFSJBSUFSJ EBO WFOBWFOB QVMNPOBMJT EJ EBMBN
CFSCBHBJ EFSBKBU CFSBUOZB TZPL EJCBHJ EBMBN UJHB UBIBQ VUBNB UPSBLT NFOJNCVMLBO SFGMFLT TJNQBUJT ZBOH TBOHBU LVBU ZBOH
CFSJLVU EJNVMBJ UFSVUBNB PMFI CBSPSFTFQUPS BSUFSJ EBO SFTFQUPS SFHBOH
1. 5BIBQ OPOQSPHSFTJG LBEBOHLBEBOH EJTFCVU KVHB UBIBQ WBTLVMBS MBJOOZB TFQFSUJ EJKFMBTLBO EJ #BC
3FGMFLTSFGMFLT JOJ
LPNQFOTBTJ
1BEB UBIBQ JOJ NFLBOJTNF LPNQFOTBTJ NFSBOHTBOH TJTUFN WBTPLPOTUSJLUPS TJNQBUJT EJ TFCBHJBO CFTBS
TJSLVMBTJ ZBOH OPSNBM QBEB BLIJSOZB BLBO NFOJNCVMLBO KBSJOHBO UVCVI ZBOH NFOHIBTJMLBO UJHB QFOHBSVI QFOUJOH

QFNVMJIBOTFNQVSOBUBOQBEJCBOUVUFSBQJEBSJMVBS ,POTUSJLTJ BSUFSJPM EJ TFCBHJBO CFTBS TJSLVMBTJ TJTUFNJL TFIJOHHB
NFOJOHLBULBOUBIBOBOQFSJGFSUPUBM
,POTUSJLTJWFOBEBOTBMVSBO
2. 5BIBQQSPHSFTJG1BEBUBIBQJOJ UBOQBUFSBQJTZPLNFOKBEJ QFOBNQVOH EBSBI WFOB TFIJOHHB NFNCBOUV NFNQFSUBIBOLBO
TFNBLJOCVSVLTBNQBJUJNCVMLFNBUJBO BMJSBOCBMJLWFOBZBOHBEFLVBUXBMBVQVOWPMVNFEBSBICFSLVSBOH
3. 5BIBQ JSFWFSTJCFM LFUJLB TZPL UFMBI KBVI CFSLFNCBOH
"LUJWJUBT KBOUVOH NFOJOHLBU TFDBSB OZBUB LBEBOHLBEBOH
TFEFNJLJBO SVQB TFIJOHHB TFNVB CFOUVL UFSBQJ ZBOH NFOJOHLBULBO EFOZVU KBOUVOH EBSJ OJMBJ OPSNBM LBMJNFOJU
EJLFUBIVJ UJEBL NBNQV MBHJ NFOPMPOH QBTJFO NFTLJQVO NFOKBEJTBNQBJLBMJNFOJU
QBEBTBBUJUV PSBOHUFSTFCVUNBTJIIJEVQ
Manfaat Refleks Saraf Simpatis. 5BOQB BEBOZB SFGMFLT
4FLBSBOH NBSJLJUBNFNCBIBTCFSCBHBJUBIBQTZPLTJSLVMBTJ TJNQBUJT IBOZB TBNQBJ QFSTFO WPMVNF EBSBI ZBOH EBQBU
ZBOH EJTFCBCLBO PMFI QFOVSVOBO WPMVNF EBSBI ZBOH EJLFMVBSLBO TFMBNB NFOJU TFCFMVN PSBOH UFSTFCVU NBUJ IBM JOJ
NFNQFSMJIBULBO QOJOTJQQSJOTJQ EBTBS TZPL ,FNVEJBO LJUB CFSCFEBEFOHBOPSBOHZBOHSFGMFLTOZBNBTJIVUVI JBEBQBUCFSUBIBO
BLBONFNCBIBTTJGBUTJGBULIBTTZPLBLJCBUQFOZFCBCMBJOOZB EFOHBO LFIJMBOHBO EBSBI TBNQBJ QFSTFO 0MFI LBSFOB JUV
SFGMFLT JOJ NFNVOHLJOLBO UFSKBEJOZB LFIJMBOHBO EBSBI EBMBN
KVNMBI ZBOH MFCJI CFTBS TBNQBJ EVB LBMJ MJQBU EJCBOEJOH UBOQB
Syok Akibat Hipovolemia-Syok Hemoragik BEBOZBSFGMFLT UBOQBNFOZFCBCLBOLFNBUJBO
Pengaruh Refleks Saraf Simpatis Lebih Besar dalam
)JQPWPMFNJB CFSBSUJ CFSLVSBOHOZB WPMVNF EBSBI 1FSEBSBIBO
Mempertahankan Tekanan Arteri daripada Mempertahankan
BEBMBI QFOZFCBC QBMJOH TFSJOH TZPL IJQPWPMFNJL 1FSEBSBIBO
Curah Jantung..FSVKVLLFNCBMJQBEB(BNCBS QFSIBUJLBO
BLBO NFOVSVOLBO UFLBOBO QFOHJTJBO TJSLVMBTJ EBO TFCBHBJ
CBIXB UFLBOBO BSUFSJ EJQFSUBIBOLBO QBEB BUBV NFOEFLBUJ OJMBJ
BLJCBUOZB NFOVSVOLBO BMJSBO CBMJL WFOB 4FCBHBJ IBTJMOZB
OPSNBM MFCJI MBNB EBSJQBEB DVSBI KBOUVOH QBEB PSBOH ZBOH
DVSBI KBOUVOH NFOVSVO EJ CBXBI OPSNBM EBO EBQBU UJNCVM
NFOHBMBNJ QFSEBSBIBO "MBTBOOZB JBMBI CBIXB SFGMFLT TJNQBUJT
TZPL
MFCJIEJQBDVVOUVLNFNQFSUBIBOLBOUFLBOBOBSUFSJEBSJQBEBVOUVL
NFNQFSUBIBOLBODVSBIKBOUVOH3FGMFLTJOJNFOJOHLBULBOUFLBOBO
Hubungan Volume Perdarahan dengan Curah Jantung BSUFSJ UFSVUBNB EFOHBO NFOJOHLBULBO UBIBOBO QFSJGFS UPUBM ZBOH
dan Tekanan Arteri UJEBL NFNQVOZBJ QFOHBSVI ZBOH CFSNBOGBBU UFSIBEBQ DVSBI
(BNCBS NFNQFSMJIBULBO QFSLJSBBO QFOHBSVI QFOHFMVBS KBOUVOH XBMBVQVO EFNJLJBO LPOTUSJLTJ TJNQBUJT EBSJ WFOB QFOUJOH
BOEBSBIEBSJTJTUFNTJSLVMBTJTFMBNBTFLJUBSNFOJUUFSIBEBQ VOUVL NFOKBHB BHBS BMJSBO CBMJL WFOB EBSJ DVSBI KBOUVOH UJEBL
DVSBI KBOUVOH EBO UFLBOBO BSUFSJ ,JSBLJSB QFSTFO EBSJ UVSVO UFSMBMV SFOEBI TFMBJO QFSBOOZB EBMBN NFNQFSUBIBOLBO
WPMVNF EBSBI UPUBM EBQBU EJIJMBOHLBO IBNQJS UBOQB NFNCFSJ UFLBOBOBSUFSJ
QFOHBSVI UFSIBEBQ DVSBI KBOUVOH BUBV UFLBOBO BSUFSJ UFUBQJ )BM ZBOH NFOBSJL QBEB (BNCBS BEBMBI HBSJT NFOEBUBS
TFNBLJOCFTBSKVNMBIEBSBIZBOHIJMBOHCJBTBOZBQFSUBNB LFEVB ZBOH NVODVM LJSBLJSB QBEB OJMBJ NN )H QBEB LVSWB
UFLBOBO BSUFSJ )BM JOJ NFSVQBLBO BLJCBU EBSJ BLUJWBTJ SFTQPOT
100 JTLFNJL TJTUFN TBSBG QVTBU ZBOH NFOZFCBCLBO QFSBOHTBOHBO
LVBU QBEB TJTUFN TBSBG TJNQBUJT TBBU PUBL NVMBJ NFOHBMBNJ
LFLVSBOHBOPLTJHFOBUBVLFMFCJIBOLBSCPOEJPLTJEB TFQFSUJZBOH
EJCBIBT EJ #BC 1FOHBSVI SFTQPOT JTLFNJL TJTUFN TBSBG QVTBU
50
JOJ EBQBU EJTFCVU TFCBHBJ QFSUBIBOBO UFSBLIJS SFGMFLT TJNQBUJT
EBMBN VTBIBOZB NFOKBHB BHBS UFLBOBO BSUFSJ UJEBL NFOVSVO
UFSMBMVSFOEBI
0 Proteksi Aliran Darah Koroner dan Serebral oleh Refleks.
0 10 20 30 40 50 .BOGBBU LIVTVT EBSJ VTBIB NFNQFSUBIBOLBO UFLBOBO BSUFSJ
OPSNBMCBILBOQBEBLFBEBBODVSBIKBOUVOHZBOHNFOVSVOBEBMBI
QSPUFLTJ BMJSBO EBSBI ZBOH NFMBMVJ TJTUFN TJSLVMBTJ LPSPOFS EBO
TFSFCSBM3BOHTBOHBOTJNQBUJTUJEBLNFOZFCBCLBOLPOTUSJLTJZBOH
OZBUBCBJLQBEBQFNCVMVIEBSBILPSPOFSNBVQVOTFSFCSBM4FMBJO
274
Bab 24 Syok Sirkulasi dan Pengobatannya
JUV QBEB LFEVB UFNQBU JOJ BVUPSFHVMBTJ BMJSBO EBSBI MPLBMOZB 'BLUPSGBLUPSZBOHNFOZFCBCLBOQBTJFOQVMJILFNCBMJEBSJ
TBOHBU CBJL ZBOH NFODFHBI QFOVSVOBO UFLBOBO BSUFSJ EBMBN TZPL UJOHLBU TFEBOH BEBMBI TFNVB NFLBOJTNF QFOHBUVSBO
UJOHLBUTFEBOHTFIJOHHBUJEBLNFOHVSBOHJBMJSBOEBSBIOZBTFDBSB VNQBOCBMJLOFHBUJGEBSJTJSLVMBTJZBOHCFSVTBIBNFOHFNCBMJ
CFSNBLOB 0MFI LBSFOB JUV QBEB EBTBSOZB BMJSBO EBSBI ZBOH LBODVSBIKBOUVOHEBOUFLBOBOBSUFSJLFNCBMJLFOJMBJOPSNBM
UNIT IV
NFMBMVJ KBOUVOH EBO PUBL EJQFSUBIBOLBO QBEB OJMBJ OPSNBM 'BLUPSGBLUPSUFSTFCVUBEBMBITFCBHBJCFSJLVU
TFMBNBUFLBOBOBSUFSJUJEBLUVSVOEJCBXBINN)H NFTLJQVO
1. 3FGMFLTCBSPSFTFQUPS ZBOHNFOJNCVMLBOSBOHTBOHBO
LFOZBUBBO NFOVOKVLLBO CBIXB QBEB TBBU JUV BMJSBO EBSBI EJ
TJNQBUJTLVBUQBEBTJSLVMBTJ
CFCFSBQB BSFB UVCVI MBJOOZB EBQBU NFOVSVO IJOHHB TFQFSUJHB
TBNQBJTFQFSFNQBUOPSNBMBLJCBUWBTPLPOTUSJLTJ 2. 3FTQPOT JTLFNJL TJTUFN TBSBG QVTBU ZBOH NFOJNCVMLBO
SBOHTBOH TJNQBUJT ZBOH CBILBO MFCJI LVBU MBHJ EJ TFMVSVI
Syok Hemoragik Progresif dan Nonprogresif UVCVI UFUBQJ UJEBL UFSBLUJWBTJ TFDBSB CFSNBLOB TBNQBJ
UFLBOBOBSUFSJUVSVOEJCBXBINN)H
(BNCBSNFNQFSMJIBULBOTVBUVFLTQFSJNFOZBOHNFOVOKVL
3. 1FNCBMJLBO QSPTFT TUSFTSFMBLTBTJ TJTUFN TJSLVMBTJ ZBOH
LBO QFOHBSVI CFSCBHBJ UJOHLBU QFSEBSBIBO BLVU NFOEBEBL
NFOZFCBCLBOQFNCVMVIEBSBICFSLPOUSBLTJTFJSJOHEFOHBO
UFSIBEBQ UFLBOBO BSUFSJ TFDBSB CFSVSVUBO #JOBUBOH QFSDPCBBO
QFOHVSBOHBO WPMVNF EBSBI TFIJOHHB WPMVNF EBSBI ZBOH
EJBOFTUFTJEBOEBSBIOZBEJLFMVBSLBOTFDBSBDFQBUTFIJOHHBUFLBOBO
UFSTFEJBNFNFOVIJTJSLVMBTJTFDBSBMFCJIBEFLVBU
BSUFSJOZBNFOVSVOIJOHHBCFSCBHBJUJOHLBUBO#JOBUBOHQFSDPCBBO
ZBOHQFOVSVOBOUFLBOBONFOEBEBLOZBUJEBLMFCJISFOEBIEBSJ 4. 1FOJOHLBUBO TFLSFTJ SFOJO PMFI HJOKBM EBO QFNCFOUVLBO
NN)H LFMPNQPL* ** EBO***
TFNVBBLIJSOZBQVMJIQFNVMJIBO BOHJPUFOTJO ** ZBOH NFOJNCVMLBO LPOTUSJLTJ BSUFSJ QFSJGFS
UFSKBEJEFOHBODFQBUKJLBUFLBOBOIBOZBUVSVOTFEJLJU LFMPNQPL*
EBO KVHB NFOZFCBCLBO QFOVSVOBO LFMVBSBO BJS EBO HBSBN
UFUBQJ UFSKBEJ MFCJI MBNCBU KJLB UVSVO IJOHHB IBNQJS NN )H PMFI HJOKBM LFEVBOZB BLBO NFNCBOUV NFODFHBI CFSMBOKVU
LFMPNQPL***
#JMBUFLBOBOBSUFSJNFOVSVOEJCBXBINN)H OZBTZPL
LFMPNQPL *7 7 EBO 7*
TFNVB CJOBUBOH DPCB BLBO NBUJ 5. 1FOJOHLBUBO TFLSFTJ WBTPQSFTJO IPSNPO BOUJEJVSFUJL
PMFI
NFTLJQVO CBOZBL EJ BOUBSBOZB CFSBEB BOUBSB IJEVQ EBO NBUJ LFMFOKBS IJQPGJTJT ZBOH NFOJNCVMLBO LPOTUSJLTJ BSUFSJ EBO
TFMBNB CFSKBNKBN TFCFMVN TJTUFN TJSLVMBTJ NFOKBEJ SVTBL EBO WFOB QFSJGFS TFSUB TBOHBU NFOJOHLBULBO SFUFOTJ BJS PMFI
CFSMBOKVULFUBIBQLFNBUJBO HJOKBM
&LTQFSJNFO UFSTFCVU NFNQFSMJIBULBO CBIXB TJTUFN TJSLVMBTJ 6. 1FOJOHLBUBO TFLSFTJ FQJOFGSJO EBO OPSFQJOFGSJO NFEVMB
EBQBUQVMJILFNCBMJTFMBNBKVNMBIQFSEBSBIBOUJEBLMFCJICFTBS BESFOBM ZBOHNFOJNCVMLBOLPOTUSJLTJBSUFSJEBOWFOBQFSJGFS
EBSJ TVBUV KVNMBI LSJUJT UFSUFOUV .FMBNQBVJ CBUBT LSJUJT JOJ TFSUBNFOJOHLBULBOGSFLVFOTJEFOZVUKBOUVOH
EFOHBO IBOZB LFIJMBOHBO CFCFSBQB NJMJMJUFS EBSBI TBKB BLBO 7. .FLBOJTNF LPNQFOTBTJ ZBOH NFOHFNCBMJLBO WPMVNF EBSBI
NFNCVBU NBTBMBI BOUBSB IJEVQ EBO NBUJ +BEJ QFSEBSBIBO EJ LF OPSNBM UFSNBTVL BCTPSQTJ TFKVNMBI CFTBS DBJSBO EBSJ
BUBT UJOHLBU LSJUJT UFSUFOUV NFOZFCBCLBO TZPL NFOKBEJ QSPHSFTJG USBLUVT JOUFTUJOBM BCTPSQTJ DBJSBO EBSJ SVBOH JOUFSTUJTJBM
"SUJOZB TZPL JUV TFOEJSJ NFOZFCBCLBO LFBEBBO NFOKBEJ MFCJI UVCVI LF EBMBN LBQJMFS EBSBI QFOBIBOBO BJS EBO HBSBN
TZPLMBHJ EBOLFBEBBOOZBNFOKBEJMJOHLBSBOTFUBOZBOHBLIJSOZB PMFIHJOKBM EBOQFOJOHLBUBOSBTBIBVTTFSUBLFOBJLBOTFMFSB
NFOJNCVMLBOLFSVTBLBOUPUBMTJTUFNTJSLVMBTJEBOLFNBUJBO VOUVL HBSBN ZBOH NFOZFCBCLBO PSBOH NJOVN BJS EBO
NBLBONBLBOBOBTJOKJLBEBQBU
Syok Nonprogresif-Syok Terkompensasi 3FGMFLT TJNQBUJT EBO QFOJOHLBUBO TFLSFTJ LBUFLPMBNJO PMFI
+JLB TZPL UJEBL DVLVQ CFSBU VOUVL NFOJNCVMLBO LFBEBBO QSPH NFEVMBBESFOBMNFNCFSJLBOCBOUVBOTFHFSBVOUVLNFOJNCVM
SFTJG QBTJFO BLBO QVMJI LFNCBMJ 0MFI LBSFOB JUV TZPL EFOHBO LBOQSPTFTQFNVMJIBO LBSFOBSFGMFLTJOJBLBOUFSBLUJWBTJTFDBSB
UJOHLBUZBOHMFCJISJOHBOJOJEJTFCVUTZPLOPOQSPHSFTJGBUBVTZPL NBLTJNBMEBMBNXBLUVEFUJLIJOHHBCFCFSBQBNFOJUTFUFMBI
UFSLPNQFOTBTJ ZBOH CFSBSUJ CBIXB SFGMFLT TJNQBUJT EBO GBLUPS QFSEBSBIBO
GBLUPS MBJOOZB UFMBI NFMBLVLBO LPNQFOTBTJ TFDVLVQOZB HVOB
.FLBOJTNF BOHJPUFOTJO EBO WBTPQSFTJO QFNCBMJLBO QSPTFT
NFODFHBILFSVTBLBOTJSLVMBTJMFCJIMBOKVU
TUSFTSFMBLTBTJ ZBOH NFOJNCVMLBO LPOUSBLTJ QFNCVMVI EBSBI
EBOTBMVSBOQFOBNQVOHEBSBIWFOB TFNVBOZBNFNCVUVILBO
XBLUVNFOJUTBNQBJKBNVOUVLCFSFTQPOTTFDBSBMFOHLBQ
100 I OBNVO SFGMFLT JOJ TBOHBU NFNCBOUV EBMBN NFOJOHLBULBO
90 II
80 UFLBOBO BSUFSJ BUBV NFOJOHLBULBO UFLBOBO QFOHJTJBO TJSLVMBTJ
III IV
70
60
EBO EFOHBO EFNJLJBO NFOJOHLBULBO LFNCBMJOZB EBSBI LF
50 V KBOUVOH
40
30 "LIJSOZB QFOZFTVBJBO LFNCBMJ WPMVNF EBSBI NFMBMVJ
20 VI
10 BCTPSQTJ DBJSBO EBSJ SVBOH JOUFSTUJTJBM EBO USBLUVT JOUFTUJOBM
0
0 60 120 180 240 300 360
KVHB LPOTVNTJ PSBM EBO BCTPSQTJ BJS EBO HBSBN UBNCBIBO
NVOHLJO NFNFSMVLBO XBLUV TBNQBJ KBN UFUBQJ QBEB
BLIJSOZBBLBOUFSKBEJQFNVMJIBO TFIJOHHBTZPLUJEBLNFOKBEJ
DVLVQCFSBUVOUVLNFNBTVLJUBIBQQSPHSFTJG
275
Unit IV Sirkulasi
"Syok Progresif" Akibat Lingkaran Setan 15

Kerusakan Kardiovaskular
(BNCBS NFOHHBNCBSLBO CFCFSBQB CFOUVL VNQBO CBMJL
QPTJUJG ZBOH TFMBOKVUOZB NFOFLBO DVSBI KBOUVOH QBEB TZPL 10
TFIJOHHB NFOZFCBCLBO TZPL NFOKBEJ QSPHSFTJG #FCFSBQB IBM
QFOUJOHEBSJVNQBOCBMJLJOJBEBMBITFCBHBJCFSJLVU 1/2
Depresi Jantung. #JMB UFLBOBO BSUFSJ UVSVO DVLVQ SFOEBI 5 3/4

BMJSBOEBSBILPSPOFSNFOVSVOEJCBXBIKVNMBIZBOHEJQFSMVLBO
VOUVL OVUSJTJ ZBOH BEFLVBU CBHJ NJPLBSEJVN )BM JOJ BLBO
NFMFNBILBO PUPU KBOUVOH EBO EFOHBO EFNJLJBO TFNBLJO 0
NFOVSVOLBODVSBIKBOUVOH+BEJ UFMBIUFSCFOUVLTJLMVTVNQBO 4 0 4 8 12
CBMJLQPTJUJGZBOHNFOZFCBCLBOTZPLTFNBLJONFNCVSVL
(BNCBS NFOHHBNCBSLBO LVSWB DVSBI KBOUVOH QFS
DPCBBO QBEB IFXBO DPCB EJFLTUSBQPMBTJLBO LF KBOUVOH
NBOVTJB NFOVOKVLLBO LFSVTBLBO KBOUVOH QSPHSFTJG QBEB
XBLUVXBLUV CFSCFEB TFUFMBI UJNCVMOZB TZPL "OKJOH ZBOH
EJBOFTUFTJ EJLFMVBSLBO EBSBIOZB TBNQBJ UFLBOBO BSUFSJ UVSVO
+BEJ TBMBI TBUV HBNCBSBO QFOUJOH TZPL QSPHSFTJG CBJL
NFODBQBJNN)H EBOUFLBOBOEJQFSUBIBOLBOQBEBUJOHLBU
EJTFCBCLBO PMFI QFSEBSBIBO NBVQVO MBJOOZB BEBMBI QBEB
JOJ EFOHBO KBMBO NFOHFMVBSLBO EBSBIOZB BUBV NFOUSBOTGVTJ
BLIJSOZB BLBO UFSKBEJ LFSVTBLBO KBOUVOH ZBOH QSPHSFTJG 1BEB
LBO LFNCBMJ TFTVBJ LFCVUVIBO 1FSIBUJLBO QBEB LVSWB LFEVB
UBIBQ EJOJ TZPL IBM JOJ LVSBOH CFSQFSBO QBEB LPOEJTJ QBTJFO
EBMBN (BNCBS UFSTFCVU CBIXB UJNCVM TFEJLJU LFSVTBLBO QBEB
TFCBHJBO LBSFOB LFSVTBLBO KBOUVOH ZBOH UJEBL CFSBU TFMBNB KBN
KBOUVOHTFMBNBKBNQFSUBNB UFUBQJTFUFMBIKBN LFSVTBLBO
QFSUBNB TZPL UFUBQJ UFSVUBNB LBSFOB KBOUVOH NFNQVOZBJ
UFMBI NFODBQBJ TFLJUBS QFSTFO LFNVEJBO TFDBSB DFQBU
LFNBNQVBO DBEBOHBO ZBOH BNBU CFTBS ZBOH TFDBSB OPSNBM
TFMBNB KBN UFSBLIJS QFSDPCBBO TFUFMBI NFOHBMBNJ UFLBOBO
NBNQV NFNPNQB EBSBI TBNQBJ QFSTFO MFCJI CBOZBL
EBSBI LPSPOFS ZBOH SFOEBI TFMBNB KBN
KBOUVOH UFMBI
EBSJQBEBZBOHEJCVUVILBOPMFIUVCVIVOUVLOVUSJTJKBSJOHBOZBOH
NFOHBMBNJLFSVTBLBOTFDBSBUPUBM
BEFLVBU /BNVO QBEB UBIBQ UFSBLIJS TZPL LFSVTBLBO KBOUVOH
NVOHLJO NFSVQBLBO GBLUPS ZBOH QBMJOH QFOUJOH EBMBN
QFSLFNCBOHBOBLIJSTZPLZBOHCFSTJGBUNFNBUJLBO
276
Kegagalan Vasomotor. 1BEB UBIBQ EJOJ TZPL CFSCBHBJ Kerusakan Selular secara Luas. ,FUJLB TZPL NFOKBEJ
SFGMFLTTJSLVMBTJNFOZFCBCLBOBLUJWJUBTTJTUFNTBSBGTJNQBUJTZBOH CFSBU CBOZBL UBOEB LFSVTBLBO TFMVMBS TFDBSB MVBT UJNCVM EJ
IFCBU )BM JOJ TFQFSUJ UFMBI EJCBIBT TFCFMVNOZB NFNCBOUV TFMVSVI UVCVI 4BMBI TBUV PSHBO ZBOH UFSLFOB UFSVUBNB BEBMBI
NFOVOEB EFQSFTJ DVSBI KBOUVOH EBO UFSVUBNB NFNCBOUV IBUJ TFQFSUJZBOHEJMVLJTLBOQBEB(BNCBS)BMJOJUFSKBEJ
UNIT IV
NFODFHBI QFOVSVOBO UFLBOBO BSUFSJ 8BMBVQVO EFNJLJBO QBEB UFSVUBNB BLJCBU LVSBOHOZB NBLBOBO HVOB NFOVOKBOH LF
TBUV UJUJL QFOVSVOBO BMJSBO EBSBI LF QVTBU WBTPNPUPS EJ PUBL DFQBUBONFUBCPMJTNFZBOHUJOHHJZBOHOPSNBMOZBUFSKBEJEJTFM
CFHJUVNFOFLBOQVTBUJOJTFIJOHHBQVTBUJOJKVHBNFOKBEJLVSBOH TFM IBUJ UFUBQJ TFCBHJBO KVHB LBSFOB QBQBSBO TFMTFM IBUJ QBEB
BLUJG TFDBSB QSPHSFTJG EBO BLIJSOZB TBNB TFLBMJ UJEBL BLUJG UPLTJOWBTLVMBSBQBQVOBUBVGBLUPSNFUBCPMJLBCOPSNBMMBJOOZB
6NQBNBOZB QFOHIFOUJBO UPUBM TJSLVMBTJ LF PUBL NFOZFCBCLBO ZBOHNVODVMQBEBTZPL
SFBLTJ TJNQBUJT ZBOH QBMJOH EBITZBU TFMBNB TBNQBJ NFOJU
QFSUBNB UFUBQJ TFUFMBI TBNQBJ NFOJU QVTBU WBTPNPUPS #FSCBHBJ QFOHBSVI TFMVMBS ZBOH CFSTJGBU NFSVTBL ZBOH
NFOKBEJCFHJUVUFSUFLBOTFIJOHHBUJEBLBEBMBHJCVLUJMFCJIMBOKVU EJLFUBIVJ UFSKBEJ QBEB TFCBHJBO CFTBS KBSJOHBO UVCVI BEBMBI
NFOHFOBJ SFBLTJ TJNQBUJT ZBOH EBQBU EJUVOKVLLBO 6OUVOHOZB TFCBHBJCFSJLVU
QVTBUWBTPNPUPSCJBTBOZBUJEBLNFOHBMBNJLFHBHBMBOQBEBUBIBQ 1. 5SBOTQPS BLUJG OBUSJVN EBO LBMJVN NFMBMVJ NFNCSBO TFM
EJOJTZPLCJMBUFLBOBOBSUFSJUFUBQCFSBEBEJBUBTNN)H TBOHBU CFSLVSBOH "LJCBUOZB OBUSJVN EBO LMPSJEB CFSUVN
Sumbatan Pembuluh Darah yang Sangat Kecil "Aliran QVL EBMBN TFM EBO LBMJVN IJMBOH EBSJ TFM 4FMBJO JUV TFM
Darah Lambat". Suatu saat UFSKBEJTVNCBUBOEJCBOZBLQFN NVMBJNFNCFOHLBL
CVMVIEBSBIZBOHTBOHBULFDJMEBMBNTJTUFNTJSLVMBTJ EBOJOJKVHB 2. "LUJWJUBTNJUPLPOESJBEJTFMTFMIBUJ CFHJUVQVMBEJTFCBHJBO
NFOZFCBCLBO CFSMBOKVUOZB TZPL 1FOZFCBC BXBM TVNCBUBO JOJ CFTBSKBSJOHBOUVCVIMBJOOZB NFOHBMBNJEFQSFTJIFCBU
BEBMBI BMJSBO EBSBI ZBOH MBNCBU EBMBN QFNCVMVI NJLSP 0MFI 3. -JTPTPNEJEBMBNTFMQBEBEBFSBIKBSJOHBOZBOHMVBTNVMBJ
LBSFOBNFUBCPMJTNFKBSJOHBOUFSVTCFSMBOHTVOHNFTLJQVOBMJSBO UFSVSBJ EFOHBOQFMFQBTBOIJESPMBTFJOUSBTFMZBOHNFOZFCBC
OZB SFOEBI TFKVNMBI CFTBS BTBN CBJL BTBN LBSCPOBU NBVQVO LBOLFSVTBLBOJOUSBTFMMFCJIMBOKVU
BTBN MBLUBU UFSVT NFOHBMJS LF EBMBN QFNCVMVI EBSBI MPLBM EBO
4. .FUBCPMJTNF [BU NBLBOBO UJOHLBU TFMVMBS TFQFSUJ HMVLPTB
TBOHBU NFOJOHLBULBO LFBTBNBO EBSBI TFUFNQBU "TBN JOJ CFS
BLIJSOZB NFOHBMBNJ EFQSFTJ CFSBU QBEB UBIBQ BLIJS TZPL
TBNB QSPEVL SVTBL MBJOOZB EBSJ KBSJOHBO JTLFNJL NFOZFCBCLBO
"LUJWJUBT CFCFSBQB IPSNPO KVHB NFOHBMBNJ EFQSFTJ UFS
BHMVUJOBTJ EBSBI TFUFNQBU NFOJNCVMLBO CFLVBO EBSBI TBOHBU
NBTVLEFQSFTJBLUJWJUBTJOTVMJOZBOHIBNQJSQFSTFO
LFDJM ZBOH NFOZFCBCLBO TVNCBUBO TBOHBU LFDJM QBEB QFNCVMVI
EBSBILFDJM.FTLJQVOQFNCVMVIJUVUJEBLUFSTVNCBU QFOJOHLBU 4FNVB QFOHBSVI JOJ CFSQFSBO QBEB LFSVTBLBO MFCJI MBOKVU
BO LFDFOEFSVOHBO TFMTFM EBSBI VOUVL NFMFLBU TBUV TBNB MBJO CFSCBHBJ PSHBO UVCVI UFSVUBNB NFMJQVUJ
IBUJ EFOHBO
NFNCVBUEBSBIMFCJITVMJUMBHJVOUVLNFOHBMJSNFMBMVJQFNCVMVI EFQSFTJQBEBCBOZBLGVOHTJNFUBCPMJLEBOEFUPLTJGJLBTJOZB

NJLSP TFIJOHHBNFOJNCVMLBOJTUJMBIBMJSBOEBSBIMBNCBU QBSV ZBOHQBEBBLIJSOZBUFSKBEJFEFNBQBSVEBOLFNBNQVBO
Peningkatan Permeabilitas Kapiler. 4FUFMBI UFSKBEJOZB PLTJHFOBTJ EBSBI QBSV NFOKBEJ CVSVL EBO
KBOUVOH ZBOH
IJQPLTJB LBQJMFS EBO LFLVSBOHBO OVUSJTJ MBJOOZB TFMBNB CFSKBN TFMBOKVUOZBNFOEFQSFTJLPOUSBLUJMJUBTKBOUVOH
KBN QFSNFBCJMJUBT LBQJMFS NBLJO NFOJOHLBU EBO TFKVNMBI CFTBS Nekrosis Jaringan pada Syok Berat-Area Nekrosis
DBJSBO NVMBJ NFOHBMBNJ USBOTVEBTJ LF EBMBN KBSJOHBO )BM JOJ yang Tidak Menyeturuh Akibat Aliran Darah yang Tidak
TFNBLJO NFOVSVOLBO WPMVNF EBSBI EFOHBO BLJCBU QFOVSVOBO Sempurna di Berbagai Organ.5JEBLTFNVBTFMUVCVINFOH
DVSBI KBOUVOH MFCJI MBOKVU TFIJOHHB TZPL NFOKBEJ MFCJI CFSBU BMBNJ LFSVTBLBO ZBOH TBNB BLJCBU TZPL LBSFOB CFCFSBQB
)JQPLTJB LBQJMFS UJEBL NFOZFCBCLBO LFOBJLBO QFSNFBCJMJUBT KBSJOHBONFNQVOZBJTVQMBJEBSBIZBOHMFCJICBJLEBSJQBEBZBOH
LBQJMFSTBNQBJUBIBQMBOKVUEBSJTZPLZBOHCFSMBOHTVOHMBNB MBJOOZB 4FCBHBJ DPOUPI TFMTFM ZBOH CFSTFCFMBIBO EFOHBO
Pelepasan Toksin oleh Jaringan Iskemik. 4FQBOKBOH LBQJMFS EJ VKVOHVKVOH BSUFSJ NFOFSJNB OVUSJTJ MFCJI CBJL
TFKBSBIQFOFMJUJBONFOHFOBJTZPL UFMBICFSLBMJLBMJEJLFNVLBLBO EBSJQBEB TFMTFM ZBOH CFSTFCFMBIBO EFOHBO LBQJMFS TBNB EJ
CBIXB TZPL NFOZFCBCLBO KBSJOHBO NFOHFMVBSLBO CBIBO UPLTJO VKVOHVKVOH WFOB 0MFI LBSFOB JUV MFCJI CBOZBL EFGJTJFOTJ
TFQFSUJIJTUBNJO TFSPUPOJO EBOFO[JNKBSJOHBO ZBOHNFOJNCVM OVUSJUJG UFSKBEJ EJ TFLJUBS VKVOHVKVOH WFOB EBSJ LBQJMFS
LBO LFSVTBLBO MFCJI MBOKVU QBEB TJTUFN TJSLVMBTJ 4UVEJ FLTQFSJ EJCBOEJOHLBOEJUFNQBUMBJOOZB4FCBHBJDPOUPI (BNCBS
NFOUBM UFMBI NFNCVLUJLBO CBIXB TFUJEBLOZB TBUV UPLTJO ZBJUV NFOHHBNCBSLBOOFLSPTJTEJCBHJBOUFOHBIMPCVMVTIBUJ CBHJBO
FOEPUPLTJO CFSQFSBOQFOUJOHEBMBNCFCFSBQBNBDBNTZPL MPCVMVT ZBOH NFSVQBLBO CBHJBO UFSBLIJS ZBOH UFSQBQBS EBSBI
Depresi Jantung yang Disebabkan oleh Endotoksin. TFXBLUVNFOHBMJSNFMBMVJTJOVTPJEIBUJ
&OEPUPLTJO EJMFQBTLBO EBSJ UVCVI CBLUFSJ HSBNOFHBUJG NBUJ EJ ,FSVTBLBO LFDJM ZBOH TFSVQB UFSKBEJ KVHB EJ PUPU KBOUVOH
TBMVSBOQFODFSOBBO1FOVSVOBOBMJSBOEBSBILFTBMVSBOQFODFSOB NFTLJQVOEJTJOJQPMBQFOHVMBOHBOUFSUFOUV TFQFSUJZBOHUFSKBEJ
BO TFSJOH NFOZFCBCLBO QFOJOHLBUBO QFNCFOUVLBO EBO BCTPSQTJ EJIBUJ UJEBLEBQBUEJQFSMJIBULBO8BMBVQVOEFNJLJBO LFSVTB
CBIBO UPLTJO JOJ 5PLTJO ZBOH CFSTJSLVMBTJLFNVEJBO NFOJNCVM LBO KBOUVOH CFSQFSBO QFOUJOH EBMBN NFOJNCVMLBO UBIBQ
LBO LFOBJLBO NFUBCPMJTNF TFMVMBS NFTLJQVO OVUSJTJ TFM UJEBL JSFWFSTJCFM BLIJS EBSJ TZPL ,FSVTBLBO KVHB UJNCVM EJ HJOKBM
BEFLVBU )BM JOJ NFNJMJLJ QFOHBSVI LIVTVT QBEB PUPU KBOUVOH UFSVUBNBEJFQJUFMUVCVMVTHJOKBM NFOZFCBCLBOHBHBMHJOKBMEBO
ZBOHNFOZFCBCLBOEFQSFTJKBOUVOH&OEPUPLTJOCFSQFSBOQFOUJOH UFSLBEBOH LFNBUJBO LBSFOB VSFNJB CFCFSBQB IBSJ LFNVEJBO
QBEB CFCFSBQB NBDBN TZPL UFSVUBNB TZPL TFQUJL ZBOH BLBO ,FSVTBLBO QBSV KVHB TFSJOH NFOJNCVMLBO EJTUSFT QFSOBQBTBO
EJCBIBTLFNVEJBOEJCBCJOJ EBO LFNBUJBO CFCFSBQB IBSJ LFNVEJBOZBOH EJTFCVU TJOESPN
TZPLQBSV TIPDLMVOHTZOESPNF

277
Unit IV Sirkulasi
TFNVBTJTUFNVNQBOCBMJLOFHBUJGQBEBQFOHBUVSBOTJSLVMBTJZBOH
CFLFSKB CFSTBNBTBNB UJEBL NBNQV NFOHFNCBMJLBO DVSBI
KBOUVOHLFNCBMJOPSNBM
%FOHBONFNQFSIBUJLBOTFLBMJMBHJQSJOTJQVNQBOCBMJLQPTJUJG
EBOMJOHLBSBOTFUBOZBOHEJCBIBTEJ#BC LJUBEBQBUNFNBIBNJ
NFOHBQBUFSEBQBUOJMBJDVSBIKBOUVOHZBOHLSJUJTEJBUBTOJMBJJUV
TFTFPSBOH BLBO QVMJI EBSJ TZPL EBO EJ CBXBI OJMBJ JUV TFTFPSBOH
BLBO NFNBTVLJ MJOHLBSBO TFUBO LFSVTBLBO TJSLVMBTJ ZBOH UFSVT
CFSMBOHTVOHTBNQBJUFSKBEJLFNBUJBO
Syok Ireversibel
4FUFMBI TZPL CFSMBOKVU IJOHHB NFODBQBJ TVBUV UBIBQ UFSUFOUV
NBLBUSBOTGVTJBUBVCFOUVLUFSBQJMBJOBQBQVOUJEBLBLBONBNQV
MBHJ VOUVL NFOPMPOH IJEVQ PSBOH UFSTFCVU 0SBOH UFSTFCVU
EJLBUBLBO CFSBEB EBMBN UBIBQ JSFWFSTJCFM EBSJ TZPL *SPOJTOZB
NFTLJQVO CFSBEB EBMBN UBIBQ JSFWFSTJCFM TVBUV UFSBQJ LBEBOH
LBEBOH EBQBU NFOHFNCBMJLBO UFLBOBO BSUFSJ EBO CBILBO DVSBI
KBOUVOHLFOJMBJOPSNBMBUBVNFOEFLBUJOPSNBMVOUVLXBLUVZBOH
TJOHLBU UFUBQJ TJTUFN TJSLVMBTJ UFSVT NFOHBMBNJ LFSVTBLBO MFCJI
MBOKVU EBO LFNBUJBO NFOZVTVM EBMBN CFCFSBQB NFOJU TBNQBJ
CFCFSBQBKBNLFNVEJBO
Asidosis Pada Syok. 4FCBHJBO CFTBS HBOHHVBO NFUBCPMJL (BNCBS NFOHHBNCBSLBO QFOHBSVI JOJ ZBOH
ZBOH UJNCVM QBEB KBSJOHBO BLJCBU TZPL EBQBU NFOZFCBCLBO NFNQFSMJIBULBOCBIXBUSBOTGVTJTFMBNBUBIBQJSFWFSTJCFMLBEBOH
BTJEPTJT EJ TFMVSVI UVCVI )BM JOJ EJTFCBCLBO TFEJLJUOZB LBEBOH EBQBU NFOZFCBCLBO DVSBI KBOUVOH NBVQVO UFLBOBO
QFOHJSJNBO PLTJHFO LF KBSJOHBO ZBOH TBOHBU NFOHVSBOHJ BSUFSJ
LFNCBMJIBNQJSOPSNBM"LBOUFUBQJ DVSBIKBOUVOHTFHFSB
NFUBCPMJTNF PLTJEBUJG NBLBOBO #JMB IBM JOJ UFSKBEJ TFM NFOVSVO MBHJ EBO USBOTGVTJ TFMBOKVUOZB TFNBLJO UJEBL
NFNQFSPMFI TFCBHJBO CFTBS FOFSHJOZB NFMBMVJ QSPTFT HMJLPTJT CFSQFOHBSVI 1BEB TBBU JOJ UFMBI UFSKBEJ CFSCBHBJ QFSVCBIBO
BOBFSPCJL ZBOH NFOZFCBCLBO QFNCFOUVLBO BTBN MBLUBU CFSTJGBU NFSVTBL QBEB TFMTFM PUPU KBOUVOH ZBOH UJEBL TFMBMV
TFDBSBCFSMFCJIBOEBMBNKVNMBICBOZBLEBMBNEBSBI4FMBJOJUV NFNFOHBSVIJ LFNBNQVBO TFHFSB KBOUVOH VOUVL NFNPNQB
TFEJLJUOZB BMJSBO EBSBI NFMBMVJ KBSJOHBO BLBO NFODFHBI EBSBI OBNVO TFUFMBI XBLUV ZBOH MBNB BLBO DVLVQ NFOFLBO
QFNCVBOHBO OPSNBM LBSCPO EJPLTJEB ,BSCPO EJPLTJEB LFNBNQVBOJOJTFIJOHHBEBQBUNFOZFCBCLBOLFNBUJBO1BEBTBUV
CFSFBLTJEFOHBOBJSTFDBSBMPLBMEJEBMBNTFMHVOBNFNCFOUVL UJUJL UFSUFOUV CFHJUV CBOZBL LFSVTBLBO KBSJOHBO UFMBI UFSKBEJ
BTBN LBSCPOBU JOUSBTFM CFSLPOTFOUSBTJ UJOHHJ BTBN LBSCPOBU CFHJUVCBOZBLFO[JNEFTUSVLUJGUFMBIEJLFMVBSLBOLFEBMBNDBJSBO
JOJTFMBOKVUOZBCFSFBLTJEFOHBOCFSCBHBJCBIBOLJNJBKBSJOHBO UVCVI CFHJUV IFCBU BTJEPTJT ZBOH UJNCVM EBO CFHJUV CBOZBL
HVOB NFNCFOUVL MBHJ CBIBO BTBN JOUSBTFM MBJOOZB +BEJ FGFL GBLUPS EFTUSVLUJG MBJOOZB LJOJ UFSCFOUVL TFIJOHHB CBILBO DVSBI
NFNCVSVL MBJOOZB QBEB TZPL BEBMBI BTJEPTJT KBSJOHBO TFDBSB KBOUVOH ZBOH OPSNBM QVO TFMBNB CFCFSBQB NFOJU UJEBL NBNQV
MPLBM NBVQVO NFOZFMVSVI ZBOH NFOZFCBCLBO TFNBLJO NFNCBMJLLBO QSPTFT QFSCVSVLBO ZBOH UFSVT CFSMBOKVU JOJ 0MFI
CFSMBOKVUOZBTZPLJUVTFOEJSJ LBSFOBJUV QBEBTZPLCFSBU BLIJSOZBQBTJFOBLBONBUJ NFTLJQVO
UFSBQJ ZBOH MVBS CJBTB NVOHLJO NBTJI EBQBU NFOHFNCBMJLBO
Umpan Balik Positif Kerusakan Jaringan pada Syok dan DVSBIKBOUVOHLFOJMBJOPSNBMVOUVLXBLUVZBOHTJOHLBU
Lingkaran Setan Syok Progresif Habisnya Cadangan Fosfat Selular Berenergi Tinggi pada
4FNVBGBLUPSZBOHCBSVEJCBIBTZBOHEBQBUNFOZFCBCLBOTZPL Syok Ireversibel. $BEBOHBO GPTGBU CFSFOFSHJ UJOHHJ EJ KBSJOHBO
QSPHSFTJG MFCJI MBOKVU NFSVQBLBO KFOJT VNQBO CBMJL QPTJUJG UVCVI UFSVUBNBEJIBUJEBOKBOUVOH BLBOTBOHBUCFSLVSBOHQBEB
:BJUV TFUJBQQFOJOHLBUBOEFSBKBUTZPLNFOZFCBCLBOLFOBJLBO
TZPLMFCJIMBOKVU
(percentage of normal)
100
/BNVO VNQBO CBMJL QPTJUJG UJEBL TFMBMV NFOJNCVMLBO
Cardiac output
TVBUV MJOHLBSBO TFUBO "QBLBI TVBUV MJOHLBSBO TFUBO UJNCVM 75

BUBVUJEBLCFSHBOUVOHQBEBJOUFOTJUBTVNQBOCBMJLQPTJUJG1BEB
50
TZPL SJOHBO NFLBOJTNF VNQBO CBMJL OFHBUJG TJSLVMBTJSFGMFLT
TJNQBUJT NFLBOJTNFUFSCBMJLTUSFTSFMBLTBTJQFOBNQVOHEBSBI 25
BCTPSQTJDBJSBOLFEBMBNEBSBIEBSJSVBOHJOUFSTUJTJBM EBOMBJO
0
MBJO EBQBU EFOHBO NVEBI NFOBOHHVMBOHJ QFOHBSVI VNQBO 0 30 60 90 120 150
CBMJLQPTJUJG EBO LBSFOBJUV NFOJNCVMLBOQFNVMJIBO/BNVO
QBEB TZPL CFSBU NFLBOJTNF VNQBO CBMJL NFOKBEJ TFNBLJO
LVBU NFOJNCVMLBOLFSVTBLBOTJSLVMBTJCFHJUVDFQBU TFIJOHHB
278
TZPL CFSBU 1BEB EBTBSOZB TFNVB LSFBUJOJO GPTGBU UFMBI UFSVSBJ Syok Hipovolemik Akibat Trauma
EBO IBNQJS TFNVB BEFOPTJO USJGPTGBU UFMBI UFSVSBJ NFOKBEJ
4BMBI TBUV QFOZFCBC TZPL TJSLVMBTJ ZBOH QBMJOH TFSJOH BEBMBI
BEFOPTJO EJGPTGBU BEFOPTJO NPOPGPTGBU EBO BLIJSOZB BEFOPTJO
USBVNB QBEB UVCVI 4FSJOH LBMJ TZPL EJUJNCVMLBO PMFI
,FNVEJBO CBOZBL EBSJ BEFOPTJO JOJ CFSEJGVTJ LFMVBS EBSJ TFM
QFSEBSBIBO LBSFOB USBVNB UFUBQJ KVHB EBQBU UJNCVM UBOQB
UNIT IV
NBTVL LF EBMBN EBSBI TJSLVMBTJ EBO EJVCBI NFOKBEJ BTBN VSBU
QFSEBSBIBO LBSFOB LPOUVTJP UVCVI ZBOH DVLVQ MVBT EBQBU
TVBUV CBIBO ZBOH UJEBL EBQBU NBTVL LFNCBMJ LF EBMBN TFM HVOB
NFSVTBLLBQJMFSTFIJOHHBUFSKBEJLFIJMBOHBOQMBTNBCFSMFCJIBO
NFNCFOUVL TJTUFN BEFOPTJO GPTGBU "EFOPTJO CBSV EBQBU
LF EBMBN KBSJOHBO *OJ NFOJNCVMLBO QFOHVSBOHBO WPMVNF
EJTJOUFTJTIBOZBTFLJUBSEBSJKVNMBITFMVMFSOPSNBMEBMBNTBUV
QMBTNBZBOHTBOHBUCFTBSEFOHBOBLJCBUTZPLIJQPWPMFNJL
KBN ZBOH CFSBSUJ CBIXB DBEBOHBO GPTGBU CFSFOFSHJ UJOHHJ TVMJU
EJHBOUJTFUFMBIDBEBOHBOGPTGBUCFSFOFSHJUJOHHJEBMBNTFMIBCJT #FSCBHBJ VTBIB UFMBI EJMBLVLBO VOUVL NFMJCBULBO GBLUPS
UPLTJL ZBOH EJCFCBTLBO PMFI KBSJOHBO ZBOH UFSLFOB USBVNB
4FIJOHHB TBMBITBUVIBTJMBLIJSTZPLZBOHQBMJOHCVSVLEBSJ TFCBHBJTBMBITBUVQFOZFCBCTZPLTFUFMBIUSBVNB/BNVO QFS
LFSVTBLBO EBO NVOHLJO ZBOH QBMJOH CFSNBLOB VOUVL DPCBBO USBOTGVTJ TJMBOH QBEB IFXBO OPSNBM UFMBI HBHBM VOUVL
UFSKBEJOZB UBIBQ BLIJS JSFWFSTJCFM BEBMBI IBCJTOZB TFOZBXB NFNCVLUJLBOFMFNFOUPLTJLZBOHCFSNBLOB
CFSFOFSHJUJOHHJEBMBNTFMJOJ
4FCBHBJLFTJNQVMBO TZPLUSBVNBUJLUBNQBLOZBEJBLJCBULBO
Syok Hipovolemik Akibat Kehilangan Plasma UFSVUBNB PMFI IJQPWPMFNJ NFTLJQVO NVOHLJO KVHB UFSEBQBU
TZPLOFVSPHFOJLEFSBKBUTFEBOHZBOHUFSKBEJTFDBSBCFSTBNBBO
,FIJMBOHBOQMBTNBEBSJTJTUFNTJSLVMBTJ CBILBOUBOQBLFIJMBOH BLJCBU IJMBOHOZB UPOVT WBTPNPUPS TFQFSUJ ZBOH BLBO EJCBIBT
BO TFM EBSBI NFSBI UFSLBEBOH EBQBU DVLVQ CFSBU VOUVL NFOH TFMBOKVUOZB
VSBOHJWPMVNFEBSBIUPUBMTFDBSBOZBUB ZBOHNFOZFCBCLBOTZPL
IJQPWPMFNJL LIBT ZBOH IBNQJS TFSVQB TFMVSVIOZB EFOHBO TZPL
Syok Neurogenik-Kenaikan Kapasitas Vaskular
BLJCBU QFSEBSBIBO ,FIJMBOHBO QMBTNB TFDBSB IFCBU UFSKBEJ QBEB
LFBEBBOLFBEBBOTFCBHBJCFSJLVU
,BEBOHLBEBOH TZPL UJNCVM UBOQB BEBOZB LFIJMBOHBO WPMVNF
1. 0CTUSVLTJ VTVT IBMVT EBQBU NFOZFCBCLBO QFOVSVOBO WPMVNF
EBSBI 4FCBMJLOZB LBQBTJUBT WBTLVMBS NFOJOHLBU CFHJUV CFTBS
QMBTNB TFDBSB IFCBU %JTUFOTJ VTVT IBMVT QBEB PCTUSVLTJ VTVT
TFIJOHHBKVNMBIEBSBIZBOHOPSNBMQVONFOKBEJUJEBLNBNQV
IBMVT TFCBHJBO BLBO NFOHIBNCBU BMJSBO CBMJL WFOB QBEB
VOUVL NFOHJTJ TJTUFN TJSLVMBTJ TFDBSB BEFLVBU 4BMBI TBUV
EJOEJOH VTVT IBMVT TFIJOHHB NFOJOHLBULBO UFLBOBO LBQJMFS
QFOZFCBCOZBBEBMBIIJMBOHOZBUPOVTWBTPNPUPSTFDBSBUJCBUJCB
VTVTIBMVT)BMJOJLFNVEJBONFOZFCBCLBODBJSBOLFMVBSEBSJ
EJ TFMVSVI UVCVI ZBOH NFOZFCBCLBO UFSVUBNB EJMBUBTJ WFOB
LBQJMFSNBTVLLFEBMBNEJOEJOHVTVTIBMVTEBOKVHBLFEBMBN
ZBOH TBOHBU MVBT ,FBEBBO UFSTFCVU EJLFOBM EFOHBO TZPL
MVNFO VTVT IBMVT 0MFI LBSFOB DBJSBO ZBOH IJMBOH NFNJMJLJ
OFVSPHFOJL
LBOEVOHBO QSPUFJO UJOHHJ BLJCBUOZB QSPUFJO QMBTNB EBSBI
UPUBMEBOKVHBWPMVNFQMBTNBNFOVSVO 1FSBOLBQBTJUBTWBTLVMBSEBMBNNFNCBOUVNFOHBUVSGVOHTJ
2. 1BEBIBNQJSTFNVBQBTJFOZBOHNFOHBMBNJMVLBCBLBSIFCBU TJSLVMBTJUFMBIEJCBIBTEJ#BC ZBOHNFOZBUBLBOCBIXBCBJL
BUBV QFOHFMVQBTBO LVMJU MBJOOZB UFSKBEJ LFIJMBOHBO QMBTNB LFOBJLBOLBQBTJUBTWBTLVMBSNBVQVOQFOVSVOBOWPMVNFEBSBI
ZBOH BNBU CBOZBL NFMBMVJ EBFSBI LVMJU ZBOH UFSLFMVQBT BLBO NFOHVSBOHJ UFLBOBO QFOHJTJBO TJTUFNJL SBUBSBUB ZBOH
TFIJOHHBWPMVNFQMBTNBNFOKBEJTBOHBUNFOVSVO TFMBOKVUOZB NFOHVSBOHJ BMJSBO CBMJL WFOB LF KBOUVOH
1FOVSVOBO BMJSBO CBMJL WFOB LBSFOB EJMBUBTJ WBTLVMBS EJTFCVU
4ZPLIJQPWPMFNJLZBOHUJNCVMBLJCBUIJMBOHOZBQMBTNBNFN QFOHVNQVMBOEBSBIEJWFOB
QVOZBJ TJGBUTJGBU LIBT ZBOH IBNQJS TBNB EFOHBO TZPL BLJCBU
QFSEBSBIBO LFDVBMJ TBUV GBLUPS LPNQMJLBTJ UBNCBIBOWJTLPTJUBT Penyebab Syok Neurogenik.#FCFSBQBGBLUPSOFVSPHFOJL
EBSBI NFOKBEJ TBOHBU NFOJOHLBU BLJCBU NFOJOHLBUOZB LPOTFO ZBOHEBQBUNFOZFCBCLBOIJMBOHOZBUPOVTWBTPNPUPSBEBMBI
TFCBHBJCFSJLVU
USBTJ TFM EBSBI NFSBI EJ EBMBN EBSBI ZBOH UFSTJTB EBO IBM JOJ
NFOJNCVMLBOLFNCBMJQFSMBNCBUBOBMJSBOEBSBI 1. "OFTUFTJVNVNZBOHEBMBNTFSJOHLBMJNFOFLBOQVTBUWBTP
NPUPS TFIJOHHB NFOJNCVMLBO QBSBMJTJT WBTPNPUPS EFOHBO
)JMBOHOZB DBJSBO EBSJ TFNVB LPNQBSUFNFO DBJSBO EBMBN
BLJCBUTZPLOFVSPHFOJL
UVCVIEJTFCVUEFIJESBTJEFIJESBTJKVHBEBQBUNFOHVSBOHJWPMVNF
EBSBI EBO NFOJNCVMLBO TZPL IJQPWPMFNJL ZBOH TFSVQB EFOHBO 2. "OFTUFTJTQJOBM UFSVUBNBCJMBNFOZFMVSVILFBUBTTFQBOKBOH
TZPLBLJCBUQFSEBSBIBO#FCFSBQBQFOZFCBCEBSJCFOUVLTZPLJOJ NFEVMB TQJOBMJT NFOHIBNCBU BMJSBO JNQVMT TBSBG TJNQBUJT
BOUBSB MBJO
NFOHFMVBSLBO LFSJOHBU TFDBSB CFSMFCJIBO
LFMVBS EBSJ TJTUFN TBSBG EBO EBQBU NFOKBEJ QFOZFCBC TZPL
IJMBOHOZB DBJSBO LBSFOB EJBSF CFSBU BUBV NVOUBINVOUBI
OFVSPHFOJLZBOHLVBU
IJMBOHOZBDBJSBOZBOHCFSMFCJIBONFMBMVJHJOKBM
BTVQBODBJSBO 3. ,FSVTBLBO PUBL TFSJOH LBMJ NFOZFCBCLBO LPMBQT QBSBMJTJT
EBO FMFLUSPMJU ZBOH UJEBL BEFLVBU BUBV
LFSVTBLBO LPSUFLT WBTPNPUPS #BOZBL QBTJFO ZBOH NFOHBMBNJ HFHBS PUBL BUBV
BESFOBM EFOHBO IJMBOHOZB TFLSFTJ BMEPTUFSPO EBO CFSBLJCBU LPOUVTJP EBFSBI CBTBM PUBL NFOHBMBNJ TZPL OFVSPHFOJL
LFHBHBMBO HJOKBM VOUVL NFSFBCTPSCTJ OBUSJVN LMPSJEB EBO BJS ZBOH IFCBU %FNJLJBO KVHB NFTLJQVO JTLFNJB PUBL TFMBNB
ZBOHEJTFCBCLBOUJEBLBEBOZBIPSNPOBESFOPLPSUJLBM BMEPTUFSPO CFCFSBQB NFOJU IBNQJS TFMBMV NFOZFCBCLBO QFSBOHTBOHBO
WBTPNPUPSZBOHMVBSCJBTB OBNVOJTLFNJBZBOHCFSMBOHTVOH
279
Unit IV Sirkulasi
MBNB MFCJI EBSJ TBNQBJ NFOJU

EBQBU NFOZFCBCLBO FGFL KBSJOHBOQFSJGFSEBOBLIJSOZBMFXBUEBSBINFOZFCBSLFPSHBO
ZBOHCFSMBXBOBOUJEBLBLUJGOZBOFVSPOWBTPNPUPSTFDBSBUPUBM PSHBOEBMBN UFSVUBNBIBUJ
EJCBUBOHPUBLEFOHBOBLJCBUTZPLOFVSPHFOJLZBOHIFCBU 5. MOGFLTJZBOHNFOZFCBSLFEBMBNEBSBIEBSJHJOKBMBUBVUSBLUVT
VSJOBSJVT TFSJOHLBMJEJTFCBCLBOPMFICBTJMVTLPMPO
Syok Anafilaktik dan Syok Histamin Gambaran Khusus Syok Septik. ,BSFOB UFSEBQBU CBOZBL
KFOJT TZPL TFQUJL NBLB TVMJU VOUVL NFOHHPMPOHLBO LFBEBBO
"OBGJMBLTJT NFSVQBLBO LPOEJTJ BMFSHJ EFOHBO DVSBI KBOUVOH UFSTFCVU #FCFSBQB HFKBMB ZBOH TFSJOH UFSMJIBU BEBMBI TFCBHBJ
EBOUFLBOBOBSUFSJZBOHTFSJOHLBMJNFOVSVOTFDBSBESBTUJT)BM CFSJLVU
JOJ BLBO EJCBIBT EJ #BC "OBGJMBLTJT UFSVUBNB EJTFCBCLBO 1. %FNBNUJOHHJ
PMFI TVBUV SFBLTJ BOUJHFO BOUJCPEJ ZBOH UFSKBEJ EFOHBO DFQBU
TFUFMBI TVBUV BOUJHFO ZBOH TBOHBU TFOTJUJG VOUVL TFTFPSBOH 2. 4FSJOHLBMJUFSKBEJWBTPEJMBUBTJZBOHOZBUBEJTFMVSVIUVCVI
NBTVL LF EBMBN TJSLVMBTJ 4BMBI TBUV FGFL VUBNBOZB BEBMBI UFSVUBNBQBEBKBSJOHBOZBOHUFSJOGFLTJ
NFOZFCBCLBOCBTPGJMEBMBNEBSBIEBOTFMNBTUEBMBNKBSJOHBO 3. $VSBI KBOUVOH ZBOH UJOHHJ QBEB TFLJUBS TFQBSVI QBTJFO
QFSJLBQJMFS NFMFQBTLBO IJTUBNJO BUBV CBIBO TFQFSUJ IJTUBNJO EJTFCBCLBO PMFI BEBOZB EJMBUBTJ BSUFSJPM EJ KBSJOHBO ZBOH
)JTUBNJO UFSTFCVU NFOZFCBCLBO
LFOBJLBO LBQBTJUBT UFSJOGFLTJ EBO PMFI LFDFQBUBO NFUBCPMJL ZBOH UJOHHJ EBO
WBTLVMBS BLJCBU EJMBUBTJ WFOB TFIJOHHB NFOZFCBCLBO WBTPEJMBUBTJ EJ UFNQBU MBJO EBMBN UVCVI BLJCBU EBSJ
QFOVSVOBO BMJSBO CBMJL WFOB TFDBSB OZBUB
EJMBUBTJ BSUFSJPM SBOHTBOHBO UPLTJO CBLUFSJ UFSIBEBQ NFUBCPMJTNF TFMVMBS EBO
ZBOH NFOHBLJCBULBO UFLBOBO BSUFSJ NFOKBEJ TBOHBU NFOVSVO TVIVUVCVIZBOHUJOHHJ
EBO
TBOHBU NFOJOHLBUOZB QFSNFBCJMJUBT LBQJMFS EFOHBO 4. .FMBNCBUOZBBMJSBOEBSBI EJTFCBCLBOPMFIBHMVUJOBTJTFMEBSBI
BLJCBU IJMBOHOZB DBJSBO EBO QSPUFJO LF EBMBN SVBOH KBSJOHBO NFSBITFCBHBJSFTQPOTUFSIBEBQKBSJOHBOZBOHNFOHBMBNJ
TFDBSBDFQBU)BTJMBLIJSOZBNFSVQBLBOTVBUVQFOVSVOBOZBOH EFHFOFSBTJ
MVBS CJBTB QBEB BMJSBO CBMJL WFOB EBO LBEBOHLBEBOH 5. 1FNCFOUVLBO CFLVBO EBSBI LFDJM EJ EBFSBI ZBOH MVBT EBMBN
NFOJNCVMLBO TZPL TFSJVT TFIJOHHB QBTJFO NFOJOHHBM EBMBN
UVCVI LFBEBBO ZBOH EJTFCVU LPBHVMBTJ JOUSBWBTLVMBS EJTFNJ
CFCFSBQBNFOJU
OBUB EJTTFNJOBUFE JOUSBWBTDVMBS DPBHVMBUJPO
)BM JOJ KVHB
1FOZVOUJLBOTFKVNMBICFTBSIJTUBNJOTFDBSBJOUSBWFOBEBQBU NFOZFCBCLBO GBLUPSGBLUPS QFNCFLVBO EBSBI NFOKBEJ IBCJT
NFOZFCBCLBO TZPL IJTUBNJO ZBOH TJGBUOZB IBNQJS TFSVQB UFSQBLBJ TFIJOHHB UJNCVM QFSEBSBIBO EJ CBOZBL KBSJOHBO
EFOHBOTZPLBOBGJMBLUJL UFSVUBNBQBEBEJOEJOHVTVTEBOUSBLUVTJOUFTUJOBM
1BEB UBIBQ EJOJ TZPL TFQUJL CJBTBOZB QBTJFO UJEBL NFNQFS
Syok Septik MJIBULBO UBOEBUBOEB LPMBQT TJSLVMBTJ UFUBQJ IBOZB UBOEBUBOEB
JOGFLTJCBLUFSJ4FUFMBIJOGFLTJNFOKBEJMFCJIIFCBU TJTUFNTJSLVMBTJ
,FBEBBO ZBOH EVMV EJLFOBM EFOHBO JTUJMBI QPQVMFS LFSBDVOBO CJBTBOZB JLVU UFSMJCBU CBJL EJTFCBCLBO PMFI QFOZFCBSBO JOGFLTJ
EBSBI TFLBSBOH EJTFCVU TZPL TFQUJL PMFI LFCBOZBLBO LMJOJTJ TFDBSB MBOHTVOH BUBVQVO TFDBSB TFLVOEFS ZBOH EJTFCBCLBO PMFI
)BMJOJEJBSUJLBOTFCBHBJJOGFLTJCBLUFSJZBOHEJTFCBSLBOMFXBU UPLTJOCBLUFSJ EFOHBOBLJCBUIJMBOHOZBQMBTNBLFEBMBNKBSJOHBO
EBSBIEBSJTBUVKBSJOHBOLFKBSJOHBOMBJOOZB EBONFOZFCBCLBO ZBOH UFSJOGFLTJ NFMBMVJ EJOEJOH LBQJMFS EBSBI ZBOH SVTBL "LIJS
LFSVTBLBO ZBOH MVBT 5FSEBQBU CBOZBL NBDBN TZPL TFQUJL OZBQBEBTVBUVTBBU LFSVTBLBOTJSLVMBTJNFOKBEJQSPHSFTJGTFSVQB
LBSFOB CBOZBL NBDBN JOGFLTJ CBLUFSJ ZBOH EBQBU NFOZFCBC EFOHBO ZBOH UFSKBEJ QBEB TFNVB KFOJT TZPL MBJOOZB 5BIBQ BLIJS
LBOOZB EBO LBSFOB JOGFLTJ QBEB EBFSBI UVCVI ZBOH CFSCFEB EBSJ TZPL TFQUJL UJEBL CBOZBL CFSCFEB EFOHBO UBIBQ BLIJS TZPL
NFOJNCVMLBOFGFLZBOHCFSCFEBQVMB IFNPSBHJL NFTLJQVO GBLUPSGBLUPS QFODFUVTOZB TBOHBU CFSMBJOBO
QBEBLFEVBNBDBNTZPLUFSTFCVU
4ZPL TFQUJL TBOHBU QFOUJOH CBHJ LMJOJTJ LBSFOB TFMBJO TZPL
LBSEJPHFOJL TZPL TFQUJL NFSVQBLBO TZPL ZBOH QBMJOH TFSJOH
NFOZFCBCLBOLFNBUJBOEJSVNBITBLJUNPEFSO Fisiologi Pengobatan Syok
#FCFSBQBQFOZFCBCLIBTTZPLTFQUJLBOUBSBMBJOTFCBHBJ Terapi Penggantian
CFSJLVU
5SBOTGVTJ %BSBI EBO 1MBTNB +JLB TFTFPSBOH CFSBEB EBMBN
1. 1FSJUPOJUJT ZBOH EJTFCBCLBO PMFI QFOZFCBSBO JOGFLTJ EBSJ LFBEBBO TZPL BLJCBU QFSEBSBIBO UFSBQJ UFSCBJL ZBOH NVOHLJO
VUFSVT EBO UVCB GBMPQJ UFSLBEBOH BLJCBU EBSJ BCPSUVT EJMBLVLBO CJBTBOZB BEBMBI USBOTGVTJ EBSBI MFOHLBQ +JLB TZPL
JOTUSVNFOUBMJTZBOHEJMBLVLBOEBMBNLPOEJTJUJEBLTUFSJM EJTFCBCLBO PMFI IJMBOHOZB QMBTNB UFSBQJ UFSCBJL BEBMBI
2. 1FSJUPOJUJT LBSFOB SVQUVS TJTUFN TBMVSBO QFODFSOBBO QFNCFSJBO QMBTNB CJMB EFIJESBTJ TFCBHBJ QFOZFCBCOZB
LBEBOHLBEBOH EJTFCBCLBO PMFI QFOZBLJU VTVT IBMVT EBO QFNCFSJBOMBSVUBOFMFLUSPMJUZBOHUFQBUEBQBUNFNVMJILBOTZPL
UFSLBEBOHPMFIBEBOZBMVLBEJTBMVSBODFSOB %BSBI MFOHLBQ UJEBL TFMBMV UFSTFEJB TFQFSUJ EBMBN LFBEBBO
3. *OGFLTJ UVCVI HFOFSBMJTBUB LBSFOB QFOZFCBSBO EBSJ JOGFLTJ QFSUFNQVSBO 1MBTNB CJBTBOZB EBQBU NFOHHBOUJLBO EBSBI
LVMJU TFQFSUJJOGFLTJTUSFQUPLPLVTBUBVTUBGJMPLPLVT MFOHLBQ LBSFOB QMBTNB NFOJOHLBULBO WPMVNF EBSBI EBO
4. MOGFLTJHBOHSFOHFOFSBMJTBUBZBOHTFDBSBTQFTJGJLEJTFCBCLBO NFOHFNCBMJLBO IFNPEJOBNJLB OPSNBM 1MBTNB UJEBL EBQBU
PMFICBTJMVTHBOHSFOHBT ZBOHNVMBNVMBNFOZFCBSNFMBMVJ NFNVMJILBO IFNBUPLSJU OPSNBM UFUBQJ UVCVI NBOVTJB CJBTBOZB
EBQBUCFSUBIBOQBEBQFOVSVOBOIFNBUPLSJUTBNQBJLJSBLJSB
280
TFQBSVI OPSNBM TFCFMVN NFOJNCVMLBO BLJCBU TFSJVT KJLB DVSBI 0CBUPCBU TJNQBUPNJNFUJL CFMVN UFSCVLUJ CFSNBOGBBU
KBOUVOH NFODVLVQJ 0MFI LBSFOB JUV QBEB LFBEBBO HBXBU QBEB TZPL IFNPSBHJL "MBTBOOZB BEBMBI CBIXB QBEB KFOJT
EBSVSBU DVLVQ CFSBMBTBO VOUVL NFOHHVOBLBO QMBTNB EBMBN TZPLJOJ TJTUFNTBSBGTJNQBUJTIBNQJSTFMBMVUFMBIUFSBLUJWBTJ
NFOHHBOUJLBO EBSBI MFOHLBQ HVOB NFOHPCBUJ TZPL IFNPSBHJL TFDBSB NBLTJNBM PMFI SFGMFLT TJSLVMBTJ BEB CFHJUV CBOZBL
UNIT IV
BUBVTFCBHJBOCFTBSCFOUVLTZPLIJQPWPMFNJLMBJOOZB OPSFQJOFGSJO EBO FQJOFGSJO ZBOH UFMBI CFSTJSLVMBTJ EBMBN
,BEBOHLBEBOH QMBTNB KVHB UJEBL UFSTFEJB %BMBN LFBEBBO EBSBI TFIJOHHB PCBU TJNQBUPNJNFUJL QBEB EBTBSOZB UJEBL
JOJ CFSCBHBJ QFOHHBOUJ QMBTNB UFMBI EJLFNCBOHLBO ZBOH NFNCFSJFGFLUBNCBIBOZBOHCFSNBOGBBU
NFMBLVLBO GVOHTJ IFNPEJOBNJLB IBNQJS UFQBU TBNB EFOHBO
QMBTNB4BMBITBUVOZBBEBMBIMBSVUBOEFLTUSBO Terapi Lain
Larutan Dekstran sebagai Pengganti Plasma. 4ZBSBU Pengobatan dengan Posisi Kepala di Bawah. #JMB
VUBNB QFOHHBOUJ QMBTNB ZBOH CFOBSCFOBS FGFLUJG BEBMBI UFUBQ UFLBOBO UVSVO UFSMBMV SFOEBI QBEB TFCBHJBO CFTBS TZPL
UJOHHBM EJ TJTUFN TJSLVMBTJ ZBJUV UJEBL UFSTBSJOH NFMBMVJ QPSJ UFSVUBNB QBEB TZPL IFNPSBHJL EBO TZPL OFVSPHFOJL
QPSJ LBQJMFS LF EBMBN SVBOH KBSJOHBO 4FMBJO JUV MBSVUBO UJEBL NFOFNQBULBO LFQBMB QBTJFO TFUJEBLOZB JODJ MFCJI SFOEBI
CPMFI CFSTJGBU UPLTJL EBO IBSVT NFOHBOEVOH FMFLUSPMJU ZBOH EBSJ LBLJ BLBO NFNCBOUV NFOJOHLBULBO BMJSBO CBMJL WFOB
UFQBU HVOB NFODFHBI LFLBDBVBO FMFLUSPMJU DBJSBO FLTUSBTFM EFOHBO EFNJLJBO NFOBJLLBO DVSBI KBOUVOH 1PTJTJ LFQBMB EJ
UVCVIQBEBXBLUVEJCFSJLBO CBXBI JOJ BEBMBI UJOEBLBO EBTBS QFSUBNB EBMBN QFOHPCBUBO
CFSCBHBJNBDBNTZPL
"HBS UFUBQ CFSBEB EJ TJSLVMBTJ QFOHHBOUJ QMBTNB IBSVT
NFOHBOEVOH CBIBO ZBOH NFNQVOZBJ VLVSBO NPMFLVM DVLVQ Terapi Oksigen. 0MFI LBSFOB QFOHBSVI CVSVL VUBNB
CFTBS VOUVL NFOHIBTJMLBO UFLBOBO PTNPUJL LPMPJE 4BUV CBIBO TFCBHJBOCFTBSKFOJTTZPLBEBMBIUFSMBMVTFEJLJUOZBQFOHJSJNBO
PLTJHFOLFKBSJOHBO QFNCFSJBOPLTJHFOVOUVLCFSOBQBTLFQBEB
ZBOHEJCVBUVOUVLUVKVBOUFSTFCVUBEBMBIEFLTUSBO TVBUVQPMJNFS
QBTJFO BLBO CFSNBOGBBU QBEB CFCFSBQB LFBEBBO 8BMBV
QPMJTBLBSJEB HMVLPTB CFTBS #BLUFSJ UFSUFOUV NFOHFMVBSLBO
EFNJLJBO NBOGBBUOZBTFSJOHLBMJKBVIEBSJZBOHLJUBIBSBQLBO
EFLTUSBO TFCBHBJ QSPEVL UBNCBIBO QFSUVNCVIBO NFSFLB EBO
LBSFOBNBTBMBIQBEBTFCBHJBOCFTBSTZPLCVLBOMBIPLTJHFOBTJ
EFLTUSBOLPNFSTJBMEBQBUEJCVBUNFMBMVJQSPTFEVSCJBLBOCBLUFSJ
EBSBI ZBOH UJEBL BEFLVBU PMFI QBSV NFMBJOLBO UJEBL
%FOHBO NFOHVCBI LPOEJTJ QFSUVNCVIBO CBLUFSJ CFSBU NPMFLVM
BEFLVBUOZBUSBOTQPSEBSBIZBOHUFMBIEJPLTJHFOBTJ
EFLTUSBOEBQBUEJLFOEBMJLBOTFTVBJLFCVUVIBO%FLTUSBOEFOHBO
CFTBSNPMFLVMZBOHTFTVBJUJEBLEBQBUNFMFXBUJQPSJLBQJMFSEBO Pengobatan dengan Glukokortikoid (Hormon Korteks
LBSFOB JUV EBQBU NFOHHBOUJLBO QSPUFJO QMBTNB TFCBHBJ CBIBO Adrenal yang Mengatur Metabolisme Glukosa).
PTNPUJLLPMPJE Glukokortikoid sering diberikan pada QBTJFO TZPL CFSBU
5JEBL CBOZBL SFBLTJ UPLTJL EJBNBUJ LFUJLB EFLTUSBO ZBOH LBSFOB CFCFSBQB BMBTBO
QFSDPCBBO UFMBI NFNQFSMJIBULBO
EJNVSOJLBOEJQBLBJVOUVLNFNCFSJLBOUFLBOBOPTNPUJLLPMPJE TFDBSB FNQJSJT CBIXB HMVLPLPSUJLPJE TFSJOH NFOJOHLBULBO
LBSFOB JUV MBSVUBO ZBOH NFOHBOEVOH CBIBO JOJ UFMBI UFSCVLUJ LFLVBUBO KBOUVOH QBEB TZPL UBIBQ MBOKVU
HMVLPLPSUJLPJE
NFOKBEJQFOHHBOUJQMBTNBZBOHNFNVBTLBOQBEBTFCBHJBOCFTBS NFOTUBCJMLBO MJTPTPN EJ EBMBN TFM KBSJOHBO EBO EFOHBO
UFSBQJQFOHHBOUJBODBJSBO EFNJLJBO NFODFHBI QFNCFCBTBO FO[JN MJTPTPN LF EBMBN
TJUPQMBTNBTFM KBEJNFODFHBILFSVTBLBOEBSJTVNCFSJOJEBO

HMVLPLPSUJLPJEEBQBUNFNCBOUVNFUBCPMJTNFHMVLPTBPMFI
Pengobatan Syok dengan Obat-Obat Simpatomimetik- TFMZBOHNFOHBMBNJLFSVTBLBOIFCBU
Kadang-Kadang Bermanfaat, Kadang-Kadang Tidak
0CBU TJNQBUPNJNFUJL BEBMBI PCBU ZBOH NFOJSV SBOHTBOHBO Henti Sirkulasi
TJNQBUJT 0CBUPCBU UFSTFCVU BOUBSB MBJO OPSFQJOFGSJO FQJOFGSJO
EBO TFKVNMBI PCBU ZBOH LFSKBOZB KBOHLB QBOKBOH EBO NFNCFSJ 4VBUVLFBEBBOZBOHTBOHBUCFSIVCVOHBOEFOHBOTZPLTJSLVMBTJ
QFOHBSVITBNBTFQFSUJFQJOFGSJOEBOOPSFQJOFGSJO BEBMBI IFOUJ TJSLVMBTJ EBMBN LFBEBBO JOJ TFNVB BMJSBO EBSBI
0CBUPCBU TJNQBUPNJNFUJL UFMBI UFSCVLUJ NFNCFSJ NBOGBBU CFSIFOUJ NFOHBMJS ,FBEBBO JOJ TFSJOH UJNCVM EJ BUBT NFKB
LIVTVTQBEBEVBKFOJTTZPL+FOJTTZPLZBOHQFSUBNBBEBMBITZPL PQFSBTJTFCBHBJBLJCBUEBSJIFOUJKBOUVOHBUBVGJCSJMBTJWFOUSJLFM
OFVSPHFOJL 1BEB TZPL JOJ TJTUFN TBSBG TJNQBUJT NFOKBEJ TBOHBU
'JCSJMBTJ WFOUSJLFM CJBTBOZB EBQBU EJIFOUJLBO EFOHBO LFKVU
UFSUFLBO 1FNCFSJBO PCBU TJNQBUPNJNFUJL NFOHHBOUJLBO LFSKB
MJTUSJLZBOHLVBUQBEBKBOUVOH QSJOTJQEBTBSIBMJOJEJCBIBTEJ
TJNQBUJT ZBOH NFOVSVO EBO TFSJOH LBMJ EBQBU NFNVMJILBO
#BC
TFMVSVIGVOHTJTJSLVMBTJ
+FOJT TZPL LFEVB ZBOH BNBU EJQFOHBSVIJ PMFI PCBUPCBU )FOUJ KBOUVOH EBQBU EJBLJCBULBO PMFI UFSMBMV TFEJLJUOZB
TJNQBUPNJNFUJL BEBMBI TZPL BOBGJMBLTJT 1BEB TZPL JOJ IJTUBNJO PLTJHFO EBMBN DBNQVSBO HBT BOFTUFTJ BUBV EBSJ QFOHBSVI
ZBOH CFSMFCJIBO NFNBJOLBO QFSBOBO ZBOH NFOPOKPM 0CBUPCBU EFQSFTBO BOFTUFTJ JUV TFOEJSJ *SBNB KBOUVOH OPSNBM CJBTBOZB
TJNQBUPNJNFUJL NFNJMJLJ FGFL WBTPLPOTUSJLUPS ZBOH NFMBXBO EBQBU EJQVMJILBO EFOHBO NFOHIJMBOHLBO [BU BOFTUFTJ EBO
FGFL WBTPEJMBUBTJ EBSJ IJTUBNJO 0MFI LBSFOB JUV FQJOFGSJO TFHFSB NFOFSBQLBO QSPTFEVS SFTVTJUBTJ LBSEJPQVMNPOBM EBO
OPSFQJOFGSJO NBVQVO PCBU TJNQBUPNJNFUJL MBJOOZB TFSJOH LBMJ QBEB TBBU ZBOH TBNB NFNCFSJ PLTJHFO WFOUJMBTJ EBMBN KVNMBI
EBQBUNFOZFMBNBULBOKJXB ZBOHDVLVQLFQBSVQBTJFO
281
Unit IV Sirkulasi
Pengaruh Henti Sirkulasi pada Otak Daftar Pustaka

.BTBMBI LIVTVT QBEB IFOUJ TJSLVMBTJ BEBMBI NFODFHBI FGFL Annane D, SeAnnane D, Sebille V, Charpentier C, et al: Effect of treatment with low
LFSVTBLBO QBEB PUBL TFCBHBJ BLJCBU EBSJ IFOUJ UFSTFCVU 1BEB doses of hydrocortisone and fludrocortisone on mortality in patients with septic
VNVNOZB IFOUJ TJSLVMBTJ UPUBM TFMBNB MFCJI EBSJ IJOHHB shock,JAMA 288:862, 2002.
Burry LD, Wax RS: Rote of corticosteroids in septic shock, Ann Pharmacother
NFOJU EBQBU NFOZFCBCLBO TFEJLJUOZB CFCFSBQB EFSBKBU
38:464, 2004.
LFSVTBLBOPUBLZBOHQFSNBOFOQBEBMFCJIEBSJTFQBSVIQBTJFO Crowell JW, Smith EE: Oxygen deficit and irreversible hemorrhagic shock, Am J
)FOUJ TJSLVMBTJ TFMBNB IJOHHB NFOJU IBNQJS TFMBMV Physiol 206:313, 1964.
NFOHIBODVSLBO LFLVBUBO NFOUBM EBMBN KVNMBI ZBOH CFTBS Fliert MA, Rittirsch D, Huber-Lang MS, et Molecular events in the cardio
TFDBSBQFSNBOFO myopathy of sepsis, Mol Med 14:327, 2008.
Gatli SJ, Tsai M, Piliponsky AM: The development of allergic inflammation,
4FMBNB CFSUBIVOUBIVO UFMBI EJBKBSLBO CBIXB FGFL Nature 454:445, 2008.
LFSVTBLBO PUBL EJTFCBCLBO PMFI IJQPLTJB TFSFCSBM BLVU ZBOH Goodnough LT, Shander A: Evolution in alternatives to blood transfusion,
UFSKBEJ TFMBNB IFOUJ TJSLVMBTJ "LBO UFUBQJ QFSDPCBBO UFMBI Hematol J 4:87, 2003.
NFOVOKVLLBO CBIXB KJLB LJUB EBQBU NFODFHBI UJNCVMOZB Guyton AC, Jones CE, Coleman TG: Circulatory physiology: cardiac output
CFLVBO EBSBI EBMBN QFNCVMVI EBSBI PUBL NBLB TFCBHJBO and its regulation, Philadelphia, 1973, WB Saunders.
CFTBS LFSVTBLBO EJOJ QBEB PUBL TFMBNB UFSKBEJOZB IFOUJ Kemp SF, Lockey RF, Simons FE: Epinephrine: the drug of choice for anaphy
A statement of the Wortd Atlergy Organization, Allergy 63:1061, 2008.
TJSLVMBTJKVHBEBQBUEJIJOEBSJ4FCBHBJDPOUPI QBEBQFSDPCBBO
Martin GS, Mannino DM, Eaton S, et The epidemiology of sepsis in the United
IFXBO TFMVSVIEBSBIEJLFMVBSLBOEBSJQFNCVMVIEBSBIIFXBO States from 1979 through 2000, N Eng1J Med 348:1546, 2003.
QBEBQFSNVMBBOIFOUJTJSLVMBTJEBOLFNVEJBOEJNBTVLLBOMBHJ Reynolds HR, Hochman J: Cardiogenic shock: current concepts and improving
QBEB BLIJS IFOUJ TJSLVMBTJ TFIJOHHB UJEBL BLBO UFSKBEJ CFLVBO outcomes, Circulation 117:686, 2008.
EBMBN QFNCVMVI EBSBI 1BEB QFSDPCBBO JOJ CJBTBOZB PUBL Rushing GD, Britt LD: Reperfusion injury after hemorrhage: a collective review,
NBNQV CFSUBIBO TFMBNB NFOJU EBMBN LFBEBBO IFOUJ Ann Surg 247:929, 2008.
TJSLVMBTJ UBOQB UFSKBEJ LFSVTBLBO PUBL ZBOH QFSNBOFO Toh CH, Dennis M: Disseminated intravascutar coagulation: old disease, new
%FNJLJBO QVMB QFNCFSJBO IFQBSJO EBSJ TUSFQUPLJOBTF VOUVL hope, BMJ 327:974, 2003.
Wheeler AP: Recent developments in the diagnosis and management of
NFODFHBI QFNCFLVBO EBSBI
TFCFMVN IFOUJ KBOUVOH UFMBI
severe sepsis, Chest 132:1967, 2007.
NFNQFSMJIBULBO QFOJOHLBUBO LFNBNQVBO PUBL VOUVL
Wilson M, Davis DP, Coimbra R: Diagnosis and monitoring of hemor-rhagic
CFSUBIBOIJEVQTBNQBJEVBIJOHHBFNQBULBMJMFCJIMBNBEBSJ shock during the initial resuscitation of multiple trauma patients: a review, J
CJBTBOZB Emerg Med 24:413, 2003.
,FNVOHLJOBO LFSVTBLBOPUBLZBOHCFSBUZBOHUFSKBEJBLJCBU
IFOUJ TJSLVMBTJ EJTFCBCLBO UFSVUBNB PMFI TVNCBUBO ZBOH
QFSNBOFO PMFI CFLVBO EBSBI QBEB CBOZBL QFNCVMVI EBSBI
LFDJM TFIJOHHB NFOJNCVMLBO JTLFNJB ZBOH CFSMBOHTVOH MBNB
EBOCBILBOLFNBUJBOOFVSPO
282
V
UNIT
$BJSBO5VCVIEBO(JOKBM
25. Kompartemen Cairan Tubuh: Cairan
Ekstraselular dan lntraselular; Edema
26. Pembentukan Urine oleh Ginjal: I. Filtrasi
Glomerulus, Aliran Darah Ginjal, dan
Pengaturannya
27. Pembentukan Urine oleh Ginjal: II.
Reabsorpsi dan Sekresi Tubulus
28. Pemekatan dan Pengenceran Urine;
Pengaturan Osmolaritas Cairan
Ekstraselular dan Konsentrasi Natrium
29. Pengaturan Ginjal terhadap Kalium,
Kalsium, Fosfat, dan Magnesium; lntegrasi
Mekanisme Ginjal untuk Pengaturan
Volume Darah dan Volume Cairan
Ekstraselular
30. Pengaturan Asam-Basa
31. Diuretik dan Penyakit-Penyakit Ginjal
BAB 25
UNIT V
,PNQPOFO$BJSBO5VCVI$BJSBO
&LTUSBTFMVMBSEBO*OUSBTFMVMBS&EFNB
.FNQFSUBIBOLBO WPMVNF DBJSBO NFMBMVJ LVMJU ZBOH LFEVBOZB NFOHFMVBSLBO BJS TFLJUBS NM
UVCVI BHBS SFMBUJGLPOTUBO EBO IBSJ QBEB LFBEBBO OPSNBM )BM JOJMBI ZBOH EJTFCVU JOTFOTJCMF
LPNQPTJTJOZB UFUBQ TUBCJM QFOUJOH XBUFS MPTT LBSFOB LJUB UJEBL NFOZBEBSJOZB XBMBVQVO UFSKBEJ
VOUVL IPNFPTUBTJT TFQFSUJ ZBOH UFSVTNFOFSVTQBEBTFNVBNBLIMVLIJEVQ
EJCJDBSBLBO EJ #BC #FCFSBQB *OTFOTJCMF XBUFS MPTT ZBOH UFSKBEJ NFMBMVJ LVMJU UJEBL CFS
NBTBMBIQBMJOHVNVNEBOQFOUJOH HBOUVOH LFQBEB LFSJOHBU EBO CBILBO UFUBQ UFSKBEJ QBEB PSBOH
EBMBN LFEPLUFSBO LMJOJT UJNCVM BLJCBU BCOPSNBMJUBT EBMBN ZBOHMBIJSUBOQBLFMFOKBSLFSJOHBUKVNMBISBUBSBUBLFIJMBOHBOBJS
TJTUFN QFOHFOEBMJBO ZBOH NFNQFSUBIBOLBO LFTUBCJMBO DBJSBO EFOHBODBSBEJGVTJNFMBMVJLVMJULJSBLJSBTBNQBJNMIBSJ
UVCVIJOJ%BMBNCBCJOJEBOCBCCFSJLVUOZBUFOUBOHHJOKBM LJUB ,FIJMBOHBO JOJ EJNJOJNBMLBO PMFI MBQJTBO LPSOFVN LVMJU ZBOH
BLBO NFNCBIBT QFOHBUVSBO WPMVNF DBJSBO UVCVI TFDBSB NFOHBOEVOH LPMFTUFSPM ZBOH NFNCFSJLBO QFSMJOEVOHBO
LFTFMVSVIBO LBOEVOHBO DBJSBO FLTUSBTFMVMBS LFTFJNCBOHBO UFSIBEBQ LFIJMBOHBO ZBOH CFSMFCJIBO NFMBMVJ EJGVTJ #JMB MBQJTBO
BTBNCBTB EBOLPOUSPMQFSUVLBSBODBJSBOBOUBSBLPNQBSUFNFO LPSOFVN JOJ IJMBOH TFQFSUJ ZBOH UFSKBEJ QBEB MVLB CBLBS ZBOH
FLTUSBTFMEBOJOUSBTFM MVBT LFDFQBUBO FWBQPSBTJ EBQBU NFOJOHLBU TBNQBJ LBMJ *JQBU
NFODBQBJ TBNQBJ -IBSJ 0MFI TFCBC JUV LPSCBO MVLB CBLBS
Asupan dan Keluaran Cairan Seimbang Selama IBSVT EJCFSJ DBJSBO EBMBN KVNMBI ZBOH CFTBS CJBTBOZB TFDBSB
Kondisi Keadaan-mantap JOUSBWFOB VOUVLNFOHJNCBOHJLFIJMBOHBODBJSBO
*OTFOTJCMF XBUFS MPTT NFMBMVJ USBLUVT SFTQJSBUPSJVT SBUBSBUB

,FTUBCJMBOSFMBUJGDBJSBOUVCVIBEBMBITBOHBUNFOHBHVNLBOLB
CFSLJTBS TBNQBJ NMIBSJ 4FXBLUV VEBSB NFNBTVLJ
SFOB BEBOZB QFSUVLBSBO DBJSBO EBO [BU UFSMBSVU ZBOH UFSVT
USBLUVT SFTQJSBUPSJVT VEBSB BLBO EJKFOVILBO EFOHBO QFOHFN
NFOFSVT EFOHBO MJOHLVOHBO FLTUFSOBM TFQFSUJ KVHB BOUBS
CVOBO EBONFODBQBJUFLBOBOVBQLJSBLJSBNN)H TFCFMVN
CFSCBHBJ LPNQBSUFNFO UVCVI MBJOOZB $POUPIOZB BEBOZB
EJLFMVBSLBO 0MFI LBSFOB UFLBOBO VBQ EBSJ VEBSB JOTQJSBTJ
BTVQBO DBJSBO ZBOH TBOHBU CFSBHBN ZBOH IBSVT EFOHBO DFSNBU
CJBTBOZB LVSBOH EBSJ NN )H DBJSBO UFSVTNFOFSVT IJMBOH
EJTFTVBJLBOEFOHBOQFOHFMVBSBOBJSZBOHTFCBOEJOHEBSJUVCVI
NFMBMVJ QBSVQBSV EFOHBO SFTQJSBTJ 1BEB DVBDB ZBOH EJOHJO
VOUVL NFODFHBI QFOVSVOBO BUBV QFOJOHLBUBO WPMVNF DBJSBO
UFLBOBO VBQ BUNPTGFS UVSVO NFOEFLBUJ NFOZFCBCLBO LFIJMB
UVCVI
OHBO BJS ZBOH CBILBO MFCJI CFTBS EBSJ QBSVQBSV CFSTBNBBO
Asupan Cairan Tubuh Harian EFOHBOUVSVOOZBTVIVUVCVI)BMUFSTFCVUNFOKFMBTLBOQFSBTBBO
$BJSBO EJUBNCBILBO LF EBMBN UVCVI EBSJ EVB TVNCFS VUBNB LFSJOHQBEBTBMVSBOOBQBTTBBUDVBDBEJOHJO

CFSBTBMEBSJBJSBUBVDBJSBOEBMBNNBLBOBO ZBOHOPSNBMOZB
NFOBNCBI DBJSBO UVCVI TFLJUBS NMIBSJ EBO
CFSBTBM ,FIJMBOHBO "JS MFXBU ,FSJOHBU +VNMBI BJS ZBOH IJMBOH
EBSJ TJOUFTJT EJ UVCVI TFCBHBJ IBTJM PLTJEBTJ LBSCPIJESBU ZBOH NFMBMVJLFSJOHBUTBOHBUCFSWBSJBTJ CFSHBOUVOHQBEBBLUJWJUBTGJTJL
NFOBNCBI TFLJUBS NMIBSJ ,FEVB IBM JOJ NFNCFSJLBO EBOTVIVMJOHLVOHBO7PMVNFLFSJOHBUOPSNBMLJSBLJSBNM
BTVQBODBJSBOIBSJBOUPUBMLJSBLJSBNMIBSJ 5BCFM
IBSJ UBQJ QBEB DVBDB ZBOH TBOHBU QBOBT BUBV TFMBNB BLUJWJUBT
"LBO UFUBQJ BTVQBO BJS TBOHBU CFSWBSJBTJ QBEB NBTJOHNBTJOH CFSBU LFIJMBOHBO DBJSBO NFMBMVJ LFSJOHBU LBEBOHLBEBOH
PSBOHEBOCBILBOQBEBPSBOHZBOHTBNBQBEBIBSJZBOHCFSCF NFOJOHLBU TBNQBJ -KBN )BM UFSTFCVU BLBO EFOHBO DFQBU
EB CFSHBOUVOH QBEB DVBDB LFCJBTBBO EBO UJOHLBU BLUJWJUBT NFOHIBCJTLBO DBJSBO UVCVI KJLB BTVQBO KVHB UJEBL EJUJOHLBULBO
GJTJL EFOHBONFOHBLUJWBTJNFLBOJTNFIBVT ZBOHBLBOEJCBIBTEJ#BC

Kehilangan Cairan Tubuh Harian ,FIJMBOHBO "JS MFXBU 'FTFT 4FDBSB OPSNBM IBOZB TFKVNMBI
,FIJMBOHBO "JS ZBOH 5JEBL %JSBTBLBO *OTFOTJCMF 8BUFS LFDJMDBJSBOZBOHEJLFMVBSLBONFMBMVJGFTFT NMIBSJ
+VNMBI
-PTT
#FCFSBQB QFOHFMVBSBO DBJSBO UJEBL EBQBU EJBUVS TFDBSB JOJ EBQBU NFOJOHLBU TBNQBJ CFCFSBQB MJUFS TFIBSJ QBEB QBTJFO
UFQBU $POUPIOZB BEB LFIJMBOHBO BJS ZBOH CFSMBOHTVOH UFSVT EJBSF CFSBU 0MFI LBSFOB JUV EJBSF ZBOH CFSBU EBQBU
NFOFSVTNFMBMVJFWBQPSBTJEBSJUSBLUVTSFTQJSBUPSJVTEBOEJGVTJ NFNCBIBZBLBOKJXBKJLBEBMBNCFCFSBQBIBSJUJEBLEJUBOHBOJ
285
Unit V Cairan Tubuh dan Ginjal
Tabel 25-1 Asupan dan Keluaran Cairan Harian (dalam ml/hari)
Normal Aktivitas Berat

Berkepanjangan
Asupan
Minuman dan makanan 2100 ?
Dari metabolisme 200 200
Total asupan 2300 ?
Keluaran
Tidak dirasakan—Kulit 350 350
Tidak dirasakan—paru 350 650
Keringat 100 5000
Feses 100 100
Urine 1400 500
Toatal keluaran 2300 6600
,FIJMBOHBO"JSNFMBMVJ(JOKBM,FIJMBOHBOBJSMBJOOZBEBSJ
UVCVI BEBMBI MFXBU VSJOF ZBOH EJFLTSFTJLBO PMFI HJOKBM "EB Gambar 25-1 Ringkasan pengaturan cairan tubuh, meliputi
CFSCBHBJ NFLBOJTNF ZBOH NFOHBUVS LFDFQBUBO FLTLSFTJ VSJOF kompartemen-kompartemen cairan tubuh utama dan membran yang
#BILBO DBSB UFSQFOUJOH ZBOH EJMBLVLBO PMFI UVCVI EBMBN memisahkan kompartemen-kompartemen ini. Nilai yang diperlihatkan
NFNQFSUBIBOLBO LFTFJNCBOHBO BTVQBO EBO LFMVBSBO DBJSBO adalah untuk orang "rata-rata" dengan berat badan 70 kg.
TFSUBLFTFJNCBOHBOBOUBSBBTVQBOEBOLFMVBSBOTFCBHJBOCFTBS
FMFLUSPMJUEJUVCVIBEBMBIEFOHBONFOHBUVSLFDFQBUBOFLTLSFTJ 3BUBSBUB TFPSBOH MBLJMBLJ EFXBTB EFOHBO CFSBU LJMPHSBN
[BU[BU UFSTFCVU EBSJ HJOKBM .JTBMOZB WPMVNF VSJOF EBQBU NFNJMJLJ UPUBM DBJSBO UVCVI TFLJUBS QFSTFO CFSBU CBEBO BUBV
CFSLVSBOH TBNQBJ -IBSJ QBEB PSBOH ZBOH NFOHBMBNJ TFLJUBS - 1FSTFOUBTF JOJ EBQBU CFSVCBI CFSHBOUVOH LFQBEB
EFIJESBTJ BUBV CJTB TFCBOZBL -IBSJ QBEB PSBOH ZBOH VNVS KFOJT LFMBNJO EBO EFSBKBU PCFTJUBT 4FJSJOH EFOHBO
NFNJOVNTFKVNMBICFTBSBJS QFSUVNCVIBO TFTFPSBOH QFSTFOUBTF UPUBM DBJSBO UVCVI UFSIBEBQ
7BSJBTJ BTVQBO JOJ KVHB UFSKBEJ QBEB LFCBOZBLBO FMFLUSPMJU CFSBUCBEBOCFSBOHTVSBOHTVSUVSVO)BMUFSTFCVUBEBMBITFCBHJBO
UVCVI TFQFSUJ OBUSJVN LMPSJEB EBO LBMJVN 1BEB CFCFSBQB BLJCBU EBSJ QFOVBBO ZBOH CJBTBOZB CFSIVCVOHBO EFOHBO
PSBOH BTVQBOOBUSJVNEBQBUTFSFOEBIN&RIBSJ TFEBOHLBO QFOJOHLBUBO QFSTFOUBTF MFNBL UVCVI TFIJOHHB NFOHVSBOHJ
QBEB PSBOH MBJO EBQBU NFODBQBJ TBNQBJ N&RIBSJ QFSTFOUBTFDBJSBOEBMBNUVCVI
(JOKBMCFSUVHBTVOUVLNFOZFTVBJLBOLFDFQBUBOFLTLSFTJBJSEBO 0MFILBSFOBXBOJUBQBEBOPSNBMOZBNFNQVOZBJMFNBLUVCVI
FMFLUSPMJU EFOHBO BTVQBO [BU[BU UFSTFCVU EBO NFOHPNQFOTBTJ MFCJI CBOZBL EBSJ QSJB DBJSBO UVCVI UPUBM NFSFLB SBUBSBUB
LFIJMBOHBOBJSEBOFMFLUSPMJUZBOHCFSMFCJIBOZBOHUFSKBEJQBEB CFSLJTBS TFLJUBS QFSTFO EBSJ CFSBU CBEBOOZB 1BEB CBZJ
QFOZBLJUQFOZBLJU UFSUFOUV 1BE #BC TBNQBJ LJUB BLBO QSFNBUVS EBO ZBOH CBSV MBIJS KVNMBI UPUBM DBJSBO UVCVIOZB
NFNCBIBT NFLBOJTNF ZBOH NFNVOHLJOLBO HJOKBM VOUVL CFSLJTBSBOUBSBTBNQBJQFSTFOEBSJCFSBUCBEBOOZB+BEJ CJMB
NFMBLVLBOUVHBTOZBZBOHMVBSCJBTBJOJ LJUBNFNCBIBTLPNQBSUFNFODBJSBOUVCVISBUBSBUB LJUBIBSVT
NFOZBEBSJBEBOZBWBSJBTJ CFSHBOUVOHQBEBVNVS KFOJTLFMBNJO
EBOQFSTFOUBTFMFNBLUVCVI
Kompartemen Cairan Tubuh Kompartemen Cairan Instraselular

4FNVB DBJSBO UVCVI EJEJTUSJCVTJLBO UFSVUBNB EJ BOUBSB EVB 4FLJUBS EBSJ - DBJSBO UVCVI BEB EJ EBMBN USJMJVO TFM
LPNQBSUFNFO DBJSBO FLTUSBTFMVMBS EBO DBJSBO JOUSBTFMVMBS EBOTFDBSBLFTFMVSVIBOEJTFCVUDBJSBOJOUSBTFMVMBS+BEJ DBJSBO
(BNCBS
$BJSBO FLTUSBTFMVMBS EJCBHJ NFOKBEJ DBJSBO JOUSBTFMVMBS NFSVQBLBO QFSTFO EBSJ CFSBU CBEBO UPUBM QBEB
JOUFSTUJTJBMEBOQMBTNBEBSBI SBUBSBUBPSBOH
"EBKVHBLPNQBSUFNFODBJSBOMBJOOZBZBOHLFDJMZBOHEJTF $BJSBO NBTJOHNBTJOH TFM NFOHBOEVOH DBNQVSBOOZB
CVUTFCBHBJDBJSBOUSBOTFMVMBS,PNQBSUFNFOJOJNFMJQVUJDBJSBO UFSTFOEJSJ EFOHBO CFSCBHBJ [BU OBNVO LPOTFOUSBTJ [BU[BU JOJ
EBMBNSPOHHBTJOPWJBM QFSJUPOFVN QFSJLBSEJVN EBOJOUSBPLV NJSJQBOUBSBTBUVTFMEFOHBOTFMMBJOOZB4FCFOBSOZB LPNQPTJTJ
MBS TFSUB DBJSBO TFSFCSPTQJOBM DBJSBODBJSBO UFSTFCVU CJBTBOZB DBJSBO TFM TBOHBU NJSJQ CBILBO QBEB IFXBO ZBOH CFSCFEB
EJBOHHBQ TFCBHBJ KFOJT DBJSBO FLTUSBTFMVMBS LIVTVT XBMBVQVO NVMBJ EBSJ NJLSPPSHBOJTNF QBMJOH QSJNJUJG TBNQBJ NBOVTJB
QBEB CFCFSBQB LBTVT LPNQPTJTJOZB EBQBU TBOHBU CFSCFEB 0MFI TFCBC JUV DBJSBO JOUSBTFMVMBS EBSJ TFMVSVI TFM ZBOH
EFOHBO LPNQPTJTJ QMBTNB BUBV DBJSBO JOUFSTUJTJBM $BJSBO CFSCFEBCFEB EJBOHHBQ TFCBHBJ TBUV LPNQBSUFNFO DBJSBO ZBOH
USBOTFMVMBSTFMVSVIOZBCFSKVNMBITFLJUBSTBNQBJMJUFS CFTBS
286
Bab 25 Kompartemen Cairan Tubuh: Cairan Ekstraselular dan Intraselutar; Edema
Komposisis Ion Plasma Serupa dengan Komposisi Ion

Kompartemen Cairan Ekstraselular
Cairan Interstisial
4FNVB DBJSBO EJ MVBS TFM TFDBSB LFTFMVSVIBO EJTFCVU DBJSBO ,PNQPTJTJ JPO QMBTNB TFSVQB EFOHBO LPNQPTJTJ DBJSBO
FLTUSBTFMVMBS$BJSBOJOJNFSVQBLBOQFSTFOEBSJCFSBUCBEBO JOUFSTUJTJBM LBSFOBLFEVBOZBIBOZBEJQJTBILBOPMFINFNCSBO
BUBV TFLJUBS - QBEB MBLJMBLJ OPSNBM EFOHBO CFSBU CBEBO LBQJMFSZBOHTBOHBUQFSNFBCFM1FSCFEBBOQBMJOHVUBNBBOUBSB
UNIT V
LJMPHSBN %VB LPNQBSUFNFO UFSCFTBS EBSJ DBJSBO FLTUSBTFMVMBS LFEVB LPNQBSUFNFO JOJ BEBMBI LPOTFOUSBTJ QSPUFJO EBMBN
BEBMBI DBJSBO JOUFSTUJTJBM ZBOH CFSKVNMBI MFCJI EBSJ UJHB QMBTNB ZBOH MFCJI UJOHHJ LBSFOB LBQJMFS NFNQVOZBJ
QFSFNQBU -
CBHJBO DBJSBO FLTUSBTFMVMBS EBO QMBTNB ZBOH QFSNFBCJMJUBT ZBOH SFOEBI UFSIBEBQ QSPUFJO QMBTNB IBOZB
CFSKVNMBIIBNQJSTFQFSFNQBUDBJSBOFLTUSBTFMVMBS BUBVTFLJUBS TFKVNMBILFDJMQSPUFJOZBOHNBTVLLFEBMBNSVBOHJOUFSTUJTJBM
- 1MBTNB BEBMBI CBHJBO EBSBI ZBOH UBL NFOHBOEVOH TFM EJLFCBOZBLBOKBSJOHBO
QMBTNB UFSVTNFOFSVT CFSUVLBS [BU EFOHBO DBJSBO JOUFSTUJTJBM ,BSFOB FGFL %POOBO LPOTFOUSBTJ JPO CFSNVBUBO QPTJUJG
NFMBMVMJ QPSJQPSJ NFNCSBO LBQJMFS 1PSJQPSJ JOJ CFSTJGBU LBUJPO
TFEJLJU MFCJI CFTBS QFSTFO
EJ EBMBN QMBTNB
TBOHBUQFSNFBCFMVOUVLIBNQJSTFNVB[BUUFSMBSVUEBMBNDBJSBO EBSJQBEB EJ EBMBN DBJSBO JOUFSTUJTJBM 1SPUFJO QMBTNB
FLTUSBTFMVMBS LFDVBMJ QSPUFJO 0MFI LBSFOB JUV DBJSBO NFNQVOZBJ NVBUBO BLIJS OFHBUJG EBO LBSFOBOZB DFOEFSVOH
FLTUSBTFMVMBS TFDBSB LPOTUBO UFSVT UFSDBNQVS TFIJOHHB QMBTNB NFOHJLBU LBUJPO TFQFSUJ JPO OBUSJVN EBO LBMJVN TFIJOHHB
EBODBJSBOJOUFSTUJTJBMNFNQVOZBJLPNQPTJTJZBOHIBNQJSTBNB TFKVNMBI CFTBS LBUJPO JOJ UFSUBIBO EJ EBMBN QMBTNB CFSTBNB
LFDVBMJ VOUVL QSPUFJO ZBOH LPOTFOUSBTJOZB MFCJI UJOHHJ EJ EFOHBOQSPUFJOQMBTNB4FCBMJLOZB LPOTFOUSBTJJPOCFSNVBUBO
EBMBNQMBTNB OFHBUJG BOJPO
EBMBNDBJSBOJOUFSTUJTJBMDFOEFSVOHMFCJIUJOHHJ
EJCBOEJOHLBO EFOHBO QMBTNB LBSFOB NVBUBO OFHBUJG QSPUFJO
QMBTNBBLBONFOPMBLBOJPOZBOHCFSNVBUBOOFHBUJG/BNVO
Volume Darah VOUVL UVKVBO QSBLUJT LPOTFOUSBTJ JPO EBMBN DBJSBO JOUFSTUJTJBM
EBOQMBTNBEJBOHHBQTFSVQB
%FOHBONFSVKVLMBHJQBEB(BNCBS LJUBEBQBUNFMJIBU
%BSBINFOHBOEVOHDBJSBOFLTUSBTFMVMBS DBJSBOEBMBNQMBTNB

CBIXB DBJSBO FLUSBTFMVMBS ZBOH NFMJQVUJ QMBTNB EBO DBJSBO
EBO DBJSBO JOUSBTFMVMBS DBJSBO EBMBN TFM EBSBI NFSBI
"LBO
JOUFSTUJTJBM NFOHBOEVOH TFKVNMBI CFTBS JPO OBUSJVN EBO
UFUBQJ EBSBI EJBOHHBQ TFCBHBJ LPNQBSUFNFO DBJSBO UFSQJTBI
LMPSJEB TFSUB JPO CJLBSCPOBU EBMBN KVNMBI ZBOH DVLVQ CFTBS
LBSFOBEBSBIUFSLBOEVOHEBMBNSVBOHOZBTFOEJSJ ZBJUVTJTUFN
OBNVO DBJSBO FLTUSBTFMVMBS IBOZB TFEJLJU NFOHBOEVOH JPO
TJSLVMBTJ 7PMVNF EBSBI LIVTVTOZB QFOUJOH VOUVL NFOHBUVS
LBMJVN LBMTJVN NBHOFTJVN GPTGBU EBOBTBNPSHBOJL
EJOBNJLBTJTUFNLBSEJPWBTLVMBS
,PNQPTJTJ DBJSBO FLTUSBTFMVMBS EJBUVS EFOHBO DFSNBU PMFI
3BUBSBUBWPMVNFEBSBIPSBOHEFXBTBBEBMBITFLJUBSQFS
CFSCBHBJNFLBOJTNF LIVTVTOZBPMFIHJOKBM TFQFSUJZBOHBLBO
TFO EBSJ CFSBU UVCVI BUBV TFLJUBS - 4FLJUBS QFSTFO EBSBI
EJCJDBSBLBOOBOUJ)BMJOJNFNVOHLJOLBOTFMVOUVLUFUBQUFSVT
CFSVQB QMBTNB EBO QFSTFOOZB CFSVQB TFM EBSBI NFSBI OB
UFSFOEBN EBMBN DBJSBO ZBOH NFOHBOEVOH LPOTFOUSBTJ
NVOQFSTFOUBTFJOJEBQBUCFSWBSJBTJQBEBNBTJOHNBTJOHPSBOH
FMFLUSPMJU EBO [BU OVUSJTJ ZBOH TFTVBJ VOUVL GVOHTJ TFM ZBOH
CFSHBOUVOHQBEBKFOJTLFMBNJO CFSBUCBEBO EBOGBLUPSMBJOOZB
PQUJNBM
)FNBUPLSJU 1BDLFE3FE$FMM7PMVNF
)FNBUPLSJUBEBMBI
GSBLTJEBSBIZBOHUFSEJSJBUBTTFMEBSBINFSBI ZBOHEJUFOUVLBO
NFMBMVJ TFOUSJGVHBTJ EBSBI EBMBN UBCVOH IFNBUPLSJU TBNQBJ
Unsur-Unsur Cairan Intraselular
TFMTFM JOJ NFOKBEJ CFOBSCFOBS NBNQBU EJ CBHJBO CBXBI UB $BJSBO JOUSBTFMVMBS EJQJTBILBO EBSJ DBJSBO FLTUSBTFMVMBS PMFI
CVOH4FNVBTFMEBSBINFSBIUJEBLNVOHLJOVOUVLEJNBNQBU NFNCSBOTFM ZBOH TBOHBUQFSNFBCFMUFSIBEBQBJS UFUBQJUJEBL
LBOLBSFOBOZB TFLJUBSTBNQBJQFSTFOQMBTNBUFUBQUFSKFCBL QFSNFBCFM UFSIBEBQ TFCBHJBO CFTBS FMFLUSPMJU EBMBN UVCVI
EJ BOUBSB TFMTFM EBO OJMBJ IFNBUPLSJU ZBOH TFCFOBSOZB IBOZB #FSCFEBEFOHBODBJSBOFLTUSBTFMVMBS DBJSBOJOUSBTFMVMBSIBOZB
TFLJUBSQFSTFOEBSJOJMBJIFNBUPLSJUZBOHUFSVLVS NFOHBOEVOH TFKVNMBI LFDJM JPO OBUSJVN EBO LMPSJEB EBO
1BEBQSJB OJMBJIFNBUPLSJUZBOHUFSVLVSOPSNBMOZBTFLJUBS IBNQJS UJEBL BEB JPO LBMTJVN .BMBI DBJSBO JOJ NFOHBOEVOH
EBO QBEB XBOJUB LJSBLJSB 1BEB BOFNJB CFSBU TFKVNMBICFTBSJPOLBMJVNEBOGPTGBUEJUBNCBIJPONBHOFTJVN
IFNBUPLSJU EBQBU UVSVO TBNQBJ ZBJUV TVBUV OJMBJ ZBOH EBO TVMGBU EBMBN KVNMBI TFEBOH TFNVB JPO JOJ NFNJMJLJ
IBNQJSUJEBLDVLVQVOUVLNFNQFSUBIBOLBOIJEVQ4FCBMJLOZB LPOTFOUSBTJ ZBOH SFOEBI EJ DBJSBO FLTUSBTFMVMBS 4FM KVHB
BEBCFCFSBQBLPOEJTJZBOHNFOHBLJCBULBOUFSKBEJOZBQSPEVLTJ NFOHBOEVOH TFKVNMBI CFTBS QSPUFJO IBNQJS FNQBU LBMJ
TFM EBSBI NFSBI ZBOH CFSMFCJIBO ZBJUV QPMJTJUFNJB 1BEB KVNMBIQSPUFJOEBMBNQMBTNB
LPOEJTJUFSTFCVU OJMBJIFNBUPLSJUEBQBUNFOJOHLBUTBNQBJ
Pengukuran Volume Cairan di Berbagai
Kompartemen Cairan Tubuh—Prinsip Pengeceran-
indikator.
Konstituensi Cairan Ekstraselular dan Intraselular
7PMVNF LPNQBSUFNFO DBJSBO EBMBN UVCVI EBQBU EJVLVS
EFOHBONFNBTVLLBOTVBUV[BUJOEJLBUPSEBMBNLPNQBSUFNFO
1FSCBOEJOHBO LPNQPTJTJ DBJSBO FLTUSBTFMVMBS ZBOH NFMJQVUJ ZBOH EJCJBSLBO UFSTFCBS TFDBSB NFSBUB LF TFMVSVI DBJSBO
QMBTNB EBO DBJSBO JOUFSTUJTJBM EBO DBJSBO JOUSBTFMVMBS LPNQBSUFNFO EBO LFNVEJBO NFOHBOBMJTJT TFKBVI NBOB [BU
EJQFSMJIBULBOQBEB(BNCBSEBOEBOQBEB5BCFM UFSTFCVUUFSFODFSLBO(BNCBSNFNQFSMJIBULBONFUPEF
287
150
100
50
HCO3
Na Ca Cl
0
K Mg
Protein
50
100
PO ––4
–
150 I
Tabel 25-2 Osmolaritas Zat-Zat dalam Cairan Ekstraselular dan Intraselular
Plasma (mOsm/L H2O) Interstisial (mOsm/L H2O) intraselular (mOsm/L H2O)
Na+ 142 139 14

K +
4.2 4.0 140
Ca ++ 1.3 1.2 0
Mg++ 0.8 0.7 20
Cl− 108 108 4
HCO3 24 28.3 10
HPO4 , H2PO4 = 2 2 11
SO4= 0.5 0.5 1
Fosfokreatin 45
Karnosin 14
Asam amino 2 2 8
Kreatin 0.2 0.2 9
Laktat 1.2 1.2 1.5
Adenosin trifosfat 5
Heksosa monofosfat 3.7
Glukosa 5.6 5.6
Protein 1.2 0.2 4
Urea 4 4 4
Lain-lain 4.8 3.9 10
Total mOsm/L 301.8 300.8 301.2
Aktivitas osmolar terkoreksi(mOsm/L) 282.0 281.0 281.0
Tekanan osomotik total pada 37 °C (mm Hg) 5443 5423 5423
288
Bab 25 Kompartemen Cairan Tubuh: Cairan Ekstraselular dan Intraselutar; Edema
.FUPEFJOJEBQBUEJHVOBLBOVOUVLNFOHVLVSWPMVNFEBO
IBNQJS TFNVB LPNQBSUFNFO UVCVI LBMBV
JOEJLBUPS
UFSTFCBS TFDBSB NFSBUB LF TFMVSVI LPNQBSUFNFO

JOEJLBUPS IBOZB UFSTFCBS QBEB LPNQBSUFNFO ZBOH TFEBOH
EJVLVS EBO
JOEJLBUPSUJEBLNFOHBMBNJNFUBCPMJTNFBUBV
UNIT V
EJFLTLSFTJ #FCFSBQB [BU EBQBU EJHVOBLBO VOUVL NFOHVLVS
WPMVNFNBTJOHNBTJOHDBJSBOUVCVIZBOHCFSCFEB
Penentuan Volume Kompartemen Cairan Tubuh

yang Spesifik
1FOHVLVSBO$BJSBO5VCVI5PUBM"JSSBEJPBLUJG USJUJVN
)
BUBV BJS CFSBU EFVUFSJVN )
EBQBU EJHVOBLBO
VOUVL NFOHVLVS DBJSBO UVCVI UPUBM #FOUVL DBJSBO JOJ
CFSDBNQVS EFOHBO DBJSBO UVCVI UPUBM EBMBN LVSVO XBLUV
CFCFSBQB KBN TFUFMBI EJTVOUJLLBO LF EBMBN EBSBI EBO
QSJOTJQ QFOHFODFSBO EBQBU EJHVOBLBO VOUVL NFOHIJUVOH
DBJSBO UVCVI UPUBM 5BCFM
;BU MBJO ZBOH UFMBI
QFOHFODFSBOJOEJLBUPS JOJ VOUVL NFOHVLVS WPMVNF LPNQBSUF EJHVOBLBO VOUVL NFOHVLVS DBJSBO UVCVI UPUBM BEBMBI
NFODBJSBO.FUPEFJOJEJEBTBSLBOQBEBQSJOTJQLFLFLBMBONBTTB BOUJQJSJO ZBOH TBOHBU MBSVU EBMBN MFNBL EBO DFQBU
ZBOH CFSBSUJ CBIXB NBTTB UPUBM [BU ZBOH TVEBI UFSTFCBS EBMBN CFSQFOFUSBTJNFMBMVJNFNCSBOTFMEBOUFSTFCBSTFDBSBNFSBUB
LPNQBSUFNFODBJSBOBLBOTBNBEFOHBONBTTBUPUBMZBOHEJTVO LFTFMVSVILPNQBSUFNFOJOUSBTFMEBOFLTUSBTFM
UJLLBOLFEBMBNLPNQBSUFNFO 1FOHVLVSBO7PMVNF$BJSBO&LTUSBTFMVMBS7PMVNFDBJSBO
%BMBNDPOUPIZBOHEJQFSMJIBULBOQBEB(BNCBS TFKVNMBI FLTUSBTFMVMBS EBQBU EJQFSLJSBLBO EFOHBO NFOHHVOBLBO CFCF
LFDJM [BU QFXBSOB BUBV [BU MBJO ZBOH UFSEBQBU EBMBN TFNQSJU SBQB[BUZBOHUFSTFCBSEBMBNDBJSBOJOUFSTUJTJBMEBOQMBTNBUBQJ
EJJOKFLTJLBO LF EBMBN TVBUV SVBOHBO MBMV [BU JOJ EJCJBSLBO UJEBL EBQBU NFOFNCVT NFNCSBO TFM EFOHBO NVEBI ;BU[BU
UFSTFCBSLFTFMVSVISVBOHBOTBNQBJUFSDBNQVSEBMBNLPOTFOUSBTJ JOJ NFMJQVUJ OBUSJVN SBEJPBLUJG LMPSJEB SBEJPBLUJG JPUBMBNBU
ZBOHTBNBEJTFMVSVIBSFB,FNVEJBOEJBNCJMTVBUVDPOUPIDBJSBO SBEJPBLUJG JPOUJPTVMGBU EBOJOVMJO#JMBTBMBITBUVEBSJ[BU[BU
ZBOH NFOHBOEVOH [BU ZBOH UFSTFCBS JUV EBO LPOTFOUSBTJOZB JOJEJTVOUJLLBOLFEBMBNEBSBI [BUUFSTFCVUCJBTBOZBUFSTFCBS
EJBOBMJTJTTFDBSBLJNJBXJ GPUPFMFLUSJL BUBVEFOHBODBSBMBJO+JLB IBNQJS TFDBSB NFSBUB LF TFMVSVI DBJSBO FLTUSBTFMVMBS EBMBN
UJEBLBEB[BUZBOHCPDPSEBSJLPNQBSUFNFO NBTTBUPUBM[BUEBMBN XBLUV TBNQBJ NFOJU /BNVO CFCFSBQB [BU JOJ TFQFSUJ
LPNQBSUFNFO 7PMVNF # Y ,POTFOUSBTJ #
BLBO TBNB EFOHBO OBUSJVNSBEJPBLUJG EBQBUCFSEJGVTJLFEBMBNTFMEBMBNKVNMBI
NBTTB UPUBM [BU ZBOH EJJOKFLTJLBO 7PMVNF " Y ,POTFOUSBTJ "
ZBOH LFDJM 0MFI LBSFOB JUV LJUB TFSJOH LBMJ NFOZFCVUOZB
%FOHBO NFOZFEFSIBOBLBO QFSIJUVOHBO TFTFPSBOH BLBO EBQBU TFCBHBJ SVBOH OBUSJVN BUBV SVBOH JOVMJO EBO CVLBO
NFOHIJUVOHWPMVNF#ZBOHUJEBLEJLFUBIVJEFOHBOSVNVT QFOHVLVSBOWPMVNFDBJSBOFLUSBTFMZBOHTFTVOHHVIOZB
Volume A A
Volume B =
B
Tabel 25-3 Pengukuran Volume Cairan Tubuh
Volume Indikator
1FSIBUJLBO CBIXB IBMIBM ZBOH QFSMV EJLFUBIVJ VOUVL
QFSIJUVOHBOJOJBEBMBI
KVNMBIUPUBM[BUZBOHEJJOKFLTJLBOLF Total cairan tubuh H2O, 2H2O, antipirin
3
EBMBNSVBOHBO QFNCJMBOHEBOQFSTBNBBO
EBO
LPOTFOUSBTJ Cairan ekstraselular
22Na,125I-iotalamat, tiosulfat,
DBJSBOEBMBNSVBOHBOTFUFMBI[BUUFSTFCBS QFOZFCVU
inulin
Cairan intraselular (Dihitung dengan; Total cairan
$POUPIOZB KJLB NM MBSVUBO ZBOH NFOHBOEVOH NH NM
tubuh-volume cairan ekstraselular)
[BU XBSOB EJTFCBS LF EBMBN SVBOHBO # EBO LPOTFOUSBTJ BLIJS
EBMBN SVBOH # BEBMBI NJMJHSBN VOUVL TFUJBQ NJMJMJUFS Volume plasma 123I-albumin, pewarna biru Evans (T-1824)
DBJSBO WPMVNFSVBOH#EBQBUEJIJUVOHTFCBHBJCFSJLVU Volume darah Sel darah merah berlabel 51Cr, atau
dihitung dengan: volume darah =
Volume plasma/(1 - Hermatokrit)
Cairan interstisial (Calculated as extracellular
1 ml 10 mg/ml
Volume B = = 1000 ml fluid volume − Plasma volume)
0.01 mg/ml
289
1FOHIJUVOHBO 7PMVNF *OUSBTFM 7PMVNF JOUSBTFM UJEBL MBUJGDBJSBOFLTUSBTFMVMBSZBOHEJEJTUSJCVTJLBOBOUBSBQMBTNBEBO

EBQBU EJVLVS TFDBSB MBOHTVOH /BNVO EBQBU EJIJUVOH TFCBHBJ SVBOH JOUFSTUJTJBM UFSVUBNB EJUFOUVLBO PMFI LFTFJNCBOHBO EBZB
CFSJLVU IJESPTUBUJLEBOPTNPUJLLPMPJEEJTFQBOKBOHNFNCSBOLBQJMFS
4FCBMJLOZB EJTUSJCVTJDBJSBOBOUBSBLPNQBSUFNFOFLTUSBTFMVMBS
Volume intrasel= Cairan tubuh total –Volume ekstrasel EBO JOUSBTFMVMBS UFSVUBNB EJUFOUVLBO PMFI FGFL PTNPUJL EBO [BU
UFSMBSVU ZBOH MFCJI TFEJLJU LIVTVTOZB OBUSJVN LMPSJEB EBO
1FOHVLVSBO 7PMVNF 1MBTNB 6OUVL NFOHVLVS WPMVNF FMFLUSPMJU MBJO ZBOH CFLFSKB EJ TFQBOKBOH NFNCSBO TFM "MBTBO
QMBTNB IBSVTEJHVOBLBOTVBUV[BUZBOHUJEBLEBQBUNFOFNCVT VOUVL IBM JOJ JBMBI CBIXB NFNCSBO TFM TBOHBU QFSNFBCFM
NFNCSBO LBQJMFS EFOHBO NVEBI UBQJ UFUBQ EBMBN TJTUFN UFSIBEBQ DBJSBO UFUBQJ SFMBUJG JNQFSNFBCFM UFSIBEBQ JPO ZBOH
WBTLVMBS TFUFMBI EJJOKFLTJ 4BMBI TBUV [BU ZBOH QBMJOH TFSJOH LFDJMTFQFSUJOBUSJVNEBOLMPSJEB0MFILBSFOBJUV DBJSBOEFOHBO
EJHVOBLBO VOUVL NFOHVLVS WPMVNF QMBTNB JBMBI BMCVNJO DFQBU CFSHFSBL NFMJOUBTJ NFNCSBO TFM EBO DBJSBO JOUSBTFMVMBS
TFSVN ZBOH EJMBCFM EFOHBO SBEJPBLUJG *"MCVNJO
;BU UFUBQJTPUPOJLUFSIBEBQDBJSBOFLTUSBTFMVMBS
QFXBSOB ZBOH KVHB UFSJLBU LVBU QBEB QSPUFJO QMBTNB TFQFSUJ %J CBHJBO CFSJLVUOZB LJUB BLBO NFNCBIBT NFOHFOBJ IVCV
QFXBSOB &WBOT #MVF KVHB EJTFCVU 5
EBQBU EJHVOBLBO OHBOBOUBSBWPMVNFDBJSBOJOUSBTFMVMBSEBOFLTUSBTFMTFSUBGBLUPS
VOUVLNFOHVLVSWPMVNFQMBTNB GBLUPS PTNPUJL ZBOH EBQBU NFOZFCBCLBO QFSQJOEBIBO DBJSBO
BOUBSBLFEVBLPNQBSUFNFOUFSTFCVU
1FOHIJUVOHBO 7PMVNF $BJSBO *OUFSTUJTJBM 7PMVNF DBJ
SBO JOUFSTUJTJBM UJEBL EBQBU EJIJUVOH TFDBSB MBOHTVOH UFUBQJ Prinsip Dasar Osmosis dan
EBQBUEJIJUVOHEFOHBOSVNVT Tekanan Osmotik
Volume Cairan Interstisial =
1SJOTJQ EBTBS PTNPTJT EBO UFLBOBO PTNPUJL TVEBI EJKFMBTLBO EJ
Volume Cairan Ekstraselular– Volume plasma
#BC 0MFI LBSFOB JUV EJ TJOJ LJUB IBOZB NFNCBIBT NFOHFOBJ
BTQFL UFSQFOUJOH EBO QSJOTJQQSJOTJQ JOJ ZBOH TFTVBJ EFOHBO
1FOHVLVSBO 7PMVNF %BSBI +JLB LJUB NFOHVLVS WPMVNF QFOFSBQBOOZBEBMBNQFOHBUVSBOWPMVNF
QMBTNBEFOHBONFOHHVOBLBONFUPEFZBOHEJKFMBTLBOTFCFMVN 0TNPTJT BEBMBI EJGVTJ OFUP DBJSBO ZBOH NFOZFCFSBOHJ
OZB NBLBWPMVNFEBSBIKVHBEBQBUEJIJUVOHKJLBLJUBNFOHFUB NFNCSBOFQFSNFBCFMTFMFLUJGEBSJUFNQBUZBOHLPOTFOUSBTJBJSOZB
IVJOJMBJIFNBUPLSJU GSBLTJWPMVNFEBSBIUPUBMZBOHUFSEJSJBUBT
UJOHHJLFUFNQBUZBOHLPOTFOUSBTJBJSOZBMFCJISFOEBI#JMBTVBUV
TFMTFM
EFOHBONFOHHVOBLBOQFSTBNBBOCFSJLVU
[BU UFSMBSVU EJUBNCBILBO QBEB BJS NVSOJ [BU JOJ BLBO
NFOVSVOLBO LPOTFOUSBTJ BJS EBMBN DBNQVSBO +BEJ TFNBLJO
UJOHHJ LPOTFOUSBTJ [BU UFSMBSVU EBMBN TVBUV MBSVUBO TFNBLJO
Volume plasma
Volume darah total = 1 –Hematokrit SFOEBI LPOTFOUSBTJ BJSOZB 4FMBOKVUOZB DBJSBO CFSEJGVTJ EBSJ
EBFSBIEFOHBOLPOTFOUSBTJ[BUUFSMBSVUZBOHSFOEBI LPOTFOUSBTJ
$POUPIOZB KJLB WPMVNF QMBTNB JBMBI - EBO IFNBUPLSJU BJS ZBOH UJOHHJ
LF EBFSBI EFOHBO LPOTFOUSBTJ [BU UFSMBSVU ZBOH
BEBMBI WPMVNFEBSBIUPUBMEBQBUEJIJUVOHTFCBHBJCFSJLVU UJOHHJ LPOTFOUSBTJBJSZBOHSFOEBI

0MFI LBSFOB NFNCSBO TFM SFMBUJG JNQFSNFBCFM UFSIBEBQ
MJUFS LFCBOZBLBO [BU UFSMBSVU UBQJ TBOHBU QFSNFBCFM UFSIBEBQ BJS
MJUFS
QFSNFBCFMTFMFLUJG
NBLBCJMBQBEBTBMBITBUVTJTJNFNCSBOTFM
LPOTFOUSBTJ [BU UFSMBSVUOZB MFCJI UJOHHJ BJS BLBO CFSEJGVTJ
$BSB MBJO VOUVL NFOHVLVS WPMVNF EBSBI JBMBI EFOHBO NFMJOUBTJ NFNCSBO NFOVKV EBFSBI EFOHBO LPOTFOUSBTJ [BU
NFOZVOUJLLBONBUFSJBMCFSMBCFMSBEJPBLUJGLFEBMBNTJSLVMBTJ UFSMBSVU ZBOH MFCJI UJOHHJ +BEJ KJLB TVBUV [BU UFSMBSVU TFQFSUJ
TFMEBSBINFSBI4FUFMBI[BUJOJCFSDBNQVSEJEBMBNTJSLVMBTJ OBUSJVN LMPSJEB EJUBNCBILBO LF EBMBN DBJSBO FLTUSBTFMVMBS BJS
SBEJPBLUJWJUBT TBNQFM EBSBI ZBOH CFSDBNQVS EBQBU EJVLVS EFOHBO DFQBU CFSEJGVTJ EBSJ TFM NFMBMVJ NFNCSBO TFM LF EBMBN
EBOWPMVNFEBSBIUPUBMEBQBUEJIJUVOHEFOHBONFOHHVOBLBO DBJSBO FLTUSBTFMVMBS TBNQBJ LPOTFOUSBTJ BJS QBEB LFEVB TJTJ
QSJOTJQ QFOHFODFSBO JOEJLBUPS ;BU ZBOH TFSJOH LBMJ EJQBLBJ NFNCSBO TBNB 4FCBMJLOZB KJLB TVBUV [BU UFSMBSVU TFQFSUJ
VOUVL NFMBCFM TFM EBSBI NFSBI BEBMBI LSPNJVN SBEJPBLUJG OBUSJVN LMPSJEB EJLFMVBSLBO EBSJ DBJSBO FLTUSBTFMVMBS BJS BLBO
$S
ZBOHUFSJLBUFSBUEFOHBOTFMEBSBINFSBI CFSEJGVTJ EBSJ DBJSBO FLTUSBTFMVMBS NFMBMVJ NFNCSBO TFM EBO
NBTVL LF EBMBN TFM ,FDFQBUBO EJGVTJ BJS JOJ EJTFCVU LFDFQBUBO
PTNPTJT
)VCVOHBO BOUBSB .PM EBO 0TNPM 0MFI LBSFOB LPOTFOUSBTJ
Pengaturan Pertukaran Cairan dan Keseimbangan BJSEBSJTVBUVMBSVUBOCFSHBOUVOHQBEBKVNMBIQBSUJLFM[BUUFSMBSVU
Osmotik antara Cairan Ekstraselular dan EBMBN MBSVUBO EJCVUVILBO TVBUV JTUJMBI LPOTFOUSBTJ VOUVL
Intraselular NFOHHBNCBSLBO LPOTFOUSBTJ UPUBM QBSUJLFM [BU UFSMBSVU UBOQB
NFNQFSIBUJLBO LPNQPTJTJOZB ZBOH QBTUJ +VNMBI UPUBM QBSUJLFM
.BTBMBIZBOHTFSJOHLBMJUJNCVMEBMBNNFOBOHBOJQBTJFOZBOH EBMBNTVBUVMBSVUBOEJVLVSEBMBNPTNPM4BUVPTNPM PTN
TBNB
TBLJU CFSBU BEBMBI NFNQFSUBIBOLBO DBJSBO ZBOH BEFLVBU QBEB EFOHBONPM Y
QBSUJLFM[BUUFSMBSVU0MFILBSFOBOZB
TBUV BUBV LFEVB LPNQBSUFNFO JOUSBTFM EBO FLTUSBTFM 4FQFSUJ TVBUVMBSVUBOZBOHNFOHBOEVOHNPMHMVLPTBEBMBNTFUJBQMJUFS
ZBOHEJCBIBTEJ#BCEBOLFNVEJBOEBMBNCBCJOJ KVNMBISF NFNQVOZBJLPOTFOUSBTJPTN-+JLBTVBUVNPMFLVMCFSEJTPTJBTJ
290
Bab 25 Komparternen Cairan Tubuh: Cairan Ekstraselutar dan Intraselutar; Ederna
NFOKBEJ EVB JPO NFOHIBTJMLBO EVB QBSUJLFM

TFQFSUJ OBUSJVN 0TNPMBSJUBT $BJSBO 5VCVI ,FNCBMJ QBEB 5BCFM
LMPSJEB ZBOH NFOHBMBNJ JPOJTBTJ NFOKBEJ JPO LMPSJEB EBO JPO QFSIBUJLBO QFSLJSBBO PTNPMBSJUBT EBSJ CFSCBHBJ [BU PTNPUJL
OBUSJVN NBLB MBSVUBO ZBOH NFOHBOEVOH NPM- BLBO BLUJGEBMBNQMBTNB DBJSBOJOUFSTUJTJBM EBODBJSBOJOUSBTFMVMBS
NFNCFSJLBOLPOTFOUSBTJPTNPMBSPTN-%FNJLJBOQVMB TVBUV 1FSIBUJLBO CBIXB TFLJUBS QFSTFO EBSJ PTNPMBSJUBT UPUBM
MBSVUBO ZBOH NFOHBOEVOH NPM NPMFLVM ZBOH CFSEJTPTJBTJ DBJSBO JOUFSTUJTJBM EBO QMBTNB BEBMBI BLJCBU JPO OBUSJVN EBO
UNIT V
NFOKBEJ UJHB JPO TFQFSUJ OBUSJVN TVMGBU /B40
BLBO LMPSJEB TFNFOUBSB IBNQJS TFUFOHBI PTNPMBSJUBT DBJSBO
NFOHIBTJMLBOPTN-+BEJ JTUJMBIPTNPMNFSVKVLQBEBKVNMBI JOUSBTFMVMBS EJUJNCVMLBO PMFI JPO LBMJVN EBO TJTBOZB
QBSUJLFMZBOHBLUJGTFDBSBPTNPUJLEBMBNTVBUVMBSVUBOEBOCVLBO EJUJNCVMLBOPMFICFSCBHBJ[BUJOUSBTFM
LPOTFOUSBTJNPMBS
4FQFSUJZBOHUBNQBLQBEB5BCFM PTNPMBSJUBTUPUBMEBO
1BEB VNVNOZB JTUJMBI PTNPM UFSMBMV CFTBS VOUVL NFOZBUB NBTJOHNBTJOHLFUJHBLPNQBSUFNFOJBMBITFLJUBSN0TN
LBOTBUVBOBLUJWJUBTPTNPUJL[BUUFSMBSVUEBMBNDBJSBOUVCVI - EFOHBO PTNPMBSJUBT QMBTNB ZBOH MFCJI UJOHHJ TFLJUBS
N0TN- EBSJQBEB PTNPMBSJUBT DBJSBO JOUSBTFMVMBS EBO
*TUJMBINJMJPTNPM N0TN
ZBOHTBNBEFOHBOPTNPM
JOUFSTUJTJBM 1FSCFEBBO LFDJM BOUBSB QMBTNB EBO DBJSBO
MFCJIVNVNEJHVOBLBO
JOUFSTUJTJBMEJTFCBCLBOPMFIFGFLPTNPUJLQSPUFJOQMBTNB ZBOH
0TNPMBMJUBT EBO 0TNPMBSJUBT ,POTFOUSBTJ PTNPM TVBUV NFNQFSUBIBOLBO UFLBOBO EBMBN LBQJMFS TFLJUBS NN )H
MBSVUBO EJTFCVU PTNPMBMJUBT CJMB LPOTFOUSBTJ EJOZBUBLBO TFCBHBJ MFCJIUJOHHJEBSJQBEBUFLBOBOSPOHHBJOUFSTUJTJBM TFQFSUJZBOH
PTNPM QFS LJMPHSBN BJS EBO EJTFCVU PTNPMBSJUBT CJMB EJOZBUBLBO EJCBIBTEJ#BC
TFCBHBJPTNPMQFSMJUFSMBSVUBO1BEBMBSVUBOFODFSTFQFSUJDBJSBO
UVCVI LFEVBJTUJMBIJOJEBQBUEJHVOBLBOIBNQJSTFDBSBTJOPOJN "LUJWJUBT 0TNPMBS 5FSLPSFLTJ EBSJ $BJSBO 5VCVI
LBSFOB QFSCFEBBOOZB LFDJM 1BEB LFCBOZBLBO LBTVT MFCJI 1BEBCBHJBOCBXBI5BCFMEJQFSMJIBULBOBLUJWJUBTPTNPMBS
NVEBI NFOZBUBLBO KVNMBI DBJSBO UVCVI EBMBN MJUFS DBJSBO UFSLPSFLTJ EBSJ QMBTNB DBJSBO JOUFSTUJTJBM EBO DBJSBO
EBSJQBEB EBMBN LJMPHSBN BJS 0MFI LBSFOB JUV LFCBOZBLBO JOUSBTFMVMBS "MBTBO VOUVL NFMBLVLBO LPSFLTJ JOJ BEBMBI
QFOHIJUVOHBOZBOHEJQBLBJTFDBSBLMJOJTEBOQFOHIJUVOHBOZBOH CBIXB LBUJPO EBO BOJPO EBMBN MBSVUBO NFNQVOZBJ EBZB
EJQBLBJ QBEB CFCFSBQB CBC CFSJLVUOZB MFCJI EJEBTBSLBO QBEB UBSJLNFOBSJL BOUBS JPO ZBOH EBQBU NFOZFCBCLBO TFEJLJU
PTNPMBSJUBTEBSJQBEBPTNPMBMJUBT QFOVSVOBOBLUJWJUBTPTNPUJL[BUUFSMBSVU
1FOHIJUVOHBO 0TNPMBSJUBT EBO 5FLBOBO 0TNPUJL

4VBUV-BSVUBO %FOHBONFOHHVOBLBOIVLVNWBOhU)PGG LJUB
EBQBU NFOHIJUVOH UFLBOBO PTNPUJL QPUFOTJBM TVBUV MBSVUBO
EFOHBO NFOHBOHHBQ CBIXB NFNCSBO TFM CFSTJGBU JNQFSNFBCFM Keseimbangan Osmotik Dipertahankan antara
UFSIBEBQ [BU UFSMBSVU $POUPIOZB UFLBOBO PTNPUJL MBSVUBO Cairan Intraselular dan Cairan Ekstraselular
QFSTFO OBUSJVN LMPSJEB EJIJUVOH TFCBHBJ CFSJLVU -BSVUBO
%FOHBO QFSVCBIBO LPOTFOUSBTJ ZBOH SFMBUJG LFDJM QBEB [BU
QFSTFOCFSBSUJCBIXBUFSEBQBU HSBNOBUSJVNLMPSJEBQFS
UFSMBSVU EBMBN DBJSBO FLTUSBTFMVMBS UFLBOBO PTNPUJL ZBOH
NM MBSVUBO BUBV H- 0MFI LBSFOB CFSBU NPMFLVM OBUSJVN
CFTBS EBQBU UFSCFOUVL EJ TFQBOKBOH NFNCSBO TFM 4FQFSUJ
LMPSJEBBEBMBI HNPM NPMBSJUBTMBSVUBOBEBMBIH-EJCBHJ
ZBOH UFMBI EJCBIBT TFCFMVNOZB VOUVL TFUJBQ HSBEJFO
HNPM BUBVTFLJUBS NPM-0MFILBSFOBTFUJBQNPMFLVM
LPOTFOUSBTJ NJMJPTNPM TVBUV [BU UFSMBSVU JNQFSNFBCFM [BU
OBUSJVNLMPSJEBTFUBSBEFOHBOPTNPM PTNPMBSJUBTMBSVUBOJBMBI
UFSMBSVU ZBOH UJEBL EBQBU NFOFNCVT NFNCSBO TFM

Y BUBV PTN-0MFILBSFOBJUV PTNPMBSJUBTMBSVUBO
EJIBTJMLBO UFLBOBO PTNPUJL TFLJUBS NN )H EJ
JOJBEBMBIN0TN-5FLBOBOPTNPUJLQPUFOTJBMMBSVUBOJOJ
TFQBOKBOH NFNCSBO TFM +JLB NFNCSBO TFM UFSQBKBO BJS
BLBO NFOKBEJ N0TN- Y NN )HN0TN - BUBV
NVSOJ EBO PTNPMBSJUBT DBJSBO JOUSBTFMVMBS BEBMBI
TFCFTBSNN)H
N0TN- NBLB UFLBOBO PTNPUJL QPUFOTJBM ZBOH EBQBU
1FOHIJUVOHBO JOJ IBOZBMBI TVBUV QFSLJSBBO LBSFOB JPO UJNCVM EJ TFQBOKBOH NFNCSBO TFM BEBMBI MFCJI EBSJ
OBUSJVN EBO LMPSJEB UJEBL TFMVSVIOZB CFCBT EBMBN MBSVUBO NN )H )BM JOJ NFNQFSMJIBULBO CBIXB EJCVUVILBO EBZB
BLJCBU BEBOZB EBZB UBSJL BOUBS JPOJPO JOJ ,JUB EBQBU ZBOH CFTBS VOUVL NFNJOEBILBO BJS BHBS EBQBU NFMJOUBTJ
NFOHPSFLTJ EFWJBTJ JOJ CFSEBTBSLBO QSFEJLTJ IVLVN WBOhU )PGG NFNCSBOTFMCJMBDBJSBOJOUSBTFMVMBSEBOFLTUSBTFMVMBSUJEBL
EFOHBO NFOHHVOBLBO GBLUPS LPSFLTJ ZBOH EJTFCVU LPFGJTJFO CFSBEBEBMBNLFTFJNCBOHBOPTNPUJL"LJCBUEBZBUFSTFCVU
PTNPUJL 6OUVL OBUSJVN LMPSJEB LPFGJTJFO PTNPUJLOZB TFLJUBS QFSVCBIBO ZBOH SFMBUJG LFDJM QBEB LPOTFOUSBTJ [BU UFSMBSVU
.BLB PTNPMBSJUBTTFCFOBSOZBEBSJMBSVUBOOBUSJVNLMPSJEB JNQFSNFBCFM EBMBN DBJSBO FLTUSBTFMVMBS TVEBI EBQBU
QFSTFO JBMBI Y BUBV TFLJUBS N0TN- 6OUVL NFOZFCBCLBOQFSVCBIBOCFTBSQBEBWPMVNFTFM
BMBTBO QSBLUJT LPFGJTJFO PTNPUJL EBSJ CFCFSBQB [BU UFSMBSVU $BJSBO *TPUPOJL )JQPUPOJL EBO )JQFSUPOJL &GFL
LBEBOHLBEBOH EJBCBJLBO EBMBN NFOFOUVLBO PTNPMBSJUBT EBO QFSCFEBBOLPOTFOUSBTJ[BUUFSMBSVUJNQFSNFBCFMEBMBNDBJSBO
UFLBOBOPTNPUJLMBSVUBOGJTJPMPHJT FLTUSBTFMVMBSUFSIBEBQWPMVNFTFMUFSMJIBUQBEB(BNCBS
+JLB TVBUV TFM EJMFUBLLBO QBEB TVBUV MBSVUBO EFOHBO [BU
UFSMBSVU JNQFSNFBCFM ZBOH NFNQVOZBJ PTNPMBSJUBT
N0TN- TFMUJEBLBLBONFOHFSVUBUBVNFNCFOHLBLLBSFOB
291
MTUJMBI IJQFSPTNPUJL EBO IJQPPTNPUJL TFDBSB CFSUVSVU

UVSVU NFSVKVL QBEB MBSVUBO ZBOH NFNQVOZBJ PTNPMBSJUBT
MFCJIUJOHHJBUBVMFCJISFOEBI EJCBOEJOHLBOEFOHBODBJSBO
FLTUSBTFMVMBS OPSNBM UBOQB NFNQFSIBUJLBO LFNBNQVBO [BU
UFSMBSVUUFSTFCVUVOUVLNFOFNCVTNFNCSBOTFM;BU[BUZBOH
TBOHBU QFSNFBCFM TFQFSUJ VSFVN EBQBU NFOZFCBCLBO QFSHF
TFSBOTFNFOUBSBWPMVNFDBJSBOBOUBSBDBJSBOJOUSBTFMVMBSEBO
FLTUSBTFMVMBS UFUBQJ NFNCFSJLBO DVLVQ XBLUV TBNQBJ
BLIJSOZB LPOTFOUSBTJ [BU[BU JOJ NFOKBEJ TBNB QBEB LFEVB
LPNQBSUFNFOEBONFNCFSJTFEJLJUFGFLQBEBWPMVNFJOUSBTFM
EBMBNLFBEBBONBOUBQ
,FTFJNCBOHBO0TNPUJLBOUBSB$BJSBO*OUSBTFMVMBSEBO
&LTUSBTFMVMBS %JDBQBJ EFOHBO $FQBU 1FSQJOEBIBO DBJSBO
ZBOHNFMJOUBTJNFNCSBOTFMUFSKBEJTFEFNJLJBODFQBUTFIJOHHB
TFUJBQ QFSCFEBBO PTNPMBSJUBT BOUBSB LFEVB LPNQBSUFNFO JOJ
CJBTBOZB BLBO EJLPSFLTJ EBMBN XBLUV CFCFSBQB EFUJL BUBV
VNVNOZB EBMBN CFCFSBQB NFOJU 1FSHFSBLBO BJS ZBOH DFQBU
JOJ UJEBL CFSBSUJ CBIXB LFTFJNCBOHBO MFOHLBQ ZBOH UFSKBEJ
BOUBSB LPNQBSUFNFO FLTUSBTFM EBO JOUSBTFM EJ TFMVSVI UVCVI
UJNCVMEBMBNXBLUVZBOHTJOHLBUTFDBSBCFSTBNBBO"MBTBOOZB
BEBMBI CBIXB DBJSBO CJBTBOZB NFNBTVLJ UVCVI NFMBMVJ VTVT
EBO IBSVT EJUSBOTQPSUBTJ PMFI EBSBI LF TFMVSVI KBSJOHBO
LPOTFOUSBTJ BJS EBMBN DBJSBO JOUSBTFMVMBS EBO FLTUSBTFM BEBMBI TFCFMVN UFSKBEJ LFTFJNCBOHBO PTNPUJL MFOHLBQ #JBTBOZB
TBNB EBO [BU UFSMBSVU UJEBL EBQBU NBTVL BUBV LFMVBS EBSJ TFM EJCVUVILBO XBLUV TFLJUBS NFOJU TFCFMVN UFSDBQBJOZB
-BSVUBOTFQFSUJJOJEJTFCVUJTPUPOJLLBSFOBUJEBLNFOJNCVMLBO LFTFJNCBOHBOPTNPUJLEJTFMVSVIUVCVITFUFMBINJOVNBJS
QFOHFSVUBO NBVQVO QFNCFOHLBLBO TFM $POUPI MBSVUBO
JTPUPOJL NFMJQVUJ MBSVUBO QFSTFO OBUSJVN LMPSJEB BUBV
MBSVUBO HMVLPTB QFSTFO -BSVUBOMBSVUBO JOJ QFOUJOH EBMBN Volume dan Osmolalitas Cairan Ekstraselular dan
QFOHPCBUBO TFDBSB LMJOJT LBSFOB EBQBU EJJOGVT LF EBMBN EBSBI Intraselular pada Keadaan Abnormal.
UBOQBBEBOZBCBIBZBZBOHNFOHBODBNLFTFJNCBOHBOPTNPUJL
BOUBSBDBJSBOJOUSBTFMVMBSEBOFLTUSBTFMVMBS #FCFSBQB GBLUPS ZBOH EBQBU NFOZFCBCLBO QFSVCBIBO OZBUB
+JLB TFCVBI TFM EJMFUBLLBO EBMBN MBSVUBO IJQPUPOJL ZBOH QBEB WPMVNF DBJSBO JOUSBTFMVMBS EBO FLTUSBTFM BEBMBI
NFNQVOZBJLPOTFOUSBTJ[BUUFSMBSVUJNQFSNFBCFMMFCJISFOEBI NFNJOVN BJS EFIJESBTJ JOGVT JOUSBWFOB CFSCBHBJ KFOJT
N0TN-
BJS BLBO CFSEJGVTJ LF EBMBN TFM EBO NFOZF MBSVUBO LFIJMBOHBO TFKVNMBI CFTBS DBJSBO EBSJ USBLUVT
CBCLBOTFMNFNCFOHLBLBJSBLBOUFSVTCFSEJGVTJLFEBMBNTFM HBTUSPJOUFTUJOBM EBO LFIJMBOHBO DBJSBO NFMBMVJ LFSJOHBU
ZBOH BLBO NFOHFODFSLBO DBJSBO JOUSBTFMVMBS EBO KVHB BUBVNFMBMVJHJOKBMZBOHCFSMBOHTVOHBCOPSNBM
NFNFLBULBO DBJSBO FLTUSBTFMVMBS TBNQBJ LFEVB MBSVUBO
NFNQVOZBJ PTNPMBSJUBT ZBOH TBNB -BSVUBO OBUSJVN LMPSJEB ,JUB EBQBU NFOHIJUVOH QFSVCBIBO WPMVNF DBJSBO
EFOHBO LPOTFOUSBTJ LVSBOH EBSJ QFSTFO CFSTJGBU IJQPUPOJL FLTUSBTFMVMBS EBO JOUSBTFMVMBS TFSUB KFOJT UFSBQJ ZBOH IBSVT
EBONFOZFCBCLBOQFNCFOHLBLBOTFM EJCFSJLBO KJLBQSJOTJQQSJOTJQEBTBSCFSJLVUJOJEJJOHBUEFOHBO
+JLB TFCVBI TFM EJMFUBLLBO EBMBN MBSVUBO IJQFSUPOJL ZBOH CBJL
NFNQVOZBJ LPOTFOUSBTJ [BU UFSMBSVU JNQFSNFBCFM ZBOH MFCJI 1. "JS CFSHFSBL DFQBU NFMJOUBTJ NFNCSBO TFM LBSFOBOZB
UJOHHJ BJS BLBO NFOHBMJS LFMVBS EBSJ TFM LF EBMBN DBJSBO
PTNPMBSJUBT DBJSBO JOUSBTFMVMBS EBO FLTUSBTFMVMBS UFUBQ
FLTUSBTFMVMBS%BMBNIBMJOJ TFMBLBONFOHLFSVUTBNQBJLFEVB
IBNQJS TBNB TBUV TBNB MBJO LFDVBMJ QBEB CFCFSBQB NFOJU
LPOTFOUSBTJNFOKBEJTBNB-BSVUBOOBUSJVNLMPSJEBZBOHMFCJI
TFUFMBIQFSVCBIBOTBMBITBUVLPNQBSUFNFO
CFTBSEBSJ QFSTFOCFSTJGBUIJQFSUPOJL
2. .FNCSBO TFM IBNQJS TFQFOVIOZB JNQFSNFBCFM UFSIBEBQ
$BJSBO *TPTNPUJL )JQFSPTNPUJL EBO )JQPPTNPUJL *TUJ CBOZBL [BU UFSMBSVU PMFI LBSFOBOZB KVNMBI PTNPM EBMBN
MBI JTPUPOJL IJQPUPOJL EBO IJQFSUPOJL NFSVKVL QBEB EBQBU DBJSBO FLTUSBTFMVMBS BUBV JOUSBTFM VNVNOZB UFUBQ LPOTUBO
UJEBLOZB TVBUV MBSVUBO NFOZFCBCLBO QFSVCBIBO WPMVNF TFM LFDVBMJ KJLB [BU UFSMBSVU EJUBNCBILBO BUBV EJLVSBOHJ EBSJ
,FLFOUBMBO MBSVUBO CFSHBOUVOH QBEB LPOTFOUSBTJ [BU UFSMBSVU LPNQBSUFNFOFLTUSBTFM
JNQFSNFBCFM /BNVO CFCFSBQB [BU UFSMBSVU EBQBU NFOFNCVT
NFNCSBOTFM-BSVUBOEFOHBOPTNPMBSJUBTZBOHTBNBEFOHBOTFM %FOHBO QSJOTJQ EBTBS JOJ LJUB EBQBU NFOHBOBMJTJT FGFL
EJTFCVU JTPTNPUJL UBOQB NFNQFSIBUJLBO [BU UFSMBSVU UFSTFCVU CFSCBHBJ LPOEJTJ DBJSBO BCOPSNBM UFSIBEBQ WPMVNF EBO
EBQBUNFOFNCVTNFNCSBOTFMBUBVUJEBL PTNPMBSJUBTDBJSBOFLTUSBTFMVMBSEBOJOUSBTFMVMBS
292
Bab 25 Komparternen Cairan Tubuh: Cairan Ekstraselutar dan Intraselutar; Ederna
Pengaruh Penambahan Larutan Salin Ke Cairan LMPSJEB IJQFSUPOJL QFSTFO LF EBMBN LPNQBSUFNFO DBJSBO
Ekstraselular FLTUSBTFMVMBS TFPSBOH QBTJFO EFOHBO CFSBU CBEBO LJMPHSBN
EFOHBOPTNPMBSJUBTQMBTNBBXBMN0TN- BQBZBOHBLBO
+JLBMBSVUBOTBMJOJTPUPOJLEJUBNCBILBOLFLPNQBSUFNFODBJSBO
UFSKBEJ QBEB PTNPMBSJUBT EBO WPMVNF DBJSBO FLTUSBTFMVMBS EBO
FLTUSBTFMVMBS PTNPMBSJUBT DBJSBO FLTUSBTFMVMBS UJEBL BLBO
JOUSBTFMTFUFMBILFTFJNCBOHBOPTNPUJLUFSCFOUVL
CFSVCBI LBSFOBOZB UJEBL BEB PTNPTJT ZBOH UFSKBEJ NFMBMVJ
UNIT V
-BOHLBIQFSUBNBBEBMBINFOHIJUVOHLPOEJTJBXBMNFMJQVUJ
NFNCSBO TFM 4BUVTBUVOZB FGFL JBMBI QFOJOHLBUBO WPMVNF
WPMVNF LPOTFOUSBTJ EBONJMJPTNPMUPUBMQBEBNBTJOHNBTJOH
DBJSBO FLTUSBTFMVMBS (BNCBS "
/BUSJVN EBO LMPSJEB
LPNQBSUFNFO %FOHBO NFOHBOHHBQ CBIXB WPMVNF DBJSBO
TFCBHJBO CFTBS UFUBQ CFSBEB EBMBN DBJSBO FLTUSBTFMVMBS LBSFOB
FLTUSBTFMVMBSTFCFTBSQFSTFOCFSBUCBEBOEBOWPMVNFDBJSBO
NFNCSBO TFM CFSUJOEBL TFPMBIPMBI IBNQJS CFSTJGBU
JOUSBTFMVMBS TFCFTBS QFSTFO CFSBU CBEBO NBLB WPMVNF EBO
JNQFSNFBCFMUFSIBEBQOBUSJVNEBOLMPSJEB
LPOTFOUSBTJDBJSBOCFSJLVUJOJEBQBUEJIJUVOH
+JLB MBSVUBO IJQFSUPOJL EJUBNCBILBO EBMBN DBJSBO
FLTUSBTFMVMBS PTNPMBSJUBTFLTUSBTFMBLBONFOJOHLBUEBONFOZF
CBCLBO PTNPTJT BJS LFMVBS EBSJ TFM LF EBMBN LPNQBSUFNFO
FLTUSBTFM MJIBU (BNCBS #
4FLBMJ MBHJ IBNQJS TFNVB Langkah 1. Kondisi Awal
OBUSJVN LMPSJEB ZBOH EJUBNCBILBO UFUBQ CFSBEB EBMBN
LPNQBSUFNFO FLTUSBTFM EBO DBJSBO CFSEJGVTJ EBSJ TFM LF EBMBN Volume Konsentrasi Total
SVBOH FLTUSBTFM VOUVL NFODBQBJ LFTFJNCBOHBO PTNPUJL &GFL (Liter) (mOsm/L) (mOsm)
BLIJSJBMBIQFOJOHLBUBOWPMVNFFLTUSBTFM MFCJICFTBSEBSJQBEB
WPMVNFDBJSBOZBOHEJUBNCBILBO
QFOVSVOBOWPMVNFJOUSBTFM Cairan ekstraselular 14 280 3,920
EBOQFOJOHLBUBOPTNPMBSJUBTEJLFEVBLPNQBSUFNFO Cairan intraselular 28 280 7,840
+JLB MBSVUBO IJQPUPOJL EJCFSJLBO LF DBJSBO FLTUSBTFMVMBS Total cairan tubuh 42 280 11,760
PTNPMBSJUBT DBJSBO FLTUSBTFMVMBS BLBO NFOVSVO EBO TFKVNMBI
BJS EBSJ DBJSBO FLTUSBTFMVMBS CFSEJGVTJ LF EBMBN TFM TBNQBJ
LPNQBSUFNFO JOUSBTFM EBO FLTUSBTFM NFNQVOZBJ PTNPMBSJUBT
ZBOH TBNB MJIBU (BNCBS $
7PMVNF JOUSBTFM NBVQVO -BMV LJUB NFOHIJUVOH NJMJPTNPM UPUBM EBMBN - MBSVUBO
FLTUSBTFM NFOJOHLBU EFOHBO QFOBNCBIBO DBJSBO IJQPUPOJL OBUSJVN LMPSJEB QFSTFO ZBOH EJUBNCBILBO LF DBJSBO
XBMBVQVOQFOJOHLBUBOWPMVNFJOUSBTFMMFCJICBOZBL FLTUSBTFMVMBS-BSVUBO QFSTFOCFSBSUJBEB HNM BUBV
HSBNOBUSJVNLMPSJEBQFSMJUFS0MFILBSFOBCFSBUNPMFLVM
1FOHIJUVOHBO1FSHFTFSBO$BJSBOEBO0TNPMBSJUBTTFUFMBI OBUSJVN LMPSJEB JBMBI HNPM IBM JOJ CFSBSUJ CBIXB BEB
MOGVT -BSVUBO 4BMJO )JQFSUPOJL ,JUB EBQBU NFOHIJUVOH NPM OBUSJVN LMPSJEB QFS MJUFS MBSVUBO .BLB VOUVL -
TFSBOHLBJBO FGFL QFNCFSJBO JOGVT CFSCBHBJ KFOJT MBSVUBO MBSVUBO BEB NPM OBUSJVN LMPSJEB 0MFI LBSFOB NPM
UFSIBEBQ WPMVNF EBO PTNPMBSJUBT DBJSBO FLTUSBTFMVMBS EBO OBUSJVNLMPSJEBTFUBSBEFOHBOPTNPM LBSFOBOBUSJVNLMPSJ
JOUSBTFMNJTBMOZB KJLBLJUBNFOHJOGVT-MBSVUBOOBUSJVNLMP EBNFNQVOZBJEVBQBSUJLFMPTNPUJLBLUJGQFSNPM
FGFLBLIJS
300
200
100
0
10 20 30 40
293
EBSJ QFOBNCBIBO - MBSVUBO JOJ JBMBI QFOBNCBIBO +BEJ EBSJ DPOUPI UFSTFCVU LJUB EBQBU NFMJIBU CBIXB
N0TNOBUSJVNLMPSJEBLFDBJSBOFLTUSBTFMVMBS QFOBNCBIBO - MBSVUBO OBUSJVN LMPSJEB IJQFSUPOJL
1BEBMBOHLBILF LJUBNFOHIJUVOHQFOHBSVITFLFUJLBEBO NFOZFCBCLBO QFOJOHLBUBO MFCJI EBSJ - EBMBN WPMVNF
QFOBNCBIBO N0TN OBUSJVN LMPSJEB LF DBJSBO DBJSBO FLTUSBTFMVMBS TFEBOHLBO WPMVNF DBJSBO JOUSBTFMVMBS
FLTUSBTFMVMBS CFSTBNB - WPMVNF 5JEBL BLBO BEB QFSVCBIBO UVSVOIBNQJSTFCBOZBL-
QBEB LPOTFOUSBTJ BUBV WPMVNF DBJSBO JOUSBTFMVMBS EBO UJEBL .FUPEF QFOHIJUVOHBO QFSVCBIBO WPMVNF EBO PTNPMBSJUBT
BLBO BEB LFTFJNCBOHBO PTNPUJL /BNVO QBEB DBJSBO DBJSBO JOUSBTFMVMBS EBO FLUSBTFM JOJ EBQBU EJUFSBQLBO EJ IBNQJS
FLTUSBTFMVMBS BLBO BEB UBNCBIBO N0TN [BU UFSMBSVU TFNVBNBTBMBILMJOJTEBSJQFOHBUVSBOWPMVNFDBJSBO1FNCBDB
UPUBM ZBOH NFOHIBTJMLBO NJMJPTNPM UPUBM TFCFTBS 0MFI IBSVT NFOHFOBMJ QFOHIJUVOHBO JOJ EFOHBO CBJL LBSFOB
LBSFOB LPNQBSUFNFO FLTUSBTFM TFLBSBOH NFNQVOZBJ WPMVNF QFOHFSUJBO BTQFL NBUFNBUJT LFTFJNCBOHBO PTNPUJL BOUBSB
- LPOTFOUSBTJ EBQBU EJIJUVOH EFOHBO NFNCBHJ LPNQBSUFNFO DBJSBO FLTUSBTFMVMBS EBO JOUSBTFMVMBS TBOHBU
N0TN EFOHBO - TFIJOHHB EJQFSPMFI LPOTFOUSBTJ QFOUJOHVOUVLNFNBIBNJIBNQJSTFNVBLFMBJOBODBJSBOEBMBN
N0TN- +BEJ OJMBJOJMBJ CFSJLVU JOJ BLBO UFSKBEJ TFLFUJLB UVCVIEBOQFOBOHBOBOOZB
TFUFMBIQFOBNCBIBOMBSVUBO
Langkah 2. Pengaruh Seketika Penambahan 2 Liter Glukosa dan Larutan Lain yang Diberikan untuk
Natrium Kloridda 3,0 Persen Tujuan Nutrisi
Volume Konsentrasi Total 5FSEBQBU CBOZBL KFOJT MBSVUBO ZBOH EBQBU EJCFSJLBO TFDBSB
(Liter) (mOsm/L) (mOsm) JOUSBWFOB VOUVL NFNCFSJ OVUSJTJ CBHJ PSBOH ZBOH UJEBL EBQBU
NFNQFSPMFIOZB TFDBSB BEFLVBU EFOHBO DBSB MBJO -BSVUBO
Cairan ekstraselular 16 373 5,971 HMVLPTBEJHVOBLBOTFDBSBMVBT TFEBOHLBOMBSVUBOBTBNBNJOP
Cairan intraselular 28 280 7,840 EBO MFNBL ZBOH EJIPNPHFOJTBTJ MFCJI TFEJLJU EJHVOBLBO #JMB
Total Cairan tubuh 44 Tidak seimbang 13,811 MBSVUBOJOJEJCFSJLBO LPOTFOUSBTJ[BUZBOHBLUJGTFDBSBPTNPUJL
CJBTBOZB EJTFTVBJLBO IBNQJS NFOEFLBUJ JTPUPOJTJUBT BUBV
1BEB MBOHLBI LFUJHB LJUB NFOHIJUVOH WPMVNF EBO MBSVUBO JOJ EJCFSJLBO QFSMBIBOMBIBO TFIJOHHB UJEBL
LPOTFOUSBTJ ZBOH BLBO UFSKBEJ EBMBN CFCFSBQB NFOJU TFUFMBI NFOHHBOHHV LFTFJNCBOHBO PTNPUJL DBJSBO UVCVI 4FUFMBI
LFTFJNCBOHBO PTNPUJL UFSCFOUVL %BMBN IBM JOJ LPOTFOUSBTJ HMVLPTB BUBV [BU OVUSJTJ MBJO EJNFUBCPMJTNF TFSJOH NBTJI
EBMBN LPNQBSUFNFO DBJSBO JOUSBTFMVMBS EBO FLTUSBTFM BLBO UFSEBQBU LFMFCJIBO BJS LIVTVTOZB KJLB BEB DBJSBO UBNCBIBO
TFUBSB EBO EBQBU EJIJUVOH EFOHBO NFNCBHJ NJMJPTNPM UPUBM ZBOHEJNJOVN#JBTBOZB HJOKBMNFOHFLTLSFTJDBJSBOJOJEBMBN
EBMBN UVCVI EFOHBO WPMVNF UPUBM ZBOH TFLBSBOH CFOUVL VSJOF ZBOH TBOHBU FODFS 0MFI LBSFOBOZB IBTJM BLIJS
TFCFTBS-%BSJTJOJBLBOEJQFSPMFILPOTFOUSBTJTFCFTBS QFOBNCBIBO MBSVUBO EJ BUBT IBOZBMBI CFSVQB QFOBNCBIBO [BU
N0TN-0MFILBSFOBJUV TFMVSVILPNQBSUFNFODBJSBOUVCVI OVUSJTJQBEBUVCVI
BLBO NFNQVOZBJ LPOTFOUSBTJ ZBOH TBNB TFUFMBI UFSDBQBJOZB
LFTFJNCBOHBO PTNPUJL %FOHBO NFOHBOHHBQ CBIXB UJEBL BEB
[BU UFSMBSVU BUBV BJS ZBOH LFMVBS EBSJ UVCVI EBO UJEBL BEB Kelainan Klinis Pengaturan Volume Cairan:
QFSHFSBLBOOBUSJVNLMPSJEBLFEBMBNBUBVLFMVBSTFM NBLBLJUB Hiponatremia dan Hipernatremia
EBQBUNFOHIJUVOHWPMVNFLPNQBSUFNFOJOUSBTFMEBOFLTUSBTFM
7PMVNF DBJSBO JOUSBTFMVMBS EJIJUVOH EFOHBO NFNCBHJ
1FOHVLVSBO QSJNFS ZBOH NVEBI EJQFSPMFI QBSB LMJOJTJ VOUVL
NJMJPTNPM UPUBM EBMBN DBJSBO FLTUSBTFMVMBS
EFOHBO
NFOJMBJTUBUVTDBJSBOQBTJFOBEBMBILPOTFOUSBTJOBUSJVNQMBTNB
LPOTFOUSBTJ N0TN-
BLBO EJIBTJMLBO WPMVNF -
0TNPMBSJUBT QMBTNB UJEBL TFDBSB SVUJO EJVLVS UBQJ LBSFOB
7PMVNF DBJSBO FLTUSBTFMVMBS EJIJUVOH EFOHBO NFNCBHJ
OBUSJVNEBOBOJPOZBOHUFSLBJU UFSVUBNBLMPSJEB
CFSUBOHHVOH
NJMJPTNPM UPUBM EBMBN DBJSBO FLTUSBTFMVMBS
EFOHBO
KBXBC BUBT MFCJI EBSJ QFSTFO [BU UFSMBSVU EBMBN DBJSBO
LPOTFOUSBTJ N0TN-
EBO NFOHIBTJMLBO WPMVNF
FLTUSBTFMVMBS NBLB LPOTFOUSBTJ OBUSJVN QMBTNB NFSVQBLBO
--BHJMBHJQFSIJUVOHBOJOJCFSEBTBSLBOQBEBBOHHBQBOCBIXB
JOEJLBUPS ZBOH DVLVQ CBJL CBHJ PTNPMBSJUBT QMBTNB QBEB
OBUSJVNLMPSJEBZBOHEJUBNCBILBOLFDBJSBOFLTUSBTFMVMBSUFUBQ
CBOZBL LFBEBBO 4FTFPSBOH EJLBUBLBO IJQPOBUSFNJB CJMB
CFSBEBEJTJUVEBOUJEBLCFSQJOEBILFEBMBNTFM
LPOTFOUSBTJ OBUSJVN QMBTNB EBMBN UVCVIOZB UVSVO MFCJI EBSJ
CFCFSBQBNJMJFLJWBMFOEJCBXBIOJMBJOPSNBM TFLJUBSN&R
-
#JMBLPOTFOUSBTJOBUSJVNQMBTNBNFOJOHLBUEJBUBTOPSNBM
NBLBTFTFPSBOHEJLBUBLBOIJQFSOBUSFNJB
Volume Konsentrasi Total Penyebab Hiponatremia: Kelebihan Air atau Kehilangan

(Liter) 9mOsm/L) (mOsm) Natrium
Cairan ekstraselular 19.02 313.9 5,971 ,FIJMBOHBOOBUSJVNLMPSJEBEBSJDBJSBOFLTUSBTFMVMBSBUBVQFOBN
Cairan intraselular 24.98 313.9 7,840 CBIBO BJS ZBOH CFSMFCJIBO QBEB DBJSBO FLTUSBTFMVMBS BLBO NF
Total cairan tubuh 44.0 313.9 13,811 OZFCBCLBOQFOVSVOBOLPOTFOUSBTJOBUSJVNQMBTNB 5BCFM

294
Bab 25 Kompartemen Cairan Tubuh: Cairan Ekstraselutar dan Intrasetular; Edema
Tabel 25-4 Abnormalitas Pengaturan Volume Cairan Tubuh: Hiponatremia dan Hipernatremia
Abnormalitas Penyebab Konsentrasi Na* Volume Cairan Volume Cairan

Plasma
Ekstraselular Intraselular
Hiponetremia-dehidrasi Adrenal insufficiency; overuse ↓ n l
UNIT V
of diuretics
Hiponatrmia-hiperhidrasi Kelebihan ADH (SIADH); ↓ ↑ ↑
tumor bronkogenik
Hipernatremia-dehidrasi Diabetes insipidus; excessive ↑ ↓ ↓
sweating
Hipernatremia-hiperhidrasi Penyakit Cushing; ↑ ↑ ↓
aldosteronisme primer
ADH, antidiuretic hormone; SIADH, syndrome of inappropriate ADH
,FIJMBOHBO OBUSJVN LMPSJEB QSJNFS CJBTBOZB UFSKBEJ QBEB "LBO UFUBQJ QFSQJOEBIBO [BU UFSMBSVU EBSJ EBMBN TFM TFMBNB
EFIJESBTJ IJQPOBUSFNJB EBO CFSIVCVOHBO EFOHBO QFOVSVOBO CFSMBOHTVOHOZB IJQPOBUSFNJB MBNCBU EBQBU NFOZFCBCLBO
WPMVNF DBJSBO FLTUSBTFMVMBS ,POEJTJLPOEJTJ ZBOH EBQBU LFSVTBLBOKBSJOHBOPUBLEFOHBONVEBI LBMBVIJQPOBUSFNJBOZB
NFOZFCBCLBO IJQPOBUSFNJB CFSIVCVOHBO EFOHBO QFOHFMVBSBO EJLPSFLTJ UFSMBMV DFQBU #JMB QFOBNCBIBO DBJSBO IJQFSUPOJT
OBUSJVN LMPSJEB BOUBSB MBJO EJBSF EBO NVOUBINVOUBI VOUVL NFOHPSFLTJ IJQPOBUSFNJB EJCFSJLBO UFSMBMV DFQBU JOJ
1FOHHVOBBO EJVSFUJL TFDBSB CFSMFCJIBO ZBOH NFOHIBNCBU BLBO NFMBNQBVJ LFNBNQVBO PUBL VOUVL EBQBU NFOZFSBQ [BU
LFNBNQVBO HJOKBM VOUVL NFNQFSUBIBOLBO OBUSJVN EBO ZBOHUFMBIIJMBOHEBSJEBMBNTFM TFIJOHHBEBQBUNFOJNCVMLBO
CFCFSBQBKFOJTQFOZBLJUHJOKBMZBOHNFOHFMVBSLBOOBUSJVN KVHB HBOHHVBO PTNPUJL OFVSPOOFVSPO ZBOH EJIVCVOHLBO EFOHBO
EBQBU NFOZFCBCLBO IJQPOBUSFNJB EFSBKBU TFEBOH "LIJSOZB EFNJFMJOJTBTJ ZBJUV IJMBOHOZB TFMVCVOH NJFMJO EBSJ TBSBG
QFOZBLJU "EEJTPO ZBOH EJBLJCBULBO PMFI QFOVSVOBO TFLSFTJ %FNJFMJOJTBTJOFVSPOOFVSPOZBOHEJTFCBCLBOPMFIQFSVCBIBO
IPSNPO BMEPTUFSPO NFOHHBOHHV LFNBNQVBO HJOKBM VOUVL PTNPUJL JOJ EBQBU EJDFHBI EFOHBO NFOHVSBOHJ LFDFQBUBO
NFSFBCTPSCTJ OBUSJVN EBO EBQBU NFOZFCBCLBO IJQPOBUSFNJB LPSFLTJ IJQPOBUSFNJB LSPOJT LVSBOH EBSJ NNPM- EBMBN
EFSBKBUTFEBOH KBNBUBVLVSBOHEBSJNNPM-EBMBNKBN
)JQPOBUSFNJB KVHB EBQBU EJTFCBCLBO PMFI SFUFOTJ BJS ZBOH
,FDFQBUBO LPSFLTJ ZBOH MBNCBU JOJ NFNCFSJ LFTFNQBUBO
CFSMFCJIBO ZBOH BLBO NFOHFODFSLBO OBUSJVN EBMBN DBJSBO
QBEB TFM PUBL VOUVL NFNVMJILBO PTNPM ZBOH IJMBOH ZBOH
FLTUSBTFMVMBS ZBJUV TVBUV LPOEJTJ ZBOH EJTFCVU IJQPOBUSFNJB
UFSKBEJTFCBHBJIBTJMBEBQUBTJUFSIBEBQIJQPOBUSFNJBLSPOJT
IJQFSIJESBTJ$POUPIOZB TFLSFTJCFSMFCJIBOIPSNPOBOUJEJVSFUJL
ZBOHNFOZFCBCLBOUVCVMVTHJOKBMNFSFBCTPSQTJBJSMFCJICBOZBL
EBQBUNFOZFCBCLBOUFSKBEJOZBIJQPOBUSFNJBEBOIJQFSIJESBTJ Penyebab Hipernatremia: Kehilangan Air atau Kelebihan
Natrium
Konsekuensi Hiponatremia: Pembengkakan Sel 1FOJOHLBUBO LPOTFOUSBTJ OBUSJVN QMBTNB ZBOH KVHB NFOZF
FCBCLBO QFOJOHLBUBO PTNPMBSJUBT EBQBU EJTFCBCLBO PMFI
1FSVCBIBO WPMVNF TFM ZBOH DFQBU ZBOH EJTFCBCLBO PMFI LFIJMBOHBO BJS EBO MBSVUBO FLTUSBTFM ZBOH NFNFLBULBO JPO
IJQPOBUSFNJB EBQBU NFOJNCVMLBO FGFL ZBOH CFTBS QBEB OBUSJVN BUBV LBSFOB LFMFCJIBO OBUSJVN EBMBN DBJSBO
GVOHTJ KBSJOHBO EBO PSHBO UFSVUBNB PUBL 1FOVSVOBO LBEBS FLTUSBTFMVMBS #JMB UFSEBQBU LFIJMBOHBO QSJNFS BJS EBSJ DBJSBO
OBUSJVN QMBTNB ZBOH DFQBU NJTBMOZB EBQBU NFOJNCVMLBO FLTUSBTFMVMBS IBM UFSTFCVU BLBO NFOHBLJCBULBO UJNCVMOZB
QFNCFOHLBLBO TFM PUBL EBO HFKBMB OFVSPMPHJL TFQFSUJ TBLJU IJQFSOBUSFNJBEFIJESBTJ ,POEJTJ JOJ EBQBU UFSKBEJ BLJCBU
LFQBMB NVBM EBO LFMFTVBO EBO EJTPSJFOUBTJ #JMB LBEBS LFUJEBLNBNQVBOVOUVLNFOZFLSFTJIPSNPOBOUJEJVSFUJL ZBOH
OBUSJVN QMBTNB UVSVO TBNQBJ EJ CBXBI TBNQBJ EJCVUVILBOPMFIHJOKBMVOUVLNFOBIBOBJS"LJCBUUJEBLBEBOZB
NNPM- QFNCFOHLBLBOPUBLEBQBUNFOZFCBCLBOLFKBOH IPSNPO BOUJEJVSFUJL JOJ HJOKBM NFOHFMVBSLBO VSJOF FODFS
TFJ[VSF
LPNB LFSVTBLBO PUBL EBO LFNBUJBO ,BSFOB EBMBNKVNMBIZBOHTBOHBUCFTBS LFMBJOBOZBOHEJTFCVUTFCBHBJ
UFOHLPSBL JUV LBLV NBLB QFOBNCBIBO WPMVNF PUBL UJEBL EJBCFUFT JOTJQJEVT
ZBOH NFOZFCBCLBO UJNCVMOZB EFIJESBTJ
EBQBU MFCJI EBSJ QFSTFO UBOQB NFOFSPCPT LF BSBI MFIFS EBO QFOJOHLBUBO LPOTFOUSBTJ OBUSJVN LMPSJEB EBMBN DBJSBO
IFSOJBTJ
ZBOH BLBO NFOHHJSJOHOZB QBEB LFSVTBLBO PUBL FLTUSBTFMVMBS 1BEB KFOJTKFOJT QFOZBLJU HJOKBM UFSUFOUV HJOKBM
ZBOHQFSNBOFOEBOLFNBUJBO UJEBL CFSFTQPOT UFSIBEBQ IPSNPO BOUJEJVSFUJL ZBOH KVHB
#JMBIJQPOBUSFNJBCFSMBOHTVOHMBNCBUTFMBNBCFCFSBQBIBSJ NFOZFCBCLBO KFOJT LFMBJOBO ZBOH EJTFCVU EJBCFUFT JOTJQJEVT
PUBL EBO KBSJOHBOKBSJOHBO MBJO BLBO CFSFTQPOT EFOHBO OFGSPHFOJL 1FOZFCBC IJQPOBUSFNJB ZBOH MFCJI VNVN BLJCBU
NFNJOEBILBOOBUSJVN LMPSJEB LBMJVN CBIBOPSHBOJLUFSMBSVU QFOVSVOBOWPMVNFDBJSBOFLTUSBTFMVMBSBEBMBIEFIJESBTJBLJCBU
TFQFSUJHMVUBNBUEBSJTFMLFLPNQBSUFNFOFLTUSBTFM1FOVSVOBO BTVQBOBJSZBOHMFCJITFEJLJUEBSJQBEBQFOHFMVBSBOOZB TFQFSUJ
PTNPUJL JOJ NFOZFCBCLBO NBTVLOZB BJS LF EBMBN TFMTFM ZBOH UJNCVM QBEB LFBEBBO CFSLFSJOHBU TFMBNB BLUJWJUBT CFSBU
TFIJOHHBKBSJOHBONFNCFOHLBL (BNCBS
ZBOHCFSLFQBOKBOHBO
295
+BEJ EBMBN NFOHBOBMJTJT LFMBJOBO LPOTFOUSBTJ OBUSJVN

QMBTNBEBONFNVUVTLBOUFSBQJZBOHUFQBU LJUBIBSVTMFCJIEVMV
NFOFOUVLBO BQBLBI LFMBJOBO JOJ EJTFCBCLBO PMFI LFIJMBOHBO
BUBV QFOBNCBIBO OBUSJVN QSJNFS BUBV LFIJMBOHBO BUBV
QFOBNCBIBOBJSQSJNFS
Konsekuensi Hipernatremia: Sel Menyusut

)JQFSOBUSFNJB MFCJI KBSBOH UFSKBEJ EJCBOEJOHLBO EFOHBO
IJQPOBUSFNJB EBO HFKBMB ZBOH NFOPOKPM CJBTBOZB IBOZB QBEB
QFOJOHLBUBO LPOTFOUSBTJ OBUSJVN QMBTNB ZBOH DFQBU EBO CFTBS
EJ BUBT TBNQBJ NNPM- 4BUV BMBTBO VOUVL JOJ BEBMBI
CBIXB IJQFSOBUSFNJB NFOJNCVMLBO SBTB IBVT ZBOH MVBS CJBTB
ZBOHNFMJOEVOHJUVCVIEBSJQFOJOHLBUBOOBUSJVNEBMBNQMBTNB
EBODBJSBOFLTUSBTFMVMBS TFQFSUJZBOHUFMBIEJCBIBTQBEB#BC
"LBOUFUBQJIJQFSOBUSFNJBZBOHCFSBUEBQBUUFSKBEJQBEBQBTJFO
ZBOHNFOHBMBNJMFTJIJQPUBMBNJLZBOHNFOHHBOHHVTFOTBTJSBTB
IBVT QBEBCBZJZBOHUJEBLEBQBUMBOHTVOHNFOEBQBUNJOVNBO
BUBVQBEBQBTJFOUVBZBOHNFOHBMBNJHBOHHVBONFOUBM
,PSFLTJ IJQFSOBUSFNJB EBQBU EJMBLVLBO EFOHBO NFNCFSJLBO
MBSVUBOOBUSJVNLMPSJEBZBOHIJQPPTNPUJLBUBVEFOHBOMBSVUBO
EFLTUSPTB "LBO UFUBQJ TBOHBUMBI QFOUJOH CBIXB QFNCFSJBO
MBSVUBO UFSTFCVU QBEB QFOEFSJUB EFOHBO QFOJOHLBUBO LBEBS
OBUSJVN ZBOH LSPOJT IBSVTMBI EFOHBO LFDFQBUBO ZBOH MBNCBU
"MBTBOOZB BEBMBI IJQFSOBUSFNJB KVHB NFOJOHLBULBO BLUJWJUBT
NFLBOJTNF QFSUBIBOBO ZBOH NFMJOEVOHJ TFM EBSJ QFSVCBIBO
WPMVNF .FLBOJTNF QFSUBIBOBO JOJ TFCBMJLOZB EBSJ BQB ZBOH
UFSKBEJ QBEB IJQPOBUSFNJB UFSEJSJ BUBT NFLBOJTNF ZBOH
NFOJOHLBULBOLBEBSOBUSJVNJOUSBTFMEBO[BUUFSMBSVUMBJOOZB
Edema: Kelebihan Cairan dalam Jaringan
&EFNB NFOVOKVLLBO BEBOZB DBJSBO CFSMFCJIBO EJ KBSJOHBO

UVCVI 1BEB TFCBHJBO CFTBS LFBEBBO FEFNB UFSVUBNB UFSKBEJ
QBEB LPNQBSUFNFO DBJSBO FLTUSBTFMVMBS UBQJ EBQBU KVHB
NFMJCBULBOLPNQBSUFNFODBJSBOJOUSBTFMVMBS
Edema Intrasel
5JHB LPOEJTJ ZBOH NFNVEBILBO UFSKBEJOZB QFNCFOHLBLBO
JOUSBTFM
IJQPOBUSFNJBTFQFSUJUFMBIEJKFMBTLBOTFCFMVNOZB

EFQSFTJTJTUFNNFUBCPMJTNFKBSJOHBOEBO
UJEBLBEBOZBOVUSJTJ
TFM ZBOH BEFLVBU $POUPIOZB CJMB BMJSBO EBSBI LF KBSJOHBO
NFOVSVO QFOHJSJNBOPLTJHFOEBOOVUSJFOCFSLVSBOH+JLBBMJSBO
EBSBI NFOKBEJ TBOHBU SFOEBI VOUVL NFNQFSUBIBOLBO
NFUBCPMJTNF KBSJOHBO OPSNBM NBLB QPNQB JPO NFNCSBO TFM
NFOKBEJ UFSUFLBO #JMB IBM JOJ UFSKBEJ JPO OBUSJVN ZBOH CJBTBOZB
NBTVLLFEBMBNTFMUJEBLEBQBUMBHJEJQPNQBLFMVBSEBSJTFM EBO
)JQFSOBUSFNJB KVHB EBQBU UFSKBEJ BLJCBU QFOBNCBIBO LFMFCJIBO JPO OBUSJVN JOUSBTFM NFOJNCVMLBO PTNPTJT BJS LF
OBUSJVN LMPSJEB ZBOH CFSMFCJIBO QBEB DBJSBO FLTUSBTFMVMBS )BM EBMBN TFM ,BEBOHLBEBOH IBM JOJ EBQBU NFOJOHLBULBO WPMVNF
JOJ TFSJOH UFSKBEJ QBEB IJQFSOBUSFNJBIJQFSIJESBTJ LBSFOB JOUSBTFM TVBUV KBSJOHBO CBILBO QBEB TFMVSVI UVOHLBJ ZBOH
LFMFCJIBOOBUSJVNLMPSJEBFLTUSBTFMCJBTBOZBKVHBCFSIVCVOHBO JTLFNJL DPOUPIOZBTBNQBJEVBBUBVUJHBLBMJWPMVNFOPSNBM#JMB
EFOHBO CFCFSBQB EFSBKBU SFUFOTJ BJS PMFI HJOKBM $POUPIOZB IBM JOJ UFSKBEJ CJBTBOZB NFSVQBLBO BXBM UFSKBEJOZB LFNBUJBO
TFLSFTJ CFSMFCJIBO EBSJ IPSNPO BMEPTUFSPO ZBOH NFSFUFOTJ KBSJOHBO
OBUSJVN EBQBU NFOZFCBCLBO IJQFSOBUSFNJB SJOHBO EBO &EFNB JOUSBTFM KVHB EBQBU UFSKBEJ QBEB KBSJOHBO ZBOH NFSB
PWFSIJESBTJ "MBTBO CBIXB IJQFSOBUSFNJB JOJ UJEBL MFCJI CFSBU EBOH 1FSBEBOHBO CJBTBOZB NFOJOHLBULBO QFSNFBCJMJUBT NFNC
JBMBICBIXBQFOJOHLBUBOTFLSFTJBMEPTUFSPONFOZFCBCLBOHJOKBM SBO TFM TFSUB NFNVOHLJOLBO OBUSJVN EBO JPOJPO MBJO CFSEJGVTJ
NFSFBCTPSCTJBJSEBOOBUSJVNEBMBNKVNMBIZBOHMFCJICFTBS NBTVLLFEBMBNTFM ZBOHEJJLVUJEFOHBOPTNPTJTBJSLFEBMBNTFM
296
Bab 25 Kompartemen Cairan Tubuh: Cairan Ekstraselular dan Intraselular; Edema
Edema Ekstrasel #FCFSBQBQFNCVMVIMJNGFQBEBBLIJSOZBBLBOUVNCVILFNCBMJ

&EFNB FLTUSBTFM UFSKBEJ CJMB BEB BLVNVMBTJ DBJSBO ZBOH TFUFMBI QFNCFEBIBO UFSTFCVU EJMBLVLBO TFIJOHHB FEFNB
CFSMFCJIBO EBMBN SVBOH FLTUSBTFM "EB EVB QFOZFCBC FEFNB JOUFSTUJTJBMCJBTBOZBIBOZBCFSMBOHTVOHTFNFOUBSB
FLTUSBTFMZBOHVNVNEJKVNQBJ
LFCPDPSBOBCOPSNBMDBJSBO
EBO QMBTNB LF SVBOH JOUFSTUJTJBM EFOHBO NFMJOUBTJ LBQJMFS EBO Ringkasan dari Penyebab-Penyebab Edema Ekstrasel
UNIT V

LFHBHBMBOTJTUFNMJNGBUJLVOUVLNFOHFNCBMJLBODBJSBOEBO 4FKVNMBICFTBSLFBEBBOEBQBUNFOZFCBCLBOBLVNVMBTJDBJSBO
JOUFSTUJTJVN LF EBMBN EBSBI TFSJOH LBMJ EJTFCVU MJNGFEFNB EBMBN SPOHHB JOUFSTUJTJBM BLJCBU LFCPDPSBO BCOPSNBM DBJSBO
1FOZFCBCLMJOJTBLVNVMBTJDBJSBOJOUFSTUJTJBMZBOHQBMJOHTFSJOH EBSJLBQJMFS BUBVEFOHBONFOHIBNCBUTBMVSBOMJNGFNFOHFN
BEBMBIGJMUSBTJDBJSBOLBQJMFSZBOHCFSMFCJIBO NFOHFNCBMJLBO DBJSBO EBSJ JOUFSTUJTJBM LF EBMBN TJSLVMBTJ
#FSJLVUJOJBEBMBITFCBHJBOEBGUBSCFSCBHBJLPOEJTJZBOHEBQBU
Faktor-Faktor yang Dapat Meningkatkan Filtrasi Kapiler NFOZFCBCLBO FEFNB FLTUSBTFM CFSEBTBSLBO EVB KFOJT
BCOPSNBMJUBTUFSTFCVU
6OUVL NFNBIBNJ QFOZFCBC GJMUSBTJ LBQJMFS ZBOH CFSMFCJIBO *1FOJOHLBUBOUFLBOBOLBQJMFS
BLBO NFNCBOUV CJMB LJUB NFOHJOHU LFNCBMJ QFOFOUV GJMUSBTJ
"3FUFOTJHBSBNEBOBJSZBOHCFSMFCJIBOEJHJOKBM
LBQJMFS ZBOH EJCBIBT EJ #BC 4FDBSB NBUFNBUJT LFDFQBUBO
GJMUSBTJLBQJMFSEBQBUEJOZBUBLBOTFCBHBJCFSJLVU (BHBMHJOKBMBLVUBUBVLSPOJT
,FMFCJIBONJOFSBMPLPSUJLPJE
Filtrasi = Kf × (Pc − Pif − Pc + Pi f),
#5FLBOBOWFOBZBOHUJOHHJEBOLPOTUSJLTJWFOB
,G BEBMBI LPFGJTJFO GJMUSBTJ LBQJMFS QSPEVL EBSJ QFSNFBCJMJUBT (BHBMKBOUVOH
EBO BSFB QFSNVLBBO LBQJMFS
1$ BEBMBI UFLBOBO IJESPTUBUJL 0CTUSVLTJWFOB
LBQJMFS 1JG BEBMBI UFLBOBO IJESPTUBUJL DBJSBO JOUFSTUJTJBM ɀD
,FHBHBMBOQPNQBWFOB
BEBMBI UFLBOBO PTNPUJL LPMPJE QMBTNB LBQJMFS ɀJG BEBMBI
UFLBOBOPTNPUJLLPMPJEDBJSBOJOUFSTUJTJBM1BEBQFSTBNBBOJOJ B
1BSBMJTJTPUPU
LJUB EBQBU NFMJIBU CBIXB TFUJBQ QFSVCBIBO CFSJLVU EBQBU C
*NPCJMJTBTJCBHJBOCBHJBOUVCVI D
NFOJOHLBULBOLFDFQBUBOGJMUSBTJ
,FHBHBMBOLBUVQWFOB
$1FOVSVOBOSFTJTUBOTJBSUFSJPMB
t 1FOJOHLBUBOLPFGJTJFOGJMUSBTJLBQJMFS 1BOBTUVCVIZBOHCFSMFCJIBOU
t 1FOJOHLBUBOUFLBOBOIJESPTUBTUJLLBQJMFS
*OTVGJTJFOTJTJTUFNTBSBGTJNQBUJT
t 1FOVSVOBOUFLBOBOPTNPUJLLPMPJEQMBTNB
0CBUPCBUWBTPEJMBUPS
Limfedema-Kegagalan Pembuluh Limfe mengembalikan **1FOVSVOBOQSPUFJOQMBTNB
Cairan dan Protein ke dalam Darah ",FIJMBOHBOQSPUFJOEBMBNVSJOF TJOESPNOFGSPUJL
#
#JMB GVOHTJ QFNCVMVI MJNGF TBOHBU UFSHBOHHV EJTFCBCLBO PMFI ,FIJMBOHBOQSPUFJOEBSJEBFSBILVMJUZBOHUFSLFMVQBT
UFSKBEJOZB IBNCBUBO BUBV IJMBOHOZB QFNCVMVI MJNGF FEFNB -VLBCBLBS
EBQBU TFNBLJO CFSBU LBSFOB QSPUFJO QMBTNB ZBOH CPDPS LF -VLB
EBMBN SVBOH JOUFSTUJTJBM UJEBL NFNQVOZBJ KBMBO MBJO VOUVL $,FHBHBMBONFOHIBTJMLBOQSPUFJO
LFMVBS1FOJOHLBUBOLPOTFOUSBTJQSPUFJONFOJOHLBULBOUFLBOBO
PTNPUJL LPMPJE DBJSBO JOUFSTUJTJBM ZBOH BLBO NFOBSJL DBJSBO 1FOZBLJUIBUJ DPOUPIOZB TJSPTJT
EBSJLBQJMFSMFCJICBOZBLMBHJ .BMOVUSJTJQSPUFJOBUBVLBMPSJZBOHCFSBU
)BNCBUBOBMJSBOMJNGFEBQBUTBOHBUCFSBU CJMBUFSKBEJJOGFLTJ ***1FOJOHLBUBOQFSNFBCJMJUBTLBQJMFS
QBEB LFMFOKBS MJNGF TFQFSUJ ZBOH UFSKBEJ QBEB JOGFLTJ OFNBUPEB
"3FBLTJJNVOZBOHNFOZFCBCLBOQFMFQBTBOIJTUBNJO
GJMBSJBM 8VDIFSFSJB CBODSPGUJ ZBOH TFDBSB NJLSPTLPQJL DBDJOH EBOQSPEVLJNVOMBJOOZB
ZBOH NFOZFSVQBJ CFOBOH $BDJOH EFXBTB IJEVQ EBMBN TJTUFN
MJNGBUJL NBOVTJB EBO CFSQJOEBI EBSJ PSBOH LF PSBOH NFMBMVJ #5PLTJO
HJHJUBO OZBNVL 0SBOH ZBOH UFSLFOB JOGFLTJ GJMBSJB EBQBU $*OGFLTJCBLUFSJ
NFOEFSJUB MJNGFEFNB ZBOH CFSBU EBO FMFGBOUJBTJT LBLJ HBKBI
%%FGJTJFOTJWJUBNJO LIVTVTOZBWJUBNJO$&
EBO QBEB MBLJMBLJ QFNCFOHLBLBO QBEB TLSPUVN EJTFCVU
*TLFNJBZBOHMBNB
IJESPLFM'JMBSJBTJMJNGBUJLNFOZFSBOHMFCJIEBSJKVUBPSBOH
EJ OFHBSB USPQJT EBO TVCUSPQJT ZBJUV "TJB "GSJLB 1BTJGJL '-VLBCBLBS
CBSBUEBOTFCBHJBOEBSJ,BSJCJBEBO"NFSJLB4FMBUBO *7 )BNCBUBOBMJSBOCBMJLMJNGF
-JNGFEFNBEBQBUKVHBUFSKBEJQBEBKFOJTLBOLFSUFSUFOUVBUBV ",BOLFS
TFUFMBI QFNCFEBIBO ZBOH NFOZFCBCLBO QFNCVMVI MJNGF #*OGFLTJ NJTBMOZB OFNBUPEBKFOJTGJMBSJB
EJBOHLBUBUBVNFOHBMBNJPCTUSVLTJ$POUPIOZB TFKVNMBICFTBS
$1FNCFEBIBO
QFNCVMVIMJNGFEJBOHLBUTFMBNBNBTUFLUPNJSBEJLBM ZBOHBLBO
NFOHHBOHHVQFSQJOEBIBODBJSBOEBSJBSFBQBZVEBSBEBOMFOHBO %,FMBJOBOBUBVUJEBLBEBOZBQFNCVMVIMJNGBUJL
TFSUBNFOZFCBCLBOFEFNBEBOQFNCFOHLBLBOSVBOHKBSJOHBO TFDBSBLPOHFOJUBM
297
&EFNB ZBOH %JTFCBCLBO PMFI (BHBM +BOUVOH 4BMBI TBUV NFOKBEJCPDPSEBOQSPUFJOQMBTNBEBQBUNFMFXBUJOZB EBOTFSJOH
QFOZFCBC FEFNB QBMJOH TFSJOH EBO QBMJOH TFSJVT BEBMBI HBHBM LBMJ NFNVOHLJOLBO TFKVNMBI CFTBS QSPUFJO MFXBU NFNBTVLJ
KBOUVOH 1BEB HBHBM KBOUVOH KBOUVOH HBHBM NFNPNQB EBSBI VSJOF #JMB LFIJMBOHBO JOJ NFMFCJIJ LFNBNQVBO UVCVI VOUVL
TFDBSB OPSNBM EBSJ WFOB LF EBMBN BSUFSJ IBM JOJ NFOJOHLBULBO NFOZJOUFTJT QSPUFJO UFSKBEJMBI QFOVSVOBO LPOTFOUSBTJ QSPUFJO
UFLBOBO WFOB EBO UFLBOBO LBQJMFS ZBOH NFOZFCBCLBO QMBTNB&EFNBHFOFSBMJTBUBZBOHTFSJVTEBQBUUFSKBEJCJMBQSPUFJO
QFOJOHLBUBOGJMUSBTJLBQJMFS4FMBJOJUV UFLBOBOBSUFSJDFOEFSVOH QMBTNBUVSVOEJCBXBI HNM
UVSVO NFOZFCBCLBO QFOVSVOBO FLTLSFTJ HBSBN EBO BJS PMFI 4JSPTJT IBUJ BEBMBI LFBEBBO MBJO ZBOH KVHB NFOZFCBCLBO
HJOKBM ZBOH NFOJOHLBULBO WPMVNF EBSBI EBO MFCJI MBOKVU QFOVSVOBOLPOTFOUSBTJQSPUFJOQMBTNB4JSPTJTCFSBSUJUJNCVMOZB
NFOJOHLBULBO UFLBOBO IJESPTUBTUJL LBQJMFS TFIJOHHB FEFNB TFKVNMBI CFTBS KBSJOHBO GJCSPTB EJ BOUBSB TFMTFM QBSFOLJN IBUJ
NBLJO CFSUBNCBI "MJSBO EBSBI LF HJOKBM QBEB HBHBM KBOUVOH 4BMBITBUVBLJCBUOZBJBMBILFHBHBMBOTFMTFMJOJVOUVLNFOHIBTJM
CFSLVSBOHEBOJOJKVHBNFSBOHTBOHTFLSFTJSFOJO NFOZFCBCLBO LBO QSPUFJO QMBTNB ZBOH DVLVQ TFIJOHHB UJNCVM QFOVSVOBO
QFOJOHLBUBO QFNCFOUVLBO BOHJPUFOTJO ** EBO QFOJOHLBUBO UFLBOBO PTNPUJL LPMPJE QMBTNB EBO FEFNB HFOFSBMJTBUB ZBOH
TFLSFTJBMEPTUFSPO ZBOHNFOBNCBICFSBUOZBSFUFOTJHBSBNEBO NFOZFSUBJLFBEBBOJOJ
BJS PMFI HJOKBM KBEJ QBEB HBHBM KBOUVOH ZBOH UJEBL EJPCBUJ 4JSPTJTIBUJKVHBNFOJNCVMLBOFEFNBEFOHBODBSBMBJO ZBJUV
TFNVB GBLUPS CFLFSKB TBNB NFNCFOUVL FEFNB FLTUSBTFM GJCSPTJT IBUJ LBEBOHLBEBOH NFOHPNQSFTJ ESBJOBTF QFNCVMVI
HFOFSBMJTBUBZBOHIFCBU WFOB QPSUB BCEPNFO TBBU QFNCVMVI JOJ NFMFXBUJ IBUJ TFCFMVN
1BEB QBTJFO EFOHBO HBHBM KBOUVOH LJSJ UBOQB HBHBM KBOUVOH CFSNVBSBLFNCBMJLFTJSLVMBTJTJTUFNJL)BNCBUBOBMJSBOLFMVBS
LBOBO ZBOH CFSNBLOB EBSBI EJQPNQB TFDBSB OPSNBM LF QBSV WFOB QPSUB NFOJOHLBULBO UFLBOBO IJESPTUBUJL LBQJMFSEJTFMVSVI
QBSVPMFIKBOUVOHLBOBOUBQJUJEBLEBQBULFMVBSEFOHBONVEBI EBFSBI HBTUSPJOUFTUJOBM EBO TFMBOKVUOZB NFOJOHLBULBO GJMUSBTJ
EBSJWFOBQVMNPOBMJTLFKBOUVOHLJSJLBSFOBTJTJLJSJKBOUVOHJOJ DBJSBOLFMVBSEBSJQMBTNBLFEBMBNBSFBJOUSBBCEPNFO#JMBIBM
TBOHBU MFNBI "LJCBUOZB TFNVB UFLBOBO QFNCVMVI QBSV JOJUFSKBEJ LPNCJOBTJFGFLQFOVSVOBOLPOTFOUSBTJQSPUFJOQMBTNB
UFSNBTVLUFLBOBOLBQJMFSQBSV NFOJOHLBUKBVIEJBUBTOPSNBM EBO UFLBOBO LBQJMFS QPSUB ZBOH UJOHHJ BLBO NFOZFCBCLBO
NFOZFCBCLBO FEFNB QBSV CFSBU EBO NFOHBODBN KJXB #JMB USBOTVEBTJ TFKVNMBI CFTBS DBJSBO EBO QSPUFJO LF EBMBN SPOHHB
UJEBL EJUBOHBOJ BLVNVMBTJ DBJSBO EBMBN QBSV BLBO CFSUBNCBI BCEPNFO ZBJUVTVBUVLFBEBBOZBOHEJTFCVUBTJUFT
EFOHBODFQBU EBONFOZFCBCLBOLFNBUJBOEBMBNCFCFSBQBKBN
Faktor Pengaman yang Secara Normal Mencegah Edema
&EFNB ZBOH %JTFCBCLBO PMFI 1FOVSVOBO &LTLSFTJ (BSBN 8BMBVQVO CBOZBL HBOHHVBO ZBOH EBQBU NFOZFCBCLBO FEFNB
EBO "JS PMFI (JOKBM 4FQFSUJ ZBOH UFMBI EJCJDBSBLBO TFCFMVNOZB OBNVO LFMBJOBO JOJ CJBTBOZB IBSVT CFSBU VOUVL EBQBU UJNCVM
TFCBHJBOCFTBSOBUSJVNLMPSJEBZBOHEJUBNCBILBOLFEBMBNEBSBI FEFNBZBOHTFSJVT"MBTBOVOUVLIBMUFSTFCVUBEBMBIBEBOZBUJHB
UFUBQCFSBEBEJLPNQBSUFNFOFLTUSBTFM EBOIBOZBTFKVNMBILFDJM GBLUPS QFOHBNBO VUBNB ZBOH NFODFHBI BLVNVMBTJ DBJSBO EJ
TBKBZBOHNFNBTVLJTFM0MFILBSFOBOZB QBEBQFOZBLJUHJOKBMZBOH SPOHHB JOUFSTUJTJBM
LPNQMJBOT JOUFSTUJTJVN ZBOH SFOEBI
NFOVSVOLBO FLTLSFTJ OBUSJVN LMPSJEB EBO BJS EBMBN VSJOF LFUJLB UFLBOBO DBJSBO JOUFSTUJTJBM CFSBEB EBMBN LJTBSBO UFLBOBO
TFKVNMBI CFTBS OBUSJVN LJPSJEB EBO BJS BLBO EJUBNCBILBO LF OFHBUJG
LFNBNQVBO BMJSBO MJNGF VOUVL NFOJOHLBU
DBJSBO FLTUSBTFMVMBS 4FCBHJBO CFTBS HBSBN EBO BJS JOJ CPDPS EBO TBNQBJ LBMJ MJQBU EBO
QFOVSVOBO LPOTFOUSBTJ QSPUFJO
EBSBI NBTVL LF EBMBN SPOHHB JOUFSTUJTJBM UBQJ TFCBHJBO NBTJI DBJSBO JOUFSTUJTJBM ZBOH NFOVSVOLBO UFLBOBO PTNPUJL LPMPJE
UFUBQ CFSBEB EBMBN EBSBI &GFL VUBNB LFKBEJBO JOJ JBMBI DBJSBOJOUFSTUJTJBMTFXBLUVGJMUSBTJLBQJMFSNFOJOHLBU
NFOZFCBCLBO
QFOJOHLBUBO WPMVNF DBJSBO JOUFSTUJTJBM ZBOH
CFTBS FEFNB FLTUSBTFM
EBO
IJQFSUFOTJ BLJCBU QFOJOHLBUBO Faktor Pengaman yang Disebabkan oleh Komplians
WPMVNF EBSBI TFQFSUJ ZBOH EJKFMBTLBO EJ #BC .JTBMOZB BOBL Interstisium yang Rendah dalam Kisaran Tekanan Negatif
ZBOHNFOEFSJUBHMPNFSVMPOFGSJUJTBLVU EFOHBODFEFSBHMPNFSVMVT
%J #BC LJUB NFOHFUBIVJ CBIXB UFLBOBO IJESPTUBUJL DBJSBO
HJOKBMBLJCBUJOGMBNBTJZBOHCFSBLJCBUHBHBMOZBQFOZBSJOHBODBJSBO
JOUFSTUJTJBM EJ LFCBOZBLBO KBSJOHBO TVCLVUBO MPOHHBS EBMBN
EBMBN KVNMBI DVLVQ KVHB BLBO NFOHBMBNJ FEFNB DBJSBO
UVCVI BEBMBI TFEJLJU MFCJI SFOEBI EBSJ UFLBOBO BUNPTGJS SBUB
FLTUSBTFMVMBSZBOHTFSJVTEJTFMVSVIUVCVICFSTBNBEFOHBOFEFNB
SBUBTFLJUBSNN)H1FOHIJTBQBOSJOHBOEBMBNKBSJOHBOJOJ
BOBLBOBLJOJCJBTBOZBNFOEFSJUBIJQFSUFOTJCFSBU
NFNCBOUV VOUVL NFOBIBO KBSJOHBO CFSTBNBTBNB (BNCBS
NFNQFSMJIBULBOIVCVOHBOBOUBSBCFSCBHBJUJOHLBUUFLBOBO
&EFNBZBOH%JTFCBCLBOPMFI1FOVSVOBO1SPUFJO1MBTNB DBJSBO JOUFSTUJTJBM EBO WPMVNF DBJSBO JOUFSTUJTJBM ZBOH EJFLT
1FOVSVOBO LPOTFOUSBTJ QSPUFJO QMBTNB BLJCBU LFHBHBMBO VOUVL USBQPMBTJ LF NBOVTJB EBSJ IFXBO QFOFMJUJBO 1FSIBUJLBO QBEB
NFOHIBTJMLBO QSPUFJO EBMBN KVNMBI ZBOH DVLVQ NBVQVO (BNCBS CBIXB TFMBNB UFLBOBO DBJSBO JOUFSTUJTJBM CFSBEB
LBSFOB LFCPDPSBO QSPUFJO EBSJ QMBTNB BLBO NFOJNCVMLBO EBMBNLJTBSBOOJMBJOFHBUJG QFSVCBIBOLFDJMQBEBWPMVNFDBJSBO
QFOVSVOBO UFLBOBO PTNPUJL LPMPJE QMBTNB )BM JOJ BLBO JOUFSTUJTJBM BLBO EJJLVUJ EFOHBO QFSVCBIBO UFLBOBO IJESPTUBUJL
NFOHBLJCBULBO QFOJOHLBUBO GJMUSBTJ LBQJMFS EJ TFMVSVI UVCVI DBJSBO JOUFSTUJTJBM ZBOH SFMBUJG CFTBS 0MFI LBSFOBOZB QBEB OJMBJ
EBOFEFNBFLTUSBTFM LJTBSBO UFLBOBO OFHBUJG LPNQMJBOT KBSJOHBO ZBOH EJEFGJOJTJLBO
4BMBI TBUV QFOZFCBC UFSQFOUJOH EBSJ QFOVSVOBO LPOTFOUSBTJ TFCBHBJ QFSVCBIBO WPMVNF QFS NJMJNFUFS UFLBOBO BJS SBLTB
QSPUFJO QMBTNB JBMBI IJMBOHOZB QSPUFJO EBMBN VSJOF ZBOH BEBMBISFOEBI
EJKVNQBJ QBEB QFOZBLJU HJOKBM UFSUFOUV ZBJUV TVBUV LFBEBBO #BHBJNBOB LPNQMJBOT KBSJOHBO ZBOH SFOEBI EBMBN LJTBSBO
ZBOH EJTFCVU TJOESPN OFGSPUJL #FSCBHBJ KFOJT QFOZBLJU HJOKBM UFLBOBO OFHBUJG JOJ CFLFSKB TFCBHBJ GBLUPS QFOHBNBO UFSIBEBQ
EBQBUNFSVTBLNFNCSBOHMPNFSVMVTHJOKBM TFIJOHHBNFNCSBO FEFNB 6OUVLNFOKBXBCQFSUBOZBBOJOJ JOHBULFNCBMJGBLUPS
298
GJMBNFO QSPUFPHMJLBO #BILBO CJMB UFLBOBO DBJSBO JOUFSTUJTJBM

UVSVO TBNQBJ NFODBQBJ OJMBJ ZBOH TBOHBU OFHBUJG HFM UJEBL
CFSLPOUSBLTJ TFEFNJLJBO IFCBU LBSFOB KBMJOBO GJMBNFO
QSPUFPHMJLBO NFNCFSJLBO UBIBOBO FMBTUJL UFSIBEBQ LPNQSFTJ
1BEB LJTBSBO UFLBOBO OFHBUJG DBJSBO WPMVNF DBJSBO JOUFSTUJTJBM
UJEBL CFSVCBI CBOZBL UBOQB NFNQFSIBUJLBO BQBLBI EFSBKBU
UNIT V
QFOHJTBQBOIBOZBCFCFSBQBNJMJNFUFSUFLBOBOOFHBUJGBJSSBLTB
BUBV TBNQBJ NN )H %FOHBO LBUB MBJO LPNQMJBOT
KBSJOHBOTBOHBUSFOEBIEBMBNLJTBSBOUFLBOBOOFHBUJG
4FCBMJLOZB CJMBUFLBOBODBJSBOJOUFSTUJTJBMNFOJOHLBUTBN
QBJ LJTBSBO UFLBOBO QPTJUJG BLBO BEB BLVNVMBTJ DBJSBO CFCBT
ZBOH IFCBU EJ KBSJOHBO 1BEB LJTBSBO UFLBOBO JOJ KBSJOHBO
CFSTJGBU MFNBI EBO NFNVOHLJOLBO TFKVNMBI CFTBS DBJSBO
CFSBLVNVMBTJ IBOZB EFOHBO NFOBNCBI TFEJLJU UFLBOBO
IJESPTUBUJL DBJSBO JOUFSTUJTJBM $BJSBO FLTUSBTFMVMBS ZBOH
LFCBOZBLBO CFSBLVNVMBTJ BEBMBI DBJSBO CFCBT LBSFOB DBJSBO
JOJNFOEPSPOHCSVTIQJMFGJMBNFOQSPUFPHMJLBOIJOHHBUFSQJTBI
0MFI LBSFOBOZB DBJSBO EBQBU NFOHBMJS CFCBT NFMBMVJ SVBOH
KBSJOHBOLBSFOBDBJSBOUFSTFCVUUJEBLEBMBNCFOUVLHFM#JMBIBM
JOJ UFSKBEJ FEFNB UFSTFCVU EJLBUBLBO TFCBHBJ QJUUJOH FEFNB
LBSFOB LJUB EBQBU NFOFLBO JCV KBSJ QBEB KBSJOHBO EBO
NFOEPSPOH DBJSBO LFMVBS EBSJ BSFB UFSTFCVU #JMB JCV KBSJ
EJBOHLBU UFSCFOUVL TVBUV MFLVLBO EJ LVMJU TFMBNB CFCFSBQB
EFUJL TBNQBJ DBJSBO LFNCBMJ MBHJ EBO KBSJOHBO EJ TFLJUBSOZB
+FOJT FEFNB JOJ IBSVT EJCFEBLBO EBSJ OPOQJUUJOH FEFNB ZBOH
UFSKBEJ CJMB TFMTFM KBSJOHBO NFNCFOHLBL NFOHHBOUJLBO
JOUFSTUJTJVN BUBVCJMBDBJSBOEJJOUFSTUJTJVNNFOHHVNQBMPMFI
GJCSJOPHFO TFIJOHHB DBJSBO UJEBL EBQBU CFSHFSBL CFCBT EBMBN
QFOFOUV GJMUSBTJ LBQJMFS ZBOH EJCBIBT TFCFMVNOZB #JMB UFLBOBO SVBOHKBSJOHBO
IJESPTUBUJL DBJSBO JOUFSTUJTJBM NFOJOHLBU QFOJOHLBUBO UFSTFCVU 1FSBOBO 'JMBNFO 1SPUFPHMJLBO TFCBHBJ 1FOHBUVS +BSBL
DFOEFSVOH NFOHIBNCBU GJMUSBTJ LBQJMFS MFCJI MBOKVU +BEJ TFMBNB VOUVL4FM4FMEBOEBMBN.FODFHBI"MJSBO$BJSBOZBOH$FQBU
UFLBOBOIJESPTUBUJLDBJSBOJOUFSTUJTJBMCFSBEBQBEBLJTBSBOUFLBOBO EJ +BSJOHBO 'JMBNFO QSPUFPHMJLBO CFSTBNB TFSBCVU LPMBHFO
OFHBUJG TFEJLJU QFOJOHLBUBO WPMVNF DBJSBO JOUFSTUJTJBM BLBO ZBOH MFCJI CFTBS EJ SVBOH JOUFSTUJTJBM CFSUJOEBL TFCBHBJ
NFOZFCBCLBO QFOJOHLBUBO UFLBOBO IJESPTUBUJL DBJSBO JOUFSTUJTJBM QFOHBUVSKBSBLBOUBSTFM/VUSJFOEBOJPOUJEBLEBQBUCFSEJGVTJ
ZBOH SFMBUJG CFTBS EBO NFOHIBNCBU GJMUSBTJ DBJSBO LF KBSJOHBO EFOHBO NVEBI NFMBMVJ NFNCSBO TFM PMFI LBSFOB JUV UBOQB
MFCJIMBOKVU QFOHBUVSBOKBSBLZBOHBEFLVBUBOUBSTFM OVUSJFO FMFLUSPMJU EBO
0MFI LBSFOB UFLBOBO IJESPTUBUJL DBJSBO JOUFSTUJTJBM OPSNBM QSPEVL MJNCBI TFMTFM JOJ UJEBL EBQBU TBMJOH CFSUVLBS UFNQBU
BEBMBI NN )H UFLBOBO IJESPTUBUJL DBJSBO JOUFSTUJTJBM IBSVT EFOHBO DFQBU BOUBSB LBQJMFS EBSBI EBO TFMTFM ZBOH CFSMPLBTJ
NFOJOHLBUTFLJUBSNN)HTFCFMVNTFKVNMBICFTBSDBJSBONVMBJ DVLVQKBVITBUVEFOHBOMBJOOZB
UFSBLVNVMBTJ EJ KBSJOHBO 0MFI TFCBC JUV GBLUPS QFOHBNBO 'JMBNFO QSPUFPHMJLBO KVHB NFODFHBI BHBS DBJSBO UJEBL EF
UFSIBEBQ FEFNB BEBMBI QFSVCBIBO UFLBOBO DBJSBO JOUFSTUJTJBM OHBO NVEBI NFOHBMJS NFMBMVJ SVBOH KBSJOHBO +JLB CVLBO
TFLJUBSNN)H LBSFOB GJMBNFO QSPUFPHMJLBO TVBUV HFSBLBO TFEFSIBOB QBEB
#FHJUVUFLBOBODBJSBOJOUFSTUJTJBMNFOJOHLBUEJBUBTNN)H TFTFPSBOH TFQFSUJ CFSEJSJ BLBO NFOZFCBCLBO TFKVNMBI CFTBS
LPNQMJBOT KBSJOHBO BLBO NFOJOHLBU EFOHBO OZBUB TFIJOHHB DBJSBO JOUFSTUJTJBM NFOHBMJS EBSJ CBHJBO UVCVI BUBT LF CBHJBO
NFNVOHLJOLBO TFKVNMBI CFTBS DBJSBO UFSBLVNVMBTJ EJ KBSJOHBO UVCVI CBXBI #JMB UFSMBMV CBOZBL DBJSBO ZBOH CFSLVNQVM EJ
EFOHBO QFOBNCBIBO QFOJOHLBUBO UFLBOBO IJESPTUBUJL DBJSBO JOUFSTUJTJVN TFQFSUJZBOHUFSKBEJQBEBFEFNBDBJSBOUBNCBIBO
JOUFSTUJTJBMZBOHSFMBUJGLFDJM+BEJ EBMBNLJTBSBOUFLBOBOKBSJOHBO JOJBLBONFNCFOUVLTBMVSBOTBMVSBOCFTBSTFIJOHHBNFNVOH
QPTJUJG GBLUPS QFOHBNBO UFSIBEBQ FEFNB JOJ NFOHIJMBOH LBSFOB LJOLBO DBJSBO NFOHBMJS EFOHBO NVEBI NFMBMVJ JOUFSTUJTJVN
QFOJOHLBUBOLPNQMJBOTKBSJOHBOZBOHCFTBS 0MFI LBSFOB JUV CJMB UFSKBEJ FEFNB CFSBU QBEB LBLJ DBJSBO
1FSBOBO(FM*OUFSTUJTJBMEBMBN.FODFHBI"LVNVMBTJ$BJ FEFNBTFSJOHLBMJEBQBUEJLVSBOHJIBOZBEFOHBONFOJOHHJLBO
SBOEJ3VBOH*OUFSTUJTJBM1FSIBUJLBOQBEB(BNCBSCBIXB LBLJ
QBEBKBSJOHBOOPSNBMEFOHBOUFLBOBODBJSBOJOUFSTUJTJBMOFHBUJG 8BMBVQVO DBJSBO UJEBL NFOHBMJS EFOHBO NVEBI NFMBMVJ
IBNQJS TFNVB DBJSBO EBMBN JOUFSTUJTJBM BEBMBI EBMBN CFOUVL KBSJOHBOBLJCBUBEBOZBGJMBNFOQSPUFPHMJLBOZBOHQBEBU UFUBQJ
HFM"SUJOZB DBJSBOUFSJLBUEBMBNKBMJOBOQSPUFPHMJLBOTFIJOHHB CFSCBHBJ[BUEBMBNDBJSBOEBQBUCFSEJGVTJNFMBMVJKBSJOHBOTFEJ
IBNQJS UJEBL BEB SVBOH DBJSBO CFCBT ZBOH EJBNFUFSOZB MF LJUOZBQFSTFOTFNVEBI[BU[BUJOJCFSEJGVTJTFDBSBOPSNBM
CJIEBSJTFQFSCFCFSBQBSBUVTNJLSPNFUFS,FHVOBBOHFMBEBMBI 0MFI LBSFOBOZB EJGVTJ OVUSJFO LF TFMTFM EBO QFOHBOHLVUBO
NFODFHBIDBJSBONFOHBMJSEFOHBONVEBINFMBMVJKBSJOHBOLB QSPEVM MJNCBI EBSJ TFM UJEBL UFSHBOHHV PMFI GJMBNFO QSPUFP
SFOBIBNCBUBOEBSJCSVTIQJMF UVNQVLBOTJLBU
EBOUSJMJVOBO HMJLBOJOUFSTUJTJVN
299
Peningkatan Aliran Limfe sebagai Faktor Pengaman NFMJQVUJSPOHHBTFOEJEBOCVSTBTFOEJ)BNQJSTFNVBSPOHHB

Terhadap Edema QPUFOTJBM JOJ NFNQVOZBJ QFSNVLBBO ZBOH IBNQJS CFSTFOUV
'VOHTJ VUBNB TJTUFN MJNGBUJL JBMBI NFOHFNCBMJLBO DBJSBO EBO IBO TBUV TBNB MBJO IBOZB EFOHBO TBUV MBQJTBO UJQJT DBJSBO EJ
QSPUFJO ZBOH UFMBI EJTBSJOH EBSJ LBQJMFS LF EBMBN JOUFSTUJTJBM BOUBSBOZB EBOQFSNVLBBOJOJCFSHFTFLBOTBUVTBNBMBJO6O
LFNCBMJLFTJSLVMBTJ5BOQBBEBOZBQFOHFNCBMJBOQSPUFJOZBOH UVLNFNQFSNVEBIQFSHFTFLBOJOJ UFSEBQBUTVBUVDBJSBOLFO
UFSTBSJOHEBODBJSBOTFDBSBUFSVTNFOFSVT WPMVNFQMBTNBBLBO UBMNFOHBOEVOHQSPUFJOZBOHNFMVNBTJQFSNVLBBOUFSTFCVU
EFOHBODFQBUNFOVSVOEBOFEFNBJOUFSTUJTJBMBLBOUFSKBEJ
$BJSBO #FSUVLBS 5FNQBU BOUBSB ,BQJMFS EBO 3POHHB
4JTUFN MJNGBUJL CFLFSKB TFCBHBJ GBLUPS QFOHBNBO UFSIBEBQ
1PUFOTJBM .FNCSBO QFSNVLBBO SPOHHB QPUFOTJBM CJBTBOZB
FEFNB LBSFOB BMJSBO MJNGF EBQBU NFOJOHLBU TBNQBJ LBMJ
UJEBL NFNQVOZBJ SFTJTUBOTJ ZBOH DVLVQ CFSNBLOB CBHJ
MJQBU LFUJLB DBJSBO NVMBJ UFSBLVNVMBTJ EBMBN KBSJOHBO )BM JOJ
KBMBOOZB DBJSBO FMFLUSPMJU BUBV CBILBO QSPUFJO ZBOH EFOHBO
NFNVOHLJOLBOTJTUFNMJNGBUJLNFOHBOHLVUDBJSBOEBOQSPUFJO
NVEBI LFMVBS NBTVL BOUBSB SPOHHB EBO DBJSBO JOUFSTUJTJBM EJ
EBMBN KVNMBI CFTBS TFCBHBJ SFTQPOT UFSIBEBQ QFOJOHLBUBO
KBSJOHBO TFLJUBSOZB 0MFI LBSFOB JUV NBTJOHNBTJOH SPOHHB
GJMUSBTJ LBQJMFS TFIJOHHB NFODFHBI QFOJOHLBUBO UFLBOBO JOUFS
QPUFOTJBM TFCFOBSOZB BEBMBI SPOHHB KBSJOHBO ZBOH CFTBS
TUJTJBM LF LJTBSBO UFLBOBO QPTJUJG 'BLUPS QFOHBNBO ZBOH
"LJCBUOZB DBJSBO EBMBN LBQJMFS ZBOH CFSEFLBUBO EFOHBO
EJUJNCVMLBOPMFIQFOJOHLBUBOBMJSBOMJNGFUFMBIEJIJUVOH ZBJUV
SPOHHB QPUFOTJBM BLBO CFSEJGVTJ UJEBL IBOZB LF EBMBN DBJSBO
TFLJUBSNN)H
JOUFSTUJTJBMUFUBQJKVHBLFEBMBNSPOHHBQPUFOTJBM
"Pengeluaran" Protein Cairan Interstisial sebagai Faktor 1FNCVMVI -JNGF .FOHFMVBSLBO 1SPUFJO EBSJ 3POHHB
Pengaman terhadap Edema 1PUFOTJBM 1SPUFJO UFSLVNQVM EBMBN SPOHHB QPUFOTJBM BLJCBU
#FSTBNB EFOHBO QFOJOHLBUBO KVNMBI DBJSBO ZBOH EJTBSJOH LF LFCPDPSBO LBQJMFS TBNB TFQFSUJ BLVNVMBTJ QSPUFJO EJ SPOHHB
EBMBN JOUFSTUJTJVN UFLBOBO DBJSBO JOUFSTUJTJBM KVHB NFOJOHLBU JOUFSTUJTJBM EJ TFMVSVI UVCVI 1SPUFJO IBSVT EJLFMVBSLBO NFMBMVJ
TFIJOHHBNFOZFCBCLBOQFOJOHLBUBOBMJSBOMJNGF1BEBLFCBOZBLBO TBMVSBOMJNGFBUBVTBMVSBOMBJOOZBEBOLFNCBMJMBHJLFTJSLVMBTJ
KBSJOHBO LPOTFOUSBTJ QSPUFJO JOUFSTUJTJVN NFOVSVO CFSTBNB 4FUJBQ SPOHHB QPUFOTJBM CFSIVCVOHBO TFDBSB MBOHTVOH NBVQVO
EFOHBO QFOJOHLBUBO BMJSBO MJNGF LBSFOB KVNMBI QSPUFJO ZBOH UJEBL MBOHTVOH EFOHBO QFNCVMVI MJNGF 1BEB CFCFSBQB LBTVT
EJCBXB MFCJI CFTBS EBSJQBEB ZBOH EBQBU EJGJMUSBTJ LFMVBS EBSJ TFQFSUJ SPOHHB QMFVSB EBO SPOHHB QFSJUPOFBM QFNCVMVI MJNGF
LBQJMFS BMBTBO VOUVL IBM JOJ BEBMBI CBIXB LBQJMFS SFMBUJG CFTBSMBOHTVOHCFSBTBMEBSJSPOHHBJUVTFOEJSJ
JNQFSNFBCFM UFSIBEBQ QSPUFJO EJCBOEJOHLBO EFOHBO QFNCVMVI
MJNGF 0MFI LBSFOBOZB QSPUFJO EJEPSPOH LFMVBS EBO DBJSBO $BJSBO &EFNB QBEB 3POHHB 1PUFOTJBM %JTFCVU &GVTJ
JOUFSTUJTJBMCFSTBNBBOEFOHBOQFOJOHLBUBOBMJSBOMJNGF ,FUJLB UFSKBEJ FEFNB QBEB KBSJOHBO TVCLVUBO ZBOH CFSEFLBUBO
0MFI LBSFOB UFLBOBO PTNPUJL LPMPJE DBJSBO JOUFSTUJTJBM ZBOH EFOHBO SPOHHB QPUFOTJBM DBJSBO FEFNB CJBTBOZB KVHB BLBO
EJTFCBCLBO PMFI QSPUFJO DFOEFSVOH VOUVL NFOBSJL DBJSBO LFMVBS UFSLVNQVM EJ SPOHHB QPUFOTJBM EBO DBJSBO JOJ EJTFCVU FGVTJ
EBSJLBQJMFS QFOVSVOBOQSPUFJODBJSBOJOUFSTUJTJBMBLBONFOVSVO +BEJ IBNCBUBO BMJSBO MJNGF BUBV TFUJBQ LFMBJOBO ZBOH EBQBU
LBOEBZBGJMUSBTJOFUPZBOHNFMJOUBTJLBQJMFS EBODFOEFSVOHNFO NFOJNCVMLBO GJMUSBTJ LBQJMFS ZBOH CFSMFCJIBO EBQBU
DFHBIBLVNVMBTJDBJSBOMFCJIMBOKVU'BLUPSQFOHBNBOEBSJFGFLJOJ NFOZFCBCLBO FGVTJ EFOHBO DBSB ZBOH TBNB TFQFSUJ UJNCVMOZB
UFMBIEJIJUVOH ZBJUVTFLJUBSNN)H FEFNB JOUFSTUJTJBM 3POHHB BCEPNFO NFSVQBLBO UFNQBU ZBOH
UFSVUBNB SFOUBO VOUVL UFSKBEJOZB QFOHVNQVMBO DBJSBO FGVTJ
3JOHLBTBO'BLUPS'BLUPS1FOHBNBOZBOH.FODFHBI&EFNB EBO QBEB LFBEBBO JOJ FGVTJ EJTFCVU BTJUFT 1BEB LBTVTLBTVT
%FOHBO NFMJIBU TFMVSVI GBLUPS QFOHBNBO UFSIBEBQ FEFNB JOJ ZBOHCFSBU CJTBUFSKBEJQFOHVNQVMBODBJSBOBTJUFTTBNQBJ-
BUBVMFCJI
CFSTBNBTBNB LJUBBLBONFOFNVLBOCBIXB
3POHHB QPUFOTJBM MBJOOZB TFQFSUJ SPOHHB QMFVSB SPOHHB
'BLUPS QFOHBNBO ZBOH EJIBTJMLBO PMFI LPNQMJBOT KBSJOHBO QFSJLBSEJVN EBOSPOHHBTFOEJ EBQBUTBOHBUNFNCFOHLBLCJMB
ZBOHSFOEBIQBEBLJTBSBOUFLBOBOOFHBUJGCFTBSOZBTFLJUBS
BEB FEFNB HFOFSBMJTBUB $FEFSB BUBV JOGFLTJ MPLBM QBEB TBMBI
NN)H TBUV SPOHHB KVHB TFSJOH NFOHIBNCBU ESBJOBTF MJNGF TFIJOHHB
'BLUPSQFOHBNBOZBOHEJIBTJMLBOPMFIQFOJOHLBUBOBMJSBO EBQBUNFOZFCBCLBOQFNCFOHLBLBOUFSJTPMJSEJSPOHHBUFSTFCVU
MJNGFJBMBITFLJUBSNN)H %JOBNJLB QFSUVLBSBO DBJSBO EBMBN SPOHHB QMFVSB BLBO
'BLUPSQFOHBNBOZBOHEJTFCBCLBOPMFIQFOHFMVBSBOQSPUFJO EJCBIBT TFDBSB SJODJ EJ #BC %JOBNJLB JOJ KVHB NFXBLJMJ
EBSJSVBOHJOUFSTUJTJBMBEBMBITFLJUBSNN)H TFNVB SPOHHB QPUFOTJBM ZBOH BEB )BM ZBOH NFOBSJL BEBMBI
0MFI LBSFOBOZB UPUBM GBLUPS QFOHBNBO UFSIBEBQ FEFNB JBMBI CBIXB UFLBOBO OPSNBM DBJSBO EJ TFCBHJBO CFTBS BUBV TFNVB
TFLJUBS NN )H )BM JOJ CFSBSUJ CBIXB UFLBOBO LBQJMFS QBEB SPOHHBQPUFOTJBMQBEBLFBEBBOOPOFEFNBCFSTJGBUOFHBUJGTBNB
KBSJOHBOQFSJGFSTFDBSBUFPSFUJTEBQBUNFOJOHLBUTFCBOZBLNN TFQFSUJ UFLBOBO DBJSBO QBEB KBSJOHBO TVCLVUBO MPOHHBS ZBOH
)H BUBV LJSBLJSB NFODBQBJ EVB LBMJ OJMBJ OPSNBM TFCFMVN KVHB CFSTJGBU OFHBUJG TVCBUNPTGFSJL
$POUPIOZB UFLBOBO
UFSKBEJOZBFEFNBZBOHCFSBU IJESPTUBUJLDBJSBOJOUFSTUJTJBMOPSNBMOZBTFLJUBSTBNQBJ
NN )H EBMBN SPOHHB QMFVSB TBNQBJ NN )H EBMBN
SPOHHB TFOEJ EBO TBNQBJ NN )H EBMBN SPOHHB
Cairan dalam "Rongga Potensi" Tubuh QFSJLBSEJVN
#FCFSBQB DPOUPI EBSJ SPOHHB QPUFOTJBM BEBMBI SPOHHB QMFVSB
SPOHHBQFSJLBSEJVN SPOHHBQFSJUPOFBM EBOSPOHHBTJOPWJB NF
300
Daftar Pustaka Loh JA, Verbalis JG: Disorders of water and salt metabolism associated with
pituitary disease, Endocrinol Metab Clin North Am 37:213, 2008.Oliver G,
Amiry-Moghaddam M, Ottersen OP: The molecular basis of water trans- Srinivasan RS: Lymphatic vasculature development: current con-
port in the brain, Nat Rev Neurosci 4:991, 2003. cepts, Ann N Y Acad Sci 1131:75, 2008.
Aukland K: Why don’t our feet swell in the upright position? News Physiol Parker JC: Hydraulic conductance of lung endothelial phenotypes and
Sci 9:214, 1994. Starling safety factors against edema, Am J Physiol Lung Cell Mol Physiol
UNIT V
Gashev AA: Physiologic aspects of lymphatic contractile function: current 292:L378, 2007.
perspectives, Ann N Y Acad Sci 979:178, 2002. Parker JC, Townsley MI: Physiological determinants of the pulmonary fil-
Guyton AC, Granger HJ, Taylor AE: Interstitial fluid pressure, Physiol Rev tration coefficient, Am J Physiol Lung Cell Mol Physiol 295:L235, 2008.
51:527, 1971. Reynolds RM, Padfield PL, Seckl JR: Disorders of sodium balance, Br Med J
Halperin ML, Bohn D: Clinical approach to disorders of salt and water bal- 332:702, 2006.
ance: emphasis on integrative physiology, Crit Care Clin 18:249, 2002.Hull Saaristo A, Karkkainen MJ, Alitalo K: Insights into the molecular pathogen-
RP, Goldsmith DJ: Nephrotic syndrome in adults, British Med J esis and targeted treatment of lymphedema, Ann N Y Acad Sci 979:94,
336:1185, 2008. 2002.
Jussila L, Alitalo K: Vascular growth factors and lymphangiogenesis, Physiol Verbalis JG, Goldsmith SR, Greenberg A, et al: Hyponatremia treatment
Rev 82:673, 2002. guidelines 2007: expert panel recommendations, Am J Med 120 (11
Lymphatic Filariasis. Centers for Disease Control and Prevention: 2008 Suppl 1):S1, 2007.
http://www.cdc.gov/ncidod/dpd/parasites/lymphaticfilariasis/index.htm.
301
BAB 26
1FNCFOUVLBO6SJOFPMFI(JOKBM*
UNIT V
'JMUSBTJ(MPNFSVMVT "MJSBO%BSBI
(JOKBM EBO1FOHBUVSBOOZB
Berbagai Fungsi Ginjal BTBN VSBU EBSJ BTBN OVLMFBU

QSPEVL BLIJS QFNFDBIBO
IFNPHMPCJO TFQFSUJCJMJSVCJO
EBONFUBCPMJUCFSCBHBJIPSNPO
,FCBOZBLBO PSBOH UFMBI NFOHFOBM 1SPEVLQSPEVL TJTB JOJ IBSVT EJCFSTJILBO EBSJ UVCVI TFDFQBU
TBMBI TBUV GVOHTJ HJOKBM ZBOH QSPEVLTJOZB(JOKBMKVHBNFNCVBOHTFCBHJBOCFTBSUPLTJOEBO
QFOUJOH VOUVL NFNCFSTJILBO [BU BTJOH MBJOOZB ZBOH EJQSPEVLTJ PMFI UVCVI BUBV EJNBLBO
UVCVIEBSJCBIBOCBIBOTJTBNBLBO TFQFSUJQFTUJTJEB PCBUPCBUBO EBO[BUBEJUJGNBLBOBO
BO BUBV ZBOH EJQSPEVLTJ PMFI NFUBCPMJTNF 'VOHTJ LFEVB
NFSVQBLBO GVOHTJ ZBOH TBOHBU QFOUJOH ZBJUV VOUVL NFOHPOUSPM Pengaturan Keseimbangan Air dan Elektrolit. 6OUVL
WPMVNF EBO LPNQPTJTJ DBJSBO UVCVI 6OUVL BJS EBO IBNQJS NFNQFSUBIBOLBOIPNFPTUBTJT FLTLSFTJBJSEBOFMFLUSPMJUIBSVT
TFNVBFMFLUSPMJUEBMBNUVCVI LFTFJNCBOHBOBOUBSBBTVQBO IBTJM UFQBU TFTVBJ EFOHBO BTVQBOOZB +JLB BTVQBO NFMFCJIJ FLTLSFTJ
EBSJNBLBOBOBUBVQSPEVLTJNFUBCPMJL
TFSUBLFMVBSBO IBTJMEBSJ KVNMBI [BU UFSTFCVU EBMBN UVCVI BLBO NFOJOHLBU +JLB BTVQBO
FLTLSFTJBUBVLPOTVNTJNFUBCPMJL
TFCBHJBOCFTBSEJQFSUBIBOLBO LVSBOH EBSJ FLTLSFTJ KVNMBI [BU UFSTFCVU EBMBN UVCVI BLBO
PMFI HJOKBM 'VOHTJ QFOHBUVSBO PMFI HJOKBM JOJ NFNQFSUBIBOLBO CFSLVSBOH
LFTUBCJMBO MJOHLVOHBO EBMBN ZBOH EJQFSMVLBO TFM VOUVL "TVQBO BJS EBO CBOZBL FMFLUSPMJU UFSVUBNB EJUFOUVLBO PMFI
NFMBLVLBOCFSCBHBJBLUJWJUBTOZB LFCJBTBBO NBLBO EBO NJOVN TFTFPSBOH TFIJOHHB
(JOKBMNFMBLVLBOGVOHTJOZBZBOHQBMJOHQFOUJOHEFOHBODBSB NFOHIBSVTLBO HJOKBM VOUVL NFOHBUVS LFDFQBUBO FLTLSFTJOZB
NFOZBSJOH QMBTNB EBO NFNJTBILBO [BU EBSJ GJMUSBU EFOHBO TFTVBJ EFOHBO BTVQBO CFSCBHBJ NBDBN [BU (BNCBS
LFDFQBUBO ZBOH CFSWBSJBTJ CFSHBOUVOH QBEB LFCVUVIBO UVCVI NFNQFSMJIBULBO SFTQPOT HJOKBM UFSIBEBQ LFOBJLBO NFOEBEBL
"LIJSOZB HJOKBMNFNCVBOH[BU[BUZBOHUJEBLEJJOHJOLBOEBSJ BTVQBO OBUSJVN TFCBOZBL LBMJ MJQBU EBSJ LBEBS SFOEBI
GJMUSBU EBO LBSFOB JUV EBSJ EBSBI
EFOHBO DBSB NFOHFLT N&RIBSJNFODBQBJLBEBSUJOHHJN&RIBSJ%BMBNXBLUV
LSFTJLBOOZB LF EBMBN VSJOF TFNFOUBSB [BU ZBOH EJCVUVILBO TBNQBJIBSJTFUFMBILFOBJLBOBTVQBOOBUSJVN FLTLSFTJHJOKBM
EJLFNCBMJLBOLFEBMBNEBSBI KVHB NFOJOHLBU IJOHHB LJSBLJSB N&RIBSJ TFIJOHHB
.FTLJQVO CBC JOJ EBO CFCFSBQB CBC TFMBOKVUOZB CFSGPLVT LFTFJNCBOHBO BOUBSB BTVQBO EBO LFMVBSBO UFSDBQBJ LFNCBMJ
UFSVUBNB QBEB NBTBMBI QFOHBUVSBO FLTLSFTJ BJS FMFLUSPMJU EBO /BNVO TFMBNBTBNQBJIBSJCFSMBOHTVOHOZBBEBQUBTJHJOKBM
TJTB NFUBCPMJTNF PMFI HJOKBM HJOKBM NFOKBMBOLBO CBOZBL GVOHTJ UFSIBEBQ BTVQBO OBUSJVN ZBOH UJOHHJ JOJ UFSKBEJ BLVNVMBTJ
IPNFPTUBUJLQFOUJOH BOUBSBMBJO TFKVNMBI OBUSJVN ZBOH TFEJLJU NFOJOHLBULBO WPMVNF DBJSBO
FLTUSBTFMVMBS TFSUB NFNJDV QFSVCBIBO IPSNPOBM EBO SFTQPOT
LPNQFOTBTJ MBJOOZB ZBOH NFNCFSJ TJOZBM LFQBEB HJOKBM VOUVL
t &LTLSFTJQSPEVLTJTBNFUBCPMJLEBOCBIBOLJNJBBTJOH
NFOJOHLBULBOFLTLSFTJOBUSJVNOZB
t 1FOHBUVSBOLFTFJNCBOHBOBJSEBOFMFLUSPMJU
,BQBTJUBT HJOKBM TBOHBU CFTBS VOUVL NFOHVCBI FLTLSFTJ
t 1FOHBUVSBOPTNPMBMJUBTDBJSBOUVCVIEBOLPOTFOUSBTJFMFLUSPMJU OBUSJVNOZB TFCBHBJ SFTQPOT UFSIBEBQ QFSVCBIBO BTVQBO
t 1FOHBUVSBOUFLBOBOBSUFSJ OBUSJVN 1FOFMJUJBO FLTQFSJNFOUBM UFMBI NFOVOKVLLBO CBIXB
t 1FOHBUVSBOLFTFJNCBOHBOBTBNCBTB QBEBCBOZBLPSBOH BTVQBOOBUSJVNEBQBUEJUJOHLBULBOIJOHHB
t N&RIBSJ MFCJI EBSJ LBMJ OPSNBM
BUBV EJUVSVOLBO
4FLSFTJ NFUBCPMJTNF EBOFLTLSFTJIPSNPO
IJOHHBN&RIBSJ LVSBOHEBSJTFQFSTFQVMVIKVNMBIOPSNBM

t (MVLPOFPHFOFTJT EFOHBO QFSVCBIBO WPMVNF DBJSBO FLTUSBTFM BUBV QFSVCBIBO
LPOTFOUSBTJ OBUSJVN QMBTNB ZBOH SFMBUJG LFDJM )BM JOJ KVHB
Ekskresi Produk Sisa Metabolik, Bahan Kimia Asing, CFSMBLVVOUVLBJSEBOTFCBHJBOCFTBSFMFLUSPMJUMBJOOZB TFQFSUJ
Obat, dan Metabolit Hormon. (JOKBM NFSVQBLBO DBSB VUBNB JPO LMPSJEB LBMJVN OBUSJVN LBMTJVN IJESPHFO NBHOFTJVN
VOUVL NFNCVBOH QSPEVL TJTB NFUBCPMJTNF ZBOH UJEBL EBOGPTGBU1BEBCFCFSBQBCBCTFMBOKVUOZB LJUBNFOEJTLVTJLBO
EJQFSMVLBO MBHJ PMFI UVCVI 1SPEVLQSPEVL JOJ NFMJQVUJ VSFVN NFLBOJTNF TQFTJGJL ZBOH NFNVOHLJOLBO HJOKBM VOUVL
EBSJNFUBCPMJTNFBTBNBNJOP
LSFBUJOJO EBSJLSFBUJOPUPU
NFMBLVLBOLFSKBZBOHIFCBUVOUVLIPNFPTUBTJT
303
Sintesis Giukosa. (JOKBM NFOZJOUFTJT HMVLPTB EBSJ BTBN

BNJOP EBO QSFLVSTPS MBJOOZB TFMBNB NBTB QVBTB ZBOH QBOKBOH
QSPTFT JOJ EJTFCVU HMVLPOFPHFOFTJT ,BQBTJUBT HJOKBM VOUVL
NFOBNCBILBO HMVLPTB QBEB EBSBI TFMBNB NBTB QVBTB ZBOH
QBOKBOHEBQBUNFOZBJOHJIBUJ
1BEB QFOZBLJU HJOKBM LSPOJT BUBV HBHBM HJOKBM BLVU GVOHTJ
IPNFPTUBUJL JOJ UFSHBOHHV EBO LFNVEJBO UFSKBEJ BCOPSNBMJUBT
LPNQPTJTJ EBO WPMVNF DBJSBO UVCVI ZBOH CFSBU EBO DFQBU 1BEB
HBHBMHJOKBMUPUBM EBMBNCFCFSBQBIBSJTBKBEBQBUUFSKBEJBLVNVMBTJ
LBMJVN BTBN DBJSBO EBO [BU[BU MBJOOZB EBMBN UVCVI TFIJOHHB
NFOZFCBCLBO LFNBUJBO EBMBN CFCFSBQB IBSJ LFDVBMJ KJLB BEB
JOUFSWFOTJ LMJOJT TFQFSUJ IFNPEJBMJTJT EJNVMBJ VOUVL NFNVMJILBO
QBMJOHUJEBLTFCBHJBO LFTFJNCBOHBODBJSBOUVCVIEBOFMFLUSPMJU
Anatomi Fisiologis Ginjal
Susunan Umum Ginjal dan Traktus Urinarius

%VB HJOKBM UFSMFUBL QBEB EJOEJOH QPTUFSJPS BCEPNFO EJ MVBS
SPOHHB QFSJUPOFVN (BNCBS
4FUJBQ HJOKBM QBEB PSBOH
EFXBTB CFSBUOZB LJSBLJSB HSBN EBO LJSBLJSB TFVLVSBO
LFQBMBO UBOHBO 4JTJ NFEJBM TFUJBQ HJOKBM NFSVQBLBO EBFSBI
Pengaturan Tekanan Arteri. 4FQFSUJ ZBOH EJCBIBT QBEB
MFLVLBO ZBOH EJTFCVU IJMVN UFNQBU MFXBUOZB BSUFSJ EBO WFOB
#BC HJOKBMCFSQFSBOQFOUJOHEBMBNNFOHBUVSUFLBOBOBSUFSJ
SFOBMJT QFNCVMVIMJNGBUJL TBSBG EBOVSFUFSZBOHNFNCBXBVSJOF
KBOHLB QBOKBOH EFOHBO NFOHFLTLSFTJLBO TFKVNMBI OBUSJVN
BLIJS EBSJ HJOKBM LF LBOEVOH LFNJI UFNQBU VSJOF EJTJNQBO
EBOBJS4FMBJOJUV HJOKBMUVSVUNFOHBUVSUFLBOBOBSUFSJKBOHLB
IJOHHB EJLFMVBSLBO (JOKBM EJCVOHLVT PMFI LBQTVM GJCSPTB ZBOH
QFOEFL EFOHBO NFOZFLSFTJLBO IPSNPO EBO GBLUPS BUBV [BU
LFSBTVOUVLNFMJOEVOHJTUSVLUVSEBMBNOZBZBOHSBQVI
WBTPBLUJG NJTBMOZB SFOJO
ZBOH NFOZFCBCLBO QFNCFOUVLBO
QSPEVLWBTPBLUJG NJTBMOZBBOHJPUFOTJO**
+JLB HJOKBM EJCFMBI EVB EBSJ BUBT LF CBXBI EVB EBFSBI VUBNB
ZBOHEBQBUEJHBNCBSLBOZBJUVEBFSBILPSUFLTEJCBHJBOMVBSEBO
Pengaturan Keseimbangan Asam-Basa. (JOKBM UVSVU NFEVMBEJCBHJBOEBMBN.FEVMBHJOKBMUFSCBHJNFOKBEJTBNQBJ
NFOHBUVS BTBNCBTB CFSTBNB EFOHBO QBSV EBO TJTUFN NBTTB KBSJOHBO CFSCFOUVL LFSVDVU ZBOH EJTFCVU QJSBNJEB
QFOZBOHHB DBJSBO UVCVI EFOHBO DBSB NFOHFLTLSFTJLBO BTBN HJOKBM%BTBSEBSJTFUJBQQJSBNJEBEJNVMBJQBEBQFSCBUBTBOBOUBSB
EBO NFOHBUVS TJNQBOBO EBQBS DBJSBO UVCVI (JOKBM NFSVQB LPSUFLT EBO NFEVMB TFSUB CFSBLIJS EJ QBQJMB ZBOH NFOPOKPM LF
LBO TBUVTBUVOZB DBSB VOUVL NFNCVBOH KFOJT BTBN UFSUFOUV EBMBN SVBOH QFMWJT HJOKBM ZBJUV TBNCVOHBO EBSJ VKVOH VSFUFS
EBSJ UVCVI TFQFSUJ BTBN TVMGVSJL EBO BTBN GPTGPSJL ZBOH CBHJBO BUBT ZBOH CFSCFOUVL DPSPOH #BUBT MVBS QFMWJT UFSCBHJ
EJIBTJMLBOEBSJNFUBCPMJTNFQSPUFJO NFOKBEJ LBOUPOHLBOUPOH EFOHBO VKVOH UFSCVLB ZBOH EJTFCVU
LBMJTFTNBZPS ZBOHNFMVBTLFCBXBIEBOUFSCBHJNFOKBEJLBMJTFT
Pengaturan Pembentukan Eritrosit.(JOKBMNFOZFLSFTJ NJOPS ZBOH NFOHVNQVMLBO VSJOF EBSJ UVCVMVT TFUJBQ QBQJMB
LBO FSJUSPQPJFUJO ZBOH NFSBOHTBOH QFNCFOUVLBO TFM EBSBI %JOEJOH LBMJTFT QFMWJT EBO VSFUFS UFSEJSJ BUBT CBHJBO LPOUSBLUJM
NFSBIEBSJTFMJOEVLIFNBUPQPJFUJLEJTVNTVNUVMBOH TFQFSUJ ZBOH NFOEPSPOH VSJOF NFOVKV LBOEVOH LFNJI UFNQBU VSJOF
ZBOHEJCBIBTQBEB#BC4BMBITBUVSBOHTBOHQFOUJOHVOUVL EJTJNQBO TBNQBJ EJLFMVBSLBO NFMBMVJ NJLTJ ZBOH BLBO EJCBIBT
TFLSFTJ FSJUSPQPJFUJO PMFI HJOKBM JBMBI IJQPLTJB 1BEB NBOVTJB LFNVEJBOEBMBNCBCJOJ
OPSNBM HJOKBMNFOHIBTJMLBOIBNQJSTFNVBFSJUSPQPJFUJOZBOH
EJTFLSFTJLFEBMBNTJSLVMBTJ1BEBPSBOHEFOHBOQFOZBLJUHJOKBM Aliran Darah Ginjal
CFSBU BUBV ZBOH HJOKBMOZB UFMBI EJBOHLBU EBO NFOHHVOBLBO
IFNPEJBMJTJT UJNCVMBOFNJBCFSBUTFCBHBJIBTJMEBSJQFOVSVOBO %BSBIZBOHNFOHBMJSLFLFEVBHJOKBMOPSNBMOZBTFLJUBSQFSTFO
QSPEVLTJFSJUSPQPJFUJO EBSJDVSBIKBOUVOH BUBVNMNFOJU"SUFSJSFOBMJTNFNBTVLJ
HJOKBM NFMBMVJ IJMVN EBO LFNVEJBO CFSDBCBOHDBCBOH TFDBSB
Pengaturan Pembentukan 1,25-Dihidroksivitamin D3. QSPHSFTJG NFNCFOUVL BSUFSJ JOUFSMPCBSJT BSUFSJ BSLVBUB BSUFSJ
(JOKBM NFOHIBTJMLBO CFOUVL BLUJG WJUBNJO % ZBJUV JOUFSMPCVMBSJT KVHB EJTFCVU BSUFSJ SBEJBMJT
EBO BSUFSJPM BGFSFO
EJIJESPLTJWJUBNJO % LBMTJUSJPM
EFOHBO NFOHIJESPLTJMBTJ ZBOHNFOVKVLFLBQJMFSHMPNFSVMVTUFNQBUTFKVNMBICFTBSDBJSBO
WJUBNJO JOJ QBEB QPTJTJ OPNPS ,BMTJUSJPM QFOUJOH VOUVL EBO[BUUFSMBSVU LFDVBMJQSPUFJOQMBTNB
EJGJMUSBTJVOUVLNFNVMBJ
EFQPTJU LBMTJVN ZBOH OPSNBM EBMBN UVMBOH EBO SFBCTPSQTJ QFNCFOUVLBO VSJOF (BNCBS
6KVOH EJTUBM LBQJMFS QBEB
LBMTJVNPMFITBMVSBODFSOB4FQFSUJZBOHEJCBIBTQBEB#BC TFUJBQ HMPNFSVMVT CFSHBCVOH VOUVL NFNCFOUVL BSUFSJPM FGFSFO
LBMTJUSJPMNFNFHBOHQFSBOQFOUJOHEBMBNQFOHBUVSBOLBMTJVN ZBOH NFOVKV KFKBSJOH LBQJMFS LFEVB ZBJUV LBQJMFS QFSJUVCVMBS
EBOGPTGBU ZBOHNFOHFMJMJOHJUVCVMVTHJOKBM
304
Bab 26 Pembentukan Urine oleh Ginjal: l. Filtrasi Glomerulus, Aliran Darah Ginjal, dan Pengaturannya
UNIT V
4JSLVMBTJ HJOKBM JOJ VOJL LBSFOB NFNJMJLJ EVB KFKBSJOH LBQJMFS BGFSFO EBO FGFSFO HJOKBM EBQBU NFOHBUVS UFLBOBO IJESPTUBUJL
ZBJUV LBQJMFS HMPNFSVMVT EBO LBQJMFS QFSJUVCVMVT ZBOH UFSTVTVO QBEB LBQJMFS HMPNFSVMVT EBO LBQJMFS QFSJUVCVMVT EFOHBO
TFSJ EBO EJQJTBILBO PMFI BSUFSJPM FGFSFO ZBOH NFNCBOUV EFNJLJBO NFOHVCBI MBKV GJMUSBTJ HMPNFSVMVT SFBCTPSQTJ
NFOHBUVS UFLBOBO IJESPTUBUJL EBMBN LFEVB QFSBOHLBU LBQJMFS UVCVMVT BUBV LFEVBOZB TFCBHBJ SFTQPOT UFSIBEBQ LFCVUVIBO
5FLBOBO IJESPTUBUJL ZBOH UJOHHJ QBEB LBQJMFS HMPNFSVMVT LJSB IPNFPTUBUJLUVCVI
LJSB NN )H
NFOZFCBCLBO GJMUSBTJ DBJSBO ZBOH DFQBU ,BQJMFS QFSJUVCVMVT NFOHBMJS LF EBMBN QFNCVMVI TJTUFN
TFEBOHLBO UFLBOBO IJESPTUBUJL ZBOH KBVI MFCJI SFOEBI QBEB WFOB ZBOH CFSKBMBO TFDBSB QBSBMFM EFOHBO QFNCVMVI BSUFSJPM
LBQJMFS QFSJUVCVMVT LJSBLJSB NN )H
NFNVOHLJOLBO 1FNCVMVIEBSBITJTUFNWFOBTFDBSBQSPHSFTJGNFNCFOUVLWFOB
SFBCTPSQTJDBJSBOZBOHDFQBU%FOHBONFOHBUVSUBIBOBOBSUFSJPM JOUFSMPCVMBSJT WFOBBSLVBUB WFOBJOUFSMPCBSJT EBOWFOBSFOBMJT
ZBOHNFOJOHHBMLBOHJOKBMEJTBNQJOHBSUFSJSFOBMJTEBOVSFUFS
Nefron sebagai Unit Fungsional Ginjal

5JBQ HJOKBM NBOVTJB UFSEJSJ BUBT LVSBOH MFCJI TBNQBJ
OFGSPO NBTJOHNBTJOH NBNQV NFNCFOUVL VSJOF
(JOKBM UJEBL EBQBU NFNCFOUVL OFGSPO CBSV 0MFI LBSFOB JUV
QBEB USBVNB HJOKBM QFOZBLJU HJOKBM BUBV QSPTFT QFOVBBO ZBOH
OPSNBM BLBOUFSKBEJQFOVSVOBOKVNMBIOFGSPOTFDBSBCFSUBIBQ
4FUFMBI VTJB UBIVO KVNMBI OFGSPO ZBOH CFSGVOHTJ CJBTBOZB
NFOVSVOLJSBLJSBQFSTFOTFUJBQUBIVOKBEJ QBEBVTJB
UBIVO KVNMBI OFGSPO ZBOH CFSGVOHTJ QFSTFO MFCJI TFEJLJU
EBSJQBEB LFUJLB VTJB UBIVO #FSLVSBOHOZB GVOHTJ JOJ UJEBL
NFOHBODBN KJXB LBSFOB QFSVCBIBO BEBQUJG TJTB OFGSPO
NFOZFCBCLBO OFGSPO UFSTFCVU EBQBU NFOHFLTLSFTJLBO BJS
FMFLUSPMJU EBO QSPEVL TJTB EBMBN KVNMBI ZBOH UFQBU TFQFSUJ
ZBOHEJCBIBTQBEB#BC
4FUJBQOFGSPOUFSEJSJBUBT
LVNQVMBOLBQJMFSZBOHEJTFCVU
HMPNFSVMVT ZBOH BLBO NFNGJMUSBTJ TFKVNMBI CFTBS DBJSBO EBSJ
EBSBI EBO
UVCVMVT QBOKBOH UFNQBU DBJSBO IBTJM GJMUSBTJ
EJVCBI NFOKBEJ VSJOF EBMBN QFSKBMBOBOOZB NFOVKV QFMWJT
HJOKBM MJIBU(BNCBS

(MPNFSVMVT UFSTVTVO EBSJ KFKBSJOH LBQJMFS HMPNFSVMVT ZBOH
CFSDBCBOH EBO CFSBOBTUPNPTJT ZBOH NFNQVOZBJ UFLBOBO
IJESPTUBUJL UJOHHJ LJSBLJSB NN )H
CJMB EJCBOEJOHLBO
EFOHBOLBQJMFSMBJOOZB,BQJMFSHMPNFSVMVTEJMBQJTJPMFITFMTFM
FQJUFM EBO LFTFMVSVIBO HMPNFSVMVT EJCVOHLVT PMFI LBQTVMB
#PXNBO
305
BO LFNCBMJOZB QBST BTFOEFOT EBSJ MFOHLVOH UFSTFCVU LF LPSUFLT

EJOEJOHOZBNFOKBEJKBVIMFCJIUFCBMEBO PMFILBSFOBJUVEJTFCVU
CBHJBOUFCBMQBSTEFTFOEFOT
1BEB VKVOH QBST BTFOEFOT UFCBM UFSEBQBU CBHJBO ZBOH QFOEFL
ZBOHQBEBEJOEJOHOZBUFSEBQBUQMBLUFSEJSJBUBTTFMFQJUFMLIVTVT
EBO EJLFOBM TFCBHBJ NBLVMB EFOTB 4FQFSUJ ZBOH EJCBIBT
LFNVEJBO NBLVMB EFOTB NFNBJOLBO QFSBO QFOUJOH EBMBN
NFOHBUVSGVOHTJOFGSPO4FUFMBINBLVMBEFOTB DBJSBONFNBTVLJ
UVCVMVT EJTUBM ZBOH UFSMFUBL EJ LPSUFLT HJOKBM TFQFSUJ UVCVMVT
QSPLTJNBM
5VCVMVT JOJ LFNVEJBO CFSMBOKVU TFCBHBJ UVCVMVT
SFOBMJT BSLVBUVT EBO UVCVMVT LPMJHFOT LPSUJLBM ZBOH NFOKBEJ
EVLUVT LPMJHFOT LPSUJLBM #BHJBO BXBM EBSJ TBNQBJ EVLUVT
LPMJHFOTLPSUJLBMCFSHBCVOHNFNCFOUVLEVLUVTLPMJHFOTUVOHHBM
ZBOH MFCJI CFTBS ZBOH UVSVO LF NFEVMB EBO NFOKBEJ EVLUVT
LPMJHFOT NFEVMB %VLUVT LPMJHFOT CFSHBCVOH NFNCFOUVL EVLUVT
ZBOHMFCJICFTBSTFDBSBQSPHSFTJG ZBOHBLIJSOZBNFOHBMJSNFOVKV
QFMWJTHJOKBMNFMBMVJVKVOHQBQJMBHJOKBM4FUJBQHJOKBM NFNQVOZBJ
LJSBLJSB EVLUVT LPMJHFOT ZBOH TBOHBU CFTBS ZBOH NBTJOH
NBTJOHNFOHVNQVMLBOVSJOFEBSJTFLJUBSOFGSPO
$BJSBO ZBOH EJGJMUSBTJ EBSJ LBQJMFS HMPNFSVMVT NFOHBMJS LF Perbedaan Regional Struktur Nefron: Nefron Kortikal dan
EBMBN LBQTVMB #PXNBO EBO LFNVEJBO NBTVL LF UVCVMVT Nefron Jukstamedular. .FTLJQVO TFUJBQ OFGSPO NFNQVOZBJ
QSPLTJNBM ZBOH UFSMFUBL EBMBN LPSUFLT HJOKBM (BNCBS
TFNVB LPNQPOFO TFQFSUJ ZBOH EJHBNCBSLBO EJ BUBT UFUBQJ UFUBQ
%BSJ UVCVMVT QSPLTJNBM DBJSBO NFOHBMJS LF BOTB )FOMF ZBOH UFSEBQBU CFCFSBQB QFSCFEBBO CFSHBOUVOH QBEB TFCFSBQB EBMBN
NBTVL LF EBMBN NFEVMB HJOKBM 4FUJBQ MFOHLVOH UFSEJSJ BUBT MFUBLOFGSPOEJNBTTBHJOKBM/FGSPOZBOHNFNJMJLJHMPNFSVMVTEJ
QBST EFTFOEFOT EBO BTFOEFOT %JOEJOH QBST EFTFOEFOT EBO LPSUFLT TJTJ MVBS EJTFCVU OFGSPO LPSUJLBM OFGSPO UFSTFCVU NFN
VKVOHQBSTBTFOEFOTZBOHQBMJOHSFOEBITBOHBUUJQJT EBOPMFI QVOZBJ BOTB )FOMF QFOEFL ZBOH IBOZB TFEJLJU NBTVL LF EBMBN
LBSFOBJUVEJTFCVUCBHJBOUJQJTBOTB)FOMF%JUFOHBIQFSKBMBO NFEVMB (BNCBS

306
Bab 26 Pembentukan Urine oleh Ginjat: I. Filtrasi Gtomerutus, Atiran Darah Ginjal, dan Pengaturannya
,JSBLJSB QFSTFO OFGSPO NFNQVOZBJ HMPNFSVMVT ZBOH HBHBM TFUJEBLOZBBLBONFOZFCBCLBOLFJOHJOBOCFSLFNJIZBOH

UFSMFUBLEJLPSUFLTHJOKBMTFCFMBIEBMBNEFLBUNFEVMB EBOEJTFCVU EJTBEBSJ.FTLJQVOSFGMFLTNJLTJBEBMBISFGMFLTNFEVMBTQJOBMJT
OFGSPO KVLTUBNFEVMBS /FGSPO JOJ NFNQVOZBJ BOTB )FOMF ZBOH ZBOHCFSTJGBUPUPOPN SFGMFLTJOJEBQBUEJIBNCBUBUBVEJGBTJMJ
QBOKBOH EBO NBTVL TBOHBU EBMBN LF NFEVMB 1BEB CFCFSBQB UBTJPMFIQVTBUQVTBUEJLPSUFLTTFSFCSJBUBVCBUBOHPUBL
LBTVT BOTB)FOMFNFODBQBJVKVOHQBQJMBHJOKBM
UNIT V
4USVLUVS WBTLVMBS OFGSPO KVLTUBNFEVMBS KVHB CFSCFEB EFOHBO
Anatomi Fisiologis Kandung Kemih
OFGSPO LPSUJLBM 1BEB OFGSPO LPSUJLBM TFMVSVI TJTUFN UVCVMVT
EJLFMJMJOHJ PMFI KBSJOHBO LBQJMFS QFSJUVCVMBS ZBOH MVBT 1BEB
,BOEVOH LFNJI UFSMJIBU QBEB (BNCBS NFSVQBLBO
OFGSPOKVLTUBNFEVMBS BSUFSJPMFGFSFOZBOHQBOKBOHBLBOCFSMBOKVU
TVBUV SVBOH PUPU QPMPT ZBOH UFSEJSJ BUBT EVB CBHJBO VUBNB
EBSJHMPNFSVMVTUVSVOLFCBXBINFOVKVNFEVMBCBHJBOMVBSEBO

CBHJBO LPSQVT ZBOH NFSVQBLBO CBHJBO VUBNB LBOEVOH
LFNVEJBO NFNCBHJ EJSJ NFOKBEJ LBQJMFSLBQJMFS QFSJUVCVMVT
LFNJI EBO UFNQBU QFOHVNQVMBO VSJOF TFSUB
CBHJBO
LIVTVT ZBOH EJTFCVU WBTB SFLUB ZBOH NFNBOKBOH LF CBXBI
MFIFSCFSCFOUVLDPSPOH ZBOHNFSVQBLBOQFSQBOKBOHBOCBHJ
NFOVKV NFEVMB EBO UFSMFUBL CFSEBNQJOHBO EFOHBO BOTB )FOMF
BO LPSQVT LBOEVOH LFNJI CFSKBMBO LF CBXBI EBO LF EFQBO
4FQFSUJ BOTB )FOMF WBTB SFLUB LFNCBMJ NFOVKV LPSUFLT EBO
NFOVKVTFHJUJHBVSPHFOJUBMEBOCFSIVCVOHBOEFOHBOVSFUSB
NFOHBMJSLBO JTJOZB LF EBMBN WFOB LPSUJLBM +BSJOHBO LBQJMFS
#BHJBO CBXBI MFIFS LBOEVOH LFNJI EJTFCVU KVHB VSFUSB
LIVTVT EBMBN NFEVMB JOJ CFSQFSBO QFOUJOH EBMBN QFNCFOUVLBO
QPTUFSJPSLBSFOBCBHJBOJOJCFSIVCVOHBOEFOHBOVSFUSB
VSJOFZBOHQFLBUEBOBLBOEJCBIBTEJ#BC
0UPUQPMPTLBOEVOHLFNJIEJTFCVUPUPUEFUSVTPS4FSBUTFSBU
PUPUOZB NFMVBT LF TFHBMB BSBI EBO LFUJLB CFSLPOUSBLTJ EBQBU
Miksi (Berkemih) NFOJOHLBULBOUFLBOBOEJEBMBNLBOEVOHLFNJIIJOHHB
NN)H+BEJ LPOUSBLTJPUPUEFUSVTPSNFSVQBLBOUBIBQVUBNB
.JLTJ BEBMBI QSPTFT QFOHPTPOHBO LBOEVOH LFNJI TFUFMBI UFSJTJ QBEB QSPTFT QFOHPTPOHBO LBOEVOH LFNJI 4FMTFM PUPU QPMPT
VSJOF .JLTJ NFMJCBULBO EVB UBIBQ VUBNB 1FSUBNB LBOEVOH QBEBPUPUEFUSVTPSNFOZBUVNFNCFOUVLKBSBTMJTUSJLCFSUBIBO
LFNJI UFSJTJ TFDBSB QSPHSFTJG IJOHHB UFHBOHBO QBEB EJOEJOHOZB BOSFOEBIEBSJTFMPUPUZBOHTBUVLFZBOHMBJO0MFILBSFOBJUV
NFOJOHLBU NFMBNQBVJ OJMBJ BNCBOH CBUBT LFBEBBO JOJ BLBO QPUFOTJBM BLTJ EBQBU NFOZFCBS LF TFMVSVI PUPU EFUSVTPS EBSJ
NFODFUVTLBO UBIBQ LFEVB ZBJUV BEBOZB SFGMFLT TBSBG EJTFCVU TBUVTFMPUPULFTFMCFSJLVUOZB NFOZFCBCLBOLPOUSBLTJTFMVSVI
SFGMFLTNJLTJZBOHBLBONFOHPTPOHLBOLBOEVOHLFNJIBUBV KJLB LBOEVOHLFNJIQBEBTBBUZBOHCFSTBNBBO
307
1BEB EJOEJOH QPTUFSJPS LBOEVOH LFNJI UFQBU EJ BUBT MFIFS 4FSBU TFOTPSJL NFOEFUFLTJ EFSBKBU SFHBOHBO EBMBN EJOEJOH
LBOEVOH LFNJI UFSEBQBU EBFSBI TFHJUJHB LFDJM ZBOH EJTFCVU LBOEVOH LFNJI 4JOZBMTJOZBM SFHBOHBO LIVTVTOZB EBSJ VSFUSB
USJHPOVN 1BEB CBHJBO UFSFOEBI BQFLT USJHPOVN MFIFS QPTUFSJPS NFSVQBLBO TJOZBM ZBOH LVBU EBO UFSVUBNB CFSQFSBO
LBOEVOHLFNJINFNCVLBLFBSBIVSFUSBQPTUFSJPS EBOLFEVB VOUVLNFNJDVSFGMFLTQFOHPTPOHBOLBOEVOHLFNJI
VSFUFS NFNBTVLJ LBOEVOH LFNJI EJ CBHJBO BUBT BQFLT USJHP 1FSTBSBGBO NPUPSJL ZBOH EJCBXB EBMBN OFSWVT QFMWJLVT
OVN 5SJHPOVN EBQBU EJLFOBMJ LBSFOB NVLPTBOZB MBQJTBO NFSVQBLBO TFSBU QBSBTJNQBUJT 4BSBG JOJ CFSBLIJS EJ TFM HBOHMJPO
EBMBNLBOEVOHLFNJIMJDJO CFSCFEBEFOHBONVLPTBEJCBHJBO ZBOHUFSMFUBLEJEBMBNEJOEJOHLBOEVOHLFNJI,FNVEJBOTBSBG
MBJOLBOEVOHLFNJIZBOHCFSMJQBUMJQBUNFNCFOUVLSVHBF TBSBG QPTUHBOHMJPOJL ZBOH QFOEFL BLBO NFNQFSTBSBGJ PUPU
4FUJBQ VSFUFS TBBU NFNBTVLJ LBOEVOH LFNJI CFSKBMBO EFUSVTPS
NJSJOH NFMJOUBTJ PUPU EFUSVTPS EBO LFNVEJBO CFSKBMBO MBHJ 4FMBJO TBSBG QFMWJT UFSEBQBU EVB KFOJT QFSTBSBGBO MBJO ZBOH
TBNQBJ DN EJ CBXBI NVLPTB LBOEVOH LFNJI TFCFMVN QFOUJOHVOUVLNFOHBUVSGVOHTJLBOEVOHLFNJI4BSBGZBOHQBMJOH
NFOHPTPOHLBOVSJOFLFLBOEVOHLFNJI QFOUJOHBEBMBITFSBUNPUPSJLTLFMFUBMZBOHEJCBXBNFMBMVJOFSWVT
1BOKBOH MFIFS LBOEVOH LFNJI VSFUSB QPTUFSJPS
BEBMBI QVEFOEVT LF TGJOHUFS FLTUFSOB LBOEVOH LFNJI 4BSBG JOJ
TBNQBJ DN EBO EJOEJOHOZB UFSTVTVO BUBT PUPU EFUSVTPS NFSVQBLBOTFSBUTBSBGTPNBUJLZBOHNFNQFSTBSBGJEBONFOHBUVS
EJKBMJO EFOHBO TFKVNMBI CFTBS KBSJOHBO FMBTUJT 0UPU EJ EBFSBI PUPU SBOHLB WPMVOUFS TGJOHUFS UFSTFCVU ,BOEVOH LFNJI KVHB
JOJ EJTFCVU TGJOHUFS JOUFSOB 5POVT OPSNBMOZB NFOZFCBCLBO NFOEBQBULBOQFSTBSBGBOTJNQBUJTEBSJSBOHLBJBOTJNQBUJTNFMBMVJ
MFIFS LBOEVOH LFNJI EBO VSFUSB QPTUFSJPS UJEBL NFOHBOEVOH OFSWVT IJQPHBTUSJL ZBOH UFSVUBNB CFSIVCVOHBO EFOHBO TFHNFO
VSJOFEBO EFOHBOEFNJLJBO NFODFHBIQFOHPTPOHBOLBOEVOH - NFEVMB TQJOBMJT 4FSBU TJNQBUJT JOJ UFSVUBNB NFSBOHTBOH
LFNJI IJOHHB UFLBOBO QBEB CBHJBO VUBNB LBOEVOH LFNJI QFNCVMVI EBSBI EBO NFNCFSJ TFEJLJU FGFL UFSIBEBQ QSPTFT
NFOJOHLBUNFMBNQBVJOJMBJBNCBOH LPOUSBLTJ LBOEVOH LFNJI #FCFSBQB TFSBU TBSBG TFOTPSJL KVHB
4FUFMBI NFMFXBUJ VSFUSB QPTUFSJPS VSFUSB CFSKBMBO NFMBMVJ CFSKBMBONFMBMVJQFSTBSBGBOTJNQBUJTEBONVOHLJOQFOUJOHVOUVL
EJBGSBHNB VSPHFOJUBM ZBOH NFOHBOEVOH TVBUV MBQJTBO PUPU TFOTBTJSBTBQFOVIEBOOZFSJ QBEBCFCFSBQBLBTVT
ZBOH EJTFCVU TGJOHUFS FLTUFSOB LBOEVOH LFNJI 0UPU JOJ
NFSVQBLBO PUPU SBOHLB WPMVOUFS CFSCFEB EFOHBO PUPU QBEB Transpor Urine dari Ginjal melalui Ureter Menuju
CBHJBO LPSQVT EBO MFIFS LBOEVOH LFNJI ZBOH TFMVSVIOZB
NFSVQBLBOPUPUQPMPT0UPUTGJOHUFSFLTUFSOBCFSBEBEJCBXBI
Kandung Kemih
LFOEBMJ WPMVOUFS TJTUFN TBSBG EBO EBQBU EJHVOBLBO VOUVL 6SJOF ZBOH EJLFMVBSLBO EBSJ LBOEVOH LFNJI QBEB EBTBSOZB
NFODFHBINJLTJTFDBSBTBEBSCBILBOLFUJLBLFOEBMJJOWPMVOUFS NFNJMJLJ LPNQPTJTJ ZBOH TBNB EFOHBO DBJSBO ZBOH NFOHBMJS
CFSVTBIBVOUVLNFOHPTPOHLBOLBOEVOHLFNJI LFMVBSEBSJEVLUVTLPMJHFOTUJEBLBEBQFSCFEBBOLPNQPTJTJVSJOF
ZBOH CFSNBLOB TFMBNB VSJOF NFOHBMJS NFMBMVJ LBMJTFT HJOKBM EBO
Persarafan Kandung Kemih VSFUFSNFOVKVLFLBOEVOHLFNJI
,BOEVOH LFNJI NFOEBQBU QFSTBSBGBO VUBNB EBSJ OFSWVT 6SJOF NFOHBMJS EBSJ EVLUVT LPMJHFOT NFOVKV LBMJTFT HJOKBM
QFMWJLVT ZBOH CFSIVCVOHBO EFOHBO NFEVMB TQJOBMJT NFMBMVJ 6SJOF NFSFHBOHLBO LBMJTFT EBO NFOJOHLBULBO BLUJWJUBT
QMFLTVTTBLSBMJT UFSVUBNBEFOHBOTFHNFO4EBO4 (BNCBS QBDFNBLFS ZBOH BEB ZBOH LFNVEJBO BLBO NFNJDV LPOUSBLTJ

NFEVMB TQJOBMJT %BMBN OFSWVT QFMWJLVT UFSEBQBU EVB QFSJTUBMUJL ZBOH NFOZFCBS LF QFMWJT HJOKBM EBO LF BSBI CBXBI EJ
KFOJTTBSBGZBJUVTFSBUTBSBGTFOTPSJLEBOTFSBUTBSBGNPUPSJL TFQBOKBOHVSFUFS EFOHBOEFNJLJBONFNBLTBVSJOFNFOHBMJSEBSJ
308
Bab 26 Pembentukan Urine oleh Ginjal: I. Filtrasi Glomerulus, Atiran Darah Ginjal, dan Pengaturannya
QFMWJT HJOKBM LF BSBI LBOEVOH LFNJI 1BEB PSBOH EFXBTB VSFUFS
OPSNBMQBOKBOHOZBTBNQBJDN TBNQBJJODJ

%JOEJOH VSFUFS UFSEJSJ BUBT PUPU QPMPT ZBOH EJQFSTBSBGJ PMFI
TBSBG TJNQBUJT EBO QBSBTJNQBUJT TFSUB QMFLTVT OFVSPO EBO TFSBU
TBSBG JOUSBNVSBM TFQBOKBOH VSFUFS 4FQFSUJ PUPU QPMPT WJTFSBM
UNIT V
MBJOOZB LPOUSBLTJQFSJTUBMUJLQBEBVSFUFSEJQFSLVBUPMFISBOHTBOH
QBSBTJNQBUJTEBOEJIBNCBUPMFISBOHTBOHTJNQBUJT
6SFUFS NFNBTVLJ LBOEVOH LFNJI NFMBMVJ PUPU EFUSVTPS EJ
EBMBN BSFB USJHPOVN LBOEVOH LFNJI TFQFSUJ ZBOH UFSMJIBU QBEB
(BNCBS #JBTBOZB VSFUFS CFSKBMBO NJSJOH TFQBOKBOH
CFCFSBQB TFOUJNFUFS LFUJLB NFMFXBUJ EJOEJOH LBOEVOH LFNJI
5POVTOPSNBMPUPUEFUSVTPSEJEBMBNLBOEVOHLFNJIDFOEFSVOH
BLBO NFOFLBO VSFUFS EFOHBO EFNJLJBO NFODFHBI BMJSBO CBMJL
SFGMVLT
VSJOF EBO LBOEVOH LFNJI LFUJLB UFLBOBO EJ EBMBN
LBOEVOH LFNJI NFOJOHLBU TFMBNB NJLTJ BUBV TFMBNB LPNQSFTJ
LBOEVOHLFNJI4FUJBQHFMPNCBOHQFSJTUBMUJLEJTFQBOKBOHVSFUFS
NFOJOHLBULBO UFLBOBO EJ EBMBN VSFUFS TFIJOHHB EBFSBI ZBOH
NFOVKV LBOEVOH LFNJI NFNCVLB EBO NFNVOHLJOLBO BMJSBO
VSJOFLFEBMBNLBOEVOHLFNJI
1BEB CFCFSBQB PSBOH KBSBL ZBOH EJUFNQVI VSFUFS EJ EBMBN Refleks Miksi
EJOEJOH LBOEVOH LFNJI MFCJI QFOEFL EBSJ OPSNBM TFIJOHHB
LPOUSBLTJLBOEVOHLFNJITFMBNBNJLTJUJEBLTFMBMVNFOZFCBCLBO -JIBULFNCBMJ(BNCBS TFJSJOHEFOHBOQFOHJTJBOLBOEVOH
PLMVTJ VSFUFS ZBOH MFOHLBQ 4FCBHBJ BLJCBUOZB TFCBHJBO VSJOF LFNJI UBNQBL UVNQBOH UJOEJI LVSWB QFOJOHLBUBO LPOUSBLTJ
EBMBN LBOEVOH LFNJI EJEPSPOH LF CFMBLBOH LF BSBI VSFUFS NJLTJ TFQFSUJ ZBOH EJUVOKVLLBO PMFI LVSWB CFSCFOUVL SVODJOH
LPOEJTJ JOJ EJTFCVU SFGMVLT WFTJLPVSFUFS 3FGMVLT TFNBDBN JOJ UFSQVUVTQVUVT ,POUSBLTJ JOJ EJIBTJMLBO EBSJ SFGMFLT SFHBOH
EBQBU NFOZFCBCLBO QFNCFTBSBO VSFUFS EBO KJLB CFSBU EBQBU ZBOH EJQJDV PMFI SFTFQUPS SFHBOH TFOTPSJL EJ EBMBN EJOEJOH
NFOJOHLBULBO UFLBOBO EBMBN LBMJTFT HJOKBM EBO TUSVLUVS NFEVMB LBOEVOH LFNJI UFSVUBNB PMFI SFTFQUPS EJ VSFUSB QPTUFSJPS
HJOKBM NFOZFCBCLBOLFSVTBLBOEJEBFSBIJOJ LFUJLB EBFSBI JOJ NVMBJ UFSJTJ EFOHBO VSJOF QBEB UFLBOBO
LBOEVOHLFNJIZBOHMFCJIUJOHHJ4JOZBMTFOTPSJLEBSJSFTFQUPS
Sensasi Nyeri dalam Ureter, dan Refleks Ureterorenal. SFHBOH LBOEVOH LFNJI EJLJSJNLBO LF TFHNFO TBLSBMJT EBSJ
6SFUFS CBOZBL EJQFSTBSBGJ PMFI TFSBU TBSBG OZFSJ #JMB VSFUFS NFEVMB TQJOBMJT NFMBMVJ OFSWVT QFMWJLVT EBO LFNVEJBO
UFSCFOEVOH NJTBMOZB PMFICBUVVSFUFS
UFSKBEJSFGMFLTLPOTUSJLTJ EJLFNCBMJLBO TFDBSB SFGMFLT LF LBOEVOH LFNJI NFMBMVJ TFSBU
LVBU EJTFSUBJ EFOHBO OZFSJ IFCBU *NQVMT OZFSJ KVHB NFOZFCBC TBSBGQBSBTJNQBUJTEFOHBONFOHHVOBLBOQFSTBSBGBOZBOHTBNB
LBO SFGMFLT TJNQBUJT CBMJL LF HJOKBM VOUVL NFOHPOTUSJLTJ BSUFSJPM
HJOKBM TFIJOHHB NFOVSVOLBO LFMVBSBO VSJOF EBSJ HJOKBM &GFL JOJ #JMB LBOEVOH LFNJI IBOZB UFSJTJ TFCBHJBO LPOUSBLTJ NJLTJ
EJTFCVU SFGMFLT VSFUFSPSFOBM EBO QFOUJOH VOUVL NFODFHBI BMJSBO JOJ CJBTBOZB BLBO CFSFMBLTBTJ TFDBSB TQPOUBO EBMBN XBLUV
DBJSBO ZBOH CFSMFCJIBO LF QFMWJT HJOKBM QBEB LFBEBBO VSFUFS LVSBOH EBSJ TFNFOJU PUPU EFUSVTPS CFSIFOUJ CFSLPOUSBLTJ EBO
UFSCFOEVOH UFLBOBO UVSVO LFNCBMJ LF OJMBJ EBTBS ,FUJLB LBOEVOH LFNJI
UFSVT UFSJTJ SFGMFLT NJLTJ NFOKBEJ TFNBLJO TFSJOH EBO
NFOZFCBCLBOLPOUSBLTJPUPUEFUSVTPSZBOHMFCJILVBU
Pengisian Kandung Kemih dan Tonus Dinding 4FLBMJ SFGMFLT NJLTJ EJNVMBJ SFGMFLT JOJ CFSTJGBU SFHFOFSBTJ
Kandung Kemih; Sistometrogram TFOEJSJ "SUJOZB LPOUSBLTJ BXBM LBOEVOH LFNJI BLBO
NFOHBLUJGLBO SFTFQUPS SFHBOH ZBOH NFOZFCBCLBO QFOJOHLBUBO
(BNCBS NFNQFSMJIBULBO QFSLJSBBO QFSVCBIBO UFLBOBO JNQVMT TFOTPSJL ZBOH MFCJI CBOZBL EBSJ LBOEVOH LFNJI EBO
JOUSBWFTJLVMBS TFXBLUV LBOEVOH LFNJI UFSJTJ EFOHBO VSJOF 1BEB TBBU VSFUSB QPTUFSJPS TFIJOHHB NFOZFCBCLBO QFOJOHLBUBO SFGMFLT
UJEBL BEB VSJOF EJ EBMBN LBOEVOH LFNJI UFLBOBO JOUSBWFTJLVMBSOZB
LPOUSBLTJ LBOEVOH LFNJI TFMBOKVUOZB KBEJ TJLMVT JOJ BLBO
TFLJUBS UFUBQJ TFUFMBI UFSJTJ VSJOF TFCBOZBL TBNQBJ NM UFLBOBO
NFOJOHLBUNFOKBEJTBNQBJDN)05BNCBIBOVSJOFTFCBOZBL CFSVMBOH UFSVTNFOFSVT TBNQBJ LBOEVOH LFNJI NFODBQBJ
TBNQBJ NM IBOZB TFEJLJU NFOBNCBI QFOJOHLBUBO UFLBOBO OJMBJ EFSBKBU LPOUSBLTJ ZBOH DVLVQ LVBU ,FNVEJBO TFUFMBICFCFSBQB
UFLBOBO ZBOH LPOTUBO JOJ EJTFCBCLBO PMFI UPOVT JOUSJOTJL QBEB EJOEJOH EFUJLTBNQBJMFCJIEBSJTFNFOJU SFGMFLTZBOHCFSFHFOFSBTJTFOEJSJ
LBOEVOH LFNJI TFOEJSJ #JMB VSJOF ZBOH UFSLVNQVM EJ EBMBN LBOEVOH JOJ NVMBJ LFMFMBIBO EBO TJLMVT SFHFOFSBUJG QBEB SFGMFLT NJLTJ
LFNJI MFCJI CBOZBL EBSJ TBNQBJ NM CBSV NFOZFCBCLBO NFOKBEJUFSIFOUJ NFNVOHLJOLBOLBOEVOHLFNJICFSFMBLTBTJ
QFOJOHLBUBOUFLBOBOTFDBSBDFQBU
+BEJ SFGMFLT NJLTJ NFSVQBLBO TJLMVT ZBOH MFOHLBS ZBOH
5VNQBOHUJOEJIQBEBLVSWBQFSVCBIBOUFLBOBOUPOJLTFMBNB UFSEJSJBUBT
LFOBJLBOUFLBOBOTFDBSBDFQBUEBOQSPHSFTJG

QFOHJTJBO LBOEVOH LFNJI BEBMBI QFOJOHLBUBO UFLBOBO BLVU QFSJPEF UFLBOBO NFOFUBQ EBO
LFNCBMJOZB UFLBOBO
QFSJPEJL ZBOH UFSKBEJ TFMBNB CFCFSBQB EFUJL IJOHHB MFCJI EBSJ LBOEVOH LFNJI LF OJMBJ UPOVT CBTBM #JMB SFGMFLT NJLTJ ZBOH
TFNFOJU 1VODBL UFLBOBO EBQBU NFOJOHLBU IBOZB CFCFSBQB DN UFMBI UFSKBEJ UJEBL NBNQV NFOHPTPOHLBO LBOEVOH LFNJI
)0 BUBV NVOHLJO NFOJOHLBU IJOHHB MFCJI EBSJ DN )0 QFSTBSBGBOQBEBSFGMFLTJOJCJBTBOZBBLBOUFUBQEBMBNLFBEBBO
1VODBLUFLBOBOJOJEJTFCVUHFMPNCBOHNJLTJQBEBTJTUPNFUPHSBN UFSJOIJCJTJTFMBNBCFCFSBQBNFOJUIJOHHBKBNBUBVMFCJI TF
EBOEJTFCBCLBOPMFISFGMFLTNJLTJ
309
CFMVN UFSKBEJ SFGMFLT NJLTJ CFSJLVUOZB #JMB LBOEVOH LFNJI 1FOZFCBC BUPOJ LBOEVOH LFNJI ZBOH VNVN BEBMBI USBVNB QBEB
UFSVTNFOFSVT EJJTJ BLBO UFSKBEJ SFGMFLT NJLTJ ZBOH TFNBLJO EBFSBI TBLSBM EBSJ NFEVMB TQJOBMJT #FCFSBQB QFOZBLJU KVHB EBQBU
TFSJOHEBOTFNBLJOLVBU NFOZFCBCLBO LFSVTBLBO TFSBU TBSBG BLBS EPSTBM ZBOH NFNBTVLJ
NFEVMB TQJOBMJT .JTBMOZB TJGJMJT EBQBU NFOZFCBCLBO GJCSPTJT
#JMB SFGMFLT NJLTJ TVEBI DVLVQ LVBU BLBO NFNJDV SFGMFLT
LPOTUSJLUJG EJ TFLJUBS TFSBU TBSBG BLBS EPSTBM EBO LFNVEJBO
MBJOZBOHCFSKBMBONFMBMVJOFSWVTQVEFOEVTLFTGJOHUFSFLTUFSOB NFOHIBODVSLBOOZB ,POEJTJ JOJ EJTFCVU UBCFT EPSTBMJT EBO LPOEJTJ
VOUVL NFOHIBNCBUOZB +JLB JOIJCJTJ JOJ MFCJI LVBU EJ EBMBN LBOEVOHLFNJIZBOHEJIBTJMLBOOZBEJTFCVUUBCFUJDCMBEEFS
PUBLEBSJQBEBTJOZBMLPOTUSJLUPSWPMVOUFSLFTGJOHUFSFLTUFSOB
NBLB BLBO UFSKBEJ QFOHFMVBSBO VSJOF +JLB UJEBL QFOHFMVBSBO Automatic Bladder Akibat Kerusakan Medula Spinalis
VSJOFUJEBLBLBOUFSKBEJIJOHHBLBOEVOHLFNJIUFSVTUFSJTJEBO di Atas Daerah Sakrum. +JLBNFEVMBTQJOBMJTZBOHSVTBLUFSMFUBL
SFGMFLTNJLTJNFOKBEJMFCJILVBUMBHJ EJ BUBT EBFSBI TBLSVN UFUBQJ TFHNFO TBLSBMJT EBSJ NFEVMB TQJOBMJT
UFUBQ VUVI SFGMFLT NJLTJ UFUBQ BLBO UFSKBEJ /BNVO SFGMFLT JOJ UJEBL
MBHJ EJLFOEBMJLBO PMFI PUBL 4FMBNB CFCFSBQB IBSJ QFSUBNB IJOHHB
Fasilitasi atau Inhibisi Proses Miksi oleh Otak CFCFSBQB NJOHHV TFUFMBI UFSKBEJ LFSVTBLBO NFEVMB TQJOBMJT SFGMFLT
3FGMFLT NJLTJ BEBMBI SFGMFLT NFEVMB TQJOBMJT ZBOH CFSTJGBU NJLTJ BLBO UFSUFLBO LBSFOB BEBOZB GFOPNFOB TZPL TQJOBM BLJCBU
IJMBOHOZB JNQVMT GBTJMJUBTJ ZBOH NFOEBEBL EBSJ CBUBOH PUBL EBO
PUPOPN UFUBQJ EBQBU EJIBNCBU BUBV EJGBTJMJUBTJ PMFI QVTBU EJ
TFSFCSVN /BNVO KJLB LBOEVOH LFNJI EJLPTPOHLBO TFDBSB QFSJPEJL
PUBL1VTBUJOJNFMJQVUJ
QVTBUGBTJMJUBTJEBOJOIJCJTJLVBUEJ
EFOHBO LBUFUFS VOUVL NFODFHBI USBVNB LBOEVOH LFNJI BLJCBU
CBUBOHPUBL UFSVUBNBUFSMFUBLEJQPOT EBO
CFCFSBQBQVTBU SFHBOHBO LBOEVOH LFNJI ZBOH CFSMFCJIBO FLTJUBCJMJUBT SFGMFLT NJLTJ
ZBOH UFSMFUBL EJ LPSUFLT TFSFCSJ ZBOH UFSVUBNB CFSTJGBU JOIJCJTJ BLBO NFOJOHLBU TFDBSB CFSUBIBQ IJOHHB SFGMFLT NJLTJ LFNCBMJ MBHJ
UFUBQJEBQBUCFSVCBINFOKBEJFLTJUBTJ LFNVEJBO UFSKBEJ QFOHPTPOHBO LBOEVOH LFNJI TFDBSB QFSJPEJL
3FGMFLT NJLTJ NFSVQBLBO QFOZFCBC EBTBS CFSLFNJI UFUBQJ UFUBQJUBOQBQFSJOHBUBOTFCFMVNOZB

CJBTBOZBQVTBUZBOHMFCJIUJOHHJZBOHBLBONFMBLVLBOLFOEBMJ #FCFSBQB QBTJFO ZBOH NFOHBMBNJ LFBEBBO JOJ EBQBU UFUBQ
BLIJSVOUVLQSPTFTNJLTJTFCBHBJCFSJLVU NFOHFOEBMJLBO QFOHFMVBSBO VSJOF EFOHBO NFMBLVLBO TUJNVMBTJ
NFOHHBSVL BUBV NFSBCB
LVMJU EJ EBFSBI HFOJUBM ZBOH LBEBOH EBQBU
1. 1VTBU ZBOH MFCJI UJOHHJ NFOKBHB BHBS SFGMFLT NJLTJ NFOJNCVMLBOSFGMFLTNJLTJ
UFUBQUFSIBNCBUTFCBHJBO LFDVBMJCJMBNJLTJEJJOHJOLBO Neurogenic Bladder yang Tak Terkendali Akibat
2. 1VTBUZBOHMFCJIUJOHHJEBQBUNFODFHBINJLTJ CBILBOKJLB Ketiadaan Sinyal Inhibisi dari Otak. ,FMBJOBO NJLTJ ZBOH MBJO
UFSKBEJ SFGMFLT NJLTJ EFOHBO DBSB TGJOHUFS LBOEVOH LFNJI EJTFCVU OFVSPHFOJD CMBEEFS ZBOH UBL UFSLFOEBMJ ZBOH NFOZFCBCLBO
FLTUFSOBNFMBLVLBOLPOUSBLTJUPOJLIJOHHBTBBUZBOHUFQBU QBTJFO TFSJOH CFSLFNJI EBO SFMBUJG UJEBL UFSLPOUSPM ,POEJTJ JOJ
EBUBOH EJTFCBCLBO PMFI LFSVTBLBO QBSTJBM NFEVMB TQJOBMJT BUBV CBUBOH PUBL
ZBOH NFOHHBOHHV TFCBHJBO CFTBS TJOZBM JOIJCJTJ 0MFI LBSFOB JUV
3. +JLBXBLUVCFSLFNJIUJCB QVTBULPSUJLBMEBQBUNFNGBTJMJUBTJ JNQVMT GBTJMJUBTJ BLBO CFSKBMBO UFSVTNFOFSVT EBSJ NFEVMB TQJOBMJT LF
QVTBUNJLTJTBLSBMVOUVLNFNCBOUVNFNVMBJSFGMFLTNJLTJ CBXBI TFIJOHHB QVTBU EJ TBLSVN BLBO UFSVT UFSFLTJUBTJ EBO CBILBO
EBO QBEB TBBU ZBOH TBNB NFOHIBNCBU TGJOHUFS FLTUFSOB EFOHBO TFEJLJU VSJOF TBKB NBNQV NFODFUVTLBO SFGMFLT NJLTJ ZBOH
TFIJOHHBQFOHFMVBSBOVSJOFEBQBUUFSKBEJ UJEBL UFSLPOUSPM TFIJOHHB NFOZFCBCLBO QBTJFO NFOKBEJ TFSJOH
CFSLFNJI
1FOHFMVBSBOVSJOFTFDBSBWPMVOUFSCJBTBOZBEJNVMBJEFOHBO
DBSB CFSJLVU .VMBNVMB PSBOH UFSTFCVU TFDBSB WPMVOUFS
NFOHPOUSBLTJLBO PUPU QFSVUOZB ZBOH BLBO NFOJOHLBULBO
UFLBOBO EJ EBMBN LBOEVOH LFNJI EBO NFNVOHLJOLBO VSJOF Pembentukan Urine Dihasilkan dari Filtrasi
UBNCBIBO NFNBTVLJ MFIFS LBOEVOH LFNJI EBO VSFUSB Glomerulus, Reabsorpsi Tubulus, dan Sekresi
QPTUFSJPS BLJCBU UFLBOBO TFIJOHHB NFSFHBOHLBO EJOEJOHOZB Tubulus
)BM JOJ NFNJDV SFTFQUPS SFHBOH ZBOH NFODFUVTLBO SFGMFLT
,FDFQBUBO FLTLSFTJ CFSCBHBJ [BU EBMBN VSJOF NFSVQBLBO KVNMBI
NJLTJ EBO TFLBMJHVT NFOHIBNCBU TGJOHUFS VSFUSB FLTUFSOB
LFUJHB QSPTFT HJOKBM ZBOH EJQFSMJIBULBO QBEB (BNCBS

#JBTBOZB TFMVSVI VSJOF BLBO EJLFMVBSLBO EBO NFOZJTBLBO
GJMUSBTJHMPNFSVMVT
SFBCTPSQTJ[BUEBSJUVCVMVTSFOBMJTLFEBMBN
UJEBLMFCJIEBSJTBNQBJNMVSJOFEJEBMBNLBOEVOHLFNJI
EBSBI EBO
TFLSFTJ[BUEBSJEBSBILFUVCVMVTSFOBMJT%JOZBUBLBO
TFDBSBNBUFNBUJT
Kelainan Mikturisi Kecepatan ekskresi urine =
Laju filtrasi — Laju reabsorpsi + Laju sekresi
Atoni Kandung Kemih dan Inkontinesia Akibat
1FNCFOUVLBO VSJOF EJNVMBJ EFOHBO GJMUSBTJ TFKVNMBI CFTBS
Destruksi Serat Saraf Sensorik.,POUSBLTJSFGMFLTNJLTJ DBJSBO ZBOH IBNQJS CFCBT QSPUFJO EBSJ LBQJMFS HMPNFSVMVT LF
UJEBLEBQBUUFSKBEJKJLBTFSBUTBSBGTFOTPSJLEBSJLBOEVOHLFNJILF
LBQTVMB#PXNBO,FCBOZBLBO[BUEBMBNQMBTNB LFDVBMJQSPUFJO
NFEVMBTQJOBMJTSVTBL EFOHBOEFNJLJBONFODFHBIQFOHIBOUBSBO
TJOZBM SFHBOH EBSJ LBOEVOH LFNJI #JMB IBM JOJ UFSKBEJ PSBOH EJGJMUSBTJ TFDBSB CFCBT TFIJOHHB LPOTFOUSBTJOZB QBEB GJMUSBU
UFSTFCVUBLBOLFIJMBOHBOLFOEBMJLBOEVOHLFNJI NFTLJQVOTFSBU HMPNFSVMVT EBMBN LBQTVMB #PXNBO IBNQJS TBNB EFOHBO EBMBN
FGFSFO EBSJ NFEVMB TQJOBMJT LF LBOEVOH LFNJI UFUBQ VUVI EBO QMBTNB ,FUJLB DBJSBO ZBOH UFMBI EJGJMUSBTJ JOJ NFOJOHHBMLBO
NFTLJQVO IVCVOHBO OFVSPHFOJL EJ EBMBN PUBL KVHB VUVI LBQTVMB #PXNBO EBO NFOHBMJS NFMFXBUJ UVCVMVT DBJSBO JOJ
,BOEVOH LFNJI UJEBL BLBO NFOHFMVBSLBO VSJOF TFDBSB QFSJPEJL NFOHBMBNJQFSVCBIBOBLJCBUBEBOZBSFBCTPSQTJBJSEBO[BUUFSMBSVU
NFMBJOLBO UFSVT UFSJTJ IJOHHB NFODBQBJ LBQBTJUBTOZB EBO TQFTJGJL LFNCBMJ LF EBMBN EBSBI BUBV TFLSFTJ [BU[BU MBJO EBSJ
NFOHFMVBSLBO VSJOF TFDBSB NFOFUFT NFMBMVJ VSFUSB )BM JOJ LBQJMFSQFSJUVCVMVTLFEBMBNUVCVMVT
EJTFCVUPWFSGMPXJODPOUJOFODF
310
Bab 26 Pembentukan Urine oleh Ginjat: I. Filtrasi Glomerutus,Aliran Darah Ginjal, dan Pengaturannya
1.
2.
3.
4.
UNIT V
(BNCBS NFNQFSMJIBULBO QFSMBLVBO HJOKBM UFSIBEBQ
FNQBU [BU IJQPUFUJT ;BU ZBOH UFSMJIBU QBEB 1BOFM " EJGJMUSBTJ
TFDBSB CFCBT PMFI LBQJMFS HMPNFSVMVT UFUBQJ UJEBL EJSFBCTPSQTJ
BUBVQVOEJTFLSFTJ0MFILBSFOBJUV MBKVFLTLSFTJOZBTBNBEFOHBO
MBKV GJMUSBTJOZB )BTJM TJTB NFUBCPMJTNF UFSUFOUV EBMBN UVCVI
TFQFSUJ LSFBUJOJO EJQFSMBLVLBO PMFI HJOKBM EFOHBO DBSB UFSTFCVU
TFIJOHHB QBEB EBTBSOZB NFOHBLJCBULBO FLTLSFTJ TFNVB CBIBO ,PNCJOBTJLIVTVTEBSJGJMUSBTJ SFBCTPSQTJ EBOTFLSFTJUFSKBEJ
ZBOHEJGJMUSBTJ QBEB TFUJBQ [BU EBMBN QMBTNB ,FDFQBUBO [BU ZBOH EJFLTLSFTJ
1BEB 1BOFM # [BU EJGJMUSBTJ TFDBSB CFCBT UFUBQJ TFCBHJBO EBMBN VSJOF CFSHBOUVOH QBEB LFDFQBUBO SFMBUJG LFUJHB QSPTFT
EJSFBCTPSQTJEBSJUVCVMVTLFNCBMJLFEBSBI0MFILBSFOBJUV MBKV EBTBSHJOKBMJOJ
FLTLSFTJ VSJOF MFCJI SFOEBI EBSJQBEB MBKV GJMUSBTJ QBEB LBQJMFS
HMPNFSVMVT %BMBN LBTVT JOJ MBKV FLTLSFTJ EJIJUVOH TFCBHBJ MBKV Filtrasi, Reabsorpsi, dan Sekresi Berbagai Zat
GJMUSBTJ EJLVSBOHJ MBKV SFBCTPSQTJ )BM JOJ LIBT VOUVL CFSCBHBJ
FMFLUSPMJUEBMBNUVCVITFQFSUJJPOOBUSJVNEBOLMPSJEB 1BEBVNVNOZB EBMBNQFNCFOUVLBOVSJOF SFBCTPSQTJUVCVMVT
TFDBSBLVBOUJUBUJGMFCJIQFOUJOHEBSJQBEBTFLSFTJUVCVMVT UFUBQJ
1BEB 1BOFM $ [BU EJGJMUSBTJ TFDBSB CFCBT PMFI LBQJMFS TFLSFTJCFSQFSBOQFOUJOHEBMBNNFOFOUVLBOKVNMBIJPOLBMJVN
HMPNFSVMVT UFUBQJ UJEBL EJFLTLSFTJ LF EBMBN VSJOF LBSFOB TFNVB EBO IJESPHFO TFSUB CFCFSBQB [BU MBJO ZBOH EJFLTLSFTJ EBMBN
[BUIBTJMGJMUSBTJEJSFBCTPSQTJEBSJUVCVMVTLFNCBMJLFEBSBI1PMB VSJOF 4FCBHJBO CFTBS [BU ZBOH IBSVT EJCFSTJILBO EBSJ EBSBI
JOJ UFSKBEJ QBEB CFCFSBQB [BU OVUSJTJ EBMBN EBSBI TFQFSUJ BTBN UFSVUBNB QSPEVL BLIJS NFUBCPMJTNF TFQFSUJ VSFVN LSFBUJOJO
BNJOP EBO HMVLPTB TFIJOHHB [BU UFSTFCVU EJQFSUBIBOLBO EBMBN BTBN VSBU EBO HBSBNHBSBN BTBN VSBU EJSFBCTPSQTJ TFEJLJU
DBJSBOUVCVI EBOLBSFOBJUV EJFLTLSFTJEBMBNKVNMBICFTBSLFEBMBNVSJOF
;BU QBEB 1BOFM % EJGJMUSBTJ TFDBSB CFCBT QBEB LBQJMFS ;BU BTJOH EBO PCBUPCBUBO UFSUFOUV KVHB EJSFBCTPSQTJ TFEJLJU
HMPNFSVMVT EBO UJEBL EJSFBCTPSQTJ UFUBQJ UBNCBIBO KVNMBI [BU UFUBQJTFMBJOJUV EJTFLSFTJEBSJEBSBILFEBMBNUVCVMVT TFIJOHHB
JOJ EJTFLSFTJ EBSJ LBQJMFS EBSBI QFSJUVCVMVT LF UVCVMVT SFOBMJT MBKV FLTLSFTJOZB UJOHHJ 4FCBMJLOZB FMFLUSPMJU TFQFSUJ JPO
1PMBJOJTFSJOHUFSKBEJQBEBBTBNEBOCBTBPSHBOJL NFOZFCBCLBO OBUSJVN LMPSJEB EBO CJLBSCPOBU EJSFBCTPSQTJ EBMBN KVNMBI
[BUJOJTFDBSBDFQBUEJCFSTJILBOEBSJEBSBIEBOEJFLTLSFTJEBMBN CFTBS TFIJOHHB IBOZB TFKVNMBI LFDJM TBKB ZBOH UBNQBL EBMBN
KVNMBICFTBSLFEBMBNVSJOF1BEBLBTVTJOJ LFDFQBUBOFLTLSFTJ VSJOF ;BU OVUSJTJ UFSUFOUV TFQFSUJ BTBN BNJOP EBO HMVLPTB
EJIJUVOHTFCBHBJMBKVGJMUSBTJEJUBNCBIMBKVTFLSFTJUVCVMVT EJSFBCTPSQTJTFMVSVIOZBPMFIUVCVMVTEBOUJEBLNVODVMEBMBN
311
VSJOF NFTLJQVO TFKVNMBI CFTBS [BU UFSTFCVU EJGJMUSBTJ PMFI VNEBOBTBNMFNBL ZBOHUJEBLEJGJMUSBTJTFDBSBCFCBTLBSFOB[BU
LBQJMFSHMPNFSVMVT UFSTFCVU TFCBHJBO UFSJLBU QBEB QSPUFJO QMBTNB .JTBMOZB IBNQJS
TFUFOHBI EBSJ LBMTJVN QMBTNB EBO TFCBHJBO CFTBS BTBN MFNBL
4FUJBQ QSPTFT GJMUSBTJ HMPNFSVMVT SFBCTPSQTJ UVCVMVT EBO
QMBTNB UFSJLBU QBEB QSPUFJO EBO CBHJBO ZBOH UFSJLBU JOJ UJEBL
TFLSFTJ UVCVMVT EJBUVS NFOVSVU LFCVUVIBO UVCVI 4FCBHBJ
EJGJMUSBTJEBSJLBQJMFSHMPNFSVMVT
DPOUPI KJLB UFSEBQBU LFMFCJIBO OBUSJVN EBMBN UVCVI MBKV
GJMUSBTJ OBUSJVN NFOJOHLBU EBO TFCBHJBO LFDJM OBUSJVN IBTJM
GJMUSBTJ BLBO EJSFBCTPSQTJ TFIJOHHB NFOZFCBCLBO QFOJOHLBUBO LFG Mencakup 20 Persen dari Aliran Plasma Ginjal
FLTLSFTJOBUSJVNVSJOF 4FQFSUJ QBEB LBQJMFS MBJO -'( EJUFOUVLBO PMFI
LFTFJNCBOHBO
6OUVL TFCBHJBO CFTBS [BU MBKV GJMUSBTJ EBO SFBCTPSQTJ SFMBUJG BOUBSB EBZB PTNPUJL LPMPJE EBO IJESPTUBUJL ZBOH CFLFSKB QBEB
TBOHBU CFTBS EJCBOEJOHLBO MBKV FLTLSFTJ 0MFI LBSFOB JUV NFNCSBO LBQJMFS EBO
LPFGJTJFO GJMUSBTJ LBQJMFS ,G
IBTJM
TFEJLJU QFSVCBIBO QBEB QSPTFT GJMUSBTJ BUBV SFBCTPSQTJ EBQBU QFSNFBCJMJUBT EBO GJMUSBTJ EBFSBI QFSNVLBBO LBQJMFS ,BQJMFS
NFOZFCBCLBO QFSVCBIBO ZBOH SFMBUJG CFTBS EBMBN FLTLSFTJ HMPNFSVMVT NFNQVOZBJ MBKV GJMUSBTJ ZBOH KBVI MFCJI UJOHHJ
HJOKBM4FCBHBJDPOUPI LFOBJLBOMBKVGJMUSBTJHMPNFSVMVT -'(
EJCBOEJOHLBO TFCBHJBO CFTBS LBQJMFS MBJOOZB LBSFOB UFLBOBO
ZBOH IBOZB QFSTFO EBSJ NFOKBEJ -IBSJ
BLBO IJESPTUBUJLHMPNFSVMVTZBOHUJOHHJEBO,GZBOHCFTBS1BEBPSBOH
NFOJOHLBULBOWPMVNFVSJOFLBMJMJQBU EBSJ NFOKBEJ EFXBTB OPSNBM -'(OZB TFLJUBS NMNFOJU BUBV -IBSJ
-IBSJ
KJLBSFBCTPSQTJUVCVMVTUFUBQLPOTUBO1BEBLFOZBUBBO 'SBLTJ BMJSBO QMBTNB SFOBM ZBOH EJGJMUSBTJ GSBLTJ GJMUSBTJ
SBUBSBUB
OZB QFSVCBIBO GJMUSBTJ HMPNFSVMVT EBO SFBCTPSQTJ UVCVMVT TFLJUBS JOJ CFSBSUJ LJSBLJSB QFSTFO QMBTNB ZBOH NFOHBMJS
TFMBMV CFLFSKB EFOHBO DBSB ZBOH UFSLPPSEJOBTJ VOUVL NFOH NFMBMVJHJOKBMBLBOEJGJMUSBTJPMFILBQJMFSHMPNFSVMVT'SBLTJGJMUSBTJ
IBTJMLBOQFSVCBIBOFLTLSFTJHJOKBMZBOHTFTVBJ EJIJUVOHTFCBHBJCFSJLVU
Mengapa Sejumlah Besar Zat Terlarut yang Difiltrasi Fraksi filtrasi = LFG/Aliran plasma ginjal
Kemudian Direabsorpsi oleh Ginjal?,JUBNVOHLJOCFSUBOZB Membran Kapiler Glomerulus
NBLOB EJCBMJL GJMUSBTJ TFKVNMBI CFTBS BJS EBO [BU UFSMBSVU ZBOH
LFNVEJBO TFCBHJBO CFTBS BLBO EJSFBCTPSQTJ 4BMBI TBUV .FNCSBOLBQJMFSHMPNFSVMVTNJSJQEFOHBONFNCSBOLBQJMFSZBOH
LFVOUVOHBOEBSJ-'(ZBOHUJOHHJZBJUVNFNCVBUHJOKBMNBNQV MBJO IBOZBNFNCSBOJOJNFNQVOZBJUJHB NFNCSBOMBJOCJBTBOZB
NFOZJOHLJSLBO QSPEVL TJTB EBSJ UVCVI EFOHBO DFQBU ZBOH EVB
MBQJTBOVUBNB
FOEPUFMLBQJMFS
NFNCSBOCBTBMJT EBO
UFSVUBNB CFSHBOUVOH QBEB GJMUSBTJ HMPNFSVMVT VOUVL
MBQJTBO TFM FQJUFMJBM QPEPTJU
ZBOH NFOHFMJMJOHJ QFSNVLBBO
FLTLSFTJOZB ,FCBOZBLBO QSPEVL TJTB UFSTFCVU EJSFBCTPSQTJ MVBSNFNCSBOCBTBMJTLBQJMFS (BNCBS
-BQJTBOMBQJTBOJOJ
TFEJLJUPMFIUVCVMVTEBO PMFILBSFOBJUV CFSHBOUVOHQBEB-'( CFSTBNBTBNB NFNCFOUVL TBXBS GJMUSBTJ ZBOH XBMBVQVO UFSEJSJ
ZBOHUJOHHJVOUVLQFOZJOHLJSBOZBOHFGFLUJGEBSJUVCVI BUBT UJHB MBQJTBO EBQBU NFOZBSJOH BJS EBO [BU UFSMBSVU CFCFSBQB
SBUVT LBMJ MFCJI CBOZBL EBSJQBEB NFNCSBO LBQJMFS ZBOH CJBTB
,FVOUVOHBOLFEVBEBSJ-'(ZBOHUJOHHJZBJUVNFOZFCBCLBO .FTLJQVO QBEB MBKV GJMUSBTJ ZBOH UJOHHJ JOJ NFNCSBO LBQJMFS
TFNVB DBJSBO UVCVI EBQBU EJGJMUSBTJ EBO EJQSPTFT MFCJI TFSJOH HMPNFSVMVTCJBTBOZBNFODFHBIGJMUSBTJQSPUFJOQMBTNB
PMFI HJOKBM TFUJBQ IBSJ 0MFI LBSFOB TFMVSVI WPMVNF QMBTNB
IBOZB LJSBLJSB MJUFS TFEBOHLBO -'( TFLJUBS -IBSJ JOJ -BKVGJMUSBTJUJOHHJZBOHNFMJOUBTJNFNCSBOLBQJMFSHMPNFSVMVT
NFOVOKVLLBO CBIXB TFMVSVI QMBTNB EBQBU EJGJMUSBTJ EBO TFCBHJBO NFSVQBLBO BLJCBU EBSJ TJGBU LIVTVT ZBOH EJNJMJLJOZB
EJQSPTFT LJSBLJSB LBMJ TFUJBQ IBSJ -'( ZBOH UJOHHJ JOJ &OEPUFM LBQJMFS NFNQVOZBJ SJCVBO MVCBOH LFDJM ZBOH EJTFCVU
NFOZFCBCLBO HJOKBM NBNQV NFOHBUVS WPMVNF EBO LPNQPTJTJ GFOFTUSB NJSJQ EFOHBO LBQJMFS GFOFTUSB ZBOH EJUFNVLBO EJ IBUJ
DBJSBOUVCVITFDBSBUFQBUEBODFQBU .FTLJQVOGFOFTUSBTJOZBSFMBUJGCFTBS TFMFOEPUFMLBZBBLBONVBUBO
OFHBUJGUFSUFOUVZBOHNFOHIBNCBUMFXBUOZBQSPUFJOQMBTNB
.FNCSBOCBTBMJTZBOHNFOHFMJMJOHJFOEPUFMUFSEJSJBUBTKBMJOBO
Filtrasi Glomerulus—Langkah Pertama TFSBULPMBHFOEBOQSPUFPHMJLBOZBOHNFNJMJLJTVBUVSVBOHBODFMBI
Pembentukan Urine CFTBS ZBOH EBQBU NFOZBSJOH TFKVNMBI CFTBS BJS EBO [BU UFSMBSVU
LFDJM .FNCSBO CBTBMJT FGFLUJG NFODFHBI GJMUSBTJ QSPUFJO QMBTNB
Komposisi Filtrat Glomerulus TFCBHJBO LBSFOB NVBUBO MJTUSJL TBOHBU OFHBUJG ZBOH CFSBTBM EBSJ
1FNCFOUVLBO VSJOF EJNVMBJ EFOHBO GJMUSBTJ TFKVNMBI CFTBS QSPUFPHMJLBO
DBJSBO NFMBMVJ LBQJMFS HMPNFSVMVT LF EBMBN LBQTVMB #PXNBO
#BHJBOBLIJSEBSJNFNCSBOHMPNFSVMVTBEBMBIMBQJTBOTFMFQJUFM
4FQFSUJ LFCBOZBLBO LBQJMFS LBQJMFS HMPNFSVMVT KVHB SFMBUJG
ZBOHNFNCBUBTJQFSNVLBBOMVBSHMPNFSVMVT4FMTFMJOJUJEBLSBUB
JNQFSNFBCFM UFSIBEBQ QSPUFJO TFIJOHHB DBJSBO IBTJM GJMUSBTJ
UFUBQJ NFNQVOZBJ UPOKPMBO QBOKBOH TFQFSUJ LBLJ QPEPTJU
ZBOH
EJTFCVU GJMUSBU HMPNFSVMVT
QBEB EBTBSOZB CFSTJGBU CFCBT
NFOHFMJMJOHJ QFSNVLBBO MVBS LBQJMFS MJIBU (BNCBS

QSPUFJO EBO UJEBL NFOHBOEVOH FMFNFO TFMVMBS UFSNBTVL TFM
5POKPMBO LBLJ JOJ EJQJTBILBO PMFI DFMBI ZBOH EJTFCVU DFMBI QPSJ
EBSBINFSBI
QPSJ TMJU QPSFT
ZBOH EJMBMVJ PMFI GJMUSBU HMPNFSVMVT 4FMTFM FQJUFM
,POTFOUSBTJ GJMUSBU HMPNFSVMVT MBJOOZB UFSNBTVL TFCBHJBO ZBOH KVHB NFNJMJLJ NVBUBO OFHBUJG NFSVQBLBO QFNCBUBT
CFTBSHBSBNEBONPMFLVMPSHBOJL TFSVQBEFOHBOLPOTFOUSBTJ UBNCBIBO UFSIBEBQ GJMUSBTJ QSPUFJO QMBTNB +BEJ TFMVSVI MBQJTBO
OZB EBMBN QMBTNB 1FOHFDVBMJBO UFSIBEBQ LFBEBBO VNVN JOJ QBEB EJOEJOH LBQJMFS HMPNFSVMVT NFSVQBLBO TBXBS VOUVL GJMUSBTJ
JBMBICFCFSBQB[BUEFOHBOCFSBUNPMFLVMSJOHBO TFQFSUJLBMTJ QSPUFJOQMBTNB
312
Bab 26 Pembentukan Urine oleh Ginjal: I. Filtrasi Glomerulus, Aliran Darah Ginjal, dan Pengaturannya
UNIT V
ZBOH EBQBU EJCFOUVL NFOKBEJ NPMFLVM OFUSBM BUBV NPMFLVM
CFSNVBUBOQPTJUJGBUBVOFHBUJG1FSIBUJLBOCFSBQBQVOVLVSBO
KBSJKBSJNPMFLVMUFSTFCVU NPMFLVMEFOHBONVBUBOQPTJUJGMFCJI
NVEBI EJGJMUSBTJ EJCBOEJOHLBO EFOHBO NPMFLVM CFSNVBUBO
OFHBUJG%FLTUSBOOFUSBMKVHBMFCJINVEBIEJGJMUSBTJEJCBOEJOH
LBO EFLTUSBO CFSNVBUBO OFHBUJG EFOHBO CFSBU NPMFLVM ZBOH
TBNB 1FOZFCBC QFSCFEBBO LFNBNQVBO GJMUSBTJ JOJ JBMBI
NVBUBO OFHBUJG QBEB NFNCSBO CBTBMJT EBO QPEPTJU ZBOH
NFSVQBLBODBSBQFOUJOHVOUVLNFOZBSJOHNPMFLVMCFSNVBUBO
OFHBUJGZBOHCFTBS UFSNBTVLQSPUFJOQMBTNB
1BEB QFOZBLJU HJOKBM UFSUFOUV NVBUBO OFHBUJG QBEB
NFNCSBO EBTBS NFOKBEJ IJMBOH CBILBO TFCFMVN UFSMJIBU
QFSVCBIBO QBEB IJTUPMPHJ HJOKBMOZB ZBJUV TVBUV LFBEBBO ZBOH
Kemampuan Filtrasi Zat Terlarut Berbanding Terbalik EJTFCVU OFGSPQBUJ QFSVCBIBO NJOJNBM "LJCBU IJMBOHOZB
dengan Ukurannya. .FNCSBO LBQJMFS HMPNFSVMVT MFCJI UFCBM NVBUBO OFHBUJG QBEB NFNCSBO CBTBMJT JOJ CFCFSBQB QSPUFJO
EJCBOEJOHLBO LFCBOZBLBO NFNCSBO LBQJMFS MBJOOZB UFUBQJ KVHB EFOHBO CFSBU NPMFLVM MFCJI SFOEBI UFSVUBNB BMCVNJO BLBO
KBVIMFCJICFSQPSJQPSJ EBOLBSFOBJUV NFOZBSJOHDBJSBOEFOHBO EJGJMUSBTJEBOUBNQBLEBMBNVSJOF LFBEBBOJOJEJLFOBMTFCBHBJ
LFDFQBUBOZBOHUJOHHJ.FTLJQVOMBKVGJMUSBTJUJOHHJ TBXBSGJMUSBTJ QSPUFJOVSJBBUBVBMCVNJOVSJB
HMPNFSVMVT CFSTJGBU TFMFLUJG EBMBN NFOFOUVLBO NPMFLVM ZBOH
BLBOEJGJMUSBTJ CFSEBTBSLBOVLVSBOEBONVBUBOMJTUSJLOZB
5BCFM NFODBOUVNLBO QFOHBSVI EBSJ VLVSBO NPMFLVM
UFSIBEBQ LFNBNQVBO GJMUSBTJ CFSCBHBJ NPMFLVM ,FNBNQVBO
GJMUSBTJ CFSBSUJ CBIXB [BU EJGJMUSBTJ TFDBSB CFCBT TFQFSUJ BJS
LFNBNQVBO GJMUSBTJ CFSBSUJ CBIXB [BU IBOZB EJGJMUSBTJ
QFSTFO EBSJ LFDFQBUBO GJMUSBTJ BJS 1FSIBUJLBO CBIXB FMFLUSPMJU
TFQFSUJ OBUSJVN EBO TFOZBXB PSHBOJL ZBOH LFDJM TFQFSUJ HMVLPTB
BLBO EJGJMUSBTJ TFDBSB CFCBT #JMB CFSBU NPMFLVMOZB NFOEFLBUJ
CFSBUNPMFLVMBMCVNJO LFNBNQVBOGJMUSBTJBLBONFOVSVOTFDBSB
DFQBU NFOEFLBUJOPM
Molekul Besar yang Bermuatan Negatif Lebih Sukar

Difiltrasi Dibandingkan dengan Molekul Bermuatan Positif
dengan Ukuran yang Sama.%JBNFUFSNPMFLVMQSPUFJOQMBTNB
BMCVNJO LJSBLJSB IBOZB OBOPNFUFS TFEBOHLBO QPSJQPSJ
NFNCSBO HMPNFSVMVT EJQFSLJSBLBO TFLJUBS OBOPNFUFS
BOHTUSPN
/BNVO GJMUSBTJ BMCVNJO UFSCBUBT LBSFOB BEBOZB
NVBUBO OFHBUJG EBO UPMBLBO FMFLUSPTUBUJL ZBOH EJIBTJMLBO PMFI
NVBUBOOFHBUJGQSPUFPHMJLBOEJOEJOHLBQJMFSHMPNFSVMVT
(BNCBS NFNQFSMJIBULBO CBHBJNBOB QBEB HMPNFSVMVT
NVBUBOMJTUSJLEBQBUNFNFOHBSVIJGJMUSBTJEFLTUSBOEFOHBOCFSBU
NPMFLVMZBOHCFSCFEBCFEB%FLTUSBONFSVQBLBOQPMJTBLBSJEB
313
Penentu LFG %BZBZBOH.FOEPSPOH'JMUSBTJ NN)H
5FLBOBOIJESPTUBUJLHMPNFSVMVT
-'(EJUFOUVLBOPMFI
KVNMBIEBZBIJESPTUBUJLEBOPTNPUJL 5FLBOBOPTNPUJLLPMPJEEJLBQTVMB#PXNBO
LPMPJEQBEBNFNCSBOHMPNFSVMVT ZBOHNFOHIBTJMLBOUFLBOBO %BZBZBOH.FMBXBO'JMUSBTJ NN)H

GJMUSBTJ OFUP EBO
LPFGJTJFO GJMUSBTJ LBQJMFS HMPNFSVMVT ,G
4FDBSB NBUFNBUJT -'( NFSVQBLBO IBTJM EBO ,G EBO UFLBOBO 5FLBOBOIJESPTUBUJLEJLBQTVMB#PXNBO
GJMUSBTJBLIJS 5FLBOBOPTNPUJLLPMPJEEJLBQJMFSHMPNFSVMVT
Tekanan filtrasi akhir = 60 — 18 — 32 = +10 mm Hg
LFG = Kf x Tekanan filtrasi akhir
5FLBOBO GJMUSBTJ OFUP NFSVQBLBO KVNMBI EBZB PTNPUJL #FCFSBQB OJMBJ UFSTFCVU EBQBU CFSVCBI TFDBSB OZBUB QBEB
LPMPJEEBOIJESPTUBUJLZBOHNFOEPSPOHBUBVNFMBXBOGJMUSBTJ CFSCBHBJ LFBEBBO GJTJPMPHJT TFEBOHLBO OJMBJ MBJOOZB UFSVUBNB
QBEB LBQJMFS HMPNFSVMVT (BNCBS
%BZB JOJ NFMJQVUJ CFSVCBIQBEBLFBEBBOQFOZBLJUUFSUFOUV TFQFSUJZBOHBLBOEJCBIBT

UFLBOBOIJESPTUBUJLEJEBMBNLBQJMFSHMPNFSVMVT UFLBOBO LFNVEJBO
IJESPTUBUJL HMPNFSVMVT 1(
ZBOH NFOEPSPOH GJMUSBTJ

UFLBOBO IJESPTUBUJL EBMBN LBQTVMB #PXNBO 1#
EJ MVBS Peningkatan LFG Akibat Peningkatan Koefisien Filtrasi
LBQJMFS ZBOH NFMBXBO GJMUSBTJ
UFLBOBO PTNPUJL LPMPJE Kapiler Glomerulus
QSPUFJO QMBTNB EJ EBMBN LBQJMFS HMPNFSVMVT ɀ(
ZBOH
NFMBXBO GJMUSBTJ EBO
UFLBOBO PTNPUJL LPMPJE QSPUFJO ,G NFSVQBLBO VLVSBO IBTJM LPOEVLUJWJUBT IJESBVMJL EBO MVBT
EBMBNLBQTVMB#PXNBO ɀ#
ZBOHNFOEPSPOHGJMUSBTJ 1BEB QFSNVLBBO LBQJMFS HMPNFSVMVT ,G UJEBL EBQBU EJVLVS TFDBSB
LFBEBBOOPSNBM LPOTFOUSBTJQSPUFJOEBMBNGJMUSBUHMPNFSVMVT MBOHTVOH UFUBQJ EJQFSLJSBLBO TFDBSB FLTQFSJNFOUBM EFOHBO DBSB
TFEFNJLJBO SFOEBIOZB TFIJOHHB UFLBOBO PTNPUJL LPMPJE NFNCBHJMBKVGJMUSBTJHMPNFSVMVTEFOHBOUFLBOBOGJMUSBTJOFUP
DBJSBOEJLBQTVMB#PXNBOEJBOHHBQOPM

Kf = LFG/Tekanan filtrasi neto
0MFILBSFOBJUV -'(EBQBUEJOZBUBLBOTFCBHBJ
0MFILBSFOB-'(UPUBMVOUVLLFEVBHJOKBMLJSBLJSBNMEBO
LFG = Kf x (PG — PB — ɀ( + ɀB) UFLBOBO GJMUSBTJ BLIJS NN )H NBLB ,GOPSNBM LJSBLJSB
NMNFOJUNN )H EBSJ UFLBOBO GJMUSBTJ UFSTFCVU +JLB ,G EJOZBUB
LBO QFS HSBN CFSBU HJOKBM SBUBSBUB ,G TFLJUBS NMNFOJU
.FTLJQVO OJMBJ OPSNBM VOUVL QFOFOUV -'( UJEBL EJIJUVOH NN )H QFS HSBN CFSBU HJOKBM OJMBJ UFSTFCVU LBMJ MFCJI
TFDBSB MBOHTVOH QBEB NBOVTJB OBNVO OJMBJ JOJ UFMBI EJIJUVOH CFTBSEBSJ,G QBEBLFCBOZBLBOTJTUFNLBQJMFSUVCVIMBJOOZBSBUB
QBEB IFXBO TFQFSUJ BOKJOH EBO UJLVT #FSEBTBSLBO IBTJM QBEB SBUB ,G QBEB CBOZBL KBSJOHBO UVCVI MBJOOZB LJSBLJSB IBOZB
IFXBO EBZB OPSNBM ZBOH NFOEPSPOH EBO NFMBXBO GJMUSBTJ NMNFOJUNN)HQFSHSBN,GLBQJMFSHMPNFSVMVTZBOHUJOHHJ
HMPNFSVMVTQBEBNBOVTJBEJEVHBTFCBHBJCFSJLVU MJIBU(BNCBS JOJTBOHBUNFNFOHBSVIJMBKVGJMUSBTJDBJSBOOZBZBOHDFQBU

.FTLJQVOQFOJOHLBUBO,G BLBONFOBJLLBO-'(EBOQFOVSVO
BO ,G BLBO NFOHVSBOHJ -'( QFSVCBIBO ,G NVOHLJO CVLBO
NFSVQBLBONFLBOJTNFVUBNBQFOHBUVSBO-'(OPSNBMEBSJIBSJ
LFIBSJ/BNVO CFCFSBQBQFOZBLJUBLBONFOVSVOLBO,GEFOHBO
DBSB NFOHVSBOHJ KVNMBI LBQJMFS HMPNFSVMVT GVOHTJPOBM EFOHBO
EFNJLJBONFOHVSBOHJMVBTQFSNVLBBOVOUVLGJMUSBTJ
BUBVEFOHBO
NFOBNCBI LFUFCBMBO NFNCSBO LBQJMFS HMPNFSVMVT EBO
NFOHVSBOHJLPOEVLUJWJUBTIJESBVMJLOZB4FCBHBJDPOUPI EJBCFUFT
NFMJUVT BUBV IJQFSUFOTJ LSPOJT ZBOH UJEBL UFSLPOUSPM BLBO
NFOVSVOLBO,GTFDBSBCFSUBIBQEFOHBONFOJOHLBULBOLFUFCBMBO
NFNCSBO CBTBMJT LBQJMFS HMPNFSVMVT EBO QBEB BLIJSOZB BLBO
NFSVTBLLBQJMFSTFEFNJLJBOCFSBUTFIJOHHBLBQJMFSNFOKBEJUJEBL
CFSGVOHTJ
Penurunan LFG Akibat Peningkatan Tekanan Hidrostatik di

Kapsula Bowman
1FOHVLVSBO MBOHTVOH UFLBOBO IJESPTUBUJL EJ LBQTVMB #PXNBO

EBO QBEB CFSCBHBJ UFNQBU EJ UVCVMVT QSPLTJNBM QBEB CJOBUBOH
DPCB EFOHBO NFOHHVOBLBO NJLSPQJQFU NFOVOKVLLBO CBIXB
EBMBNLFBEBBOOPSNBMQFSLJSBBOUFLBOBOLBQTVMB#PXNBOQBEB
NBOVTJB JBMBI NN )H ,FOBJLBO UFLBOBO IJESPTUBUJL QBEB
LBQTVMB#PXNBOBLBONFOVSVOLBO-'( TFEBOHLBOQFOVSVOBO
314
Bab 26 Pembentukan Urine oleh Ginjal: I. Filtrasi Clomerulus,Aliran Darah Ginjal, dan Pengaturannya
UFSTFCVUBLBONFOJOHLBULBO-'(/BNVO QFSVCBIBOUFLBOBOEJ ,FOBJLBO GSBLTJ GJMUSBTJ KVHB BLBO NFNFLBULBO QSPUFJO

LBQTVMB #PXNBO CJBTBOZB CVLBO NFSVQBLBO DBSB VUBNB VOUVL QMBTNB EBO NFOJOHLBULBO UFLBOBO PTNPUJL LPMPJE HMPNFSVMVT
NFOHBUVS-'( MJIBU (BNCBS
0MFI LBSFOB GSBLTJ GJMUSBTJ BEBMBI -'(
BMJSBO QMBTNB HJOKBM NBLB GSBLTJ GJMUSBTJ EBQBU EJUJOHLBULBO
%BMBN LFBEBBO QBUPMPHJT UFSUFOUV ZBOH EJTFSUBJ EFOHBO
EFOHBO DBSB NFOBJLLBO -'( BUBV NFOVSVOLBO BMJSBO QMBTNB
PCTUSVLTJ USBLUVT VSJOBSJVT UFLBOBO EJ LBQTVMB #PXNBO EBQBU
UNIT V
HJOKBM 4FCBHBJ DPOUPI QFOVSVOBO BMJSBO QMBTNB HJOKBM UBOQB
NFOJOHLBU TFDBSB OZBUB NFOZFCBCLBO QFOVSVOBO -'( ZBOH
QFSVCBIBO BXBM -'( BLBO DFOEFSVOH NFOJOHLBULBO GSBLTJ
CFSBSUJ 4FCBHBJ DPOUPI QFOHFOEBQBO LBMTJVN BUBV BTBN VSBU
GJMUSBTJ ZBOH BLBO NFOBJLLBO UFLBOBO PTNPUJL LPMPJE EJ
EBQBU NFOZFCBCLBO UJNCVMOZB CBUV QBEB USBLUVT VSJOBSJVT
LBQJMFS HMPNFSVMVT EBO DFOEFSVOH NFOVSVOLBO -'( 0MFI
TFSJOH LBMJ EJ VSFUFS LBSFOB JUV NFOHIBNCBU BMJSBO USBLUVT
LBSFOB JUV QFSVCBIBO BMJSBO EBSBI HJOKBM EBQBU NFNFOHBSVIJ
VSJOBSJVTEBONFOJOHLBULBOUFLBOBOEJLBQTVMB#PXNBO)BMJOJ
-'(UFSMFQBTEBSJQFSVCBIBOUFLBOBOIJESPTUBUJLHMPNFSVMVT
NFOVSVOLBO -'( EBO BLIJSOZB EBQBU NFOZFCBCLBO IJESPO
FGSPTJT QFSFHBOHBO EBO QFMFCBSBO QFMWJT EBO LBMJTFT HJOKBM
EBO 1BEBLFOBJLBOBMJSBOEBSBIHJOKBM NVMBNVMBIBOZBTFEJLJU
EBQBU NFSVTBL BUBV CBILBO NFOHIBODVSLBO HJOKBM LFDVBMJ KJLB GSBLTJ QMBTNB ZBOH EJTBSJOH LFMVBS EBSJ LBQJMFS HMPNFSVMVT
PCTUSVLTJEJIJMBOHLBO TFIJOHHB LFOBJLBO UFLBOBO PTNPUJL LPMPJE EJ LBQJMFS
HMPNFSVMVT ZBOH MFCJI MBNCBU EBO FGFL QFOHIBNCBUBO -'(
MFCJITFEJLJU"LJCBUOZB XBMBVQVOEFOHBOUFLBOBOIJESPTUBUJL
Penurunan LFG Akibat Peningkatan Tekanan Osmotik HMPNFSVMVTZBOHLPOTUBO MBKVBMJSBOEBSBIZBOHMFCJICFTBSLF
Koloid di Kapiler Glomerulus EBMBNHMPNFSVMVTDFOEFSVOHBLBONFOJOHLBULBO-'( EBOMBKV
,FUJLB EBSBI NFOHBMJS EBSJ BSUFSJPM BGFSFO NFMBMVJ LBQJMFS BMJSBO EBSBI ZBOH MFCJI SFOEBI LF HMPNFSVMVT DFOEFSVOH BLBO
HMPNFSVMVTNFOVKVLFBSUFSJPMFGFSFO LPOTFOUSBTJQSPUFJOQMBTNB NFOVSVOLBO-'(
NFOJOHLBU LJSBLJSB QFSTFO (BNCBS
"MBTBOOZB JBMBI
LJSBLJSBTFQFSMJNBDBJSBOQBEBLBQJMFSEJTBSJOHLFEBMBNLBQTVMB Peningkatan LFG Akibat Peningkatan Tekanan Hidro-
#PXNBO TFIJOHHBBLBONFNFLBULBOQSPUFJOQMBTNBHMPNFSVMVT statik di Kapiler Glomerulus
ZBOHUJEBLEJTBSJOH#JMBUFLBOBOPTNPUJLLPMPJEQMBTNBOPSNBM 1BEB LPOEJTJ OPSNBM UFLBOBO IJESPTUBUJL LBQJMFS HMPNFSVMVT
ZBOH NFNBTVLJ LBQJMFS HMPNFSVMVT CFTBSOZB NN )H NBLB EJQFSLJSBLBO CFTBSOZB TFLJUBS NN )H 1FSVCBIBO UFLBOBO
OJMBJ UFSTFCVU CJBTBOZB NFOJOHLBU NFOKBEJ LJSBLJSB NN )H IJESPTUBUJLHMPNFSVMVTNFSVQBLBODBSBVUBNBVOUVLNFOHBUVS
QBEBTBBUEBSBINFODBQBJVKVOHFGFSFOLBQJMFS0MFILBSFOBJUV -'(TFDBSBGJTJPMPHJT,FOBJLBOUFLBOBOIJESPTUBUJLHMPNFSVMVT
UFLBOBO PTNPUJL LPMPJE SBUBSBUB EBSJ QSPUFJO QMBTNB LBQJMFS BLBO NFOJOHLBULBO -'( TFEBOHLBO QFOVSVOBO UFLBOBO
HMPNFSVMVT NFSVQBLBO OJMBJ QFSUFOHBIBO BOUBSB EBO NN IJESPTUBUJLHMPNFSVMVTBLBONFOHVSBOHJ-'(
)H BUBVLJSBLJSBNN)H 5FLBOBO IJESPTUBUJL HMPNFSVMVT EJUFOUVLBO PMFI UJHB
%FOHBOEFNJLJBO BEBEVBGBLUPSZBOHNFNFOHBSVIJUFLBOBO WBSJBCFM NBTJOHNBTJOH WBSJBCFM CFSBEB EJ CBXBI LFOEBMJ
PTNPUJL LPMPJE LBQJMFS HMPNFSVMVT
UFLBOBO PTNPUJL LPMPJE GJTJPCPHJT
UFLBOBO BSUFSJ
UBIBOBO BSUFSJPM BGFSFO EBO
QMBTNB BSUFSJBM EBO
GSBLTJ QMBTNB ZBOH EJTBSJOH PMFI LBQJMFS
UBIBOBOBSUFSJPMFGFSFO
HMPNFSVMVT GSBLTJ GJMUSBTJ
,FOBJLBO UFLBOBO PTNPUJL LPMPJE ,FOBJLBO UFLBOBO BSUFSJ DFOEFSVOH NFOJOHLBULBO UFLBOBO
QMBTNB BSUFSJBM BLBO NFOJOHLBULBO UFLBOBO PTNPUJL LPMPJE EJ IJESPTUBUJL HMPNFSVMVT EBO LBSFOB JUV NFOJOHLBULBO -'(
LBQJMFSHMPNFSVMVT ZBOHLFNVEJBOBLBONFOVSVOLBO-'( /BNVO TFQFSUJ ZBOH EJEJTLVTJLBO TFMBOKVUOZB FGFL JOJ
EJUPQBOHPMFINFLBOJTNFBVUPSFHVMBTJZBOHNFNQFSUBIBOLBO
UFLBOBOHMPNFSVMVTBHBSSFMBUJGLPOTUBOQBEBLFBEBBOUFLBOBO
EBSBIZBOHCFSVCBIVCBI

,FOBJLBO UBIBOBO BSUFSJPM BGFSFO NFOHVSBOHJ UFLBOBO
IJESPTUBUJL HMPNFSVMVT EBO NFOVSVOLBO -'( 4FCBMJLOZB
EJMBUBTJ BSUFSJPM BGFSFO NFOJOHLBULBO UFLBOBO IJESPTUBUJL
HMPNFSVMVTEBO-'( (BNCBS

,POTUSJLTJ BSUFSJPM FGFSFO NFOJOHLBULBO UBIBOBO BMJSBO
LFMVBS EBSJ LBQJMFS HMPNFSVMVT )BM JOJ BLBO NFOBJLLBO
UFLBOBO IJESPTUBUJL HMPNFSVMVT EBO TFQBOKBOH LFOBJLBO
UBIBOBO FGFSFO UJEBL NFOHVSBOHJ BMJSBO EBSBI HJOKBM
UFSMBMV CBOZBL NBLB -'( IBOZB NFOJOHLBU TFEJLJU MJIBU
(BNCBS
/BNVO LBSFOBLPOTUSJLTJBSUFSJPMFGFSFOKVHB
NFOHVSBOHJ BMJSBO EBSBI HJOKBM GSBLTJ GJMUSBTJ EBO UFLBOBO
PTNPUJL LPMPJE HMPNFSVMVT BLBO NFOJOHLBU TFJSJOH EFOHBO
QFOJOHLBUBO UBIBOBO BSUFSJPM FGFSFO 0MFI LBSFOB JUV KJLB
LPOTUSJLTJ BSUFSJPM FGFSFO DVLVQ CFSBU NFMFCJIJ UJHB LBMJ MJQBU
LFOBJLBO UBIBOBO BSUFSJPM FGFSFO
NBLB LFOBJLBO UFLBOBO
PTNPUJL LPMPJE BLBO NFMFCJIJ LFOBJLBO UFLBOBO IJESPTUBUJL
LBQJMFS HMPNFSVMVT ZBOH EJTFCBCLBO PMFI LPOTUSJLTJ BSUFSJPM
FGFSFO#JMBIBMJOJUFSKBEJ EBZBOFUPGJMUSBTJNFOKBEJNFOVSVO
NFOZFCBCLBOQFOVSVOBO-'(
315
Tabel 26-2 Berbagai Faktor yang Dapat Menurunkan Laju Filtrasi

Glomerulus (LFG)
Faktor Fisika* Penyebab Fisiologis/Patofisiologis
↓K f → ↓ GFR Penyakit ginjal, diabetes melitus, hipertensi
↑ PB → ↓ GFR Obstruksi saluran kemih (misalnya batu

ginjal)
↑ πG → ↓ GFR ↓ Aliran darah ginjal, peningkatan protein
plasma
↓ PG → ↓ GFR
↓ AP → ↓ PG ↓Tekanan arteri (hanya sedikit berpengaruh
karena adanya autoregulasi)
↓ RE → ↓ PG ↓ Angiotensin II (obat yang menghambat
pembentukan angiotensin II)
↑ RA → ↓ PG ↑ Aktivitas simpatis, hormon vasokonstriksi
(misalnya, norepinefrin dan endotelin)
*Perubahan faktor tersebut ke arah sebaliknya (bertawanan), biasanya akan

meningkatkan LFG.
Kf, koefisien filtrasi glomerulus; PB, tekanan hidrostatik kapsula Bowman; ɀG,
tekanan osmotik koloid kapiter glomerulus; PG, tekanan hidrostatik kapiler
glomerulus; Ap, tekanan arteri sistemik; RE, tahanan aretriot eferen; RA, tahanan
arteriol aferen.
%FOHBO EFNJLJBO LPOTUSJLTJ BSUFSJPM FGFSFO NFNQVOZBJ 4FQFSUJ QBEB KBSJOHBO MBJOOZB BMJSBO EBSBI NFOZVQMBJ HJOKBM
QFOHBSVICJGBTJLUFSIBEBQ-'(1BEBLPOTUSJLTJUJOHLBUTFEBOH EFOHBO OVUSJTJ EBO NFOHFMVBSLBO QSPEVL TJTB /BNVO BMJSBO
UFSKBEJTFEJLJULFOBJLBO-'( UFUBQJQBEBLPOTUSJLTJZBOHCFSBU UJOHHJZBOHNFOVKVHJOKBMUFSTFCVUTBOHBUNFMFCJIJLFCVUVIBOJOJ
UFSKBEJ QFOVSVOBO -'( 1FOZFCBC VUBNB QFOVSVOBO -'( JOJ 5VKVBO QFOBNCBIBO BMJSBO JOJ BEBMBI VOUVL NFNCFSJ DVLVQ
BEBMBI TFCBHBJ CFSJLVU ,FUJLB LPOTUSJLTJ FGFSFO NFOKBEJ CFSBU QMBTNB VOUVL MBKV GJMUSBTJ HMPNFSVMVT ZBOH UJOHHJ ZBOH QFOUJOH
EBOLPOTFOUSBTJQSPUFJOQMBTNBNFOJOHLBU UFSKBEJQFOJOHLBUBO VOUVL QFOHBUVSBO WPMVNF DBJSBO UVCVI EBO LPOTFOUSBTJ [BU
UFLBOBO PTNPUJL LPMPJE ZBOH DFQBU EBO OPOMJOJFS ZBOH UFSMBSVU TFDBSB UFQBU 4FQFSUJ ZBOH EJQFSLJSBLBO NFLBOJTNF ZBOH
EJTFCBCLBO PMFI FGFL %POOBO TFNBLJO UJOHHJ LPOTFOUSBTJ NFOHBUVS BMJSBO EBSBI HJOKBM CFSLBJUBO FSBU EFOHBO QFOHBUVSBO
QSPUFJO TFNBLJO DFQBU UFLBOBO PTNPUJL LPMPJE NFOJOHLBU -'(EBOGVOHTJFLTLSFTJHJOKBM
LBSFOBJOUFSBLTJJLBUBOJPOUFSIBEBQQSPUFJOQMBTNB ZBOHKVHB
NFOJNCVMLBOFGFLPTNPUJL TFQFSUJZBOHEJCBIBTQBEB#BC Aliran Darah Ginjal dan Konsumsi Oksigen
4JOHLBUOZB LPOTUSJLTJ BSUFSJPM BGFSFO NFOVSVOLBO -'( 6OUVL TFUJBQ HSBN CFSBU HJOKBM CJBTBOZB NFOHPOTVNTJ PLTJHFO
/BNVO FGFL LPOTUSJLTJ BSUFSJPM FGFSFO CFSHBOUVOH QBEB TFCBOZBLEVBLBMJMJQBUEBSJLPOTVNTJPUBLUFUBQJNFNJMJLJBMJSBO
CFSBUOZB LPOTUSJLTJ LPOTUSJLTJ FGFSFO ZBOH TFEBOH BLBO EBSBI IBNQJS UVKVI LBMJ MJQBU MFCJI CFTBS EBSJQBEB PUBL +BEJ
NFOBJLLBO-'( UFUBQJLPOTUSJLTJFGFSFOZBOHCFSBU MFCJIEBSJ PLTJHFO ZBOH EJLJSJNLBO LF HJOKBM KBVI NFMFCJIJ LFCVUVIBO
UJHBLBMJMJQBULFOBJLBOUBIBOBO
DFOEFSVOHBLBONFOVSVOLBO NFUBCPMJLOZB EBO FLTUSBLTJ PLTJHFO EJ BSUFSJWFOB SFMBUJG SFOEBI
-'( EJCBOEJOHLBOEJTFCBHJBOCFTBSKBSJOHBOMBJOOZB
5BCFM NFSBOHLVN CFSCBHBJ GBLUPS ZBOH EBQBU 4FKVNMBICFTBSPLTJHFOZBOHEJLPOTVNTJPMFIHJOKBMEJLBJULBO
NFOVSVOLBO-'( EFOHBO MBKV SFBCTPSQTJ BLUJG OBUSJVN ZBOH UJOHHJ QBEB UVCVMVT
HJOKBM +JLB BMJSBO EBSBI HJOKBM EBO -'( CFSLVSBOH EBO MFCJI
Aliran Darah Ginjal TFEJLJU OBUSJVN ZBOH EJGJMUSBTJ NBLB MFCJI TFEJLJU OBUSJVN ZBOH
EJSFBCTPSQTJEBOMFCJITFEJLJUQVMBPLTJHFOZBOHEJLPOTVNTJ0MFI
1BEBMBLJMBLJCJBTBEFOHBOCFSBUCBEBOLH HBCVOHBOBMJSBO LBSFOB JUV LPOTVNTJ PLTJHFO HJOKBM CFSWBSJBTJ TFTVBJ EFOHBO
EBSBIZBOHNFMBMVJLFEVBHJOKBMLJSBLJSBNMNFOJU BUBV SFBCTPSQTJ OBUSJVN EJ UVCVMVT HJOKBM ZBOH LFNVEJBO CFSLBJUBO
LJSBLJSB QFSTFO EBSJ DVSBI KBOUVOH %FOHBO NFNQFS FSBU EFOHBO -'( EBO MBKV GJMUSBTJ OBUSJVN (BNCBS
+JLB
UJNCBOHLBO CBIXB LFEVB HJOKBM IBOZB NFODBLVQ QFSTFO GJMUSBTJHMPNFSVMVTCFSIFOUJTBNBTFLBMJ SFBCTPSQTJOBUSJVNHJOKBM
EBSJ UPUBM CFSBU CBEBO LJUB EBQBU TFHFSB NFMJIBU CBIXB HJOKBM KVHB BLBO CFSIFOUJ EBO LPOTVNTJ PLTJHFO NFOVSVO NFOKBEJ
NFOFSJNBBMJSBOEBSBIZBOHTBOHBUUJOHHJEJCBOEJOHLBOPSHBO TFLJUBS TFQFSFNQBU OJMBJ OPSNBM ,POTVNTJ PLTJHFO TJTBOZB
MBJO NFODFSNJOLBOLFCVUVIBONFUBCPMJLEBTBSEBSJTFMTFMHJOKBM
316
Bab 26 Pembentukan Urine oleh Ginjal: I. Filtrasi Glomerulus,Aliran Darah Ginjal, dan Pengaturannya
Tabel 26-3 Perkiraan Tekanan dan Tahanan Vaskular Peredaran

Darah pada Ginjal Normal
Tekanan dalam
Pembuluh (mm Hg)
UNIT V
Pembuluh Awal Akhir Persentase
Tahanan Pembuluh
Renal Total
Arteri renal 100 100 ≈0

Arteri interlobaris, ≈100 85 ≈16
arkuata, dan
interlobularis
Arteriol aferen 85 60 ≈26
Kapiler glomerulus 60 59 ≈1
Arteriol eferen
Kapiler peritubulus 59 18 ≈43
Vena interlobaris, 18 8 ≈10
arkuata, dan
interlobularis 8 4 ≈4
Vena renalis 4 ≈4 ≈0
Penentu Aliran Darah Ginjal

"MJSBO EBSBI HJOKBM EJUFOUVLBO PMFI HSBEJFO UFLBOBO QBEB Aliran Darah dalam Vasa Rekta Medula Ginjal Jauh Lebih
QFNCVMVI SFOBM QFSCFEBBO BOUBSB UFLBOBO IJESPTUBUJL EJ BSUFSJ Rendah Dibandingkan dengan Aliran dalam Korteks Ginjal
SFOBMJTEBOWFOBSFOBMJT
EJCBHJEFOHBOUBIBOBOQFNCVMVISFOBM #BHJBO MVBS HJOKBM ZBJUV LPSUFLT SFOBM NFOFSJNB TFCBHJBO
UPUBM CFTBS BMJSBO EBSBI HJOKBM "MJSBO EBSBI QBEB NFEVMB HJOKBM
IBOZB NFODBLVQ TBNQBJ QFSTFO EBSJ BMJSBO EBSBI HJOKBM
(Tekanan arteri renalis —Tekanan vena renalis) UPUBM"MJSBOLFNFEVMBHJOKBMEJQBTPLPMFICBHJBOLIVTVTEBSJ
Tahanan pembuluh renal total TJTUFN LBQJMFS QFSJUVCVMVT ZBOH EJTFCVU WBTB SFLUB 1FNCVMVI
JOJ UVSVO NFOVKV NFEVMB EBO CFSKBMBO QBSBMFM EFOHBO BOTB
5FLBOBO BSUFSJ SFOBMJT LJSBLJSB TBNB EFOHBO UFLBOBO BSUFSJ )FOMF VOUVL LFNVEJBO NFMFOHLVOH LFNCBMJ LF BUBT CFSTBNB
TJTUFNJL EBO UFLBOBO WFOB SFOBMJT SBUBSBUB TFLJUBS TBNQBJ EFOHBO BOTB )FOMF EBO LFNCBMJ LF LPSUFLT TFCFMVN NFOHBMJS
NN )H QBEB TFCBHJBO CFTBS LPOEJTJ 4FQFSUJ QBEB TJTUFN LF TJTUFN WFOB 4FQFSUJ ZBOH EJCBIBT QBEB #BC WBTB SFLUB
QFNCVMVI EBSBI MBJOOZB UBIBOBO QFNCVMVI UFOBM UPUBM EJ CFSQFSBO QFOUJOH EBMBN NFNVOHLJOLBO HJOKBM VOUVL NFN
TFMVSVI HJOKBM EJUFOUVLBO PMFI KVNMBI UBIBOBO QBEB NBTJOH CFOUVLVSJOFZBOHQFLBU
NBTJOH TFHNFO QFNCVMVI EBSBI UFSNBTVL BSUFSJ BSUFSJPM
LBQJMFS EBOWFOB 5BCFM

4FCBHJBO CFTBS UBIBOBO QFNCVMVI SFOBM UFSMFUBL QBEB UJHB
Kontrol Fisiologis terhadap Filtrasi Glomerulus
TFHNFO VUBNB BSUFSJ JOUFSMPCVMBSJT BSUFSJPM BGFSFO EBO BSUFSJPM
dan Aliran Darah Ginjal
FGFSFO 5BIBOBO EJ QFNCVMVI JOJ EJLPOUSPM PMFI TJTUFN TBSBG
1FOFOUV -'( ZBOH QBMJOH CFSWBSJBTJ EBO NFOKBEJ TVCKFL
TJNQBUJT CFSCBHBJIPSNPO EBONFLBOJTNFQFOHBUVSBOJOUFSOBM
LPOUSPM GJTJPMPHJT JBMBI UFLBOBO IJESPTUBUJL HMPNFSVMVT EBO
HJOKBM TFUFNQBU TFQFSUJ ZBOH BLBO EJCBIBT LFNVEJBO ,FOBJLBO
UFLBOBO PTNPUJL LPMPJE EJ LBQJMFS HMPNFSVMVT 4FMBOKVUOZB
UBIBOBO QBEB TFUJBQ TFHNFO QFNCVMVI EBSBI HJOKBM DFOEFSVOH
WBSJBCFM JOJ EJQFOHBSVIJ PMFI TJTUFN TBSBG TJNQBUJT IPSNPO
BLBO NFOHVSBOHJ BMJSBO EBSBI HJOKBM TFEBOHLBO QFOVSVOBO
EBO BVUBLPJE [BU WBTPBLUJG ZBOH EJMFQBTLBO EBMBN HJOKBM EBO
UBIBOBO WBTLVMBS BLBO NFOJOHLBULBO BMJSBO EBSBI HJOKBM KJLB
CFLFSKB TFDBSB MPLBM
EBO LPOUSPM VNQBO CBMJL MBJOOZB ZBOH
UFLBOBOBSUFSJEBOWFOBSFOBMJTUFUBQLPOTUBO
CFSTJGBUJOUSJOTJLUFSIBEBQHJOKBM
8BMBVQVO QFSVCBIBO UFLBOBO BSUFSJ NFNQVOZBJ CFCFSBQB
QFOHBSVI UFSIBEBQ BMJSBO EBSBI HJOKBM HJOKBM NFNQVOZBJ
NFLBOJTNF ZBOH FGFLUJG VOUVL NFNQFSUBIBOLBO BMJSBO EBSBI Penurunan LFG Akibat Aktivasi Sistem Saraf Simpatis
HJOKBM EBO -'( BHBS SFMBUJG LPOTUBO QBEB LJTBSBO UFLBOBO BSUFSJ 1BEB EBTBSOZB TFNVB QFNCVMVI EBSBI HJOKBM UFSNBTVL
BOUBSB EBO NN )H QSPTFT ZBOH EJTFCVU BVUPSFHVMBTJ BSUFSJPM BGFSFO EBO FGFSFO LBZB BLBO QFSTBSBGBO TFSBU TBSBG
,BQBTJUBT BVUPSFHVMBTJ JOJ UFSKBEJ NFMBMVJ NFLBOJTNF ZBOH TJNQBUJT "LUJWBTJ TBSBG TJNQBUJT HJOKBM ZBOH LVBU EBQBU
TFMVSVIOZB JOUSJOTJL QBEB HJOKBM TFQFSUJ ZBOH BLBO LJUB CBIBT NFOHBLJCBULBO LPOTUSJLTJ BSUFSJPM HJOKBM EBO NFOVSVOLBO
LFNVEJBOEBMBNCBCJOJ BMJSBOEBSBIHJOKBMTFSUB-'(3BOHTBOHTJNQBUJTZBOHSJOHBO
317
BUBVTFEBOHNFNCFSJLBOQFOHBSVIZBOHLFDJMQBEBBMJSBOEBSBI Angiotensin II Lebih Cenderung Menyebabkan Konstriksi

HJOKBM EBO -'( 4FCBHBJ DPOUPI BLUJWBTJ SFGMFLT TJTUFN TBSBG Arteriol Eferen pada Sebagian Besar Keadaan Fisiologis.
TJNQBUJTZBOHEJTFCBCLBOPMFIQFOVSVOBOTFEBOHQBEBUFLBOBO 7BTPLPOTUSJLUPS HJOKBM ZBOH LVBU ZBJUV BOHJPUFOTJO EBQBU
CBSPSFTFQUPS EJ TJOVT LBSPUJE BUBV SFTFQUPS LBSEJPQVMNPOBM EJBOHHBQTFCBHBJIPSNPOZBOHCFSFEBS EBOKVHBTFCBHBJBVUBLPJE
IBOZBNFNCFSJLBOQFOHBSVILFDJMQBEBBMJSBOEBSBIHJOKBMBUBV ZBOH EJIBTJMLBO TFDBSB MPLBM LBSFOB EJCFOUVL EBMBN HJOKBM EBO
-'( TJSLVMBTJ TJTUFNJL 3FTFQUPS VOUVL BOHJPUFOTJO ** BEB EJ IBNQJS
TFNVBQFNCVMVIEBSBIHJOKBM/BNVOEFNJLJBO QFNCVMVIEBSBI
4BSBG TJNQBUJT HJOKBM UBNQBLOZB CFSQFSBO QFOUJOH EBMBN
QSBHMPNFSVMBS UFSVUBNB BSUFSJPM BGFSFO OBNQBLOZB SFMBUJG
NFOVSVOLBO -'( TFMBNB HBOHHVBO BLVU EBO CFSBU ZBOH
UFSMJOEVOHJ EBSJ LPOTUSJLTJ BLJCBU BOHJPUFOTJO ** QBEB TFCBHJBO
CFSMBOHTVOH TFMBNB CFCFSBQB NFOJU TBNQBJ CFCFSBQB KBN
CFTBSLFBEBBOGJTJPMPHJTZBOHCFSLBJUBOEFOHBOQFOHBLUJGBOTJTUFN
TFQFSUJZBOHEJUJNCVMLBOPMFISFBLTJQFSUBIBOBO JTLFNJBPUBL
SFOJOBOHJPUFOTJO TFQFSUJ TFMBNB EJFU SFOEBIOBUSJVN BUBV
BUBV QFSEBSBIBO IFCBU 1BEB PSBOH TFIBU EBMBN LFBEBBO
UFLBOBO QFSGVTJ HJOKBM ZBOH CFSLVSBOH BLJCBU TUFOPTJT BSUFSJ
JTUJSBIBU UBNQBLOZB UPOVT TJNQBUJT IBOZB BLBO NFNCFSJ
SFOBMJT 1FSMJOEVOHBO JOJ EJTFCBCLBO PMFI QFMFQBTBO WBTPEJMBUPS
TFEJLJUQFOHBSVIUFSIBEBQBMJSBOEBSBIHJOKBM
UFSVUBNBPLTJEBOJUSBUEBOQSPTUBHMBOEJO ZBOHNFOJBEBLBOQFOH
BSVIWBTPLPOTUSJLUPSBOHJPUFOTJO**EJQFNCVMVIEBSBIJOJ
Kontrol Hormonal dan Autakoid pada Sirkulasi Ginjal /BNVO EFNJLJBO BSUFSJPM FGFSFO TBOHBU QFLB UFSIBEBQ
#FCFSBQBIPSNPOEBOBVUBLPJEEBQBUNFNFOHBSVIJ-'(EBO BOHJPUFOTJO ** 0MFI LBSFOB BOHJPUFOTJO ** TFDBSB LIVTVT
BMJSBOEBSBIHJOKBM TFQFSUJZBOHEJDBOUVNLBOQBEB5BCFM NFOZFCBCLBO LPOTUSJLTJ BSUFSJPM FGFSFO QBEB TFCBHJBO CFTBS
LFBEBBO GJTJPMPHJT NBLB QFOJOHLBUBO LBEBS BOHJPUFOTJO ** BLBO
Norepinefrin, Epinefrin, dan Endotelin Menyebabkan NFOJOHLBULBO UFLBOBO IJESPTUBUJL HMPNFSVMVT EBO NFOVSVOLBO
Konstriksi Pembuluh Darah Ginjal dan Menurunkan LFG. BMJSBO EBSBI HJOKBM ,JUB IBSVT JOHBU CBIXB LFOBJLBO QFNCFOUV
)PSNPO ZBOH NFOHBLJCBULBO LPOTUSJLTJ BSUFSJPM BGFSFO EBO LBO BOHJPUFOTJO ** CJBTBOZB UFSKBEJ QBEB LFBEBBO ZBOH EJTFSUBJ
FGFSFO TFIJOHHB NFOZFCBCLBO QFOVSVOBO -'( EBO BMJSBO EFOHBO QFOVSVOBO UFLBOBO BSUFSJ BUBV LFIJMBOHBO WPMVNF ZBOH
EBSBIHJOKBM BOUBSBMBJOJBMBIOPSFQJOFGSJOEBOFQJOFGSJOZBOH DFOEFSVOH NFOVSVOLBO -'( 1BEB LFBEBBO JOJ LFOBJLBO LBEBS
EJMFQBTLBO EBSJ NFEVMB BESFOBM 1BEB VNVNOZB LBEBS BOHJPUFOTJO** ZBOHNFOZFCBCLBOLPOTUSJLTJBSUFSJPMFGFSFO EBQBU
IPSNPOIPSNPOUFSTFCVUEBMBNEBSBITFKBKBSEFOHBOBLUJWJUBT NFNCBOUV NFODFHBI QFOVSVOBO UFLBOBO IJESPTUBUJL HMPNFSVMVT
TJTUFN TBSBG TJNQBUJT KBEJ OPSFQJOFGSJO EBO FQJOFGSJO IBOZB EBO -'( OBNVO QBEB TBBU ZBOH TBNB QFOVSVOBO BMJSBO EBSBI
NFNCFSJ TFEJLJU QFOHBSVI QBEB IFNPEJOBNJLB HJOKBM LFDVBMJ HJOKBM ZBOH EJTFCBCLBO PMFI LPOTUSJLTJ BSUFSJPM FGFSFO UVSVU
EBMBNLPOEJTJZBOHFLTUSFN TFQFSUJQFSEBSBIBOIFCBU CFSQFSBO EBMBN QFOVSVOBO BMJSBO EBSBI ZBOH NFMBMVJ LBQJMFS
QFSJUVCVMVT ZBOH LFNVEJBO NFOZFCBCLBO LFOBJLBO SFBCTPSQTJ
7BTPLPOTUSJLUPS MBJO ZBJUV FOEPUFMJO BEBMBI TVBUV QFQUJEB OBUSJVNEBOBJS TFQFSUJZBOHEJCBIBTQBEB#BC
ZBOH EBQBU EJMFQBTLBO PMFI TFM FOEPUFM WBTLVMBS HJOKBM BUBV +BEJ LFOBJLBOLBEBSBOHJPUFOTJO**ZBOHUFSKBEJQBEBEJFUSFO
KBSJOHBO MBJO ZBOH SVTBL 1FSBO GJTJPMPHJT BVUBLPJE JOJ UJEBL EBI OBUSJVN BUBV LFIJMBOHBO WPMVNF EBQBU NFNCBOUV
TFMVSVIOZB EJNFOHFSUJ /BNVO KJLB QFNCVMVI EBSBI NFNQFSUBIBOLBO -'( EBO FLTLSFTJ QSPEVL TJTB NFUBCPMJL
UFSQPUPOH TFIJOHHB FOEPUFM SVTBL EBO NFMFQBTLBO FOEPUFMJO TFQFSUJ VSFVN EBO LSFBUJOJO
ZBOH OPSNBM ZBOH FLTLSFTJOZB
NBLB WBTPLPOTUSJLUPS LVBU JOJ EBQBU NFNCBOUV IFNPTUBTJT CFSHBOUVOHQBEBGJMUSBTJHMPNFSVMVTQBEBXBLUVZBOHCFSTBNBBO
NFOHVSBOHJ LFIJMBOHBO EBSBI
,BEBS FOEPUFMJO EBMBN LPOTUSJLTJ BSUFSJPM FGFSFO ZBOH EJQJDV PMFI BOHJPUFOTJO ** EBQBU
QMBTNB KVHB NFOJOHLBU QBEB LFBEBBO TBLJU UFSUFOUV ZBOH NFOZFCBCLBO LFOBJLBO SFBCTPSQTJ OBUSJVN EBO BJS EJ EBMBN
EJTFSUBJ EFOHBO DFEFSB WBTLVMBS TFQFSUJ UPLTFNJB QBEB UVCVMVT ZBOHNFNCBOUVNFNVMJILBOWPMVNFEBSBIEBOUFLBOBO
LFIBNJMBO HBHBMHJOKBMBLVU EBOVSFNJBLSPOJT EBONVOHLJO EBSBI &GFL BOHJPUFOTJO ** EBMBN NFNCBOUV BVUPSFHVMBTJ -'(
CFSQFSBOEBMBNQSPTFTWBTPLPOTUSJLTJHJOKBMEBONFOVSVOLBO JOJBLBOEJCBIBTLFNVEJBOEBMBNCBCJOJTFDBSBMFCJIEFUBJM
-'(QBEBCFCFSBQBLFBEBBOZBOHQBUPGJTJPMPHJTJOJ
Endothelial-Derived Nitric Oxide Menurunkan Tahanan
Vaskular Ginjal dan Meningkatkan LFG. 4VBUVKFOJTBVUBLPJE
Tabel 26-4 Hormon dan Autakoid yang Memengaruhi LFG
ZBOH NFOVSVOLBO UBIBOBO WBTLVMBS HJOKBM EBO EJMFQBTLBO PMFI
FOEPUFM WBTLVMBS LF TFMVSVI UVCVI EJTFCVU FOEPUIFMJBMEFSJWFE
OJUSJD PYJEF 1SPEVLTJ PLTJEB OJUSBU OJUSJD PYJEF
EBMBN LBEBS
Hormon atau Autakoid Pengaruhnya pada LFG
CBTBM UBNQBLOZB QFOUJOH VOUVL NFNQFSUBIBOLBO WBTPEJMBUBTJ
HJOKBM TFIJOHHB NFNVOHLJOLBO HJOKBM VOUVL NFOHFLTLSFTJLBO
Norepinefrin OBUSJVN EBO BJS EBMBN KVNMBI OPSNBM 0MFI LBSFOB JUV
Epinefrin QFNCFSJBO PCBU ZBOH NFOHIBNCBU QFNCFOUVLBO PLTJEB OJUSBU
EBQBU NFOJOHLBULBO UBIBOBO WBTLVMBS HJOKBM EBO NFOVSVOLBO
Endotelin
-'( TFSUB FLTLSFTJ OBUSJVN VSJOF EBO BLIJSOZB NFOZFCBCLBO
Angiotensin II (mencegah UFLBOBO EBSBI UJOHHJ 1BEB CFCFSBQB QBTJFO IJQFSUFOTJ BUBV QBEB
Endothelial-derived nitric oxide ) QBTJFOEFOHBOBUFSPTLMFSPTJT LFSVTBLBOFOEPUFMQFNCVMVIEBSBI
Prostaglandin EBOQSPEVLTJPLTJEBOJUSBUZBOHUFSHBOHHVEBQBUCFSQFSBOEBMBN
NFOJOHLBULBO WBTPLPOTUSJLTJ HJOKBM EBO QFOJOHLBUBO UFLBOBO
EBSBI
318
Bab 26 Pembentukan Urine oleh GinjaL• I. Filtrasi GiomeruEus,Aliran Darah Ginjal, dan Pengaturannya
Prostoglandin dan Bradikinin Cenderung Meningkatkan HJOKBM ZBJUV NFNQFSUBIBOLBO -'( BHBS SFMBUJG LPOTUBO EBO
LFG. )PSNPO EBO BVUBLPJE ZBOH NFOZFCBCLBO WBTPEJMBUBTJ NFNVOHLJOLBO LPOUSPM ZBOH UFQBU UFSIBEBQ FLTLSFTJ BJS EBO
TFSUB NFOJOHLBULBO BMJSBO EBSBI HJOKBM EBO -'( BOUBSB MBJO [BUUFSMBSVUPMFIHJOKBM
QSPTUBHMBOEJO 1(& EBO 1(*
EBO CSBEJLJOJO ;BU[BU JOJ -'( CJBTBOZB UFUBQ EJBVUPSFHVMBTJ BHBS UFUBQ SFMBUJG
EJCBIBTQBEB#BC.FTLJQVOWBTPEJMBUPSJOJUBNQBLOZBCVLBO LPOTUBO
XBMBVQVO UFSKBEJ GMVLUVBTJ UFLBOBO BSUFSJ TFMBNB
UNIT V
NFSVQBLBOGBLUPSVUBNBZBOHNFOHBUVSBMJSBOEBSBIHJOKBMBUBV BLUJWJUBTZBOHCJBTBEJMBLVLBOPMFITFTFPSBOH4FCBHBJDPOUPI
-'( EBMBN LPOEJTJ OPSNBM WBTPEJMBUPS UFSTFCVU EBQBU QFOVSVOBOUFLBOBOBSUFSJTBNQBJNN)HBUBVQFOJOHLBUBO
NFOHVSBOHJ FGFL WBTPLPOTUSJLUPS HJOKBM BLJCBU BLUJWBTJ TBSBG TBNQBJ NN )H CJBTBOZB NFOHVCBI -'( LVSBOH EBSJ
TJNQBUJT BUBV BOHJPUFOTJO ** UFSVUBNB QFOHBSVIOZB UFSIBEBQ QFSTFO 1BEB VNVNOZB BMJSBO EBSBI HJOKBM EJBVUPSFHVMBTJ
LPOTUSJLTJBSUFSJPMBGFSFO QBSBMFMEFOHBO-'( UFUBQJBVUPSFHVMBTJ-'(MFCJIFGJTJFOQBEB
%FOHBONFMBXBOWBTPLPOTUSJLTJBSUFSJPMBGFSFO QSPTUBHMBOEJO LPOEJTJUFSUFOUV
EBQBU NFNCBOUV NFODFHBI QFOVSVOBO -'( EBO BMJSBO EBSBI
HJOKBM ZBOH CFSMFCJIBO %BMBN LPOEJTJ ZBOH QFOVI TUSFT TFQFSUJ Arti Penting Autoregulasi LFG dalam Mencegah Per-
QBEBLFBEBBOLFIJMBOHBOWPMVNFBUBVTFUFMBIPQFSBTJ QFNCFSJBO ubahan Hebat Ekskresi Renal
PCBUBOUJJOGMBNBTJOPOTUFSPJE TFQFSUJBTQJSJO ZBOHNFOHIBNCBU .FTLJQVO NFLBOJTNF BVUPSFHVMBTJ HJOKBM UJEBL TFNQVSOB
TJOUFTJT QSPTUBHMBOEJO EBQBU NFOHBLJCBULBO QFOVSVOBO -'( UFUBQJ EBQBU NFODFHBI QFSVCBIBO -'( TFSUB FLTLSFTJ BJS EBO
ZBOHCFSBSUJ [BU UFSMBSVU ZBOH IFCBU ZBOH BLBO UFSKBEJ QBEB TFUJBQ
QFSVCBIBO UFLBOBO EBSBI ,JUB EBQBU NFNBIBNJ QFOUJOHOZB
BVUPSFHVMBTJ TFDBSB LVBOUJUBUJG EFOHBO NFMJIBU CFTBS SFMBUJG
Autoregulasi LFG dan Aliran Darah Ginjal GJMUSBTJHMPNFSVMVT SFBCTPSQTJUVCVMVT EBOFLTLSFTJHJOKBMTFSUB
QFSVCBIBOFLTLSFTJHJOKBMZBOHBLBOUFSKBEJUBOQBNFLBOJTNF
.FLBOJTNF VNQBO CBMJL JOUSJOTJL UFSIBEBQ HJOKBM EBQBU BVUPSFHVMBTJJOJ
NFNQFSUBIBOLBO BMJSBO EBSBI HJOKBM EBO -'( BHBS SFMBUJG %BMBN LFBEBBO OPSNBM OJMBJ -'( LJSBLJSB - IBSJ EBO
LPOTUBO XBMBVQVO UFSKBEJ QFSVCBIBO UFLBOBO EBSBI BSUFSJ ZBOH SFBCTPSQTJ UVCVMVT -IBSJ NFOZJTBLBO DBJSBO -IBSJ
OZBUB .FLBOJTNF JOJ UFUBQ CFSGVOHTJ QBEB HJOKBM ZBOH UFMBI VOUVLEJFLTLSFTJLBOLFEBMBNVSJOF#JMBUJEBLBEBBVUPSFHVMBTJ
EJBOHLBUEBSJUVCVIUFUBQJNBTJINFOEBQBUEBSBI EBOCFCBTEBSJ NBLBTFEJLJULFOBJLBOUFLBOBOEBSBI EBSJNFOKBEJNN
QFOHBSVI TJTUFNJL -'( EBO BMJSBO EBSBI HJOKBM ZBOH SFMBUJG )H
BLBONFOZFCBCLBOLFOBJLBO-'(TFCBOZBLQFSTFO EBO
LPOTUBOJOJEJTFCVUBVUPSFHVMBTJ (BNCBS
LJSBLJSB NFOKBEJ -IBSJ
+JLB SFBCTPSQTJ UVCVMVT UFUBQ
'VOHTJVUBNBBVUPSFHVMBTJBMJSBOEBSBIQBEBCBOZBLKBSJOHBO LPOTUBOTFCFTBS -IBSJ LFOBJLBO-'(BLBONFOJOHLBULBO
MBJO TFMBJO HJOKBM BEBMBI VOUVL NFNQFSUBIBOLBO PLTJHFO EBO BMJSBO VSJOF NFOKBEJ -IBSJ TFMJTJI BOUBSB -'( EBO
CBIBO OVUSJTJ MBJO EBMBN LBEBS OPSNBM EBO NFNCVBOH QSPEVL SFBCTPSQTJ UVCVMVT
NFOHBLJCBULBO QFOJOHLBUBO VSJOF UPUBM
TJTB NFUBCPMJTNF XBMBVQVO UFSKBEJ QFSVCBIBO QBEB UFLBOBO MFCJIEBSJLBMJ0MFILBSFOBWPMVNFQMBTNBUPUBMIBOZBLJSB
BSUFSJ 1BEB HJOKBM BMJSBO EBSBIOZB KBVI MFCJI UJOHHJ EBSJQBEB LJSB MJUFS QFSVCBIBO TFQFSUJ JUV BLBO NFOVSVOLBO WPMVNF
ZBOHEJCVUVILBOVOUVLGVOHTJJOJ'VOHTJVUBNBBVUPSFHVMBTJ EBSBIEFOHBODFQBU
1BEB LFOZBUBBOOZB QFSVCBIBO UFLBOBO BSUFSJ IBOZB BLBO
NFOJNCVMLBO TFEJLJU FGFL UFSIBEBQ WPMVNF VSJOF LBSFOB EVB
BMBTBO
BVUPSFHVMBTJHJOKBMNFODFHBIQFSVCBIBO-'(ZBOH
CFTBS ZBOH EBQBU UFSKBEJ EBO
UFSEBQBU NFLBOJTNF BEBQUJG
UBNCBIBO QBEB UVCVMVT HJOKBM ZBOH NFOZFCBCLBOOZB
NFOJOHLBULBO MBKV SFBCTPSCTJ CJMB -'( NFOJOHLBU TVBUV
GFOPNFOB ZBOH EJTFCVU TFCBHBJ JNCBOHBO HMPNFSVMPUVCVMVT
EJCBIBT QBEB #BC
5FSOZBUB NFTLJQVO EFOHBO NFLB
OJTNFLPOUSPMZBOHLIVTVTJOJ QFSVCBIBOUFLBOBOBSUFSJUFUBQ
NFNCFSJ FGFL ZBOH CFSNBLOB UFSIBEBQ FLTLSFTJ BJS EBO
OBUSJVN PMFI HJOKBM IBM JOJ EJTFCVU TFCBHBJ EJVSFTJT UFLBOBO
BUBVOBUSJVSFTJTUFLBOBO EBOIBMJOJQFOUJOHEBMBNQFOHBUVSBO
WPMVNFDBJSBOUVCVIEBOUFLBOBOBSUFSJ TFQFSUJZBOHEJCBIBT
QBEB#BCEBO
Umpan Balik Tubuloglomerulus dan Autoregulasi LFG

6OUVL NFMBLVLBO GVOHTJ BVUPSFHVMBTJ HJOKBM NFNQVOZBJ
NFLBOJTNF VNQBO CBMJL ZBOH NFOHIVCVOHLBO QFSVCBIBO
LPOTFOUSBTJ OBUSJVN LMPSJEB EJ NBLVMB EFOTB EFOHBO
(mm Hg)
QFOHBUVSBO UBIBOBO BSUFSJPM HJOKBM .FLBOJTNF VNQBO CBMJL
JOJ NFNCBOUV NFOKBNJO QFOHJSJNBO OBUSJVN LMPSJEB ZBOH
SFMBUJG LPOTUBO LF UVCVMVT EJTUBM EBO NFNCBOUV NFODFHBI
GMVLUVBTJFLTLSFTJHJOKBMZBOHUJEBLCFOBSZBOHBLBOUFSKBEJCJMB
319
UJEBL BEB NFLBOJTNF VNQBO CBMJL JOJ 1BEB CBOZBL LFBEBBO TB1FOVSVOBOLPOTFOUSBTJOBUSJVNLMPSJEBJOJLFNVEJBONFNJDV
NFLBOJTNF VNQBO CBMJL JOJ NFOHBVUPSFHVMBTJ BMJSBO EBSBI TJOZBMZBOHCFSBTBMEBSJNBLVMBEFOTB EBONFNCFSJLBOEVBFGFL
HJOKBM EBO -'( TFDBSB CFSTBNBBO /BNVO LBSFOB NFLBOJTNF (BNCBS

NFOVSVOLBOUBIBOBOBMJSBOEBSBIEJBSUFSJPM
JOJLIVTVTMBOHTVOHEJUVKVLBOVOUVLNFOTUBCJMLBOQFOHJSJNBO BGFSFO ZBOH NFOJOHLBULBO UFLBOBO IJESPTUBUJL HMPNFSVMVT EBO
OBUSJVN LMPSJEB LF UVCVMVT EJTUBM NBLB UFSEBQBU CFCFSBQB NFNCBOUV NFOHFNCBMJLBO -'( NFOKBEJ OPSNBM EBO

LFBEBBO EJ NBOB -'( EJBVUPSFHVMBTJ EFOHBO NFOHPSCBOLBO NFOJOHLBULBOQFMFQBTBOSFOJOEBOTFMTFMKVLTUBHMPNFSVMVTQBEB
QFSVCBIBOBMJSBOEBSBIHJOKBM TFQFSUJZBOHEJCBIBTLFNVEJBO BSUFSJPMBGFSFOEBOFGFSFO ZBOHNFSVQBLBOUFNQBUQFOZJNQBOBO
.FLBOJTNF VNQBO CBMJL UVCVMPHMPNFSVMVT NFNQVOZBJ EVB VUBNB VOUVL SFOJO 3FOJO ZBOH EJMFQBTLBO EBSJ TFMTFM JOJ
LPNQPOFOZBOHCFLFSKBCFSTBNBTBNBVOUVLNFOHPOUSPM-'( LFNVEJBO CFSGVOHTJ TFCBHBJ FO[JN VOUVL NFOJOHLBULBO

NFLBOJTNFVNQBOCBMJLBOUFSJPMBGFSFOEBO
NFLBOJTNF QFNCFOUVLBO BOHJPUFOTJO * ZBOH BLBO EJVCBI NFOKBEJ
VNQBO CBMJL BSUFSJPM FGFSFO .FLBOJTNF VNQBO CBMJL JOJ BOHJPUFOTJO ** "LIJSOZB BOHJPUFOTJO ** NFOHBLJCBULBO
CFSHBOUVOH QBEB TVTVOBO BOBUPNJ LIVTVT QBEB LPNQMFLT LPOTUSJLTJ BSUFSJPM FGFSFO TFIJOHHB NFOJOHLBULBO UFLBOBO
KVLTUBHMPNFSVMVT (BNCBS
IJESPTUBUJL HMPNFSVMVT EBO NFNCBOUV NFOHFNCBMJLBO -'(
NFOKBEJOPSNBM
,PNQMFLT KVLTUBHMPNFSVMVT UFSEJSJ BUBT TFMTFM NBLVMB EFOTB
QBEB CBHJBO BXBM UVCVMVT EJTUBM EBO TFMTFM KVLTUBHMPNFSVMVT %VB LPNQPOFO NFLBOJTNF VNQBO CBMJL UVCVMPHMPNFSVMVT
QBEBEJOEJOHBOUFSJPMBGFSFOEBOFGFSFO.BLVMBEFOTBNFSVQB JOJ CFLFSKB TBNB NFMBMVJ TUSVLUVS BOBUPNJ LIVTVT BQBSBUVT
LBO LFMPNQPL TFM FQJUFM LIVTVT QBEB UVCVMVT EJTUBM ZBOH KVLTUBHMPNFSVMVT NFNCFSJLBO TJOZBM VNQBO CBMJL LF LFEVB
CFSIVCVOHBOFSBUEFOHBOBOUFSJPMBGFSFOEBOFGFSFO4FMNBLVMB BSUFSJPM BGFSFO EBO FGFSFO VOUVL BVUPSFHVMBTJ -'( ZBOH FGJTJFO
EFOTB NFOHBOEVOH BQBSBUVT (PMHJ PSHBOFM TFLSFUPSJL JOUSBTFM TFMBNB QFSVCBIBO UFLBOBO BSUFSJ +JLB LFEVB NFLBOJTNF JOJ
ZBOH NFOHBSBI LF BSUFSJPM NFNCFSJ LFTBO TFMTFM UFSTFCVU CFSGVOHTJ CFSTBNBTBNB -'( IBOZB CFSVCBI CFCFSBQB QFSTFO
NVOHLJONFOZFLSFTJLBO[BULFBSBIBSUFSJPM CBILBO KVHB QBEB LFBEBBO GMVLUVBTJ UFLBOBO BSUFSJ ZBOH CFTBS
ZBJUVBOUBSBEBONN)H
Penurunan Natrium Klorida di Makula Densa Hambatan Pembentukan Angiotensin II Menambah
Menyebabkan Dilatasi Arteriol Aferen dan Meningkatkan Penurunan Lebih Lanjut LFG selama Hipoperfusi Ginjal.
Pelepasan Renin. 4FMTFM NBLVMB EFOTB NFSBTBLBO BEBOZB 4FQFSUJZBOHUFMBIEJCBIBTTFCFMVNOZB FGFLLPOTUSJLUPSBOHJPUFOTJO**
QFSVCBIBO QFOHJSJNBO WPMVNF LF UVCVMVT EJTUBM NFMBMVJ TJOZBM ZBOH LIVTVT QBEB BSUFSJPM FGFSFO BLBO NFNCBOUV NFODFHBI
ZBOH CFMVN EJNFOHFSUJ TFQFOVIOZB 1FOFMJUJBO FLTQFSJNFOUBM QFOVSVOBO UFLBOBO IJESPTUBUJL HMPNFSVMVT EBO -'( ZBOH CFSBU KJLB
UFLBOBO QFSGVTJ HJOKBM NFOVSVO EJ CBXBI OPSNBM 1FNCFSJBO PCBU
NFOVOKVLLBOCBIXBQFOVSVOBO-'(BLBONFNQFSMBNCBUMBKV ZBOH NFOHIBNCBU QFNCFOUVLBO BOHJPUFOTJO ** BOHJPUFOTJO
BMJSBO EJ BOTB )FOMF NFOZFCBCLBO LFOBJLBO SFBCTPSQTJ JPO DPOWFSUJOHFO[ZNFJOIJCJUPS
BUBVZBOHNFOHIBNCBULFSKBBOHJPUFOTJO
OBUSJVN EBO LMPSJEB QBEB BOTB )FOMF BTFOEFO EBO LBSFOB JUV ** BOUBHPOJTSFTFQUPSBOHJPUFOTJO**
NFOZFCBCLBOQFOVSVOBO-'(
NFOVSVOLBOLPOTFOUSBTJOBUSJVNLMPSJEBEJTFMTFMNBLVMBEFO ZBOHMFCJI
320
Bab 26 Pembentukan Urine oleh Ginjal: I. Filtrasi Glomerulus,Aliran Darah Ginjal, dan Pengaturannya
CFTBS EBSJQBEB CJBTBOZB KJLB UFLBOBO BSUFSJ SFOBMJT UVSVO EJ CBXBI TFQFSUJZBOHUFMBIEJCBIBTTFCFMVNOZB1FOVSVOBOUBIBOBOBSUFSJPM
OPSNBM 0MFI LBSFOB JUV LPNQMJLBTJ QFOUJOH EBSJ QFOHHVOBBO PCBU BGFSFOBLBONFOJOHLBULBOBMJSBOEBSBIHJOKBMEBO-'(,FOBJLBO
UFSTFCVU VOUVL NFOHPCBUJ QBTJFO ZBOH NFNQVOZBJ IJQFSUFOTJ LBSFOB -'(JOJNFOZFCBCLBOFLTLSFTJOBUSJVNEJQFSUBIBOLBOQBEBLBEBS
TUFOPTJT BSUFSJ SFOBMJT IBNCBUBO QBSTJBM QBEB BSUFSJ SFOBMJT
BEBMBI ZBOH NFOEFLBUJ OPSNBM TFNFOUBSB UFSKBEJ LFOBJLBO FLTLSFTJ
QFOVSVOBO -'( ZBOH IFCBU ZBOH EBQBU NFOZFCBCLBO HBHBM HJOKBM BLVU QSPEVLTJTBNFUBCPMJTNFQSPUFJO TFQFSUJVSFVN
QBEBCFCFSBQBLBTVT
/BNVO PCBUPCBUZBOHNFOHIBNCBUBOHJPUFOTJO .FLBOJTNFTFSVQBKVHBEBQBUNFOKFMBTLBOUFSKBEJOZBLFOBJLBO
UNIT V
**EBQBUCFSHVOBTFCBHBJPCBUUFSBQFVUJLQBEBCBOZBLQBTJFOIJQFSUFOTJ BMJSBO EBSBI HJOKBM EBO -'( QBEB LPOEJTJ LBEBS HMVLPTB EBSBI
HBHBMKBOUVOHLPOHFTUJG EBOCFSCBHBJLPOEJTJMBJOTFMBNBQBTJFOUFSTFCVU UJOHHJ ZBOHEJBMBNJ PMFI QBTJFO EJBCFUFT NFMJUVT ZBOH UJEBL
UFUBQ EJBXBTJ VOUVL NFNBTUJLBO UJEBL UFSKBEJ QFOVSVOBO -'( ZBOH UFSLPOUSPM0MFILBSFOBHMVLPTB TBNBTFQFSUJCFCFSBQBKFOJTBTBN
IFCBU BNJOP KVHB EJSFBCTPSCTJ CFSTBNB EFOHBO OBUSJVN EJ UVCVMVT
QSPLTJNBM NBLB LFOBJLBO QFOHJSJNBO HMVLPTB LF UVCVMVT
Autoregulasi Miogenik Aliran Darah Ginjal dan LFG NFOZFCBCLBO UVCVMVT NFSFBCTPSCTJ LFMFCJIBO OBUSJVN CFSTBNB
EFOHBO HMVLPTB )BM JOJ LFNVEJBO NFOVSVOLBO QFOHJSJNBO
.FLBOJTNF MBJO ZBOH NFNCBOUV NFNQFSUBIBOLBO BMJSBO EBSBI OBUSJVN LMPSJEB LF NBLVMB EFOTB NFOHBLUJGLBO EJMBUBTJ BSUFSJPM
HJOKBM EBO -'( BHBS SFMBUJG LPOTUBO BEBMBI LFNBNQVBO TFUJBQ BGFSFOZBOHEJQFSBOUBSBJPMFIVNQBOCBMJLUVCVMPHMPNFSVMVT EBO
QFNCVMVI EBSBI VOUVL NFOBIBO SFHBOHBO ZBOH UFSKBEJ TFMBNB TFMBOKVUOZBNFOJOHLBULBOBMJSBOEBSBIHJOKBMEBO-'(
LFOBJLBO UFLBOBO BSUFSJ GFOPNFOB JOJ EJTFCVU NFLBOJTNF $POUPIJOJNFNQFSMJIBULBOCBIXBBMJSBOEBSBIHJOKBMEBO-'(
NJPHFOJL 1FOFMJUJBO QBEB QFNCVMVI EBSBI UFSVUBNB BSUFSJPM CVLBONFSVQBLBOWBSJBCFMVUBNBZBOHEJLPOUSPMPMFINFLBOJTNF
LFDJM
EJ TFMVSVI UVCVI UFMBI NFOVOKVLLBO QFNCVMVI UFSTFCVU VNQBO CBMJL UVCVMPHMPNFSVMVT 5VKVBO VUBNB VNQBO CBMJL JOJ
JBMBIVOUVLNFNBTUJLBOQFOHJSJNBOOBUSJVNLMPSJEBZBOHLPOTUBO
CFSFTQPOTUFSIBEBQQFOJOHLBUBOUFHBOHBOEJOEJOHBUBVSFHBOHBO
LF UVCVMVT EJTUBM UFNQBU BLIJS QFOHPMBIBO VSJOF +BEJ CFSCBHBJ
EJOEJOH EFOHBO DBSB NFOHPOUSBLTJLBO PUPU QPMPT WBTLVMBS HBOHHVBO ZBOH DFOEFSVOH NFOJOHLBULBO SFBCTPSQTJ OBUSJVN
3FHBOHBO EJOEJOH WBTLVMBS NFNVEBILBO QFOJOHLBUBO QFSHFSB LMPSJEB QBEB UVCVMVT TFCFMVN NFODBQBJ NBLVMB EFOTB DFOEFSVOH
LBOJPOLBMTJVNEBSJDBJSBOFLTUSBTFMLFEBMBNTFM NFOZFCBCLBO BLBO NFOJNCVMLBO LFOBJLBO BMJSBO EBSBI HJOKBM EBO -'( ZBOH
QFNCVMVI CFSLPOUSBLTJ NFMBMVJ NFLBOJTNF ZBOH EJCBIBT QBEB LFNVEJBO BLBO NFNCBOUV NFOHFNCBMJLBO QFOHJSJNBO OBUSJVN
#BC ,POUSBLTJ JOJ NFODFHBI SFHBOHBO CFSMFCJIBO QFNCVMVI LMPSJEBEJTUBMNFOKBEJOPSNBM TFIJOHHBMBKVFLTLSFTJOBUSJVNEBO
EBO QBEB XBLUV ZBOH CFSTBNBBO NFMBMVJ LFOBJLBO UBIBOBO BJSZBOHOPSNBMEBQBUEJQFSUBIBOLBO MJIBU(BNCBS

WBTLVMBS NFNCBOUV NFODFHBI LFOBJLBO BMJSBO EBSBI HJOKBM EBO 6SVUBOQFSJTUJXBZBOHCFSMBXBOBO EBQBUUFSKBEJKJLBSFBCTPSQTJ
-'(ZBOHCFSMFCJIBOLFUJLBUFLBOBOBSUFSJNFOJOHLBU UVCVMVT QSPLTJNBM CFSLVSBOH 4FCBHBJ DPOUPI CJMB UVCVMVT
QSPLTJNBMSVTBL ZBOHEBQBUUFSKBEJBLJCBULFSBDVOBOMPHBNCFSBU
.FTLJQVO NFLBOJTNF NJPHFOJL NVOHLJO CFLFSKB QBEB TFQFSUJ BJS SBLTB BUBV PCBU EPTJT UJOHHJ TFQFSUJ UFUSBTJLMJO
NBLB
TFCBHJBOCFTBSBOUFSJPMEJTFMVSVIUVCVI BSUJQFOUJOHOZBUFSIBEBQ LFNBNQVBOOZB VOUVL NFSFBCTPSCTJ OBUSJVN LMPSJEB BLBO
BVUPSFHVMBTJ BMJSBO EBSBI HJOKBM EBO -'( EJQFSUBOZBLBO PMFI NFOVSVO 4FCBHBJ BLJCBUOZB TFKVNMBI CFTBS OBUSJVN LMPSJEB
CFCFSBQB BIMJ GJTJPMPHJ LBSFOB NFLBOJTNF ZBOH TFOTJUJGUFLBOBO EJLJSJNLBO LF UVCVMVT EJTUBM EBO UBOQB BEBOZB LPNQFOTBTJ ZBOH
JOJUJEBLNFNQVOZBJDBSBVOUVLMBOHTVOHNFOEFUFLTJQFSVCBIBO TFTVBJ TFDBSB DFQBU BLBO NFOZFCBCLBO LFIJMBOHBO WPMVNF EBMBN
BMJSBO EBSBI HJOKBM BUBV -'( /BNVO EFNJLJBO NFLBOJTNF JOJ KVNMBI CFTBS 4BMBI TBUV SFTQPOT LPNQFOTBTJ ZBOH QFOUJOH
UBNQBLOZB BEBMBI WBTPLPOTUSJLTJ HJOKBM ZBOH EJQFSBOUBSBJ PMFI
NVOHLJOMFCJIQFOUJOHEBMBNNFMJOEVOHBJHJOKBMEBSJLFSVTBLBO
VNQBO CBMJL UVCVMPHMPNFSVMVT ZBOH UFSKBEJ TFCBHBJ SFTQPOT
BLJCBU IJQFSUFOTJ 4FCBHBJ KBXBCBO QFOJOHLBUBO UFLBOBO EBSBI UFSIBEBQ QFOJOHLBUBO QFOHJSJNBO OBUSJVN LMPSJEB LF NBLVMB
NFOEBEBL SFTQPOT LPOTUSJLUPS NJPHFOJL EJ BSUFSJPMB BGFSFO EFOTB $POUPI UFSTFCVU TFLBMJ MBHJ NFNQFSMJIBULBO CFUBQB
UFSKBEJ EBMBN CFCFSBQB EFUJL EBO PMFI LBSFOB JUV NFMFNBILBO QFOUJOHOZBNFLBOJTNFVNQBOCBMJLJOJEBMBNNFNBTUJLBOCBIXB
QFOHIBOUBSBOQFOJOHLBUBOUFLBOBOBSUFSJLFLBQJMFSHMPNFSVMVT UVCVMVT EJTUBM UFMBI NFOFSJNB OBUSJVN LMPSJEB [BU UFSMBSVU DBJSBO
UVCVMVT ZBOH MBJO EBO WPMVNF DBJSBO UVCVMVT EFOHBO MBKV
Faktor Lain yang Meningkatkan Aliran Darah Ginjal QFOHJSJNBO ZBOH UFQBU TFIJOHHB [BU[BU UFSTFCVU BLBO
dan LFG: Asupan Tinggi Protein dan Kenaikan Glukosa EJFLTLSFTJLBOEBMBNVSJOFEFOHBOKVNMBIZBOHTFTVBJ
Darah Meskipun aliran
EBSBIHJOKBMEBO-'(SFMBUJGTUBCJMQBEBCBOZBLLPOEJTJ OBNVOUFSEBQBU
CFCFSBQB LFBEBBO ZBOH EJTFSUBJ QFSVCBIBO CFSNBLOB EBSJ WBSJBCFM Daftar Pustaka
WBSJBCFM JOJ 4FCBHBJ DPOUPI BTVQBO UJOHHJ QSPUFJO EJLFUBIVJ EBQBU
Beeuwkes R III: The vascular organization of the kidney, Annu Rev
NFOJOHLBULBOBMJSBOEBSBIHJOKBMEBO-'(1BEBEJFUUJOHHJQSPUFJOZBOH
Physiol 42:531, 1980.
LSPOJT TFQFSUJ ZBOH UFSKBEJ QBEB EJFU ZBOH NFOHBOEVOH TFKVNMBI CFTBS Bell PD, Lapointe JY, Peti-Peterdi J: Macula densa cell signaling, Annu Rev
EBHJOH LFOBJLBO -'( EBO BMJSBO EBSBI HJOKBM JOJ TFCBHJBO EJTFCBCLBO Physiol 65:481, 2003.
PMFI QFSUVNCVIBO HJOKBM /BNVO -'( EBO BMJSBO EBSBI HJOKBM Cowley AW Jr, Mori T, Mattson D, et al: Role of renal NO production in the
NFOJOHLBU QFSTFO EBMBN XBLUV BUBV KBN TFUFMBI TFTFPSBOH regulation of medullary blood flow, Am J Physiol Regul Integr Comp
NBLBONBLBOBOCFSQSPUFJOUJOHHJ Physiol 284:R1355, 2003.
4BMBI TBUV LFUFSBOHBO QFOJOHLBUBO -'( JOJ BEBMBI TFCBHBJ CFSJLVU Cupples WA, Braam B: Assessment of renal autoregulation, Am J Physiol
%BHJOHCFSQSPUFJOUJOHHJNFOJOHLBULBOQFMFQBTBOBTBNBNJOPLFEBMBN Renal Physiol 292:F1105, 2007.
EBSBI ZBOH LFNVEJBO EJSFBCTPSQTJ EJ UVCVMVT QSPLTJNBM 0MFI LBSFOB Deen WN: What determines glomerular capillary permeability? J Clin Invest
114:1412, 2004.
BTBN BNJOP EBO OBUSJVN EJSFBCTPSCTJ CFSTBNB PMFI UVCVMVT QSPLTJNBM
DiBona GF: Physiology in perspective: The Wisdom of the Body. Neural control
NBLB LFOBJLBO SFBCTPSCTJ BTBN BNJOP KVHB NFSBOHTBOH SFBCTPSCTJ
of the kidney, Am J Physiol Regul Integr Comp Physiol 289:R633, 2005.
OBUSJVN EBMBN UVCVMVT QSPLTJNBM 1FOVSVOBO QFOHJSJNBO OBUSJVN LF Drummond HA, Grifoni SC, Jernigan NL: A new trick for an old dogma:
NBLVMB EFOTB MJIBU (BNCBS
JOJ LFNVEJBO NFODFUVTLBO ENaC proteins as mechanotransducers in vascular smooth muscle,
QFOVSVOBO UBIBOBO BSUFSJPM BGFSFO ZBOH EJQFSBOUBSBJ PMFI VNQBO CBMJL Physiology (Bethesda) 23:23, 2008.
UVCVMPHMPNFSVMVT
321
Fowler CJ, Griffiths D, de Groat WC: The neural control of micturition, Nat Kriz W, Kaissling B: Structural organization of the mammalian kidney. In
Rev Neurosci 9:453, 2008. Seldin DW, Giebisch G, eds: The Kidney—Physiology and
Hall JE: Angiotensin II and long-term arterial pressure regulation: the overrid- Pathophysiology, ed 3, New York, 2000, Raven Press, pp 587–654.
ing dominance of the kidney, J Am Soc Nephrol 10:(Suppl 12):s258, 1999. Loutzenhiser R, Griffin K, Williamson G, et al: Renal autoregulation: new
Hall JE, Brands MW: The renin-angiotensin-aldosterone system: renal perspectives regarding the protective and regulatory roles of the under-lying
mechanisms and circulatory homeostasis. In Seldin DW, Giebisch G, eds: mechanisms, Am J Physiol Regul Integr Comp Physiol 290:R1153, 2006.
The Kidney—Physiology and Pathophysiology, ed 3, New York, 2000, Raven Pallone TL, Zhang Z, Rhinehart K: Physiology of the renal medullary micro-
Press, pp 1009–1046. circulation, Am J Physiol Renal Physiol 284:F253, 2003.
Hall JE, Henegar JR, Dwyer TM, et al: Is obesity a major cause of chronic Roman RJ: P-450 metabolites of arachidonic acid in the control of cardio-
kidney disease? Adv Ren Replace Ther 11:41, 2004. vascular function, Physiol Rev 82:131, 2002.
Haraldsson B, Sörensson J: Why do we not all have proteinuria? An update Schnermann J, Levine DZ: Paracrine factors in tubuloglomerular feedback:
of our current understanding of the glomerular barrier, News Physiol adenosine, ATP, and nitric oxide, Annu Rev Physiol 65:501, 2003.
Sci 19:7, 2004.
322
BAB 27
UNIT V
1FNCFOUVLBO6SJOFPMFI(JOKBM
** 3FBCTPSQTJEBO4FLSFTJ5VCVMVT
%BSJ 5BCFM EVB IBM TFHFSB UFSMJIBU EFOHBO KFMBT

Reabsorpsi dan 1FSUBNB VOUVLLFCBOZBLBO[BU QSPTFTGJMUSBTJHMPNFSVMVTEBO
Sekresi Tubulus SFBCTPSQTJ UVCVMVT TFDBSB LVBOUJUBUJG SFMBUJG CFTBS
Ginjal EJCBOEJOHLBOEFOHBOFLTLSFTJVSJOF*OJCFSBSUJCBIXBTFEJLJU
4FXBLUVGJMUSBUHMPNFSVMVT TBKB QFSVCBIBO QBEB GJMUSBTJ HMPNFSVMVT BUBV SFBCTPSCTJ
NFNBTVLJUVCVMVTHJOKBM GJMUSBU UVCVMVT NBLBTFDBSBQPUFOTJBMEBQBUNFOZFCBCLBOQFSVCBIBO
JOJ NFOHBMJS NFMBMVJ CBHJBOCBHJBO UVCVMVT TFDBSB ZBOH SFMBUJG CFTBS QBEB FLTLSFTJ VSJOF 4FCBHBJ DPOUPI
CFSVSVUBOUVCVMVTQSPLTJNBMJT BOTB)FOMF UVCVMVTEJTUBMJT QFOVSVOBO SFBCTPSQTJ UVCVMVT TFCFTBS QFSTFO EBSJ
UVCVMVT LPMJHFOT EBO BLIJSOZB EVLUVT LPMJHFOT TFCFMVN NFOKBEJ -IBSJ BLBO NFOJOHLBULBO WPMVNF VSJOF EBSJ
EJFLTLSFTJLBO TFCBHBJ VSJOF %J TFQBOKBOH KBMBO ZBOH NFOKBEJ -IBSJ NFOJOHLBU IBNQJS LBMJ MJQBU
CJMB
EJMBMVJOZB CFCFSBQB [BU EJSFBCTPSCTJ TFDBSB TFMFLUJG EBSJ MBKV GJMUSBTJ HMPNFSVMVT -'(
UFUBQ LPOTUBO 5FUBQJ QBEB
UVCVMVT LFNCBMJ LF EBMBN EBSBI TFEBOHLBO ZBOH MBJO LFOZBUBBOOZB QFSVCBIBOQFSVCBIBO SFBCTPSQTJ UVCVMVT EBO
EJTFLSFTJLBO EBSJ EBSBI LF EBMBN MVNFO UVCVMVT 1BEB GJMUSBTJ HMPNFSVMVT UFSLPPSEJOBTJ CFHJUV LFUBU TFIJOHHB EBQBU
BLIJSOZB VSJOF ZBOH UFSCFOUVL EBO TFNVB [BU EJ EBMBN EJIJOEBSJUFSKBEJOZBGMVLUVBTJFLTLSFTJVSJOFZBOHCFTBS
VSJOF BLBO NFOHHBNCBSLBO QFOKVNMBIBO EBSJ UJHB QSPTFT ,FEVB UJEBL TFQFSUJ GJMUSBTJ HMPNFSVMVT ZBOH TFDBSB SFMBUJG
EBTBS HJOKBM GJMUSBTJ HMPNFSVMVT SFBCTPSQTJ UVCVMVT EBO UJEBLTFMFLUJG QBEBEBTBSOZBTFNVB[BUUFSMBSVUEBMBNQMBTNB
TFLSFTJUVCVMVT BLBOEJGJMUSBTJLFDVBMJQSPUFJOQMBTNBBUBV[BU[BUZBOHUFSJLBU
Ekskresi urine = Filtrasi glomerulus — Reabsorpsi QBEB QSPUFJO
SFBCTPSQTJ UVCVMVT CFSTJGBU TBOHBU TFMFLUJG
tubulus + Sekresi tubulus #FCFSBQB [BU TFQFSUJ HMVLPTB EBO BTBN BNJOP EJSFBCTPSCTJ
IBNQJS TFNQVSOB EBSJ UVCVMVT TFIJOHHB QBEB EBTBSOZB
6OUVL LFCBOZBLBO [BU EBMBN NFOFOUVLBO LFDFQBUBO
LFDFQBUBOFLTLSFTJVSJOFBEBMBIOPM#BOZBLJPOEBMBNQMBTNB
BLIJS FLTLSFTJ VSJOF SFBCTPSCTJ UVCVMBS NFNFHBOH QFSBO
TFQFSUJ OBUSJVN LMPSJEB EBO CJLBSCPOBU KVHB TBOHBU UJOHHJ
MFCJIQFOUJOHEBSJQBEBTFLSFTJ8BMBVQVOEFNJLJBO TFLSFTJ
EJSFBCTPSCTJ UFUBQJLFDFQBUBOSFBCTPSQTJEBOFLTLSFTJVSJOFOZB
UVCVMVT CFSQFSBO BUBT TFKVNMBI CFTBS JPO LBMJVN JPO
CFSWBSJBTJ CFSHBOUVOH QBEB LFCVUVIBO UVCVI 1SPEVL
IJESPHFOEBOCFCFSBQB[BUMBJOZBOHEJKVNQBJEBMBNVSJOF
CVBOHBOTFQFSUJVSFVNEBOLSFBUJOJO TFEJLJUEJSFBCTPSCTJEBSJ
UVCVMVTEBOEJFLTLSFTJEBMBNKVNMBIZBOHSFMBUJGCFTBS
Reabsorpsi Tubulus secara Kuantitatif Besar 0MFILBSFOBJUV EFOHBONFOHPOUSPMLFDFQBUBOSFBCTPSCTJ
dan Sangat Selektif CFSCBHBJ [BU HJOKBM NFOHBUVS FLTLSFTJ [BU UFSMBSVU TFDBSB
UFSQJTBI ZBOH NFSVQBLBO TVBUV LFNBNQVBO ZBOH QFOUJOH
5BCFM NFOVOKVLLBO QFSMBLVBO HJOKBM VOUVL CFCFSBQB VOUVLQFOHBUVSBOLPNQPTJTJDBJSBOUVCVIZBOHUFQBU%BMBN
[BUZBOHEJGJMUSBTJTFDBSBCFCBTEBMBNHJOKBMEBOEJSFBCTPSCTJ CBC JOJ LJUB NFNCBIBT NFOHFOBJ NFLBOJTNF ZBOH
QBEB LFDFQBUBO ZBOH CFSCFEBCFEB ,FDFQBUBO GJMUSBTJ NFOZFCBCLBOHJOKBMNBNQVTFDBSBTFMFLUJGNFSFBCTPSCTJBUBV
NBTJOHNBTJOH[BUJOJEJIJUVOHTFCBHBJCFSJLVU NFOZFLSFTJCFSCBHBJ[BUQBEBLFDFQBUBOZBOHCFSCFEBCFEB
Filtrasi = Kecepatan filtrasi glomerulus x Konsentrasi
plasma Reabsorpsi Tubulus Termasuk Mekanisme
Pasif dan Aktif
1FSIJUVOHBO JOJ NFOHBOHHBQ [BU[BU EJGJMUSBTJ TFDBSB
CFCBT EBO UJEBL UFSJLBU QBEB QSPUFJO QMBTNB 4FCBHBJ
DPOUPI LBMBV LPOTFOUSBTJ HMVLPTB QMBTNB BEBMBI H- #JMB TVBUV [BU BLBO EJSFBCTPSCTJ QFSUBNB [BU UFSTFCVU IBSVT
KVNMBI HMVLPTB ZBOH EJGJMUSBTJ TFUJBQ IBSJ LJSBLJSB - EJUSBOTQPS
NFMJOUBTJ NFNCSBO FQJUFM UVCVMVT LF EBMBN
IBSJYH- BUBVHIBSJ0MFILBSFOBTFCFUVMOZBTFDBSB DBJSBO JOUFSTUJTJBM HJOKBM EBO LFNVEJBO
NFMBMVJ NFNCSBO
OPSNBM UJEBL BEB HMVLPTB IBTJM GJMUSBTJ ZBOH EJFLTLSFTJLBO LBQJMFSQFSJUVCVMVTLFNCBMJLFEBMBNEBSBI (BNCBS

NBLBLFDFQBUBOSFBCTPSQTJHMVLPTBKVHBHIBSJ
323
+VNMBI ZBOH +VSOUBIZBOH +VNUBIZBOH #FCBO5FSGJMUSBTJZBOH

%JGJUUSBTJ %JSFBCTPSQTJ %JFLTLSFTJ %JSFBCTPSQTJ
Glukosa (g/hari) 180 180 0 100
Bikarbonat (mEq/hari) 4,320 4,318 2 >99.9
Sodium (mEq/hari) 25,560 25,410 150 99.4
Klorida (mEq/hari) 19,440 19,260 180 99.1
Potasium (mEq/hari) 756 664 92 87.8
Ureum (g/hari) 46.8 23.4 23.4 50
Kreatinin (g/hari) 1.8 0 1.8 0
5SBOTQPS BLUJG EBQBU NFOEPSPOH TVBUV [BU UFSMBSVU NFMBXBO

HSBEJFOFMFLUSPLJNJBEBONFNCVUVILBOFOFSHJZBOHCFSBTBMEBO
NFUBCPMJTNF 5SBOTQPS ZBOH CFSIVCVOHBO MBOHTVOH EFOHBO
TVBUV TVNCFS FOFSHJ TFQFSUJ IJESPMJTJT BEFOPTJO USJGPTGBU "51

EJTFCVU TFCBHBJ USBOTQPS BLUJG QSJNFS 4VBUV DPOUPI ZBOH CBJL
BEBMBI QPNQB OBUSJVN LBMJVN "51BTF ZBOH CFSGVOHTJ QBEB
IBNQJSTFNVBCBHJBOUVCVMVTHJOKBM5SBOTQPSZBOHCFSIVCVOHBO
TFDBSB UJEBL MBOHTVOH EFOHBO TVBUV TVNCFS FOFSHJ TFQFSUJ ZBOH
EJBLJCBULBO PMFI HSBEJFO JPO EJTFCVU TFCBHBJ USBOTQPS BLUJG
TFLVOEFS 3FBCTPSQTJ HMVLPTB PMFI UVCVMVT HJOKBM BEBMBI TVBUV
DPOUPIEBSJUSBOTQPSBLUJGTFLVOEFS8BMBVQVO[BUUFSMBSVUEBQBU
EJSFBCTPSCTJPMFIUVCVMVTNFMBMVJNFLBOJTNFBLUJGEBOBUBVQBTJG
BJS TFMBMV EJSFBCTPSCTJ EFOHBO NFLBOJTNF GJTJL QBTJG OPOBLUJG

ZBOH EJTFCVU PTNPTJT ZBOH CFSBSUJ TVBUV EJGVTJ BJS EBSJ EBFSBI
EFOHBOLPOTFOUSBTJ[BUUFSMBSVUZBOHSFOEBI LPOTFOUSBTJBJSZBOH
UJOHHJ
LF EBFSBI EFOHBO LPOTFOUSBTJ [BU UFSMBSVU UJOHHJ
LPOTFOUSBTJBJSSFOEBI

Zat Terlarut Dapat Ditranspor melalui Sel Epitel atau
Antara Sel-Sel4FMTFMUVCVMVTHJOKBM TFQFSUJTFMTFMFQJUFMMBJOOZB
UFSJLBU TBUV TBNB MBJO PMFI UBVU FSBU UJHIU KVODUJPOT
3VBOH
JOUFSTFMVMBS MBUFSBMJT UFSEBQBU EJ CFMBLBOH UBVU FSBU EBO
NFNJTBILBOTFMTFMFQJUFMUVCVMVT;BUUFSMBSVUEBQBUEJSFBCTPSCTJ
BUBVEJTFLSFTJNFMJOUBTJTFMTFMNFMBMVJKBMVSUSBOTFMVMBS BUBVBOUBSB
TFMTFMEFOHBOCFSHFSBLNFMJOUBTJUBVUFSBUEBOSVBOHJOUFSTFMVMBS
0MFI LBSFOB JUV SFBCTPSQTJ BJS EBO [BU UFSMBSVU NFMJQVUJ
NFMBMVJ KBMVS QBSBTFMVMBS /BUSJVN BEBMBI TVBUV VOTVS ZBOH
TFSBOHLBJBO MBOHLBI USBOTQPS 3FBCTPSQTJ NFMBMVJ FQJUFM
CFSHFSBL NFMBMVJ LFEVB KBMVS XBMBVQVO TFCBHJBO CFTBS OBUSJVN
UVCVMVTLFEBMBNDBJSBOJOUFSTUJTJBMNFMJQVUJUSBOTQPSBLUJG
EJUSBOTQPSNFMBMVJKBMVSUSBOTFMVMBS1BEBCFCFSBQBTFHNFOOFGSPO
BUBVQBTJGEFOHBONFLBOJTNFEBTBSZBOHTBNBTFQFSUJZBOH
UFSVUBNB UVCVMVT QSPLTJNBM BJS KVHB EJSFBCTPSCTJ NFMBMVJ KBMVS
EJCBIBTEBMBN#BC ZBJUVUSBOTQPSNFMBMVJNFNCSBOMBJO
QBSBTFMVMBS EBO [BU[BU ZBOH UFSMBSVU EBMBN BJS LIVTVTOZB JPO
EBMBN UVCVI 4FCBHBJ DPOUPI BJS EBO [BU UFSMBSVU EBQBU
LBMJVN NBHOFTJVN EBO LMPSJEB EJCBXB CFSTBNB DBJSBO ZBOH
EJUSBOTQPS NFMBMVJ NFNCSBO TFMOZB TFOEJSJ KBMVS
EJSFBCTPSCTJEJBOUBSBTFMTFM
USBOTFMVMBS
BUBVNFMBMVJSVBOHBOUBSTFM KBMVSQBSBTFMVMBS

,FNVEJBO TFUFMBI BCTPSQTJ NFMBMVJ TFM FQJUFM UVCVMVT LF Transpor Aktif Primer melalui Membran Tubulus
EBMBNDBJSBOJOUFSTUJTJBMJOJ BJSEBO[BUUFSMBSVUTFMBOKVUOZB Berhubungan dengan Hidrolisis ATP 1FSBO USBOTQPS BLUJG
EJUSBOTQPSNFMBMVJEJOEJOHLBQJMFSLFEBMBNEBSBIEFOHBO QSJNFSZBOHQFOUJOHBEBMBICBIXBIBMJOJEBQBUNFOHHFSBLLBO[BU
DBSBVMUSBGJMUSBTJ CVMLGMPX
ZBOHEJQFSBOUBSBJPMFIUFLBOBO UFSMBSVU NFMBXBO TVBUV HSBEJFO FMFLUSPLJNJB &OFSHJ VOUVL
IJESPTUBUJL EBO UFLBOBO PTNPUJL LPMPJE ,BQJMFS USBOTQPS BLUJG JOJ CFSTVNCFS EBSJ IJESPMJTJT "51 NFMBMVJ "51BTF
QFSJUVCVMVT CFSTJGBU TFQFSUJ VKVOH WFOB EBSJ LBQJMFS QBEB ZBOH UFSJLBU NFNCSBO "51BTF JOJ KVHB NFSVQBLBO TVBUV
VNVNOZB LBSFOB UFSEBQBU EBZB SFBCTPSQTJ OFUP ZBOH LPNQPOFO EBSJ NFLBOJTNF LBSJFS ZBOH NFOHJLBU EBO
NFOHHFSBLLBO DBJSBO EBO [BU UFSMBSVU EBSJ JOUFSTUJTJVN LF NFOHHFSBLLBO [BU UFSMBSVU NFMJOUBTJ NFNCSBO TFM 1FOHBOHLVU
EBMBNEBSBI BLUJGQSJNFSEJHJOKBMZBOHUFMBIEJLFOBMBOUBSBMBJOOBUSJVN
324
Bab 27 Pembentukan Urine oleh Ginjal: II. Reabsorpsi dan Sekresi Tubulus
NFMFQBTLBOJPOJOJLFEBMBNTFM TFIJOHHBNFOHIBTJMLBOEJGVTJ
UFSGBTJMJUBTJ OBUSJVN NFMBMVJ NFNCSBO LF EBMBN TFM 1SPUFJO
QFNCBXB OBUSJVN JOJ KVHB QFOUJOH VOUVL USBOTQPS BLUJG
UNIT V
TFLVOEFS [BU[BU MBJO TFQFSUJ HMVLPTB EBO BTBN BNJOP ZBOH
Na BLBOLJUBCBIBTLFNVEJBO
%FOHBOEFNJLJBO SFBCTPSQTJBLIJSJPOOBUSJVNEBSJMVNFO
UVCVMVT LFNCBMJ LF EBMBN EBSBI NFMJCBULBO TFUJEBLOZB UJHB
UBIBQCFSJLVU
1. /BUSJVN CFSEJGVTJ NFMBMVJ NFNCSBO MVNJOBM ZBOH KVHB
EJTFCVU NFNCSBO BQJLBM
LF EBMBN TFM NFOHJLVUJ TVBUV
HSBEJFOFMFLUSPLJNJBZBOHUFSCFOUVLPMFIQPNQBOBUSJVN
LBMJVN"51BTFQBEBTJTJCBTPMBUFSBMNFNCSBO
2. /BUSJVNEJUSBOTQPSNFMBMVJNFNCSBOCBTPMBUFSBMNFMBXBO
TVBUV HSBEJFO FMFLUSPLJNJB ZBOH EJUJNCVMLBO PMFI QPNQB
OBUSJVNLBMJVN"51BTF
3. /BUSJVN BJS EBO [BU[BU MBJO EJSFBCTPSCTJ EBSJ DBJSBO
JOUFSTUJTJBM LF EBMBN LBQJMFS QFSJUVCVMVT EFOHBO DBSB
VMUSBGJMUSBTJ ZBJUVTVBUVQSPTFTQBTJGZBOHEJHFSBLBOPMFI
HSBEJFO UFLBOBO IJESPTUBUJL EBO UFLBOBO LPMPJE
PTNPUJL
Reabsorpsi Aktif Sekunder melalui Membran Tubulus.

LBMJVN"51BTF IJESPHFO"51BTF IJESPHFOLBMJVN"51BTF EBO 1BEB USBOTQPS BLUJG TFLVOEFS EVB BUBV MFCJI [BU CFSJOUFSBLTJ
LBMTJVN"51BTF EFOHBO TVBUV QSPUFJO NFNCSBO TQFTJGJL NPMFLVM DBSSJFS
EBO
EJUSBOTQPS CFSTBNB NFMFXBUJ NFNCSBO 4BBU TBMBI TBUV [BU
4VBUV DPOUPI ZBOH CBJL EBSJ TJTUFN USBOTQPS BLUJG QSJNFS
NJTBMOZB OBUSJVN
CFSEJGVTJ NFOHJLVUJ HSBEJFO
BEBMBISFBCTPSQTJJPOJPOOBUSJVNNFMJOUBTJNFNCSBOUVCVMVT
FMFLUSPLJNJBOZB FOFSHJ ZBOH EJMFQBTLBO EJHVOBLBO VOUVL
QSPLTJNBM TFQFSUJ ZBOH UFSMJIBU QBEB (BNCBS 1BEB TJTJ
NFOHHFSBLLBO [BU MBJO NJTBMOZB HMVLPTB
VOUVL NFMBXBO
CBTPMBUFSBM TFMTFM FQJUFM UVCVMVT NFNCSBO TFM NFNQVOZBJ
HSBEJFO FMFLUSPLJNJBOZB +BEJ USBOTQPS BLUJG TFLVOEFS UJEBL
TJTUFN OBUSJVNLBMJVN "51BTF FLTUFOTJG ZBOH NFOHIJESPMJTJT
NFNCVUVILBO FOFSHJ TFDBSB MBOHTVOH EBSJ "51 BUBV EBSJ
"51 EBO NFOHHVOBLBO FOFSHJ ZBOH EJMFQBTLBO VOUVL
TVNCFS GPTGBU CFSFOFSHJ UJOHHJ ZBOH MBJO 4FCBMJLOZB TVNCFS
NFOUSBOTQPS JPO OBUSJVN LFMVBS EBSJ TFM NBTVL LF EBMBN
FOFSHJ MBOHTVOH BEBMBI FOFSHJ ZBOH EJMFQBTLBO PMFI EJGVTJ
JOUFSTUJTJVN 1BEB XBLUV ZBOH CFSTBNBBO LBMJVN EJUSBOTQPS
UFSGBTJMJUBTJ TFDBSB TJNVMUBO EBSJ [BU[BU MBJO ZBOH EJUSBOTQPS
EBSJ JOUFSTUJTJVN LF EBMBN TFM $BSB LFSKB QPNQB JPO JOJ
NFOHJLVUJHSBEJFOFMFLUSPLJNJBOZB
NFNQFSUBIBOLBO LPOTFOUSBTJ OBUSJVN JOUSBTFM UFUBQ SFOEBI
EBO LBMJVN JOUSBTFM UFUBQ UJOHHJ TFSUB NFODJQUBLBO TVBUV (BNCBS NFOVOKVLLBO USBOTQPS BLUJG TFLVOEFS EBSJ
NVBUBO OFHBUJG BLIJS LJSBLJSB NJMJWPMU EJ EBMBN TFM HMVLPTBEBOBTBNBNJOPEBMBNUVCVMVTQSPLTJNBM1BEBLFEVB
1FNPNQBBO BLUJG OBUSJVN LFMVBS EBSJ TFM NFMJOUBTJ NFNCSBO [BU JOJ QSPUFJO QFOHBOHLVU LIVTVT EJ EBMBN CSVTI CPSEFS
CBTPMBUFSBMTFMNFNCBOUVEJGVTJOBUSJVNTFDBSBQBTJGNFMJOUBTJ CFSJLBUBO EFOHBO JPO OBUSJVN EBO TBUV NPMFLVM BTBN BNJOP
NFNCSBOTFMMVNJOBM EBSJMVNFOUVCVMVTLFEBMBNTFM EFOHBO BUBV HMVLPTB QBEB XBLUV ZBOH CFSTBNBBO .FLBOJTNF
EVB BMBTBO
5FSEBQBU TVBUV HSBEJFO LPOTFOUSBTJ ZBOH NFLBOJTNF USBOTQPS JOJ CFHJUV FGJTJFO TFIJOHHB NFLBOJTNF
NFNCBOUV EJGVTJ OBUSJVN LF EBMBN TFM LBSFOB LPOTFOUSBTJ UFSTFCVU CFUVMCFUVM NFOHBOHLVU TFNVB HMVLPTB EBO BTBN
OBUSJVN JOUSBTFM SFOEBI N&R-
EBO LPOTFOUSBTJ OBUSJVN BNJOPEBSJMVNFOUVCVMVT4FUFMBINBTVLLFEBMBNTFM HMVLPTB
EBMBNDBJSBOUVCVMVTUJOHHJ N&R-
EBO
JOUSBTFMZBOH EBO BTBN BNJOP LFMVBS NFMBMVJ NFNCSBO CBTPMBUFSBM EFOHBO
OFHBUJGNJMJWPUJOJ NFOBSJLJPOOBUSJVNQPTJUJGEBSJMVNFO DBSB EJGVTJ EJEPSPOH PMFI LPOTFOUSBTJ ZBOH UJOHHJ EBSJ HMVLPTB
UVCVMVTLFEBMBNTFM EBO BTBN BNJOP EBMBN TFM ZBOH EJGBTJMJUBTJ PMFI QSPUFJO
USBOTQPSTQFTJGJL
3FBCTPSQTJ BLUJG OBUSJVN PMFI OBUSJVNLBMJVN "51BTF
UFSKBEJ QBEB TFCBHJBO CFTBS UVCVMVT 1BEB CBHJBOCBHJBO ,PUSBOTQPSUFSOBUSJVNHMVLPTB 4(-5EBO4(-5
UFSEBQBU
UFSUFOUV OFGSPO UFSEBQBU QFSMFOHLBQBO UBNCBIBO VOUVL QBEBCSVTICPSEFSTFMUVCVMVTQSPLTJNBMEBONFNCBXBHMVLPTB
NFOHHFSBLLBOOBUSJVNEBMBNKVNMBICFTBSLFEBMBNTFM1BEB LF EBMBN TJUPQMBTNB TFM NFMBXBO HSBEJFO LPOTFOUSBTJ TFQFSUJ
UVCVMVT QSPLTJNBM UFSEBQBU TFKVNUBI CFTBS CSVTI CPSEFS QBEB ZBOH UFMBI EJKFMBTLBO TFCFMVNOZB ,JSBLJSB QFSTFO HMVLPTB
TJTJ MVNJOBM EBO NFNCSBO TJTJ ZBOH NFOHIBEBQ MVNFO ZBOH EJGJMUSBTJ BLBO EJSFBCTPSQTJ PMFI 4(-5 EJ CBHJBO BXBM
UVCVMVT
ZBOH NFNQFSMVBT BSFB QFSNVLBBO LJSBLJSB LBMJ UVCVMVT QSPLTJNBM TFHNFO 4
EBO QFSTFO TJTBOZB
MJQBU%JTJUVKVHBUFSEBQBUQSPUFJOQFNCBXBZBOHNFOHJLBUJPO EJUSBOTQPSPMFI4(-5EJCBHJBOBLIJSUVCVMVTQSPLTJNBM1BEB
OBUSJVNQBEBCBHJBOQFSNVLBBOMVNJOBMNFNCSBOEBO TJTJCBTPMBUFSBMNFNCSBO HMVLPTBCFSEJGVTJLFMVBSTFMNFOVKV
325
Sekresi Aktif Sekunder ke dalam Tubulus. #FCFSBQB [BU

EJTFLSFTJLBO LF EBMBN UVCVMVT EFOHBO DBSB USBOTQPS BLUJG
TFLVOEFS )BM JOJ TFSJOH LBMJ NFMJCBULBO LPOUFSUSBOTQPS
DPVOUFSUSBOTQPSU
[BU EFOHBO JPOJPO OBUSJVN 1BEB LPOUFS
USBOTQPS FOFSHJZBOHEJMFQBTLBOEBSJHFSBLBONBTVLTBMBITBUV
[BU TFCBHBJ DPOUPI JPO OBUSJVN
NFOZFCBCLBO QFSHFSBLBO
LFMVBS[BULFEVBEBMBNBSBIZBOHCFSMBXBOBO
4BMBITBUVDPOUPILPOUFSUSBOTQPS EJUVOKVLLBOQBEB(BNCBS
Amino acids BEBMBI TFLSFTJ BLUJG JPO IJESPHFO ZBOH UFSBOHLBJ EFOHBO
SFBCTPSQTJ OBUSJVN QBEB NFNCSBO MVNJOBM UVCVMVT QSPLTJNBM
%BMBN IBM JOJ OBUSJVN NBTVL LF EBMBN TFM CFSTBNBBO EFOHBO
QFOHFMVBSBO IJESPHFO EBSJ TFM PMFI LPOUFSUSBOTQPS OBUSJVN
IJESPHFO 5SBOTQPS JOJ EJQFSBOUBSBJ PMFI TVBUV QSPUFJO TQFTJGJL
FYDIBOHFS OBUSJVN IJESPHFO
QBEB CSVTI CPSEFS NFNCSBO
MVNJOBM 4FXBLUV OBUSJVN EJBOHLVU LF CBHJBO EBMBN TFM JPO
IJESPHFO EJEFTBL LFMVBS EBSJ BSBI ZBOH CFSMBXBOBO LF EBMBN
MVNFO UVCVMVT 1SJOTJQ EBTBS EBSJ USBOTQPS BLUJG QSJNFS EBO
TFLVOEFSEJCBIBTTFDBSBMFCJIEFUBJMQBEB#BC
Pinositosis—Suatu Mekanisme Transpor Aktif untuk

Reabsorpsi Protein.#FCFSBQBCBHJBOEBSJUVCVMVT UFSVUBNBUV
CVMVT QSPLTJNBM NFSFBCTPSCTJ NPMFLVMNPMFLVM CFTBS TFQFSUJ
QSPUFJOEFOHBODBSBQJOPTJUPTJT%BMBNQSPTFTJOJ QSPUFJONFMFLBU
LF CSVTI CPSEFS NFNCSBO MVNJOBM EBO LFNVEJBO CBHJBO
NFNCSBO JOJ CFSJOWBHJOBTJ LF CBHJBO EBMBN TFM TBNQBJ QSPUFJO
UFSKFQJU EFOHBO TFNQVSOB EBO UFSCFOUVL TVBUV WFTJLFM ZBOH
NFOHBOEVOHQSPUFJOUFSTFCVU4FHFSBTFUFMBICFSBEBEJEBMBNTFM
QSPUFJO JUV EJDFSOB NFOKBEJ BTBN BNJOP QFOZVTVOOZB ZBOH
EJSFBCTPSCTJ NFMFXBUJ NFNCSBO CBTPMBUFSBM LF EBMBN DBJSBO
JOUFSTUJTJBM 0MFI LBSFOB QJOPTJUPTJT NFNCVUVILBO FOFSHJ NBLB
EJEVHBNFSVQBLBOTVBUVCFOUVLUSBOTQPSBLUJG
SVBOHJOUFSTUJTJBMEFOHBOCBOUVBOUSBOTQPSUFSHMVLPTB(--*5 Transpor Maksimum untuk Zat yang Direabsorbsi
EJTFHNFO4 EBO(-65EJCBHJBOBLIJS TFHNFO4
UVCVMVT Secara Aktif. 1BEB LFCBOZBLBO [BU ZBOH EJSFBCTPSCTJ EBO
QSPLTJNBM EJTFLSFTJLBOTFDBSBBLUJG UFSEBQBUTVBUVCBUBTLFDFQBUBOBHBS[BU
8BMBVQVO USBOTQPS HMVLPTB NFMBXBO HSBEJFO LJNJB UJEBL UFSMBSVU EBQBU EJUSBOTQPS TFSJOH EJTFCVU TFCBHBJ USBOTQPS
TFDBSB MBOHTVOH NFOHHVOBLBO "51 SFBCTPSQTJ HMVLPTB NBLTJNVN ,FUFSCBUBTBO JOJ EJTFCBCLBO PMFI LFKFOVIBO EBSJ
CFSHBOUVOH QBEB FOFSHJ ZBOH EJMFQBTLBO PMFI QPNQB OBUSJVN TJTUFN USBOTQPS TQFGJTJL ZBOH EJMJCBULBO BQBCJMB KVNMBI [BU
LBMJVN "51BTF BLUJG QSJNFS EJ NFNCSBO CBTPMBUFSBM "LJCBU UFSMBSVU ZBOH TBNQBJ LF UVCVMVT EJTFCVU CFCBO UVCVMVT

BLUJWJUBTQPNQBJOJ HSBEJFOFMFLUSPLJNJBVOUVLEJGVTJUFSGBTJMJUBTJ NFMFCJIJ LBQBTJUBT QSPUFJO QFOHBOHLVU EBO FO[JNFO[JN
OBUSJVNZBOHNFMJOUBTJNFNCSBOMVNJOBMEBQBUEJQFSUBIBOLBO TQFTJGJLZBOHUFSMJCBUEBMBNQSPTFTUSBOTQPS
EBOEJGVTJOBUSJVNNBTVLLFEBMBNTFMJOJMBIZBOHNFOZFEJBLBO 4JTUFN USBOTQPS HMVLPTB EJ EBMBN UVCVMVT QSPLTJNBM
FOFSHJ VOUVL USBOTQPS LFMVBS HMVLPTB NFMJOUBTJ NFNCSBO NFSVQBLBO TBUV DPOUPI ZBOH CBJL /PSNBMOZB HMVLPTB UJEBL
MVNJOBMZBOHUFSKBEJQBEBTBBUZBOHCFSTBNBBO0MFILBSFOBJUV UFSEBQBU EBMBN VSJOF LBSFOB QBEB EBTBSOZB TFNVB HMVLPTB ZBOH
SFBCTPSQTJ HMVLPTB JOJ EJTFCVU TFCBHBJ USBOTQPS BLUJG TFLVOEFS EJGJMUSBTJ BLBO EJSFBCTPSCTJ EJ UVCVMVT QSPLTJNBM /BNVO CJMB
LBSFOB HMVLPTB TFOEJSJ EJSFBCTPSCTJ NFMBXBO HSBEJFO LJNJB CFCBO ZBOH EJGJMUSBTJ NFMFCJIJ LFNBNQVBO UVCVMVT NFSFBCTPSCTJ
UFUBQJTFLVOEFSUFSIBEBQUSBOTQPSBLUJGQSJNFSOBUSJVN HMVLPTB NBLBBLBOUFSKBEJFLTLSFTJHMVLPTBEBMBNVSJOF
)BM QFOUJOH MBJOOZB BEBMBI CBIXB TVBUV [BU EJLBUBLBO 1BEB PSBOH EFXBTB USBOTQPS NBLTJNVN HMVLPTB SBUBSBUB
NFOHBMBNJUSBOTQPSBLUJGBQBCJMBQBMJOHTFEJLJUUFSEBQBUTBUV TFLJUBS NHNFOJU TFEBOHLBO CFCBO HMVLPTB ZBOH EJGJMUSBTJ
UBIBQEBMBNSFBCTPSQTJZBOHNFMJCBULBOUSBOTQPSBLUJGQSJNFS IBOZB TFLJUBS NHNFOJU -'( Y HMVLPTB QMBTNB NM
BUBV TFLVOEFS XBMBVQVO UBIBQUBIBQ MBJO EBMBN QSPTFT NFOJUYNHN
%FOHBOQFOJOHLBUBO-'(ZBOHCFTBSEBOBUBV
SFBCTPSQTJ BEBMBI QBTJG 6OUVL SFBCTPSQTJ HMVLPTB UFSKBEJ LPOTFOUSBTJ HMVLPTB QMBTNB ZBOH NFOJOHLBULBO CFCBO HMVLPTB
USBOTQPS BLUJG TFLVOEFS QBEB NFNCSBO MVNJOBM UFUBQJ EJGVTJ ZBOH EJGJMUSBTJ NFMFCJIJ NHNFOJU LFMFCJIBO HMVLPTB ZBOH
UFSGBTJMJUBTJ QBTJG UFSKBEJ EJ NFNCSBO CBTPMBUFSBM EBO EJGJMUSBTJUJEBLEJSFBCTPSCTJEBOEJFLTLSFTJLBOLFEBMBNVSJOF
QFOHBNCJMBO QBTJG BLJCBU CVML GMPX ZBOH UFSKBEJ EJ LBQJMFS
QFSJUVCVMVT
326
Bab 27 Pembentukan Urine oleh Ginjal: II, Reabsorpsi dan Sekresi Tubulus
UNIT V
Transpor Maksimum untuk Zat yang Diskresi secara
Aktif. ;BU[BU ZBOH EJTFLSFTJ TFDBSB BLUJG KVHB NFNQVOZBJ
USBOTQPSNBLTJNVNTFCBHBJCFSJLVU
100 200 300 400 500 600 700 800
Zat yang Ditranspor secara Aktif tetapi Tidak

Mempunyai Transpor Maksimum. "MBTBO NFOHBQB [BU
UFSMBSVU ZBOH EJUSBOTQPS TFDBSB BLUJG NFNQVOZBJ USBOTQPS
NBLTJNVN BEBMBI LBSFOB TJTUFN QFOHBOHLVU USBOTQPS
NFOHBMBNJ LFKFOVIBO TFXBLUV CFCBO UVCVMVT CFSUBNCBI
#FCFSBQB [BU ZBOH EJSFBCTPSCTJ TFDBSB QBTJG UJEBL NFNQVOZBJ
USBOTQPSNBLTJNVNLBSFOBMBKVUSBOTQPS[BU[BUJOJEJUFOUVLBO
PMFI GBLUPSGBLUPS MBJO TFQFSUJ
HSBEJFO FMFLUSPLJNJB CBHJ
(BNCBS NFOVOKVLLBO IVCVOHBO BOUBSB LPOTFOUSBTJ EJGVTJ [BU[BU NFMFXBUJ NFNCSBO
QFSNFBCJMJUBT NFNCSBO
HMVLPTB QMBTNB CFCBO HMVLPTB ZBOH EJGJMUSBTJ USBOTQPS CBHJ [BU[BU EBO
MBNBOZB DBJSBO ZBOH NFOHBOEVOH [BU
NBLTJNVN UVCVMVT VOUVL HMVLPTB EBO LFDFQBUBO FLTLSFTJ UFSTFCVU CFSBEB EJ EBMBN UVCVMVT 5JQF USBOTQPS TFQFSUJ JOJ
HMVLPTB LF EBMBN VSJOF 1FSIBUJLBO CBIXB CJMB LPOTFOUSBTJ EJTFCVU USBOTQPS HSBEJFOXBLUV LBSFOB MBKV USBOTQPSOZB
HMVLPTBQMBTNB BEBMBINHNMEBOCFCBOZBOHEJGJMUSBTJ CFSHBOUVOHQBEBHSBEJFOFMFLUSPLJNJBEBOMBNBOZB[BU[BUJUV
QBEB CBUBT OPSNBM NHNFOJU NBLB UJEBL BEB FLTLSFTJ CFSBEB EBMBN UVCVMVT ZBOH TFMBOKVUOZB CFSHBOUVOH QBEB MBKV
HMVLPTBLFEBMBNVSJOF/BNVO CJMBLPOTFOUSBTJHMVLPTBQMBTNB BMJSBOUVCVMVT
NFOJOHLBU NFOKBEJ TFLJUBS NH NM EBO CFCBO ZBOH #FCFSBQB [BU ZBOH EJUSBOTQPS TFDBSB BLUJG KVHB NFNQVOZBJ
EJGJMUSBTJ NFOJOHLBU NFOKBEJ TFLJUBS NHNFOJU TFKVNMBI TJGBU USBOTQPS HSBEJFOXBLUV $POUPIOZB BEBMBI SFBCTPSQTJ
LFDJM HMVLPTB NVMBJ EJFLTLSFTJLBO EBMBN VSJOF 5JUJL JOJ EJTFCVU OBUSJVN EBMBN UVCVMVT QSPLTJNBM "MBTBO VUBNB CBIXB
TFCBHBJ BNCBOH VOUVL HMVLPTB 1FSIBUJLBO CBIXB NVODVMOZB USBOTQPS OBUSJVN EBMBN UVCVMVT QSPLTJNBM UJEBL NFNQVOZBJ
HMVLPTB EBMBN VSJOF QBEB BNCBOH
UFSKBEJ TFCFMVN USBOTQPS TVBUV USBOTQPS NBLTJNVN JBMBI LBSFOB UFSEBQBU GBLUPSGBLUPS
NBLTJNVNUFSDBQBJ4BUVIBMZBOHNFNCFEBLBOBOUBSBBNCBOH MBJOZBOHNFNCBUBTJMBKVSFBCTPSQTJEJTBNQJOHMBKVNBLTJNVN
EBO USBOTQPS NBLTJNVN BEBMBI CBIXB UJEBL TFNVB OFGSPO USBOTQPS BLUJG 4FCBHBJ DPOUPI QBEB UVCVMVT QSPLTJNBM
NFNQVOZBJUSBOTQPSNBLTJNVNZBOHTBNBVOUVLHMVLPTB EBO LBQBTJUBT USBOTQPS NBLTJNVN QPNQB OBUSJVNLBMJVN "51BTF
TFCBHJBO OFGSPO LBSFOB JUV NVMBJ NFOHFLTLSFTJLBO HMVLPTB CBTPMBUFSBM CJBTBOZB KBVI MFCJI CFTBS EBSJQBEB MBKV SFBCTPSQTJ
TFCFMVN CBHJBO ZBOH MBJO NFODBQBJ USBOTQPS NBLTJNVNOZB OBUSJVNZBOHTFCFOBSOZB1FOZFCBCOZBBEBMBILBSFOBTFKVNMBI
4FDBSB LFTFMVSVIBO USBOTQPS NBLTJNVN VOUVL HJOKBM ZBOH CFTBS OBUSJVN ZBOH EJUSBOTQPS LFMVBS TFM NBTVL LFNCBMJ LF
OPSNBMOZB TFLJUBS NHNFOJU UFSDBQBJ BQBCJMB TFNVB OFGSPO EBMBN MVNFO UVCVMVT NFMBMVJ FQJUFM UBVU FSBU -BKV UFSKBEJOZB
UFMBI NFODBQBJ LBQBTJUBT NBLTJNVNOZB VOUVL NFSFBCTPSCTJ LFCPDPSBO JOJ CFSHBOUVOH LFQBEB CFCFSBQB GBLUPS BOUBSB MBJO
HMVLPTB
QFSNFBCJMJUBT UBVU FSBU EBO
HBZBHBZB GJTJLB JOUFSTUJTJBM
(MVLPTB QMBTNB QBEB PSBOH TFIBU IBNQJS UJEBL QFSOBI ZBOH NFOFOUVLBO MBKV SFBCTPSQTJ CVML GMPX EBSJ DBJSBO
NFOKBEJ DVLVQ UJOHHJ VOUVL NFOZFCBCLBO FLTLSFTJ HMVLPTB EJ JOUFSTUJTJBM LF EBMBN LBQJMFS QFSJUVCVMVT 0MFI LBSFOB JUV
EBMBNVSJOF CBILBOTFUFMBINBLBO5FUBQJ QBEBEJBCFUFTNFMJUVT USBOTQPS OBUSJVN EBMBN UVCVMVT QSPLTJNBM UFSVUBNB MFCJI
ZBOH UJEBL UFSLPOUSPM HMVLPTB QMBTNB EBQBU NFOJOHLBU TBNQBJ NFOHJLVUJ QSJOTJQ USBOTQPS HSBEJFOXBLUV EBSJQBEB QSJOTJQ
LBEBS ZBOH UJOHHJ NFOZFCBCLBO CFCBO HMVLPTB ZBOH EJGJMUSBTJ USBOTQPS NBLTJNVN UVCVMVT )BM JOJ CFSBSUJ CBIXB TFNBLJO
NFMFCJIJ USBOTQPS NBLTJNVNOZB EBO TFCBHBJ BLJCBUOZB UFSKBEJ CFTBS LPOTFOUSBTJ OBUSJVN EBMBN UVCVMVT QSPLTJNBM TFNBLJO
FLTLSFTJHMVLPTBEBMBNVSJOF#FCFSBQBUSBOTQPSNBLTJNVNZBOH CFTBSQVMBMBKVSFBCTPSQTJOZB#FHJUVQVMB TFNBLJOMBNCBUMBKV
QFOUJOHVOUVL[BU[BUZBOHEJSFBCTPSCTJTFDBSBBLUJGPMFIUVCVMVT BMJSBO DBJSBO UVCVMVT NBLJO CFTBS QVMBMBI QFSTFOUBTF OBUSJVN
BEBMBITFCBHBJCFSJLVU ZBOHEBQBUEJSFBCTPSCTJEBSJUVCVMVTQSPLTJNBM
327
1BEB CBHJBO ZBOH MFCJI EJTUBM EBSJ OFGSPO TFM FQJUFM CBHJBO BLIJS UVCVMVTVCVMVT EJTUBM UVCVMVT LPMJHFOT EBO EVLUVT
NFNQVOZBJUBVUZBOHMFCJIFSBUEBONFOUSBOTQPSMFCJITFEJLJU LPMJHFOT EBQBU UJOHHJ BUBV SFOEBI CFSHBOUVOH QBEB BEB BUBV
OBUSJVN 1BEB TFHNFO JOJ SFBCTPSQTJ OBUSJVN NFNQVOZBJ UJEBLOZB"%)
USBOTQPS NBLTJNVN ZBOH NJSJQ EFOHBO USBOTQPS NBLTJNVN
VOUVL [BU ZBOH EJUSBOTQPS TFDBSB BLUJG MBJOOZB 4FMBOKVUOZB Reabsorpsi Klorida, Ureum, dan Zat-Zat Terlarut Lainnya
USBOTQPS NBLTJNVN JOJ EBQBU EJQFSCFTBS PMFI QFOHBSVI melalui Difusi Pasif
IPSNPOUFSUFOUV TFQFSUJBMEPTUFSPO
4FXBLUV OBUSJVN EJSFBCTPSCTJ NFMBMVJ TFM FQJUFM UVCVMVT JPO
Reabsorpsi Air secara Pasif melalui Osmosis Terutama OFHBUJGTFQFSUJLMPSJEBEJUSBOTQPSCFSTBNBEFOHBOOBUSJVNLBSFOB
Berhubungan dengan Reabsorpsi Natrium BEBOZBQPUFOTJBMMJTUSJL%FOHBOEFNJLJBO USBOTQPSJPOOBUSJVN
#JMB[BUUFSMBSVUEJUSBOTQPSLFMVBSEBSJUVCVMVTNFMBMVJUSBOTQPS CFSNVBUBO QPTJUJG LFMVBS EBSJ MVNFO BLBO NFOJOHHBMLBO CBHJBO
BLUJG QSJNFS BUBV TFLVOEFS LPOTFOUSBTJOZB DFOEFSVOH EBMBN MVNFO NFOKBEJ CFSNVBUBO OFHBUJG EJCBOEJOHLBO EFOHBO
CFSLVSBOH EJ EBMBN UVCVMVT TFNFOUBSB EJ EBMBN JOUFSTUJTJVN DBJSBO JOUFSTUJTJBM )BM JOJ NFOZFCBCLBO JPO LMPSJEB CFSEJGVTJ
HJOKBM NFOJOHLBU *OJ NFOJNCVMLBO TVBUV QFSCFEBBO TFDBSBQBTJGNFMBMVJKBMVSQBSBTFMVMBS 3FBCTPSQTJ UBNCBIBO JPO
LPOTFOUSBTJ ZBOH NFOZFCBCLBO UFSKBEJOZB PTNPTJT BJS EBMBN LMPSJEB UJNCVM LBSFOB UFSKBEJOZB HSBEJFO LPOTFOUSBTJ LMPSJEB
BSBI ZBOH TBNB EFOHBO USBOTQPS [BU UFSMBSVU EBSJ MVNFO LFUJLBBJSEJSFBCTPSCTJEBSJUVCVMVTEFOHBODBSBPTNPTJT TFIJOHHB
UVCVMVT LF JOUFSTUJTJVN HJOKBM #FCFSBQB CBHJBO EBSJ UVCVMVT NFOHPOTFOUSBTJLBO JPO LJPSJEB EBMBN MVNFO UVCVMVT (BNCBS
HJOKBM UFSVUBNBUVCVMVTQSPLTJNBM TBOHBUQFSNFBCFMUFSIBEBQ
+BEJ SFBCTPSQTJ BLUJG OBUSJVN CFSQBTBOHBO FSBU EFOHBO
BJS EBO SFBCTPSQTJ BJS UFSKBEJ CFHJUV DFQBU TFIJOHHB IBOZB SFBCTPSQTJ QBTJG LMPSJEB NFMBMVJ QPUFOTJBM MJTUSJL EBO HSBEJFO
UFSEBQBUHSBEJFOLPOTFOUSBTJZBOHLFDJMVOUVL[BUUFSMBSVUZBOH LPOTFOUSBTJLMPSJEB
NFMFXBUJNFNCSBOUVCVMVT
*PO LMPSJEB KVHB EBQBU EJSFBCTPSCTJ NFMBMVJ USBOTQPS BLUJG
4FCBHJBO CFTBS BMJSBO PTNPUJL BJS EJ UVCVMVT QSPLTJNBM TFLVOEFS #BHJBO QBMJOH QFOUJOH EBSJ QSPTFT USBOTQPS BLUJG
UFSKBEJ NFMBMVJ UBVU FSBU BOUBSB TFMTFM FQJUFM EBO KVHB NFMBMVJ TFLVOEFS VOUVL SFBCTPSQTJ LMPSJEB NFMJCBULBO LPUSBOTQPS
TFMTFM JUV TFOEJSJ "MBTBO VOUVL IBM JOJ TFQFSUJ ZBOH UFMBI LMPSJEBEFOHBOOBUSJVNNFMBMVJNFNCSBOMVNJOBM
EJCBIBT BEBMBI CBIXB UBVU BOUBSB TFMTFM UJEBL TFFSBU OBNB
6SFVNKVHBEJSFBCTPSCTJTFDBSBQBTJGEBSJUVCVMVTUFUBQJKBVI
ZBOHEJTBOEBOHOZB EBONFNVOHLJOLBOEJGVTJBJSEBOJPOLFDJM
MFCJI TFEJLJU EBSJQBEB JPO LJPSJEB ,FUJLB BJS EJSFBCTPSCTJ EBSJ
MBJOOZBEBMBNKVNMBIZBOHCFSNBLOB)BMJOJUFSKBEJUFSVUBNB
UVCVMVT NFMBMVJ PTNPTJT CFSTBNB EFOHBO SFBCTPSQTJ OBUSJVN

EJ UVCVMVT QSPLTJNBM ZBOH NFNQVOZBJ QFSNFBCJMJUBT UJOHHJ
LPOTFOUSBTJ VSFVN EBMBN MVNFO UVCVMVT NFOJOHLBU MJIBU
UFSIBEBQ BJS EBO QFSNFBCJMJUBT ZBOH MFCJI LFDJM OBNVO UFUBQ
(BNCBS
)BM JOJ NFOJNCVMLBO HSBEJFO LPOTFOUSBTJ ZBOH
CFSNBLOB VOUVL TFCBHJBO CFTBS JPO TFQFSUJ OBUSJVN LMPSJEB
NFOZFCBCLBOSFBCTPSQTJVSFVN"LBOUFUBQJ VSFVNUJEBLEBQBU
LBMJVN LBMTJVN EBONBHOFTJVN
NFNBTVLJ UVCVMVT TFNVEBI BJS 1BEB CFCFSBQB CBHJBO OFGSPO
4FXBLUV BJS CFSHFSBL NFMJOUBTJ UBVU FSBU EFOHBO DBSB UFSVUBNB EJ EVLUVT LPMJHFOT NFEVMB CBHJBO EBMBN SFBCTPSQTJ
PTNPTJT BJS KVHB EBQBU NFNCBXB TFSUB CFCFSBQB [BU UFSMBSVU QBTJG VSFVN EJGBTJMJUBTJ PMFI USBOTQPSUFS VSFVN TQFTJGJL /BNVO
ZBJUV TVBUV QSPTFT ZBOH EJTFCVU TFCBHBJ UBSJLBO [BU UFSMBSVU LJSBLJSB IBOZB TBUV TFUFOHBI VSFVN ZBOH EJGJMUSBTJ NFMBMVJ
TPMWFOU ESBH
4FMBJO JUV LBSFOB SFBCTPSQTJ BJS [BU UFSMBSVU LBQJMFS HMPNFSVMVT BLBO EJSFBCTPSCTJ EBSJ UVCVMVT 6SFVN ZBOH
PSHBOJL EBOJPOUFSKBEJCFSTBNBBOEFOHBOSFBCTPSQTJOBUSJVN NBTJI UFSTJTB BLBO NBTVL LF EBMBN VSJOF NFOZFCBCLBO HJOKBM
NBLB QFSVCBIBO QBEB SFBCTPSQTJ OBUSJVN BLBO TBOHBU NFOHFLTLSFTJLBO TFKVNMBI CFTBS QSPEVL CVBOHBO NFUBCPMJTNF
NFNFOHBSVIJSFBCTPSQTJBJSEBOCBOZBL[BUUFSMBSVUMBJOOZB JOJ1BEBNBNBMJB MFCJIEBSJQFSTFOOJUSPHFOCVBOHBO
1BEBCBHJBOOFGSPOZBOHUFSMFUBLMFCJIEJTUBM NVMBJEBSJBOTB
)FOMF TBNQBJ LF UVCVMVT LPMJHFOT UBVU FSBU JOJ NFOKBEJ KBVI
LVSBOH QFSNFBCFM UFSIBEBQ BJS EBO [BU UFSMBSVU EBO MVBT BSFB
QFSNVLBBONFNCSBOTFMTFMFQJUFMKBVICFSLVSBOH0MFILBSFOB
JUV BJS UJEBL EBQBU CFSHFSBL TFDBSB NVEBI NFMFXBUJ UBVU FSBU
NFNCSBO UVCVMVT EFOHBO PTNPTJT "LBO UFUBQJ IPSNPO
BOUJEJVSFUJL "%)
EBQBU TBOHBU NFOJOHLBULBO QFSNFBCJMJUBT
BJS EJ UVCVMVT EJTUBM EBO UVCVMVT LPMJHFOT TFQFSUJ ZBOH BLBO
EJCBIBTLFNVEJBO
+BEJ QFSHFSBLBOBJSNFMFXBUJFQJUFMUVCVMVTCJTBUFSKBEJIBOZB
CJMB NFNCSBO JUV QFSNFBCFM UFSIBEBQ BJS UJEBL QFEVMJ CFSBQB
CFTBS HSBEJFO PTNPUJLOZB 1BEB UVCVMVT QSPLTJNBM
QFSNFBCJMJUBT BJS TFMBMV UJOHHJ EBO BJS EJSFBCTPSCTJ TFDFQBU [BU
UFSMBSVU 1BEB CBHJBO BTFOEFOT BOTB )FOMF QFSNFBCJMJUBT BJS
TFMBMVSFOEBI TFIJOHHBIBNQJSUJEBLBEBBJSZBOHEJSFBCTPSCTJ
XBMBVQVOHSBEJFOPTNPUJLOZBCFTBS1FSNFBCJMJUBTBJSQBEB
328
NFUBCPMJTNF JOJ 1BEB NBNBMJB MFCJI EBSJ QFSTFO OJUSPHFO

CVBOHBO ZBOH UFSVUBNB EJCFOUVL EJ IBUJ TFCBHBJ IBTJM
NFUBCPMJTNF QSPUFJO CJBTBOZB EJFLTLSFTJ PMFI HJOKBM TFCBHBJ
VSFVN
UNIT V
1SPEVL CVBOHBO NFUBCPMJTNF MBJOOZB ZBJUV LSFBUJOJO BEBMBI
NPMFLVMZBOHCBILBOMFCJICFTBSEBSJVSFVNEBOQBEBEBTBSOZB Na+, Cl –, HCO 3–, K+, H2O,
UJEBL EBQBU NFOFNCVT NFNCSBO UVCVMVT 0MFI LBSFOB JUV glu os , a
LSFBUJOJOZBOHUFMBIEJGJMUSBTJIBNQJSUJEBLBEBZBOHEJSFBCTPSCTJ
TFIJOHHB TFCFOBSOZB TFNVB LSFBUJOJO ZBOH EJGJMUSBTJ PMFI Isosmoti
HMPNFSVMVTBLBOEJFLTLSFTJLBOLFEBMBNVSJOF
H+,
Reabsorpsi dan Sekresi di Sepanjang

Berbagai Bagian Nefron
1BEBCBHJBOTFCFMVNOZB LJUBUFMBINFNCBIBTNFOHFOBJQSJOTJQ
QSJOTJQ EBTBS CBHBJNBOB BJS EBO [BU UFSMBSVU EJUSBOTQPS NFMFXBUJ
NFNCSBO UVCVMVT %FOHBO QFOHFUBIVBO JOJ LJUB TFLBSBOH EBQBU
NFNCBIBT NFOHFOBJ CFSCBHBJ TJGBU TFHNFO UVCVMVT ZBOH
NFNVOHLJOLBOOZB VOUVL NFMBLVLBO GVOHTJ ZBOH TQFTJGJL )BM
ZBOHQBMJOHQFOUJOHEJCJDBSBLBOIBOZBMBIGVOHTJUSBOTQPSUVCVMVT 4FQFSUJ ZBOH UFMBI EJCBIBT EBMBN #BC TFLSFTJ JPO IJESPHFO
TFDBSB LVBOUJUBUJG UFSVUBNB GVOHTJ ZBOH CFSIVCVOHBO EFOHBO LF EBMBN MVNFO UVCVMVT BEBMBI MBOHLBI QFOUJOH EBMBN
SFBCTPSQTJ OBUSJVN LMPSJEB EBO BJS 1BEB CBCCBC CFSJLVUOZB QFNJOEBIBO JPO CJLBSCPOBU EBSJ UVCVMVT EFOHBO
LJUB BLBO NFNCBIBT SFBCTPSQTJ EBO TFLSFTJ EBSJ [BU[BU TQFTJGJL NFOHHBCVOHLBO ) EFOHBO )$0 NFOKBEJ CFOUVL )$0
MBJOOZBQBEBCFSCBHBJCBHJBOTJTUFNUVCVMVT ZBOHLFNVEJBOCFSEJTPTJBTJNFOKBEJ)0EBO$0

Reabsorpsi Tubulus Proksimal 8BMBVQVO QPNQB OBUSJVNLBMJVN "51BTF NFOZFEJBLBO
4FDBSBOPSNBM TFLJUBSQFSTFOEBSJCFCBOOBUSJVNEBOBJSZBOH UFOBHB ZBOH VUBNB VOUVL SFBCTPSQTJ OBUSJVN LMPSJEB EBO BJS
EJGJMUSBTJ EBO OJMBJ QFSTFOUBTF ZBOH TFEJLJU MFCJI SFOEBI EBSJ EJ TFMVSVI UVCVMVT QSPLTJNBM UFSEBQBU CFCFSBQB QFSCFEBBO
LMPSJEB BLBO EJSFBCTPSCTJ PMFI UVCVMVT QSPLTJNBM TFCFMVN GJMUSBU NFLBOJTNFCBHBJNBOBOBUSJVNEBOLMPSJEBEJUSBOTQPSNFMBMVJ
NFODBQBJ BOTB )FOMF 1FSTFOUBTF JOJ EBQBU NFOJOHLBU BUBV TJTJ MVNFO CBHJBO QFSUBNB EBO BLIJS NFNCSBO UVCVMVT
NFOVSVO EBMBN CFSCBHBJ LPOEJTJ GJTJPMPHJT TFQFSUJ ZBOH BLBO QSPLTJNBM
EJCBIBTLFNVEJBO 1BEB QFSUFOHBIBO QFSUBNB UVCVMVT QSPLTJNBM OBUSJVN
EJSFBCTPSCTJ EFOHBO DBSB LPUSBOTQPS CFSTBNBTBNB EFOHBO
Tubulus Proksimal Mempunyai Kapasitas yang Besar HMVLPTB BTBN BNJOP EBO [BU UFSMBSVU MBJOOZB 5FUBQJ QBEB
untuk Reabsorpsi Aktif dan Pasif. ,BQBTJUBT SFBCTPSQTJ ZBOH CBHJBO QFSUFOHBIBO LFEVB EBSJ UVCVMVT QSPLTJNBM IBOZB
CFTBS EBSJ UVCVMVT QSPLTJNBM BEBMBI IBTJM EBSJ TJGBUTJGBU TFEJLJU HMVLPTB EBO BTBN BNJOP ZBOH EJSFBCTPSCTJ +VTUSV
TFMVMBSOZB ZBOH LIVTVT TFQFSUJ EJUVOKVLLBO QBEB (BNCBS TFLBSBOHOBUSJVNZBOHUFSVUBNBEJSFBCTPSCTJCFSTBNBEFOHBO
4FM FQJUFM UVCVMVT QSPLTJNBM CFSTJGBU TBOHBU NFUBCPMJL EBO JPO LMPSJEB 1FSUFOHBIBO LFEVB UVCVMVT QSPLTJNBM NFNJMJLJ
NFNQVOZBJ TFKVNMBI CFTBS NJUPLPOESJB VOUVL NFOEVLVOH LPOTFOUSBTJ LMPSJEB ZBOH SFMBUJG UJOHHJ TFLJUBS N&R-

QSPTFTUSBOTQPSBLUJGZBOHLVBU4FMBJOJUV TFMUVCVMVTQSPLTJNBM EJCBOEJOHLBO EFOHBO CBHJBO BXBM UVCVMVT QSPLTJNBM TFLJUBS
NFNQVOZBJ CBOZBL TFLBMJ CSVTI CPSEFS QBEB TJTJ MVNFO BQJLBM
N&R-
LBSFOB TBBU OBUSJVN EJSFBCTPSCTJ OBUSJVN
NFNCSBO EBOKVHBTVTVOBOJOUFSTFMVMBSTFSUBLBOBMCBTBMJTZBOH NFNCBXB HMVLPTB CJLBSCPOBU EBO JPO PSHBOJL QBEB CBHJBO
MVBT SVNJU TFNVBOZB JOJ CFSTBNBTBNB NFOHIBTJMLBO BSFB BXBM UVCVMVT QSPLTJNBM NFOJOHHBMLBO TVBUV MBSVUBO ZBOH
QFSNVLBBO NFNCSBO ZBOH MVBT QBEB TJTJ MVNFO EBO TJTJ NFNQVOZBJ LPOTFOUSBTJ LMPSJEB ZBOH UJOHHJ %J QFSUFOHBIBO
CBTPMBUFSBMFQJUFMVOUVLNFOUSBOTQPSJPOOBUSJVNEBO[BU[BUMBJO LFEVB UVCVMVT QSPLTJNBM UJOHHJOZB LPOTFOUSBTJ LMPSJEB
EFOHBODFQBU NFNCBOUV EJGVTJ JPO JOJ EBSJ MVNFO UVCVMVT NFMBMVJ UBVU
1FSNVLBBO NFNCSBO FQJUFM CSVTI CPSEFS ZBOH MVBT KVHB JOUFSTFMVMBS LF EBMBN DBJSBO JOUFSTUJTJBM HJOKBM 4FCBHJBO LFDJM
EJNVBUJ NPMFLVM QSPUFJO QFNCBXB ZBOH NFOUSBOTQPS TFCBHJBO LMPSJEB KVHB EJSFBCTPSQTJ NFMBMVJ LBOBM LMPSJEB LIVTVT EJ
CFTBS JPO OBUSJVN NFMFXBUJ NFNCSBO MVNJOBM ZBOH CFSLBJUBO NFNCSBOTFMUVCVMVTQSPLTJNBM
EFOHBOCFSCBHBJOVUSJFOPSHBOJLTFQFSUJBTBNBNJOPEBOHMVLPTB Konsentrasi Zat Terlarut di Sepanjang Tubulus
NFMBMVJ NFLBOJTNF LPUSBOTQPS 5BNCBIBO OBUSJVN EJUSBOTQPS Proksimal. (BNCBS NFNQFSMJIBULBO QFSVCBIBO
EBSJ MVNFO UVCVMVT LF EBMBN TFM EFOHBO NFLBOJTNF LPOUFS LPOTFOUSBTJ CFSCBHBJ [BU UFSMBSVU EJ TFQBOKBOH UVCVMVT
USBOTQPS ZBOH NFSFBCTPSCTJ OBUSJVN TBNCJM NFOZFLSFTJ [BU[BU QSPLTJNBM 8BMBVQVO KVNMBI OBUSJVN EBMBN DBJSBO UVCVMVT
MBJOLFEBMBNMVNFOUVCVMVT UFSVUBNBJPOIJESPHFO NFOVSVOTFDBSBOZBUBEJTFQBOKBOHUVCVMVTQSPLTJNBM
329
4FOZBXB MBJO ZBOH EJTFLSFTJ TFDBSB DFQBU PMFI UVCVMVT

QSPLTJNBM BEBMBI BTBN QBSBBNJOPIJQVSBU 1")
1")
EJTFLSFTJLBO CFHJUV DFQBU TFIJOHHB SBUBSBUB PSBOH EBQBU
NFNCFSTJILBOTFLJUBSQFSTFO1")EBSJQMBTNBZBOHNFOHBMJS
NFMBMVJ HJOKBM EBO NFOHFLTLSFTJLBOOZB LF EBMBN VSJOF 0MFI
LBSFOB BMBTBO JOJ LFDFQBUBO CFSTJIBO 1") EBQBU EJHVOBLBO
VOUVL NFNQFSLJSBLBO MBKV QMBTNB HJOKBM TFQFSUJ ZBOH BLBO
EJCBIBTLFNVEJBO
Transpor Zat Tertarut dan Air dalam Ansa Henle

"OTB )FOMF UFSEJSJ BUBT UJHB TFHNFO GVOHTJPOBM ZBOH CFSCFEB
TFHNFO UJQJT EFTFOEFOT TFHNFO UJQJT BTFOEFOT EBO TFHNFO UFCBM
BTFOEFOT 4FHNFO UJQJT EFTFOEFOT EBO TFHNFO UJQJT BTFOEFOT
TFTVBJ EFOHBO OBNBOZB NFNQVOZBJ NFNCSBO FQJUFM ZBOH UJQJT
UBOQB CSVTI CPSEFS TFEJLJU NJUPLPOESJB EBO UJOHLBU BLUJWJUBT
NFUBCPMJLZBOHSFOEBI (BNCBS

#BHJBOEFTFOEFOTTFHNFOUJQJTTBOHBUQFSNFBCFMUFSIBEBQBJS
EBO TFEJLJU QFSNFBCFM UFSIBEBQ TFCBHJBO CFTBS [BU UFSMBSVU
UFSNBTVLVSFVNEBOOBUSJVN'VOHTJTFHNFOOFGSPOJOJUFSVUBNB
VOUVL NFNVOHLJOLBO EJGVTJ [BU[BU TFDBSB TFEFSIBOB NFMBMVJ
EJOEJOHOZB 4FLJUBS QFSTFO EBSJ BJS ZBOH EJGJMUSBTJ BLBO
EJSFBCTPSCTJEJBOTB)FOMF EBOIBNQJSTFNVBOZBUFSKBEJEJQBST
UJQJTEFTFOEFOT1BSTBTFOEFOT UFSNBTVLTFHNFOUJQJTEBO
LPOTFOUSBTJ OBUSJVN EBO PTNPMBSJUBT UPUBM

UFUBQ SFMBUJG
LPOTUBO LBSFOB QFSNFBCJMJUBT BJS EJ UVCVMVT QSPLTJNBM TBOHBU
CFTBS TFIJOHHB SFBCTPSQTJ BJS EBQBU NFOHJNCBOHJ SFBCTPSQTJ
OBUSJVN ;BU UFSMBSVU PSHBOJL UFSUFOUV TFQFSUJ HMVLPTB BTBN
BNJOP EBOCJLBSCPOBU MFCJICBOZBLEJSFBCTPSCTJEBSJQBEBBJS
TFIJOHHB LPOTFOUSBTJ [BU[BU UFSTFCVU NFOVSVO EFOHBO OZBUB
EJ TFQBOKBOH UVCVMVT QSPLTJNBM ;BU[BU UFSMBSVU PSHBOJL ZBOH
MBJOZBOHLVSBOHQFSNFBCFMEBOUJEBLEJSFBCTPSCTJTFDBSBBLUJG
TFQFSUJ LSFBUJOJO LPOTFOUSBTJOZB NFOJOHLBU EJ TFQBOKBOH
UVCVMVT QSPLTJNBM ,POTFOUSBTJ UPUBM [BU UFSMBSVU TFQFSUJ ZBOH
EJHBNCBSLBO PMFI PTNPMBSJUBT QBEB EBTBSOZB UFUBQ TBNB EJ
TFQBOKBOH UVCVMVT QSPLTJNBM LBSFOB TBOHBU UJOHHJOZB
QFSNFBCJMJUBTCBHJBOOFGSPOJOJUFSIBEBQBJS
Sekresi Asam dan Basa Organik oleh Tubulus Na+, Cl–, K+,
Ca++, HCO3–, Mg++
Proksimal. 5VCVMVT QSPLTJNBM KVHB NFSVQBLBO UFNQBU
QFOUJOH VOUVL TFLSFTJ BTBN EBO CBTB PSHBOJL TFQFSUJ HBSBN
FNQFEV PLTBMBU VSBU EBO LBUFLPMBNJO #BOZBL EBSJ [BU[BU
JOJ NFSVQBLBO QSPEVL BLIJS EBSJ NFUBCPMJTNF EBO IBSVT
EJLFMVBSLBO EBSJ UVCVI TFDBSB DFQBU 4FLSFTJ [BU[BU JOJ LF
EBMBN UVCVMVT QSPLTJNBM EJUBNCBI GJMUSBTJ [BU[BU JOJ LF
EBMBNUVCVMVTQSPLTJNBMPMFILBQJMFSHMPNFSVMVTEBOIBNQJS
UJEBL BEB SFBCTPSQTJ PMFI UVCVMVT TFNVBOZB NFOZFCBCLBO
FLTLSFTJZBOHDFQBULFEBMBNVSJOF
4FMBJO QSPEVL CVBOHBO NFUBCPMJTNF HJOKBM NFOZFLSFTJ
TFDBSB MBOHTVOH CBOZBL PCBU BUBV UPLTJO ZBOH QPUFOTJBM
CFSCBIBZB NFMBMVJ TFMTFM UVCVMVT LF EBMBN UVCVMVT EBO
EFOHBODFQBUNFNCFSTJILBO[BU[BUJOJEBSJEBSBI1BEBPCBU
PCBU UFSUFOUV TFQFSUJ QFOJTJMJO EBO TBMJTJMBU CFSTJIBO ZBOH
DFQBU PMFI HJOKBM NFOJNCVMLBO TVBUV NBTBMBI CBHBJNBOB
NFNQFSUBIBOLBO LPOTFOUSBTJ PCBU BHBS FGFLUJG TFDBSB
UFSBQFVUJL
330
Bab 27 Pembentukan Urine oleh Ginjal: 11. Reabsorpsi dan Sekresi Tubulus
EFTFOEFOT 1BST BTFOEFOT UFSNBTVL TFHNFO UJQJT EBO TFHNFO

UFCBM TFCFOBSOZBUJEBLQFSNFBCFMUFSIBEBQBJS TVBUVLBSBLUFSJTUJL
ZBOHQFOUJOHVOUVLNFNFLBULBOVSJOF
4FHNFO UFCBM BOTB )FOMF ZBOH EJNVMBJ EBSJ TFQBSVI CBHJBO
UNIT V
BUBT QBST BTFOEFOT NFNJMJLJ TFMTFM FQJUFM ZBOH UFCBM ZBOH
NFNQVOZBJ BLUJWJUBT NFUBCPMJL UJOHHJ EBO NBNQV NFMBLVLBO Na Na
SFBCTPSQTJBLUJGOBUSJVN LMPSJEB EBOLBMJVN MJIBU(BNCBS
ATP H
K
4FLJUBS QFSTFO EBSJ CFCBO OBUSJVN LMPSJEB EBO LBMJVN ZBOH
EJGJMUSBTJ BLBO EJSFBCTPSCTJ EJ BOTB )FOMF LFCBOZBLBO EJ QBST .A+
UFCBM BTFOEFOT 4FKVNMBI CFTBS JPO MBJO TFQFSUJ LBMTJVN Cl K
2Cl– -
CJLBSCPOBU EBO NBHOFTJVN KVHB EJSFBCTPSCTJ QBEB QBST UFCBM K+
BTFOEFOT BOTB )FOMF 4FHNFO UJQJT QBST BTFOEFOT NFNJMJLJ
LBQBTJUBTSFBCTPSQTJZBOHMFCJISFOEBIEBSJQBEBTFHNFOUFCBM EBO
QBST EFTFOEFOT UJQJT UJEBL NFSFBCTPSCTJ [BU UFSMBSVU JOJ EBMBN
KVNMBIZBOHCFSNBLOB
4VBUV LPNQPOFO QFOUJOH EBSJ SFBCTPSQTJ [BU UFSMBSVU EBMBN
s
QBST BTFOEFOT UFCBM BEBMBI QPNQB OBUSJVNLBMJVN "51BTF QBEB s
NFNCSBOCBTPMBUFSBMTFMFQJUFM4FQFSUJEBMBNUVCVMVTQSPLTJNBM s
SFBCTPSQTJ [BU UFSMBSVU MBJO EBMBN TFHNFO UFCBM BTFOEFOT BOTB
)FOMF CFSIVCVOHBO FSBU EFOHBO LFNBNQVBO SFBCTPSQTJ QPNQB
OBUSJVN LBMJVN "51BTF ZBOH NFNQFSUBIBOLBO LPOTFOUSBTJ
OBUSJVN JOUSBTFM ZBOH SFOEBI ,POTFOUSBTJ OBUSJVN JOUSBTFM ZBOH
SFOEBI JOJ LFNVEJBO NFOHIBTJMLBO TVBUV HSBEJFO VOUVL
QFSHFSBLBOOBUSJVNEBSJDBJSBOUVCVMVTNBTVLLFEBMBNTFM1BEB
QBST BTFOEFOT UFCBM QFSHFSBLBO OBUSJVN NFMFXBUJ NFNCSBO
MVNJOBM UFSVUBNB EJQFSBOUBSBJ PMFI LPUSBOTQPSUFS OBUSJVN
LMPSJEB LBMJVN (BNCBS
,PUSBOTQPS QSPUFJO QFNCBXB
EBMBNNFNCSBOMVNJOBMJOJNFOHHVOBLBOFOFSHJQPUFOTJBMZBOH
EJMFQBTLBO PMFI EJGVTJ NBTVL OBUSJVN LF EBMBN TFM VOUVL
NFOHFOEBMJLBO SFBCTPSQTJ LBMJVN LF EBMBN TFM NFMBXBO TVBUV
HSBEJFOLPOTFOUSBTJ
4FHNFO UFCBM BTFOEFOT BOTB )FOMF NFSVQBLBO UFNQBU LFSKB QBST BTFOEFOT NFOKBEJ TBOHBU FODFS TFXBLUV DBJSBO NFOHBMJS
EBSJ MPPQ EJVSFUJDT ZBOH LVBU TFQFSUJ GVSPTFNJE BTBN FUBLSJOBU NFOVKV UVCVMVT EJTUBM TVBUV TJGBU ZBOH QFOUJOH VOUVL
EBOCVNFUBOJETFNVBOZBNFOHIBNCBULFSKBOBUSJVN LMPSJEB NFNVOHLJOLBO HJOKBM NFOHFODFSLBO BUBV NFNFLBULBO VSJOF
LPUSBOTQPSUFSLBMJVN%JVSFUJLJOJBLBOEJCBIBTEBMBN#BC QBEB CFSCBHBJ LPOEJTJ TFQFSUJ ZBOH BLBO LJUB CBIBT MFCJI
MFOHLBQEBMBN#BC
1BSTBTFOEFOTUFCBMKVHBNFNJMJLJNFLBOJTNFLPOUFSUSBOTQPS
OBUSJVNIJESPHFO EJ NFNCSBO TFM MVNJOBMOZB ZBOH Tubulus Distal
NFNQFSBOUBSBJ SFBCTPSQTJ OBUSJVN EBO TFLSFTJ IJESPHFO EBMBN 4FHNFOUFCBMBTFOEFOTBOTB)FOMFCFSMBOKVULFEBMBNUVCVMVT
TFHNFOJOJ MJIBU(BNCBS
EJTUBM #BHJBO QFSUBNB EBSJ UVCVMVT EJTUBM NFNCFOUVL NBLVMB
EFOTB TFLFMPNQPL TFM FQJUFM ZBOH UFSTVTVO QBEBU ZBOH
1BEBTFHNFOUFCBMBTFOEFOT KVHBUFSKBEJSFBCTPSQTJQBSBTFMVMBS
NFSVQBLBO CBHJBO EBSJ LPNQMFLT KVLTUBHMPNFSVMVT ZBOH
ZBOH CFSNBLOB EBSJ LBUJPO TFQFSUJ .B $B /Bh EBO ZBOH
NFNCFSJ LPOUSPM VNQBO CBMJL -'( EBO BMJSBO EBSBI EBMBN
EJTFCBCLBO PMFI NVBUBO MVNFO UVCVMVT ZBOH MFCJI QPTJUJG
OFGSPOZBOHTBNB
EJCBOEJOHLBO EFOHBO DBJSBO JOUFSTUJTJBM 8BMBVQVO LP
#BHJBO UVCVMVT EJTUBM TFMBOKVUOZB TBOHBU CFSLFMPLLFMPL
USBOTQPSUFS OBUSJVN LMPSJEB LBMJVN NFNJOEBILBO LBUJPO
EFOHBOCBOZBLDJSJSFBCTPSQTJZBOHTBNBEFOHBOTFHNFOUFCBM
EBO BOJPO LF EBMBN TFM EBMBN KVNMBI ZBOH TBNB UFSKBEJ TFEJLJU
QBST BTFOEFOT BOTB )FOMF "SUJOZB CBHJBO UFSTFCVU
LFCPDPSBO JPO LBMJVN LF EBMBN MVNFO ZBOH NFOJNCVMLBO
NFSFBCTPSCTJ TFCBHJBO CFTBS JPO UFSNBTVL OBUSJVN LBMJVN
NVBUBOQPTJUJGLJSBLJSBTFCFTBSN7EJMVNFOUVCVMVT.VBUBO
EBOLMPSJEB UFUBQJTFTVOHHVIOZBUJEBLQFSNFBCFMUFSIBEBQBJS
QPTJUJG JOJ NFNBLTB LBUJPO TFQFSUJ .H EBO $B CFSEJGVTJ EBSJ
EBO VSFVN 0MFI LBSFOB BMBTBO JOJ CBHJBO JUV EJTFCVU TFHNFO
MVNFO UVCVMVT NFMBMVJ SVBOH QBSBTFMVMBS EBO NBTVL LF DBJSBO
QFOHFODFS EJMVUJOHTFHNFOU
LBSFOBKVHBNFOHFODFSLBODBJSBO
JOUFSTUJTJBM
UVCVMVT
4FHNFOUFCBMBTFOEFOTBOTB)FOMFTFTVOHHVIOZBJNQFSNFBCFM ,VSBOH MFCJI QFSTFO EBSJ CFCBO OBUSJVN LMPSJEB ZBOH
UFSIBEBQ BJS 0MFI LBSFOB JUV LFCBOZBLBO BJS ZBOH EJCBXB LF EJGJMUSBTJ BLBO EJSFBCTPSCTJ EJ CBHJBO BXBM EBSJ UVCVMVT EJTUBM
TFHNFO JOJ UFUBQ UJOHHBM EBMBN UVCVMVT XBMBVQVO UFSKBEJ ,PUSBOTQPSUFS OBUSJVNLMPSJEB NFNJOEBILBO OBUSJVN
SFBCTPSQTJ[BUUFSMBSVUEBMBNKVNMBICFTBS$BJSBOUVCVMVTQBEB LMPSJEBEBOMVNFOUVCVMVTNBTVLLFEBMBNTFM EBOQPNQB
331
Na+, Cl–, Ca++, Mg++
Na+
ATP Na+
K+

Cl–
Cl–
Na+, Cl–
K+ (+ADH) H2O
H+
OBUSJVNLBMJVN "51BTF NFOUSBOTQPS OBUSJVN LFMVBS EBSJ TFM HCO3–

NFMBMVJ NFNCSBO CBTPMBUFSBM (BNCBS
,MPSJEB K+
CFSEJGVTJLFMVBSEBSJTFMEBONBTVLLFEBMBNDBJSBOJOUFSTUJTJBM
HJOKBMNFMBMVJLBOBMLMPSJEBEJNFNCSBOCBTPMBUFSBM
%JVSFUJL UJB[JE ZBOH EJHVOBLBO TFDBSB MVBT VOUVL
NFOHPCBUJ QFOZBLJU TFQFSUJ IJQFSUFOTJ EBO HBHBM KBOUVOH
NFOHIBNCBULPUSBOTQPSUFSOBUSJVNLMPSJEB
Tubulus Distal Bagian Akhir dan Tubulus Koligens

Kortikalis
4FQBSVICBHJBOLFEVBEBSJUVCVMVTEJTUBMEBOUVCVMVTLPMJHFOT
LPSUJLBMJT CFSJLVUOZB NFNQVOZBJ DJSJDJSJ GVOHTJPOBM ZBOH
TBNB4FDBSBBOBUPNJT LFEVBOZBUFSEJSJEBSJEVBUJQFTFMZBOH
CFSCFEB TFMTFM QSJOTJQBMJT EBO TFMTFM JOUFSLBMBUVT (BNCBS

4FMTFM QSJOTJQBMJT NFSFBCTPSCTJ OBUSJVN EBO BJS EBSJ 4QJSPOPMBLUPO EBO FQMFSFOPO NFSVQBLBO BOUBHPOJT SFTFQUPS
MVNFOEBONFOZFLSFTJLBOJPOLBMJVNLFEBMBNMVNFO4FMTFM NJOFSBMPLPSUJLPJE ZBOH CFSTBJOH EFOHBO BMEPTUFSPO VOUVL
JOUFSLBMBUVTNFSFBCTPSCTJJPOLBMJVNEBONFOZFLSFTJLBOJPO SFTFQUPS EJ TFM QSJOTJQBMJT EBO PMFI LBSFOB JUV NFOHIBNCBU FGFL
IJESPHFOLFEBMBNMVNFOUVCVMVT BMEPTUFSPOZBOHCFSTJGBUNFSBOHTBOHQBEBSFBCTPSQTJOBUSJVNEBO
Sel Prinsipalis Mereabsorbsi Natrium dan Menyekresi TFLSFTJLBMJVN"NJMPSJEBEBOUSJBNUFSFONFSVQBLBOQFOHIBNCBU
Kalium. 3FBCTPSQTJ OBUSJVN EBO TFLSFTJ LBMJVN PMFI TFM LBOBM OBUSJVN ZBOH TFDBSB MBOHTVOH NFOHIBNCBU NBTVLOZB
QSJOTJQBMJT CFSHBOUVOH LFQBEB BLUJWJUBT QPNQB OBUSJVN OBUSJVN LF EBMBN LBOBM OBUSJVN EJ NFNCSBO MVNJOBM EBO PMFI
LBMJVN "51BTF EJ NBTJOHNBTJOH NFNCSBO CBTPMBUFSBM TFM LBSFOBOZB NFOHVSBOHJ KVNMBI OBUSJVN ZBOH EBQBU EJUSBOTQPS
(BNCBS
1PNQBJOJNFNQFSUBIBOLBOLPOTFOUSBTJJPO NFMBMVJ NFNCSBO CBTPMBUFSBM PMFI QPNQB OBUSJVNLBMJVN
OBUSJVN ZBOH SFOEBI EJ EBMBN TFM EBO PMFI LBSFOB JUV "51BTF,FNVEJBOIBMJOJNFOHVSBOHJUSBOTQPSLBMJVNLFEBMBN
NFNCBOUV OBUSJVN CFSEJGVTJ LF EBMBN TFM NFMBMVJ LBOBM TFM EBO QBEB BLIJSOZB NFOVSVOLBO TFLSFTJ LBMJVN LF EBMBN
LIVTVT 4FLSFTJ LBMJVN PMFI TFMTFM JOJ EBSJ EBSBI LF EBMBN DBJSBO UVCVMVT 6OUVL BMBTBO JOJMBI QFOHIBNCBU LBOBM OBUSJVN
MVNFO UVCVMVT NFMJQVUJ EVB MBOHLBI
,BMJVN NBTVL LF EBO KVHB BOUBHPOJT BMEPTUFSPO NFOHVSBOHJ FLTLSFTJ LBMJVN LF
EBMBN TFM LBSFOB QPNQB OBUSJVNLBMJVN "51BTF ZBOH EBMBNVSJOFEBOCFSUJOEBLTFCBHBJEJVSFUJLQPUBTTJVNTQBSJOH
NFNQFSUBIBOLBOLPOTFOUSBTJLBMJVNJOUSBTFMZBOHUJOHHJ EBO Sel Interkalatus Menyekresi lon Hidrogen serta
TFMBOKVUOZB
TFLBMJ CFSBEB EJ EBMBN TFM LBMJVN CFSEJGVTJ Mereabsorbsi lon Bikarbonat dan Kalium.*POIJESPHFOZBOH
NFOVSVU HSBEJFO LPOTFOUSBTJOZB NFMFXBUJ NFNCSBO MVNJOBM EJTFLSFTJ PMFI TFM JOUFSLBMBUVT EJQFSBOUBSBJ PMFI USBOTQPSUFS
NBTVLLFEBMBNDBJSBOUVCVMVT IJESPHFO"51BTF )JESPHFO EJIBTJMLBO EBMBN TFMTFM JOJ NFMBMVJ
4FMQSJOTJQBMJTNFSVQBLBOUFNQBULFSKBVUBNBEBOEJVSFUJL LFSKB BOIJESBTF LBSCPOBU QBEB BJS EBO LBSCPO EJPLTJEB VOUVL
QPUBTTJVNTQBSJOH NFMJOEVOHJ LBMJVN
UFSNBTVL NFNCFOUVLBTBNLBSCPOBU ZBOHLFNVEJBOCFSEJTPTJBTJNFOKBEJ
TQJSPOPMBLUPO FQMFSFOPO BNJMPSJE EBOUSJBNUFSFO JPOIJESPHFOEBOJPOCJLBSCPOBU*POIJESPHFOLFNVEJBO
332
Bab 27 Pembentukan Urine oleh Cinjal:11. Reabsotpsi dan Sekresi Tubulus
EBQBU EJDBQBJ NFMBMVJ TFLSFTJ BLUJG TFLVOEFS EJ EBMBN

UVCVMVTQSPLTJNBM+BEJ TFMJOUFSLBMBUVTNFNBJOLBOQFSBO
LVODJEBMBNSFHVMBTJBTBNCBTBDBJSBOUVCVI
UNIT V
4. 1FSNFBCJMJUBT CBHJBO BXBM UVCVMVT BLIJS EBO EVLUVT
LPMJHFOTLPSUJLBMJTUFSIBEBQBJSEJLPOUSPMPMFILPOTFOUSBTJ
K+ "%) ZBOH KVHB EJTFCVU WBTPQSFTJO %FOHBO LBEBS "%)
Na+ ZBOH UJOHHJ TFHNFOTFHNFO UVCVMVT JOJ NFOKBEJ
ATP Na+
QFSNFBCFM UFSIBEBQ BJS UFUBQJ CJMB UJEBL BEB "%)
K+
- - TFHNFOTFHNFO JOJ TFTVOHHVIOZB JNQFSNFBCFM UFSIBEBQ
Cl BJS ,BSBLUFSJTUJL ZBOH LIVTVT JOJ NFOZFEJBLBO
NFLBOJTNF QFOUJOH VOUVL QFOHBUVSBO UJOHLBU
QFOHFODFSBOBUBVQFNFLBUBOVSJOF
s s Duktus Koligens Medula

s s
8BMBVQVO EVLUVT LPMJHFOT CBHJBO NFEVMB NFSFBCTPSCTJ
LVSBOHEBSJQFSTFOBJSEBOOBUSJVNZBOHEJGJMUSBTJ EVLUVT
JOJBEBMBICBHJBOUFSBLIJSEBSJQFNSPTFTBOVSJOFEBO LBSFOB
JUV NFNBJOLBO QFSBO ZBOH TBOHBU QFOUJOH EBMBN
NFOFOUVLBO LFMVBSBO BLIJS EBSJ BJS EBO [BU UFSMBSVU EBMBN
VSJOF
4FM FQJUFM EVLUVT LPMJHFOT NFOEFLBUJ CFOUVL LVCPJE
EFOHBOQFSNVLBBOZBOHIBMVTEBOSFMBUJGTFEJLJUNJUPLPOESJB
(BNCBS
$JSJDJSJ LIVTVT TFHNFO UVCVMVT JOJ BEBMBI
TFCBHBJCFSJLVU
1. 1FSNFBCJMJUBT EVLUVT LPMJHFOT CBHJBO NFEVMB UFSIBEBQ BJS
EJTFLSFTJLBO LF EBMBN MVNFO UVCVMVT EBO VOUVL TFUJBQ JPO
IJESPHFO ZBOH EJTFLSFTJLBO UFSTFEJB TFCVBI JPO CJLBSCPOBU EJLPOUSPM PMFI LBEBS "%) %FOHBO LBEBS "%) ZBOH
VOUVL EJSFBCTPSQTJ NFMFXBUJ NFNCSBO CBTPMBUFSBM 1FNCBIBTBO UJOHHJ BJS CBOZBL EJSFBCTPSCTJ LF EBMBN JOUFSTUJTJVN
ZBOHMFCJIEFUBJMNFOHFOBJNFLBOJTNFJOJEJKBCBSLBOEBMBN#BC NFEVMB TFIJOHHB NFOHVSBOHJ WPMVNF VSJOF EBO
4FMJOUFSLBMBUVTKVHBNFSFBCTPSCTJJPOLBMJVN NFNFLBULBOTFCBHJBOCFTBS[BUUFSMBSVUEBMBNVSJOF
2. 5JEBL TFQFSUJ UVCVMVT LPMJHFOT LPSUJLBMJT EVLUVT LPMJHFOT
,BSBLUFSJTUJL GVOHTJPOBM EBSJ CBHJBO BLIJS UVCVMVT EJTUBM EBO CBHJBONFEVMBCFSTJGBUQFSNFBCFMUFSIBEBQVSFVNEBOBEB
UVCVMVTLPMJHFOTLPSUJLBMJTEBQBUEJSJOHLBTTFCBHBJCFSJLVU USBOTQPSUFSVSFVNLIVTVTZBOHNFNVEBILBOEJGVTJVSFVN
1. .FNCSBO UVCVMVT LFEVB TFHNFO IBNQJS TFMVSVIOZB NFMFXBUJ NFNCSBO MVNJOBM EBO CBTPMBUFSBM 0MFI LBSFOB
JNQFSNFBCFM UFSIBEBQ VSFVN NJSJQ EFOHBO TFHNFO JUV TFCBHJBO VSFVN UVCVMVT EJSFBCTPSCTJ LF EBMBN
QFOHFODFSQBEBCBHJBOBXBMUVCVMVTEJTUBMKBEJ IBNQJSTFNVB JOUFSTUJTJVNNFEVMB NFNCBOUVNFOJOHLBULBOPTNPMBMJUBT
VSFVN ZBOH NFNBTVLJ TFHNFOTFHNFO JOJ CFSKBMBO IBOZB EBFSBIHJOKBMJOJEBOUVSVUCFSQFSBOEBMBNTFMVSVI
NFMFXBUJ EBO NBTVL LF EBMBN EVLUVT LPMJHFOT VOUVL
EJFLTLSFTJLBO EBMBN VSJOF XBMBVQVO CFCFSBQB SFBCTPSQTJ
VSFVNUFSKBEJEJEBMBNEVLUVTLPMJHFOTCBHJBONFEVMB +, C
l–
Na
2. #BHJBO BXBM UVCVMVT BLIJS EBO TFHNFO UVCVMVT LPMJHFOT H 2O
LPSUJLBMJTNFSFBCTPSCTJJPOOBUSJVN EBOLFDFQBUBOSFBCTPSQTJ DH)
(+A
JOJ EJLPOUSPM PMFI IPSNPO UFSVUBNB BMEPTUFSPO 1BEB XBLUV Urea
ZBOH CFSTBNBBO TFHNFO JOJ NFOZFLSFTJLBO JPO LBMJVN EBSJ
EBSBI LBQJMFS QFSJUVCVMVT LF EBMBN MVNFO UVCVMVT TVBUV
QSPTFT ZBOH KVHB EJLPOUSPM PMFI BMEPTUFSPO EBO GBLUPSGBLUPS H+
MBJOTFQFSUJLPOTFOUSBTJJPOLBMJVNEBMBNDBJSBOUVCVI HCO –
3
3. 4FM JOUFSLBMBUVT EBSJ TFHNFOTFHNFO OFGSPO JOJ CBOZBL
NFOZFLSFTJLBO JPO IJESPHFO NFMBMVJ NFLBOJTNF IJESPHFO
"51BTFBLUJG1SPTFTJOJCFSCFEBEFOHBOTFLSFTJBLUJGTFLVOEFS
JPO IJESPHFO NFMBMVJ UVCVMVT QSPLTJNBM LBSFOB QSPTFT JOJ
NBNQV NFOZFLSFTJLBO JPO IJESPHFO NFMBXBO HSBEJFO
HSBEJFOLPOTFOUSBTJZBOHCFTBS TFCFTBSUFSIBEBQ)BM
JOJLFCBMJLBOEFOHBOHSBEJFOJPOIJESPHFOZBOHSFMBUJGLFDJM
HSBEJFOJPOIJESPHFOZBOHSFMBUJGLFDJM TBNQBJLBMJ
ZBOH
333
LFNBNQVBOHJOKBMVOUVLNFNCFOUVLVSJOFZBOHQFLBU)BMJOJ BLIJS [BU UFSMBSVU LF EBMBN DBJSBO UVCVMVT +JLB SBTJP LPOTFOUSBTJ
EJCBIBTEJ#BC TFDBSBQSPHSFTJGNFOKBEJLVSBOHEBSJ IBMJOJCFSBSUJCBIXBMFCJI
3. %VLUVTLPMJHFOTCBHJBONFEVMBNBNQVNFOZFLSFTJLBOJPO CBOZBL[BUUFSMBSVUZBOHEJSFBCTPSCTJEBSJQBEBBJS
IJESPHFO NFMBXBO HSBEJFO LPOTFOUSBTJ ZBOH CFTBS TFQFSUJ ;BU[BU ZBOH EJUVOKVLLBO QBEB CBHJBO BUBT (BNCBS
ZBOH KVHB UFSKBEJ EBMBN UVCVMVT LPMJHFOT LPSUJLBMJT +BEJ TFQFSUJ LSFBUJOJO NFOKBEJ TBOHBU QFLBU EBMBN VSJOF 1BEB
EVLUVT LPMJHFOT CBHJBO NFEVMB KVHB NFNBJOLBO QFSBO VNVNOZB [BU[BU JOJ UJEBL EJQFSMVLBO PMFI UVCVI EBO HJOKBM
LVODJEBMBNNFOHBUVSLFTFJNCBOHBOBTBNCBTB UFMBICFSBEBQUBTJVOUVLIBOZBTFEJLJUNFSFBCTPSCTJOZBBUBVUJEBL
TBNB TFLBMJ BUBV CBILBO NFOZFLSFTJLBOOZB LF EBMBN UVCVMVT
Ringkasan Konsentrasi Berbagai Zat Terlarut dalam TFIJOHHB EJFLTLSFTJLBO EBMBN KVNMBI CFTBS LF EBMBN VSJOF
Segmen-Segmen Tubulus yang Berbeda 4FCBMJLOZB [BU[BU ZBOH EJUVOKVLLBO EJ CBHJBO CBXBI HBNCBS
;BU UFSMBSVU BLBO NFOKBEJ QFLBU BUBV UJEBL EBMBN DBJSBO TFQFSUJ HMVLPTB EBO BTBN BNJOP TFNVBOZB EJSFBCTPSCTJ EFOHBO
UVCVMVT EJUFOUVLBO PMFI EFSBKBU SFMBUJG SFBCTPSQTJ EBSJ [BU LVBU [BU[BU JOJ BEBMBI [BU[BU ZBOH EJQFSMVLBO UVCVI VOUVL
UFSMBSVU UFSTFCVU EJCBOEJOHLBO EFOHBO SFBCTPSQTJ BJS #JMB EJTJNQBOEBOIBNQJSUJEBLBEBZBOHLFMVBSEBMBNVSJOF
QFSTFOUBTFSFBCTPSQTJBJSMFCJICFTBS [BU[BUUFSTFCVUNFOKBEJ
MFCJIQFLBU#JMBQFSTFOUBTFSFBCTPSQTJ[BUUFSMBSVUMFCJICFTBS Rasio Konsentrasi Cairan Tubulus/Inulin Plasma Dapat
[BU[BUNFOKBEJMFCJIFODFS Digunakan untuk Menghitung Reabsorpsi Air oleh Tubulus
(BNCBS NFOVOKVLLBO EFSBKBU LPOTFOUSBTJ CFCFSBQB Ginjal.
[BU QBEB CFSCBHBJ TFHNFO UVCVMVT 4FNVB OJMBJ EBMBN HBNCBS *OVMJO TVBUV QPMJTBLBSJEB ZBOH EJHVOBLBO VOUVL NFOHIJUVOH
JOJ NFSVQBLBO LPOTFOUSBTJ DBJSBO UVCVMVT EJCBHJ EFOHBO -'( UJEBL EJSFBCTPSCTJ NBVQVO EJTFLSFTJ UVCVMVT HJOKBM 0MFI
LPOTFOUSBTJ[BUEBMBNQMBTNB#JMBLPOTFOUSBTJTVBUV[BUEBMBN LBSFOB JUV QFSVCBIBO LPOTFOUSBTJ JOVMJO QBEB UFNQBU ZBOH
QMBTNB EJBOHHBQ LPOTUBO TFUJBQ QFSVCBIBO SBTJP DBJSBO CFSCFEBCFEB EJ TFQBOKBOH UVCVMVT HJOKBM NFOHHBNCBSLBO
UVCVMVTMBKV LPOTFOUSBTJ QMBTNB BLBO NFOHHBNCBSLBO QFSVCBIBO KVNMBI BJS ZBOH UFSEBQBU EJ EBMBN DBJSBO UVCVMVT
QFSVCBIBOEBMBNLPOTFOUSBTJDBJSBOUVCVMVT 4FCBHBJ DPOUPI SBTJP LPOTFOUSBTJ DBJSBO UVCVMVT QMBTNB VOUVL
4FXBLUVGJMUSBUCFSHFSBLEJTFQBOKBOHTJTUFNUVCVMVT TFDBSB JOVMJO NFOJOHLBU NFOKBEJ TFLJUBS QBEB CBHJBO BLIJS UVCVMVT
QSPHSFTJGLPOTFOUSBTJBLBONFOJOHLBUMFCJIEBSJ CJMBMFCJI QSPLTJNBM ZBOH NFOVOKVLLBO CBIXB LPOTFOUSBTJ JOVMJO EJ
CBOZBLBJSZBOHEJSFBCTPSCTJEBSJQBEB[BUUFSMBSVU BUBVCJMB DBJSBOUVCVMVTUJHBLBMJMFCJICFTBSEBSJQBEBEJEBMBNQMBTNBEBO
EJGJMUSBUHMPNFSVMVT
5
0MFI LBSFOB JOVMJO UJEBL EJTFLSFTJ BUBV EJSFBCTPSCTJ EBSJ

58
140
100.0 UVCVMVT SBTJP LPOTFOUSBTJ DBJSBO UVCVMVTQMBTNB TFCFTBS

CFSBSUJ IBOZB TFQFSUJHB BJS ZBOH EJGJMUSBTJ ZBOH UFUBQ CFSBEB EJ
50.0
EBMBNUVCVMVTHJOKBMEBOEVBQFSUJHBEBSJBJSZBOHEJGJMUSBTJUFMBI
EJSFBCTPSCTJ TFXBLUV DBJSBO NFMFXBUJ UVCVMVT QSPLTJNBM 1BEB
20.0
CBHJBO BLIJS EVLUVT LPMJHFOT SBTJP LPOTFOUSBTJ DBJSBO UVCVMVT
10.0 QMBTNB NFOJOHLBU NFOKBEJ MJIBU (BNCBS
ZBOH
5.0
NFOVOKVLLBO CBIXB IBOZB EBSJ BJS ZBOH EJGJMUSBTJ ZBOH
UFUBQCFSBEBEJEBMBNUVCVMVTEBOMFCJIEBSJQFSTFOOZBUFMBI
Cl EJSFBCTPSCTJ
2.0
K
1.0 K Cl Pengaturan Reabsorpsi Tubulus
Na
0.50 Na
0MFI LBSFOB QFOUJOH VOUVL NFNQFSUBIBOLBO TVBUV
0.20 LFTFJNCBOHBO ZBOH UFQBU BOUBSB SFBCTPSQTJ UVCVMVT EBO GJMUSBTJ
HMPNFSVMVT BEB CBOZBL NFLBOJTNF TBSBG IPSNPOBM EBO
0.10 LPOUSPM TFUFNQBU ZBOH NFOHBUVS SFBCTPSQTJ UVCVMVT TFQFSUJ
Ami
HCO3
Prot
0.05 ZBOH UFSEBQBU VOUVL QFOHBUVSBO GJMUSBTJ HMPNFSVMVT 4BUV

no a
HBNCBSBO QFOUJOH QBEB SFBCTPSQTJ UVCVMVT BEBMBI CBIXB

ein
c
0.02 SFBCTPSQTJ EBSJ CFCFSBQB [BU UFSMBSVU EBQBU EJBUVS TFDBSB CFCBT
ids
UFSQJTBI EBSJ ZBOH MBJO UFSVUBNB NFMBMVJ NFLBOJTNF

QFOHPOUSPMBOIPSNPOBM
Keseimbangan Glomerulotubulus—Kemampuan Tubulus
untuk Meningkatkan Kecepatan Reabsorpsi sebagai
Respons terhadap Peningkatan Beban Tubulus
4BMBITBUVNFLBOJTNFQBMJOHEBTBSVOUVLNFOHPOUSPMLFDFQBUBO
SFBCTPSQTJ UVCVMVT BEBMBI LFNBNQVBO JOUSJOTJL UVCVMVT VOUVL
NFOJOHLBULBO LFDFQBUBO SFBCTPSQTJ TFCBHBJ SFTQPOT UFSIBEBQ
QFOJOHLBUBOCFCBOUVCVMVT QFOJOHLBUBOBMJSBONBTVLLF
334
UVCVMVT
'FOPNFOB JOJ EJLFOBM TFCBHBJ LFTFJNCBOHBO IJESPTUBUJL QFSJUVCVMVT QFSJUVCVMVT <1+
ZBOH NFMBXBO
HMPNFSVMPUVCVMBS 4FCBHBJ DPOUPI CJMB -'( NFOJOHLBU EBSJ SFBCTPSQTJ
UFLBOBO IJESPTUBUJL EBMBN JOUFSTUJTJVN HJOKBM
NMNFOJU NFOKBEJ NMNFOJU LFDFQBUBO SFBCTPSQTJ UVCVMVT 1JG
EJ MVBS LBQJMFS ZBOH NFNCBOUV SFBCTPSQTJ
UFLBOBO
QSPLTJNBM ZBOH BCTPMVU KVHB NFOJOHLBU EBSJ TFLJUBS NMNFOJU PTNPUJL LPMPJE EBSJ QSPUFJO QMBTNB LBQJMFS QFSJUVCVMVT JUD

QFSTFO EBSJ -'(
NFOKBEJ TFLJUBS NMNFOJU QFSTFO ZBOH NFNCBOUV SFBCTPSQTJ EBO
UFLBOBO PTNPUJL LPMPJE
UNIT V
EBSJ -'(
+BEJ LFTFJNCBOHBO HMPNFSVMPUVCVMVT BEBMBI QSPUFJO EBMBN JOUFSTUJTJVN HJOKBM MMJG
ZBOH NFMBXBO
LFDFQBUBO SFBCTPSQTJ UPUBM ZBOH NFOJOHLBU CJMB CFCBO ZBOH SFBCTPSQTJ
UFSGJMUSBTJCFSUBNCBIXBMBVQVOQFSTFOUBTF-'(ZBOHEJSFBCTPSCTJ (BNCBS NFOVOKVLLBO HBZBHBZB OPSNBM ZBOH LJSB
EBMBN UVCVMVT QSPLTJNBM UFUBQ SFMBUJG LPOTUBO QBEB TFLJUBS LJSB NFNCBOUV EBO NFMBXBO SFBCTPSQTJ QFSJUVCVMVT 0MFI
QFSTFO LBSFOBSBUBSBUBUFLBOBOLBQJMFSQFSJUVCVMVTOPSNBMTFLJUBS
4FEJLJU CBOZBL LFTFJNCBOHBO HMPNFSVMPUVCVMVT KVHB UFSKBEJ NN )H EBO SBUBSBUB UFLBOBO IJESPTUBUJL DBJSBO JOUFSTUJTJBM
QBEB TFHNFO UVCVMVT ZBOH MBJO UFSVUBNB QBEB BOTB )FOMF HJOKBMBEBMBINN)H UFSEBQBUTVBUVHSBEJFOQPTJUJGUFLBOBO
.FLBOJTNFUFQBUZBOHCFSUBOHHVOHKBXBCVOUVLLFKBEJBOJOJUJEBL IJESPTUBUJLEBSJLBQJMFSQFSJUVCVMVTUFSIBEBQDBJSBOJOUFSTUJTJBM
TFQFOVIOZB EJQBIBNJ UFUBQJ NVOHLJO TFCBHJBO EJTFCBCLBO PMFI TFLJUBS NN )H ZBOH NFMBXBO SFBCTPSQTJ DBJSBO /JMBJ JOJ
QFSVCBIBO HBZBHBZB GJTJLB EBMBN UVCVMVT EBO EJ TFLFMJMJOH DVLVQNFOHJNCBOHJUFLBOBOPTNPUJLLPMPJEZBOHNFNCBOUV
JOUFSTUJTJVN HJOKBM TFQFSUJ ZBOH BLBO EJCBIBT LFNVEJBO +FMBTMBI SFBCTPSQTJ 5FLBOBO PTNPUJL LPMPJE QMBTNB ZBOH NFNCBOUV
TVEBI CBIXB NFLBOJTNF VOUVL LFTFJNCBOHBO HMPNFSVMPUVCVMVT SFBCTPSQTJ BEBMBI TFLJUBS NN )H EBO UFLBOBO PTNPUJL
EBQBUUFSKBEJUJEBLCFSHBOUVOHLFQBEBIPSNPOIPSNPOEBOEBQBU LPMPJE JOUFSTUJTJVN ZBOH NFMBXBO SFBCTPSQTJ BEBMBI NN
EJQFSMJIBULBO QBEB HJOKBM ZBOH EJJTPMBTJ TFMVSVIOZB BUBV CBILBO )H NFOZFCBCLBO UFLBOBO PTNPUJL LPMPJE BLIJS TFLJUBS
EBMBNTFHNFOUVCVMVTQSPLTJNBMZBOHEJJTPMBTJTFMVSVIOZB NN)H ZBOHNFNCBOUVSFBCTPSQTJ0MFILBSFOBJUV EFOHBO
,FTFJNCBOHBO HMPNFSVMPUVCVMVT NFNCBOUV NFODFHBI NFOHVSBOHJ UFLBOBO PTNPUJL LPMPJE OFUP ZBOH NFNCBOUV
LFMFCJIBO CFCBO QBEB TFHNFO UVCVMVT EJTUBM CJMB -'( NFOJOHLBU SFBCTPSQTJ NN )H
EFOHBO UFLBOBO IJESPTUBUJL OFUP ZBOH
,FTFJNCBOHBO HMPNFSVMPUVCVMVT CFSQFSBO TFCBHBJ HBSJT NFMBXBOSFBCTPSQTJ NN)H
NFNCFSJUFLBOBOSFBCTPSQTJ
QFSUBIBOBO LFEVB VOUVL NFOBIBO FGFLFGFL QFSVCBIBO TQPOUBO OFUPBEBMBINN)H*OJNFSVQBLBOOJMBJZBOHUJOHHJ NJSJQ
EBMBN -'( UFSIBEBQ LFMVBSBO VSJOF (BSJT QFSUBIBOBO QFSUBNB EFOHBO ZBOH EJUFNVLBO EBMBN LBQJMFS HMPNFSVMVT UFUBQJ
UFMBIEJCBIBTTFCFMVNOZB NFMJQVUJNFLBOJTNFBVUPSFHVMBTJHJOKBM EFOHBOBSBIZBOHCFSMBXBOBO
UFSVUBNB VNQBO CBMJL UVCVMPHMPNFSVMVT ZBOH NFNCBOUV
NFODFHBI QFSVCBIBO EBMBN -'( 4FDBSB CFSTBNBTBNB 'BLUPSMBJOZBOHCFSQFSBOEBMBNLBQJMFSQFSJUVCVMVTBEBMBI
NFLBOJTNF BVUPSFHVMBTJ EBO LFTFJNCBOHBO UVCVMPHMPNFSVMVT LPFGJTJFOGJMUSBTJ ,G
ZBOHCFTBSLBSFOBLPOEVLUJWJUBTIJESBVMJL
EBQBUNFODFHBIQFSVCBIBOCFTBSQBEBBMJSBODBJSBOEBMBNUVCVMVT ZBOH UJOHHJ EBO MVBTOZB QFSNVLBBO LBQJMFS 0MFI LBSFOB
EJTUBMTBBUUFLBOBOBSUFSJCFSVCBIBUBVCJMBUFSEBQBUHBOHHVBOMBJO LFDFQBUBO SFBCTPSQTJ OPSNBMOZB TFLJUBS NM NFOJU EBO
ZBOHBLBONFOHHBOHHVIPNFPTUBTJTOBUSJVNEBOWPMVNF UFLBOBO SFBCTPSCTJ OFUP BEBMBI NN )H ,G OPSNBMOZB
BEBMBITFLJUBS NMNFOJUNN)H
Gaya-Gaya Fisika Cairan Interstisial Ginjal dan Kapiler
Peritubulus
(BZB PTNPTUJL LPMPJE EBO IJESPTUBUJL NFOFOUVLBO LFDFQBUBO
SFBCTPSQTJZBOHNFMFXBUJLBQJMFSQFSJUVCVMVT TBNBTFQFSUJNFSFLB
NFOHPOUSPM GJMUSBTJ EBMBN LBQJMFS HMPNFSVMVT 1FSVCBIBO EBMBN
SFBCTPSQTJ LBQJMFS QFSJUVCVMVT LFNVEJBO EBQBU NFNFOHBSVIJ Pif
Pc 6 mm Hg
UFLBOBO PTNPUJL LPMPJE EBO IJESPTUBUJL EBO JOUFSTUJTJVN HJOKBM
13 mm Hg
EBO BLIJSOZB SFBCTPSQTJBJSEBO[BUUFSMBSVUEBSJUVCVMVTHJOKBM Pif
Pc 15 mm Hg
Nilai Normal untuk Gaya-Gaya Fisika dan Kecepatan 32 mm Hg
Reabsorpsi. 4FXBLUV GJMUSBU HMPNFSVMVT NFMFXBUJ UVCVMVT HJOKBM Bulk
H2O H 2O
flow
OPSNBMOZBMFCJIEBSJQFSTFOBJSEBOTFCBHJBOCFTBS[BUUFSMBSVU
10 mm Hg Na Na
BLBO EJSFBCTPSCTJ $BJSBO EBO FMFLUSPMJU EJSFBCTPSCTJ EBSJ UVCVMVT ATP
NBTVL LF EBMBN JOUFSTUJTJVN HJOKBM EBO LFNVEJBO NBTVL LF
LBQJMFS QFSJUVCVMVT ,FDFQBUBO OPSNBM SFBCTPSQTJ LBQJMFS
QFSJUVCVMVTBEBMBITFLJUBSNMNFOJU
3FBCTPSQTJNFMFXBUJLBQJMFSQFSJUVCVMVTEBQBUEJIJUVOHTFCBHBJ
CFSJLVU
3FBCTPSQTJ = Kf × (BZBSFBCTPSQTJOFUP
(BZB SFBCTPSQTJ OFUP NFSVQBLBO KVNMBI EBSJ HBZBHBZB
PTNPUJL LPMPJE EBO IJESPTUBUJL ZBOH NFNCBOUV BUBV NFMBXBO
SFBCTPSQTJ NFMBMVJ LBQJMFS QFSJUVCVMVT (BZBHBZB JOJ BOUBSB MBJO

UFLBOBOIJESPTUBUJLEJEBMBNLBQJMFSQFSJUVCVMVT UFLBOBO
335
Tabel 27-2 Faktor-Faktor yang Dapat Memengaruhi Reabsorpsi Kapiter

Pengaturan Gaya Fisika Kapiler Peritubulus. %VB Pentubutus
QFOFOUV SFBCTPSQTJ LBQJMFS QFSJUVCVMVT ZBOH TFDBSB MBOHTVOH
EJQFOHBSVIJ PMFI QFSVCBIBO IFNPEJOBNJL HJOKBM BEBMBI l Pc m n 3FBCTPSQTJ
UFLBOBO IJESPTUBUJL EBO PTNPUJL LPMPJE LBQJMFS QFSJUVCVMVT n RA m l Pc
5FLBOBO IJESPTUBMJL LBQJMFS QFSJUVCVMVT EJQFOHBSVIJ PMFI n RE m l Pc
UFLBOBO BSUFSJ EBO UBIBOBO BSUFSJPM BGFSFO EBO FGFSFO
l 5FLBOBOBSUFSJ m l Pc
1FOJOHLBUBO UFLBOBO BSUFSJ DFOEFSVOH NFOJOHLBULBO UFLBOBO l Pc m l 3FBCTPSQTJ
IJESPTUBUJL LBQJMFS QFSJUVCVMVT EBO NFOVSVOLBO LFDFQBUBO l PA m l Pc
SFBCTPSQTJ &GFL JOJ EJCBOUV TFDVLVQOZB PMFI NFLBOJTNF l FF m l Pc
lKf m l 3FBCTPSQTJ
BVUPSFHVMBTJZBOHNFNQFSUBIBOLBOBMJSBOEBSBIHJOKBMEBOKVHB
UFLBOBO IJESPTUBUJL EBMBN QFNCVMVI EBSBI HJOKBM BHBS SFMBUJG 1 UFLBOBO IJESPTUBUJL LBQJSF QFSJUVCVMVT 3" EBO 3 UBIBOBO BSUFSJ BGFSFO
LPOTUBO
1FOJOHLBUBO UBIBOBO BSUFSJPM BGFSFO BUBVQVO EBO FGFSFO NBTJOHNBTJOH Pc , UFLBOBO PTNPUJL LBQJMFS QFSJUVCVMVT PA, UFLBOBO
FGFSFO BLBO NFOVSVOLBO UFLBOBO IJESPTUBUJL LBQJMFS PTNPUJL LPMPJE QMBTNB BSUFSJ '' GSBLTJ GJMUSBTJ ,S LPFGJTJFO GJMUSBTJ
LBQJMFSQFSJUVCVMVT
QFSJUVCVMVT EBO DFOEFSVOH NFOJOHLBULBO LFDFQBUBO
SFBCTPSQTJ 8BMBVQVO LPOTUSJLTJ BSUFSJPM FGFSFO NFOJOHLBULBO ,FBEBBO JOJ LFNVEJBO NFOJOHLBULBO UFLBOBO IJESPTUBUJL DBJSBO
UFLBOBOIJESPTUBUJLLBQJMFSHMPNFSVMVT LPOTUSJLTJUFSTFCVUBLBO JOUFSTUJTJBMHJOKBMEBONFOVSVOLBOUFLBOBOPTNPUJLLPMPJEDBJSBO
NFOVSVOLBOUFLBOBOIJESPTUBUJLLBQJMFSQFSJUVCVMVT JOUFSTUJTJBM BLJCBU QFOHFODFSBO QSPUFJO EBMBN JOUFSTUJTJVN HJOKBM
1FOFOUV VUBNB LFEVB CBHJ SFBCTPSQTJ LBQJMFS QFSJUVCVMVT 1FSVCBIBOJOJLFNVEJBONFOVSVOLBOSFBCTPSQTJOFUPDBJSBOEBSJ
BEBMBI UFLBOBO PTNPUJL LPMPJE QMBTNB EBMBN LBQJMFS JOJ UVCVMVT HJOKBM NBTVL LF EBMBN JOUFSTUJTJVN UFSVUBNB EBMBN
QFOJOHLBUBO UFLBOBO PTNPUJL LPMPJE NFOJOHLBULBO SFBCTPSQTJ UVCVMVTQSPLTJNBM
LBQJMFSQFSJUVCVMVT5FLBOBOPTNPUJLLPMPJELBQJMFSQFSJUVCVMVT .FLBOJTNF QFSVCBIBO UFLBOBO IJESPTUBUJL DBJSBO JOUFSTUJTJBM
EJUFOUVLBO PMFI
UFLBOBO PTNPUJL LPMPJE QMBTNB TJTUFNJL EBOUFLBOBOPTNPUJLLPMPJEZBOHEBQBUNFNFOHBSVIJSFBCTPSQTJ
QFOJOHLBUBO LPOTFOUSBTJ QSPUFJO QMBTNB EBO EBSBI TJTUFNJL UVCVMVT EBQBU EJQBIBNJ EFOHBO NFMJIBU UFNQBU [BU UFSMBSVU EBO
DFOEFSVOH NFOJOHLBULBO UFLBOBO PTNPUJL LPMPJE LBQJMFS BJSEJSFBCTPSCTJ (BNCBS
#JMB[BUUFSMBSVUNFNBTVLJLBOBM
QFSJUVCVMVT TFIJOHHB NFOJOHLBULBO SFBCTPSQTJ EBO
GSBLTJ JOUFSTFM BUBV JOUFSTUJTJVN HJOKBM EFOHBO DBSB USBOTQPS BLUJG BUBV
GJMUSBTJ TFNBLJO UJOHHJ GSBLTJ GJMUSBTJ TFNBLJO CFTBS GSBLTJ EJGVTJ QBTJG BJS EJUBSJL EBSJ MVNFO UVCVMVT LF EBMBN JOUFSTUJTJVN
QMBTNB ZBOH EJGJMUSBTJ NFMBMVJ HMPNFSVMVT EBO BLJCBUOZB NFMBMVJ PTNPTJT #JMB BJS EBO [BU UFSMBSVU CFSBEB EBMBN
QSPUFJO EBMBN QMBTNB ZBOH UFUBQ UJOHHBM NFOKBEJ MFCJI QFLBU SVBOHJOUFSTUJTJBM MBSVUBOUFSTFCVUEBQBUUFSCBXBNBTVLLFEBMBN
+BEJ QFOJOHLBUBO GSBLTJ GJMUSBTJ KVHB DFOEFSVOH NFOJOHLBULBO LBQJMFS QFSJUVCVMVT BUBV CFSEJGVTJ LFNCBMJ NFMBMVJ UBVU FQJUFM LF
LFDFQBUBO SFBCTPSQTJ LBQJMFS QFSJUVCVMVT 0MFI LBSFOB GSBLTJ EBMBN MVNFO UVCVMVT 5BVU FSBU BOUBSB TFMTFM FQJUFMJBM UVCVMVT
GJMUSBTJ EJEFGJOJTJLBO TFCBHBJ SBTJP -'(BMJSBO QMBTNB HJOKBM QSPLTJNBM TFCFOBSOZB CPDPS TFIJOHHB TFKVNMBI OBUSJVN EBQBU
QFOJOHLBUBO GSBLTJ GMJUSBTJ EBQBU UFSKBEJ TFCBHBJ BLJCBU EBSJ CFSEJGVTJ EBMBN EVB BSBI NFMBMVJ UBVU JOJ %FOHBO LFDFQBUBO
QFOJOHLBUBO -'( BUBV QFOVSVOBO BMJSBO QMBTNB HJOKBM SFBCTPSQTJ LBQJMFS QFSJUVCVMVT ZBOH OPSNBMOZB UJOHHJ UFSKBEJ
#FCFSBQB WBTPLPOTUSJLUPS HJOKBM TFQFSUJ BOHJPUFOTJO ** QFSHFSBLBO BLIJS BJS EBO [BU UFSMBSVU LF LBQJMFS QFSJUVCVMVT
NFOJOHLBULBO SFBCTPSQTJ LBQJMFS QFSJUVCVMVT EFOHBO EFOHBO TFEJLJU LFCPDPSBO LF EBMBN MVNFO UVCVMVT 8BMBVQVO
NFOVSVOLBO BMJSBO QMBTNB HJOKBM EBO NFOJOHLBULBO GSBLTJ EFNJLJBO CJMB SFBCTPSQTJ LBQJMFS QFSJUVCVMVT NFOVSVO UFSKBEJ
GJMUSBTJ TFQFSUJZBOHBLBOEJCBIBTLFNVEJBO QFOJOHLBUBO UFLBOBO IJESPTUBUJL DBJSBO JOUFSTUJTJBM EBO
1FSVCBIBO QBEB ,G LBQJMFS QFSJUVCVMVT KVHB EBQBU LFDFOEFSVOHBOTFKVNMBICFTBS[BUUFSMBSVUEBOBJSVOUVLCPDPSLF
NFNFOHBSVIJ LFDFQBUBO SFBCTPSQTJ LBSFOB ,G BEBMBI VLVSBO EBMBNMVNFOUVCVMVT TFIJOHHBNFOHVSBOHJLFDFQBUBOSFBCTPSQTJ
QFSNFBCJMJUBT EBO BSFB QFSNVLBBO LBQJMFS 1FOJOHLBUBO ,G BLIJS MJIBUMBHJLF(BNCBS

BLBO NFOJOHLBUBO SFBCTPSQTJ TFEBOHLBO QFOVSVOBO ,G BLBO
NFOVSVOLBO SFBCTPSQTJ LBQJMFS QFOJUVCVMVT ,G UFUBQ SFMBUJG ,FCBMJLBOOZB EBQBU UFSKBEJ CJMB UFSEBQBU QFOJOHLBUBO
LPOTUBO EBMBN LFCBOZBLBO LPOEJTJ GJTJPMPHJT 5BCFM SFBCTPSQTJLBQJMFSQFSJUVCVMVTEJBUBTLBEBSOPSNBM1FOJOHLBUBO
NFSBOHLVN GBLUPSGBLUPS ZBOH EBQBU NFNFOHBSVIJ LFDFQBUBO BXBMSFBCTPSQTJPMFILBQJMFSQFSJUVCVMVTDFOEFSVOHNFOVSVOLBO
SFBCTPSQTJLBQJMFSQFSJUVCVMVT UFLBOBOIJESPTUBUJLDBJSBOJOUFSTUJTJBMEBONFOJOHLBULBOUFLBOBO
PTNPUJL LPMPJE DBJSBO JOUFSTUJTJBM ,FEVB UFLBOBO JOJ NFNCBOUV
Tekanan Osmotik Koloid dan Hidrostatik Interstisial QFSHFSBLBODBJSBOEBO[BUUFSMBSVULFMVBSEBSJMVNFOUVCVMVTEBO
Ginjal. "LIJSOZB QFSVCBIBO HBZB GJTJLB LBQJMFS QFSJUVCVMVT NBTVLLFEBMBNJOUFSTUJTJVNPMFILBSFOBJUV LFCPDPSBOBJSEBO
NFNFOHBSVIJSFBCTPSQTJUVCVMVTEFOHBONFOHVCBIHBZBGJTJLB [BU UFSMBSVU LF EBMBN MVNFO UVCVMVT CFSLVSBOH EBO SFBCTPSQTJ
EBMBNJOUFSTUJTJVNHJOKBMEJTFLFMJMJOHUVCVMVT4FCBHBJDPOUPI OFUPUVCVMVTNFOJOHLBU
QFOVSVOBO HBZB SFBCTPSQTJ ZBOH NFMFXBUJ NFNCSBO LBQJMFS +BEJ NFMBMVJ QFSVCBIBO UFLBOBO IJESPTUBUJL EBO PTNPUJL
QFSJUVCVMVT EJTFCBCLBO PMFI QFOJOHLBUBO UFLBOBO IJESPTUBUJL LPMPJE JOUFSTUJTJVN HJOKBM BNCJMBO BJS EBO [BU UFSMBSVU PMFI
LBQJMFS QFSJUVCVMVT BUBV QFOVSVOBO UFLBOBO PTNPUJL LPMPJE LBQJMFSQFSJUVCVMVTIBNQJSTBNBEFOHBOSFBCTPSQTJOFUPBJSEBO
LBQJMFSQFSJUVCVMVT TFIJOHHBNFOVSVOLBOBNCJMBODBJSBOEBO [BU UFSMBSVU EBSJ MVNFO UVCVMVT LF EBMBN JOUFSTUJTJVN 0MFI
[BUUFSMBSVUEBSJJOUFSTUJTJVNLFEBMBNLBQJMFSQFSJUVCVMVT LBSFOBJUV QBEBVNVNOZB HBZBZBOHNFOJOHLBULBO
336
&GFL LFEVB EBSJ QFOJOHLBUBO UFLBOBO BSUFSJ HJOKBM ZBOH

NFOJOHLBULBO LFMVBSBO VSJOF BEBMBI CBIXB IBM JOJ
NFOVSVOLBO QFSTFOUBTF EBSJ CFCBO OBUSJVN EBO BJS ZBOH
EJGJMUSBTJ VOUVL EJSFBCTPSCTJ EJ UVCVMVT .FLBOJTNF ZBOH
UNIT V
Pc
CFSUBOHHVOH KBXBC VOUVL FGFL JOJ NFMJQVUJ QFOJOHLBUBO LFDJM
Pc
UFLBOBO IJESPTUBUJL LBQJMFS QFSJUVCVMVT UFSVUBNB EBMBN WBTB
SFLUB NFEVMB HJOKBM EBO TFMBOKVUOZB QFOJOHLBUBO UFLBOBO
IJESPTUBUJL DBJSBO JOUFSTUJTJBM HJOKBM 4FQFSUJ UFMBI EJCBIBT
ATP
TFCFMVNOZB QFOJOHLBUBO UFLBOBO IJESPTUBUJL DBJSBO
JOUFSTUJTJBM HJOKBM NFOJOHLBULBO LFCPDPSBO OBUSJVN LF EBMBN
MVNFOUVCVMVT TFIJOHHBNFOHVSBOHJSFBCTPSQTJBLIJSOBUSJVN
ATP EBO BJS EBO MFCJI KBVI MBHJ NFOJOHLBULBO LFDFQBUBO LFMVBSBO
VSJOFTBBUUFLBOBOBSUFSJHJOKBMNFOJOHLBU
'BLUPS LFUJHB ZBOH UVSVU CFSQFSBO UFSIBEBQ NFLBOJTNF
OBUSJVSFTJT UFLBOBO EBO EJVSFTJT UFLBOBO BEBMBI QFOVSVOBO
QFNCFOUVLBOBOHJPUFOTJO**"OHJPUFOTJO**TFOEJSJNFOJOHLBU
LBO SFBCTPSQTJ OBUSJVN PMFI UVCVMVT IBM JOJ KVHB NFSBOHTBOH
Pc TFLSFTJ BMEPTUFSPO ZBOH TFMBOKVUOZB NFOJOHLBULBO SFBCTPSQTJ
Pc OBUSJVN0MFILBSFOBJUV QFOVSVOBOQFNCFOUVLBOBOHJPUFOTJO
**UVSVUCFSQFSBOUFSIBEBQQFOVSVOBOSFBCTPSQTJOBUSJVNPMFI
ATP
UVCVMVTZBOHUFSKBEJTBBUUFLBOBOBSUFSJNFOJOHLBU
Pengendalian Hormonal terhadap Reabsorpsi Tubulus.
1FOHBUVSBOWPMVNFDBJSBOUVCVIEBOLPOTFOUSBTJ[BUUFSMBSVUZBOH
ATP UFQBU NFOHIBSVTLBO HJOKBM VUOVL NFOHFLTLSFTJ CFSCBHBJ [BU
UFSMBSVUEBOBJSQBEBCFSCBHBJLFDFQBUBO LBEBOHUJEBLCFSHBOUVOH
TBUV TBNB MBJO 4FCBHBJ DPOUPI CJMB BTVQBO LBMJVN NFOJOHLBU
HJOKBM IBSVT NFOHFLTLSFTJLBO MFCJI CBOZBL LBMJVN TFNFOUBSB
NFNQFSUBIBOLBOFLTLSFTJOPSNBMEBSJOBUSJVNEBOFMFLUSPMJUMBJO
%FNJLJBOKVHB CJMBBTVQBOOBUSJVNCFSVCBI HJOKBMIBSVTEFOHBO
UFQBU NFOZFTVBJLBO FLTLSFTJ OBUSJVN VSJOF UBOQB NFNCVBU
QFSVCBIBO CFTBS QBEB FLTLSFTJ FMFLUSPMJU MBJO #FCFSBQB IPSNPO
EBMBN UVCVI NFOZFEJBLBO LFNBNQVBO SFBCTPSQTJ TQFTJGJL
UVCVMVTVOUVLCFSCBHBJFMFLUSPMJUEBOBJS5BCFMNFSBOHLVN
CFCFSBQB IPSNPO ZBOH QBMJOH QFOUJOH VOUVL NFSFHVMBTJ
SFBCTPSQTJ UVCVMVT UFNQBU LFSKB VUBNB IPSNPO QBEB UVCVMVT
HJOKBM EBO QFOHBSVI IPSNPO UFSIBEBQ FLTLSFTJ [BU UFSMBSVU EBO
SFBCTPSQTJLBQJMFSQFSJUVCVMVTKVHBNFOJOHLBULBOSFBCTPSQTJEBSJ BJS#FCFSBQBEBSJIPSNPOJOJEJCBIBTMFCJIEFUBJMQBEB#BCEBO
UVCVMVT HJOKBM 4FCBMJLOZB QFSVCBIBO IFNPEJOBNJL ZBOH UFUBQJ LJUB BLBO NFNCBIBT LFNCBMJ LFSKB UVCVMVT HJOKBM JOJ
NFOHIBNCBU SFBCTPSQTJ LBQJMFS QFSJUVCVMVT KVHB NFOHIBNCBU TFDBSBTJOHLBUEBMBNCFCFSBQBQBSBHSBGCFSJLVU
SFBCTPSQTJBJSEBO[BUUFSMBSVUPMFIUVCVMVT
Aldosteron Meningkatkan Reabsorpsi Natrium dan
Pengaruh Tekanan Arteri pada Ketuaran Urine-Natriuresis- Merangsang Sekresi Kalium. "MEPTUFSPO ZBOHEJTFLSFTJLBO
Tekanan dan Diuresis-Tekanan PMFI TFMTFM [POB HMPNFSVMPTB QBEB LPSUFLT BESFOBM BEBMBI
#BILBO QFOJOHLBUBO UFLBOBO BSUFSJ ZBOH LFDJM EBQBU TVBUV SFHVMBUPS QFOUJOH CBHJ SFBCTPSQTJ OBUSJVN EBO TFLSFTJ
NFOZFCBCLBO QFOJOHLBUBO FLTLSFTJ OBUSJVN EBO BJS ZBOH OZBUB LBMJVN PMFI UVCVMVT HJOKBM 5FNQBU VUBNB EJ UVCVMVT
EBMBN VSJOF GFOPNFOB JOJ EJTFCVU OBUSJVSFTJT UFLBOBO EBO HJOKBMVOUVL LFSKB BMEPTUFSPO BEBMBI QBEB TFMTFM QSJOTJ QBMJT EJ
EJVSFTJTUFLBOBO"LJCBUNFLBOJTNFBVUPSFHVMBTJZBOHEJKFMBTLBO UVCVMVT LPMJHFOT LPSUJLBMJT .FLBOJTNF BMEPTUFSPO
EBMBN #BC QFOJOHLBUBO UFLBOBO BSUFSJ BOUBSB CBUBT EBO NFOJOHLBULBO SFBCTPSQTJ OBUSJVN TFNFOUBSB QBEB TBBU ZBOH
NN)HCJBTBOZBIBOZBNFNCFSJFGFLZBOHLFDJMQBEBBMJSBO TBNBNFOJOHLBULBOTFLSFTJLBMJVNBEBMBIEFOHBONFSBOHTBOH
EBSBI HJOKBM EBO -'( 1FOJOHLBUBO LFDJM -'( ZBOH UFSKBEJ UVSVU QPNQB OBUSJVNLBMJVN "51BTF QBEB TJTJ CBTPMBUFSBM EBSJ
CFSQFSBO EBMBN FGFL QFOJOHLBUBO UFLBOBO BSUFSJ QBEB LFMVBSBO NFNCSBO UVCVMVT LPMJHFOT LPSUJLBMJT "MEPTUFSPO KVHB
VSJOF #JMB BVUPSFHVMBTJ -'( UFSHBOHHV TFQFSUJ ZBOH TFSJOH NFOJOHLBULBO QFSNFBCJMJUBT OBUSJVN QBEB TJTJ MVNJOBM
UFSKBEJ QBEB QFOZBLJU HJOKBM QFOJOHLBUBO UFLBOBO BSUFSJ NFNCSBO .FLBOJTNF TFMVMBS EBSJ LFSKB BMEPTUFSPO EJCBIBT
NFOZFCBCLBOQFOJOHLBUBO-'(ZBOHMFCJICFTBS EBMBN#BC
337
Tabel 27-3 Hormon yang Mengatur Reabsorpsi Tubulus
Hormon Tempat Kerja Pengaruh
Aldosteron Tubulus dan duktus koligens l NaCl, H2O reabsorpsi, l K+ sekresi

Angiotensin II Tubulus proksimal, segmen tebal ansa Henle/ l NaCl, H2O reabsorpsi, l H+ sekresi
tubulus tubulus koligens
Hormon antidiuretik Tubulus distal/tubulus dan duktus koligens l H2O reabsorpsi
Peptida natriuretik atrium Tubulus distal/tubulus dan duktus koligens n NaCl reabsorpsi
Hormon paratiroid Tubulus proksimal, segmen tebal asendens ansa Herde n POy4 reabsorpsi, l Ca++ reabsorpsi
3BOHTBOHZBOHQBMJOHQFOUJOHVOUVLBMEPTUFSPOBEBMBI
UVCVMVT QSPLTJNBM ,FEVB LPOTUSJLTJ BSUFSJPM FGFSFO EFOHBO
QFOJOHLBUBOLPOTFOUSBTJLBMJVNFLTUSBTFMEBO
QFOJOHLBUBO NFOHVSBOHJ BMJSBO EBSBI HJOKBM NFOJOHLBULBO GSBLTJ GJMUSBTJ
LBEBSBOHJPUFOTJO** ZBOHCJBTBOZBUFSKBEJQBEBLFBEBBOZBOH EBMBN HMPNFSVMVT EBO NFOJOHLBULBO LPOTFOUSBTJ QSPUFJO EBO
CFSIVCVOHBO EFOHBO LFLVSBOHBO OBUSJVN EBO WPMVNF BUBV UFLBOBO PTNPUJL LPMPJE EBMBN LBQJMFS QFSJUVCVMVT JOJ
QFOVSVOBO UFLBOBO EBSBI 1FOJOHLBUBO TFLSFTJ BMEPTUFSPO NFOJOHLBULBO HBZB SFBCTPSQTJ QBEB LBQJMFS QFSJUVCVMVT EBO
ZBOHCFSIVCVOHBOEFOHBOLFBEBBOLFBEBBOJOJNFOZFCBCLBO NFOJOHLBULBOSFBCTPSQTJOBUSJVNEBOBJSPMFIUVCVMVT
SFUFOTJ OBUSJVN EBO BJS EJ HJOKBM TFIJOHHB NFNCBOUV 3. "OHJPUFOTJOTFDBSBMBOHTVOHNFSBOHTBOHSFBCTPSQTJOBUSJVN
NFOJOHLBULBO WPMVNF DBJSBO FLTUSBTFM EBO NFOHFNCBMJLBO EJ UVCVMVT QSPLTJNBM BOTB )FOMF UVCVMVT EJTUBM EBO UVCVMVT
UFLBOBOEBSBINFOKBEJOPSNBM LPMJHFOT 4BMBI TBUV FGFL MBOHTVOH EBSJ BOHJPUFOTJO ** BEBMBI
#JMB UJEBL BEB BMEPTUFSPO TFQFSUJ ZBOH UFSKBEJ QBEB NFSBOHTBOH QPNQB OBUSJVNLBMJVN "51BTF QBEB NFNCSBO
LFSVTBLBOBUBVNBMGVOHTJBESFOBM QFOZBLJU"EEJTPO
UFSEBQBU CBTPMBUFSBMTFMFQJUFMUVCVMVT&GFLLFEVBBEBMBINFSBOHTBOH
LFIJMBOHBO OBUSJVN ZBOH OZBUB EBSJ UVCVI EBO UFSKBEJ QFSUVLBSBO OBUSJVNIJESPHFO EBMBN NFNCSBO MVNJOBM
BLVNVMBTJ LBMJVN 4FCBMJLOZB TFLSFTJ BMEPTUFSPO ZBOH UFSVUBNB EBMBN UVCVMVT QSPLTJNBM &GFL BOHJPUFOTJO ** ZBOH
CFSMFCJIBO TFQFSUJ ZBOH UFSKBEJ QBEB QBTJFO EFOHBO UVNPS LFUJHB BEBMBI NFSBOHTBOH LPUSBOTQPS OBUSJVNCJLBSCPOBU EJ
BESFOBM TJOESPN$POO
CFSIVCVOHBOEFOHBOSFUFOTJOBUSJVN NFNCSBOCBTPMBUFSBM (BNCBS

EBO IJMBOHOZB LPOTFOUSBTJ LBMJVN QMBTNB ZBOH TFCBHJBO +BEJ BOHJPUFOTJO ** NFSBOHTBOH USBOTQPS OBUSJVN NFMFXBUJ
EJTFCBCLBO PMFI TFLSFTJ LBMJVN CFSMFCJIBO PMFI HJOKBM QFSNVLBBO MVNJOBM EBO CBTPMBUFSBM EBSJ NFNCSBO TFM FQJUFM
8BMBVQVO SFHVMBTJ LFTFJNCBOHBO OBUSJVN EBSJ IBSJ LF IBSJ QBEBTFCBHJBOCFTBSTFHNFOUVCVMVT,FSKBBOHJPUFOTJO**ZBOH
EBQBU EJQFSUBIBOLBO TFMBNB UFSEBQBU LBEBS BMEPTUFSPO NVMUJQFMJOJNFOZFCBCLBOSFUFOTJOBUSJVNEBOBJSZBOHCFSBSUJ
NJOJNBM LFUJEBLNBNQVBOVOUVLNFOZFTVBJLBOEFOHBOUFQBU PMFIHJOKBMCJMBLBEBSBOHJPUFOTJO**NFOJOHLBUEBONFNBJOLBO
TFLSFTJ BMEPTUFSPO JOJ TBOHBU NFOHHBOHHV SFHVMBTJ FLTLSFTJ QFSBOQFOUJOHEBMBNNFNVOHLJOLBOUVCVIVOUVL
LBMJVN HJOKBM EBO LPOTFOUSBTJ LBMJVN EBMBN DBJSBO UVCVI
0MFI LBSFOB JUV BMEPTUFSPO MFCJI QFOUJOH TFCBHBJ SFHVMBUPS
LPOTFOUSBTJLBMJVNEBSJQBEBLPOTFOUSBTJOBUSJVN
Angiotensin II Meningkatkan Reabsorpsi Natrium dan
Air. "OHJPUFOTJO ** LFNVOHLJOBO NFSVQBLBO IPSNPO
QFOBIBOOBUSJVNZBOHQBMJOHLVBUEBMBNUVCVI4FQFSUJUFMBI
EJCBIBTEBMBN#BC QFNCFOUVLBOBOHJPUFOTJO**NFOJOHLBU
QBEB LFBEBBOLFBEBBO UFSUFOUV ZBOH CFSIVCVOHBO EFOHBO
UFLBOBO EBSBI ZBOH SFOEBI EBO BUBV WPMVNF DBJSBO FLTUSBTFM
ZBOH SFOEBI TFQFSUJ ZBOH UFSKBEJ TFMBNB QFSEBSBIBO BUBV Na+
+ +
Na
ATP NHE
LFIJMBOHBO HBSBN EBO BJS EBSJ DBJSBO UVCVI PMFI LFSJOHBU K+ H+
CFSMFCJI BUBV EJBSF IFCBU 1FOJOHLBUBO QFNCFOUVLBO
BOHJPUFOTJO ** NFNCBOUV NFOHFNCBMJLBO UFLBOBO EBSBI EBO Ang II AT1 AT1 Ang II
WPMVNF FLTUSBTFM NFOKBEJ OPSNBM EFOHBO NFOJOHLBULBO
SFBCTPSQTJOBUSJVNEBOBJSEBSJUVCVMVTHJOKBMNFMBMVJUJHBFGFL Na+
VUBNB +
-
HCO3
1. "OHJPUFOTJO NFSBOHTBOH TFLSFTJ BMEPTUFSPO ZBOH
LFNVEJBONFOJOHLBULBOSFBCTPSQTJOBUSJVN
2. "OHJPUFOTJO ** NFOHPOTUSJLTJLBO BSUFSJPM FGFSFO ZBOH
NFNQVOZBJ EVB FGFL UFSIBEBQ EJOBNJLB LBQJMFS
QFSJUVCVMVT ZBOH EBQBU NFOJOHLBULBO SFBCTPSQTJ OBUSJVN
EBO BJS 1FSUBNB LPOTUSJLTJ BSUFSJPM FGFSFO NFOHVSBOHJ
UFLBOBO IJESPTUBUJL LBQJMFS QFSJUVCVMVT ZBOH
NFOJOHLBULBOSFBCTPSQTJBLIJSUVCVMVT UFSVUBNBEBSJ
338
Bab 27 Pembentukan Urine oleh Ginjal II. Reabsorpsi dan Sekresi Tubulus
CFSBEBQUBTJ WBSJBTJ BTVQBO OBUSJVN ZBOH MVBT UBOQB QFSVCBIBO

CFTBSWPMVNFDBJSBOFLTUSBTFMVMBSEBOUFLBOBOEBSBI TFQFSUJZBOH
EJCBIBTEJ#BC
1BEB TBBU ZBOH CFSTBNBBO BOHJPUFOTJO ** NFOJOHLBULBO
UNIT V
SFBCTPSQTJ OBUSJVN UVCVMVT SFOBM FGFL WBTPLPOTUSJLUPSOZB QBEB AQP-3 H 2O
BSUFSJPMFGFSFOKVHBNFNCBOUVNFNQFSUBIBOLBOFLTLSFTJOPSNBM AQP-4
QSPEVL TJTB NFUBCPMJTNF TFQFSUJ VSFVN EBO LSFBUJOJO ZBOH AVP V2
H2O
UFSVUBNB CFSHBOUVOH LFQBEB -'( ZBOH DVLVQ VOUVL FLTLSFTJ Gs
cAMP
NFSFLB 0MFI LBSFOB JUV QFOJOHLBUBO QFNCFOUVLBO BOHJPUFOTJO
AC
** NFNVOHLJOLBO HJOKBM VOUVL NFSFUFOTJ OBUSJVN EBO BJS UBOQB A
ATP
NFOZFCBCLBOSFUFOTJQSPEVLTJTBNFUBCPMJTNF Gs AQP-2
AVP V2
ADH Meningkatkan Reabsorpsi Air. ,FSKB"%)HJOKBMZBOH
QBMJOHQFOUJOHBEBMBINFOJOHLBULBOQFSNFBCJMJUBTBJSQBEBUVCVMVT
EJTUBM UVCVMVT LPMJHFOT EBO FQJUFM EVLUVT LPMJHFOT )BM JOJ
NFNCBOUV UVCVI VOUVL NFOZJNQBO BJS EBMBN LFBEBBO TFQFSUJ
EFIJESBTJ #JMB UJEBL BEB "%) QFSNFBCJMJUBT UVCVMVT EJTUBM EBO (AQP-2)
EVLUVTLPMJHFOTUFSIBEBQBJSNFOKBEJSFOEBI NFOZFCBCLBOHJOKBM
NFOHFLTLSFTJ TFKVNMBI CFTBS VSJOF ZBOH FODFS +BEJ LFSKB "%)
NFNFHBOH QFSBO QFOUJOH EBMBN NFOHPOUSPM EFSBKBU QFOHFODFSBO
BUBVQFNFLBUBOVSJOF TFQFSUJBLBOEJCBIBTMFCJIMBOKVUEBMBN#BC
EBO#BC
"%) CFSJLBUBO EFOHBO SFTFQUPS 7 TQFTJGJL EJ CBHJBO BLIJS
UVCVMVT EJTUBM UVCVMVT LPMJHFOT EBO EVLUVT LPMJHFOT ZBOH
NFOJOHLBULBO QFNCFOUVLBO ".1 TJLMJL EBO NFOHBLUJWBTJ
QSPUFJO LJOBTF (BNCBS
,FNVEJBO LFEVB IBM UFSTFCVU
NFSBOHTBOH QFSHFSBLBO TVBUV QSPUFJO JOUSBTFM ZBOH EJTFCVU
BRVBQPSJO "21
LF TJTJ MVNJOBM NFNCSBO TFM .PMFLVM
NPMFLVM "21 CFSLFMPNQPL EBO CFSHBCVOH EFOHBO NFNCSBO
TFM NFMBMVJ FLTPTJUPTJT VOUVL NFNCFOUVL LBOBM BJS ZBOH
NFOZFCBCLBO EJGVTJ BJS TFDBSB DFQBU NFMBMVJ TFM +VHB UFSEBQBU Hormon Paratiroid Meningkatkan Reabsorpsi Kalsium.
BRVBQPSJO MBJOOZB "21 EBO "21 EJ TJTJ CBTPMBUFSBM EBSJ )PSNPOQBSBUJSPJEBEBMBITBMBITBUVIPSNPOQFOHBUVSLBMTJVN
NFNCSBOTFMZBOHNFOZFEJBLBOTVBUVKBMVSCBHJBJSVOUVLLFMVBS ZBOHQBMJOHQFOUJOHEBMBNUVCVI,FSKBOZBZBOHVUBNBEBMBN
EBSJTFMTFDBSBDFQBU XBMBVQVOIBMJOJUJEBLEJZBLJOJEJBUVSPMFI HJOKBM BEBMBI NFOJOHLBULBO SFBCTPSQTJ LBMTJVN PMFI UVCVMVT
"%)1FOJOHLBUBOLBEBS"%)TFDBSBLSPOJTKVHBNFOJOHLBULBO UFSVUBNB EBMBN UVCVMVT EJTUBM EBO LFNVOHLJOBO KVHB EBMBN
QFNCFOUVLBO QSPUFJO "21 EJ TFM UVCVMVT HJOKBM EFOHBO BOTB )FOMF )PSNPO QBSBUJSPJE KVHB NFNQVOZBJ LFSKB ZBOH
NFSBOHTBOH USBOTLSJQTJ HFO "21 #JMB LPOTFOUSBTJ "%) MBJO UFSNBTVL NFOHIBNCBU SFBCTPSQTJ GPTGBU PMFI UVCVMVT
NFOVSVO NPMFLVM "21 CFSQJOEBI LFNCBMJ LF TJUPQMBTNB TFM QSPLTJNBM EBO NFSBOHTBOH SFBCTPSQTJ NBHOFTJVN PMFI BOTB
EFOHBOEFNJLJBONFNJOEBILBOLBOBMBJSEBSJNFNCSBOMVNJOBM )FOMF TFQFSUJZBOHEJCBIBTEBMBN#BC
EBO NFOVSVOLBO QFSNFBCJMJUBT BJS ,FSKB TFMVMBS "%) JOJ
EJCBIBTMFCJIMBOKVUEJ#BC Aktivasi Sistem Saraf Simpatis Meningkatkan Reabsorpsi
Natrium
Peptida Natriuretik Atrium Menurunkan Reabsorpsi "LUJWBTJ TJTUFN TBSBGTJNQBUJT CJMB IFCBU EBQBUNFOVSVOLBO
Natrium dan Air. 4FMTFM TQFTJGJL QBEB BUSJVN KBOUVOH CJMB FLTLSFTJ OBUSJVN EBO BJS EFOHBO NFOHPOTUSJLTJLBO BSUFSJPM
NFOHFNCBOH LBSFOB QFSMVBTBO WPMVNF QMBTNB BLBO HJOKBM TFIJOHHB NFOHVSBOHJ -'( /BNVO EFNJLJBO UJOHLBU
NFOZFLSFTJLBO TVBUV QFQUJEB ZBOH EJTFCVU QFQUJEB OBUSJVSFUJL BLUJWBTJ TJNQBUJT ZBOH SFOEBIQVO BLBO NFOVSVOLBO FLTLSFTJ
BUSJVN "/1
1FOJOHLBUBOLBEBSQFQUJEBJOJLFNVEJBOMBOHTVOH OBUSJVN EBO BJS LBSFOB SFBCTPSQTJ OBUSJVN EBMBN UVCVMVT
NFOHIBNCBU SFBCTPSQTJ OBUSJVN EBO BJS PMFI UVCVMVT HJOKBM QSPLTJNBM TFHNFO UFCBM BTFOEFOT BOTB )FOMF EBO
UFSVUBNB EBMBN EVLUVT LPMJHFOT "/1 KVHB NFOHIBNCBU TFLSFTJ LFNVOHLJOBOEJCBHJBOUVCVMVTHJOKBMZBOHMFCJIEJTUBM)BMJOJ
SFOJO EBO EFOHBO EFNJLJBO QFNCBOUVLBO BOHJPUFOTJO ** ZBOH UFSKBEJ NFMBMVJ BLUJWBTJ SFTFQUPS BESFOFSHJLB EJ TFM FQJUFM
TFMBOKVUOZB NFOVSVOLBO SFBCTPSQTJ UVCVMVT HJOKBM 1FOVSVOBO UVCVMVTHJOKBM
SFBCTPSQTJOBUSJVNEBOBJSJOJNFOJOHLBULBOFLTLSFTJVSJOFZBOH 1FSBOHTBOHBO TJTUFN TBSBG TJNQBUJT KVHB BLBO
NFNCBOUVNFOHFNCBMJLBOWPMVNFEBSBINFOKBEJOPSNBM NFOJOHLBULBO QFMFQBTBO SFOJO EBO QFNCFOUVLBO BOHJPUFOTJO
,BEBS "/1 TBOHBU NFOJOHLBU QBEB HBHBM KBOUVOH LPOHFTUJG ** ZBOH NFNCBOUV LFTFMVSVIBO FGFL VOUVL NFOJOHLBULBO
LFUJLBBUSJBKBOUVOHNFSFHBOHLBSFOBUFSHBOHHVOZBGVOHTJQPNQB SFBCTPSQTJ UVCVMVT EBO NFOVSVOLBO FLTLSFTJ OBUSJVN PMFI
WFOUSJLFM 1FOJOHBULBO "/1 NFNCBOUV NFOHVSBOHJ SFUFOTJ HJOKBM
OBUSJVNEBOBJSQBEBHBHBMKBOUVOH
339
Penggunaan Metode Bersihan untuk Menghitung NBLBCFSTJIBOEBQBUEJUVMJTTFCBHBJ

Fungsi Ginjal U V
Cs = s
Ps
#FTBS LFDFQBUBO CFSCBHBJ [BU ZBOH EJCFSTJILBO EBSJ QMBTNB
+BEJ CFSTJIBOHJOKBMUFSIBEBQTVBUV[BUEJIJUVOHEBSJLFDFQBUBO
NFSVQBLBO DBSB ZBOH CFSHVOB VOUVL NFOHIJUVOH FGFLUJWJUBT
FLTLSFTJ [BU UFSTFCVU EBMBN VSJOF 6T Y 7
EJCBHJ LPOTFOUSBTJ
HJOKBM EBMBN NFOHFLTLSFTJLBO CFSCBHBJ [BU 5BCFM

QMBTNBOZB
4FDBSB EFGJOJTJ CFSTJIBO HJOKBM UFSIBEBQ TVBUV [BU BEBMBI
WPMVNFQMBTNBZBOHEJCFSTJILBOTFDBSBNFOZFMVSVIEBSJTVBUV Bersihan Inulin Dapat Digunakan untuk Memperkirakan
[BUPMFIHJOKBMQFSTBUVBOXBLUV LFG#JMBTVBUV[BUEJGJMUSBTJTFDBSBCFCBT EJGJMUSBTJTFCFCBTBJS

,POTFQ JOJ NFSVQBLBO LPOTFQ ZBOH BCTUSBL LBSFOB UJEBL EBOUJEBLEJSFBCTPSCTJBUBVEJTFLSFTJLBOPMFIUVCVMVTHJOKBM
NBLBLFDFQBUBO[BUUFSTFCVUEJFLTLSFTJLBOLFEBMBNVSJOF 6TY
BEB WPMVNF QMBTNB ZBOH TFDBSB NFOZFMVSVI EJCFSTJILBO EBSJ
7
TBNBEFOHBOLFDFQBUBOGJMUSBTJ[BUUFSTFCVUPMFIHJOKBM -'(
TVBUV[BU"LBOUFUBQJ LPOTFQJOJNFSVQBLBOTVBUVDBSBZBOH
Y1T
+BEJ
CFSHVOB VOUVL NFOHIJUVOH GVOHTJ FLTLSFTJ HJOKBM EBO TFQFSUJ
ZBOH BLBO EJCBIBT LFNVEJBO EBQBU EJHVOBLBO VOUVL LFG× Ps = Us × V
NFOHIJUVOH LFDFQBUBO BMJSBO EBSBI ZBOH NFMBMVJ HJOKBM EBO 0MFILBSFOBJUV -'( EBQBUEJIJUVOHTFCBHBJCFSTJIBO[BUEFOHBO
KVHB GVOHTJGVOHTJ EBTBS EBSJ HJOKBM GJMUSBTJ HMPNFSVMVT QFSTBNBBOCFSJLVU
SFBCTPSQTJUVCVMVT EBOTFLSFTJUVCVMVT
Us V
6OUVL NFOHHBNCBSLBO QSJOTJQ CFSTJIBO QJLJSLBO DPOUPI GFR = = Cs
Ps
CFSJLVU JOJ #JMB QMBTNB ZBOH NFMFXBUJ HJOKBM NFOHBOEVOH
NH [BU EBMBN TFUJBQ NJMJMJUFSOZB EBO NH [BU JOJ KVHB 4VBUV[BUZBOHDPDPLEFOHBOLSJUFSJBJOJBEBMBIJOVMJO TVBUVNPMFLVM
EJFLTLSFTJLBOLFEBMBNVSJOFTFUJBQNFOJU NMNFOJUQMBTNB QPMJTBLBSJEB EFOHBO CFSBU NPMFLVM TFLJUBS *OVMJO ZBOH UJEBL
EJCFSTJILBO EBSJ [BU +BEJ CFSTJIBO BEBMBI WPMVNF QMBTNB EJIBTJMLBO PMFI UVCVI EJUFNVLBO EBMBN BLBS UBOBNBO UFSUFOUV EBO
ZBOH EJQFSMVLBO VOUVL NFOTVQMBJ KVNMBI [BU ZBOH IBSVTEJCFSJLBOTFDBSBJOUSBWFOBQBEBQBTJFOVOUVLNFOHVLVS-'(
EJFLTLSFTJLBOEBMBNVSJOFQFSTBUVBOXBLUV1FOVMJTBOTFDBSB (BNCBS NFOVOKVLLBO CBHBJNBOB HJOKBM
NBUFNBUJT NFNQFSMBLVLBO JOVMJO 1BEB DPOUPI JOJ LPOTFOUSBTJ QMBTNB
Cs × PS = Us × V, BEBMBI NHNM LPOTFOUSBTJ VSJOF BEBMBI NHNM EBO
EFOHBO $T BEBMBI OJMBJ CFSTJIBO TVBUV [BU T 1T BEBMBI LFDFQBUBOBMJSBOVSJOFBEBMBINMNFOJU0MFILBSFOBJUV
LPOTFOUSBTJ[BUEBMBNQMBTNB6TBEBMBILPOTFOUSBTJ[BUEBMBN NHNFOJU JOVMJO NBTVL LF EBMBN VSJOF ,FNVEJBO CFSTJIBO
VSJOF EBO7BEBMBILFDFQBUBOBMJSBOVSJOF%FOHBONFOZVTVO JOVMJOEJIJUVOHTFCBHBJLFDFQBUBOFLTLSFTJJOVMJOEBMBNVSJOF
LFNCBMJQFSTBNBBOJOJ
Tabel 27-4 Penggunaan Bersihan untuk Mengukur Fungsi Ginjal
lstilah Persamaan Satuan
s
Laju bersihan (Cs) Us V ml/min
Cs =
Ps
s
laju filtrasi glomerulus (LFG) Uinulin V

LFG = Pinulin
Rasio klirens C None

3BTJPCFSTJIBO= C s
inulin
s
Aliran plasma ginjal UPAHV ml/min

ERPF = CPAH =
efektif {ERPF) PPAH
s
Aliran plasma ginjal CPAH (UPAH V/PPAH) ml/min
RPF = =
(RPF) EPAH (PPAH VPAH)/PPAH
s
UPAH V
=
PPAH VPAH
Aliran darah ginjal RPF ml/min
RBF=
(RBF) 1 Hematokrit
s
Kecepatan ekskresi Kecepatan ekskresi =V Us × mg/min, mmol/min, or mEq/min
Kecepatan reabsorpsi Kecepatan reabsorpsi= Muatan yang difiltrasi− Kecepatan ekskresi mg/min, mmol/min, or mEq/min
s
= (GFR × Ps ) − (Us × V)
Kecepatan sekresi Kecepatan sekresi = Kecepatan ekskresi - muatan terfiltrasi mg/menit, mmol/menit, atau mEq/
menit
S, suatu zat; U, konsentrasi urine;V, kecepatan aliran urine; P, konsentrasi plasma; PAH, asam para-aminohipurat; PPAH' konsentrasi PAH arteri ginjal; EPAH' PAH
rasio ekstrasi; VPAH' konsentrasi PAH vena ginjal.
340
Bab 27 Pembentukan Urine oteh Ginjal: II. Reabsorpsi dan Sekresi Tubulus
Pinulin = 1 mg/ml 1DS Y -'(

EBO FLTLSFTJ LSFBUJOJO 6DS Y 7
LFNCBMJ OPSN_ $S
EBO UFSKBEJ LFTFJNCBOHBO BOUBSB QSPEVLTJ LSFBUJOJO EBO
FLTLSFTJ LSFBUJOJO )BM JOJ BLBO UFSKBEJ CJMB LSFBUJOJO QMBTNB
NFOJOHLBU IJOHHB LVSBOH MFCJI EVB LBMJ OPSNBM TFQFSUJ ZBOH
EJQFSMJIBULBOEBMBN(BNCBS
UNIT V
+JLB -'( NFOVSVO IJOHHB TFQFSFNQBU OPSNBM LSFBUJOJO
.
GFR x Pinulin = Uinulin x V QMBTNB BLBO NFOJOHLBU IJOHHB FNQBU LBMJ OPSNBM EBO
QFOVSVOBO -'( IJOHHB TFQFSEFMBQBO OPSNBM BLBO
.
Uinulin x V NFOJOHLBUBO LSFBUJOJO QMBTNB NFOKBEJ EFMBQBO LBMJ OPSNBM
Pinulin
+BEJ EBMBN LFBEBBO ZBOH TUBCJM LFDFQBUBO FLTLSFTJ LSFBUJOJO
TBNB EFOHBO LFDDQBUBO QSPEVLTJ LSFBUJOJO XBMBVQVO UFSKBEJ
= 125 ml/min QFOVSVOBO -'( /BNVO LFDFQBUBO FLTLSFTJ LSFBUJOJO ZBOH
OPSNBM JOJ UFSKBEJ QBEB LFBEBBO LPOTFOUSBTJ LSFBUJOJO QMBTNB
ZBOH NFOJOHLBU TFQFSUJ ZBOH EJQFSMJIBULBO EBMBN (BNCBS

Bersihan PAH Dapat Digunakan untuk

Memperkirakan Aliran Plasma Ginjal
Uinulin = 125 mg/ml 4FDBSB UFPSFUJT CJMB TVBUV [BU EJCFSTJILBO TFDBSB NFOZFMVSVI
.
V = 1 ml/min EBSJ QMBTNB LFDFQBUBO CFSTJIBO [BU UFSTFCVU TBNB EFOHBOUPUBM
BMJSBOQMBTNBHJOKBM%FOHBOLBUBMBJO KVNMBI[BUZBTOHTBNQBJLF
HJOKBM EBMBN EBSBI BMJSBO QMBTNB HJOKBM Y 1T
BLBO TBNB EFOHBO
KVNMBI ZBOH EJFLTLSFTJLBO EBMBN VSJOF 6T Y :
+BEJ BMJSBO
QMBTNBHJOKBM 31'
EBQBUEJIJUVOHTFCBHBJCFSJLVU

U s V
EJCBHJ EFOHBO LPOTFOUSBTJ QMBTNB ZBOH NFOHIBTJMLBO OJMBJ RPF = = Cs
Ps
NMNFOJU +BEJ NMQMBTNBZBOHNFOHBMJSNFMBMVJHJOKBMIBSVT
EJGJMUSBTJVOUVLNFNCBXBJOVMJOZBOHUBNQBLEBMBNVSJOF
*OVMJOCVLBOMBITBUVTBUVOZB[BUZBOHEBQBUEJHVOBLBOVOUVL 100
NFOFOUVLBO-'(;BU[BUMBJOZBOHUFMBIEJHVOBLBOTFDBSBLMJOJT
)
VOUVL NFNQFSLJSBLBO -'( BOUBSB MBJO LSFBUJOJO EBO JPUBMBNBU

(ml/m
SBEJPBLJG 50
Bersihan Kreatinin dan Konsentrasin Kreatinin Plasma yang
Dapat Di gunakan untuk Memperkirakan LFG
0
,SFBUJOJONFSVQBLBOQSPEVLTBNQJOHBONFUBCPMJTNFPUPUEBOIBNQJS
TFMVSVIOZBEJCFSTJILBOEBSJUVCVIPMFIGJMUSBTJHMPNFSVMVT0MFILBSFOB
JUV CFSTJIBO LSFBUJOJO EBQBU KVHB EJHVOBLBO VOUVL NFOHIJUVOH -'(
0MFILBSFOBQFOHIJUVOHBOCFSTJIBOLSFBUJOJOUJEBLNFNCVUVILBOJOGVT 2
(mg/dl)
JOUSBWFOB QBEB QBTJFO NFUPEF JOJ MFCJI CBOZBL EJHVOBLBO EBSJQBEB

CFSTJIBO JOVMJO VOUVL NFNQFSLJSBLBO -'( TFDBSB LMJOJT "LBO UFUBQJ
CFSTJIBO LSFBUJOJO CVLBOMBI QFOBOEB ZBOH CBJL VOUVL -'( LBSFOB 1
TFKVNMBI LFDJM LSFBUJOJO EJTFLSFTJLBO PMFI UVCVMVT TFIJOHHB KVNMBI
LSFBUJOJO ZBOH EJFLTLSFTJLBO EBMBN VSJOF TFEJLJU NFMFCJIJ KVNMBI ZBOH
EJGJMUSBTJ 4FDBSB OPSNBM UFSEBQBU LFTBMBIBO LFDJM EBMBN QFOHVLVSBO
0
LSFBUJOJOQMBTNBZBOHNFOHIBTJMLBOLFMFCJIBOQFOHVLVSBOLPOTFOUSBTJ
QMBTNB EBOTFDBSBLFCFUVMBO LFEVBLFTBMBIBOJOJDFOEFSVOHNFOVUVQJ
)
TBUV TBNB MBJO 0MFI LBSFOB JUV CFSTJIBO LSFBUJOJO NFOHIBTJMLBO

(g/
QFSLJSBBO-'(ZBOHNBTVLBLBM 2
1BEBCFCFSBQBLFBEBBO NVOHLJOUJEBLQSBLUJTVOUVLNFOHVNQVMLBO
VSJOF QBEB TFPSBOH QBTJFO HVOB NFOHVLVS CFSTJIBO LSFBUJOJO $DS
GFR x P
8BMBVQVO EFNJLJBO TVBUV QFSLJSBBO QFSVCBIBO -'( EBQBU EJIJUVOH 1
IBOZB EFOHBO NFOHVLVS LPOTFOUSBTJ LSFBUJOJO QMBTNB 1DS
ZBOH
CFSCBOEJOHUFSCBMJLEFOHBO-'(

0
U V 0 1 2 3 4
LFG zCCr = CrPCr
+JLB-'(TFDBSBUJCBUJCBNFOVSVOIJOHHBQFSTFO HJOKBMTFDBSBTF
NFOUBSB BLBO NFMBLVLBO GPMZUBTJ EBO FLTLSFTJ IBOZB TFQBSVI EBSJ
LSFBUJOJO ZBOH NFOZFCBCLBO BLVNVMBTJ LSFBUJOJO EBMBN DBJSBO UVCVI
EBO NFOJOHLBULBO LPOTFOUSBTJ QMBTNB ,POTFOUSBTJ LSFBUJOJO QMBTNB
BLBOUFSVTNFOJOHLBUTBNQBJCFCBOLSFBUJOJOZBOHEJGJMUSBTJ
341
14
12
10
(mg/100 ml)
UPAH x V
6 =
PPAH
2 Normal PAH =
0.001 mg/ml
25 50 75 100 125 150 UPAH = 5.85 mg/ml

V = 1 ml/
(ml/m )
0MFILBSFOB-'(IBOZBTFLJUBSQFSTFOEBSJBMJSBOQMBTNBUPUBM
[BU ZBOH EJCFSTJILBO TFDBSB NFOZFMVSVI EBSJ QMBTNB IBSVT
EJFLTLSFTJLBO PMFI TFLSFTJ UVCVMVT EBO GJMUSBTJ HMPNFSVMVT (BNCBS

5JEBL BEB TBUV QVO [BU ZBOH EJCFSTJILBO TFDBSB NFOZFMVSVI
PMFI HJOKBM "LBO UFUBQJ TBUV [BU ZBJUV 1") TFLJUBS QFSTFO
EJCFSTJILBO EBSJ QMBTNB 0MFI LBSFOB JUV CFSTJIBO 1") EBQBU
,JUBEBQBUNFOHIJUVOHUPUBMBMJSBOEBSBIZBOHNFMBMVJHJOKBMEBSJBMJSBO
EJHVOBLBOTFCBHBJQFSLJSBBOBMJSBOQMBTNBHJOKBM6OUVLMFCJIBLVSBU
QMBTNB HJOKBM EBO IFNPUPLSJU QFSTFOUBTF TFM EBSBI NFSBI EBMBN
LJUBEBQBUNFNFSJLTBQFSTFOUBTF1")ZBOHNBTJIUFSEBQBUEJEBMBN
EBSBI
#JMB IFNBUPLSJU BEBMBI EBO UPUBM BMJSBO QMBTNB HJOKBM BEBMBI
EBSBI TFXBLUV 1") NFOJOHHBMLBO HJOKBM 1FSTFOUBTF 1") ZBOH
NMNFOJU NBLB UPUBM BMJSBO EBSBI ZBOH NFMBMVJ LFEVB HJOKBM
EJQJOEBILBOEBSJEBSBIEJTFCVUTFCBHBJSBTJPFLTUSBLTJ1")EBOOJMBJ
BEBMBI
BUBVNMNFOJU
SBUBSBUBOZB TFLJUBS QFSTFO QBEB HJOKBM OPSNBM 1BEB HJOKBM ZBOH
TBLJU SBTJP FLTUSBLTJ JOJ EBQBU NFOVSVO LBSFOB LFUJEBLNBNQVBO Fraksi Filtrasi Dihitung dari LFG Dibagi Aliran Plasma Ginjal
UVCVMVTZBOHSVTBLVOUVLNFOZFLSFTJ1")LFEBMBNDBJSBOUVCVMVT
6OUVL NFOHIJUVOH GSBLTJ GJMUSBTJ ZBJUV GSBLTJ QMBTNB ZBOH EJGJMUSBTJ
1FOHIJUVOHBO 31' EBQBU EJQFSBHBLBO PMFI DPOUPI CFSJLVU NFMBMVJNFNCSBOHMPNFSVMVT LJUBIBSVTMFCJIEVMVNFOHFUBIVJBMJSBO
"OHHBQ LPOTFOUSBTJ 1") QMBTNB BEBMBI NHNM LPOTFOUSBTJ QMBTNB HJOKBM CFSTJIBO 1")
EBO -'( CFSTJIBO JOVMJO
#JMB BMJSBO
VSJOF BEBMBI NHNM EBO LFDFQBUBO BMJSBO VSJOF BEBMBI NM QMBTNB HJOKBM BEBMBI NMNFOJU EBO -'( BEBMBI NMNFOJU
NFOJU #FSTJIBO 1") EBQBU EJIJUVOH EBSJ LFDFQBUBO FLTLSFTJ 1") GSBLTJGJMUSBTJ ''
EJIJUVOHTFCBHBJ
EBMBN VSJOF NHN Y NM NFOJU
EJCBHJ EFOHBO LPOTFOUSBTJ
1")QMBTNB NHNM
+BEJ QFSIJUVOHBOCFSTJIBO1")NFOKBEJ
NMNFOJU Penghitungan Reabsorpsi atau Sekresi Tubulus dari
#JMB SBTJP FLTUSBLTJ VOUVL 1") BEBMBI QFSTFO BMJSBO QMBTNB Bersihan Ginjal
HJOKBMZBOHTFCFOBSOZBEBQBUEJIJUVOHEFOHBONFNCBHJNMNFOJU #JMB LFDFQBUBO GJMUSBTJ HMPNFSVMVT EBO FLTLSFTJ HJOKBM UFSIBEBQ TVBUV [BU
EFOHBO TFIJOHHB NFOHIBTJMLBO OJMBJ NMNFOJU +BEJ UPUBM EJLFUBIVJ LJUB EBQBU NFOHIJUVOH BQBLBI BEB SFBCTPSQTJ BLIJS BUBV
BMJSBOQMBTNBHJOKBMEBQBUEJIJUVOHTFCBHBJCFSJLVU TFLSFTJ BLIJS EBSJ [BU UFSTFCVU PMFI UVCVMVT HJOKBM 4FCBHBJ DPOUPI CJMB
Bersihan PAH LFDFQBUBOFLTLSFTJ[BUUFSTFCVU 6TYLVSBOHEBSJCFCBO[BUZBOHEJGJMUSBTJ
Aliran plasma ginjal total
Rasio ekstraksi PAH -'( Y 14
NBLB CFCFSBQB [BU UFSTFCVU IBSVT EJSFBCTPSCTJ EBSJ UVCVMVT
HJOKBM
3BTJP FLTUSBLTJ &1")
EJIJUVOH TFCBHBJ QFSCFEBBO BOUBSB
LPOTFOUSBTJ 1") BSUFSJ HJOKBM 11")
EFOHBO LPOTFOUSBTJ 1") 4FCBMJLOZB CJMB LFDFQBUBO FLTLSFTJ TVBUV [BU MFCJI CFTBS EBSJQBEB
WFOB HJOKBM 71")
EJCBHJ EFOHBO LPOTFOUSBTJ 1") BSUFSJ CFCBO ZBOH EJGJMUSBTJOZB NBLB LFDFQBUBO NVODVMOZB [BU UFSTFCVU EBMBN
HJOKBM VSJOFNFOVOKVLLBOKVNMBILFDFQBUBOGJMUSBTJHMPNFSVMVTEJUBNCBITFLSFTJ
P VPAH UVCVMVT
EPAH = PAH
PPAH
342
$POUPI CFSJLVU JOJ NFOVOKVLLBO QFOHIJUVOHBO SFBCTPSQTJ UVCVMVT Féraille E, Doucet A: Sodium-potassium-adenosine-triphosphatase–
"OHHBQMBIEBSJTFPSBOHQBTJFOEJQFSPMFIOJMBJMBCPSBUPSJVNCFSJLVUJOJ dependent sodium transport in the kidney: hormonal control, Physiol
Rev 81:345, 2001.
,FDFQBUBOBMJSBOVSJOFNMNFOJU Granger JP, Alexander BT, Llinas M: Mechanisms of pressure natriuresis, Curr
,POTFOUSBTJOBUSJVNVSJOF 6/
N&R-H&RN Hypertens Rep 4:152, 2002.
Hall JE, Brands MW: The renin-angiotensin-aldosterone system: renal
,POTFOUSBTJOBUSJVNQMBTNBN&R-H&RN
UNIT V
mechanisms and circulatory homeostasis. In Seldin DW, Giebisch G,
-'( CFSTJIBOJOVMJO
NMNFOJU eds: The Kidney—Physiology and Pathophysiology, ed 3, New York, 2000,
1BEBDPOUPIJOJ CFCBOOBUSJVNZBOHEJGJMUSBTJBEBMBI-'(Y1/B Raven Press.
Hall JE, Granger JP: Regulation of fluid and electrolyte balance in hyperten-
BUBVNMNFOJUYH&RNH&RNFOJU&LTLSFTJOBUSJVN
sion- role of hormones and peptides. In Battegay EJ, Lip GYH, Bakris GL,
VSJOF 6/BLFDFQBUBOBMJSBOVSJOF
BEBMBIH&RNFOJU0MFILBSFOB
eds: Hypertension-Principles and Practice, Boca Raton, 2005, Taylor and
JUV SFBCTPSQTJOBUSJVNPMFIUVCVMVTNFSVQBLBOQFSCFEBBOBOUBSBCFCBO Francis Group, LLC, pp 121–142.
ZBOHEJGJMUSBTJEFOHBOFLTLSFTJVSJOF BUBVH&RNFOJUH&R Humphreys MH, Valentin J-P: Natriuretic hormonal agents. In Seldin DW,
NFOJUJJ&RNFOJU Giebisch G, eds: The Kidney—Physiology and Pathophysiology, ed 3,
New York, 2000, Raven Press.
Perbandingan Bersihan Inulin dengan Bersihan Berbagai Kellenberger S, Schild L: Epithelial sodium channel/degenerin family of
Zat Terlarut. 1FOZBNBSBUBBO CFSJLVU JOJ EBQBU EJCVBU EFOHBO ion channels: A variety of functions for a shared structure, Physiol Rev
NFNCBOEJOHLBO CFSTJIBO TVBUV [BU EFOHBO CFSTJIBO JOVMJO TVBUV 82:735, 2002.
VLVSBO VOUVL -'(
CJMB LFDFQBUBO CFSTJIBO TVBUV [BU TBNB EFOHBO Nielsen S, Frøkiær J, Marples D, et al: Aquaporins in the kidney: from mol-
JOVMJO [BU UFOTFCVU IBOZB EJGJMUSBTJ EBO UJEBL EJSFBCTPSCTJ BUBVQVO ecules to medicine, Physiol Rev 82:205, 2002.
EJTFLSFTJ
CJMB LFDFQBUBO CFSTJIBO TVBUV [BU LVSBOH EBSJ CFSTJIBO Palmer LG, Frindt G: Aldosterone and potassium secretion by the cortical
collecting duct, Kidney Int 57:1324, 2000.
JOVMJO [BU UFSTFCVU TFIBSVTOZB UFMBI EJSFBCTPSCTJ PMFI UVCVMVT OFGSPO
Rahn KH, Heidenreich S, Bruckner D: How to assess glomerular function
EBO
KJLBLFDFQBUBOCFSTJIBOTVBUV[BUMFCJICFTBSEBSJQBEBJOVMJO [BU
and damage in humans, J Hypertens 17:309, 1999.
UFOTFCVU IBSVT EJTFLSFTJ PMFI UVCVMVT OFGSPO %J CBXBI JOJ BEBMBI Reeves WB, Andreoli TE: Sodium chloride transport in the loop of Henle,
QFSLJSBBO LFDFQBUBO CFSTJIBO VOUVL CFCFSBQB [BU ZBOH OPSNBMOZB distal convoluted tubule and collecting duct. In Seldin DW, Giebisch G,
EJUBOHBOJPMFIHJOKBM eds: The Kidney—Physiology and Pathophysiology, ed 3, New York, 2000,
Raven Press.
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Glukosa 0
Rossier BC, Praderv S, Schild L, et al: Epithelial sodium channel and the con-
Natrium 0.9
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280:F10, 2001.
343
BAB 28
1FNFLBUBOEBO1FOHFODFSBO6SJOF
UNIT V
1FOHBUVSBO0TNPMBSJUBT$BJSBO
&LTUSBTFMVMBSEBO,POTFOUSBTJ/BUSJVN
"HBS TFMTFM UVCVI EBQBU QFOHFMVBSBO BJS ZBOH UJEBL CFSHBOUVOH QBEB QFOHFMVBSBO [BU
CFSGVOHTJ EFOHBO CBJL TFM UFSMBSVUJOJ QFOUJOHVOUVLCFSUBIBOIJEVQ UFSVUBNBCJMBBTVQBO
UFSTFCVU IBSVT UFSFOEBN DBJSBOUFSCBUBT
EBMBN DBJSBO FLTUSBTFMVMBS
EFOHBOLPOTFOUSBTJFMFLUSPMJU Hormon Antidiuretik Mengatur Kepekatan Urine
EBO[BUUFSMBSVUMBJOOZBZBOH "EBTJTUFNVNQBOCBMJLZBOHLVBUVOUVLNFOHBUVSPTNPMBSJUBT
SFMBUJG LPOTUBO ,POTFOUSBTJ UPUBM [BU UFSMBSVU EBMBN DBJSBO QMBTNBEBOLPOTFOUSBTJOBUSJVN ZBOHCFLFSKBEFOHBONFOHVCBI
FLTUSBTFMVMBS EBO PMFI LBSFOB JUV PTNPMBSJUBT EJUFOUVLBO PMFI FLTLSFTJ BJS PMFI HJOKBM EBO UJEBL CFSHBOUVOH LFQBEB LFDFQBUBO
KVNMBI [BU UFSMBSVU EJCBHJ WPMVNF DBJSBO FLTUSBTFMVMBS +BEJ FLTLSFTJ[BUUFSMBSVU1FMBLVVUBNBTJTUFNVNQBOCBMJLJOJBEBMBI
LPOTFOUSBTJ EBO PTNPMBSJUBT OBUSJVN DBJSBO FLTUSBTFMVMBS TBOHBU IPSNPOBOUJEJVSFUJL "%)
ZBOHKVHBEJTFCVUWBTPQSFTJO
EJQFOHBSVIJ PMFI KVNMBI BJS FLTUSBTFM +VNMBI UPUBM BJS EBMBN #JMB PTNPMBSJUBT DBJSBO UVCVI NFOJOHLBU EJ BUBT OPSNBM
UVCVIEJUFOUVLBOPMFI
BTVQBODBJSBO ZBOHEJBUVSPMFIGBLUPS ZBJUV [BU UFSMBSVU EBMBN DBJSBO UVCVI NFOKBEJ UFSMBMV QFLBU

GBLUPSZBOHNFOFOUVLBOSBTBIBVT EBO
FLTLSFTJBJSPMFIHJOKBM LFMFOKBSIJQPGJTJTQPTUFSJPSBLBONFOZFLSFTJMFCJICBOZBL"%)
ZBOH EJBUVS PMFI CFSCBHBJ GBLUPS ZBOH NFNFOHBSVIJ GJMUSBTJ ZBOH NFOJOHLBULBO QFSNFBCJMJUBT UVCVMVT EJTUBM EBO EVLUVT
HMPNFSVMVTEBOSFBCTPSQTJUVCVMVT LPMJHFOT UFSIBEBQ BJS TFQFSUJ ZBOH EJCBIBT EJ #BC ,FBEBBO
1BEBCBCJOJ LJUBBLBONFNCBIBT
NFLBOJTNFNFLBOJTNF JOJNFNVOHLJOLBOUFSKBEJOZBSFBCTPSCTJBJSEBMBNKVNMBICFTBS
ZBOHNFOZFCBCLBOHJOKBMEBQBUNFNCVBOHLFMFCJIBOBJSEFOHBO EBOQFOVSVOBOWPMVNFVSJOF UFUBQJUJEBLNFOHVCBILFDFQBUBO
NFOHFLTLSFTJLBO VSJOF ZBOH FODFS
NFLBOJTNFNFLBOJTNF FLTLSFTJ[BUUFSMBSVUPMFIHJOKBMTFDBSBCFSBSUJ
ZBOH NFOZFCBCLBO HJOKBM NFOZJNQBO BJS EFOHBO #JMB UFSEBQBU LFMFCJIBO BJS EBMBN UVCVI EBO PTNPMBSJUBT
NFOHFLTLSFTJLBO VSJOF ZBOH QFLBU
NFLBOJTNF VNQBO CBMJL DBJSBO FLTUSBTFMVMBS NFOVSVO NBLB TFLSFTJ "%) PMFI IJQPGJTJT
HJOKBMZBOHNFOHBUVSLPOTFOUSBTJEBOPTNPMBSJUBTOBUSJVNDBJSBO QPTUFSJPS BLBO NFOVSVO 0MFI TFCBC JUV QFSNFBCJMJUBT UVCVMVT
FLTUSBTFMVMBSTFSUB
NFLBOJTNFSBTBIBVTEBOLFJOHJOBOHBSBN EJTUBMEBOEVLUVTLPMJHFOTUFSIBEBQBJSBLBONFOVSVO TFIJOHHB
ZBOH NFOFOUVLBO BTVQBO BJS EBO HBSBN ZBOH KVHB NFNCBOUV NFOHIBTJMLBOTFKVNMBICFTBSVSJOFFODFS+BEJ LFDFQBUBOTFLSFTJ
NFOHBUVS WPMVNF DBJSBO FLTUSBTFMVMBS PTNPMBSJUBT EBO "%) TBOHBU NFOFOUVLBO FODFS BUBV QFLBUOZB VSJOF ZBOH BLBO
LPOTFOUSBTJOBUSJVN EJLFMVBSLBOHJOKBM
Mekanisme Ginjal untuk Mengekskresi Urine Encer

Ginjal Mengekskresi Kelebihan Air dengan
Membentuk Urine Encer #JMB UFSEBQBU LFMFCJIBO BJS EBMBN UVCVI HJOKBM EBQBU
NFOHFLTLSFTJLBO VSJOF FODFS TFCBOZBL -IBSJ EFOHBO
LPOTFOUSBTJ TFCFTBS N0TN- (JOKBM NFMBLVLBO UVHBT ZBOH
(JOKBM OPSNBM NFNJMJLJ LFNBNQVBO CFTBS VOUVL NFNCFOUVL IFCBU JOJ EFOHBO NFSFBCTPSCTJ [BU UFSMBSVU UFSVTNFOFSVT EBO
CFSCBHBJ QFSCBOEJOHBO SFMBUJG [BU UFSMBSVU EBO BJS EBMBN VSJOF QBEB TBBU ZBOH TBNB UJEBL NFSFBCTPSCTJ TFKVNMBI CFTBS BJS EJ
TFCBHBJ SFTQPOT UFSIBEBQ CFSCBHBJ QFSVCBIBO #JMB UFSEBQBU OFGSPO CBHJBO EJTUBM ZBOH NFMJQVUJ UVCVMVT EJTUBM BLIJS EBO
LFMFCJIBO BJS EBMBN UVCVI EBO PTNPMBSJUBT DBJSBO UVCVI EVLUVTLPMJHFOT
NFOVSVO HJOKBM BLBO NFOHFLTLSFTJLBO VSJOF EFOHBO (BNCBS NFOVOKVLLBO SFTQPOT HJOKBM QBEB TFPSBOH
PTNPMBSJUBT TFCFTBS N0TN- TVBUV LPOTFOUSBTJ ZBOH IBOZB NBOVTJBTFUFMBINJOVN-BJS1FSIBUJLBOCBIXBWPMVNFVSJOF
TFLJUBS TFQFSFOBN EBSJ PTNPMBSJUBT DBJSBO FLTUSBTFMVMBS OPSNBM NFOJOHLBU TFLJUBS FOBN LBMJ OPSNBM EBMBN XBLUV NFOJU
4FCBMJLOZB CJMB UFSKBEJ LFLVSBOHBO BJS EBO PTNPMBSJUBT DBJSBO TFUFMBIBJSEJNJOVN"LBOUFUBQJ KVNMBIUPUBM[BUUFSMBSVUZBOH
FLTUSBTFMVMBS UJOHHJ HJOKBM NFOHFLTLSFTJLBO VSJOF EFOHBO EJFLTLSFTJLBO SFMBUJG LPOTUBO LBSFOB CFOUVL VSJOF NFOKBEJ
LPOTFOUSBTJTBNQBJN0TN-4FMBJOJUV HJOKBMEBQBU TBOHBU FODFS EBO PTNPMBSJUBT VSJOF NFOVSVO EBSJ NFOKBEJ
NFOHFLTLSFTJLBOTFKVNMBICFTBSVSJOFFODFSBUBVTFKVNMBILFDJM TFLJUBSN0TN-+BEJ TFUFMBINJOVNBJSZBOHCBOZBL HJOKBM
VSJOFQFLBUUBOQBQFSVCBIBOCFTBSEBMBNLFDFQBUBOFLTLSFTJ[BU BLBO NFOHFLTLSFTJLBO LFMFCJIBO BJS UFUBQJ UJEBL
UFSMBSVUTFQFSUJOBUSJVNEBOLBMJVN,FNBNQVBONFOHBUVS NFOHFLTLSFTJLBOLFMFCJIBO[BUUFSMBSVU
345
800
100
400
Cortex
0
6
4 400
NaCl
2
Medulla
0 NaCl
1.2
0.6
0
0 60 120 180
OZB "%) DBJSBO ZBOH NFOJOHHBMLBO CBHJBO BXBM UVCVMVT EJTUBM

CFSTJGBUIJQPPTNPUJL EFOHBOPTNPMBSJUBTIBOZBTFLJUBSTFQFSUJHBEBSJ
PTNPMBSJUBTQMBTNB
Cairan Tubulus di Tubulus Distal dan Koligens

1BEBBXBMQFNCFOUVLBOGJMUSBUHMPNFSVMVT PTNPMBSJUBTGJMUSBU
Selanjutnya Diencerkan Tanpa Adanya ADH. 4FXBLUVDBJSBO
LJSBLJSB TBNB EFOHBO PTNPMBSJUBT QMBTNB N0TN-

FODFS QBEB TFHNFO BXBM UVCVMVT EJTUBM NFMFXBUJ CBHJBO BLIJS
6OUVL NFOHFLTLSFTJLBO LFMFCJIBO BJS GJMUSBU IBSVT EJFODFSLBO
UVCVMVT LPOUPSUVT EJTUBMJT EVLUVT LPMJHFOT LPSUJLBMJT EBO EVLUVT
TFXBLUVNFMFXBUJUVCVMVT)BMJOJEJDBQBJEFOHBONFSFBCTPSCTJ
LPMJHFOT UFSKBEJ SFBCTPSQTJ UBNCBIBO OBUSJVN LMPSJEB 5BOQB
MFCJICBOZBL[BUUFSMBSVUEBSJQBEBBJS TFQFSUJZBOHUFSMJIBUQBEB
BEBOZB "%) CBHJBO UVCVMVT JOJ KVHB JNQFSNFBCFM UFSIBEBQ BJS
(BNCBS OBNVO IBM JOJ IBOZB UFSKBEJ QBEB CFCFSBQB
EBOSFBCTPSQTJUBNCBIBO[BUUFSMBSVUNFOZFCBCLBODBJSBOUVCVMVT
TFHNFOUFSUFOUVEJTJTUFNUVCVMVTTFCBHBJCFSJLVUJOJ
NFOKBEJ MFCJI FODFS ZBOH BLBO NFOVSVOLBO PTNPMBSJUBTOZB
Cairan Tubulus Tetap Isosmotik di Tubulus Proksimal. TBNQBJ TFCFTBS N0TN- ,FHBHBMBO SFBCTPSCTJ BJS EBO
4BBU DBJSBO NFOHBMJS NFMBMVJ UVCVMVT QSPLTJNBM [BU UFSMBSVU EBO SFBCTPSQTJ [BU UFSMBSVU NFOHIBTJMLBO VSJOF FODFS EFOHBO WPMVNF
BJSEJSFBCTPSCTJEBMBNKVNMBIZBOHTBNB TFIJOHHBUFSKBEJTFEJLJU ZBOHCFTBS
QFSVCBIBOEBMBNPTNPMBSJUBTTFIJOHHB DBJSBOUVCVMVTQSPLTJNBM 4FCBHBJ SJOHLBTBO NFLBOJTNF ZBOH NFNCFOUVL VSJOF FODFS
UFUBQ JTPTNPUJL UFSIBEBQ QMBTNB EFOHBO PTNPMBSJUBT TFLJUBS BEBMBIEFOHBOUFSVTNFOFSVTNFSFBCTPSCTJ[BUUFSMBSVUEBSJCBHJBO
N0TN-4FXBLUVDBJSBONFMFXBUJQBSTEFTFOEFOTBOTB)FOMF BJS EJTUBM TJTUFN UVCVMVT EBO UJEBL NFMBLVLBO SFBCTPSQTJ BJS 1BEB
EJSFBCTPSCTJ NFMBMVJ QSPTFT PTNPTJT EBO DBJSBO EJ UVCVMVT HJOKBM ZBOH TFIBU DBJSBO ZBOH NFOJOHHBMLBO QBST BTFOEFOT BOTB
NFODBQBJ LFTFJNCBOHBO EFOHBO DBJSBO JOUFSTUJTJBM NFEVMB HJOKBM )FOMF EBO CBHJBO BXBM UVCVMVT EJTUBM TFMBMV FODFS UBOQB
TFLJUBS ZBOH TBOHBU IJQFSUPOJL TFLJUBS EVB TBNQBJ FNQBU LBMJ NFNQFSIBUJLBO KVNMBI "%) #JMB UJEBL BEB "%) VSJOF
PTNPMBSJUBTGJMUSBUHMPNFSVMVTBXBM0MFITFCBCJUV DBJSBOUVCVMVT TFMBOKVUOZB BLBO EJFODFSLBO EJ TFHNFO BLIJS UVCVMVT EJTUBM EBO
NFOKBEJ MFCJI QFLBU TFXBLUVDBJSBO UFSTFCVU NFOHBMJSLF NFEVMB EVLUVT LPMJHFOT EBO TFKVNMBI CFTBS WPMVNF VSJOF FODFS BLBO
CBHJBOEBMBN EJFLTLSFTJLBO
Cairan Tubulus Encer di Pars Asendens Ansa Henle

1BEB QBST BTFOEFOT BOTB )FOMF UFSVUBNB EJ TFHNFO UFCBM Ginjal Mengonservasi Air dengan Mengekskresikan
OBUSJVN LBMJVN EBO LMPSJEB CBOZBL EJSFBCTPSCTJ "LBO UFUBQJ Urine Pekat
CBHJBO TFHNFO UVCVMVT JOJ JNQFSNFBCFM UFSIBEBQ BJS XBMBVQVO
UFSEBQBU CBOZBL "%) 0MFI TFCBC JUV DBJSBO UVCVMVT NFOKBEJ ,FNBNQVBO HJOKBM VOUVL NFNCFOUVL VSJOF ZBOH MFCJI QFLBU
MFCJIFODFSTFXBLUVNFOHBMJSEJQBSTBTFOEFOTBOTB)FOMFNFOVKV EBSJQBEB QMBTNB QFOUJOH VOUVL LFMBOHTVOHBO IJEVQ NBNBMJB
CBHJBO BXBM UVCVMVT EJTUBM EFOHBO PTNPMBSJUBT ZBOH NFOVSVO ZBOHIJEVQEJEBSBU UFSNBTVLNBOVTJB"JSTFDBSBUFSVTNFOFSVT
TFDBSBCFSUBIBQTBNQBJTFLJUBSN0TN-TBBUDBJSBONFNBTVLJ IJMBOH EBSJ UVCVI NFMBMVJ CFCFSBQB SVUF QBSVQBSV NFMBMVJ
CBHJBOBXBMUVCVMVTEJTUBM+BEJ UBOQBNFNQFSIBUJLBOBEBUJEBL FWBQPSBTJLFEBMBNVEBSBFLTQJSBTJ USBLUVTHBTUSPJOUFTUJOBMNFMBMVJ
346
Bab 28 Pemekatan dan Pengenceran Urine; Pengaturan Osmotaritas Cairan Ekstraselutar dari Konsentrasi Natrium
FWBQPSBTJ EBO QFSTQJSBTJ EBO HJOKBM NFMBMVJ FLTLSFTJ VSJOF ,FBEBBO JOJ NFOHIBTJMLBO LFIJMBOHBO OFUP - DBJSBO VOUVL
"TVQBODBJSBOEJCVUVILBOVOUVLNFOHJNCBOHJLFIJMBOHBODBJSBO TFUJBQ MJUFS BJS MBVU ZBOH EJNJOVN ZBOH NFOKFMBTLBO UFSKBEJOZB
JOJ EBOLFNBNQVBOHJOKBMVOUVLNFNCFOUVLWPMVNFVSJOFQFLBU EFIJESBTJ DFQBU QBEB LPSCBO LBQBM UFOHHFMBN ZBOH NJOVN BJS
MBVU"LBOUFUBQJ TFFLPS"VTUSBMJBOIPQQJOHNPVTFNJMJLLPSCBO
ZBOH TFEJLJU BLBO NFOHVSBOHJ BTVQBO DBJSBO ZBOH EJCVUVILBO
LBQBMUFOHHFMBNEBQBUNJOVNEFOHBOCFCBTTFNVBBJSMBVUZBOH
VOUVL NFNQFSUBIBOLBO IPNFPTUBTJT TVBUV GVOHTJ ZBOH TBOHBU
EJJOHJOLBO
UNIT V
QFOUJOHTBBUTVQMBJBJSIBOZBTFEJLJU
Berat Jenis Urine
#JMB UFSEBQBU LFLVSBOHBO BJS EBMBN UVCVI HJOKBM NFNCFOUVL
VSJOF QFLBU EFOHBO UFSVTNFOFSVT NFOHFLTLSFTJLBO [BU UFSMBSVU #FSBU KFOJT VSJOF TFSJOH EJHVOBLBO EJ LMJOJL VOUVL
EBOQBEBTBBUZBOHCFSTBNBBO KVHBNFOJOHLBULBOSFBCTPSQTJBJS NFNCFSJLBO QFSLJSBBO DFQBU LPOTFOUSBTJ [BU UFSMBSVU VSJOF
TFIJOHHB NFOVSVOLBO WPMVNF VSJOF ZBOH UFSCFOUVL (JOKBM 4FNBLJO UFSLPOTFOUSBTJ VSJOF TFNBLJO UJOHHJ CFSBU KFOJT
NBOVTJB EBQBU NFNQSPEVLTJ VSJOF QFLBU EFOHBO LPOTFOUSBTJ VSJOF%BMBNLFCBOZBLBOLBTVT CFSBUKFOJTVSJOFNFOJOHLBU
NBLTJNBM TFCFTBS TBNQBJ N0TN- ZBJUV FNQBU TFDBSB MJOFBS EFOHBO NFOJOHLBUOZB PTNPMBSJUBT VSJOF
TBNQBJMJNBLBMJPTNPMBSJUBTQMBTNB (BNCBS
/BNVOCFSBUKFOJTVSJOF NFSVQBLBOVLVSBO
CFSBU[BUUFSMBSVUEBMBNWPMVNFVSJOFUFSUFOUVEBOLBSFOBJUV
#FCFSBQB IFXBO HVSVO TFQFSUJ "VTUSBMJBO IPQQJOH NPVTF EJUFOUVLBOPMFIKVNMBIEBOVLVSBONPMFLVM[BUUFSMBSVU)BM
EBQBU NFNFLBULBO VSJOF TBNQBJ N0TN- ,FNBNQVBO JOJ CFSCFEB EFOHBO PTNPMBSJUBT ZBOH IBOZB EJUFOUVLBO PMFI
JOJNFNCVBUUJLVTUFSTFCVUEBQBUCFSUBIBOIJEVQEJHVSVOUBOQB KVNMBINPMFLVM[BUUFSMBSVUEBMBNWPMVNFUFSUFOUV
NJOVNBJSLFDVLVQBOBJSEBQBUEJQFSPMFINFMBMVJNBLBOBOZBOH #FSBU KFOJT VSJOF VNVNOZB EJOZBUBLBO EBMBN HNM EBO
EJDFSOB EBO BJS ZBOH EJIBTJMLBO PMFI UVCVI NFMBMVJ NFUBCPMJTNF QBEB NBOVTJB VNVNOZB CFSLJTBS BOUBSB HNM
NBLBOBO)FXBOZBOHCFSBEBQUBTJUFSIBEBQMJOHLVOHBOBJSUBXBS EBO NFOJOHLBU TFCFTBS VOUVL TFUJBQ QFOJOHLBUBO
CJBTBOZB NFNJMJLJ LFNBNQVBO QFNFLBUBO VSJOF ZBOH SFOEBI TBNQBJ N0TNPM- PTNPMBSJUBT VSJOF )VCVOHBO BOUBSB
#FSBOHCFSBOH NJTBMOZB IBOZBEBQBUNFNFLBULBOVSJOFTBNQBJ CFSBU KFOJT EBO PTNPMBSJUBT CFSVCBI CJMB BEB TFKVNMBI CFTBS
TFLJUBSN0TN- NPMFLVM ZBOH CFSBSUJ EBMBN VSJOF TFQFSUJ HMVLPTB [BU
SBEJPLPOUSBT ZBOH EJHVOBLBO VOUVL UVKVBO EJBHOPTUJL BUBV
Volume Urine yang harus Diekskresikan (Obligatorik)
CFCFSBQB BOUJCJPUJL %BMBN IBM JOJ QFOHVLVSBO CFSBU KFOJT
VSJOF EBQBU NFNCFSJLBO JOGPSNBTJ TBMBI NFOHFOBJ VSJOF
,FNBNQVBO QFNFLBUBO NBLTJNBM HJOKBM NFOFOUVLBO
CBOZBLOZB WPMVNF VSJOF ZBOH IBSVT EJFLTLSFTJLBO TFUJBQ IBSJ
ZBOHTBOHBUQFLBU NFTLJQVOPTNPMBMJUBTVSJOFUFUBQOPSNBM
VOUVL NFNCVBOH TJTBTJTB NFUBCPMJTNF EBO JPO ZBOH UFMBI 5FSTFEJB VKJ DFMVQ EJQTUJDL
ZBOH NFOHVLVS QFSLJSBBO
EJLPOTVNTJUVCVI4FPSBOHNBOVTJBOPSNBMEFOHBOCFSBUCBEBO CFSBU KFOJT VSJOF OBNVO TFCBHJBO CFTBS MBCPSBUPSJVN
LJMPHSBN IBSVT NFOHFLTLSFTJLBO TFLJUBS NJMJPTNPM [BU NFOHVLVSCFSBUKFOJTEFOHBOSFGSBLUPNFUFS
UFSMBSVUTFUJBQIBSJ#JMBLFNBNQVBONBLTJNBMQFNFLBUBOVSJOF
BEBMBIN0TN- NBLBWPMVNFNJOJNBMVSJOFZBOHIBSVT Persyaratan untuk Mengekskresi Urine Pekat—
EJFLTLSFTJLBO ZBOH EJTFCVU WPMVNF VSJOF ZBOH IBSVT Kadar ADH yang Tinggi dan Medula Ginjal yang
EJFLTLSFTJLBO PCMJHBUPSJL
EBQBUEJIJUVOHTFCBHBJCFSJLVU Hiperosmotik
600 mOsm/hari
0.5L/hari 1FSTZBSBUBO EBTBS VOUVL NFNCFOUVL VSJOF QFLBU BEBMBI

1200 mOsm/L
LBEBS "%) ZBOH UJOHHJ ZBOH NFOJOHLBULBO QFSNFBCJMJUBT
,FIJMBOHBOWPMVNFVSJOFZBOHNJOJNBMJOJUVSVUCFSQFSBOQBEB UVCVMVTEJTUBMEBOEVLUVTLPMJHFOTUFSIBEBQBJS TFIJOHHB
EFIJESBTJ CFSTBNB EFOHBO BJS ZBOH IJMBOH EBSJ LVMJU USBLUVT
SFTQJSBUPSJVT EBOUSBLUVTHBTUSPJOUFTUJOBM CJMBUJEBLBEBBJSZBOH
EBQBUEJNJOVN
,FNBNQVBOHJOKBMNBOVTJBZBOHUFSCBUBTVOUVLNFNFLBULBO
VSJOF IJOHHB LPOTFOUSBTJ NBLTJNBM N0TN- NFOKFMBTLBO
NFLBOJTNF UFSKBEJOZB EFIJESBTJ CFSBU CJMB TFTFPSBOH NFODPCB
NJOVN BJS MBVU ,POTFOUSBTJ OBUSJVN LMPSJEB EBMBN MBVU
NFODBQBJ TBNQBJ QFSTFO EFOHBOPTNPMBSJUBTBOUBSB
EBO N0TN- %FOHBO NFNJOVN - BJS MBVU EFOHBO
LPOTFOUSBTJ N0TN- NBLB BTVQBO OBUSJVN LMPSJEB UPUBM
TFCFTBS NJMJPTNPM #JMB LFNBNQVBO QFNFLBUBO VSJOF
NBLTJNBM BEBMBI N0TN- WPMVNF VSJOF ZBOH EJQFSMVLBO
VOUVL NFOHFLTLSFTJ N0TN BEBMBI EJCBHJ
N0TN- BUBV - .FOHBQB BJS MBVU ZBOH EJNJOVN
NFOZFCBCLBO EFIJESBTJ +BXBCBOOZB BEBMBI HJOKBM KVHB IBSVT
NFOHFLTLSFTJLBO [BU UFSMBSVU MBJO UFSVUBNB VSFVN ZBOH
NFOZVNCBOH TFLJUBS N0TN- CJMB LFQFLBUBO VSJOF
NFODBQBJ NBLTJNBM 0MFI LBSFOBOZB LPOTFOUSBTJ NBLTJNBM
OBUSJVNLMPSJEBZBOHEBQBUEJFLTLSFTJLBOPMFIHJOKBMTFLJUBS
N0TN- +BEJ VOUVL TFUJBQ MJUFS BJS MBVU ZBOH EJNJOVN -
WPMVNF VSJOF BLBO EJCVUVILBO VOUVL NFNCVBOH N0TN
OBUSJVN LMPSJEB ZBOH EJLPOTVNTJ TFMBJO N0TN [BU[BU
UFSMBSVUMBJOTFQFSUJVSFVNZBOHEJDFSOB EJCVBOHEBSJUVCVI
347
NFNCVBU TFHNFOTFHNFO UVCVMVT JOJ NFSFBCTPSCTJ BJS DVLVQ NFOJOHLBU TFDBSB CFSUBIBQ NFODBQBJ TFLJUBS TBNQBJ
CBOZBL EBO
PTNPMBSJUBTDBJSBOJOUFSTUJTJBMNFEVMBHJOKBMZBOH N0TN- EJ VKVOH QFMWJT NFEVMB )BM JOJ CFSBSUJ JOUFSTUJTJVN
UJOHHJ ZBOHNFNCFOUVLHSBEJFOPTNPUJLZBOHEJQFSMVLBOVOUVL NFEVMB HJOKBM UFMBI NFNFLBULBO [BU UFSMBSVU EBMBN TFKVNMBI
UFSKBEJOZBSFBCTPSQTJBJSCJMBLBEBS"%)UJOHHJ UFSUFOUVBJS#FHJUVLFQFLBUBO[BUUFSMBSVUEBMBNNFEVMBNFOKBEJ
*OUFSTUJTJVN NFEVMB HJOKBM EJ TFLJUBS EVLUVT LPMJHFOT EBMBN UJOHHJ LFQFLBUBOUFSTFCVUBLBOEJQFSUBIBOLBOPMFILFTFJNCBOHBO
LFBEBBO OPSNBM CFSTJGBU TBOHBU IJQFSPTNPUJL KBEJ CJMB LBEBS BOUBSBBMJSBONBTVLEBOBMJSBOLFMVBS[BUUFSMBSVUEBOBJSEJEBMBN
"%) UJOHHJ BJS CFSHFSBL NFMFXBUJ NFNCSBO UVCVMVT TFDBSB NFEVMB
PTNPTJTLFEBMBNJOTUFSTUJTJVNHJOKBMLFNVEJBO BJSBLBOEJCBXB
PMFI WBTB SFLUB LFNCBMJ LF QFSFEBSBBO EBSBI +BEJ LFNBNQVBO 'BLUPSGBLUPSVUBNBZBOHJLVUCFSQFSBOEBMBNQFNFLBUBO[BU
QFNFLBUBO VSJOF EJCBUBTJ PMFI LBEBS "%) EBO PMFI UJOHLBU UFSMBSVUEJNFEVMBHJOKBMBEBMBI
IJQFSPTNPMBSJUBTNFEVMBHJOKBM,JUBBLBONFOEJTLVTJLBOGBLUPS 1. 5SBOTQPS BLUJG JPO OBUSJVN EBO LPUSBOTQPS LBMJVN LMPSJEB
GBLUPS ZBOH NFOHBUVS TFLSFTJ "%) LFNVEJBO UFUBQJ TFLBSBOH EBOJPOJPOMBJOLFMVBSEBSJTFHNFOUFCBMQBSTBTFOEFOTBOTB
QSPTFTBQBZBOHUFSKBEJTFIJOHHBDBJSBOJOUFSTUJTJBMNFEVMBHJOKBM )FOMFLFJOUFSTUJTJVNNFEVMB
NFOKBEJ IJQFSPTNPUJL 1SPTFT JOJ NFMJCBULBO LFSKB NFLBOJTNF
DPVOUFSDVSSFOU 2. 5SBOTQPS BLUJG JPOJPO EBSJ EVLUVT LPMJHFOT LF JOUFSTUJTJVN
NFEVMB
.FLBOJTNF DPVOUFSDVSSFOU CFSHBOUVOH LFQBEB CFOUVL
3. %JGVTJUFSGBTJMJUBTJVSFVNEBSJCBHJBOEBMBNNFEVMBEVLUVT
BOBUPNJT LIBT BOTB )FOMF EBO WBTB SFLUB LBQJMFS QFSJUVCVMBS
LIVTVT NFEVMB HJOKBM 1BEB NBOVTJB TFLJUBS QFSTFO OFGSPO LPMJHFOTLFJOUFSTUJTJVNNFEVMB
NFSVQBLBOOFGSPOKVLTUBNFEVMBSJT EFOHBOBOTB)FOMFEBOWBTB 4. %JGVTJ IBOZB TFKVNMBI LFDJM BJS EBSJ UVCVMVT EJ NFEVMB LF
SFLUB ZBOH NBTVL MFCJI EBMBN LF NFEVMB TFCFMVN LFNCBMJ LF JOUFSTUJTJVNNFEVMBZBOHMFCJITFEJLJUEBSJQBEBSFBCTPSQTJ[BU
LPSUFLT #FCFSBQB BOTB )FOMF NBTVL TBNQBJ LF VKVOHVKVOH UFSMBSVULFJOUFSTUJTJVNNFEVMB
QBQJMBHJOKBMZBOHNFOPOKPMEBSJNFEVMBLFEBMBNQFMWJTHJOKBM
7BTB SFLUB CFSKBMBO TFKBKBS BOTB )FOMF ZBOH QBOKBOH ZBOH KVHB
NFMFOHLVOH LF CBXBI LF EBMBN NFEVMB TFCFMVN LFNCBMJ OBJL Sifat khas Ansa Henle Menyebabkan Zat Terlarut
LF LPSUFLT HJOKBM "LIJSOZB EVLUVT LPMJHFOT ZBOH NFNCBXB Terperangkap di Medula Ginjal. 4JGBU USBOTQPS EJ BOTB )FOMF
VSJOF NFMBMVJ NFEVMB HJOKBM ZBOH IJQFSPTNPUJL TFCFMVN EJSBOHLVNEJ5BCFM CFSTBNBTJGBUUVCVMVTQSPLTJNBM UVCVMVT
EJLFMVBSLBO KVHB NFNFHBOH QFSBO QFOUJOH EBMBN NFLBOJTNF EJTUBM EVLUVT LPMJHFOT LPSUJLBMJT EBO EVLUVT LPMJHFOT NFEVMB
DPVOUFSDVSSFOU CBHJBOEBMBN
1FOZFCBC UFSQFOUJOH UJOHHJOZB PTNPMBSJUBT NFEVMB BEBMBI
Mekanisme Countercurrent Menghasilkan
USBOTQPS BLUJG OBUSJVN EBO LPUSBOTQPS LBMJVN LMPSJEB EBO JPO
Interstisium Medula Ginjal yang Hiperosmotik
JPO MBJO EBSJ TFHNFO UFCBM QBST BTFOEFOT BOTB )FOMF LF EBMBN
0TNPMBSJUBT DBJSBO JOUFSTUJTJBM EJ IBNQJS TFMVSVI CBHJBO UVCVI JOUFSTUJTJVN1PNQBJOJNBNQVNFOHIBTJMLBOHSBEJFOLPOTFOUSBTJ
BEBMBI TFLJUBS N0TN- ZBOH NJSJQ EFOHBO PTNPMBSJUBT TFLJUBS N0TN BOUBSB MVNFO UVCVMVT EBO DBJSBO JOUFSTUJTJBM
QMBTNB 4FQFSUJ ZBOH EJEJTLVTJLBO EJ #BC BLUJWJUBT 0MFI LBSFOB TFHNFO UFCBM QBST BTFOEFOT JNQFSNFBCFM UFSIBEBQ
PTNPMBSJUBT UFSLPSFLTJ ZBOH CFSQFSBO QBEB UBSJLNFOBSJL BJS [BU UFSMBSVU ZBOH EJQPNQB LFMVBS UBL EJJLVUJ PMFI BMJSBO
BOUBSNPMFLVM LJSBLJSB N0TN-
0TNPMBSJUBT DBJSBO PTNPUJL BJS LF JOUFSTUJTJVN +BEJ USBOTQPS BLUJG OBUSJVN EBO JPO
JOUFSTUJTJBMEBMBNNFEVMBHJOKBMKBVIMFCJIUJOHHJ EBOEBQBU MBJOLFMVBSEBSJTFHNFOUFCBMQBSTBTFOEFOTNFOBNCBI[BUUFSMBSVU
Tabet 28-1 Ringkasan Karakteristik Tubulus Pemekatan Urine
Permeabilitas
Transpor Aktif NaCI H2O NaCl Urea
Tubulus proksimal ++ ++ + +
Segmen tipis desendens 0 ++ + +
Segmen tipis asendens 0 0 + +
Segmen tebal asendens ++ 0 0 0
Tubulus distal + +ADH 0 0
Tubulus koligens kortikahs + +ADH 0 0
Tubulus kolugens medula bagian dalam + +ADH 0 ++ADH
0, permeabilitas atau transpor aktif tingkat minimal; +, permeabilitas atau transpor aktif tingkat sedang; ++, permeabilitas atau transpor aktif tingkat
tinggi; +ADH, permeabilitas terhadap air atau ureum ditingkatkan oleh ADH.
348
Bab 28 Pemekatan dan Pengenceran Urine; Pengaturan Osmolaritas Cairan Ekstraselular dan Konsentrasi Natrium
ZBOH EJQPNQB LFMVBS UBL EJJLVUJ PMFI BMJSBO PTNPUJL BJS LF HNFOUFCBMQBSTBTFOEFOTBOTB)FOMF+BEJ EFOHBOTFOEJSJOZB
JOUFSTUJTJVN +BEJ USBOTQPS BLUJG OBUSJVN EBO JPO MBJO LFMVBS USBOTQPS BLUJG OBUSJVN LMPSJEB LFMVBS EBSJ TFHNFO UFCBM
EBSJ TFHNFO UFCBM QBST BTFOEFOT NFOBNCBI [BU UFSMBSVU BTFOEFOT IBOZB NBNQV NFODBQBJ HSBEJFO LPOTFOUSBTJ
LFUJNCBOH BJS LF JOUFSTUJTJVN NFEVMB HJOKBM "EB TFEJLJU N0TN- KBVIMFCJITFEJLJUEBSJQBEBZBOHEJDBQBJPMFITJTUFN
SFBCTPSQTJQBTJGOBUSJVNLMPSJEBEBSJTFHNFOUJQJTQBSTBTFOEFOT DPVOUFSDVSSFOU
UNIT V
BOTB )FOMF ZBOH KVHB JNQFSNFBCFM UFSIBEBQ BJS ZBOH MFCJI -BOHLBILFBEBMBIUBNCBIBOBMJSBODBJSBOLFBOTB)FOMF
NFOBNCBI LPOTFOUSBTJ [BU UFSMBSVU ZBOH UJOHHJ EJ JOUFSTUJTJVN EBSJ UVCVMVT QSPLTJNBM ZBOH NFOZFCBCLBO DBJSBO
NFEVMBHJOKBM IJQFSPTNPUJL ZBOH UFSCFOUVL TFCFMVNOZB EJ QBST EFTFOEFOT
1BST EFTFOEFOT BOTB )FOMF CFSCFEB EFOHBO QBST BTFOEFOT NFOHBMJS LF QBST BTFOEFOT #FHJUV DBJSBO JOJ CFSBEB EJ EBMBN
TBOHBU QFSNFBCFM UFSIBEBQ BJS EBO PTNPMBSJUBT DBJSBO UVCVMVT QBST BTFOEFOT JPOJPO UBNCBIBO BLBO EJQPNQB LF EBMBN
EFOHBO DFQBU NFOKBEJ TBNB EFOHBO PTNPMBSJUBT NFEVMB HJOKBM JOUFSTUJTJVN EFOHBOBJSUFUBQCFSBEBEJDBJSBOUVCVMVT TBNQBJ
0MFI TFCBC JUV BJS CFSEJGVTJ LFMVBS EBSJ QBST EFTFOEFOT BOTB UFSDBQBJ HSBEJFO PTNPUJL TFCFTBS N0TN- EFOHBO
)FOMF NBTVL LF JOUFSTUJTJVN EBO PTNPMBSJUBT DBJSBO UVCVMVT PTNPMBSJUBT DBJSBO JOUFSTUJTJBM ZBOH NFOJOHLBU TBNQBJ
TFDBSB CFSUBIBQ NFOJOHLBU TFJSJOH EFOHBO NFOHBMJSOZB DBJSBO N0TN- MBOHLBI
,FNVEJBOTFLBMJMBHJ DBJSBOEBMBNQBST
LFVKVOHBOTB)FOMF EFTFOEFOT NFODBQBJ LFTFJNCBOHBO EFOHBO DBJSBO JOUFSTUJTJBM
NFEVMB HJOKBM ZBOH IJQFSPTNPUJL MBOHLBI
EBO TFXBLUV
Langkah-Langkah yang Menyebabkan Interstisium DBJSBOIJQFSPTNPUJLUVCVMVTNFOHBMJSEBSJQBSTEFTFOEFOTBOTB
Medula Ginjal Menjadi Hiperosmotik. .FOHJOHBU )FOMFLFQBSTBTFOEFOT NBTJICBOZBL[BUUFSMBSVUZBOHUFSVT
LBSBLUFSJTUJLBOTB)FOMF NBSJMBILJUBTFLBSBOHNFNCBIBTDBSB NFOFSVT EJQPNQB LFMVBS EBSJ UVCVMVT EBO EJUVNQVL EBMBN
NFEVMBHJOKBMNFOKBEJIJQFSPTNPUJL1FSUBNB BOHHBQMBICBIXB JOUFSTUJTJVNNFEVMB
BOTB )FOMF EJJTJ PMFI DBJSBO EFOHBO LPOTFOUSBTJ N0TN- -BOHLBIMBOHLBIJOJEJVMBOHCFSLBMJLBMJ EFOHBOFGFLBLIJS
ZBOH TBNB EFOHBO LPOTFOUSBTJ DBJSBO ZBOH NFOJOHHBMLBO CFSVQB QFOBNCBIBO [BU UFSMBSVU ZBOH TFNBLJO CBOZBL
UVCVMVTQSPLTJNBM (BNCBS MBOHLBI
,FNVEJBO QPNQB EJCBOEJOHLBO BJS EJ NFEVMB EBMBN XBLUV ZBOH DVLVQ QSPTFT
BLUJG JPO EBSJ QBST BTFOEFOT TFHNFO UFCBM BOTB )FOMF JOJ TFDBSB CFSUBIBQ NFOKFCBL [BU UFSMBSVU EJ NFEVMB EBO
NFOVSVOLBO LPOTFOUSBTJ EJ EBMBN UVCVMVT EBO NFOJOHLBULBO NFOJOHLBULBO HSBEJFO LPOTFOUSBTJ ZBOH EJDBQBJ PMFI
LPOTFOUSBTJ JOUFSTUJTJBM QPNQB JOJ NFOHIBTJMLBO HSBEJFO QFNPNQBBO BLUJG JPOJPO LFMVBS EBSJ TFHNFO UFCBM QBST
LPOTFOUSBTJBOUBSBDBJSBOUVCVMVTEBODBJSBOJOUFSTUJTJBMTFCFTBS BTFOEFOTBOTB)FOMF ZBOHBLIJSOZBNFOJOHLBULBOPTNPMBSJUBT
N0TN- MBOHLBI
#BUBT HSBEJFO BEBMBI TFLJUBS DBJSBO JOUFSTUJTJBM NFOKBEJ TBNQBJ N0TN- ZBOH
N0TN- LBSFOB BEB EJGVTJ JPO QBSBTFMVMBS LFNCBMJ LF EBMBN EJQFSMJIBULBOQBEBMBOHLBILF
UVCVMVT TFIJOHHB BLIJSOZB BLBO NFOHJNCBOHJ USBOTQPS JPO +BEJ SFBCTPSQTJ OBUSJVN LMPSJEB ZBOH CFSVMBOHVMBOH PMFI
LFMVBSEBSJMVNFOTBBUUFSDBQBJHSBEJFOLPOTFOUSBTJTFCFTBS TFHNFO UFCBM QBST BTFOEFOT BOTB )FOMF EBO QFNBTVLBO
N0TN- OBUSJVN LMPSJEB CBSV ZBOH UFSVTNFOFSVT EBSJ UVCVMVT
-BOHLBI LF BEBMBI DBJSBO UVCVMVT EBMBN QBST EFTFOEFOT QSPLTJNBM LF BOTB )FOMF EJTFCVU DPVOUFSDVSSFOU NVMUJQMJFS
BOTB )FOMF EBO DBJSBO JOUFSTUJTJBM EFOHBO DFQBU NFODBQBJ /BUSJVN LMPSJEB ZBOH EJSFBCTPCTJ EBSJ QBST BTFOEFOT BOTB
LFTFJNCBOHBOPTNPUJLBLJCBUPTNPTJTBJSZBOHLFMVBSEBSJQBST )FOMFUFUBQNFOBNCBIKVNMBIOBUSJVNLMPSJEBZBOHCBSVUJCB
EFTFOEFOT 0TNPMBSJUBT JOUFSTUJTJBM EJQFSUBIBOLBO QBEB TFIJOHHB NFOHHBOEBLBO NVMUJQMZ
LPOTFOUSBTJOZB EJ
N0TN-BLJCBUUSBOTQPSJPOLFMVBSZBOHUFSVTNFOFSVTEBSJTF JOUFSTUJTJVNNFEVMB
200
1 2 3 4
400
400
5 6 7
349
EFOHBO DBJSBO JOUFSTUJTJBM NFEVMB HJOKBM TFLJUBS N0TN-

MJIBU (BNCBS
+BEJ EFOHBO NFSFBCTPSCTJ BJS TFCBOZBL
,FUJLB DBJSBO UVCVMVT NFOJOHHBMLBO BOTB )FOMF EBO NFOHBMJS NVOHLJO HJOKBM NFNCFOUVL VSJOF EFOHBO LFQFLBUBO UJOHHJ
LFUVCVMVTLPOUPSUVTEJTUBMEJLPSUFLTHJOKBM DBJSBOOZBNFOKBEJ EFOHBO NFOHFLTLSFTJLBO OPSNBM [BU UFSMBSVU EBMBN VSJOF EBO
FODFS EFOHBOPTNPMBSJUBTIBOZBTFLJUBSN0TN- (BNCBS NFOHFNCBMJLBOBJSLFDBJSBOFLTUSBTFMVMBSVOUVLNFOHPNQFOTBTJ

#BHJBO BXBM UVCVMVT EJTUBM LFNVEJBO NFOHFODFSLBO LFLVSBOHBODBJSBOUVCVI
DBJSBOUVCVMVTLBSFOBTFHNFOJOJ TFQFSUJTFHNFOQBSTBTFOEFOT
BOTB )FOMF TFDBSB BLUJG NFOUSBOTQPS OBUSJVN LMPSJEB LFMVBS
Ureum Berperan pada Interstisium Medula Ginjal yang
EBSJUVCVMVTUFUBQJSFMBUJGJNQFSNFBCFMUFSIBEBQBJS
Hiperosmotik dan Pembentukan Urine yang Pekat
4FKBVIJOJ LJUBIBOZBNFNCBIBTQFSBOOBUSJVNLMPSJEBUFSIBEBQ
4FXBLUV DBJSBO NFOHBMJS LF EVLUVT LPMJHFOT LPSUJLBMJT
JOUFSTUJTJVNNFEVMBHJOKBMZBOHIJQFSPTNPUJL"LBOUFUBQJ VSFVN
KVNMBI BJS ZBOH EJSFBCTPSCTJ TBOHBU CFSHBOUVOH QBEB
CFSQFSBO NFOZVNCBOH TFLJUBS TBNQBJ QFSTFO PTNPMBSJUBT
LPOTFOUSBTJ "%) QMBTNB #JMB "%) UJEBL BEB TFHNFO JOJ
N0TN-
JOUFSTUJTJVN NFEVMB HJOKBM TBBU HJOKBM
JNQFSNFBCFM UFSIBEBQ BJS EBO UJEBL NFSFBCTPSCTJ BJS UFUBQJ
NFNCFOUVL VSJOF EFOHBO LFQFLBUBO NBLTJNBM 5JEBL TFQFSUJ
UFUBQ NFSFBCTPSCTJ [BU UFSMBSVU EBO NFOHFODFSLBO VSJOF MFCJI
OBUSJVNLMPSJEB VSFVNEJSFBCTPSCTJTFDBSBQBTJGEBSJUVCVMVT#JMB
MBOKVU 4BBU LPOTFOUSBTJ "%) UJOHHJ EVLUVT LPMJHFOT LPSUJLBMJT
UFSKBEJ LFLVSBOHBO BJS EBO LPOTFOUSBTJ "%) EBSBI UJOHHJ
NFOKBEJTBOHBUQFSNFBCFMUFSIBEBQBJS TFIJOHHBTFKVNMBICFTBS
TFKVNMBI CFTBS VSFVN EJSFBCTPSCTJ TFDBSB QBTJG EBSJ EVLUVT
BJSEJSFBCPSCTJEBSJUVCVMVTLFJOUFSTUJTJVNLPSUFLT EJNBOBBJS
LPMJHFOTEJNFEVMBCBHJBOEBMBNLFJOUFSTUJTJVN
BLBO EJBOHLVU PMFI LBQJMFS QFSJUVCVMVT ZBOH BSVTOZB NFOHBMJS
EFOHBODFQBU#BIXBTFKVNMBICFTBSBJSEJSFBCTPSCTJLFLPSUFLT .FLBOJTNF SFBCTPSQTJ VSFVN LF NFEVMB HJOKBM BEBMBI TFCBHBJ
EBO CVLBO LF NFEVMB HJOKBM NFNCBOUV NFNQFSUBIBOLBO CFSJLVU4FXBLUVBJSNFOHBMJSLFBUBTEJQBSTBTFOEFOTBOTB)FOMF
PTNPMBSJUBTDBJSBOJOUFSTUJTJVNNFEVMBZBOHUJOHHJ EBONBTVLLFUVCVMVTEJTUBMEBOEVLUVTLPMJHFOTLPSUJLBMJT TFEJLJU
VSFVN BLBO EJSFBCTPSCTJ LBSFOB TFHNFO JOJ JNQFSNFBCFM
4FXBLUV DBJSBO UVCVMVT NFOHBMJS EJ TFQBOKBOH EVLUVT UFSIBEBQ VSFVN MJIBU 5BCFM
%FOHBO LPOTFOUSBTJ "%)
LPMJHFOTEJNFEVMB UFSKBEJSFBCTPSQTJBJSMFCJIMBOKVUEBSJDBJSBO ZBOH UJOHHJ BJS EJSFBCTPSCTJ TFDBSB DFQBU EBSJ EVLUVT LPMJHFOT
UVCVMVT LF JOUFSTUJTJVN UFUBQJ KVNMBI UPUBM DBJSBO SFMBUJG MFCJI LPSUJLBMJTEBOLPOTFOUSBTJVSFVNNFOJOHLBUEFOHBODFQBULBSFOB
LFDJM EJCBOEJOHLBO DBJSBO ZBOH EJUBNCBILBO LF JOUFSTUJTJVN CBHJBOUVCVMVTJOJUJEBLCFHJUVQFSNFBCFMVOUVLVSFVN
LPSUFLT "JS ZBOH EJSFBCTPSCTJ EFOHBO DFQBU EJCBXB PMFI WBTB
SFLUB NFOVKV EBSBI WFOB #JMB LBEBS "%) UJOHHJ EVLUVT 4FXBLUV DBJSBO UVCVMVT NFOHBMJS LF EVLUVT LPMJHFOT NFEVMB
LPMJHFOT NFOKBEJ QFSNFBCFM UFSIBEBQ BJS TFIJOHHB DBJSBO QBEB CBHJBO EBMBN SFBCTPSQTJ BJS NBTJI UFSKBEJ ZBOH NFOHIBTJMLBO
CBHJBOBLIJSEVLUVTLPMJHFOTNFNJMJLJPTNPMBSJUBTZBOHTBNB LPOTFOUSBTJ VSFVN ZBOH KBVI MFCJI UJOHHJ EBMBN DBJSBO
,POTFOUSBTJ VSFVN ZBOH UJOHHJ EBMBN DBJSBO UVCVMVT EVLUVT
LPMJHFOT EJ NFEVMB CBHJBO EBMBN NFOZFCBCLBO VSFVN CFSEJGVTJ
LFMVBS EBSJ UVCVMVT NBTVL LF DBJSBO JOUFSTUJTJVN HJOKBM %JGVTJ JOJ
TBOHBU UFSCBOUV PMFI USBOTQPSUFS VSFVN ZBOH TQFTJGJL 65" EBO
65"4BMBITBUVQFOHBOHLVUVSFVNJOJ ZBJUV65" EJBLUJGLBO
PMFI "%) ZBOH BLBO NFOJOHLBULBO QFOHBOHLVUBO VSFVN LFMVBS
300 EVLUVT LPMJHFOT EJ NFEVMB CBHJBO EBMBN MFCJI CBOZBL CJMB LBEBS
300 "%) NFOJOHLBU 1FSHFSBLBO CFSTBNBBO BJS EBO VSFVN LFMVBS
NaCl EVLUVT LPMJHFOT EJ NFEVMB CBHJBO EBMBN BLBO NFNQFSUBIBOLBO
LPOTFOUSBTJ VSFVN ZBOH UJOHHJ EJ EBMBN DBJSBO UVCVMVT EBO QBEB
BLIJSOZB EBMBNVSJOF XBMBVQVOVSFVNUFUBQEJSFBCTPSCTJ
1FSBO VUBNB VSFVN QBEB LFNBNQVBO NFNFLBULBO VSJOF
EJCVLUJLBO QBEB NBOVTJB ZBOH NFOHPOTVNTJ NBLBOBO UJOHHJ
600 QSPUFJO ZBOH NFOHIBTJMLBO TFKVNMBI CFTBS VSFVN TFCBHBJ QSPEVL
CVBOHBO OJUSPHFO EBQBU NFNFLBULBO VSJOFOZB KBVI MFCJI CBJL
H2O
EBSJQBEBPSBOHZBOHBTVQBOQSPUFJOEBOQSPEVLTJVSFVNOZBSFOEBI
.BMOVUSJTJ EJLBJULBO EFOHBO LPOTFOUSBTJ VSFVN ZBOH SFOEBI EJ
JOUFSTUJTJVN NFEVMB EBO UFSKBEJOZB HBOHHVBO LFNBNQVBO
QFNFLBUBOVSJOF
Resirkulasi Ureum dari Duktus Koligens ke Ansa Henle

Berperan pada Pembentukan Hiperosmotik Medula Ginjal.
4FPSBOH NBOVTJB TFIBU CJBTBOZB NFOHFLTLSFTJLBO TFLJUBS
TBNQBJ QFSTFO CFCBO VSFVN ZBOH UFMBI EJGJMUSBTJ 1BEB
VNVNOZB LFDFQBUBO FLTLSFTJ VSFVN UFSVUBNB EJUFOUVLBO PMFI
EVBGBLUPS
LPOTFOUSBTJVSFVNEBMBNQMBTNBEBO
MBKV
350
GJMUSBTJHMPNFSVMVT -'(
1BEBQBTJFOQFOZBLJUHJOKBMZBOH-'( )FOMF UVCVMVT EJTUBM EVLUVT LPMJHFOT LPSUJLBMJT EBO UVSVO
OZB TBOHBU NFOVSVO LPOTFOUSBTJ VSFVN QMBTNB TBOHBU LFNCBMJ NFMBMVJ EVLUVT LPMJHFOT NFEVMB %FOHBO DBSB JOJ
NFOJOHLBU ZBOH BLBO NFOHFNCBMJLBO NVBUBO VSFVN ZBOH VSFVNEBQBUCFSTJSLVMBTJLFNCBMJNFMBMVJCBHJBOCBHJBOBLIJS
EJGJMUSBTJ EBO LFDFQBUBO FLTLSFTJ VSFVN LF CBUBT OPSNBM TBNB EBSJ TJTUFN UVCVMVT JOJ CFCFSBQB LBMJ TFCFMVN EJLFMVBSLBO
EFOHBOLFDFQBUBOQSPEVLTJVSFVN
NFTLJQVO-'(NFOVSVO 4FUJBQ LBMJ NFMBLVLBO TJSLVMBTJ LPOTFOUSBTJ VSFVN NFOKBEJ
UNIT V
%J UVCVMVT QSPLTJNBM TBNQBJ QFSTFO VSFVN ZBOH TFNBLJOUJOHHJ
EJGJMUSBTJ BLBO EJSFBCTPSCTJ NFTLJQVO EFNJLJBO LPOTFOUSBTJ 3FTJSLVMBTJ VSFVN JOJ NFSVQBLBO NFLBOJTNF UBNCBIBO
VSFVN DBJSBO UVCVMVT NFOJOHLBU LBSFOB VSFVN UJEBL QFNCFOUVLBO NFEVMB HJOKBM ZBOH IJQFSPTNPUJL 0MFI LBSFOB
TFQFSNFBCFM BJS ,POTFOUSBTJ VSFVN UFSVT NFOJOHLBU TFKBMBO VSFVN BEBMBI TBMBI TBUV QSPEVL CVBOHBO UFSCBOZBL ZBOH
EFOHBO BMJSBO DBJSBO UVCVMVT LF TFHNFO UJQJT BOTB )FOMF IBSVT EJCVBOH PMFI HJOKBM NFLBOJTNF UFSTFCVU ZBOH BLBO
TFCBHJBO BLJCBU SFBCTPSQTJ BJS ZBOH LFMVBS EBSJ QBST EFTFOEFOT NFMBLVLBO QFNFLBUBO VSFVN TFCFMVN EJLFMVBSLBO
BOTB)FOMFUFUBQJKVHBBLJCBUTFLSFTJVSFVNLFTFHNFOUJQJTBOTB EJQFSMVLBO VOUVL NFOKBHB DBJSBO UVCVI CJMB TVQMBJ BJS IBOZB
)FOMF EBO JOUFSTUJTJVN NFEVMB (BNCBS
4FLSFTJ QBTJG TFEJLJU
VSFVN LF TFHNFO UJQJT BOTB )FOMF EJGBTJMJUBTJ PMFI USBOTQPSUFS #JMB BEB LFMFCJIBO BJS EJ UVCVI LFDFQBUBO BMJSBO VSJOF
VSFVN65" CJBTBOZB NFOJOHLBU EBO PMFI LBSFOB JUV LBEBS VSFVN EJ
4FHNFOUFCBMBOTB)FOMF UVCVMVTEJTUBM EBOEVLUVTLPMJHFOT EVLUVT LPMJHFOT NFEVMB CBHJBO EBMBN CFSLVSBOH TFIJOHHB
LPSUJLBMJT SFMBUJG JNQFSNFBCFM UFSIBEBQ VSFVN EBO TBOHBU EJGVTJ VSFVN LF JOUFSTUJTJVN NFEVMB HJOKBM KVHB CFSLVSBOH
TFEJLJUVSFVNZBOHEJSFBCTPSCTJEJTFHNFOTFHNFOUVCVMVTJOJ ,BEBS "%) KVHB CFSLVSBOH CJMB BEB LFMFCJIBO BJS EJ UVCVI
,FUJLB HJOKBM NFNCFOUVL VSJOF ZBOH QFLBU EBO LBEBS "%) EBO JOJ TFMBOKVUOZB BLBO NFOHVSBOHJ QFSNFBCJMJUBT EVLUVT
UJOHHJ SFBCTPSQTJ BJS EBSJ UVCVMVT EJTUBM EBO EVLUVT LPMJHFOT LPMJHFOTNFEVMBCBHJBOEBMBNVOUVLBJSEBOVSFVN EBOMFCJI
LPSUJLBMJTBLBOMFCJINFOJOHLBULBOLPOTFOUSBTJVSFVNEJDBJSBO CBOZBLVSFVNEJFLTLSFTJEBMBNVSJOF
UVCVMVT 4FXBLUV VSFVN JOJ NFOHBMJS LF EVLUVT LPMJHFOT EJ
NFEVMB CBHJBO EBMBN LPOTFOUSBTJ VSFVN ZBOH UJOHHJ EJ DBJSBO
UVCVMVTEBOUSBOTQPSUFSVSFVNZBOHTQFTJGJLBLBONFOZFCBCLBO
VSFVN CFSEJGVTJ LF JOUFSTUJTJVN NFEVMB 4FCBHJBO VSFVN ZBOH
CFSHFSBL LF JOUFSTUJTJVN NFEVMB BLIJSOZB CFSEJGVTJ LF TFHNFO 6OUVL NFNFOVIJ LFCVUVIBO NFUBCPMJL TFM EJ NFEVMB HJOKBM
UJQJTBOTB)FOMF EBOLFNVEJBOOBJLNFMBMVJQBSTBTFOEFOTBOTB BMJSBOEBSBIIBSVTUFSTFEJBLFCBHJBOHJOKBMJOJ5BOQBBEBOZB
TVBUV TJTUFN BMJSBO EBSBI NFEVMB ZBOH LIVTVT [BU UFSMBSVU
ZBOH EJQPNQB LF NFEVMB HJOKBM PMFI TJTUFN DPVOUFSDVSSFOU
NVMUJQMJFS BLBONFOHIJMBOHEFOHBODFQBU
"EBEVBDJSJLIBTBMJSBOEBSBINFEVMBHJOKBMZBOHCFSQFSBO
4.5 Urea 4.5 NFNQFSUBIBOLBOLPOTFOUSBTJ[BUUFSMBSVUZBOHUJOHHJ
1. "MJSBO EBSBI NFEVMB ZBOH MBNCBU ZBOH UFSIBEBQ
7 NFSVQBLBOLVSBOHEBSJQFSTFOBMJSBOEBSBIHJOKBMUPUBM
"MJSBO EBSBI ZBOH MBNCBU JOJ DVLVQ VOUVL NFOZVQMBJ
LFCVUVIBO NFUBCPMJL KBSJOHBO UFUBQJ NFNCBOUV
30 NFOHVSBOHJ LFIJMBOHBO [BU UFSMBSVU EBSJ JOUFSTUJTJVN
NFEVMB
2. 7BTB SFLUB CFSQFSBO TFCBHBJ DPVOUFSDVSSFOU FYDIBOHFS
ZBOH NFOHVSBOHJ QFOHFMVBSBO [BU UFSMBSVU EBO
JOUFSTUJTJVNNFEVMB
.FLBOJTNFDPVOUFSDVSSFOUFYDIBOHFSCFLFSKBTFCBHBJ
CFSJLVU (BNCBS
%BSBI NFNBTVLJ EBO NFOJOHHBMLBO
NFEVMB NFMBMVJ WBTB SFLUB QBEB QFSCBUBTBO LPSUFLT EBO
NFEVMB HJOKBM 7BTB SFLUB TFQFSUJ LBQJMFSLBQJMFS MBJOOZB
TBOHBU QFSNFBCFM UFSIBEBQ [BU UFSMBSVU EBMBN EBSBI LFDVBMJ
UFSIBEBQQSPUFJOQMBTNB4FXBLUVEBSBIUVSVOLFNFEVMBLF
BSBIQBQJMB EBSBINFOKBEJMFCJIQFLBUEFOHBODFQBU TFCBHJBO
LBSFOB[BUUFSMBSVUZBOHNBTVLEBSJJOUFSTUJTJVNEBOTFCBHJBO
LBSFOB IJMBOHOZB BJS LF EBMBN JOUFSTUJTJVN 4BBU EBSBI
NFODBQBJVKVOHWBTBSFLUB EBSBITVEBINFNJMJLJLPOTFOUSBTJ
TFLJUBS N0TN- TBNB TFQFSUJ LPOTFOUSBTJ EJ
JOUFSTUJTJVN NFEVMB 4FXBLUV EBSBI OBJL LFNCBMJ LF BSBI
LPSUFLT LFQFLBUBO EBSBI CFSLVSBOH TFDBSB CFSUBIBQ TFJSJOH
EJGVTJ [BU UFSMBSVU ZBOH LFNCBMJ LF JOUFSTUJTJVN NFEVMB EBO
TFJSJOHNFOHBMJSOZBBJSLFEBMBNWBTBSFLUB
351
NFNCBXB LFMVBS [BU UFSMBSVU EBO BJS TFTVBJ EFOHBO ZBOH

EJBCTPSCTJ EBSJ UVCVMVT NFEVMB EBO UJOHHJOZB LPOTFOUSBTJ [BU
300 350 300 UFSMBSVUZBOHEJCFOUVLPMFINFLBOJTNFBSVTCBMJLEJQFSUBIBOLBO
H2O 600 Peningkatan Aliran Darah Medula Mengurangi

600
600 Kemampuan Pemekatan Urine #FCFSBQB WBTPEJMBUPS UFSUFOUV
600 EBQBU TBOHBU NFOJOHLBULBO BMJSBO EBSBI NFEVMB HJOKBM TFIJOHHB
H2O 800
BLBO NFOHVSBT CFCFSBQB [BU UFSMBSVU EBSJ NFEVMB HJOKBM EBO
800 NFOHVSBOHJ LFNBNQVBO NBLTJNBM HJOKBM VOUVL NFNFLBULBO
800
VSJOF 1FOJOHLBUBO UFLBOBO BSUFSJ ZBOH CFTBS KVHB NFOJOHLBULBO
900
H2O 1000
BMJSBO EBSBI NFEVMB HJOKBM TFIJOHHB MFCJI UJOHHJ EBSJQBEB EJ
1000 EBFSBI MBJO HJOKBM EBO DFOEFSVOH NFOHIJMBOHLBO IJQFSPTNPUJL
1000
JOUFSTUJTJVN ZBOH BLBO NFOHVSBOHJ LFNBNQVBO QFNFLBUBO
1200
VSJOF 4FQFSUJ ZBOH TVEBI EJCBIBT TFCFMVNOZB LFNBNQVBO
1200
QFNFLBUBO NBLTJNBM HJOKBM EJUFOUVLBO UJEBL IBOZB PMFI LBEBS
"%)UFUBQJKVHBPMFIPTNPMBSJUBTDBJSBOJOUFSTUJTJBMNFEVMBHJOKBM
#BILBO EFOHBO LBEBS "%) ZBOH NBLTJNBM LFNBNQVBO
QFNFLBUBO VSJOF BLBO NFOVSVO CJMB BMJSBO EBSBI NFEVMB
NFOJOHLBU TFIJOHHB NFOHVSBOHJ IJQFSPTNPMBSJUBT EJ NFEVMB
HJOKBM
Ringkasan Mekanisme Pemekatan Urine dan Perubahan

Osmolaritas di Berbagai Segmen Tubulus
1FSVCBIBOPTNPMBSJUBTEBOWPMVNFDBJSBOUVCVMVTTFXBLUVDBJSBO
NFMFXBUJCFSCBHBJCBHJBOOFGSPOEJUVOKVLLBOEJ(BNCBS
8BMBVQVOUFSEBQBUQFSUVLBSBOTFKVNMBICFTBSDBJSBOEBO[BU
UFSMBSVU ZBOH NFMFXBUJ WBTB SFLUB IBOZB TFEJLJU QFOHFODFSBO
Tubulus Proksimal. 4FLJUBSQFSTFOFMFLUSPMJUZBOHEJGJMUSBTJ
BLIJS EBSJ LPOTFOUSBTJ DBJSBO JOUFSTUJTJBM EJ TFUJBQ UJOHLBU
BLBO EJSFBCTPSCTJ EJ UVCVMVT QSPLTJNBM "LBO UFUBQJ NFNCSBO
NFEVMB HJOKBM LBSFOB CFOUVL 6 EBSJ LBQJMFS LBQJMFS WBTB SFLUB
UVCVMVT TBOHBU QFSNFBCFM UFSIBEBQ BJS TFIJOHHB TFUJBQ LBMJ [BU
ZBOH CFSUJOEBL TFCBHBJ DPVOUFSDVSSFOU FYDIBOHFS +BEJ WBTB
UFSMBSVUEJSFBCTPSCTJ BJSKVHBCFSEJGVTJNFMBMVJNFNCSBOUVCVMVT
SFLUB UJEBL NFNCFOUVL IJQFSPTNPMBSJUBT NFEVMB UFUBQJ TFDBSB PTNPTJT 0MFI TFCBC JUV PTNPMBSJUBT DBJSBO ZBOH UFSTJTB
NFNQFSUBIBOLBOOZBBHBSUJEBLIJMBOH LVSBOHMFCJITBNBEFOHBOGJMUSBUHMPNFSVMVT ZBJUVN0TN-
4USVLUVS QFNCVMVI EBSBI EFOHBO CFOUVL6 NFNQFSLFDJM
IJMBOHOZB [BU UFSMBSVU EBSJ JOUFSTUJTJVN UFUBQJ UJEBL NFODFHBI Pars Desendens Ansa Henle. 4FXBLUV DBJSBO NFOVSVOJ
CFTBSOZB KVNMBI DBJSBO EBO [BU UFSMBSVU ZBOH NBTVL LF EBMBN QBSTEFTFOEFOTBOTB)FOMF BJSEJBCTPSCTJLFEBMBNNFEVMB1BST
EBSBI NFMBMVJ UFLBOBO PTNPUJL LPMPJE EBO UFLBOBO IJESPTUBUJL EFTFOEFOTTBOHBUQFSNFBCFMUFSIBEBQBJSUFUBQJLVSBOHQFSNFBCFM
ZBOH DFOEFSVOH NFOJNCVMLBO SFBCTPSQTJ EBMBN LBQJMFSLBQJMFS UFSIBEBQOBUSJVNLMPSJEBEBOVSFVN0MFITFCBCJUV PTNPMBSJUBT
JOJ%BMBNLPOEJTJZBOHNBOUBQEBOTUBCJM WBTBSFLUBIBOZB DBJSBOZBOHNFOHBMJSNFMBMVJQBSTEFTFOEFOTBLBONFOJOHLBU
25 ml 0.2 ml
1200
Diluting segment
Osmolarity (mOsm/L)
Late distal
Medullary
Cortical
900
Effect of ADH
600
8 ml
300 125 ml 44 ml
200
100 25 ml
20 ml
0
Proximal Loop of Henle Distal Collecting Urine
tubule tubule tubule
and duct
352
TFDBSB CFSUBIBQ IJOHHB IBNQJS TBNB EFOHBO DBJSBO JOUFSTUJTJBM PTNPMBSJUBT BLBO MFCJI NFOVSVO MBHJ BLJCBU SFBCTPSQTJ BLUJG
EJTFLJUBSOZB ZBJUVTFLJUBSN0TN-CJMBLPOTFOUSBTJ"%) JPOZBOHUFSVTNFOFSVTEBSJTFHNFOTFHNFOUFSTFCVU
EBSBIUJOHHJ
Duktuskoligens di Medula Bagian Dalam.
,FUJLB UFSCFOUVL VSJOF ZBOH FODFS BLJCBU LPOTFOUSBTJ "%) ,POTFOUSBTJDBJSBOEJEVLUVTLPMJHFOTNFEVMBCBHJBOEBMBN
ZBOH SFOEBI PTNPMBSJUBT JOUFSTUJTJBM NFEVMB NFOKBEJ LVSBOH
UNIT V
KVHB CFSHBOUVOH QBEB
"%) EBO
PTNPMBSJUBT
EBSJ N0TN- TFIJOHHB PTNPMBSJUBT DBJSBO UVCVMVT QBST JOUFSTUJTJVN NFEVMB TFLJUBSOZB ZBOH EJCFOUVL PMFI
EFTFOEFOT KVHB CFSLVSBOH )BM JOJ TFCBHJBO EJTFCBCLBO PMFI NFLBOJTNF DPVOUFSDVSSFOU #JMB UFSEBQBU "%) EBMBN
VSFVN ZBOH TFEJLJU EJBCTPSCTJ LF JOUFSTUJTJVN NFEVMB EBSJ KVNMBICFTBS EVLUVTEVLUVTJOJTBOHBUQFSNFBCFMUFSIBEBQ
EVLUVTLPMJHFOTTBBULBEBS"%)SFOEBIEBOHJOKBMNFNCFOUVL BJS EBO BJS CFSEJGVTJ EBSJ UVCVMVT LF DBJSBO JOUFSTUJTJVN
VSJOFZBOHFODFSEBMBNKVNMBICFTBS TBNQBJUFSDBQBJLFTFJNCBOHBOPTNPUJL EFOHBOLPOTFOUSBTJ
DBJSBOUVCVMVTZBOHLVSBOHMFCJITBNBEFOHBOJOUFSTUJTJVN
Segmen Tipis Pars Asendens Ansa Henle4FHNFOUJQJT NFEVMBHJOKBM N0TN-
+BEJ CJMBLBEBS"%)
QBST BTFOEFOT QBEB EBTBSOZB JNQFSNFBCFM UFSIBEBQ BJS UFUBQJ UJOHHJ EJIBTJMLBO VSJOF ZBOH TBOHBU QFLBU UFUBQJ CFSKVNMBI
EBQBU NFSFBCTPSCTJ TFKVNMBI OBUSJVN LMPSJEB 0MFI LBSFOB TFEJLJU 0MFI LBSFOB SFBCTPSQTJ BJS NFOJOHLBULBO
LPOTFOUSBTJOBUSJVNLMPSJEBEBMBNDBJSBOUVCVMVTDVLVQUJOHHJ LPOTFOUSBTJVSFVNEBMBNDBJSBOUVCVMVT EBOLBSFOBEVLUVT
BLJCBU QFSHFSBLBO BJS EBO QBST EFTFOEFOT BOTB )FOMF UFSKBEJ LPMJHFOT EJ NFEVMB CBHJBO EBMBN NFNJMJLJ USBOTQPSUFS
EJGVTJQBTJGOBUSJVNLMPSJEBEBSJTFHNFOUJQJTQBSTBTFOEFOTLF VSFVN ZBOH TQFTJGJL ZBOH TBOHBU NFNCBOUV UFSKBEJOZB
JOUFSTUJTJVN NFEVMB +BEJ DBJSBO UVCVMVT NFOKBEJ MFCJI FODFS EJGVTJ TFCBHJBO CFTBS VSFVN EFOHBO LFQFLBUBO UJOHHJ EJ
TFXBLUV OBUSJVN LMPSJEB CFSEJGVTJ LFMVBS EBSJ UVCVMVT EBO BJS EVLUVT JOJ CFSEJGVTJ BLBO LFMVBS MVNFO UVCVMVT LF
UFUBQUJOHHBMEJUVCVMVT JOUFSTUJTJVN NFEVMB "CTPSQTJ VSFVN LF NFEVMB HJOKBM JOJ
UVSVU NFNCBOUV NFNCFOUVL PTNPMBSJUBT JOUFSTUJTJVN
4FKVNMBIVSFVNZBOHEJBCTPSCTJLFJOUFSTUJTJVNNFEVMBEBSJ
NFEVMBZBOHUJOHHJEBOLFNBNQVBOQFNFLBUBOHJOKBMZBOH
EVLUVT LPMJHFOT KVHB CFSEJGVTJ LF QBST BTFOEFOT EFOHBO
UJOHHJ
EFNJLJBO BLBO NFOHFNCBMJLBO VSFVN LF TJTUFN UVCVMVT EBO
NFNCBOUV NFODFHBI IJMBOHOZB VSFVN EBSJ NFEVMB HJOKBM #FCFSBQB IBM QFOUJOH QBUVU EJQFSUJNCBOHLBO ZBOH
4JLMVT VSFVN ZBOH CFSVMBOH JOJ NFSVQBLBO TVBUV NFLBOJTNF NVOHLJO UJEBL KFMBT EBMBN EJTLVTJ JOJ 1FSUBNB XBMBVQVO
UBNCBIBO ZBOH JLVU NFNCFOUVL IJQFSPTNPMBSJUBT EJ NFEVMB OBUSJVN LMPSJEB BEBMBI TBMBI TBUV [BU UFSMBSVU VUBNB ZBOH
HJOKBM NFNCFOUVL IJQFSPTNPMBSJUBT JOUFSTUJTJVN NFEVMB CJMB
EJQFSMVLBO HJOKBM NBNQV NFOHFLTLSFTJLBO VSJOF EFOHBO
Segmen Tebal Pars Asendens Ansa Henle. 4FHNFO LFQFLBUBO UJOHHJ ZBOHNFOHBOEVOHTFEJLJU OBUSJVN LMPSJEB
UFCBM QBST BTFOEFOT BOTB )FOMF KVHB IBNQJS JNQFSNFBCFM )JQFSPTNPMBSJUBT VSJOF QBEB LFBEBBO JOJ EJTFCBCLBO PMFI
UFSIBEBQ BJS UFUBQJ TFKVNMBI CFTBS OBUSJVN LMPSJEB LBMJVN UJOHHJOZB LPOTFOUSBTJ [BU UFSMBSVU MBJO UFSVUBNB QSPEVL
EBO JPOJPO MBJO EJUSBOTQPS TFDBSB BLUJG EBSJ UVCVMVT LF EBMBN CVBOHBO TFQFSUJ VSFVN EBO LSFBUJOJO 4BUV LFBEBBO ZBOH
JOUFSTUJTJVN NFEVMB 0MFI LBSFOB JUV DBJSBO EJ TFHNFO UFCBM NFOZFCBCLBO IBM JOJ BEBMBI EFIJESBTJ ZBOH EJTFSUBJ EFOHBO
QBST BTFOEFOT BOTB )FOMF NFOKBEJ TBOHBU FODFS EBO BTVQBO OBUSJVN ZBOH SFOEBI 4FQFSUJ ZBOH EJEJTLVTJLBO EJ
LPOTFOUSBTJOZBCFLVSBOHTBNQBJTFLJUBSN0TN- #BC BTVQBO OBUSJVN ZBOH SFOEBI BLBO NFSBOHTBOH
QFNCFOUVLBO IPSNPO BOHJPUFOTJO ** EBO BMEPTUFSPO ZBOH
Segmen Awal Tubulus Distal. 4FHNFO BXBM UVCVMVT EJTUBM CFSTBNBTBNB NFOJNCVMLBO SFBCTPSQTJ OBUSJVN ZBOH IFCBU
NFNQVOZBJ LFNBNQVBO ZBOH NJSJQ EFOHBO TFHNFO UFCBM QBST EBSJ UVCVMVT TBNCJM NFOJOHHBMLBO VSFVN EBO [BU UFSMBSVU
BTFOEFOT BOTB )FOMF TFIJOHHB UFSKBEJ QFOHFODFSBO DBJSBO MBJOOZBVOUVLNFNQFSUBIBOLBOLFQFLBUBOVSJOFZBOHUJOHHJ
UVCVMVT MFCJI MBOKVU TBNQBJ LJSBLJSB N0TN- TFXBLUV [BU ,FEVB TFKVNMBI CFTBS VSJOF FODFS EBQBU EJLFMVBSLBO
UFSMBSVUEJSFBCTPSCTJTFEBOHLBOBJSUFUBQUJOHHBMEJUVCVMVT UBOQB NFOJOHLBULBO QFOHFMVBSBO OBUSJVN ,FBEBBO JOJ
EBQBU EJDBQBJ EFOHBO NFOVSVOLBO TFLSFTJ "%) ZBOH
Segmen Akhir Tubulus dan Duktus Koligens Kortikalis. BLBO NFOHVSBOHJ SFBCTPSQTJ BJS EJ TFHNFO UVCVMVT ZBOH
1BEBTFHNFOBLIJSUVCVMVTEJTUBMEBOEVLUVTLPMJHFOTLPSUJLBMJT MFCJI EJTUBM UBOQB NFOHVCBI SFBCTPSQTJ OBUSJVN TFDBSB
PTNPMBSJUBT DBJSBO CFSHBOUVOH QBEB LBEBS "%) %FOHBO LBEBS CFSNBLOB
"%)ZBOHUJOHHJ UVCVMVTUVCVMVTJOJTBOHBUQFSNFBCFMUFSIBEBQ %BOBLIJSOZB BEBWPMVNFVSJOFZBOHIBSVTEJFLTLSFTJLBO
BJS EBO BJS BLBO EJSFBCTPSCTJ "LBO UFUBQJ VSFVN UJEBL CFHJUV PCMJHBUPSJL
ZBOH EJIBTJMLBO PMFI LFNBNQVBO QFNFLBUBO
QFSNFBCFM EJ CBHJBO OFGSPO JOJ TFIJOHHB NFOZFCBCLBO NBLTJNVN HJOKBM EBO KVNMBI [BU UFSMBSVU ZBOH IBSVT
QFOJOHLBUBO LPOTFOUSBTJ VSFVN TFXBLUV BJS EJSFBCTPSCTJ EJFLTLSFTJLBO 0MFI LBSFOB JUV KJLB TFKVNMBI CFTBS [BU
,FBEBBO JOJ NFNCVBU TFCBHJBO CFTBS VSFVN ZBOH EJLJSJN LF UFSMBSVU IBSVT EJFLTLSFTJLBO [BU UFSTFCVU IBSVT EJTFSUBJ
UVCVMVTEJTUBMEBOEVLUVTLPMJHFOT NBTVLLFEVLUVTLPMJHFOTEJ EFOHBO KVNMBI BJS NJOJNBM ZBOH EJQFSMVLBO VOUVL
NFEVMB CBHJBO EBMBN EBO EBSJ TJOJMBI VSFVN BLIJSOZB NFOHFLTLSFTJLBO [BU[BU UFSTFCVU .JTBMOZB KJLB N0TN
EJSFBCTPSCTJ BUBV EJFLTLSFTJLBO EBMBN VSJOF #JMB UJEBL BEB [BU UFSMBSVU IBSVT EJLFMVBSLBO TFUJBQ IBSJ LFBEBBO JOJ
"%) IBOZBTFEJLJUBJSZBOHBLBOEJSFBCTPSCTJEJTFHNFOBLIJS NFNCVUVILBO QBMJOH TFEJLJU - VSJOF CJMB LFNBNQVBO
UVCVMVTEJTUBMEBOEVLUVTLPMJHFOTLPSUJLBMJTPMFILBSFOBJUV QFNFLBUBOVSJOFNBLTJNBMBEBMBIN0TN-
1. 4FLSFTJ"FTZBOHUJEBLTFTVBJ4FLSFTJ"%)ZBOHUFSMBMVCBOZBL
Penentuan Kepekatan dan Keenceran Urine BUBV UFSMBMV TFEJLJU EBQBU NFOHIBTJMLBO QFOHBUVSBO DBJSBO
Ginjal: Bersihan "Air Bebas" dan Osmol ZBOHBCOPSNBMPMFIHJOKBM
2. ,FSVTBLBO NFLBOJTJNF DPVOUFSDVSSFOU )JQFSPTNPUJL
1SPTFTQFNFLBUBOEBOQFOHFODFSBOVSJOFNFOHIBSVTLBOHJOKBM
JOUFSTUJTJVN NFEVMB EJCVUVILBO VOUVL LFNBNQVBO
VOUVL NFOHFLTLSFTJLBO BJS EBO [BU UFSMBSVU TFDBSB CFCBT #JMB
QFNFLBUBO VSJOF ZBOH NBLTJNBM .FTLJQVO CBOZBL "%)
VSJOFFODFS BJSEJLFMVBSLBOMFCJICBOZBLEBSJQBEB[BUUFSMBSVU
ZBOHUFSTFEJB LFQFLBUBOVSJOFNBLTJNBMEJCBUBTJPMFIEFSBKBU
4FCBMJLOZB CJMB VSJOF QFLBU [BU UFSMBSVU EJLFMVBSLBO MFCJI
IJQFSPTNPMBSJUBTJOUFSTUJTJVNNFEVMB
CBOZBLEBSJQBEBBJS
+VNMBI UPUBM CFSTJIBO [BU UFSMBSVU EBSJ EBSBI EBQBU EJTFCVU 3. ,FUJEBLNBNQVBO UVCVMVT EJTUBM UVCVMVT LPMJHFOT EBO EVLUVT
TFCBHBJ CFSTJIBO DMFBSBODF
PTNPM $P
JOJ NFSVQBLBO LPMJHFOTVOUVLCFSFTQPOT"%)
WPMVNFQMBTNBZBOHEJCFSTJILBOEBSJ[BUUFSMBSVUTFUJBQNFOJU
EFOHBO DBSB ZBOH TBNB TFQFSUJ CFSTJIBO TVBUV [BU UVOHHBM Kegagalan Membentuk ADH: Diabetes Insipidus "Sentral".
EJIJUVOH
,FUJEBLNBNQVBO VOUVL NFOHIBTJMLBO BUBV NFMFQBTLBO "%)
U osm V EBSJIJQPGJTJTQPTUFSJPSEBQBUEJTFCBCLBOPMFIUSBVNBLFQBMBBUBV
C osm
Posm JOGFLTJ BUBV EBQBU KVHB LPOHFOJUBM 0MFI LBSFOB TFHNFO UVCVMVT
EJTUBMUJEBLEBQBUNFOZFSBQBJSUBOQBBEBOZB"%) LFBEBBOZBOH
EJ NBOB Uosm BEBMBI PTNPMBSJUBT VSJOF 7 BEBMBI MBKV BMJSBO EJTFCVU EJBCFUFT JOTJQJEVT TFOUSBM JOJ NFOHBLJCBULBO
VSJOF EBO1PTNBEBMBIPTNPMBSJUBTQMBTNB4FCBHBJDPOUPI CJMB
PTNPMBSJUBTQMBTNBN0TN- PTNPMBSJUBTVSJOFN0TN QFNCFOUVLBO TFKVNMBI CFTBS VSJOF FODFS EFOHBO WPMVNF VSJOF
- EBO VSJOF NMNFOJU -NFOJU
MBKV FLTLSFTJ PTNPM ZBOHEBQBUNFMFCJIJ-IBSJ.FLBOJTNFSBTBIBVT ZBOHBLBO
BEBMBI N0TNNFOJU N0TN- Y -NFOJU
EBO EJEJTLVTJLBO LFNVEJBO EBMBN CBC JOJ BLBO UFSBLUJWBTJ CJMB
CFSTJIBO PTNPM BEBMBI N0TNNFOJU EJCBHJ EFOHBO KVNMBIBJSZBOHIJMBOHEBSJUVCVIDVLVQCBOZBLPMFITFCBCJUV
N0TN- BUBV -NFOJU NM NFOJU
*OJ CFSBSUJ NM TFMBNBTFTFPSBOHNFNJOVNBJSEBMBNKVNMBIDVLVQ UJEBLBLBO
QMBTNBEJCFSTJILBOEBO[BUUFSMBSVUTFUJBQNFOJU
UFSKBEJQFOVSVOBODBJSBOUVCVIZBOHCFTBS,FMBJOBOQSJNFSZBOH
EJPCTFSWBTJ TFDBSB LMJOJT QBEB PSBOH EFOHBO LFBEBBO JOJ BEBMBI
WPMVNF VSJOF FODFS ZBOH CFTBS "LBO UFUBQJ CJMB BTVQBO BJS
Laju Retatif Ekskresi Zat Terlarut dan Air dapat EJCBUBTJ TFQFSUJ ZBOH EBQBU UFSKBEJ EJ SVNBI TBLJU CJMB BTVQBO
Dinitai dengan Menggunakan Konsep "Bersihan DBJSBO EJCBUBTJ BUBV QBTJFO UJEBL TBEBS NJTBMOZB BLJCBU USBVNB
Air Bebas." LFQBMB
EFIJESBTJCFSBUEBQBUUFSKBEJEFOHBODFQBU
#FSTJIBO BJSCFCBT $)0
EJIJUVOH EBSJ QFSCFEBBO BOUBSB 1FOHPCBUBO EJBCFUFT JOTJQJEVT TFOUSBM BEBMBI EFOHBO
FLTLSFTJBJS MBKVBMJSBOVSJOF
EBOCFSTJIBOPTNPM NFNCFSJLBO BOBMPH TJOUFUJL "%) ZBJUV EFTNPQSFTTJO ZBOH
CFLFSKB TFDBSB TFMFLUJG QBEB SFTFQUPS 7 VOUVL NFOJOHLBULBO
(Uosm V) QFSNFBCJMJUBT CBHJBO BXBM UVCVMVT BLIJS EBO LPMJHFOT UFSIBEBQ
CH2O V Cosm V
(Posm) BJS %FTNPQSFTTJO EBQBU EJCFSJLBO NFMBMVJ TVOUJLBO TFNQSPU
IJEVOH BUBV PSBM ZBOH EFOHBO DFQBU BLBO NFOHFNCBMJLBO
+BEJ MBKV CFSTJIBO BJSCFCBT NFSVQBLBO LFDFQBUBO QFOHFMVBSBOVSJOFLFLFBEBBOOPSNBM
FLTLSFTJ BJSCFCBT [BU UFSMBSVU PMFI HJOKBM #JMB CFSTJIBO BJS
CFCBTQPTJUJG BJSZBOHCFSMFCJIBOEJLFMVBSLBOPMFIHJOKBMCJMB Ketidakmampuan Ginjal untuk Merespons ADH: Diabetes
CFSTJIBO BJSCFCBT OFHBUJG [BU UFSMBSVU ZBOH CFSMFCJIBO Insipidus "Nefrogenik". 1BEB CFCFSBQB LFBEBBO TFHNFO UVCVMVT
EJLFMVBSLBOEBSJEBSBIPMFIHJOKBMEBOBJSEJUBIBO HJOKBM UJEBL EBQBU NFNCFSJ SFTQPOT ZBOH TFTVBJ NFTLJQVO LBEBS
%FOHBO NFOHHVOBLBO DPOUPI ZBOH EJEJTLVTJLBO "%) OPSNBM BUBV NFOJOHLBU ,FBEBBO JOJ EJTFCVU EJBCFUFT
TFCFMVNOZB KJLB MBKV BMJSBO VSJOF BEBMBI NMNFOJU EBO JOTJQJEVTOFGSPHFOJLLBSFOBLFMBJOBOUFSMFUBLEJHJOKBM,FMBJOBO
CFSTJIBO PTNPM BEBMBI NMNFOJU CFSTJIBO BJSCFCBT BLBO JOJ EBQBU EJTFCBCLBO PMFI LFHBHBMBO NFLBOJTNF DPVOUFSDVSSFOU
NFOKBEJ NMNFOJU )BM JOJ CFSBSUJ CVLBO BJS UFUBQJ VOUVLNFNCFOUVLJOUFSTUJTJVNNFEVMBHJOKBMZBOHIJQFSPTNPUJL
LFMFCJIBO [BU UFSMBSVU ZBOH EJCFSTJILBO EBSJ HJOKBM TFIJOHHB BUBV LFHBHBMBO UVCVMVT EJTUBM EBO LPMJHFOT TFSUB EVLUVT LPMJHFOT
HJOKBM NFOHFNCBMJLBO BJS LF TJSLVMBTJ TJTUFNJL TFQFSUJ ZBOH VOUVL NFSFTQPOT "%) 1BEB LBTVTLBTVT UFSTFCVU UFSCFOUVL
UFSKBEJ TFMBNB LFLVSBOHBO BJS +BEJ CJMB PTNPMBSJUBT VSJOF VSJOF FODFS EBMBN KVNMBI CFTBS ZBOH DFOEFSVOH NFOZFCBCLBO
MFCJI CFTBS EBSJQBEB PTNPMBSJUBT QMBTNB CFSTJIBO BJSCFCBT EFIJESBTJLFDVBMJCJMBBTVQBODBJSBOEJUJOHLBULBOEFOHBOKVNMBI
OFHBUJGZBOHNFOVOKVLLBOUFSKBEJOZBLPOTFSWBTJBJS ZBOHTBNBEFOHBOQFOJOHLBUBOWPMVNFVSJOF
#JMB HJOKBM NFNCFOUVL VSJOF ZBOH FODFS ZBJUV #FSCBHBJ KFOJT QFOZBLJU HJOKBM ZBOH EBQBU NFOHHBOHHV
PTNPMBSJUBTVSJOFLVSBOHEBSJPTNPMBSJUBTQMBTNB
CFSTJIBO NFLBOJTNFQFNFLBUBO UFSVUBNBQFOZBLJUZBOHNFSVTBLNFEVMB
BJSCFCBTBLBOCFSOJMBJQPTJUJG ZBOHNFOVOKVLLBOCBIXBBJS HJOKBM MJIBU #BC VOUVL QFNCBIBTBO MFCJI MBOKVU
(BOHHVBO
TFEBOH EJLFMVBSLBO EBSJ QMBTNB PMFI HJOKBM MFCJI CBOZBL GVOHTJ BOTB )FOMF TFQFSUJ ZBOH UFSKBEJ QBEB QFNCFSJBO EJVSFUJL
EBSJQBEB [BU UFSMBSVU +BEJ BJS ZBOH CFCBT EBSJ [BU UFSMBSVU ZBOH NFOHIBNCBU SFBCTPSQTJ FMFLUSPMJU EJ TFHNFO JOJ TFQFSUJ
ZBOH EJTFCVU BJS CFCBT IJMBOH EBSJ UVCVI EBO QMBTNB GVSPTFNJEKVHBEBQBUNFOHHBOHHVLFNBNQVBOQFNFLBUBOVSJOF
EJQFLBULBOCJMBCFSTJIBOBJSCFCBTCFSOJMBJQPTJUJG %BO PCBUPCBUBO UFSUFOUV TFQFSUJ MJUJVN ZBOH EJHVOBLBO VOUVL
NFOHPCBUJ HBOHHVBO NBOJLEFQSFTJG
EBO UFUSBTJLMJO ZBOH
EJHVOBLBO TFCBHBJ BOUJCJPUJL
EBQBU NFSVTBL LFNBNQVBO
Gangguan Kemampuan Pemekatan Urine TFHNFOOFGSPOEJTUBMVOUVLNFSFTQPOT"%)
%JBCFUFT JOTJQJEVT OFGSPHFOJL EBQBU EJCFEBLBO EBSJ EJBCFUFT
(BOHHVBO LFNBNQVBO HJOKBM VOUVL NFNFLBULBO BUBV JOTJQJEVT TFOUSBM EFOHBO NFNCFSJLBO EFTNPQSFTTJO BOBMPH
NFOHFODFSLBOVSJOFZBOHTFTVBJEBOEBQBUUFSKBEJQBEBTBUV TJOUFUJL"%)5JEBLBEBOZBQFOVSVOBOWPMVNFVSJOFZBOHDFQBU
BUBVMFCJIEBSJLFMBJOBOCFSJLVUJOJ EBONFOJOHLBUOZBPTNPMBSJUBTVSJOFEBMBNXBLUVKBNTFUFMBI
354
EFTNPQSFTTJO EJTVOUJL NFOHJOEJLBTJLBO EJBHOPTJT LF BSBI LPOTFOUSBTJ OBUSJVN EBO PTNPMBSJUBT DBJSBO FLSUSBTFM
EJBCFUFT JOTJQJEVT OFGSPHFOJL 1FOHPCBUBO EJBCFUFT JOTJQJEVT BEBMBI
TJTUFN PTNPSFTFQUPS"%) EBO
NFLBOJTNF
OFGSPHFOJML BEBMBI EFOHBO NFOHBUBTJ QFOZBLJU HJOKBM ZBOH IBVT
NFOEBTBSJOZB KJLB NVOHLJO )JQFSOBUSFNJB KVHB EBQBU
EJLVSBOHJ EFOHBO EJFU SFOEBI HBSBN EBO QFNCFSJBO EJVSFUJL Sistem Umpan Balik Osmoreseptor-ADH
UNIT V
ZBOH NFOJOHLBULBO FLTLSFTJ OBUSJVN HJOKBM TFQFSUJ EJVSFUJL
UJB[JE (BNCBS NFOVOKVLLBO LPNQPOFOLPNQPOFO EBTBS
TJTUFN VNQBO CBMJL PTNPSFTFQUPS"%) VOUVL
Pengaturan Osmolaritas Cairan Ekstraselular NFOHFOEBMJLBOLPOTFOUSBTJEBOPTNPMBSJUBTOBUSJVNDBJSBO
dan Konsentrasi Natrium FLTUSBTFMVMBS#JMBPTNPMBSJUBT LPOTFOUSBTJOBUSJVNQMBTNB

NFOJOHLBUEJBUBTOPSNBMBLJCBULFLVSBOHBOBJS NJTBMOZB
TJTUFNVNQBOCBMJLJOJBLBOCFLFSKBTFCBHBJCFSJLVU
1FOHBUVSBOPTNPMBSJUBTDBJSBOFLTUSBTFMVMBSCFSIVCVOHBOFSBU
EFOHBO LPOTFOUSBTJ OBUSJVN LBSFOB OBUSJVN NFSVQBLBO JPO 1. 1FOJOHLBUBO PTNPMBSJUBT DBJSBO FLTUSBTFMVMBS ZBOH
UFSCBOZBL EBMBN SVBOH FLTUSBTFM 4FDBSB %BMBN LFBEBBO QSBLUJTCFSBSUJQFOJOHLBUBOLPOTFOUSBTJOBUSJVNQMBTNB
OPSNBM LPOTFOUSBTJ OBUSJVN QMBTNB EJBUVS EBMBN SFOUBOH NFOZFCBCLBO TFM TBSBG LIVTVT ZBOH EJTFCVU TFM
CBUBTZBOHTFNQJUTBNQBJN&R-EFOHBOLPOTFOUSBTJ PTNPSFTFQUPS ZBOH UFSMFUBL EJ IJQPUBMBNVT BOUFSJPS
SBUBSBUB TFLJUBS N&R- 0TNPMBSJUBT SBUBSBUB TFLJUBS EFLBUOVLMFVTTVQSBPQUJL NFOHLFSVU
N0TN- LJSBLJSBN0TN-CJMBEJLPSFLTJPMFIHBZBUBSJL 2. #FSLFSVUOZB TFM PTNPSFTFQUPS NFOZFCBCLBO TFM UFSTFCVU
BOUBSJPO
EBO KBSBOH CFSVCBI NFMFCJIJ TBNQBJ QFSTFO NFOHJSJNLBO TJOZBM TBSBG LF TFM TBSBG UBNCBIBO EJ
4FQFSUJZBOHUFMBIEJEJTLVTJLBOEJ#BC WBSJBCFMWBSJBCFMJOJ OVLMFVT TVQSBPQUJL ZBOH LFNVEJBO NFOFSVTLBO TJOZBM
IBSVT EJLPOUSPM EJLFOEBMJLBO TFDBSB LFUBU LBSFOB WBSJBCFM JOJ NFOZVTVSJ UBOHLBJ IJQPGJTJT NFOVKV IJQPGJTJT
UFSTFCVU NFOFOUVLBO EJTUSJCVTJ DBJSBO BOUBSB SVBOH JOUSBTFM QPTUFSJPS
EBOFLTUSBTFM
3. 1PUFOTJBM BLTJ ZBOH EJIBOUBSLBO LF IJQPGJTJT QPTUFSJPS
Memperkirakan Osmolaritas Plasma dan BLBONFSBOHTBOHQFMFQBTBO"%) ZBOHEJTJNQBOEBMBN
Konsentrasi Natrium Plasma HSBOVMBTFLSFUPSJL BUBVWFTJLFM
EJVKVOHTBSBG
I1BEB CBOZBL MBCPSBUPSJVN LMJOJL PTNPMBSJUBT QMBTNB UJEBL

EJVLVS TFDBSB SVUJO "LBO UFUBQJ LBSFOB OBUSJVN EBO BOJPO
ZBOHUFSLBJUEFOHBOOZBNFSVQBLBOQFSTFOEBSJ[BUUFSMBSVU
EBMBN SVBOH FLTUSBTFM PTNPMBSJUBT QMBTNB 1PTN
EBQBU
EJQFSLJSBLBOTFDBSBLBTBSTFCBHBJ
Posm = 2.1 × Plasma sodium concentration
.JTBMOZB EFOHBOLPOTFOUSBTJOBUSJVNQMBTNBN&R-
PTNPMBSJUBT QMBTNB EBQBU EJQFSLJSBLBO EBSJ SVNVT EJ BUBT
NFOKBEJ N0TN- 6OUVL MFCJI UFQBUOZB UFSVUBNB EBMBN
LPOEJTJ ZBOH CFSIVCVOHBO EFOHBO QFOZBLJU HJOKBM LPOUSJCVTJ
EVB [BU UFSMBSVU MBJOOZB ZBJUV HMVLPTB EBO VSFVN IBSVT
EJJLVUTFSUBLBO1FSLJSBBOPTNPMBSJUBTQMBTNBDBSBJOJCJBTBOZB
NFNJMJLJ LFUFQBUBO MFCJI LVSBOH CFCFSBQB QFSTFO EBSJ OJMBJ
ZBOHEJVLVSTFDBSBMBOHTVOH
%BMBNLFBEBBOOPSNBM JPOOBUSJVNEBOBOJPOZBOHUFSLBJU
UFSVUBNB CJLBSCPOBU EBO LMPSJEB
NFXBLJMJ TFLJUBS QFSTFO
EBSJ PTNPMBMJUBT FLTUSBTFM EFOHBO HMVLPTB EBO VSFVN ZBOH
UVSVU CFSQFSBO TFLJUBS TBNQBJ QFSTFO EBSJ UPUBM "LBO
UFUBQJ LBSFOBVSFVNEFOHBONVEBINFOFNCVTTFCBHJBOCFTBS
NFNCSBO TFM VSFVN NFNCFSJLBO QFOHBSVI UFLBOBO PTNPUJL
FGFLUJG LFDJM EBMBN LFBEBBO NBOUBQ 0MFI TFCBC JUV JPO
OBUSJVN EJ DBJSBO FLTUSBTFMVMBS EBO BOJPO ZBOH UFSLBJU BEBMBI
QFOFOUV VUBNB QFSHFSBLBO DBJSBO NFMFXBUJ NFNCSBO TFM
"LJCBUOZB LJUB EBQBU NFOEJTLVTJLBO QFOHBUVSBO PTNPMBSJUBT
EBOQFOHBUVSBOLPOTFOUSBTJJPOOBUSJVNTFDBSBCFSTBNBBO
8BMBVQVO UFSEBQBU CFSCBHBJ NFLBOJTNF ZBOH NFOHPOUSPM
KVNMBIFLTLSFTJOBUSJVNEBOBJSPMFIHJOKBM EVBTJTUFNQSJNFS
ZBOHUFSMJCBULIVTVTEBMBNQFOHBUVSBO
355
4. "%) NFNBTVLJ BMJSBO EBSBI EBO EJUSBOTQPS LF HJOKBM EJ

NBOB "%) BLBO NFOJOHLBULBO QFSNFBCJMJUBT BJS EJ CBHJBO
BLIJS UVCVMVT EJTUBM UVCVMVT LPMJHFOT LPSUJLBMJT EBO EVLUVT
LPMJHFOTNFEVMB
5. 1FOJOHLBUBO QFSNFBCJMJUBT BJS EJ TFHNFO OFGSPO EJTUBM
NFOZFCBCLBO QFOJOHLBUBO SFBCTPSQTJ BJS EBO FLTLSFTJ
TFKVNMBILFDJMVSJOFZBOHQFLBU
+BEJ BJSEJLPOTFSWBTJEBMBNUVCVITFEBOHLBOOBUSJVNEBO
[BUUFSMBSVUMBJOOZBTFMBOKVUOZBEJLFMVBSLBOEBMBNVSJOF)BMJOJ
NFOZFCBCLBO QFOHFODFSBO [BU UFSMBSVU EBMBN DBJSBO
FLTUSBTFMVMBS ZBOH BLBO NFNQFSCBJLJ DBJSBO FLTUSBTFMVMBS ZBOH
BXBMOZBTBOHBUQFLBU
4FSBOHLBJBO LFKBEJBO ZBOH CFSMBXBOBO UFSKBEJ TBBU DBJSBO
FLTUSBTFMVMBS NFOKBEJ UFSMBMV FODFS IJQPPTNPUJL
.JTBMOZB
Posterior
QBEB BTVQBO BJS ZBOH CFSMFCJIBO EBO QFOVSVOBO PTNPMBSJUBT lobe
DBJSBO FLTUSBTFMVMBS MFCJI TFEJLJU "%) ZBOH UFSCFOUVL MBMV
UVCVMVT HJOKBM NFOHVSBOHJ QFSNFBCJMJUBTOZB UFSIBEBQ BJS
TFIJOHHBMFCJITFEJLJUBJSZBOHEJSFBCTPSCTJ EBOTFKVNMBICFTBS
VSJOF FODFS EJCFOUVL )BM UFSTFCVU LFNVEJBO NFNFLBULBO
DBJSBO UVCVI EBO NFOHFNCBMJLBO PTNPMBSJUBT QMBTNB LFNCBMJ
LFOJMBJOPSNBM
Sintesis ADH di Nukleus Supraoptik dan Nukleus
Paraventrikular Hipotalamus dan Pelepasan ADH dari
Hipofisis Posterior
(BNCBS NFOVOKVLLBO OFVSPBOBUPNJ IJQPUBMBNVT EBO
LFMFOKBS IJQPGJTJT UFNQBU "%) EJTJOUFTJT EBO EJMFQBTLBO
)JQPUBMBNVT UFSEJSJ BUBT EVB KFOJT OFVSPOOFVSPO NBHOPTFM Urine:
CFTBS
ZBOH NFOZJOUFTJT "%) EJ OVLMFVT TVQSBPQUJL EBO
OVLMFVT QBSBWFOUSJLVMBS IJQPUBMBNVT LJSBLJSB TFCBOZBL MJNB
QFSFOBN EJ OVLMFVT TVQSBPQUJL EBO TFQFSFOBN EJ OVLMFVT
QBSBWFOUSJLVMBS,FEVBOVLMFVTJOJNFNQVOZBJQFSQBOKBOHBO
BLTPO TBNQBJ LF IJQPGJTJT QPTUFSJPS 4FUFMBI EJTJOUFTJT "%)
EJUSBOTQPS NFMBMVJ BLTPOBLTPO OFVSPO LF VKVOHOZB ZBOH
CFSBLIJS EJ LFMFOKBS IJQPGJTJT QPTUFSJPS #JMB OVLMFVT QFOHBUVSBO UFLBOBO EBSBI EJ NFEVMB PUBL -FTJ SFHJP "77
TVQSBPQUJL EBO OVLMFVT QBSBWFOUSJLVMBS EJSBOHTBOH PMFI NFOZFCBCLBO CFSCBHBJ LFLVSBOHBO EBMBN QFOHBUVSBO TFLSFTJ
QFOJOHLBUBO PTNPMBSJUBT BUBV GBLUPS MBJO JNQVMT TBSBG "%) SBTB IBVT LFJOHJOBO BLBO OBUSJVN TPEJVN BQQFUJUF
EBO
EJIBOUBSLBO LF VKVOH TBSBG JOJ ZBOH BLBO NFOHVCBI UFLBOBOEBSBI1FSBOHTBOHBOMJTUSJLEBFSBIJOJBUBVQFSBOHTBOHBO
QFSNFBCJMJUBT NFNCSBOOZB EBO NFOJOHLBULBO QFNBTVLBO PMFIBOHJPUFOTJO**EBQBUNFOJOHLBULBOTFLSFTJ"%) SBTBIBVT
LBMTJVN "%) ZBOH EJTJNQBO EBMBN HSBOVMB TFLSFUPSJL KVHB EBOQFSBOHTBOHBOLFJOHJOBOBLBOOBUSJVN
EJTFCVU WFTJLFM
QBEB VKVOHVKVOH TBSBG EJMFQBTLBO TDCBHBJ %J TFLJUBS EBFSBI "77 EBO OVLMFVT TVQSBPQUJL UFSEBQBU TFM
SFTQPOTUFSIBEBQQFOJOHLBUBOQFNBTVLBOLBMTJVN"%)ZBOH TFM TBSBG ZBOH EJSBOHTBOH PMFI QFOJOHLBUBO LFDJM PTNPMBSJUBT
EJMFQBTLBO LFNVEJBO EJCBXB PMFI LBQJMFS EBSBI IJQPGJTJT DBJSBO FLTUSBTFMVMBS PMFI TFCBC JUV JTUJMBI PTNPSFTFQUPS UFMBI
QPTUFSJPSLFTJSLVMBTJTJTUFNJL EJHVOBLBO VOUVL OFVSPOOFVSPO JOJ 4FMTFM JOJ NFOHJSJN TJOZBM
4FLSFTJ "%) TFCBHBJ SFTQPOT UFSIBEBQ SBOHTBOHBO PTNPUJL
TBSBG LF OVLMFVT TVQSBPQUJL VOUVL NFOHBUVS QFSBOHTBOHBOOZB
TJGBUOZB DFQBU TFIJOHHB LBEBS "%) QMBTNB EBQBU NFOJOHLBU
EBOTFLSFTJ"%)4FMTFMUFSTFCVUBHBLOZBKVHBNFOHJOEVLTJSBTB
CFCFSBQBLBMJMJQBUEBMBNCFCFSBQBNFOJU0MFITFCBCJUV TFLSFTJ
IBVT TFCBHBJ SFTQPOT UFSIBEBQ QFOJOHLBUBO PTNPMBSJUBT DBJSBO
"%)NFSVQBLBOTVBUVDBSBDFQBUVOUVLNFOHIBNCBUFLTLSFTJ
FLTUSBTFMVMBS
BJSPMFIHJOKBM
%BFSBIQFSTBSBGBOLFEVBZBOHQFOUJOHEBMBNNFOHFOEBMJLBO 0SHBOTVCGPSOJLBMEBOPSHBOVNWBTLVMPTVNMBNJOBUFSNJOBMJT
PTNPMBSJUBT EBO TFLSFTJ "%) UFSMFUBL EJ TFQBOKBOH SFHJP NFNJMJLJQFNCVMVIEBSBIZBOHTFEJLJUNFOHBOEVOHTBXBSEBSBI
BOUFSPWFOUSBM WFOUSJLFM LFUJHB ZBOH EJTFCVU SFHJP "77 1BEB PUBL ZBOHEBQBUNFOHIBMBOHJEJGVTJTFCBHJBOCFTBSJPOEBSJEBSBI
CBHJBOBUBTSFHJPJOJUFSEBQBUTVBUVTUSVLUVSZBOHEJTFCVUPSHBO LF EBMBN KBSJOHBO PUBL )BM JOJ NFNCVBU JPO EBO [BU UFSMBSVU
TVCGPSOJLBM EBOQBEBCBHJBOJOGFSJPSUFSEBQBUTUSVLUVSMBJOZBOH MBJOOZB EBQBU NFMJOUBT BOUBSB EBSBI EBO DBJSBO JOUFSTUJTJBM EJ
EJTFCVUPSHBOVNWBTLVMPTVNMBNJOBUFSNJOBMJT%JBOUBSBLFEVB TFLJUBS EBFSBI JOJ "LJCBUOZB PTNPSFTFQUPS EFOHBO DFQBU
PSHBO JOJ UFSEBQBU OVLMFVT QSFPQUJL NFEJBO ZBOH NFNQVOZBJ NFSFTQPOT QFSVCBIBO PTNPMBSJUBT DBJSBO FLTUSBTFMVMBS ZBOH
CBOZBLIVCVOHBOQFSTBSBGBOEFOHBOLFEVBPSHBOTFCBHBJNBOB NFNCFSJ QFOHBSVI CFTBS UFSIBEBQ TFLSFTJ "%) EBO SBTB IBVT
IBMOZBEFOHBOOVLMFVTTVQSBPQUJLEBOQVTBU TFQFSUJZBOHEJEJTLVTJLBOLFNVEJBO
356
Rangsang Pelepasan ADH oleh Penurunan Tekanan LFDJM EBSJQBEB QFSTFOUBTF QFSVCBIBO ZBOH TBNB WPMVNF
Arteri dan/atau Penurunan Volume Darah EBSBI .JTBMOZB QFSVCBIBO PTNPMBSJUBT QMBTNB TFCFTBS
QFSTFO TBKB TVEBI DVLVQ VOUVL NFOJOHLBULBO LBEBS "%)
1FMFQBTBO "%) KVHB EJLPOUSPM PMFI SFGMFLTSFGMFLT
4FCBMJLOZB TFUFMBI LFIJMBOHBO EBSBI LBEBS "%) QMBTNB
LBSEJPWBTLVMBSZBOHNFSFTQPOTQFOVSVOBOUFLBOBOEBSBIEBO
UJEBL CFSVCBI TFQFSUJ ZBOH EJIBSBQLBO TBNQBJ WPMVNF
BUBVWPMVNFEBSBI NFMJQVUJ
SFGMFLTCBSPSFTFQUPSBSUFSJBMEBO
UNIT V
EBSBI CFSLVSBOH TFLJUBS QFSTFO %FOHBO QFOVSVOBO

SFGMFLT LBSEJPQVMNPOBM ZBOH LFEVBOZB EJCBIBT EJ #BC
WPMVNF EBSBI MFCJI MBOKVU LBEBS "%) BLBO NFOJOHLBU
+BMVS SFGMFLT JOJ CFSBTBM EBSJ EBFSBI TJSLVMBTJ CFSUFLBOBO UJOHHJ
EFOHBO DFQBU +BEJ QBEB QFOVSVOBO WPMVNF EBSBI ZBOH
TFQFSUJ BSLVT BPSUB EBO TJOVT LBSPUJLVT EBO EBSJ EBFSBI
CFTBS SFGMFLT LBSEJPWBTLVMBS NFNBJOLBO QFSBO QFOUJOH
CFSUFLBOBO SFOEBI UFSVUBNB EJ BUSJVN KBOUVOH 3BOHTBOH
EBMBN NFSBOHTBOH TFLSFTJ "%) 1FOHBUVSBO TFLSFTJ "%)
BGFSFO EJCBXB PMFI OFSWVT WBHVT EBO OFSWVT HMPTPGBSJOHFVT
TFIBSJIBSJ TFMBNB EFIJESBTJ SJOHBO UFSVUBNB EJQFOHBSVIJ
EFOHBOTJOBQTTJOBQTEJOVLMFVTUSBLUVTTPMJUBSJVT1SPZFLTJEBSJ
PMFIQFSVCBIBOPTNPMBSJUBTQMBTNB"LBOUFUBQJ QFOVSVOBO
OVLMFVT JOJ NFOFSVTLBO TJOZBM NFOVKV OVLMFVT IJQPUBMBNJL
WPMVNFEBSBITBOHBUNFOJOHLBULBOSFTQPOT"%)UFSIBEBQ
ZBOHNFOHBUVSTJOUFTJTEBOTFLSFTJ"%)
QFOJOHLBUBOPTNPMBSJUBT
+BEJ TFMBJO VOUVL NFOJOHLBULBO PTNPMBSJUBT EVB SBOHTBOH
CFSJLVU EBQBU NFOJOHLBULBO TFLSFTJ "%)
QFOVSVOBO 4FLSFTJ "%) EBQBU KVHB EJUJOHLBULBO BUBV EJUVSVOLBO PMFI
UFLBOBO BSUFSJ EBO
QFOVSVOBO WPMVNF EBSBI #JMBNBOB SBOHTBOHMBJOQBEBTJTUFNTBSBGQVTBUEBOPMFICFSCBHBJPCBU
UFLBOBOEBSBIEBOWPMVNFEBSBICFSLVSBOH TFQFSUJZBOHUFSKBEJ EBO IPSNPO TFQFSUJ ZBOH UFSDBOUVN QBEB 5BCFM
QBEB QFSEBSBIBO QFOJOHLBUBO TFLSFTJ "%) BLBO NFOZFCBCLBO .JTBMOZB NVBMBEBMBISBOHTBOHLVBUVOUVLQFMFQBTBO"%)
QFOJOHLBUBO SFBCTPSQTJ DBJSBO PMFI HJOKBM ZBOH NFNCBOUV ZBOH EBQBU NFOJOHLBU TBNQBJ TFCBOZBL LBMJ OPSNBM
NFOHFNCBMJLBO UFLBOBO EBSBI EBO WPMVNF EBSBI LF LFBEBBO TFUFMBINVOUBI+VHB PCBUPCBUBOTFQFSUJOJLPUJOEBONPSGJO
OPSNBM NFSBOHTBOH QFMFQBTBO "%) TFEBOHLBO CFCFSBQB PCBU
Kepentingan Kuantitatif Refleks-Refleks TFQFSUJBMLPIPM NFOHIBNCBUQFMFQBTBO"%)%JVSFTJTCFSBU
Osmolaritas dan Kardiovaskular dalam ZBOHUFSKBEJTFUFMBINFNJOVNBMLPIPMTFCBHJBOEJBLJCBULBO
Merangsang Sekresi ADH PMFIIBNCBUBOQFMFQBTBO"%)
4FQFSUJ ZBOH EJUVOKVLLBO (BNCBS QFOVSVOBO WPMVNF Pentingnya Rasa Haus dalam Mengatur
EBSBI FGFLUJG NBVQVO QFOJOHLBUBO PTNPMBSJUBT DBJSBO Osmolaritas Cairan Ekstraselular dan
FLTUSBTFMVMBSBLBONFSBOHTBOHTFLSFTJ"%)"LBOUFUBQJ "%) Konsentrasi Natrium
EJBOHHBQMFCJITFOTJUJGUFSIBEBQQFSVCBIBOPTNPMBSJUBTZBOH
(JOKBM NFOFLBO LFIJMBOHBO DBJSBO TFMBNB LFLVSBOHBO BJS
NFMBMVJ TJTUFN VNQBO CBMJL PTNPSFTFQUPS"%) "LBO
UFUBQJ BTVQBO DBJSBO ZBOH BEFLVBU EJQFSMVLBO VOUVL
NFOHJNCBOHJ LFIJMBOHBO DBJSBO ZBOH UFSKBEJ NFMBMVJ
PAVP = 1.3 e 0.17 vol. LFSJOHBU EBO OBQBT TFSUB NFMBMVJ TBMVSBO QFODFSOBBO
50
"TVQBO DBJSBO EJBUVS PMFI NFLBOJTNF SBTB IBVT ZBOH
45 CFSTBNB EFOHBO NFLBOJTNF PTNPSFTFQUPS"%)
40 NFNQFSUBIBOLBO PTNPMBSJUBT DBJSBO FLTUSBTFMVMBS EBO
LPOTFOUSBTJOBUSJVNTFDBSBUFQBU
35
#BOZBLGBLUPSTBNBZBOHNFSBOHTBOHTFLSFTJ"%)KVHB
30 BLBO NFOJOHLBULBO SBTB IBVT ZBOH EJEFGJOJTJLBO TFCBHBJ
25 LFJOHJOBOTBEBSUFSIBEBQBJS
PAVP = 2.5 Osm + 2.0
20
15
10
Peningkatan ADH Penurunan ADH
5
↑ Osmolaritas plasma ↓ Osmolaritas plasma
0
↓Volume darah ↑ Volume darah
0 5 10 15 20 ↓ Tekanan darah ↑ Tekanan darah
Percent change
Nausea (muat)
Hipoksia
Obat: Obat:
Morfin Alkohol
Nikotin Klonidin (obat antihipertensi)
Siklofosfamida Haloperidol (dopamine blocker)
357
CFSTBNB EFOHBO LFSKB MBJO EBSJ BOHJPUFOTJO ** QBEB HJOKBM VOUVL
%FOHBONFSVKVLLFNCBMJQBEB(BNCBS EBFSBIZBOHTBNB NFOVSVOLBOFLTLSFTJDBJSBO
EJ TFQBOKBOH EJOEJOH BOUFSPWFOUSBM WFOUSJLFM LFUJHB ZBOH ,FLFSJOHBO QBEB NVMVU EBO NFNCSBO NVLPTB FTPGBHVT EBQBU
NFOJOHLBULBOQFMFQBTBO"%)KVHBNFSBOHTBOHSBTBIBVT"EB NFNCFSJ TFOTBTJ SBTB IBVT "LJCBUOZB TFTFPSBOH ZBOH LFIBVTBO
KVHB TVBUV EBFSBI LFDJM ZBOH UFSMFUBL BOUFSPMBUFSBM OVLMFVT EBQBU TFHFSB NFMFQBTLBO SBTB EBIBHBOZB TFUFMBI EJB NJOVN BJS
QSFPQUJL ZBOH CJMB EJSBOHTBOH TFDBSB MJTUSJL TFHFSB XBMBVQVO BJS UFSTFCVU CFMVN EJBCTPSCTJ EBSJ TBMVSBO QFODFSOBBO
NFOZFCBCLBO LFHJBUBO NJOVN ZBOH CFSMBOKVU TFMBNB EBOCFMVNNFNCFSJFGFLUFSIBEBQPTNPMBSJUBTDBJSBOFLTUSBTFMVMBS
SBOHTBOHBO CFSMBOHTVOH 4FNVB EBFSBI JOJ EJTFCVU QVTBU SBTB 3BOHTBOH HBTUSPJOUFTUJOBM EBO GBSJOH NFNFOHBSVIJ UJNCVMOZB
IBVT SBTBIBVT1BEBCJOBUBOHZBOHFTPGBHVTOZBNFNCVLBLFBSBIMVBS
/FVSPOOFVSPOEJQVTBUSBTBIBVTNFNCFSJSFTQPOTUFSIBEBQ TFIJOHHBBJSUJEBLQFSOBIEJBCTPSCTJLFEBMBNEBSBI BEBLFQVBTBO
QFOZVOUJLBOMBSVUBOHBSBNIJQFSUPOJLEFOHBODBSBNFSBOHTBOH TFCBHJBO TFUFMBI NJOVN XBMBVQVO LFQVBTBO JUV CFSTJGBU
QFSJMBLV NJOVN 4FMTFM JOJ IBNQJS QBTUJ CFSGVOHTJ TFCBHBJ TFNFOUBSB %JTUFOTJ TBMVSBO QFODFSOBBO KVHB EBQBU TFEJLJU
PTNPSFTFQUPSVOUVLNFOHBLUJWBTJNFLBOJTNFSBTBIBVT EFOHBO NFOHVSBOHJ SBTB IBVT DPOUPIOZB QFOJVQBO TFCVBI CBMPO EBMBN
DBSBZBOHTBNBTBBUPTNPSFTFQUPSNFSBOHTBOHQFMFQBTBO"%) MBNCVOHEBQBUNFOHIJMBOHLBOSBTBIBVT"LBOUFUBQJ QFOVSVOBO
1FOJOHLBUBO PTNPMBSJUBT DBJSBO TFSFCSPTQJOBM EJ WFOUSJLFM TFOTBTJSBTBIBVTNFMBMVJNFLBOJTNFHBTUSPJOUFTUJOBMBUBVGBSJOHFBM
LFUJHB NFNCFSJ QFOHBSVI ZBOH QBEB EBTBSOZB TBNB ZBJUV IBOZB CFSUBIBO TJOHLBU LFJOHJOBO VOUVL NJOVN IBOZB EBQBU
NFOJNCVMLBO LFJOHJOBO VOUVL NJOVN 0SHBOVN WBTLVMPTVN EJQVBTLBO TFQFOVIOZB CJMB PTNPMBSJUBT QMBTNB EBOBUBV WPMVNF
MBNJOB UFSNJOBMJT ZBOH UFSMFUBL UFQBU EJ CBXBI QFSNVLBBO EBSBILFNCBMJOPSNBM
WFOUSJLFM QBEB VKVOH JOGFSJPS EBFSBI "77 BHBLOZB JLVU ,FNBNQVBOCJOBUBOHEBONBOVTJBVOUVLNFOHVLVSBTVQBO
NFNQFSBOUBSBJSFTQPOTUFSTFCVU DBJSBO TBOHBU QFOUJOH LBSFOB EBQBU NFODFHBI IJESBTJ ZBOH
CFSMFCJIBO 4FUFMBI TFTFPSBOH NJOVN BJS NVOHLJO EJCVUVILBO
XBLUV TBNQBJ NFOJU BHBS BJS EJSFBCTPSCTJ EBO
5BCFM NFSBOHLVN CFCFSBQB SBOHTBOH SBTB IBVT ZBOH EJEJTUSJCVTJLBO LF TFMVSVI UVCVI #JMB TFOTBTJ SBTB IBVT UJEBL
EJLFUBIVJ 4BMBI TBUV ZBOH UFSQFOUJOH BEBMBI QFOJOHLBUBO IJMBOH TFNFOUBSB TFUFMBI NJOVN BJS PSBOH UFSTFCVU BLBO UFSVT
PTNPMBSJUBT DBJSBO FLTUSBTFMVMBS ZBOH NFOZFCBCLBO EFIJESBTJ NJOVNMFCJICBOZBLMBHJ ZBOHBLIJSOZBNFOJNCVMLBOIJESBTJEBO
JOUSBTFM EJ QVTBU SBTB IBVT ZBOH BLBO NFSBOHTBOH TFOTBTJ SBTB QFOHFODFSBO DBJSBO UVCVI ZBOH CFSMFCJIBO 1FOFMJUJBO EBO
IBVT ,FHVOBBO SFTQPOT JOJ TBOHBU KFMBT NFNCBOUV QFSDPCBBOCFSVMBOHLBMJNFOVOKVLLBOCJOBUBOHNFNJOVNKVNMBI
NFOHFODFSLBO DBJSBO FLTUSBTFMVMBS EBO NFOHFNCBMJLBO BJS ZBOH IBNQJS TFTVBJ EFOHBO KVNMBI ZBOH EJCVUVILBO VOUVL
PTNPMBSJUBTLFLFBEBBOOPSNBM NFOHFNCBMJLBO PTNPMBSJUBT EBO WPMVNF QMBTNB LF LFBEBBO
1FOVSVOBO WPMVNF DBJSBO FLTUSBTFMVMBS EBO UFLBOBO BSUFSJ OPSNBM
KVHB NFSBOHTBOH SBTB IBVT NFMBMVJ TVBUV KBMVS ZBOH UJEBL
CFSHBOUVOH QBEB KBMVS ZBOH EJSBOHTBOH PMFI QFOJOHLBUBO
PTNPMBSJUBT QMBTNB +BEJ LFIJMBOHBO WPMVNF EBSBI NFMBMVJ (JOKBM IBSVT UFSVTNFOFSVT NFOHFLTLSFTJLBO TFKVNMBI BJS ZBOH
QFSEBSBIBO BLBO NFSBOHTBOH SBTB IBVT XBMBVQVO NVOHLJO CFSTJGBU PCMJHBUPSJL CBILBO QBEB TFTFPSBOH ZBOH EFIJESBTJQVO
UJEBL UFSKBEJ QFSVCBIBO PTNPMBSJUBT QMBTNB )BM JOJ NVOHLJO VOUVL NFNCFSTJILBO UVCVI EBSJ LFMFCJIBO [BU UFSMBSVU ZBOH
UFSKBEJ BLJCBU NBTVLBO TBSBG EBSJ CBSPSFTFQUPS LBSEJPQVMNPOBM EJLPOTVNTJ BUBV ZBOH EJIBTJMLBO PMFI NFUBCPMJTNF "JS KVHB
EBOCBSPSFTFQUPSBSUFSJTJTUFNJLEJTJSLVMBTJ IJMBOH NFMBMVJ FWBQPSBTJ EBSJ QBSV EBO TBMVSBO QFODFSOBBO TFSUB
NFMBMVJ FWBQPSBTJ EBO LFSJOHBU EBSJ LVMJU 0MFI LBSFOB JUV TFMBMV
3BOHTBOHSBTBIBVTLFUJHBZBOHQFOUJOHBEBMBIBOHJPUFOTJO**
BEB LFDFOEFSVOHBO EFIJESBTJ EFOHBO BLJCBU QFOJOHLBUBO
1FOFMJUJBO QBEB CJOBUBOH NFOVOKVLLBO BOHJPUFOTJO ** CFLFSKB
PTNPMBSJUBTEBOLPOTFOUSBTJOBUSJVNDBJSBOFLTUSBTFMVMBS
QBEB PSHBO TVCGPSOJLBM EBO QBEB PSHBOVN WBTLVMPTVN MBNJOB
UFSNJOBMJT %BFSBIEBFSBI JOJ CFSBEB EJ MVBS TBXBS EBSBI PUBL #JMBLPOTFOUSBTJOBUSJVNIBOZBNFOJOHLBUTFLJUBSN&R-EJ
EBO QFQUJEBQFQUJEB TFQFSUJ BOHJPUFOTJO ** CFSEJGVTJ LF EBMBN BUBTOPSNBM NFLBOJTNFSBTBIBVTEJBLUJGLBO ZBOHNFOJNCVMLBO
KBSJOHBO0MFILBSFOBBOHJPUFOTJO**KVHBEJSBOHTBOHPMFIGBLUPS LFJOHJOBO VOUVL NJOVN BJS ,FBEBBO JOJ EJTFCVU BNCBOH
GBLUPS ZBOH CFSIVCVOHBO EFOHBO IJQPWPMFNJB EBO UFLBOBO SBOHTBOH VOUVL NJOVN +BEJ QFOJOHLBUBO PTNPMBSJUBT QMBTNB
EBSBISFOEBI QFOHBSVIOZB QBEB SBTB IBVT NFNCBOUV ZBOH TFEJLJU TBKB CJBTBOZB EJJLVUJ PMFI BTVQBO BJS ZBOH BLBO
NFNVMJILBOWPMVNFEBSBIEBOUFLBOBOEBSBILFNCBMJOPSNBM NFNVMJILBOPTNPMBSJUBTEBOWPMVNFDBJSBOFLTUSBTFMVMBSLFNCBMJ
OPSNBM %FOHBO DBSB JOJ PTNPMBSJUBT DBJSBO FLTUSBTFMVMBS EBO
LPOTFOUSBTJOBUSJVNEJBUVSEFOHBOUFQBU
Tabel 28-3 Pengaturan Rasa Haus
Rasa Haus Meninglcat Rasa Haus Menurun Integrasi Respons Osmoreseptor-ADH dan Mekanisme
Rasa Haus dalam Pengaturan Osmolaritas Cairan
↑ Osmotaritas ↓ Osmolaritas plasma
Ekstraselular dan Konsentrasi Natrium
↓Volume darah ↑ Volume darah 1BEB TFTFPSBOH ZBOH TFIBU NFLBOJTNF PTNPSFTFQUPS"%) EBO
↓ Tekanan darah ↑ Tekanan darah SBTB IBVT CFLFSKB TFDBSB QBSBMFM VOUVL NFOHBUVS PTNPMBSJUBT
DBJSBO FLTUSBTFMVMBS EBO LPOTFOUSBTJ OBUSJVN EFOHBO UFQBU
↑ Tekanan darah ↓ Tekanan darah
XBMBVQVOSBOHTBOHBOEFIJESBTJCFSTJGBULPOTUBO#BILBOEFOHBO
Mulut kering Distensi lambung
QFSBOHTBOHBOUBNCBIBO TFQFSUJLPOTVNTJHBSBNUJOHHJ TJTUFN
358
VNQBO CBMJL JOJ NBNQV NFNQFSUBIBOLBO PTNPMBSJUBT QMBTNB 0MFI LBSFOB QFOUJOHOZB BOHJPUFOTJO ** EBO BMEPTUFSPO EBMBN
BHBS UFUBQ LPOTUBO (BNCBS NFOVOKVLLBO QFOJOHLBUBO NFOHBUVS FLTLSFTJ OBUSJVN PMFI HJOKBM TFTFPSBOH EBQBU TBMBI
BTVQBOOBUSJVNTBNQBJFOBNLBMJOPSNBMIBOZBNFNCFSJTFEJLJU NFOEVHB CBIXB LFEVB IPSNPO UFSTFCVU KVHB NFNBJOLBO QFSBO
QFOHBSVI UFSIBEBQ LPOTFOUSBTJ OBUSJVN QMBTNB TFMBNB QFOUJOH EBMBN NFOHBUVS LPOTFOUSBTJ OBUSJVN DBJSBO FLTUSBTFMVMBS
8BMBVQVO IPSNPOIPSNPO JOJ NFOJOHLBULBO KVNMBI OBUSJVN
NFLBOJTNF"%)EBOSBTBIBVTCFSGVOHTJOPSNBM
EBMBN DBJSBO FLTUSBTFMVMBS IPSNPOIPSNPO JUV KVHB NFOJOHLBULBO
UNIT V
#JMB NFLBOJTNF "%) BUBV NFLBOJTNF SBTB IBVT HBHBM
WPMVNF DBJSBO FLTUSBTFMVMBS EFOHBO NFOJOHLBULBO SFBCTPSQTJ BJS
NFLBOJTNFZBOHMBJOCJBTBOZBNBTJIEBQBUNFOHBUVSPTNPMBSJUBT CFSTBNB EFOHBO OBUSJVN 0MFI LBSFOB JUV BOHJPUFOTJO ** EBO
FLTUSBTFM EBO LPOTFOUSBTJ OBUSJVN EFOHBO DVLVQ FGFLUJG TFMBNB BMEPTFSPO NFNQVOZBJ QFOHBSVI ZBOH LFDJM UFSIBEBQ LPOTFOUSBTJ
UFSTFEJB BTVQBO DBJSBO ZBOH DVLVQ VOUVL NFOHJNCBOHJ WPMVNF OBUSJVN LFDVBMJEBMBNLPOEJTJLPOEJTJFLTUSFN
VSJOFPCMJHBUPSJLEBOLFIJMBOHBOBJSNFMBMVJQFSOBQBTBO LFSJOHBU ,FUJEBLQFOUJOHBO SFMBUJG BMEPTUFSPO EBMBN NFOHBUVS LPOTFOUSBTJ
BUBV TBMVSBO QFODFSOBBO "LBO UFUBQJ CJMB NFLBOJTNF "%) EBO OBUSJVN DBJSBO FLTUSBTFMVMBS EJQFSMJIBULBO NFMBMVJ QFSDPCBBO QBEB
SBTB IBVT TFLBMJHVT HBHBM LPOTFOUSBTJ OBUSJVN EBO PTNPMBSJUBT (BNCBS (BNCBS JOJ NFOVOKVLLBO QFOHBSVI QFSVCBIBO
QMBTNB UJEBL EBQBU EJLPOUSPM EFOHBO CBJL KBEJ CJMB BTVQBO BTVQBO OBUSJVN MFCJI EBSJ FOBN LBMJ MJQBU QBEB EVB LFBEBBO
OBUSJVN NFOJOHLBU TFUFMBI NFOHIBNCBU TJTUFN "%)SBTB IBVT LPOTFOUSBTJOBUSJVNQMBTNB
QBEBLPOEJTJOPSNBMEBO
TFTVEBI
UFSKBEJ QFSVCBIBO LPOTFOUSBTJ OBUSJVN QMBTNB ZBOH SFMBUJG CFTBS TJTUFN VNQBO CBMJL BMEPTUFSPO EJIBNCBU EFOHBO NFOHBOHLBU
#JMB NFLBOJTNF "%)SBTB IBVT UJEBL BEB UJEBL BEB NFLBOJTNF LFMFOKBS BESFOBM EBO CJOBUBOH UFSTFCVU EJCFSJ BMEPTUFSPO QBEB
LFDFQBUBO LPOTUBO TFIJOHHB LBEBS QMBTNB UJEBL CFSVCBI OBJL BUBV
VNQBOCBMJLMBJOZBOHNBNQVNFOHBUVSLPOTFOUSBTJOBUSJVNEBO
UVSVO 1FSIBUJLBO CBIXB TFXBLUV BTVQBO OBUSJVN NFODBQBJ FOBN
PTNPMBSJUBTQMBTNBTFDBSBDVLVQCBJL
LBMJMJQBU LPOTFOUSBTJQMBTNBIBOZBCFSVCBITFLJUBSTBNQBJQFSTFO
Peran Angiotensin II dan Aldosteron dalam QBEB LFEVB LBTVT )BM JOJ NFOVOKVLLBO CBIXB NFTLJQVO UBOQB
Mengatur Osmolaritas Cairan Ekstraselular dan TJTUFNVNQBOCBMJLBMEPTUFSPOZBOHGVOHTJPOBM LPOTFOUSBTJOBUSJVN
Konsentrasi Natrium QMBTNB EBQBU EJBUVS EFOHBO CBJL +FOJT QFSDPCBBO ZBOH TBNB UFMBI
EJMBLVLBOTFUFMBINFOHIBNCBUQFNCFOUVLBOBOHJPUFOTJO** EFOHBO
4FQFSUJ ZBOH EJEJTLVTJLBO EJ #BC BOHJPUFOTJO ** EBO IBTJMZBOHTBNB
BMEPTUFSPO NFNBJOLBO QFSBO QFOUJOH EBMBN NFOHBUVS "EB EVB BMBTBO VUBNB NFOHBQB QFSVCBIBO BOHJPUFOTJO ** EBO
SFBCTPSQTJ OBUSJVN PMFI UVCVMVT HJOKBM #JMB BTVQBO OBUSJVN BMEPTUFSPO UJEBL NFNCFSJ QFOHBSVI CFTBS UFSIBEBQ LPOTFOUSBTJ
SFOEBI QFOJOHLBUBO LBEBS LFEVB IPSNPO JUV BLBO OBUSJVN QMBTNB 1FSUBNB TFQFSUJ ZBOH EJEJTLVTJLBO TFCFMVNOZB
NFSBOHTBOH SFBCTPSQTJ OBUSJVN PMFI HJOKBM TFIJOHHB BLBO BOHJPUFOTJO**EBOBMEPTUFSPONFOJOHLBULBOSFBCTPSQTJOBUSJVNEBO
NFODFHBI LFIJMBOHBO OBUSJVN EBMBN KVNMBI ZBOH CFTBS BJS PMFI UVCVMVT HJOKBM ZBOH NFOHIBTJMLBO QFOJOHLBUBO WPMVNF
XBMBVQVO BTVQBO OBUSJVN NVOHLJO NFOVSVO TBNQBJ DBJSBO FLTUSBTFMVMBS EBO KVNMBI OBUSJVN UFUBQJ TFEJLJU QFSVCBIBO
QFSTFO EBSJ OPSNBM 4FCBMJLOZB EFOHBO BTVQBO OBUSJVN ZBOH QBEB LBEBS OBUSJVN ,FEVB TFMBNB NFLBOJTNF "%)SBTB IBVT
UJOHHJ QFOVSVOBO QFNCFOUVLBO LFEVB IPSNPO JOJ CFSGVOHTJ LFDFOEFSVOHBO BQBQVO ZBOH NFOJOHLBULBO LPOTFOUSBTJ
NFNVOHLJOLBO HJOKBM NFOHFLTLSFTJLBO OBUSJVN EBMBN OBUSJVN QMBTNB BLBO EJLPNQFOTBTJ PMFI QFOJOHLBUBO BTVQBO BJS
KVNMBICFTBS BUBV QFOJOHLBUBO TFLSFTJ "%) QMBTNB ZBOH DFOEFSVOH
NFOHFODFSLBO DBJSBO FLTUSBTFMVMBS LFNCBMJ LF BSBI OPSNBM 4JTUFN
"%)SBTB IBVT NFOHBMBILBO TJTUFN BOHJPUFOTJO ** EBO BMEPTUFSPO
EBMBN NFOHBUVS LPOTFOUSBTJ OBUSJVN QBEB LPOEJTJ OPSNBM #BILBO
QBEB QBTJFO EFOHBO BMEPTUFSPOJTNF QSJNFS ZBOH NFNJMJLJ LBEBS
BMEPTUFSPOTBOHBUUJOHHJ LPOTFOUSBTJOBUSJVNQMBTNBCJBTBOZBIBOZB
NFOJOHLBUTFLJUBSTBNQBJN&R-EJBUBTOPSNBM
150
Normal
140
130
120
110
100
0 30 60 90 120 150 180 0 30 60 90 120 150 180 210
(mEq/ ) Sodium intake (mEq/L)
359
%BMBNLPOEJTJFLTUSFN ZBOHEJTFCBCLBOPMFIIJMBOHOZBTFLSFTJ NFOZFCBCLBO LFIJMBOHBO OBUSJVN ZBOH CBOZBL EBMBN VSJOF EBO
BMEPTUFSPO TFDBSB NFOZFMVSVI BLJCBU BESFOBMFLUPNJ BUBV QBEB NFOJNCVMLBO QFOVSVOBO WPMVNF DBJSBO FLTUSBTFMVMBS EBO
QBTJFO EFOHBO QFOZBLJU "EEJTPO HBOHHVBO TFLSFTJ BMEPTUFSPO QFOVSVOBO LPOTFOUSBTJ OBUSJVN LFEVB QFSVCBIBO JOJ
ZBOH CFSBU BUBV UJEBL BEB BMEPTUFSPO TBNB TFLBMJ
UFSEBQBU NFNCBOHLJULBOLFJOHJOBOBLBOHBSBN
LFIJMBOHBO OBUSJVN ZBOH TBOHBU IFCBU PMFI HJOKBM ZBOH EBQBU 1BEBVNVNOZB SBOHTBOHVUBNBZBOHNFOJOHLBULBOLFJOHJOBO
NFOJNCVMLBO QFOVSVOBO LPOTFOUSBTJ OBUSJVN QMBTNB 4BMBI TBUV BLBO HBSBN BEBMBI ZBOH CFSLBJUBO EFOHBO LFLVSBOHBO OBUSJVN
BMBTBOOZB BEBMBI LFIJMBOHBO OBUSJVN ZBOH CBOZBL QBEB BLIJSOZB EBOQFOVSVOBOWPMVNFEBSBIBUBVUFLBOBOEBSBI ZBOHCFSLBJUBO
BLBO NFOZFCBCLBO QFOVSVOBO WPMVNF EBO QFOVSVOBO UFLBOBO EFOHBOJOTVGJTJFOTJTJSLVMBTJ
EBSBI ZBOH IFCBU ZBOH EBQBU NFOHBLUJGLBO NFLBOJTNF SBTB IBVT .FLBOJTNF QFSTBSBGBO VOUVL LFJOHJOBO BLBO HBSBN EBQBU
NFMBMVJSFGMFLTLBSEJPWBTLVMBS)BMJOJNFOJNCVMLBOQFOHFODFSBO EJTBNBLBO EFOHBO NFLBOJTNF SBTB IBVT #FCFSBQB QVTBU
LPOTFOUSBTJ OBUSJVN QMBTNB MFCJI MBOKVU XBMBVQVO QFOJOHLBUBO QFSTBSBGBO ZBOH TBNB EJ EBFSBI "77 PUBL NVOHLJO UFSMJCBU
BTVQBO BJS NFNCBOUV NFNQFSLFDJM QFOVSVOBO WPMVNF DBJSBO LBSFOBMFTJMFTJQBEBEBFSBIJOJTFSJOHLBMJNFNFOHBSVIJLFJOHJOBO
UVCVIEBMBNLPOEJTJUFSTFCVU BLBOHBSBNEBOSBTBIBVTEBMBNTBBUZBOHCFSTBNBBOEJCJOBUBOH
+BEJ UFSEBQBU LFBEBBOLFBEBBO FLTUSFN ZBOH NVOHLJO 3FGMFLTSFGMFLT TJSLVMBTJ ZBOH EJCBOHLJULBO PMFI UFLBOBO EBSBI
NFOZFCBCLBO QFSVCBIBO LPOTFOUSBTJ OBUSJVN QMBTNB TFDBSB SFOEBIBUBVQFOVSVOBOWPMVNFEBSBIKVHBNFNFOHBSVIJSBTBIBVT
CFSNBLOB CBILBO EFOHBO NFLBOJTNF "%)SBTB IBVT ZBOH EBOLFJOHJOBOBLBOHBSBNQBEBXBLUVZBOHCFSTBNBBO
GVOHTJPOBM 8BMBVQVO EFNJLJBO NFLBOJTNF "%)SBTB IBVT
NFSVQBLBO TJTUFN VNQBO CBMJL ZBOH UFSCBJL EJ UVCVI VOUVL
NFOHBUVSPTNPMBSJUBTDBJSBOFLTUSBTFMVMBSEBOLPOTFOUSBTJOBUSJVN
Daftar Pustaka
Mekanisme Keinginan Akan Garam untuk
Antunes-Rodrigues J, de Castro M, Elias LL, et al: Neuroendocrine control of
Mengatur Konsentrasi dan Volume Natrium body fluid metabolism, Physiol Rev 84:169, 2004.
Cairan Ekstraselular Bourque CW: Central mechanisms of osmosensation and systemic osmo-
regulation, Nat Rev Neurosci 9:519–531, 2008.
1FNFMJIBSBBOWPMVNFDBJSBOFLTUSBTFMVMBSEBOLPOTFOUSBTJOBUSJVN Cowley AW Jr, Mori T, Mattson D, et al: Role of renal NO production in
the regulation of medullary blood flow, Am J Physiol Regul Integr Comp
ZBOH OPSNBM NFNCVUVILBO TVBUV LFTFJNCBOHBO BOUBSB FLTLSFTJ
Physiol 284:R1355, 2003.
OBUSJVNEBOBTVQBOOBUSJVN%BMBNLFIJEVQBONPEFSOTFLBSBOH Dwyer TM, Schmidt-Nielsen B: The renal pelvis: machinery that concen-
JOJ BTVQBOOBUSJVNIBNQJSTFMBMVMFCJICFTBSEBSJQBEBLFCVUVIBO trates urine in the papilla, News Physiol Sci 18:1, 2003.
VOUVL IPNFPTUBTJT .FNBOH BTVQBO OBUSJVN SBUBSBUB VOUVL Fenton RA, Knepper MA: Mouse models and the urinary concentrating
TFUJBQPSBOHEBMBNCVEBZBJOEVTUSJBMJTBTJZBOHNFNBLBONBLBOBO mechanism in the new millennium, Physiol Rev 87:1083, 2007.
ZBOHUFMBIEJQSPTFTCFSLJTBSBOUBSBEBON&RIBSJ QBEBIBM Finley JJ 4th, Konstam MA, Udelson JE: Arginine vasopressin antagonists for
NBOVTJBEBQBUCFSUBIBOEBOCFSGVOHTJOPSNBMQBEBTBNQBJ the treatment of heart failure and hyponatremia, Circulation 118:410,
N&RIBSJ +BEJ LFCBOZBLBO PSBOH NBLBO OBUSJVN KBVI MFCJI 2008.
CBOZBL EBSJQBEB ZBOH EJCVUVILBO VOUVL IPNFPTUBTJT UVCVI EBO Geerling JC, Loewy AD: Central regulation of sodium appetite, Exp Physiol
BEBCVLUJCBIXBLFCJBTBBOBTVQBOOBUSJVNLJUBZBOHUJOHHJEBQBU 93:177, 2008.
Kozono D, Yasui M, King LS, et al: Aquaporin water channels: atomic
JLVU CFSQFSBO UFSIBEBQ UJNCVMOZB LFMBJOBOLFMBJOBO
structure molecular dynamics meet clinical medicine, J Clin Invest
LBSEJPWBTLVMBS TFQFSUJIJQFSUFOTJ 109:1395, 2002.
,FJOHJOBOBLBOHBSBNBEBMBITFCBHJBOBLJCBULFOZBUBBOCBIXB Loh JA, Verbalis JG: Disorders of water and salt metabolism associated with
CJOBUBOH EBO NBOVTJB NFOZVLBJ HBSBN EBO NFNBLBOOZB UBOQB pituitary disease, Endocrinol Metab Clin North Am 37:213, 2008.
NFNQFSIBUJLBOBQBLBICJOBUBOHBUBVNBOVTJBUFSTFCVUNFOHBMBNJ McKinley MJ, Johnson AK: The physiological regulation of thirst and fluid
EFGJTJFOTJ HBSBN 4FMBJO JUV UFSEBQBU LPNQPOFO QFOHBUVS intake, News Physiol Sci 19:1, 2004.
LFJOHJOBO BLBO HBSBN ZBOH NFOJNCVMLBO EPSPOHBO QFSJMBLV Pallone TL, Zhang Z, Rhinehart K: Physiology of the renal medullary micro-
VOUVL NFNQFSPMFI HBSBN CJMB UFSEBQBU EFGJTJFOTJ OBUSJVN EBMBN circulation, Am J Physiol Renal Physiol 284:F253, 2003.
Sands JM, Bichet DG: Nephrogenic diabetes insipidus, Ann Intern Med
UVCVI ,FBEBBO JOJ UFSVUBNB QFOUJOH QBEB IFSCJWPSB ZBOH TFDBSB
144:186, 2006.
BMBNJ NFOHPOTVNTJ TFEJLJU OBUSJVN UFUBQJ LFJOHJOBO UFSIBEBQ Schrier RW: Body water homeostasis: clinical disorders of urinary dilution
HBSBN NVOHLJO KVHB QFOUJOH QBEB NBOVTJB ZBOH NFOHBMBNJ and concentration, J Am Soc Nephrol 17:1820, 2006.
EFGJTJFOTJOBUSJVNZBOHFLTUSFN TFQFSUJZBOHUFSKBEJQBEBQFOZBLJU Sharif-Naeini R, Ciura S, Zhang Z, et al: Contribution of TRPV channels to
"EEJTPO 1BEB QFOZBLJU UFSTFCVU UFSKBEJ QBEB QFOZBLJU "EEJTPO osmosensory transduction, thirst, and vasopressin release, Kidney Int
1BEBQFOZBLJUUFSTFCVU UFSEBQBUEFGJTJFOTJTFLSFTJBMEPTUFSPO ZBOH 73:811, 2008.
360
BAB 29
1FOHBUVSBO(JOKBMUFSIBEBQ,BMJVN ,BMTJVN
'PTGBU EBO.BHOFTJVN*OUFHSBTJ.FLBOJTNF
UNIT V
(JOKBMVOUVL1FOHBUVSBO7PMVNF%BSBIEBO
7PMVNF$BJSBO&LTUBTFMVMBS
0MFI LBSFOB MFCJI EBSJ QFSTFO LBMJVN UVCVI UPUBM UFSEBQBU
Pengaturan EBMBN TFM TFMTFM UFSTFCVU EBQBU NFOKBEJ UFNQBU QFOBNQVOHBO
Konsentrasi Kalium LFMFCJIBO LBMJVN DBJSBO FLTUSBTFMVMBS TFMBNB IJQFSLBMFNJB BUBV
Cairan Ekstrasel dan NFOKBEJ TVNCFS LBMJVN QBEB IJQPLBMFNJB 0MFI LBSFOB JUV
Ekskresi Kalium SFEJTUSJCVTJLBMJVNBOUBSBLPNQBSUFNFODBJSBOFLTUSBTFMVMBSEBO
JOUSBTFMVMBS NFSVQBLBO HBSJT QFSUBIBOBO QFSUBNB UFSIBEBQ
QFSVCBIBOLPOTFOUSBTJLBMJVNEBMBNDBJSBOFLTUSBTFMVMBS
,POTFOUSBTJ LBMJVN DBJSBO FLTUSBTFMVMBS OPSNBM EJBUVS EFOHBO
UFQBU LJSBLJSB N&R- KBSBOH TFLBMJ OBJL BUBV UVSVO MFCJI
EBSJ N&R-1FOHBUVSBOZBOHUFQBUJOJQFSMVLBSFOBCBOZBL Pengaturan Distribusi Kalium Internal
GVOHTJ TFM ZBOH TBOHBU TFOTJUJG UFSIBEBQ QFSVCBIBO LPOTFOUSBTJ 4FTVEBI NBLBO NBLBOBO CJBTB LPOTFOUSBTJ LBMJVN DBJSBO
LBMJVN DBJSBO FLTUSBTFMVMBS 4FCBHBJ DPOUPI QFOJOHLBUBO FLTUSBTFMVMBS BLBO NFOJOHLBU NFODBQBJ LBEBS ZBOH NFNCB
LPOTFOUSBTJ LBMJVN QMBTNB IBOZB TFCFTBS IJOHHB N&R- IBZBLBO CJMB LBMJVN ZBOH EJNBLBO UJEBL EJQJOEBILBO TFDBSB
EBQBUNFOZFCBCLBOBSJUNJBKBOUVOH EBOLPOTFOUSBTJZBOHMFCJI DFQBU LF EBMBN TFM 4FCBHBJ DPOUPI BCTPSQTJ N&R LBMJVN
UJOHHJ MBHJ EBQBU NFOJNCVMLBO IFOUJ KBOUVOH BUBV GJCSJMBTJ KVNMBI ZBOH UFSLBOEVOH EJ EBMBN NBLBOBO ZBOH CBOZBL
KBOUVOH NFOHBOEVOH TBZVSBO EBO CVBICVBIBO
LF EBMBN DBJSBO
,FTVMJUBO LIVTVT EBMBN NFOHBUVS LPOTFOUSBTJ LBMJVN FLTUSBTFMVMBSZBOHCFSWPMVNFMJUFSBLBONFOJOHLBULBOLPO
FLTUSBTFMVMBS LBSFOB MFCJI EBSJ QFSTFO LBMJVN UVCVI UPUBM UFS TFOUSBTJ LBMJVN QMBTNB NFOKBEJ TFLJUBS N&R- 6OUVOH
LBOEVOH EJ EBMBN TFM EBO IBOZB QFSTFO EBMBN DBJSBO FLTUSB OZB TFCBHJBO CFTBS LBMJVN ZBOH NBLBO BLBO DFQBU CFSQJOEBI
TFMVMBS (BNCBS
6OUVL PSBOH EFXBTB EFOHBO CFSBU LFEBMBNTFMTBNQBJHJOKBMEBQBUNFNCVBOHLFMFCJIBOLBMJVN
LJMPHSBNZBOHNFNJMJLJTFLJUBS-DBJSBOJOUSBTFMVMBS QFSTFO UFSTFCVU 5BCFM NFSBOHLVN CFCFSBQB GBLUPS ZBOH EBQBU
EBSJ CFSBU CBEBO
EBO - DBJSBO FLTUSBTFMVMBS QFSTFO EBSJ NFNFOHBSVIJ EJTUSJCVTJ LBMJVN BOUBSB LPNQBSUFNFO DBJSBO
CFSBUCBEBO
TFLJUBSN&RLBMJVNUFSEBQBUEJEBMBNTFMEBO FLTUSBTFMVMBSEBOJOUSBTFMVMBS
IBOZB TFLJUBS N&R EJ DBJSBO FLTUSBTFMVMBS +VHB LBMJVN ZBOH Insulin Merangsang Ambilan Kalium ke dalam Sel. *OTVMJO
UFSLBOEVOH EBMBN TBUV LBMJ NBLBO TFSJOH LBMJ TFCBOZBL N&R NFSVQBLBO GBLUPS QFOUJOH VOUVL NFOJOHLBULBO BNCJBO LBMJVN
EBOBTVQBOIBSJBOCJBTBOZBCFSLJTBSBOUBSBEBON&RIBSJ TFM TFUFMBI NBLBO 1BEB PSBOH EFOHBO EFGJTJFOTJ JOTVMJO BLJCBU
PMFILBSFOBJUV LFHBHBMBOVOUVLNFNCVBOHEFOHBODFQBUDBJSBO EJBCFUFTNFMJUVT QFOJOHLBUBOLPOTFOUSBTJLBMJVNQMBTNBTFTVEBI
FLTUSBTFMVMBS ZBOH NFOHBOEVOH LBMJVN ZBOH EJNBLBO EBQBU NBLBOMFCJICFTBSEBSJQBEBPSBOHOPSNBM/BNVO QFOZVOUJLBO
NFOZFCBCLBO IJQFSLBMFNJB QFOJOHLBUBO LPOTFOUSBTJ LBMJVN JOTVMJOEBQBUNFNCBOUVNFOHPSFLTJIJQFSLBMFNJB
QMBTNB
ZBOH NFNCBIBZBLBO KJXB %FNJLJBO KVHB LFIJMBOHBO
TFEJLJULBMJVNEBSJDBJSBOFLTUSBTFMVMBSEBQBUNFOZFCBCLBOIJQP Aldosteron Meningkatkan Ambilan Kalium ke dalam Sel.
LBMFNJB LPOTFOUSBTJLBMJVNQMBTNBZBOHSFOEBI
ZBOHCFSBUCJMB 1FOJOHLBUBO BTVQBO LBMJVN KVHB NFSBOHTBOH TFLSFTJ BMEPT
UJEBLBEBSFTQPOTLPNQFOTBTJZBOHDFQBUEBOUFQBU UFSPO ZBOHNFOJOHLBULBOBNCJMBOLBMJVNLFEBMBNTFM4FLSFTJ
BMEPTUFSPO ZBOH CFSMFCJIBO TJOESPN $POO
IBNQJSTFMBMVUFS
1FNFMJIBSBBO JNCBOHBO BOUBSB BTVQBO EBO LFMVBSBO LBMJVN
LBJU EFOHBO IJQPLBMFNJB ZBOH TFCBHJBO CFSIVCVOHBO EFOHBO
UFSVUBNB CFSHBOUVOH QBEB FLTLSFTJ HJOKBM LBSFOB KVNMBI ZBOH
QFSQJOEBIBO LBMJVN FLTUSBTFM LF EBMBN TFM 4FCBMJLOZB QBTJFO
EJFLTLSFTJLBOEBMBNGFTFTIBOZBTFLJUBSQFSTFOEBSJBTVQBO
ZBOH QSPEVLTJ BMEPTUFSPOOZB CFSLVSBOH QFOZBLJU "EEJTPO

LBMJVN 0MFI LBSFOB JUV QFOHBUVSBO JNCBOHBO LBMJVN ZBOH
TFSJOH LBMJ NFOHBMBNJ IJQFSLBMFNJB ZBOH TFDBSB LMJOJT CFSBSUJ
OPSNBM NFNCVUVILBO QFOZFTVBJBO HJOKBM UFSIBEBQ FLTLSFTJ
BLJCBU BLVNVMBTJ LBMJVN EJ SVBOH FLTUSBTFM EBO KVHB SFUFOTJ
LBMJVNOZB EFOHBO DFQBU EBO UFQBU TFCBHBJ KBXBCBO BUBT WBSJBTJ
LBMJVNPMFIHJOKBM
BTVQBO ZBOH CFTBS TFQFSUJ KVHB ZBOH UFSKBEJ QBEB LFCBOZBLBO
FMFLUSPMJUMBJO
1FOHBUVSBO EJTUSJCVTJ LBMJVN BOUBSB LPNQBSUFNFO FLTUSBTFM Rangsangan Ϡ-Adrenergik Meningkatkan Ambilan Kalium
EBOJOUSBTFMKVHBCFSQFSBOQFOUJOHEBMBNIPNFPTUBTJTLBMJVN Sel. 1FOJOHLBUBO TFLSFTJ LBUFLPMBNJO LIVTVTOZB FQJOFGSJO
361
K ZBOH CFSBSUJ CJMB BEB TFCBHJBO CFTBS KBSJOHBO SVTBL TFQFSUJ ZBOH
100 mEq/ UFSKBEJQBEBUSBVNBPUPUCFSBUBUBVQBEBMJTJTTFMEBSBINFSBI
Olahraga Berat Dapat Menyebabkan Hiperkalemia

dengan Melepaskan Kalium dari Otot Rangka. 4FMBNB
4.2 mEq/L 140 mEq/L PMBISBHBZBOHMBNB LBMJVNEJMFQBTLBOEBSJPUPUSBOHLBLFDBJSBO
x 14 L x 28 L FLTUSBTFMVMBS#JBTBOZBUFSKBEJIJQFSLBMFNJBSJOHBO OBNVOEBQBU
NFOKBEJ CFSBSUJ TFDBSB LMJOJT TFUFMBI NFMBLVLBO LFSKB CFSBU
59 mEq 3920 mEq LIVTVTOZB QBEB QBTJFO ZBOH EJPCBUJ EFOHBO QFOHIBNCBU Ϡ
BESFOFSHJL BUBV QBEB PSBOH ZBOH NFOHBMBNJ EFGJTJFOTJ JOTVMJO
)JQFSLBMFNJBTFTVEBIPMBISBHBEBQBUDVLVQCFSBUVOUVLNFOZF
Urine 92 mEq/day CBCLBO BSJUNJB KBOUVOH EBO LFNBUJBO ZBOH NFOEBEBL TVEEFO
Fe es 8 mEq/day EFBUI
NFTLJQVOKBSBOHTFLBMJUFSKBEJ
100 mEq/day
Peningkatan Osmolaritas Cairan Ekstraselular

Menyebabkan Redistribusi Kalium dari Sel ke Cairan
1FOJOHLBUBOPTNPMBSJUBTDBJSBOFLTUSBTFMVMBSNFOZFCBCLBOBMJSBO
PTNPTJT BJS LFMVBS EBSJ TFM %FIJESBTJ TFM NFOJOHLBULBO LPOTFO
USBTJ LBMJVN JOUSBTFM EFOHBO EFNJLJBO NFOJOHLBULBO EJGVTJ
LBMJVN LFMVBS EBSJ TFM EBO NFOJOHLBULBO LPOTFOUSBTJ LBMJVN
Faktor yang Memindahkan K+ ke Faktor yang Memindahkan K+ FLTUSBTFM1FOVSVOBOPTNPMBSJUBTDBJSBOFLTUSBTFMVMBSNFNQVOZBJ
Dalam Sel (Menurunkan [K+] ke Dalam Sel (Menurunkan [K+] FGFLZBOHCFSMBXBOBO
Ekstraselular) Ekstraselular)
Insulin Defisiensi insulin

Intisari Ekskresi Kalium Ginjal
Aldosteron (diabetes melitus &LTLSFTJ LBMJVN HJOKBM EJUFOUVLBO PMFI KVNMBI LFUJHB QSPTFT
Perangsangan adrenergik Defisiensi Aldosteron CFSJLVU
MBKVGJMUSBTJLBMJVN -'(EJLBMJLBOLPOTFOUSBTJLBMJVN
Alkalosis (penyakit Addison) QMBTNB

MBKV SFBCTPSQTJ LBMJVN PMFI UVCVMVT EBO
MBKV
Penyakit -adrenergik TFLSFTJ LBMJVN PMFI UVCVMVT -BKV GJMUSBTJ LBMJVN OPSNBM PMFI
Asidosis
LBQJMFSHMPNFSVMVTBEBMBITFLJUBSN&RIBSJ -'(-IBSJ
Lisis sel
EJLBMJLBO LBMJVN QMBTNB N&R-
MBKV GJMUSBTJ JOJ CJBTBOZB
Kerja berat
Kenaikan osmolaritas SFMBUJGLPOTUBOQBEBPSBOHTFIBULBSFOBNFLBOJTNFBVUPSFHVMBTJ
cairan ekstraselular VOUVL -'( ZBOH TVEBI EJCBIBT TFCFMVNOZB EBO LFUFQBUBO
QFOHBUVSBOLPOTFOUSBTJLBMJVNQMBTNB/BNVO QFOVSVOBO-'(
ZBOH IFCBU QBEB QFOZBLJU HJOKBM UFSUFOUV EBQBU NFOZFCBCLBO
EBQBU NFOZFCBCLBO QFSQJOEBIBO LBMJVN EBSJ DBJSBO FLTUSBTF BLVNVMBTJLBMJVNZBOHCFSCBIBZBEBOUFSKBEJOZBIJQFSLBMFNJB
MVMBSLFJOUSBTFM UFSVUBNBPMFIBLUJWBTJSFTFQUPSϠBESFOFSHJL (BNCBSBEBMBISJOHLBTBOQFSMBLVBOLBMJVNPMFIUVCVMVT
1FOHPCBUBO IJQFSUFOTJ NFOHHVOBLBO QFOHIBNCBU SFTFQUPS Ϡ EBMBN LFBEBBO OPSNBM 4FLJUBS QFSTFO EBSJ LBMJVN ZBOH
BESFOFSHJL TFQFSUJ QSPQSBOPMPM NFOZFCBCLBO LBMJVN LFMVBS EJGJMUSBTJ BLBO EJSFBCTPSCTJ EJ UVCVMVT QSPLTJNBM 4FLJUBS
EBSJTFMEBONFOJNCVMLBOLFDFOEFSVOHBOUFSKBEJOZBIJQFSLBMF TBNQBJ QFSTFO TJTBOZB EJSFBCTPSCTJ EJ BOTB )FOMF UFSVUBNB
NJB QBEB TFHNFO UFCBM QBST BTFOEFOT UFNQBU LBMJVN NFOHBMBNJ LP
USBOTQPS BLUJG EFOHBO OBUSJVN EBO LMPSJEB #BJL EJ UVCVMVT
Gangguan Asam-Basa Dapat Menyebabkan QSPLTJNBM EBO BOTB )FOMF GSBLTJ CFCBO LBMJVN ZBOH EJGJMUSBTJ
Perubahan Distribusi Kalium. "TJEPTJTNFUBCPMJLNFOJOHLBULBO BLBO EJSFBCTPSCTJ EBMBN KVNMBI SFMBUJG LPOTUBO 1FSVCBIBO
LPOTFOUSBTJ LBMJVN FLTUSBTFM TFCBHJBO EFOHBO NFOZFCBCLBO SFBCTPSQTJ LBMJVN QBEB TFHNFOTFHNFO JOJ EBQBU NFNFOHBSVIJ
LFIJMBOHBO LBMJVN EBSJ TFM TFEBOHLBO BMLBMPTJT NFUBCPMJL FLTLSFTJLBMJVN UFUBQJTFCBHJBOCFTBSWBSJBTJFLTLSFTJLBMJVNEBSJ
NFOVSVOLBOLPOTFOUSBTJLBMJVNDBJSBOFLTUSBTFMVMBS8BMBVQVO IBSJ LF IBSJ UJEBL EJTFCBCLBO PMFI QFSVCBIBO SFBCTPSQTJ EJ
NFLBOJTNFZBOHCFSUBOHHVOHKBXBCBUBTQFOHBSVILPOTFOUSBTJ UVCVMVTQSPLTJNBMBUBVBOTB)FOMF
JPO IJESPHFO QBEB EJTUSJCVTJ JOUFSOBM LBMJVN UJEBL TFQFOVIOZB
EJQBIBNJ TBMBITBUVFGFLQFOJOHLBUBOLPOTFOUSBTJJPOIJESPHFO Sebagian Besar Variasi Harian Ekskresi Kalium
BEBMBI QFOVSVBO BLUJWJUBT QPNQB OBUSJVNLBMJVN BEFOPTJO Terutama Disebabkan oleh Perubahan Sekresi Kalium di
USJGPTGBUBTF "51BTF
)BM JOJ LFNVEJBO NFOVSVOLBO BNCJMBO Tubulus Distal dan Koligens. 5FNQBU ZBOH QBMJOH QFOUJOH
LBMJVNTFMEBONFOJOHLBULBOLPOTFOUSBTJLBMJVNFLTUSBTFM VOUVL QFOHBUVSBO FLTLSFTJ LBMJVN BEBMBI TFMTFM QSJOTJQBMJT EJ
UVCVMVT EJTUBM CBHJBO BLIJS EBO UVCVMVT LPMJHFOT LPSUJLBMJT 1BEB
TFHNFOTFHNFO UVCVMVT JOJ LBMJVN EBQBU EJSFBCTPSCTJ BUBV
Lisis Sel Menyebabkan Peningkatan Konsentrasi Kalium
EJTFLSFTJ CFSHBOUVOH QBEB LFCVUVIBO UVCVI %FOHBO BTVQBO
Ekstrasel. "QBCJMB TFM SVTBL TFCBHJBO CFTBS LBMJVN ZBOH
LBMJVNZBOHOPSNBMTFCFTBSN&RIBSJ HJOKBMIBSVTNFOHFMV
CFSBEBEBMBNTFM EJMFQBTLBOLFLPNQBSUFNFOFLTUSBTFM)BMJOJ
EBQBUNFOZFCBCLBOIJQFSLBMFNJB
362
Bab 29 Pengaturan Ginjal terhadap Kalium, Kalsium, Fosfat, dan Magnesium;
Sekresi Kalium oleh Sel Prinsipalis di Tubulus Distal

Bagian Akhir dan Tubulus Koligens Kortikalis
4FMTFMEJ UVCVMVTEJTUBMCBHJBOBLIJSEBO UVCVMVTLPMJHFOT
LPSUJLBMJT ZBOH NFOZFLSFTJ LBMJVN EJTFCVU TFM QSJOTJQBMJT
UNIT V
EBO NFNCFOUVL TFLJUBS QFSTFO TFM FQJUFM EJ EBFSBI JOJ
(BNCBS NFOVOKVLLBO NFLBOJTNF TFM EBTBS EBSJ
TFLSFTJLBMJVNPMFITFMTFMQSJOTJQBMJT
4FLSFTJ LBMJVN EBSJ EBSBI LF MVNFO UVCVMVT BEBMBI
QSPTFT EVB MBOHLBI EJNVMBJ EFOHBO BNCJMBO EBSJ
JOUFSTUJTJVNLFTFMPMFIQPNQBOBUSJVNLBMJVN"51BTFEJ
NFNCSBO CBTPMBUFSBM TFM QPNQB JOJ NFNJOEBILBO
OBUSJVNLFMVBSEBSJTFMEBONBTVLLFJOUFSTUJTJVNEBOQBEB
XBLUVZBOHCFSTBNBBO NFNJOEBILBOLBMJVNLFEBMBNTFM
-BOHLBILFEVBEBSJQSPTFTJOJBEBMBIEJGVTJQBTJGLBMJVN
EBSJ EBMBN TFM LF DBJSBO UVCVMVT 1PNQB OBUSJVNLBMJVN
"51BTF NFNCFOUVL LPOTFOUSBTJ LBMJVN JOUSBTFM ZBOH
UJOHHJ ZBOH NFOZFEJBLBO UFOBHB QFOEPSPOH VOUVL EJGVTJ
QBTJG LBMJVN EBSJ TFM LF EBMBN MVNFO UVCVMVT .FNCSBO
MVNJOBM TFM QSJOTJQBMJT TBOHBU QFSNFBCFM UFSIBEBQ LBMJVN
12% 4BMBI TBUV QFOZFCBC QFSNFBCJMJUBT ZBOH UJOHHJ JOJ BEBMBI
LBOBMLBOBM LIVTVT CFSTJGBU QFSNFBCFM UFSIBEBQ JPOJPO
Gambar 29-2 LBMJVN TFIJOHHB NFNVOHLJOLBO JPOJPO JOJ CFSEJGVTJ
TFDBSBDFQBUNFMFXBUJNFNCSBO
Pengaturan Sekresi Kalium oleh Sel Prinsipalis.

'BLUPSGBLUPSVUBNBZBOHNFOHBUVSTFLSFTJLBMJVNPMFITFM
QSJOTJQBMJTUVCVMVTEJTUBMCBHJBOBLIJSEBOUVCVMVTLPMJHFOT
LPSUJLBMJT BEBMBI
BLUJWJUBT QPNQB OBUSJVNLBMJVN
"51BTF
HSBEJFO FMFLUSPLJNJB VOUVL TFLSFTJ LBMJVN
EBSJ EBSBI LF MVNFO UVCVMVT EBO
QFSNFBCJMJUBT
BSLBOTFLJUBSN&RIBSJ N&RTJTBOZBEJFLTLSFTJLBOEBMBN NFNCSBO MVNJOBM UFSIBEBQ LBMJVN ,FUJHB GBLUPS QFOFOUV
GFTFT
4FLJUBS N&RIBSJ LBMJVN JOJ EJTFLSFTJLBO LF EBMBN TFLSFTJ LBMJVN JOJ EJBUVS PMFI GBLUPSGBLUPS ZBOH BLBO
UVCVMVT EJTUBM EBO UVCVMVT LPMJHFOT ZBOH NFSVQBLBO TFQFSUJHB EJCBIBTLFNVEJBO
LBMJVNZBOHEJFLTLSFTJ
%FOHBOBTVQBOLBMJVNZBOHUJOHHJ FLTLSFTJLBMJVNUBNCBIBO
TFCBHJBO CFTBS EJDBQBJ EFOHBO NFOJOHLBULBO TFLSFTJ LBMJVN LF
EBMBN UVCVMVT EJTUBM EBO UVCVMVT LPMJHFOT #BILBO EFOHBO EJFU
LBMJVN ZBOH TBOHBU UJOHHJ MBKV FLTLSFTJ LBMJVN EBQBU NFMFCJIJ
KVNMBI LBMJVN ZBOH EJGJMUSBTJ HMPNFSVMVT ZBOH NFOVOKVLLBO
NFLBOJTNFTFLSFTJLBMJVNZBOHLVBU
#JMB BTVQBO LBMJVN SFOEBI MBKV TFLSFTJ LBMJVN EJ UVCVMVT
EJTUBM EBO UVCVMVT LPMJHFOT NFOVSVO TFIJOHHB NFOZFCBCLBO
QFOHVSBOHBO TFLSFTJ LBMJVN QBEB VSJOF %FOHBO QFOHVSBOHBO Na
ENaC
BTVQBOLBMJVNZBOHTBOHBUCFTBS UFSKBEJSFBCTPSQTJBLIJSLBMJVN
EJTFHNFOEJTUBMOFGSPOEBOFLTLSFTJLBMJVNEBQBUUVSVOTBNQBJ
QFSTFO EBSJ LBMJVN GJMUSBU HMPNFSVMVT N&RIBSJ
%FOHBO
BTVQBO LBMJVN EJ CBXBI CBUBT JOJ EBQBU UJNCVM IJQPLBMFNJB
CFSBU
+BEJ TFCBHJBO CFTBS QFOHBUVSBO FLTLSFTJ LBMJVN IBSJ QFS IBSJ
UFSKBEJ EJ UVCVMVT EJTUBM CBHJBO BLIJS EBO UVCVMVT LPMJHFOT
LPSUJLBMJT EJ NBOB LBMJVN EBQBU EJSFBCTPSCTJ BUBV EJTFLSFTJ
CFSHBOUVOHQBEBLFCVUVIBOUVCVI1BEBCBHJBOCFSJLVUOZB LJUB
BLBO NFNCBIBT NFLBOJTNF EBTBS TFLSFTJ LBMJVN EBO GBLUPS
GBLUPSZBOHNFOHBUVSQSPTFTJOJ
29-3
363
Sel interkalatus Dapat Mereabsorbsi Kalium Selama 4

Kekurangan Kalium. 1BEB LFBEBBO ZBOH UFSLBJU EFOHBO
LFIJMBOHBO LBMJVN ZBOH CFSBU UFSEBQBU QFOHIFOUJBO TFLSFTJ
LBMJVN EBO SFBCTPSQTJ BLIJS LBMJVN ZBOH TFCFOBSOZB QBEB 3
UVCVMVT EJTUBM CBHJBO BLIJS EBO UVCVMVT LPMJHFOT 3FBCTPSQTJ
JOJUFSKBEJNFMBMVJTFMJOUFSLBMBUVTXBMBVQVOQSPTFTSFBCTPSQTJ
2
JOJ UJEBL TFQFOVIOZB EJQBIBNJ TBUV NFLBOJTNF ZBOH EJQFS
DBZB UVSVU CFSQFSBO BEBMBI NFLBOJTNF USBOTQPS IJESPHFO
LBMJVN "51BTF ZBOH UFSMFUBL EJ NFNCSBO MVNJOBM 5SBOT
1
QPSUFSJOJNFSFBCTPSCTJLBMJVNNFMBMVJQFSUVLBSBOEFOHBOJPO
IJESPHFO ZBOH EJTFLSFTJ LF EBMBN MVNFO UVCVMVT EBO LFNV
EJBO LBMJVN CFSEJGVTJ NFMFXBUJ NFNCSBO CBTPMBUFSBM EBSJ TFM 0
LF EBMBN EBSBI 5SBOTQPSUFS JOJ EJQFSMVLBO VOUVL NFNV 0 1 2 3 4 5
OHLJOLBOSFBCTPSQTJLBMJVNTFMBNBUFSKBEJLFLVSBOHBOLBMJVN
DBJSBO FLTUSBTFMVMBS UFUBQJ EBMBN LPOEJTJ OPSNBM USBOTQPSUFS 1 2 3 4 5
JOJIBOZBTFEJLJUCFSQFSBOEBMBNNFOHBUVSFLTLSFTJLBMJVN
29-4
Ringkasan Faktor-Faktor yang Mengatur Sekresi Kalium:
Konsentrasi Kalium Plasma, Aldosteron, Laju Aliran
Tubulus, dan Konsentrasi Ion Hidrogen
0MFI LBSFOB QFOHBUVSBO FLTLSFTJ LBMJVN ZBOH OPSNBM UFSKBEJ
UFSVUBNBTFCBHBJBLJCBUQFSVCBIBOEBMBNTFLSFTJLBMJVNPMFI
TFM QSJOTJQBMJT EJ UVCVMVT EJTUBM CBHJBO BLIJS EBO UVCVMVT
LPMJHFOT QBEB CBC JOJ LJUB NFNCBIBT GBLUPSGBLUPS VUBNB
ZBOH NFNFOHBSVIJ TFLSFTJ PMFI TFM JOJ 'BLUPSGBLUPS QBMJOH
SBOHTBOHTFLSFTJBMEPTUFSPOPMFILPSUFLTBESFOBM ZBOHLFNVEJBO
QFOUJOH ZBOH NFSBOHTBOH TFLSFTJ LBMJVN PMFI TFM QSJOTJQBMJT
MFCJI NFSBOHTBOH TFLSFTJ LBMJVN TFQFSUJ ZBOH BLBO EJCBIBT
NFMJQVUJ
QFOJOHLBUBO LPOTFOUSBTJ LBMJVN DBJSBO FLTUSB
LFNVEJBO
TFMVMBS
QFOJOHLBUBO BMEPTUFSPO EBO
QFOJOHLBUBO MBKV
BMJSBOUVCVMVT
4BUV GBLUPS ZBOH NFOVSVOLBO TFLSFTJ LBMJVN BEBMBI Aldosteron Merangsang Sekresi Kalium. "MEPTUFSPO
QFOJOHLBUBOLPOTFOUSBTJJPOIJESPHFO BTJEPTJT
NFSBOHTBOHSFBCTPSQTJBLUJGJPOOBUSJVNPMFITFMQSJOTJQBMJTQBEB
UVCVMVT EJTUBM CBHJBO BLIJS EBO UVCVMVT LPMJHFOT MJIBU #BC

1FOHBSVI JOJ EJQFSBOUBSBJ NFMBMVJ QPNQB OBUSJVNLBMJVN
Peningkatan Konsentrasi Kalium Cairan Ekstraselular "51BTF ZBOH NFOUSBOTQPS OBUSJVN LFMVBS NFMBMVJ NFNCSBO
Merangsang Sekresi Kalium. -BKV TFLSFTJ LBMJVN EBMBN CBTPMBUFSBM TFM EBO NBTVL LF EBMBN EBSBI QBEB TBBU ZBOH
UVCVMVT EJTUBM CBHJBO BLIJS EBO UVCVMVT LPMJHFOT LPSUJLBMJT CFSTBNBBO NFNPNQB LBMJVN LF EBMBN TFM +BEJ BMEPTUFSPO KVHB
EJSBOHTBOH MBOHTVOH PMFI QFOJOHLBUBO LPOTFOUSBTJ LBMJVN NFNQVOZBJFGFLZBOHLVBUVOUVLNFOHPOUSPMMBKVTFMQSJOTJQBMJT
DBJSBO FLTUSBTFMVMBS ZBOH NFOJNCVMLBO QFOJOHLBUBO FLTLSFTJ NFOZFLSFTJLBMJVN
LBMJVN TFQFSUJZBOHEJQFSMJIBULBOQBEB(BNCBS&GFLJOJ
1FOHBSVI LFEVB BMEPTUFSPO BEBMBI NFOJOHLBULBO
UFSVUBNB KFMBT LFUJLB LPOTFOUSBTJ LBMJVN DBJSBO FLTUSBTFMVMBS
QFSNFBCJMJUBT NFNCSBO MVNJOBM VOUVL LBMJVN ZBOH MFCJI
NFOJOHLBU EJ BUBT N&R- TFEJLJU EJ CBXBI LPOTFOUSBTJ
NFOBNCBI FGFLUJWJUBT BMEPTUFSPO EBMBN NFSBOHTBOH TFLSFTJ
OPSNBM 0MFI LBSFOB JUV QFOJOHLBUBO LPOTFOUSBTJ LBMJVN
LBMJVN0MFILBSFOBJUV BMEPTUFSPONFNJMJLJQFOHBSVIZBOHLVBU
QMBTNB CFSQFSBO TFCBHBJ TBMBI TBUV NFLBOJTNF ZBOH QBMJOH
VOUVL NFOJOHLBULBO FLTLSFTJ LBMJVN TFQFSUJ ZBOH EJQFSMJIBULBO
QFOUJOH VOUVL NFOJOHLBULBO TFLSFTJ LBMJVN EBO NFOHBUVS
LPOTFOUSBTJJPOLBMJVNDBJSBOFLTUSBTFMVMBS QBEB(BNCBS
1FOJOHLBUBO LPOTFOUSBTJ LBMJVN DBJSBO FLTUSBTFMVMBS Peningkatan Konsentrasi Ion Kalium Ekstrasel
NFOJOHLBULBO TFLSFTJ LBMJVN NFMBMVJ UJHB NFLBOJTNF
Merangsang Sekresi Aldosteron. %BMBN TJTUFN LPOUSPM
1FOJOHLBUBO LPOTFOUSBTJ LBMJVN DBJSBO FLTUSBTFMVMBS
VNQBO CBMJL OFHBUJG GBLUPS ZBOH EJLPOUSPM CJBTBOZB NFNJMJLJ
NFSBOHTBOH QPNQB OBUSJVNLBMJVN "51BTF TFIJOHHB
QFOHBSVIVNQBOCBMJLUFSIBEBQQFOHPOUSPM1BEBTJTUFNLPOUSPM
QFOJOHLBUBO BNCJMBO LBMJVN NFMFXBUJ NFNCSBO CBTPUBUFSBM
BMEPTUFSPOLBMJVN MBKV TFLSFTJ BMEPTUFSPO PMFI LFMFOKBS BESFOBM
)BM JOJ LFNVEJBO NFOJOHLBULBO LPOTFOUSBTJ JPO LBMJVN
EJBUVS TFDBSB LVBU PMFI LPOTFOUSBTJ JPO LBMJVN DBJSBO FLTUSB
JOUSBTFM ZBOH NFOZFCBCLBO LBMJVN CFSEJGVTJ NFMFXBUJ
TFMVMBS(BNCBSNFNQFSMJIBULBOQFOJOHLBUBOLPOTFOUSBTJ
NFNCSBO MVNJOBM NBTVL LF EBMBN UVCVMVT
1FOJOHLBUBO
LPOTFOUSBTJ LBMJVN FLTUSBTFM NFOJOHLBULBO HSBEJFO LBMJVN
EBSJ DBJSBO JOUFSTUJTJBM HJOKBM LF EBMBN TFM FQJUFM IBM JOJ
NFOHVSBOHJ LFCPDPSBO JPO LBMJVN EBSJ EBMBN TFM NFMBMVJ
NFNCSBOCBTPMBUFSBM
1FOJOHLBUBOLPOTFOUSBTJLBMJVNNF
364
70
(ng/100 ml plasma)
60
50
UNIT V
40
30
20
10
0
3.0 3.5 4.0 4.5 5.0 5.5 6.0 6.5
(mEq/L)
29-5
29-7
LBMJVN QMBTNB TFLJUBS N&R- EBQBU NFOJOHLBULBO

LPOTFOUSBTJ LPOTFOUSBTJ BMEPTUFSPO QMBTNB BMEPTUFSPO Penghambatan Sistem Umpan Batik Aldosteron
QMBTNB EBSJ IBNQJS TBNQBJ OH NM TVBUV Sangat Mengganggu Kontrol Konsentrasi Kalium. #JMB
LPOTFOUSBTJIBNQJSLBMJOPSNBM UJEBL BEB TFLSFTJ BMEPTUFSPO TFQFSUJ ZBOH UFSKBEJ QBEB PSBOH
&GFL LPOTFOUSBTJ JPO LBMJVN ZBOH NFSBOHTBOH TFLSFTJ EFOHBO QFOZBLJU "EEJTPO TFLSFTJ LBMJVN HJOKBM UFSHBOHHV
BMEPTUFSPO BEBMBI CBHJBO EBSJ TJTUFN VNQBO CBMJL ZBOH LVBU TFIJOHHB NFOZFCBCLBO LPOTFOUSBTJ LBMJVN DBJSBO FLTUSBTF
VOUVL NFOHBUVS FLTLSFTJ LBMJVN TFQFSUJ ZBOH EJQFSMJIBULBO MVMBS NFOJOHLBU TBNQBJ LBEBS UJOHHJ ZBOH NFNCBIBZBLBO
EBMBN(BNCBS%BMBNTJTUFNVNQBOCBMJLJOJ QFOJOHLBUBO 4FCBMJLOZB EFOHBO TFLSFTJ BMEPTUFSPO ZBOH CFSMFCJIBO BMEPT
LPOTFOUSBTJ LBMJVN QMBTNB NFSBOHTBOH TFLSFTJ BMEPTUFSPO UFSPOJTNF QSJNFS
TFLSFTJ LBMJVN NFOKBEJ TBOHBU NFOJOHLBU
TFIJOHHB NFOJOHLBULBO LBEBS BMEPTUFSPO EBMBN EBSBI ,PUBL NFOZFCBCLBO IJMBOHOZB LBMJVN PMFI HJOKBM EBO NFOJNCVMLBO

1FOJOHLBUBO BMEPTUFSPO EBSBI LFNVEJBO NFOZFCBCLBO IJQPLBMFNJB
QFOJOHLBUBOZBOHOZBUBQBEBFLTLSFTJLBMJVNPMFIHJOKBM ,PUBL 4FMBJO FGFL TUJNVMBTJ QBEB TFLSFTJ LBMJVN HJOKBM BMEPTUFSPO

1FOJOHLBUBO FLTLSFTJ LBMJVN LFNVEJBO NFOVSVOLBO KVHB NFOJOHLBULBO BNCJMBO LBMJVN PMFI TFM EBO NFOBNCBI
LPOTFOUSBTJ LBMJVN DBJSBO FLTUSBTFMVMBS LFNCBMJ LF OPSNBM QFOHBSVIQBEBTJTUFNVNQBOCBMJLBMEPTUFSPOLBMJVNZBOHLVBU
,PUBLEBO
+BEJ NFLBOJTNFVNQBOCBMJLJOJCFLFSKBTFDBSB JUV TFQFSUJZBOHUFMBIEJCBIBTTFCFMVNOZB
TJOFSHJT EFOHBO FGFL MBOHTVOH QFOJOHLBUBO LPOTFOUSBTJ LBMJVN ,FQFOUJOHBO LVBMJUBUJG LIVTVT TJTUFN VNQBO CBMJL
FLTUSBTFM VOUVL NFOJOHLBULBO FLTLSFTJ LBMJVN TBBU BTVQBO BMEPTUFSPO EBMBN NFOHBUVS LPOTFOUSBTJ LBMJVN EJUVOKVLLBO
LBMJVNNFOJOHLBU (BNCBS
EBMBN (BNCBS 1BEB QFSDPCBBO JOJ BTVQBO LBMJVN EJ
UJOHLBULBO IBNQJS UVKVI LBMJ MJQBU QBEB BOKJOH EBMBN EVB
LPOEJTJ
EBMBN LPOEJTJ OPSNBM EBO
TFUFMBI TJTUFN
VNQBO CBMJL BMEPTUFSPO EJIBNCBU EFOHBO NFOHBOHLBU
LFMFOKBSBESFOBMOZBEBONFNCFSJIFXBOIFXBOUFSTFCVUJOGVT
BMEPTUFSPO EFOHBO LFDFQBUBO ZBOH UFUBQ TFIJOHHB LPOTFOUSBTJ
1 BMEPTUFSPOQMBTNBUJEBLEBQBUNFOJOHLBUNBVQVONFOVSVO
1FSIBUJLBO QBEB IFXBO ZBOH OPSNBM QFOJOHLBUBO BTVQBO
LBMJVN TFCBOZBL UVKVI LBMJ MJQBU IBOZB NFOZFCBCLBO TFEJLJU
QFOJOHLBUBO LPOTFOUSBTJ LBMJVN EBO NFOKBEJ N&R-
+ +BEJ CJMB TJTUFN VNQBO CBMJL BMEPTUFSPO CFSGVOHTJ OPSNBM
4 LPOTFOUSBTJLBMJVNEJLPOUSPMEFOHBOUFQBU XBMBVQVOUFSEBQBU
QFSVCBIBOCFTBSQBEBBTVQBOLBMJVN
#JMBTJTUFNVNQBOCBMJLBMEPTUFSPOEJIBNCBU QFOJOHLBUBO
BTVQBO LBMJVN ZBOH TBNB BLBO NFOJOHLBULBO LPOTFOUSBTJ
LBMJVN ZBOH MFCJI CFTBS EBSJ NFOKBEJ IBNQJS N&R-
+BEJ QFOHBUVSBOLPOTFOUSBTJLBMJVNNFOKBEJTBOHBUUFSHBOHHV

CJMB TJTUFN VNQBO CBMJL BMEPTUFSPO EJIBNCBU (BOHHVBO
2
QFOHBUVSBO LBMJVN ZBOH TFSVQB BEB QBEB NBOVTJB EFOHBO
29-6 TJTUFN VNQBO CBMJL BMEPTUFSPO ZBOH LVSBOH CFSGVOHTJ TFQFSUJ
ZBOHUFSKBEJQBEBQBTJFOBMEPTUFSPOJTNFQSJNFS UFSMBMVCBOZBL
BMEPTUFSPO
BUBVQFOZBLJU"EEJTPO UFSMBMVTFEJLJUBMEPTUFSPO

365
4.8 70
60
4.6
50
)
4.4
(pmol/m
40
4.2
30
4.0 20
10
3.8
0 30 60 90 120 150 180 210 0 5 10 15 20 25 30
29-8 :
29-9
Peningkatan Laju Aliran Tubulus Distal Merangsang

Sekresi Kalium. 1FOJOHLBUBOMBKVBMJSBOUVCVMVTEJTUBM TFQFSUJ
ZBOH UFSKBEJ QBEB QFOJOHLBUBO WPMVNF BTVQBO OBUSJVN ZBOH
UJOHHJ BUBV QFOHPCBUBO EFOHBO CFCFSBQB EJVSFUJL BLBO
NFSBOHTBOH TFLSFTJ LBMJVN (BNCBS
4FCBMJLOZB
QFOVSVOBOMBKVBMJSBOUVCVMVTEJTUBM TFQFSUJZBOHEJUJNCVMLBO
PMFILFIJMBOHBOOBUSJVN BLBONFOHVSBOHJTFLSFTJLBMJVN
&GFLMBKVBMJSBOUVCVMVTQBEBTFLSFTJLBMJVNEJUVCVMVTEJTUBM
EBO LPMJHFOT TBOHBU EJQFOHBSVIJ PMFI BTVQBO LBMJVN #JMB
BTVQBOLBMJVNUJOHHJ QFOJOHLBUBOMBKVBMJSBOUVCVMVTNFNCFSJ
QFOHBSVI ZBOH MFCJI CFTBS VOUVL NFSBOHTBOH TFLSFTJ LBMJVN
EBSJQBEBCJMBBTVQBOLBMJVNSFOEBI *JIBU(BNCBS

.FLBOJTNF VOUVL QFOHBSVI MBKV BMJSBO WPMVNF ZBOH UJOHHJ
BEBMBI TFCBHBJ CFSJLVU #JMB LBMJVN EJTFLSFTJLBO LF EBMBN
DBJSBO UVCVMVT LPOTFOUSBTJ LBMJVN MVNJOBM NFOJOHLBU
TFIJOHHB NFOHVSBOHJ UFOBHB QFOEPSPOH VOUVL EJGVTJ LBMJVN
NFMFXBUJNFNCSBOMVNJOBMNFOJOHLBUOZBMBKVBMJSBOUVCVMVT
LBMJVN ZBOH EJTFLSFTJLBO LF EBMBN UVCVMVT MBOHTVOH UFSCJMBT
TFIJOHHB QFOJOHLBUBO LPOTFOUSBTJ LBMJVN UVCVMVT NFOKBEJ
NJOJNBM0MFILBSFOBJUV TFLSFTJLBMJVNBLIJSEJSBOHTBOHPMFI
QFOJOHLBUBOMBKVBMJSBOUVCVMVT
1FOHBSVI QFOJOHLBUBO MBKV BMJSBO UVCVMVT UFSVUBNB QFOUJOH
EBMBN NFNCBOUV NFNQFSUBIBOLBO FLTLSFTJ LBMJVN OPSNBM
TFMBNB UFSKBEJ QFSVCBIBO BTVQBO OBUSJVN 4FCBHBJ DPOUPI
QBEB BTVQBO OBUSJVN ZBOH UJOHHJ UFSKBEJ QFOVSVOBO TFLSFTJ
BMEPTUFSPO ZBOH UFOUVOZB BLBO DFOEFSVOH NFOVSVOLBO MBKV
TFLSFTJ LBMJVN TFIJOHHB NFOHVSBOHJ FLTLSFTJ LBMJVN EBMBN MBKV BMJSBOUVCVMVT ZBOH UJOHHJ TBMJOH NFOHJNCBOHJ TFIJ
VSJOF 8BMBVQVO EFNJLJBO MBKV BMJSBO UVCVMVT EJTUBM ZBOH OHHB IBOZB UFSKBEJ QFSVCBIBO LFDJM FLTLSFTJ LBMJVN %FNJLJBO
UJOHHJ ZBOH UFSKBEJ QBEB BTVQBO OBUSJVN UJOHHJ DFOEFSVOH KVHB EFOHBO BTVQBO OBUSJVN ZBOH SFOEBI UFSKBEJ TFEJLJU QFSV
NFOJOHLBULBO TFLSFTJ LBMJVN (BNCBS
TFQFSUJ ZBOH CBIBO FLTLSFTJ LBMJVN LBSFOB QFOHBSVI JNCBOHBO EBSJ QFOJOH
EJCBIBT QBEB QBSBHSBG TFCFMVNOZB 0MFI LBSFOB JUV EVB FGFL LBUBOTFLSFTJBMEPTUFSPOEBOQFOVSVOBOMBKVBMJSBOUVCVMVTQBEB
BTVQBOOBUSJVNZBOHUJOHHJ QFOVSVOBOTFLSFTJBMEPTUFSPOEBO TFLSFTJLBMJVN
366
"TJEPTJT"LVU.FOVSVOLBO4FLSFTJ,BMJVN
Pengaturan Ekskresi Kalsium oleh Ginjal dan
1FOJOHLBUBO BLVU LPOTFOUSBTJ JPO IJESPHFO DBJSBO FLTUSBTFMVMBS Konsentrasi Ion Kalsium Ekstraset
BTJEPTJT
NFOHVSBOHJ TFLSFTJ LBMJVN TFEBOHLBO QFOVSVOBO
LPOTFOUSBTJ JPO IJESPHFO BMLBMPTJT
NFOJOHLBULBO TFLSFTJ
.FLBOJTNF VOUVL NFOHBUVS LPOTFOUSBTJ JPO LBMTJVN
LBMJVN.FLBOJTNFVUBNBQFOJOHLBUBOLPOTFOUSBTJJPOIJESPHFO
EJCBIBT MFCJI EFUBJM QBEB #BC CFSTBNB EFOHBO FOEP
UNIT V
NFOHIBNCBUTFLSFTJLBMJVNBEBMBIEFOHBONFOHVSBOHJBLUJWJUBT
LSJOPMPHJ IPSNPO QFOHBUVS LBMTJVN IPSNPO QBSBUJSPJE
QPNQBOBUSJVNLBMJVN"51BTF)BMJOJLFNVEJBONFOVSVOLBO
15)
EBO LBMTJUPOJO 0MFI LBSFOB JUV QFOHBUVSBO JPO
LPOTFOUSBTJ LBMJVN JOUSBTFM EBO TFMBOKVUOZB EJJLVUJ PMFI EJGVTJ
LBMTJVNIBOZBEJCBIBTTFDBSBTJOHLBUEBMBNCBCJOJ
QBTJGLBMJVNNFMFXBUJNFNCSBOMVNJOBMLFEBMBNUVCVMVT
,POTFOUSBTJJPO LBMTJVN DBJSBO FLTUSBTFMVMBS OPSNBMOZB
%FOHBO BTJEPTJT ZBOH CFSLFQBOKBOHBO CFSMBOHTVOH TFMBNB EJBUVS EFOHBO LFUBU EBMBN CFCFSBQB QFSTFOUBTF EBSJ OJMBJ
CFCFSBQB IBSJ UFSKBEJ QFOJOHLBUBO FLTLSFTJ LBMJVN VSJOF OPSNBMOZB N&R- #JMB LPOTFOUSBTJ JPO LBMTJVN UVSVO
.FLBOJTNFVOUVLFGFLJOJTFCBHJBOEJTFCBCLBOPMFIFGFLBTJEPTJT IJOHHB LBEBS ZBOH SFOEBI IJQPLBMTFNJB
LFQFLBBO TFMTFM
LSPOJT ZBOH NFOHIBNCBU SFBCTPSQTJ OBUSJVN LMPSJEB EBO BJS EJ TBSBG EBO PUPU TBOHBU NFOJOHLBU EBO QBEB CFCFSBQB LFB
UVCVMVT QSPLTJNBM ZBOH NFOJOHLBULBO QFOZBNQBJBO WPMVNF EJ EBBOFLTUSFN EBQBUNFOHBLJCBULBOUFUBQJIJQPLBMTFNJL
OFGSPO EJTUBM TFIJOHHB NFSBOHTBOH TFLSFTJ LBMJVN &GFL JOJ
NFOJBEBLBO FGFL QFOHIBNCBUBO EBSJ JPO IJESPHFO QBEB QPNQB ,FBEBBOJOJEJUBOEBJPMFILPOUSBLTJTQBTUJTPUPUSBOHLB)JQFS
OBUSJVNLBMJVN "51BTF +BEJ BTJEPTJT LSPOJT NFOZFCBCLBO LBMTFNJB QFOJOHLBUBOLPOTFOUSBTJLBMTJVN
NFOFLBOLFQFLB
IJMBOHOZB LBMJVN TFEBOHLBO BTJEPTJT BLVU NFOZFCBCLBO BOOFVSPNVTLVMBSEBOEBQBUNFOHBLJCBULBOBSJUNJBKBOUVOH
QFOVSVOBOFLTLSFTJLBMJVN 4FLJUBS QFSTFO LBMTJVN UPUBM EBMBN QMBTNB N&R-

CFSBEB EBMBN CFOUVL UFSJPOJTBTJ ZBJUV CFOUVL ZBOH NFNJMJLJ
BLUJWJUBT CJPMPHJT QBEB NFNCSBO TFM 4JTBOZB UFSJLBU QBEB
Pengaruh Manfaat Diet Berkadar Tinggi Kalium QSPUFJOQMBTNB TFLJUBSQFSTFO
BUBVEBMBNJLBUBOLPNQMFLT
dan Rendah Natrium. %BMBN TFCBHJBO CFTBS TFKBSBI NBOVTJB EBMBN CFOUVL OPOJPOJTBTJ EFOHBO BOJPOBOJPO TFQFSUJ GPTGBU
EJFU ZBOH MB[JN BEBMBI SFOEBI LBOEVOHBO OBUSJVN EBO UJOHHJ EBOTJUSBU TFLJUBSQFSTFO

LBMJVN EJCBOEJOHLBO EFOHBO EJFU NPEFSO ZBOH MB[JN %BMBN
1FSVCBIBO LPOTFOUSBTJ JPO IJESPHFO QMBTNB EBQBU
QPQVMBTJ UFSJTPMBTJ ZBOH CFMVN NFOHBMBNJ JOEVTUSJBMJTBTJ TFQFSUJ
NFNFOHBSVIJ EFSBKBU JLBUBO LBMTJVN EFOHBO QSPUFJO QMBTNB
TVLV :BOPNBNP ZBOH IJEVQ EJ "NB[PO #SB[JM 6UBSB BTVQBO
1BEB BTJEPTJT MFCJI TFEJLJU LBMTJVN CFSJLBUBO EFOHBO QSPUFJO
OBUSJVN EBQBU TFSFOEBI TBNQBJ NNPMIBSJ TFNFOUBSB
QMBTNB 4FCBMJLOZB QBEB BMLBMPTJT TFCBHJBO CFTBS LBMTJVN
BTVQBO LBMJVN EBQBU TFUJOHHJ NNPMIBSJ )BM JOJ LBSFOB
UFSJLBU QBEB QSPUFJO QMBTNB 0MFI LBSFOB JUV QBTJFO EFOHBO
LPOTVNTJ EJFU NFSFLB ZBOH TFCBHJBO CFTBS CVBICVBIBO EBO
BMLBMPTJTMFCJISFOUBOUFSIBEBQUFUBOJIJQPLBMTFNJL
TBZVSBO EBO UJEBL BEB NBLBOBO PMBIBO 1PQVMBTJ ZBOH
NFOHPOTVNTJ KFOJT NBLBOBO JOJ UJEBL NFOHBMBNJ QFOJOHLBUBO 4FQFSUJ [BU[BU MBJO EBMBN UVCVI BTVQBO LBMTJVN IBSVT
UFLBOBO EBSBI EBO QFOZBLJU KBOUVOH ZBOH CFSIVCVOHBO EFOHBO EJJNCBOHJ EFOHBO LFIJMBOHBO OFUP LBMTJVN EBMBN XBLUV ZBOH
VTJB MBNB "LBO UFUBQJ UJEBL TFQFSUJ JPOJPO OBUSJVN EBO LMPSJEB
TFCBHJBOCFTBSFLTLSFTJLBMTJVNUFSKBEJNFMBMVJGFTFT/JMBJBTVQBO
%FOHBO JOEVTUSJBMJTBTJ EBO QFOJOHLBUBO LPOTVNTJ NBLBOBO
LBMTJVNEBMBNNBLBOBOOPSNBMOZBTFLJUBSNHIBSJ EFOHBO
PMBIBO ZBOHTFSJOHLBMJNFNJMJLJLBOEVOHBOOBUSJVNUJOHHJEBO
TFLJUBS NHIBSJ LBMTJVN EJFLTLSFTJLBO EJ EBMBN GFTFT %BMBN
LBMJVNZBOHSFOEBI UFMBIUFSKBEJQFOJOHLBUBOCFTBSQFOJOHLBUBO
LPOEJTJUFSUFOUV FLTLSFTJLBMTJVNEJGFTFTEBQBUNFMFCJIJLBMTJVN
BTVQBOOBUSJVNEBOQFOVSVOBOBTVQBOLBMJVN%JTFCBHJBOCFTBS
ZBOHEJNBLBOLBSFOBLBMTJVNKVHBEBQBUEJTFLSFTJLFEBMBNMVNFO
OFHBSB JOEVTUSJ SBUBSBUB LPOTVNTJ LBMJVN IBOZB NNPM
VTVT 0MFI LBSFOB JUV USBLUVT HBTUSPJOUFTUJOBM EBO NFLBOJTNF
IBSJ TFNFOUBSBSBUBSBUBBTVQBOOBUSJVNNNPMIBSJ
SFHVMBTJZBOHNFNFOHBSVIJBCTPSQTJEBOTFLSFTJLBMTJVNJOUFTUJOBM
1FOFMJUJBO FLTQFSJNFOUBM EBO LMJOJT UFMBI NFOVOKVLLBO CFSQFSBO QFOUJOH EBMBN IPNFPTUBTJT LBMTJVN TFQFSUJ ZBOH BLBO
HBCVOHBO BTVQBO OBUSJVN UJOHHJ EBO LBMJVN ZBOH SFOEBI EJCBIBTEBMBN#BC
NFOJOHLBULBO SJTJLP IJQFSUFOTJ EBO KBOUVOH EBO QFOZBLJU HJOKBM
)BNQJSTFNVBLBMTJVNEBMBNUVCVI QFSTFO
EJTJNQBO
UFSLBJU /BNVO EJFU LBZB QPUBTJVN UBNQBLOZB NFMJOEVOHJ
EBMBNUVMBOH EBOIBOZB QFSTFOEBMBNDBJSBOFLTUSBTFMVMBS
UFSIBEBQ FGFL CVSVL EBSJ EJFU UJOHHJ OBUSJVN NFOVSVOLBO
EBO QFSTFO EBMBN DBJSBO JOUSBTFMVMBS EBO PSHBOFM TFM 0MFI
UFLBOBO EBSBI EBO SJTJLP TUSPLF QFOZBLJU BSUFSJ LPSPOFS EBO
LBSFOB JUV UVMBOH CFSQFSBO TFCBHBJ SFTFSWPJS QFOBNQVOH
QFOZBLJU HJOKBM &GFL NBOGBBU BTVQBO LBMJVN ZBOH NFOJOHLBU
ZBOH CFTBS VOUVL NFOZJNQBO LBMTJVN EBO TFCBHBJ TVNCFS
UFSVUBNB UFSMJIBU LFUJLB EJLPNCJOBTJLBO EFOHBO EJFU SFOEBI
LBMTJVN CJMB LPOTFOUSBTJ LBMTJVN DBJSBO FLTUSBTFMVMBS
OBUSJVN
DFOEFSVOHNFOVSVO
1FEPNBOEJFUZBOHEJUFSCJULBOPMFI64/BUJPOBM"DBEFNZPG
4DJFODFT "NFSJDBO )FBSU "TTPDJBUJPO EBO PSHBOJTBTJ MBJOOZB 4BMBITBUVQFOHBUVSBNCJMBOEBOQFMFQBTBOLBMTJVNUVMBOH
NFOHBOKVSLBO VOUVL NFOHVSBOHJ BTVQBO OBUSJVN LMPSJEB ZBOH QBMJOH QFOUJOH BEBMBI 15) #JMB LPOTFOUSBTJ LBMTJVN
NBLBOBONFOKBEJTFLJUBSNNPMIBSJ TFTVBJEFOHBO HIBSJ DBJSBO FLTUSBTFMVMBS UVSVO EJ CBXBI OPSNBM LFMFOKBS
OBUSJVN BUBV H IBSJ OBUSJVN LMPSJEB
TFLBMJHVT QBSBUJSPJE MBOHTVOH EJSBOHTBOH PMFI LBEBS LBMTJVN ZBOH
NFOJOHLBULBO BTVQBO LBMJVN NNPMIBSJ HIBSJ
VOUVL SFOEBI VOUVL NFOJOHLBULBO TFLSFTJ 15) )PSNPO JOJ
PSBOHEFXBTBZBOHTFIBU LFNVEJBOCFLFSKBMBOHTVOHQBEBUVMBOHVOUVLNFOJOHLBULBO
SFTPSQTJ HBSBNHBSBN UVMBOH QFMFQBTBO HBSBN EBSJ UVMBOH

EBONFMFQBTLBOTFKVNMBICFTBSLBMTJVNLFEBMBNDBJSBOFLTU
367
SBTFMVMBS TFIJOHHB NFOHFNCBMJLBO LBEBS LBMTJVN LFNCBMJ KBM XBMBVQVO TFCBHJBO CFTBS QFOJOHLBUBO BTVQBO LBMTJVN
OPSNBM #JMB LPOTFOUSBTJ JPO LBMTJVN NFOJOHLBU TFLSFTJ 15) EJCVBOHEBMBNGFTFT%FOHBOIJMBOHOZBLBMTJVN FLTLSFTJLBMTJVN
NFOVSVO TFIJOHHB IBNQJS UJEBL UFSKBEJ SFTPSQTJ UVMBOH PMFI HJOKBM NFOVSVO TFCBHBJ BLJCBU EBSJ QFOJOHLBUBO SFBCTPSQTJ
LBMTJVN ZBOH CFSMFCJIBO KVTUSV EJEFQPTJU EBMBN UVMBOH +BEJ UVCVMVT
QFOHBUVSBO LPOTFOUSBTJ JPO LBMTJVN EBSJ IBSJ LF IBSJ TFCBHJBO
CFTBSEJQFSBOUBSBJPMFIQFOHBSVI15)QBEBSFTPSQTJUVMBOH Reabsorpsi Kalsium di Tubulus Proksimal. 4FCBHJBOCFTBS
/BNVO UVMBOH UJEBL NFNQVOZBJ QFSTFEJBBO LBMTJVN ZBOH SFBCTPSQTJ LBMTJVN EJ UVCVMVT QSPLTJNBM UFSKBEJ NFMBMVJ KBMVS
UBLIBCJTIBCJT0MFILBSFOBJUV EBMBNKBOHLBQBOKBOH BTVQBO QBSBTFM EJMBSVULBO EBMBN BJS EBO EJCBXB EFOHBO DBJSBO ZBOH
LBMTJVNIBSVTEJJNCBOHJEFOHBOFLTLSFTJLBMTJVNPMFIUSBLUVT EJSFBCTPSQTJ TBBU NFOHBMJS EJ BOUBSB TFMTFM )BOZB TFLJUBS
HBTUSPJOUFTUJOBM EBO HJOKBM 1FOHBUVS SFBCTPSQTJ LBMTJVN ZBOH QFSTFO EBSJ SFBCTPSQTJ LBMTJVN QSPLTJNBM UVCVMBS NFMBMVJ KBMVS
QBMJOH QFOUJOH EJ LFEVB UFNQBU JOJ BEBMBI 15) +BEJ 15) USBOTFM EBMBN EVB MBOHLBI
LBMTJVN CFSEJGVTJ EBSJ MVNFO
NFOHBUVS LPOTFOUSBTJ LBMTJVN QMBTNB NFMBMVJ UJHB FGFL VUBNB UVCVMVT LF EBMBN TFM NFOHJLVUJ HSBEJFO FMFLUSPLJNJB LBSFOB

EFOHBONFSBOHTBOHSFTPSQTJUVMBOH
EFOHBONFSBOHTBOH LPOTFOUSBTJZBOHLBMTJVNKBVIMFCJIUJOHHJEBMBNMVNFOUVCVMBS
BLUJWBTJ WJUBNJO % ZBOH LFSOVEJBO NFOJOHLBULBO SFBCTPSQTJ EJCBOEJOHLBO EFOHBO TJUPQMBTNB TFM FQJUFM EBO LBSFOB JOUSBTFM
LBMTJVN JOUFTUJOBM EBO
EFOHBO NFOJOHLBULBO TFDBSB SFMBUJGOFHBUJGUFSIBEBQMVNFOUVCVMBS
LBMTJVNLFMVBSEBSJTFM
MBOHTVOHSFBCTPSQTJLBMTJVNPMFIUVCVMVTHJOKBM (BNCBS
NFMJOUBTJ NFNCSBO CBTPMBUFSBM NFMBMVJ QPNQB LBMTJVN"51BTF
1FOHBUVSBOSFBCTPSQTJLBMTJVNHBTUSPJOUFTUJOBMEBOQFSUVLBSBO EBO EFOHBO OBUSJVNLBMTJVN LPOUFSUSBOTQPSUFS (BNCBS
LBMTJVN EBMBN UVMBOH EJCBIBT EJ UFNQBU MBJO EBO TJTB EBSJ

CBHJBO JOJ BLBO EJGPLVTLBO QBEB NFLBOJTNF ZBOH NFOHBUVS
FLTLSFTJLBMTJVNPMFIHJOKBM Reabsorpsi Kalsium di Ansa Henle dan Tubulus Distal.
%JBOTB)FOMF LBMTJVNSFBCTPSQTJUFSCBUBT QBEBCBHJBOUFCBMQBST
Kontrol Ekskresi Kalsium oleh Ginjal BTFOEFOT 4FLJUBS QFSTFO EBSJ SFBCTPSQTJ LBMTJVN EJ CBHJBO
,BMTJVN EJGJMUSBTJ EBO EJSFBCTPSCTJ PMFI HJOKBM UFUBQJ UJEBL UFCBM QBST BTFOEFOT UFSKBEJ NFMBMVJ KBMVS QBSBTFM PMFI EJGVTJ QBTJG
EJTFLSFTJLBO 0MFI LBSFOB JUV MBKV FLTLSFTJ LBMTJVN HJOKBM LBSFOB NVBUBO QPTJUJG LFDJM MVNFO UVCVMBS SFMBUJG EJCBOEJOHLBO
EJIJUVOHTFCBHBJCFSJLVU DBJSBO JOUFSTUJTJBM 4JTBOZB QFSTFO EBSJ SFBCTPSQTJ LBMTJVN EJ
CBHJBO UFCBM QBST BTFOEFOT UFSKBEJ NFMBMVJ KBMVS USBOTFM TFCVBI
Ekskresi kalsium ginjal =Kalsium yang difiltrasi-Kalsium yang
QSPTFTZBOHEJSBOHTBOHPMFI15)
direabsorbsi
%J UVCVMVT EJTUBM IBNQJS TFMVSVI SFBCTPSQTJ LBMTJVN UFSKBEJ
)BOZBTFLJUBSQFSTFOLBMTJVNQMBTNBZBOHUFSJPOJTBTJ EBO PMFI USBOTQPS BLUJG NFMBMVJ NFNCSBO TFM .FLBOJTNF USBOTQPS
TJTBOZBUFSJLBUQBEBQSPUFJOQMBTNBBUBVEBMBNJLBUBOLPNQMFLT BLUJGJOJNJSJQEFOHBOZBOHEJUVCVMVTQSPLTJNBMEBOCBHJBOUFCBM
EFOHBO BOJPO TFQFSUJ GPTGBU 0MFI LBSFOB JUV IBOZB TFLJUBS QBSTBTFOEFOTEBONFMJCBULBOEJGVTJNFMJOUBTJNFNCSBOMVNJOBM
QFSTFOLBMTJVNQMBTNBEBQBUEJGJMUSBTJEJHMPNFSVMVT/PSNBMOZB NFMBMVJLBOBMLBMTJVNEBOLFMVBSNFMJOUBTJNFNCSBOCBTPMBUFSBM
TFLJUBS QFSTFO LBMTJVN ZBOH EJGJMUSBTJ BLBO EJSFBCTPSCTJ PMFI PMFI QPNQB LBMTJVN"51BTF TFSUB LPOUFS USBOTQPS OBUSJVN
UVCVMVT EBO IBOZB TFLJUBS QFSTFO LBMTJVN ZBOH EJGJMUSBTJ BLBO LBMTJVN NFLBOJTNF %J TFHNFO JOJ TFSUB EJ BOTB )FOMF 15)
EJFLTLSFTJLBO 4FLJUBS QFSTFO LBMTJVN ZBOH EJGJMUSBTJ BLBO NFSBOHTBOH SFBCTPSQTJ LBMTJVN 7JUBNJO % LBMTJUSPM
EBO LBMTJ
EJSFBCTPSCTJ EBMBN UVCVMVT QSPLTJNBM TBNQBJ QFSTFO UPOJOKVHBNFSBOHTBOHSFBCTPSQTJLBMTJVNEJCBHJBOUFCBMQBSTBT
EJSFBCTPSQTJEJBOTB)FOMF EBOTBNQBJQFSTFOEJSFBCTPSCTJEJ
UVCVMVT EJTUBM EBO UVCVMVT LPMJHFOT 1PMB SFBCTPSQTJ JOJ NJSJQ
EFOHBOQPMBSFBCTPSQTJQBEBOBUSJVN
4FQFSUJ IBMOZB EFOHBO JPOJPO MBJO FLTLSFTJ LBMTJVN EJ
TFTVBJLBOEFOHBOLFCVUVIBOUVCVI%FOHBOQFOJOHLBUBOBTV
QBOLBMTJVN UFSEBQBUKVHBQFOJOHLBUBOFLTLSFTJLBMTJVNHJO
[Ca] Ca++
PTH
Figure 29-11
29-12
368
FOEFOT BOTB )FOMF EBO EJ UVCVMVT EJTUBM XBMBVQVO IPSNPO GJMUSBU HMPNFSVMVT IBNQJS TFNVB GPTGBU ZBOH EJGJMUSBTJ BLBO
IPSNPO JOJ TFDBSB LVBOUJUBUJG UJEBL TFQFOUJOH 15) EBMBN EJSFBCTPSCTJ #JMB MFCJI CBOZBL LFMFCJIBOOZB BLBO
NFOHVSBOHJFLTLSFTJLBMTJVNHJOKBM EJFLTLSFTJLBO 0MFI LBSFOB JUV TFDBSB OPSNBM GPTGBU NVMBJ
CPDPS LF EBMBN VSJOF TBBU LPOTFOUSBTJOZB EBMBN DBJSBO
FLTUSBTFMVMBSNFOJOHLBUEJBUBTLBEBSBNCBOHTFLJUBS N.
UNIT V
Faktor-Faktor yang Mengatur Reabsorpsi Kalsium di - ZBOHNFNCFSJLBOCFCBOGPTGBUQBEBUVCVMVTTFLJUBS N.
- CJMB EJBOHHBQ -'( TFCFTBS NMNFOJU 0MFI LBSFOB
Tubulus. 4BMBITBUVQFOHBUVSVUBNBSFBCTPSQTJLBMTJVNUVCVMVT LFCBOZBLBOPSBOHNBLBOKVNMBICFTBSGPTGBUEBSJQSPEVLTVTV
HJOKBM BEBMBI 15) 1FOJOHLBUBO LBEBS 15) NFSBOHTBOH EBOEBHJOH LPOTFOUSBTJGPTGBUCJBTBOZBEJQFSUBIBOLBOEJBUBT
SFBCTPSQTJLBMTJVNEJTFHNFOUFCBMQBSTBTFOEFOTBOTB)FOMFEBO N.- TVBUV LBEBS ZBOH NFOZFCBCLBO UFSKBEJ FLTLSFTJ GPTGBU
UVCVMVT EJTUBM ZBOH NFOHVSBOHJ FLTLSFTJ LBMTJVN EBMBN VSJOF ZBOHUFSVTNFOFSVTLFEBMBNVSJOF
4FCBMJLOZB QFOVSVOBO 15) NFOJOHLBULBO FLTLSFTJ LBMTJVN
EFOHBONFOVSVOLBOSFBCTPSQTJEJBOTB)FOMFEBOUVCVMVTEJTUBM 5VCVMVT QSPLTJNBM CJBTBOZB NFSFBCTPSQTJ TBNQBJ
QFSTFO EBSJ GPTGBU ZBOH EJGJMUSBTJ 5VCVMVT EJTUBM NFSBCTPSQTJ
%JUVCVMVTQSPLTJNBM SFBCTPSQTJLBMTJVNCJBTBOZBNFOHJLVUJ
TFLJUBSQFSTFOEBSJCFCBOGJMUSBTJ EBOIBOZBTFCBHJBOZBOH
SFBCTPSQTJ OBUSJVN EBO BJS EBO UJEBL CFSHBOUVOH LFQBEB 15)
TBOHBU LFDJM EJSFBCTPSQTJ EBMBN BOTB )FOMF UVCVMVT LPMJHFOT
0MFILBSFOBJUV QBEBQFOJOHLBUBOWPMVNFFLTUSBTFMBUBVQFOJOH
EBO EVLUVT LPMJHFOT 4FLJUBS QFSTFO EBSJ GPTGBU ZBOH
LBUBO UFLBOBO BSUFSJ ZBOH LFEVBOZB NFOVSVOLBO SFBCTPSQTJ
EJGJMUSBTJEJFLTLSFTJLBOEBMBNVSJOF
OBUSJVN EBO BJS EJ QSPLTJNBMBLBO UFSKBEJ KVHB QFOVSVOBO
SFBCTPSQTJ LBMTJVN EBO BLJCBUOZB FLTLSFTJ LBMTJVN EBMBN VSJOF %J UVCVMVT QSPLTJNBM SFBCTPSQTJ GPTGBU UFSKBEJ UFSVUBNB
NFOJOHLBU 4FCBMJLOZB EFOHBO QFOHVSBOHBO WPMVNF FLTUSBTFM NFMBMVJ KBMVS USBOTFM 'PTGBU NFNBTVLJ TFM EBSJ MVNFO NFMBMVJ
BUBV QFOVSVOBO UFLBOBO EBSBI FLTLSFTJ LBMTJVN NFOVSVO UFSV LPUSBOTQPS OBUSJVNGPTGBU EBO LFMVBS TFM NFMJOUBTJ NFNCSBO
UBNBLBSFOBQFOJOHLBUBOSFBCTPSQTJEJUVCVMVTQSPLTJNBM CBTPMBUFSBM EFOHBO QSPTFT ZBOH UJEBL EJQBIBNJ EFOHBO CBJL
UFUBQJ NVOHLJO NFMJCBULBO NFLBOJTNF LPOUFS USBOTQPS ZBOH
'BLUPS MBJO ZBOH NFNFOHBSVIJ SFBCTPSQTJ LBMTJVN BEBMBI
NFOVLBSGPTGBUEFOHBOBOJPO
LPOTFOUSBTJ GPTGBU QMBTNB 1FOJOHLBUBO GPTGBU QMBTNB
NFSBOHTBOH 15) ZBOH NFOJOHLBULBO SFBCTPSQTJ LBMTJVN PMFI 1FSVCBIBOLFNBNQVBOSFBCTPSQTJGPTGBUUVCVMVTEBQBUKVHB
UVCVMVT HJOKBM EFOHBO EFNJLJBO NFOHVSBOHJ FLTLSFTJ LBMTJVN UFSKBEJ QBEB LFBEBBO CFSCFEB EBO NFNFOHBSVIJ FLTLSFTJ
)BM ZBOH CFSMBXBOBO UFSKBEJ CJMB LPOTFOUSBTJ GPTGBU QMBTNB GPTGBU 4FCBHBJ DPOUPI EJFU SFOEBI GPTGBU ZBOH MBNB EBQBU
NFOVSVO NFOJOHLBULBO USBOTQPS NBLTJNVN SFBCTPSQTJ VOUVL GPTGBU
3FBCTPSQTJ LBMTJVN KVHB EJSBOHTBOH PMFI BTJEPTJT NFUBCPMJL TFIJOHHB NFOHVSBOHJ LFDFOEFSVOHBO LFCPDPSBO GPTGBU LF
EBO EJIBNCBU PMFI BMLBMPTJT NFUBCPMJL 4FCBHJBO CFTBS FGFL EBMBNVSJOF
LPOTFOUSBTJ JPO IJESPHFO QBEB FLTLSFTJ LBMTJVN CFSBTBM EBSJ 15) EBQBU CFSQFSBO QFOUJOH EBMBN NFOHBUVS LPOTFOUSBTJ
QFSVCBIBOSFBCTPSQTJLBMTJVNEJUVCVMVTEJTUBM GPTGBUNFMBMVJEVBFGFL
15)NFOJOHLBULBOSFTPSQTJUVMBOH
3BOHLVNBO GBLUPSGBLUPS ZBOH EJLFUBIVJ NFNFOHBSVIJ TFIJOHHB NFMJNQBILBO TFKVNMBI CFTBS JPO GPTGBU LF EBMBN
FLTLSFTJLBMTJVNPMFIUVCVMVTHJOKBMEJUVOKVLLBOQBEBMBCFM DBJSBOFLTUSBTFMVMBSZBOHCFSBTBMEBSJHBSBNHBSBNUVMBOH EBO

15) NFOVSVOLBO USBOTQPS NBLTJNVN VOUVL GPTGBU PMFI
UVCVMVTHJOKBM TFIJOHHBTFCBHJBOCFTBSGPTGBUUVCVMVTUFSCVBOH
EBMBNVSJOF+BEJ CJMBNBOB15)QMBTNBNFOJOHLBU SFBCTPSQTJ
Pengaturan Ekskresi Fosfat Ginjal GPTGBUUVCVMVTCFSLVSBOHEBOMFCJICBOZBLGPTGBUEJFLTLSFTJLBO
4BMJOH CFSIVCVOHBO JOJ BOUBSB GPTGBU 15) EBO LBMTJVN
&LTLSFTJ GPTGBU PMFI HJOKBM UFSVUBNB EJBUVS PMFI NFLBOJTNF
EJCBIBTMFCJIUFSQFSJODJQBEB#BC
LFMFCJIBO ZBOH EBQBU EJKFMBTLBO TFCBHBJ CFSJLVU 5VCVMVT HJOKBM
NFNJMJLJUSBOTQPSNBLTJNVNOPSNBMVOUVLNFSFBCTPSCTJGPTGBU
TFLJUBS N.NFOJU#JMBKVNMBIGPTGBULVSBOHEBSJOJMBJJOJEJ
Pengaturan Ekskresi Magnesium Ginjal dan
Konsentrasi Ion Magnesium Ekstrasel
-FCJIEBSJTFQBSVINBHOFTJVNUVCVIEJTJNQBOEBMBNUVMBOH
4FCBHJBO CFTBS EBSJ TJTBOZB UFSTJNQBO EBMBN TFM EFOHBO
TabFM 29-2 'BLUPSGBLUPSZBOH.FOHVCBI&LTLSFTJ,BMTJVNPMFI(JOKBM LVSBOH EBSJ QFSTFOOZB UFSEBQBU EBMBN DBJSBO FLTUSBTFMVMBS
8BMBVQVO LPOTFOUSBTJ NBHOFTJVN QMBTNB UPUBM TFLJUBS
nEkskresi Kalsium l Ekskresi Kalsium N&R- MFCJI EBSJ TFQBSVIOZB UFSJLBU QBEB QSPUFJO QMBTNB
0MFILBSFOBJUV LPOTFOUSBTJNBHOFTJVNUFSJPOJTBTJZBOHCFCBT
lHormon paratiroid (PTH) nPTH IBOZBTFLJUBS N&R-
nVolume cairan ekstraselular lVolume cairan ekstraselular
nTekanan darah l Tekanan darah "TVQBO IBSJBO OPSNBM NBHOFTJVN BEBMBI TFLJUBS
lFosfat plasma nFosfat plasma NHIBSJ UFUBQJIBOZBTFLJUBSTFQBSVIEBSJBTVQBOJOJZBOHEJ
Alkalosis metabolik Alkalosis metabolik BCTPSCTJ PMFI USBLUVT HBTUSPJOUFTUJOBMJT 6OUVL NFNQFSUBIBO
Vitamin D3 LBOJNCBOHBONBHOFTJVN HJOKBMIBSVTNFOHFLTLSFTJLBONBH
OFTJVNZBOHEJBCTPSCTJJOJZBJUVTFLJUBSTFQBSVIEBSJBTVQBO
369
NBHOFTJVNIBSJBOBUBVTBNQBJNHIBSJ/PSNBMOZB BOKVNMBIBTVQBOOZB0MFILBSFOBJUV NFTLJQVOQBEBHBOHHVBO

HJOKBM NFOHFLTLSFTJLBO TFLJUBS QFSTFO NBHOFTJVN ZBOH NFOZFCBCLBO QFSVCBIBO CFTBS GVOHTJ HJOKBM JNCBOHBO
EBMBNGJMUSBUHMPNFSVMVT BOUBSBBTVQBOEBOLFMVBSBOOBUSJVNCJBTBOZBQVMJIEBMBNXBLUV
CFCFSBQBIBSJ
&LTLSFTJ NBHOFTJVN PMFI HJOKBM EBQBU NFOJOHLBU EFOHBO
OZBUB CJMB NBHOFTJVN CFSMFCJIBO BUBV NFOVSVO TBNQBJ +JLB HBOHHVBO GVOHTJ HJOKBM UJEBL UFSMBMV CFSBU LFTFJNCBOHBO
IBNQJS OPM TFMBNB LFIJMBOHBO NBHOFTJVN 0MFI LBSFOB OBUSJVN EBQBU EJDBQBJ UFSVUBNB NFMBMVJ QFOZFTVBJBO JOUSBSFOBM
NBHOFTJVN UFSMJCBU EBMBN CBOZBL QSPTFT CJPLJNJB EBMBN EFOHBOQFSVCBIBOWPMVNFDBJSBOFLTUSBTFMVMBSZBOHNJOJNBMBUBV
UVCVI UFSNBTVLBLUJWBTJCFSCBHBJFO[JN LPOTFOUSBTJOZBIBSVT QFOZFTVBJBO TJTUFNJL MBJOOZB /BNVO CJMB HBOHHVBO QBEB HJOKBM
EJBUVSTFDBSBLFUBU CFSTJGBU CFSBU EBO LPNQFOTBTJ JOUSBSFOBM TVEBI KFOVI
QFOZFTVBJBO TJTUFNJL IBSVT CFSKBMBO TFQFSUJ QFSVCBIBO UFLBOBO
1FOHBUVSBO FLTLSFTJ NBHOFTJVN UFSVUBNB EJDBQBJ NFMBMVJ EBSBI QFSVCBIBOIPSNPOZBOHCFSFEBS EBOQFSVCBIBOBLUJWJUBT
QFOHVCBIBO SFBCTPSQTJ UVCVMVT 5VCVMVT QSPLTJNBM CJBTBOZB TJTUFNTBSBGTJNQBUJT
IBOZB NFSFBCTPSCTJ TFLJUBS QFSTFO EBSJ NBHOFTJVN ZBOH
1FOZFTVBJBO JOJ NFSVHJLBO VOUVL LFTFMVSVIBO IPNFPTUBTJT
EJGJMUSBTJ5FNQBUVUBNBSFBCTPSQTJBEBMBIBOTB)FOMF UFNQBU
LBSFOB QFOZFTVBJBO JOJ NFOZFCBCLBO QFSVCBIBO MBJO EJ TFMVSVI
TFLJUBS QFSTFO EBSJ CFCBO NBHOFTJVN ZBOH EJGJMUSBTJ BLBO
UVCVI ZBOH QBEB BLIJSOZB CFSTJGBU NFSVTBL .JTBMOZB HBOHHVBO
EJSFBCTPSCTJ)BOZBTFKVNMBILFDJM CJBTBOZBQFSTFO
EBSJ
GVOHTJHJOKBMEBQBUNFOZFCBCLBOQFOJOHLBUBOUFLBOBOEBSBI ZBOH
NBHOFTJVN ZBOH EJGJMUSBTJ BLBO EJSFBCTPSCTJ EBMBN UVCVMVT
TFMBOKVUOZB NFNCBOUV NFNQFSUBIBOLBO FLTLSFTJ OBUSJVN ZBOH
EJTUBMEBOUVCVMVTLPMJHFOT
OPSNBM %BMBN KBOHLB QBOKBOH UFLBOBO EBSBI ZBOH UJOHHJ EBQBU
.FLBOJTNF ZBOH NFOHBUVS FLTLSFTJ NBHOFTJVN UJEBL NFSVTBLQFNCVMVIEBSBI KBOUVOH EBOPSHBOMBJOOZB8BMBVQVO
EJLFUBIVJ EFOHBO CBJL UFUBQJ HBOHHVBOHBOHHVBO CFSJLVU JOJ CFHJUV LPNQFOTBTJ JOJ EJQFSMVLBO LBSFOB LFUJEBLTFJNCBOHBO
NFOJNCVMLBO QFOJOHLBUBO FLTLSFTJ NBHOFTJVN
QFOJOH UFSVTNFOFSVT BOUBSB BTVQBO TFSUB LFMVBSBO DBJSBO EBO FMFLUSPMJU
LBUBOLPOTFOUSBTJNBHOFTJVNDBJSBOFLTUSBTFMVMBS
QFOJOH BLBO DFQBU NFOZFCBCLBO FMFLUSPMJU EBO BJS UFSBLVNVMBTJ BUBV
LBUBOWPMVNFFLTUSBTFM EBO
QFOJOHLBUBOLPOTFOUSBTJLBMTJ IJMBOH ZBOH EBQBU NFOZFCBCLBO LPMBQT KBOUVOH EBO QFNCVMVI
VNDBJSBOFLTUSBTFMVMBS EBSBI EBMBN XBLUV CFCFSBQB IBSJ +BEJ LJUB EBQBU NFMJIBU
QFOZFTVBJBO TJTUFNJL ZBOH UFSKBEJ TFCBHBJ SFTQPOT UFSIBEBQ
BCOPSNBMJUBT GVOHTJ HJOKBM NFSVQBLBO TVBUV QFSUVLBSBO ZBOH
IBSVT EJMBLVLBO BHBS FLTLSFTJ FMFLUSPMJU EBO DBJSBO TFJNCBOH
Integrasi Mekanisme Ginjal untuk LFNCBMJEFOHBOBTVQBOOZB
Mengatur Cairan Ekstraselular
Ekskresi Natrium Diatur oleh Perubahan Laju Filtrasi
7PMVNF DBJSBO FLTUSBTFMVMBS UFSVUBNB EJUFOUVLBO PMFI
Glomerulus atau Kecepatan Reabsorpsi Natrium Tubulus
JNCBOHBO BOUBSB BTVQBO TFSUB LFMVBSBO BJS EBO HBSBN 1BEB
CFCFSBQB LFBEBBO BTVQBO HBSBN EBO BJS UFSVUBNB MFCJI %VBWBSJBCFMZBOHNFNFOHBSVIJFLTLSFTJOBUSJVNEBOBJSBEBMBI
EJUFOUVLBOPMFILFCJBTBBOTFTFPSBOHEBSJQBEBPMFINFLBOJTNF MBKVGJMUSBTJHMPNFSVMVTEBOLFDFQBUBOSFBCTPSQTJUVCVMVT
QFOHBUVSBO GJTJPMPHJT 0MFI TFCBC JUV CFCBO QFOHBUVSBO Ekskresi = Filtrasi Glomerulus – Reabsorpsi Tubulus
WPMVNF FLTUSBTFM CJBTBOZB UFSMFUBL QBEB HJOKBM ZBOH IBSVT
NFOZFTVBJLBO FLTLSFTJ HBSBN EBO BJSOZB EFOHBO BTVQBO -'( OPSNBMOZB BEBMBI TFLJUBS -IBSJ SFBCTPSQTJ UVCVMVT
HBSBNEBOBJSEBMBNLFBEBBONBOUBQ BEBMBI -IBSJ EBO FLTLSFTJ VSJOF BEBMBI -IBSJ +BEJ
%BMBN QFNCBIBTBO NFOHFOBJ QFOHBUVSBO WPMVNF DBJSBO QFSVCBIBO -'( BUBV SFBCTPSQTJ UVCVMVT ZBOH LFDJM CFSQPUFOTJ
FLTUSBTFMVMBS LJUB NFNQFSUJNCBOHLBO GBLUPSGBLUPS ZBOH NFOZFCBCLBO QFSVCBIBO CFTBS EBMBN FLTLSFTJ HJOKBM 4FCBHBJ
NFOHBUVS KVNMBI OBUSJVN LMPSJEB EBMBN DBJSBO FLTUSBTFMVMBS DPOUPI QFOJOHLBUBO -'( TFCFTBS QFSTFO NFOKBEJ -IBSJ

LBSFOB QFSVCBIBO LBEBS OBUSJVN LMPSJEB EBMBN DBJSBO BLBO NFOZFCBCLBO QFOJOHLBUBO WPMVNF VSJOF TFCFTBS -IBSJ
FLTUSBTFMVMBSCJBTBOZBNFOZFCBCLBOQFSVCBIBOWPMVNFDBJSBO CJMB LPNQFOTBTJ UVCVMVT UJEBL UFSKBEJ IBM JOJ BLBO EFOHBO DFQBU
FLTUSBTFMVMBS BTBMLBO NFLBOJTNF IPSNPO BOUJEJVSFUJL NFOZFCBCLBO QFSVCBIBO WPMVNF DBJSBO UVCVI ZBOH
"%)
SBTB IBVT CFLFSKB #JMB NFLBOJTNF "%)SBTB IBVT NFNCBIBZBLBO%FNJLJBOKVHB QFSVCBIBOLFDJMQBEBSFBCTPSQTJ
CFSGVOHTJ OPSNBM QFSVCBIBO KVNMBI OBUSJVN LMPSJEB EBMBN UVCVMVT UBOQB QFOZFTVBJBO LPNQFOTBTJ -'( KVHB BLBO
DBJSBO FLTUSBTFMVMBS EJTFTVBJLBO EFOHBO QFSVCBIBO ZBOH NFOJNCVMLBO QFSVCBIBO WPMVNF VSJOF EBO FLTLSFTJ OBUSJVN
TFSVQB QBEB KVNMBI BJS FLTUSBTFM TFIJOHHB PTNPMBMJUBT EBO ZBOHIFCBU3FBCTPSQTJUVCVMVTEBO-'(CJBTBOZBEJBUVSEFOHBO
LPOTFOUSBTJOBUSJVNEJQFSUBIBOLBOSFMBUJGLPOTUBO UFQBU TFIJOHHBFLTLSFTJPMFIHJOKBMEBQBUEJTFTVBJLBOTFDBSBUFQBU
EFOHBOBTVQBOBJSEBOFMFLUSPMJU
Asupan dan Ekskresi Natrium Disesuaikan secara Tepat #BILBO QBEB HBOHHVBO ZBOH NFOHVCBI -'( BUBV SFBCTPSQTJ
pada Keadaan Mantap UVCVMVT QFSVCBIBOEBMBNFLTLSFTJVSJOFEJQFSLFDJMPMFICFSCBHBJ
NFLBOJTNF QFOZBOHHB 4FCBHBJ DPOUPI CJMB HJOKBM NFOHBMBNJ
4BMBI TBUV IBM ZBOH QFSMV EJQFSIBUJLBO EBMBN LFTFMVSVIBO
WBTPEJMBUBTJIFCBUEBO-'(NFOJOHLBU ZBOHEBQBUUFSKBEJBLJCBU
QFOHBUVSBO FLTLSFTJ OBUSJVN BUBV TFCFOBSOZB FLTLSFTJ TFCB
PCBUPCBUUFSUFOUVBUBVQBEBEFNBNUJOHHJ
UFSKBEJQFOJOHLBUBO
HJBO CFTBS FMFLUSPMJU BEBMBI QBEB LFBEBBO NBOUBQ FLTLSFTJ
QFOZBNQBJBO OBUSJVN LMPSJEB LF UVCVMVT ZBOH LFNVEJBO
NFMBMVJ HJOKBM EJUFOUVLBO PMFI BTVQBOOZB 6OUVL NFNQFSUB
NFOJNCVMLBOTFEJLJUOZBEVBLPNQFOTBTJJOUSBSFOBM
NFOJOH
IBOLBOIJEVQ TFTFPSBOH EBMBNKBOHLBQBOKBOH IBSVTNFOHF
LBUOZBSFBCTPSQTJUVCVMVTUFSIBEBQTFCBHJBOCFTBSOBUSJVNLMPSJ
LTLSFTJLBOTFKVNMBIOBUSJVNEFOHBOIBNQJSUFQBUTBNBEFOH
370
EBUBNCBIBOZBOHEJGJMUSBTJ ZBOHEJTFCVUJNCBOHBOHMPNFSVMP 8
UVCVMBS EBO
VNQBO CBMJL NBLVMB EFOTB NFOJOHLBUOZB
QFOZBNQBJBO OBUSJVN LMPSJEB LF UVCVMVT EJTUBM NFOZFCBCLBO 6
LPOTUSJLTJ BOUFSJPM BGFSFO EBO NFOHFNCBMJLBO -'( LF OJMBJ
OPSNBM%FNJLJBOKVHB HBOHHVBOSFBCTPSQTJUVCVMVTEJUVCVMVT
UNIT V
QSPLTJNBM BUBV BOTB )FOMF TFCBHJBO EJLPNQFOTBTJ PMFI VNQBO 4
CBMJLJOUSBSFOBMJOJ
0MFILBSFOBUJEBLTBUVQVOEBSJLFEVBNFLBOJTNFJOJCFLFSKB 2
TFDBSB TFNQVSOB VOUVL NFNVMJILBO QFOZBNQBJBO EJTUBM
OBUSJVN LMPSJEB LFNCBMJ OPSNBM TFQFOVIOZB QFSVCBIBO QBEB 0
-'( BUBV SFBCTPSQTJ UVCVMVT EBQBU NFOJNCVMLBO QFSVCBIBO 0 20 40 60 80 100 120 140 160 180 200
ZBOHCFSNBLOBQBEBFLTLSFTJOBUSJVNEBOBJSEBMBNVSJOF#JMB (mm Hg)
LFBEBBOJOJUFSKBEJ NFLBOJTNFVNQBOCBMJLMBJOUVSVUCFSQFSBO Gambar 29-13Pengaruh akut dan kronis tekanan arteri pada keluaran
TFQFSUJ QFSVCBIBO UFLBOBO EBSBI EBO QFSVCBIBO CFSCBHBJ natrium oleh ginjal (natriuresis tekanan). Perhatikan bahwa
peningkatan kronis tekanan arteri menyebabkan peningkatan keluaran
IPSNPO EBO BLIJSOZB NFOHFNCBMJLBO FLTLSFTJ OBUSJVN
natrium yang jauh lebih besar daripada yang diukur selama
NFOKBEJ TBNB EFOHBO BTVQBO OBUSJVN %BMBN CFCFSBQB CBHJBO peningkatan tekanan arteri mendadak.
CFSJLVUOZB LJUBBLBONFNCBIBTLFNCBMJCBHBJNBOBNFLBOJTNF
JOJCFLFSKBTBNBVOUVLNFOHBUVSLFTFJNCBOHBOOBUSJVNEBOBJS tensin **EBOBMEPTUFSPONFOHIBNCBUSFBCTPSQTJOBUSJVNPMFI
EBO TFLBMJHVT NFOHBUVS WPMVNF DBJSBO FLTUSBTFMVMBS 4FNVB UVCVMVT HJOKBM TFIJOHHB NFNQFSLVBU QFOHBSVI MBOHTVOH
NFLBOJTNF VNQBO CBMJL JOJ NFOHBUVS FLTLSFTJ OBUSJVN EBO BJS QFOJOHLBUBOUFLBOBOEBSBIZBOHNFOJOHLBULBOFLTLSFTJOBUSJ
EFOHBONFOHVCBI-'(BUBVSFBCTPSQTJUVCVMVT VNEBOBJS
Natriuresis dan Diuresis Tekanan adalah Komponen

Pentingnya Natriuresis Tekanan dan Diuresis Kunci dari Umpan Batik Cairan Tubuh Ginjal dalam
Tekanan dalam Mempertahankan Mengatur Volume Cairan Tubuh dan Tekanan Arteri
Keseimbangan Natrium dan Cairan Tubuh 1FOHBSVI QFOJOHLBUBO UFLBOBO EBSBI VOUVL NFOJOHLBULBO
LFMVBSBO VSJOF BEBMBI CBHJBO EBSJ TJTUFN VNQBO CBMJL LVBU
4BMBI TBUV NFLBOJTNF ZBOH QBMJOH EBTBS EBO LVBU VOUVL ZBOH CFLFSKB VOUVL NFNQFSUBIBOLBO BTVQBO EBO LFMVBSBO
NFNQFSUBIBOLBO JNCBOHBO OBUSJVN EBO DBJSBO TFLBMJHVT DBJSBO TFQFSUJ ZBOH EJUVOKVLLBO EBMBN (BNCBS
NFOHFOEBMJLBO WPMVNF EBSBI EBO WPMVNF DBJSBO FLTUSBTFMVMBS .FLBOJTNFJOJTBNBTFQFSUJNFLBOJTNFZBOHEJCBIBTQBEB#BC
BEBMBI QFOHBSVI UFLBOBO EBSBI UFSIBEBQ FLTLSFTJ OBUSJVN EBO VOUVL QFOHBUVSBO UFLBOBO BSUFSJ 7PMVNF DBJSBO
BJS NBTJOHNBTJOH EJTFCVU NFLBOJTNF OBUSJVSFTJT UFLBOBO EBO FLTUSBTFMVMBS WPMVNFEBSBI DVSBIKBOUVOH UFLBOBOBSUFSJ EBO
EJVSFTJT UFLBOBO 4FQFSUJ ZBOH EJCBIBT EBMBN #BC VNQBO LFMVBSBO VSJOF TFNVBOZB EJLPOUSPM QBEB TBBU ZBOH CFSTBNBBO
CBMJLBOUBSBHJOKBMEBOTJTUFNTJSLVMBTJJOJKVHBNFNQVOZBJQFSBO TFCBHBJCBHJBOUFSQJTBIEBSJNFLBOJTNFVNQBOCBMJLEBTBSJOJ
ZBOHEPNJOBOEBMBNQFOHBUVSBOUFLBOBOEBSBIKBOHLBQBOKBOH
%JVSFTJT UFLBOBO NFSVKVL QBEB QFOHBSVI QFOJOHLBUBO 4FMBNBUFSKBEJQFSVCBIBOQBEBBTVQBOOBUSJVNEBODBJSBO
UFLBOBO EBSBI VOUVL NFOJOHLBULBO FLTLSFTJ WPMVNF VSJOF NFLBOJTNF VNQBO CBMJL JOJ NFNCBOUV NFNQFSUBIBOLBO
TFEBOHLBO OBUSJVSFTJT UFLBOBO NFSVKVL QBEB QFOJOHLBUBO JNCBOHBO DBJSBO EBO NFNQFSLFDJM QFSVCBIBO WPMVNF EBSBI
FLTLSFTJ OBUSJVN ZBOH UFSKBEJ QBEB QFOJOHLBUBO UFLBOBO EBSBI WPMVNFDBJSBOFLTUSBTFMVMBS EBOUFLBOBOBSUFSJTFCBHBJCFSJLVU
0MFI LBSFOB EJVSFTJT EBO OBUSJVSFTJT UFLBOBO CJBTBOZB
CFSMBOHTVOH QBSBMFM NBLB EBMBN QFNCBIBTBO TFMBOKVUOZB LJUB 1. 1FOJOHLBUBO BTVQBO DBJSBO EJBOHHBQ CBIXB OBUSJVN
NFOZFCVU NFLBOJTNF JOJ TFDBSB TFEFSIBOB TFCBHBJ OBUSJVSFTJT NFOZFSUBJ BTVQBO DBJSBO
EJ BUBT CBUBT LFMVBSBO VSJOF
UFLBOBO NFOZFCBCLBOBLVNVMBTJTFNFOUBSBDBJSBOEJEBMBNUVCVI
(BNCBS NFOVOKVLLBO QFOHBSVI UFLBOBO BSUFSJ 2. 4FMBNB BTVQBO DBJSBO NFMFCJIJ LFMVBSBO VSJOF DBJSBO
UFSIBEBQ LFMVBSBO OBUSJVN EBMBN VSJOF 1FSIBUJLBO CBIXB CFSBLVNVMBTJ EBMBN EBSBI EBO SVBOH JOUFSTUJTJBM
QFOJOHLBUBODFQBUUFLBOBOEBSBIEBSJLFNN)HNFOZF NFOZFCBCLBO QFOJOHLBUBO ZBOH TBNB QBEB WPMVNF EBSBI
CBCLBO QFOJOHLBUBO LFMVBSBO OBUSJVN EBMBN VSJOF TFCFTBS EVB EBO WPMVNF DBJSBO FLTUSBTFMVMBS 4FQFSUJ BLBO EJCBIBT
TBNQBJ UJHB LBMJ MJQBU 1FOHBSVI JOJ UJEBL CFSHBOUVOH QBEB LFNVEJBO QFOJOHLBUBO ZBOH TFCFOBSOZB EBSJ WBSJBCFM
QFSVCBIBOBLUJWJUBTTJTUFNTBSBGTJNQBUJTBUBVCFSCBHBJIPSNPO WBSJBCFMJOJCJBTBOZBLFDJMLBSFOBFGFLUJWJUBTVNQBOCBMJLJOJ
TFQFSUJBOHJPUFOTJO** "%) BUBVBMEPTUFSPO LBSFOBOBUSJVSFTJT 3. 1FOJOHLBUBO WPMVNF EBSBI NFOJOHLBULBO UFLBOBO
UFLBOBOEBQBUEJQFSMJIBULBOQBEBHJOKBMZBOHEJJTPMBTJZBOHUFMBI QFOHJTJBOTJSLVMBTJSBUBSBUB
EJMFQBTLBO EBSJ QFOHBSVI GBLUPSGBLUPS JOJ 1BEB QFOJOHLBUBO 4. 1FOJOHLBUBO UFLBOBO QFOHJTJBO TJSLVMBTJ SBUBSBUB
UFLBOBOEBSBIZBOHLSPOJT FGFLUJWJUBTOBUSJVSFTJTUFLBOBONFO NFOJOHLBULBOHSBEJFOUFLBOBOVOUVLBSVTCBMJLWFOB
KBEJTBOHBUNFOJOHLBULBSFOBTFUFMBICFCFSBQBTBBU QFOJOHLBUBO
5. 1FOJOHLBUBO HSBEJFO UFLBOBO VOUVL BSVT CBMJL WFOB
UFLBOBO EBSBI KVHB NFOFLBO QFMFQBTBO SFOJO EBO PMFI LBSFOB
JUV NFOVSVOLBO QFNCFOUVLBO BOHJPUFOTJO ** EBO BMEPTUFSPO NFOJOHLBULBODVSBIKBOUVOH
4FQFSUJZBOHUFMBIEJCBIBTTFCFMVNOZB QFOVSVOBOLBEBSBOHJP 6. 1FOJOHLBUBODVSBIKBOUVOHNFOJOHLBULBOUFLBOBOBSUFSJ
371
Renal fluid
excretion
Arterial pressure
29-14
7. 1FOJOHLBUBO UFLBOBO BSUFSJ NFOJOHLBULBO LFMVBSBO VSJOF

NFMBMVJ EJVSFTJT UFLBOBO ,FDVSBNBO IVCVOHBO OBUSJVSFTJT
UFLBOBO ZBOH OPSNBM NFOVOKVLLBO IBOZB EJCVUVILBO
QFOJOHLBUBO UFLBOBO EBSBI LFDJM TBKB VOUVL NFOJOHLBULBO
FLTLSFTJVSJOFNFOKBEJCFCFSBQBLBMJMJQBU
8. 1FOJOHLBUBO FLTLSFTJ DBJSBO NFOHJNCBOHJ QFOJOHLBUBO
BTVQBO EBONFODFHBIBLVNVMBTJDBJSBOMFCJIKBVI
+BEJ NFLBOJTNF VNQBO CBMJL DBJSBO UVCVI HJOKBM CFLFSKB
VOUVL NFODFHBI BLVNVMBTJ HBSBN EBO BJS UFSVTNFOFSVT EB
MBN UVCVI TFMBNB UFSKBEJ QFOJOHLBUBO BTVQBO HBSBN EBO BJS
4FMBNB HJOKBM CFSGVOHTJ OPSNBM EBO NFLBOJTNF EJVSFTJT UFLB
OBOCFLFSKBTFDBSBFGFLUJG QFSVCBIBOCFTBSQBEBBTVQBOHBSBN
EBO BJS EBQBU EJTFTVBJLBO EFOHBO IBOZB TFEJLJU QFSVCBIBO
WPMVNFEBSBI WPMVNFDBJSBOFLTUSBTFMVMBS DVSBIKBOUVOH EBO 29-15
UFLBOBOBSUFSJ
3BOHLBJBO LFKBEJBO ZBOH CFSMBXBOBO UFSKBEJ CJMB BTVQBO
DBJSBO NFOVSVO EJ CBXBI OPSNBM %BMBN IBM JOJ BEB LFDFO
EFSVOHBO UFSKBEJ QFOVSVOBO WPMVNF EBSBI EBO WPMVNF DBJSBO UJ QBEB CBOZBL PSBOH 1BEB PSBOHPSBOH MBJO ZBOH MFCJI QFLB
FLTUSBTFMVMBS EBO KVHB QFOVSVOBO UFLBOBO BSUFSJ #BILBO HBSBN UFSKBEJ QFOJOHLBUBO UFLBOBO BSUFSJ ZBOH CFSNBLOB QBEB
QFOVSVOBO UFLBOBO EBSBI ZBOH LFDJM TFLBMJ QVO EBQBU QFOJOHLBUBO BTVQBO OBUSJVN ZBOH TFEBOH TBKB %FOHBO BTVQBO
NFOZFCBCLBO QFOVSVOBO LFMVBSBO VSJOF ZBOH CFTBS TFIJOHHB OBUSJVNUJOHHJCFSLFQBOKBOHBO TFMBNBCFCFSBQBUBIVO UFLBOBO
NFNVOHLJOLBOJNCBOHBODBJSBOEBQBUEJQFSUBIBOLBOEFOHBO EBSBIUJOHHJEBQBUUFSKBEJNFTLJQVOPSBOHUFSTFCVUQBEBBXBMOZB
IBOZB QFSVCBIBO LFDJM UFLBOBO EBSBI WPMVNF EBSBI BUBV UJEBL QFLB HBSBN #JMB UFLBOBO EBSBI OBJL OBUSJVSFTJT UFLBOBO
WPMVNF DBJSBO FLTUSBTFMVMBS &GFLUJWJUBT NFLBOJTNF JOJ EBMBN NFNCFSJLBO DBSB ZBOH QFOUJOH VOUVL NFNQFSUBIBOLBO JNCB
NFODFHBI QFSVCBIBO WPMVNF EBSBI ZBOH CFTBS EJUVOKVLLBO OHBOBOUBSBBTVQBOOBUSJVNEBOFLTLSFTJOBUSJVNVSJOF
PMFI (BNCBS ZBOH NFOVOKVLLBO CBIXB QFSVCBIBO
WPMVNF EBSBI IBNQJS UJEBL UFSMJIBU XBMBVQVO UFSKBEJ WBSJBTJ Ketepatan Pengaturan Volume Darah dan Volume Cairan
BTVQBOBJSEBOFMFLUSPMJUZBOHCFTBSTFUJBQIBSJOZB LFDVBMJCJMB Ekstraselular
BTVQBO NFOKBEJ TBOHBU SFOEBI TFIJOHHB UJEBL DVLVQ VOUVL
NFOHHBOUJLBO LFIJMBOHBO DBJSBO ZBOH EJTFCBCLBO PMFI FWBQP %FOHBO NFNQFMBKBSJ (BNCBS LJUB EBQBU NFOHFSUJ
SBTJBUBVLFIJMBOHBOZBOHUJEBLEBQBUEJIJOEBSJMBJOOZB NFOHBQBWPMVNFEBSBIUFUBQIBNQJSCFOBSCFOBSLPOTUBOXBMBV
4FQFSUJ ZBOH BLBO EJCBIBT OBOUJ UFSEBQBU TJTUFN TBSBG EBO QVO UFSKBEJ QFSVCBIBO ZBOH CFTBS QBEB BTVQBO DBJSBO IBSJBO
IPSNPOBM TFMBJONFLBOJTNFJOUSBSFOBM ZBOHEBQBUNFOJOHLBU "MBTBOVOUVLIBMJOJBEBMBITFCBHBJCFSJLVU
QFSVCBIBOLFDJM
LBOFLTLSFTJOBUSJVNVOUVLNFOZFTVBJLBOEFOHBOQFOJOHLBUBO WPMVNF EBSBI NFOZFCBCLBO QFSVCBIBO DVSBI KBOUVOH ZBOH
BTVQBOOBUSJVNNFTLJQVOUBOQBQFOJOHLBUBOBSUFSJZBOHCFSBS OZBUB
QFSVCBIBOLFDJMDVSBIKBOUVOHNFOZFCBCLBOQFSVCB
372
IBO UFLBOBOEBSBIZBOHCFTBS EBO

QFSVCBIBOLFDJMUFLBOBO Edema
EBSBI NFOZFCBCLBO QFSVCBIBO LFMVBSBO VSJOF ZBOH CFTBS
4FNVBGBLUPSJOJCFLFSKBCFSTBNBVOUVLNFNCFSJLBOQFOHBUVSBO
VNQBOCBMJLZBOHFGFLUJGUFSIBEBQWPMVNFEBSBI
.FLBOJTNF QFOHBUVSBO ZBOH TBNB CFLFSKB CJMB UFSKBEJ
UNIT V
LFIJMBOHBO EBSBI BLJCBU QFSEBSBIBO %BMBN IBM JOJ QFOVSVOBO
UFLBOBO EBSBI CFSTBNB GBLUPS QFSTBSBGBO EBO IPSNPO DBJSBO
ZBOH EJCBIBT OBOUJ NFOZFCBCLBO SFUFOTJ DBJSBO PMFI HJOKBM
1SPTFT QBSBMFM MBJOOZB UFSKBEJ VOUVL NFNCFOUVL LFNCBMJ TFMTFM
EBSBI NFSBI EBO QSPUFJO QMBTNB EBMBN EBSBI #JMB LFMBJOBO
WPMVNF TFM EBSBI NFSBI NFOFUBQ TFQFSUJ ZBOH UFSKBEJ CJMB
UFSEBQBU EFGJTJFOTJ FSJUSPQPJFUJO BUBV GBLUPSGBLUPS MBJO ZBOH
EJCVUVILBO VOUVL NFSBOHTBOH QSPEVLTJ TFM EBSBI NFSBI
29-16
WPMVNF QMBTNB BLBO NFNQFSCBJLJ QFSCFEBBO JOJ EBO LFTFMV
SVIBO WPMVNF EBSBI BLBO LFNCBMJ OPSNBM XBMBVQVO KVNMBI TFM
EBSBINFSBISFOEBI
Distribusi Cairan Ekstrasekdar Antara Ruang

Interstisial dan Sistem Vaskular
OZFCBCLBOFEFNB TFQFSUJZBOHEJKFMBTLBOQBEB#BC UFUBQJ
%BSJ (BNCBS UBNQBL KFMBT CBIXB WPMVNF EBSBI EBO SVBOH JOUFSTUJTJBM KVHB CFSUJOEBL TFCBHBJ LBUVQ QFMFQBT BMJSBO
WPMVNF DBJSBO FLTUSBTFMVMBS CJBTBOZB EJBUVS TFDBSB QBSBMFM TBUV
CFSMFCJIBOZBOHQFOUJOHVOUVLTJSLVMBTJ TFIJOHHBNFMJOEVOHJ
TBNB MBJO "JS ZBOH EJUFMBO NVMBNVMB NBTVL LF EBMBN EBSBI
TJTUFN LBSEJPWBTLVMBS UFSIBEBQ CBIBZB LFMFCJIBO CFCBO ZBOH
UFUBQJ TFDBSB DFQBU EJEJTUSJCVTJLBO LF SVBOH JOUFSTUJTJBM EBO
EBQBUNFOJNCVMLBOFEFNBQBSVEBOHBHBMKBOUVOH
QMBTNB 0MFI LBSFOB JUV WPMVNF EBSBI EBO WPMVNF DBJSBO
FLTUSBTFMVMBSCJBTBOZBEJBUVSTFDBSBCFSTBNBBO 4FCBHBJSJOHLBTBO WPMVNFDBJSBOFLTUSBTFMVMBSEBOWPMVNF
EBSBI EJBUVS TFDBSB CFSTBNBBO UFUBQJ KVNMBI LVBOUJUBUJG
"LBO UFUBQJ UFSEBQBU LFBEBBO LFUJLB EJTUSJCVTJ DBJSBO
EJTUSJCVTJ DBJSBO BOUBSB SVBOH JOUFSTUJTJVN EBO EBSBI
FLTUSBTFMVMBS BOUBSB SVBOH JOUFSTUJTJBM EBO EBSBI EBQBU TBOHBU
CFSHBOUVOHQBEBTJGBUGJTJLTJSLVMBTJEBOSVBOHJOUFSTUJTJBMTFSUB
CFSCFEB4FQFSUJZBOHEJCBIBTEBMBN#BC GBLUPSGBLUPSVUBNB
EJOBNJLBQFSUVLBSBODBJSBONFMBMVJNFNCSBOLBQJMFS
ZBOH EBQBU NFOZFCBCLBO BLVNVMBTJ DBJSBO EBMBN SVBOH
JOUFSTUJTJBM BOUBSB MBJO
QFOJOHLBUBO UFLBOBO IJESPTUBUJL
LBQJMFS
QFOVSVOBO UFLBOBO PTNPUJL LPMPJE QMBTNB
Faktor Saraf dan Hormon Meningkatkan
QFOJOHLBUBO QFSNFBCJMJUBT LBQJMFS EBO
PCTUSVLTJ QFNCVMVI Efektivitas Pengaturan Umpan Batik Cairan
MJNGBUJL 1BEB TFNVB LPOEJTJ JOJ TFCBHJBO CFTBS DBJSBO Tubuh-Ginjal
FLTUSBTFMVMBSUFSEJTUSJCVTJLFSVBOHJOUFSTUJTJBM
(BNCBSNFOVOKVLLBOEJTUSJCVTJOPSNBMDBJSBOBOUBSB 1BEB #BC LJUB NFNCBIBT GBLUPS TBSBG EBO IPSNPO ZBOH
SVBOH JOUFSTUJTJBM EBO TJTUFN WBTLVMBS TFSUB EJTUSJCVTJ ZBOH NFNFOHBSVIJ -'( EBO SFBCTPSQTJ UVCVMVT EBO EFOHBO
UFSKBEJ QBEB LFBEBBO FEFNB #JMB TFKVNMBI LFDJM DBJSBO EFNJLJBOFLTLSFTJHBSBNEBOBJSPMFIHJOKBM.FLBOJTNFTBSBG
UFSLVNQVM EBMBN EBSBI TFCBHBJ BLJCBU EBSJ UFSMBMV CBOZBLOZB EBOIPSNPOJOJCJBTBOZBCFLFSKBCFSTBNBEFOHBONFLBOJTNF
BTVQBO DBJSBO BUBV QFOVSVOBO LFMVBSBO DBJSBO PMFI HJOKBM OBUSJVSFTJT UFLBOBO EBO EJVSFTJT UFLBOBO ZBOH NFNCVBU
TFLJUBSTBNQBJQFSTFOBLBOUFUBQCFSBEBEBMBNEBSBIEBO NFLBOJTNF UFSTFCVU MFCJI FGFLUJG MBHJ EBMBN NFNQFSLFDJM
NFOJOHLBULBO WPMVNF EBSBI 4JTBOZB EJEJTUSJCVTJLBO LF SVBOH QFSVCBIBO WPMVNF EBSBI WPMVNF DBJSBO FLTUSBTFMVMBS EBO
JOUFSTUJTJBM #JMB WPMVNF DBJSBO FLTUSBTFMVMBS NFOJOHLBU MFCJI UFLBOBOBSUFSJZBOHUFSKBEJTFCBHBJSFTQPOTUFSIBEBQQFSVCBIBO
EBSJTBNQBJQFSTFOEJBUBTOPSNBM IBNQJSTFNVBDBJSBO TFIBSJIBSJ "LBO UFUBQJ LFMBJOBO GVOHTJ HJOKBM BUBV CFSCBHBJ
UBNCBIBONBTVLLFSVBOHJOUFSTUJTJBMEBOIBOZBTFEJLJUCFSBEB GBLUPS TBSBG EBO IPSNPO ZBOH NFNFOHBSVIJ HJOKBM EBQBU
EJ EBMBN EBSBI )BM JOJ UFSKBEJ LBSFOB TFLBMJ UFLBOBO DBJSBO NFOJNCVMLBO QFSVCBIBO UFLBOBO EBSBI EBO WPMVNF DBJSBO
JOUFSTUJTJBM NFOJOHLBU EBSJ OJMBJ OPSNBMOZB ZBOH OFHBUJG UVCVIZBOHCFSBU TFQFSUJZBOHBLBOEJCBIBTLFNVEJBO
NFOKBEJQPTJUJG SVBOHJOUFSTUJTJBMKBSJOHBONFOKBEJUVOEVLEBO
TFKVNMBI CFTBS DBJSBO NBTVL LF EBMBN KBSJOHBO UBOQB
Pengaturan Ekskresi Ginjal oleh Sistem Saraf Simpatis:
NFOJNCVMLBOMFCJICBOZBLQFOJOHLBUBOUFLBOBODBJSBOJOUFST
Refleks Baroreseptor Arteri dan Refleks Reseptor
UJTJBM %FOHBO LBUB MBJO GBLUPS LFBNBOBO UFSIBEBQ FEFNB
Regangan Tekanan Rendah
LBSFOB QFOJOHLBUBO UFLBOBO DBJSBO JOUFSTUJTJBM ZBOH NFOJBEB
LBO BLVNVMBTJ DBJSBO EBMBN KBSJOHBO NFOKBEJ IJMBOH TFXBLUV 0MFI LBSFOB HJOKBM NFOFSJNB QFSTBSBGBO TJNQBUJT ZBOH MVBT
KBSJOHBONFOKBEJTBOHBUUVOEVL QFSVCBIBOBLUJWJUBTTJNQBUJTEBQBUNFOHVCBIFLTLSFTJOBUSJVN
+BEJ EBMBN LPOEJTJ OPSNBM SVBOH JOUFSTUJTJBM CFSUJOEBL EBOBJSPMFIHJOKBM EBOKVHBQFOHBUVSBOWPMVNFDBJSBOFLTUSB
TFCBHBJ QFOBNQVOH MVBQBO DBJSBO ZBOH CFSMFCJI LBEBOH TFMVMBS EBMBN CFCFSBQB LPOEJTJ 4FCBHBJ DPOUPI CJMB WPMVNF
LBEBOHNFOJOHLBULBOWPMVNFTFCBOZBLMJUFS)BMJOJNF EBSBICFSLVSBOHLBSFOBQFSEBSBIBO UFLBOBOEBMBNQFNCVMVI
373
EBSBIQBSVEBO EBFSBICFSUFLBOBOSFOEBIMBJOOZBQBEBUPSBLT
Sodium intake and output

BLBO NFOVSVO NFOZFCBCLBO BLUJWBTJ SFGMFLT TJTUFN TBSBG
TJNQBUJT )BM JOJ LFNVEJBO NFOJOHLBULBO BLUJWJUBT TBSBG
(times normal)
TJNQBUJT HJOKBM ZBOH NFNQVOZBJ CFCFSBQB FGFL ZBOH
NFOVSVOLBOFLTLSFTJOBUSJVNEBOBJS
LPOTUSJLTJBOUFSJPMB Normal
HJOKBM EFOHBO IBTJM QFOVSVOBO -'( BLJCBU BLUJWBTJ TJNQBUJT
CJMB CFSBU
QFOJOHLBUBO SFBCTPSQTJ HBSBN EBO BJS PMFI
UVCVMVT EBO
QFSBOHTBOHBO QFMFQBTBO SFOJO EBO
QFOJOHLBUBOQFNCFOUVLBOBOHJPUFOTJO**EBOBMEPTUFSPO ZBOH
TFMBOKVUOZB NFOJOHLBULBO SFBCTPSQTJ UVCVMVT #JMB
QFOHVSBOHBO WPMVNF EBSBI DVLVQ CFTBS VOUVL NFOVSVOLBO (mm Hg)
UFLBOBO BSUFSJ TJTUFNJL BLUJWBTJ TJTUFN TBSBG TJNQBUJT 29-17
TFMBOKVUOZB UFSKBEJ BLJCBU QFOVSVOBO SFHBOHBO CBSPSFTFQUPS
BSUFSJZBOHUFSMFUBLEJTJOVTLBSPUJLVTEBOBSLVTBPSUB4FNVB
SFGMFLT JOJ CFSTBNBTBNB NFNBJOLBO QFSBO QFOUJOH EBMBN
QFNVMJIBO WPMVNF EBSBI TFDBSB DFQBU ZBOH UFSKBEJ EBMBN
LPOEJTJ BLVU TFQFSUJ QFSEBSBIBO #FHJUV QVMB QFOHIBNCBUBO
SFGMFLT BLUJWJUBT TJNQBUJT HJOKBM NVOHLJO UVSVU KVHB CFSQFSBO
EBMBN QFOHFMVBSBO LFMFCJIBO DBJSBO EBMBN TJSLVMBTJ TFDBSB OHJPUFOTJO ** UJOHHJ
TFQFSUJ ZBOH UFSKBEJ QBEB QBTJFO IJQFSUFOTJ
DFQBU ZBOH UFSKBEJ TFUFMBI NBLBO NBLBOBO ZBOH NFOHBOEVOH ZBOH NFOHBMBNJ HBOHHVBO LFNBNQVBO NFOVSVOLBO TFLSFTJ
CBOZBLHBSBNEBOBJS SFOJO LVSWB OBUSJVSFTJT UFLBOBO UJEBL CFHJUV DVSBN 0MFI LBSFOB
JUV CJMBBTVQBOOBUSJVNNFOJOHLBU EJQFSMVLBOQFOJOHLBUBOUFLB
Peran Angiotensin II dalam Mengatur Ekskresi OBOBSUFSJZBOHMFCJICFTBSVOUVLNFOJOHLBULBOFLTLSFTJOBUSJVN
Ginjal EBONFNQFSUBIBOLBOLFTFJNCBOHBOOBUSJVN4FCBHBJDPOUPI QB
4BMBI TBUV QFOHBUVS FLTLSFTJ OBUSJVN ZBOH QBMJOH LVBU EBMBN EB TFCBHJBO CFTBS PSBOH QFOJOHLBUBO BTVQBO OBUSJVN TFCFTBS
UVCVI BEBMBI BOHJPUFOTJO ** 1FSVCBIBO BTVQBO OBUSJVN EBO LBMJMJQBUIBOZBNFOZFCBCLBOQFOJOHLBUBOCFCFSBQBNJMJNFUFSBJS
DBJSBO CFSIVCVOHBO EFOHBO QFSVCBIBO UJNCBM CBMJL QBEB SBLTBQBEBUFLBOBOEBSBI TFEBOHLBOQBEBPSBOHZBOHUJEBLEBQBU
QFNCFOUVLBO BOHJPUFOTJO ** EBO IBM JOJ LFNVEJBO TBOHBU NFOFLBO QFNCFOUVLBO BOHJPUFOTJO ** EFOHBO UFQBU TFCBHBJ
NFNCBOUV NFNQFSUBIBOLBO LFTFJNCBOHBO OBUSJVN EBO DBJ SFTQPOT UFSIBEBQ OBUSJVN ZBOH CFSMFCJIBO QFOJOHLBUBO BTVQBO
SBO UVCVI "SUJOZB CJMB BTVQBO OBUSJVN NFOJOHLBU EJ BUBT OBUSJVN EBMBN KVNMBI ZBOH TBNB BLBO NFOZFCBCLBO UFLBOBO
OPSNBM TFLSFTJ SFOJO NFOVSVO NFOZFCBCLBO QFOVSVOBO EBSBI NFOJOHLBU TFCBOZBL NN )H +BEJ LFUJEBL NBNQVBO
QFNCFOUVLBOBOHJPUFOTJO**0MFILBSFOBBOHJPUFOTJO**NFN VOUVLNFOFLBOQFNCFOUVLBOBOHJPUFOTJO**CJMBUFSEBQBUOBUSJVN
JMJLJCFCFSBQBQFOHBSVIQFOUJOHVOUVLNFOJOHLBULBOSFBCTPS ZBOH CFSMFCJIBO BLBO NFOVSVOLBO LFNJSJOHBO LVSWB OBUSJVSFTJT
QTJOBUSJVNPMFIUVCVMVT TFQFSUJZBOHEJKFMBTLBOQBEB#BC UFLBOBO EBO NFNCVBU UFLBOBO BSUFSJ NFOKBEJ TBOHBU TFOTJUJG
QFOVSVOBOLBEBSBOHJPUFOTJO**NFOVSVOLBOSFBCTPSQTJOBUSJ UFSIBEBQHBSBN TFQFSUJZBOHEJCBIBTQBEB#BC
VNEBOBJSPMFIUVCVMVT TFIJOHHBNFOJOHLBULBOFLTLSFTJOBU 1FOHHVOBBOPCBUVOUVLNFOHIBNCBUQFOHBSVIBOHJPUFOTJO**
SJVN EBO BJS PMFI HJOKBM )BTJM BLIJSOZB BEBMBI NFNQFSLFDJM UFMBI UFSCVLUJ QFOUJOH TFDBSB LMJOJT EBMBN NFNQFSCBJLJ LFNBN
QFOJOHLBUBO WPMVNF DBJSBO FLTUSBTFMVMBS EBO UFLBOBO BSUFSJ QVBO HJOKBM VOUVL NFOHFLTLSFTJLBO HBSBN EBO BJS #JMB QFNCFO
ZBOHBLBOUFSKBEJCJMBBTVQBOOBUSJVNNFOJOHLBU UVLBOBOHJPUFOTJO**EJIBNCBUEFOHBOQFOHIBNCBUFO[JNQFOHP
4FCBMJLOZB CJMBBTVQBOOBUSJVNNFOVSVOEJCBXBIOPSNBM OWFSTJ BOHJPUFOTJO MJIBU (BNCBS
BUBV EFOHBO BOUBHPOJT
QFOJOHLBUBO LBEBS BOHJPUFOTJO ** NFOZFCBCLBO SFUFOTJ SFTFQUPS BOHJPUFOTJO ** LVSWB OBUSJVSFTJT UFLBOBO HJOKBM CFSHFTFS
OBUSJVNEBOBJS EBONFMBXBOQFOVSVOBOUFLBOBOEBSBIBSUFSJ LFUFLBOBOSFOEBIIBMJOJNFOVOKVLLBOQFOJOHLBUBOLFNBNQVBO
ZBOH BLBO UFSKBEJ +BEJ QFSVCBIBO BLUJWJUBT TJTUFN SFOJO HJOKBMVOUVLNFOHFLSFTJLBOOBUSJVNLBSFOBLBEBSOPSNBMFLTLSFTJ
BOHJPUFOTJO CFSQFSBO TFCBHBJ QFOHVBU NFLBOJTNF OBUSJVSFTJT OBUSJVN TFLBSBOH EBQBU EJQFSUBIBOLBO QBEB UFLBOBO BSUFSJ ZBOH
UFLBOBO ZBOH TBOHBU BNQVI VOUVL NFNQFSUBIBOLBO UFLBOBO ZBOH MFCJI SFOEBI 1FSHFTFSBO OBUSJVSFTJT UFLBOBO JOJ NFOKBEJ
EBSBIEBOWPMVNFDBJSBOUVCVIZBOHTUBCJM EBTBS VOUVL FGFL QFOVSVOBO UFLBOBO EBSBI LSPOJT QBEB QBTJFO
IJQFSUFOTJ EFOHBO NFOHHVOBLBO QFOHIBNCBU FO[JN QFOHPOWFSTJ
BOHJPUFOTJOEBOBOUBHPOJTSFTFQUPSBOHJPUFOTJO**
Pentingnya Perubahan Angiotensin II dalam Mengubah
Natriuresis Tekanan. 1FOUJOHOZB BOHJPUFOTJO ** EBMBN Angiotensin II yang Berlebihan Biasanya Tidak Menye-
NFNCVBU NFLBOJTNF OBUSJVSFTJTUFLBOBO NFOKBEJ MFCJI FGFLUJG babkan Peningkatan Volume Cairan Ekstraselular yang
EJUVOKVLLBO EBMBN (BNCBS 1FSIBUJLBO CBIXB CJMB Besar Karena Peningkatan Tekanan Arteri Mengimbangi
QFOHPOUSPMBO BOHJPUFOTJO UFSIBEBQ OBUSJVSFTJT CFSGVOHTJ Retensi Natrium yang Diperantarai-Angiotensin. 8BMBVQVO
TFNQVSOB LVSWB OBUSJVSFTJT UFLBOBO NFOKBEJ DVSBN LVSWB BOHJPUFOTJO**BEBMBITBMBITBUVIPSNPOQFOBIBOBJSEBOOBUSJVN
OPSNBM
ZBOH NFOVOKVLLBO CBIXB IBOZB EJQFSMVLBO TFEJLJU ZBOH QBMJOH LVBU EBMBN UVCVI QFOVSVOBO NBVQVO QFOJOHLBUBO
QFSVCBIBOUFLBOBOEBSBIVOUVLNFOJOHLBUBOFLTLSFTJOBUSJVN BOHJPUFOTJO**ZBOHCFSTJSLVMBTJUJEBLCFSQFOHBSVICFTBSUFSIBEBQ
CJMBBTVQBOOBUSJVNNFOJOHLBU WPMVNF DBJSBO FLTUSBTFMVMBS BUBV WPMVNF EBSBI TFMBNB UJEBL UFS
4FCBMJLOZB CJMBLBEBSBOHJPUFOTJOUJEBLEBQBUEJUVSVOLBO KBEJ LFHBHBMBO KBOUVOH BUBV LFHBHBMBO HJOKBM )BM JOJ LBSFOB EF
TFCBHBJSFTQPOTUFSIBEBQQFOJOHLBUBOBTVQBOOBUSJVN LVSWB OHBOQFOJOHLBUBOLBEBSBOHJPUFOTJO**ZBOHCFTBS TFQFSUJZBOH
374
UFSKBEJ QBEB UVNPS HJOKBM ZBOH NFOZFLSFTJLBO SFOJO LBEBS -OBUSJVSFTJT EBO EJVSFTJT UFLBOBO ZBOH UFSKBEJ TBBU UFLBOBO
BOHJPUFOTJO ** ZBOH UJOHHJ QBEB NVMBOZB NFOZFCBCLBO SFUFOTJ BSUFSJNFOJOHLBU
OBUSJVN EBO BJS PMFI HJOKBM EBO QFOJOHLBUBO LFDJM QBEB WPMVNF 1BEB QBTJFO EFOHBO JOTVGJTJFOTJ BESFOBM ZBOH UJEBL EBQBU
DBJSBO FLTUSBTFMVMBS )BM JOJ KVHB NFOHBXBMJ QFOJOHLBUBO UFLBOBO NFOZFLSFTJ BMEPTUFSPO EBMBN KVNMBI DVLVQ QFOZBLJU
BSUFSJ ZBOH EFOHBO DFQBU NFOJOHLBULBO FLTLSFTJ OBUSJVN EBO BJS "EEJTPO
UFSKBEJ QFOJOHLBUBO FLTLSFTJ OBUSJVN EBO BJS
UNIT V
PMFI HJOKBM EFOHBO EFNJLJBO NFOHBUBTJ QFOHBSVI QFOBIBOBO BJS QFOVSVOBO WPMVNF DBJSBO FLTUSBTFMVMBS EBO LFDFOEFSVOHBO
EBOOBUSJVNPMFIBOHJPUFOTJO**EBONFNCVBUTVBUVLFTFJNCBOHBO QFOVSVOBO UFLBOBO EBSBI 1BEB LFBEBBO ZBOH CFOBSCFOBS
LFNCBMJBOUBSBBTVQBOEBOLFMVBSBOOBUSJVNQBEBUFLBOBOEBSBI UJEBLBEBBMEPTUFSPO QFOVSVOBOWPMVNFZBOHUFSKBEJNVOHLJO
ZBOHMFCJIUJOHHJ4FCBMJLOZB TFUFMBIQFOHIBNCBUBOQFNCFOUVLBO IFCBULFDVBMJPSBOHUFSTFCVUEJQFSCPMFILBONBLBOHBSBNEBMBN
BOHJPUFOTJO ** TFQFSUJ ZBOH UFSKBEJ CJMB EJCFSJ QFOHIBNCBU FO[JN KVNMBI CFTBS EBO NJOVN CBOZBL BJS VOUVL NFOHJNCBOHJ
QFOHPOWFSTJ BOHJPUFOTJO NVMBNVMB UFSKBEJ LFIJMBOHBO OBUSJVN QFOJOHLBUBOLFMVBSBOHBSBNEBOBJSEBMBNVSJOF
EBO BJS UFUBQJ QFOVSVOBO UFLBOBO EBSBI NFMBXBO QFOHBSVI JOJ
EBOFLTLSFTJOBUSJVNLFNCBMJOPSNBM Peran ADH dalam Mengatur Ekskresi Air Ginjal
#JMBKBOUVOHNFMFNBIBUBVBEBQFOZBLJUKBOUVOH LFNBNQVBO 4FQFSUJ ZBOH EJCBIBT EBMBN #BC "%) NFNBJOLBO QFSBO
QPNQBKBOUVOHNVOHLJOUJEBLDVLVQCFTBSVOUVLNFOJOHLBULBO QFOUJOHQBEBHJOKBMVOUVLNFNCFOUVLWPMVNFVSJOFQFLBUZBOH
UFLBOBOBSUFSJVOUVLEBQBUNFOHBUBTJSFUFOTJOBUSJVNBLJCBULB TFEJLJU EBO NFOHFMVBSLBO HBSBN EBMBN KVNMBI OPSNBM
EBS UJOHHJ BOHJPUFOTJO ** QBEB LFBEBBO JOJ BOHJPUFOTJO ** EBQBU 1FOHBSVIJOJTBOHBUQFOUJOHTFMBNBLFIJMBOHBOBJS ZBOHEFOHBO
NFOZFCBCLBO SFUFOTJ OBUSJVN EBO BJS ZBOH CFTBS TFIJOHHB CFS LVBU NFSBOHTBOH QFOJOHLBUBO LBEBS "%) QMBTNB ZBOH
MBOKVU NFOKBEJ HBHBM KBOUVOH LPOHFTUJG )BNCBUBO QFNCFOUVLBO LFNVEJBO NFOJOHLBULBO SFBCTPSQTJ BJS PMFI HJOKBM EBO
BOHJPUFOTJO ** EBQBU QBEB CFCFSBQB LBTVT TFEJLJU NFOHVSBOHJ NFNCBOUVNFNQFSLFDJMQFOVSVOBOWPMVNFDBJSBOFLTUSBTFMVMBS
SFUFOTJOBUSJVNEBOBJSEBONFSFEBNQFOJOHLBUBOWPMVNFDBJSBO EBO UFLBOBO BSUFSJ ZBOH BLBO UFSKBEJ ,FIJMBOHBO BJS TFMBNB
FLTUSBTFMVMBS ZBOH CFTBS ZBOH EJLBJULBO EFOHBO LFHBHBMBO TBNQBJKBNCJBTBOZBIBOZBNFOZFCBCLBOQFOVSVOBOWPMVNF
KBOUVOH DBJSBO FLTUSBTFMVMBS EBO UFLBOBO BSUFSJ ZBOH LFDJM TBKB "LBO
UFUBQJ CJMBQFOHBSVI"%)EJIBNCBUEFOHBOPCBUZBOHCFSTJGBU
Peran Aldosteron dalam Mengatur Ekskresi Ginjal BOUBHPOJTUFSIBEBQLFSKB"%)VOUVLNFOJOHLBULBOSFBCTPSQTJ
"MEPTUFSPO NFOJOHLBULBO SFBCTPSQTJ OBUSJVN UFSVUBNB QBEB BJS EJ UVCVMVT EJTUBM EBO UVCVMVT LPMJHFOT NBTB LFIJMBOHBO BJS
UVCVMVT LPMJHFOT LPSUJLBMJT 1FOJOHLBUBO SFBCTPSQTJ OBUSJVN KVHB ZBOH TBNB BLBO NFOZFCBCLBO QFOVSVOBO WPMVNF DBJSBO
CFSLBJUBO EFOHBO QFOJOHLBUBO SFBCTPSQTJ BJS EBO TFLSFTJ LBMJVN FLTUSBTFMVMBS EBO UFLBOBO BSUFSJ ZBOH CFTBS 4FCBMJLOZB CJMB
0MFI LBSFOB JUV QFOHBSVI BLIJS BMEPTUFSPO BEBMBI NFNCVBU UFSEBQBU WPMVNF FLTUSBTFM ZBOH CFSMFCJIBO QFOVSVOBO LBEBS
HJOKBM NFSFUFOTJ OBUSJVN EBO BJS UFUBQJ NFOJOHLBULBO FLTLSFTJ "%) NFOHVSBOHJ SFBCTPSQTJ BJS PMFI HJOKBM KBEJ NFNCBOUV
LBMJVNEBMBNVSJOF NFOHIJMBOHLBOWPMVNFZBOHCFSMFCJIBOEBSJUVCVI
'VOHTJ BMEPTUFSPO EBMBN NFOHBUVS LFTFJNCBOHBO OBUSJVN
CFSIVCVOHBO FSBU EFOHBO ZBOH UFMBI EJKFMBTLBO NFOHFOBJ BOHJP Sekresi ADH yang Berlebihan Biasanya Hanya Menye-
UFOTJO ** +BEJ EFOHBO QFOVSVOBO BTVQBO OBUSJVN QFOJOHLBUBO babkan Sedikit Peningkatan pada Volume Cairan Ekstra-
LBEBS BOHJPUFOTJO ** ZBOH UFSKBEJ NFSBOHTBOH TFLSFTJ BMEPTUFSPO selularTetapi Menyebabkan Penurunan yang Besar pada
ZBOH LFNVEJBO NFNCBOUV NFOVSVOLBO FLTLSFTJ OBUSJVN VSJOF Konsentrasi Natrium. 8BMBVQVO "%) QFOUJOH EBMBN QFOHB
EBO PMFI LBSFOB JUV NFNQFSUBIBOLBO LFTFJNCBOHBO OBUSJVN UVSBOWPMVNFDBJSBOFLTUSBTFMVMBS LBEBS"%)ZBOHCFSMFCJIBO
4FCBMJLOZB QBEBBTVQBOOBUSJVNZBOHUJOHHJ IBNCBUBOQFNCFO KBSBOHNFOZFCBCLBOQFOJOHLBUBOZBOHCFTBSQBEBUFLBOBOBS
UVLBO BMEPTUFSPO NFOVSVOLBO SFBCTPSQTJ UVCVMVT NFNVOHLJO UFSJBUBVWPMVNFDBJSBOFLTUSBTFMVMBS1FNCFSJBOJOGVT"%)EB
LBO HJOKBM NFOHFLTLSFTJLBO OBUSJVN EBMBN KVNMBI ZBOH MFCJI MBN KVNMBI CFTBS LFQBEB IFXBO QBEB BXBMOZB NFOZFCBCLBO
CFTBS %FOHBO EFNJLJBO QFSVCBIBO QFNCFOUVLBO BMEPTUFSPO SFUFOTJBJSPMFIHJOKBMEBOQFOJOHLBUBOWPMVNFDBJSBOFLTUSBTF
KVHBNFNCBOUVNFLBOJTNFOBUSJVSFTJTUFLBOBOEBMBNNFNQFSUB MVMBSTFCFTBSTBNQBJQFSTFO4FXBLUVUFLBOBOBSUFSJNFOJ
IBOLBOLFTFJNCBOHBOOBUSJVNTFMBNBWBSJBTJBTVQBOOBUSJVN OHLBUTFCBHBJSFTQPOTUFSIBEBQQFOJOHLBUBOWPMVNFJOJ TFCBHJ
BOCFTBSLFMFCJIBOWPMVNFJOJEJFLTLSFTJLBOBLJCBUNFLBOJTNF
Selama Kelebihan Sekresi Aldosteron Kronis, Ginjal EJVSFTJT UFLBOBO 4FMBJO JUV QFOJOHLBUBO UFLBOBO EBSBI NFOZF
"Lepas" dari Retensi Natrium Sewaktu Tekanan Arteri CBCLBO OBUSJVSFTJT UFLBOBO EBO LFIJMBOHBO OBUSJVN EBSJ DBJSBO
.FOJOHLBU 8BMBVQVOBMEPTUFSPONFNJMJLJQFOHBSVIZBOHLVBU FLTUSBTFMVMBS 4FUFMBI QFNCFSJBO JOGVT "%) TFMBNB CFCFSBQB
UFSIBEBQSFBCTPSQTJOBUSJVN CJMBUFSEBQBUQFNCFSJBOBMEPTUFSPO IBSJ WPMVNF EBSBI EBO WPMVNF DBJSBO FLTUSBTFMVMBS NFOJOHLBU
ZBOH CFSMFCJIBO BUBV QFNCFOUVLBO BMEPTUFSPO ZBOH CFSMFCJIBO UJEBLMFCJIEBSJTBNQBJQFSTFOEBOUFLBOBOBSUFSJKVHBNFOJ
TFQFSUJ ZBOH UFSKBEJ QBEB QBTJFO EFOHBO UVNPS LFMFOKBS BESFOBM OHLBULVSBOHEBSJNN)H)BMZBOHTBNBUFSKBEJQBEBQBTJFO
TJOESPN$POO
QFOJOHLBUBOSFBCTPSQTJOBUSJVNEBOQFOVSVOBO EFOHBO TJOESPN "%) ZBOH UJEBL TFTVBJ JOBQQSPQSJBUF "%)
FLTLSFTJOBUSJVNPMFIHJOKBMCFSTJGBUTFNFOUBSB4FUFMBISFUFOTJBJS TZOESPNF
ZBOHLBEBS"%)OZBNVOHLJONFOJOHLBUCFCFSBQB
EBO OBUSJVN ZBOH CFSMBOHTVOH TBNQBJ IBSJ WPMVNF DBJSBO LBMJMJQBU
FLTUSBTFMVMBS NFOJOHLBU TFLJUBS TBNQBJ QFSTFO EBO UFSEB +BEJ LBEBS"%)ZBOHUJOHHJUJEBLNFOZFCBCLBOQFOJOHLBUBO
QBU QFOJOHLBUBO UFLBOBO EBSBI BSUFSJ TFDBSB CFSTBNBBO #JMB UF ZBOH CFTBS CBJL QBEB WPMVNF DBJSBO UVCVI NBVQVO UFLBOBO
LBOBO BSUFSJ DVLVQ NFOJOHLBU HJOKBM MFQBT EBSJ SFUFOTJ BJS EBO BSUFSJ XBMBVQVOLBEBS"%)ZBOHUJOHHJEBQBUNFOZFCBCLBOQF
OBUSJVN EBO LFNVEJBO NFOHFLTLSFTJLBO OBUSJVN EBMBN KVNMBI OVSVOBO EBQBU NFOZFCBCLBO QFOVSVOBO LPOTFOUSBTJ JPO
ZBOH TBNB EFOHBO BTVQBO TFIBSJIBSJ XBMBVQVO NBTJI UFSEBQBU OBUSJVNFLTUSBTFMZBOHCFSBU"MBTBOVOUVLLFKBEJBOJOJBEBMBI
LBEBSBMEPTUFSPOZBOHUJOHHJ1FOZFCBCVUBNBMFQBTJOJBEBMBI
375
QFOJOHLBUBO SFBCTPSQTJ BJS PMFI HJOKBM BLBO NFOHFODFSLBO

OBUSJVN TFEJLJU UFSUJOHHBM EJ CFMBLBOH BTVQBO ,FUFSMBNCBUBO
OBUSJVN FLTUSBTFM EBO QBEB XBLUV ZBOH CFSTBNBBO TFEJLJU
XBLUV UFSTFCVU NFOHBLJCBULBO TFEJLJU QFOJOHLBUBO QBEB LFTFJN
QFOJOHLBUBOUFLBOBOEBSBIZBOHUFSKBEJNFOZFCBCLBOIJMBOH
CBOHBO OBUSJVN ZBOH LVNVMBUJG ZBOH NFOZFCBCLBO TFEJLJU
OZBOBUSJVNEBODBJSBOFLTUSBTFMVMBSEBMBNVSJOFNFMBMVJOB
QFOJOHLBUBOQBEBWPMVNFDBJSBOFLTUSBTFMVMBS1FOJOHLBUBOWPMV
USJVSFTJTUFLBOBO
NF DBJSBO FLTUSBTFMVMBS ZBOH LFDJM JOJMBI ZBOH UFSVUBNB NFNJDV
1BTJFO ZBOH UFMBI LFIJMBOHBO LFNBNQVBOOZB VOUVL CFSCBHBJ NFLBOJTNF EBMBN UVCVI VOUVL NFOJOHLBULBO FLTLSFTJ
NFOZFLSFTJ"%)LBSFOBLFSVTBLBOOVLMFVTTVQSBPQUJL WPMV OBUSJVN.FLBOJTNFNFLBOJTNFJOJBEBMBITFCBHBJCFSJLVU
NFVSJOFNVOHLJONFOKBEJLBMJOPSNBM)BMJOJCJBTBOZB
IBNQJS TFMBMV EJLPNQFOTBTJ PMFI NJOVN DVLVQ CBOZBL BJS 1. "LUJWBTJ SFGMFLT SFTFQUPS CFSUFLBOBO SFOEBI ZBOH CFSBTBM EBSJ
VOUVL NFNQFSUBIBOLBO LFTFJNCBOHBO DBJSBO #JMB KVNMBI SFTFQUPSSFHBOHQBEBBUSJVNLBOBOEBOQFNCVMVIEBSBIQBSV
QFNCFSJBO BJS EJIBNCBU LFUJEBLNBNQVBO VOUVL NFOZFLSFTJ 4JOZBM EBSJ SFTFQUPS SFHBOH NFOVKV CBUBOH PUBL EBO EJ TBOB
"%)EBQBUNFOJNCVMLBOQFOVSVOBOWPMVNFEBSBIEBOUFLB NFOHIBNCBU BLUJWJUBT TBSBG TJNQBUJT HJOKBM VOUVL NFOVSVO
OBOBSUFSJZBOHOZBUB LBOSFBCTPSQTJOBUSJVNPMFIUVCVMVT.FLBOJTNFJOJNFSVQB
LBONFLBOJTNFZBOHQBMJOHQFOUJOHQBEBCFCFSBQBKBNQFSUB
Peran Peptida Natriuretik Atrium dalam Mengatur NB BUBV NVOHLJO QBEB IBSJ QFSUBNB TFUFMBI QFOJOHLBUBO
Ekskresi Ginjal BTVQBOHBSBNEBOBJSZBOHCFTBS
4FKBVI JOJ LJUB UFMBI NFNCBIBT UFSVUBNB NFOHFOBJ QFSBO 2. )BNCBUBO QFNCFOUVLBO BOHJPUFOTJO MM EJTFCBCLBO PMFI
IPSNPOIPSNPO ZBOH NFSFUFOTJ OBUSJVN EBO BJS EBMBN QFOJOHLBUBO UFLBOBO BSUFSJ EBO QFOJOHLBUBO WPMVNF DBJSBO
NFOHBUVS WPMVNF DBJSBO FLTUSBTFMVMBS "LBO UFUBQJ CFCFSBQB FLTUSBTFMVMBS ZBOHNFOVSVOLBOSFBCTPSQTJOBUSJVNEJUVCVMVT
IPSNPO OBUSJVSFUJL NVOHLJO KVHB CFSQFSBO EBMBN QFOHBUVSBO EFOHBO NFOHIJMBOHLBO QFOHBSVI OPSNBM EBSJ BOHJPUFOTJO **
WPMVNF4BMBITBUVIPSNPOOBUSJVSFUJLZBOHQBMJOHQFOUJOHBEB VOUVLNFOJOHLBULBOSFBCTPSQTJOBUSJVN1FOHVSBOHBOBOHJP
MBI QFQUJEB ZBOH EJTFCVU QFQUJEB OBUSJVSFUJL BUSJVN BUSJBM UFOTJO**KVHBNFOVSVOLBOTFLSFTJBMEPTUFSPO TFIJOHHBLFNV
OBUSJVSFUJD QFQUJEF <"/1>
ZBOH EJMFQBTLBO PMFI TFSBUTFSBU PUPU EJBONFOVSVOLBOSFBCTPSQTJOBUSJVNEJUVCVMVT
BUSJVNKBOUVOH3BOHTBOHVOUVLNFMFQBTLBOQFQUJEBJOJUBNQBL 3. 1FSBOHTBOHBO TJTUFN OBUSJVSFUJL UFSVUBNB "/1 ZBOH UVSVU
OZBCFSVQBQFOJOHLBUBOQFSFHBOHBOBUSJVN ZBOHEBQBUEJUJNCVM CFSQFSBONFOJOHLBULBOFLTLSFTJOBUSJVN+BEJ HBCVOHBOLFSKB
LBO PMFI WPMVNF EBSBI ZBOH CFSMFCJIBO 4FLBMJ EJMFQBTLBO PMFI TJTUFN OBUSJVSFUJL EBO QFOFLBOBO TJTUFN SFUFOTJ OBUSJVN EBO
BUSJVNKBOUVOH "/1NFNBTVLJTJSLVMBTJEBOCFLFSKBQBEBHJOKBM BJS BLBO NFOJNCVMLBO QFOJOHLBUBO FLTSFTJ OBUSJVN CJMB
VOUVL NFOZFCBCLBO TFEJLJU QFOJOHLBUBO -'( EBO QFOVSVOBO BTVQBO OBUSJVN NFOJOHLBU )BM ZBOH CFSMBXBOBO UFSKBEJ CJMB
SFBCTPSQTJ OBUSJVN PMFI EVLUVT LPMJHFOT (BCVOHBO LFSKB "/1 BTVQBOOBUSJVNNFOVSVOEJCBXBILBEBSOPSNBM
JOJ NFOZFCBCLBO QFOJOHLBUBO FLTLSFTJ HBSBN EBO BJS ZBOH 4. 1FOJOHLBUBO UFLBOBO BSUFSJ ZBOH LFDJM ZBOH EJTFCBCLBO PMFI
NFNCBOUVNFOHPNQFOTBTJLFMFCJIBOWPMVNFEBSBI QFOJOHLBUBO WPMVNF EBQBU UFSKBEJ BLJCBU QFOJOHLBUBO BTVQBO
1FSVCBIBO LBEBS "/1 NVOHLJO NFNCBOUV NFNQFSLFDJM OBUSJVN ZBOH CFTBS IBM JOJ NFOJOHLBULBO FLTLSFTJ OBUSJVN
QFSVCBIBO WPMVNF EBSBI TFMBNB UFSKBEJOZB CFSCBHBJ HBOHHVBO NFMBMVJ OBUSJVSFTJT UFLBOBO 4FQFSUJ ZBOH UFMBI EJCBIBT
TFQFSUJQFOJOHLBUBOBTVQBOHBSBNEBOBJS"LBOUFUBQJ QSPEVLTJ TFCFMVNOZB CJMB NFLBOJTNF TBSBG IPSNPO EBO JOUSBSFOBM
"/1ZBOHCFSMFCJIBOBUBVCBILBOUJEBLBEBOZB"/1TBNBTFLBMJ CFLFSKB FGFLUJG QFOJOHLBUBO UFLBOBO EBSBI ZBOH CFSBSUJ
UJEBLNFOZFCBCLBOQFSVCBIBOCFTBSEBMBNWPMVNFEBSBILBSFOB NVOHLJO UJEBL UFSKBEJ NFTLJQVO QFOJOHLBUBO BTVQBO OBUSJVN
FGFLFGFL JOJ EFOHBO NVEBI EBQBU EJBUBTJ PMFI QFSVCBIBO LFDJM CFTBS TFMBNB CFCFSBQB IBSJ /BNVO EFNJLJBO CJMB BTVQBO
QBEB UFLBOBO EBSBI NFMBMVJ LFSKB OBUSJVSFTJT UFLBOBO 4FCBHBJ OBUSJVN UJOHHJ EJQFSUBIBOLBO TFMBNB CFCFSBQB CVMBO BUBV
DPOUPI QFNCFSJBOJOGVT"/1EBMBNKVNMBICFTBSQBEBBXBMOZB UBIVO HJOKBM NVOHLJO SVTBL EBO LVSBOH FGFLUJG EBMBN
NFOJOHLBULBO FLTLSFTJ HBSBN EBO BJS EBMBN VSJOF EBO NFOZF NFOHFLTLSFTJ OBUSJVN TFIJOHHB NFNFSMVLBO QFOJOHLBUBO
CBCLBOWPMVNFEBSBITFEJLJUNFOVSVO%BMBNXBLUVLVSBOHEBSJ UFLBOBO EBSBI VOUVL NFNQFSUBIBOLBO JNCBOHBO OBUSJVN
KBN FGFLJOJUFMBIUFSBUBTJPMFITFEJLJUQFOVSVOBOQBEBUFLBOBO NFMBMVJNFLBOJTNFOBUSJVSFTJTUFLBOBO
EBSBI ZBOH NFOHFNCBMJLBO LFMVBSBO VSJOF LFNCBMJ OPSNBM
XBMBVQVO"/1UFSVTCFSMFCJIBO Keadaan yang Menyebabkan Peningkatan
yang Besar dari Volume Darah dan Volume
Respons yang Terintegrasi untuk Mengubah Cairan Ekstraselular
Asupan Natrium
8BMBVQVO NFLBOJTNF QFOHBUVSBO LVBU ZBOH NFNQFSUBIBOLBO
*OUFHSBTJEBSJCFSCBHBJTJTUFNLPOUSPMZBOHNFOHBUVSFLTLSFTJ WPMVNFEBSBIEBOWPMVNFDBJSBOFLTUSBTFMVMBSCJBTBOZBLPOTUBO
OBUSJVN EBO DBJSBO EBMBN LPOEJTJ OPSNBM EBQBU EJSJOHLBT BEBLFBEBBOBCOPSNBMZBOHEBQBUNFOZFCBCLBOQFOJOHLBUBOCF
EFOHBO NFNCBIBT SFTQPOT IPNFPTUBTJT UFSIBEBQ BTVQBO OB TBSQBEBLFEVBWBSJBCFMJOJ)BNQJSTFNVBLPOEJTJUFSTFCVUBEB
USJVN EBMBN NBLBOBO ZBOH NBLJO NFOJOHLBU 4FQFSUJ ZBOH MBIBLJCBUEBSJLFMBJOBOTJSLVMBTJ
UFMBI EJCBIBT TFCFMVNOZB HJOKBM NFNJMJLJ LFNBNQVBO ZBOH Peningkatan Volume Darah dan Volume Cairan
NFOHBHVNLBO EBMBN NFOZFTVBJLBO FLTLSFTJ HBSBN EBO BJS Ekstraselular yang Disebabkan oleh Penyakit Jantung
UFSIBEBQ BTVQBO ZBOH EBQBU CFSLJTBS EBSJ TFQFSTFQVMVI OJMBJ
OPSNBMTBNQBJLBMJOPSNBM
1BEBHBHBMKBOUVOHLPOHFTUJG WPMVNFEBSBIEBQBUNFOJOHLBU
Asupan Natrium yang Tinggi Menekan Sistem
TBNQBJ QFSTFO EBO WPMVNF DBJSBO FLTUSBTFMVMBS LBEBOH
Antinatriuretik dan Mengaktivasi Sistem Natriuretik. LBEBOHNFOJOHLBUTBNQBJQFSTFOBUBVMFCJI"MBTBOLFKBEJBO
4FXBLUVBTVQBOOBUSJVNNFOJOHLBU QBEBBXBMOZBLFMVBSBO JOJEBQBUEJNFOHFSUJEFOHBONFMJIBULFNCBMJ(BNCBS1B
376
EB BXBMOZB HBHBM KBOUVOH NFOVSVOLBO DVSBI KBOUVOH EBO UFSTUJTJVN ZBOH DFOEFSVOH NFOVSVOLBO WPMVNF EBSBI
BLJCBUOZB NFOVSVOLBOUFLBOBOBSUFSJ)BMJOJLFNVEJBONFOH 3FTQPOT HJOKBM QBEB LFBEBBO JOJ NJSJQ EFOHBO SFTQPOT HJOKBM
BLUJGLBOCFSCBHBJTJTUFNSFUFOTJOBUSJVN UFSVUBNBTJTUFNTJTUFN TFTVEBIUFSKBEJQFSEBSBIBO1BEBLFBEBBOJOJ HJOKBMNFSFUFOTJ
SFOJO BOHJPUFOTJO BMEPTUFSPO EBO TBSBG TJNQBUJT 4FMBJO JUV HBSBNEBOBJSTFCBHBJVTBIBVOUVLNFNVMJILBOWPMVNFEBSBI
UFLBOBO EBSBI ZBOH SFOEBI JUV TFOEJSJ NFOZFCBCLBO HJOKBM LFNCBMJ OPSNBM "LBO UFUBQJ TFCBHJBO CFTBS EBSJ DBJSBO
UNIT V
NFSFUFOTJHBSBNEBOBJS0MFILBSFOBJUV HJOKBMNFSFUFOTJWPMV UBNCBIBO CPDPS LF EBMBN JOUFSTUJTJVN ZBOH TFMBOKVUOZB
NFTFCBHBJVTBIBVOUVLNFOHFNCBMJLBOUFLBOBOBSUFSJEBODV NFOZFCBCLBOUFSKBEJOZBFEFNBMFCJIMBOKVU
SBIKBOUVOHBHBSLFNCBMJOPSNBM
#JMB HBHBM KBOUVOH UJEBL UFSMBMV CFSBU QFOJOHLBUBO WPMVNF Sindrom Nefrotik—Hilangnya Protein Plasma dalam
EBSBI TFSJOH EBQBU NFOHFNCBMJLBO DVSBI KBOUVOH EBO UFLBOBO Urine dan Retensi Natrium oleh Ginjal
BSUFSJIBNQJSLFNCBMJOPSNBM EBOFLTLSFTJOBUSJVNQBEBBLIJS .FLBOJTNF VNVN ZBOH NFOJNCVMLBO FEFNB FLTUSBTFM
OZB BLBO NFOJOHLBU LFNCBMJ OPSNBM XBMBVQVO BLBO UFSEBQBU EJCBIBT QBEB #BC 4BMBI TBUV QFOZFCBC LMJOJT FEFNB ZBOH
QFOJOHLBUBO WPMVNF DBJSBO FLTUSBTFMVMBS EBO WPMVNF EBSBI VO QBMJOHQFOUJOHBEBMBITJOESPNOFGSPUJL1BEBTJOESPNOFGSPUJL
UVL NFNQFSUBIBOLBO QFNPNQBBO KBOUVOH ZBOH MFNBI TFDBSB LBQJMFS HMPNFSVMVT NFNCPDPSLBO QSPUFJO EBMBN KVNMBICFTBS
BEFLVBU"LBOUFUBQJ CJMBKBOUVOHTBOHBUNFMFNBI UFLBOBOBSUFSJ LF EBMBN GJMUSBU EBO VSJOF BLJCBU QFOJOHLBUBO QFSNFBCJMUBT
NVOHLJOUJEBLBLBOEBQBUDVLVQNFOJOHLBUVOUVLNFNVMJILBO LBQJMFSHMPNFSVMVT5JHBQVMVITBNQBJHSBNQSPUFJOQMBTNB
FLTLSFTJ VSJOF LFNCBMJ OPSNBM #JMB IBM JOJ UFSKBEJ HJOKBM UFSVT EBQBUIJMBOHEBMBNVSJOFTFUJBQIBSJOZB LBEBOHLBEBOHNFOZF
NFSFUFOTJWPMVNFTBNQBJPSBOHUFSTFCVUCFSLFNCBOHNFOHBMBNJ CBCLBO LPOTFOUSBTJ QSPUFJO QMBTNB UVSVO TBNQBJ LVSBOH EBSJ
LPOHFTUJ TJSLVMBTJ ZBOH CFSBU EBO NVOHLJO BLIJSOZB NFOJOHHBM TFQFSUJHB OPSNBM 4FCBHBJ BLJCBU EBSJ QFOVSVOBO LPOTFOUSBTJ
LBSFOBFEFNBQBSV QSPUFJO QMBTNB UFLBOBO PTNPUJL LPMPJE QMBTNB UVSVO TBNQBJ
1BEB HBHBM NJPLBSE QFOZBLJU LBUVQ KBOUVOH EBO LFMBJOBO UJOHLBU ZBOH SFOEBI )BM JOJ NFOZFCBCLBO LBQJMFS EJ TFMVSVI
LPOHFOJUBMKBOUVOH QFOJOHLBUBOWPMVNFEBSBINFSVQBLBOTVBUV UVCVINFNGJMUSBTJTFKVNMBICFTBSDBJSBOLFEBMBNCFSCBHBJKBSJ
LPNQFOTBTJ TJSLVMBTJ ZBOH QFOUJOH ZBOH NFNCBOUV OHBO ZBOH LFNVEJBO NFOZFCBCLBO FEFNB EBO NFOVSVOLBO
NFOHFNCBMJLBO DVSBI KBOUVOH EBO UFLBOBO EBSBI LFNCBMJ WPMVNFQMBTNB
OPSNBM )BM JOJ CBILBO NFNVOHLJOLBO KBOUVOH ZBOH NFMFNBI 3FUFOTJ OBUSJVN PMFI HJOKBM QBEB TJOESPN OFGSPUJL UFSKBEJ
VOUVL NFNPNQB DVSBI KBOUVOH EBMBN LBEBS ZBOH EBQBU NFMBMVJ CFSCBHBJ NFLBOJTNF ZBOH EJBLUJWBTJ PMFI LFCPDPSBO
NFNQFSUBIBOLBOIJEVQ QSPUFJO EBO DBJSBO EBSJ QMBTNB LF DBJSBO JOUFSTUJTJBM UFSNBTVL
Peningkatan Volume Darah yang Disebabkan oleh QFSBOHTBOHBO CFSCBHBJ TJTUFN SFUFOTJ OBUSJVN TFQFSUJ TJTUFN
Peningkatan Kapasitas Sirkulasi SFOJOBOHJPUFOTJO BMEPTUFSPO EBOTJTUFNTBSBGTJNQBUJT(JOKBM
,POEJTJ BQBQVO ZBOH NFOJOHLBULBO LBQBTJUBT QFNCVMVI EBSBI UFSVTNFSFUFOTJOBUSJVNEBOBJSTBNQBJWPMVNFQMBTNBLFNCBMJ
KVHB BLBO NFOZFCBCLBO QFOJOHLBUBO WPMVNF EBSBI VOUVL NFOEFLBUJ OPSNBM "LBO UFUBQJ BLJCBU SFUFOTJ TFKVNMBI CFTBS
NFOHJTJ LBQBTJUBT FLTUSB JOJ 1FOJOHLBUBO LBQBTJUBT WBTLVMBS OBUSJVN EBO BJS LPOTFOUSBTJ QMBTNB NFOKBEJ MFCJI FODFS
NVMBNVMB NFOHVSBOHJ UFLBOBO QFOHJTJBO TJSLVMBTJ SBUBSBUB NFOZFCBCLBO MFCJI CBOZBL MBHJ DBJSBO ZBOH CPDPS LF EBMBN
MJIBU (BNCBS
ZBOH NFOZFCBCLBO QFOVSVOBO DVSBI KBSJOHBO UVCVI )BTJM BLIJS BEBMBI SFUFOTJ DBJSBO ZBOH TBOHBU
KBOUVOHEBOQFOVSVOBOUFLBOBOBSUFSJ1FOVSVOBOUFLBOBONF CBOZBL PMFI HJOKBM TBNQBJ UFSKBEJ FEFNB FLTUSBTFM ZBOH IFCBU
OZFCBCLBO SFUFOTJ HBSBN EBO BJS PMFI HJOKBM TBNQBJ WPMVNF LFDVBMJ CJMB EJCFSJLBO QFOHPCBUBO VOUVL NFNVMJILBO QSPUFJO
EBSBI DVLVQ NFOJOHLBU VOUVL NFOHJTJ LBQBTJUBT FLTUSB 1BEB QMBTNB
LFIBNJMBO QFOJOHLBUBO WBTLVMBS VUFSVT QMBTFOUB EBO PSHBO
PSHBO MBJO ZBOH NFNCFTBS QBEB UVCVI XBOJUB CJBTBOZB BLBO Sirosis Hati—Penurunan Sintesis Protein Plasma oleh
NFOJOHLBULBOWPMVNFEBSBITBNQBJQFSTFO Hati dan Retensi Natrium oleh Ginjal
%FNJLJBO KVHB QBEB QBTJFO ZBOH NFNJMJLJ WBSJTFT QFNCVMVI 4FSBOHLBJBO LFKBEJBO ZBOH TFSVQB UFSKBEJ QBEB TJSPTJT IBUJ
WFOB CFTBS EJ LBLJ ZBOH QBEB TBBU UFSUFOUV NVOHLJO NFOBIBO TFQFSUJ QBEB TJOESPN OFGSPUJL IBOZB QBEB TJSPTJT IBUJ
CFCFSBQBMJUFSEBSBIFLTUSB NBLBWPMVNFEBSBIBLBONFOJOHLBU QFOVSVOBO LPOTFOUSBTJ QSPUFJO QMBTNB EJTFCBCLBO PMFI
VOUVLNFOHJTJWBTLVMBSFLTUSB1BEBLBTVTLBTVTJOJ HBSBNEBO LFSVTBLBO TFM IBUJ TFIJOHHB NFOHVSBOHJ LFNBNQVBO IBUJ
BJSEJSFUFOTJPMFIHJOKBMTBNQBJTFMVSVIKBSJOHBOQFNCVMVIEBSBI VOUVL NFNCVBU QSPUFJO QMBTNB ZBOH DVLVQ 4JSPTJT KVHB
DVLVQ UFSJTJ VOUVL NFOJOHLBULBO UFLBOBO EBSBI TBNQBJ CBUBT NFOZFCBCLBO UFSKBEJOZB KBSJOHBO GJCSPTB ZBOH MVBT EBMBN
ZBOHEJCVUVILBOVOUVLNFOHJNCBOHJLFMVBSBODBJSBOPMFIHJOKBM KBSJOHBOIBUJ)BMJOJLFNVEJBONFOJOHLBULBOUFLBOBOLBQJMFS
EFOHBOBTVQBODBJSBOTFIBSJIBSJ EJ TFMVSVI KBSJOHBO QFNCVMVI EBSBI QPSUBM ZBOH KVHB UVSVU
CFSQFSBO QBEB LFCPDPSBO DBJSBO EBO QSPUFJO LF EBMBN SVBOH
Keadaan yang Menyebabkan Peningkatan QFSJUPOFBM TVBUVLFBEBBOZBOHEJTFCVUBTJUFT
Besar pada Volume Cairan Ekstraselular tetapi 4FLBMJDBJSBOEBOQSPUFJOIJMBOHEBSJTJSLVMBTJ SFTQPOTHJOKBM
Volume Darahnya Normal NJSJQ EFOHBO SFTQPOT ZBOH UFSMJIBU QBEB LFBEBBO MBJO ZBOH
CFSIVCVOHBO EFOHBO QFOVSVOBO WPMVNF QMBTNB 1BEB
1BEB CFCFSBQB LFBEBBO WPMVNF DBJSBO FLTUSBTFMVMBS NFOJOHLBU LFBEBBO JOJ HJOKBM UFSVT NFSFUFOTJ HBSBN EBO BJS TBNQBJ
EFOHBOOZBUBUFUBQJWPMVNFEBSBIOZBUFUBQOPSNBMBUBVCBILBO WPMVNF QMBTNB EBO UFLBOBO BSUFSJ LFNCBMJ OPSNBM 1BEB
CFSLVSBOH TFEJLJU ,FBEBBO JOJ CJBTBOZB EJBXBMJ PMFI CPDPSOZB CFCFSBQBLBTVT WPMVNFQMBTNBEBQBUCFOBSCFOBSNFOJOHLBU
DBJSBOEBOQSPUFJONBTVLLFJO
377
EJ BUBT OPSNBM BLJCBU QFOJOHLBUBO LBQBTJUBT WBTLVMBS QBEB FET5IF,JEOFZ1IZTJPMPHZBOE1BUIPQIZTJPMPHZ FE /FX:PSL
3BWFO1SFTT QQ
TJSPTJT UJOHHJOZB UFLBOBO EBMBN TJSLVMBTJ QPSUBM EBQBU TBOHBU
)BMM+&"OHJPUFOTJO**BOEMPOHUFSNBSUFSJBMQSFTTVSFSFHVMBUJPOUIFPWFS
NFMFCBSLBOWFOBTFIJOHHBNFOJOHLBULBOLBQBTJUBTWBTLVMBS EJOHEPNJOBODFPGUIFLJEOFZ +"N4PD/FQISPM 4VQQM
T
)FCFSU4$ %FTJS( (JFCJTDI( FUBM.PMFDVMBSEJWFSTJUZBOESFHVMBUJPOPG
SFOBMQPUBTTJVNDIBOOFMT 1IZTJPM3FW
)PFOEFSPQ+( #JOEFMT3+&QJUIFMJBM$BBOE.HDIBOOFMTJOIFBMUI
%BGUBS1VTUBLB BOEEJTFBTF +"N4PD/FQISPM
)VBOH$- ,VP&.FDIBOJTNPGIZQPLBMFNJBJONBHOFTJVNEFGJDJFODZ +
"QQFM-+ #SBOET.8 %BOJFMT43 FUBM%JFUBSZBQQSPBDIFTUPQSFWFOUBOE "N4PD/FQISPM
USFBUIZQFSUFOTJPOBTDJFOUJGJDTUBUFNFOUGSPNUIF"NFSJDBO)FBSU .VSFS) )FSOBOEP/ 'PSTUFS* FUBM3FHVMBUJPOPG/B1JUSBOTQPSUFSJO
"TTPDJBUJPO )ZQFSUFOTJPO UIFQSPYJNBMUVCVMF "OOV3FW1IZTJPM
"OUVOFT3PESJHVFT+ EF$BTUSP. &MJBT-- FUBM/FVSPFOEPDSJOFDPOUSPMPG 4DISJFS38%FDSFBTFEFGGFDUJWFCMPPEWPMVNFJOFEFNBUPVTEJTPSEFST
CPEZGMVJENFUBCPMJTN 1IZTJPM3FW XIBUEPFTUIJTNFBO +"N4PD/FQISPM
$PXMFZ"8+S-POHUFSNDPOUSPMPGBSUFSJBMQSFTTVSF 1IZTJPM3FW 4VLJ8/ -FEFSFS&% 3PVTF%3FOBMUSBOTQPSUPGDBMDJVNNBHOFTJVNBOE
QIPTQIBUF*O#SFOOFS#. FE5IF,JEOFZ FE 1IJMBEFMQIJB
(JFCJTDI( )FCFSU4$ 8BOH8)/FXBTQFDUTPGSFOBMQPUBTTJVN 8#4BVOEFST QQ
USBOTQPSU 1GMVHFST"SDI 4V[VLJ: -BOEPXTLJ$1 )FEJHFS.".FDIBOJTNTBOESFHVMBUJPOPG
(VZUPO"$#MPPEQSFTTVSFDPOUSPMTQFDJBMSPMFPGUIFLJEOFZTBOECPEZ FQJUIFMJBM$BBCTPSQUJPOJOIFBMUIBOEEJTFBTF "OOV3FW1IZTJPM
GMVJET 4DJFODF
(SBOHFS+1 )BMM+&3PMFPGUIFLJEOFZJOIZQFSUFOTJPO*O-JQ(:) )BMM+& 8BMM4.3FDFOUBEWBODFTJOPVSVOEFSTUBOEJOHPGJOUFSDBMBUFEDFMMT
FET$PNQSFIFOTJWF)ZQFSUFOTJPO 1IJMBEFMQIJB .PTCZ&MTFWJFS QQ $VSS0QJO/FQISPM)ZQFSUFOT
8BSOPDL%(3FOBMHFOFUJDEJTPSEFSTSFMBUFEUP,BOE.S "OOV3FW
)BMM+& (SBOHFS+1 )BMM.& FUBM1BUIPQIZTJPMPHZPGIZQFSUFOTJPO*O 1IZTJPM
)VSTUhT5IF)FBSU FE /FX:PSL .D(SBX)JMM.FEJDBM QQ 8PSDFTUFS&. $PF'-/FXJOTJHIUTJOUPUIFQBUIPHFOFTJTPGJEJPQBUIJD
IZQFSDBMDJVSJB 4FNJO/FQISPM
)BMM+& #SBOET.85IFSFOJOBOHJPUFOTJOBMEPTUFSPOFTZTUFNSFOBM :PVOH%#2VBOUJUBUJWFBOBMZTJTPGBMEPTUFSPOFhTSPMFJOQPUBTTJVN
NFDIBOJTNTBOEDJSDVMBUPSZIPNFPTUBTJT*O4FMEJO%8 (JFCJTDI( SFHVMBUJPO "N+1IZTJPM'
:PVOH%#"OBMZTJTPGMPOHUFSNQPUBTTJVNSFHVMBUJPO &OEPDS3FW

378
BAB 30
UNIT V
1FOHBUVSBO"TBN#BTB
1FOHBUVSBO JNCBOHBO JPO IJESPHFO .PMFLVM ZBOH NFOHBOEVOH BUPN IJESPHFO ZBOH EBQBU
)
EBMBNCFCFSBQBIBMTBNBEFOHBO NFMFQBTLBO JPO IJESPHFO EBMBN MBSVUBO EJTFCVU BTBN 4BMBI
QFOHBUVSBO JPO MBJO EBMBN UVCVI TBUV DPOUPIOZB BEBMBI BTBN IJESPLMPSJEB )$M
ZBOH
4FCBHBJ DPOUPI IBSVT BEB LFTFJN CFSJPOJTBTJ EBMBN BJS NFNCFOUVL JPO IJESPHFO )|
EBO JPO
CBOHBO LFTFJNCBOHBO BOUBSB BTVQBO LMPSJEB $M
%FNJLJBO KVHB BTBN LBSCPOBU )$0

BUBVQSPEVLTJ)EBSJUVCVIVOUVL CFSJPOJTBTJ EBMBN BJS NFNCFOUVL JPO )h EBO JPO CJLBSCPOBU
NFODBQBJ IPNFPTUBTJT %BO TFQFSUJ QBEB JPOJPO MBJO HJOKBM )$0

NFNBJOLBO QFSBO LVODJ EBMBN QFOHBUVSBO QFOHFMVBSBO ) #BTB BEBMBI JPO BUBV NPMFLVM ZBOH EBQBU NFOFSJNB )
"LBO UFUBQJ QFOHBUVSBO LPOTFOUSBTJ ) DBJSBO FLTUSBTFMVMBS 4FCBHBJDPOUPI )$0BEBMBITVBUVCBTBLBSFOBJPOJOJEBQBU
ZBOH UFQBU NFMJCBULBO KBVI MFCJI CBOZBL EBSJQBEB FMJNJOBTJ CFSJLBUBO EFOHBO TBUV ) VOUVL NFNCFOUVL )$0
TFEFSIBOB ) PMFI HJOKBM +VHB UFSEBQBU CFSCBHBJ NFLBOJTNF %FNJLJBOKVHB )10BEBMBITVBUVCBTBLBSFOBJPOJOJEBQBU
EBQBS BTBNCBTB ZBOH NFMJCBULBO EBSBI TFM EBO QBSV ZBOH NFOFSJNB TBUV ) VOUVL NFNCFOUVL )10 1SPUFJO EBMBN
QFOUJOH VOUVL NFNQFSUBIBOLBO LPOTFOUSBTJ ) OPSNBM EBMBN UVCVIKVHBCFSGVOHTJTFCBHBJCBTBLBSFOBCFCFSBQBBTBNBNJOP
DBJSBOFLTUSBTFMVMBSEBOJOUSBTFM ZBOH NFNCFOUVL QSPUFJO NFNJMJLJ NVBUBO OFUP OFHBUJG ZBOH
%BMBN CBC JOJ EJCBIBT CFSCBHBJ NFLBOJTNF ZBOH EBQBUEFOHBONVEBINFOFSJNB)1SPUFJOIFNPHMPCJOEBMBN
NFNCBOUV NFOHBUVS LPOTFOUSBTJ ) EFOHBO QFOFLBOBO TFM EBSBI NFSBI EBO QSPUFJO EBMBN TFM UVCVI ZBOH MBJO
LIVTVTQBEBQFOHBUVSBOTFLSFTJ)PMFIHJOKBMEBOSFBCTPSQTJ NFSVQBLBOCBTBUVCVIZBOHQBMJOHQFOUJOH
QSPEVLTJ EBO FLTLSFTJ JPO CJLBSCPOBU )$0
PMFI HJOKBM
*TUJMBI CBTB EBO BMLBMJ TFSJOH EJHVOBLBO TFCBHBJ TJOPOJN
ZBJUV TBMBI TBUV LPNQPOFO LVODJ TJTUFN QFOHBUVSBO BTBN
"MLBMJ BEBMBI TVBUV NPMFLVM ZBOH UFSCFOUVL EBSJ LPNCJOBTJ
CBTBEBMBNDBJSBOUVCVI
TBUV BUBV MFCJI MPHBN BMLBMJ OBUSJVN LBMJVN MJUJVN EBO
TFUFSVTOZBEFOHBOJPOEBTBSCBTBTFQFSUJJPOIJESPLTJM 0)

Konsentrasi H+ Diatur dengan Tepat #BHJBOCBTBEBSJNPMFLVMJOJCFSFBLTJTFDBSBDFQBUEFOHBO)
VOUVLNFOHIJMBOHLBO)EBSJMBSVUBOPMFILBSFOBJUV NFSFLB
1FOHBUVSBO ) ZBOH UFQBU TBOHBU QFOUJOH LBSFOB IBNQJS TFNVB CFSTJGBU LIBT CBTB 0MFI LBSFOB JUV JTUJMBI BMLBMPTJT BEBMBI
BLUJWJUBTTJTUFNFO[JNEBMBNUVCVIEJQFOHBSVIJPMFILPOTFOUSBTJ QFOHFMVBSBO)ZBOHCFSMFCJIBOEBSJDBJSBOUVCVI TFCBMJLOZB
) 0MFI LBSFOB JUV QFSVCBIBO LPOTFOUSBTJ ) NFOHVCBI QFOBNCBIBO)ZBOHCFSMFCJIBO EJLFOBMTFCBHBJBTJEPTJT
IBNQJSTFNVBGVOHTJTFMVSVITFMEBSJUVCVI
Asam dan Basa yang Kuat dan Lemah. "TBN LVBU
%JCBOEJOHLBO EFOHBO JPOJPO MBJO LPOTFOUSBTJ ) EBMBN BEBMBI BTBN ZBOH EBQBU DFQBU UFSVSBJ EBO NFMFQBTLBO
DBJSBO UVCVI OPSNBMOZB EJQFSUBIBOLBO QBEB UJOHLBU ZBOH UFSVUBNB TFKVNMBI CFTBS JPO ) EBMBN MBSVUBO $POUPIOZB
SFOEBI 4FCBHBJ DPOUPI LPOTFOUSBTJ OBUSJVN EBMBN DBJSBO BEBMBI )$* "TBN MFNBI LFDJM LFNVOHLJOBO VOUVL
FLTUSBTFMVMBS N&R-
BEBMBITFLJUBS KVUBLBMJMFCJICFTBS NFOHVSBJLBO JPOJPOOZB EBO PMFI LBSFOB JUV LVSBOH LVBU
EBSJLPOTFOUSBTJOPSNBM) ZBOHSBUBSBUBIBOZB N&R NFMFQBTLBO ) $POUPIOZB BEBMBI )$0 #BTB LVBU BEBMBI
-4BNBQFOUJOHOZB WBSJBTJOPSNBMLPOTFOUSBTJ)EBMBNDBJSBO CBTBZBOHCFSFBLTJDFQBUEBOLVBUEFOHBO)EBO PMFILBSFOB
FLTUSBTFMVMBS IBOZB TFLJUBS TFQFSTFKVUB WBSJBTJ OPSNBM JUV EFOHBO DFQBU NFOHIJMBOHLBOOZB EBSJ MBSVUBO $POUPI
LPOTFOUSBTJ JPO OBUSJVN /B
+BEJ LFUFQBUBO QFOHBUVSBO ) ZBOH LIBT BEBMBI 0) ZBOH CFSFBLTJ EFOHBO ) VOUVL
NFOFLBOLBOLFQFOUJOHBOOZBCBHJCFSNBDBNNBDBNGVOHTJTFM NFNCFOUVL BJS )0
#BTB MFNBI ZBOH LIBT BEBMBI )$0
LBSFOBCBTBJOJCFSJLBUBOEFOHBO)hKBVIMFCJIMFNBIEBSJQBEB
Asam dan Basa—Definisi dan Artinya 0) ,FCBOZBLBO BTBN EBO CBTB EBMBN DBJSBO FLTUSBTFMVMBS
ZBOHUFSMJCBUEBMBNQFOHBUVSBOBTBNCBTBOPSNBMBEBMBIBTBN
EBO CBTB MFNBI "TBN EBO CBTB MFNBI QBMJOH QFOUJOH ZBOH
*POIJESPHFOBEBMBIQSPUPOUVOHHBMCFCBTZBOHEJMFQBTLBOEBSJ
BLBO LJUB CBIBT TFDBSB UFSQFSJODJ BEBMBI )$0 EBO CBTB
BUPNIJESPHFO
)$0
379
Konsentrasi H+ dan pH Cairan Tubuh Normal serta Q) VSJOF EBQBU CFSLJTBS EBSJ TBNQBJ CFSHBOUVOH QBEB
Perubahan yang Terjadi pada Asidosis dan Alkalosis. TUBUVT BTBNCBTB DBJSBO FLTUSBTFMVMBS 4FQFSUJ ZBOH BLBO EJCBIBT
4FQFSUJZBOHTVEBIEJCBIBTTFCFMVNOZB LPOTFOUSBTJ) EBSBI LFNVEJBO HJOKBM CFSQFSBO QFOUJOH EBMBN NFOHPSFLTJ LFMBJOBO
OPSNBMOZB EJQFSUBIBOLBO EBMBN CBUBT LFUBU TFLJUBS OJMBJ LPOTFOUSBTJ)hDBJSBOFLTUSBTFMVMBSEFOHBONFOHFLTLSFTJLBOBTBN
OPSNBM N&R- O&R-
7BSJBTJ OPSNBM IBOZB BUBVCBTBQBEBLFDFQBUBOZBOHCFSWBSJBTJ
TFLJUBSTBNQBJO&R- UFUBQJEBMBNLPOEJTJZBOHFLTUSFN $POUPI FLTUSFN EBSJ TVBUV DBJSBO UVCVI ZBOH CFSTJGBU BTBN
LPOTFOUSBTJ ) EBQBU CFSWBSJBTJ EBSJ TFSFOEBI O&R- BEBMBI)$MZBOHEJTFLSFTJLBOLFEBMBNMBNCVOHPMFITFMPLTJOUJL
TBNQBJTFUJOHHJO&R-UBOQBNFOZFCBCLBOLFNBUJBO QBSJFUBM
EBONVLPTBMBNCVOH TFQFSUJZBOHEJCBIBTQBEB#BC
0MFILBSFOBLPOTFOUSBTJ)OPSNBMOZBSFOEBIEBOLBSFOB ,POTFOUSBTJ ) EBMBN TFM JOJ TFLJUBS KVUB LBMJ MFCJI CFTBS
KVNMBI ZBOH LFDJM JOJ UJEBL QSBLUJT CJBTBOZB LPOTFOUSBTJ ) EBSJQBEBLPOTFOUSBTJIJESPHFOEBMBNEBSBI EFOHBOQ) 1BEB
EJOZBUBLBO EBMBN TLBMB MPHBSJUNB EFOHBO NFOHHVOBLBO TJTBEBSJCBCJOJ LJUBBLBONFNCBIBTQFOHBUVSBOLPOTFOUSBTJ)
TBUVBO Q) Q) CFSIVCVOHBO EFOHBO LPOTFOUSBTJ ) ZBOH DBJSBOFLTUSBTFMVMBS
TFCFOBSOZB NFMBMVJ SVNVT CFSJLVU JOJ LPOTFOUSBTJ )
EJOZBUBLBOEBMBNFLVJWBMFOQFSMJUFS

Bertahan terhadap Perubahan Konsentrasi H+:
1
Dapar, Paru, dan Ginjal
pH log log H+
H+
4FCBHBJ DPOUPI OPSNBM <)> BEBMBI O&R 5JHB TJTUFN VUBNB NFOHBUVS LPOTFOUSBTJ ) EBMBN DBJSBO UVCVI
- &R-
0MFILBSFOBJUV Q)OPSNBMBEBMBI VOUVLNFODFHBIBTJEPTJTBUBVBMLBMPTJT
TJTUFNEBQBSBTBNCBTB
LJNJBXJEBMBNDBJSBOUVCVI ZBOHEFOHBOTFHFSBCFSJLBUBOEFOHBO
pH = −log [0.00000004]
BTBN BUBV CBTB VOUVL NFODFHBI QFSVCBIBO LPOTFOUSBTJ ) ZBOH
pH = 7.4
CFSMFCJIBO
QVTBU QFSOBQBTBO ZBOH NFOHBUVS QFNCVBOHBO
%BSJ SVNVT JOJ LJUB EBQBU NFMJIBU CBIXB Q) CFSCBOEJOH $0 EBO PMFI LBSFOB JUV )$0
EBSJ DBJSBO FLTUSBTFMVMBS EBO
UFSCBMJL EFOHBO LPOTFOUSBTJ ) PMFI LBSFOB JUV Q) ZBOH
HJOKBM ZBOH EBQBU NFOHFLTLSFTJLBO VSJOF BTBN BUBV VSJOF
SFOEBI CFSIVCVOHBO EFOHBO LPOTFOUSBTJ ) ZBOH UJOHHJ EBO BMLBMJ TFIJOHHB NFOZFTVBJLBO LFNCBMJ LPOTFOUSBTJ ) DBJSBO
Q) ZBOH UJOHHJ CFSIVCVOHBO EFOHBO LPOTFOUSBTJ ) ZBOH FLTUSBTFMVMBSNFOVKVOPSNBMTFMBNBBTJEPTJTBUBVBMLBMPTJT
SFOEBI
#JMBUFSKBEJQFSVCBIBOLPOTFOUSBTJ) TJTUFNEBQBSDBJSBOUVCVI
/JMBJ Q) OPSNBM EBSBI BSUFSJ BEBMBI TFEBOHLBO Q) CFLFSKBEBMBNXBLUVCFCFSBQBEFUJLVOUVLNFNQFSLFDJMQFSVCBIBO
EBSBI WFOB EBO DBJSBO JOUFSTUJTJBM TFLJUBS BLJCBU KVNMBI JOJ 4JTUFN EBQBS UJEBL NFOHFMVBSLBO ) EBSJ UVCVI BUBV
FLTUSB LBSCPO EJPLTJEB $0
ZBOH EJCFCBTLBO EBSJ KBSJOHBO NFOBNCBIOZB LF EBMBN UVCVI UFUBQJ IBOZB NFOKBHB BHBS JPOJPO
VOUVLNFNCFOUVL)$0 EBMBNDBJSBOJOJ 5BCFM
0MFI UFSTFGJVUUFUBQUFSJLBUTBNQBJLFTFJNCBOHBOUFSDBQBJLFNCBMJ
LBSFOBQ)OPSNBMEBSBIBSUFSJBEBMBI TFTFPSBOHEJBOHHBQ
NFOHBMBNJ BTJEPTJT CJMB Q) UVSVO EJ CBXBI OJMBJ JOJ EBO (BSJT QFSUBIBOBO LFEVB TJTUFN QFSOBQBTBO CFLFSKB EBMBN
NFOHBMBNJBMLBMPTJTCJMBQ)NFOJOHLBUEJBUBT 4FTFPSBOH CFCFSBQB NFOJU VOUVL NFOHFMVBSLBO $0 EBO PMFI LBSFOB JUV
EBQBUIJEVQMFCJIEBSJCFCFSBQBKBNEFOHBOCBUBTCBXBIQ) )$0EBSJUVCVI
TFLJUBS EBOCBUBTBUBTQ)TFLJUBS ,FEVBHBSJTQFSUBIBOBOQFSUBNBJOJNFOKBHBLPOTFOUSBTJ)EBSJ
Q) JOUSBTFM CJBTBOZB TFEJLJU MFCJI SFOEBI EBSJQBEB Q) QFSVCBIBO ZBOH UFSMBMV CFTBS TBNQBJ HBSJT QFSUBIBOBO LFUJHB ZBOH
QMBTNB LBSFOB NFUBCPMJTNF TFM NFOHIBTJMLBO BTBN UFSVUBNB CFSFBLTJ MFCJI MBNCBU ZBJUV HJOKBM EBQBU NFOHFMVBSLBO LFMFCJIBO
) $0 #FSHBOUVOH QBEB KFOJT TFM Q) DBJSBO JOUSBTFMVMBS BTBNBUBVCBTBEBSJUVCVI8BMBVQVOHJOKBMSFMBUJGMBNCBUNFNCFSJ
EJQFSLJSBLBO CFSLJTBS BOUBSB EBO )JQPLTJB KBSJOHBO SFTQPOT EJCBOEJOHLBO EFOHBO QFSUBIBOBO MBJO HJOKBM NFSVQBLBO
EBO BMJSBO EBSBI ZBOH CVSVL LF KBSJOHBO EBQBU NFOZFCBCLBO TJTUFN QFOHBUVS BTBNCBTB ZBOH QBMJOH LVBU ZBOH CFLFSKB TFMBNB
BLVNVMBTJBTBNEBOEBQBUNFOVSVOLBOQ)JOUSBTFM CFCFSBQBKBNTBNQBJCFCFSBQBIBSJ
5BCFMQ)EBO,POTFOUSBTJ)EBMBN$BJSBO5VCVI
Pendaparan H+ dalam Cairan Tubuh
,POTFOUSBTJ) N&R-
Q) %BQBSBEBMBI[BUBQBQVOZBOHTFDBSBSFWFSTJCFMEBQBUNFOHJLBU)
#FOUVLVNVNEBSJSFBLTJEBQBSBEBMBI
$BJSBOJOUSBTFMVMBS
%BSBIBSUFSJ 4.0 × 10 5
7.40
%BQBS H +
H %BQBS
%BSBIWFOB 4.5 × 10 5
7.35
$BJSBOJOUFSTUJTJBM 4.5 × 10 5 7.35 1BEB DPOUPI JOJ ) CFCBT CFSJLBUBO EFOHBO EBQBS VOUVL
$BJSBOJOUSBTFMVMBS
NFNCFOUVL BTBN MFNBI EBQBS )
ZBOH EBQBU UFUBQ TFCBHBJ
1 × 10 3 to 4 × 10 5
6.0-7.4
NPMFLVM ZBOH UJEBL CFSEJTPTJBTJ NBVQVO ZBOH CFSEJTPTJBTJ
6SJOF 3 × 10 to 1 × 10
2 5
4.5-8.0 LFNCBMJ NFOKBEJ EBQBS EBO ) #JMB LPOTFOUSBTJ ) NFOJOHLBU
)$MMBNCVOH 160 0.8 SFBLTJEJQBLTBCFSHFTFSLFLBOBOEBOMFCJICBOZBL)hZBOH
380
Bab 30 Pengaturan Asam-Basa
ZBOH CFSJLBUBO EFOHBO EBQBS TFMBNB EBQBS NBTJI UFSTFEJB 4FCBHBJ IBTJMOZB MFCJI CBOZBL )$0 ZBOH EJCFOUVL
4FCBMJLOZB CJMBLPOTFOUSBTJ) NFOVSVO SFBLTJCFSHFTFSLFBSBI NFOZFCBCLBOQFOJOHLBUBOQSPEVLTJ$0EBO)0%BSJSFBLTJ
LJSJ EBO ) EJMFQBTLBO EBSJ EBQBS %FOHBO DBSB JOJ QFSVCBIBO JOJ LJUB EBQBU NFMJIBU CBIXB ) EBSJ BTBN LVBU ZBJUV )$*
LPOTFOUSBTJ)EJQFSLFDJM CFSFBLTJ EFOHBO )$0 VOUVL NFNCFOUVL BTBN ZBOH TBOHBU
,JUB BLBO NFOZBEBSJ QFOUJOHOZB EBQBS DBJSBO UVCVI EFOHBO MFNBI ZBJUV )$0 ZBOH LFNVEJBO NFNCFOUVL $0 EBO
UNIT V
DFQBU CJMB LJUB NFOHJOHBU LPOTFOUSBTJ ) ZBOH SFOEBI EJ DBJSBO )0 $0 ZBOH CFSMFCJIBO TBOHBU NFSBOHTBOH QFSOBQBTBO
UVCVI EBO KVNMBI QSPEVLTJ BTBN ZBOH SFMBUJG CFTBS PMFI UVCVI ZBOHNFOHFMVBSLBO$0EBSJDBJSBOFLTUSBTFMVMBS
TFUJBQ IBSJOZB 4FCBHBJ DPOUPI TFLJUBS NJMJFLVJWBMFO ) 3FBLTJ ZBOH TFCBMJLOZB UFSKBEJ CJMB TVBUV CBTB LVBU TFQFSUJ
EJNBLBO BUBV EJQSPEVLTJ TFUJBQ IBSJ NFMBMVJ NFUBCPMJTNF OBUSJVN IJESPLTJEB /B0)
EJUBNCBILBO LF EBMBN MBSVUBO
TFEBOHLBO LPOTFOUSBTJ ) EBMBN DBJSBO UVCVI OPSNBMOZB IBOZB EBQBSCJLBSCPOBU
TFLJUBS N&R-5BOQBQFOEBQBSBO QSPEVLTJEBOBTVQBO
BTBN TFIBSJIBSJOZB BLBO NFOZFCBCLBO QFSVCBIBO CFTBS QBEB NaOH + H2CO3 Æ NaHCO3 + H2O
LPOTFOUSBTJ)DBJSBOUVCVI %BMBN IBM JOJ 0) EBSJ /B0) CFSJLBUBO EFOHBO )$0
,FSKB EBQBS BTBNCBTB LFNVOHLJOBO EBQBU EJKFMBTLBO QBMJOH VOUVL NFNCFOUVL )$0 UBNCBIBO +BEJ CBTB MFNBI
CBJL EFOHBO NFNJLJSLBO TJTUFN EBQBS ZBOH TFDBSB LVBOUJUBUJG /B)$0 NFOHHBOUJLBO CBTB LVBU /B0) 1BEB XBLUV ZBOH
QBMJOH QFOUJOH EBMBN DBJSBO FLTUSBTFMVMBS TJTUFN EBQBS CFSTBNBBO LPOTFOUSBTJ )$0 NFOVSVO LBSFOB CFSFBLTJ
CJLBSCPOBU EFOHBO /B0)
NFOZFCBCLBO MFCJI CBOZBL $0 CFSJLBUBO
EFOHBO)VOUVLNFOHHBOUJLBO)$0
Sistem Dapar Bikarbonat CO2 + H2O H2CO3 HCO3−+ H+

4JTUFNEBQBSCJLBSCPOBUUFSEJSJBUBTMBSVUBOBJSZBOHNFOHBOEVOH NaOH Na
EVB VOTVS
BTBN MFNBI )$0 EBO
HBSBN CJLBSCPOBU 0MFI LBSFOB JUV IBTJM BLIJSOZB BEBMBI LFDFOEFSVOHBO
TFQFSUJ/B)$0 QFOVSVOBO LBEBS $0 EBMBN EBSBI UFUBQJ QFOVSVOBO $0
)$0EJCFOUVLEBMBNUVCVIPMFISFBLTJ$0EFOHBO)0 EBMBN EBSBI NFOHIBNCBU QFSOBQBTBO EBO NFOVSVOLBO MBKV
,BSCPOJL
FLTQJSBTJ $0 1FOJOHLBUBO )$0 ZBOH UFSKBEJ EBMBN EBSBI
BOIJESBTF EJLPNQFOTBTJPMFIQFOJOHLBUBOFLTLSFTJ)$0PMFIHJOKBM
CO2 + H2O H2CO3
3FBLTJ JOJ MBNCBU EBO TBOHBU TFEJLJU KVNMBI )$0 ZBOH Dinamika Kuantitatif Sistem Dapar Bikarbonat 4BNQBJ CBUBT
UFSUFOUV TFNVB BTBN UFSNBTVL )$0 EJJPOJTBTJ #FSEBTBSLBO
EJCFOUVL LFDVBMJ CJMB BEB FO[JN BOIJESBTF LBSCPOBU &O[JN JOJ
QFSUJNCBOHBO LFTFJNCBOHBO NBTTB LPOTFOUSBTJ ) EBO )$0
TBOHBU CBOZBL UFSVUBNB EJ EJOEJOH BMWFPMJ QBSV UFNQBU $0
TFCBOEJOHEFOHBOLPOTFOUSBTJ)$0
EJMFQBTLBO BOIJESBTF LBSCPOBU KVHB EJUFNVLBO EJ TFM FQJUFM
UVCVMVT HJOKBM UFNQBU $0 CFSFBLTJ EFOHBO )0 VOUVL H2CO3 Æ H ++ HCO3−
NFNCFOUVL)$0
6OUVLBTBNBQBQVO QFSCBOEJOHBOLPOTFOUSBTJBTBNEFOHBO
)$0CFSJPOJTBTJTFDBSBMFNBIVOUVLNFNCFOUVL JPOJPOEJTPTJBTJOZBEJUFOUVLBOPMFILPOTUBOUBEJTPTJBTJ,
TFKVNMBILFDJM)EBO)$0 H + × HCO3−
K ¢= (1)
H2CO3 Æ H+ + HCO3− H2CO3
,PNQPOFO LFEVB EBSJ TJTUFN ZBJUV HBSBN CJLBSCPOBU 1FSTBNBBOJOJNFOVOKVLLBOCBIXBEBMBNMBSVUBO)$0

UFSVUBNB UFSEBQBU TFCBHBJ OBUSJVN CJLBSCPOBU /B)$0
EBMBN KVNMBI)CFCBTTBNBEFOHBO
DBJSBO FLTUSBTFMVMBS /B)$0 UFSJPOJTBTJ IBNQJS MFOHLBQ VOUVL H2CO3
NFNCFOUVL JPO CJLBSCPOBU )$0
EBO JPOJPO OBUSJVN /B
H+ = K¢ × (2)
HCO3−
TFCBHBJCFSJLVU
NaHCO3 ¨ Na+ + HCO3−
,POTFOUSBTJ )$0 ZBOH UJEBL CFSEJTPTJBTJ UJEBL EBQBU EJVLVS
4FLBSBOH EFOHBONFNBTVLLBOTFNVBTJTUFNCFSTBNB EBMBN MBSVUBO LBSFOB EFOHBO DFQBU CFSEJTPTJBTJ NFOKBEJ $0 EBO
TBNB LJUBBLBONFOEBQBULBOTFCBHBJCFSJLVU )0 BUBV NFOKBEJ ) EBO )$0 "LBO UFUBQJ $0 ZBOH UFSMBSVU
EBMBN EBSBI CFSCBOEJOH MVSVT EFOHBO KVNMBI ) $0 ZBOH UJEBL
CO2 + H2O H2CO3 Æ H+ + HCO3− CFSEJTPTJBTJ 0MFI LBSFOB JUV QFSTBNBBO EBQBU EJUVMJT LFNCBMJ
Ï
Ì
Ó
+ TFCBHBJ CO2
Na+ H+ = K × (3)
HCO3−
"LJCBUMFNBIOZBQFOHVSBJBO)$0 LPOTFOUSBTJ)
NFOKBEJTBOHBULFDJM ,POTUBOUBEJTPTJBTJ ,
VOUVLQFSTBSOBBOIBOZBTFLJUBS
EBSJ LPOTUBOUB EJTPTJBTJ ,
QBEB QFSTBNBBO LBSFOB SBTJP
#JMB BTBN LVBU TFQFSUJ )$M EJUBNCBILBO LF EBMBN MBSVUBO LFTFJNCBOHBOBOUBSB)$0EBO$0BEBMBI
EBQBS CJLBSCPOBU QFOJOHLBUBO ) ZBOH EJMFQBTLBO EBSJ BTBN 1FSTBNBBO EJUVMJT TFCBHBJ KVNMBI UPUBM $0 ZBOH UFSMBSVU
)$*Ȕ)$*
EJEBQBSPMFI)$0 EBMBN MBSVUBO "LBO UFUBQJ LFCBOZBLBO MBCPSBUPSJVN LMJOJT MFCJI
NFOHVLVS UFLBOBO $0 EBSBI 1$0
EBSJQBEB KVNMBI $0 ZBOH
≠H+ + HCO3 Æ H2CO3 Æ CO2 + H2O TFCFOBSOZB6OUVOHOZB KVNMBI$0EBMBNEBSBINFSVQBLBO
381
GVOHTJMJOJFSEBSJ1$0 EJLBMJLBOLPFGJTJFOLFMBSVUBOVOUVL$0 EBMBN #JMB HBOHHVBO LFTFJNCBOHBO BTBNCBTB BEBMBI BLJCBU QFSVCBIBO
LFBEBBO GJTJPMPHJT LPFGJTJFO LFMBSVUBO VOUVL $0 BEBMBI NNPM QSJNFS LPOTFOUSBTJ )$0 DBJSBO FLTUSBTFMVMBS HBOHHVBO UFSTFCVU
NN )H QBEB TVIV UVCVI *OJ CFSBSUJ NNPM )$0 UFSEBQBU EJTFCVUHBOHHVBOBTBNCBTBNFUBCPMJL0MFILBSFOBJUV BTJEPTJTZBOH
EBMBNEBSBIVOUVLTFUJBQNN)H1$0 ZBOHUFSVLVS0MFITFCBCJUV EJTFCBCLBO PMFI QFOVSVOBO QSJNFS LPOTFOUSBTJ )$0 EJTFCVU
QFSTBNBBOEBQBUEJUVMJTVMBOHTFCBHBJ BTJEPTJT NFUBCPMJL TFEBOHLBO BMLBMPTJT ZBOH EJTFCBCLBO PMFI
QFOJOHLBUBO QSJNFS QBEB LPOTFOUSBTJ )$0 EJTFCVU BMLBMPTJT
NFUBCPMJL"TJEPTJTZBOHEJTFCBCLBOPMFIQFOJOHLBUBO1$0EJTFCVU
(0.03 × Pco2 ) BTJEPTJT SFTQJSBUPSJL TFEBOHLBO BMLBMPTJT ZBOH EJTFCBCLBO PMFI
H+ = K × (4)
HCO3− QFOVSVOBO1$0 EJTFCVUBMLBMPTJTSFTQJSBUPSJL
Persamaan Henderson-Hasselbalch 4FQFSUJ ZBOH TVEBI Kurva Titrasi Sistem Dapar Bikarbonat. (BNCBS
EJCBIBTTFCFMVNOZB LPOTFOUSBTJ)hMFCJICJBTBEJOZBUBLBOEBMBNVOJU NFOVOKVLLBOQFSVCBIBOQ)DBJSBOFLTUSBTFMVMBSLFUJLBSBTJP)$0
Q)EBSJQBEBEBMBNLPOTFOUSBTJZBOHTFCFOBSOZB*OHBULFNCBMJCBIXB UFSIBEBQ $0 DBJSBO FLTUSBTFMVMBS EJVCBI #JMB LPOTFOUSBTJ LFEVB
Q)EJOZBUBLBOTFCBHBJQ)MPH) LPNQPOFOJOJTBNBCFTBS TJTJTFCFMBILBOBOQFSTBNBBONFOKBEJMPH
,POTUBOUBEJTPTJBTJEBQBUEJOZBUBLBOEFOHBODBSBZBOHTFSVQB ZBOHTBNBEFOHBO0MFILBSFOBJUV CJMBLFEVBLPNQPOFOTJTUFN
EBQBS TBNB Q) MBSVUBO TBNB EFOHBO Q,
QBEB TJTUFN EBQBS
CJLBSCPOBU #JMB EJUBNCBILBO CBTB LF EBMBN TJTUFN TFCBHJBO $0
pK = - log K ZBOHUFSMBSVUEJVCBINFOKBEJ)$0 NFOZFCBCLBOQFOJOHLBUBOSBTJP
0MFI LBSFOB JUV LJUB EBQBU NFOZBUBLBO LPOTFOUSBTJ )h QBEB )$0 UFSIBEBQ $0 EBO QFOJOHLBUBO Q) TFQFSUJ ZBOH UFSMJIBU EBSJ
QFSTBNBBOEBMBNVOJUQ)EFOHBONFOHBNCJMMPHBSJUNBOFHBUJGEBSJ QFSTBNBBO )FOEFSTPO)BTTFMCBMDI #JMB EJUBNCBILBO BTBN TJTUFN
QFSTBNBBOUFSTFCVU ZBOHNFOHIBTJMLBO EJEBQBS PMFI )$0 ZBOH LFNVEJBO EJVCBI NFOKBEJ $0 UFSMBSVU
NFOVSVOLBO SBTJP )$0 UFSIBEBQ $0 EBO NFOVSVOLBO Q) DBJSBO
(0.03 × Pco2) FLTUSBTFMVMBS
−log H+ = −log pK − log (5)
HCO3−
0MFILBSFOBJUV "Kekuatan Dapar" Ditentukan oleh Jumlah dan Kon-

(0. 03 × Pco2 ) sentrasi Relatif dari Komponen Dapar.%BSJLVSWBUJUSBTJQBEB
pH = pK − log (6) (BNCBS UFSMJIBUCFCFSBQBIBM1FSUBNB Q)TJTUFNTBNBEFOHBO
HCO3−
Q,LFUJLBNBTJOHNBTJOHLPNQPOFO )$0EBO$0
NFSVQBLBO
%BSJQBEB CFLFSKB EFOHBO TVBUV MPHBSJUNB OFHBUJG LJUB EBQBU QFSTFO LPOTFOUSBTJ UPUBM TJTUFN EBQBS ,FEVB TJTUFN EBQBS QBMJOH
NFOHVCBI UBOEB MPHBSJUNB EBO NFNCBMJL QFNCJMBOH EBO QFOZFCVU FGFLUJGQBEBCBHJBOUFOHBILVSWB UFNQBUQ)NFOEFLBUJQ,TJTUFN*OJ
EBMBN QFSTBNBBO UFSBLIJS EFOHBO NFOHHVOBLBO IVLVN MPHBSJUNB CFSBSUJCBIXBQFSVCBIBOQ)VOUVLTFUJBQKVNMBIUFSUFOUVQFOBNCBIBO
TFIJOHHBNFOHIBTJMLBO BTBN BUBV CBTB LF TJTUFN BEBMBI UFSLFDJM CJMB OJMBJ Q) EFLBU OJMBJ Q,
TJTUFN4JTUFNEBQBSNBTJIBHBLFGFLUJGVOUVLVOJUQ) QBEBLFEVB
HCO3− TJTJ Q, TFEBOHLBO VOUVL TJTUFN EBQBS CJLBSCPOBU CFSLJTBS EBO Q)
pH = pK + log (7)
(0. 03 × Pco2 ) TFLJUBS IJOHHB VOJU %J MVBS CBUBT JOJ LFLVBUBO EBQBS EFOHBO
DFQBUCFSLVSBOH#JMBTFNVB$0UFMBIEJVCBINFOKBEJ)$0BUBVCJMB
6OUVLTJTUFNEBQBSCJLBSCPOBU Q,BEBMBI EBOQFSTBNBBO TFNVB)$0UFMBIEJVCBINFOKBEJ$0 TJTUFNUJEBLMBHJNFNQVOZBJ
EBQBUEJUVMJTTFCBHBJ LFLVBUBOEBQBS
HCO3− ,POTFOUSBTJNVUMBLEBQBSKVHBNFSVQBLBOGBLUPSQFOUJOHEBMBN
pH = 6.1 + log (8)
0. 03 × Pco2 NFOFOUVLBO LFLVBUBO EBQBS TVBUV TJTUFN 1BEB LPOTFOUSBTJ EBQBS
ZBOH SFOEBI IBOZB EFOHBO QFOBNCBIBO TFKVNMBI LFDJM BTBN BUBV
1FSTBNBBO BEBMBI QFSTBNBBO )FOEFSTPO)BTTFMCBMDI EBO CBTBLFEBMBNMBSVUBOEBQBUTBOHBUNFOHVCBIQ)
EFOHBOQFSTBNBBOUFSTFCVU LJUBEBQBUNFOHIJUVOHQ)TVBUVMBSVUBO
CJMBLPOTFOUSBTJNPMBS)$0EBO1$0EJLFUBIVJ
%BSJ QFSTBNBBO )FOEFSTPO)BTTFMCBMDI KFMBTMBI CBIXB
QFOJOHLBUBO LPOTFOUSBTJ )$0 NFOZFCBCLBO Q) NFOJOHLBU
0 100
NFOHHFTFS LFTFJNCBOHBO BTBNCBTB NFOVKV BMLBMPTJT 1FOJOHLBUBO
1$0 NFOZFCBCLBO Q) NFOVSVO NFOHHFTFS LFTFJNCBOHBO BTBN
CO2
CBTBNFOVKVBTJEPTJT 25 75
1FSTBNBBO )FOEFSTPO)BTTFMCBMDI TFMBJO VOUVL NFOFOUVLBO
GBLUPSGBLUPSQFOFOUVQFOHBUVSBOQ)OPSNBMEBOLFTFJNCBOHBOBTBN
HCO3–
CBTBEBMBNDBJSBOFLTUSBTFMVMBS KVHBNFNCFSJLBOHBNCBSBONFOHFOBJ 50 50
LPOUSPMGJTJPMPHJTLPNQPTJTJBTBNEBOCBTBDBJSBOFLTUSBTFMVMBS4FQFSUJ pK
ZBOHBLBOEJCBIBTLFNVEJBO LPOTFOUSBTJ)$0EJBUVSUFSVUBNBPMFI
75 25
HJOKBM TFEBOHLBO 1$0 EBMBN DBJSBO FLTUSBTFMVMBS EJBUVS PMFI MBKV
QFSOBQBTBO %FOHBO NFOJOHLBULBO MBKV QFSOBQBTBO QBSV
P
NFOHFMVBSLBO$0 EBSJQMBTNB EBOEFOHBONFOVSVOLBOQFSOBQBTBO 100 0

QBSV NFOJOHLBULBO 1$0 )PNFPTUBTJT BTBNCBTB GJTJPMPHJT OPSNBM 4 5 6 7 8
BEBMBI IBTJM VTBIB EBSJ QBSV EBO HJOKBM ZBOH UFSLPPSEJOBTJ EBO pH
HBOHHVBO BTBNCBTB UFSKBEJ CJMB TBMBI TBUV BUBV LFEVB NFLBOJTNF
QFOHBUVS JOJ UFSHBOHHV TFIJOHHB JOFOHVCBI LPOTFOUSBTJ )$0 BUBV
1$0EBMBNDBJSBOFLTUSBTFMVMBS
382
Sistem Dapar Bikarbonat merupakan Dapar Ekstrasel UVCVMVT HJOKBM VOUVL EVB BMBTBO CFSJLVU
GPTGBU CJBTBOZB
yang Paling Penting. %BSJ LVSWB UJUSBTJ ZBOH EJUVOKVLLBO QBEB NFOKBEJ TBOHBU QFLBU EBMBN UVCVMVT TFIJOHHB NFOJOHLBULBO
(BNCBS LJUBUJEBLBLBONFOZBOHLBTJTUFNEBQBSCJLBSCPOBU LFLVBUBO EBQBS TJTUFN GPTGBU EBO
DBJSBO UVCVMVT CJBTBOZB
TBOHBU LVBU LBSFOB EVB BMBTBO CFSJLVU 1FSUBNB Q) DBJSBO NFNQVOZBJQ)ZBOHMFCJISFOEBIEBSJQBEBDBJSBOFLTUSBTFMVMBS
FLTUSBTFMVMBS TFLJUBS TFEBOHLBO Q, TJTUFN EBQBS CJLBSCPOBU TFIJOHHBLJTBSBOLFSKBEBQBSMFCJINFOEFLBUJQ,
TJTUFN
UNIT V
BEBMBI )BMJOJCFSBSUJUFSEBQBUTJTUFNEBQBSCJLBSCPOBUEBMBN
4JTUFN EBQBS GPTGBU KVHB QFOUJOH EBMBN QFOEBQBSBO DBJSBO
CFOUVL )$0 TFCBOZBL LBMJ MFCJI CFTBS EBSJQBEB CFOUVL $0
JOUSBTFMVMBSLBSFOBLPOTFOUSBTJGPTGBUEBMBNDBJSBOJOJCFCFSBQB
ZBOH UFSMBSVU 0MFI LBSFOB BMBTBO JOJ TJTUFN UFSTFCVU CFLFSKB QBEB
LBMJMFCJICFTBSEBSJQBEBEBMBNDBJSBOFLTUSBTFMVMBS4FMBJOJUV
CBHJBO LVSWB EBQBS ZBOH LFDVSBNBOOZB SFOEBI EBO LFLVBUBO
Q) DBJSBO JOUSBTFMVMBS MFCJI SFOEBI EBSJQBEB Q) DBJSBO
EBQBSOZB MFNBI ,FEVB LPOTFOUSBTJ LFEVB VOTVS TJTUFN
FLTUSBTFMVMBSEBOPMFILBSFOBJUVCJBTBOZBMFCJINFOEFLBUJQ,
CJLBSCPOBU ZBJUV$0EBO)$0 UJEBLCFTBS
TJTUFNEBQBSGPTGBUEJCBOEJOHLBOEFOHBODBJSBOFLTUSBTFMVMBS
8BMBVQVOTJTUFNEBQBSCJLBSCPOBUNFNJMJLJDJSJDJSJUFSTFCVU
TJTUFN EBQBS CJLBSCPOBU NFSVQBLBO EBQBS FLTUSBTFM ZBOH QBMJOH
LVBU EBMBN UVCVI 4JGBU ZBOH KFMBT CFSMBXBOBO JOJ UFSVUBNB Protein merupakan Dapar Intrasel yang Penting.
CFSIVCVOHBOEFOHBOLFOZBUBBOCBIXBLFEVBVOTVSTJTUFNEBQBS
)$0 EBO $0 EJBUVS NBTJOHNBTJOH PMFI HJOKBM EBO QBSV 1SPUFJOUFSNBTVLEBQBSZBOHQBMJOHCBOZBLEBMBNUVCVILBSFOB
TFQFSUJBLBOEJCBIBTLFNVEJBO4FCBHBJIBTJMEBSJQFOHBUVSBOJOJ LPOTFOUSBTJOZBZBOHUJOHHJ UFSVUBNBEJEBMBNTFM
Q)DBJSBOFLTUSBTFMVMBSEBQBUEJBUVSEFOHBOUFQBUPMFILFDFQBUBO
Q) TFM XBMBVQVO TFEJLJU MFCJI SFOEBI EBSJQBEB Q) EBMBN
SFMBUJG QFOHFMVBSBO EBO QFOBNCBIBO )$0 PMFI HJOKBM EBO
DBJSBO FLTUSBTFMVMBS OBNVO QFSVCBIBOOZB LJSBLJSB TFCBOEJOH
LFDFQBUBOQFOHFMVBSBO$0PMFIQBSVQBSV
EFOHBO QFSVCBIBO Q) DBJSBO FLTUSBTFMVMBS "EB TFEJLJU ) EBO
)$0ZBOHCFSEJGVTJNFMBMVJNFNCSBOTFM XBMBVQVOJPOJPO
Sistem Dapar Fosfat JOJ NFNCVUVILBO XBLUV CFCFSBQB KBN VOUVL NFOKBEJ
TFJNCBOH EFOHBO DBJSBO FLTUSBTFMVMBS LFDVBMJ LFTFJNCBOHBO
8BMBVQVO TJTUFN EBQBS GPTGBU UJEBL CFSQFSBO QFOUJOH TFCBHBJ DFQBU ZBOH UFSKBEJ EJ EBMBN TFM EBSBI NFSBI "LBO UFUBQJ $0
EBQBS DBJSBO FLTUSBTFMVMBS TJTUFN EBQBS JOJ CFSQFSBO QFOUJOH EBQBU EFOHBO DFQBU CFSEJGVTJ NFMBMVJ TFNVB NFNCSBO TFM
EBMBNQFOEBQBSBODBJSBOUVCVMVTHJOKBMEBODBJSBOJOUSBTFMVMBS %MGVTJ VOTVS TJTUFN EBQBS CJLBSCPOBU NFOZFCBCLBO Q) DBJSBO
JOUSBTFMVMBS CFSVCBI LFUJLB UFSKBEJ QFSVCBIBO Q) DBJSBO
6OTVS VUBNB EBMBN TJTUFN EBQBS GPTGBU BEBMBI )10 EBO FLTUSBTFMVMBS0MFILBSFOBBMBTBOJOJ TJTUFNEBQBSEJEBMBNTFM
)10 #JMB TVBUV BTBN LVBU TFQFSUJ )$* EJUBNCBILBO LF EBMBN NFNCBOUVNFODFHBIQFSVCBIBOQ)DBJSBOFLTUSBTFMVMBSUFUBQJ
DBNQVSBOLFEVB[BUJOJ IJESPHFOEJUFSJNBPMFICBTB)10EBO NVOHLJO NFNCVUVILBO XBLUV CFCFSBQB KBN VOUVL NFOKBEJ
EJVCBINFOKBEJ)10 FGFLUJGTFDBSBNBLTJNBM
HCl + Na2HPO4 Æ NaH2PO4 + NaCl %BMBNTFMEBSBINFSBI IFNPHMPCJO )C
BEBMBIEBQBSZBOH
)BTJM EBSJ SFBLTJ JOJ BTBN LVBU ZBJUV )$* EJHBOUJLBO PMFI QFOUJOHTFCBHBJCFSJLVU
TFKVNMBI BTBN MFNBI UBNCBIBO /B)10 EBO QFOVSVOBO Q) H+ + Hb HHb
NFOKBEJ NJOJNBM #JMB TVBUV CBTB LVBU TFQFSUJ /B0)
EJUBNCBILBO LF EBMBN TJTUFN EBQBS 0) EJEBQBS PMFI )10 ,JSBLJSB TBNQBJ QFSTFO EBQBS LJNJB UPUBM DBJSBO
VOUVLNFNCFOUVLTFKVNMBI)10)0UBNCBIBO UVCVI CFSBEB EBMBN TFMTFM ZBOH TFCBHJBO CFTBS EJIBTJMLBO
EBSJ QSPUFJO JOUSBTFM "LBO UFUBQJ LFDVBMJ VOUVL TFMTFM EBSBI
#JMBTVBUVCBTBLVBU TFQFSUJ/B0) EJUBNCBILBOLFEBMBNTJTUFN
NFSBI MBNCBUOZB QFSHFSBLBO ) EBO )$0 NFMBMVJ
EBQBS 0)EJEBQBSPMFI)10VOUVLNFNCFOUVLTFKVNMBI)10
NFNCSBO TFM TFSJOH NFNQFSMBNCBU TBNQBJ CFCFSBQB KBN
)0UBNCBIBO
LFNBNQVBO NBLTJNBM QSPUFJO JOUSBTFM VOUVL NFOEBQBS
NaOH + NaH2PO4 Æ Na2HPO4 + H2O HBOHHVBOBTBNCBTBFLTUSBTFM
%BMBN LFBEBBO JOJ TVBUV CBTB LVBU /B0) EJUVLBS EFOHBO 4FMBJO LPOTFOUSBTJ QSPUFJO ZBOH UJOHHJ EBMBN TFM GBLUPS MBJO
TVBUV CBTB MFNBI /B)10 ZBOH NFOZFCBCLBO Q) IBOZB ZBOHUVSVUCFSQFSBOQBEBLFLVBUBOEBQBSOZBBEBMBILBSFOBQ,
NFOJOHLBUTFEJLJU LFCBOZBLBOTJTUFNQSPUFJOJOJIBNQJSNFOEFLBUJQ)JOUSBTFM
4JTUFNEBQBSGPTGBUNFNJMJLJQ, ZBOHUJEBLKBVIEBSJQ) Prinsip Isohidrik: Semua Dapar dalam Satu Larutan
OPSNB EBMBN DBJSBO UVCVI LFBEBBO JOJ NFNCVBU TJTUFN
Berada dalam Keseimbangan dengan Konsentrasi H+
UFSTFCVU EBQBU CFLFSKB NFOEFLBUJ LFLVBUBO EBQBS NBLTJNVN
"LBO UFUBQJ LPOTFOUSBTJOZB EBMBN DBJSBO FLTUSBTFMVMBS SFOEBI
yang Sama ,JUB UFMBI NFNCBIBT TJTUFN EBQBS TFPMBIPMBI
NBTJOHNBTJOH TJTUFN CFLFSKB TFDBSB TFOEJSJTFOEJSJ EBMBN DBJSBO
IBOZB TFLJUBS QFSTFO EBSJ LPOTFOUSBTJ EBQBS CJLBSCPOBU 0MFI
UVCVI"LBOUFUBQJ TFNVBTJTUFNCFLFSKBCFSTBNBTBNBLBSFOB)
LBSFOBJUV LFLVBUBOEBQBSUPUBMEBSJTJTUFNGPTGBUEBMBNDBJSBO CFSTJGBUVNVNVOUVLSFBLTJEJTFNVBTJTUFN0MFILBSFOBJUV CJMB
FLTUSBTFMVMBS KBVI MFCJI LFDJM EJCBOEJOHLBO EFOHBO LFLVBUBO BEB QFSVCBIBO QBEB LPOTFOUSBTJ ) DBJSBO FLTUSBTFMVMBS
TJTUFNEBQBSCJLBSCPOBU LFTFJNCBOHBO TFNVB TJTUFN EBQBS CFSVCBI QBEB XBLUV ZBOH
#FSCFEBEFOHBOQFSBOOZBZBOHUJEBLCFHJUVCFSNBLOBTFCBHBJ CFSTBNBBO 'FOPNFOB JOJ EJTFCVU QSJOTJQ JTPIJESJL EBO
EJHBNCBSLBOPMFISVNVTCFSJLVU
EBQBSFLTUSBTFM EBQBSGPTGBUTBOHBUQFOUJOHEBMBNDBJSBOUVCVMVT
383
HA1 HA2 HA3 +0.3

H+ = K1 × = K2 × K=
A1 A2 A3 +0.2
3
×
+0.1
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)" )" )" EBO " " " BEBMBI LPOTFOUSBTJ JPO OFHBUJG CFCBT
-0.1
ZBOHNFNCFOUVLCBTBEBOLFUJHBTJTUFNEBQBS
-0.2
%BNQBL QSJOTJQ JOJ BEBMBI LPOEJTJ BQB QVO ZBOH NFOHVCBI -0.3
LFTFJNCBOHBOTBMBITBUVTJTUFNEBQBSKVHBNFOHVCBILFTFJNCBOHBO -0.4
TFNVB TJTUFN ZBOH MBJO LBSFOB TJTUFN EBQBS TFCFOBSOZB TBMJOH
NFOEBQBSEFOHBONFOHHFTFS)NBKVEBONVOEVSEJBOUBSBNFSFLB -0.5
0.5 1.0 1.5 2.0 2.5
Pengaturan Pernafasan terhadap (normal = 1)

Keseimbangan Asam-Basa
(BSJTQFSUBIBOBOLFEVBUFSIBEBQHBOHHVBOBTBNCBTBBEBMBI
QFOHBUVSBO LPOTFOUSBTJ $0 DBJSBO FLTUSBTFMVMBS PMFI QBSV
DBJSBO FLTUSBTFMVMBS TFLJUBS #JMB Q) DBJSBO UVCVI
1FOJOHLBUBO WFOUJMBTJ BLBO NFOHFMVBSLBO $0 EBSJ DBJSBO
EFOHBO WFOUJMBTJ BMWFPMVT OPSNBM QFOJOHLBUBO LBMJ LFDFQBUBO
FLTUSBTFMVMBS ZBOH NFMBMVJ LFSKB NBTTBM BLBO NFOHVSBOHJ
WFOUJMBTJBLBONFOJOHLBULBOQ)NFOKBEJTFLJUBS 4FCBMJLOZB
LPOTFOUSBTJ ) 4FCBMJLOZB QFOVSVOBO WFOUJMBTJ BLBO
QFOVSVOBO WFOUJMBTJ BMWFPMVT TBNQBJ TFQFSFNQBU OPSNBM BLBO
NFOJOHLBULBO $0 ZBOH KVHB NFOJOHLBULBO LPOTFOUSBTJ )
NFOHVSBOHJQ)TFCFTBS "SUJOZB CJMBQ) QBEBWFOUJMBTJ
EBMBNDBJSBOFLTUSBTFMVMBS
BMWFPMVTOPSNBM QFOVSVOBOWFOUJMBTJTBNQBJTFQFSFNQBUOPSNBM
BLBO NFOHVSBOHJ Q) NFOKBEJ 0MFI LBSFOB LFDFQBUBO
Ekspirasi CO2 oleh Paru Mengimbangi Pembentukan
WFOUJMBTJ BMWFPMVT EBQBU CFSVCBI EFOHBO OZBUB EBO TFSFOEBI
CO2 Metabolik
TBNQBJ LBMJ OPSNBM LJUB EBQBU EFOHBO NVEBI NFNBIBNJ
$0EJCFOUVLTFDBSBUFSVTNFOFSVTEBMBNUVCVINFMBMVJQSPTFT TFCFSBQB CFTBS Q) DBJSBO UVCVI EBQBU EJVCBI PMFI TJTUFN
NFUBCPMJTNF JOUSBTFM 4FUFMBI EJCFOUVL $0 CFSEJGVTJ EBSJ TFM QFSOBQBTBO
NBTVL LF EBMBN DBJSBO JOUFSTUJTJBM EBO EBSBI EBO BMJSBO EBSBI
NFOHBOHLVU$0LFQBSV UFNQBU$0CFSEJGVTJLFEBMBNBMWFPMJ Peningkatan Konsentrasi H+ Merangsang Ventilasi Alveolus
EBO LFNVEJBO EJQJOEBILBO LF BUNPTGFS NFMBMVJ WFOUJMBTJ QBSV
/PSNBMOZB UFSEBQBUTFLJUBS NPM-$0 ZBOHUFSMBSVUEJEBMBN 5JEBLIBOZBLFDFQBUBOWFOUJMBTJBMWFPMVTTBKBZBOHNFNFOHBSVIJ
DBJSBOFLTUSBTFMVMBS ZBOHTBNBEFOHBO1$0TFCFTBSNN)H LPOTFOUSBTJ ) EFOHBO NFOHVCBI 1$0 DBJSBO UVCVI UFUBQJ
LPOTFOUSBTJ ) KVHB NFNFOHBSVIJ LFDFQBUBO WFOUJMBTJ BMWFPMVT
#JMB LFDFQBUBO QFNCFOUVLBO $0 NFUBCPMJL NFOJOHLBU +BEJ (BNCBS NFOVOKVLLBO CBIXB LFDFQBUBO WFOUJMBTJ
1$0 DBJSBO FLTUSBTFMVMBS KVHB NFOJOHLBU 4FCBMJLOZB BMWFPMVT NFOJOHLBU FNQBU TBNQBJ MJNB LBMJ LFDFQBUBO OPSNBM
QFOVSVOBO LFDFQBUBO NFUBCPMJL NFOVSVOLBO 1$0 #JMB TFXBLUVQ)UVSVOEBOOJMBJOPSNBM NFOKBEJ ZBOHTBOHBU
LFDFQBUBOWFOUJMBTJQBSVNFOJOHLBU $0EJIFNCVTLBOLFMVBS BTBN4FCBMJLOZB TBBUQ)QMBTNBNFOJOHLBUEJBUBT LFBEBBO
EBSJQBSVEBO1$0EBMBNDBJSBOFLTUSBTFMVMBSNFOVSVO0MFI JOJ NFOZFCBCLBO QFOVSVOBO LFDFQBUBO WFOUJMBTJ 4FQFSUJ ZBOH
LBSFOBJUV QFSVCBIBOWFOUJMBTJQBSVBUBVQFSVCBIBOLFDFQBUBO EBQBU LJUB MJIBU QBEB HSBGJL QFSVCBIBO LFDFQBUBO WFOUJMBTJ QFS
QFNCFOUVLBO$0PMFIKBSJOHBOEBQBUNFOHVCBI1$0DBJSBO QFSVCBIBO VOJU Q) KBVI MFCJI CFTBS QBEB QFOVSVOBO LBEBS Q)
FLTUSBTFMVMBS TBNBEFOHBOQFOJOHLBUBOLPOTFOUSBTJ)
EJCBOEJOHLBO
Peningkatan Ventilasi Alveolus Menurunkan Konsentrasi

H+ Cairan ekstraselular dan Meningkatkan pH 4
#JMBQFNCFOUVLBO$0NFUBCPMJLUFUBQLPOTUBO TBUVTBUVOZB
3
GBLUPS MBJO ZBOH NFNFOHBSVIJ 1$0 DBJSBO FLTUSBTFMVMBS
BEBMBI LFDFQBUBO WFOUJMBTJ BMWFPMVT 4FNBLJO UJOHHJ WFOUJMBTJ
BMWFPMVT TFNBLJO SFOEBI 1$0 TFCBMJLOZB TFNBLJO SFOEBI 2
LFDFQBUBO WFOUJMBTJ BMWFPMVT TFNBLJO UJOHHJ 1$0 4FQFSUJ
UFMBI EJCBIBT TFCFMVNOZB CJMB LPOTFOUSBTJ $0 NFOJOHLBU 1
LPOTFOUSBTJ )$0 EBO LPOTFOUSBTJ ) KVHB NFOJOHLBU
TFIJOHHBNFOVSVOLBOQ)DBJSBOFLTUSBTFMVMBS 0
7.0 7.1 7.2 7.3 7.4 7.5 7.6
(BNCBSNFOVOKVLLBOQFSLJSBBOQFSVCBIBOQ)EBSBI
ZBOHEJTFCBCLBOPMFIQFOJOHLBUBOBUBVQFOVSVOBOLFDFQBUBO pH
WFOUJMBTJ BMWFPMVT 1FSIBUJLBO QFOJOHLBUBO WFOUJMBTJ BMWFPMVT
TBNQBJTFLJUBSEVBLBMJOJMBJOPSNBMBLBONFOJOHLBULBOQ)
384
4FQFSUJ ZBOH EBQBU LJUB MJIBU QBEB HSBGJL QFSVCBIBO LFDFQBUBO ,FNBNQVBO VOUVL NFNCFSJ SFTQPOT UFSIBEBQ BTJEPTJT
WFOUJMBTJQFSQFSVCBIBOVOJUQ)KBVIMFCJICFTBSQBEBQFOVSVOBO NFUBCPMJL KVHB NFOKBEJ UFSHBOHHV LBSFOB QFOVSVOBO
LBEBS Q) TBNB EFOHBO QFOJOHLBUBO LPOTFOUSBTJ )
LPNQFOTBTJ 1$0 ZBOH OPSNBM UFSKBEJ NFMBMVJ QFOJOHLBUBO
EJCBOEJOHLBOEFOHBOQFOJOHLBUBOLBEBSQ)"MBTBOVOUVLIBMJOJ WFOUJMBTJ NFOKBEJ CFSLVSBOH 1BEB LFBEBBO JOJ HJOKBM NFOKBEJ
BEBMBI CBIXB TFXBLUV LFDFQBUBO WFOUJMBTJ BMWFPMVT NFOVSVO NFLBOJTNF GJTJPMPHJT UVOHHBM ZBOH NBTJI BEB VOUVL
UNIT V
LBSFOB QFOJOHLBUBO Q) QFOVSVOBO LPOTFOUSBTJ )
KVNMBI NFOHFNCBMJLBOQ)LFOPSNBMTFUFMBIUFSKBEJQFOEBQBSBOLJNJB
QFOBNCBIBO PLTJHFO LF EBMBN EBSBI NFOVSVO EBO UFLBOBO BXBMEBMBNDBJSBOFLTUSBTFMVMBS
QBSTJBM PLTJHFO 10
EJ EBMBN EBSBI KVHB NFOVSVO ZBOH
NFSBOHTBOH LFDFQBUBO WFOUJMBTJ 0MFI LBSFOB JUV LPNQFOTBTJ Pengaturan Keseimbangan Asam-Basa oleh Ginjal
QFSOBQBTBO VOUVL QFOJOHLBUBO Q) UJEBL TFFGFLUJG SFTQPOT
UFSIBEBQQFOVSVOBOQ)ZBOHOZBUB (JOKBM NFOHBUVS LFTFJNCBOHBO BTBNCBTB EFOHBO
Pengaturan Umpan Balik Konsentrasi H+ oleh Sistem NFOHFLTLSFTJLBOVSJOFZBOHBTBNBUBVCBTB1FOHFMVBSBOVSJOF
Pernapasan. ,BSFOB QFOJOHLBUBO LPOTFOUSBTJ ) NFSBOHTBOH BTBN BLBO NFOHVSBOHJ KVNMBI BTBN EBMBN DBJSBO
QFSOBQBTBO EBO LBSFOB QFOJOHLBUBO WFOUJMBTJ BMWFPMVT FLTUSBTFMVMBS TFEBOHLBO QFOHFMVBSBO VSJOF CBTB CFSBSUJ
NFOVSVOLBO LPOTFOUSBTJ ) TJTUFN QFSOBQBTBO CFLFSKB TFCBHBJ NFOHIJMBOHLBOCBTBEBSJDBJSBOFLTUSBTFMVMBS
QFOHBUVSVNQBOCBMJLOFHBUJGMB[JNVOUVLLPOTFOUSBTJ)
,FTFMVSVIBONFLBOJTNFFLTLSFTJVSJOFBTBNBUBVCBTBPMFI
[H+]7FOUJMBTJBMWFPMVT HJOKBM BEBMBI TFCBHBJ CFSJLVU 4FKVNMBI CFTBS )$0 EJGJMUSBTJ
– TFDBSB UFSVTNFOFSVT LF EBMBN UVCVMVT EBO CJMB )$0 JOJ
PCO2 EJFLTLSFTJLBOLFEBMBNVSJOF LFBEBBOJOJNFOHIJMBOHLBOCBTB
+BEJ CJMB LPOTFOUSBTJ
) NFOJOHLBU EJ BUBT OPSNBM TJTUFN EBO EBSBI 4FKVNMBI CFTBS ) KVHB EJTFLSFTJLBO LF EBMBN
QFSOBQBTBO EJSBOHTBOH EBO WFOUJMBTJ BMWFPMVT NFOJOHLBU MVNFOUVCVMVTPMFITFMFQJUFMUVCVMVT TFIJOHHBNFOHIJMBOHLBO
,FBEBBO JOJ NFOVSVOLBO 1$0 DBJSBO FLTUSBTFMVMBS EBO BTBN EBO EBSBI #JMB MFCJI CBOZBL ) ZBOH EJTFLSFTJLBO
NFOHVSBOHJLPOTFOUSBTJ)LFNCBMJNFOVKVOPSNBM4FCBMJLOZB EBSJQBEB )$0 ZBOH EJGJMUSBTJ BLBO UFSKBEJ LFIJMBOHBO OFUP
CJMBLPOTFOUSBTJ)UVSVOEJCBXBIOPSNBM UFSKBEJEFQSFTJQVTBU BTBN EBO DBJSBO FLTUSBTFMVMBS 4FCBMJLOZB CJMB MFCJI CBOZBL
QFSOBQBTBO WFOUJMBTJ BMWFPMVT NFOVSVO EBO LPOTFOUSBTJ ) )$0 ZBOH EJGJMUSBTJ EBSJQBEB ) ZBOH EJTFLSFTJLBO BLBO
NFOJOHLBULFNCBMJNFOVKVOPSNBM UFSKBEJLFIJMBOHBOCBTB
Efisiensi Pengaturan Pernapasan terhadap Konsentrasi H. 4FQFSUJ UFMBI EJCBIBT TFCFMVNOZB TFUJBQ IBSJ UVCVI
1FOHBUVSBO QFSOBQBTBO UJEBL EBQBU NFOHFNCBMJLBO LPOTFOUSBTJ NFOHIBTJMLBOTFLJUBSN&RBTBNOPOWPMBUJM UBLNFOHVBQ

) TFQFOVIOZB NFOKBEJ OPSNBM CJMB HBOHHVBO EJ MVBS TJTUFN UFSVUBNB EBSJ NFUBCPMJTNF QSPUFJO "TBNBTBN JOJ EJTFCVU
QFSOBQBTBO UFMBI NFOHVCBI Q) #JBTBOZB NFLBOJTNF OPOWPMBUJM LBSFOB BTBN UFSTFCVU CVLBO )$0 EBO PMFI
QFSOBQBTBO VOUVL NFOHBUVS LPOTFOUSBTJ ) NFNQVOZBJ LBSFOB JUV UJEBL EBQBU EJFLTLSFTJLBO PMFI QBSV .FLBOJTNF
FGFLUJWJUBT BOUBSB EBO QFSTFO TBNB EFOHBO QFOJOHLBUBO QSJNFSVOUVLNFOHFMVBSLBOBTBNJOJEBOUVCVIBEBMBINFMBMVJ
VNQBO CBMJL EBSJ LF "SUJOZB CJMB Q) UJCBUJCB NFOVSVO FLTLSFTJ HJOKBM (JOKBM KVHB IBSVT NFODFHBI LFIJMBOHBO
NFMBMVJQFOBNCBIBOBTBNLFEBMBNDBJSBOFLTUSBTFMVMBSEBOQ) CJLBSCPOBU EBMBN VSJOF TVBUV GVOHTJ LVBOUJUBUJG MFCJI QFOUJOH
UVSVO EBO NFOKBEJ TJTUFN QFSOBQBTBO EBQBU EBSJQBEB FLTLSFTJ BTBN OPOWPMBUJM 4FUJBQ IBSJ HJOKBM
NFOHFNCBMJLBO Q) NFOKBEJ TFLJUBS TBNQBJ 3FTQPOT JOJ NFNGJMUSBTJ TFLJUBS N&R CJLBSCPOBU -IBSJ Y
UFSKBEJEBMBNXBLUVTBNQBJNFOJU N&R-
EBOEBMBNLPOEJTJOPSNBM IBNQJSTFNVBEJSFBCTPSCTJ
Kekuatan Pendaparan Sistem Pernapasan. 1FOHBUVSBO EBSJ UVCVMVT TFIJOHHB NFNQFSUBIBOLBO TJTUFN EBQBS VUBNB
QFSOBQBTBO UFSIBEBQ LFTFJNCBOHBO BTBN CBTB NFSVQBLBO TJTUFN DBJSBOFLTUSBTFMVMBS
EBQBSKFOJTGJTJPMPHJTLBSFOBQFOHBUVSBOJOJCFLFSKBEFOHBODFQBUEBO 4FQFSUJZBOHBLBOEJCBIBTLFNVEJBO SFBCTPSQTJCJLBSCPOBU
NFOKBHBLPOTFOUSBTJ)EBSJQFSVCBIBOZBOHUFSMBMVCFTBSTBNQBJ EBOFLTLSFTJ) EJDBQBJNFMBMVJQSPTFTTFLSFTJ)PMFIUVCVMVT
HJOKBM ZBOH CFSFTQPOT MBNCBU EBQBU NFOHIJMBOHLBO LFUJEBL 0MFI LBSFOB )$0 IBSVT CFSFBLTJ EFOHBO TBUV ) ZBOH
TFJNCBOHBOUFSTFCVU1BEBVNVNOZB LFTFMVSVIBOLFLVBUBOEBQBS EJTFLSFTJLBO VOUVL NFNCFOUVL )$0 TFCFMVN EBQBU
TJTUFN QFSOBQBTBO TBUV TBNQBJ EVB LBMJ MFCJI CFTBS EBO QBEB EJSFBCTPSCTJ N&R ) IBSVT EJTFLSFTJLBO TFUJBQ IBSJ
LFLVBUBO EBQBS HBCVOHBO TFMVSVI EBQBS LJNJB MBJO EBMBN DBJSBO IBOZB VOUVL NFSFBCTPSCTJ CJLBSCPOBU ZBOH EJGJMUSBTJ
FLTUSBTFMVMBS"SUJOZB TBUVTBNQBJEVBLBMJMFCJICBOZBLBTBNBUBV ,FNVEJBOBEBUBNCBIBON&R)IBSVTEJTFLSFTJLBOVOUVL
CBTB ZBOH TFDBSB OPSNBM EBQBU EJEBQBS PMFI NFLBOJTNF JOJ NFOHIJMBOHLBO BTBN OPOWPMBUJM ZBOH EJQSPEVLTJ PMFI UVCVI
EBSJQBEBPMFIEBQBSLJNJB TFUJBQIBSJ TFIJOHHBUPUBN&R)EJTFLSFTJLBOLFEBMBN
DBJSBOUVCVMVTTFUJBQIBSJOZB
Gangguan Fungsi Paru Dapat Menyebabkan Asidosis
Respiratorik. 4FKBVI JOJ LJUB UFMBI NFNCBIBT QFSBO NFLBOJTNF #JMB UFSEBQBU QFOHVSBOHBO LPOTFOUSBTJ ) DBJSBO
QFSOBQBTBO OPSNBM TFCBHBJ BMBU VOUVL NFOEBQBS QFSVCBIBO FLTUSBTFMVMBS BMLBMPTJT
HJOKBM HBHBM NFSFBCTPSCTJ TFNVB
LPOTFOUSBTJ ) "LBO UFUBQJ HBOHHVBO QFSOBQBTBO EBQBU KVHB )$0 ZBOH EJGJMUSBTJ TFIJOHHB NFOJOHLBULBO FLTLSFTJ )$0
NFOZFCBCLBO QFSVCBIBO LPOTFOUSBTJ ) 4FCBHBJ DPOUPI 0MFI LBSFOB )$0 OPSNBMOZB NFOEBQBS ) EBMBN DBJSBO
HBOHHVBO GVOHTJ QBSV TFQFSUJ FNGJTFNB CFSBU NFOVSVOLBO FLTUSBTFMVMBS LFIJMBOHBO )$0 JOJ TBNB EFOHBO QFOBNCBIBO
LFNBNQVBO QBSV VOUVL NFOHFMVBSLBO $0 LFBEBBO JOJ TBUV ) LF EBMBN DBJSBO FLTUSBTFMVMBS 0MFI LBSFOB JUV QBEB
LFNVEJBO NFOZFCBCLBO QFOVNQVLBO $0 EBMBN DBJSBO BMLBMPTJT QFOHFMVBSBO )$0 BLBO NFOJOHLBULBO LPOTFOUSBTJ
FLTUSBTFMVMBSEBOLFDFOEFSVOHBOLFBSBIBTJEPTJTSFTQJSBUPSJL )DBJSBOFLTUSBTFMVMBSLFNCBMJNFOVKVOPSNBM
385
1BEBBTJEPTJT HJOKBMUJEBLNFOHFLTLSFTJLBO)$0LFEBMBN H+ Disekresikan oleh Transpor Aktif Sekunder di Awal

VSJOF UFUBQJ NFSFBCTPSCTJ TFNVB )$0 ZBOH EJGJMUSBTJ EBO Segmen Tubulus
NFOHIBTJMLBO )$0 CBSV ZBOH EJUBNCBILBO LFNCBMJ LF 4FM FQJUFM UVCVMVT QSPLTJNBM TFHNFO UFCBM QBST BTFOEFO BOTB
DBJSBOFLTUSBTFMVMBS)BMJOJNFOHVSBOHJLPOTFOUSBTJ)DBJSBO )FOMF EBO CBHJBO BXBM UVCVMVT EJTUBM TFNVBOZB NFOZFLSFTJLBO
FLTUSBTFMVMBSLFNCBMJNFOVKVOPSNBM ) LF EBMBN DBJSBO UVCVMVT NFMBMVJ LPOUFSUSBOTQPS OBUSJVN
+BEJ HJOKBM NFOHBUVSLPOTFOUSBTJ ) DBJSBO FLTUSBTFMVMBS IJESPHFO TFQFSUJ ZBOH EJUVOKVLLBO QBEB (BNCBS 4FLSFTJ
NFMBMVJ UJHB NFLBOJTNF EBTBS
TFLSFTJ )
SFBCTPSQTJ BLUJG TFLVOEFS EBO ) JOJ CFSQBTBOHBO EFOHBO USBOTQPS /B LF
)$0 ZBOH EJGJMUSBTJ EBO
QSPEVLTJ )$0 CBSV 4FNVB EBMBN TFM QBEB NFNCSBO MVNJOBM PMFI QSPUFJO QFOVLBS
QSPTFTJOJEJDBQBJNFMBMVJNFLBOJTNFEBTBSZBOHTBNB TFQFSUJ FYDIBOHFS
OBUSJVNIJESPHFO EBO FOFSHJ VOUVL TFLSFTJ )
ZBOHBLBOEJCBIBTQBEBCFCFOBQBCBHJBOCFSJLVU NFMBXBO HSBEJFO LPOTFOUSBTJ CFSBTBM EBSJ HSBEJFO OBUSJVN ZBOH
NFNCBOUV QFSHFSBLBO /B LF EBMBN TFM (SBEJFO JOJ EJIBTJMLBO
PMFI QPNQB OBUSJVNLBMJVN BEFOPTJO USJGPTGBUBTF "51BTF
EJ
Sekresi H+ dan Reabsorpsi HCO3- oleh Tubulus
NFNCSBOCBTPMBUFSBM,JSBLJSBQFSTFOCJLBSCPOBUEJSFBCTPSCTJ
Ginjal EFOHBODBSBJOJ ZBOHNFNCVUVILBOTFLSFTJTFLJUBSN&R)h
PMFI UVCVMVT TFUJBQ IBSJOZB "LBO UFUBQJ NFLBOJTNF NM UJEBL
4FLSFTJ JPO IJESPHFO EBO SFBCTPSQTJ )$0 UFSKBEJ IBNQJS EJ NFOHIBTJMLBO LPOTFOUSBTJ )h ZBOH UJOHHJ EBMBN DBJSBO UVCVMVT
TFMVSVICBHJBOUVCVMVTLFDVBMJTFHNFOUJQJTQBSTEFTFOEFOEBO DBJSBO UVCVMVT NFOKBEJ TBOHBU BTBN IBOZB EJ UVCVMVT LPMJHFOUFT
BTFOEFO BOTB )FOMF (BNCBS NFSBOHLVN SFBCTPSQTJ EBOEVLUVTLPMJHFOT
)$0 EJ TFQBOKBOH UVCVMVT *OHBUMBI CBIXB VOUVL TFUJBQ
(BNCBS NFOVOKVLLBO CBHBJNBOB QSPTFT TFLSFTJ )
)$0ZBOHEJSFBCTPSCTJ TBUV)IBSVTEJTFLSFTJLBO
NFOHIBTJMLBO SFBCTPSQTJ )$0 1SPTFT TFLSFTJ EJNVMBJ LFUJLB
4FLJUBS IJOHHB QFSTFO SFBCTPSQTJ CJLBSCPOBU EBO $0 CFSEJGVTJ LF EBMBN TFM UVCVMVT BUBV EJCFOUVL NFMBMVJ
TFLSFTJ )
UFSKBEJ EJ UVCVMVT QSPLTJNBM TFIJOHHB IBOZB NFUBCPMJTNFEJEBMBNTFMFQJUFMUVCVMVT$0vEJCBXBIQFOHBSVI
TFKVNMBI LFDJM )$0 ZBOH NFOHBMJS LF UVCVMVT EJTUBM EBO FO[JN BOIJESBTF LBSCPOBU CFSHBCVOH EFOHBO )0 VOUVL
EVLUVT LPMJHFOT %J TFHNFO UFCBM QBST BTFOEFO BOTB )FOMF NFNCFOUVL)$0 ZBOHCFSEJTPTJBTJNFOKBEJ)$0EBO))
UFSKBEJ UBNCBIBO SFBCTPSQTJ QFSTFO )$0 EBSJ ZBOH EJTFLSFTJLBO EBSJ TFM NBTVL LF EBMBN MVNFO UVCVMVT NFMBMVJ
EJGJMUSBTJ EBOTJTBOZBEJSFBCTPSQTJEJUVCVMVTEJTUBMEBOEVLUVT LPOUFSUSBOTQPS OBUSJVNIJESPHFO "SUJOZB LFUJLB /B CFSHFSBL
LPMJHFOT 4FQFSUJ UFMBI EJCBIBT TFCFMVNOZB NFLBOJTNF EBO MVNFO UVCVMVT LF CBHJBO EBMBN TFM /B NVMBNVMB
SFBCTPSQTJ)$0KVHBNFMJCBULBOTFLSFTJ)PMFIUVCVMVT UFUBQJ CFSHBCVOH EFOHBO QSPUFJO QFNCBXB EJ MVNJOBM NFNCSBO TFM
EFOHBO DBSB ZBOH CFSCFEBCFEB EJ UJBQ TFHNFO UVCVMVT ZBOH QBEB XBLUV ZBOH CFSTBNBBO ) EJ CBHJBO EBMBN TFM CFSHBCVOH
CFSCFEB EFOHBO QSPUFJO QFNCBXB /Bh CFSHFSBL LF EBMBN TFM NFOHJLVUJ
HSBEJFO LPOTFOUSBTJ ZBOH UFMBI EJIBTJMLBO PUFI QPNQB OBUSJVN
LBMJVN"51BTFEJNFNCSBOCBTPMBUFSBM(SBEJFOVOUVL
85%
(3672 mEq/ )
4320 mEq/
Na+ + HCO3-
10%
(432 mEq/ )
4.9% Na+ Na+
(215 ATP
K+ H+
mEq/ )
HCO3- + H+
H2CO3
Na+
H2CO3
Carbonic
anhydrase
H2O
CO2 +
CO2 CO2 + H2O
(1 mEq/ )
386
QFSHFSBLBO /B LF EBMBN TFM LFNVEJBO NFOZFEJBLBO FOFSHJ #JMB UFSEBQBU LFMFCJIBO )$0 NFMFCJIJ ) EBMBN VSJOF
VOUVLNFOHHFSBLLBO)LFBSBIZBOHCFSMBXBOBO EBOEBMBNTFM TFQFSUJZBOHUFSKBEJQBEBBMLBMPTJTNFUBCPMJL LFMFCJIBO)$0
LFMVNFOUVCVMVT UJEBL EBQBU EJSFBCTPSCTJ PMFI LBSFOB JUV LFMFCJIBO )$0
)$0 ZBOH EJIBTJMLBO EJ EBMBN TFM LFUJLB ) CFSEJTPTJBTJ UFUBQ EJ EBMBN UVCVMVT EBO BLIJSOZB EJFLTLSFTJLBO LF EBMBN
EBSJ )$0
LFNVEJBO CFSHFSBL NFOHJLVUJ HSBEJFO NFMJOUBTJ VSJOF ZBOHNFNCBOUVNFOHPSFLTJBMLBMPTJTNFUBCPMJL
UNIT V
NFNCSBO CBTPMBUFSBM NBTVL LF EBMBN DBJSBO JOUFSTUJTJBM HJOKBM 1BEB BTJEPTJT UFSEBQBU LFMFCJIBO KVNMBI ) EJCBOEJOHLBO
EBO EBSBI LBQJMFS QFSJUVCVMVT )BTJM OFUP BEBMBI CBIXB VOUVL EFOHBO )$0 NFOZFCBCLBO SFBCTPSQTJ QFNCBXB)$0
TFUJBQ)ZBOHEJTFLSFTJLBOLFEBMBNMVNFOUVCVMVT TBUV)$0 TFMVSVIOZB EBO LFMFCJIBO ) EJLFMVBSLBO LF EBMBN VSJOF
NBTVLLFEBMBNEBSBI ,FMFCJIBO ) JOJ EJEBQBS EJ EBMBN UVCVMVT PMFI GPTGBU EBO
HCO3- yang Difiltrasi, Direabsorbsi melalui Interaksi dengan BNPOJB EBO BLIJSOZB EJFLTLSFTJLBO TFCBHBJ HBSBN +BEJ
H+ dalam Tubulus NFLBOJTNF EBTBS QFOHPSFLTJBO BTJEPTJT BUBV BMLBMPTJT PMFI
HJOKBM BEBMBI UJUSBTJ UJEBL MFOHLBQ ) UFSIBEBQ )$0 ZBOH
*PO CJLBSCPOBU UJEBL NVEBI NFOFNCVT NFNCSBO MVNJOBM TFM
NFOZFCBCLBO TBMBI TBUV JPO JOJ EJLFMVBSLBO LF EBMBN VSJOF
UVCVMVT HJOKBM PMFI LBSFOB JUV )$0 ZBOH EJGJMUSBTJ PMFI
EBOEJIJMBOHLBOEBODBJSBOFLTUSBTFMVMBS
HMPNFSVMVTUJEBLEBQBUEJSFBCTPSCTJTFDBSBMBOHTVOH4FCBMJLOZB
)$0 EJSFBCTPSCTJ NFMBMVJ QSPTFT LIVTVT NVMBNVMB )$0 Sekresi Aktif Primer dan H+ dalam Sel Interkatalus pada
CFSHBCVOHEFOHBO)VOUVLNFNCFOUVL)$0 ZBOHBLIJSOZB Tubulus Distal Bagian Akhir dan Tubulus Koligens
NFOKBEJ $0 EBO )0 TFQFSUJ ZBOH EJUVOKVLLBO QBEB (BNCBS %JNVMBJEBSJCBHJBOBLIJSUVCVMVTEJTUBMEBOCFSMBOKVUNFMBMVJ
TJTBTJTUFNUVCVMBS FQJUFMUVCVMVTNFOZFLSFTJLBO)NFMBMVJ
3FBCTPSQTJ )$0 JOJ EJBXBMJ PMFI SFBLTJ EJ EBMBN UVCVMVT USBOTQPSBLUJGQSJNFS$JSJDJSJUSBOTQPSJOJCFSCFEBEFOHBO
BOUBSB )$0 ZBOH EJGJMUSBTJ QBEB HMPNFSVMVT EBO ) ZBOH USBOTQPSZBOHEJCBIBTVOUVLUVCVMVTQSPLTJNBM BOTB)FOMF
EJTFLSFTJ PMFI TFM UVCVMVT )$0 ZBOH UFSCFOUVL LFNVEJBO EBOBXBMUVCVMVTEJTUBM
CFSEJTPTJBTJ NFOKBEJ $0 EBO )0 $0 EBQBU CFSHFSBL EFOHBO
NVEBI NFMFXBUJ NFNCSBO UVCVMVT PMFI LBSFOB JUV $0 TFHFSB .FLBOJTNF TFLSFTJ BLUJG QSJNFS ) EJUVOKVLLBO QBEB
CFSEJGVTJ NBTVL LF EBMBN TFM UVCVMVT UFNQBU $0 CFSHBCVOH (BNCBS 4FLSFTJ UFSKBEJ QBEB NFNCSBO MVNJOBM TFM
LFNCBMJ EFOHBO )0 EJ CBXBI QFOHBSVI BOIJESBTF LBSCPOBU UVCVMVT UFNQBU)EJUSBOTQPSTFDBSBMBOHTVOHPMFIQSPUFJO
VOUVL NFOHIBTJMLBO NPMFLVM )$0 ZBOH CBSV )$0 JOJ LIVTVT ZBJUV IZESPHFOUSBOTQPSJOH "51BTF &OFSHJ ZBOH
LFNVEJBO CFSEJTPTJBTJ NFNCFOUVL )$0 EBO )h )$0 EJCVUVILBOVOUVLNFNPNQB)EJIBTJMLBOEBSJQFNFDBIBO
LFNVEJBO CFSEJGVTJ NFMBMVJ NFNCSBO CBTPMBUFSBM NBTVL LF "51NFOKBEJBEFOPTJOEJGPTGBU
EBMBNDBJSBOJOUFSTUJTJBMEBOEJCBXBLFEBSBILBQJMFSQFSJUVCVMVT
4FLSFTJBLUJGQSJNFS)UFSKBEJEJTFMLIVTVTZBOHEJTFCVUTFM
5SBOTQPS)$0NFMBMVJNFNCSBOCBTPMBUFSBMEJGBTJMJUBTJPMFIEVB
JOUFSLBMBUVT QBEB UVCVMVT EJTUBM CBHJBO BLIJS UVCVMVT LPMJHFOT
NFLBOJTNF
LPUSBOTQPS/B)$0EJUVCVMVTQSPLTJNBMEBO
4FLSFTJ JPO IJESPHFO EBMBN TFM JOJ EJMBLVLBO NFMBMVJ EVB

QFSUVLBSBO $*)$0 EJ BLIJS UVCVMVT QSPLTJNBM CBHJBO
MBOHLBI
$0 UFSMBSVU EBMBN TFM JOJ CFSHBCVOH EFOHBO )
UFCBM QBST BTFOEFOT BOTB )FOMF EBO EJ UVCVMVT EBO EVLUVT
NFNCFOUVL )$0 EBO
)$0 LFNVEJBO CFSEJTPTJBTJ
LPMJHFOT
NFOKBEJ)$0ZBOHEJSFBCTPSCTJLFEBMBNEBSBI UBNCBI)
+BEJ TFUJBQ LBMJ TBUV ) EJCFOUVL EJ EBMBN TFM FQJUFM UVCVMVT ZBOH EJTFLSFTJLBO LF EBMBN UVCVMVT NFMBMVJ NFLBOJTNF
TBUV )$0 KVHB EJCFOUVL EBO EJMFQBTLBO LFNCBMJ LF EBMBN IJESPHFO"51BTF 6OUVL TFUJBQ ) ZBOH EJTFLSFTJLBO TBUV
EBSBI 1FOHBSVI OFUP SFBLTJ JOJ BEBMBI SFBCTPSQTJ )$0 EBO )$0EJSFBCTPSCTJ NJSJQEFOHBOQSPTFTZBOHUFSKBEJEJUVCVMVT
UVCVMVT XBMBVQVO )$0 ZBOH TFCFOBSOZB NFNBTVLJ DBJSBO QSPLTJNBM 1FSCFEBBO VUBNBOZB BEBMBI ) CFSHFSBL NFMFXBUJ
FLTUSBTFMVMBS CVLBO ZBOH EJGJMUSBTJ LF EBMBN UVCVMVT 3FBCTPSQTJ NFNCSBOMVNJOBMNFMBMVJQPNQB)BLUJGEBOCVLBONFMBMVJ
)$0ZBOHEJGJMUSBTJUJEBLNFOHIBTJMLBOTFLSFTJ)OFUPLBSFOB
) ZBOH EJTFLSFTJLBO CFSHBCVOH EFOHBO )$0 ZBOH EJGJMUSBTJ
EBOLBSFOBJUV UJEBLEJFLTLSFTJLBO
HCO3- "Dititrasi" terhadap H dalam Tubulus. %BMBN
LPOEJTJOPSNBM LFDFQBUBOTFLSFTJ)UVCVMVTBEBMBITFLJUBS
Cl- Cl- Cl-
N&RIBSJEBOLFDFQBUBOGJMUSBTJ)$0BEBMBITFLJUBSN&R
IBSJ +BEJ KVNMBI LFEVB JPO ZBOH NFNBTVLJ UVCVMVT JOJ IBNQJS HCO3- + H+ H+
TBNB EBO JPOJPO JUV CFSHBCVOH VOUVL NFNCFOUVL $0 EBO ATP
)0 0MFI LBSFOB JUV EJLBUBLBO CBIXB )$0 EBO JPO ) H2CO3
OPSNBMOZB NFMBLVLBO UJUSBTJ TBUV EFOHBO MBJOOZB EJ EBMBN
UVCVMVT H2O
+
1SPTFT UJUSBTJ JOJ UJEBL CFHJUV UFQBU LBSFOB CJBTBOZB UFSEBQBU CO2 CO2
TFEJLJU LFMFCJIBO ) EBMBN UVCVMVT ZBOH BLBO EJFLTLSFTJLBO
EBMBN VSJOF ,FMFCJIBO ) JOJ TFLJUBS N&RIBSJ

NFNCFSTJILBO UVCVI EBSJ BTBN OPOWPMBUJM ZBOH EJIBTJMLBO PMFI
NFUBCPMJTNF 4FQFSUJ BLBO EJCBIBT LFNVEJBO TFCBHJBO CFTBS )
JOJ UJEBL EJFLTLSFTJLBO TFCBHBJ ) CFCBT UFUBQJ EBMBN CFOUVL
LPNCJOBTJ EFOHBO EBQBS VSJOF MBJOOZB UFSVUBNB GPTGBU EBO
BNPOJB
387
LPOUFSUSBOTQPS TFQFSUJ ZBOH UFSKBEJ QBEB CBHJBOCBHJBO BXBM

OFGSPO Tubular cells
Na+ + NaHPO4-
8BMBVQVO TFLSFTJ ) EJ BLIJS UVCVMVT EJTUBM EBO UVCVMVT
LPMJHFOT IBOZB NFSVQBLBO TFLJUBS QFSTFO ) UPUBM ZBOH
Na+ Na+ Na+
EJTFLSFTJLBO NFLBOJTNF JOJ QFOUJOH EBMBN QFNCFOUVLBO ATP
VSJOF BTBN ZBOH NBLTJNBM %J UVCVMVT QSPLTJNBM LPOTFOUSBTJ K+ H+ + NaHPO4-
HCO3- HCO3- + H+
) EBQBU EJUJOHLBULBO IBOZB TFLJUBS UJHB TBNQBJ FNQBU LBMJ
MJQBU EBO Q) DBJSBO UVCVMVT EBQBU EJUVSVOLBO IBOZB TBNQBM
TFLJUBS XBMBVQVO TFKVNMBI CFTBS ) EJTFLSFTJLBO NFMBMVJ H2CO3 NaH2PO4
TFHNFO OFGSPO JOJ "LBO UFUBQJ LPOTFOUSBTJ ) EBQBU
EJUJOHLBULBOTFCBOZBLLBMJMJQBUEJEBMBNUVCVMVTLPMJHFOT H2O
CO2 +
1FOVSVOBO Q) DBJSBO UVCVMVT JOJ NFOKBEJ TFLJUBS ZBOH CO2
NFSVQBLBO CBUBT CBXBI Q) ZBOH EBQBU EJDBQBJ PMFI HJOKBM
OPSNBM
Kombinasi H+ yang Berlebihan dengan Dapar

Fosfat dan Amonia pada Tubutus Menghasilkan
'BLUPSMBJOZBOHNFNCVBUGPTGBUQFOUJOHTFCBHBJEBQBSUVCVMVT
HCO3 yang "Baru"
BEBMBI LFOZBUBBO CBIXB Q, TJTUFN JOJ BEBMBI TFLJUBS 1BEB
#JMB JPO ) EJTFLSFTJLBO MFCJI CBOZBL EBSJ )$0 ZBOH LPOEJTJ OPSNBM VSJOF TFEJLJU BTBN EBO Q) VSJOF NFOEFLBUJ Q,
EJGJMUSBTJ LF EBMBN DBJSBO UVCVMVT IBOZB TFCBHJBO LFDJM TJTUFNEBQBSGPTGBU0MFILBSFOBJUV EJEBMBNUVCVMVT TJTUFNEBQBS
LFMFCJIBO JOJ ZBOH EBQBU EJFLTLSFTJLBO EBMBN CFOUVL JPO ) GPTGBUOPSNBMOZBCFSGVOHTJNFOEFLBUJLJTBSBOQ)OZBZBOHQBMJOH
EBMBNVSJOF"MBTBOVOUVLJOJBEBMBIQ)NJOJNBMVSJOFBEBMBI FGFLUJG
TFLJUBS TBNBEFOHBOLPOTFOUSBTJ)N&R- BUBV (BNCBSNFOVOKVLLBOVSVUBOLFKBEJBOFLTLSFTJ)EBMBN
N&R- +BEJ VOUVL TFUJBQ MJUFS VSJOF ZBOH EJCFOUVL KVNMBI CFOUVL LPNCJOBTJ EFOHBO EBQBS GPTGBU EBO NFLBOJTNF
NBLTJNBM)CFCBTZBOHEBQBUEJFLTLSFTJLBOIBOZBTFLJUBS QFOBNCBIBO )$0 CBSV LF EBMBN EBSBI 1SPTFT TFLSFTJ ) LF
N&R 6OUVL NFOHFLTLSFTJLBO N&R BTBN OPOWPMBUJM ZBOH EBMBN UVCVMVT TBNB TFQFSUJ ZBOH EJKFMBTLBO TFCFMVNOZB 4FMBNB
EJCFOUVL PMFI NFUBCPMJTNF TFUJBQ IBSJOZB TFLJUBS MJUFS UFSEBQBU LFMFCJIBO )$0 EBMBN DBJSBO UVCVMVT LFCBOZBLBO )
VSJOFIBSVTEJFLTLSFTJLBOCJMB)UFUBQEBMBNCFOUVLCFCBTEJ ZBOHEJTFLSFTJLBO CFSHBCVOHEFOHBO)$0"LBOUFUBQJ CFHJUV
EBMBNMBSVUBO TFNVB)$0UFMBIEJSFBCTPSCTJEBOUJEBLBEBMBHJZBOHUFSTFEJB
&LTLSFTJ TFKVNMBI CFTBS ) LBEBOHLBEBOH TFCBOZBL VOUVLCFSJLBUBOEFOHBO) TFUJBQLFMFCJIBO) EBQBUCFOHBCVOH
N&RIBSJ
EBMBNVSJOFUFSVUBNBEJDBQBJEFOHBONFOHHBCVOH EFOHBO )10 EBO EBQBS UVCVMVT MBJOOZB 4FUFMBI ) CFSHBCVOH
LBO)EFOHBOEBQBSEBMBNDBJSBOUVCVMVT%BQBSZBOHQBMJOH EFOHBO )10 VOUVL NFNCFOUVL )10 LFNVEJBO EBQBU
QFOUJOH BEBMBI EBQBS GPTGBU EBO EBQBS BNPOJB 4JTUFN EBQBS EJFLTLSFTJLBO TFCBHBJ HBSBN OBUSJVN /B)10
EFOHBO
MFNBIMBJO TFQFSUJVSBUEBOTJUSBU LVSBOHCFHJUVQFOUJOH NFNCBXBTFSUBLFMFCJIBO)
#JMB)EJUJUSBTJEBMBNDBJSBOUVCVMVTEFOHBO)$0 IBMJOJ "EB TBUV QFSCFEBBO QFOUJOH EBMBN VSVUBO FLTLSFTJ ) JOJ
LFNVEJBONFOZFCBCLBOSFBCTPSQTJTBUV)$0VOUVLTFUJBQ) EFOHBOZBOHUFMBIEJCBIBTTFCFMVNOZB1BEBLFBEBBOJOJ )$0
ZBOHEJTFLSFTJLBO TFQFSUJUFMBIEJCBIBTTFCFMVNOZB5FUBQJCJMB ZBOH EJIBTJMLBO EBMBN TFM UVCVMVT EBO ZBOH NFNBTVLJ EBSBI
UFSEBQBULFMFCJIBO)EBMBNVSJOF )BLBOCFSHBCVOHEFOHBO QFSJUVCVMVTNFSVQBLBOUBNCBIBOOFUP)$0PMFIEBSBI CVLBO
EBQBS TFMBJO )$0 EBO IBM JOJ LFNVEJBO NFOZFCBCLBO IBOZBQFOHHBOUJBO)$0ZBOHEJGJMUSBTJ0MFILBSFOBJUV LBQBO
QFNCFOUVLBO )$0 CBSV ZBOH KVHB EBQBU NBTVL LF EBMBN QVO ) ZBOH EJTFLSFTJLBO LF EBMBN MVNFO UVCVMVT CFSHBCVOH
EBSBI+BEJ CJMBUFSEBQBULFMFCJIBO)EBMBNDBJSBOFLTUSBTFMVMBS EFOHBO EBQBS TFMBJO )$0 IBTJM BLIJSOZB BEBMBI QFOBNCBIBO
HJOKBM UJEBL IBOZB NFSFBCTPSCTJ TFNVB )$0 ZBOH EJGJMUSBTJ )$0 CBSV LF EBMBN EBSBI )BM JOJ NFOVOKVLLBO TBMBI TBUV
UFUBQJ KVHB NFOHIBTJMLBO )$0 CBSV EFOHBO EFNJLJBO NFLBOJTNF ZBOH EJMBLVLBO PMFI HJOKBM VOUVL NFNQFSCBSVJ
NFNCBOUV NFOHHBOUJ )$0 ZBOH IJMBOH EBSJ DBJSBO TJNQBOBO)$0DBJSBOFLTUSBTFMVMBS
FLTUSBTFMVMBSQBEBLFBEBBOBTJEPTJT1BEBEVBCBHJBOCFSJLVUJOJ
1BEB LPOEJTJ OPSNBM LFCBOZBLBO GPTGBU ZBOH EJGJMJSBTJ BLBO
LJUB BLBO NFNCBIBT NFLBOJTNF EBQBS GPTGBU EBO BNPOJB
EJSFBCTPSCTJ EBO IBOZB UFSTFEJB TFLJUBS N&RM IBSJ VOUVL
UFSIBEBQQFNCFOUVLBO)$0CBSV
NFOEBQBS ) 0*FI LBSFOB JUV TFCBHJBO CFTBS QFOEBQBSBO VOUVL
LFMFCJIBO)EBMBNDBJSBOUVCVMVTQBEBLFBEBBOBTJEPTJTUFSKBEJ
Sistem Dapar Fosfat Membawa Kelebihan H+ ke dalam
NFMBMVJTJTUFNEBQBSBNPOJB
Urine dan Membentuk HCO3- Baru
4JTUFN EBQBS GPTGBU UFSEJSJ BUBT )10 EBO )10 ,FEVBOZB
Ekskresi Kelebihan H+ dan Pembentukan HCO3 Baru oleh
NFOKBEJ QFLBU EJ EBMBN DBJSBO UVCVMVT LBSFOB BJS TFDBSB
Sistem Dapar Amonia
OPSNBMMFCJICBOZBLEJSFBCTPSQTJEBSJQBEBGPTGBUPMFIUVCVMVT 4JTUFN EBQBS LFEVB EBMBN DBJSBO UVCVMVT ZBOH CBILBO MFCJI
HJOKBM0MFILBSFOBJUV XBMBVQVOGPTGBUCVLBOMBIEBQBSDBJSBO QFOUJOHTFDBSBLVBOUJUBUJGEBSJQBEBTJTUFNEBQBSGPTGBU UFSEJSJBUBT
FLTUSBTFMVMBS ZBOH QFOUJOH GPTGBU KBVI MFCJI FGFLUJG TFCBHBJ BNPOJB /)
EBOJPOBNPOJVN /)
*POBNPOJVNEJTJOUFTJT
EBQBSEBMBNDBJSBOUVCVMVT EBSJHMVUBNJO ZBOHUFSVUBNBCFSBTBMEBONFUBCPMJTNF
388
Renal Proximal Tubular

interstitial tubular cells lumen
fluid
Na+ NH3 NH3
UNIT V
ATP
K+ Cl-
Glutamine Glutamine Glutamine
HCO3- + H+ ATP
H+
Cl-
2HCO3- 2NH4+ H2CO3
NH4+ + Cl-
NH4+ NH4+ + Cl- H2O

CO2 +
Na+ Na+ CO2
BTBNBNJOPEJEBMBNIBUJ(MVUBNJOZBOHEJBOHLVULFHJOKBMBLBO EJFLTLSFTJLBO EBO QFSTFO )$0 CBSV ZBOH EJIBTJMLBO PMFI
EJUSBOTQPS LF EBMBN TFM FQJUFM UVCVMVT QSPLTJNBM TFHNFO UFCBM HJOKBM "LBO UFUBQJ QBEB BTJEPTJT LSPOJT LFDFQBUBO FLTLSFTJ
QBSTBTFOEFOBOTB)FOMF EBOUVCVMVTEJTUBM (BNCBS
4FLBMJ /) NFOJOHLBU NFODBQBJ N&R IBSJ 0MFI LBSFOB JUV
CFSBEB EJ EBMBN TFM TFUJBQ NPMFLVM HMVUBNJO EJNFUBCPMJTNF QBEB BTJEPTJT LSPOJT NFLBOJTNF VUBNB ZBOH NFOHFMVBSLBO
EBMBNTFSBOHLBJBOSFBLTJBHBSQBEBBLIJSOZBNFNCFOUVLEVBJPO BTBN BEBMBI FLTLSFTJ /) .FLBOJTNF JOJ KVHB NFSVQBLBO
/) EBO EVB JPO )$0 /) EJTFLSFTJLBO LF EBMBN MVNFO NFLBOJTNF ZBOH QBMJOH QFOUJOH VOUVL NFOHIBTJMLBO
UVCVMVT NFMBMVJ NFLBOJTNF LPOUFSUSBOTQPS EJUVLBSLBO EFOHBO CJLBSCPOBUCBSVTFMBNBBTJEPTJTLSPOJT
JPO OBUSJVN ZBOH EJSFBCTPSCTJ )$0 EJUSBOTQPS NFMFXBUJ
NFNCSBO CBTPMBUFSBM CFSTBNB EFOHBO /B ZBOH EJSFBCTPCTJ Penghitungan Ekskresi Asam-Basa oleh Ginjal
NBTVL LF EBMBN DBJSBO JOUFSTUJTJBM EBO EJBNCJM PMFI LBQJMFS
QFSJUVCVMVT +BEJ VOUVL TFUJBQ NPMFLVM HMVUBNJO ZBOH #FSEBTBSLBOQSJOTJQZBOHUFMBIEJCBIBTTFCFMVNOZB LJUBEBQBU
EJNFUBCPMJTNF EJ EBMBN UVCVMVT QSPLTJNBM EVB JPO /) NFOHIJUVOH FLTLSFTJ OFUP BTBN PMFI HJOKBM BUBV QFOBNCBIBO
EJTFLSFTJLBO LF EBMBN VSJOF EBO EVB JPO )$0 EJSFBCTPSCTJ LF OFUPBUBVFMJNJOBTJOFUP)$0EBOEBSBITFCBHBJCFSJLVU
EBMBN EBSBI )$0 ZBOH EJIBTJMLBO PMFI QSPTFT JOJ NFSVQBLBO &LTLSFTJCJLBSCPOBUEJIJUVOHTFCBHBJLFDFQBUBOBMJSBOVSJOF
CJLBSCPOBUCBSV EJLBMJ LPOTFOUSBTJ )$0 VSJOF +VNMBI JOJ NFOVOKVLLBO
%BMBN UVCVMVT LPMJHFOT QFOBNCBIBO JPO /) LF DBJSBO TFCFSBQB DFQBU HJOKBM NFOHFMVBSLBO )$0 EBSJ EBSBI TBNB
UVCVMVTUFSKBEJNFMBMVJNFLBOJTNFZBOHCFSCFEB (BNCBS
EFOHBO QFOBNCBIBO TBUV )h LF EBMBN EBSBI
1BEB BMLBMPTJT
%JTJOJ )EJTFLSFTJLBOPMFINFNCSBOUVCVMVTLFEBMBNMVNFO LFIJMBOHBO )$0 NFNCBOUV NFOHFNCBMJLBO Q) QMBTNB
UFNQBUOZBCFSHBCVOHEFOHBO/)VOUVLNFNCFOUVL/) ZBOH NFOKBEJOPSNBM
LFNVEJBO EJFLTLSFTJLBO %VLUVT LPMJHFOT CFSTJGBU QFSNFBCFM
VOUVL/) ZBOHEBQBUEFOHBONVEBICFSEJGVTJLFEBMBNMVNFO +VNMBI )$0 CBSV ZBOH EJCFSJLBO LF EBMBN EBSBI QBEB
UVCVMVT XBLUVUFSUFOUVTBNBEFOHBOKVNMBITFLSFTJ)ZBOHCFSBLIJSEJ
"LBO UFUBQJ NFNCSBO MVNJOBM CBHJBO UVCVMVT JOJ LVSBOH MVNFOUVCVMVTEFOHBOEBQBSVSJOFOPOCJLBSCPOBU4FQFSUJUFMBI
QFSNFBCFM VOUVL /) PMFI LBSFOB JUV TFLBMJ ) UFMBI CFSFBLTJ EJCBIBT TFCFMVNOZB TVNCFS VUBNB EBQBS VSJOF OPO
EFOHBO /) VOUVL NFNCFOUVL /) /) UFSQFSBOHLBQ EJ CJLBSCPOBU BEBMBI /) EBO GPTGBU 0MFI LBSFOB JUV KVNMBI
EBMBNMVNFOUVCVMVTEBOEJLFMVBSLBOEBMBNVSJOF6OUVLTFUJBQ )$0 ZBOH EJUBNCBILBO LF EBMBN EBSBI EBO ) ZBOH
/) ZBOH EJFLTLSFTJLBO EJIBTJMLBO )$0 ZBOH CBSV EBO EJFLTLSFTJLBO PMFI /)
EJIJUVOH EFOHBO NFOHVLVS FLTLSFTJ
EJUBNCBILBOLFEBMBNEBSBI /) LFDFQBUBOBMJSBOVSJOFEJLBMJLPOTFOUSBTJ/)VSJOF

4JTB EBQBS OPOCJLBSCPOBU OPO/) ZBOH EJFLTLSFTJLBO LF
Asidosis Kronis Meningkatkan Ekskresi NH4+. 4BMBI TBUV EBMBNVSJOFEJVLVSEFOHBONFOFOUVLBOTVBUVOJMBJZBOHEJTFCVU
DJSJ QBMJOH QFOUJOH TJTUFN EBQBS BNPOJVNBNPOJB HJOKBM BEBMBI TFCBHBJBTBNZBOHEBQBUEJUJUSBTJ UJUSBUBCMFBDJE
+VNMBIBTBN
TJTUFN JOJ CFSBEB EJ CBXBI LPOUSPM GJTJPMPHJT 1FOJOHLBUBO ZBOH EBQBU EJUJUSBTJ EJ EBMBN VSJOF EJVLVS EFOHBO NFOJUSBTJ
LPOTFOUSBTJ ) DBJSBO FLTUSBTFMVMBS NFSBOHTBOH NFUBCPMJTNF VSJOF EFOHBO TVBUV CBTB LVBU TFQFSUJ /B0) TBNQBJ Q)
HMVUBNJO HJOKBM EBO PMFI LBSFOB JUV NFOJOHLBULBO QFNCFOUVL NFOKBEJ ZBJUVQ)QMBTNBOPSNBMEBOQ)GJMUSBUHMPNFSVMVT
LBO/)REBO)$0CBSVVOUVLEJHVOBLBOEBMBNQFOEBQBSBO) 5JUSBTJJOJNFOHFNCBMJLBOIBMZBOHUFSKBEJEBMBNMVNFOUVCVMVT
QFOVSVOBOLPOTFOUSBTJ)NFNJMJLJFGFLZBOHCFSMBXBOBO
TBBU DBJSBO UVCVMVT EJUJUSBTJ PMFI ) ZBOH EJTFLSFTJLBO 0MFI
1BEBLPOEJTJOPSNBM KVNMBI)ZBOHEJLFMVBSLBOPMFITJTUFN LBSFOBJUV KVNMBINJMJFLVJWBMFO/B0)ZBOHEJCVUVILBOVOUVL
EBQBSBNPOJBNFODBLVQTFLJUBSQFSTFOEBSJBTBNZBOH NFOHFNCBMJLBOQ)VSJOFNFOKBEJ TBNBEFOHBOKVNMBI
389
NJMJFLVJWBMFO ) ZBOH EJUBNCBILBO LF DBJSBO UVCVMVT ZBOH EBMBN BTJEPTJT SFTQJSBUPSJL EBO
QFOJOHLBUBO LPOTFOUSBTJ )
CFSJLBUBO EFOHBO GPTGBU EBO EBQBS PSHBOJL MBJOOZB DBJSBO FLTUSBTFMVMBS QFOVSVOBO Q)
EBMBN BTJEPTJT SFTQJSBUPSJL
1FOHVLVSBOBTBNZBOHEBQBUEJUJUSBTJUJEBLNFODBLVQ)hZBOH BUBVNFUBCBMJL
CFSJLBUBO EFOHBO /) LBSFOB Q, SFBLTJ BNPOJBBNPOJVN 4FM UVCVMVT NFNCFSJ SFTQPOT TFDBSB MBOHTVOH UFSIBEBQ
BEBMBI EBO UJUSBTJ EFOHBO /B0) TBNQBJ Q) NFOKBEJ QFOJOHLBUBO 1$0 EBSBI TFQFSUJ ZBOH UFSKBEJ QBEB BTJEPTJT
UJEBLNFOHIJMBOHLBO)EBO/) SFTQJSBUPSJL EFOHBO QFOJOHLBUBO LFDFQBUBO TFLSFTJ ) TFCBHBJ
+BEJ IBTJM OFUP FLTLSFTJ BTBN PMFI HJOKBM EBQBU EJUVMJT CFSJLVU 1FOJOHLBUBO 1$0 NFOJOHLBULBO 1$0 TFM UVCVMVT
TFCBHBJ NFOZFCBCLBO QFOJOHLBUBO QFNCFOUVLBO )$0 EBMBN TFM
UVCVMVT ZBOHLFNVEJBONFSBOHTBOHTFLSFTJ)'BLPSLFEVBZBOH
NFSBOHTBOHTFLSFTJ)BEBMBIQFOJOHLBUBOLPOTFOUSBTJ)DBJSBO
FLTUSBTFMVMBS QFOVSVOBOQ)

"MBTBO NFOHBQB LJUB NFOHVSBOHJ EFOHBO FLTLSFTJ )$0 'BLUPS LIVTVT ZBOH EBQBU NFOJOHLBULBO TFLSFTJ ) QBEB
BEBMBILBSFOBIJMBOHOZB)$0TBNBEFOHBOQFOBNCBIBO) CFCFSBQB LFBEBBO QBUPGJTPMPHJT BEBMBI TFLSFTJ BMEPTUFSPO ZBOH
LFEBMBNEBSBI6OUVLNFNQFSUBIBOLBOLFTFJNCBOHBOBTBN CFSMFCJIBO "MEPTUFSPO NFSBOHTBOH TFLSFTJ ) PMFI TFM
CBTB FLTLSFTJ OFUP BTBN IBSVT TBNB EFOHBO QSPEVLTJ BTBN JOUFSLBMBUVT EVLUVT LPMJHFOT 0MFI LBSFOB JUV TFLSFTJ BMEPTUFSPO
OPOWPMBUJM EBMBN UVCVI 1BEB BTJEPTJT FLTLSFTJ OFUP BTBN ZBOH CFSMFCJIBO TFQFSUJ ZBOH UFSKBEJ QBEB TJOESPN $POO EBQBU
NFOJOHLBUEFOHBOOZBUB UFSVUBNBBLJCBUQFOJOHLBUBOFLTLSFTJ NFOZFCBCLBO QFOJOHLBUBO TFLSFTJ ) LF EBMBN DBJSBO UVCVMVT
/) TFIJOHHBNFOHIJMBOHLBOBTBNEBSJEBSBI&LTLSFTJOFUP EBO BLJCBUOZB NFOJOHLBULBO KVNMBI )$0 ZBOH LFNCBMJ LF
BTBNKVHBTBNBEFOHBOLFDFQBUBOQFOBNCBIBOOFUP)$0LF EBSBI )BM JOJ CJBTBOZB LFNVEJBO NFOZFCBCLBO BMLBMPTJT QBEB
EBMBN EBSBI 0MFI LBSFOB JUV QBEB BTJEPTJT UFSEBQBU QBTJFOEFOHBOTFLSFTJBMEPTUFSPOZBOHCFSMFCJIBO
QFOBNCBIBO OFUP )$0 LFNCBMJ LF EBMBN EBSBI TFCBOZBL
FLTLSFTJ /) EBO FLTLSFTJ BTBN EBMBN VSJOF ZBOH EBQBU #JBTBOZBTFMUVCVMVTNFNCFSJLBOSFTQPOTUFSIBEBQQFOVSVOBO
EJUJUSBTJ LPOTFOUSBTJ ) BMLBMPTJT
EFOHBO NFOHVSBOHJ TFLSFTJ )
1FOHVSBOHBO TFLSFTJ ) UFSKBEJ TFCBHBJ BLJCBU QFOVSVOBO 1$0
1BEBBMLBMPTJT FLTLSFTJBTBNZBOHEBQBUEJUJUSBTJEBO/) FLTUSBTFM TFQFSUJ ZBOH UFSKBEJ QBEB BMLBMPTJT SFTQJSBUPSJL BUBV
EBMBN VSJOF NFOVSVO TBNQBJ TFEBOHLBO FLTLSFTJ )$0 TFCBHBJBLJCBUQFOVSVOBOLPOTFOUSBTJ)JUVTFOEJSJ TFQFSUJZBOH
NFOJOHLBU 0MFI LBSFOB JUV QBEB BMLBMPTJT TFLSFTJ BTBN OFUP UFSKBEJQBEBBMLBMPTJTSFTQJSBUPSJLEBOBMLBMPTJTNFUBCPMJL
OFHBUJG )BM JOJ CFSBSUJ UFSEBQBU LFIJMBOHBO )$0 EBSJ EBSBI
ZBOHTBNBEFOHBOQFOBNCBIBO)LFEBMBNEBSBI
EBOUJEBL 5BCFM NFSBOHLVN GBLUPSGBLUPS VUBNB ZBOH
BEB)$0CBSVZBOHEJIBTJMLBOPMFIHJOKBM NFNFOHBSVIJTFLSFTJ)EBOSFBCTPSQTJ)$0#FCFSBQBGBLUPS
UJEBL CFSIVCVOHBO MBOHTVOH EFOHBO QFOHBUVSBO LFTFJNCBOHBO
Pengaturan Sekresi H+ oleh Tubulus Ginjal BTBNCBTB 4FCBHBJ DPOUPI TFLSFTJ ) UFSKBEJ CFSTBNBBO EFOHBO
4FQFSUJUFMBIEJCBIBTTFCFMVNOZB TFLSFTJ)PMFIFQJUFMUVCVMVT SFBCTPSQTJ /B NFMBMVJ /B) FYDIBOHFS EJ UVCVMVT QSPLTJNBM
EJQFSMVLBOVOUVLSFBCTPSQTJ)$0EBOQFNCFOUVLBO)$0 EBOTFHNFOUFCBMQBSTBTFOEFOBOTB)FOMF0MFILBSFOBJUV GBLUPS
CBSVZBOHCFSIVCVOHBOEFOHBOQFNCFOUVLBOBTBNZBOHEBQBU ZBOH NFSBOHTBOH SFBCTPSQTJ /B TFQFSUJ QFOVSVOBO WPMVNF
EJUJUSBTJ 0MFI LBSFOB JUV LFDFQBUBO TFLSFTJ ) IBSVT EJBUVS DBJSBO FLTUSBTFMVMBS KVHB EBQBU NFOJOHLBULBO TFLSFTJ ) TFDBSB
EFOHBOUFMJUJCJMBHJOKBMBLBONFMBLVLBOGVOHTJOZBTFDBSBFGFLUJG TFLVOEFS
EBMBN IPNFPTUBTJT BTBNCBTB 1BEB LFBEBBO OPSNBM UVCVMVT
,FIJMBOHBOWPMVNFDBJSBOFLTUSBTFMVMBSNFSBOHTBOHSFBCTPSQTJ
HJOKBM NFOZFLSFTJ TFEJLJUOZB TFKVNMBI ) ZBOH DVLVQ VOUVL
OBUSJVN PMFI UVCVMVT HJOKBM EBO NFOJOHLBULBO TFLSFTJ /B EBO
NFSFBCTPSQTJ IBNQJS TFNVB )$0 ZBOH EJGJMUSBTJ EBO IBSVT
SFBCTPSQTJ )$0 NFMBMVJ CFSCBHBJ NFLBOJTNF NFMJQVUJ

UFSEBQBUTJTB)ZBOHDVLVQVOUVLEBQBUEJFLTLSFTJLBOTFCBHBJ
QFOJOHLBUBO LBEBS BOHJPUFOTJO ** ZBOH TFDBSB MBOHTVOH
BTBN ZBOH EBQBU EJUJUSBTJ BUBV /) VOUVL NFNCFSTJILBO
NFSBOHTBOHBLUJWJUBT/B)FYDIBOHFSEBMBNUVCVMVTHJOKBM EBO
UVCVIEBOBTBNOPOWPMBUJMZBOHEJQSPEVLTJPMFINFUBCPMJTNF

QFOJOHLBUBO LBEBS BMEPTUFSPO ZBOH NFSBOHTBOH TFLSFTJ )
TFUJBQIBSJ
PMFI TFM JOUFSLBMBUVT EJ UVCVMVT LPMJHFOT LPSUJLBMJT 0MFI LBSFOB
1BEB BMLBMPTJT TFLSFTJ ) UVCVMVT IBSVT EJLVSBOHJ TBNQBJ JUV LFIJMBOHBO WPMVNF DBJSBO FLTUSBTFMVMBS DFOEFSVOH NF
CBUBT ZBOH TBOHBU SFOEBI TFIJOHHB UJEBL UFSKBEJ SFBCTPSQTJ OZFCBCLBO BMLBMPTJT BLJCBU LFMFCJIBO TFLSFTJ ) EBO SFBCTPSQTJ
)$0TFMVSVIOZB ZBOHNFNCVBUHJOKBMNBNQVNFOJOHLBULBO )$0
FLTLSFTJ)$01BEBLFBEBBOJOJ BTBNZBOHEBQBUEJUJUSBTJEBO
BNPOJBUJEBLEJFLTLSFTJLBOLBSFOBUJEBLBEBLFMFCJIBO)ZBOH
UFSTFEJB VOUVL CFSJLBUBO EFOHBO EBQBS OPOCJLBSCPOBU PMFI
LBSFOB JUV UJEBL BEB )$0 CBSV ZBOH EJUBNCBILBO LF EBMBN 1FOJOHLBUBO4FLSFTJ)EBO 1FOVSVOBO4FLSFTJ)EBO
VSJOF QBEB LFBEBBO BMLBMPTJT 4FMBNB BTJEPTJT TFLSFTJ ) PMFI 3FBCTPSQTJ)$0 3FBCTPSQTJ)$0
UVCVMVT IBSVT DVLVQ EJUJOHLBULBO VOUVL NFSFBCTPSCTJ TFNVB
)$0ZBOHEJGMJUSBTJEBOUFUBQNFNQVOZBJTJTB)ZBOHDVLVQ ↑Pco2 ↓ Pco2
VOUVLNFOHFLTLSFTJTFKVNMBICFTBS/) EBOBTBNZBOHEBQBU ↑ H+, ↓ HCO3− ↓ H+, ↑ HCO3−
EJUJUSBTJ TFIJOHHB NFOBNCBI TFKVNMBI CFTBS JPO )$0 CBSV Volume cairan ekstraselurar Volume cairan ekstraselular
LF DBJSBO FLTUSBTFMVMBS UVCVI UPUBM 3BOHTBOH QBMJOH QFOUJOH
Angiotensin II Angiotensin II
VOUVL NFOJOHLBULBO TFLSFTJ ) PMFI UVCVMVT EBMBN LFBEBBO
BTJEPTJTBEBMBI
QFOJOHLBUBO1$0DBJSBOFLTUSBTFMVMBS Aldosteron ↓ Aldosteron
Hipokalemia Hiperkalemia
390
1FSVCBIBOLPOTFOUSBTJLBMJVNQMBTNBKVHBEBQBUNFNFOHBSVIJ 4FQFSUJZBOHUFMBIEJCBIBTTFCFMVNOZB QBEBBTJEPTJTLSPOJT

TFLSFTJ)LBSFOBIJQPLBMFNJBNFSBOHTBOHTFLSFTJ)EBOIJQFSLB UBOQB NFOHIJSBVLBO BQBLBI BTJEPTJT CFSTJGBU SFTQJSBUPSJLBUBV
MFNJB NFOHIBNCBU TFLSFTJ ) EJ UVCVMVT QSPLTJNBM 1FOVSVOBO NFUBCPMJL UFSEBQBU QFOJOHLBUBO QSPEVLTJ /) ZBOH
LPOTFOUSBTJ LBMJVN QMBTNB DFOEFSVOH NFOJOHLBULBO LPOTFOUSBTJ TFMBOKVUOZBUVSVUCFSQFSBOEBMBNFLTLSFTJ)EBOQFOBNCBIBO
) EBMBN TFM UVCVMVT HJOKBM ,FNVEJBO QFOJOHLBUBO JOJ )$0CBSVLFEBMBNDBJSBOFLTUSBTFMVMBS1BEBBTJEPTJTLSPOJT
UNIT V
NFSBOHTBOH TFLSFTJ ) EBO SFBCTPSQTJ )$0 EBO NFOZFCBCLBO ZBOH CFSBU TFCBOZBL N&RIBSJ ) EBQBU EJFLTLSFTJLBO
UFSKBEJOZB BMLBMPTJT )JQFSLBMFNJB NFOHVSBOHJ TFLSFTJ ) EBO EBMBN VSJOF UFSVUBNB EBMBN CFOUVL /) IBM JOJ LFNVEJBO
SFBCTPSQTJ)$0EBODFOEFSVOHNFOZFCBCLBOBTJEPTJT UVSVU CFSQFSBO NFOZFCBCLBO QFOBNCBIBO )$0 CBSV LF
EBMBNEBSBITBNQBN&RIBSJ
Koreksi Asidosis oleh Ginjal—Peningkatan Ekskresi H +BEJ QBEB BTJEPTJT LSPOJT QFOJOHLBUBO TFLSFTJ ) PMFI
+ dan Penambahan HCO3- ke dalam Cairan UVCVMVTNFNCBOUVNFOHFMVBSLBOLFMFCJIBO)EBSJUVCVIEBO
Ekstraselular NFOJOHLBULBO KVNMBI )$0 EBMBN DBJSBO FLTUSBTFMVMBS )BM
JOJ NFOJOHLBULBO CBHJBO )$0 TJTUFN EBQBS CJLBSCPOBU
0MFI LBSFOB LJUB UFMBI NFNCBIBT NFLBOJTNF TFLSFTJ ) EBO ZBOHNFOVSVUQFSTBNBBO)FOEFSTPO)BTTFMCBMDI NFNCBOUV
SFBCTPSQTJ)$0PMFIHJOKBM TFLBSBOHLJUBEBQBUNFOFSBOHLBO NFOJOHLBULBO Q) FLTUSBTFM EBO NFOHPSFLTJ BTJEPTJT +JLB
CBHBJNBOBHJOKBMNFOZFTVBJLBOLFNCBMJQ)DBJSBOFLTUSBTFMVMBS BTJEPTJT UFSKBEJ TFDBSB NFUBCPMJL LPNQFOTBTJ UBNCBIBO PMFI
TBBUQ)NFOKBEJBCOPSNBM QBSV NFOZFCBCLBO QFOHVSBOHBO 1$0 KVHB NFNCBOUV
NFOHPSFLTJBTJEPTJT
.FSVKVL QBEB QFSTBNBBO QFSTBNBBO )FOEFSTPO
)BTTFMCBMDI LJUBEBQBUNFMJIBUCBIXBBTJEPTJTUFSKBEJLFUJLBSBTJP 5BCFM NFSBOHLVN DJSJDJSJ BTJEPTJT SFTQJSBUPSJL EBO
)$0 UFSIBEBQ $0 EBMBN DBJSBO FLTUSBTFMVMBS NFOVSVO NFUBCPMJL EBO KVHB DJSJDJSJ BMLBMPTJT SFTQJSBUPSJL EBO
TFIJOHHB NFOZFCBCLBO QFOVSVOBO Q) #JMB SBTJP JOJ NFOVSVO NFUBCPMJL ZBOH BLBO EJCBIBT QBEB CBHJBO CFSJLVUOZB
BLJCBU QFOVSVOBO )$0 BTJEPTJT ZBOH UFSKBEJ EJTFCVU BTJEPTJT 1FSIBUJLBO CBIXB QBEB BTJEPTJT SFTQJSBUPSJL UFSEBQBU
NFUBCPMJL #JMB Q) UVSVO LBSFOB QFOJOHLBUBO 1$0 BTJEPTJT QFOVSVOBOQ) QFOJOHLBUBOLPOTFOUSBTJ)DBJSBOFLTUSBTFMVMBS
ZBOHUFSKBEJEJTFCVUBTJEPTJTSFTQJSBUPSJL EBO QFOJOHLBUBO 1$0 ZBOH NFSVQBLBO QFOZFCBC BXBM
BTJEPTJT 3FTQPOT LPNQFOTBTJ BEBMBI QFOJOHLBUBO )$0
Asidosis Menurunkan Rasio HCO3 /H+ dalam Cairan QMBTNB ZBOH EJTFCBCLBO PMFI QFOBNCBIBO )$0 CBSV LF
Tubulus Ginjal. EBMBN DBJSBO FLTUSBTFMVMBS PMFI HJOKBM 1FOJOHLBUBO )$0
NFNCBOUV NFOHJNCBOHJ QFOJOHLBUBO 1$0 TFIJOHHB
"TJEPTJT SFTQJSBUPSJL EBO NFUBCPMJL NFOZFCBCLBO QFOVSVOBO
NFOHFNCBMJLBOQ)QMBTNBLFNCBMJOPSNBM
SBTJP)$0UFSIBEBQ)EBMBNDBJSBOUVCVMVTHJOKBM"LJCBUOZB
UFSEBQBU LFMFCJIBO ) EJ EBMBN UVCVMVT HJOKBM NFOZFCBCLBO 1BEB BTJEPTJT NFUBCPMJL KVHB UFSEBQBU QFOVSVOBO Q) EBO
SFBCTPSQTJ TFNVB )$0 EBO NBTJI NFOZJTBLBO ) ZBOH QFOJOHLBUBOLPOTFOUSBTJ)DBJSBOFLTUSBTFMVMBS"LBOUFUBQJ QBEB
UFSTFEJB VOUVL CFSJLBUBO EFOHBO EBQBS VSJOF /) EBO )10 LFBEBBO JOJ LFMBJOBO VUBNBOZB BEBMBI QFOVSVOBO )$0
+BEJ QBEB BTJEPTJT HJOKBM NFSFBCTPSCTJ TFNVB )$0 ZBOH QMBTNB ,PNQFOTBTJ VUBNBOZB NFMJQVUJ QFOJOHLBUBO LFDFQBUBO
EJGJMUSBTJ EBO NFOZVNCBOHLBO )$0 CBSV NFMBMVJ WFOUJMBTJ ZBOH NFOHVSBOHJ 1$0 EBO LPNQFOTBTJ HJOKBM ZBOH
QFNCFOUVLBO/)EBOBTBNZBOHEBQBUEJUJUSBTJ EFOHBO NFOBNCBILBO )$0 CBSV LF DBJSBO FLTUSBTFMVMBS
NFNCBOUV NFNQFSLFDJM QFOVSVOBO BXBM LPOTFOUSBTJ )$0
1BEB BTJEPTJT NFUBCPMJL QFOJOHLBUBO ) NFMFCJIJ )$0 FLTUSBTFM
ZBOHUFSKBEJUFSVUBNBEJDBJSBOUVCVMVTBLJCBUQFOVSVOBOGJMUSBTJ
)$0 1FOVSVOBO GJMUSBTJ )$0 JOJ UFSVUBNB EJTFCBCLBO PMFI Koreksi Alkalosis oleh Ginjal—Penurunan Sekresi H+
QFOVSVOBOLPOTFOUSBTJ)$0DBJSBOFLTUSBTFMVMBS oleh Tubulus dan Peningkatan Ekskresi HCO3
1BEB BTJEPTJT SFTQJSBUPSJL LFMFCJIBO ) EJ EBMBN DBJSBO
UVCVMVT UFSVUBNB EJTFCBCLBO PMFI QFOJOHLBUBO 1$0 DBJSBO 3FTQPOT LPNQFOTBTJ UFSIBEBQ BMLBMPTJT QBEB EBTBSOZB
FLTUSBTFMVMBS ZBOHNFSBOHTBOHTFLSFTJ) CFSMBXBOBO EFOHBO SFTQPOT ZBOH UFSKBEJ QBEB BTJEPTJT 1BEB
BMLBMPTJT SBTJP )$0 UFSIBEBQ $0 EJ EBMBN DBJSBO
FLTUSBTFMVMBSNFOJOHLBU NFOZFCBCLBOQFOJOHLBUBOQBEB
pH H+ PCO2 HCO3−
7.4 40 mEq/L 40 mm Hg 24 mEq/L
Kejadian primer ditunjukkan oleh panah yang rangkap (jT atau j I). Perhatikan bahwa gangguan asam-basa respiratorik diawali dengan peningkatan atau
penurunan PCOZ, sedangkan gangguan metabolik diawali dengan peningkatan atau penurunan HCO3 .
391
Q) QFOVSVOBOLPOTFOUSBTJ)
TFQFSUJZBOHUFSCVLUJEBSJ LPOTFOUSBTJ) TFIJOHHBNFOJNCVMLBOBTJEPTJT0MFILBSFOBBTJEPTJT
QFSTBNBBO)FOEFSTPO)BTTFMCBMDI EJTFCBCLBOPMFIHBOHHVBOSFTQJSBTJ NBLBEJTFCVUBTJEPTJTSFTQJSBUPSJL
"TJEPTJT SFTQJSBUPSJL EBQBU UFSKBEJ BLJCBU LPOEJTJ QBUPMPHJT ZBOH
Alkalosis Meningkatkan Rasio HCO3 /H dalam Cairan NFSVTBL QVTBU QFSOBQBTBO BUBV ZBOH NFOVSVOLBO LFNBNQVBO QBSV
Tubulus Ginjal VOUVL NFOHFMVBSLBO $0 4FCBHBJ DPOUPI LFSVTBLBO QVTBU
QFSOBQBTBO EJ NFEVMB PCMPOHBUB EBQBU NFOJNCVMLBO BTJEPTJT
5BOQB NFNQFSIBUJLBO QFOZFCBC BMLBMPTJT CBJL BLJCBU SFTQJSBUPSJL 0CTUSVLTJ KBMVS USBLUVT SFTQJSBUPSJVT QOFVNPOJB
HBOHHVBO NFUBCPMJL BUBV SFTQJSBUPSJL NBTJI UFSEBQBU TVBUV FNGJTFNB BUBVQFOVSVOBOMVBTQFSNVLBBONFNCSBOQBSV EBOTFUJBQ
QFOJOHLBUBOSBTJP)$0UFSIBEBQ)EJDBJSBOUVCVMVTHJOKBM GBLUPS ZBOH NFOHHBOHHV QFSUVLBSBO HBT BOUBSB EBSBI EBO VEBSB
&GFLOFUPNFLBOJTNFLPNQFOTBTJJOJBEBMBILFMFCJIBO)$0 BMWFPMVT KVHBEBQBUNFOZFCBCLBOBTJEPTJTSFTQJSBUPSJL
ZBOH UJEBL EBQBU EJSFBCTPSCTJ EBSJ UVCVMVT EBO PMFI LBSFOB 1BEB BTJEPTJT SFTQJSBUPSJL SFTQPOT LPNQFOTBTJ ZBOH UFSTFEJB
JUV EJFLTLSFTJLBO EBMBN VSJOF +BEJ QBEB BMLBMPTJT )$0 BEBMBI
EBQBS DBJSBO UVCVI EBO
HJOKBM ZBOH NFNCVUVILBO
EJLFMVBSLBO EBSJ DBJSBO FLTUSBTFMVMBS NFMBMVJ FLTLSFTJ HJOKBM XBLUVCFCFSBQBIBSJVOUVLNFOHPNQFOTBTJHBOHHVBO
ZBOHNFNQVOZBJFGFLZBOHTBNBTFQFSUJQFOBNCBIBO)QBEB
DBJSBO FLTUSBTFMVMBS )BM JOJ NFNCBOUV NFOHFNCBMJLBO Alkalosis Respiratorik Disebabkan oleh Peningkatan
LPOTFOUSBTJ)EBOQ)LFNCBMJOPSNBM Ventilasi dan Penurunan PCO2
"MLBMPTJTSFTQJSBUPSJLEJTFCBCLBOPMFIWFOUJMBTJZBOHCFSMFCJIBOPMFIQBSV
5BCFM NFOVOKVLLBO TFMVSVI DJSJ BMLBMPTJT SFTQJSBUPSJL
)BMJOJKBSBOHUFSKBEJBLJCBULPOEJTJQBUPMPHJTGJTJL"LBOUFUBQJ TFPSBOH
EBO NFUBCPMJL 1BEB BMLBMPTJT SFTQJSBUPSJL UFSEBQBU QFOEFSJUB QTJLPOFVSPTJT LBEBOHLBEBOH NFOJOHLBULBO QFSOBQBTBOOZB
QFOJOHLBUBO Q) DBJSBO FLTUSBTFMVMBS EBO QFOVSVOBO TFIJOHHBJBNFOHBMBNJBMLBMPTJT
LPOTFOUSBTJ ) 1FOZFCBC BMLBMPTJT BEBMBI QFOVSVOBO 1$0
4FKFOJT BMLBMPTJT SFTQJSBUPSJL ZBOH GJTJPMPHJT EBQBU UFSKBEJ LFUJLB
QMBTNB ZBOHEJTFCBCLBOPMFIIJQFSWFOUJMBTJ1FOVSVOBO1$0 TFTFPSBOH NFOEBLJ IJOHHB NFODBQBJ UFNQBU EJ LFUJOHHJBO ,BEBS
LFNVEJBONFOJNCVMLBOQFOVSVOBOLFDFQBUBOTFLSFTJ)PMFI PLTJHFOZBOHSFOEBIEBMBNVEBSBBLBONFSBOHTBOHQFSOBQBTBO ZBOH
UVCVMVT HJOKBM 1FOVSVOBO TFLSFTJ ) NFOHVSBOHJ KVNMBI ) NFOZFCBCLBOCBOZBLTFLBMJQFMFQBTBO$0EBOUFSCFOUVLOZBBMLBMPTJT
EBMBNDBJSBOUVCVMVTHJOKBM"LJCBUOZB KVNMBI)UJEBLDVLVQ SFTQJSBUPSJL SJOHBO 4FLBMJ MBHJ BMBU VUBNB VOUVL LPNQFOTBTJ BEBMBI
VOUVL CFSFBLTJ EFOHBO TFNVB )$0 ZBOH EJGJMUSBTJ 0*FI EBQBS LJNJBXJ DBJSBO UVCVI EBO LFNBNQVBO HJOKBM VOUVL
LBSFOBJUV )$0ZBOHUJEBLEBQBUCFSFBLTJEFOHBO) UJEBL NFOJOHLBULBOFLTLSFTJ)$0
EJSFBCTPSCTJ EBO EJFLTLSFTJLBO EBMBN VSJOF )BM JOJ
NFOHIBTJMLBO QFOVSVOBO LPOTFOUSBTJ )$0 QMBTNB EBO Asidosis Metabolik Disebabkan oleh Penurunan
LPSFLTJ UFSIBEBQ BMLBMPTJT 0MFI LBSFOB JUV SFTQPOT HCO3- Cairan Ekstraselular
LPNQFOTBTJ UFSIBEBQ QFOVSVOBO 1$0 QSJNFS QBEB BMLBMPTJT *TUJMBI BTJEPTJT NFUBCPMJL BEBMBI TFNVB UJQF BTJEPTJT TFMBJO BTJEPTJT
SFTQJSBUPSJL BEBMBI QFOHVSBOHBO LPOTFOUSBTJ )$0 QMBTNB ZBOH EJTFCBCLBO PMFI LFMFCJIBO $0 EBMBN DBJSBO UVCVI "TJEPTJT
ZBOHEJTFCBCLBOPMFIQFOJOHLBUBOFLTLSFTJ)$0PMFIHJOKBM NFUBCPMJL EBQBU EJTFCBCLBO PMFI CFCFSBQB QFOZFCBC VNVN

LFHBHBMBO HJOKBM VOUVL NFOHFLTLSFTJLBO BTBN NFUBCPMJL ZBOH
1BEB BMLBMPTJT NFUBCPMJL KVHB UFSEBQBU QFOJOHLBUBO Q)
OPSNBMOZB EJCFOUVL EBMBN UVCVI
QFNCFOUVLBO BTBN NFUBCPMJL
QMBTNBEBOQFOVSVOBOLPOTFOUSBTJ)"LBOUFUBQJ QFOZFCBC ZBOH CFSMFCJIBO EBMBJO UVCVI
QFOBNCBIBO BTBN NFUBCPMJL LF
BMLBMPTJT NFUBCPMJL BEBMBI QFOJOHLBUBO LPOTFOUSBTJ )$0 EBMBN UVCVI NFMBMVJ NBLBOBO BUBV QFNCFSJBO BTBN EBO

DBJSBOFLTUSBTFMVMBS,FBEBBOJOJEJLPNQFOTBTJTFCBHJBOPMFI LFIJMBOHBO CBTB EBO DBJSBO UVCVI ZBOH NFNJMJLJ FGFL ZBOH TBNB
QFOHVSBOHBO LFDFQBUBO QFSOBQBTBO ZBOH NFOJOHLBULBO TFQFSUJ QFOBNCBIBO BTBN LF EBMBN DBJSBO UVCVI #FCFSBQB LPOEJTJ
1$0EBONFNCBOUVNFOHFNCBMJLBOQ)DBJSBOFLTUSBTFMVMBS LIVTVTZBOHNFOZFCBCLBOBTJEPTJTNFUBCPMJLBEBMBITFCBHBJCFSJLVU
LF OPSNBM 4FMBJO JUV QFOJOHLBUBO LPOTFOUSBTJ )$0 EBMBN "TJEPTJT 5VCVMVT (JOKBM +FOJT BTJEPTJT JOJ EJTFCBCLBO PMFI
DBJSBO FLTUSBTFMVMBS NFOJNCVMLBO QFOJOHLBUBO CFCBO GJMUSBTJ HBOHHVBOTFLSFTJ)BUBVSFBCTPSQTJ)$0PMFIHJOKBM BUBVLFEVBOZB
)$0 ZBOH LFNVEJBO NFOZFCBCLBO QFOJOHLBUBO )$0 ,FMBJOBO JOJ CJBTBOZB NFODBLVQ EVB UJQF
HBOHHVBO SFBCTPOQTJ
NFMFCJIJ ) ZBOH EJTFLSFTJLBO EBMBN DBJSBO UVCVMVT HJOKBM )$0PMFIUVCVMVTHJOKBM ZBOHNFOZFCBCLBOIJMBOHOZB)$0EBMBN
,FMFCJIBO )$0 EJ EBMBN DBJSBO UVCVMVT HBHBM EJSFBCTPCTJ VSJOF BUBV
LFUJEBLNBNQVBO NFLBOJTNF TFLSFTJ ) PMFI UVCVMVT
LBSFOBUJEBLBEB)VOUVLCFSFBLTJEFOHBO)$0 EBOPMFI HJOKBM VOUVL NFOJNCVMLBO LFBTBNBO VSJOF ZBOH OPSNBM
NFOZFCBCLBO FLTLSFTJ VSJOF ZBOH BMLBMJ 1BEB LFBEBBO JOJ
LBSFOBJUVLFMFCJIBO)$0EJFLTLSFTJLBOEBMBNVSJOF1BEB
EJFLTLSFTJLBOBTBNZBOHEBQBUEJUJUSBTJEBO/)EBMBNKVNMBIZBOH
BMLBMPTJTNFUBCPMJL LPNQFOTBTJVUBNBOZBBEBMBIQFOVSVOBO
UJEBL BEFLVBU TFIJOHHB UFSKBEJ QFOHVNQVMBO BTBN EBMBN DBJSBO
WFOUJMBTJ ZBOHNFOJOHLBULBO1$0 EBOQFOJOHLBUBOFLTLSFTJ UVCVI#FCFSBQBQFOZFCBCBTJEPTJTUVCVMVTHJOKBMUFSNBTVLHBHBMHJOKBM
)$0 PMFI HJOKBM ZBOH NFNCBOUV NFOHPNQFOTBTJ LSPOJT JOTVGJTJFOTJ TFLSFTJ BMEPTUFSPO QFOZBLJU "EEJTPO
EBO
QFOJOHLBUBOBXBMLPOTFOUSBTJ)$0DBJSBOFLTUSBTFMVMBS CFCFSBQBHBOHHVBOIFSFEJUFSEBOHBOHHVBOEJEBQBUZBOHNFOHHBOHHV
GVOHTJUVCVMVT TFQFSUJTJOESPN'BODPOJ MJIBU#BC

Penyebab Klinis Gangguan Asam-Basa %JBSF %JBSF CFSBU NVOHLJO NFSVQBLBO QFOZFCBC BTJEPTJT
NFUBCPMJLZBOHQBMJOHTFSJOH1FOZFCBCBTJEPTJTJOJBEBMBIIJMBOHOZB
TFKVNMBI CFTBS OBUSJVN CJLBSCPOBU LF EBMBN GFTFT 4FLSFTJ
Asidosis Respiratorik Disebabkan oleh Penurunan HBTUSPJOUFTUJOBM OPSNBM NFOHBOEVOH TFKVNMBI CFTBS CJLBSCPOBU EBO
Ventilasi dan Peningkatan PCO2 EJBSF NFOZFCBCLBO IJMBOHOZB )$0 JOJ EBSJ UVCVI ZBOH NFNCFSJ
%BSJQFNCBIBTBOTFCFMVNOZBTVEBIKFMBTCBIXBGBLUPSBQBQVOZBOH FGFL ZBOH TBNB TFQFSUJ IJMBOHOZB TFKVNMBI CFTBS CJLBSCPOBU EBMBN
NFOVSVOLBO LFDFQBUBO WFOUJMBTJ QBSV BLBO NFOJOHLBULBO 1$0 VSJOF #FOUVL BTJEPTJT NFUBCPMJL JOJ EBQBU CFSMBOHTVOH CFSBU EBO
DBJSBOFLTUSBTFMVMBS)BMJOJNFOZFCBCLBOQFOJOHLBUBO)$0EBO EBQBUNFOZFCBCLBOLFNBUJBO UFSVUBNBQBEBBOBLBOBL
392
.FNVOUBILBO*TJ6TVT.FNVOUBILBOJTJMBNCVOHTBKBBLBO FLTUSBTFMVMBSEBOUFSKBEJOZBBMLBMPTJTNFUBCPMJL"MLBMPTJTKFOJTJOJ
NFOZFCBCLBO IJMBOHOZB BTBN EBO LFDFOEFSVOHBO LF BSBI UFSVUBNB UFSKBEJ QBEB OFPOBUVT EFOHBO PCTUSVLTJ QJMPSVT BLJCBU
BMLBMPTJTLBSFOBTFLSFTJMBNCVOHCFSTJGBUTBOHBUBTBN"LBOUFUBQJ IJQFSUSPGJPUPUTGJOHUFSQJMPSVT
NFNVOUBILBO TFKVNMBI CFTBS JTJ EBSJ CBHJBO USBLUVT
,POTVNTJ 0CBUPCBUBO "MLBMJ 4BMBI TBUV QFOZFCBC BMLBMPTJT
HBTUSPJOUFTUJOBM CBHJBO CBXBI ZBOH LBEBOHLBEBOH EBQBU UFSKBEJ
NFUBCPMJLZBOHCJBTBBEBMBILPOTVNTJPCBUBMLBMJ TFQFSUJOBUSJVN
NFOZFCBCLBO IJMBOHOZB CJLBSCPOBU EBO NFOJNCVMLBO BTJEPTJT
UNIT V
NFUBCPMJL EFOHBO DBSB ZBOH TBNB TFQFSUJ EJBSF NFOJNCVMLBO CJLBSCPOBU VOUVLQFOHPCBUBOHBTUSJUJTBUBVVMLVTQFQUJL
BTJEPTJT
%JBCFUFT .FMJUVT %JBCFUFT NFMJUVT EJTFCBCLBO PMFI UJEBL Pengobatan Asidosis atau Alkalosis
BEBOZB TFLSFTJ JOTVMJO PMFI QBOLSFBT EJBCFUFT UJQF *
BUBV PMFI
JOTVGJTJFOTJ TFLSFTJ JOTVMJO VOUVL NFOHPNQFOTBTJ QFOVSVOBO
TFOTJUJWJUBT QBEB FGFL JOTVMJO EJBCFUFT UJQF **
,FBEBBO EFOHBO 1FOHPCBUBO ZBOH QBMJOH CBJL VOUVL BTJEPTJT BUBV BMLBMPTJT BEBMBI
JOTVMJOZBOHUJEBLDVLVQ NFOHIBMBOHJQFOHHVOBBOHMVLPTBEBMBN NFOHPSFLTJ LFBEBBO ZBOH UFMBI NFOZFCBCLBO LFMBJOBO )BM JOJ
NFUBCPMJTNF TFDBSB OPSNBM 4FCBMJLOZB CFCFSBQB MFNBL EJQFDBI TFSJOHLBMJTVMJU UFSVUBNBQBEBQFOZBLJULSPOJTZBOHNFOZFCBCLBO
NFOKBEJ BTBN BTFUPBTFUBU EBO BTBN JOJ EJNFUBCPMJTNF PMFI HBOHHVBOGVOHTJQBSVBUBVHBHBMHJOKBM1BEBLFBEBBOJOJ CFSCBHBJ
KBSJOHBO VOUVL NFOHIBTJMLBO FOFSHJ NFOHHBOUJLBO HMVLPTB 1BEB [BUEBQBUEJHVOBLBOVOUVLNFOFUSBMLBOLFMFCJIBOBTBNBUBVCBTB
EJBCFUFT NFMJUVT ZBOH CFSBU LBEBS BTBN BTFUPBTFUBU EBSBI EBQBU EBMBNDBJSBOFLTUSBTFMVMBS
NFOJOHLBU TBOHBU UJOHHJ TFIJOHHB NFOZFCBCLBO BTJEPTJT 6OUVL NFOFUSBMLBO LFMFCJIBO BTBN TFKVNMBI CFTBS OBUSJVN
NFUBCPMJLZBOHCFSBU%BMBNVTBIBVOUVLNFOHPNQFOTBTJBTJEPTJT CJLBSCPOBU EBQBU EJCFSJLBO NFMBMVJ NVMVU /BUSJVN CJLBSCPOBU
JOJ TFKVNMBI CFTBS BTBN EJFLTLSFTJLBO EBMBN VSJOF UFSLBEBOH EJBCTPSCTJ EBSJ USBLUVT HBTUSPJOUFTUJOBM LF EBMBN EBSBI EBO
TFCBOZBLNNPMIBSJ NFOJOHLBULBO CBHJBO )$0 TJTUFN EBQBS CJLBSCPOBU TFIJOHHB
.BLBO 4FKVNMBI "TBN +BSBOH TFLBMJ TFKVNMBI CFTBS BTBN NFOJOHLBULBOQ)NFOVKVOPSNBM/BUSJVNCJLBSCPOBUEBQBUKVHB
EJNBLBO EBSJ NBLBOBO CJBTB "LBO UFUBQJ BTJEPTJT NFUBCPMJL ZBOH EJCFSJLBO TFDBSB JOUSBWFOB UFUBQJ LBSFOB FGFL GJTJPMPHJT
CFSBU LBEBOHLBEBOH EJTFCBCLBO PMFI SBDVO BTBN UFSUFOUV QFOHPCBUBOTFNBDBNJOJCFSQPUFOTJDVLVQCFSCBIBZB MFCJITFSJOH
#FCFSBQBSBDVOUFSTFCVUBOUBSBMBJOBTFUJMTBMJTJMBU BTQJSJO
EBONFUJM EJHVOBLBO [BU[BU MBJO VOUVL NFOHHBOUJLBOOZB TFQFSUJ OBUSJVN
BMLPIPM ZBOHNFNCFOUVLBTBNGPSNBUTBBUEJNFUBCPMJTNF
MBLUBU EBO OBUSJVN HMVLPOBU .PMFLVM MBLUBU EBO HMVLPOBU
EJNFUBCPMJTNF EBMBN UVCVI NFOJOHHBMLBO OBUSJVN EJ EBMBN
(BHBM (JOKBM ,SPOJT #JMB GVOHTJ HJOKBM TBOHBU NFOVSVO
DBJSBOFLTUSBTFMVMBSEBMBNCFOUVLOBUSJVNCJLBSCPOBUEBOEFOHBO
UFSEBQBUQFNCFOUVLBOBOJPOEBSJBTBNMFNBIEBMBNDBJSBOUVCVI
EFNJLJBONFOJOHLBULBOQ)DBJSBONFOVKVOPSNBM
ZBOH UJEBL EJFLTLSFTJLBO PMFI HJOKBM 4FMBJO JUV QFOVSVOBO MBKV
GJMUSBTJ HMPNFSVMVT NFOHVSBOHJ FLTLSFTJ GPTGBU EBO /) ZBOH 6OUVLQFOHPCBUBOBMLBMPTJT BNPOJVNLMPSJEBEBQBUEJCFSJLBO
NFOHVSBOHJ KVNMBI )$0 ZBOH EJUBNCBILBO LFNCBMJ LF EBMBN NFMBMVJ NVMVU #JMB BNPOJVN LMPSJEB EJBCTPSCTJ LF EBMBN EBSBI
DBJSBOUVCVI+BEJ HBHBMHJOKBMLSPOJTEBQBUNFOZFCBCLBOBTJEPTJT CBHJBO BNPOJVN EJLPOWFSTJ PMFI IBUJ NFOKBEJ VSFVN 3FBLTJ JOJ
NFUBCPMJLCFSBU NFNCFCBTLBO )$* ZBOH TFHFSB CFSFBLTJ EFOHBO EBQBS DBJSBO
UVCVI VOUVL NFOHHFTFS LPOTFOUSBTJ ) LF BSBI BTBN "NPOJVN
Alkalosis Metabolik Disebabkan oleh Peningkatan Konsentrasi
LMPSJEB LBEBOHLBEBOH EJCFSJLBO TFDBSB JOUSBWFOB UFUBQJ /)
HCO3 Cairan Ekstraselular. #JMB UFSEBQBU SFUFOTJ )$0 ZBOH
TBOHBU UPLTJL EBO QSPTFEVS JOJ EBQBU CFSCBIBZB ;BU MBJO ZBOH
CFSMFCJIBO BUBV IJMBOHOZB ) EBO EBMBN UVCVI LFBEBBO JOJ
LBEBOHLBEBOHEJHVOBLBOBEBMBIMJTJONPOPIJESPLMPSJEB
NFOZFCBCLBOBMLBMPTJTNFUBCPMJL"MLBMPTJTNFUBCPMJLUJEBLCFHJUV
VNVN TFQFSUJ BTJEPTJT NFUBCPMJL UFUBQJ CFCFSBQB QFOZFCBC
BMLBMPTJTNFUBCPMJLBEBMBITFCBHBJCFSJLVU Pengukuran Klinis dan Analisis Gangguan Asam-
Pemberian Diuretika (Kecuali Penghambat Anhidrase Basa
Karbonat)4FNVBEJVSFUJLBZBOHNFOZFCBCLBOQFOJOHLBUBOBMJSBO
DBJSBO EJ TFQBOKBOH UVCVMVT CJBTBOZB NFOJOHLBULBO BMJSBO EBMBN 5FSBQJ ZBOH TFTVBJ VOUVL HBOHHVBO BTBNCBTB NFNCVUVILBO
UVCVMVT EJTUBM EBO UVCVMVT LPMJHFOT ,FBEBBO JOJ NFOJNCVMLBO EJBHOPTJTZBOHUFQBU6OUVLHBOHHVBOBTBNCBTBTFEFSIBOBTFQFSUJ
QFOJOHLBUBO SFBCTPSQTJ /B EBSJ CBHJBO OFGSPO JOJ 0MFI LBSFOB ZBOH UFMBI EJKBCBSLBO TFCFMVNOZB EBQBU EJEJBHOPTJT EFOHBO
SFBCTPSQTJ OBUSJVN EJ TJOJ CFSQBTBOHBO EFOHBO TFLSFTJ ) NFOHBOBMJTJT UJHB QFOHVLVSBO EBSJ TVBUV DPOUPI EBSBI BSUFSJ Q)
QFOJOHLBUBO SFBCTPSQTJ OBUSJVN KVHB NFOJNCVMLBO QFOJOHLBUBO LPOTFOUSBTJ)$0QMBTNB EBO1$0
TFLSFTJ ) EBO QFOJOHLBUBO SFBCTPSQTJ CJLBSCPOBU 1FSVCBIBO JOJ
NFOZFCBCLBOUFSKBEJOZBBMLBMPTJT ZBOHEJUBOEBJEFOHBOQFOJOHLBUBO %JBHOPTJT HBOHHVBO BTBNCBTB TFEFSIBOB NFMJQVUJ CFCFSBQB
LPOTFOUSBTJCJLBSCPOBUDBJSBOFLTUSBTFMVMBS MBOHLBI TFQFSUJ ZBOH EJUVOKVLLBO EBMBN (BNCBS %FOHBO
NFNFSJLTB Q) LJUB EBQBU NFOFOUVLBO BQBLBI HBOHHVBO CFSTJGBU
,FMFCJIBO "MEPTUFSPO #JMB TFKVNMBI CFTBS BMEPTUFSPO
BTJEPTJT BUBV BMLBMPTJT /JMBJ Q) LVSBOH EBSJ NFOVOKVLLBO
EJTFLSFTJLBOPMFILFMFOKBSBESFOBM BLBOUFSKBEJBMLBMPTJTNFUBCPMJL
BTJEPTJT TFEBOHLBOQ)MFCJICFTBSEBSJ NFOVOKVLLBOBMLBMPTJT
SJOHBO 4FQFSUJ ZBOH UFMBI EJCBIBT TFCFMVNOZB BMEPTUFSPO
NFOJOHLBULBO SFBCTPSQTJ /B EBMBN KVNMBI CBOZBL EBSJ UVCVMVT -BOHLBILFEVBBEBMBINFNFSJLTB1$0QMBTNBEBOLPOTFOUSBTJ
EJTUBM EBO UVCVMVT LPMJHFOT EBO QBEB XBLUV ZBOH CFSTBNBBO )$0 /JMBJ OPSNBM VOUVL 1$0 BEBMBI NN )H EBO VOUVL
NFSBOHTBOHTFLSFTJ)PMFITFMJOUFSLBMBUVTQBEBUVCVMVTLPMJHFOT )$0BEBMBIN&R-#JMBHBOHHVBOTVEBIEJHPMPOHLBOTFCBHBJ
1FOJOHLBULBOTFLSFTJ)JOJNFOJNCVMLBOQFOJOHLBUBOFLTLSFTJ) BTJEPTJT EBO 1$0 QMBTNB NFOJOHLBU CFSBSUJ UFSEBQBU LPNQPOFO
PMFIHJOKBMTFIJOHHBNFOJNCVMLBOBMLBMPTJTNFUBCPMJL SFTQJSBUPSJL UFSIBEBQ BTJEPTJT 4FUFMBI LPNQFOTBTJ HJOKBM
.FNVOUBILBO *TJ -BNCVOH .FNVOUBILBO JTJ MBNCVOH TBKB LPOTFOUSBTJ )$0 QMBTNB QBEB BTJEPTJT SFTQJSBUPSJL BLBO
UBOQB NFNVOUBILBO JTJ USBLUVT HBTUSPJOUFTUJOBM ZBOH MFCJI SFOEBI DFOEFSVOH NFOJOHLBU EJ BUBT OPSNBM 0MFI LBSFOB JUV OJMBJ ZBOH
NFOZFCBCLBO IJMBOHOZB )$M ZBOH EJTFLSFTJLBO PMFI NVLPTB EJIBSBQLBO VOUVL BTJEPTJT SFTQJSBUPSJL TFEFSIBOB BEBMBI
MBNCVOH)BTJMOFUPOZBBEBMBIIJMBOHOZBBTBNEBSJDBJSBO QFOVSVOBOQ)QMBTNB QFOJOHLBUBO1$0
393
LPOTFOUSBTJ)$0QMBTNBZBOHSFOEBI EBOQFOVSVOBO1$0TFUFMBI
LPNQFOTBTJSFTQJSBUPSJLTFCBHJBO
1SPTFEVS VOUVL NFOHFMPNQPLLBO KFOJTKFOJT BMLBMPTJT NFMJQVUJ
<7.4 >7.4 MBOHLBIMBOHLBIEBTBSZBOHTBNB1FSUBNB BMLBMPTJTCFSBSUJUFSEBQBU
pH? QFOJOHLBUBO Q) QMBTNB #JMB QFOJOHLBUBO Q) EJTFCBCLBO PMFI
QFOVSVOBO 1$0 CFSBSUJ BEB LPNQPOFO SFTQJSBUPSJL QBEB BMLBMPTJT
#JMBQFOJOHLBUBOQ)EJTFCBCLBOPMFIQFOJOHLBUBO)$0 CFSBSUJBEB
LPNQPOFO NFUBCPMJL QBEB BMLBMPTJT 0MFI LBSFOB JUV QBEB BMLBMPTJT
HCO3- Pco2 HCO3- Pco2 SFTQJSBUPSJL TFEFSIBOB LJUB CFSIBSBQ BLBO NFOFNVLBO QFOJOHLBUBO
<24 mEq/L >40 mm Hg >24 mEq/L <40 mm Hg Q) QFOVSVOBO1$0EBOQFOVSVOBOLPOTFOUSBTJ)$0QMBTNB1BEB
BMLBMPTJT NFUBCPMJL TFEFSIBOB LJSB CFSIBSBQ BLBO NFOFNVLBO
QFOJOHLBUBOQ) QFOJOHLBUBO)$0QMBTNB EBOQFOJOHLBUBO1$0
Gangguan Asam-Basa Kompteks dan Penggunaan

Nomogram Asam-Basa untuk Diagnosis
1BEB CFCFSBQB LFBEBBO HBOHHVBO BTBNCBTB UJEBL EJTFSUBJ PMFI
Pco2 HCO3- Pco2 HCO3-
<40 mm Hg >24 mEq/L >40 mm Hg <24 mEq/L SFTQPOTLPNQFOTBTJZBOHTFTVBJ#JMBLFBEBBOJOJUFSKBEJ HBOHHVBOJUV
EJTFCVUHBOHHVBOBTBNCBTBDBNQVSBO)BMJOJCFSBSUJCBIXBBEBEVB
QFOZFCBCEBTBSBUBVMFCJIHBOHHVBOBTBNCBTBCBTB4FCBHBJDPOUPI
TFPSBOHQBTJFOEFOHBOQ)ZBOHSFOEBIBLBOEJLFMPNQPLLBOTFCBHBJ
BTJEPTJT #JMB HBOHHVBO EJTFCBCLBO PMFI NFUBCPMJL LFBEBBO JOJ KVHB
BLBO EJTFSUBJ EFOHBO LPOTFOUSBTJ )$0 QMBTNB ZBOH SFOEBI EBO
TFUFMBILPNQFOTBTJSFTQJSBUPSJLZBOHTFTVBJ KVHBBLBOEJTFSUBJEFOHBO
EBOQFOJOHLBUBOLPOTFOUSBTJ)$0QMBTNBTFUFMBILPNQFOTBTJHJOKBM 1$0 ZBOH SFOEBI "LBO UFUBQJ CJMB Q) QMBTNB SFOEBI EBO
TFCBHJBO LPOTFOUSBTJ )$0 SFOEBI UFSLBJU EFOHBO QFOJOHLBUBO 1$0 LJUB
6OUVL BTJEPTJT NFUBCPMJL BLBO UFSEBQBU KVHB QFOVSVOBO Q) BLBONFOEVHBCBIXBNVOHLJOUFSEBQBUKVHBLPNQPOFOSFTQJSBUPSJL
QMBTNB "LBO UFUBQJ QBEB BTJEPTJT NFUBCPMJL HBOHHVBO VUBNBOZB QBEBBTJEPTJTTFMBJOLPNQPOFONFUBCPMJL0MFILBSFOBJUV HBOHHVBO
BEBMBI QFOVSVOBO LPOTFOUSBTJ )$0 QMBTNB 0MFI LBSFOB JUV CJMB JOJ BLBO EJLFMPNQPLLBO TFCBHBJ BTJEPTJT DBNQVSBO 4FCBHBJ DPOUPI
Q) ZBOH SFOEBI EJTFCBCLBO PMFI LPOTFOUSBTJ )$0 ZBOH SFOEBI LFBEBBOJOJEBQBUUFSKBEJQBEBQBTJFOEFOHBOLFIJMBOHBO)$0ZBOH
CFSBSUJ BEB LPNQPOFO NFUBCPMJL QBEB BTJEPTJT 1BEB BTJEPTJT BLVU EBSJ USBLUVT HBTUSPJOUFTUJOBM BLJCBU EJBSF BTJEPTJT NFUBCPMJL

NFUBCPMJLTFEFSIBOB 1$0CFSLVSBOHBLJCBULPNQFOTBTJSFTQJSBUPSJL ZBOHKVHBNFOEFSJUBFNGJTFNB BTJEPTJTSFTQJSBUPSJL

TFCBHJBO CFSCFEB EFOHBO BTJEPTJT SFTQJSBUPSJL ZBOH 1$0OZB 4VBUV DBSB ZBOH CBJL VOUVL NFOEJBHOPTJT HBOHHVBO BTBNCBTB
NFOJOHLBU 0MFI LBSFOB JUV QBEB BTJEPTJT NFUBCPMJL TFEFSIBOB BEBMBI EFOHBO NFOHHVOBLBO OPNPHSBN BTBNCBTB TFQFSUJ ZBOH
CFSIBSBQBLBONFOFNVLBOOJMBJQ)ZBOHSFOEBI EJUVOKVLLBOQBEB(BNCBS%JBHSBNJOJEBQBUEJHVOBLBOVOUVL
60
120 100 90 80 70 60 50 40
56 110
52
35
48 Pco2 (mm Hg)
44 30
40
36 25
32 acidosis
28 20
24 Normal
20 15
16
10
12
8
Pco2 (mm Hg)
4
0
7.00 7.10 7.20 7.30 7.40 7.50 7.60 7.70 7.80
394
VOUVL NFOFOUVLBO KFOJT BTJEPTJT BUBV BMLBMPTJT EBO KVHB EFSBKBU 5BCFM"TJEPTJT.FUBCPMJLZBOH5FSLBJUEFOHBO"OJPO(BQ
LFQBSBIBOOZB 1BEB EJBHSBN BTBNCBTB JOJ Q) LPOTFOUSBTJ )$0 1MBTNB/PSNBMBUBV
EBO OJMBJ 1$0 TBMJOH CFSQPUPOHBO TFTVBJ EFOHBO QFSTBNBBO
)FOEFSTPO )BTTFMCBMDI -JOHLBSBO UFSCVLB EJ UFOHBI NFOVOKVLLBO "OJPO(BQ.FOJOHLBU "OJPO(BQ/PSNBM
OJMBJ OPSNBM EBO QFOZJNQBOHBO ZBOH NBTJI EBQBU EJBOHHBQ CFSBEB /PSNPLMPSFNJB
)JQFSLMPSFNJB
EBMBN LJTBSBO OPSNBM %BFSBI EJBHSBN ZBOH HFMBQ NFOVOKVLLBO
UNIT V
QFSTFO JOUFSWBM LFQFSDBZBBO VOUVL LPNQFOTBTJ OPSNBM CBHJ HBOHHVBO %JBCFUFTNFMJUVT %JBSF
NFUBCPMJLEBOSFTQJSBUPSJLZBOHTFEFSIBOB (LFUPBTJEPTJT) "TJEPTJT UVCVMVTHJOKBM
"TJEPTJTMBLUBU 1FOHIBNCBUBOIJESBTF
,FUJLBNFOHHVOBLBOEJBHSBNJOJ LJUBIBSVTNFOHBOHHBQCBIXBLJUB (BHBMHJOKBMLSPOJT,FSBDVOBO LBSCPOBU
UFMBI NFMFXBUJ DVLVQ XBLUV BHBS UJNCVM SFTQPOT LPNQFOTBTJ ZBOH BTQFSJO (BTBNBTFUJMTBMJTJMBU) 1FOZBLJUBEETPO
MFOHLBQ ZBJUV KBN VOUVL LPNQFOTBTJ WFOUJMBTJ QBEB HBOHHVBO ,FSBDVOBONFUBOPM
NFUBCPMJL QSJNFS EBO IBSJ VOUVL LPNQFOTBTJ NFUBCPMJL QBEB ,FSBDVOBOHMJLPM
HBOHHVBO SFTQJSBUPSJLQSJNFS #JMB OJMBJ CFSBEB EBMBN EBFSBIHFMBQ IBM FMJUFO,FMBQBSBO
JOJ NFOZBUBLBO CBIXB BEB HBOHHVBO BTBNCBTB ZBOH TFEFSIBOB
4FCBMJLOZB CJMBOJMBJQ) )$0 BUBV1$0UFSMFUBLEJMVBSEBFSBIHFMBQ
IBMJOJNFOZBUBLBOCBIXBNVOHLJOBEBHBOHHVBOBTBNCBTBDBNQVSBO
TFEBOHLBO BOJPO UJEBL UFSVLVS ZBOH QFOUJOH BEBMBI BMCVNJO

1FOUJOH VOUVL NFOZBEBSJ OJMBJ BTBNCBTB EBMBN EBFSBI HFMBQ UJEBL GPTGBU TVMGBU EBO BOJPO PSHBOJL MBJOOZB #JBTBOZB BOJPO UJEBL
TFMBMV CFSBSUJ BEB HBOHHVBO BTBNCBTB TFEFSIBOB %FOHBO NFOHJOHBU UFSVLVS NFMFCJIJ LBUJPO UJEBL UFSVLVS EBO BOJPO HBQOZB CFSLJTBS
LFLVSBOHBO JOJ EJBHSBN BTBNCBTB EBQBU EJHVOBLBO TFCBHBJ BMBU ZBOH BOUBSBEBON&R
DFQBUVOUVLNFOFOUVLBOUJQFTQFTJGJLEBOEFSBKBUHBOHHVBOBTBNCBTB "OJPO HBQ QMBTNB EJHVOBLBO UFSVUBNB EBMBN NFOEJBHOPTJT
4FCBHBJ DPOUPI NJTBMOZB QMBTNB BSUFSJ TFPSBOH QBTJFO TFCBHBJ CFSCBHBJ QFOZFCBC BTJEPTJT NFUBCPMJL 1BEB BTJEPTJT NFUBCPMJL
CFSJLVU Q) LPOTFOUSBTJ )$0 QMBTNB N&R- EBO 1$0 )$0 QMBTNB NFOVSVO #JMB LPOTFOUSBTJ OBUSJVN QMBTNB UJEBL
QMBTNBNN)H%FOHBOOJMBJJOJLJUBEBQBUNFMJIBUQBEBEJBHSBNEBO CFSVCBI LPOTFOUSBTJ BOJPO CBJL $* BUBV TVBUV BOJPO UJEBL
NFOHFUBIVJ LFBEBBO JOJ NFXBLJMJ BTJEPTJT NFUBCPMJL TFEFSIBOB EFOHBO UFSVLVS
IBSVT NFOJOHLBU VOUVL NFNQFSUBIBOLBO LFOFUSBMBO
LPNQFOTBTJ SFTQJSBUPSJL ZBOH TFTVBJ ZBOH NFOHVSBOHJ 1$0 OJMBJ MJTUSJL #JMB $M QMBTNB NFOJOHLBU TFCBOEJOH EFOHBO QFOVSVOBO
OPSNBMOZBNN)HNFOKBEJNN)H )$0 QMBTNB BOJPO HBQ BLBO UFUBQ OPSNBM ,FBEBBO JOJ TFSJOH
EJTFCVUTFCBHBJBTJEPTJTNFUBCPMJLIJQFSLMPSFNJL
$POUPI LFEVB BEBMBI TFPSBOH QBTJFO EFOHBO Q) LPOTFOUSBTJ #JMB QFOVSVOBO )$0 QMBTNB UJEBL EJTFSUBJ EFOHBO
)$0QMBTNBN&R- EBO1$0QMBTNBNN)H1BEBDPOUPINJ QFOJOHLBUBO$M IBSVTBEBQFOJOHLBUBOLBEBSBOJPOUJEBLUFSVLVS
QBTJFO UFSTFCVU NFOHBMBNJ BTJEPTJT EBO UBNQBL BEB LPNQPOFO EBO KVHB QFOJOHLBUBO BOJPO HBQ ZBOH EJIJUVOH "TJEPTJT
NFUBCPMJL LBSFOB LPOTFOUSBTJ )$0 QMBTNB MFCJI SFOEBI EBSJ OJMBJ NFUBCPMJL ZBOH EJTFCBCLBO PMFI LFMFCJIBO BTBN OPOWPMBUJM
OPSNBMN&R-"LBOUFUBQJ LPNQFOTBTJSFTQJSBUPSJLZBOHOPSNBMOZB TFMBJO )$M
TFQFSUJ BTBN MBLUBU BUBV BTBN LFUPO UFSLBJU EFOHBO
BLBO NFOHVSBOHJ 1$0 UJEBL UFSKBEJ EBO 1$0 TFEJLJU NFOJOHLBU EJ QFOJOHLBUBO BOJPO HBQ QMBTNB LBSFOB QFOVSVOBO )$0 UJEBL
BUBTOJMBJOPSNBMNN)H)BMJOJTFTVBJEFOHBOHBOHHVBOBTBNCBTB EJTFSUBJEFOHBOQFOJOHLBUBO$*ZBOHTFCBOEJOH#FCFSBQBDPOUPI
DBNQVSBO ZBOH UFSEJSJ BUBT BTJEPTJT NFUBCPMJL EBO KVHB LPNQPOFO BTJEPTJT NFUBCPMJL ZBOH UFSLBJU EFOHBO BOJPO HBQ ZBOH OPSNBM
SFTQJSBUPSJL BUBV NFOJOHLBU EJUVOKVLLBO EBMBN 5BCFM %FOHBO
%JBHSBNBTBNCBTBCFSUJOEBLTFCBHBJBMBUZBOHDFQBUVOUVLNFOJMBJ NFOHIJUVOH BOJPO HBQ LJUB EBQBU NFNQFSTFNQJU CFCFSBQB
UJQF EBO CFSBUOZB HBOHHVBO ZBOH NVOHLJO CFSQFSBO EBMBN QFOZFCBCBTJEPTJTNFUBCPMJL
NFOZFCBCLBO LFMBJOBO Q) 1$0 EBO LPOTFOUSBTJ CJLBSCPOBU QMBTNB
1BEB LFBEBBO LMJOJT SJXBZBU TFPSBOH QBTJFO EBO UFNVBO GJTJL MBJOOZB %BGUBS1VTUBLB
KVHB NFNCFSJLBO QFUVOKVL QFOUJOH QFOZFCBC TFSUB QFOHPCBUBO
HBOHHVBOBTBNCBTB Attmane-Elakeb A, Amlal H, Bichara M: Ammonium carriers in medullary
thick ascending limb, Am J Physiol Renal Physiol 280:F1, 2001.
Alpern RJ: Renal acidification mechanisms. In Brenner BM, ed: The Kidney,
Penggunaan Anion Gap untuk Mendiagnosis Gangguan ed 6, Philadelphia, 2000, WB Saunders, pp 455–519.
Asam-Basa Breton S, Brown D: New insights into the regulation of V-ATPase-dependent
proton secretion, Am J Physiol Renal Physiol 292:F1, 2007.
,POTFOUSBTJ BOJPO EBO LBUJPO EBMBN QMBTNB IBSVT TBNB CFTBS VOUVL Decoursey TE: Voltage-gated proton channels and other proton transfer
NFOKBHB LFOFUSBMBO MJTUSJL 0MFI LBSFOB JUV UJEBL BEB hhBOJPO HBQ ZBOH pathways, Physiol Rev 83:475, 2003.
TFCFOBSOZB EBMBN QMBTNB 8BMBVQVO EFNJLJBO IBOZB LBUJPO EBO Fry AC, Karet FE: Inherited renal acidoses, Physiology (Bethesda) 22:202, 2007.
BOJPO UFSUFOUV ZBOH EJVLVS TFDBSB SVUJO EBMBN MBCPSBUPSJVN LMJOJL Gennari FJ, Maddox DA: Renal regulation of acid-base homeostasis. In Seldin
DW, Giebisch G, eds: The Kidney—Physiology and Pathophysiology, ed 3,
,BUJPOZBOHOPSNBMOZBEJVLVSBEBMBI/BEBOBOJPOCJBTBOZB$*EBO New York, 2000, Raven Press, pp 2015–2054.
)$0 "OJPO HBQ ZBOH IBOZBMBI LPOTFQ EJBHOPTUJL
NFSVQBLBO
Good DW: Ammonium transport by the thick ascending limb of Henle’s
QFSCFEBBO BOUBSB BOJPO ZBOH UJEBL UFSVLVS EBO LBUJPO ZBOH UJEBL loop, Ann Rev Physiol 56:623, 1994.
UFSVLVS EBOEJQFSLJSBLBOTFCBHBJ Igarashi I, Sekine T, Inatomi J, et al: Unraveling the molecular pathogenesis of
isolated proximal renal tubular acidosis, J Am Soc Nephrol 13:2171,
= [Na+] - [HCO3-] - [Cl-] 2002.
= 144 - 24 - 108 = 12 mEq/L Karet FE: Inherited distal renal tubular acidosis, J Am Soc Nephrol 13:2178,
2002.
"OJPOHBQBLBONFOJOHLBUCJMBBOJPOZBOHUJEBLUFSVLVSNFOJOHLBU Kraut JA, Madias NE: Serum anion gap: its uses and limitations in clinical
BUBV CJMB LBUJPO ZBOH UJEBL UFSVLVS NFOVSVO ,BUJPO UJEBL UFSVLVS medicine, Clin J Am Soc Nephrol 2:162, 2007.
ZBOHQBMJOHQFOUJOHNFMJQVUJLBMTJVNNBHOFTJVN EBOLBMJVN Laffey JG, Kavanagh BP: Hypocapnia, N Engl J Med 347:43, 2002.
395
UnitV Cairan Tubuh dan Ginja(
Lemann J Jr, Bushinsky DA, Hamm LL: Bone buffering of acid and base in Wagner CA, Finberg KE, Breton S, et al: Renal vacuolar H+-ATPase, Physiol
humans, Am J Physiol Renal Physiol 285:F811, 2003. Rev 84:1263, 2004.
Madias NE, Adrogue HJ: Cross-talk between two organs: how the kid- Wesson DE, Alpern RJ, Seldin DW: Clinical syndromes of metabolic alka-
ney responds to disruption of acid-base balance by the lung, Nephron losis. In Seldin DW, Giebisch G, eds: The Kidney—Physiology and
Physiol 93:61, 2003. Pathophysiology, ed 3, New York, 2000, Raven Press, pp 2055–2072.White NH:
Purkerson JM, Schwartz GJ: The role of carbonic anhydrases in renal physi- Management of diabetic ketoacidosis, Rev Endocr Metab Disord
ology, Kidney Int 71:103, 2007. 4:343, 2003.
396
BAB 31
UNIT V
%JVSFUJLEBO1FOZBLJU1FOZBLJU(JOKBM
%JVSFUJL ZBOH CBOZBL UFSTFEJB VOUVL QFOHHVOBBO LMJOJT

Diuretik dan Mekanisme
NFNQVOZBJ NFLBOJTNF LFSKB ZBOH CFSCFEBCFEB EBO PMFI
Kerjanya
LBSFOBJUV NFOHIBNCBUSFBCTPSQTJUVCVMVTEJCFSCBHBJUFNQBU
TFQBOKBOH OFGSPO HJOKBM 1FOHFMPNQPLBO VNVN EJVSFUJL EBO
%JVSFUJLBEBMBITVBUV[BUZBOH NFLBOJTNFLFSKBOZBEJQFSMJIBULBOQBEB5BCFM
NFOJOHLBULBOMBKVQFOHFMVBSBO
WPMVNFVSJOF TFQFSUJZBOH
Diuretik Osmotik Menurunkan Reabsorpsi Air dengan
EJUVOKVLLBO PMFI OBNBOZB 4FCBHJBO CFTBS EJVSFUJL KVHB Meningkatkan Tekanan Osmotik Cairan Tubulus
NFOJOHLBULBO FLTLSFTJ [BU UFSMBSVU EBMBN VSJOF LIVTVTOZB
OBUSJVN EBO LMPSJEB #BILBO TFCBHJBO CFTBS EJVSFUJL ZBOH .FOZVOUJLLBO [BU LF EBMBN QFNCVMVI EBSBI ZBOH UJEBL
EJQBLBJTFDBSBLMJOJTCFLFSKBEFOHBONFOVSVOLBOMBKVSFBCTPSQTJ NVEBI EJSFBCTPSCTJ PMFI UVCVMVT HJOKBM UVCVMVT SFOBMJT

OBUSJVN EBSJ UVCVMVT ZBOH NFOZFCBCLBO OBUSJVSFTJT QFOJOH TFQFSUJ VSFVN NBOJUPM EBO TVLSPTB BLBO NFOZFCBCLBO QFO
LBUBO QFOHFMVBSBO OBUSJVN
ZBOH LFNVEJBO NFOJNCVMLBO JOHLBUBOZBOHOZBUBQBEBLPOTFOUSBTJNPMFLVMPTNPUJLBLUJGEJ
EJVSFTJT QFOJOHLBUBO QFOHFMVBSBO BJS
"SUJOZB EJ TFCBHJBO EBMBNUVCVMVT5FLBOBOPTNPUJLEBSJ[BUUFSMBSVUJOJLFNVEJBO
CFTBSLBTVT QFOJOHLBUBOQFOHFMVBSBOBJSUJNCVMTFDBSBTFLVOEFS NFOVSVOLBOSFBCTPSQTJBJS ZBOHNFNCJMBTKVNMBICFTBSDBJSBO
BLJCBU JOIJCJTJ SFBCTPSQTJ OBUSJVN UVCVMVT LBSFOB OBUSJVN ZBOH UVCVMVTNBTVLLFEBMBNVSJOF
UFSTJTB EJ UVCVMVT CFLFSKB TFDBSB PTNPUJL VOUVL NFOVSVOLBO 6SJOF EBMBN KVNMBI CFTBS KVHB UFSCFOUVL QBEB QFOZBLJU
SFBCTPSQTJ BJS 0MFI LBSFOB SFBCTPSQTJ UVCVMVT HJOKBM UFSIBEBQ UFSUFOUV ZBOH CFSLBJUBO EFOHBO LFMFCJIBO [BU UFSMBSVU ZBOH
CBOZBL [BU UFSMBSVU TFQFSUJ LBMJVN LMPSJEB NBHOFTJVN EBO HBHBM EJSFBCTPSCTJ EBSJ DBJSBO UVCVMVT $POUPIOZB LFUJLB
LBMTJVN KVHB EJQFOHBSVIJ TFDBSB TFLVOEFS PMFI SFBCTPSQTJ LPOTFOUSBTJ HMVLPTB EBSBI NFOJOHLBU IJOHHB NFODBQBJ LBEBS
OBUSJVN CBOZBL EJVSFUJL ZBOH BLBO NFOJOHLBULBO QFOHFMVBSBO ZBOH UJOHHJ QBEB EJBCFUFT NFMJUVT QFOJOHLBUBO CFCBO GJMUSBTJ
[BU[BUUFSMBSVUUFSTFCVUNFMBMVJHJOKBM HMVLPTBLFEBMBNUVCVMVTBLBONFMFCJIJLFNBNQVBOOZBVOUVL
%JVSFUJL QBMJOH TFSJOH EJHVOBLBO EBMBN LMJOJT VOUVL NFSFBCTPSCTJ HMVLPTB BSUJOZB NFMFCJIJ USBOTQPS NBLTJNVN
NFOVSVOLBO WPMVNF DBJSBO FLTUSBTFMVMBS LIVTVTOZB QBEB OZB VOUVL HMVLPTB
,JSBLJSB QBEB LBEBS HMVLPTB QMBTNB EJ
QFOZBLJU ZBOH CFSIVCVOHBO EFOHBO FEFNB EBO IJQFSUFOTJ BUBT NHEM TFEJLJU LFMFCJIBO HMVLPTB ZBOH BLBO
4FQFSUJ ZBOH EJCJDBSBLBO QBEB #BC IJMBOHOZB OBUSJVN EBSJ EJSFBCTPSCTJ PMFI UVCVMVT CBILBO LFMFCJIBO HMVLPTB UFUBQ
UVCVI UFSVUBNB NFOVSVOLBO WPMVNF DBJSBO FLTUSBTFMVMBS PMFI CFSBEB EJ UVCVMVT CFLFSKB TFCBHBJ EJVSFUJL PTNPUJL EBO
LBSFOB JUV EJVSFUJL QBMJOH TFSJOH EJCFSJLBO QBEB LFBEBBO LMJOJT NFOZFCBCLBO IJMBOHOZB DBJSBO LF EBMBN VSJOF EFOHBO DFQBU
EFOHBOQFOJOHLBUBOWPMVNFDBJSBOFLTUSBTFMVMBS 1BEB QBTJFO EFOHBO EJBCFUFT NFMJUVT CFTBSOZB QFOHFMVBSBO
VSJOF EJJNCBOHJ EFOHBO CFTBSOZB BTVQBO DBJSBO ZBOH
#FCFSBQBEJVSFUJLEBQBUNFOJOHLBULBOQFOHFMVBSBOVSJOFMFCJI CFSIVCVOHBOEFOHBOBLUJWBTJNFLBOJTNFSBTBIBVT
EBSJ LBMJ MJQBU EBMBN CFCFSBQB NFOJU TFUFMBI QFNCFSJBOOZB
/BNVO FGFLTFCBHJBOCFTBSEJVSFUJLUFSIBEBQQFOHFMVBSBOHBSBN
EBOBJSEBSJHJOKBMBLBOCFSLVSBOHEBMBNCFCFSBQBIBSJ (BNCBS Diuretik "Loop"Menurunkan Reabsorpsi Aktif

)BM JOJ LBSFOB BLUJWBTJ NFLBOJTNF LPNQFOTBTJ MBJO ZBOH Natrium-Klorida-Kalium di Segmen Tebal Pars
EJDFUVTLBOPMFIQFOVSVOBOWPMVNFDBJSBOFLTUSBTFMVMBS$POUPI Asenden Ansa Henle
OZB QFOVSVOBO WPMVNF DBJSBO FLTUSBTFMVMBS EBQBU NFOVSVOLBO 'VSPTFNJE BTBN FUBLSJOBU EBO CVNFUBOJE BEBMBI EJVSFUJL LVBU
UFLBOBOBSUFSJEBOMBKVGJMUSBTJHMPNFSVMVT -'(
EBONFOJOHLBU ZBOH NFOVSVOLBO SFBCTPSQTJ BLUJG EJ TFHNFO UFCBM QBST BTFOEFO
LBO TFLSFTJ SFOJO TFSUB QFNCFOUVLBO BOHJPUFOTJO ** TFNVB BOTB )FOMF EFOHBO NFOHIBNCBU LPUSBOTQPSUFS OBUSJVN
SFTQPOTJOJ CFSTBNBTBNB QBEBBLIJSOZBBLBONFOJBEBLBOFGFL LMPSJEB LBMJVN ZBOH UFSMFUBL EJ NFNCSBO MVNJOBM TFM FQJUFM
LSPOJT EJVSFUJL UFSIBEBQ QFOHFMVBSBO VSJOF +BEJ QBEB LFBEBBO %JVSFUJLJOJUFSNBTVLEJVSFUJLUFSLVBUZBOHEJQBLBJTFDBSBLMJOJT
NBOUBQ QFOHFMVBSBO VSJOF NFOKBEJ TBNB EFOHBO QFNBTVLBO %FOHBO NFOHIBNCBU LPUSBOTQPS BLUJG OBUSJVNLMPSJEB
OBNVO IBOZB TFUFMBI UFSKBEJ QFOVSVOBO UFLBOBO BSUFSJ EBO LBMJVNQBEBNFNCSBOMVNJOBMBOTB)FOMF EJVSFUJLMPPQBLBO
WPMVNF DBJSBO FLTUSBTFMVMBS BLBO NFOHVSBOHJ IJQFSUFOTJ EBO
FEFNBZBOHBXBMOZBNFNFSMVLBOQFOHHVOBBOEJVSFUJL
397
SFBCTPSQTJ OBUSJVN EBO LMPSJEB EJ BOTB )FOMF NFOZFCBCLBO

CBOZBL JPOJPO JOJ EJFLTLSFTJLBO CFSTBNB EFOHBO QFOJOHLBUBO
FLTLSFTJ BJS 1FNFLBUBO VSJOF UFSHBOHHV LBSFOB QFNFLBUBO JPO
sodium intake (mEq/day)
Sodium excretion or 200 JPO UFSTFCVU EJ DBJSBO JOUFSTUJTJBM NFEVMB HJOKBM EBO PMFI LBSFOB
JUV PTNPMBSJUBT NFEVMB HJOKBM NFOVSVO "LJCBUOZB SFBCTPSQTJ
DBJSBO EBSJ EVLUVT LPMJHFOT NFOVSVO TFIJOHHB LFNBNQVBO
100 QFNFLBUBO NBLTJNBM HJOKBM KVHB TBOHBU NFOVSVO 4FMBJO JUV
QFOVSVOBO PTNPMBSJUBT DBJSBO JOUFSTUJTJBM NFEVMB HJOKBM
NFOVSVOLBO BCTPSQTJ BJS EBSJ QBST EFTFOEFO BOTB )FOMF "LJCBU
CFSCBHBJ FGFL UFSTFCVU QFSTFO GJMUSBU HMPNFSVMVT EBQBU
EJTBMVSLBO LF EBMBN VSJOF ZBOH NFOZFCBCLBO EBMBN LFBEBBO
BLVU QFOJOHLBUBO QFOHFMVBSBO VSJOF TFCFTBS LBMJ OPSNBM
15.0
Extracellular fluid
QBMJOHUJEBLTFMBNBCFCFSBQBNFOJU
volume (liters)
14.0 Diuretik Tiazid Menghambat Reabsorpsi Natrium-Klorida

pada Tubulus Distal Bagian Awal
13.0 %FSJWBU UJB[JE TFQFSUJ LMPSPUJB[JE UFSVUBNB CFLFSKB QBEB UVCVMVT
EJTUBM CBHJBO BXBM VOUVL NFOHIBNCBU LPUSBOTQPSUFS OBUSJVN
LMPSJEB EJ NFNCSBO MVNJOBM TFM UVCVMVT %BMBN LFBEBBO ZBOH
-4 -2 0 2 4 6 8
CBJL PCBU JOJ EBQBU NFOZFCBCLBO QBMJOH CBOZBL TBNQBJ
QFSTFO GJMUSBU HMPNFSVMVT NFOHBMJS LF EBMBN VSJOF +VNMBI JOJ
LJSBLJSB TBNB EFOHBO KVNMBI OBUSJVN ZBOH OPSNBMOZB
EJSFBCTPSCTJPMFIUVCVMVTEJTUBM
Inhibitor Anhidrase Karbonat Menghambat Reabsorpsi

Natrium Bikarbonat di Tubulus Proksimal
"TFUB[PMBNJE NFOHIBNCBU FO[JN BOIJESBTF LBSCPOBU ZBOH
NFOJOHLBULBO QFOHFMVBSBO OBUSJVN LMPSJEB LBMJVN EBO QFOUJOHVOUVLSFBCTPSQTJCJLBSCPOBUEJUVCVMVTQSPLTJNBM TFQFSUJ
FMFLUSPMJUMBJO TFSUBBJSLBSFOBEVBBMBTBO
EJVSFUJLUFSTFCVU ZBOH EJCJDBSBLBO QBEB #BC "OIJESBTF LBSCPOBU CBOZBL
TBOHBUNFOJOHLBULBOKVNMBI[BUUFSMBSVUZBOHEJTBNQBJLBOLF UFSEBQBU EJ UVCVMVT QSPLTJNBM ZBOH NFSVQBLBO UFNQBU VUBNB
CBHJBO EJTUBM OFGSPO EJTUBM EFMJWFSZ
EBO [BU JOJ KVHB CFLFSKB CFLFSKBOZB JOIJCJUPS BOIJESBTF LBSCPOBU 4FKVNMBI BOIJESBTF
TFCBHBJ [BU PTNPUJL ZBOH KVHB NFODFHBI SFBCTPSQTJ BJS TFSUB LBSCPOBU KVHB UFSEBQBU EJ TFM UVCVMVT MBJO TFQFSUJ TFM JOUFSLBMBUVT

EJVSFUJL JOJ NFOHHBOHHV TJTUFN DPVOUFSDVSSFOU EFOHBO EJUVCVMVTLPMJHFOT
NFOVSVOLBO SFBCTPSQTJ JPO EBSJ BOTB )FOMF LF EBMBN JOUFS
TUJTJVN NFEVMB ZBOH BLBO NFOVSVOLBO PTNPMBSJUBT JOUFSTUJ 0MFI LBSFOB TFLSFTJ )h EBO SFBCTPSQTJ )$0 EJ UVCVMVT
TJVNNFEVMB0MFILBSFOBFGFLJOJ EJVSFUJLMPPQNFOHHBOHHV QSPLTJNBMEJLBJULBO DPVQMFE
EFOHBOSFBCTPSQTJOBUSJVNNFMBMVJ
LFNBNQVBO HJOKBM VOUVL NFNFLBULBO BUBV NFOHFODFSLBO NFLBOJTNF LPOUFSUSBOTQPS JPO OBUSJVNIJESPHFO EJ NFNCSBO
VSJOF1FOHFODFSBOVSJOFUFSHBOHHVLBSFOBQFOHIBNCBUBO MVNJOBM QFOVSVOBOSFBCTPSQTJ)$0KVHBNFOVSVOLBO
398
Bab 31 Diuretik dan Penyakit-Penyakit Ginjal
SFBCTPSQTJ OBUSJVN 1FOHIBNCBUBO SFBCTPSQTJ OBUSJVN EBO LFSKB HJOKBM UJCBUJCB CFSIFOUJ UFUBQJ ZBOH OBOUJOZB EBQBU
)$0 EBSJ DBJSBO UVCVMVT NFOHBLJCBULBO JPOJPO JOJ UFUBQ NFNCBJLNFOEFLBUJGVOHTJOPSNBM EBO
HBHBMHJOKBMLSPOJT
CFSBEB EJ UVCVMVT EBO CFLFSKB TFCBHBJ EJVSFUJL PTNPUJL 4FQFSUJ ZBJUV HJOKBM TFDBSB QSPHSFTJG LFIJMBOHBO GVOHTJ OFGSPOOZB TBUV
ZBOHEJQFSLJSBLBO LFSVHJBOJOIJCJUPSBOIJESBTFLBSCPOBUBEBMBI QFSTBUV ZBOH TFDBSB CFSUBIBQ NFOVSVOLBO LFTFMVSVIBO GVOHTJ
NFOZFCBCLBO BHBL BTJEPTJT BLJCBU IJMBOHOZB )$0 TFDBSB HJOKBM%BMBNEVBLBUFHPSJVNVNJOJ UFSEBQBUCBOZBLQFOZBLJU
UNIT V
CFSMFCJIBOEBMBNVSJOF HJOKBMTQFTJGJLZBOHEBQBUNFNFOHBSVIJQFNCVMVIEBSBIHJOKBM
HMPNFSVMVT UVCVMVT JOUFSTUJTJVN HJOKBM EBO CBHJBO USBLUVT
Inhibitor Kompetitif Aldosteron Menurunkan Reabsorpsi VSJOBSJVT EJ MVBS HJOKBM NFMJQVUJ VSFUFS EBO LBOEVOH LFNJI
Natrium dari dan Sekresi Kalium ke dalam Tubulus %BMBNCBCJOJ LJUBBLBONFNCBIBTLFMBJOBOGJTJPMPHJTTQFTJGJL
Koligens Kortikalis ZBOHUJNCVMQBEBCFCFSBQBKFOJTQFOZBLJUHJOKBMZBOHQFOUJOH
4QJSPOPMBLUPO EBO FQMFSFOPO NFSVQBLBO BOUBHPOJT NJOFSB
MPLPSUJLPJEZBOHCFSTBJOHEFOHBOBMEPTUFSPOVOUVLUFNQBUJLBUBO Gagal Ginjal Akut
SFTFQUPS EJ TFM FQJUFM UVCVMVT LPMJHFOT LPSUJLBMJT EBO PMFI TFCBC
JUV EBQBUNFOVSVOLBOSFBCTPSQTJOBUSJVNEBOTFLSFTJLBMJVNEJ 1FOZFCBCHBHBMHJOKBMBLVUEBQBUEJCBHJUJHBLBUFHPSJVUBNB
TFHNFO UVCVMVT UFSTFCVU "LJCBUOZB OBUSJVN UFUBQ CFSBEB EJ 1. (BHBM HJOKBM BLVU BLJCBU QFOVSVOBO BMJSBO EBSBI LF HJOKBM
EBMBN UVCVMVT EBO CFLFSKB TFCBHBJ EJVSFUJL PTNPUJL LFBEBBOJOJTFSJOHEJTFCVUTFCBHBJHBHBMHJOKBMBLVUQSBSFOBM
NFOZFCBCLBO QFOJOHLBUBO FLTLSFTJ BJS TFSUB OBUSJVN 0MFI VOUVL NFODFSNJOLBO LFMBJOBO JOJ ZBOH UFSKBEJ TFCBHBJ
LBSFOB PCBUPCBU JOJ KVHB NFOHIBNCBU FGFL BMEPTUFSPO VOUVL BLJCBULFMBJOBOZBOHCFSBTBMEBSJMVBSHJOKBM.JTBMOZB HBHBM
NFOJOHLBULBOTFLSFTJLBMJVNEJUVCVMVT PCBUUFSTFCVUKVHBBLBO HJOKBMQSBSFOBMCJTBBLJCBUHBHBMKBOUVOHEFOHBOQFOVSVOBO
NFOVSVOLBO FLTLSFTJ LBMJVN "OUBHPOJT SFTFQUPS NJOFSBMP DVSBIKBOUVOHEBOUFLBOBOEBSBISFOEBIBUBVLFBEBBOZBOH
LPSUJLPJE KVHB NFOZFCBCLBO QFSQJOEBIBO LBMJVN EBSJ TFM LF CFSIVCVOHBOEFOHBOQFOVSVOBOWPMVNFEBSBIEBOUFLBOBO
DBJSBO FLTUSBTFMVMBS 1BEB LFBEBBO UFSUFOUV IBM UFSTFCVU EBSBISFOEBI TFQFSUJQBEBQFSEBSBIBOIFCBU
NFOZFCBCLBO LPOTFOUSBTJ LBMJVN EJ DBJSBO FLTUSBTFMVMBS TBOHBU
NFOJOHLBU %BMBN IBM JOJ TQJSPOPMBLUPO EBO BOUBHPOJT SFTFQUPS 2. (BHBM HJOKBM BLVU JOUSBSFOBM BLJCBU LFMBJOBO EBMBN HJOKBM JUV
NJOFSBMPLPSUJLPJE MBJO EJTFCVU TFCBHBJ QPUBTTJVNTQBSJOH TFOEJSJ UFSNBTVL LFMBJOBOLFMBJOBO ZBOH NFNFOHBSVIJ
EJVSFUJDT #BOZBL EJVSFUJL MBJO ZBOH NFOZFCBCLBO LFIJMBOHBO QFNCVMVIEBSBI HMPNFSVMVT BUBVUVCVMVT
LBMJVN EBMBN VSJOF CFSMBXBOBO EFOHBO BOUBHPOJT SFTFQUPS 3. (BHBM HJOKBM BLVU QBTDBSFOBM BLJCBU TVNCBUBO QBEB TJTUFN
NJOFSBMPLPSUJLPJEZBOHNFOHIFNBULFIJMBOHBOLBMJVN QFOHVNQVM VSJOF EJ NBOB TBKB NVMBJ EBSJ LBMJLT TBNQBJ
BMJSBO LFMVBS EBSJ LBOEVOH LFNJI 1FOZFCBC TVNCBUBO
Diuretik yang Menghambat Kanal Natrium dalam Tubulus QBMJOH TFSJOH EJ USBLUVT VSJOBSJVT EJ MVBS HJOKBM BEBMBI CBUV
Koligens Menurunkan Reabsorpsi Natrium HJOKBM BLJCBUFOEBQBOLBMTJVN VSBU BUBVTJTUJO
"NJMPSJE EBO USJBNUFSFO KVHB NFOHIBNCBU SFBCTPSQTJ OBUSJVN
EBO TFLSFTJ LBMJVN EJ UVCVMVT LPMJHFOT TFSVQB EFOHBO FGFL Gagal Ginjal Akut Prarenal Akibat Penurunan Aliran
TQJSPOPMBLUPO .FTLJQVO EFNJLJBO QBEB UJOHLBU TFMVMBS PCBU Darah ke Ginjal
PCBUJOJCFLFSKBTFDBSBMBOHTVOHNFOHIBNCBUNBTVLOZBOBUSJVN /PSNBMOZB HJOKBM NFOFSJNB QBTPLBO EBSBI ZBOH TBOHBU CFTBS
LF EBMBN LBOBM OBUSJVN EJ NFNCSBO MVNJOBM TFM FQJUFM UVCVMVT TFLJUBS NMNFOJU BUBV TFLJUBS TBNQBJ QFSTFO EBSJ
LPMJHFOT "LJCBU QFOVSVOBO NBTVLOZB OBUSJVN JOJ LF EBMBN TFM DVSBIKBOUVOH5VKVBOVUBNBEBSJUJOHHJOZBBMJSBOEBSBILFHJOKBM
FQJUFM UFSKBEJ KVHB QFOVSVOBO USBOTQPS OBUSJVN NFMJOUBTJ JOJ BEBMBI NFOZFEJBLBO DVLVQ QMBTNB VOUVL MBKV GJMUSBTJ
NFNCSBO CBTPMBUFSBM TFM EBO PMFI TFCBC JUV BLBO NFOVSVOLBO HMPNFSVMVT ZBOH UJOHHJ ZBOH EJCVUVILBO VOUVL QFOHBUVSBO
BLUJWJUBT QPNQB OBUSJVNLBMJVN BEFOPTJO USJGPTGBUBTF 1FOVSVO WPMVNF DBJSBO UVCVI EBO LPOTFOUSBTJ [BU UFSMBSVU TFDBSB FGFLUJG
BO BLUJWJUBT JOJ BLBO NFOVSVOLBO USBOTQPS LBMJVN LF EBMBN TFM 0MFI LBSFOB JUV QFOVSVOBO BMJSBO EBSBI LF HJOKBM CJBTBOZB
EBO BLIJSOZB NFOVSVOLBO TFLSFTJ LBMJVN LF EBMBN DBJSBO EJJLVUJ PMFI QFOVSVOBO -'( TFSUB QFOVSVOBO LFMVBSBO BJS EBO
UVCVMVT 6OUVL JUV QFOHIBNCBU LBOBM OBUSJVN KVHB NFSVQBLBO [BU UFSMBSVU "LJCBUOZB LFBEBBO ZBOH NFOVSVOLBO BMJSBO EBSBI
QPUBTTJVNTQBSJOHEJVSFUJDTEBONFOVSVOLBOMBKVFLTLSFTJLBMJVN LFHJOKBMTFDBSBBLVUCJBTBOZBBLBONFOZFCBCLBOPMJHVSJB ZBOH
EBMBNVSJOF CFSBSUJNFOVSVOOZBLFMVBSBOVSJOFEJCBXBIUJOHLBUBTVQBOBJS
EBO[BUUFSMBSVU)BMJOJNFOHBLJCBULBOUFSLVNQVMOZBBJSEBO[BU
Penyakit-Penyakit Ginjal UFSMBSVU EBMBN DBJSBO UVCVI +JLB BMJSBO EBSBI HJOKBM TBOHBU
NFOVSVO EBQBU UFSKBEJ QFOHIFOUJBO UPUBM LFMVBSBO VSJOF TVBUV
1FOZBLJU HJOKBM BEBMBI TBMBI TBUV QFOZFCBC UFSQFOUJOH EBSJ LFBEBBOZBOHEJTFCVUBOVSJB
LFNBUJBO EBO LFDBDBUBO EJ CBOZBL OFHBSB EJ TFMVSVI EVOJB 4FMBNB BMJSBO EBSBI HJOKBM UJEBL LVSBOH EBSJ TBNQBJ
$POUPIOZB QBEB UBIVO MFCJI EBSJ KVUB PSBOH EFXBTB EJ QFSTFO OPSNBM HBHBM HJOKBM BLVU CJBTBOZB EBQBU NFNCBJL KJLB
"NFSJLB 4FSJLBU EJQFSLJSBLBO NFOHJEBQ QFOZBLJU HJOKBM LSPOJT QFOZFCBC JTLFNJB EJLPSFLTJ TFCFMVN UFSKBEJ LFSVTBLBO TFMTFM
EBOMFCJIEBSJKVUBBOPSBOHMBHJZBOHNFOHBMBNJHBHBMHJOKBMBLVU HJOKBM 5JEBL TFQFSUJ CFCFSBQB KBSJOHBO MBJO HJOKBM UBIBO
BUBVCFOUVLMFCJISJOHBOEJTGVOHTJHJOKBMMBJOOZB UFSIBEBQ QFOVSVOBO BMJSBO EBSBI HJOKBM ZBOH SFMBUJG CFTBS
1FOZBLJU HJOKBM ZBOH CFSBU EBQBU EJCBHJ EBMBN EVB LBUFHPSJ TFCFMVN UFSKBEJ LFSVTBLBO TFMTFM HJOKBM "MBTBO VOUVL IBM JOJ
VNVN
HBHBMHJOKBMBLVU ZBJUV TFMVSVIBUBVIBNQJSTFMVSVI BEBMBICBIXBLFUJLBBMJSBOEBSBIHJOKBMNFOVSVO -'(EBO
399
Tabel 31-2 Beberapa Penyebab Gagal Ginjal Akut Prarenal Tabel 31-3 Beberapa Penyebab Gagal Ginjal Akut Intrarenal
Penurunan Volume Intrayaskular Cedera Pembuluh Darah Kecit dan/atau Glomerululus

Perdarahan (akibat trauma, pembedahan, postpartum, gastrointestinal) Vaskulitis (poliarteritis nodosa)
Diare atau muntah Emboli kolesterol
Luka bakar Hipertensi maligna
Gagal Jantung Glomerulonefritis akut
Infark miokard Cedera Epitelium Tubulus (Nekrosis Tubulus)
Kerusakan katup Nekrosis tubulus akut akibat iskemia
Vasodilatasi Perifer dan Hipotensi yang Dihasilkan Nekrosis tubulus akut karena toksin (logam berat, glikol
Syok anafilaksis etilen, insekstisida, jamur beracun, tertraklorida karbon)
Anestesi Cedera Intertisial Ginjal
Sepsis, infeksi berat Pielonefritis akut
Kelainan hemodinamik ginjal primer Nefritis interstisial alergi akut
Stenosis arteri ginjal, emboli, atau trombosis arteri atau

vena ginjal
KVNMBI OBUSJVN LMPSJEB ZBOH EJGJMUSBTJ PMFI HMPNFSVMVT EBO KVHB LFBEBBOZBOHNFSVTBLFQJUFMUVCVMVTHJOKBM EBO
LFBEBBOZBOH
MBKV GJMUSBTJ BJS EBO FMFLUSPMJU MBJO
BLBO NFOVSVO )BM JOJ NFOZFCBCLBO LFSVTBLBO JOUFSTUJTJVN HJOKBM +FOJT QFOHHPMPOHBO
NFOVSVOLBOKVNMBIOBUSJVNLMPSJEBZBOHIBSVTEJSFBCTPSCTJPMFI JOJ NFSVKVL QBEB MPLBTJ DFEFSB QSJNFS UFUBQJ LBSFOB TJTUFN
UVCVMVT ZBOH NFOHHVOBLBO TFCBHJBO CFTBS FOFSHJ EBO PLTJHFO QFNCVMVI EBSBI HJOKBM EBO TJTUFN UVCVMVT TFDBSB GVOHTJPOBM
ZBOH EJLPOTVNTJ PMFI HJOKBM OPSNBM 0MFI LBSFOB JUV TFXBLUV TBMJOH CFSHBOUVOH LFSVTBLBO QFNCVMVI EBSBI HJOKBM EBQBU
BMJSBO EBSBI HJOKBM EBO -'( NFOVSVO LFCVUVIBO VOUVL NFOJNCVMLBO LFSVTBLBO UVCVMVT EBO LFSVTBLBO UVCVMVT QSJNFS
NFOHPOTVNTJ PLTJHFO HJOKBM KVHB UVSVO ,FUJLB -'( NFOEFLBUJ EBQBU NFOZFCBCLBO LFSVTBLBO QFNCVMVI EBSBI HJOKBM #FCFSBQB
OPM KVNMBI LPOTVNTJ PLTJHFO HJOKBM NFOEFLBUJ MBKV ZBOH QFOZFCBCHBHBMHJOKBMBLVUJOUSBSFOBMUFSUFSBQBEB5BCFM
EJCVUVILBO VOUVL NFOKBHB TFMTFM UVCVMVT HJOKBM UFUBQ IJEVQ
NFTLJQVO TFM UVCVMVT UJEBL NFSFBCTPSCTJ OBUSJVN ,FUJLB BMJSBO Gagal Ginjal Akut Akibat Glomerulonefritis
EBSBI NFOVSVO TBNQBJ EJ CBXBI LFCVUVIBO CBTBM JOJ ZBOH
CJBTBOZB LVSBOH EBSJ TBNQBJ QFSTFO BMJSBO EBSBI HJOKBM (MPNFSVMPOFGSJUJT BLVU BEBMBI KFOJT HBHBM HJOKBM BLVU JOUSBSFOBM
OPSNBM TFMTFM HJOKBM NVMBJ NFOKBEJ IJQPLTJB EBO QFOVSVOBO ZBOH CJBTBOZB EJTFCBCLBO PMFI LFMBJOBO SFBLTJ JNVO ZBOH
BMJSBO EBSBI HJOKBM ZBOH MFCJI MBOKVU KJLB CFSLFQBOKBOHBO BLBO NFSVTBLHMPNFSVMVT1BEBLVSBOHMFCJIQFSTFOQBTJFOEFOHBO
NFOJNCVMLBO LFSVTBLBO BUBV CBILBO LFNBUJBO TFMTFM HJOKBM QFOZBLJU JOJ UFSKBEJ LFSVTBLBO HMPNFSVMVT TBNQBJ NJOHHV
UFSVUBNBTFMFQJUFMUVCVMVT TFUFMBINFOHBMBNJJOGFLTJEJUFNQBUMBJOEJUVCVI ZBOHCJBTBOZB
EJTFCBCLBO PMFI KFOJT UFSUFOUV TUSFQUPLPLVT CFUB HSVQ " MOGFLTJ
+JLBQFOZFCBCHBHBMHJOKBMBLVUQSBSFOBMUJEBLEJLPSFLTJEBO EBQBU CFSVQB SBEBOH UFOHHPSPL TUSFQUPLPLVT UPOTJMJUJT TUSFQUP
JTLFNJB HJOKBM NFOFUBQ MFCJI EBSJ CFCFSBQB KBN UJQF HBHBM LPLVT BUBV CBILBO JOGFLTJ LVMJU TUSFQUPLPLVT #VLBO JOGFLTJ JUV
HJOKBM JOJ EBQBU CFSLFNCBOH NFOKBEJ HBHBM HJOKBM BLVU JOUSBS TFOEJSJ ZBOH NFSVTBL HJOKBM 5FUBQJ TFMBNB CFCFSBQB NJOHHV
FOBM ZBOH BLBO EJCBIBT LFNVEJBO 1FOVSVOBO BMJSBO EBSBI TFXBLUV BOUJCPEJ UFSIBEBQ BOUJHFO TUSFQUPLPLVT UFSCFOUVL
HJOKBM BLVU NFSVQBLBO QFOZFCBC UFSTFSJOH HBHBM HJOKBM BLVU BOUJCPEJ EBO BOUJHFO CFSFBLTJ TBUV TBNB MBJO NFNCFOUVL
QBEBQBTJFOEJSVNBITBMEUUFSVUBNBNFSFLBZBOHNFOHBMBNJ LPNQMFLT JNVO UBL MBSVU ZBOH LFNVEJBO UFSQFSBOHLBQ EJ
DFEFSB IFCBU 5BCFM NFNQFSMJIBULBO CFCFSBQB QFOZFCBC HMPNFSVMJ UFSVUBNBEJCBHJBONFNCSBOCBTBMHMPNFSVMJ
UFSTFSJOH QFOVSVOBO BMJSBO EBSBI HJOKBM EBO HBHBM HJOKBM BLVU
QSBSFOBM #FHJUV LPNQMFLT JNVO UFSUJNCVO EJ HMPNFSVMJ CBOZBL TFM
HMPNFSVMJ NVMBJ CFSQSPMJGFSBTJ UFSVUBNB TFM NFTBOHJBM ZBOH
UFSMFUBLEJBOUBSBFOEPUFMEBOFQJUFM4FMBJOJUV TFKVNMBICFTBSTFM
Gagal Ginjal Akut Intrarenal Akibat Kelainan di dalam
EBSBIQVUJINFOKBEJUFSQFSBOHLBQEJHMPNFSVMJ#BOZBLHMPNFSVMJ
Ginjal
NFOKBEJ UFSTVNCBU PMFI SFBLTJ JOGMBNBTJ JOJ EBO HMPNFSVMJ ZBOH
,FMBJOBO ZBOH CFSBTBM EBSJ EBMBN HJOKBM EBO ZBOH UJCBUJCB UJEBL UFSTVNCBU CJBTBOZB NFOKBEJ TBOHBU QFSNFBCFM ZBOH
NFOVSVOLBOLFMVBSBOVSJOF NBTVLEBMBNLBUFHPSJVNVNHBHBM NFNVOHLJOLBOQSPUFJOEBOTFMTFMEBSBINFSBICPDPSEBSJEBSBI
HJOKBMBLVUJOUSBSFOBM,BUFHPSJHBHBMHJOKBMBLVUJOJTFMBOKVUOZB LBQJMFS HMPNFSVMVT NBTVL LF GJMUSBU HMPNFSVMVT 1BEB LBTVT ZBOH
EBQBU EJCBHJ NFOKBEJ
LFBEBBO ZBOH NFODFEFSBJ LBQJMFS CFSBU TFMVSVIBUBVIBNQJSTFMVSVIGVOHTJHJOKBMEBQBUUFSIFOUJ
HMPNFSVMVTBUBVQFNCVMVIEBSBILFDJMHJOKBMMBJOOZB
400
*OGMBNBTJBLVUQBEBHMPNFSVMJCJBTBOZBNFSFEBEBMBNXBLUV HJOKBMEBOGVOHTJGVOHTJMBJOOPSNBMQBEBBXBMOZB+JLBLFMVBSBO
TFLJUBS NJOHHV EBO QBEB LFCBOZBLBO QBTJFO HJOKBM LFNCBMJ VSJOF NFOVSVO IBOZB QBEB TBMBI TBUV HJOKBM UJEBL BLBO BEB
CFSGVOHTJ IBNQJS OPSNBM EBMBN CFCFSBQB NJOHHV TBNQBJ QFSVCBIBO ZBOH CFSBSUJ QBEB LPNQPTJTJ DBJSBO UVCVI LBSFOB
CFCFSBQBCVMBOCFSJLVUOZB/BNVO UFSLBEBOH CBOZBLHMPNFSVMJ HJOKBM LPOUSBMBUFSBM EBQBU DVLVQ NFOJOHLBULBO LFMVBSBO
ZBOH SVTBL UBL EBQBU NFNCBJL EBO QBEB TFCBHJBO LFDJM QBTJFO VSJOFOZB VOUVL NFNQFSUBIBOLBO LBEBS ZBOH SFMBUJG OPSNBM
UNIT V
LFNVOEVSBO HJOKBM TFDBSB QSPHSFTJG UFSVT UFSKBEJ VOUVL KBOHLB FMFLUSPMJU EBO [BU UFSMBSVU FLTUSBTFM TFSUB WPMVNF DBJSBO
XBLUVUJEBLUFSCBUBT ZBOHNFOJNCVMLBOHBHBMHJOKBMLSPOJT ZBOH FLTUSBTFMVMBS OPSNBM 1BEB KFOJT HBHBM HJOKBM TFQFSUJ JOJ GVOHTJ
EJKFMBTLBOEJCBHJBOCFSJLVUOZBEBMBNCBCJOJ OPSNBMHJOKBMEBQBUEJQVMJILBOKJLBQFOZFCBCEBTBSNBTBMBIOZB
EJLPSFLTJ EBMBN XBLUV CFCFSBQB KBN 5FUBQJ TVNCBUBO LSPOJT
Nekrouis Tubular sebagai Penyebab Gagal Ginjal Akut QBEB USBLUVT VSJOBSJVT ZBOH CFSMBOHTVOH TFMBNB CFCFSBQB IBSJ
BUBV CFSNJOHHVNJOHHV EBQBU NFOZFCBCLBO LFSVTBLBO HJOKBM
1FOZFCBC MBJO HBHBM HJOKBM BLVU JOUSBSFOBM BEBMBI OFLSPTJT UVCVMVT
ZBOHJSFWFSTJCFM#FCFSBQBQFOZFCBCHBHBMHJOKBMBLVUQBTDBSFOBM
ZBOH CFSBSUJ LFSVTBLBO TFM FQJUFM UVCVMVT #FCFSBQB QFOZFCBC
BOUBSBMBJO
TVNCBUBOCJMBUFSBMVSFUFSBUBVQFMWJTSFOBMJTPMFI
VNVN OFLSPTJT UVCVMBS BEBMBI
JTLFNJB CFSBU EBO QBTPLBO
CBUV BUBV HVNQBMBO EBSBI ZBOH CFTBS
TVNCBUBO LBOEVOH
PLTJHFO EBO [BU NBLBOBO LF TFM FQJUFM UVCVMVT ZBOH UJEBL BEFLVBU
LFNJI EBO
TVNCBUBOEJVSFUSB
EBO
SBDVO UPLTJO BUBVPCBUPCBUBOZBOHNFSVTBLTFMTFMFQJUFM
UVCVMVT
Efek Fisiologis Gagal Ginjal Akut
Nekrouis Tubulus Akut Akibat Iskemia Ginjal Berat &GFL GJTJPMPHJT ZBOH VUBNB HBHBM HJOKBM BLVU BEBMBI SFUFOTJ BJS
SFUFOTJ TJTB NFUBCPMJTNF EBO SFUFOTJ FMFLUSPMJU EJ EBSBI EBO
*TLFNJB HJOKBM CFSBU EBQBU EJBLJCBULBO PMFI TZPL TJSLVMBTJ BUBV
DBJSBO FLTUSBTFMVMBS )BM JOJ EBQBU NFOZFCBCLBO QFOVNQVLBO
HBOHHVBOMBJOZBOHTBOHBUNFOVSVOLBOQBTPLBOEBSBILFHJOKBM
BJS EBO HBSBN ZBOH CFSMFCJIBO ZBOH LFNVEJBO EBQBU
+JLB JTLFNJB DVLVQ CFSBU TBNQBJ NFOZFCBCLBO HBOHHVBO IFCBU
NFOHBLJCBULBO FEFNB EBO IJQFSUFOTJ /BNVO SFUFOTJ LBMJVN
QBEB QFOHBOHLVUBO [BU NBLBOBO EBO PLTJHFO LF TFMTFM FQJUFM
ZBOH CFSMFCJIBO TFSJOH NFOZFCBCLBO BODBNBO ZBOH MFCJI
UVCVMVTHJOKBM EBOKJLBHBOHHVBOJOJUFSVTCFSMBOHTVOH LFSVTBLBO
TFSJVT UFSIBEBQ QBTJFO EFOHBO HBHBM HJOKBM BLVU LBSFOB
BUBVQFOHIBODVSBOTFMTFMFQJUFMEBQBUUFSKBEJ+JLBIBMJOJUFSKBEJ
QFOJOHLBUBO LPOTFOUSBTJ LBMJVN QMBTNB IJQFSLBMFNJB
EJ BUBT
TFMTFMUVCVMVTUFSMFQBTEBONFOZVNCBUCBOZBLOFGSPO TFIJOHHB
N&R- IBOZB EVB LBMJ OJMBJ OPSNBM
EBQBU NFOKBEJ GBUBM
UJEBLUFSEBQBULFMVBSBOVSJOFEBSJOFGSPOZBOHUFSTVNCBUOFGSPO
0MFI LBSFOB HJOKBM KVHB UJEBL EBQBU NFOHFLTLSFTJ DVLVQ JPO
JOJ TFSJOH LBMJ HBHBM NFOHFLTLSFTJ VSJOF CBILBO LFUJLB BMJSBO
IJESPHFO QBTJFO EFOHBO HBHBM HJOKBM BLVU NFOHBMBNJ BTJEPTJT
EBSBI HJOKBM LFNCBMJ OPSNBM TFMBNB UVCVMVT NBTJI UFSTVNCBU
NFUBCPMJL ZBOH CJTB NFOZFCBCLBO LFNBUJBO BUBV
1FOZFCBCUFSTFSJOHLFSVTBLBOFQJUFMUVCVMVTBLJCBUJTLFNJBBEBMBI
NFNQFSCVSVLIJQFSLBMFNJB
QFOZFCBC QSBSFOBM EBSJ HBHBM HJOKBM BLVU ZBOH CFSIVCVOHBO
EFOHBOTZPLTJSLVMBTJ TFQFSUJZBOHUFMBIEJCJDBSBLBOTFCFMVNOZB 1BEB LBTVT HBHBM HJOKBM BLVU UFSQBSBI UJNCVM BOVSJB
EBMBNCBCJOJ NFOZFMVSVI1BTJFOBLBONFOJOHHBMEBMBNXBLUVTBNQBJ
IBSJKJLBGVOHTJHJOKBMUJEBLEJQFSCBJLJBUBVHJOKBMCVBUBOUJEBL
EJHVOBLBO VOUVL NFNCFSTJILBO UVCVI EBSJ SFUFOTJ LFMFCJIBO
Nekrouis Tubulus Akut Akibat Tnksin atau Obat-obatan
BJS FMFLUSPMJU EBO QSPEVL TJTB NFUBCPMJTNF &GFL MBJO EBSJ
#BOZBL TFLBMJ SBDVO EBO PCBUPCBUBO ZBOH EBQBU NFSVTBL FQJUFM QFOVSVOBOLFMVBSBOVSJOF EBOKVHBQFOHPCBUBOEFOHBOHJOKBM
UVCVMVTEBONFOZFCBCLBOHBHBMHJOKBMBLVU#FCFSBQBEJBOUBSBOZB CVBUBO BLBO EJCJDBSBLBO EJ CBHJBO CFSJLVUOZB EBMBN
BEBMBI LBSCPO UFUSBLMPSJEB MPHBN CFSBU TFQFSUJ BJS SBLTB EBO IVCVOHBOOZBEFOHBOHBHBMHJOKBMLSPOJT
UJNBI IJUBN
FUJMFO HMJLPM ZBOH NFSVQBLBO LPNQPOFO VUBNB
EBMBN DBJSBO BOUJCFLV
CFSNBDBNNBDBN JOTFLUJTJEB EBO
Gagal Ginjal Kronisr Penurunan Jumlah Nefron
CFCFSBQB PCBU TFQFSUJ UFUSBTJLMJO
ZBOH EJHVOBLBO TFCBHBJ
Fungsional yang Ireversibel
BOUJCJPUJL EBO DJTQMBUJOVN ZBOH EJHVOBLBO EBMBN QFOHPCBUBO
LBOLFSUFSUFOUV.BTJOHNBTJOH[BUJOJNFNJMJLJFGFLUPLTJLZBOH
TQFTJGJLQBEBTFMFQJUFMUVCVMVTHJOKBM ZBOHNFOZFCBCLBOLFNBUJBO (BHBM HJOKBM LSPOJT EJTFCBCLBO PMFI IJMBOHOZB TFKVNMBI CFTBS
QBEB CBOZBL TFM )BTJM BLIJSOZB TFMTFM FQJUFM UFSMFQBT EBSJ OFGSPO GVOHTJPOBM ZBOH QSPHSFTJG EBO JSFWFSTJCFM (FKBMBHFKBMB
NFNCSBOCBTBMEBONFOZVNCBUUVCVMVT1BEBCFCFSBQBLFBEBBO LMJOJT CFSBU TFSJOH LBMJ UJEBL NVODVM TBNQBJ KVNMBI OFGSPO
NFNCSBO CBTBM KVHB IBODVS +JLB NFNCSBO CBTBM UFUBQ VUVI TFM GVOHTJPOBMCFSLVSBOHTFEJLJUOZBTBNQBJQFSTFOEJCBXBI
FQJUFM UVCVMVT ZBOH CBSV EBQBU UVNCVI EJ TFQBOKBOH QFSNVLBBO OPSNBM #BILBO LPOTFOUSBTJ LFCBOZBLBO FMFLUSPMJU EBMBN
NFNCSBO TFIJOHHBUVCVMVTEBQBUNFNQFSCBJLJEJSJTFOEJSJEBMBN EBSBI EBO WPMVNF DBJSBO UVCVI EBQBU EJQFSUBIBOLBO QBEB
XBLUVTBNQBJIBSJ LFBEBBO ZBOH SFMBUJG OPSNBM TBNQBJ KVNMBI OFGSPO GVOHTJPOBM
NFOVSVOEJCBXBITBNQBJQFSTFOKVNMBIOPSNBM
Gagal. Ginjal Akut Passarenal Akibat Kelainan Traktus 5BCFM NFODBOUVNLBO CFCFSBQB QFOZFCBC UFSQFOUJOH
Urinarius Bagian Bawah HBHBM HJOKBM LSPOJT 6NVNOZB HBHBM HJOKBM BLVU TFQFSUJ HBHBM
#FSCBHBJ LFMBJOBO QBEB USBLUVT VSJOBSJVT CBHJBO CBXBI EBQBU HJOKBM LSPOJT EBQBU UFSKBEJ BLJCBU HBOHHVBO QFNCVMVI EBSBI
NFOZVNCBU TFMVSVI BUBV TFCBHJBO BMJSBO VSJOF EBO PMFI LBSFOB HMPNFSVMVT UVCVMVT JOUFSTUJTJVN HJOKBM EBO USBLUVT VSJOBSJVT
JUV NFOJNCVMLBOHBHBMHJOKBMBLVUCBILBOCJMBQBTPLBOEBSBI CBHJBOCBXBI8BMBVQVOCBOZBLSBHBNQFOZBLJUEBQBUNFOJN
401
Tabel 31-4 Beberapa Penyebab Gagal Ginjal Kronis NFTLJQVO NBTTB HJOKBM CFSLVSBOH TFCBOZBL TBNQBJ QFSTFO
EBSJ OPSNBM #JBSQVO CFHJUV TFMBNB CFCFSBQB UBIVO QFSVCBIBO
Gangguan Metabolisme BEBQUJGHJOKBMEBQBUNFOJNCVMLBOLFSVTBLBOMFCJIMBOKVUQBEBTJTB
Diabetes melitus OFGSPOZBOHBEB LIVTVTOZBHMPNFSVMVTOFGSPOOFGSPOUFSTFCVU
Obesitas 1FOZFCBC LFSVTBLBO UBNCBIBO JOJ UJEBL EJLFUBIVJ UFUBQJ
Amiloidosis CFCFSBQB QFOFMJUJ CFSBOHHBQBO CBIXB IBM JOJ NVOHLJO
CFSIVCVOHBO EFOHBO QFOJOHLBUBO UFLBOBO BUBV QFSFHBOHBO TJTB
Hipertensi
HMPNFSVMVT ZBOHUFSKBEJTFCBHBJBLJCBUWBTPEJMBUBTJGVOHTJPOBMBUBV
Gangguan Pembuluh Darah Renalis QFOJOHLBUBO UFLBOBO EBSBI QFOJOHLBUBO UFLBOBO EBO SFHBOHBO
Ateroskterosis ZBOH LSPOJT QBEB BSUFSJPMB LFDJM EBO HMPNFSVMJ EJZBLJOJ
Hipertensi-nefrosklerosis NFOZFCBCLBO DFEFSB EBO TLMFSPTJT QBEB QFNCVMVI JOJ
QFOHHBOUJBO KBSJOHBO OPSNBM EFOHBO KBSJOHBO JLBU
-FTJMFTJ
Gangguan Imunologis
TLMFSPUJLJOJQBEBBLIJSOZBEBQBUNFOHIJMBOHLBOHMPNFSVMVT EBO
Glomerulonefritis NFOHBLJCBULBO QFOVSVOBO GVOHTJ HJOKBM MFCJI MBOKVU QFSVCBIBO
Poliarteritis nodosa BEBQUJG MFCJI MBOKVU QBEB OFGSPO ZBOH NBTJI BEB EBO
Lupus eritematosus NFOJNCVMLBOMJOHLBSBOTFUBOZBOHCFSLFNCBOHTFDBSBMBNCBUEBO
CFSBLIJS TFCBHBJ QFOZBLJU HJOKBM TUBEJVN BLIJS (BNCBS

Infeksi
4BUVTBUVOZB NFUPEF ZBOH UFSCVLUJ EBQBU NFNQFSMBNCBU
Pielonefritis LFIJMBOHBOQSPHSFTJGGVOHTJHJOKBMJOJBEBMBIEFOHBONFOVSVOLBO
Tuberkulosis UFLBOBO BSUFSJ EBO UFLBOBO IJESPTUBUJL HMPNFSVMVT LIVTVTOZB
Gangguan Tubutus Primer EFOHBO NFOHHVOBLBO PCBUPCBUBO TFQFSUJ JOIJCJUPS FO[JN
QFOHPOWFSTJBOHJPUFOTJO "$&*OIJCJUPST
BUBVBOUBHPOJTSFTFQUPS
Nefrotoksin (analgesik, logam berat)
BOHJPUFOTJO**
Obstruksi Traktus Urinarius
5BCFM NFODBOUVNLBO QFOZFCBC UFSTFSJOH QFOZBLJU HJOKBM
Batu ginjal
TUBEJVNBLIJS1BEBBXBMUBIVOBO HMPNFSVMPOFGSJUJTEFOHBO
Hipertrofi prostat TFNVB CFOUVLOZB EJBOHHBQ TFCBHBJ QFODFUVT QBMJOH TFSJOH ZBOH
Konstriksi uretra NFOZFCBCLBO QFOZBLJU HJOKBM TUBEJVN BLIJS 1BEB UBIVOUBIVO
Gangguan Kongenital UFSBLIJS EJBCFUFTNFMJUVTEBOIJQFSUFOTJEJLFUBIVJTFCBHBJQFOZFCBC
VUBNB QFOZBLJU HJOKBM TUBEJVN BLIJS ZBOH CFSTBNBTBNB NFOKBEJ
Penyakit polikistik
QFOZFCBCMFCJIEBSJQFSTFOTFNVBLBTVTHBHBMHJOKBMLSPOJT
Tidak adanya jaringan ginjal kongenital (hipoplasia ginjal)
CVMLBO HBHBM HJOKBM LSPOJT OBNVO IBTJM BLIJSOZB TBNB QFOV

SVOBOKVNMBIOFGSPOGVOHTJPOBM
+
eingkaran Setan Gagal Ginjal Kronis MengAkibatkan
Penyakit Ginjal Stadium Akhir
1BEB CBOZBL LBTVT HBOHHVBO BXBM QBEB HJOKBM NFOJNCVMLBO
LFNVOEVSBO QSPHSFTJG QBEB GVOHTJ HJOKBM EBO CFSLVSBOHOZB
OFGSPO MFCJI MBOKVU TBNQBJ QBEB TVBUV UJUJL TFTFPSBOH IBSVT
NFOKBMBOJ UFSBQJ EJBMJTJT BUBV USBOTQMBOUBTJ EFOHBO HJOKBM ZBOH
NBTJI CFSGVOHTJ BHBS EBQBU CFSUBIBO IJEVQ ,FBEBBO JOJ
EJTFCVUQFOZBLJUHJOKBMTUBEJVNBLIJS
1FOFMJUJBO QBEB IFXBO QFSDPCBBO NFNQFSMJIBULBO CBIXB
QFOHBOHLBUBOTFCBHJBOCFTBSHJOKBMNFMBMVJQFNCFEBIBONVMB
NVMB NFOJNCVMLBO QFSVCBIBO BEBQUJG QBEB TJTB OFGSPO ZBOH
NFOHBLJCBULBO QFOJOHLBUBO BMJSBO EBSBI QFOJOHLBUBO -'(
EBO QFOJOHLBUBO LFMVBSBO VSJOF EJ OFGSPO ZBOH NBTJI
CFSUBIBO .FLBOJTNF UFQBUOZB ZBOH CFSQFSBO BUBT QFSVCBIBO
JOJ NBTJI CFMVN EJNFOHFSUJ CFOBS UBQJ NFMJCBULBO IJQFSUSPGJ
QFSUVNCVIBOCFSCBHBJTUSVLUVSOFGSPOZBOHNBTJICFSUBIBO

TFMBJO KVHB CFSCBHBJ QFSVCBIBO GVOHTJPOBM ZBOH NFOVSVOLBO
UBIBOBOWBTLVMBSEBOSFBCTPSQTJUVCVMVTEJEBMBNOFGSPOZBOH
NBTJI CFSUBIBO 1FSVCBIBO BEBQUJG JOJ NFNVOHLJOLBO TFTF
PSBOHNFOHFLTLSFTJBJSEBSJ[BUUFSMBSVUEBMBNKVNMBIOPSNBM
402
Tabel 31-5. Penyebab Paling Sering Penyakit Ginjal 2.5

Stadium Akhir (End-Stage Renal Disease—ESRD)
2.0
Penyebab Persentase dari
Total Pasien ESRD 1.5
UNIT V
Diabetes melitus 45 1.0
Hipertensi 27
0.5
Gtomerutonefritis 8
Penyakit ginjal polikistik 2 0.0
Lain-tain/tidak diketahui 18 0 20 40 60 80
1FOJOHLBUBO CFSBU CBEBO CFSMFCJI PCFTJUBT

OBNQBLOZB SFOBMJT LFDJM TVNCBUBO TBUV BUBV MFCJI QFNCVMVI EBSBI JOJ
NFSVQBLBO GBLUPS SJTJLP UFSQFOUJOH VOUVL EVB QFOZFCBC VUBNB BLBO NFOZFCBCLBO LFSVTBLBO CBOZBL OFGSPO 0MFI TFCBC JUV
QFOZBLJUHJOKBMTUBEJVNBLIJSEJBCFUFTEBOIJQFSUFOTJ4FQFSUJZBOH CBOZBL KBSJOHBO HJOKBM EJHBOUJLBO PMFI TFKVNMBI LFDJM KBSJOHBO
GJCSPTB #JMB T*EFSPTJT UFSKBEJ EJ HMPNFSVMJ LFSVTBLBO ZBOH UFSKBEJ
EJCBIBT QBEB #BC EJBCFUFT UJQF ** ZBOH UFSLBJU FSBU EFOHBO
EJTFCVUHMPNFSVMPTLMFSPTJT
PCFTJUBT QFOZFCBCMFCJIEBSJQFSTFOEBSJTFNVBLBTVTEJBCFUFT
NFMJUVT #FSBU CBEBO CFSMFCJI KVHB NFSVQBLBO QFOZFCBC VUBNB /FGSPTLMFSPTJT EBO HMPNFSVMPTLMFSPTJT CFSCBHBJ EFSBKBU
IJQFSUFOTJ FTFOTJBM ZBOH NFSVQBLBO TBNQBJ QFSTFO EBSJ UFSKBEJ QBEB TFCBHJBO CFTBS JOEJWJEV TFUFMBI VNVS FNQBU
GBLUPS SJTJLP UJNCVMOZB IJQFSUFOTJ QBEB PSBOH EFXBTB 4FMBJO QVMVIBO ZBOH NFOJNCVMLBO QFOVSVOBO TFLJUBS QFSTFO
NFOZFCBCLBO LFSVTBLBO HJOKBM NFMBMVJ EJBCFUFT EBO IJQFSUFOTJ KVNMBI OFGSPO GVOHTJPOBM TFUJBQ UBIVOOZB TFUFMBI
PCFTJUBTKVHBEBQBUNFNQVOZBJFGFLUBNCBIBOBUBVTJOFSHJTZBOH CFSVNVSUBIVO (BNCBS
)JMBOHOZBHMPNFSVMJEBO
NFNQFSCVSVL GVOHTJ HJOKBM QBEB QBTJFO EFOHBO QFOZBLJU HJOKBM LFTFMVSVIBO GVOHTJ OFGSPO UFSDFSNJO EBSJ QFOVSVOBO
ZBOHTVEBIBEBTFCFMVNOZB QSPHSFTJGCBJLQBEBBMJSBOEBSBIHJOKBMNBVQVO-'(#BILBO
QBEBPSBOHOPSNBM BMJSBOQMBTNBHJOKBMEBO-'(NFOVSVO
Kerusakan Sistem Pembuluh Darah Ginjal sebagai TFCBOZBLTBNQBJQFSTFOTFUFMBICFSVTJBUBIVO
Penyebab Gagat Ginjal Kronis 'SFLVFOTJ EBO CFSBUOZB OFGSPTLMFSPTJT EBO HMPNFSVMPT
LMFSPTJT TBOHBU NFOJOHLBU CJMB EJTFSUBJ IJQFSUFOTJ BUBV
#FSCBHBJ KFOJT MFTJ WBTLVMBS EBQBU NFOZFCBCLBO JTLFNJB HJOKBM EJBCFUFT NFMJUVT #BILBO EJBCFUFT NFMJUVT EBO IJQFSUFOTJ
EBO LFNBUJBO KBSJOHBO HJOKBM -FTJ UFSTFSJOH BEBMBI
BEBMBIEVBQFOZFCBCUFSQFOUJOHEBSJQFOZBLJUHJOKBMTUBEJVN
BUFSPTLMFSPTJT QBEB BSUFSJ SFOBMJT ZBOH CFTBS EFOHBO LPOTUSJLTJ BLIJS TFQFSUJZBOHUFMBIEJCBIBTTFCFMVNOZB
TLMFSPUJL QSPHSFTJG QBEB QFNCVMVI EBSBI
IJQFSQMBTJB
+BEJ OFGSPTLMFSPTJT CFOJHOB ZBOH CFSIVCVOHBO EFOHBO
GJCSPNVTLVMBS QBEB TBUV BUBV MFCJI BSUFSJ CFTBS ZBOH KVHB
IJQFSUFOTJ CFSBU EBQBU NFOJNCVMLBO OFGSPTLMFSPTJT NBMJHOB
NFOJNCVMLBO PLMVTJ QFNCVMVI EBSBI EBO
OFGSPTLMFSPTJT
ZBOH CFSLFNCBOH EFOHBO DFQBU (BNCBSBO IJTUPMPHJT ZBOH
ZBOH EJTFCBCLBO PMFI MFTJ TLMFSPUJL BSUFSJ LFDJM BSUFSJPMB EBO
LIBT EBO OFGSPTLMFSPTJT NBMJHOB NFMJQVUJ EFQPTJU GJCSJOPJE
HMPNFSVMJ
EBMBN KVNMBI CFTBS EJ BSUFSJPMB EBO QFOFCBMBO QSPHSFTJG
-FTJ BUFSPTLMFSPUJL BUBV IJQFSQMBTUJL QBEB BSUFSJ CFTBS TFSJOH QFNCVMVIEBSBIUFSTFCVU EFOHBOJTLFNJBCFSBUZBOHUFSKBEJ
LBMJ NFOHFOBJ TBMBI TBUV HJOKBM NFMFCJIJ HJOKBM ZBOH MBJO EBO EJ OFGSPO ZBOH CFSTBOHLVUBO 6OUVL BMBTBO ZBOH UBL
LBSFOBOZB NFOZFCBCLBO QFOVSVOBO GVOHTJ HJOKBM VOJMBUFSBM EJLFUBIVJ JOTJEFO OFGSPTLMFSPTJT NBMJHOB EBO HMPNFSVMPT
4FQFSUJUFMBIEJCBIBTEJ#BC IJQFSUFOTJTFSJOHUFSKBEJCJMBBSUFSJ LMFSPTJTCFSBUMFCJIUJOHHJTFDBSBCFSNBLOBQBEBPSBOHLVMJU
TBMBI TBUV HJOKBM LPOTUSJLTJ TFEBOHLBO BSUFSJ HJOKBM MBJO NBTJI IJUBN EBSJQBEB PSBOH LVMJU QVUJI QBEB VNVS ZBOH TBNB
OPSNBM LPOEJTJ ZBOH BOBMPH EFOHBO IJQFSUFOTJ (PMECMBUU EVB ZBOH NFOEFSJUB IJQFSUFOTJ BUBV EJBCFUFT EFOHBO UJOHLBU
HJOKBMh LFQBSBIBOZBOHTBNB
/FGSPTLMFSPTJT CFOJHOB CFOUVL QFOZBLJU HJOKBM UFSTFSJOH
EJKVNQBJ EBMBN CFSCBHBJ EFSBKBU EJ TFLJUBS QFSTFO Kerusakan Glomeruli sebagai Penyebab Gagal Ginjal
QFNFSJLTBBO QPTUNPSUFN QBEB PSBOHPSBOH ZBOH NFOJOHHBM Kronis-Glomerulonefritis
TFUFMBICFSVNVSUBIVO+FOJTMFTJWBTLVMBSJOJUFSKBEJEJBSUFSJ (MPNFSVMPOFGSJUJT LSPOJT EBQBU EJTFCBCLBO PMFI CFCFSBQB
JOUFSMPCVMBS ZBOH MFCJI LFDJM EBO EJ BSUFSJPMB BGFSFO HJOKBM QFOZBLJU ZBOH NFOZFCBCLBO JOGMBNBTJ EBO LFSVTBLBO
.VOHLJO MFTJ JOJ CFSNVMB EBSJ LFCPDPSBO QMBTNB NFMBMVJ LBQJMFS HMPNFSVMVT HJOKBM #FSMBXBOBO EFOHBO CFOUVL BLVU
NFNCSBOJOUJNBQFNCVMVIQFNCVMVIJOJ)BMJOJNFOZFCBCLBO QFOZBLJU JOJ HMPNFSVMPOFGSJUJT LSPOJT BEBMBI QFOZBLJU ZBOH
UFSCFOUVLOZB FOEBQBO GJCSJOPJE EJ MBQJTBO NFEJB QFNCVMVI CFSLFNCBOH MBNCBU ZBOH TFSJOH NFOJNCVMLBO HBHBM HJOKBM
ZBOHEJJLVUJEFOHBOQFOFCBMBOQSPHSFTJGEJOEJOHQFNCVMVIZBOH JSFWFSTJCFM,FBEBBOJOJNVOHLJONFSVQBLBOQFOZBLJUHJOKBM
BLIJSOZB BLBO NFOZFCBCLBO LPOTUSJLTJ QFNCVMVI EBSBI EBO QSJNFS ZBOH NFOHJLVUJ HMPNFSVMPOFGSJUJT BLVU BUBV UFSKBEJ
QBEB CFCFSBQB LBTVT NFOZVNCBU QFNCVMVI UFSTFCVU 0MFI TFLVOEFS BLJCBU QFOZBLJU TJTUFNJL TFQFSUJ MVQVT FSJUFNBU
LBSFOBQBEBEBTBSOZBUJEBLBEBTJSLVMBTJLPMBUFSBMEJBOUBSBBSUFSJ PTVT
403
1BEBTFCBHJBOCFTBSLBTVT HMPNFSVMPOFGSJUJTLSPOJTCFSNVMBEFOHBO ZBOH NFOJOHLBULBO QFSNFBCJMJUBT NFNCSBO EBQBU NFOZFCBCLBO

BLVNVMBTJLPNQMFLTBOUJHFOBOUJCPEJZBOHNFOHFOEBQEJNFNCSBO TJOESPN OFGSPUJL 1FOZBLJUQFOZBLJU TFNBDBN JOJ NFMJQVUJ

HMPNFSVMVT #FSCFEB EFOHBO HMPNFSVMPOFGSJUJT BLVU JOGFLTJ HMPNFSVMPOFGSJUJT LSPOJT ZBOH UFSVUBNB NFNFOHBSVIJ HMPNFSVMVT
TUSFQUPLPLVT IBOZB UFSKBEJ QBEB TFCBHJBO LFDJM QBTJFO EFOHBO TFIJOHHB TFSJOH LBMJ NFOZFCBCLBO QFOJOHLBUBO QFSNFBCJMJUBT
HMPNFSVMPOFGSJUJTUJQFLSPOJT"LVNVMBTJLPNQMFLTBOUJCPEJBOUJHFO NFNCSBOHMPNFSVMVT
BNJMPJEPTJT ZBOHEJTFCBCLBOPMFIFOEBQBO
QBEB NFNCSBO HMPNFSVMVT NFOZFCBCLBO JOGMBNBTJ QFOFCBMBO [BU[BU QSPUFJOPJE BCOPSNBM QBEB EJOEJOH QFNCVMVI EBSBI EBO
NFNCSBO QSPHSFTJG EBO BLIJSOZB JOWBTJ HMPNFSVMJ PMFI KBSJOHBO TBOHBUNFSVTBLNFNCSBOCBTBMHMPNFSVMVTEBO
TJOESPNOFGSPUJL
GJCSPTB 1BEB TUBEJVN MBOKVU QFOZBLJU JOJ LPFGJTJFO GJMUSBTJ LBQJMFS EFOHBOQFSVCBIBONJOJNBM EFOHBOUJEBLBEBOZBLFMBJOBOCFSBUQBEB
HMPNFSVMVT NFOKBEJ TBOHBU CFSLVSBOH BLJCBU QFOVSVOBO KVNMBI NFNCSBO LBQJMFS HMPNFSVMVT ZBOH EBQBU EJEFUFLTJ EFOHBO
LBQJMFS GJMUSBTJ EJ HMPNFSVMVT EBO BLJCBU QFOFCBMBO NFNCSBO NJLSPTLPQ DBIBZB 4FQFSUJ ZBOH EJCBIBT QBEB #BC OFGSPQBUJ
HMPNFSVMVT 1BEB TUBEJVN BLIJS QBOZBLJU CBOZBL HMPNFSVMJ ZBOH EFOHBO QFSVCBIBO NJOJNBM EJLFUBIVJ CFSIVCVOHBO EFOHBO
EJHBOUJLBO PMFI KBSJOHBO GJCSPTB TFIJOHHB UJEBL EBQBU NFOZBSJOH IJMBOHOZB NVBUBO OFHBUJG ZBOH OPSNBMOZB UFSEBQBU QBEB NFNCSBO
DBJSBO CBTBMLBQJMFSHMPNFSVMVT1FOFMJUJBOJNVOPMPHJTKVHBNFNQFSMJIBULBO
SFBLTJJNVOZBOHBCOPSNBMQBEBCFCFSBQBLBTVT ZBOHNFOVOKVLLBO
Kerusakan Interstisium Ginjal sebagai Penyebab Gagal IJMBOHOZB NVBUBO OFHBUJG NVOHLJO EJTFCBCLBO PMFI TFSBOHBO
BOUJCPEJ QBEB NFNCSBO )JMBOHOZB NVBUBO OFHBUJG OPSNBM QBEB
Ginjal Kronis-Nefritis Interstisial
NFNCSBO CBTBM LBQJMFS HMPNFSVMVT NFNVOHLJOLBO QSPUFJO
1FOZBLJU QSJNFS BUBV TFLVOEFS QBEB JOUFSTUJTJVN HJOKBM EJTFCVU
LIVTVTOZB BMCVNJO EFOHBO NVEBI NFMFXBUJ NFNCSBO HMPNFSVMVT
OFGSJUJTJOUFSTUJTJBM1BEBVNVNOZB IBMJOJEJTFCBCLBOPMFILFSVTBL
LBSFOB NVBUBO OFHBUJG QBEB NFNCSBO CBTBM CJBTBOZB NFOPMBL
BO WBTLVMBS HMPNFSVMVT BUBV UVCVMVT ZBOH NFSVTBL NBTJOHNBTJOH
NVBUBOOFHBUJGQSPUFJOQMBTNB
OFGSPO BUBV EBQBU NFSVQBLBO LFSVTBLBO QSJNFS JOUFSTUJTJVN HJOKBM
BLJCBUSBDVO PCBUPCBUBO EBOJOGFLTJCBLUFSJ /FGSPQBUJEFOHBOQFSVCBIBONJOJNBMEBQBUUFSKBEJQBEBPSBOH
,FSVTBLBO JOUFSTUJTJBM HJOKBM ZBOH EJTFCBCLBO PMFI JOGFLTJ CBLUFSJ EFXBTB UFUBQJMFCJITFSJOHQBEBBOBLBOBLCFSVNVSBOUBSBEBO
EJTFCVU QJFMPOFGSJUJT *OGFLTJ EBQBU EJTFCBCLBO PMFI CFSCBHBJ KFOJT UBIVO 1FOJOHLBUBO QFSNFBCJMJUBT NFNCSBO LBQJMFS HMPNFSVMVT
CBLUFSJ UFUBQJ UFSVUBNB EBSJ &TDIFSJDIJB DPMJ ZBOH CFSBTBM EBSJ LBEBOHLBEBOH NFNVOHLJOLBO QSPUFJO QMBTNB TFCBOZBL HSBN
LPOUBNJOBTJUJOKBQBEBUSBLUVTVSJOBSJVT#BLUFSJJOJNFODBQBJHJOKBM IJMBOH NFMBMVJ VSJOF TFUJBQ IBSJOZB ZBOH NFSVQBLBO KVNMBI
NFMBMVJ BMJSBO EBSBI BUBV ZBOH MFCJI TFSJOH TFDBSB BTFOEFO EBSJ TBOHBU CBOZBL CBHJ TFPSBOH BOBL LFDJM 0MFI LBSFOB JUV
USBLUVTVSJOBSJVTCBHJBOCBXBINFMFXBUJVSFUFSLFHJOKBM LPOTFOUSBTJQSPUFJOQMBTNBBOBLBOBLTFSJOHLBMJUVSVOEJCBXBI
HEM EBO UFLBOBO PTNPUJL LPMPJE UVSVO EBSJ OJMBJ OPSNBM
8BMBVQVO LBOEVOH LFNJI OPSNBM NBNQV NFNCJMBT CBLUFSJ NFOKBEJ LVSBOH EBSJ NN )H "LJCBU UFLBOBO PTNPUJL LPMPJE
EFOHBO NVEBI OBNVO UFSEBQBU EVB LPOEJTJ LMJOJT VNVN ZBOH ZBOH SFOEBI JOJ EBMBN QMBTNB TFKVNMBI CFTBS DBJSBO CPDPS EBSJ
EBQBUNFOHHBOHHVQFNCJMBTBOOPSNBMCBLUFSJEBOLBOEVOHLFNJI LBQJMFS EJ TFMVSVI UVCVI EBO NBTVL LF EBMBN TFCBHJBO CFTBS

LFUJEBLNBNQVBO LBOEVOH LFNJI VOUVL NFOHPTPOHLBO JTJOZB KBSJOHBO NFOJNCVMLBO FEFNB CFSBU TFQFSUJ ZBOH EJCJDBSBLBO
TBNQBJ IBCJT ZBOH NFOHIBTJMLBO TJTB VSJOF EBMBN LBOEVOH LFNJI QBEB#BC
EBO
BEBOZB PCTUSVLTJ QBEB BMJSBO LFMVBS VSJOF #JMB UFSKBEJ
HBOHHVBOLFNBNQVBOVOUVLNFNCJMBTCBLUFSJEBSJLBOEVOHLFNJI
CBLUFSJ BLBO CFSLFNCBOH CJBL EBO LBOEVOH LFNJI NFSBEBOH Fungsi Nefron pada Gagal Ginjal Kronis
LPOEJTJ ZBOH EJTFCVU TJTUJUJT #FHJUV TJTUJUJT UFSKBEJ TJTUJUJT EBQBU Hilangnya Nefron Fungsional Memaksa Nefron yang
UFSMPLBMJTBTJUBOQBNFOKBMBSOBJLLFHJOKBM BUBVQBEBCFCFSBQBPSBOH Masih Bertahan untuk Mengekskresikan Lebih Banyak
CBLUFSJ EBQBU NFODBQBJ QFMWJT SFOBMJT BLJCBU LPOEJTJ QBUPMPHJT ZBOH
NFOZFCBCLBOVSJOFUFSEPSPOHLFBUBTNFMBMVJTBUVBUBVLFEVBVSFUFS
Air dan Zat Terlarut."LBODVLVQCFSBMBTBOVOUVLNFOEVHB
TFMBNB CFSLFNJI ,FBEBBO JOJ EJTFCVU SFGMVLT WFTJLPVSFUFS EBO CBIXB QFOVSVOBO KVNMBI OFGSPO GVOHTJPOBM ZBOH BLBO
EJTFCBCLBOPMFILFHBHBMBOEJOEJOHLBOEVOHLFNJIVOUVLNFOVUVQ NFOVSVOLBO-'( KVHBBLBONFOZFCBCLBOQFOVSVOBOCFTBS
VSFUFSTFMBNBCFSLFNJIBLJCBUOZBTFKVNMBIVSJOFUFSEPSPOHLFBUBT QBEB FLTLSFTJ BJS EBO [BU UFSMBSVU PMFI HJOKBM /BNVO QBTJFO
LFBSBIHJOKBM EFOHBONFNCBXBTFSUBCBLUFSJZBOHEBQBUNFODBQBJ ZBOH UFMBI LFIJMBOHBO TFCBOZBL TBNQBJ QFSTFO
QFMWJT SFOBMJT EBO NFEVMB SFOBMJT EJ NBOB CBLUFSJ EBQBU NFNJDV OFGSPOOZB NBNQV NFOHFLTLSFTJ BJS EBO FMFLUSPMJU EBMBN
JOGFLTJEBOQFSBEBOHBOZBOHCFSLBJUBOEFOHBOQJFMPOFGSJUJT KVNMBIOPSNBMUBOQBUFSKBEJBLVNVMBTJZBOHTFSJVTEBSJDBJSBO
1JFMPOFGSJUJT CFSNVMB EJ NFEVMB SFOBMJT EBO LBSFOB JUV CJBTBOZB EBO FMFLUSPMJU JOJ EJ EBMBN DBJSBO UVCVI /BNVO QFOVSVOBO
MFCJI NFNFOHBSVIJ GVOHTJ NFEVMB EBSJQBEB NFNFOHBSVIJ LPSUFLT KVNMBIOFGSPOMFCJIMBOKVUNFOJNCVMLBOSFUFOTJFMFLUSPMJUEBO
QBMJOHUJEBLQBEBTUBEJVNBXBM0MFILBSFOBTBMBITBUVGVOHTJVUBNB DBJSBO EBOLFNBUJBOCJBTBOZBUFSKBEJCJMBKVNMBIOFGSPOUVSVO
NFEVMB BEBMBI NFOZFEJBLBO NFLBOJTNF DPVOUFSDVSSFOU VOUVL EJCBXBITBNQBJQFSTFOOPSNBM
NFNFLBULBOVSJOF QBTJFOEFOHBOQJFMPOFGSJUJTTFSJOHLBMJNFOHBMBNJ
HBOHHVBOZBOHCFSBUQBEBLFNBNQVBOOZBVOUVLNFNFLBULBOVSJOF #FSCFEBEFOHBOFMFLUSPMJU CBOZBLTJTBNFUBCPMJTNF TFQFSUJ
VSFVN EBO LSFBUJOJO NFOVNQVL IBNQJS TFCBOEJOH EFOHBO
1BEB QJFMPOFGSJUJT ZBOH CFSLFQBOKBOHBO JOWBTJ CBLUFSJ LF HJOKBM
KVNMBI OFGSPO ZBOH SVTBL "MBTBO UFSKBEJOZB IBM JOJ JBMBI [BU
UJEBL IBOZB NFOJNCVMLBO LFSVTBLBO JOUFSTUJTJVN NFEVMB SFOBMJT
[BUTFQFSUJLSFBUJOJOEBOVSFVNTBOHBUCFSHBOUVOHQBEBGJMUSBTJ
UFUBQJ KVHB NFOJNCVMLBO LFSVTBLBO QSPHSFTJG UVCVMVT SFOBMJT
HMPNFSVMJ EBO TUSVLUVS MBJO EJ TFMVSVI HJOKBM "LJCBUOZB TFCBHJBO HMPNFSVMVT VOUVL FLTLSFTJOZB EBO [BU[BU UFSTFCVU UJEBL
CFTBS KBSJOHBO GVOHTJPOBM HJOKBM IJMBOH EBO HBHBM HJOKBM LSPOJT EBQBU EJSFBCTPSCTJ TFCBOZBL FMFLUSPMJU $POUPIOZB LSFBUJOJO UJEBL
UJNCVM EJSFBCTPSCTJ TBNB TFLBMJ EBO MBKV FLTLSFTJOZB LJSBLJSB
TFCBOEJOHEFOHBOMBKVGJMUSBTJ
Sindrom Nefrotik-Ekskresi Protein dalam Urine Akibat
Peningkatan Permeabilitas Glomerulus Laju filtrasi kreatinin = LFG x Konsentrasi kreatinin
#BOZBLQBTJFOEFOHBOQFOZBLJUHJOKBMNFOHBMBNJTJOESPNOFGSPUJL plasma = Laju ekskresi kreatinin
404
0MFITFCBCJUV KJLB-'(NFOVSVO MBKVFLTLSFTJLSFBUJOJOKVHB

NFOVSVO TFNFOUBSB ZBOH NFOZFCBCLBO BLVNVMBTJ LSFBUJOJO
EBMBN DBJSBO UVCVI EBO NFOJOHLBULBO LPOTFOUSBTJOZB EBMBN
QMBTNB TBNQBJ MBKV FLTLSFTJ LSFBUJOJO LFNCBMJ OPSNBM MBKV ZBOH
TBNB EFOHBO MBKV QSPEVLTJ LSFBUJOJO EJ EBMBN UVCVI (BNCBS
UNIT V

+BEJ QBEB LFBEBBO ZBOH NBOUBQ EBO TUBCJM MBKV FLTLSFTJ
LSFBUJOJO TFCBOEJOH EFOHBO MBKV QSPEVLTJ LSFBUJOJO XBMBVQVO
BEB QFOVSVOBO -'( BLBO UFUBQJ MBKV FLTLSFTJ LSFBUJOJO ZBOH
OPSNBM UFSKBEJ QBEB QFOJOHLBUBO LPOTFOUSBTJ LSFBUJOJO QMBTNB
TFQFSUJZBOHEJQFSMJIBULBOPMFILVSWB"QBEB(BNCBS
PO4
#FCFSBQB [BU UFSMBSVU TFQFSUJ GPTGBU VSBU EBO JPO IJESPHFO H+
TFSJOH EJQFSUBIBOLBO NFOEFLBUJ LJTBSBO OPSNBM TBNQBJ -'(
UVSVO EJ CBXBI TBNQBJ QFSTFO OJMBJ OPSNBM 4FUFMBI JUV C Na+, Cl–
LPOTFOUSBTJ[BU[BUJOJEBMBNQMBTNBBLBONFOJOHLBUUFUBQJUJEBL
TFCBOEJOH EFOHBO QFOVSVOBO -'( TFQFSUJ ZBOH UFSMJIBU QBEB
0 25 50 75 100
LVSWB # EJ (BNCBS 1FNFMJIBSBBO LPOTFOUSBTJ [BU UFSMBSVU
JOJ EBMBN QMBTNB BHBS SFMBUJG LPOTUBO TFXBLUV -'( NFOVSVO
EJDBQBJ EFOHBO NFOHFLTLSFTJ [BU UFSMBSVU ZBOH TFDBSB QSPHSFTJG
TFNBLJO CFTBS KVNMBI ZBOH EJGJMUSBTJ LBQJMFS HMPNFSVMVT JOJ
UFSKBEJ EFOHBO NFOVSVOLBO MBKV SFBCTPSQTJ UVCVMVT BUBV QBEB
CFCFSBQBLFBEBBO EFOHBONFOJOHLBULBOMBKVTFLSFTJUVCVMVT
1BEB IBMOZB JPO OBUSJVN EBO LMPSJEB LPOTFOUSBTJ QMBTNB

OZB EJQFSUBIBOLBO IBNQJS LPOTUBO CBILBO QBEB QFOVSVOBO
100 -'( ZBOH IFCBU MJIBU LVSWB $ QBEB (BNCBS
)BM JOJ
EJDBQBJ EFOHBO NFOVSVOLBO SFBCTPSQTJ FMFLUSPMJU UFSTFCVU EJ
UVCVMVTEBMBNKVNMBICFTBS
50 $POUPIOZB EFOHBOIJMBOHOZBQFSTFOOFGSPOGVOHTJPOBM
NBTJOHNBTJOH OFGSPO ZBOH NBTJI CFSUBIBO IBSVT NFOH
FLTLSFTJFNQBULBMJMFCJICBOZBLOBUSJVNEBOFNQBULBMJMFCJI
0 CBOZBLWPMVNFEJCBOEJOHLBOLFBEBBOOPSNBM 5BCFM

4FCBHJBO BEBQUBTJ JOJ UFSKBEJ BLJCBU QFOJOHLBUBO BMJSBO EBSBI
EBO QFOJOHLBUBO -'( EJ NBTJOHNBTJOH OFGSPO ZBOH NBTJI
2
CFSUBIBO LBSFOB IJQFSUSPGJ QFNCVMVI EBSBI EBO HMPNFSVMJ EBO
KVHBQFSVCBIBOGVOHTJPOBMZBOHNFOZFCBCLBOEJMBUBTJQFNCVMVI
EBSBI #BILBO EFOHBO QFOVSVOBO -'( UPUBM ZBOH DVLVQ CFTBS
1
LFDFQBUBO FLTLSFTJ HJOKBM OPSNBM NBTJI EBQBU EJQFSUBIBOLBO
EFOHBONFOVSVOLBOLFDFQBUBOSFBCTPSQTJBJSEBO[BUUFSMBSVUEJ
UVCVMVT
0
Tabel 31-6 Ekskresi Ginjal Total dan Ekskresi per Nefron pada Gagal
Ginjal
2
Normat Kehitangan
nefron 75%
1 Jumlah nefron 2,000,000 500,000
Total LFG (ml/menit) 125 40
LFG satu nefron (nl/menit) 62.5 80
0
0 1 2 3 4 Volume yang dieksresikan 1.5 1.5
semua nefron (ml/menit)
Volume yang diekskresi per 0.75 3.0
nefron (nl/menit)
LFG, Laju filtrasi glomerulus.
405
Isostenuria-Ketidakmampuan Ginjal Memekatkan atau

Mengencerkan Urine. 4BMBI TBUV FGFL QFOUJOH EBSJ
QFOBNCBIBOLFDFQBUBOBMJSBOUVCVMVTZBOHUFSKBEJQBEBOFGSPO
ter
ZBOH UFSTJTB HJOKBM ZBOH TBLJU BEBMBI UVCVMVT HJOKBM LFIJMBOHBO Wa +
+ N a
LFNBNQVBOOZB VOUVL NBLTJNBM NFNFLBULBO BUBV K
H+
NFOHFODFSLBO VSJOF ,FNBNQVBO HJOKBM VOUVL NFNFLBULBO Phenols
VSJOFUFSHBOHHVUFSVUBNBLBSFOB
BMJSBODBJSBOUVCVMVTZBOH SO4=
HPO4=
DFQBU NFMBMVJ EVLUVT LPMJHFOT BLBO NFODFHBI SFBCTPSQTJ BJS HCO -
ZBOHDVLVQEBO
BMJSBOZBOHDFQBUCBJLNFMBMVJBOTB)FOMF 3
NBVQVOEVLUVTLPMJHFOTNFODFHBINFLBOJTNFDPVOUFSDVSSFOU
VOUVL NFNFLBULBO [BU UFSMBSVU DBJSBO JOUFSTUJTJBM NFEVMB
TFDBSBFGFLUJG
0MFI LBSFOBOZB TFNBLJO QSPHSFTJG LFSVTBLBO OFGSPO 0 3 6 9 12
LFNBNQVBO QFNFLBUBO NBLTJNVN HJOKBM QVO NFOVSVO EBO
PTNPMBSJUBTVSJOFTFSUBCFSBUKFOJTTQFTJGJL VLVSBOLPOTFOUSBTJ
[BU UFSMBSVU UPUBM
NFOEFLBUJ PTNPMBSJUBT EBO CFSBU KFOJT GJMUSBU
HMPNFSVMVT TFQFSUJZBOHUBNQBLQBEB (BNCBS
.FLBOJTNF QFOHFODFSBO HJOKBM KVHB UFSHBOHHV CJMB KVNMBI NFMJQVUJ GFOPM TVMGBU GPTGBU LBMJVN EBO CBTB HVBOJEJO 4FMVSVI
OFGSPOCFSLVSBOHLBSFOBBMJSBODBJSBOZBOHDFQBUNFMBMVJBOTB LPOEJTJ JOJ EJTFCVU VSFNJB LBSFOB UJOHHJOZB LPOTFOUSBTJ VSFVN
EBMBNDBJSBOUVCVI
)FOMF EBO CFCBO [BU UFSMBSVU ZBOH UJOHHJ TFQFSUJ VSFVN
NFOZFCBCLBOLPOTFOUSBTJ[BUUFSMBSVUZBOHSFMBUJGUJOHHJEBMBN
DBJSBO UVCVMVT EJ CBHJBO OFGSPO JOJ "LJCBUOZB LFNBNQVBO Retensi Air dan Timbutnya Edema pada Gagal
QFOHFODFSBO HJOKBM UFSHBOHHV EBO PTNPMBMJUBT VSJOF ZBOH Ginjal.+JLB BTVQBO BJS TFHFSB EJCBUBTJ TFUFMBI UJNCVM HBHBM HJOKBM
NJOJNBMTFSUBCFSBUKFOJTNFOEFLBUJPTNPMBMJUBTEBOCFSBUKFOJT BLVU LBEBS DBJSBO UVCVI UPUBM NVOHLJO IBOZB TFEJLJU NFOJOHLBU
GJMUSBU HMPNFSVMVT 0MFI LBSFOB NFLBOJTNF QFNFLBUBO MFCJI +JLB BTVQBO DBJSBO UJEBL EJCBUBTJ EBO QBTJFO UFUBQ NJOVN TFCBHBJ
SFTQPOTOZB BUBT NFLBOJTNF SBTB IBVT ZBOH OPSNBM DBJSBO UVCVI
CFSBU UFSHBOHHV EJCBOEJOHLBO NFLBOJTNF QFOHFODFSBO QBEB
BLBOTFHFSBEBODFQBUNFOJOHLBU
HBHBM HJOKBM LSPOJT VKJ LMJOJT GVOHTJ HJOKBM ZBOH QFOUJOH JBMBI
NFOFOUVLBOTFCFSBQBCBJLHJOKBMEBQBUNFNFLBULBOVSJOFCJMB 1BEB HBHBM HJOKBM QBSTJBM ZBOH LSPOJT QFOVNQVLBO DBJSBO
BTVQBOBJSTFTFPSBOHEJCBUBTJTFMBNBKBNBUBVMFCJI NVOHLJO UJEBL UFSMBMV CFSBU TFMBNB BTVQBO HBSBN EBO DBJSBO UJEBL
CFSMFCJIBO TBNQBJ GVOHTJ HJOKBM UVSVO NFODBQBJ QFSTFO EBSJ
OPSNBM BUBV MFCJI SFOEBI MBHJ "MBTBO VOUVL IBM JOJ TFQFSUJ UFMBI
Pengaruh Gagal Ginjal terhadap Cairan Tubuh-Uremia EJKFMBTLBO TFCFMVNOZB JBMBI OFGSPO ZBOH UFSTJTB NFOHFLTLSFTJLBO
1FOHBSVI HBHBM HJOKBM UFSIBEBQ DBJSBO UVCVI CFSHBOUVOH QBEB
HBSBNEBOBJSEBMBNKVNMBIMFCJICFTBS#BILBOSFUFOTJDBJSBOZBOH
BTVQBOBJSEBONBLBOBO TFSUB
EFSBKBUHBOHHVBOGVOHTJHJOKBM#JMB IBOZBTFEJLJUUFSKBEJ CFSTBNBEFOHBOQFOJOHLBUBOTFLSFTJSFOJOEBO
TFTFPSBOH EFOHBO HBHBM HJOKBM UPUBM UFSVT NJOVN BJS EBO NBLBO BOHJPUFOTJO ** ZBOH CJBTBOZB UFSKBEJ QBEB QFOZBLJU HJOKBM JTLFNJL
EFOHBO KVNMBI ZBOH TBNB LPOTFOUSBTJ CFSCBHBJ [BU EBMBN DBJSBO TFSJOHNFOZFCBCLBOIJQFSUFOTJCFSBUQBEBHBHBMHJOKBMLSPOJT)BNQJS
TFNVB QBTJFO EFOHBO GVOHTJ HJOKBM ZBOH CFHJUV NFOVSVO TFIJOHHB
FLTUSBTFMVMBS EJQFSMJIBULBO QBEB (BNCBS 1FOHBSVI QFOUJOH
NFNFSMVLBO EJBMJTJT VOUVL NFNQFSUBIBOLBO IJEVQOZB BLBO
UFSTFCVU NFMJQVUJ
FEFNB VNVN BLJCBU SFUFOTJ BJS EBO HBSBN

NFOHBMBNJ IJQFSUFOTJ 1BEB LFCBOZBLBO QBTJFO JOJ QFOVSVOBO
BTJEPTJTBLJCBULFHBHBMBOHJOKBMNFNCFSTJILBOUVCVIEBSJIBTJMBTBN
BTVQBO HBSBN EBMBN KVNMBI CFTBS BUBV QFOHFMVBSBO DBJSBO FLTUSBT
OPSNBM
LPOTFOUSBTJ OJUSPHFO OPOQSPUFJO ZBOH UJOHHJUFSVUBNB
FMVMBSNFMBMVJEJBMJTJTEBQBUNFOHFOEBMJLBOIJQFSUFOTJ4JTBOZB UFUBQ
VSFVN LSFBUJOJO EBO BTBN VSBUBLJCBU LFHBHBMBO UVCVI NFOHFL
NFOHBMBNJ IJQFSUFOTJ NFTLJQVO TFKVNMBI CFTBS OBUSJVN UFMBI
TLSFTJTJTBNFUBCPMJTNFQSPUFJOEBO
LPOTFOUSBTJ[BU[BUMBJOEBMBN
EJLFMVBSLBONFMBMVJEJBMJTJT1BEBLFMPNQPLJOJ QFOHBOHLBUBOHJOKBM
KVNMBIUJOHHJZBOHEJFLTLSFTJPMFIHJOKBM NFMJQVUJGFOPM
ZBOH JTLFNJL CJBTBOZB BLBO NFNQFSCBJLJ IJQFSUFOTJ TFMBNB SFUFOTJ
DBJSBO EJDFHBI EFOHBO EJBMJTJT
LBSFOB UJOEBLBO JOJ NFOHBOHLBU
1.050
TVNCFSTFLSFTJSFOJOZBOHCFSMFCJIBOEBOQFOJOHLBUBOBOHJPUFOTJO**
ZBOHUFSCFOUVL
Specific gravity of urine
1.040
1.030 Uremia-Peningkatan Ureum dan Nitrogen Nonprotein

Lainnya (Azotemia). /JUSPHFOOPOQSPUFJONFMJQVUJVSFVN BTBN
1.020 VSBU LSFBUJOJO EBO TFKVNMBI TFOZBXB LVSBOH QFOUJOH 1BEB
VNVNOZB JOJBEBMBITJTBNFUBCPMJTNFQSPUFJOEBOIBSVTEJLFMVBSLBO
1.010 EBSJ UVCVI VOUVL NFNBTUJLBO UFUBQ CFSMBOHTVOHOZB NFUBCPMJTNF
QSPUFJO EBMBN TFM ,POTFOUSBTJ [BU[BU JOJ LIVTVTOZB VSFVN EBQBU
NFOJOHLBUTBNQBJLBMJOPSNBMTFMBNBTBNQBJNJOHHVTFUFMBI
1.000
HBHBM HJOKBM UPUBM 1BEB HBHBM HJOKBM LSPOJT QFOJOHLBUBO LPOTFOUSBTJ
2,000,000 1,500,000 1,000,000 500,000 0
LJSBLJSB TFCBOEJOH EFOHBO KVNMBI QFOVSVOBO OFGSPO GVOHTJPOBM
0MFILBSFOBJUV QFOHVLVSBOLPOTFOUSBTJ[BU[BUUFSTFCVU LIVTVTOZB
Gambar 31- 6 Ti mbul nya i sost enur i a pada pasi en dengan VSFVN EBO LSFBUJOJO NFSVQBLBO DBSB ZBOH QFOUJOH VOUVL NFOJMBJ
penurunan jumlah nefron fungsional. UJOHLBUHBHBMHJOKBM
406
Asidosis pada Gagal Ginjal. 4FDBSB OPSNBM TFUJBQ IBSJ UVCVI Lesi Ginjal yang Menurunkan Kemampuan Ginjal
NFOHIBTJMLBO TFLJUBS TBNQBJ NNPM MFCJI CBOZBL BTBN NFUBCPMJL untuk Mengekskresi Natrium dan Air Mempermudah
EBSJQBEB CBTB NFUBCPMJL 0MFI LBSFOB JUV LFUJLB HJOKBM HBHBM CFSGVOHTJ Timbulnya Hipertensi. -FTJMFTJ HJOKBM ZBOH NFOVSVOLBO
BTBNBLBONFOVNQVLEBMBNDBJSBOUVCVI%BQBSDBJSBOUVCVICJBTBOZB
LFNBNQVBO HJOKBM VOUVL NFOHFLTLSFTJ OBUSJVN EBO BJS IBNQJS
EBQBU NFOEBQBU TBNQBJ NNPM BTBN UBOQB NFOJOHLBULBO )
TFMBMV NFOZFCBCLBO IJQFSUFOTJ 0MFI LBSFOBOZB MFTJMFTJ ZBOH
DBJSBOFLTUSBTFMVMBSLFLPOTFOUSBTJNFNBUJLBO EBOTFOZBXBGPTGBUEBMBN
UNIT V
NFOVSVOLBO-'(BUBVNFOJOHLBULBOSFBCTPSQTJUVCVMVTCJBTBOZB
UVMBOH EBQBU NFOEBQBS CFCFSBQB SJCV NJMJNPM /BNVO CJMB EBZB
NFOJNCVMLBO IJQFSUFOTJ EFOHBO CFSCBHBJ UJOHLBU LFQBSBIBO
QFOEBQBSBO JOJ IBCJT UFSQBLBJ Q) EBSBI BLBO NFOVSVO ESBTUJT EBO
#FCFSBQB KFOJT LIVTVT LFMBJOBO HJOKBM ZBOH EBQBU NFOZFCBCLBO
QBTJFO BLBO KBUVI EBMBN LPNB EBO NFOJOHHBM CJMB Q) EBSBI UVSVO
IJQFSUFOTJBEBMBITFCBHBJCFSJLVU
TBNQBJEJCBXBI
1. 1FOJOHLBUBO SFTJTUBOTJ QFNCVMVI EBSBI HJOKBM ZBOH
NFOVSVOLBO BMJSBO EBSBI HJOKBM EBO -'( $POUPIOZB BEBMBI
Anemia pada Gagal Ginjal Kronis Akibat Penurunan
IJQFSUFOTJZBOHEJTFCBCLBOPMFITUFOPTJTBSUFSJHJOKBM
Sekresi Eritropoietin.1BTJFOEFOHBOHBHBMHJOKBMLSPOJTCFSBUIBNQJS
TFMBMV NFOHBMBNJ BOFNJB 1FOZFCBC UFSQFOUJOH EBSJ IBM JOJ BEBMBI 2. 1FOVSVOBO LPFGJTJFO GJMUSBTJ LBQJMFS HMPNFSVMVT ZBOH NFOV
CFSLVSBOHOZB TFLSFTJ FSJUSPQPJFUJO HJOKBM ZBOH NFSBOHTBOH TVNTVN SVOLBO -'( 4BMBI TBUV DPOUPIOZB JBMBI HMPNFSVMPOFGSJUJT
UVMBOH VOUVL NFOHIBTJMLBO TFM EBSBI NFSBI +JLB HJOKBM NFOHBMBNJ LSPOJT ZBOH NFOZFCBCLBO QFSBEBOHBO EBO QFOFCBMBO NFN
LFSVTBLBO CFSBU HJOKBM UJEBL NBNQV NFNCFOUVL FSJUSPQPJFUJO EBMBN CSBO LBQJMFS HMPNFSVMVT TFIJOHHB NFOVSVOLBO LPFGJTJFO
KVNMBI DVLVQ TFIJOHHB NFOHBLJCBULBO QFOVSVOBO QSPEVLTJ TFM EBSBI GJMUSBTJLBQJMFSHMPNFSVMVT
NFSBIEBONFOJNCVMLBOBOFNJB 3. 3FBCTPSQTJOBUSJVNUVCVMVTZBOHCFSMFCJIBO4BMBITBUVDPOUPI
/BNVO BEBOZB FSJUSPQPJFUJO SFLPNCJOBO TFKBL NFOKBEJ DBSB JBMBI IJQFSUFOTJ ZBOH EJTFCBCLBO PMFI TFLSFTJ BMEPTUFSPO ZBOH
QFOHPCBUBOBOFNJBQBEBQBTJFOEFOHBOHBHBMHJOKBMLSPOJT CFSMFCJIBO ZBOHNFOJOHLBULBOSFBCTPSQTJOBUSJVNUFSVUBNBEJ
UVCVMVTLPMJHFOTLPSUJLBMJT
Osteomalasia pada Gagal Ginjal Kronis Akibat Penurunan #FHJUV IJQFSUFOTJ UFSKBEJ FLTLSFTJ OBUSJVN EBO BJS PMFI HJOKBM
Produksi Vitamin D Aktif dan Akibat Retensi Fosfat oteh LFNCBMJ OPSNBM LBSFOB UFLBOBO BSUFSJ ZBOH UJOHHJ NFOZFCBCLBO
OBUSJVSFTJT UFLBOBO EBO EJVSFTJT UFLBOBO TFIJOHHB BTVQBO TFSUB
Ginjal. (BHBM HJOKBM ZBOH CFSLFQBOKBOHBO KVHB NFOZFCBCLBO PTUFP LFMVBSBO OBUSJVN EBO BJS LFNCBMJ TFJNCBOH MBHJ #BILBO CJMB BEB
NBMBTJB LFBEBBO ZBOH NFOZFCBCLBO TFCBHJBO UVMBOH EJBCTPSCTJ QFOJOHLBUBO ZBOH CFTBS QBEB SFTJTUBOTJ WBTLVMBS HJOKBM BUBV
TFIJOHHB UVMBOH NFOKBEJ TBOHBU MFNBI 1FOZFCBC QFOUJOH EBSJ LFBEBBO QFOVSVOBO QBEB LPFGJTJFO LBQJMFS HMPNFSVMVT -'( NBTJI EBQBU
JOJ JBMBI TFCBHBJ CFSJLVU 7JUBNJO % IBSVT EJVCBI NFMBMVJ QSPTFT EVB LFNCBMJ NFOEFLBUJ OJMBJ OPSNBM TFUFMBI UFLBOBO EBSBI BSUFSJ
UBIBQ QFSUBNB EJ IBUJ EBO LFNVEJBO EJ HJOKBM NFOKBEJ
NFOJOHLBU %FNJLJBO QVMB LFUJLB SFBCTPSQTJ UVCVMVT NFOJOHLBU
EJIJESPLTJLPMFLBMTJGFSPM TFCFMVN EBQBU NFOJNCVMLBO BCTPSQTJ LBMTJVN
TFQFSUJ ZBOH UFSKBEJ QBEB TFLSFTJ BMEPTUFSPO ZBOH CFSMFCJIBO
EBSJ VTVT 0MFI LBSFOBOZB LFSVTBLBO CFSBU QBEB HJOKBM BLBO TBOHBU
LFDFQBUBO FLTLSFTJ VSJOF NVMBNVMB CFSLVSBOH UBQJ LFNVEJBO
NFOVSVOLBO LPOTFOUSBTJ WJUBNJO % BLUJG EBMBN EBSBI ZBOH LFNVEJBO
LFNCBMJ OPSNBM CFHJUV UFLBOBO BSUFSJ NFOJOHLBU +BEJ TFUFMBI
NFOHVSBOHJ BCTPSQTJ LBMTJVN VTVT EBO LFUFSTFEJBBO LBMTJVN EBMBN
UJNCVM IJQFSUFOTJ NVOHLJO UJEBL BEB UBOEBUBOEB KFMBT HBOHHVBO
UVMBOH
FLTLSFTJ OBUSJVN EBO BJS TFMBJO IJQFSUFOTJ 4FQFSUJ ZBOH UFMBI
1FOZFCBC EFNJOFSBMJTBTJ UVMBOH ZBOH QFOUJOH MBJOOZB QBEB HBHBM EJKFMBTLBOEJ#BC FLTLSFTJOPSNBMOBUSJVNEBOBJSQBEBUFLBOBO
HJOKBM LSPOJT JBMBI QFOJOHLBUBO LPOTFOUSBTJ GPTGBU TFSVN ZBOH UFSKBEJ BSUFSJZBOHNFOJOHLBUCFSBSUJCBIXBUFSKBEJOZBOBUSJVSFTJTUFLBOBO
BLJCBU CFSLVSBOHOZB -'( .FOJOHLBUOZB GPTGBU TFSVN NFOJOHLBULBO EBOEJVSFTJTUFLBOBOUFMBIEJTFTVBJLBOLFNCBMJQBEBUFLBOBOBSUFSJ
QFOHJLBUBOGPTGBUEFOHBOLBMTJVNEBMBNQMBTNB TFIJOHHBNFOVSVOLBO ZBOHMFCJIUJOHHJ
LPOTFOUSBTJ LBMTJVN UFSJPOJTBTJ EBMBN TFSVN QMBTNB ZBOH LFNVEJBO
NFSBOHTBOH TFLSFTJ IPSNPO QBSBUJSPJE )JQFSQBSBUJSPJEJTNF TFLVOEFS
JOJ LFNVEJBO NFSBOHTBOH QFMFQBTBO LBMTJVN EBSJ UVMBOH ZBOH
Hipertensi Akibat Kerusakan Ginjal Setempat dan
NFOZFCBCLBOEFNJOFSBMJTBTJUVMBOHMFCJIMBOKVU Peningkatan Sekresi Renin Ginjal. +JLB TBMBI TBUV CBHJBO
HJOKBM NFOHBMBNJ JTLFNJB EBO TFMFCJIOZB UJEBL JTLFNJL TFQFSUJ
ZBOH UFSKBEJ CJMB TBMBI TBUV BSUFSJ SFOBMJT CFSLPOTUSJLTJ LVBU
Hipertensi dan Penyakit Ginjal KBSJOHBOHJOKBMZBOHJTLFNJLBLBONFOZFLSFTJSFOJOEBMBNKVNMBI
4FQFSUJ ZBOH UFMBI EJCBIBT TFCFMVNOZB QBEB CBC JOJ IJQFSUFOTJ EBQBU CFTBS 4FLSFTJ JOJ NFOZFCBCLBO QFOJOHLBUBO QFNCFOUVLBO
NFNQFSCFSBU UFSKBEJOZB LFSVTBLBO QBEB HMPNFSVMVT EBO QFNCVMVI BOHJPUFOTJO ** ZBOH EBQBU NFOZFCBCLBO IJQFSUFOTJ 3BOHLBJBO
EBSBI HJOKBM EBO LBSFOB JUV NFOKBEJ QFOZFCBC VUBNB QFOZBLJU HJOKBM LFKBEJBOZBOHQBMJOHNVOHLJONFOZFCBCLBOIJQFSUFOTJJOJ TFQFSUJ
TUBEJVN BLIJS ,FMBJOBO GVOHTJ HJOKBM EBQBU KVHB NFOZFCBCLBO ZBOHEJCBIBTEJ#BC BEBMBI
KBSJOHBOHJOKBMJTLFNJLTFOEJSJ
IJQFSUFOTJ TFQFSUJ ZBOH EJIBIBT TFDBSB EFUBJM EJ #BC +BEJ QBEB NFOHFLTLSFTJBJSEBOHBSBNEBMBNKVNMBILVSBOHEBSJOPSNBM

CFCFSBQBLFBEBBO IVCVOHBOBOUBSBIJQFSUFOTJEBOQFOZBLJUHJOKBMEBQBU SFOJO ZBOH EJTFLSFTJ PMFI HJOKBM ZBOH JTLFNJL EBO QFOJOHLBUBO
NFOJNCVMLBO MJOHLBSBO TFUBO LFSVTBLBO HJOKBM QSJNFS NFOJNCVMLBO QFNCFOUVLBO BOHJPUFOTJO ** BLBO NFNFOHBSVIJ KBSJOHBO HJOKBM
QFOJOHLBUBO UFLBOBO EBSBI ZBOH NFOZFCBCLBO LFSVTBLBO HJOKBM MFCJI OPOJTLFNJL TFIJOHHBNFOJNCVMLBOSFUFOTJHBSBNEBOBJSEBO

MBOKVU MBMV MFCJI NFOJOHLBULBO UFLBOBO EBSBI EBO TFUFSVTOZB TBNQBJ LFMFCJIBO HBSBN EBO BJS NFOZFCBCLBO IJQFSUFOTJ EFOHBO DBSB
UJNCVMQFOZBLJUHJOKBMTUBEJVNBLIJS ZBOHCJBTB
5JEBL TFNVB KFOJT QFOZBLJU HJOKBM NFOJNCVMLBO IJQFSUFOTJ LBSFOB +FOJTIJQFSUFOTJZBOHTFSVQBEBQBUUFSKBEJCJMBTFCBHJBOEBSJTBUV
LFSVTBLBOCBHJBOUFSUFOUVHJOKBMNFOZFCBCLBOVSFNJBUBOQBIJQFSUFOTJ BUBV LFEVB HJOKBM NFOHBMBNJ JTLFNJB TFCBHBJ BLJCBU BSUFSJPT*DMF
/BNVO EFNJLJBO CFCFSBQB KFOJT LFSVTBLBO HJOKBM UFSVUBNB DFOEFSVOH SPTJTBUBVLFSVTBLBOQFNCVMVIEBSBIEJCBHJBOHJOKBMUFSUFOUV#JMB
NFOZFCBCLBO IJQFSUFOTJ ,MBTJGJLBTJ QFOZBLJU HJOKBM CFSEBTBSLBO SFMBUJG IBMJOJUFSKBEJ OFGSPOJTLFNJLNFOHFLTLSFTJHBSBNEBOBJSMFCJI
FGFLNFOKBEJIJQFSUFOTJBUBVOPOIJQFSUFOTJBEBMBITFCBHBJCFSJLVU
407
TFEJLJU UBQJ NFOZFLSFTJ SFOJO EBMBN KVNMBI MFCJI CFTBS ZBOH BEBOZB HMVLPTB EBMBN VSJOF EJBHOPTJT HMVLPTVSJB SFOBMJT ZBOH
NFOZFCBCLBO QFOJOHLBUBO QFNCFOUVLBO BOHJPUFOTJO ** ,BEBS NFSVQBLBOLPOEJTJCFOJHOB IBSVTEJTJOHLJSLBOTFCFMVNNFOFHBLLBO
BOHJPUFOTJO**ZBOHUJOHHJLFNVEJBONFOHHBOHHVLFNBNQVBOOFGSPO EJBHOPTJTEJBCFUFTNFMJUVT
OPSNBMEJTFLJUBSOZBVOUVLNFOHFLTLSFTJOBUSJVNEBOBJS"LJCBUOZB
UJNCVM IJQFSUFOTJ ZBOH NFNVMJILBO LFTFMVSVIBO FLTLSFTJ OBUSJVN Aminoasiduria-Ginjal Gagal Mereabsorbsi Asam Amino.
EBO BJS PMFI HJOKBM TFIJOHHB LFTFJNCBOHBO BOUBSB BTVQBO EBO #FCFSBQB BTBN BNJOP CFSCBHJ TJTUFN USBOTQPS ZBOH TBNB VOUVL
LFMVBSBOHBSBNEBOBJSEJQFSUBIBOLBO UFUBQJQBEBUFLBOBOEBSBIZBOH QSPTFT SFBCTPSQTJOZB TFEBOHLBO BTBN BNJOP MBJOOZB NFNQVOZBJ
KBVIMFCJIUJOHHJ TJTUFN USBOTQPS ZBOH CFSCFEB 4BOHBU KBSBOH LFBEBBO ZBOH EJTFCVU
BNJOPBTJEVSJB VNVN UFSKBEJ BLJCBU LFLVSBOHBO SFBCTPSQTJ TFNVB
Penyakit Ginjal yang Menyebabkan Hilangnya Seluruh BTBN BNJOP MFCJI TFSJOH EFGJTJFOTJ TJTUFN USBOTQPS TQFTJGJL EBQBU
Nefron Menimbulkan Gagal Ginjal tetapi Belum Tentu NFOJNCVMLBO
TJTUJOVSJBFTFOTJBM ZBJUVTFKVNMBICFTBSTJTUFNHBHBM
EJSFBCTPSCTJ EBO TFSJOH LBMJ NFOHBMBNJ LSJTUBMJTBTJ EBMBN VSJOF
Menimbulkan Hipertensi. )JMBOHOZBTFKVNMBICFTBSOFGSPOVUVI TFIJOHHB UFSCFOUVL CBUV HJOKBM
HMJTJOVSJB TFEFSIBOB ZBJUV HMJTJO
TFQFSUJ ZBOH UFSKBEJ QBEB LFIJMBOHBO TBUV HJOKBM EBO TFCBHJBO HJOKBM HBHBMEJSFBCTPSCTJBUBV
CFUBBNJOPJTPCVUJSBUBTJEVSJB ZBOHUFSKBEJ
MBJOOZB IBNQJSTFMBMVNFOJNCVMLBOHBHBMHJOKBMKJLBKVNMBIKBSJOHBO QBEBTFLJUBSQFSTFOQFOEVEVLUBQJUBNQBLOZBUJEBLNFNQVOZBJBSUJ
HJOKBM ZBOH IJMBOH DVLVQ CBOZBL +JLB OFGSPO TJTBOZB CFSTJGBU OPSNBM LMJOJTZBOHCFSNBLOB
EBO BTVQBO HBSBN UJEBL CFSMFCJIBO LPOEJTJ JOJ NVOHLJO UJEBL
NFOJNCVMLBO IJQFSUFOTJ ZBOH CFSNBLOB TFDBSB LMJOJT LBSFOB TFEJLJU
TBKB QFOJOHLBUBO UFLBOBO EBSBI BLBO NFOJOHLBULBO -'( EBO Hipofosfatemia Ginjal-Ginjal Gagal Mereabsorbsi Fosfat.
NFOVSVOLBO SFBCTPSQTJ OBUSJVN EJ UVCVMVT VOUVL NFNVEBILBO 1BEBIJQPGPTGBUFNJBHJOKBM UVCVMVTHJOKBMHBHBMNFSFBCTPSCTJTFKVNMBI
FLTLSFTJ BJS EBO HBSBN QBEB VSJOF EBMBN KVNMBI ZBOH DVLVQ CFTBS JPO GPTGBU LFUJLB LPOTFOUSBTJ GPTGBU DBJSBO UVCVI UVSVO TBOHBU
XBMBVQVO IBOZB TFEJLJU TFLBMJ OFGSPO ZBOH NBTJI VUVI "LBO UFUBQJ SFOEBI,FBEBBOJOJCJBTBOZBUJEBLNFOZFCBCLBOLFMBJOBOTFHFSBZBOH
QBTJFOEFOHBOKFOJTLFMBJOBOJOJEBQBUNFOHBMBNJIJQFSUFOTJCFSBUKJLB TFSJVT LBSFOB LPOTFOUSBTJ GPTGBU DBJSBO FLTUSBTFMVMBS EBQBU TBOHBU
BEB TUSFT MBJO ZBOH NFOZFSUBJ TFQFSUJ NBLBO TFKVNMBI CFTBS HBSBN CFSWBSJBTJUBOQBNFOJNCVMLBOEJTGVOHTJTFMZBOHCFSBSUJ4FUFMBIXBLUV
1BEB LFBEBBO JOJ HJOKBM UJEBL NBNQV NFOHFMVBSLBO HBSBN EBMBN ZBOH MBNB LBEBS GPTGBU ZBOH SFOEBI NFOJNCVMLBO QFOVSVOBO
KVNMBI ZBOH BEFLVBU QBEB UFLBOBO EBSBI OPSNBM EFOHBO TFEJLJU LBMTJGJLBTJ UVMBOH ZBOH NFOJNCVMLBO SBLIJUJT QBEB QBTJFO +FOJT
OFGSPO GVOHTJPOBM ZBOH NBTJI UFSTJTB 1FOJOHLBUBO UFLBOBO EBSBI SBLIJUJT JOJ UJEBL NFNQBO QFOHPCBUBO EFOHBO WJUBNJO % CFSCFEB
NFOHFNCBMJLBO FLTLSFTJ HBSBN EBO BJS VOUVL NFOZBNBJ BTVQBO EFOHBO KFOJT SBLIJUJT CJBTB ZBOH NFNCFSJ SFTQPOT DFQBU TFQFSUJ ZBOH
HBSBNEBOBJSEBMBNLFBEBBONBOUBQ TUFBEZTUBUF
EJCBIBTQBEB#BC
1FOHPCBUBOIJQFSUFOTJZBOHFGFLUJGNFNFSMVLBOLFNBNQVBOHJOKBM
VOUVLNFOJOHLBULBOFLTLSFTJHBSBNEBOBJS NFMBMVJQFOJOHLBUBO-'( Asidosis Tubulus Ginjal-Tubulus Gagal Menyekresi lon
BUBVQFOVSVOBOSFBCTPSQTJUVCVMVT TFIJOHHBJNCBOHBOBOUBSBBTVQBO Hidrogen. 1BEB LFBEBBO JOJ UVCVMVT HJOKBM UJEBL NBNQV
EBO FLTLSFTJ HBSBN EBO BJS PMFI HJOKBM EBQBU EJQFSUBIBOLBO QBEB NFOZFLSFTJ JPO IJESPHFO EBMBN KVNMBI DVLVQ "LJCBUOZB TFKVNMBI
UFLBOBO EBSBI ZBOH MFCJI SFOEBI *OJ EBQBU EJDBQBJ PMFI PCBUPCBUBO CFTBS OBUSJVN CJLBSCPOBU UFSVT UFSCVBOH EBMBN VSJOF )BM JOJ
ZBOH NFOHIBNCBU QFOHBSVI TJOZBM TBSBG EBO IPSNPO ZBOH NFOJNCVMLBOLFBEBBOBTJEPTJTNFUBCPMJL TFQFSUJZBOHEJCBIBTEJ#BC
NFOZFCBCLBO HJOKBM NFSFUFOTJ HBSBN EBO BJS NJTBMOZB EFOHBO +FOJTLFMBJOBOHJOKBMJOJEBQBUEJUJNCVMLBOPMFILFMBJOBOIFSFEJUFS
QFOHIBNCBU BESFOFSHJL BUBV QFOHIBNCBU BOHJPUFOTJODPOWFSUJOH BUBVEBQBUUJNCVMBLJCBULFSVTBLBOUVCVMVTHJOKBMZBOHMVBT
FO[ZNF
BUBV EFOHBO PCBU EJVSFUJL ZBOH MBOHTVOH NFOHIBNCBU
SFBCTPSQTJHBSBNEBOBJSPMFIUVCVMVTHJOKBM
Diabetes Insipidus Nefrogenik-Ginjal Gagal Merespons
Hormon Antidiuretik. ,BEBOHLBEBOH UVCVMVT HJOKBM UJEBL
Gangguan Tubulus Spesifik CFSFTQPOTUFSIBEBQIPSNPOBOUJEJVSFUJL ZBOHNFOZFCBCLBOFLTLSFTJ
TFKVNMBI CFTBS VSJOF ZBOH FODFS 4FMBNB PSBOH UFSTFCVU NFOEBQBU
%J #BC LJUB NFOHFUBIVJ CBIXB CFCFSBQB NFLBOJTNF USBOTQPS DVLVQ BJS LPOEJTJ JOJ KBSBOH NFOJNCVMLBO LFTVMJUBO CFTBS /BNVO
CFSUBOHHVOH KBXBC QBEB QFOHBOHLVUBO [BU[BU UFSUFOUV NFMJOUBTJ CJMB BTVQBO BJS UJEBL NFODVLVQJ QBTJFO BLBO DFQBU NFOHBMBNJ
NFNCSBO FQJUFM UVCVMVT %J #BC LJUB KVHB NFOHFUBIVJ CBIXB EFIJESBTJ
TFUJBQ FO[JN TFM EBO TFUJBQ QSPUFJO QFNCBXB EJCFOUVL TFCBHBJ
SFTQPOT UFSIBEBQ HFO ZBOH UFSLBJU EJ OVLMFVT +JLB HFO ZBOH
EJCVUVILBO UJEBL BEB BUBV BCOPSNBM UVCVMVT NFOHBMBNJ Sindrom Fanconi-Kelainan Reabsorpsi Umum pada
LFLVSBOHBO QSPUFJO QFNCBXB ZBOH TFTVBJ BUBV TBMBI TBUV FO[JN Tubulus Ginjal. 4JOESPN 'BODPOJ CJBTBOZB CFSIVCVOHBO EFOHBO
ZBOH EJCVUVILBO VOUVL USBOTQPS [BU UFSMBSVU PMFI TFM FQJUFM UVCVMVT QFOJOHLBUBOFLTLSFTJIBNQJSTFNVBBTBNBNJOP HMVLPTB EBOGPTGBU
HJOKBM 1BEB LFBEBBO MBJO UFSMBMV CBOZBL FO[JN BUBV QSPUFJO EBMBN VSJOF 1BEB LBTVTLBTVT CFSBU UFSMJIBU KVHB NBOJGFTUBTJ MBJO
QFNCBXB ZBOH EJCFOUVL 0MFI LBSFOB JUV CBOZBL LFMBJOBO UVCVMVT TFQFSUJ
HJOKBM HBHBM NFSFBCTPSCTJ OBUSJVN CJLBSCPOBU ZBOH
IFSFEJUFS ZBOH UFSKBEJ BLJCBU LFMBJOBO USBOTQPS [BU[BU UFSUFOUV BUBV NFOJNCVMLBO BTJEPTJT NFUBCPMJL
QFOJOHLBUBO FLTLSFTJ LBMJVN
TFLFMPNQPL [BU NFMBMVJ NFNCSBO UVCVMVT 4FMBJO JUV LFSVTBLBO EBOLBEBOHLBEBOHLBMTJVNEBO
EJBCFUFTJOTJQJEVTOFGSPHFOJL
NFNCSBO FQJUFM UVCVMVT PMFI UPLTJO BUBV JTLFNJB EBQBU
4JOESPN 'BODPOJ EJTFCBCLBO PMFI CFSCBHBJ QFOZFCBC ZBOH
NFOZFCBCLBOLFMBJOBOUVCVMVTHJOKBMZBOHQFOUJOH
EJUJNCVMLBO PMFI LFUJEBLNBNQVBO VNVN TFM UVCVMVT HJOKBM VOUVL
NFOUSBOTQPS CFSCBHBJ [BU #FCFSBQB QFOZFCBC JOJ NFMJQVUJ

Glukosuria Ginjal-Ginjal Gagal Mereabsorbsi Glukosa. LFMBJOBOIFSFEJUFSQBEBNFLBOJTNFUSBOTQPSTFM
UPLTJOBUBVPCBU
1BEB LFBEBBO JOJ LPOTFOUSBTJ HMVLPTB EBSBI NVOHLJO OPSNBM UFUBQJ PCBUBO ZBOH NFSVTBL TFMTFM FQJUFM UVCVMVT HJOKBM EBO
LFSVTBLBO
NFLBOJTNFUSBOTQPSVOUVLSFBCTPSQTJHMVLPTBEJUVCVMVTBLBOTBOHBU QBEBTFMUVCVMVTHJOKBMBLJCBUJTLFNJB4FMTFMUVCVMVTQSPLTJNBMQBMJOH
UFSCBUBT BUBV UJEBL BEB "LJCBUOZB NFTLJQVO LBEBS HMVLPTB EBSBI TFSJOHUFSLFOBQBEBTJOESPN'BODPOJZBOHEJTFCBCLBOPMFILFSVTBLBO
OPSNBM TFKVNMBI CFTBS HMVLPTB EJLFMVBSLBO NFMBMVJ VSJOF TFUJBQ UVCVMVT LBSFOB TFMTFM JOJ NFSFBCTPSCTJ EBO NFOZFLSFTJ CBOZBL PCBU
IBSJOZB0MFILBSFOBEJBCFUFTNFMJUVTKVHBCFSIVCVOHBOEFOHBO EBOUPLTJOZBOHEBQBUNFOZFCBCLBOLFSVTBLBO
408
Sindroma Bartter-Penurunan Reabsorpsi Natrium, TFNVB QBTJFO VOUVL NFNCBOUV NFODFHBI QFOPMBLBO BLVU EBO
Klorida, dan Kalsium di Ansa Henle. 4JOESPNB #BSUUFS LFIJMBOHBO HJOKBM ZBOH UFMBI EJUSBOTQMBOUBTJ &GFL TBNQJOH PCBU
PCBU ZBOH NFOFLBO TJTUFN JNVO NFMJQVUJ QFOJOHLBUBO SJTJLP
NFSVQBLBO LFMBJOBO BVUPTPNBM SFTFTJG ZBOH EJTFCBCLBO PMFI HBOHHVBO
JOGFLTJ EBO CFCFSBQB LBOLFS NFTLJQVO KVNMBI PCBUPCBUBO
GVOHTJLPUSBOTQPSUFSOBUSJVN LMPSJEB LBMJVN BUBVPMFILFMBJOBO
JNVOPTVQSFTJG CJBTBOZB EBQBU EJLVSBOHJ TFUFMBI CFCFSBQB MBNB
LBOBM LBMJVN EJ NFNCSBO MVNJOBM BUBV LBOBM LMPSJEB EJ NFNCSBO
TFIJOHHBTBOHBUNFOHVSBOHJSJTJLPJOJ
UNIT V
CBTPMBUFSBM CBHJBO UFCBM QBST BTFOEFO "OTB )FOMF ,FMBJOBO JOJ
NFOZFCBCLBO QFOJOHLBUBO FLTLSFTJ BJS OBUSJVN LMPSJEB LBMJVN EBO -FCJI EBSJ PSBOH EJ "NFSJLB 4FSJLBU EFOHBO HBHBM
LBMTJVNPMFIHJOKBM,FIJMBOHBOHBSBNEBOBJSLFNVEJBONFOZFCBCLBO HJOKBM JSFWFSTJCFM BUBV QFOHBOHLBUBO UPUBM HJOKBM EJQFSUBIBOLBO
LFLVSBOHBO WPMVNF SJOHBO TFIJOHHB UFSKBEJ BLUJWBTJ TJTUFN SFOJO EFOHBO EJBMJTJT LSPOJT NFOHHVOBLBO HJOKBM CVBUBO %JBMJTJT KVHB
BOHJPUFOTJOBMEPTUFSPO 1FOJOHLBUBO BMEPTUFSPO EBO BMJSBO UVCVMVT EJHVOBLBOQBEBCFCFSBQBKFOJTHBHBMHJOKBMBLVU VOUVLNFNCBOUV
EJTUBM ZBOH UJOHHJ BLJCBU HBOHHVBO SFBCTPSQTJ EJ BOTB )FOMF QBTJFONFMFXBUJNBTBLSJTJTTBNQBJGVOHTJHJOKBMLFNCBMJOPSNBM
NFSBOHTBOH TFLSFTJ LBMJVN EBO IJESPHFO PMFI UVCVMVT LPMJHFOT +JLB IJMBOHOZB GVOHTJ HJOKBM CFSTJGBU JSFWFSTJCFM QFSMV EJMBLVLBO
TFIJOHHBUFSKBEJIJQPLBMFNJBEBOBMLBMPTJTNFUBCPMJL EJBMJTJT UFSVTNFOFSVT VOUVL NFNQFSUBIBOLBO IJEVQ 0MFI
LBSFOB EJBMJTJT UJEBL EBQBU NFNQFSUBIBOLBO TFQFOVIOZB
LPNQPTJTJ DBJSBO UVCVI OPSNBM EBO UJEBL EBQBU NFOHHBOUJLBO
Sindroma GitelmanPenurunan Reabsorpsi Natrium
TFMVSVI GVOHTJ HJOKBM ZBOH CFSBHBN LFTFIBUBO QBTJFO ZBOH
Klorida di Tubulus Distal.4JOESPNB(JUFMNBONFSVQBLBOLFMBJOBO EJQFSUBIBOLBOEFOHBOHJOKBMCVBUBOCJBTBOZBDVLVQUFSHBOHHV
BVUPTPNBM SFTFTJG LPUSBOTQPSUFS OBUSJVN LMPSJEB QFLBUJB[JE EJ UVCVMVT
EJTUBM1BTJFOEFOHBOTJOESPNB(JUFMNBONFNQVOZBJLBSBLUFSJTUJLZBOH
TBNB EFOHBO QBTJFO TJOESPNB #BSUUFS LFIJMBOHBO HBSBN EBO BJS LFIJ Prinsip-Prinsip Dasar Dialisis.1SJOTJQEBTBSHJOKBMCVBUBO
MBOHBO WPMVNF BJS ZBOH SJOHBO EBO BLUJWBTJ TJTUFN SFOJOBOHJPUFOTJO JBMBI NFOHBMJSLBO EBSBI NFMBMVJ TBMVSBO EBSBI LFDJM ZBOH EJMBQJTJ
BMEPTUFSPO NFTLJQVO LFMBJOBOOZB CJBTBOZB UJEBL TFCFSBU TJOESPNB PMFINFNCSBOUJQJT1BEBTJTJMBJOEBSJNFNCSBOUJQJTJOJUFSEBQBU
(JUFMNBO DBJSBOEJBMJTJTEJNBOB[BU[BUZBOHUJEBLEJJOHJOLBOEBMBNEBSBI
NBTVLLFEBMBNOZBNFMBMVJEJGVTJ
0MFI LBSFOB LFMBJOBO UVCVMVT QBEB TJOESPNB #BSUUFS BUBV (JUFMNBO
UJEBLEBQBUEJQFSCBJLJ QFOHPCBUBOCJBTBOZBEJUVKVLBOQBEBQFOHHBOUJBO (BNCBS NFNQFSMJIBULBO LPNQPOFOLPNQPOFO TVBUV
LFIJMBOHBOOBUSJVNLMPSJEBEBOLBMJVN#FCFSBQBQFOFMJUJBONFOVOKVL KFOJTHJOKBMCVBUBOEFOHBOEBSBINFOHBMJSUFSVTNFOFSVTEJBOUBSB
LBOIBNCBUBOTJOUFTJTQSPTUBHMBOEJOEFOHBOPCBUBOUJJOGMBNBTJOPOTUF EVB NFNCSBO TFMPGBO UJQJT EJ MVBS NFNCSBO UFSEBQBU DBJSBO
SPJE EBO QFNCFSJBO BOUBHPOJT BMEPTUFSPO TFQFSUJ TQJSPOPMBLUPO EBQBU EJBMJTJT 4FMPGBO DVLVQ CFSQPSJ VOUVL NFNVOHLJOLBO LPNQPOFO
CFSHVOBEBMBNNFNQFSCBJLJIJQPLBMFNJB QMBTNB LFDVBMJQSPUFJOQMBTNB CFSEJGVTJEFOHBOEVBBSBIEBSJ
Sindroma Liddle--Peningkatan Reabsorpsi Natrium.

4JOESPNB -JEEMF BEBMBI LFMBJOBO BVUPTPNBM EPNJOBO ZBOH KBSBOH EBO
EJTFCBCLBO PMFI CFSCBHBJ NVUBTJ LBOBM OBUSJVN FQJUFM QFLBBNJMPSJEB
&/B$
UVCVMVT EJTUBM EBO LPMJHFOT .VUBTJ JOJ NFOZFCBCLBO BLUJWJUBT
&/B$ CFSMFCJIBO NFOHBLJCBULBO QFOJOHLBUBO SFBCTPSQTJ OBUSJVN EBO
BJS IJQFSUFOTJ EBO BMLBMPTJT NFUBCPMJL ZBOH NFOZFSVQBJ QFSVCBIBO
ZBOHUFSKBEJQBEBTFLSFTJBMEPTUFSPOCFSMFCJIBO BMEPTUFSPOJTNFQSJNFS

/BNVO QBTJFO EFOHBO TJOESPNB -JEEMF NFNQVOZBJ LBEBS
BMEPTUFSPOZBOHNFOVSVOBLJCBUSFUFOTJOBUSJVNEBOQFOVSVOBOTFLSFTJ
SFOJO EBO LBEBS BOHJPUFOTJO ** LPNQFOTBUPSJL 6OUVOHOZB TJOESPNB
-JEEMF EBQBU EJPCBUJ EFOHBO EJVSFUJL BNJMPSJE ZBOH NFOHIBNCBU
LFHJBUBO&/B$ZBOHCFSMFCJIBO
Pengobatan Gagal Ginjal dengan Transplantasi atau

dengan Dialisis Menggunakan Ginjal Buatan
)JMBOHOZB GVOHTJ HJOKBM ZBOH CFSBU CBJL TFDBSB BLVU NBVQVO LSPOJT
NFNCBIBZBLBO OZBXB QBTJFO EBO NFNCVUVILBO QFNCFSTJIBO QSPEVL
CVBOHBO ZBOH UPLTJL TFSUBQFOHFNCBMJBO WPMVNF EBO LPNQPTJTJ DBJSBO
UVCVI LF LDBEBBO OPSNBM )BM JOJ EBQBU EJDBQBJ NFMBMVJ USBOTQMBOUBTJ
HJOKBMBUBVEFOHBOEJBMJTJTZBOHNFOHHVOBLBOHJOKBMCVBUBO-FCJIEBSJ
QBTJFO EJ "NFSJLB 4FSJLBU TBBU JOJ NFOKBMBOLBO QFOHPCBUBO
VOUVLTBMBITBUVCFOUVLQFOZBLJUHJOKBMTUBEJVNBLIJS
5SBOTQMBOUBTJZBOHCFSIBTJMEBSJEPOPSHJOKBMUVOHHBMLFQBEBQBTJFO
QFOZBLJU HJOKBM TUBEJVN BLIJS EBQBU NFOHFNCBMJLBO GVOHTJ HJOKBM LF
UJOHLBUZBOHDVLVQVOUVLNFNQFSUBIBOIPNFPTUBTJTDBJSBOUVCVIEBO
FMFLUSPMJU FTFOTJBM ZBOH OPSNBM ,JSBLJSB USBOTQMBOUBTJ HJOKBM
EJMBLVLBO UJBQ UBIVO EJ "NFSJLB 4FSJLBU 1BTJFO ZBOH NFOFSJNB
USBOTQMBO HJOKBM CJBTBOZB IJEVQ MFCJI MBNB EBO NFNQVOZBJ NBTBMBI
LFTFIBUBO ZBOH MFCJI TFEJLJU EJCBOEJOHLBO NFSFLB ZBOH EJQFSUBIBOLBO
EFOHBOEJBMJTJT1FOHHVOBBOUFSBQJJNVOPTVQSFTJGEJQFSMVLBOIBNQJS Gambar 31- 8 Pr i nsi p di al i si s dengan gi nj al buat an.
409
QMBTNB LF EBMBN DBJSBO EJBMJTJT BUBV EBSJ DBJSBO EJBMJTJT LFNCBMJ LF Tabel 31-7 Perbandingan Cairan Dialisis dengan
EBMBNQMBTNB+JLBLPOTFOUSBTJ[BUMFCJICFTBSEBMBNQMBTNBEBSJQBEB Plasma Normal dan Plasma Uremik
EBMBN DBJSBO EJBMJTJT BLBO BEB TVBUV USBOTGFS OFUP OFU USBOTGFS
[BU
EBSJQMBTNBLFEBMBNDBJSBOEJBMJTJT Komponen Plasma Cairan Plasma
,FDFQBUBO QFSHFSBLBO [BU UFSMBSVU NFMBMVJ NFNCSBO EJBMJTJT Normal. terdialisis ureum
CFSHBOUVOH QBEB
HSBEJFO LPOTFOUSBTJ [BU UFSMBSVU BOUBSB EVB
DBJSBO
QFSNFBCJMJUBT NFNCSBO VOUVL [BU UFSMBSVU
MVBT Elektrolit (mEq/L)
QFSNVLBBONFNCSBO TFSUB
MBNBOZBEBSBIEBODBJSBOCFSLPOUBL Na' 142 133 142
EFOHBONFNCSBO
K+ 5 1.0 7
+BEJ LFDFQBUBONBLTJNVNUSBOTGFS[BUUFSMBSVUNVMBNVMBUFSKBEJ
Ca" 3 3.0 2
CJMB HSBEJFO LPOTFOUSBTJ NBLTJNVN LFUJLB EJBMJTJT EJNVMBJ
EBO
NFMBNCBU CFHJUV HSBEJFO LPOTFOUSBTJ IJMBOH %BMBN TJTUFN Mg++ 1.5 1.5 1.5
QFOHBMJSBO TFQFSUJQBEBIFNPEJBMJTJT ZBOHNFOZFCBCLBOEBSBIEBO Cl− 107 105 107
DBJSBO EJBMJTJT NFOHBMJS NFMBMVJ HJOKBM CVBUBO LFIJMBOHBO HSBEJFO
LPOTFOUSBTJ EBQBU EJQFSLFDJM EBO EJGVTJ [BU UFSMBSVU NFMJOUBTJ HCO−3 24 35.7 14
NFNCSBOEBQBUEJPQUJNBMLBOEFOHBONFOJOHLBULBOLFDFQBUBOBMJSBO Lactate −
1.2 1.2 1.2
EBSBI DBJSBOEJBMJTJT BUBVLFEVBOZB HPO =
3 0 9
4
1BEBHJOKBMCVBUBOZBOHCFSGVOHTJOPSNBM EBSBINFOHBMJSTFDBSB Urate− 0.3 0 2
UFSVTNFOFSVTBUBVTFDBSBJOUFSNJUFOLFNCBMJLFEBMBNWFOB+VNMBI
UPUBM EBSBI EBMBN HJOKBM CVBUBO QBEB TBUV TBBU CJBTBOZB LVSBOH EBSJ Sulfate =
0.5 0 3
NM LFDFQBUBOBMJSBONVOHLJOCFCFSBQBSBUVTNJMJMJUFSQFSNFOJU Nonelectrolytes
EBO MVBT QFSNVLBBO UPUBM EJGVTJ BOUBSB EBO N 6OUVL
Glucose 100 125 100
NFODFHBI QFNCFLVBO EBSBI EBMBN HJOKBM CVBUBO TFKVNMBI LFDJM
IFQBSJO EJNBTVLLBO LF EBMBN EBSBI TBBU EBSBI NFNBTVLJ HJOKBM Urea 26 0 200
CVBUBO 4FMBJO EJGVTJ [BU UFSMBSVU USBOTGFS [BU UFSMBSVU EBO BJS EBMBN Creatinine 1 0 6
KVNMBI CFTBS EBQBU EJIBTJMLBO EFOHBO NFNCFSJ UFLBOBO IJESPTUBUJL
VOUVLNFOEPSPOHDBJSBOEBO[BUUFSMBSVUNFMJOUBTJNFNCSBOEJBMJTJT
GJMUSBTJTFNBDBNJOJEJTFCVUCVMLGMPX
Daftar Pustaka
Cairan Dialisis. 5BCFM NFNCBOEJOHLBO LBOEVOHBO QBEB "OESFPMJ5& FE$FDJMhT&TTFOUJBMTPG.FEJDJOF FE 1IJMBEFMQIJB 8#
4BVOEFST
DBJSBO EJBMJTJT ZBOH LIBT EFOHBO LBOEVOHBO EBMBN QMBTNB OPSNBM
$BMIPVO%" +POFT% 5FYUPS4 FUBM3FTJTUBOUIZQFSUFOTJPOEJBHOPTJT FWBMVBUJPO
EBO QMBTNB VSFNJL 1FSIBUJLBO CBIXB LPOTFOUSBTJ JPOJPO EBO [BU
BOEUSFBUNFOUBTDJFOUJGJDTUBUFNFOUGSPNUIF"NFSJDBO)FBSU"TTPDJBUJPO
MBJOEBMBNDBJSBOEJBMJTJTUJEBLTBNBEFOHBOLPOTFOUSBTJQBEBQMBTNB
1SPGFTTJPOBM&EVDBUJPO$PNNJUUFFPGUIF$PVODJMGPS)JHI#MPPE1SFTTVSF
OPSNBM BUBV QBEB QMBTNB VSFNJL 5BNQBLOZB LPOTFOUSBTJ UFSTFCVU 3FTFBSDI )ZQFSUFOTJPO
EJTFTVBJLBO EFOHBO LBEBS ZBOH EJCVUVILBO VOUVL NFOJNCVMLBO
%FWBSBKBO16QEBUFPONFDIBOJTNTPGJTDIFNJDBDVUFLJEOFZJOKVSZ +"N4PD
QFSHFSBLBOBJSEBO[BUUFSMBSVUZBOHTFTVBJNFMBMVJNFNCSBOTFMBNB /FQISPM
EJBMJTJT
(SBOUIBN++$MJOJDBUQSBDUJDF "VUPTPNBMEPNJOBOUQPMZDZTUJDLJEOFZEJTFBTF /
1FSIBUJLBO CBIXB UJEBL UFSEBQBU GPTGBU VSFVN VSBU TVMGBU BUBV &OHM+.FE
LSFBUJOJO EBMBN DBJSBO EJBMJTJT OBNVO [BU[BU UFSTFCVU BEB EBMBN (SJGGJO," ,SBNFS) #JEBOJ","EWFSTFSFOBMDPOTFRVFODFTPGPCFTJUZ "N+
LPOTFOUSBTJ UJOHHJ QBEB EBSBI VSFNJL 0MFI LBSFOBOZB CJMB TFPSBOH 1IZTJPM3FOBM1IZTJPM'
QBTJFOVSFNJBNFOKBMBOJEJBMJTJT [BU[BUJOJBLBOIJMBOHEBMBNKVNMBI )BMM+&5IFLJEOFZ IZQFSUFOTJPO BOEPCFTJUZ )ZQFSUFOTJPO )BMM+&
CFTBSLFEBMBNDBJSBOEJBMJTJT EB4JMWB"" #SBOEPO& FUBM1BUIPQIZTJPMPHZPGPCFTJUZIZQFSUFOTJPO
BOEUBSHFUPSHBOJOKVSZJO-JQ(:1 )BMM+& FEJUPST$PNQSFIFOTJWF
&GFLUJWJUBT HJOKBM CVBUBO EBQBU EJOZBUBLBO TFCBHBJ KVNMBI QMBTNB
)ZQFSUFOTJPO /FX:PSL &MTFWJFS QQ
ZBOH EJCFSTJILBO EBSJ CFSCBHBJ KFOJT [BU QFS NFOJU TFQFSUJ ZBOH
)BMM+& )FOFHBS+3 %XZFS5. FUBMJTPCFTJUZBNBKPSDBVTFPGDISPOJDSFOBME
EJCBIBT EJ #BC NFSVQBLBO DBSB VUBNB VOUVL NFOZBUBLBO JTFBTF "EW3FO3FQMBDF5IFS
FGFLUJWJUBT GVOHTJPOBM HJOKBM JUV TFOEJSJ VOUVL NFNCFSTJILBO UVCVI
.JUDI8&"DVUFSFOBMGBJMVSFJO(PMENBO' #FOOFUU+$ FEJUPST$FDJM
EBSJ [BU[BU ZBOH UJEBL EJJOHJOLBO ,FCBOZBLBO HJOKBM CVBUBO EBQBU 5FYUCPPLPG.FEJDJOF FE 1IJMBEFMQIJB 8#4BVOEFST QQ
NFNCFSTJILBOVSFVNEBSJQMBTNBEFOHBOLFDFQBUBOTBNQBJ
.PMJUPSJT#"5SBOTJUJPOJOHUPUIFSBQZJOJTDIFNJDBDVUFSFOBMGBJUVSF +"N4PD
NMNFOJU ZBOH NFOVOKVLLBO QBMJOH UJEBL VOUVL FLTLSFTJ VSFVN
/FQISPM
HJOKBM CVBUBO EBQBU CFSGVOHTJ EVB LBMJ MFCJI DFQBU EBSJQBEB LFEVB
3PESJHVF[JUVSCF# .VTTFS+.5IFDVSSFOUTUBUFPGQPTUTUSFQUPDPDDBMHMPNFSVMP
HJOKBMOPSNBMCFSTBNBTBNB ZBOHOJMBJCFSTJIBOVSFVNOZBIBOZB OFQISJUJTE"N4PD/FQISPM
NMNFOJU /BNVO HJOKBM CVBUBO IBOZB EBQBU EJHVOBLBO TBNQBJ
3PTTJFS#$ 4DIJME-&QJUIFMJBMTPEJVNDIBOOFM.FOEFMJBOWFSTVTFTTFOUJBM
KBN TFIBSJ UJHB LBMJ TFNJOHHV 0MFI LBSFOBOZB LFTFMVSVIBO OJMBJ
IZQFSUFOTJPO )ZQFSUFOTJPO
CFSTJIBO QMBTNB NBTJI TBOHBU UFSCBUBT CJMB HJOKBM CVBUBO
4BSOBL.+ -FWFZ"4 4DIPPMXFSUI"$ FUBM,JEOFZEJTFBTFBTBSJTLGBDUPSGPS
NFOHHBOUJLBO HJOKBM OPSNBM 4FMBJO JUV QFOUJOH KVHB EJJOHBU CBIXB
EFWFUPQNFOUPGDBSEJPWBTDVMBSEJTFBTF )ZQFSUFOTJPO
HJOKBMCVBUBOUJEBLEBQBUNFOHHBOUJLBOCFCFSBQBGVOHTJHJOKBMMBJOOZB
4JOHSJ/ "IZB4/ -FWJO.-"DVUFSFOBMGBJUVSF +"." 6OJUFE
TFQFSUJ TFLSFTJ FSJUSPQPJFUJO ZBOH EJQFSMVLBO VOUVL NFOHIBTJMLBO TFM
4UBUFT3FOBM%BUB4ZTUFNIUUQXXXVTSETPSH
EBSBINFSBI
8JUDPY$4/FXJOTJHIUTJOUPEJVSFUJDVTFJOQBUJFOUTXJUIDISPOJDSFOBMEJTFBTF
+BN4PD/FQISPM
410
VI
UNIT
4FM4FM%BSBI *NVOJUBT
EBO1FNCFLVBO%BSBI
32. Sel-Sel Darah Merah, Anemia, dan
Polisitemia
33. Pertahanan Tubuh terhadap lnfeksi:
I. Leukosit, Granulosit, Sistem
MonositMakrofag, dan lnflamasi
34. Pertahanan Tubuh terhadap lnfeksi: II.
lmunitas dan lmunitas Bawaan Alergi
35. Golongan Darah; Transfusi;
Transplantasi Jaringan dan Organ
36. Hemostasis dan Pembekuan Darah
BAB 32
UNIT VI
4FM4FM%BSBI.FSBI "OFNJB EBO1PMJTJUFNJB
%BMBN CBC JOJ LJUB BLBO CBHJBOUFOHBIOZB7PMVNFSBUBSBUBTFMEBSBINFSBIBEBMBI

NVMBJNFNCBIBTTFMTFMEBSBI TBNQBJN
EBO TFMTFM QBEB TJTUFN #FOUVL TFM EBSBI NFSBI EBQBU CFSVCBIVCBI LFUJLB TFM
NBLSPGBHEBSJTJTUFNMJNGBUJL CFSKBMBO NFMFXBUJ LBQJMFS 4FTVOHHVIOZB TFM EBSBI NFSBI
1FSUBNBUBNB BLBO LJUB NFSVQBLBO TVBUV LBOUPOH ZBOH EBQBU EJVCBI NFOKBEJ
CBIBTGVOHTJTFMEBSBINFSBI CFSCBHBJ CFOUVL 4FMBOKVUOZB LBSFOB TFM ZBOH OPSNBM
ZBOHNFSVQBLBOTFMEBSBI NFNQVOZBJLFMFCJIBONFNCSBOTFMVOUVLNFOBNQVOHCBOZBL
UFSCBOZBL EBO EJQFSMVLBO VOUVL NFOHIBOUBSLBO PLTJHFO LF [BU EJ EBMBNOZB NBLB QFSVCBIBO CFOUVL UBEJ UJEBL BLBO
KBSJOHBO NFSFHBOHLBONFNCSBOTFDBSBIFCBU EBOTFCBHBJBLJCBUOZB TFM
UJEBLBLBONFOHBMBNJSVQUVS TFQFSUJZBOHUFSKBEJQBEBCBOZBL
Sel-Sel Darah Merah (Eritrosit) TFMMBJOOZB
'VOHTJVUBNBTFMEBSBINFSBI ZBOHKVHBEJLFOBMTFCBHBJFSJUSPTJU
Konsentrasi Sel-Sel Darah Merah dalam Darah. 1BEB
MBLJMBLJ OPSNBM TFIBU KVNMBI SBUBSBUB TFM EBSBI NFSBI QFS
BEBMBI NFOHBOHLVU IFNPHMPCJO ZBOH TFMBOKVUOZB NFOHBOHLVU
NJMJNFUFS LVCJL BEBMBI
QBEB XBOJUB
PLTJHFO EBSJ QBSV LF KBSJOHBO 1BEB CFCFSBQB IFXBO UJOHLBU

0SBOH ZBOH UJOHHBM EJ EBFSBI EBUBSBO
SFOEBI IFNPHMPCJOCFSFEBSTFCBHBJQSPUFJOCFCBTEBMBNQMBTNB
UJOHHJNFNJMJLJKVNMBITFMEBSBINFSBIZBOHMFCJICBOZBL)BM
EBO UJEBL UFSLVOHLVOH EJ EBMBN TFM EBSBI NFSBI +JLB
JOJBLBOEJCBIBTLFNVEJBO
IFNPHMPCJO UFSCFCBT EBMBN QMBTNB NBOVTJB LJSBLJSB QFSTFO
EBSJIFNPHMPCJOUFSTFCVUCPDPSNFMBMVJNFNCSBOLBQJMFSNBTVL Jumlah Hemoglobin dalam Sel. 4FMTFM EBSBI NFSBI
LF EBMBN SVBOH KBSJOHBO BUBV NFMBMVJ NFNCSBO HMPNFSVMVT NBNQV NFOHPOTFOUSBTJLBO IFNPHMPCJO EBMBN DBJSBO TFM
HJOKBM NBTVL LF EBMBN GJMUSBU HMPNFSVMVT TFUJBQ LBMJ EBSBI TBNQBJTFLJUBSHSBNQFSNMTFM,POTFOUSBTJJOJUBLBLBO
NFMFXBUJ LBQJMFS %FOHBO EFNJLJBO IFNPHMPCJO IBSVT UFUBQ NFMFCJIJ OJMBJ UFSTFCVU LBSFOB OJMBJ JOJ NFSVQBLBO CBUBT
EBMBN TFM EBSBI NFSBI BHBS CFSGVOHTJ TFDBSB FGFLUJG QBEB NFUBCPMJL NFLBOJTNF QFNCFOUVLBO IFNPHMPCJO TFM
NBOVTJB 4FMBOKVUOZB QBEB PSBOH OPSNBM QFSTFOUBTF IFNPHMPCJO
4FMBJO NFOHBOHLVU IFNPHMPCJO TFM EBSBI NFSBI KVHB IBNQJS TFMBMV NFOEFLBUJ OJMBJ NBLTJNVN EBMBN TFUJBQ TFM
NFNQVOZBJ GVOHTJ MBJO $POUPIOZB TFM UFSTFCVU NFOHBOEVOH /BNVO CJMBQFNCFOUVLBOIFNPHMPCJOEBMBNTVNTVNUVMBOH
TFKVNMBI CFTBS BOIJESBTF LBSCPOBU TVBUV FO[JN ZBOH CFSLVSBOH QFSTFOUBTF IFNPHMPCJO EBMBN TFM EBQBU UVSVO
NFOHBUBMJTJT SFBLTJ SFWFSTJCFM BOUBSB LBSCPO EJPLTJEB $0
EBO TBNQBJ EJ CBXBI OJMBJ UFSTFCVU EBO WPMVNF TFM EBSBI NFSBI
BJS VOUVL NFNCFOUVL BTBN LBSCPOBU )$0
ZBOH EBQBU KVHB EBQBU NFOVSVO LBSFOB KVNMBI IFNPHMPCJO ZBOH NFOHJTJ
NFOJOHLBULBO LFDFQBUBO SFBLTJ JOJ CFCFSBQB SJCV LBMJ MJQBU TFMNFOKBEJCFSLVSBOH
$FQBUOZBSFBLTJJOJNFNCVBUBJSEBMBNEBSBIEBQBUNFOHBOHLVU #JMB IFNBUPLSJU QFSTFOUBTF KVNMBI TFM EBMBN EBSBI
TFKVNMBI CFTBS $0 EBMBN CFOUVL JPO CJLBSCPOBU )$0
EBSJ OPSNBMOZB TBNQBJ QFSTFO
EBO KVNMBI IFNPHMPCJO
KBSJOHBO LF QBSV %J QBSV JPO UFSTFCVU EJVCBI LFNCBMJ NFOKBEJ EBMBNNBTJOHNBTJOHTFMCFSOJMBJOPSNBM NBLBTFMVSVIEBSBI
$0EBOEJLFMVBSLBOLFEBMBNBUNPTGFSTFCBHBJQSPEVLMJNCBI TFPSBOH MBLJMBLJ SBUBSBUB NFOHBOEVOH HSBN IFNPHMPCJO
UVCVI)FNPHMPCJOZBOHUFSEBQBUEJEBMBNTFMNFSVQBLBOEBQBS QFS NJMJMJUFS TFM QBEB XBOJUB SBUBSBUB NFOHBOEVOH
BTBNCBTB ZBOH CBJL TFQFSUJ IBMOZB QBEB LFCBOZBLBO QSPUFJO
HSBNQFSNJMJMJUFSTFM
TFIJOHHB TFM EBSBI NFSBI CFSUBOHHVOH KBXBC VOUVL TFCBHJBO 4FQFSUJ EBMBN QFNCBIBTBO #BC ZBOH CFSIVCVOHBO
CFTBSEBZBEBQBSBTBNCBTBTFMVSVIEBSBI EFOHBO USBOTQPS PLTJHFO TFUJBQ HSBN IFNPHMPCJO NVSOJ
CFSJLBUBO EFOHBO NM PLTJHFO 0MFI LBSFOB JUV QBEB
Bentuk dan Ukuran Sel Darah Merah. 4FM EBSBI NFSBI TFPSBOHMBLJMBLJOPSNBM KVNMBINBLTJNVNTFCBOZBLLJSBLJSB
OPSNBM UBNQBLQBEB(BNCBS CFSCFOUVLDBLSBNCJLPOLBG NJMJMJUFS PLTJHFO EBQBU EJCBXB EBMBN CFOUVL HBCVOHBO
EFOHBOEJBNFUFSSBUBSBUBLJSBLJSB HNEBOEFOHBOLFUFCBMBO EFOHBO IFNPHMPCJO QFS NJMJMJUFS EBSBI EBO QBEB XBOJUB
NQBEBCBHJBOZBOHQBMJOHUFCBMTFSUBNBUBVLVSBOHEJ OPSNBM PLTJHFOZBOHEBQBUEJBOHLVUTFCFTBSNJMJMJUFS
413
Unit Vl Sel-Sel Darah, lmunitas, dan Pembekuan Darah
Produksi Sel-Sel Darah Merah QBOKBOH LFDVBMJ CBHJBO QSPLTJNBM IVNFSVT EBO UJCJB NFOKBEJ
Daerah-Daerah Tubuh yang Memproduksi Sel Darah TBOHBU CFSMFNBL EBO UJEBL NFNQSPEVLTJ TFMTFM EBSBI NFSBI
Merah. %BMBN NJOHHVNJOHHV QFSUBNB LFIJEVQBO FNCSJP TFUFMBICFSVTJBLVSBOHMFCJIUBIVO4FUFMBIVTJBJOJ LFCBOZBLBO
TFMTFM EBSBI NFSBI QSJNJUJG ZBOH CFSJOUJ EJQSPEVLTJ EJ ZPML TFM EBSBI NFSBI EJQSPEVLTJ EBMBN TVNTVN UVMBOH NFNCSBOPTB
TBD4FMBNBQFSUFOHBIBOUSJNFTUFSNBTBHFTUBTJ IBUJEJBOHHBQ TFQFSUJWFSUFCSB TUFSOVN SVTVL EBOJMJVN#BILBOEBMBNUVMBOH
TFCBHBJPSHBOVUBNBVOUVLNFNQSPEVLTJTFMTFMEBSBINFSBI UVMBOH JOJ TVNTVN UVMBOH NFOKBEJ LVSBOH QSPEVLUJG TFJSJOH
OBNVO UFSEBQBU KVHB TFM EBSBI NFSBI EBMBN KVNMBI DVLVQ EFOHBOCFSUBNCBIOZBVTJB
CBOZBLZBOHEJQSPEVLTJEJMJNQBEBOLFMFOKBSMJNGF-BMVLJSB
LJSBTFMBNBCVMBOUFSBLIJSLFIBNJMBOEBOTFTVEBIMBIJS TFMTFM Pembentukan Sel Darah
EBSBINFSBIIBOZBEJQSPEVLTJEJTVNTVNUVMBOH Sel Punca Hematopoietik Pluripoten, Penginduksi
4FQFSUJZBOHEJQFSMJIBULBOQBEB(BNCBS QBEBEBTBSOZB Pertumbuhan, dan Penginduksi Diferensiasi. 4FM EBSBI NFNVMBJ
TVNTVN UVMBOH EBSJ TFNVB UVMBOH NFNQSPEVLTJ TFM EBSBI LFIJEVQBOOZB EJ EBMBN TVNTVN UVMBOH EBSJ TVBUV UJQF TFM ZBOH
NFSBITBNQBJTFTFPSBOHCFSVTJBUBIVOUFUBQJTVNTVNUVMBOH EJTFCVU TFM QVODB IFNBUPQPJFUJL QMVSJQPUFO ZBOH NFSVQBLBO BTBM
EBSJ TFNVB TFM EBMBN EBSBI TJSLVMBTJ (BNCBS
100 NFNQFSMJIBULBO VSVUBO QFNCFMBIBO TFMTFM QMVSJQPUFO VOUVL
NFNCFOUVLCFSCBHBJTFMEBSBITJSLVMBTJ4FXBLUVTFMTFMEBSBIJOJ
75 e e a CFSFQSPEVLTJ BEB TFCBHJBO LFDJM EBSJ TFMTFM JOJ ZBOH CFSUBIBO
QFSTJT TFQFSUJ TFMTFM QMVSJQPUFO BTMJOZB EBO EJTJNQBO EBMBN
Fem
50 en m
Tibia
TVNTVN UVMBOH HVOB NFNQFSUBIBOLBO TVQMBJ TFMTFM EBSBI

ur
UFSTFCVU XBMBVQVO KVNMBIOZB CFSLVSBOH TFJSJOH EFOHBO

(ko
(k
25 ga
or
rpu
pu
QFSUBNCBIBO VTJB 4FCBHJBO CFTBS TFMTFM ZBOH EJSFQSPEVLTJ BLBO

s)
s)
0
CFSEJGFSFOTJBTJ VOUVL NFNCFOUVL TFMTFM UJQF MBJO ZBOH
0 5 10 15 20 30 40 50 60 70
EJQFSMJIBULBO QBEB (BNCBS TFCFMBI LBOBO 4FM ZBOH CFSBEB
QBEB UBIBQ QFSUFOHBIBO TBOHBU NJSJQ EFOHBO TFM QVODB
e e a an ela i od ksi sel da a me a di QMVSJQPUFO XBMBVQVO TFMTFM JOJ UFMBI NFNCFOUVL TVBUV KBMVS
s ms m e ma am ma am lang ada e agai sia
LIVTVTQFNCFMBIBOTFMEBOEJTFCVUDPNNJUUFETUFNDFMMT
CF -B
ni em en k ( ni em en k
koloni las koloni e i osi
e o il
osino i
aso i
H
sel n a ni em en k ( ni em en k koloni
ema o oe ik koloni lim a g an losi monosi
l i o en
( ni em en k
koloni megaka iosi
H
(sel n a lim oid
em en kan e agai sel da a ang e eda eda da i el e o oie i l i oe C asli dalam s ms m

lang
414
Bab 32 Sel-Sel Darah Merah, Anemia, dan Polisitemia
#FSCBHBJDPNNJUUFETUFNDFMMT CJMBEJUVNCVILBOEBMBNCJBLBO Tahap-Tahap Diferensiasi Sel Darah Merah

BLBO NFOHIBTJMLBO LPMPOJ UJQF TFM EBSBI ZBOH TQFTJGJL 4VBUV
4FMQFSUBNBZBOHEBQBUEJLFOBMJTFCBHBJCBHJBOEBSJSBOHLBJBO
DPNNJUUFE TUFN DFMMT ZBOH NFOHIBTJMLBO FSJUSPTJU EJTFCVU VOJU
TFM EBSBI NFSBI BEBMBI QSPFSJUSPCMBT ZBOH UBNQBL QBEB
QFNCFOUVLLPMPOJFSJUSPTJU EBOTJOHLBUBO$'6&EJHVOBLBOVOUVL
QFSNVMBBO (BNCBS %FOHBO SBOHTBOHBO ZBOH TFTVBJ
UNIT VI
NFOBOEBJ KFOJT TFM QVODB JOJ %FNJLJBO QVMB VOJU ZBOH
TFKVNMBICFTBSTFMJOJEJCFOUVLEBSJTFMTFMQVODB$'6&
NFNCFOUVL LPMPOJ HSBOVMPTJU EBO NPOPTJU EJUBOEBJ EFOHBO
TJOHLBUBO$'6(. EBOTFUFSVTOZB #FHJUV QSPFSJUSPCMBT JOJ UFSCFOUVL NBLB JB BLBO NFNCFMBI
1FSUVNCVIBO EBO SFQSPEVLTJ CFSCBHBJ TFM QVODB EJBUVS PMFI CFCFSBQB LBMJ TBNQBJ BLIJSOZB NFNCFOUVL CBOZBL TFM EBSBI
CFSNBDBNNBDBN QSPUFJO ZBOH EJTFCVU QFOHJOEVLTJ NFSBI ZBOH NBUBOH 4FMTFM HFOFSBTJ QFSUBNB JOJ EJTFCVU
QFSUVNCVIBO 5FMBI EJLFNVLBLBO FNQBU QFOHJEVLTJ FSJUSPCMBTCBTPGJMTFCBCEBQBUEJQVMBTEFOHBO[BUXBSOBCBTBTFM
QFSUVNCVIBO ZBOH VUBNB EBO NBTJOHNBTJOH NFNJMJLJ DJSJ LIBT ZBOH UFSEBQBU QBEB UBIBQ JOJ NFOHVNQVMLBO TFEJLJU TFLBMJ
UFSTFOEJSJ 4BMBI TBUVOZB BEBMBI JOUFSMFVLJO ZBOH NFNVMBJ IFNPHMPCJO 1BEB HFOFSBTJ CFSJLVUOZB TFQFSUJ ZBOH UBNQBL
QFSUVNCVIBOEBOSFQSPEVLTJIBNQJSTFNVBKFOJTDPNNJUFETUFN QBEB(BNCBS TFMTVEBIEJQFOVIJPMFIIFNPHMPCJOTBNQBJ
DFMMTZBOHCFSCFEBCFEB TFEBOHLBOZBOHMBJOIBOZBNFOHJOEVLTJ LPOTFOUSBTJTFLJUBSQFSTFO OVLMFVTNFNBEBUNFOKBEJLFDJM
QFSUVNCVIBOQBEBUJQFUJQFZBOHTQFTJGJL EBOTJTBBLIJSOZBEJBCTPSCTJBUBVEJEPSPOHLFMVBSEBSJTFM1BEB
1FOHJOEVLTJ QFSUVNCVIBO BLBO NFNJDV QFSUVNCVIBO EBO TBBUZBOHTBNB SFUJLVMVNFOEPQMBTNBEJSFBCTPSCTJ4FMQBEB
CVLBO NFNJDV EJGFSFOTJBTJ TFMTFM %JGFSFOTJBTJ TFM BEBMBI GVOHTJ UBIBQ JOJ EJTFCVU SFUJLVMPTJU LBSFOB NBTJI NFOHBOEVOH
EBSJ SBOHLBJBO QSPUFJO ZBOH MBJO ZBOH EJTFCVU QFOHJOEVLTJ TFKVNMBI LFDJM NBUFSJ CBTPGJMJL ZBJUV UFSEJSJ BUBT TJTBTJTB
EJGFSFOTJBTJ .BJOHNBTJOH QSPUFJO JOJ BLBO NFOZFCBCLBO TBUV BQBSBUVT (PMHJ NJUPLPOESJB EBO TFEJLJU PSHBOFM TJUPQMBTNB
UJQF DPNNJUFE TUFN DFMMT VOUVL CFSEJGFSFOTJBTJ TFCBOZBL TBUV MBJOOZB 4FMBNB UBIBQ SFUJLVMPTJU JOJ TFMTFM CFSKBMBO EBSJ
MBOHLBIBUBVMFCJINFOVKVLFTFMEBSBIEFXBTBCFOUVLBLIJS TVNTVN UVMBOH NBTVL LF EBMBN LBQJMFS EBSBI EFOHBO DBSB
EJBQFEFTJT UFSQFSBTNFMBMVJQPSJQPSJNFNCSBOLBQJMFS

1FNCFOUVLBO QFOHJOEVLTJ QFSUVNCVIBO EBO QFOHJOEVLTJ
EJGFSFOTJBTJ JUV TFOEJSJ EJLFOEBMJLBO PMFI GBLUPSGBLUPS EJ MVBS .BUFSJ CBTPGJMJL ZBOH UFSTJTB EBMBN SFUJLVMPTJU OPSNBMOZB
TVNTVN UVMBOH $POUPIOZB QBEB FSJUSPTJU TFM EBSBI NFSBI
BLBO NFOHIJMBOH EBMBN XBLUV TBNQBJ IBSJ EBO TFM
QBQBSBO EBSBI EFOHBO PLTJHFO ZBOH SFOEBI EBMBN XBLUV ZBOH LFNVEJBO NFOKBEJ FSJUSPTJU NBUBOH 0MFI LBSFOB XBLUV IJEVQ
MBNBBLBONFOHBLJCBULBOJOEVLTJQFSUVNCVIBO EJGFSFOTJBTJ EBO SFUJLVMPTJUJOJQFOEFL NBLBLPOTFOUSBTJOZBEJBOUBSBTFNVBTFM
QSPEVLTJFSJUSPTJUEBMBNKVNMBIZBOHTBOHBUCBOZBL TFQFSUJZBOH EBSBINFSBIOPSNBMOZBLVSBOHTFEJLJUEBSJQFSTFO
BLBOEJCJDBSBLBOLFNVEJBOEBMBNCBCJOJ1BEBTFMEBSBIQVUJI
QFOZBLJU JOGFLTJ BLBO NFOZFCBCLBO QFSUVNCVIBO EJGFSFOTJBTJ
EBO BLIJSOZB QFNCFOUVLBO TFM EBSBI QVUJI UJQF UFSUFOUV ZBOH
EJQFSMVLBOVOUVLNFNCFSBOUBTTFUJBQJOGFLTJ
oe i o las
i on las
aso i
nemia i ok omik
mik osi ik nemia sel sa i
i o las
olik oma o il
i o las
o ok oma ik
e ik losi
i osi
nemia megalo las ik i o las osis e alis
em en kan sel da a me a no mal dan ka ak e is ik sel da a me a dalam e agai i e anemia
415
Unit Vl Sel-Sel Darah, Imunitas, dan Pembekuan Darah
Pengaturan Produksi Sel Darah Merah—Peran EFOHBOIBTJMBLIJSCFSVQBLFOBJLBOIFNBUPLSJUEBOCJBTBOZBKVHB

Eritropoietin BLBONFOJOHLBULBOWPMVNFEBSBIUPUBM
+VNMBI UPUBM TFM EBSBI NFSBI EBMBN TJTUFN TJSLVMBTJ EJBUVS Eritropoietin Merangsang Produksi Sel Darah Merah, dan
EBMBN LJTBSBO ZBOH TFNQJU TFIJOHHB
TFMTFM EBSBI NFSBI Pembentukannya Meningkat sebagai Respons terhadap
ZBOH BEFLVBU TFMBMV UFSTFEJB VOUVL NFOHBOHLVU PLTJHFO ZBOH Hipoksia. 4UJNVMVT VUBNB ZBOH EBQBU NFSBOHTBOH QSPEVLTJ TFM
DVLVQ EBSJ QBSV LF KBSJOHBO OBNVO
TFMTFM UFSTFCVU UJEBL EBSBINFSBIEBMBNLFBEBBOPLTJHFOZBOHSFOEBIBEBMBIIPSNPO
NFOKBEJ CFSMJNQBI SVBI TFIJOHHB BMJSBO EBSBI UJEBL EBMBN TJSLVMBTJ ZBOH EJTFCVU FSJUSPQPJFUJO ZBJUV TVBUV
UFSIBNCBU .FLBOJTNF QFOHBUVSBO JOJ EJQFSMJIBULBO QBEB HMJLPQSPUFJO EFOHBO CFSBU NPMFLVM LJSBLJSB 5BOQB
(BNCBSEBOEBMBNQFNCBIBTBOTFCBHBJCFSJLVU BEBOZB FSJUSPQPJFUJO LFBEBBO IJQPLTJB UJEBL BLBO CFSQFOHBSVI
BUBVQFOHBSVIOZBTFEJLJUTFLBMJEBMBNQFSBOHTBOHBOQSPEVLTJTFM
Oksigenasi Jaringan adalah Pengatur Utama Produksi
EBSBINFSBI"LBOUFUBQJ CJMBTJTUFNFSJUSPQPJFUJOJOJCFSGVOHTJ
Sel Darah Merah. 4FUJBQ LFBEBBO ZBOH NFOZFCBCLBO NBLB IJQPLTJB BLBO NFOJNCVMLBO QFOJOHLBUBO QSPEVLTJ
QFOVSVOBOUSBOTQPSUBTJTFKVNMBIPLTJHFOLFKBSJOHBOCJBTBOZB FSJUSPQPJFUJO ZBOH OZBUB EBO FSJUSPQPJFUJO TFMBOKVUOZB BLBO
BLBONFOJOHLBULBOLFDFQBUBOQSPEVLTJTFMEBSBINFSBI+BEJ NFNQFSLVBUQSPEVLTJTFMEBSBINFSBITBNQBJIJQPLTJBNFSFEB
CJMB TFTFPSBOH NFOKBEJ CFHJUV BOFNJT BLJCBU BEBOZB
QFSEBSBIBO BUBV LPOEJTJ MBJOOZB NBLB TVNTVN UVMBOH NVMBJ Peran Ginjal dalam Pembentukan Eritropoietin.
NFNQSPEVLTJ TFKVNMBI CFTBS TFM EBSBI NFSBI 4FMBJO JUV CJMB 4FDBSB OPSNBM LJSBLJSB QFSTFO EBSJ FSJUSPQPJFUJO UPUBM
UFSKBEJ LFSVTBLBO QBEB TFCBHJBO CFTBS TVNTVN UVMBOH BLJCBU EJCFOUVL EBMBN HJOKBM TJTBOZB TFCBHJBO CFTBS EJCFOUVL EJ IBUJ
TFCBC BQBQVO UFSVUBNB PMFI UFSBQJ EFOHBO TJOBSY BLBO #FMVN EJLFUBIVJ TFDBSB UFQBU CBHJBO HJOKBM ZBOH NFNCFOUVL
NFOHBLJCBULBO IJQFSMBTJB TVNTVN UVMBOH ZBOH UFSTJTB EBMBN FSJUSPQPJFUJO #FCFSBQB QFOFMJUJBO NFOHBSBILBO FSJUSPQPJFUJO
VTBIBOOZB VOUVL NFNFOVIJ LFCVUVIBO TFM EBSBI NFSBI EJTFLSFTJ UFSVUBNB PMFI TFM JOUFSTUJTJBM NJSJQ GJCSPCMBT EJTFLJUBS
EBMBNUVCVI UVCVMVT QBEB TFLSFU LPSUFLT EBO NFEVMB MVBS UFNQBU LPOTVNTJ
%JEBUBSBOZBOHTBOHBUUJOHHJ EFOHBOKVNMBIPLTJHFOVEBSB PLTJHFO HJOKBM CBOZBL UFSKBEJ "EB LFNVOHLJOBO CBIXB TFMTFM
ZBOH TBOHBU SFOEBI PLTJHFO EBMBN KVNMBI ZBOH UJEBL DVLVQ MBJO UFSNBTVL TFM FQJUFM HJOKBM TFOEJSJ KVHB NFOZFLSFTJ
JUVEJBOHLVULFKBSJOHBO EBOQSPEVLTJTFMEBSBINFSBITBOHBU FSJQUSPQPFUJOTFCBHBJSFTQPOTUFSIBEBQIJQPLTJB
NFOJOHLBU%BMBNIBMJOJ CVLBOLPOTFOUSBTJTFMEBSBINFSBI )JQPLTJB KBSJOHBO HJOKBM BLBO NFOJOHLBULBO LBEBS IZQPYJB
EBMBN EBSBI ZBOH NFOHBUVS QSPEVLTJ TFM NFSBI NFMBJOLBO JOEVDJCMFGBDUPS )*'
KBSJOHBO ZBOH CFSGVOHTJ TFCBHBJ GBLUPS
KVNMBIPLTJHFOZBOHEJBOHLVULFKBSJOHBOEBMBNIVCVOHBOOZB USBOTLSJQTJ VOUVL TFKVNMBI CFTBS HFO UFSJOEVLTJ IJQPLTJB
EFOHBOLFCVUVIBOKBSJOHBOBLBOPLTJHFO IZQPYJBJOEVDJCMF HFOFT
UFSNBTVL HFO FSJUSPQFUJO )*'
#FSCBHBJQFOZBLJUQBEBTJTUFNTJSLVMBTJZBOHNFOZFCBCLBO NFOHJLBUVOTVSSFTQPOTIJQPLTJB IZQPYJBSFTQPOTFFMFNFOU
ZBOH
QFOVSVOBO BMJSBO EBSBI KBSJOHBO EBO UFSVUBNB ZBOH EBQBU BEB QBEB HFO FSJUSPQFUJO NFSBOHTBOH USBOTLSJQTJ N3/" EBO
NFOZFCBCLBO LFHBHBMBO QFOZFSBQBO PLTJHFO PMFI EBSBI QBEBBLIJSOZBNFOJOHLBULBOTJOUFTJTFSJUSPQPJFUJO
TFXBLUV NFMFXBUJ QBSV EBQBU KVHB NFOJOHLBULBO LFDFQBUBO ,BEBOHLBEBOH LFBEBBO IJQPLTJB EJ CBHJBO UVCVI MBJOOZB
QSPEVLTJTFMEBSBINFSBI)BMJOJUBNQBLKFMBTUFSVUBNBQBEB UFUBQJ CVLBO EJ HJOKBM BLBO NFSBOHTBOH TFLSFTJ FSJUSPQPJFUJO
LFBEBBO HBHBM KBOUVOH ZBOH MBNB EBO QBEB LFCBOZBLBO HJOKBM )BM JOJ NFOVOKVLLBO CBIXB NVOHLJO UFSEBQBU CFCFSBQB
QFOZBLJU QBSV LBSFOB IJQPLTJB KBSJOHBO ZBOH UJNCVM BLJCBU TFOTPSEJMVBSHJOKBMZBOHNFOHJSJNLBOTJOZBMUBNCBIBOLFHJOKBM
LFBEBBOJOJBLBONFOJOHLBULBOQSPEVLTJTFMEBSBINFSBI VOUVL NFNQSPEVLTJ IPSNPO UFSTFCVU ,IVTVTOZB CBJL
OPSFQJOFGSJO NBVQVO FQJOFGSJO TFSUB CFCFSBQB QSPTUBHMBOEJO
BLBONFSBOHTBOHQSPEVLTJFSJUSPQPJFUJO
injal
#JMBLFEVBHJOKBMTFTFPSBOHEJBOHLBUBUBVSVTBLBLJCBUQFOZBLJU
HJOKBM NBLBPSBOHUFSTFCVUBLBONFOKBEJTBOHBUBOFNJT TFCBC
QFSTFO FSJUSPQPJFUJO OPSNBM ZBOH EJCFOUVL EJ KBSJOHBO MBJO
UFSVUBNB EJ IBUJ
IBOZB DVLVQ NFOZFEJBLBO TFQFSUJHB TBNQBJ
en n TFUFOHBI EBSJ QSPEVLTJ TFM EBSBI NFSBI ZBOH EJQFSMVLBO PMFI
UVCVI
Efek Eritropoietin pada Pembentukan Sel Darah Merah.
#JMB LJUB NFOFNQBULBO TFFLPS IFXBO BUBV TFTFPSBOH EBMBN
BUNPTGFSZBOHLBEBSPLTJHFOOZBSFOEBI FSJUSPQPJFUJOBLBONVMBJ
en n
EJCFOUVL EBMBN CFCFSBQB NFOJU TBNQBJ CFCFSBQB KBN EBO
QSPEVLTJOZBNFODBQBJNBLTJNVNEBMBNXBLUVKBN/BNVO
ak o ak o ang IBNQJS UJEBL EJKVNQBJ BEBOZB TFM EBSBI NFSBI CBSV EBMBN
men nkan oksigenasi TJSLVMBTJ EBSBI TBNQBJ IBSJ LFNVEJBO #FSEBTBSLBO GBLUB JOJ
. ol me da a ang enda EBOKVHBQFOFMJUJBOMBJO TVEBIEBQBUEJUFOUVLBOCBIXBQFOHBSVI
2 nemia
. Hemoglo in enda VUBNB FSJUSPQPJFUJO BEBMBI NFSBOHTBOH QSPEVLTJ QSPFSJUSPCMBT
4. li an da a ang k ang EBSJTFMQVODBIFNBUPQPJFUJLEJTVNTVNUVMBOH4FMBJOJUV CFHJUV
. en aki a QSPFSJUSPCMBT UFSCFOUVL NBLB FSJUSPQPJFUJO KVHB NFOZFCBCLBO
ngsi mekanisme e i o oie in n k TFMTFM JOJ EFOHBO DFQBU NFMBMVJ CFSCBHBJ UBIBQ FSJUSPCMBTUJL
meningka kan od ksi sel da a me a ke ika oksigenasi LFUJNCBOH QBEB LFBEBBO OPSNBM )BM UFSTFCVU BLBO MFCJI
ja ingan e k ang NFNQFSDFQBUQSPEVLTJTFMEBSBINFSBIZBOHCBSV$FQBUOZB
416
Bab 32 Sel-Sel Darah Merah, Anemia, dan Potisitemia
QSPEVLTJ TFM JOJ UFSVT CFSMBOHTVOH TFMBNB PSBOH UFSTFCVU UFUBQ

,FNVEJBO WJUBNJO # EJBOHLVU LF EBMBN EBSBI TFMBNB
EBMBN LFBEBBO PLTJHFO SFOEBI BUBV TBNQBJ KVNMBI TFM EBSBI CFCFSBQB KBN CFSJLVUOZB NFMBMVJ QSPTFT QJOPTJUPTJT ZBOH
NFSBI ZBOH UFMBI UFSCFOUVL DVLVQ VOUVL NFOHBOHLVU PLTJHFO NFOHBOHLVU GBLUPS JOUSJOTJL CFSTBNB WJUBNJO NFMFXBUJ
EBMBN KVNMBI ZBOH NFNBEBJ LF KBSJOHBO XBMBVQVO LBEBS NFNCSBO 0MFI LBSFOB JUV LFLVSBOHBO GBLUPS JOUSJOTJL BLBO
PLTJHFOOZB SFOEBI QBEB TBBU JOJ LFDFQBUBO QSPEVLTJ NFOVSVOLBO LFUFSTFEJBBO WJUBNJO # BLJCBU HBOHHVBO
UNIT VI
FSJUSPQPJFUJO NFOVSVO TBNQBJ LBEBS UFSUFOUV ZBOH BLBO BCTPSCTJWJUBNJOUFSTFCVU
NFNQFSUBIBOLBO KVNMBI TFM EBSBI NFSBI ZBOH EJCVUVILBO #FHJUV WJUBNJO # TVEBI EJBCTPSCTJ EBSJ USBLUVT
OBNVOUJEBLTBNQBJCFSMFCJIBO HBTUSPJOUFTUJOBM NBLBWJUBNJOJOJBLBOEJTJNQBOEBMBNKVNMBI
#JMBUJEBLBEBFSJUSPQPJFUJO TVNTVNUVMBOHIBOZBNFNCFOUVL ZBOH CFTBS EJ IBUJ EBO LFNVEJBO EJMFQBTLBO TFDBSB MBNCBU
TFEJLJU TFM EBSBI NFSBI 1BEB LFBEBBO MBJO ZBOH FLTUSFN CJMB TFTVBJ LFCVUVIBO TVNTVN UVMBOH +VNMBI NJOJNVN WJUBNJO
KVNMBI FSJUSPQPJFUJO ZBOH UFSCFOUVL TBOHBU CBOZBL EBO KJLB # ZBOH EJCVUVILBO TFUJBQ IBSJ VOUVL NFOKBHB TVQBZB
UFSTFEJB TFKVNMBI CFTBS [BU CFTJ EBO [BU OVUSJTJ MBJOOZB ZBOH QFNBUBOHBO TFM EBSBI NFSBI UFUBQ OPSNBM IBOZB TFCFTBS
EJQFSMVLBO NBLB LFDFQBUBO QSPEVLTJ TFM EBSBI NFSBI EBQBU TBNQBJ NH EBO ZBOH EJTJNQBO EJ IBUJ EBO KBSJOHBO UVCVI
NFOJOHLBU TBNQBJ TFQVMVI LBMJ MJQBU BUBV MFCJI EJCBOEJOHLBO MBJOOZB LJSBLJSB LBMJ KVNMBI JOJ +BEJ VOUVL
LFBEBBOOPSNBM0MFILBSFOBJUV NFLBOJTNFFSJUSPQPJFUJOEBMBN NFOJNCVMLBO BOFNJB BLJCBU LFHBHBMBO QFNBUBOHBO
QFOHBUVSBO QSPEVLTJ TFM EBSBI NFSBI NFSVQBLBO TVBUV EJCVUVILBOHBOHHVBOBCTPSQTJ#TFMBNBTBNQBJUBIVO
NFLBOJTNFZBOHLVBU
Kegagalan Pematangan Akibat Defisiensi Asam Folat
Pematangan Sel Darah Merah—Kebutuhan Vitamin Asam Pteroilglutamat). "TBN GPMBU BEBMBI CBIBO OPSNBM
B12 (Sianokobalamin) dan Asam Folat ZBOH EJUFNVLBO QBEB TBZVSBO IJKBV CVBICVBIBO UFSUFOUV
0MFI LBSFOB BEBOZB LFCVUVIBO ZBOH CFSLFTJOBNCVOHBO VOUVL EBO EBHJOH UFSVUBNB IBUJ
/BNVO CBIBO JOJ NVEBI SVTBL
NFNFOVIJ TFM EBSBI NFSBI NBLB TFM FSJUSPQPJFUJL TVNTVN TFMBNBNBLBOBOEJNBTBL4FMBJOJUV QBEBPSBOHPSBOHEFOHBO
UVMBOH NFSVQBLBO TBMBI TBUV TFM ZBOH UVNCVI EBO CFSFQSPEVLTJ LFMBJOBO BCTPSQTJ HBTUSPJOUFTUJOBM NJTBMOZB TFSJOH NFOHBMBNJ
QBMJOH DFQBU EJ TFMVSVI UVCVI 0MFI LBSFOB JUV TFQFSUJ ZBOH QFOZBLJUVTVTIBMVTZBOHEJTFCVUTQSVF TFSJBXBOVTVT
TFSJOH
EJQFSLJSBLBO QFNBUBOHBO EBO LFDFQBUBO QSPEVLTJOZB TBOHBU LBMJ NFOHBMBNJ LFTVMJUBO ZBOH TFSJVT EBMBN NFOHBCTPSCTJ
EJQFOHBSVIJPMFIOVUSJTJTFTFPSBOH BTBNGPMBUNBVQVOWJUBNJO#0MFILBSFOBJUV TFCBHJBOCFTBS
%VBWJUBNJOZBOHLIVTVTOZBQFOUJOHVOUVLQFNBUBOHBOBLIJS LFHBHBMBONBUVSBTJEJTFCBCLBOBEBOZBEFGJTJFOTJBCTPSQTJBTBN
TFM EBSBI NFSBI BEBMBI WJUBNJO # EBO BTBN GPMBU ,FEVBOZB GPMBUEBOWJUBNJO#EJVTVT
QFOUJOH VOUVL TJOUFTJT %/" LBSFOB NBTJOHNBTJOH WJUBNJO Pembentukan Hemoglobin
EFOHBO DBSB ZBOH CFSCFEB EJCVUVILBO VOUVL QFNCFOUVLBO
4JOUFTJTIFNPHMPCJOEJNVMBJEBMBNQSPFSJUSPCMBTEBOCFSMBOKVU
UJNJEJO USJGPTGBU ZBJUV TBMBI TBUV [BU QFNCBOHVO FTFOTJBM %/"
CBILBOEBMBNTUBEJVNSFUJLVMPTJUQBEBQFNCFOUVLBOTFMEBSBI
0MFI LBSFOB JUV LVSBOHOZB WJUBNJO # BUBV BTBN GPMBU EBQBU
NFSBI 0MFI LBSFOB JUV LFUJLB SFUJLVMPTJU NFOJOHHBMLBO
NFOZFCBCLBO BCOPSNBMJUBT EBO CFSLVSBOHOZB %/" EBO
TVNTVN UVMBOH EBO NBTVL LF EBMBN BMJSBO EBSBI SFUJLVMPTJU
BLJCBUOZBBEBMBI LFHBHBMBOQFNBUBOHBOJOUJEBOQFNCFMBIBOTFM
UFUBQNFNCFOUVLTFKVNMBILFDJMIFNPHMPCJOTBUVIBSJTFTVEBI
4FMBOKVUOZB TFMTFMFSJUSPCMBTUJLQBEBTVNTVNUVMBOH TFMBJOHBHBM
EBO TFUFSVTOZB TBNQBJ TFM UFSTFCVU NFOKBEJ FSJUSPTJU ZBOH
CFSQSPMJGFSBTJ TFDBSB DFQBU BLBO NFOHIBTJMLBO TFM EBSBI NFSBI
NBUBOH
ZBOHMFCJICFTBSEBSJOPSNBM EJTFCVUNBLSPTJU EBOTFMJUVTFOEJSJ
NFNQVOZBJ NFNCSBO ZBOH TBOHBU MFNBI EBO TFSJOH LBMJ (BNCBS NFNQFSMJIBULBO UBIBQ EBTBS LJNJBXJ
CFSCFOUVL UJEBL UFSBUVS CFTBS EBO PWBM CFSCFEB EFOHBO CFOUVL QFNCFOUVLBO IFNPHMPCJO .VMBNVMB TVLTJOJM,P" ZBOH
MFNQFOHCJLPOLBGZBOHCJBTB4FMZBOHCFSCFOUVLLVSBOHCBJLJOJ EJCFOUVLEBMBNTJLMVT,SFCT TFQFSUJZBOHEJKFMBTLBOEJ#BC

TFUFMBI NBTVL EBMBN TJSLVMBTJ EBSBI NBNQV NFOHBOHLVU CFSJLBUBO EFOHBO HMJTJO VOUVL NFNCFOUVL NPMFLVM QJSPM
PLTJHFO TFDBSB OPSNBM BLBO UFUBQJ LFSBQVIBOOZB NFOZFCBCLBO ,FNVEJBO FNQBU QJSPM CFSHBCVOH VOUVL NFNCFOUVL
TFM UFSTFCVU NFNJMJLJ NBTB IJEVQ ZBOH QFOEFL ZBLOJ TFUFOHBI QSPUPQPSGJSJO*9 ZBOHLFNVEJBOCFSHBCVOHEFOHBOCFTJVOUVL
TBNQBJ TFQFSUJHB OPSNBM 0MFI LBSFOB JUV EJLBUBLBO CBIXB NFNCFOUVL NPMFLVM IFNF "LIJSOZB TFUJBQ NPMFLVM IFNF
EFGJTJFOTJ WJUBNJO # BUBV BTBN GPMBU EBQBU NFOZFCBCLBO CFSHBCVOHEFOHBOSBOUBJQPMJQFQUJEBQBOKBOH ZBJUVHMPCJOZBOH
LFHBHBMBOQFNBUBOHBOEBMBNQSPTFTFSJUSPQPJFTJT EJTJOUFTJTPMFISJCPTPN NFNCFOUVLTVBUVTVCVOJUIFNPHMPCJO
Kegagalan Pematangan Sel Akibat Buruknya Absorpsi ZBOHEJTFCVUSBOUBJIFNPHMPCJO (BNCBS
5JBQUJBQSBOUBJ
NFNQVOZBJ CFSBU NPMFLVM LJSBLJSB FNQBU SBOUBJ JOJ
Vitamin B12—Anemia Pernisiosa. 1FOZFCBCVNVNLFHBHBMBO
QFNBUBOHBO BEBMBI BEBOZB LFHBHBMBO VOUVL NFOHBCTPSCTJ TFMBOKVUOZB BLBO CFSJLBUBO MPOHHBS TBUV TBNB MBJO VOUVL
WJUBNJO #J EBSJ USBLUVT HBTUSPJOUFTUJOBM )BM JOJ TFSJOH UFSKBEJ NFNCFOUVLNPMFLVMIFNPHMPCJOZBOHMFOHLBQ
QBEB QFOZBLJU BOFNJB QFSOJTJPTB EFOHBO EBTBS LFMBJOBO CFSVQB
BUSPGJ NVLPTB MBNCVOH ZBOH HBHBM NFOHIBTJMLBO TFLSFTJ
MBNCVOH OPSNBM 4FMTFM QBSJFUBM QBEB LFMFOKBS MBNCVOH
NFOZFLSFTJ HMJLPQSPUFJO ZBOH EJTFCVU GBLUPS JOUSJOTJL ZBOH
CFSHBCVOHEFOHBOWJUBNJO#JEBSJNBLBOBO TFIJOHHB# EBQBU . s ksinil o glisin H H
EJBCTPSQTJ PMFI VTVT )BM UFSTFCVU EBQBU UFSKBEJ EFOHBO DBSB N
CFSJLVU
'BLUPS JOUSJOTJL CFSJLBUBO FSBU EFOHBO WJUBNJO # . i ol o o o i in H
%BMBN LFBEBBO UFSJLBU # UFSMJOEVOHJ EBSJ QFODFSOBBO PMFI . o o o i in e heme ( i ol)
TFLSFTJ HBTUSPJOUFTUJOBM
.BTJI EBMBN LFBEBBO UFSJLBU GBLUPS V. heme + oli e ida an ai hemoglobin (a or b)
GBLUPS JOUSJOTJL BLBO CFSJLBUBO EFOHBO SFTFQUPS LIVTVT ZBOH V. 2 an ai a + 2 an ai b emoglo in
UFSMFUBLEJ CSVTICPSEFSNFNCSBOTFMNVLPTBEJJMFVN em en kan emoglo in
417
CH2 LBSFOBGVOHTJVUBNBIFNPHMPCJOEBMBNUVCVIBEBMBICFSHBCVOH
H EFOHBO PLTJHFO EBMBN QBSV EBO LFNVEJBO NFMFQBTLBO PLTJHFO
CH C CH3 JOJEJEBMBNLBQJMFSKBSJOHBOQFSJGFSZBOHUFLBOBOHBTPLTJHFOOZB
H3C
A B CH CH2 KBVIMFCJISFOEBIEBSJQBEBEJQBSV
O2
(–)N 0LTJHFOUJEBLCFSHBCVOHEFOHBOEVBJLBUBOQPTJUJGCFTJEBMBN
N
NPMFLVM IFNPHMPCJO .BMBIBO CFSJLBUBO TFDBSB MPOHHBS EFOHBO
HC Fe CH TBMBITBUVJLBUBOZBOHEJTFCVUJLBUBOLPPSEJOBTJBUPNCFTJ*LBUBO
N(–) N JOJ CFHJUV MPOHHBSOZB TFIJOHHB HBCVOHBO UFSTFCVU CFSTJGBU TBOHBU
SFWFSTJCFM4FMBOKVUOZB PLTJHFOEJBOHLVULFKBSJOHBOCVLBOEBMBN
H3C D C CH3 CFOUVL JPO NFMBJOLBO EBMBN CFOUVL NPMFLVM ZBOH UFSEJSJ BUBT
EVBBUPNPLTJHFO
ZBOHLBSFOBMPOHHBSOZBEBOTBOHBUSFWFSTJCFM
C
CH2 H CH2
PLTJHFO EJMFQBTLBO LF EBMBN DBJSBO KBSJOHBO EBMBN CFOUVL
NPMFLVM EBOCVLBOEBMBNCFOUVLJPO
CH2 CH2
Metabolisme Besi
COOH COOH
,BSFOBCFTJUJEBLIBOZBQFOUJOHVOUVLQFNCFOUVLBOIFNPHMPCJO
oli e ida OBNVOKVHBVOUVLFMFNFOQFOUJOHMBJOOZB DPOUPIOZB NJPHMPCJO
( an ai emoglo in –a or b) TJUPLSPN TJUPLSPN PLTJEBTF QFSPLTJEBTF LBUBMBTF
LJUB IBSVT
k dasa molek emoglo in NFOHFSUJ DBSB CFTJ JOJ EJHVOBLBO EJ EBMBN UVCVI +VNMBI UPUBM
mem e li a kan sa da i em a an ai eme ang e ika an CFTJSBUBSBUBEBMBNUVCVITFCFTBSTBNQBJHSBN EBOLJSBLJSB
e sama sama n k mem en k molek l emoglo in
QFSTFOOZB EJKVNQBJ EBMBN CFOUVL IFNPHMPCJO 4FLJUBS
QFSTFOOZBEBMBNCFOUVLNJPHMPCJO QFSTFOEBMBNCFOUVLWBSJBTJ
5FSEBQBU CFCFSBQB WBSJBTJ LFDJM EJ CFSCBHBJ SBOUBJ TVCVOJU TFOZBXB IFNF ZBOH NFNJDV PLTJEBTJ JOUSBTFM QFSTFO
IFNPHMPCJO CFSHBOUVOH QBEB TVTVOBO BTBN BNJOP EJ CBHJBO CFSHBCVOHEFOHBOQSPUFJOUSBOTGFSJOEBMBNQMBTNBEBSBI EBSJ
QPMJQFQUJEBOZB 5JQFUJQF SBOUBJ JUV EJTFCVU SBOUBJ BMGB SBOUBJ TBNQBJ QFSTFO EJTJNQBO VOUVL QFOHHVOBBO TFMBOKVUOZB
CFUB SBOUBJHBNNB EBOSBOUBJEFMUB#FOUVLIFNPHMPCJOZBOH UFSVUBNB EJ TJTUFN SFUJLVMPFOEPUFMJBM EBO TFM QBOSFOLJN IBUJ
QBMJOH VNVN QBEB PSBOH EFXBTB ZBJUV IFNPHMPCJO " LIVTVTOZBEBMBNCFOUVLGFSJUJO
NFSVQBLBO LPNCJOBTJ EBSJ EVB SBOUBJ BMGB EBO EVB SBOUBJ
CFUB)FNPHMPCJO"NFNQVOZBJCFSBUNPMFLVM Pengangkutan dan Penyimpanan Besi 1FOHBOHLVUBO
QFOZJNQBOBO EBO NFUBCPMJTNF CFTJ EBMBN UVCVI EJJMVTUSBTJLBO
0MFI LBSFOB TFUJBQ SBOUBJ IFNPHMPCJO NFNQVOZBJ TFCVBI
QBEB (BNCBS EBO EBQBU EJKFMBTLBO TFCBHBJ CFSJLVU ,FUJLB
HVHVT QSPTUFUJL IFNF ZBOH NFOHBOEVOH TBUV BUPN CFTJ EBO
CFTJEJBCTPSCTJEBSJVTVTIBMVT CFTJUFSTFCVUTFHFSBCFSHBCVOHEJ
LBSFOB BEBOZB FNQBU SBOUBJ IFNPHMPCJO EJ TFUJBQ NPMFLVM
EBMBN QMBTNB EBSBI EFOHBO CFUB HMPCVMJO ZBLOJ BQPUSBOTGFSJO
IFNPHMPCJO LJUB EBQBU NFOFNVLBO BEBOZB FNQBU BUPN CFTJ
VOUVL NFNCFOUVL USBOTGFSJO ZBOH TFMBOKVUOZB EJBOHLVU EBMBN
EJTFUJBQNPMFLVMIFNPHMPCJOTFUJBQBUPNJOJEBQBUCFSJLBUBO
QMBTNB#FTJJOJCFSJLBUBOTFDBSBMPOHHBSEJEBMBNUSBOTGFSJOEBO
MPOHHBSEFOHBOTBUVNPMFLVMPLTJHFO TFIJOHHBFNQBUNPMFLVM
BLJCBUOZB EBQBUEJMFQBTLBOLFTFUJBQTFMKBSJOHBOEJTFUJBQUFNQBU
PLTJHFO BUBV EFMBQBO BUPN PLTJHFO
EBQBU EJBOHLVU PMFI
EBMBN UVCVI ,FMFCJIBO CFTJ EBMBN EBSBI EJTJNQBO UFSVUBNB EJ
TFUJBQNPMFLVMIFNPHMPCJO
IFQBUPTJUIBUJEBOTFEJLJUEJTFMSFUJLVMPFOEPUFMJBMTVNTVNUVMBOH
5JQF SBOUBJ IFNPHMPCJO QBEB NPMFLVM IFNPHMPCJO
NFOFOUVLBO BGJOJUBT JLBUBO IFNPHMPCJO UFSIBEBQ PLTJHFO
"COPSNBMJUBTSBOUBJJOJEBQBUNFOHVCBIDJSJDJSJGJTJLNPMFLVM
ili in dieksk esi
IFNPHMPCJO $POUPIOZB QBEB BOFNJB TFM TBCJU BTBN BNJOP
WBMJO EJHBOUJLBO PMFI BTBN HMVUBNBU QBEB TBUV UJUJL NBTJOH Fentin Hemosiderin
NBTJOHEJLFEVBSBOUBJCFUB+JLBUJQFIFNPHMPCJOJOJUFSQBQBS
Heme
EFOHBO PLTJHFO CFSLBEBS SFOEBI BLBO UFSCFOUVL LSJTUBM esi
Hemoglo in ang Enzim
QBOKBOH EJ EBMBN TFMTFM EBSBI NFSBI ZBOH QBOKBOHOZB e as Besi bebas
di aikan
LBEBOHLBEBOH NFODBQBJ N )BM JOJ NFNCVBU TFMTFM
UFSTFCVUIBNQJSUJEBLNVOHLJONFMFXBUJLBQJMFSLBQJMFSLFDJM
EBO VKVOH LSJTUBM UFSTFCVU ZBOH UBKBN DFOEFSVOH NFSPCFL
Hemoglobin Transferrin–Fe
NFNCSBOTFM TFIJOHHBUFSKBEJBOFNJBTFMTBCJU
Kombinasi Hemoglobin dengan Oksigen. (BNCBSBO

QBMJOH QFOUJOH EBSJ NPMFLVM IFNPHMPCJO BEBMBI e ilangan da a – Fe++ ang Fe yang dieksresi–0.6
0.7 mg Fe e a i dia so si s s mg per a i
LFNBNQVBOOZB VOUVL EBQBU CFSJLBUBO TFDBSB MPOHHBS EBO ada mens asi al s
SFWFSTJCFM EFOHBO PLTJHFO ,FNBNQVBO JOJ BLBO EJCJDBSBLBO
MFCJIEFUBJMEJ#BCEBMBNLBJUBOOZBEFOHBOQFSOBQBTBO engangk an esi dan me a olismen a
418
Bab 32 Darah Merah,Anemia, dan Polisitemia
%BMBN TJUPQMBTNB TFM CFTJ JOJ CFSHBCVOH UFSVUBNB EFOHBO EJMFQBTLBOLFEBMBNLBQJMFSEBSBIZBOHCFSBEBEJCBXBITFMJOJ

TVBUV QSPUFJO ZBLOJ BQPGFSJUJO VOUVL NFNCFOUVL GFSJUJO EBMBNCFOUVLUSBOTGFSJOQMBTNB
"QPGFSJUJO NFNQVOZBJ CFSBU NPMFLVM LJSBLJSB EBO "CTPSCTJ CFTJ EBSJ VTVT CFSMBOHTVOH TBOHBU MBNCBU EFOHBO
CFSCBHBJ KVNMBI CFTJ EBQBU CFSHBCVOH EBMBN CFOUVL LFMPNQPL LFDFQBUBO NBLTJNVN IBOZB CFCFSBQB NJMJHSBN QFS IBSJ *OJ
SBEJLBM CFTJ EFOHBO NPMFLVM CFTBS JOJ PMFI LBSFOB JUV GFSJUJO CFSBSUJ CBIXB NFTLJQVO EBMBN NBLBOBO UFSEBQBU TFKVNMBI
UNIT VI
NVOHLJO IBOZB NFOHBOEVOH TFEJLJU CFTJ BUBV CBILBO TFKVNMBI CFTBSCFTJ IBOZBTFCBHJBOLFDJMTBKBZBOHEBQBUEJBCTPSCTJ
CFTBS CFTJ #FTJ ZBOH EJTJNQBO TFCBHBJ GFSJUJO JOJ EJTFCVU CFTJ
DBEBOHBO Pengaturan Jumlah Total Besi Tubuh dengan Mengatur
%J UFNQBU QFOZJNQBOBO UFSEBQBU CFTJ ZBOH EJTJNQBO EBMBN Kecepatan Absorbsi. #JMB UVCVI NFOKBEJ KFOVI EFOHBO CFTJ
KVNMBI ZBOH MFCJI TFEJLJU EBO CFSTJGBU TBOHBU UJEBL MBSVU EJTFCVU TFIJOHHB TFMVSVI BQPGFSJUJO EJ UFNQBU DBEBOHBO CFTJ TVEBI
IFNPTJEFSJO )BM JOJ UFSKBEJ CJMB KVNMBI UPUBM CFTJ EBMBN UVCVI UFSJLBU EFOHBO CFTJ LFDFQBUBO BCTPSCTJ CFTJ UBNCBIBO EBSJ
NFMFCJIJKVNMBIZBOHEBQBUEJUBNQVOHPMFIUFNQBUQFOZJNQBOBO USBLUVT JOUFTUJOBMJT BLBO TBOHBU NFOVSVO 4FCBMJLOZB CJMB
BQPGFSJUJO )FNPTJEFSJO NFNCFOUVL LFMPNQPL CFTBS EBMBN TFM DBEBOHBO CFTJ TBOHBU CFSLVSBOH NBLB LFDFQBUBO BCTPSCTJOZB
ZBOH EBQBU EJMJIBU TFDBSB NJLSPTLPQJT TFCBHBJ QBSUJLFM CFTBS BLBO CFSUBNCBI NVOHLJO TBNQBJ MJNB LBMJ BUBV MFCJI
4FCBMJLOZB QBSUJLFM GFSJUJO CFHJUV LFDJM EBO UFSTFCBS TFIJOHHB EJCBOEJOHLBOLFDFQBUBOOPSNBM+BEJ KVNMBIUPUBMCFTJEBMBN
CJBTBOZB IBOZB EBQBU EJMJIBU EFOHBO NFOHHVOBLBO NJLSPTLPQ UVCVI EJBUVS UFSVUBNB EFOHBO NFOHVCBI LFDFQBUBO
FMFLUSPO BCTPSCTJOZB
#JMB KVNMBI CFTJ EBMBN QMBTNB TBOHBU SFOEBI CFCFSBQB CFTJ Masa Hidup Sel Darah Merah Sekitar 120 hari
ZBOH UFSEBQBU EJ UFNQBU QFOZJNQBOBO GFSJUJO EJMFQBTLBO EFOHBO
NVEBIEBOEJBOHLVUEBMBNCFOUVLUSBOTGFSJOEJEBMBNQMBTNBLF ,FUJLB TFM EBSBI NFSBI EJIBOUBSLBO EBSJ TVNTVN UVMBOH
BSFB UVCVI ZBOH NFNCVUVILBO ,BSBLUFSJTUJL VOJL EBSJ NPMFLVM NBTVLLFEBMBNTJTUFNTJSLVMBTJ TFMUFSTFCVUOPSNBMOZBBLBO
USBOTGFSJO BEBMBI CBIXB NPMFLVM JOJ CFSJLBUBO FSBU EFOHBO CFSTJSLVMBTJ SBUBSBUB TFMBNB IBSJ TFCFMVN EJIBODVSLBO
SFTFQUPS QBEB NFNCSBO TFM FSJUSPCMBT EJ TVNTVN UVMBOH 8BMBVQVO TFM EBSBI NFSBI ZBOH NBUBOH UJEBL NFNQVOZBJ
4FMBOKVUOZB CFSTBNB EFOHBO CFTJ ZBOH UFSJLBU USBOTGFSJO NBTVL JOUJ NJUPLPOESJB BUBV SFUJLVMVN FOEPQMBTNB TFM UFSTFCVU
LFEBMBNFSJUSPCMBTEFOHBODBSBFOEPTJUPTJT%JEBMBNFSJUSPCMBT NFNQVOZBJFO[JNFO[JNTJUPQMBTNBZBOHNBNQVNFMBLVLBO
USBOTGFSJO NFMFQBTLBO CFTJ TFDBSB MBOHTVOH LF NJUPLPOESJB NFUBCPMJTNF HMVLPTB EBO NFNCFOUVL TFKVNMBI LFDJM "51
UFNQBUIFNFEJTJOUFTJT1BEBPSBOHPSBOHZBOHUJEBLNFNQVOZBJ &O[JNUFSTFCVUKVHBNBNQV
NFNQFSUBIBOLBOLFMFOUVSBO
USBOTGFSJO EBMBN KVNMBI DVLVQ EJ EBMBN EBSBIOZB LFHBHBMBO NFNCSBO TFM
NFNQFSUBIBOLBO USBOTQPS JPO NFMBMVJ
QFOHBOHLVUBO CFTJ LF FSJUSPCMBT EFOHBO DBSB UFSTFCVU EBQBU NFNCSBO
NFOKBHB CFTJ IFNPHMPCJO TFM BHBS UFUBQ EBMBN
NFOZFCBCLBO BOFNJB IJQPLSPN ZBOH CFSBU ZBLOJ TFM EBSBI CFOUVL GFSP CVLBO EBMBN CFOUVL GFSJ TFSUB
NFODFHBI
NFSBI NFOHBOEVOH MFCJI TFEJLJU IFNPHMPCJO EBSJQBEB TFM ZBOH PLTJEBTJ QSPUFJO EJ EBMBN TFM EBSBI NFSBI .FTLJQVO
OPSNBM EFNJLJBO TJTUFN NFUBCPMJL EBMBN TFM EBSBI NFSBI ZBOH UVB
TFDBSBQSPHSFTJGNBLJOLVSBOHBLUJG EBOTFMNFOKBEJTFNBLJO
#JMB NBTB IJEVQ TFM EBSBI NFSBI ZBOH CFSLJTBS IBSJ UFMBI SBQVI EJEVHBLBSFOBQSPTFTLFIJEVQBOOZBTVEBICBOZBLZBOH
IBCJT EBO TFM UFMBI EJIBODVSLBO NBLB IFNPHMPCJO ZBOH UFSQBLBJ
EJMFQBTLBO EBSJ TFM BLBO EJDFSOB PMFI TFM NBLSPGBH NPOPTJU %J #FHJUV NFNCSBO TFM EBSBI NFOKBEJ SBQVI TFM UFSTFCVU CJTB
TJOJ UFSKBEJ QFMFQBTBO CFTJ CFCBT EBO EJTJNQBO UFSVUBNB EJ SPCFL TFXBLUV NFMFXBUJ UFNQBUUFNQBU ZBOH TFNQJU EJ
UFNQBU QFOZJNQBOBO GFSJUJO ZBOH BLBO EJHVOBLBO TFTVBJ TJSLVMBTJ%JMJNQBBLBOEJKVNQBJCBOZBLTFMEBSBINFSBIZBOH
LFCVUVIBOVOUVLQFNCFOUVLBOIFNPHMPCJOCBSV IBODVS LBSFOBTFMTFMJOJUFSQFSBTTFXBLUVNFMBMVJQVMQBNFSBI
Besi yang Terbuang dalam Sehari. 4FUJBQ IBSJ TFPSBOH MBLJ MJNQB3VBOHBOEJBOUBSBTUSVLUVSUSBCFLVMBQVMQBNFSBI ZBOH
MBLJ NFOHFLTLSFTJLBO TFLJUBS NH CFTJ UFSVUBNB EBMBN UJOKB IBSVT EJMBMVJ PMFI TFCBHJBO CFTBS TFM MFCBSOZB IBOZB N
#JMBUFSKBEJQFSEBSBIBO NBLBKVNMBICFTJZBOHIJMBOHBLBOMFCJI EJCBOEJOHLBOEFOHBOTFMEBSBINFSBIZBOHCFSEJBNFUFSN
CBOZBL MBHJ 1BEB XBOJUB IJMBOHOZB EBSBI NFOTUSVBTJ CJMB MJNQB EJBOHLBU KVNMBI TFM EBSBI NFSBI BCOPSNBM
NFOHBLJCBULBO LFIJMBOHBO CFTJ KBOHLB QBOKBOH SBUBSBUB TFLJUBS CFSVNVSUVBZBOHCFSFEBSEBMBNEBSBIBLBONFOJOHLBUTFDBSB
NHIBSJ CFSNBLOB
Absorbsi Besi dan Traktus Intestinal Penghancuran Hemoglobin. )FNPHMPCJO ZBOH
#FTJ EJBCTPSCTJ EBSJ TFNVB CBHJBO VTVT IBMVT TFCBHJBO CFTBS EJMFQBTLBOEBSJTFMTFXBLUVTFMEBSBINFSBIQFDBI BLBOTFHFSB
NFMBMVJNFLBOJTNFCFSJLVU)BUJNFOZFLSFTJBQPUSBOTGFSJOEBMBN EJGBHPTJUPMFITFMTFMNBLSPGBHEJCBOZBLCBHJBOUVCVI OBNVO
KVNMBI TFEBOH LF EBMBN FNQFEV ZBOH NFOHBMJS NFMBMVJ EVLUVT UFSVUBNB PMFI TFMTFM ,VQGGFS IBUJ NBLSPGBH MJNQB EBO
CJMJBSJT LF EBMBN EVPEFOVN %J UFNQBU JOJ BQPUSBOTGFSJO NBLSPGBHTVNTVNUVMBOH4FMBNBCFCFSBQBKBNBUBVCFCFSBQB
CFSJLBUBO EFOHBO CFTJ CFCBT EBO KVHB EFOHBO TFOZBXB CFTJ IBSJTFTVEBIOZB NBLSPGBHBLBONFMFQBTLBOCFTJZBOHEJEBQBU
UFSUFOUVTFQFSUJIFNPHMPCJOEBONJPHMPCJOEBSJEBHJOH ZBJUVEVB EBSJ IFNPHMPCJO EBO NFOHIBOUBSLBOOZB LFNCBMJ LF EBMBN
TVNCFS CFTJ UFSQFOUJOH EBMBN EJFU ,PNCJOBTJ JOJ EJTFCVU EBSBI EBO EJBOHLVU PMFI USBOTGFSJO LF TVNTVN UVMBOH VOUVL
USBOTGFSJO ,PNCJOBTJ JOJ TFMBOKVUOZB UFSUBSJL EBO CFSJLBUBO NFNCFOUVL TFM EBSBI NFSBI CBSV BUBV LF IBUJ EBO KBSJOHBO
EFOHBOSFTFQUPSQBEBNFNCSBOTFMFQJUFMVTVT,FNVEJBO EFOHBO MBJOOZB VOUVL EJTJNQBO EBMBN CFOUVL GFSJUJO #BHJBO QPSGJSJO
DBSB QJOPTJUPTJT NPMFLVM USBOTGFSJO ZBOH NFNCBXB CFTJ EBSJ NPMFLVM IFNPHMPCJO EJVCBI PMFI NBLSPGBH NFMBMVJ
CFSTBNBOZB BLBOEJBCTPSCTJLFEBMBNTFMFQJUFMEBOLFNVEJBOEJ TFSBOHLBJBOUBIBQNFOKBEJQJHNFOFNQFEVCJMJSVCJO ZBOHEJ
419
MFQBTLBOLFEBMBNEBSBIEBOLFNVEJBOEJLFMVBSLBOEBSJUVCVI CFSCFOUVL BOFI EBO NFNCSBOOZB SBQVI 4FMTFM JOJ NVEBI

PMFITFLSFTJNFMBMVJIBUJLFEBMBNDBJSBOFNQFEVIBMJOJBLBO QFDBI TFIJOHHB PSBOH UFSTFCVU TBOHBU NFNCVUVILBO TFM EBSBI
EJCJDBSBLBOTFIVCVOHBOEFOHBOGVOHTJIBUJEJ#BC NFSBIEBMBNKVNMBIZBOHNFNBEBJ
Anemia Hemolitik. #FSCBHBJ LFMBJOBO TFM EBSBI NFSBI
Anemia LFCBOZBLBO EJEBQBU TFDBSB LFUVSVOBO 4FMTFM UFSTFCVU CFSTJGBU
SBQVI TFIJOHHB NVEBI QFDBI XBLUV NFMFXBUJ LBQJMFS UFSVUBNB
"OFNJB CFSBSUJ LVSBOHOZB IFNPHMPCJO EJ EBMBN EBSBI ZBOH XBLUVNFMBMVJMJNQB8BMBVQVOTFMEBSBINFSBIZBOHUFSCFOUVL
EBQBU EJTFCBCLBO PMFI KVNMBI TFM EBSBI NFSBI ZBOH UFSMBMV KVNMBIOZBEBQBUNFODBQBJOPSNBM BUBVCBILBOMFCJICFTBSEBSJ
TFEJLJUBUBVKVNMBIIFNPHMPCJOEBMBNTFMZBOHUFSMBMVTFEJLJU OPSNBM QBEB QFOZBLJUQFOZBLJU IFNPMJUJL NBTB IJEVQ TFM EBSBI
#FCFSBQB UJQF BOFNJB EBO QFOZFCBC GJTJPMPHJTOZB BEBMBI NFSBIJOJTBOHBUTJOHLBUTFIJOHHBTFMJOJEJIBODVSLBOMFCJIDFQBU
TFCBHBJCFSJLVU EJCBOEJOH QFNCFOUVLBOOZB EBO NFOHBLJCBULBO BOFNJB ZBOH
Anemia Akibat Kehilangan Darah 4FUFMBI NFOHBMBNJ QBSBI
QFSEBSBIBO ZBOH DFQBU UVCVI BLBO NFOHHBOUJ DBJSBO QMBTNB 1BEB TGFSPTJUPTJT IFSFEJUFS TFM EBSBI NFSBI CFSVLVSBO TBOHBU
EBMBN XBLUV TBNQBJ IBSJ OBNVO IBM JOJ BLBO LFDJM EBO CFSCFOUVL TGFSJT EBO UJEBL CFSCFOUVL MFNQFOH
NFOZFCBCLBO LPOTFOUSBTJ TFM EBSBI NFSBI NFOKBEJ SFOEBI CJLPOLBG 4FMTFM JOJ UJEBL EBQBU CFSUBIBO UFSIBEBQ QFOFLBOBO
#JMBUJEBLUFSKBEJQFSEBSBIBOCFSJLVUOZB LPOTFOUSBTJTFMEBSBI LBSFOBUJEBLNFNQVOZBJTUSVLUVSNFNCSBOTFMDBLSBNCJLPOLBG
NFSBI CJBTBOZB LFNCBMJ OPSNBM EBMBN XBLUV TBNQBJ TFQFSUJ LBOUPOH ZBOH MFOUVS ,FUJLB NFMFXBUJ QVMQB MJNQB EBO
NJOHHV QFNCVMVI EBSBI TFNQJU MBJOOZB TFMTFM JOJ NVEBI QFDBI
1BEBLFIJMBOHBOEBSBIZBOHLSPOJT QBTJFOTFSJOHLBMJUJEBL XBMBVQVOIBOZBEFOHBOTFEJLJUUFLBOBO
EBQBU NFOHBCTPSCTJ DVLVQ CFTJ EBSJ VTVT VOUVL NFNCFOUVL 1BEB BOFNJB TFM TBCJU ZBOH EJUFNVLBO QBEB TBNQBJ
IFNPHMPCJOTFDFQBUEBSBIZBOHIJMBOH4FMEBSBINFSBIZBOH QFSTFOPSBOHPSBOHIJUBNEJ"GSJLB#BSBUEBO"NFSJLB TFMEBSBI
ZBOH EJCFOUVL CFSVLVSBO KBVI MFCJI LFDJM LFUJNCBOH VLVSBO NFSBI NFOHBOEVOH UJQF IFNPHMPCJO BCOPSNBM ZBOH EJTFCVU
ZBOH OPSNBM EBO NFOHBOEVOH TFEJLJU TFLBMJ IFNPHMPCJO EJ IFNPHMPCJO 4 ZBOH NFNJMJLJ LFMBJOBO SBOUBJ CFUB QBEB NPMFLVM
EBMBNOZB TFIJOHHB NFOJNCVMLBO LFBEBBO BOFNJB IFNPHMPCJO TFQFSUJ ZBOH UFMBI EJKFMBTLBO TFCFMVNOZB #JMB
IJQPLSPNJLNJLSPTJUJL TFQFSUJZBOHUFSMJIBUQBEB(BNCBS IFNPHMPCJO JOJ UFSQBQBS EFOHBO PLTJHFO LBEBS SFOEBI JB BLBO
Anemia Aptastik. "QMBTJB TVNTVN UVMBOH CFSBSUJ UJEBL NFOHFOEBQ NFOKBEJ LSJTUBMLSJTUBM QBOKBOH EJ EBMBN TFM EBSBI
CFSGVOHTJOZBTVNTVNUVMBOH4FCBHBJDPOUPI TFTFPSBOHZBOH NFSBI ,SJTUBMLSJTUBM JOJ BLBO NFNQFSQBOKBOH TFM EBO MFCJI
UFSQBQBSPMFIEPTJTSBEJBTJUJOHHJBUBVLFNPUFSBQJUFSBQJVOUVL NFNCFSJ HBNCBSBO TFQFSUJ CVMBO TBCJU EBO CVLBO NFOZFSVQBJ
QFOZBLJU LBOLFS EBQBU NFSVTBL TFMTFM QVODB TUFN DFMM
DBLSBN CJLPOLBG )FNPHMPCJO ZBOH NFOHFOEBQ KVHB NFSVTBL
TVNTVN UVMBOH ZBOH EBMBN CFCFSBQB NJOHHV CFSJLVUOZB NFNCSBO TFM TFIJOHHB TFM NFOKBEJ TBOHBU SBQVI EBO
NFOKBEJ BOFNJB %FNJLJBO KVHB EPTJT UJOHHJ CBIBO LJNJB NFOZFCBCLBOBOFNJBZBOHQBSBI1BTJFOJOJTFSJOHNBTVLEBMBN
CFSBDVO UFSUFOUV TFQFSUJ JOTFLUJTJEB BUBV CFO[FOB EBMBN TVBUV MJOHLBSBO TFUBO ZBOH EJTFCVU TFCBHBJ LSJTJT QFOZBLJU TFM
CFOTJO EBQBU NFOZFCBCLBO FGFL ZBOH TBNB 1BEB HBOHHVBO TBCJU ZBJUV UFLBOBO PLTJHFO ZBOH SFOEBI EBMBN KBSJOHBO BLBO
BVUPJNVO NJTBMOZB MVQVT FSJUFNBUPTVT TJTUFN JNVO NVMBJ NFOHIBTJMLBO CFOUVL TBCJU ZBOH NFOZFCBCLBO QFDBIOZB TFM
NFOZFSBOH TFMTFM OPSNBM TFQFSUJ TFM QVODB TVNTVN UVMBOH EBSBI NFSBI )BM JOJ LFNVEJBO NFOJNCVMLBO QFOVSVOBO
ZBOH EBQBU NFOJNCVMLBO BOFNJB BQMBTUJL 1BEB LJSBLJSB UFLBOBO PLTJHFO MFCJI MBOKVU EBO CFOUVL TFM ZBOH NBLJO
TFQBSVI LBTVTLBTVT BOFNJB BQMBTUJL EJTFCVU BOFNJB BQMBTUJL NFOZFSVQBJTBCJUTFSUBIBODVSOZBTFMEBSBINFSBI#FHJUVQSPTFT
JEJPQBUJLLBSFOBQFOZFCBCOZBUJEBLEJLFUBIVJ JOJ EJNVMBJ LFBEBBO UFSTFCVU BLBO CFSLFNCBOH EFOHBO DFQBU
1FOEFSJUBBOFNJBBQMBTUJLCFSBUCJBTBOZBNFOJOHHBMLFDVBMJ ZBOHCFSBLIJSEFOHBOQFOHVSBOHBOKVNMBITFMEBSBINFSBIZBOH
EJUFSBQJ EFOHBO USBOTGVTJ EBSBI ZBOH EBQBU NFOJOHLBULBO ESBTUJT EBMBN XBLUV CFCFSBQB KBN EBO QBEB CFCFSBQB KBN EBO
KVNMBI TFM EBSBI NFSBI TFNFOUBSB BUBV EJUFSBQJ EFOHBO QBEBCFCFSBQBLBTVTCFSBLIJSEFOHBOLFNBUJBO
USBOTQMBOUBTJTVNTVNUVMBOH 1BEB FSJUSPCMBTUPTJT GFUBMJT TFMTFM EBSBI NFSBI EFOHBO 3I
QPTJUJG QBEB KBOJO EJTFSBOH PMFI BOUJCPEJ EBSJ EBSBI JCV EFOHBO
Anemia Megaloblastik. #FSEBTBSLBO QFNCJDBSBBO 3IOFHBUJG "OUJCPEJ JOJ NFOZFCBCLBO TFM EFOHBO 3IQPTJUJG
UFSEBIVMV NFOHFOBJ WJUBNJO # BTBN GPMBU EBO GBLUPS NFOKBEJ SBQVI ZBOH EFOHBO DFQBU NFOJNCVMLBO QFDBIOZB TFM
JOUSJOTJL ZBOH CFSBTBM EBSJ NVLPTB MBNCVOH LJUB EBQBU EBO NFOZFCBCLBO BOBL EJMBIJSLBO EFOHBO BOFNJB ZBOH CFSBU
NFOHFSUJEFOHBONVEBICBIXBIJMBOHOZBTBMBITBUVGBLUPSJOJ )BM JOJ EJCJDBSBLBO EJ #BC TFIVCVOHBO EFOHBO GBLUPS 3I
EBQBU NFNQFSMBNCBU QSPEVLTJ FSJUSPCMBT EBMBN TVNTVN EBMBN EBSBI 1FNCFOUVLBO TFM EBSBI NFSBI CBSV ZBOH TBOHBU
UVMBOH "LJCBUOZB TFM EBSBI NFSBI UVNCVI UFSMBMV CFTBS DFQBU VOUVL NFOHHBOUJLBO TFMTFM EBSBI ZBOH SVTBL QBEB
EFOHBOCFOUVLZBOHBOFI EBOEJTFCVUNFHBMPCMBT+BEJ BUSPGJ FSJUSPCMBTUPTJTGFUBMJT NFOZFCBCLBOEJMFQBTLBOOZBTFMCMBTEBMBN
NVLPTBMBNCVOH TFQFSUJZBOHUFSKBEJQBEBBOFNJBQFSOJTJPTB KVNMBIZBOHCFTBSEBSJTVNTVNUVMBOHLFEBMBNEBSBI
BUBV IJMBOHOZB MBNCVOH TFUFMBI PQFSBTJ HBTUSFLUPNJ UPUBM
EBQBU NFOZFCBCLBO UFSKBEJOZB BOFNJB NFHBMPCMBTUJL 4FMBJO Pengaruh Anemia terhadap Fungsi Sistem Sirkulasi
JUV QBTJFO TFSJBXBO VTVT JOUFTUJOBM TQSVF
ZBOH EJUBOEBJ 7JTLPTJUBTEBSBI ZBOHTVEBIEJCJDBSBLBOEJ#BC CFSHBOUVOH
EFOHBO TFEJLJUOZB BCTPSQTJ BTBN GPMBU # EBO TFOZBXB UFSVUBNB QBEB LPOTFOUSBTJ TFM EBSBI NFSBI 1BEB BOFNJB CFSBU
WJUBNJO # MBJOOZB TFSJOH LBMJ NFOHBMBNJ BOFNJB WJTLPTJUBT EBSBI EBQBU UVSVO IJOHHB LBMJ WJTLPTJUBT BJS
NFHBMPCMBTUJL1BEBLFBEBBOJOJ LBSFOBFSJUSPCMBTUJEBLEBQBU QBEBIBM OPSNBMOZB LJSBLJSB LBMJ WJTLPTJUBT BJS ,FBEBBO JOJ
CFSQSPMJGFSBTJDVLVQDFQBUVOUVLNFNCFOUVLTFMEBSBINFSBI BLBO NFOHVSBOHJ UBIBOBO UFSIBEBQ BMJSBO EBSBI EBMBN
KVNMBIOPSNBM TFMTFMZBOHUFSCFOUVLNFOKBEJUFSMBMVCFTBS QFNCVMVIEBSBIQFSJGFS TFIJOHHBKVNMBIEBSBIZBOHNFOHBMJS
420
Bab 32 Darah Merah,Anemia, dan Polisitemia
NFMBMVJKBSJOHBOEBOLFNVEJBOLFNCBMJLFKBOUVOHKBVINFMFCJIJ LBEBOHLBEBOH TBNQBJ EVB LBMJ OPSNBM "LJCBUOZB TFMVSVI

OPSNBM )BM UFSTFCVU BLBO TBOHBU NFOJOHLBULBO DVSBI KBOUVOH TJTUFN QFNCVMVI EBSBI NFOKBEJ TBOHBU NFNCFTBS 4FMBJO JUV
4FMBJO JUV IJQPLTJB ZBOH UFSKBEJ BLJCBU QFOVSVOBO USBOTQPS CBOZBL LBQJMFS EBSBI NFOKBEJ UFSTVNCBU PMFI EBSBI ZBOH
PLTJHFOPMFIEBSBIBLBONFOZFCBCLBOQFNCVMVIEBSBIKBSJOHBO LFOUBM WJTLPTJUBT EBSBI QBEB QPMJTJUFNJB WFSB LBEBOHLBEBOH
QFSJGFS CFSEJMBUBTJ ZBOH TFMBOKVUOZB NFOJOHLBULBO KVNMBI EBSBI NFOJOHLBUEBSJLBMJWJTLPTJUBTBJSNFOKBEJLBMJWJTLPTJUBT
UNIT VI
ZBOHLFNCBMJLFKBOUVOHEBONFOJOHLBULBODVSBIKBOUVOHTBNQBJ BJS
OJMBJZBOHMFCJIUJOHHJLBEBOHLBEBOHUJHBTBNQBJFNQBULBMJOJMBJ
OPSNBM +BEJ TBMBI TBUV FGFL VUBNB EBSJ BOFNJB BEBMBI Pengaruh Polisitemia terhadap Fungsi
QFOJOHLBUBO DVSBI KBOUVOH EBO QFOJOHLBUBO CFCBO LFSKB Sistem Sirkulasi
QFNPNQBBOKBOUVOH 0MFI LBSFOB WJTLPTJUBT EBSBI TBOHBU NFOJOHLBU QBEB
1FOJOHLBUBO DVSBI KBOUVOH QBEB BOFNJB TFDBSB QBSTJBM QPMJTJUFNJB BMJSBOEBSBIZBOHNFMBMVJQFNCVMVIEBSBIQFOJGFS
NFOHJNCBOHJ FGFLFGFL QFOHVSBOHBO IBOUBSBO PLTJHFO BLJCBU TFSJOHLBMJNFOKBEJTBOHBUMBNCBU4FTVBJEFOHBOGBLUPSGBLUPS
BOFNJB LBSFOB XBMBVQVO UJBQ VOJU KVNMBI EBSBI IBOZB ZBOH NFOHBUVS QFOHFNCBMJBO EBSBI LF KBOUVOH TFQFSUJ ZBOH
NFOHBOHLVU TFKVNMBI LFDJM PLTJHFO OBNVO LFDFQBUBO BMJSBO EJCJDBSBLBO EJ #BC LFOBJLBO WJTLPTJUBT NFOVSVOLBO
EBSBI EBQBU DVLVQ NFOJOHLBU TFIJOHHB KVNMBI PLTJHFO ZBOH LFDFQBUBO BMJSBO CBMJL WFOB LF KBOUVOH 4FCBMJLOZB QBEB
EJBMJSLBO LF KBSJOHBO TFCFOBSOZB IBNQJS NFOEFLBUJ OPSNBM QPMJTJUFNJB WPMVNF EBSBI TBOHBU NFOJOHLBU ZBOH DFOEFSVOH
/BNVO CJMB QBTJFO BOFNJB NVMBJ CFSPMBISBHB KBOUVOH UJEBL NFOBNCBI BMJSBO CBMJL WFOB +BEJ TFTVOHHVIOZB DVSBI
NBNQV NFNPNQB KVNMBI EBSBI MFCJI CBOZBL EBSJQBEB KVNMBI KBOUVOH QBEB QPMJTJUFNJB UJEBL KBVI EBSJ OJMBJ OPSNBM TFCBC
ZBOH EJQPNQB TFCFMVNOZB "LJCBUOZB TFMBNB CFSPMBISBHB TBBU LFEVBGBLUPSUFSTFCVULVSBOHMFCJIBLBOTBMJOHNFOFUSBMLBO
UFSKBEJ QFOJOHLBUBO LFCVUVIBO KBSJOHBO BLBO PLTJHFO EBQBU
1BEBTFCBHJBOCFTBSQBTJFOQPMJTJUFNJB UFLBOBOBSUFSJOZB
UJNCVM IJQPLTJB KBSJOHBO ZBOH TFSJVT EBO EBQBU UFSKBEJ HBHBM
KVHB OPSNBM XBMBVQVO TFLJUBS TFQFSUJHB EBSJ QBTJFO
KBOUVOHBLVU
QPMJTJUFNJBUFSTFCVUNFOHBMBNJQFOJOHLBUBOUFLBOBOBSUFSJ JOJ
CFSBSUJCBIXBNFLBOJTNFQFOHBUVSBOUFLBOBOEBSBICJBTBOZB
Polisitemia EBQBUNFOHJNCBOHJLFDFOEFSVOHBOLFOBJLBOWJTLPTJUBTEBSBI
VOUVLNFOBJLLBOUBIBOBOQFSJGFSZBOHEFOHBOEFNJLJBO BLBO
Polisitemia Sekunder ,BQBO QVO KBSJOHBO NFOHBMBNJ NFOJOHLBULBO UFLBOBO BSUFSJ "LBO UFUBQJ EJ BUBT CBUBT OJMBJ
IJQPLTJB BLJCBU UFSMBMV TFEJLJUOZB PLTJHFO EJ EBMBN VEBSB ZBOH UFSUFOUV QFOHBUVSBO JOJ EBQBU HBHBM EBO UJNCVM IJQFSUFOTJ
EJIJSVQ NJTBMOZB EJ UFNQBU ZBOH UJOHHJ BUBV BLJCBU HBHBMOZB
QFOHJSJNBOPLTJHFOLFKBSJOHBO TFQFSUJQBEBHBHBMKBOUVOH NBLB 8BSOB LVMJU CFSHBOUVOH QBEB CFTBSOZB KVNMBI EBSBI EJ
PSHBOPSHBO QFNCFOUVL EBSBI TFDBSB PUPNBUJT BLBO QMFLTVTWFOBTVCQBQJMBSJTLVMJU1BEBQPMJTJUFNJBWFSB KVNMBI
NFNQSPEVLTJTFKVNMBICFTBSTFMEBSBINFSBIUBNCBIBO,FBEBBO EBSBIEBMBNQMFLTVTJOJTBOHBUNFOJOHLBU4FMBOKVUOZB LBSFOB
JOJ EJTFCVU QPMJTJUFNJB TFLVOEFS EBO KVNMBI TFM EBSBI NFSBI BMJSBOEBSBIZBOHNFMBMVJLBQJMFSLVMJUCFSKBMBOTBOHBUMBNCBU
VNVNOZBBLBOOBJLIJOHHBTBNQBJKVUBNN BUBVTFLJUBS TFCFMVN NFNBTVLJ QMFLTVT WFOB NBLB TFKVNMBI IFNPHMPCJO
QFSTFOEJBUBTOJMBJOPSNBM ZBOH NFMFCJIJ OPSNBM BLBO NFOHBMBNJ EFPLTJHFOBTJ 8BSOB
+FOJT QPMJTJUFNJB TFLVOEFS ZBOH VNVN EJTFCVU QPMJTJUFNJB CJSVEBSJTFNVBIFNPHMPCJOZBOHNFOHBMBNJEFPLTJHFOBTJJOJ
GJTJPMPHJT UFSKBEJQBEBQFOEVEVLZBOHIJEVQEJLFUJOHHJBO BLBO NFOVUVQJ XBSOB NFSBI IFNPHMPCJO ZBOH NFOHBMBNJ
TBNQBJ LBLJ EFOHBO LBEBS PLTJHFO BUNPTGFS ZBOH TBOHBU PLTJHFOBTJ +BEJ QBTJFO EFOHBO QPMJTJUFNJB WFSB CJBTBOZB
SFOEBI +VNMBI TFM EBSBI VNVNOZB TBNQBJ KVUBNN IBM NFNJMJLJ XBKBI CFSXBSOB OPSNBM LFNFSBIBO EFOHBO LVMJU
UFSTFCVU DVLVQ NFNVOHLJOLBO PSBOHPSBOH JOJ VOUVL EBQBU CFSXBSOBLFCJSVCJSVBO TJBOPTJT

NFMBLVLBOLFSKBCFSBUZBOHUFSVTNFOFSVTCBILBOQBEBBUNPTGFS
ZBOHUJQJT Daftar Pustaka
Alayash AI: Oxygen therapeutics: can we tame haemoglobin? Nat Rev Drug
Polisitemia Vera (Eritremia). 4FMBJO QPMJTJUFNJB GJTJPMPHJT Discov 3:152, 2004.
BEB TVBUV LFBEBBO MBJO ZBOH QBUPMPHJT EBO EJTFCVU QPMJTJUFNJB Alleyne M, Horne MK, Miller JL: Individualized treatment for iron-deficiency
WFSB EFOHBO KVNMBI TFM EBSBI NFSBI ZBOH EBQBU NFODBQBJ anemia in adults, Am J Med 121:943, 2008.
TBNQBJ KVUBNN EBO IFNBUPLSJU ZBOH EBQBU NFODBQBJ Claster S, Vichinsky EP: Managing sickle cell disease, BMJ 327:1151, 2003. de
Montalembert M: Management of sickle cell disease, BMJ. 337:a1397,
TBNQBJQFSTFONFMFCJIJOJMBJOPSNBMOZBTFCFTBSTBNQBJ
2008.
QFSTFO1PMJTJUFNJBWFSBEJTFCBCLBOPMFIQFOZJNQBOHBOHFOZBOH Elliott S, Pham E, Macdougall IC: Erythropoietins: a common mechanism of
UFSKBEJ EJ TFM IFNPTJUPCMBTUJL ZBOH NFNQSPEVLTJ TFMTFM EBSBI action, Exp Hematol 36:1573, 2008.
4FMTFM CMBT UJEBL CFSIFOUJ NFOHIBTJMLBO TFM EBSBI NFSBI Fandrey J: Oxygen-dependent and tissue-specific regulation of erythropoietin
XBMBVQVOUFMBIUFSEBQBUTFKVNMBICFTBSTFM)BMJOJNFOZFCBCLBO gene expression, Am J Physiol Regul Integr Comp Physiol 286:R977, 2004.
Hentze MW, Muckenthaler MU, Andrews NC: Balancing acts: molecular
QSPEVLTJ TFM EBSBI NFSBI NFOKBEJ CFSMFCJIBO TFQFSUJ IBMOZB
control of mammalian iron metabolism, Cell 117:285, 2004.
ZBOH UFSKBEJ QBEB UVNPS QBZVEBSB ZBOH NFOZFCBCLBO Kato GJ, Gladwin MT: Evolution of novel small-molecule therapeutics tar-
UFSCFOUVLOZBTFMQBZVEBSBZBOHTQFTJGJLTFDBSBCFSMFCJIBO)BMJOJ geting sickle cell vasculopathy, JAMA 300:2638, 2008.
CJBTBOZB NFOZFCBCLBO QSPEVLTJ TFM EBSBI QVUJI EBO USPNCPTJU Lappin T: The cellular biology of erythropoietin receptors, Oncologist
NFOKBEJCFSMFCJIBOQVMB 8(Suppl 1):15, 2003.
Maxwell P: HIF-1: an oxygen response system with special relevance to the
1BEB QPMJTJUFNJB WFSB CVLBO IBOZB IFNBUPLSJU TBKB ZBOH kidney, J Am Soc Nephrol 14:2712, 2003.
NFOJOHLBUNFMBJOLBOWPMVNFUPUBMEBSBIKVHBNFOJOHLBU Metcalf D: Hematopoietic cytokines, Blood 111:485, 2008.
421
Unit VI Sel-Set Darah, lmunitas, dan Pembekuan Darah
Nangaku M, Eckardt KU: Hypoxia and the HIF system in kidney disease, Pietrangelo A: Hereditary hemochromatosis—a new look at an old disease,
J Mol Med 85:1325, 2007. N Engl J Med 350:2383, 2004.
Percy MJ, Rumi E: Genetic origins and clinical phenotype of familial and Platt OS: Hydroxyurea for the treatment of sickle cell anemia, N Engl J Med
acquired erythrocytosis and thrombocytosis, Am J Hematol 84:46, 2009. 27;358:1362, 2008.
422
BAB 33
1FSUBIBOBO5VCVIUFSIBEBQ*OGFLTJ*-FVLPTJU
UNIT VI
(SBOVMPTJU 4JTUFN.POPTJU.BLSPGBH EBO
*OGMBNBTJ
5VCVILJUBTFQBOKBOHXBLUV 4JGBU4JGBU6NVN-FVLPTJU
UFSQBQBS EFOHBO CBLUFSJ KFOJTKFOJT 4FM %BSBI 1VUJI "EB FOBN NBDBN TFM EBSBI
WJSVT KBNVS EBO QBSBTJU QVUJIZBOHCJBTBEJUFNVLBOEBMBNEBSBI,FFOBNTFMUFSTFCVU
TFNVBOZB UFSKBEJ TFDBSB BEBMBI OFVUSPGJM QPMJNPSGPOVLMFBS FPTJOPGJM QPMJNPSGPOVLMFBS
OPSNBM EBO EBMBN CFSCBHBJ CBTPGJM QPMJNPSGPSOVLMFBS NPOPTJU MJNGPTJU EBO LBEBOH TFM
UJOHLBUBOQBEBLVMJU NVMVU QMBTNB 4FMBJO JUV UFSEBQBU TFKVNMBI CFTBS USPNCPTJU ZBOH
KBMBOOBQBT TBMVSBODFSOB NFSVQBLBOQFDBIBOEBSJTFMKFOJTMBJOZBOHTFSVQBEFOHBOTFM
NFNCSBO ZBOH NFMBQJTJ NBUB EBO CBILBO TBMVSBO LFNJI EBSBI QVUJI ZBOH EJKVNQBJ EBMBN TVNTVN UVMBOH ZBJUV
#BOZBL EBSJ BHFO JOGFLTJVT JOJ NBNQV NFOZFCBCLBO LFMBJOBO NFHBLBSJPTJU ,FUJHB UJQF QFSUBNB TFMTFM JOJ ZBJUV TFMTFM
GVOHTJ GJTJPMPHJT ZBOH TFSJVT BUBV CBILBO LFNBUJBO CJMB BHFO QPMJNPSGPOVLMFBS TFMVSVIOZBNFNQVOZBJHBNCBSBOHSBOVMBS
JOGFLTJVT UFSTFCVU NBTVL LF KBSJOHBO ZBOH MFCJI EBMBN 4FMBJO TFQFSUJ ZBOH UFSMJIBU QBEB TFM OPNPS EBO QBEB
JUV TFDBSB JOUFSNJUFO LJUB UFSQBQBS EFOHBO CBLUFSJ EBO WJSVT (BNCBS EBO LBSFOB BMBTBO JUV TFMTFM UFSTFCVU EJTFCVU
ZBOH TBOHBU JOGFLTJVT EJ TBNQJOH CFOUVLCFOUVL ZBOH NFNBOH HSBOVMPTJU BUBVEBMBNUFSNJOPMPHJLMJOJTEJTFCVUQPMJ LBSFOB
EJKVNQBJ EBMBN LFBEBBO OPSNBM CBLUFSJ BUBV WJSVT JOJ EBQBU JOUJOZBZBOHNVMUJQFM
NFOZFCBCLBO QFOZBLJU BLVU ZBOH NFNBUJLBO NJTBMOZB (SBOVMPTJU EBO NPOPTJU NFMJOEVOHJ UVCVI UFSIBEBQ
QOFVNPOJB JOGFLTJTUSFQUPLPLVT EBOEFNBNUJGPJE PSHBOJTNF QFOZFSBOH UFSVUBNB EFOHBO DBSB NFNBLBOOZB
5VCVI LJUB NFNQVOZBJ TVBUV TJTUFN LIVTVT VOUVL NFMBXBO NJTBMOZB NFMBMVJ GBHPTJUPTJT
'VOHTJ MJNGPTJU EBO TFMTFM
CFSNBDBNNBDBN BHFO ZBOH JOGFLTJVT EBO UPLTJL 4JTUFN JOJ QMBTNB UFSVUBNB CFSIVCVOHBO EFOHBO TJTUFN JNVO IBM JOJ
UFSEJSJ BUBT MFVLPTJU EBSBI TFM EBSBI QVUJI
EBO TFMTFM KBSJOHBO EJCJDBSBLBO EJ #BC "LIJSOZB GVOHTJ USPNCPTJU UFSVUBNB
ZBOH CFSBTBM EBSJ MFVLPTJU 4FMTFM JOJ CFLFSKB CFSTBNBTBNB NFOHBLUJGLBONFLBOJTNFQFNCFLVBOEBSBI ZBOHEJCJDBSBLBO
NFMBMVJ EVB DBSB VOUVL NFODFHBI QFOZBLJU
EFOHBO CFOBS EJ#BC
CFOBS NFSVTBL CBLUFSJ BUBV WJSVT ZBOH NFOHJOWBTJ NFMBMVJ
GBHPTJUPTJT TFSUB
EFOHBO NFNCFOUVL BOUJCPEJ EBO MJNGPTJU ,POTFOUSBTJ#FSCBHBJ.BDBN4FM%BSBI1VUJIEBMBN
ZBOH UFSTFOTJUJTBTJ ZBOH EBQBU NFOHIBODVSLBO BUBV NFNCVBU %BSBI .BOVTJB EFXBTB NFNQVOZBJ TFLJUBS TFM EBSBI
BHFO NFOKBEJ UJEBL BLUJG #BC JOJ CFSIVCVOHBO EFOHBO NFUPEF QVUJI QFS NJLSPMJUFS EBSBI EJCBOEJOHLBO EFOHBO TFM EBSBI
ZBOH QFSUBNB EBO #BC CFSIVCVOHBO EFOHBO NFUPEF ZBOH NFSBI ZBOH CFSKVNMBI KVUB
1FSTFOUBTF OPSNBM CFSCBHBJ
LFEVB KFOJTTFMEBSBIQVUJIEBOKVNMBIUPUBMTFMEBSBIQVUJILJSBLJSB
TFCBHBJCFSJLVU
Sel Darah Putih (Leukosit)
Neutrofil polimorfonuklear 62.0%
-FVLPTJU EJTFCVU KVHB TFM EBSBI QVUJI NFSVQBLBO VOJU TJTUFN Eosinofil polimorfonuklear 2.3%
QFSUBIBOBO UVCVI ZBOH NPCJM -FVLPTJU TFCBHJBO EJCFOUVL EJ Basofil polimorfonuklear 0.4%
TVNTVNUVMBOH HSBOVMPTJUEBONPOPTJUTFSUBTFEJLJUMJNGPTJU
EBO Monosit 5.3%
Limfosit 30.0%
TFCBHJBO MBHJ EJ KBSJOHBO MJNGF MJNGPTJU EBO TFMTFM QMBTNB

4FUFMBI EJCFOUVL TFMTFM JOJ EJBOHLVU EBMBN EBSBI NFOVKV LF
CFSCBHBJCBHJBOUVCVIZBOHNFNCVUVILBOOZB 5SPNCPTJU ZBOH IBOZB NFSVQBLBO GSBHNFOGSBHNFO TFM
.BOGBBUTFMEBSBIQVUJIZBOHTFTVOHHVIOZBJBMBITFCBHJBOCFTBS EBMBN LFBEBBO OPSNBM KVNMBIOZB LJSBLJSB QFS
EJBOHLVUTFDBSBLIVTVTLFEBFSBIZBOHUFSJOGFLTJEBONFOHBMBNJ NJLSPMJUFSEBSBI
QFSBEBOHBO TFSJVT EFOHBO EFNJLJBO NFOZFEJBLBO QFSUBIBOBO
Pembentukan Leukosit
ZBOH DFQBU EBO LVBU UFSIBEBQ BHFOBHFO JOGFLTJVT 4FQFSUJ ZBOH
LJUBMJIBUOBOUJ HSBOVMPTJUEBONPOPTJUNFNQVOZBJLFNBNQVBO %JGFSFOTJBTJ EJOJ TFM QVODB IFNPQPJFUJL QMVSJQPUFO NFOKBEJ
LIVTVT VOUVL NFODBSJ EBO NFSVTBL TFUJBQ CFOEB BTJOH ZBOH CFSCBHBJUJQFDPNNJUUFETUFNDFMMEJQFSMJIBULBOEBMBN(BNCBS
NFOZFSBOH EJCBCTFCFMVNOZB4FMTFMDPNNJUUFEJOJTFMBJONFNCFO
423
Unit VI Sel-Sel Darah, Imunitas, dan Pembukaan Darah
3
2
13
4 8 11
14
5
9
15
6
7 10 12 16
UVL TFM EBSBI NFSBI KVHB NFNCFOUVL EVB TJMTJMBI VUBNB Masa hidup Sel Darah Putih
TFM EBSBI QVUJI TJMTJMBI NJFMPTJUJL EBO MJNGPTJUJL 1BEB .BTB IJEVQ HSBOVMPTJU TFTVEBI EJMFQBTLBO EBSJ TVNTVN UVMBOH
CBHJBO LJSJ (BNCBS UBNQBL TJMTJMBI NJFMPTJUJL ZBOH OPSNBMOZBTBNQBJKBNEBMBNTJSLVMBTJEBSBI EBOTBNQBJ
EJNVMBJEFOHBONJFMPCMBTEBOQBEBCBHJBOLBOBOUBNQBL IBSJCFSJLVUOZBEBMBNKBSJOHBOZBOHNFNCVUVILBO1BEBLFBEBBO
TJMTJMBIMJNGPTJUJLZBOHEJNVMBJEFOHBOMJNGPCMBT JOGFLTJ KBSJOHBO ZBOH CFSBU NBTB IJEVQ LFTFMVSVIBO TFSJOH LBMJ
(SBOVMPTJU EBO NPOPTJU IBOZB EJCFOUVL EJ EBMBN CFSLVSBOH TBNQBJ IBOZB CFCFSBQB KBN LBSFOB HSBOVMPTJU CFLFSKB
TVNTVN UVMBOH -JNGPTJU EBO TFM QMBTNB UFSVUBNB MFCJIDFQBUQBEBEBFSBIZBOHUFSJOGFLTJ NFMBLVLBOGVOHTJOZB EBO
EJQSPEVLTJ EJ CFSCBHBJ KBSJOHBO MJNGPHFO LIVTVTOZB EJ LFNVEJBO NBTVL EBMBN QSPTFT LFUJLB TFMTFM JUV TFOEJSJ
LFMFOKBSMJNGF MJNQB UJNVT UPOTJM EBOCFSCBHBJLBOUPOH EJNVTOBILBO
KBSJOHBO MJNGPJE EJ NBOB TBKB EBMBN UVCVI TFQFSUJ .POPTJU KVHB NFNQVOZBJ NBTB FEBS ZBOH TJOHLBU ZBJUV
TVNTVN UVMBOH EBO QMBL 1FZFS EJ CBXBI FQJUFM EJOEJOH TBNQBJ KBN EBMBN EBSBI TFCFMVN NFOHFNCBSB NFMBMVJ
VTVT NFNCSBO LBQJMFS LF EBMBN KBSJOHBO #FHJUV NBTVL LF EBMBN
4FM EBSBI QVUJI ZBOH EJCFOUVL EBMBN TVNTVN UVMBOH KBSJOHBO TFMTFM JOJ NFNCFOHLBL TBNQBJ VLVSBOOZB CFTBS TFLBMJ
EJTJNQBO EBMBN TVNTVN TBNQBJ EJQFSMVLBO EJ TJTUFN EBO NFOKBEJ NBLSPGBH KBSJOHBO EBO EBMBN CFOUVL JOJ TFMTFM
TJSLVMBTJ ,FNVEJBO CJMB LFCVUVIBO TFM EBSBI QVUJI JOJ UFSTFCVU EBQBU IJEVQ CFSCVMBOCVMBO LFDVBMJ CJMB TFMTFM JUV
NVODVM CFSCBHBJ NBDBN GBLUPS BLBO NFOZFCBCLBO EJNVTOBILBO TBBU NFMBLVLBO GVOHTJ GBHPTJUJL .BLSPGBH KBSJOHBO
MFVLPTJU UFSTFCVU EJMFQBTLBO GBLUPSGBLUPS JOJ BLBO JOJ NFSVQBLBO EBTBS TJTUFN NBLSPGBH KBSJOHBO ZBOH NFSVQBLBO
EJCBIBT LFNVEJBO
#JBTBOZB MFVLPTJU ZBOH CFSTJSLVMBTJ QFSUBIBOBO MBOKVUBO VOUVL NFMBXBO JOGFLTJ TFQFSUJ ZBOH BLBO
EBMBN TFMVSVI EBSBI LJSBLJSB UJHB LBMJ MJQBU KVNMBI ZBOH EJCBIBTMFCJIEFUBJMLFNVEJBO
EJTJNQBO EBMBN TVNTVN +VNMBI JOJ TFTVBJ EFOHBO -JNGPTJU NFNBTVLJ TJTUFN TJSLVMBTJ TFDBSB LPOUJOV CFSTBNB
QFSTFEJBBOMFVLPTJUTFMBNBIBSJ EFOHBOBMJSBOMJNGFEBSJOPEVTMJNGFEBOKBSJOHBOMJNGPJEMBJOOZB
-JNGPTJU TFCBHJBO CFTBS EJTJNQBO EJ CFSCBHBJ BSFB 4FUFMBI CFCFSBQB KBN MJNGPTJU LFMVBS EBSJ EBSBI EBO LFNCBMJ LF
KBSJOHBO MJNGPJE LFDVBMJ TFKVNMBI LFDJM MJNGPTJU ZBOH KBSJOHBO EFOHBO DBSB EJBQFEFTJT ,FNVEJBO MJNGPTJU NFNBTVLJ
EJBOHLVUEBMBNEBSBIVOUVLTFNFOUBSBXBLUV MJNGF EBO LFNCBMJ LF EBSBI MBHJ EFNJLJBO TFUFSVTOZB EFOHBO
4FQFSUJ ZBOH UFSMJIBU QBEB (BNCBS NFHBLBSJPTJU EFNJLJBO UFSKBEJ TJSLVMBTJ MJNGPTJU ZBOH UFSVTNFOFSVT EJ TFMVSVI
TFM
KVHBEJCFOUVLEBMBNTVNTVNUVMBOH.FHBLBSJPTJU UVCVI -JNGPTJU NFNJMJLJ NBTB IJEVQ CFSNJOHHVNJOHHV BUBV
JOJ MBMV NFNCFOUVL GSBHNFOGSBHNFO EBMBN TVNTVN CFSCVMBOCVMBO CFSHBOUVOH QBEB LFCVUVIBO UVCVI BLBO TFMTFM
UVMBOH NFOKBEJGSBHNFOLFDJMZBOHEJLFOBMTFCBHBJQMBUFMFU UFSTFCVU
BUBVUSPNCPTJU
ZBOHTFMBOKVUOZBNBTVLLFEBMBNEBSBI 5SPNCPTJU EBMBN EBSBI BLBO EJHBOUJ LJSBLJSB TFUJBQ IBSJ
EFOHBOLBUBMBJO TFUJBQIBSJUFSCFOUVLLJSBLJSBUSPNCPTJU
QFSNJLSPMJUFSEBSBI
424
BAB 33 Pertahanan Tubuh terhadap Infeksi: I. Leukosit, Granulosit, Sistem Monosit-Makrograf, dan Inflamasi
TFIJOHHB NFOZFCBCLBO LFNPUBLTJT LF BSBI BSFB ZBOH

Sifat Pertahanan Neutrofil dan Makrofag NFOHBMBNJ QFSBEBOHBO ;BU[BU JOJ BEBMBI
CFCFSBQB
terhadap Infeksi UPLTJO CBLUFSJ BUBV WJSVT
QSPEVL EFHFOFSBUJG KBSJOHBO
5FSOZBUB OFVUSPGJM EBO NBLSPGBH KBSJOHBO ZBOH UFSVUBNB ZBOH NFSBEBOH JUV TFOEJSJ
CFCFSBQB QSPEVL SFBLTJ
NFOZFSBOHEBONFOHIBODVSLBOCBLUFSJ WJSVT EBOBHFOBHFO LPNQMFLT LPNQMFNFO EJCJDBSBLBO EJ #BC
ZBOH
UNIT VI
NFSVHJLBO MBJO ZBOH NFOZFSCV NBTVL LF EBMBN UVCVI EJBLUJGLBO EJ KBSJOHBO ZBOH NFSBEBOH EBO
CFCFSBQB
/FVUSPGJM BEBMBI TFM NBUBOH ZBOH EBQBU NFOZFSBOH EBO QSPEVL SFBLTJ ZBOH EJTFCBCLBO PMFI QFNCFLVBO QMBTNB EJ
NFOHIBODVSLBO CBLUFSJ CBILBO EJ EBMBN EBSBI TJSLVMBTJ BSFBZBOHNFSBEBOH EBOKVHB[BU[BUMBJOOZB
4FCBMJLOZB NBLSPGBH KBSJOHBO NFNVMBJ IJEVQ TFCBHBJ 4FQFSUJZBOHUFSMJIBUQBEB(BNCBS QSPTFTLFNPUBLTJT
NPOPTJUEBSBI ZBOHNFSVQBLBOTFMCFMVNNBUBOHXBMBVQVO CFSHBOUVOHQBEBQFSCFEBBOLPOTFOUSBTJ[BU[BULFNPUBLUJL
UFUBQCFSBEBEJEBMBNEBSBIEBONFNJMJLJTFEJLJULFNBNQVBO 1BEB EBFSBI EFLBU TVNCFS LPOTFOUSBTJ [BU[BU JOJ QBMJOH
VOUVL NFMBXBO BHFOBHFO JOGFLTJVT QBEB TBBU JUV /BNVO UJOHHJ EBO NFOZFCBCLBO HFSBLBO TFM EBSBI QVUJI ZBOH
CFHJUV NBLSPGBH NBTVL LF EBMBN KBSJOHBO TFMTFM JOJ NVMBJ UFSBSBI ,FNPUBLTJT FGFLUJG TBNQBJ KBSBL N EBSJ
NFNCFOHLBLLBEBOHEJBNFUFSOZBNFNCFTBSIJOHHBMJNBLBMJ KBSJOHBOZBOHNFSBEBOH0MFILBSFOBIBNQJSUJEBLBEBBSFB
MJQBU TBNQBJ TFCFTBS IJOHHB HSO TVBUV VLVSBO ZBOH KBSJOHBO ZBOH KBVIOZB MFCJI EBSJ N EBSJ LBQJMFS NBLB
IBNQJS EBQBU EJMJIBU EFOHBO NBUB UFMBOKBOH 4FMTFM JOJ TJOZBM LFNPUBLUJL EBQBU EFOHBO NVEBI NFNJOEBILBO
TFLBSBOH EJTFCVU NBLSPGBH EBO NFNQVOZBJ LFNBNQVBO TFLFMPNQPL TFM EBSBI QVUJI EBSJ LBQJMFS LF EBFSBI ZBOH
IFCBU VOUVL NFNCFSBOUBT BHFOBHFO QFOZBLJU EJ EBMBN NFSBEBOH
KBSJOHBO
Sel Darah Putih Memasuki Ruang Jaringan dengan
'VOHTJ OFVUSPGJM EBO NBLSPGBH ZBOH UFSQFOUJOH BEBMBI
Cara Diapedesis. /FVUSPGJM EBO NPOPTJU EBQBU UFSQFSBT
GBHPTJUPTJT ZBOH CFSBSUJ QFODFSOBBO TFMVMBS UFSIBEBQ BHFO
NFMBMVJ QPSJQPSJ LBQJMFS EBSBI EFOHBO DBSB EJBQFEFTJT +BEJ
XBMBVQVO TFCVBI QPSJ VLVSBOOZB KBVI MFCJI LFDJM EBSJQBEB TFM ZBOHNFOHHBOHHV4FMGBHPTJUIBSVTNFNJMJICBIBOCBIBO
QBEBTVBUVLFUJLBTFCBHJBOLFDJMTFMUFSTFCVUNFMVODVSNFMFXBUJ ZBOH BLBO EJGBHPTJUPTJT LBMBV UJEBL EFNJLJBO TFM OPSNBM
QPSJQPSJ CBHJBO ZBOH NFMVODVS UFSTFCVU VOUVL TFTBBU EBO TUSVLUVS UVCVI BLBO EJDFSOB QVMB 5FSKBEJOZB
UFSLPOTUSJLTJ TFTVBJ EFOHBO VLVSBO QPSJ TFQFSUJ ZBOH UFSMJIBU GBHPTJUPTJTUFSVUBNBCFSHBOUVOHQBEBUJHBQSPTFEVSTFMFLUJG
QBEB(BNCBSEBO CFSJLVU
1FSUBNB TFCBHJBO CFTBS TUSVLUVS BMBNJ EBMBN KBSJOHBO
Sel Darah Putih Bergerak Melewati Ruang Jaringan NFNJMJLJ QFSNVLBBO IBMVT ZBOH EBQBU NFOBIBO
dengan Gerakan Ameboid. /FVUSPGJM EBO NBLSPGBH EBQBU GBHPTJUPTJT 5FUBQJ KJLB QFSNVLBBOOZB LBTBS NBLB
CFSHFSBLNFMBMVJKBSJOHBOEFOHBOHFSBLBOBNFCPJETFQFSUJZBOH LFDFOEFSVOHBOGBHPTJUPTJTBLBONFOJOHLBU
EJKFMBTLBO EJ #BC #FCFSBQB TFM EBQBU CFSHFSBL EFOHBO ,FEVB TFCBHJBO CFTBS CBIBO BMBNJ UVCVI NFNQVOZBJ
LFDFQBUBO HSOJNFOJU TFQBOKBOH VLVSBO UVCVIOZB TFOEJSJ TFMVCVOH QSPUFJO QFMJOEVOH ZBOH NFOPMBL GBHPTJUPTJT
TFUJBQNFOJU 4FCBMJLOZB TFCBHJBOCFTBSKBSJOHBONBUJEBOQBSUJLFMBTJOH
Sel Darah Putih Tertarik ke Daerah Jaringan yang UJEBL NFNQVOZBJ TFMVCVOH QFMJOEVOH TFIJOHHB KBSJOHBO
Meradang dengan Cara Kemotaksis. #BOZBL KFOJT [BU LJNJB BUBVQBSUJLFMUFSTFCVUNFOKBEJTVCKFLVOUVLEJGBHPTJUPTJT
EBMBN KBSJOHBO EBQBU NFOZFCBCLBO OFVUSPGJM EBO NBLSPGBH ,FUJHB TJTUFN JNVO UVCVI EJKFMBTLBO EFOHBO SJODJ EJ
CFSHFSBLNFOVKVTVNCFS[BULJNJB'FOPNFOBJOJ TFQFSUJZBOH #BC
NFNCFOUVL BOUJCPEJ VOUVL NFMBXBO BHFO
UBNQBL QBEB (BNCBS EJLFOBM TFCBHBJ LFNPUBLTJT #JMB JOGFLTJVTTFQFSUJCBLUFSJ"OUJCPEJLFNVEJBONFMFLBUQBEB
TVBUVKBSJOHBONFOHBMBNJQFSBEBOHBO CBOZBLQSPEVLEJCFOUVL NFNCSBO CBLUFSJ EBO EFOHBO EFNJLJBO NFNCVBU CBLUFSJ
NFOKBEJ SFOUBO LIVTVTOZB UFSIBEBQ GBHPTJUPTJT 6OUVL
NFMBLVLBO IBM JOJ NPMFLVM BOUJCPEJ KVHB CFSHBCVOH
EFOHBO QSPEVL $ EBSJ LBTLBEF LPNQMFNFO ZBOH
NFSVQBLBO CBHJBO UBNCBIBO TJTUFN JNVO ZBOH BLBO
EJCJDBSBLBOEJ#BC.PMFLVM$LFNVEJBONFMFLBULBO
EJSJ QBEB SFTFQUPS EJ BUBT NFNCSBO TFM GBHPTJU EFOHBO
EFNJLJBO NFNJDV GBHPTJUPTJT 1SPTFT TFMFLTJ EBO
GBHPTJUPTJTJOJEJTFCVUPQTPOJTBTJ
Fagositosis oleh Neutrofil. /FVUSPGJM TFXBLUV

NFNBTVLJKBSJOHBOTVEBINFSVQBLBOTFMTFMNBUBOHZBOH
EBQBUTFHFSBNFNVMBJGBHPTJUPTJT,FUJLBNFOEFLBUJTVBUV
QBSUJLFM VOUVL EJGBHPTJUPTJT NVMBNVMB OFVUSPGJM
NFMFLBULBO EJSJ QBEB QBSUJLFM LFNVEJBO NFOPOKPMLBO
QTFVEPQPEJB LF TFNVB KVSVTBO EJ TFLFMJMJOH QBSUJLFM
1TFVEPQPEJB CFSUFNV TBUV TBNB MBJO QBEB TJTJ ZBOH
CFSMBXBOBO EBO CFSHBCVOH )BM JOJ OFODJQUBLBO SVBOHBO
UFSUVUVQ ZBOH CFSJTJ QBSUJLFM ZBOH TVEBI EJGBHPTJUPTJT
,FNVEJBOSVBOHBOJOJCFSJOWBHJOBTJLFEBMBNSPOHHB
425
Unit VI Sel-Sel Darah, Imunitas, dan Pembekuan Darah
TJUPQMBTNB ,FNVEJBO SVBOHBO JOJ CFSJOWBHJOBTJ LF EBMBN SPOHHB

Sistem Monosit—Sel Makrofag (Sistem
TJUPQMBTNBEBONFMFQBTLBOEJSJEBSJNFNCSBOTFMCBHJBOMVBSVOUVL
Retikuloendotelial)
NFNCFOUVL WFTJLFM GBHPTJUJL ZBOH NFOHBQVOH EFOHBO CFCBT KVHB
EJTFCVUGBHPTPN
EJEBMBNTJUPQMBTNB4FCVBITFMOFVUSPGJMCJBTBOZB
1BEB QBSBHSBG UFSEBIVMV LJUB UFMBI NFOHHBNCBSLBO
EBQBUNFNGBHPTJUPTJTTBNQBJCBLUFSJTFCFMVNTFMOFVUSPGJMJUV
NBLSPGBH UFSVUBNB TFCBHBJ TFM NPCJM ZBOH NBNQV
TFOEJSJNFOKBEJJOBLUJGEBONBUJ
NFOHFNCBSB LF TFMVSVI KBSJOHBO /BNVO TFUFMBI
Fagositosis oleh Makrofag. .BLSPGBH NFSVQBLBO QSPEVL NFNBTVLJ KBSJOHBO EBO NFOKBEJ NBLSPGBH TFCBHJBO CFTBS
UBIBQ BLIJS NPOPTJU ZBOH NFNBTVLJ KBSJOHBO EBSJ EBMBN EBSBI NPOPTJU MBJOOZB NFMFLBU QBEB KBSJOHBO EBO UFUBQ NFMFLBU
#JMB NBLSPGBH EJBLUJGLBO PMFI TJTUFN JNVO TFQFSUJ ZBOH EJKFMBTLBO TFMBNBCFSCVMBOCVMBOBUBVCBILBOCFSUBIVOUBIVOTBNQBJ
EJ #BC NBLSPGBH NFSVQBLBO TFM GBHPTJU ZBOH KBVI MFCJI LVBU NPOPTJU UFSTFCVU EJQBOHHJM VOUVL NFMBLVLBO GVOHTJ
EBSJQBEB OFVUSPGJM TFSJOH LBMJ NBNQV NFNGBHPTJUPTJT TBNQBJ QFSUBIBOBO MPLBM TQFTJGJL .BLSPGBH KBSJOHBO NFNQVOZBJ
CBLUFSJ .BLSPGBH KVHB NFNQVOZBJ LFNBNQVBO VOUVL NFOFMBO LFNBNQVBO TFSVQB EFOHBO NBLSPGBH ZBOH NPCJM VOUVL
QBSUJLFM ZBOH KBVI MFCJI CFTBS CBILBO TFM EBSBI NFSBI VUVI BUBV NFNGBHPTJUPTJT TFKVNMBI CFTBS CBLUFSJ WJSVT KBSJOHBO
LBEBOH QBSBTJU NBMBSJB TFEBOHLBO OFVUSPGJM UJEBL NBNQV OFLSPUJL BUBV QBSUJLFM BTJOH MBJOOZB EBMBN KBSJOHBO %BO
NFNGBHPTJUPTJT QBSUJLFM ZBOH KBVI MFCJI CFTBS EBSJ CBLUFSJ CJMB EJSBOHTBOH EFOHBO UFQBU NBLSPGBH KBSJOHBO EBQBU
.BLSPGBH TFUFMBI NFNBLBO QBSUJLFM KVHB EBQBU NFOHFMVBSLBO NFMFQBTLBO EJSJ EBSJ UFNQBU QFMFLBUBOOZB EBO TFLBMJ MBHJ
QSPEVLSFTJEVEBOTFSJOHLBMJEBQBUCFSUBIBOIJEVQTFSUBCFSGVOHTJ NFOKBEJ NBLSPGBH NPCJM ZBOH BLBO CFSFBLTJ UFSIBEBQ
TBNQBJCFSCVMBOCVMBOLFNVEJBO LFNPUBLTJT EBO TFNVB SBOHTBOHBO ZBOH CFSIVCVOHBO
EFOHBO QSPTFT QFSBEBOHBO +BEJ UVCVI NFNJMJLJ TJTUFN
Setelah Difagositosis, Sebagian Besar partikel Dicerna oleh
NPOPTJUNBLSPGBH ZBOH UFSTFCBS MVBT IBNQJS EJ TFMVSVI
Enzim Intraseluler. 4FUFMBI %JGBHPTJUPTJT 4FCBHJBO #FTBS 1BSUJLFM BSFBKBSJOHBO
%JDFSOB PMFI &O[JN *OUSBTFMVMBS 4FHFSB TFUFMBI QBSUJLFM BTJOH (BCVOHBO LFTFMVSVIBO NPOPTJU NBLSPGBH NPCJM
EJGBHPTJUPTJT MJTPTPNEBOHSBOVMBTJUPQMBTNJLMBJOOZBTFHFSBEBUBOH NBLSPGBHZBOHUFSGJLTBTJQBEBKBSJOHBO CFCFSBQBTFMFOEPUFM
VOUVL CFSTFOUVIBO EFOHBO WFTJLFM GBHPTJUJL EBO NFNCSBOOZB
LIVTVT EBMBN TVNTVN UVMBOH MJNQB EBO OPEVT MJNGF
CFSHBCVOH EFOHBO NFNCSBO WFTJLFM TFMBOKVUOZB NFOHFMVBSLBO
EJTFCVU TJTUFN SFUJLVMPFOEPUFMJBM /BNVO TFMVSVI BUBV
CBOZBLFO[JNQFODFSOBBOEBOCBIBOCBLUFSJTJEBMLFEBMBNWFTJLFM
IBNQJSTFMVSVITFMTFMJOJCFSBTBMEBSJTFMQVODBNPOPTJUJL
+BEJ WFTJLFMGBHPTJUJLTFLBSBOHNFOKBEJWFTJLFMQFODFSOB EBOTFHFSB
PMFI LBSFOB JUV TJTUFN SFUJLVMPFOEPUFMJBM IBNQJS TJOPOJN
EJNVMBJMBIQSPTFTQFODFSOBBOQBSUJLFMZBOHTVEBIEJGBHPTJUPTJT
/FVUSPGJM EBO NBLSPGBH LFEVBOZB NFNQVOZBJ TFKVNMBI CFTBS EFOHBOTJTUFNNPOPTJUNBLSPGBH0MFILBSFOBJTUJMBITJTUFN
MJTPTPN ZBOH CFSJTJ FO[JN QSPUFPMJUJL ZBOH LIVTVT EJQBLBJ VOUVL SFUJLVMPFOEPUFMJBMKBVIMFCJIEJLFOBMEJMJUFSBUVSLFEPLUFSBO
NFODFSOB CBLUFSJ EBO CBIBO QSPUFJO BTJOH MBJOOZB -JTPTPN ZBOH EBSJQBEB JTUJMBI TJTUFN NPOPTJUNBLSPGBH JTUJMBI JOJ IBSVT
BEB QBEB NBLSPGBH UFUBQJ UJEBL QBEB OFVUSPGJM
KVHB NFOHBOEVOH EJJOHBU TFCBHBJ TJTUFN GBHPTJUJL VNVN ZBOH UFSMFUBL EJ
CBOZBL MJQBTF ZBOH NFODFSOB NFNCSBO MJQJE UFCBM ZBOH EJNJMJLJ TFNVB KBSJOHBO LIVTVTOZB EJ BSFB KBSJOHBO UFNQBU
PMFICFCFSBQBCBLUFSJUFSUFOUVTFQFSUJCBTJMUVCFSLVMPTJT TFKVNMBI CFTBS QBSUJLFM UPLTJO EBO TVCTUBOTJ ZBOH UJEBL
EJJOHJOLBOMBJOOZBIBSVTEJIBODVSLBO
Neutrofil dan Makrofag Dapat Membunuh Bakteri. 4FMBJO
Makrograf Jaringan di Kulit dan Jaringan Subkutan
NFODFSOB CBLUFSJ ZBOH UFSUFMBO EBMBN GBHPTPN OFVUSPGJM EBO
NBLSPGBH KVHB NFOHBOEVOH CBIBO CBLUFSJTJEBM ZBOH NFNCVOVI (Histiosit). 8BMBVQVO CJBTBOZB LVMJU UBIBO UFIBEBQ BHFO
TFCBHJBOCFTBSCBLUFSJ CBILBOCJMBFO[JNMJTPTPNBMHBHBMNFODFSOB JOGFLTJVT UFUBQJ IBM JOJ UJEBL CFSMBLV MBHJ CJMB LVMJU SVTBL
CBLUFSJUFSTFCVU)BMJOJNFOKBEJEFNJLJBOQFOUJOHTFCBCCFCFSBQB #JMB JOGFLTJ EJNVMBJ EJ KBSJOHBO TVCLVUBO EBO UJNCVM
QFSBEBOHBO TFUFNQBU NBLB NBLSPGBH KBSJOHBO TFUFNQBU
CBLUFSJ NFNQVOZBJ TFMVCVOH QFMJOEVOH BUBV GBLUPS MBJO ZBOH
EBQBU NFNCFMBI JO TJUV EBO NFNCFOUVL NBLSPGBH MFCJI
NFODFHBI QFOHIBODVSBOOZB PMFI FO[JN QFODFSOBBO #BOZBL FGFL
CBOZBL MBHJ 4FMBOKVUOZB NBLSPGBH KBSJOHBO NFMBLVLBO
QFNCVOVIBO NFSVQBLBO IBTJM EBSJ CFCFSBQB CBIBO QFOHPLTJEBTJ
GVOHTJOZB TFQFSUJ CJBTB ZBLOJ NFOZFSBOH EBO
LVBUZBOHEJCFOUVLPMFIFO[JNEBMBNNFNCSBOGBHPTPN BUBVPMFI
NFOHIBODVSLBOBHFOJOGFLTJVT TFQFSUJZBOHUFMBIEJKFMBTLBO
PSHBOFM LIVTVT ZBOH EJTFCVU QFSPLTJTPN #BIBO QFOHPLTJEBTJ
TFCFMVNOZB
JOJ NFMJQVUJ TFKVNMBI CFTBS TVQFSPLTJEB 0
IJESPHFO QFSPLTJEB Makrofag di Nodus Limfe. 1BEB EBTBSOZB UJEBL BEB
) 0
EBOJPOJPOIJESPLTJM 0)
TFNVBOZBCFSTJGBUNFNBUJLBO CBIBO UFSUFOUV ZBOH NBTVL LF KBSJOHBO TFQFSUJ CBLUFSJ
CBHJ TFCBHJBO CFTBS CBLUFSJ CBILBO CJMB CBIBO QFOHPLTJEBTJ JUV EBQBUMBOHTVOHEJBCTPSQTJLFEBMBNEBSBINFMBMVJNFNCSBO
KVNMBIOZB TFEJLJU 4FMBJO JUV TBMBI TBUV FO[JN MJTPTPN ZBJUV LBQJMFS/BNVO CJMBQBSUJLFMUJEBLEJIBODVSLBOEJKBSJOHBO
NJFMPQFSPLTJEBTF NFOHBUBMJTJT SFBLTJ BOUBSB )0 EBO JPO LMPSJEB TFUFNQBU NBLBQBSUJLFMBLBONBTVLLFEBMBNDBJSBOMJNGF
VOUVLNFNCFOUVLIJQPLMPSJU ZBOHTFDBSBMVBTCFSTJGBUCBLUFSJTJE EBO NFOHBMJS NFOVKV OPEVT MJNGF ZBOH MFUBLOZB UJEBL
/BNVO CFCFSBQB CBLUFSJ LIVTVTOZB CBTJM UVCFSLVMPTJT UFSBUVS EJ TFQBOKBOH QFSKBMBOBO BMJSBO MJNGF 1BSUJLFM BTJOH
NFNQVOZBJ TFMVCVOH ZBOH CFSTJGBU SFTJTUBO UFSIBEBQ QFODFSOBBO JUVMBMVUFSKFCBLEJOPEVTMJNGFEBMBNBOZBNBOTJOVTZBOH
PMFI MJTPTPN EBO KVHB NFOZFLSFTJLBO [BU[BU ZBOH NFNJMJLJ EJCFOUFOHJPMFINBLSPGBHKBSJOHBO
LFUBIBOBO QBSTJBM UFSIBEBQ FGFL QFNCVOVIBO OFVUSPGJM EBO (BNCBS NFNQFSMJIBULBO TVTVOBO VNVN OPEVT
NBLSPGBH#BLUFSJTFQFSUJJOJCFSQFSBOQBEBCBOZBLQFOZBLJULSPOJT MJNGF UBNQBL DBJSBO MJNGF ZBOH NBTVL EBSJ LBQTVM OPEVT
EBOTBMBITBUVDPOUPIOZBBEBMBIUVCFSLVMPTJT MJNGFNFMBMVJMJNGBUJLBGFSFO LFNVEJBONFOHBMJSNFMFXBUJ
426
UNIT VI
TJOVT NFEVMBSJT OPEVT MJNGF EBO BLIJSOZB LFMVBS EBSJ IJMVT
NBTVLLFEBMBNMJNGBUJLFGFSFO
4FKVNMBICFTBSNBLSPGBHNFNCFOUFOHJTJOVTMJNGF EBOCJMB
BEB QBSUJLFM ZBOH NBTVL LF EBMBN TJOVT NFMBMVJ DBJSBO MJNGF
NBLSPGBH NFNGBHPTJUPTJTOZB EBO NFODFHBI QFOZFCBSBO MFCJI
MBOKVULFTFMVSVIUVCVI EBMBN BOZBNBO SFUJLVMBS LFEVB PSHBO UFSTFCVU EBO CJMB
Makrofag Alveolus di Paru. +BMBO MBJO ZBOH TFSJOH BEBQBSUJLFMBTJOHZBOHCFSTFOUVIBOEFOHBONBLSPGBHJOJ
EJHVOBLBOPMFIPSHBOJTNFVOUVLNBTVLLFEBMBNUVCVIBEBMBI NBLBQBSUJLFMBLBOEJGBHPTJUPTJT
NFMBMVJ QBSV 4FKVNMBI CFTBS NBLSPGBH KBSJOHBO NFSVQBLBO -JNQB NJSJQ EFOHBO OPEVT MJNGF LFDVBMJ CBIXB ZBOH
LPNQPOFO VUVI EJOEJOH BMWFPMVT .BLSPGBH JOJ EBQBU NFOHBMJS NFMBMVJ SVBOH KBSJOHBO MJNQB BEBMBI EBSBI
NFNGBHPTJUPTJT QBSUJLFM ZBOH UFSQFSBOHLBQ EJ EBMBN BMWFPMJ CVLBO DBJSBO MJNGF (BNCBS NFNQFSMJIBULBO
#JMB QBSUJLFM JUV EBQBU EJDFSOB NBLB NBLSPGBH KVHB EBQBU TFHNFO QFSJGFS KBSJOHBO MJNQB ZBOH LFDJM 1FSIBUJLBO
NFODFSOBOZB EBO NFMFQBTLBO QSPEVLQSPEVL QFODFSOBBO LF CBIXBTFCVBIBSUFSJLFDJMNFOFNCVTLBQTVMMJNQBNBTVL
EBMBN DBJSBO MJNGF #JMB QBSUJLFM UJEBL EBQBU EJDFSOB NBLB LF EBMBN QVMQB MJNQB EBO CFSBLIJS EJ LBQJMFS LFDJM
NBLSPGBH TFSJOH NFNCFOUVL LBQTVM TFM SBLTBTB ZBOH ,BQJMFS JOJ TBOHBU CFSQPSJQPSJ TFIJOHHB NFNVOHLJOLBO
NFOHFMJMJOHJ QBSUJLFM TBNQBJ TVBUV TBBU CJMB UFSKBEJ QBSUJLFM JUV TFMVSVI LPNQPOFO EBSBI LFMVBS EBSJ LBQJMFS NBTVL LF
QFMBOQFMBO EBQBU EJMBSVULBO ,BQTVM TFNBDBN JOJ TFSJOH EBMBN LPSEB QVMQB NFSBI ,FNVEJBO EBSBI TFDBSB
UFSCFOUVL EJ TFLFMJMJOH CBTJM UVCFSLVMPTJT QBSUJLFM EFCV TJMJLB CFSUBIBQ UFSQFSBT NFMBMVJ BOZBNBO USBCFLVMB LPSEB EBO
EBOCBILBOQBSUJLFMLBSCPO BLIJSOZB LFNCBMJ LF TJSLVMBTJ NFMBMVJ EJOEJOH FOEPUFM
TJOVTWFOPTVT5SBCFLVMBQVMQBNFSBIEJMBQJTJPMFICBOZBL
Makrofag di Sinusoid Hati (Sel Kupffer)..BTJIBEBKBMBO TFLBMJ NBLSPGBH EBO TJOVT WFOPTVT KVHB EJMBQJTJ PMFI
MBJO VOUVL NBTVLOZB CBLUFSJ LF EBMBN UVCVI ZBJUV NFMBMVJ NBLSPGBH+BMBOBMJSBOEBSBIZBOHLIVTVTNFMBMVJLPSEB
TBMVSBO DFSOB 4FKVNMBI CFTBS CBLUFSJ ZBOH CFSBTBM EBSJ
NBLBOBO ZBOH EJUFMBO NBTVL UFSVTNFOFSVT NFMBMVJ NVLPTB
HBTUSPJOUFTUJOBM LF EBMBN EBSBI QPSUBM 4FCFMVN EBSBI QPSUBM
NBTVL LF TJSLVMBTJ VNVN EBSBI JOJ MFCJI EVMV NFMJOUBTJ
TJOVTPJEIBUJTJOVTPJEJOJEJMBQJTJPMFINBLSPGBHKBSJOHBOZBOH
EJTFCVU TFM ,VQGGFS TFQFSUJ ZBOH UFSMJIBU QBEB (BNCBS
4FMTFM JOJ NFNCFOUVL TFNBDBN TJTUFN GJMUSBTJ LIVTVT ZBOH
FMFLUJGTFIJOHHBIBNQJSUJEBLBEBTBUVQVOCBLUFSJEBSJTBMVSBO
DFSOBZBOHCFSIBTJMNFMFXBUJBMJSBOEBSBIQPSUBMVOUVLNBTVL
LFEBMBNTJTUFNTJSLVMBTJVNVN#BILBOUBNQBLEBMBNTVBUV
GJMN NFOHFOBJ GBHPTJUPTJT PMFI TFM ,VQGGFS NFNQFSMJIBULBO
CBIXB GBHPTJUPTJT TBUV CBLUFSJ NFNCVUVILBO XBLUV LVSBOH
EBSJEFUJL
Makrofag di Limpa dan Sumsum Tulang. #JMB BEB

PSHBOJTNFZBOHCFSIBTJMNFOHJOWBTJNBTVLLFEBMBNTJSLVMBTJ
VNVN NBTJI BEB HBSJT QFSUBIBOBO MBJO PMFI TJTUFN NBLSPGBH
KBSJOHBO LIVTVTOZB PMFI NBLSPGBH EJ MJNQB EBO TVNTVN
UVMBOH1BEBLFEVBKBSJOHBOJOJ NBLSPGBHUFSKFSBU
427
QVMQB NFSBI JOJ TBOHBU CFSQFSBO QBEB QSPTFT GBHPTJUPTJT CBOZBL TUSFQUPLPLVT ZBOH CFSLFNCBOH CJBL EBO CFSNJHSBTJ
EFCSJT ZBOH UJEBL EJJOHJOLBO EJ EBMBN EBSBI UFSNBTVL "LJCBUOZB TUSFQUPLPLVTTFSJOHLBMJMFCJIDFOEFSVOHNFOZFCBSLF
LIVTVTOZBTFMEBSBINFSBIZBOHBCOPSNBMEBOZBOHTVEBI TFMVSVIUVCVIEBONFOZFCBCLBOLFNBUJBOEBSJQBEBTUBGJMPLPLVT
UVB XBMBVQVOTFCFOBSOZB
Respons Makrofag dan Neutrofil selama Peradangan
Peradangan: Peran Neutrofil dan
Makrofag Makrofag Jaringan sebagai Garis Pertahanan Pertama
Melawan Infeksi. %BMBN XBLUV CFCFSBQB NFOJU TFUFMBI
Peradangan QFSBEBOHBO EJNVMBJ NBLSPGBH UFMBI BEB EJ EBMBN KBSJOHBO
CFSVQB IJTUJPTJU EJ KBSJOHBO TVCLVUBO NBLSPGBH BMWFPMVT EJ QBSV
#JMBUFSKBEJDFEFSBKBSJOHBO FOUBILBSFOBCBLUFSJ USBVNB NJLSPHMJB EJ PUBL BUBV ZBOH MBJOOZB EBO TFHFSB NFNVMBJ LFSKB
CBIBOLJNJB QBOBT BUBVGFOPNFOBMBJOOZB NBLBKBSJOHBO GBHPTJUJLOZB#JMBEJBLUJGLBOPMFIQSPEVLJOGFLTJEBOQFSBEBOHBO
ZBOH DFEFSB JUV BLBO NFMFQBTLBO CFSCBHBJ [BU ZBOH FGFL ZBOH NVMBNVMB UFSKBEJ BEBMBI QFNCFOHLBLBO TFUJBQ TFMTFM
NFOJNCVMLBO QFSVCBIBO TFLVOEFS ZBOH ESBNBUJT EJ JOJEFOHBODFQBU4FMBOKVUOZB CBOZBLNBLSPGBHZBOHTFCFMVNOZB
TFLFMJMJOH KBSJOHBO ZBOH UJEBL DFEFSB ,FTFMVSVIBO UFSJLBU LFNVEJBO MFQBT EBSJ QFMFLBUBOOZB EBO NFOKBEJ NPCJM
LPNQMFLT QFSVCBIBO KBSJOHBO JOJ EJTFCVU QFSBEBOHBO NFNCFOUVL HBSJT QFSUBNB QFSUBIBOBO UVCVI UFSIBEBQ JOGFLTJ
JOGMBNBTJ
TFMBNBCFCFSBQBKBNQFSUBNB+VNMBINBLSPGBHZBOHNFOHBMBNJ
1FSBEBOHBO EJUBOEBJ PMFI
WBTPEJMBUBTJ QFNCVMVI NPCJMJTBTJ EJOJ JOJ TFSJOH LBMJ UJEBL CBOZBL UFUBQJ EBQBU
EBSBI MPLBM ZBOH NFOHBLJCBULBO UFSKBEJOZB BMJSBO EBSBI NFOZFMBNBULBOKJXB
TFUFNQBU ZBOH CFSMFCJIBO
QFOJOHLBUBO QFSNFBCJMJUBT
LBQJMFS NFOJNCVMLBO LFCPDPSBO CBOZBL TFLBMJ DBJSBO LF Invasi Neutrofil ke Daerah, Peradangan sebagai Garis
EBMBNSVBOHJOUFSTUJTJBM
TFSJOHLBMJUFSKBEJQFNCFLVBO Pertahanan Kedua. %BMBN KBN QFSUBNB TFUFMBI QFSBEBOHBO
DBJSBO EJ EBMBN SVBOH JOUFSTUJTJBM ZBOH EJTFCBCLBO PMFI EJNVMBJ TFKVNMBI CFTBS OFVUSPGJM EBSJ EBSBI NVMBJ NFOHJOWBTJ
QFOJOHLBUBO TFKVNMBI CFTBS GJCSJOPHFO EBO QSPUFJO EBFSBIZBOHNFSBEBOH)BMJOJEJTFCBCLBOPMFITJUPLJOJOGMBNBTJ
MBJOOZBZBOHCPDPSEBSJLBQJMFS
NJHSBTJTFKVNMBICFTBS NJTBMOZB 5/' *-
EBO QSPEVL CJPLJNJB MBJOOZB ZBOH
HSBOVMPTJU EBO NPOPTJU LF EBMBN KBSJOHBO TFSUB
EJQSPEVLTJPMFIKBSJOHBOSBEBOHZBOHBLBONFNJDVSFBLTJCFSJLVU
QFNCFOHLBLBO TFM KBSJOHBO #FCFSBQB EBSJ TFLJBO CBOZBL 1. 1SPEVL UFSTFCVU NFOZFCBCLBO QFOJOHLBUBO QFOBNQJMBO
QSPEVL KBSJOHBO ZBOH NFOJNCVMLBO SFBLTJ JOJ BEBMBI NPMFLVM BEIFTJ TFQFSUJ TFMFLUJO EBO NPMFLVM BEIFTJ JOUSBTFM
IJTUBNJO CSBEJLJOJO TFSPUPOJO QSPTUBHMBOEJO CFCFSBQB JOUSBDFMMVMBSBEIFTJPONPMFDVMF<*$".>
QBEBQFSNVLBBO
NBDBNQSPEVLSFBLTJTJTUFNLPNQMFNFO ZBOHEJKFMBTLBO TFM FOEPUFM LBQJMFS EBO WFOVMB .PMFLVM BEIFTJ JOJ CFSFBLTJ
EJ #BC
QSPEVL SFBLTJ TJTUFN QFNCFLVBO EBSBI EBO EFOHBO NPMFLVM JOUFHSJO LPNQMFNFOUFS EJ OFVUSPGJM
CFSCBHBJ TVCTUBOTJ ZBOH EJTFCVU MJNGPLJO ZBOH EJMFQBTLBO NFOZFCBCLBO OFVUSPGJM NFOFNQFM EJ EJOEJOH LBQJMFS EBO
PMFI TFM 5 ZBOH UFSTFOTJUJTBTJ CBHJBO EBSJ TJTUFN JNVO WFOVMBQBEBEBFSBIQFSBEBOHBO&GFLJOJEJTFCVUNBSHJOBTJEBO
KVHB EJCJDBSBLBO EJ #BC
#FCFSBQB EBSJ TVCTUBOTJ JOJ EJQFSMJIBULBO EBMBN (BNCBS EBO MFCJI EFUBJM QBEB
EBQBU NFOHBLUJGLBO TJTUFN NBLSPGBH EFOHBO LVBU EBO (BNCBS
EBMBN XBLUV CFCFSBQB KBN NBLSPGBH NVMBJ NFMBIBQ
2. 1SPEVL JOJ KVHB NFOZFCBCLBO MPOHHBSOZB QFMFLBUBO
KBSJOHBO ZBOH UFMBI EJIBODVSLBO 5FUBQJ QBEB TVBUV TBBU
NBLSPGBH TFMBOKVUOZB KVHB EBQBU NFODFEFSBJ TFMTFM JOUFSTFMVMBSBOUBSBTFMFOEPUFMLBQJMFSEBOWFOVMBLFDJM TFIJOHHB
KBSJOHBOZBOHNBTJIIJEVQ UFSCVLB DVLVQ MFCBS ZBOH NFNVOHLJOLBO OFVUSPGJM VOUVL
CFSHFSBLMBNCBUNFMBMVJQSPTFTEJBQFEFTJTTFDBSBMBOHTVOHEBSJ
Pembatasan ("Walling Off') Efek Peradangan. EBSBILFEBMBNSVBOHSVBOHKBSJOHBO
4BMBI TBUV FGFL QFSUBNB EBSJ QFSBEBOHBO BEBMBI 3. 1SPEVL QFSBEBOHBO MBJO NFOZFCBCLBO LFNPUBLTJT OFVUSPGJM
QFNCBUBTBO XBMMPGG
BSFBZBOHDFEFSBEBSJTJTBKBSJOHBO
ZBOH UJEBL NFOHBMBNJ SBEBOH 3VBOH KBSJOHBO EBO DBJSBO NFOVKV LF BSBI EBFSBI ZBOH DFEFSB TFQFSUJ ZBOH EJKFMBTLBO
MJNGBUJL EJ EBFSBI ZBOH NFSBEBOH EJIBMBOHJ PMFI CFLVBO TFCFMVNOZB
GJCSJOPHFO TFIJOHHBVOUVLTFNFOUBSBXBLUVIBNQJSUJEBL
+BEJ EBMBN XBLUV CFCFSBQB KBN TFUFMBI EJNVMBJOZB LFSVTBLBO
BEB DBJSBO ZBOH NFMJOUBTJ SVBOHBO 1SPTFT QFNCBUBTBO
KBSJOHBO UFNQBU UFSTFCVU BLBO EJJTJ PMFI OFVUSPGJM 0MFI LBSFOB
BLBONFOVOEBQFOZFCBSBOCBLUFSJBUBVQSPEVLUPLTJL
OFVUSPGJM EBSBI UFMBI CFSCFOUVL TFM NBUBOH NBLB TFMTFM UFSTFCVU
*OUFOTJUBTQSPTFTQFSBEBOHBOCJBTBOZBTFCBOEJOHEFOHBO
TVEBI TJBQ VOUVL TFHFSB NFNVMBJ GVOHTJOZB VOUVL NFNCVOVI
EFSBKBU DFEFSB KBSJOHBO $POUPIOZB LFUJLB TUBGJMPLPLVT
CBLUFSJEBONFOZJOHLJSLBOCFOEBCFOEBBTJOH
ZBOHNFNBTVLJKBSJOHBONFMFQBTLBOCBOZBLTFLBMJUPLTJO
ZBOH NFNBUJLBO TFMTFM "LJCBUOZB UJNCVM QFSBEBOHBO Peningkatan Akut Jumlah Neutrofil dalam Darah-
EFOHBO DFQBU CBILBO KBVI MFCJI DFQBU EBSJQBEB "Neutrofilia". %BMBN XBLUV CFCFSBQB KBN TFTVEBI EJNVMBJOZB
LFNBNQVBO TUBGJMPLPLVT VOUVL NFOHHBOEBLBO EJSJ EBO SBEBOHBLVUZBOHCFSBU KVNMBIOFVUSPGJMEJEBMBNEBSBILBEBOH
NFMBLVLBOQFOZFCBSBO+BEJ JOGFLTJTUBGJMPLPLVTTFUFNQBU LBEBOH NFOJOHLBU TFCBOZBL FNQBU TBNQBJ MJNB LBMJ MJQBU EBSJ
EJUBOEBJEFOHBODFQBUOZBQFNCFOUVLBOEJOEJOHQFNCBUBT KVNMBI OPSNBM TBNQBJ
NFOKBEJ TBNQBJ
EBOQFODFHBIBOQFOZFCBSBOLFTFMVSVIUVCVI4FCBMJLOZB OFVUSPGJM QFS NJLSPMJUFS ,FBEBBO JOJ EJTFCVU OFVUSPGJMJB
TUSFQUPLPLVTUJEBLNFOJNCVMLBOLFSVTBLBOKBSJOHBOMPLBM ZBOH CFSBSUJ UFSKBEJ QFOJOHLBUBO KVNMBI OFVUSPGJM EBMBN EBSBI
ZBOH IFCBU 4FIJOHHB QSPTFT QFNCFOUVLBO EJOEJOH /FVUSPGJMJB EJTFCBCLBO PMFI QSPEVL QFSBEBOHBO ZBOH NFNBTVLJ
QFNCBUBTCFSKBMBOMBNCBOTFMBNBCFCFSBQBKBN TFNFOUBSB BMJSBOEBSBI LFNVEJBOEJBOHLVULFTVNTVNUVMBOH EBOEJTJUV
428
Bab 33 Pertahanan Tubuh terhadap Infeksi: I. Leukosit, Granulosit, Sistem Monosit-Makrograf, dan Inflamasi
CFLFSKB QBEB OFVUSPGJM ZBOH UFSTJNQBO EBMBN TVNTVN EBMBNTVNTVNUVMBOH TFQFSUJZBOHEJCBIBTLFNVEJBO

VOUVL NFOHHFSBLLBO OFVUSPGJMOFVUSPGJM JOJ LF TJSLVMBTJ 4FQFSUJ ZBOH UFMBI EJKFMBTLBO NBLSPGBH EBQBU
EBSBI )BM JOJ NFNCVBU MFCJI CBOZBL MBHJ OFVUSPGJM ZBOH NFNGBHPTJUPTJT KBVI MFCJI CBOZBL CBLUFSJ LJSBLJSB MJNB
UFSTFEJBEJBSFBKBSJOHBOZBOHNFSBEBOH LBMJ MFCJI CBOZBL
EBO QBSUJLFM ZBOH KBVI MFCJI CFTBS
CBILBOUFSNBTVLOFVUSPGJMJUVTFOEJSJEBOTFKVNMBICFTBS
UNIT VI
Invasi Makrofag Kedua ke Jaringan Inflamasi KBSJOHBO OFLSPUJL EBSJQBEB ZBOH EBQBU EJMBLVLBO PMFI
sebagai Garis Pertahanan Ketiga. #FSTBNB EFOHBO OFVUSPGJM.BLSPGBHKVHBCFSQFSBOQFOUJOHEBMBNNFNJDV
JOWBTJ OFVUSPGJM NPOPTJU EBSJ EBSBI BLBO NFNBTVLJ QFNCFOUVLBO BOUJCPEJ TFQFSUJ ZBOH EJCJDBSBLBO EJ #BC
KBSJOHBO ZBOH NFSBEBOH EBO NFNCFTBS NFOKBEJ
NBLSPGBH/BNVO KVNMBINPOPTJUEBMBNTJSLVMBTJEBSBI
TFEJLJU UFNQBU QFOZJNQBOBO NPOPTJU EJ TVNTVN UVMBOH Peningkatan Produksi Granulosit dan Monosit
KVHBKBVIMFCJITFEJLJUEBSJQBEBOFVUSPGJM0MFILBSFOBJUV oleh Sumsum Tulang sebagai Lini Garis Pertahanan
QFNCFOUVLBO NBLSPGBH EJ BSFB KBSJOHBO ZBOH NFSBEBOH Keempat. (BSJT QFSUBIBOBO UVCVI ZBOH LFFNQBU BEBMBI
KBVI MFCJI MBNCBU EBSJQBEB OFVUSPGJM EBO NFNFSMVLBO QFOJOHLBUBO IFCBU QSPEVLTJ HSBOVMPTJU EBO NPOPTJU PMFI
XBLUV CFCFSBQB IBSJ TVQBZB NFOKBEJ FGFLUJG 4FMBOKVUOZB TVNTVN UVMBOH )BM JOJ EJTFCBCLBO PMFI QFSBOHTBOHBO
CBILBO TFUFMBI NFOHJOWBTJ KBSJOHBO ZBOH NFSBEBOH TFMTFMQSPHFOJUPSHSBOVMPTJUJLEBONPOPTJUJLEJTVNTVN
NPOPTJU NBTJI NFSVQBLBO TFM CFMVN NBUBOH EBO /BNVO IBM UFSTFCVU NFNFSMVLBO XBLUV TBNQBJ IBSJ
NFNFSMVLBOXBLUVKBNBUBVMFCJIVOUVLNFNCFOHLBL TFCFMVN HSBOVMPTJU EBO NPOPTJU ZBOH CBSV UFSCFOUVL JOJ
LFVLVSBOZBOHKBVIMFCJICFTBSEBONFNCFOUVLMJTPTPN NFODBQBJUBIBQNFOJOHHBMLBOTVNTVNUVMBOH+JLBUFSVT
EBMBN KVNMBI ZBOH TBOHBU CBOZBL CBSVMBI LFNVEJBO NFOFSVT UFSEBQBU QFSBOHTBOHBO EBSJ KBSJOHBO ZBOH
NFODBQBJ LBQBTJUBT QFOVI TFCBHBJ NBLSPGBH KBSJOHBO NFSBEBOH NBLB TVNTVN UVMBOH EBQBU UFSVTNFOFSVT
VOUVL QSPTFT GBHPTJUPTJT 5FSOZBUB TFUFMBI CFCFSBQB IBSJ NFNQSPEVLTJTFMTFMJOJEBMBNKVNMBIZBOHCBOZBLTFLBMJ
TBNQBJCFCFSBQBNJOHHV NBLSPGBHBLIJSOZBEBUBOHEBO TFMBNB CFSCVMBOCVMBO EBO CBILBO CFSUBIVOUBIVO
NFOEPNJOBTJ TFMTFM GBHPTJUJL EJ BSFB ZBOH NFSBEBOH LBEBOHLBEBOHEFOHBOLFDFQBUBOQSPEVLTJTBNQBJ
LBSFOBQSPEVLTJNPOPTJUCBSVZBOHTBOHBUNFOJOHLBU LBMJEJBUBTOPSNBM
429
Unit VI Sel-Sel Darah, Imunitas, dan Pembekuan Darahn
Pengaturan Umpan Balik terhadap Respons Makrofag TFCBHJBOCFTBSNBLSPGBHBLIJSOZBBLBONBUJ4FTVEBICFCFSBQB

dan Neutrofil IBSJ EJEBMBNKBSJOHBOZBOHNFSBEBOHBLBOUFSCFOUVLSPOHHB
3POHHB UFSTFCVU NFOHBOEVOH CFSCBHBJ CBHJBO KBSJOHBO
8BMBVQVO UFSEBQBU MFCJI EBSJ EVB MVTJO GBLUPS ZBOH UFSMJCBU
OFLSPUJL OFVUSPGJM NBUJ NBLSPGBH NBUJ EBO DBJSBO KBSJOHBO
EBMBN QFOHBUVSBO SFTQPOT NBLSPGBH UFSIBEBQ QFSBEBOHBO
$BNQVSBO TFQFSUJ JOJ CJBTBOZB EJTFCVU QVT 4FUFMBI QSPTFT
MJNB EJ BOUBSBOZB EJQFSDBZB NFNJMJLJ QFSBO ZBOH EPNJOBO
JOGFLTJ EBQBU EJUFLBO TFMTFM NBUJ EBO KBSJOHBO OFLSPUJL ZBOH
'BLUPSGBLUPSJOJEJQFSMJIBULBOQBEB(BNCBSEBOUFSEJSJ
UFSEBQBU EBMBN QVT TFDBSB CFSUBIBQ BLBO NFOHBMBNJ BVUPMJTJT
BUBT
GBLUPS OFLSPTJT UVNPS 5/'

JOUFSMFVLJO *-

EBMBN XBLUV CFCFSBQB IBSJ EBO LFNVEJBO QSPEVL BLIJSOZB

GBLUPSQFSBOHTBOHLPMPOJHSBOVMPTJUNPOPTJU (.$4'

BLBO EJBCTPSQTJ LF EBMBN KBSJOHBO TFLJUBS EBO DBJSBO MJNGF
GBLUPS QFSBOHTBOHLPMPOJ HSBOVMPTJU ($4'
EBO
GBLUPS
IJOHHBTFCBHJBOCFTBSUBOEBLFSVTBLBOKBSJOHBOIJMBOH
QFSBOHTBOHLPMPOJ NPOPTJU .$4'
'BLUPSGBLUPS JOJ
EJCFOUVL PMFI TFM NBLSPGBH ZBOH UFSBLUJWBTJ EJ KBSJOHBO ZBOH
NFSBEBOH EBO TFCBHJBO LFDJM EJCFOUVL PMFI TFMTFM KBSJOHBO Eosinofil
ZBOHNFSBEBOH
1FOZFCBCQFOJOHLBUBOQSPEVLTJHSBOVMPTJUEBONPOPTJUPMFI &PTJOPGJM OPSNBMOZB NFODBLVQ TFLJUBS QFSTFO EBSJ TFMVSVI
TVNTVN UVMBOH JOJ UFSVUBNB BEBMBI UJHB GBLUPS QFSBOHTBOH MFVLPTJUEBSBI&PTJOPGJMNFSVQBLBOTFMGBHPTJUZBOHMFNBI EBO
LPMPOJ TBUV EJ BOUBSBOZB (.$4' NFSBOHTBOH QSPEVLTJ NFOVOKVLLBOGFOPNFOBLFNPUBLTJT OBNVOCJMBEJCBOEJOHLBO
HSBOVMPTJUNBVQVONPOPTJUEBOEVBMBJOOZB ($4'EBO. EFOHBO OFVUSPGJM QFSBO FPTJOPGJM EBMBN QFSUBIBOBO UVCVI
$4' CFSUVSVUUVSVU NFSBOHTBOH HSBOVMPTJU EBO NPOPTJU UFSIBEBQUJQFJOGFLTJZBOHVNVNNBTJIEJSBHVLBO
,PNCJOBTJ BOUBSB 5/' *- EBO GBLUPS QFSBOHTBOH LPMPOJ /BNVO FPTJOPGJMTFSJOHEJQSPEVLTJEBMBNKVNMBICFTBSQBEB
NFSVQBLBO NFLBOJTNF VNQBO CBMJL ZBOH LVBU ZBOH EJNVMBJ QBTJFOJOGFLTJQBSBTJU EBOFPTJOPGJMJOJCFSNJHSBTJEBMBNKVNMBI
EFOHBOQFSBEBOHBOKBSJOHBO LFNVEJBOCFSMBOKVUNFNCFOUVL CFTBSLFKBSJOHBOZBOHEJTFSBOHPMFIJOGFLTJQBSBTJU8BMBVQVO
TFKVNMBI CFTBS TFM EBSBI QVUJI QFSUBIBOBO ZBOH NFNCBOUV LFCBOZBLBOQBSBTJUUFSMBMVCFTBSVOUVLEBQBUEJGBHPTJUPTJTPMFI
VOUVLNFOHIJMBOHLBOQFOZFCBCSBEBOH FPTJOPGJM BUBV PMFI TFM GBHPTJUJL MBJO OBNVO FPTJOPGJM BLBO
NFMFLBULBO EJSJ QBEB QBSBTJU NFMBMVJ NPMFLVM QFSNVLBBO
Pembentukan Pus
LIVTVT EBONFMFQBTLBO[BU[BUZBOHEBQBUNFNCVOVICBOZBL
#JMBOFVUSPGJMEBONBLSPGBHNFOFMBOTFKVNMBICFTBSCBLUFSJ QBSBTJU $POUPIOZB TBMBI TBUV JOGFLTJ ZBOH QBMJOH CBOZBL
EBOKBSJOHBOOFLSPUJL QBEBEBTBSOZBTFNVBOFVUSPGJMEBO UFSTFCBS EJ TFMVSVI EVOJB BEBMBI TLJTUPTPNJBTJT TVBUV JOGFLTJ
QBSBTJU ZBOH EJKVNQBJ QBEB TFQFSUJHB QFOEVEVL EJ CFCFSBQB
OFHBSB CFSLFNCBOH EJ "TJB "GSJLB EBO "NFSJLB 4FMBUBO
QBSBTJU JOJ EBQBU NBTVL LF TFUJBQ CBHJBO UVCVI &PTJOPGJM
NFMFLBULBO EJSJ QBEB QBSBTJU CFOUVL NVEB EBO NFNCVOVI
CBOZBLQBSBTJUJOJ&PTJOPGJMNFMBLVLBOIBMJOJNFMBMVJCFCFSBQB
DBSB
EFOHBO NFMFQBTLBO FO[JN IJESPMJUJL EBSJ HSBOVMBOZB
ZBOH EJNPEJGJLBTJ MJTPTPN
NVOHLJO KVHB EFOHBO
NFMFQBTLBOCFOUVLPLTJHFOZBOHTBOHBUSFBLUJGZBOHLIVTVTOZB
CFSTJGBU NFNBUJLBO CBHJ QBSBTJU EBO
EFOHBO NFMFQBTLBO
TVBUV QPMJQFQUJEB ZBOH TBOHBU MBSWBTJEBM EBSJ HSBOVMBOZB ZBOH
EJTFCVUQSPUFJOEBTBSVUBNB
%JTFCBHJBOLFDJMUFNQBUEJEVOJB QFOZBLJUQBSBTJUMBJOZBOH
NFOZFCBCLBO FPTJOPGJMJB BEBMBI USJLJOPTJT 5SJLJOPTJT
EJTFCBCLBO PMFI JOWBTJ QBSBTJU 5SJDIJOFMMB DBDJOH CBCJ
LF
EBMBN PUPU TFUFMBI TFTFPSBOH NBLBO EBHJOH CBCJ ZBOH
NFOHBOEVOHQBSBTJUEBOUJEBLEJNBTBLIJOHHBNBUBOH
&PTJOPGJM KVHB NFNQVOZBJ LFDFOEFSVOHBO LIVTVT VOUVL
CFSLVNQVM EJ KBSJOHBO UFNQBU CFSMBOHTVOHOZB SFBLTJ BMFSHJ
TFQFSUJ EJ KBSJOHBO QFSJCSPOLJBM QBSV QBTJFO BTNB EBO EJ LVMJU
TFUFMBI NFOHBMBNJ SFBLTJ LVMJU BMFSHJ 4FEJLJUOZB IBM JOJ
TFCBHJBO EJTFCBCLBO PMFI GBLUB CBIXB CBOZBL TFM NBTU EBO
CBTPGJM ZBOH CFSQFSBO TFSUB EBMBN SFBLTJ BMFSHJ TFQFSUJ ZBOH
BLBO EJCJDBSBLBO EJ QBSBHSBG CFSJLVU 4FM NBTU EBO CBTPGJM JOJ
NFMFQBTLBO GBLUPS LFNPUBLTJT FPTJOPGJM ZBOH NFOZFCBCLBO
FPTJOPGJM CFSNJHSBTJ LF BSBI KBSJOHBO BMFSHJL ZBOH NFSBEBOH
&PTJOPGJM EJEVHB NBNQV NFOEFUPLTJGJLBTJ CFCFSBQB [BU
QFODFUVTQFSBEBOHBOZBOHEJMFQBTLBOPMFITFMNBTUEBOCBTPGJM
EBO NVOHLJO KVHB NFNGBHPTJUPTJT EBO NFOHIBODVSLBO
LPNQMFLT BMFSHFO BOUJCPEJ KBEJ NFODFHBI QFOZFCBSBO QSPTFT
QFSBEBOHBOTFUFNQBU
430
CFCFSBQB PCBU VNVN TFQFSUJ LMPSBNGFOJLPM BOUJCJPUJL

Basophils UJPVSBTJM EJQBLBJ VOUVL NFOHPCBUJ UJSPUPLTJLPTJT
EBO
CBILBO CFSCBHBJ NBDBN PCBU IJQOPUJL CBSCJUVSBU EBMBN
#BTPGJM EBMBN TJSLVMBTJ EBSBI TFSVQB EFOHBO TFM NBTU KBSJOHBO LFBEBBO ZBOH TBOHBU KBSBOH EBQBU NFOJNCVULBO
ZBOHCFTBSZBOHUFSMFUBLUFQBUEJTJTJMVBSCBOZBLLBQJMFSEBMBN MFVLPQFOJB IJOHHBNFNCVBULFTFMVSVIBOSBOHLBJBOJOGFLTJ
UNIT VI
UVCVI 4FM NBTU EBO CBTPGJM NFMFQBTLBO IFQBSJO LF EBMBN QBEBPSBOHUFSTFCVU
EBSBI ZBJUV TVBUV CBIBO ZBOH EBQBU NFODFHBI QFNCFLVBO 4FUFMBI TVNTVN UVMBOH NFOHBMBNJ LFSVTBLBO TFEBOH
EBSBI BLJCBU QFOZJOBSBO NBTJI BEB CFCFSBQB TFM QVODB
4FMNBTUEBOCBTPGJMKVHBNFMFQBTLBOIJTUBNJO EBOTFKVNMBI NJFMPCMBT EBO IFNPTJUPCMBT ZBOH UJEBL SVTBL EBMBN
LFDJM CSBEJLJOJO TFSUB TFSPUPOJO 5FOUV TBKB TFM NBTU QBEB TVNTVN EBO NBNQV NFMBLVLBO SFHFOFSBTJ TVNTVN
KBSJOHBO SBEBOH UFSVUBNB NFMFQBTLBO CBIBOCBIBO JOJ LFUJLB UVMBOH BTBMLBOUFSTFEJBXBLUVZBOHDVLVQ1BTJFOEJUFSBQJ
UFSKBEJQFSBEBOHBO EFOHBOUSBOTGVTJZBOHUFQBU EJUBNCBIBOUJCJPUJLEBOPCBU
4FM NBTU EBO CBTPGJM CFSQFSBO QFOUJOH QBEB CFCFSBQB UJQF PCBU MBJOOZB VOUVL NFOBOHHVMBOHJ JOGFLTJ CJBTBOZB
SFBLTJ BMFSHJ LBSFOB UJQF BOUJCPEJ ZBOH NFOZFCBCLBO SFBLTJ UFSCFOUVL TVNTVN UVMBOH CBSV ZBOH DVLVQ EBMBN XBLUV
BMFSHJ ZBJUV UJQF JNVOPHMPCVMJO & *H&
NFNQVOZBJ CFCFSBQB NJOHHV TBNQBJ CFCFSBQB CVMBO TVQBZB
LFDFOEFSVOHBO LIVTVT VOUVL NFMFLBU QBEB TFM NBTU EBO LPOTFOUSBTJTFMTFMEBSBIEBQBULFNCBMJOPSNBM
CBTPGJM 4FMBOKVUOZB CJMB UFSEBQBU BOUJHFO ZBOH TQFTJGJL VOUVL
BOUJCPEJ *H& UFSUFOUV EBO LFNVEJBO BOUJHFO JOJ CFSFBLTJ Leukemia
EFOHBO BOUJCPEJ NBLB BLBO UFSKBEJ QFMFLBUBO BOUBSB BOUJHFO
EBOBOUJCPEJZBOHNFOZFCBCLBOTFMNBTUBUBVCBTPGJMNFOKBEJ 1SPEVLTJTFMEBSBIQVUJIZBOHUJEBLUFSLPOUSPMEJTFCBCLBO
QFDBI EBO NFMFQBTLBO TFKVNMBI CFTBS IJTUBNJO CSBEJLJOJO PMFINVUBTJZBOHCFSTJGBULBOLFSQBEBTFMNJFMPHFOBUBVTFM
TFSPUPOJO IFQBSJO TVCTUBOTJ BOBGJMBLTJT ZBOH CFSFBLTJ MBNCBU MJNGPHFO )BM JOJ NFOZFCBCLBO MFVLFNJB ZBOH CJBTBOZB
EBO TFKVNMBI FO[JN MJTPTPNBM #BIBOCBIBO JOJ TFMBOKVUOZB EJUBOEBJ EFOHBO KVNMBI TFM EBSBI QVUJI BCOPSNBM ZBOH
NFOZFCBCLBO SFBLTJ KBSJOHBO EBO QFNCVMVI EBSBI TFUFNQBU TBOHBUNFOJOHLBUEBMBNTJSLVMBTJEBSBI
ZBOH NFOZFCBCLBO CBOZBL BUBV TFCBHJBO CFTBS NBOJGFTUBTJ Tipe Leukemia. -FVLFNJB EJCBHJ NFOKBEJ EVB UJQF
BMFSHJ3FBLTJJOJEJCJDBSBLBOMFCJIEFUBJMEJ#BC VNVN MFVLFNJB MJNGPTJUJL EBO MFVLFNJB NJFMPHFOPTB
-FVLFNJB MJNGPTJUJL EJTFCBCLBO PMFI QSPEVLTJ TFM MJNGPJE
Leukopenia ZBOHCFSTJGBULBOLFS CJBTBOZBEJNVMBJEJOPEVTMJNGFBUBV
KBSJOHBO MJNGPTJUJL MBJO EBO NFOZFCBS LF EBFSBI UVCVI
,FBEBBO LMJOJT ZBOH EJLFOBM TFCBHBJ MFVLPQFOJB LBSFOB MBJOOZB5JQFMFVLFNJBZBOHLFEVB MFVLFNJBNJFMPHFOPTB
TVNTVN UVMBOH NFNCFOUVL TBOHBU TFEJLJU TFM EBSBI QVUJI EJNVMBJ EFOHBO QSPEVLTJ TFM NJFMPHFOPTB NVEB ZBOH
LBEBOHLBEBOH UFSKBEJ )BM JOJ NFOZFCBCLBO UVCVI UBL CFSTJGBULBOLFSEJTVNTVNUVMBOHEBOLFNVEJBONFOZFCBS
UFSMJOEVOHUFSIBEBQCBOZBLCBLUFSJEBOBHFOBHFOZBOHEBQBU LF TFMVSVI UVCVI TFIJOHHB TFM EBSBI QVUJI EJQSPEVLTJ EJ
NFOZFSBOHKBSJOHBO CBOZBL PSHBO FLTUSBNFEVMBS UFSVUBNB EJ OPEVT MJNGF
#JBTBOZB UVCVI NBOVTJB IJEVQ CFSTJNCJPTJT EFOHBO MJNQB EBOIBUJ
CFSNBDBNNBDBN CBLUFSJ LBSFOB TFMVSVI NFNCSBO NVLPTB 1BEBMFVLFNJBNJFMPHFOPTB LBEBOHLBEBOHQSPTFTZBOH
UVCVI UFSVTNFOFSVT CFSIVCVOHBO EFOHBO CBOZBL TFLBMJ CFSTJGBU LBOLFS JUV NFNQSPEVLTJ TFM ZBOH CFSEJGFSFOTJBTJ
CBLUFSJ .VMVU IBNQJS TFMBMV NFOHBOEVOH CFSNBDBNNBDBN TFCBHJBO NFOHIBTJMLBOBQBZBOHEJTFCVUEFOHBOMFVLFNJB
CBLUFSJ TQJSPLIFUB QOFVNPLPLVT EBO TUSFQUPLPLVT EBO OFVUSPGJMJL MFVLFNJB FPTJOPGJMJL MFVLFNJB CBTPGJMJL BUBV
CBLUFSJ ZBOH TBNB JOJ EJUFNVLBO EBMBN KVNMBI ZBOH MFCJI MFVLFNJBNPOPTJUJL/BNVO ZBOHMFCJITFSJOHUFSKBEJJBMBI
TFEJLJU EJ TFMVSVI TBMVSBO OBQBT 4BMVSBO DFSOB CBHJBO EJTUBM TFM MFVLFNJB EFOHBO CFOUVL ZBOH BOFI EBO UJEBL
LIVTVTOZBEJQFOVIJEFOHBOCBTJMLPMPO4FMBOKVUOZB LJUBEBQBU CFSEJGFSFOTJBTJ TFSUB UJEBL JEFOUJL EFOHBO TFM EBSBI QVUJI
TFMBMVNFOKVNQBJCBLUFSJEJBUBTQFSNVLBBONBUB VSFUSB EBO ZBOH OPSNBM BQB QVO #JBTBOZB CJMB TFM TFNBLJO UJEBL
WBHJOB4FUJBQQFOVSVOBOKVNMBITFMEBSBIQVUJIEFOHBOTFHFSB CFSEJGFSFOTJBTJ NBLB MFVLFNJB ZBOH UFSKBEJ TFNBLJO BLVU
BLBO NFNVOHLJOLBO JOWBTJ KBSJOHBO TFLJUBS PMFI CBLUFSJ ZBOH EBOKJLBUJEBLEJPCBUJTFSJOHNFOZFCBCLBOLFNBUJBOEBMBN
NFNBOHTVEBIBEBEBMBNUVCVI XBLUV CFCFSBQB CVMBO 1BEB CFCFSBQB TFM ZBOH MFCJI
CFSEJGFSFOTJBTJ QSPTFTOZB EBQBU CFSMBOHTVOH LSPOJT
%BMBN XBLUV EVB IBSJ TFTVEBI TVNTVN UVMBOH CFSIFOUJ
LBEBOHLBEBOH CFHJUV MBNCBUOZB TBNQBJ MFCJI EBSJ
NFNQSPEVLTJTFMEBSBIQVUJI EJEBMBNNVMVUEBOLPMPOEBQBU
IJOHHB UBIVO 4FM MFVLFNJB LIVTVTOZB TFM ZBOH TBOHBU
UJNCVM VMLVT BUBV PSBOH UFSTFCVU EBQBU NFOHBMBNJ CFCFSBQB
UJEBLCFSEJGFSFOTJBTJ CJBTBOZBUJEBLCFSGVOHTJNFNCFSJLBO
CFOUVLJOGFLTJQFSOBQBTBOZBOHCFSBU#BLUFSJZBOHCFSBTBMEBO
QFSMJOEVOHBOOPSNBMUFSIBEBQJOGFLTJ
VMLVT TFDBSB DFQBU NFOHJOWBTJ KBSJOHBO TFLJUBS EBO EBSBI
5BOQB QFOHPCBUBO EBMBN XBLUV LVSBOH EBSJ TBUV NJOHHV Pengaruh Leukemia pada Tubuh
TFUFMBI EJNVMBJOZB MFVLPQFOJB UPUBM BLVU EBQBU UFSKBEJ &GFLQFSUBNBMFVLFNJBBEBMBIQFSUVNCVIBONFUBTUBUJLTFM
LFNBUJBO MFVLFNJL EJ UFNQBU ZBOH BCOPSNBM EBMBN UVCVI 4FM
3BEJBTJUVCVIEFOHBOTJOBSYBUBVTJOBSHBNNB BUBVTFUFMBI MFVLFNJL EBSJ TVNTVN UVMBOH EBQBU CFSLFNCBOH CJBL
UFSQBKBO EFOHBO PCBUPCBUBO EBO CBIBO LJNJB ZBOH TFEFNJLJBOIFCBUOZBTFIJOHHBEBQBUNFOHJOWBTJUVMBOHEJ
NFOHBOEVOH JOUJ CFO[FOB BUBV JOUJ BOUSBTFOB LFNVOHLJOBO TFLJUBSOZB NFOJNCVMLBO SBTB OZFSJ EBO QBEB BLIJSOZB
CFTBSEBQBUNFOJNCVMLBOBQMBTJBTVNTVNUVMBOH.FNBOH UVMBOHDFOEFSVOHNVEBIGSBLUVS
431
)BNQJS TFNVB TFM MFVLFNJB BLBO NFOZFCBS LF MJNQB Bromley SK, Mempel TR, Luster AD: Orchestrating the orchestrators:
chemokines in control of T cell traffic, Nat Immunol 9:970, 2008.
OPEVT MJNGF IBUJ EBO EBFSBI QFNCVMVI EBSBI MBJOOZB
Ferrajoli A, O’Brien SM: Treatment of chronic lymphocytic leukemia, Semin
UBOQB NFOHIJSBVLBO BQBLBI MFVLFNJB JUV CFSBTBM EBSJ
Oncol 31(Suppl 4):60, 2004.
TVNTVN UVMBOH BUBV OPEVT MJNGF &GFL VNVN MFVLFNJB Huynh KK, Kay JG, Stow JL, et al: Fusion, fission, and secretion during
BEBMBI UJNCVMOZB JOGFLTJ BOFNJB CFSBU EBO phago-
LFDFOEFSVOHBO VOUVL CFSEBSBI LBSFOB UFSKBEJ cytosis, Physiology (Bethesda) 22:366, 2007.
Johnson LA, Jackson DG: Cell traffic and the lymphatic endothelium, Ann
USPNCPTJUPQFOJB LFLVSBOHBO USPNCPTJU
#FSCBHBJ
N Y Acad Sci 1131:119, 2008.
QFOHBSVI JOJ UFSVUBNB EJBLJCBULBO PMFI QFOHHBOUJBO TFM Kinchen JM, Ravichandran KS: Phagosome maturation: going through
OPSNBM EJ TVNTVN UVMBOH EBO TFM MJNGPJE PMFI TFM theacid test, Nat Rev Mol Cell Biol 9:781, 2008.
MFVLFNJLZBOHUJEBLCFSGVOHTJ Kunkel EJ, Butcher EC: Plasma-cell homing, Nat Rev Immunol 3:822,
"LIJSOZB QFOHBSVIMFVLFNJBZBOHQFOUJOHQBEBUVCVI 2003. Kvietys PR, Sandig M: Neutrophil diapedesis: paracellular or
transcellular?
BEBMBIQFOHHVOBBOCBIBONFUBCPMJLZBOHCFSMFCJIBOPMFI News Physiol Sci 16:15, 2001.
TFM LBOLFS ZBOH TFEBOH UVNCVI +BSJOHBO MFVLFNJL Medzhitov R: Origin and physiological roles of inflammation, Nature
NFNQSPEVLTJ LFNCBMJ TFMTFM CBSV EFOHBO CFHJUV DFQBU 24:454, 428, 2008.
TFIJOHHB UJNCVM LFCVUVIBO NBLBOBO ZBOH CFTBS TFLBMJ Ossovskaya VS, Bunnett NW: Protease-activated receptors: contribution
to physiology and disease, Physiol Rev 84:579, 2004.
EBSJ DBEBOHBO UVCVI LIVTVTOZB BTBN BNJOP EBO
Pui CH, Relling MV, Downing JR: Acute lymphoblastic leukemia, N
WJUBNJO "LJCBUOZB FOFSHJ QBTJFO NFOKBEJ TBOHBU Engl J
CFSLVSBOH EBOQFOHHVOBBOBTBNBNJOPZBOHCFSMFCJIBO Med 350:1535, 2004.
LIVTVTOZB NFOZFCBCLBO KBSJOHBO QSPUFJO UVCVI ZBOH Ricardo SD, van Goor H, Eddy AA: Macrophage diversity in renal injury
OPSNBM NFOHBMBNJ LFNVOEVSBO ZBOH DFQBU +BEJ TBBU andrepair, J Clin Invest 118:3522, 2008.
Sigmundsdottir H, Butcher EC: Environmental cues, dendritic cells and
KBSJOHBO MFVLFNJL UVNCVI KBSJOHBO MBJO BLBO NFMFNBI the programming of tissue-selective lymphocyte trafficking, Nat Immunol
4FUFMBI NFOHBMBNJ LFMBQBSBO NFUBCPMJL ZBOH 9:981, 2008.
CFSLFQBOKBOHBO IBM JOJ TBKB TVEBI DVLVQ VOUVL Smith KA, Griffin JD: Following the cytokine signaling pathway to
NFOZFCBCLBOLFNBUJBO leukemo-
genesis: a chronology, J Clin Invest 118:3564, 2008.
Daftar Pusaka Viola A, Luster AD: Chemokines and their receptors: drug targets in immu-
nity and inflammation, Annu Rev Pharmacol Toxicol 48:171, 2008.
Alexander JS, Granger DN: Lymphocyte trafficking mediated by vascular Werner S, Grose R: Regulation of wound healing by growth factors
adhesion protein-1: implications for immune targeting and cardiovas- andcytokines, Physiol Rev 83:835, 2003.
cular disease, Circ Res 86:1190, 2000. Zullig S, Hengartner MO: Cell biology: tickling macrophages, a
Blander JM, Medzhitov R: Regulation of phagosome maturation by signals serious
from toll-like receptors, Science 304:1014, 2004. business, Science 304:1123, 2004.
432
BAB 34
1FSUBIBOBO5VCVIUFSIBEBQ*OGFLTJ
UNIT VI
** *NVOJUBTEBO*NVOJUBT#BXBBO
"MFSHJ
5VCVI NBOVTJB NFNQVOZBJ LF

Imunitas Didapat (Adaptif)
NBNQVBO VOUVL NFMBXBO IBNQJS
TFNVB KFOJT PSHBOJTNF BUBV UPLTJO
4FMBJO JNVOJUBT CBXBBO ZBOH CFSTJGBU VNVN UVCVI NBOVTJB
ZBOH DFOEFSVOH NFSVTBL KBSJOHBO
KVHB NBNQV NFNCFOUVL JNVOJUBT TQFTJGJL ZBOH TBOHBU LVBU
EBSJ PSHBO UVCVI ,FNBNQVBO JOJ
VOUVL NFMBXBO BHFO QFOZFSBOH ZBOH NFNBUJLBO TFQFSUJ
EJTFCVUJNVOJUBT4FCBHJBOCFTBS
CBLUFSJ WJSVT UPLTJO EBO CBILBO KBSJOHBO BTJOH ZBOH CFSBTBM
JNVOJUBTNFSVQBLBOJNVOJUBTEJEBQBUZBOHUJEBLUJNCVMTBNQBJ EBSJ IFXBO MBJO *NVOJUBT TFNBDBN JOJ EJTFCVU JNVOJUBT
UVCVI QFSUBNB LBMJ EJTFSBOH PMFI CBLUFSJ WJSVT BUBV UPLTJO EJEBQBUBUBVJNVOJUBTBEBQUJG*NVOJUBTEJEBQBUEJIBTJMLBOPMFI
TFSJOH LBMJ NFNCVUVILBO XBLUV CFSNJOHHVNJOHHV BUBV TJTUFN JNVO LIVTVT ZBOH NFNCFOUVL BOUJCPEJ EBO BUBV
CFSCVMBOCVMBO VOUVL NFNCFOUVL JNVOJUBT JOJ "EB TVBUV NFOHBLUJGLBO MJNGPTJU ZBOH NBNQV NFOZFSBOH EBO
JNVOJUBT KFOJT MBJO ZBOH NFSVQBLBO BLJCBU EBSJ QSPTFT VNVN NFOHIBODVSLBOPSHBOJTNFTQFTJGJLBUBVUPLTJO%BMBNCBCJOJ
EBO CVLBO EBSJ QSPTFT ZBOH EJUVKVLBO VOUVL TVBUV PSHBOJTNF BLBO EJCBIBT NFOHFOBJ NFLBOJTNF JNVOJUBT EJEBQBU EBO
QFOZFCBC QFOZBLJU UFSUFOUV *NVOJUBT JOJ EJTFCVU JNVOJUBT CFCFSBQBSFBLTJUFSLBJU UFSVUBNBBMFSHJ
CBXBBO ZBOHNFMJQVUJ
*NVOJUBT EJEBQBU TFSJOH LBMJ NBNQV NFNCFSJLBO
1. 1SPTFT GBHPTJUPTJT CBLUFSJ EBO PSHBOJTNF MBJOOZB PMFI TFM QFSMJOEVOHBOZBOHLVBU$POUPIOZB JNVOJUBTEJEBQBUNBNQV
EBSBI QVUJI EBO TFM QBEB TJTUFN NBLSPGBH KBSJOHBO TFQFSUJ NFMJOEVOHJ UVCVI EBSJ FGFL UPLTJO UFSUFOUV TFQFSUJ UPLTJO
ZBOHEJKFMBTLBOQBEB#BC CPUVMJOVN ZBOH CFSTJGBU QBSBMJUJL BUBV UPLTJO UFUBOVT ZBOH
2. 1FOHIBODVSBOPSHBOJTNFZBOHUFSUFMBOLFEBMBNTBMVSBO NFOJNCVMLBO LFKBOH EBMBN EPTJT TFCBOZBL LBMJ
DFSOBPMFIBTBNMBNCVOHEBOFO[JNQFODFSOBBO KVNMBI ZBOH EBQBU NFOJNCVMLBO LFNBUJBO CJMB UJEBL BEB
3. %BZBUBIBOLVMJUUFSIBEBQJOWBTJPSHBOJTNF JNVOJUBT *OJ NFSVQBLBO BMBTBO NFOHBQB TVBUV QSPTFT ZBOH
4. "EBOZB TFOZBXB LJNJB UFSUFOUV EBMBN EBSBI ZBOH NFMFLBU EJLFOBM TFCBHBJ JNVOJTBTJ TBOHBU QFOUJOH EBMBN NFMJOEVOHJ
NBOVTJB UFSIBEBQ QFOZBLJU EBO UPLTJO TFQFSUJ ZBOH BLBO
QBEB PSHBOJTNF BTJOH BUBV UPLTJO EBO LFNVEJBO
EJCJDBSBLBOEJCBCJOJ
NFOHIBODVSLBOOZB #FCFSBQB TFOZBXB UFSTFCVU BEBMBI
MJTP[JN TVBUV QPMJTBLBSJEB NVLPMJUJL ZBOH NFOZFSBOH CBLUFSJ

EBO NFNCVBUOZB MBSVU
QPMJQFQUJEB EBTBS ZBOH CFSFBLTJ Tipe-Tipe Dasar Imunitas Didapat Diperantarai Humoral
EFOHBO CBLUFSJ HSBNQPTJUJG UFSUFOUV EBO NFNCVBUOZB dan Selular
NFOKBEJ UJEBL BLUJG
LPNQMFLT LPNQMFNFO ZBOH BLBO %BMBN UVCVI EBQBU EJKVNQBJ EVB UJQF EBTBS JNVOJUBT EJEBQBU
EJCJDBSBLBO LFNVEJBO NFSVQBLBO TVBUV TJTUFN ZBOH UFSEJSJ ZBOH CFSIVCVOHBO FSBU TBUV TBNB MBJO 1BEB UJQF QFSUBNB
BUBT LVSBOH MFCJI QSPUFJO ZBOH EBQBU EJBLUJGLBO NFMBMVJ UVCVI NFNCFOUVL BOUJCPEJ ZBOH CFSTJSLVMBTJ ZBJUV NPMFLVM
CFSCBHBJ NBDBN DBSB VOUVL NFOHIBODVSLBO CBLUFSJ EBO
HMPCVMJO EBMBN QMBTNB EBSBI ZBOH NBNQV NFOZFSBOH BHFO
MJNGPTJU QFNCVOVI BMBNJ OBUVSBM LJMMFS MZNQIPDZUF
ZBOH ZBOH NBTVL LF EBMBN UVCVI 5JQF JNVOJUBT JOJ EJTFCVU
EBQBUNFOHFOBMJEBONFOHIBODVSLBOTFMTFMBTJOH TFMUVNPS JNVOJUBT IVNPSBM BUBV JNVOJUBT TFM# LBSFOB MJNGPTJU #
EBOCBILBOCFCFSBQBTFMZBOHUFSJOGFLTJ NFNQSPEVLTJ BOUJCPEJ
4FNFOUBSB JUV UJQF ZBOH LFEVB
*NVOJUBTCBXBBOJOJNFNCVBUUVCVINBOVTJBUBIBOUFSIBEBQ EJQFSPMFI NFMBMVJ QFNCFOUVLBO MJNGPTJU 5 UFSBLUJWBTJ EBMBN
QFOZBLJU TFQFSUJ CFCFSBQB JOGFLTJ WJSVT QBSBMJUJL QBEB IFXBO KVNMBI CFTBS ZBOH TFDBSB LIVTVT EJSBODBOH VOUVL
LPMFSB QBEB CBCJ QFT QBEB MFNCV EBO EJTUFNQFS QFOZBLJU WJSVT NFOHIBODVSLBO CFOEB BTJOH +FOJT JNVOJUBT JOJ EJTFCVU
ZBOHCBOZBLNFOZFCBCLBOLFNBUJBOQBEBBOKJOHZBOHNFOEFSJUB JNVOJUBT ZBOH EJQFSBOUBSBJ TFM BUBV JNVOJUBT TFM 5 LBSFOB
QFOZBLJU JOJ 4FCBMJLOZB CBOZBL CJOBUBOH UJOHLBU SFOEBI ZBOH MJNGPTJU ZBOH UFSBLUJWBTJ NFSVQBLBO MJNGPTJU 5
,JUB BLBO
UBIBO BUBV CBILBO LFCBM UFSIBEBQ CBOZBL QFOZBLJU ZBOH TFHFSB NFMJIBU CBIXB BOUJCPEJ EBO MJNGPTJU ZBOH UFSBLUJWBTJ
NFOZFSBOH NBOVTJB TFQFSUJ QPMJPNJFMJUJT QBSPUJUJT LPMFSB EJCFOUVL EBMBN KBSJOHBO MJNGPJE UVCVI 1FSUBNBUBNB NBSJ
DBNQBL EBO TJGJMJT ZBOH NFOJNCVMLBO LFSVTBLBO BUBV CBILBO LJUB NFNCBIBT UFOUBOH EJNVMBJOZB QSPTFT JNVOJUBT ZBOH
LFNBUJBOCBHJNBOVTJB EJQJDVPMFIBOUJHFO
433
Unit VI Sel-Sel darah, Imunitas, dan Pembekuan Darah
Kedua Tipe Imunitas Didapat Dicetuskan oleh Antigen UVLJNVOJUBTEJQFSBOUBSBJTFM EBOLFMPNQPLMBJO ZBJUVMJNGPTJU
0MFI LBSFOB JNVOJUBT ZBOH EJEBQBU JOJ UJEBL BLBO UFSCFOUVL # CFSUBOHHVOH KBXBC EBMBN QFNCFOUVLBO BOUJCPEJ ZBOH
TBNQBJ BEB JOWBTJ PMFI PSHBOJTNF BTJOH BUBV UPLTJO NBLB NFNCFSJLBOJNVOJUBTIVNPSBM
KFMBTMBI CBIXB UVCVI IBSVT NFNQVOZBJ TVBUV NFLBOJTNF 1BEB NBTB FNCSJP LFEVB NBDBN MJNGPTJU JOJ CFSBTBM EBSJ TFM
UFSUFOUV VOUVL NFOHFOBMJ JOWBTJ JOJ 4FUJBQ UPLTJO BUBV TFUJBQ QVODB IFNBUPQPJFUJL QMVSJ QPUFO ZBOH NFNCFOUVL TFM QSPHFOJUPS
KFOJT PSHBOJTNF IBNQJS TFMBMV NFOHBOEVOH TBUV BUBV MFCJI MJNGPJE VNVN TFCBHBJ TBMBI TBUV IBTJM EJGFSFOTJBTJ TFM UFSQFOUJOH
TFOZBXB LJNJB TQFTJGJL ZBOH NFNCVBUOZB CFSCFEB EFOHBO )BNQJS TFNVB MJNGPTJU ZBOH UFSCFOUVL BLIJSOZB CFSBEB EBMBN
TFMVSVI TFOZBXB MBJOOZB 1BEB VNVNOZB TFOZBXB UFSTFCVU KBSJOHBOMJNGPJE OBNVOTFCFMVNTBNQBJ MJNGPTJUCFSEJGFSFOTJBTJ
BEBMBI QSPUFJO BUBV QPMJTBLBSJEB CFTBS EBO TFOZBXB JOJMBI MFCJIMBOKVUBUBVEJPMBIMFCJIEVMVEFOHBODBSBCFSJLVU
ZBOH NFNJDV JNVOJUBT EJEBQBU #BIBOCBIBO JOJ EJTFCVU 4FMTFM QSPHFOJUPS MJNGPJE ZBOH EJQFSTJBQLBO VOUVL
BOUJHFO BOUJCPEZHFOFSBUJPOT
NFNCFOUVL MJNGPTJU 5 UFSBLUJWBTJ NVMBNVMB CFSNJHSBTJ LF
"HBS TVBUV CBIBO EBQBU CFSTJGBU BOUJHFOJL CJBTBOZB IBSVT LFMFOKBS UJNVT EBO EJPMBI MFCJI EVMV EJ TBOB TFIJOHHB MJNGPTJU
NFNQVOZBJ CFSBU NPMFLVM ZBOH CFTBS BUBV MFCJI UFSTFCVU EJTFCVU MJNGPTJU 5 VOUVL NFOVOKVLLBO QFSBOBO
4FMBOKVUOZB QSPTFT QFNCFOUVLBO TJGBU BOUJHFOJL CJBTBOZB LFMFOKBSUJNVT-JNGPTJUJOJCFSUBOHHVOHKBXBCVOUVLNFNCFOUVL
CFSHBOUVOH QBEB QFOHVMBOHBO LFMPNQPL NPMFLVMBS TFDBSB JNVOJUBTZBOHEJQFSBOUBSBJTFM
SFHVMFS ZBOH EJTFCVU FQJUPQ QBEB QFSNVLBBO NPMFLVM CFTBS ,FMPNQPL MJNGPTJU ZBOH MBJO MJNGPTJU # ZBOH EJQFSTJBQLBO
)BM JOJ KVHB NFOKFMBTLBO NFOHBQB QSPUFJO EBO QPMJTBLBSJEB VOUVL NFNCFOUVL BOUJCPEJ NVMBNVMB EJPMBI MFCJI EVMV EJ IBUJ
CFTBS IBNQJS TFMBMV CFSTJGBU BOUJHFOJL LBSFOB LFEVBOZB TFMBNB NBTB QFSUFOHBIBO LFIJEVQBO KBOJO LFNVEJBO EJPMBI EJ
NFNQVOZBJTJGBUTUFSFPLJNJBUFSTFCVU TVNTVN UVMBOH QBEB NBTB BLIJS KBOJO EBO TFTVEBI MBIJS
,FMPNQPL TFM JOJ NVMBNVMB EJUFNVLBO QBEB CVSVOH ZBOH
Limfosit Berperan dalam Pembentukan Imunitas Didapat NFNQVOZBJPSHBOQFOHPMBIBOLIVTVTZBJUVCVSTB'BCSJDJVT0MFI
*NVOJUBT EJEBQBU NFSVQBLBO QSPEVL MJNGPTJU UVCVI 0SBOH LBSFOB BMBTBO UFSTFCVU MJNGPTJU JOJ EJTFCVU MJNGPTJU # EBO
PSBOHZBOHNFNJMJLJDBDBUHFOFUJLCFSVQBLFLVSBOHBOMJNGPTJU CFSUBOHHVOH KBXBC VOUVL JNVOJUBT IVNPSBM (BNCBS
BUBV ZBOH MJNGPTJUOZB UFMBI SVTBL BLJCBU SBEJBTJ BUBV CBIBO NFNQFSMJIBULBO LFEVB TJTUFN MJNGPTJU CFSUVSVUUVSVU VOUVL
LJNJB UJEBLEBQBUNFNCFOUVLJNVOJUBTEJEBQBU%BMBNXBLUV QFNCFOUVLBO
MJNGPTJU5UFSBLUJWBTJEBO
BOUJCPEJ
CFCFSBQBIBSJTFUFMBIMBIJS QBTJFOTFQFSUJJOJNFOJOHHBMBLJCBU
JOGFLTJCBLUFSJZBOHHBOBTLFDVBMJCJMBEJPCBUJEFOHBOUJOEBLBO Pengolahan Pendahuluan terhadap Limfosit T dan B
ZBOH IFCBU 0MFI LBSFOB JUV KFMBTMBI CBIXB MJNGPTJU TBOHBU 8BMBVQVO TFNVB MJNGPTJU UVCVI CFSBTBM EBSJ TFM QVODB ZBOH
QFOUJOHVOUVLLFMBOHTVOHBOIJEVQNBOVTJB NFNCFOUVL MJNGPTJU EJ NBTB FNCSJP TFM QVODB JOJ TFOEJSJ UJEBL
-JNGPTJU QBMJOH CBOZBL EJUFNVLBO EBMBN OPEVT MJNGF NBNQV NFNCFOUVL MJNGPTJU 5 UFSBLUJWBTJ BUBV BOUJCPEJ TFDBSB
OBNVO EBQBU KVHB EJKVNQBJ EBMBN KBSJOHBO MJNGPJE LIVTVT MBOHTVOH 4FCFMVN EBQBU NFMBLVLBO IBM JUV TFM QVODB UFSTFCVU
TFQFSUJ MJNQB EBFSBI TVCNVLPTB TBMVSBO DFSOB UJNVT EBO IBSVTCFSEJGFSFOTJBTJMFCJIMBOKVUEJUFNQBUQFOHPMBIBOZBOHUFQBU
TVNTVNUVMBOH+BSJOHBOMJNGPJEUFSTFCBSEJMPLBTJMPLBTJZBOH TFCBHBJCFSJLVU
TBOHBUNFOHVOUVOHLBOEJEBMBNUVCVIVOUVLNFOBIBOJOWBTJ
PSHBOJTNFBUBVUPLTJOTFCFMVNEBQBUNFOZFCBSMFCJIMVBT Limfosit T Diolah Lebih Dulu di Kelenjar Timus.-JNGPTJU
1BEB LFCBOZBLBO LBTVT NVMBNVMB BHFO ZBOH NFOHJOWBTJ 5 TFUFMBI QFNCFOUVLBOOZB EJ TVNTVN UVMBOH NVMBNVMB
BLBO NBTVL LF EBMBN DBJSBO KBSJOHBO EBO LFNVEJBO EJCBXB CFSNJHSBTJLFLFMFOKBSUJNVT%JTJOJ MJNGPTJU5NFNCFMBITFDBSB
NFMBMVJ QFNCVMVI MJNGF LF OPEVT MJNGF BUBV KBSJOHBO MJNGPJE DFQBU EBO QBEB XBLUV ZBOH CFSTBNBBO NFNCFOUVL LFBOFLB
ZBOH MBJO $POUPIOZB KBSJOHBO MJNGPJE EJ EJOEJOH TBMVSBO SBHBNBOZBOHFLTUSFNVOUVLCFSFBLTJNFMBXBOCFSCBHBJBOUJHFO
DFSOB BLBO UFSQBKBO TFDBSB MBOHTVOH EFOHBO BOUJHFO ZBOH TQFTJGJL"SUJOZB UJBQTBUVMJNGPTJUEJLFMFOKBSUJNVTNFNCFOUVL
NBTVL NFMBMVJ VTVT +BSJOHBO MJNGPJE EJ UFOHHPSPLBO EBO SFBLUJWJUBT ZBOH TQFTJGJL VOUVL NFMBXBO TBUV BOUJHFO ,FNVEJBO
GBSJOH UPOTJM EBO BEFOPJE
UFSMFUBL QBEB UFNQBU ZBOH UFQBU MJNGPTJUCFSJLVUOZBNFNCFOUVLTQFTJGJTJUBTUFSIBEBQBOUJHFOZBOH
VOUVL NFOBIBO BOUJHFO ZBOH NBTVL NFMBMVJ TBMVSBO MBJO )B* JOJ UFSVT CFSMBOHTVOH TBNQBJ UFSEBQBU SJCVBO KFOJT
QFSOBQBTBO CBHJBO BUBT +BSJOHBO MJNGPJE EJ OPEVT MJNGF MJNGPTJU UJNVT EFOHBO SFBLUJWJUBT TQFTJGJL VOUVL NFMBXBO SJCVBO
UFSQBKBO EFOHBO BOUJHFO ZBOH NFOHJOWBTJ KBSJOHBO QFSJGFS KFOJT BOUJHFO #FSCBHBJ UJQF MJNGPTJU 5 ZBOH UFMBI EJQSPTFT JOJ
UVCVI %BO BLIJSOZB KBSJOHBO MJNGPJE EJ MJNQB UJNVT EBO TFLBSBOH NFOJOHHBMLBO UJNVT EBO NFOZFCBS LF TFMVSVI UVCVI
TVNTVN UVMBOH CFSQFSBO QFOUJOH LIVTVTOZB EBMBN NFOBIBO NFMBMVJEBSBIVOUVLNFOHJTJKBSJOHBOMJNGPJEEJTFUJBQUFNQBU
BHFOBOUJHFOJLZBOHCFSIBTJMNFODBQBJTJSLVMBTJEBSBI 5JNVT KVHB NFNBTUJLBO CBIXB TFUJBQ MJNGPTJU 5 ZBOH
NFOJOHHBMLBO UJNVT UJEBL BLBO CFSFBLTJ UFSIBEBQ QSPUFJO BUBV
Dua Macam Li mfosityang Menimbulkan Imunitas yang BOUJHFOMBJOZBOHCFSBTBMEBSJKBSJOHBOUVCVITFOEJSJLBMBVUJEBL
"Diperantarai Sel" dan Imunitas "Humoral"Limfosit T MJNGPTJU 5 BLBO CFSTJGBU NFNBUJLBO CBHJ KBSJOHBO UVCVI EBMBN
dan B. 8BMBVQVO TFCBHJBO CFTBS MJNGPTJU EBMBN KBSJOHBO XBLUVCFCFSBQBIBSJTBKB5JNVTNFOZFMFLTJMJNGPTJU5ZBOHBLBO
MJNGPJEOPSNBMUBNQBLTFSVQBEJCBXBINJLSPTLPQ UFUBQJTFM EJMFQBTLBO ZBJUVNVMBNVMBEFOHBODBSBNFODBNQVSLBOMJNGPTJU
TFMUFSTFCVUTFDBSBKFMBTEBQBUEJCFEBLBOEBMBNEVBLFMPNQPL EFOHBO TFNVB BOUJHFOTFOEJSJ ZBOH TQFTJGJL ZBOH CFSBTBM EBSJ
CFTBS,FMPNQPLQFSUBNB ZBJUVMJNGPTJU5 CFSUBOHHVOHKBXBC KBSJOHBOUVCVITFOEJSJ+JLBMJNGPTJU5CFSFBLTJ NBLBMJNGPTJUJOJ
EBMBNQFNCFOUVLBOMJNGPTJUUFSBLUJWBTJZBOHEBQBUNFNCFO BLBOEJIBODVSLBOEBOEJGBHPTJUPTJT UFUBQJZBOHUJEBLCFSFBLTJ
434
Bab 34 Pertahanan Tubuh terhadap Infeksi: II. Imunitas dan Imunitas Bawaan Alergi
UNIT VI
BLBOEJMFQBTLBO JOJMBIZBOHUFSKBEJQBEBQFSTFOTFM+BEJ ZBOH EJ TFMVSVI UVCVI UFNQBU MJNGPTJU # UFSTFCVU NFOFNQBUJ
BLIJSOZB EJMFQBTLBO IBOZBMBI TFMTFM ZBOH CFSTJGBU OPOSFBLUJG EBFSBI ZBOH CFSEFLBUBO EFOHBO MJNGPTJU5 UFUBQJ TFEJLJU MFCJI
UFSIBEBQ BOUJHFO UVCVIOZB TFOEJSJ MJNGPTJU IBOZB CFSFBLTJ KBVI
UFSIBEBQBOUJHFOEBSJTVNCFSEJMVBSUVCVI TFQFSUJEBSJCBLUFSJ
UPLTJO BUBVCBILBOKBSJOHBOZBOHEJUSBOTQMBOUBTJLBOEBSJPSBOH Limfosit T dan Antibodi Limfosit B Bereaksi secara
MBJO Sangat Spesifik terhadap Antigen Spesifik—Peran Klon
4FCBHJBO CFTBS QSPTFT QFOHPMBIBO MJNGPTJU 5 EBMBN UJNVT Limfosit
CFSMBOHTVOH CFCFSBQB TBBU TFCFMVN CBZJ MBIJS EBO TFMBNB #JMBBOUJHFOTQFTJGJLNFMBLVLBOLPOUBLEFOHBOMJNGPTJU5EBO
CFCFSBQB CVMBO TFUFMBI MBIJS 4FTVEBI NFMFXBUJ QFSJPEF JOJ CJMB #EJEBMBNKBSJOHBOMJNGPJE NBLBMJNGPTJU5UFSUFOUVNFOKBEJ
EJMBLVLBOQFOHBOHLBUBOLFMFOKBSUJNVTNBLBBLBONFOVSVOLBO UFSBLUJWBTJ VOUVL NFNCFOUVL TFM 5 UFSBLUJWBTJ EBO MJNGPTJU #
UFUBQJ UJEBL NFOHIJMBOHLBO
TJTUFN JNVO MJNGPTJU 5 /BNVO UFSUFOUVNFOKBEJUFSBLUJWBTJVOUVLNFNCFOUVLBOUJCPEJ4FM5
QFOHBOHLBUBOLFMFOKBSUJNVTCFCFSBQBCVMBOTFCFMVNMBIJSEBQBU ZBOH UFSBLUJWBTJ EBO BOUJCPEJ JOJ LFNVEJBO CFSFBLTJ EFOHBO
NFODFHBI QFNCFOUVLBO TFNVB JNVOJUBT ZBOH EJQFSBOUBSBJ TFM TBOHBU TQFTJGJL UFSIBEBQ BOUJHFO UJQF UFSUFOUV ZBOH NFO
0MFI LBSFOB UJQF JNVOJUBT TFMVMBS JOJ UFSVUBNB CFSUBOHHVOH DFUVTLBO QFNCFOUVLBO TFM JNVO UBEJ .FLBOJTNF TQFTJGJTJUBT
KBXBCVOUVLQFOPMBLBOUFSIBEBQPSHBOZBOHEJUSBOTQMBOUBTJLBO JOJBEBMBITFCBHBJCFSJLVU
TFQFSUJKBOUVOHEBOHJOKBM NBLBLJUBEBQBUNFOUSBOTQMBOTJPSHBO
Jutaan Tipe Limfosit yang Spesifik Disimpan dalam
EFOHBO TFEJLJU TFLBMJ LFNVOHLJOBO QFOPMBLBO KJLB UJNVT QBEB
Jaringan Limfoid. 5FSEBQBUCFSKVUBKVUBKFOJTDBMPOMJNGPTJU#
TFFLPS IFXBO EJBOHLBU TFCFMVN MBIJS UFUBQJ NBTJI EBMBN NBTB
EBOMJNGPTJU5ZBOHEJTJNQBOEBMBNKBSJOHBOMJNGF4FMTFMJOJ
ZBOHNFNVOHLJOLBO

NBNQV NFNCFOUVL BOUJCPEJ BUBV TFM 5 ZBOH TBOHBU TQFTJGJL
Limfosit B Diolah Lebih Dulu di Hati dan Sumsum .BTJOHNBTJOH MJNGPTJU JOJ IBOZB NBNQV NFNCFOUVL TBUV
Tulang. 1FOHPMBIBOMJNGPTJU#ZBOHEFUBJMMFCJITFEJLJUEJLFUBIVJ KFOJTBOUJCPEJBUBVTBUVKFOJTTFM5EFOHBOTBUVNBDBNTQFTJGJ
EBSJQBEBQSPTFTQFOHPMBIBOMJNGPTJU51BEBNBOVTJB MJNGPTJU# TJUBT #FHJUV MJNGPTJU ZBOH TQFTJGJL EJBLUJGLBO PMFI BOUJHFOOZB
EJLFUBIVJ EJPMBI MFCJI EVMV EJ IBUJ TFMBNB QFSJPEF QFSUFOHBIBO NBLBJBBLBOCFSLFNCBOHCJBLEFOHBODFQBUEBONFNCFOUVL
LFIJEVQBO KBOJO EBO EJ TVNTVN UVMBOH TFMBNB NBTB BLIJS CBOZBLTFLBMJMJNGPTJUUVSVOBO (BNCBS
#JMBMJNGPTJUJUV
LFIJEVQBOKBOJOEBOTFUFMBIMBIJS BEBMBI MJNGPTJU # NBLB LFUVSVOBOOZB LFNVEJBO BLBO
NFOZFLSFTJLBOBOUJCPEJTQFTJGJLZBOHLFNVEJBOCFSTJSLVMBTJLF
-JNGPTJU#CFSCFEBEFOHBOMJNGPTJU5EBMBNEVBIBM1FSUBNB
TFMVSVI UVCVI #JMB MJNGPTJU UFSTFCVU BEBMBI MJNGPTJU 5 NBLB
QBEB MJNGPTJU 5 TFMVSVI TFM NFNCFOUVL SFBLUJWJUBT UFSIBEBQ
LFUVSVOBOOZB BEBMBI TFM 5 TQFTJGJL ZBOH UFSTFOTJUJTBTJ ZBOH
BOUJHFO MJNGPTJU # TFDBSB BLUJG NFOZFLSFTJ BOUJCPEJ ZBOH
BLBOEJMFQBTLBOLFEBMBNDBJSBOMJNGFEBOEJBOHLVULFEBMBN
NFSVQBLBOCBIBOSFBLUJG#BIBOJOJCFSVQBNPMFLVMQSPUFJOCFTBS
EBSBI LFNVEJBOEJTJSLVMBTJLBOLFTFMVSVIDBJSBOKBSJOHBOEBO
ZBOH NBNQV CFSJLBUBO EFOHBO CBIBO BOUJHFOJL EBO NFOH
LFNCBMJ MBHJ LF EBMBN MJNGF LBEBOHLBEBOH TJSLVMBTJ ZBOH
IBODVSLBOOZB ZBOHBLBOEJKFMBTLBOEJCBHJBOMBJOEJCBCJOJEBO
UFSVTNFOFSVTEBMBNTJSLVJUJOJUFSKBEJTFMBNBCFSCVMBOCVMBO
EJ #BC ,FEVB MJNGPTJU # CBILBO NFNJMJLJ MFCJI CBOZBL
BUBVCFSUBIVOUBIVO
LFBOFLBSBHBNBO EBSJQBEB MJNGPTJU 5 KBEJ NFNCFOUVL CBOZBL
TFLBMJ TBNQBJ CFSKVUBKVUB BOUJCPEJ UJQF MJNGPTJU # EFOHBO 4FNVBKFOJTMJNGPTJUCFSCFEBZBOHNBNQVNFNCFOUVLTBUV
CFSCBHBJ SFBLUJWJUBT ZBOH TQFTJGJL 4FUFMBI EJPMBI MFCJI EVMV BOUJCPEJTQFTJGJLBUBVTFM5EJTFCVULMPOMJNGPTJU-JNGPTJUQBEB
MJNGPTJU# TFQFSUJKVHBMJNGPTJU5 CFSNJHSBTJLFKBSJOHBOMJNGPJE TFUJBQ LMPO CFSTJGBU TBNB EBO CFSBTBM EBSJ TBUV BUBV CFCFSBQB
MJ
435
EBO# TFHNFOTFHNFOHFOJOJNFOKBEJUFSDBNQVSTBUVTBNBMBJO
EBMBNLPNCJOBTJBDBL EBOEFOHBODBSBJOJBLIJSOZBNFNCFOUVL
HFOHFOVUVI
0MFI LBSFOB KFOJT TFHNFO HFO BEB CFCFSBQB SBUVT NBLB
UFSEBQBUKVUBBOLPNCJOBTJTFHNFOZBOHEBQBUUFSTVTVOEBMBNTFM
UVOHHBM TFIJOHHB LJUB EBQBU NFOHFSUJ NFOHBQB EBQBU UFSKBEJ
KVUBBOKFOJTHFOTFMZBOHCFSCFEBCFEB1BEBTFUJBQMJNGPTJU5BUBV
MJNGPTJU#GVOHTJPOBMZBOHBLIJSOZBUFSCFOUVL TBOEJTUSVLUVSHFO
ZBOHBEBIBOZBVOUVLTBUVTQFTJGJTJUBTBOUJHFO4FMTFMNBUBOHJOJ
LFNVEJBO NFOKBEJ TFM 5 EBO TFM # ZBOH TBOHBU TQFTJGJL ZBOH
NFNFOVIJEBONFOZFCBSLFKBSJOHBOMJNGPJE
Mekanisme untuk Mengaktifkan Suatu Klon Limfosit

4FUJBQ LMPO MJNGPTJU IBOZB SFTQPOTJG UFSIBEBQ TBUV UJQF BOUJHFO
BUBVUFSIBEBQCFCFSBQBBOUJHFOTFSVQBZBOHTJGBUTUFSFPLJNJBOZB
IBNQJS TBNB
"MBTBO UFSKBEJOZB IBM JOJ BEBMBI TFCBHBJ CFSJLVU
1BEB MJNGPTJU # NBTJOHNBTJOH NFNQVOZBJ LJSBLJSB
NPMFLVM BOUJCPEJ QBEB QFSNVLBBO NFNCSBO TFMOZB ZBOH BLBO
CFSFBLTJTBOHBUTQFTJGJLEFOHBOTBUVNBDBNBOUJHFOTQFTJGJLTBKB
+BEJ CJMBBEBBOUJHFOZBOHDPDPL NBLBBOUJHFOJOJTFHFSBNFMFLBU
EFOHBO BOUJCPEJ EJ NFNCSBO TFM LFBEBBO JOJ NFOJNCVMLBO
QSPTFT BLUJWBTJ ZBOH BLBO LJUB CJDBSBLBO MFCJI EFUBJM LFNVEJBO
1BEBMJNGPTJU5 EJQFSNVLBBONFNCSBOTFMOZBUFSEBQBUNPMFLVM
ZBOHTBOHBUNJSJQEFOHBOBOUJCPEJ ZBOHEJTFCVUQSPUFJOSFTFQUPS
QFSNVLBBO BUBV QFOBOEB TFM 5
EBO UFSOZBUB QSPUFJO JOJ KVHB
CFSTJGBU TBOHBU TQFTJGJL UFSIBEBQ TBUV BOUJHFO TQFTJGJL ZBOH
NFOHBLUJGLBOOZB %FOHBO EFNJLJBO BOUJHFO NFSBOHTBOH IBOZB
TFMTFM ZBOH NFNJMJLJ SFTFQUPS LPNQMFNFO UFSIBEBQ BOUJHFOOZB
EBOTVEBICFSLPNJUNFOVOUVLCFSFTQPOTUFSIBEBQOZB
Peran Makrofag dalam Proses Aktivasi. %BMBN KBSJOHBO

MJNGPJE TFMBJO MJNGPTJU KVHB UFSEBQBU CFSKVUBKVUB NBLSPGBH
.BLSPGBH NFMBQJTJ TJOVTPJETJOVTPJE QBEB OPEVT MJNGF MJNQB
EBOKBSJOHBOMJNGPJEMBJO EBONBLSPGBHJOJUFSMFUBLCFSTFCFMBIBO
EFOHBO CBOZBL MJNGPTJU EBMBN OPEVT MJNGF ,FCBOZBLBO
PSHBOJTNFZBOHNFOHJOWBTJNVMBNVMBEJGBHPTJUPTJTEBOTFCBHJBO
NGPTJUUJQFTQFTJGJLBXBM BLBO EJDFSOB PMFI NBLSPGBH LFNVEJBO QSPEVL BOUJHFOJLOZB
EJMFQBTLBO LF EBMBN TJUPTPM NBLSPGBH .BLSPGBH LFNVEJBO
NFOUSBOTGFS BOUJHFOBOUJHFO UFSTFCVU TFDBSB MBOHTVOH LF MJNGPTJU
Asal-Usul Banyak Klon Limfosit EFOHBO DBSB LPOUBL TFMLFTFM TFIJOHHB NFOJNCVMLBO BLUJWBTJ
)BOZBBEBCFCFSBQBSBUVTTBNQBJCFCFSBQBSJCVQFOZBOEJHFO LMPO MJNGPTJUJL ZBOH TQFTJGJL 4FMBJO JUV NBLSPGBH KVHB
VOUVL KVUBBO KFOJT BOUJCPEJ EBO MJNGPTJU 5 1BEB NVMBOZB NFOZFLSFTJLBO [BU QFOHBLUJWBTJ LIVTVT JOUFSMFVLJO ZBOH
NFNBOHNBTJINFSVQBLBOTVBUVNJTUFSJCBHBJNBOBNVOHLJO NFOJOHLBULBOQFSUVNCVIBOEBOSFQSPEVLTJMJNGPTJUTQFTJGJL
EFOHBO KVNMBI HFO ZBOH IBOZB TFEJLJU EBQBU NFOZBOEJ
CFSKVUBKVUBTJGBUTQFTJGJLQBEBNPMFLVMBOUJCPEJBUBVTFM5ZBOH Peran Sel T dalam Mengaktifkan Limfosit B. ,FCBOZBLBO
EBQBU EJIBTJMLBO PMFI KBSJOHBO MJNGPJE LIVTVTOZB CJMB LJUB BOUJHFO NFOHBLUJGLBO MJNGPTJU 5 EBO MJNGPTJU # QBEB TBBU ZBOH
CFSQJLJS CBIXB TBUV HFO CJBTBOZB IBOZB CFSHVOB VOUVL CFSTBNBBO#FCFSBQBTFM5ZBOHUFSCFOUVL EJTFCVUTFMQFNCBOUV
QFNCFOUVLBO TFUJBQ UJQF QSPUFJO ZBOH CFSCFEB .JTUFSJ JOJ IFMQFSDFMM
LFNVEJBONFOZFLSFTJLBOCBIBOLIVTVT ZBOHTFDBSB
TFLBSBOHUFMBIUFSQFDBILBO LFTFMVSVIBO EJTFCVU MJNGPLJO
ZBOH NFOHBLUJGLBO MJNGPTJU #
4FMVSVI HFO ZBOH NFNCFOUVL TFUJBQ KFOJT TFM 5 BUBV TFM # TQFTJGJL4FTVOHHVIOZB UBOQBCBOUVBOTFM5QFNCBOUVJOJ KVNMBI
UJEBL QFNBI BEB EJ EBMBN TFM QVODB BTBM UFNQBU TFM JNVO BOUJCPEJ ZBOH EJCFOUVL PMFI MJNGPTJU # CJBTBOZB TFEJLJU ,JUB
GVOHTJPOBM UFSCFOUVL .FMBJOLBO ZBOH BEB IBOZBMBI TFHNFO NFNCJDBSBLBO IVCVOHBO LFSKBTBNB BOUBSB TFM 5 QFNCBOUV EBO
HFOTFCFOBSOZB UFSEJSJBUBTCFSBUVTSBUVTTFHNFOUFUBQJCVLBO TFM # JOJ TFTVEBI LJUB NFNCBIBT NFOHFOBJ NFLBOJTNF TJTUFN
HFOHFOVUVI4FMBNBQSPTFTQFOHPMBIBOTFMMJNGPTJU5 JNVOJUBTTFM5
436
Sifat-Sifat Khusus Sistem Limfosit B—Imunitas Humoral

dan Antibodi
Pembentukan Antibodi oleh Sel Plasma.4FCFMVNUFSQBKBO
EFOHBOBOUJHFOZBOHTQFTJGJL LMPOMJNGPTJU#UFUBQEBMBNLFBEBBO
UNIT VI
UJEBL BLUJG EPSNBO
EJ EBMBN KBSJOHBO MJNGPJE #JMB BEB BOUJHFO
BTJOH ZBOH NBTVL NBLSPGBH EBMBN KBSJOHBO MJNGPJE BLBO
NFNGBHPTJUPTJT BOUJHFO EBO LFNVEJBO NFNCBXBOZB LF MJNGPTJU
#EJEFLBUOZB4FMBJOJUV BOUJHFOUFSTFCVUKVHBEBQBUEJCBXBLFTFM
5QBEBTBBUZBOHCFSTBNBBO EBOUFSCFOUVLTFM5QFNCBOUVZBOH
UFSBLUJWBTJ 4FM QFNCBOUV JOJ KVHB CFSQFSBO EBMBN BLUJWBTJ IFCBU
MJNGPTJU# ZBOHBLBOLJUBCJDBSBLBOTFDBSBMFCJIMFOHLBQOBOUJ
-JNGPTJU # ZBOH CFSTJGBU TQFTJGJL UFSIBEBQ BOUJHFO TFHFSB
NFNCFTBS EBO UBNQBL TFQFSUJ HBNCBSBO MJNGPCMBT #FCFSBQB
MJNGPCMBT CFSEJGFSFOTJBTJ MFCJI MBOKVU VOUVL NFNCFOUVL QMBTNB
CMBT ZBOH NFSVQBLBO QSFLVSTPS TFM QMBTNB %BMBN QMBTNBCMBT
JOJ TJUPQMBTNB NFMVBT EBO SFUJLVMVN FOEPQMBTNB LBTBS BLBO
CFSQSPMJGFSBTJ EFOHBO DFQBU 4FMTFM JOJ LFNVEJBO NVMBJ Sifat Antibodi
NFNCFMBI EFOHBO LFDFQBUBO TBUV LBMJ TFUJBQ KBN TBNQBJ
"OUJCPEJ NFSVQBLBO HBNNB HMPCVMJO ZBOH EJTFCVU
TFLJUBSTFNCJMBOQFNCFMBIBO TFIJOHHBEBSJTBUVQMBTNBCMBTEBQBU
JNVOPHMPCVMJO EJTJOHLBU TFCBHBJ *H
EBO CFSBU NPMFLVMOZB
UFSCFOUVL LJSBLJSB TFM EBMBN XBLUV IBSJ 4FM QMBTNB ZBOH
BOUBSB EBO MNVOPHMPCVMJO CJBTBOZB NFO
NBUBOH LFNVEJBO NFOHIBTJMLBO BOUJCPEJ HBNNB HMPCVMJO
DBLVQTFLJUBSQFSTFOEBSJTFMVSVIQSPUFJOQMBTNB
EFOHBOLFDFQBUBOUJOHHJLJSBLJSBNPMFLVMQFSEFUJLVOUVL
4FNVB JNVOPHMPCVMJO UFSEJSJ BUBT LPNCJOBTJ SBOUBJ
TFUJBQ TFM QMBTNB ,FNVEJBO BOUJCPEJ EJTFLSFTJLBO LF EBMBN
QPMJQFQUJEB SJOHBO EBO CFSBU 4FCBHJBO CFTBS NFSVQBLBO
DBJSBOMJNGFEBOEJBOHLVULFTJSLVMBTJEBSBI1SPTFTJOJCFSMBOKVU
LPNCJOBTJ SBOUBJ CFSBU EBO SBOUBJ SJOHBO TFQFSUJ ZBOH
UFSVT TFMBNB CFCFSBQB IBSJ BUBV CFCFSBQB NJOHHV TBNQBJ TFM
UFSMJIBU QBEB (BNCBS .FTLJQVO CFHJUV BEB CFCFSBQB
QMBTNBBLIJSOZBLFMFMBIBOEBONBUJ
JNVOPHMPCVMJO ZBOH NFNQVOZBJ LPNCJOBTJ TBNQBJ SBOUBJ
Pembentukan Sel "Memori" Perbedaan antara Respons CFSBUEBOSBOUBJSJOHBO ZBOHNFOHIBTJMLBOJNVOPHMPCVMJO
Primer dan Respons Sekunder. #FCFSBQB MJNGPCMBT ZBOH EFOHBO CFSBU NPMFLVM CFTBS 5FSOZBUB EBMBN TFNVB
UFSCFOUVL PMFI QFOHBLUJGBO LMPO MJNGPTJU # UJEBL CFSMBOKVU JNVOPHMPCVMJO UJBQ SBOUBJ CFSBU UFSMFUBL TFKBKBS EFOHBO TBUV
NFNCFOUVL TFM QMBTNB NFMBJOLBO NFNCFOUVL TFM MJNGPTJU # SBOUBJ SJOHBO QBEB TBMBI TBUV VKVOHOZB TFIJOHHB NFNCFOUVL
CBSV EBMBN KVNMBI ZBOH DVLVQ EBO TFSVQB EFOHBO LMPO BTBM TBUV QBTBOH CFSBUSJOHBO TFSUB TFMBMV UFSEBQBU TFEJLJUOZB
%FOHBOLBUBMBJO QPQVMBTJTFM#EBSJLMPOZBOHUFSBLUJWBTJTFDBSB QBTBOHEBOTFCBOZBLCBOZBLOZBQBTBOHTFNBDBNJOJEBMBN
TQFTJGJL NFOKBEJ TBOHBU NFOJOHLBU -JNGPTJU # CBSV UFSTFCVU TFUJBQNPMFLVMJNVOPHMPCVMJO
EJUBNCBILBO LF MJNGPTJU BTBM QBEB LMPO ZBOH TBNB -JNGPTJU # (BNCBS NFNQFSMJIBULBO CBHJBO VKVOH EBSJ TFUJBQ
ZBOHCBSVJOJKVHBCFSTJSLVMBTJLFTFMVSVIUVCVIVOUVLNFOEJBNJ SBOUBJCFSBUEBOSBOUBJSJOHBO ZBOHEJTFCVUCBHJBOZBOHEBQBU
TFMVSVI KBSJOHBO MJNGPJE UFUBQJ TFDBSB JNVOPMPHJT MJNGPTJU # CFSVCBI CBHJBO WBSJBCFM
EBO TJTB EBSJ NBTJOHNBTJOH SBOUBJ
UFUBQ EBMBN LFBEBBO EPSNBO TBNQBJ EJBLUJGLBO MBHJ PMFI EJTFCVU CBHJBO ZBOH UFUBQ CBHJBO LPOTUBO
#BHJBO WBSJBCFM
TFKVNMBI BOUJHFO CBSV ZBOH TBNB -JNGPTJU JOJ EJTFCVU TFM CFSCFEBCFEBVOUVLTFUJBQTQFTJGJTJUBTBOUJCPEJ EBOCBHJBOJOJ
NFNPSJ 1BKBOBO CFSJLVUOZB PMFI BOUJHFO ZBOH TBNB BLBO
NFOJNCVMLBO SFTQPOT BOUJCPEJ VOUVL LFEVB LBMJOZB ZBOH KBVI
MFCJIDFQBUEBOKBVIMFCJILVBU LBSFOBUFSEBQBUMFCJICBOZBLTFM
NFNPSJ EBSJQBEB ZBOH EJCFOUVL IBOZB PMFI TFM MJNGPTJU # BTBM
ZBOHTQFTJGJL
(BNCBSNFOVOKVLLBOQFSCFEBBOBOUBSBSFTQPOTQSJNFS
VOUVL QFNCFOUVLBO BOUJCPEJ ZBOH UFSKBEJ QBEB TBBU QBKBOBO
QFSUBNB PMFI TVBUV BOUJHFO TQFTJGJL EBO SFTQPOT TFLVOEFS ZBOH
UFSKBEJTFUFMBIQBKBOBOLFEVBPMFIBOUJHFOZBOHTBNB1FSIBUJLBO
UJNCVMOZB QFOVOEBBO SFTQPOT QSJNFS TFMBNB TBUV NJOHHV
QPUFOTJOZB ZBOH MFNBI EBO NBTB IJEVQOZB ZBOH TJOHLBU
4FCBMJLOZB SFTQPOT TFLVOEFS UJNCVM EFOHBO DFQBU TFUFMBI
UFSQBKBOEFOHBOBOUJHFO TFSJOHLBMJEBMBNXBLUVCFCFSBQBKBN

CFSTJGBU KBVI MFCJI LVBU EBO NFNCFOUVL BOUJCPEJ TFMBNB
CFSCVMBOCVMBO LFUJNCBOH IBOZB CFCFSBQB NJOHHV TBKB
1FOJOHLBUBO QPUFOTJ EBO NBTB LFSKB SFTQPOT TFLVOEFS JOJ EBQBU
NFOKFMBTLBO NFOHBQB JNVOJTBTJ CJBTBOZB EJMBLVLBO EFOHBO
NFOZVOUJLLBOBOUJHFOEBMBNEPTJTNVMUJQFMEBOEFOHBOQFSJPEF
BOUBSB QFOZVOUJLBO TFMBNB CFCFSBQB NJOHHV BUBV CFCFSBQB
CVMBO
437
MBI ZBOH TFDBSB LIVTVT NFMFLBU QBEB UJQF BOUJHFO UFSUFOUV NFOZFSBOH QFOZFCBC QFOZBLJU UFSTFCVU EBO
EFOHBO
#BHJBO LPOTUBO EBSJ BOUJCPEJ NFOFOUVLBO TJGBUTJGBU BOUJCPEJ NFOHBLUJGLBO TJTUFN LPNQMFNFO ZBOH LFNVEJBO EFOHBO
ZBOH MBJO NFOFUBQLBO CFCFSBQB GBLUPS TFQFSUJ QFOZFCBSBO CFSCBHBJ DBSB ZBOH EJNJMJLJOZB BLBO NFOHIBODVSLBO QFOZFCBC
BOUJCPEJ EBMBN KBSJOHBO QFMFLBUBO BOUJCPEJ QBEB TUSVLUVS QFOZBLJUUFSTFCVU
TUSVLUVS TQFTJGJL EBMBN KBSJOHBO QFMFLBUBO QBEB LPNQMFLT
LPNQMFNFO LFNVEBIBO BOUJCPEJ NFMFXBUJ NFNCSBO EBO Kerja Langsung Antibodi terhadap Agen yang Meng-
TJGBUTJGBU CJPMPHJT BOUJCPEJ ZBOH MBJO 4VBUV LPNCJOBTJ JLBUBO invasi.(BNCBSNFNQFSMJIBULBOBOUJCPEJBOUJCPEJ EJUBOEBJ
LPWBMFO EJTVMGJEB
EBO OPOLPWBMFO NFOHJLBU SBOUBJ SJOHBO EFOHBOHBSJTNFSBICFSCFOUVL:
ZBOHCFSFBLTJEFOHBOBOUJHFO
EBOCFSBUCFSTBNBTBNB BOUJHFO EJUBOEBJEFOHBOPCKFLPCKFLZBOHCFSXBSOBMFCJIHFMBQ

0MFI LBSFOB TJGBU CJWBMFO ZBOH EJNJMJLJ PMFI BOUJCPEJ EBO
Spesifisitas Antibodi. 4FUJBQ BOUJCPEJ CFSTJGBU TQFTJGJL CBOZBLOZB UFNQBU BOUJHFO QBEB TFCBHJBO CFTBS BHFO QFOZFCBC
VOUVL BOUJHFO UFSUFOUV IBM JOJ EJTFCBCLBO PMFI TUSVLUVS QFOZBLJU NBLBBOUJCPEJEBQBUNFNBUJLBOBLUJWJUBTBHFOUFSTFCVU
PSHBOJTBTJ BTBN BNJOP ZBOH VOJL QBEB CBHJBO ZBOH EBQBU EFOHBOTBMBITBUVDBSBCFSJLVUJOJ
CFSVCBI EBSJ LFEVB SBOUBJ SJOHBO EBO CFSBU 4VTVOBO BTBN 1. "HMVUJOBTJ ZBJUV QSPTFT ZBOH NFOZFCBCLBO CBOZBL QBSUJLFM
BNJOP JOJ NFNJMJLJ CFOUVL TUFSJL ZBOH CFSCFEB VOUVL TFUJBQ CFTBSEFOHBOBOUJHFOEJQFSNVLBBOOZB TFQFSUJCBLUFSJBUBVTFM
TQFTJGJTJUBT BOUJHFO TFIJOHHB CJMB TVBUV BOUJHFO NFMBLVLBO EBSBINFSBI UFSJLBUCFSTBNBTBNBNFOKBEJTBUVHVNQBMBO
LPOUBL EFOHBO CBHJBO JOJ NBLB CFSCBHBJ LFMPNQPL QSPTUFUJL 2. 1SFTJQJUBTJ ZBJUV QSPTFT ZBOH NFOZFCBCLBO LPNQMFLT
BOUJHFOUFSTFCVUTFQFSUJTFCVBICBZBOHBODFSNJOEFOHBOBTBN
NPMFLVMBS EBO BOUJHFO ZBOH NVEBI MBSVU NJTBMOZB SBDVO
BNJOPZBOHUFSEBQBUEBMBNBOUJCPEJ TFIJOHHBUFSKBEJMBIJLBUBO
UFUBOVT
EBO BOUJCPEJ NFOKBEJ CFHJUV CFTBS TFIJOHHB CFSVCBI
ZBOHDFQBUEBOLVBUBOUBSBBOUJCPEJEBOBOUJHFO#JMBBOUJCPEJ
NFOKBEJUJEBLMBSVUEBONFNCFOUVLQSFTJQJUBU
CFSTJGBU TBOHBU TQFTJGJL NBLB BLBO BEB CBOZBL UFNQBU JLBUBO
3. /FUSBMJTBTJ ZBJUVQSPTFTZBOHNFOZFCBCLBOBOUJCPEJNFOVUVQJ
ZBOH EBQBU NFNCVBU QBTBOHBO BOUJCPEJBOUJHFO JUV TBOHBU
UFNQBUUFNQBUZBOHUPLTJLEBSJBHFOZBOHCFSTJGBUBOUJHFOJL
LVBU UFSJLBU TBUV TBNB MBJO ZBJUV EFOHBO DBSB
JLBUBO
IJESPGPCJL
JLBUBO IJESPHFO
EBZB UBSJL JPOJL EBO
4. -JTJT ZBJUV QSPTFT ZBOH NFOZFCBCLBO CFCFSBQB BOUJCPEJ ZBOH
LFLVBUBO WBO EFS 8BBMT *LBUBO JOJ KVHB NFNBUVIJ IVLVN TBOHBU LVBU LBEBOHLBEBOH NBNQV MBOHTVOH NFOZFSBOH
LFSKBNBTTBUFSNPEJOBNJL NFNCSBO TFM BHFO QFOZFCBC QFOZBLJU TFIJOHHB NFOZFCBCLBO
BHFOUFSTFCVUQFDBI
Konsentrasi ikatan antibodi-antigen
Ka = ──────────────────
Konsentrasi antibodi Konsentrasi antigen
,FSKB BOUJCPEJ ZBOH MBOHTVOH NFOZFSBOH BHFO QFOZFCBC
QFOZBLJU ZBOH CFSTJGBU BOUJHFOJL TFSJOH LBMJ UJEBL DVLVQ LVBU
,B EJTFCVU LPOTUBOUB BGJOJUBT EBO NFSVQBLBO VLVSBO ZBOH VOUVL NFMJOEVOHJ UVCVI UFSIBEBQ QFOZFCBC QFOZBLJU UFSTFCVU
NFOVOKVLLBO TFCFSBQB LVBU JLBUBO BOUBSB BOUJCPEJ EFOHBO ,FCBOZBLBOTJGBUQFSUBIBOBOEJEBQBUNFMBMVJFGFLQFOHVBUBOPMFI
BOUJHFO TJTUFNLPNQMFNFOZBOHBLBOEJKFMBTLBOEJCBXBIJOJ
1FSIBUJLBO LIVTVTOZB QBEB (BNCBS CBIXB EJ TJUV
UFSEBQBUEVBUFNQBUZBOHEBQBUCFSVCBIQBEBBOUJCPEJ VOUVL Sistem Komplemen pada Kerja Antibodi
UFNQBU NFMFLBUOZB BOUJHFO ZBOH NFNCVBU BOUJCPEJ KFOJT JOJ ,PNQMFNFO NFSVQBLBO JTUJMBI HBCVOHBO VOUVL NFOHHBNCBS
CFSTJGBU CJWBMFO 4FCBHJBO LFDJM BOUJCPEJ ZBOH UFSEJSJ BUBT LBO TVBUV TJTUFN ZBOH UFSEJSJ BUBT LJSBLJSB QSPUFJO ZBOH
LPNCJOBTJ TBNQBJ SBOUBJ CFSBU EBO SBOUBJ SJOHBO LFCBOZBLBONFSVQBLBOQSFLVSTPSFO[JN1FNFSBOVUBNBEBMBN
NFNQVOZBJTBNQBJTFQVMVIUFNQBUJLBUBO TJTUFNJOJBEBMBIQSPUFJOZBOHEJUBOEBJEFOHBO$MTBNQBJ$
Penggolongan Antibodi. 5FSEBQBU MJNB HPMPOHBO VNVN # EBO % TFQFSUJ ZBOH UBNQBL QBEB (BNCBS #JBTBOZB
BOUJCPEJ NBTJOHNBTJOHEJCFSJOBNB*H( *H" *H% EBO*H&*H TFNVB QSPUFJO JOJ BEB EJ BOUBSB QSPUFJOQSPUFJO QMBTNB EBMBN
TJOHLBUBO EBSJ JNVOPHMPCVMJO EBO LFMJNB IVSVG EJ BUBT EBSBIEBOKVHBBEBEJBOUBSBQSPUFJOQSPUFJOZBOHCPDPSLFMVBS
NFOVOKVLLBONBTJOHNBTJOHHPMPOHBO
6OUVL NFNCBUBTJ QFNCJDBSBBO LJUB BEB EVB HPMPOHBO
BOUJCPEJ ZBOH TBOHBU QFOUJOH *H( ZBOH NFSVQBLBO BOUJCPEJ
CJWBMFO EBO NFODBLVQ LJSBLJSB QFSTFO EBSJ TFMVSVI
BOUJCPEJ QBEB PSBOH OPSNBM EBO *H& ZBOH NFSVQBLBO
BOUJCPEJ EBMBN KVNMBI LFDJM UFUBQJ UFSVUBNB UFSMJIBU EBMBN
QFSJTUJXB BMFSHJ (PMPOHBO *H. KVHB QFOUJOH TFCBC TFCBHJBO
CFTBS BOUJCPEJ ZBOH UFSCFOUVL TFMBNB SFTQPOT QSJNFS BEBMBI
BOUJCPEJ KFOJT JOJ "OUJCPEJ JOJ NFNQVOZBJ UFNQBU JLBUBO
TFIJOHHBTBOHBUFGFLUJGEBMBNNFMJOEVOHJUVCVIUFSIBEBQBHFO
ZBOH NBTVL XBMBVQVO BOUJCPEJ *H. KVNMBIOZB UJEBL CFHJUV
CBOZBL
Mekanisme Kerja Antibodi

"OUJCPEJCFLFSKBUFSVUBNBNFMBMVJEVBDBSBVOUVLNFMJOEVOHJ
UVCVIUFSIBEBQBHFOZBOHNFOHJOWBTJ
EFOHBOMBOHTVOH
438
Bab 34 Pertahanan Tubuh terhadap Infeksi: 11. Imunitas dan Imunitas Bawaan Alergi
UNIT VI
EBSJ LBQJMFS NBTVL LF EBMBN SVBOH KBSJOHBO #JBTBOZB QSFLVSTPS JLJBONFOHVCBIOZBNFOKBEJOPOWJSVMFO
FO[JN JOJ CFSTJGBU JOBLUJG OBNVO EBQBU EJBLUJGLBO UFSVUBNB PMFI 5. ,FNPUBLTJT'SBHNFO$BNFNJDVLFNPUBLTJTOFVUSPGJMEBO
KBMVSLMBTJL NBLSPGBH TFIJOHHBNFOZFCBCLBOTFKVNMBICFTBSTFMGBHPTJU
Jalur Klasik. +BMVS JOJ EJBLUJGLBO PMFI TVBUV SFBLTJ BOUJHFO JOJ CFSNJHSBTJ LF EBMBN KBSJOHBO ZBOH CFSCBUBTBO EFOHBO
BOUJCPEJ:BJUV CJMBTVBUVBOUJCPEJCFSJLBUBOEFOHBOTVBUVBOUJHFO BHFOBOUJHFOJL
NBLBUFNQBUSFBLUJGZBOHTQFTJGJLQBEBCBHJBOBOUJCPEJZBOHUFUBQ 6. "LUJWBTJ TFM NBTU EBO CBTPGJM 'SBHNFO $B $B EBO $B
BLBOUFSCVLB BUBVEJBLUJGLBOEBOCBHJBOJOJLFNVEJBOMBOHTVOH NFOHBLUJGLBO TFM NBTU EBO CBTPGJM TFIJOHHB NFOZFCBCLBO
CFSJLBUBO EFOHBO NPMFLVM $M EBSJ TJTUFN LPNQMFNFO NFNVMBJ TFMTFMUFSTFCVUNFMFQBTLBOIJTUBNJO IFQBSJO EBOCFCFSBQB
QFSHFSBLBO LBTLBEF SBOHLBJBO SFBLTJ TFQFSUJ ZBOH UBNQBL QBEB TVCTUBOTJMBJOOZBLFEBMBNDBJSBOTFUFNQBU#BIBOCBIBOJOJ
(BNCBS ZBOH EJBXBMJ EFOHBO QFOHBLUJGBO QSPFO[JN $M JUV LFNVEJBONFOZFCBCLBOQFOJOHLBUBOBMJSBOEBSBITFUFNQBU
TFOEJSJ &O[JN $M ZBOH UFSCFOUVL LFNVEJBO NFOHBLUJGLBO NFOJOHLBULBO LFCPDPSBO DBJSBO EBO QSPUFJO QMBTNB LF
QFOBNCBIBOKVNMBIFO[JNTFDBSBCFSUVSVUUVSVUQBEBUBIBQTJTUFN EBMBNKBSJOHBO EBONFOJOHLBULBOSFBLTJKBSJOHBOTFUFNQBU
CFSJLVUOZB TFIJOHHB EBSJ BXBM ZBOH LFDJM UFSKBEJMBI SFBLTJ MBJOOZB ZBOH NFNCBOUV BHBS BHFO BOUJHFOJL NFOKBEJ UJEBL
QFOHVBUBO ZBOH TBOHBU CFTBS %J TFCFMBI LBOBO HBNCBS UFSTFCVU BLUJG BUBV UJEBL NPCJM MBHJ 'BLUPSGBLUPS ZBOH TBNB KVHB
UBNQBL UFSCFOUVL CFSCBHBJ QSPEVL BLIJS EBO CFCFSBQB EJ CFSQFSBO QFOUJOH EBMBN QSPTFT QFSBEBOHBO ZBOH UFMBI
BOUBSBOZB NFOJNCVMLBO FGFL QFOUJOH ZBOH NFNCBOUV NFODFHBI EJCJDBSBLBOEBMBN#BC
EBOBMFSHJ TFQFSUJZBOHBLBOLJUB
LFSVTBLBO KBSJOHBO UVCVI BLJCBU PSHBOJTNF ZBOH NFOHJOWBTJ BUBV CJDBSBLBOLFNVEJBO
PMFIUPLTJO#FCFSBQBFGFLQFOUJOHUFSTFCVUBEBMBITFCBHBJCFSJLVU 7. &GFL QFSBEBOHBO %J TBNQJOH FGFL QFSBEBOHBO ZBOH
1. 0QTPOJTBTJ EBO GBHPTJUPTJT 4BMBI TBUV QSPEVL LBTLBEF LPNQ EJTFCBCLBO PMFI BLUJWBTJ TFM NBTU EBO CBTPGJM BEB CFCFSBQB
MFNFO ZBJUV$C EFOHBOLVBUNFOHBLUJGLBOQSPTFTGBHPTJUPTJT QSPEVL LPNQMFNFO MBJO ZBOH UVSVU NFOJNCVMLBO
PMFIOFVUSPGJMEBONBLSPGBH NFOZFCBCLBOTFMTFMJOJNFOFMBO QFSBEBOHBOTFUFNQBU1SPEVLQSPEVLJOJNFOZFCBCLBO

CBLUFSJ ZBOH UFMBI EJMFLBUJ PMFI LPNQMFLT BOUJHFO BOUJCPEJ BMJSBO EBSBI ZBOH TFCFMVNOZB UFMBI NFOJOHLBU NFOKBEJ
1SPTFT JOJ EJTFCVU PQTPOJTBTJ 1SPTFT JOJ TFSJOH LBMJ NBNQV TFNBLJONFOJOHLBU
QFOJOHLBUBOLFCPDPSBOQSPUFJOEBO
NFOJOHLBULBOKVNMBICBLUFSJZBOHEBQBUEJIBODVSLBO TBNQBJ LBQJMFS EBO
QSPUFJODBJSBOJOUFSTUJTJBMBLBOCFSLPBHVMBTJ
SBUVTBOLBMJMJQBU EBMBN SVBOH KBSJOHBO TFIJOHHB NFOHIBNCBU QFSHFSBLBO
2. -JTJT 4BMBI TBUV QSPEVL QBMJOH QFOUJOH EBSJ TFMVSVI QSPEVL PSHBOJTNFZBOHNFMFXBUJKBSJOHBO
LBTLBEF LPNQMFNFO BEBMBI LPNQMFLT MJUJL ZBOH NFSVQBLBO Sifat-Sifat Khusus Sistem Limfosit-T Sel T Teraktivasi dan
LPNCJOBTJEBSJCBOZBLGBLUPSLPNQMFNFOEBOEJUBOEBJEFOHBO Imunitas yang Diperantarai Sel
$C 1SPEVL JOJ NFNQVOZBJ QFOHBSVI MBOHTVOH VOUVL
NFSPCFL NFNCSBO TFM CBLUFSJ BUBV PSHBOJTNF QFOHJOWBTJ Pelepasan Sel T yang Teraktivasi dari Jaringan Limfoid
MBJOOZB dan Pembentukan Sel Memori. 1BEBXBLUVUFSQBQBSEFOHBO
3. "HMVUJOBTJ 1SPEVL LPNQMFNFO KVHB NFOHVCBI QFSNVLBBO BOUJHFOZBOHTFTVBJ TFQFSUJZBOHEJUBNQJMLBOPMFINBLSPGBHEJ
PSHBOJTNFZBOHNFOHJOWBTJUVCVI TFIJOHHBNFMFLBUTBUVTBNB EFLBUOZB MJNGPTJU 5 EBSJ LMPO MJNGPTJU ZBOH TQFTJGJL BLBO
MBJO EBOEFOHBOEFNJLJBONFNJDVQSPTFTBHMVUJOBTJ CFSQSPMJGFSBTJEBONFMFQBTLBOCBOZBLTFM5ZBOHUFSBLUJWBTJEBO
4. /FUSBMJTBTJ WJSVT &O[JN LPNQMFNFO EBO QSPEVL LPNQMFNFO CFSFBLTJ TFDBSB TQFTJGJL CFSTBNBBO EFOHBO QFMFQBTBO BOUJCPEJ
PMFITFM#ZBOHUFSBLUJWBTJ
MBJOEBQBUNFOZFSBOHTUSVLUVSCFCFSBQBWJSVTEBOEFOHBOEFN
439
1FSCFEBBO VUBNBOZB BEBMBI CVLBO BOUJCPEJ ZBOH EJMFQBTLBO DFMM ZBOH QBMJOH QPUFO BEB EJ TFMVSVI UVCVI EBO GVOHTJ TFM JOJ
UFUBQJ TFMVSVI TFM 5 UFSBLUJWBTJ ZBOH UFSCFOUVL EBO EJMFQBTLBO ZBOH EJLFUBIVJ IBOZBMBI VOUVL NFNQFSLFOBMLBO BOUJHFO LFQBEB
LF EBMBN DBJSBO MJNGF 4FMBOKVUOZB TFM 5 JOJ BLBO NBTVL LF TFM5MOUFSBLTJZBOHUFSKBEJQBEBQSPUFJOBEIFTJTFMNFSVQBLBOIBM
EBMBN TJSLVMBTJ EBO EJTFCBSLBO LF TFMVSVI UVCVI NFMFXBUJ QFOUJOHZBOHNFNVOHLJOLBOTFM5CFSJLBUBODVLVQMBNBEFOHBO
EJOEJOH LBQJMFS NBTVL LF EBMBN SVBOH KBSJOHBO TFLBMJ MBHJ BOUJHFOQSFTFOUJOHDFMMTFIJOHHBTFM5NFOKBEJTFM5UFSBLUJWBTJ
LFNCBMJ NBTVL LF EBMBN DBJSBO MJNGF EBO EBSBI EBO 1SPUFJO .)$ EJTBOEJLBO PMFI TFLFMPNQPL CFTBS HFO ZBOH
CFSTJSLVMBTJ LF TFMVSVI UVCVI EFNJLJBO TFUFSVTOZB LBEBOH EJTFCVU LPNQMFLT IJTUPLPNQBUJCJMJUBT NBZPS NBKPS IJTUPDPNQB
LBEBOH CFSMBOHTVOH TBNQBJ CFSCVMBOCVMBO BUBV CBILBO UJCJMJUZ DPNQMFY .)$
1SPUFJO .)$ CFSJLBUBO EFOHBO GSBHNFO
CFSUBIVOUBIVO QFQUJEB EBSJ QSPUFJO BOUJHFO ZBOH EJQFDBI EJ EBMBN BOUJHFO
4FM NFNPSJ MJNGPTJU5 KVHB EJCFOUVL NFMBMVJ DBSB ZBOH QSFTFOUJOHDFMMEBOLFNVEJBONFOHBOHLVUOZBLFQFSNVLBBOTFM
TBNB TFQFSUJ QFNCFOUVLBO TFM NFNPSJ # EBMBN TJTUFN 5FSEBQBU EVB KFOJT QSPUFJO .)$
1SPUFJO .)$* ZBOH
BOUJCPEJ +BEJ CJMB BEB TVBUV LMPO MJNGPTJU 5 EJBLUJGLBO PMFI NFNQFSLFOBMLBO BOUJHFO LFQBEB TFM 5 TJUPUPLTJL EBO
1SPUFJO
TVBUV BOUJHFO NBLB CBOZBL MJNGPTJU ZBOH CBSV UFSCFOUVL .)$ ** ZBOH NFNQFSLFOBMLBO BOUJHFO LFQBEB TFM 5 QFNCBOUV
EJTJNQBO EBMBN KBSJOHBO MJNGPJE VOUVL NFOKBEJ MJNGPTJU 5 'VOHTJ LIVTVT TFM 5 TJUPUPLTJL EBO TFM 5 QFNCBOUV BLBO
UBNCBIBO QBEB LMPO ZBOH TQFTJGJL JUV EBO UFSOZBUB TFMTFM EJCJDBSBLBOLFNVEJBO
NFNPSJ JOJ CBILBO NFOZFCBS LF TFMVSVI KBSJOHBO MJNGPJE EJ "OUJHFO QBEB QFSNVLBBO BOUJHFOQSFTFOUJOH DFMM BLBO CFSJLBU
TFMVSVI UVCVI 0MFI LBSFOB JUV QBEB QBQBSBO CFSJLVUOZB BO EFOHBO NPMFLVM SFTFQUPS QBEB QFSNVLBBO TFM 5 NFMBMVJ DBSB
UFSIBEBQBOUJHFOZBOHTBNBEJCBHJBOUVCVINBOBQVO UFSKBEJ ZBOH TBNB TFQFSUJ JLBUBOOZB EFOHBO BOUJCPEJ QSPUFJO QMBTNB
QFMFQBTBO TFMTFM 5 UFSBLUJWBTJ ZBOH KBVI MFCJI DFQBU EBO KBVI .PMFLVMSFTFQUPSJOJEJCFOUVLEBSJVOJUZBOHEBQBUCFSVCBI VOJU
MFCJILVBUEJCBOEJOHLBOEFOHBOQBQBSBOQFSUBNB WBSJBCFM
ZBOH TFSVQB EFOHBO CBHJBO WBSJBCFM QBEB BOUJCPEJ
IVNPSBM UFUBQJCBHJBOVUBNBOZBCFSJLBUBOLVBUEFOHBONFNCSBO
4el yang Menampilkan Antigen, Protein MHC, dan TFMMJNGPTJU54FM5NFNJMJLJUFNQBUSFTFQUPS
Reseptor Antigen pada Limfosit T. 3FTQPOTTFM5UFSIBEBQ
BOUJHFO CFSTJGBU TBOHBU TQFTJGJL TBNB TFQFSUJ SFTQPOT BOUJCPEJ Beberapa Tipe Sel T dan Berbagai Fungsinya
TFM# EBOQBMJOHUJEBLTBNBQFOUJOHOZBEFOHBOQFSBOBOUJCPEJ ,JUB UFMBI NFOHFUBIVJ EFOHBO KFMBT BEB CBOZBL UJQF TFM 5 4FM JOJ
EBMBN NFMBLVLBO QFSUBIBOBO NFMBXBO JOGFLTJ 1BEB LFOZBUB EJHPMPOHLBOEBMBNUJHBLFMPNQPLVUBNB
TFM5QFNCBOUV

BOOZB SFTQPOT JNVO ZBOH EJEBQBU CJBTBOZB NFNCVUVILBO TFM 5 TJUPUPLTJL EBO
TFM 5 TVQSFTPS 'VOHTJ UJBQUJBQ TFM JOJ
CBOUVBOTFM5VOUVLNFNVMBJOZB EBOTFM5TVOHHVICFSQFSBO CFOBSCFOBSCFSCFEB
QFOUJOHVOUVLNFNCBOUVNFMFOZBQLBOQBUPHFOZBOHNBTVL
.FTLJQVO MJNGPTJU # EBQBU NFOHFOBMJ BOUJHFO ZBOH VUVI Sel T Pembantu Perannya dalam Seluruh Pengaturan
MJNGPTJU5BLBOCFSFTQPOTUFSIBEBQBOUJHFOIBOZBCJMBBOUJHFO Imunitas
CFSJLBUBOEFOHBONPMFLVMTQFTJGJLZBOHEJLFOBMTFCBHBJQSPUFJO 4FM 5 QFNCBOUV TFKBVI JOJ NFSVQBLBO TFM 5 ZBOH KVNMBIOZB
.)$ QBEB QFSNVLBBO TFM ZBOH NFOBNQJMLBO BOUJHFO BOUJ QBMJOHCBOZBL CJBTBOZBNFMJQVUJMFCJIEBSJUJHBQFSFNQBUKVNMBI
HFOQSFTFOUJOH DFMM
EJ EBMBN KBSJOHBO MJNGPJE (BNCBS
TFM 5 4FQFSUJ ZBOH EJUVOKVLLBO PMFI OBNBOZB TFMTFM JOJ
5JHB UJQF BOUJHFOQSFTFOUJOH DFMM ZBOH VUBNB BEBMBI NBLSPGBH NFNCBOUV VOUVL NFMBLVLBO GVOHTJ TJTUFN JNVO EFOHBO CBOZBL
MJNGPTJU# EBOTFMEFOESJUJL4FMEFOESJUJL BOUJHFOQSFTFOUJOH DBSB 1BEB LFOZBUBBOOZB TFMTFM JOJ CFSUJOEBL TFCBHBJ QFOHBUVS
VUBNB CBHJ TFMVSVI GVOHTJ JNVO TFQFSUJ ZBOH UBNQBL QBEB
(BNCBS 4FMTFM JOJ NFMBLVLBO IBM UFSTFCVU EFOHBO
NFNCFOUVLTFSBOHLBJBONFEJBUPSQSPUFJO ZBOHEJTFCVUMJNGPLJO
ZBOHCFLFSKBQBEBTFMTFMMBJOEBSJTJTUFNJNVOEBOTFMTFMEBMBN
TVNTVNUVMBOH-JNGPLJOZBOHQFOUJOHZBOHEJTFLSFTJLBOPMFITFM
5QFNCBOUVBEBMBITFCBHBJCFSJLVU
*OUFSMFVLJO
*OUFSMFVLJO
*OUFSMFVLJO
*OUFSMFVLJO
*OUFSMFVLJO
'BLUPSQFSBOHTBOHLPMPOJHSBOVMPTJUNPOPTJU
*OUFSGFSPOϡ
Fungsi Pengaturan Spesifik oleh Limfokin. #JMB UJEBL
UFSEBQBUMJNGPLJOZBOHCFSBTBMEBSJTFM5QFNCBOUV NBLBTJTUFN
JNVO ZBOH UFSTJTB IBNQJS NFOKBEJ MVNQVI 1BEB LFOZBUBBOOZB
TFM5QFNCBOUVMBIZBOHEJJOBLUJWBTJBUBVEJIBODVSLBOPMFIWJSVT
BDRVJSFEJNNVOPEFGJDJFODZTZOESPNF "*%4
ZBOHNFNCVBUUVC
440
CBCLBO QFOHVNQVMBO NBLSPGBH EBMBN KVNMBI ZBOH CBOZBL

,FEVB MJNGPLJO UFSTFCVU NFOHBLUJGLBO NBLSPGBH VOUVL
NFMBLVLBO GBHPTJUPTJT ZBOH KBVI MFCJI FGJTJFO TFIJOHHB
NFNVOHLJOLBONBLSPGBHVOUVLNFOZFSBOHEBONFOHIBODVS
LBO PSHBOJTNF BUBV BHFO QFSVTBL KBSJOHBO MBJOOZB EBMBN
UNIT VI
KVNMBIZBOHMFCJICBOZBL
Efek Perangsangan Umpan Balik terhadap Sel,

Pembantu. #FCFSBQB MJNGPLJO LIVTVTOZB JOUFSMFVLJO
NFNJMJLJ FGFL VNQBO CBMJL QPTJUJG ZBOH MBOHTVOH NFSBOHTBOH
BLUJWBTJ TFM 5 QFNCBOUV JUV TFOEJSJ ,FSKB JOJ CFSMBLV TFCBHBJ
TVBUV QFOHVBU EFOHBO DBSB TFNBLJO NFNQFSLVBU SFTQPOT TFM
QFNCBOUV TFMBOKVUOZB EBO KVHB SFTQPOT JNVO LFTFMVSVIBO
EBMBNNFMBXBOBOUJHFOZBOHNBTVL
Sel T Sitotoksik merupakan Sel "Pembunuh"

4FM 5 TJUPUPLTJL NFSVQBLBO TFM QFOZFSBOH MBOHTVOH ZBOH
NBNQV NFNCVOVI NJLSPPSHBOJTNF EBO QBEB TVBUV TBBU
CBILBO NFNCVOVI TFMTFM UVCVI TFOEJSJ %FOHBO BMBTBO
UFSTFCVU NBLB TFM JOJ EJTFCVU TFM QFNCVOVI 1SPUFJO SFTFQUPS
QBEB QFSNVLBBO TFM TJUPUPLTJL NFOZFCBCLBO TFM JOJ CFSJLBUBO
FSBU EFOHBO PSHBOJTNF BUBV TFM ZBOH NFOHBOEVOH BOUJHFO
TQFTJGJL4FMBOKVUOZB TFMUFSTFCVUNFNCVOVITFMZBOHEJTFSBOH
UBEJ EFOHBO DBSB TFQFSUJ ZBOH EJMVLJTLBO QBEB (BNCBS
4FUFMBI CFSJLBUBO TFM 5 TJUPUPLTJL NFOZFLSFTJLBO QSPUFJO
QFNCFOUVL MVCBOH ZBOH EJTFCVU QFSGPSJO ZBOH NFNCVBU
MVCBOH CFSCFOUVL CVMBU QBEB NFNCSBO TFM ZBOH EJTFSBOH
,FNVEJBO DBJSBO EBSJ SVBOH JOUFSTUJTJBM BLBO NFOHBMJS TFDBSB
DFQBU LF EBMBN TFM 4FMBJO JUV TFM TJUPUPLTJL KVHB NFMFQBTLBO
CVI IBNQJS TFDBSB UPUBM UJEBL UFSMJOEVOHJ UFSIBEBQ QFOZBLJU TVCTUBOTJ TJUPUPLTJL TFDBSB MBOHTVOH LF EBMBN TFM ZBOH
JOGFLTJ TFIJOHHB NFOJNCVMLBO FGFL ZBOH TFLBSBOH EJLFOBM EJTFSBOH )BNQJS EFOHBO TFHFSB TFM ZBOH EJTFSBOH NFOKBEJ
TFCBHBJFGFLNFMFNBILBOEBONFNBUJLBOBLJCBU"*%4#FCFSBQB TBOHBU NFNCFOHLBL EBO CJBTBOZB UJEBL MBNB LFNVEJBO BLBO
GVOHTJQFOHBUVSBOTQFTJGJLBEBMBITFCBHBJCFSJLVU UFSMBSVU
)BMZBOHQBMJOHQFOUJOHBEBMBITFMQFNCVOVITJUPUPLTJLJOJ
Perangsangan Pertumbuhan dan Proliferasi Sel T Sito- EBQBU UFSEPSPOH LFMVBS EBSJ TFM LPSCBO TFUFMBI TFM QFNCVOVI
toksik dan Sel T Supresor.#JMBUJEBLBEBTFM5QFNCBOUV LMPO NFNCVBU MVCBOH EBO NFOHJSJNLBO TVCTUBOTJ TJUPUPLTJL EBO
VOUVLNFNQSPEVLTJTFM5TJUPUPLTJLEBOTFM5TVQSFTPSEJBLUJGLBO LFNVEJBO QJOEBI VOUVL NFNCVOVI MFCJI CBOZBL TFM MBHJ
TFEJLJUTFLBMJPMFITFCBHJBOCFTBSBOUJHFO-JNGPLJOJOUFSMFVLJO 4FTVOHHVIOZB CFCFSBQB TFMTFM QFNCVOVI JOJ EBQBU NFOFUBQ
LIVTVTOZB NFNJMJLJ FGFL QFSBOHTBOHBO ZBOH TBOHBU LVBU EBMBN TFMBNBCFSCVMBOCVMBOEBMBNKBSJOHBO
NFOZFCBCLBO QFSUVNCVIBO EBO QSPMJGFSBTJ TFM 5 TJUPUPLTJL EBO
TFM 5 TVQSFTPS 4FMBJO JUV CFCFSBQB MJNGPLJO MBJO NFNJMJLJ FGFL
QPUFOTJBMZBOHMFCJITFEJLJU
Perangsangan Pertumbuhan dan Diferensiasi Sel-B

untuk Membentuk Sel Plasma dan Antibodi. ,FSKB MBOHTVOH
BOUJHFO VOUVL NFOHIBTJMLBO QFSUVNCVIBO TFM# QSPMJGFSBTJ
QFNCFOUVLBO TFM QMBTNB EBO TFLSFTJ BOUJCPEJ KVHB MFNBI UBOQB
CBOUVBO TFM 5 QFNCBOUV )BNQJS TFNVB JOUFSMFVLJO CFSQFSBO
TFSUBEBMBNSFTQPOTTFM# UFUBQJLIVTVTOZBJOUFSMFVLJO EBO
1BEB LFOZBUBBOOZB LFUJHB JOUFSMFVLJO JOJ NFNJMJLJ FGFL ZBOH
LVBU QBEB TFM # TFIJOHHB JOUFSMFVLJO UFSTFCVU EJTFCVU TFCBHBJ
GBLUPSQFSBOHTBOHTFM#BUBVGBLUPSQFSUVNCVIBOTFM#
Aktivasi Sistem Makrofag. -JNGPLJO KVHB NFNFOHBSVIJ

NBLSPGBH 1FSUBNB MJNGPLJO NFNQFSMBNCBU BUBV NFOHIFOUJLBO
NJHSBTJNBLSPGBHTFUFMBINBLSPGBHTFDBSBLFNPUBLUJLUFSUBSJLLF
EBMBNEBFSBIKBSJOHBOZBOHNFSBEBOH EFOHBOEFNJLJBONFOZF
441
Unit VI Sel-Set darah, Imunitas, dan Pembekuan Darah
#FCFSBQBTFM5TJUPUPLTJLCFSTJGBUNFNBUJLBOUFSIBEBQTFM Kegagalan Mekanisme Toleransi Menyebabkan Penyakit

TFM KBSJOHBO ZBOH UFMBI EJJOWBTJ PMFI WJSVT LBSFOB CBOZBL Autoimun. ,BEBOHLBEBOH PSBOH LFIJMBOHBO TFCBHJBO UPMFSBOTJ
QBSUJLFM WJSVT ZBOH UFSQFSBOHLBQ EBMBN NFNCSBO TFM KBSJOHBO JNVOUFSIBEBQKBSJOHBOOZBTFOEJSJ4FNBLJOUVBTFTFPSBOH IBMJOJ
EBONFOBSJLTFM5TFCBHBJSFTQPOTUFSIBEBQBOUJHFOJTJUBTWJSVT BLBO NFOKBEJ TFNBLJO CFSBU #JBTBOZB IBM JOJ UFSKBEJ TFUFMBI
4FM TJUPUPLTJL KVHB CFSQFSBO QFOUJOH EBMBN QFOHIBODVSBO TFM UJNCVMLFSVTBLBOCFCFSBQBKBSJOHBOUVCVI ZBOHCBOZBLNFMFQBT
LBOLFS TFM DBOHLPL KBOUVOH BUBV KFOJTKFOJT TFM MBJO ZBOH LBOBOUJHFOTFOEJSJZBOHCFSTJSLVMBTJEJEBMBNUVCVIEBOEJEVHB
EJBOHHBQBTJOHPMFIUVCVIPSBOHJUVTFOEJSJ NFOJNCVMLBO JNVOJUBT EJEBQBU EBMBN CFOUVL TFM 5 ZBOH
UFSBLUJWBTJBUBVBOUJCPEJ
Sel T Supresor "EB CFCFSBQB QFOZBLJU TQFTJGJL ZBOH EJTFCBCLBO PMFI
%JCBOEJOHLBO EFOHBO TFMTFM ZBOH MBJO QFSJIBM TFM 5 TVQSFTPS BVUPJNVOJUBT BOUBSB MBJO
EFNBN SFVNBUJL ZBOH NFOZFCBC
NBTJI TFEJLJU ZBOH EJLFUBIVJ OBNVO TFM JOJ NFNQVOZBJ LBO UVCVI NFOKBEJ UFSJNVOJTBTJ UFSIBEBQ KBSJOHBO EBMBN TFOEJ
LFNBNQVBO VOUVL NFOFLBO GVOHTJ TFM 5 TJUPUPLTJL EBO TFM 5 EBO KBOUVOH LIVTVTOZB LBUVQ KBOUVOH TFUFMBI UFSQBKBO EFOHBO
QFNCBOUV 'VOHTJ TVQSFTPS JOJ EJEVHB CFSUVKVBO VOUVL UPLTJO TUSFQUPLPLVT KFOJT UFSUFOUV ZBOH NFNJMJLJ FQJUPQ QBEB
NFODFHBI TFM TJUPUPLTJL BHBS UJEBL NFOZFCBCLBO SFBLTJ JNVO TUSVLUVSNPMFLVMBSOZBZBOHNJSJQEFOHBOTUSVLUVSQBEBCFCFSBQB
ZBOH CFSMFCJIBO ZBOH EBQBU NFSVTBL KBSJOHBO UVCVI TFOEJSJ BOUJHFOTFOEJSJEBSJUVCVI
TBUVUJQFHMPNFSVMPOFGSJUJT LBSFOB
%FOHBO BMBTBO JOJMBI NBLB TFMTFM TVQSFTPS CFSTBNB EFOHBO PSBOH UFSTFCVU NFOKBEJ UFSJNVOJTBTJ UFSIBEBQ NFNCSBO CBTBM
TFM 5 QFNCBOUV EJHPMPOHLBO TFCBHBJ TFM 5 SFHVMBUPS 4FM 5 HMPNFSVMJ
NJBTUFOJB HSBWJT ZBOH NFNCFOUVL JNVOJUBT
TVQSFTPS NVOHLJO CFSQFSBO QFOUJOH EBMBN NFNCBUBTJ UFSIBEBQQSPUFJOSFTFQUPSBTFUJMLPMJOQBEBTBNCVOHBOOFVSPNVT
LFNBNQVBO TJTUFN JNVO VOUVL NFOZFSBOH KBSJOHBO UVCVI LVMBS TFIJOHHB UFSKBEJ LFMVNQVIBO EBO
MVQVT FSJUFNBUPTVT
TFOEJSJ ZBOH EJTFCVU TFCBHBJ UPMFSBOTJ JNVO TFQFSUJ ZBOH LJUB ZBOHEJTFCBCLBOLBSFOBQBTJFOQBEBTBBUZBOHTBNBUFSJNVOJTBTJ
CJDBSBLBOEJCBHJBOCFSJLVU UFSIBEBQ CFSCBHBJ KBSJOHBO UVCVI QFOZBLJU JOJ NFOZFCBCLBO
LFSVTBLBO ZBOH TBOHBU MVBT EBO TFSJOH LBMJ DFQBU NFOJNCVMLBO
LFNBUJBO
Toleransi Sistem Imunitas Didapat terhadap Jaringan
Tubuh Sendiri Peranan Pengolahan Sel di Timus dan
Sumsum Tulang Imunisasi dengan Injeksi Antigen
*NVOJTBTJ UFMBI EJQBLBJ TFMBNB CFSUBIVOUBIVO VOUVL
#JMB TFTFPSBOH NFOKBEJ JNVO UFSIBEBQ KBSJOHBOOZB TFOEJSJ NFOJNCVMLBO JNVOJUBT EJEBQBU UFSIBEBQ QFOZBLJUQFOZBLJU
NBLBQSPTFTJNVOJUBTEJEBQBUBLBONFOHIBODVSLBOUVCVIOZB UFSUFOUV4FTFPSBOHEBQBUEJJNVOJTBTJEFOHBODBSBNFOZVOUJLLBO
TFOEJSJ #JBTBOZB NFLBOJTNF JNVO EBQBU NFOHFOBMJ PSHBOJTNF ZBOH UFMBI NBUJ ZBOH UJEBL NBNQV NFOJNCVMLBO
KBSJOHBOOZB TFOEJSJ ZBOH KFMBT CFSCFEB EFOHBO CBLUFSJ BUBV QFOZBLJUMBHJ UFUBQJNBTJINFNQVOZBJCFCFSBQBBOUJHFOLJNJBXJ
WJSVT EBOTJTUFNJNVOJUBTNFNCFOUVLTFEJLJUBOUJCPEJBUBVTFM 5JQF JNVOJTBTJ JOJ EJQBLBJ VOUVL NFMJOEVOHJ UVCVI UFSIBEBQ
5UFSBLUJWBTJUFSIBEBQBOUJHFOOZBTFOEJSJ EFNBN UJGPJE CBUVL SFKBO EJGUFSJ EBO CBOZBL NBDBN QFOZBLJU
CBLUFSJBMMBJOOZB
Sebagian Besar Toleransi Disebabkan oleh Seleksi
Klon selama Proses Pengolahan. 4FCBHJBOCFTBSGFOPNFOB %BQBU KVHB EJQFSPMFI JNVOJUBT UFSIBEBQ UPLTJO ZBOH UFMBI
UPMFSBOTJ EJEVHB UJNCVM TFXBLUV UFSKBEJ QFOHPMBIBO QFO EJPMBIEFOHBOCBIBOLJNJB TFIJOHHBTJGBUUPLTJLOZBTVEBISVTBL
EBIVMVBOMJNGPTJU5EJUJNVTEBOMJNGPTJU#EJTVNTVNUVMBOH XBMBVQVO BOUJHFO ZBOH NFOJNCVMLBO JNVOJUBT UFUBQ VUVI $BSB
"MBTBOVOUVLBOHHBQBOJOJLBSFOBCJMBEJMBLVLBOQFOZVOUJLBO JOJ EJQBLBJ QBEB JNVOJTBTJ UFSIBEBQ UFUBOVT CPUVMJTNF EBO
TVBUVBOUJHFOZBOHLVBULFEBMBNKBOJOTFXBLUVMJNGPTJUEJPMBI QFOZBLJUUPLTJLMBJOZBOHTFSVQB
MFCJIEVMVEJLFEVBUFNQBUUBEJ BLBONFODFHBIQFNCFOUVLBO "LIJSOZB TFTFPSBOH EBQBU EJJNVOJTBTJ EFOHBO KBMBO NFOH
LMPO MJNGPTJU EJ EBMBN KBSJOHBO MJNGPJE ZBOH CFSTJGBU TQFTJGJL JOGFLTJOZB EFOHBO PSHBOJTNF IJEVQ ZBOH TVEBI EJMFNBILBO
UFSIBEBQ BOUJHFO ZBOH EJTVOUJLLBO #FCFSBQB QFSDPCBBO KVHB "SUJOZB PSHBOJTNFJOJUFMBIEJUBOBNEBMBNNFEJBCJBLBOLIVTVT
UFMBINFNCVLUJLBOCBIXBMJNGPTJUJNBUVSTQFTJGJLZBOHCFSBEB BUBV EJUSBOTGFS QBEB TFSBOHLBJBO CJOBUBOH TBNQBJ PSHBOJTNF JOJ
EBMBNUJNVT CJMBUFSQBKBOEFOHBOBOUJHFOZBOHLVBU NBLBTFM DVLVQ CFSNVUBTJ TFIJOHHB PSHBOJTNF JOJ UJEBL BLBO NFOJNCVM
JOJ BLBO NFOKBEJ MJNGPCMBTUJL TBOHBU CFSQSPMJGFSBTJ EBO LBO QFOZBLJU UBQJ NBTJI NFNCBXB BOUJHFO TQFTJGJL ZBOH
LFNVEJBO CFSHBCVOH EFOHBO BOUJHFO ZBOH NFSBOHTBOH UBEJ EJCVUVILBO VOUVL JNVOJTBTJ $BSB JOJ EJQBLBJ VOUVL NFMJOEVOHJ
TVBUV FGFL ZBOH EJEVHB EBQBU NFOZFCBCLBO TFM JUV TFOEJSJ UVCVI UFSIBEBQ DBDBS BJS EFNBN LVOJOH QPMJPNJFMJUJT DBNQBL
EJIBODVSLBOPMFITFMFQJUFMUJNVTTFCFMVNTFMMJNGPTJUUFSTFCVU EBOCBOZBLQFOZBLJUWJSVTMBJOOZB
EBQBU CFSNJHSBTJ LF KBSJOHBO MJNGPJE EBO CFSLPMPOJ EJ
EBMBNOZB
Imunitas Pasif
0MFILBSFOBJUV EJEVHBCBIXBTFMBNBMJNGPTJUEJPMBIMFCJI 4BNQBJ TFKBVI JOJ TFNVB JNVOJUBT EJEBQBU ZBOH UFMBI LJUB
EVMV EJ UJNVT EBO TVNTVN UVMBOH TFNVB BUBV TFCBHJBO CFTBS CJDBSBLBO BEBMBI JNVOJUBT BLUJG :BJUV UVCVI TFTFPSBOH NFN
LMPO MJNGPTJU UFSTFCVU ZBOH CFSTJGBU TQFTJGJL VOUVL NFSVTBL CFOUVL BOUJCPEJ BUBV TFM 5 UFSBLUJWBTJ TFCBHBJ SFTQPOT UFSIBEBQ
KBSJOHBO UVCVI TFOEJSJ BLBO EJIBODVSLBO TFOEJSJ LBSFOB BOUJHFO BTJOH ZBOH NBTVL LF EBMBN UVCVI 5BQJ JNVOJUBT
BEBOZBLPOUBLZBOHUFSVTNFOFSVTEFOHBOBOUJHFOUVCVI TFNFOUBSBQBEBTFTFPSBOHEBQBUEJDBQBJUBOQBNFOZVOZVOUJLLBO
442
BOUJHFO BQB QVO )BM JOJ EJEBQBU EFOHBO DBSB QFNCFSJBO JOGVT 4JGBU LIVTVT BOUJCPEJ *H& SFBHJO
BEBMBI BEBOZB LFDFOEF
BOUJCPEJ TFM 5 UFSBLUJWBTJ BUBV LFEVBOZB EBSJ EBSBI PSBOH MBJO SVOHBO ZBOH LVBU VOUVL NFMFLBU QBEB TFM NBTU EBO CBTPGJM
BUBVEBSJCFCFSBQBCJOBUBOHMBJOZBOHUFMBINFNQVOZBJJNVOJUBT 4FTVOHHVIOZB TBUV TFM NBTU BUBV CBTPGJM EBQBU NFOHJLBU
BLUJGUFSIBEBQBOUJHFOUFSTFCVU TBNQBJTFUFOHBIKVUBNPMFLVMBOUJCPEJ*H&#JMBTVBUVBOUJHFO
"OUJCPEJJOJBLBOIBCJTEBMBNXBLUVTBNQBJNJOHHVEBMBN BMFSHFO
ZBOH NFNQVOZBJ CBOZBL UFNQBU JLBUBO LFNVEJBO
UNIT VI
UVCVI SFTJQJFO EBO TFMBNB XBLUV JOJ PSBOH UFSTFCVU UFSMJOEVOH CFSJLBUBOEFOHBOCFCFSBQBBOUJCPEJ*H&ZBOHNFMFLBUQBEBTFM
EBSJQFOZBLJUZBOHNFOHJOWBTJ4FM5UFSBLUJWBTJCJMBEJUSBOTGVTJ NBTU BUBV CBTPGJM NBLB JOJ NFOZFCBCLBO QFSVCBIBO TFHFSB
LBO EBSJ PSBOH MBJO NBLB BLBO IBCJT EBMBN XBLUV CFCFSBQB QBEBNFNCSBOTFMNBTUBUBVCBTPGJM NVOHLJOEJTFCBCLBOPMFI
NJOHHV UFUBQJ CJMB EJUSBOTGVTJLBO EBSJ TFFLPS CJOBUBOH NBLB FGFLGJTJLNPMFLVMBOUJCPEJZBOHEBQBUNFOHVCBINFNCSBOTFM
BLBOIBCJTEBMBNXBLUVCFCFSBQBKBNTBNQBJCFCFSBQBIBSJTBKB 1BEB TFUJBQ TBBU CBOZBL TFM NBTU EBO CBTPGJM ZBOH QFDBI BEB
5SBOTGVTJ BOUJCPEJ BUBV MJNGPTJU 5 TFNBDBN JOJ NFOJNCVMLBO KVHBZBOHTFHFSBNFMFQBTLBOTVCTUBOTJLIVTVTTFQFSUJIJTUBNJO
JNVOJUBTZBOHEJTFCVUJNVOJUBTQBTJG QSPUFBTF TVCTUBOTJ BOBGJMBLTJT ZBOH CFSFBLTJ MBNCBU ZBOH
NFSVQBLBO DBNQVSBO MFVLPUSJFOMFVLPUSJFO UPLTJL
TVCTUBOTJ
LFNPUBLUJL FPTJOPGJM TVCTUBOTJ LFNPUBLUJL OFVUSPGJM IFQBSJO
Alergi dan Hipersensitivitas
EBO GBLUPS QFOHBLUJG USPNCPTJU 4VCTUBOTJTVCTUBOTJ JOJ
NFOZFCBCLBO CFCFSBQB FGFL TFQFSUJ EJMBUBTJ QFNCVMVI EBSBI
1BEBCFCFSBQBLPOEJTJ TBMBITBUVFGFLTBNQJOHJNVOJUBTQFOUJOH
TFUFNQBU QFOBSJLBO FPTJOPGJM EBO OFVUSPGJM NFOVKV UFNQBU
ZBOH UJEBL EJJOHJOLBO BEBMBI UJNCVMOZB BMFSHJ BUBV KFOJT
ZBOH SFBLUJG QFOJOHLBUBO QFSNFBCJMJUBT LBQJMFS EBO IJMBOHOZB
IJQFSTFOTJUJWJUBT JNVO MBJOOZB "EB CFCFSBQB UJQF BMFSHJ EBO
DBJSBO LF EBMBN KBSJOHBO EBO LPOUSBLTJ TFM PUPU QPMPT MPLBM
IJQFSTFOTJUJWJUBT MBJOOZB CFCFSBQB EJ BOUBSBOZB IBOZB UFSKBEJ
0MFI LBSFOB JUV EBQBU UFSKBEJ CFSCBHBJ SFTQPOT KBSJOHBO
QBEB PSBOHPSBOH ZBOH NFNQVOZBJ LFDFOEFSVOHBO BMFSHJ ZBOH
CFSHBOUVOHQBEBNBDBNKBSJOHBOUFNQBUSFBLTJBMFSHFOSFBHJO
TQFTJGJL
UFSKBEJ #FSNBDBNNBDBN SFBLTJ BMFSHJ ZBOH EJTFCBCLBO PMFI
Alergi yang Disebabkan oleh Sel T Teraktivasi: Alergi QPMBJOJBEBMBITFCBHBJCFSJLVU
Reaksi-Lambat Anafilaksis. #JMB TVBUV BMFSHFO TQFTJGJL EJTVOUJLLBO TFDBSB
"MFSHJSFBLTJMBNCBUEJTFCBCLBOPMFITFM5UFSBLUJWBTJEBOCVLBO MBOHTVOH LF EBMBN TJSLVMBTJ NBLB BMFSHFO UFSTFCVU EBQBU
PMFI BOUJCPEJ 1BEB LBTVT UFSLFOB SBDVO EBSJ UVNCVIBO ZBOH CFSFBLTJ EFOHBO CBTPGJM EBMBN EBSBI EBO TFM NBTU QBEB
NFOKBMBS UPLTJO EBSJ SBDVO JUV TFOEJSJ UJEBL NFOZFCBCLBO KBSJOHBO ZBOH UFSMFUBL UFQBU EJ MVBS QFNCVMVI EBSBI LFDJM KJLB
CBOZBLLFSVTBLBOKBSJOHBO/BNVO QBEBLPOUBLZBOHCFSVMBOH CBTPGJM EBO TFM NBTU UFSTFCVU UFMBI EJTFOTJUJTBTJ PMFI QFMFLBUBO
UPLTJO NFOZFCBCLBO QFNCFOUVLBO TFM 5 QFNCBOUV EBO TFM 5 SFBHJO*H&0MFILBSFOBJUV UFSKBEJMBISFBLTJBMFSHJZBOHMVBTEJ
TJUPUPLTJL ZBOH UFSBLUJWBTJ ,FNVEJBO QBEB LPOUBL CFSJLVUOZB TFMVSVI TJTUFN QFNCVMVI EBSBI EBO KBSJOHBO ZBOH CFSLBJUBO
EBMBNXBLUVTBUVIBSJBUBVMFCJI TFM5UFSBLUJWBTJEBMBNKVNMBI FSBU )BM JOJ EJTFCVU BOBGJMBLTJT )JTUBNJO ZBOH EJMFQBTLBO LF
CFTBS BLBO CFSEJGVTJ EBSJ TJSLVMBTJ EBSBI LF EBMBN LVMJU TFCBHBJ EBMBN TJSLVMBTJ BLBO NFOJNCVMLBO WBTPEJMBUBTJ EJ TFMVSVI
SFTQPOT UFSIBEBQ UPLTJO EBSJ UVNCVIBO CFSBDVO UBEJ 1BEB TBBU UVCVI EBO QFOJOHLBUBO QFSNFBCJMJUBT LBQJMFS TFIJOHHB
ZBOHTBNB TFM5JOJNFOJNCVMLBOSFBLTJJNVOZBOHEJQFSBOUBSBJ NFOZFCBCLBO LFIJMBOHBO CBOZBL TFLBMJ QMBTNB EBSJ TJSLVMBTJ
TFM .FOHJOHBU CBIXB UJQF JNVOJUBT JOJ EBQBU NFOZFCBCLBO ,BEBOHLBEBOH TFTFPSBOH ZBOH NFOHBMBNJ SFBLTJ JOJ EBMBN
QFMFQBTBO CBOZBL CBIBO UPLTJL EBSJ TFM 5 ZBOH UFSBLUJWBTJ EBO XBLUVCFCFSBQBNFOJUNFOJOHHBMBLJCBUTZPLTJSLVMBTJ LFDVBMJ
KVHBNFOZFCBCLBOJOWBTJNBLSPGBHZBOHMVBTLFKBSJOHBOCFTFSUB LBMBV EJPCBUJ EFOHBO QFNCFSJBO FQJOFGSJO VOUVL NFMBXBO
FGFLFGFLNBLSPGBHTFMBOKVUOZB NBLBLJUBEBQBUNFOHFSUJCBIXB QFOHBSVIIJTUBNJO
IBTJM BLIJS EBSJ CFCFSBQB BMFSHJ SFBLTJ MBNCBU EBQBU NFOZFCBC #BTPGJMEBOTFMNBTUZBOHUFSBLUJWBTJKVHBNFMFQBTLBOTVBUV
LBO LFSVTBLBO KBSJOHBO ZBOH TFSJVT #JBTBOZB LFSVTBLBO UFSKBEJ DBNQVOBO MFVLPUSJFO ZBOH EJTFCVU TVCTUBOTJ BOBGJMBLTJT
QBEBEBFSBIKBSJOHBOZBOHEJUFNQBUJPMFIBOUJHFOQFNJDV TFQFSUJ CFSFBLTJMBNCBU-FVLPUSJFOMFVLPUSJFOJOJEBQBUNFOZFCBCLBO
EJ LVMJU QBEB LBTVT UFSLFOB SBDVO UVNCVIBO BUBV EJ QBSV ZBOH TQBTNF PUPU QPMPT CSPOLJPMVT TFIJOHHB NFOJNCVMLBO TFSBOH
NFOZFCBCLBO FEFNB QBSV EBO TFSBOHBO BTNB QBEB LBTVT ZBOH BO TFQFSUJ BTNB EBO LBEBOHLBEBOH NFOJNCVMLBO LFNBUJBO
EJTFCBCLBOPMFICFCFSBQBBOUJHFOZBOHEJUVMBSLBOMFXBUVEBSB BLJCBUNBUJMFNBT
Alergi pada Orang "Alergik" dengan Antibodi IgE yang Urtikaria. 6SUJLBSJB UJNCVM BLJCBU NBTVLOZB BOUJHFO LF
Berlebihan EBFSBI LVMJU ZBOH TQFTJGJL EBO NFOJNCVMLBO SFBLTJ TFUFNQBU
#FCFSBQB PSBOH NFNQVOZBJ LFDFOEFSVOHBO BMFSHJL "MFSHJ ZBOH NJSJQ SFBLTJ BOBGJMBLTJT )JTUBNJO ZBOH EJMFQBTLBO
TFNBDBN JOJ EJTFCVU BMFSHJ BUPQJL LBSFOB EJTFCBCLBO PMFI TFUFNQBUBLBONFOJNCVMLBO
WBTPEJMBUBTJZBOHNFOZFCBC
SFTQPOTTJTUFNJNVOZBOHUJEBLMB[JN,FDFOEFSVOHBOBMFSHJJOJ LBO UJNCVMOZB SFE GMBSF LFNFSBIBO
EBO
QFOJOHLBUBO
EJUVSVOLBO TFDBSB HFOFUJT EBSJ PSBOH UVB LF BOBL EBO EJUBOEBJ QFSNFBCJMJUBTLBQJMFSTFUFNQBUTFIJOHHBEBMBNCFCFSBQBNFOJU
EFOHBO BEBOZB TFKVNMBI CFTBS BOUJCPEJ *H& EBMBN EBSBI LFNVEJBOBLBOUFSKBEJQFNCFOHLBLBOTFUFNQBUZBOHCFSCBUBT
"OUJCPEJ JOJ EJTFCVU SFBHJO BUBV BOUJCPEJ UFSTFOTJUJTBTJ VOUVL KFMBT 1FNCFOHLBLBO JOJ VNVNOZB EJTFCVU VSUJLBSJBh
NFNCFEBLBOOZB EFOHBO BOUJCPEJ *H( ZBOH MFCJI VNVN #JMB 1FNCFSJBOPCBUBOUJIJTUBNJOTFCFMVNTFTFPSBOHUFSQBKBOBLBO
TVBUV BMFSHFO ZBOH EJEFGJOJTJLBO TFCBHBJ TVBUV BOUJHFO ZBOH NFODFHBIUJNCVMOZBVSUJLBSJB
CFSFBLTJTFDBSBTQFTJGJLEFOHBOBOUJCPEJSFBHJO*H&UJQFTQFTJGJL
Hay Fever. 1BEB IBZ GFWFS SFBLTJ BMFSHFOSFBHJO UFSKBEJ
NFNBTVLJ UVCVI NBLB UFSKBEJ SFBLTJ BMFSHFOSFBHJO EBO EBMBN IJEVOH )JTUBNJO ZBOH EJMFQBTLBO TFCBHBJ SFTQPOT
LFNVEJBOUFSKBEJSFBLTJBMFSHJ UFSIBEBQSFBLTJ NFOJNCVMLBOEJMBUBTJQFNCVMVIEBSBIJOUSBO
443
BTBM TFUFNQBU TFIJOHHB NFOZFCBCLBO QFOJOHLBUBO UFLBOBO Cossart P, Sansonetti PJ: Bacterial invasion: the paradigms of enteroinvasive
LBQJMFS EBO QFOJOHLBUBO QFSNFBCJMJUBT LBQJMFS ,FEVB FGFL JOJ pathogens, Science 304:242, 2004.
NFOJNCVMLBO LFCPDPSBO DBJSBO ZBOH DFQBU LF EBMBN SPOHHB Dorshkind K, Montecino-Rodriguez E, Signer RA: The ageing immune system:
IJEVOH EBO LF EBMBN KBSJOHBO IJEVOH ZBOH MFCJI EBMBN EBO is it ever too old to become young again? Nat Rev Immunol 9:57, 2009.
TBMVSBO IJEVOH NFOKBEJ CFOHLBL EBO QFOVI EFOHBO TFLSFU Eisenbarth GS, Gottlieb PA: Autoimmune polyendocrine syndromes, N Engl
4FLBMJ MBHJ QFOHHVOBBO PCBU BOUJIJTUBNJO EBQBU NFOHIJOEBSJ J Med 350:2068, 2004.
SFBLTJ QFNCFOHLBLBO 5FUBQJ QSPEVL SFBLTJ BMFSHFOSFBHJO Fanta CH: Asthma, N Engl J Med 360:1002, 2009.
ZBOH MBJO UFUBQ EBQBU NFOZFCBCLBO JSJUBTJ QBEB IJEVOH Figdor CG, de Vries IJ, Lesterhuis WJ, et al: Dendritic cell immunotherapy:
TFIJOHHBNFOJNCVMLBOTJOESPNCFSTJOZBOHLIBT mapping the way, Nat Med 10:475, 2004.
Grossman Z, Min B, Meier-Schellersheim M, et al: Concomitant regulation
Asma. "TNB TFSJOH UFSKBEJ QBEB TFTFPSBOH ZBOH BMFSHJL of T-cell activation and homeostasis, Nat Rev Immunol 4:387, 2004. Kupper
1BEB PSBOH TFQFSUJ JOJ SFBLTJ BMFSHFOSFBHJO UFSKBEJ EJ EBMBN TS, Fuhlbrigge RC: Immune surveillance in the skin: mechanisms
CSPOLJPMVT QBSV %J UFNQBU JOJ QSPEVL QBMJOH QFOUJOH ZBOH and clinical consequences, Nat Rev Immunol 4:211, 2004.
Linton PJ, Dorshkind K: Age-related changes in lymphocyte development
EJMFQBTLBO EBSJ TFM NBTU UBNQBLOZB BEBMBI TVCTUBOTJ
and function, Nat Immunol 5:133, 2004.
BOBGJMBLTJT CFSFBLTJMBNCBU ZBOH NFOJNCVMLBO TQBTNF PUPU Mackay IR: Autoimmunity since the 1957 clonal selection theory: a little
QPMPT CSPOLJPMVT "LJCBUOZB PSBOH UFSTFCVU NFOHBMBNJ acorn to a large oak, Immunol Cell Biol 86:67, 2008.
LFTVLBSBO CFSOBQBT TBNQBJ QSPEVL SFBLUJG EBSJ SFBLTJ BMFSHJL Medzhitov R: Recognition of microorganisms and activation of the immune
EJIJMBOHLBO1FNCFSJBOPCBUBOUJIJTUBNJONFNCFSJFGFLZBOH response, Nature 449:819, 2007.
Mizushima N, Levine B, Cuervo AM, et al: Autophagy fights disease through
TFEJLJU TBKB UFSIBEBQ QFSKBMBOBO QFOZBLJU BTNB LBSFOB
cellular self-digestion, Nature 45:1069, 2008.
IJTUBNJO CVLBOMBI GBLUPS VUBNB ZBOH NFOJNCVMLBO SFBLTJ Petrie HT: Cell migration and the control of post-natal T-cell lymphopoiesis
BTNB in the thymus, Nat Rev Immunol 3:859, 2003.
Rahman A, Isenberg DA: Systemic lupus erythematosus, N Engl J Med
358:929, 2008.
Daftar Pustaka Vivier E, Anfossi N: Inhibitory NK-cell receptors on T cells: witness of the
Alberts B, Johnson A, Lewis J, et al: Molecular Biology of the Cell, ed 5, New past, actors of the future, Nat Rev Immunol 4:190, 2004.
York, 2008, Garland Science. Welner RS, Pelayo R, Kincade PW: Evolving views on the genealogy of B
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ms in a complex, heterogeneous disease, Lancet 372:1107, 2008.
Barton GM: A calculated response: control of inflammation by the innate
immune system, J Clin Invest 118:413, 2008.
444
BAB 35
UNIT VI
(PMPOHBO%BSBI5SBOTGVTJ
5SBOTQMBOUBTJ+BSJOHBOEBO0SHBO
(PMPOHBO %BSBI 0"# ZBOH 6UBNB %BMBN NFOUSBOTGVTJ

400 Antigenisitas yang EBSBI EBSJ PSBOH LF PSBOH EBSBI EPOPS EBO EBSBI SFTJQJFO
300
Menyebabkan Reaksi Imun OPSNBMOZB EJLMBTJGJLBTJLBO LF EBMBN FNQBU UJQF HPMPOHBO
200
100
pada Darah EBSBI0"#ZBOHVUBNB TFQFSUJZBOHUBNQBLQBEB5BCFM
0
0 10 20 30 40 50 60 70 80 90 100
CFSHBOUVOH QBEB BEB BUBV UJEBLOZB LFEVB BHMVUJOPHFO ZBJUV
BHMVUJOPHFO"EBO##JMBUJEBLUFSEBQBUBHMVUJOPHFO"BUBVQVO
,FUJLB USBOTGVTJ EBSBI EBSJ QFSUBNB # EBSBIOZBBEBMBIHPMPOHBO0#JMBIBOZBUFSEBQBUBHMVUJOPHFO
PSBOHLFPSBOHEJDPCBVOUVLLBMJ UJNCVMBHMVUJOBTJEBOIFNPMJTJT UJQF " EBSBIOZB BEBMBI HPMPOHBO " #JMB IBOZB UFSEBQBU
TFM EBSBI NFSBI TFDBSB DFQBU BUBV MBNCBU ZBOH NFOJNCVMLBO BHMVUJOPHFO UJQF # EBSBIOZB BEBMBI HPMPOHBO # %BO CJMB
SFBLTJ USBOTGVTJ ZBOH LIBT EBO LBEBOHLBEBOH NFOZFCBCLBO UFSEBQBUBHMVUJOPHFO"EBO# EBSBIOZBBEBMBIHPMPOHBO"#
LFNBUJBO4FHFSBTFUFMBIJUV EJUFNVLBOCBIXBEBSBIEBSJPSBOH
ZBOH CFSCFEB NFNQVOZBJ TJGBU BOUJHFO EBO JNVOJUBT ZBOH Penentuan Genetik terhadap Aglutinogen. %VB HFO
CFSCFEB QVMB TFIJOHHB BOUJCPEJ EBMBN QMBTNB EBSBI TFTFPSBOH TBMBITBUVOZBUFSEBQBUEJTFUJBQLSPNPTPNEBOEVBLSPNPTPN
BLBO CFSFBLTJ EFOHBO BOUJHFO QBEB QFSNVLBBO TFM EBSBI NFSBI ZBOH CFSQBTBOHBO NFOFOUVLBO HPMPOHBO EBSBI 0"# (FO
PSBOH MBJO ZBOH HPMPOHBO EBSBIOZB CFSCFEB #JMB EJMBLVLBO HFOUFSTFCVUEBQBUNFOHBOEVOHTBMBITBUVEBSJLFUJHBBOUJHFO
UJOEBLBO QFODFHBIBO ZBOH UFQBU LJUB EBQBU NFOFOUVLBO OBNVOIBOZBTBUVUJQFTBKBZBOHUFSEBQBUEJTFUJBQLSPNPTPN
TFCFMVNOZB BQBLBI BOUJCPEJ EBO BOUJHFO ZBOH UFSEBQBU QBEB EBSJ EVB LSPNPTPN UJQF 0 UJQF " BUBV UJQF # (FO UJQF 0
EBSBI EPOPS EBO EBSBI SFTJQJFO BLBO NFOJNCVMLBO SFBLTJ UJEBL CFSGVOHTJ BUBV IBNQJS UJEBL CFSGVOHTJ TFIJOHHB HFO UJQF
USBOTGVTJBUBVUJEBL JOJNFOHIBTJMLBOBHMVUJOPHFOUJQF0ZBOHUJEBLCFSNBLOBQBEB
TFM 4FCBMJLOZB HFO UJQF " EBO # NFOHIBTJMLBO BHMVUJOPHFO
Keragaman Antigen dalam Sel Darah. 4FUJEBLOZB ZBOHLVBUQBEBTFM
EJKVNQBJ KFOJT BOUJHFO ZBOH CBOZBL UFSEBQBU EBO SBUVTBO
&OBN LFNVOHLJOBO LPNCJOBTJ EBSJ HFOHFO JOJ EBQBU
BOUJHFO MBJOOZB ZBOH MBOHLB ZBOH NBTJOHNBTJOH QBEB TVBUV
EJMJIBU QBEB 5BCFM ZBJUV 0" 0# "" ## EBO "#
TBBU EBQBU NFOJNCVMLBO SFBLTJ BOUJHFOBOUJCPEJ UFMBI
,PNCJOBTJ HFOHFO JOJ EJLFOBM TFCBHBJ HFOPUJQ EBO TFUJBQ
EJUFNVLBOQBEBQFSNVLBBONFNCSBOTFMEBSJTFMEBSBINBOVTJB
PSBOHNFNJMJLJTBMBITBUVEBSJLFFOBNHFOPUJQUFSTFCVU
4FCBHJBO CFTBS NFSVQBLBO BOUJHFO MFNBI EBO LBSFOB JUV
%BQBU EJMJIBU EBSJ UBCFM CBIXB PSBOH EFOHBO HFOPUJQ
UFSVUBNB QFOUJOH VOUVL NFNQFMBKBSJ HFO LFUVSVOBO VOUVL
UJEBL NFOHIBTJMLBO BHMVUJOPHFO EBO LBSFOB JUV HPMPOHBO
NFOFUBQLBOBTBMVTVMPSBOHUVBOZB
EBSBIOZB BEBMBI 0 0SBOH EFOHBO HFOPUJQ 0" BUBV ""
5FSEBQBU EVB HPMPOHBO BOUJHFO ZBOH KBVI MFCJI TFSJOH NFOHIBTJMLBO BHMVUJOPHFO UJQF " EBO LBSFOB JUV NFNQVOZBJ
NFOJNCVMLBOSFBLTJUSBOTGVTJEBSBIEBSJQBEBHPMPOHBOMBJOOZB HPMPOHBOEBSBI"(FOPUJQ0#EBO##NFOHIBTJMLBOHPMPOHBO
(PMPOHBOJOJEJOBNBLBOTJTUFNBOUJHFO0"#EBOTJTUFN3I EBSBI# EBOHFOPUJQ"#NFOHIBTJMLBOHPMPOHBOEBSBI"#
Golongan Darah O-A-B Frekuensi Retatif Berbagai Tipe Darah.1SFWBMFOTJ

CFSCBHBJHPMPOHBOEBSBIQBEBTFLFMPNQPLSFTQPOTEFOLJSBLJSB
TFCBHBJCFSJLVU
Antigen A dan B—Aglutinogen
%VBBOUJHFOUJQF"EBOUJQF#UFSEBQBUQBEBQFSNVLBBOTFMEBSBI O 47%
NFSBI QBEB TFKVNMBI CFTBS NBOVTJB "OUJHFOBOUJHFO JOJMBI A 41%
ZBOH EJTFCVU KVHB BHMVUJOPHFO LBSFOB TFSJOH LBMJ NFOZFCBCLBO B 9%
BHMVUJOBTJ TFM EBSBI
ZBOH NFOZFCBCLBO SFBLTJ USBOTGVTJ 0MFI AB 3%
LBSFOB BHMVUJOPHFO UFSTFCVU EJUVSVOLBO PSBOH EBQBU UJEBL
NFNQVOZBJ BOUJHFO UFSTFCVU EJ EBMBN TFMOZB BUBV IBOZB +FMBTEBSJQFSTFOUBTFJOJCBIXBHFOEBO"TFSJOHEJKVNQBJ
NFNQVOZBJTBUV BUBVLFEVBOZB TFEBOHLBOHFO#KBSBOH
445
Unit VI Sel-Sel Darah, lmunitas, dan Pembekuan Darah
Tabel 35-1 Golongan Darah dengan Genotip Serta Unsur

Pokok Aglutinogen dan Aglutininnya
/BNVO NFOHBQB BHMVUJOJO JOJ EJIBTJMLBO PMFI PSBOHPSBOH
ZBOHUJEBLNFNQVOZBJBHMVUJOPHFOZBOHCFSTBOHLVUBOEBMBNTFM
OO O − Anti-A dan EBSBI NFSBIOZB +BXBCBOOZB BEBMBI CBIXB TFKVNMBI LFDJM
Anti-B BOUJHFO HPMPOHBO " EBO # NFNBTVLJ UVCVI NFMBMVJ NBLBOBO
OA atau AA A A Anti-B CBLUFSJ BUBV EFOHBO DBSB MBJO EBO [BU[BU JOJ NFNQSBLBSTBJ
OB atau BB B B Anti-A
UJNCVMOZBBHMVUJOJOBOUJ"BUBVBOUJ#
.JTBMOZB JOGVT BOUJHFO HPMPOHBO " LF EBMBN SFTJQJFO ZBOH
AB AB A dan B − NFNJMJLJHPMPOHBOEBSBIOPO"BLBONFOZFCBCLBOSFTQPOT JNVO
Aglutinin ZBOHLIBTEFOHBOQFNCFOUVLBOBHMVUJOJOEBMBNKVNMBIZBOHMFCJI
#JMB UJEBL UFSEBQBU BHMVUJOPHFO UJQF " EBMBN TFM EBSBI NFSBI CFTBS EBSJQBEB TFCFMVNOZB #BZJ ZBOH CBSV MBIJS KVHB NFNQVOZBJ
TFTFPSBOH NBLB EBMBN QMBTNBOZB BLBO UFSCFOUVL BOUJCPEJ BHMVUJOJO EBMBN KVNMBI TFEJLJU ZBOH NFOVOKVLLBO CBIXB
ZBOH EJLFOBM TFCBHBJ BHMVUJOJO BOUJ" %FNJLJBO QVMB CJMB QFNCFOUVLBOBHMVUJOJOUFSKBEJIBNQJSTFMVSVIOZBTFUFMBIMBIJS
UJEBL UFSEBQBU BHMVUJOPHFO UJQF # EJ EBMBN TFM EBSBI NFSBI
NBLB EBMBN QMBTNBOZB UFSCFOUVL BOUJCPEJ ZBOH EJLFOBM
Proses Aglutinasi pada Reaksi Transfusi
TFCBHBJBHMVUJOJOBOUJ# #JMBEBSBIZBOHUJEBLDPDPLEJDBNQVSTFIJOHHBBHMVUJOJOQMBTNB
+BEJ EFOHBO NFSVKVL LFNCBMJ QBEB 5BCFM QFSIBUJLBO BOUJ" BUBV BOUJ# EJDBNQVS EFOHBO TFM EBSBI NFSBI ZBOH
CBIXB HPMPOHBO EBSBI NFTLJQVO UJEBL NFOHBOEVOH NFOHBOEVOH BHMVUJOPHFO " BUBV # TFM EBSBI NFSBI BLBO
BHMVUJOPHFO NFOHBOEVOH BHMVUJOJO BOUJ" EBO BOUJ# NFOHBMBNJ BHMVUJOBTJ LBSFOB BHMVUJOJO NFMFLBULBO EJSJ QBEB TFM
HPMPOHBO EBSBI " NFOHBOEVOH BHMVUJOPHFO UJQF " EBO EBSBI NFSBI 0MFI LBSFOB BHMVUJOJO NFNQVOZBJ EVB UFNQBU
BHMVUJOJO BOUJ# EBO HPMPOHBO EBSBI # NFOHBOEVOH QFOHJLBUBO UJQF*H(
BUBVUFNQBUQFOHJLBUBO UJQF*H.
NBLB
BHMVUJOPHFO UJQF # EBO BHMVUJOJO BOUJ" "LIJSOZB HPMPOHBO TBUVBHMVUJOJOEBQBUNFMFLBUQBEBEVBBUBVMFCJITFMEBSBINFSBI
EBSBI"#NFOHBOEVOHLFEVBBHMVUJOPHFO"EBO#UFUBQJUJEBL QBEB XBLUV ZBOH TBNB EFOHBO EFNJLJBO NFOZFCBCLBO TFM
NFOHBOEVOHBHMVUJOJOTBNBTFLBMJ UFSTFCVU NFMFLBU CFSTBNBBO EFOHBO BHMVUJOJO ,FBEBBO JOJ
NFOZFCBCLBO TFMTFM NFOHHVNQBM ZBOH NFSVQBLBO QSPTFT
Titer Aglutinin pada Berbagai Usia.4FHFSBTFTVEBIMBIJS BHMVUJOBTJh ,FNVEJBO HVNQBMBO JOJ NFOZVNCBU QFNCVMVI
KVNMBI BHMVUJOJO EJ EBMBN QMBTNB IBNQJS OPM %VB TBNQBJ EBSBI LFDJM EJ TFMVSVI TJTUFN TJSLVMBTJ 4FMBNB CFCFSBQB KBN
EFMBQBOCVMBOTFUFMBIMBIJS CBZJNVMBJNFOHIBTJMLBOBHMVUJOJO TBNQBJCFCFSBQBIBSJCFSJLVUOZB CBJLHBOHHVBOGJTJLTFMNBVQVO
BHMVUJOJOBOUJ"CJMBUJEBLUFSEBQBUBHMVUJOPHFOUJQF"EBMBNTFM TFSBOHBOPMFITFMEBSBIQVUJIGBHPTJUJLBLBONFOHIBODVSLBOTFM
EBO BHMVUJOJO BOUJ# CJMB UJEBL UFSEBQBU BHMVUJOPHFO UJQF # TFM ZBOH UFSBHMVUJOBTJ ZBOH BLBO NFMFQBTLBO IFNPHMPCJO LF
EBMBN TFM (BNCBS NFMVLJTLBO QFSVCBIBO UJUFS BHMVUJOJO EBMBN QMBTNB ZBJUV TVBUV LFBEBBO ZBOH EJTFCVU IFNPMJTJT TFM
BOUJ" EBO BOUJ# QBEB CFSCBHBJ VTJB 5JUFS UFSUJOHHJ CJBTBOZB EBSBINFSBI
EJDBQBJQBEBVNVSTBNQBJUBIVO EBOUJUFSJOJCFSBOHTVS
BOHTVSNFOVSVOQBEBVTJBLFIJEVQBOTFMBOKVUOZB Hemolisis Akut yang Terjadi pada Beberapa Reaksi
Transfusi. ,BEBOHLBEBOH KJLB EBSBI SFTJQJFO EBO EBSBI EPOPS
Asal Mula Aglutinin dalam Plasma. 4FQFSUJ LFCBOZBLBO UJEBLDPDPL TFHFSBUFSKBEJIFNPMJTJTTFMEBSBINFSBIEBMBNEBSBI
BOUJCPEJZBOHMBJO BHMVUJOJONFSVQBLBOHBNNBHMPCVMJO EBO TJSLVMBTJ %BMBN IBM JOJ BOUJCPEJ NFOZFCBCLBO MJTJT TFM EBSBI
EJIBTJMLBO PMFI TFMTFM ZBOH TBNB EJ TVNTVN UVMBOH EBO NFSBIEFOHBONFOHBLUJGLBOTJTUFNLPNQMFNFO ZBOHTFMBOKVUOZB
LFMFOKBS MJNGF ZBOH NFOHIBTJMLBO BOUJCPEJ UFSIBEBQ BOUJHFO NFMFQBTLBO FO[JNFO[JN QSPUFPMJUJL LPNQMFLT MJUJL
ZBOH BLBO
ZBOH MBJO ,FCBOZBLBO CFSVQB NPMFLVM JNVOPHMPCVMJO *H. NFSPCFL NFNCSBO TFM TFQFSUJ ZBOH EJKFMBTLBO EJ #BC
EBO*H( )FNPMJTJT JOUSBWBTLVMBS TFHFSB KBVI MFCJI KBSBOH UFSKBEJ EBSJQBEB
BHMVUJOJUBTJ ZBOH EJJLVUJ PMFI IFNPMJTJT MBNCBU LBSFOB VOUVL
UFSKBEJOZB QSPTFT MJTJT UFSTFCVU UJEBL IBOZB EJQFSMVLBO UJUFS
BOUJCPEJ ZBOH UJOHHJ UFUBQJ KVHB EJQFSMVLBO UJQF BOUJCPEJ ZBOH
CFSCFEB UFSVUBNBBOUJCPEJ*H.BOUJCPEJJOJEJTFCVUIFNPMJTJO
Penggolongan Darah
4FCFMVNNFMBLVLBOUSBOTGVTJ QFSMVVOUVLNFOFOUVLBOHPMPOHBO
EBSBI SFTJQJFO EBO HPMPOHBO EBSBI EPOPS TFIJOHHB LFEVB EBSBI
UFSTFCVU EBQBU EJDPDPLLBO EFOHBO CFOBS *OJ EJTFCVU
QFOHHPMPOHBO EBSBI EBO QFODPDPLBO EBSBI EBO EJMBLVLBO
EFOHBODBSBCFSJLVU.VMBNVMBTFMEBSBINFSBIEJQJTBILBOEBSJ
QMBTNB EBO EJFODFSLBO EFOHBO TBMJOF ,FNVEJBO TBUV CBHJBO
EJDBNQVS EFOHBO BHMVUJOJO BOUJ" TFEBOHLBO CBHJBO ZBOH MBJO
EJDBNQVSEFOHBOBHMVUJOJOBOUJ#4FUFMBICFCFSBQBNFOJU
446
Bab 35 Golongan Darah; Transfusi; Transplantasi Jaringan dan Organ
Tabel 35-2 Penggolongan Darah, yang Memperlihatkan Aglutinasi Sel ,JSBLJSBQFSTFOEBSJTFMVSVIPSBOHLVMJUQVUJIBEBMBI3I

dari Berbagai Golongan Darah dengan Aglutinin Anti-A atau Anti-B QPTJUJG EBO QFSTFOOZB 3I OFHBUJG 1BEB PSBOH LVMJU IJUBN
dalam Serum
"NFSJLB QFSTFOUBTF 3IQPTJUJGOZB LJSBLJSB QFSTFO
UNIT VI
TFEBOHLBOQBEBPSBOHLVMJUIJUBN"GSJLB IBNQJSQFSTFO
Pembentukan Aglutinin Anti-Rh. #JMB TFM EBSBI NFSBI

− −
ZBOHNFOHBOEVOHGBLUPS3IEJTVOUJLLBOLFUVCVIPSBOHZBOH
EBSBIOZBUJEBLNFNJMJLJGBLUPS3IZBJUVLFPSBOHEFOHBO3I
+ − OFHBUJG QFSMBIBOMBIBO BLBO UFSCFOUVL BHMVUJOJO BOUJ3I ZBOH
− + BLBO NFODBQBJ LPOTFOUSBTJ NBLTJNVN BHMVUJOJO LJSBLJSB
+ + TBNQBJCVMBOLFNVEJBO3FTQPOTJNVOJOJUFSKBEJMFCJIIFCBU
QBEBCFCFSBQBPSBOHUFSUFOUVEJCBOEJOHLBOPSBOHMBJO%FOHBO
DBNQVSBO UBEJ EJQFSJLTB EJ CBXBI NJLSPTLPQ #JMB TFM EBSBI QBKBOBO GBLUPS 3I CFSVMBOH LBMJ PSBOH EFOHBO 3IOFHBUJG
NFSBINFOHHVNQBMCFSBSUJ UFSBHMVUJOBTJLJUBUBIVCBIXBUFMBI BLIJSOZBNFOKBEJTBOHBUUFSTFOTJUJTBTJUFSIBEBQGBLUPS3I
UFSKBEJSFBLTJBOUJCPEJBOUJHFO Karakteristik Reaksi Transfusi Rh.#JMBTFTFPSBOHEFOHBO
5BCFM NFODBOUVNLBO BEBOZB
BUBV UJEBL UFSKBEJOZB 3IOFHBUJG TFCFMVNOZB UJEBL QFSOBI UFSQBKBO EFOHBO EBSBI
o
BHMVUJOBTJQBEBLFFNQBUHPMPOHBOTFMEBSBINFSBI4FMEBSBI 3IQPTJUJG USBOTGVTJ EBSBI 3IQPTJUJG LF UVCVI PSBOH UFSTFCVU
NFSBIHPMPOHBO0UJEBLNFNQVOZBJBHMVUJOPHFOTFIJOHHBUJEBL BHBLOZBUJEBLTFHFSBNFOZFCBCLBOSFBLTJ.FTLJQVOEFNJLJBO
CFSFBLTJEFOHBOBHMVUJOJOBOUJ"BUBVBOUJ#(PMPOHBOEBSBI" BOUJCPEJ BOUJ3I EBMBN KVNMBI ZBOH DVLVQ EBQBU UFSCFOUVL
NFNQVOZBJ BHMVUJOPHFO" TFIJOHHB BLBO CFSBHMVUJOBTJ EFOHBO TFMBNBTBNQBJNJOHHVCFSJLVUOZB ZBOHBLBONFOJNCVMLBO
BHMVUJOJO BOUJ" (PMPOHBO EBSBI # NFNQVOZBJ BHMVUJOPHFO # BHMVUJOBTJ KJLB TFMTFM EBSBI USBOTGVTJ NBTJI UFSEBQBU EJ EBMBN
EBO CFSBHMVUJOBTJ EFOHBO BHMVUJOJO BOUJ# (PMPOHBO EBSBI "# TJSLVMBTJ 4FM EBSBI USBOTGVTJ JOJ LFNVEJBO BLBO EJIFNPMJTJT
NFNQVOZBJ BHMVUJOPHFO " EBO # TFSUB CFSBHMVUJOBTJ EFOHBO PMFI TJTUFN NBLSPGBH KBSJOHBO +BEJ UJNCVM SFBLTJ USBOTGVTJ
LFEVBKFOJTBHMVUJOJO MBNCBU XBMBVQVO CJBTBOZB SJOHBO 1BEB USBOTGVTJ EBSBI 3I
QPTJUJGTFMBOKVUOZBLFPSBOHZBOHTBNBZBOHTVEBIUFSJNVOJTBTJ
UFSIBEBQGBLUPS3I NBLBSFBLTJUSBOTGVTJNFOKBEJTBOHBULVBU
EBO EBQBU TFHFSB UJNCVM TFSUB TFIFCBU SFBLTJ USBOTGVTJ BLJCBU
#FSTBNBEFOHBOTJTUFNHPMPOHBOEBSBI0"# HPMPOHBOEBSBI LFUJEBLDPDPLBOHPMPOHBOEBSBI"BUBV#
TJTUFN 3I KVHB QFOUJOH EBMBN NFOUSBOTGVTJ EBSBI 1FSCFEBBO
VUBNBBOUBSBTJTUFN0"#EBOTJTUFN3IBEBMBITFCBHBJCFSJLVU Eritroblastosis Fetalis ("Penyakit Hemolitik pada Bayi
1BEB TJTUFN 0"# BHMVUJOJO QMBTNB CFSUBOHHVOH KBXBC BUBT Baru Lahir")
UJNCVMOZBSFBLTJUSBOTGVTJZBOHUFSKBEJTFDBSBTQPOUBO TFEBOHLBO &SJUSPCMBTUPTJTGFUBMJTBEBMBIQFOZBLJUQBEBKBOJOEBOQBEBCBZJ
QBEB TJTUFN 3I SFBLTJ BHMVUJOJO TQPOUBO IBNQJS UJEBL QFSOBI CBSV MBIJS ZBOH EJUBOEBJ PMFI BHMVUJOBTJ EBO GBHPTJUPTJT TFM
UFSKBEJ4FCBHBJHBOUJOZB PSBOHNVMBNVMBIBSVTUFSQBKBOTFDBSB EBSBI NFSBI KBOJO 1BEB TFCBHJBO CFTBS FSJUSPCMBTUPTJT GFUBMJT
NBTJGEFOHBOBOUJHFO3I NJTBMOZBNFMBMVJUSBOTGVTJEBSBIZBOH JCVOZB BEBMBI 3IOFHBUJG EBO BZBIOZB 3IQPTJUJG #BZJ
NFOHBOEVOH BOUJHFO 3I TFCFMVN UFSEBQBU DVLVQ BHMVUJOJO NFNQVOZBJ BOUJHFO 3IQPTJUJG ZBOH EJUVSVOLBO EBSJ BZBIOZB
VOUVLNFOZFCBCLBOSFBLTJUSBOTGVTJZBOHCFSNBLOB EBO JCV NFNCFOUVL BHMVUJOJO BOUJ3I BLJCBU UFSQBKBO EFOHBO
BOUJHFO 3I KBOJO ,FNVEJBO BHMVUJOJO JCV CFSEJGVTJ LF EBMBN
Antigen Rh—Orang dengan "Rh Positif" dan "Rh Negatif". UVCVI KBOJO NFMBMVJ QMBTFOUB EBO NFOJNCVMLBO BHMVUJOBTJ TFM
5FSEBQBU FOBN UJQF BOUJHFO 3I ZBOH VNVN TFUJBQ UJQF EJTFCVU EBSBINFSBI
GBLUPS3I5JQFUJQFJOJEJUBOEBJEFOHBO$ % & D E EBOF0SBOH Insidens Penyakit. 4FPSBOH JCV 3IOFHBUJG ZBOH BOBL
ZBOH NFNJMJLJ BOUJHFO $ UJEBL NFNQVOZBJ BOUJHFO D UFUBQJ PSBOH QFSUBNBOZB 3IQPTJUJG CJBTBOZB CFMVN NFNCFOUVL BHMVUJOJO
ZBOHUJEBLNFNJMJLJBOUJHFO$TFMBMVNFNQVOZBJBOUJHFOD,FBEBBO BOUJ3I EBMBN KVNMBI ZBOH DVLVQ VOUVL NFOJNCVMLBO TVBUV
JOJ TBNB IBMOZB VOUVL BOUJHFO %E EBO &F 0MFI LBSFOB GBLUPS NBMBQFUBLB"LBOUFUBQJ LJSBLJSBQFSTFOEBSJCBZJ3IQPTJUJG
GBLUPS JOJ EJUVSVOLBO EFOHBO DBSB UFSTFCVU TFUJBQ PSBOH IBOZB ZBOHLFEVBNFOVOKVLLBOCFCFSBQBUBOEBFSJUSPCMBTUPTJTGFUBMJT
NFNQVOZBJTBUVEBSJLFUJHBQBTBOHBOUJHFOUFSTFCVU LJSBLJSB QFSTFO EBSJ CBZJ LFUJHB NFNQFSMJIBULBO QFOZBLJU
5JQF BOUJHFO % EJKVNQBJ TFDBSB MVBT EBMBN QPQVMBTJ EBO JOJ EBO JOTJEFOTOZB UFSVT NFOJOHLBU TFDBSB QSPHSFTJG QBEB
CFSTJGBUMFCJIBOUJHFOJLEBSJQBEBBOUJHFO3IMBJO4FTFPSBOHZBOH LFIBNJMBOCFSJLVUOZB
NFNQVOZBJ UJQF BOUJHFO JOJ EJLBUBLBO 3I QPTJUJG TFEBOHLBO Efek Antibodi Ibu terhadap Janin.4FTVEBIBOUJCPEJBOUJ
PSBOHZBOHUJEBLNFNQVOZBJUJQFBOUJHFO%EJLBUBLBO3IOFHBUJG 3I UFSCFOUVL QBEB JCV BOUJCPEJ JOJ CFSEJGVTJ EFOHBO MBNCBU
.FTLJQVOEFNJLJBO QFSMVEJQFSIBUJLBOCBIXBQBEBPSBOHPSBOH NFMBMVJ NFNCSBO QMBTFOUB LF EBMBN EBSBI KBOJO %J TJOJ
EFOHBO 3IOFHBUJG CFCFSBQB BOUJHFO 3I MBJOOZB CBILBO NBTJI BOUJCPEJ UFSTFCVU NFOZFCBCLBO BHMVUJOBTJ EBSBI KBOJO 4FM
EBQBU NFOJNCVMLBO SFBLTJ USBOTGVTJ XBMBVQVO SFBLTJ UFSTFCVU EBSBI NFSBI ZBOH UFSBHMVUJOBTJ BLBO NFOHBMBNJ IFNPMJTJT
CJBTBOZBKBVIMFCJISJOHBO TFTVEBIOZB EBONFMFQBTLBOIFNPHMPCJOLFEBMBNEBSBI
447
.BLSPGBH KBOJO LFNVEJBO NFOHVCBI IFNPHMPCJO NFOKBEJ Reaksi Transfusi Akibat Gotongan Darah yang Tidak Cocok
CJMJSVCJO ZBOH NFOZFCBCLBO LVMJU CBZJ NFOKBEJ LFLVOJOHBO +JLB EBSBI EPOPS EFOHBO HPMPOHBO EBSBI UFSUFOUV EJUSBOTGVTJLBO
JLUFSJL
"OUJCPEJ UBEJ EBQBU KVHB NFOZFSBOH EBO NFSVTBL LF EBMBN EBSBI SFTJQJFO EFOHBO HPMPOHBO EBSBI ZBOH MBJO SFBLTJ
TFMTFMUVCVIMBJOOZB USBOTGVTJ ZBOH DFOEFSVOH UFSKBEJ BEBMBI BHMVUJOBTJ QBEB TFM EBSBI
Gambaran Klinis Eritroblastosis. #BZJ CBSV MBIJS ZBOH NFSBI EBSBI EPOPS +BSBOH UFSKBEJ CBIXB EBSBI ZBOH EJUSBOTGVTJ
JLUFSJL BLJCBU FSJUSPCMBTUPTJT CJBTBOZB NFOEFSJUB BOFNJB QBEB BLBO NFOZFCBCLBO BHMVUJOBTJ QBEB TFMTFM EBSBI SFTJQJFO LBSFOB
XBLUV MBIJS EBO BHMVUJOJO BOUJ3I EBSJ JCV CJBTBOZB BMBTBO CFSJLVU #BHJBO QMBTNB EBSBI EPOPS EFOHBO TFHFSB BLBO
CFSTJSLVMBTJEBMBNEBSBICBZJTFMBNBTBNQBJCVMBOTFUFMBI EJFODFSLBO PMFI TFMVSVI QMBTNB EBSJ SFTJQJFO ZBOH EFOHBO
MBIJS EBONFSVTBLMFCJICBOZBLMBHJTFMEBSBINFSBI EFNJLJBO BLBO NFOVSVOLBO UJUFS BHMVUJOJO ZBOH EJJOGVTLBO
+BSJOHBOIFNBUPQPJFUJLCBZJNFODPCBVOUVLNFOHHBOUJTFM #JBTBOZB LBEBS BHMVUJOJO UFSTFCVU EJUVSVOLBO TBNQBJ NFODBQBJ
TFM EBSBI NFSBI ZBOH NFOHBMBNJ IFNPMJTJT )BUJ EBO MJNQB KVNMBI ZBOH TBOHBU SFOEBI VOUVL EBQBU NFOJNCVMLBO BHMVUJOBTJ
NFOKBEJTBOHBUNFNCFTBSEBONFNQSPEVLTJTFMEBSBINFSBI 4FCBMJLOZB TFKVNMBILFDJMEBSBIZBOHEJJOGVTUJEBLNFOHFODFSLBO
EFOHBO DBSB ZBOH TBNB TFQFSUJ OPSNBM ZBOH UFSKBEJ TFMBNB BHMVUJOJOEBMBNQMBTNBSFTJQJFO0MFILBSFOBJUV BHMVUJOJOSFTJQJFO
QFSUFOHBIBO NBTB LFIBNJMBO 0MFI LBSFOB DFQBUOZB QSPEVLTJ UFUBQ NBTJI CJTB NFOHBHMVUJOBTJLBO TFMTFM EPOPS ZBOH HPMPOHBO
TFM EBSBI NFSBI CBOZBL CFOUVL TFM EBSBI NFSBI ZBOH NVEB EBSBIOZBCFSMBJOBO
NFMJQVUJ CFOUVL CMBTUJL ZBOH CFSJOUJ CBOZBL EJMFQBTLBO EBSJ 4FQFSUJZBOHUFMBIEJKFMBTLBOTFCFMVNOZB TFNVBSFBLTJUSBOTGVTJ
TVNTVN UVMBOH CBZJ LF EBMBN TJTUFN TJSLVMBTJ EBO LBSFOB BLIJSOZB EBQBU NFOZFCBCLBO IFNPMJTJT TFHFSB BLJCBU IFNPMJTJO
BEBOZB TFM EBSBI NFSBI EBMBN CFOUVL CMBTUJL CFSJOUJ JOJ NBVQVO IFNPMJTJT BLJCBU GBHPTJUPTJT TFM ZBOH UFSBHMVUJOBTJ
QFOZBLJUUFSTFCVUEJOBNBLBOFSJUSPCMBTUPTJTGFUBMJT )FNPHMPCJO ZBOH EJMFQBTLBO EBSJ TFM EBSBI NFSBI LFNVEJBO
.FTLJQVO BOFNJB CFSBU BLJCBU FSJUSPCMBTUPTJT GFUBMJT BEBMBI EJVCBI PMFI TFMTFM GBHPTJU NFOKBEJ CJMJSVCJO EBO LFNVEJBO
QFOZFCBC LFNBUJBO ZBOH VNVN CFCFSBQB BOBL ZBOH NBNQV EJFLTLSFTJLBOLFEBMBNFNQFEVPMFIIBUJ TFQFSUJZBOHEJCBIBTEJ
CFSUBIBO IJEVQ EBSJ BOFNJB JOJ BLBO NFNQFSMJIBULBO #BC ,POTFOUSBTJ CJMJSVCJO EBMBN DBJSBO UVCVI TFSJOH LBMJ
HBOHHVBONFOUBMZBOHNFOBUBQBUBVLFSVTBLBOBSFBNPUPUJL NFOJOHLBU DVLVQ UJOHHJ TFIJOHHB NFOZFCBCLBO KBVOEJTJLUFSVT
PUBL BLJCBU QFOHFOEBQBO CJMJSVCJO EJ EBMBN TFMTFM OFVSPO ZBJUV KBSJOHBO JOUFSOBM EBO LVMJU TFTFPSBOH NFOKBEJ CFSXBSOB
TFIJOHHB NFOZFCBCLBO LFIBODVSBO TFKVNMBI CFTBS TFM LVOJOH BLJCBU QJHNFO FNQFEV 5FUBQJ CJMB GVOHTJ IBUJ OPSNBM
UFSTFCVU,FBEBBOJOJEJOBNBLBOLFSOJLUFSVT QJHNFOFNQFEVBLBOEJFLTLSFTJLBOLFEBMBNVTVTNFMBMVJLBOBMJT
Pengobatan Eritroblastosis pada Bayi Baru Lahir. CJMJBSJT IBUJ TFIJOHHB JLUFSVT CJBTBOZB UJEBL UJNCVM QBEB TFPSBOH
1FOHPCBUBOZBOHEJMBLVLBOVOUVLFSJUSPCMBTUPTJTGFUBMJTBEBMBI EFXBTB LFDVBMJ KJLB MFCJI EBSJ NM EBSBI EJIFNPMJTJT EBMBN
NFOHHBOUJ EBSBI CBZJ ZBOH CBSV MBIJS EFOHBO EBSBI 3I XBLUVLVSBOHEBSJTFIBSJ
OFHBUJG 4FLJUBS NM EBSBI 3IOFHBUJG EJNBTVLLBO EBMBN Penghentian Akut Fungsi Ginjal setelah Reaksi Transfusi.
XBLUV KBN BUBV MFCJI TFNFOUBSB EBSBI 3IQPTJUJG CBZJ 4BMBI TBUV FGFL SFBLTJ USBOTGVTJ ZBOH QBMJOH NFNBUJLBO BEBMBI
EJLFMVBSLBO $BSB JOJ EBQBU EJVMBOHJ CFCFSBQB LBMJ TFMBNB QFOHIFOUJBO GVOHTJ HJOKBM ZBOH EBQBU EJNVMBJ EBMBN XBLUV
NJOHHVNJOHHVQFSUBNBLFIJEVQBO UFSVUBNBVOUVLNFOKBHB CFCFSBQB NFOJU TBNQBJ CFCFSBQB KBN EBO UFSVT CFSMBOHTVOH
LBEBS CJMJSVCJO BHBS UFUBQ SFOEBI EBO EFOHBO EFNJLJBO TBNQBJPSBOHJUVNBUJLBSFOBHBHBMHJOKBM
NFODFHBI UFSKBEJOZB LFSOJLUFSVT 1BEB XBLUV TFM EBSBI 3I 1FOHIFOUJBO GVOHTJ HJOKBM TFQFSUJOZB EJTFCBCLBO PMFI UJHB IBM
OFHBUJG EBSJ USBOTGVTJ JOJ EJHBOUJ EFOHBO TFM 3IQPTJUJG NJMJL 1FSUBNB SFBLTJ BOUJHFOBOUJCPEJ QBEB SFBLTJ USBOTGVTJ BLBO
CBZJ ZBJUV TVBUV QSPTFT ZBOH NFNFSMVLBO XBLUV NJOHHV NFOHFMVBSLBO [BU UPLTJL ZBOH CFSBTBM EBSJ EBSBI ZBOH NFOHBMBNJ
BUBVMFCJI NBLBBHMVUJOJOBOUJ3IZBOHCFSBTBMEBSJJCVUFMBI IFNPMJTJT ZBOH LFNVEJBO NFOJNCVMLBO WBTPLPOTUSJLTJ LVBU QBEB
EJIBODVSLBO HJOKBM ,FEVB IJMBOHOZB TFMTFM EBSBI NFSBI EBSJ TJSLVMBTJ QBEB
Pencegahan Eritroblastosis Fetalis. "OUJHFO % QBEB SFTJQJFO EJTFSUBJ QSPEVLTJ [BU UPLTJL EBO TFM ZBOH NFOHBMBNJ
TJTUFNHPMPOHBOEBSBI3INFSVQBLBOTVNCFSNBTBMBIVUBNB IFNPMJTJTEBSJSFBLTJJNVO TFSJOHLBMJNFOZFCBCLBOTZPLTJSLVMBTJ
ZBOH NFOZFCBCLBO UJNCVMOZB SFBLTJ JNVO EBSBI JCV EFOHBO 5FLBOBO EBSBI BSUFSJ UVSVO TBOHBU SFOEBI EBO BMJSBO EBSBI HJOKBM
3IOFHBUJGUFSIBEBQEBSBIKBOJOEFOHBO3IQPTJUJG1BEBUBIVO TFSUB QFOHFMVBSBO VSJOF NFOVSVO ,FUJHB CJMB KVNMBI UPUBM
BO QFOVSVOBO JOTJEFOT FSJUSPCMBTUPTJT ZBOH ESBNBUJT IFNPHMPCJO CFCBT ZBOH EJMFQBTLBO LF EBMBN EBSBI TJSLVMBTJ MFCJI
EJDBQBJEFOHBOQFOHFNCBOHBOHMPCJOJNVOPHMPCVMJO3I TVBUV CFTBS EBSJ KVNMBI IFNPHMPCJO ZBOH CFSJLBUBO EFOHBO
BOUJCPEJ BOUJ% ZBOH EJNBTVLLBO LF EBMBN EBSBI JCV ZBOH IBQUPHMPCJO TVBUV QSPUFJO QMBTNB ZBOH NFOHJLBU TFKVNMBI LFDJM
IBNJM EBOEJNVMBJEBSJVTJBLFIBNJMBOTBNQBJNJOHHV IFNPHMPCJO
NBLB IFNPHMPCJO ZBOH CFSMFCJIBO UFSTFCVU BLBO
"OUJCPEJBOUJ%KVHBEJNBTVLLBOLFEBMBNEBSBIJCVEFOHBO NFOFSPCPT NFNCSBO HMPNFSVMVT NBTVL LF EBMBN UVCVMVT HJOKBM
3I OFHBUJG ZBOH NFMBIJSLBO CBZJ EFOHBO 3I QPTJUJG VOUVL #JMB KVNMBI IFNPHMPCJO ZBOH NBTVL LF UVCVMVT JOJ TFEJLJU
NFODFHBI TFOTJUJTBTJ JCV UFSIBEBQ BOUJHFO % )BM UFSTFCVU IFNPHMPCJO UFSTFCVU EBQBU EJSFBCTPSCTJ NFMBMVJ FQJUFM UVCVMVT
TBOHBU NFOHVSBOHJ SJTJLP UFSCFOUVLOZB TFKVNMBI CFTBS NBTVL LF EBMBN EBSBI EBO UJEBL BLBO NFOJNCVMLBO LFSVTBLBO
BOUJCPEJ%TFMBNBLFIBNJMBOCFSJLVUOZB UFUBQJ CJMB KVNMBIOZB CFTBS IBOZB TFEJLJU ZBOH EJSFBCTPSCTJ "LBO
.FLBOJTNF ZBOH EJHVOBLBO HMPCJO JNVOPHMPCVMJO 3I UFUBQJ BJS EJ EBMBN UVCVMVT UFSVTNFOFSVT EJSFBCTPSCTJ TFIJOHHB
VOUVL NFODFHBI TFOTJUJTBTJ UFSIBEBQ BOUJHFO % UJEBL LPOTFOUSBTJ IFNPHMPCJO EJ EBMBN UVCVMVT EBQBU NFOJOHLBU
TFQFOVIOZB EJQBIBNJ OBNVO TBMBI TBUV FGFL BOUJCPEJ BOUJ% TFEFNJLJBO UJOHHJ TFIJOHHB IFNPHMPCJO UFSTFCVU NFOHFOEBQ EBO
BEBMBINFOHIBNCBUQSPEVLTJBOUJCPEJZBOHUFSJOEVLTJBOUJHFO NFOZVNCBU CBOZBL UVCVMVT +BEJ WBTPLPOTUSJLTJ HJOKBM TZPL
EBSJ MJNGPTJU # QBEB JCV ZBOH IBNJM "OUJCPEJ BOUJ% ZBOH TJSLVMBTJ EBO QFOZVNCBUBO UVCVMVT HJOKBM CFSTBNBTBNB BLBO
EJNBTVLLBO KVHB NFOFNQFM EJ UFNQBU QFOHJLBUBO BOUJHFO % NFOZFCBCLBO QFOHIFOUJBO BLVU GVOHTJ HJOKBM +JLB QFOHIFOUJBO
QBEB TFM EBSBI NFSBI KBOJO EFOHBO 3I QPTJUJG ZBOH EBQBU GVOHTJ HJOKBM JOJ CFSTJGBU UPUBM EBO UJEBL NFNCBJL QBTJFO BLBO
NFOFNCVT QMBTFOUB EBO NFNBTVLJ TJSLVMBTJ JCV NBLB IBM NFOJOHHBMEBMBNXBLUVTBUVNJOHHVTBNQBJIBSJ TFQFSUJZBOH
UFSTFCVUBLBONFOHHBOHHVSFTQPOTJNVOUFSIBEBQBOUJHFO%
448
Bab 35 Golongan Darah;Transfusi;Transplantasi Jaringan dan Organ
EJKFMBTLBOEJ#BC LFDVBMJKJLBQBTJFOJOJEJPCBUJEFOHBOHJOKBM CBIXB BEB EVB PSBOH LFDVBMJ QBEB LBTVT LFNCBS JEFOUJL
CVBUBO VOUVLNFNJMJLJFOBNBOUJHFO)-"ZBOHTBNB1FNCFOUVLBO
JNVOJUBT ZBOH TJHOJGJLBO UFSIBEBQ TBMBI TBUV EBSJ BOUJHFO
Transplantasi Jaringan dan Organ BOUJHFOJOJEBQBUNFOZFCBCLBOQFOPMBLBOUFSIBEBQKBSJOHBO
USBOTQMBO
UNIT VI
,FCBOZBLBO BOUJHFO TFM EBSBI NFSBI ZBOH NFOZFCBCLBO SFBLTJ "OUJHFO)-"UFSEBQBUEJEBMBNTFMEBSBIQVUJIEBOEJTFM
USBOTGVTJKVHBUFSEBQBUTFDBSBMVBTEJEBMBNTFMTFMUVCVIZBOHMBJO KBSJOHBO 0MFI LBSFOB JUV QFOHHPMPOHBO KBSJOHBO VOUVL
EBOTFUJBQTFMKBSJOHBOUVCVINFNJMJLJLPNQMFNFOUBNCBIBOOZB BOUJHFOBOUJHFO JOJ EBQBU EJMBLVLBO QBEB NFNCSBO MJNGPTJU
NBTJOHNBTJOHUFSIBEBQBOUJHFO"LJCBUOZB TFUJBQTFMBTJOHZBOH ZBOH UFMBI EJQJTBILBO EBSJ EBSBI PSBOH UFSTFCVU -JNGPTJU
EJUSBOTQMBOUBTJLBO LF UVCVI SFTJQJFO EBQBU NFOJNCVMLBO SFBLTJ EJDBNQVS EFOHBO BOUJTFSVN EBO LPNQMFNFO ZBOH TFTVBJ
JNVO %FOHBO LBUB MBJO LFCBOZBLBO SFTJQJFO EBQBU NFMBXBO TFTVEBI JOLVCBTJ TFM EJVKJ VOUVL NFOHFUBIVJ BEBOZB
JOWBTJ TFMTFM KBSJOHBO BTJOH TFQFSUJ IBMOZB QFSMBXBOBO UFSIBEBQ LFSVTBLBO NFNCSBO CJBTBOZB EFOHBO NFNFSJLTB LFDFQBUBO
JOWBTJCBLUFSJBTJOHBUBVTFMEBSBIBTJOH BNCJMBOUSBOTNFNCSBOEBSJ[BUXBSOBLIVTVTPMFIMJNGPTJU
Autograf, Isograf, Alograf, dan Xenograf 5SBOTQMBOUBTJ #FCFSBQB BOUJHFO )-" CVLBO BOUJHFO ZBOH LVBU LBSFOB
KBSJOHBOBUBVTFMVSVIPSHBOEBSJTBUVCBHJBOUVCVILFCBHJBOMBJO QFODPDPLBO ZBOH UFQBU EBSJ CFCFSBQB BOUJHFO BOUBSB EPOPS
QBEB IFXBO ZBOH TBNB EJTFCVU BVUPHSBGJ EBSJ TFPSBOH LFNCBS EBO SFTJQJFO UJEBL TFMBMV QFOUJOH VOUVL NFNVOHLJOLBO
JEFOUJL LFQBEB TBVEBSB LFNCBSOZB EJTFCVU JTPHSBG EBSJ TFPSBOH USBOTQMBOUBTJ BMPHSBG 0MFI LBSFOB JUV EFOHBO NFOEBQBULBO
NBOVTJB LF NBOVTJB MBJOOZB BUBV EBSJ TFFLPS IFXBO LF IFXBO QBTBOHBO ZBOH QBMJOH DPDPL BOUBSB EPOPS EFOHBO SFTJQJFO
MBJOOZB EBSJ TQFTJFT ZBOH TBNB EJTFCVU BMPHSBG EBO EBSJ TFFLPS CBIBZB QSPTFEVS QFODBOHLPLBO NFOKBEJ KBVI MFCJI LFDJM
IFXBO ZBOH MFCJI SFOEBI UJOHLBUBOOZB LF NBOVTJB BUBV EBSJ 1FODBQBJBO UFSCBJL BEBMBI EFOHBO NFODPDPLLBO KFOJT
TFFLPSIFXBOTQFTJFTUFSUFOUVLFTQFTJFTMBJOOZB EJTFCVUYFOPHSBG KBSJOHBOBOUBSBBOHHPUBLFMVBSHBZBOHTBNBEBOBOUBSBPSBOH
Transplantasi Jaringan Sel 1BEB BVUPHSBG EBO JTPHSBG TFM UVBEFOHBOBOBLOZB,FDPDPLBOQBEBLFNCBSJEFOUJLBEBMBI
TFM USBOTQMBOUBTJ NFOHBOEVOH KFOJT BOUJHFO ZBOH IBNQJS TBNB ZBOH QBMJOH UFQBU TFIJOHHB USBOTQMBOUBTJ BOUBSB LFNCBS
EFOHBOKFOJTBOUJHFOEJKBSJOHBOSFTJQJFOEBOIBNQJSTFMBMVEBQBU JEFOUJL IBNQJS UJEBL QFSOBI NFOHBMBNJ QFOPMBLBO BLJCBU
IJEVQ UFSVT TFDBSB OPSNBM CJMB TVQMBJ EBSBI ZBOH BEFLVBU SFBLTJJNVO
UFSTFEJB Pencegahan Penolakan Transplan dengan Menekan
%JQJIBLMBJO QBEBYFOPHSBGSFBLTJJNVOIBNQJSTFMBMVUFSKBEJ Sistem Imun
EBO NFOZFCBCLBO LFNBUJBO TFM ZBOH EJUSBOTQMBOUBTJLBO EBMBN +JLB TJTUFN JNVO EJUFLBO EFOHBO TFNQVSOB QFOPMBLBO
XBLUVIBSJTBNQBJNJOHHVTFTVEBIUSBOTQMBOUBTJ LFDVBMJCJMB USBOTQMBOUJEBLBLBOUFSKBEJ#BILBO QBEBPSBOHZBOHTJTUFN
EJMBLVLBO CFCFSBQB UFSBQJ TQFTJGJL VOUVL NFOHIJOEBSJ SFBLTJ JNVOOZB TBOHBU SFOEBI USBOTQMBO EBQBU CFSIBTJM EFOHBO
JNVO CBJL UBOQB QFNCFSJBO UFSBQJ ZBOH TJHOJGJLBO VOUVL
#FCFSBQB KBSJOHBO TFMVMBS EBO PSHBO ZBOH CFSCFEB ZBOH UFMBI NFOHIJOEBSJ QFOPMBLBO "LBO UFUBQJ QBEB PSBOH OPSNBM
EJUSBOTQMBOUBTJ TFCBHBJ BMPHSBG CBJL VOUVL QFSDPCBBO NBVQVO CBILBOEFOHBOQFOHHPMPOHBOKBSJOHBOZBOHUFSCBJL BMPHSBG
VOUVL UVKVBO QFOHPCBUBO EBSJ TBUV PSBOH LF PSBOH MBJO BEBMBI KBSBOH EBQBU NFODFHBI QFOPMBLBO EBMBN XBLUV MFCJI EBSJ
LVMJU HJOKBM KBOUVOH IBUJ KBSJOHBOLFMFOKBS TVNTVNUVMBOH EBO CFCFSBQB IBSJ BUBV CFCFSBQB NJOHHV UBOQB QFOHHVOBBO
QBSV%FOHBOQFODPDPLBOKBSJOHBOZBOHCFOBSBOUBSTFTFPSBOH QFOHPCBUBO ZBOH TQFTJGJL VOUVL NFOFLBO TJTUFN JNVO
CBOZBLBMPHSBGHJOKBMZBOHTVLTFTQBMJOHUJEBLTFMBNBTBNQBJ 4FMBOKVUOZB LBSFOB TFM 5 UFSVUBNB NFSVQBLBO CBHJBO EBSJ
UBIVO EBO BMPHSBG IBUJ TFSUB USBOTQMBOUBTJ KBOUVOH TFMBNB TJTUFN JNVO ZBOH QFOUJOH VOUVL NFNCVOVI TFM USBOTQMBO
TBNQBJUBIVO NBLBQFOFLBOBOUFSIBEBQTFM5KBVIMFCJIQFOUJOHEBSJQBEB
QFOFLBOBOBOUJCPEJQMBTNB#FCFSBQBCBIBOUFSBQFVUJLZBOH
Usaha untuk Mengatasi Reaksi Imun pada Jaringan yang UFMBIEJQBLBJVOUVLUVKVBOJOJBOUBSBMBJOTFCBHBJCFSJLVU
Ditransplantasi 1. )PSNPO HMVLPLPSUJLPJE ZBOH EJJTPMBTJ EBSJ LFMFOKBS LPSUFLT
0MFI LBSFOB USBOTQMBOUBTJ KBSJOHBO EBO PSHBO UFSUFOUV TBOHBU
BESFOBM BUBV PCBUPCBUBO EFOHBO BLUJWJUBT NJSJQ
QFOUJOH EJMBLVLBO NBLB UFMBI EJMBLVLBO VTBIB ZBOH TVOHHVI
HMVLPLPSUJLPJE
ZBOH NFOFLBO QFSUVNCVIBO TFNVB KBSJOHBO
TVOHHVI VOUVL NFODFHBI SFBLTJ BOUJHFOBOUJCPEJ ZBOH
MJNGPJE EBO PMFI LBSFOB JUV NFOVOVOLBO QFNCFOUVLBO
CFSIVCVOHBOEFOHBOUSBOTQMBOUBTJ1SPTFEVSLIVTVTCFSJLVUUFMBI
BOUJCPEJEBOTFM5
CFSIBTJM EJMBLVLBO CBJL TFDBSB LMJOJT NBVQVO QBEB QFSDPCBBO 2. #FSCBHBJ PCBU ZBOH NFNQVOZBJ FGFL UPLTJL QBEB TJTUFN
EBMBNCFCFSBQBIBM MJNGPJE TFIJOHHB NFOHIBNCBU QFNCFOUVLBO BOUJCPEJ EBO
TFMTFM5 UFSVUBNBPCBUB[BUIJPQSJOF
Penggolongan Jaringan (Tissue Typing) Antigen
3. 4JLMPTQPSJO ZBOH NFNQVOZBJ FGFL JOIJCJUPS UFSIBEBQ
Kompleks Antigen Leukosit Manusia (HLA, Human
Leukocyte Antigen) QFNCFOUVLBO TFM 5 QFNCBOUV EBO LBSFOB JUV TBOHBU
"OUJHFO UFSQFOUJOH ZBOH NFOZFCBCLBO SFBLTJ QFOPMBLBO NBOKVS EBMBN NFNCMPLJS SFBLTJ QFOPMBLBO PMFI TFM5
UFSIBEBQUSBOTQMBOBEBMBITVBUVLPNQMFLTZBOHEJTFCVUBOUJHFO 4JLMPTQPSJO UFMBI UFSCVLUJ NFOKBEJ TBMBI TBUV PCBU ZBOH
)-" &OBN EBSJ BOUJHFO UFSTFCVU EJKVNQBJ EJ NFNCSBO TFM QBMJOH CFSOJMBJ LBSFOB PCBU JOJ UJEBL NFOFLBO CFCFSBQB
KBSJOHBO EJ TFUJBQ PSBOH OBNVO UFSEBQBU TFLJUBS BOUJHFO CBHJBOMBJOEBSJTJTUFNJNVO
)-" ZBOH CFSCFEB ZBOH EBQBU EJTFMFLTJ 0MFI LBSFOB JUV 1FNBLBJBOPCBUPCBUBOJOJTFSJOHLBMJNFOZFCBCLBOPSBOH
LFSBHBNBO BOUJHFO UFSTFCVU NFXBLJMJ MFCJI EBSJ TBUV USJMJVO
LPNCJOBTJLFNVOHLJOBO"LJCBUOZB IBNQJSUJEBLNVOHLJO NFOKBEJUJEBLUFSMJOEVOHEBSJQFOZBLJUJOGFLTJTFIJOHHB
449
JOGFLTJ CBLUFSJ EBO WJSVT LBEBOHLBEBOH NFOKBEJ NFSBKBMFMB Gonzalez-Rey E, Chorny A, Delgado M: Regulation of immune tolerance by
anti-inflammatory neuropeptides, Nat Rev Immunol 7:52, 2007.
4FMBJO JUV JOTJEFOT LBOLFS NFOKBEJ CFCFSBQB LBMJ MFCJI CFTBS
Horn KD: The classification, recognition and significance of polyagglutina-
QBEB PSBOH ZBOH TJTUFN JNVOJUBTOZB UFSTVQSFTJ CBSBOH LBMJ tion in transfusion medicine, Blood Rev 13:36, 1999.
LBSFOBTJTUFNJNVOJOJQFOUJOHVOUVLNFOHIBODVSLBOCBOZBL Hunt SA, Haddad F: The changing face of heart transplantation, J Am Coll
TFM LBOLFS EJOJ TFCFMVN TFM LBOLFS UFSTFCVU EBQBU NVMBJ Cardiol 52:587, 2008.
CFSQSPMJGFSBTJ Miller J, Mathew JM, Esquenazi V: Toward tolerance to human organ trans-
plants: a few additional corollaries and questions, Transplantation
5SBOTQMBOUBTJ KBSJOHBO IJEVQ QBEB NBOVTJB UFMBI 77:940, 2004.
NFNQFSMJIBULBO LFCFSIBTJMBO QFOUJOH UFSVUBNB LBSFOB Olsson ML, Clausen H: Modifying the red cell surface: towards an ABO-
QFSLFNCBOHBO PCBUPCBUBO QFOFLBO SFTQPOT TJTUFN JNVO universal blood supply, Br J Haematol 140:3, 2008.
%FOHBO BEBOZB QFSCBJLBO PCBU JNVOPTVQSFTJG NBLB Shimizu K, Mitchell RN: The role of chemokines in transplant graft arterial
USBOTQMBOUBTJ PSHBO ZBOH CFSIBTJM TFNBLJO CBOZBL 4BBU JOJ disease, Arterioscler Thromb Vasc Biol 28:1937, 2008.
Spahn DR, Pasch T: Physiological properties of blood substitutes, News
QFOEFLBUBO UFSIBEBQ UFSBQJ JNVOPTVQSFTJG BEBMBI Physiol Sci 16:38, 2001.
NFOHVQBZBLBO VOUVL NFOZFJNCBOHLBO QFOFSJNBBO UJOHLBU Stroncek DF, Rebulla P: Platelet transfusions, Lancet 370:427, 2007.
QFOPMBLBOZBOHNPEFSBUQBEBFGFLCVSVLPCBUJNVOPTVQSFTJG Sumpter TL, Wilkes DS: Role of autoimmunity in organ allograft rejec-
tion: a focus on immunity to type V collagen in the pathogene-
Daftar Pustaka sis of lung transplant rejection, Am J Physiol Lung Cell Mol Physiol
286:L1129, 2004.
Avent ND, Reid ME: The Rh blood group system: a review, Blood 95:375, Westhoff CM: The structure and function of the Rh antigen complex, Semin
2000. Hematol 44:42, 2007.
An X, Mohandas N: Disorders of red cell membrane, Br J Haematol 141:367, Yazer MH, Hosseini-Maaf B, Olsson ML: Blood grouping discrepancies
2008. between ABO genotype and phenotype caused by O alleles, Curr Opin
Bowman J: Thirty-five years of Rh prophylaxis, Transfusion 43:1661, 2003. Hematol 15:618, 2008.
Burton NM, Anstee DJ: Structure, function and significance of Rh proteins
in red cells, Curr Opin Hematol 15:625, 2008.
450
BAB 36
UNIT VI
)FNPTUBTJTEBO1FNCFLVBO%BSBI
Ciri-Ciri Fisik dan Kimiawi Platelet

Peristiwa Hemostasis
1MBUFMFU EJTFCVUKVHBUSPNCPTJU
CFSCFOUVLDBLSBNLFDJMEFOHBO
EJBNFUFSTBNQBJHN5SPNCPTJUEJCFOUVLEJTVNTVNUVMBOH
*TUJMBI IFNPTUBTJT CFSBSUJ EBO NFHBLBSJPTJU ZBJUV TFM ZBOH TBOHBU CFTBS EBMBN TVTVOBO
QFODFHBIBO IJMBOHOZB EBSBI #JMB IFNBUPQPJFUJL EBMBN TVNTVN NFHBLBSJPTJU QFDBI NFOKBEJ
QFNCVMVIEBSBINFOHBMBNJ USPNCPTJU LFDJM CBJL EJ TVNTVN UVMBOH BUBV TFHFSB TFUFMBI
DFEFSB BUBV SVQUVS IFNPTUBTJT UFSKBEJ NFMBMVJ CFCFSBQB DBSB
NFNBTVLJ EBSBI LIVTVTOZB LFUJLB NFNBTVLJ LBQJMFS
LPOTUSJLTJ QFNCVMVI EBSBI
QFNCFOUVLBO TVNCBU QMBUFMFU
,POTFOUSBTJOPSNBMUSPNCPTJUEBMBNEBSBIJBMBIBOUBSB
QFNCFOUVLBO CFLVBO EBSBI TFCBHBJ IBTJM QFNCFLVBO EBSBI EBO EBOQFSNJLSPMJUFS

BLIJSOZB UFSKBEJ QFSUVNCVIBO KBSJOHBO GJCSPTB LF EBMBN 5SPNCPTJU NFNQVOZBJ CBOZBL DJSJ LIBT GVOHTJPOBM TFM
CFLVBO EBSBI VOUVL NFOVUVQ MVCBOH QBEB QFNCVMVI TFDBSB MFOHLBQ XBMBVQVO UJEBL NFNQVOZBJ JOUJ EBO UJEBL EBQBU
QFSNBOFO CFSFQSPEVLTJ %J EBMBN TJUPQMBTNBOZB UFSEBQBU GBLUPSGBLUPS
BLUJG TFQFSUJ
NPMFLVM BLUJO EBO NJPTJO ZBOH NFSVQBLBO
Konstriksi Pembuluh Darah QSPUFJO LPOUSBLUJM TBNB TFQFSUJ ZBOH UFSEBQBU EBMBN TFMTFM
PUPU EBO KVHB QSPUFJO LPOUSBLUJM MBJOOZB ZBJUV USPNCPTUFOJO
4FHFSB TFUFMBI QFNCVMVI EBSBI UFSQPUPOH BUBV SVQUVS EJOEJOH ZBOHEBQBUNFOZFCBCLBOUSPNCPTJUCFSLPOUSBLTJ
TJTBTJTB
QFNCVMVIEBSBIZBOHSVTBLJUVNFOZFCBCLBOPUPUQPMPTEJOEJOH SFUJLVMVN FOEPQMBTNB EBO BQBSBUVT (PMHJ ZBOH NFOZJOUFTJT
QFNCVMVI CFSLPOUSBLTJ TFIJOHHB EFOHBO TFHFSB BMJSBO EBSBI CFSCBHBJ FO[JN EBO UFSVUBNB NFOZJNQBO TFKVNMBI CFTBS JPO
QFNCVMVIZBOHSVQUVSCFSLVSBOH,POUSBLTJUFSKBEJTFCBHBJBLJCBU LBMTJVN
NJUPLPOESJB EBO TJTUFN FO[JN ZBOH NBNQV
EBSJ
TQBTNF NJPHFOJL MPLBM
GBLUPS BVUBLPJE MPLBM ZBOH NFNCFOUVL BEFOPTJO USJGPTGBU "51
EBO BEFOPTJU EJGPTGBU
CFSBTBMEBSJKBSJOHBOZBOHUFSLFOBUSBVNBEBOQMBUFMFUEBSBI EBO "%1

TJTUFN FO[JN ZBOH NFOZJOUFTJT QSPTUBHMBOEJO

CFSCBHBJ SFGMFLT TBSBG 3FGMFLT TBSBG EJDFUVTLBO PMFI JNQVMT ZBJUV IPSNPO MPLBM ZBOH NFOZFCBCLBO CFSCBHBJ SFBLTJ
TBSBG OZFSJ BUBV PMFI JNQVMTJNQVMT TFOTPSJL MBJO EBSJ QFNCVMVI QFNCVMVI EBSBI EBO SFBLTJ KBSJOHBO MPLBM MBJOOZB
TVBUV
ZBOH SVTBL BUBV EBSJ KBSJOHBO ZBOH CFSEFLBUBO /BNVO UFSKBEJ QSPUFJO QFOUJOH ZBOH EJTFCVU GBLUPS TUBCJMJTBTJ GJCSJO ZBOH
WBTPLPOTUSJLTJZBOHMFCJILVBUMBHJLFNVOHLJOBOBLJCBULPOUSBLTJ BLBO LJUB CBIBT OBOUJ TFIVCVOHBO EFOHBO QFNCFLVBO EBSBI
NJPHFOJL TFUFNQBU QBEB QFNCVMVI EBSBI ,POUSBLTJ JOJ UFSKBEJ EBO
GBLUPS QFSUVNCVIBO HSPXUI GBDUPS
ZBOH
LBSFOB LFSVTBLBO QBEB EJOEJOH QFNCVMVI EBSBI 6OUVL NFOZFCBCLBO QFOHHBOEBBO EBO QFSUVNCVIBO TFM FOEPUFM
QFNCVMVIEBSBIZBOHMFCJILFDJM QMBUFMFUNFOHBLJCBULBOTFCBHJBO QFNCVMVI EBSBI TFM PUPU QPMPT QFNCVMVI EBSBI EBO
CFTBS WBTPLPOTUSJLTJ EFOHBO NFMFQBTLBO TFCVBI TVCTUBOTJ GJCSPCMBT TFIJOHHB NFOJNCVMLBO QFSUVNCVIBO TFMVMBS ZBOH
WBTPLPOTUSJLUPS USPNCPLTBO" BLIJSOZBNFNQFSCBJLJEJOEJOHQFNCVMVIZBOHSVTBL
4FNBLJO CFSBU LFSVTBLBO ZBOH UFSKBEJ TFNBLJO IFCBU .FNCSBO TFM USPNCPTJU KVHB QFOUJOH %J QFSNVLBBOOZB
TQBTNFOZB 4QBTNF QFNCVMVI MPLBM JOJ EBQBU CFSMBOHTVOH UFSEBQBU MBQJTBO HMJLPQSPUFJO ZBOH NFODFHBI QFMFLBUBO EFOHBO
CFCFSBQBNFOJUCBILBOCFCFSBQBKBN EBOTFMBNBJUVCFSMBOHTVOH FOEPUFM OPSNBM EBO KVTUSV NFOZFCBCLBO QFMFLBUBO EFOHBO
QSPTFTQFNCFOUVLBOTVNCBUQMBUFMFUEBOQFNCFLVBOEBSBI EBFSBI EJOEJOH QFNCVMVI ZBOH DFEFSB UFSVUBNB QBEB TFMTFM
FOEPUFMZBOHDFEFSB EBOCBILBONFMFLBUQBEBKBSJOHBOLPMBHFO
Pembentukan Sumbat Platelet ZBOH UFSCVLB EJ CBHJBO EBMBN QFNCVMVI 4FMBJO JUV NFNCSBO
#JMB MVLB QBEB QFNCVMVI EBSBI CFSVLVSBO TBOHBU LFDJMNFNBOH NFOHBOEVOH CBOZBL GPTGPMJQJE ZBOH NFOHBLUJGLBO CFSCBHBJ
TFUJBQIBSJUFSCFOUVLCBOZBLMVCBOHQFNCVMVIEBSBIZBOHTBOHBU UJOHLBU EBMBN QSPTFT QFNCFLVBO EBSBI ZBOH BLBO LJUB CBIBT
LFDJM EJ TFMVSVI UVCVI MVCBOH JUV CJBTBOZB EJUVUVQ PMFI TVNCBU OBOUJ
QMBUFMFU CVLBO PMFI CFLVBO EBSBI 6OUVL NFNBIBNJ LFKBEJBO +BEJ USPNCPTJUNFSVQBLBOTUSVLUVSZBOHBLUJG8BLUVQBSVI
JOJ QFOUJOH VOUVL NFOHVSBJLBO UFSMFCJI EBIVMV TJGBUTJGBU IJEVQOZB EBMBN EBSBI JBMBI TBNQBJ IBSJ KBEJ TFUFMBI
QMBUFMFUJUVTFOEJSJ CFCFSBQBNJOHHVQSPTFTGVOHTJPOBMOZBCFSBLIJS5SPNCPTJUJUV
451
Unit VI Sel-Sel darah, lmunitas, Pembekuan Darah
LFNVEJBO EJBNCJM EBSJ TJSLVMBTJ UFSVUBNB PMFI TJTUFN

NBLSPGBHKBSJOHBO-FCJIEBSJTFQBSVIUSPNCPTJUEJBNCJMPMFI
NBLSPGBHEBMBNMJNQB ZBJUVQBEBTBBUEBSBINFMFXBUJLJTJLJTJ
USBCFLVMBZBOHSBQBU
Mekanisme Sumbat Trombosit
5SPNPTJUNFMBLVLBOQFSCBJLBOUFSIBEBQQFNCVMVIZBOHSVTBL
EJEBTBSLBOQBEBCFCFSBQBGVOHTJQFOUJOHEBSJUSPNCPTJU1BEB
XBLUVUSPNCPTJUCFSTJOHHVOHBOEFOHBOQFSNVLBBOQFNCVMVI
ZBOH SVTBL UFSVUBNB EFOHBO TFSBCVU LPMBHFO EJ EJOEJOH
QFNCVMVI TJGBUTJGBU USPNCPTJU TFHFSB CFSVCBI TFDBSB ESBUJT
5SPNCPTJU NVMBJ NFNCFOHLBL CFOUVLOZB NFOKBEJ JSFHVMFS
EFOHBO UPOKPMBOUPOKPMBO ZBOH NFODVBU EBSJ QFSNVLBBOOZB
QSPUFJO LPOUSBLUJMOZB CFSLPOTUSBLTJ EFOHBO LVBU EBO
NFOZFCBCLBO QFMFQBTBO HSBOVMB ZBOH NFOHBOEVOH CFSCBHBJ
GBLUPS BLUJG USPNCPTJU JUV NFOKBEJ MFOHLFU TFIJOHHB NFMFLBU
QBEB LPMBHFO EBMBN KBSJOHBO EBO QBEB QSPUFJO ZBOH EJTFCVU
GBLUPS WPO XJMMFCSBOE ZBOH CPDPS EBSJ QMBTNB NFOVKV LF
KBSJOHBO ZBOH USBVNB USPNCPTJU NFOZFLSFTJ TFKVNMBI CFTBS
"%1 EBO FO[JNFO[JNOZB NFNCFOUVL USPNCPLTBO " "%1
EBO USPNCPLTBO LFNVEJBO NFOHBLUJGLBO USPNCPTJU ZBOH
CFSEFLBUBO EBO TJGBU MFOHLFU USPNCPTJU UBNCBIBO JOJ BLBO %BMBNXBLUVTBNQBJNFOJUTFUFMBIQFNCVMVISVQUVS CJMB
NFOZFCBCLBONFMFLBUQBEBUSPNCPTJUTFNVMBZBOHTVEBIBLUJG MVLBQBEBQFNCVMVIUJEBLUFSMBMVCFTBS TFMVSVICBHJBOQFNCVMVI
ZBOH UFSMVLB BUBV VKVOH QFNCVMVI ZBOH UFSCVLB BLBO EJJTJ PMFI
%FOHBO EFNJLJBO QBEB TFUJBQ MPLBTJ EJOEJOH QFNCVMVI CFLVBO EBSBI 4FUFMBI NFOJU TBNQBJ TBUV KBN CFLVBO BLBO
EBSBI ZBOH MVLB EJOEJOH QFNCVMVI ZBOH SVTBL NFOHBMBNJ SFUSBLTJ JOJ BLBO NFOVUVQ UFNQBU MVLB 5SPNCPTJU
NFOHBLJGLBO CFSUVSVUUVSVU USPNCPTJU ZBOH KVNMBIOZB KVHB NFNFHBOH QFSBO QFOUJOH EBMBN QFSJTUJXB SFUSBLTJ CFLVBO
UFSVT NFOJOHLBU ZBOH NFOZFCBCLBOOZB NFOBSJL MFCJI JOJ TFQFSUJZBOHEJKFMBTLBOLFNVEJBO
CBOZBL MBHJ USPNCPTJU UBNCBIBO TFIJOHHB NFNCFOUVL
TVNCBU USPNCPTJU 4VNCBU JOJ QBEB NVMBOZB MPOHHBS
OBNVOCJBTBOZBCFSIBTJMNFOHIBMBOHJIJMBOHOZBEBSBICJMB Faktor Pembekuan Sinonim
MVLB EJ QFNCVMVI VLVSBOOZB LFDJM 4FUFMBI JUV TFMBNB I
QSPTFTQFNCFLVBOEBSBITFMBOKVUOZB CFOBOHCFOBOHGJCSJO
II
UFSCFOUVL #FOBOH GJCSJO JOJ NFMFLBU FSBU QBEB USPNCPTJU
TFIJOHHBUFSCFOUVLMBITVNCBUZBOHLVBU
Pentingnya Mekanisme Trombosit untuk Penutupan IV
Luka Pembuluh Darah. .FLBOJTNF TVNCBU USPNCPTJU
TBOHBU QFOUJOH VOUVL NFOVUVQ SVQUVSSVQUVS LFDJM QBEB
QFNCVMVI EBSBI ZBOH TBOHBU LFDJM ZBOH UFSKBEJ SJCVBO LBMJ
TFUJBQIBSJ#FSCBHBJMVCBOHLFDJMQBEBTFMFOEPUFMJUVTFOEJSJ
TFSJOH LBMJ EJUVUVQJ PMFI USPNCPTJU ZBOH TFCFOBSOZB
CFSHBCVOH EFOHBO TFM FOEPUFM VOUVL NFNCFOUVL NFNCSBO
TFM FOEPUFM UBNCBIBO 0SBOH ZBOH NFNQVOZBM USPNCPTJU
EBSBITFEJLJUTFLBMJ TFUJBQIBSJNFOHBMBNJSJCVBOQFSEBSBIBO
LFDJM EJ CBXBI LVMJU EBO EJ TFMVSVI KBSJOHBO CBHJBO EBMBN
QBEBPSBOHOPSNBMIBMJOJUJEBLUFSKBEJ
Pembekuan Darah pada Pembuluh yang Ruptur
.FLBOJTNF LFUJHB VOUVL IFNPTUBTJT JBMBI QFNCFOUVLBO
CFLVBO EBSBI #FLVBO NVMBJ UFSCFOUVL EBMBN XBLUV XI
TBNQBJ EFUJL CJMB USBVNB QBEB EJOEJOH QFNCVMVI TBOHBU
IFCBU EBOEBMBNTBNQBJNFOJUCJMBUSBVNBOZBLFDJM;BU XII
[BU BLUJWBUPS EBSJ EJOEJOH QFNCVMVI EBSBI ZBOH SVTBL EBSJ
XIII
USPNCPTJU EBOEBSJQSPUFJOQSPUFJOEBSBIZBOHNFMFLBUQBEB
EJOEJOHQFNCVMVIEBSBIZBOHSVTBL BLBONFOHBXBMJQSPTFT
QFNCFLVBO EBSBI 1FSJTUJXBQFSJTUJXB GJTJL QSPTFT JOJ
EJQFSMJIBULBO QBEB (BNCBS EBO GBLUPSGBLUPS
QFNCFLVBO EBSBI ZBOH QBMJOH QFOUJOH EJDBOUVNLBO QBEB
5BCFM
452
Bab 36 Hemostasis dan Pembekuan Darah
Ca++
4FUFMBICFLVBOEBSBIUFSCFOUVL EVBQSPTFTCFSJLVUEBQBUUFSKBEJ

#FLVBO EBQBU EJJOWBTJ PMFI GJCSPCMBT ZBOH LFNVEJBO
NFNCFOUVL KBSJOHBO JLBU QBEB TFMVSVI CFLVBO UFSTFCVU BUBV
UNIT VI
EBQBU KVHB CFLVBO JUV EJIBODVSLBO #JBTBOZB CFLVBO ZBOH
UFSCFOUVL QBEB MVLB LFDJM EJ EJOEJOH QFNCVMVI EBSBI BLBO
EJJOWBTJ PMFI GJCSPCMBT ZBOH NVMBJ UFSKBEJ CFCFSBQB KBN TFUFMBI
CFLVBO JUV UFSCFOUVL EJQFSNVEBI QBMJOH UJEBL PMFI GBLUPS Ca++
QFSUVNCVIBO ZBOH EJTFLSFTJ PMFI USPNCPTJU
)BM JOJ CFSMBOKVU
TBNQBJ UFSKBEJ QFNCFOUVLBO CFLVBO ZBOH MFOHLBQ NFOKBEJ
KBSJOHBOGJCSPTBEBMBNXBLUVLJSBLJSBTBNQBJNJOHHV
4FCBMJLOZB CJMB TFKVNMBI CFTBS EBSBI NFSFNCFT LF KBSJOHBO
EBO UFSKBEJ CFLVBO KBSJOHBO ZBOH UJEBL EJCVUVILBO [BU LIVTVT
ZBOHUFSEBQBUEBMBNCFLVBOJUVTFOEJSJNFOKBEJUFSBLUJWBTJ;BUJOJ
CFSGVOHTJTFCBHBJFO[JNZBOHNFOHIBODVSLBOCFLVBOJUV TFQFSUJ
ZBOHBLBOEJVSBJLBOLFNVEJBOEJCBCJOJ
CFSJLVUOZB +BEJ GBLUPS ZBOH NFNCBUBTJ LFDFQBUBO QFNCFLVBO
EBSBI CJBTBOZB BEBMBI QFNCFOUVLBO BLUJWBUPS QSPUSPNCJO EBO
Teori Dasar. -FCJI EBSJ NBDBN [BU QFOUJOH ZBOH CVLBO SFBLTJSFBLTJ CFSJLVUOZB LBSFOB MBOHLBI BLIJS CJBTBOZB
NFOZFCBCLBO BUBV NFNFOHBSVIJ QFNCFLVBO EBSBI UFMBI UFSKBEJTBOHBUDFQBUVOUVLNFNCFOUVLCFLVBOJUVTFOEJSJ
EJUFNVLBO EBMBN EBSBI EBO KBSJOHBO CFCFSBQB EJ BOUBSBOZB 5SPNCPTJU KVHB CFSQFSBO QFOUJOH EBMBN NFOHVCBI
NFNQFSNVEBI UFSKBEJOZB QFNCFLVBO EJTFCVU QSPLPBHVMBO EBO QSPUSPNCJO NFOKBEJ USPNCJO LBSFOB CBOZBL QSPUSPNCJO
ZBOHMBJONFOHIBNCBUQFNCFLVBO EJTFCVUBOUJLPBHVMBO"QBLBI NVMBNVMB NFMFLBU QBEB SFTFQUPS QSPUSPNCJO QBEB USPNCPTJU
QFNCFLVBO BLBO UFSKBEJ BUBV UJEBL CFSHBOUVOH QBEB ZBOHUFMBICFSJLBUBOEFOHBOKBSJOHBOZBOHSVTBL
LFTFJNCBOHBO BOUBSB LFEVB HPMPOHBO [BU JOJ 1BEB BMJSBO EBSBI Protrombin dan Trombin. 1SPUSPNCJO BEBMBI TVBUV
EBMBN LFBEBBO OPSNBM BOUJLPBHVMBO MFCJI EPNJOBO TFIJOHHB QSPUFJO QMBTNB ZBJUV BMGBHMPCVMJO ZBOH NFNQVOZBJ CFSBU
EBSBIUJEBLNFNCFLVTBBUCFSTJSLVMBTJEJEBMBNQFNCVMVIEBSBI NPMFLVM 1SPUSPNCJO UFSEBQBU EBMBN QMBTNB OPSNBM
5FUBQJCJMBQFNCVMVIEBSBINFOHBMBNJSVQUVS QSPLPBHVMBOEBSJ EFOHBO LPOTFOUSBTJ LJSBLJSB NHE 1SPUSPNCJO
EBFSBI ZBOH SVTBL NFOKBEJ UFSBLUJWBTJ EBO NFMFCJIJ BLUJWJUBT NFSVQBLBO QSPUFJO UJEBL TUBCJM ZBOH EFOHBO NVEBI EBQBU
BOUJLPBHVMBO EBOCFLVBOQVOUFSCFOUVL QFDBI NFOKBEJ TFOZBXBTFOZBXB ZBOH MFCJI LFDJM TBUV EJ
Mekanisme Umum. 1FNCFLVBO UFSKBEJ NFMBMVJ UJHB UBIBQ BOUBSBOZB JBMBI USPNCJO ZBOH NFNQVOZBJ CFSBU NPMFLVM
VUBNB
4FCBHBJ SFTQPOT UFSIBEBQ SVQUVSOZB QFNCVMVI EBSBI IBNQJSUFQBUTFQBSVIEBSJCFSBUNPMFLVMQSPUSPNCJO
BUBV LFSVTBLBO EBSBI JUV TFOEJSJ SBOHLBJBO SFBLTJ LJNJBXJ ZBOH 1SPUSPNCJO EJCFOUVL UFSVTNFOFSVT PMFI IBUJ EBO TFDBSB
LPNQMFLT UFSKBEJ EBMBN EBSBI ZBOH NFMJCBULBO MFCJI EBSJ TFMVTJO UFSVTNFOFSVT EJQBLBJ EJ TFMVSVI UVCVI VOUVL QFNCFLVBO
GBLUPS QFNCFLVBO EBSBI )BTJM BLIJSOZB BEBMBI UFSCFOUVLOZB EBSBI#JMBIBUJHBHBMNFNCFOUVLQSPUSPNCJO LJSBLJSBEBMBN
TVBUV LPNQMFLT TVCTUBOTJ UFSBLUJWBTJ ZBOH TFDBSB LPMFLUJG EJTFCVU TBUVIBSJLBEBSQSPUSPNCJOEBMBNQMBTNBBLBOUFSMBMVSFOEBI
BLUJWBUPS QSPUSPNCJO
"LUJWBUPS QSPUSPNCJO NFOHBUBMJTJT VOUVLNFOEVLVOHUFSKBEJOZBQFNCFLVBOEBSBIZBOHOPSNBM
QFOHVCBIBO QSPUSPNCJO NFOKBEJ USPNCJO
5SPNCJO CFLFSKB 7JUBNJO , EJCVUVILBO PMFI IBUJ VOUVL BLUJWBTJ OPSNBM
TFCBHBJ FO[JN VOUVL NFOHVCBI GJCSJOPHFO NFOKBEJ CFOBOH GJCSJO QSPUSPNCJO TFQFSUJ CFCFSBQB GBLUPS QFNCFLVBO MBJOOZB 0MFI
ZBOH NFSBOHLBJ USPNCPTJU TFM EBSBI EBO QMBTNB VOUVL LBSFOB JUV LFLVSBOHBO WJUBNJO , BUBV BEBOZB QFOZBLJU IBUJ
NFNCFOUVLCFLVBO ZBOH NFODFHBI QFNCFOUVLBO QSPUSPNCJO OPSNBM EBQBU
.BSJMBI LJUB NVMBNVMB NFNCBIBT NFLBOJTNF UFSCFOUVLOZB NFOVSVOLBO LBEBS QSPUSPNCJO TFEFNJLJBO SFOEBI TFIJOHHB
CFLVBO EBSBI JUV TFOEJSJ NVMBJ EBSJ QFSVCBIBO QSPUSPNCJO UFSKBEJLFDFOEFSVOHBOQFSEBSBIBO
NFOKBEJ USPNCJO LFNVEJBO LJUB LFNCBMJ LF MBOHLBI QSPTFT BXBM
QFNCFLUJBO VOUVL NFNCBIBT NFOHFOBJ QFNCFOUVLBO BLUJWBUPS Perubahan Fibrinogen menjadi Fibrin Pembentukan
QSPUSPNCJO Bekuan
Fibrinogen. 'JCSJOPHFO BEBMBI QSPUFJO EFOHBO CFSBU
Perubahan Protrombin menjadi Trombin NPMFLVM ZBOH CFTBS #.
ZBOH UFSEBQBU EBMBN
1FSUBNB BLUJWBUPS QSPUSPNCJO UFSCFOUVL TFCBHBJ BLJCBU SVQUVSOZB QMBTNB EFOHBO LBEBS TBNQBJ NHE 'JCSJOPHFO
QFNCVMVIEBSBIBUBVTFCBHBJBLJCBULFSVTBLBOQBEB[BU[BULIVTVT EJCFOUVL EBMBN IBUJ EBO QFOZBLJU IBUJ EBQBU NFOVSVOLBO
EBMBNEBSBI,FEVB BLUJWBUPSQSPUSPNCJO EFOHBOBEBOZBJPO$B LBEBS GJCSJOPHFO ZBOH CFSTJSLVMBTJ KVHB LPOTFOUSBTJ
EBMBN KVNMBI ZBOH NFODVLVQJ BLBO NFOZFCBCLBO QFSVCBIBO QSPUSPNCJO ZBOHQFSOBIEJVSBJLBOTFCFMVNOZB
QSPUSPNCJO NFOKBEJ USPNCJO (BNCBS
,FUJHB USPNCJO 0MFILBSFOBVLVSBONPMFLVMOZBZBOHCFTBS EBMBNLFBEBBO
NFOZFCBCLBO QPMJNFSJTBTJ NPMFLVMNPMFLVM GJCSJOPHFO NFOKBEJ OPSNBMIBOZBTFEJLJUGJCSJOPHFOZBOHCPDPSEBSJQFNCVMVI
CFOBOHCFOBOHCFOBOHGJCSJOEBMBNXBLUVTBNQBJEFUJL EBSBILFEBMBNDBJSBOJOUFSTUJTJBMEBOLBSFOBGJCSJOPHFO
453
Unit VI Sel-Sel darah, imunitas, Pembekuan Darah
NFSVQBLBOTBUVGBLUPSZBOHQPLPLEBMBNQSPTFTQFNCFLVBO USPNCPTJUZBOHUFSQFSBOHLBQEBMBNCFLVBOUFSVTNFMFQBTLBO[BU
DBJSBOJOUFSTUJTJBMCJBTBOZBUJEBLEBQBUNFNCFLV/BNVOCJMB [BU QSPLPBHVMBO TBMBI TBUV ZBOH QBMJOH QFOUJOH JBMBI GBLUPS
QFSNFBCJMJUBT LBQJMFS NFOJOHLBU TFDBSB QBUPMPHJT GJCSJOPHFO TUBCJMJTBTJGJCSJO ZBOHNFOZFCBCLBOUFSKBEJOZBJLBUBOTJMBOHZBOH
BLBOCPDPSLFEBMBNDBJSBOKBSJOHBOEBMBNKVNMBIZBOHDVLVQ TFNBLJO CBOZBL BOUBSB CFOBOHCFOBOH GJCSJO ZBOH CFSEFLBUBO
VOUVL NFOJNCVMLBO QFNCFLVBO DBJSBO JOJ EFOHBO DBSB ZBOH 4FMBJO JUV USPNCPTJU TFOEJSJ NFNCFSJ EVLVOHBO MBOHTVOH VOUVL
IBNQJSTBNBTFQFSUJQMBTNBEBOEBSBIZBOHEBQBUNFNCFLV UFSKBEJOZB SFUSBLTJ CFLVBO EFOHBO DBSB NFOHBLUJGLBO NPMFLVM
BLUJO NJPTJO EBO USPNCPTUFOJO USPNCPTJU ZBOH TFNVBOZB
Kerja Trombin dalam Mengubah Fibrinogen menjadi
NFSVQBLBO QSPUFJO LPOUSBLUJM EBMBN USPNCPTJU EBO EBQBU
Fibrin. 5SPNCJO BEBMBI FO[JN QSPUFJO EFOHBO LFNBNQVBO NFOJNCVMLBO LPOUSBLTJ LVBU QBEB UPOKPMBOUPOKPMBO SVODJOH
QSPUFPMJUJLZBOHMFNBI*BCFLFSKBQBEBGJCSJOPHFOEFOHBODBSB USPNCPTJU ZBOH NFMFLBU QBEB GJCSJO 1FSJTUJXB JOJ KVHB BLBO
NFMFQBTLBO FNQBU QFQUJEB EFOHBO CFSBU NPMFLVM SFOEBI EBSJ NFODJVULBO KBSJOHBO GJCSJO NFOKBEJ NBTTB ZBOH MFCJI LFDJM
TFUJBQ NPMFLVM GJCSJOPHFO NFNCFOUVL TBUV NPMFLVM GJCSJO ,POUSBLTJEJBLUJGLBOEBOEJQFSDFQBUPMFIUSPNCJO EBOKVHBPMFI
NPOPNFS ZBOH NFNQVOZBJ LFNBNQVBO PUPNBUJT VOUVL JPO LBMTJVN ZBOH EJMFQBTLBO PMFI HVEBOH LBMTJVN EBMBN
CFSQPMJNFSJTBTJ EFOHBO NPMFLVM GJCSJO NPOPNFS ZBOH MBJO NJUPLPOESJB SFUJLVMVN FOEPQMBTNB EBO BQBSBUVT (PMHJ QBEB
VOUVL NFNCFOUVL CFOBOHCFOBOH GJCSJO %FOHBO DBSB USPNCPTJU
EFNJLJBO EBMBN CFCFSBQB EFUJL CBOZBL NPMFLVM NPOPNFS %FOHBO UFSKBEJOZB SFUSBLTJ CFLVBO VKVOHVKVOH QFNCVMVI
GJCSJO CFSQPMJNFSJTBTJ NFOKBEJ CFOBOHCFOBOH GJCSJO ZBOH EBSBI ZBOH SPCFL BLBO EJUBSJL TBMJOH NFOEFLBU TFIJOHHB NBTJI
QBOKBOH ZBOHNFSVQBLBOSFUJLVMVNCFLVBOEBSBI NFOVOKBOHQSPTFTIFNPTUBTJTTFMBOKVUOZB
1BEB UJOHLBU BXBM QPMJNFSJTBTJ NPMFLVM GJCSJO NPOPNFS
TBMJOH CFSJLBUBO NFMBMVJ JLBUBO IJESPHFO OPOLPWBMFO ZBOH Umpan Balik Positif pada Pembentukan Bekuan
MFNBI EBO CFOBOHCFOBOH ZBOH CBSV UFSCFOUVL JOJ UJEBL 4FHFSB TFUFMBI QSPTFT QFNCFLVBO EBSBI NVMBJ UFSCFOUVL TFDBSB
CFSJLBUBO TJMBOH ZBOH LVBU BOUBSB TBUV EFOHBO MBJOOZB PMFI OPSNBM BLBO TFHFSB NFMVBT LF EBSBI TFLFMJMJOHOZB EBMBN
LBSFOBJUV CFMVBOZBOHEJIBTJMLBOUJEBLMBILVBUEBONVEBIEJ CFCFSBQB NFOJU #FSBSUJ CFLVBO UFSTFCVU NFNVMBJ TVBUV VNQBO
DFSBJCFSBJLBO5FUBQJQSPTFTMBJOUFSKBEJEBMBNCFCFSBQBNFOJU CBMJL QPTJUJG VOUVL NFOEPSPOH QFNCFLVBO MFCJI MBOKVU 4BMBI
CFSJLVUOZB ZBOH BLBO TBOHBU NFNQFSLVBU KBMJOBO GJCSJO TBUV QFOZFCBC UFSQFOUJOH UFSKBEJOZB QSPTFT JOJ JBMBI LFOZBUBBO
UFSTFCVU 1SPTFT JOJ NFMJCBULBO TVBUV [BU ZBOH EJTFCVU GBLUPS CBIXB LFSKB QSPUFPMJUJL USPNCJO ZBOH NFNVOHLJOLBOOZB VOUVL
TUBCJMJTBTJGJCSJO ZBOHUFSEBQBUEBMBNKVNMBILFDJMEJHMPCVMJO CFLFSKBUFSIBEBQGBLUPSGBLUPSQFNCFLVBOMBJOTFMBJOGJCSJOPHFO
QMBTNB ZBOH OPSNBM UFUBQJ KVHB EJMFQBTLBO PMFI USPNCPTJU 4FCBHBJ DPOUPI USPNCJO NFNQVOZBJ FGFL QSPUFPMJUJL MBOHTVOH
ZBOH UFSQFSBOHLBQ EBMBN CFLVBO 4FCFMVN GBLUPS TUBCJMJTBTJ UFSIBEBQ QSPUSPNCJO TFOEJSJ DFOEFSVOH NFOHVCBI QSPUSPNCJO
GJCSJO JOJ EBQBU CFLFSKB UFSIBEBQ CFOBOHCFOBOH GJCSJO JB NFOKBEJUSPNCJOZBOHMFCJICBOZBLMBHJ EBOJOJCFLFSKBUFSIBEBQ
TFOEJSJ IBSVT EJBLUJGLBO UFSMFCJI EBIVMV 5SPNCJO ZBOH TBNB CFCFSBQB GBLUPS QFNCFLVBO EBSBI ZBOH CFSUBOHHVOH KBXBC
ZBOH NFOZFCBCLBO QFNCFOUVLBO GJCSJO KVHB NFOHBLUJGLBO UFSIBEBQ QFNCFOUVLBO BLUJWBUPS QSPUSPNCJO &GFL JOJ BLBO
GBLUPS TUBCJMJTBTJ GJCSJO ,FNVEJBO [BU ZBOH UFMBI BLUJG JOJ EJVSBJLBO EJ QBSBHSBG CFSJLVU ZBOH NFMJQVUJ QFSDFQBUBO LFSKB
'BLUPS'BLUPS 7*** *9 9 9* EBO 9** TFSUB BHSFHBTJ USPNCPTJU

CFLFSKB TFCBHBJ FO[JN VOUVL NFOJNCVMLBO JLBUBO LPWBMFO
4FUFMBI KVNMBI LSJUJT USPNCJO UFSCFOUVL VNQBO CBMJL QPTJUJG
BOUBSB NPMFLVM GJCSJO NPOPNFS ZBOH TFNBLJO CBOZBL EBO
UFSKBEJZBOHNFOZFCBCLBOUFSCFOUVLOZBMFCJICBOZBLMBHJCFLVBO
KVHB JLBUBO TJMBOH BOUBSB CFOBOHCFOBOH GJCSJO ZBOH
EBO USPNCJO EFOHBO EFNJLJBO CFLVBO BLBO CFSUBNCBI CFTBS
CFSEFLBUBO TFIJOHHB TBOHBU NFOBNCBI LFLVBUBO KBSJOHBO
TBNQBJLFCPDPSBOEBSBICFSIFOUJ
GJCSJOTFDBSBUJHBEJNFOTJ
Bekuan Darah.#FLVBOEBSBIUFSEJSJBUBTKBSJOHBOCFOBOH Awal Proses Pembekuan: Pembentukan Aktivator
GJCSJOZBOHCFSKBMBOLFTFHBMBBSBIEBONFOKFSBUTFMTFMEBSBI Protrombin
USPNCPTJU EBO QMBTNB #FOBOHCFOBOH GJCSJO KVHB NFMFLBU 4BNQBJEJTJOJLJUBUFMBINFNCBIBTNFOHFOBJQSPTFTQFNCFLVBO
QBEBQFSNVLBBOQFNCVMVIEBSBIZBOHSVTBLPMFILBSFOBJUV TFLBSBOH TBBUOZB VOUVL NFNCJDBSBLBO MFCJI NFOEBMBN
CFLVBOEBSBINFOFNQFMQBEBMVCBOHEJQFNCVMVIEBOEFOHBO NFOHFOBJ NFLBOJTNF LPNQMFLT ZBOH NFOHBXBMJ QFNCFLVBO
EFNJLJBONFODFHBILFCPDPSBOEBSBICFSJLVUOZB QBEB UFNQBU QFSUBNB .FLBOJTNF JOJ EJNVMBJ CJMB
UFSKBEJ
Retraksi Bekuan—Serum. %BMBN XBLUV CFCFSBQB NFOJU USBVNB QBEB EJOEJOH QFNCVMVI EBSBI EBO KBSJOHBO ZBOH
TFUFMBICFLVBOUFSCFOUVL CFLVBONVMBJNFODJVUEBOCJBTBOZB CFSEFLBUBO
USBVNB QBEB EBSBI
BUBV LPOUBLOZB EBSBI
NFNFSBT LFMVBS IBNQJS TFMVSVI DBJSBO EBSJ CFLVBO JUV EBMBN EFOHBO TFM FOEPUFM ZBOH SVTBL BUBV EFOHBO LPMBHFO EBO VOTVS
XBLUVTBNQBJNFOJU$BJSBOZBOHUFSQFSBTLFMVBSEJTFCVU KBSJOHBO MBJOOZB EJ MVBS QFNCVMVI EBSBI 1BEB TFUJBQ LFKBEJBO
TFSVN TFCBC TFMVSVI GJCSJOPHFO EBO TFCBHJBO CFTBS GBLUPS UFSTFCVU NFLBOJTNF JOJ BLBO NFOZFCBCLBO QFNCFOUVLBO
GBLUPS QFNCFLVBO MBJOOZB UFMBI EJLFMVBSLBO EBO EFOHBO BLUJWBUPS QSPUSPNCJO ZBOH TFMBOKVUOZB NFOHVCBI QSPUPNCJO
EFNJLJBO TFSVN CFSCFEB EFOHBO QMBTNB 4FSVN UJEBL EBQBU NFOKBEJUSPNCJOEBONFOJNCVMLBOTFMVSVIMBOHLBICFSJLVUOZB
"LUJWBUPS QSPUSPNCJO CJBTBOZB EBQBU EJCFOUVL NFMBMVJ EVB
NFNCFLV LBSFOB TFSVN UJEBL NFOHBOEVOH GBLUPSGBLUPS
DBSB XBMBVQVO QBEB LFOZBUBBOOZB LFEVB DBSB JOJ TBMJOH
QFNCFLVBO
CFSJOUFSBLTJ TFDBSB LPOTUBO TBUV TBNB MBJO
NFMBMVJ KBMVS
5SPNCPTJU EJQFSMVLBO VOUVL UFSKBEJOZB SFUSBLTJ CFLVBO
FLTUSJOTJL ZBOH EJNVMBJ EFOHBO UFSKBEJOZB USBVNB QBEB EJOEJOH
0MFI TFCBC JUV LFHBHBMBO QBEB QSPTFT SFUSBLTJ NFSVQBLBO
QFNCVMVIEBOKBSJOHBOTFLJUBSOZBEBO
NFMBMVJKBMVSJOUSJOTJL
UBOEB CBIXB KVNMBI USPNCPTJU ZBOH CFSFEBS EBMBN EBSBI
ZBOHCFSBXBMEJEBMBNEBSBITFOEJSJ
LVSBOH .JLSPHSBG FMFLUSPO USPNCPTJU EBMBN CFLVBO EBSBI
1BEB LFEVB KBMVS JUV FLTUSJOTJL NBVQVO JOUSJOTJL CFSCBHBJ
NFNQFSMJIBULBO CBIXB USPNCPTJUUSPNCPTJU UFSTFCVU
QSPUFJO QMBTNB ZBOH CFSCFEB ZBOH EJTFCVU GBLUPSGBLUPS
TFCFOBSOZB NFMFLBU QBEB CFOBOHCFOBOH GJCSJO EFOHBO DBSB
QFNCFLVBOEBSBINFNFHBOHQFSBOZBOHVUBNB4FCBHJBOCFTBS
NFOHJLBUCFOBOHCFOBOHJUVTFIJOHHBNFOKBEJTBUV4FMBJOJUV
454
QSPUFJOQSPUFJO JOJ BEBMBI CFOUVL JOBLUJG FO[JN QSPUFPMJUJL #JMB QSPUSPNCJO NFOKBEJ USPNCJO EBO CFSMBOHTVOHMBI QSPTFT
CFSVCBI NFOKBEJ BLUJG LFSKB FO[JNBUJLOZB BLBO NFOJNCVMLBO QFNCFLVBO TFQFSUJ ZBOH UFMBI EJKFMBTLBO EJ BUBT 1BEB UBIBQ
QSPTFT QFNCFLVBO CFSVQB SFBLTJSFBLTJ ZBOH CFSVOUVO EBO QFSNVMBBO 'BLUPS 7 ZBOH UFSEBQBU EBMBN LPNQMFLT BLUJWBUPS
CFSUJOHLBU QSPUSPNCJOCFSTJGBUJOBLUJG UFUBQJTFLBMJQSPTFTQFNCFLVBOJOJ
4FCBHJBO CFTBS GBLUPS QFNCFLVBO EJUBOEBJ EFOHBO BOHLB EJNVMBJEBOUSPNCJONVMBJUFSCFOUVL LFSKBQSPUFPMJUJLUSPNCJO
UNIT VI
3PNBXJ TFQFSUJ EJDBOUVNLBO QBEB 5BCFM 6OUVL BLBO NFOHBLUJGLBO 'BLUPS 7 'BLUPS JOJ LFNVEJBO BLBO
NFOZBUBLBO CFOUVL GBLUPS ZBOH UFMBI UFSBLUJWBTJ IVSVG B NFOKBEJ BLTFMFSBUPS UBNCBIBO ZBOH LVBU EBMBN QFOHBLUJGBO
EJUBNCBILBO TFUFMBI BOHLB 3PNBXJ DPOUPIOZB 'BLUPS 7***B QSPUSPNCJO+BEJ EBMBNLPNQMFLTBLUJWBUPSQSPUSPNCJOBLIJS
NFOVOKVLLBO'BLUPS7***EBMBNLFBEBBOUFSBLUJWBTJ 'BLUPS 9 ZBOH UFSBLUJWBTJMBI ZBOH NFSVQBLBO QSPUFBTF
TFTVOHHVIOZB ZBOH NFOZFCBCLBO QFNFDBIBO QSPUSPNCJO
Jalur Ekstrinsik sebagai Awal Pembekuan VOUVL NFNCFOUVL USPNCJO 'BLUPS 7 ZBOH UFSBLUJWBTJ TBOHBU
.FLBOJTNF FLTUSJOTJL TFCBHBJ BXBM QFNCFOUVLBO BLUJWBUPS NFNQFSDFQBULFSKBQSPUFBTFJOJ TFEBOHLBOGPTGPMJQJEUSPNCPTJU
QSPUSPNCJO EJNVMBJ EFOHBO EJOEJOH QFNCVMVI EBSBI BUBV CFLFSKB TFCBHBJ BMBU QFOHBOHLVU ZBOH NFNQFSDFQBU QSPTFT
KBSJOHBO FLTUSBWBTLVMBS ZBOH SVTBL ZBOH LPOUBL EFOHBO EBSBI UFSTFCVU1FSIBUJLBOUFSVUBNBVNQBOCBMJLQPTJUJGUSPNCJO ZBOH
,FKBEJBO JOJ NFOJNCVMLBO MBOHLBIMBOHLBI CFSJLVUOZB TFQFSUJ CFLFSKB NFMBMVJ 'BLUPS 7 VOUVL NFNQFSDFQBU QSPTFT
ZBOHUFSMJIBUQBEB(BNCBS TFMVSVIOZB
1. 1FMFQBTBO GBLUPS KBSJOHBO +BSJOHBO ZBOH DFEFSB NFMFQBTLBO
Jalur Intrinsik untuk Memulai Pembekuan
CFCFSBQBGBLUPSZBOHEJTFCVUGBLUPSKBSJOHBOBUBVUSPNCPQMBTUJO .FLBOJTNF LFEVB VOUVL NFNVMBJ QFNCFOUVLBO BLUJWBUPS
KBSJOHBO 'BLUPS JOJ UFSVUBNB UFSEJSJ BUBT GPTGPMJQJE EBSJ QSPUSPNCJO EBOEFOHBOEFNJLJBOKVHBVOUVLNFNVMBJQSPTFT
NFNCSBO KBSJOHBO EJUBNCBI LPNQMFLT MJQPQSPUFJO ZBOH QFNCFLVBO EJNVMBJEFOHBOUFSKBEJOZBUSBVNBUFSIBEBQEBSBI
UFSVUBNBCFSGVOHTJTFCBHBJFO[JNQSPUFPMJUJL BUBVEBSBICFSLPOUBLEFOHBOLPMBHFOQBEBEJOEJOHQFNCVMVI
2. "LUJWBTJ 'BLUPS 9QFSBOBO 'BLUPS 7** EBO GBLUPS KBSJOHBO EBSBI ZBOH SVTBL ,FNVEJBO QSPTFT CFSMBOHTVOH NFMBMVJ
,PNQMFLT MJQPQSPUFJO EBO GBLUPS KBSJOHBO TFMBOKVUOZB TFSBOHLBJBOSFBLTJLBTLBEF TFQFSUJQBEB(BNCBS
CFSHBCVOHEFOHBO'BLUPS7**EBO CFSTBNBBOEFOHBOIBEJSOZB 1. %BSBI ZBOH UFSLFOB USBVNB NFOZFCBCLBO
QFOHBLUJGBO
JPOLBMTJVN GBLUPSJOJCFLFSKBTFCBHBJFO[JNUFSIBEBQ'BLUPS9 'BLUPS 9** EBO
QFMFQBTBO GPTGPMJQJE USPNCPTJU 5SBVNB
VOUVLNFNCFOUVL'BLUPS9ZBOHUFSBLUJWBTJ 9B
UFSIBEBQ EBSBI BUBV CFSLPOUBLOZB EBSBI EFOHBO LPMBHFO
3. &GFL9BEBMBNNFNCFOUVLBLUJWBUPSQSPUSPNCJOQFSBOBO'BLUPS EJOEJOH QFNCVMVI EBSBI BLBO NFOHVCBI EVB GBLUPS
7'BLUPS9ZBOHUFSBLUJWBTJTFHFSBCFSJLBUBOEFOHBOGPTGPMJQJE QFNCFLVBOQFOUJOHEBMBNEBSBI'BLUPS9**EBOUSPNCPTJU
KBSJOHBO ZBOH NFSVQBLBO CBHJBO EBSJ GBLUPS KBSJOHBO BUBV #JMB 'BLUPS 9** UFSHBOHHV NJTBMOZB LBSFOB CFSLPOUBL
EFOHBO GPTGPMJQJE UBNCBIBO ZBOH EJMFQBTLBO EBSJ USPNCPTJU EFOHBOLPMBHFOBUBVEFOHBOQFSNVLBBOZBOHCBTBITFQFSUJ
KVHB EFOHBO 'BLUPS 7 VOUVL NFNCFOUVL TVBUV TFOZBXB ZBOH HFMBT JB BLBO CFSVCBI NFOKBEJ CFOUVL NPMFLVM CBSV ZBJUV
EJTFCVU BLUJWBUPS QSPUSPNCJO %BMBN CFCFSBQB EFUJL EFOHBO TFCBHBJ FO[JN QSPUFPMJUJL ZBOH EJTFCVU 'BLUPS 9** ZBOH
BEBOZBJPOLBMTJVN TFOZBXBJUVNFNFDBI UFSBLUJWBTJh 1BEB TBBU ZBOH CFSTBNBBO USBVNB UFSIBEBQ
EBSBI KVHB BLBO NFSVTBL USPNCPTJU BLJCBU CFSTFOUVIBO
EFOHBO LPMBHFO BUBV EFOHBO QFSNVLBBO CBTBI BUBV SVTBL
LBSFOB DBSB MBJO
EBO JOJ BLBO NFOZFCBCLBO QFMFQBTBO
CFSCBHBJ GPTGPMJQJE USPNCPTJU ZBOH NFOHBOEVOH
MJQPQSPUFJO ZBOH EJTFCVU GBLUPS USPNCPTJU ZBOH KVHB
NFNFHBOHQFSBOEBMBNQSPTFTQFNCFLVBOTFMBOKVUOZB
2. 1FOHBLUJGBO 'BLUPS 9M 'BLUPS 9** ZBOH UFSBLUJWBTJ CFLFSKB
TFDBSB FO[JNBUJL UFSIBEBQ 'BLUPS 9* EBO KVHB
NFOHBLUJGLBOOZB*OJNFSVQBLBOMBOHLBILFEVBEBMBNKBMVS
JOUSJOTJL 3FBLTJ JOJ KVHB NFNFSMVLBO LJOJOPHFO #.8
IJHINPMFDVMBSXFJHIU
EBOEJQFSDFQBUPMFIQSFLBMJLSFJO
3. 1FOHBLUJGBO'BLUPS*9PMFI'BLUPS9*ZBOHUFSBLUJWBTJ'BLUPS
9*ZBOHUFSBLUJWBTJCFLFSKBTFDBSBFO[JNBUJLUFSIBEBQ'BLUPS
*9EBONFOHBLUJGLBOOZB
4. 1FOHBLUJGBO'BLUPS9QFSBOBO'BLUPS7***'BLUPS*9ZBOH
UFSBLUJWBTJ ZBOH CFLFSKB TBNB EFOHBO 'BLUPS 7***
UFSBLUJWBTJ EBO EFOHBO GPTGPMJQJE USPNCPTJU EBO GBLUPS
EBSJUSPNCPTJUZBOHDFEFSB NFOHBLUJGLBO'BLUPS9+FMBTMBI
CBIXB CJMB 'BLUPS 7*** BUBV USPNCPTJU LVSBOH
QFSTFEJBBOOZB MBOHLBI JOJ BLBO UFSIBNCBU 'BLUPS 7***
BEBMBI GBLUPS ZBOH UJEBL EJNJMJLJ PMFI QBTJFO IFNPGJMJB
LMBTJL EBO LBSFOB BMBTBO JUV EJTFCVU GBLUPS BOUJIFNPGJMJB
5SPNCPTJU BEBMBI GBLUPS QFNCFLVBO ZBOH UJEBL EJEBQBUJ
QBEBQFOZBLJUQFSEBSBIBOZBOHEJTFCVUUSPNCPTJUPQFOJB
455
XII
XI
Ca++
IX
VIII
VIIIa Ca++
Ca++
Ca++
5. ,FSKB 'BLUPS 9 UFSBLUJWBTJ EBMBN QFNCFOUVLBO BLUJWBUPS Interaksi Antara Jalur Ekstrinsik dan Intrinsik-Ringkasan
QSPUSPNCJOQFSBO'BLUPS7-BOHLBIEBMBNKBMVSJOUSJOTJLJOJ Mulainya Pembekuan Darah
QBEB QSJOTJQOZB TBNB EFOHBO MBOHLBI UFSBLIJS EBMBN KBMVS 5FMBIKFMBTEBSJTLFNBTJTUFNJOUSJOTJLEBOFLTUSJOTJLCBIXBTFUFMBI
FLTUSJOTJL "SUJOZB GBLUPS 9 ZBOH UFSBLUJWBTJ CFSHBCVOH QFNCVMVIEBSBIQFDBI QFNCFLVBOUFSKBEJPMFILFEVBKBMVSUFSTFCVU
EFOHBO 'BLUPS 7 EBO USPNCPTJU BUBV GPTGPMJQJE KBSJOHBO TFDBSB CFSTBNBBO 'BLUPS KBSJOHBO NFNVMBJ KBMVS FLTUSJOTJL
VOUVL NFNCFOUVL TVBUV LPNQMFLT ZBOH EJTFCVU BLUJWBUPS TFEBOHLBO CFSLPOUBLOZB 'BLUPS 9** EBO USPNCPTJU EFOHBO LPMBHFO
QSPUSPNCJO "LUJWBUPS QSPUSPNCJO EBMBN CFCFSBQB EFUJL EJEJOEJOHQFNCVMVINFNVMBJKBMVSJOUSJOTJL
NFNVMBJ QFNFDBIBO QSPUSPNCJO NFOKBEJ USPNCJO EBO 4VBUV QFSCFEBBO ZBOH TBOHBU QFOUJOH BOUBSB KBMVS FLTUSJOTJL
EFOHBO EFNJLJBO QSPTFT QFNCFLVBO TFMBOKVUOZB EBQBU EBO JOUSJOTJL JBMBI CBIXB KBMVS FLTUSJOTJL EBQBU FLTQMPTJG TFLBMJ
CFSMBOHTVOHTFQFSUJZBOHUFMBIEJVSBJLBOUFSEBIVMV EJNVMBJ LFDFQBUBONFOZFMFTBJLBOBLIJSQSPTFTOZBIBOZBEJCBUBTJ
PMFI KVNMBI GBLUPS KBSJOHBO ZBOH EJMFQBTLBO PMFI KBSJOHBO ZBOH
Peran lon Kalsium dalam Jalur Intrinsik dan Ekstrinsik DFEFSB EBOPMFIKVNMBI'BLUPS9 7** EBO7ZBOHUFSEBQBUEBMBN
%J MVBS EVB MBOHLBI QFSUBNB EBMBN KBMVS JOUSJOTJL JPO EBSBI1BEBDFEFSBKBSJOHBOZBOHIFCBU QFNCFLVBOEBQBUUFSKBEJ
LBMTJVN EJQFSMVLBO VOUVL NFNQFSNVEBI BUBV EBMBN EFUJL +BMVS JOUSJOTJL QSPTFTOZB KBVI MFCJI MBNCBU
NFNQFSDFQBU TFNVB SFBLTJ QFNCFLVBOEBSBI 0MFI LBSFOB
CJBTBOZB NFNFSMVLBO XBLUV TBNQBJ NFOJU VOUVL
JUV UBOQB JPO LBMTJVN QFNCFLVBO EBSBI NFMBMVJ UJBQ KBMVS
NFOHIBTJMLBOQFNCFLVBO
QFNCFLVBOUJEBLUFSKBEJ
,BEBS JPO LBMTJVN EBMBN UVCVI KBSBOH TFLBMJ UVSVO Pencegahan Pembekuan Darah dalam Sistem
TFEFNJLJBO SFOEBI TFIJOHHB OZBUB NFNFOHBSVIJ LJOFUJL Pembuluh Darah Normal—Antikoagulan Intravaskular
QFNCFLVBO EBSBI 5FUBQJ CJMB EBSBI EJLFMVBSLBO EBSJ UVCVI Faktor-Faktor di Permukaan Endotel. ,FNVOHLJOBO GBLUPS
NBOVTJB QFNCFLVBO EBQBU EJDFHBI EFOHBO NFOVSVOLBO QBMJOH QFOUJOH ZBOH EBQBU NFODFHBI QFNCFLVBO EBMBN TJTUFN
LBEBS JPO LBMTJVN TBNQBJ EJ CBXBI BNCBOH QFNCFLVBO QFNCVMVI EBSBI OPSNBM JBMBI
MJDJOOZB QFSNVLBBO TFM FOEPUFM
EFOHBO DBSB EFJPOJTBTJ LBMTJVN ZBJUV NFOZFCBCLBOOZB TFIJOHHBUJEBLUFSKBEJBLUJWBTJLPOUBLTJTUFNQFNCFLVBOJOUSJOTJL
CFSFBLTJ EFOHBO [BU[BU MBJO TFQFSUJ JPO TJUSBU BUBV EFOHBO
MBQJTBO HMJLPLBMJLT QBEB FOEPUFM HMJLPLBMJLT BEBMBI TVBUV
NFOHFOEBQLBOLBMTJVNEFOHBOJPOPLTBMBU NVLPQPMJTBLBSJEBZBOHEJBCTPSCTJLFQFSNVLBBOCBHJBOEBMBNTFM
456
FOEPUFM
ZBOHNFNQVOZBJTJGBUNFOPMBLGBLUPSGBLUPSQFNCFLVBO TJTUFNTJSLVMBTJ4FMCBTPGJMEBSBIZBOHGVOHTJOZBIBNQJSTBNB
EBO USPNCPTJU EBO EFOHBO EFNJLJBO NFODFHBI BLUJWBTJ EFOHBO TFM NBTU KVHB NFMFQBTLBO IFQBSJO EBMBN KVNMBI LFDJM
QFNCFLVBO EBO
JLBUBO QSPUFJO EFOHBO NFNCSBO FOEPUFM LFEBMBNQMBTNB
ZBJUV USPNCPNPEVMJO ZBOH NFOHJLBU USPNCJO 1FOHJLBUBO 4FM NBTU UFSEBQBU CBOZBL TFLBMJ EJ KBSJOHBO ZBOH
USPNCPNPEVMJO EFOHBO USPNCJO UJEBL IBOZB NFNQFSMBNCBU NFOHFMJMJOHJ LBQJMFS QBSV EBO EBMBN KVNMBI ZBOH LFDJM
UNIT VI
QSPTFT QFNCFLVBO EFOHBO DBSB NFOHBOHLBU USPNCJO UFUBQJ UFSEBQBUKVHBEJEFLBULBQJMFSIBUJ.VEBIEJQBIBNJNFOHBQB
LPNQMFLT USPNCPNPEVMJO USPNCJO KVHB NFOHBLUJGLBO QSPUFJO TFKVNMBI CFTBS IFQBSJO EJQFSMVLBO EJ EBFSBI UFSTFCVU LBSFOB
QMBTNB ZBJUVQSPUFJO$ ZBOHCFLFSKBTFCBHBJBOUJLPBHVMBOEFOHBO LBQJMFSQBSVEBOIBUJNFOFSJNBCBOZBLCFLVBOFNCPMVTZBOH
NFOHJOBLUJGLBO'BLUPS7EBO7***ZBOHUFSBLUJWBTJ UFSCFOUVL EBMBN EBSBI WFOB ZBOH NFOHBMJS MBNCBU
#JMB EJOEJOH FOEPUFM SVTBL QFSNVLBBOOZB ZBOH MJDJO EBO QFNCFOUVLBOIFQBSJOZBOHDVLVQEJQFSMVLBOVOUVLNFODFHBI
MBQJTBOUSPNCPNPEVMJOHMJLPLBMJLTOZBIJMBOH BLBONFOHBLUJGLBO UFSKBEJOZBCFLVBOMFCJICBOZBLMBHJ
'BLUPS9**EBOUSPNCPTJU TFIJOHHBEJNVMBJMBIQSPTFTQFNCFLVBO
KBMVS JOUSJOTJL #JMB 'BLUPS 9** EBO USPNCPTJU CFSLPOUBL EFOHBO 1SPUFJO QMBTNB NFOHBOEVOH FVHMPCVMJO ZBOH EJTFCVU
LPMBHFOTVCFOEPUFM QFOHBLUJGBOBLBONFOKBEJMFCJIIFCBUMBHJ QMBTNJOPHFO BUBV QSPGJCSJOPMJTJO
ZBOH CJMB UFSBLUJWBTJ BLBO
Kerja Antitrombin Fibrin dan Antitrombin III. %J BOUBSB NFOKBEJ QMBTNJO BUBV GJCSJOPMJTJO
1MBTNJO BEBMBI FO[JN
BOUJLPBHVMBOBOUJLPBHVMBOZBOHQBMJOHQFOUJOHEBMBNEBSBIJBMBI QSPUFPMJUJL ZBOH NFOZFSVQBJ USJQTJO TVBUV FO[JN QFODFSOBBO
BOUJLPBHVMBO ZBOH NFOHIJMBOHLBO USPNCJO EBO EBSBI %VB EJ QSPUFPMJUJL QBMJOH QFOUJOH ZBOH EJTFLSFTJ QBOLSFBT 1MBTNJO
BOUBSBOZB ZBOH QBMJOH LVBU JBMBI
CFOBOHCFOBOH GJCSJO ZBOH NFODFSOB CFOBOHCFOBOH GJCSJO EBO CFCFSBQB QSPUFJO
UFSCFOUVL TFMBNB QSPTFT QFNCFLVBO EBO
TVBUV BMGBHMPCVMJO LPBHVMBO MBJO TFQFSUJ GJCSJOPHFO 'BLUPS 7 'BLUPS 7***
ZBOHEJTFCVUBOUJUSPNCJOBUBVLPGBLUPSBOUJUSPNCJOIFQBSJO QSPUSPNCJO EBO 'BLUPS 9** 0MFI LBSFOB JUV LBQBO QVO
4FNFOUBSB CFLVBO TFEBOH EJCFOUVL LJSBLJSB TBNQBJ QMBTNJO EJCFOUVL QMBTNJO BLBO NFMJTJT CFLVBO EFOHBO
QFSTFO USPNCJO ZBOH UFSCFOUVL EBSJ QSPUSPNCJO EJBETPSCTJ LF NFOHIBODVSLBO CBOZBL GBLUPS QFNCFLVBO TFIJOHHB LBEBOH
EBMBN CFOBOHCFOBOH GJCSJO CFHJUV GJCSJO JOJ UFSCFOUVL *OJ LBEBOHCBILBONFOZFCBCLBOIJQPLPBHVMBCJMJUBTEBSBI
UFOUVOZB NFNCBOUV NFODFHBI QFOZFCBSBO USPNCJO LF EBMBN Aktivasi Plasminogen untuk Membentuk Plasmin:
Kemudian Melisis Bekuan. #JMB TVBUV CFLVBO UFSCFOUVL EJ
EBSBI EJ EBFSBI ZBOH MBJO TFIJOHHB EBQBU NFODFHBI QFOZFCBSBO
EBMBNOZB BLBO UFSEBQBU TFKVNMBI CFTBS QMBTNJOPHFO CFSTBNB
CFLVBOZBOHCFSMFCJIBO
EFOHBOQSPUFJOQSPUFJOQMBTNBZBOHMBJO1MBTNJOPHFOJOJUJEBL
5SPNCJOZBOHUJEBLUFSBETPSCTJLFCFOBOHCFOBOHGJCSJOBLBO BLBONFOKBEJQMBTNJOBUBVNFOZFCBCLBOMJTJTCFLVBOTFCFMVN
TFHFSB CFSJLBUBO EFOHBO BOUJUSPNCJO *** ZBOH TFMBOKVUOZB JB EJBLUJGLBO +BSJOHBO ZBOH UFSMVLB EBO TFM FOEPUFM QFNCVMVI
NFOHIBMBOHJ FGFL USPNCJO UFSIBEBQ GJCSJOPHFO EBO LFNVEJBO EBSBI EFOHBO TBOHBU MBNCBU NFMFQBTLBO TVBUV BLUJWBUPS LVBU
KVHB NFOHJOBLUJGLBO USPNCJO JUV TFOEJSJ EBMBN XBLUV TBNQBJ ZBOH EJTFCVU BLUJWBUPS QMBTNJOPHFO KBSJOHBO U1"
ZBOH QBEB
NFOJUCFSJLVUOZB IBSJIBSJ CFSJLVUOZB TFUFMBI CFLVBO CFSIBTJM NFOHIFOUJLBO
Heparin. )FQBSJONFSVQBLBOBOUJLPBHVMBOLVBUMBJOOZB UFUBQJ QFSEBSBIBO BLIJSOZB QMBTNJOPHFO CFSVCBI NFOKBEJ QMBTNJO
LBEBSOZB EBMBN EBSBI EBMBN LFBEBBO OPSNBM SFOEBI TFIJOHHB ZBOH LFNVEJBO NFOHIJMBOHLBO CFLVBO EBSBI ZBOH UJEBL
IBOZB EBMBN LPOEJTJ GJTJPMPHJT LIVTVT TBKB JB CFSGVOHTJ TFCBHBJ EJQFSMVLBO 1BEB LFOZBUBBOOZB CBOZBL QFNCVMVI EBSBI LFDJM
BOUJLPBHVMBO ZBOH DVLVQ CFSBSUJ /BNVO EBMBN QSBLUJL ZBOH TFCFMVNOZB EJIBNCBU BLBO UFSCVLB MBHJ NFMBMVJ
LFEPLUFSBO IFQBSJOTBOHBUMVBTEJQBLBJTFCBHBJBHFOGBSNBLPMPHJT NFLBOJTNF JOJ %FOHBO EFNJLJBO GVOHTJ QFOUJOH LIVTVT EBSJ
EBMBN LPOTFOUSBTJ ZBOH MFCJI UJOHHJ VOUVL NFODFHBI QFNCFLVBO TJTUFN QMBTNJO BEBMBI NFNCVBOH CFLVBO LFDJM EBSJ KVUBBO
JOUSBWBTLVMBS QFNCVMVI QFSJGFS LFDJM ZBOH QBEB BLIJSOZB EBQBU NFOHBMBNJ
.PMFLVM IFQBSJO BEBMBI QPMJTBLBSJEB ZBOH CFSNVBUBO TBOHBU QFOZVNCBUBOCJMBUJEBLBEBDBSBVOUVLNFNCFSTJILBOOZB
OFHBUJG *B TFOEJSJ UJEBL BUBV TFEJLJU TFLBMJ NFNQVOZBJ TJGBUTJGBU
BOUJLPBHVMBO UFUBQJ CJMB CFSJLBUBO EFOHBO BOUJUSPNCJO *** Keadaan yang Menimbulkan Perdarahan Hebat
LFFGFLUJGBO BOUJUSPNCJO *** VOUVL NFOZJOHLJSLBO USPNCJO BLBO pada Manusia
NFOJOHLBU TFSBUVT TBNQBJ TFSJCV LBMJ MJQBU EBO EFOHBO EFNJLJBO
1FSEBSBIBOIFCBUEBQBUUFSKBEJBLJCBUEFGJTJFOTJTBMBITBUVEBSJ
CFLFSKB TFCBHBJ BOUJLPBHVMBO 0MFI LBSFOB JUV EFOHBO BEBOZB
GBLUPSGBLUPS QFNCFLVBO 5JHB KFOJT VUBNB QFSEBSBIBO ZBOH
IFQBSJOZBOHCFSMFCJIBO QFOZJOHLJSBOCFOUVLUSPNCJOCFCBTEBSJ
UFMBI EJQFMBKBSJ TFDBSB NFOEBMBN BLBO EJCBIBT EJ TJOJ
QFSFEBSBOEBSBIPMFIBOUJUSPNCJO***UFSKBEJIBNQJSTFLFUJLB
QFSEBSBIBOBLJCBU
EFGJTJFOTJWJUBNJO,
IFNPGJMJB EBO
,PNQMFLT IFQBSJO EBO BOUJUSPNCJO *** BLBO NFOHIJMBOHLBO

USPNCPTJUPQFOJB EFGJTJFOTJUSPNCPTJU

CFCFSBQB GBLUPS QFNCFLVBO ZBOH UFSBLUJWBTJ MBJOOZB TFMBJO
USPNCJO TFIJOHHB MFCJI NFOJOHLBULBO FGFLUJWJUBTOZB TFCBHBJ
BOUJLPBHVMBO 5FSNBTVL LF EBMBN GBLUPSGBLUPS UFSTFCVU JBMBI
'BLUPS9** 9* 9 EBO*9 %FOHBO CFCFSBQB QFOHFDVBMJBO IBNQJS TFNVB GBLUPS
QFNCFLVBO EJCFOUVL EJ IBUJ 0MFI LBSFOB JUV QFOZBLJU
)FQBSJO EJCFOUVL PMFI CFSNBDBNNBDBN TFM EBMBN UVCVI
QFOZBLJU IBUJ TFQFSUJ IFQBUJUJT TJSPTJT EBO BDVUF ZFMMPX BUSPQZ
UFUBQJTFCBHJBOCFTBSEJCFOUVLPMFITFMNBTUCBTPGJMJLZBOHUFSMFUBL
LBEBOHLBEBOHEBQBUNFOFLBOTJTUFNQFNCFLVBOTFEFNJLJBO
EJKBSJOHBOJLBUQFSJLBQJMFSTFMVSVIUVCVI4FMTFMJOJUFSVTNFOFSVT
LVBUOZB TFIJOHHB QBTJFO DFOEFSVOH NFOHBMBNJ QFSEBSBIBO
NFOHFMVBSLBOIFQBSJOTFEJLJUTFEJLJUZBOHCFSEJGVTJLFEBMBN
IFCBU
457
1FOZFCBC MBJO ZBOH NFOFLBO QFNCFOUVLBO GBLUPS 4JGBU QFSEBSBIBO QBEB IFNPGJMJB EBQBU CFSNBDBNNBDBN
QFNCFLVBO PMFI IBUJ BEBMBI EFGJTJFOTJ WJUBNJO , 7JUBNJO , UJOHLBUBOOZB CFSHBOUVOH QBEB UJOHLBU TJGBU EFGJTJFOTJ HFOFUJL
NFSVQBLBO GBLUPS FTFOTJBM QFOUJOH
VOUVL LBSCPLTJMBTJ IBUJ #JBTBOZB QFSEBSBIBO UJEBL UFSKBEJ LFDVBMJ TFTVEBI NFOEBQBU
ZBOH NFOBNCBI HVHVT LBSCPLTJM QBEB SFTJEV BTBN HMVUBNBU USBVNB UFUBQJ QBEB CFCFSBQB QBTJFO CFSBUOZB USBVNB ZBOH
QBEB MJNB GBLUPS QFNCFLVBO EBSBI QFOUJOH QSPUSPNCJO EJQFSMVLBOVOUVLNFOJNCVMLBOQFSEBSBIBOZBOHIFCBUEBOMBNB
'BLUPS 7** 'BLUPS *9 'BLUPS 9 EBO QSPUFJO $ %BMBN CJTB TBKB TBOHBU SJOHBO EBO MVQVU EBSJ QFSIBUJBO $POUPIOZB
NFOBNCBILBO HVHVT LBSCPLTJM QBEB SFTJEV BTBN HMVUBNBU QFSEBSBIBOTFUFMBIQFODBCVUBOHJHJTFSJOHLBMJEBQBUCFSMBOHTVOH
QBEBGBLUPSGBLUPSQFNCFLVBOZBOHCFMVNNBUBOH WJUBNJO, CFSIBSJIBSJ
EJPLTJEBTJEBONFOKBEJUJEBLBLUJG&O[JNMBJOOZB LPNQMFLT 'BLUPS 7*** UFSEJSJ BUBT EVB LPNQPOFO BLUJG LPNQPOFO CFTBS
WJUBNJO,FQPYJEFSFEVLUBTF 7,03DM
NFOHVSBOHJWJUBNJO, EFOHBOCFSBUNPMFLVMKVUBBOEBOLPNQPOFOZBOHMFCJILFDJMEFOHBO
LFNCBMJLFCFOUVLZBOHBLUJG CFSBUNPMFLVMTFLJUBS,PNQPOFOZBOHMFCJILFDJMJOJTBOHBU
QFOUJOHVOUVLKBMVSQFNCFLVBOJOUSJOTJL EBOEFGJTJFOTJLPNQPOFO
%BMBN LFUJBEBBO WJUBNJO , BLUJG JOTVGJTJFOTJ GBLUPS
JOJMBI ZBOH NFOZFCBCLBO UJNCVMOZB IFNPGJMJB LMBTJL 1FOZBLJU
LPBHVMBTJ UFSTFCVU EBMBN EBSBI EBQBU NFOZFCBCLBO
QFSEBSBIBOMBJOZBOHNFNQVOZBJDJSJDJSJZBOHBHBLCFSCFEB EJTFCVU
LFDFOEFSVOHBOQFSEBSBIBOTFSJVT
QFOZBLJUWPO8JMMFCSBOE BEBMBIBLJCBUEBOUJEBLBEBOZBLPNQPOFO
7JUBNJO,EJTJOUFTJTUFSVTEBMBNVTVTPMFICBLUFSJ TFIJOHHB ZBOHCFTBS
EFGJTJFOTJWJUBNJO,ZBOHEJBLJCBULBOUJEBLBEBOZBWJUBNJO, #JMB TFTFPSBOH QFOEFSJUB IFNPGJMJB LMBTJL NFOHBMBNJ QFSEBSBIBO
EBMBN EJFU LFDVBMJ QBEB CBZJ CBSV MBIJS TFCFMVN VTVTOZB IFCBU EBO MBNB NBLB IBOZB UFSBQJ ZBOH CFOBSCFOBS FGFLUJG ZBJUV
NFOHBOEVOH GMPSB CBLUFSJ VTVT
KBSBOH UFSKBEJ QBEB PSBOH NFOZVOUJLLBO 'BLUPS 7*** ZBOH EJNVSOJLBO )BSHB GBLUPS 7***
OPSNBM /BNVO QBEB QFOZBLJU HBTUSPJOUFTUJOBM EFGJTJFOTJ TBOHBU NBIBM TFCBC GBLUPS 7*** EJEBQBULBO EBSJ EBSBI NBOVTJB EBO
WJUBNJO,TFSJOHUFSKBEJQBEBPSBOHZBOHNFOHBMBNJHBOHHVBO IBOZBEBMBNKVNMBIZBOHTBOHBULFDJM/BNVO QFOJOHLBUBOQSPEVLTJ
BCTPSQTJ MFNBL QBEB USBLUVT HBTUSPJOUFTUJOBMOZB "MBTBOOZB EBO QFOHHVOBBO 'BLUPS 7*** SFLPNCJOBO BLBO NFNCVBU UFSBQJ JOJ
BEBMBI CBIXB WJUBNJO , CFSTJGBU MBSVU EBMBN MFNBL EBO EBQBUEJHVOBLBOQBEBMFCJICBOZBLQBTJFOIFNPGJMJBLMBTJL
CJBTBOZBEJBCTPSQTJLFEBMBNEBSBICFSTBNBBOEFOHBOMFNBL Trombositopenia
4BMBITBUVQFOZFCBCQBMJOHTFSJOHEFGJTJFOTJWJUBNJO,JBMBI 5SPNCPTJUPQFOJB CFSBSUJ USPNCPTJU EBMBN EBSBI ZBOH
LFHBHBMBO IBUJ VOUVL NFOZFLSFTJ FNQFEV LF EBMBN USBLUVT CFSTJSLVMBTJ KVNMBIOZB TFEJLJU TFLBMJ 1BTJFO USPNCPTJUPQFOJB
HBTUSPJOUFTUJOBM ZBOH UFSKBEJ TFCBHBJ BLJCBU PCTUSVLTJ EVLUVT DFOEFSVOH NFOHBMBNJ QFSEBSBIBO TFQFSUJ IBMOZB QBEB
FNQFEV BUBV BLJCBU QFOZBLJU IBUJ
,FLVSBOHBO FNQFEV BLBO IFNPGJMJB LFDVBMJ CBIXB CJBTBOZB QFSEBSBIBO CFSBTBM EBSJ
NFOHHBOHHV QFODFSOBBO EBO BCTPSQTJ MFNBL TFIJOHHB WFOVMBWFOVMB BUBV LBQJMFSLBQJMFS LFDJM CVLBO EBSJ QFNCVMVI
NFOFLBO BCTPSCTJ WJUBNJO , +BEJ QFOZBLJU IBUJ TFSJOH ZBOH MFCJI CFTBS TFQFSUJ QBEB IFNPGJMJB "LJCBUOZB UJNCVM
NFOHBLJCBULBOQFOVSVOBOQSPEVLTJQSPUSPNCJOEBOCFCFSBQB CJOUJLCJOUJLQFSEBSBIBOEJTFMVSVIKBSJOHBOUVCVI,VMJUQBTJFO
GBLUPSQFNCFLVBOMBJOLBSFOBUFSHBOHHVOZBBCTPSQTJWJUBNJO, NFOBNQBLLBO CFSDBLCFSDBL LFDJM CFSXBSOB VOHV TFIJOHHB
EBO LBSFOB TFMTFM IBUJ ZBOH TBLJU %BMBN LFBEBBO EFNJLJBO QFOZBLJU JUV EJTFCVU USPNCPTJUPQFOJB QVSQVSB 4FQFSUJ ZBOH
WJUBNJO , EJTVOUJLLBO LFQBEB TFNVB QBTJFO ZBOH NFOEFSJUB EJCJDBSBLBO EJ BUBT USPNCPTJU UFSVUBNB EJQFSMVLBO VOUVL
QFOZBLJUIBUJBUBVPCTUSVLTJTBMVSBOFNQFEVTFCFMVNEJMBLVLBO NFOVUVQ LFCPDPSBOLFCPDPSBO LFDJM EJ LBQJMFS EBO QFNCVMVI
TVBUV UJOEBLBO PQFSBTJ #JBTBOZB CJMB QBTJFO ZBOH NFOHBMBNJ LFDJMMBJOOZB
LFLVSBOHBO WJUBNJO UFSTFCVU EJCFSJ WJUBNJO , EBMBN XBLUV #JBTBOZB QFSEBSBIBO UJEBL BLBO UFSKBEJ TBNQBJ KVNMBI
TBNQBJ KBN TFCFMVN PQFSBTJ EBO QBMJOH TFEJLJU TFQBSVI TFM USPNCPTJU EBMBN EBSBI UVSVO EJ CBXBI /JMBJ
QBSFOLJN IBUJOZB CFSGVOHTJ OPSNBM NBLB BLBO UFSCFOUVL OPSNBMOZB BEBMBI TBNQBJ ,BEBS TFSFOEBI
DVLVQ CBOZBL GBLUPS QFNCFLVBO TFIJOHHB QFSEBSBIBO ZBOH TFSJOHLBMJNFOJNCVMLBOLFNBUJBO
CFSMFCJIBOTFMBNBPQFSBTJEBQBUEJDFHBI #BILBOUBOQBNFMBLVLBOQFOHIJUVOHBOUSPNCPTJUEBMBNEBSBI
QVO LBEBOHLBEBOH LJUB EBQBU NFODVSJHBJ UFSKBEJOZB
Hemofilia USPNCPTJUPQFOJBCJMBEBSBIOZBHBHBMVOUVLSFUSBLTJLBSFOB TFQFSUJ
)FNPGJMJB JBMBI TVBUV QFOZBLJU QFSEBSBIBO ZBOH IBNQJS UFMBIEJTFCVULBOUFSEBIVMV SFUSBLTJCFLVBOOPSNBMOZBCFSHBOUVOH
TFMVSVIOZB UJNCVM QBEB MBLJMBLJ 1BEB QFSTFO LBTVT QBEBQFMFQBTBOCFSCBHBJGBLUPSQFNCFLVBOEBSJTFKVNMBIUSPNCPTJU
QFOZBLJU JOJ EJTFCBCLBO PMFI LFMBJOBO BUBV EFGJTJFOTJ 'BLUPS ZBOHUFSQFSBOHLBQEBMBNKBSJOHBOGJCSJOCFLVBO
7*** KFOJT IFNPGJMJB JOJ EJTFCVU IFNPGJMJB " BUBV IFNPGJMJB 4FCBHJBO CFTBS QBTJFO USPNCPTJUPQFOJB NFNQVOZBJ QFOZBLJU
LMBTJL,JSBLJSBEJBOUBSBMBLJ*BLJEJ"NFSJLB4FSJLBU ZBOH EJLFOBM TFCBHBJ USPNCPTJUPQFOJB JEJPQBUJL ZBOH CFSBSUJ
NFOEFSJUB IFNPGJMJB LMBTJL 1BEB QFSTFO QBTJFO IFNPGJMJB USPNCPTJUPQFOJB ZBOH UJEBL EJLFUBIVJ QFOZFCBCOZB 1BEB
MBJOOZB LFDFOEFSVOHBOQFSEBSBIBOEJTFCBCLBOPMFIEFGJTJFOTJ LFCBOZBLBO QBTJFO UFMBI EJUFNVLBO CBIXB VOUVL BMBTBO ZBOH
'BLUPS *9 ,FEVB GBLUPS UFSTFCVU EJUVSVOLBO TFDBSB HFOFUJL UJEBLEJLFUBIVJ UFSEBQBUBOUJCPEJTQFTJGJLZBOHCFSFBLTJUFSIBEBQ
NFMBMVJ LSPNPTPN QFSFNQVBO 0MFI LBSFOB JUV QFSFNQVBO USPNCPTJU JUV TFOEJSJ MBMV NFOHIBODVSLBOOZB 1FOHIFOUJBO
IBNQJSUJEBLQFSOBINFOEFSJUBIFNPGJMJBLBSFOBQBMJOHTFEJLJU QFSEBSBIBOTFMBNBTBNQBJIBSJTFSJOHLBMJEBQBUEJDBQBJQBEB
TBUV EBSJ LFEVB LSPNPTPN 9OZB NFNQVOZBJ HFOHFO ZBOH QBTJFOUSPNCPTJUPQFOJBEFOHBODBSBNFNCFSJLBOUSBOTGVTJEBSBI
TFNQVSOB #JMB TBMBI TBUV LSPNPTPN 9OZB NFOHBMBNJ MFOHLBQ TFHBS ZBOH NFOHBOEVOH TFKVNMBI CFTBS USPNCPTJU
EFGJTJFOTJ JB BLBO NFOKBEJ QFNCBXB DBSSJFS
IFNPGJMJB 4QMFOFLUPNJ KVHB TFSJOH LBMJ TBOHBU NFOPMPOH LBEBOHLBEBOH
NFOVSVOLBO QFOZBLJU QBEB TFQBSVI BOBL MBLJMBLJOZB EBO NFNCFSJ LFTFNCVIBO ZBOH IBNQJS TFNQVSOB LBSFOB MJNQB
NFOVSVOLBO TJGBU QFNCBXB IFNPGJMJB LFQBEB TFQBSVI BOBL OPSNBMOZB NFOHIJMBOHLBO TFKVNMBI CFTBS USPNCPTJU EBSJ
QFSFNQVBOOZB QFSFEBSBOEBSBI UFSVUBNBZBOHTVEBISVTBL
458
Pembekuan Intravaskular Diseminata

Keadaan Tromboembolik pada Manusia ,BEBOHLBEBOH NFLBOJTNF QFNCFLVBO NFOKBEJ BLUJG EJ
CFSCBHBJUFNQBUEBMBNTJSLVMBTJ NBLBUFSKBEJMBILFBEBBOZBOH
EJTFCVU QFNCFLVBO JOUSBWBTLVMBS EJTFNJOBUB EJTTFNJOBUFE
Trombus dan Embolus. #FLVBO BCOPSNBM ZBOH UFSCFOUVL
UNIT VI
JOUSBWBTDVMBS DPBHVMBUJPO
,FBEBBO JOJ TFSJOH UJNCVM BLJCBU
EBMBNQFNCVMVIEBSBIEJTFCVUUSPNCVT,FUJLBUFSCFOUVLCFLVBO
CBOZBLOZB KBSJOHBO ZBOH DFEFSB BUBV NBUJ EBMBN UVCVI ZBOH
EBSBIZBOHNFOHBMJSUFSVTNFOFSVTEBQBUNFMFQBTLBOCFLVBOJUV
NFMFQBTLBO GBLUPS KBSJOHBO EBMBN KVNMBI CFTBS LF EBMBN
EBSJ UFNQBU QFMFLBUBOOZB EBO CFLVBO ZBOH NFOHBMJS CFCBT JUV
EBSBI 4FSJOH LBMJ CFLVBO JOJ LFDJMLFDJM UFUBQJ CBOZBL EBO
EJLFOBM TFCBHBJ FNCPMVT 4FMBJO JUV FNCPMVT ZBOH CFSBTBM EBSJ
CFLVBOCFLVBO JUV NFOZVNCBU TFKVNMBI CFTBS QFNCVMVI
BSUFSJCFTBSBUBVKBOUVOHCBHJBOLJSJEBQBUNFOHBMJSLFQFSJGFSEBO
EBSBI QFSJGFS ZBOH LFDJM *OJ UFSVUBNB UFSKBEJ QBEB QBTJFO
NFOZVNCBUBSUFSJBSUFSJBUBVBSUFSJPMEJPUBL HJOKBM BUBVEJNBOB
EFOHBOTFQUJLFNJBZBOHNFMVBT CBLUFSJBUBVUPLTJOCBLUFSJOZB
TBKB &NCPMVT ZBOH CFSBTBM EBSJ TJTUFN WFOB BUBV KBOUVOH CBHJBO
UFSVUBNB FOEPUPLTJO NFOHBLUJGLBO NFLBOJTNF QFNCFLVBO
LBOBO VNVNOZB BLBO NFOHBMJS NFNBTVLJ QBSV EBO
4VNCBUBO QBEB QFNCVMVI QFSJGFS JUV TBOHBU NFOHVSBOHJ
NFOJNCVMLBOFNCPMJEBMBNBSUFSJQVMNPOBMJT
QFOHJSJNBOPLTJHFOEBOOVUSJFOOVUSJFOMBJOLFKBSJOHBOTVBUV
Penyebab Tromboembolus. 1FOZFCBC UJNCVMOZB LFBEBBO ZBOH NFOJNCVMLBO BUBV NFOHFLTBTFSCBTJ TZPL
USPNCPFNCPMVTQBEBNBOVTJBCJBTBOZBBEBEVBIBM
1FSNVLBBO TJSLVMBTJ *OJMBI TFCBHJBO BMBTBO NFOHBQB TZPL TFQUJLFNJL
FOEPUFM QFNCVMVI ZBOH LBTBS EBQBU EJTFCBCLBO PMFI CFSTJGBUMFUBMQBEBQFSTFOQBTJFOBUBVMFCJI
BSUFSJPTLMFSPTJT JOGFLTJ BUBV USBVNB SVQBOZB EBQBU NFOHBXBMJ &GFL ZBOH NFOZVMJULBO QBEB QFNCFLVBO JOUSBWBTLVMBS
QSPTFTQFNCFLVBO
%BSBITFSJOHNFNCFLVCJMBNFOHBMJSTBOHBU EJTFNJOBUB JBMBI CBIXB QBTJFO UFSLBEBOH NFOHBMBNJ
MBNCBUNFMBMVJQFNCVMVIEBSBIUFNQBUTFKVNMBILFDJMUSPNCJOEBO QFSEBSBIBO 1FOZFCBCOZB JBMBI UFSMBMV CBOZBL GBLUPS
QSPLPBHVMBOMBJOTFMBMVEJCFOUVL QFNCFLVBOZBOHUFMBIUFSQBLBJPMFIQFNCFLVBOZBOHUFSTFCBS
*VBT TFIJOHHB QSPLPBHVMBO ZBOH UFSTJTB UJEBL EBQBU
Penggunaan t-PA atau Streptokinase dalam Mengobati NFNQFSUBIBOLBOIFNPTUBTJTZBOHOPSNBM
Bekuan Intravaskular. 5FMBI UFSTFEJB U1" BLUJWBUPS
QMBTNJOPHFOKBSJOHBO
ZBOHEJCVBUEFOHBODBSBSFLBZBTBHFOFUJL Antikoagulan untuk Penggunaan Klinis
#JMB EJCFSJLBO TFDBSB MBOHTVOH NFMBMVJ LBUFUFS LF BSFB ZBOH
UFSLFOBUSPNCPTJT TFDBSBFGFLUJGBLBONFOHBLUJGLBOQMBTNJOPHFO 1BEBCFCFSBQBLFBEBBOUSPNCPFNCPMJL EJQFSMVLBODBSBVOUVL
NFOKBEJ QMBTNJO ZBOH LFNVEJBO EBQBU NFMBSVULBO CFLVBO NFNQFSMBNCBU QSPTFT QFNCFLVBO #FSNBDBNNBDBN
JOUSBWBTLVMBS 4FCBHBJ DPOUPI KJLB EJCFSJLBO QBEB KBN QFSUBNB BOUJLPBHVMBO UFMBI EJLFNCBOHLBO VOUVL UVKVBO JOJ 5FSOZBUB
BUBV KBNKBN TFMBOKVUOZB TFUFMBI USPNCVT NFOZVNCBU BSUFSJ ZBOHQBMJOHCFSIBTJMTFDBSBLMJOJTJBMBIIFQBSJOEBOLVNBSJO
LPSPOBSJB NBLB KBOUVOH TFSJOH LBMJ EBQBU UFSIJOEBS EBSJ Heparin sebagai Antikoagulan Intravena
LFSVTBLBOZBOHTFSJVT )FQBSJO ZBOH EJQFSKVBMCFMJLBO EJFLTUSBLTJ EBSJ CFCFSBQB
KBSJOHBOIFXBOZBOHCFSCFEBEBOEJCVBUEBMBNCFOUVLIBNQJS
Trombosis Vena Femoralis dan Emboli Paru Masif NVSOJ 1FOZVOUJLBO EBMBN EPTJT SFMBUJG LFDJM LJSBLJSB
0MFI LBSFOB QFNCFLVBO IBNQJS TFMBMV UFSKBEJ QBEB EBSBI ZBOH
TBNQBJNHLHCFSBUCBEBO NFOZFCBCLBOXBLUVQFNCFLVBO
BMJSBOOZB EBMBN QFNCVMVI NFOHBMBNJ IBNCBUBO TFMBNB
EBSBI NFOJOHLBU EBSJ OJMBJ OPSNBM NFOJU NFOKBEJ NFOJU
CFCFSBQBKBN JNPCJMJUBTQBTJFOEJUFNQBUUJEVSEJUBNCBIEFOHBO
BUBV MFCJI 4FMBJO JUV QFSVCBIBO XBLUV QFNCFLVBO JOJ UFSKBEJ
QFOZBOHHBMVUVUEFOHBOCBOUBMTFSJOHNFOJNCVMLBOQFNCFLVBO
TFDBSB TFLFUJLB TFIJOHHB EFOHBO TFHFSB QVMB EBQBU NFODFHBI
JOUSBWBTLVMBS BLJCBU CFOEVOHBO EBSBI QBEB TBUV BUBV MFCJI WFOB
BUBVNFNQFSMBNCBUCFSMBOKVUOZBLFBEBBOUSPNCPFNCPMJ
UVOHLBJ TFMBNB CFCFSBQB KBN #FLVBO JUV LFNVEJBO CFSUBNCBI ,FSKB IFQBSJO CFSMBOHTVOH LJSBLJSB TBNQBJ KBN
CFTBS UFSVUBNBLFBSBICBHJBOEBSBIWFOBZBOHCFSHFSBLMBNCBO )FQBSJOZBOHUFMBIEJTVOUJLLBOBLBOEJIBODVSLBOPMFIFO[JN
LBEBOHLBEBOH TBNQBJ NFOHJTJ TFMVSVI WFOB UVOHLBJ EBO EBMBNEBSBIZBOHEJTFCVUIFQBSJOBTF
UFSLBEBOHCBILBONFMVBTLFBUBTTBNQBJLFWFOBJMJBLBLPNVOJT
EBOWFOBDBWBJOGFSJPS,JSBLJSBEJBOUBSBLFKBEJBO CBHJBO Kumarin sebagai Antikoagulan
UFSCFTBS EBSJ CFLVBO BLBO UFSMFQBT EBSJ QFMFLBUBOOZB QBEB #JMB TVBUV LVNBSJO NJTBMOZB XBSGBSJO EJCFSJLBO LFQBEB
EJOEJOH QFNCVMVI EBSBI EBO NFOHBMJS TFDBSB CFCBT NFOHJLVUJ QBTJFO NBLB TFKVNMBI QSPUSPNCJO BLUJG EBO 'BLUPS'BLUPS
EBSBIWFOBNFMFXBUJKBOUVOHCBHJBOLBOBO EBONFOVKVLFBSUFSJ 7** *9 EBO9ZBOHTFNVBOZBEJCFOUVLEJIBUJ LBEBSOZBNVMBJ
QVMNPOBMJT VOUVL NFOJNCVMLBO IBNCBUBO NBTJG QBEB BSUFSJ NFOVSVO 8BSGBSJO NFOZFCBCLBO QFOVSVOBO JOJ EFOHBO
QVMNPOBMJT EJTFCVU FNCPMJ QBSV ZBOH NBTJG #JMB CFLVBO JUV NFOHIBNCBU FO[JN WJUBNJO , ,PNQMFLT FQPLTJ SFEVLUBTF
DVLVQCFTBSVOUVLNFOVUVQLFEVBBSUFSJQVMNPOBMJTQBEBXBLUV 7,03 DM
4FQFSUJ UFMBI EJCBIBT TFCFMVNOZB FO[JN JOJ
CFSTBNBBO LFNBUJBO TFHFSB UFSKBEJ #JMB IBOZB TBUV BSUFSJ NFOHVCBI7JUBNJO,CFOUVLJOBLUJG UFSPLTJEBTJNFOKBEJBLUJG
QVMNPOBMJT ZBOH UFSUVUVQ LFNBUJBO EBQBU UJEBL UFSKBEJ 5FUBQJ EBO CFOUVL UFSFEVLTJ %FOHBO NFOHIBNCBU 7,03 DM NBLB
CJMB CFLVBO EBMBN QFNCVMVIQFNCVMVI QBSV UFSVT NFMVBT XBSGBSJO NFOVSVOLBO WJUBNJO , CFOUVL BLUJG EBMBN KBSJOHBO
FNCPMJ JUV BLBO NFOJNCVMLBO LFNBUJBO EBMBN CFCFSBQB KBN ,FUJLB JOJ UFSKBEJ GBLUPSGBLUPS LPBHVMBTJ UJEBL MBHJ
TBNQBJ CFCFSBQB IBSJ LFNVEJBO 5FUBQJ TFLBMJ MBHJ U1" EBQBU UFSLBSCPLTJMBTJ EBO CJPMPHJT UJEBL BLUJG 4FMBNB CFCFSBQB IBSJ
NFOKBEJQFOZFMBNBUKJXB TJNQBOBOUVCVIVOUVLGBLUPSLPBHVMBOBLUJGNFOVSVOEBO
459
EJHBOUJLBO PMFI GBLUPSGBLUPS ZBOH UJEBL BLUJG .FTLJQVO LBEBSJPOLBMTJVNEBSBI TFIJOHHBUJNCVMMBIUFUBOJEBOLFNBUJBO

GBLUPSGBLUPS LPBHVMBTJ UFSVT EJQSPEVLTJ OBNVO BLUJWJUBT EFOHBOLFKBOHLFKBOH
LPBHVMBOOZBTBOHBUNFOVSVO
4FUFMBI QFNCFSJBO XBSGBSJO EBMBN EPTJT FGFLUJG BLUJWJUBT
QFNCFLVBO EBSBI UVSVO LJSBLJSB QFSTFO EBSJ LFBEBBO Tes Pembekuan Darah
OPSNBMTFUFMBIKBN EBOUJOHHBMLJSBLJSBQFSTFOTFUFMBI
KBN %FOHBO LBUB MBJO QSPTFT QFNCFLVBO UJEBL TFHFSB Waktu Perdarahan
EJIFOUJLBO UFUBQJ IBSVT NFOVOHHV QFSVTBLBO QSPUSPNCJO #JMB VKVOH KBSJ BUBV DVQJOH UFMJOHB EJUVTVL EFOHBO KBSVN UBKBN
BLUJG EBO GBLUPSGBLUPS QFNCFLVBO ZBOH UFSMJCBU MBJOOZB ZBOH QFSEBSBIBO CJBTBOZB CFSMBOHTVOH TBNQBJ NFOJU -BNB
UFMBIBEBEBMBNQMBTNB1FNCFLVBONFOKBEJOPSNBMLFNCBMJ QFSEBSBIBO TBOHBU CFSHBOUVOH QBEB EBMBNOZB MVLB EBO EFSBKBU
TBNQBJIBSJTFUFMBIQFOHIFOUJBOUFSBQJLVNBSJO IJQFSFNJB EJ KBSJ BUBV DVQJOH UFMJOHB QBEB TBBU UFT EJMBLVLBO
Mencegah Pembekuan Darah di Luar Tubuh 8BLUV QFSEBSBIBO BLBO NFNBOKBOH CJMB LFLVSBOHBO TBMBI TBUV
%BSBIZBOHEJLFMVBSLBOEBSJUVCVIEBOEJUBSVIEBMBNUBCVOH GBLUPSGBLUPS QFNCFLVBO EBO BLBO TBOHBU NFNBOKBOH CJMB
HFMBTSFBLTJ OPSNBMOZBBLBONFNCFLVEBMBNXBLUVNFOJU LFLVSBOHBOUSPNCPTJU
UFUBQJ CJMB EJUBSVI EBMBN UBCVOH CFSTJMJLPO TFSJOH LBMJ UJEBL
NFNCFLV TBNQBJ KBN BUBV MFCJI "MBTBO VOUVL Waktu Pembekuan
LFUFSMBNCBUBO JOJ BEBMBI CBIXB UBCVOH ZBOH UFMBI EJMBQJTJ #FCFSBQBDBSBUFMBIEJQBLBJVOUVLNFOFOUVLBOXBLUVQFNCFLVBO
EFOHBOTJMJLPOEBQBUNFODFHBIBLUJWBTJLPOUBLUSPNCPTJUEBO EBSBI $BSB ZBOH QBMJOH CBOZBL EJQBLBJ JBMBI EFOHBO
'BLUPS 9** ZBOH NFSVQBLBO EVB GBLUPS EBTBS ZBOH NFOFNQBULBO EBSBI EBMBN UBCVOH HFMBT SFBLTJ ZBOH CFSTJI
NFODFUVTLBO NFLBOJTNF QFNCFLVBO JOUSJOTJL 4FCBMJLOZB LFNVEJBO NFOHHPZBOHLBO UBCVOH JUV TFUJBQ EFUJL TBNQBJ
UBCVOH HFMBT ZBOH UJEBL EJCFSJ BQBBQB BLBO NFOZFCBCLBO UFSCFOUVL CFLVBO %FOHBO DBSB JOJ XBLUV QFNCFLVBO OPSNBM
QFOHBLUJGBO USPNCPTJU EBO GBLUPS 9** EBO QFNCFOUVLBO BEBMBI TBNQBJ NFOJU 1SPTFEVS ZBOH NFOHHVOBLBO UBCVOH
CFLVBOZBOHDFQBU SFBLTJ NVMUJQFM KVHB EBQBU NFOFOUVLBO XBLUV QFNCFLVBO TFDBSB
MFCJIBLVSBU
HeparinEBQBUEJQBLBJTFCBHBJQFODFHBIQFNCFLVBOEBSBI
4BZBOHOZB XBLUV QFNCFLVBO TBOHBU CFSWBSJBTJ CFSHBOUVOH
CBJLEJMVBSNBVQVOEJEBMBNUVCVI)FQBSJOLIVTVTOZBKVHB
QBEB NFUPEF QFOHVLVSBO ZBOH EJHVOBLBO KBEJ XBLUV
EJQBLBJ EBMBN QSPTFEVS PQFSBTJ ZBOH NFOHIBSVTLBO EBSBI
QFNCFLVBO UJEBL EJHVOBLBO MBHJ QBEB CBOZBL LMJOJL +VTUSV
EJBMJSLBONFMBMVJNFTJOKBOUVOHQBSVBUBVNFTJOHJOKBMCVBUBO
EJMBLVLBO QFOHVLVSBO GBLUPS QFNCFLVBO JUV TFOEJSJ EFOHBO
EBOLFNVEJBOLFNCBMJMBHJLFUVCVIQBTJFO
NFOHHVOBLBOQSPTFEVSLJNJBXJZBOHDBOHHJI
#FSNBDBNNBDBN [BU ZBOH EBQBU NFOVSVOLBO LBEBS JPO
LBMTJVN EBMBN EBSBI EBQBU KVHB EJHVOBLBO VOUVL NFODFHBI Waktu Protrombin dan Rasio Normalisasi Internasional
QFNCFLVBO EJ MVBS UVCVI 4FCBHBJ DPOUPI TFKVNMBI LFDJM 8BLUVQSPUSPNCJONFNCFSJQFUVOKVLUFOUBOHLBEBSQSPUSPNCJO
TFOZBXB PLTBMBU NVEBI MBSVU ZBOH EJDBNQVS EFOHBO EBSBI EBMBN EBSBI (BNCBS NFNQFSMJIBULBO IVCVOHBO BOUBSB
EBQBU NFOZFCBCLBO QFOHFOEBQBO LBMTJVN PLTBMBU EBSJ LBEBS QSPUSPNCJO EFOHBO XBLUV QSPUSPNCJO .FUPEF VOUVL
QMBTNB EBOEFOHBOEFNJLJBONFOVSVOLBOLBEBSJPOLBMTJVN NFOFOUVLBOXBLUVQSPUSPNCJOBEBMBITFCBHBJCFSJLVU
TFIJOHHBQFNCFLVBOEBSBIUJEBLUFSKBEJ
;BU MBJO ZBOH NFOHVCBI LBMTJVN BHBS UJEBL CFSCFOUVL JPO
BLBONFODFHBIQFNCFLVBO*POTJUSBUZBOHCFSNVBUBOOFHBUJG
EJDBNQVS EFOHBO EBSBI CJBTBOZB EBMBN CFOUVL OBUSJVN
BNPOJVN BUBV LBMJVN TJUSBU UFSVUBNB CFSNBOGBBU VOUVL
NFODFHBI QFNCFLVBO *PO TJUSBU CFSJLBUBO EFOHBO LBMTJVN
EBMBNEBSBIVOUVLNFOHIBTJMLBOTFOZBXBLBMTJVNZBOHUJEBL
CFSCFOUVLJPO EBOLFLVSBOHBOJPOLBMTJVNBLBONFOHIBNCBU
QFNCFLVBO"OUJLPBHVMBOTJUSBUNFNQVOZBJLFVOHHVMBOZBOH
TBOHBU QFOUJOH EJCBOEJOHLBO BOUJLPBHVMBO PLTBMBU LBSFOB
PLTBMBUCFSTJGBUUPLTJLUFSIBEBQUVCVI TFEBOHLBOTJUSBUEBMBN
KVNMBI TFEBOH EBQBU EJTVOUJLLBO TFDBSB JOUSBWFOB 4FUFMBI
EJTVOUJLLBO JPO TJUSBU BLBO EJIJMBOHLBO EBSJ UVCVI EBMBN
CFCFSBQB NFOJU PMFI IBUJ EBO EJQPMJNFSJTBTJ NFOKBEJ HMVLPTB
BUBV EJNFUBCPMJTNF MBOHTVOH VOUVL NFOHIBTJMLBO FOFSHJ
"LJCBUOZB EBSBI TFCBOZBL NM ZBOH UFMBI EJCVBU UJEBL
NFNCFLV PMFI TJUSBU CJBTBOZB EBQBU EJUSBOTGVTJLBO LFQBEB
QBTJFOEBMBNCFCFSBQBNFOJUUBOQBNFOJNCVMLBOBLJCBUZBOH
NFOBLVULBO5FUBQJCJMBIBTJMSVTBLBUBVTFKVNMBICFTBSEBSBI
BUBV QMBTNB ZBOH NFOHBOEVOH TJUSBU EJCFSJLBO UFSMBMV DFQBU
EBMBN IJUVOHBO NFOJU
JPO TJUSBU UJEBL EBQBU EJIJMBOHLBO
EFOHBODFQBU EBOTJUSBUUFSTFCVUBLBOTBOHBUNFOVSVOLBO
460
%BSBIZBOHEJBNCJMEBSJQBTJFOTFHFSBEJCFSJPLTBMBUBHBSUJEBL LBMTJVN EBO TFNVB GBLUPS MBJO TFMBJO ZBOH

BEB QSPUSPNCJO ZBOH CFSVCBI NFOKBEJ USPNCJO ,FNVEJBO EJUFT EJUBNCBILBO LF EBMBN EBSBI PLTBMBU TFLBMJHVT
TFKVNMBICFTBSJPOLBMTJVNEBOGBLUPSKBSJOHBOEJDBNQVSTFDBSB ,FNVEJBO XBLUV ZBOH EJQFSMVLBO VOUVL UFSKBEJOZB
DFQBU LF EBMBN EBSBI PLTBMBU ,BMTJVN ZBOH CFSMFCJIBO QFNCFLVBO EJUFOUVLBO EFOHBO DBSB ZBOH TBNB TFQFSUJ XBLUV
NFOHIJMBOHLBO FGFL PLTBMBU EBO GBLUPS KBSJOHBO NFOHBLUJGLBO QSPUSPNCJO #JMB GBLUPS ZBOH EJUFT UFSOZBUB LVSBOH XBLUV
UNIT VI
SFBLTJ QSPUSPNCJO NFOKBEJ USPNCJO NFMBMVJ KBMVS QFNCFLVBO QFNCFLVBO BLBO NFNBOKBOH 8BLUV JUV TFOEJSJ ZBOH
FLTUSJOTJL 8BLUV ZBOH EJQFSMVLBO VOUVL UFSKBEJOZB QFNCFLVBO LFNVEJBO EBQBU EJHVOBLBO VOUVL NFOHVLVS LBEBS GBLUPS
EJTFCVUXBLUVQSPUSPNCJO1FOEFLOZBXBLUVEJUFOUVLBOUFSVUBNB QFNCFLVBO
PMFI LBEBS QSPUSPNCJO 8BLUV QSPUSPNCJO OPSNBM LJSBLJSB
EFUJL %J TFUJBQ MBCPSBUPSJVN LVSWB ZBOH NFOVOKVLLBO
IVCVOHBO BOUBSB LBEBS QSPUSPNCJO EFOHBO XBLUV QSPUSPNCJO Daftar Pustaka
TFQFSUJ ZBOH UFSMJIBU QBEB (BNCBS EJCVBU TFTVBJ EFOHBO
Andrews RK, Berndt MC: Platelet adhesion: a game of catch and release,
NFUPEF ZBOH EJQBLBJ TFIJOHHB QSPUSPNCJO EBMBN EBSBI EBQBU J Clin Invest 118:3009, 2008.
EJIJUVOH Brass LF, Zhu L, Stalker TJ: Minding the gaps to promote thrombus growth
)BTJMZBOHEJQFSPMFIVOUVLXBLUVQSPUSPNCJOEBQBUCFSWBSJBTJ and stability, J Clin Invest 115:3385, 2005.
Crawley JT, Lane DA: The haemostatic role of tissue factor pathway inhibi-
CBILBOEBMBNJOEJWJEVZBOHTBNBKJLBUFSEBQBUQFSCFEBBOEBMBN
tor, Arterioscler Thromb Vasc Biol 28:233, 2008.
BLUJWJUBTGBLUPSKBSJOHBOEBOTJTUFNBOBMJTJTZBOHEJHVOBLBOVOUVL Furie B, Furie BC: Mechanisms of thrombus formation, N Engl J Med
NFMBLVLBO UFT 'BLUPS KBSJOHBO EJJTPMBTJ EBSJ KBSJOHBO NBOVTJB 359:938, 2008.
TFQFSUJ KBSJOHBO QMBTFOUB EBO CFSCBHBJ LFMPNQPL ZBOH CFSCFEB Gailani D, Renné T: Intrinsic pathway of coagulation and arterial thrombo-
NVOHLJO NFNJMJLJ BLUJWJUBT CFSCFEB /PSNBMJTBTJ SBTJP sis, Arterioscler Thromb Vasc Biol 27:2507, 2007.
Jennings LK: Role of platelets in atherothrombosis, Am J Cardiol 103(3
JOUFSOBTJPOBM JOUFSOBUJPOBM OPSNBMJ[FE SBUJP <*/3>
EJDJQUBLBO
Suppl):4A, 2009.
TFCBHBJDBSBVOUVLNFNCBLVLBOQFOHVLVSBOXBLUVQSPUSPNCJO Koreth R, Weinert C, Weisdorf DJ, et al: Measurement of bleeding severity:
6OUVL UJBQ LFMPNQPL GBLUPS KBSJOHBO QSPEVTFO NFOFUBQLBO a critical review, Transfusion 44:605, 2004.
JOEFLT LFQFLBBO JOUFSOBTJPOBM JOUFSOBUJPOBM TFOTJUJWJUZ JOEFY Nachman RL, Rafii S: Platelets, petechiae, and preservation of the vascular
<*4*>
ZBOHNFOVOKVLLBOBLUJWJUBTGBLUPSKBSJOHBOEFOHBOTBNQFM wall, N Engl J Med 359:1261, 2008.
Pabinger I, Ay C: Biomarkers and venous thromboembolism, Arterioscler
UFSTUBOEBS*4*CJBTBOZBCFSWBSJBTJBOUBSB EBO */3BEBMBI
Thromb Vasc Biol 29:332, 2009.
SBTJP XBLUV QSPUSPNCJO TFTFPSBOH VOUVL TBNQFM LPOUSPM OPSNBM Rijken DC, Lijnen HR: New insights into the molecular mechanisms of the
VOUVLNFOJOHLBULBOLFLVBUBO*4* fibrinolytic system, J Thromb Haemost 7:4, 2009.
Schmaier AH: The elusive physiologic role of Factor XII, J Clin Invest
118:3006, 2008.
Smyth SS, Woulfe DS, Weitz JI, et al: 2008 Platelet Colloquium Participants.
PTtes ISI
G-protein-coupled receptors as signaling targets for antiplatelet ther-
INR =
PTnormal apy, Arterioscler Thromb Vasc Biol. 29:449, 2009.
Tapson VF: Acute pulmonary embolism, N Engl J Med 358:1037, 2008.
3FOUBOH OPSNBM */3 QBEB PSBOH ZBOH TFIBU BEBMBI Toh CH, Dennis M: Disseminated intravascular coagulation: old disease,
TBNQBJ 5JOHLBU */3 UJOHHJ NJTBMOZB BUBV
new hope, BMJ 327:974, 2003.
NFOVOKVLLBO SJTJLP UJOHHJ QFSEBSBIBO TFEBOHLBO */3 Tsai HM: Advances in the pathogenesis, diagnosis, and treatment of
thrombotic thrombocytopenic purpura, J Am Soc Nephrol 14:1072,
SFOEBI NJTBMOZB
NFOVOKVLLBO LFNVOHLJOBO VOUVL 2003.
UFSKBEJOZB HVNQBMBO EBSBI 1BTJFO EFOHBO UFSBQJ XBSGBSJO Tsai HM: Platelet activation and the formation of the platelet plug: defi-
CJBTBOZBNFNJMJLJ*/3 TBNQBJ ciency of ADAMTS13 causes thrombotic thrombocytopenic purpura,
5FT ZBOH TFSVQB EFOHBO QFOFOUVBO XBLUV QSPUSPNCJO Arterioscler Thromb Vasc Biol 23:388, 2003.
EBO */3 KVHB EJQBLBJ VOUVL NFOFOUVLBO KVNMBI GBLUPSGBLUPS VandenDriessche T, Collen D, Chuah MK: Gene therapy for the hemophilias,
J Thromb Haemost 1:1550, 2003.
QFNCFLVBOEBSBIMBJOOZB1BEBTFUJBQUFTJOJ LFMFCJIBOJPO
461
VII
II
UNIT
1FSOBQBTBO
37. Ventilasi Paru
38. Sirkulasi Paru, Edema Paru, Cairan
Pleura
39. Prinsip-Prinsip Fisika Pertukaran Gas;
Difusi Oksigen dan Karbon Dioksida
melalui Membran Pernapasan
40. Pengangkutan Oksigen dan Karbon
Dioksida di dalam Darah dan Cairan
Tubuh
41. Pengaturan Pernapasan
42. lnsufisiensi Pernapasan-Patofisiologi,
Diagnosis, Terapi Oksigen
BAB 37
UNIT VII
Ventilasi Paru
1FSOBQBTBO NFOZFEJBLBO PLTJHFO EJBOHLBU UVMBOH JHB MBOHTVOH NBKV TFIJOHHB TUFSOVN KVHB
CBHJ KBSJOHBO EBO NFNCVBOH LBS CFSHFSBL LF EFQBO NFOKBVIJ TQJOBM NFNCVBU KBSBL BOUFSPQPT
CPO EJPLTJEB &NQBU GVOHTJ VUBNB UFSJPS EBEB EJQFSCFTBS LJSBLJSB QFSTFO TFMBNB JOTQJSBTJ
QFSOBQBTBO BEBMBI
WFOUJMBTJ NBLTJNVN EJCBOEJOHLBO TFMBNB FLTQJSBTJ 0MFI LBSFOB JUV
QBSV ZBJUV NBTVL EBO LFMVBSOZB PUPUPUPU ZBOH NFOHBOHLBU SBOHLB EBEB EBQBU EJLMBTJGJLBTJLBO
VEBSBBOUBSBBUNPTGFSEBOBMWFPMJ TFCBHBJ PUPUPUPU JOTQJSBTJ EBO PUPUPUPU ZBOH NFOVSVOLBO
QBSV
EJGVTJ PLTJHFO EBO LBSCPO EJPLTJEB BOUBSB BMWFPMJ EBO SBOHLB EBEB EJLMBTJGJLBTJLBO TFCBHBJ PUPUPUPU FLTQJSBTJ 0UPU
EBSBI
QFOHBOHLVUBOPLTJHFOEBOLBSCPOEJPLTJEBEBMBNEBSBI QBMJOH QFOUJOH ZBOH NFOHBOHLBU SBOHLB JHB BEBMBI PUPU
EBO DBJSBO UVCVI LF EBO EBSJ TFM KBSJOHBO UVCVI EBO
JOUFSLPTUBMJT FLTUFSOB UFUBQJ PUPUPUPU MBJO ZBOH NFNCBOUVOZB
QFOHBUVSBO WFOUJMBTJ EBO TFHJ MBJO EBSJ QFSOBQBTBO #BC JOJ BEBMBI
TUFSOPLMFJEPNBTUPJEFVT NFOHBOHLBUTUFSOVNLFBUBT
NFNCBIBT NFOHFOBJ WFOUJMBTJ QBSV EBO MJNB CBC TFMBOKVUOZB
TFSSBUVT BOUFSJPS NFOHBOHLBU TFCBHJBO CFTBS JHB EBO

NFNCBIBT GVOHTJ QFSOBQBTBO MBJO TFSUB GJTJPMPHJ BCOPSNBMJUBT TLBMFOVT NFOHBOHLBUEVBJHBQFSUBNB
QFSOBQBTBOLIVTVT 0UPUPUPU ZBOH NFOBSJL SBOHLB JHB LF CBXBI TFMBNB FLTQJ
SBTJ BEBMBI
SFLUVT BCEPNJOJT ZBOH NFNQVOZBJ FGFL NFOB
SJL JHBJHB CBHJBO CBXBI LF BSBI CBXBI EFOHBO TBOHBU LVBU
Mekanika Ventilasi Paru EBO TFLBMJHVT CFSTBNB EFOHBO PUPUPUPU BCEPNFO MBJOOZB
NFOFLBO JTJ BCEPNFO LF BUBT LF BSBI EJBGSBHNB EBO

Otot yang Menimbulkan Pengembangan dan JOUFSLPTUBMJTJOUFSOVT
Pengempisan Paeu (BNCBS KVHB NFMVLJTLBO NFLBOJTNF LFSKB PUPU
1BSVQBSV EBQBU EJLFNCBOHLFNQJTLBO NFMBMVJ EVB DBSB
JOUFSLPTUBMJT FLTUFSOVT EBO JOUFSOVT VOUVL NFOJNCVMLBO
EFOHBO HFSBLBO OBJL UVSVOOZB EJBGSBHNB VOUVL NFNQFSCFTBS JOTQJSBTJ EBO FLTQJSBTJ 1BEB CBHJBO LJSJ TFMBNB FLTQJSBTJ
BUBVNFNQFSLFDJMSPOHHBEBEB EBO
EFOHBONFOHBOHLBUEBO UVMBOHUVMBOH JHB NFNCFOUVL TVEVU LF CBXBI EBO PUPU
NFOFLBO UVMBOH JHB VOUVL NFNQFSCFTBS BUBV NFNQFSLFDJM JOUFSLPTUBMJTFLTUFSOVTNFNBOKBOHLFEFQBOEBOLFCBXBI#JMB
EJBNFUFSBOUFSPQPTUFSJPSSPOHHBEBEB(BNCBSNFMVLJTLBO PUPUPUPU JOJ CFSLPOUSBLTJ PUPU UFSTFCVU NFOBSJL UVMBOH JHB
LFEVBNFUPEFJOJ CBHJBO BUBT LF EFQBO EBMBN IVCVOHBOOZB EFOHBO UVMBOH JHB
ZBOHMFCJICBXBI LFBEBBOJOJBLBONFOHIBTJMLBOEBZBVOHLJU
1FSOBQBTBOOPSNBMEBOUFOBOHEBQBUEJDBQBJEFOHBOIBNQJS QBEB UVMBOH JHB VOUVL NFOHBOHLBUOZB LF BUBT EFOHBO
TFNQVSOBNFMBMVJNFUPEFQFSUBNB ZBJUVNFMBMVJHFSBLBOEJBG EFNJLJBO NFOJNCVMLBO JOTQJSBTJ 0UPU JOUFSLPTUBMJT JOUFSOVT
SBHNB 4FMBNB JOTQJSBTJ LPOUSBLTJ EJBGSBHNB NFOBSJL QFSNV NFNJMJLJ GVOHTJ CFSMBXBOBO ZBOH CFSGVOHTJ TFCBHBJ PUPUPUPU
LBBO CBXBI QBSV LF BSBI CBXBI ,FNVEJBO TFMBNB FLTQJSBTJ FLTQJSBTJ LBSFOBPUPUPUPUJOJNFNCFOUVLTVEVUBOUBSBUVMBOH
EJBGSBHNB CFSFMBLTBTJ EBO TUGBU SFLPJM FMBTUJL QBSV FMBTUJD JHBEBMBNBSBIZBOHCFSMBXBOBOEBONFOHIBTJMLBOEBZBVOHLJU
SFDPJM
EJOEJOH EBEB EBO TUSVLUVS BCEPNFO BLBO NFOFLBO ZBOHCFSMBXBOBOQVMB
QBSVQBSV EBO NFOHFMVBSLBO VEBSB /BNVO TFMBNB CFSOBQBT
LVBU EBZB FMBTUJT UJEBL DVLVQ LVBU VOUVL NFOHIBTJMLBO
Tekanan yang Menyebabkan Pergerakan Udara ke Dalam
FLTQJSBTJ DFQBU ZBOH EJQFSMVLBO TFIJOHHB EJQFSMVLBO UFOBHB
dan Keluar Paru
FLTUSB ZBOH UFSVUBNB EJQFSPMFI EBSJ LPOUSBLTJ PUPUPUPU
1BSVQBSVNFSVQBLBOTUSVLUVSFMBTUJTZBOHBLBONFOHFNQJTTF
BCEPNFO ZBOHNFOEPSPOHJTJBCEPNFOLFBUBTNFMBXBOEBTBS
QFSUJ CBMPO EBO NFOHFMVBSLBO TFNVB VEBSBOZB NFMBMVJ USBLFB
EJBGSBHNB TFIJOHHBNFOHPNQSFTJQBSV
CJMBUJEBLBEBLFLVBUBOVOUVLNFNQFSUBIBOLBOQFSLFNCBOHBO
.FUPEF LFEVB VOUVL NFOHFNCBOHLBO QBSV BEBMBI EFOHBO OZB +VHB UJEBL UFSEBQBU QFMFLBUBO BOUBSB QBSVQBSV EBO EJO
NFOHBOHLBU SBOHLB JHB 1FOHFNCBOHBO QBSV JOJ EBQBU UFSKBEJ EJOHSBOHLBEBEB LFDVBMJEJCBHJBOIJMVNQBSVUFNQBUOZBEJUP
LBSFOB QBEB QPTJTJ JTUJSBIBU JHB NJSJOH LF CBXBI TFQFSUJ QBOH QBEB NFEJBTUJOVN CBHJBO UFOHBI SPOHHB EBEB #BILBO
UBNQBLQBEB(BNCBS EFOHBOEFNJLJBOTUFSOVNUVSVOLF QBSVQBSVTFCFUVMOZBNFOHBQVOHEBMBNSPOHHBUPSBLT EJLFMJ
CFMBLBOHLFBSBILPMVNOBWFSUFCSBMJT/BNVO CJMBSBOHLBJHB MJOHJPMFITVBUVMBQJTBOUJQJTDBJSBOQMFVSBZBOHNFOKBEJQMVNBT
465
Unit VII Pernapasan
CBHJ QFSHFSBLBO QBSV EJ EBMBN SPOHHB 4FMBOKVUOZB JTBQBO

UFSVTNFOFSVTDBJSBOZBOHCFSMFCJIBOLFEBMBNTBMVSBOMJNGBUJL
NFOKBHB BHBS UFSEBQBU TFEJLJU EBZB JTBQ BOUBSB QFSNVLBBO
WJTFSBM QMFVSB QBSV EBO QFSNVLBBO QBSJFUBM QMFVSB SPOHHB
UPSBLT0MFILBSFOBJUV LFEVBQBSVCFSBEBQBEBEJOEJOHUPSBLT
TFPMBIPMBITFQFSUJEJMFLBULBO IBOZBTBKBLFUJLBEBEBNFOHFN
CBOH EBO NFOHFNQJT NBLB QBSVQBSV EBQBU CFSHFTFS TFDBSB
CFCBTLBSFOBUFSMVNBTEFOHBOCBJL
Tekanan Pleura dan Perubahannya selama Pernapasan

5FLBOBO QMFVSB BEBMBI UFLBOBO DBJSBO EBMBN SVBOH TFNQJU
BOUBSBQMFVSBQBSVEBOQMFVSBEJOEJOHEBEB4FQFSUJZBOHUFMBI
EJTFCVULBO TFCFMVNOZB OPSNBMOZB UFSEBQBU TFEJLJU JTBQBO
ZBOHCFSBSUJTVBUVUFLBOBOOFHBUJGZBOHSJOHBO5FLBOBOQMFVSB
OPSNBM QBEB BXBM JOTQJSBTJ BEBMBI TFLJUBS DN ) ZBOH
NFSVQBLBOOJMBJJTBQZBOHEJCVUVILBOVOUVLNFNQFSUBIBOLBO
QBSVBHBSUFUBQUFSCVLBQBEBUJOHLBUBOJTUJSBIBUOZB,FNVEJBO
TFMBNB JOTQJSBTJ OPSNBM QFOHFNCBOHBO SBOHLB EBEB BLBO
NFOBSJL QBSV LF BSBI MVBS EFOHBO LFLVBUBO ZBOH MFCJI CFTBS
EBONFOZFCBCLBOUFLBOBONFOKBEJMFCJIOFHBUJG NFOKBEJSBUB
SBUBTFLJUBS DN)
)VCVOHBO BOUBSB UFLBOBO QMFVSB EBO QFSVCBIBO WPMVNF
QBSVJOJEJUVOKVLLBOQBEB(BNCBS ZBOHNFNQFSMJIBULBO
UFSKBEJOZB QFOJOHLBUBO OFHBUJWJUBT UFLBOBO QMFVSB EBSJ .
NFOKBEJ TFMBNB JOTQJSBTJ QBEB HBNCBS CBHJBO CBXBI EBO
QBEB HBNCBS CBHJBO BUBT UFSMJIBU QFOJOHLBUBO WPMVNF QBSV
TFCBOZBL - ,FNVEJBO TFMBNB FLTQJSBTJ QFSJTUJXB ZBOH EJ CBXBI UFLBOBO BUNPTGFS EJ CBXBI
,VSWB LFEVB ZBOH
UFSKBEJBEBMBILFCBMJLBOOZB EJCFSJMBCFMUFLBOBOBMWFPMVT
QBEB(BNCBSNFNQFSMJIBU
LBOCBIXBTFMBNBJOTQJSBTJOPSNBM UFLBOBOBMWFPMVTNFOVSVO
Tekanan Alveolus TBNQBJ TFLJUBS o DN ) 5FLBOBO ZBOH TFEJLJU OFHBUJG JOJ
5FLBOBO BMWFPMVT BEBMBI UFLBOBO VEBSB EJ CBHJBO EBMBN DVLVQ VOUVL NFOBSJL TFLJUBS MJUFS VEBSB LF EBMBN QBSV
BMWFPMJ QBSV ,FUJLB HMPUJT UFSCVLB EBO UJEBL BEB VEBSB ZBOH EBMBN XBLUV EFUJL TFCBHBJNBOB ZBOH EJQFSMVLBO VOUVL
NFOHBMJSLFEBMBNBUBVLFMVBSQBSV NBLBUFLBOBOQBEBTFNVB JOTQJSBTJOPSNBMEBOUFOBOH
CBHJBO KBMBO OBQBT TBNQBJ BMWFPMJ TFNVBOZB TBNB EFOHBO 4FMBNBFLTQJSBTJ UFSKBEJUFLBOBOZBOHCFSMBXBOBO5FLBOBO
UFLBOBO BUNPTGFS ZBOH EJBOHHBQ TFCBHBJ UFLBOBO BDVBO BMWFPMVTNFOJOHLBUTBNQBJTFLJUBSDN) EBOUFLBOBOJOJ
EBMBN KBMBO OBQBT ZBJUV UFLBOBO TFOUJNFUFS BJS "HBS VEBSB NFOEPSPOH -VEBSBJOTQJSBTJLFMVBSQBSVQBEBTBBUFLTQJSBTJ
NFOHBMJSLFEBMBNBMWFPMJIBSVTUVSVOTBNQBJNJMBJOZBTFEJLJU TFMBNBTBNQBJEFUJL
466
Bab 37 Ventilasi Paru
5FLBOBO 5SBOTQVMNPOBM "LIJSOZB QFSIBUJLBO QBEB

(BNCBS UFSEBQBU QFSCFEBBO BOUBSB UFLBOBO BMWFPMVT EBO
UFLBOBO QMFVSB 1FSCFEBBO JOJ EJTFCVU UFLBOBO USBOTQVMNPOBM
*OJ NFSVQBLBO QFSCFEBBO BOUBSB UFLBOBO BMWFPMJ EBO UFLBOBO
UNIT VII
QBEB QFSNVLBBO MVBS QBSV EBO JOJ BEBMBI OJMBJ EBZB FMBTUJT
EBMBN QBSV ZBOH DFOEFSVOH NFOHFNQJTLBO QBSV QBEB TFUJBQ
QFSOBQBTBO ZBOHEJTFCVUUFLBOBOSFLPJM
Komplians Paru
-VBTOZB QFOHFNCBOHBO QBSV VOUVL TFUJBQ VOJU QFOJOHLBUBO
UFLBOBO USBOTQVMNPOBM KJLB UFSEBQBU DVLVQ XBLUV VOUVL
NFODBQBJ LFTFJNCBOHBO
EJTFCVU LPNQMJBOT QBSV /JMBJ LPN
QMJBOT UPUBM EBSJ LFEVB QBSV QBEB PSBOH EFXBTB OPSNBM SBUB
SBUB TFLJUBS NM VEBSBDN ) UFLBOBO USBOTQVMNPOBM
"SUJOZB TFUJBQLBMJUFLBOBOUSBOTQVMNPOBMNFOJOHLBUTFCBOZBL
DN) NBLBTFUFMBIIJOHHBEFUJLWPMVNFQBSVBLBO
NFOHFNCBOHNM
%BZB FMBTUJT ZBOH EJTFCBCLBO PMFI UFHBOHBO QFSNVLBBO
%JBHSBN ,PNQMJBOT 1BSV (BNCBS BEBMBI EJBHSBN
TJGBUOZB KBVI MFCJI LPNQMFLT "SUJ QFOUJOH EBSJ UFHBOHBO
ZBOH NFOHIVCVOHLBO QFSVCBIBO WPMVNF QBSV EFOHBO QF
QFSNVLBBO EJQFSMJIBULBO QBEB (BNCBS ZBOH NFNCBO
SVCBIBOUFLBOBOUSBOTQVMNPOBM1FSIBUJLBOCBIXBIVCVOHBO
EJOHLBO LPNQMJBOT QBSV LFUJLB UFSJTJ PMFI VEBSB EBO LFUJLB
JOJCFSCFEBQBEBXBLUVJOTQJSBTJNBVQVOFLTQJSBTJ4FUJBQLVS
UFSJTJ PMFI MBSVUBO TBMJO ,FUJLB QBSV UFSJTJ PMFI VEBSB UFSEBQBU
WB EJSFLBN EFOHBO NFOHVCBI UFLBOBO USBOTQVMNPOBM EBMBN
QFSUFNVBOBOUBSBDBJSBOBMWFPMVTEFOHBOVEBSBEBMBNBMWFPMVT
UBIBQUBIBQ ZBOH TFNQJU EBO NFNVOHLJOLBO WPMVNF QBSV
1BEBLFBEBBOQBSVUFSJTJMBSVUBOTBMJO UJEBLUFSEBQBUQFSUFNVBO
VOUVL NFODBQBJ UJOHLBU ZBOH TUBCJM BOUBSB UBIBQUBIBQ ZBOH
VEBSBDBJSBOTFIJOHHB UJEBLBEBQFOHBSVIUFHBOHBOQFSNVLBBO
CFSVSVUBO UFSTFCVU ,FEVB LVSWB JOJ EJTFCVU LVSWB LPNQMJBOT
IBOZB EBZB FMBTUJT KBSJOHBO TBKB ZBOH CFLFSKB EBMBN QBSV ZBOH
JOTQJSBUPSJL EBO LVSWB LPNQMJBOT FLTQJSBUPSJL EBO TFMVSVI
UFSJTJMBSVUBOTBMJO
EJBHSBNEJTFCVUEJBHSBNLPNQMJBOTQBSV
$JSJ LIBT EJBHSBN LPNQMJBOT EJUFOUVLBO PMFI EBZB FMBTUJT 1FSIBUJLBO CBIXB UFLBOBO USBOTQMFVSB ZBOH EJCVUVILBO
QBSV%BZBFMBTUJTJOJEBQBUEJCBHJNFOKBEJEVBCBHJBO
EBZB VOUVL NFOHFNCBOHLBO QBSV ZBOH UFSJTJ VEBSB KVNMBIOZB
FMBTUJT KBSJOHBO QBSV JUV TFOEJSJ EBO
EBZB FMBTUJT ZBOH TFLJUBS UJHB LBMJ MFCJI CFTBS EBSJQBEB UFLBOBO ZBOH EJCVUVILBO
EJTFCBCLBO PMFI UFHBOHBO QFSNVLBBO DBJSBO ZBOH NFMBQJTJ VOUVLNFOHFNCBOHLBOQBSVZBOHUFSJTJMBSVUBOTBMJO+BEJ LJUB
EJOEJOHCBHJBOEBMBNBMWFPMJEBOSVBOHVEBSBQBSVMBJOOZB EBQBU NFOZJNQVMLBO CBIXB EBZB FMBTUJT KBSJOHBO ZBOH DFOEF
SVOHNFOZFCBCLBOQBSVZBOHUFSJTJVEBSBNFOKBEJLPMBQT IBOZB
%BZB FMBTUJT KBSJOHBO QBSV UFSVUBNB EJUFOUVLBO PMFI KBMJOBO
NFOVOKVLLBO TFLJUBS TFQFSUJHB EBSJ FMBTUJTJUBT QBSV UPUBM
TFSBCVU FMBTUJO EBO TFSBCVU LPMBHFO EJ BOUBSB QBSFOLJN QBSV
TFEBOHLBO EBZB UFHBOHBO QFSNVLBBO DBJSBOVEBSB NFOVOKVL
1BEB QBSV ZBOH NFOHFNQJT TFSBCVUTFSBCVU JOJ TFDBSB FMBTUJT
LBOTFLJUBSEVBQFSUJHBEBSJFMBTUJTJUBTQBSVUPUBM
CFSLPOUSBLTJ EBO NFOKBEJ LBLV LFNVEJBO LFUJLB QBSV NF
OHFNCBOH TFSBCVUTFSBCVU NFOKBEJ UFSFHBOH EBO UJEBL LBLV %BZB FMBTUJT UFHBOHBO QFSNVLBBO DBJSBO VEBSB KVHB TBOHBU
MBHJ EFOHBOEFNJLJBONFOKBEJMFCJIQBOKBOHEBONFOHFSBILBO NFOJOHLBU LFUJLB [BU ZBOH EJTFCVU TVSGBLUBO UJEBL UFSEBQBU
EBZBFMBTUJTZBOHMFCJILVBU EBMBN DBJSBO BMWFPMVT 0MFI LBSFOB JUV NBSJ LJUB CBIBT NOHF
OBJ TVSGBLUBO EBO IVCVOHBOOZB EFOHBO EBZB UFHBOHBO QFSNV
VLBBO
Surfaktan, Tegangan Permukaan, dan Kolapsnya Alveoli

1SJOTJQ 5FHBOHBO 1BSV ,FUJLB BJS NFNCFOUVL TVBUV
QFSNVLBBO EFOHBO VEBSB NBLB NPMFLVM BJS QBEB QFSNVLBBO
BJSUFSTFCVUNFNJMJLJEBZBUBSJLZBOHTBOHBULVBUTBUVTBNBMBJO
4FCBHBJ BLJCBUOZB QFSNVLBBO BJS TFMBMV CFSVTBIB VOUVL
CFSLPOUSBLTJ ,FBEBBO JOJMBI ZBOH NFOKBHB BHBS BJS EBQBU
NFOFUFT CFSTBNBTBNB BSUJOZB UFSEBQBU NFNCSBO LPOUSBLUJM
ZBOH SBQBU QBEB NPMFLVM BJS ZBOH NFOHFMJMJOHJ TFMVSVI
QFSNVLBBO UFUFTBOOZB 4FLBSBOH NBSJ LJUB CBMJLLBO QSJOTJQ
QSJOTJQJOJEBONFMJIBUBQBZBOHUFSKBEJQBEBQFSNVLBBOCBHJBO
EBMBN BMWFPMJ %J TJOJ QFSNVLBBO BJS KVHB CFSVTBIB VOUVL
CFSLPOUSBLTJ 6TBIB UFSTFCVU BLBO NFOEPSPOH VEBSB LF MVBS
EBSJ BMWFPMJ NFMBMVJ CSPOLJ EBO EBMBN NFMBLVLBO IBM JOJ KVHB
NFOZFCBCLBOBMWFPMJCFSVTBIBVOUVLLPMBQT&GFLBLIJSOZBBEB
467
Unit VII Pernapasan
BEBMBI NFOZFCBCLBO EBZB LPOUSBLTJ FMBTUJT EJ TFMVSVI QBSV LBSFOB JUV CBOZBL CBZJ QSFNBUVS IBOZB NFNJMJLJ TFEJLJU BUBV UJEBL
ZBOHEJTFCVUEBZBFMBTUJTUFHBOHBOQFSNVLBBO NFNJMJLJ TBNB TFLBMJ TVSGBLUBO EBMBN BMWFPMJOZB LFUJLB CBZJ UFSTFCVU
EJMBIJSLBO EBO QBSVOZB DFOEFSVOH VOUVL LPMBQT LBEBOHLBEBOH
4VSGBLUBO EBO &GFLOZB UFSIBEBQ 5FHBOHBO 1FSNVLBBO TFCFTBS FOBN IJOHHB EFMBQBO LBMJ EBSJQBEB PSBOH EFXBTB )BM JOJ
4VSGBLUBO NFSVQBLBO CBIBO BLUJG QFSNVLBBO EBMBN BJS ZBOH NFOZFCBCLBOLPOEJTJZBOHEJLFOBMEFOHBOTJOESPNEJTUSFTQFSOBQBTBO
CFSBSUJ CBIXB TVSGBLUBO TBOHBU NFOVSVOLBO UFHBOHBO QFSNV QBEBCBZJCBSVMBIJS,FBEBBOJOJCFSTJGBUGBUBMKJLBUJEBLEJPCBUJEFOHBO
LBBO BJS 4VSGBLUBO EJTFLSFTJLBO PMFI TFMTFM FQJUFM QFOZFLSFTJ DBSBDBSB ZBOH TFTVBJ UFSVUBNB EFOHBO NFNCFSJLBO QFSOBQBTBO
TVSGBLUBO LIVTVT ZBOH EJTFCVU TFM FQJUFM BMWFPMVT UJQF ** EBO UFLBOBOQPTJUJGTFDBSBUFSVTNFOFSVT
LJSBLJSBNFSVQBLBOQFSTFOEBSJTFMVSVIEBFSBIQFSNVLBBO
BMWFPMJ4FMTFMJOJCFSCFOUVLHSBOVMBS NFOHBOEVOHJOLMVTJMJQJE
Efek Rangka Toraks pada Kemampuan Pengembangan
ZBOHEJTFLSFTJEJTVSGBLUBOEBMBNBMWFPMJ paru
4VSGBLUBO NFSVQBLBO DBNQVSBO LPNQMFLT EBSJ CFCFSBQB 4FKBVI JOJ LJUB UFMBI NFNCBIBT NFOHFOBJ LFNBNQVBO QF
GPTGPMJQJE QSPUFJO EBO JPO ,PNQPOFO ZBOH QBMJOH QFOUJOH OHFNCBOHBO QBSV UBOQB NFNQFSIJUVOHLBO SBOHLB UPSBLT
BEBMBI GPTGPMJQJE EJQBMNJUPJMGPTGBUJEJMLPMJO BQPQSPUFJO TVSGBL 3BOHLB UPSBLT NFNJMJLJ LBSBLUFSJTUJL FMBTUJTJUBT EBO LFBQEBUBO
UBO EBO JPO LBMTJVN %JQBMNJUPJMGPTGBUJEJMLPMJO EBO CFCFSBQB OZBTFOEJSJ NJSJQEFOHBOZBOHUFSEBQBUQBEBQBSVCBILBOKJLB
GPTGPMJQJE ZBOH LVSBOH QFOUJOH MBJOOZB CFSUBOHHVOH KBXBC QBSV UJEBL UFSEBQBU EBMBN UPSBLT NBTJI UFUBQ EJQFSMVLBO
VOUVLNFOVSVOLBOUFHBOHBOQFSNVLBBO;BU[BUJOJNFOVSVO QFOHBSVIPUPUVOUVLNFOHFNCBOHLBOSBOHLBUPSBLT
LBO UFHBOHBO QFSNVLBBO EFOHBO UJEBL UFSMBSVU TFMVSVIOZB
EBMBN DBJSBO ZBOH NFMBQJTJ QFSNVLBBO BMWFPMJ 4FCBMJLOZB Komplians Toraks dan Paru Bersama-samar
TFCBHJBO NPMFLVM UFSMBSVU TFEBOHLBO TJTBOZB NFOZFCBS LF ,PNQMJBOT TFMVSVI TJTUFN QBSV QBSV EBO SBOHLB UPSBLT
TFMVSVI QFSNVLBBO BJS EBMBN BMWFPMJ 1FSNVLBBO JOJ NFNJMJLJ CFSTBNBTBNB
EBQBU EJIJUVOH LFUJLB NFOHFNCBOHLBO QBSV
CFTBS UFHBOHBO EBSJ TFQFSEVBCFMBT TBNQBJ TFUFOHBI KVNMBI TFTFPSBOH ZBOH UFMBI EJSFMBLTBTJLBO BUBV EJMFNBILBO TFQFOVI
UFHBOHBOQFSNVLBBOQBEBQFSNVLBBOBJSNVSOJ OZB 6OUVL NFMBLVLBO IBM JOJ VEBSB EJQBLTB NBTVL LF EBMBN
%BSJ TFHJ LVBOUJUBUJG UFHBOHBO QFSNVLBBO QBEB CFSCBHBJ QBSV TFEJLJU EFNJ TFEJLJU TFNFOUBSB EJMBLVLBO QFSFLBNBO
DBJSBO ZBOH CFSCFEB LVSBOH MFCJI BEBMBI TFCBHBJ CFSJLVU BJS UFLBOBO EBO WPMVNF QBSV 6OUVL NFOHFNCBOHLBO TFMVSVI
NVSOJ EZOFDN DBJSBO OPSNBM ZBOH NFMBQJTJ BMWFPMJ UFUBQJ TJTUFNQBSVJOJ EJCVUVILBOUFLBOBOIBNQJSEVBLBMJMFCJICFTBS
UBOQB TVSGBLUBO EZOFDN DBJSBO ZBOH NFMBQJTJ BMWFPMJ VOUVLNFOHFNCBOHLBOQBSVZBOHTBNBTFUFMBIEJLFMVBSLBOEBSJ
EFOHBO EJMJQVUJ PMFI TVSGBLUBO EBMBN KVNMBI OPSNBM BOUBSB SBOHLB UPSBLT 0MFI LBSFOB JUV LPNQMJBOT HBCVOHBO TJTUFN
TBNQBJEZOFDN QBSVUPSBLTIBNQJSTFQBSVIEBSJQBSVJUVTFOEJSJNJMJMJUFS
5FLBOBO EBMBN "MWFPMJ ZBOH 5FSTVNCBU "LJCBU WPMVNF QFS TFOUJNFUFS UFLBOBO BJS VOUVL TJTUFN HBCVOHBO
5FHBOHBO1FSNVLBBO +JLBBMJSBOVEBSBZBOHCFSBTBMEBSJBMWFPMJ EJCBOEJOHLBO EFOHBO NMDN VOUVL QBSV TBKB 4FMBOKVUOZB
QBSV EJIBNCBU NBLB UFHBOHBO QFSNVLBBO DFOEFSVOH NFOZFCBCLBO CJMB QBSV EJLFNCBOHLBO TBNQBJ WPMVNF ZBOH CFTBS BUBV
BMWFPMJ LPMBQT *OJ NFODJQUBLBO UFLBOBO QPTJUJG EBMBN BMWFPMJ ZBOH EJLPNQSFTJLBO NFOKBEJ WPMVNF ZBOH LFDJM NBLB LFUFSCBUBTBO
CFSVTBIB NFOEPSPOH VEBSB LFMVBS +VNMBI UFLBOBO EBMBN BMWFPMVT EBEB NFOKBEJ FLTUSFN CJMB NFOEFLBUJ CBUBTCBUBT JOJ NBLB
ZBOHUFSCFOUVLEFOHBODBSBJOJEBQBUEJIJUVOHEBSJSVNVTCFSJLVU LPNQMJBOT TJTUFN HBCVOHBO QBSVUPSBLT EBQBU NFOKBEJ LVSBOH
Tekanan = 2 × Tekanan surfaktan EBSJTFQFSMJNBEBSJLPNQMJBOTQBSVTFOEJSJ
Radius alveolus
"kerja" Pernapasan
6OUVLBMWFPMVTEFOHBOVLVSBOSBUBSBUBEBOEFOHBOSBEJVTTFLJUBS
NTFSUBUFSMBQJTJPMFITVSGBLUBOOPSNBM NBLBQFOHIJUVOHBOJOJ ,JUBUFMBINFOFLBOLBOCBIXBTFMBNBQFSOBQBTBOOPSNBMEBOUFOBOH
NFOKBEJ TFLJUBS DN UFLBOBO BJS NN )H
+JLB BMWFPMJ UFSMBQJTJ TFNVB LPOUSBLTJ PUPU QFSOBQBTBO UFSKBEJ TFMBNB JOTQJSBTJ FLTQJSBTJ
EFOHBO BJS NVSOJ UBOQB BEBOZB TVSGBLUBO QFSIJUVOHBO UFLBOBOOZB BEBMBI QSPTFT ZBOH IBNQJS TFMVSVIOZB QBTJG BLJCBU TJGBU SFLPJM FMBTUJT
QBSV FMBTUJDSFDPJM
EBOSBOHLBEBEB+BEJ QBEBLFBEBBOJTUJSBIBU PUPU
BLBONFOKBEJTFOUJNFUFSUFLBOBOBJS LBMJMFCJICFTBS+BEJ LJUB
EBQBU NFMJIBU CFUBQB QFOUJOHOZB TVSGBLUBO EBMBN NFOVSVOLBO PUPU QFSOBQBTBO CFLFSKB VOUVL NFOJNCVMLBO JOTQJSBTJ UBQJ UJEBL
UFHBOHBO QFSNVLBBO BMWFPMVT EBO PMFI LBSFOBOZB KVHB NFOVSVOLBO VOUVLNFOJNCVMLBOFLTQJSBTJ
VTBIB ZBOH EJQFSMVLBO PMFI PUPU QFSOBQBTBO VOUVL NFOHFNCBOHLBO ,FSKB JOTQJSBTJ EBQBU EJCBHJ NFOKBEJ UJHB CBHJBO
ZBOH EJCV
QBSV UVILBO VOUVL QFOHFNCBOHBO QBSV EBMBN NFMBXBO EBZB FMBTUJTJUBT
QBSVEBOEBEB ZBOHEJTFCVULFSKBLPNQMJBOTBUBVLFSKBFMBTUJT
ZBOH
1FOHBSVI 3BEJVT "MWFPMVT UFSIBEBQ 5FLBOBO "LJCBU
EJCVUVILBO VOUVL NFOHBUBTJ WJTLPTJUBT QBSV EBO TUSVLUVS EJOEJOH
5FHBOHBO 1FSNVLBBO 1FSIBUJLBO EBSJ SVNVT TFCFMVNOZB CBIXB EBEB ZBOH EJTFCVU LFSKB SFTJTUBOTJ KBSJOHBO EBO
ZBOH EJCVUVILBO
UFLBOBO ZBOH EJIBTJMLBO PMFI UFHBOHBO QFSNVLBBO EBMBN BMWFPMJ
VOUVL NFOHBUBTJ SFTJTUBOTJ KBMBO OBQBT UFSIBEBQ QFSHFSBLBO VEBSB LF
CFSCBOEJOH UFSCBMJL EFOHBO SBEJVT BMWFPMVT ZBOH CFSBSUJ CBIXB
EBMBNQBSV ZBOHEJTFCVULFSKBSFTJTUBOTJKBMBOOBQBT
TFNBLJO LFDJM BMWFPMVT NBLB TFNBLJO CFTBS UFLBOBO BMWFPMVT ZBOH
EJTFCBCLBO PMFI UFHBOHBO QFSNVLBBO +BEJ CJMB BMWFPMJ NFNJMJLJ &OFSHJ ZBOH %JCVUVILBO VOUVL 1FSOBQBTBO 4FMBNB 1FSOBQBTBO
SBEJVT TFUFOHBI EBSJ OPSNBM IBOZB EBO HN
NBLB CFTBS OPSNBM EBO UFOBOH IBOZB TBNQBJ QFSTFO EBSJ FOFSHJ UPUBM ZBOH
UFLBOBOOZB NFOKBEJ EVB LBMJ MJQBU EBSJ UFLBOBO ZBOH UFMBI UFSDBUBU EJLFMVBSLBO PMFI UVCVI EJQFSMVLBO VOUVL WFOUJMBTJ QBSV 5BQJ TFMBNB
TFCFMVNOZB)BMJOJTFDBSBLIVTVTNFNJMJLJBSUJQFOUJOHCBHJCBZJCBZJ LFSKB CFSBU KVNMBI FOFSHJ ZBOH EJCVUVILBO EBQBU NFOJOHLBU TBNQBJ
QSFNBUVS ZBOH LFDJM LBSFOB CBOZBL CBZJ UFSTFCVU ZBOH NFNJMJLJ LBMJ MJQBU UFSVUBNB KJLB PSBOH UFSTFCVU NFOHBMBNJ QFOJOHLBUBO
BMWFPMJ EFOHBO SBEJVT LVSBOH EBSJ TFQFSFNQBU SBEJVT BMWFPMJ PSBOH SFTJTUBOTJ KBMBO OBQBT BUBV QFOVSVOBO LPNQMJBOT QBSV 0MFI LBSFOB
EFXBTB 4FMBOKVUOZB TVSGBLUBO TFDBSB OPSNBM NVMBJ EJTFLSFTJLBO LF JUV TBMBI TBUV LFUFSCBUBTBO VUBNB QBEB JOUFOTJUBT LFSKB ZBOH EBQBU
EBMBNBMWFPMJBOUBSBCVMBOLFFOBNEBOLFUVKVILFIBNJMBOEBO QBEB EJMBLVLBO BEBMBI LFNBNQVBO PSBOH UFSTFCVU VOUVL NFOHIBTJMLBO
CFCFSBQBCBZJ CBILBOMFCJIEBSJJUV0MFI DVLVQFOFSHJPUPUVOUVLQSPTFTQFSOBQBTBO
468
Volume dan Kapasitas Paru Volume Paru

1BEB CBHJBO LJSJ (BNCBS EJUVMJTLBO FNQBU WPMVNF QBSV
Perekaman Perubahan Volume Paru—Spirometri CJMB TFNVBOZB EJKVNMBILBO TBNB EFOHBO WPMVNF NBLTJNBM
UNIT VII
QBSV ZBOH NFOHFNCBOH "SUJ EBSJ NBTJOHNBTJOH WPMVNF JOJ
7FOUJMBTJQBSVEBQBUEJQFMBKBSJEFOHBONFODBUBUWPMVNFVEBSB BEBMBITFCBHBJCFSJLVU
ZBOH NBTVL EBO LFMVBS QBSV TVBUV NFUPEF ZBOH EJTFCVU 7PMVNF UJEBM BEBMBI WPMVNF VEBSB ZBOH EJJOTQJSBTJ BUBV
TQJSPNFUSJ#FOUVLTQJSPNFUFSEBTBSZBOHLIBTEJMVLJTLBOQBEB
EJFLTQJSBTJ TFUJBQ LBMJ CFSOBQBT OPSNBM CFTBSOZB LJSBLJSB
(BNCBS4QJSPNFUFSJOJUFSEJSJBUBTTFCVBIESVNUFSCBMJL
NMQBEBMBLJMBLJEFXBTB
ZBOHEJUFNQBULBOEJBUBTCBLBJS EBOESVNUFSTFCVUEJJNCBOHJ
PMFI TVBUV CFCBO %BMBN ESVN UFSEBQBU HBT VOUVL CFSOBQBT 7PMVNF DBEBOHBO JOTQJSBTJ BEBMBI WPMVNF VEBSB FLTUSB
CJBTBOZB VEBSB BUBV PLTJHFO EBO TFCVBI QJQB ZBOH NFOHIV ZBOH EBQBU EJJOTQJSBTJ TFUFMBI EBO EJ BUBT WPMVNF UJEBM
CVOHLBONVMVUEFOHBOSVBOHHBT"QBCJMBTFTFPSBOHCFSOBQBT OPSNBM CJMB EJMBLVLBO JOTQJSBTJ LVBU CJBTBOZB NFODBQBJ
EBSJ EBO LF EBMBN SVBOH JOJ ESVN BLBO OBJL UVSVO EBO NM
UFSFLBNQBEBHVMVOHBOLFSUBTZBOHCFSQVUBS 7PMVNF DBEBOHBO FLTQJSBTJ BEBMBI WPMVNF VEBSB FLTUSB
NBLTJNBM ZBOH EBQBU EJFLTQJSBTJ NFMBMVJ FLTQJSBTJ LVBU
(BNCBSBEBMBITFCVBITQJSPHSBNZBOHNFOVOKVLLBO
QBEB BLIJS FLTQJSBTJ UJEBM OPSNBM KVNMBI OPSNBMOZB
QFSVCBIBO WPMVNF QBSV QBEB CFSCBHBJ LPOEJTJ QFSOBQBTBO
BEBMBITFLJUBSNM
6OUVL NFNVEBILBO QFOKFMBTBO NFOHFOBJ QFSJTUJXB WFOUJMBTJ
QBSV NBLB VEBSB EBMBN QBSV QBEB EJBHSBN EJCBHJ NFOKBEJ 7PMVNFSFTJEVZBJUVWPMVNFVEBSBZBOHNBTJIUFUBQCFSBEB
FNQBUWPMVNFEBOFNQBULBQBTJUBT ZBOHNFSVQBLBOSBUBSBUB EBMBN QBSV TFUFMBI FLTQJSBTJ QBMJOH LVBU WPMVNF JOJ
QBEBMBLJMBLJEFXBTBNVEB CFTBSOZBLJSBLJSBNM
6OUVL NFOHVSBJLBO QFSJTUJXBQFSJTUJXB EBMBN TJLMVT QBSV

LBEBOHLBEBOH QFSMV NFOZBUVLBO EVB BUBV MFCJI WPMVNF EJ
BUBT ,PNCJOBTJ TFQFSUJ JUV EJTFCVU LBQBTJUBT QBSV %J CBHJBO
LBOBO QBEB (BNCBS EJUVMJTLBO CFSCBHBJ LBQBTJUBT QBSV
Drum yang
mengapung ZBOHQFOUJOH ZBOHEBQBUEJVSBJLBOTFCBHBJCFSJLVU
1. ,BQBTJUBT JOTQJSBTJ TBNB EFOHBO WPMVNF UJEBM EJUBNCBI
Ruang
tempat
Drum pencatat WPMVNF DBEBOHBO JOTQJSBTJ *OJ BEBMBI KVNMBI VEBSB LJSB
oksigen LJSBNM
ZBOHEBQBUEJIJSVQPMFITFTFPSBOH EJNVMBJ
Pipa QBEB UJOHLBU FLTQJSBTJ OPSNBM EBO QFOHFNCBOHBO QBSV
Air penghubung
Beban mulut
TBNQBJKVNMBINBLTJNVN
pengimbang 2. ,BQBTJUBTSFTJEVGVOHTJPOBMTBNBEFOHBOWPMVNFDBEBOHBO
FLTQJSBTJEJUBNCBIWPMVNFSFTJEV*OJBEBMBIKVNMBIVEBSB
(BNCBS4QJSPNFUFS ZBOHUFSTJTBEBMBNQBSVQBEBBLIJSFLTQJSBTJOPSNBM LJSB
LJSBNM

3. ,BQBTJUBT WJUBM TBNB EFOHBO WPMVNF DBEBOHBO JOTQJSBTJ
EJUBNCBIWPMVNFUJEBMEBOWPMVNFDBEBOHBOFLTQJSBTJ*OJ
BEBMBI KVNMBI VEBSB NBLTJNVN ZBOH EBQBU EJLFMVBSLBO
TFTFPSBOH EBSJ QBSV TFUFMBI UFSMFCJI EBIVMV NFOHJTJ QBSV
TFDBSBNBLTJNVNEBOLFNVEJBONFOHFMVBSLBOTFCBOZBL
CBOZBLOZB LJSBLJSBNM

4. ,BQBTJUBTQBSVUPUBMBEBMBIWPMVNFNBLTJNVNZBOHEBQBU
NFOHFNCBOHLBO QBSV TFCFTBS NVOHLJO EFOHBO JOTQJSBTJ
TFLVBU NVOHLJO LJSBLJSB NM
KVNMBI JOJ TBNB
EFOHBOLBQBTJUBTWJUBMEJUBNCBIWPMVNFSFTJEV
7PMVNF EBO LBQBTJUBT TFMVSVI QBSV QBEB XBOJUB LJSBLJSB
TBNQBJ QFSTFO MFCJI LFDJM EBSJQBEB QSJB EBO MFCJI CFTBS MBHJ
QBEBPSBOHZBOHBUMFUJTEBOCFSUVCVICFTBSEBSJQBEBPSBOHZBOH
CFSUVCVILFDJMEBOBTUFOJT
4JOHLBUBOEBO-BNCBOHZBOH%JQBLBJQBEB1FOFMJUJBO
'VOHTJ1BSV
4QJSPNFUFS IBOZBMBI TBMBI TBUV DBSB QFOHVLVSBO ZBOH EJQBLBJ
TFIBSJIBSJ PMFI EPLUFS QBSV ,FCBOZBLBO DBSB QFOHVLVSBO JOJ
TBOHBUCFSHBOUVOHQBEBQFSIJUVOHBONBUFNBUJLB6OUVLNFOZF
469
Unit VII Pernapasan
EFSIBOBLBO QFSIJUVOHBO EBO QSFTFOUBTJ EBUB GVOHTJ QBSV JOJ VEBSB EBMBN WPMVNF SFTJEV QBSV UJEBL EBQBU EJFLTQJSBTJ LF
TFKVNMBITJOHLBUBOEBOTJNCPMUFMBIEJTUBOEBSEJTBTJLBO#FCFSB EBMBNTQJSPNFUFS EBOWPMVNFJOJLJSBLJSBNFSVQBLBOTFQBSVI
QBTJOHLBUBOEBSJTJNCPMZBOHQFOUJOHEJDBOUVNLBOQBEB5BCFM EBSJ LBQBTJUBT SFTJEV GVOHTJPOBM 6OUVL NFOHVLVS LBQBTJUBT
%FOHBO NFNBLBJ MBNCBOHMBNCBOH JOJ EJQFSMJIBULBO SFTJEV GVOHTJPOBM TQJSPNFUFS IBSVT EJHVOBLBO TFDBSB UJEBL
CFCFSBQBMBUJIBOBMKBCBSTFEFSIBOBZBOHNFOVOKVLLBOTFCBHJBO MBOHTVOH CJBTBOZBEFOHBONFOHHVOBLBONFUPEFQFOHFODFSBO
IVCVOHBO UJNCBM CBMJL BOUBSB WPMVNF EBO LBQBTJUBT QBSV IFMJVN TFCBHBJCFSJLVU
NBIBTJTXB EBQBU NFNJLJSLBO EBO NFNCVLUJLBO IVCVOHBO 4QJSPNFUFS ZBOH TVEBI EJLFUBIVJ WPMVNFOZB EJJTJ EFOHBO
UJNCBMCBMJLJOJ VEBSB CFSDBNQVS IFMJVN ZBOH LPOTFOUSBTJOZB UFMBI EJLFUBIVJ
4FCFMVN CFSOBQBT EBSJ TQJSPNFUFS TFTFPSBOH NFOHFMVBSLBO
7$*3775&37 OBQBT TFDBSB OPSNBM 1BEB BLIJS FLTQJSBTJ JOJ WPMVNF ZBOH
7$*$&37 UFSTJTBEBMBNQBSVTBNBEFOHBOLBQBTJUBTSFTJEVGVOHTJPOBM1BEB
5-$7$37 UJUJL JOJ PSBOH TFHFSB NVMBJ CFSOBQBT EBSJ TQJSPNFUFS EBO HBT
EBSJTQJSPNFUFSNFOKBEJCFSDBNQVSEFOHBOHBTQBSV"LJCBUOZB
5-$*$'3$
IFMJVN EJFODFSLBO PMFI HBT LBQBTJUBT SFTJEV GVOHTJPOBM EBO
'3$&3737 WPMVNF LBQBTJUBT SFTJEV GVOHTJPOBM EBQBU EJIJUVOH EBSJ EFSBKBU
QFOHFODFSBOIFMJVN EFOHBONFOHHVOBLBOSVNVTCFSJLVUJOJ
.FOFOUVLBO,BQBTJUBT3FTJEV'VOHTJPOBM 7PMVNF
3FTJEV EBO,BQBTJUBT1BSV5PUBM.FUPEF
1FOHFODFSBO %JMVTJ
)FMJVN Ci
FRC = Ê He −1ˆ ViSpir
Ë CfHe ¯
,BQBTJUBT SFTJEV GVOHTJPOBM '3$
ZBJUV WPMVNF VEBSB ZBOH
UFUBQ CFSBEB EBMBN QBSV QBEB BLIJS FLTQJSBTJ OPSNBM QFOUJOH
VOUVL GVOHTJ QBSV 0MFI LBSFOB OJMBJOZB CFSVCBI OZBUB QBEB EFOHBO '3$ BEBMBI LBQBTJUBT SFTJEV GVOHTJPOBM $J)F BEBMBI
CFCFSBQBKFOJTQFOZBLJUQBSV NBLBLJUBTFSJOHLBMJQFSMVVOUVL LPOTFOUSBTJ BXBM IFMJVN EBMBN TQJSPNFUFS $G)F BEBMBI
NFOHVLVS LBQBTJUBT JOJ 4QJSPNFUFS UJEBL EBQBU EJHVOBLBO LPOTFOUSBTJ BLIJS IFMJVN EBMBN TQJSPNFUFS 7JTQJS BEBMBI
VOUVLNFOHVLVSMBOHTVOHLBQBTJUBTSFTJEVGVOHTJPOBMLBSFOB WPMVNFBXBMTQJSPNFUFS
VT 7PMVNFUJEBM PB 5FLBOBOBUNPTGFS
FRC ,BQBTJUBTSFTJEVGVOHTJPOBM Palv 5FLBOBOBMWFPMVT
ERV 7PMVNFDBEBOHBOFLTQJSBTJ Ppl 5FLBOBOQMFVSB
RV 7PMVNFSFTJEV PO2 5FLBOBOQBSTJBMPLTJHFO
IC ,BQBTJUBTJOTQJSBTJ PCO2 5FLBOBOQBSTJBMLBSCPOEJPLTJEB
IRV 7PMVNFDBEBOHBOJOTQJSBTJ PN2 5FLBOBOQBSTJBMOJUSPHFO
TLC ,BQBTJUBTQBSVUPUBM PaO2 5FLBOBOQBSTJBMPLTJHFOEBMBNEBSBIBSUFSJ
VC ,BQBTJUBTWJUBM PaCO2 5FLBOBOQBSTJBMLBSCPOEJPLTJEBEBMBNEBSBIBSUFSJ
Raw 3FTJTUBOTJKBMBOOBQBTUFSIBEBQQFSHFSBLBOVEBSB PAO2 5FLBOBOQBSTJBMPLTJHFOEBMBNHBTBMWFPMVT
LFEBMBNQBSV
C ,PNQMJBOT PACO2 5FLBOBOQBSTJBMLBSCPOEJPLTJEBEBMBNHBTBMWFPMVT
VD 7PMVNFSVBOHSVHJ PAH2o 5FLBOBOQBSTJBMBJSEBMBNHBTBMWFPMVT
VA 7PMVNFHBTBMWFPMVT R 3BTJPQFSVCBIBOQFSOBQBTBO
.
V̇I 7PMVNFWFOUJMBTJJOTQJSBTJUJBQNFOJU Q $VSBIKBOUVOH
V̇E 7PMVNFWFOUJMBTJFLTQJSBTJUJBQNFOJU
V̇s "MJSBOQJOUBT
V̇A 7FOUJUBTJBMWFPMVTUJBQNFOJU CaO2 ,POTFOUSBTJPLTJHFOEBMBNEBSBIBSUFSJ
V̇O2 ,FDFQBUBOQFOHBNCJMBOPLTJHFOUJBQNFOJU Cv-o 2
,POTFOUSBTJPLTJHFOEBMBNDBNQVSBOEBSBIWFOB
V̇CO2 KVNMBILBSCPOEJPLTJEBZBOHEJCVBOHUJBQNFOJU SO2 1FSTFOUBTFTBUVSBTJIFNPHMPCJOEFOHBOPLTJHFO
V̇CO ,FDFQBUBOQFOHBNCJMBOLBSCPONPOPLTJEBUJBQ SaO2 1FSTFOUBTFTBUVSBTJIFNPHMPCJOEFOHBOPLTJHFO
NFOJU EBMBNEBSBIBSUFSJ
DLO2 ,BQBTJUBTEJGVTJQBSVVOUVLPLTJHFO
DLCO ,BQBTJUBTEJGVTJQBSVVOUVLLBSCPONPOPLTJEB
470
#JMB '3$ UFMBI EJUFUBQLBO WPMVNF SFTJEV 37

EBQBU
EJUFOUVLBOEFOHBONFOHVSBOHJ'3$EFOHBOWPMVNFDBEBOHBO
FLTQJSBTJ &37
ZBOHEJVLVSEFOHBOTQJSPNFUSJ,BQBTJUBTQBSV e
UPUBM KVHB EBQBU EJUFOUVLBO EFOHBO NFOBNCBILBO LBQBTJUBT
UNIT VII
JOTQJSBTJ *$
EFOHBO'3$:BJUV
RV = FRC - ERV
EBO
TLC = FRC + IC
Volume Pernapasan Semenit Sama dengan

Frekuensi Pernapasan Dikali Volume Tidal
7PMVNFQFSOBQBTBOTFNFOJUBEBMBIKVNMBIUPUBMVEBSBCBSVZBOH
NBTVL LF EBMBN TBMVSBO QFSOBQBTBO UJBQ NFOJU WPMVNF
QFSOBQBTBO TFNFOJU JOJ TBNB EFOHBO WPMVNF UJEBM EJLBMJLBO CFSDBNQVS EFOHBO VEBSB BMWFPMVT UFUBQJ UJEBL TFMVSVIOZB
EFOHBO GSFLVFOTJQFSOBQBTBO QFS NFOJU 7PMVNF UJEBM OPSNBM NFOHHBOUJLBO VEBSB JOJ ,FNVEJBO PSBOH UFSTFCVU NFMBLVLBO
LJSBLJSBNMEBOGSFLVFOTJQFSOBQBTBOOPSNBMLJSBLJSBY FLTQJSBTJ NFMBMVJ TFCVBI BMBU QFSFLBN OJUSPHFO DFQBU ZBOH
NFOJU 0MFI LBSFOB JUV SBUBSBUB WPMVNF QFSOBQBTBO TFNFOJU NFOHIBTJMLBO JOJ TFQFOVIOZB UFMBI EJHBOUJLBO PMFI PLTJHFO 0MFI
TFLJUBS - * NFOJU 4FTFPSBOH EBQBU IJEVQ VOUVL XBLUV ZBOH LBSFOB JUV QBEB CBHJBO BXBM QFSFLBNBO IBOZB PLTJHFO ZBOH
TJOHLBUEFOHBOWPMVNFQFSOBQBTBOTFNFOJUTFSFOEBI -NFOJU UFSFLBN TFEBOHLBOLPOTFOUSBTJOJUSPHFOOPM,FNVEJBO CJMBVEBSB
EBOEFOHBOGSFLVFOTJQFSOBQBTBOTBNQBJYNFOJU BMWFPMVT NVMBJ NFODBQBJ BMBU QFSFLBN OJUSPHFO LPOTFOUSBTJ
'SFLVFOTJ QFSOBQBTBO LBEBOHLBEBOH NFOJOHLBU TBNQBJ OJUSPHFO NFOJOHLBU TFDBSB DFQBU LBSFOB VEBSB BMWFPMVT ZBOH
NFOHBOEVOH TFKVNMBI CFTBS OJUSPHFO NVMBJ CFSDBNQVS EFOHBO
YNFOJU EBO WPMVNF UJEBM EBQBU NFOKBEJ TBNB CFTBS
VEBSB SVBOH SVHJ 4FUFMBI VEBSB ZBOH UFSTJTB EJFLTQJSBTJLBO NBLB
EFOHBO LBQBTJUBT WJUBM LJSBLJSB NM QBEB MBLJMBLJ EFXBTB TFMVSVI VEBSB SVBOH SVHJ UFMBI EJLFMVBSLBO EBSJ KBMBO OBQBT EBO
NVEB ,FBEBBO JOJ EBQBU NFOJNCVMLBO WPMVNF QFSOBQBTBO IBOZB VEBSB BMWFPMVT TBKB ZBOH UFSTJTB ,POTFOUSBTJ OJUSPHFO ZBOH
TFNFOJU MFCJI EBSJ -NFOJU BUBV MFCJI EBSJ LBMJ OPSNBM UFSFLBN NFODBQBJ OJMBJ UFUBQ ZBOH TBNB EFOHBO LPOTFOUSBTJOZB
,FCBOZBLBO PSBOH UJEBL EBQBU NFNQFSUBIBOLBO MFCJI EBSJ EBMBN BMWFPMJ TFQFSUJ ZBOH UBNQBL QBEB TFCFMBI LBOBO HBNCBS
TFUFOHBITBNQBJEVBQFSUJHBKVNMBIJOJTFMBNBMFCJIEBSJNFOJU %FOHBO TFEJLJU QFNJLJSBO NBIBTJTXB EBQBU NFMJIBU CBIXB BSFB
BCVBCV HFMBQ NFOHHBNCBSLBO VEBSB ZBOH UJEBL NFOHBOEVOH
OJUSPHFOEJEBMBNOZBBSFBJOJNFSVQBLBOWPMVNFVEBSBSVBOHSVHJ
Ventilasi Alveolus 6OUVLQFSIJUVOHBOZBOHMFCJIUFQBU NBLBSVNVTCFSJLVUJOJEBQBU
EJHVOBLBO
)BM ZBOH QBMJOH QFOUJOH EBSJ WFOUJMBTJ QBSV BEBMBI QFSCBSVBO
VEBSB TFDBSB UFSVTNFOFSVT EBMBN BSFB QFSUVLBSBO HBT EJ QBSV "SFBBCVBCV × VE
UFNQBUVEBSBEBOEBSBIQBSVTBMJOHCFSEFLBUBO"SFBJOJNFMJQV VD =
UJ BMWFPMJ LBOUPOH BMWFPMVT EVLUVT BMWFPMBSJT EBO CSPOLJPMVT "SFBBCVBCVNVEB+ "SFBBCVBCVHFMBQ
SFTQJSBUPSJVT ,FDFQBUBO VEBSB CBSV ZBOH NBTVL QBEB BSFB JOJ EFOHBO7%BEBMBIVEBSBSVBOHSVHJ 7&BEBMBIWPMVNFVEBSBFLT
EJTFCVUWFOUJMBTJBMWFPMVT QJSBTJUPUBM
4FCBHBJ DPOUPI NBSJ LJUB BTVNTJLBO CBIXB BSFB BCVBCV QBEB
HBNCBS BEBMBI DN BSFB BCVBCV HFMBQ BEBMBI DN EBO
3VBOH3VHJEBO1FOHBSVIOZBQBEB7FOUJMBTJ"MWFPMVT WPMVNFFLTQJSBTJUPUBMBEBMBINM3VBOHSVHJBLBONFOKBEJ
4FCBHJBOVEBSBZBOHEJIJSVQPMFITFTFPSBOHUJEBLQFSOBITBNQBJ
QBEBEBFSBIQFSUVLBSBOHBT UFUBQJIBOZBNFOHJTJTBMVSBOOBQBT 30
ZBOH UJEBL NFOHBMBNJ QFSUVLBSBO HBT TFQFSUJ QBEB IJEVOH × 500 = 150 ml
30 + 70
GBSJOH EBO USBLFB 6EBSB JOJ EJTFCVU VEBSB SVBOH SVHJ TFCBC
UJEBLCFSHVOBVOUVLQFSUVLBSBOHBT 7PMVNF3VBOH3VHJ/PSNBM7PMVNFSVBOHSVHJOPSNBMQBEB
1BEB XBLUV FLTQJSBTJ ZBOH QFSUBNB LBMJ EJLFMVBSLBO BEBMBI MBLJMBLJEFXBTBNVEBLJSBLJSBNM/JMBJJOJNFOJOHLBUEFOHBO
VEBSBEBMBNSVBOHSVHJ TFCFMVNVEBSBBMWFPMJTBNQBJLFVEBSB CFSUBNCBIOZBVTJB
3VBOH 3VHJ "OBUPNJT WT 3VBOH 3VHJ 'JTJPMPHJT .FUPEF
MVBS 0MFI LBSFOB JUV SVBOH SVHJ NFSVQBLBO LFSVHJBO VOUVL
QFOHVLVSBO SVBOH SVHJ ZBOH CBSV TBKB EJKFMBTLBO NFOHVLVS
QFOHFMVBSBOHBTFLTQJSBTJEBOQBSV WPMVNFTFMVSVISVBOHTJTUFNQFSOBQBTBOTFMBJOBMWFPMJEBOEBFSBI
1FOHVLVSBO7PMVNF3VBOH3VHJ.FUPEFTFEFSIBOBVOUVL QFSUVLBSBOHBTMBJOOZBZBOHCFSLBJUBOFSBUSVBOHJOJEJTFCVUSVBOH
NFOHVLVSWPMVNFSVBOHSVHJEJMVLJTLBOPMFIHSBGJLQBEB(BNCBS SVHJ BOBUPNJT ,BEBOHLBEBOH TFCBHJBO BMWFPMJ TFOEJSJ UJEBL
1BEB QFOHVLVSBO JOJ PSBOH ZBOH EJVLVS TFLPOZPOHLPOZPOH CFSGVOHTJ BUBV IBOZB TFCBHJBO CFSGVOHTJ LBSFOB UJEBL BEBOZB BUBV
NFOHBNCJMPLTJHFOEFOHBOOBQBTEBMBN%FOHBODBSBJOJ TFNVBSVBOH CVSVLOZBBMJSBOEBSBIZBOHNFMFXBUJLBQJMFSQBSVZBOHCFSEFLBUBO
SVHJBLBOEJJTJEFOHBOPLTJHFONVSOJ4FCBHJBOPLTJHFOKVHB 0MFILBSFOBJUV EBSJTFHJGVOHTJPOBM BMWFPMJJOJIBSVTKVHBEJBOHHBQ
471
Unit VII Pernapasan
TFCBHBJ SVBOH SVHJ #JMB SVBOH SVHJ BMWFPMVT EJTFSUBLBO EBMBN HBT QBEB CBCCBC TJTUFN QFSOBQBTBO CFSJLVUOZB NFOFLBOLBO
QFOHVLVSBO SVBOH SVHJ UPUBM JOJ EJTFCVU SVBOH SVHJ GJTJPHJT UFOUBOHWFOUJMBTJBMWFPMVT
CFSMBXBOBO EFOHBO SVBOH SVHJ BOBUPNJL 1BEB PSBOH OPSNBM
SVBOH SVHJ BOBUPNJT EBO SVBOH SVHJ GJTJPMPHJT IBNQJS TBNB TFCBC
QBEBQBSVOPSNBMTFNVBBMWFPMJCFSGVOHTJ UFUBQJQBEBPSBOHZBOH Fungsi Saluran Pernapasan
BMWFPMJOZB IBOZB CFSGVOHTJ TFCBHJBO BUBV UJEBL CFSGVOHTJ TBNB
TFLBMJ EJ TFCBHJBO QBSV SVBOH SVHJ GJTJPMPHJTOZB EBQBU NFODBQBJ Trakea, Bronkus, dan Bronkiolus
TFQVMVILBMJWPMVNFSVBOHSVHJBOBUPNJT BUBVTFCFTBSTBNQBJ
(BNCBS NFMVLJTLBO TJTUFN QFSOBQBTBO UFSVUBNB TBMVSBO
- .BTBMBI JOJ BLBO EJCBIBT MFCJI MBOKVU QBEB #BC EBMBN
OBQBT 6EBSB EJEJTUSJCVTJLBO LF EBMBN QBSV NFMBMVJ USBLFB
IVCVOHBOOZBEFOHBOQFSUVLBSBOHBTEBMBNQBSVEBOQBEB#BC
CSPOLVT EBOCSPOLJPMVT.
EBMBNIVCVOHBOOZBEFOHBOQFOZBLJUQBSVUFSUFOUV 4BMBI TBUV UBOUBOHBO UFSQFOUJOH QBEB TFMVSVI CBHJBO TBMVSBO
QFSOBQBTBOBEBMBINFOKBHBTBMVSBOUFUBQUFSCVLBBHBSVEBSBEBQBU
LFMVBSEBONBTVLBMWFPMJEFOHBONVEBI6OUVLNFNQFSUBIBOLBO
Kecepatan Ventilasi Alveolus USBLFB BHBS UJEBL LPMBQT UFSEBQBU DJODJO LBSUJMBHP NVMUJQFM ZBOH
7FOUJMBTJ BMWFPMVT TFUJBQ NFOJU BEBMBI WPMVNF UPUBM VEBSB CBSV NFOHFMJMJOHJ USBLFB QBEB LJSBLJSB MJNB QFSFOBN QBOKBOH USBLFB
1BEB EJOEJOH CSPOLVT UFSEBQBU MFNQFOH LBSUJMBHP ZBOH LFDJM EBO
ZBOHNBTVLLFEBMBNBMWFPMJEBOEBFSBIQFSUVLBSBOHBTZBOHCFS
NFMFOHLVOH ZBOH NFNQFSUBIBOLBO SJHJEJUBT OBNVO UFUBQ
EFLBUBOMBJOOZBTFUJBQNFOJU*OJTBNBEFOHBOGSFLVFOTJOBQBTEJ NFNVOHLJOLBO QFSHFSBLBO ZBOH DVLVQ BHBS QBSV EBQBU
LBMJLBO EFOHBO KVNMBI VEBSB CBSV ZBOH NFNBTVLJ BMWFPMJ EBO NFOHFNCBOH EBO NFOHFNQJT ,BSUJMBHP JOJ TFDBSB QSPHSFTJG
EBFSBI QFSUVLBSBO HBT ZBOH CFSEFLBUBO MBJOOZB TFUJBQ LBMJ NFOKBEJ TFNBLJO LFDJM QBEB HFOFSBTJ BLIJS CSPOLVT EBO UJEBL
CFSOBQBT EJKVNQBJ MBHJ EBMBN CSPOLJPMVT ZBOH CJBTBOZB NFNJMJLJ EJBNFUFS
. LVSBOH EBSJ NN #SPOLJVMVT EJDFHBI BHBS UJEBL LPMBQT CVLBO
VA = Frek ¥ (VT - VD)
NFMBMVJ SJHJEJUBT EJOEJOHOZB /BNVO CSPOLJPMVT EJMFCBSLBO PMFI
EFOHBO 7" BEBMBI WPMVNF WFOUJMBTJ BMWFPMVT QFS NFOJU 'SFL UFLBOBO USBOTQVMNPOBM ZBOH TBNB ZBOH NFOHFNCBOHLBO BMWFPMJ
BEBMBIGSFLVFOTJQFSOBQBTBOQFSNFOJU 75BEBMBIWPMVNFUJEBM %FOHBO EFNJLJBO CJMB BMWFPMJ NFMFCBS CSPOLJPMVT KVHB NFMFCBS
EBO7%BEBMBIWPMVNFSVBOHSVHJGJTJPMPHJT UFUBQJUJEBLTFMFCBSBMWFPMJ
+BEJ EFOHBOWPMVNFUJEBMOPSNBMTFCFTBSNM SVBOHSVHJ %JOEJOH .VTLVMBS QBEB #SPOLVT EBO #SPOLJPMVT TFSUB
OPSNBM NM EBO GSFLVFOTJ QFSOBQBTBO LBMJ QFS NFOJU 1FOHBUVSBOOZB %J TFNVB CBHJBO USBLFB EBO CSPOLVT ZBOH UJEBL
WFOUJMBTJBMWFPMVTTBNBEFOHBOY
BUBVNM UFSEBQBU UVMBOH SBXBO LBSUJMBHP
EJOEJOHOZB UFSVUBNB UFSCFOUVL
NFOJU PMFI PUPU QPMPT %JOEJOH CSPOLJPMVT KVHB IBNQJS TFMVSVIOZB
NFSVQBLBOPUPUQPMPT LFDVBMJCSPOLJPMVTUFSNJOBMJT ZBOHEJTFCVU
7FOUJMBTJBMWFPMVTBEBMBITBMBITBUVGBLUPSQFOUJOHZBOHNF CSPOLJPMVT SFTQJSBUPSJVT ZBOH UFSVUBNB UFSEJSJ BUBT FQJUFM QBSV
OFOUVLBOLPOTFOUSBTJPLTJHFOEBOLBSCPOEJPLTJEBEBMBNBMWF KBSJOHBOGJCSPTBEBOCFCFSBQBTFSBCVUPUPUQPMPT#BOZBLQFOZBLJU
PMJ0MFILBSFOBJUV IBNQJSTFNVBVSBJBONFOHFOBJQFSUVLBSBO PCTUSVLTJQBSVEJTFCBCLBOPMFIQFOZFNQJUBOCSPOLVTZBOHMFCJI
472
LFDJM EBO CSPOLJPMVT ZBOH MFCJI CFTBS TFSJOH LBMJ LBSFOB LPOUSBLTJ Mukus yang Melapisi Saluran Pernapasan, dan Kerja Silia untuk
ZBOHCFSMFCJIBOEBSJPUPUQPMPTJUVTFOEJSJ Membersihkan Saluran Napas
3FTJTUBOTJ UFSIBEBQ "MJSBO 6EBSB EBMBN $BCBOH #SPOLVT 4FMVSVI TBMVSBO OBQBT EBSJ IJEVOH TBNQBJ CSPOLJPMVT UFSNJOBMJT
1BEB LFBEBBO QFSOBQBTBO OPSNBM VEBSB EBQBU EFOHBO TBOHBU EJQFSUBIBOLBOBHBSUFUBQMFNCBQPMFIMBQJTBONVLVTZBOHNFMBQJTJ
UNIT VII
NVEBINFOHBMJSNFMBMVJKBMBOQFSOBQBTBO TFIJOHHBEFOHBOHSBEJFO TFMVSVIQFSNVLBBO.VLVTJOJEJTFLSFTJLBOTFCBHJBOPMFITFMHPCMFU
UFLBOBO EBSJ BMWFPMJ LF BUNPTGFS LVSBOH EBSJ DN ) TBKB TVEBI NVLPTB EBMBN MBQJTBO FQJUFM TBMVSBO OBQBT EBO TFCBHJBO MBHJ PMFI
DVLVQVOUVLNFOZFCBCLBOTFKVNMBIBMJSBOVEBSBHVOBQFSOBQBTBO LFMFOKBS TVCNVLPTB ZBOH LFDJM 4FMBJO VOUVL NFNQFSUBIBOLBO
UFOBOH +VNMBI UBIBOBO UFSCFTBS VOUVL BMJSBO VEBSB UJEBL UFSKBEJ LFMFNCBQBO QFSNVLBBO NVLVT KVHB NFOBOHLBQ QBSUJLFMQBSUJLFM
QBEBKBMBOVEBSBZBOHLFDJMQBEBCSPOLJPMVTUFSNJOBMJT UFUBQJQBEB LFDJM EBSJ VEBSB JOTQJSBTJ EBO NFOBIBOOZB BHBS UJEBL TBNQBJ LF
CFCFSBQBCSPOLJPMVTEBOCSPOLVTZBOHMFCJICFTBSEJEFLBUUSBLFB BMWFPMJ .VLVT JUV TFOEJSJ EJLFMVBSLBO EBSJ TBMVSBO OBQBT EFOHBO
1FOZFCBC UBIBOBO ZBOH CFTBS JOJ BEBMBI LBSFOB KVNMBI CSPOLVT DBSBTFCBHBJCFSJLVU
CFTBSSFMBUJGTFEJLJUEJCBOEJOHLBOEFOHBOTFLJUBSCSPOLJPMVT 4FMVSVI QFSNVLBBO TBMVSBO OBQBT CBJL EBMBN IJEVOH NBVQVO
UFSNJOBMJT QBSBMFM ZBOH TFUJBQ CSPOLJPMVTOZB IBOZB EJMBMVJ PMFI EBMBN TBMVSBO OBQBT CBHJBO CBXBI TBNQBJ TFKBVI CSPOLJPMVT
TFEJLJUVEBSB UFSNJOBMJT EJMBQJTJ PMFI FQJUFM CFSTJMJB EFOHBO LJSBLJSB TJMJB
QBEB TFUJBQ TFM FQJUFM 4JMJB JOJ UFSVTNFOFSVT NFOEPSPOH EFOHBO
/BNVOEBMBNLFBEBBOTBLJU CSPOLJPMVTZBOHMFCJILFDJMTFSJOH LFDFQBUBO YEFUJL EFOHBO NFLBOJTNF ZBOH UFMBI EJKFMBTLBO
LBMJ NFNQVOZBJ QFSBO ZBOH MFCJI CFTBS EBMBN NFOFOUVLBO QBEB#BC EBOBSBILFLVBUBONFOEBZVOHOZBTFMBMVNFOHBSBILF
SFTJTUBOTJ BMJSBO VEBSB LBSFOB VLVSBOOZB ZBOH LFDJM EBO LBSFOB GBSJOH%FOHBOEFNJLJBO TJMJBEBMBNQBSVNFOEPSPOHLFBSBIBUBT
CSPOLJPMVT NVEBI UFSTVNCBU BLJCBU
LPOUSBLTJ PUPU QBEB TFEBOHLBOTJMJBEBMBNIJEVOHNFOEPSPOHLFBSBICBXBI%PSPOHBO
EJOEJOHOZB
UFSKBEJOZBFEFNBQBEBEJOEJOHCSPOLJPMVT BUBV
ZBOHUFSVTNFOFSVTJOJNFOZFCBCLBOTFMVCVOHNVLVTJOJNFOHBMJS
QFOHVNQVMBONVLVTEJEBMBNMVNFOCSPOLJPMVT EFOHBO MBNCBU QBEB LFDFQBUBO CFCFSBQB NJMJNFUFS QFS NFOJU LF
1FOHBUVSBO0UPU0UPU#SPOLJPMVTPMFI4JTUFN4BSBGEBO4JT BSBIGBSJOH,FNVEJBONVLVTEBOQBSUJLFMQBSUJLFMZBOHEJKFSBUOZB
UFN4FUFNQBU%JUBUBTJ4JNQBUJTQBEB#SPOLJPMVT1FOHBUVSBO EJUFMBOBUBVEJCBUVLLBOLFMVBS
MBOHTVOH CSPOLJPMVT PMFI TFSBCVU TBSBG TJNQBUJT TJGBUOZB SFMBUJG
MFNBI LBSFOB CFCFSBQB TFSBCVU JOJ NFOFNCVT NBTVL LF CBHJBO Refleks Batuk
QVTBU QBSV /BNVO DBCBOH CSPOLVT TBOHBU UFSQBQBS EFOHBO #SPOLVTEBOUSBLFBTBOHBUTFOTJUJGUFSIBEBQTFOUVIBOSJOHBO TFIJOH
OPSFQJOFGSJO EBO FQJOFGSJO ZBOH EJMFQBTLBO LF EBMBN EBSBI PMFI HBCJMBUFSEBQBUCFOEBBTJOHBUBVQFOZFCBCJSJUBTJMBJOOZBXBMBVQVO
QFSBOHTBOHBO TJNQBUJT EBSJ NFEVMB LFMFOKBS BESFOBM ,FEVB EBMBN KVNMBI TFEJLJU BLBO NFOJNCVMLBO SFGMFLT CBUVL -BSJOH EBO
IPSNPO JOJ UFSVUBNB FQJOFGSJO LBSFOB SBOHTBOHBOOZB ZBOH MFCJI LBSJOB UFNQBU USBLFB CFSDBCBOH NFOKBEJ CSPOLVT
BEBMBI ZBOH
CFTBS QBEB SFTFQUPS CFUBBESFOFSHJL NFOZFCBCLBO EJMBUBTJ DBCBOH QBMJOHTFOTJUJG EBOCSPOLJPMVTUFSNJOBMJTEBOCBILBOBMWFPMJCFSTJGBU
CSPOLVT TFOTJUJG UFSIBEBQ SBOHTBOHBO CBIBO LJNJB LPSPTJG TFQFSUJ HBT TVMGVS
,POTUSJLTJ 1BSBTJNQBUJT QBEB #SPOLJPMVT #FCFSBQB TFSBCVU EJPLTJEB BUBV LMPSJO *NQVMT BGFSFO ZBOH CFSBTBM EBSJ TBMVSBO
TBSBG QBSBTJNQBUJT ZBOH CFSBTBM EBSJ OFSWVT WBHVT NFOFNCVT QFSOBQBTBOUFSVUBNBCFSKBMBONFMBMVJOFSWVTWBHVTLFNFEVMBPUBL
QBSFOLJNQBSV4BSBGJOJNFOZFLSFTJBTFUJMLPMJOEBO CJMBEJBLUJWBTJ %JTBOB TVBUVSBOHLBJBOQFSJTUJXBPUPNBUJTEJHFSBLLBOPMFIMJOUBTBO
BLBONFOZFCBCLBOLPOTUSJLTJSJOHBOTBNQBJTFEBOHQBEBCSPOLJP OFVSPOBMNFEVMB ZBOHNFOZFCBCLBOFGFLTFCBHBJCFSJLVU
MVT#JMBQSPTFTQFOZBLJUTFQFSUJBTNBUFMBINFOZFCBCLBOCFCFSBQB 1FSUBNB LJSBLJSB - VEBSB EJJOTQJSBTJ TFDBSB DFQBU ,FEVB
LPOTUSJLTJ QBEB CSPOLJPMVT NBLB BEBOZB QFSBOHTBOHBO TBSBG FQJHMPUJT NFOVUVQ EBO QJUB TVBSB NFOVUVQ FSBUFSBU VOUVL NFOKF
QBSBTJNQBUJTCFSJLVUOZBTFSJOHLBMJNFNQFSCVSVLLFBEBBO#JMBIBM SBU VEBSB EBMBN QBSV ,FUJHB PUPUPUPU BCEPNFO CFSLPOUSBLTJ EF
JOJ UFSKBEJ NBLB QFNCFSJBO PCBUPCBUBO ZBOH NFOHIBNCBU FGFL OHBO LVBU NFOEPSPOH EJBGSBHNB TFEBOHLBO PUPUPUPU FLTQJSBTJ
BTFUJMLPMJO TFQFSUJ BUSPQJO LBEBOHLBEBOH EBQBU NFSFMBLTBTJLBO MBJOOZB TFQFSUJJOUFSLPTUBMJTJOUFSOVT KVHBCFSLPOUSBLTJEFOHBOLVBU
KBMBOQFSOBQBTBOTFIJOHHBDVLVQVOUVLNFOHBUBTJPCTUSVLTJ "LJCBUOZB UFLBOBO EBMBN QBSV NFOJOHLBU TFDBSB DFQBU TBNQBJ
,BEBOHLBEBOH TBSBG QBSBTJNQBUJT EJBLUJWBTJ PMFI SFGMFLT ZBOH NN)HBUBVMFCJI,FFNQBU QJUBTVBSBEFOHBOFQJHMPUJTTFLPOZPOH
CFSBTBM EBSJ QBSV 4FCBHJBO CFTBS EJBXBMJ EFOHBO JSJUBTJ QBEB LPOZPOHUFSCVLBMFCBS TFIJOHHBVEBSBCFSUFLBOBOUJOHHJEBMBNQBSV
NFNCSBO FQJUFM KBMBO OBQBT JUV TFOEJSJ ZBOH EJDFUVTLBO PMFI HBT JOJNFMFEBLLFMVBS5FOUVTBKB VEBSBJOJLBEBOHLBEBOHEJLFMVBSLBO
HBT CFSBDVO EFCV BTBQ SPLPL BUBV JOGFLTJ CSPOLJBM 3FGMFLT EFOHBOLFDFQBUBOTBNQBJNJMKBN)BMZBOHQFOUJOH BEBMBI
LPOTUSJLUPS CSPOLJPMBS KVHB TFSJOH LBMJ UFSKBEJ CJMB NJLSPFNCPMJ LPNQSFTJ LVBU QBEB QBSV ZBOH NFOZFCBCLBO CSPOLVT EBO USBLFB
NFOZVNCBUBSUFSJQBSVZBOHLFDJM NFOKBEJ LPMBQT NFMBMVJ JOWBHJOBTJ CBHJBO ZBOH UJEBL CFSLBSUJMBHP LF
BSBI EBMBN BLJCBUOZB VEBSB ZBOH NFMFEBL UFSTFCVU CFOBSCFOBS
'BLUPS'BLUPS 4FLSFTJ -PLBM ZBOH 4FSJOH .FOZFCBCLBO
NFOHBMJS NFMBMVJ DFMBIDFMBI CSPOLVT EBO USBLFB 6EBSB ZBOH
,POTUSJLTJ #SPOLJPMVT #FCFSBQB TVCTUBOTJ ZBOH UFSCFOUVL EBMBN
NFOHBMJSEFOHBODFQBUUFSTFCVUCJBTBOZBNFNCBXBQVMBCFOEBBTJOH
QBSV TFSJOH LBMJ TBOHBU BLUJG NFOZFCBCLBO LPOTUSJLTJ CSPOLJPMVT
BQBQVOZBOHUFSEBQBUEBMBNCSPOLVTBUBVUSBLFB
%VB EJ BOUBSBOZB ZBOH QBMJOH QFOUJOH BEBMBI IJTUBNJO EBO [BU
BOBGJMBLTJT ZBOH CFSFBLTJ MBNCBU ,FEVBOZB EJMFQBTLBO EBMBN
KBSJOHBO QBSV PMFI TFM NBTU TFMBNB SFBLTJ BMFSHJ UFSVUBNB ZBOH Refleks Bersin
EJTFCBCLBO PMFI BEBOZB TFSCVL TBSJ EBMBN VEBSB 0MFI LBSFOB JUV 3FGMFLT CFSTJO TBOHBU NJSJQ EFOHBO SFGMFLT CBUVL LFDVBMJ CBIXB
LFEVB TVCTUBOTJ UFSTFCVU NFNFHBOH QFSBOBO QFOUJOH TFCBHBJ SFGMFLT JOJ CFSMBOHTVOH QBEB TBMVSBO IJEVOH CVLBO QBEB TBMVSBO
QFOZFCBCPCTUSVLTJTBMVSBOOBQBTZBOHUFSKBEJQBEBBTNBBMFSHJLB QFSOBQBTBO CBHJBO CBXBI 3BOHTBOHBO BXBM ZBOH NFOJNCVMLBO
UFSVUBNB[BUBOBGJMBLTJTZBOHCFSFBLTJMBNCBU SFGMFLT CFSTJO BEBMBI JSJUBTJ EBMBN TBMVSBO IJEVOH JNQVMT BGFSFO
#BIBO JSJUBO ZBOH KVHB NFOZFCBCLBO SFGMFLT LPOTUSJLUPS CFSKBMBO EBMBN OFSWVT LFMJNB NFOVKV NFEVMB UFNQBU SFGMFLT JOJ
QBSBTJNQBUJTQBEBTBMVSBOOBQBTSPLPL EFCV TVMGVSEJPLTJEB EBO EJDFUVTLBO 5FSKBEJ TFSBOHLBJBO SFBLTJ ZBOH NJSJQ EFOHBO SFGMFLT
CFCFSBQBFMFNFOBTBNEBMBNLBCVUBTBQEBQBUNFNJDVSFBLTJOPO CBUVLUFUBQJ VWVMBEJUFLBO TFIJOHHBTFKVNMBICFTBSVEBSBEFOHBO
TBSBGTFUFNQBUZBOHNFOZFCBCLBOLPOTUSJLTJPCTUSVLTJKBMBOOBQBT DFQBUNFMBMVJIJEVOH EFOHBOEFNJLJBONFNCBOUVNFNCFSTJILBO
TBMVSBOIJEVOHEBSJCFOEBBTJOH
473
Unit VII Perrnapasan
Fungsi Pernapasan Normal pada Hidung NJLSPNFUFS1BSUJLFMQBSUJLFMJOJIBNQJSUJEBLBEBZBOHEJFOEBQLBO

4BBU VEBSB NFOHBMJS NFMBMVJ IJEVOH UFSEBQBU UJHB GVOHTJ CFSCFEB EBMBN TBMVSBO OBQBT TFCFMVN TBNQBJ LF BMWFPMJ 4BZBOHOZB MFCJI
ZBOH EJLFSKBLBO PMFI SPOHHB IJEVOH
VEBSB EJIBOHBULBO PMFI EBSJ TFQFSUJHBOZB NFOHFOEBQ EBMBN BMWFPMJ NFMBMVJ QSPTFT EJGVTJ
QFSNVLBBOLPOLBEBOTFQUVNZBOHMVBT EFOHBOUPUBMBSFBLJSBLJSB EFOHBONFNCFOUVLTVTQFOTJZBOHUFUBQTFJNCBOHEBOEJLFMVBSLBO
DN MJIBU(BNCBS

VEBSBEJMFNCBQLBOTBNQBJIBNQJS EBMBNVEBSBFLTQJSBTJ
#BOZBL QBSUJLFM ZBOH UFSKFSBU EBMBN BMWFPMJ EJLFMVBSLBO PMFI
MFNCBQTFNQVSOBCBILBOTFCFMVNVEBSBNFOJOHHBMLBOIJEVOH EBO
NBLSPGBHBMWFPMVT TFQFSUJZBOHEJKFMBTLBOQBEB#BC EBOQBSUJLFM

VEBSB EJTBSJOH TFCBHJBO 4FNVB GVOHTJ JOJ TFDBSB CFSTBNBTBNB
MBJOOZB EJCBXB LFMVBS PMFI BMJSBO MJNGBUJL QBSV 1BSUJLFM ZBOH
EJTFCVUGVOHTJQFMFNCBQVEBSBTBMVSBOOBQBTCBHJBOBUBT#JBTBOZB
CFSMFCJIBO EBQBU NFOZFCBCLBO QFSUVNCVIBO KBSJOHBO GJCSPTB
TVIV VEBSB JOTQJSBTJ NFOJOHLBU TBNQBJ ¡' NFMFCJIJ TVIV UVCVI
EBMBNTFQUVNBMWFPMVT TFIJOHHBNFOJNCVMLBODBDBUQFSNBOFO
EBO EFOHBO LFKFOVIBO VBQ BJS TBNQBJ QFSTFO TFCFMVN VEBSB
NFODBQBJ USBLFB #JMB PSBOH CFSOBQBT NFMBMVJ QJQB MBOHTVOH LF
USBLFB TFQFSUJ QBEB USBLFPTUPNJ
QFOEJOHJOBO EBO UFSVUBNB FGFL Vocalization
QFOHFSJOHBO EJ CBHJBO CBXBI QBSV EBQBU NFOJNCVMLBO LFSVTBLBO 1SPTFT CFSCJDBSB UJEBL IBOZB NFMJCBULBO TJTUFN QFSOBQBTBO TBKB
EBOJOGFLTJQBSVZBOHTFSJVT UFUBQJ KVHB
QVTBU QFOHBUVS TBSBG CJDBSB TQFTJGJL EBMBN LPSUFLT
TFSFCSJ ZBOH BLBO EJCBIBT QBEB #BC
QVTBU QFOHBUVS
'VOHTJ 1FOZBSJOHBO )JEVOH #VMVCVMV QBEB QJOUV NBTVL QFSOBQBTBOEJPUBL EBO
TUSVLUVSBSUJLVMBTJEBOSFTPOBOTJQBEB
MVCBOH IJEVOH QFOUJOH VOUVL NFOZBSJOH QBSUJLFMQBSUJLFM CFTBS SPOHHB NVMVU EBO IJEVOH #FSCJDBSB EJBUVS PMFI EVB GVOHTJ
8BMBVQVO EFNJLJBO KBVI MFCJI QFOUJOH VOUVL NFOHFMVBSLBO NFLBOJT
GPOBTJ ZBOHEJMBLVLBOPMFIMBSJOH EBO
BSUJLVMBTJ
QBSUJLFM NFMBMVJ QSFTJQJUBTJ UVSCVMFO "SUJOZB VEBSB ZBOH NFOHBMJS ZBOHEJMBLVLBOPMFITUSVLUVSQBEBNVMVU
NFMBMVJ TBMVSBO IJEVOH NFNCFOUVS CBOZBL EJOEJOH QFOHIBMBOH
'POBTJ -BSJOH ZBOH EJQFSMJIBULBO QBEB (BNCBS "
LPOLB EJTFCVU KVHB UVSCJOBMFT TFCBC LPOLB NFOJNCVMLBO
LIVTVTOZB CFSQFSBO TFCBHBJ QFOHHFUBS WJCSBUPS
&MFNFO ZBOH
UVSCVMFOTJ VEBSB
TFQUVN EBO EJOEJOH GBSJOH 5JBQ LBMJ VEBSB
CFSHFUBS BEBMBI MJQBUBO QJUB TVBSB ZBOH VNVNOZB EJTFCVU QJUB
NFNCFOUVSQFOHIBMBOHJOJ VEBSBIBSVTNFOHVCBIBSBIBMJSBOOZB
TVBSB 1JUB TVBSB NFOPOKPM EBSJ EJOEJOH MBUFSBM MBSJOH LF BSBI
1BSUJLFMQBSUJLFM ZBOH UFSTVTQFOTJ EBMBN VEBSB NFNQVOZBJ
UFOHBIHMPUJTQJUBTVBSBJOJEJSFHBOHLBOEBOEJBUVSQPTJTJOZBPMFI
NPNFOUVN EBO NBTTB ZBOH KBVI MFCJI CFTBS EBSJQBEB VEBSB
CFCFSBQBPUPUTQFTJGJLQBEBMBSJOHJUVTFOEJSJ
TFIJOHHB UJEBL EBQBU NFOHVCBI BSBI QFSKBMBOBOOZB TFDFQBU VEBSB
(BNCBS#NFOHHBNCBSLBOQJUBTVBSBTFQFSUJZBOHUBNQBL
0MFI LBSFOB JUV QBSUJLFMQBSUJLFM UFSTFCVU UFSVT NBKV LF EFQBO
CJMB LJUB NFMJIBU LF EBMBN HMPUJT EFOHBO NFOHHVOBLBO MBSJOHPT
NFNCFOUVSQFSNVLBBOQFOHIBMBOHQFOHIBMBOHJOJ EBOLFNVEJBO
LPQ4FMBNBQFSOBQBTBOOPSNBM QJUBBLBOUFSCVLBMFCBSBHBSBMJSBO
EJKFSBU PMFI NVLVT QFMBQJT EBO EJBOHLVU PMFI TJMJB LF GBSJOH VOUVL
VEBSB NVEBI MFXBU 4FMBNB GPOBTJ QJUB NFOVUVQ CFSTBNBTBNB
EJUFMBO
TFIJOHHB BMJSBO VEBSB EJ BOUBSB QJUB UFSTFCVU BLBO NFOHIBTJMLBO
6LVSBO 1BSUJLFM ZBOH 5FSKFSBU EBMBN 4BMVSBO 1FSOBQBTBO HFUBSBO WJCSBTJ
,VBUOZB HFUBSBO UFSVUBNB EJUFOUVLBO PMFI
.FLBOJTNF UVSCVMFOTJ IJEVOH VOUVL NFOHFMVBSLBO QBSUJLFM EBSJ EFSBKBUQFSFHBOHBOQJUB UFUBQJKVHBPMFICBHBJNBOBLFSBQBUBOQJUB
VEBSB CFHJUV FGFLUJG TFIJOHHB IBNQJS UJEBL BEB QBSUJLFM EFOHBO TBUVTBNBMBJOEBOPMFINBTTBQBEBUFQJOZB
VLVSBOEJBNFUFSMFCJICFTBSEBSJNJLSPNFUFSZBOHEBQBUNBTVLLF (BNCBS"NFNQFSMJIBULBOJSJTBOMJQBUBOQJUBTVBSBTFUFMBI
QBSV NFMBMVJ IJEVOH 6LVSBO JOJ MFCJI LFDJM EBSJQBEB VLVSBO TFM MBQJTBO FQJUFM NVLPTBOZB EJCVBOH 5FQBU EJ TFCFMBI EBMBN TFUJBQ
EBSBINFSBI QJUBUFSEBQBUMJHBNFOFMBTUJLZBOHLVBUEBOEJTFCVUMJHBNFOWPLBMJT
1BSUJLFMQBSUJLFM ZBOH UFSTJTB LFCBOZBLBO QBSUJLFM ZBOH CFSV -JHBNFO JOJ NFMFLBU EJ TFCFMBI BOUFSJPS EBSJ LBSUJMBHP UJSPJE ZBOH
LVSBOBOUBSBEBOHNNFOHFOEBQEBMBNCSPOLJPMVTLFDJMTFCBHBJ CFTBS ZBJUVLBSUJMBHPZBOHNFOPOKPMEBSJQFSNVLBBOBOUFSJPSMFIFS
BLJCBU EBSJ QSFTJQJUBTJ HSBWJUBTJ $POUPIOZB QFOZBLJU CSPOLJPMVT EBOEJTFCVUKBLVO%JTFCFMBIQPTUFSJPS MJHBNFOWPLBMJTEJSFLBU
UFSNJOBMJT CJBTB UFSKBEJ QBEB QFOHHBMJ UBNCBOH CBUV CBSB BLJCBU LBO QBEB QSPTFTVT WPLBMJT EBSJ LFEVB LBSUJMBHP BSJUFOPJE #BHJBO
NFOFUBQOZB QBSUJLFMQBSUJLFM EFCV #FCFSBQB QBSUJLFM MFCJI LFDJM CBXBI LBSUJMBHP UJSPJE EBO LBSUJMBHP BSJUFOPJE JOJ CFSBSUJLVMBTJ
ZBOH UFSTJTB EJBNFUFS MFCJI LFDJM EBSJ HN
CFSEJGVTJ NFMFXBUJ EFOHBOLBSUJMBHPMBJO ZBJUVLBSUJMBHPLSJLPJE UJEBLUBNQBLEBMBN
EJOEJOH BMWFPMJ EBO NFMFLBU QBEB DBJSBO BMWFPMVT 5FUBQJ CBOZBL (BNCBS

QBSUJLFMZBOHEJBNFUFSOZBMFCJILFDJMEBSJ HNUFUBQUFSTVTQFOTJ 1JUBTVBSBEBQBUEJSFHBOHLBOCBJLPMFISPUBTJLBSUJMBHPUJSPJELF
EBMBN VEBSB BMWFPMVT EBO BLIJSOZB EJLFMVBSLBO NFMBMVJ FLTQJSBTJ EFQBO NBVQVO PMFI SPUBTJ QPTUFSJPS EBSJ LBSUJMBHP BSJUFOPJE ZBOH
.JTBMOZB QBSUJLFMQBSUJLFMBTBQSPLPLZBOHVLVSBOOZBTFLJUBS EJBLUJWBTJ PMFI PUPUPUPU ZBOH NFSFHBOH EBSJ LBSUJMBHP UJSPJE EBO
LBS
474
LBSUJMBHP BSJUFOPJE LF LBSUJMBHP LSJLPJE 0UPUPUPU ZBOH UFSMFUBL EJ Hilaire G, Duron B: Maturation of the mammalian respiratory system,
EBMBN QJUB TVBSB EJ TFCFMBI MBUFSBM MJHBNFO WPLBMJT ZBJUV PUPU Physiol Rev 79:325, 1999.
UJSPBSJUFOPJE EBQBU NFOBSJL LBSUJMBHP BSJUFOPJE LF BSBI LBSUJMBHP Lai-Fook SJ: Pleural mechanics and fluid exchange, Physiol Rev 84:385,
2004.
UJSPJE EBO PMFI LBSFOB JUV NFMPOHHBSLBO QJUB TVBSB 1FSHFSBLBO
UNIT VII
Mason RJ, Greene K, Voelker DR: Surfactant protein A and surfactant pro-
PUPUPUPUJOJEJEBMBNQJUBTVBSBKVHBEBQBUNFOHVCBICFOUVLEBO
tein D in health and disease, Am J Physiol Lung Cell Mol Physiol 275:L1,
NBTTB QBEB UFQJ QJUB TVBSB NFOBKBNLBOOZB VOUVL NFOHIBTJMLBO 1998.
CVOZJEFOHBOOBEBUJOHHJEBONFOVNQVMLBOOZBVOUVLTVBSBZBOH McConnell AK, Romer LM: Dyspnoea in health and obstructive pulmonary
MFCJISFOEBI CBTT
disease: the role of respiratory muscle function and training, Sports Med
5FSEBQBU CFCFSBQB LFMPNQPL PUPU MBSJOH LFDJM ZBOH UFSMFUBL EJ 34:117, 2004.
BOUBSB LBSUJMBHP BSJUFOPJE EBO LBSUJMBHP LSJLPJE EBO EBQBU Paton JF, Dutschmann M: Central control of upper airway resistance regu-
NFSPUBTJLBO LBSUJMBHP JOJ LF BSBI EBMBN BUBV LF BSBI MVBS BUBV lating respiratory airflow in mammals, J Anat 201:319, 2002.
NFOBSJL EBTBSOZB CFSTBNBTBNB BUBV NFNJTBILBOOZB VOUVL Pavord ID, Chung KF: Management of chronic cough, Lancet 371:1375,
NFOHIBTJMLBO CFSCBHBJ LPOGJHVSBTJ QJUB TVBSB TFQFSUJ ZBOH UBNQBL 2008.
Powell FL, Hopkins SR: Comparative physiology of lung complexity: impli-
EBMBN(BNCBS#
cations for gas exchange, News Physiol Sci 19:55, 2004. Sant’Ambrogio G,
"SUJLVMBTJ EBO 3FTPOBOTJ 5JHB PSHBO BSUJLVMBTJ ZBOH VUBNB
Widdicombe J: Reflexes from airway rapidly adapting
ZBJUV CJCJS MJEBI EBO QBMBUVN NPMF ,FUJHB PSHBO JOJ UJEBL LJUB receptors, Respir Physiol 125:33, 2001.
CBIBT TFDBSB UFSQFSJODJ TFCBC LJUB UFMBI NFOHFOBM QFSHFSBLBO Uhlig S, Taylor AE: Methods in Pulmonary Research, Basel, 1998, Birkhauser
PSHBOPSHBOJOJTFMBNBCFSCJDBSBEBOWPLBMJTBTJMBJOOZB Verlag.
#BHJBOZBOHUFSNBTVLSFTPOBUPSBEBMBINVMVU IJEVOHEBOTJOVT Voynow JA, Rubin BK: Mucins, mucus, and sputum, Chest 135:505, 2009. West
OBTBM ZBOH CFSIVCVOHBO GBSUO EBO CBILBO SPOHHB EBEB TFOEJSJ JB: Respiratory Physiology, New York, 1996, Oxford University Press. West JB:
4FLBMJMBHJ LJUBTVEBINFOHFOBMTJGBUSFTPOBOTJTUSVLUVSTUSVLUVSJOJ Why doesn’t the elephant have a pleural space? News Physiol Sci
.JTBMOZB GVOHTJ SFTPOBUPS IJEVOH EJQFSMJIBULBO PMFI QFSVCBIBO 17:47, 2002.
LVBMJUBT TVBSB CJMB TFTFPSBOH NFOEFSJUB QJMFL CFSBU ZBOH Widdicombe J: Reflexes from the lungs and airways: historical perspective,
NFOHIBNCBUBMJSBOVEBSBLFSFTPOBUPSSFTPOBUPSJOJ J Appl Physiol 101:628, 2006.
Widdicombe J: Neuroregulation of cough: implications for drug therapy,
Daftar Pustaka Curr Opin Pharmacol 2:256, 2002.
Wright JR: Pulmonary surfactant: a front line of lung host defense, J Clin
Anthony M: The obesity hypoventilation syndrome, Respir Care 53:1723, Invest 111:1453, 2003.
2008. Zeitels SM, Healy GB: Laryngology and phonosurgery. N Engl J Med 349:882,
Daniels CB, Orgeig S: Pulmonary surfactant: the key to the evolution of air 2003.
breathing, News Physiol Sci 18:151, 2003.
475
BAB 38
UNIT VII
4JSLVMBTJ1BSV &EFNB1BSV
$BJSBO1MFVSB
1BSV NFNJMJLJ EVB TJSLVMBTJ

QVMNPOBMJT NBNQV NFOBNQVOH DVSBI WPMVNF TFLVODVQ EBSJ
4JSLVMBTJ CFSUFLBOBO UJOHHJ CFSBMJSBO WFOUSJLFMLBOBO
SFOEBI ZBOH NFOZBNQBJLBO EBSBI 7FOBWFOB QBSV TFQFSUJ KVHB BSUFSJ QVMNPOBMJT CFSVLVSBO
BSUFSJ TJTUFNJL LF USBLFB DBCBOH QFOEFL 7FOBWFOB JOJ BLBO TFHFSB NFOHPTPOHLBO EBSBI LF
CSPOLJPMVT UFSNBTVL CSPOLJPMVT EBMBNBUSJVNLJSJ
UFSNJOBMJT KBSJOHBO QFOVOKBOH QBSV
EBOMBQJTBOQBMJOHMVBS BEWFOUJB
Pembuluh Darah Bronkial. %BSBI KVHB NFOHBMJS LF QBSV
BSUFSJ EBO WFOB QVMNPOBMJT "SUFSJ CSPOLJBM ZBOH NFSVQBLBO NFMBMVJCFCFSBQBBSUFSJCSPOLJBMLFDJMZBOHCFSBTBMEBSJTJSLVMBTJ
DBCBOHEBSJBPSUBUPSBLBM NFOZBNQBJLBOTFCBHJBOCFTBSEBSBI TJTUFNJL CFSKVNMBI TFLJUBS TBNQBJ QFSTFO DVSBI KBOUVOH
BSUFSJ TJTUFNJL JOJ QBEB UFLBOBO ZBOH TFEJLJU MFCJI SFOEBI EBSJ UPUBM%BSBIBSUFSJCSPOLJBMJOJNFSVQBLBOEBSBIUFSPLTJHFOBTJ
UFLBOBOBPSUB
4JSLVMBTJCFSUFLBOBOSFOEBI CFSBMJSBOUJOHHJ CFSCFEB EFOHBO EBSBI EBMBN BSUFSJ QVMNPOBMJT ZBOH
ZBOH NFOZBNQBJLBO EBSBI WFOB EBSJ TFMVSVI CBHJBO UVCVI LF UFSEFPLTJHFOBTJ TFCBHJBO %BSBI JOJ NFOZVQMBJ KBSJOHBO
LBQJMFS BMWFPMJ EJ NBOB PLTJHFO EJUBNCBILBO EBO LBSCPO QFOVOKBOH QBSV UFSNBTVL KBSJOHBO JLBU TFQUB EBO CSPOLJ
EJPLTJEBEJCVBOH"SUFSJQVMNPOBMJT ZBOHNFOFSJNBEBSBIEBSJ CFTBS NBVQVO LFDJM 4FTVEBI EBSBI BSUFSJ CSPOLJBM NFMFXBUJ
WFOUSJLFMLBOBO CFTFSUBQFSDBCBOHBOBSUFSJOZBNFNCBXBEBSBI KBSJOHBOQFOVOKBOH EBSBINBTVLLFEBMBNWFOBWFOBQBSVEBO
LF LBQJMFS BMWFPMJ VOUVL QFSUVLBSBO HBT EBO WFOB QVMNPOBMJT NBTVL LF BUSJVN LJSJ EBO CVLBO LFNCBMJ LF BUSJVN LBOBO
NFOHFNCBMJLBO EBSBI LF BUSJVN LJSJ VOUVL TFMBOKVUOZB 0MFILBSFOBJUV BMJSBOLFEBMBNBUSJVNLJSJEBODVSBIWFOUSJLFM
EJQPNQBPMFIWFOUSJLFMLJSJNFOVKVTJSLVMBTJTJTUFNJL LJSJ LJSBLJSB TBNQBJ QFSTFO MFCJI CFTBS EBSJQBEB DVSBI
1BEB CBC JOJ LJUB BLBO NFNCBIBT BTQFLBTQFL LIVTVT WFOUSJLFMLBOBO
EJTUSJCVTJBMJSBOEBSBIEBOIFNPEJOBNJLMBJOTJSLVMBTJQBSV ZBOH
UFSVUBNBQFOUJOHVOUVLQFSUVLBSBOHBTEJQBSV Saluran Limfe. 1FNCVMVIMJNGFUFSEBQBUEJTFNVBKBSJOHBO
QFOVOKBOH QBSV EJNVMBJ QBEB SVBOH KBSJOHBO JLBU ZBOH
NFOHFMJMJOHJCSPOLJPMVTUFSNJOBMJT CFSKBMBOLFIJMVTQBSV EBO
Anatomi Fisiologis Sistem Sirkulasi Paru LFNVEJBO UFSVUBNB NBTVL LF EBMBN EVLUVT MJNGBUJL UPSBTJLVT
LBOBO1BSUJLFMLFDJMZBOHNFNBTVLJBMWFPMJTFCBHJBOEJBOHLVU
Pembuluh Darah Paru. 1BOKBOH BSUFSJ QVMNPOBMJT IBOZB NFMBMVJ TBMVSBOTBMVSBO JOJ EBO QSPUFJO QMBTNB ZBOH LFMVBS
DN EJ MVBS BQFLT WFOUSJLBM LBOBO EBO LFNVEJBO UFSCBHJ NFOKBEJ EBSJ LBQJMFS QBSV KVHB EJBOHLVU EBSJ KBSJOHBO QBSV EFOHBO
DBCBOHVUBNBLBOBOEBOLJSJ ZBOHNFOZFEJBLBOEBSBILFLFEVB EFNJLJBONFNCBOUVVOUVLNFODFHBIFEFNBQBSV
QBSVZBOHCFSTBOHLVUBO
"SUFSJ QVMNPOBMJT KVHB UJQJT LFUFCBMBO EJOEJOHOZB TFQFSUJHB Tekanan dalam Sistem Paru
LFUFCBMBOEJOEJOHBPSUB$BCBOHDBCBOHBSUFSJQVMNPOBMJTTBOHBU
QFOEFL EBOTFNVBBSUFSJQVMNPOBMJT UFSNBTVLBSUFSJZBOHMFCJI Tekanan dalam Sistem Paru ,VSWB UFLBOBO OBEJ EJ
LFDJM EBO BSUFSJPM NFNJMJLJ EJBNFUFS ZBOH MFCJI CFTBS EBSJQBEB WFOUSJLFM LBOBO EBO BSUFSJ QVMNPOBMJT UFSMJIBU QBEB CBHJBO
BSUFSJBSUFSJ TJTUFNJL ZBOH TFEFSBKBU )BM JOJ EJTFSUBJ EFOHBO CBXBI (BNCBS ,VSWB JOJ UFSMJIBU CFSCFEB EFOHBO LVSWB
LFOZBUBBO CBIXB QFNCVMVI EBSBI QBSV TBOHBU UJQJT EBO EBQBU UFLBOBOBPSUBZBOHKBVIMFCJIUJOHHJTFQFSUJUFSMJIBUQBEBCBHJBO
NFOHFNCBOH NFNCVBU TJTUFN BSUFSJ QVMNPOBMJT NFOKBEJ TVBUV BUBT HBNCBS 5FLBOBO TJTUPMJL EJ WFOUSJLFM LBOBO QBEB PSBOH
TJTUFN EFOHBO LPNQMJBOT ZBOH TBOHBU CFTBS SBUBSBUB IBNQJS OPSNBM SBUBSBUB TFLJUBS NN )H TFEBOHLBO UFLBOBO
NMNN )H ZBOH TBNB EFOHBO LPNQMJBOT TFMVSVI TJTUFN BSUFSJ EJBTUPMJLSBUBSBUBTFLJUBSTBNQBJNN)H OJMBJZBOHIBOZB
TJTUFNJL,PNQMJBOTZBOHCFTBSJOJNFOZFCBCLBOBSUFSJ NFSVQBLBOTFQFSMJNBEBSJOJMBJEJWFOUSJLBMLJSJ
477
Unit Vll Pernapasan
a ekanan ao a )H#JBTBOZBUJEBLNVOHLJOVOUVLNFOHVLVSUFLBOBOBUSJVNLJSJ
120
NBOVTJB EFOHBO NFOHHVOBLBO BMBU VLVS MBOHTVOH LBSFOB TVMJU
VOUVLNFNBTVLLBOLBUFUFSNFMBMVJSVBOHKBOUVOHLFBUSJVNLJSJ
"LBOUFUBQJ UFLBOBOBUSJVNLJSJTFSJOHEBQBUEJQFSLJSBLBOEFOHBO
OJMBJ LFUFQBUBO ZBOH TFEBOH EFOHBO DBSB NFOHVLVS UFLBOBO
75 KFQJUBO QBSV QVMNPOBSZ XFEHF QSFTTVSF
*OJ EJQFSPMFI EFOHBO
NFNBTVLLBO LBUFUFS NVMBNVMB NFMBMVJ WFOB QFSJGFS LF BUSJVN
LBOBO EBO LFNVEJBO NFMBMVJ TJTJ LBOBO KBOUVOH NFMFXBUJ BSUFSJ
a en ikel kanan QVMNPOBMJT NBTVL LF EBMBN TBMBI TBUV DBCBOH LFDJM BSUFSJ
aa ei lmona is QVMNPOBMJT BLIJSOZB NFOEPSPOH LBUFUFS TBNQBJ UFSKFQJU FSBU EJ
25
DBCBOHBSUFSJLFDJM
8
0 5FLBOBO LFNVEJBO EJVLVS NFMBMVJ LBUFUFS EJTFCVU UFLBOBO
0 1 2 KFQJUBO ZBOH CFTBSOZB LJSBLJSB NN )H %JLBSFOBLBO TFNVB
BMJSBOEBSBIEJBSUFSJLFDJMZBOHUFSKFQJUUFSTFCVUUFMBIEJIFOUJLBO
am a an ekanan nadi di en ikel kanan a e i EBO QFNCVMVI EBSBI ZBOH CFSMBOKVU EBSJ BSUFSJ JUV NFNCVBU
lmonalis dan ao a IVCVOHBOMBOHTVOHEFOHBOLBQJMFSQBSV NBLBUFLBOBOKFQJUBOJOJ
CJBTBOZBIBOZBTBNQBJNN)HMFCJICFTBSEBSJQBEBUFLBOBO
BUSJVN LJSJ #JMB UFLBOBO BUSJVN LJSJ NFOJOHLBU LF OJMBJ ZBOH
Tekanan di Arteri Pulmonalis 4FMBNB TJTUPM UFLBOBO EJ UJOHHJ NBLB UFLBOBO KFQJUBO QBSV KVHB BLBO NFOJOHLBU 0MFI
BSUFSJ QVMNPOBMJT QBEB EBTBSOZB TBNB EFOHBO UFLBOBO EJ LBSFOB JUV QFOHVLVSBO UFLBOBO KFQJUBO EBQBU EJQBLBJ VOUVL
WFOUSJLFM LBOBO TFQFSUJ UFSMJIBU QBEB (BNCBS "LBO NFNQFMBKBSJ TFDBSB LMJOJT QFSVCBIBO QBEB UFLBOBO LBQJMFS QBSV
UFUBQJ TFUFMBI LBUVQ QVMNPOBM NFOVUVQ QBEB BLIJS TJTUPM EBO UFLBOBO EJ BUSJVN LJSJ QBEB QBTJFO EFOHBO HBHBM KBOUVOH
NBLBUFLBOBOWFOUSJLFMNFOVSVOTFLFUJLB TFEBOHLBOUFLBOBO LPOHFTUJG
BSUFSJ QVMNPOBMJT NFOVSVO TFDBSB MBNCBU TFXBLUV EBSBI
NFOHBMJSNFMBMVJLBQJMFSQBSV
4FQFSUJ UFSMJIBU EBMBN (BNCBS UFLBOBO TJTUPMJL BSUFSJ Volume Darah di Paru
QVMNPOBMJT SBUBSBUB TFLJUBS NN )H QBEB PSBOH OPSNBM
TFEBOHLBO UFLBOBO EJBTUPMJL BSUFSJ QVMNPOBMJT LJSBLJSB NN 7PMVNF EBSBI EJ QBSV LJSBLJSB NM TFLJUBS QFSTFO EBSJ
)H EBOUFLBOBOBSUFSJQVMNPOBMJTSBUBSBUBBEBMBINN)H WPMVNFEBSBIUPUBMQBEBTFMVSVITJTUFNTJSLVMBTJ,JSBLJSBNM
EBSJ WPMVNF EBSBI EJ QBSV CFSBEB EJ LBQJMFS QBSV TFEBOHLBO
Tekanan Kapiler Paru. 5FLBOBO LBQJMFS QBSV SBUBSBUB TJTBOZBUFSCBHJTBNBSBUBBOUBSBBSUFSJEBOWFOBQBSV
TFQFSUJ UFSMJIBU EBMBN (BNCBS CFTBSOZB LJSBLJSB NN
)H .BLOB UFLBOBO LBQJMFS ZBOH SFOEBI JOJ BLBO EJCJDBSBLBO Paru Berfungsi sebagai Tempat Penyimpanan Darah
TFDBSB EFUBJM EBMBN CBC ZBOH CFSIVCVOHBO EFOHBO GVOHTJ 1BEBCFSCBHBJLFBEBBOGJTJPMPHJTEBOQBUPMPHJT KVNMBIEBSBIEJ
QFSUVLBSBODBJSBOEJLBQJMFSQBSV QBSV EBQBU CFSWBSJBTJ EBSJ TFQBSVI TBNQBJ EFOHBO EVB LBMJ
OPSNBM 4FCBHBJ DPOUPI CJMB TFTFPSBOH NFOHIFNCVTLBO VEBSB
Tekanan Atrium Kiri dan Vena Paru. 5FLBOBOSBUBSBUB EFOHBO TBOHBU LVBU BLBO UJNCVM UFLBOBO UJOHHJ EJ QBSV TFQFSUJ
EJ BUSJVN LJSJ EBO WFOBWFOB QBSV VUBNB SBUBSBUB TFLJUBS NFOJVQUFSPNQFUTFCBOZBLNMEBSBIEBQBUEJLFMVBSLBOEBSJ
NN)HQBEBNBOVTJBZBOHCFSCBSJOHUFSMFOUBOH UFLBOBOJOJ TJTUFNTJSLVMBTJQBSVLFTJSLVMBTJTJTUFNJL#FHJUVQVMB IJMBOHOZB
CFSWBSJBTJNVMBJEBSJTFSFOEBINN)HTBNQBJTFUJOHHJNN EBSBI EBSJ TJSLVMBTJ TJTUFNJL LBSFOB QFSEBSBIBO EBQBU
EJLPNQFOTBTJ TFCBHJBO PMFI QFSQJOEBIBO EBSBI TFDBSB PUPNBUJT
EBSJQBSVLFQFNCVMVITJTUFNJL
25 S
Patologi Jantung Dapat Memindahkan Darah dari
a ile Sirkulasi Sistemik ke Sirkulasi Paru. (BHBM KBOUVOH LJSJ BUBV
15 M a i m
ki i
QFOJOHLBUBO UBIBOBO UFSIBEBQ BMJSBO EBSBI NFMBMVJ LBUVQ NJUSBM
8 D BLJCBU TUFOPTJT NJUSBMJT BUBV SFHVSHJUBTJ NJUSBMJT NFOZFCBCLBO
7
EBSBIUFSCFOEVOHEJTJSLVMBTJQBSV LBEBOHLBEBOHNFOJOHLBULBO
2 WPMVNF EBSBI QBSV TBNQBJ QFSTFO EBO NFOZFCBCLBO
0
ei a a ile a i m
LFOBJLBOCFTBSQBEBUFLBOBOQFNCVMVIQBSV0MFILBSFOBWPMVNF
ki i TJSLVMBTJ TJTUFNJL LJSBLJSB TFNCJMBO LBMJ WPMVNF TJTUFN QBSV
ekanan ada e agai em l da a di a NBLBQFSQJOEBIBOEBSBIEBSJTBUVTJTUFNLFTJTUFNMBJOOZBBLBO
dias olik aa aa sis olik k a a a lsasi TBOHBU NFNFOHBSVIJ TJTUFN QBSV UFUBQJ CJBTBOZB LVSBOH
a ei CFSQFOHBSVIUFSIBEBQTJSLVMBTJTJTUFNJL
478
Bab 38 Sirkulasi paru, Edema paru, Cairan Pleura
Aliran Darah yang melalui Paru dan )H EJ CBXBI KBOUVOH "SUJOZB UFLBOBO BSUFSJ QVMNPOBMJT EJ
Distribusinya CBHJBO QBSV ZBOH QBMJOH BUBT QBEB TFTFPSBOH ZBOH TFEBOH
CFSEJSJ LJSBLJSB NN )H MFCJI SFOEBI EBSJQBEB UFLBOBO
"MJSBO EBSBI ZBOH NFMBMVJ QBSV QBEB EBTBSOZB TBNB EFOHBO BSUFSJ QVMNPOBMJT TFUJOHHJ KBOUVOH EBO UFLBOBO EJ CBHJBO
UNIT VII
DVSBI KBOUVOH %FOHBO EFNJLJBO GBLUPSGBLUPS ZBOH UFSCBXBIQBSVLJSBLJSBNN)HMFCJICFTBS4FMJTJIUFLBOBO
NFOHFOEBMJLBO DVSBI KBOUVOH UFSVUBNB GBLUPSGBLUPS QFSJGFS TFQFSUJ JUV NFOZFCBCLBO QFOHBSVI CFTBS QBEB BMJSBO EBSBI
TFQFSUJ EJCJDBSBLBO QBEB #BC KVHB NFOHFOEBMJLBO BMJSBI ZBOHNFMBMVJCFSCBHBJCBHJBOQBSV)BMJOJEJQFSMJIBULBOPMFI
EBSBI QBSV %BMBN LPOEJTJ ZBOH VNVN QFNCVMVI QBSV LVSWB CBHJBO CBXBI QBEB (BNCBS ZBOH NFMVLJTLBO
CFSGVOHTJTFCBHBJUBCVOHZBOHQBTJGEBONVEBINFSFHBOH ZBOH BMJSBO EBSBI QFS VOJU KBSJOHBO QBSV QBEB CFSCBHBJ UFNQBU
BLBO NFNCFTBS TFJSJOH EFOHBO QFOJOHLBUBO UFLBOBO EBO LFUJOHHJBO QBSV QBEB PSBOH ZBOH TFEBOH CFSEJSJ UFHBL
NFOHFDJM QBEB QFOVSVOBO UFLBOBO 6OUVL PLTJHFOBTJ EBSBI 1FSIBUJLBOCBIXBQBEBQPTJTJCFSEJSJEBMBNLFBEBBOJTUJSBIBU
TFDBSB PQUJNBM NBLB EBSBI IBSVT EJEJTUSJCVTJLBO LF TFHNFO UFSEBQBUBMJSBOLFDJMEJQVODBLQBSVUFUBQJUFSEBQBUBMJSBOMJNB
TFHNFOQBSVZBOHBMWFPMJOZBUFSPLTJHFOBTJEFOHBOCBJL)BMJOJ LBMJ MFCJI CFTBS EJ QBSV CBHJBO CBXBI 6OUVL NFNCBOUV
EJDBQBJNFMBMVJNFLBOJTNFCFSJLVU NFOKFMBTLBO QFSCFEBBO JOJ NBLB QBSV TFSJOH EJCBHJ NFOKBEJ
UJHB [POB TFQFSUJ UFSMJIBU EBMBN (BNCBS 1BEB UJBQUJBQ
Penurunan Oksigen Alveolus Mengurangi Aliran [POB QPMBBMJSBOEBSBIOZBCFSCFEBCFEB
Darah Alveolus Setempat dan Mengatur Distribusi
Aliran Darah Paru. #JMB LPOTFOUSBTJ PLTJHFO EBMBN VEBSB EJ Zona 1, 2, dan 3 dan Aliran Darah Paru
BMWFPMJ UVSVO EJ CBXBI OPSNBM UFSVUBNB CJMB UVSVO EJ CBXBI ,BQJMFS EBMBN EJOEJOH BMWFPMVT EJSFHBOHLBO PMFI UFLBOBO
QFSTFO EBSJ OPSNBM 10 EJ CBXBI NN )H
QFNCVMVI EBSBI EJ EBMBNOZB UFUBQJ TFDBSB CFSTBNBBO KVHB EJLPNQSFTJ
EBSBI ZBOH MFUBLOZB CFSTFCFMBIBO BLBO CFSLPOTUSJLTJ EBO PMFIUFLBOBOVEBSBBMWFPMVTQBEBTJTJMVBSOZB0MFILBSFOBJUV
UBIBOBO WBTLVMBS NFOJOHLBU MFCJI EBSJ MJNB LBMJ MJQBU QBEB TFUJBQ LBMJ UFLBOBO VEBSB BMWFPMVT QBSV NFOKBEJ MFCJI CFTBS
LBEBSPLTJHFOZBOHTBOHBUSFOEBI)BMJOJCFSMBXBOBOEFOHBO EBSJQBEB UFLBOBO EBSBI LBQJMFS NBLB LBQJMFS NFOVUVQ EBO
FGFL ZBOH CJBTBOZB LJUB KVNQBJ EJ QFNCVMVI TJTUFNJL ZBOH UJEBLBEBEBSBIZBOHNFOHBMJS1BEBLFBEBBOQBSVZBOHOPSNBM
KVTUSVCFSEJMBUBTJTFCBHBJSFBLTJUFSIBEBQPLTJHFOZBOHSFOEBI
NBVQVO QBUPMPHJT LJUB EBQBU NFOFNVLBO TBMBI TBUV EBSJ UJHB
%JEVHB CBIXB LPOTFOUSBTJ PLTJHFO ZBOH SFOEBI JOJ
[POB QPMB
BMJSBOEBSBIQBSVZBOHNVOHLJO TFCBHBJCFSJLVU
NFOZFCBCLBO EJCFCBTLBOOZB [BU WBTPLPOTUSJLUPS UFSUFOUV EBSJ
KBSJOHBOQBSV TVCTUBOTJJOJCFMVNEJUFNVLBO
TFMBOKVUOZB[BU ;POB5JEBLBEBBMJSBOEBSBIQBEBTFUJBQGBTFTJLMVTKBOUVOH
JOJ BLBO NFOJOHLBULBO LPOTUSJLTJ BSUFSJBSUFSJ LFDJM EBO LBSFOBUFLBOBOLBQJMFSBMWFPMVTMPLBMEBMBNBSFBQBSVUFSTFCVU
BSUFSJPM +VHB UFSEBQBU EVHBBO CBIXB [BU WBTPLPOTUSJLUPS UJEBL QFSOBI NFOJOHLBU MFCJI UJOHHJ EBO UFLBOBO VEBSB
UFSTFCVUBLBOEJTFLSFTJLBOPMFITFMFQJUFMBMWFPMVTCJMBTFMFQJUFM BMWFPMVTTFMBNBGBTFNBOBQVOEBSJTJLMVTKBOUVOH
BMWFPMVTUFSTFCVUNFOHBMBNJIJQPLTJB ;POB "MJSBO EBSBI CFSLBMB IBOZB TFMBNB UFLBOBO BSUFSJ
1FOHBSVI PLTJHFO SFOEBI JOJ UFSIBEBQ UBIBOBO WBTLVMBS QVMNPOBMJT UFSUJOHHJ LBSFOB UFLBOBO TJTUPMJL NFOKBEJ MFCJI
QBSVNFNQVOZBJGVOHTJZBOHQFOUJOHVOUVLNFOEJTUSJCVTJLBO CFTBSEBSJQBEBUFLBOBOVEBSBBMWFPMVT UFUBQJUFLBOBOEJBTUPMJL
BMJSBOEBSBITFDBSBTBOHBUFGFLUJG:BJUV CJMBWFOUJMBTJCFCFSBQB LVSBOHEBSJUFLBOBOVEBSBBMWFPMVT
BMWFPMJ TBOHBU CVSVL TFIJOHHB LPOTFOUSBTJ PLTJHFO EJ
EBMBNOZB NFOKBEJ TBOHBU SFOEBI NBLB QFNCVMVI EBSBI
TFUFNQBUBLBOCFSLPOTUSJLTJ)BMJOJNFOZFCBCLBOEBSBIBLBO
NFOHBMJS NFMBMVJ CBHJBO MBJO EBSJ QBSV ZBOH PLTJHFOBTJOZB
MFCJI CBJL KBEJ NFOJNCVMLBO TVBUV TJTUFN QFOHBUVS PUPNBUJT
VOUVL NFOEJTUSJCVTJLBO BMJSBO EBSBI LF CFSCBHBJ EBFSBI QBSV e ja isik
TFCBOEJOHEFOHBOUFLBOBOPLTJHFOBMWFPMVTOZB
Pengaruh Gradien Tekanan Hidrostatik dalam

Paru Terhadap Aliran Darah Regional Paru e di i saa is a a
%BMBN#BC UFMBIEJOZBUBLBOCBIXBUFLBOBOEBSBIQBEBLBLJ
TFTFPSBOH ZBOH TFEBOH CFSEJSJ EBQBU TBNQBJ NN )H MFCJI
CFTBSEBSJQBEBUFLBOBOEJUFNQBUTFUJOHHJKBOUVOH*OJEJTFCBCLBO
n ak enga asa
PMFI UFLBOBO IJESPTUBUJL ZBJUV PMFI CFSBU EBSBI JUV TFOEJSJ EJ
EBMBNQFNCVMVIEBSBI"LJCBUZBOHTBNB XBMBVQVOMFCJILFDJM
EFSBKBUOZB UFSKBEJ EJ QBSV 1BEB PSBOH EFXBTB OPSNBM ZBOH li an da a ada e agai agian di a ada
seseo ang ang e di i egak ada keadaan is i a a dan
TFEBOHCFSEJSJUFHBL UJUJLUFSFOEBIQBEBQBSVOZBLJSBLJSBDN selama ke ja isik e a ikan a a ila o ang e se
EJCBXBIUJUJLUFSUJOHHJ4FMJTJIUJOHHJJOJNFXBLJMJTFMJTJIUFLBOBO is i a a ali an da a ada n ak a sanga enda dan
TFCFTBSNN)H LJSBLJSBNN)HEJBUBTKBOUVOHEBONN aling an ak mengali melal i a a agian a a
479
Unit VII Pernapasan
1BEBSFHJPQBSVZBOHMFCJICBXBI LJSBLJSBNVMBJEBSJDNEJ
BUBT LFUJOHHJBO KBOUVOH MBMV NFOHBSBI LF EBTBS QBSV NBLB
ei ena UFLBOBO BSUFSJ QVMNPOBMJT TFMBNB TJTUPM EBO EJBTUPM UFUBQ MFCJI
CFTBS EBSJQBEB UFLBOBO OPM VEBSB EJ BMWFPMVT 0MFI LBSFOB JUV
UFSKBEJBMJSBOZBOHUFSVTNFOFSVTEJEBMBNLBQJMFSBMWFPMVT ZBOH
CFSBSUJ NFSVQBLBO [POB BMJSBO EBSBI +VHB CJMB TFTFPSBOH
CFSBEBEBMBNQPTJTJCFSCBSJOH NBLBUJEBLBEBCBHJBOQBSVZBOH
MFCJIUJOHHJCFCFSBQBTFOUJNFUFSEJBUBTLFUJOHHJBOKBOUVOH1BEB
LBTVTJOJ BMJSBOEBSBIQBEBPSBOHOPSNBMTFMVSVIOZBNFSVQBLBO
ei ena [POB UFSNBTVLEJCBHJBOBQFLTQBSV
Zona 1 Aliran Darah Hanya Terjadi pada Keadaan

Abnormal. ;POB BMJSBO EBSBI ZBJUV CFSBSUJ UJEBL BEB EBSBI
NFOHBMJS TFMBNB TJLMVT KBOUVOH UFSKBEJ CJMB UFLBOBO BSUFSJ TJTUPMJL
QBSV UFSMBMV SFOEBI BUBV UFLBOBO BMWFPVT UFSMBMV UJOHHJ VOUVL
NFNVOHLJOLBOBMJSBO4FCBHBJDPOUPI KJLBTFTFPSBOHZBOHCFSEJSJ
ei ena UFHBL CFSOBQBT NFMBXBO UFLBOBO VEBSB QPTJUJG TFIJOHHB UFLBOBO
VEBSB JOUSBBMWFPMVT QBMJOH TFEJLJU NN )H MFCJI CFTBS EBSJ
OPSNBM UFUBQJ UFLBOBO EBSBI TJTUPMJL QBSV CFSTJGBU OPSNBM BLBO
UJNCVM[POBBMJSBOEBSBIUJEBLBEBBMJSBOEBSBIQBEBBQFLTQBSV
$POUPI MBJO UJNCVMOZB [POB BMJSBO EBSBI BEBMBI QBEB PSBOH
EFOHBO QPTJTJ UFHBL ZBOH UFLBOBO BSUFSJ TJTUPMJL QBSVOZB TBOHBU
ekanika ali an da a ada ke iga ona ali an
da a a ona li ekanan da a al eol s
SFOEBI TFQFSUJZBOHNVOHLJOUFOKBEJTFUFMBIQFSEBSBIBOIFCBU
le i esa da i ada ekanan a e i ona li
i e i e ekanan a e i sis olik meningka le i inggi da i ada
ekanan da a al eol s e a i ekanan a e i dias olik men n Pengaruh Kerja Fisik terhadap Aliran Darah yang melalui
di a a ekanan da a al eol s dan ona li o i Berbagai Bagian Paru. %FOHBO NFMJIBU LFNCBMJ(BNCBS
ekanan a e i dan ekanan ka ile a e a le i inggi LJUB EBQBU NFMJIBU CBIXB BMJSBO EBSBI EJ TFNVBCBHJBO
da i ada ekanan da a al eol s se anjang ak QBSV NFOJOHLBU TFMBNB LFSKB GJTJL 1FOJOHLBUBO BMJSBO EJ
QVODBL QBSV EBQBU NFODBQBJ IJOHHB QFSTFO TFEBOHLBO
LFOBJLBO EJ CBHJBO CBXBI QBSV NVOHLJO UJEBL MFCJI EBSJ
;POB "MJSBO EBSBI ZBOH UFSVTNFOFSVT LBSFOB UFLBOBO TBNQBJ QFSTFO 1FOZFCBC QFSCFEBBO JOJ BEBMBI UFLBOBO
LBQJMFSBMWFPMVTNBTJIUFUBQMFCJICFTBSEBSJQBEBUFLBOBOVEBSB WBTLVMBS QBSV ZBOH DVLVQ UJOHHJ TFMBNB LFSKB GJTJL VOUVL
BMWFPMVTTFMBNBTFMVSVITJLMVTKBOUVOH NFOHVCBIBQFLTQBSVEBSJQPMB[POBNFOKBEJQPMB[POB
#JBTBOZB QBSVQBSV IBOZB NFNJMJLJ [POB EBO [POB
Peningkatan Curah Jantung Selama Kerja Fisik Berat
BMJSBO JOUFSNJUFO
QBEB BQFLT EBO [POB BMJSBO UFSVT
Normalnya Diakomodasi oleh Sirkulasi Paru tanpa
NFOFSVT
QBEBTFNVBEBFSBIZBOHMFCJISFOEBI4FCBHBJDPOUPI
Peningkatan Besar pada Tekanan Arteri Pulmonal
CJMB TFTFPSBOH CFSEJSJ EBMBN QPTJTJ UFHBL NBLB UFLBOBO BSUFSJ
QVMNPOBMJT QBEB BQFLT QBSV NFOKBEJ TFLJUBS NN )H MFCJI 4FMBNB LFSKB GJTJL CFSBU BMJSBO EBSBI NFMBMVJ QBSV NFOJOHLBU
SFOEBI EBSJQBEB UFLBOBO QBEB UFNQBU TFUJOHHJ KBOUVOH 0MFI TBNQBJFNQBUIJOHHBUVKVILBMJMJQBU"MJSBOFLTUSBJOJEJUBNQVOH
LBSFOBJUVUFLBOBOTJTUPMJLBQJLBMIBOZBNN)H NN)H EBMBN QBSV NFMBMVJ UJHB DBSB
EFOHBO NFOJOHLBULBO KVNMBI
QBEB UFNQBU TFUJOHHJ KBOUVOH EJLVSBOHJ TFMJTJI UFLBOBO LBQJMFS ZBOH UFSCVLB LBEBOHLBEBOH TBNQBJ UJHB LBMJ MJQBU

IJESPTUBUJL TFCFTBS NN )H
5FLBOBO BQJLBM NN )H JOJ EFOHBONFSFHBOHLBOTFNVBLBQJMFSEBONFOJOHLBULBOLFDFQBUBO
MFCJICFTBSEBSJQBEBUFLBOBOOPMVEBSBBMWFPMVT TFIJOHHBTFMBNB BMJSBO EJ TFUJBQ LBQJMFS MFCJI EBSJ EVB LBMJ MJQBU EBO
EFOHBO
TJTUPM EBSBI NFOHBMJS NFMBMVJ LBQJMFS BQFLT QBSV 4FCBMJLOZB NFOJOHLBULBO UFLBOBO BSUFSJ QVMNPOBMJT 1BEB PSBOH ZBOH
TFMBNB EJBTUPM UFLBOBO EJBTUPMJL QBEB UFNQBU TFUJOHHJ KBOUVOH OPSNBM EVB QFSVCBIBO ZBOH QFSUBNB BLBO TBOHBU NFOVSVOLBO
CFTBSOZB NN )H ZBOH UJEBL DVLVQ VOUVL NFOEPSPOH EBSBI UBIBOBO WBTLVMBS QBSV TFIJOHHB UFLBOBO BSUFSJ QVMNPOBMJT
TBNQBJ NN )H HSBEJFO UFLBOBO IJESPTUBUJL
ZBOH NFOJOHLBU TBOHBU TFEJLJU CBILBO TFMBNB LFSKB GJTJL ZBOH
EJCVUVILBOBHBSEBSBINFOHBMJSEBMBNLBQJMFSTFMBNBEJBTUPMJL NBLTJNVNFGFLJOJEJQFSMJIBULBOQBEB(BNCBS
0MFILBSFOBJUV EBSBIZBOHNFOHBMJSNFMBMVJCBHJBOBQFLTQBSV ,FNBNQVBO QBSV VOUVL NFOBNQVOH LFOBJLBO BMJSBO EBSBI
CFSTJGBUJOUFSNJUFO NFOHBMJSTFMBNBTJTUPMUFUBQJCFSIFOUJTFMBNB ZBOH CFTBS TFMBNB LFSKB GJTJL UBOQB NFOJOHLBULBO UFLBOBO BSUFSJ
EJBTUPM IBM JOJ EJTFCVU [POB BMJSBO EBSBI 1BEB QBSV OPSNBM QVMNPOBMJT BLBO NFOHIFNBU FOFSHJ KBOUVOH TJTJ LBOBO EBO
[POB BMJSBO EBSBI CFSBXBM EBSJ LVSBOH MFCJI DN EJ BUBT NFODFHBI LFOBJLBO UFLBOBO LBQJMFS QBSV ZBOH CFSBSUJ TFIJOHHB
QFSUFOHBIBOKBOUVOHEBOEBSJTJOJNFMVBTLFBSBIQVODBLQBSV KVHBNFODFHBIUFSKBEJOZBFEFNBQBSV
480
UFLOJL TFQFSUJ ZBOH EJKFMBTLBO QBEB #BC UFMBI NFOHIBTJMLBO

30 OJMBJ TFCFTBS NN )H *OJ NVOHLJO TBOHBU NFOEFLBUJ
LFCFOBSBO LBSFOBUFLBOBOBUSJVNLJSJSBUBSBUBBEBMBITFLJUBS
NN )H EBO UFLBOBO BSUFSJ QVMNPOBMJT SBUBSBUB IBOZB NN
UNIT VII
ilai no mal )H TFIJOHHB UFLBOBO LBQJMFS QBSV SBUBSBUB IBSVT UFSMFUBL EJ
20 BOUBSBLFEVBOJMBJUFSTFCVU
Lamanya Darah Berada di Kapiler Paru. %BSJQFOFMJUJBO

10 IJTUPMPHJT UFOUBOH MVBT QFOBNQBOH UPUBM TFNVB LBQJMFS QBSV
EBQBU EJIJUVOH CBIXB CJMB DVSBI KBOUVOH OPSNBM EBSBI
NFOHBMJS NFMBMVJ LBQJMFS QBSV EBMBN XBLUV EFUJL #JMB
DVSBI KBOUVOH NFOJOHLBU BLBO NFNQFSQFOEFL XBLUV JOJ
0 TBNQBJTFTJOHLBUTJOHLBUOZB EFUJL8BLUVJOJBLBOTFNBLJO
0 4 8 12 16 20 24
QFOEFLCJMBLBQJMFSLBQJMFSMBJO ZBOHCJBTBOZBLPMBQT NFOKBEJ
enga eningka an a jan ng selama UFSCVLB VOUVL NFOBNQVOH QFOJOHLBUBO BMJSBO EBSBI +BEJ
ke ja isik e ada ekanan a e i lmonalis a a a a EBMBNXBLUVLVSBOHEBSJEFUJL EBSBIZBOHNFOHBMJSNFMBMVJ
LBQJMFS BMWFPMVT NFOKBEJ UFSPLTJHFOBTJ EBO NFMFQBTLBO
LFMFCJIBOLBSCPOEJPLTJEBOZB
Fungsi Sirkulasi Paru ketika Tekanan Atrium
Kiri Meningkat Akibat Gagal Jantung Kiri Pertukaran Cairan Kapiler dalam Paru, dan
1BEB PSBOH TFIBU UFLBOBO BUSJVN LJSJ IBNQJS UJEBL QFSOBI Dinamika Cairan Interstisial Paru
NFOJOHLBU EJ BUBT NN )H CBILBO TFMBNB LFSKB GJTJL ZBOH
CFSBU 1FSVCBIBO UFLBOBO BUSJVN LJSJ ZBOH TFEJLJU JOJ IBNQJS %JOBNJLB QFSUVLBSBO DBJSBO ZBOH NFMBMVJ NFNCSBO LBQJMFS
UJEBL CFSQFOHBSVI UFSIBEBQ GVOHTJ TJSLVMBTJ QBSV LBSFOB IBOZB QBSV TFDBSB LVBMJUBUJG TBNB EFOHBO EJOBNJLB DBJSBO QBEB
BLBO NFOHFNCBOHLBO WFOVMBWFOVMB QBSV EBO NFNCVLB MFCJI KBSJOHBO QFSJGFS /BNVO TFDBSB LVBOUJUBUJG UFSEBQBU CFCFSBQB
CBOZBL LBQJMFS TFIJOHHB EBSBI EBSJ BSUFSJ QVMNPOBMJT UFSVT QFSCFEBBOQFOUJOH TFCBHBJCFSJLVU
NFOHBMJSEFOHBOLFDFQBUBOZBOHIBNQJSTBNB 1. 5FLBOBOLBQJMFSQBSVDVLVQSFOEBI LVSBOHMFCJINN)H
#JMB TJTJ LJSJ KBOUVOH NFOHBMBNJ LFHBHBMBO NBLB EBSBI NVMBJ EJCBOEJOHLBOEFOHBOUFLBOBOLBQJMFSGVOHTJPOBMEJKBSJOHBO
UFSCFOEVOH EBMBN BUSJVN LJSJ 4FCBHBJ BLJCBUOZB UFLBOBO BUSJVN QFSJGFSZBOHTBOHBUUJOHHJ ZBJUVTFLJUBSNN)H
LJSJ EBQBU NFOJOHLBU EBSJ OJMBJ OPSNBMOZB TBNQBJ NN )H 2. 5FLBOBO DBJSBO JOUFSTUJTJBM EBMBN QBSV TFEJLJU MFCJI OFHBUJG
NFODBQBJTBNQBJNN)H1FOJOHLBUBOBXBMUFLBOBOBUSJVN EBSJQBEB UFLBOBO DBJSBO JOUFSTUJTJBM EJ KBSJOHBO TVCLVUBO
TBNQBJTFLJUBSNN)H TFEJLJUNFNFOHBSVIJGVOHTJTJSLVMBTJQBSV QFSJGFS 5FLBOBO JOJ UFMBI EJVLVS NFMBMVJ EVB DBSB EFOHBO
5FUBQJCJMBUFLBOBOBUSJVNNFOJOHLBUMFCJIEBSJBUBVNN)H NFOHHVOBLBO NJLSPQJQFU ZBOH EJTJTJQLBO LF EBMBN
NBLB QFOJOHLBUBO UFLBOBO BUSJVN LJSJ TFMBOKVUOZB EJ BUBT OJMBJ JOJ JOUFSTUJTJVN QBSV NFNCFSJ OJMBJ TFLJUBS NN )H EBO
BLBONFOZFCBCLBOQFOJOHLBUBOUFLBOBOBSUFSJQVMNPOBMJTEFOHBO NFMBMVJ QFOHVLVSBO UFLBOBO BCTPSQTJ ZBOH EJMBLVLBO QBEB
OJMBJZBOHIBNQJSTBNBCFTBS TFIJOHHBNFOZFCBCLBOQFOJOHLBUBO DBJSBOEBSJBMWFPMJ ZBOHNFNCFSJOJMBJTFLJUBSNN)H
CFCBOQBEBKBOUVOHLBOBO4FUJBQQFOJOHLBUBOUFLBOBOBUSJVNLJSJ
EJ BUBT BUBV NN )H KVHB BLBO NFOJOHLBULBO UFLBOBO LBQJMFS 3. ,BQJMFS QBSV SFMBUJG NVEBI EJMBMVJ PMFI NPMFLVM QSPUFJO
IBNQJSTBNBCFTBSOZB#JMBUFLBOBOBUSJVNLJSJUFMBINFOJOHLBUEJ TFIJOHHBUFLBOBOPTNPUJLLPMPJEQBEBDBJSBOJOUFSTUJTJBMQBSV
BUBTNN)H BLBONFOZFCBCLBOQFOJOHLBUBOZBOHTFSVQBQBEB LJSBLJSB NN )H TFEBOHLBO UFLBOBO PTNPUJL LPMPJE EJ
UFLBOBO LBQJMFS MBMV BLBO UFSKBEJ FEFNB QBSV TFQFSUJ ZBOH LJUB KBSJOHBOQFSJGFSLVSBOHEBSJTFQBSVIOJMBJJOJ
CBIBTLFNVEJBOEBMBNCBCJOJ 4. %JOEJOH BMWFPMVT TBOHBU UJQJT EBO FQJUFM BMWFPMVT ZBOH
NFOVUVQJQFSNVLBBOBMWFPMVTTBOHBU*FNBITFIJOHHBTFM
Dinamika Kapiler Paru TFM JOJ EBQBU EJSVTBL PMFI TFUJBQ UFLBOBO QPTJUJG EBMBN
SVBOHJOUFSTUJTJBMZBOHMFCJICFTBSEBSJQBEBUFLBOBOVEBSB
BMWFPMVT NN )H
ZBOH NFOZFCBCLBO DBJSBO
1FSUVLBSBO HBT BOUBSB VEBSB BMWFPMVT EBO EBSBI LBQJMFS QBSV BLBO
NFMJNQBIEBSJSVBOHJOUFSTUJTJBMLFEBMBNBMWFPMVT
EJCJDBSBLBOQBEB#BC"LBOUFUBQJ QFOUJOHVOUVLLJUBQFSIBUJLBO
EJ TJOJ CBIXB EJOEJOH BMWFPMVT EJMBQJTJ PMFI CFHJUV CBOZBL LBQJMFS 4FLBSBOHNBSJLJUBMJIBUCBHBJNBOBQFSCFEBBOLVBOUJUBUJG
TFIJOHHB QBEB CBOZBL UFNQBU LBQJMFSLBQJMFS IBNQJS CFSTFOUVIBO JOJNFNFOHBSVIJEJOBNJLBDBJSBOQBSV
TBUV TBNB MBJO 0MFI LBSFOB JUV TFSJOH LBMJ EJLBUBLBO CBIXB EBSBI
LBQJMFS NFOHBMJS EJ EBMBN EJOEJOH BMWFPMVT TFQFSUJ MFNCBSBO EBO Hubungan Timbal Balik antara Tekanan Cairan
CVLBOOZBNFOHBMJSEBMBNQFNCVMVIUFSTFOEJSJ Interstisial dan Tekanan Lain dalam Paru. (BNCBS
NFMVLJTLBOTFCVBILBQJMFSQBSV TFCVBIBMWFPMVTQBSV EBOLBQJMFS
Tekanan Kapiler Paru. 5JEBL QFSOBIEJMBLVLBOQFOHVLVSBO MJNGBUJLZBOHNFOESBJOBTFSVBOHJOUFSTUJTJBMBOUBSBLBQJMFSEBSBI
UFLBOBO LBQJMFS QBSV TFDBSB MBOHTVOH "LBO UFUBQJ QFOHVLVSBO EBO BMWFPMVT 1FSIBUJLBO LFTFJNCBOHBO EBZB QBEB NFNCSBO
JTPHSBWJNFUSJLQBEBUFLBOBOLBQJMFSQBSV EFOHBONFNBLBJ LBQJMFS TFCBHBJCFSJLVU
481
Unit VII Pernapasan
/BNVO KJLB LJUB JOHBU CBIXB TFDBSB OPSNBM LBQJMFS QBSV EBO
TJTUFNMJNGBUJLQBSVNFNQFSUBIBOLBOTFEJLJUUFLBOBOOFHBUJGEBMBN
SVBOH JOUFSTUJTJBM NBLB KFMBTMBI CBIXB LBQBO QVO UFSEBQBU DBJSBO
FLTUSBEBMBNBMWFPMJ NBLBDBJSBOJUVBLBOEJJTBQTFDBSBNFLBOJTLF
ekanan EBMBN JOUFSTUJTJVN QBSV NFMBMVJ MVCBOH LFDJM EJ BOUBSB TFM FQJUFM
-8
id os a ik +7 -8 - 8 ( egangan BMWFPMVT,FNVEJBOLFMFCJIBODBJSBOBLBOEJCBXBPMFIMJNGBUJLQBSV
e m kaan BUBV EJBCTPSQTJ LF EBMBN LBQJMFS QBSV +BEJ QBEB LFBEBBO OPSNBM
di o i
ekanan BMWFPMVT UFUBQ LFSJOH LFDVBMJ VOUVL TFKVNMBI LFDJM DBJSBO ZBOH
smo ik - 28 - 14
NFSFNCFT EBSJ FQJUFM LF QFSNVLBBO BMWFPMVT VOUVL NFOKBHB
ekanan ( + 1) ( 0) ( a o asi) LFMFNCBQBOOZB
ne o -5
Edema Paru
-4 &EFNBQBSVUFSKBEJEFOHBODBSBZBOHTBNBTFQFSUJFEFNBEJUFNQBU
MBJO EBMBN UVCVI 4FUJBQ GBLUPS ZBOH NFOJOHLBULBO GJMUSBTJ DBJSBO
om a lim a ik LFMVBSEBSJLBQJMFSQBSVBUBVNFOHHBOHHVGVOHTJMJNGBUJLQBSVTFSUB
NFOZFCBCLBOUFLBOBODBJSBOJOUFSTUJTJBMQBSVNFOJOHLBUEBSJLJTBSBO
ekanan osmo ik dan id os a ik da am mm Hg OFHBUJG NFOKBEJ LJTBSBO QPTJUJG BLBO NFOZFCBCLBO QFOHJTJBO DFQBU
ada ka ile i i dan mem an al eol s a ga TFKVNMBICFTBSDBJSBOCFCBTQBEBSVBOHJOUFSTUJTJBMQBSVEBOBMWFPMJ
me kiskan j ng em l lim a ik e g ang memom a
ai an da i ang in e s isial a imodi ikasi da i on 1FOZFCBCFEFNBQBSVZBOHQBMJOHVNVNBEBMBITFCBHBJCFSJLVU
a lo ange H Ci l o y y iology y i 1. (BHBM KBOUVOH TJTJLJSJ BUBV QFOZBLJU LBUVQ NJUSBM EFOHBO
Co ol o e Bo y l i iladel ia a nde s LPOTFLVFOTJ QFOJOHLBUBO UFLBOBO WFOB QBSV EBO UFLBOBO LBQJMFS
QBSV EBOSVBOHJOUFSTUJTJBMTFSUBBMWFPMJNFOKBEJCBOKJS
mm Hg
Daya yang cenderung menyebabkan perpindahan cairan keluar 2. ,FSVTBLBO QBEB NFNCSBO LBQJMFS QBSV ZBOH EJTFCBCLBO PMFI
dari kapiler dan masuk ke dalam interstisium paru: JOGFLTJ TFQFSUJ QOFVNPOJB BUBV UFSIJSVQOZB CBIBOCBIBO ZBOH
Tekanan kapiler 7 CFSCBIBZB TFQFSUJ HBT LMPSJO BUBV HBT TVMGVS EJPLTJEB .BTJOH
Tekanan osmotik koloid cairan interstisial 14 NBTJOHNFOZFCBCLBOLFCPDPSBOQSPUFJOQMBTNBEBODBJSBOTFDBSB
Tekanan negatif cairan interstisial 8 DFQBULFMVBSEBSJLBQJMFSEBONBTVLLFSVBOHJOUFSTUJTJBMQBSVTFSUB
TOTAL DAYA KELUAR 29 BMWFPMJ
Daya yang cenderung menyebabkan absorpsi cairan ke dalam
kapiler: "Faktor Pengaman Edema Paru." 1BEBQFSDPCBBO
Tekanan osmotik koloid plasma 28
EFOHBOCJOBUBOH UFMBIEJUFNVLBOCBIXBUFLBOBOLBQJMFSQBSV
TOTAL DAYA KE DALAM 28
OPSNBMOZB IBSVT NFOJOHLBU LF TVBUV OJMBJ ZBOH TFUJEBLOZB
+BEJ EBZBLFMVBSOPSNBMTFEJLJUMFCJICFTBSEBSJQBEBEBZBLF TBNBEFOHBOUFLBOBOPTNPUJLLPMPJEQMBTNBLBQJMFS TFCFMVN
EBMBN TFIJOHHBNFOJNCVMLBOBEBOZBUFLBOBOGJMUSBTJSBUBSBUB
QBEBNFNCSBOLBQJMFSQBSVZBOHEBQBUEJIJUVOHTFCBHBJCFSJLVU
mm Hg
Total tekanan ke luar +29
10
Total tekanan ke datam −28
TEKANAN FILTRASI RATA-RATA +1 9 x
x
8
5FLBOBO GJMUSBTJ JOJ NFOZFCBCLBO UJNCVMOZB TFEJLJU BMJSBO 7

x
DBJSBO ZBOH LPOUJOV EBSJ LBQJMFS QBSV LF EBMBN SVBOH 6
JOUFSTUJTJBM EBOLFDVBMJVOUVLTFKVNMBILFDJMZBOHNFOHVBQEJ 5 x
BMWFPMJ DBJSBOJOJEJQPNQBLFNCBMJLFEBMBNTJSLVMBTJNFMBMVJ 4 x x
TJTUFNMJNGBUJLQBSV x
x
3 x
x x
2 x
Tekanan interstisial Paru yang Negatif dan Mekanisme x x
untuk Menjaga agar Alveoli Tetap "Kering". "QB ZBOH 1 x x
x
x xx
NFODFHBI UFSJTJOZB BMWFPMJ EFOHBO DBJSBO QBEB LFBEBBO 0 x x x x x
OPSNBM ,JUB DFOEFSVOH QFSUBNB LBMJ CFSQJLJS CBIXB FQJUFM 0 5 10 15 20 25 30 35 40 45 50
BMWFPMVT DVLVQ LVBU EBO DVLVQ CFSLFTJOBNCVOHBO VOUVL
NFOKBHB BHBS DBJSBO UJEBL CPDPS EBSJ SVBOH JOUFSTUJTJBM LF
e e a an e inda n a ai an ke dalam ja ingan
EBMBN BMWFPMJ )BM JOJ UJEBL CFOBS LBSFOB QFSDPCBBO UFMBI a ke ika ekanan a i m ki i dan j ga ekanan ka ile a
NFNCVLUJLBOCBIXBTFMBMVBEBMVCBOHZBOHUFSCVLBEJBOUBSB di ingka kan ai on dan indse e o ele e
TFMTFM FQJUFM BMWFPMVT ZBOH CBILBO EBQBU EJMBMVJ PMFI NPMFLVM le i l e e e e e l o ei o e io o
QSPUFJOCFTBS TFSUBBJSEBOFMFLUSPMJU e e elo e o l o ye e i es
482
UFSKBEJ FEFNB QBSV ZBOH OZBUB 4FCBHBJ DPOUPI (BNCBS is em ena
NFNQFSMJIBULBO FGFL EBSJ OJMBJ UFLBOBO BUSJVN LJSJ ZBOH
CFSCFEBCFEB UFSIBEBQ QFOJOHLBUBO LFDFQBUBO QFNCFOUVLBO
im a ik
FEFNB QBSV QBEB TFFLPS BOKJOH *OHBUMBI CBIXB TFUJBQ LBMJ
UNIT VII
UFLBOBO BUSJVN LJSJ NFOJOHLBU TBNQBJ OJMBJ ZBOH UJOHHJ NBLB
ei
UFLBOBOLBQJMFSQBSVNFOJOHLBUTBNQBJIJOHHBNN)HMFCJI
CFTBS EBSJQBEB UFLBOBO BUSJVN LJSJ 1BEB QFSDPCBBO JOJ TFHFSB
TFUFMBI UFLBOBO BUSJVN LJSJ NFOJOHLBU EJ BUBT NN )H
NFOZFCBCLBO UFLBOBO LBQJMFS QBSV NFOJOHLBU EJBUBT NN
)H
DBJSBO NVMBJ CFSBLVNVMBTJ EJ EBMBN QBSV "LVNVMBTJ
DBJSBO JOJ CFSUBNCBI TFNBLJO DFQBU ZBOH TFMBOKVUOZB BLBO
NFOJOHLBULBO UFLBOBO LBQJMFS MFCJI UJOHHJ MBHJ 5FLBOBO
PTNPUJLLPMPJEQMBTNBTFMBNBQFSDPCBBOJOJTBNBEFOHBOOJMBJ
UFLBOBO ZBOH LSJUJT JOJ ZBJUV TFCFTBS NN )H 0MFI LBSFOB
JUV QBEB NBOVTJB ZBOH OPSNBMOZB NFNJMJLJ UFLBOBO PTNPUJL
LPMPJEQMBTNBTFCFTBSNN)H LJUBEBQBUNFSBNBMLBOCBIXB Vein
UFLBOBO LBQJMFS QBSV IBSVT NFOJOHLBU EBSJ OJMBJ OPSNBM NN
)H NFOKBEJ MFCJI EBSJ NN )H VOUVL NFOZFCBCLBO
UJNCVMOZB FEFNB QBSV NFNCFSJLBO TVBUV GBLUPS QFOHBNBO
BLVUUFSIBEBQFEFNBQBSVTFCFTBSNN)H Gambar 28-8 Dinamika pertukaran cairan di dalam ruang intrapleura.
Faktor Pengaman pada Keadaan Kronis. #JMB UFLBOBO LBQJMFS
QBSV UFSVT NFOJOHLBU TFDBSB LSPOJT TFLVSBOHLVSBOHOZB EBMBN
XBLUV NJOHHV
NBLB QBSV NFOKBEJ MFCJI SFTJTUBO UFSIBEBQ MBUFSBM QMFVSB QBSJFUBMJT 0MFI LBSFOB JUV SVBOH QMFVSB SVBOH
FEFNB QBSV LBSFOB QFNCVMVI MJNGF NFOHFNCBOH DVLVQ CFTBS BOUBSB QMFVSB QBSJFUBMJT EBO QMFVSB WJTFSBMJT EJTFCVU SVBOH
NFOJOHLBULBOLFNBNQVBOOZBVOUVLNFNCBXBLFMVBSDBJSBOEBSJ QPUFOTJBM LBSFOB SVBOH JOJ OPSNBMOZB CFHJUV TFNQJU TFIJOHHB
SVBOH JOUFSTUJTJBM TBNQBJ TFQVMVI LBMJ MFCJI CBOZBL 0MFI LBSFOB CVLBONFSVQBLBOSVBOHGJTJLZBOHOZBUB
JUV TFPSBOH QBTJFO EFOHBO TUFOPTJT NJUSBMJT LSPOJT NFNQVOZBJ
UFLBOBO LBQJMFS QBSV TFCFTBS TBNQBJ NN )H UBOQB "Tekanan Negatif" dalam Cairan Pleura. 4FMBMV
NFOHBMBNJFEFNBQBSVZBOHNFNBUJLBO EJQFSMVLBO UFLBOBO OFHBUJG QBEB TJTJ MVBS QBSV VOUVL
Cepatnya Kematian pada Edema Paru Akut. #JMB UFLBOBO NFNQFSUBIBOLBO QFOHFNCBOHBO QBSV 5FLBOBO JOJ EJTFCBCLBO
LBQJMFSQBSVNFOJOHLBUTFEJLJUEJBUBTOJMBJGBLUPSQFOHBNBO FEFNB PMFIUFLBOBOOFHBUJGEBMBNSVBOHQMFVSBOPSNBM1FOZFCBCEBTBS
QBSVZBOHNFNBUJLBOEBQBUUFSKBEJEBMBNXBLUVCFCFSBQBKBN BUBV BEBOZBUFLBOBOOFHBUJGJOJBEBMBIQFNPNQBBODBJSBOEBSJSVBOH
CBILBO EBMBN XBLUV IJOHHB NFOJU CJMB UFLBOBO LBQJMFS QMFVSB PMFI TBMVSBO MJNGBUJL ZBOH KVHB NFSVQBLBO EBTBS EBSJ
NFOJOHLBU TFCFTBS TBNQBJ NN )H EJ BUBT OJMBJ GBLUPS UFLBOBO OFHBUJG ZBOH EJKVNQBJ QBEB TFCBHJBO CFTBS SVBOH
QFOHBNBO +BEJ QBEB HBHBM KBOUVOH LJSJ BLVU ZBOH EBQBU
KBSJOHBOEBMBNUVCVI
/PSNBMOZB QBSVDFOEFSVOHBLBOLPMBQT
NFOZFCBCLBO UFLBOBO LBQJMFS QBSV LBEBOHLBEBOH NFOJOHLBU
TBNQBJTFUJOHHJNN)H LFNBUJBO TFSJOHUFSKBEJLVSBOHEBSJ
QBEB UFLBOBO TFLJUBS NN )H NBLB UFLBOBO DBJSBO QMFVSB
NFOJUBLJCBUFEFNBQBSVBLVU QBMJOH TFEJLJU IBSVT TFMBMV NN )H VOUVL NFNQFSUBIBOLBO
QFOHFNCBOHBO QBSV 1FOHVLVSBO ZBOH TFCFOBSOZB UFMBI
Cairan dalam Rongga Pleura NFNCVLUJLBO CBIXB UFLBOBO JOJ CJBTBOZB TFLJUBS NN )H
ZBJUV CFCFSBQB NJMJMJUFS BJS SBLTB MFCJI OFHBUJG EBSJQBEB UFLBOBO
#JMB QBSVQBSV NFOHFNCBOH EBO CFSLPOUSBLTJ TFMBNB CFOBQBT LPMBQT QBSV +BEJ LFOFHBUJGBO DBJSBO QMFVSB NFNQFSUBIBOLBO
OPSNBM NBLB QBSVQBSV CFSHFSBL LF EFQBO EBO LF CFMBLBOH BHBSQBSVOPSNBMUFSUBSJLLFMVBSLFBSBIQMFVSBQBSJFUBMJTSPOHHB
EBMBN SPOHHB QMFVSB 6OUVL NFNVEBILBO QFSHFSBLBO JOJ EBEB LFDVBMJQBEBMBQJTBODBJSBONVLPJEZBOHTBOHBUUJQJTZBOH
UFSEBQBUMBQJTBOUJQJTDBJSBONVLPJEZBOHUFSMFUBLEJBOUBSBQMFVSB CFSUJOEBLTFCBHBJQFMVNBT
QBSJFUBMJTEBOQMFVSBWJTFSBMJT Efusi Pleura—Pengumpulan Sejumlah Besar Cairan
(BNCBS NFNQFSMJIBULBO EJOBNJLB QFSUVLBSBO DBJSBO Bebas dalam Rongga Pleura. &GVTJ QMFVSB BOBMPH EFOHBO
EBMBN SVBOH QMFVSB .FNCSBO QMFVSB NFSVQBLBO NFNCSBO DBJSBOFEFNBEBMBNKBSJOHBO EBOEBQBUEJTFCVUTFCBHBJFEFNB
TFSPTB NFTFOLJNBM ZBOH CFSQPSJQPSJ UFNQBU TFKVNMBI LFDJM SPOHHB QMFVSBh 1FOZFCBC FGVTJ BEBMBI TBNB EFOHBO ZBOH
DBJSBO JOUFSTUJTJBM CFSUSBOTVEBTJ TFDBSB UFSVTNFOFSVT LF EBMBN NFOZFCBCLBO FEFNB QBEB KBSJOHBO MBJO EJCBIBT EBMBN #BC
SVBOH QMFVSB $BJSBO JOJ NFNCBXB QSPUFJO KBSJOHBO ZBOH
ZBJUV
IBNCBUBOESBJOBTFMJNGBUJLEBSJSPOHHBQMFVSB

NFNCFSJ TJGBU NVLPJE QBEB DBJSBO QMFVSB TFIJOHHB HBHBM KBOUVOH ZBOH NFOZFCBCLBO UFLBOBO QFSJGFS EBO UFLBOBO
NFNVOHLJOLBO QFSHFSBLBO QBSV CFSMBOHTVOH EFOHBO TBOHBU LBQJMFS QBSV NFOKBEJ TBOHBU UJOHHJ TFIJOHHB NFOJNCVMLBO
NVEBI USBOTVEBTJ DBJSBO ZBOH CFSMFCJIBO LF EBMBN SPOHHB QMFVSB

+VNMBIUPUBMDBJSBOEBMBNTFUJBQSPOHHBQMFVSBTBOHBUTFEJLJU UFLBOBOPTNPUJLLPMPJEQMBTNBZBOHTBOHBUNFOVSVO TFIJOHHB
IBOZBCFCFSBQBNJMJMJUFS#JMBKVNMBIJOJNFOKBEJMFCJIEBSJDVLVQ NFNVOHLJOLBO USBOTVEBTJ DBJSBO ZBOH CFSMFCJIBO EBO

VOUVL NFODJQUBLBO TVBUV BMJSBO EBMBN SPOHHB QMFVSB LFMFCJIBO JOGFLTJ BUBV TFUJBQ QFOZFCBC QFSBEBOHBO MBJOOZB QBEB
UFSTFCVU BLBO EJQPNQB LFMVBS PMFI QFNCVMVI MJNGBUJL ZBOH QFSNVLBBOSPOHHBQMFVSB ZBOHNFSVTBLNFNCSBOLBQJMFSEBO
UFSCVLB TFDBSB MBOHTVOH EBSJ SPOHHB QMFVSB LF EBMBN
NFNVOHLJOLBOLFCPDPSBOQSPUFJOQMBTNBEBODBJSBOLFEBMBN
NFEJBTUJOVN
QFSNVLBBOBUBTEJBGSBHNB EBO
QFSNVLBBO SPOHHBTFDBSBDFQBU
483
Unit VII Pernapasan
Daftar Pustaka
Bogaard HJ, Abe K, Vonk Noordegraaf A, et al: The right ventricle Michelakis ED, Wilkins MR, Rabinovitch M: Emerging concepts and
under pres-sure: cellular and molecular mechanisms of right-heart translational
failure in pulmonary hypertension, Chest 135:794, 2009.
Effros RM, Parker JC: Pulmonary vascular heterogeneity and the priorities in pulmonary arterial hypertension, Circulation 118:1486, 2008.
Starling hypothesis, Microvasc Res 78:71, 2009. Miserocchi G, Negrini D, Passi A, et al: Development of lung edema: inter-
stitial fluid dynamics and molecular structure, News Physiol Sci 16:66,
Effros RM, Pornsuriyasak P, Porszasz J, et al: Indicator dilution measure- 2001.
ments of extravascular lung water: basic assumptions and observations, Parker JC: Hydraulic conductance of lung endothelial phenotypes and
Am J Physiol Lung Cell Mol Physiol 294:L1023, 2008.
Starling safety factors against edema, Am J Physiol Lung Cell Mol Physiol
Guyton AC, Lindsey AW: Effect of elevated left atrial pressure and decreased
292:L378, 2007.
plasma protein concentration on the development of pulmonary Parker JC, Townsley MI: Physiological determinants of the pulmonary filtra-
edema, Circ Res 7:649, 1959.
tion coefficient, Am J Physiol Lung Cell Mol Physiol 295:L235, 2008.
Guyton AC, Taylor AE, Granger HJ: Circulatory Physiology. II. Dynamics and Peinado VI, Pizarro S, Barber JA: Pulmonary vascular involvement in COPD,
Control of the Body Fluids, Philadelphia, 1975, WB Saunders. Chest 134:808, 2008.
Hoschele S, Mairbaurl H: Alveolar flooding at high altitude: failure of reab- Robertson HT, Hlastala MP: Microsphere maps of regional blood flow and
sorption? News Physiol Sci 18:55, 2003. regional ventilation, J Appl Physiol 102:1265, 2007.
Hughes M, West JB: Gravity is the major factor determining the distribution West JB: Respiratory Physiology—The Essentials, ed 8, Baltimore, Lippincott,
of blood flow in the human lung, J Appl Physiol 104:1531, 2008. Williams & Wilkins, 2008.
Lai-Fook SJ: Pleural mechanics and fluid exchange, Physiol Rev
84:385, 2004.
484
BAB 39
1SJOTJQ1SJOTJQ'JTJLB1FSUVLBSBO
UNIT VII
(BT%JGVTJ0LTJHFOEBO,BSCPO
%JPLTJEBNFMBMVJ.FNCSBO
1FSOBQBTBO
4FUFMBI BMWFPMJ EJWFOUJMBTJ Tekanan Gas dalam Campuran Gas—"Tekanan Parsial" dari
EFOHBO VEBSB TFHBS MBOHLBI Masing-Masing Gas
TFMBOKVUOZB EBMBN QSPTFT 5FLBOBO EJTFCBCLBO PMFI CFSCBHBJ CFOUVSBO EBSJ NPMFLVM
NPMFLVM ZBOH CFSHFSBL QBEB TVBUV QFSNVLBBO 0MFI LBSFOB JUV
QFSOBQBTBO BEBMBI EJGVTJ
UFLBOBO HBT QBEB QFSNVLBBO TBMVSBO QFSOBQBTBO EBO BMWFPMJ
PLTJHFO EBSJ BMWFPMJ LF
BEBMBI TFCBOEJOH EFOHBO KVNMBI LFLVBUBO CFOUVSBO EBSJ TFMVSVI
QFNCVMVI EBSBI QBSV EBO NPMFLVM HBT ZBOH NFNCFOUVS QFSNVLBBO QBEB LFBEBBO UFSUFOUV
EJGVTJLBSCPOEJPLTJEBEBMBN *OJ CFSBSUJ CBIXB UFLBOBO CFSCBOEJOH MBOHTVOH EFOHBO LPOTFOUSBTJ
BSBI TFCBMJLOZB LFMVBS EBSJ QFNCVMVI EBSBI 1SPTFT EJGVTJ TFDBSB NPMFLVMNPMFLVMHBT
TFEFSIBOB NFSVQBLBO HFSBLBO NPMFLVMNPMFLVM TFDBSB BDBL ZBOH 1BEB GJTJPMPHJ QFSOBQBTBO CBOZBL TFLBMJ DBNQVSBO HBTHBT
NFOKBMJO KBMBO LF TFMVSVI BSBI NFMBMVJ NFNCSBO QFSOBQBTBO EBO UFSVUBNB PLTJHFO OJUSPHFO EBO LBSCPO EJPLTJEB ,FDFQBUBO EJGVTJ
DBJSBO ZBOH CFSEFLBUBO 8BMBVQVO EFNJLJBO EBMBN GJTJPMPHJ NBTJOHNBTJOH HBT JOJ CFSCBOEJOH MBOHTVOH EFOHBO UFLBOBO ZBOH
QFSOBQBTBO LJUB UJEBL IBOZB NFNQFSIBUJLBO NFLBOJTNF EBTBS EJTFCBCLBO PMFI HBT JUV TFOEJSJ ZBOH EJTFCVU UFLBOBO QBSTJBM HBT
UFSKBEJOZB EJGVTJ UFUBQJ KVHB LFDFQBUBO EJGVTJ IBM JOJ NFSVQBLBO ,POTFQUFLBOBOQBSTJBMEBQBUEJKFMBTLBOTFCBHBJCFSJLVU
NBTBMBI ZBOH KBVI MFCJI SVNJU EBO NFNFSMVLBO QFOHFSUJBO ZBOH 6EBSB NFNQVOZBJ QFSLJSBBO LPNQPTJTJ TFQFSUJ CFSJLVU
OJUSPHFO QFSTFO EBO PLTJHFO QFSTFO 5FLBOBO UPUBM EBSJ
NFOEBMBNNFOHFOBJGJTJLBEJGVTJEBOQFSUVLBSBOHBT
DBNQVSBO JOJ QBEB LFUJOHHJBO EJ BUBT QFSNVLBBO MBVU LJSBLJSB
NN )H %BSJ EFTLSJQTJ TFCFMVNOZB NFOHFOBJ EBTBS
Fisika Difusi Gas dan Tekanan Parsial Gas NPMFLVMBSUFLBOBOUFMBIKFMBTCBIXBNBTJOHNBTJOHHBTCFSQFSBO
UFSIBEBQ UFLBOBO UPUBM EFOHBO QFSCBOEJOHBO MBOHTVOH UFSIBEBQ
LPOTFOUSBTJOZB 0MFI LBSFOB JUV QFSTFO EBSJ NN )H
Dasar Molekular Difusi Gas EJTFCBCLBO PMFI OJUSPHFO NN )H
EBO QFSTFO PMFI
4FNVB HBT ZBOH CFSIVCVOHBO EFOHBO GJTJPMPHJ QFSOBQBTBO BEBMBI PLTJHFO NN )H
%FOHBO EFNJLJBO UFLBOBO QBSTJBM
NPMFLVMNPMFLVM TFEFSIBOB ZBOH EBQBU CFSHFSBL CFCBT EJ BOUBSB OJUSPHFO EBMBN DBNQVSBO BEBMBI NN )H EBO UFLBOBO
TBUV TBNB MBJO TVBUV QSPTFT ZBOH EJTFCVU EJGVTJ *OJ KVHB UFSMJIBU QBSTJBMPLTJHFOBEBMBINN)HUFLBOBOUPUBMOZBBEBMBI
EBSJHBTHBTZBOHUFSMBSVUEBMBNDBJSBOEBOKBSJOHBOUVCVI NN)H ZBJUVQFOKVNMBIBOEBSJUFLBOBOQBSTJBMNBTJOHNBTJOH
6OUVL UFSKBEJOZB EJGVTJ IBSVT BEB TVNCFS FOFSHJ &OFSHJ JOJ 5FLBOBOQBSTJBMNBTJOHNBTJOHHBTEBMBNDBNQVSBOEJOZBUBLBO
EJIBTJMLBO PMFI HFSBLBO LJOFUJL NPMFLVM JUV TFOEJSJ ,FDVBMJ QBEB EFOHBOTJNCPM10 1$0 1/ 1)F EBOTFCBHBJOZB
TVIVOPM TFNVBNPMFLVMCFSHFSBLTFDBSBUFSVTNFOFSVTQBEBTFUJBQ
XBLUV 6OUVL NPMFLVMNPMFLVM CFCBT ZBOH TFDBSB GJTJL UJEBL Tekanan Gas Terlarut dalam Air dan Jaringan
CFSJLBUBO EFOHBO NPMFLVM MBJOOZB IBM JOJ CFSBSUJ UFSEBQBU HFSBLBO
(BTZBOHUFSMBSVUEBMBNBJSBUBVKBSJOHBOUVCVIKVHBNFOJNCVMLBO
MJOJFSEFOHBOLFDFQBUBOUJOHHJTBNQBJNPMFLVMUFSTFCVUCFSCFOUVSBO
UFLBOBO TFCBC NPMFLVM HBT ZBOH MBSVU CFSHFSBL TFDBSB BDBL EBO
EFOHBONPMFLVMMBJOOZB,FNVEJBONPMFLVMJUVNFMBNCVOHLFBSBI
NFNQVOZBJ FOFSHJ LJOFUJL 4FMBOKVUOZB CJMB NPMFLVM HBT ZBOH
MBJOEBOCFHJUVTFMBOKVUOZBTBNQBJUFSKBEJCFOUVSBOEFOHBONPMFLVM
UFSMBSVU EBMBN DBJSBO NFOHFOBJ QFSNVLBBO TFQFSUJ NFNCSBO TFM
ZBOHMBJOMBHJ%FOHBODBSBJOJ NPMFLVMCFSHFSBLEFOHBODFQBUEBO
NPMFLVM HBT JUV NFOJNCVMLBO UFLBOBO QBSTJBMOZB TFOEJSJ TFQFSUJ
TFDBSBBDBLEJBOUBSBTBUVTBNBMBJO
IBMOZBEFOHBOTVBUVHBTEBMBNGBTFHBT5FLBOBOQBSTJBMEBSJTFUJBQ
Difusi Neto Gas dalam Satu Arah—Efek Gradien Konsentrasi. HBT ZBOH MBSVU EJOZBUBLBO TBNB TFQFSUJ UFLBOBO QBSTJBM HBT EBMBN
+JLB TFCVBI UBCVOH HBT BUBV TVBUV MBSVUBO EFOHBO LPOTFOUSBTJ HBT LFBEBBOHBT ZBJUV 10 1$0 1/ 1)F EBOTFCBHBJOZB
UFSUFOUVZBOHUJOHHJQBEBTBUVVKVOHUBCVOHTFEBOHLBOQBEBVKVOH
MBJO LPOTFOUSBTJOZB SFOEBI TFQFSUJ ZBOH EJMVLJTLBO QBEB (BNCBS Faktor-Faktor yang Menentukan Tekanan Parsial Gas
EJGVTJ OFUP HBT BLBO UFSKBEJ EBSJ EBFSBI EFOHBO LPOTFOUSBTJ Terlarut dalam Cairan. 5FLBOBO QBSTJBM HBT EBMBN MBSVUBO
UJOHHJNFOVKVEBFSBIEFOHBOLPOTFOUSBTJSFOEBI"MBTBOOZBTBOHBU EJUFOUVLBO UJEBL IBOZB PMFI LPOTFOUSBTJOZB UFUBQJ KVHB PMFI
KFMBT 5FSEBQBU MFCJI CBOZBL NPMFLVM QBEB VKVOH " UBCVOH ZBOH LPFGJTJFO LFMBSVUBO HBT #FCFSBQB UJQF NPMFLVM UFSVUBNB LBSCPO
CFSEJGVTJNFOVKVVKVOH#EBSJQBEBNPMFLVMNPMFLVMZBOHCFSEJGVTJ EJPLTJEB TFDBSB GJTJLB BUBV LJNJBXJ EJUBSJL LF NPMFLVM BJS
LFBSBIZBOHCFSMBXBOBO0MFILBSFOBJUV LFDFQBUBOEJGVTJNBTJOH TFEBOHLBOZBOHMBJOOZBEJUPMBL#JMBNPMFLVMNPMFLVMEJUBSJL MFCJI
NBTJOH BSBI UJEBL TBNB TFQFSUJ EJMVLJTLBO PMFI QBOKBOH QBOBI CBOZBLNPMFLVMHBTUFSTFCVUZBOHEBQBUUFSMBSVUUBOQBNFOHIBTJMLBO
EBMBNHBNCBS UFLBOBOQBSTJBMCFSMFCJIBOEBMBNMBSVUBO4FCBMJLOZB QBEBNPMFLV
485
Unit VII Pernapasan
NBOB NPMFLVM HBT EFOHBO LFMBSVUBO CFSCFEB UFSVTNFOFSVT LFMVBS

EBSJ QFSNVLBBO BJS NBTVL LF EBMBN GBTF HBT 5FLBOBO QBSTJBM ZBOH
EJHVOBLBO PMFI NPMFLVM BJS VOUVL LFMVBS NFOFNCVT QFSNVLBBO
EJTFCVUUFLBOBOV BQBJS1BEBTVIVUVCVIOPSNBM ¡$ UFLBOBOVBQ
JOJ BEBMBI NN )H 0MFI LBSFOB JUV TFLBMJ DBNQVSBO HBT UFMBI
NFOKBEJ MFNCBQ TFQFOVIOZB ZBJUV LFUJLB CFSBEB EBMBN LFBEBBO
TFJNCBOH EFOHBO BJS UFLBOBO QBSTJBM VBQ BJS EBMBN DBNQVSBO HBT
BEBMBI NN )H 5FLBOBO QBSTJBM JOJ TFQFSUJ KVHB UFLBOBO QBSTJBM
ZBOHMBJO EJOZBUBLBOTFCBHBJ1) 0
5FLBOBOVBQBJSCFSHBOUVOHTFMVSVIOZBLFQBEBTVIVBJS4FNBLJO
UJOHHJ TVIV BJS TFNBLJO CFTBS BLUJWJUBT LJOFUJL NPMFLVM EBO PMFI
LBSFOBJUV TFNBLJOCFTBSLFNVOHLJOBONPMFLVMBJSBLBOLFMVBSEBSJ
QFSNVLBBO BJS NBTVL LF EBMBN GBTF HBT .JTBMOZB UFLBOBO VBQ BJS
QBEBTVIV¡$BEBMBINN)HEBOQBEB¡$BEBMBINN)H
ZBOH EJUPMBL BLBO NFOHIBTJMLBO UFLBOBO ZBOH CFSMFCJIBO EFOHBO
"LBO UFUBQJ OJMBJ ZBOH QBMJOH QFOUJOH VOUVL EJJOHBU BEBMBI UFLBOBO
MFCJITFEJLJUNPMFLVMZBOHUFSMBSVU)VCVOHBOJOJEBQBUEJOZBUBLBO
VBQ QBEB TVIV UVCVI NN )H OJMBJ JOJ BLBO NVODVM MBHJ QBEB
EFOHBOSVNVTCFSJLVU ZBJUV)VLVN)FOSZ
CBOZBLQFNCBIBTBOLJUBOBOUJ
Difusi Gas melalui Cairan—Perbedaan Tekanan

#JMB UFLBOBO QBSTJBM EJOZBUBLBO EBMBN BUNPTGFS UFLBOBO Menyebabkan Difusi Neto
BUNPTGFS TFUBSB EFOHBO NN )H
EBO LPOTFOUSBTJ EJOZBUBLBO
EBMBN WPMVNF HBT ZBOH UFSMBSVU EBMBN TFUJBQ WPMVNF BJS NBLB %BSJQFNCBIBTBOTFCFMVNOZBTVEBIKFMBTCBIXBCJMBUFLBOBOHBT
LPFGJTJFO LFMBSVUBO VOUVL HBTHBT QFSOBQBTBO ZBOH QFOUJOH QBEB QBEB TVBUV BSFB MFCJI CFTBS EBSJQBEB BSFB MBJOOZB BLBO UFSKBEJ
TVIVUVCVIBEBMBITFCBHBJCFSJLVU EJGVTJ OFUP EBSJ BSFB EFOHBO UFLBOBO UJOHHJ LF BSFB ZBOH
CFSUFLBOBO SFOEBI .JTBMOZB LFNCBMJ LF (BNCBS UFSMJIBU
0.024 CBIXB NPMFLVM ZBOH CFSBEB QBEB BSFB CFSUFLBOBO UJOHHJ LBSFOB
0.57 KVNMBIOZB ZBOH MFCJI CFTBS NFNQVOZBJ LFTFNQBUBO ZBOH MFCJI
0.018 CFTBSVOUVLCFSHFSBLTFDBSBBDBLLFBSFBZBOHCFSUFLBOBOSFOEBI
Nitrogen 0.012 EBSJQBEB NPMFLVMNPMFLVM ZBOH CFSVTBIB CFSHFSBL LF BSBI
Helium 0.008 TFCBMJLOZB/BNVO CFCFSBQBNPMFLVMNFNBOUVMTFDBSBBDBLEBSJ
BSFB CFSUFLBOBO SFOEBI LF BSFB CFSUFLBOBO UJOHHJ 0MFI LBSFOB
%BSJ UBCFM JOJ LJUB EBQBU NFMJIBU CBIXB LBSCPO EJPLTJEB EVB
JUV EJGVTJ OFUP HBT EBSJ EBFSBI ZBOH CFSUFLBOBO UJOHHJ LF BSFB
QVMVI LBMJ MFCJI NVEBI MBSVU EBSJQBEB PLTJHFO 0MFI LBSFOB JUV
UFLBOBO QBSTJBM LBSCPO EJPLTJEB VOUVL LPOTFOUSBTJ UFSUFOUV

ZBOH CFSUFLBOBO SFOEBI BEBMBI TBNB EFOHBO KVNMBI NPMFLVM
LVSBOHEBSJTFQFSEVBQVMVIEBSJZBOHEJIBTJMLBOPMFIPLTJHFO ZBOH NFNBOUVM LF BSBI EFQBO EJLVSBOHJ EFOHBO KVNMBI ZBOH
NFNBOUVM EBMBN BSBI CFSMBXBOBO IBM JOJ TFCBOEJOH EFOHBO
Difusi Gas antara Fase Gas dalam Alveoli dan Fase Terlarut QFSCFEBBO UFLBOBO QBSTJBM HBT EJ BOUBSB LFEVB BSFB ZBOH TFDBSB
dalam Darah Paru. 5FLBOBO QBSTJBM NBTJOHNBTJOH HBT EBMBN TFEFSIBOBEJTFCVUQFSCFEBBOUFLBOBOVOUVLNFOJNCVMLBOEJGVTJ
DBNQVSBO HBT QFSOBQBTBO BMWFPMVT DFOEFSVOH NFNBLTB NPMFLVM
HBT UFSTFCVU NBTVL LF MBSVUBO EJ EBMBN EBSBI LBQJMFS BMWFPMVT Menghitung Kecepatan Neto Difusi dalam Cairan. 4FMBJOQFSCFEBBO
4FCBMJLOZB NPMFLVMNPMFLVMEBSJHBTZBOHTBNB ZBOHUFMBIUFSMBSVU UFLBOBO CFSCBHBJ GBLUPS MBJO NFNFOHBSVIJ LFDFQBUBO EJGVTJ HBT
EBMBN EBSBI NFNBOUVM TFDBSB BDBL EBMBN DBJSBO EBSBI EBO EBMBNDBJSBO'BLUPSGBLUPSUFSTFCVUBEBMBI
EBZBMBSVUHBTEBMBN
TFCBHJBOEBSJNPMFLVMZBOHNFNBOUVMJOJNBTVLLFNCBMJLFEBMBN DBJSBO
MVBT QFOBNQBOH DBJSBO
KBSBL ZBOH IBSVT EJMBMVJ HBT
BMWFPMJ ,FDFQBUBO NBTVL NPMFLVM JOJ TFCBOEJOH EFOHBO UFLBOBO TFXBLUV EJGVTJ
CFSBU NPMFLVM HBT EBO
TVIV DBJSBO %BMBN
QBSTJBMOZBEBMBNEBSBI UVCVI GBLUPS ZBOH UFSBLIJS ZBJUV TVIV UFUBQ LPOTUBO EBO CJBTBOZB
/BNVO LF BSBI NBOBLBI EJGVTJ OFUP HBT BLBO UFSKBEJ UJEBLQFSMVEJQFSUJNCBOHLBO
+BXBCBOOZB EJGVTJ OFUP EJUFOUVLBO PMFI QFSCFEBBO BOUBSB LFEVB
.BLJO CFTBS EBZB MBSVU HBT NBLJO CBOZBL KVNMBI NPMFLVM ZBOH
UFLBOBOQBSTJBM+JLBUFLBOBOQBSTJBMMFCJICFTBSQBEBGBTFHBTEBMBN
UFSTFEJB VOUVL CFSEJGVTJ QBEB QFSCFEBBO UFLBOBO QBSTJBM UFSUFOUV
BMWFPMJ TFQFSUJOPSNBMOZBUFSKBEJQBEBPLTJHFO NBLBMFCJICBOZBL
.BLJO CFTBS MVBT QFOBNQBOH MJOUBOH EBFSBI EJGVTJ JUV NBLJO CFTBS
NPMFLVM ZBOH BLBO CFSEJGVTJ LF EBMBN EBSBI EBSJQBEB BSBI
KVNMBI UPUBM NPMFLVM ZBOH CFSEJGVTJ 4FCBMJLOZB NBLJO KBVI KBSBL
TFCBMJLOZB ,FNVOHLJOBO MBJO KJLB UFLBOBO QBSTJBM HBT MFCJI CFTBS
ZBOH IBSVT EJUFNQVI PMFI NPMFLVM NBLJO MBNB XBLUV ZBOH
QBEBLFBEBBOUFSMBSVUEBMBNEBSBI ZBOHTFDBSBOPSNBMUFSKBEJQBEB
EJQFSMVLBO PMFI NPMFLVM UFSTFCVU VOUVL CFSEJGVTJ "LIJSOZB NBLJO
LBSCPO EJPLTJEB NBLB EJGVTJ OFUP BLBO UFSKBEJ LF BSBI GBTF HBT
CFTBS LFDFQBUBO HFSBLBO LJOFUJL NPMFLVMNPMFLVM ZBOH CFSCBOEJOH
EBMBNBMWFPMJ
UFSCBMJL EFOHBO BLBS QBOHLBU EVB CFSBU NPMFLVM NBLJO CFTBS
LFDFQBUBO EJGVTJ HBT JUV 4FNVB GBLUPS JOJ EBQBU EJOZBUBLBO EBMBN
Tekanan Uap Air TFCVBISVNVT TFCBHBJCFSJLVU
#JMBVEBSBZBOHUJEBLMFNCBQEJIJSVQLFEBMBNTBMVSBOQFSOBQBTBO
BJSTFHFSBNFOHVBQEBSJQFSNVLBBOTBMVSBOJOJEBONFMFNCBQLBO DP × A × S ,
VEBSB*OJUFSKBEJLBSFOBGBLUBCBIXBNPMFLVMNPMFLVMBJS TFCBHBJ Dµ
d × MW
486
Bab 39 Prinsip-Prinsip Fisika Pertukaran Gas; Difusi Oksigen dan Karbon Dioksida melalui Membran Pernapasan
EFOHBO % BEBMBI LFDFQBUBO EJGVTJ $P BEBMBI QFSCFEBBO UFLBOBO NFNBTVLJ TBMVSBO QFSOBQBTBO EJMFNCBQLBO CBILBO
QBSTJBM EJ BOUBSB LFEVB VKVOH KBMVS EJGVTJ UFSTFCVU " BEBMBI MVBT TFCFMVNVEBSBUFSTFCVUTBNQBJLFBMWFPMJ
QFOBNQBOHKBMVSJUV 4BEBMBIEBZBMBSVUHBT EBEBMBIKBSBLEJGVTJ EBO
.8BEBMBICFSBUNPMFLVMHBTUFSTFCVU Pelembapan Udara saat melalui Saluran
UNIT VII
4VEBIKFMBTEBSJSVNVTJOJCBIXBLBSBLUFSJTUJLHBTNFOFOUVLBOEVB
pernapasan. 5BCFM NFNQFSMJIBULBO CBIXB LPNQPTJTJ
GBLUPS EBSJ SVNVT UFSTFCVU EBZB MBSVU EBO CFSBU NPMFLVM 4FDBSB
VEBSB BUNPTGFS IBNQJS TFMVSVIOZB UFSEJSJ BUBT OJUSPHFO EBO
CFSTBNBTBNB LFEVB GBLUPS JOJ NFOFOUVLBO LPFGJTJFO EJGVTJ HBT ZBOH PLTJHFO OPSNBMOZB IBNQJS UJEBL NFOHBOEVOH LBSCPO
TFCBOEJOHEFOHBO4 .8 ZBJUVLFDFQBUBOSFMBUJGZBOHNFOZFCBCLBO EJPLTJEB EBO IBOZB NFOHBOEVOH TFEJLJU VBQ BJS 5FUBQJ
CFSCBHBJ HBT CFSCFEB QBEB UFLBOBO QBSTJBM ZBOH TBNB BLBO CFSEJGVTJ TFHFSB TFUFMBI VEBSB BUNPTGFS NFNBTVLJ TBMVSBO
TFCBOEJOH EFOHBO LPFGJTJFO EJGVTJOZB %FOHBO NFOHBOHHBQ LPFGJTJFO QFSOBQBTBO VEBSB UFSQBQBS EFOHBO DBJSBO ZBOH NFMBQJTJ
EJGVTJVOUVLPLTJHFOBEBMBI LPFGJTJFOEJGVTJSFMBUJGVOUVLCFSCBHBJHBT QFSNVLBBO TBMVSBO QFSOBQBTBO #BILBO TFCFMVN VEBSB
QFSOBQBTBOZBOHQFOUJOHEBMBNDBJSBOUVCVIBEBMBITFCBHBJCFSJLVU NFNBTVLJ BMWFPMJ VEBSB VOUVL TFNVB UVKVBO QSBLUJT

TVEBIEJMFNCBQLBOTFMVSVIOZB
5FLBOBO QBSTJBM VBQ BJS QBEB TVIV UVCVI ¡$ BEBMBI
Oksigen 1.0 NN )H ZBOH NFSVQBLBO UFLBOBO QBSTJBM VBQ BJS EBMBN
Karbon dioksida 20.3 VEBSBBMWFPMVT0MFILBSFOBUFLBOBOUPUBMEBMBNBMWFPMJUJEBL
Karbon monoksida 0.81 EBQBU NFOJOHLBU NFMFCJIJ UFLBOBO BUNPTGFS NN )H
Nitrogen 0.53 QBEB LFUJOHHJBO EJ BUBT QFSNVLBBO MBVU
VBQ BJS JOJ TFDBSB
Helium 0.95 TFEFSIBOB NFOHFODFSLBO TFNVB HBT MBJOOZB EBMBN VEBSB
JOTQJSBTJ 5BCFM KVHB NFOVOKVLLBO CBIXB QFMFNCBQBO
VEBSBNFOHFODFSLBOUFLBOBOQBSTJBMPLTJHFOQBEBLFUJOHHJBO
Difusi Gas metalui Jaringan
EJBUBTQFSNVLBBOMBVUEBSJSBUBSBUBNN)HQBEBVEBSB
(BTHBT ZBOH QFOUJOH EBMBN QFSOBQBTBO NFNJMJLJ EBZB MBSVU ZBOH
UJOHHJ EBMBN MJQJE EBO BLJCBUOZB EBZB MBSVU EBMBN NFNCSBO TFM KVHB
BUNPTGFS NFOKBEJ NN )H EBMBN VEBSB MFNCBQ EBO
UJOHHJ 0MFI LBSFOB IBM JOJ LFUFSCBUBTBO VUBNB HFSBLBO HBT EBMBN NFOHFODFSLBOUFLBOBOQBSTJBMOJUSPHFOEBSJNFOKBEJ
KBSJOHBO BEBMBI LFDFQBUBO ZBOH EBQBU NFNCVBU HBT CFSEJGVTJ NFMBMVJ NN)H
BJSKBSJOHBO UJTTVFXBUFS
EBSJQBEBNFMBMVJNFNCSBOTFM0MFILBSFOB Kecepatan Pembaruan Udara Alveolus dengan Udara
JUV EJGVTJHBTNFMBMVJKBSJOHBO UFSNBTVLNFMBMVJNFNCSBOQFSOBQBTBO Atmosfer
IBNQJSTBNBEFOHBOEJGVTJHBTNFMBMVJBJS TFQFSUJZBOHUFMBIEJCFSJLBO 1BEB #BC UFMBI EJUFHBTLBO CBIXB SBUBSBUB LBQBTJUBT
QBEBEBGUBSEJBUBT
SFTJEVGVOHTJPOBMQBSV KVNMBIVEBSBZBOHUFSTJTBEBMBNQBSV
QBEB BLIJS FLTQJSBTJ OPSNBM
QBEB MBLJMBLJ KVNMBIOZB LJSB
LJSB NM /BNVO IBOZB NM EBSJ VEBSB CBSV ZBOH
Komposisi Udara Alveolus Berbeda
NBTVL LF EBMBN BMWFPMJ QBEB TFUJBQ JOTQJSBTJ OPSNBM EBO
dengan Udara Atmosfer
EBMBN KVNMBI ZBOH TBNB VEBSB MBNB EBMBN BMWFPMVT
EJLFMVBSLBO 0MFI LBSFOB JUV KVNMBI VEBSB BMWFPMVT ZBOH
6EBSB BMWFPMVT UJEBL NFNQVOZBJ LPOTFOUSBTJ HBT ZBOH EJHBOUJLBO PMFI VEBSB BUNPTGFS CBSV TBBU UJBQ LBMJ CFSOBQBT
TBNB EFOHBO VEBSB BUNPTGFS IBM JOJ EBQBU EFOHBO IBOZB TFQFSUVKVI EBSJ KVNMBI UPUBM TFIJOHHB EJCVUVILBO
NVEBI EJMJIBU EFOHBO NFNCBOEJOHLBO LPNQPTJTJ CBOZBL JOTQJSBTJ VOUVL NFOVLBS TFCBHJBO CFTBS VEBSB
VEBSB BMWFPMVT EBMBN 5BCFM EFOHBO LPNQPTJTJ BMWFPMVT UFSTFCVU (BNCBS NFMVLJTLBO SFOEBIOZB
VEBSB BUNPTGFS "EB CFCFSBQB QFOZFCBC QFSCFEBBO JOJ LFDFQBUBO QFNCBSVBO VEBSB BMWFPMVT JOJ 1BEB BMWFPMVT
1FSUBNB VEBSB BMWFPMVT IBOZB TFCBHJBO EJHBOUJ PMFI QFSUBNBEBMBNHBNCBSUFSTFCVU UBNQBLHBTZBOHCFSMFCJIBO
VEBSB BUNPTGFS UJBQ LBMJ CFSOBQBT ,FEVB PLTJHFO CFSBEB EBMBN BMWFPMJ UFUBQJ QFSIBUJLBO CBIXB QBEB BLIJS
TFDBSB UFSVTNFOFSVT EJBCTPSCTJ LF EBMBN EBSBI QBSV QFSOBQBTBO ZBOH LF KVNMBI HBT ZBOH CFSMFCJIBO NBTJI
EBO VEBSB BMWFPMVT ,FUJHB LBSCPO EJPLTJEB CFMVNTFMVSVIOZBEJLFMVBSLBOEBSJBMWFPMVT
CFSEJGVTTFDBSBUFSVTNFOFSVTEBSJEBSBIQBSVLFEBMBN (BNCBSNFMVLJTLBOHSBGJLLFDFQBUBOQFOHFMVBSBO
BMWFPMJ,FFNQBU VEBSBBUNPTGFSLFSJOHZBOHNFNBTVLJ HBTZBOHCFSMFCJIBOEBMBNBMWFPMJQBEBLFBEBBOOPSNBM
Tabel 39-1 Tekanan Parsial Gas Pernapasan Saat Masuk dan Keluar Paru (pada Ketinggian di Atas Permukaan Laut)
Udara atmosfer* Udara Lembap Udara di Alveolus Udara yang Dieskpirasi

(mm Hg) (mm Hg) (mm Hg) (mm Hg)
N2 597.0 (78.62%) 563.4 (74.09%) 569.0 (74.9%) 566.0 (74.5%)

O2 159.0 (20.84%) 149.3 (19.67%) 104.0 (13.6%) 120.0 (15.7%)
CO2 0.3 (0.04%) 0.3 (0.04%) 40.0 (5.3%) 27.0 (3.6%)
H2O 3.7 (0.50%) 47.0 (6.20%) 47.0 (6.2%) 47.0 (6.2%)
TOTAL 760.0 (100.0%) 760.0 (100.0%) 760.0 (100.0%) 760.0 (100.0%)
*Pada suhu rata-rata sejuk, hari yang cerah.

487
Unit VII Pernapasan
150
125
100 A
75
50
25
0
0 5 10 15 20 25 30 35 40
(BNCBSNFMVLJTLBOFGFLWFOUJMBTJBMWFPMVTEBOLFDFQBUBO
BCTPSQTJ PLTJHFO LF EBMBN EBSBI QBEB UFLBOBO QBSTJBM PLTJHFO
BMWFPMVT 10
,VSWB EFOHBO HBSJT UFCBM NFOZBUBLBO LFDFQBUBO
BCTPSCTJ PLTJHFO TFCFTBS NMNFOJU EBO LVSWB UJUJLUJUJL
NFOVOKVLLBOLFDFQBUBONMNFOJU1BEBLFDFQBUBOWFOUJMBTJ
OPSNBM - NFOJU EBO QFNBLBJBO PLTJHFO NMNFOJU UJUJL
LFSKB OPSNBM QBEB (BNCBS BEBMBI UJUJL " (BNCBS KVHB
NFNQFSMJIBULBO CBIXB CJMB NM PLTJHFO EJBCTPSCTJ TFUJBQ
NFOJU TFQFSUJ ZBOH UFSKBEJ TFMBNB LFSKB TFEBOH NBLB LFDFQBUBO
WFOUJMBTJ BMWFPMVT IBSVT NFOJOHLBU FNQBU LBMJ MJQBU VOUVL
NFNQFSUBIBOLBO 10 BMWFPMVT QBEB OJMBJ OPSNBM ZBJUV NN
)H
&GFL MBJO ZBOH EJMVLJTLBO QBEB (BNCBS BEBMBI CBIXB
QFOJOHLBUBO ZBOH MVBS CJBTB EBMBN WFOUJMBTJ BMWFPMVT UJEBL EBQBU
NFNQFSMJIBULBO CBIXB EFOHBO WFOUJMBTJ BMWFPMVT OPSNBM
NFOJOHLBULBO 10 BMWFPMVT MFCJI EBSJ NN )H TFMBNB
LVSBOH MFCJI TFQBSVI HBT EBQBU EJLFMVBSLBO EBMBN XBLUV
TFTFPSBOHCFSOBQBTEBMBNVEBSBBUNPTGFSOPSNBMEFOHBOUFLBOBO
EFUJL#JMBLFDFQBUBOWFOUJMBTJBMWFPMVTTFTFPSBOHIBOZBTFUFOHBI
QBEB LFUJOHHJBO EJ BUBT QFSNVLBBO MBVU LBSFOB JOJ NFSVQBLBO
EBSJOPSNBM TFQBSVIHBTEJLFMVBSLBOEBMBNXBLUVEFUJL EBO
10 NBLTJNVN EJ EBMBN VEBSB ZBOH EJMFNCBQLBO QBEB UFLBOBO
CJMB LFDFQBUBO WFOUJMBTJ EVB LBMJ OPSNBM TFQBSVI HBT
JOJ #JMB TFTFPSBOH NFOHIJSVQ HBT ZBOH NFOHBOEVOH UFLBOBO
EJLFMVBSLBOEBMBNXBLUVLJSBLJSBEFUJL
QBSTJBM PLTJHFO MFCJI EBSJ NN )H NBLB 10 BMWFPMVT EBQBU
Manfaat Penggantian Udara Alveolus secara Lambat. NFOEFLBUJ UFLBOBO ZBOH MFCJI UJOHHJ JOJ QBEB LFDFQBUBO WFOUJMBTJ
1FOHHBOUJBO VEBSB BMWFPMVT TFDBSB MBNCBU UFSVUBNB QFOUJOH ZBOHUJOHHJ
VOUVL NFODFHBI QFSVCBIBO LPOTFOUSBTJ HBT ZBOH NFOEBEBL
EBMBN EBSBI ,FBEBBO JOJ NFOZFCBCLBO NFLBOJTNF ZBOH Konsentrasi dan Tekanan Parsial CO2
NFOHBUVSQFSOBQBTBONFOKBEJKBVIMFCJITUBCJMEBSJQBEBDBSBMBJO dalam Alveoli
EBO NFNCBOUV NFODFHBI QFOJOHLBUBO EBO QFOVSVOBO TFDBSB ,BSCPOEJPLTJEBTFDBSBUFSVTNFOFSVTEJCFOUVLEBMBNUVCVIEBO
CFSMFCJIBOQBEBPLTJHFOBTJKBSJOHBO LPOTFOUSBTJLBSCPOEJPLTJEB LFNVEJBOEJBOHLVUEBMBNEBSBILFBMWFPMJLBSCPOEJPLTJEBTFDBSB
KBSJOHBO EBO Q) KBSJOHBO TFXBLUV QFSOBQBTBO UFSHBOHHV UFSVTNFOFSVT QVMB EJLFMVBSLBO EBSJ BMWFPMJ NFMBMVJ WFOUJMBTJ
TFNFOUBSBXBLUV (BNCBS NFMVLJTLBO FGFL WFOUJMBTJ BMWFPMVT EBSJ EVB
Konsentrasi dan Tekanan Parsial Oksigen LFDFQBUBO FLTLSFTJ LBSCPO EJPLTJEB EBO NMNFOJU
dalam Alveolus UFSIBEBQUFLBOBOQBSTJBMLBSCPOEJPLTJEB 1$0
EJBMWFPMVT4BUV
0LTJHFO EJBCTPSCTJ EBSJ BMWFPMJ LF EBMBN EBSBI QBSV TFDBSB LVSWBNFOHHBNCBSLBOLFDFQBUBOFLTLSFTJLBSCPOEJPLTJEBEBMBN
UFSVTNFOFSVT EBOPLTJHFOZBOHCBSVKVHBTFDBSBUFSVTNFOFSVT LFBEBBO OPSNBM NMNFOJU 1BEB LFDFQBUBO WFOUJMBTJ BMWFPMVT
EJIJSVQ NBTVL LF BMWFPMJ EBSJ BUNPTGFS .BLJO DFQBU PLTJHFO OPSNBM -NFOJU UJUJLLFSKBVOUVL1$0BMWFPMVTBEBMBIUJUJL"
EJBCTPSCTJ NBLJO SFOEBI LPOTFOUSBTJOZB EBMBN BMWFPMJ EBMBN(BNCBS ZBJUV NN)H

TFCBMJLOZB NBLJO DFQBU PLTJHFO CBSV EJIJSVQ LF EBMBN BMWFPMJ %VB GBLUB MBJOOZB ZBOH KVHB KFMBT UFSMJIBU QBEB (BNCBS
EBO BUNPTGFS NBLJO UJOHHJ LPOTFOUSBTJOZB 0MFI LBSFOB JUV 1FSUBNB QFOJOHLBUBO 1$0 BMWFPMVT CFSCBOEJOH MVSVT EFOHBO
LPOTFOUSBTJ PLTJHFO EBMBN BMWFPMJ EBO KVHB UFLBOBO QBSTJBMOZB LFDFQBUBOFLTLSFTJLBSCPOEJPLTJEB TFQFSUJZBOHEJUVOKVLLBOPMFI
EJBUVSPMFI
LFDFQBUBOBCTPSQTJPLTJHFOLFEBMBNEBSBIEBO QFOJOHLBUBO FNQBU LBMJ MJQBU QBEB LVSWB LFUJLB NM $0

LFDFQBUBO NBTVLOZB PLTJHFO CBSV LF EBMBN QBSV NFMBMVJ EJFLTLSFTJLBO UJBQ NFOJU
,FEVB QFOVSVOBO 1$0 BMWFPMVT
QSPTFTWFOUJMBTJ CFSCBOEJOHUFSCBMJLEFOHBOWFOUJMBTJBMWFPMVT
488
QFSUJ ZBOH EJQFSMJIBULBO QBEB 5BCFM LPOTFOUSBTJ BOUBSB HBT

175
ZBOH UFSEBQBU EBMBN VEBSB BMWFPMVT EBO VEBSB BUNPTGFS ZBOH
150 MFNCBQ

UNIT VII
125
800 ml CO2/
100 Difusi Gas metalui Membran
Pernapasan
75
50 Unit Pernapasan (BNCBS NFMVLJTLBO VOJU

A QFSOBQBTBO ZBOH KVHB EJTFCVU MPCVMVT QFSOBQBTBO
ZBOH
25
UFSEJSJ BUBT CSPOLJPMVT SFTQJSBUPSJVT EVLUVT BMWFPMBSJT BUSJB
0 EBOBMWFPMJ,JSBLJSBUFSEBQBUKVUBBMWFPMJEJLFEVBQBSV
0 5 10 15 20 25 30 35 40 NBTJOHNBTJOH BMWFPMVT NFNQVOZBJ EJBNFUFS SBUBSBUB
NM %JOEJOH BMWFPMVT TBOHBU UJQJT EBO EJ BOUBSB BMWFPMJ
UFSEBQBU KBSJOHBO LBQJMFS ZBOH IBNQJS QBEBU EBO TBMJOH
CFSIVCVOHBO TFQFSUJ ZBOH EJMVLJTLBO QBEB (BNCBS
0MFILBSFOBMVBTOZBQMFLTVTLBQJMFSJOJMBI NBLBBMJSBOEBSBI
EBMBN EJOEJOH BMWFPMVT UFMBI EJVSBJLBO TFCBHBJ TVBUV
0MFI LBSFOB JUV LPOTFOUSBTJ EBO UFLBOBO QBSTJBM PLTJHFO EBO IBNQBSBOBMJSBOEBSBI%FOHBOEFNJLJBO KFMBTCBIXBHBT
LBSCPOEJPLTJEBEBMBNBMWFPMJEJUFUBQLBOPMFILFDFQBUBOBCTPSQTJ BMWFPMVT CFSBEB TBOHBU EFLBU EFOHBO EBSBI LBQJMFS QBSV
BUBV FLTLSFTJ EBSJ LFEVB HBT JOJ EBO KVHB PMFI KVNMBI WFOUJMBTJ 4FMBOKVUOZB QFSUVLBSBOHBTBOUBSBVEBSBBMWFPMVTEBOEBSBI
BMWFPMVT QBSV UFSKBEJ NFMBMVJ NFNCSBO EJ TFMVSVI CBHJBO UFSNJOBM
QBSV UJEBL IBOZB EBMBN BMWFPMJ JUV 4FMVSVI NFNCSBO ZBOH
Udara Ekspirasi adalah Kombinasi dari Udara EJHBCVOHLBO EJTFCVU TFCBHBJ NFNCSBO QFSOBQBTBO BUBV
Ruang Rugi dan Udara Alveolus EJTFCVUKVHBNFNCSBOQBSV
,PNQPTJTJ VEBSB FLTQJSBTJ TFDBSB LFTFMVSVIBO EJUFOUVLBO PMFI
Membran Pernapasan (BNCBS NFMVLJTLBO
KVNMBI VEBSB FLTQJSBTJ ZBOH NFSVQBLBO VEBSB SVBOH SVHJ EBO
QPUPOHBO NFMJOUBOH VMUSBTUSVLUVS NFNCSBO QFSOBQBTBO EJ
KVNMBI VEBSB BMWFPMVT (BNCBS NFNQFSMJIBULBO QFSVCBIBO TFCFMBI LJSJ EBO TFM EBSBI NFSBI EJ TFCFMBI LBOBO (BNCBS
QSPHSFTJG UFLBOBO QBSTJBM PLTJHFO EBO LBSCPO EJPLTJEB EBMBN VEBSB
UFSTFCVUKVHBNFNQFSMJIBULBOEJGVTJPLTJHFOEBSJBMWFPMVTLF
FLTQJSBTJ TFMBNB CFSMBOHTVOHOZB FLTQJSBTJ #BHJBO QFSUBNB EBSJ
EBMBN TFM EBSBI NFSBI EBO EJGVTJ LBSCPO EJPLTJEB EBMBN
VEBSB JOJ VEBSB SVBOH SVHJ EBSJ TBMVSBO QFSOBQBTBO NFSVQBLBO
VEBSB MFNCBQ ZBOH LIBT TFQFSUJ EJQFSMJIBULBO QBEB 5BCFM BSBITFCBMJLOZB
,FNVEJBO TFDBSB QSPHSFTJG TFNBLJO CBOZBL VEBSB BMWFPMVT ZBOH
CFSDBNQVSEFOHBOVEBSBSVBOHSVHJTBNQBJTFNVBVEBSBSVBOHSVHJ
BLIJSOZB IBCJT EJLFMVBSLBO TFIJOHHB IBOZB VEBSB BMWFPMVT ZBOH
EJLFMVBSLBO QBEB BLIJS FLTQJSBTJ 0MFI LBSFOB JUV NFUPEF
QFOHVNQVMBO VEBSB BMWFPMVT VOUVL QFOFMJUJBO EJMBLVLBO IBOZB
EFOHBONFOHVNQVMLBODPOUPICBHJBOBLIJSVEBSBFLTQJSBTJTFTVEBI
FLTQJSBTJLVBUUFMBINFOHFMVBSLBOTFMVSVIVEBSBSVBOHSVHJ
6EBSB FLTQJSBTJ OPSNBM ZBOH CFSJTJ VEBSB SVBOH SVHJ EBO VEBSB
BMWFPMVT NFNJMJLJLPOTFOUSBTJHBTEBOUFLBOBOQBSTJBMLJSBLJSBTF
160
140
120
100
80
60
40
20
0
0 100 200 300 400 500
489
Unit VII Pernapasan
B
EFXBTB OPSNBM *OJ TBNB EFOHBO MVBT MBOUBJ TVBUV SVBOHBO
EFOHBO QBOKBOH LBLJ EBO MFCBS LBLJ +VNMBI UPUBM EBSBI
EBMBN LBQJMFS QBSV QBEB TVBUV XBLUV UFSUFOUV BEBMBI TBNQBJ
NM 4FLBSBOH CBZBOHLBO KJLB KVNMBI EBSBI ZBOH TFEJLJU JOJ
EJTFCBSLBOEJBUBTQFSNVLBBOMBOUBJEFOHBOMVBTLBMJLBLJ
NBLBEFOHBONVEBILJUBNFNBIBNJCBHBJNBOBQFSUVLBSBOHBT
PLTJHFO EBO LBSCPO EJPLTJEB QFSOBQBTBO EBQBU UFSKBEJ
1FSIBUJLBOCFSCBHBJMBQJTBONFNCSBOQFSOBQBTBOCFSJLVUJOJ TFEFNJLJBODFQBU
1. -BQJTBO DBJSBO ZBOH NFMBQJTJ BMWFPMVT EBO CFSJTJ TVSGBLUBO %JBNFUFS SBUBSBUB LBQJMFS QBSV IBOZB TFLJUBS UJN ZBOH
ZBOHNFOHVSBOHJUFLBOBOQFSNVLBBODBJSBOBMWFPMVT CFSBSUJ CBIXB TFM EBSBI NFSBI IBSVT EJQFSBT VOUVL NFMBMVJOZB
.FNCSBO TFM EBSBI NFSBI CJBTBOZB NFOZFOUVI EJOEJOH LBQJMFS
2. &QJUFMBMWFPMVTZBOHUFSEJSJBUBTTFMTFMFQJUFMZBOHUJQJT
TFIJOHHB PLTJHFO EBO LBSCPO EJPLTJEB UJEBL QFSMV NFMFXBUJ
3. .FNCSBOCBTBMFQJUFM TFKVNMBICFTBSQMBTNBLFUJLBCFSEJGVTJEJBOUBSBBMWFPMVTEBOTFM
4. 3VBOH JOUFSTUJTJBM ZBOH UJQJT EJ BOUBSB FQJUFM BMWFPMVT EBO EBSBINFSBI5FOUVTBKB JOJKVHBNFOJOHLBULBOLFDFQBUBOEJGVTJ
NFNCSBOLBQJMFS UFSTFCVU
5. .FNCSBO CBTBM LBQJMFS ZBOH QBEB CBOZBL UFNQBU CFSTBUV
EFOHBONFNCSBOCBTBMFQJUFMBMWFPMVT
6. .FNCSBOFOEPUFMLBQJMFS Faktor-Faktor yang Memengaruhi Kecepatan
Difusi Gas melalui Membran Pernapasan
8BMBVQVO MBQJTBOOZB CBOZBL LFUFCBMBO NFNCSBO QFSOBQBTBO ,FNCBMJ QBEB QFNCBIBTBO TFCFMVNOZB NFOHFOBJ EJGVTJ HBT
QBEB CFCFSBQB BSFB IBOZB EBO SBUBSBUBOZB TFLJUBS N NFMBMVJ BJS LJUB EBQBU NFOFSBQLBO CFCFSBQB QSJOTJQ EBO SVNVT
LFDVBMJ QBEB UFNQBU OVLMFVT TFM CFSBEB %BSJ QFOFMJUJBO NBUFNBUJT ZBOH TBNB UFSIBEBQ EJGVTJ HBT NFMBMVJ NFNCSBO
IJTUPMPHJT UFMBI EJQFSLJSBLBO CBIXB LFTFMVSVIBO MVBT BSFB QFSOBQBTBO %FOHBO EFNJLJBO GBLUPSGBLGPS ZBOH NFOFOUVLBO
QFSNVLBBONFNCSBOQFSOBQBTBOLJSBLJSBNQBEBMBLJMBLJ CFSBQBLFDFQBUBOHBTZBOHNFMBMVJNFNCSBOBEBMBI
LFUFCBMBO
490
NFNCSBO
MVBT QFSNVLBBO NFNCSBO
LPFGJTJFO EJGVTJ HBT Kapasitas Difusi Membran Pernapasan
EBMBNTVCTUBOTJNFNCSBO EBO
QFSCFEBBOUFLBOBOQBSTJBMHBT ,FNBNQVBO NFNCSBO QFSOBQBTBO EBMBN QFSUVLBSBO HBT
BOUBSBLFEVBTJTJNFNCSBO BOUBSB BMWFPMJ EBO EBSBI QBSV EBQBU EJOZBUBLBO TFDBSB
LVBOUJUBUJG EFOHBO LBQBTJUBT EJGVTJ NFNCSBO QFSOBQBTBO
UNIT VII
5FCBMOZBNFNCSBOQFSOBQBTBOLBEBOHNFOJOHLBUDPOUPIOZB
BLJCBU DBJSBO FEFNB EBMBN SVBOH JOUFSTUJTJBM NFNCSBO EBO EJ ZBOH EJEFGJOJTJLBO TFCBHBJ WPMVNF HBT ZBOH CFSEJGVTJ NFMBMVJ
EBMBN BMWFPMJ TFIJOHHB HBTHBT QFSOBQBTBO LFNVEJBO IBSVT NFNCSBOUJBQNFOJUQBEBTFUJBQQFSCFEBBOUFLBOBOQBSTJBM
CFSEJGVTJUJEBLIBOZBNFMBMVJNFNCSBOUFUBQJKVHBNFMBMVJDBJSBO NN )H 4FNVB GBLUPS ZBOH UFMBI EJCBIBT TFCFMVNOZB ZBOH
JOJ %FNJLJBO KVHB CFCFSBQB QFOZBLJU QBSV ZBOH NFOZFCBCLBO NFNFOHBSVIJ EJGVTJ NFMBMVJ NFNCSBO QFSOBQBTBO EBQBU
GJCSPTJT QBSV EBQBU NFOBNCBI LFUFCBMBO CFCFSBQB CBHJBO NFNFOHBSVIJLBQBTJUBTEJGVTJJOJ
NFNCSBO QFSOBQBTBO 0MFI LBSFOB LFDFQBUBO EJGVTJ NFMBMVJ
NFNCSBOCFSCBOEJOHUFSCBMJLEFOHBOLFUFCBMBONFNCSBO NBLB Kapasitas Difusi untuk Oksigen. 1BEB SBUBSBUB MFMBLJ
TFUJBQGBLUPSZBOHEBQBUNFOJOHLBULBOLFUFCBMBONFNCSBOMFCJI EFXBTBNVEB LBQBTJUBTEJGVTJPLTJHFOQBEBLFBEBBOJTUJSBIBU
SBUBSBUB NMNFOJUNN )H "QBLBI BSUJOZB JOJ TFDBSB
EBSJ EVB TBNQBJ UJHB LBMJ OPSNBM EBQBU NFOHIBMBOHJ QFSUVLBSBO
GVOHTJPOBM 1FSCFEBBO UFLBOBO PLTJHFO SBUBSBUB EJ BOUBSB
HBTTFDBSBCFSNBLOB
NFNCSBOQFSOBQBTBOTFMBNBQFSOBQBTBOUFOBOHEBOOPSNBM
-VBTQFSNVLBBONFNCSBOQFSOBQBTBOEBQBUTBOHBUCFSLVSBOH BEBMBI TFLJUBS NN )H 1FSLBMJBO UFLBOBO JOJ EFOHBO
PMFI CFCFSBQB LFBEBBO .JTBMOZB QFOHBOHLBUBO TBUV QBSV LBQBTJUBTEJGVTJ Y
NFNCFSJIBTJMUPUBMLJSBLJSBNM
TFMVSVIOZB NFOHVSBOHJ MVBT QFSNVLBBO UPUBM TBNQBJ TFUFOHBI PLTJHFO ZBOH CFSEJGVTJ NFMBMVJ NFNCSBO QFSOBQBTBO UJBQ
EBSJ OPSNBM +VHB QBEB FNGJTFNB CFCFSBQB BMWFPMJ CFSTBUV NFOJU OJMBJ JOJ TBNB EFOHBO LFDFQBUBO QFNBLBJBO PLTJHFO
EFOHBOQFOHIBODVSBOTFCBHJBOEJOEJOHBMWFPMVT0MFILBSFOBJUV UVCVITBBUJTUJSBIBU
SVBOHBO BMWFPMVT CBSV ZBOH UFSCFOUVL KBVI MFCJI CFTBS EBSJQBEB
BMWFPMJ ZBOH BTMJ UFUBQJ KVNMBI UPUBM QFSNVLBBO NFNCSBO Peningkatan Kapasitas Difusi Oksigen selama kerja
QFSOBQBTBO TFSJOH LBMJ CFSLVSBOH TBNQBJ MJNB LBMJ MJQBU BLJCBU Fisik. 4FMBNBLFSKBCFSBU BUBVQBEBLPOEJTJMBJOZBOHTBOHBU
IJMBOHOZB EJOEJOH BMWFPMVT #JMB KVNMBI UPUBM QFSNVLBBO NFOJOHLBULBO BMJSBO EBSBI QBSV EBO WFOUJMBTJ BMWFPMVT
CFSLVSBOHTBNQBJNFODBQBJTFQFSUJHBIJOHHBTFQFSFNQBUOPSNBM LBQBTJUBT EJGVTJ PLTJHFO NFOJOHLBU QBEB QSJB EFXBTB NVEB
QFSUVLBSBO HBT NFMBMVJ NFNCSBO UFSTFCVU TBOHBU UFSHBOHHV TBNQBJ NBLTJNVN LJSBLJSB NMNFOJU NN )H UJHB LBMJ
CBILBO EBMBN LFBEBBO JTUJSBIBU EBO TFMBNB QFSUBOEJOHBO LBQBTJUBT EJGVTJ QBEB LFBEBBO JTUJSBIBU 1FOJOHLBUBO JOJ
PMBISBHB EBO LFSKB GJTJL CFSBU MBJOOZB CBILBO QFOVSVOBO MVBT EJTFCBCLBOPMFICFSCBHBJNBDBNGBLUPS EJBOUBSBOZBBEBMBI
QFSNVLBBO QBSV ZBOH QBMJOH TFEJLJU QVO EBQBU NFOHHBOHHV
QFNCVLBBOTFKVNMBILBQJMFSQBSVZBOHUBEJOZBUJEBLBLUJG
QFSUVLBSBOHBTQFSOBQBTBO BUBV EJMBUBTJ FLTUSB QBEB LBQJMFS ZBOH UFMBI UFSCVLB EFOHBO
EFNJLJBO NFOJOHLBULBO MVBT QFSNVLBBO EBSBI UFNQBU
,PFGJTJFO EJGVTJ VOUVL NFNJOEBILBO TFUJBQ HBT NFMBMVJ PLTJHFO EBQBU CFSEJGVTJ EBO
QFSUVLBSBO ZBOH MFCJI CBJL
NFNCSBO QFSOBQBTBO CFSHBOUVOH LFQBEB LFMBSVUBO HBT EBMBN BOUBSB WFOUJMBTJ BMWFPMJ EBO QFSGVTJ LBQJMFS BMWFPMVT EFOHBO
NFNCSBO EBO CFSCBOEJOH UFSCBMJL EFOHBO BLBS QBOHLBU EVB EBSBI EJTFCVUSBTJPWFOUJMBTJQFSGVTJ ZBOHEJCBIBTLFNVEJBO
CFSBUNPMFLVMHBT,FDFQBUBOEJGVTJEBMBNNFNCSBOQFSOBQBTBO TFDBSBEFUBJMEBMBNCBCJOJ0MFILBSFOBJUV TFMBNBLFSKBGJTJL
IBNQJS TBNB EFOHBO LFDFQBUBOOZB EBMBN BJS BMBTBO VOUVL JOJ PLTJHFOBTJ EBSBI EJUJOHLBULBO UJEBL IBOZB PMFI QFOJOHLBUBO
UFMBI EJKFMBTLBO TFCFMVNOZB 0MFI LBSFOB JUV VOUVL QFSCFEBBO WFOUJMBTJ BMWFPMVT UFUBQJ KVHB EFOHBO NFNQFSCFTBS LBQBTJUBT
UFLBOBOUFSUFOUV LBSCPOEJPLTJEBCFSEJGVTJLJSBLJSBLBMJMFCJI EJGVTJNFNCSBOQFSOBQBTBOVOUVLNFNJOEBILBOPLTJHFOLF
DFQBU EBSJ PLTJHFO 0LTJHFO CFSEJGVTJ LJSBLJSB EVB LBMJ MFCJI EBMBNEBSBI
DFQBUEBSJOJUSPHFO
Kapasitas Difusi Karbon Dioksida. ,BQBTJUBT EJGVTJ
1FSCFEBBOUFLBOBOEJBOUBSBLFEVBTJTJNFNCSBOQFSOBQBTBO
LBSCPO EJPLTJEB CFMVN QFSOBI EJVLVS LBSFOB BEBOZB
BEBMBI QFSCFEBBO BOUBSB UFLBOBO QBSTJBM HBT EBMBN BMWFPMJ EBO
LFTVLBSBO UFLOJT CFSJLVU JOJ ,BSCPO EJPLTJEB CFSEJGVTJ
UFLBOBO QBSTJBM HBT EBMBN EBSBI LBQJMFS QBSV 5FLBOBO QBSTJBM NFMBMVJ NFNCSBO QFSOBQBTBO TFEFNJLJBO DFQBUOZB IJOHHB
NFOZBUBLBOTVBUVVLVSBOKVNMBIUPUBMNPMFLVMHBTUFSUFOUVZBOH 1$0 SBUBSBUB EBMBN EBSBI QBSV UJEBL CFSCFEB CBOZBL
NFNCFOUVL TVBUV TBUVBO MVBT QFSNVLBBO NFNCSBO BMWFPMVT EFOHBO 1$0 EBMBN BMWFPMJ QFSCFEBBO SBUBSBUBOZB LVSBOH
QBEB TBUV TBUVBO XBLUV EBO UFLBOBO HBT EBMBN EBSBI EBSJ NN )H EBO EFOHBO NFOHHVOBLBO UFLOJL ZBOH BEB
NFOZBUBLBO KVNMBI NPMFLVM ZBOH CFSVTBIB LFMVBS EBSJ EBSBI QFSCFEBBOJOJUFSMBMVLFDJMVOUVLEJVLVS
EBMBNBSBIZBOHCFSMBXBOBO0MFILBSFOBJUV QFSCFEBBOBOUBSB
4FLBMJ QVO EFNJLJBO QFOHVLVSBO EJGVTJ HBT MBJOOZB UFMBI
LFEVB UFLBOBO JOJ BEBMBI VLVSBO LFDFOEFSVOHBO OFUP VOUVL
NFNQFSMJIBULBO CBIXB LBQBTJUBT EJGVTJ CFSVCBIVCBI TFTVBJ
NPMFLVMHBTCFSHFSBLNFMBMVJNFNCSBO
EFOHBO LPFGJTJFO EJGVTJ HBT UFSUFOUV 0MFI LBSFOB LPFGJTJFO
#JMB UFLBOBO QBSTJBM HBT EBMBN BMWFPMJ MFCJI CFTBS EBSJQBEB EJGVTJLBSCPOEJPLTJEBLBMJMFCJICFTBSEBSJPLTJHFO NBLB
UFLBOBOHBTEBMBNEBSBI TFQFSUJQBEBPLTJHFO UFSKBEJEJGVTJOFUP EJIBSBQLBO LBQBTJUBT EJGVTJ LBSCPO EJPLTJEB QBEB LFBEBBO
EBSJ BMWFPMJ LF EBMBN EBSBI CJMB UFLBOBO HBT EBMBN EBSBI MFCJI JTUJSBIBU LJSBLJSB TBNQBJ NMNFOJUNN )H EBO
CFTBSEBSJQBEBUFLBOBOQBSTJBMEBMBNBMWFPMJ TFQFSUJQBEBLBSCPO TFMBNBLFSKBGJTJLLJSBLJSBTBNQBJNMNFOJUNN
EJPLTJEB UFSKBEJEJGVTJOFUPEBSJEBSBILFEBMBNBMWFPMJ )H(BNCBSEBMBNLFBEBBOJTUJSBIBUEBOTFMBNBLFSKB
491
Unit VII Pernapasan
1300 LBSCPONPOPLTJEBQBEBQSJBEFXBTBNVEBTBBUJTUJSBIBUBEBMBINM
NFOJUNN)H EBOLBQBTJUBTEJGVTJPLTJHFOBEBMBI LBMJJOJ BUBV
1200
NMNFOJUNN)H
1100
1000 Efek Rasio Ventilasi-Perfusi terhadap

900 Konsentrasi Gas Alveolus
800 1BEB CBHJBO BXBM CBC JOJ LJUB UFMBI NFNQFMBKBSJ CBIXB 10 EBO
700 1$0 EBMBN BMWFPMJ EJUFOUVLBO PMFI EVB GBLUPS
LFDFQBUBO
WFOUJMBTJ BMWFPMVT EBO
LFDFQBUBO USBOTGFS PLTJHFO EBO LBSCPO
600 EJPLTJEB NFMBMVJ NFNCSBO QFSOBQBTBO 1FNCBIBTBO TFCFMVNOZB
UFMBI NFNCVBU BOHHBQBO CBIXB TFNVB BMWFPMJ EJWFOUJMBTJ EFOHBO
500
TBNB CFTBS EBO CBIXB BMJSBO EBSBI ZBOH NFOHBMJS NFMBMVJ LBQJMFS
400 BMWFPMVT TBNB QBEB NBTJOHNBTJOH BMWFPMVT /BNVO CBILBO QBEB
LFBEBBO OPSNBM TFLBMJQVO TBNQBJ UBSBG UFSUFOUV EBO UFSVUBNB QBEB
300 CBOZBLQFOZBLJUQBSV TFCBHJBOEBFSBIQBSVUFSWFOUJMBTJEFOHBOCBJL
200 UFUBQJ IBNQJS UJEBL NFNQVOZBJ BMJSBO EBSBI TFEBOHLBO EBFSBI MBJO
NVOHLJONFNQVOZBJBMJSBOEBSBIZBOHTBOHBUCBJLUBQJWFOUJMBTJOZB
100 TFEJLJU BUBV UJEBL BEB 1BEB LPOEJTJLPOEJTJ JOJ QFSUVLBSBO HBT
NFMBMVJNFNCSBOQFSOBQBTBOTBOHBUUFSHBOHHV EBOTFTFPSBOHEBQBU
0
NFOEFSJUBEJTUSFTQFSOBQBTBOZBOHCFSBUXBMBVQVOWFOUJMBTJUPUBMEBO
BMJSBOEBSBIQBSVUPUBMOZBOPSNBM UFUBQJEFOHBOWFOUJMBTJEBOBMJSBO
EBSBI ZBOH NFOHBMJS LF CBHJBO QBSV ZBOH MBJO 0MFI LBSFOB JUV
LPOTFQZBOHTBOHBULVBOUJUBUJGUFMBIEJLFNCBOHLBOVOUVLNFNCBOUV
LJUB NFNBIBNJ NFOHFOBJ QFSUVLBSBO QFSOBQBTBO CJMB UFSEBQBU
LFUJEBLTFJNCBOHBOBOUBSBWFOUJMBTJBMWFPMVTEBOBMJSBOEBSBIBMWFPMVT
,POTFQJOJEJTFCVUSBTJPWFOUJMBTJQFSGVTJ
GJTJL ZBOHNFNQFSMJIBULBOLBQBTJUBTEJGVTJZBOHMVBSCJBTBEBSJ . .
4FDBSBLVBOUJUBUJG SBTJPWFOUJMBTJQFSGVTJEJOZBUBLBOTFCBHBJ7
. "2
LBSCPO EJPLTJEB EBO KVHB FGFL LFSKB GJTJL UFSIBEBQ LBQBTJUBT #JMB 7" 7FOUJMBTJ BMWFPMVT
BEBMBI OPSNBM VOUVL BMWFPMVT UFSUFOUV
EJGVTJEBSJNBTJOHNBTJOHHBTJOJ EBO 2 BMJSBO EBSBI
KVHB OPSNBM QBEB BMWFPMVT ZBOH TBNB NBLB
. .
SBTJP WFOUJMBTJQFSGVTJ
. 7" 2
KVHB EJLBUBLBO
. OPSNBM 5FUBQJ CJMB
WFOUJMBTJ 7"
OPMOBNVONBTJIBEBQFSGVTJ 2
QBEBBMWFPMVT NBLB
SBTJPWFOUJMBTJQFSGVTJOZBBEBMBIOPM"UBV LFBEBBOFLTUSFNMBJOOZB .
Pengukuran Kapasitas Difusi—Metode Karbon Monoksida .
CJMB UFSEBQBU WFOUJMBTJ
. . ZBOH BEFLVBU 7"
UBQJ QFSGVTJOZB OPM 2

,BQBTJUBT EJGVTJ PLTJHFO EBQBU EJIJUVOH EBSJ QFOHVLVSBO
10 NBLB SBTJPOZB 7"2
BEBMBI UBL UFSIJOHHB 1BEB SBTJP OPM BUBV UBL
BMWFPMVT
10 EBMBN EBSBI LBQJMFS QBSV EBO
LFDFQBUBO UFSIJOHHB UJEBLUFSKBEJQFSUVLBSBOHBTNFMBMVJNFNCSBOQFSOBQBTBO
BNCJMBO PLTJHFO PMFI EBSBI 8BMBVQVO EFNJLJBO NFOHVLVS 10 QBEB BMWFPMJ ZBOH UFSLFOB ZBOH NFOKFMBTLBO QFOUJOHOZB LPOTFQ JOJ
EBMBN EBSBI LBQJMFS QBSV TBOHBUMBI TVLBS EBO CFHJUV UJEBL UFQBU 0MFILBSFOBJUV BLBOEJKFMBTLBOBLJCBUBLJCBUQFSOBQBTBOEBSJLFEVB
TFIJOHHB UJEBL QSBLUJT VOUVL NFOHVLVS LBQBTJUBT EJGVTJ PLTJHFO LFBEBBOFLTUSFNJOJ
EFOHBOQSPTFEVSMBOHTVOHTFQFSUJJUV LFDVBMJVOUVLQFOFMJUJBO
Tekanan Parsial Oksigen dan Karbon Dioksida Alveolus bila VA/Q
6OUVL NFOHIJOEBSJ LFTVLBSBO ZBOH EJKVNQBJ EBMBN Sama dengan Nol. #JMB 7"2 TBNB EFOHBO OPM CFSBSUJ UJEBL BEB
QFOHVLVSBOLBQBTJUBTEJGVTJPLTJHFOTFDBSBMBOHTVOH BIMJGJTJPMPHJ WFOUJMBTJ BMWFPMBS VEBSB EBMBN BMWFPMVT NFOKBEJ TFJNCBOH EFOHBO
CJBTBOZB NFOHVLVS LBQBTJUBT EJGVTJ LBSCPO NPOPLTJEB UFSMFCJI LBSCPO EJPLTJEB EBO PLTJHFO EBSBI LBSFOB HBTHBT JOJ CFSEJGVTJ EJ
EBIVMV EBO LFNVEJBO EBSJ IBTJM QFOHVLVSBO UFSTFCVU EJIJUVOH BOUBSBEBSBIEBOVEBSBBMWFPMVT0MFILBSFOBEBSBIZBOHNFOHBMJSJEJ
LBQBTJUBTEJGVTJPLTJHFO1SJOTJQNFUPEFLBSCPONPOPLTJEBBEBMBI LBQJMFSBEBMBIEBSBIWFOBZBOHLFNCBMJLFQBSVEBSJTJSLVMBTJTJUFNJL
TFCBHBJ CFSJLVU 4FKVNMBI LFDJM LBSCPO NPOPLTJEB EJIJSVQ LF NBLBHBTBMWFPMVTNFOKBEJTFJNCBOHEFOHBOHBTHBTEBSBIJOJ1BEB
EBMBNBMWFPMJ EBOUFLBOBOQBSTJBMLBSCPONPOPLTJEBEBMBNBMWFPMJ #BC LJUB KFMBTLBO CBHBJNBOB EBSBI WFOB OPSNBM W
NFNQVOZBJ
EJVLVS EBSJ DPOUPI VEBSB BMWFPMVT ZBOH UFQBU 5FLBOBO LBSCPO 10 NN )H EBO 1$0 NN )H 0MFI LBSFOB JUV JOJ KVHB
NPOPLTJEB EBMBN EBSBI TFTVOHHVIOZB OPM TFCBC IFNPHMPCJO NFSVQBLBOUFLBOBOQBSTJBMZBOHOPSNBMQBEBLFEVBHBTEBMBNBMWFPMJ
TBOHBU DFQBU CFSHBCVOH EFOHBO HBT JOJ TFIJOHHB UJEBL BEB JOJZBOHNFNQVOZBJBMJSBOEBSBIUFUBQJUJEBLNFNQVOZBJWFOUJMBTJ
LFTFNQBUBOVOUVLUFSDJQUBOZBUFLBOBO0MFILBSFOBJUV QFSCFEBBO
UFLBOBOLBSCPONPOPLTJEBBOUBSBLFEVBTJTJNFNCSBOQFSOBQBTBO . .
Tekanan Parsial Oksigen dan Karbon Dioksida Alveolus Bila VA/Q
TBNB EFOHBO UFLBOBO QBSTJBMOZB EBMBN DPOUPI VEBSB BMWFPMJ
,FNVEJBO EFOHBO NFOHVLVS WPMVNF LBSCPO NPOPLTJEB ZBOH
Besarnya
. . Tak Terhingga &GFL UFSIBEBQ UFLBOBO QBSTJBM HBT BMWFPMVT
CJMB 7"2 TBNB EFOHBO . UBL
. UFSIJOHHB TFQFOVIOZB CFSCFEB EFOHBO
EJBCTPSCTJ EBMBN TVBUV XBLUV TJOHLBU EBO NFNCBHJOZB EFOHBO FGFL ZBOH UFSKBEJ CJMB 7"2 TBNB EFOHBO OPM LBSFOB TFLBSBOH UJEBL
UFLBOBOQBSTJBMLBSCPONPOPLTJEBBMWFPMVT NBLBLBQBTJUBTEJGVTJ BEB BMJSBO EBSBI LBQJMFS ZBOH NFNCBXB QFSHJ PLTJHFO BUBV ZBOH
LBSCPONPOPLTJEBEBQBUEJUFOUVLBOTFDBSBUFQBU NFNCBXBLBSCPOEJPLTJEBLFBMWFPMJ0MFILBSFOBJUV CVLBOOZBHBT
6OUVL NFOHVCBI LBQBTJUBT EJGVTJ LBSCPO NPOPLTJEB NFOKBEJ HBT BMWFPMVT ZBOH NFOKBEJ TFJNCBOH EFOHBO EBSBI WFOB VEBSB
LBQBTJUBT EJGVTJ PLTJHFO OJMBJ ZBOH EJQFSPMFI EJLBMJLBO EFOHBO BMWFPMVT KVTUSV NFOKBEJ TBNB EFOHBO VEBSB JOTQJSBTJ ZBOH TVEBI
GBLUPS TFCBC LPFGJTJFO EJGVTJ VOUVL PLTJHFO BEBMBI LBMJ EJMFNCBQLBO "SUJOZB VEBSB ZBOH EJJOTQJSBTJ UJEBL NFMFQBTLBO
LBSCPONPOPLTJEB%FOHBOEFNJLJBO LBQBTJUBTEJGVTJSBUBSBUB PLTJHFOVOUVLEBSBI
492
%BOLBSFOBVEBSBJOTQJSBTJOPSNBMEBOZBOHMFNCBQNFOHBOEVOH10 +VNMBI LVBOUJUBUJG EBSBI QJOUBT TFDBSB UPUBM UJBQ NFOJUOZB

NN)HEBO1$0NN)H NBLBOJMBJJOJBEBMBIUFLBOBOQBSTJBM EJTFCVU QJOUBTBO GJTJPMPHJT QIZTJPMPHJD TIVOU
1JOUBTBO
EBSJLFEVBHBTEBMBNBMWFPMJ GJTJPMPHJT JOJ EJVLVS EBMBN MBCPSBUPSJVN LMJOJL GVOHTJ QBSV
Pertukaran Gas dan Tekanan Parsial Alveolus Bila VA/Q Normal. EFOHBO NFOHBOBMJTJT LPOTFOUSBTJ PLTJHFO EBMBN DBNQVSBO
UNIT VII
#JMB WFOUJMBTJ BMWFPMVT EBO BMJSBO EBSBI LBQJMFS BMWFPMVT OPSNBM ZBOH EBSBI WFOB EBO EBSBI BSUFSJ CFSTBNBBO EFOHBO QFOHVLVSBO
CFSBSUJ QFSGVTJ BMWFPMVT OPSNBM
NBLB QFSUVLBSBO PLTJHFO EBO LBSCPO DVSBI KBOUVOH %BSJ OJMBJOJMBJ JOJ QJOUBTBO GJTJPMPHJT EBQBU
EJPLTJEB NFMBMVJ NFNCSBO QFSOBQBTBO IBNQJS PQUJNBM EBO 10 EJIJUVOHEFOHBONFOHHVOBLBOQFSTBNBBOCFSJLVU
BMWFPMVT OPSNBMOZB TFCFTBS NN )H ZBOH NFSVQBLBO OJMBJ BOUBSB .
VEBSB JOTQJSBTJ NN )H
EBO EBSBI WFOB NN )H
%FNJLJBO QPS CiO2 - CaO2
. = .
KVHB OJMBJ 1$0 BMWFPMVT UFSMFUBL BOUBSB EVB LFBEBBO FLTUSFN JOJ QT CiO2 - CvO2
OPSNBMOZB TFCFTBS NN )H CFSCFEB EFOHBO EBSBI WFOB NN )H
EBOVEBSBJOTQJSBTJNN)H%FOHBOEFNJLJBO QBEBLFBEBBOOPSNBM EFOHBO214BEBMBIBMJSBOEBSBIQJOUBTBOGJTJPMPHJTUJBQNFOJU
10 VEBSB BMWFPMVT SBUBSBUB NN )H EBO 1$0 SBUBSBUB NN
25 BEBMBI DVSBI KBOUVOH UJBQ NFOJU $J0 BEBMBI LPOTFOUSBTJ
)H
PLTJHFO EBMBN EBSBI BSUFSJ KJLB UFSEBQBU SBTJP WFOUJMBTJQFSGVTJ
Diagram PO2-PCO2, VA/Q JEFBM $B0 BEBMBI LPOTFOUSBTJ UFSVLVS PLTJHFO EBMBN EBSBI

BSUFSJ EBO $W0 BEBMBI LPOTFOUSBTJ UFSVLVS PLTJHFO EBMBN
,POTFQLPOTFQ ZBOH EJOZBUBLBO QBEB QFNCBIBTBO TFCFMVNOZB EBQBU DBNQVSBOEBSBIWFOB
EJQFSMJIBULBO EBMBN CFOUVL HSBGJL TFQFSUJ EJMVLJTLBO
. . EBMBN (BNCBS 4FNBLJOCFTBSQJOUBTBOGJTJPMPHJT TFNBLJOCFTBSQVMBKVNMBI
ZBOH EJTFCVU TFCBHBJ EJBHSBN 101$0 7"2 ,VSWB EBMBN EBSBIZBOHUJEBLUFSPLTJHFOJTBTJTFXBLUVNFMBMVJQBSV
EJBHSBNNFOZBUBLBOTFNVBLFNVOHLJOBOLPNCJOBTJ10
. . EBO1$0EJ
BOUBSBCBUBTOPMEBO7"2UBLUFSIJOHHB CJMBUFLBOBOHBTEBMBNEBSBI . .
WFOB OPSNBM EBO PSBOH CFSOBQBT EFOHBO VEBSB QBEB UFLBOBO EJ BUBT Konsep "Ruang Rugi Fisiologis" (Bila VA/Q Lebih
-
QFSNVLBBOMBVU%FOHBOEFNJLJBO UJUJL7TFTVBJEFOHBO10
Besar dari Normal)
. . EBO1$0
#JMB WFOUJMBTJ CFCFSBQB BMWFPMJ DVLVQ CFTBS UFUBQJ BMJSBO EBSBI
CJMB7"2OPM1BEBUJUJLJOJ 10BEBMBINN)HEBO1$0NN
BMWFPMVT SFOEBI BLBO BEB MFCJI CBOZBL PLTJHFO EBMBN BMWFPMJ
)H ZBOHNFSVQBLBOOJMBJOJMBJEBMBNEBSBIWFOBZBOHOPSNBM
EBSJQBEB ZBOH EBQBU EJBOHLVU EBSJ BMWFPMJ PMFI BMJSBO EBSBI
1BEBVKVOHLVSWBZBOHMBJOOZB CJMB7"2TBNBEFOHBOUBLUFSIJOHHB %FOHBO EFNJLJBO WFOUJMBTJ EBMBN BMWFPMJ JOJ EJTFCVU UJEBL
UJUJL*NFOZBUBLBOVEBSBJOTQJSBTJ ZBOHNFOVOKVLLBO10NN)H CFSHVOB 7FOUJMBTJ EBSJ SVBOH SVHJ BOBUPNJT TBMVSBO OBQBT KVHB
TFEBOHLBO 1$0 OPM 1BEB LVSWB KVHB UFSEBQBU UJUJL ZBOH NFOZBUBLBO UJEBL CFSHVOB +VNMBI EBSJ LFEVB WFOUJMBTJ ZBOH UJEBL CFSHVOB
VEBSB BMWFPMVT OPSNBM CJMB 7"2 OPSNBM 1BEB UJUJL JOJ 10 NN JOJ EJTFCVU SVBOH SVHJ GJTJPMPHJT 3VBOH SVHJ JOJ EJVLVS EBMBN
)HEBO1$0NN)H MBCPSBUPSJVN GVOHTJ QBSV LMJOJT EFOHBO NFNFSJLTB EBSBI EBO
NFOHVLVS HBT QFSOBQBTBO TFSUB NFOHHVOBLBO QFSTBNBBO
Konsep " Pintasan Fisiologi" (Bila VA/Q di Bawah Normal CFSJLVU ZBOHEJTFCVUQFSTBNBBO#PIS
,BQBOQVO7"2EJCBXBIOPSNBM UJEBLUFSEBQBUWFOUJMBTJZBOHBEFLVBU

VOUVL NFOZFEJBLBO LFCVUVIBO PLTJHFO ZBOH EJQFSMVLBO VOUVL VDphys PaCO2 − PeCO2
PLTJHFOBTJBMJSBOEBSBIZBOHNFMBMVJLBQJMFSBMWFPMVTTFDBSBQFOVI0MFI = ,
VT PaCO2
LBSFOBJUV TFCBHJBOEBSBIWFOBZBOHNFOHBMJSNFMBMVJLBQJMFSQBSVUJEBL
UFSPLTJHFOBTJ #BHJBO JOJ EJTFCVU EBSBI QJOUBT TIVOUFE CMPPE
+VHB . .
EFOHBO 7%GJT BEBMBI SVBOH SVHJ GJTJPMPHJT 75 BEBMBI WPMVNF
CFCFSBQBBMJSBOEBSBIUBNCBIBOZBOHNFMBMVJQFNCVMVIEBSBICSPOLJBM UJEBM 1BDP BEBMBI UFLBOBO QBSTJBM LBSCPO EJPLTJEB EBMBN EBSBI
EBOCVLBONFMBMVJLBQJMFSBMWFPMVT ZBOHQBEBLFBEBBOOPSNBMLJSBLJSB BSUFSJEBO1FDPBEBMBIUFLBOBOQBSTJBMSBUBSBUBLBSCPOEJPLTJEB
QFSTFOEBSJDVSBIKBOUVOH JOJQVOKVHBNFSVQBLBOEBSBIQJOUBTZBOH EBMBNTFMVSVIVEBSBFLTQJSBTJ
UBLUFSPLTJHFOBTJ
#JMBSVBOHSVHJGJTJPMPHJTTBOHBUCFTBS CBOZBLLFSKBWFOUJMBTJ
ZBOH UJEBL CFSHVOB TFCBC CBOZBL TFLBMJ VEBSB WFOUJMBTJ ZBOH
UJEBLQFSOBINFODBQBJEBSBI
Kelainan Rasio Ventilasi-Perfusi
VA/Q Abnormal pada Bagian Atas dan Bawah dari
Paru yang Normal. 1BEB PSBOH OPSNBM EBMBN QPTJTJ
50 v VA/Q = 0 UFHBL KVNMBI BMJSBO EBSBI LBQJMFS QBSV NBVQVO WFOUJMBTJ
BMWFPMVT QBEB CBHJBO BUBT QBSV MFCJI TFEJLJU EBSJQBEB
40 (PO2 = 40) CBHJBO CBXBI UFUBQJ BMJSBO EBSBI MFCJI CBOZBL CFSLVS
(PCO2 = 45)
EBSJQBEBWFOUJMBTJ0MFILBSFOBJUV QBEBQVODBLQBSV 7"
30
2 LBMJ MFCJI CFTBS EBSJQBEB OJMBJ JEFBM ZBOH
(PO2 = 104) NFOZFCBCLBO SVBOH SVHJ GJTJPMPHJT UJOHLBU TFEBOH QBEB
20 (PCO2 = 40)
EBFSBIQBSVJOJ
10 1BEB LFBEBBO FLTUSFN MBJO EJ EBTBS QBSV WFOUJMBTJ
(PO2 = 149) VA/Q = d
(PCO2 = 0) I TBOHBU LFDJM EJCBOEJOHLBO EFOHBO BMJSBO EBSBI EFOHBO
7"2 LBMJ OJMBJ JEFBM 1BEB EBFSBI JOJ TFCBHJBO LFDJM
0 20 40 60 80 100 120 140 160 EBSBIUJEBLUFSPLTJHFOJTBTJTFDBSBOPSNBM EBOEJOZBUBLBO
PO2 (mm Hg) TFCBHBJQJOUBTBOGJTJPMPHJT
. .
493
Unit VII Pernapasan
1BEB LFEVB LFBEBBO QBSV ZBOH FLTUSFN JOJ WFOUJMBTJ EBO QFSGVTJ Daftar Pustaka
ZBOH UJEBL TBNB BLBO TFEJLJU NFOHVSBOHJ FGFLUJWJUBT QFSUVLBSBO
Albert R, Spiro S, Jett J: Comprehensive Respiratory Medicine, Philadelphia,
PLTJHFOEBOLBSCPOEJPLTJEBQBSV8BMBVQVOEFNJLJBO TFMBNBLFSKB
2002, Mosby.
GJTJL BMJSBO EBSBI LF CBHJBO BUBT QBSV NFOJOHLBU TFDBSB OZBUB Guazzi M: Alveolar-capillary membrane dysfunction in heart failure:
TFIJOHHB SVBOH SVHJ GJTJPMPHJT ZBOH UJNCVM KBVI MFCJI TFEJLJU EBO evidence of a pathophysiologic role, Chest 124:1090, 2003.
FGFLUJWJUBTQFSUVLBSBOHBTTFLBSBOHNFOEFLBUJPQUJNVN Hughes JM: Assessing gas exchange, Chron Respir Dis 4:205, 2007. Hopkins SR,
Levin DL, Emami K, et al: Advances in magnetic resonance
. .
VA/Q Abnormal pada Penyakit Paru Obstruktif Kronis. imaging of lung physiology, J Appl Physiol 102:1244, 2007.
MacIntyre NR: Mechanisms of functional loss in patients with chronic lung
,FCBOZBLBOPSBOHZBOHNFSPLPLTFMBNBCFSUBIVOUBIVO NFOEFSJUB disease, Respir Care 53:1177, 2008.
PCTUSVLTJ CSPOLVT EBMBN CFSCBHBJ EFSBKBU QBEB TFCBHJBO CFTBS EBSJ Moon RE, Cherry AD, Stolp BW, et al: Pulmonary gas exchange in diving, J
NFSFLB LPOEJTJ JOJ NFOKBEJ TBOHBU CFSBU EBO CFSMBOKVU EFOHBO Appl Physiol 106:668, 2009.
BEBOZB VEBSB ZBOH UFSQFSBOHLBQ EBMBN BMWFPMVT BMWFPMBS BJS Otis AB: Quantitative relationships in steady-state gas exchange. In Fenn
USBQQJOH
EBO NFOHBLJCBULBO FNGJTFNB ,FNVEJBO FNGJTFNB WQ, Rahn H, eds. Handbook of Physiology, Sec 3, vol 1, Baltimore, 1964,
NFOZFCBCLBO TFCBHJBO CFTBS EJOEJOH BMWFPMVT NFOKBEJ SVTBL Williams & Wilkins, pp 681.
%FOHBO EFNJLJBO
. . QBEB TFPSBOH QFSPLPL BEB EVB LFMBJOBO ZBOH
Powell FL, Hopkins SR: Comparative physiology of lung complexity: impli-
NFOZFCBCLBO7"2BCOPSNBM1FSUBNB LBSFOBTFCBHJBOCSPOLJPMVT cations for gas exchange, News Physiol Sci 19:55, 2004.
Rahn H, Farhi EE: Ventilation, perfusion, and gas exchange-the Va/Q con-
LFDJM UFSTVNCBU TFIJOHHB BMWFPMJ ZBOH BEB EJ CFMBLBOH TVNCBUBO
. . cept. In Fenn WO, Rahn H, eds. Handbook of Physiology, Sec 3, vol 1,
NFOKBEJ UJEBL UFSWFOUJMBTJ NFOZFCBCLBO 7"2 NFOEFLBUJ OPM
Baltimore, 1964, Williams & Wilkins, pp 125.
,FEVB QBEB EBFSBI QBSV ZBOH TFCBHJBO CFTBS EJOEJOH BMWFPMVTOZB Robertson HT, Hlastala MP: Microsphere maps of regional blood flow and
UFMBI SVTBL UFUBQJ NBTJI BEB WFOUJMBTJ BMWFPMVT TFCBHJBO CFTBS regional ventilation, J Appl Physiol 102:1265, 2007.
WFOUJMBTJOZBNFOKBEJUJEBLCFSHVOBLBSFOBBMJSBOEBSBIUJEBLBEFLVBU Wagner PD: Assessment of gas exchange in lung disease: balancing accu-
VOUVLNFOHBOHLVUHBTHBTEBSBI racy against feasibility, Crit Care 11:182, 2007.
Wagner PD: The multiple inert gas elimination technique (MIGET), Intensive
%FOHBOEFNJLJBO QBEBQFOZBLJUQBSVPCTUSVLUJGLSPOJT CFCFSBQB Care Med 34:994, 2008.
EBFSBI QBSV NFOVOKVLLBO QJOUBT GJTJPMPHJT ZBOH TFSJVT EBO QBEB West JB: Pulmonary Physiology-The Essentials, Baltimore, 2003, Lippincott
EBFSBI MBJO NFOVOKVLLBO SVBOH SVHJ GJTJPMPHJT ZBOH TFSJVT ,FEVB Williams & Wilkins.
LPOEJTJTBOHBUNFOHVSBOHJFGFLUJWJUBTQBSVTFCBHBJPSHBOQFSUVLBSBO
HBT LBEBOHLBEBOH FGFLUJWJUBTOZB NFOVSVO TBNQBJ TFQFSTFQVMVI
EBSJ OPSNBM #BILBO GBLUPSGBLUPS JOJ ZBOH QBMJOH CBOZBL
NFOZFCBCLBOHBOHHVBOQBSVQBEBNBTBTFLBSBOH
494
BAB 40
UNIT VII
1FOHBOHLVUBO0LTJHFOEBO,BSCPO%JPLTJEBEJ
EBMBN%BSBIEBO$BJSBO5VCVI
#JMB PLTJHFO UFMBI CFSEJGVTJ EBSJ Difusi Oksigen dari Alveoli ke Darah Kapiler Paru
BMWFPMJLFEBMBNEBSBIQBSV PLTJHFO #BHJBO BUBT EBSJ (BNCBS NFMVLJTLBO BMWFPMVT QBSV ZBOH
EJBOHLVU LF LBQJMFS KBSJOHBO QFSJGFS CFSCBUBTBO EFOHBO LBQJMFS QBSV NFNQFSMJIBULBO EJGVTJ
IBNQJS TFMVSVIOZB EBMBN CFOUVL NPMFLVMNPMFLVM PLTJHFO BOUBSB VEBSB BMWFPMVT EBO EBSBI
HBCVOHBO EFOHBO IFNPHMPCJO QBSV 1P EBSJ HBT PLTJHFO EBMBN BMWFPMVT SBUBSBUB NN
"EBOZBIFNPHMPCJOEJEBMBNTFM )H TFEBOHLBO 1P EBSBI WFOB ZBOH NBTVL LBQJMFS QBSV QBEB
VKVOH BSUFSJOZB SBUBSBUB IBOZB NN )H LBSFOB TFKVNMBI
EBSBI NFSBI NFNVOHLJOLBO EBSBI VOUVL NFOHBOHLVU CFTBS PLTJHFO EJLFMVBSLBO EBSJ EBSBI JOJ TFUFMBI NFMBMVJ
TBNQBJ LBMJ KVNMBI PLTJHFO ZBOH EBQBU EJBOHLVU EBMBN KBSJOHBOQFSJGFS0MFILBSFOBJUV QFSCFEBBOUFLBOBOBXBMZBOH
CFOUVLPLTJHFOUFSMBSVUEJEBMBNDBJSBOEBSBI NFOZFCBCLBO PLTJHFO CFSEJGVTJ LF EBMBN LBQJMFS QBSV BEBMBI
%BMBNTFMKBSJOHBOUVCVI PLTJHFOCFSFBLTJEFOHBOCFSCBHBJ BUBV NN )H 1BEB CBHJBO CBXBI HBNCBS UFSEBQBU
CBIBO NBLBOBO VOUVL NFNCFOUVL TFKVNMBI CFTBS LBSCPO LVSWBZBOHNFNQFSMJIBULBOQFOJOHLBUBO1PZBOHDFQBUEBMBN
EJPLTJEB ,BSCPO EJPLTJEB JOJ NBTVL LF EBMBN LBQJMFS KBSJOHBO EBSBI TFXBLUV EBSBI NFMFXBUJ LBQJMFS 1P EBSBI NFOJOHLBU
EBOEJBOHLVULFNCBMJLFQBSV,BSCPOEJPLTJEB TFQFSUJPLTJHFO IBNQJSTFCBOEJOHEFOHBOQFOJOHLBUBOZBOHUFSKBEJQBEBVEBSB
KVHB CFSHBCVOH EFOHBO CBIBOCBIBO LJNJB EBMBN EBSBI ZBOH BMWFPMVT TFXBLUV EBSBI UFMBI NFMFXBUJ TFQFSUJHB QBOKBOH
NFOJOHLBULBO QFOHBOHLVUBO LBSCPO EJPLTJEB IJOHHB LBMJ LBQJMFS NFOKBEJIBNQJSNN)H
MJQBU
5VKVBO EBSJ QFOZBKJBO CBC JOJ BEBMBI NFNCBIBT QSJOTJQ Pengambilan Oksigen oleh Darah Paru selama Kerja
QSJOTJQGJTJLBEBOLJNJBTFDBSBLVBMJUBUJGEBOLVBOUJUBUJGNFOHFOBJ 4FMBNB LFSKB CFSBU UVCVI NBOVTJB NFNCVUVILBO LBMJ
QFOHBOHLVUBO PLTJHFO EBO LBSCPO EJPLTJEB EBMBN EBSBI EBO KVNMBI PLTJHFO OPSNBM +VHB LBSFOB QFOJOHLBUBO DVSBI
DBJSBOKBSJOHBO KBOUVOH TFMBNB LFSKB XBLUV NFOFUBQOZB EBSBI EBMBN LBQJMFS
QBSV EBQBU CFSLVSBOH IJOHHB NFOKBEJ LVSBOH EBSJ TFUFOHBI
Pengangkutan Oksigen dari Paru ke Jaringan Tubuh OPSNBM/BNVO LBSFOBBEBTVBUVGBLUPSQFOHBNBOZBOHCFTBS
VOUVL EJGVTJ PLTJHFO NFMBMVJ NFNCSBO QBSV EBSBI UFSTFCVU
1BEB#BC UFMBIEJUFLBOLBOCBIXBHBTEBQBUCFSHFSBLEBSJTBUV IBNQJSTFQFOVIOZBUFSTBUVSBTJEFOHBOPLTJHFOQBEBTBBUEBSBI
UFNQBU LF UFNQBU MBJO EFOHBO DBSB EJGVTJ EBO QFSHFSBLBO JOJ NFOJOHHBMLBO LBQJMFS QBSV )BM JOJ EBQBU EJKFMBTLBO TFCBHBJ
TFMBMV EJTFCBCLBO PMFI QFSCFEBBO UFLBOBO QBSTJBM EBSJ UFNQBU CFSJLVU
QFSUBNB LF UFNQBU CFSJLVUOZB %FOHBO EFNJLJBO PLTJHFO 1FSUBNB TFQFSUJ ZBOH UFMBI EJCBIBT QBEB #BC CBIXB
CFSEJGVTJEBSJBMWFPMJLFEBMBNEBSBILBQJMFSQBSVLBSFOBUFLBOBO LBQBTJUBT EJGVTJ PLTJHFO NFOJOHLBU LJSBLJSB IBNQJS UJHB LBMJ
QBSTJBM PLTJHFO 1P
EBMBN BMWFPMJ MFCJI CFTBS EBSJQBEB 1P MJQBUTFMBNBLFSKBGJTJLIBTJMJOJUFSVUBNBBLJCBUNFOJOHLBUOZB
EBMBN EBSBI LBQJMFS QBSV %BMBN KBSJOHBO UVCVI MBJOOZB 1P EBFSBIQFSNVLBBOLBQJMFSZBOHCFSQFSBOEBMBNEJGVTJEBOKVHB
ZBOH MFCJI UJOHHJ EBMBN EBSBI LBQJMFS EBSJQBEB EBMBN KBSJOHBO EBSJ SBTJP WFOUJMBTJQFSGVTJ ZBOH TFNBLJO NFOEFLBUJ JEFBM EJ
NFOZFCBCLBOPLTJHFOCFSEJGVTJLFEBMBNTFMTFMEJTFLJUBSOZB CBHJBOBUBTQBSV
4FCBMJLOZB CJMB PLTJHFO EJNFUBCPMJTNF EBMBN TFM VOUVL ,FEVB QFSIBUJLBO QBEB LVSWB EBMBN (BNCBS CBIXB
NFNCFOUVL LBSCPO EJPLTJEB UFLBOBO LBSCPO EJPLTJEB 1DP
QBEB LFBEBBO UBOQB BLUJWJUBT EBSBI NFOKBEJ IBNQJS
JOUSBTFM NFOJOHLBU LF OJMBJ ZBOH UJOHHJ TFIJOHHB NFOZFCBCLBO TFQFOVIOZB UFSTBUVSBTJ EFOHBO PLTJHFO QBEB TBBU NFMBMVJ
LBSCPO EJPLTJEB CFSEJGVTJ LF EBMBN LBQJMFS KBSJOHBO 4FUFMBI TFQFSUJHBLBQJMFSQBSV EBOOPSNBMOZBBEBTFEJLJUQFOBNCBIBO
EBSBI NFOHBMJS LF QBSV LBSCPO EJPLTJEB CFSEJGVTJ LFMVBS EBSJ PLTJHFO ZBOH NBTVL LF EBMBN EBSBI TFMBNB EVB QFSUJHB BLIJS
EBSBI NBTVL LF EBMBN BMWFPMJ LBSFOB 1DP EBMBN EBSBI LBQJMFS EBSJQFSQJOEBIBOOZB%FOHBOEFNJLJBO QBEBLFBEBBOOPSNBM
QBSVMFCJICFTBSEBSJQBEBEBMBNBMWFPMJ4FIJOHHB QFOHBOHLVUBO EBSBINFOFUBQEBMBNLBQJMFSQBSVLJSBLJSBUJHBLBMJMFCJIMBNB
PLTJHFOEBOLBSCPOEJPLTJEBPMFIEBSBICFSHBOUVOHCBJLLFQBEB EBSJZBOHEJQFSMVLBOVOUVLPLTJHFOBTJQFOVI0MFILBSFOBJUV
EJGVTJNBVQVOBMJSBOEBSBI4FLBSBOHLJUBBLBONFNCBIBTTFDBSB TFMBNB LFSKB GJTJL XBMBVQVO EBSBI IBOZB TFCFOUBS TBKB CFSBEB
LVBOUJUBUJG NFOHFOBJ GBLUPSGBLUPS ZBOH CFSQFSBO NFOZFCBCLBO EBMBN LBQJMFS UFUBQJ EBSBI NBTJI EBQBU UFSPLTJHFOBTJ QFOVI
FGFLJOJ BUBVIBNQJSQFOVI
495
Unit VII Pernapasan
Transpor Oksigen dalam Darah Arteri

,JSBLJSB QFSTFO EBSBI EBSJ QBSV ZBOH NFNBTVLJ BUSJVN
LJSJ NFOHBMJS NFMBMVJ LBQJMFS BMWFPMVT EBO NFOKBEJ
UFSPLTJHFOBTJ TBNQBJ 1P LJSBLJSB NN )H 4FLJUBS i si oksigen da i ka ile ja ingan e i e ke sel o ada
QFSTFOOZB MBHJ NFMFXBUJ BPSUB NFMBMVJ TJSLVMBTJ CSPOLJBM ZBOH ai an in e s isial mm Hg dan di sel ja ingan mm Hg
UFSVUBNB NFOZVQMBJ KBSJOHBO EBMBN QBEB QBSV EBO UJEBL
OPSNBM BLBO NFOJOHLBULBO 1P EBSJ NN )H QBEB UJUJL "
UFSQBQBS EFOHBO VEBSB QBSV "MJSBO EBSBI JOJ EJTFCVU BMJSBO
EBMBN HBNCBS
NFOKBEJ NN )H QBEB UJUJL #
5FUBQJ CBUBT
QJOUBT ZBOH CFSBSUJ EBSBI ZBOH NFNJOUBT EBFSBI QFSUVLBSBO
BUBTQFOJOHLBUBO1PCBILBOEFOHBOBMJSBOEBSBIZBOHNBLTJNBM
HBT1BEBXBLUVNFOJOHHBMLBOQBSV 1PEBSBIQJOUBTIBNQJS
BEBMBI NN )H LBSFOB OJMBJ JOJ NFSVQBLBO UFLBOBO PLTJHFO
TBNBEFOHBOEBSBIWFOBTJTUFNJLOPSNBM LJSBLJSBNN)H
EBMBN EBSBI BSUFSJ 4FCBMJLOZB CJMB EBSBI ZBOH NFOHBMJS NFMBMVJ
,FUJLB EBSBI JOJ CFSDBNQVS EBMBN EBSBI WFOB QBSV EFOHBO
KBSJOHBO NFOVSVO 1P KBSJOHBO KVHB NFOVSVO TFQFSUJ ZBOH
EBSBIZBOHUFSPLTJHFOBTJEBSJLBQJMFSBMWFPMVTDBNQVSBOEBSBI
EJUVOKVLLBOQBEBUJUJL$
JOJEJTFCVUDBNQVSBOEBSBIWFOB EBONFOZFCBCLBO1PEBSBI
ZBOH NBTVL LF KBOUVOH LJSJ EBO EJQPNQB LF EBMBN BPSUB
NFOKBEJUVSVOTBNQBJTFLJUBSNN)H1FSVCBIBO1PEBSBI
Efek Kecepatan Metabolisme Jaringan terhadap Po2 Cairan
JOJQBEBUFNQBUZBOHCFSCFEBEBMBNTJTUFNTJSLVMBTJEJMVLJTLBO lnterstisial. +JLB TFM NFNBLBJ PLTJHFO VOUVL NFUBCPMJTNF MFCJI
QBEB(BNCBS CBOZBL EBSJ OPSNBM NBLB LFBEBBO JOJ BLBO NFOVSVOLBO 1P
DBJSBO JOUFSTUJTJBM (BNCBS KVHB NFMVLJTLBO FGFL JOJ ZBOH
Difusi Oksigen dari Kapiler Perifer ke dalam Cairan NFNQFSMJIBULBOQFOVSVOBO1PDBJSBOJOUFSTUJTJBMCJMBQFNBLBJBO
PLTJHFOTFMVMBSEJUJOHLBULBO EBOQFOJOHLBUBO1PCJMBQFNBLBJBO
Interstisial
PLTJHFOTFMVMBSEJLVSBOHJ
#JMBEBSBIBSUFSJTBNQBJLFKBSJOHBOQFSJGFS 1PEBMBNLBQJMFS
NBTJINN)H/BNVO TFQFSUJUFSMJIBUQBEB(BNCBS
1P EBMBN DBJSBO JOUFSTUJTJBM ZBOH NFOHFMJMJOHJ TFM KBSJOHBO
SBUBSBUB IBOZB NN )H %FOHBO EFNJLJBO UFSEBQBU
QFSCFEBBOUFLBOBOBXBMZBOHTBOHBUCFTBSZBOHNFOZFCBCLBO
PLTJHFO CFSEJGVTJ TFDBSB DFQBU EBSJ EBSBI LBQJMFS LF EBMBN
KBSJOHBOCFHJUV DFQBUOZB TFIJOHHB 1P LBQJMFS UVSVO IBNQJS
TBNB EFOHBO UFLBOBO EBMBN JOUFSTUJTJVN ZBJUV NN )H
0MFILBSFOBJUV 1PEBSBIZBOHNFOJOHHBMLBOLBQJMFSKBSJOHBO
EBONFNBTVLJWFOBTJTUFNJLKVHBLJSBLJSBNN)H
Pengaruh Laju Aliran Darah terhadap Po2 Cairan

Interstisial. +JLB BMJSBO EBSBI ZBOH NFMBMVJ TVBUV KBSJOHBO
UFSUFOUV NFOJOHLBU NBLB MFCJI CBOZBL KVNMBI PLTJHFO ZBOH
EJBOHLVU LF EBMBN KBSJOHBO UFSTFCVU EBO 1P KBSJOHBO KBEJ
UVSVU NFOJOHLBU &GFL JOJ EJMVLJTLBO QBEB (BNCBS
1FSIBUJLBOCBIXBQFOJOHLBUBOBMJSBOTFCFTBSQFSTFOEBSJ
496
Bab 40 Pengangkutan Oksigen dan Karbon Dioksida di dalam Darah
4FCBHBJLFTJNQVMBO 1PKBSJOHBOEJUFOUVLBOPMFILFTFJNCBOHBO
BOUBSB
LFDFQBUBO QFOHBOHLVUBO PLTJHFO EBMBN EBSBI LF
KBSJOHBOEBO
LFDFQBUBOQFNBLBJBOPLTJHFOPMFIKBSJOHBO
UNIT VII
Difusi Oksigen dari Kapiler Perifer ke Sel Jaringan
0LTJHFO TFMBMV EJQBLBJ PMFI TFM 0MFI LBSFOB JUV 1P JOUSBTFM
EBMBN KBSJOHBO QFSJGFS UFUBQ MFCJI SFOEBI EBSJQBEB 1P EBMBN
LBQJMFSQFSJGFS+VHB QBEBCFCFSBQBLFBEBBO BEBKBSBLGJTJLZBOH
TBOHBUCFTBSBOUBSBLBQJMFSEBOTFM0MFILBSFOBJUV 1P JOUSBTFM
OPSNBMCFSLJTBSEBSJNN)HTBNQBJNN)H EFOHBOSBUB
SBUB EFOHBO QFOHVLVSBO MBOHTVOH QBEB IFXBO UJOHLBU SFOEBI
DBSB ZBOH CFSMBXBOBO EBSJ QFOHBSVIOZB UFSIBEBQ 1P
NN )H ,BSFOB QBEB LFBEBBO OPSNBM IBOZB EJCVUVILBO KBSJOHBO (BNCBS NFNQFSMJIBULBO FGFLFGFL TFCBHBJ
UFLBOBO PLTJHFO TFCFTBS TBNQBJ NN )H VOUVL NFOEVLVOH CFSJLVU
TFQFOVIOZB QSPTFT LJNJBXJ EBMBN TFM ZBOH NFOHHVOBLBO 1FOVSVOBO BMJSBO EBSBI EBSJ OPSNBM UJUJL "
NFOKBEJ
PLTJHFO NBLBLJUBEBQBUNFMJIBUCBIXB1PJOUSBTFMZBOHSFOEBI TFQFSFNQBU EBSJ OPSNBM UJUJL #
NFOJOHLBULBO 1DP
ZBJUV NN )H MFCJI EBSJ DVLVQ EBO NFSVQBLBO TVBUV GBLUPS KBSJOHBO QFSJGFS EBSJ OJMBJ OPSNBM NN )H NFOKBEJ
QFOHBNBOZBOHCFTBS NN )H 4FCBMJLOZB QFOJOHLBUBO BMJSBO EBSBI NFOKBEJ
FOBNLBMJOPSNBM UJUJL$
NFOVSVOLBO1DPJOUFSTUJTJBMEBSJ
Difusi Karbon Dioksida dari Sel Jaringan Perifer ke dalam OJMBJOPSNBMNN)H NFOKBEJNN)H UVSVOIBNQJS
Kapiler Jaringan dan dari Kapiler Paru ke dalam Alveoli NFOEFLBUJ 1DP EBSBI BSUFSJ NN )H
ZBOH NFNBTVLJ
,FUJLB PLTJHFO EJQBLBJ PMFI TFM TFCFOBSOZB TFMVSVI PLTJHFO JOJ LBQJMFSKBSJOHBO
NFOKBEJ LBSCPO EJPLTJEB TFIJOHHB 1DP JOUSBTFM NFOJOHLBU 1FSIBUJLBO KVHB CBIXB CJMB LFDFQBUBO NFUBCPMJTNF
LBSFOB1DPTFMKBSJOHBOZBOHUJOHHJJOJ LBSCPOEJPLTJEBCFSEJGVTJ KBSJOHBO NFOJOHLBU LBMJ MJQBU NBLB QFOJOHLBUBO 1DP
EBSJ TFM LF EBMBN LBQJMFS KBSJOHBO EBO LFNVEJBO EJCBXB PMFI DBJSBO JOUFSTUJTJBM BLBO MFCJI CFTBS QBEB TFMVSVI MBKVBMJSBO
EBSBI LF QBSV %J QBSV LBSCPO EJPLTJEB CFSEJGVTJ EBSJ LBQJMFS EBSBI TFEBOHLBO QFOVSVOBO NFUBCPMJTNF NFOKBEJ
QBSVLFEBMBNBMWFPMJEBOLFNVEJBOEJLFMVBSLBO TFQFSFNQBU EBSJ OPSNBM NFOZFCBCLBO 1DP DBJSBO
%FOHBOEFNJLJBO QBEBUJBQUFNQBUEBMBNSBOUBJQFOHBOHLVUBO JOUFSTUJTJBM UVSVO TBNQBJ LJSBLJSB NN )H IBNQJS
HBT LBSCPO EJPLTJEB CFSEJGVTJ EBMBN BSBI ZBOH CFSMBXBOBO NFOEFLBUJ1DPEBSBIBSUFSJ NN)H
EFOHBO EJGVTJ PLTJHFO .FTLJQVO EFNJLJBO UFSEBQBU TBUV
QFSCFEBBO CFTBS BOUBSB EJGVTJ LBSCPO EJPLTJEB EBO PLTJHFO Peran Hemoglobin dalam Pengangkutan Oksigen
LBSCPO EJPLTJEB EBQBU CFSEJGVTJ LJSBLJSB LBMJ MFCJI DFQBU EBSJ 1BEB LFBEBBO OPSNBM TFLJUBS QFSTFO PLTJHFO ZBOH
PLTJHFO 0MFI LBSFOB JUV QFSCFEBBO UFLBOBO ZBOH EJCVUVILBO EJBOHLVU EBSJ QBSV LF KBSJOHBO EJCBXB EBMBN DBNQVSBO
VOUVLNFOJNCVMLBOEJGVTJLBSCPOEJPLTJEB QBEBTFUJBQLFBEBBO LJNJBXJ EFOHBO IFNPHMPCJO EJ EBMBN TFM EBSBI NFSBI
KBVI MFCJI LFDJM EBSJQBEB QFSCFEBBO UFLBOBO ZBOH EJCVUVILBO 4JTBOZB TFCBOZBL QFSTFO EJBOHLVU EBMBN CFOUVL UFSMBSVU
VOUVL NFOJNCVMLBO EJGVTJ PLTJHFO 5FLBOBOUFLBOBO $0 JOJ EBMBNDBJSBOQMBTNBEBOTFMEBSBI%FOHBOEFNJLJBO QBEB
LVSBOHMFCJITFCBHBJCFSJLVU LFBEBBO OPSNBM PLTJHFO EJCBXB LF KBSJOHBO IBNQJS
1DPJOUSBTFM LJSBLJSBNN)H1DPJOUFSTUJTJBM LJSBLJSB TFMVSVIOZBPMFIIFNPHMPCJO
NN)H%FOHBOEFNJLJBO IBOZBBEBQFSCFEBBOUFLBOBONN
)H TFQFSUJZBOHEJMVLJTLBOQBEB(BNCBS
1DP EBSBI BSUFSJ ZBOH NBTVL LF KBSJOHBO NN )H 1DP
EBSBI WFOB ZBOH NFOJOHHBMLBO KBSJOHBO NN )H %FOHBO
EFNJLJBO TFCBHBJNBOB EJMVLJTLBO QBEB (BNCBS EBSBI
LBQJMFS KBSJOHBO NFODBQBJ JNCBOHBO ZBOH IBNQJS TBNB EFOHBO
1DPJOUFSTUJTJBM ZBJUVNN)H
1DP EBSBI ZBOH NBTVL LBQJMFS QBSV QBEB VKVOH BSUFSJ NN
)H 1DP VEBSB BMWFPMVT NN )H %FOHBO EFNJLJBO
QFSCFEBBO UFLBOBO ZBOH EJCVUVILBO VOUVL NFOZFCBCLBO EJGVTJ
LBSCPO EJPLTJEB EBSJ LBQJMFS QBSV LF EBMBN BMWFPMJ IBOZB NN
)H -BHJ QVMB TFQFSUJ ZBOH EJMVLJTLBO QBEB (BNCBS 1DP
EBSBILBQJMFSQBSVUVSVOIBNQJSNFOEFLBUJ1DPBMWFPMVT NN
)H TFCFMVN EBSBI NFMFXBUJ MFCJI EBSJ LJSBLJSB TFQFSUJHB KBSBL
LBQJMFS&GFLJOJTBNBEFOHBOFGFLZBOHEJBNBUJQBEBQFSNVMBBO
EJGVTJ PLTJHFO IBOZB TBKB FGFL JOJ CFSMBOHTVOH EBMBN BSBI ZBOH
CFSMBXBOBO
Efek Kecepatan Metabolisme Jaringan dan Aliran Darah

Jaringan terhadap Pco2 Interstisial "MJSBO EBSBI LBQJMFS
KBSJOHBOEBONFUBCPMJTNFKBSJOHBONFNFOHBSVIJ1DPEFOHBO
497
Unit VII Pernapasan
Jumlah Oksigen yang Dilepaskan dari Hemoglobin Ketika

Aliran Darah Arteri Sistemik Mengalir metalui Jaringan
+VNMBIUPUBMPLTJHFOZBOHUFSJLBUEFOHBOIFNPHMPCJOEJEBMBN
Gabungan Reversibel antara Oksigen dengan EBSBI BSUFSJ TJTUFNJL OPSNBM EFOHBO TBUVSBTJ QFSTFO LJSB
Hemoglobin LJSB BEBMBI NM UJBQ NM EBSBI *OJ EJQFSMJIBULBO QBEB
4JGBULJNJBIFNPHMPCJOUFMBIEJCBIBTQBEB#BC ZBOHUFMBI (BNCBS 4BBU NFMFXBUJ LBQJMFS KBSJOHBO KVNMBI JOJ
NFOKFMBTLBOCBIXBNPMFLVMPLTJHFOCFSHBCVOHTFDBSBMPOHHBS CFSLVSBOH SBUBSBUBNFOKBEJ NM 1PNN)H TBUVSBTJ
EBOSFWFSTJCFMEFOHBOCBHJBOIFNFEBSJIFNPHMPCJO#JMB1P IFNPHMPCJO QFSTFO
%FOHBO EFNJLJBO QBEB LFBEBBO
UJOHHJ TFQFSUJ EBMBN LBQJMFS QBSV PLTJHFO CFSJLBUBO EFOHBO OPSNBM LJSBLJSB NM PLTJHFO EJBOHLVU EBSJ QBSV LF KBSJOHBO
IFNPHMPCJO UFUBQJ CJMB 1P SFOEBI TFQFSUJ EBMBN LBQJMFS PMFITFUJBQNMBMJSBOEBSBI
KBSJOHBO PLTJHFOEJMFQBTLBOEBSJIFNPHMPCJO*OJBEBMBIEBTBS
Pengangkutan Oksigen Selama Kerja Berat 4FMBNB LFSKB
VOUVL IBNQJS TFMVSVI QFOHBOHLVUBO PLTJHFO EBSJ QBSV LF
CFSBU TFMTFMPUPUNFNBLBJPLTJHFOEFOHBOTBOHBUDFQBU ZBOH
KBSJOHBO
QBEB LFBEBBO FLTUSFN EBQBU NFOZFCBCLBO 1P DBJSBO
JOUFSTUJTJBMPUPUUVSVOEBSJOJMBJOPSNBMNN)HNFOKBEJ
Kurva Disosiasi Oksigen-Hemoglobin (BNCBS NN )H 1BEB UFLBOBO ZBOH SFOEBI JOJ IBOZB NM PLTJHFO
NFMVLJTLBO LVSWB EJTPTJBTJ PLTJHFOIFNPHMPCJO ZBOH
ZBOH UFUBQ CFSJLBUBO EFOHBO IFNPHMPCJO EBMBN TFUJBQ NM
NFNQFSMJIBULBO QFOJOHLBUBO QSPHSFTJG QBEB QFSTFOUBTF
EBSBI TFQFSUJ ZBOH EJQFSMJIBULBO QBEB (BNCBS %FOHBO
IFNPHMPCJO ZBOH UFSJLBU EFOHBO PLTJHFO LFUJLB 1P
EFNJLJBO o BUBV NM NFSVQBLBO KVNMBI PLTJHFO
NFOJOHLBU ZBOH EJTFCVU QFSTFOUBTF TBUVSBTJ IFNPHMPCJO
TFCFOBSOZBZBOHEJBOHLVULFKBSJOHBOPMFITFUJBQNMBMJSBO
,BSFOB EBSBI ZBOH NFOJOHHBMLBO QBSV EBO NFNBTVLJ BSUFSJ
EBSBI %FOHBO EFNJLJBO KVNMBI PLTJHFO ZBOH EJUSBOTQPS
TJTUFNJL CJBTBOZB NFNQVOZBJ 1P LJSBLJSB NN )H LJUB
EBMBN TFUJBQ WPMVNF EBSBI ZBOH NFOHBMJS NFMBMVJ KBSJOHBO
EBQBU MJIBU EBSJ LVSWB EJTPTJBTJ CBIXB TBUVSBTJ PLTJHFO QBEB
NFOKBEJ UJHB LBMJ KVNMBI OPSNBM 1FSMV EJJOHBU CBIXB DVSBI
EBSBI BSUFSJ TJTUFNJL OPSNBMOZB LJSBLJSB QFSTFO
KBOUVOHEBQBUNFOJOHLBUFOBNTBNQBJUVKVILBMJOPSNBMQBEB
4FCBMJLOZB QBEB LFBEBBO OPSNBM 1P EBSBI WFOB ZBOH
QFMBSJ NBSBUPO ZBOH UFSMBUJI EFOHBO CBJL %FOHBO EFNJLJBO
LFNCBMJEBSJKBSJOHBOQFSJGFSLJSBLJSBNN)HEBOTBUVSBTJ
QFSLBMJBO BOUBSB QFOJOHLBUBO DVSBI KBOUVOH IJOHHB LBMJ
IFNPHMPCJOOZBLJSBLJSBQFSTFO
MJQBU
EFOHBOQFOJOHLBUBOQFOHBOHLVUBOPLTJHFOEBMBNTFUJBQ
WPMVNF EBSBI LBMJ MJQBU
BLBO NFOHIBTJMLBO QFOJOHLBUBO
Jumlah Maksimum Oksigen yang dapat Bergabung QFOHBOHLVUBO PLTJHFO LF KBSJOHBO TFCBOZBL LBMJ MJQBU ,JUB
dengan Hemoglobin Darah %BSBI PSBOH OPSNBM BLBOMJIBULFNVEJBOEBMBNCBCJOJCBIXBBEBCFCFSBQBGBLUPS
NFOHBOEVOHTFLJUBSHSBNIFNPHMPCJOEBMBNTFUJBQNM MBJO ZBOH NFNVEBILBO QFOHBOHLVUBO PLTJHFO QBEB XBLUV
EBSBI EBO UJBQ HSBN IFNPHMPCJO EBQBU CFSJLBUBO NBLTJNBM LFSKBGJTJL TFIJOHHB1PPUPUTFSJOHLBMJUVSVOTFEJLJUEJCBXBI
EFOHBO NM PLTJHFO NM CJMB IFNPHMPCJO TFDBSB OPSNBMCBILBOTFMBNBLFSKBZBOHTBOHBUCFSBU
LJNJBXJ CFSTJGBU NVSOJ UFUBQJ LFUJEBL NVSOJBO TFQFSUJ
NFUIFNPHMPCJO NFOHVSBOHJ KVNMBI JOJ
0MFI LBSFOB JUV Koefisien Penggunaan 1FSTFOUBTF EBSBI ZBOH NFMFQBTLBO
EJLBMJ TBNBEFOHBO ZBOHCFSBSUJCBIXBSBUBSBUB PLTJHFO TFXBLUV NFMFXBUJ LBQJMFS KBSJOHBO EJTFCVU LPFGJTJFO
HSBN IFNPHMPCJO EBMBN NM EBSBI EBQBU CFSHBCVOH QFOHHVOBBO/JMBJOPSNBMOZBLJSBLJSBQFSTFO TFQFSUJZBOH
EFOHBO KVNMBI UPUBM TFLJUBS NM PLTJHFO CJMB TBUVSBTJ UFMBIEJKFMBTLBOQBEBQFNCBIBTBOTFCFMVNOZBZBJUV QFSTFO
IFNPHMPCJOOZBQFSTFO*OJCJBTBOZBEJOZBUBLBOTFCBHBJ EBSJIFNPHMPCJOZBOHUFSPLTJHFOBTJNFMFQBTLBOPLTJHFOOZBLF
QFSTFO WPMVNF ,VSWB EJTPTJBTJ PLTJHFOIFNPHMPCJO VOUVL KBSJOHBO 4FMBNB LFSKB CFSBU LPFGJTJFO QFOHHVOBBO QBEB
PSBOH OPSNBM EBQBU KVHB EJOZBUBLBO EBMBN CFOUVL WPMVNF TFMVSVI UVCVI EBQBU NFOJOHLBU TBNQBJ QFSTFO 1BEB
QFSTFO PLTJHFO TFQFSUJ ZBOH EJQFSMJIBULBO PMFI TLBMB QBMJOH EBFSBIKBSJOHBOMPLBMZBOHBMJSBOEBSBIOZBTBOHBUMBNCBUBUBV
LBOBO QBEB (BNCBS UJEBL IBOZB EFOHBO QFSTFOUBTF LFDFQBUBO NFUBCPMJTNFOZB TBOHBU UJOHHJ QFSOBI UFSDBUBU
TBUVSBTJIFNPHMPCJO LPFGJTJFO QFOHHVOBBO NFOEFLBUJ QFSTFO BSUJOZB QBEB
498 EBTBSOZB TFNVBPLTJHFOEJMFQBTLBOLFKBSJOHBO
%BQBUUFSMJIBUEBSJLVSWBEJTPTJBTJPLTJHFOIFNPHMPCJOQBEB
(BNCBS CBIXB CJMB 1P BMWFPMVT EJUVSVOLBO TBNQBJ
NN )H TBUVSBTJ PLTJHFO IFNPHMPCJO BSUFSJ NBTJI
QFSTFOIBOZB QFSTFO EJ CBXBI TBUVSBTJ OPSNBM TFCFTBS
UNIT VII
QFSTFO4FMBOKVUOZB KBSJOHBONBTJINFOHBNCJMLJSBLJSBNM
PLTJHFO EBSJ TFUJBQ NM EBSBI ZBOH NFOHBMJS NFMBMVJ
KBSJOHBO UFSTFCVU VOUVL NFOHFMVBSLBO PLTJHFO 1P EBSBI
WFOBUVSVONFOKBEJNN)HIBOZBNN)HEJCBXBIOJMBJ
OPSNBM TFCFTBS NN )H %FOHBO EFNJLJBO 1P KBSJOHBO
IBNQJS UBL CFSVCBI XBMBVQVO 1P BMWFPMVT TFDBSB OZBUB
NFOVSVOEBSJNFOKBEJNN)H
4FCBMJLOZB CJMB1PBMWFPMVTNFOJOHLBUTBNQBJNN)H
TBUVSBTJ PLTJHFO NBLTJNVN EBSJ IFNPHMPCJO UJEBL QFSOBI
EBQBU NFOJOHLBU EJ BUBT QFSTFO ZBOH IBOZB QFSTFO EJ
BUBT OJMBJ OPSNBM ZBJUV QFSTFO )BOZB TFKVNMBI LFDJM
Efek Hemoglobin untuk "Mendapar" Po2 PLTJHFO UBNCBIBO ZBOH UFSMBSVU EBMBN DBJSBO EBSBI TFQFSUJ
+BSJOHBO .FTLJQVO IFNPHMPCJO EJQFSMVLBO VOUVL ZBOHBLBOEJCBIBTLFNVEJBO-BMV CJMBEBSBINFOHBMJSNFMBMVJ
QFOHBOHLVUBO PLTJHFO LF KBSJOHBO IFNPHMPCJO NFNQVOZBJ LBQJMFSKBSJOHBOEBONFMFQBTLBOCFCFSBQBNJMJMJUFSPLTJHFOLF
GVOHTJVUBNBMBJOOZBVOUVLLFIJEVQBO'VOHTJJOJBEBMBIGVOHTJ KBSJOHBO IBM JOJ BLBO NFOHVSBOHJ 1P EBSBI LBQJMFS LF TVBUV
IFNPHMPCJO TFCBHBJ TJTUFN EBQBS PLTJHFO KBSJOHBO OJMBJ ZBOH IBOZB CFCFSBQB NJMJMJUFS MFCJI CFTBS EBSJ OJMBJ
.BLTVEOZB IFNPHMPCJO EBMBN EBSBI CFSUBOHHVOH KBXBC OPSNBM NN )H "LJCBUOZB PLTJHFO BMWFPMVT NFOKBEJ
UFSVUBNB VOUVL TUBCJMJTBTJ UFLBOBO PLTJHFO EBMBN KBSJOHBO TBOHBU CFSWBSJBTJ EBSJ IJOHHB MFCJI EBSJ NN )HEBO
'VOHTJJOJEBQBUEJKFMBTLBOTFCBHBJCFSJLVU CFTBSOZB1PEBMBNKBSJOHBOQFSJGFSUFUBQTBKBIBOZBCFCFSBQB
NJMJMJUFSEBSJOJMBJOPSNBM ZBOHNFOHHBNCBSLBOGVOHTJEBQBS
Peran Hemoglobin dalam Mempertahankan Po2 yang PLTJHFO KBSJOHBO EBSJ TJTUFN IFNPHMPCJO EBSBI ZBOH CBJL
Hampir Konstan dalam Jaringan 1BEB LFBEBBO CBTBM TFLBMJ
KBSJOHBO NFNCVUVILBO LJSBLJSB NM PLTJHFO EBSJ TFUJBQ
NMEBSBIZBOHNFMBMVJLBQJMFSKBSJOHBO.FSVKVLLFQBEBLVSWB Faktor-Faktor yang Menggeser Kurva Disosiasi Oksigen
EJTPTJBTJPLTJHFOIFNPHMPCJOEBMBN(BNCBS EBQBUEJMJIBU Hemoglobin Manfaatnya untuk Pengangkutan Oksigen
CBIXB VOUVL TFUJBQ NM PLTJHFO ZBOH EJMFQBTLBO PMFI TFUJBQ ,VSWB EJTPTJBTJ PLTJHFOIFNPHMPCJO QBEB (BNCBS EBO
NMBMJSBOEBSBI 1PIBSVTUVSVOLJSBLJSBNN)H0MFI CFSMBLVVOUVLEBSBIOPSNBMEBOCFSTJGBUSBUBSBUB5FUBQJ
LBSFOB JUV 1P KBSJOHBO OPSNBMOZB UJEBL EBQBU NFOJOHLBU EJ CFSCBHBJGBLUPSEBQBUNFOHHFTFSLVSWBEJTPTJBTJQBEBTBUVBSBI
BUBT NN )H LBSFOB TFBOEBJOZB UFSKBEJ EFNJLJBO PLTJHFO BUBV MBJOOZB TFQFSUJ EJMVLJTLBO QBEB (BNCBS (BNCBS
ZBOH EJQFSMVLBO KBSJOHBO UJEBL EBQBU EJMFQBTLBO EBSJ JOJ NFNQFSMJIBULBO CBIXB CJMB EBSBI NFOKBEJ TFEJLJU BTBN
IFNPHMPCJO %FOHBO DBSB JOJ EBMBN LFBEBBO OPSNBM EFOHBO QFOVSVOBO Q) EBSJ OJMBJ OPSNBM NFOKBEJ
IFNPHMPCJO NFOHBUVS CBUBT BUBT UFLBOBO PLTJHFO EBMBN UFSKBEJ QFSHFTFSBO LVSWB EJTPTJBTJ PLTJHFO IFNPHMPCJO
KBSJOHBO ZBJUVTFLJUBSNN)H SBUBSBUB QFSTFO LF LBOBO 4FCBMJLOZB QFOJOHLBUBO Q)
4FCBMJLOZB TFMBNB LFSKB CFSBU TFKVNMBI CFTBS PLTJHFO OPSNBM NFOKBEJ BLBO NFOHHFTFS LVSWB LF LJSJ EFOHBO
TFCBOZBL LBMJ MJQBU EBSJ OPSNBM
IBSVT EJMFQBTLBO EBSJ CFTBSZBOHTBNB
IFNPHMPCJO LF KBSJOHBO 5FUBQJ JOJ EBQBU EJDBQBJ EFOHBO 4FMBJOQFSVCBIBOQ) EJLFOBMQVMBCFCFSBQBGBLUPSMBJOZBOH
QFOVSVOBO 1P KBSJOHBO ZBOH TBOHBU TFEJLJU LBSFOB
NFOZFCBCLBOQFSHFTFSBOLVSWB5JHBGBLUPSEJBOUBSBOZB ZBOH
LFNJSJOHBO LVSWB EJTPTJBTJ ZBOH DVSBN EBO
QFOJOHLBUBO LFUJHBOZB NFOHFTFS LVSWB LF LBOBO JBMBI
QFOJOHLBUBO
BMJSBO EBSBI KBSJOHBO ZBOH EJTFCBCLBO PMFI QFOVSVOBO 1P LPOTFOUSBTJ LBSCPO EJPLTJEB
QFOJOHHJBO TVIV EBSBI EBO
BSUJOZB QFOVSVOBO 1P ZBOH TFEJLJU NFOZFCBCLBO TFKVNMBI
QFOJOHLBUBO EJGPTGPHMJTFSBU %1(
TVBUVTFOZBXBGPTGBU
CFTBS PLTJHFO EJMFQBTLBO EBSJ IFNPHMPCJO 4FMBOKVUOZB EBQBU ZBOH TFDBSB NFUBCPMJL QFOUJOH UFSEBQBU EBMBN EBSBI EFOHBO
EJMJIBU CBIXB IFNPHMPCJO EBMBN EBSBI TFDBSB PUPNBUJT LPOTFOUSBTJ ZBOH CFSVCBIVCBI UFSHBOUVOH QBEB LPOEJTJ
NFMFQBTLBO PLTJHFO LF KBSJOHBO QBEB UFLBOBO ZBOH NFUBCPMJLZBOHCFSCFEB
EJQFSUBIBOLBOEFOHBOBHBLLFUBUBOUBSBEBONN)H
Peningkatan Pengiriman Oksigen ke Jaringan bila
Bila Konsentrasi Oksigen Atmosfer Berubah secara Karbon Dioksida dan lon Hidrogen Menggeser Kurva
Nyata, Efek Dapar Hemoglobin Masih Dapat Disosiasi Oksigen-Hemoglobin-Efek Bohr
Mempertahankan Po2 Jaringan yang Hampir Konstan1P 1FSHFTFSBO LVSWB EJTPTJBTJ PLTJHFOIFNPHMPCJO TFCBHBJ
OPSNBM EBMBN BMWFPMJ LJSBLJSB NN )H UFUBQJ LFUJLB SFTQPOT UFSIBEBQ QFOJOHLBUBO LBSCPO EJPLTJEB EBO JPO
TFTFPSBOHNFOEBLJHVOVOHBUBVOBJLQFTBXBUVEBSB 1PEBQBU IJESPHFO EBMBN EBSBI NFNCFSJ QFOHBSVI QFOUJOH EBMBN
UVSVO EFOHBO NVEBI TBNQBJ LVSBOH EBSJ TFUFOHBI KVNMBI JOJ NFOJOHLBULBO QFMFQBTBO PLTJHFO EBSJ EBSBI EBMBN KBSJOHBO
4FCBMJLOZB CJMB TFTFPSBOH NFNBTVLJ EBFSBI CFSUFLBOBO VEBSB EBONFOJOHLBULBOPLTJHFOBTJEBSBIEBMBNQBSV1FOHBSVIJOJ
UJOHHJ TFQFSUJ EJ MBVU ZBOH EBMBN BUBV EBMBN SVBOH ZBOH EJTFCVUFGFL#PIS EBOEBQBUEJKFMBTLBOTFCBHBJCFSJLVU,FUJLB
CFSUFLBOBO UJOHHJ 1P KBSJOHBO EBQBU NFOJOHLBU LBMJ MJQBU EBSBI NFMBMVJ KBSJOHBO LBSCPO EJPLTJEB CFSEJGVTJ EBSJ TFM
8BMBVQVOEFNJLJBO 1PKBSJOHBOIBOZBCFSVCBITFEJLJU KBSJOHBOLFEBMBNEBSBI1SPTFTJOJNFOBJLLBO1DPEBSBI EBO
499
Unit VII Pernapasan
LFTFSBUTFSBUPUPUMFCJICBOZBLMBHJ4FNVBGBLUPSJOJCFLFSKB
TBNB NFOHHFTFS LVSWB EJTPTJBTJ PLTJHFOIFNPHMPCJO EBSJ
EBSBI LBQJMFS PUPU UFSTFCVU DVLVQ KBVI LF LBOBO 1FSHFTFSBO
LVSWB LF BSBI LBOBO NFNBLTB PLTJHFO EJMFQBTLBO EBSJ
IFNPHMPCJO EBSBI LF PUPU QBEB 1P TFCFTBS NN )H
XBMBVQVO QFSTFO PLTJHFO UFMBI EJLFMVBSLBO EBSJ
IFNPHMPCJO ,FNVEJBO EBMBN QBSV UFSKBEJ QFSHFTFSBO LF BSBI
ZBOH CFSMBXBOBO ZBOH NFNVOHLJOLBO QFOHBNCJMBO TFKVNMBI
PLTJHFOUBNCBIBOEBSJBMWFPMJ
Penggunaan Metabolik Oksigen oleh Sel

Efek Po2 Intrasel terhadap Kecepatan Pemakaian Oksigen
%BMBN TFM IBOZB EJCVUVILBO TFEJLJU UFLBOBO PLTJHFO VOUVL
UFSKBEJOZB SFBLTJ LJNJB JOUSBTFM ZBOH OPSNBM "MBTBOOZB BEBMBI
CBIXBTJTUFNFO[JNQFSOBQBTBOTFM ZBOHBLBOEJCBIBTQBEB#BC
EJTFTVBJLBO TFEFNJLJBO SVQB TFIJOHHB CJMB 1P TFMVMBS MFCJI
EBSJ NN )H LFUFSTFEJBBO PLTJHFO UJEBL MBHJ NFSVQBLBO TVBUV
GBLUPSQFNCBUBTLFDFQBUBOSFBLTJLJNJBUFSTFCVU'BLUPSQFNCBUBT
LFNVEJBONFOJOHLBULBO)$0EBSBI BTBNLBSCPOBU
EBSBI VUBNBOZBKVTUSVBEBMBILPOTFOUSBTJBEFOPTJOEJGPTGBU "%1
EBMBN
EBO LPOTFOUSBTJ JPO IJESPHFO &GFL JOJ NFOHHFTFS LVSWB TFM &GFL JOJ EJMVLJTLBO EBMBN (BNCBS ZBOH
EJTPTJBTJ PLTJHFOIFNPHMPCJO LF LBOBO EBO LF BSBI CBXBI NFNQFSMJIBULBO IVCVOHBO BOUBSB 1P JOUSBTFM EBO LFDFQBUBO
TFQFSUJ ZBOH UFSMJIBU EBMBN (BNCBS ZBOH NFNBLTB QFNBLBJBO PLTJHFO QBEB LPOTFOUSBTJ "%1 ZBOH CFSCFEBCFEB
PLTJHFO UFSMFQBT EBSJ IFNPHMPCJO EBO EFOHBO EFNJLJBO 1FSIBUJLBO CBIXB LBQBO QVO 1P JOUSBTFM EJ BUBT NN )H
NFOJOHLBULBOKVNMBIQFOHJSJNBOPLTJHFOLFKBSJOHBO LFDFQBUBOQFNBLBJBOPLTJHFONFOKBEJLPOTUBOVOUVLLPOTFOUSBTJ
5FSKBEJ FGFL ZBOH CFSMBXBOBO EJ EBMBN QBSV ZBOH "%1 CFSBQB QVO EBMBN TFM 4FCBMJLOZB CJMB LPOTFOUSBTJ "%1
NFOZFCBCLBO LBSCPO EJPLTJEB CFSEJGVTJ EBSJ EBSBI LF EBMBN EJVCBI LFDFQBUBOQFNBLBJBOPLTJHFOCFSVCBITFCBOEJOHEFOHBO
BMWFPMJ &GFL JOJ NFOVSVOLBO 1DP EBSBI EBO NFOVSVOLBO QFSVCBIBOLPOTFOUSBTJ"%1
LPOTFOUSBTJ JPO IJESPHFO NFOHHFTFS LVSWB EJTPTJBTJ PLTJHFO 4FQFSUJ EJKFMBTLBO QBEB #BC CJMB BEFOPTJO USJGPTGBU "51

IFNPHMPCJO LF LJSJ EBO LF BSBI BUBT 0MFI LBSFOB JUV KVNMBI EJHVOBLBO EBMBN TFM VOUVL NFOHIBTJMLBO FOFSHJ "51 EJVCBI
PLTJHFO ZBOH CFSJLBUBO EFOHBO IFNPHMPCJO QBEB 1P BMWFPMVT NFOKBEJ"%11FOJOHLBUBOLPOTFOUSBTJ"%1BLBONFOJOHLBULBO
UFSUFOUV NFOKBEJ TBOHBU NFOJOHLBU TFIJOHHB NFOZFCBCLBO QFNBLBJBO NFUBCPMJL PLTJHFO TBBU "%1 CFSHBCVOH EFOHBO
QFOHJSJNBOPLTJHFOLFKBSJOHBOEBMBNKVNMBIZBOHMFCJICFTBS CFSCBHBJ [BU NBLBOBO TFM NFMFQBTLBO FOFSHJ ZBOH NFOHVCBI
"%1 LFNCBMJ NFOKBEJ "51 1BEB LFBEBBO LFSKB ZBOH OPSNBM
Efek DPG Menyebabkan Pergeseran Kurva Disosiasi LFDFQBUBO QFNBLBJBO PLTJHFO PMFI TFM EJBUVS PMFI LFDFQBUBO
QFOHFMVBSBO FOFSHJ EBMBN TFM UFSTFCVUZBJUV PMFI LFDFQBUBO
Oksigen-Hemoglobin ke Kanan QFNCFOUVLBO"%1EBSJ"51
%1( OPSNBM EBMBN EBSBI NFNQFSUBIBOLBO LVSWB EJTPTJBTJ
Efek Jarak Difusi dari Kapiler ke Sel terhadap
PLTJHFOIFNPHMPCJO TFEJLJU CFSHFTFS LF LBOBO TFUJBQ TBBU
5FUBQJ QBEB LFBEBBO IJQPLTJB ZBOH CFSMBOHTVOH MFCJI EBSJ Pemakaian Oksigen +BSBL EBSJ TFM KBSJOHBO LF LBQJMFS KBSBOH
CFCFSBQB KBN KVNMBI %1( EBMBN EBSBI TBOHBU NFOJOHLBU MFCJI EBSJ HN EBO PLTJHFO EBMBN LFBEBBO OPSNBM EBQBU
TFIJOHHB NFOHHFTFS LVSWB EJTPTJBTJ PLTJHFOIFNPHMPCJO MFCJI CFSEJGVTJEFOHBONVEBIEBSJLBQJMFSLFTFMVOUVLNFNFOVIJ
LF LBOBO *OJ NFOZFCBCLBO PLTJHFO EJLJSJNLBO LF KBSJOHBO TFKVNMBIPLTJHFOZBOHEJQFSMVLBOVOUVLNFUBCPMJTNF5FUBQJ
QBEBUFLBOBOPLTJHFONN)HMFCJICFTBSEBSJQBEBLFBEBBO LBEBOHLBMB TFMUFSMFUBLMFCJIKBVIEBSJLBQJMFS EBOLFDFQBUBO
UBOQB QFOJOHLBUBO %1( JOJ 0MFI LBSFOB JUV QBEB CFCFSBQB EJGVTJPLTJHFOLFTFMJOJTBOHBUSFOEBITFIJOHHB1PJOUSBTFMUVSVO
LFBEBBO IBMJOJEBQBUNFOKBEJTVBUVNFLBOJTNFQFOUJOHVOUVL EJ CBXBI UJUJL LSJUJT ZBOH EJCVUVILBO VOUVL NFNQFSUBIBOLBO
NFOZFTVBJLBO EJSJ UFSIBEBQ IJQPLTJB LIVTVTOZB UFSIBEBQ NFUBCPMJTNF JOUSBTFM ZBOH NBLTJNBM %FOHBO EFNJLJBO QBEB
IJQPLTJBBLJCBUBMJSBOEBSBIKBSJOHBOZBOHLVSBOHCBJL LPOEJTJTFQFSUJJOJ QFNBLBJBOPLTJHFOPMFITFMEJLBUBLBOEJCBUBTJ
PMFI EJGVTJ EBO UJEBL MBHJ EJUFOUVLBO PMFI KVNMBI "%1 ZBOH
EJCFOUVL EBMBN TFM UFSTFCVU 5FUBQJ IBM JOJ IBNQJS UJEBL QFSOBI
Pergeseran Kurva Disosiasi Oksigen-Hemoglobin ke
UFSKBEJLFDVBMJQBEBLFBEBBOQBUPMPHJT
Kanan selama Kerja Fisik
1BEBXBLUVLFSKBGJTJL CFSCBHBJGBLUPSEBQBUNFOHHFTFSLVSWB Efek Aliran Darah terhadap Pemakaian Metabolik Oksigen
EJTPTJBTJ DVLVQ KBVI LF LBOBO TFIJOHHB NFOZFCBCLBO +VNMBI UPUBM PLTJHFO UFSUFOUV ZBOH UFSTFEJB TFUJBQ NFOJU VOUVL
QFOHJSJNBOTFKVNMBIPLTJHFOUBNCBIBOLFTFSBUTFSBUPUPUBLUJG LFQFSMVBO KBSJOHBO UFSUFOUV EJUFOUVLBO PMFI
KVNMBI PLTJHFO
ZBOHTFEBOHCFLFSKB,FNVEJBOPUPUZBOHTFEBOHCFLFSKBBLBO ZBOHEBQBUEJUSBOTQPSLFKBSJOHBOEBMBNTFUJBQNMEBSBIEBO
NFMFQBTLBO TFKVNMBI CFTBS LBSCPO EJPLTJEB LBSCPO EJPLTJEB
LFDFQBUBO BMJSBO EBSBI +JLB LFDFQBUBO BMJSBO EBSBI UVSVO
JOJEBOCFCFSBQBBTBNMBJOOZBZBOHEJMFQBTLBOPMFIPUPU BLBO TBNQBJOPM KVNMBIPLTJHFOZBOHUFSTFEJBKVHBUVSVONFOKBEJOPM
NFOJOHLBULBO LPOTFOUSBTJ JPO IJESPHFO EBMBN EBSBI LBQJMFS %FOHBO EFNJLJBO BEB TBBUTBBU LFUJLB LFDFQBUBO BMJSBO EBSBI
PUPUUFSTFCVU4FMBJOJUV TVIVPUPUTFSJOHLBMJNFOJOHLBUTFCFTBS ZBOH NFMBMVJ KBSJOHBO NFOKBEJ TFEFNJLJBO SFOEBI TFIJOHHB 1P
¡TBNQBJ¡$ ZBOHEBQBUNFOJOHLBULBOQFOHJSJNBOPLTJHFO KBSJOHBOUVSVOEJCBXBIOJMBJLSJUJTNN)HZBOHEJQFSMVLBO
500
IFNPHMPCJO TFIJOHHB NFOVSVOLBO LBQBTJUBT EBSBI TFCBHBJ

QFNCBXB PLTJHFO 4FMBJO JUV LFLVBUBO JLBUBOOZB LJSBLJSB
LBMJ LFLVBUBO PLTJHFO ZBOH EJMVLJTLBO PMFI LVSWB
EJTPTJBTJ LBSCPO NPOPLTJEBIFNPHMPCJO QBEB (BNCBS
UNIT VII
,VSWB JOJ IBNQJS TBNB EFOHBO LVSWB EJTPTJBTJ
PLTJHFOIFNPHMPCJO LFDVBMJ UFLBOBO QBSTJBM LBSCPO
NPOPLTJEB ZBOH UFSMJIBU QBEB BCTJT CFSBEB QBEB UJOHLBU
EBSJLVSWBEJTPTJBTJPLTJHFOIFNPHMPCJOQBEB(BNCBS
0MFI LBSFOB JUV UFLBOBO QBSTJBM LBSCPO NPOPLTJEB
ZBOH IBOZB NN )H EBMBN BMWFPMJ EBSJ PLTJHFO
BMWFPMVT OPSNBM 1P NN )H
NFOZFCBCLBO LBSCPO
NPOPLTJEB TBNBTBNB CFSTBJOH EFOHBO PLTJHFO VOUVL
CFSHBCVOH EFOHBO IFNPHMPCJO EBO NFOZFCBCLBO TFQBSVI
IFNPHMPCJO EBMBN EBSBI CFSJLBUBO EFOHBO LBSCPO
NPOPLTJEB EBSJQBEB EFOHBO PLTJHFO 0MFI LBSFOB JUV
UFLBOBO LBSCPO NPOPLTJEB ZBOH IBOZB NN )H
LPOTFOUSBTJ WPMVNFOZB LVSBOH EBSJ TFQFSTFSJCV EBMBN
VEBSB
EBQBUNFOZFCBCLBOLFNBUJBO
8BMBVQVO LBOEVOHBO PLTJHFO EJ EBMBN EBSBI TBOHBU
CFSLVSBOHQBEBLFBEBBOLFSBDVOBOLBSCPONPOPLTJEB 1P
EBSBI EBQBU UFUBQ OPSNBM )BM JOJ ZBOH NFOZFCBCLBO
QBQBSBO EFOHBO LBSCPO NPOPLTJEB TBOHBU CFSCBIBZB
VOUVL NFUBCPMJTNF JOUSBTFM 1BEB LFBEBBO JOJ LFDFQBUBO LBSFOB EBSBI CFSXBSOB NFSBI UFSBOH EBO UJEBL UFSEBQBU
QFNBLBJBO PLTJHFO PMFI KBSJOHBO EJCBUBTJ PMFI BMJSBO EBSBI UBOEBUBOEB IJQPLTFNJB ZBOH KFMBT TFQFSUJ XBSOB LFCJSV
%BMBN LFBEBBO EJCBUBTJ PMFI EJGVTJ BUBV PMFI BMJSBO EBSBI CJSVBO QBEB VKVOH KBSJ BUBV CJCJS TJBOPTJT
1P KVHB UJEBL
QFNBLBJBO PLTJHFO UJEBL EBQBU CFSMBOHTVOH MBNB LBSFOB TFM NFOVSVO EBO UJEBL BEB NFLBOJTNF VNQBO CBMJL ZBOH
NFOFSJNBPLTJHFOMFCJITFEJLJUEBSJQBEBZBOHEJCVUVILBOVOUVL CJBTBOZB NFSBOHTBOH QFOJOHLBUBO GSFLVFOTJ QFSOBQBTBO
LFMBOHTVOHBOIJEVQOZB TFCBHBJ SFTQPOT UFSIBEBQ LVSBOHOZB PLTJHFO CJBTBOZB
EJUVOKVLLBO EFOHBO 1P ZBOH SFOEBI
,BSFOB PUBL
Transpor Oksigen dalam Bentuk Terlarut NFSVQBLBO TBMBI TBUV PSHBO QFSUBNB ZBOH UFSQFOHBSVI
1BEB LFBEBBO 10 BSUFSJ OPSNBM ZBJUV NN )H BLJCBU LVSBOHOZB PLTJHFO PSBOH ZBOH LFLVSBOHBO PLTJHFO
TFLJUBS NM PLTJHFO EJMBSVULBO EBMBN TFUJBQ NM DBJSBO EBQBUNFOHBMBNJEJTPSJFOUBTJEBONFOKBEJUBLTBEBSLBOEJSJ
EBSBI EBO CJMB 1P EBSBI UVSVO NFOKBEJ NN )H EBMBN TFCFMVNBLIJSOZBPSBOHUFSTFCVUNFOZBEBSJBEBOZBCBIBZB
LBQJMFS KBSJOHBO IBOZB NM PLTJHFO ZBOH UFUBQ UFSMBSVU 1BTJFO ZBOH NFOEFSJUB LFSBDVOBO LBSCPO NPOPLTJEB CFSBU
%FOHBO LBUB MBJO NM PLTJHFO TFDBSB OPSNBM EJBOHLVU EBQBU EJPCBUJ EFOHBO NFNCFSJLBO PLTJHFO NVSOJ LBSFOB
EBMBN LFBEBBO UFSMBSVU LF KBSJOHBO PMFI TFUJBQ NM EBSBI PLTJHFO QBEB UFLBOBO BMWFPMVT ZBOH UJOHHJ EBQBU
+VNMBI JOJ TFCBOEJOH EFOHBO LJSBLJSB NM PLTJHFO ZBOH NFOHHBOUJLBO LBSCPO NPOPLTJEB ZBOH CFSDBNQVS EFOHBO
EJBOHLVU PMFI IFNPHMPCJO TFM EBSBI NFSBI 0MFI LBSFOB JUV IFNPHMPCJOTFDBSBDFQBU
PLTJHFO ZBOH EJBOHLVU LF KBSJOHBO EBMBN CFOUVL UFSMBSVU 1BTJFO EBQBU KVHB EJPCBUJ EFOHBO QFNCFSJBO TFDBSB
OPSNBMOZB CFSKVNMBI TFEJLJU IBOZB LJSBLJSB QFSTFO EBSJ TJNVMUBO LBSCPO EJPLTJEB QFSTFO LBSFOB SBOHTBOHBOOZB
KVNMBI UPUBM CJMB EJCBOEJOHLBO EFOHBO QFSTFO ZBOH LVBUQBEBQVTBUQFSOBQBTBO ZBOHNFOJOHLBULBOWFOUJMBTJ
EJBOHLVUPMFIIFNPHMPCJO
4FMBNBLFSKBCFSBU CJMBQFMFQBTBOPLTJHFOPMFIIFNPHMPCJOLF
KBSJOHBO NFOJOHLBU UJHB LBMJ MJQBU NBLB KVNMBI SFMBUJG ZBOH
EJBOHLVU EBMBN CFOUVL UFSMBSVU UVSVO NFOKBEJ QFSTFO #JMB
TFTFPSBOH NFOHIJSVQ PLTJHFO QBEB 1P BMWFPMVT TBOHBU UJOHHJ
KVNMBI ZBOH EJBOHLVU EBMBN CFOUVL UFSMBSVU EBQBU NFOKBEJ
CFSMFCJIBO TFIJOHHB UFSLBEBOH UFSKBEJ LFMFCJIBO ZBOH TFSJVT
EBMBN KBSJOHBO EBO NFOHBLJCBULBO LFSBDVOBO PLTJHFO *OJ
TFSJOH LBMJ NFOZFCBCLBO LFKBOH PUBL EBO CBILBO LFNBUJBO
TFQFSUJ ZBOH EJCBIBT TFDBSB EFUBJM QBEB #BC EBMBN
IVCVOHBOOZB EFOHBO QFSOBQBTBO PLTJHFO QBEB UFLBOBO UJOHHJ
TFQFSUJQBEBQFOZFMBNMBVUEBMBN
Gabungan Hemoglobin dengan Karbon Monoksida-

Pemindahan Oksigen
,BSCPO NPOPLTJEB CFSHBCVOH EFOHBO NPMFLVM IFNPHMPCJO
QBEB UFNQBU ZBOH TBNB TFQFSUJ PLTJHFO 0MFI LBSFOB JUV
LBSCPO NPOPLTJEB EBQBU NFNJOEBILBO PLTJHFO EBSJ
501
Unit VII Pernapasan
BMWFPMVTEBONFOHVSBOHJLBSCPONPOPLTJEBBMWFPMVT%FOHBO
UFSBQJ PLTJHFO EBO LBSCPO EJPLTJEB TFDBSB JOUFOTJG LBSCPO
NPOPLTJEB EBQBU EJLFMVBSLBO EBSJ EBSBI LBMJ MFCJI DFQBU
EBSJQBEBUBOQBUFSBQJ
Pengangkutan Karbon Dioksida dalam Darah
1FOHBOHLVUBO LBSCPO EJPLTJEB EBMBN EBSBI UJEBLMBI TFTVLBS

QFOHBOHLVUBO PLTJHFO TFCBC XBMBVQVO EBMBN LPOEJTJ ZBOH
TBOHBU BCOPSNBM LBSCPO EJPLTJEB CJBTBOZB EBQBU EJBOHLVU
EBMBN KVNMBI ZBOH MFCJI CFTBS EBSJQBEB PLTJHFO 5FUBQJ
KVNMBI LBSCPO EJPLTJEB EBMBN EBSBI CFSIVCVOHBO FSBU
EFOHBO LFTFJNCBOHBO BTBNCBTB DBJSBO UVCVI TFQFSUJ ZBOH
UFMBI EJCBIBT QBEB #BC 1BEB LFBEBBO JTUJSBIBU ZBOH Plasma
OPSNBM SBUBSBUBNMLBSCPOEJPLTJEBEJBOHLVUEBSJKBSJOHBO
LFQBSVEBMBNTFUJBQNJMJUFSEBSBI
Bentuk-Bentuk Kimia Karbon Dioksida Saat Diangkut LBSCPOBU ZBOH EJCFOUVL EBMBN TFM EBSBI NFSBI )$0
UFSVSBJ
6OUVL NFNVMBJ QSPTFT QFOHBOHLVUBO LBSCPO EJPLTJEB NFOKBEJ JPO IJESPHFO EBO JPO CJLBSCPOBU ) EBO )$0

LBSCPO EJPLTJEB CFSEJGVTJ LFMVBS EBSJ TFM KBSJOHBO EBMBN ,FNVEJBOTFCBHJBOCFTBSJPOCFSTBUVEFOHBOIFNPHMPCJOEBMBN
CFOUVL NPMFLVM LBSCPO EJPLTJEB ZBOH UFSMBSVU 8BLUV TFM EBSBI NFSBI TFCBC QSPUFJO IFNPHMPCJO NFSVQBLBO EBQBS
NFNBTVLJ LBQJMFS KBSJOHBO LBSCPO EJPLTJEB TFHFSB NFNVMBJ BTBNCBTB ZBOH LVBU -BMV CBOZBL JPO )$0 ZBOH CFSEJGVTJ
TFSBOHLBJBOSFBLTJTFDBSBLJNJBEBOGJTJLB ZBOHQFOUJOHVOUVL EBSJ TFM EBSBI NFSBI LF EBMBN QMBTNB TFNFOUBSB JPO LMPSJEB
USBOTQPS LBSCPO EJPLTJEB LFBEBBO JOJ EJMVLJTLBO QBEB CFSEJGVTJLFEBMBNTFMEBSBINFSBIVOUVLNFOHHBOUJLBOOZB)BM
(BNCBS JOJ EBQBU UFSKBEJ LBSFOB BEBOZB QSPUFJO QFNCBXB CJLBSCPOBU
LMPSJEB ZBOH LIVTVT EBMBN NFNCSBO TFM EBSBI NFSBI ZBOH
Pengangkutan Karbon Dioksida dalam Bentuk Terlarut NFOHHFSBLLBOLFEVBJPOJOJCPMBLCBMJLEFOHBODFQBUEBMBNBSBI
4FCBHJBO LFDJM LBSCPO EJPLTJEB EJUSBOTQPS EBMBN CFOUVL ZBOH CFSMBXBOBO %FOHBO EFNJLJBO LBEBS LMPSJEB TFM EBSBI
UFSMBSVU LF QBSV 5FMBI EJKFMBTLBO CBIXB 1DP EBSBI WFOB NFSBI WFOB MFCJI CFTBS EBSJQBEB TFM EBSBI NFSBI EJ BSUFSJ
BEBMBINN)HEBOEBSBIBSUFSJBEBMBINN)H+VNMBI GFOPNFOBJOJEJTFCVUQFSHFTFSBOLMPSJEB
LBSCPOEJPLTJEBUFSMBSVUEBMBNDBJSBOEBSBIQBEBUFLBOBO %J CBXBI QFOHBSVI BOIJESBTF LBSCPOBU HBCVOHBO LBSCPO
NN)HLJSBLJSB NMEM WPMVNFQFSTFO
+VNMBIZBOH EJPLTJEB EFOHBO BJS EBMBN TFM EBSBI NFSBI ZBOH CFSTJGBU
UFSMBSVUQBEBUFLBOBONN)HLJSBLJSB NM BUBVCFSCFEB SFWFSTJCFM NFMJQVUJTFLJUBSQFSTFOEBSJTFMVSVILBSCPOEJPLTJEB
NM 0MFI LBSFOB JUV LJSBLJSB IBOZB NM LBSCPO ZBOHEJBOHLVUEBSJKBSJOHBOLFQBSV%FOHBOEFNJLJBO JOJCFSBSUJ
EJPLTJEBZBOHEJBOHLVUEBMBNCFOUVLLBSCPOEJPLTJEBUFSMBSVU CBIXBQFOHBOHLVUBOLBSCPOEJPLTJEBNFSVQBLBOQFOHBOHLVUBO
PMFITFUJBQNMBMJSBOEBSBI+VNMBIJOJLJSBLJSBQFSTFO ZBOH QBMJOH QFOUJOH #JMB TVBUV JOIJCJUPS BOIJESBTF LBSCPOBU
EBSJTFNVBLBSCPOEJPLTJEBZBOHEJBOHLVUTFDBSBOPSNBM BTFUB[PMBNJE
EJCFSJLBO QBEB TFFLPS CJOBUBOH VOUVL
NFOHIBNCBU LFSKB BOIJESBTF LBSCPOBU EBMBN TFM EBSBI NFSBI
Pengangkutan Karbon Dioksida dalam Bentuk lon QFOHBOHLVUBO LBSCPO EJPLTJEB EBSJ KBSJOHBO NFOKBEJ TBOHBU
TFEJLJUTFIJOHHB1DPKBSJOHBOEBQBUNFOJOHLBUNFODBQBJNN
Bikarbonat
)H EJCBOEJOHLBOEFOHBOLFBEBBOOPSNBMOZBTFCFTBSNN)H
Reaksi Karbon Dioksida dengan Air dalam Sel Darah
Merah-Efek Anhidrase Karbonat ,BSCPO EJPLTJEB ZBOH Pengangkutan Karbon Dioksida dalam Gabungannya dengan
UFSUBSVU EBMBN EBSBI CFSFBLTJ EFOHBO BJS VOUVL NFNCFOUVL Hemoglobin dan Protein Plasma-Karbaminohemoglobin 4FMBJO
BTBN LBSCPOBU 3FBLTJ JOJ UFSKBEJ TBOHBU MBNCBU EBO UJEBL CFSFBLTJ EFOHBO BJS LBSCPO EJPLTJEB KVHB CFSFBLTJ MBOHTVOH
QFOUJOHTFBOEBJOZBUJEBLBEBFO[JNQSPUFJOEJEBMBNTFMEBSBI EFOHBO SBEJLBM BNJOP NPMFLVM IFNPHMPCJO VOUVL NFNCFOUVL
NFSBIZBOHEJTFCVUBOIJESBTFLBSCPOBU ZBOHCFSGVOHTJVOUVL TFOZBXB LBSCBNJOPIFNPHMPCJO $0)HC
(BCVOHBO LBSCPO
NFOHLBUBMJTJT SFBLTJ BOUBSB LJSBLJSB LBMJ MJQBU 0MFI EJPLTJEB EFOHBO IFNPHMPCJO JOJ BEBMBI SFBLTJ SFWFSTJCFM ZBOH
LBSFOB JUV CFSCFEB EFOHBO SFBLTJ EBMBN QMBTNB ZBOH UFSKBEJ EFOHBO JLBUBO MPOHHBS TFIJOHHB LBSCPO EJPLTJEB NVEBI
NFNFSMVLBOXBLUVCFSEFUJLEFUJLBUBVCFSNFOJUNFOJU NBLB EJMFQBTLBO LF EBMBN BMWFPMJ ZBOH NFNJMJLJ 1DP MFCJI SFOEBI
EBMBNTFMEBSBINFSBISFBLTJJOJUFSKBEJTFEFNJLJBODFQBUOZB EBSJQBEBLBQJMFSQBSV
TFIJOHHB NFODBQBJ LFTFJNCBOHBO IBNQJS TFNQVSOB EBMBN 4FKVNMBI LFDJM LBSCPO EJPLTJEB KVHB CFSFBLTJ EFOHBO QSPUFJO
XBLUV TFQFSTFLJBO EFUJL *OJ NFNVOHLJOLBO TFKVNMBI CFTBS QMBTNB EFOHBO DBSB ZBOH TBNB EBMBN LBQJMFS KBSJOHBO 5FUBQJ
LBSCPO EJPLTJEB CFSFBLTJ EFOHBO DBJSBO TFM EBSBI NFSBI SFBLTJ JOJ LVSBOH QFOUJOH VOUVL QFOHBOHLVUBO LBSCPO EJPLTJEB
CBILBO TFCFMVN EBSBI UFSTFCVU NFOJOHHBMLBO LBQJMFS TFCBC KVNMBI QSPUFJO JOJ EBMBN EBSBI IBOZB TFQFSFNQBU EBSJ
KBSJOHBO KVNMBIIFNPHMPCJO
+VNMBI LBSCPO EJPLTJEB ZBOH EBQBU EJCBXB EBSJ KBSJOHBO LF
Disosiasi Asam Karbonat menjadi Bikarbonat dan lon QBSVEBMBNCFOUVLHBCVOHBOLBSCBNJOPEFOHBOIFNPHMPCJOEBO
Hidrogen%BMBNXBLUVTFQFSTFLJBOEFUJLTFMBOKVUOZB BTBN QSPUFJOQMBTNBBEBMBITFLJUBSQFSTFOEBSJKVNMBIUPUBMZBOH
502
EJBOHLVUOPSNBMOZB LJSBLJSB NM LBSCPO EJPLTJEB EBMBN

TFUJBQ NM EBSBI 5FUBQJ LBSFOB SFBLTJ JOJ KBVI MFCJI MBNCBU
EBSJQBEB SFBLTJ LBSCPO EJPLTJEB EFOHBO BJS EJ EBMBN TFM EBSBI
NFSBI NBTJIEJSBHVLBOBQBLBIQBEBLPOEJTJOPSNBMNFLBOJTNF
UNIT VII
LBSCBNJOP JOJ EBQBU NFOHBOHLVU MFCJI EBSJ QFSTFO EBSJ
KVNMBIUPUBMLBSCPOEJPLTJEB
Kurva Disosiasi Karbon Dioksida

,VSWB QBEB (BNCBS ZBOH EJTFCVU LVSWB EJTPTJBTJ LBSCPO
EJPLTJEBNFNQFSMJIBULBOLFUFSHBOUVOHBOLBSCPOEJPLTJEBEBSBI
UPUBM EBMBN TFNVB CFOUVLOZB UFSIBEBQ 1DP 1FSIBUJLBO CBIXB
1DP EBSBI OPSNBM CFSLJTBS BOUBSB CBUBT OJMBJ NN )H EBMBN
EBSBIBSUFSJEBONN)HEBMBNEBSBIWFOB ZBOHNFSVQBLBO
LJTBSBO ZBOH TBOHBU TFNQJU 1FSIBUJLBO KVHB CBIXB LPOTFOUSBTJ
LBSCPO EJPLTJEB OPSNBM EBMBN EBSBI QBEB TFNVB CFOUVLOZB
ZBOH CFSCFEBCFEB LJSBLJSB WPMVNF QFSTFO UFUBQJ IBOZB LVSWB EJTPTJBTJ LBSCPO EJPLTJEB UJEBL CFSHFTFS BLJCBU FGFL
WPMVNF QFSTFO EBSJ JOJ ZBOH NFOHBMBNJ QFSUVLBSBO TFMBNB )BMEBOF NBLBLBOEVOHBOLBSCPOEJPLTJEBEBMBNEBSBIBLBO
QFOHBOHLVUBO OPSNBM LBSCPO EJPLTJEB EBSJ KBSJOHBO LF QBSV UVSVO IBOZB TBNQBJ WPMVNF QFSTFO CFSBSUJ IBOZB UFSKBEJ
"SUJOZB LPOTFOUSBTJ NFOJOHLBU NFOKBEJ TFLJUBS WPMVNF LFIJMBOHBO WPMVNF QFSTFO LBSCPO EJPLTJEB 5FUBQJ
QFSTFOTFXBLUVEBSBINFMBMVJKBSJOHBO EBOUVSVONFOKBEJTFLJUBS QFOJOHLBUBO 1P EBMBN QBSV NFOVSVOLBO LVSWB EJTPTJBTJ
WPMVNFQFSTFOTFXBLUVEBSBINFMFXBUJQBSV LBSCPO EJPLTJEB EBSJ LVSWB BUBT NFOKBEJ LVSWB CBXBI QBEB
HBNCBS TFIJOHHB LBOEVOHBO LBSCPO EJPLTJEB UVSVO NFOKBEJ
Bila Oksigen Berikatan dengan Hemoglobin, Karbon WPMVNF QFSTFO UJUJL #
*OJ NFOHHBNCBSLBO UBNCBIBO
Dioksida Dilepaskan (Efek Haldane) untuk Meningkatkan LFIJMBOHBO LBSCPO EJPLTJEB TFCFTBS EVB WPMVNF QFSTFO
Pengangkutan CO2 %FOHBOEFNJLJBO FGFL)BMEBOFNFOHHBOEBLBOKVNMBILBSCPO
1BEB QFSNVMBBO CBC UFMBI EJUFHBTLBO CBIXB TVBUV QFOJOHLBUBO EJPLTJEB ZBOH EJMFQBTLBO EBSJ EBSBI EBMBN QBSV EBO
LBSCPO EJPLTJEB EBMBN EBSBI BLBO NFOZFCBCLBO PLTJHFO QFOHBNCJMBOLBSCPOEJPLTJEBEBMBNKBSJOHBONFOKBEJEVBLBMJ
EJMFQBTLBO EBSJ IFNPHMPCJO FGFL #PIS
EBO JOJ NFSVQBLBO MJQBU
GBLUPS QFOUJOH EBMBN NFOJOHLBULBO QFOHBOHLVUBO PLTJHFO
4FCBMJLOZB QFOHJLBUBO PLTJHFO EFOHBO IFNPHMPCJO DFOEFSVOH Perubahan Keasaman Darah selama Pengangkutan
NFOHFMVBSLBO LBSCPO EJPLTJEB EBSJ EBSBI 4FTVOHHVIOZB FGFL Karbon Dioksida
JOJ ZBOH EJTFCVU FGFL )BMEBOF TFDBSB LVBOUJUBUJG KBVI MFCJI "TBNLBSCPOBUZBOHUFSCFOUVLCJMBLBSCPOEJPLTJEBNFNBTVLJ
QFOUJOH EBMBN NFOJOHLBULBO QFOHBOHLVUBO LBSCPO EJPLTJEB EBSBI EBMBN KBSJOHBO QFSJGFS NFOVSVOLBO Q) EBSBI /BNVO
EBSJQBEBFGFL#PISEBMBNNFOJOHLBULBOQFOHBOHLVUBOPLTJHFO SFBLTJ BTBN JOJ EFOHBO EBQBS BTBNCBTB EBSBI NFODFHBI
&GFL )BMEBOF EJTFCBCLBO PMFI GBLUB ZBOH TFEFSIBOB CBIXB LPOTFOUSBTJ)NFOJOHLBUUFSMBMVUJOHHJ EBOQ)EBSBIUVSVO
HBCVOHBOPLTJHFOEFOHBOIFNPHMPCJOEBMBNQBSVNFOZFCBCLBO UFSMBMV CBOZBL
#JBTBOZB EBSBI BSUFSJ NFNQVOZBJ Q) TFLJUBS
IFNPHMPCJONFOKBEJBTBNZBOHMFCJILVBU)BMJOJNFOZFCBCLBO EBO LFUJLB EBSBI UFSTFCVU NFOEBQBU LBSCPO EJPLTJEB
QJOEBIOZB LBSCPO EJPLTJEB EBSJ EBSBI EBO NBTVL LF EBMBN EBMBNLBQJMFSKBSJOHBO Q)UVSVONFOKBEJTFLJUBS %FOHBO
BMWFPMJ NFMBMVJ EVB DBSB
4FNBLJO UJOHHJ LFBTBNBO LBUB MBJO UFSKBEJ QFSVCBIBO Q) TFCFTBS VOJU ,FBEBBO
IFNPHMPCJO TFNBLJO CFSLVSBOH LFDFOEFSVOHBOOZB VOUVL TFCBMJLOZB BLBO UFSKBEJ CJMB LBSCPO EJPLTJEB EJMFQBTLBO EBSJ
CFSHBCVOH EFOHBO LBSCPO EJPLTJEB VOUVL NFNCFOUVL EBSBI EBMBN QBSV TFIJOHHB Q) NFOJOHLBU NFODBQBJ OJMBJ
LBSCBNJOP IFNPHMPCJO KBEJ NFNJOEBILBO CBOZBL LBSCPO BSUFSJ TFCFTBS MBHJ 4BBU LFSKB CFSBU BUBV LPOEJTJ BLUJWJUBT
EJPLTJEBEBMBNCFOUVLLBSCBNJOPEBSJEBSBI
.FOJOHLBUOZB NFUBCPMJTNF ZBOH UJOHHJ MBJOOZB BUBV CJMB BMJSBO EBSBI LF
LFBTBNBO IFNPHMPCJO KVHB NFOZFCBCLBO IFNPHMPCJO KBSJOHBONFOKBEJMBNCBU QFOVSVOBOQ)EBMBNEBSBIKBSJOHBO
NFMFQBTLBO TFKVNMBI JPO IJESPHFO EBO JPOJPO JOJ CFSJLBUBO EBO EBMBN KBSJOHBOOZB TFOEJSJ
EBQBU NFODBQBJ TFLJUBS
EFOHBO JPO CJLBSCPOBU VOUVL NFNCFOUVL BTBN LBSCPOBU LBMJ EBSJ OPSNBM TFIJOHHB NFOZFCBCLBO BTJEPTJT KBSJOHBO
LFNVEJBO UFSVSBJ NFOKBEJ BJS EBO LBSCPO EJPLTJEB EBO LBSCPO ZBOHCFSNBLOB
EJPLTJEB EJLFMVBSLBO EBSJ EBSBI NBTVL LF EBMBN BMWFPMJ EBO
BLIJSOZB LFVEBSB Rasio Pertukaran Pernapasan
(BNCBS NFMVLJTLBO TFDBSB LVBOUJUBUJG QFOUJOHOZB FGFL
)BMEBOF UFSIBEBQ QFOHBOHLVUBO LBSCPO EJPLTJEB EBSJ KBSJOHBO 5FMBI EJQFMBKBSJ CBIXB QBEB LFBEBBO OPSNBM QFOHBOHLVUBO
LFQBSV(BNCBSJOJNFNQFSMJIBULBOCBHJBOLFDJMEBSJEVBLVSWB PLTJHFOEBSJQBSVLFKBSJOHBOPMFITFUJBQNMEBSBIBEBMBI
EJTPTJBTJLBSCPOEJPLTJEB
CJMB1PBEBMBINN)H ZBJUV TFLJUBSNM TFEBOHLBOQFOHBOHLVUBOOPSNBMLBSCPOEJPLTJEB
1PEBMBNLBQJMFSEBSBIQBSV EBO
CJMB1PNN)H ZBJUV EBSJ KBSJOHBO LF QBSV LJSBLJSB NM %FOHBO EFNJLJBO QBEB
1PEBMBNLBQJMFSKBSJOHBO5JUJL"NFNQFSMJIBULBOCBIXBQBEB LFBEBBO JTUJSBIBU OPSNBM KVNMBI LBSCPO EJPLTJEB ZBOH
UFLBOBO 1DP OPSNBM TFCFTBS NN )H EBMBN KBSJOHBO EJLFMVBSLBOQBSVLJSBLJSBIBOZBTFCFTBSQFSTFOEBSJKVNMBI
NFOZFCBCLBO WPMVNF QFSTFO LBSCPO EJPLTJEB CFSHBCVOH QFOHBNCJMBOPLTJHFOPMFIQBSV3BTJPBOUBSBLFMVBSBOLBSCPO
EFOHBO EBSBI 1BEB XBLUV NFNBTVLJ QBSV 1DP UVSVO NFOKBEJ EJPLTJEB EFOHBO BNCJMBO PLTJHFO EJTFCVU SBTJP QFSUVLBSBO
NN)H TFEBOHLBO1PNFOJOHLBUNFOKBEJNN)H+JLB QFSOBQBTBO 3
:BJUV
503
Unit VII Pernapasan
Daftar Pustaka
"MCFSU 3 4QJSP 4 +FUU + $PNQSFIFOTJWF 3FTQJSBUPSZ .FEJDJOF
1IJMBEFMQIJB .PTCZ
"NBOO. $BMCFU+"$POWFDUJWFPYZHFOUSBOTQPSUBOEGBUJHVF +
"QQM1IZTJPM
(FFST $ (SPT ( $BSCPO EJPYJEF USBOTQPSU BOE DBSCPOJD
BOIZESBTF JO CMPPE BOE NVTDMF 1IZTJPM 3FW
)PQLJOT 43 -FWJO %- &NBNJ , FU "EWBODFT JO NBHOFUJD
SFTPOBODFJNBHJOHPGMVOHQIZTJPMPHZ +"QQM1IZTJPM

)VHIFT +."TTFTTJOH HBT FYDIBOHF $ISPO 3FTQJS %JT

+FOTFO '# 3FE CMPPE DFMM Q) UIF #PIS FGGFDU BOE PUIFS
PYZHFOBUJPOMJOLFE QIFOPNFOB JO CMPPE BOE $0 USBOTQPSU
"DUB1IZTJPM4DBOE
.BJOB +/ 8FTU +# 5IJO BOE TUSPOH 5IF CJPFOHJOFFSJOH
EJMFNNBJOUIFTUSVDUVSBMBOEGVODUJPOBMEFTJHOPGUIFCMPPEHBT
CBSSJFS 1IZTJPM3FW
R = Kecepatan pengeluaran karbon dioksida 1JJQFS + 1FSGVTJPO EJGGVTJPO BOE UIFJS IFUFSPHFOFJUJFT MJNJUJOH
Kecepatan ambil oksigen
CMPPEUJTTVF0USBOTGFSJONVTDMF "DUB1IZTJPM4DBOE
/JMBJ 3 CFSVCBI QBEB CFSCBHBJ LFBEBBO NFUBCPMJL #JMB
TFTFPSBOHIBOZBNFNBLBJLBSCPIJESBUVOUVLNFUBCPMJTNF 3JDIBSETPO340YZHFOUSBOTQPSUBOEVUJMJ[BUJPOBOJOUFHSBUJPO
UVCVIOZB 3 NFOJOHLBU TBNQBJ 4FCBMJLOZB CJMB PGUIFNVTDMFTZTUFNT "EW1IZTJPM&EVD
TFTFPSBOH TFQFOVIOZB NFNBLBJ MFNBL VOUVL FOFSHJ 4POWFBVY 1 -PCZTIFWB ** 'FSPO 0 FU BU 5SBOTQPSU BOE
NFUBCPMJLOZB NBLB 3 UVSVO NFOKBEJ "MBTBO VOUVL QFSJQIFSBM CJPBDUJWJUJFT PG OJUSPHFO PYJEFT DBSSJFE CZ SFE CMPPE
QFSCFEBBO JOJ BEBMBI CBIXB CJMB PLTJHFO EJNFUBCPMJTNF DFMMIFNPHMPCJOSPMFJOPYZHFOEFMJWFSZ 1IZTJPMPHZ #FUIFTEB

EFOHBO LBSCPIJESBU UFSCFOUVL TBUV NPMFLVM LBSCPO
EJPLTJEB VOUVL TFUJBQ NPMFLVM PLTJHFO ZBOH EJHVOBLBO 5TBJ "( +PIOTPO 1$ *OUBHMJFUUB . 0YZHFO HSBEJFOUT JO UIF
TFEBOHLBO CJMB PLTJHFO CFSFBLTJ EFOHBO MFNBL CBOZBL NJDSPDJSDVMBUJPO 1IZTJPM3FW
PLTJHFO CFSHBCVOH EFOHBO BUPN IJESPHFO EBSJ MFNBL 8FTU+#3FTQJSBUPSZ1IZTJPMPHZ5IF&TTFOUJBMT FE #BMUJNPSF
VOUVLNFNCFOUVLBJS CVLBOOZBLBSCPOEJPLTJEB%FOHBO -JQQJODPUU 8JMMJBNT
LBUBMBJO IBTJMCBHJQFSOBQBTBO SFTQJSBUPSZRVPUJFOU
SFBLTJ
LJNJB EBMBN KBSJOHBO LJSBLJSB CVLBO )BTJM CBHJ
QFSOBQBTBO KBSJOHBO BLBO EJCBIBT EBMBN #BC
1BEB
PSBOHEFOHBOEJFUOPSNBMZBOHNFOHPOTVNTJLBSCPIJESBU
MFNBL EBOQSPUFJOEBMBNKVNMBISBUBSBUB NBLBOJMBJSBUB
SBUBVOUVL3EJBOHHBQTFCFTBS
504
BAB 41
UNIT VII
1FOHBUVSBO1FSOBQBTBO
4JTUFN TBSBG TFDBSB OPSNBM NFOH CBUBOHPUBLEJUSBOTFLTJEJBUBTEBOEJCBXBINFEVMB LFMPNQPL

BUVS LFDFQBUBO WFOUJMBTJ BMWFPMVT OFVSPOJOJNBTJINFOHFMVBSLBOQPUFOTJBMBLTJOFVSPOJOTQJSBTJ
IBNQJS TFTVBJ EFOHBO QFSNJOUBBO TFDBSB CFSVMBOHVMBOH 1FOZFCBC EBTBS QFMFQBTBO ZBOH
UVCVI TFIJOHHB UFLBOBO PLTJHFO CFSVMBOHVMBOHJOJCFMVNEJLFUBIVJ1BEBIFXBOQSJNJUJG UFMBI
1P
EBO UFLBOBO LBSCPO EJPLTJEB EJUFNVLBO KBSJOHBO TBSBG ZBOH BLUJWJUBT TBUV SBOHLBJBO
1DP
EJEBMBNEBSBIBSUFSJIBNQJS OFVSPOOZB NFOHFLTJUBTJ SBOHLBJBO ZBOH LFEVB ZBOH
UJEBLCFSVCBI CBILBOTFMBNBLFSKBGJTJLCFSBUEBOLFCBOZBLBO TFMBOKVUOZB BLBO NFOHIBNCBU SBOHLBJBO QFSUBNB 4FMBOH
TUSFT QFSOBQBTBO MBJOOZB #BC JOJ BLBO NFOHVSBJLBO GVOHTJ CFCFSBQB XBLUV LFNVEJBO NFLBOJTNF JOJ CFSVMBOH LFNCBMJ
TJTUFNTBSBGJOJVOUVLQFOHBUVSBOQFSOBQBTBO UFSVTNFOFSVT TFQBOKBOH IJEVQ IFXBO UFSTFCVU 0MFI LBSFOB
JUV LFCBOZBLBO BIMJ GJTJPMPHJ QFSOBQBTBO QFSDBZB CBIXB
UFSEBQBU CFCFSBQB KBSJOHBO TBSBG TFNBDBN JOJ QBEB NBOVTJB
Pusat Pernapasan ZBOHTFMVSVIOZBUFSMFUBLEJEBMBNNFEVMBLFNVOHLJOBOUJEBL
IBOZBNFMJCBULBOLFMPNQPLQFSOBQBTBOEPSTBMTBKBUFUBQJKVHB
EBFSBI CFSEFLBUBO QBEB NFEVMB ZBOH CFSUBOHHVOH KBXBC
1VTBU QFSOBQBTBO UFSEJSJ BUBT CFCFSBQB LFMPNQPL OFVSPO ZBOH
VOUVLJSBNBEBTBSQFSOBQBTBO
UFSMFUBLCJMBUFSBMEJNFEVMBPCMPOHBUBEBOQPOTQBEBCBUBOHPUBL
TFQFSUJEJMVLJTLBOQBEB(BNCBS%BFSBIJOJEJCBHJNFOKBEJ Sinyal Inspirasi "yang Landai".4JOZBMTBSBGZBOHEJLJSJN
UJHB LFMPNQPL OFVSPO VUBNB
LFMPNQPL QFSOBQBTBO EPSTBM LBO LF PUPU JOTQJSBTJ UFSVUBNB EJBGSBHNB CVLBOMBI TVBUV
UFSMFUBL EJ CBHJBO EPSTBM NFEVMB UFSVUTBNB NFOZFCBCLBO MFUVQBO QPUFOTJBM BLTJ TFLFUJLB .BMBIBO TJOZBM TBSBG JUV
JOTQJSBTJ
LFMPNQPL QFSOBQBTBO WFOUSBM UFSMFUBL EJ WFOUSP CFSBXBM MFNBI EBO NFOJOHLBU QFSMBIBOMBIBO TFDBSB MBOEBJ
MBUFSBM NFEVMB UFSVUBNB NFOZFCBCLBO FLTQJSBTJ EBO
QVTBU TFMBNBLJSBLJSBEFUJLTFMBNBQFSOBQBTBOOPSNBM,FNVEJBO
QOFVNPUBLTJL UFSMFUBL EJ TFCFMBI EPSTBM CBHJBO TVQFSJPS QPOT TFLPOZPOHLPOZPOH CFSBLIJS TFMBNB IBNQJS EFUJL CFSJLVU
UFSVUBNBNFOHBUVSLFDFQBUBOEBOLFEBMBNBOOBQBT OZB ZBOHNFOHBLJCBULBOQFOHIFOUJBOFLTJUBTJQBEBEJBGSBHNB
EBONFNVOHLJOLBOTJGBUMFOUJOHFMBTUJTQBSVEBOEJOEJOHEBEB
VOUVL NFOJNCVMLBO FLTQJSBTJ 4FMBOKVUOZB TJOZBM JOTQJSBTJ
Kelompok Neuron Pernapasan Dorsal Pengendaliannya NVMBJ LFNCBMJ VOUVL TJLMVT ZBOH CFSJLVUOZB EFNJLJBO
pada Inspirasi dan Irama Pernapasan TFUFSVTOZB EFOHBO FLTQJSBTJ EJ BOUBSB TJLMVT +BEJ TJOZBM
,FMPNQPLOFVSPOQFSOBQBTBOEPSTBMNFNFHBOHQFSBOBOQBMJOH JOTQJSBTJ NFSVQBLBO TJOZBM ZBOH MBOEBJ SBNQ TJHOBM

NFOEBTBS EBMBN NFOHFOEBMJLBO QFSOBQBTBO EBO NFOFNQBUJ ,FVOUVOHBO ZBOH OZBUB EBSJ TJOZBM ZBOH MBOEBJ BEBMBI CBIXB
TFCBHJBO CFTBS QBOKBOH NFEVMB 4FCBHJBO CFTBS OFVSPOOZB TJOZBMJOJNFOZFCBCLBOQFOJOHLBUBOWPMVNFQBSVZBOHNBOUBQ
UFSMFUBL EJ EBMBN OVLMFVT USBLUVT TPMJUBSJVT /54
XBMBVQVO TFMBNBJOTQJSBTJ TFIJOHHBLJUBUJEBLNFHBQNFHBQ
OFVSPOOFVSPO UBNCBIBO EJ TVCTUBOTJB SFUJLVMBSJT NFEVMB ZBOH "EB EVB TJGBU JOTQJSBTJ MBOEBJ ZBOH EJBUVS ZBJUV TFCBHBJ
CFSEFLBUBOKVHBNFNFHBOHQFSBOBOQFOUJOHEBMBNNFOHFOEBMJ CFSJLVU
LBO QFSOBQBTBO /54 NFSVQBLBO VKVOH TFOTPSJT EBSJ OFSWVT 1. 1FOHFOEBMJBOLFDFQBUBOQFOJOHLBUBOTJOZBMMBOEBJ TFIJOHHB
WBHVT EBO OFSWVT HMPTPGBSJOHFVT ZBOH NFOUSBOTNJTJLBO TJOZBM TFMBNB QFSOBQBTBO LVBU LFMBOEBJBO JOJ NFOJOHLBU EFOHBO
TFOTPSJTOZB LF EBMBN QVTBU QFSOBQBTBO EBSJ
LFNPSFTFQUPS DFQBU EBO PMFI LBSFOB JUV QBSV EBQBU UFSJTJ EFOHBO DFQBU
QFSJGFS
CBSPSFTFQUPS EBO
CFSCBHBJNBDBNSFTFQUPSEBMBN QVMB
QBSV 2. 1FOHFOEBMJBO UJUJL CBUBT LFUJLB TJOZBM MBOEBJ UJCBUJCB
Pelepasan Sinyal Inspirasi Berirama dari Kelompok CFSBLIJS *OJ BEBMBI DBSB ZBOH CJBTB VOUVL NFOHFOEBMJLBO
Neuron Pernapasan Dorsal. *SBNBEBTBSQFSOBQBTBOUFSVUBNB GSFLVFOTJ QFSOBQBTBO ZBJUV TFNBLJO EJOJ TJOZBM MBOEBJ JOJ
CFSBTBM EBSJ LFMPNQPL OFVSPO QFSOBQBTBO EPSTBM #BILBO CJMB CFSBLIJS TFNBLJO TJOHLBU XBLUV JOTQJSBTJOZB )BM JOJ KVHB
TFNVBTBSBGQFSJGFSZBOHNFNBTVLJNFEVMBUFMBIEJQPUPOHEBO BLBO NFNQFSQFOEFL XBLUV FLTQJSBTJ %FOHBO EFNJLJBO
GSFLVFOTJQFSOBQBTBOEJUJOHLBULBO
505
Unit VII Pernapasan
2. /FVSPO QFSOBQBTBO WFOUSBM UBNQBLOZB UJEBL JLVU CFSQBSUJTJQ

BTJEBMBNNFOFOUVLBOJSBNBEBTBSZBOHNFOHBUVSQFSOBQBTBO
3. #JMB SBOHTBOH QFSOBQBTBO VOUVL NFOJOHLBULBO WFOUJMBTJ QBSV
NFOKBEJ MFCJI CFTBS EBSJ OPSNBM TJOZBM SFTQJSBTJ ZBOH CFSBTBM
EBONFLBOJTNFHFUBSBOEBTBSEJBSFBQFSOBQBTBOEPSTBMBLBO
UFSDVSBI LF OFVSPO QFSOBQBTBO WFOUSBM "LJCBUOZB BSFB
QFSOBQBTBOWFOUSBMUVSVUNFNCBOUVNFOBNCBIQFSBOHTBOHBO
QFSOBQBTBO
4. 3BOHTBOHBO MJTUSJL EBSJCFCFSBQB OFVSPO QBEB LFMPNQPL
WFOUSBM NFOZFCBCLBO JOTQJSBTJ TFEBOHLBO SBOHTBOHBO EBSJ
OFVSPO MBJOOZB NFOZFCBCLBO FLTQJSBTJ 0MFI LBSFOB JUV
OFVSPOOFVSPO JOJ NFOZPLPOH JOTQJSBTJ NBVQVO FLTQJSBTJ
/FVSPOUFSTFCVUUFSVUBNBQFOUJOHEBMBNNFOHIBTJMLBOTJOZBM
FLTQJSBTJ LVBU LF PUPUPUPU BCEPNFO TFMBNB FLTQJSBTJ ZBOH
TBOHBU LVBU %FOHBO EFNJLJBO BSFB JOJ CFLFSKB MFCJI LVSBOH
TFCBHBJTVBUVNFLBOJTNFQFOEPSPOHCJMBEJCVUVILBOWFOUJMBTJ
QBSVZBOHMFCJICFTBS LIVTVTOZBTFMBNBLFSKBGJTJLCFSBU
Pusat Pneumotaksik Membatasi Masa Inspirasi dan
Meningkatkan Frekuensi Pernapasan Pembatasan Inspirasi oleh Sinyal Inflasi Paru-Refleks Inflasi
Hering-Breuer
1VTBU QOFVNPUBLTJL ZBOH UFSMFUBL EJ TFCFMBI EPSTBM EJ EBMBN
OVLMFVTQBSBCSBLJBMJTQPOTCBHJBOBUBT NFOHJSJNLBOTJOZBMLF 4FMBJONFLBOJTNFQFOHBUVSBOQFSOBQBTBOTJTUFNTBSBGQVTBUZBOH
BSFB JOTQJSBTJ &GFL VUBNB QVTBU JOJ BEBMBI NFOHBUVS UJUJL TFMVSVIOZBCFLFSKBEJEBMBNCBUBOHPUBL NBTJIBEBTJOZBMTJOZBM
IFOUJ JOTQJSBTJ MBOEBJ EFOHBO EFNJLJBO NFOHBUVS MBNBOZB TBSBGTFOTPSJTZBOHCFSBTBMEBSJQBSVVOUVLNFNCBOUVNFOHBUVS
GBTF QFOHJTJBO TJLMVT QBSV #JMB TJOZBM QOFVNPUBLTJL DVLVQ QFSOBQBTBO 1BMJOH QFOUJOH BEBMBI ZBOH UFSMFUBL EJ PUPU EJOEJOH
LVBU JOTQJSBTJ EBQBU CFSMBOHTVOH IBOZB TFMBNB EFUJL KBEJ CSPOLVTEBOCSPOLJPMVTTFMVSVIQBSV ZBJUVSFTFQUPSSFHBOH ZBOH
QFOHJTJBO QBSV IBOZB TFEJLJU UFUBQJ CJMB TJOZBM QOFVNPUBLTJL NFOKBMBSLBO TJOZBM NFMBMVJ OFSWVT WBHVT LF LFMPNQPL OFVSPO
MFNBI JOTQJSBTJ EBQBU CFSMBOHTVOH UFSVT TFMBNB EFUJL BUBV QFSOBQBTBO EPSTBM BQBCJMB QBSVQBSV NFOKBEJ TBOHBU UFSFHBOH
MFCJI EFOHBOEFNJLJBOQBSVUFSJTJEFOHBOVEBSBZBOHCBOZBL 4JOZBM JOJ NFNQFOHBSVIJ JOTQJSBTJ IBNQJS TBNB EFOHBO TJOZBM
TFLBMJ EBSJ QVTBU QOFVNPUBLTJL ZBJUV CJMB QBSVQBSV NFOKBEJ TBOHBU
NFOHFNCBOH SFTFQUPSSFHBOHNFOHBLUJGLBOSFTQPOTVNQBOCBMJL
'VOHTJ VUBNB QVTBU QOFVNPUBLTJL BEBMBI NFNCBUBTJ ZBOH NFNBUJLBO JOTQJSBTJ MBOEBJ EBO EFOHBO EFNJLJBO
JOTQJSBTJ )BM JOJ NFOJNCVMLBO FGFL TFLVOEFS CFSVQB QFO NFOHIFOUJLBO JOTQJSBTJ TFMBOKVUOZB *OJ EJTFCVU SFGMFLT JOGMBTJ
JOHLBUBO GSFLVFOTJ QFSOBQBTBO LBSFOB QFNCBUBTBO JOTQJSBTJ )FSJOH#SFVFS 3FGMFLT JOJ KVHB NFOJOHLBULBO GSFLVFOTJ
KVHBNFNQFSQFOEFLFLTQJSBTJEBOTFMVSVIQFSJPEFQFSOBQBTBO QFSOBQBTBO TBNBTFQFSUJTJOZBMEBSJQVTBUQOFVNPUBLTJL
4JOZBMQOFVNPUBLTJLZBOHLVBUEBQBUNFOJOHLBULBOGSFLVFOTJ
QFSOBQBTBO TBNQBJ LBMJ QFS NFOJU TFEBOHLBO TJOZBM 1BEB NBOVTJB SFGMFLT )FSJOH#SFVFS LFNVOHLJOBO UJEBL
QOFVNPUBLTJL ZBOH MFNBI EBQBU NFOVSVOLBO GSFLVFOTJ EJBLUJGLBO TBNQBJ WPMVNF UJEBM NFOJOHLBU MFCJI EBSJ UJHB LBMJ
NFOKBEJIBOZBTBNQBJQFSOBQBTBOQFSNFOJU OPSNBM ȵ - UJBQ CFSOBQBT
0MFI LBSFOB JUV SFGMFLT JOJ
UBNQBLOZB MFCJI NFSVQBLBO NFLBOJTNF QSPUFLUJG VOUVL
Kelompok Neuron Pernapasan Ventral Fungsi pada NFODFHBIJOGMBTJQBSVCFSMFCJIBO EBSJQBEBTFCBHBJVOTVSQFOUJOH
Inspirasi dan Ekspirasi QBEBQFOHFOEBMJBOWFOUJMBTJOPSNBM
,FMPNQPLOFVSPOQFSOBQBTBOWFOUSBM ZBOHUFSEBQBUEJCBHJBO
SPTUSBM EBSJ OVLMFVT BNCJHVT EBO CBHJBO LBVEBM EBSJ OVLMFVT Pengendalian Aktivitas Pusat Pernapasan secara Ke-
SFUSPBNCJHVT UFSMFUBLQBEBUJBQTJTJNFEVMB LJSBLJSBNNEJ seluruhan
TFCFMBI BOUFSJPS EBO MBUFSBM LFMPNQPL OFVSPO QFSOBQBTBO 4BNQBJ EJ TJOJ JOJ LJUB UFMBI NFNCBIBT NFLBOJTNF EBTBS ZBOH
EPSTBM'VOHTJLFMPNQPLOFVSPOJOJCFSCFEBEFOHBOLFMPNQPL NFOZFCBCLBO JOTQJSBTJ EBO FLTQJSBTJ UFUBQJ QFOUJOH KVHB
QFSOBQBTBOEPSTBMEBMBNCFSCBHBJIBMQFOUJOHCFSJLVUJOJ EJLFUBIVJCBHBJNBOBJOUFOTJUBTTJOZBMTJOZBMQFOHBUVSQFSOBQBTBO
1. /FVSPOOFVSPO EBSJ LFMPNQPL QFSOBQBTBO WFOUSBM IBNQJS EJUJOHLBULBO BUBV EJUVSVOLBO VOUVL NFNFOVIJ LFCVUVIBO
TFMVSVIOZBUFUBQJOBLUJGTFMBNBQFSOBQBTBOUFOBOHOPSNBM WFOUJMBTJ UVCVI .JTBMOZB TFMBNB LFSKB GJTJL CFSBU LFDFQBUBO
0MFI LBSFOB JUV QFSOBQBTBO UFOBOH OPSNBM IBOZB UJNCVM QFNBLBJBOPLTJHFOEBOQFNCFOUVLBOLBSCPOEJPLTJEBTFSJOHLBMJ
PMFI TJOZBM JOTQJSBTJ CFSVMBOHVMBOH EBSJ LFMPNQPL QFS NFOJOHLBU TBNQBJ LBMJ OPSNBM TFIJOHHB NFNCVUVILBO
OBQBTBOEPSTBMZBOHUFSVUBNBEJLJSJNLBOLFEJBGSBHNB EBO QFOJOHLBUBO ZBOH TFUBSB QBEB WFOUJMBTJ QBSV 1FNCBIBTBO VUBNB
FLTQJSBTJZBOHNFSVQBLBOIBTJMEBSJTJGBUMFOUJOHFMBTUJTQBSV TFMBOKVUOZBQBEBCBCJOJBEBMBINFOHFOBJQFOHBUVSBOWFOUJMBTJJOJ
EBOSBOHLBUPSBLT TFTVBJEFOHBOLFCVUVIBOUVCVI
506
Bab 41 Pengaturan Pernapasan
Pengendalian Kimiawi pada Pernapasan Eksitasi Neuron Kemosensitif oleh lon Hidrogen Ke-
mungkinan merupakan Rangsangan Primer
5VKVBO BLIJS QFSOBQBTBO BEBMBI VOUVL NFNQFSUBIBOLBO /FVSPOOFVSPO TFOTPSJT QBEB BSFB LFNPTFOTJUJG UFSVUBNB
UNIT VII
LPOTFOUSBTJ PLTJHFO LBSCPO EJPLTJEB EBO JPO IJESPHFO ZBOH EJHJBULBOPMFIJPOIJESPHFOLFOZBUBBOOZB EJZBLJOJCBIXBJPO
TFTVBJ EBMBN KBSJOHBO 6OUVOHOZB BLUJWJUBT QFSOBQBTBO TBOHBU IJESPHFONVOHLJONFSVQBLBOTBUVTBUVOZBSBOHTBOHMBOHTVOH
SFTQPOTJG UFSIBEBQ QFSVCBIBO NBTJOHNBTJOH LPOTFOUSBTJ ZBOHQFOUJOHVOUVLOFVSPOOFVSPOJOJ/BNVO JPOIJESPHFO
UFSTFCVU UJEBLNVEBINFOFNCVTTBXBSEBSBIPUBL#FSEBTBSLBOBMBTBO
UFSTFCVU QFSVCBIBO LPOTFOUSBTJ JPO IJESPHFO EBMBN EBSBI
,FMFCJIBOLBSCPOEJPLTJEBBUBVLFMFCJIBOJPOIJESPHFOEBMBN UFSOZBUB LVSBOH CFSFGFL EBMBN NFSBOHTBOH OFVSPOOFVSPO
EBSBI UFSVUBNB CFLFSKB MBOHTVOH QBEB QVTBU QFSOBQBTBO JUV LFNPTFOTJUJG EJCBOEJOHLBO FGFL QFSVCBIBO LBSCPO EJPLTJEB
TFOEJSJ NFOZFCBCLBO LFLVBUBO TJOZBM NPUPSJL JOTQJSBTJ EBO EBMBN EBSBI XBMBVQVO LBSCPO EJPLTJEB EJEVHB NFSBOHTBOH
FLTQJSBTJLFPUPUPUPUQFSOBQBTBOTBOHBUNFOJOHLBU OFVSPOOFVSPO JOJ TFDBSB TFLVOEFS NFMBMVJ QFSVCBIBO
0LTJHFO TFCBMJLOZB UJEBL NFNQVOZBJ FGFL MBOHTVOH ZBOH LPOTFOUSBTJ JPO IJESPHFO TFQFSUJ ZBOH BLBO EJKFMBTLBO QBEB
CFSNBLOBUFSIBEBQQVTBUQFSOBQBTBOEJPUBLEBMBNQFOHFOEBMJ CBHJBOCFSJLVU
BO QFSOBQBTBO +VTUSV PLTJHFO CFLFSKB IBNQJS TFMVSVIOZB QBEB
LFNPSFTFQUPS QFSJGFS ZBOH UFSMFUBL EJ CBEBOCBEBO LBSPUJT EBO Karbon Dioksida Merangsang Area Kemosensitif
BPSUB EBO LFNVEJBO NFOHJSJNLBO TJOZBM TBSBG ZBOH TFTVBJ LF
8BMBVQVO FGFL QFSBOHTBOHBO MBOHTVOH LBSCPO EJPLTJEB
QVTBUQFSOBQBTBOVOUVLQFOHFOEBMJBOQFSOBQBTBO
UFSIBEBQ OFVSPOOFVSPO BSFB LFNPTFOTJUJG IBOZB LFDJM TBKB
UFUBQJFGFLUJEBLMBOHTVOHLBSCPOEJPLTJEBTBOHBULVBU,BSCPO
Pengendalian Kimiawi secara Langsung pada Aktivitas EJPLTJEB BLBO CFSFBLTJ EFOHBO DBJSBO KBSJOHBO VOUVL
Pusat Pernapasan oleh Karbon Dioksida dan lon Hidrogen NFNCFOUVL BTBN LBSCPOBU ZBOH CFSEJTPTJBTJ NFOKBEJ JPO
Area Kemosensitif pada Pusat Pernapasan. ,JUB UFMBI CJLBSCPOBU EBO JPO IJESPHFO EBO JPO IJESPHFO NFNQVOZBJ
NFNCJDBSBLBO UJHB BSFB VUBNB QVTBU QFSOBQBTBO LFMPNQPL FGFL QFSBOHTBOHBO MBOHTVOH ZBOH LVBU QBEB QFSOBQBTBO
OFVSPO QFSOBQBTBO EPSTBM LFMPNQPL QFSOBQBTBO WFOUSBM EBO 3FBLTJJOJEJMVLJTLBOQBEB(BNCBS
QVTBU QOFVNPUBLTJL %JZBLJOJ CBIXB UJEBL TBUV QVO EBSJ BSFB .FOHBQB LBSCPO EJPLTJEB EBSBI MFCJI LVBU NFSBOHTBOH
BSFB JOJ EJQFOHBSVIJ MBOHTVOH PMFI QFSVCBIBO LPOTFOUSBTJ OFVSPOOFVSPO LFNPTFOTJUJG EBSJQBEB JPO IJESPHFO EBSBI
LBSCPO EJPLTJEB BUBV JPO IJESPHFO EBMBN EBSBI +VTUSV BSFB +BXBCBOOZB BEBMBI CBIXB TBXBS EBSBI PUBL UJEBL UFSMBMV
OFVSPO UBNCBIBO BSFB LFNPTFOTJUJG EJMVLJTLBO QBEB (BNCBS QFSNFBCFMUFSIBEBQJPOIJESPHFO TFEBOHLBOLBSCPOEJPLTJEB
UFSMFUBLCJMBUFSBMIBOZB NMEJCBXBIQFSNVLBBOWFOUSBM NFOFNCVT TBXBS JOJ IBNQJS TFQFSUJ TBXBS JOJ UJEBL BEB
NFEVMB ZBOH EJQFOHBSVIJ "SFB JOJ TBOHBU TFOTJUJG UFSIBEBQ "LJCBUOZB LBQBOQVO1DPEBSBINFOJOHLBU NBLB1DPDBJSBO
QFSVCBIBO1DP BUBVLPOTFOUSBTJJPOIJESPHFOEBMBNEBSBI EBO JOUFSTUJTJBM NFEVMB EBO DBJSBO TFSFCSPTQJOBM KVHB JLVU
LFNVEJBONFSBOHTBOHCBHJBOMBJOQBEBQVTBUQFSOBQBTBO NFOJOHLBU %BMBN LFEVB DBJSBO JOJ LBSCPO EJPLTJEB TFHFSB
CFSFBLTJEFOHBOBJSVOUVLNFNCFOUVLJPOIJESPHFOZBOHCBSV
%FOHBO EFNJLJBO MFCJI CBOZBL JPO IJESPHFO EJMFQBTLBO LF
EBMBN BSFB TFOTPSJT LFNPTFOTJUJG QFSOBQBTBO NFEVMB CJMB
LPOTFOUSBTJ LBSCPO EJPLTJEB EBSBI NFOJOHLBU EBSJQBEB CJMB
LPOTFOUSBTJ JPO IJESPHFO EBSBI NFOJOHLBU 0MFI LBSFOB JUV
QFSVCBIBO LBSCPO EJPLTJEB EBSBI BLBO TBOHBU NFOJOHLBULBO
BLUJWJUBT QVTBU QFSOBQBTBO TVBUV LFOZBUBBO ZBOH BLBO
EJCJDBSBLBOTFDBSBLVBOUJUBUJGOBOUJ
Penurunan Efek Perangsangan Karbon Dioksida Se-telah

Hari Pertama dan Hari Kedua. &LTJUBTJQVTBUQFSOBQBTBOPMFI
LBSCPO EJPLTJEB TBOHBU LVBU QBEB KBNKBN QFSUBNB TFUFMBI
LBSCPO EJPLTJEB EBSBI NFOHBMBNJ QFOJOHLBUBO UFUBQJ
LFNVEJBO SBOHTBOHBOOZB NFOVSVO TFDBSB CFSUBIBQ EBMBN
XBLUV TBNQBJ IBSJ CFSJLVUOZB IJOHHB LVSBOH MFCJI
TFQFSMJNB EBSJ FGFL QFSNVMBBO 1FOVSVOBO JOJ TFCBHJBO
EJTFCBCLBOPMFIQFOZFTVBJBOLFNCBMJLPOTFOUSBTJJPOIJESPHFO
EJ TJSLVMBTJ EBSBI PMFI HJOKBM LFNCBMJ LF LPOTFOUSBTJ OPSNBM
TFUFMBI LBSCPO EJPLTJEB NFOJOHLBULBO LPOTFOUSBTJ IJESPHFO
(JOKBM NFMBLVLBO IBM JOJ EFOHBO DBSB NFOJOHLBULBO CJLBS
CPOBUEBSBIZBOHCFSJLBUBOEFOHBOJPOIJESPHFOEBMBNEBSBI
EBO DBJSBO TFSFCSPTQJOBM HVOB NFOVSVOLBO LPOTFOUSBTJOZB
5FUBQJ ZBOH MFCJI QFOUJOH BEBMBI TFMBNB CFCFSBQB KBN JPO
CJLBSCPOBUKVHBEFOHBOMBNCBUCFSEJGVTJNFMBMVJTBXBSEBSBI
507
Unit VII Pernapasan
DBJSBO TFSFCSPTQJOBM EBO CFSHBCVOH TFDBSB MBOHTVOH EFOHBO ,JUBUFMBINFNQFMBKBSJEBMBN#BCCBIXBTJTUFNEBQBSPLTJ

JPO IJESPHFO ZBOH CFSEFLBUBO EFOHBO OFVSPOOFVSPO QFS HFOIFNPHMPCJONFOHBMJSLBOPLTJHFOEBMBNKVNMBIZBOHIBNQJS
OBQBTBO KBEJ NFOVSVOLBO JPO IJESPHFO LFNCBMJ NFOEFLBUJ OPSNBM LF KBSJOHBO CBILBO LFUJLB 1P QBSV CFSVCBI EBSJ OJMBJ
OJMBJ OPSNBM 0MFI LBSFOB JUV QFSVCBIBO LPOTFOUSBTJ LBSCPO TFSFOEBI NN )H OBJL IJOHHB OJMBJ TFUJOHHJ NN )H
EJPLTJEB EBSBI NFNQVOZBJ FGFL BLVU ZBOH LVBU VOUVL 0MFI LBSFOB JUV LFDVBMJ EBMBN LFBEBBO UFSUFOUV QFOHJSJNBO
NFOHBUVS EPSPOHBO QFSOBQBTBO UFUBQJ IBOZB CFSFGFL LSPOJT PLTJHFO EBMBN KVNMBI ZBOH BEFLVBU EBQBU UFUBQ EJMBLVLBO
MFNBITFUFMBITVBUVBEBQUBTJCFCFSBQBIBSJ NFTLJQVO UFSKBEJ QFSVCBIBO WFOUJMBTJ QBSV EBSJ TFEJLJU MFCJI
SFOEBIEBSJTFQBSVIOPSNBMTBNQBJTFUJOHHJLBMJOPSNBMBUBV
Efek Kuantitatif Pco2 Darah dan Konsentrasi lon Hidro- MFCJI )BM JOJ UJEBL UFSKBEJ QBEB LBSCPO EJPLTJEB LBSFOB 1DP
gen Darah terhadap Ventilasi Alveolus EBSBI EBO KBSJOHBO CFSVCBI TFCBMJLOZB EBSJ LFDFQBUBO WFOUJMBTJ
QBSVKBEJ QSPTFTFWPMVTJIFXBOUFMBINFNCVBULBSCPOEJPLTJEB
(BNCBSNFMVLJTLBOTFDBSBLVBOUJUBUJGQFSLJSBBOFGFL1DP NFOKBEJQFOHFOEBMJQFSOBQBTBOZBOHVUBNB CVLBOPLTJHFO
EBSBI EBO Q) EBSBI TVBUV QFOHVLVSBO MPHBSJUNJL LFCBMJLBO
5FUBQJ VOUVL LPOEJTJLPOEJTJ LIVTVT TFQFSUJ LFUJLB KBSJOHBO
EBSJ LPOTFOUSBTJ JPO IJESPHFO
QBEB WFOUJMBTJ BMWFPMVT
NFOHBMBNJ LFTVMJUBO LBSFOB LVSBOH PLTJHFO NBLB UVCVI
5FSVUBNB QFSIBUJLBO QFOJOHLBUBO WFOUJMBTJ ZBOH TBOHBU OZBUB
NFNJMJLJ NFLBOJTNF LIVTVT VOUVL NFOHBUVS QFSOBQBTBO ZBOH
ZBOHEJTFCBCLBOPMFIQFOJOHLBUBO1DPEBMBNLJTBSBOOPSNBM
UFSMFUBL EJ LFNPSFTFQUPS QFSJGFS ZBJUV EJ MVBS QVTBU QFSOBQBTBO
BOUBSB EBO NN )H )BM JOJ NFNQFSMJIBULBO CBIXB
PUBLNFLBOJTNFJOJNFNCFSJSFTQPOTLFUJLBPLTJHFOEBSBIUVSVO
QFSVCBIBO LBSCPO EJPLTJEB NFNCFSJLBO FGFL ZBOH MVBS CJBTB
NFOKBEJ UFSMBMV SFOEBI UFSVUBNB EJ CBXBI 1P NN )H
QBEB QFOHFOEBMJBO QFSOBQBTBO 4FCBMJLOZB QFSVCBIBO QFS
TFQFSUJZBOHEJKFMBTLBOQBEBQFNCBIBTBOCFSJLVUOZB
OBQBTBO QBEB Q) EBSBI OPSNBM BOUBSB EBO BEBMBI
LVSBOHEBSJTFQFSTFQVMVIOZB
Sistem Kemoreseptor Perifer untuk Mengendalikan
Perubahan Oksigen Memberi Efek Langsung yang Kecil Aktivitas Pernapasan-Peranan Oksigen dalam
pada Pengendalian Pusat Pernapasan Pengendalian Pernapasan
1FSVCBIBO LPOTFOUSBTJ PLTJHFO TFCFUVMOZB UJEBL NFNCFSJLBO 4FMBJO QFOHFOEBMJBO BLUJWJUBT QFSOBQBTBO PMFI QVTBU QFSOBQBTBO
FGFL MBOHTVOH QBEB QVTBU QFSOBQBTBO JUV TFOEJSJ EBMBN JUV TFOEJSJ NBTJI BEB NFLBOJTNF MBJO ZBOH UFSTFEJB VOUVL
NFOHVCBI SBOHTBOH QFSOBQBTBO XBMBVQVO QFSVCBIBO NFOHFOEBMJLBO QFSOBQBTBO .FLBOJTNF JOJ BEBMBI TJTUFN
PLTJHFO NFNJMJLJ FGFL UJEBL MBOHTVOH ZBOH CFLFSKB NFMBMVJ LFNPSFTFQUPS QFSJGFS ZBOH UBNQBL QBEB (BNCBS 3FTFQUPS
LFNPSFTFQUPS QFSJGFS TFQFSUJ ZBOH EJKFMBTLBO QBEB QFN LJNJB TBSBG LIVTVT ZBOH EJTFCVU LFNPSFTFQUPS UFSMFUBL EJ
CBIBTBOCFSJLVUOZB
CFCFSBQBBSFBEJMVBSPUBL3FTFQUPSJOJLIVTVTOZBQFOUJOHVOUVL
NFOEFUFLTJ QFSVCBIBO PLTJHFO EBMBN EBSBI XBMBVQVO SFTFQUPS
JUVKVHBTFEJLJUCFSFTQPOTUFSIBEBQQFSVCBIBOLPOTFOUSBTJLBSCPO
EJPLTJEB EBO JPO IJESPHFO ,FNPSFTFQUPS NFOHJSJNLBO TJOZBM
TBSBG LF QVTBU QFSOBQBTBO EJ PUBL VOUVL NFNCBOUV NFOHBUVS
BLUJWJUBTQFSOBQBTBO
4FCBHJBO CFTBS LFNPSFTFQUPS UFSMFUBL EJ CBEBO LBSPUJT
/BNVO TFKVNMBILFDJMUFSMFUBLKVHBEJCBEBOBPSUB ZBOHEJQFSMJ
pH
508
IBULBOQBEBCBHJBOCBXBI(BNCBSEBOEBMBNKVNMBIZBOH Mekanisme Dasar Perangsangan Kemoreseptor Akibat

TBOHBUTFEJLJUUFSMFUBLEJUFNQBUMBJOZBOHCFSLBJUBOEFOHBOBSUFSJ Kekurangan Oksigen. #FMVNEJLFUBIVJTFDBSBQBTUJCBHBJNBOB
BSUFSJMBJOOZBEBOSFHJPUPSBLTEBOSFHJPBCEPNFOUVCVI 1P ZBOH SFOEBI NFSBOHTBOH VKVOHVKVOH TBSBG EBMBN CBEBO
#BEBOLBSPUJTUFSMFUBLCJMBUFSBMQBEBQFSDBCBOHBOBSUFSJLBSPUJT LBSPUJT EBO CBEBO BPSUB 5FUBQJ CBEBOCBEBO JOJ NFNQVOZBJ
UNIT VII
LPNVOJT4FSBCVUTBSBGBGFSFOOZBCFSKBMBONFMBMVJOFSWVT)FSJOH CBOZBL NBDBN TFM NJSJQ LFMFOKBS ZBOH TBOHBU LBSBLUFSJTUJL
LFOFSWVTHMPTPGBSJOHFVTEBOLFNVEJBOLFBSFBQFSOBQBTBOEPSTBM EJTFCVU TFM HMPNVT ZBOH CFSTJOBQT TFDBSB MBOHTVOH NBVQVO
EJNFEVMB#BEBOBPSUBUFSMFUBLEJTFQBOKBOHBSLVTBPSUBTFSBCVU UJEBL MBOHTVOH EFOHBO VKVOHVKVOH TBSBG #FCFSBQB QFOFMJUJ
TBSBG BGFSFOOZB CFSKBMBO NFMBMVJ OFSWVT WBHVT KVHB LF BSFB NFOEVHB IBIXB TFM HMPNVT JOJ NVOHLJO CFSGVOHTJ TFCBHBJ
QFSOBQBTBOEPSTBMNFEVMB LFNPSFTFQUPS EBO LFNVEJBO NFSBOHTBOH VKVOHVKVOH TBSBG
5JBQ CBEBO LFNPSFTFQUPS JOJ NFOFSJNB TVQMBJ EBSBI LIVTVT 5FUBQJ QFOFMJUJ MBJO NFOEVHB CBIXB VKVOHVKVOH TBSBG JUV
NJMJLOZB TFOEJSJ NFMBMVJ BSUFSJ LFDJM TFDBSB MBOHTVOH EBSJ BSUFSJ TFOEJSJTFDBSBMBOHTVOHTFOTJUJGUFSIBEBQ1PZBOHSFOEBI
CFTBS ZBOH CFSEFLBUBO %BSBI ZBOH NFOHBMJS NFMBMVJ CBEBO Pengaruh Po2 Arteri yang Rendah terhadap
CBEBO JOJ CFSTJGBU FLTUSFN ZBJUV LBMJ CFSBU CBEBOOZB TFOEJSJ Perangsangan Ventilasi Alveolus Ketika
TFUJBQ NFOJU 0MFI LBSFOB JUV QFSTFOUBTF QFNJOEBIBO PLTJHFO
Konsentrasi Karbon Dioksida Arteri dan lon
EBSJ EBSBI ZBOH NFOHBMJS TFCFUVMOZB OPM )BM JOJ CFSBSUJ CBIXB
LFNPSFTFQUPS TFUJBQ TBBU UFSQBKBO EFOHBO EBSBI BSUFSJ CVLBO
Hidrogen Normal
EFOHBOEBSBIWFOB EBO1POZBNFSVQBLBO1PBSUFSJ (BNCBS NFOVOKVLLBO QFOHBSVI 1P BSUFSJ ZBOH SFOEBI
UFSIBEBQ WFOUJMBTJ BMWFPMVT CJMB 1DP EBO LPOTFOUSBTJ JPO
IJESPHFO EJQFSUBIBOLBO UFUBQ LPOTUBO QBEB OJMBJ OPSNBMOZB
Penurunan Oksigen Arteri Merangsang Kemoreseptor. #JMB %FOHBO LBUB MBJO QBEB HBNCBS JOJ IBOZB SBOHTBOH WFOUJMBTJ
LPOTFOUSBTJ PLTJHFO EBSBI BSUFSJ NFOVSVO EJ CBXBI OPSNBM ZBOH EJTFCBCLBO PMFI FGFL PLTJHFO ZBOH SFOEBI QBEB LFNP
LFNPSFTFQUPS NFOKBEJ TBOHBU UFSBOHTBOH )BM JOJ EJUVOKVLLBO SFTFQUPS ZBOH BLUJG (BNCBS NFNQFSMJIBULBO IBNQJS UJEBL
QBEB(BNCBS ZBOHNFNQFSMJIBULBOFGFLCFSCBHBJOJMBJ1P BEBQFOHBSVIBQBQVOQBEBWFOUJMBTJTFQBOKBOH1PBSUFSJMFCJI
BSUFSJ UFSIBEBQ GSFLVFOTJ USBOTNJTJ JNQVMT TBSBG EBSJ CBEBO CFTBSEBSJNN)H5FUBQJQBEBUFLBOBOZBOHMFCJISFOEBI
LBSPUJT 1FSIBUJLBO CBIXB GSFLVFOTJ JNQVMT TFOTJUJG UFSVUBNB EBSJ NN )H WFOUJMBTJ BLBO NFOJOHLBU LJSBLJSB NFOKBEJ
UFSIBEBQQFSVCBIBO1PBSUFSJEBMBNLJTBSBOBOUBSBTBNQBJ EVBLBMJMJQBUCJMB1PBSUFSJUVSVOTBNQBJNN)HEBOEBQBU
NN)H ZBJUVTVBUVLJTBSBOEJNBOBTBUVSBTJIFNPHMPCJOEFOHBO NFOJOHLBU TFCBOZBL MJNB LBMJ MJQBU QBEB 1P ZBOH TBOHBU
PLTJHFONFOVSVOEFOHBODFQBU SFOEBI %BMBN LPOEJTJ TFQFSUJ JOJ 1P BSUFSJ ZBOH SFOEBI
EFOHBOOZBUBNFSBOHTBOHQSPTFTWFOUJMBTJEFOHBOTBOHBULVBU
Peningkatan Konsentrasi Karbon Dioksida dan lon Hidrogen 0MFI LBSFOB FGFL IJQPLTJB QBEB WFOUJMBTJ VOUVL 1P MFCJI
Merangsang Kemoreseptor. 1FOJOHLBUBO LPOTFOUSBTJ LBSCPO CFTBS EBSJ TBNQBJ NN )H IBOZB SJOHBO NBLB SFTQPOT
EJPLTJEB BUBV LPOTFOUSBTJ JPO IJESPHFO KVHB NFOHFLTJUBTJ UFSIBEBQ 1DP EBO JPO IJESPHFO ZBOH UFSVUBNB CFSUBOHHVOH
LFNPSFTFQUPS EBO EFOHBO DBSB JOJ TFDBSB UJEBL MBOHTVOH KBXBC EBMBN NFOHBUVS WFOUJMBTJ QBEB NBOVTJB TFIBU EJ
NFOJOHLBULBO BLUJWJUBT QFSOBQBTBO /BNVO FGFL MBOHTVOH EBSJ LFUJOHHJBOQFSNVLBBOMBVU
LFEVBGBLUPSJOJQBEBQVTBUQFSOBQBTBOOZBTFOEJSJKBVIMFCJILVBU
EBSJQBEB FGFL UJEBL MBOHTVOH ZBOH EJQFSBOUBSBJ LFNPSFTFQUPS
LVSBOH MFCJI UVKVI LBMJ MFCJI LVBU
5FUBQJ UFSEBQBU TBUV
QFSCFEBBOBOUBSBQFOHBSVIQFSJGFSEFOHBOQFOHBSVITFOUSBMEBSJ
LBSCPO EJPLTJEB QFSBOHTBOHBO NFMBMVJ LFNPSFTFQUPS QFSJGFS
UFSKBEJ MJNB LBMJ MFCJI DFQBU EBSJQBEB QFSBOHTBOHBO TFOUSBM KBEJ
NVOHLJO LFNPSFTFQUPS QFSJGFS UFSVUBNB QFOUJOH EBMBN
NFOJOHLBULBOLFDFQBUBOSFTQPOTUFSIBEBQLBSCPOEJPLTJEBQBEB
BXBMLFSKBGJTJL
509
Unit Vll Pernapasan
Bernapas Kronis dengan Oksigen Rendah Merangsang 4FLBSBOH QFSIBUJLBO LVSWB BCVBCV UFSBOH ,VSWB BCVBCV
Pernapasan yang Lebih Dalam Lagi Fenomena Aklima- HFMBQ EJVLVS QBEB Q) EBSBI LVSWB BCVBCV UFSBOH EJVLVS
tisasi QBEB Q) ,JUB TFLBSBOH NFNJMJLJ EVB LFMPNQPL LVSWB ZBOH
1FOEBLJ HVOVOH UFMBI NFOFNVLBO CBIXB CJMB NFSFLB NFXBLJMJFGFLHBCVOHBOEBSJ1DPEBO1PUFSIBEBQWFOUJMBTJQBEB
NFOEBLJ HVOVOH TFDBSB QFSMBIBOMBIBO TFMBNB CFCFSBQB IBSJ EVBOJMBJQ)ZBOHCFSCFEB,FMPNQPLLVSWBMBJOEFOHBOQ)ZBOH
EJCBOEJOHLBO EFOHBO TFMBNB CFCFSBQB KBN NFSFLB BLBO MFCJIUJOHHJEJUFNQBULBOQBEBCBHJBOLBOBO EBOEFOHBOQ)ZBOH
CFSOBQBT MFCJI EBMBN EBO LBSFOB JUV EBQBU CFSUBIBO QBEB MFCJISFOEBIEJTFCFMBILJSJ+BEJ EFOHBONFOHHVOBLBOEJBHSBN
LPOTFOUSBTJPLTJHFOBUNPTGFSZBOHKBVIMFCJISFOEBIEBSJQBEB JOJ TFTFPSBOH EBQBU NFSBNBMLBO OJMBJ WFOUJMBTJ BMWFPMVT QBEB
CJMB NFSFLB NFOEBLJ EFOHBO DFQBU ,FBEBBO JOJ EJTFCVU TFCBHJBOCFTBSLPNCJOBTJEBSJ1DPBMWFPMVT 1PBMWFPMVT EBOQ)
BLMJNBUJTBTJ BSUFSJ
"MBTBOUFSKBEJOZBBLMJNBUJTBTJBEBMBICBIXB EBMBNXBLUV
TBNQBJ IBSJ QVTBU QFSOBQBTBO EJ CBUBOH PUBL LFIJMBOHBO Pengaturan Pernapasan Selama Latihan Fisik
TFLJUBSFNQBUQFSMJNBTFOTJUJWJUBTOZBUFSIBEBQQFSVCBIBO1DP
EBO JPO IJESPHFO 0MFI LBSFOB JUV WFOUJMBTJ QFOHIFNCVTBO 1BEB LFSKB GJTJL CFSBU QFNBLBJBO PLTJHFO EBO QFNCFOUVLBO
CMPXPGG
LBSCPO EJPLTJEB CFSMFCJIBO ZBOH OPSNBMOZB BLBO LBSCPOEJPLTJEBEBQBUNFOJOHLBUTBNQBJLBMJMJQBU5FSOZBUB
NFOHIBNCBU QFOJOHLBUBO QFSOBQBTBO HBHBM UFSKBEJ EBO TFQFSUJ ZBOH EJMVLJTLBO QBEB (BNCBS QBEB TFPSBOH BUMFU
PLTJHFO ZBOH SFOEBI EBQBU NFSBOHTBOH TJTUFN QFSOBQBTBO ZBOH TFIBU WFOUJMBTJ BMWFPMVT CJBTBOZB NFOJOHLBU IBNQJS TBNB
VOUVL NFODBQBJ OJMBJ WFOUJMBTJ BMWFPMVT ZBOH KBVI MFCJI UJOHHJ EFOHBO MBOHLBIMBOHLBI QFOJOHLBUBO UJOHLBU NFUBCPMJTNF
EBSJQBEB EBMBN LPOEJTJ BLVU #FSCFEB EFOHBO QFSTFO PLTJHFO1P 1DP EBOQ)BSUFSJUFUBQIBNQJSNFOEFLBUJOPSNBM
QFOJOHLBUBO WFOUJMBTJ ZBOH NVOHLJO UFSKBEJ TFUFMBI LPOUBL %BMBN VTBIB VOUVL NFOHBOBMJTJT BQB ZBOH NFOZFCBCLBO
UFSIBEBQ PLTJHFO SFOEBI ZBOH BLVU WFOUJMBTJ BMWFPMVT TFSJOH QFOJOHLBUBO WFOUJMBTJ TFMBNB MBUJIBO GJTJL LJUB UFSUBSJL VOUVL
LBMJNFOJOHLBUTBNQBJQFSTFOTFUFMBITBNQBJIBSJ NFOHBOHHBQIBMJOJCFSBTBMEBSJQFOJOHLBUBOLBSCPOEJPLTJEBEBO
EBMBN LFBEBBO PLTJHFO SFOEBI IBM JOJ TBOHBU NFNCBOUV JPO IJESPHFO TFSUB QFOVSVOBO PLTJHFO EBSBI 5FUBQJ IBM JOJ
EBMBNNFOZVQMBJPLTJHFOUBNCBIBOCBHJQFOEBLJHVOVOH NBTJIEJQFSUBOZBLBOLBSFOBQFOHVLVSBO1DP Q) EBO1PBSUFSJ
NFNQFSMJIBULBO CBIXB UJEBL TBUV QVO EBSJ LFUJHB OJMBJ JOJ
Efek Gabungan dari Pco2, pH, dan Po2 terhadap CFSVCBITFDBSBCFSNBLOBTFMBNBMBUJIBOGJTJL TFIJOHHBUJEBLTBUV
Ventilasi Alveolus QVO NFOKBEJ DVLVQ BCOPSNBM VOUVL NFSBOHTBOH QFSOBQBTBO
(BNCBS NFNCFSJLBO HBNCBSBO TJOHLBU NFOHFOBJ DBSB EFNJLJBO LVBUOZB TFQFSUJ ZBOH EJBNBUJ TFMBNB LFSKB GJTJL CFSBU
GBLUPS LJNJB 1P 1DP EBO Q) CFSTBNBTBNB NFNFOHBSVIJ 0MFI LBSFOB JUV NBTBMBI ZBOH IBSVT EJQFSUBOZBLBO BEBMBI "QB
WFOUJMBTJ BMWFPMVT 6OUVL EBQBU NFNBIBNJ EJBHSBN JOJ ZBOH NFOZFCBCLBO HJBUOZB WFOUJMBTJ TFMBNB MBUJIBO GJTJL 1BMJOH
QFSUBNBUBNB QFSIBUJLBO FNQBU LVSWB BCVBCV HFMBQ ,VSWB UJEBL BEB TBUV NBDBN FGFL ZBOH UBNQBL EPNJOBO 0UBL LFUJLB
LVSWB JOJ EJSFLBN QBEB OJMBJ 1P BSUFSJ ZBOH CFSCFEBCFEB NFOHJSJNLBO JNQVMT NPUPSJL LF PUPU ZBOH TFEBOH CFLFSKB
NN)H NN)H NN)H EBONN)H6OUVLTFUJBQ EJZBLJOJ NFOHJSJNLBO JNQVMT LPMBUFSBM LF CBUBOH PUBL QBEB TBBU
LVSWB JOJ 1DP EJVCBI EBSJ OJMBJ SFOEBI LF OJMBJ UJOHHJ +BEJ ZBOH TBNB VOUVL NFOHFLTJUBTJ QVTBU QFSOBQBTBO )BM JOJ BOBMPH
LFMPNQPL LVSWB BCVBCV HFMBQ JOJ NFNQFSMJIBULBO FGFL EFOHBO QFSBOHTBOHBO QVTBU WBTPNPUPS EJ CBUBOH PUBL TFMBNB
HBCVOHBOEBSJ1DP EBO1PBMWFPMVTUFSIBEBQWFOUJMBTJ LFSKB GJTJL ZBOH NFOZFCBCLBO QFOJOHLBUBO UFLBOBO BSUFSJ TFDBSB
CFSTBNBBO
4FTVOHHVIOZB CJMB TFTFPSBOH NVMBJ NFMBLVLBO LFSKB GJTJL
QFOJOHLBUBOWFOUJMBTJUPUBMZBOHDVLVQCFTBSNVMBJUFSKBEJTFHFSB
TFUFMBI LFSKB GJTJL EJNVMBJ TFCFMVN TFNVB CBIBO LJNJBXJ EBSBI
NFNJMJLJXBLUVVOUVLCFSVCBI,FNVOHLJOBOTFCBHJBOCFTBSQF
60 120
110
100 100
80
60
40
20
0
0 1.0 2.0 3.0 4.0
510
OJOHLBUBO QFSOBQBTBO EJTFCBCLBO PMFI TJOZBM OFVSPHFOJL ZBOH

EJLJSJNLBO MBOHTVOH LF EBMBN QVTBU QFSOBQBTBO CBUBOH PUBL
QBEB XBLUV CFSTBNBBO EFOHBO TJOZBM ZBOH NFOVKV PUPUPUPU
UVCVIVOUVLNFOJNCVMLBOLPOUSBLTJPUPU
UNIT VII
Hubungan Timbal Balik antara Faktor Kimiawi dan Faktor
Saraf dalam Mengendalikan Pernapasan Selama Latihan
Fisik. #JMB TFTFPSBOH NFMBLVLBO LFSKB GJTJL LFNVOHLJOBO TJOZBM
TBSBGMBOHTVOHNFSBOHTBOHQVTBUQFSOBQBTBOEBMBNUJOHLBUZBOH
IBNQJS TFTVBJ VOUVL QFOZFEJBBO LFCVUVIBO PLTJHFO UBNCBIBO
ZBOH EJCVUVILBO TFMBNB LFSKB GJTJL EBO NFNCVBOH LBSCPO
EJPLTJEB FLTUSB /BNVO LBEBOHLBEBOH TJOZBM TBSBG QFOHFOEBMJ
QFSOBQBTBO UFSMBMV LVBU BUBV UFSMBMV MFNBI 4FMBOKVUOZB GBLUPS
GBLUPS LJNJB NFNFHBOH QFSBOBO QFOUJOH EBMBN NFMBLVLBO
QFOZFTVBJBO BLIJS QFSOBQBTBO ZBOH EJCVUVILBO VOUVL
NFNQFSUBIBOLBO LPOTFOUSBTJ PLTJHFO LBSCPO EJPLTJEB EBO JPO
IJESPHFO DBJSBO UVCVI TFEFLBU NVOHLJO EFOHBO LPOTFOUSBTJ
OPSNBM
)BMJOJEJMVMETLBOQBEB(BNCBS ZBOHEJQFSMJIBULBOPMFI
LVSWBCBHJBOCBXBI QFSVCBIBOWFOUJMBTJBMWFPMVTTFMBNBQFSJPEF
LFSKBNFOJUEBO PMFILVSWBCBHJBOBUBT ZBJUVQFSVCBIBO1DP
1FSIBUJLBOCBIXBQBEBTBBULFSKBGJTJLEJNVMBJ WFOUJMBTJBMWFPMVT
IBNQJS EFOHBO TFHFSB NFOJOHLBU UBOQB EJEBIVMVJ PMFI
QFOJOHLBUBO 1DP BSUFSJ ,FOZBUBBOOZB QFOJOHLBUBO WFOUJMBTJ
BMWFPMVT JOJ CJBTBOZB DVLVQ CFTBS TFIJOHHB QBEB BXBMOZB
NFOVSVOLBO 1DP BSUFSJ EJ CBXBI OPSNBM TFQFSUJ ZBOH (BNCBS NFOZJNQVMLBO QFOHFOEBMJBO QFSOBQBTBO
EJQFSMJIBULBO EBMBN HBNCBS %VHBBO BMBTBO NFOHBQB WFOUJMBTJ TFMBNBLFSKBGJTJLEBMBNDBSBZBOHMBJOMBHJ ZBOHCFSTJGBUMFCJI
NFOEBIVMVJ QFOJOHLBULBO QFNCFOUVLBO LBSCPO EJPLTJEB EBMBN LVBOUJUBUJG,VSWBZBOHMFCJICBXBIQBEBHBNCBSNFNQFSMJIBU
EBSBI BEBMBI CBIXB PUBL NFOHBEBLBO TVBUV SBOHTBOHBO LBO QFOHBSVI CFSCBHBJ OJMBJ 1DP BSUFSJ UFSIBEBQ WFOUJMBTJ
BOUJTJQBTJ QFSOBQBTBO QBEB QFSNVMBBO MBUJIBO NFOHIBTJMLBO BMWFPMVTCJMBUVCVIEBMBNLFBEBBOJTUJSBIBUBSUJOZB UJEBLEBMBN
WFOUJMBTJ BMWFPMVT FLTUSB NFTLJQVO CFMVN EJCVUVILBO /BNVO LFBEBBO LFSKB ,VSWB ZBOH MFCJI BUBT NFOVOKVLLBO QFSLJSBBO
TFUFMBILJSBLJSBTBNQBJEFUJL KVNMBILBSCPOEJPLTJEBZBOH QFSHFTFSBOLVSWBWFOUJMBTJJOJZBOHEJTFCBCLBOPMFISBOHTBOHBO
EJMFQBTLBOLFEBMBNEBSBIEBSJPUPUBLUJGIBNQJSTFQBEBOEFOHBO OFVSPHFOJL EBSJ QVTBU QFSOBQBTBO ZBOH UJNCVM TFMBNB MBUJIBO
QFOJOHLBUBOLFDFQBUBOWFOUJMBTJ EBO1DPBSUFSJLFNCBMJOPSNBM GJTJL CFSBU 5JUJL ZBOH EJUVOKVLLBO QBEB LFEVB LVSWB UFSTFCVU
CBILBOTFMBNBLFSKBCFSMBOHTVOH TFQFSUJZBOHUFSMJIBUQBEBBLIJS NFNQFSMJIBULBO 1DP BSUFSJ ZBOH NVMBNVMB QBEB LFBEBBO
QFSJPEFMBUJIBONFOJUEBMBNHBNCBS JTUJSBIBU EBO LFNVEJBO QBEB LFBEBBO MBUJIBO GJTJL 1FSIBUJLBO
QBEBLFEVBLFBEBBOJOJ UFSOZBUB1DPCFSBEBQBEBOJMBJOPSNBM
TFCFTBS NN )H %FOHBO LBUB MBJO GBLUPS OFVSPHFOJL
NFOHHFTFS LVSWB LF BSBI BUBT TFLJUBS LBMJ MJQBU TFIJOHHB
WFOUJMBTJ IBNQJS CFSTFTVBJBO EFOHBO LFDFQBUBO QFMFQBTBO
LBSCPO EJPLTJEB EFOHBO EFNJLJBO EBQBU NFNQFSUBIBOLBO
1DP BSUFSJNFOEFLBUJOJMBJOPSNBMOZB,VSWBCBHJBOBUBTQBEB
(BNCBS KVHB NFNQFSMJIBULBO CBIXB KJLB TFMBNB LFSKB
1DPBSUFSJCFSVCBIEBSJOJMBJOPSNBMOZBNN)H NBLBIBM
JOJ BLBO NFNCFSJ FGFL QFSBOHTBOHBO FLTUSB UFSIBEBQ WFOUJMBTJ
QBEB 1DP MFCJI EBSJ NN )H EBO FGFL EFQSFTBO QBEB 1DP
LVSBOHEBSJNN)H
Pengendatian Neurogenik terhadap Ventilasi Selama

Kerja Mungkin Sebagian merupakan Respons yang Di-
pelajari. #BOZBL QFSDPCBBO UFMBI NFOVOKVLLBO CBIXB
LFNBNQVBO PUBL VOUVL NFOHHFTFS LVSWB SFTQPOT WFOUJMBTJ
TFMBNB LFSKB GJTJL TFQFSUJ ZBOH UBNQBL QBEB (BNCBS
TFEJLJUOZB NFSVQBLBO CBHJBO EBSJ SFTQPOT ZBOH EJQFMBKBSJ
"SUJOZB EFOHBO QFSJPEF MBUJIBO ZBOH CFSVMBOHVMBOH PUBL
TFDBSB QSPHSFTJG NFOKBEJ MFCJI NBNQV VOUVL NFOHIBTJMLBO
CFSCBHBJ TJOZBM PUBL ZBOH TFTVBJ ZBOH EJCVUVILBO VOUVL
NFNQFSUBIBOLBO1DPEBSBIQBEBOJMBJOPSNBMOZB
511
Unit Vll Pernapasan
+VHB UFSEBQBU BMBTBO VOUVL NFNQFSDBZBJ CBIXB CBILBO

LPSUFLT TFSFCSBM UFSMJCBU EBMBN QFNCFMBKBSBO JOJ LBSFOB CFS
CBHBJ QFOFMJUJBO EFOHBO NFMBLVLBO IBNCBUBO IBOZB QBEB
LPSUFLT KVHB NFOJNCVMLBO IBNCBUBO UFSIBEBQ SFTQPOT ZBOH
EJQFMBKBSJ
Faktor-Faktor Lain yang Memengaruhi Pernapasan
Pengendalian Volunter dari Pernapasan. 4FKBVI JOJ LJUB UFMBI

NFNCBIBT TJTUFN JOWPMVOUFS VOUVL QFOHFOEBMJBO QFSOBQBTBO
/BNVO LJUBTFNVBUBIVCBIXBVOUVLQFSJPEFXBLUVZBOHTJOHLBU
QFSOBQBTBO EBQBU EJBUVS TFDBSB WPMVOUFS EBO TFTFPSBOH EBQBU
NFMBLVLBO IJQFSWFOUJMBTJ BUBV IJQPWFOUJMBTJ TFEFNJLJBO CFTBSOZB
TFIJOHHB LFLBDBVBO 1DP Q) EBO 1P ZBOH TFSJVT EBMBN EBSBI XBLUV ZBOH CFSTBNBBO NFOJOHLBULBO PLTJHFO EBSBI LFBEBBO JOJ
EBQBUUFSKBEJ NFNFSMVLBOXBLUVCFCFSBQBEFUJLTFCFMVNEBSBIQBSVZBOHCFSVCBI
Efek Reseptor Iritan pada Jalan Napas. &QJUFMUSBLFB CSPOLVT JOJ EBQBU EJBOHLVU LF PUBL EBO NFOHIBNCBU WFOUJMBTJ ZBOH
EBO CSPOLJPMVT EJTVQMBJ EFOHBO VKVOH TBSBG TFOTPSJT EJTFCVU CFSMFCJIBO1BEBTBBUEBSBIQBSVNFODBQBJPUBL PSBOHUFSTFCVUUFMBI
SFTFQUPSJSJUBOQVMNPOBM ZBOHUFSBOHTBOHPMFICFSCBHBJQFSJTUJXB NFOHBMBNJ WFOUJMBTJ ZBOH CFSMFCJIBO TFMBNB CFCFSBQB EFUJL 0MFI
,FBEBBO JOJ NFOZFCBCLBO CBUVL EBO CFSTJO TFQFSUJ ZBOH UFMBI LBSFOB JUV LFUJLB EBSBI BLJCBU WFOUJMBTJ ZBOH CFSMFCJIBO BLIJSOZB
EJCBIBT QBEB #BC )BM UFSTFCVU EBQBU KVHB NFOZFCBCLBO NFODBQBJ QVTBU QFSOBQBTBO EJ PUBL QVTBU JOJ NFOKBEJ TBOHBU
LPOTUSJLTJCSPOLVTTFQFSUJQBEBQFOZBLJUBTNBEBOFNGJTFNB UFSUFLBO ,FNVEJBO NVMBJMBI TJLMVT ZBOH CFSMBXBOBO ZBJUV LBSCPO
Fungsi "Reseptor J" Paru. 4FCBHJBOLFDJMVKVOHTBSBGTFOTPSJT EJPLTJEB NFOJOHLBU EBO PLTJHFO NFOVSVO QBEB BMWFPMJ 4FLBMJ MBHJ
UFMBI EJKFMBTLBO CFSBEB EBMBN EJOEJOH BMWFPMVT EBMBN QPTJTJ IBM JOJ NFNFSMVLBO XBLUV CFCFSBQB EFUJL TFCFMVN PUBL EBQBU
CFSKFKFS KVYUBQPTJUJPO
UFSIBEBQ LBQJMFS QBSV PMFC TFCBC JUV CFSFTQPOT UFSIBEBQ QFSVCBIBO ZBOH CBSV JOJ ,FUJLB PUBL NFNCFSJ
OBNBOZB SFTFQUPS + 3FTFQUPS JOJ UFSBOHTBOH LIVTVTOZB CJMB SFTQPOT NBLB PSBOH BLBO CFSOBQBT LVBU TBUV LBMJ MBHJ EBO TJLMVT
LBQJMFS QBSV NFOKBEJ UFSJTJ QFOVI EFOHBO EBSBI BUBV CJMB UFSKBEJ UFSKBEJCFSVMBOHVMBOH
FEFNB QBSV QBEB LPOEJTJ TFQFSUJ HBHBM KBOUVOH LPOHFTUJG 1FOZFCBC EBTBS QFSOBQBTBO $IFZOF4UPLFT UFSKBEJ QBEB TFNVB
8BMBVQVOGVOHTJSFTFQUPS+UJEBLEJLFUBIVJ SBOHTBOHBOSFTFQUPS+ PSBOH /BNVO EBMBN LPOEJTJ OPSNBM NFLBOJTNF JOJ TBOHBU
UFSTFCVUEBQBUNFOZFCBCLBOTFTFPSBOHNFSBTBTFTBLOBQBT EJSFEBN"SUJOZBDBJSBOEBSBIEBOBSFBQVTBUQFOHBUVSQFSOBQBTBO
Edema Otak Mendepresi Pusat Pernapasan. "LUJWJUBT QVTBU NFNJMJLJ TFKVNMBI CFTBS LBSCPO EJPLTJEB EBO PLTJHFO ZBOH UFSMBSVU
QFSOBQBTBO EBQBU EJUFLBO BUBV CBILBO EJJOBLUJGLBO PMFI FEFNB EBOUFSJLBUTFDBSBLJNJBXJ0MFILBSFOBJUV TFDBSBOPSNBM QBSVQBSV
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PCBU JOJ TBOHBU NFOFLBO QVTBU QFSOBQBTBO TFNFOUBSB EBZB LFOZBUBBOOZB QBEB QBTJFO EFOHBO HBHBM KBOUVOH LSPOJT
BOFTUFTJOZBUFSIBEBQLPSUFLTTFSFCSJMFCJIMFNBI QFSOBQBTBO $IFZOF4UPLFT JOJ UFSLBEBOH EBQBU UFSKBEJ TFDBSB
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0SBOH CFSOBQBT EBMBN VOUVL JOUFSWBM XBLUV ZBOH TJOHLBU EBO VNQBOCBMJLOFHBUJGUFSIBEBQBSFBQFOHFOEBMJQFSOBQBTBO)BMJOJ
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JOUFSWBM CFSJLVUOZB TJLMVT UFSTFCVU UFSKBEJ TFDBSB CFSVMBOHVMBOH PLTJHFO NFOZFCBCLBO KBVI MFCJI CBOZBL QFSVCBIBO UFSIBEBQ
4BUV UJQF QFSOBQBTBO QFSJPEJL ZBJUV QFSOBQBTBO $IFZOF4UPLFT WFOUJMBTJ EBSJQBEB TBBU LFBEBBO OPSNBM 4FCBHBJ DPOUPI CFSCFEB
EJUBOEBJ EFOHBO QFSOBQBTBO ZBOH CFSUBNCBI EBO CFSLVSBOH EFOHBOQFOJOHLBUBOWFOUJMBTJOPSNBMTBNQBJLBMJMJQBULFUJLB
TFDBSBQFSMBIBOMBIBO UFSKBEJLJSBLJSBTFUJBQTBNQBJEFUJL 1DP NFOJOHLBU NN )H NBLB QFOJOHLBUBO NN )H ZBOH
TFQFSUJZBOHEJMVLJTLBOQBEB(BNCBS TBNB EBQBU NFOJOHLBULBO WFOUJMBTJ TBNQBJ LBMJ MJQBU
MekanismeDasarPernapasanCheyne-Stokes. 1FOZFCBC VUBNB ,FDFOEFSVOHBO VNQBO CBMJL PUBL TFMBNB QFSOBQBTBO QFSJPEJL
EBSJ QFSOBQBTBO $IFZOF4UPLFT BEBMBI TFCBHBJ CFSJLVU #JMB TFLBSBOH NFOKBEJ DVLVQ LVBU VOUVL NFOZFCBCLBO QFSOBQBTBO
TFTFPSBOH CFSOBQBT TFDBSB CFSMFCJIBO IJOHHB NFOHIFNCVTLBO $IFZOF4UPLFT UBOQB LFUFSMBNCBUBO FLTUSB BMJSBO EBSBI BOUBSB
LBSCPOEJPLTJEBUFSMBMVCBOZBLEBSJEBSBIQBSVTFNFOUBSBQBEB QBSVQBSVEBOPUBL5JQFQFSOBQBTBO$IFZOF4UPLFTJOJUFSVUBNB
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UFSKBEJ QBEB QBTJFO EFOHBO LFSVTBLBO PUBL ,FSVTBLBO PUBL TFSJOH LBMJ TFNFOUBSB (BOHHVBO ZBOH EBQBU NFOZFCBCLBO QFOHIFOUJBO
NFNBUJLBO SBOHTBOH QFSOBQBTBO TFDBSB LFTFMVSVIBO TFMBNB CFCFSBQB SBOHTBOHBO WFOUJMBTJ TBBU UJEVS BEBMBI LFSVTBLBO QVTBU
EFUJL LFNVEJBO QFOJOHLBUBO LBSCPO EJPLTJEB EBSBI ZBOH TBOHBU IFCBU QFSOBQBTBO EJ TFOUSBM BUBV LFMBJOBO QBEB BQBSBUVT
NFOHFNCBMJLBO SBOHTBOH QFSOBQBTBO UFSTFCVU EFOHBO LFLVBUBO ZBOH OFVSPNVTLVMBS 1BTJFO ZBOH UFSLFOB BQOFB UJEVS TFOUSBM EBQBU
CFTBS 1FSOBQBTBO $IFZOF4UPLFT UJQF JOJ TFSJOH LBMJ NFOJNCVMLBO
UNIT VII
NFOHBMBNJ QFOVSVOBO WFOUJMBTJ LFUJLB UFSCBOHVO NFTLJQVO
LFNBUJBOBLJCBUNBMGVOHTJPUBL NBNQV TFQFOVIOZB CFSOBQBT WPMVOUFS OPSNBM 4FMBNB UJEVS
3FLBNBO ZBOH LIBT EBSJ QFSVCBIBO 1DP EBMBN QBSV EBO QVTBU HBOHHVBO QFSOBQBTBO ZBOH QBTJFO BMBNJ CJBTBOZB NFNCVSVL
QFSOBQBTBO TFMBNB QFSOBQBTBO $IFZOF4UPLFT EJUVOKVLLBO QBEB ZBOH NFOJNCVMLBO FQJTPEF BQOFB MFCJI TFSJOH TFIJOHHB
(BNCBS 1FSIBUJLBO CBIXB 1DP EBSBI QBSV CFSVCBI NFMFCJIJ QFOVSVOBO 1P EBO QFOJOHLBUBO 1DP TBNQBJ UJOHLBU LSJUJT
1DP QBEB OFVSPO QFSOBQBTBO 5FUBQJ EBMBNOZB QFSOBQBTBO TFTVBJ UFSDBQBJ ZBOH BLIJSOZB NFSBOHTBOH QFSOBQBTBO ,FUJEBLTUBCJMBO
EFOHBO 1DP EBMBN PUBL UJEBL EFOHBO 1DP EBMBN EBSBI QBSV UFNQBU QFSOBQBTBO ZBOH TFNFOUBSB JOJ NFOZFCBCLBO UJEVS ZBOH HFMJTBI
WFOUJMBTJUFSKBEJ EBONFNJMJLJHBNCBSBOLMJOJTZBOHTBNBEFOHBOHBNCBSBOLMJOJT
ZBOHEJPCTFSWBTJQBEBBQOFBUJEVSPCTUSVLUJG
Apnea Tidur 1BEBTFCBHJBOCFTBSPSBOH QFOZFCBCBQOFBUJEVSTFOUSBMUJEBL
"QOFB BEBMBI UJEBL BEBOZB QFSOBQBTBO TQPOUBO "QOFB LBEBOH EBQBU EJLFUBIVJ NFTLJQVO LFUJEBLTUBCJMBO SBOHTBOHBO QFSOBQBTBO
UFSKBEJTBBUUJEVSOPSNBM UFUBQJQBEBPSBOHZBOHNFOHBMBNJBQOFBUJEVS EBQBUEJBLJCBULBOEBSJTUSPLFBUBVHBOHHVBOMBJOZBOHNFNCVBU
GSFLVFOTJ EBO EVSBTJOZB TBOHBU NFOJOHLBU EFOHBO FQJTPEF BQOFB ZBOH QVTBU QFSOBQBTBO EJ PUBL LVSBOH SFTQPOTJG UFSIBEBQ FGFL
CFSMBOHTVOHTFMBNBEFUJLBUBVMFCJIMBNBEBOUFSKBEJTBNQBJ QFSBOHTBOHBO LBSCPO EJPLTJEB EBO JPO IJESPHFO 1BTJFO EFOHBO
LBMJ UJBQ NBMBN "QOFB UJEVS EBQBU EJTFCBCLBO PMFI PCTUSVLTJ KBMBO QFOZBLJU JOJ TBOHBU TFOTJUJG CBILBO UFSIBEBQ EPTJT LFDJM PCBU
OBQBT BUBT LIVTVTOZB GBSJOH BUBV PMFI HBOHHVBO SBOHTBOH QFSOBQBTBO QFOFOBOH BUBV OBSLPUJL ZBOH TFMBOKVUOZB NFOHVSBOHJ SFTQPOT
EJTJTUFNTBSBGQVTBU QVTBU QFSOBQBTBO UFSIBEBQ FGFL QFSBOHTBOHBO LBSCPO EJPLTJEB
0CBUPCBUBOZBOHNFSBOHTBOHQVTBUQFSOBQBTBOUFSLBEBOHEBQBU
Apnea Tidur Obstruktif Disebabkan oleh Hambatan Jalan Napas Atas.
NFNCBOUV UFUBQJCJBTBOZBQBEBNBMBNIBSJQFSMVNFOHHVOBLBO
0UPUPUPU GBSJOH TFDBSB OPSNBM NFOKBHB KBMBO OBQBT UFUBQ UFSCVLB ZBOH
WFOUJMBTJEFOHBO$1"1
NFNVOHLJOLBO VEBSB NFOHBMJS LF EBMBN QBSVQBSV TFMBNB JOTQJSBTJ
4FMBNBUJEVS PUPUPUPUJOJCJBTBOZBCFSFMBLTBTJ UFUBQJKBMBOOBQBTUFUBQ
DVLVQ UFSCVLB VOUVL NFOHBMJSLBO VEBSB ZBOH BEFLVBU #FCFSBQB Daftar Pusaka
JOEJWJEVNFNJMJLJTBMVSBOZBOHTFNQJU EBOSFMBLTBTJPUPUPUPUJOJTFMBNB Albert R, Spiro S, Jett J: Comprehensive Respiratory Medicine, Philadelphia,
UJEVSNFOZFCBCLBOGBSJOHUFSUVUVQTFNQVSOBTFIJOHHBVEBSBUJEBLEBQBU 2002, Mosby.
NFOHBMJSLFEBMBNQBSVQBSV Bradley TD, Floras JS: Obstructive sleep apnoea and its cardiovascular
1BEB PSBOH EFOHBO BQOFB UJEVS UJNCVM EFOHLVSBO ZBOH LFSBT EBO consequences, Lancet 373:82, 2009.
Datta A, Tipton M: Respiratory responses to cold water immersion: neural
LFTVMJUBO CFSOBQBT TFHFSB TFUFMBI UFSUJEVS 5FSKBEJ QFSJTUJXB
pathways, interactions, and clinical consequences awake and asleep,
NFOEFOHLVS ZBOHTFSJOHLBMJNFOKBEJMFCJILFSBT EBOLFNVEJBOEJTFMB
EFOHBO TFCVBI QFSJPEF EJBN ZBOH QBOKBOH TFMBNB UFSKBEJ BQOFB UJEBL Dean JB, Ballantyne D, Cardone DL, et al: Role of gap junctions in
CFSOBQBT
1FSJPEF BQOFB JOJ NFOJNCVMLBO QFOVSVOBO 1P EBO CO2chemoreception and respiratory control, Am J Physiol Lung Cell
QFOJOHLBUBO 1DP CFSNBLOB ZBOH TBOHBU NFSBOHTBOH QFSOBQBTBO )BM Mol Physiol 283:L665, 2002.
JOJ LFNVEJBO NFOZFCBCLBOVQBZBZBOHUJCBUJCBVOUVLCFSOBQBT ZBOH Dempsey JA, McKenzie DC, Haverkamp HC, et al: Update in the under-
NFOJNCVMLBO EFOHLVSBO ZBOH LFSBT EBO NFHBQNFHBQ ZBOH EJJLVUJ standing of respiratory limitations to exercise performance in fit, active
EFOHBOEFOHLVSBOEBOFQJTPEFBQOFBCFSVMBOHLBMJ1FSJPEFBQOFBEBO adults, Chest 134:613, 2008.
QFSOBQBTBO ZBOH TVMJU UJNCVM CFSVMBOH LBMJ IJOHHB CFCFSBQB SBUVT LBMJ Eckert DJ, Jordan AS, Merchia P, et al: Central sleep apnea: Pathophysiology
TFQBOKBOH NBMBN ZBOH NFOZFCBCLBO UJEVS ZBOH UFSQVUVTQVUVT EBO and treatment, Chest 131:595, 2007.
HFMJTBI0MFILBSFOBJUV QBTJFOEFOHBOBQOFBUJEVSCJBTBOZBNFOHBMBNJ Forster HV: Plasticity in the control of breathing following sensory dener-
SBTB LBOUVL QBEB TJBOH IBSJ ZBOH CFSMFCJIBO TFSUB HBOHHVBO MBJOOZB vation, J Appl Physiol 94:784, 2003.
Gaultier C, Gallego J: Neural control of breathing: insights from genetic
NFMJQVUJQFOJOHLBUBOBLUJWJUBTTJNQBUJL GSFLVFOTJEFOZVUKBOUVOHZBOH
mouse models, J Appl Physiol 104:1522, 2008.
UJOHHJ IJQFSUFOTJ QVMNPOBM EBO TJTUFNJL EBO SJTJLP ZBOH TBOHBU UJOHHJ
Gray PA: Transcription factors and the genetic organization of brain stem
UFSIBEBQQFOZBLJULBSEJPWBTLVMBS respiratory neurons, J Appl Physiol 104:1513, 2008.
"QOFB UJEVS PCTUSVLUJG QBMJOH TFSJOH UFSKBEJ QBEB PSBOH VTJB MBOKVU Guyenet PG: The 2008 Carl Ludwig Lecture: retrotrapezoid nucleus, CO2
EBO PCFTF LBSFOB UFSEBQBU QFOJOHLBUBO QFOVNQVLBO MFNBL QBEB homeostasis, and breathing automaticity, J Appl Physiol 105:404,
KBSJOHBOMVOBLGBSJOHBUBVQFOFLBOBOQBEBGBSJOHZBOHEJBLJCBULBOPMFI 2008.
NBTTB MFNBL ZBOH CFSMFCJI QBEB MFIFS 1BEB CFCFSBQB JOEJWJEV BQOFB Hilaire G, Pasaro R: Genesis and control of the respiratory rhythm in adult
UJEVS EBQBU EJTFCBCLBO PMFI PCTUSVLTJ OBTBM MJEBI ZBOH TBOHBU CFTBS mammals, News Physiol Sci 18:23, 2003.
UPOTJM ZBOH NFNCFTBS BUBV CFOUVL UFSUFOUV QBMBUVN ZBOH TBOHBU Horner RL, Bradley TD: Update in sleep and control of ventilation 2008,
NFOJOHLBULBO SFTJTUBOTJ BMJSBO VEBSB LF QBSV TFMBNB JOTQJSBTJ Am J Respir Crit Care Med 179:528, 2009.
1FOBUBMBLTBOBBO QBMJOH TFSJOH QBEB BQOFB UJEVS PCTUSVLUJG BEBMBI
Morris KF, Baekey DM, Nuding SC, et al: Neural network plasticity in respi-
ratory control, J Appl Physiol 94:1242, 2003.
QFNCFEBIBO VOUVL NFOHBOHLBU KBSJOHBO MFNBL ZBOH CFSMFCJI EJ
Somers VK, White DP, Amin R, et al: J Am Coll Cardiol 52:686, 2008.
CFMBLBOH UFOHHPSPLBO QSPTFEVSOZB EJTFCVU VWVMPQBMBUPGBSJOHPQMBTUJ

Sharp FR, Bernaudin M: HIF1 and oxygen sensing in the brain, Nat Rev
VOUVL NFOHBOHLBU UPOTJM BUBV BEFOPJE ZBOH NFNCFTBS BUBV VOUVL
Neurosci 5:437, 2004.
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VOUVLNFOHBUBTJKBMBOOBQBT Thach BT: Some aspects of clinical relevance in the maturation of respira-
ZBOHUFSTVNCBUTBBUUJEVS EBO
WFOUJMBTJOBTBMEFOHBOUFLBOBOKBMBO tory control in infants, J Appl Physiol 104:1828, 2008.
OBQBT QPTJUJG UFSVTNFOFSVT DPOUJOVPVT QPTJUJWF BJSXBZ QSFTTVSF West JB: Pulmonary Physiology-The Essentials, Baltimore, 2003, Lippincott
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Williams & Wilkins.
Younes M: Role of respiratory control mechanisms in the pathogenesis of
Apnea Tidur "Sentral" Terjadi bila Rangsangan Saraf Terhadap Otot obstructive sleep disorders, J Appl Physiol 105:1389, 2008.
Pernapasan Terhenti Sementara. 1BEB CFCFSBQB PSBOH EFOHBO BQOFB Young T, Skatrud J, Peppard PE: Risk factors for obstructive sleep apnea in
UJEVS SBOHTBOHBOTJTUFNTBSBGQVTBUUFSIBEBQPUPUPUPUWFOUJMBTJCFSIFOUJ adults, JAMA 291:2013, 2004.
513
BAB 42
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CFSHBOUVOH QBEB QFNBIBNBO EBSBI EFOHBO DBSB TFCBHBJ CFSJLVU #JMB MBSVUBO OBUSJVN
UFOUBOH QSJOTJQQSJOTJQ EBTBS CJLBSCPOBU MFNBI EJQBQBSLBO QBEB HBT LBSCPO EJPLTJEB
GJTJPMPHJ QFSOBQBTBO EBO QFSUVLBSBO NBLB LBSCPO EJPLTJEB BLBO UFSMBSVU EBMBN MBSVUBO IJOHHB
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UFSBQJ ZBOH TFTVBJ CBHJ EJTUSFT QFSOBQBTBO BLVU BUBV HBOHHVBO PLTJHFO BLBO EJTJNQBO QBEB FMFLUSPEB 4FMBOKVUOZB LFDFQBUBO
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%FOHBOEFNJLJBO QFSVCBIBOHBTEBOQ)EBSBIEBQBUEJJLVUJ QBSV CFHJUVQVMBEFOHBOLPMBQTCSPOLJPMVT
QBEBBMJSBOFLTQJSBTJ
IBNQJSTFUJBQTBBUEJTJTJUFNQBUUJEVS NBLTJNVN$BUBUBOLVSWBQBEBCBHJBOJOJNFNQFSMJIBULBOBMJSBO
Pengukuran Aliran Ekspirasi Maksimum FLTQJSBTJ NBLTJNVO QBEB TFNVB OJMBJ WPMVNF QBSV TFUFMBI
TFPSBOH ZBOH TFIBU NVMBNVMB NFOHIJSVQ VEBSB TFCBOZBL
1BEB CBOZBL QFOZBLJU QFSOBQBTBO UFSVUBNB BTNB NVOHLJO EBO LFNVEJBO NFOHFMVBSLBOOZB EFOHBO VQBZB
SFTJTUBOTJ BMJSBO VEBSB NFOKBEJ CFTBS UFSVUBNB TFMBNB FLTQJSBTJ NBLTJNVO TBNQBJ EJB UJEBL EBQBU NFOHFMVBSLBO VEBSB
FLTQJSBTJ TFIJOHHB LBEBOH NFOZFCBCLBO LFTVLBSBO MFCJI CBOZBL MBHJ 1FSIBUJLBO CBIXB PSBOH UFSTFCVU EFOHBO DFQBU
CFSOBQBT ZBOH IFCBU )BM JOJ NFMBIJSLBO TVBUV LPOTFQ NFODBQBJ BMJSBO VEBSB FLTQJSBTJ NBLTJNVN MFCJI EBSJ MJUFS
ZBOH EJTFCVU BMJSBO FLTQJSBTJ NBLTJNVN ZBOH EBQBU NFOJU 5FUBQJ CFSBQBQVO CBOZBLOZB VQBZB FLTQJSBTJ UBNCBIBO
EJEFGJOJTJLBO TFCBHBJ CFSJLVU #JMB TFTFPSBOH NFMBLVLBO ZBOH EJMBLVLBOOZB OJMBJ JOJ UFUBQ NFSVQBLBO LFDFQBUBO BMJSBO
FLTQJSBTJ EFOHBO UFOBHB LVBU NBLB BMJSBO VEBSB FLTQJSBTJ NBLTJNVNZBOHEBQBUEJDBQBJOZB
NFODBQBJ BMJSBO NBLTJNVN LFUJLB BMJSBO UJEBL EBQBU 1FSIBUJLBOKVHBCBIXBLFUJLBWPMVNFQBSVNFOKBEJMFCJILFDJM
EJUJOHLBULBO MBHJ XBMBVQVO EFOHBO QFOJOHLBUBO UFOBHB NBLB LFDFQBUBO BMJSBO FLTQJSBTJ NBLTJNVN KVHB NFOKBEJ
ZBOH CFTBS *OJ BEBMBI BMJSBO FLTQJSBTJ NBLTJNVN CFSLVSBOH "MBTBO VUBNB UFSKBEJOZB LFBEBBO JOJ BEBMBI CBIXB
"MJSBO FLTQJSBTJ NBLTJNVN KBVI MFCJI CFTBS CJMB QBSV EBMBN QBSV ZBOH NFOHFNCBOH CSPOLVT EBO CSPOLJPMVT UFSCVLB
UFSJTJ EFOHBO WPMVNF VEBSB CFTBS EBSJQBEB CJMB QBSV TFCBHJBONFMBMVJUBSJLBOFMBTUJTQBEBCBHJBOMVBSOZBPMFIFMFNFO
IBNQJS LPTPOH 1SJOTJQ JOJ EBQBU EJNFOHFSUJ EFOHBO TUSVLUVSBM QBSV OBNVO LFUJLB QBSV NFOKBEJ MFCJI LFDJM TUSVLUVS
NFNQFSIBUJLBO(BNCBS JOJ NFOHBMBNJ SFMBLTBTJ TFIJOHHB CSPOLVT EBO CSPOLJPMVT MFCJI
(BNCBS " NFMVLJTLBO FGFL QFOJOHLBUBO UFLBOBO QBEB NVEBI LPMBQT PMFI UFLBOBO EBEB FLTUFSOBM KBEJ TFDBSB QSPHSFTJG
CBHJBO MVBS BMWFPMJ EBO TBMVSBO OBQBT ZBOH EJTFCBCLBO PMFI NFOVSVOLBOLFDFQBUBOBMJSBOFLTQJSBTJNBLTJNVNKVHB
LPNQSFTJ SBOHLB EBEB 5BOEB QBOBI NFOVOKVLLBO CBIXB Kelainan Kurva Volume-Aliran Ekspirasi Maksimum.
UFLBOBOZBOHTBNBEJLFOBLBOQBEBLFEVBTJTJMVBSBMWFPMJEBO (BNCBS NFMVLJTLBO LVSWB OPSNBM WPMVNF BMJSBO FLTQJSBTJ
CSPOLJPMVT0MFILBSFOBJUV UFLBOBOJOJUJEBLIBOZBNFNBLTB NBLTJNVN CFSTBNB EFOHBO EVB LVSWB WPMVNF BMJSBO UBNCBIBO
VEBSB EBSJ BMWFPMJ VOUVL NBTVL LF EBMBN CSPOLJPMVT UFUBQJ ZBOHNFODBUBUEVBUJQFQFOZBLJUQBSVQBSVSFTUSJLUJGEBOPCTUSVLTJ
QBEB TBBU CFSTBNBBO KVHB DFOEFSVOH NFNCVBU CSPOLJPMVT QBSTJBMKBMBOOBQBT1FSIBUJLBOCBIXBQBEBQBSVSFTUSJLUJGUFSEBQBU
NFOKBEJ LPMBQT ZBOH BLBO NFMBXBO HFSBLBO VEBSB LFMVBS QFOVSVOBO LBQBTJUBT QBSV UPUBM 5-$
EBO QFOVSVOBO WPMVNF
,FUJLB CSPOLJPMVT IBNQJS LPMBQT TFNQVSOB UFOBHB FLTQJSBTJ SFTJEV 37
4FMBOKVUOZB LBSFOB QBSV UJEBL EBQBU NFOHFNCBOH
MFCJIMBOKVUNBTJIEBQBUNFOJOHLBULBOUFLBOBOBMWFPMVTEBMBN NFODBQBJ WPMVNF NBLTJNVN OPSNBM XBMBVQVO EFOHBO VQBZB
KVNMBI CFTBS UFUBQJ UFLBOBO JOJ KVHB NFOJOHLBULBO EFSBKBU FLTQJSBTJ UFSCFTBS ZBOH NVOHLJO BMJSBO FLTQJSBTJ NBLTJNBM UJEBL
LPMBQT CSPOLJPMVT EBO UBIBOBO KBMBO OBQBT EFOHBO KVNMBI EBQBU NFOJOHLBU TBNB TFQFSUJ LVSWB OPSNBM 1FOZBLJU ZBOH
ZBOH TBNB EFOHBO EFNJLJBO NFODFHBI QFOJOHLBUBO BMJSBO NFOZFCBCLBO QBSV SFTUSJLUJG BOUBSB MBJO QFOZBLJU GJCSPTJT QBSV
TFMBOKVUOZB 0MFI LBSFOB JUV EJ MVBS UJOHLBU LSJUJT LFLVBUBO TFQFSUJ UVCFSLVMPTJT TJMJLPTJT EBO KVHB QFOZBLJU ZBOH
FLTQJSBTJ BMJSBOFLTQJSBTJNBLTJNVNUFMBIEJDBQBJ NFOZFNQJULBOSBOHLBEBEB TFQFSUJLJGPTJT TLPMJPTJTEBOQMFVSJUJT
GJCSPUJL
1BEB QFOZBLJU PCTUSVLTJ TBMVSBO OBQBT CJBTBOZB QBTJFO KBVI
MFCJI TVMJU NFMBLVLBO FLTQJSBTJ EBSJQBEB JOTQJSBTJ TFCBC
LFDFOEFSVOHBONFOVUVQOZBTBMVSBOOBQBTTBOHBUNFOJOHLBU
TLC
516
Bab 42 Insufisiensi Pernapasan Patofisiologi, Diagnosis,Terapi Oksigen
BLJCBU UFLBOBO FLTUSB QPTJUJG EBMBN EBEB TFMBNB FLTQJSBTJ PMFI LFEVB PSBOH UFSTFCVU TFUJBQ EFUJL UFSVUBNB TFMBNB EFUJL
4FCBMJLOZB UFLBOBOFLTUSBOFHBUJGQBEBQMFVSBZBOHUFSKBEJTFMBNB QFSUBNB 0MFI LBSFOB JUV CJBTBOZB LJUB NFNCBOEJOHLBO
JOTQJSBTJ UFSOZBUB NFOBSJL TBMVSBO OBQBT NFNCVLB CFSTBNBBO SFLBNBOWPMVNFFLTQJSBTJQBLTBTFMBNBEFUJLQFSUBNB '&7

EFOHBO NFOHFNCBOHOZB BMWFPMJ 0MFI LBSFOB JUV VEBSB EFOHBO ZBOH OPSNBM 1BEB PSBOH OPSNBM MJIBU (BNCBS
UNIT VII
DFOEFSVOH NFNBTVLJ QBSV EFOHBO NVEBI UFUBQJ LFNVEJBO "
QFSTFOUBTF '7$ ZBOH EJLFMVBSLBO TFMBNB EFUJL
NFOKBEJUFSQFSBOHLBQEJEBMBNQBSV4FUFMBICFCFSBQBCVMBOBUBV QFSUBNB EJCBHJ EFOHBO '7$ UPUBM '&7'7$
BEBMBI
CFCFSBQB UBIVO FGFL JOJ NFOJOHLBULBO CBJL LBQBTJUBT QBSV UPUBM TFCFTBS QFSTFO /BNVO QFSIBUJLBO (BNCBS # CBIXB
NBVQVOWPMVNFSFTJEV TFQFSUJZBOHEJUVOKVLLBOPMFILVSWBBCV QBEBPCTUSVLTJTBMVSBOOBQBT OJMBJJOJUVSVONFOKBEJIBOZB
BCVUFSBOHQBMJOHLJSJQBEB(BNCBS"LJCBUBEBOZBPCTUSVLTJ QFSTFO1BEBPCTUSVLTJTBMVSBOOBQBTCFSBU TFQFSUJZBOHTFSJOH
TBMVSBO OBQBT EBO LBSFOB TBMVSBO OBQBT MFCJI NVEBI LPMBQT UFSKBEJQBEBBTNBBLVU QFSTFOUBTFJOJEBQBUNFOVSVONFOKBEJ
EBSJQBEB TBMVSBO OPSNBM NBLB LFDFQBUBO BMJSBO FLTQJSBTJ LVSBOHEBSJQFSTFO
NBLTJNVNNFOKBEJTBOHBUCFSLVSBOH
1FOZBLJU LMBTJL ZBOH NFOZFCBCLBO PCTUSVLTJ TBMVSBO OBQBT Patofisiologi Ketainan Paru Spesifik
CFSBU BEBMBI BTNB 0CTUSVLTJ TBMVSBO OBQBT ZBOH TFSJVT KVHB
UFSKBEJQBEBCFCFSBQBUJOHLBUBOFNGJTFNB Emfisema Paru Kronis
*TUJMBIFNGJTFNBQBSVCFSBSUJBEBOZBVEBSBZBOHCFSMFCJIBOEJ
Kapasitas Vital Ekspirasi Paksa dan Volume Ekspirasi EBMBN QBSV 5FUBQJ JTUJMBI JOJ CJBTBOZB EJHVOBLBO VOUVL
Paksa NFOHHBNCBSLBO QSPTFT PCTUSVLUJG EBO EFTUSVLUJG QBSV ZBOH
6KJQBSVLMJOJTMBJOOZBZBOHTBOHBUCFSHVOB EBOKVHBTFEFSIBOB
LPNQMFLTBLJCBUNFSPLPLTFMBNBCFSUBIVOUBIVO,FBEBBOJOJ
BEBMBI NFSFLBN LBQBTJUBT WJUBM FLTQJSBTJ QBLTB '7$
QBEB
NFSVQBLBO BLJCBU EBSJ CFSCBHBJ QFSVCBIBO QBUPGJTJPMPHJT
TQJSPNFUFS3FLBNBOTFQFSUJJUVEJUVOKVLLBOQBEB(BNCBS"
VUBNBEBMBNQBSVTFCBHBJCFSJLVU
VOUVL TFTFPSBOH EFOHBO QBSV OPSNBM EBO QBEB (BNCBS #
1. *OGFLTJ LSPOJT ZBOH EJTFCBCLBO PMFI NFOHJTBQ SPLPL BUBV
VOUVL TFTFPSBOH EFOHBO PCTUSVLTJ QBSTJBM TBMVSBO OBQBT 6OUVL
CBIBOCBIBOMBJOZBOHNFOHJSJUBTJCSPOLVTEBOCSPOLJPMVT
NFMBLVLBO QFNFSJLTBBO '7$ PSBOH ZBOH EJQFSJLTB NVMBNVMB
*OGFLTJ LSPOJT JOJ TBOHBU NFOHBDBVLBO NFLBOJTNF
NFMBLVLBO JOTQJSBTJ NBLTJNBM TBNQBJ LBQBTJUBT QBSV UPUBM EBO
QFSUBIBOBO OPSNBM TBMVSBO OBQBT UFSNBTVL LFMVNQVIBO
LFNVEJBOFLTQJSBTJLFEBMBNTQJSPNFUFSEFOHBOVQBZBFLTQJSBTJ
TFCBHJBO TJMJB FQJUFM QFSOBQBTBO PMFI FGFL OJLPUJO TFIJOHHB
NBLTJNBM TFDFQBUOZB EBO TFTFNQVSOB NVOHLJO +BSBL UPUBM
NVLVTUJEBLEBQBUEJLFMVBSLBOEFOHBONVEBIEBSJTBMVSBO
QFOVSVOBO LVSWB QBEB SFLBNBO WPMVNF QBSV NFOHHBNCBSLBO
OBQBT +VHB UFSKBEJ QFSBOHTBOHBO TFLSFTJ NVLVT ZBOH
'7$ TFQFSUJZBOHEJUVOKVLLBOEBMBNHBNCBS
CFSMFCJIBO ZBOH TFMBOKVUOZB NFOHBLJCBULBO LFLBNCVIBO
4FLBSBOH LJUB QFMBKBSJ QFSCFEBBO BOUBSB EVB SFLBNBO

LPOEJTJJOJ4FMBJOJUV UFSKBEJIBNCBUBOUFSIBEBQNBLSPGBH
VOUVLQBSVOPSNBMEBO
VOUVLPCTUSVLTJQBSTJBMTBMVSBOOBQBT
BMWFPMVT TFIJOHHBNFOKBEJLVSBOHFGFLUJGEBMBNNFNFSBOHJ
1FSVCBIBO WPMVNF UPUBM QBEB '7$ UJEBL KBVI CFSCFEB ZBOH
JOGFLTJ
NFOVOKVLLBO CBIXB IBOZB UFSEBQBU TFEJLJU QFSCFEBBO QBEB
WPMVNF EBTBS QBSV BOUBSB LFEVB PSBOH JOJ /BNVO UFSEBQBU 2. *OGFLTJ LFMFCJIBONVLVT EBOFEFNBQFSBEBOHBOQBEBFQJUFM
QFSCFEBBOCFTBSQBEBKVNMBIVEBSBZBOHEBQBUEJFLTQJSBTJLBO CSPOLJPMVT CFSTBNBTBNB NFOZFCBCLBO PCTUSVLTJ LSPOJT
QBEB CBOZBL TBMVSBO OBQBT ZBOH MFCJI LFDJMon, excess
mucus, and inflammatory edema
3. 0CTUSVLTJ TBMVSBO OBQBT UFSVUBNB NFOZFCBCLBO LFTVLBSBO
FLTQJSBTJ TFIJOHHB VEBSB UFSQFSBOHLBQ EBMBN BMWFPMJ EBO
FEV1
NFOZFCBCLBO BMWFPMJ TBOHBU UFSFHBOH ,FBEBBO JOJ
FVC EJLPNCJOBTJLBO EFOHBO JOGFLTJ QBSV NFOZFCBCLBO
FEV1/FVC%
= 80%
LFSVTBLBO ZBOH IFCBU QBEB TBNQBJ QFSTFO EJOEJOH
BMWFPMVT 0MFI LBSFOB JUV HBNCBSBO BLIJS FNGJTFNB QBSV
0 1 2 3 4 5 6 7 BEBMBITFQFSUJZBOHEJMVLJTLBOQBEB(BNCBS BUBT
EBO

&GFL GJTJPMPHJT EBSJ FNGJTFNB LSPOJT CFSWBSJBTJ CFSHBOUVOH
QBEB CFSBUOZB QFOZBLJU EBO QFSCBOEJOHBO EFSBKBU PCTUSVLTJ
FEV1 CSPOLJPMVT SFMBUJG UFSIBEBQ LFSVTBLBO QBSFOLJN QBSV
FEV1/FVC% FVC #FCFSBQBLFMBJOBOOZBBEBMBITFCBHBJCFSJLVU
= 47%
1. 0CTUSVLTJ CSPOLJPMVT NFOJOHLBULBO UBIBOBO TBMVSBO OBQBT
EBO NFOHBLJCBULBO QFOJOHLBUBO IFCBU LFSKB QFSOBQBTBO
4FTFPSBOH NFOKBEJ TVTBI NFOHFMVBSLBO VEBSB NFMBMVJ
CSPOLJPMVT TFMBNB FLTQJSBTJ TFCBC UFOBHB ZBOH NFOFLBO
QBEBCBHJBOMVBSQBSVUJEBLIBOZBNFOFLBOBMWFPMJUBQJKVHB
NFOFLBO CSPOLJPMVT ZBOH TFMBOKVUOZB NFOJOHLBULBO
UBIBOBOOZBTFMBNBFLTQJSBTJ
517
Unit VII Pernapasan
NFOHBLJCBULBOBFSBTJEBSBIZBOHCVSVL EBO7B2ZBOHTBOHBU
UJOHHJ QBEB CBHJBO MBJO SVBOH SVHJ GJTJPMPHJT
NFOHBLJCBULBO
WFOUJMBTJ ZBOH QFSDVNB LFEVB FGFL JOJ UFSKBEJ QBEB QBSVQBSV
ZBOHTBNB
4. )JMBOHOZB TFCBHJBO CFTBS EJOEJOH BMWFPMVT KVHB NFOHVSBOHJ
KVNMBI LBQJMFS QBSV ZBOH EBQBU EJMBMVJ EBSBI 4FCBHBJ
BLJCBUOZB UBIBOBOWBTLVMBSQBSVTFSJOHLBMJNFOJOHLBUEFOHBO
OZBUB NFOZFCBCLBO IJQFSUFOTJ QVMNPOBM ,FBEBBO JOJ
LFNVEJBO BLBO NFOBNCBI CFCBO KBOUVOH TJTJ LBOBO EBO
TFSJOHNFOZFCBCLBOHBHBMKBOUVOHLBOBO
&NGJTFNBLSPOJTCJBTBOZBCFSLFNCBOHTFDBSBMBNCBUTFMBNB
CFSUBIVOUBIVO 4FTFPSBOH BLBO NFOHBMBNJ IJQPLTJB EBO
IJQFSLBQOJB LBSFOB IJQPWFOUJMBTJ QBEB CBOZBL BMWFPMJ EBO
LBSFOBLFIJMBOHBOEJOEJOHBMWFPMVT)BTJMBLIJSEBOTFNVBFGFL
JOJ BEBMBI MBQBS VEBSB BJS IVOHFS
ZBOH IFCBU MBNB EBO
CFSTJGBU NFSVTBL ZBOH EBQBU CFSMBOHTVOH CFSUBIVOUBIVO
TBNQBJIJQPLTJBEBOIJQFSLBQOJBNFOZFCBCLBOLFNBUJBOTVBUV
IVLVNBO TBOHBU CFSBU ZBOH IBSVT EJCBZBS PMFI TFPSBOH
QFSPLPL
Pneumonia
MTUJMBIQOFVNPOJB NFODBLVQ TFUJBQ LFBEBBO SBEBOHQBSV
EFOHBO CFCFSBQB BUBV TFMVSVI BMWFPMJ UFSJTJ DBJSBO EBO TFMTFM
EBSBI TFQFSUJ ZBOH EJQFSMJIBULBO QBEB (BNCBS +FOJT
QOFVNPOJB ZBOH VNVN BEBMBI QOFVNPOJB CBLUFSJBM ZBOH
QBMJOH TFSJOH EJTFCBCLBO PMFI QOFVNPLPLVT 1FOZBLJU JOJ
EJNVMBJ EFOHBO JOGFLTJ EBMBN BMWFPMJ NFNCSBO QBSV
NFOHBMBNJ QFSBEBOHBO EBO CFSMVCBOHMVCBOH TFIJOHHB DBJSBO
EBO CBILBO TFM EBSBI NFSBI EBO TFM EBSBI QVUJI LFMVBS EBSJ
EBSBI NBTVL LF EBMBN BMWFPMJ %FOHBO EFNJLJBO BMWFPMJ ZBOH
UFSJOGFLTJTFDBSBQSPHSFTJGUFSJTJEFOHBODBJSBOEBOTFMTFM EBO
JOGFLTJ NFOZFCBS NFMBMVJ QFSMVBTBO CBLUFSJ BUBV WJSVT EBSJ
BMWFPMVTLFBMWFPMVT"LIJSOZB EBFSBIMVBTQBEBQBSV LBEBOH
LBEBOH TFMVSVI MPCVT CBILBO TFMVSVI QBSV NFOKBEJ
2. )JMBOHOZB TFCBHJBO CFTBS EJOEJOH BMWFPMVT BLBO TBOHBU
CFSLPOTPMJEBTJ ZBOHCFSBSUJCBIXBQBSVUFSJTJDBJSBOEBOTJTB
NFOVSVOLBO LBQBTJUBT EJGVTJ QBSV ZBOH NFOHVSBOHJ TJTBTFM
LFNBNQVBO QBSV VOUVL NFOHPLTJHFOBTJ EBSBI EBO 1BEB QOFVNPOJB GVOHTJ QFSUVLBSBO VEBSB QBSV NFOVSVO
NFOHFMVBSLBOLBSCPOEJPLTJEBEBSJEBSBI EBMBN CFSCBHBJ TUBEJVN QFOZBLJU ZBOH CFSCFEBCFEB 1BEB
3. 1SPTFTPCTUSVLUJGTFSJOHLBMJKBVIMFCJICVSVLQBEBCFCFSBQB TUBEJVN BXBM QSPTFT QOFVNPOJB EBQBU EJMPLBMJTBTJLBO EFOHBO
CBHJBO QBSV EBSJQBEB CBHJBO MBJOOZB TFIJOHHB CFCFSBQB CBJLIBOZBQBEBTBUVQBSV EJTFSUBJEFOHBOQFOVSVOBOWFOUJMBTJ
CBHJBO QBSV WFOUJMBTJOZB CBJL TFNFOUBSB CBHJBO MBJO BMWFPMVT TFEBOHLBO BMJSBO EBSBI ZBOH NFMBMVJ QBSV UFUBQ
WFOUJMBTJOZB CVSVL ,FBEBBO JOJ TFSJOH LBMJ NFOHIBTJMLBO OPSNBM *OJ NFOHBLJCBULBO EVB LFMBJOBO VUBNB QBSV

SBTJP WFOUJMBTJ QFSGVTJ ZBOH TBOHBU BCOPSNBM EFOHBO 7B2 QFOVSVOBO MVBT QFSNVLBBO UPUBM NFNCSBO EBO

TBOHBUSFOEBIQBEBCFCFSBQBCBHJBO QJOUBTBOGJTJPMPHJT
NFOVSVOOZBSBTJPWFOUJMBTJQFSGVTJ,FEVBFGFLJOJ,FEVBFGFL
518
Bab 42 Insufisiensi Pernapasan Patofisiologi, Diagnosis,Terapi Oksigen
UNIT VII
Atele tasis
1/5 normal
1/2 = 97% 5/6 = 97%

1/2 = 60% 1/6 = 60%
= 78%
= 91%
JOJ NFOZFCBCLBO IJQPLTFNJB PLTJHFO EBSBI SFOEBI

EBO QBEB (BNCBS ,PMBQT KBSJOHBO QBSV UJEBL IBOZB
IJQFSLBQOJB LBSCPOEJPLTJEBEBSBIUJOHHJ
NFOZVNCBU BMWFPMJ UBQJ IBNQJS TFMBMV KVHB NFOJOHLBULBO
(BNCBS NFMVLJTLBO FGFL QFOVSVOBO SBTJP WFOUJMBTJ UBIBOBOBMJSBOEBSBINFMBMVJQFNCVMVIEBSBIQBSVZBOHLPMBQT
QFSGVTJ QBEB QOFVNPOJB NFNQFSMJIBULBO CBIXB EBSBI ZBOH 1FOJOHLBUBOUBIBOBOJOJTFCBHJBOUFSKBEJLBSFOBLPMBQTQBSVJUV
NFOHBMJS NFMBMVJ QBSV ZBOH UFSBFSBTJ NFOKBEJ QFSTFO TFOEJSJ ZBOH NFOFLBO EBO NFMJQBU QFNCVMVI EBSBI TFJSJOH
UFSTBUVSBTJEFOHBOPLTJHFO TFEBOHLBOZBOHNFOHBMJSNFMBMVJTJTB EFOHBO CFSLVSBOHOZB WPMVNF QBSV 4FMBJO JUV IJQPLTJB QBEB
QBSVZBOHUJEBLUFSBFSBTJIBOZBQFSTFOUFSTBUVSBTJ0MFILBSFOB BMWFPMJ ZBOH LPMBQT NFOZFCBCLBO WBTPLPOTUSJLTJ CFSUBNCBI
JUV TBUVSBTJSBUBSBUBEBSBIZBOHEJQPNQBLBOPMFIKBOUVOHLJSJLF TFQFSUJZBOHUFMBIEJKFMBTLBOQBEB#BC
EBMBNBPSUBIBOZBTFLJUBSQFSTFO KBVIEJCBXBIOPSNBM "LJCBU LPOTUSJLTJ QFNCVMVI EBSBI NBLB BMJSBO EBSBI ZBOH
NFMBMVJ QBSV BUFMFLUBUJL TBOHBU NFOVSVO 6OUVOHOZB TFCBHJBO
Atelektasis CFTBS EBSBI NFOHBMJS NFMBMVJ QBSV ZBOH UFSWFOUJMBTJ TFIJOHHB
"UFMFLUBTJT CFSBSUJ BMWFPMJ NFOHFNQJT LPMBQT
)BM JOJ EBQBU UFSKBEJ BFSBTJ EFOHBO CBJL 1BEB LFBEBBO ZBOH EJQFSMJIBULBO
UFSKBEJ QBEB UFNQBUUFNQBU ZBOH UFSMPLBMJTBTJ EJ QBSV BUBV QBEB EBMBN(BNCBS MJNBQFSFOBNEBSBINFOHBMJSNFMBMVJQBSV
TFMVSVIQBSV1FOZFCBCBUFMFLUBTJTZBOHQBMJOHTFSJOHBEBMBI
ZBOH UFSBFSBTJ EBO IBOZB TFQFSFOBN ZBOH NFMBMVJ QBSV ZBOH
PCTUSVLTJ UPUBM TBMVSBO OBQBT BUBV
CFSLVSBOHOZB TVSGBLUBO UJEBL UFSBFSBTJ 4FCBHBJ BLJCBUOZB SBTJP WFOUJMBTJQFSGVTJ TFDBSB
QBEBDBJSBOZBOHNFMBQJTJBMWFPMJ LFTFMVSVIBO IBOZB TFEJLJU UFSHBOHHV TFIJOHHB EBSBI BPSUB
IBOZB NFOHBMBNJ EFTBUVSBTJ PLTJHFO SJOHBO XBMBVQVO UFSKBEJ
Obstruksi Saluran Napas Menyebabkan Kolaps Paru. LFIJMBOHBOWFOUJMBTJUPUBMQBEBTFMVSVIQBSV
0CTUSVLTJ TBMVSBO OBQBT KFOJT BUFMFLUBTJT CJBTBOZB NFSVQBLBO
BLJCBU EBSJ
TVNCBUBO CBOZBL CSPOLJ LFDJM PMFI NVLVT BUBV Kekurangan "Surfaktan" sebagai Penyebab Kolaps

TVNCBUBO CSPOLVT CFTBS PMFI HVNQBMBO NVLVT ZBOH CFTBS Paru. 4FLSFTJ EBO GVOHTJ TVSGBLUBO QBEB BMWFPMJ EJCBIBT QBEB
BUBV CFOEB QBEBU TFQFSUJ UVNPS 6EBSB ZBOH UFSQFSBOHLBQ EJ #BC5FMBIEJKFMBTLBOCBIXB[BUTVSGBLUBOEJTFLSFTJLBOPMFI
CFMBLBOHTVNCBUBOEJTFSBQEBMBNXBLUVCFCFSBQBNFOJUTBNQBJ TFMTFM FQJUFM BMWFPMVT TQFTJGJL LF EBMBN DBJSBO ZBOH NFMBQJTJ
CFCFSBQBKBNPMFIEBSBIZBOHNFOHBMJSEBMBNLBQJMFSQBSV+JLB QFSNVLBBOCBHJBOEBMBNBMWFPMJ;BUJOJNFOVSVOLBOUFHBOHBO
KBSJOHBOQBSVDVLVQMFOUVS BMWFPMJBLBONFOKBEJLPMBQT5FUBQJ QFSNVLBBOQBEBBMWFPMJTBNQBJLBMJMJQBU ZBOHNFNFHBOH
KJLB QBSV CFSTJGBU LBLV BLJCBU KBSJOHBO GJCSPUJL EBO UJEBL EBQBU QFSBOBO QFOUJOH EBMBN NFODFHBI LPMBQTOZB BMWFPMVT 5FUBQJ
LPMBQT NBLB BCTPSQTJ VEBSB EBSJ BMWFPMJ NFOJNCVMLBO UFLBOBO QBEB CFSCBHBJ LFBEBBO TFQFSUJ QFOZBLJU NFNCSBO IJBMJO KVHB
OFHBUJGZBOHIFCBUEBMBNBMWFPMJEBONFOBSJLDBJSBOLFMVBSEBSJ EJTFCVU TJOESPN HBXBU OBQBT
TFSJOH UFSKBEJ QBEB CBZJCBZJ
LBQJMFS QBSV NBTVL LF EBMBN BMWFPMJ EFOHBO EFNJLJBO QSFNBUVS CBSV MBIJS KVNMBI TVSGBLUBO ZBOH EJTFLSFTJLBO PMFI
NFOZFCBCLBO BMWFPMJ UFSJTJ QFOVI EFOHBO DBJSBO FEFNB *OJ BMWFPMJ TBOHBU LVSBOH "LJCBUOZB UFHBOHBO QFSNVLBBO DBJSBO
NFSVQBLBO FGFL ZBOH IBNQJS TFMBMV UFSKBEJ CJMB TFMVSVI QBSV BMWFPMVT NFOKBEJ CFCFSBQB LBMJ MJQBU MFCJI UJOHHJ EBSJ OPSNBM
NFOHBMBNJ BUFMFLUBTJT TVBUV LFBEBBO ZBOH EJTFCVU LPMBQT NBTJG TFIJOHHB NFOZFCBCLBO QBSV CBZJ DFOEFSVOH LPMBQT BUBV UFSJTJ
QBSV DBJSBO4FQFSUJZBOHUFMBIEJKFMBTLBOEBMBN#BC CBOZBLEBSJ
&GFLUFSIBEBQGVOHTJQBSVLFTFMVSVIBOZBOHEJTFCBCLBOPMFI CBZJ JOJ NBUJ MFNBT LBSFOB TFCBHJBO CFTBS QBSV NFOKBEJ
LPMBQTNBTJG BUFMFLUBTJT
QBEBTFMVSVIQBSVEJMVLJTLBOQBEB BUFMFLUBTJT
519
Unit VII Pernapasan
Asma—Kontraksi Spasmodik Otot Polos Bronkiolus Tuberkulosis

"TNBEJUBOEBJEFOHBOLPOUSBLTJTQBTUJLPUPUQPMPTCSPOLJPMVT 1BEB UVCFSLVMPTJT CBTJM UVCFSLFM NFOZFCBCLBO SFBLTJ KBSJOHBO
ZBOH NFOZVNCBU CSPOLJPMVT TFDBSB QBSTJBM EBO NFOZFCBCLBO ZBOH BOFI EBMBN QBSV BOUBSB MBJO
KBSJOHBO ZBOH UFSJOGFLTJ
LFTVLBSBOCFSOBQBTZBOHIFCBU)BMJOJUFSKBEJQBEBTBNQBJ EJTFSBOH PMFI NBLSPGBH EBO
EBFSBI MFTJ EJLFMJMJOHJ TFQFSUJ
QFSTFOEBSJTFMVSVINBOVTJBQBEBTVBUVTBBUEBMBNIJEVQOZB EJOEJOH PMFI KBSJOHBO GJCSPUJL VOUVL NFNCFOUVL ZBOH EJTFCVU
1FOZFCBCBTNBZBOHVNVNJBMBIIJQFSTFOTJUJWJUBTLPOUSBLUJM UVCFSLFM 1SPTFT QFNCFOUVLBO EJOEJOH JOJ NFNCBOUV NFNCBUBTJ
CSPOLJPMVT TFCBHBJ SFTQPOT UFSIBEBQ CFOEBCFOEB BTJOH EJ QFOZFCBSBO CBTJM UVCFSLFM EBMBN QBSV EBO PMFI LBSFOB JUV
VEBSB 1BEB QBTJFO EJ CBXBI VTJB UBIVO TFLJUBS QFSTFO NFSVQBLBO CBHJBO EBO QSPTFT QSPUFLUJG UFSIBEBQ QFSMVBTBO
BTNB EJTFCBCLBO PMFI IJQFSTFOTJUJWJUBT BMFSHJL UFSVUBNB JOGFLTJ5FUBQJ IBNQJSQFSTFOEBSJTFMVSVIQBTJFOUVCFSLVMPTJT
IJQFSTFOTJUJWJUBT UFSIBEBQ TFSCVL TBSJ UBOBNBO 1BEB QBTJFO KJLB UJEBL EJPCBUJ UJEBL UFSCFOUVL QSPTFT QFNCFOUVLBO EJOEJOH
MFCJIUVB QFOZFCBCOZBIBNQJSTFMBMVIJQFSTFOTJUJWJUBTUFSIBEBQ JOJ EBO CBTJM UVCFSLFM NFOZFCBS LF TFMVSVI QBSV TFSJOH LBMJ
CBIBO JSJUBO OPOBMFSHFOJL EJ VEBSB TFQFSUJ JSJUBO QBEB LBCVU NFOZFCBCLBO LFSVTBLBO CFSBU KBSJOHBO QBSV EFOHBO
BTBQ QFNCFOUVLBOLBWJUBTBCTFTZBOHCFTBS
3FBLTJ BMFSHJ ZBOH UJNCVM QBEB BTNB UJQF BMFSHJ EJEVHB %FOHBO EFNJLJBO QBEB UVCFSLVMPTJT TUBEJVN MBOKVU CBOZBL
UFSKBEJ NFOVSVU DBSB CFSJLVU JOJ 4FTFPSBOH ZBOH BMFSHJ UJNCVM EBFSBI GJCSPTJT EJ TFMVSVI QBSV EBO NFOHVSBOHJ KVNMBI
NFNQVOZBJ LFDFOEFSVOHBO VOUVL NFNCFOUVL BOUJCPEJ *H& UPUBM KBSJOHBO QBSV GVOHTJPOBM ,FBEBBO JOJ NFOZFCBCLBO

BCOPSNBM EBMBN KVNMBI CFTBS EBO BOUJCPEJ JOJ NFOZFCBCLBO QFOJOHLBUBO LFSKB QBEB CBHJBO PUPU QFSOBQBTBO ZBOH CFSGVOHTJ
SFBLTJBMFSHJCJMBPSBOHUFSTFCVUCFSFBLTJEFOHBOBOUJHFOTQFTJGJL VOUVL WFOUJMBTJ QBSV EBO CFSLVSBOHOZB LBQBTJUBT WJUBM EBO
ZBOHNFNJDVUFSCFOUVLOZBBOUJCPEJUFSTFCVUQBEBQFSUBNBLBMJ LBQBTJUBTQFSOBQBTBO
CFSLVSBOHOZBMVBTQFSNVLBBONFNCSBO
TFQFSUJZBOHUFMBIEJUFSBOHLBOQBEB#BC1BEBBTNB BOUJCPEJ QFSOBQBTBO UPUBM EBO QFOJOHLBUBO LFUFCBMBO NFNCSBO
JOJ UFSVUBNB NFMFLBU QBEB TFM NBTU ZBOH UFSEBQBU EBMBN QFSOBQBTBO IBMJOJNFOJNCVMLBOQFOVSVOBOLBQBTJUBTEJGVTJQBSV
JOUFSTUJUJBMQBSVZBOHCFSIVCVOHBOFSBUEFOHBOCSPOLJPMVTEBO TFDBSB QSPHSFTJG EBO
LFMBJOBO SBTJP WFOUJMBTJQFSGVTJ EBMBN
CSPOLVTLFDJM#JMBTFTFPSBOHZBOHNFOEFSJUBBTNBNFOHIJSVQ QBSV TFIJOHHB NFOHVSBOHJ EJGVTJ PLTJHFO EBO LBSCPO EJPLTJEB
TFSCVL TBSJ ZBOH TFOTJUJG CBHJOZB UFMBI UFSCFOUVL BOUJCPEJ *H& QBSVTFDBSBLFTFMVSVIBO
UFSIBEBQTFSCVLTBSJQBEBPSBOHUFSTFCVU
TFSCVLTBSJCFSFBLTJ
EFOHBO BOUJCPEJ ZBOH UFSMFLBU TFM NBTU EBO NFOZFCBCLBO TFM Hipoksia dan Terapi Oksigen
NBTU NFOHFMVBSLBO CFSCBHBJ NBDBN [BU %J BOUBSBOZB BEBMBI
B
IJTUBNJO C
[BU BOBGJMBLTJT ZBOH CFSFBLTJ MBNCBU ZBOH )BNQJS TFUJBQ LPOEJTJ ZBOH UFMBI EJCJDBSBLBO QBEB CFCFSBQB
NFSVQBLBO DBNQVSBO MFVLPUSJFO
D
GBLUPS LFNPUBLUJL CBHJBO UFSEBIVMV EBMBN CBC JOJ EBQBU NFOJNCVMLBO IJQPLTJB TFM
EBO E
CSBEJLJOJO &GFL HBCVOHBO EBSJ TFNVB GBLUPS JOJ ZBOH TFSJVT EJ TFMVSVI UVCVI ,BEBOHLBEBOH UFSBQJ PLTJHFO
UFSVUBNB [BU BOBGJMBLTJT ZBOH CFSFBLTJ MBNCBU BLBO TBOHBUMBI CFSHVOB QBEB TFCBHJBO MBJOOZB DVLVQ CFSHVOB
NFOHIBTJMLBO
FEFNB MPLBM QBEB EJOEJOH CSPOLJPMVT LFDJM TFEBOHLBOQBEBZBOHMBJOMBHJIBNQJSUJEBLCFSHVOB0MFILBSFOB
NBVQVOTFLSFTJNVLVTZBOHLFOUBMLFEBMBNMVNFOCSPOLJPMVT JUV QFSMV VOUVL NFOHFSUJ CFSCBHBJ KFOJT IJQPLTJB LFNVEJBO LJUB
EBO
TQBTNFPUPUQPMPTCSPOLJPMVT0MFILBSFOBJUV UBIBOBO EBQBU NFNCJDBSBLBO QSJOTJQQSJOTJQ GJTJPMPHJT UFSBQJ PLTJHFO
TBMVSBOOBQBTNFOKBEJTBOHBUNFOJOHLBU #FSJLVU JOJ BEBMBI LMBTJGJLBTJ EFTLSJQUJG EBSJ CFSNBDBNNBDBN
4FQFSUJZBOHUFMBIEJCJDBSBLBOQBEBBXBMCBCJOJ CBIXBQBEB QFOZFCBCIJQPLTJB
BTNB EJBNFUFS CSPOLJPMVT MFCJI CBOZBL CFSLVSBOH TFMBNB 1. 0LTJHFOBTJEBSBIEJEBMBNQBSVZBOHUJEBLNFNBEBJLBSFOB
FLTQJSBTJ EBSJQBEB TFMBNB JOTQJSBTJ LBSFOB CSPOLJPMVT LPMBQT LFBEBBOFLTUSJOTJL
TFMBNB VQBZB FLTQJSBTJ BLJCBU QFOFLBOBO QBEB CBHJBO MVBS a. ,FLVSBOHBOPLTJHFOEBMBNBUNPTGFS
CSPOLJPMVT ,BSFOB CSPOLJPMVT QBEB QBSV BTNBUJL TVEBI
UFSTVNCBU TFCBHJBO NBLB TVNCBUBO TFMBOKVUOZB BEBMBI BLJCBU b. )JQPWFOUJMBTJ HBOHHVBOOFVSPNVTLVMBS
EBSJ UFLBOBO FLTUFSOBM ZBOH NFOJNCVMLBO PCTUSVLTJ CFSBU 2. 1FOZBLJUQBSV

UFSVUBNB TFMBNB FLTQJSBTJ 1BTJFO BTNB CJBTBOZB EBQBU a. )JQPWFOUJMBTJLBSFOBQFOJOHLBUBOUBIBOBOTBMVSBOOBQBT
NFMBLVLBO JOTQJSBTJ EFOHBO CBJL EBO BEFLVBU UFUBQJ TVLBS BUBVQFOVSVOBOLPNQMJBOTQBSV
TFLBMJNFMBLVLBOFLTQJSBTJ1FOHVLVSBOLMJOJTNFNQFSMJIBULBO b. ,FMBJOBO SBTJP WFOUJMBTJQFSGVTJ BMWFPMVT UFSNBTVL

QFOVSVOBO TBOHBU CFTBS MBKV FLTQJSBTJ NBLTJNVN EBO

QFOJOHLBUBO SVBOH SVHJ GJTJPMPHJT BUBV QJOUBTBO
CFSLVSBOHOZB WPMVNF FLTQJSBTJ UFSVLVS UJNFE FYQJSBUPSZ
GJTJPMPHJT
WPMVNF
+VHB TFNVB LFBEBBO JOJ NFOZFCBCLBO EJTQOFB BUBV
MBQBSVEBSB ZBOHBLBOEJCJDBSBLBOLFNVEJBOQBEBCBCJOJ c. #FSLVSBOHOZBEJGVTJNFNCSBOQFSOBQBTBO
,BQBTJUBTSFTJEVGVOHTJPOBMEBOWPMVNFSFTJEVQBSVNFOKBEJ 3. 1JOUBTBOWFOBLFBSUFSJ QJOUBTBOKBOUVOHLBOBOLF
NFOJOHLBU UFSVUBNB TFMBNB TFSBOHBO BTNB BLVU BLJCBU LJSJ

LFTVLBSBO NFOHFMVBSLBO VEBSB EBSJ QBSV +VHB TFUFMBI 4. 5SBOTQPSPLTJHFOZBOHUJEBLNFNBEBJPMFIEBSBILF
CFSUBIVOUBIVO SPOHHBEBEBNFOKBEJCFTBSTFDBSBQFSNBOFO KBSJOHBO
NFOHBLJCBULBOEBEBUPOH CBSSFMDIFTU
EBOLBQBTJUBTSFTJEV a. "OFNJBBUBVIFNPHMPCJOBCOPSNBM
GVOHTJPOBM EBO WPMVNF SFTJEV QBSV NFOKBEJ NFOJOHLBU TFDBSB
b. 1FOVSVOBOTJSLVMBTJVNVN
QFSNBOFO
520
Bab 42 Insufisiensi Pernapasan–Patofisiologi, Diagnosis,Terapi Oksigen
c. 1FOVSVOBO TJSLVMBTJ MPLBM QFSJGFS TFSFCSBM QFNCVMVI EBSBI

LPSPOFS
d. &EFNBKBSJOHBO
5. ,FNBNQVBOKBSJOHBOVOUVLNFOHHVOBLBOPLTJHFOUJEBLNFNBEBJ
a. ,FSBDVOBOFO[JNPLTJEBTJTFMVMBS
UNIT VII
b. 1FOVSVOBO LBQBTJUBT NFUBCPMJL TFMVMBS VOUVL NFOHHVOBLBO
PLTJHFO LBSFOB UPLTJTJUBT EFGJTJFOTJ WJUBNJO BUBV GBLUPS
GBLUPSMBJO
,MBTJGJLBTJ KFOJTKFOJT IJQPLTJB JOJ UFSVUBNB EJCVLUJLBO
EBMBN QFNCBIBTBO QBEB BXBM CBC JOJ )BOZB TBUV NBDBN
IJQPLTJBQBEBLMBTJGJLBTJEJBUBTZBOHQFSMVEJUFMJUJMFCJIKBVI
IJQPLTJB JOJ EJTFCBCLBO PMFI LFNBNQVBO TFM KBSJOHBO UVCVI
ZBOHUJEBLNFNBEBJVOUVLNFNBLBJPLTJHFO
Kemampuan Jaringan untuk Menggunakan Oksigen
Tidak Memadai. 1FOZFCBC LMBTJL EBSJ LFUJEBLNBNQVBO
KBSJOHBO VOUVL NFOHHVOBLBO PLTJHFO BEBMBI LFSBDVOBO
TJBOJEB LBSFOB LFSKB FO[JN TJUPLSPN PLTJEBTF EJIBNCBU
EFOHBO TFNQVSOB PMFI TJBOJEB TFIJOHHB VOUVL TFMBOKVUOZB EBQBU NFOJOHLBULBO 1P EBMBN BMWFPMJ QBSV EBSJ OJMBJ OPSNBM
KBSJOHBO UJEBL NBNQV NFOHHVOBLBO PLTJHFO XBMBVQVO LJSBLJSB NN )H TBNQBJ TFUJOHHJ NN )H )BM JOJ
UFSTFEJBDVLVQCBOZBL,FLVSBOHBOCFCFSBQBFO[JNPLTJEBUJG NFOJOHLBULBO HSBEJFO UFLBOBO PLTJHFO VOUVL EJGVTJ PLTJHFO
TFMVMBSKBSJOHBOBUBVCBIBOCBIBOMBJOEBMBNTJTUFNPLTJEBUJG EBSJ BMWFPMJ LF EBSBI EBSJ OJMBJ OPSNBM NN )H IJOHHB
KBSJOHBO KVHB EBQBU NFOJNCVMLBO IJQPLTJB KFOJT JOJ $POUPI NFOKBEJ NN )H BUBV QFOJOHLBUBO ZBOH MFCJI EBSJ
LIVTVT UFSKBEJ QBEB QFOZBLJU CFSJCFSJ LBSFOB CFCFSBQB QFSTFO .BOGBBU ZBOH CFTBS UFSBQJ PLTJHFO JOJ QBEB IJQPLTJB
MBOHLBI QFOUJOH EBMBN QFNBLBJBO PLTJHFO KBSJOHBO EBO EJGVTJ EJMVLJTLBO QBEB (BNCBS ZBOH NFNQFSMJIBULBO
QFNCFOUVLBO LBSCPO EJPLTJEB UFSHBOHHV BLJCBU LFLVSBOHBO CBIXBEBSBIQBSVQBEBQBTJFOEFOHBOFEFNBQBSVNFOHBNCJM
WJUBNJO# PLTJHFO UJHB TBNQBJ FNQBU LBMJ MFCJI DFQBU EBSJQBEB UBOQB
Pengaruh Hipoksia pada Tubuh. )JQPLTJB CJMB DVLVQ UFSBQJ
CFSBU EBQBU NFOZFCBCLBO LFNBUJBO TFMTFM TFMVSVI UVCVI 1BEB IJQPLTJB ZBOH EJTFCBCLBO PMFI BOFNJB LFMBJOBO
UFUBQJ QBEB EFSBKBU ZBOH LVSBOH CFSBU UFSVUBNB BLBO USBOTQPS PLTJHFO PMFI IFNPHMPCJO EFGJTJFOTJ TJSLVMBTJ BUBV
NFOHBLJCBULBO
QFOFLBOBO BLUJWJUBT NFOUBM LBEBOH QJOUBTBO GJTJPMPHJT NBLB UFSBQJ PLTJHFO OJMBJOZB KBVI MFCJI
LBEBOH NFNCFSBU TBNQBJ LPNB EBO
NFOVSVOLBO SFOEBI LBSFOB EBMBN BMWFPMJ UFMBI UFSEBQBU PLTJHFO ZBOH
LBQBTJUBT LFSKB PUPU 1FOHBSVI JOJ EJCJDBSBLBO TFDBSB LIVTVT OPSNBM.BTBMBITFCFOBSOZBBEBMBITBMBITBUVNFLBOJTNFBUBV
QBEB #BC EBMBN IVCVOHBOOZB EFOHBO GJTJPMPHJ UFNQBU MFCJIVOUVLNFOHBOHLVUPLTJHFOEBSJQBSVLFKBSJOHBONFOKBEJ
UJOHHJ IJHIBMUJUVEF
CFSLVSBOH 8BMBVQVO EFNJLJBO TFKVNMBI LFDJM PLTJHFO
Terapi Oksigen pada Berbagai Jenis Hipoksia UBNCBIBO BOUBSB TBNQBJ QFSTFO EBQBU EJBOHLVU EBMBN
0LTJHFO EBQBU EJCFSJLBO EFOHBO DBSB
NFMFUBLLBO LFQBMB LFBEBBO UFSMBSVU EBMBN EBSBI CJMB PLTJHFO BMWFPMVT
QBTJFO EJ EBMBN TVBUV UFOEB UFNQBU UFSUVUVQ
CFSJTJ VEBSB EJUJOHLBULBO IJOHHB NFODBQBJ NBLTJNVN XBMBVQVO KVNMBI
ZBOH NFOHBOEVOH PLTJHFO
QBTJFO CFSOBQBT EFOHBO ZBOH EJBOHLVU PMFI IFNPHMPCJO TBOHBU CFSVCBI +VNMBI
PLTJHFO NVSOJ BUBV PLTJHFO EFOHBO LPOTFOUSBTJ UJOHHJ EBO PLTJHFO UBNCBIBO ZBOH TFEJLJU JOJ NVOHLJO NFOKBEJ QFOFOUV
TFCVBI NBTLFS BUBV
QFNCFSJBO PLTJHFO NFMBMVJ TFMBOH BOUBSBLFBEBBOIJEVQEBONBUJ
JOUSBOBTBM 1BEB CFSCBHBJ KFOJT IJQPLTJB BLJCBU QFOHHVOBBO PLTJHFO
%FOHBO NFOHJOHBU LFNCBMJ QSJOTJQQSJOTJQ EBTBS GJTJPMPHJ KBSJOHBO ZBOH UJEBL BEFLVBU BCOPSNBMJUBT ZBOH UFSKBEJ CVLBO
CFSCBHBJ KFOJT IJQPLTJB LJUB EBQBU NFOFOUVLBO LBQBO UFSBQJ QBEBQFOHBNCJMBOPLTJHFOPMFIQBSVBUBVQVOUSBOTQPSUOZBLF
PLTJHFO BLBO NFNCFSJ NBOGBBU EBO KJLB EFNJLJBO CFSBQB KBSJOHBO NFMBJOLBO LBSFOB TJTUFN FO[JN NFUBCPMJL KBSJOHBO
CFTBSNBOGBBUOZB ZBOH UJEBL NBNQV NFOHHVOBLBO PLTJHFO ZBOH EJLJSJNLBO
1BEB IJQPLTJB BUNPTGFSJL UFSBQJ PLTJHFO EBQBU 0MFILBSFOBJUV NBTJIEJSBHVLBOBQBLBIUFSBQJPLTJHFOBEBMBI
NFOQFSCBJLJLFLVSBOHBOLBEBSPLTJHFOEBMBNVEBSBJOTQJSBTJ TVBUVUFSBQJZBOHCFSNBOGBBU
TFDBSB TFNQVSOB EBO PMFI LBSFOB JUV NFNCFSJ IBTJM UFSBQJ
QFSTFOFGFLUJG MTUJMBI TJBOPTJT CFSBSUJ LFCJSVBO QBEB LVMJU EBO QFOZFCBCOZB
1BEB IJQPLTJB IJQPWFOUJMBTJ TFTFPSBOH ZBOH CFSOBQBT
BEBMBI IFNPHMPCJO ZBOH UJEBL NFOHBOEVOH PLTJHFO
EFOHBO PLTJHFO QFSTFO TFUJBQ LBMJ CFSOBQBT EBQBU
KVNMBIOZB CFSMFCJIBO EBMBN QFNCVMVI EBSBI LVMJU UFSVUBNB
NFOHBMJSLBO PLTJHFO LF EBMBN BMWFPMJ MJNB LBMJ MFCJI CBOZBL
EBMBN LBQJMFS )FNPHMPCJO ZBOH UJEBL NFOHBOEVOH PLTJHFO
EBSJQBEBCJMBCFSOBQBTEFOHBOVEBSBOPSNBM0MFILBSFOBJUV
NFNJMJLJ XBSOB CJSV HFMBQ LFVOHVBO ZBOH UFSMJIBU NFMBMVJ
EJ TJOJ UFSBQJ PLTJHFO EBQBU TBOHBU CFSNBOGBBU 5FUBQJ
LVMJU
QFOHHVOBBO JOJ UJEBL CFSHVOB QBEB LFBEBBO LFMFCJIBO 1BEB VNVNOZB TJBOPTJT NVODVM BQBCJMB EBSBI BSUFSJ
LBSCPO EJPLTJEB EBMBN EBSBI ZBOH KVHB EJTFCBCLBO PMFI NFOHBOEVOH MFCJI EBSJ HSBN IFNPHMPCJO ZBOH UJEBL
IJQPWFOUJMBTJ
NFOHBOEVOH PLTJHFO EBMBN TFUJBQ NM EBSBI 1BTJFO
1BEB IJQPLTJB ZBOH EJTFCBCLBO PMFI HBOHHVBO EJGVTJ BOFNJBIBNQJSUJEBLQFSOBINFOHBMBNJTJBOPTJTLBSFOBUJEBL
NFNCSBO BMWFPMVT QBEB EBTBSOZB UFSKBEJ FGFL ZBOH TBNB UFSEBQBU DVLVQ CBOZBL IFNPHMPCJO VOUVL EJEFPLTJHFOBTJ
TFQFSUJQBEBIJQPLTJBIJQPWFOUJMBTJ LBSFOBUFSBQJPLTJHFO TFCBOZBLHSBNEBMBNNMEBSBIBSUFSJ4FCBMJLOZB QBEB
521
Unit VII Pernapasan
QBTJFOZBOHNFOHBMBNJLFMFCJIBOTFMEBSBINFSBI TFQFSUJZBOH 1BMJOH TFEJLJU BEB UJHB GBLUPS ZBOH TFSJOH NFOZFSUBJ
UFSKBEJ QBEB QPMJTJUFNJB WFSB IFNPHMPCJO ZBOH KVNMBIOZB QFSLFNCBOHBO TFOTBTJ EJTQOFB :BJUV
LFMBJOBO HBTHBT
CBOZBL JUV EBQBU EJEFPLTJHFOBTJ TFIJOHHB TFSJOH LBMJ QFSOBQBTBO EBMBN DBJSBO UVCVI UFSVUBNB IJQFSLBQOJB EBO
NFOZFCBCLBOTJBOPTJT CBILBOEBMBNLFBEBBOOPSNBM IJQPLTJB EFOHBO QPSTJ ZBOH KBVI MFCJI TFEJLJU

KVNMBI LFSKB
ZBOH IBSVT EJMBLVLBO PMFI PUPUPUPU QFSOBQBTBO VOUVL
Hiperkapnia—Kelebihan Karbon Dioksida NFOHIBTJMLBO WFOUJMBTJ ZBOH NFNBEBJ EBO
LFBEBBO QJLJSBO
dalam Cairan Tubuh PSBOHUFSTFCVU
,FNVOHLJOBO QFSUBNB ZBOH IBSVT EJQJLJSLBO BEBMBI CBIXB 4FTFPSBOH NFOKBEJ TBOHBU EJTQOFB UFSVUBNB BLJCBU
TFUJBQ HBOHHVBO SFTQJSBTJ ZBOH NFOZFCBCLBO IJQPLTJB KVHB QFNCFOUVLBO LBSCPO EJPLTJEB ZBOH CFSMFCJIBO EBMBN DBJSBO
BLBO NFOZFCBCLBO IJQFSLBQOJB 5FUBQJ CJBTBOZB IJQFSLBQOJB UVCVI /BNVO QBEB TVBUV XBLUV LBEBS LBSCPO EJPLTJEB EBO
ZBOH UJNCVM EBMBN LBJUBOOZB EFOHBO IJQPLTJB IBOZB UFSKBEJ PLTJHFO EBMBN DBJSBO UVCVI EBMBN CBUBT OPSNBM UFUBQJ VOUVL
CJMBIJQPLTJBEJTFCBCLBOPMFIIJQPWFOUJMBTJBUBVPMFIHBOHHVBO NFODBQBJ HBTHBT JOJ EBMBN CBUBT OPSNBM PSBOH UFSTFCVU IBSVT
TJSLVMBTJ"MBTBOVOUVLIBMJOJBEBMBITFCBHBJCFSJLVU CFSOBQBT EFOHBO LVBU 1BEB LFBEBBO TFQFSUJ JOJ BLUJWJUBT PUPU
PUPU QFSOBQBTBO ZBOH LVBU TFSJOH LBMJ NFNCFSJ TFOTBTJ EJTQOFB
)JQPLTJB ZBOH EJTFCBCLBO PMFI UFSMBMV TFEJLJUOZB PLTJHFO
QBEBPSBOHUFSTFCVU
EBMBN VEBSB UFSMBMV TFEJLJUOZB IFNPHMPCJO BUBV LFSBDVOBO
"LIJSOZB GVOHTJ QFSOBQBTBO PSBOH UFSTFCVU NVOHLJO TVEBI
FO[JN PLTJEBUJG IBOZB UFSKBEJ CJMB UFSEBQBU PLTJHFO BUBV
OPSNBM LFNCBMJ UBQJ NBTJI NFOHBMBNJ EJTQOFB LBSFOB
EJHVOBLBOOZB PLTJHFO PMFI KBSJOHBO 0MFI LBSFOB JUV NVEBI
QFSBTBBOOZB NBTJI BCOPSNBM ,FBEBBO JOJ EJTFCVU EJTQOFB
EJNFOHFSUJCBIXBIJQFSLBQOJBUJEBLUFSKBEJCFSTBNBBOEFOHBO
OFVSPHFOJLBUBVEJTQOFBFNPTJPOBM.JTBMOZB IBNQJSTFUJBQPSBOH
UJQFIJQPLTJBJOJ
ZBOH QBEB TVBUV TBBU NFNJLJSLBO BLUJWJUBT QFSOBQBTBO
1BEB IJQPLTJB ZBOH EJTFCBCLBO PMFI EJGVTJ ZBOH CVSVL
TFLPOZPOHLPOZPOH JB NVMBJ CFSOBQBT MFCJI EBMBN EBO CJBTBOZB
NFMBMVJ NFNCSBO QBSV BUBV NFMBMVJ KBSJOHBO IJQFSLBQOJB
LBSFOB BEB QFSBTBBO EJTQOFB SJOHBO 1FSBTBBO JOJ TFNBLJO
ZBOHCFSBUCJBTBOZBUJEBLUFSKBEJQBEBXBLUVZBOHCFSTBNBBO
CFSUBNCBICJMBPSBOHUFSTFCVUNFNQVOZBJSBTBUBLVUTFDBSBQTJLJT
LBSFOB EJGVTJ LBSCPO EJPLTJEB LBMJ MFCJI DFQBU EBSJQBEB
CBIXB EJB UJEBL EBQBU NFNQFSPMFI KVNMBI VEBSB ZBOH DVLVQ
PLTJHFO +JLB IJQFSLBQOJB NVMBJ UFSKBEJ IJQFSLBQOJB JOJ BLBO
TFQFSUJLFUJLBNFNBTVLJSVBOHBOZBOHTFNQJUBUBVZBOHSBNBJ
TFHFSB NFSBOHTBOH WFOUJMBTJ QBSV ZBOH EBQBU NFNQFSCBJLJ
IJQFSLBQOJBUFUBQJUJEBLNFNQFSCBJLJIJQPLTJB Pernapasan Buatan
4FCBMJLOZB QBEB IJQPLTJB ZBOH EJTFCBCLBO PMFI
IJQPWFOUJMBTJ USBOTGFS LBSCPO EJPLTJEB BOUBSB BMWFPMJ EBO Resusitator. 5FSTFEJB CBOZBL KFOJT SFTVTJUBUPS QFSOBQBTBO
BUNPTGFS KVHB JLVU UFSQFOHBSVI TFQFSUJ ZBOH UFSKBEJ QBEB NBTJOHNBTJOH NFNQVOZBJ QSJOTJQ QFNBLBJBO ZBOH LIVTVT
USBOTGFS PLTJHFO ,FNVEJBO UFSKBEJ IJQFSLBQOJB CFSTBNBBO 3FTVTJUBUPS ZBOH EJMVLJTLBO QBEB (BNCBS " UFSEJSJ BUBT
EFOHBO IJQPLTJB 1BEB EFGJTJFOTJ TJSLVMBTJ QFOVSVOBO BMJSBO QFSTFEJBBO PLTJHFO BUBV VEBSB EBMBN UBOHLJ TVBUV NFLBOJTNF
EBSBINFOHVSBOHJQFOHFMVBSBOLBSCPOEJPLTJEBEBSJKBSJOHBO VOUVLNFOHBEBLBOUFLBOBOQPTJUJGZBOHJOUFSNJUFOEBO EFOHBO
NFOZFCBCLBO IJQFSLBQOJB KBSJOHBO TFLBMJHVT IJQPLTJB
KBSJOHBO5FUBQJ LBQBTJUBTQFOHBOHLVUBOEBSBIVOUVLLBSCPO
EJPLTJEB MFCJI EBSJ UJHB LBMJ LBQBTJUBT QFOHBOHLVUBO PLTJHFO
TFIJOHHB IJQFSLBQOJB KBSJOHBO MFCJI KBSBOH UFSKBEJ EBSJQBEB
IJQPLTJBKBSJOHBO
#JMB 1DP BMWFPMVT NFOJOHLBU EJ BUBT TFLJUBS TBNQBJ
NN )H NBLB PSBOH ZBOH OPSNBM LFNVEJBO BLBO CFSOBQBT
TFDFQBU EBO TFEBMBN NVOHLJO EBO MBQBS VEBSB ZBOH KVHB
EJTFCVUEJTQOFB NFOKBEJCFSBU
+JLB 1DP NFOJOHLBU TBNQBJ IJOHHB NN )H NBLB
PSBOH UFSTFCVU NFOKBEJ MFUBSHJ EBO LBEBOHLBEBOH CBILBO
TFUFOHBILPNB"OFTUFTJBEBOLFNBUJBOEBQBUUFSKBEJCJMB1DP
NFOJOHLBU TBNQBJ IJOHHB NN )H 1BEB LBEBS 1DP
ZBOH MFCJI UJOHHJ JOJ LFMFCJIBO LBSCPO EJPLTJEB TFLBSBOH
NVMBJ NFOFLBO QFSOBQBTBO EBSJQBEB NFSBOHTBOHOZB
TFIJOHHB NFOJNCVMLBO MJOHLBSBO TFUBO
LBSCPO EJPLTJEB
ZBOH MFCJI CBOZBL
TFMBOKVUOZB NFOVSVOLBO QFSOBQBTBO

LFNVEJBOMFCJICBOZBLMBHJUFSEBQBULBSCPOEJPLTJEB EBO
TFUFSVTOZB NFODBQBJ QVODBLOZB TFDBSB DFQBU QBEB LFNBUJBO
BLJCBUQFSOBQBTBO
Dispnea
%JTQOFB CFSBSUJ QFOEFSJUBBO NFOUBM ZBOH EJBLJCBULBO PMFI
LFUJEBLNBNQVBOWFOUJMBTJVOUVLNFNFOVIJLFCVUVIBOVEBSB
4JOPOJNZBOHTFSJOHEJQBLBJBEBMBIMBQBSVEBSB
522
Bab 42 Insufisiensi Pernapasan Patofisiologi, Diagnosis, Terapi Oksigen
CFCFSBQB NFTJO KVHB UFLBOBO OFHBUJG EBO NBTLFS ZBOH UFQBU NN )H TFMBNB MFCJI EBSJ CFCFSBQB NFOJU EBQBU
EJMFUBLLBO EJ BUBT NVLB QBTJFO BUBV TVBUV LPOFLUPS ZBOH NFOZFCBCLBO LFNBUJBO LBSFOB KVNMBI EBSBI WFOB ZBOH
NFOHIVCVOHLBO QFSBMBUBO LF QJQB FOEPUSBLFB "MBUBMBU JOJ LFNCBMJLFKBOUVOHUJEBLNFODVLVQJ
NFOEPSPOH VEBSB VOUVL NFNBTVLJ QBSV QBTJFO NFMBMVJ NBTLFS
UNIT VII
BUBV QJQB FOEPUSBLFB TFMBNB TJLMVT UFLBOBO QPTJUJG SFTVTJUBUPS Daftar Pustaka
UFSTFCVU EBO CJBTBOZB LFNVEJBO NFNCJBSLBO VEBSB NFOHBMJS Albert R, Spiro S, Jett J: Comprehensive Respiratory Medicine, Philadelphia,
TFDBSBQBTJGLFMVBSEBSJQBSVTFMBNBTJTBTJLMVT 2002, Mosby.
3FTVTJUBUPS UFSEBIVMV TFSJOH NFOZFCBCLBO LFSVTBLBO QBSV Barnes PJ: The cytokine network in asthma and chronic obstructive pulmo-
nary disease, J Clin Invest 118:3546, 2008.
BLJCBU UFLBOBO QPTJUJG ZBOH CFSMFCJIBO TFIJOHHB QFOHHVOBBOOZB Cardoso WV: Molecular regulation of lung development, Annu Rev Physiol
TVEBI EJMBSBOH 5FUBQJ SFTVTJUBUPS TFLBSBOH JOJ NFNQVOZBJ 63:471, 2001.
QFOFOUV CBUBT UFLBOBO QPTJUJG ZBOH VNVNOZB EJQBTBOH QBEB Casey KR, Cantillo KO, Brown LK: Sleep-related hypoventilation/hypoxemic
UFLBOBOTBNQBJDN)0VOUVLQBSVOPSNBM UFUBQJLBEBOH syndromes, Chest 131:1936, 2007.
LBEBOHKBVIMFCJICFTBSVOUVLQBSVZBOHUJEBLLPNQMJBOT
Eder W, Ege MJ, von Mutius E: The asthma epidemic, N Engl J Med 355:2226,
2006.
Tangki Respirator ("Iron-Lung"). (BNCBS#NFMVLJTLBOUBOHLJ Herzog EL, Brody AR, Colby TV, et al: Knowns and unknowns of the alveolus,
SFTQJSBUPSEFOHBOUVCVIQBTJFOEJEBMBNUBOHLJUFSTFCVUEBOLFQBMBOZB Proc Am Thorac Soc 5:778, 2008.
Knight DA, Holgate ST: The airway epithelium: structural and functional
NFOPOKPM LFMVBS NFMBMVJ TVBUV CBO MFIFS DPMMBS
ZBOH GMFLTJCFM UFUBQJ
properties in health and disease, Respirology 8:432, 2003.
LFEBQ VEBSB 1BEB VKVOH UBOHLJ CFSMBXBOBO EFOHBO LFQBMB QBTJFO McConnell AK, Romer LM: Dyspnoea in health and obstructive pulmonary
UFSEBQBUEJBGSBHNBLVMJUZBOHEJHFSBLLBOPMFINFTJO ZBOHCFSHFSBLNBKV disease: the role of respiratory muscle function and training, Sports Med
NVOEVS EFOHBO TJNQBOHBO ZBOH DVLVQ VOUVL NFOBJLLBO EBO 34:117, 2004.
NFOVSVOLBOUFLBOBOEJEBMBNUBOHLJ#JMBEJBGSBHNBLVMJUCFSHFSBLLF Mühlfeld C, Rothen-Rutishauser B, Blank F, et al: Interactions of nanoparti-
cles with pulmonary structures and cellular responses, Am J Physiol Lung
EBMBN UFLBOBO QPTJUJG UFSCFOUVL EJ TFLJUBS UVCVI EBO NFOZFCBCLBO
Cell Mol Physiol 294:L817, 2008.
FLTQJSBTJ EBO CJMB EJBGSBHNB CFSHFSBL LFMVBS UFLBOBO OFHBUJG Naureckas ET, Solway J: Clinical practice. Mild asthma, N Engl J Med
NFOZFCBCLBO JOTQJSBTJ ,BUVQ QFNFSJLTB QBEB SFTQJSBUPS NFOHBUVS 345:1257, 2001.
UFLBOBO QPTJUJG EBO OFHBUJG #JBTBOZB UFLBOBO JOJ EJTFTVBJLBO TFIJOHHB Ramanathan R: Optimal ventilatory strategies and surfactant to protect
UFLBOBOOFHBUJGZBOHNFOZFCBCLBOJOTQJSBTJUVSVONFOKBEJoTBNQBJo the preterm lungs, Neonatology 93:302, 2008.
Sharafkhaneh A, Hanania NA, Kim V: Pathogenesis of emphysema: from the
DN)0 EBOUFLBOBOQPTJUJGNFOJOHLBUNFOKBEJTBNQBJDN)
bench to the bedside, Proc Am Thorac Soc 5:475, 2008.
Pengaruh Resusitator dan Tangki Respirator terhadap Sin DD, McAlister FA, Man SF, et al: Contemporary management of chronic
Aliran Balik Vena (Venous Return). #JMB SFTVTJUBUPS obstructive pulmonary disease: scientific review, JAMA 290:2301,
2003.
NFOEPSPOH VEBSB LF EBMBN QBSV QBEB UFLBOBO QPTJUJG BUBV CJMB
Soni N, Williams P: Positive pressure ventilation: what is the real cost? Br J
UBOHLJ SFTQJSBUPS NFOHVSBOHJ UFLBOBO EJ TFLJUBS UVCVI QBTJFO Anaesth 101:446, 2008.
UFLBOBO EJ EBMBN QBSV NFOKBEJ MFCJI CFTBS EBSJQBEB UFLBOBO EJ Taraseviciene-Stewart L, Voelkel NF: Molecular pathogenesis of emphy-
NBOB QVO EBMBN UVCVI "MJSBO EBSBI EBSJ WFOBWFOB QFSJGFS LF sema, J Clin Invest 118:394, 2008.
EBMBNEBEBEBOKBOUVOHNFOKBEJUFSIBMBOH"LJCBUOZB QFNBLBJBO Whitsett JA, Weaver TE: Hydrophobic surfactant proteins in lung function
UFLBOBO ZBOH CFSMFCJIBO EFOHBO SFTVTJUBUPS NBVQVO UBOHLJ and disease, N Engl J Med 347:2141, 2002.
Wills-Karp M, Ewart SL: Time to draw breath: asthma-susceptibility genes
SFTQJSBUPS EBQBU NFOHVSBOHJ DVSBI KBOUVOH LBEBOHLBEBOH
are identified, Nat Rev Genet 5:376, 2004.
TBNQBJUJOHLBUZBOHNFNBUJLBO.JTBMOZB TFTFPSBOHZBOHUFSVT Wright JL, Cosio M, Churg A: Animal models of chronic obstructive pulmo-
NFOFSVTNFOHBMBNJUFLBOBOQPTJUJGEBMBNQBSVMFCJIEBSJ nary disease, Am J Physiol Lung Cell Mol Physiol 295:L1, 2008.
523
VIII
UNIT
'JTJPMPHJ1FOFSCBOHBO 3VBOH
"OHLBTB EBO1FOZFMBNBO-BVU%BMBN
43. Fisiologi Penerbangan, Tempat Tinggi
(High Altitude) dan Ruang Angkasa
44. Fisiologi Penyelaman Laut Dalam
dan Keadaan Hiperbarik Lainnya
BAB 43
UNIT VIII
'JTJPMPHJ1FOFSCBOHBO 5FNQBU5JOHHJ
)JHI"MUJUVEF
EBO3VBOH"OHLBTB
4FNBLJO UJOHHJ LFNBNQVBO NBOVTJB TFLJUBSNN)HBLJCBUQFOJOHLBUBOQFSOBQBTBO
VOUVL NFODBQBJ LFUJOHHJBO QBEB 4FLBSBOH NBSJ LJUB MJIBU CBHBJNBOB UFLBOBO LFEVB HBT
QFOFSCBOHBO QFOEBLJBO HVOVOH EBO UFSTFCVU NFNFOHBSVIJ PLTJHFO BMWFPMBS 4FCBHBJ DPOUPI
QFTBXBUMVBSBOHLBTB TFNBLJOQFOUJOH LBUBLBOMBI CBIXB UFLBOBO CBSPNFUFS UVSVO EBSJ OJMBJ OPSNBM
LJUB NFNBIBNJ FGFL LFUJOHHJBO EJ QFSNVLBBO MBVU TFCFTBS NN )H NFOKBEJ NN )H
UFNQBUEBOSFOEBIOZB ZBOH NFSVQBLBO OJMBJ ZBOH CJBTB UFSVLVS EJ 1VODBL (VOVOH
SFOEBIOZBUFLBOBOVEBSB UFSIBEBQUVCVINBOVTJB#BCJOJBLBO &WFSFTU QBEB LFUJOHHJBO LBLJ &NQBU QVMVI UVKVI NN
NFNCBIBT NBTBMBINBTBMBI UFSTFCVU EJ TBNQJOH GBLUPS )HEBSJOJMBJJOJUFOUVOZBVBQBJS EBOTJTBOZBIBOZBNN
QFSDFQBUBO LFBEBBO UBOQB CPCPU EBO UBOUBOHBO MBJO QBEB )H VOUVL TFMVSVI HBTHBT MBJO 1BEB TFTFPSBOH ZBOH
IPNFPTUBTJT UVCVI ZBOH UFSKBEJ EJ UFNQBU LFUJOHHJBO EBO UFSBLMJNBUJTBTJ NN EBSJ NN )H UFSTFCVU UFOUVOZB
QFOFSCBOHBOSVBOHBOHLBTB NFSVQBLBO LBSCPO EJPLTJEB EBO TJTBOZB IBOZB NN )H
+JLB UJEBL BEB PLTJHFO ZBOH EJHVOBLBO PMFI UVCVI TFQFSMJNB
Efek Tekanan Oksigen yang Rendah terhadap Tubuh EBSJ NN )H JOJ BLBO CFSVQB PLTJHFO EBO FNQBU
QFSMJNBOZB CFSVQB OJUSPHFO BUBV 1P EBMBN BMWFPMJ BLBO
NFOKBEJ NN )H /BNVO TFCBHJBO EBSJ PLTJHFO BMWFPMBS
Tekanan Barometer di Berbagai Ketinggian 5BCFM ZBOHUFSTJTBJOJBLBOEJBCTPSCTJLFEBMBNEBSBI NFOHIBTJMLBO
NFOVOKVLLBO OJMBJ QFSLJSBBO UFLBOBO CBSPNFUFS EBO UFLBOBO UFLBOBO PLTJHFO TFLJUBS NN )H EJ EBMBN BMWFPMJ 1BEB
PLTJHFO EJ CFSCBHBJ LFUJOHHJBO %BSJ TJUV UFSMJIBU CBIXB QBEB QVODBL (VOVOH &WFSFTU IBOZB PSBOHPSBOH ZBOH
LFUJOHHJBO QFSNVLBBO MBVU UFLBOBO CBSPNFUFS BEBMBI NN UFSBLMJNBUJTBTJ UFSCBJL TBKB ZBOH EBQBU CFSUBIBO IJEVQ TBBU
)H QBEB LFUJOHHJBO LBLJ IBOZB NN )H EBO QBEB NFOHIJSVQ VEBSB 5FUBQJ QFOHBSVI JOJ TBOHBU CFSCFEB CJMB
LBLJ NN )H 1FOVSVOBO UFLBOBO CBSPNFUFS JOJ TFTFPSBOH NFOHIJSVQ PLTJHFO NVSOJ TFQFSUJ ZBOH BLBO LJUB
NFSVQBLBO QFOZFCBC EBTBS TFNVB QFSTPBMBO IJQPLTJB QBEB MJIBUEJQFNCBIBTBOCFSJLVU
GJTJPMPHJ UFNQBUUJOHHJ LBSFOB TFJSJOH UFSKBEJOZB QFOVSVOBO
UFLBOBOCBSPNFUFSBLBOUFSKBEJKVHBQFOVSVOBOUFLBOBOQBSTJBM Po2 Alveolar di Berbagai Ketinggian.,PMPNLFMJNBQBEB
PLTJHFO 1P
TFDBSB QSPQPSTJPOBM TFIJOHHB UFLBOBO PLTJHFO 5BCFMNFNQFSMJIBULBOOJMBJQFSLJSBBO1P EJBMWFPMJQBEB
TFMBMVUFUBQEBSJXBLUVLFXBLUV ZBJUVTFEJLJUOZBQFSTFOEBSJ CFSCBHBJ LFUJOHHJBO CJMB TFTFPSBOH NFOHIJSVQ VEBSB CJBTB
UFLBOBO CBSPNFUFS UPUBM QBEB LFUJOHHJBO QFSNVLBBO MBVU 1P EBMBN LFBEBBO UFSBLMJNBUJTBTJ EBO UJEBL UFSBLMJNBUJTBTJ 1BEB
CFSOJMBJ TFLJUBS NN )H UFUBQJ QBEB LFUJOHHJBO LBLJ LFUJOHHJBO QFSNVLBBO MBVU 1P BMWFPMBS BEBMBI NN )H
1PIBOZBNN)H QBEB LFUJOHHJBO LBLJ UFLBOBO JOJ NFOVSVO TBNQBJ
TFLJUBSNN)HQBEBPSBOHZBOHUJEBLUFSBLMJNBUJTBTJ UFUBQJ
Po2 Alveolar di Berbagai Ketinggian IBOZB TBNQBJ NN )H QBEB PSBOH ZBOH UFSBLMJNBUJTBTJ
1FSCFEBBO LFEVB IBM JOJ BEBMBI CBIXB WFOUJMBTJ BMWFPMBS
Karbon Dioksida dan Uap Air Menurunkan Oksigen NFOJOHLBU TFLJUBS MJNB LBMJ MJQBU QBEB PSBOH ZBOH
"MWFPMBS%JUFNQBUUJOHHJQVOLBSCPOEJPLTJEBUFSVTNFOFSVT UFSBLMJNBUJTBTJ TFQFSUJZBOHBLBOLJUBCBIBTLFNVEJBO
EJFLTLSFTJEBSJEBSBIQBSVLFBMWFPMJ%FNJLJBOQVMBEFOHBOBJS
ZBOH NFOHVBQ LF EBMBN VEBSB JOTQJSBTJ EBSJ QFSNVLBBO BMBU Saturasi Hemoglobin oleh Oksigen di Berbagai Ke-
QFSOBQBTBO,FEVBHBTJOJBLBONFOHFODFSLBOPLTJHFOEJEBMBN tinggian.(BNCBSNFNQFSMJIBULBOTBUVSBTJPLTJHFOEBSBI
BMWFPMJ TFIJOHHBNFOVSVOLBOLBEBSPLTJHFO5FLBOBOVBQBJSEJ EJ BSUFSJ QBEB CFSCBHBJ LFUJOHHJBO CJMB NFOHIJSVQ VEBSB CJBTB
EBMBNBMWFPMJUFUBQQBEBNN)HTFMBNBTVIVUVCVIOPSNBM EBO CJMB NFOHIJSVQ PLTJHFO 4BNQBJ LFUJOHHJBO LJSBLJSB
UJEBLCFSHBOUVOHQBEBLFUJOHHJBO LBLJ XBMBVQVO ZBOH EJIJSVQ BEBMBI VEBSB CJBTB
TBUVSBTJ PLTJHFO BSUFSJ TFUJEBLOZB NBTJI UFUBQ TFUJOHHJ
-BJOIBMOZBEFOHBOLBSCPOEJPLTJEB TFMBNBCFSBEBEJUFNQBU QFSTFO%JBUBTLBLJ TBUVSBTJPLTJHFOBSUFSJUVSVOTFDBSB
ZBOHTBOHBUUJOHHJ 1DPBMWFPMBSUVSVOEBSJNN)H OJMBJEJ QSPHSFTJG TFQFSUJZBOHEJQFSMJIBULBOPMFILVSWBEJTFCFMBILJSJ
QFSNVLBBO MBVU
LF OJMBJ MFCJI SFOEBI 1BEB TFTFPSBOH ZBOH QBEB HBNCBS TFIJOHHB TBUVSBTJOZB IBOZB QFSTFO QBEB
UFSBLMJNBUJTBTJ ZBOH WFOUJMBTJOZB NFOJOHLBU TBNQBJ MJNB LBMJ LFUJOHHJBOLBLJEBOTBOHBUCFSLVSBOHQBEBUFNQBUZBOH
MJQBU UFSKBEJQFOVSVOBO1DP MFCJIUJOHHJ
527
Unit Vlll Fisiologi Penerbangan, Ruang Angkasa, dan Penyetaman Laut Dalam
Tabel 43-1 Pengaruh Pajanan Akut Tekanan Atmosfer Rendah pada Kadar Gas Alveolar dan Saturasi Oksigen Arteri*
Breathing Air Menghirup Oksigen Murni

Ketinggian tekanan PO2 di PO2 di PO2 di PCO2 di PO2di Saturasi
/meter.. Barometer Udara Alveoli Alveoli Alveoli Alveoli Oksigen
(mm Hg) (mm Hg) (mm Hg) (mm Hg) (mm Hg) (mm Hg) Arteri
(%) (%)
0 760 159 40 (40) 104 (104) 97 (97) 40 673 100

10,000/3048 523 110 36 (23) 67 (77) 90 (92) 40 436 100
20,000/6096 349 73 24 (10) 40 (53) 73 (85) 40 262 100
30,000/9144 226 47 24 (7) 18 (30) 24 (38) 40 139 99
40,000/12,192 141 29 36 58 84
50,000/15,240 87 18 24 16 15
/PNPSEJEBMBNLVSVOHBEBMBIOJMBJUFSLMJNBUJTBTJ
4FCBHBJ DPOUPI TBUVSBTJ BSUFSJ QBEB LFUJOHHJBO LBLJ CJMB

TFTFPSBOH NFOHIJSVQ PLTJHFO LJSBLJSB QFSTFO EBO JOJ TBNB
100
EFOHBOLFKFOVIBOPLTJHFOBSUFSJQBEBLFUJOHHJBOLBLJCJMB
TFTFPSBOH NFOHIJSVQ VEBSB CJBTB 4FMBJO JUV LBSFOB TFTFPSBOH
90
ZBOH UJEBL UFSBLMJNBUJTBTJ CJBTBOZB EBQBU UFUBQ TBEBS TBNQBJ
LFKFOVIBO PLTJHFO BSUFSJ UVSVO IJOHHB QFSTFO EBMBN XBLUV
80
ZBOHTJOHLBU QMBGPOCBHJQFOFSCBOHZBOHNFOHFNVEJLBOQFTBXBU
UBOQBBMBUQFOHBUVSUFLBOBOCJMBNFOHIJSVQVEBSBCJBTBLJSBLJSB
70
BEBMBI LBLJ TFEBOHLBO CJMB NFOHIJSVQ PLTJHFO NVSOJ
LJSBLJSB LBLJ BTBMLBO BMBU QFOZVQMBJ PLTJHFO CFSKBMBO
60
EFOHBOCBJL
50 &GFL"LVU)JQPLTJB
0 10 20 30 40 50
#FCFSBQB FGFL BLVU QFOUJOH IJQPLTJB QBEB PSBOH ZBOH
CFMVN UFSBLMJNBUJTBTJ TBBU NFOHIJSVQ VEBSB CJBTB NVMBJ EBSJ
LFUJOHHJBOLBLJJBMBINFOHBOUVL NBMBT LFMFMBIBONFOUBM
EBO PUPU LBEBOH TBLJU LFQBMB NVBM EBO FVGPSJB 4FNVB FGFL JOJ
CFSLFNCBOH QSPHSFTJG JOFOKBEJ UBIBQ LFEVUBO UXJUDIJOH
BUBV
Efek Menghirup Oksigen Murni terhadap Po2 Alveolar di LFKBOHEJBUBTLFUJOHHJBOLBLJEBOBLIJSOZB EJBUBT
Berbagai Ketinggian LBLJ CFSBLIJS EFOHBO LPNB QBEB PSBOH ZBOH CFMXO
#JMB TFTFPSBOH NFOHIJSVQ PLTJHFO NVSOJ TFCBHBJ QFOHHBOUJ UFSBLMJNBUJTBTJ ZBOHTFHFSBEJJLVUJPMFILFNBUJBO
VEBSB CJBTB NBLB TFCBHJBO CFTBS SVBOHBO EJ BMWFPMJ ZBOH
4BMBI TBUV FGFL VUBNB EBSJ IJQPLTJB JBMBI NFOVSVOOZB
TFCFMVNOZB UFSJTJ PMFI OJUSPHFO TFLBSBOH NFOKBEJ UFSJTJ PMFI
LFDBLBQBO NFOUBM ZBOH BLBO NFOVSVOLBO LFNBNQVBO EBMBN
PLTJHFO1BEBLFUJOHHJBOLBLJTFPSBOHQFOFSCBOHEBQBU
NFOHBNCJM LFQVUVTBO NFOHJOHBU EBO NFMBLVLBO HFSBLBO
NFNQVOZBJ1P TFCFTBSNN)H CVLBONN)HTFQFSUJ
NPUPSJL UFSBNQJM 4FCBHBJ DPOUPI KJLB TFPSBOH QFOFSCBOH ZBOH
LFUJLB NFOHIJSVQ VEBSB CJBTB MJIBU 5BCFM

CFMVNUFSBLMJNBUJTBTJCFSBEBQBEBLFUJOHHJBOLBLJTFMBNB
,VSWB LFEVB QBEB (BNCBS NFNQFSMJIBULBO TBUVSBTJ
KBN LFNBNQVBO NFOUBM CJBTBOZB UVSVO NFOKBEJ QFSTFO EBSJ
PLTJHFOIFNPHMPCJOEBSBIBSUFSJQBEBCFSCBHBJLFUJOHHJBOCJMB
OPSNBM EBOTFUFMBIKBNUVSVONFOKBEJQFSTFOEBSJOPSNBM
TFTFPSBOH NFOHIJSVQ PLTJHFO NVSOJ 1FSIBUJLBO CBIXB
TBUVSBTJ UFUBQ EJ BUBT QFSTFO TBNQBJ QFOFSCBOH OBJL LJSB .
LJSB LBLJ LFNVEJBO NFOVSVO EFOHBO DFQBU TBNQBJ
4FTFPSBOH ZBOH UJOHHBM EJ UFNQBU UJOHHJ TFMBNB CFCFSBQB IBSJ
LJSBLJSBQFSTFOQBEBLFUJOHHJBOLBLJ
NJOHHV BUBV UBIVO NFOKBEJ TFNBLJO UFSBLMJNBUJTBTJ UFSIBEBQ
"Plafon" yang Dicapai Ketika Menghirup Udara Biasa 1P ZBOH SFOEBI TFIJOHHB FGFL CVSVLOZB UFSIBEBQ UVCVI NBLJO
dan Oksigen dalam Pesawat Tanpa Alat Pengatur MBNB NBLJO CFSLVSBOH EBO NFNVOHLJOLBO PSBOH UFSTFCVU
Tekanan CFLFSKB MFCJI CFSBU UBOQB NFOHBMBNJ FGFL IJQPLTJB BUBV VOUVL
OBJLLFUFNQBUZBOHMFCJIUJOHHJ
+JLB LJUB NFNCBOEJOHLBO LFEVB LVSWB TBUVSBTJ PLTJHFO BSUFSJ
QBEB (BNCBS LJUB NFMJIBU CBIXB QFOFSCBOH ZBOH 1SJOTJQQSJOTJQ VUBNB ZBOH UFSKBEJ QBEB BLMJNBUJTBTJ JBMBI

NFOHIJSVQ PLTJHFO NVSOJ EBMBN QFTBXBU UBOQB BMBU QFOHBUVS QFOJOHLBUBO WFOUJMBTJ QBSV ZBOH DVLVQ CFTBS
QFOJOHLBUBO
UFLBOBOEBQBUOBJLKBVIMFCJIUJOHHJEJCBOEJOHQFOFSCBOHZBOH KVNMBI TFM EBSBI NFSBI
QFOJOHLBUBO LBQBTJUBT EJGVTJ QBSV
NFOHIJSVQVEBSBCJBTB
QFOJOHLBUBOWBTLVMBSJTBTJKBSJOHBOQFSJGFS EBO
528
Bab 43 Fisiologi Penerbangan, Tempat Tinggi (High Altitude), dan Ruang Angkasa

QFOJOHLBUBOLFNBNQVBOTFMEBMBNNFOHHVOBLBOPLTJHFO Peningkatan Kapasitas Difusi Setelah Aklimatisasi.
TFLBMJQVOOJMBJ1P SFOEBI ,BQBTJUBTEJGVTJOPSNBMVOUVLPLTJHFOLFUJLBNFMBMVJNFNCSBO
QBSV LJSBLJSB NMNN )H NFOJU EBO LBQBTJUBT EJGVTJ JOJ
UNIT VIII
Peningkatan Ventilasi Paru—Peran Kemoreseptor Arteri. EBQBU NFOJOHLBU TFCBOZBL UJHB LBMJ MJQBU TFMBNB PMBISBHB
1BKBOBO 1P SFOEBI TFDBSB NFOEBEBL BLBO NFSBOHTBOH 1FOJOHLBUBOLBQBTJUBTEJGVTJZBOHTFSVQBKVHBUFSKBEJEJUFNQBU
LFNPSFTFQUPS BSUFSJ TFIJOHHB LFNPSFTFQUPS UFSTFCVU BLBO UJOHHJ
NFOJOHLBULBOWFOUJMBTJBMWFPMBSNFOKBEJNBLTJNBMTFLJUBS LBMJ 4FCBHJBO EBSJ QFOJOHLBUBO JOJ EJTFCBCLBO PMFI QFOJOHLBUBO
EJ BUBT OPSNBM +BEJ LPNQFOTBTJ UFSKBEJ TFHFSB EBMBN IJUVOHBO WPMVNF EBSBI LBQJMFS QBSV ZBOH NFOZFCBCLBO UFSKBEJOZB
EFUJLLFUJLBOBJLLFUFNQBUUJOHHJ EBOEFOHBOJOJTBKBPSBOHEBQBU QFMFCBSBO LBQJMFS EBO QFOJOHLBUBO MVBT EBFSBI QFSNVLBBO
OBJL CFCFSBQB SJCV LBLJ MFCJI UJOHHJ EJCBOEJOH NFMBLVLBOOZB UFNQBU PLTJHFO CFSEJGVTJ LF EBMBN EBSBI 4FCBHJBO MBHJ
UBOQB QFOJOHLBUBO WFOUJMBTJ #JMB PSBOH JUV LFNVEJBO UJOHHBM EJ EJTFCBCLBO PMFI QFOJOHLBUBO WPMVNF VEBSB QBSV ZBOH
UFNQBU ZBOH TBOHBU UJOHHJ TFMBNB CFCFSBQB IBSJ LFNPSFTFQUPS NFOHBLJCBULBO BOUBSNVLB JOUFSGBDF
LBQJMFSBMWFPMVT MFCJI
NBTJI NFOJOHLBULBO WFOUJMBTJ TBNQBJ OBJL NFOKBEJ MJNB LBMJ NFMVBTMBHJ#BHJBOUFSBLIJSZBOHNFOZPLPOHJBMBIQFOJOHLBUBO
OPSNBM UFLBOBO EBSBI BSUFSJ QBSV UFOBHB JOJ BLBO NFOEPSPOH EBSBI
,FOBJLBOWFOUJMBTJQBSVZBOHNFOEBEBLQBEBTBBULJUBOBJLLF VOUVL NFMBMVJ MFCJI CBOZBL LBQJMFS BMWFPMVT EBSJQBEB EBMBN
UFNQBU UJOHHJ BLBO NFOHIJMBOHLBO TFKVNMBI CFTBS LBSCPO LFBEBBO OPSNBM UFSVUBNB CBHJBO BUBT QBSV ZBOH QBEB LFBEBBO
EJPLTJEB TFIJOHHB 1DP UVSVO EBO NFOJOHLBULBO Q) DBJSBO CJBTBQFSGVTJOZBCVSVL
UVCVI4FNVBQFSVCBIBOJUVBLBONFOHIBNCBUQVTBUQFSOBQBTBO Perubahan Sistem Sirkulasi Perifer Selama Aklimatisasi
CBUBOH PUBL EBO EFOHBO EFNJLJBO NFMBXBO FGFL 1P ZBOH SFOEBI —Peningkatan Kapilaritas Jaringan. 4FHFSB TFUFMBI
VOUVL NFSBOHTBOH QFSOBQBTBO NFOHHVOBLBO LFNPSFTFQUPS NFODBQBJ TVBUV UFNQBU UJOHHJ DVSBI KBOUVOH TFSJOH LBMJ
QFSOBQBTBO QFSJGFS EJ CBEBO LBSPUJE EBO CBEBO BPSUJL /BNVO NFOJOHLBU TBNQBJ QFSTFO UFUBQJ LFNVEJBO UVSVO LFNCBMJ
FGFLIBNCBUBOJOJQFSMBIBOMBIBOIJMBOHEBMBNXBLUVEVBTBNQBJ NFOKBEJ OPSNBM EBMBN IJUVOHBO NJOHHV TFJSJOH UFSKBEJOZB
MJNB IBSJ TFIJOHHB QVTBU QFSOBQBTBO EBQBU NFOHBEBLBO SFTQPOT QFOJOHLBUBO IFNBUPLSJU EBSBI KBEJ KVNMBI PLTJHFO ZBOH
NBLTJNBM UFSIBEBQ SBOHTBOHBO LFNPSFTFQUPS QFSJGFS TFCBHBJ EJBOHLVULFKBSJOHBOUVCVIQFSJGFSUFUBQEBMBNLJTBSBOOPSNBM
BLJCBU EBSJ IJQPLTJB EBO WFOUJMBTJ NFOJOHLBU TFLJUBS MJNB LBMJ "EBQUBTJ TJSLVMBTJ MBJO JBMBI QFOJOHLBUBO KVNMBI
OPSNBM QFSUVNCVIBO LBQJMFS TJSLVMBTJ TJTUFNJL EJ KBSJOHBO OPOQBSV
1FOZFCBC IJMBOHOZB IBNCBUBO JOJ EJQFSDBZB UFSKBEJ UFSVUBNB ZBOH EJTFCVU TFCBHBJ QFOJOHLBUBO LBQJMBSJUBT KBSJOHBO BUBV
LBSFOB BEBOZB QFOVSVOBO LBEBS JPO CJLBSCPOBU EBMBN DBJSBO BOHJPHFOFTJT
)BM JOJ UFSVUBNB UFSKBEJ QBEB CJOBUBOH ZBOH MBIJS
TFSFCSPTQJOBM TFCBHBJNBOB EBMBN KBSJOHBO PUBL 1FSVCBIBO EBOEJCJBLLBOEJUFNQBUUJOHHJ EBOLVSBOHOZBUBFGFLOZBQBEB
QFSVCBIBO UFSTFCVU BLBO NFOVSVOLBO Q) DBJSBO EJ TFLFMJMJOH CJOBUBOH ZBOH CBSV CFSBEB EJ UFNQBU UJOHHJ TFUFMBI VNVSOZB
OFVSPO LFNPTFOTJUJG EJ QVTBU QFSOBQBTBO EFOHBO EFNJLJBO BLBO DVLVQUVB
NFOJOHLBULBO BLUJWJUBT QVTBU UFSTFCVU EBMBN NFOTUJNVMBTJ
QFSOBQBTBO 1FOJOHLBUBO LBQJMBSJUBT BLBO UFSMJIBU TBOHBU OZBUB QBEB
KBSJOHBOKBSJOHBO BLUJG ZBOH UFSQBKBO IJQPLTJB LSPOJT 4FCBHBJ
.FLBOJTNF QFOUJOH QFOVSVOBO CFSLBMB LPOTFOUSBTJ DPOUPI LFQBEBUBO LBQJMFS EBMBN PUPU WFOUSJLFM LBOBO
CJLBSCPOBU NFSVQBLBO LPNQFOTBTJ HJOKBM UFSIBEBQ BMLBMPTJT NFOJOHLBU TFDBSB CFSNBLOB BLJCBU IJQPLTJB EBO CFCBO LFSKB
SFTQJSBUPSJL TFQFSUJ ZBOH UFMBI EJCBIBT EJ #BC (JOKBM ZBOH CFSBU ZBOH EJTFCBCLBO PMFI IJQFSUFOTJ QVMNPOBM QBEB
NFNCFSJLBO SFTQPOT UFSIBEBQ QFOVSVOBO 1DP EFOHBO DBSB LFUJOHHJBO
NFOVSVOLBO TFLSFTJ JPO IJESPHFO EBO NFOJOHLBULBO FLTLSFTJ
CJLBSCPOBU ,PNQFOTBTJ NFUBCPMJL VOUVL BMLBMPTJT SFTQJSBUPSJL
Aklimatisasi Sel.1BEBCJOBUBOHZBOHTFDBSBBMBNJIJEVQEJ
LFUJOHHJBO TBNQBJ LBLJ TJTUFN NJUPLPOESJB TFM
JOJ TFDBSB CFSUBIBQ NFOVSVOLBO LPOTFOUSBTJ CJLBSCPOBU EBMBN
EBO FO[JN PLTJEBUJG TFM TFEJLJU MFCJI CBOZBL EBSJQBEB CJOBUBOH
DBJSBO QMBTNB EBO TFSFCSPTQJOBM EBO NFOVSVOLBO Q) LF BSBI
ZBOH NFOHIVOJ EBFSBI TFUJOHHJ QFSNVLBBO MBVU 0MFI LBSFOB
OPSNBM TFSUB NFNCVBOH FGFL JOIJCJTJ QFSOBQBTBO BLJCBU
JUV EJEVHB TFMTFM KBSJOHBO PSBOH ZBOH UFSBLMJNBUJTBTJ PMFI
LPOTFOUSBTJ IJESPHFO ZBOH SFOEBI +BEJ QVTBU QFSOBQBTBO KBVI
LFUJOHHJBO KVHB EBQBU NFOHHVOBLBO PLTJHFO MFCJI FGFLUJG
MFCJI SFTQPOTJG UFSIBEBQ TUJNVMVT LFNPSFTFQUPS QFSJGFS BLJCBU
EJCBOEJOHLBO TFTBNBOZB ZBOH UJOHHBM EJ UFNQBU TFUJOHHJ
IJQPLTJBTFUFMBIHJOKBMNFMBLVLBOLPNQFOTBTJUFSIBEBQBMLBMPTJT
QFSNVLBBOMBVU
Peningkatan Jumlah Sel Darah Merah dan Konsentrasi
Aklimatisasi Alami pada Penduduk Asli yang Hidup di
Hemoglobin selama Aklimatisasi 4FQFSUJ EJCBIBT EJ #BC
Tempat Tinggi
IJQPLTJB NFSVQBLBO SBOHTBOHBO VUBNB ZBOH NFOZFCBCLBO
QFOJOHLBUBO QSPEVLTJ TFM EBSBI NFSBI #JBTBOZB LFUJLB PSBOH #BOZBL QFOEVEVL BTMJ EJ QFSHVOVOHBO "OEFT EBO )JNBMBZB
UFUBQ UFSQBKBO PMFI LBEBS PLTJHFO SFOEBI TFMBNB CFSNJOHHV IJEVQQBEBLFUJOHHJBOEJBUBTLBLJTBUVLFMPNQPLPSBOH
NJOHHV IFNBUPLSJU EBQBU NFOJOHLBU QFSMBIBOMBIBO EBSJ OJMBJ ZBOHUJOHHBMEJ"OEFT 1FSVCBILBOIJEVQEJLFUJOHHJBO
OPSNBM ZBOH CFSLJTBS TBNQBJ NFOKBEJ SBUBSBUB EBO JOJ LBLJ EBO CFLFSKB EJ QFSUBNCBOHBO EFOHBO LFUJOHHJBO
TFTVBJEFOHBOQFOJOHLBUBOLBEBSIFNPHMPCJOEBSJOJMBJOPSNBM LBLJ#BOZBLEBSJQFOEVEVLBTMJUFSTFCVUMBIJSEJLFUJOHHJBOJUV
HEMNFOKBEJHEM EBO UJOHHBM EJ TBOB TFQBOKBOH IJEVQOZB 1BEB TFNVB BTQFL
4FMBJOJUV WPMVNFEBSBIKVHBCFSUBNCBI TFSJOHLBMJNFOJOHLBU BLMJNBUJTBTJ QFOEVEVL BTMJ JOJ MFCJI TVQFSJPS EJCBOEJOHLBO
TBNQBJ QFSTFO EBO QFOJOHLBUBO JOJ EJLBMJ EFOHBO EFOHBO QFOEVEVL EBSJ UFNQBU SFOEBI EFOHBO BLMJNBUJTBTJ
QFOJOHLBUBO LPOTFOUSBTJ IFNPHMPCJO EBSBI NFOHIBTJMLBO UFSCBJL XBMBVQVOQFOEVEVLEBSJUFNQBUSFOEBIJUVUFMBIIJEVQ
QFOJOHLBUBOUPUBMIFNPHMPCJOUVCVINFOKBEJQFSTFOBUBVMFCJI EJUFNQBUUJOHHJTFMBNBUBIVOBUBVMFCJI
529
Unit VIII Fisiologi Penerbangaan, Ruang Angkasa, dan Penyelaman Laut Dalam
,BQBTJUBTLFSKB QFSTFOEBSJ
28 OPSNBM
26 (15,000 ) 5JEBLUFSBLMJNBUJTBTJ 50
24
22
( ) 5FSBLMJNBUJTBTJTFMBNBCVMBO 68
X 1FOEVEVLBTMJZBOHIJEVQEJLFUJOHHJBO
20 X 87
18 LBLJOBNVOCFLFSKBEJLFUJOHHJBOLBLJ
X
16 X
14
( ) 6OUVL NFNCFSJ HBNCBSBO UFOUBOH QFOUJOHOZB BLMJNBUJTBTJ
12 EBMBN NFOJOHLBULBO LBQBTJUBT LFSKB QFSIBUJLBO BEBOZB
10
8
QFSCFEBBOCFTBSEBMBNLBQBTJUBTLFSKBTFCBHBJQFSTFOEBSJOPSNBM
6 VOUVL PSBOHPSBOH ZBOH UJEBL UFSBLMJNBUJTBTJ EBO UFSBLMJNBUJTBTJ
4 QBEBLFUJOHHJBOLBLJ
2
0 +BEJ QFOEVEVL BTMJ ZBOH UFSBLMJNBUJTBTJ TFDBSB BMBNJ TFIBSJ
0 20 40 60 80 100 120 140 IBSJ EBQBU CFLFSKB EJ UFNQBU UJOHHJ IBNQJS TBNB TFQFSUJ PSBOH
OPSNBM ZBOH UJOHHBM EJ UFNQBU TFUJOHHJ QFSNVLBBO MBVU UFUBQJ
QFOEVEVL EBSJ UFNQBU SFOEBI ZBOH LFNVEJBO UFSBLMJNBUJTBTJ
EFOHBO CBJL IBNQJS UJEBL QFSOBI NFODBQBJ IBTJM TFCBJL
QFOEVEVLBTMJJUVEBMBNCFLFSKB
Mountain Sickness Akut dan Edema Paru Akut pada
Ketinggian Tempat
4FKVNMBI LFDJM PSBOH ZBOH OBJL TFDBSB DFQBU LF UFNQBU UJOHHJ
NFOKBEJ TBLJU TFDBSB BLVU EBO EBQBU NFOJOHHBM KJLB UJEBL
1SPTFT BLMJNBUJTBTJ QBEB QFOEVEVL BTMJ UFSTFCVU UFMBI EJNVMBJ EJCFSJLBO PLTJHFO BUBV EJQJOEBILBO LF UFNQBU SFOEBI
TFNFOKBL NBTB CBZJ 6LVSBO EBEBOZB UFSVUBNB TBOHBU .VODVMOZB TBLJU UFSTFCVU CFSBXBM TFKBL CFCFSBQB KBN TBNQBJ
NFNCFTBS TFEBOHLBO VLVSBO UVCVIOZB BHBL NFOHFDJM TFLJUBSIBSJTFUFMBIOBJL"EBEVBIBMZBOHUFSKBEJ
TFIJOHHBSBTJPLBQBTJUBTWFOUJMBTJUFSIBEBNBTTBUVCVINFOKBEJ
1. &EFNBTFSFCSJBLVU)BMJOJEJQFSDBZBUFSKBEJLBSFOBQFNCVMVI
UJOHHJ 4FMBJO JUV KBOUVOHOZB ZBOH TFNFOKBL MBIJS TBNQBJ
EBSBI PUBL NFOHBMBNJ WBTPEJMBUBTJ MPLBM BLJCBU IJQPLTJB
EFXBTB TVEBI NFNPNQB DVSBI KBOUVOH EBMBN KVNMBI FLTUSB
%JMBUBTJ BSUFSJPMBSUFSJPM BLBO NFOJOHLBULBO BMJSBO EBSBI
UFSOZBUB MFCJI CFTBS EBSJQBEB KBOUVOH PSBOH ZBOH UJOHHBM EJ
NFOVKVLBQJMFS TFIJOHHBNFOJOHLBULBOUFLBOBOLBQJMFS ZBOH
UFNQBUSFOEBI
QBEB HJMJSBOOZB NFOZFCBCLBO QFSFNCFTBO DBJSBO LF KBSJOHBO
1FOHBOHLVUBO PLTJHFO PMFI EBSBI LF KBSJOHBO KVHB KBVI PUBL &EFNB TFSFCSJ LFNVEJBO EBQBU NFOJNCVMLBO
MFCJINVEBIQBEBQFOEVEVLBTMJJOJ4FCBHBJDPOUPI (BNCBS EJTPSJFOUBTJCFSBUEBOFGFLFGFLMBJOZBOHCFSIVCVOHBOEFOHBO
NFNQFSMJIBULBOLVSWBEJTPTJBTJPLTJHFOIFNPHMPCJOQBEB EJTGVOHTJPUBL
QFOEVEVLBTMJZBOHUJOHHBMEJUFNQBUTFUJOHHJQFSNVLBBOMBVU 2. &EFNB QBSV BLVU 1FOZFCBC UFSKBEJOZB IBM JOJ CFMVN
EBO QFOEVEVL BTMJ TFTBNBOZB ZBOH UJOHHBM QBEB LFUJOHHJBO EJLFUBIVJ OBNVO TBUV QFOKFMBTBOOZB BEBMBI TFCBHBJ CFSJLVU
LBLJ 1FSIBUJLBOIBI CBIXB 1P PLTJHFO BSUFSJ QBEB )JQPLTJBCFSBUNFOZFCBCLBOBSUFSJPMBSUFSJPMQBSVNFOHBMBNJ
QFOEVEVLBTMJZBOHUJOHHBMEJUFNQBUUJOHHJIBOZBNN)H LPOTUSJLTJ LVBU OBNVO LPOTUSJLTJ UFSTFCVU MFCJI LVBU UFSKBEJ
UFUBQJ LBSFOB KVNMBI IFNPHMPCJOOZB MFCJI CBOZBL NBLB EJ CFCFSBQB CBHJBO QBSV EJCBOEJOHLBO CBHJBO MBJO )BM
KVNMBI PLTJHFO EBMBN EBSBI BSUFSJ QFOEVEVL BTMJ UFSTFCVU UFSTFCVU NFOHBLJCBULBO TFNBLJO CBOZBL BMJSBO EBSBI
NFOKBEJ MFCJI CBOZBL EJCBOEJOHLBO PLTJHFO EBMBN EBSBI QVMNPOBM EJQBLTB NBTVL LF QFNCVMVI EBSBI QVMNPOBM ZBOH
QFOEVEVL BTMJ ZBOH UJOHHBM EJ UFNQBU SFOEBI 1FSIBUJLBO KVHB CFMVN CFSLPOTUSJLTJ ZBOH KVNMBIOZB TFNBLJO TFEJLJU
CBIXB1PWFOBQBEBQFOEVEVLBTMJEJUFNQBUUJOHHJIBOZB ,FTJNQVMBO QPTUVMBU UFSTFCVU BEBMBI UFLBOBO LBQJMFS EJ
NN )H MFCJI SFOEBI EBSJQBEB 1P WFOB QBEB QFOEVEVL EJ EBFSBI QBSV UFSTFCVU BLBO NFOKBEJ TBOHBU UJOHHJ TFIJOHHB
UFNQBU SFOEBI 4FLBMJQVO 1P; BSUFSJOZB TBOHBU SFOEBI JOJ UJNCVMFEFNBMPLBM1FSMVBTBOQSPTFTUFSTFCVUTFDBSBQSPHSFTJG
NFOVOKVLLBO CBIXB QFOHBOHLVUBO PLTJHFO LF KBSJOHBO LF EBFSBI QBSV MBJO NFOHBLJCBULBO QFOZFCBSBO FEFNB QBSV
TBOHBUMBI FGFLUJG QBEB QFOEVEVL BTMJ ZBOH UJOHHBM EJ UFNQBU EBOEJTGVOHTJQBSVCFSBUZBOHNFNBUJLBO1FNCFSJBOPLTJHFO
UJOHHJZBOHUFSBLMJNBUJTBTJTFDBSBBMBNJ VOUVL CFSOBQBT QBEB PSBOH UFSTFCVU CJBTBOZB NFNCBMJLLBO
Penurunan Kapasitas Kerja di Tempat Tinggi dan Efek QSPTFTUFSTFCVUEBMBNIJUVOHBOKBN
Positif Aklimatisasi Mountain Sickness Kronis
,BEBOH PSBOH ZBOH CFSEJBN UFSMBMV MBNB EJ UFNQBU UJOHHJ EBQBU
4FMBJO EFQSFTJ NFOUBM ZBOH EJTFCBCLBO PMFI IJQPLTJB TFQFSUJ
NFOEFSJUBNPVOUBJOTJDLOFTTLSPOJT EFOHBOHFKBMBHFKBMBTFCBHBJ
ZBOH UFMBI EJVSBJLBO TFCFMVNOZB LBQBTJUBT LFSKB TFNVB PUPU
CFSJLVU
TFM EBSBI NFSBI EBO IFNBUPLSJU NFOJOHLBU UJOHHJ
KVHB UFSOZBUB TBOHBU NFOVSVO QBEB IJQPLTJB #VLBO IBOZB
TFLBMJ
UFLBOBOBSUFSJQVMNPOBMJTNFOJOHLBU CBILBONFMFCJIJ
NFNFOHBSVIJPUPUSBOHLBUFUBQJKVHBPUPUKBOUVOH
QFOJOHLBUBO OPSNBM ZBOH UFSKBEJ TFMBNB BLMJNBUJTBTJ
KBOUVOH
4FDBSBVNVN EBQBUEJLBUBLBOCBIXBLBQBTJUBTLFSKBUVSVO TJTJ LBOBO TBOHBU NFNCFTBS
UFLBOBO BSUFSJ QFSJGFS NFOVSVO
TFCBOEJOH EFOHBO BNCJMBO PLTJHFO NBLTJNBM ZBOH EBQBU
UFSKBEJHBHBMKBOUVOHLPOHFTUJGEBO
LFNBUJBOTFSJOHUFSKBEJ
EJDBQBJPMFIUVCVI LFDVBMJKJLBQBTJFOEJQJOEBILBOLFUFNQBUZBOHMFCJISFOEBI
530
1FOZFCBCQFSJTUJXBQFSJTUJXBUFSTFCVUNVOHLJOLBSFOBUJHBIBM Efek Gaya Percepatan Sentrifugal terhadap Tubuh—(G

ZBJUV 1FSUBNB NBTTB TFM EBSBI NFSBI NFOKBEJ UFSMBMV CFTBS Positif)
TFIJOHHB WJTLPTJUBT EBSBI NFOJOHLBU CFCFSBQB LBMJ MJQBU Efek terhadap Sistem Sirkulasi. &GFL QBMJOH QFOUJOH
UNIT VIII
QFOJOHLBUBOWJTLPTJUBTEBSBIJOJBLBONFOVSVOLBOBMJSBOEBSBI QFSDFQBUBO TFOUSJGVHBM JBMBI UFSIBEBQ TJTUFN TJSLVMBTJ LBSFOB
KBSJOHBOTFIJOHHBQFOHBOHLVUBOPLTJHFOKVHBCFSLVSBOH,FEVB EBSBI CFSTJGBU NVEBI CFSHFSBL EBO EBQBU CFSQJOEBI BLJCBU
BSUFSJPMQBSVNFOHBMBNJWBTPLPOTUSJLTJBLJCBUIJQPLTJBQBSV)BM HBZBTFOUSJGVHBM
JOJUFSKBEJBLJCBUNFLBOJTNFLPOTUSJLTJTFCBHBJSFBLTJUFSIBEBQ 4FXBLUVQFOFSCBOHUFSLFOB(QPTJUJG EBSBIBLBOUFSUBSJLLF
IJQPLTJB ZBOH TFDBSB OPSNBM UFSKBEJ EFOHBO UVKVBO NFOHBMJILBO CBHJBO UFSCBXBI UVCVI +BEJ CJMB HBZB QFSDFQBUBO TFOUSJGVHBM
BMJSBO EBSBI EBSJ BMWFPMJ SFOEBI PLTJHFO LF BMWFPMJ UJOHHJ PLTJHFO CFTBSOZB(EBOPSBOHUFSTFCVUEBMBNLFBEBBOCFSEJSJEJBN
TFQFSUJZBOHUFMBIEJKFMBTLBOEJ#BC5FUBQJLBSFOBTFNVBBMWFPMJ UFLBOBO EJ EBMBN WFOBWFOB LBLJ NFOKBEJ TBOHBU NFOJOHLBU
TFLBSBOH CFSBEB EBMBN LFBEBBO SFOEBI PLTJHFO TFNVB BSUFSJPM NFOKBEJ TFLJUBS NN )H
1BEB QPTJTJ EVEVL UFLBOBOOZB
NFOHBMBNJLPOTUSJLTJ UFLBOBOBSUFSJQVMNPOBMJTNFOJOHLBUIFCBU NFOKBEJ LJSBLJSB NN )H 4FMBOKVUOZB EFOHBO
TFIJOHHB UFSKBEJMBI QBZBI KBOUVOH LBOBO * FUJHB TQBTNF BSUFSJPM NFOJOHLBUOZB UFLBOBO EJ EBMBN QFNCVMVI EBSBI EJ UVCVI
BMWFPMVT NFOHBMJILBO CBOZBL BMJSBO EBSBI LF QFNCVMVI QBSV CBXBI QFNCVMVI JUV BLBO CFSEJMBUBTJ TFDBSB QBTJG TFIJOHHB
OPOBMWFPMBS NFOZFCBCLBOCBOZBLBMJSBOEBSBIQBSVNFNJOUBTLF CBOZBLEBSBIEBSJCBHJBOBUBTUVCVIBLBOCFSQJOEBILFCBXBI
QFNCVMVIEBSBIZBOHPLTJHFOBTJOZBSFOEBI EBOIBMJOJBLBOMFCJI ,BSFOBKBOUVOHUJEBLEBQBUNFNPNQBLFDVBMJBEBEBSBIZBOH
NFNQFSTVMJULFBEBBO,FCBOZBLBOEBSJQBTJFOEBQBUQVMJILFNCBMJ LFNCBMJ LF KBOUVOH NBLB NBLJO CBOZBL EBSBI ZBOH
EBMBNCFCFSBQBIBSJBUBVNJOHHVTFUFMBIQBTJFOJUVEJQJOEBILBOLF UFSLVNQVM EFOHBO DBSB JOJ EJ UVCVI CBHJBO CBXBI TFIJOHHB
UFNQBUZBOHMFCJISFOEBI NBLJOTFEJLJUEBSBIZBOHUFSTFEJBVOUVLDVSBIKBOUVOH
(BNCBS NFMVLJTLBO QFSVCBIBO UFLBOBO TJTUPMJL EBO
Efek Gaya Percepatan terhadap Tubuh pada Fisiologi EJBTUPMJL QVODBL EBO EBTBS LVSWB
QBEB UVCVI CBHJBO BUBT
Penerbangan dan Luar Angkasa LFUJLB HBZB QFSDFQBUBO TFCFTBS ( NFOEBEBL EJCFSJLBO
LFQBEB TFTFPSBOH ZBOH TFEBOH EVEVL 1FSIBUJLBOMBI CBIXB
,BSFOB UFSKBEJ QFSVCBIBO ZBOH DFQBU QBEB LFDFQBUBO EBO BSBI LFEVB UFLBOBO UFSTFCVU UVSVO NFOKBEJ EJ CBXBI NN )H
HFSBL QFTBXBU UFSCBOH BUBV QFTBXBU MVBS BOHLBTB CFCFSBQB KFOJT QBEB EFUJLEFUJL QFSUBNB TFUFMBI QFSDFQBUBO NVMBJ EJCFSJLBO
HBZB QFSDFQBUBO NFNFOHBSVIJ UVCVI TFXBLUV LJUB UFSCBOH 1BEB UFUBQJLFNVEJBOUFLBOBOTJTUPMJLLFNCBMJOBJLNFOKBEJNN
TBBU QFSNVMBBO UFSCBOH UFSKBEJ QFSDFQBUBO MJOJFS ZBOH TFEFSIBOB )HEBOUFLBOBOEJBTUPMJLNFOKBEJNN)HEBMBNXBLUV
QBEB BLIJS UFSCBOH UFSKBEJ QFSMBNCBUBO EBO TFUJBQ LBMJ QFTBXBU TBNQBJ EFUJL CFSJLVUOZB 1FNVMJIBO TFLVOEFS JOJ UFSVUBNB
CFSCFMPLUFSKBEJQFSDFQBUBOTFOUSJGVHBM CFSLBULFHJBUBOSFGMFLTCBSPSFTFQUPS
Gaya Percepatan Sentrifugal 1FSDFQBUBOZBOHMFCJICFTBSEBSJTBNQBJ(NFOJNCVMLBO
CMBDLPVU WJTVBM EBMBN CFCFSBQB EFUJL EJTVTVM IJMBOHOZB
,FUJLB TFCVBI QFTBXBU UFSCBOH CFSCFMPL HBZB QFSDFQBUBO LFTBEBSBO CFCFSBQB TBBU LFNVEJBO #JMB QFSDFQBUBO UJOHLBU
TFOUSJGVHBMZBOHEJUJNCVMLBOOZBEBQBUEJIJUVOHEFOHBOQFSTBNBBO UJOHHJ TFQFSUJ JOJ CFSMBOKVU PSBOH ZBOH CFSTBOHLVUBO BLBO
CFSJLVU NFOJOHHBM
2
f = mv
r &GFLUFSIBEBQ7FSUFCSB(BZBQFSDFQBUBOZBOHTBOHBUUJOHHJ
EFOHBO G BEBMBI HBZB QFSDFQBUBO TFOUSJGVHBM N BEBMBI NBTTB XBMBVQVO IBOZB CFSMBOHTVOH TFQFSTFLJBO EFUJL EBQBU
CFOEB W BEBMBI LFDFQBUBO UFSCBOH EBO S BEBMBI KBSJKBSJ NFNBUBILBO WFSUFCSB 1FSDFQBUBO QPTJUJG ZBOH EBQBU EJUBIBO
LFMFOHLVOHBOCFMPLBO%BSJSVNVTJOJKFMBTUFSMJIBUCBIXBEFOHBO NBOVTJB QBEB QPTJTJ EVEVL TFCFMVN UFSKBEJ GSBLUVS WFSUFCSB
LJSBLJSBTFCFTBS(
NFOJOHLBUOZB LFDFQBUBO HBZB QFSDFQBUBO TFOUSJGVHBM BLBO
NFOJOHLBU TFCBOEJOH EFOHBO LVBESBU LFDFQBUBO +FMBT KVHB ( /FHBUJG &GFL ( OFHBUJG UFSIBEBQ UVCVI TFDBSB BLVU UJEBL
UFSMJIBU CBIXB HBZB QFSDFQBUBO CFSCBOEJOH MVSVT EFOHBO CFHJUV IFCBU UFUBQJ NVOHLJO MFCJI CFSTJGBU NFSVTBL TFDBSB
LFUBKBNBOCFMPLBO CFSLVSBOHOZBVLVSBOKBSJKBSJ
QFSNBOFOEJCBOEJOHFGFL(QPTJUJG1FOFSCBOHCJBTBOZBEBQBU
Pengukuran Gaya Percepatan—"G". ,FUJLB QFOFSCBOH

100
EVEVLEJLVSTJOZB HBZBPSBOHJUVZBOHNFOFLBOLVSTJOZBBEBMBI
TFTVBJ EFOHBO HBZB UBSJL #VNJ EBO JOJ TFCBOEJOH EFOHBO CFSBU
50
CBEBOOZB #FTBSOZB HBZB JOJ EJLBUBLBO TFCFTBS ( LBSFOB
TFCBOEJOH EFOHBO HBZB UBSJL #VNJ #JMB HBZB ZBOH NFOFLBO 0
LVSTJOZBNFOKBEJMJNBLBMJMJQBUCPCPUOPSNBMLFUJLBOBJLTFUFMBI 0 5 10 15 20 25 30
NFOVLJL NBLBHBZBZBOHCFLFSKBUFSIBEBQLVSTJOZBBEBMBI(
#JMBQFTBXBUUFSCBOHNFNCVBUNBOVWFSPVUTJEFMPPQTFIJOHHB
PSBOH UFSTFCVU UFSUBIBO EJ LVSTJ PMFI TBCVL QFOHBNBO NBLB
UVCVIOZB EJTFCVU NFOEBQBU ( OFHBUJG t CJMB CFTBSOZB HBZB ZBOH
NFNCVBUOZB UFSUBIBO EJ LVSTJ PMFI TBCVL QFOHBNBO UFSTFCVU
TBNBEFOHBOCPCPUUVCVIOZB NBLBHBZBOFHBUJGJUVCFTBSOZBo
(
531
Unit Vlll Fisiologi Penerbangan, Ruang Angkasa, dan Penyelaman Laut Dalam
UFSCBOHEFOHBONBOVWFSPVUTJEFMPPQQBEBHBZBQFSDFQBUBO 10
TBNQBJ(UBOQBUFSLFOBFGFLCVSVLZBOHQFSNBOFO
XBMBV NFOZFCBCLBO IJQFSFNJB CFSBU TFKFOBL EJ LFQBMBOZB 8
,BEBOH UJNCVM HBOHHVBO QTJLPUJL ZBOH CFSMBOHTVOH TFMBNB
TBNQBJNFOJUTFCBHBJBLJCBUEBSJFEFNBPUBL
6
,BEBOH HBZB ( OFHBUJG EBQBU EFNJLJBO IFCBU TFCBHBJ
DPOUPI (
EBO TFOUSJGVHBTJ EBSBI LF LFQBMB KVHB UJOHHJ
4
TFIJOHHBEBQBUNFOJOHLBULBOUFLBOBOQFNCVMVIPUBLNFOKBEJ
TBNQBJ NN )H ,BEBOH QFNCVMVI EBSBI LFDJM EJ
QFSNVLBBO LFQBMB EBO EJ PUBL EBQBU QFDBI /BNVO 2
LFNVOHLJOBOQFNCVMVIEBMBNLSBOJVNVOUVLQFDBIUFSOZBUB
MFCJILFDJMEBSJQBEBZBOHEJTBOHLB BMBTBOVOUVLIBMJOJBEBMBI
0
DBJSBO TFSFCSPTQJOBM UFSTFOUSJGVHBTJ LF BSBI LFQBMB CFSTBNBBO 0 1 2 3 4 5
EFOHBO UFSTFOUSJGVHBTJOZB EBSBI LF BSBI QFNCVMVI EBSBI
LSBOJBM EBO UFLBOBO DBJSBO TFSFCSPTQJOBM ZBOH TBOHBU
NFOJOHLBU CFSUJOEBL TFCBHBJ CBOUBMBO UFSIBEBQ TJTJ MVBS PUBL
VOUVLNFODFHBIQFDBIOZBQFNCVMVIEBSBI 1FOEPSPOHUJOHLBUQFSUBNBNFOJNCVMLBOQFSDFQBUBOTBNQBJ(
0MFI LBSFOB NBUB UJEBL UFSMJOEVOH PMFI LSBOJVN EBO ZBOH LFEVB TBNQBJ ( %FOHBO QPTJTJ CFSEJSJ UVCVI UJEBL
IJQFSFNJB CFSBU EBQBU UFSKBEJ TFXBLUV UFSLFOB ( OFHBUJG EBQBU CFSUBIBO UFSIBEBQ QFSDFQBUBO TFCFTBS JOJ UFUBQJ EFOHBO
"LJCBUOZB NBUB TFSJOH NFOHBMBNJ CVUB TFNFOUBSB EJTFSUBJ QPTJTJTFUFOHBICFSCBSJOHUFHBLMVSVTUFSIBEBQTVNCVQFSDFQBUBO
EFOHBOSFEPVUh UVCVI EBQBU CFSUBIBO UFSIBEBQ HBZB QFSDFQBUBO TFKVNMBI UBEJ
TFLBMJQVO HBZB JUV CFSMBOHTVOH TBNQBJ MJNB NFOJU 0MFI LBSFOB
Perlindungan Tubuh terhadap Gaya Percepatan JUV LJUB NFNBIBNJ NFOHBQB LVSTJ ZBOH EJQBLBJ BTUSPOPU
Sentrifugal. 1SPTFEVS EBO QFSBMBUBO LIVTVT UFMBI QPTJTJOZBTFUFOHBICFSCBSJOH
EJLFNCBOHLBOEBMBNSBOHLBNFMJOEVOHJQFOFSCBOHBHBSUJEBL
UFSKBEJLPMBQTTJSLVMBTJZBOHNVOHLJOUFSKBEJLBSFOB(QPTJUJG 1FSTPBMBOUJNCVMMBHJTFXBLUVQFTBXBUNFOHBMBNJQFSMBNCBUBO
1FSUBNB CJMB QFOFSCBOH NFOHFODBOHLBO PUPUPUPU QFSVUOZB TBBU LFNCBMJ NFNBTVLJ BUNPTGFS 0SBOH ZBOH UFSCBOH EFOHBO
EFOHBO TBOHBU LVBU EBO NFNCVOHLVL LF EFQBO TBNCJM LFDFQBUBO .BDI LFDFQBUBO TVBSB BUBV QFTBXBU UFSCBOH DFQBU

NFOFLBO QFSVUOZB NBLB QFOJNCVOBO EBSBI EJ QFNCVMVI EBQBUNFOHBMBNJQFSMBNCBUBOEFOHBOBNBOKJLBQFSMBNCBUBOJUV
QFNCVMVIEBSBICFTBSBCEPNFOEBQBUEJIJOEBSJ EBOEFOHBO CFSMBOHTVOH QBEB KBSBL LJSBLJSB NJM TFEBOHLBO PSBOH ZBOH
EFNJLJBO NFOVOEB UFSKBEJOZB CMBDLPVUhh 4FMBJO JUV QBLBJBO UFSCBOHEFOHBOLFDFQBUBO.BDI TFXBLUVQFOFSCBOHBOBOUBS
LIVTVT BOUJ ( UFMBI EJCVBU VOUVL NFODFHBI QFOJNCVOBO QMBOFU
NFNFSMVLBO KBSBL NJM VOUVL QFSMBNCBUBO ZBOH
EBSBI EJ QFSVU CBHJBO CBXBI EBO UVOHLBJ $BSB ZBOH QBMJOH BNBO 1SJOTJQ EBTBS QFSCFEBBO JOJ JBMBI KVNMBI FOFSHJ UPUBM ZBOH
TFEFSIBOB JBMBI EFOHBO NFOHFNCBOHLBO LBOUPOH ZBOH BLBO IBSVT EJCVBOH TFMBNB QFSMBNCBUBO TFCBOEJOH EFOHBO LVBESBU
NFOFLBOUVOHLBJEBOQFSVUTFJSJOHEFOHBOLFOBJLBO(4FDBSB LFDFQBUBO ZBOH TFDBSB UFSTFOEJSJ NFOJOHLBULBO KBSBL LBMJ
UFPSFUJT QJMPUZBOHEJNBTVLLBOLFEBMBNUBOHLJBUBVQBLBJBO MJQBU0MFILBSFOBJUV QFSMBNCBUBOIBSVTEJBUVSKBVIMFCJIMBNCBU
CFSJTJ BJS NVOHLJO IBOZB NFOHBMBNJ TFEJLJU FGFL HBZB ( TFUFMBI UFSCBOH EFOHBO LFDFQBUBO ZBOH TBOHBU UJOHHJ EJCBOEJOH
UFSIBEBQ TJSLVMBTJ LBSFOB UFLBOBO BJS UFSIBEBQ QFSNVLBBO TFUFMBIUFSCBOHEFOHBOLFDFQBUBOZBOHMFCJISFOEBI
UVCVI TFMBNB UFSKBEJOZB QFSDFQBUBO TFOUSJGVHBM EBQBU
NFOHJNCBOHJ HBZB ZBOH CFLFSKB UFSIBEBQ TUVCVI /BNVO Gaya Perlambatan ketika Terjun dengan Parasut.
UFSOZBUB LFCFSBEBBO VEBSB EBMBN QBSV UFUBQ EBQBU ,FUJLB QFOFSKVO QBZVOH NFOJOHHBMLBO QFTBXBU EFOHBO QBSBTVU
NFOHBLJCBULBO UFSKBEJOZB QFSHFTFSBO KBOUVOH KBSJOHBO QBSV LFDFQBUBOUFSKVOOZBQBEBTBBUQFSNVMBBOBEBMBILBLJQFSEFUJL
EBOEJBGSBHNBLFQPTJTJZBOHTBOHBUBCOPSNBMTFLBMJQVOUVCVI /BNVO EFOHBOBEBOZBHBZBQFSDFQBUBOHSBWJUBTJ EBMBNEFUJL
UFSFOEBN EBMBN BJS 0MFI LBSFOB JUV XBMBVQVO QSPTFEVS JOJ LFDFQBUBO UFSKVOOZB NFOKBEJ LBLJ QFS EFUJL CJMB UJEBL BEB
EJKBMBOLBO CBUBT LFBNBOBO IBNQJS QBTUJ BLBO UFUBQ LVSBOH UBIBOBO VEBSB
EBMBN EFUJL NFOKBEJ LBLJ QFS EFUJL EBO
EBSJ( TFUFSVTOZB %FOHBO NFOJOHLBUOZB LFDFQBUBO UFSKVO UBIBOBO
VEBSBZBOHNFNQFSMBNCBUKBUVIKVHBBLBONFOJOHLBU"LIJSOZB
Efek Gaya Percepatan Linier pada Tubuh
HBZB QFSMBNCBUBO UBIBOBO VEBSB BLBO NFOZBNBJ HBZB HSBWJUBTJ
Gaya Percepatan dalam Penerbangan Luar Angkasa. TFIJOHHB LJSBLJSB TFUFMBI KBUVI TFMBNB EFUJL PSBOH UFSTFCVU
5JEBLTFQFSUJQFTBXBUVEBSB QFTBXBUMVBSBOHLBTBUJEBLEBQBU BLBOKBUVIEFOHBOLFDFQBUBOBLIJSTFCFTBSTBNQBJNJM
NFNCFMPL EFOHBO DFQBU LBSFOB JUV QFSDFQBUBO TFOUSJGVHBM KBN LBLJEFUJL
#JMB QFOFSKVO QBZVOH UFMBI NFODBQBJ
CVLBONFSVQBLBOQFSTPBMBOQFOUJOHLFDVBMJCJMBQFTBXBUMVBS LFDFQBUBOBLIJSTFCFMVNNFNCVLBQBSBTVUOZB BLBOUFSKBEJHBZB
BOHLBTBJUVCFSQVUBSQVUBSBCOPSNBM/BNVO QFSDFQBUBOTBBU LFKVUBO LJSBLJSB TFCFTBS QPO TFXBLUV QBSBTVU
QFMVODVSBO EBO QFSMBNCBUBO QBEB TBBU QFOEBSBUBO EBQBU EJLFNCBOHLBO
NFSVQBLBOQFSTPBMBOTFSJVTLFEVBOZBNFSVQBLBOQFSDFQBUBO
MJOJFS ZBOHTBUVQPTJUJGEBOZBOHMBJOOZBOFHBUJG 6LVSBO QBSBTVU CJBTB EBQBU NFNQFSMBNCBU KBUVIOZB QFOFSKVO
NFOKBEJ TFQFSTFNCJMBO EBSJ LFDFQBUBO BLIJS %FOHBO QFSLBUBBO
(BNCBSNFMVLJTLBOQFSLJSBBOQSPGJMQFSDFQBUBOQBEB MBJO LFDFQBUBO QBEB XBLUV QFOEBSBUBO BEBMBI LBLJ QFS EFUJL
QFTBXBUMVBSBOHLBTBUJHBUJOHLBUTBBUNFMBLVLBOQFMVODVSBO EBOCFTBSOZBHBZBTFXBLUVCFSCFOUVSBOEFOHBO#VNJBEBMBI
532
EBSJ HBZB UBOQB QBSBTVU 8BMBVQVO EFNJLJBO HBZB CFOUVSBO LFTBMBITBUVTJTJUFSUFOUVEBSJQFTBXBUMVBSBOHLBTB

TFCFTBSJUVNBTJIDVLVQCFTBSVOUVLNFOJNCVMLBODFEFSBTFSJVT
UFSIBEBQ UVCVI LFDVBMJ CJMB QFOFSKVO UFMBI UFSMBUJI VOUVL Masalah Fisiologis Keadaan Tanpa Bobot (Gravitasi
UNIT VIII
NFOEBSBU EFOHBO CBJL 4FCFOBSOZB HBZB CFOUVSBO JUV LJSBLJSB Mikro). .BTBMBI GJTJPMPHJT ZBOH CFSLBJUBO EFOHBO LFBEBBO
TBNB TFQFSUJ ZBOH EJBMBNJ PSBOH ZBOH UFSKVO UBOQB QBSBTVU EBSJ UBOQB CPCPU UFSOZBUB UJEBL UFSMBMV TJHOJGJLBO TFMBNB LFBEBBO
LFUJOHHJBO LBLJ #JMB UJEBL EJQFSJOHBULBO UFSMFCJI EBIVMV UBOQB CPCPU UFSTFCVU UJEBL CFSMBOHTVOH MBNB 4FCBHJBO CFTBS
QFOFSKVO BLBO EJLFDPILBO PMFI QFSBTBBOOZB VOUVL NFOEBSBU EJ NBTBMBI ZBOH UFSKBEJ UFSLBJU EFOHBO UJHB FGFL LFBEBBO UBOQB
#VNJ EFOHBO LFEVB UVOHLBJ EBMBN QPTJTJ FLTUFOTJ EBO LFBEBBO CPCPU ZBJUV
NBCVL QFSKBMBOBO TFMBNB IBSJIBSJ QFSUBNB
JOJ BLBO NFOHIBTJMLBO HBZB QFSMBNCBUBO ZBOH IFCBU TFQBOKBOH QFSKBMBOBO
USBOTMPLBTJ DBJSBO UVCVI BLJCBU LFHBHBMBO
TVNCV UVCVI NFOHBLJCBULBO UFSKBEJOZB GSBLUVS QFMWJT WFSUFCSB HSBWJUBTJ NFOJNCVMLBO UFLBOBO IJESPTUBUJL EBO
UJEBL
BUBVUVOHLBJ#FSEBTBSLBOBMBTBOJUV QFOFSKVOZBOHUFSMBUJIBLBO BEBOZB BLUJWJUBT GJTJL LBSFOB LFLVBUBO PUPU UJEBL EJQFSMVLBO
NFOEBSBUEFOHBOMVUVUUFSUFLVLUFUBQJEFOHBOPUPUZBOHLFODBOH VOUVLNFMBXBOHBZBHSBWJUBTJ
EFOHBO NBLTVE VOUVL NFOHVSBOHJ HBZB LFKVU QBEB XBLUV
QFOEBSBUBO )BNQJS QFSTFO BTUSPOPU NFOHBMBNJ NBCVL QFOKBMBOBO
CFSVQB NVBM EBO LBEBOH NVOUBI TFMBNB TBNQBJ IBSJ
QFSUBNB QFSKBMBOBO MVBS BOHLBTB )BM JOJ NVOHLJO BLJCBU QPMB
"Iklim Buatan" datam Pesawat Luar Angkasa yang
TJOZBM QFSHFSBLBO ZBOH UJEBL VNVN ZBOH UJCB EJ QVTBU
Tertutup Rapat LFTFJNCBOHBO EJ PUBL EBO QBEB TBBU ZBOH CFSTBNBBO UJEBL
UFSEBQBUTJOZBMTJOZBMHSBWJUBTJPOBM
0MFI LBSFOB EJ BOHLBTB MVBS UJEBL UFSEBQBU BUNPTGFS NBLB
BUNPTGFS EBO JLMJN CVBUBO IBSVT EJCVBU EBMBN QFTBXBU MVBS "LJCBU ZBOH UFSMJIBU TFUFMBI UJOHHBM MBNB EJ SVBOH BOHLBTB
BOHLBTB )BM UFSQFOUJOH JBMBI LBEBS PLTJHFO IBSVT DVLVQ UJOHHJ JBMBI
CFSLVSBOHOZB WPMVNF EBSBI
CFSLVSBOHOZB
EBO LBEBS LBSCPO EJPLTJEB IBSVT DVLVQ SFOEBI VOUVL NBTTB TFM EBSBI NFSBI
CFSLVSBOHOZB LFLVBUBO PUPU EBO
NFOHIJOEBSJ UFSKBEJOZB BTGJLTJB %BMBN CFCFSBQB NJTJ LBQBTJUBT LFSKB
QFOVSVOBO DVSBI KBOUVOH NBLTJNVN
QFOFSCBOHBO MVBS BOHLBTB TFCFMVNOZB EJHVOBLBO LBQTVM CFSJTJ TFSUB
IJMBOHOZB LBMTJVN EBO GPTGBU EBSJ UVMBOH EBO
PLTJHFO NVSOJ CFSUFLBOBO LJSBLJSB NN )H UFUBQJ QBEB IJMBOHOZB NBTTB UVMBOH &GFL ZBOH TBNB KVHB UFSKBEJ QBEB
QFTBXBU MVBS BOHLBTB NPEFSO EJHVOBLBO HBTHBT ZBOH TFUBSB PSBOH ZBOH CFSCBSJOH EJ UFNQBU UJEVS EBMBN XBLUV MBNB
EFOHBO ZBOH UFSEBQBU EBMBN VEBSB CJBTB EFOHBO OJUSPHFO EBO LBSFOB BMBTBOBMBTBO JUV LFQBEB QBSB BTUSPOPU EJCFSJLBO
PLTJHFO FNQBU LBMJ MFCJI CBOZBL EBO UFLBOBO UPUB NN )H QSPHSBN PMBISBHB TFMBNB NFOKBMBOJ NJTJ QFOFSCBOHBO MVBS
/JUSPHFO ZBOH CFSBEB EBMBN DBNQVSBO JOJ TBOHBU NFOVSVOLBO BOHLBTBZBOHMBNB
LFDFOEFSVOHBO UFSKBEJOZB LFCBLBSBO EBO MFEBLBO )BM JOJ KVHB
NFOKBEJ GBLUPS QFMJOEVOH UFSIBEBQ QFSUVNCVIBO CFSDBLCFSDBL 1BEB FLTQFEJTJ MBCPSBUPSJVN MVBS BOHLBTB TFCFMVNOZB
MPLBM BUFMFLUBTJT QBSV ZBOH TFSJOH LBMJ UFSKBEJ TBBU NFOHIJSVQ EFOHBO QSPHSBN PMBISBHB ZBOH UJEBL CFHJUV CFSBU LBQBTJUBT
PLTJHFO NVSOJ LBSFOB PLTJHFO EJBCTPSCTJ EFOHBO DFQBU LFUJLB LFSKB BTUSPOPU NFOVSVO ESBTUJT EBMBN CFCFSBQB IBSJ QFSUBNB
CSPOLVTLFDJMLBEBOHUFSUVUVQPMFITVNCBUBONVLVT TFUFMBI LFNCBMJ LF #VNJ "TUSPOPU UFSTFCVU KVHB DFOEFSVOH
NVEBIQJOHTBO EBOCFSMBOKVUVOUVLCFCFSBQBXBLUV
QBEBTBBU
6OUVLQFOFSCBOHBOMVBSBOHLBTBZBOHCFSMBOHTVOHMFCJIEBSJ CFSEJSJ TFMBNB IBSJ QFSUBNB BUBV CFCFSBQB IBSJ TFUFMBI
CFCFSBQBCVMBO UJEBLMBIQSBLUJTVOUVLNFNCBXBTVQMBJPLTJHFO NFNQFSPMFI LFNCBMJ HSBWJUBTJ )BM JOJ EJTFCBCLBO PMFI
,BSFOB BMBTBO JOJ EJLFNCBOHLBOMBI UFLOJL EBVS VMBOH PLTJHFO QFOVSVOBO WPMVNF EBSBI EBO CFSLVSBOHOZB SFTQPOT
TFIJOHHB PLTJHFO ZBOH TBNB EBQBU EJHVOBLBO CFSVMBOHVMBOH NFLBOJTNFLFOEBMJUFLBOBOBSUFSJ
#FCFSBQB QSPTFT EBVS VMBOH IBOZB CFSHBOUVOH QBEB QSPTFEVS
GJTJLB NJTBMOZBFMFLUSPMJTJTBJSVOUVLNFMFQBTLBOPLTJHFO1SPTFT "Penurunan Kondisi" Sistem Kardiovaskular, Otot, dan
ZBOH MBJO CFSHBOUVOH QBEB NFUPEF CJPMPHJT TFQFSUJ QFOHHVOBBO Tulang selama Terpajan Keadaan Tanpa Bobot yang
HBOHHBOH ZBOH NFOZJNQBO TFKVNMBI CFTBS LMPSPGJM VOUVL Lama.4FMBNBQFOFSCBOHBOMVBSBOHLBTBZBOHTBOHBUMBNBEBO
NFMFQBT PLTJHFO EBO LBSCPO EJPLTJEB MFXBU QSPTFT GPUPTJOUFTJT NFOHBMBNJ QBKBOBO HSBWJUBTJ NJLSP ZBOH MBNB TFDBSB CFSUBIBQ
4JTUFN EBVS VMBOH ZBOH NFNVBTLBO VOUVL IBM UFSTFCVU NBTJI NVODVM FGFL QFOVSVOBO LPOEJTJ QBEB TJTUFN LBSEJPWBTLVMBS
IBSVTEJUFNVLBO PUPUPUPU SBOHLB EBO UVMBOH )BM JOJ UFSKBEJ XBMBVQVO TFMBNB
QFOFSCBOHBO QBSB BTUSPOPU UFMBI CFSPMBISBHB LFSBT 1FOFMJUJBO
Keadaan tanpa Bobot di Ruang Angkasa UFSIBEBQQBSBBTUSPOPUEJMVBSBOHLBTBZBOHCFSMBOHTVOHTFMBNB
0SBOH ZBOH CFSBEB EBMBN TBUFMJU ZBOH TFEBOH NFOHPSCJU BUBV CFCFSBQBCVMBONFOVOKVLLBOIJMBOHOZB QFSTFONBTTBUVMBOH
CFSBEB EBMBN QFTBXBU MVBS BOHLBTB ZBOH UJEBL CFSHFSBL BLBO TFUJBQ CVMBO XBMBVQVO BTUSPOPU UFSTFCVU UFUBQ NFMBOKVULBO
NFOHBMBNJ LFBEBBO UBOQB CPCPU BUBV CFSBEB EBMBN TUBUVT PMBISBHB"USPGJPUPUKBOUVOHEBOPUPUSBOHLBTFDBSBTVCTUBOTJBM
NFOEFLBUJHBZB(OPM ZBOHLBEBOHEJTFCVUHSBWJUBTJNJLSP1BEB KVHB UFSKBEJ TFMBNB UFSQBKBO MJOHLVOHBO HSBWJUBTJ NJLSP ZBOH
LFBEBBO JUV PSBOH UJEBL UFSUBSJL LF CBXBI LF TBNQJOH BUBV LF MBNB
BUBT UFUBQJ NFMBZBOH EJ EBMBN SVBOHBO 1FOZFCBC EBSJ LFBEBBO 4BUVEBSJFGFLFGFLQBMJOHTFSJVTBEBMBIQFOVSVOBOLPOEJTJ
JOJ CVLBO BLJCBU HBHBMOZB HBZB HSBWJUBTJ NFOBSJL UVCVI LBSFOB KBOUVOH ZBOHNFMJQVUJQFOVSVOBOLBQBTJUBTLFSKB QFOHVSBOHBO
HSBWJUBTJ EBSJ CFOEB BOHLBTB ZBOH CFSEFLBUBO NBTJI BLUJG WPMVNF EBSBI UFSHBOHHVOZB SFGMFLT CBSPSFTFQUPS EBO
/BNVO HSBWJUBTJ CFLFSKB UFSIBEBQ QFTBXBU EBO UFSIBEBQ PSBOH QFOHVSBOHBO UPMFSBOTJ PSUPTUBUJL 1FSVCBIBO JOJ TBOHBU
QBEBTBBUZBOHCFSTBNBBO LBSFOBJUVLFEVBOZBBLBOEJUBSJLPMFI NFNCBUBTJ LFNBNQVBO BTUSPOPU VOUVL CFSEJSJ UFHBL BUBV
HBZBQFSDFQBUBOZBOHUFQBUTBNBCFTBSEBOEJUBSJLLFBSBIZBOH NFMBLVLBO BLUJWJUBT LFSKB IBSJBO CJBTB TFUFMBI LFNCBMJ LF
TBNBQVMB,BSFOBBMBTBOJUV PSBOHUJEBLUFSUBSJL LFBEBBOHSBWJUBTJQFOVIEJ#VJOJ
533
Unit Vlll Fisiologi Penerbangan, Ruang Angkasa, dan Penyelaman Laut Dalam
"TUSPOPU ZBOH LFNCBMJ EBSJ QFOFSCBOHBO MVBS BOHLBTB ZBOH #ÊSUTDI1 .BJSCÊVSM) .BHHJPSJOJ. FUBM1IZTJPMPHJDBMBTQFDUTPGIJHIaltitude
CFSMBOHTVOH TBNQBJ CVMBO KVHB NVEBI NFOHBMBNJ QBUBI pulmonary edema, J Appl Physiol 98:1101, 2005.
Basnyat B, Murdoch DR: High-altitude illness, Lancet 361:1967, 2003.Convertino
UVMBOH EBO NVOHLJO NFNFSMVLBO XBLUV CFCFSBQB NJOHHV VA: Mechanisms of microgravity induced orthostatic intoler-
TFCFMVN BTUSPOPU UFSTFCVU LFNCBMJ CFSBEB QBEB LPOEJTJ ance: implications for effective countermeasures, J Gravit Physiol 9:1,
LBSEJPWBTLVMBS UVMBOH EBO PUPU ZBOH GJU TFQFSUJ TFCFMVN 2002.
NFMBLVLBO QFOFSCBOHBO ,FUJLB QFOFSCBOHBO MVBS BOHLBTB Diedrich A, Paranjape SY, Robertson D: Plasma and blood volume in space,
Am J Med Sci 334:80, 2007.
NFOKBEJTFNBLJOMBNBTFCBHBJQFSTJBQBOVOUVLNFNVOHLJOLBO Di Rienzo M, Castiglioni P, Iellamo F, et al: Dynamic adaptation of cardiac
NBOVTJBNFOHFLTQMPSBTJQMBOFUMBJO TFQFSUJ.BST FGFLHSBWJUBTJ baroreflex sensitivity to prolonged exposure to microgravity: data from
NJLSP ZBOH MBNB EBQBU NFSVQBLBO BODBNBO TFSJVT VOUVL QBSB a 16-day spaceflight, J Appl Physiol 105:1569, 2008.
BTUSPOPU TBBU NFOEBSBU LIVTVTOZB EBMBN IBM QFOEBSBUBO Hackett PH, Roach RC: High-altitude illness, N Engl J Med 345:107, 2001.Hainsworth
EBSVSBU 0MFI LBSFOB JUV CBOZBL QFOFMJUJBO UFMBI EJMBLVLBO R, Drinkhill MJ: Cardiovascular adjustments for life at high alti-
tude, Respir Physiol Neurobiol 158:204, 2007.
EBMBN NFOHFNCBOHLBO QFSBOHLBU TFCBHBJ UBNCBIBO PMBISBHB Hoschele S, Mairbaurl H: Alveolar flooding at high altitude: failure of reab-
ZBOH EBQBU NFODFHBI BUBV NFNQFSMBNCBU QFSVCBIBO sorption? News Physiol Sci 18:55, 2003.
QFSVCBIBO UFSTFCVU 4BMBI TBUV QFSBOHLBU ZBOH TFEBOH EJVKJ LeBlanc AD, Spector ER, Evans HJ, et al: Skeletal responses to space flight
BEBMBI BQMJLBTJ HSBWJUBTJ BSUJGJTJBM TFNFOUBSB ZBOH EJTFCBCLBO and the bed rest analog: a review, J Musculoskelet Neuronal Interact
BLTFMFSBTJ TFOUSJGVHBM CFSQFSJPEF TJOHLBU NJTBM KBN TFUJBQ 7:33, 2007.
Penaloza D, Arias-Stella J: The heart and pulmonary circulation at high alti-
IBSJ
TBBUBTUSPOPUUFSTFCVUEVEVLEJBMBUTFOUSJGVHBTJCFSMFOHBO tudes: healthy highlanders and chronic mountain sickness, Circulation
QFOEFL ZBOH EJSBODBOH TFDBSB LIVTVT TFIJOHHB EBQBU 115:1132, 2007.
NFODJQUBLBOHBZBTBNQBJBUBV( Smith SM, Heer M: Calcium and bone metabolism during space flight,
Nutrition 18:849, 2002.
Daftar Pustaka West JB: Man in space, News Physiol Sci 1:198, 1986.
West JB: George I. Finch and his pioneering use of oxygen for climbing at
Adams GR, Caiozzo VJ, Baldwin KM: Skeletal muscle unweighting: space-
flight and ground-based models, J Appl Physiol 95:2185, 2003. extreme altitudes, J Appl Physiol 94:1702, 2003.
534
BAB 44
UNIT VIII
'JTJPMPHJ1FOZFMBNBO-BVU%BMBNEBO
,FBEBBO)JQFSCBSJL-BJOOZB
#JMB NBOVTJB UVSVO LF EBMBN Efek Tingginya Tekanan Parsial Masing-Masing
MBVU UFLBOBOTFLFMJMJOHOZBBLBO Gas terhadap Tubuh
NFOJOHLBUEFOHBOTBOHBUIFCBU
6OUVL NFOKBHB BHBS QBSV UJEBL 4BBUTFPSBOHQFOZFMBNNFOHIJSVQVEBSB JBBLBOUFSQBKBOPMFI
LPMBQT VEBSB ZBOH EJCFSJLBO HBTHBT CFSJLVU JOJ ZBJUV OJUSPHFO PLTJHFO EBO LBSCPO EJPLTJ
IBSVTCFSUFLBOBOTBOHBUUJOHHJ EB EBO NBTJOHNBTJOH HBT UFSTFCVU EBQBU NFOZFCBCLBO FGFL
BHBS QBSV UFUBQ NFOHFNCBOH )BM JOJ NFOZFCBCLBO EBSBI EJ GJTJPMPHJTZBOHTFSJVTQBEBUFLBOBOUJOHHJ
EBMBN QBSV UFSQBKBO EFOHBO UFLBOBO HBT BMWFPMVT ZBOH TBOHBU
UJOHHJ LFBEBBO JOJ EJTFCVU IJQFSCBSJL #JMB UFLBOBO ZBOH UJOHHJ Narkosis Nitrogen pada Tekanan Nitrogen Tinggi
JOJNFMFCJIJCBUBTUFSUFOUV UFSKBEJQFSVCBIBOIFCBUQBEBGJTJPMPHJ ,JSBLJSB FNQBU QFSMJNB CBHJBO VEBSB UFSEJSJ BUBT OJUSPHFO
UVCVIEBOEBQBUNFOZFCBCLBOLFNBUJBO 1BEBUFLBOBOEJQFSNVLBBOMBVU OJUSPHFOUJEBLNFNJMJLJFGFL
ZBOH CFSNBLOB UFSIBEBQ GVOHTJ UVCVI UFUBQJ QBEB UFLBOBO UJ
Hubungan Kedalaman Laut dengan Tekanan. 4BUV OHHJ EBQBU NFOJNCVMLBO OBSLPTJT EFOHBO EFSBKBU CFSWBSJBTJ
LPMPN BJS MBVU EFOHBO LFEBMBNBO LBLJ N
BLBO #JMBQFOZFMBNCFSEJBNEJEBMBNMBVUTFMBNBTBUVKBNBUBVMFCJI
NFOHIBTJMLBO UFLBOBO EJ CBHJBO EBTBS ZBOH TBNB CFTBS EFOHBO EBO NFOHIJSVQ VEBSB CFSUFLBOBO HFKBMB QFSUBNB OBSLPTJT SJ
UFLBOBO BUNPTGFS EJ BUBT MBVU 0MFI LBSFOB JUV TFTFPSBOH ZBOH OHBO UJNCVM QBEB LFEBMBNBO LBLJ 1BEB LFEBMBNBO JOJ
CFSBEBQBEBLFEBMBNBOLBLJEJCBXBIQFSNVLBBOMBVU BLBO HFKBMB ZBOH EJSBTBLBO PMFI TFPSBOH QFOZFMBN JBMBI SBTB SJBOH
NFOEBQBU UFLBOBO TFCFTBS BUNPTGFS UFLBOBO BUNPTGFS EBOLVSBOHCFSIBUJIBUJ1BEBLFEBMBNBOTBNQBJLBLJ
EJTFCBCLBO PMFI CFSBU VEBSB EJ BUBT QFSNVLBBO MBVU EBO UJNCVMSBTBNFOHBOUVL1BEBLFEBMBNBOTBNQBJLBLJ
BUNPTGFSMBHJCFSBTBMEBSJCFSBUBJSJUVTFOEJSJ1BEBLFEBMBNBO LFLVBUBOOZBBLBOCFSLVSBOHTFLBMJ EBOQFOZFMBNTFSJOHUFSMB
LBLJ UFLBOBOOZB BEBMBI BUNPTGFS EBO TFUFSVTOZB TFQFSUJ MVMFNBIVOUVLNFMBLVLBOQFLFSKBBOZBOHEJQFSMVLBOOZB1BEB
UFSMJIBUQBEB(BNCBS LFEBMBNBOMFCJIEBOLBLJ UFLBOBO BUNPTGFS
CJBTBOZB
QFOZFMBNIBNQJSUJEBLEBQBUNFMBLVLBOBQBBQBBLJCBUOBSLP
Efek Kedalaman Laut terhadap Volume Gas—Hukum TJT PMFI OJUSPHFO CJMB JB CFSEJBN UFSMBMV MBNB EJ LFEBMBNBO
Boyle. &GFLQFOUJOHMBJOEBSJLFEBMBNBOJBMBIBEBOZBLPNQSFTJ UFSTFCVU
HBT TFIJOHHB WPMVNFOZB TFNBLJO NFOHFDJM #BHJBO CBXBI /BSLPTJTPMFIOJUSPHFONFNQVOZBJDJSJDJSJZBOHNJSJQEFOHBO
(BNCBS NFNQFSMJIBULBO XBEBI CFSCFOUVL MPODFOH QBEB LFSBDVOBOBMLPIPM PMFITFCBCJUVTFSJOHEJTFCVUTFCBHBJLFSJB
LFUJOHHJBOQFSNVLBBOMBVUZBOHCFSJTJMJUFSVEBSB1BEBLFEBMB OHBOBLJCBULFEBMBNBOh.FLBOJTNFUFSKBEJOZBOBSLPTJTEJEVHB
NBO LBLJ EJ CBXBI QFSNVLBBO MBVU UFLBOBOOZB NFOKBEJ TBNB EFOHBO OBSLPTJT ZBOH EJUJNCVMLBO PMFI LFCBOZBLBO HBT
BUNPTGFS EBOWPMVNFOZBNFOHFDJMNFOKBEJIBOZBTFUFOHBIMJUFS BOFTUFTJ MBJOOZB .FLBOJTNFOZB JBMBI OJUSPHFO MBSVU EBMBN
EBO QBEB UFLBOBO BUNPTGFS LBLJ
WPMVNFOZB NFOKBEJ TVCTUBOTJMFNBLEJNFNCSBOTBSBGEBO LBSFOBFGFLGJTJLOJUSP
TFQFSEFMBQBOMJUFS+BEJ WPMVNFZBOHEJCFSJLBOPMFITFKVNMBIHBT HFOEBMBNNFOHVCBIBMJSBOJPOZBOHNFMFXBUJNFNCSBO BLBO
ZBOHUFSLPNQSFTJCFSCBOEJOHUFSCBMJLEFOHBOUFLBOBOOZB1SJO NFOVSVOLBOFLTJUBCJMJUBTTBSBG
TJQ GJTJLB JOJ EJTFCVU )VLVN #PZMF NFSVQBLBO IVLVN ZBOH
TBOHBU QFOUJOH QBEB GJTJPMPHJ QFOZFMBNBO LBSFOB UFLBOBO ZBOH Keracunan Oksigen pada Tekanan Tinggi
NFOJOHLBU EBQBU NFOZFCBCLBO SPOHHB VEBSB EBMBN UVCVI Efek Po2 yang Sangat Tinggi terhadap Pengangkutan
QFOZFMBNNFOKBEJLPMBQT UFSVUBNBQBSV EBOTFSJOHNFOZFCBC Oksigen Darah. #JMB1PEBSBINFOJOHLBUEJBUBTNN)H
LBOLFSVTBLBOZBOHTFSJVT NBLB KVNMBI PLTJHFO ZBOH MBSVU EBMBN DBJSBO EBSBI BLBO
%BMBN CBC JOJ CFCFSBQB LBMJ LJUB NFNCJDBSBLBO NFOHFOBJ NFOJOHLBU TFDBSB OZBUB )BM JOJ EBQBU EJMJIBU QBEB (BNCBS
QFSCBOEJOHBO BOUBSB WPMVNF TBBU JOJ EBO WPMVNF QBEB LFUJOH ZBOH HBNCBSOZB NJSJQ EFOHBO LVSWB EJTPTJBTJ PLTJHFO
HJBOQFSNVLBBOMBVU.JTBMOZB LJUBCFSCJDBSBUFOUBOHWPMVNF IFNPHMPCJOTFQFSUJZBOHUFSEBQBUEJ#BC UFUBQJEFOHBO1P
- TBBU JOJ EJ LFEBMBNBO LBLJ JOJ BEBMBI KVNMBI VEBSB ZBOH BMWFPMVT NFODBQBJ MFCJI EBSJ NN )H 1BEB LVSWB QBMJOH
TBNBEFOHBOWPMVNF-EJQFSNVLBBOMBVU CBXBI KVHBEJHBNCBSLBOWPMVNFPLTJHFOZBOHMBSVUEBMBNDBJ
535
Unit VIII Fisiologi Penerbangan, Ruang angkasa, dan Penyelaman Laut Dalam
EBSBI QBEB CFSCBHBJ UJOHLBU 1P 1FSIBUJLBOMBI CBIXB EBMBN

CBUBTCBUBT1PBMWFPMVTOPSNBM EJCBXBINN)H
EBSJTFMVSVI
PLTJHFOZBOHCFSBEBEBMBNEBSBIIBNQJSUJEBLBEBZBOHCFSVQBPLTJ
HFO UFSMBSVU UFUBQJ EFOHBO OBJLOZB UFLBOBO PLTJHFO NFOKBEJ SJCVBO
NJMJNFUFSBJSSBLTB TFCBHJBOCFTBSEBOLFTFMVSVIBOPLTJHFOLFNVEJ
BOMBSVUEJEBMBNDBJSBOEBSBI TFMBJOZBOHCFSJLBUBOEFOHBOIFNP
HMPCJO
Efek Po2 Alveolus yang Tinggi terhadap Po2 Jaringan.

.BSJ LJUB VNQBNBLBO CBIXB 1P EBMBN QBSV BEBMBI TFLJUBS
NN )H UFLBOBO BUNPTGFS
#FSEBTBSLBO (BNCBS
CBIXB UPUBM LBOEVOHBO PLTJHFO TFUJBQ NM EBSBI BEBMBI
WPMVNF QFSTFO ZBJUV TFTVBJ EFOHBO UJUJL " QBEB HBNCBS IBM JOJ
CFSBSUJ CBIXB WPMVNF QFSTFO UFSJLBU QBEB IFNPHMPCJO EBO
WPMVNF QFSTFO UFSMBSVU EBMBN DBJSBO EBSBI ,FUJLB EBSBI NFMFXBUJ
LBQJMFSKBSJOHBO KBSJOHBOOPSNBM BLBO NFOHBNCJM NM EBSJ UJBQ
NM EBSBI TFIJOHHBLBOEVOHBOPLTJHFOTFXBLUVNFOJOHHBMLBO
LBQJMFSKBSJOHBONBTJIWPMVNF QFSTFO UJUJL # QBEB (BNCBS
%J
UJUJL JOJ 1P TFLJUBS NN )H ZBOH CFSBSUJ CBIXB PLTJHFO
EJIBOUBSLBO LF KBSJOHBO EFOHBO UFLBOBO ZBOH TBOHBU UJOHHJ
EJCBOEJOHLBO EFOHBO UFLBOBO OPSNBM ZBOH IBOZB NN )H
+BEJ LFUJLB 1P BMWFPMVT NFOJOHLBU IJOHHB NFMFXBUJ CBUBT LSJUJT
NFLBOJTNF EBQBS PLTJHFOIFNPHMPCJO UFMBIEJVSBJLBO QBEB #BC

UJEBL MBHJ EBQBU NFNQFSUBIBOLBO 1P KBSJOHBO EBMBN
CBUBTCBUBT OPSNBM ZBOH BNBO ZBJUV BOUBSB TBNQBJNN
)H
Keracunan Oksigen Akut. ,FUJLB NFOHIJSVQ PLTJHFO ZBOH
CFSUFLBOBO TBOHBU UJOHHJ EBQBU UJNCVM 1P KBSJOHBO ZBOH TBOHBU
UJOHHJ QVMB )BM JOJ EBQBU NFSVTBL CFSCBHBJ KBSJOHBO UVCVI
.JTBMOZB LFUJLBNFOHIJSVQPLTJHFOQBEBUFLBOBOBUNPTGFS 1P
NN )H
TFCBHJBO CFTBS PSBOH BLBO NFOHBMBNJ LFKBOH PUBL
ZBOHEJJLVUJLPNBTFUFMBIIJOHHBNFOJU,FKBOHLFKBOHTFSJOH
UJNCVM UBOQB EJEBIVMVJ UBOEBUBOEB QFSJOHBUBO TFIJOHHB EBQBU
NFOHBLJCBULBOLFNBUJBOQBEBQFOZFMBNEJEBMBNMBVU
(FKBMBHFKBMB MBJO LFSBDVOBO PLTJHFO BLVU BEBMBI SBTB NVBM
LFEVUBO QBEB PUPUPUPU QVTJOH HBOHHVBO QFOHMJIBUBO NVEBI
UFSTJOHHVOH EBO EJTPSJFOUBTJ (FSBLBOHFSBLBO UVCVI TBOHBU
NFOJOHLBULBO LFDFOEFSVOHBO UFSKBEJOZB LFSBDVOBO PLTJHFO QBEB
QFOZFMBN HFKBMBHFKBMB ZBOH UJNCVM KBVI MFCJI EJOJ EBO MFCJI IFCBU
EJCBOEJOHPSBOHZBOHCFSBEBEBMBNLFBEBBOEJBN
Oksidasi Intrasel Berlebihan sebagai Penyebab Keracunan

Oksigen pada Sistem Saraf—"Radikal Bebas Pengoksidasi."
.PMFLVM PLTJHFO 0
NFNQVOZBJ LFNBNQVBO ZBOH TBOHBU SFOEBI
EBMBN NFOHPLTJEBTJ TFOZBXBTFOZBXB LJNJB MBJOOZB #BILBO
NPMFLVM JOJ IBSVT EJVCBI EVMV NFOKBEJ CFOUVL PLTJHFO ZBOH BLUJGh
0LTJHFO BLUJG UFSEBQBU EBMBN CFCFSBQB CFOUVL CJBTBOZB EJTFCVU
TFCBHBJ SBEJLBM CFCBT PLTJHFO 4BMBI TBUV ZBOH QBMJOH QFOUJOH JBMBI
SBEJLBM CFCBT TVQFSPLTJEB 0 EBO ZBOH MBJO BEBMBI SBEJLBM QFSPLTJEB
EBMBN CFOUVL IJESPHFO QFSPLTJEB 4FLBMJ QVO 1P KBSJOHBO CFSTJGBU
OPSNBM EFOHBO OJMBJ NN )H TFKVNMBI LFDJM SBEJLBM CFCBT UFUBQ
UFSCFOUVL UFSVTNFOFSVT EBSJ NPMFLVM PLTJHFO ZBOH UFSMBSVU
6OUVOHOZB KBSJOHBO KVHB NFOHBOEVOH CFSCBHBJ FO[JN ZBOH EBQBU
EFOHBO DFQBU NFOHIJMBOHLBO SBEJLBM CFCBT UFSTFCVU &O[JNFO[JN
JUV JBMBI QFSPLTJEBTF LBUBMBTF EBO EJTNVUBTF TVQFSPLTJEB 0MFI
44-2 LBSFOB JUV TFMBNB NFLBOJTNF EBQBS PLTJHFOIFNPHMPCJO NBNQV
NFNQFSUBIBOLBOOJMBJOPSNBM1PKBSJOHBO SBEJLBMCFCBTQFOHPLTJ
536
Bab 44 Fisiologi Penyelaman Laut Dalam dan Keadaan Hiperbarik Lainnya
EBTJ BLBO DFQBU EJIJMBOHLBO TFIJOHHB IBOZB TFEJLJU BUBV UJEBL 4FMBJO JUV QFOZFMBN NFOHBMBNJ BTJEPTJT SFTQJSBUPSJL IFCBU
NFNFOHBSVIJKBSJOHBOTBNBTFLBMJ EJTFSUBJ CFSCBHBJ UJOHLBUBO MFUBSHJ OBSLPTJT EBO CBILBO
#JMB 1P BMWFPMVT CFSBEB EJ BUBT UJUJL LSJUJT EJ BUBT TFLJUBS BLIJSOZBUFSKBEJBOFTUFTJ TFQFSUJZBOHUFMBIEJVSBJLBOQBEB#BC
UNIT VIII
BUNPTGFS1P
NBLBNFLBOJTNFEBQBSPLTJHFOIFNPHMPCJOUJEBL
BLBONBNQVNFOHBUBTJ TFIJOHHB1PKBSJOHBOBLBONFOJOHLBU
NFOKBEJ SBUVTBO BUBV SJCVBO NJMJNFUFS BJS SBLTB 1BEB UFLBOBO Dekompresi Penyelam setelah Terpajan Tekanan Tinggi
ZBOH UJOHHJ JOJ KVNMBI SBEJLBM CFCBT QFOHPLTJEBTJ BLBO Berlebihan
NFMBNQBVJ LFNBNQVBO TJTUFN FO[JN ZBOH CFSGVOHTJ VOUVL #JMB PSBOH CFSOBQBT EBMBN MJOHLVOHBO VEBSB CFSUFLBOBO
NFOHIJMBOHLBO SBEJLBM CFCBT QFOHPLTJEBTJ UFSTFCVU TFIJOHHB UJOHHJ EBMBN KBOHLB XBLUV MBNB KVNMBI OJUSPHFO ZBOH MBSVU
NFOJNCVMLBO LFSVTBLBO IFCBU CBILBO LFNBUJBO TFM 4BMBI TBUV EBMBN DBJSBO UVCVIOZB BLBO NFOJOHLBU .FOHBQB EFNJLJBO
FGFLVUBNBOZBJBMBINFOHPLTJEBTJBTBNMFNBLUJEBLKFOVIHBOEB BLBO EJKFMBTLBO CFSJLVU JOJ %BSBI ZBOH NFOHBMJS NFMBMVJ
ZBOH NFSVQBLBO LPNQPOFO VUBNB CFSCBHBJ NFNCSBO TFM &GFL LBQJMFS QBSV BLBO KFOVI EFOHBO OJUSPHFO QBEB UFLBOBO ZBOH
ZBOH MBJOOZB BEBMBI NFOHPLTJEBTJ CFCFSBQB FO[JN TFM TFIJOHHB TBNB EFOHBO UFLBOBO DBNQVSBO VEBSB QFSOBQBTBO EBMBN
NFOHBLJCBULBO LFSVTBLBO TFSJVT QBEB TJTUFN NFUBCPMJTNF TFM BMWFPMVT 4FUFMBI CFCFSBQB KBN DVLVQ CBOZBL OJUSPHFO ZBOH
+BSJOHBO TBSBG UFSVUBNB TBOHBU SFOUBO LBSFOB LBOEVOHBO EJBOHLV LF KBSJOHBO EJ TFMVSVI UVCVI VOUVL NFOJOHLBULBO
MFNBLOZBZBOHUJOHHJ0MFILBSFOBJUV TFCBHJBOCFTBSFGFLBLVU 1OEJKBSJOHBOTFUBSBEFOHBO1/VEBSBZBOHEJIJSVQ
ZBOH NFNBUJLBO EBSJ LFSBDVOBO PLTJHFO BLVU EJTFCBCLBO PMFI 0MFI LBSFOB OJUSPHFO UJEBL EJNFUBCPMJTNF PMFI UVCVI
HBOHHVBOGVOHTJPUBL OJUSPHFOBLBOUFUBQMBSVUEJTFMVSVIKBSJOHBOUVCVITBNQBJUF
LBOBO OJUSPHFO EBMBN QBSV UVSVO LFNCBMJ IJOHHB CFCFSBQB
Keracunan Oksigen Kronis Menyebabkan Gangguan UJOHLBU MFCJI SFOEBI 1BEB TBBU JUVMBI OJUSPHFO EBQBU EJCVBOH
Paru. 4FTFPSBOHEBQBUUFSQBKBOQBEBUFLBOBOPLTJHFOBUNPTGFS NFMBMVJQFSOBQBTBO UFUBQJQFNCVBOHBOJOJTFSJOHLBMJNFNFS
EFOHBO IBNQJS UJEBL NFOHBMBNJ LFSBDVOBO PLTJHFO BLVU QBEB MVLBOXBLUVCFCFSBQBKBN EBOIBMJOJNFSVQBLBOTVNCFSEBSJ
TJTUFN TBSBG TFQFSUJ ZBOH UFMBI EJVSBJLBO EJ BUBT /BNVO IBOZB TFLVNQVMBONBTBMBIZBOHEJTFCVUQFOZBLJUEFLPNQSFTJ
TFUFMBIUFSQBKBOUFLBOBOPLTJHFOBUNPTGFSTFMBNBKBN CBSV
LFNVEJBO UFSKBEJ QFNCFOHLBLBO EJ TBMVSBO QBSV FEFNB QBSV Volume Nitrogen yang Larut dalam Cairan Tubuh
EBOBUFMFLUBTJTBLJCBULFSVTBLBOQBEBMBQJTBOCSPOLJEBOBMWFPMJ di Berbagai Kedalaman. 1BEB LFUJOHHJBO QFSNVLBBO
"MBTBO NFOHBQB FGFL JOJ UFSKBEJ EBMBN QBSV EBO CVLBO EJ MBVU IBNQJS NFOEFLBUJ TFCBOZBL - OJUSPHFO MBSVU EBMBN
KBSJOHBO MBJO BEBMBI CBIXB SVBOH VEBSB QBSV TFDBSB MBOHTVOH UVCVILJUB ,VSBOH TFEJLJU EBSJ TFQBSVI KVNMBI UFSTFCVU MBSVU
UFSQBKBO PMFI UFLBOBO PLTJHFO ZBOH UJOHHJ TFNFOUBSB EBMBN DBJSBO UVCVI EBO TJTBOZB CFSBEB EBMBN MFNBL
QFOHIBOUBSBO PLTJHFO LF KBSJOHBO MBJO QBEB 1P ZBOH IBNQJS UVCVI,PNQPTJTJ TFQFSUJ JUV UFSEBQBU EBMBN UVCVI LJUB
OPSNBMLBSFOBBEBOZBTJTUFNEBQBSPLTJHFOIFNPHMPCJO LBSFOB OJUSPHFO MJNB LBMJ MFCJI MBSVU EBMBN MFNBL EJCBOEJOH
EBMBNBJS
4FUFMBI QFOZFMBN NFOKBEJ KFOVI EFOHBO OJUSPHFO WPMVNF
Keracunan Karbon Dioksida di Laut yang Sangat OJUSPHFOEJQFSNVLBBOMBVUZBOHMBSVUEBMBNDBJSBOUVCVIQBEB
Dalam CFSCBHBJLFEBMBNBOBEBMBITFCBHBJCFSJLVU
+JLBBMBUBMBUTFMBNEJSBODBOHEFOHBOCBJLEBOCFSGVOHTJEFOHBO
Kaki Liter
CBJL NBLB QFOZFMBN UJEBL QFSMV LIBXBUJS UFSIBEBQ LFSBDVOBO
0 1
LBSCPO EJPLTJEB LBSFOB GBLUPS LFEBMBNBO TBKB UJEBL BLBO 33 2
NFOJOHLBULBO UFLBOBO QBSTJBM LBSCPO EJPLTJEB EBMBN BMWFPMJ 100 4
)BMJOJUFSKBEJLBSFOBLFEBMBNBOUJEBLNFOJOHLBULBOLFDFQBUBO 200 7
QSPEVLTJ LBSCPO EJPLTJEB EBMBN UVCVI TFMBNB QFOZFMBN UFSVT 300 10
NFOFSVTNFOHIJSVQVEBSBEFOHBOWPMVNFUJEBMZBOHOPSNBMEBO
NFOHFMVBSLBO LBSCPO EJPLTJEB ZBOH UFSCFOUVL UFLBOBO LBSCPO %JQFSMVLBOCFCFSBQBKBNBHBSUFLBOBOHBTOJUSPHFOEBMBN
EJPLTJEBBMWFPMVTBLBOUFUBQEJQFSUBIBOLBOEBMBNOJMBJOPSNBM KBSJOHBOUVCVINFOKBEJIBNQJSTFJNCBOHEFOHBOUFLBOBOHBT
1BEB CFCFSBQB KFOJT BMBU TFMBN NJTBMOZB IFMN TFMBN EBO OJUSPHFO EBMBN BMWFPMVT "MBTBO VOUVL IBM JOJ BEBMBI CBIXB
CFCFSBQB BMBU TFMBN ZBOH VEBSBOZB EJIJSVQ VMBOH LBSCPO BMJSBO EBSBI EBO EJGVTJ OJUSPHFO UJEBL CFSMBOHTVOH DVLVQ
EJPLTJEB EBQBU UFSUJNCVO EBMBN SVBOH SVHJ BMBU EBO EJIJSVQ DFQBUVOUVLEBQBUNFODJQUBLBOLFTFJNCBOHBOEFOHBOTFHFSB
LFNCBMJ PMFI QFOZFMBN 1FOZFMBN CJBTBOZB NBTJI EBQBU /JUSPHFOZBOHMBSVUEBMBNDBJSBOUVCVIBLBONFOKBEJIBNQJS
NFOPMFSBOTJ UFLBOBO LBSCPO EJPLTJEB 1DP
BMWFPMVT TBNQBJ TFJNCBOH EBMBN XBLUV LVSBOH EBSJ TBUV KBN UFUBQJ VOUVL
TFLJUBS NN )H ZBJUV EVB LBMJ LFBEBBO OPSNBM EFOHBO DBSB KBSJOHBO MFNBL LFTFJNCBOHBO CBSV UFSKBEJ TFUFMBI CFCFSBQB
NFOJOHLBULBO WPMVNF SFTQJSBTJ TFNFOJUOZB TBNQBJ NBLTJNVN KBN LBSFOBNFNFSMVLBOOJUSPHFOMJNBLBMJMJQBUMFCJICBOZBL
ZBJUV TBNQBJ LBMJ MJQBU VOUVL NFOHPNQFOTBTJ QFOJOHLBUBO EBO TVQMBJ EBSBIOZB SFMBUJG TFEJLJU ,BSFOB BMBTBO JOJ CJMB
LBSCPO EJPLTJEB #JMB 1DP BMWFPMVT MFCJI EBSJ NN )H PSBOHUJOHHBMEJLFEBMBNBOIBOZBVOUVLCFCFSBQBNFOJUTBKB
LFBEBBO UJEBL EBQBU EJJNCBOHJ MBHJ EBO QVTBU QFSOBQBTBO QBEB UJEBL CBOZBL OJUSPHFO ZBOH MBSVU EBMBN DBJSBO UVCVI EBO
BLIJSOZB CVLBO UFSBOHTBOH UFUBQJ NBMBI UFSUFLBO LBSFOB FGFL KBSJOHBO TFNFOUBSB CJMB PSBOH UFSTFCVU CFSEJBN TFMBNB
OFHBUJG NFUBCPMJL KBSJOHBO BLJCBU 10 ZBOH UJOHHJ ,FNVEJBO CFCFSBQB KBN DBJSBO UVCVI EBO KBSJOHBO MFNBL BLBO KFOVI
QFOZFMBNNVMBJNFOHBMBNJHBHBMCFSOBQBT CVLBOLPNQFTOBTJ EFOHBOOJUSPHFO
537
Unit VIII Fisiologi Penerbangan, Ruang Angkasa, dan Penyelaman Laut Dalam
Penyakit Dekompresi (Sinonim: Bends, Penyakit CFMVN UFSMJIBU EBMBN CFCFSBQB NFOJU BUBV KBN LBSFOB LBEBOH
Kompresi Udara, Penyakit Caisson, Paralisis LBEBOHHBTEBQBUUFUBQMBSVUEBMBNLFBEBBOTBOHBUKFOVITFMB
1FOZFMBN %JTCBSJTNF
#JMB TFPSBOH QFOZFMBN UFMBI MBNB NBCFCFSBQBKBNTFCFMVNNFNCFOUVLHFMFNCVOH
CFSBEBEJEBMBNMBVUTFIJOHHBTFKVNMBICFTBSOJUSPHFOUFSMBSVU
EBMBN UVCVIOZB EBO KJLB LFNVEJBO JB UJCBUJCB OBJL LF QFS Gejala Penyakit Dekompresi ("Bends").
NVLBBOMBVU EBQBUUJNCVMTFKVNMBIHFMFNCVOHOJUSPHFOZBOH 4FCBHJBO CFTBS HFKBMB QFOZBLJU EFLPNQSFTJ EJTFCBCLBO PMFI
DVLVQ TJHOJGJLBO EBMBN DBJSBO UVCVIOZB CBJL EJ EBMBN NBV HFMFNCVOHHFMFNCVOH HBT ZBOH NFOZVNCBU CBOZBL QFNCVMVI
QVO EJ MVBS TFM EBO IBM JOJ EBQBU NFOJNCVMLBO LFSVTBLBO EJ EBSBI EJ CFSCBHBJ KBSJOHBO .VMBNVMB IBOZB QFNCVMVI EBSBI
IBNQJSTFUJBQUFNQBUEBMBNUVCVI EBSJEFSBKBUSJOHBOTBNQBJ QBMJOHLFDJMZBOHEJTVNCBUPMFIHFMFNCVOHHFMFNCVOHLFDJM UF
CFSBU CFSHBOUVOH QBEB KVNMBI EBO VLVSBO HFMFNCVOH ZBOH UBQJ TFJSJOH EFOHBO QFOZBUVBO HFMFNCVOHHFMFNCVOH UFSTFCVU
UFSCFOUVLIBMJOJEJTFCVUQFOZBLJUEFLPNQSFTJ QFNCVMVIEBSBIZBOHCFTBSTFDBSBQSPHSFTJGBLIJSOZBUFSTVNCBU
1SJOTJQQSJOTJQ ZBOH NFMBUBS CFMBLBOHJ QFNCFOUVLBO KVHB"LJCBUOZBUFSKBEJJTLFNJBKBSJOHBOEBOLBEBOHLBEBOHCBI
HFMFNCVOH EBQBU EJMJIBU QBEB (BNCBS 1BEB (BNCBS LBOLFNBUJBOKBSJOHBO
" EBQBU EJMJIBU CBIXB KBSJOHBO QFOZFMBN UFMBI EJTFJN 1BEB LFCBOZBLBO PSBOH EFOHBO QFOZBLJU EFLPNQSFTJ HFKBMB
CBOHLBO IJOHHB UFLBOBO OJUSPHFO ZBOH MBSVU UJOHHJ 1/ OZB BEBMBI OZFSJ QBEB TFOEJ EBO PUPUPUPU MFOHBO EBO UVOHLBJ
NN)H
TFLJUBS LBMJKVNMBIOJUSPHFOOPSNBMEBMBN NFNFOHBSVIJTFLJUBSQFSTFOZBOHUFSLFOBQFOZBLJUEFLPN
KBSJOHBO 4FMBNB QFOZFMBN NBTJI UFUBQ CFSBEB EJ EBMBN MBVU QSFTJ /ZFSJ TFOEJ ZBOH EJJTUJMBILBO EFOHBO CFOET TFSJOH LBMJ
UFLBOBOEJMVBSUVCVIOZB NN)H
BLBONFOFLBOTFMV UFSKBEJQBEBLPOEJTJJOJ
SVI KBSJOHBO UVCVI TFIJOHHB HBT OJUSPHFO ZBOH CFSMFCJIBO 1BEB TBNQBJ QFSTFO PSBOHPSBOH EFOHBO QFOZBLJU
BLBOUFSMBSVU5FUBQJCJMBQFOZFMBNJUVNFOEBEBLOBJLLFQFS EFLPNQSFTJ UFSKBEJ HFKBMB TJTUFN TBSBG ZBOH CFSLJTBS EBSJ SBTB
NVLBBO MBVU (BNCBS #
UFLBOBO EJ MVBS UVCVIOZB QVTJOHQBEBTFLJUBSQFSTFOQBTJFOTBNQBJQBSBMJTJTBUBVLPMBQT
NFOKBEJ IBOZB BUNPTGFS NN )H
TFEBOHLBO UFLBOBO EBO IJMBOH LFTBEBSBO QBEB QFSTFO QBTJFO 1BSBMJTJT CFSTJGBU
HBT EBMBN DBJSBO UVCVIOZB NFSVQBLBO KVNMBI EBSJ UFLBOBO TFNFOUBSB UFUBQJ QBEB CFCFSBQB LBTVT LFSVTBLBO JOJ CFSTJGBU
VBQ BJS LBSCPO EJPLTJEB PLTJHFO EBO OJUSPHFO BUBV UPUBM NFOFUBQ
NN)H TFLJUBSQFSTFOOZBEJTFCBCLBOPMFIOJUSPHFO "LIJSOZB TFLJUBS QFSTFO QBTJFO EFOHBO QFOZBLJU EFLPN
5FSMJIBUKFMBTCBIXBOJMBJUPUBMNN)HKBVIMFCJICFTBS QSFTJ NFOHBMBNJ SBTB UFSDFLJL ZBOH EJTFCBCLBO PMFI HFMFN
EBSJUFLBOBOEJMVBSUVCVIZBJUVNN)H0MFILBSFOBJUV CVOHHFMFNCVOH LFDJM NBTJG ZBOH NFOZVNCBU LBQJMFS QBSV IBM
HBT BLBO LFMVBS EBSJ MBSVUBO EBO NFNCFOUVL HFMFNCVOH JOJEJUBOEBJEFOHBOOBQBTQFOEFLQFOEFLZBOHCFSBU TFSJOHLBMJ
HFMFNCVOH ZBOH IBNQJS TFMVSVIOZB UFSEJSJ BUBT OJUSPHFO IBM EJJLVUJEFOHBOFEFNBQBSVCFSBUEBO LBEBOHLBEBOH LFNBUJBO
JOJEBQBUUFSKBEJEJEBMBNKBSJOHBOEBOEBMBNEBSBI ZBOHLF
NVEJBONFOZVNCBUQFNCVMVIEBSBILFDJM(FMFNCVOHNBTJI Pembuangan Nitrogen dari Tubuh; Tabel
Dekompresi. +JLBQFOZFMBNEJCBXBLFQFSNVLBBOTFDBSBQFSMB
IBOMBIBO CJBTBOZBOJUSPHFOZBOHUFSMBSVUBLBOEJCVBOHEFOHBO
FLTQJSBTJ NFMBMVJ QBSV TFIJOHHB UJEBL QFSMV UFSKBEJ QFOZBLJU EF
LPNQSFTJ,JSBLJSBEVBQFSUJHBEBSJOJUSPHFOUPUBMBLBOUFSCVBOH
O2 = 1044 mm Hg O2 = 159 mm Hg EBMBNTBUVKBN EBOLJSBLJSBQFSTFOEBMBNKBN
N2 = 3956 N2 = 601
5BCFM EFLPNQSFTJ ZBOH NFSJODJ QSPTFEVS EFLPNQSFTJ ZBOH
Total = 5000 mm Hg Total = 760 mm Hg BNBOUFMBIEJCVBUPMFI"OHLBUBO-BVU"NFSJLB4FSJLBU4FCBHBJ
DPOUPIVOUVLNFNCFSJLBOHBNCBSBOLFQBEBNBIBTJTXBUFOUBOH
QSPTFT EFLPNQSFTJ TFPSBOH QFOZFMBN ZBOH UFMBI NFOHIJSVQ
VEBSB EBO CFSBEB EJ LFEBMBNBO MBVU LBLJ TFMBNB NFOJU
EJMBLVLBOEFLPNQSFTJTFCBHBJCFSJLVU
NFOJUQBEBLFEBMBNBOLBLJ
H2O = 47 mm Hg H2O = 47 mm Hg
CO2 = 40 CO2 = 40
O2 = 60 O2 = 60 +BEJ VOUVLPSBOHZBOHCFLFSKBTFMBNBKBNEJLFEBMBNBO UPUBM
N2 = 3918 N2 = 3918
XBLUVVOUVLEFLPNQSFTJOZBLJSBLJSBUJHBKBN
A Total = 4065 B Total = 4065
Tangki Dekompresi dan Terapi Penyakit Dekompresi.

1SPTFEVS MBJO ZBOH CBOZBL EJHOOBLBO VOUVL EFLPNQSFTJ
QFOZFMBN QSPGFTJPOBM BEBMBI EFOHBO NFNBTVLLBO QFOZFMBN LF
EBMBN UBOHLJ CFSUFLBOBO EBO LFNVEJBO NFOVSVOLBO UFLBOBO
TFDBSB CFSUBIBQ LFNCBMJ LF UFLBOBO BUNPTGFS OPSNBM EFOHBO
NFOHHVOBLBO KBEXBM XBLUV ZBOH TBNB TFQFSUJ UFSUVMJT
TFCFMVNOZB
538
Bab 44 Fisiologi Penyelaman Laut Dalam dan Keadaan Hiperbarik Lainnya
5BOHLJ EFLPNQSFTJ CBILBO MFCJI QFOUJOH VOUVL NFOHPCBUJ

PSBOHPSBOHZBOHNFNJMJLJHFKBMBQFOZBLJUEFLPNQSFTJZBOHUF
MBI CFSMBOHTVOH TFMBNB CFSNFOJUNFOJU CBILBO CFSKBNKBN TF
UNIT VIII
UFMBI PSBOH UFSTFCVU LFNCBMJ LF QFSNVLBBO %BMBN IBM JOJ QF
OZFMBNTFHFSBEJSFLPNQSFTJLFNCBMJLFUJOHLBUZBOHEBMBN,F
NVEJBOEFLPNQSFTJEJMBLVLBOTFMBNBKBOHLBXBLUVCFCFSBQBMB
NBTFQFSUJEFLPNQSFTJZBOHCJBTB
"Penyelaman Jenuh" dan Penggunaan Campuran
Helium-Oksigen pada Penyelaman Dalam. ,FUJLBQFOZFMBN
IBSVT CFLFSKB QBEB UJOHLBU LFEBMBNBO ZBOH DVLVQ CFTBS BOUBSB
LBLJ EBO NFOEFLBUJ LBLJ QFOZFMBN TFSJOH LBMJ CFS
EJBNEJEBMBNUBOHLJLPNQSFTJZBOHCFTBSTFMBNBCFCFSBQBIBSJ
BUBV CFCFSBQB NJOHHV UFUBQ UFSLPNQSFTJ QBEB UJOHLBU UFLBOBO
ZBOH NFOEFLBUJ LPOEJTJ UFLBOBO EJ UFNQBU QFOZFMBN UFSTFCVU
BLBOCFLFSKB)BMJOJBLBONFNQFSUBIBOLBOKBSJOHBOEBODBJSBO
UVCVINFOKBEJKFOVIEFOHBOHBTHBTZBOHBLBOUFSQBKBOPMFIQF
OZFMBN LFUJLB NFOZFMBN -BMV CJMB QBSB QFOZFMBN LFNCBMJ LF
UBOHLJZBOHTBNBTFUFMBICFLFSKB UJEBLUFSEBQBUQFSVCBIBOZBOH
CFSNBLOB QBEB UFLBOBO EFOHBO EFNJLJBO UJEBL UFSKBEJ HFMFN
CVOHHFMFNCVOHEFLPNQSFTJ
1BEB QFOZFMBNBO ZBOH TBOHBU EBMBN UFSVUBNB TFMBNB
QFOZFMBNBO KFOVI TBUVSBUJPO EJWJOH
CJBTBOZB MFCJI TFSJOH EJ
HVOBLBOIFMJVNEBMBNDBNQVSBOHBTEBSJQBEBOJUSPHFO IBMJOJ
LBSFOBLFUJHBBMBTBOCFSJLVU
IFMJVNIBOZBNFNJMJLJTFQFSMJ Gambar 44-4 Alat SCBUA jenis sirkuit terbuka.
NBFGFLOBSLPUJLOJUSPHFO
WPMVNFIFMJVNZBOHMBSVUEBMBN
KBSJOHBOUVCVIIBOZBTFLJUBSTFUFOHBIWPMVNFOJUSPHFO EBOWP
MVNFZBOHUFSMBSVUTFMBNBEFLPNQSFTJBLBOCFSEJGVTJLFMVBSEBSJ LJCFSJTJVEBSBCFSUFLBOBOBUBVVEBSBDBNQVSBOMBJOOZB

KBSJOHBO CFCFSBQB LBMJ MFCJI DFQBU EBSJQBEB OJUSPHFO KBEJ BLBO LBUVQQFOHVSBOHUBIBQQFSUBNBVOUVLNFOHVSBOHJUFLBOBO
NFOHVSBOHJ NBTBMBI QFOZBLJU EFLPNQSFTJ EBO
LFQBEBUBO ZBOH TBOHBU UJOHHJ EBSJ UBOHLJ BHBS VEBSB NFOHBMJS EFOHBO
IFMJVNZBOHSFOEBI TFQFSUVKVILFQBEBUBOOJUSPHFO
BLBONFOK UFLBOBOSFOEBI
LPNCJOBTJLBUVQJOTQJSBTJZBOHCFSEBTBS
BHB SFTJTUBOTJ BMJSBO VEBSB VOUVL CFSOBQBT QBEB LFBEBBO NJOJ LBOLFCVUVIBOEBOLBUVQFLTQJSBTJZBOHTFDBSBLFTFMVSVIBO
NVN IBM JOJ NFOKBEJ TBOHBU QFOUJOH LBSFOB OJUSPHFO ZBOH UFS NFNVOHLJOLBOVEBSBNBTVLLFEBMBNQBSVEFOHBOUFLBOBO
LPNQSFTJ UJOHHJ CFSTJGBU TBOHBU QBEBU TFIJOHHB SFTJTUBOTJ BMJSBO TFEJLJU OFHBUJG EBO LFNVEJBO EJFLTQJSBTJLBO LF EBMBN MBVU
VEBSB EBQBU NFOKBEJ FLTUSFN LBEBOHLBEBOH NFNCVBU VQBZB EFOHBOUFLBOBOTFEJLJUQPTJUJGLFUFLBOBOBJSTFLJUBS EBO

CFSOBQBTNFMFCJIJCBUBTLFLVBUBO TFCVBINBTLFSEBOTVTVOBOQJQBZBOHSVBOHSVHJOZBLFDJM
"LIJSOZB QBEBQFOZFMBNBOZBOHTBOHBUEBMBN QFOUJOHVOUVL
NFOVSVOLBO LBEBS PLTJHFO EBMBN DBNQVSBO HBT LBSFOB BLBO 4JTUFN ZBOH CFSEBTBSLBO LFCVUVIBO JOJ CFLFSKB TFCBHBJ
NFOHBLJCBULBOLFSBDVOBOPLTJHFO4FCBHBJDPOUPI QBEBLFEBMB CFSJLVU,BUVQQFOHVSBOHUFLBOBOUBIBQQFSUBNBNFOHVSBOHJ
NBOLBLJ UFLBOBOBUNPTGFS
QFSTFODBNQVSBOPLTJHFO UFLBOBOVEBSBZBOHCFSBTBMEBOUBOHLJ LBSFOBJUVVEBSBZBOH
BLBONFOZFEJBLBOTFMVSVIPLTJHFOZBOHEJQFSMVLBOPMFIQFOZF NFOHBMJS LF NBTLFS NFNJMJLJ UFLBOBO ZBOH IBOZB CFCFSBQB
MBN TFEBOHLBOQFSTFODBNQVSBOPLTJHFO QFSTFOUBTFEJVEB NN)HTFEJLJUMFCJICFTBSEBSJQBEBUFLBOBOBJSEJTFLJUBSOZB
SB
BLBO NFOHIBTJMLBO 1P QBSV MFCJI EBSJ BUNPTGFS LBEBS 6EBSBDBNQVSBOVOUVLQFSOBQBTBOUJEBLNFOHBMJSTFDBSBLPO
ZBOH DFOEFSVOH EBQBU NFOZFCBCLBO LFKBOH EBMBN XBLUV UJOVLFEBMBNNBTLFS4FCBMJLOZB TFUJBQLBMJJOTQJSBTJ UFLBOBO
NFOJU ZBOH TFEJLJU FLTUSB OFHBUJG EBMBN LBUVQ LFCVUVIBO QBEB
NBTLFS BLBO NFOBSJL EJBGSBHNB EJ LBUVQ UFSCVLB EBO LFNV
Penyelaman dengan SCUBA (Self- EJBO TFDBSB PUPNBUJT NFMFQBTLBO VEBSB EBSJ UBOHLJ LF EBMBN
Contained Underwater Breathing Apparatus) NBTLFSEBOQBSV%FOHBODBSBJOJ IBOZBVEBSBZBOHEJQFSMV
LBO VOUVL JOTQJSBTJ TBKB ZBOH NBTVL ,FNVEJBO QBEB XBLUV
4FCFMVN BO IBNQJS TFNVB QFOZFMBNBO EJMBLVLBO EF FLTQJSBTJ VEBSBUJEBLEBQBUNFOHBMJSLFNCBMJLFUBOHLJUFUBQJ
OHBO NFOHHVOBLBO IFMN ZBOH EJIVCVOHLBO LF QFSNVLBBO TFCBMJLOZBEJFLTQJSBTJLBOLFMVBS
NFMBMVJQJQBVOUVLNFNQFSPMFIVEBSBZBOHEJQPNQBLBO1BEB 1FSTPBMBO QBMJOH QFOUJOH EBMBN QFOHHVOBBO BMBU 4$6#"
UBIVO TFPSBOHQFOKFMBKBI1SBODJT+BDRVFT$PVTUFBVNFN JBMBIUFSCBUBTOZBXBLUVQFOZFMBNBOTFCBHBJDPOUPI QFOZFMB
QPQVMFSLBO TFMGDPOUBJOFE VOEFSXBUFS CSFBUIJOH BQQBSBUVT NBO TFEBMBN LBLJ IBOZB EBQBU CFSMBOHTVOH TFMBNB CFCF
ZBOHEJLFOBMTFCBHBJBMBU4$6#"+FOJTBMBU4$6#"ZBOHEJHV SBQBNFOJU)BMJOJLBSFOBEJQFSMVLBOBMJSBOVEBSBZBOHTBOHBU
OBLBO QBEB LJSBLJSB MFCJI EBSJ QFSTFO PMBISBHB TFMBN EBO IFCBUEBSJUBOHLJVOUVLNFOHIBMBVLBSCPOEJPLTJEBEBSJQBSV
QFOZFMBNBO LPNFSTJBM BEBMBI TJTUFN TJSLVJU UFSCVLB TFQFSUJ TFNBLJO EBMBN QFOZFMBNBO TFNBLJO CFTBS KVNMBI BMJSBO
ZBOH EJQFSMJIBULBO QBEB (BNCBS 4JTUFN JOJ UFSEJSJ BUBT VEBSB ZBOH EJQFSMVLBO TFUJBQ NFOJUOZB LBSFOB WPMVNF UFMBI
LPNQPOFOLPNQPOFOCFSJLVU
UFSEBQBUTBUVBUBVMFCJIUBOH EJLPNQSFTJNFOKBEJMFCJILFDJM
539
Unit VIII Fisiologi penerbangan, Ruang Angkasa, dan Penyelaman Laut Dalam
Beberapa Aspek Fisiologis Kapal Selam QVTBUQVTBU NFEJL TFLBSBOH UFSTFEJB UBOHLJUBOHLJ CFTBS CFSUF
Sewaktu Keluar dari Kapal Selam. 1FSTPBMBO QSBLUJT LBOBOVOUVLNFMFUBLLBOQBTJFOZBOHBLBOEJCFSJUFSBQJEFOHBO
ZBOH UFSKBEJ QBEB QFOZFMBNBO EJ MBVU EBMBN TFSJOH EJKVNQBJ PLTJHFO IJQFSCBSJL #JBTBOZB PLTJHFO EJCFSJLBO EFOHBO 1P[
KVHBQBEBLBQBMTFMBN UFSVUBNBCJMBLJUBIBSVTLFMVBSEBSJLB TBNQBJBUNPTGFSEFOHBONFOHHVOBLBONBTLFSBUBVQJQBJOUSB
QBM 5BOQB NFOHHVOBLBO BMBU BQBQVO LJUB EBQBU LFMVBS EBSJ USBLFB TFNFOUBSBHBTEJTFLJUBSUVCVINFSVQBLBOVEBSBOPSNBM
LFEBMBNBO LBLJ /BNVO EFOHBO BMBU QFSOBQBTBO ZBOH ZBOHUFSLPNQSFTTBNQBJNFODBQBJUFLBOBOZBOHTBNB
VEBSBOZB EJIJSVQ VMBOH UFSVUBNB ZBOH NFOHBOEVOH IFMJVN %JEVHB CBIXB SBEJLBM CFCBT QFOHPLTJEBTJ TFMBJO CFSUBOHHVOH
TFDBSBUFPSFUJTLJUBEBQBULFMVBSEBSJLFEBMBNBOLBLJBUBV KBXBC UFSIBEBQ UFSKBEJOZB LFSBDVOBO PLTJHFO KVHB QBMJOH UJEBL
CBILBOMFCJI NFNCFSJLBO CFCFSBQB LFVOUVOHBO EBMBN UFSBQJ 5FSBQJ EFOHBO
4BMBITBUVQFSTPBMBOVUBNBQBEBQFSJTUJXBEJBUBTJBMBIQFO PLTJHFO IJQFSCBSJL TBOHBU CBJL VOUVL CFCFSBQB LFBEBBO ZBOH
DFHBIBO UFSKBEJOZB FNCPMJ VEBSB 1BEB XBLUV OBJL LF BUBT BLBOEJVSBJLBOCFSJLVU
VEBSBEBMBNQBSVBLBONFOHFNCBOH LBEBOHLBEBOHLFBEBBO .VOHLJO ZBOH QBMJOH TVLTFT EBMBN QFOHHVOBBO PLTJHFO
JOJ NFNFDBILBO QFNCVMVI EBSBI QBSV NFNBLTB VEBSB NB IJQFSCBSJL JBMBI VOUVL UFSBQJ HBOHSFO HBT #BLUFSJ QFOZFCBC
TVLLFEBMBNQFNCVMVIEBSBIUFSTFCVUTFIJOHHBUJNCVMFNCPMJ QFOZBLJUJOJ ZBJUVLVNBOLMPTUSJEJVN TBOHBUCBJLUVNCVIQBEB
VEBSB0MFILBSFOBJUV TFXBLUVOBJLPSBOHUFSTFCVUIBSVTNF MJOHLVOHBO BOBFSPC EBO BLBO CFSIFOUJ UVNCVI QBEB UFLBOBO
MBLVLBO VQBZB LIVTVT BHBS EBQBU NFNCVBOH VEBSB OBGBTOZB PLTJHFO MFCJI EBSJ NN )H 0MFI LBSFOB JUV QFNCFSJBO
TFDBSBLPOUJOV PLTJHFOIJQFSCBSJLQBEBKBSJOHBOTFSJOHLBMJEBQBUNFOHIFOUJLBO
Persoalan Kesehatan dalam Kapal Selam. QSPTFTJOGFLTJTFDBSBUPUBM EFOHBOEFNJLJBODBSBJOJUFMBINFOHV
4FMBJO QFSTPBMBO ZBOH UFSKBEJ TFXBLUV OBJL LF QFSNVLBBO CBI LFBEBBO TFCFMVNOZB ZBOH IBNQJS QFSTFO GBUBM NFOKBEJ
LFEPLUFSBO CBXBI MBVU VNVNOZB CFSLBJUBO EFOHBO IBMIBM LFBEBBO ZBOH EBQBU EJTFNCVILBO NFMBMVJ QFOHPCBUBO EJOJ
UFLOJT ZBOH CFSUVKVBO VOUVL NFOKBHB BHBS MJOHLVOHBO EBMBN EFOHBOUFSBQJIJQFSCBSJL
LBQBM TFMBN UFUBQ BNBO )BM ZBOH QFSUBNB QBEB LBQBM TFMBN 5FSBQJEFOHBOPLTJHFOIJQFSCBSJLKVHBCFSHVOBBUBVNVOHLJO
CFSUFOBHB BUPN UFSEBQBU QFSTPBMBO SBEJBTJ OBNVO EFOHBO CFSHVOB UFSIBEBQ CFCFSBQB LFBEBBO JOJ ZBJUV QFOZBLJU EFLPN
QFMJOEVOH ZBOH NFNBEBJ KVNMBI SBEJBTJ ZBOH EJUFSJNB PMFI QSFTJ FNCPMJ HBT EBMBN BSUFSJ LFSBDVOBO LBSCPO NPOPLTJEB
BXBL ZBOH CFLFSKB EJ CBXBI MBVU BLBO MFCJI LFDJM EJCBOEJOH PTUFPNJFMJUJT EBOJOGBSLNJPLBSE
EFOHBOSBEJBTJOPSNBMTJOBSLPTNJLZBOHEJUFSJNBPMFIPSBOH
PSBOHZBOHCFSBEBEJBUBTQFSNVLBBOMBVU
)BM LFEVB ZBOH IBSVT EJQFSIBUJLBO JBMBI LBEBOHLBEBOH HBT Daftar Pustaka
CFSBDVO NBTVL LF EBMBN SVBOH LBQBM TFMBN EBO JOJ IBSVT
Butler PJ: Diving beyond the limits, News Physiol Sci 16:222, 2001.
EJEFUFLTJ TFDFQBUOZB 4FCBHBJ DPOUPI TFUFMBI NFOZFMBN
Leach RM, Rees PJ,Wilmshurst P: Hyperbaric oxygen therapy, BMJ 317:1140,
CFSNJOHHVNJOHHV SPLPL ZBOH EJJTBQ PMFI BXBL LBQBM EBQBU 1998.
NFOHIBTJMLBOTFKVNMBILBSCPONPOPLTJEB ZBOHCJMBUJEBLEJ Lindholm P, Lundgren CE: The physiology and pathophysiology of human
CVBOH EFOHBO TFHFSB EBQBU NFOJNCVMLBO LFSBDVOBO LBSCPO breath-hold diving,JApplPhysiol 106:284, 2009.
NPOPLTJEB EBO CBILBO LBEBOHLBEBOH HBT 'SFPO KVHB EJUF Moon RE, Cherry AD, Stolp BW, et Pulmonary Gas Exchange in Diving, J
NVLBO CFSEJGVTJ LFMVBS EBSJ TJTUFN QFOEJOHJO EBMBN KVNMBI Appl Physiol 2008 [Epub ahead of pr i nt ].
Neuman TS: Arterial gas embolism and decompression sickness, News
ZBOHDVLVQCBOZBLTFIJOHHBNFOJNCVMLBOLFSBDVOBO Physiol Sci 17:77, 2002.
Terapi Oksigen Hiperbarik Pendergast DR, Lundgren CEG: The physiology and pathophysiology of the
hyperbaric and diving environments, J Appl Physiol 106:274, 2009. Thom SR:
Oxidative stress is fundamental to hyperbaric oxygen therapy,
4JGBU PLTJEBTJ LVBU ZBOH EJNJMJLJ PMFI PLTJHFO CFSUFLBOBO J Appl Physiol 2008 doi:10.1152/japplphysio191004.
UJOHHJ PLTJHFOIJQFSCBSJL
NFNQVOZBJFGFLUFSBQJZBOHTBOHBU
CFSIBSHBEBMBNCFCFSBQBLFBEBBOLMJOJT0MFILBSFOBJUV EJ
540
IX
UNIT
4JTUFN4BSBG"1SJOTJQ1SJOTJQ
6NVNEBO'JTJPMPHJ4FOTPSJL
45. Organisasi Sistem Saraf, Fungsi
Dasar Sinaps, dan Neurotransmiter
46. Reseptor-Reseptor Sensorik, Rangkaian
Saraf untuk Pengolahan lnformasi
47. Sensasi Somatik: I. Susunan Umum,
Indra Taktil, dan Posisi
48. Sensasi Somatik: II. Nyeri, Sakit
Kepala, dan Suhu
BAB 45
UNIT IX
0SHBOJTBTJ4JTUFN4BSBG 'VOHTJ%BTBS
4JOBQT EBO/FVSPUSBOTNJUFS
4JTUFNTBSBGCFSTJGBUVOJLEBMBNIBM 1FOHBMBNBOTFOTPSJLJOJEBQBUNFOJNCVMLBOSFBLTJTFHFSBEBSJ
QSPTFT CFSQJLJS EBO GVOHTJ PUBL BUBV NFNPSJ EBSJ QFOHBMBNBO UFSTFCVU EBQBU EJTJNQBO
QFOHBUVSBO ZBOH TBOHBU LPNQMFLT EBMBN PUBL TFMBNB CFCFSBQB NFOJU CFCFSBQB NJOHHV BUBV
ZBOH EBQBU EJMBLVLBOOZB 4JTUFN CFCFSBQB UBIVO EBO TFMBOKVUOZB EBQBU NFOFOUVLBO SFBLTJ
JOJ TFUJBQ NFOJU NFOFSJNB CFSKVUB UVCVIEJNBTBEBUBOH
KVUB JOGPSNBTJ ZBOH CFSBTBM EBSJ (BNCBS NFOHHBNCBSLBO CBHJBO TPNBUJL TJTUFN
CFSNBDBNNBDBNTBSBGTFOTPSJL TFOTPSJLZBOHNFOHIBOUBSLBOJOGPSNBTJTFOTPSJLEBSJSFTFQUPS
EBO PSHBO TFOTPSJL LFNVEJBO NFOHJOUFHSBTJLBO TFNVBOZB VOUVL EJTFMVSVIQFSNVLBBOUVCVIEBOEBSJCFCFSBQBTUSVLUVSPSHBO
NFOFOUVLBOSFTQPOTUVCVI EBMBN*OGPSNBTJJOJNBTVLLFEBMBNTJTUFNTBSBGQVTBUNFMBMVJ
4FCFMVN NFNVMBJ QFNCBIBTBO NFOHFOBJ TJTUFN TBSBG JOJ TBSBGTBSBG QFSJGFS EBO TFHFSB EJIBOUBSLBO LF CFSCBHBJ BSFB
TFCBJLOZBQFNCBDBNFMJIBULFNCBMJ#BCEBO ZBOHNFOZBKJLBO TFOTPSJL EJ
TFNVB UJOHLBU NFEVMB TQJOBMJT
TVCTUBOTJB
QSJOTJQQSJOTJQQPUFOTJBMNFNCSBOEBOQFOHIBOUBSBOTJOZBMQBEB SFUJLVMBS NFEVMB PCMPOHBUB QPOT EBO NFTFOTFGBMPO

TBSBGEBONFMBMVJUBVUOFVSPNVTLVMBS OFVSPNVTDVMBSKVODUJPO
TFSFCFMVN
UBMBNVTEBO
BSFBLPSUFLTTFSFCSJ
Desain Umum Sistem Saraf Bagian Motorik Sistem Saraf—Efektor

1BEB BLIJSOZB QFSBO ZBOH QBMJOH QFOUJOH EBSJ TJTUFN TBSBG
Neuron Sistem Saraf Pusat: Unit Fungsional Dasar BEBMBINFOHBUVSCFSCBHBJBLUJWJUBTUVCVI)BMJOJEBQBUEJDBQBJ
4JTUFN TBSBG QVTBU NFOHBOEVOH MFCJI EBSJ NJMJBS OFVSPO NFMBMVJ QFOHBUVSBO
LPOUSBLTJ PUPU SBOHLB ZBOH UFQBU EJ
(BNCBSNFNQFSMJIBULBOTBMBITBUVKFOJTOFVSPOZBOHLIBT TFMVSVI UVCVI
LPOUSBLTJ PUPU QPMPT PSHBO EBMBN EBO

ZBOH EJUFNVLBO EJ LPSUFLT NPUPSJL PUBL 4JOZBM ZBOH EBUBOH TFLSFTJ CBIBO LJNJB BLUJG PMFI LFMFOKBS FLTPLSJO EBO FOEPLSJO
NBTVLLFOFVSPOJOJNFMBMVJTJOBQTZBOHMPLBTJOZBTFCBHJBOCFTBS EJ TFCBHJBO CFTBS UVCVI 4FMVSVI BLUJWJUBT JOJ EJTFCVU GVOHTJ
UFSMFUBL EJ EFOESJU OFVSPO EBO KVHB QBEB CBEBO TFM 6OUVL NPUPSJL TJTUFN TBSBG TFEBOHLBO PUPU EBO LFMFOKBS EJTFCVU
CFSCBHBJ KFOJT OFVSPO NVOHLJO IBOZB UFSEBQBU CFCFSBQB SBUVT FGFLUPS LBSFOB NFSVQBLBO TUSVLUVS BOBUPNJT TFTVOHHVIOZB
BUBV TBNQBJ IVCVOHBO TJOBQUJL TFNBDBN JUV EBSJ TFSBU ZBOH NFMBLTBOBLBO GVOHTJOZB TFTVBJ EFOHBO ZBOH
TFSBUZBOHNBTVL4FCBMJLOZB TJOZBMZBOHLFMVBSCFSKBMBONFMBMVJ EJQFSJOUBILBOPMFITJOZBMTBSBG
BLTPO UVOHHBM ZBOH NFOJOHHBMLBO OFVSPO ,FNVEJBO BLTPO JOJ (BNCBS NFNQFSMJIBULBO BLTJT TBSBG NPUPSJL TLFMFUBM
CFSDBCBOHCBOZBLNFOVKVLFCBHJBOCBHJBOMBJOTJTUFNTBSBGBUBV EBSJ TJTUFN TBSBG ZBOH NFOHBUVS LPOUSBLTJ PUPU SBOHLB
UVCVICBHJBOQFSJGFS 5FSEBQBUTJTUFNTBSBGMBJOZBOHCFSKBMBOTFKBKBSEFOHBOBLTJTJOJ
$JSJ LIVTVT EBSJ TFCBHJBO CFTBS TJOBQT BEBMBI CBIXB EBMBN ZBOH NFOHBUVS PUPU QPMPT LFMFOKBS EBO TJTUFN EBMBN UVCVI
LFBEBBOOPSNBMTJOZBMIBOZBCFSKBMBOLFBSBIEFQBO EBSJBLTPO MBJOOZB ZBLOJ TJTUFN TBSBG PUPOPN IBM JOJ BLBO EJCBIBT QBEB
OFVSPO TFCFMVNOZB LF EFOESJU QBEB NFNCSBO TFM OFVSPO #BC
CFSJLVUOZB)BMJOJNFNBLTBTJOZBMVOUVLCFSKBMBOLFBSBIZBOH
1FSIBUJLBO QBEB (BNCBS UBNQBL CBIXB PUPU SBOHLB
EJQFSMVLBOVOUVLNFMBLTBOBLBOGVOHTJTBSBGZBOHLIVTVT
EBQBUEJBUVSEBSJCBOZBLUJOHLBUBOTJTUFNTBSBGQVTBU UFSNBTVL

NFEVMB TQJOBMJT
TVCTUBOTJB SFUJLVMBS NFEVMB PCMPOHBUB
Bagian Sensorik Sistem Saraf—Reseptor-Reseptor
QPOT EBONFTFOTFGBMPO
HBOHMJBCBTBMJT
TFSFCFMVNEBO
Sensorik
LPSUFLT NPUPSJL 4FUJBQ BSFB JOJ NFNQVOZBJ QFSBO ZBOH
4FCBHJBO CFTBS BLUJWJUBT TJTUFN TBSBG EJBXBMJ PMFI QFOHBMBNBO LIVTVT CBHJBO CBXBI UFSVUBNB CFSIVCVOHBO EFOHBO SFTQPOT
QFOHBMBNBO TFOTPSJL ZBOH NFSBOHTBOH SFTFQUPS TFOTPSJL EBQBU PUPUZBOHPUPNBUJT TFLFUJLBUFSIBEBQSBOHTBOHBOTFOTPSJL EBO
CFSVQB SFTFQUPS WJTVBM EJ NBUB SFTFQUPS BVEJUPSJL EJ UFMJOHB EBFSBIEBFSBI ZBOH MFCJI UJOHHJ CFSIVCVOHBO EFOHBO HFSBLBO
SFTFQUPS UBLUJM EJ QFSNVLBBO UVCVI BUBV KFOJT SFTFQUPS MBJOOZB PUPU LPNQMFLT ZBOH EJTFOHBKB ZBOH EJBUVS PMFI QSPTFT CFSQJLJS
1FOHBMBNBOTFOTPSJLJOJEBQBUNFOJNCVMLBOSFBLTJTFHFSBEBSJ EBSJPUBL
543
Unit IX Sistem Saraf: A. Prinsip-Prinsip Umum dan Fisiologi Sensorik
ea somes e ik o eks mo o ik
end i
alam s
o masio
ak
ons l o e ik la
adan sel ed la
e e el m li
ed la s inalis e i dingin
anga j ng sa a
e as
ekan adan
a ini ele a aan
j ng j ng
a a adan
eisane
elendong o o
aa s
endon o ese o kines e ik
kson olgi
endi
ina s
ksis soma osenso ik sis em sa a

ed la
s inalis e on o de
ked a
ea se a mo o ik ea
ang men j ke o o mo o ik
k se a ne on e k an esa di o ak
mem e li a kan agian agian ngsionaln a ang en ing kle s
igam a lang da i on B i e o ie e ka da s
o y y iology iladel ia a nde s
Pengolahan Informasi— Fungsi "Integrasi" Sistem Saraf

4BMBITBUVGVOHTJZBOHQBMJOHQFOUJOHEBSJTJTUFNTBSBGBEBMBI
NFOHPMBIJOGPSNBTJZBOHNBTVLEFOHBODBSBZBOHTFEFNJLJBO
SVQBTFIJOHHBUJNCVMSFTQPOTNPUPSJLEBONFOUBMZBOHTFTVBJ
-FCJI EBSJ QFSTFO JOGPSNBTJ TFOTPSJL EJBCBJLBO PMFI PUBL alam s
LBSFOB UJEBL SFMFWBO EBO UJEBL QFOUJOH 4FCBHBJ DPOUPI amen
lo s allid s
TFTFPSBOH CJBTBOZB TBNB TFLBMJ UJEBL NFNQFSIBUJLBO CBHJBO kle s s alamik s
UVCVI ZBOH CFSTJOHHVOHBO EFOHBO QBLBJBO TFQFSUJ KVHB UJEBL
NFNQFSIBUJLBOUFLBOBOQBEBUFNQBUEVEVLTFXBLUVJBEVEVL o masio l o e ik la
e e el m
4FSVQBEFOHBOIBMJOJ QFSIBUJBOIBOZBBLBOEJDVSBILBOQBEB
PCKFL LIVTVT ZBOH UFSEBQBU QBEB MBQBOHBO QFOHMJIBUBO EBO
CBILBO TVBSB CJTJOH EJ TFLJUBS LJUB ZBOH CFSMBOHTVOH UFSVT
NFOFSVTCJBTBOZBBLBOEJQJOEBILBOLFBMBNCBXBITBEBS
/BNVO LFUJLB JOGPSNBTJ TFOTPSJL ZBOH QFOUJOH

NFSBOHTBOH QJLJSBO JOGPSNBTJ UFSTFCVU TFHFSB EJTBMVSLBO LF e a mo o ik gamma
CBHJBO JOUFHSBTJ EBO NPUPSJL PUBL ZBOH TFTVBJ TFIJOHHB EBQBU e a mo o ik al a
UJNCVM SFTQPOT ZBOH EJJOHJOLBO 1FOZBMVSBO EBO QFNSPTFTBO
JOGPSNBTJ JOJ EJTFCVU GVOHTJ JOUFHSBUJG TJTUFN TBSBG +BEJ CJMB
TFTFPSBOH NFMFUBLLBO UBOHBOOZB EJ BUBT TFCVBI UVOHLV ZBOH
QBOBT BLBO UJNCVM SFTQPOT TFHFSB ZBOH EJJOHJOLBO ZBLOJ Stretch receptor fiber elendong o o
NFOHBOHLBUUBOHBOUFSTFCVU5FSKBEJKVHBSFTQPOTCFSJLVUOZB ksis sa a mo o ik skele al sis em sa a
544
Bab 45 Organisasi Sistem Saraf, Fungsi Dasar Sinaps, dan Neurotransmiter
TFQFSUJNFNJOEBILBOTFMVSVIUVCVINFOKBVIJUVOHLVEBOCBILBO Tingkatan Utama Fungsi Sistem

NVOHLJOCFSUFSJBLLFTBLJUBO Saraf Pusat
Peran Sinaps dalam Pengolahan Informasi. 4JOBQT
NFSVQBLBOUJUJLQFOHIVCVOHEBSJTBUVOFVSPOLFOFVSPOMBJOOZB 4JTUFN TBSBG NBOVTJB NFNQVOZBJ LFNBNQVBO GVOHTJPOBM
UNIT IX
%JCBHJBOTFMBOKVUOZBEBSJCBCJOJLJUBBLBONFNCJDBSBLBOTFDBSB LIVTVT ZBOH EJUVSVOLBO QBEB TFUJBQ UBIBQ QFSLFNCBOHBO
MFCJI EFUBJM NFOHFOBJ GVOHTJ TJOBQT /BNVO QFOUJOH VOUVL FWPMVTJ NBOVTJB %BSJ TJGBUTJGBU ZBOH EJXBSJTLBO JOJ UJHB
EJUFLBOLBO EJ TJOJ CBIXB TJOBQT NFOFOUVLBO BSBI QFOZFCBSBO UJOHLBU VUBNB TJTUFN TBSBG QVTBU NFNQVOZBJ TJGBUTJGBU
TJOZBM TBSBG NFMBMVJ TJTUFN TBSBG #FCFSBQB TJOBQT EBQBU EFOHBO GVOHTJPOBM ZBOH LIBT ZBLOJ
UJOHLBU NFEVMB TQJOBMJT

NVEBI NFOHJSJNLBO TJOZBM EBSJ TBUV OFVSPO LF OFVSPO MBJOOZB UJOHLBU PUBL CBHJBO CBXBI BUBV TVCLPSUJLBM EBO
UJOHLBU
TFEBOHLBOTJOBQTMBJONFMBLVLBOOZBEFOHBOMFCJITVMJU4FMBJOJUV PUBLCBHJBOBUBTBUBVUJOHLBULPSUFLT
TJOZBM ZBOH CFSTJGBU NFNGBTJMJUBTJ BUBV NFOHJOIJCJTJ EBSJ EBFSBI Tingkat Medula Spinalis
TJTUFNTBSBGMBJOEBQBUKVHBNFOHBUVSQFOHJSJNBOTJOBQUJL LBEBOH ,JUBTFSJOHLBMJCFSQJLJSCBIXBNFEVMBTQJOBMJTIBOZBMBITVBUV
LBMB NFNCVLB TJOBQT VOUVL QFOHJSJNBO LBEBOH NFOVUVQ TJOBQT TBMVSBO VOUVL NFOZBMVSLBO TJOZBM ZBOH CFSBTBM EBSJ CBHJBO
UFSTFCVU4FMBJOJUV CFCFSBQBOFVSPOQBTDBTJOBQUJLEBQBUNFNCFSJ QFSJGFSUVCVILFPUBL BUBVQBEBBSBIZBOHCFSMBXBOBOEBSJPUBL
SFTQPOTCJMBNFOEBQBUJNQVMTEBSJMVBSEBMBNKVNMBIZBOHCFTBS LFNCBMJ LF UVCVI )BM JOJ KBVI EBSJ LFBEBBO ZBOH TFCFOBSOZB
TFEBOHLBO ZBOH MBJO TVEBI EBQBU NFNCFSJLBO SFTQPOT XBMBVQVO #BILBO TFUFMBI NFEVMB TQJOBMJT EJQPUPOH TFUJOHHJ EBFSBI MFIFS
JNQVMTZBOHEBUBOHJUVMFCJITFEJLJU+BEJ LFSKBTJOBQTJUVCFSTJGBU BUBT CBOZBL GVOHTJ NFEVMB TQJOBMJT ZBOH NBTJI UFUBQ BEB
TFMFLUJG TFSJOHOZB NFOHIBNCBU TJOZBM ZBOH MFNBI TFEBOHLBO $POUPIOZB TJSLVJU OFVSPOBM EBMBN NFEVMB TQJOBMJT EBQBU
TJOZBMZBOHMFCJILVBUEJKBMBSLBO OBNVOQBEBTBBUMBJONFOZFMFLTJ NFOZFCBCLBO
HFSBLBO CFSKBMBO
SFGMFLT ZBOH NFOBSJL
EBO NFNQFSLVBU TJOZBM MFNBI UFSUFOUV BUBV KVHB NFOFSVTLBO CBHJBO UVCVI EBSJ TVBUV PCKFL
SFGMFLT ZBOH NFOFHBOHLBO
TJOZBMTJOZBMJOJLFTFHBMBBSBIEBOUJEBLIBOZBLFTBUVBSBI LBLJHVOBNFOVOKBOHUVCVIUFSIBEBQHSBWJUBTJ EBO
SFGMFLT
ZBOH EJQBLBJ VOUVL NFOHBUVS QFNCVMVIQFNCVMVI EBSBI
Penyimpanan Informasi—Memori MPLBM HFSBLBOHBTUSPJOUFTUJOBMBUBVFLTLSFTJVSJOF4FCFOBSOZB
)BOZB TFCBHJBO LFDJM JOGPSNBTJ TFOTPSJL CBILBO ZBOH EBSJ DBSBLFSKBCBHJBOBUBTTJTUFNTBSBGTFSJOHUJEBLTFDBSBMBOHTVOH
JOGPSNBTJ TFOTPSJL QBMJOH QFOUJOH EBQBU TFHFSB NFOJNCVMLBO NFOHJSJNLBOTJOZBMLFCBHJBOQFSJGFSUVCVINFMBJOLBOEFOHBO
SFTQPOT NPUPSJL /BNVO TFCBHJBO CFTBS JOGPSNBTJ UFSTFCVU NFOHJSJN TJOZBM LF QVTBUQVTBU QFOHBUVS EBMBN NFEVMB
EJTJNQBOVOUVLQFOHBUVSBOBLUJWJUBTNPUPSJLEJNBTBEBUBOHEBO TQJOBMJT EBO NFNFSJOUBILBO QVTBUQVTBU NFEVMB TQJOBMJT
VOUVL EJQBLBJ EBMBN QSPTFT CFSQJLJS 4FCBHJBO CFTBS VOUVLCFSGVOHTJ
QFOZJNQBOBO JOJ UFSKBEJ EBMBN LPSUFLT TFSFCSJ UFUBQJ BSFB CBTBM Tingkat Otak Bagian Bawah atau Tingkat Subkortikal
PUBL EBO NFEVMB TQJOBMJT EBQBU KVHB NFOZJNQBO TFCBHJBO LFDJM
#BOZBL LBMBV CVLBO TFCBHJBO CFTBS BLUJWJUBT CBXBI TBEBS
JOGPSNBTJJOJ
UVCVI EJBUVS PMFI CBHJBO CBXBI PUBL EJ NFEVMB PCMPOHBUB
1FOZJNQBOBOJOGPSNBTJJOJNFSVQBLBOQSPTFTZBOHLJUBTFCVU
QPOT NFTFOTFGBMPO IJQPUBMBNVT UBMBNVT TFSFCFMVN EBO
NFNPSJ EBOQSPTFTJOJKVHBNFSVQBLBOGVOHTJEBSJTJOBQT4FUJBQ
HBOHMJB CBTBMJT 4FCBHBJ DPOUPI QFOHBUVSBO CBXBI TBEBS EBSJ
LBMJ TVBUV TJOZBM TFOTPSJL UFSUFOUV NFMFXBUJ TFSFOUFUBO TJOBQT
UFLBOBO BSUFSJ EBO QFSOBQBTBO UFSVUBNB EJMBLTBOBLBO EJ
TJOBQTTJOBQT JOJ TFMBOKVUOZB BLBO NFOKBEJ MFCJI NBNQV
NFEVMB PCMPOHBUB EBO QPOT 1FOHBUVSBO LFTFJNCBOHBO
NFOHIBOUBSLBOKFOJTTJOZBMZBOHTBNB TVBUVQSPTFTZBOHEJTFCVU
NFSVQBLBO GVOHTJ HBCVOHBO EBSJ CBHJBO TFSFCFMVN ZBOH MFCJI
TFCBHBJ GBTJMJUBTJ #JMB TFCVBI TJOBQT TVEBI TFSJOH LBMJ EJMFXBUJ
EBIVMV UFSCFOUVL EBO TVCTUBOTJB SFUJLVMBS NFEVMB PCMPOHBUB
PMFI TVBUV TJOZBM TFOTPSJL TJOBQT BLBO TBOHBU UFSGBTJMJUBTJ
QPOT TFSUBNFTFOTFGBMPO3FGMFLTVOUVLNBLBO TFQFSUJTBMJWBTJ
TFIJOHHB TJOZBM ZBOH UJNCVM EJ EBMBN PUBL TFOEJSJ KVHB EBQBU
EBO NFOKJMBU CJCJS TFCBHBJ SFTQPOT UFSIBEBQ SBTB NBLBOBO
NFOJNCVMLBOQFOHIBOUBSBOJNQVMTNFMBMVJSFOUFUBOTJOBQTZBOH
EJBUVS PMFI EBFSBIEBFSBI EBMBN NFEVMB PCMPOHBUB QPOT
TBNB CBILBO TBBU NBTVLBO TFOTPSJT UJEBL UFSBOHTBOH )BM JOJ
NFTFOTFGBMPO BNJHEBMB EBO IJQPUBMBNVT 4FMBJO JUV CBOZBL
BLBO NFOJNCVMLBO TVBUV QFSTFQTJ TFOTBTJ ZBOH TFCFOBSOZB
QPMB FNPTJ TFQFSUJ NBSBI HFNCJSB LFHJBUBO TFLTVBM SFBLTJ
XBMBVQVO QFSTFQTJ UFSTFCVU IBOZBMBI TVBUV NFNPSJ UFSIBEBQ
UFSIBEBQOZFSJ BUBVSFBLTJUFSIBEBQSBTBTFOBOH TFNVBOZBJOJ
TVBUVTFOTBTJ
NBTJI EBQBU UJNCVM TFUFMBI LFSVTBLBO CBOZBL CBHJBO LPSUFLT
#BHBJNBOBUFQBUOZBNFLBOJTNFGBTJMJUBTJTJOBQTKBOHLBQBOKBOH TFSFCSJ
ZBOHUFSKBEJQBEBQSPTFTNFNPSJCFMVNEJLFUBIVJ UFUBQJBQBZBOH
UFMBI EJLFUBIVJ NFOHFOBJ IBM UFSTFCVU EBO QFSJODJBO MBJO QSPTFT Tingkat Otak Bagian Atas atau Tingkat Korteks
NFNPSJTFOTPSJLEJCBIBTQBEB#BC 4FUFMBITFCFMVNOZBEJKFMBTLBOCFSCBHBJGVOHTJTJTUFNTBSBGZBOH
4FHFSB TFUFMBI EJTJNQBO EBMBN TJTUFN TBSBG NFNPSJ BLBO EBQBU UFSKBEJ QBEB UJOHLBU NFEVMB TQJOBMJT EBO UJOHLBU PUBL
NFOKBEJ CBHJBO EBSJ NFLBOJTNF QFOHPMBIBO PUBL VOUVL CBHJBO CBXBI UJNCVM QFSUBOZBBO BQB TJTB GVOHTJ ZBOH
QFNJLJSBO EJ NBTB EFQBO :BJUV QSPTFT CFSQJLJS PUBL BLBO EJMBLTBOBLBO PMFI LPSUFLT TFSFCSJ +BXBCBO VOUVL NBTBMBI JOJ
NFNCBOEJOHLBOQFOHBMBNBOTFOTPSJLZBOHCBSVEFOHBONFNPSJ TBOHBU LPNQMFLT OBNVO EBQBU EJBXBMJ EFOHBO LFOZBUBBO
ZBOH TVEBI EJTJNQBO NFNPSJ JUV LFNVEJBO NFNCBOUV CBIXBLPSUFLTTFSFCSJNFSVQBLBOHVEBOHNFNPSJZBOHTBOHBU
NFOZFMFLTJ JOGPSNBTJ TFOTPSJL CBSV ZBOH QFOUJOH EBO CFTBS ,PSUFLT UJEBL QFSOBI CFSGVOHTJ TFOEJSJ UFUBQJ TFMBMV
NFOZBMVSLBOOZBLFBSFBQFOZJNQBOBONFNPSJZBOHTFTVBJVOUVL CFSIVCVOHBOEFOHBOQVTBUQVTBUCBHJBOCBXBITJTUFNTBSBG
EJHVOBLBO EJ NBTB ZBOH BLBO EBUBOH BUBV LF EBFSBI NPUPSJL 5BOQB BEBOZB LPSUFLT TFSFCSJ GVOHTJ QVTBUQVTBU PUBL
VOUVLTFHFSBNFOJNCVMLBOSFTQPOTUVCVI CBHJBOCBXBITFSJOHUJEBLUFQBU5FNQBUQFOZJNQBOBOBUBV
545
HVEBOHJOGPSNBTJZBOHMVBTEBMBNLPSUFLTCJBTBOZBNFOHVCBI TBNB EFOHBO JOGPSNBTJ ZBOH UFMBI EJTJNQBO VOUVL NFOHBUVS

GVOHTJGVOHTJJOJNFOKBEJLFSKBZBOHMFCJIUFQBUEBOTQFTJGJL SBOHLBJBOBLUJWJUBTUVCVITFIBSJIBSJ
"LIJSOZB LPSUFLTTFSFCSJTBOHBUMBIQFOUJOHVOUVLTFCBHJBO
CFTBS QSPTFT CFSQJLJS UFUBQJ LPSUFLT UJEBL EBQBU CFSLFSKB Sinaps Sistem Saraf Pusat
TFOEJSJ 1BEB LFOZBUBBOOZB QVTBUQVTBU EJ CBHJBO CBXBI
PUBLMBI CVLBO LPSUFLT ZBOH NFOJNCVMLBO LFTBEBSBO EBMBN *OGPSNBTJ EJIBOUBSLBO EBMBN TJTUFN TBSBG QVTBU UFSVUBNB EBMBN
LPSUFLT TFSFCSJ TFIJOHHB NFNCVLB QFOZJNQBOBO NFNPSJ CFOUVLQPUFOTJBMBLTJTBSBG EJTFCVUJNQVMTTBSBG ZBOHNFMFXBUJ
NFOKBEJ NFTJO PUBL VOUVL CFSQJLJS +BEJ TFCFOBSOZB TFUJBQ TFSBOHLBJBO OFVSPO EBSJ TBUV OFVSPO LF OFVSPO CFSJLVUOZB
CBHJBO TJTUFN TBSBG NFNCFOUVL GVOHTJ ZBOH LIBT 5FUBQJ /BNVO TFMBJO JUV TFUJBQ JNQVMT
EBQBU EJIBNCBU TFXBLUV
LPSUFLTMBI ZBOH NFNCVLB EVOJB QFOZJNQBOBO JOGPSNBTJ EJIBOUBSLBO EBSJ TBUV OFVSPO LF OFVSPO CFSJLVUOZB
EBQBU
VOUVLEJHVOBLBOPMFIQJLJSBOTFTFPSBOH EJVCBI EBSJ JNQVMT UVOHHBM NFOKBEJ JNQVMT ZBOH EBUBOHOZB
Perbandingan antara Sistem Saraf CFSVOUVO BUBV
EBQBUEJHBCVOHLBOEFOHBOJNQVMTZBOHEBUBOH
dengan Sebuah Komputer EBSJOFVSPOOFVSPOMBJOOZBVOUVLNFNCFOUVLQPMBJNQVMTZBOH
TBOHBUSVNJUZBOHNFMFXBUJTFSBOHLBJBOOFVSPO4FNVBGVOHTJJOJ
EBQBUEJLMBTJGJLBTJLBOTFCBHBJGVOHTJTJOBQUJLOFVSPO
4FXBLUV LPNQVUFS NVMBNVMB EJUFNVLBO TFHFSB UFSMJIBU
CBIXB NFTJO JOJ NFNQVOZBJ CBOZBL DJSJ ZBOH TBNB EFOHBO
TJTUFN TBSBG 1FSUBNB TFNVB LPNQVUFS NFNQVOZBJ TJSLVJU Jenis-Jenis Sinaps—Kimiawi dan Listrik
NBTVLBO ZBOH TFCBOEJOH EFOHBO CBHJBO TFOTPSJL TJTUFN TBSBG 5FSEBQBUEVBNBDBNTJOBQT
TJOBQTLJNJBXJ EBO
TJOBQT
EBO TJSLVJU LFMVBSBO ZBOH TFCBOEJOH EFOHBO CBHJBO NPUPSJL MJTUSJL
TJTUFNTBSBG )BNQJS TFNVB TJOBQT ZBOH EJHVOBLBO VOUVL NFOHIBOUBSLBO
1BEB LPNQVUFS ZBOH TFEFSIBOB TJOZBM LFMVBSBO MBOHTVOH TJOZBMQBEBTJTUFNTBSBGQVTBUNBOVTJBBEBMBITJOBQTLJNJBXJ1BEB
EJBUVS PMFI TJOZBM NBTVLBO DBSB LFSKBOZB TFSVQB EFOHBO TJOBQT LJNJB JOJ OFVSPO QFSUBNB NFOZFLSFTJ TVBUV CBIBO LJNJB
SFGMFLT NFEVMB TQJOBMJT ZBOH TFEFSIBOB /BNVO QBEB ZBOH EJTFCVU OFVSPUSBOTNJUFS BUBV TFSJOH EJTFCVU [BU USBOTNJUFS

LPNQVUFS ZBOH MFCJI LPNQMFLT TJOZBM LFMVBSBO EJUFOUVLBO QBEB TJOBQT VKVOH TBSBGOZB EBO [BU USBOTNJUFS JOJ LFNVEJBO
PMFI TJOZBM NBTVLBO EBO PMFI JOGPSNBTJ ZBOH UFMBI EJTJNQBO CFLFSKB QBEB QSPUFJO SFTFQUPS QBEB NFNCSBO OFVSPO CFSJLVUOZB
EBMBNCBHJBONFNPSJLPNQVUFSUFSTFCVU ZBOHBOBMPHEFOHBO VOUVL NFSBOHTBOH OFVSPO UFSTFCVU NFOHIBNCBUOZB BUBV
SFGMFLT ZBOH MFCJI LPNQMFLT EBO NFNQVOZBJ NFLBOJTNF NFOHVCBI TFOTJUJWJUBTOZB EFOHBO CFSCBHBJ DBSB 4BNQBJ TBBU JOJ
QFOHPMBIBOTJTUFNGVOHTJMVIVS,FNVEJBO EFOHBOCFSUBNCBI UFMBIEJUFNVLBOMFCJIEBSJ[BUUSBOTNJUFSQFOUJOH#FCFSBQBEJ
DBOHHJIOZBLPNQVUFS EJQFSMVLBOQFOBNCBIBOVOJUMBHJ ZBOH BOUBSBOZB BEBMBI BTFUJMLPMJO OPSFQJOFGSJO FQJOFGSJO IJTUBNJO
EJTFCVUTFCBHBJVOJUQFOHPMBITFOUSBM ZBOHNFOFOUVLBOVSVUBO BTBN HBNNB BNJOPCVUJSBU ("#"
HMJTJO TFSPUPOJO EBO
LFSKB BMBU LPNQVUFS JUV 6OJU JOJ BOBMPH EFOHBO NFLBOJTNF HMVUBNBU
QFOHBUVSBO PUBL NBOVTJB ZBOH NFNVOHLJOLBO LJUB VOUVL
4FCBMJLOZB TJOBQT MJTUSJL EJUBOEBJ PMFI BEBOZB LBOBM DBJSBO
NFOHBSBILBOQFSIBUJBOMFCJIEVMVLFTBUVQJLJSBOBUBVTFOTBTJ
UFSCVLBZBOHMBOHTVOH ZBOHNFOHIBOUBSLBOMJTUSJLEBSJTBUVTFM
BUBVBLUJWJUBTNPUPSJL VOUVLTFMBOKVUOZBNFNQFSIBUJLBOZBOH
LF TFM CFSJLVUOZB ,FCBOZBLBO TBMVSBO JOJ UFSEJSJ BUBT TUSVLUVS
MBJO EBOTBNQBJBLIJSOZBUFSCFOUVLVSVUBOQJLJSBOBUBVLFSKB
UVCVMBS QSPUFJO LFDJM ZBOH EJTFCVU UBVU JNCBT HBQ KVODUJPOT

ZBOHMFCJILPNQMFLT
ZBOHNFNVEBILBOQFSHFSBLBOJPOJPOEFOHBOCFCBTEBSJCBHJBO
(BNCBS BEBMBI EJBHSBN TFEFSIBOB TFCVBI LPNQVUFS
EBMBN TVBUV TFM LF CBHJBO EBMBN TFM CFSJLVUOZB 5BVU JOJ UFMBI
#BILBO LFUJLB EJQFMBKBSJ EFOHBO DFQBU EJBHSBN JOJ
EJCJDBSBLBO QBEB #BC )BOZB TFEJLJU DPOUPI UBVU JNCBT ZBOH
NFNQFSMJIBULBO LFNJSJQBO LPNQVUFS EFOHBO TJTUFN TBSBG
EJUFNVLBOEJTJTUFNTBSBGQVTBU/BNVO NFMBMVJUBVUJNCBTEBO
'BLUB CBIXB LPNQPOFO EBTBS LPNQVUFS TFDBSB VNVN TFSVQB
UBVUUBVU TFSVQB MBJOOZBMBI QPUFOTJBM BLTJ EJIBOUBSLBO EBSJ TBUV
EFOHBO TJTUFN TBSBG NFNQFSMJIBULBO CBIXB QBEB EBTBSOZB
TFSBU PUPU QPMPT LF TFSBU PUPU QPMPT CFSJLVUOZB QBEB PUPU QPMPT
PUBL BEBMBI TFCVBI LPNQVUFS ZBOH UFSVTNFOFSVT
WJTFSBM #BC
EBOEBSJTBUVTFMPUPUKBOUVOHLFTFMPUPUKBOUVOH
NFOHVNQVMLBOJOGPSNBTJTFOTPSJLEBONFOHHVOBLBOOZBCFS
CFSJLVUOZBQBEBPUPUKBOUVOH #BC

Konduksi "Satu Arah" pada Sinaps Kimiawi.4JOBQTLJNJBXJ

as kan el a an NFNQVOZBJ TJGBU ZBOH TBOHBU QFOUJOH ZBOH NFOZFCBCLBO
OZB NFOKBEJ TJOBQT ZBOH CBOZBL EJHVOBLBO VOUVL
NFOHIBOUBSLBO TFCBHJBO CFTBS TJOZBM TJTUFN TBSBG 4JOBQT JOJ
aa aa Hasil TFMBMV NFOHIBOUBSLBO TJOZBM EBMBN TBUV BSBI ZBLOJ EBSJ
eme a an a al ke ja
dang OFVSPO ZBOH NFOZFLSFTJ [BU USBOTNJUFS ZBOH EJTFCVU OFVSPO
in o masi QSBTJOBQUJL LFOFVSPO UFNQBU [BU USBOTNJUFS UBEJ CFLFSKB ZBOH
EJTFCVU OFVSPO QBTDBTJOBQUJL *OJMBI QSJOTJQ LPOEVLTJ TBUV
ni ni BSBI QBEB TJOBQT LJNJBXJ EBO TBOHBU CFSCFEB EFOHBO
engola eng i ng LPOEVLTJ NFMBMVJ TJOBQT MJTUSJL ZBOH TFSJOH NFOHIBOUBSLBO
TJOZBMEVBBSBI
iag am se a kom e m m ang 1JLJSLBO TFKFOBL QFSJIBM NBLOB ZBOH TBOHBU QFOUJOH EBSJ
menggam a kan kom onen kom onen dasa dan NFLBOJTNF LPOEVLTJ TBUV BSBI JOJ .FLBOJTNF JOJ
ngann a
NFNVOHLJOLBOTJOZBMEJIBOUBSLBONFOVKVBSBIUFSUFOUV
546
4FTVOHHVIOZB QFSKBMBOBOTJOZBMLFEBFSBIZBOHUFQBUEBOTQFTJGJL /FVSPOOFVSPO EJ CBHJBOCBHJBO MBJO NFEVMB TQJOBMJT EBO

EJ EBMBN TJTUFN TBSBG EBO EJ VKVOHVKVOH TBSBG UFQJ JOJMBI ZBOH PUBL CFSCFEB EBSJ OFVSPO NPUPSJL BOUFSJPS EBMBN IBM

NFNVOHLJOLBOTJTUFNTBSBGNFMBLTBOBLBOGVOHTJOZBZBOHTBOHBU VLVSBO CBEBO TFM
QBOKBOH VLVSBO EBO KVNMBI EFOESJU
CBOZBLTFQFSUJTFOTBTJ QFOHBUVSBONPUPSJL NFNPSJ EBOCFSCBHBJ QBOKBOHOZB CFSLJTBS EBSJ IBNQJS OPM TBNQBJ CFCFSBQB
GVOHTJMBJOOZB
UNIT IX
TFOUJNFUFS
QBOKBOH EBO CFTBSOZB BLTPO EBO
KVNMBI
UFSNJOBM QSBTJOBQUJL ZBOH CFSLJTBS BOUBSB IBOZB CFCFSBQB
Anatomi Fisiologis Sinaps TBNQBJ1FSCFEBBOQFSCFEBBOJOJNFNCVBUOFVSPOEJ
CBHJBO TJTUFN TBSBG ZBOH CFSCFEB CFSFBLTJ TFDBSB CFSCFEB
(BNCBS NFNQFSMJIBULBO TFCVBI OFVSPO NPUPSJL BOUFSJPS
UFSIBEBQ TJOZBM TJOBQUJL ZBOH NBTVL TFIJOHHB NFMBLVLBO
ZBOHLIBTEJLPSOVBOUFSJPSNFEVMBTQJOBMJT/FVSPONPUPSJLJOJ
CBOZBLGVOHTJOZBZBOHCFSCFEB
UFSEJSJ BUBT UJHB CBHJBO VUBNB ZBLOJ TPNB ZBOH NFSVQBLBO
CBEBOVUBNBEBSJOFVSPOTFCVBIBLTPOUVOHHBM ZBOHNFNBOKBOH Terminal Prasinaptik. 1FOFMJUJBO EFOHBO NFOHHVOBLBO
EBSJ TPNB LF TBSBG QFSJGFS ZBOH NFOJOHHBMLBO NFEVMB TQJOBMJT NJLSPTLPQFMFLUSPOQBEBUFSNJOBMQSBTJOBQUJLNFNQFSMJIBULBO
EBOEFOESJU ZBOHNFSVQBLBOTFKVNMBICFTBSQFOPOKPMBOUJQJTEBSJ CBIXB UFSNJOBM QSBTJOBQUJL NFNQVOZBJ CFSNBDBNNBDBN
TPNBZBOHNFNBOKBOHLFMVBSTFQBOKBOHNNLFEBFSBITFLJUBS CFOUVL BOBUPNJT OBNVO LFCBOZBLBO CFOUVLOZB NFOZFSVQBJ
NFEVMBTQJOBMJT UPNCPM CVMBU BUBV TFIJOHHB LBEBOH EJTFCVU TFCBHBJ UPNCPM
4FCBOZBLLVSBOHMFCJITBNQBJUPNCPMTJOBQUJL UFSNJOBM UFSNJOBMLOPCT
CPVUPOT VKVOHLBLJ FOEGFFU
BUBV
LFDJM ZBOH EJTFCVU UFSNJOBM QSBTJOBQUJL UFSMFUBL EJ QFSNVLBBO UPNCPMTJOBQUJL TZOBQUJDLOPCT

EFOESJUEBOTPNBOFVSPONPUPSJL TFLJUBSTBNQBJQFSTFOOZB (BNCBSNFOHHBNCBSLBOTUSVLUVSEBTBSTFCVBITJOBQT
EJ EFOESJU EBO IBOZB TBNQBJ QFSTFO EJ TPNB 5FSNJOBM ZBOH NFNQFSMJIBULBO TFCVBI UFSNJOBM QSBTJOBQUJL QBEB
QSBTJOBQUJL JOJ NFSVQBLBO VKVOH EBSJ TFSBUTFSBU TBSBG ZBOH QFSNVLBBO NFNCSBO OFVSPO QBTDBTJOBQUJL 5FSNJOBM
CFSBTBM EBSJ CBOZBL OFVSPO MBJO 4FCBHJBO CFTBS UFSNJOBM QSBTJOBQUJLJOJEJQJTBILBOEBSJTPNBOFVSPOQBTDBTJOBQUJLPMFI
QSBTJOBQUJL JOJ CFSTJGBU FLTJUBUPSJL BSUJOZB NFOZFLSFTJ [BU TVBUV DFMBI TJOBQT ZBOH MFCBSOZB CJBTBOZB TBNQBJ
USBOTNJUFS ZBOH NFSBOHTBOH OFVSPO QBTDBTJOBQUJL /BNVO BOHTUSPN 5FSNJOBM QSBTJOBQUJL JOJ NFNQVOZBJ EVB TUSVLUVS
CFCFSBQBUFSNJOBMQSBTJOBQUJLMBJOOZBCFSTJGBUJOIJCJUPSJLUFSNJOBM JOUFSOBMZBOHQFOUJOHVOUVLGVOHTJFLTJUBUPSJLBUBVJOIJCJUPSJL
UFSTFCVU NFOZFLSFTJ [BU USBOTNJUFS ZBOH NFOHIBNCBU OFVSPO TJOBQT WFTJLFM USBOTNJUFS EBO NJUPLPOESJB 7FTJLFM USBOTNJUFS
QBTDBTJOBQUJL NFOHBOEVOH [BU USBOTNJUFS ZBOH CJMB EJMFQBTLBO LF DFMBI
TJOBQT EBQBU NFSBOHTBOH BUBV NFOHIBNCBU OFVSPO
QBTDBTJOBQUJL BLBO NFSBOHTBOH CJMB NFNCSBO OFVSPOOZB
NFOHBOEVOH SFTFQUPS QFSBOHTBOH EBO BLBO NFOHIBNCBU CJMB
NFNCSBO OFVSPO UFSTFCVU NFOHBOEVOH SFTFQUPS QFOHIBNCBU
.JUPLPOESJB NFOZFEJBLBO BEFOPTJO USJGPTGBU "51
ZBOH
NFOZVQMBJFOFSHJVOUVLTJOUFTJT[BUUSBOTNJUFSCBSV
#JMB TVBUV QPUFOTJBM BLTJ NFOZFCBS EJ TFQBOKBOH UFSNJOBM
QSBTJOBQUJL EFQPMBSJTBTJ QBEB NFNCSBOOZB NFOZFCBCLBO
TFKVNMBILFDJMWFTJLFMNFOHFMVBSLBOJTJOZBLFDFMBITJOBQT
end i
kson
oma
i okond ia
e minal
asina ik
ela sina s
e a ne on mo o ik an e io ang k as angs oms end i da i ne on

mem e li a kan e minal asina ik ada soma ne on dan
dend i e a ikan j ga adan a akson nggal na omi isiologis sina s
547
;BU USBOTNJUFS ZBOH EJLFMVBSLBO LFNVEJBO TFHFSB

LBOBMBOJPOZBOHUFSVUBNBNFNVOHLJOLBOJPOLMPSJEBVOUVL
NFOZFCBCLBO QFSVCBIBO QBEB TJGBU QFSNFBCJMJUBT NFNCSBO MFXBUEBOKVHBTFEJLJUTFLBMJBOJPOZBOHMBJO
OFVSPO QBTDBTJOBQUJL EBO IBM UFSTFCVU NFNQFSNVEBI
UFSKBEJOZB QFSBOHTBOHBO BUBV QFOHIBNCBUBO QBEB OFVSPO ,BOBM LBUJPO ZBOH NFOHIBOUBSLBO JPO OBUSJVN EJMBQJTJ PMFI
QBTDBTJOBQUJL UFSTFCVU CFSHBOUVOH LFQBEB TJGBU SFTFQUPS NVBUBO OFHBUJG .VBUBO JOJ NFOBSJL NVBUBO JPO OBUSJVN ZBOH
OFVSPOOZB CFSTJGBU QPTJUJG LF EBMBN LBOBM LFUJLB EJBNFUFS LBOBM NFOJOHLBU
NFOKBEJVLVSBOZBOHMFCJICFTBSEBSJJPOOBUSJVNZBOHUFSIJESBTJ
5FUBQJNVBUBOOFHBUJGZBOHTBNBUFSTFCVUNFOPMBLJPOLMPSJEBEBO
Mekanisme Bagaimana Potensial Aksi Menyebabkan BOJPOMBJOEBONFOHIBNCBUKBMBOOZB
Pelepasan Transmiter dari Terminal Prasinaptik
Peran lon Kaisium 6OUVL LBOBM BOJPO LFUJLB EJBNFUFS LBOBM NFOKBEJ DVLVQ
.FNCSBO UFSNJOBM QSBTJOBQUJL EJTFCVU NFNCSBO QSBTJOBQUJL CFTBS JPO LMPSJEB NBTVL LF EBMBN LBOBM NFOVKV LF BSBI ZBOH
.FNCSBO QSBTJOBQUJL NFOHBOEVOH CBOZBL TFLBMJ LBOBM CFSMBXBOBO TFEBOHLBO LBUJPO OBUSJVN LBMJVN EBO LBMTJVN
LBMTJVN CFSHFSCBOH WPMUBTF #JMB TFCVBI QPUFOTJBM BLTJ EJIBNCBU UFSVUBNBLBSFOBCFOUVLJPOUFSIJESBTJOZBUFSMBMVCFTBS
NFOEFQPMBSJTBTJNFNCSBOQSBTJOBQUJL LBOBMLBMTJVNUFSTFCVU VOUVLEBQBUMFXBU
BLBO NFNCVLB EBO NFNVOHLJOLBO TFKVNMBI CFTBS JPO ,JUB BLBO NFNQFMBKBSJ LFNVEJBO CBIXB TBBU LBOBM LBUJPO
LBMTJVN VOUVL NFOHBMJS NBTVL LF EBMBN +VNMBI [BU UFSCVLBEBONFOZFCBCLBOJPOOBUSJVNCFSNVBUBOQPTJUJGNBTVL
USBOTNJUFS ZBOH LFNVEJBO EJMFQBTLBO EBSJ UFSNJOBM LF EBMBN NVBUBO MJTUSJL QPTJUJG EBSJ JPO OBUSJVN TFMBOKVUOZB BLBO
DFMBITJOBQTCFSCBOEJOHMVSVTEFOHBOKVNMBIJPOLBMTJVNZBOH NFSBOHTBOH OFVSPO JOJ 0MFI LBSFOB JUV [BU USBOTNJUFS ZBOH
NBTVL #BHBJNBOB UFQBUOZB NFLBOJTNF JPO LBMTJVN NFNCVLBLBOBMLBUJPOEJTFCVUUSBOTNJUFSFLTJUBUPSJL4FCBMJLOZB
NFOZFCBCLBO QFMFQBTBO [BU USBOTNJUFS CFMVN EJLFUBIVJ QFNCVLBBO LBOBM BOJPO NFOZFCBCLBO NBTVLOZB NVBUBO MJTUSJL
OBNVOEJZBLJOJCBIXBNFLBOJTNFOZBBEBMBITFCBHBJCFSJLVU OFHBUJG ZBOHNFOHIBNCBUOFVSPO0MFILBSFOBJUV [BUUSBOTNJUFS
4FXBLUV JPO LBMTJVN NFNBTVLJ UFSNJOBM QSBTJOBQUJL ZBOHNFNCVLBLBOBMJOJEJTFCVUUSBOTNJUFSJOIJCJUPSJL
EJZBLJOJ CBIXB JPOJPO JOJ CFSJLBUBO EFOHBO NPMFLVM QSPUFJO
,FUJLB [BU USBOTNJUFS NFOHBLUJWBTJ LBOBM JPO LBOBM CJBTBOZB
LIVTVTQBEBQFSNVLBBOTJTJEBMBNNFNCSBOQSBTJOBQUJL ZBOH
BLBO NFNCVLB EBMBN IJUVOHBO NJMJEFUJL LFUJLB [BU USBOTNJUFS
EJTFCVU UFNQBU QFMFQBTBO 1FOHJLBUBO JOJ TFMBOKVUOZB BLBO
UJEBL BEB MBHJ LBOBM NFOVUVQ EFOHBO DFQBU 1FNCVLBBO EBO
NFOZFCBCLBO UFNQBU QFMFQBTBO NFNCVLB NFMBMVJ NFNCSBO
QFOVUVQBO LBOBM JPO NFSVQBLBO DBSB VOUVL QFOHBUVSBO ZBOH
NFNVOHLJOLBOCFCFSBQBWFTJLFMUSBOTNJUFSVOUVLNFMFQBTLBO
TBOHBUDFQBUQBEBOFVSPOQBTDBTJOBQUJL
USBOTNJUFSOZB LF EBMBN DFMBI TFUJBQ QPUFOTJBM BLTJ 1BEB
WFTJLFMWFTJLFM ZBOH NFOZJNQBO OFVSPUSBOTNJUFS BTFUJMLPMJO
EJUFNVLBO BOUBSB TBNQBJ NPMFLVM BTFUJMLPMJO EJ Sistem "Caraka Kedua" pada Neuron Pascasinaptik.
TFUJBQWFTJLFM EBOUFSEBQBUDVLVQCBOZBLWFTJLFMQBEBUFSNJOBM #BOZBL GVOHTJ TJTUFN TBSBG TFCBHBJ DPOUPI QSPTFT NFNPSJ
QSBTJOBQUJL VOUVL NFOHJSJNLBO CFCFSBQB SBUVT TBNQBJ MFCJI NFNFSMVLBO QFSVCBIBO ZBOH DVLVQ MBNB EBMBN OFVSPO TFMBNB
EBSJQPUFOTJBMBLTJ CFCFSBQBEFUJLTBNQBJCFCFSBQBCVMBOTFUFMBI[BUUSBOTNJUFSBXBM
NFOHIJMBOH ,BOBM JPO UJEBL TFTVBJ VOUVL NFOZFCBCLBO
Kerja Zat Transmiter pada Neuron QFSVCBIBO OFVSPO QBTDBTJOBQUJL ZBOH MBNB TFCBC LBOBM JOJ
Pascasinaptik-Fungsi "Protein Reseptor" UFSUVUVQEBMBNIJUVOHBONJMJEFUJLTFUFMBI[BUUSBOTNJUFSUJEBLBEB
MBHJ/BNVO EBMBNCBOZBLLFBEBBO FLTJUBTJBUBVJOIJCJTJOFVSPO
.FNCSBO OFVSPO QBTDBTJOBQUJL NFOHBOEVOH CBOZBL TFLBMJ
QBTDBTJOBQUJLZBOHMBNBEJDBQBJNFMBMVJQFOHBLUJGBOTJTUFNLJNJB
QSPUFJO SFTFQUPS EJQFSMJIBULBO QBEB (BNCBS .PMFLVM
DBSBLB LFEVB EJ EBMBN TFM OFVSPO QBTDBTJOBQUJL EBO LFNVEJBO
NPMFLVM SFTFQUPS JOJ NFNQVOZBJ EVB LPNQPOFO QFOUJOH
DBSBLBLFEVBJOJMBIZBOHNFOKBEJQFOZFCBCFGFLZBOHQBOKBOH
ZBLOJ
LPNQPOFO QFOHJLBU ZBOH NFOPOKPM LFMVBS EBSJ
NFNCSBO LF EBMBN DFMBI TJOBQT EJ TJOJ LPNQPOFO JOJ BLBO 5FSEBQBU CFCFSBQB KFOJT TJTUFN DBSBLB LFEVB 4BUV KFOJT ZBOH
CFSJLBUBO EFOHBO OFVSPUSBOTNJUFS ZBOH CFSBTBM EBSJ UFSNJOBM QBMJOH VNVN NFOHHVOBLBO TFLFMPNQPL QSPUFJO ZBOH EJTFCVU
QSBTJOBQUJL EBO
LPNQPOFO JPOPGPS ZBOH NFOFNCVT QSPUFJO( (BNCBS TVEVU LJSJ BUBT NFNQFSMJIBULBO QSPUFJO
NFNCSBOQBTDBTJOBQUJLLFCBHJBOEBMBNOFVSPOQBTDBTJOBQUJL SFTFQUPSNFNCSBO1SPUFJO(NFMFLBUQBEBCBHJBOSFTFQUPSZBOH
*POPGPSNFSVQBLBOTBMBITBUVEBSJLFEVBUJQFJOJ
LBOBMJPO NFOPOKPM LF CBHJBO JOUFSJPS TFM 1SPUFJO( UFSEJSJ BUBT UJHB
ZBOH NFNVOHLJOLBO JPO KFOJT UFSUFOUV VOUVL NFOFNCVT LPNQPOFOLPNQPOFOBMGB (A) ZBOHNFSVQBLBOCBHJBOBLUJWBUPS
NFNCSBOBUBV
BLUJWBUPSDBSBLBLFEVBZBOHCVLBOCFSVQB QSPUFJO( EBOLPNQPOFOCFUB (B) TFSUBHBNNB(G) LPNQPOFO
LBOBM JPO NFMBJOLBO TVBUV NPMFLVM ZBOH NFOPOKPM LF EBMBN BMGB EBO KVHB LF CBHJBO EBMBN NFNCSBO TFM ZBOH CFSEFLBUBO
TJUPQMBTNB TFM EBO NFOHBLUJWBTJ TBUV BUBV MFCJI [BU[BU EJ EFOHBO QSPUFJO SFTFQUPS 1BEB QSPTFT BLUJWBTJ PMFI JNQVMT TBSBG
CBHJBO EBMBN OFVSPO QBTDBTJOBQUJL ;BU[BU JOJ CFSUJOEBL CBHJBO BMGB QSPUFJO( NFNJTBILBO EJSJ EBSJ CBHJBO CFUB EBO
TFCBHBJDBSBLBLFEVBVOUVLNFOJOHLBULBOBUBVNFOVSVOLBO HBNNBEBOLFNVEJBOCFCBTVOUVLCFSHFSBLEJEBMBNTJUPQMBTNB
GVOHTJTFMUFSUFOUV TFM
Kanal lon. ,BOBMJPOQBEBNFNCSBOOFVSPOQBTDBTJOBQUJL %JEBMBNTJUPQMBTNB LPNQPOFOBMGBZBOHUFSQJTBINFNCFOUVL
CJBTBOZB EVB KFOJT
LBOBM LBUJPO ZBOH QBMJOH TFSJOH TBUVBUBVMFCJIGVOHTJ CFSHBOUVOHQBEBDJSJLIBTEBSJTFUJBQKFOJT
NFNVOHLJOLBO JPO OBUSJVN MFXBU LFUJLB UFSCVLB UFUBQJ OFVSPO (BNCBS NFNQFSMJIBULBO FNQBU QFSVCBIBO ZBOH
LBEBOHNFMFXBULBOKVHBJPOLBMJVNEBOBUBVJPOLBMTJVN EBO EBQBUUFSKBEJ,FFNQBUIBMJUVBEBMBITFCBHBJCFSJLVU
548
ansi ansmi e
o ein anal
ese o kali m
UNIT IX
g b
em ka n im
o ein kanal mem an
a
engak i kan
sa a a le i engak i kan engak i lkan
ansk isi gen n im aa
en im in asel
k i a o kimia sel o ein dan

s esi ik e a aan s k
is em a aka ked a di mana a ansmi e ang e asal da i ne on e ama da a mengak i asi ne on ked a m la
m la melal i ele asan o ein ke dalam si o lasma ne on ked a i e li a kan em a e ek o ein an a a lain mem ka
kanal ion dalam mem an ne on ked a mengak i asi sis em en im dalam mem an ne on mengak i asi sis em en im in asel
dan a a men e a kan ansk i si gen dalam ne on ked a
1. 1FNCVLBBO LBOBM JPO NFMBMVJ NFNCSBO TFM QBTDBTJOBQUJL TBMBI JOJ TFDBSB MFCJI EFUBJM QBEB #BC LFUJLB NFNCBIBT
5FSMJIBUQBEBCBHJBOLBOBOBUBT LBOBMLBMJVNUFSCVLBTFCBHBJ NFOHFOBJGVOHTJNFNPSJTJTUFNTBSBG
SFTQPOTUFSIBEBQQSPUFJO(LBOBMJOJTFSJOHLBMJUFUBQUFSCVLB
VOUVL XBLUV ZBOH MBNB CFSCFEB EFOHBO QFOVUVQBO DFQBU Reseptor Eksitatorik atau Inhibitorik pada
BLJCBU BLUJWBTJ MBOHTVOH LBOBM JPO ZBOH UJEBL NFOHHVOBLBO Membran Pascasinaptik
TJTUFNDBSBLBLFEVB
#FCFSBQB SFTFQUPS QBTDBTJOBQUJL CJMB EJBLUJWBTJ NFOZFCBCLBO
2. "LUJWBTJ BEFOPTJO NPOPGPTGBU TJLMJL D".1
BUBV HVBOPTJO
FLTJUBTJ OFVSPO QBTDBTJOBQUJL EBO ZBOH MBJOOZB NFOZFCBCLBO
NPOPGPTGBU TJLMJL D(.1
EBMBN TFM OFVSPO MOHBUMBI CBIXB JOIJCJTJ 1FOUJOHOZB NFNJMJLJ SFTFQUPS KFOJT JOIJCJTJ TFQFSUJ
".1 TJLMJL BUBV (.1 TJLMJL EBQBU NFOHBLUJGLBO QFSBOHLBU KVHBKFOJTFLTJUBTJBEBMBICBIXBSFTFQUPSSFTFQUPSJOJNFNCFSJ
NFUBCPMJLZBOHTBOHBUTQFTJGJLEBMBNOFVSPOEBO LBSFOBJUV EJNFOTJ UBNCBIBO UFSIBEBQ GVOHTJ TBSBG NFNVOHLJOLBO
EBQBU NFODFUVTLBO CBOZBL QFSVCBIBO LJNJBXJ UFSNBTVL QFOHFOEBMJBOLFSKBTBSBGEBOKVHBQFSBOHTBOHBOOZB
QFSVCBIBO KBOHLB QBOKBOH EBMBN TUSVLUVS TFM TFOEJSJ ZBOH
TFMBOKVUOZB BLBO NFOHVCBI LFQFLBBO OFVSPO TFDBSB KBOHLB #FSCBHBJ NFLBOJTNF NPMFLVMBS EBO NFNCSBO EJHVOBLBO
QBOKBOH PMFI CFSCBHBJ SFTFQUPS VOUVL NFOJNCVMLBO FLTJUBTJ BUBV
JOIJCJTJTFQFSUJCFSJLVUJOJ
3. "LUJWBTJTBUVBUBVMFCJIFO[JNJOUSBTFM1SPUFJO(EBQBUTFDBSB
MBOHTVOH NFOHBLUJWBTJ TBUV BUBV MFCJI FO[JN JOUSBTFM Eksitasi
,FNVEJBO FO[JN EBQBU NFOJNCVMLBO CBOZBL GVOHTJ LJNJB
1. 1FNCVLBBO LBOBM OBUSJVN NFNVOHLJOLBO MJTUSJL
TQFTJGJLTFM
CFSNVBUBO QPTJUJG EBMBN KVNMBI CFTBS VOUVL NFOHBMJS LF
4. "LUJWBTJ USBOTLSJQTJ HFO )BM JOJ NFSVQBLBO FGFL BLUJWBTJ CBHJBOJOUFSJPSTFMQBTDBTJOBQUJL)BMJOJBLBONFOJOHLBULBO
TJTUFN DBSBLB LFEVB ZBOH QBMJOH QFOUJOH LBSFOB USBOTLSJQTJ QPUFOTJBM NFNCSBO LF BSBI QPTJUJG NFOVKV OJMBJ BNCBOH
HFO EBQBU NFOZFCBCLBO QFNCFOUVLBO QSPUFJO CBSV EJ EBMBN SBOHTBOHVOUVLNFOZFCBCLBOFLTJUBTJ$BSBJOJNFSVQBLBO
OFVSPO TFIJOHHB NFOHVCBI QFSBOHLBU NFUBCPMJL BUBV DBSB ZBOH QBMJOH CBOZBL EJHVOBLBO VOUVL NFOZFCBCLBO
TUSVLUVSOZB 4FCBMJLOZB UFMBI EJLFUBIVJ EFOHBO CBJL CBIXB FLTJUBTJ
QFSVCBIBO TUSVLUVSBM OFVSPO ZBOH UFSBLUJWBTJ TFDBSB CBJL
NFNBOH UFSKBEJ UFSVUBNB QBEB QSPTFT NFNPSJ KBOHLB 2. 1FOFLBOBO IBOUBSBO NFMBMVJ LBOBM LMPSJEB BUBV LBMJVN BUBV
QBOKBOH LFEVBOZB )BM JOJ BLBO NFOVSVOLBO EJGVTJ JPO LMPSJEB
CFSNVBUBOOFHBUJGLFCBHJBOEBMBNOFVSPOQBTDBTJOBQUJLBUBV
"LUJWBTJTJTUFNDBSBLBLFEVBEJEBMBNOFVSPO BQBLBICFSVQB NFOVSVOLBO EJGVTJ JPO LBMJVN CFSNVBUBO QPTJUJG LF CBHJBO
QSPUFJO(BUBVKFOJTMBJO UFMBIKFMBTCFSTJGBUTBOHBUQFOUJOHVOUVL MVBS 1BEB LFEVB DBSB JOJ QFOHBSVIOZB BEBMBI EFOHBO
NFOHVCBI CFSCBHBJ HBNCBSBO SFTQPOT EBSJ KBMVS OFVSPO ZBOH NFNCVBU QPUFOTJBM NFNCSBO JOUFSOBM NFOKBEJ MFCJI QPTJUJG
CFSCFEBTFDBSBKBOHLBQBOKBOH,JUBBLBOLFNCBMJNFNCBIBTNB EBSJOPSNBM ZBOHCFSTJGBUFLTJUBUPSJL
549
Unit IX Sistem Sarat A. Prinsip-Prinsip Umum dan Fisiologi Sensorik
3. #FSCBHBJ QFSVCBIBO NFUBCPMJTNF JOUFSOBM OFVSPO Tabel 45-2 Neuropeptida, Transmiter yang Bekerja Lambat atau Faktor
QBTDBTJOBQUJL VOUVL NFSBOHTBOH BLUJWJUBT TFM BUBV QBEB Pertumbuhan
CFCFSBQB LFBEBBO VOUVL NFOJOHLBULBO KVNMBI SFTFQUPS
NFNCSBO FLTJUBUPSJL BUBV NFOVSVOLBO KVNMBI SFTFQUPS Hypothalamic-releasing hormones
NFNCSBOJOIJCJUPSJL Thyrotropin-releasing hormone
Luteinizing hormone—releasing hormone
Inhibisi
Somatostatin (faktor penghambat hormon pertumbuhan)
1. 1FNCVLBBO LBOBM JPO LMPSJEB QBEB NFNCSBO OFVSPO
Peptida hipofisis
QBTDBTJOBQUJL)BMJOJNFNVOHLJOLBOJPOLMPSJEBCFNVBUBO
OFHBUJGVOUVLCFSEJGVTJTFDBSBDFQBUEBSJCBHJBOMVBSOFVSPO Adrenocorticotropic hormone (ACTH)
QBTDBTJOBQUJLLFCBHJBOEBMBN EFOHBOEFNJLJBONFNCBXB B- Endorfhin
NVBUBO OFHBUJG LF EBMBN EBO NFOJOHLBULBO LFOFHBUJGBO EJ A- Melanocyte-stimulating hormone
CBHJBOEBMBN ZBOHCFSTJGBUJOIJCJUPSJL
Prolaktin
2. 1FOJOHLBUBO IBOUBSBO JPO LBMJVN LFMVBS EBSJ OFVSPO )BM
Luteinizing hormone
JOJ NFNVOHLJOLBO JPO LBMJVN ZBOH CFSNVBUBO QPTJUJG
VOUVL CFSEJGVTJ LF CBHJBO FLTUFSJPS ZBOH NFOZFCBCLBO Tirotropin
QFOJOHLBUBO LFOFHBUJGBO EJ EBMBN OFVSPO ZBOH CFSTJGBU Hormon pertumbuhan (growth hormone)
JOIJCJUPSJL Vasopresin
3. "LUJWBTJFO[JNSFTFQUPSZBOHNFOHIBNCBUGVOHTJNFUBCPMJL Oksitosin
TFMVMBS ZBOH NFOJOHLBULBO KVNMBI SFTFQUPS TJOBQUJL
Peptida yang bekerja pada usus dan otak
JOIJCJUPSJLBUBVNFOVSVOLBOKVNMBISFTFQUPSFLTJUBUPSJL
Enkefalin leusin
Substansi Kimia yang Berfungsi sebagai Transmiter Enkefalin metionin
Sinaptik Substansi
-FCJIEBSJTVCTUBOTJLJNJBUFMBIEJCVLUJLBOBUBVEJOZBUBLBO Gastrin
CFSGVOHTJ TFCBHBJ USBOTNJUFS TJOBQUJL #BOZBL EBSJ TVCTUBOTJ Kolesistokinin
UFSTFCVUEJDBOUVNLBOEBMBN5BCFMEBO ZBOHUFSCBHJ
Polipeptida vasoaktif intestinum (VIP)
EBMBN EVB LFMPNQPL USBOTNJUFS TJOBQUJL 4BUV LFMPNQPL
NFSVQBLBO USBOTNJUFS NPMFLVMLFDJM ZBOH CFLFSKB DFQBU Faktor pertumbuhan saraf (Nerve growth factor)
,FMPNQPL ZBOH MBJO UFSEJSJ BUBT CBOZBL OFVSPQFQUJEB ZBOH Brain-derived neurotropic factor
NFNJMJLJVLVSBONPMFLVMKBVIMFCJICFTBSEBOCJBTBOZBCFLFSKB Neurotensin
KBVIMFCJIMBNCBU
Insulin
Glukagon
Dari jaringan-jaringan lain
Tabel 45-1 Transmiter Molekul-Kecil yang Bekerja Cepat Angiotensin II
Bradikinin
Golongan I
Karnosin
Asetilkolin
Sleep peptides
Golongan II: Amina
Kalsitonin
Noreprinefrin
Epinephrine
5SBOTNJUFSNPMFLVMLFDJMZBOHCFLFSKBDFQBUBEBMBIUSBOTNJUFS
Dopamin ZBOHNFOZFCBCLBOTFCBHJBOCFTBSSFTQPOTDFQBUEBSJTJTUFNTBSBG
Serotonin TFQFSUJ QFOHJSJNBO TJOZBM TFOTPSJL LF PUBL EBO TJOZBM NPUPSJL
Histamin LFNCBMJ LF PUPU /FVSPQFQUJEB TFCBMJLOZB CJBTBOZB
NFOZFCBCLBO LFSKB ZBOH MFCJI MBNCBU TFQFSUJ QFSVCBIBO KBOHLB
Golongan III: Asam amino
QBOKBOH QBEB KVNMBI SFTFQUPS QFNCVLBBO BUBV QFOVUVQBO
Gamma-aminobutyric acid (GABA) KBOHLB QBOKBOH LBOBM JPO UFSUFOUV EBO NVOHLJO CBILBO
Glisin QFSVCBIBOKBOHLBQBOKBOHKVNMBITJOBQTBUBVVLVSBOTJOBQT
Glutamat
Transmiter Molekul-Kecil yang Bekerja Cepat
Aspartat
Golongan IV: 1BEB TFCBHJBO CFTBS LBTVT USBOTNJUFS KFOJT NPMFLVM LFDJM
EJTJOUFTJT EBMBN TJUPTPM UFSNJOBM QSBTJOBQUJL EBO EJBCTPSQTJ
Nitrat oksida (NO) EFOHBODBSBUSBOTQPSBLUJGLFEBMBNCBOZBLWFTJLFMUSBOTNJUFSEJ
550
UFSNJOBM TJOBQT ,FNVEJBO TFUJBQ LBMJ QPUFOTJBM BLTJ BI ZBOH MVBT EJ EBMBN PUBL EBO NFNCBOUV NFOHBUVS
NFODBQBJ UFSNJOBM QSBTJOBQUJL CFCFSBQB WFTJLFM TFHFSB LFTFMVSVIBO BLUJWJUBT EBO TVBTBOB QJLJSBO NPPE
TFQFSUJ
NFMFQBTLBO USBOTNJUFSOZB LF EBMBN DFMBI TJOBQUJL )BM JOJ QFOJOHLBUBO LFTBEBSBO 1BEB TFCBHJBO CFTBS EBFSBI JOJ
CJBTBOZBUFSKBEJEBMBNXBLUVTFNJMJEFUJLBUBVLVSBOHNFMBMVJ OPSFQJOFGSJO NVOHLJO NFOHBLUJWBTJ SFTFQUPS FLTJUBUPSJL
NFLBOJTNF ZBOH UFMBI EJKFMBTLBO TFCFMVNOZB ,FSKB OBNVO QBEB EBFSBI ZBOH MBJO NFOHBLUJWBTJ SFTFQUPS
UNIT IX
TFMBOKVUOZB USBOTNJUFS KFOJT NPMFLVM LFDJM JOJ QBEB SFTFQUPS JOIJCJUPSJL /PSFQJOFGSJO KVHB EJTFLSFTJ PMFI TFCBHJBO CFTBS
NFNCSBO OFVSPO QBTDBTJOBQUJL CJBTBOZB KVHB UFSKBEJ EBMBN OFVSPO QPTUHBOHMJPO TJTUFN TBSBG TJNQBUJL ZBOH NFSBOHTBOH
XBLUV NJMJEFUJL MBHJ BUBV LVSBOH &GFL ZBOH QBMJOH TFSJOH CFCFSBQBPSHBOUFUBQJNFOHIBNCBUPSHBOZBOHMBJO
BEBMBI NFOJOHLBULBO BUBV NFOVSVOLBO IBOUBSBO NFMBMVJ %PQBNJO EJTFLSFTJ PMFI OFVSPOOFVSPO ZBOH CFSBTBM EBSJ
LBOBMJPODPOUPIOZBBEBMBINFOJOHLBULBOIBOUBSBOOBUSJVN TVCTUBOTJB OJHSB /FVSPOOFVSPO JOJ UFSVUBNB CFSBLIJS QBEB
ZBOH NFOZFCBCLBO FLTJUBTJ BUBV NFOJOHLBULBO IBOUBSBO SFHJP TUSJBUB HBOHMJB CBTBMJT 1FOHBSVI EPQBNJO CJBTBOZB
LBMJVNBUBVLMPSJEB ZBOHNFOZFCBCLBOJOIJCJTJ CFSTJGBUJOIJCJTJ
Daur Ulang Vesikel Jenis Molekul-Kecil. 7FTJLFMZBOHNF (MJTJO UFSVUBNB EJTFLSFTJ QBEB TJOBQT EJ EBMBN NFEVMB
TQJOBMJT (MJTJO JOJ EJZBLJOJ TFMBMV CFLFSKB TFCBHBJ USBOTNJUFS
OZJNQBOEBONFMFQBTLBOUSBOTNJUFSNPMFLVMLFDJMUFSVTNFOFSVT
JOIJCJUPSJL
NFOHBMBNJ EBVS VMBOH EBO EBQBU EJHVOBLBO MBHJ 4FUFMBI WFTJLFM
UFSTFCVUCFSTBUVEFOHBONFNCSBOTJOBQUJLEBONFNCVLBVOUVL ("#" BTBN HBNNBBNJOPCVUJSBU
EJTFLSFTJ PMFI VKVOH
NFMFQBTLBO [BU USBOTNJUFSOZB NVMBNVMB WFTJLFM NFNCSBO TBSBG ZBOH UFSEBQBU EBMBN NFEVMB TQJOBMJT TFSFCFMVN HBOHMJB
NFOKBEJCBHJBOEBSJNFNCSBOTJOBQUJL/BNVO EBMBNIJUVOHBO CBTBMJT EBO CBOZBL BSFB LPSUFLT #BIBO JOJ EJBOHHBQ
CFCFSBQB EFUJL TBNQBJ CFCFSBQB NFOJU CBHJBO WFTJLFM EBSJ NFOZFCBCLBOJOIJCJTJ
NFNCSBO CFSJOWBHJOBTJ LFNCBMJ LF CBHJBO EBMBN UFSNJOBM (MVUBNBU EJTFLSFTJ PMFI UFSNJOBM QSBTJOBQUJL QBEB CBOZBL
QSBTJOBQUJL EBO UFSMFQBT VOUVL NFNCFOUVL WFTJLFM CBSV KBSBT TBSBG TFOTPSJL ZBOH NFNBTVLJ TJTUFN TBSBG EJ TFCBHJBO
.FNCSBO WFTJLFM ZBOH CBSV JOJ UFUBQ CFSJTJ QSPUFJO FO[JN BUBV CFTBS EBFSBI LPSUFLT TFSFCSJ 5SBOTNJUFS JOJ LFNVOHLJOBO
QSPUFJO USBOTQPS ZBOH TFTVBJ VOUVL NFOZJOUFTJT EBO BUBV TFMBMVNFOZFCBCLBOFLTJUBTJ
NFOHPOTFOUSBTJLBO[BUUSBOTNJUFSCBSVEJCBHJBOEBMBNWFTJLFM 4FSPUPOJO EJTFLSFTJ PMFI OVLMFVT ZBOH CFSBTBM EBSJ SBGF
"TFUJMLPMJO BEBMBI USBOTNJUFS NPMFLVM LFDJM ZBOH LIBT ZBOH NFEJBO CBUBOH PUBL EBO CFSQSPZFLTJ LF CFSCBHBJ EBFSBI PUBL
NFNBUVIJ QSJOTJQQSJOTJQ TJOUFTJT EBO QFMFQBTBO ZBOH EBO NFEVMB TQJOBMJT LIVTVTOZB ZBOH NFOVKV SBEJLT EPSTBMJT
EJLFNVLBLBOTFCFMVNOZB;BUUSBOTNJUFSJOJEJTJOUFTJTEJUFSNJOBM NFEVMB TQJOBMJT EBO NFOVKV IJQPUBMBNVT 4FSPUPOJO CFLFSKB
QSBTJOBQUJLEBSJBTFUJMLPFO[JN"EBOLPMJOEFOHBOCBOUVBOFO[JN TFCBHBJQFOHIBNCBUKBSBTSBTBTBLJUEBMBNNFEVMBTQJOBMJT EBO
LPMJO BTFUJMUSBOTGFSBTF ,FNVEJBO USBOTNJUFS JOJ EJCBXB LF EBMBN LFSKBOZBTFCBHBJQFOHIBNCBUEJEBFSBITJTUFNTBSBGZBOHMFCJI
WFTJLFM TQFTJGJLOZB ,FUJLB LFNVEJBO WFTJLFM NFMFQBTLBO UJOHHJ EJEVHB VOUVL NFNCBOUV QFOHBUVSBO TVBTBOB IBUJ
BTFUJMLPMJO LF EBMBN DFMBI TJOBQUJL BTFUJMLPMJO EFOHBO DFQBU TFTFPSBOH CBILBONVOHLJOKVHBNFOZFCBCLBOUJEVS
UFSQFDBILFNCBMJNFOKBEJBTFUBUEBOLPMJOEFOHBOCBOUVBOFO[JN /JUSBU PLTJEB UFSVUBNB EJTFLSFTJ PMFI VKVOH TBSBG EJ EBFSBI
LPMJOFTUFSBTF ZBOH UFSEBQBU QBEB SFUJLVMVN QSPUFPHMJLBO ZBOH PUBL ZBOH CFSUBOHHVOH KBXBC UFSIBEBQ UJOHLBI MBLV KBOHLB
NFOHJTJ SVBOH DFMBI TJOBQUJL ,FNVEJBO EJ EBMBN UFSNJOBM QBOKBOH EBO VOUVL NFNPSJ 0MFI LBSFOB JUV EJ NBTB EFQBO
QSBTJOBQUJL WFTJLFM NFOHBMBNJ EBVS VMBOH LPMJO TFDBSB BLUJG TJTUFN USBOTNJUFS JOJ NVOHLJO EBQBU NFOKFMBTLBO NFOHFOBJ
EJCBXBLFNCBMJLFEBMBNUFSNJOBMVOUVLEJHVOBLBOLFNCBMJQBEB CFCFSBQB UJOHLBI MBLV EBO GVOHTJ NFNPSJ ZBOH TFMBNB JOJ
TJOUFTJTBTFUJMLPMJOCBSV TBOHBU NFOBOUBOH VOUVL EJNFOHFSUJ /JUSBU PLTJEB CFSCFEB
EBSJ USBOTNJUFS NPMFLVM LFDJM MBJOOZB EBMBN IBM NFLBOJTNF
Ciri Khas Beberapa Transmiter Molekul-Kecil yang Lebih QFNCFOUVLBO EJ UFSNJOBM QSBTJOBQUJL EBO LFSKBOZB EJ OFVSPO
Penting. 5SBOTNJUFSUSBOTNJUFS NPMFLVM LFDJM ZBOH QBMJOH QBTDBTJOBQUJL;BUJOJUJEBLEJCFOUVLTFCFMVNOZBEBOEJTJNQBO
QFOUJOHBEBMBITFCBHBJCFSJLVU EBMBN WFTJLFM EJ UFSNJOBM QSBTJOBQUJL TFQFSUJ USBOTNJUFS ZBOH
"TFUJMLPMJO EJTFLSFTJ PMFI OFVSPOOFVSPO EJ CBOZBL EBFSBI MBJO 4FCBMJLOZB [BU JOJ EJTJOUFTJT IBNQJS TFLFUJLB TBBU
TJTUFN TBSBG OBNVO LIVTVTOZB PMFI
VKVOHVKVOH TFMTFM EJQFSMVLBO EBO LFNVEJBO CFSEJGVTJ LFMVBS EBSJ UFSNJOBM
QJSBNJECFTBSLPSUFLTNPUPSJL
CFCFSBQBKFOJTOFVSPOEBMBN QSBTJOBQUJL EBMBN XBLUV CFCFSBQB EFUJL EBO UJEBL EJMFQBTLBO
HBOHMJB CBTBMJT
OFVSPO NPUPSJL ZBOH NFOHJOFSWBTJ PUPUPUPU EBMBN QBLFUQBLFU WFTJLFM 4FMBOKVUOZB [BU JOJ CFSEJGVTJ LF
SBOHLB
OFVSPOQSFHBOHMJPOTJTUFNTBSBGPUPOPN
OFVSPO EBMBN OFVSPO QBTDBTJOBQUJL EJ EFLBUOZB %J OFVSPO
QPTUHBOHMJPOTJTUFNTBSBGQBSBTJNQBUJL EBO
CFCFSBQBOFVSPO QBTDBTJOBQUJL [BU JOJ CJBTBOZB UJEBL UFSMBMV NFNFOHBSVIJ
QPTUHBOHMJPOTJTUFNTBSBGTJNQBUJL1BEBTFCBHJBOCFTBSLFBEBBO NFNCSBOQPUFOTJBMUFUBQJNFOHVCBIGVOHTJNFUBCPMJLJOUSBTFM
BTFUJMLPMJO NFOZFCBCLBO FGFL FLTJUBTJ OBNVO BTFUJMLPMJO UFMBI ZBOH LFNVEJBO NFNFOHBSVIJ FLTJUBCJMJUBT OFVSPO EBMBN
EJLFUBIVJ KVHB NFOZFCBCLBO FGFL JOIJCJTJ QBEB CFCFSBQB VKVOH CFCFSBQBEFUJL NFOJU BUBVNVOHLJOMFCJIMBNBMBHJ
TBSBGQBSBTJNQBUJLQFSJGFS NJTBMOZBJOIJCJTJKBOUVOHPMFIOFSWVT
WBHVT Neuropeptida
/PSFQJOFGSJOEJTFLSFTJPMFIVKVOHOFVSPOOFVSPOZBOHCBEBO /FVSPQFQUJEB EJTJOUFTJT TFDBSB CFSCFEB EBO CJBTBOZB CFLFSKB
TFMOZB UFSMFUBL EBMBN CBUBOH PUBL EBO IJQPUBMBNVT 4FDBSB LIBT MBNCBUEBOEBMBNIBMMBJOCFSCFEBEFOHBOUSBOTNJUFSNPMFLVM
OFVSPOOFVSPO QFOZFLSFTJ OPSFQJOFGSJO ZBOH UFSMFUBL EJ EBMBN LFDJM /FVSPQFQUJEB UJEBL EJTJOUFTJT EBMBN TJUPTPM UFSNJOBM
MPLVTTFSVMFVTEJQPOTNFOHJSJNLBOTFSBCVUTFSBCVUTBSBGLFEBFS QSBTJOBQUJL.FMBJOLBO [BUJOJEJTJOUFTJTTFCBHBJCBHJBOJOUFHSBM
551
NPMFLVMQSPUFJOCFTBSPMFISJCPTPNSJCPTPNEBMBNCBEBOTFM end i
OFVSPO
.PMFLVM QSPUFJO TFMBOKVUOZB NFNBTVLJ SVBOHBO EJ EBMBN
SFUJLVMVN FOEPQMBTNB CBEBO TFM EBO LFNVEJBO LF EBMBN
BQBSBUVT(PMHJ ZBJUVUFNQBUUFSKBEJOZBEVBQFSVCBIBOCFSJLVU
m m
1FSUBNB QSPUFJO QFNCFOUVL OFVSPQFQUJEB TFDBSB FO[JNBUJL om a
NFNFDBI QSPUFJO NFOKBEJ GSBHNFOGSBHNFO ZBOH MFCJI LFDJM m
m
CFCFSBQB EJ BOUBSBOZB BEBMBI OFVSPQFQUJEBOZB TFOEJSJ BUBV kson
m
QSFLVSTPSOZB,FEVB BQBSBUVT(PMHJNFOHFNBTOFVSPQFQUJEB
NFOKBEJ WFTJLFMWFTJLFM USBOTNJUFS CFSVLVSBO LFDJM ZBOH m ? m
om a
EJMFQBTLBO LF EBMBN TJUPQMBTNB 4FMBOKVUOZB WFTJLFM
USBOTNJUFS JOJ EJCBXB LF VKVOH TFSBCVU TBSBG NFMBMVJ BMJSBO onjolan akson
BLTPO TJUPQMBTNB BLTPO CFSKBMBO EFOHBO LFDFQBUBO MBNCBU
IBOZB CFCFSBQB TFOUJNFUFS QFS IBSJ "LIJSOZB WFTJLFM JOJ
NFMFQBTLBO USBOTNJUFSOZB QBEB UFSNJOBM OFVSPO TFCBHBJ
SFTQPOTUFSIBEBQQPUFOTJBMBLTJEFOHBODBSBZBOHTBNBTFQFSUJ is i si ion ion na i m kali m dan klo ida
USBOTNJUFSNPMFLVMLFDJM/BNVO WFTJLFMEJBVUPMJTJTEBOUJEBL se anjang mem an soma ne on ang e asal da i o ensial
EJHVOBLBOLFNCBMJ mem an in asoma
0MFILBSFOBNFUPEFQFNCFOUVLBOOFVSPQFQUJEBZBOHTVMJU Perbedaan Konsentrasi lon-lon Lintas Membran Soma

JOJ KVNMBI OFVSPQFQUJEB ZBOH EJMFQBTLBO KBVI MFCJI TFEJLJU Neuron. (BNCBS KVHB NFNQFSMJIBULBO QFSCFEBBO
EJCBOEJOHLBO EFOHBO USBOTNJUFS NPMFLVMLFDJM )BM JOJ LPOTFOUSBTJ UJHB NBDBN JPO MJOUBT NFNCSBO TPNB OFVSPO ZBOH
EJLPNQFOTBTJTFCBHJBOEFOHBOLFOZBUBBOCBIXBOFVSPQFQUJEB QBMJOH QFOUJOH VOUVL GVOHTJ OFVSPO ZBLOJ JPO OBUSJVN JPO
VNVNOZBMFCJILVBUTFSJCVLBMJBUBVMFCJIEBSJQBEBUSBOTNJUFS LBMJVN EBO JPO LMPSJEB %J CBHJBO QBMJOH BUBT UBNQBL
NPMFLVMLFDJM $JSJ QFOUJOH MBJO OFVSPQFQUJEB BEBMBI CBIXB LPOTFOUSBTJ JPO OBUSJVN UJOHHJ EBMBN DBJSBO FLTUSBTFM N&R
[BU JOJ TFSJOH NFOZFCBCLBO LFSKB ZBOH KBVI MFCJI MBNB -
UFUBQJSFOEBIEJCBHJBOEBMBNOFVSPO N&R-
1FSCFEBBO
#FCFSBQB EBSJ LFSKB ZBOH EJNBLTVE JOJ NFODBLVQ QFOVUVQBO LPOTFOUSBTJ OBUSJVN JOJ EJTFCBCLBO PMFI QPNQB OBUSJVN
LBOBMLBOBM LBMTJVN ZBOH MFCJI MBNB QFSVCBIBO QFSBOHLBU NFNCSBOTPNBZBOHLVBUEBOUFSVTNFOFSVTNFNPNQBOBUSJVN
NFUBCPMJL TFM ZBOH MFCJI MBNB QFSVCBIBO BLUJWBTJ BUBV LFMVBSEBSJOFVSPO
EFBLUJWBTJ HFOHFO TQFTJGJL QBEB OVLMFVT TFM ZBOH MFCJI MBNB
(BNCBS JOJ KVHB NFNQFSMJIBULBO CBIXB LPOTFOUSBTJ JPO
EBOBUBV QFSVCBIBO KVNMBI SFTFQUPS FLTJUBUPSJL BUBV
LBMJVNUJOHHJEJEBMBNTPNBOFVSPO N&R-
OBNVOSFOEBI
JOIJCJUPSJL ZBOH MFCJI MBNB #FCFSBQB FGFL JOJ CFSMBOHTVOH
EJ EBMBN DBJSBO FLTUSBTFMVMBS N&R-
,FBEBBO JOJ
TFMBNB CFSIBSJIBSJ OBNVO ZBOH MBJOOZB NVOHLJO TBNQBJ
NFOHHBNCBSLBOCBIXBUFSEBQBUQPNQBLBMJVN TFQBSVICBHJBO
CFSCVMBOCVMBO BUBV CFSUBIVOUBIVO 1FOHFUBIVBO LJUB
EBSJQPNQB /B¦,
ZBOHNFNPNQBLBMJVNLFEBMBN
NFOHFOBJGVOHTJOFVSPQFQUJEBCBSVNVMBJCFSLFNCBOH
(BNCBS NFOHHBNCBSLBO CBIXB LPOTFOUSBTJ JPO LMPSJEB
Peristiwa Listrik yang Timbul selama Eksitasi Saraf UJOHHJ EBMBN DBJSVO FLTUSBTFM OBNVO EJ EBMBN OFVSPO
1FSJTUJXB MJTUSJL ZBOH UJNCVM TFMBNB FLTJUBTJ TBSBG UFMBI LPOTFOUSBTJOZB SFOEBI .FNCSBO UFSTFCVU NVOHLJO TFEJLJU
EJQFMBKBSJ UFSVUBNB QBEB OFVSPO NPUPSJL CFTBS QBEB SBEJLT QFSNFBCFM UFSIBEBQ JPO LMPSJEB EBO NVOHLJO UFSEBQBU QPNQB
BOUFSJPS NFEVMB TQJOBMJT 0MFI LBSFOB JUV QFSJTUJXBQFSJTUJXB LMPSJEB ZBOH MFNBI 5FUBQJ BMBTBO VUBNB SFOEBIOZB LPOTFOUSBTJ
ZBOHEJHBNCBSLBOEBMBNCFCFSBQBCBHJBOCFSJLVUOZBUFSVUBNB JPOLMPSJEBEJEBMBNOFVSPOBEBMBINVBUBOoNJMJWPMUEJEBMBN
BLBO NFOZJOHHVOH OFVSPO JOJ ,FDVBMJ VOUVL CFCFSBQB OFVSPO +BEJ NVBUBO OFHBUJG JOJ BLBO NFOPMBL JPOJPO LMPSJEB
QFSCFEBBO LFBEBBOLFBEBBO UFSTFCVU EBQBU EJUFSBQLBO QBEB ZBOH CFSNVBUBO OFHBUJG NFNBLTB JPOJPO UFSTFCVU LFMVBS
TFCBHJBOCFTBSOFVSPOTJTUFNTBSBGMBJOOZB NFMFXBUJ QPSJQPSJ TBNQBJ LPOTFOUSBTJOZB KBVI MFCJI TFEJLJU EJ
EBMBNNFNCSBOEBSJQBEBEJMVBSNFNCSBO
Potensial Membran Istirahat Soma. (BNCBSNFN .BSJMBI LJUB NFOHJOHBU LFNCBMJ EBSJ #BC EBO CBIXB CJMB
NFNQFSMJIBULBO TPNB OFVSPO NPUPSJL TQJOBMJT ZBOH
QPMBSJUBT EBO CFTBSOZB QPUFOTJBM TFTVBJ NBLB QPUFOTJBM MJTUSJL EJ
NFOVOKVLLBO QPUFOTJBM NFNCSBO JTUJSBIBU TFLJUBS
TFQBOKBOH NFNCSBO TFM BLBO NFMBXBO QFSHFSBLBO JPOJPO ZBOH
NJMJWPMU /JMBJ JOJ LVSBOH OFHBUJG EBSJQBEB NJMJWPMU ZBOH
NFMBMVJ NFNCSBO 1PUFOTJBM ZBOH EFOHBO UFQBU NFMBXBO
EJKVNQBJ QBEB TFSBCVU TBSBG QFSJGFS CFTBS EBO QBEB TFSBCVU
QFSHFSBLBO TVBUV JPO EJTFCVU TFCBHBJ QPUFOTJBM /FSOTU
PUPUSBOHLBCFTBSWPMUBTFZBOHMFCJISFOEBIJOJQFOUJOHLBSFOB
QFSTBNBBOOZBBEBMBITFCBHBJCFSJLVU
NFNVOHLJOLBO QFOHBUVSBO QPTJUJG EBO OFHBUJG QBEB EFSBKBU
FLTJUBCJMJUBTOFVSPO+BEJ NFOVSVOOZBWPMUBTFLFOJMBJOFHBUJG Konsentrasi bagian dalamˆ
¯
EMF (mV) = ± 61 × log
ZBOH MFCJI SFOEBI NFNCVBU NFNCSBO OFVSPO NFOKBEJ MFCJI Konsentrasi bagian luar ¯
ˆ
NVEBI EJSBOHTBOH TFEBOHLBO NFOVSVOOZB WPMUBTF LF OJMBJ
ZBOH MFCJI OFHBUJG NFNCVBU OFVSPO MFCJI TVMJU EJSBOHTBOH EFOHBO &.' BEBMBI CFTBSOZB QPUFOTJBM /FSOTU EBMBN TBUVBO
,FBEBBOJOJNFSVQBLBOEBTBSVOUVLEVBNPEFMGVOHTJOFVSPO NJMJWPMU EJ CBHJBO EBMBN NFNCSBO 6OUVL JPO QPTJUJG QPUFOTJBM
FLTJUBTJ BUBV JOIJCJTJ TFQFSUJ ZBOH BLBO EJKFMBTLBO MFCJI EFUBJM JOJ BLBO OFHBUJG
EBO VOUVL JPO OFHBUJG QPUFOTJBM JOJ BLBO
QBEBCBHJBOTFMBOKVUOZB QPTJUJG

552
4FLBSBOH NBSJMBI LJUB IJUVOH CFTBSOZB QPUFOTJBM /FSOTU ZBOH

EFOHBO UFQBU NFMBXBO QFSHFSBLBO EBSJ LFUJHB JPO CFSJLVU
OBUSJVN LBMJVN EBOLMPSJEB
0MFI LBSFOB QFSCFEBBO LPOTFOUSBTJ OBUSJVN ZBOH m
UNIT IX
EJHBNCBSLBOQBEB(BNCBSBEBMBIN&R-EJCBHJBOMVBS
EBO N&R- EJ CBHJBO EBMBN NBLB QPUFOTJBM NFNCSBO ZBOH
EFOHBO UFQBU BLBO NFMBXBO QFSHFSBLBO JPO OBUSJVN ZBOH e on dalam
NFMFXBUJ LBOBM OBUSJVN EJIJUVOH TFCFTBS NJMJWPMU /BNVO keadaan is a a
egmen a al
QPUFOTJBM NFNCSBO ZBOH TFCFOBSOZB BEBMBI o NJMJWPMU CVLBO akson
NJMJWPMU 0MFI LBSFOB JUV JPOJPO OBUSJVN ZBOH CPDPS LF Excitatory
CBHJBOEBMBNPMFIQPNQBOBUSJVNBLBOTFHFSBEJQPNQBLFNCBMJ
LF CBHJBO MVBS TFIJOHHB NFNQFSUBIBOLBO QPUFOTJBM OFHBUJG m
TFCFTBSoNJMJWPMUEJEBMBNOFVSPO
6OUVL JPO LBMJVN HSBEJFO LPOTFOUSBTJ EJ CBHJBO EBMBN emas kaan
OFVSPOBEBMBIN&R-EBOEJCBHJBOMVBS N&R-,FBEBBO in l ks a
e on dalam en e a an
JOJ NFOZFCBCLBO QPUFOTJBM /FSOTU EJIJUVOH TFCFTBS o NJMJWPMU keadaan e eksi asi o ensial aksi
EJ CBHJBO EBMBN OFVSPO ZBOH MFCJI OFHBUJG EBSJQBEB CFTBSOZB emas kan
QPUFOTJBM /FSOTU ZBOH TFCFOBSOZB ZBLOJ o NJMJWPMU 0MFI
n i isi
LBSFOBJUV LBSFOBUJOHHJOZBLPOTFOUSBTJJPOLBMJVNQBEBJOUSBTFM
JPOJPO LBMJVN BLBO DFOEFSVOH CFSEJGVTJ LF CBHJBO MVBS OFVSPO m
OBNVO IBM JOJ BLBO EJMBXBO PMFI QPNQB LBMJVN ZBOH UFSVT
NFOFSVTCFLFSKBTFIJOHHBJPOJPOLBMJVNBLBOEJEPSPOHLFNCBMJ engel a an
LFCBHJBOEBMBN e l ks e on dalam
"LIJSOZB HSBEJFOJPOLMPSJEBBEBMBIN&R-EJCBHJBOMVBS keadaan e in i isi
EBO N&R- EJ CBHJBO EBMBN NFOHIBTJMLBO QPUFOTJBM /FSOTU iga keadaan ne on e on dalam keadaan
TFCFTBS o NJMJWPMU EJ CBHJBO EBMBN OFVSPO ZBOH IBOZB TFEJLJU is i a a dengan o ensial in ane on no mal mili ol
e on dalam keadaan e eksi asi dengan o ensial
MFCJI OFHBUJG EBSJQBEB CFTBSOZB QPUFOTJBM /FSOTU ZBOH UFSVLVS in ane on ang k ang nega i mili ol ang dise a kan
ZBJUV o NJMJWPMU 0MFI LBSFOB JUV EBMBN LFBEBBO OPSNBM JPO ole in l ks na i m e on dalam keadaan e in i isi
JPO LMPSJEB DFOEFSVOH CPDPS TBOHBU TFEJLJU NBTVL LF CBHJBO dengan o ensial mem an in ane on ang le i nega i
EBMBNOFVSPO OBNVOJPOJPOLMPSJEBUFSTFCVUBLBOEJQJOEBILBO mili ol ang dise a kan ole e l ks ion kali m in l ks ion
LFNCBMJ LF CBHJBO MVBS NVOHLJO PMFI QPNQB LMPSJEB ZBOH klo ida a a ked an a
CFSTJGBUBLUJG NFNCSBO SFTFQUPS FLTJUBUPSJL VOUVL NFOJOHLBULBO
*OHBUMBI CFTBS LFUJHB QPUFOTJBM /FSOTU JOJ EBO KVHB BSBI QFSNFBCJMJUBTNFNCSBOUFSIBEBQJPO/B0MFILBSFOBHSBEJFO
LFDFOEFSVOHBO EJGVTJ UJBQUJBQ JPO EJ BUBT TFCBC JOGPSNBTJ JOJ LPOTFOUSBTJOBUSJVNZBOHCFTBSEBONVBUBOMJTUSJLOFHBUJGZBOH
TBOHBU CFSHVOB VOUVL EBQBU NFOHFSUJ CBHBJNBOB UFSKBEJOZB CFTBS EJ EBMBN OFVSPO JPO OBUSJVN TFHFSB CFSEJGVTJ TFDBSB
QFSJTUJXBQFSJTUJXB FLTJUBTJ EBSJ JOIJCJTJ OFVSPO NFMBMVJ BLUJWBTJ DFQBULFCBHJBOEBMBNNFNCSBO
BUBVJOBLUJWBTJLBOBMJPOTJOBQT
*POOBUSJVNCFSNVBUBOQPTJUJGZBOHEFOHBODFQBUNBTVLLF
Keseragaman Distribusi Potensial Listrik di dalam Soma. CBHJBO EBMBN OFVSPO NFOFUSBMLBO CBHJBO OFHBUJG QPUFOTJBM
#BHJBO EBMBN TPNB OFVSPO NFOHBOEVOH DBJSBO FMFLUSPMJU ZBOH
NFNCSBO JTUJSBIBU +BEJ TFQFSUJ ZBOH UBNQBL QBEB (BNCBS
CFSLFNBNQVBOUJOHHJVOUVLNFOHJSJNLBOSBOHTBOH ZBLOJDBJSBO
# QPUFOTJBM NFNCSBO JTUJSBIBU NFOJOHLBU LF BSBI QPTJUJG
JOUSBTFMVMBS OFVSPO 4FMBOKVUOZB EJBNFUFS TPNB OFVSPO ZBOH
EBSJoNFOKBEJoNJMJWPMU,FOBJLBOWPMUBTFNFOKBEJMFCJI
DVLVQ CFTBS TBNQBJ HN
NFOZFCBCLBO IBNQJS UJEBL
QPTJUJG EJ BUBT QPUFOTJBM OFVSPO JTUJSBIBU ZBOH OPSNBM ZBLOJ
BEBOZB UBIBOBO CBHJ QFOHJSJNBO BMJSBO MJTUSJL EBSJ TBMBI TBUV
NFOVKV LF OJMBJ ZBOH LVSBOH OFHBUJG EJTFCVU QPUFOTJBM
CBHJBO EBMBN TPNB LF CBHJBO MBJOOZB 0MFI LBSFOB JUV TFUJBQ
QBTDBTJOBQUJL FLTJUBUPSJL FYDJUBUPSZ QPTUTZOBQUJD QPUFOUJBM
QFSVCBIBO QPUFOTJBM EJ TFUJBQ CBHJBO DBJSBO JOUSBTPNB IBNQJS
BUBV&141
LBSFOBCJMBQPUFOTJBMJOJOBJLDVLVQUJOHHJLFBSBI
TFMBMV BLBO NFOZFCBCLBO QFSVCBIBO QPUFOTJBM ZBOH TFTVBJ EJ
QPTJUJG BLBOUFSKBEJQPUFOTJBMBLTJEBMBNOFVSPOQBTDBTJOBQUJL
TFMVSVI CBHJBO EBMBN TPNB ZBJUV TFMBNB OFVSPO UJEBL
TFIJOHHB NFSBOHTBOH OFVSPO UFSTFCVU 1BEB LBTVT JOJ
NFOHJSJNBOLBO TVBUV QPUFOTJBM BLTJ
1SJOTJQ JOJ QFOUJOH LBSFOB
CFTBSOZB &141 BEBMBI NJMJWPMU ZBJUV NJMJWPMU MFCJI
NFNBJOLBO QFSBO VUBNB EBMBN QFSJTUJXB TVNBTJ TJOZBMTJOZBM
QPTJUJGEBSJQBEBOJMBJJTUJSBIBU
ZBOH NFNBTVLJ OFVSPO EBSJ CFSCBHBJ TVNCFS TFQFSUJ ZBOH BLBO

LJUBMJIBUEBMBNCBHJBOTFMBOKVUOZBQBEBCBCJOJ /BNVO LJUB IBSVT CFSIBUJIBUJ 3BOHTBOH EBSJ TFCVBI
UFSNJOBM QSBTJOBQUJL UJEBL QFSOBI BLBO NFOJOHLBULBO
Pengaruh Eksitasi Sinaptik terhadap Membran Pasca— QPUFOTJBM OFVSPO EBSJ o NJMJWPMU NFOKBEJ o NJMJWPMU
sinaptik—Potensial Pascasinaptik Eksitatorik. (BNCBS" 1FOJOHLBUBO JOJ NFNCVUVILBO SBOHTBOHBO ZBOH CFSTBNBBO
NFOHHBNCBSLBO OFVSPO JTUJSBIBU EFOHBO UFSNJOBM QSBTJOBQUJL TJNVMUBOEBSJCBOZBLUFSNJOBMVOUVLOFVSPONPUPSJLBOUFSJPS
ZBOH UJEBL UFSBOHTBOH EJ QFSNVLBBOOZB #FTBSOZB QPUFOTJBM LJSBLJSB NFNCVUVILBO TBNQBJ TFSBCVU TBSBG QBEB TBBU
NFNCSBOJTUJSBIBUEJTFUJBQCBHJBOTPNBJUVBEBMBIoNJMJWPMU ZBOH TBNB BUBV EBMBN TFSBOHLBJBO SBOHTBOHBO ZBOH DFQBU
(BNCBS # NFOHHBNCBSLBO UFSNJOBM QSBTJOBQUJL ZBOH ,FBEBBO JOJ UFSKBEJ NFMBMVJ TVBUV QSPTFT ZBOH EJTFCVU TVNBTJ
UFMBI NFOZFLSFTJ USBOTNJUFS FLTJUBUPSJL LF EBMBN DFMBI BOUBSB ZBOHEJCBIBTTFDBSBMFCJIEFUBJMQBEBCBHJBOCFSJLVUOZB
UFSNJOBMEBONFNCSBOTPNBOFVSPO5SBOTNJUFSJOJCFLFSKBQBEB
553
Pembentukan Potensial Aksi pada Segmen Awal OPSNBM EJTFCVU QPUFOTJBM QBTDBTJOBQUJL JOIJCJUPSJL JOIJCJUPSZ
Akson yang Meninggalkan Neuron—Nilai Ambang untuk QPTUTZOBQUJDQPUFOUJBMBUBV*141

Eksitasi. #JMB NFOJOHLBU DVLVQ UJOHHJ LF BSBI QPTJUJG &141 (BNCBS $ NFNQFSMJIBULBO BLJCBU ZBOH UFSKBEJ QBEB
BLBO NFODBQBJ TVBUV UJUJL ZBOH BLBO NFSBOHTBOH UJNCVMOZB QPUFOTJBM NFNCSBO ZBOH EJTFCBCLBO PMFI BLUJWBTJ TJOBQT
QPUFOTJBM BLTJ EBMBN OFVSPO /BNVO QPUFOTJBM BLTJ UJEBL JOIJCJUPSJL ZBOHNFNVOHLJOLBONBTVLOZBJPOLMPSJEBLFEBMBN
EJNVMBJ CFSEFLBUBO EFOHBO TJOBQT FLTJUBUPSJL .FMBJOLBO TFMEBOBUBVLFMVBSOZBJPOLBMJVNLFMVBSEBSJTFM EJTFSUBJEFOHBO
QPUFOTJBM BLTJ EJNVMBJ EBSJ TFHNFO BXBM BLTPO UFNQBU BLTPO NFOVSVOOZB QPUFOTJBM NFNCSBO EBSJ OJMBJ OPSNBM o NJMJWPMU
NFOJOHHBMLBO TPNB OFVSPO "MBTBO VUBNB EBSJ UFNQBU BTBM LFOJMBJZBOHMFCJIOFHBUJGZBLOJoNJMJWPMU1PUFOTJBMNFNCSBO
QPUFOTJBM BLTJ JOJ BEBMBI LBSFOB KVNMBI LBOBM OBUSJVN JOJ MFCJI OFHBUJG NJMJWPMU EJCBOEJOHLBO OPSNBM TFIJOHHB *141
CFSHFSCBOH WPMUBTF ZBOH SFMBUJG TFEJLJU QBEB NFNCSBO TPNB TFCFTBSoNJMJWPMUNFOHJOIJCJTJQFOHJSJNBOTJOZBMTBSBGNFMBMVJ
TFIJOHHB &141 TVLBS NFNCVLB TFKVNMBI LBOBM OBUSJVN ZBOH TJOBQT
EJCVUVILBO VOUVL NFNVODVMLBO QPUFOTJBM BLTJ 4FCBMJLOZB Penghambatan Prasinaptik
NFNCSBO TFHNFO BXBM NFNJMJLJ LPOTFOUSBTJ LBOBM OBUSJVN 4FMBJO JOIJCJTJ ZBOH EJTFCBCLBO PMFI CFLFSKBOZB TJOBQT
CFSHFSCBOH WPMUBTF LBMJ MJQBU MFCJI CFTBS EBSJQBEB TPNB JOIJCJUPSJL QBEB NFNCSBO OFVSPO ZBOH EJTFCVU QFOHIBNCBUBO
TFIJOHHB EBQBU MFCJI NVEBI NFOJNCVMLBO QPUFOTJBM BLTJ QBTDBTJOBQUJL UFSEBQBUKFOJTQFOHIBNCBUBOMBJOZBOHUFSKBEJQBEB
EJCBOEJOHLBO TPNB &141 ZBOH BLBO NFOJNCVMLBO QPUFOTJBM UFSNJOBM QSBTJOBQUJL TFCFMVN TJOZBM NFODBQBJ TJOBQT +FOJT
BLTJEJEBMBNTFHNFOBXBMBEBMBIBOUBSBEBONJMJWPMU QFOHIBNCBUBO JOJ EJTFCVU QFOHIBNCBUBO QSBTJOBQUJL ZBOH
,FBEBBOJOJCFSCFEBEFOHBOZBOHEJCVUVILBOPMFITPNB ZBLOJ UFSKBEJNFMBMVJDBSBCFSJLVU
TFCFTBSBUBVNJMJWPMU 1FOHIBNCBUBO QSBTJOBQUJL EJTFCBCLBO PMFI QFMFQBTBO [BU
4FHFSB TFUFMBI UJNCVM QPUFOTJBM BLTJ BLBO NFOKBMBS
JOIJCJUPSJL LF CBHJBO TFSBU TBSBG QSBTJOBQUJL TFCFMVN UFSNJOBM
TFQBOKBOH BLTPO EBO CJBTBOZB LFNCBMJ KVHB LF TPNB 1BEB
QSBTJOBQUJL UFSTFCVU CFSBLIJS EJ OFVSPO QBTDBTJOBQUJL 1BEB
CFCFSBQB LFBEBBO QPUFOTJBM BLTJ KVHB NFOKBMBS LFNCBMJ LF
TFCBHJBO CFTBS LFBEBBO [BU USBOTNJUFS JOIJCJUPSJLOZB BEBMBI
EBMBN EFOESJU OBNVO UJEBL TFNVBOZB TFCBC TFQFSUJ IBMOZB
("#" BTBN HBNNBBNJOPCVUJSBU
)BM JOJ NFOJNCVMLBO FGFL
QBEB TPNB OFVSPO EFOESJU NFNQVOZBJ LBOBM OBUSJVN
TQFTJGJL ZBJUV NFNCVLBOZB LBOBM BOJPO TFIJOHHB
CFSHFSCBOH WPMUBTF TBOHBU TFEJLJU TFIJOHHB TFSJOH LBMJ UJEBL
NFNVOHLJOLBO TFKVNMBI CFTBS JPO LMPSJEB CFSEJGVTJ LF EBMBN
EBQBU NFOHIBTJMLBO QPUFOTJBM BLTJ TBNB TFLBMJ +BEJ TFQFSUJ
UFSNJOBM TFSBU TBSBG .VBUBO OFHBUJG EBSJ JPOJPO JOJ
ZBOH UBNQBL QBEB (BNCBS # OJMBJ BNCBOH VOUVL
NFOHIBNCBU QFOHJSJNBO TJOBQUJL LBSFOB NVBUBO UFSTFCVU
UJNCVMOZB FLTJUBTJ OFVSPO BEBMBI TFLJUBS o NJMJWPMU ZBOH
NFMBXBO TFCBHJBO CFTBS FGFL FLTJUBTJ JPO OBUSJVN ZBOH
NFOVOKVLLBO&141TFCFTBSNJMJWPMUZBJUV NJMJWPMUMFCJI
CFSNVBUBO QPTJUJG ZBOH KVHB NFNBTVLJ UFSNJOBM TFSBU TBSBG
QPTJUJGEBSJQBEBQPUFOTJBMOFVSPOJTUJSBIBUTFCFTBSoNJMJWPMU
LFUJLBQPUFOTJBMBLTJUJCB
*OIJCJTJ QSBTJOBQUJL UFSKBEJ QBEB CBOZBL KBSBT TFOTPSJL EJ
Peristiwa Listrik yang Timbul selama Penghambatan TJTUFN TBSBG 4FCFOBSOZB TFSBUTFSBU TBSBG TFOTPSJT ZBOH
Neuron CFSEFLBUBO TFSJOH TBMJOH NFOHIBNCBU ZBOH NFNJOJNBMLBO
Pengaruh Sinaps Inhibitorik terhadap Membran Pasca QFOZFCBSBOEBOQFODBNQVSBOTJOZBMTJOZBMEJKBSBTTFOTPSJL,JUB
sinaptik—Potensial Pascasinaptik Inhibitorik. 4JOBQT BLBONFNCBIBTOJMBJQFOUJOHEBSJGFOPNFOBJOJMFCJINFOEBMBN
JOIJCJUPSJL UFSVUBNB BLBO NFNCVLB LBOBM LMPSJEB QBEBCBCCBCTFMBOKVUOZB
NFNVOHLJOLBO MFXBUOZB JPO LMPSJEB EFOHBO NVEBI 4FLBSBOH Durasi Potensial Pascasinaptik
VOUVL NFOHFSUJ CBHBJNBOB TJOBQT JOIJCJUPSJL EBQBU
NFOHIBNCBU OFVSPO QBTDBTJOBQUJLUJL LJUB IBSVT NFOHJOHBU #JMB TVBUV TJOBQT FLTJUBUPSJL NFSBOHTBOH OFVSPO NPUPSJM
LFNCBMJ BQB ZBOH UFMBI LJUB QFMBKBSJ NFOHFOBJ QPUFOTJBM /FSOTU BOUFSJPS NFNCSBO OFVSPO BLBO NFOKBEJ TBOHBU QFSNFBCFM
ZBOHCFSMBLVVOUVLJPOLMPSJEB,JUBUFMBINFOHIJUVOHCFTBSOZB UFSIBEBQJPOOBUSJVNTFMBNBTBNQBJNJMJEFUJL4FMBNBXBLUV
QPUFOTJBM/FSOTUVOUVLJPOLMPSJEB ZBJUVoNJMJWPMU1PUFOTJBM ZBOH TBOHBU TJOHLBU JOJ KVNMBI JPO OBUSJVN ZBOH CFSEJGVTJ
JOJ MFCJI OFHBUJG EBSJQBEB CFTBSOZB QPUFOTJBM EBMBN NFNCSBO EFOHBO DFQBU LF CBHJBO EBMBN OFVSPO NPUPSJL QBTDBTJOBQUJL
OFVSPOJTUJSBIBUQBEBLFBEBBOOPSNBM ZBLOJoNJMJWPMU0MFI DVLVQ VOUVL NFOJOHLBULBO QPUFOTJBM JOUSBOFVSPO TFCFTBS
LBSFOB JUV QFNCVLBBO LBOBM LMPSJEB BLBO NFNQFSNVEBI CFCFSBQB NJMJWPMU EFOHBO EFNJLJBO NFNCFOUVL QPUFOTJBM
CFSHFSBLOZB JPO LMPSJEB ZBOH CFSNVBUBO OFHBUJG EBSJ DBJSBO QBTDBTJOBQUJLFLTJUBUPSJL &141
TFQFSUJZBOHEJQFSMJIBULBOPMFI
FLTUSBTFM LF BSBI EBMBN TFIJOHHB BLBO NFNCVBU QPUFOTJBM LVSWB BCVBCV HFMBQ EBO BCVBCV UFSBOH QBEB (BNCBS
NFNCSBOEBMBNMFCJIOFHBUJGEBSJQBEBOPSNBM NFOEFLBUJOJMBJ 1PUFOTJBM JOJ LFNVEJBO NFOVSVO TFDBSB QFSMBIBO TFMBNB
oNJMJWPMU NJMJEFUJL CFSJLVUOZB TFCBC XBLUV JOJ EJCVUVILBO PMFI LFMFCJIBO
1FNCVLBBO LBOBM LBMJVN BLBO NFNVOHLJOLBO JPO LBMJVN NVBUBO QPTJUJG VOUVL LFMVBS EBSJ OFVSPO ZBOH UFSFLTJUBTJ EBO
ZBOH CFSNVBUBO QPTJUJG VOUVL CFSHFSBL LF BSBI MVBS EBO KVHB LFNCBMJNFODBQBJQPUFOTJBMNFNCSBOJTUJSBIBUOPSNBM
BLBONFNCVBUQPUFOTJBMNFNCSBOEBMBNNFOKBEJMFCJIOFHBUJG 1FOHBSVI ZBOH QFSTJT CFSMBXBOBO UFSKBEJ QBEB *141 ZBJUV
EBSJQBEB CJBTBOZB +BEJ CBJL JOGMVLT LMPSJEB NBVQVO FGMVLT TJOBQT JOIJCJUPSJL BLBO NFOJOHLBULBO QFSNFBCJMJUBT NFNCSBO
LBMJVN BLBO NFOJOHLBULBO EFSBKBU OFHBUJWJUBT JOUSBTFM ZBOH CBHJJPOJPOLBMJVNEBOLMPSJEB BUBVLFEVBOZB TFMBNBTBNQBJ
EJTFCVUIJQFSQPMBSJTBTJ,FBEBBOJOJBLBONFOHIBNCBUOFVSPO NJMJEFUJL EBO LFBEBBO JOJ NFOVSVOLBO QPUFOTJBM JOUSBOFVSPO
LBSFOB QPUFOTJBM NFNCSBO NFOKBEJ MFCJI OFHBUJG EBSJQBEB NFOKBEJ MFCJI OFHBUJG EBSJQBEB OJMBJOPSNBM EFOHBO EFNJLJBO
QPUFOTJBM JOUSBTFM OPSNBM 0MFI LBSFOB JUV QFOJOHLBUBO NFNCFOUVL*1411PUFOTJBMJOJKVHBBLBOIJMBOHEBMBNXBLUV
OFHBUJWJUBTZBOHNFMFCJIJCFTBSOZBQPUFOTJBMNFNCSBOJTUJSBIBU NJMJEFUJLCFSJLVUOZB
554
+20 16 e angsangan sina s BNCBOH MFUVQ UFMBI UFSDBQBJ EBO QBEB TFHNFO BXBM BLTPO
o ensial aksi 8 e angasangan sina s UJNCVMQPUFOTJBMBLTJ
0 4 e angsangan sina s
1FOHBSVI QFOKVNMBIBO QPUFOTJBM QBTDBTJOBQUJL ZBOH
UNIT IX
TJNVMUBO EFOHBO DBSB NFOHBLUJWBTJ CBOZBL UFSNJOBM QBEB
–20
Millivolts
16 EBFSBI NFNCSBO OFVSPO ZBOH MVBT EJTFCVU TVNBTJ TQBTUBMM

SVBOH
–40 o ensial eksi asi
8
as asina ik "Sumasi Temporal" Disebabkan oleh Rangsangan
–60 4 Berturut-turut dari Sebuah Terminal Prasinaptik
o ensial mem an is a a 4FUJBQ LBMJ UFSNJOBM QSBTJOBQUJL UFSBOHTBOH [BU USBOTNJUFS
–80 ZBOH EJMFQBTLBO NFNCVLB LBOBMLBOBM NFNCSBO TFMBNB
0 2 4 6 8 10 12 14 16
NBLTJNBM TBUV NJMJEFUJL /BNVO QFSVCBIBO QPUFOTJBM
QBTDBTJOBQUJL CFSUBIBO TBNQBJ NJMJEFUJL TFUFMBI LBOBM
o ensial as asina ik eksi a o ik men nj kkan LBOBM NFNCSBO TJOBQT TVEBI UFSMFCJI EBIVMV UFSUVUVQ 0MFI
a a e angsangan sim l an ada sina s dalam j mla ang
LBSFOB JUV QFNCVLBBO ZBOH LFEVB EBSJ LBOBM ZBOH TBNB
an a sediki idak akan men e a kan o ensial s masi ang
k n k menim lkan o ensial aksi nam n ila EBQBUNFOJOHLBULBOCFTBSOZBQPUFOTJBMQBTDBTJOBQUJLTBNQBJ
e angsangan sim l an adi e jadi ada sina s ang le i an ak OJMBJ ZBOH MFCJI CFTBS EBO NBLJO DFQBU LFDFQBUBO
akan meningka kan o ensial ang dis masi men j ke nilai QFSBOHTBOHBO NBLJOCFTBSQVMBQPUFOTJBMQBTDBTJOBQUJLZBOH
am ang n k eksi asi dan men e a kan e jadin a o ensial aksi UFSKBEJ+BEJCJMBQFMFQBTBOSBOHTBOHZBOHCFSUVSVUUVSVUEBSJ
ang m ang indi dengan s masi o ensial as asina ik
UFSNJOBM QSBTJOBQUJL UVOHHBM UJNCVMOZB DVLVQ DFQBU BLBO
s e im osed a ion o en ial
EBQBUNFOBNCBITBUVTBNBMBJOBSUJOZBQFMFQBTBOJUVEBQBU
EJTVNBTJh1FOKVNMBIBOJOJEJTFCVUTVNBTJUFNQPSBM
;BU USBOTNJUFS KFOJT MBJO EBQBU NFSBOHTBOH BUBV NFOHIBNCBU Sumasi secara Simultan dari Potensial Pascasinaptik
OFVSPO QBTDBTJOBQUJL VOUVL XBLUV ZBOH KBVI MFCJI MBNB TFMBNB Inhibitorik dan Eksitatorik. #JMB TVBUV *141 DFOEFSVOH
CFCFSBQB SBUVT NJMJEFUJL BUBV CBILBO TFMBNB CFCFSBQB EFUJL NFOHVSBOHJ CFTBSOZB QPUFOTJBM NFNCSBO LF OJMBJ ZBOH MFCJI
CFCFSBQB NFOJU BUBV CFCFSBQB KBN )BM JOJ LIVTVTOZB UFSKBEJ OFHBUJG MBHJ QBEBIBM QBEB TBBU ZBOH TBNB &141 DFOEFSVOH
QBEBCFCFSBQBUSBOTNJUFSOFVSPQFQUJEB NFOJOHLBULBO QPUFOTJBM LFEVB QFOHBSVI JOJ BLBO TBMJOH
NFOJBEBLBO CBJL TFDBSB UPUBM BUBV TFCBHJBO TBKB +BEJ CJMB
TFCVBI OFVSPO EJSBOHTBOH PMFI &141 SBOHTBOHBO
"Sumasi Spasial" dalam Neuron—Ambang Letup
QFOHIBNCBU ZBOH CFSBTBM EBSJ TVNCFS MBJO EBQBU TFSJOH LBMJ
&LTJUBTJ TBUV UFSNJOBM QSBTJOBQUJL QBEB QFSNVLBBO TFCVBI NFOHVSBOHJQPUFOTJBMQBTDBTJOBQUJLLFOJMBJZBOHMFCJISFOEBI
OFVSPO IBNQJS TBNB TFLBMJ UJEBL QFSOBI NFSBOHTBOH OFVSPO EBSJQBEB BNCBOH VOUVL FLTJUBTJ TFIJOHHB NFMBXBO BLUJWJUBT
UFSTFCVU"MBTBOOZBBEBMBILBSFOBKVNMBICBIBOUSBOTNJUFSZBOH OFVSPO
EJMFQBTLBO PMFI TBUV UFSNJOBM BLBO NFOZFCBCLBO UJNCVMOZB
"Fasilitasi" Neuron
&141ZBOHCJBTBOZBUJEBLMFCJICFTBSEBSJ TBNQBJNJMJWPMU
EBSJQBEB TBNQBJ NJMJWPMU ZBOH OPSNBMOZB EJCVUVILBO 4FSJOH QPUFOTJBM QBTDBTJOBQUJL ZBOH EJTVNBTJ CFSTJGBU FLTJUBTJ
VOUVLEBQBUNFODBQBJBNCBOHVOUVLFLTJUBTJ OBNVOOBJLOZBUBLDVLVQUJOHHJVOUVLNFODBQBJOJMBJBNCBOH
/BNVO CJBTBOZB CBOZBL UFSNJOBM QSBTJOBQUJL ZBOH MFUVQ OFVSPO QSBTJOBQUJL #JMB LFBEBBO JOJ UFSKBEJ OFVSPO
UFSBOHTBOH QBEB TBBU ZBOH CFSTBNBBO 8BMBVQVO UFSNJOBM EJLBUBLBO EBMBN LFBEBBO UFSGBTJMJUBTJ +BEJ CFTBSOZB QPUFOTJBM
UFSNJOBMJOJUFSTFCBSMVBTEJOFVSPO QFOHBSVIOZBNBTJIEBQBU NFNCSBONFOEFLBUJOJMBJBNCBOHMFUVQEJCBOEJOHLBOEFOHBO
EJTVNBTJ ZBJUV EBQBU EJUBNCBILBO TBUV TBNB MBJO TBNQBJ LFBEBBO OPSNBM UFUBQJ CFMVN DVLVQ NFODBQBJ CBUBT MFUVQ
FLTJUBTJ OFVSPO UFSKBEJ "MBTBOOZB BEBMBI TFCBHBJ CFSJLVU "LJCBUOZB TJOZBM FLTJUBTJ EBSJ TVNCFS MBJO ZBOH NFNBTVLJ
5FMBI EJUVOKVLLBO TFCFMVNOZB CBIXB QFSVCBIBO QPUFOTJBM OFVSPO EBQBU EFOHBO NVEBIOZB NFSBOHTBOH OFVSPO JUV
QBEB TFUJBQ UJUJL UVOHHBM EBMBN TPNB BLBO NFOZFCBCLBO 3BOHTBOHBO ZBOH UFSTFCBSEJGVT QBEB TJTUFN TBSBG TFSJOH LBMJ
QFSVCBIBO QPUFOTJBM ZBOH IBNQJS TBNB EJ TFMVSVI CBHJBO NFNQFSNVEBI TFLFMPNQPL CFTBS OFVSPO VOUVL EJSBOHTBOH
TPNB *OJ UFSKBEJ BLJCBU LPOEVLUJWJUBT MJTUSJL ZBOH TBOHBU LVBU TFIJOHHB OFVSPOOFVSPO EBQBU EFOHBO DFQBU EBO NVEBI
EJ EBMBN TPNB TFM OFVSPO ZBOH CFTBS 0MFI LBSFOB JUV VOUVL NFOBOHHBQJTJOZBMTJOZBMZBOHEBUBOHEBSJTVNCFSMBJO
TFUJBQ TJOBQT ZBOH UFSFLTJUBTJ TFDBSB TJNVMUBO QPUFOTJBM Fungsi Khusus Dendrit untuk Merangsang Neuron
JOUSBTPNBUPUBMBLBONFOKBEJMFCJIQPTJUJGTFCBOZBL TBNQBJ Lapangan Spasial Eksitasi Dendrit yang Luas. %FOESJUEFOESJU
NJMJWPMU #JMB CFTBSOZB &141 NFOKBEJ DVLVQ CFTBS BLBO
EBSJ OFVSPO NPUPSJL BOUFSJPS TFSJOH NFOZFCBS TFQBOKBOH
UFSDBQBJ OJMBJ BNCBOH MFUVQ GJSJOH UISFTIPME
EBO QPUFOTJBM
TBNQBJ N LF TFHBMB BSBI EBSJ TPNB OFVSPO 4FMBJO JUV
BLTJ BLBO UFSCFOUVL TFDBSB TQPOUBO QBEB TFHNFO BXBM BLTPO
EFOESJUEFOESJUJOJEBQBUNFOFSJNBTJOZBMEBSJSVBOHZBOHMVBT
)BM JOJ EJHBNCBSLBO QBEB (BNCBS 1PUFOTJBM
ZBOH BEB EJ TFLJUBS OFVSPO NPUPSJL ,FBEBBO JOJ BLBO
QBTDBTJOBQUJL EJ CBHJBO CBXBI HBNCBS EJUJNCVMLBO PMFI
NFNQFSDFQBUUFSKBEJOZBTVNBTJTJOZBMTJOZBMZBOHCFSBTBMEBSJ
QFSBOHTBOHBO TFDBSB TJNVMUBO TJOBQT QPUFOTJBM CFSJLVUOZB
CBOZBLTFSBCVUTBSBGQSBTJOBQUJLZBOHUFSQJTBI
ZBOH MFCJI UJOHHJ EJTFCBCLBO PMFI QFSBOHTBOHBO TJOBQT
BLIJSOZB HBNCBSBO &141 ZBOH MFCJI UJOHHJ MBHJ EJTFCBCLBO 1FOUJOHKVHBEJLFUBIVJCBIXBTBNQBJQFSTFOUFSNJOBM
PMFIQFSBOHTBOHBOTJOBQT1BEBTBBUZBOHUFSBLIJSJOJMBI QSBTJOBQUJLOFVSPONPUPSJLBOUFSJPSCFSBLIJSQBEBEFOESJU
555
CFSCFEBEFOHBOIBOZBTBNQBJQFSTFOZBOHCFSBLIJSQBEB 1FOVSVOBO QPUFOTJBM NFNCSBO ZBOH EJTFCBSLBO TFDBSB MJTUSJL EJ

TPNBOFVSPO0MFILBSFOBJUV TFCBHJBOCFTBSFLTJUBTJOFVSPO TFQBOKBOH EFOESJU ZBOH NFOVKV LF TPNB JOJ EJTFCVU TFCBHBJ
EJTFEJBLBO PMFI TJOZBMTJOZBM ZBOH EJIBOUBSLBO NFMBMVJ QFOHVSBOHBOLPOEVLTJ EFDSFNFOUBMDPOEVDUJPO

EFOESJU 4FNBLJO KBVI TJOBQT ZBOH TFEBOH UFSFLTJUBTJ EBSJ TPNB TVBUV
Sebagian Besar Dendrit Tidak Dapat Mengirimkan OFVSPO QFOHVSBOHBO LPOEVLTJ NBLJO CFTBS EBO TFNBLJO LFDJM
Potensial Aksi—tetapi Dapat Mengirimkan Sinyal-Sinyal TJOZBM FLTJUBTJ ZBOH NFODBQBJ TPNB 0MFI LBSFOB JUV TJOBQT
melalui Konduksi Listrik. 4FCBHJBO CFTBS EFOESJU HBHBM TJOBQT ZBOH MFUBLOZB EFLBU TPNB NFNQVOZBJ QFOHBSVI VOUVL
EBMBN NFOHJSJNLBO QPUFOTJBM BLTJ LBSFOB NFNCSBOOZB NFOZFCBCLBO FLTJUBTJ BUBV JOIJCJTJ ZBOH MFCJI CFTBS LFUJNCBOH
NFNQVOZBJ QJOUV LBOBM OBUSJVN CFSHFSCBOH WPMUBTF EBMBN TJOBQTZBOHMFUBLOZBMFCJIKBVIEBSJTPNB
KVNMBI ZBOH SFMBUJG SFOEBI EBO OJMBJ BNCBOH VOUVL FLTJUBTJ
UFSMBMV UJOHHJ VOUVL NFOJNCVMLBO QPUFOTJBM BLTJ/BNVO Sumasi Eksitasi dan Inhibisi dalam Dendrit. 1BEB(BNCBS
EFOESJUUFSTFCVUEBQBUNFOHJSJNLBOBMJSBOMJTUSJLEBSJEFOESJU EFOESJUZBOHUFSBUBTUBNQBLUFSBOHTBOHPMFILFEVBTJOBQT
NFOVKVLFTPNB1FOHJSJNBOBMJSBOMJTUSJLCFSBSUJQFOZFCBSBO FLTJUBUPSJLEBOTJOBQTJOIJCJUPSJL%JCBHJBOVKVOHEFOESJUUJNCVM
MBOHTVOH BMJSBO MJTUSJL NFMBMVJ LPOEVLTJ JPO EBMBN DBJSBO QPUFOTJBMQBTDBTJOBQUJLFLTJUBUPSJLZBOHLVBU UFUBQJEJEFLBUTPNB
EFOESJU UFUBQJ UBOQB UJNCVMOZB QPUFOTJBM BLTJ 1FSBOHTBOHBO BEB EVB CVBI TJOBQT JOIJCJUPSJL ZBOH CFLFSKB QBEB EFOESJU ZBOH
BUBV QFOHIBNCBUBO
OFVSPO PMFI BMJSBO JOJ NFNQVOZBJ TJGBU TBNB4JOBQTJOIJCJUPSJLJOJNFOHIBTJMLBOWPMUBTFIJQFSQPMBSJTBTJ
ZBOHLIBTTFCBHBJCFSJLVU ZBOH TFDBSB UPUBM NFOJBEBLBO QFOHBSVI FLTJUBTJ EBO KVTUSV
Pengurangan Konduksi Listrik dalam Dendrit- NFOHIBOUBSLBO BMJSBO MJTUSJL ZBOH CFSTJGBU TFEJLJU NFOHIBNCBU
Peningkatan Efek Eksitasi (atau Inhibisi) oleh Sinaps NFOVKV LF TPNB +BEJ EFOESJU EBQBU NFOKVNMBILBO QPUFOTJBM
yang Berada Dekat Soma. 1BEB (BNCBS QBTDBTJOBQUJL FLTJUBUPSJL EBO QPUFOTJBM QBTDBTJOBQUJL JOIJCJUPSJL
EJUVOKVLLBO TFKVNMBI TJOBQT FLTJUBUPSJL EBO JOIJCJUPSJL ZBOH EFOHBO DBSB ZBOH TBNB EFOHBO TPNB 1BEB HBNCBS KVHB UFSMJIBU
TFEBOH NFSBOHTBOH EFOESJU TFCVBI OFVSPO 1BEB LFEVB CFCFSBQBTJOBQTJOIJCJUPSJLZBOHCFSMPLBTJMBOHTVOHQBEBIJMMPDL
EFOESJU EJ TFCFMBI LJSJ UFSEBQBU FGFL FLTJUBTJ EJ EFLBU QVODBL BYPO EBO TFHNFO BXBM BLTPO -PLBTJ JOJ NFOJNCVMLBO JOIJCJTJ
EFOESJU QFSIBUJLBO UJOHHJOZB QPUFOTJBM QBTDBTJOBQUJL LVBU LBSFOB TJOBQT NFNCFSJ QFOHBSVI MBOHTVOH EBMBN
FLTJUBUPSJL QBEB VKVOHVKVOH JOJBSUJOZB QFSIBUJLBO NFOJOHLBULBO BNCBOH SBOHTBOH VOUVL UJNCVMOZB FLTJUBTJ UFQBU
QPUFOTJBMNFNCSBOOZBZBOHLVSBOHOFHBUJG/BNVO TFCBHJBO QBEBUJUJLEJNBOBQPUFOTJBMBLTJTFDBSBOPSNBMEJCFOUVL
CFTBS QPUFOTJBM QBTDBTJOBQUJL FLTJUBUPSJL BLBO IJMBOH TFCFMVN
NFODBQBJ TPNB "MBTBOOZB BEBMBI LBSFOB EFOESJU QBOKBOH Hubungan Keadaan Eksitasi Neuron dengan Frekuensi
NFNCSBOOZBUJQJT EBOTFUJEBLOZBTFCBHJBONFNCSBOUFSTFCVU Pencetusan Potensial Aksi
QFSNFBCFM UFSIBEBQ JPO LBMJVN EBO LMPSJEB NFNCVBUOZB "Keadaan Eksitasi." TFCVBI OFVSPO EJEFGJOJTJLBO TFCBHBJ
NVEBI CPDPS UFSIBEBQ BMJSBO MJTUSJL 0MFI LBSFOB JUV KVNMBI EFSBKBU FLTJUBTJ ZBOH NFSBOHTBOH TFCVBI OFVSPO #JMB
TFCFMVN QPUFOTJBM FLTJUBTJ EBQBU NFODBQBJ TPNB TFCBHJBO EFSBKBU FLTJUBTJ MFCJI UJOHHJ EBSJ EFSBKBU JOIJCJTJ QBEB OFVSPO
CFTBSQPUFOTJBMIJMBOHNFMBMVJNFNCSBOZBOHCPDPS LFBEBBO JOJ EJTFCVU LFBEBBO FLTJUBTJ 4FCBMJLOZB CJMB UFSEBQBU
JOIJCJTJ ZBOH MFCJI UJOHHJ EBSJ FLTJUBTJ LFBEBBO JUV EJTFCVU
LFBEBBOJOIJCJTJ
E #JMB LFBEBBO FLTJUBTJ TVBUV OFVSPO NFOJOHLBU TBNQBJ EJ BUBT
-2
OJMBJ BNCBOH VOUVL FLTJUBTJ OFVSPO BLBO UFSBOHTBOH TFDBSB

0
E
0
-2
E CFSVOUVO TFMBNB LFBEBBO FLTJUBTJ EJQFSUBIBOLBO QBEB OJMBJ

E E
-40 UFSTFCVU(BNCBSNFOHHBNCBSLBOSFTQPOTEBSJUJHBNBDBN
E E -50 OFVSPOZBOHCFSCFEBUFSIBEBQCFSCBHBJUJOHLBUBOLFBEBBOFLTJ
-1
-2 I -75 I
0
E 0
-3 -70
5 -60
-5
0- 600
E 60
-3
0
-40 -60 mV I I 500
-50 -60
-30 -40 -70 -75
E 400
I I
e on e on
300
ilai
200 am ang
e on
100
e angsangan ne on ole e minal
asina ik ang e le ak ada dend i dalam gam a ini 0
am ak se a a k s s eng angan kond ksi o ensial lis ik 0 5 10 15 20 25 30 35
eksi a o ik dalam d a a dend i ke a a ki i dan in i isi
eksi asi dend i ada dend i ang aling a as i e li a kan i i es ons da i e agai jenis ne on e ada
j ga enga sina s in i i o ik ang k a ada segmen a al
akson e agai ingka keadaan eksi asi ang e eda
556
UBTJ1FSIBUJLBOCBIXBOFVSPONFNQVOZBJOJMBJBNCBOHZBOH TBNQBJ TFSJOH LBMJ NFOZFCBCLBO LFKBOH FQJMFQTJ PUBL

SFOEBI VOUVL FLTJUBTJ TFEBOHLBO OFVSPO NFNQVOZBJ OJMBJ BLJCBUQFOJOHLBUBOFLTJUBCJMJUBTCFCFSBQBBUBVTFMVSVIOFVSPO
BNCBOH ZBOH UJOHHJ /BNVO QFSIBUJLBO KVHB CBIXB OFVSPO PUBL ,FBEBBO JOJ UFSVUBNB EBQBU EJQFSMJIBULBO EFOHBO
NFNQVOZBJGSFLVFOTJNBLTJNBMSBOHTBOHBOZBOHQBMJOHSFOEBI NFNJOUB TFTFPSBOH ZBOH NVEBI UFSTFSBOH LFKBOH FQJMFQUJL
TFEBOHLBOOFVSPONFNQVOZBJGSFLVFOTJNBLTJNBMSBOHTBOHBO
UNIT IX
VOUVLCFSOBQBTTFDBSBCFSMFCJIBO#FSOBQBTTFDBSBCFSMFCJIBO
ZBOHQBMJOHUJOHHJ BLBONFNCVBOHLBSCPOEJPLTJEBTFDBSBDFQBUEBOPMFILBSFOB
#FCFSBQB OFVSPO EBMBN TJTUFN TBSBG QVTBU UFSVTNFOFSVT JUV NFOJOHLBULBO Q) EBSBI VOUVL TFNFOUBSB XBLUV OBNVO
NFODFUVTLBOQPUFOTJBMBLTJTFCBCLFBEBBOFLTJUBTJOPSNBMOZBEJ XBLUVZBOHTJOHLBUJOJEBQBUNFODFUVTLBOTFSBOHBOFQJMFQTJ
BUBT OJMBJ BNCBOH #JBTBOZB GSFLVFOTJ QFODFUVTBO QPUFOTJBM BLTJ 4FCBMJLOZB BTJEPTJT TBOHBU NFOVSVOLBO BLUJWJUBT OFVSPO
EBQBU EJOBJLLBO MFCJI UJOHHJ MBHJ EFOHBO DBSB NFOJOHLBULBO QFOVSVOBO Q) EBSJ NFOKBEJ EJ CBXBI CJBTBOZB
LFBEBBO FLTJUBTJOZB 'SFLVFOTJOZB EBQBU EJUVSVOLBO BUBV NFOZFCBCLBO LFBEBBO LPNB $POUPIOZB QBEB LFBEBBO
CBILBO EBQBU EJIFOUJLBO EFOHBO DBSB NFOVNQBOHUJOEJILBO BTJEPTJTEJBCFUJLBUBVVSFNJLCFSBU LPNBIBNQJSTFMBMVUFSKBEJ
TVQFSJNQPTJOH
LFBEBBOIBNCBUBOQBEBOFVSPOJUV+BEJ OFVSPO Pengaruh Hipoksia pada Pengiriman Sinaptik. Eksitabilitas
ZBOH CFSCFEB NFNCFSJLBO SFTQPOT ZBOH CFSCFEB NFNQVOZBJ
OFVSPO KVHB TBOHBU CFSHBOUVOH QBEB QFOZFEJBBO PLTJHFO ZBOH
OJMBJ BNCBOH FLTJUBTJ ZBOH CFSCFEB EBO NFNJMJLJ SFOUBOH
DVLVQ 1FOHVSBOHBO PLTJHFO TFMBNB CFCFSBQB EFUJL TBKB TVEBI
GSFLVFOTJ NBLTJNBM QFSBOHTBOHBO ZBOH TBOHBU CFTBS
EBQBU NFOHIJMBOHLBO FLTJUBCJMJUBT OFVSPO TFDBSB UPUBM ,FBEBBO
QFSCFEBBOOZB %FOHBO TFEJLJU JNBKJOBTJ TFTFPSBOH EBQBU
JOJ UFSMJIBU CJMB BMJSBO EBSBI PUBL UFSHBOHHV VOUVL TFNFOUBSB
NFOHFSUJ QFOUJOHOZB LFCFSBEBBO OFVSPO ZBOH CFSCFEB ZBOH
XBLUV LBSFOB EBMBN TBNQBJ EFUJL PSBOH UFSTFCVU NFOKBEJ
NFNQVOZBJ LFNBNQVBO NFOHIBTJMLBO CFSCBHBJ SFTQPOT LIBT
UJEBLTBEBS
ZBOH CFSCFEB VOUVL NFMBLVLBO GVOHTJ TJTUFN TBSBG ZBOH TBOHBU
CFSBHBN Pengaruh Obat-Obatan pada Pengiriman Sinaptik.
5FMBIEJLFUBIVJCBOZBLPCBUPCBUBOZBOHEBQBUNFOJOHLBULBO
FLTJUBCJMJUBT OFVSPO EBO EJLFUBIVJ KVHB PCBUPCBU MBJO ZBOH
Beberapa Sifat Khusus Pengiriman Sinaptik EBQBU NFOVSVOLBO FLTJUBCJMJUBT OFVSPO $POUPIOZB LBGFJO
UFPGJMJO EBOUFPCSPNJO ZBOHEJUFNVLBOTFDBSBCFSVSVUBOEBMBN
Kelelahan Pengiriman Sinaptik. #JMB TVBUV TJOBQT LPQJ UFI EBO DPLFMBU TFNVBOZB NFOJOHLBULBO FLTJUBCJMJUBT
FLTJUBUPSJLEJSBOHTBOHTFDBSBCFSVOUVOEFOHBOLFDFQBUBOUJOHHJ OFVSPO EJEVHBEFOHBONFOVSVOLBOOJMBJBNCBOHFLTJUBTJQBEB
NVMBNVMB KVNMBI SBOHTBOHBO ZBOH EJIBTJMLBO PMFI OFVSPO OFVSPO
QBTDBTJOBQUJL TBOHBU CFTBS OBNVO LFDFQBUBO MFUVQBOOZB QBEB
4USJLOJO BEBMBI TBMBI TBUV CBIBO ZBOH QBMJOH EJLFOBM EBQBU
CFCFSBQB NJMJEFUJL BUBV CFCFSBQB EFUJL CFSJLVUOZB BLBO NBLJO
NFOJOHLBULBO FLTJUBCJMJUBT OFVSPO /BNVO TUSJLOJO UJEBL
CFSLVSBOH,FBEBBOJOJEJTFCVULFMFMBIBOQFOHJSJNBOTJOBQUJL
CFLFSKB EFOHBO NFOVSVOLBO OJMBJ BNCBOH FLTJUBTJ OFVSPO
,FMFMBIBONFSVQBLBODJSJGVOHTJTJOBQUJLZBOHTBOHBUQFOUJOH OBNVO CFLFSKB EFOHBO DBSB NFOHIBNCBU LFSKB CFCFSBQB [BU
LBSFOB CJMB UFSEBQBU CFCFSBQB BSFB TJTUFN TBSBG ZBOH UFSBOHTBOH USBOTNJUFS JOIJCJTJ QBEB OFVSPO UFSVUBNB QFOHBSVI JOIJCJTJ
TFDBSBCFSMFCJIBO LFMFMBIBOBLBONFOHVSBOHJLFMFCJIBOLFBEBBO HMJTJO QBEB NFEVMB TQJOBMJT 0MFI LBSFOB JUV QFOHBSVI
FLTJUBCJMJUBT JOJ VOUVL TFNFOUBSB XBLUV $POUPIOZB TFMBNB USBOTNJUFS FLTJUBTJ NFOKBEJ CFSMFCJIBO EBO OFVSPO NFOKBEJ
LFKBOH QBEB FQJMFQTJ LFBEBBO LFMFMBIBO TBOHBU QFOUJOH LBSFOB TBOHBUUFSBOHTBOHTFIJOHHBEFOHBODFQBUNFODFUVTLBOQPUFOTJBM
LFMFCJIBOFLTJUBCJMJUBTPUBLBLIJSOZBBLBOCFSLVSBOHEBOEFOHBO BLTJ TFDBSB CFSVOUVO EBO BLIJSOZB UJNCVM TQBTNF UPOJL PUPU
EFNJLJBO LFKBOH QBEB FQJMFQTJ BLBO CFSIFOUJ +BEJ UJNCVMOZB ZBOHCFSBU
LFMFMBIBO JOJ BEBMBI TFCBHBJ TVBUV NFLBOJTNF QFSUBIBOBO
4FCBHJBO CFTBS BOFTUFUJL BLBO NFOJOHLBULBO OJMBJ BNCBOH
UFSIBEBQ BLUJWJUBT OFVSPO ZBOH CFSMFCJIBO .BTBMBI JOJ BLBO
NFNCSBO TBSBG VOUVL FLTJUBTJ EBO EFOHBO EFNJLJBO
EJCJDBSBLBO MFCJI MBOKVU QBEB EFTLSJQTJ UFOUBOH TJSLVJU OFVSPO
NFOVSVOLBO QFOHJSJNBO TJOBQUJL QBEB CBOZBL EBFSBI TJTUFN
ZBOHCFSHBVOH SFWFSCFSBUJOHOFVSPOBMDJSDVJUT
QBEB#BC
TBSBG 0MFI LBSFOB CBOZBL [BU BOFTUFUJL ZBOH CFSTJGBU MBSVU
.FLBOJTNF LFMFMBIBO JOJ UFSVUBNB EJTFCBCLBO PMFI UFNQBU MFNBL CFCFSBQBEBSJCBIBOJOJEJBOHHBQEBQBUNFOHVCBITJGBU
QFOZJNQBOBOQBEBUFSNJOBMTJOBQUJLZBOHLFIBCJTBOTFMVSVIBUBV TJGBUGJTJLNFNCSBOOFVSPO TFIJOHHBNFNCSBONFOKBEJLVSBOH
TFCBHJBO [BU USBOTNJUFSOZB 5FSNJOBM FLTJUBUPSJL QBEB CBOZBL QFLBUFSIBEBQCBIBOFLTJUBTJ
OFVSPO EBQBU NFOZJNQBO DVLVQ CBOZBL USBOTNJUFS FLTJUBUPSJL
Perlambatan Sinaptik. 1BEBQFOHJSJNBOTVBUVTJOZBMTBSBG
VOUVLNFOZFCBCLBOTFLJUBSQPUFOTJBMBLTJ EBOUSBOTNJUFS
EBSJ OFVSPO QSBTJOBQUJL NFOVKV OFVSPO QBTDBTJOBQUJL
EBQBU IBCJT UFSQBLBJ IBOZB EBMBN XBLUV CFCFSBQB EFUJL TBNQBJ
EJCVUVILBO XBLUV UFSUFOUV VOUVL NFMBLVLBO QSPTFT

CFCFSBQBNFOJUTFUFMBIQFSBOHTBOHBOZBOHDFQBU4FCBHJBOQSPTFT
QFMFQBTBO[BUUSBOTNJUFSPMFIQSBTJOBQUJL
EJGVTJUSBOTNJUFS
LFMFMBIBO NVOHLJO KVHB EJTFCBCLBO PMFI EVB GBLUPS CFSJLVU JOJ
NFOVKV NFNCSBO OFVSPO
LFSKB USBOTNJUFS QBEB SFTFQUPS

JOBLUJWBTJ ZBOH NFOJOHLBU QBEB CBOZBL SFTFQUPS NFNCSBO
NFNCSBO
LFSKBSFTFQUPSVOUVLNFOJOHLBULBOQFSNFBCJMJUBT
QBTDBTJOBQUJL EBO
QFNCFOUVLBO LPOTFOUSBTJ BCOPSNBM JPO
NFNCSBO EBO EBO
EJGVTJ OBUSJVN LF EBMBN HVOB
JPOZBOHMBNCBUEBMBNTFMOFVSPOQBTDBTJOBQUJL
NFOJOHLBULBO QPUFOTJBM QBTDBTJOBQUJL FLTJUBUPSJL TBNQBJ
Pengaruh Asidosis atau Alkalosis pada Pengiriman UJOHLBU ZBOH DVLVQ UJOHHJ VOUVL NFODFUVTLBO TVBUV QPUFOTJBM
Sinaptik. 4FCBHJBO CFTBS OFVSPO TBOHBU QFLB UFSIBEBQ BLTJ +BOHLB XBLUV NJOJNBM ZBOH EJCVUVILBO VOUVL UFSKBEJOZB
QFSVCBIBOQ)EBMBNDBJSBOJOUFSTUJTJBMEJTFLFMJMJOHOZB"MLBMPTJT QSPTFTQSPTFT UFSTFCVU CBILBO CJMB TFCBHJBO CFTBS TJOBQT
OPSNBMOZBTBOHBUNFOJOHLBULBOFLTJUBCJMJUBTOFVSPO$POUPIOZB FLTJUBUPSJL EJSBOHTBOH TFDBSB CFSTBNBBO BEBMBI TFLJUBS
LFOBJLBOQ)EBSBIBSUFSJEBSJOJMBJOPSNBMOZBZBLOJ NFOKBEJ NJMJEFUJL,FBEBBOJOJEJTFCVUQFSMBNCBUBOTJOBQT1BSBBIMJOF
557
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tic mechanism for LTP, Nat Rev Neurosci 9:813, 2008.
UFSKBEJ BOUBSB NBTVLBO JNQVMT CFSVOUVO LF TFLVNQVMBO
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OFVSPO EFOHBO LFMVBSBO JNQVMT ZBOH CFSVOUVO %BSJ naling, Nat Neurosci 12:15, 2009.
QFOHVLVSBO QFSMBNCBUBO XBLUV UFSTFCVU NBLB LFNVEJBO Lisman JE, Raghavachari S, Tsien RW: The sequence of events that under-
EBQBU EJQFSLJSBLBO KVNMBI SBOHLBJBO OFVSPO ZBOH BEB EBMBN lie quantal transmission at central glutamatergic synapses, Nat Rev
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558
BAB 46
UNIT IX
3FTFQUPS3FTFQUPS4FOTPSJL 3BOHLBJBO
4BSBGVOUVL1FOHPMBIBO*OGPSNBTJ
.BTVLBO LF TJTUFN TBSBG EJ EBLNFNCFSJSFTQPOTUFSIBEBQSBOHTBOHBOTFOTPSJLKFOJTMBJO

NVOHLJOLBO PMFI SFTFQUPS TFO +BEJ TFMTFM CBUBOH EBO LFSVDVU NBUB TBOHBU QFLB UFSIBEBQ
TPSJL ZBOH NFOHFOBMJ CFSNB SBOHTBOH DBIBZB OBNVO IBNQJS UJEBL NFNCFSJ SFTQPOT
DBNNBDBN SBOHTBOHBO TFOTP UFSIBEBQ SBOHTBOHBO QBOBT EJOHJO UFLBOBO QBEB CPMB NBUB
SJLT TFQFSUJ TFOUVIBO CVOZJ BUBV QFSVCBIBO LJNJBXJ EBMBN EBSBI 0TNPSFTFQUPS ZBOH
DBIBZB OZFSJ EJOHJO EBO UFSEBQBU EBMBN OVLMFJ TVQSBPQUJL IJQPUBMBNVT EBQBU
IBOHBU5VKVBOCBCJOJBEBMBI NFOEFUFLTJ QFSVCBIBO PTNPMBMJUBT DBJSBO UVCVI ZBOH TBOHBU
NFNCBIBT NFLBOJTNF EBTBS ZBOH EJQBLBJ PMFI SFTFQUPS VOUVL LFDJM OBNVO CFMVN QFSOBI EJLFUBIVJ NFNCFSJ SFTQPOT
NFOHVCBISBOHTBOHBOTFOTPSJLNFOKBEJTJOZBMTBSBGZBOHLFNV UFSIBEBQSBOHTBOHBOCVOZJ"LIJSOZB SFTFQUPSSBTBOZFSJZBOH
EJBOBLBOEJTBNQBJLBOLFEBOEJQSPTFTEBMBNTJTUFNTBSBGQVTBU UFSEBQBUEJLVMJUIBNQJSUJEBLQFSOBIUFSBOHTBOHPMFISBOHTBOH
TFOUVIBOBUBVUFLBOZBOHOPSNBM OBNVOBLBOTBOHBUBLUJGTBBU
SBOHTBOHUBLUJMNFOKBEJDVLVQCFSBUVOUVLNFSVTBLKBSJOHBO
Jenis Reseptor Sensorik dan Rangsangan
Sensorik yang Dapat Dideteksi
Modalitas Sensasi—Prinsip "Labeled Line"
1BEB5BCFMUFSEBQBUEBGUBSEBOLMBTJGJLBTJMJNBKFOJTSFTFQUPS 4FUJBQ KFOJT TFOTBTJ VUBNB ZBOH EBQBU LJUB BMBNJ OZFSJ SBCB
TFOTPSJL EBTBS
NFLBOPSFTFQUPS ZBOH NFOEFUFLTJ UFLBOBO MJIBU CVOZJ EBO TFCBHBJOZB EJTFCVU TFCBHBJ NPEBMJUBT TFOTBTJ
NFLBOJT BUBV QFSFHBOHBO QBEB SFTFQUPS BUBV KBSJOHBO ZBOH 8BMBVQVO LJUB NFOHBMBNJ NPEBMJUBT TFOTBTJ ZBOH CFSCFEB
UFSMFUBL CFSEFLBUBO EFOHBO SFTFQUPS
UFSNPSFTFQUPS ZBOH CFEB UFSOZBUB TFSBU TBSBG IBOZB NFOHIBOUBSLBO JNQVMT 0MFI
NFOEFUFLTJQFSVCBIBOTVIV CFCFSBQBSFTFQUPSNFOEFUFLTJTVIV LBSFOB JUV CBHBJNBOB TFSBU TBSBG ZBOH CFSCFEBCFEB JOJ
EJOHJO EBO MBJOOZB TVIV QBOBT
OPTJTFQUPS SFTFQUPS OZFSJ
NFOZBMVSLBOCFSNBDBNNBDBNNPEBMJUBTTFOTBTJ
ZBOHNFOEFUFLTJLFSVTBLBOKBSJOHBOZBOHUFSKBEJ BQBLBICFSVQB +BXBCBOOZBBEBMBICBIXBTFUJBQKBSBTTBSBGCFSBLIJSQBEB
LFSVTBLBO GJTJL NBVQVO LFSVTBLBO LJNJBXJ
SFTFQUPS TVBUVUJUJLUFSUFOUVEBMBNTJTUFNTBSBGQVTBU EBOKFOJTTFOTBTJ
FMFLUSPNBHOFUJL ZBOH NFOEFUFLTJ DBIBZB QBEB SFUJOB NBUB EBO ZBOHEJSBTBLBOLFUJLBTFSBUTBSBGUFSBOHTBOHEJUFOUVLBOPMFI

LFNPSFTFQUPS ZBOH NFOEFUFLTJ SBTBQFOHFDBQBO EBMBN UJUJL EBMBN TJTUFN TBSBG JOJ $POUPIOZB CJMBTVBUVTFSBUSBTB
NVMVU CBVCBVBO EBMBN IJEVOH LBEBS PLTJHFO EBMBN EBSBI OZFSJ UFSBOHTBOH PSBOH JUV BLBO NFSBTBLBO OZFSJ UBOQB
BSUFSJ PTNPMBMJUBTDBJSBOUVCVI LPOTFOUSBTJLBSCPOEJPLTJEB EBO NFOHIJSBVLBO KFOJT SBOHTBOHBO UFSTFCVU 3BOHTBOH EBQBU
GBLUPSGBLUPSMBJOOZBZBOHNFOZVTVOLFBEBBOLJNJBXJUVCVI CFSVQB SBOHTBOH MJTUSJL QFNBOBTBO TFSBU TBSBG ZBOH
#BC JOJ BLBO NFNCJDBSBLBO GVOHTJ CFCFSBQB SFTFQUPS CFSMFCJIBO QFSVTBLBO TFSBU TBSBG BUBV QFSBOHTBOHBO VKVOH
LIVTVT UFSVUBNBNFLBOPSFTFQUPSQFSJGFS VOUVLNFOHHBNCBS TBSBG OZFSJ BLJCBU BEBOZB LFSVTBLBO TFMTFM KBSJOHBO 1BEB
LBOCFCFSBQBQSJOTJQLFSKBSFTFQUPS3FTFQUPSSFTFQUPSMBJOOZB TFNVBLFBEBBOUFSTFCVU PSBOHUFSTFCVUBLBONFNFSTFQTJLBO
BLBO EJCJDBSBLBO EBMBN CBC MBJO TFIVCVOHBO EFOHBO TJTUFN OZFSJ %FNJLJBO KVHB CJMB TVBUV TFSBU TBSBG SBCB UFSBOHTBOH
TFOTPSJL EJ NBOB SFTFQUPS UFSTFCVU UFSMFUBL (BNCBS EFOHBOSBOHTBOHMJTUSJLQBEBSFTFQUPSSBCBBUBVEFOHBODBSB
NFOHHBNCBSLBO CFCFSBQB KFOJT NFLBOPSFTFQUPS ZBOH EJKVN MBJOOZB PSBOH JUV BLBO NFNFSTFQTJLBO SBCB LBSFOB TFSBU
QBJEJLVMJUBUBVKBSJOHBOEBMBNQBEBUVCVI SBTB SBCBOZB NFOVKV LF TVBUV EBFSBI SBCB TQFTJGJL ZBOH
UFSMFUBL EBMBN PUBL 4FTVBJ EFOHBO IBM JOJ TFSBUTFSBU ZBOH
CFSBTBM EBO SFUJOB NBUB BLBO CFSBLIJS QBEB EBFSBI
Perbedaan Kepekaan Reseptor
QFOHMJIBUBO EBMBN PUBL TFSBU ZBOH CFSBTBM EBO UFMJOHB BLBO
#BHBJNBOB EVB KFOJT SFTFQUPS TFOTPSJL NFOEFUFLTJ SBOHTBOHBO CFSBLIJS EJ EBFSBI QFOEFOHBSBO EBMBN PUBL EBOTFSBUTFSBU
TFOTPSJL ZBOH CFSCFEB +BXBCBOOZB BEBMBI EFOHBO QFSCFEBBO VOUVLTVIVBLBOCFSBLIJSQBEBEBFSBITVIV
LFQFLBBO +BEJ TFUJBQ KFOJT SFTFQUPS TBOHBU QFLB UFSIBEBQ TBMBI 4QFTJGJTJUBT TFSBU TBSBG ZBOH IBOZB NFOHJSJNLBO
TBUVKFOJTSBOHTBOHBOZBOHEJSBODBOHVOUVLOZB EBOIBNQJSUJ TBUVNPEBMJUBTTFOTBTJEJTFCVUQSJOTJQMBCFMFEMJOF
559
Unit IX Sistem Saraf:A. Prinsip-Prinsip Umum dan Fisiologi Sensorik
Tabel 46-1 Klasifikasi Reseptor Sensorik
I. Mekanoreseptor
Kepekaan taktit kulit (epidermis dan dermis)
Ujung saraf bebas
Ujung akhir yang metuas
Diskus merkel
Ditambah dengan beberapa variasi lainnya
Ujung menyebar (spray ending)
Ujung Ruffini
Ujung berkapsul (Encapsulated endings)
Badan Meissner
Badan Krause
Organ ujung rambut (hair end-organs)
Kepekaan jaringan dalam
Ujung saraf bebas
Ujung akhir yang meluas
Ujung menyebar
Ujung ruffini
Ujung berkapsul
Badan Pacini
Ditambah dengan beberapa variasi lainnya
Ujung otot
Getendong otot
Reseptor tendon Golgi
Pendengaran
Reseptor suara pada koktea
Keseimbangan (ekuilibrium)
Reseptor vestibular
Tekanan arteri
Baroreseptor pada sinus karotikus dan aorta
II. Termoreseptor
Dingin Transduksi Rangsangan Sensorik
Reseptor menjadi Impuls Saraf
dingin Hangat
Reseptor hangat Aliran Listrik Lokal pada Ujung
III Nosiseptor Saraf—Potensial Reseptor
Rasa sakit Ujung
saraf bebas 4FNVB SFTFQUPS TFOTPSJL NFNQVOZBJ TBUV DJSJ ZBOH TBNB "QB
IV. Reseptor elektromagnetik QVO KFOJT TUJNVMVT ZBOH NFSBOHTBOH SFTFQUPS QFOHBSVI ZBOH
Pengiihatan TFHFSB UFSKBEJ BEBMBI QFSVCBIBO QPUFOTJBM MJTUSJL NFNCSBO
Sel-sel batang SFTFQUPS1FSVCBIBOQPUFOTJBMJOJEJTFCVUQPUFOTJBMSFTFQUPS
Sel-sel kerucut
V. Kemoreseptor
Pengecap
Mekanisme Potensial Reseptor. 6OUVL NFOJNCVMLBO
Reseptor-reseptor pada kuncup kecap (taste buds) QPUFOTJBM SFTFQUPS CFSNBDBN SFTFQUPS EBQBU EJSBOHTBOH EFOHBO
Penghidu TBMBITBUVDBSBCFSJLVUJOJ
EFOHBOQFSVCBIBOSFTFQUPSTFDBSB
Reseptor pada epitel olfaktorius NFLBOJT ZBOH BLBO NFSFHBOHLBO SFTFQUPS NFNCSBO EBO NFN
Oksigen dalam arteri CVLB LBOBMLBOBM JPO
EFOHBO QFNCFSJBO TVBUV CBIBO LJNJB
Reseptor pada aorta dan badan karotis QBEBNFNCSBO TFIJOHHBCBIBOJOJOBOUJOZBKVHBBLBONFNCVLB
Osmotalitas LBOBMLBOBM JPO
EFOHBO NFOHVCBI TVIV NFNCSBO ZBOH
Neuron-neuron di dalam atau di dekat nuklei supraoptikus BLBONFOHVCBIQFSNFBCJMJUBTNFNCSBOBUBV
EFOHBOFGFLSB
CO2 dalam darah EJBTJFMFLUSPNBHOFUJL TFQFSUJDBIBZBZBOHEJCFSJLBOQBEBSFTFQ
Reseptor-reseptor di dalam atau pada UPS WJTVBM SFUJOB ZBOH TFDBSB MBOHTVOH BUBV UJEBL MBOHTVOH NF
permukaan medula dan di dalam aorta dan badan karotis OHVCBI TJGBUTJGBU SFTFQUPS NFNCSBO EBO NFNVOHLJOLBO MF
Glukosa darah, asam amino, asam lemak
XBUOZBJPOJPONFMBMVJLBOBMNFNCSBO
Reseptor-reseptor di dalam hipotalamus
,FFNQBU DBSB QFSBOHTBOHBO QBEB SFTFQUPS UFSTFCVU QBEB
VNVNOZBTFTVBJEFOHBOCFSCBHBJKFOJTSFTFQUPSTFOTPSJLZBOHUF
MBI EJLFUBIVJ 1BEB TFNVB LFBEBBO QFOZFCBC VUBNB QFSVCBIBO
QPUFOTJBMNFNCSBOBEBMBIBEBOZBQFSVCBIBOQBEBQFSNFBCJMJUBT
NFNCSBO SFTFQUPS ZBOH BLBO NFNVOHLJOLBO JPOJPO CFSEJGVTJ
EBMBNKVNMBIZBOHMFCJICBOZBLBUBVMFCJITFEJLJUNFMFXBUJNFN
560
Bab 46 Reseptor-Reseptor Sensorik, Rangkaian Saraf untuk Pengolahan Informasi
CSBO EBO EFOHBO EFNJLJBO BLBO NFOHVCBI QPUFOTJBM

USBOTNFNCSBO
Amplitudo Maksimum Potensial Reseptor. "NQMJUVEP + + + ++ - - - - + + + + ++ + + + + + + + + + + + + + +
UNIT IX
NBLTJNVN QBEB TFCBHJBO CFTBS QPUFOTJBM SFTFQUPS TFOTPSJL +
+ + + + +
BEBMBI TFLJUBS NJMJWPMU OBNVO OJMBJ JOJ IBOZB UFSKBEJ QBEB + + + +
+
+ + + ++ - - - - + + + + ++ + + + + + + + + + + + + + +
JOUFOTJUBT SBOHTBOH TFOTPSJL ZBOH TBOHBU UJOHHJ 1FOJOHLBUBO JOJ
LVSBOHMFCJITBNBEFOHBOWPMUBTFNBLTJNVNZBOHUFSDBUBUQBEB
QPUFOTJBM BLTJ EBO KVHB QFSVCBIBO WPMUBTF LFUJLB NFNCSBO
NFOKBEJQFSNFBCFMTFDBSBNBLTJNBMUFSIBEBQJPOOBUSJVN
Hubungan Potensial Reseptor dengan Potensial Aksi.

#JMB QPUFOTJBM SFTFQUPS NFOJOHLBU TBNQBJ EJ BUBT OJMBJ BNCBOH
VOUVLNFOJNCVMLBOQPUFOTJBMBLTJQBEBTFSBUTBSBGZBOHNFMFLBU
QBEB SFTFQUPS QPUFOTJBM BLTJ BLBO UJNCVM TFQFSUJ ZBOH
EJQFSMJIBULBOQBEB(BNCBS1FSIBUJLBOKVHBCBIXBTFNBLJO QPTJUJG EBMBN TFSBU ZBOH NFSVQBLBO QPUFOTJBM SFTFQUPS
CFTBS QFOJOHLBUBO QPUFOTJBM SFTFQUPS EJ BUBT OJMBJ BNCBOHOZB 1PUFOTJBM SFTFQUPS LFNVEJBO BLBO NFOZFCBCLBO UJNCVMOZB
TFNBLJOCFTBSGSFLVFOTJQPUFOTJBMBLTJ TJSLVJU BMJSBO MJTUSJL MPLBM ZBOH NFOKBMBS EJ TFQBOKBOH TFSBU
TBSBG TFQFSUJ ZBOH EJUVOKVLLBO PMFI UBOEB QBOBI 1BEB OPEVT
Potensial Reseptor Badan Pacini—Contoh Fungsi 3BOWJFS ZBOH QFSUBNB ZBOH UFSMFUBL EJ CBHJBO EBMBN LBQTVM
Reseptor CBEBO QBDJOJ BMJSBO MJTUSJL MPLBM BLBO NFOEFQPMBSJTBTJ NFN
1BEBCBHJBOJOJNBIBTJTXBTFCBJLOZBNFNQFMBKBSJLFNCBMJTUSVL CSBO TFSBU QBEB OPEVT UFSTFCVU ZBOH LFNVEJBO NFNCFOUVL
UVS BOBUPNJ EBO CBEBO QBDJOJ TFQFSUJ ZBOH EJQFSMJIBULBO QBEB QPUFOTJBMBLTJVNVNZBOHEJLJSJNLBOEJTFQBOKBOHTFSBUTBSBG
(BNCBS 1FSIBUJLBOMBI CBIXB CBEBO QBDJOJ NFNQVOZBJ NFOVKVLFTJTUFNTBSBGQVTBU
QVTBUTFSBUTBSBGZBOHNFOKVMVSLFCBHJBOJOUJOZB4FSBUJOJEJLF
MJMJOHJPMFICBOZBLMBQJTBOLPOTFOUSJT TFIJOHHBUFLBOBOZBOHEJ Hubungan antara Kekuatan Rangsangan dan Potensial
CFSJLBOQBEBTFUJBQUFNQBUEJCBHJBOMVBSCBEBOJOJBLBONFNBO Reseptor. (BNCBS NFOHHBNCBSLBO QFSVCBIBO QBEB
KBOH NFMFLVL BUBV EFOHBO DBSB MBJO NFOHVCBI CFOUVL TFSBU BNQMJUVEP QPUFOTJBM SFTFQUPS ZBOH EJTFCBCLBO PMFI UFLBOBO
TFOUSBM NFLBOJLZBOHMFCJILVBU NFOJOHLBULBOLFLVBUBOSBOHTBOH

4FLBSBOH QFSIBUJLBO (BNCBS ZBOH IBOZB NFNQFSMJIBU ZBOH EJCFSJLBO TFDBSB QSPHSFTJG QBEB QFSDPCBBO QBEB CBHJBO
LBOTFSBUTFOUSBMCBEBOQBDJOJTFUFMBITFNVBLFDVBMJTBUVMBQJTBO QVTBUJOUJCBEBOQBDJOJ1FSIBUJLBOCBIXBBNQMJUVEPJOJNVMB
LBQTVMUFMBIEJIJMBOHLBO#BHJBOQBMJOHVKVOHTFSBUTFOUSBMCBHJBO NVMB NFOJOHLBU EFOHBO DFQBU OBNVO EFOHBO CFSUBNCBIOZB
EJ EBMBN LBQTVM UJEBL CFSNJFMJO UFUBQJ TFSBU BLBO TFHFSB LFLVBUBO SBOHTBOH QFOJOHLBUBO BNQMJUVEPOZB CFSLVSBOH
UFSTFMVCVOH NJFMJO TFMVCVOH BCVBCV HFMBQ ZBOH UFSMJIBU QBEB TFDBSBQSPHSFTJG
HBNCBS
TFCFMVN NFOJOHHBMLBO CBEBO QBDJOJ VOUVL NFNBTVLJ
4FMBOKVUOZB GSFLVFOTJQPUFOTJBMBLTJCFSVMBOHZBOHEJIBOUBS
TBSBGTFOTPSJLQFSJGFS
LBOEBSJSFTFQUPSTFOTPSJLNFOJOHLBULVSBOHMFCJITFCBOEJOH
(BNCBSUFSTFCVUKVHBNFNQFSMJIBULBONFLBOJTNFQFNCFOUV
100
LBOQPUFOTJBMSFTFQUPSEJCBEBOQBDJOJ"NBUJEBFSBILFDJMVKVOH
TFSBUZBOHCFSVCBICFOUVLOZBPMFIQFOFLBOBOQBEBCBEBOQBDJ 90
OJ EBOQFSIBUJLBOCBIXBLBOBMJPOUFMBIUFSCVLBQBEBNFNCSBO
80
NFNVOHLJOLBOJPOOBUSJVNZBOHCFSNVBUBOQPTJUJGVOUVLCFSEJ
GVTJLFCBHJBOEBMBN,FBEBBOJOJBLBONFNQFSCFTBSLFBEBBO 70
60
+30 50
0 40
30
-30
20
-60 10
0
-90 0 20 40 60 80 100
0 10 20 30 40 60 80 100 120 140

46-4
561
EFOHBO QFOJOHLBUBO QPUFOTJBM SFTFQUPS %FOHBO NFOHBQMJLBTJ Mekanisme yang Digunakan untuk Adaptasi Reseptor.
LBO QSJOTJQ JOJ CFSTBNB EBUB QBEB (BNCBS LJUB EBQBU .FLBOJTNFBEBQUBTJSFTFQUPSCFSCFEBVOUVLTFUJBQKFOJTSFTFQUPS
NFMJIBU CBIXB SBOHTBOHBO ZBOH TBOHBU LVBU EBSJ SFTFQUPS TFQFSUJ IBMOZB UFSKBEJOZB QPUFOTJBM SFTFQUPS $POUPIOZB QBEB
NFOZFCBCLBO TFNBLJO CFSLVSBOHOZB QFOJOHLBUBO UBNCBIBO NBUB TFMTFM CBUBOH EBO LFSVDVU CFSBEBQUBTJ NFMBMVJ QFSVCBIBO
KVNMBI QPUFOTJBM BLTJ TFDBSB QSPHSFTJG *OJ BEBMBI QSJOTJQ ZBOH LPOTFOUSBTJ CBIBO LJNJB ZBOH TFOTJUJG DBIBZB BLBO EJCJDBSBLBO
TBOHBU QFOUJOH ZBOH EBQBU EJUFSBQLBO QBEB IBNQJS TFNVB QBEB#BC

SFTFQUPS TFOTPSJL *OJ NFOZFCBCLBO SFTFQUPS NFOKBEJ TFOTJUJG 1BEB NFLBOPSFTFQUPS SFTFQUPS ZBOH UFMBI EJQFMBKBSJ EFOHBO
UFSIBEBQQFOHBMBNBOTFOTPSJLZBOHTBOHBUMFNBI OBNVOUJEBL TBOHBUEFUBJMBEBMBICBEBOQBDJOJ1SPTFTBEBQUBTJOZBCFSMBOHTVOH
NFODBQBJUJOHLBUQFODFUVTBOQPUFOTJBMBLTJNBLTJNVNTBNQBJ EBMBN EVB DBSB 1FSUBNB CBEBO QBDJOJ NFSVQBLBO TUSVLUVS
QFOHBMBNBO TFOTPSJL NFODBQBJ UJOHLBU FLTUSFN )BM JOJ KVHB WJTLPFMBTUJL TFIJOHHB CJMB QBEB TBMBI TBUV TJTJ CBEBO EFOHBO
NFNCVBU SFTFQUPS NFNJMJLJ CFSCBHBJ SFOUBOH SFTQPOT ZBOH NFOEBEBL EJCFSJLBO HBZB ZBOH NFOHVCBI CFOUVLOZB HBZB JOJ
FLTUSFN EBSJTBOHBUMFNBITBNQBJTBOHBULVBU MBOHTVOH EJLJSJNLBO PMFI LPNQPOFO WJTLVT CBEBO QBDJOJ LF
Adaptasi Reseptor CBHJBO QVTBU TFSBU TBSBG QBEB TJTJ ZBOH TBNB TFIJOHHB
4JGBUMBJOEBSJTFNVBSFTFQUPSTFOTPSJLBEBMBILFNBNQVBOOZB NFOJNCVMLBO TVBUV QPUFOTJBM SFTFQUPS /BNVO EBMBN XBLUV
CFSBEBQUBTJ EFOHBO CBJL UFSIBEBQ TFUJBQ SBOHTBOHBO LPOTUBO TFQFSTFSBUVT EFUJL DBJSBO ZBOH BEB EJ EBMBN CBEBO QBDJOJ BLBO
TFDBSB TFCBHJBO BUBV LFTFMVSVIBO TFTVEBI QFSJPEF XBLUV UFS EJEJTUSJCVTJLBOLFNCBMJ TFIJOHHBQPUFOTJBMSFTFQUPSUJEBLUJNCVM
UFOUV +BEJ CJMB TFCVBI SBOHTBOHBO TFOTPSJL EJCFSJLBO UFSVT +BEJ QPUFOTJBM SFTFQUPS BLBO UJNCVM QBEB XBLUV QFSNVMBBO
NFOFSVT SFTFQUPS NVMBNVMB BLBO CFSFTQPOT EFOHBO LFDFQB QFNCFSJBO HBZB UBQJ BLBO NFOHIJMBOH EBMBN XBLUV TFQFSTFLJBO
UBO QFODFUVTBO JNQVMT ZBOH UJOHHJ LFNVEJBO TFDBSB QSPHSFTJG EFUJLXBMBVQVOUFLBOBOUBEJUFUBQEJCFSJLBO
BLBOCFSLVSBOHTBNQBJBLIJSOZBLFDFQBUBOQFODFUVTBOQPUFO .FLBOJTNF BEBQUBTJ LFEVB EBSJ CBEBO QBDJOJ UBQJ KBVI MFCJI
TJBMBLTJNFOVSVONFOKBEJTBOHBUTFEJLJUBUBVTFSJOHLBMJUJEBL MBNCBU EJIBTJMLBOPMFITVBUVQSPTFTZBOHEJTFCVUBLPNPEBTJ ZBOH
BEBTBNBTFLBMJ UFSKBEJ QBEB TFSBU TBSBG TFOEJSJ +BEJ CJMB CBHJBO QVTBU JOUJ UFSVT
(BNCBSNFOHHBNCBSLBOBEBQUBTJVNVNEBSJCFCFSBQB NFOFSVT EJHBOHHV CBHJBO VKVOH TFSBU TBSBG JUV TFOEJSJ TFDBSB
KFOJT SFTFQUPS 1FSIBUJLBO CBIXB CBEBO QBDJOJ TBOHBU DFQBU CFSUBIBQ BLBO CFSBLPNPEBTJ UFSIBEBQ SBOHTBOHBO ,FBEBBO JOJ
CFSBEBQUBTJ SFTFQUPSSFTFQUPSSBNCVUCFSBEBQUBTJEBMBNXBLUV NVOHLJO UJNCVM BLJCBU LFBEBBO JOBLUJWBTJ QSPHSFTJG LBOBM
TBUV EFUJL BUBV MFCJI TFSUB SFTFQUPS QBEB LBQTVM TFOEJ EBO OBUSJVN ZBOH UFSEBQBU QBEB NFNCSBO TFSBU TBSBG ZBOH CFSBSUJ
LVNQBSBOPUPUCFSBEBQUBTJEFOHBOMBNCBU CBIXB BMJSBO OBUSJVN NFMFXBUJ LBOBM BLBO NFOZFCBCLBO
,FNVEJBO CFCFSBQBSFTFQUPSTFOTPSJLCFSBEBQUBTJKBVIMFCJI QFOVUVQBOLBOBMTFDBSBCFSUBIBQ TVBUVQFOHBSVIZBOHTFQFSUJOZB
DFQBU EBSJQBEB ZBOH MBJO 4FCBHBJ DPOUPI CBEBO QBDJOJ CFSB UFSKBEJQBEBTFNVBBUBVIBNQJSTFNVBLBOBMOBUSJVNNFNCSBOTFM
EBQUBTJ TBNQBJ QBEBN EBMBN XBLUV TFQFSTFSBUVT EFUJL EBO TFQFSUJZBOHUFMBIEJKFMBTLBOQBEB#BC
SFTFQUPS QBEB QBOHLBM SBNCVU EBQBU CFSBEBQUBTJ EBMBN XBLUV
%JEVHB LFEVB DBSB NFLBOJTNF BEBQUBTJ ZBOH TBNB JOJ EBQBU
TBUVEFUJLBUBVMFCJITFCFMVNQBEBN.VOHLJOQBEBBLIJSOZB
KVHB EJUFSBQLBO QBEB NFLBOPSFTFQUPS KFOJT MBJO +BEJ TFCBHJBO
TFNVB NFLBOPSFTFQUPS MBJO CFSBEBQUBTJ TBNQBJ IBNQJS TFQF
QSPTFT BEBQUBTJ EBQBU UJNCVM BLJCBU QFOHBUVSBO LFNCBMJ TUSVLUVS
OVIOZB OBNVO CFCFSBQB EJ BOUBSBOZB NFNCVUVILBO XBLUV
SFTFQUPSJUVTFOEJSJ EBOTFCBHJBOEBSJBLPNPEBTJKFOJTMJTUSJLZBOH
CFCFSBQB KBN BUBV CFCFSBQB IBSJ TFIJOHHB NFLBOPSFTFQUPS
UJNCVMEJCBHJBOVKVOHTFSBUTBSBG
EJTFCVUTFCBHBJSFTFQUPSZBOHUJEBLEBQBUCFSBEBQUBTJ8BLUV
UFSMBNBZBOHEJCVUVILBOVOUVLBEBQUBTJNFLBOPSFTFQUPSTBN
QBJIBNQJSTFQFOVIOZBBEBMBITFLJUBSIBSJ ZBOHNFSVQBLBO Reseptor Beradaptasi Lambat Mendeteksi Kekuatan
XBLUVBEBQUBTJUPUBMCBHJCBOZBLCBSPSFTFQUPSBPSUBEBOLBSP Rangsangan yang Terus-Menerus—Reseptor "Tonik".
UJT 4FCBMJLOZB CFCFSBQB OPO NFLBOPSFTFQUPSLFNPSFTFQUPS 3FTFQUPS CFSBEBQUBTJ MBNCBU UFSVTNFOFSVT NFOHJSJNLBO
EBOSFTFQUPSOZFSJ TFCBHBJDPOUPINVOHLJOUJEBLQFSOBICFSB JNQVMTLFPUBLTFMBNBSBOHTBOHBOUFUBQBEB BUBVQBMJOHTFEJLJU
EBQUBTJTFQFOVIOZB TFMBNB CFCFSBQB NFOJU BUBV CFCFSBQB KBN
0MFI LBSFOB JUV
250 KFOJT SFTFQUPS JOJ TFDBSB LPOTUBO NFOHJSJNLBO JOGPSNBTJ
NFOHFOBJLFBEBBOUVCVIEBOIVCVOHBOOZBEFOHBOMJOHLVOHBO
200 TFLJUBS $POUPI JNQVMT ZBOH CFSBTBM EBO LVNQBSBO PUPU EBO
BQBSBUVTUFOEPO(PMHJNFNVOHLJOLBOTJTUFNTBSBGNFOHFUBIVJ
150 LFBEBBOLPOUSBLTJPUPUEBOCFCBOQBEBUFOEPOPUPUQBEBTFUJBQ
TBBU
100 3FTFQUPS CFSBEBQUBTJ MBNCBU ZBOH MBJO NFMJQVUJ
SFTFQUPS
SFTFQUPSNBLVMBQBEBBQBSBUVTWFTUJCVMBS
SFTFQUPSOZFSJ

50 CBSPSFTFQUPS QBEB DBCBOHDBCBOH BSUFSJ EBO
LFNPSFTFQUPS
QBEBCBEBOLBSPUJTEBOBPSUB
0
0 1 2 3 4 5 6 7 8 0MFI LBSFOB EBQBU UFSVTNFOFSVT NFOHJSJNLBO JOGPSNBTJ
TFMBNB CFCFSBQB KBN SFTFQUPS CFSBEBQUBTJ MBNCBU JOJ EJTFCVU
SFTFQUPSUPOJL
Gambar 46-5
562
Reseptor Beradaptasi Cepat Mendeteksi Perubahan

Kekuatan Rangsangan—"Reseptor Kecepatan",
"Reseptor Gerakan, atau "Reseptor Fasik". 3FTFQUPS 0.5
20 15 10 5 1 2.0
SFTFQUPS ZBOH CFSBEBQUBTJ EFOHBO DFQBU UJEBL EBQBU EJHVOBLBO
UNIT IX
VOUVL NFOHJSJNLBO TJOZBM ZBOH UFSVTNFOFSVT TFCBC SFTFQUPS
SFTFQUPS JOJ IBOZB UFSBOHTBOH CJMB LFLVBUBO SBOHTBOHBO JUV 120 80 60 30 6 2.0 0.5
CFSVCBI/BNVOSFTFQUPSJOJBLBOCFSFBLTJEFOHBOLVBUTFXBLUV
UFSKBEJ QFSVCBIBO 0MFI LBSFOB JUV SFTFQUPS KFOJT JOJ EJTFCVU A C
SFTFQUPS LFDFQBUBO SFTFQUPS HFSBLBO BUBV SFTFQUPS GBTJL +BEJ a
TFQFSUJQBEBCBEBOQBDJOJ UFLBOBOZBOHEJCFSJLBOTFDBSBNFOEB b
g
EBLQBEBKBSJOHBOBLBONFSBOHTBOHSFTFQUPSSFTFQUPSJOJTFMBNB
d
CFCFSBQBNJMJEFUJL EBOTFMBOKVUOZBQFSBOHTBOHBOBLBOCFSIFOUJ
XBMBVQVO UFLBOBOOZB NBTJI UFSVT EJCFSJLBO 5FUBQJ LFNVEJBO
SFTFQUPS JOJ BLBO NFOHJSJNLBO TJOZBM MBHJ CJMB UFLBOBOOZB EJIJ I II III IV
IA
MBOHLBO %FOHBO LBUB MBJO CBEBO QBDJOJ TBOHBU QFOUJOH EBMBN IB
QSPTFTQFNCFSJUBIVBOLFQBEBTJTUFNTBSBGNFOHFOBJQFSVCBIBO
CFOUVLKBSJOHBOZBOHDFQBU UFUBQJUJEBLCFSHVOBVOUVLNFOZBN
QBJLBOJOGPSNBTJNFOHFOBJLFBEBBOZBOHLPOTUBOQBEBUVCVI
Makna Penting Reseptor Kecepatan—Fungsi Meramalkan.

#JMB LJUB NFOHFUBIVJ LFDFQBUBO QFSVCBIBO LFBEBBO UVCVI LJUB
EBQBU NFSBNBMLBO LFBEBBO UVCVI TFMBNB CFCFSBQB EFUJL BUBV
CBILBOCFCFSBQBNFOJUTFTVEBIOZB$POUPI SFTFQUPSZBOHUFSEB
QBU EBMBN LBOBMJT TFNJTJSLVMBSJT QBEB BQBSBUVT WFTUJCVMBS UFMJOHB
EBQBUEJQBLBJVOUVLNFOEFUFLTJLFDFQBUBOQFSQVUBSBOLFQBMBTBBU
NVMBJ CFSCFMPL TFXBLUV TFTFPSBOH CFSMBSJ NFOHFMJMJOHJ TVBUV
MFOHLVOHBO %FOHBO NFOHHVOBLBO JOGPSNBTJ JOJ TFTFPSBOH EB
QBU NFSBNBMLBO TFCFSBQB KBVI EJB BLBO CFSQJOEBI QBEB EFUJL
CFSJLVUOZB EBO EBQBU NFOHBUVS HFSBLBO LBLJ TFCFMVNOZB BHBS
UJEBLLFIJMBOHBOLFTFJNCBOHBO%FNJLJBOKVHB SFTFQUPSSFTFQUPS ( Aa) ( Ag) ( C)
ZBOHUFSMFUBLEJEBMBNBUBVEFLBUEFOHBOTFOEJNFNCBOUVNFO 20 15 10 5 1 2.0 0.5

EFUFLTJ LFDFQBUBO HFSBLBO CBHJBOCBHJBO UVCVI 4FCBHBJ DPOUPI
CJMB TFTFPSBOH CFSMBSJ JOGPSNBTJ ZBOH CFSBTBM EBSJ SFTFQUPS LFDF
QBUBOTFOEJJOJNFNVOHLJOLBOTJTUFNTBSBGVOUVLNFSBNBMLBOEJ
NBOBMFUBLLBLJTFIBSVTOZBEBMBNXBLUVTFQFSTFLJBOEFUJLCFSJ
LVUOZB 0MFI LBSFOB JUV TJOZBM NPUPSJL ZBOH TFTVBJ EBQBU EJLJ
SJNLBONFOVKVPUPULBLJVOUVLNFMBLVLBOHFSBLBOBOUJTJQBTJVO EBO$ EBOTFSBUKFOJT"TFMBOKVUOZBEJCBHJMBHJNFOKBEJTFSBUϟ Ϡ
UVLNFNQFSCBJLJQPTJTJTFIJOHHBJBUJEBLKBUVI#JMBGVOHTJNFSB ϡ EBOϢ
NBMLBOJOJIJMBOHNBLBPSBOHJUVUJEBLNVOHLJOEBQBUCFSMBSJ 4FSBU KFOJT " NFSVQBLBO TFSBU CFSVLVSBO CFTBS EBO TFEBOH
VNVNZBOHCFSNJFMJOQBEBTBSBGTQJOBM4FSBUKFOJT$NFSVQBLBO
TFSBU TBSBG LFDJM UJEBL CFSNJFMJO ZBOH LFDFQBUBO QFOHJSJNBO JN
Serat Saraf yang Mengirimkan Berbagai QVMTOZBMBNCBU4FSBU$NFNCFOUVLMFCJIEBSJTFQBSVITFSBUTFO
Jenis Sinyal dan Klasifikasi Fisiologisnya TPSJLQBEBTFCBHJBOCFTBSTBSBGQFSJGFS EFNJLJBOKVHBQBEBTFNVB
#FCFSBQB TJOZBM QFSMV EJLJSJNLBO NFOVKV TJTUFN TBSBG QVTBU QPTUHBOHMJPOJLPUPOPN
EFOHBOTBOHBUDFQBUCJMBUJEBL NBLBJOGPSNBTJOZBNFOKBEJUJEBL 6LVSBO LFDFQBUBO QFOHJSJNBO EBO GVOHTJ CFSNBDBN
CFSHVOB $POUPI VOUVL JOJ BEBMBI TJOZBM TFOTPSJL ZBOH NBDBN TFSBU TBSBG KVHB EJKFMBTLBO EBMBN (BNCBS
NFNCFSJUBIVLBO QBEB PUBL NFOHFOBJ QPTJTJ LBLJ QBEB TFUJBQ 1FSIBUJLBO CBIXB CFCFSBQB TFSBU CFSNJFMJO ZBOH CFTBS EBQBU
TFQFSTFLJBO EFUJL TFXBLUV CFSMBSJ 1BEB LFBEBBO TFCBMJLOZB NFOHIBOUBSLBO JNQVMT EFOHBO LFDFQBUBO TBNQBJ TFCFTBS
CFCFSBQB KFOJT JOGPSNBTJ TFOTPSJL TFQFSUJ OZFSJ UVNQVM ZBOH NEFUJL KBEJKBSBLOZBEBMBNEFUJLMFCJIQBOKBOHEBSJMBQBOHBO
CFSEVSBTJ MBNB UJEBL QFSMV EJLJSJNLBO TFDBSB DFQBU TFIJOHHB TFQBL CPMB 4FCBMJLOZB ZBOH UFSLFDJM NFOHIBOUBSLBO JNQVMT
DVLVQ EJLJSJNLBO PMFI TFSBU TBSBG ZBOH NFOHIBOUBSLBO JNQVMT TFMBNCBU NEFUJL TFIJOHHB QFOHJSJNBO JNQVMT EBSJ JCV KBSJ
EFOHBO LFDFQBUBO MBNCBU 4FQFSUJ EJQFSMJIBULBO QBEB (BNCBS LBLJ TBNQBJ NFEVMB TQJOBMJT NFNCVUVILBO XBLUV TFLJUBS
EJBNFUFS TFSBU TBSBG CFSVLVSBO BOUBSB TBNQBJ EFUJL
NJLSPNFUFS TFNBLJO CFTBS EJBNFUFSOZB TFNBLJO UJOHHJ
LFDFQBUBO IBOUBSOZB #BUBT LFDFQBUBO QFOHJSJNBO BEBMBI BOUBSB Klasifikasi Alternatif yang Digunakan oleh Ahli Fisiologi Sensorik.
TBNQBJNEFUJL %FOHBO UFLOJL QFSFLBNBO UFSUFOUV TFSBU KFOJT "B EBQBU EJCBHJ
,MBTJGJLBTJ 6NVN 4FSBU 4BSBG (BNCBS NFNQFSMJIBULBO NFOKBEJ EVB TVCHSVQ OBNVO UFLOJL QFSFLBNBO ZBOH TBNB JOJ
LMBTJGJLBTJ VNVN EBO LMBTJGJLBTJ TBSBG TFOTPSJL CFSCBHBJ KFOJT TVLBS NFNCFEBLBO TFSBU "# EBO "Z 0MFI LBSFOB JUV LMBTJGJLBTJ
TFSBUTBSBG1BEBLMBTJGJLBTJVNVN TFSBUTBSBGEJCBHJNFOKBEJKFOJT" CFSJLVUTFSJOHEJQBLBJPMFIBIMJGJTJPMPHJTFOTPSJL
563
(SVQMB
4FSBU ZBOH CFSBTBM EBSJ VKVOH BOVMPTQJSBM LVNQBSBO PUPU EJBNFUFS
SBUBSBUBTFLJUBSNJLSPOJOJBEBMBITFSBU"KFOJTBEBMBNLMBTJGJLBTJ
VNVN

(SVQMC
4FSBUZBOHCFSBTBMEBSJPSHBOUFOEPO(PMHJ EJBNFUFSSBUBSBUB
TFLJUBSNJLSPNFUFSJOJKVHBNFSVQBLBOTFSBU"KFOJTA

(SVQ**
4FSBU ZBOH CFSBTBM EBSJ SFTFQUPS UBLUJM LIBT EJ LVMJU EBO EBSJ
VKVOHGMPXFS TQSBZ HFMFOEPOH PUPU EJBNFUFS SBUBSBUB TFLJUBS
NJLSPNFUFSJOJBEBMBITFSBU"KFOJT B- EBOKFOJT GEBMBNLMBTJGJLBTJ
VNVN

(SVQ***
4FSBUJOJNFOHJSJNLBOTFOTBTJTVIV TFOUVIBOLBTBS EBOTFOTBTJOZFSJ
UVTVLBO EJBNFUFS SBUBSBUB TFLJUBS NJLSPNFUFS JOJ BEBMBI TFSBU "
KFOJT DEBMBNLMBTJGJLBTJVNVN

(SVQ*7
4FSBU UJEBL CFSNJFMJO ZBOH NFOHJSJNLBO SBTB OZFSJ HBUBM TVIV EBO
TFOTBTJTFOUVIBOLBTBS EJBNFUFSBOUBSB TBNQBJNJLSPNFUFSJOJ
BEBMBITFSBU$EBMBNLMBTJGJLBTJVNVN

Pengiriman Sinyal dengan Intensitas Berbeda

pada Jaras Saraf—Sumasi Spasial dan
Temporal
4BMBI TBUV TJGBU TFUJBQ TJOZBM ZBOH IBSVT TFMBMV EJTBNQBJLBO TBSBGZBOHCFSBTBMEBSJTVBUVEBFSBILVMJU%JCBHJBOLJSJUBNQBL
BEBMBI JOUFOTJUBT TJOZBM TFCBHBJ DPOUPI JOUFOTJUBT SBTB OZFSJ FGFL EBSJ SBOHTBOHBO SJOHBO EFOHBO IBOZB TBUV TFSBU TBSBG ZBOH
(SBEBTJJOUFOTJUBTZBOHCFSCFEBJOJEBQBUEJLJSJNLBOEFOHBO UFSBOHTBOH EFOHBO LVBU EJHBNCBSLBO EFOHBO BCVBCV
EFOHBO
NFOHHVOBLBO MFCJI CBOZBL TFSBU TBSBG QBSBMFM BUBV EFOHBO CFCFSBQBZBOHCFSEFLBUBOZBOHUFSBOHTBOHEFOHBOSJOHBO EJQFS
DBSBNFOHJSJNLBOMFCJICBOZBLQPUFOTJBMBLTJTFQBOKBOHTBUV MJIBULBOEFOHBOTFUFOHBIBCVBCV
,FEVBHBNCBSMBJOOZBBEBMBI
TFSBU UVOHHBM ,FEVB NFLBOJTNF JOJ NBTJOHNBTJOH EJTFCVU QPUPOHBO NFMJOUBOH TBSBG ZBOH EJSBOHTBOH EFOHBO SBOHTBOHBO
TVNBTJTQBTJBMEBOTVNBTJUFNQPSBM TFEBOHEBOSBOHTBOHBOLVBUEBOEJUVOKVLLBOKVNMBITFSBUZBOH
Sumasi Spasial. (BNCBS NFOHHBNCBSLBO UFSBOHTBOH NFOJOHLBU TFDBSB QSPHSFTJG +BEJ CJMB TJOZBM TFNBLJO
GFOPNFOB TVNBTJ TQBTJBM EJ NBOB LFLVBUBO TJOZBM ZBOH LVBU TFNBLJO CBOZBL TFSBU ZBOH NFOHJSJNLBO TJOZBM 'FOPNFOB
NBLJO LVBU EJLJSJNLBO EFOHBO DBSB NFNQFSCBOZBL KVNMBI JOJEJTFCVUTVNBTJTQBTJBM
TFSBUZBOHNFOHJSJNLBOOZB(BNCBSJOJKVHBNFOVOKVLLBO Sumasi Temporal. $BSBLFEVBZBOHEBQBUEJHVOBLBOVOUVL
TBUV CBHJBO LVMJU ZBOH EJQFSTBSBGJ PMFI TFKVNMBI CFTBS TFSBU NFOHJSJNLBOTJOZBMZBOHMFCJILVBUBEBMBIEFOHBODBSBNFNQFS
QBSBMFMVOUVLSBTBOZFSJZBOHCFSKBMBOTFKBKBS4FUJBQTFSBUJOJ CFTBS GSFLVFOTJ JNQVMT TBSBG QBEB TFUJBQ TFSBU ZBOH EJTFCVU TV
BLBO CFSDBCBOH NFOKBEJ CFSBUVTSBUVT VKVOH TBSBG CFCBT NBTJ UFNQPSBM (BNCBS NFNQFSMJIBULBO TVNBTJ JOJ HBN
CFSVLVSBO LFDJM ZBOH NFOEFUFLTJ SBTB OZFSJ 4FMVSVI CBS CBHJBO BUBT NFNQFSMJIBULBO LFLVBUBO TJOZBM ZBOH CFSVCBI
LFMPNQPLTFSBUSBTBOZFSJTFSJOHLBMJNFOVUVQJTVBUVEBFSBI VCBI EBO HBNCBS CBHJBO CBXBI NFOVOKVLLBO QFOHJSJNBO JN
LVMJU EFOHBO EJBNFUFS IJOHHB DN %BFSBI JOJ EJTFCVU QVMTZBOHTFTVOHHVIOZBEBSJTVBUVTFSBUTBSBG
MBQBOHBOSFTFQUJG SFDFQUJWFGJFME
EBSJTFSBUUFSTFCVU+VNMBI
TFSBUCBOZBLEJCBHJBOUFOHBIMBQBOHBOUFUBQJCFSLVSBOHLF Pengiriman dan Pengolahan Sinyal dalam
BSBIQFSJGFS,JUBEBQBUKVHBNFMJIBUEBSJHBNCBSJOJ CBIXB Kelompok Neuron
DBCBOHDBCBOH TFSBU TBMJOH UVNQBOH UJOEJI EFOHBO TFSBU
OZFSJ ZBOH MBJO 0MFI LBSFOB JUV UVTVLBO QFOJUJ QBEB LVMJU 4JTUFN TBSBG QVTBU UFSTVTVO BUBT CFSJCVSJCV TBNQBJ CFSKVUBKVUB
TFSJOH LBMJ BLBO NFSBOHTBOH CBOZBL VKVOH TFSBU SBTB OZFSJ LVNQVMBO OFVSPO CFCFSBQB EJ BOUBSBOZB NFOHBOEVOH TFEJLJU
TFDBSB CFSTBNBTBNB #JMB UVTVLBO QFOJUJ UBEJ EJCFSJLBO EJ OFVSPO TFEBOHLBOZBOHMBJONFOHBOEVOHCBOZBLTFLBMJOFVSPO
CBHJBO QVTBU MBQBOHBO SFTFQUPS OZFSJ UFSUFOUV LFLVBUBO 4FCBHBJ DPOUPI LPSUFLT TFSFCSJ TFDBSB LFTFMVSVIBO EBQBU EJBOH
SBOHTBOH QBEB TFSBU JUV KBVI MFCJI CFTBS EBSJQBEB CJMB HBQTFCBHBJTBUVLVNQVMBOOFVSPOZBOHMVBT,VNQVMBOOFVSPO
SBOHTBOH EJCFSJLBO EJ CBHJBO QFSJGFS MBQBOHBO SFTFQUPS MBJOOZB NFMJQVUJ HBOHMJB CBTBMJT EBO OVLMFVT TQFTJGJL EBMBN
LBSFOB KVNMBI VKVOH TBSBG CFCBT EJ UFOHBI MBQBOHBO KBVI UBMBNVT TFSFCFMVN NFTFOTFGBMPO QPOT EBONFEVMB+VHB TFMV
MFCJICBOZBLEBSJQBEBEJCBHJBOQFSJGFS SVI CBHJBO EPSTBM TVCTUBOTJ BCVBCV NFEVMB TQJOBMJT EBQBU
+BEJ CBHJBO CBXBI (BNCBS NFOVOKVLLBO UJHB EJBOHHBQTFCBHBJTBUVLVNQVMBOOFVSPOZBOHQBOKBOH
HBNCBSZBOHUFSQJTBI ZBLOJQPUPOHBONFMJOUBOHCFSLBTTB 4FUJBQLVNQVMBOOFVSPONFNQVOZBJTVTVOBOLIVTVTOZBTFOEJ
564
80 EBMBNLVNQVMBOJUV%FOESJUCJBTBOZBKVHBCFSDBCBOHDBCBOH
EBO NFOZFCBS TBNQBJ SBUVTBO IJOHHB SJCVBO NJLSPNFUFS EJ
60 EBMBNLVNQVMBO
%BFSBIOFVSPOZBOHUFSBOHTBOHPMFITFUJBQTFSBUZBOHNBTVL
UNIT IX
40
LF EBFSBI UFSTFCVU EJTFCVU MBQBOHBO SBOHTBOHBO TUJNVMBUPSZ
GJFME
1FSIBUJLBO QBEB (BNCBS CBIXB UFSEBQBU CBOZBL
UFSNJOBM EBSJ TFSBU NBTVLBO ZBOH UFSMFUBL QBEB OFVSPO ZBOH
20
UFSEFLBUEBMBNMBQBOHBOOZB OBNVOKVNMBIUFSNJOBMNFOKBEJ
0 TFNBLJOTFEJLJUQBEBOFVSPOZBOHKBSBLOZBMFCJIKBVI
Ambang Rangsang dan Bawah Ambang Rangsang

Stimuli—Eksitasi atau Fasilitasi. %BMBN QFNCJDBSBBO NF
OHFOBJ GVOHTJ TJOBQUJL QBEB #BC UFMBI EJJOHBULBO CBIXB
46-8 MFUVQBOTVBUVUFSNJOBMQSBTJOBQUJLUVOHHBMZBOHCFSTJGBUFLTJUBTJ
IBNQJSUJEBLQFSOBINFOZFCBCLBOQPUFOTJBMBLTJQBEBOFVSPO
QBTDBTJOBQUJL.BMBIBO TFKVNMBICFTBSUFSNJOBMTFSBUNBTVLBO
IBSVTNFOHFMVBSLBOMFUVQBOQBEBOFVSPOZBOHTBNBCBJLTFDB
SJ ZBOH NFOZFCBCLBO TFUJBQ LVNQVMBO OFVSPO NFOHPMBITJOZBM SBTJNVMUBONBVQVOTFDBSBCFSVOUVOEFOHBODFQBUBHBSUFSKBEJ
NFOVSVU DBSBOZB TFOEJSJ ZBOH VOJL TFIJOHHB NFNVOHLJOLBO FLTJUBTJ $POUPIOZB QBEB (BNCBS LJUB EBQBU NFOH
LFSKB TBNB LFTFMVSVIBO LVNQVMBO OFVSPO JUV VOUVL NFOHIBTJM BOHHBQ CBIXB FOBN UFSNJOBM TBSBG IBSVT NFOHFMVBSLBO MFUV
LBO CFSCBHBJ GVOHTJ TJTUFN TBSBG 8BMBVQVO GVOHTJOZB CFSCFEB QBO IBNQJS TFDBSB CFSTBNBBO BHBS EBQBU NFSBOHTBOH TFUJBQ
LVNQVMBO OFVSPO KVHB NFNQVOZBJ CBOZBL LFTBNBBO QSJOTJQ OFVSPO#JMBLJUBIJUVOHKVNMBIUFSNJOBMOFVSPOEBSJTFUJBQTF
GVOHTJ TFQFSUJZBOHBLBOEJKFMBTLBOQBEBIBMBNBOCFSJLVU SBUNBTVLBO LJUBBLBONFMJIBUCBIXBTFSBUNBTVLBONFNQV
OZBJ KVNMBI UFSNJOBM ZBOH MFCJI EBSJ DVLVQ VOUVL EBQBU NF
Penyampaian Sinyal melalui Kumpulan Neuron OZFCBCLBO OFVSPO B NFODFUVTLBO MFUVQBO 0MFI LBSFOB JUV
4VTVOBO/FVSPOVOUVL1FOZBNQBJBO4JOZBM SBOHTBOHBOZBOHCFSBTBMEBSJTFSBUNBTVLBONFOVKVLFOFV
(BNCBS NFSVQBLBO EJBHSBN TLFNBUJL CFCFSBQB OFVSPO SPO JOJ EJTFCVU TFCBHBJ SBOHTBOHBO FLTJUBUPSJL FYDJUBUPSZ TUJ
ZBOH CFSBEB EBMBN TVBUV LVNQVMBO OFVSPO NFNQFSMJIBULBO NVMVT
BUBV EJTFCVU KVHB SBOHTBOHBO BUBT BNCBOH TVQSBUI
TFSBU NBTVLBO EJ TFCFMBI LJSJ EBO TFSBU LFMVBSBO EJ TFCFMBI SFTIPME TUJNVMVT
LBSFOB CFTBSOZB SBOHTBOHBO JOJ NFMFCJIJ OJ
LBOBO4FUJBQTFSBUNBTVLBONFNCBHJEJSJCFSBUVTSBUVTTBNQBJ MBJBNCBOHZBOHEJCVUVILBOVOUVLUFSKBEJOZBFLTJUBTJ
CFSJCVSJCVLBMJ TFIJOHHBBEBTFSJCVBUBVMFCJIVKVOHTFSBUZBOH 4FSBU NBTVLBO KVHB BLBO NFOZFCBSLBO UFSNJOBMOZB LF
NFOZFCBS LF EBMBN TVBUV EBFSBI ZBOH MVBT QBEB LVNQVMBO OFVSPOCEBODOBNVOUBLDVLVQVOUVLNFOJNCVMLBOFLTJUBTJ
OFVSPOVOUVLCFSTJOBQTEFOHBOEFOESJUBUBVCBEBOTFMOFVSPO .FTLJQVO EFNJLJBO MFUVQBO ZBOH EJLFMVBSLBO PMFI UFSNJOBM
UFSNJOBM JOJ BLBO NFOZFCBCLBO LFEVB OFVSPO UFSTFCVU CFSBEB
EBMBNLFBEBBOZBOHMFCJINVEBIEJSBOHTBOHPMFITJOZBMTJOZBM
EBSJ TFSBU TBSBG MBJOOZB 0MFI LBSFOB JUV SBOHTBOHBO ZBOH NF
1 OVKV LF OFVSPO JOJ EJTFCVU SBOHTBOHBO CBXBI BNCBOH TVCUI
a
SFTIPMETUJNVMVT
EBOOFVSPOOFVSPOJOJEJLBUBLBOCFSBEBEB
MBNLFBEBBOUFSGBTJMJUBTJ
%FNJLJBOQVMBQBEBTFSBUNBTVLBO SBOHTBOHBOZBOHNF
b
OVKV LF OFVSPO E NFSVQBLBO SBOHTBOHBO BUBT BNCBOH EBO
SBOHTBOHBO ZBOH NFOVKV LF OFVSPO C EBO D NFSVQBLBO SBOH
TBOHCBXBIBNCBOH UFUBQJNFSVQBLBOSBOHTBOHBOGBTJMJUBTJ
c (BNCBS NFOHHBNCBSLBO LVNQVMBO OFVSPO ZBOH
TBOHBUQBEBU LBSFOBTFUJBQTFSBUNBTVLBOCJBTBOZBNFNQVOZBJ
QFSDBCBOHBO UFSNJOBM TBSBG NFOVKV CFSBUVTSBUVT BUBV CFSJCV
SJCVOFVSPOZBOHUFSMFUBLEBMBNTVBUVMBQBOHBO TFQFSUJZBOH
EBMBN (BNCBS %J CBHJBO UFOHBI MBQBOHBO EBMBN
d HBNCBSJOJ EJQFSMJIBULBOTFCBHBJEBFSBIMJOHLBSBO TFNVBOFV
2
46-9
565
SPOUFSBOHTBOH PMFI TFSBUTFSBU NBTVLBO 0MFI LBSFOB JUV Konvergensi Sinyal

EBFSBI JOJ EJTFCVU EBFSBI MFUVQBO EJTDIBSHF [POF
EBSJ TFSBU ,POWFSHFOTJ CFSBSUJ TJOZBMTJOZBM EBSJ CBOZBL TFSBU NBTVLBO
TFSBUNBTVLBO EJTFCVUKVHBEBFSBIFLTJUBTJ FYDJUFE[POF
BUBV NFOZBUV VOUVL NFOHFLTJUBTJ OFVSPO UVOHHBM (BNCBS "
EBFSBIMJNJOBM EBFSBICBUBT
1BEBTFUJBQTJTJ OFVSPOCFSBEB NFNQFSMJIBULBO LPOWFSHFOTJ EBSJ TVNCFS UVOHHBM ZBJUV CBOZBL
EBMBN LFBEBBO NVEBI EJSBOHTBOH UFSGBTJMJUBTJ
OBNVO UJEBL UFSNJOBM EBSJ TFSBU NBTVLBO UVOHHBM CFSBLIJS QBEB OFVSPO ZBOH
UFSFLTJUBTJ EBOEBFSBIJOJEJTFCVUEBFSBIGBTJMJUBTJ BUBVEJTFCVU TBNB1FOUJOHOZBLFBEBBOJOJBEBMBICBIXBOFVSPOIBNQJSUJEBL
KVHBEBFSBICBXBIBNCBOHBUBVEBFSBITVCMJNJOBM QFSOBIUFSFLTJUBTJPMFIQPUFOTJBMBLTJZBOHCFSBTBMEBSJTBUVUFSNJ
Penghambatan Kumpulan Neuron. ,JUB IBSVT OBM TFSBU NBTVLBO 5BQJ QPUFOTJBM BLTJ ZBOH CFSLPOWFSHFOTJ QBEB
NFOHJOHBU QVMB CBIXB CFCFSBQB TFSBU NBTVLBO BLBO OFVSPO EBSJ CBOZBL UFSNJOBM DVLVQ VOUVL NFOJNCVMLBO TVNBTJ
NFOHIBNCBU OFVSPO CVLBO NFSBOHTBOH ,FBEBBO JOJ TQBTJBMTFIJOHHBOFVSPONFODBQBJOJMBJBNCBOHZBOHEJCVUVILBO
CFSMBXBOBO EFOHBO LFBEBBO GBTJMJUBTJ EBO TFMVSVI VOUVLQFODFUVTBOQPUFOTJBMBLTJ
MBQBOHBO UFNQBU DBCBOHDBCBOH QFOHIBNCBU EJTFCVU ,POWFSHFOTJEBQBUKVHBEJTFCBCLBOEBSJTJOZBMTJOZBMNBTVLBO
EBFSBI JOIJCJTJ %FSBKBU QFOHIBNCBUBO EJ CBHJBO QVTBU FLTJUBTJ BUBV JOIJCJTJ
EBSJ CFSNBDBNNBDBN TVNCFS TFQFSUJ
EBFSBI JOJ CFTBS LBSFOB CBOZBLOZB VKVOHVKVOH TBSBG ZBOH ZBOH EJQFSMJIBULBO QBEB (BNCBS # $POUPI JOUFSOFVSPO
CFSBLIJS EJ CBHJBO QVTBU EBO TFNBLJO LF UFQJ KVNMBIOZB NFEVMBTQJOBMJTNFOFSJNBTJOZBMTJOZBMLPOWFSHFOTJZBOHCFSBTBM
TFNBLJOTFEJLJU EBSJ
TFSBUTBSBGQFSJGFSZBOHNBTVLLFEBMBNNFEVMBTQJOBMJT

TFSBU QSPQSJPTQJOBM ZBOH CFSKBMBO EBSJ TBUV TFHNFO NFEVMB
Divergensi Sinyal yang TQJOBMJTNFOVKVTFHNFOMBJOOZB
TFSBULPSUJLPTQJOBMZBOHCFS
Melewati Kumpulan Neuron BTBM EBSJ LPSUFLT TFSFCSJ EBO
CFCFSBQB KBSBT QBOKBOH MBJOOZB
4FSJOH LBMJ QFOUJOH CBHJ TJOZBM MFNBI ZBOH NFNBTVLJ TVBUV ZBOHUVSVOEBSJPUBLNFOVKVNFEVMBTQJOBMJT4FMBOKVUOZB TJOZBM
LVNQVMBOOFVSPO VOUVLEBQBUNFSBOHTBOHMFCJICBOZBLTFSBU ZBOHCFSBTBMEBSJJOUFSOFVSPOJOUFSOFVSPOJOJBLBONFOZBUVQBEB
TBSBG ZBOH NFOJOHHBMLBO LVNQVMBO OFVSPO 'FOPNFOB JOJ OFVSPONPUPSJLBOUFSJPSVOUVLNFOHBUVSGVOHTJPUPU
EJTFCVU EJWFSHFOTJ 5FSEBQBU EVB KFOJT VUBNB EJWFSHFOTJ EBO ,POWFSHFOTJUFSTFCVUNFNVOHLJOLBOTVNBTJJOGPSNBTJJOGPS
LFEVBOZBNFNQVOZBJUVKVBOZBOHCFSCFEB NBTJ ZBOH CFSBTBM EBSJ CFSNBDBNNBDBN TVNCFS EBO SFTQPOT
(BNCBS " NFNQFSMJIBULBO EJWFSHFOTJ UJQF QFNCF BLIJSOZBNFSVQBLBOTVNBTJFGFLEBSJTFNVBKFOJTJOGPSNBTJUBEJ
TBSBO BNQMJGZJOH
,FBEBBO JOJ CFSBSUJ CBIXB TVBUV TJOZBM ,POWFSHFOTJNFSVQBLBOTBMBITBUVQFSJTUJXBZBOHQFOUJOH LBSFOB
NBTVLBO ZBOH NFNBTVLJ SBOHLBJBO LVNQVMBO KBSBT OFVSPO NFMBMVJDBSBJOJTJTUFNTBSBGQVTBUEBQBUNFOHIVCVOHLBO NFOH
BLBO NFOZFCBS LF MFCJI CBOZBL OFVSPO +FOJT EJWFSHFOTJ JOJ HBCVOHLBO EBONFOZPSUJSCFSNBDBNNBDBNJOGPSNBTJ
NFSVQBLBODJSJLIBTKBSBTLPSUJLPTQJOBMVOUVLNFOHBUVSPUPU
SBOHLB EFOHBOLFNBNQVBOTFMQJSBNJECFTBSUVOHHBMEBMBN Sirkuit Neuronal dengan Sinyal Keluaran
LPSUFLT NPUPSJL EBMBN LFBEBBBO TBOHBU UFSGBTJMJUBTJ VOUVL
yang Bersifat Eksitasi dan Inhibisi
NFOHFLTJUBTJTFCBOZBLTFSBUPUPU
,BEBOHTJOZBMZBOHNFNBTVLJTVBUVLVNQVMBOOFVSPONFOHIB
%JWFSHFOTJUJQFLFEVB EJQFSMJIBULBOQBEB(BNCBS#
TJMLBO TJOZBM LFMVBS ZBOH CFSTJGBU FLTJUBTJ EBMBN TBUV BSBI EBO
BEBMBI EJWFSHFOTJ NFOVKV CBOZBL KBSBT NVMUJQMF USBDUT
1BEB
QBEB TBBU ZBOH TBNB KVHB NFOJNCVMLBO TJOZBM JOIJCJTJ LF BSBI
LBTVT JOJ TJOZBM EJLJSJNLBO EBSJ LVNQVMBO OFVSPO LF EVB
MBJO $POUPIOZB QBEB TBBU TJOZBM FLTJUBTJ EJLJSJNLBO PMFI TVBUV
BSBI$POUPI JOGPSNBTJZBOHEJLJSJNLBOEJLPMVNOBEPSTBMJT
TFLFMPNQPL OFVSPO EBMBN NFEVMB TQJOBMJT BHBS UFSKBEJ HFSBLBO
NFEVMB TQJOBMJT BLBO NFMFXBUJ EVB KBMVS QBEB CBHJBO CBXBI
NBKV EBSJ LBLJ TFCVBI TJOZBM JOIJCJTJ KVHB EJIBOUBSLBO NFMBMVJ
PUBL
NFOVKVLFTFSFCFMVN EBO
NFMFXBUJCBHJBOCBXBI
TFLVNQVMBO OFVSPO ZBOH UFSQJTBI VOUVL NFOHIBNCBU PUPUPUPU
PUBL NFOVKV UBMBNVT EBO LPSUFLT TFSFCSJ %FNJLJBO KVHB EJ
EJ CBHJBO CFMBLBOH LBLJ TFIJOHHB PUPUPUPU JOJ UJEBL BLBO NFMB
EBMBNUBMBNVTIBNQJSTFNVBJOGPSNBTJTFOTPSJLBLBOEJUFSVT
XBOHFSBLBONBKVLBLJUBEJ5JQFTJSLVJUJOJNFSVQBLBODJSJLIBT
LBO LF TUSVLUVS UBMBNVT ZBOH MFCJI EBMBN EBO EBMBN XBLUV
QFOHBUVSBOTFNVBQBTBOHBOPUPUBOUBHPOJTUJL EBOEJTFCVUTJSLVJU
ZBOHCFSTBNBBOLFCFSCBHBJEBFSBIZBOHLPSUFLTTFSFCSJZBOH
JOIJCJTJUJNCBMCBMJL SFTJQSPDBMJOIJCJUJPODJSDVJU

CFSCFEB
A B
A B #1
#2 #3
46-12
566
A
#1
#2
#3
B
UNIT IX
(BNCBS NFOKFMBTLBO DBSB ZBOH EJHVOBLBO VOUVL Facilitation
NFOHIBTJMLBOJOIJCJTJ4FSBUTFSBUNBTVLBOTFDBSBMBOHTVOHNFSBOHTBOH
KBSBT LFMVBS ZBOH CFSTJGBU FLTJUBTJ OBNVO TFSBUTFSBU JUV KVHB C
NFSBOHTBOH OFVSPO JOIJCJTJ QFSBOUBSB OFVSPO
ZBOH LFNVEJBO
NFOZFLSFTJ KFOJT [BU USBOTNJUFS MBJO VOUVL NFOHIBNCBU KBSBT LFMVBS
LFEVB EBSJ LVNQVMBO OFVSPO 5JQF TJSLVJU JOJ KVHB CFSHVOB VOUVL
NFOHIBNCBUBLUJWJUBTZBOHCFSMFCJIBOQBEBCFCFSBQBCBHJBOPUBL
Perpanjangan Sinyal oleh Kumpulan Neuron

—"Pascaletupan"
4BNQBJ TFKBVI JOJ LJUB IBOZB NFNCBIBT TJOZBMTJOZBM ZBOH EJUFSVTLBO
NFMBMVJ LVNQVMBO OFVSPO #JBSQVO CFHJUV EBMBN CBOZBL LFBEBBO
TJOZBM ZBOH NBTVL LF EBMBN TVBUV LVNQVMBO EBQBU NFOZFCBCLBO
QFSQBOKBOHBO XBLUV QFOHFMVBSBO MFUVQBO EJTFCVU QBTDBMFUVQBO BGUFS
EJTDIBSHF
ZBOH CFSMBOHTVOH TFMBNB CFCFSBQB NJMJEFUJL TBNQBJ
CFCFSBQBNFOJUTFUFMBICFSBLIJSOZBTJOZBMNBTVLBO.FLBOJTNFQBMJOH D
QFOUJOH ZBOH NFOZFCBCLBO UJNCVMOZB QBTDBMFUVQBO BEBMBI TFCBHBJ
CFSJLVU
Pascaletupan Sinaptik. #JMB TVBUV TJOBQT FLTJUBUPSJL NF

SBOHTBOH QFSNVLBBO EFOESJU BUBV TPNB OFVSPO QBEB OFVSPO BLBO
UJNCVM QPUFOTJBM MJTUSJL QBTDBTJOBQUJL EBO CFSMBOHTVOH TBNQBJ
CFCFSBQB NJMJEFUJL UFSVUBNB CJMB NFMJCBULBO [BU USBOTNJUFS TJOBQUJL
EFOHBOEVSBTJLFSKBMBNB MPOHBDUJOHTZOBQUJDUSBOTNJUUFSTVCTUBODF

4FMBNB QPUFOTJBM JOJ UFUBQ BEB QPUFOTJBM JOJ NBTJI EBQBU NFSBOHTBOH
OFVSPO TFIJOHHB OFVSPO NBTJI EBQBU NFOHJSJNLBO JNQVMT LFMVBS 46-14
ZBOH UFSVTNFOFSVT TFQFSUJ ZBOH UFMBI EJKFMBTLBO QBEB #BC +BEJ
TFCBHBJBLJCBUEBSJNFLBOJTNFQBTDBMFUVQBOTJOBQUJLJUVTFOEJSJ TBUV
TJOZBM NBTVLBO ZBOH EBUBOHOZB TFLFUJLB EBQBU NFOZFCBCLBO (BNCBS # NFOHHBNCBSLBO CFCFSBQB OFVSPO UBNCBIBO
UJNCVMOZB TJOZBM LFMVBS ZBOH CFSMBOHTVOH TFDBSB UFSVTNFOFSVT EBMBN TJSLVJU VNQBO CBMJL ZBOH BLBO NFOZFCBCLBO UJNCVMOZB
TFSBOHLBJBO MFUVQBO ZBOH CFSVOUVO
ZBOH BLBO CFSMBOHTVOH TFMBNB QFSMBNCBUBO ZBOH MFCJI MBNB BOUBSB SBOHTBOHBO BXBM EFOHBO
CFCFSBQBNJMJEFUJL UJNCVMOZB TJOZBM VNQBO CBMJL (BNCBS $ NFOHHBNCBSLBO
TJTUFN ZBOH MFCJI LPNQMFLT EJ NBOB TFSBU JOIJCJTJ EBO TFSBU
GBTJMJUBTJOZB CFSBEB QBEB TBUV TJSLVJU CFSHBVOH 4JOZBM GBTJMJUBTJ BLBO
Sirkuit Reverberasi (Bergaung) akibat Perpanjangan NFNQFSCFTBS JOUFOTJUBT EBO GSFLVFOTJ SFWFSCFSBTJ TFEBOHLBO TJOZBM
Waktu sinyal. 4BMBI TBUV TJSLVJU ZBOH QBMJOH QFOUJOH EBO TFMVSVI JOIJCJTJBLBONFOVSVOLBOBUBVNFOHIFOUJLBOUJNCVMOZBSFWFSCFSBTJ
TJSLVJU TJTUFN TBSBG BEBMBI TJSLVJU SFWFSCFSBTJ BUBV TJSLVJU CFSHBVOH (BNCBS % NFOKFMBTLBO CBIXB TFCBHJBO CFTBS KBSBT
PTDJMBUPSZ
4JSLVJU JOJ EJTFCBCLBO PMFI VNQBO CBMJL QPTJUJG EJ EBMBN SFWFSCFSBTJUFSEJSJBUBTCBOZBLTFSBUZBOHCFSKBMBOTFKBKBS1BEBTFUJBQ
TJSLVJU OFVSPOBM VNQBO CBMJL JOJ NFSBOHTBOH LFNCBMJ NBTVLBO QBEB TJOBQT TFSBU UFSNJOBM BLBO NFOZFCBS TFDBSB MVBT 1BEB TJTUFN JOJ
TJSLVJU ZBOH TBNB +BEJ TFLBMJ UFSBOHTBOH TJSLVJU JUV EBQBU KVNMBI TJOZBM SFWFSCFSBTJ EBQBU MFNBI BUBV LVBU CFSHBOUVOH QBEB
NFOHFMVBSLBOMFUVQBOCFSVMBOHVMBOHVOUVLXBLUVZBOHMBNB CFSBQBCBOZBLTFSBUTFKBKBSZBOHUFSMJCBUQBEBSFWFSCFSBTJ
1BEB (BNCBS EJUVOKVLLBO CFCFSBQB NBDBN LFNVOHLJOBO
CFOUVL TJSLVJU CFSHBVOH #FOUVL TJSLVJU CFSHBVOH ZBOH QBMJOH
TFEFSIBOB EJUVOKVLLBOQBEB(BNCBS" NFMJCBULBOTBUVOFVSPO
Sifat-sifat Perpanjangan Sinyal dari Sirkuit Reverberasi.
(BNCBS NFOKFMBTLBO TJOZBMTJOZBM LFMVBSBO ZBOH CFSBTBM EBSJ
1BEB LFBEBBO JOJ OFVSPO UVOHHBM IBOZB NFOHJSJNLBO TBUV TFSBU TBSBG
TJSLVJUSFWFSCFSBTJVNVN3BOHTBOHNBTVLBOEBQBUCFSMBOHTVOHTFMB
LPMBUFSBM ZBOH LFNCBMJ NFOVKV LF EFOESJU BUBV TPNBOZB VOUVL
NBNJMJEFUJLBUBVMFCJI OBNVOLFMVBSBOOZBEBQBUCFSUBIBOTFMBNB
NFSBOHTBOH LFNCBMJ EFOESJU BUBV TPNB JUV TFOEJSJ 8BMBVQVO TJSLVJU
CFCFSBQBNJMJEFUJLBUBVCBILBOCFCFSBQBNFOJU(BNCBSJOJNFNQFS
KFOJT JOJ NVOHLJO CVLBO KFOJT ZBOH QFOUJOH NFOVSVU UFPSJ TFLBMJ
MJIBULBO CBIXB JOUFOTJUBT TJOZBM LFMVBSBO QBEB UBIBQ QFSNVMBBO SF
OFVSPO NFOHFMVBSLBO MFUVQBO SBOHTBOHBO VNQBO CBMJL JUV BLBO
WFSCFSBTJ BLBO NFOJOHLBU TBNQBJ OJMBJ ZBOH UJOHHJ EBO LFNVEJBO
NFNQFSUBIBOLBO OFVSPO BHBS UFUBQ NFOHFMVBSLBO MFUVQBO ZBOH
CFSLVSBOH TBNQBJ TVBUV UJUJL LSJUJT EJ NBOB LFLVBUBO TJOZBM NFOEB
CFSLFMBOKVUBO
EBLIJMBOHTFQFOVIOZB1FOZFCBCEBSJQFOHIFOUJBOSFWFSCFSBTJZBOH
567
Excitation
UJCBUJCB JOJ BEBMBI LFMFMBIBO UBVU TJOBQUJL EBMBN TJSLVJU ,FMFMBIBO

TFUFMBI UJOHLBU LSJUJT UFSUFOUV BLBO NFOVSVOLBO SBOHTBOHBO QBEB
OFVSPO CFSJLVUOZB EBMBN TJSLVJU EJ CBXBI OJMBJ BNCBOH SBOHTBOH
EBOEFOHBOEFNJLJBOSBOHTBOHCBMJLTJSLVJUUJCBUJCBUFSQVUVT BLBO TBOHBU NFNQFSCFTBS TJOZBM LFMVBSBO TFEBOHLBO TJOZBM
-BNB LFSKB TFMVSVI TJOZBM TFCFMVN QFOHIFOUJBO EBQBU KVHB NBTVLBO ZBOH TJGBUOZB JOIJCJTJ BLBO TBOHBU NFOVSVOLBO TJOZBM
EJLFOEBMJLBOPMFITJOZBMEBSJCBHJBOMBJOPUBLZBOHNFOHIBNCBUBUBV LFMVBSBO .FSFLB ZBOH CJBTB CFSNBJO EFOHBOBMBUUSBOTNJUFSSBEJP
NFNVEBILBOQFSBOHTBOHBOTJSLVJU1PMBTJOZBMLFMVBSBOZBOHIBNQJS BLBO NFOHFOBMJ IBM JOJ TFCBHBJ TFNBDBN HFMPNCBOH QFNCBXB DBSSJFS
TBNB EJSFLBN EBSJ TBSBGTBSBG NPUPSJL ZBOH NFSBOHTBOH PUPUPUPU XBWF
QBEB QFOHJSJNBO JOGPSNBTJ +BEJ TJOZBM QFOHBUVS ZBOH TJGBUOZB
ZBOHUFSMJCBUEBMBNSFGMFLTGMFLTPSTFUFMBISBOHTBOHBOSBTBOZFSJQBEB FLTJUBTJBUBVJOIJCJTJCVLBONFSVQBLBOQFOZFCBCTJOZBMLFMVBSBO OBNVO
LBLJ BLBOEJQFSMJIBULBOQBEB(BNCBS
TJOZBM JUV NFOHBUVS QFSVCBIBO UJOHLBU JOUFOTJUBTOZB 1FSIBUJLBO CBIXB
TJTUFN HFMPNCBOH QFNCBXB JOJ NFOZFCBCLBO QFOVSVOBO JOUFOTJUBT
Sinyal Keluaran yangTerus-Menerus TJOZBMTFQFSUJIBMOZBEFOHBOQFOJOHLBUBOJOUFOTJUBT EJNBOBTBNQBJTBBU
dari Beberapa Sirkuit Neuronal JOJ UJQFQFOZBNQBJBOJOGPSNBTJTFQFSUJZBOHUFMBILJUBCJDBSBLBOUFSVUBNB
#FCFSBQBTJSLVJUOFVSPOBMNFNBODBSLBOTJOZBMLFMVBSBOTFDBSBUFSVT NFSVQBLBO JOGPSNBTJ ZBOH TJGBUOZB QPTJUJG EBSJQBEB JOGPSNBTJ ZBOH
NFOFSVTUBOQBBEBOZBTJOZBMFLTJUBTJZBOHNBTVL1BMJOHTFEJLJUBEB TJGBUOZBOFHBUJG+FOJTQFOZBNQBJBOJOGPSNBTJTFQFSUJJOJEJHVOBLBOPMFI
EVB NFLBOJTNF ZBOH EBQBU NFOZFCBCLBO LFBEBBO JOJ
TJTUFN TBSBG PUPOPN VOUVL NFOHBUVS CFCFSBQB GVOHTJ TFQFSUJ UPOVT
SBOHTBOHBO JOUSJOTJL OFVSPO ZBOH UFSVTNFOFSVT EBO
TJOZBM QFNCVMVIEBSBI UPOVTVTVT EFSBKBULPOTUSJLTJJSJTEJNBUB EBOGSFLVFOTJ
SFWFSCFSBTJZBOHUFSVTNFOFSVT EFOZVUKBOUVOH4FUJBQTJOZBMQFSBOHTBOHBOTBSBGEBQBUEJUJOHLBULBOBUBV
EJUVSVOLBO PMFI TJOZBM NBTVLBO UBNCBIBO LF EBMBN KBSBT OFVSPO
Peletupan Terus-Menerus yang Disebabkan oleh SFWFSCFSBTJ
Eksitabilitas Intrinsik Neuron. Sinyal Keluaran Ritmis
4FQFSUJ IBMOZB KBSJOHBOKBSJOHBO MBJO ZBOH QFLB SBOHTBOH CJMB
#BOZBL TJSLVJU OFVSPOBM NFNBODBSLBO TJOZBM LFMVBS TFDBSB SJUNJT
QPUFOTJBM NFNCSBOOZB OBJL TBNQBJ EJ BUBT OJMBJ BNCBOH UFSUFOUV
DPOUPIOZB TJOZBMQFSOBQBTBOSJUNJTZBOHCFSBTBMEBSJQVTBUQFSOBQBTBO
OFVSPO NFODFUVTLBO QPUFOTJBM BLTJ CFSVMBOHVMBOH 1PUFOTJBM
EJ NFEVMB EBO QPOT 4JOZBM QFSOBQBTBO SJUNJT CFSMBOHTVOH UFSVT
NFNCSBOCBOZBLOFVSPOQBEBLFBEBBOOPSNBMCBILBODVLVQUJOHHJ
NFOFSVT TFQBOKBOH IJEVQ 4JOZBM SJUNJT MBJOOZB TFQFSUJ ZBOH
VOUVLEBQBUNFNBODBSLBOJNQVMTTFDBSBUFSVTNFOFSVT,FBEBBOJOJ
NFOZFCBCLBO HFSBLBO NFOHHBSVL QBEB LBLJ CFMBLBOH BOKJOH BUBV
UFSVUBNBUFSKBEJQBEBCBOZBLOFVSPOEBMBNTFSFCFMVN TFQFSUJIBMOZB
HFSBLBOCFSKBMBOCJOBUBOHNBOBQVO NFNCVUVILBOSBOHTBOHNBTVLBO
EBMBN TFCBHJBO CFTBS JOUFSOFVSPO NFEVMB TQJOBMJT ,FDFQBUBO
QBEBTJSLVJUZBOHTFTVBJVOUVLNFNJDVTJOZBMSJUNJT
QFNBODBSBO JNQVMT PMFI TFMTFM JOJ EBQBU EJUJOHLBULBO PMFI TJOZBM
GBTJMJUBTJ BUBV EBQBU EJUVSVOLBO PMFI TJOZBM JOIJCJTJ TJOZBM JOIJCJTJ 4FNVBBUBVIBNQJSTFNVBTJOZBMSJUNJTZBOHUFMBIEJUFMJUJ UFSOZBUB
TFSJOHLBMJEBQBUNFOVSVOLBOLFDFQBUBOQFMFUVQBOTBNQBJOPM CFSBTBM EBO TJSLVJU CFSHBVOH BUBV SBOHLBJBO TJSLVJU CFSHBVOH ZBOH
CFSVSVUBOZBOHNFOHIBTJMLBOTJOZBMFLTJUBUPSJLBUBVJOIJCJUPSJLEBMBN
TVBUVKBSBTNFMJOHLBSZBOHEJLJSJNLBOEBSJTBUVLVNQVMBOOFVSPOLF
Pemancaran Sinyal Terus-Menerus dari Sirkuit
LVNQVMBOOFVSPOCFSJLVUOZB
Bergaung sebagai Cara Penyampaian Informasi. 4JSLVJU
CFSHBVOH ZBOH CFMVN NFOHBMBNJ LFMFMBIBO VOUVL NFOHIFOUJLBO 4JOZBM FLTJUBUPSJL BUBV JOIJCJUPSJL KVHB EBQBU NFOJOHLBULBO BUBV
SFWFSCFSBTJ NFSVQBLBO TVBUV TVNCFS CBHJ JNQVMT ZBOH EJQBODBSLBO NFOVSVOLBO BNQMJUVEP TJOZBM LFMVBSBO SJUNJT $POUPI (BNCBS
UFSVTNFOFSVT *NQVMT FLTJUBUPSJL ZBOH NFNBTVLJ LVNQVMBO NFOHHBNCBSLBO QFSVCBIBO TJOZBM LFMVBSBO QFSOBQBTBO QBEB OFSWVT
SFWFSCFSBTJ EBQBU NFOJOHLBULBO TJOZBM LFMVBSBO TFNFOUBSB JOIJCJTJ GSFOJLVT #JMB CBEBO LBSPUJT UFSBOHTBOH PMFI EFGJTJFOTJ PLTJHFO QBEB
EBQBUNFOVSVOLBOBUBVCBILBONFNBEBNLBOTJOZBM BSUFSJ CBJL GSFLVFOTJ NBVQVO BNQMJUVEP TJOZBM LFMVBSBO SJUNJT
QFSOBQBTBOBLBONFOJOHLBUTFDBSBQSPHSFTJG
(BNCBS NFOHHBNCBSLBO TVBUV TJOZBM LFMVBSBO ZBOH
CFSMBOHTVOH UFSVTNFOFSVT ZBOH CFSBTBM EBSJ LVNQVMBO OFVSPO
,VNQVMBO EBQBU NFNBODBSLBO JNQVMT LBSFOB FLTJUBCJMJUBT JOUSJOTJL
OFVSPO JOUSJOTJD OFVSPOBM FYDJUBCJMJUZ
BUBV TFCBHBJ BLJCBU EBSJ
SFWFSCFSBTJ1FSIBUJLBOCBIXBTJOZBMNBTVLBOZBOHTJGBUOZBFLTJUBTJ
568
Kelelahan Sinaps sebagai Cara Menstabilkan Sistem

Saraf
,FMFMBIBOQBEBTJOBQTCFSBSUJQFOHJSJNBOTJOBQUJLNFOKBEJ
MFCJI MFNBI MFCJI MBNB EBO EFOHBO QFSJPEF FLTJUBTJ MFCJI
UNIT IX
LVBU (BNCBS NFOHHBNCBSLBO UJHB SFLBNBO
SFGMFLTGMFLTPSCFSVSVUBOQBEBTFFLPSCJOBUBOHZBOHUFMBQBL
LBLJOZBEJCFSJSBOHTBOHSBTBOZFSJ1FSIBUJLBOCBIXBQBEB
TFUJBQ SFLBNBO UBNQBL LFLVBUBO LPOUSBLTJ CFSLVSBOH
TFDBSB QSPHSFTJG KBEJ LFLVBUBOOZB BLBO NFOHIJMBOH FGFL
JOJ LFCBOZBLBO EJTFCBCLBO BEBOZB LFMFMBIBO TJOBQT QBEB
TJSLVJU SFGMFLT GMFLTPS 4FMBOKVUOZB CJMB JOUFSWBM BOUBSB
SBOHLBJBO SFGMFLT GMFLTPS JUV TFNBLJO EFLBU JOUFOTJUBT
SFTQPOTSFGMFLTTFMBOKVUOZBNBLJOCFSLVSBOHQVMB
Penyesuaian Otomatis Jangka Pendek pada

Sensitivitas Jaras oleh Mekanisme Kelelahan. 4FLBSBOH
NBSJMBI LJUB UFSBQLBO GFOPNFOB LFMFMBIBO JOJ QBEB KBSBTKBSBT
MBJO ZBOH BEB EBMBN PUBL +BSBT ZBOH UFSMBMV CBOZBL EJQBLBJ
CJBTBOZB BLBO NFOHBMBNJ LFMFMBIBO TFIJOHHB TFOTJUJWJUBT KBSBT
Instabilitas dan Stabilitas CFSLVSBOH 4FCBMJLOZB KBSBT ZBOH LVSBOH TFSJOH EJQBLBJ BLBO
Sirkuit Neuronal JTUJSBIBU EBO LFQFLBBOOZB NFOJOHLBU +BEJ LFMFMBIBO EBO
QFNVMJIBO EBSJ LFMFMBIBO QFOUJOH TFCBHBJ DBSB NFOHBUVS
)BNQJS TFUJBQ CBHJBO PUBL CBJL TFDBSB MBOHTVOH NBVQVO UJEBL LFQFLBBOEBMBNKBOHLBQFOEFLCBHJCFSNBDBNNBDBNTJSLVJU
MBOHTVOH CFSIVCVOHBO EFOHBO TFUJBQ CBHJBO MBJOOZB EBO TJTUFNTBSBG)BMUFSTFCVUNFNCBOUVTJSLVJUTJTUFNTBSBGVOUVL
LFBEBBO JOJ NFOJNCVMLBO NBTBMBI ZBOH TFSJVT #JMB CBHJBO EBQBUCFLFSKBEBMBNSFOUBOHLFQFLBBOBHBSGVOHTJTBSBGFGFLUJG
QFSUBNB NFSBOHTBOH CBHJBO LFEVB CBHJBO LFEVB NFSBOHTBOH
CBHJBO LFUJHB CBHJBO LFUJHB NFSBOHTBOH CBHJBO LFFNQBU CFHJUV Perubahan Jangka Panjang Sensitivitas Sinaptik
TFUFSVTOZB TBNQBJ BLIJSOZB TJOZBM JUV NFSBOHTBOH CBHJBO ZBOH Akibat Peningkatan atau Penurunan Reseptor
QFSUBNB MBHJ NBLB TJOZBM FLTJUBTJ ZBOH NBTVL LF EBMBN TFUJBQ Sinaptik secara Otomatis. ,FQFLBBO KBOHLB QBOKBOH QBEB
CBHJBO PUBL BLBO NFOJNCVMLBO TJLMVT QFSBOHTBOHBO LFNCBMJ TJOBQTEBQBUTBOHBUEJVCBIEFOHBOQFOJOHLBUBOKVNMBIQSPUFJO
SFFLTJUBTJ ZBOH CFSMBOHTVOH TFDBSB UFSVTNFOFSVT EJ TFMVSVI SFTFQUPS EJ CBHJBO TJOBQT TFXBLUV TJOBQT LVSBOH BLUJG EBO
CBHJBO PUBL #JMB LFBEBBO JOJ UFSKBEJ PUBL BLBO EJCBOKJSJ PMFI QFOHVSBOHBO SFTFQUPS TFXBLUV TJOBQT TBOHBU BLUJG
NBTTBTJOZBMSFWFSCFSBTJZBOHUBLUFSBUVSTJOZBMTJOZBMZBOHUJEBL .FLBOJTNFOZB BEBMBI TFCBHBJ CFSJLVU 1SPUFJO SFTFQUPS
NFOHBOHLVU JOGPSNBTJ OBNVO BLBO NFNBLBJ TJSLVJUTJSLVJU EJCFOUVL TFDBSB LPOTUBO PMFI SFUJLVMVN FOEPQMBTNBTJTUFN
OFVSPOBM EBMBN PUBL TFIJOHHB UJEBL EBQBU EJHVOBLBO VOUVL BQBSBUVT (PMHJ EBO TFDBSB LPOTUBO QVMB EJTJTJQLBO LF EBMBN
QFOZBNQBJBO JOGPSNBTJ ,FBEBBO JOJ UFSKBEJ QBEB EBFSBI ZBOH SFTFQUPS NFNCSBO TJOBQUJL OFVSPO /BNVO CJMB TJOBQT UFSMBMV
MVBT EBMBN PUBL TFMBNB LFKBOH FQJMFQUJL #BHBJNBOB TJTUFN TBSBG BLUJG TFIJOHHB UFSMBMV CBOZBL [BU USBOTNJUFS ZBOH CFSJLBUBO
QVTBUNFODFHBIBHBSIBMJOJUBLTBNQBJUFSKBEJTFQBOKBOHXBLUV EFOHBO QSPUFJO SFTFQUPS CBOZBL EBSJ SFTFQUPS JOJ ZBOH
+BXBCBOOZB UFSMFUBL QBEB EVB NFLBOJTNF EBTBS ZBOH CFSGVOHTJ EJJOBLUJWBTJEBOEJQJOEBILBOEBSJNFNCSBOTJOBQUJL
QBEB TJTUFN TBSBG QVTBU
TJSLVJU QFOHIBNCBU JOIJCJUPSZ
DJSDVJU
EBO
LFMFMBIBOTJOBQT
Sirkuit Penghambat sebagai Mekanisme

untuk Menstabilkan Fungsi Sistem Saraf
5FSEBQBU EVB KFOJT TJSLVJU QFOHIBNCBU QBEB EBFSBI ZBOH MVBT 50
EBMBN PUBL ZBOH NFNCBOUV NFODFHBI QFOZFCBSBO TJOZBMTJOZBM 40
ZBOH CFSMFCJIBO
TJSLVJU VNQBO CBMJL QFOHIBNCBU ZBOH
30
LFNCBMJEBSJVKVOHKBSBTNFOVKVOFVSPOOFVSPOFLTJUBUPSJLBXBM
QBEB KBSBT ZBOH TBNB TJSLVJU JOJ UFSEBQBU EBMBN IBNQJS TFNVB 20
KBSBT TBSBG TFOTPSJL EBO NFOHIBNCBU OFVSPO NBTVLBO BUBV 10
OFVSPO QFSBOUBSB QBEB KBSBT TFOTPSJL TFXBLUV UFSNJOBM OFVSPO
0
CFSBEB EBMBN LFBEBBO TBOHBU UFSFLTJUBTJ EBO
CFCFSBQB
LVNQVMBOOFVSPOZBOHNFOHHVOBLBOQFOHBUVSBOJOIJCJTJLBTBS
QBEB EBFSBI ZBOH MVBT EBMBN PUBL DPOUPIOZB CBOZBL HBOHMJB 0 15 30 45 60
CBTBMJT NFOHHVOBLBO QFOHBSVI IBNCBUBO JOJ UFSIBEBQ TJTUFN
QFOHBUVSPUPU
569
)BMJOJTFCFOBSOZBNFOHVOUVOHLBOTFCBCQFOJOHLBUBOBUBV Gebhart GF: Descending modulation of pain, Neurosci Biobehav Rev 27:729,
2004.
QFOVSVOBOSFTFQUPS TFQFSUJNFLBOJTNFQFOHBUVSMBJOOZBZBOH
Hamill OP, Martinac B: Molecular basis of mechanotransduction in living
CFSGVOHTJ VOUVL QFOFOUVBO TFOTJUJWJUBT TJOBQUJL BLBO UFSVT cells, Physiol Rev 81:685, 2001.
NFOFSVTNFOHBUVSLFQFLBBOTFUJBQTJSLVJUTBNQBJQBEBTVBUV Housley GD, Bringmann A: Reichenbach A Purinergic signaling in special
OJMBJ ZBOH EJCVUVILBO BHBS UJNCVM GVOHTJ ZBOH TFTVBJ senses, Trends Neurosci 32:128, 2009.
1JLJSLBOMBI TFKFOBL CFUBQB TFSJVTOZB CJMB QBEB TFCBHJBO LFDJM Kandel ER, Schwartz JH, Jessell TM: Principles of Neural Science, ed 4, New,
TJSLVJU LFQFLBBOOZB NFOKBEJ TBOHBU UJOHHJ EJ BUBT OPSNBM
Katz DB, Matsunami H, Rinberg D, et al: Receptors, circuits, and behaviors:
EBQBU EJEVHB BLBO UJNCVM LSBN PUPU UFSVTNFOFSVT LFKBOH new directions in chemical senses, J Neurosci 28:11802, 2008.rLumpkin EA,
LFMBJOBOQTJLPUJL IBMVTJOBTJ LFUFHBOHBONFOUBM EBOLFMBJOBO Caterina MJ: Mechanisms of sensory transduction in the skin,
TBSBG MBJOOZB /BNVO VOUVOHOZB TFUJBQ LBMJ TJSLVJU NFOKBEJ Nature 445:858, 2007.
TBOHBU BLUJG QFOHBUVSBO PUPNBUJT BLBO NFOHBUVS LFNCBMJ Pearson KG: Neural adaptation in the generation of rhythmic behavior,
Annu Rev Physiol 62:723, 2000.
LFQFLBBO TJSLVJU TBNQBJ QBEB CBUBT SFBLTJ ZBOH NBTJI EBQBU
Pugh JR, Raman IM: Nothing can be coincidence: synaptic inhibition and
EJLFOEBMJLBO plasticity in the cerebellar nuclei, Trends Neurosci 32:170, 2009.rRamocki MB,
Zoghbi HY: Failure of neuronal homeostasis results in com-
mon neuropsychiatric phenotypes, Nature 455:912, 2008.
Daftar Pustaka
Richerson GB, Wu Y: Dynamic equilibrium of neurotransmitter transporters:
Bensmaia SJ: Tactile intensity and population codes, Behav Brain Res not just for reuptake anymore, J Neurophysiol 90:1363, 2003.rSchepers RJ,
190:165, 2008. Ringkamp M: Thermoreceptors and thermosensitive afferents,
Buzsaki G: Large-scale recording of neuronal ensembles, Nat Neurosci Neurosci Biobehav Rev 33:205, 2009.
7:446, 2004. Schoppa NE: Making scents out of how olfactory neurons are ordered in
Faisal AA, Selen LP, Wolpert DM: Noise in the nervous system, Nat Rev space, Nat Neurosci 12:103, 2009.
Neurosci 9:292, 2008. PJ, Rancz EA, Roth A, et al: Dendritic excitability and synaptic
Fontanini A, Katz DB: Behavioral states, network states, and sensory plasticity, Physiol Rev 88:769, 2008.
response variability, J Neurophysiol 100:1160, 2008. Stein BE, Stanford TR: Multisensory integration: current issues from the
Gandevia SC: Spinal and supraspinal factors in human muscle fatigue, perspective of the single neuron, Nat Rev Neurosci 9:255, 2008.
Physiol Rev 81:1725, 2001.
570
BAB 47
UNIT IX
4FOTBTJ4PNBUJL*4VTVOBO6NVN
*OESB5BLUJM EBO1PTJTJ
1FOHJOESBBO TPNBUJL BEBMBI NFLB

Deteksi dan Pengiriman Sensasi Taktil
OJTNF TBSBG ZBOH NFOHVNQVMLBO
JOGPSNBTJ TFOTPSJL EBSJ TFMVSVI
Hubungan antara Sensasi Taktil Raba, Tekanan, dan
UVCVI 1FOHJOESBBO JOJ CFSCFEB
Getaran. 8BMBVQVO TFOTBTJ SBCB UFLBO EBO HFUBSBO TFSJOH
EFOHBO JOESB LIVTVT QBODBJOESB

LBMJ EJHPMPOHLBO TFDBSB UFSQJTBI TFNVB TFOTBTJ JOJ EBQBU
ZBJUVJOESBQFOHMJIBUBO QFOEFOHBS
EJEFUFLTJ PMFI KFOJT SFTFQUPS ZBOH TBNB 5FSEBQBU UJHB
BO QFOHIJEV QFOHFDBQ EBOLFTFJNCBOHBO QFSCFEBBO VUBNB EJ BOUBSB TFOTBTJ UFSTFCVU
TFOTBTJ SBCB
VNVNOZB EJTFCBCLBO PMFI QFSBOHTBOHBO SFTFQUPS UBLUJM ZBOH
UFSEBQBU EJ LVMJU EBO EBMBN KBSJOHBO UFQBU EJ CBXBI LVMJU

Klasifikasi Indra Somatik TFOTBTJ UFLBO VNVNOZB EJTFCBCLBO PMFI BEBOZB QFSVCBIBO
QBEB KBSJOHBO ZBOH MFCJI EBMBN EBO
TFOTBTJ HFUBSBO
*OESB TPNBUJL EBQBU EJLMBTJGJLBTJLBO NFOKBEJ UJHB UJQF GJTJPMPHJT EJTFCBCLBO PMFI TJOZBM TFOTPSJL CFSVMBOHVMBOH ZBOH DFQBU

JOESBTPNBUJLNFLBOPSFTFQUJGZBOHNFMJQVUJTFOTBTJUBLUJMEBO UBQJ CFCFSBQB CFCFSBQB SFTFQUPS ZBOH EJHVOBLBO NFSVQBLBO
QPTJTJ ZBOH EJSBOHTBOH PMFI QFNJOEBIBO TFDBSB NFLBOJT SFTFQUPSZBOHTBNBZBOHEJHVOBLBOKVHBVOUVLSBCBEBOUFLBO
CFCFSBQBKBSJOHBOUVCVI
JOESBUFSNPSFTFQUJG ZBOHNFOEFUFLTJ
Reseptor Taktil. 5FSEBQBU QBMJOH TFEJLJU KFOJT SFTFQUPS
QBOBTEBOEJOHJOTFSUB
JOESBSBTBOZFSJ ZBOHEJBLUJGLBOPMFI
UBLUJM UBQJ TFCFOBSOZB NBTJI CBOZBL UFSEBQBU SFTFQUPS UBLUJM
TFUJBQGBLUPSZBOHNFSVTBLKBSJOHBO
ZBOH TFSVQB #FCFSBQB EJHBNCBSLBO QBEB (BNCBS CBC
#BCJOJNFNCJDBSBLBOJOESBUBLUJMEBOQPTJTJNFLBOPSFTFQUJG TFCFMVNOZBTJGBUTJGBULIVTVTOZBBEBMBITFCBHBJCFSJLVU
#BCNFNCJDBSBLBOJOESBUFSNPSFTFQUJGEBOOZFSJ*OESBUBLUJM 1FSUBNB CFCFSBQB VKVOH TBSBG CFCBT ZBOH EBQBU EJKVNQBJ
NFMJQVUJJOESBSBCB UFLBOBO HFUBSBO EBOHBUBM TFEBOHLBOJOESB EJ TFNVB CBHJBO LVMJU EBO KBSJOHBOKBSJOHBO MBJOOZB EBQBU
QPTJTJNFMJQVUJJOESBQPTJTJTUBUJTEBOLFDFQBUBOQFSHFSBLBO NFOEFUFLTJSBCBEBOUFLBO$POUPIOZB CBILBOLPOUBLSJOHBO
QBEB LPSOFB NBUB ZBOH UJEBL NFOHBOEVOH KFOJT VKVOH TBSBG
Klasifikasi Lain Sensasi Somatik. 4FOTBTJ TPNBUJL KVHB MBJO LFDVBMJ VKVOH TBSBG CFCBT EBQBU NFSBTBLBO TFOTBTJ SBCB
TFSJOH EJLFMPNQPLLBO CFSTBNB EBMBN LFMBT ZBOH MBJO ZBLOJ EBOUFLBO
TFCBHBJCFSJLVU ,FEVB SFTFQUPSSBCBEFOHBOTFOTJUJWJUBTUJOHHJ ZBLOJCBEBO
4FOTBTJ FLTUFSPSFTFQUJG ZBOH CFSBTBM EBSJ QFSNVLBBO UVCVI .FJTTOFS EJMVLJTLBO QBEB (BNCBS
ZBOH NFSVQBLBO
4FOTBTJ QSPQSJPTFQUJG BEBMBI TFOTBTJ ZBOH CFSIVCVOHBO EFOHBO KVMVSBO VKVOH TBSBG CFSLBQTVM EBSJ TBSBG TFOTPSJL CFTBS
LFBEBBO GJTJL UVCVI NFMJQVUJ TFOTBTJ QPTJTJ TFOTBTJ UFOEPO EBO CFSNJFMJO KFOJT "Ϡ
%J EBMBN LBQTVM JOJ UFSEBQBU CBOZBL
PUPU TFOTBTJ UFLBO ZBOH CFSBTBM EBSJ UFMBQBL LBLJ EBO TFOTBTJ QFSDBCBOHBOUFSNJOBMGJMBNFOTBSBG#BEBOJOJEBQBUEJKVNQBJ
LFTFJNCBOHBO TFSJOH EJBOHHBQ TFCBHBJ TFOTBTJ LIVTVT CVLBO QBEB CBHJBO LVMJU ZBOH UJEBL CFSBNCVU EBO UFSVUBNB CBOZBL
TVBUVTFOTBTJTPNBUJL
TFLBMJ EJKVNQBJ EJ VKVOH KBSJ CJCJS EBO EBFSBI LVMJU MBJO
TFIJOHHB LFNBNQVBO TFTFPSBOH VOUVL NFNCFEBLBO MPLBTJ
4FOTBTJ WJTFSBM NFSVQBLBO TFOTBTJ ZBOH CFSBTBM EBSJ PSHBO TQBTJBM EBSJ TFOTBTJ SBCB TBOHBU CFSLFNCBOH QBEB EBFSBI
WJTFSB UVCVI TFDBSB LIVTVT JTUJMBI JOJ TFSJOH LBMJ EJQBLBJ VOUVL EBFSBI UFSTFCVU #BEBO .FJTTOFS CFSBEBQUBTJ EBMBN XBLUV
NFOZBUBLBOTFOTBTJCFSBTBMEBSJPSHBOEBMBN TFQFSTFLJBO EFUJL TFTVEBI EJSBOHTBOH ZBOH CFSBSUJ CBIXB
4FOTBTJ EBMBN NFSVQBLBO TFOTBTJ ZBOH CFSBTBM EBSJ PSHBO SFTFQUPS JOJ UFSVUBNB QFLB UFSIBEBQ QFSHFSBLBO PCKFL EJ BUBT
PSHBOEBMBN TFQFSUJGBTJB PUPU EBOUVMBOH4FTBOTJJOJUFSVUBNB QFSNVLBBO LVMJU TFQFSUJ KVHB UFSIBEBQ HFUBSBO CFSGSFLVFOTJ
NFMJQVUJUFLBOBOEBMBN OZFSJ EBOHFUBSBO SFOEBI
571
,FUJHB VKVOH KBSJ EBO EBFSBIEBFSBI MBJOOZB ZBOH LFQBOKBOHBO 3FTFQUPS JOJ KVHB EJKVNQBJ QBEB LBQTVM TFOEJ EBO
NFOHBOEVOH CBOZBL TFLBMJ CBEBO .FJTTOFS CJBTBOZB KVHB NFNCBOUVNFOHJSJNLBOTJOZBMCFSVQBEFSBKBUSPUBTJTFOEJ
NFOHBOEVOHCBOZBLSFTFQUPSUBLUJMZBOHVKVOHOZBNFMVBT ZBOH ,FFOBN CBEBO QBDJOJ ZBOH UFMBI EJCJDBSBLBO TFDBSB EFUBJM
TBMBI TBUV KFOJTOZB BEBMBI EJTLVT .FSLFM EJQFSMJIBULBO QBEB QBEB #BC UFSMFUBL UFQBU EJ CBXBI LVMJU EBO KVHB EJ KBSJOHBO
(BNCBS #BHJBO LVMJU ZBOH CFSBNCVU KVHB NFOHBOEVOH GBTJB UVCVI ZBOH MFCJI EBMBN 3FTFQUPS JOJ IBOZB EBQBU EJ
DVLVQ CBOZBL VKVOH SFTFQUPS ZBOH NFMVBT XBMBVQVO CBHJBO SBOHTBOH PMFI QFOFLBOBO MPLBM KBSJOHBO ZBOH DFQBU LBSFOB
LVMJUJOJIBNQJSTBNBTFLBMJUJEBLNFOHBOEVOHCBEBO.FJTTOFS SFTFQUPSJOJCFSBEBQUBTJEBMBNXBLUVCFCFSBQBTFQFSTFSBUVTEFUJL
+FOJT SFTFQUPS JOJ CFSCFEB EFOHBO CBEBO .FJTTOFS LBSFOB KFOJT 0MFILBSFOBJUV SFTFQUPSJOJUFSVUBNBQFOUJOHVOUVLNFOEFUFLTJ
SFTFQUPS JOJ NFOHJSJNLBO TJOZBM ZBOH QBEB NVMBOZB LVBU HFUBSBO KBSJOHBO BUBV QFSVCBIBO NFLBOJT ZBOH DFQBU QBEB
OBNVO EBZB BEBQUBTJOZB IBOZB TFCBHJBO TFIJOHHB LFNVEJBO KBSJOHBO
NFOHIBOUBSLBO TJOZBM ZBOH MFCJI MFNBI EFOHBO EBZB BEBQUBTJ
MBNCBU 0MFI LBSFOB JUV SFTFQUPS JOJ CFSQFSBO EBMBN Pengiriman Sinyal Taktil di Serat Saraf Perifer. )BNQJS
NFOHIBOUBSLBO TJOZBM UFUBQ ZBOH EBQBU NFOZFCBCLBO PSBOH TFNVB SFTFQUPS TFOTPSJL ZBOH LIVTVT TFQFSUJ CBEBO .FJTTOFS
EBQBU UFSVTNFOFSVT NFOEFUFLTJ TFOUVIBO TVBUV PCKFL QBEB SFTFQUPS CFSCFOUVL LVCBI *HHP SFTFQUPS SBNCVU CBEBO QBDJOJ
LVMJUOZB EBO VKVOH 3VGGJOJ NFOHIBOUBSLBO TJOZBMOZB NFMBMVJ TFSBU TBSBG
KFOJT"ϠZBOHNFNQVOZBJLFDFQBUBOQFOHJSJNBOTBNQBJN
%JTLVT.FSLFMTFSJOHEJLFMPNQPLLBOCFSTBNBTBNBEBMBN EFUJL 4FCBMJLOZB SFTFQUPS UBLUJM VKVOH TBSBG CFCBT UFSVUBNB
TVBUV PSHBO SFTFQUPS ZBOH EJTFCVU SFTFQUPS CFSCFOUVL LVCBI NFOHIBOUBSLBO TJOZBMOZB NFMBMVJ TFSBU TBSBG LFDJM KFOJT "
*HHP ZBOH NFOPOKPM LF BUBT TBNQBJ EJ CBXBI FQJUFM LVMJU CFSNJFMJO ZBOH NFNQVOZBJ LFDFQBUBO QFOHJSJNBO IBOZB
TFQFSUJ ZBOH EJHBNCBSLBO QBEB (BNCBS ,FBEBBO JOJ TBNQBJNEFUJL
BLBONFOZFCBCLBOFQJUFMEJUJUJLJOJNFOPOKPMLFMVBS TFIJOHHB
NFNCFOUVL TVBUV LVCBI EBO NFNCFSJ SBTB TFOTJUJG ZBOH #FCFSBQB VKVOH TBSBG CFCBT VOUVL TFOTBTJ UBLUJM NFOHIBOUBS
FLTUSFN 1FSIBUJLBO KVHB CBIXB TFMVSVI LFMPNQPL EJTLVT LBO TJOZBMOZB NFMBMVJ TFSBU TBSBG KFOJT $ UJEBL CFSNJFMJO ZBOH
.FSLFMEJQFSTBSBGJPMFITBUVTFSBUTBSBGUVOHHBMCFTBSCFSNJFMJO NFNQVOZBJ LFDFQBUBO IBOUBS TFQFSTFLJBO NFUFS TBNQBJ N
KFOJT"Ϡ
3FTFQUPSJOJ CFSTBNBEFOHBOCBEBO.FJTTOFSZBOH EFUJL TFSBU TBSBG JOJ NFOHJSJNLBO TJOZBM LF NFEVMB TQJOBMJT EBO
TVEBI EJCBIBT TFCFMVNOZB CFSQFSBO TBOHBU QFOUJOH EBMBN CBUBOHPUBLCBHJBOCBXBI ZBOHEJEVHBUFSVUBNBNFOHIBOUBSLBO
NFMPLBMJTBTJ TFOTBTJ SBCB EJ EBFSBI QFSNVLBBO UVCVI ZBOH TFOTBTJHBUBM
TQFTJGJLEBONFOFOUVLBOUFLTUVSCFOEBZBOHEJSBTBLBO +BEJ KFOJTTJOZBMTFOTPSJLZBOHTJGBUOZBMFCJILSJUJTZBLOJZBOH
,FFNQBU QFSHFSBLBO TFEJLJU TBKB QBEB SBNCVU UVCVI NFNCBOUV NFOFOUVLBO UFNQBU ZBOH UFQBU EJ LVMJU QFSVCBIBO
NBOBQVO BLBO NFSBOHTBOH TFSBU TBSBG ZBOH NFOHFMJMJOHJ JOUFOTJUBT ZBOH TBOHBU NJOJN BUBV QFSVCBIBO JOUFOTJUBT TJOZBM
QBOHLBMOZB+BEJ TFUJBQSBNCVUEBOTFSBUTBSBGCBTBMOZB ZBOH TFOTPSJT ZBOH DFQBU TFNVBOZB EJIBOUBSLBO NFMBMVJ KFOJT TFSBU
EJTFCVUPSHBOVKVOHSBNCVU IBJSFOEPSHBO
KVHBNFSVQBLBO TBSBGTFOTPSJLZBOHQFOHJSJNBOOZBDFQBU4FCBMJLOZB TJOZBMZBOH
SFTFQUPS SBCB 3FTFQUPS JOJ CFSBEBQUBTJ EFOHBO DFQBU EBO CFSTJGBUMFCJILBTBS TFQFSUJUFLBO SBCBZBOHMPLBMJTBTJOZBLVSBOH
TFQFSUJ IBMOZB CBEBO .FJTTOFS UFSVUBNB NFOEFUFLTJ B
CBJL EBO UFSVUBNB HBUBM EJIBOUBSLBO NFMBMVJ TFSBU TBSBG TBOHBU
QFSHFSBLBOPCKFLQBEBQFSNVLBBOUVCVIBUBV C
LPOUBLBXBM LFDJMZBOHKBVIMFCJIMBNCBUZBOHNFNCVUVILBOSVBOHMFCJILFDJM
EFOHBOUVCVI EBMBNCFSLBTTBSBGEJCBOEJOHLBOTFSBCVUZBOHMFCJIDFQBU
,FMJNB EJ MBQJTBO LVMJU ZBOH MFCJI EBMBN EBO KVHB EJ Deteksi Getaran
KBSJOHBO EBMBN CBOZBL EJKVNQBJ VKVOH 3VGGJOJ 3VGGJOJhT
4FNVB SFTFQUPS UBLUJM JLVU CFSQFSBO EBMBN NFOEFUFLTJ HFUBSBO
FOEJOHT
ZBOH CFSDBCBOH CBOZBL VKVOHOZB CFSLBQTVM TFQFSUJ
XBMBVQVO SFTFQUPS ZBOH CFSCFEB NFOEFUFLTJ GSFLVFOTJ HFUBSBO
ZBOH UFMBI EJHBNCBSLBO QBEB (BNCBS "EBQUBTJ VKVOH
ZBOH CFSCFEB #BEBO QBDJOJ EBQBU NFOEFUFLTJ TJOZBM HFUBSBO
3VGGJOJJOJTBOHBUMBNCBU TFIJOHHBSFTFQUPSJOJQFOUJOHVOUVL
EFOHBO LFDFQBUBO TBNQBJ HFUBSBO QFS EFUJL LBSFOB
NFOHJSJNLBO TJOZBM QFSVCBIBO CFOUVL KBSJOHBO ZBOH UFSVT
SFTFQUPS EFOHBO TBOHBU DFQBU CFSFTQPOT UFSIBEBQ QFSVCBIBO
NFOFSVT NJTBMOZBTJOZBMSBCBEBOUFLBOZBOHEBMBNEBOCFS
CFOUVL KBSJOHBO ZBOH DFQBU EBO LFDJM EBO SFTFQUPS JOJ KVHB
NFOHIBOUBSLBO TJOZBMOZB NFMBMVJ TFSBU TBSBG KFOJT "Ϡ ZBOH
NFOHIBOUBSLBO IJOHHB JNQVMT QFS EFUJL 4FCBMJLOZB
HFUBSBO CFSGSFLVFOTJ SFOEBI EBSJ TBNQBJ HFUBSBO QFS EFUJL
BLBO NFSBOHTBOH SFTFQUPS UBLUJM MBJOOZB UFSVUBNB CBEBO
.FJTTOFS ZBOHBEBQUBTJOZBMFCJIMBNCBUEBSJQBEBBEBQUBTJCBEBO
QBDJOJ
c Deteksi Geli dan Gatal oleh Ujung Saraf Bebas Mekano-
reseptif
1FOFMJUJBOOFVSPGJTJPMPHJUFMBINFNQFSMJIBULBOLFCFSBEBBOVKVOH
TBSBG CFCBT NFLBOPSFTFQUJG ZBOH TBOHBU QFLB EBO CFSBEBQUBTJ
DFQBU ZBOH IBOZB NFOFSJNB TFOTBTJ HFMJ EBO HBUBM 4FMBOKVUOZB
VKVOH TFSBU TBSBG JOJ CBOZBL TFLBMJ EJKVNQBJ QBEB MBQJTBO
TVQFSGJTJBMLVMJU ZBOHKVHBNFSVQBLBOTBUVTBUVOZBKBSJOHBOZBOH
CJBTBOZB EBQBU NFOFSJNB SBOHTBOHBO HBUBM EBO HFMJ 4FOTBTJ JOJ
EJIBOUBSLBO NFMBMVJ TFSBU TBSBG $ TBOHBU LFDJM ZBOH UJEBL
CFSNJFMJO TFQFSUJ TFSBU TBSBG ZBOH EJQBLBJ VOUVL NFOHIBOUBSLBO
OZFSJUVNQVMUJQFMBNCBU
572
Bab 47 Sensasi Somatik: I. Susunan Umum, Indra Taktit, dan Posisi
%JEVHBCBIXBUVKVBOTFOTBTJHBUBMJOJBEBMBIVOUVLNFNCFSJLBO %FOHBO NFOHJOHBU EJGFSFOTJBTJ JOJ LJUB EBQBU NFNCVBU

QFSIBUJBOQBEBSBOHTBOHBOQFSNVLBBOZBOHSJOHBO TFQFSUJLVUVZBOH EBGUBS KFOJTKFOJT TFOTBTJ ZBOH EBQBU EJLJSNLBO PMFI LFEVB
NFSBNCBUQBEBLVMJUBUBVHJHJUBOOZBNVL EBOTJOZBMZBOHEJUFSJNB TJTUFNEJBUBT
LFNVEJBO BLBO NFOHBLUJGLBO SFGMFLT NFOHHBSVL BUBV UJOEBLBO MBJO
VOUVL NFNCVBOH CBIBO JSJUBO (BUBM EBQBU EJIJMBOHLBO EFOHBO
UNIT IX
Sistem Kolumna Dorsalis—Lemniskus Mediatis
NFOHHBSVL KJLB UJOEBLBO JOJ NFNCVBOH CBIBO JSJUBO BUBV KJLB 1. 4FOTBTJSBCBZBOHNFNCVUVILBOLFUFQBUBOMPLBMJTBTJSBOHTBOH
HBSVLBO DVLVQ LVBU VOUVL NFOJNCVMLBO OZFSJ 4JOZBM OZFSJ JOJ BOZBOHUJOHHJ
EJQFSDBZB NFOFLBO TJOZBM HBUBM EBMBN NFEVMB TQJOBMJT EFOHBO DBSB 2. 4FOTBTJ TFOUVIBO ZBOH NFNCVUVILBO QFOHIBOUBSBO JNQVMT
JOIJCJTJMBUFSBM TFQFSUJZBOHEJKFMBTLBOQBEB#BC EFOHBOHSBEBTJJOUFOTJUBTZBOHLFDJM
3. 4FOTBTJGBTJL NJTBMOZBTFOTBTJHFUBSBO
Jaras Sensorik untuk Mengirimkan Sinyal Somatik 4. 4FOTBTJUFSIBEBQTJOZBMQFSHFSBLBOQBEBLVMJU
ke Sistem Saraf Pusat 5. 4FOTBTJQPTJTJUVCVIEBSJQFSTFOEJBO
6. 4FOTBTJUFLBOZBOHCFSLBJUBOEFOHBOEFSBKBUQFOFOUVBOJOUFO
)BNQJS TFMVSVI JOGPSNBTJ TFOTPSJL ZBOH CFSBTBM EBSJ TFHNFO
TJUBTUFLBOBO
TPNBUJL UVCVI NFNBTVLJ NFEVMB TQJOBMJT NFMBMVJ TBSBGTBSBG
TQJOBM QBEB SBEJLT EPSTBMJT #JBSQVO CFHJUV EBSJ UJUJL NBTVL LF
Sistem Anterotateral
EBMBN NFEVMB TQJOBMJT JOJ IJOHHB LF PUBL TJOZBM TFOTPSJL BLBO 1. 3BTBOZFSJ
EJIBOUBSLBONFMBMVJTBMBITBUVEBSJEVBKBSBTTFOTPSJLBMUFSOBUJG

TJTUFN LPMVNOB EPSTBMJTMFNOJTLVT NFEJBMJT BUBV
TJTUFN 2. 4FOTBTJUFSNBM NFMJQVUJTFOTBTJIBOHBUEBOEJOHJO
BOUFSPMBUFSBM ,FEVB TJTUFN JOJ TFCBHJBO BLBO LFNCBMJ CFSTBUV 3. 4FOTBTJSBCBEBOUFLBOLBTBSZBOHIBOZBNBNQVNFOFOUVLBO
QBEBUJOHLBUUBMBNVT MPLBMJTBTJSBOHTBOHTFDBSBLBTBSQBEBQFSNVLBBOUVCVI
4. 4FOTBTJHFMJEBOHBUBM
4JTUFN LPMVNOB EPSTBMJTMFNOJTLVT NFEJBMJT TFTVBJ EFOHBO
OBNBOZB NFOHJSJNLBO TJOZBM OBJL LF NFEVMB PUBL UFSVUBNB 5. 4FOTBTJTFLTVBM
EBMBN LPMVNOB EPSTBMJT NFEVMB TQJOBMJT -BMV TFUFMBI TJOZBM
UFSTFCVU CFSTJOBQT EBO NFOZJMBOH LF TJTJ CFSMBXBOBO EJ EBMBN
NFEVMB TJOZBM UFSTFCVU BLBO OBJL NFMBMVJ MFNOJLVT NFEJBMJT EJ Pengirirnan pada Sistem Kolumna DorsaLis—
CBUBOHPUBLNFOVKVUBMBNVT Lemniskus Medialis
4FCBMJLOZB TJOZBM EBMBN TJTUFN BOUFSPMBUFSBM TFHFSB TFUFMBI
NFNBTVLJ NFEVMB TQJOBMJT EBO SBEJLT EPSTBMJT TBSBG TQJOBM Anatomi Sistem Kolumna Dorsalis—Lemnikus Medialis
CFSTJOBQT EJ EBMBN LPSOV EPSTBMJT TVCTUBOTJB HSJTFB TVCTUBOTJ 4FXBLUVNFNBTVLJNFEVMBTQJOBMJTNFMBMVJTBSBGTQJOBMEBMBN
BCVBCV
NFEVMBTQJOBMJT MBMVNFOZJMBOHLFTJTJZBOHCFSMBXBOBO SBEJLT EPSTBMJT TFSBU TBSBG CFTBS CFSNJFMJO ZBOH CFSBTBM EBSJ
EBO OBJL NFMBMVJ TVCTUBOTJB BMCB TVCTUBOTJ QVUJI
BOUFSJPS EBO NFLBOPSFTFQUPSLIVTVTTFHFSBUFSCBHJNFOKBEJDBCBOHNFEJBM
MBUFSBM NFEVMB TQJOBMJT 4JOZBM UFSTFCVU CFSBLIJS QBEB TFMVSVI EBO DBCBOH MBUFSBM TFQFSUJ ZBOH EJQFSMJIBULBO QBEB TFSBU EBSJ
UJOHLBUCBUBOHPUBLZBOHMFCJISFOEBIEBOKVHBEJUBMBNVT UBOHBO LBOBO ZBOH NBTVL NFMBMVJ SBEJLT TQJOBMJT EBMBN
4JTUFNLPMVNOBEPSTBMJTMFNOJTLVTNFEJBMJTUFSEJSJBUBTTFSBU (BNCBS$BCBOHNFEJBMQFSUBNBLBMJCFSCFMPLLFBSBI
TFSBU TBSBG CFTBS CFSNJFMJO ZBOH NFOHJSJNLBO TJOZBM LF PUBL
EFOHBO LFDFQBUBO TBNQBJ NEFUJL TFEBOHLBO TJTUFN
BOUFSPMBUFSBM UFSEJSJ BUBT TFSBCVU TBSBG CFSNJFMJO ZBOH MFCJI LFDJM
ZBOH NFOHJSJNLBO TJOZBM EFOHBO LFDFQBUBO CFCFSBQB NFUFS QFS
EFUJLTBNQBJNEFUJL
1FSCFEBBO MBJO BOUBSB LFEVB TJTUFN JOJ BEBMBI CBIXB TFSBU
TFSBU TBSBG EBMBN TJTUFN LPMVNOB EPSTBMJTMFNOJTLVT NFEJBMJT
NFNQVOZBJ TJGBU PSJFOUBTJ TQBTJBM ZBOH TBOHBU UJOHHJ TFTVBJ
EFOHBOBTBMTFSBUTBSBGJUV TFNFOUBSBTJTUFNBOUFSPMBUFSBMNFN
QVOZBJTJGBUPSJFOUBTJTQBTJBMZBOHKBVIMFCJILFDJM1FSCFEBBOJOJ
BLBO NFNFOHBSVIJ KFOJT JOGPSNBTJ TFOTPSJL BQB ZBOH EBQBU
EJIBOUBSLBO PMFI LFEVB TJTUFN UFSTFCVU :BLOJ JOGPSNBTJ
TFOTPSJLZBOHIBSVTEJIBOUBSLBOEFOHBODFQBUEBONFNFSMVLBO
PSJFOUBTJ TQBTJBM ZBOH CBJL UFSVUBNB BLBO EJIBOUBSLBO PMFI
TJTUFN LPMVNOB EPSTBMJTMFNOJTLVT NFEJBMJT TFEBOHLBO JOGPS
NBTJ ZBOH UJEBL QFSMV EJIBOUBSLBO EFOHBO DFQBU BUBV UJEBL
NFNFSMVLBOPSJFOUBTJTQBTJBMZBOHCBJLUFSVUBNBEJLJSNLBOPMFI
TJTUFNBOUFSPMBUFSBM
4JTUFN BOUFSPMBUFSBM NFNQVOZBJ LFNBNQVBO LIVTVT ZBOH
UJEBLEJNJMJLJPMFITJTUFNEPSTBMJTLFNBNQVBOVOUVLNFOHJSJN
LBO NPEBMJUBT TFOTBTJ ZBOH TBOHBU MVBT NJTBMOZB TFOTBTJ OZFSJ
IBOHBU EJOHJO EBO UBLUJM ZBOH LBTBS TFCBHJBO EBSJ TFNVB JOJ
BLBO EJCBIBT EFOHBO MFCJI EFUBJM QBEB #BC 4JTUFN EPSTBMJT
IBOZBUFSCBUBTVOUVLTFOTBTJNFLBOPSFTFQUJGKFOJTUFSUFOUV
573
Unit IX Sistem Saraf: A. Prinsip-Prinsip Umum dan Fistologi Sensorik
NFEJBM MBMV OBJL NFMBMVJ LPMVNOB EPSTBMJT NFMBOKVULBO

QFSKBMBOBOOZBLFPUBLNFMFXBUJKBSBTLPMVNOBEPSTBMJT
$BCBOH MBUFSBM NFNBTVLJ LPSOV EPSTBMJT TVCTUBOTJB HSJTFB
NFEVMB TQJOBMJT LFNVEJBO CFSDBCBOH CBOZBL TFLBMJ VOUVL
NFNCFOUVL UFSNJOBMUFSNJOBM ZBOH BLBO CFSTJOBQT EFOHBO
OFVSPOOFVSPO MPLBM EJ EBMBN CBHJBO QFSUFOHBIBO EBO BOUF
SJPS TVCTUBOTJB HSJTFB NFEVMB TQJOBMJT /FVSPOOFVSPO MPLBM
BLBO NFMBLVLBO UJHB GVOHTJ
TFCBHJBO CFTBS NFNCFOUVL
TFSBU TBSBG ZBOH NBTVL LF LPMVNOB EPSTBMJT NFEVMB TQJOBMJT
EBO LFNVEJBO CFSKBMBO OBJL LF PUBL
#BOZBL EBSJ TFSBU
UFSTFCVU TBOHBU QFOEFL EBO CFSBLIJS TFDBSB MPLBM EJ EBMBN
LPSEB EPSTBMJT TVCTUBOTJB HSJTFB VOUVL NFOJNCVMLBO SFGMFLT
NFEVMB TQJOBMJT MPLBM ZBOH BLBO EJKFMBTLBO QBEB #BC

-BJOOZB NFNCFOUVL USBLUVT TQJOPTFSFCFMBSJT ZBOH BLBO LJUB
CJDBSBLBOQBEB#BCTFIVCVOHBOEFOHBOGVOHTJTFSFCFMVN
Jaras Kolumna Dorsalis-Lemniskus Medialis1FSIBUJLBO
QBEB (BNCBS CBIXB TFSBUTFSBU TBSBG ZBOH NFNBTVLJ
LPMVNOBEPSTBMJTOBJLNFOVKVNFEVMBEPSTBMJTUBOQBUFSQVUVT EJ
NBOBTFSBUTFSBUJOJBLBOCFSTJOBQTQBEBOVLMFJLPMVNOBEPSTBMJT
OVLMFJHSBTJMJTEBOOVLMFJLVOFBUVT
%BSJOVLMFJUFSTFCVU OFVSPO
PSEF LFEVB BLBO TFHFSB NFOZJMBOH LF TJTJ CBUBOH PUBL ZBOH
CFSMBXBOBO EBO OBJL NFMBMVJ MFNOJTLVT NFEJBMJT LF UBMBNVT
%BMBN KBSBT ZBOH NFMFXBUJ CBUBOH PUBL JOJ TFUJBQ MFNOJTLVT
NFEJBMJTCFSHBCVOHEFOHBOTFSBUTFSBUUBNCBIBOZBOHCFSBTBMEBSJ
OVLMFVTTFOTPSJLOFSWVTUSJHFNJOBMTFSBUTFSBUJOJNFNJMJLJGVOHTJ
TFOTPSJL ZBOH TBNB VOUVL EBFSBI LFQBMB TFQFSUJ GVOHTJ TFSBU
LPMVNOBEPSTBMJTVOUVLEBFSBIUVCVI
%J UBMBNVT TFSBCVU MFNOJTLVT NFEJBMJT CFSBLIJS QBEB EBFSBI
QFOZBNQBJBO SFMBZ
TFOTPSJL UBMBNVT EJLFOBM TFCBHBJ LPNQMFLT
WFOUSPCBTBM%BSJLPNQMFLTWFOUSPCBTBMJOJ TFSBUTBSBGPSEFLFUJHB
CFSQSPZFLTJ TFQFSUJ ZBOH UBNQBL QBEB (BNCBS UFSVUBNB
NFOVKV HJSVT QPTUTFOUSBMJT LPSUFLT TFSFCSJ ZBOH EJTFCVU BSFB
TPNBUPTFOTPSJL * TFQFSUJ EJUVOKVLLBO EBMBN (BNCBS TFSBU
TFSBU JOJ KVHB CFSQSPZFLTJ LF BSFB ZBOH MFCJI LFDJM QBEB LPSUFLT
QBSJFUBMMBUFSBMJTZBOHEJTFCVUBSFBTPNBUPTFOTPSJL**

Orientasi Spasial Serat Saraf pada Sistem

Kolumna Dorsalis—Lemniskus Medialis
4BMBI TBUV DJSJ LIBT TJTUFN LPMVNOB EPSTBMJTMFNOJTLVT
NFEJBMJT ZBOH NFNCFEBLBOOZB EBSJ KBSBT MBJO BEBMBI BEBOZB
PSJFOUBTJ TQBTJBM ZBOH KFMBT QBEB TFSBU TBSBG ZBOH CFSBTBM EBSJ
TFUJBQ CBHJBO UVCVI EBO PSJFOUBTJ JOJ UFUBQ EJQFSUBIBOLBO
$POUPIOZB EBMBN LPMVNOB EPSTBMJT NFEVMB TQJOBMJT TFSBU
ZBOHCFSBTBMEBSJCBHJBOCBXBIUVCVIUFSMFUBLEJCBHJBOQVTBU
NFEVMB TQJOBMJT TFEBOHLBO TFUJBQ TFSBU ZBOH NFNBTVLJ
NFEVMBTQJOBMJTQBEBTFHNFONFEVMBTQJOBMJTZBOHMFCJIUJOHHJ
BLBOEJMFUBLLBOMFCJIMBUFSBMTFDBSBQSPHSFTJG
1BEB UBMBNVT PSJFOUBTJ TQBTJBM ZBOH KFMBT NBTJI UFUBQ
EJQFSUBIBOLBO EFOHBOCBHJBOQBMJOHCBXBIUVCVIEJSFQSFTFO
UBTJLBO PMFI CBHJBO QBMJOH MBUFSBM LPNQMFLT WFOUSPCBTBM EBO
LFQBMB TFSUB XBKBI EJSFQSFTFOUBTJLBO PMFI BSFB NFEJBM LPNQ
MFLT UFSTFCVU 0MFI LBSFOB MFNOJTLVT NFEJBMJT NFOZJMBOH EJ
NFEVMBPCMPOHBUB TJTJLJSJUVCVIBLBOEJSFQSFTFOUBTJLBOEJTJTJ
LBOBOUBMBNVT EBOTJTJLBOBOUVCVIBLBOEJSFQSFTFOUBTJLBOEJ
TJTJLJSJUBMBNVT
Korteks Somatosensorik
NFNQFSMJIBULBO CBIXB EBFSBI JOJ UFSCBHJ NFOKBEJ TFLJUBS
4FCFMVNNFNCBIBTTJGBULPSUFLTTFSFCSJQBEBTFOTBTJTPNBUJL EBFSBI CFSCBUBT KFMBT ZBOH EJTFCVU BSFB #SPENBOO CFSEBTBSLBO
LJUB QFSMV NFOHFSUJ EBIVMV PSJFOUBTJ CFSCBHBJ BSFB QBEB LPS QFSCFEBBO TUSVLUVS IJTUPMPHJOZB 1FUB JOJ TBOHBU QFOUJOH LBSFOB
UFLT(BNCBSBEBMBIQFUBLPSUFLTTFSFCSJNBOVTJB ZBOH EJHVOBLBOPMFIIBNQJSTFNVBBIMJOFVSPGJTJPMPHJEBOBIMJOFVSP
574
Bab 47 Sensasi Somatik: I. Susunan Umum, Indra Taktil, dan Posisi
4JOZBM QFOHMJIBUBO CFSBLIJS EJ MPCVT PLTJQJUBMJT TFEBOHLBO

TJOZBMQFOEFOHBSBOCFSBLIJSEJMPCVTUFNQPSBMJT
4FCBMJLOZB CBHJBOLPSUFLTTFSFCSJEJTFCFMBIBOUFSJPSGJTVSB
TFOUSBMJT IJOHHB TFQBSVI CBHJBO QPTUFSJPS MPCVT GSPOUBMJT
UNIT IX
EJTFCVU LPSUFLT NPUPSJL EBO IBNQJS TFMVSVIOZB EBQBU
EJLBUBLBO CFLFSKB NFOHFOEBMJLBO LPOUSBLTJ PUPU EBO HFSBLBO
UVCVI 4FCBHJBO CFTBS QFOHFOEBMJBO NPUPSJL JOJ BEBMBI
SFTQPOT UFSIBEBQ TJOZBM TPNBUPTFOTPSJL ZBOH EJUFSJNB EBSJ
CBHJBOTFOTPSJLLPSUFLT ZBOHNFNCVBULPSUFLTNPUPSJLUFUBQ
NFOEBQBU JOGPSNBTJ TFUJBQ TBBU NFOHFOBJ QPTJTJ EBO HFSBLBO
CFSCBHBJCBHJBOUVCVIZBOHCFSCFEB
Area Somatosensorik I dan II. (BNCBS NFNQFS
MJIBULBO EVB EBFSBI TFOTPSJL UFSQJTBI EJ MPCVT QBSJFUBMJT
BOUFSJPS ZBOH EJTFCVU BSFB TPNBUPTFOTPSJL * EBO BSFB
TPNBUPTFOTPSJL ** "MBTBO VOUVL QFNCBHJBO LFEVB EBFSBI JOJ
BEBMBI EJUFNVLBOOZB PSJFOUBTJ TQBTJBM ZBOH CFSCFEB EBO
UFSQJTBI EBSJ TFUJBQ CBHJBO UVCVI QBEB LFEVB EBFSBI JOJ
#JBSQVOCFHJUV BSFBTPNBUPTFOTPSJL*KBVIMFCJIMVBTEBOKBVI
MFCJI QFOUJOH CBHJ GVOHTJ TFOTPSJL UVCVI EBSJQBEB BSFB
TPNBUPTFOTPSJL ** TFIJOHHB QBEB VNVNOZB JTUJMBI LPSUFLT
TPNBUPTFOTPSJLIBNQJSTFMBMVCFSBSUJBSFBTPNBUPTFOTPSJL*
"SFB TPNBUPTFOTPSJL * NFNJMJLJ EFSBKBU MPLBMJTBTJ ZBOH
UJOHHJ UFSIBEBQ CFSCBHBJ CBHJBO UVCVI ZBOH CFSCFEB TFQFSUJ
ZBOH EJUVOKVLLBO PMFI OBNBOBNB IBNQJS TFMVSVI CBHJBO
UVCVI QBEB (BNCBS 4FCBMJLOZB MPLBMJTBTJ UJEBL CFHJUV
CBJL QBEB EBFSBI TPNBUPTFOTPSJL ** XBMBVQVO TFDBSB LBTBS
XBKBI EJSFQSFTFOUBTJLBO EJ TFCFMBI BOUFSJPS MFOHBO EJ EBFSBI
GJTJPMPHJ EBO BIMJ OFVSPMPHJ VOUVL NFSVKVL CFSCBHBJ EBFSBI
TFOUSBM EBOUVOHLBJEJEBFSBIQPTUFSJPS
GVOHTJPOBMQBEBLPSUFLTNBOVTJBEFOHBOOPNPS
)BOZBTFEJLJUZBOHUFMBIEJLFUBIVJNFOHFOBJGVOHTJEBFSBI
1FSIBUJLBO QBEB HBNCBS UFSTFCVU UFSEBQBU EBFSBI GJTVSB TPNBUPTFOTPSJL ** 5FMBI EJLFUBIVJ CBIXB TJOZBM ZBOH NBTVL
TFOUSBMJT ZBOH CFTBS KVHB EJTFCVU TVMLVT TFOUSBMJT
ZBOH LFEBFSBIJOJCFSBTBMEBSJCBUBOHPUBL EJLJSJNLBOLFBUBTEBSJ
NFNBOKBOHTFDBSBIPSJ[POUBMEJTFQBOKBOHQFSNVLBBOPUBL1BEB LFEVB TJTJ UVCVI 4FMBJO JUV CBOZBL TJOZBM UBNCBIBO ZBOH
VNVNOZB TJOZBMTFOTPSJLEBSJTFNVBNPEBMJUBTTFOTBTJCFSBLIJS EBUBOHEBSJEBFSBITPNBUPTFOTPSJL*EBOEBFSBITFOTPSJLMBJO
QBEB LPSUFLT TFSFCSJ UFQBU EJ CBHJBO QPTUFSJPS GJTVSB TFOUSBMJT QBEB PUBL CBILBO EBSJ EBFSBI QFOHMJIBUBO EBO QFOEFOHBSBO
6NVNOZB TFQBSVI CBHJBO BOUFSJPS MPCVT QBSJFUBMJT IBNQJS 1SPZFLTJ EBSJ BSFB TPNBUPTFOTPSJL * EJCVUVILBO VOUVL GVOHTJ
TFMVSVIOZBEJLBJULBOEFOHBOQFOFSJNBBOEBOJOUFSQSFUBTJTJOZBM BSFB TPNBUPTFOTPSJL ** /BNVO QFOHBOHLBUBO CBHJBO BSFB
TPNBUPTFOTPSJL /BNVO TFQBSVI CBHJBO QPTUFSJPS MPCVT TPNBUPTFOTPSJL ** UBNQBLOZB UJEBL NFOJNCVMLBO BLJCBU
QBSJFUBMJT CFSGVOHTJ VOUVL UJOHLBU JOUFSQSFUBTJ ZBOH MFCJI UJOHHJ BQBQVO QBEB SFTQPOT OFVSPO BSFB TPNBUPTFOTPSJL * +BEJ BQB
MBHJ ZBOH LJUB LFUBIVJ UFOUBOH TFOTBTJ TPNBUJL UBNQBLOZB TVEBI
EJKFMBTLBOPMFIGVOHTJEBFSBITPNBUPTFOTPSJL*
575
Orientasi Spasial Sinyal yang Berasal dari Berbagai

Bagian Tubuh dalam Area Somatosensorik I. 1BEB
LPSUFLT TFSFCSJ NBOVTJB BSFB TPNBUPTFOTPSJL * UFSMFUBL EJ
HJSVT QPTUTFOUSBMJT QBEB BSFB #SPENBOO EBO
ZBOH
UFSMFUBLUFQBUEJCFMBLBOHTVMLVTTFOUSBMJT
(BNCBS NFNQFSMJIBULBO QPUPOHBO NFMJOUBOH PUBL
TFUJOHHJHJSVTQPTUTFOUSBMJT UBNQBLBEBOZBHBNCBSBOCBHJBO
CBHJBO UVCVI QBEB CFSNBDBNNBDBN EBFSBI BSFB TPNBUP
TFOTPSJL*/BNVOQFSIBUJLBOCBIXBTFUJBQTJTJMBUFSBMLPSUFLT
NFOFSJNB JOGPSNBTJ TFOTPSJL IBNQJS TFMVSVIOZB EBSJ TJTJ
UVCVIZBOHCFSMBXBOBO
#FCFSBQB EBFSBI UVCVI NFNQVOZBJ HBNCBSBO BSFB ZBOH
MVBTEJLPSUFLTTPNBUJLCJCJSNFNQVOZBJHBNCBSBOBSFBZBOH
QBMJOH MVBT EJJLVUJ PMFI XBKBI EBO JCV KBSJ TFEBOHLBO
QVOHHVOH EBO UVCVI CBHJBO CBXBI NFNJMJLJ HBNCBSBO BSFB
ZBOHSFMBUJGLFDJM6LVSBOEBFSBIJOJCFSCBOEJOHMVSVTEFOHBO
KVNMBI SFTFQUPS TFOTPSJL LIVTVT ZBOH UFSEBQBU QBEB BSFB
QFSJGFSUVCVIZBOHTFTVBJ$POUPIOZB QBEBCJCJSEBOJCVKBSJ
EJKVNQBJ CBOZBL TFLBMJ VKVOH TFSBU TBSBG LIVTVT TFEBOHLBO
QBEBLVMJUQVOHHVOHIBOZBTFEJLJU
1FSIBUJLBO KVHB CBIXB LFQBMB EJHBNCBSLBO QBEB CBHJBO
QBMJOHMBUFSBMBSFBTPNBUPTFOTPSJL* EBOUVCVICBHJBOCBXBI
EJHBNCBSLBOQBEBCBHJBONFEJBM
Lapisan Korteks Somatosensorik dan Fungsinya

,PSUFLT TFSFCSJ UFSEJSJ BUBT FOBN MBQJTBO OFVSPO EJNVMBJ
EFOHBOMBQJTBO*ZBOHUFSMFUBLUFQBUEJCBXBIQFSNVLBBOPUBL
EBO NFMVBT MFCJI EBMBN TBNQBJ MBQJTBO 7* TFQFSUJ ZBOH
UFSMJIBUQBEB(BNCBS4FQFSUJZBOHUFMBIEJEVHB TFUJBQ
MBQJTBO OFVSPO NFNQVOZBJ GVOHTJ ZBOH CFSCFEB TBUV TBNB MBJO

#FCFSBQBGVOHTJUFSTFCVUBEBMBITFCBHBJCFSJLVU
1. 4JOZBM NBTVLBO TFOTPSJL NVMBNVMB NFSBOHTBOH MBQJTBO

OFVSPO*7TFMBOKVUOZBTJOZBMJOJNFOZFCBSLFBSBIQFSNVLBBO
LPSUFLTEBOKVHBNFOVKVMBQJTBOZBOHMFCJIEBMBN
2. -BQJTBO*EBO**NFOFSJNBJNQVMTTJOZBMNBTVLBOZBOHCFSTJGBU
EJGVT EBO OPOTQFTJGJL EBSJ QVTBU PUBL MFCJI CBXBI ZBOH
NFNGBTJMJUBTJ EBFSBI TQFTJGJL QBEB LPSUFLT TJTUFN JOJ BLBO
EJKFMBTLBO QBEB #BC .BTVLBO JOJ UFSVUBNB NFOHBUVS
TFMVSVIUJOHLBUFLTJUBCJMJUBTEBFSBIZBOHUFSBOHTBOH
3. /FVSPOOFVSPO QBEB MBQJTBO ** EBO *** BLBO NFOHJSJNLBO
BLTPOOZB LF CBHJBO LPSUFLT TFSFCSJ ZBOH CFSIVCVOHBO EFOHBO
TJTJCFSMBXBOBOPUBLNFMBMVJLPSQVTLPMPTVN
4. /FVSPOOFVSPO QBEB MBQJTBO 7 EBO 7* NFOHJSJNLBO BLTPOOZB
LF CBHJBO TJTUFN TBSBG ZBOH MFCJI EBMBN -BQJTBO 7 NFSVQBLBO
MBQJTBOZBOHOFVSPOOZBVNVNOZBMFCJICFTBSEBOQSPZFLTJOZB
LFEBFSBIZBOHMFCJIKBVI TFQFSUJLFHBOHMJBCBTBMJT CBUBOHPUBL
EBONFEVMBTQJOBMJTZBOHNFOHBUVSUSBOTNJTJTJOZBMTJOZBM%BSJ
MBQJTBO 7* TFKVNMBI CFTBS BLTPO UFSVUBNB BLBO NFOZFCBS LF
UBMBNVT NFOHIBOUBSLBO TJOZBM EBSJ LPSUFLT TFSFCSJ ZBOH
CFSJOUFSBLTJ EFOHBO EBO NFNCBOUV NFOHBUVS UJOHLBU QFSBOH
TBOHBOTJOZBMTFOTPSJLZBOHNFNBTVLJUBMBNVT
576
Korteks Sensorik Tersusun dalam Kolumna Vertikalis 5. 4FTFPSBOH UJEBL NBNQV NFOFOUVLBO UFLTUVS TVBUV CBIBO
Neuron; Setiap Kolumna Mendeteksi Lokasi Sensorik yang TFCBC LFNBNQVBO JOJ CFSHBOUVOH LFQBEB TFOTBTJ LSJUJT
Berbeda pada Tubuh dengan Modalitas Sensorik yang UJOHLBU UJOHHJ ZBOH EJUJNCVMLBO PMFI HFSBLBO KBSJ EJ BUBT
Spesifik QFSNVLBBOZBOHBLBOEJUFOUVLBOJUV
UNIT IX
4FDBSB GVOHTJPOBM OFVSPOOFVSPO LPSUFLT TPNBUPTFOTPSJL 1FSIBUJLBOCBIXBEBMBNEBGUBSEJBUBTUJEBLEJTJOHHVOHTB
UFSTVTVO EBMBN TVBUV LPMVNOB WFSUJLBMJT ZBOH NFOFNCVT NB TFLBMJ NFOHFOBJ IJMBOHOZB OZFSJ EBO TVIV 1BEB LFBEBBO
LFFOBNMBQJTBOLPSUFLT TFUJBQLPMVNOBNFNQVOZBJEJBNFUFS TQFTJGJL EJ NBOB IBOZB BSFB TPNBUPTFOTPSJL * ZBOH IJMBOH
TBNQBJ NN EBO NFOHBOEVOH LJSBLJSB CBEBO TFM QFOFSJNBBO NPEBMJUBT TFOTPSJL UFSTFCVU UFUBQ EJQFSUBIBOLBO
OFVSPO 4FUJBQ LPMVNOB JOJ CFSFTQPOT UFSIBEBQ TBUV NPEBMJUBT CBJL QBEB LVBMJUBT EBO JOUFOTJUBTOZB /BNVO TFOTBTJ UFSTFCVU
TFOTPSJL UVOHHBM ZBOH TQFTJGJL CFCFSBQB LPMVNOB CFSFTQPOT TVLBS EJMPLBMJTBTJ NFOVOKVLLBO CBIXB MPLBMJTBTJ OZFSJ EBO
UFSIBEBQ SFTFQUPS SFHBOH EJ TFLFMJMJOH TFOEJ CFCFSBQB UFSIBEBQ TVIV TBOHBU CFSHBOUVOH QBEB TVTVOBO QFUB UPQPHSBGJ CBHJBO
SBOHTBOHBO UBLUJM ZBOH EJCFSJLBO QBEB SBNCVU ZBOH MBJOOZB CBHJBO UVCVI QBEB BSFB TPNBUPTFOTPSJL * BHBS TVNCFS
UFSIBEBQ UFLBOBO MPLBM QBEB LVMJU EBO TFCBHBJOZB 1BEB MBQJTBO SBOHTBOHBOEBQBUEJMPLBMJTBTJ
*7 UFNQBU TJOZBM NBTVLBO TFOTPSJL QFSUBNBUBNB NBTVL
LPSUFLT GVOHTJ OFVSPO EBMBN LPMVNOB IBNQJS TFMVSVIOZB Area Somatosensorik Asosiasi
UFSQJTBI TBUV TBNB MBJO 1BEB UJOHLBU LPMVNOB MBJOOZB UFSKBEJ "SFB #SPENBOO EBO QBEB LPSUFLT TFSFCSJ UFSMFUBL QBEB
JOUFSBLTJZBOHNFOHBXBMJBOBMJTJTNBLOBTJOZBMTFOTPSJL LPSUFLT QBSJFUBMJT EJ CFMBLBOH BSFB TPNBUPTFOTPSJL * MJIBU
1BEB KBSBL TBNQBJ NN EJ CBHJBO QBMJOH BOUFSJPS HJSVT (BNCBS
CFSQFSBOQFOUJOHVOUVLNFOFSKFNBILBONBLOB
QPTUTFOUSBMJT UFSMFUBLEJCBHJBOEBMBNTVMLVTTFOUSBMJTQBEBBSFB MFCJI EBMBN JOGPSNBTJ TFOTPSJL ZBOH UFSEBQBU QBEB BSFB
B #SPENBOO TFCBHJBO CFTBS OFVSPO QBEB LPMVNOB WFSUJLBMJT TPNBUPTFOTPSJL 0MFI LBSFOB JUV EBFSBI JOJ EJTFCVU BSFB
TBOHBU MVBT ZBOH CFSFTQPOT UFSIBEBQ SFTFQUPS SFHBOH EJ PUPU TPNBUPTFOTPSJLBTPTJBTJ
UFOEPO EBO TFOEJ #BOZBL TJOZBM ZBOH CFSBTBM EBSJ LPMVNOB 3BOHTBOHBOMJTUSJLQBEBBSFBTPNBUPTFOTPSJLBTPTJBTJLBEBOH
TFOTPSJLJOJLFNVEJBONFOZFCBSLFBOUFSJPS MBOHTVOHLFLPSUFLT LBMB EBQBU NFOZFCBCLBO TFTFPSBOH ZBOH UFSKBHB NFOHBMBNJ
NPUPSJL ZBOH UFSMFUBL UFQBU EJ EFQBO TVMLVT TFOUSBMJT 4JOZBM JOJ TFOTBTJ UVCVI ZBOH LPNQMFLT ZBOH LBEBOH LBMB CBILBO EBQBU
CFSQFSBO QFOUJOH EBMBN NFOHBUVS BMJSBO TJOZBM NPUPSJL ZBOH NFSBTBLBOTVBUVCFOEBNJTBMOZBQJTBVBUBVCPMB0MFILBSFOB
NFOHBLUJGLBOTFSBOHLBJBOLPOUSBLTJPUPU JUV UBNQBLOZB NFNBOH KFMBT CBIXB BSFB TPNBUPTFOTPSJL
#JMBLJUBCFSHFSBLLFBSBIQPTUFSJPSQBEBBSFBTPNBUPTFOTPSJL BTPTJBTJ JOJ EBQBU NFOHHBCVOHLBO JOGPSNBTJJOGPSNBTJ ZBOH
* NBLBUFSEBQBUMFCJICBOZBLLPMVNOBWFSUJLBMJTZBOHCFSFTQPOT EBUBOH EBSJ CBOZBL UJUJL QBEB BSFB TPNBUPTFOTPSJL QSJNFS
UFSIBEBQSFTFQUPSLVMJUCFSBEBQUBTJMBNCBU EBOMFCJILFQPTUFSJPS TFIJOHHB BLIJNZB NBLOB JOGPSNBTJ JUV EBQBU EJUFSKFNBILBO
MBHJEBQBULJUBKVNQBJCBOZBLTFLBMJLPMVNOBZBOHQFLBUFSIBEBQ ,FBEBBOJOJKVHBTFTVBJEFOHBOTVTVOBOBOBUPNJUSBLUVTOFVSPO
SBTBUFLBOEBMBN ZBOH NFNBTVLJ BSFB TPNBUPTFOTPSJL BTPTJBTJ LBSFOB BSFB JOJ
NFOFSJNB TJOZBMTJOZBM ZBOH CFSBTBM EBSJ
BSFB TPNBUP
%J CBHJBO ZBOH QBMJOH QPTUFSJPS BSFB TPNBUPTFOTPSJL * TFOTPSJL*
OVLMFJWFOUSPCBTBMUBMBNVT
EBFSBIMBJOEBMBN
UFSEBQBU LJSBLJSB QFSTFO LPMVNOB WFSUJLBMJT ZBOH IBOZB UBMBNVT
LPSUFLTWJTVBM EBO
LPSUFLTBVEJUPSJL
CFSFTQPOT CJMB EJCFSJLBO SBOHTBOHBO ZBOH EJHFSBLLBO EJ
TFQBOKBOHLVMJUEFOHBOBSBIUFSUFOUV+BEJ TFCFOBSOZBJOJNBTJI Efek Pengangkatan Area Somatosensorik Asosiasi-
NFSVQBLBOUJOHLBUJOUFSQSFUBTJTJOZBMTFOTPSJLZBOHMFCJIUJOHHJ Amorfosintesis. #JMB BSFB BTPTJBTJ TPNBUPTFOTPSJL EJBOHLBU
QSPTFTOZB NFOKBEJ MFCJI LPNQMFLT LBSFOB TJOZBM LFNVEJBO QBEB TBMBI TBUV TJTJ PUBL TFTFPSBOH BLBO LFIJMBOHBO
NFOZFCBSMFCJIKBVILFBSBIQPTUFSJPSEBSJBSFBTPNBUPTFOTPSJL* LFNBNQVBO VOUVL NFOHFOBMJ PCKFL LPNQMFLT EBO CFOUVL
LF LPSUFLT QBSJFUBM TVBUV EBFSBI ZBOH EJTFCVU BSFB TPNBUP LPNQMFLT ZBOH EJSBTBLBO QBEB TJTJ UVCVI ZBOH CFSMBXBOBO
TFOTPSJLBTPTJBTJ ZBOHBLBOEJCJDBSBLBOTFMBOKVUOZB 4FMBJO JUV TFTFPSBOH BLBO LFIJMBOHBO TFCBHJBO CFTBS TFOTBTJ
Fungsi Area Somatosensorik I NFOHFOBJ CFOUVL UVCVI BUBV CBHJBO UVCVIOZB QBEB TJTJ ZBOH
CFSMBXBOBO #BILBO JB CJBTBOZB UJEBL TBEBS UFOUBOH TJTJ
1FNPUPOHBO CJMBUFSBM ZBOH NFMVBT QBEB BSFB TPNBUPTFOTPSJL *
UVCVIOZB ZBOH CFSMBXBOBO KBEJ JB MVQB CBIXB BEB TJTJ UVCVI
NFOZFCBCLBOIJMBOHOZBKFOJTQFOJMBJBOTFOTPSJLCFSJLVU
ZBOH MBJOOZB 0MFI LBSFOB JUV JB TFSJOH LBMJ MVQB VOUVL
1. 4FTFPSBOH UJEBL EBQBU NFOFOUVLBO MPLBTJ CFSCBHBJ KFOJT NFOHHVOBLBO TJTJ UVCVIOZB ZBOH CFSMBXBOBO UFSTFCVU VOUVL
TFOTBTJ ZBOH UJNCVM EJ CFSCBHBJ CBHJBO UVCVI /BNVO GVOHTJNPUPSJL%FOHBOEFNJLJBO CJMBNFSBTBLBOTVBUVPCKFL
TFTFPSBOH EBQBU NFOFOUVLBO MPLBTJ TFOTBTJ JOJ TFDBSB LBTBS JB BLBO DFOEFSVOH NFOHFOBMJ IBOZB TBUV TJTJ PCKFL EBO
NJTBMOZBQBEBTBMBITBUVUBOHBO CBHJBOVUBNBUVCVI BUBVLF NFMVQBLBO LFCFSBEBBO TJTJ MBJOOZB %FGJTJU TFOTPSJL ZBOH
TBMBITBUVUVOHLBJ+BEJ KFMBTCBIXBCBUBOHPUBL UBMBNVT BUBV LPNQMFLTJOJEJTFCVUTFCBHBJBNPSGPTJOUFTJT
CBHJBOLPSUFLTTFSFCSJMBJOZBOHCJBTBOZBTFDBSBOPSNBMUJEBL Sifat-Sifat Pengiriman dan Analisis Sinyal dalam Sistem
CFSGVOHTJVOUVLNFOFSJNBTFOTBTJTPNBUJLEBQBUNFMBLTBOB
Kolumna Dorsalis—Lemnikus Medialis
LBOGVOHTJMPLBMJTBTJTBNQBJUJOHLBUBOUFSUFOUV
2. 4FTFPSBOHUJEBLEBQBUNFOFOUVLBOCFSBQBCFTBSUFLBOBOZBOH Sirkuit Neuronal Dasar dalam Sistem Kolumna Dorsalis—
EJCFSJLBOQBEBUVCVI emnikus Medialis. #BHJBO CBXBI (BNCBS NFOKFMBTLBO
TVTVOBO EBTBS TJSLVJU OFVSPOBM EBMBN KBSBT LPMVNOB EPSTBMJT
3. 4FTFPSBOHUJEBLEBQBUNFOFOUVLBOCFSBQBCFSBUTVBUVPCKFL NFEVMB TQJOBMJT UBNQBL QBEB TFUJBQ TJOBQT UFSKBEJ EJWFSHFOTJ
4. 4FTFPSBOH UJEBL NBNQV NFOFOUVLBO CFOUVL TVBUV PCKFL ,VSWB UFSBUBT QBEB HBNCBS NFOVOKVLLBO CBIXB OFVSPO
,FBEBBOJOJEJTFCVUBTUFSFPHOPTJT LPSUJLBMZBOHQBMJOHCBOZBLNFOHFMVBSLBOJNQVMTUFSMFUBLEJ
577
UPTFOTPSJL ZBOH TBOHBU EJQFSCFTBS

ZBOH UFSBOHTBOH EBSJ LFEVB
UJUJL UBEJ ,VSWB BCVBCV NFOHHBNCBSLBO QPMB TQBTJBM EBMBN
LPSUFLT ZBOH NFOEBQBU SBOHTBOHBO CJMB BEB EVB UJUJL ZBOH
EJSBOHTBOH TFDBSB CFSTBNBBO 1FSIBUJLBO CBIXB UFSOZBUB EBFSBI
IBTJM ZBOH UFSBOHTBOH NFNQVOZBJ EVB QVODBL ZBOH UFSQJTBI
,FEVB QVODBL JOJ EJQJTBILBO PMFI TFCVBI HBNCBSBO MFNCBI
TFIJOHHB NFNQFSNVEBI LPSUFLT TFOTPSJL VOUVL NFOHFUBIVJ
CBHJBO QVTBU MBQBOHBO LPSUJLBM CBHJ SFTFQUPS ZBOH TFTVBJ BEBOZBEVBUJUJLZBOHNFOEBQBUSBOHTBOHBOLFUJNCBOHTBUVUJUJL
+BEJ SBOHTBOHBOZBOHMFNBIIBOZBBLBONFSBOHTBOHOFVSPO ,FNBNQVBOJOESBVOUVLNFNCFEBLBOLFCFSBEBBOEVBUJUJLZBOH
OFVSPO EJ CBHJBO QBMJOH UFOHBI TBKB 3BOHTBOHBO ZBOH MFCJI NFOEBQBU SBOHTBOHBO TBOHBU EJQFOHBSVIJ PMFI NFLBOJTNF MBJO
LVBU BLBO NFSBOHTBOH MFCJI CBOZBL OFVSPO OBNVO OFVSPO ZBLOJ NFLBOJTNF JOIJCJTJ MBUFSBM TFQFSUJ ZBOH BLBO EJKFMBTLBO
ZBOH MFUBLOZB EJ UFOHBI NFOHFMVBSLBO JNQVMT EFOHBO QBEBCBHJBOCFSJLVU
LFDFQBUBO ZBOH MFCJI UJOHHJ EBSJQBEB OFVSPO ZBOH MFCJI KBVI Efek Inhibisi Lateral (Disebut juga Inhibisi Sekeliling)
EBSJQVTBU untuk Meningkatkan Derajat Kontras pada Pola Spasial
%JTLSJNJOBTJ %VB 5JUJL .FUPEF ZBOH TFSJOH EJHVOBLBO yang Dirasakan. 4FQFSUJ ZBOH EJKFMBTLBO QBEB #BC IBNQJS
VOUVL NFOHVKJ EJTLSJNJOBTJ UBLUJM TFTFPSBOH BEBMBI EFOHBO TFUJBQ KBSBT TFOTPSJL CJMB EJSBOHTBOH TFDBSB TJNVMUBO BLBO
NFOHVKJLFNBNQVBONFNCFEBLBOEVBUJUJLOZB1BEBUFTJOJ NFOHIBTJMLBO TJOZBM JOIJCJUPSJL MBUFSBM TJOZBM JOJ NFOZFCBS LF
EJMBLVLBO QFOFLBOBO SJOHBO EFOHBO EVB KBSVN EJ LVMJU QBEB TJTJTJTJ TJOZBM FLTJUBUPSJL EBO NFOHIBNCBU OFVSPO ZBOH
TBBU CFSTBNBBO EBO PSBOH QFSDPCBBO EJNJOUB VOUVL CFSEFLBUBO 4FCBHBJ DPOUPI JOHBUMBI OFVSPO ZBOH EJSBOHTBOH EJ
NFOFOUVLBO BQBLBI LFEVB UJUJL UFNQBU QFSBOHTBOHBO UFSBTB OVLMFVT LPMVNOB EPSTBMJT 4FMBJO EBSJ QVTBU TJOZBM FLTJUBUPSJL
TFCBHBJ EVB UJUJL BUBV UFSBTB TFCBHBJ TBUV UJUJL TBKB 1BEB KBSBT MBUFSBM QFOEFL KVHB NFOHJSJNLBO TJOZBM JOIJCJUPSJL LF
LFBEBBOOPSNBM VKVOHKBSJTFTFPSBOHEBQBUNFNCFEBLBOEVB OFVSPO EJ TFLJUBSOZB +BEJ TJOZBM JOJ MFXBU NFMBMVJ JOUFSOFVSPO
UJUJL ZBOH UFSQJTBI XBMBVQVO KBSBL LFEVB KBSVN TFCFHJUV UBNCBIBOZBOHNFOZFLSFTJUSBOTNJUFSJOIJCJUPSJL
EFLBUOZB ZBLOJIBOZBTBNQBJNJMJNFUFSTBKB/BNVO CJMB 1FOUJOHOZB JOIJCJTJ MBUFSBM BEBMBI CBIXB JOIJCJTJ JOJ NFOH
LFEVB KBSVN JUV EJUFLBOLBO QBEB QVOHHVOH TFTFPSBOH VOUVL IBNCBU QFOZFCBSBO TJOZBM FLTJUBUPSJL LF BSBI MBUFSBM TFIJOHHB
EBQBU EJSBTBLBO TFCBHBJ EVB KBSVN ZBOH UFSQJTBI CJBTBOZB NFOJOHLBULBOEFSBKBULPOUSBTEBMBNQPMBTFOTPSJLZBOHEJSBTBLBO
KBSBLLFEVBKBSVNJUVIBSVTMFCJIKBVIZBLOJBOUBSBTBNQBJ EJLPSUFLTTFSFCSJ
NN"MBTBOVOUVLIBMJOJBEBMBIQFSCFEBBOKVNMBISFTFQUPS 1BEBTJTUFNLPMVNOBEPSTBMJT TJOZBMJOIJCJTJMBUFSBMJOJUJNCVM
UBLUJMQBEBLFEVBEBFSBIUFSTFCVU EJ TFUJBQ UJOHLBU TJOBQT DPOUPIOZB EBMBN
OVLMFJ LPMVNOB
(BNCBS NFOKFMBTLBO NFLBOJTNF ZBOH EJQBLBJ PMFI EPSTBMJTNFEVMBPCMPOHBUB
OVLMFJWFOUSPCBTBMUBMBNVT EBO

KBSBT LPMVNOB EPSTBMJT EBO KBSBT TFOTPSJL MBJOOZB
EBMBN LPSUFLT JUV TFOEJSJ 1BEB TFUJBQ UJOHLBUBO JOJ JOIJCJTJ MBUFSBM
NFOHJSJNLBO JOGPSNBTJ EJTLSJNJOBTJ EVB UJUJL (BNCBS JOJ NFNCBOUV NFNCMPL QFOZFCBSBO TJOZBM FLTJUBTJ LF BSBI MBUFSBM
NFOKFMBTLBO BEBOZB EVB UJUJL ZBOH CFSEFLBUBO EJ LVMJU EBO "LJCBUOZB QVODBL FLTJUBTJ BLBO NFOPOKPM EBO TFCBHJBO CFTBS
CFSTBNBTBNBEJSBOHTBOHEFOHBOLVBU EBOBSFBLPSUFLTTPNB SBOHTBOHBOEJGVTEJTFLFMJMJOHOZBEJIBNCBU1FOHBSVIJOJEJHBN
578
Bab 47 Sensasi Somatik I. Susunan Umum, Indra Taktil, dan Posisi
CBSLBO PMFI EVB LVSWB IJUBN QBEB (BNCBS ZBOH UBNCBI FGFL MBOHTVOH JOUFOTJUBT SBOHTBOHBO UFSIBEBQ LFDFQBUBO
NFNQFSMJIBULBO QFNJTBIBO QVODBL TFQFOVIOZB CJMB JOUFOTJUBT JNQVMTEBMBNTFUJBQTFSBUTBSBGTFSUBCFCFSBQBNFLBOJTNFMBJOOZB
JOIJCJTJMBUFSBMTBOHBUCFTBS NFNCVBUCFCFSBQBTJTUFNTFOTPSJLEBQBUCFLFSKBEFOHBOCBJLQBEB
LFBEBBOQFSVCBIBOUJOHLBUJOUFOTJUBTSBOHTBOHBOTFCBOZBLKVUBBO
LBMJ
UNIT IX
Pengiriman Sensasi yang Cepat Berubah dan Berulang-
Ulang. 4JTUFN LPMVNOB EPSTBMJT KVHB CFSQFSBO QFOUJOH EBMBN Pentingnya Rentang Intensitas yang Besar pada Penerimaan
NFNCFSJUBIV TJTUFN JOESB UFOUBOH LPOEJTJ QFSJGFS ZBOH DFQBU Sensorik. ,BMBV CVLBO LBSFOB SFOUBOH JOUFOTJUBT QFOFSJNBBO
CFSVCBI #FSEBTBSLBO QPUFOTJBM BLTJ ZBOH UFSDBUBU TJTUFN JOJ TFOTPSJLZBOHTBOHBUMVBTZBOHEBQBULJUBSBTBLBO CFSCBHBJTJTUFN
EBQBUNFOHFOBMJQFSVCBIBOTUJNVMJZBOHUFSKBEJTBNQBJTFTJOHLBU TFOTPSJLBLBOMFCJITFSJOHCFLFSKBQBEBSFOUBOHZBOHTBMBI)BMJOJ
EFUJL EJQFSMJIBULBO PMFI VTBIB TFCBHJBO CFTBS PSBOH LFUJLB NFOHBNCJM
GPUP EFOHBO LBNFSB VOUVL NFOHBUVS QBKBOBO DBIBZB UBOQB
NFOHHVOBLBO BMBU VLVS DBIBZB 0MFI LBSFOB UJEBL NFNJMJLJ
Sensasi Getaran. 4JOZBM HFUBSBO UJNCVM TFDBSB DFQBU EBO
LFNBNQVBO VOUVL NFOJMBJ JOUFOTJUBT DBIBZB TFTFPSBOH IBNQJS
CFSVMBOHVMBOHTFSUBEBQBUEJEFUFLTJTFCBHBJTVBUVHFUBSBOTBNQBJ TFMBMV NFOHIBTJMLBO GJMN ZBOH UFSMBMV UFSBOH PWFSFYQPTVSF
QBEB
HFUBSBOQFSEFUJL4JOZBMHFUBSBOEFOHBOGSFLVFOTJZBOHMFCJI TJBOH IBSJ EBO NFOHIBTJMLBO GJMN ZBOH UFSMBMV HFMBQ VOEFSFY
UJOHHJ CFSBTBM EBSJ CBEBO QBDJOJ QBEB LVMJU EBO KBSJOHBO EBMBN QPTVSF
QBEB TBBU TFOKB 5FSOZBUB NBUB TFTFPSBOH NBNQV
OBNVOTJOZBMEFOHBOGSFLVFOTJSFOEBI TFLJUBSEJCBXBIQFS NFNCFEBLBOPCKFLQFOHMJIBUBOEFOHBOTBOHBUEFUBJMQBEBDBIBZB
EFUJL
EBQBU CFSBTBM EBSJ CBEBO .FJTTOFS 4JOZBM JOJ IBOZB NBUBIBSJ UFSBOH EBO QBEB DBIBZB SFNBOHSFNBOH TFEBOHLBO
EJLJSNLBO NFMBMVJ KBSBT LPMVNOB EPSTBMJT %FOHBO BMBTBO JOJ LBNFSB UJEBL EBQBU NFMBLVLBO IBM JOJ UBOQB NBOJQVMBTJ ZBOH
QFNCFSJBO SBOHTBOHBO HFUBSBO DPOUPIOZB EFOHBO TFCVBI TBOHBU LIVTVT LBSFOB SFOUBOH LSJUJT JOUFOTJUBT DBIBZBOZB ZBOH
HBSQV UBMB
QBEB CFSNBDBNNBDBN CBHJBO UVCVI QFSJGFS EJQFSMVLBOVOUVLQFNBKBOBOGJMNZBOHTFTVBJ TBOHBUTFNQJU
NFSVQBLBO BMBU CBOUV QFOUJOH ZBOH EJHVOBLBO PMFI QBSB
OFVSPMPHVOUVLNFOHVKJJOUFHSJUBTGVOHTJPOBMLPMVNOBEPSTBMJT Penilaian Intensitas Rangsangan
Prinsip Weber-Fechner—Deteksi "Rasio" Kekuatan Rangsang-
Interpretasi mengenai Intensitas Rangsangan Sensoris an. 1BEB QFSUFOHBIBO BCBE BO NVMBNVMB 8FCFS EBO
LFNVEJBO 'FDIOFS NFOHBKVLBO QSJOTJQ CBIXB HSBEBTJ LFLVBUBO
5VKVBO BLIJS TFCBHJBO CFTBS SBOHTBOHBO TFOTPSJL BEBMBI VOUVL SBOHTBOHBOEJCFEBLBOTFDBSBQSPQPSTJPOBMEBMBNCFOUVLMPHBSJUNB
NFNCFSJUBIV LJUB UFOUBOH LFBEBBO UVCVI EBO TFLJUBSOZB 0MFI LFLVBUBO SBOHTBOHBO :BJUV TFTFPSBOH ZBOH TVEBI NFNFHBOH
LBSFOBJUV QFOUJOHCBHJLJUBVOUVLNFNCBIBTTFDBSBSJOHLBTUFOUBOH CFCBOHSBNEJUBOHBOOZBIBNQJSUJEBLEBQBUNFOZBEBSJBEBOZB
CFCFSBQB QSJOTJQ ZBOH CFSLBJUBO EFOHBO QFOHJSJNBO JOUFOTJUBT LFOBJLBO CFSBU TFCBOZBL HSBN %BO LFUJLB TVEBI NFNFHBOH
SBOHTBOHBOTFOTPSJLLFUJOHLBUZBOHMFCJIUJOHHJQBEBTJTUFNTBSBG CFCBO TFCFSBU HSBN PSBOH UFSTFCVU IBNQJS UJEBL EBQBU
4BMBI TBUV QFSUBOZBBO ZBOH NVODVM EJ CFOBL LJUB BEBMBI NFOZBEBSJBEBOZBLFOBJLBOHSBN+BEJ QBEBLFBEBBOJOJ SBTJP
CBHBJNBOBNVOHLJOTJTUFNTFOTPSJLEBQBUNFOHJSJNLBOQFOHBMBNBO QFSVCBIBOLFLVBUBOSBOHTBOHBOZBOHEJQFSMVLBOVOUVLNFOZBEBSJ
TFOTPSJLEFOHBOCFSCBHBJJOUFOTJUBTZBOHTBOHBUMVBT 4FCBHBJDPOUPI QFSVCBIBO JUV NBTJI UFUBQ LPOTUBO TFLJUBS CFSCBOEJOH ZBOH
TJTUFN BVEJUPSJL EBQBU NFOHFOBMJ CJTJLBO ZBOH QBMJOH MFNBI UFUBQJ NFSVQBLBO QSJOTJQ MPHBSJUNBOZB 6OUVL NFNQFSMJIBULBO IBM JOJ
EBQBU KVHB NFOBOHLBQ EFOHBO KFMBT BSUJ TVBSB MFEBLBO CBILBO TFDBSBNBUFNBUJT
NFTLJQVO JOUFOTJUBT TVBSB LFEVB QFOHBMBNBO JOJ EBQBU CFSWBSJBTJ Kekuatan sinyal yang diinterpretasikan =
TBNQBJMFCJIEBSJNJMJBSLBMJNBUBEBQBUNFMJIBUCBZBOHBOWJTVBM Log (Rangsangan) + Konstanta
EFOHBO JOUFOTJUBT DBIBZB ZBOH WBSJBTJOZB TBNQBJ TFUFOHBI KVUB LBMJ
EBOLVMJUEBQBUNFOHFOBMJQFSCFEBBOUFLBOBOTBNQBJ "LIJSBLIJSJOJ UFMBIEJCVLUJLBOCBIXBQSJOTJQ8FCFS'FDIOFS
LBMJ TFDBSB LVBOUJUBUJG IBOZB BLVSBU VOUVL JOUFOTJUBT QFOHMJIBUBO
QFOEFOHBSBO EBOQFOHBMBNBOTFOTPSJLLVUBOFVTZBOHMFCJIUJOHHJ
4FCBHJBOQFOKFMBTBOEBSJFGFLFGFLJOJEJQFSMJIBULBOPMFI(BNCBS EBOQFOFSBQBOOZBUJEBLCFHJUVCBJLQBEBLFCBOZBLBOQFOHBMBNBO
QBEBCBCTFCFMVNOZBZBOHNFNQFSMJIBULBOIVCVOHBOQPUFOTJBM TFOTPSJL KFOJT MBJO #JBSQVO CFHJUV QSJOTJQ 8FCFS'FDIOFS NBTJI
SFTFQUPS ZBOH EJIBTJMLBO PMFI CBEBO QBDJOJ EFOHBO JOUFOTJUBT QSJOTJQZBOHQBMJOHCBJLVOUVLEJJOHBULBSFOBIBMJOJNFNQFSLVBU
SBOHTBOHBO TFOTPSJL 1BEB JOUFOTJUBT SBOHTBOHBO ZBOH MFNBI UFPSJ CBIXB TFNBLJO CFTBS JOUFOTJUBT TFOTPSJL ZBOH EJUFSJNB
QFSVCBIBOJOUFOTJUBTZBOHLFDJMNFOJOHLBULBOQPUFOTJBMTFDBSBOZBUB TFNBLJO CFTBS QVMB QFSVCBIBO UBNCBIBO SBOHTBOHBO ZBOH
TFEBOHLBO QBEB JOUFOTJUBT SBOHTBOHBO ZBOH LVBU QFOJOHLBUBO EJQFSMVLBOBHBSLJUBEBQBUNFOEFUFLTJQFSVCBIBOUFSTFCVU
QPUFOTJBM SFTFQUPS TFMBOKVUOZB IBOZB TFEJLJU +BEJ CBEBO QBDJOJ
NBNQV NFOJMBJ TFDBSB BLVSBU QFSVCBIBOQFSVCBIBO SBOHTBOHBO Hukum Kekuatan.1FSDPCBBOMBJOZBOHEJMBLVLBOPMFIQBSBBIMJ
ZBOHTBOHBULFDJMQBEBJOUFOTJUBTSFOEBI UFUBQJQBEBJOUFOTJUBTUJOHHJ GJTJPMPHJVOUVLNFOFNVLBOIVCVOHBONBUFNBUJTZBOHCBJLBEBMBI
QFSVCBIBO SBOHTBOHBO IBSVT KBVI MFCJI CFTBS VOUVL NFOHIBTJMLBO EFOHBOSVNVTCFSJLVU EJLFOBMTFCBHBJIVLVNLFLVBUBO
KVNMBIQFSVCBIBOZBOHTBNBQBEBQPUFOTJBMSFTFQUPS Kekuatan sinyal yang diinterpretasikan =
.FLBOJTNF USBOTEVLTJ VOUVL NFOEFUFLTJ CVOZJ NFMBMVJ LPLMFB K x (Rangsangan – k)y
UFMJOHB NFNQFSMJIBULBO BEBOZB NFUPEF MBJO VOUVL NFNJTBILBO
1BEB SVNVT JOJ FLTQPOFO Z EBO LPOTUBOUB , EBO L CFSCFEB
HSBEBTJJOUFOTJUBTSBOHTBOHBO,FUJLBCVOZJNFSBOHTBOHTFCVBIUJUJL
VOUVLTFUJBQKFOJTTFOTBTJ
TQFTJGJL EJ NFNCSBO CBTJMBS CVOZJ ZBOH MFNBI IBOZB NFSBOHTBOH
TFMTFM SBNCVU QBEB UJUJL HFUBSBO TVBSB NBLTJNVN 5FUBQJ TFJSJOH #JMBIVCVOHBOIVLVNLFLVBUBOJOJEJUFSBQLBOQBEBHSBGJLZBOH
EFOHBO QFOJOHLBUBO JOUFOTJUBTOZB MFCJI CBOZBL TFMTFM SBNCVU MBJO NFOHHVOBLBO LPPSEJOBU MPHBSJUNB HBOEB TFQFSUJ ZBOH EJUVOKVL
EBMBN TFUJBQ BSBI ZBOH UFSMFUBL MFCJI KBVI EBSJ UJUJL NBLTJNVN LBO QBEB (BNCBS EBO CJMB OJMBJ LVBOUJUBUJG ZBOH TFTVBJ
HFUBSBO NFOKBEJ UFSBOHTBOH +BEJ QFOHIBOUBSBO TJOZBMTJOZBM VOUVL LPOTUBOUB Z , EBO L UFMBI EJUFNVLBO EBQBU EJQFSPMFI
EJIBOUBSLBO NFMBMVJ TFSBU TBSBG ZBOH KVNMBIOZB NFOJOHLBU TFDBSB IVCVOHBO MJOFBS BOUBSB LFLVBUBO SBOHTBOHBO ZBOH EJJOUFSQSFUBTJ
QSPHSFTJGZBOHNFSVQBLBOCFOUVLNFLBOJTNFMBJOVOUVLNFOHJSJN LBO EFOHBO LFLVBUBO SBOHTBOHBO TFCFOBSOZB IJOHHB NFODBQBJ
LBOJOUFOTJUBTSBOHTBOHBOLFTJTUFNTBSBGQVTBU.FLBOJTNFJOJ EJ SFOUBOHZBOHMVBTVOUVLIBNQJSTFNVBKFOJTQFSTFQTJTFOTPSJL
579
Indra Posisi
CBIXB JOJ BEBMBI SFTFQUPS ZBOH QBMJOH CFSUBOHHVOH KBXBC VOUVL
*OESB QPTJTJ TFSJOH LBMJ EJTFCVU KVHB JOESB QSPQSJPTFQUJG *OESB
NFOEFUFLTJLFDFQBUBOQFSHFSBLBO
JOJEBQBUEJCBHJEBMBNEVBTVCUJQF
JOESBQPTJTJTUBUJT ZBOH
CFSBSUJ QFSTFQTJ TBEBS PSJFOUBTJ CBHJBOCBHJBO UVCVI BOUBSB
TBUV EFOHBO MBJOOZB EBO
JOESB LFDFQBUBO HFSBLBO ZBOH Pengolahan Informasi Indra Posisi dalam Jaras Kolumna
KVHBEJTFCVULJOFTUFTJBBUBVQSPQSJPTFQTJEJOBNJL Dorsalis Lemnikus Medialis. 4FQFSUJ ZBOH UBNQBL QBEB
(BNCBS EJQFSMJIBULBOCBIXBUFSEBQBUEVBLBUFHPSJOFVSPO
Reseptor Indra Posisi. 1FOHFUBIVBO NFOHFOBJ QPTJTJ UBMBNVT ZBOH CFSFTQPOT UFSIBEBQ SPUBTJ TFOEJ
OFVSPO ZBOH
CBJL ZBOH TUBUJL NBVQVO ZBOH EJOBNJL CFSHBOUVOH QBEB UFSBOHTBOHTFDBSBNBLTJNBMCJMBTFOEJEJQVUBSEFOHBOTFNQVSOB
QFOHFUBIVBONFOHFOBJEFSBKBUTVEVUTFNVBTFOEJQBEBTFNVB EBO
OFVSPO ZBOH UFSBOHTBOH TFDBSB NBLTJNBM CJMB TFOEJ
CJEBOHEBOLFDFQBUBOQFSVCBIBOOZB0MFILBSFOBJUV CFSCBHBJ EJQVUBS NJOJNBM +BEJ TJOZBMTJOZBM ZBOH CFSBTBM EBSJ TFUJBQ
KFOJT SFTFQUPS NFNCBOUV NFOFOUVLBO TVEVU TFOEJ EBO SFTFQUPS TFOEJ EJHVOBLBO VOUVL NFNCFSJUBIV LFTBEBSBO LJUB
EJHVOBLBO CFSTBNBTBNB VOUVL JOESB QPTJTJ 3FTFQUPS UBLUJM TFCFSBQBCBOZBLTFUJBQQFSTFOEJBONFOHBMBNJSPUBTJ
LVMJUEBOSFTFQUPSEBMBNEJTFLJUBSTFOEJEJHVOBLBOQVMB1BEB
KBSJKBSJ ZBOH NFNJMJLJ SFTFQUPS LVMJU TBOHBU CBOZBL IJOHHB Pengiriman Sinyal Sensorik Kurang Penting dalam
TFUFOHBI QFOHFOBMBO QPTJTJ EJEVHB EJMBLVLBO PMFI SFTFQUPS Jaras Anterolateral
LVMJU 4FCBMJLOZB QBEB TFCBHBO CFTBS TFOEJ CFTBS SFTFQUPS
EBMBNMFCJIQFOUJOH +BSBTBOUFSPMBUFSBMVOUVLNFOHJSJNLBOTJOZBMTFOTPSJLZBOHOBJL
6OUVL NFOFOUVLBO TVEVU TFOEJ QBEB SFOUBOH HFSBLBO QBEB NFEVMB TQJOBMJT EBO LF PUBL CFSMBXBOBO EFOHBO KBSBT
TFEBOH SFTFQUPS ZBOH QBMJOH QFOUJOH BEBMBI HFMPOEPOH PUPU LPMVNOB EPSTBMJT NFOHJSJNLBO TJOZBM TFOTPSJL ZBOH UJEBL
(FMPOEPOH PUPU KVHB TBOHBU QFOUJOH EBMBN NFNCBOUV NFNFSMVLBOQFNJTBIBOMPLBMJTBTJTVNCFSTJOZBMTFDBSBEFUBJMEBO
NFOHFOEBMJLBOHFSBLBOPUPU TFQFSUJZBOHBLBOLJUBMJIBUQBEB UJEBLNFNFSMVLBOQFNCFEBBOHSBEBTJJOUFOTJUBTZBOHLFDJM+FOJT
#BC #JMB TVEVU TFOEJ CFSVCBI CFCFSBQB PUPU NFOKBEJ TJOZBMZBOHEJLJSNLBOJOJBOUBSBMBJOBEBMBIOZFSJ QBOBT EJOHJO
UFSFHBOH TFNFOUBSB ZBOH MBJO NFOHFOEVS EBO JOGPSNBTJ UBLUJMLBTBS HFMJ HBUBM TFSUBTFOTBTJTFLTVBM1BEB#BC TFOTBTJ
SFHBOHBOOFUPEBSJHFMPOEPOHEJLJSJNLBOLFTJTUFNLPNQVUB OZFSJEBOTVIVEJCBIBTTFDBSBLIVTVT
TJPOBM NFEVMB TQJOBMJT EBO EBFSBI ZBOH MFCJI UJOHHJ QBEB
TJTUFNLPMVNOBEPSTBMJTVOUVLNFOFSKFNBILBOTVEVUTFOEJ Anatomi Jaras Anterolateral
1BEBQFNCFOHLPLBOTFOEJZBOHFLTUSFN SFHBOHBOMJHBNFO 4FSBUTFSBUBOUFSPMBUFSBMNFEVMBTQJOBMJTUFSVUBNBCFSBTBMEBSJLPSOV
EBO KBSJOHBO EBMBN EJ TFLJUBS TFOEJ BEBMBI GBLUPS UBNCBIBO EPSTBMJT MBNJOB * *7 7 EBO 7* MJIBU (BNCBS
-BNJOB JOJ
QFOUJOHEBMBNNFOFOUVLBOQPTJTJ+FOJTVKVOHVKVOHTFOTPSJL NFSVQBLBO UFNQBU CFSBLIJSOZB CBOZBL TFSBU TBSBG TFOTPSJL SBEJLT
ZBOH EJHVOBLBO VOUVL IBM JOJ BEBMBI CBEBO QBDJOJ VKVOH EPSTBMJTTFUFMBINFNBTVLJNFEVMBTQJOBMJT
3VGGJOJ EBO SFTFQUPS ZBOH TFSVQB EFOHBO SFTFQUPS UFOEPO 4FMBOKVUOZB TFQFSUJ ZBOH EJQFSMJIBULBO EBMBN (BNCBS
TFSBUTFSBU BOUFSPMBUFSBM BLBO TFHFSB NFOZJMBOH QBEB LPNJTVSB
(PMHJZBOHEJUFNVLBOQBEBUFOEPOPUPU
BOUFSJPS NFEVMB TQJOBMJT NFOVKV LPMVNOB BMCB BOUFSJPS EBO MBUFSBM
#BEBO QBDJOJ EBO HFMPOEPOH PUPU UFSVUBNB EJBEBQUBTJLBO TJTJ ZBOH CFSMBXBOBO UFNQBU TFSBUTFSBU JUV OBJL LF PUBL NFMBMVJ
VOUVLNFOEFUFLTJQFSVCBIBOEFOHBOLFDFQBUBOUJOHHJ%JEVHB USBLUVTTQJOPUBMBNJLVTBOUFSJPSEBOUSBLUVTTQJOPUBMBNJLVTMBUFSBM
580
4FCBMJLOZB IBOZB TFCBHJBO LFDJM TJOZBM OZFSJ ZBOH EJQSPZFLTJ

LBOMBOHTVOHQBEBLPNQMFLTWFOUSPCBTBMUBMBNVT+VTUSV TFCBHJBO
CFTBS TJOZBM OZFSJ CFSBLIJS EJ OVLMFJ SFUJLVMBSJT CBUBOH PUBL EBO
EBSJ TJOJ BLBO EJTFCBSLBO LF OVLMFJ JOUSBMBNJOBS UBMBNVT UFNQBU
TJOZBMOZFSJBLBOEJPMBIMFCJIMBOKVU TFQFSUJZBOHBLBOEJCJDBSBLBO
UNIT IX
TFDBSBMFCJIEFUBJMQBEB#BC
Sifat Penghantaran dalam Jaras Anterolateral. 1BEB

VNVNOZB TFQFSUJ IBMOZB EBMBN TJTUFN LPMVNOB EPSTBMJT
MFNOJTLVTNFEJBMJT QFOHJSJNBOEBMBNKBSBTBOUFSPMBUFSBMEBQBU
EJUFSBQLBOQSJOTJQQSJOTJQZBOHTBNB LFDVBMJQBEBQFSCFEBBO
QFSCFEBBO CFSJLVU JOJ
LFDFQBUBO QFOHJSJNBOOZB IBOZB
TFQFSUJHBTBNQBJTFUFOHBILFDFQBUBOQFOHJSJNBOEBMBNTJTUFN
LPMVNOBEPSTBMJTMFNOJTLVTNFEJBMJT EFOHBOSFOUBOHBOUBSB
EBO N EFUJL
EFSBKBU MPLBMJTBTJ TQBTJBM TJOZBM LVSBOH
CBJL
EFSBKBU JOUFOTJUBT KVHB KBVI MFCJI UJEBL BLVSBU
TFCBHJBOCFTBSLFLVBUBOTFOTBTJOZBEBQBUEJLFOBMJEBMBNUBIBQ
TBNQBJ LBMJ LFUJNCBOH IJOHHB LBMJ EBMBN TJTUFN
LPMVNOB EPSTBMJT EBO
LFNBNQVBO NFOHJSJNLBO TJOZBM
ZBOH DFQBU CFSVCBI BUBV TJOZBM ZBOH CFSVMBOHVMBOH TFDBSB
DFQBUTBOHBULFDJM
%FOHBOEFNJLJBO KFMBTCBIXBTJTUFNBOUFSPMBUFSBMNFSVQB
LBO TJTUFN QFOHJSJNBO ZBOH MFCJI LBTBS EBSJQBEB TJTUFN
LPMVNOB EPSTBMJTMFNOJTLVT NFEJBMJT 8BMBVQVO CFHJUV
CFCFSBQBNPEBMJUBTTFOTBTJUFSUFOUVIBOZBEJIBOUBSLBONFMBMVJ
TJTUFN JOJ EBO UJEBL EJIBOUBSLBO TBNB TFLBMJ EBMBN TJTUFN
LPMVNOB EPSTBMJTMFNOJTLVT NFEJBMJT 4FOTBTJ UFSTFCVU BEBMBI
OZFSJ TVIV HBUBM HFMJ TFSUB TFOTBTJ TFLTVBM TFMBJO SBCB LBTBS
EBOUFLBO
Beberapa Aspek Khusus Fungsi Somatosensorik
Fungsi Talamus pada Sensasi Somatik

#JMB LPSUFLT TPNBUPTFOTPSJL NBOVTJB SVTBL PSBOH UFSTFCVU BLBO
LFIJMBOHBO TFCBHJBO CFTBS TFOTBTJ UBLUJM LSJUJT UBQJ TFEJLJU TFOTBTJ
UBLUJMLBTBSEBQBUQVMJILFNCBMJ0MFILBSFOBJUV UBMBNVT TFQFSUJ
IBMOZB QVTBUQVTBU ZBOH MFCJI CBXBI
NFNQVOZBJ TFEJLJU
LFNBNQVBO VOUVL NFOEJTLSJNJOBTJ TFOTBTJ UBLUJM NFTLJQVO
EBMBNLFBEBBOOPSNBMUBMBNVTNFNQVOZBJGVOHTJNFOZBNQBJLBO
KFOJTJOGPSNBTJJOJLFLPSUFLT
4FCBMJLOZB IJMBOHOZB LPSUFLT TPNBUPTFOTPSJL NFNQVOZBJ
TFEJLJU QFOHBSVI QBEB LFNBNQVBO QFSTFQTJ TFTFPSBOH UFSIBEBQ
TFOTBTJ OZFSJ EBO IBOZB TFCBHJBO NFNFOHBSVIJ QFSTFQTJ TVIV
0MFI LBSFOB JUV UFSEBQBU CBOZBL BMBTBO VOUVL NFNQFSDBZBJ
CBIXB CBUBOH PUBL ZBOH MFCJI SFOEBI UBMBNVT EBO SFHJP CBTBM
PUBL MBJOOZB ZBOH CFSLBJUBO TBOHBU CFSQFSBO EBMBN EJTLSJNJOBTJ
TFOTBTJ JOJ .FOBSJL CBIXB TFOTBTJ JOJ UJNCVM QBEB UBIBQ ZBOH
TBOHBUBXBMQFSLFNCBOHBOGJMPHFOFUJLCJOBUBOH TFEBOHLBOTFOTBTJ
UBLUJM LSJUJT EBO LPSUFLT TPNBUPTFOTPSJL UJNCVM QBEB QFSJPEF
QFSLFNCBOHBOBLIJS
Pengaturan Sensitivitas Sensorik oleh Korteks Sinyal "Korti-

kofugal"
,FEVB USBLUVT TQJOPUBMBNJLVT UFSTFCVU NFNJMJLJ UFSNJOBM EJ 4FMBJOTJOZBMTPNBUPTFOTPSJLZBOHEJLJSNLBOEBSJQFSJGFSLFPUBL
CBHJBO BUBT UFSVUBNB QBEB EVB MPLBTJ
NFMBMVJ OVLMFJ SFUJLVMBS TJOZBMLPSUJLPGVHBMEJLJSJNLBOEFOHBOBSBILFCBMJLBOEBSJLPSUFLT
CBUBOH PUBL EBO
EBMBN EVB NBDBN LPNQMFLT OVLMFJ UBMBNVT TFSFCSJ LF EBFSBI QFOZBNQBJBO TFOTPSJL ZBOH MFCJI SFOEBI EJ
ZBOH CFSCFEB ZBLOJ LPNQMFLT WFOUSPCBTBM EBO OVLMFJ JOUSBMBNJOBS UBMBNVT NFEVMB PCMPOHBUB EBO NFEVMB TQJOBMJT TJOZBM LPSUJLP
1BEB VNVNOZB TJOZBM UBLUJM BLBO EJLJSNLBO UFSVUBNB LF EBMBN GVHBM UFSTFCVU NFOHFOEBMJLBO JOUFOTJUBT TFOTJUJWJUBT NBTVLBO
LPNQMFLT WFOUSPCBTBM CFSBLIJS QBEB CFCFSBQB OVLMFJ UBMBNVT ZBOH TFOTPSJL
TBNB UFNQBUTJOZBMUBLUJMLPMVNOBEPSTBMJTCFSBLIJS%BSJTJOJ TJOZBM 4JOZBM LPSUJLPGVHBM IBNQJS TFMVSVIOZB CFSTJGBU NFOHIBNCBU
UBLUJMEJLJSJNLBOLFLPSUFLTTPNBUPTFOTPSJLCFSTBNBEFOHBOTJOZBM EFOHBOEFNJLJBOLFUJLBJOUFOTJUBTNBTVLBOTFOTPSJLUFSMBMVCFTBS
TJOZBMZBOHCFSBTBMEBSJLPMVNOBEPSTBMJT TJOZBMLPSUJLPGVHBMTFDBSBPUPNBUJTNFOHVSBOHJQFOHJSJNBOEBMBN
581
OVLMFJQFOZBNQBJBO)BMJOJNFOZFCBCLBOEVBIBM1FSUBNB IBMJOJ
NFOHVSBOHJ QFOZFCBSBO TJOZBM TFOTPSJL MBUFSBM LF OFVSPO ZBOH 4FUJBQTBSBGTQJOBMNFNQFSTBSBGJTVBUVMBQBOHBOTFHNFOLVMJUZBOH
CFSEFLBUBO TFIJOHHB NFOJOHLBULBO EFSBKBU LFUBKBNBO QPMB TJOZBM EJTFCVU EFSNBUPN (BNCBS NFOHHBNCBSLBO CFSNBDBN
,FEVB IBM JOJ NFOKBHB TJTUFN TFOTPSJL VOUVL UFUBQ CFLFSKB EBMBN NBDBNEFSNBUPN(BNCBSJOJTFBLBOBLBONFMVLJTLBOBEBOZBCBUBT
SFOUBOHTFOTJUJWJUBTZBOHUJEBLUFSMBMVSFOEBITFIJOHHBTJOZBMNFOKBEJ ZBOH KFMBT EJ BOUBSB EFSNBUPN ZBOH CFSEFLBUBO UFUBQJ TFCFOBSOZB
UJEBL CFSQFOHBSVI BUBV UFSMBMV UJOHHJ TFIJOHHB TJTUFN UFSCBOKJSJ LFBEBBOJOJKBVIEBSJLFOZBUBBOTFCBCBEBCBOZBLTFHNFOEFSNBUPN
NFMFCJIJ LBQBTJUBTOZB VOUVL NFNCFEBLBO QPMB TFOTPSJL 1SJOTJQ ZBOHTBMJOHUVNQBOHUJOEJI
QFOHFOEBMJBOTFOTPSJLLPSUJLPGVHBMJOJEJHVOBLBOPMFITFNVBTJTUFN
(BNCBSKVHBNFNQFSMJIBULBOSFHJPBOBMUVCVIZBOHUFSMFUBLQBEB
TFOTPSJL UJEBL IBOZB TJTUFN TPNBUJL TFQFSUJ ZBOH BLBO EJKFMBTLBO
EFSNBUPNTFHNFONFEVMBTQJOBJMTZBOHQBMJOHEJTUBM EFSNBUPN4
QBEBCBCCBCTFMBOKVUOZB
1BEBFNCSJP JOJBEBMBISFHJPFLPSEBONFSVQBLBOCBHJBOUVCVIZBOH
QBMJOHEJTUBM,BLJTFDBSBFNCSJPMPHJTCFSBTBMEBSJTFHNFOMVNCBMEBO
TFHNFO BUBT TBLSBM - TBNQBJ 4
EBO CVLBO EBSJ TFHNFO TBLSBM
EJTUBM ZBOH UBNQBL KFMBT QBEB QFUB EFSNBUPN ,JUB EBQBU
NFOHHVOBLBO QFUB EFSNBUPN TFQFSUJ ZBOH EJMVLJTLBO QBEB (BNCBS
VOUVL NFOFOUVLBO LFUJOHHJBO UFNQBU UFSKBEJOZB TVBUV KFKBT
QBEB NFEVMB TQJOBMJT CJMB TFOTBTJ QFSJGFS UFSHBOHHV BLJCBU KFKBT
UFSTFCVU
Daftar Pustaka
Alonso JM, Swadlow HA: Thalamocortical specificity and the synthesis of
sensory cortical receptive fields, J Neurophysiol 94:26, 2005.
Baker SN: Oscillatory interactions between sensorimotor cortex and the
periphery, Curr Opin Neurobiol 17:649, 2007.
Bosco G, Poppele RE: Proprioception from a spinocerebellar perspective,
Physiol Rev 81:539, 2001.
Chalfie M: Neurosensory mechanotransduction, Nat Rev Mol Cell
Biol10:44, 2009.
Cohen YE, Andersen RA: A common reference frame for movement plans in
the posterior parietal cortex, Nat Rev Neurosci 3:553, 2002.
Craig AD: Pain mechanisms: labeled lines versus convergence in central
processing, Annu Rev Neurosci 26:1, 2003.
Fontanini A, Katz DB: Behavioral states, network states, and sensory
response variability, J Neurophysiol 100:1160, 2008.
Fox K: Experience-dependent plasticity mechanisms for neural rehabilitation
in somatosensory cortex, Philos Trans R Soc Lond B Biol Sci 364:369, 2009.
Haines DE: Fundamental Neuroscience for Basic and Clinical Applications,
ed 3, Philadelphia, 2006, Churchill Livingstone, Elsevier.
Hsiao S: Central mechanisms of tactile shape perception, Curr Opin
Neurobiol 18:418, 2008.
Johansson RS, Flanagan JR: Coding and use of tactile signals from the fin-
gertips in object manipulation tasks, Nat Rev Neurosci 10:345, 2009.
Kaas JH: The evolution of the complex sensory and motor systems of the
human brain, Brain Res Bull 75:384, 2008.
Kaas JH, Qi HX, Burish MJ, et al: Cortical and subcortical plasticity in the
brains of humans, primates, and rats after damage to sensory afferents
in the dorsal columns of the spinal cord, Exp Neurol 209:407, 2008.
Knutsen PM, Ahissar E: Orthogonal coding of object location, Trends
Neurosci 32:101, 2009.
Pelli DG, Tillman KA: The uncrowded window of object recognition, Nat
Neurosci 11:1129, 2008.
Suga N, Ma X: Multiparametric corticofugal modulation and plasticity in
the auditory system, Nat Rev Neurosci 4:783, 2003.
582
BAB 48
UNIT IX
4FOTBTJ4PNBUJL**4FOTBTJ/ZFSJ
4BLJU,FQBMB EBO4VIV
)BNQJS TFNVB QFOZBLJU QBEB /ZFSJ MBNCBU KVHB NFNQVOZBJ CBOZBL OBNB MBJO TFQFSUJ
UVCVI NFOJNCVMLBO OZFSJ OZFSJ UFSCBLBS MBNCBU OZFSJ UVNQVM OZFSJ CFSEFOZVU OZFSJ
4FMBOKVUOZB LFNBNQVBO VOUVL NVBM EBO OZFSJ LSPOJT +FOJT OZFSJ JOJ CJBTBOZB EJLBJULBO
NFOEJBHOPTJT CFSCBHBJ QFOZBLJU EFOHBO LFSVTBLBO KBSJOHBO /ZFSJ EBQBU CFSMBOHTVOH MBNB
CFSHBOUVOH QBEB TFCFSBQB KBVI EBO SBTB TBLJUOZB EBQBU NFOKBEJ QFOEFSJUBBO ZBOH IBNQJS
QFOHFUBIVBO TFPSBOH EPLUFS UJEBL UFSUBIBOLBO /ZFSJ JOJ EBQBU UFSBTB EJ LVMJU EBO IBNQJS
NFOHFOBJCFSCBHBJLVBMJUBTOZFSJ TFNVBKBSJOHBOBUBVPSHBOEBMBN
%FOHBO BMBTBO UFSTFCVU CBHJBO QFSUBNB CBC JOJ UFSVUBNB
NFODVSBILBO QFSIBUJBO QBEB OZFSJ EBO EBTBSEBTBS Reseptor Nyeri dan Rangsangannya
GJTJPMPHJTOZBZBOHCFSLBJUBOEFOHBOGFOPNFOBLMJOJT
Nyeri Merupakan Mekanisme Perlindungan. /ZFSJ Reseptor Nyeri merupakan Ujung Saraf Bebas.
UJNCVM CJMB BEB LFSVTBLBO KBSJOHBO EBO IBM JOJ BLBO 3FTFQUPS OZFSJ ZBOH UFSEBQBU EJ LVMJU EBO KBSJOHBO MBJO
NFOZFCBCLBO JOEJWJEV CFSFBLTJ EFOHBO DBSB NFOHIJMBOHLBO TFNVBOZBNFSVQBLBOVKVOHTBSBGCFCBT3FTFQUPSJOJUFSTFCBS
TUJNVMVT OZFSJ #BILBO BLUJWJUBT SJOHBO TBKB NJTBMOZB EVEVL MVBT QBEB QFSNVLBBO TVQFSGJTJBM LVMJU EBO KVHB EJ KBSJOHBO
EFOHBOCFSUPQBOHQBEBUVMBOHJTLIJBTFMBNBKBOHLBXBLUVMBNB EBMBN UFSUFOUV NJTBMOZB QFSJPTUFVN EJOEJOH BSUFSJ
EBQBU NFOZFCBCLBO LFSVTBLBO KBSJOHBO LBSFOB CFSLVSBOHOZB QFSNVLBBOTFOEJ EBOGBMLTTFSUBUFOUPSJVNUFNQVSVOHLFQBMB
BMJSBO EBSBI NFOVKV LF LVMJU ZBOH UFSUFLBO PMFI CFSBU CBEBO 4FCBHJBO CFTBS KBSJOHBO EBMBN MBJOOZB IBOZB TFEJLJU TFLBMJ
PSBOH UFSTFCVU #JMB LVMJU NFOKBEJ OZFSJ BLJCBU JTLFNJB EBMBN EJQFSTBSBGJ PMFI VKVOH TBSBG OZFSJ OBNVO TFUJBQ LFSVTBLBO
LFBEBBO CBXBI TBEBS PSBOH JUV BLBO NFOHVCBI QPTJTJOZB KBSJOHBOZBOHMVBTEBQBUEJKVNMBILBOTFIJOHHBNFOZFCBCLBO
1BTJFO ZBOH LFIJMBOHBO TFOTBTJ OZFSJ TFUFMBI NFOHBMBNJ OZFSJKFOJTMBNCBULSPOJTUVNQVM
LFDFMBLBBO QBEB NFEVMB TQJOBMJT UJEBL BLBO NFSBTBLBO OZFSJ Tiga Jenis Stimulus yang Merangsang Reseptor
TFIJOHHB UJEBL BLBO NFOHVCBI QPTJTJOZB "LIJSOZB LFBEBBO Nyeri—Mekanis, Suhu, dan Kimiawi. /ZFSJ EBQBU EJ
JOJ BLBO NFOJNCVMLBO LFSVTBLBO EBO EFTLVBNBTJ LVMJU QBEB TFCBCLBO PMFI CFSCBHBJ KFOJT SBOHTBOHBO 3BOHTBOHBO JOJ
EBFSBIZBOHUFSUFLBO EJLFMPNQPLLBO TFCBHBJ SBOHTBOH OZFSJ NFLBOJT TVIV EBO
LJNJBXJ 1BEB VNVNOZB OZFSJ DFQBU EJTFCBCLBO PMFI
Jenis Nyeri dan Kualitasnya—Nyeri Cepat dan SBOHTBOHBO KFOJT NFLBOJT BUBV TVIV TFEBOHLBO OZFSJ MBNCBU
Nyeri Lambat EJTFCBCLBOPMFILFUJHBKFOJTSBOHTBOHBOUFSTFCVU
#FCFSBQB [BU LJNJB ZBOH NFSBOHTBOH KFOJT OZFSJ LJNJBXJ
/ZFSJ EBQBU EJCBHJ NFOKBEJ EVB KFOJT VUBNB OZFSJ DFQBU EBO BEBMBI CSBEJLJOJO TFSPUPOJO IJTUBNJO JPO LBMJVN BTBN
OZFSJMBNCBU#JMBEJCFSJLBOTUJNVMVT OZFSJDFQBUUJNCVMEBMBN BTFUJMLPMJO EBOFO[JNQSPMFPMJUJL4FMBJOJUV QSPTUBHMBOEJOEBO
XBLUVTFLJUBS EFUJL TFEBOHLBOOZFSJMBNCBUUJNCVMTFUFMBI TVCTUBOTJ1NFOJOHLBULBOTFOTJUJWJUBTVKVOHVKVOHTFSBUOZFSJ
EFUJL BUBV MFCJI EBO LFNVEJBO TFDBSB QFSMBIBO NFOJOHLBU UFUBQJ UJEBL TFDBSB MBOHTVOH NFSBOHTBOHOZB 4VCTUBOTJ LJNJB
TFMBNBCFCFSBQBEFUJLEBOLBEBOHLBMBCBILBOCFCFSBQBNFOJU UFSVUBNB QFOUJOH VOUVL QFSBOHTBOHBO OZFSJ MBNCBU KFOJT
4FQBOKBOH CBC JOJ LJUB BLBO NFMJIBU CBIXB KBSBT QFOHJSJNBO OZFSJZBOHUFSKBEJTFUFMBIDFEFSBKBSJOHBO
VOUVL LFEVB NBDBN OZFSJ JOJ CFSCFEB EBO NBTJOHNBTJOH Sifat Reseptor Nyeri yangTidak Beradaptasi. #FSCFEB
NFNQVOZBJLVBMJUBTZBOHTQFTJGJL EFOHBO TFCBHJBO CFTBS SFTFQUPS TFOTPSJL UVCVI MBJOOZB
/ZFSJ DFQBU KVHB NFNJMJLJ CBOZBL OBNB MBJO TFQFSUJ OZFSJ SFTFQUPS OZFSJ TFEJLJU TFLBMJ CFSBEBQUBTJ EBO LBEBOH UJEBL
UBKBN OZFSJ UFSUVTVL OZFSJ BLVU EBO OZFSJ UFSTFUSVN +FOJT CFSBEBQUBTJ TBNB TFLBMJ #BILBO QBEB CFCFSBQB LPOEJTJ
OZFSJ JOJ BLBO UFSBTB CJMB TFCVBI KBSVN EJUVTVLLBO LF EBMBN FLTJUBTJ TFSBU OZFSJ TFNBLJO NFOJOHLBU TFDBSB QSPHSFTJG
LVMJU CJMB LVMJU UFSTBZBU QJTBV BUBV CJMB LVMJU UFSCBLBS TFDBSB UFSVUBNB QBEB OZFSJ MBNCBU UVNQVM NVBM LBSFOB TUJNVMVT
BLVU /ZFSJ JOJ KVHB BLBO UFSBTB CJMB LVMJU NFOEBQBU TFUSVNBO OZFSJ CFSMBOHTVOH UFSVTNFOFSVT ,FBEBBO JOJ BLBO
MJTUSJL/ZFSJDFQBUUBKBNUJEBLUFSBTBEJTFCBHJBOCFTBSKBSJOHBO NFOJOHLBULBO TFOTJUJWJUBT SFTFQUPS OZFSJ EBO EJTFCVU
EBMBNUVCVI IJQFSBMHFTJB
583
,JUB EBQBU NFOHFSUJ QFOUJOHOZB LFUJEBLNBNQVBO SFTFQUPS TBKB KBSJOHBO NFOKBEJ TBOHBU OZFSJ #JMB NFUBCPMJTNF KBSJOHBO
OZFSJ VOUVL CFSBEBQUBTJ LBSFOB IBM JOJ NFNVOHLJOLBO OZFSJ NBLJO DFQBU OZFSJ ZBOH UJNCVM BLBO TFNBLJO DFQBU QVMB
VOUVL NFNCFSJUBIV TFTFPSBOH UFSVTNFOFSVT UFOUBOH BEBOZB $POUPIOZB CJMBLJUBMJOHLBSLBONBOTFUUFLBOBOEBSBIEJTFLFMJMJOH
TUJNVMVT ZBOH NFSVTBL KBSJOHBO TFMBNB TUJNVMVT UFSTFCVU MFOHBO BUBT EBO TFMBOKVUOZB EJQPNQBLBO VEBSB JOGMBTJ
LF EBMBN
NBTJIBEB NBOTFU TBNQBJ BMJSBO EBSBI BSUFSJOZB CFSIFOUJ QFSHFSBLBO PUPU
Kecepatan Kerusakan Jaringan sebagai Stimulus Nyeri PUPU MFOHBO CBXBI PSBOH QFSDPCBBO LBEBOH EBQBU NFOJNCVMLBO
1BEB VNVNOZB OZFSJ BLBO UFSBTB CJMB TFTFPSBOH EJSBOHTBOH OZFSJPUPUEBMBNXBLUVEFUJL#JMBPUPUUBEJUJEBLEJHFSBLLBO
QBOBT EFOHBO TVIV EJ BUBT ¡$ TFQFSUJ ZBOH UFSMJIBU QBEB EBMBN XBLUV TBNQBJ NFOJU NVOHLJO UJEBL BLBO UJNCVM OZFSJ
(BNCBS 4VIV JOJ KVHB NFSVQBLBO TVIV LFUJLB KBSJOHBO XBMBVQVOBMJSBOEBSBILFPUPUUFUBQOPM
NVMBJ NFOHBMBNJ LFSVTBLBO BLJCBU QBOBT NFNBOH KBSJOHBO %JEVHB TBMBI TBUV QFOZFCBC OZFSJ QBEB LFBEBBO JTLFNJB
QBEB BLIJSOZB BLBO SVTBL KJLB TVIV NFOFUBQ EJ BUBT OJMBJ JOJ BEBMBI UFSLVNQVMOZB TFKVNMBI CFTBS BTBN MBLUBU EBMBN KBSJOHBO
0MFI LBSFOB JUV KFMBTMBI CBIXB OZFSJ ZBOH EJTFCBCLBO PMFI TFCBHBJ LPOTFLVFOTJ NFUBCPMJTNF BOBFSPCJL NFUBCPMJTNF UBOQB
QBOBT TBOHBU FSBU IVCVOHBOOZB EFOHBO LFDFQBUBO LFSVTBLBO PLTJHFO
.VOHLJOKVHBBEBCBIBOCBIBOLJNJBXJMBJOOZB TFQFSUJ
KBSJOHBOZBOHUFSKBEJEBOUJEBLCFSIVCVOHBOEFOHBOLFSVTBLBO CSBEJLJOJO EBO FO[JN QSPUFPMJUJL ZBOH UFSCFOUVL EBMBN KBSJOHBO
UPUBMZBOHUFMBIUFSKBEJ BLJCBULFSVTBLBOTFM EBOCBIBOCBIBOJOJTFMBJOBTBNMBLUBU BLBO
*OUFOTJUBT OZFSJ KVHB CFSIVCVOHBO FSBU EFOHBO LFDFQBUBO NFSBOHTBOHVKVOHTFSBUTBSBGOZFSJ
LFSVTBLBO KBSJOHBO ZBOH EJTFCBCLBO PMFI QFOHBSVI MBJO TFMBJO Spasme Otot sebagai Penyebab Nyeri. 4QBTNF PUPU KVHB
QBOBT TFQFSUJ JOGFLTJ CBLUFSJ JTLFNJB KBSJOHBO LPOUVTJP NFSVQBLBO QFOZFCBC VNVN OZFSJ EBO NFSVQBLBO EBTBS CBOZBL
KBSJOHBO EBOTFCBHBJOZB TJOESPN OZFSJ LMJOJT /ZFSJ JOJ NVOHLJO TFCBHJBO EJTFCBCLBO
Makna Khusus Stimulus Kimiawi sebagai Penyebab TFDBSBMBOHTVOHPMFITQBTNFPUPUZBOHNFSBOHTBOHSFTFQUPSOZFSJ
Nyeri Selama Kerusakan Jaringan. &LTUSBL EBSJ KBSJOHBO ZBOHCFSTJGBUNFLBOPTFOTJUJG OBNVONVOHLJOKVHBOZFSJJOJTFDBSB
SVTBLNFOZFCBCLBOOZFSJZBOHIFCBUCJMBEJTVOUJLLBOEJCBXBI UJEBL MBOHTVOH EJTFCBCLBO PMFI QFOHBSVI TQBTNF PUPU ZBOH
LVMJU OPSNBM #BOZBL [BU LJNJB ZBOH EJTFCVULBO TFCFMVNOZB NFOFLBOQFNCVMVIEBSBIEBONFOZFCBCLBOJTLFNJB4QBTNFPUPU
ZBOHNFSBOHTBOHSFTFQUPSOZFSJLJNJB EBQBUEJUFNVLBOEBMBN JOJKVHBNFOJOHLBULBOLFDFQBUBONFUBCPMJTNFEBMBNKBSJOHBOPUPU
FLTUSBLFLTUSBL JOJ 4BUV [BU LJNJB ZBOH NFOHBLJCBULBO OZFSJ TFIJOHHB SFMBUJG NFNQFSCFSBU LFBEBBO JTLFNJB NFOZFCBCLBO
MFCJI IFCBU EBSJQBEB ZBOH MBJO BEBMBI CSBEJLJOJO #BOZBL LPOEJTJ ZBOH JEFBM VOUVL QFMFQBTBO CBIBO LJNJBXJ QFNJDV
QFOFMJUJZBOHNFOEVHBCBIXBCSBEJLJOJONVOHLJONFSVQBLBO UJNCVMOZBOZFSJ
[BU ZBOH QBMJOH CFSUBOHHVOH KBXBC UFSIBEBQ QFOZFCBC OZFSJ
ZBOH UFSKBEJ TFUFMBI LFSVTBLBO KBSJOHBO +VHB JOUFOTJUBT OZFSJ Dua Jaras untuk Pengiriman Sinyal Nyeri ke
ZBOHEJSBTBLBOCFSLPSFMBTJEFOHBOQFOJOHLBUBOLPOTFOUSBTJJPO Dalam Sistem Saraf Pusat
LBMJVN TFUFNQBU BUBV QFOJOHLBUBO FO[JN QSPUFPMJUJL ZBOH
TFDBSB MBOHTVOH NFOZFSBOH VKVOHVKVOH TBSBG EBO
4FLBMJ QVO TFNVB SFTFQUPS OZFSJ NFSVQBLBO VKVOH TFSBU TBSBG
NFOJNCVMLBO OZFSJ EFOHBO DBSB NFNCVBU NFNCSBO TBSBG
CFCBT EBMBN NFOHJSJNLBO TJOZBM OZFSJ LF TJTUFN TBSBG QVTBU
UFSTFCVUMFCJIQFSNFBCFMUFSIBEBQJPOJPO
VKVOHVKVOH TFSBU JOJ NFOHHVOBLBO EVB KBSBT ZBOH UFSQJTBI
Iskemia Jaringan sebagai Penyebab Nyeri.#JMBBMJSBO ,FEVBKBSBTJOJUFSVUBNBCFSIVCVOHBOEFOHBOEVBUJQFOZFSJKBSBT
EBSBIZBOHNFOVKVKBSJOHBOUFSIBNCBU TFSJOHEBMBNXBLUV OZFSJDFQBUUBKBNEBOKBSBTOZFSJMBNCBULSPOJT
Serat Nyeri Perifer—Serat "Cepat" dan "Lambat."
4JOZBM OZFSJ DFQBU UBKBN EJSBOHTBOH PMFI TUJNVMJ NFLBOJL BUBV
TVIV TJOZBM JOJ EJLJSJNLBO NFMBMVJ TBSBG QFSJGFS LF NFEVMB
TQJOBMJTPMFITFSBUTFSBULFDJMUJQF"QBEBLFDFQBUBOQFOHJSJNBO
BOUBSB TBNQBJ NEFUJL 4FCBMJLOZB OZFSJ MBNCBULSPOJT
EJSBOHTBOH UFSVUBNB PMFI TUJNVMJ OZFSJ UJQF LJNJBXJ UFUBQJ
LBEBOHKVHBPMFITUJNVMJNFLBOJLEBOTVIVZBOHNFOFUBQ/ZFSJ
MBNCBULSPOJTJOJEJLJSJNLBOLFNFEVMBTQJOBMJTPMFITFSBUUJQF$
EFOHBOLFDFQBUBOQFOHJSJNBOBOUBSB TBNQBJNEFUJL
0MFI LBSFOB BEBOZB EVB TJTUFN QFSTBSBGBO OZFSJ NBLB
TUJNVMVT OZFSJ ZBOH UJCBUJCB TFSJOH NFOJNCVMLBO TFOTBTJ OZFSJ
ZBOHTJGBUOZBHBOEBOZFSJDFQBUUBKBNZBOHEJLJSJNLBOLFPUBL
PMFIKBSBTTFSBU" EJJLVUJTFEFUJLBUBVMFCJILFNVEJBOPMFIOZFSJ
MBNCBU ZBOH EJLJSJNLBO PMFI KBSBT TFSBU $ /ZFSJ UBKBN EFOHBO
DFQBU BLBO NFNCFSJUBIV TFTFPSBOH BEBOZB TVBUV LFSVTBLBO
TFIJOHHBNFNCVBUPSBOHUFSTFCVUTFHFSBCFSFBLTJNFNJOEBILBO
EJSJOZB EBSJ TUJNVMVT UBEJ /ZFSJ MBNCBU DFOEFSVOH NFOJOHLBU
TFJSJOH XBLUV 4FOTBTJ JOJ QBEB BLIJSOZB BLBO NFOHBLJCBULBO
OZFSJ ZBOH UJEBL UFSUBIBOLBO EBO NFNCVBU TFTFPSBOH UFSVT
NFOFSVTNFODPCBVOUVLNFSFEBLBOQFOZFCBCOZFSJ
584
Bab 48 Sensasi Somatik: II. Sensasi Nyeri, Sakit Kepala, dan Suhu
C Ad TVIV BLVU 4FSBU JOJ CFSBLIJS QBEB MBNJOB * MBNJOB

NBSHJOBMJT
QBEBLPSOVEPSTBMJT TFQFSUJUFSMJIBUQBEB(BNCBS
EBO EJ TJOJ NFSBOHTBOH OFVSPO PSEF LFEVB USBLUVT
OFPTQJOPUBMBNJLVT /FVSPO JOJ BLBO NFOHJSJNLBO TJOZBM LF
UNIT IX
III
TFSBU QBOKBOH ZBOH TFHFSB NFOZJMBOH LF TJTJ NFEVMB TQJOBMJT
III
IV ZBOH CFSMBXBOBO NFMBMVJ LPNJTVSB BOUFSJPS EBO TFMBOKVUOZB
V CFSCFMPLOBJLLFPUBLEBMBNLPMVNOBBOUFSPMBUFSBM
VI
VII Tempat Berakhirnya Traktus Neospinotalamikus
dalam Batang Otak dan Talamus. #FCFSBQB TFSBU USBLUVT
IX VIII OFPTQJOPUBMBNJLVTCFSBLIJSEJEBFSBISFUJLVMBSJTCBUBOHPUBL
Lamina
UFUBQJ TFCBHJBO CFTBS NFOVKV LF UBMBNVT UBOQB IBNCBUBO
Substan ia CFSBLIJS EJ LPNQMFLT WFOUSPCBTBM EJ USBLUVT LPMVNOB
EPSTBMJToMFNOJTLVTNFEJBMJTVOUVLTFOTBTJUBLUJM TFQFSUJZBOH
UFMBI EJCBIBT QBEB #BC #FCFSBQB TFSBU KVHB CFSBLIJS EJ
LFMPNQPLOVLMFVTQPTUFSJPSUBMBNVT%BSJEBFSBIUBMBNVTJOJ
TJOZBMBLBOEJIBOUBSLBOLFEBFSBICBTBMPUBLMBJO EBOKVHBLF
LPSUFLTTPNBUPTFOTPSJL
Kemampuan Sistem Saraf untuk Melokalisasi Nyeri
Cepat pada Tubuh. /ZFSJ DFQBUUBKBN EBQBU EJMPLBMJTBTJ
EFOHBO KBVI MFCJI CBJL EJ CFSCBHBJ CBHJBO UVCVI EBSJQBEB
OZFSJ MBNCBULSPOJT /BNVO LFUJLB IBOZB SFTFQUPS OZFSJ
ZBOH UFSBOHTBOH UBOQB TUJNVMBTJ SFTFQUPS UBLUJM TFDBSB
CFSTBNBBO CBILBO OZFSJ DFQBU NBTJI LVSBOH CJTB
EJMPLBMJTBTJ TFSJOH LBMJ IBOZB EBMBN KBSBL DN BUBV MFCJI
EBSJ EBFSBI ZBOH UFSBOHTBOH /BNVO LFUJLB SFTFQUPS UBLUJM
ZBOH NFSBOHTBOH TJTUFN LPMVNOB EPSTBMJToMFNOJTLVT
NFEJBMJT EJSBOHTBOH CFSTBNBBO MPLBTJ OZFSJ EBQBU
EJUFOUVLBOEFOHBOIBNQJSUFQBU
Glutamat, Kemungkinan Neurotransmiter Serat Nyeri
Cepat Tipe AS. %JEVHB HMVUBNBU NFSVQBLBO TVCTUBOTJ
OFVSPUSBOTNJUFS ZBOH EJTFLSFTJLBO EJ NFEVMB TQJOBMJT QBEB
VKVOHVKVOHTFSBUTBSBGOZFSJUJQF"4(MVUBNBUBEBMBITBMBI
TBUV USBOTNJUFS FLTJUBUPSJL ZBOH QBMJOH CBOZBL EJHVOBLBO
EBMBNTJTUFNTBSBGQVTBU CJBTBOZBNFNJMJLJNBTBLFSKBZBOH
CFSMBOHTVOHIBOZBCFCFSBQBNJMJEFUJL
Jaras Paleospinotalamikus untuk Mengirimkan Nyeri
Lambat-Kronis. +BSBT QBMFPTQJOPUBMBNJLVT BEBMBI TJTUFN
ZBOH KBVI MFCJI UVB EBO NFOHJSJNLBO OZFSJ UFSVUBNB EBSJ
TFSBU OZFSJ MBNCBULSPOJT UJQF $ QFSJGFS XBMBVQVO KBSBT JOJ
KVHBNFOHJSJNLBOCFCFSBQBTJOZBMEBSJTFSBUUJQF%BMBNKBSBT
JOJ TFSBUTFSBU QFSJGFS CFSBLIJS EJ EBMBN NFEVMB TQJOBMJT
4FXBLUV NFNBTVLJ NFEVMB TQJOBMJT EBSJ SBEJLT TQJOBMJT
IBNQJSTFMVSVIOZBEJMBNJOB**EBO***LPSOVEPSTBMJT ZBOH
EPSTBMJT TFSBU OZFSJ CFSBLIJS QBEB OFVSPOOFVSPO QFOZBNQBJBO
CFSTBNBTBNB EJTFCVU TVCTUBOTJB HFMBUJOPTB TFQFSUJ ZBOH
SFMBZ
TJOZBMEJLPSOVEPSTBMJT%JTJOJ UFSEBQBUEVBTJTUFNVOUVL
EJHBNCBSLBOPMFITFSBUSBEJLTEPSTBMJTUJQF$QBMJOHMBUFSBMEJ
QFOHPMBIBOTJOZBMTJOZBMOZFSJQBEBKBMVSOZBLFPUBL TFQFSUJZBOH
(BNCBS4FCBHJBOCFTBSTJOZBMLFNVEJBONFMFXBUJTBUV
UFSMJIBUQBEB(BNCBSEBO
BUBV MFCJI OFVSPO TFSBU QFOEFL UBNCBIBO EJ EBMBN LPSOV
Dua Jaras Nyeri pada Medula Spinalis dan Batang Otak— EPSTBMJTOZB TFOEJSJ TFCFMVN UFSVUBNB NFNBTVLJ MBNJOB 7
Traktus Neospinotalamikus dan Traktus Paleospinotalamikus KVHBEJLPSOVEPSTBMJT%JTJOJ OFVSPOOFVSPOUFSBLIJSEBMBN
4FXBLUV NFNBTVLJ NFEVMB TQJOBMJT TJOZBM OZFSJ NFMFXBUJ EVB SBOHLBJBO JOJ NFNCFOUVL BLTPOBLTPO QBOKBOH ZBOH
KBSBT LF PUBL NFMBMVJ
USBLUVT OFPTQJOPUBMBNJLVT EBO
TFCBHJBOCFTBSCFSHBCVOHEFOHBOTFSBUTFSBUEBSJKBSBTOZFSJ
USBLUVTQBMFPTQJOPUBMBNJLVT DFQBU NVMBNVMB NFMFXBUJ LPNJTVSB BOUFSJPS LF TJTJ
Traktus Neospinotalamikus untuk Nyeri Cepat.4FSBUOZFSJ CFSMBXBOBO NFEVMB TQJOBMJT LFNVEJBO OBJL LF PUBL EBMBN
DFQBUUJQF"UFSVUBNBNFOHJSJNLBOOZFSJNFLBOJLEBOOZFSJ KBSBTBOUFSPMBUFSBM
585
Substansi P, Kemungkinan Neurotransmiter Ujung- QVTBUQVTBUPUBLZBOHMFCJISFOEBIMBJOOZBNFOJNCVMLBOQFSTFQTJ

Ujung Saraf Lambat-Kronis Tipe C 1FOFMJUJBO OZFSJZBOHEJTBEBSJ)BMJOJUJEBLMBICFSBSUJCBIXBLPSUFLTTFSFCSJ
NFOVOKVLLBOCBIXBVKVOHTFSBUOZFSJUJQF$ZBOHNFNBTVLJ UJEBL CFSQFSBO BQBQVO EBMBN QFNBLOBBO OZFSJ OPSNBM
NFEVMB TQJOBMJT NFMFQBTLBO USBOTNJUFS HMVUBNBU EBO QFSBOHTBOHBO MJTUSJL QBEB BSFB LPSUFLT TPNBUPTFOTPSJL
USBOTNJUFS TVCTUBOTJ 1 5SBOTNJUFS HMVUBNBU CFLFSKB TFDBSB NFOZFCBCLBO TFTFPSBOH NFSBTBLBO OZFSJ SJOHBO QBEB TFLJUBS
DFQBU EBO IBOZB CFSMBOHTVOH CFCFSBQB NJMJEFUJL 4VCTUBOTJ 1 QFSTFO EBSJ EBFSBI ZBOH EJSBOHTBOH /BNVO EJQFSDBZB CBIXB
EJMFQBTLBO EFOHBO KBVI MFCJI MBNCBU NFOJOHLBU LPSUFLT CFSQFSBO QFOUJOH EBMBN NFOHJOUFSQSFUBTJLBO LVBMJUBT
LPOTFOUSBTJOZB EBMBN XBLUV CFCFSBQB EFUJL BUBV CBILBO OZFSJ NFTLJQVOQFSTFQTJOZFSJUFSVUBNBNFSVQBLBOGVOHTJQVTBU
CFCFSBQB NFOJU #BILBO EJEVHB CBIXB TFOTBTJ OZFSJ HBOEB QVTBUZBOHMFCJISFOEBI
ZBOH EJSBTBLBO TFTFPSBOH TFUFMBI UVTVLBO KBSVN QJOQSJDL
Kemampuan Khusus Sinyal Nyeri untuk Menimbulkan
EBQBU EJIBTJMLBO TFCBHJBO EBSJ GBLUB CBIXB USBOTNJUFS Eksitabilitas Otak secara Keseluruhan.3BOHTBOHMJTUSJLEBMBN
HMVUBNBU NFOHIBTJMLBO TFOTBTJ OZFSJ ZBOH MFCJI DFQBU EBFSBI SFUJLVMBS CBUBOH PUBL EBO EBMBN OVLMFJ JOUSBMBNJOBS
TFEBOHLBO USBOTNJUFS TVCTUBOTJ 1 NFOHIBTJMLBO TFOTBTJ ZBOH UBMBNVT UFNQBU CFSBLIJSOZB TFSBU OZFSJ MBNCBU NFNJMJLJ
MFCJI MBNCBU 8BMBVQVO NFLBOJTNF EFUBJM NBTJI CFMVN LFNBNQVBO LVBU VOUVL NFOJNCVMLBO FGFL SBOHTBOHBO QBEB
EJLFUBIVJ TFQFSUJOZB UFMBI KFMBT CBIXB HMVUBNBU BEBMBI BLUJWJUBT TBSBG TFMVSVI PUBL 1BEB LFOZBUBBOOOZB LFEVB EBFSBI
OFVSPUSBOTNJUFS ZBOH QBMJOH CFSQFSBO EBMBN NFOHJSJNLBO JOJNFSVQBLBOCBHJBOEBSJTJTUFNQFSBOHTBOHVUBNBPUBL ZBOH
OZFSJ DFQBU LF EBMBN TJTUFN TBSBG QVTBU EBO TVCTUBOTJ 1 EJCBIBTEBMBN#BC)BMJOJNFOKFMBTLBONFOHBQBIBNQJSUJEBL
CFSIVCVOHBOEFOHBOOZFSJMBNCBULSPOJT NVOHLJO CBHJ TFTFPSBOH VOUVL UJEVS LFUJLB EJB NFOEFSJUB OZFSJ
IFCBU
Proyeksi Jaras Paleospinatalamikus (Sinyal Nyeri Tindakan Bedah pada Jaras Nyeri. #JMB BEB PSBOH ZBOH
Lambat-Kronis) ke dalam Batang Otak dan Talamus. NFSBTBLBO OZFSJ TFEFNJLJBO CFSBU EBO UJEBL UFSUBIBOLBO
+BSBT QBMFPTQJOPUBMBNJLVT MBNCBULSPOJT CFSBLIJS TFDBSB MVBT CJBTBOZB OZFSJ JOJ BLJCBU QFOZFCBSBO LBOLFS ZBOH DFQBU
QFSMV
EBMBN CBUBOH PUBL EBMBN EBFSBI ZBOH EJBSTJS CFTBS QBEB EJMBLVLBOTVBUVUJOEBLBOVOUVLNFSFEBLBOOZFSJUFSTFCVU6OUVL
(BNCBS )BOZB TFQFSTFQVMVI TBNQBJ TFQFSFNQBU TFSBU JUV EBQBU EJMBLVLBO UJOEBLBO QFNPUPOHBO QBEB CFCFSBQB UJUJL
ZBOH CFSBLIJS EJ UBMBNVT 4FCBHJBO CFTBS TFSBUTFSBU JOJ KBSBT TBSBG OZFSJ #JMB OZFSJOZB UFSEBQBU EJ UVCVI CBHJBO CBXBI
CFSBLIJSEJTBUVEBSJUJHBEBFSBICFSJLVU
OVLMFVTSFUJLVMBSJT UJOEBLBOLPSEPUPNJQBEBSFHJPUPSBLTNFEVMBTQJOBMJTTFSJOHLBMJ
NFEVMB QPOT EBO NFTFOTFGBMPO
BSFB UFLUBM NFTFOTFGBMPO EBQBU NFOHIJMBOHLBO OZFSJ TFMBNB CFCFSBQB NJOHHV TBNQBJ
EJ EBMBN LPMJLVMJ TVQFSJPS EBO JOGFSJPS BUBV
EBFSBI CFCFSBQBCVMBO6OUVLNFMBLVLBOUJOEBLBOJUV NFEVMBTQJOBMJT
QFSJBRVBEVLUBM HSJTFB ZBOH NFOHFMJMJOHJ BRVBEVLUVT 4ZMWJJ QBEBTJTJZBOHCFSMBXBOBOEFOHBOOZFSJEJQPUPOHTFCBHJBOQBEB
%BFSBI ZBOH MFCJI SFOEBI EBSJ PUBL JOJ UBNQBLOZB QFOUJOH LVBESBO BOUFSPMBUFSBMOZB VOUVL NFOHHBOHHV KBSBT TFOTPSJL
VOUVL NFSBTBLBO OZFSJ LBSFOB IFXBO ZBOH PUBLOZB BOUFSPMBUFSBM
NFOHBMBNJ QFNPUPOHBO EJ BUBT NFTFOTFGBMPO VOUVL /BNVO BEBEVBBMBTBONFOHBQBUJOEBLBOLPSEPUPNJJOJUJEBL
NFOHIBNCBU TJOZBM OZFSJ VOUVL NFODBQBJ TFSFCSVN NBTJI TFMBMVCFSIBTJMEBMBNNFOBOHHVMBOHJOZFSJ1FSUBNB CBOZBLTFSBU
NFOVOKVLLBO EFOHBO KFMBT CVLUJCVLUJ ZBOH UJEBL EBQBU OZFSJ EBSJ CBHJBO BUBT UVCVI UJEBL NFOZJMBOH NFEVMB TQJOBMJT LF
EJTBOHLBMEBSJOZFSJLFUJLBCBHJBOUVCVINBOBQVONFOHBMBNJ TJTJ ZBOH CFSMBXBOBO TBNQBJ TFSBU JOJ NFODBQBJ PUBL TFIJOHHB
USBVNB %BSJ BSFB OZFSJ CBUBOH PUBL CBOZBL OFVSPO TFSBU UJOEBLBOLPSEPUPNJUJEBLNFNPUPOHTFSBUTFSBUJOJ,FEVB OZFSJ
QFOEFL ZBOH NFOZBNQBJLBO TJOZBM OZFSJ OBJL LF OVLMFJ TFSJOH UJNCVM LFNCBMJ EBMBN XBLUV CFCFSBQB CVMBO CFSJLVUOZB
JOUSBMBNJOBS EBO WFOUSPMBUFSBM UBMBNVT EBO LF CBHJBO UFSUFOUV TFCBHJBOEJTFCBCLBOPMFITFOTJUJTBTJKBSBTMBJOZBOHTFDBSBOPSNBM
IJQPUBMBNVTEBOEBFSBICBTBMPUBLMBJOOZB UFSMBMV MFNBI VOUVL NFOJNCVMLBO FGFL OZFSJ DPOUPIOZB KBSBT
ZBOHUFSTFCBSKBSBOHQBEBNFEVMBTQJOBMJTEPSTPMBUFSBM
5JOEBLBO
Kemampuan Sistem Saraf yang Sangat Buruk dalam
PQFSBTJ FLTQFSJNFOUBM MBJO VOUVL NFOHIJMBOHLBO OZFSJ BEBMBI
Menentukan Lokasi Sumber Nyeri dalam Jaras Lambat-
EFOHBO DBSB NFNCBLBS EBFSBI OZFSJ TQFTJGJL QBEB OVLMFJ
Kronis. -PLBMJTBTJ OZFSJ ZBOH EJIBOUBSLBO MFXBU KBSBT
JOUSBMBNJOBS UBMBNVT ZBOH EBQBU NFOHIJMBOHLBO QFOEFSJUBBO
QBMFPTQJOPUBMBNJLVT CFSTJGBU UJEBL BLVSBU 4FCBHBJ DPOUPI
BLJCBUOZFSJTFEBOHLBOQFNBLOBBOOZFSJBLVUUFUBQVUVI TVBUV
OZFSJ KFOJT MBNCBULSPOJT EBQBU TFMBMV EJMPLBMJTBTJ IBOZB QBEB
NFLBOJTNFQFSUBIBOBOZBOHQFOUJOH
TVBUV CBHJBO UVCVI CFTBS TFQFSUJ TBUV MFOHBO BUBV UVOHLBJ
UFUBQJ UJEBL QBEB EBFSBI TQFTJGJL *FOHBO BUBV UVOHLBJ )BM JOJ
TFTVBJ EFOHBO TJGBU KBSBT ZBOH LPOFLUJWJUBTOZB EJGVT EBO Sistem Penekan Nyeri ("Analgesia") dalam Otak
NVMUJTJOBQUJL *OJ NFOKFMBTLBO NFOHBQB TFTFPSBOH TFSJOH LBMJ dan Medula Spinalis
NFNJMJLJ LFTVMJUBO ZBOH TFSJVT EBMBN NFMPLBMJTBTJ TVNCFS
CFCFSBQBKFOJTOZFSJLSPOJT %FSBKBU SFBLTJ TFTFPSBOH UFSIBEBQ OZFSJ TBOHBU CFSWBSJBTJ
,FBEBBO JOJ TFCBHJBO EJTFCBCLBO PMFI LFNBNQVBO PUBL TFOEJSJ
Fungsi Formasio Retikularis, Talamus, dan Korteks VOUVL NFOFLBO TJOZBM OZFSJ ZBOH NBTVL LF EBMBN TJTUFN TBSBG
Serebri dalam Pemaknaan Nyeri. 1FOHBOHLBUBO
ZBJUVEFOHBONFOHBLUJGLBOTJTUFNQFOHBUVSOZFSJ EJTFCVUTJTUFN
TFQFOVIOZB BSFB TFOTPSJL LPSUFLT TFSFCSJ UJEBL NFOHHBOHHV
BOBMHFTJB
LFNBNQVBO TFFLPS IFXBO VOUVL NFSBTBLBO OZFSJ 0MFI
4JTUFNBOBMHFTJBEJQFSMJIBULBOQBEB(BNCBS4JTUFNJOJ
LBSFOB JUV TBOHBUMBI NVOHLJO CBIXB JNQVMT OZFSJ ZBOH
UFSEJSJBUBTUJHBLPNQPOFOVUBNB
"SFBQFSJBRVBEVLUBMHSJTFB
NFNBTVLJGPSNBTJPSFUJLVMBSJTCBUBOHPUBL UBMBNVT EBO
EBOBSFBQFSJWFOUSJLVMBSNFTFOTFGBMPOEBOCBHJBOBUBTQPOTZBOH
586
TBSBG ZBOH CFSBTBM EBSJ OVLMFJ QFSJWFOUSJLVMBS EBO BSFB

QFSJBRVBEVLUBM HSJTFB NFOZFLSFTJ FOLFGBMJO +BEJ TFQFSUJ ZBOH
UBNQBLEBMBN(BNCBS CBOZBLVKVOHTFSBUEBMBNOVLMFVT
SBGFNBHOVTNFMFQBTLBOFOLFGBMJOKJLBEJSBOHTBOH
UNIT IX
4FSBUTFSBUZBOHCFSBTBMEBSJEBFSBIJOJNFOHJSJNLBOTJOZBM
LFLPSOVEPSTBMJTNFEVMBTQJOBMJTVOUVLNFOZFLSFTJTFSPUPOJO
4FSPUPOJO NFOZFCBCLBO OFVSPOOFVSPO MPLBM NFEVMB TQJOBMJT
VOUVL NFOZFLSFTJ FOLFGBMJO &OLFGBMJO EJBOHHBQ EBQBU
NFOJNCVMLBO CBJL IBNCBUBO QSBTJOBQUJL NBVQVO
QBTDBTJOBQUJL QBEB TFSBUTFSBU OZFSJ UJQF $ EBO UJQF "4 ZBOH
CFSTJOBQTEJLPSOVEPSTBMJT
+BEJ TJTUFNBOBMHFTJBJOJEBQBUNFNCMPLTJOZBMOZFSJQBEB
UFNQBU NBTVLOZB EJ NFEVMB TQJOBMJT 1BEB LFOZBUBBOOZB
Medula TJTUFN JOJ KVHB EBQBU NFNCMPL TFCBHJBO CFTBS SFGMFLTSFGMFLT
NFEVMB TQJOBMJT ZBOH UJNCVM BLJCBU TJOZBM OZFSJ LIVTVTOZB
SFGMFLT QFOBSJLBO XJUIESBXBM SFGMFY
ZBOH BLBO EJKFMBTLBO
QBEB#BC
Sistem Opium Otak—Endorfin dan Enkefalin

-FCJI EBSJ UBIVO ZBOH MBMV EJUFNVLBO CBIXB QFOZVOUJLBO
NPSGJO EBMBN KVNMBI ZBOH TBOHBU TFEJLJU LF EBMBN OVLMFVT
QFSJWFOUSJLVMBS EJ TFLJUBS WFOUSJLFM LFUJHB BUBV LF EBMBN BSFB
QFSJBRVBEVLUBM HSJTFB CBUBOH PUBL NFOJNCVMLBO QFSBTBBO
BOBMHFTJB ZBOH IFCBU TFLBMJ %BMBN QFOFMJUJBO ZBOH EJMBLVLBO
TFTVEBI JUV EJUFNVLBO CBIXB [BU TFSVQBNPSGJO UFSVUBNB
PQJBU KVHB CFLFSKB EJ CBOZBL UJUJL MBJO QBEB TJTUFN BOBMHFTJB
UFSNBTVL LPSOV EPSTBMJT NFEVMB TQJOBMJT 0MFI LBSFOB
LFCBOZBLBO PCBU ZBOH NFNFOHBSVIJ FLTJUBCJMJUBT OFVSPO
CFLFSKB QBEB SFTFQUPSSFTFQUPS TJOBQUJL BEB BOHHBQBO CBIXB
SFTFQUPS NPSGJO TJTUFN BOBMHFTJB TFCFOBSOZB NFSVQBLBO
SFTFQUPS VOUVL CFCFSBQB OFVSPUSBOTNJUFS TFQFSUJNPSGJO ZBOH
NFNBOH EJTFLSFTJLBO EBMBN PUBL 0MFI LBSFOB JUV EJMBLVLBO
QFOFMJUJBO ZBOH FLTUFOTJG VOUVL PQJVN BMBNJ EBMBN PUBL
4FLBSBOHUFMBIUFSCVLUJCBIXBEBMBNPUBLBEBQBMJOHTFEJLJUEVB
CFMBTCBIBOTFSVQBPQJVNZBOHUFSEBQBUQBEBCFCFSBQBUFNQBU
EBMBNTJTUFNTBSBGZBOHTFNVBOZBNFSVQBLBOIBTJMQFNFDBIBO
UJHBNPMFLVMQSPUFJOCFTBSQSPPQJPNFMBOPLPSUJO QSPFOLFGBMJO
NFOHFMJMJOHJBRVBEVLUVT4ZMWJJEBOTFCBHJBOWFOUSJLFMLFUJHBEBO EBO QSPEJOPSGJO #BIBO TFSVQBPQJVN ZBOH QFOUJOH JOJ EJ
LFFNQBU/FVSPOOFVSPOEBSJEBFSBIJOJNFOHJSJNLBOTJOZBMLF BOUBSBOZB BEBMBI GJFOEPSGJO NFUFOLFGBMJO MFVFOLFGBMJO EBO

OVLMFVT SBGF NBHOVT ZBOH NFSVQBLBO OVLMFVT UJQJT EJ HBSJT EJOPSGJO
UFOHBI ZBOH UFSMFUBL EJ CBHJBO CBXBI QPOT EBO CBHJBO BUBT
,FEVB FOLFGBMJO EJKVNQBJ EJ CBUBOH PUBL EBO NFEVMB
NFEVMB PCMPOHBUB EBO OVLMFVT SFUJLVMBSJT QBSBHJHBOUPTFMVMBSJT
TQJOBMJT QBEB CBHJBO TJTUFN BOBMHFTJB ZBOH UFMBI EJKFMBTLBO
ZBOH UFSMFUBL EJ TFCFMBI MBUFSBM NFEVMB %BSJ OVLMFJ JOJ TJOZBM
TFCFMVNOZB EBO BFOEPSGJO EBQBU EJKVNQBJ EBMBN
TJOZBMPSEFLFEVBEJLJSJNLBOLFCBXBIEJLPMVNOBEPSTPMBUFSBMJT
IJQPUBMBNVTEBOLFMFOKBSIJQPGJTJT%JUFNVLBOKVHBEJOPSGJOEJ
NFEVMB TQJOBMJT NFOVKV LF
LPNQMFLT QFOHIBNCBU OZFSJ EJ
UFNQBU ZBOH TBNB EFOHBO FOLFGBMJO UFUBQJ EFOHBO KVNMBI
EBMBN SBEJLT EPSTBMJT NFEVMB TQJOBMJT 1BEB UFNQBU JOJ TJOZBM
ZBOHTBOHBUTFEJLJU
BOBMHFTJB EBQBU NFOHIBNCBU TJOZBM OZFSJ TFCFMVN EJTBNQBJLBO
+BEJ XBMBVQVO TBNQBJ TFLBSBOH TJTUFN PQJVN EBMBN PUBL
LFPUBL
CFMVNEJLFUBIVJTFDBSBEFUBJM QFOHBLUJGBOTJTUFNBOBMHFTJBPMFI
1FSBOHTBOHBO MJTUSJL CBJL QBEB BSFB QFSJBRVBEVLUBM HSJTFB
TJOZBMTJOZBM TBSBG ZBOH NFNBTVLJ BSFB QFSJBRVBEVLUBM HSJTFB
NBVQVOQBEBOVLMFVTSBGFNBHOVTEBQBUNFOFLBOCBOZBLTJOZBM
EBO QFSJWFOUSJLVMBS BUBV JOBLUJWBTJ KBSBT OZFSJ PMFI PCBUPCBU
OZFSJIFCBUZBOHNFNBTVLJSBEJLTEPSTBMJTNFEVMBTQJOBMJT+VHB
TFSVQB NPSGJO EBQBU IBNQJS TFQFOVIOZB NFOFLBO CBOZBL
QFSBOHTBOHBO QBEB EBFSBIEBFSBI PUBL ZBOH MFCJI UJOHHJ ZBOH
TJOZBMTJOZBMOZFSJZBOHNBTVLNFMFXBUJTBSBGQFSJGFS
NFSBOHTBOH QFSJBRVBEVLUBM HSJTFB KVHB EBQBU NFOFLBO OZFSJ
#FCFSBQB EBFSBI JOJ BEBMBI
OVLMFJ QFSJWFOUSJLVMBS EBMBN Penghambatan Pengiriman Nyeri oleh Sinyal Sensorik
IJQPUBMBNVT UFSMFUBLCFSEFLBUBOEFOHBOWFOUSJLFMLFUJHB EBO
Taktit Simultan
QBEB LFLVBUBO ZBOH MFCJI SFOEBI CFSLBT QSPTFOTFGBMPO NFEJBM 1FSJTUJXB MBJO ZBOH QFOUJOH EBMBN LJTBI QFOHBUVSBO OZFSJ BEBMBI
ZBOHKVHBUFSMFUBLEJIJQPUBMBNVT QFOFNVBO ZBOH NFOKFMBTLBO CBIXB QFSBOHTBOHBO TFSBUTFSBU TFOTPSJL
5FSEBQBU CFCFSBQB [BU USBOTNJUFS ZBOH UFSMJCBU EBMBN TJTUFN CFTBSUJQF"ϠZBOHCFSBTBMEBSJSFTFQUPSUBLUJMEJQFSJGFSEBQBUNFOFLBO
BOBMHFTJBLIVTVTOZBFOLFGBMJOEBOTFSPUPOJO#BOZBLVKVOHTFSBU QFOHJSJNBOTJOZBMOZFSJEBSJEBFSBI
587
Unit IX Sistem Saraf A. Prinsip-Prinsip Umum dan Fisiologi Sensorik
UVCVI ZBOH TBNB )BM JOJ EJEVHB NFSVQBLBO BLJCBU EBSJ JOIJCJTJ CFSBTBMEBSJLVMJU EBOBLJCBUOZBPSBOHJUVBLBONFSBTBLBO
MBUFSBM TFUFNQBU EJ EBMBN NFEVMB TQJOBMJT ZBOH EBQBU NFOKFMBTLBO TFOTBTJZBOHCFSBTBMEBSJEBFSBILVMJU
NFOHBQB HFSBLBOHFSBLBO ZBOH TFEFSIBOB TFQFSUJ UJOEBLBO
NFOHHPTPL LVMJU EFLBU EBFSBI ZBOH OZFSJ TFSJOH LBMJ FGFLUJG VOUVL Nyeri Viseral
NFOHVSBOHJOZFSJ)BMJOJNVOHLJOKVHBNFOKFMBTLBONFOHBQBPCBU
PCBUHPTPLTFSJOHLBMJCFSHVOBVOUVLNFOHVSBOHJOZFSJ
/ZFSJ ZBOH CFSBTBM EBSJ CFSNBDBNNBDBN PSHBO WJTFSB EBMBN
.FLBOJTNF JOJ EBO FLTJUBTJ QTJLPHFOJL ZBOH CFSTBNBBO QBEB
BCEPNFOEBOEBEBNFSVQBLBOTBMBITBUVLSJUFSJBZBOHEBQBUEJQBLBJ
TJTUFN BOBMHFTJB QVTBU NVOHLJO KVHB NFSVQBLBO EBTBS QSPTFT
VOUVL NFOEJBHOPTJT QFSBEBOHBO WJTFSB QFOZBLJU JOGFLTJ WJTFSB EBO
NFOHIJMBOHLBOOZFSJEFOHBOBLVQVOLUVS
LFMBJOBO WJTFSB MBJO 4FSJOH LBMJ WJTFSB UJEBL NFNQVOZBJ SFTFQUPS
Tata Laksana Nyeri dengan Perangsangan Listrik SFTFQUPS TFOTPSJL VOUVL NPEBMJUBT TFOTBTJ MBJO LFDVBMJ VOUVL OZFSJ
5FMBI EJLFNCBOHLBO CFCFSBQB UJOEBLBO LMJOJT VOUVL NFOFLBO OZFSJ +VHB EBMBN CFCFSBQB BTQFL ZBOH QFOUJOH OZFSJ WJTFSBM CFSCFEB
EFOHBOQFSBOHTBOHBOMJTUSJL&MFLUSPEBQFSBOHTBOHEJUFNQBULBOQBEB EFOHBOOZFSJZBOHCFSBTBMEBOQFSNVLBBOUVCVI
EBFSBI LVMJU UFSUFOUV BUBV UFSLBEBOH EJUBOBN QBEB NFEVMB TQJOBMJT 4BMBI TBUV QFSCFEBBO QBMJOH QFOUJOH BOUBSB OZFSJ QFSNVLBBO
VOUVLNFSBOHTBOHLPMVNOBTFOTPSJLEPSTBMJT EFOHBO OZFSJ WJTFSBM BEBMBI XBMBVQVO PSHBO WJTFSB NFOHBMBNJ
1BEB CFCFSBQB PSBOH EFOHBO NFUPEF TUFSFPUBLTJL EJMBLVLBO LFSVTBLBOCFSBUZBOHTBOHBUUFSMPLBMJTBTJ OBNVOKBSBOHNFODFUVTLBO
QFOFNQBUBOFMFLUSPEB LF EBMBN OVLMFJ JOUSBMBNJOBS UBMBNVT ZBOH OZFSJ ZBOH IFCBU $POUPIOZB TFPSBOH BIMJ CFEBI EBQBU NFNPUPOH
UFQBU BUBV QBEB BSFB QFSJWFOUSJLVMBS BUBV QFSJBRVBEVLUBM EJFOTFGBMPO TFMVSVI VTVT NFOKBEJ EVB QBEB PSBOH ZBOH UFUBQ TBEBS UBOQB
%FOHBO EFNJLJBO TFTFPSBOH EBQBU NFOHBUVS TFCFSBQB CFTBS NFOJNCVMLBO OZFSJ ZBOH CFSBSUJ 4FCBMJLOZB TFUJBQ TUJNVMVT ZBOH
SBOHTBOHBO ZBOH EJCFSJLBO %JMBQPSLBO CBIXB UJOEBLBO JOJ EBQBU NFOJNCVMLBO QFSBOHTBOHBO EJGVT QBEB VKVOH TFSBU OZFSJ NFMBMVJ
NFOHIJMBOHLBOOZFSJTFDBSBESBNBUJT+VHB IJMBOHOZBOZFSJEJLFUBIVJ PSHBO WJTFSB WJTLVT
EBQBU NFOJNCVMLBO OZFSJ ZBOH TBOHBU IFCBU
CFSMBOHTVOHIJOHHBKBNTFUFMBIQFNCFSJBOSBOHTBOHBOZBOHIBOZB $POUPIOZB LFBEBBO JTLFNJB ZBOH EJTFCBCLBO PMFI UFSTVNCBUOZB
CFCFSBQBNFOJU BMJSBOEBSBILFEBFSBIVTVTZBOHMVBT QBEBTBBUZBOHCFSTBNBBOBLBO
NFSBOHTBOH TFSBU OZFSJ ZBOH EJGVT EBO NFOJNCVMLBO OZFSJ ZBOH
FLTUSFN
Nyeri Alih (Referred Pain)
Penyebab Nyeri Viseral Sebenamya
4FUJBQ TUJNVMVT ZBOH EBQBU NFSBOHTBOH VKVOH TFSBU TBSBG OZFSJ EJ
4FSJOH LBMJ TFTFPSBOH NFSBTBLBO OZFSJ EJ CBHJBO UVCVI ZBOH EBFSBI WJTFSB ZBOH MVBT EBQBU NFOJNCVMLBO OZFSJ WJTFSBM #FCFSBQB
MFUBLOZB DVLVQ KBVI EBSJ KBSJOHBO ZBOH NFOZFCBCLBO OZFSJ TUJNVMVTJOJBEBMBILFBEBBOJTLFNJBKBSJOHBOWJTFSBM LFSVTBLBOBLJCBU
/ZFSJ JOJ EJTFCVU OZFSJ BMJI $POUPIOZB OZFSJ EJ EBMBN TBMBI CBIBO LJNJB QBEB QFSNVLBBO WJTFSB TQBTNF PUPU QPMPT QBEB PSHBO
TBUV PSHBO WJTFSBM TFSJOH EJBMJILBO LF TVBUV EBFSBI EJ EBMBN ZBOH CFSPOHHB QFSFHBOHBO CFSMFCJIBO PSHBO QFSVU CFSPOHHB
QFSNVLBBOUVCVI1FOHFUBIVBONFOHFOBJCFSCBHBJKFOJTOZFSJ BUBV UFSFHBOHOZB KBSJOHBO JLBU ZBOH NFOHFMJMJOHJ PSHBO WJTFSB
BMJIJOJTBOHBUCFSHVOBEBMBNEJBHOPTJTLMJOJTQFOZBLJU LBSFOB )BNQJSTFNVBOZFSJWJTFSBZBOHTFCFOBSOZBEBMBNSPOHHBUPSBLTEBO
QBEB CBOZBL QFOZBLJU WJTFSBM TBUVTBUVOZB UBOEB LMJOJT ZBOH BCEPNFO EJLJSJNLBO NFMBMVJ TFSBU TBSBG OZFSJ LFDJM UJQF $ TFIJOHHB
EJUFNVJBEBMBIOZFSJBMJI IBOZBEBQBUNFOHJSJNLBOOZFSJUJQFLSPOJTUVNQVM
Mekanisme Nyeri Alih. (BNCBS NFOHHBNCBSLBO Iskemia. *TLFNJB NFOZFCBCLBO OZFSJ WJTFSBM EFOHBO DBSB ZBOH
NFLBOJTNF ZBOH NVOHLJO UFSKBEJ QBEB QFOHBMJIBO OZFSJ TBNB TFQFSUJ UJNCVMOZB OZFSJ EJ KBSJOHBO MBJO NVOHLJO LBSFOB
UFSCFOUVLOZB QSPEVL BLIJS NFUBCPMJL ZBOH BTBN BUBV QSPEVL ZBOH
%BMBN HBNCBS JOJ UBNQBL DBCBOHDBCBOH TFSBU OZFSJ WJTFSBM
EJIBTJMLBO PMFI KBSJOHBO EFHFOFSBUJG TFQFSUJ CSBEJLJOJO FO[JN
EBMBNNFEVMBTQJOBMJTCFSTJOBQTEFOHBOOFVSPOPSEFLFEVB
QSPUFPMJUJL BUBVCBIBOMBJOZBOHNFSBOHTBOHVKVOHTFSBUOZFSJ
EBO
ZBOH TBNB EFOHBO TJOZBM OZFSJ ZBOH CFSBTBM EBSJ LVMJU
#JMB TFSBU OZFSJ WJTFSBM UFSBOHTBOH TJOZBM OZFSJ ZBOH CFSBTBM Stimulus Kimia.5FSLBEBOH CBIBOCBIBOZBOHNFSVTBLCPDPS
EBSJWJTFSBTFMBOKVUOZBEJLJSJNLBONFMBMVJTFUJEBLOZBCFCFSBQB EBSJ USBLUVT HBTUSPJOUFTUJOBM NBTVL LF EBMBN SPOHHB QFSJUPOFVN
$POUPIOZB BTBN QSPUFPMJUJL HFUBI MBNCVOH EBQBU CPDPS EBSJ
OFVSPOZBOHTBNBZBOHKVHBNFOHJSJNLBOTJOZBMOZFSJZBOH
MBNCVOH ZBOH SPCFL BUBV UVLBL EVPEFOVN (FUBI JOJ LFNVEJBO
NFOZFCBCLBO QFODFSOBBO TFDBSB MVBT QFSJUPOFVN WJTFSBM TFIJOHHB
NFSBOHTBOHEBFSBITFSBUOZFSJZBOHMVBT/ZFSJZBOHUJNCVMCJBTBOZB
TBOHBUIFCBU
Spasme Organ Visera Berongga. 4QBTNF QBEB TFCBHJBO
VTVT LBOEVOH FNQFEV TBMVSBO FNQFEV VSFUFS BUBV TFUJBQ PSHBO
WJTFSBCFSPOHHBEBQBUNFOJNCVMLBOOZFSJ LFNVOHLJOBOEJTFCBCLBO
PMFI UFSBOHTBOHOZB VKVOH TFSBU OZFSJ TFDBSB NFLBOJT "UBV TQBTNF
1
2 ZBOH UFSKBEJ NVOHLJO NFOZFCBCLBO CFSLVSBOHOZB BMJSBO EBSBI LF
PUPU CFSTBNBBOEFOHBOOBJLOZBLFCVUVIBOOVUSJTJPUPUVOUVLQSPTFT
NFUBCPMJTNFTFIJOHHBNFOJNCVMLBOOZFSJZBOHIFCBU
4FSJOHOZFSJBLJCBUTQBTUJTOZBPSHBOWJTFSBUJNCVMEBMBNCFOUVL
LSBN OZFSJZBOHNFOJOHLBULFQBSBIBOOZBNFOKBEJTBOHBUIFCBUEBO
LFNVEJBO NFOHIJMBOH 1SPTFT JOJ CFSMBOKVU TFDBSB IJMBOH UJNCVM
TFUJBQCFCFSBQBNFOJUTFLBMJ4JLMVTIJMBOHUJNCVMUFSTFCVUEJTFCBCLBO
PMFIQFSVMBOHBOLPOUSBLTJPUPUQPMPT$POUPIOZB LSBNBLBOUJNCVM
TFUJBQ LBMJ BEB HFMPNCBOH QFSJTUBMUJL ZBOH NFOZFCBS NFMBMVJ VTVT
ZBOH TQBTUJL /ZFSJ UJQF LSBN TFSJOH LBMJ UJNCVM QBEB QFOZBLJU
BQFOEJTJUJT HBTUSPFOUFSJUJT LPOTUJQBTJ NFOTUSVBTJ QFSTBMJOBO
QFOZBLJULBOEVOHFNQFEV BUBVPCTUSVLTJVSFUFS
588
Bab 48 Sensasi Somatik: II. Sensasi Nyeri, Sakit Kepata, dan Suhu
Distensi Berlebihan Organ Viseral Berongga.0SHBOWJTFSBM

CFSPOHHB ZBOH EJJTJ CFSMFCJIBO KVHB BLBO NFOJNCVMLBO OZFSJ JOJ
NVOHLJO EJTFCBCLBO PMFI QFSFHBOHBO CFSMFCJIBO KBSJOHBO JUV TFOEJSJ
,FBEBBOEJTUFOTJZBOHCFSMFCJIBOKVHBEBQBUNFNCVBULPMBQTQFNCVMVI
QFNCVMVI EBSBI ZBOH NFOHFMJMJOHJ PSHBO WJTFSB BUBV ZBOH NFMBMVJ
UNIT IX
EJOEJOHPSHBOWJTFSB KBEJNVOHLJONFNJDVUJNCVMOZBOZFSJJTLFNJB
Visera yang Tidak Sensitif. 4FCBHJBO LFDJM EBFSBI PSHBO WJTFSB
IBNQJS TBNB TFLBMJ UJEBL QFLB UFSIBEBQ TFNVB KFOJT OZFSJ %BFSBI JOJ
NFMJQVUJ QBSFOLJN IBUJ EBO BMWFPMJ QBSV 8BMBVQVO CFHJUV LBQTVM IBUJ
TBOHBU QFLB UFSIBEBQ USBVNB MBOHTVOH EBO QFSFHBOHBO EBO TBMVSBO
FNQFEV KVHB QFLB UFSIBEBQ OZFSJ %BMBN QBSV XBMBVQVO BMWFPMJ UJEBL
TFOTJUJG UFSOZBUB CBJL CSPOLJ NBVQVO QMFVSB QBSJFUBMJT TBOHBU TFOTJUJG
UFSIBEBQOZFSJ
"Nyeri Parietal" Akibat Penyakit Viseral

#JMB TVBUV QFOZBLJU NFNFOHBSVIJ PSHBO WJTFSB TFSJOH LBMJ QSPTFT
QFOZBLJUJUVNFOZFCBSLFQFSJUPOFVNQBSJFUBM QMFVSB BUBVQFSJLBSEJVN
1FSNVLBBOQBSJFUBMJOJ TFQFSUJLVMJU EJQFSTBSBGJPMFICBOZBLTFLBMJTBSBG
OZFSJ ZBOH CFSBTBM EBSJ TBSBGTBSBG TQJOBM QFSJGFS 0MFI LBSFOB JUV OZFSJ
ZBOHCFSBTBMEBSJEJOEJOHQBSJFUBMPSHBOWJTFSBMTFSJOHLBMJCFSTJGBUOZFSJ
UBKBN4FCVBIDPOUPIEBQBUNFOFHBTLBOQFSCFEBBOBOUBSBOZFSJQBSJFUBM
EFOHBO OZFSJ WJTFSBM ZBOH TFCFOBSOZB JSJTBO QJTBV ZBOH NFMBMVJ
QFSJUPOFVN QBSJFUBM UFSBTB TBOHBU OZFSJ TFNFOUBSB JSJTBO ZBOH TFSVQB
NFMBMVJ QFSJUPOFVN WJTFSBM BUBV NFMBMVJ EJOEJOH VTVT UFSOZBUB UJEBL
CFHJUVOZFSJ CBILBOEBQBUUJEBLUFOZFSJ
QFSBMJIBO OZFSJ PSHBOPSHBO WJTFSBM ZBOH TFDBSB VNVN
Lokalisasi Nyeri Viseral—Jaras Pengiriman Nyeri "Viseral" NFNQFSMJIBULBO EJ EBFSBI FNCSJP NBOB PSHBO ZBOH
dan "Parietal" CFSTBOHLVUBOCFSBTBM
/ZFSJ ZBOH CFSBTBM EBSJ CFSNBDBNNBDBN PSHBO WJTFSB TVLBS
Jaras Parietal untuk Pengiriman Nyeri Abdomen
EJMPLBMJTBTJLBO LBSFOB CFCFSBQB BMBTBO 1FSUBNB PUBL QBTJFO UJEBL UBIV
dan Torakal. /ZFSJ EBSJ WJTFSB TFSJOH LBMJ TFDBSB CFSTBNBBO
BLBO LFCFSBEBBO PSHBO JOUFSOBM ZBOH CFSCFEB LBSFOB JUV TFUJBQ OZFSJ
EJMPLBMJTBTJ EJ EVB EBFSBI QFSNVLBBO UVCVI LBSFOB OZFSJ
ZBOH CFSBTBM EBSJ CBHJBO EBMBN BLBO EJMPLBMJTBTJ TFDBSB VNVN TBKB
EJLJSJNLBO NFMBMVJ EVB KBSBT KBSBT WJTFSB BMJI EBO KBSBT QBSJFUBM
,FEVB TFOTBTJ ZBOH CFSBTBM EBSJ BCEPNFO EBO UPSBLT EJIBOUBSLBO
MBOHTVOH (BNCBS NFOHHBNCBSLBO QFOHJSJNBO HBOEB
NFMBMVJ EVB KBSBT NFOVKV TJTUFN TBSBG QVTBUKBSBT WJTFSBM ZBOH
BQFOEJLTZBOHNFSBEBOH*NQVMTOZFSJZBOHCFSBTBMEBSJBQFOEJLT
TFCFOBSOZBEBOKBSBTQBSJFUBM/ZFSJWJTFSBMZBOHTFCFOBSOZBEJIBOUBSLBO
QFSUBNBBLBONFMFXBUJTFSBUTFSBUOZFSJWJTFSBMZBOHCFSBEBEBMBN
NFMBMVJ TFSBUTFSBU TFOTPSJL OZFSJ EJ EBMBN CFSLBT TBSBG PUPOPN EBO
CFSLBT TBSBG TJNQBUJT EBO LFNVEJBO NBTVL LF NFEVMB TQJOBMJT
TFOTBTJOZB BLBO EJBMJILBO LF EBFSBI QFSNVLBBO UVCVI ZBOH TFSJOH LBMJ
LJSBLJSBTFUJOHHJ5BUBV5OZFSJJOJBLBOEJBMJILBOLF
KBVI EBSJ PSHBO ZBOH NFOJNCVMLBO OZFSJ 4FCBMJLOZB TFOTBTJ QFSJFUBM
EJLJSJNLBO MBOHTVOH LF EBMBN TBSBGTBSBG TQJOBM TFUFNQBU EBSJ
QFSJUPOFVNQBSJFUBMJT QMFVSBBUBVQFSJLBSEJVN EBOTFOTBTJJOJCJBTBOZB
EJMPLBMJTBTJLBOUFQBUEJEBFSBIZBOHNFOJNCVMLBOOZFSJ T-10
Lokalisasi Nyeri Alih yang Dihantarkan melalui Jaras
Viseral.
#JMBOZFSJWJTFSBMEJBMJILBOLFQFSNVLBBOUVCVI CJBTBOZBOZFSJJUVBLBO
L-1
EJMPLBMJTBTJ TFTVBJ TFHNFO EFSNBUPN EBSJ NBOB PSHBO WJTFSB JUV CFSBTBM
QBEB XBLUV FNCSJP EBO CFMVN UFOUV TFTVBJ EFOHBO EJ NBOB PSHBO JUV
TFLBSBOH CFSBEB $POUPIOZB KBOUVOH CFSBTBM EBSJ MFIFS EBO EBEB CBHJBO
BUBT BLJCBUOZB TFSBU OZFSJ WJTFSBM VOUVL KBOUVOH OBJL TFQBOKBOH TBSBG
TFOTPSJLTJNQBUJTEBONFNBTVLJNFEVMBTQJOBMJTBOUBSBTFHNFO$EBO
50MFILBSFOBJUV TFQFSUJZBOHEJQFSMJIBULBOQBEB(BNCBS OZFSJ
ZBOH CFSBTBM EBSJ KBOUVOH EJBMJILBO LF CBHJBO MFIFS NFMFXBUJ CBIV PUPU
QFLUPSBMJT UVSVOLFMFOHBO EBOLFEBFSBITVCTUFSOBMCBHJBOEBEBBUBT*OJ
TFNVB BEBMBI EBFSBI QFSNVLBBO UVCVI ZBOH NFOHJSJNLBO TFSBU TBSBG
TPNBUPTFOTPSJLOZB LF TFHNFO $ TBNQBJ 5 NFEVMB TQJOBMJT 1BMJOH
TFSJOH OZFSJ UJNCVM QBEB TJTJ LJSJ EBSJQBEB TJTJ LBOBO LBSFOB QBEB
QFOZBLJULPSPOFS TJTJLJSJKBOUVOHKBVIMFCJITFSJOHUFSLFOBEBSJQBEBTJTJ
LBOBO
4FNBTBFNCSJP MBNCVOHLJSBLJSBCFSBTBMEBSJTFHNFOUPSBLBMLFUVKVI
TBNQBJ LFTFNCJMBO 0MFI LBSFOB JUV OZFSJ MBNCVOH EJBMJILBO LF
FQJHBTUSJVN BOUFSJPS EJ BUBT VNCJMJLVT ZBJUV EBFSBI QFSNVLBBO UVCVI
ZBOH EJJOFSWBTJ PMFI TFHNFO UPSBLBM LFUVKVI TBNQBJ LFTFNCJMBO 1BEB
(BNCBSUFSMJIBUCFCFSBQBEBFSBIQFSNVLBBOMBJOOZB UFNQBU
589
EBFSBI TFLFMJMJOH VNCJMJLVT EBO NFSVQBLBO OZFSJ UVNQVM EBO LSBN LFMJNBUFSQJTBI TFIJOHHBCBHJBONPUPSJLOZB ZBOHEJCVUVILBOVOUVL
*NQVMT OZFSJ TFSJOH LBMJ KVHB EJNVMBJ EJ QFSJUPOFVN QBSJFUBM UFNQBU HFSBLBO SBIBOH UJEBL BLBO UFSQFOHBSVI TFEBOHLBO FMFNFO
BQFOEJLT ZBOH NFSBEBOH NFOZFOUVI BUBV NFMFLBU QBEB EJOEJOH TFOTPSJLOZB BLBO SVTBL 0QFSBTJ JOJ BLBO NFOHBLJCBULBO TFQBSVI
BCEPNFO )BM JOJ NFOZFCBCLBO OZFSJ UBKBN EJ TFLJUBS QFSJUPOFVN XBKBI NFOHBMBNJ BOFTUFTJB EBO LFBEBBO JOJ NVOHLJO BLBO
ZBOHUFSJSJUBTJEJLVBESBOLBOBOCBXBIBCEPNFO NFOHHBOHHV QBTJFO 4FMBOKVUOZB LBEBOH LBMB PQFSBTJ JOJ UJEBL
CFSIBTJM ZBOH CFSBSUJ CBIXB KFKBT ZBOH NFOZFCBCLBO OZFSJ NVOHLJO
Beberapa Nyeri Klinis Abnormal dan Sensasi CFSBEB QBEB OVMEFVT TFOTPSJL EJ CBUBOH PUBL EBO CVLBO EJ TBSBG
Somatik Lainnya QFSJGFS
Sindroma Brown-Séquard
Hiperalgesia #JMB EJMBLVLBO QFNPUPOHBO TFMVSVI NFEVMB TQJOBMJT TFMVSVI TFOTBTJ
4VBUVKBSBTTBSBGOZFSJLBEBOHNFOKBEJTBOHBUNVEBIEJSBOHTBOHJOJ EBO GVOHTJ NPUPSJL EJ CBHJBO EJTUBM TFHNFO ZBOH EJQPUPOH BLBO
NFOHIBTJMLBOLFBEBBOIJQFSBMHFTJB ZBJUVTVBUVLFBEBBOIJQFSTFOTJUJG UFSCMPL UBQJ CJMB QFNPUPOHBO UBEJ IBOZB EJMBLVLBO QBEB TBMBI TBUV
UFSIBEBQ OZFSJ ,FNVOHLJOBO QFOZFCBC IJQFSBMHFTJB BEBMBI
TJTJ NFEVMB TQJOBMJT UJNCVM TJOESPNB #SPXO4QBSE "LJCBUBLJCBU
SFTFQUPS OZFSJ TFOEJSJ NFOKBEJ TBOHBU QFLB EJTFCVU IJQFSBMHFTJB UJOEBLBO USBOTFLTJ UBEJ EBQBU EJSBNBMLBO EFOHBO NFNQFMBKBSJ KBSBT
QSJNFS EBO
BEBOZB GBTJMJUBTJ QBEB QFOHJSJNBO TFOTPSJL ZBOH TFSBUTFSBU NFEVMB TQJOBMJT TFQFSUJ ZBOH UBNQBL QBEB (BNCBS
EJTFCVUIJQFSBMHFTJBTFLVOEFS 4FNVBGVOHTJNPUPSJLQBEBTFNVBTFHNFOEJCBXBIUFNQBUUSBOTFLTJ
$POUPI LFBEBBO IJQFSBMHFTJB QSJNFS BEBMBI LFBEBBO TFOTJUJWJUBT QBEB TJTJ ZBOH TBNB BLBO EJCMPL 1BEB TJTJ QFNPUPOHBO IBOZB
FLTUSFN QBEB LVMJU ZBOH UFSCBLBS TJOBS NBUBIBSJ BLJCBU TFOTJUJTBTJ CFCFSBQBNPEBMJUBTTFOTBTJZBOHIJMBOH EBOZBOHMBJOOZBIJMBOHQBEB
VKVOH TBSBG OZFSJ QBEB LVMJU PMFI NFUBCPMJU KBSJOHBO MPLBM BLJCBU TJTJ ZBOH CFSMBXBOBO 4FOTBTJ OZFSJ QBOBT EBO EJOHJO TFOTBTJ ZBOH
QSPTFT UFSCBLBS NVOHLJO IJTUBNJO QSPTUBHMBOEJO EBO TFCBHBJOZB EJLJSJNLBOPMFIKBSBTTQJOPUBMBNJLVTBLBOIJMBOHQBEBTJTJUVCVIZBOH
)JQFSBMHFTJBTFLVOEFSTFSJOHLBMJEJTFCBCLBOPMFIKFKBTQBEBNFEVMB CFSMBXBOBO QBEB TFNVB EFSNBUPN EVB TBNQBJ FOBN TFHNFO EJ
TQJOBMJT BUBV UBMBNVT #FCFSBQB LFBEBBO JOJ BLBO EJCJDBSBLBO QBEB CBXBI UFNQBU USBOTFLTJ 4FCBMJLOZB TFOTBTJTFOTBTJ ZBOH IBOZB
CBHJBOTFMBOKVUOZB EJLJSJNLBOQBEBLPMVNOBEPSTBMJTEBOEPSTPMBUFSBMTFOTBTJLJOFTUFUJL
EBO QPTJTJ TFOTBTJ HFUBSBO TFOTBTJ MPLBMJTBTJ ZBOH KFMBT EBO
Herpes Zoster (Shingles) EJTLSJSOJOBTJ EVBUJUJL BLBO IJMBOH QBEB TJTJ USBOTFLTJ QBEB TFNVB
,BEBOHLBEBOHIFSQFTWJSVTNFOHJOGFLTJHBOHMJPOSBEJLTEPSTBMJT)BM EFSNBUPN EJ CBXBI UFNQBU USBOTFLTJ 1BEB TJTJ USBOTFLTJ SBTB SBCB
JOJ NFOZFCBCLBO OZFSJ IFCBU QBEB TFHNFO EFSNBUPN ZBOH SJOHBOBLBOUFSHBOHHVLBSFOBKBSBTVUBNBVOUVLQFOHIBOUBSBOSBCB
EJQFSTBSBGJHBOHMJPOUFSTFCVU TFIJOHHBOZFSJZBOHUJNCVMNFSVQBLBO SJOHBO LPMVNOB EPSTBMJT UFSQPUPOH /BNVO SBTB SBCB LBTBS ZBOH
OZFSJ UJQF TFHNFOUBM ZBOH NFOHFMJMJOHJ TFUFOHBI CBEBO 1FOZBLJU JOJ LVSBOHCBJLEJMPLBMJTBTJ UFUBQVUVILBSFOBTFCBHJBOQFOHIBOUBSBOOZB
EJLFOBM TFCBHBJ IFSQFT [PTUFS BUBV TIJOHMFT LBSFOB TFSJOH UFSKBEJ NFMBMVJUSBLUVTTQJOPUBMBNJLVTTJTJZBOHMBJOOZB
FSVQTJLVMJU
1FOZFCBC OZFSJ EJEVHB BEBMBI JOGFLTJ TFMTFM OFVSPO OZFSJ EBMBN Sakit Kepala
HBOHMJBSBEJLTEPSTBMJTPMFIWJSVT4FMBJOTFCBHBJQFOZFCBCOZFSJ WJSVT
EJCBXBPMFITJUPQMBTNBOFVSPOVOUVLNFOHBMJSLFMVBSNFMBMVJBLTPO 4BLJU LFQBMB NFSVQBLBO TVBUV KFOJT OZFSJ BMJI LF QFSNVLBBO LFQBMB
QFSJGFS OFVSPO LF UFNQBU LVUBOFVTOZB %J TJOJ WJSVT NFOZFCBCLBO ZBOH CFSBTBM EBSJ TUSVLUVS CBHJBO EBMBN #FCFSBQB TBLJU LFQBMB
SVBNSVBN ZBOH NFOKBEJ WFTJLFM EBMBN XBLUV CFCFSBQB IBSJ MBMV EJTFCBCLBO PMFI TUJNVMVT OZFSJ ZBOH CFSBTBM EBSJ EBMBN LSBOJVN
NFOKBEJ LSVTUB EBMBN CFCFSBQB IBSJ LFNVEJBO TFNVB JOJ UFSKBEJ UFUBQJZBOHMBJONVOHLJOKVHBEBSJMVBSLSBOJVN NJTBMOZBEBSJTJOVT
EBMBN EBFSBI EFSNBUPN ZBOH EJQFSTBSBGJ PMFI SBEJLT EPSTBMJT ZBOH OBTBMJT
UFSJOGFLTJ
Tic Douloureux
1BEBCFCFSBQBPSBOH LBEBOHEBQBUUFSKBEJOZFSJTFQFSUJUFSUVTVLQBEB
TBMBITBUVTJTJXBKBIEJEBFSBI BUBVTFCBHJBOEBFSBI
EJTUSJCVTJTFSBU
TFOTPSJL TBSBG LFMJNB BUBV LFTFNCJMBO GFOPNFOB JOJ EJTFCVU UJD
EPVMPVSFVY BUBVOFVSBMHJBUSJHFNJOBMBUBVOFVSBMHJBHMPTPGBSJOHFBM

/ZFSJJOJUFSBTBTFQFSUJLFKVUBOMJTUSJLZBOHNFOEBEBL EBONVOHLJO
UJNCVMIBOZBTFMBNBCFCFSBQBEFUJLQBEBTBUVTBBUBUBVNVOHLJOKVHB
UFSBTBUFSVTNFOFSVT4FSJOHLBMJ OZFSJJOJUJNCVMEJEBFSBIQFODFUVT
ZBOH TBOHBU TFOTJUJG QBEB QFSNVLBBO XBKBI NVMVU BUBV EJ EBMBN
UBOHHPSPLBO IBNQJS TFMBMV PMFI TUJNVMVT NFLBOPSFTFQUJG EBSJQBEB
PMFI TUJNVMVT OZFSJ $POUPIOZB CJMB TFPSBOH QBTJFO NFOHVOZBI
CPMVT NBLBOBO TFXBLUV NBLBOBO JUV NFOZFOUVI UPOTJM NVOHLJO
BLBO UJNCVM OZFSJ TFQFSUJ UFSUVTVL ZBOH IFCBU EJ CBHJBO NBOEJCVMBS
TBSBGLFMJNB
#JBTBOZB OZFSJ QBEB UJD EPVMPVSFVY EBQBU EJCMPL EFOHBO DBSB
PQFSBTJ QFNPUPOHBO TBSBG QFSJGFS EBFSBI ZBOH IJQFSTFOTJUJG $BCBOH
TFOTPSJL TBSBG LFMJNB TFSJOH LBMJ EJQPUPOH UFQBU EJ CBXBI LSBOJVN
LBSFOBQBEBUFNQBUJUVSBEJLTNPUPSJLEBOSBEJLTTFOTPSJLTBSBG
590
Sakit Kepala dengan Sumber Intrakranial NFOZFCBCLBO TBLJU LFQBMB JOUSBLSBOJBM ZBOH IFCBU 1FNCVBOHBO
%BFSBI4FOTJUJG/ZFSJQBEB5FNQVSVOH,FQBMB+BSJOHBOPUBLTFOEJSJ DBJSBO TFSFCSPTQJOBM JOJ BLBO NFOHIJMBOHLBO TFCBHJBO
IBNQJSTFMVSVIOZBUJEBLQFLBUFSIBEBQOZFSJ#BILBOQFNPUPOHBOBUBV LFNBNQVBO NFOHBNCBOH PUBL ZBOH EBMBN LFBEBBO OPSNBM
QFSBOHTBOHBOMJTUSJLQBEBEBFSBITFOTPSJLLPSUFLTTFSFCSJIBOZBLBEBOH EBQBU EJMBLTBOBLBO PMFI BEBOZB DBJSBO TFSFCSPTQJOBM #FSBU PUBL
NFOJNCVMLBOOZFSJKVTUSVCJMBEBFSBITFOTPSJLLPSUFLTEJSBOHTBOHBLBO BLBO NFSFHBOH EBO NFOHVCBI CFSCBHBJ QFSNVLBBO EVSBNBUFS
UNIT IX
UJNCVMQBSFTUFTJBTFQFSUJUFSUVTVLQBEBEBFSBIUVCVIZBOHTFTVBJEFOHBO TFIJOHHBUJNCVMOZFSJZBOHNFOZFCBCLBOTBLJULFQBMB
EBFSBI PUBL ZBOH EJSBOHTBOH 0MFI LBSFOB JUV TFCBHJBO CFTBS TBLJU Sakit Kepala Migren. 4BLJU LFQBMB NJHSFO BEBMBI KFOJT
LFQBMB LFNVOHLJOBO UJEBL EJTFCBCLBO PMFI LFSVTBLBO EBMBN PUBL JUV TBLJU LFQBMB LIVTVT ZBOH EBQBU EJBLJCBULBO PMFI GFOPNFOB
TFOEJSJ WBTLVMBS ZBOH BCOPSNBM XBMBVQVO NFLBOJTNF ZBOH TFCFOBSOZB
4FCBMJLOZB UBSJLBO QBEB TJOVT WFOPTVT TFLJUBS PUBL LFSVTBLBO CFMVN EJLFUBIVJ /ZFSJ LFQBMB NJHSFO JOJ TFSJOH LBMJ EJEBIVMVJ
UFOUPSJVN BUBV SFHBOHBO QBEB EVSB EJ CBTJT PUBL EBQBU NFOJNCVMLBO PMFI CFSNBDBNNBDBN TFOTBTJ QSPESPNBM NJTBMOZB OBVTFB
OZFSJIFCBUZBOHEJLFOBMEFOHBOTBLJULFQBMB+VHB IBNQJSTFUJBQNBDBN IJMBOHOZB TFCBHJBO MBQBOH QBOEBOH BVSB WJTVBM BUBV IBMVTJOBTJ
USBVNB DFEFSB DSVTIJOH
BUBV TUJNVMVT SFHBOHBO UFSIBEBQQFNCVMVI UJQFTFOTPSJLMBJOOZB#JBTBOZB HFKBMBQSPESPNBMUJNCVMNFOJU
EBSBI TFMBQVU PUBL EBQBU NFOJNCVMLBO TBLJU LFQBMB 4USVLUVS ZBOH TBNQBJ KBN TFCFMVN OZFSJ LFQBMB 4FUJBQ UFPSJ ZBOH EBQBU
UFSVUBNB TFOTJUJG BEBMBI BSUFSJ NFOJOHFBM NFEJB EBO QBSB BIMJ CFEBI NFOKFMBTLBO TBLJU LFQBMB NJHSFO IBSVT KVHB EBQBU NFOKFMBTLBO
TBSBG TBOHBU CFSIBUJIBUJ NFOHBOFTUFTJ BSUFSJ JOJ QBEB XBLUV NFMBLVLBO UJNCVMOZBHFKBMBHFKBMBQSPESPNBMJOJ
PQFSBTJPUBLEFOHBOBOFTUFTJMPLBM 4BMBI TBUV UFPSJ QFOZFCBC TBLJU LFQBMB NJHSFO JOJ BEBMBI CBIXB
FNPTJ BUBV LFUFHBOHBO ZBOH CFSMBOHTVOH MBNB BLBO
Daerah Kepala Tempat Peralihan Sakit Kepala Intrakranial. NFOJNCVMLBO SFGMFLT WBTPTQBTNF CFCFSBQB QFNCVMVI BSUFSJ
1FSBOHTBOHBOSFTFQUPSOZFSJQBEBUFNQVSVOHTFSFCSJEJBUBTUFOUPSJVN LFQBMB UFSNBTVL QFNCVMVI BSUFSJ ZBOH NFNQFSEBSBIJ PUBL
NFMJQVUJ CBHJBO QFSNVLBBO BUBT UFOUPSJVN JUV TFOEJSJ BLBO 4FDBSBUFPSFUJT WBTPTQBTNFBLBONFOJNCVMLBOJTLFNJBTFCBHJBO
NFOJNCVMLBO JNQVMT OZFSJ QBEB TBSBG LFMJNB TFIJOHHB BLBO PUBL EBO LFBEBBO JOJ BLBO NFOZFCBCLBO UJNCVMOZB HFKBMB
NFOJNCVMLBO TBLJU LFQBMB BMJI EJ QFSNVLBBO TFQBSVI CBHJBO EFQBO QSPESPNBM 4FMBOKVUOZB BLJCBU JTLFNJB ZBOH IFCBU EJOEJOH
LFQBMB QBEB EBFSBI TPNBUPTFOTPSJL ZBOH EJJOFSWBTJ OFSWVT LSBOJBMJT QFNCVMVI EBSBI UFSQFOHBSVI CBSBOHLBMJ LFMFMBIBO LPOUSBLTJ
LFMJNB TFQFSUJZBOHEJHBNCBSLBOQBEB(BNCBS PUPUQPMPT ZBOHNFNCVBUQFNCVMVIEBSBINFOKBEJMFNCFLEBO
4FCBMJLOZB JNQVMT OZFSJ ZBOH CFSBTBM EBSJ CBHJBO CBXBI UFOUPSJVN UJEBL NBNQV NFNQFSUBIBOLBO UPOVT OPSNBM QFNCVMVI EBSBI
NFNBTVLJ TJTUFN TBSBG QVTBU UFSVUBNB NFMBMVJ TBSBG TFSWJLBM LFEVB TFMBNBTBNQBJKBN5FLBOBOEBSBIQBEBQFNCVMVIEBSBI
HMPTPGBSJOHFBM EBO WBHVT ZBOH KVHB NFOHJOFSWBTJ LVMJU LFQBMB EJ BUBT BLBO NFOZFCBCLBO QFNCVMVI JUV CFSEJMBUBTJ EBO CFSEFOZVU
CFMBLBOH EBO TFEJLJU EJ CBXBI UFMJOHB /ZFSJ TVCUFOUPSJBM BLBO TFDBSB IFCBU EBO BEB EBMJM CBIXB SFHBOHBO ZBOH IFCBU QBEB
NFOJNCVMLBO TBLJU LFQBMB PLTJQJUBM ZBOH BLBO EJBMJILBO LF CBHJBO EJOEJOH BSUFSJ UFSNBTVL CFCFSBQB BSUFSJ FLTUSBLSBOJBM TFQFSUJ
QPTUFSJPSLFQBMB BSUFSJ UFNQPSBMJTNFOJNCVMLBO TBLJU LFQBMB NJHSFO 5FPSJ MBJO
NFOHBUBLBO CBIXB QFOZFCBC TBLJU LFQBMB NJHSFO NFODBLVQ
Jenis Sakit Kepala tntrakranial
EFQSFTJ LPSUJLBM ZBOH NFOZFCBS BCOPSNBMJUBT QTJLPMPHJT EBO
Sakit Kepala Meningitis. 4BMBI TBUV TBLJU LFQBMB ZBOH QBMJOH WBTPTQBTNF ZBOH EJTFCBCLBO PMFI LBEBS LBMJVN MPLBM ZBOH
IFCBUBEBMBIBLJCBUQFOZBLJUNFOJOHJUJT ZBOHNFOZFCBCLBOQFSBEBOHBO CFSMFCJIBOEBMBNDBJSBOFLTUSBTFMTFSFCSJ
QBEB TFNVB TFMBQVU PUBL UFSNBTVL EBFSBIEBFSBI EVSB EBO EBFSBI EJ .VOHLJO UFSEBQBU QSFEJTQPTJTJ HFOFUJL VOUVL TBLJU LFQBMB
TFLFMJMJOH TJOVT WFOPTVT ZBOH TFOTJUJG ,FSVTBLBO ZBOH QBSBI UFSTFCVU NJHSFO LBSFOBSJXBZBULFMVBSHBZBOHQPTJUJGVOUVLNJHSFOUFMBI
BLBO NFOJNCVMLBO TBLJU LFQBMB ZBOH IFCBU ZBOH BLBO EJBMJILBO LF EJMBQPSLBO UFSKBEJ QBEB TBNQBJ QFSTFO LBTVT 4BLJU LFQBMB
TFMVSVILFQBMB NJHSFO KVHB EVB LBMJ MFCJI TFSJOH UFSKBEJ QBEB XBOJUB
Sakit Kepala Akibat Rendahnya Tekanan Cairan EJCBOEJOHLBOQSJB
Serebrospinal. 1FNCVBOHBO DBJSBO EBSJ LBOBMJT TQJOBM TFCBOZBL Nyeri Kepala Alkoholik.4FQFSUJZBOHQFSOBIEJBMBNJPMFI
NM LIVTVTOZBCJMBQBTJFOUFUBQEBMBNQPTJTJCFSEJSJ TFSJOHLBMJBLBO CBOZBLPSBOH TBLJULFQBMBTFSJOHUJNCVMTFTVEBINJOVNBMLPIPM
ZBOH CFSMFCJIBO )BM JOJ NVOHLJO EJTFCBCLBO LBSFOB BMLPIPM
CFSTJGBU UPLTJL UFSIBEBQ KBSJOHBO MBOHTVOH NFOHJSJUBTJ TFMBQVU
PUBL EBO NFOZFCBCLBO OZFSJ JOUSBLSBOJBM %FIJESBTJ KVHB
NVOHLJOCFSQFSBOEBMBNNBCVL IBOHPWFS
ZBOHUFSKBEJTFUFMBI
LPOTVNTJBMLPIPMCFSMFCJIBOIJESBTJCJBTBOZBNFOHVSBOHJUFUBQJ
UJEBLNFOHIJMBOHLBOTBLJULFQBMBEBOHFKBMBMBJOEBSJNBCVL
Sakit Kepala Ekstrakranial
Sakit Kepala Akibat Spasme Otot. ,FUFHBOHBO FNPTJ
TFSJOH LBMJ NFOZFCBCLBO TQBTNF PUPU LIVTVTOZB PUPUPUPU ZBOH
NFMFLBU QBEB LVMJU LFQBMB EBO PUPUPUPU MFIFS ZBOH NFMFLBU QBEB
UFOHLVL EBO BEB EBMJM CBIXB LFBEBBO JOJ NFSVQBLBO TBMBI TBUV
QFOZFCBC VNVN UJNCVMOZB TBLJU LFQBMB %JEVHB OZFSJ BLJCBU
TQBTNFPUPUPUPULFQBMBJOJBLBOEJBMJILBOLFEBFSBILFQBMBZBOH
MFCJI TVQFSGJTJBM TFIJOHHB TBLJU LFQBMB ZBOH UJNCVM TBNB TFQFSUJ
KFOJTTBLJULFQBMBBLJCBUMFTJJOUSBLSBOJBM
Sakit Kepala Akibat Iritasi Hidung dan Struktur-
Struktur Sekitar Hidung. .VLPTB NFNCSBO IJEVOH TFSUB
TJOVT OBTBMJT TFOTJUJG UFSIBEBQ OZFSJ OBNVO UJEBL CFHJUV IFCBU
8BMBVQVOEFNJLJBO JOGFLTJBUBVQSPTFTJSJUBTJQBEBBSFBTUSVLUVS
IJEVOHZBOHMVBTTFSJOHEJKVNMBILBOEBONFOJNCVMLBOTBLJU
591
Unit IX Sistem Saraf' A. Prinsip-Prinsip Umum dan Fisiologi Sensorik
TBLJULFQBMBZBOHBLBOEJBMJILBOLFEBFSBICFMBLBOHNBUBBUBV QBEB Perangsangan Reseptor Suhu—Sensasi Dingin, Sejuk,

JOGFLTJTJOVTGSPOUBMJT EJBMJILBOLFQFSNVLBBOGSPOUBMEBIJEBOLVMJU
Indiferen, Hangat, dan Panas.(BNCBSNFOHHBNCBSLBO
LFQBMB TFQFSUJ ZBOH UBNQBL QBEB (BNCBS +VHB OZFSJ ZBOH
BLJCBU EBSJ QFSCFEBBO TVIV QBEB SFTQPOT FNQBU KFOJT TFSBU TBSBG
CFSBTBM EBSJ TJOVT CBHJBO CBXBI NJTBMOZB TJOVT NBLTJMBSJT EBQBU
UFSBTBEJXBKBI
TFSBUTBSBGOZFSJZBOHEJSBOHTBOHPMFIEJOHJO
TFSBUEJOHJO
Sakit Kepala Akibat Kelainan Mata. ,FTVMJUBO TFTFPSBOH
TFSBU IBOHBU EBO
TFSBU OZFSJ ZBOH EJSBOHTBOH PMFI QBOBT
VOUVL NFNGPLVTLBO NBUB BHBS UJNCVM QFOHMJIBUBO ZBOH KFMBT BLBO 1FSIBUJLBO TFDBSB LIVTVT CBIXB TFSBU TBSBG CFSCFEB CFSFTQPOT
NFOJNCVMLBO LPOUSBLTJ ZBOH CFSMFCJIBO QBEB PUPUPUPU TJMJBSJT QBEB TVIV ZBOH CFSCFEB QVMB $POUPI QBEB EBFSBI ZBOH TBOHBU
8BMBVQVO VLVSBOOZB TBOHBU LFDJM LPOUSBLTJ UPOJL PUPUPUPU JOJ EJOHJO TFSBU TBSBG ZBOH UFSBOHTBOH IBOZBMBI TFSBU TBSBG OZFSJ
EJEVHBEBQBUNFOJNCVMLBOTBLJULFQBMBEJEBFSBISFUSPPSCJUBM+VHB EJOHJO KJLB LVMJU NFOKBEJ MFCJI EJOHJO MBHJ TBNQBJ IBNQJS
VTBIB NFNGPLVTLBO NBUB TFDBSB CFSMFCJIBO EBQBU NFOJNCVMLBO NFNCFLV BUBV CFOBSCFOBS NFNCFLV TFSBUTFSBU JOJ UJEBL EBQBU
SFGMFLT TQBTNF CFSCBHBJ PUPU GBTJBM EBO FLTUSBPLVMBS ZBOH NVOHLJO EJSBOHTBOH
#JMBTVIVNFOJOHLBUIJOHHBTBNQBJ¡$ JNQVMT
NFOJNCVMLBOTBLJULFQBMB4BLJULFQBMBUJQFLFEVBZBOHCFSBTBMEBSJ OZFSJEJOHJO BLBO NFOHIJMBOH OBNVO QBEB TBBU JUV SFTFQUPS
NBUB EBQBU UJNCVM CJMB NBUB UFSQBKBO DBIBZB TFDBSB CFSMFCJIBO EJOHJO NVMBJ UFSBOHTBOH NFODBQBJ QVODBL QFSBOHTBOHBO QBEB
UFSVUBNB TJOBS VMUSBWJPMFU .FMJIBU NBUBIBSJ BUBV CVOHB BQJ BSD TVIV TFLJUBS ¡$ EBO NVMBJ NFOHIJMBOH TFDBSB QFSMBIBO TBNQBJ
XFMEFS
TFMBNB CFCFSBQB EFUJL TBKB EBQBU NFOJNCVMLBO TBLJU LFQBMB TVIV¡$%JBUBT¡$SFTFQUPSIBOHBUNVMBJUFSBOHTBOH UFUBQJ
ZBOH CFSMBOHTVOH TBNQBJ KBN MBNBOZB ,BEBOH LBMB TBLJU
KVHB BLBO NFOHIJMBOH QBEB TVIV TFLJUBS ¡$ "LIJSOZB QBEB
LFQBMBUJNCVMLBSFOBJSJUBTJLPOKVOHUJWBPMFICBIBOBLUJO EBOOZFSJ
ZBOH UJNCVM BLBO EJBMJILBO LF EBFSBI QFSNVLBBO LFQBMB BUBV LF
TFLJUBS ¡$ TFSBU OZFSJQBOBT NVMBJ UFSBOHTBOH PMFI QBOBT EBO
EBFSBI SFUSPPSCJUBM /BNVO QFNVTBUBO TJOBS ZBOH CBOZBL EBSJ BOFIOZB CFCFSBQB TFSBU EJOHJO NVMBJ UFSBOHTBOH MBHJ CBSBOHLBMJ
CVOHB BQJ BUBV EBSJ TJOBS NBUBIBSJ QBEB SFUJOB EBQBU NFNCBLBS LBSFOB LFSVTBLBO VKVOHVKVOH SFTFQUPS EJOHJO ZBOH EJTFCBCLBO
SFUJOB EBOLFBEBBOJOJNVOHLJONFOKBEJQFOZFCBCTBLJULFQBMB PMFIQBOBTZBOHCFSMFCJIBO
%BSJ (BNCBS LJUB EBQBU NFOHFSUJ CBIXB LFNBNQVBO
Sensasi Suhu TFTFPSBOH VOUVL EBQBU NFOFOUVLBO QFSCFEBBO HSBEBTJ TFOTBTJ
TVIV EJEBQBU NFMBMVJ QFSBOHTBOHBO SFMBUJG UFSIBEBQ CFSNBDBN
Reseptor Suhu dan Perangsangannya NBDBN UJQF VKVOH TBSBG ,JUB KVHB EBQBU NFOHFSUJ NFOHBQB TVIV
.BOVTJB EBQBU NFSBTBLBO CFSNBDBNNBDBN HSBEBTJ QBOBT EJOHJO BUBV TVIV QBOBT ZBOH FLTUSFN EBQBU NFOZBLJULBO EBO
EBO EJOHJO NVMBJ EBSJ TVIV EJOHJO ZBOH NFNCFLV LF TVIV NFOHBQB LFEVB TFOTBTJ JOJ CJMB DVLVQ UJOHHJ EBQBU KVHB
EJOHJOTBNQBJTVIVTFKVL TFMBOKVUOZBEBSJTVIVIBOHBUTBNQBJ NFNCFSJLBO LVBMJUBT TFOTBTJ ZBOH TBNB ZBJUV TFOTBTJ EJOHJO
QBOBTEBOBLIJSOZBTBNQBJQBOBTZBOHNFNCBLBS NFNCFLVEBOTFOTBTJQBOBTNFNCBLBSZBOHUFSBTBIBNQJSTBNB
(SBEBTJ UFSNBM EBQBU EJCFEBLBO PMFI QBMJOH TFEJLJU UJHB Pengaruh Rangsangan Kenaikan dan Penurunan Suhu—
NBDBN SFTFQUPS TFOTPSJL SFTFQUPS EJOHJO SFTFQUPS IBOHBU Adaptasi Reseptor Suhu. #JMB EFOHBO UJCBUJCB SFTFQUPS EJOHJO
EBO SFTFQUPS OZFSJ 3FTFQUPS OZFSJ IBOZB EJSBOHTBOH PMFI
EJQBKBOLBO QBEB QFOVSVOBO TVIV NVMBNVMB SFTFQUPS BLBO
EFSBKBU QBOBT BUBV EJOHJO ZBOH FLTUSFN TFIJOHHB CFSTBNB
UFSBOHTBOH EFOHBO LVBU TFLBMJ OBNVO SBOHTBOHBO JOJ EFOHBO
EFOHBO SFTFQUPS EJOHJO EBO SFTFQUPS IBOHBU CFSUBOHHVOH
DFQBU BLBO NFNVEBS EBMBN XBLUV CFCFSBQB EFUJL QFSUBNB EBO
KBXBCUFSIBEBQUFSKBEJOZBTFOTBTJEJOHJONFNCFLV GSFF[JOH
NFOKBEJ TFNBLJO MBNCBU TFDBSB QSPHSFTJG TFMBNB NFOJU
DPME
EBOTFOTBTJQBOBTNFNCBLBS CVSOJOHIPU

CFSJLVUOZB BUBV MFCJI %FOHBO LBUB MBJO BEBQUBTJ SFTFQUPS JOJ
3FTFQUPSEJOHJOEBOSFTFQUPSIBOHBUUFSMFUBLUFQBUEJCBXBI TBOHBUMVBTUFUBQJUJEBLQFSOBIQFSTFO
LVMJU QBEB UJUJLUJUJL ZBOH CFSCFEB EBO UFSQJTBIQJTBI 1BEB
+BEJ KFMBTMBI CBIXB JOESB TVIV JOJ EFOHBO CFSFTQPOT TFDBSB
TFCBHJBO CFTBS EBFSBI UVCVI KVNMBI UJUJL EJOHJO LJSBLJSB
CFSNBLOBUFSIBEBQQFSVCBIBOTVIV EJTBNQJOHEBQBUCFSFTQPOT
TBNQBJ LBMJ MJQBU UJUJL IBOHBU EBO KVNMBI SFTFQUPSOZB
UFSIBEBQ LFBEBBO TVIV ZBOH UFUBQ *OJ CFSBSUJ CJMB TVIV LVMJU
CFSWBSJBTJEJCFSCBHBJEBFSBIUVCVI TBNQBJUJUJLEJOHJO
TFDBSBBLUJGNFOVSVO NBLBPSBOHJUVBLBONFSBTBMFCJIEJOHJO
DN QBEB CJCJS TBNQBJ UJUJL EJOHJODN QBEB KBSJ EBO
LVSBOH EBSJ TBUV UJUJL EJOHJO DN QBEB EBFSBI QFSNVLBBO
CBUBOHUVCVIZBOHMVBT
8BMBVQVO CFSEBTBSLBO VKJ QTJLPMPHJT LFCFSBEBBO VKVOH
TFSBU TBSBG IBOHBU ZBOH LIBT DVLVQ NFZBLJOLBO VKVOH TFSBU
TBSBG JOJ CFMVN EBQBU EJJEFOUJGJLBTJ TFDBSB IJTUPMPHJT 6KVOH 10
TFSBUTBSBGJOJEJBOHHBQTFCBHBJVKVOHTBSBGCFCBTLBSFOBTJOZBM 8
UFSVUBNB EJLJSJNLBO QBEB TFSBU TBSBG UJQF $ QBEB LFDFQBUBO
6
QFOHJSJNBOIBOZB TBNQBJNEFUJL
/BNVO SFTFQUPS EJOHJO ZBOH EFGJOJUJG UFMBI EBQBU 4
EJJEFOUJGJLBTJ6KVOHTBSBGLFDJMLIVTVTUJQF"4ZBOHCFSNJFMJO
2
CFSDBCBOHCFCFSBQBLBMJ VKVOHOZBNFOFNCVTLFCBHJBOCBXBI
QFSNVLBBO TFMTFM FQJEFSNJT CBTBM 4JOZBM EBSJ SFTFQUPS
SFTFQUPS JOJ BLBO EJLJSJNLBO NFMBMVJ TFSBU TBSBG UJQF "4 ZBOH 5 10 15 20 25 30 35 40 45 50 55 60
CFSLFDFQBUBO TFLJUBS NEFUJL 4FCBHJBO TFOTBTJ EJOHJO KVHB Temperature (∞C)
EJEVHB EJLJSJNLBO NFMBMVJ TFSBU TBSBG UJQF $ ZBOH NFNCFSJ
LFTBOCBIXBVKVOHTBSBGCFCBTNVOHLJOKVHBCFSGVOHTJTFCBHBJ
SFTFQUPSEJOHJO
592
EBSJQBEB CJMB TVIV JUV EBMBN LFBEBBO UFUBQ EJOHJOOZB TQFTJGJL /BNVO QFOHBOHLBUBO TFMVSVI HJSVT QPTUTFOUSBMJT
4FCBMJLOZB CJMB TVIV TFDBSB BLUJG OBJL NBLB PSBOH JUV BLBO LPSUJLBM QBEB NBOVTJB EBQBU NFOHVSBOHJ UBQJ UJEBL
NFSBTB MFCJI IBOHBU EBSJQBEB CJMB TVIV UFUBQ LPOTUBO 3FTQPOT NFOHIJMBOHLBO LFNBNQVBO VOUVL NFNCFEBLBO HSBEBTJ
UFSIBEBQ QFSVCBIBO TVIV EBQBU NFOKFMBTLBO BEBOZB SBTB QBOBT TVIV
UNIT IX
ZBOH FLTUSFN LFUJLB TFTFPSBOH NFNBTVLJ CBL NBOEJ CFSJTJ BJS
QBOBTEBOBLBONFSBTBEJOHJOZBOHFLTUSFNTFXBLUVLFMVBSEBSJ Daftar Pustaka
SVBOHZBOHQBOBT Almeida TF, Roizenblatt S, Tufik S: Afferent pain pathways: a neuroanatomi-
cal review, Brain Res 1000:40, 2004.
Mekanisme Perangsangan Reseptor Suhu Ballantyne JC, Mao J: Opioid therapy for chronic pain, N Engl J Med
%JEVHB CBIXB SFTFQUPS IBOHBU EBO EJOHJO EJSBOHTBOH PMFI 349:1943, 2003.
Bandell M, Macpherson LJ, Patapoutian A: From chills to chilis: mechanisms
QFSVCBIBO LFDFQBUBO NFUBCPMJTNFOZB EBO QFSVCBIBO JOJ for thermosensation and chemesthesis via thermoTRPs, Curr Opin
NFSVQBLBO BLJCBU EBSJ LFOZBUBBO CBIXB TFUJBQ QFSVCBIBO TVIV Neurobiol 17:490, 2007.
¡$ BLBO NFNFOHBSVIJ LFDFQBUBO SFBLTJ LJNJB JOUSBTFMVMBS Benarroch EE: Descending monoaminergic pain modulation: bidirectional
TFCBOZBLEVBLBMJMJQBU%FOHBOLBUBMBJO EFUFLTJTVIVNVOHLJO control and clinical relevance, Neurology 71:217, 2008.
CVLBO IBTJM EBSJ QFOHBSVI GJTJL QBOBT BUBV EJOHJO QBEB VKVOH Bingel U, Tracey I: Imaging CNS modulation of pain in humans, Physiology
(Bethesda) 23:371, 2008.
VKVOHTBSBGTFDBSBMBOHTVOHUFUBQJEBSJQFSBOHTBOHBOLJNJBQBEB Borsook D, Becerra L: Pain imaging: future applications to integrative clini-
VKVOHTFSBUTBSBGZBOHUFMBIEJNPEJGJLBTJPMFITVIV cal and basic neurobiology, Adv Drug Deliv Rev 55:967, 2003.
Sumasi Spasial Sensasi Suhu. 0MFI LBSFOB KVNMBI VKVOH Bromm B: Brain images of pain, News Physiol Sci 16:244, 2001.
Franks NP: General anaesthesia: from molecular targets to neuronal path-
TFSBUTBSBGEJOHJOBUBVIBOHBUZBOHUFSEBQBUEJTFUJBQQFSNVLBBO ways of sleep and arousal, Nat Rev Neurosci 9:370, 2008.
UVCVITFTFPSBOHTBOHBUTFEJLJU TVLBSVOUVLNFOFOUVLBOHSBEBTJ Gebhart GF: Descending modulation of pain, Neurosci Biobehav Rev 27:729,
TVIVCJMBEBFSBILVMJUZBOHUFSBOHTBOHLFDJM/BNVO CJMBEBFSBI 2004.
LVMJU ZBOH MVBT EJSBOHTBOH CFSTBNBBO NBLB TJOZBM TVIV EBSJ Kandel ER, Schwartz JH, Jessell TM: Principles of Neural Science, ed 4, New
TFMVSVI EBFSBI BLBO EJKVNMBILBO $POUPIOZB QFSVCBIBO TVIV York, 2000, McGraw-Hill.
Lumpkin EA, Caterina MJ: Mechanisms of sensory transduction in the skin,
ZBOHDFQBUTBNQBJTFLFDJM ¡$EBQBUEJEFUFLTJCJMBQFSVCBIBO Nature 445:858, 2007.
JOJ NFNFOHBSVIJ TFMVSVI QFSNVLBBO UVCVI TFDBSB CFSTBNBBO McKemy DD: Temperature sensing across species, Pflugers Arch 454:777,
4FCBMJLOZB QFSVCBIBOTVIVTBNQBJLBMJMJQBUQVOTFSJOHUJEBL 2007.
BLBO UFSEFUFLTJ CJMB MVBT EBFSBI LVMJU ZBOH UFSQFOHBSVI IBOZB Mendell JR, Sahenk Z: Clinical practice: painful sensory neuropathy, N Engl
DN J Med 348:1243, 2003.
Milligan ED, Watkins LR: Pathological and protective roles of glia in chronic
Pengiriman Sinyal Suhu dalam Sistem Saraf pain, Nat Rev Neurosci 10:23, 2009.
Montell C: Thermosensation: hot findings make TRPNs very cool, Curr Biol
1BEBVNVNOZB TJOZBMTVIVEJLJSJNLBOEBMBNKBSBTZBOHQBSBMFM
13:R476, 2003.
EFOHBO KBSBT VOUVL TJOZBM OZFSJ 4FXBLUV NFNBTVLJ NFEVMB Sanchez-del-Rio M, Reuter U: Migraine aura: new information on underly-
TQJOBMJT TJOZBMBLBONFOZFCBSTFCBOZBLCFCFSBQBTFHNFOLFBUBT ing mechanisms, Curr Opin Neurol 17:289, 2004.
BUBV LF CBXBI EBMBN USBLUVT -JTTBVFS EBO TFMBOKVUOZB BLBO Sandkühler J: Models and mechanisms of hyperalgesia and allodynia,
CFSBLIJS UFSVUBNB QBEB MBNJOB * ** *** SBEJLT EPSTBMJT TBNB Physiol Rev 89:707, 2009.
Schaible HG, Ebersberger A, Von Banchet GS: Mechanisms of pain in arthri-
TFQFSUJ VOUVL OZFSJ 4FTVEBI QFNSPTFTBO PMFI TBUV BUBV MFCJI
tis, Ann N Y Acad Sci 966:343, 2002.
OFVSPO EBMBN NFEVMB TQJOBMJT TJOZBM BLBO EJLJSJNLBO LF TFSBU Schepers RJ, Ringkamp M: Thermoreceptors and thermosensitive afferents,
UFSNBMBTFOEFOZBOHNFOZJMBOHLFUSBLUVTTFOTPSJLBOUFSPMBUFSBM Neurosci Biobehav Rev 33:205, 2009.
TJTJ CFSMBXBOBO EBO BLBO CFSBLIJS EJ
BSFB SFUJLVMBS CBUBOH Silberstein SD: Recent developments in migraine, Lancet 372:1369, 2008.
PUBLEBO
LPNQMFLTWFOUSPCBTBMUBMBNVT#FCFSBQBTJOZBMTVIV Stein BE, Stanford TR: Multisensory integration: current issues from the
perspective of the single neuron, Nat Rev Neurosci 9:255, 2008.
EBSJ LPNQMFLT WFOUSPCBTBM BLBO EJTBNQBJLBO NFOVKV LPSUFLT
Watkins LR, Maier SF: Beyond neurons: evidence that immune and glial
TPNBUPTFOTPSJL TFSFCSJ 5FSLBEBOH EFOHBO QFOFMJUJBO cells contribute to pathological pain states, Physiol Rev 82:981, 2002.
NJLSPFMFLUSPEB EJUFNVLBO TVBUV OFVSPO QBEB BSFB White FA, Jung H, Miller RJ: Chemokines and the pathophysiology of neu-
TPNBUPTFOTPSJL LPSUJLBM * ZBOH EBQBU MBOHTVOH CFSFTQPOT ropathic pain, Proc Natl Acad Sci U S A 104:20151, 2007.
UFSIBEBQTUJNVMVTEJOHJOBUBVIBOHBUQBEBEBFSBILVMJUZBOH Zubrzycka M, Janecka A: Substance P: transmitter of nociception (minire-
view), Endocr Regul 34:195, 2000.
593
X
UNIT
4JTUFN4BSBG#*OESB,IVTVT
49. Mata: I. Sifat Optik Mata

50. Mata: II. Reseptor dan Fungsi Neural
Retina
51. Mata Ill. Neurofisiologi Penglihatan
Sentral
52. Indra Pendengaran
53. Indra Kimia-Pengecapan dan Penghidu
BAB 49
UNIT X
.BUB*4JGBU0QUJL.BUB
Prinsip-Prinsip Fisika NFEJVN LFEVB UBOQB NFOHBMBNJ QFNCFMPLBO "LJCBU ZBOH UFSKBEJ
Alat Optik IBOZB CFSVQB QFOVSVOBO LFDFQBUBO EBO QFNFOEFLBO QBOKBOH
HFMPNCBOH TFQFSUJ EJQFS*JIBULBO QBEB HBNCBS EFOHBO TFNBLJO
4FCFMVN EBQBU NFNBIBNJ TJTUFN QFOEFLOZBKBSBLBOUBSBHFMPNCBOHDBIBZB
PQUJL NBUB NBIBTJTXB IBSVT #JMBDBIBZBJUVNFOFNCVTQFSNVLBBOZBOHNJSJOH TFQFSUJZBOH
NFNBIBNJ EVMV EFOHBO CBJL EJQFSMJIBULBO QBEB (BNCBS # CFSLBT DBIBZB BLBO NFNCFMPL
QSJOTJQQSJOTJQEBTBSBMBUBMBU CJMB JOEFLT CJBT LFEVB NFEJB JUV CFSCFEB ,IVTVT QBEB HBNCBS JOJ
PQUJL UFSNBTVL JMNV GJTJLB NFOHFOBJ QFNCJBTBO DBIBZB UJUJL CFSLBT DBIBZB NFOJOHHBMLBO VEBSB ZBOH CFSJOEFLT CJBT EBO
NBTVL LF EBMBN LBDB CFSJOEFLT CJBT ,FUJLB CFSLBT DBIBZB
GPLVT LFEBMBNBO GPLVT EBO TFCBHBJOZB 5FSMFCJI EBIVMV BLBO
NFNCFOUVS CJEBOH QFSBMJIBO ZBOH NJSJOH CFSLBT CBHJBO CBXBI
EJVSBJLBO TFDBSB TJOHLBU NFOHFOBJ QSJOTJQQSJOTJQ GJTJLB
NFNBTVLJLBDBMFCJIEBIVMVTFCFMVNCBHJBOBUBT#FSLBTCBHJBOBUBT
UFSTFCVULFNVEJBOCBSVEJCBIBTNFOHFOBJTJTUFNPQUJLNBUB NBTJI CFSLFDFQBUBO LNEFUJL TFEBOHLBO ZBOH UFMBI
NFNBTVLJ LBDB CFSKBMBO EFOHBO LFDFQBUBO LN EFUJL
Pembiasan Cahaya 1FSJTUJXB JOJ NFOZFCBCLBO HFMPNCBOH DBIBZB CBHJBO BUBT CFSKBMBO
Indeks Bias Substansi Transparan. $BIBZB NFSBNCBU NFOEBIVMVJ CBHJBO CBXBI TFIJOHHB HFMPNCBOH UJEBL CFSCFOUVL
NFMBMVJVEBSBLJSBLJSBEFOHBOLFDFQBUBOLNEFUJL UFUBQJ WFSUJLBM MBHJ NFMBJOLBO NFNCFOUVL TVEVU LF LBOBO 0MFI LBSFOB
QFSBNCBUBOOZB NFMBMVJ CFOEB QBEBU EBO DBJSBO ZBOH USBOTQBSBO BSBI SBNCBU DBIBZB TFMBMV UFHBL MVSVT UFSIBEBQ CJEBOH HFMPNCBOH
KBVIMFCJIMBNCBU*OEFLTCJBTTVCTUBOTJUSBOTQBSBONFSVQBLBOSBTJP BSBISBNCBUCFSLBTDBIBZBCFSCFMPLLFCBXBI
EBSJ LFDFQBUBO DBIBZB EBMBN VEBSB EBO LFDFQBUBO EBMBN TVCTUBOTJ
1FNCFMPLBO CFSLBT DBIBZB QBEB CJEBOH QFSBMJIBO ZBOH NJSJOH
JUV *OEFLT CJBT VEBSB BEBMBI %FOHBO EFNJLJBO CJMB DBIBZB
EJTFCVU TFCBHBJ QFNCJBTBO *OHBUMBI EFOHBO CBJL CBIXB EFSBKBU
NFOFNCVT LBDB KFOJT UFSUFOUV EFOHBO LFDFQBUBO LNEFUJL
QFNCJBTBOBLBONFOJOHLBUTFTVBJEFOHBO
SBTJPJOEFLTCJBTEBSJ
JOEFLTCJBTLBDBJUVTBNBEFOHBOEJCBHJBUBV
LFEVBNFEJBUSBOTQBSBO EBO
EFSBKBULFNJSJOHBOBOUBSBCJEBOH
Pembiasan Cahaya di Tempat Peralihan Dua Media yang QFSBMJIBOEBOQFSNVLBBOHFMPNCBOHZBOHEBUBOH
Berbeda Indeks Biasnya. #JMBTVBUVCFSLBTDBIBZBNFNCFOUVS
TVBUV QFSNVLBBO ZBOH UFSMFUBL UFHBL MVSVT UFSIBEBQ CFSLBT JUV Penerapan Prinsip Pembiasan pada Lensa
TFQFSUJUFSMJIBUQBEB(BNCBS"
CFSLBTDBIBZBBLBONFNBTVLJ Lensa Konveks Memfokuskan Berkas Cahaya.
A (BNCBS NFNQFSMJIBULBO CFSLBT DBIBZB TFKBKBS ZBOH
NFNBTVLJ TFCVBI MFOTB LPOWFLT #FSLBT DBIBZB ZBOH NFMBMVJ
CBHJBO UFOHBI NFOFNCVT MFOTB UFQBU UFHBL MVSVT UFSIBEBQ
QFSNVLBBO MFOTB EBO EFOHBO EFNJLJBO DBIBZB UJEBL EJCJBTLBO
.BLJO EFLBU LF CBHJBO UFQJ MFOTB CFSLBT DBIBZB NFNCFOUVS
QFSNVLBBONFEJBZBOHTFNBLJOCFSTVEVU
597
Unit X Sistem Saraf B. Indra Khusus
$BIBZBZBOHUFSMFUBLMFCJILFUFQJBLBOTFNBLJOEJCFMPLLBOLFBSBI
UFOHBI ZBOH EJLFOBM EFOHBO LPOWFSHFOTJ DBIBZB 4FQBSVI EBSJ
QFNCFMPLBOUFSKBEJTFXBLUVDBIBZBNFNBTVLJMFOTB EBOTFQBSVIMBHJ
LFUJLBDBIBZBLFMVBSEBOMFOTB#JMBMFOTBNFNJMJLJLFMFOHLVOHBOZBOH
TFNQVSOB CFSLBT DBIBZB TFKBKBS ZBOH NFMBMVJ CFSCBHBJ CBHJBO MFOTB
BLBO EJCFMPLLBO TFEFNJLJBO SVQB TFIJOHHB TFMVSVI CFSLBT DBIBZB
BLBONFOVKVTVBUVUJUJL ZBOHEJTFCVUUJUJLGPLVT
Lensa Konkaf Menyebarkan Berkas Cahaya. (BNCBS
NFNQFSMJIBULBO FGFL MFOTB LPOLBG UFSIBEBQ CFSLBT DBIBZB A
TFKBKBS $BIBZB ZBOH NFOHFOBJ CBHJBO TFOUSBM EBSJ MFOTB NFNCFOUVS
QFSNVLBBO ZBOH CFOBSCFOBS UFHBL UVSVT UFSIBEBQ CFSLBT TFIJOHHB
UJEBLEJCJBTLBO$BIBZBEJCBHJBOUFQJNFNBTVLJMFOTBMFCJIEVMVEBSJ
DBIBZB ZBOH NBTVL LF TFOUSBM )BM JOJ CFSMBXBOBO EFOHBO FGFL QBEB
MFOTB LPOWFLT EBO JOJ NFOZFCBCLBO DBIBZB EJ CBHJBO QFSJGFS
NFOHBMBNJEJWFSHFOTJBUBVNFOZFCBSNFOKBVIJDBIBZBZBOHNBTVLLF
TFOUSBM MFOTB +BEJ MFOTB LPOLBG JOFOZFCBSLBO EJWFSHFOTJ
CFSLBT
DBIBZB TFEBOHLBO MFOTB LPOWFLT NFNVTBULBO LPOWFSHFOTJ
CFSLBT
DBIBZB
B
Lensa Silindris Membelokkan Berkas Cahaya Hanya
dalam Satu Bidang—Pembandingan dengan Lensa
Sferis.(BNCBSNFNQFSMJIBULBOMFOTBTGFSJTLPOWFLTEBOMFOTB
TJMJOESJT LPOWFLT 1FSIBUJLBOMBI CBIXB MFOTB TJMJOESJT NFNCFMPLLBO
DBIBZB ZBOH EBUBOH EBSJ LFEVB TJTJ MFOTB UFUBQJ UJEBL EBSJ BUBT BUBV
CBXBI"SUJOZB QFNCFMPLBOUFSKBEJQBEBTBUVCJEBOHUFUBQJUJEBLQBEB
CJEBOH ZBOH MBJO +BEJ DBIBZB TFKBKBS EJCFMPLLBO QBEB TVBUV HBSJT
GPLVT 4FCBMJLOZB DBIBZB ZBOH NFMBMVJ MFOTB TGFSJT EJCJBTLBO QBEB
TFNVBTJTJMFOTB QBEBLFEVBCJEBOH
LFBSBITFOUSBM TFIJOHHBTFMVSVI
DBIBZBNFOVKVQBEBTBUVUJUJLGPLVT
-FOTB TJMJOESJT EBQBU EJJMVTUSBTJLBO EFOHBO TFCVBI UBCVOH SFBLTJ
ZBOHCFSJTJBJS#JMBUBCVOHJUVEJMFUBLLBOEJCBXBI DBIBZBNBUBIBSJ
EBO TFDBSJL LFSUBT EJEFLBULBO LF UBCVOH JUV QBEB TJTJ ZBOH
CFSMBXBOBO QBEB TVBUV KBSBL UFSUFOUV BLBO UFSMJIBU HBNCBSBO HBSJT
GPLVT QBEB LFSUBT -FOTB TGFSJT EBQBU EJJMVTUSBTJLBO EFOHBO TFCVBI MVSVT-FOTBTJMJOESJTWFSUJLBMNFNVTBULBODBIBZBZBOHEBUBOHNFMBMVJ
LBDB QFNCFTBS CJBTB +JLB MFOTB JOJ EJMFUBLLBO EJ CBXBI DBIBZB LFEVB TJTJOZB EBO MFOTB IPSJ[POUBM NFNVTBULBO DBIBZB ZBOH EBUBOH
NBUBIBSJ EBO TFDBSJL LFSUBT EJEFLBULBO EJ CBXBI MFOTB DBIBZB BLBO NFMBMVJ TJTJ BUBT EBO CBXBI %FOHBO EFNJLJBO TFNVB DBIBZB BLBO
TBNQBJLFTBUVUJUJLGPLVTQBEBKBSBLUFSUFOUV NFOVKVLFTBUVUJUJLGPLVT%FOHBOQFSLBUBBOMBJO EVBMFOTBTJMJOESJT
ZBOHEJMFUBLLBOTBMJOHUFHBLMVSVTBLBOCFSGVOHTJTFQFSUJTFCVBIMFOTB
-FOTBTJMJOESJTLPOLBGNFOZFCBSLBOCFSLBTDBIBZBIBOZBQBEBTBUV
TGFSJTEFOHBOEBZBCJBTZBOHTBNB
CJEBOH TFQFSUJ IBMOZB MFOTB TJMJOESJT LPOWFLT NFNVTBULBO CFSLBT
DBIBZBIBOZBQBEBTBUVCJEBOH
Jarak Fokus Lensa
Kombinasi Dua Lensa Silindris yang Saling Tegak
+BSBL EJ CFMBLBOH MFOTB LPOWFLT TBNQBJ LF UFNQBU CFSLBT DBIBZB
Lurus Setara dengan Lensa Sferis.(BNCBS# TFKBKBS NFOZBUV NFOKBEJ TBUV UJUJL GPLVT EJTFCVU KBSBL GPLVT MFOTB
NFNQFSMJIBULBOEVBMFOTBTJMJOESJTLPOWFLTZBOHUFSMFUBLTBMJOHUFHBL %JBHSBNQBEBCBHJBOBUBT(BNCBSNFNQFSMJIBULBOQFNGPLVTBO
CFSLBTDBIBZBTFKBKBSJOJ
1BEB EJBHSBN UFOHBI DBIBZB ZBOH EBUBOH LF MFOTB
LPOWFLT UJEBL TFKBKBS NFMBJOLBO NFOZFCBS LBSFOB TVNCFS DBIBZBOZB
UFSMFUBLUJEBLKBVIEBSJMFOTB0MFILBSFOBDBIBZBZBOHEBUBOHCFSTJGBU
NFOZFCBS EBSJ UJUJL TVNCFS UBJOQBL QBEB EJBHSBN CBIXB DBIBZB JOJ
UJEBL UFSGPLVT QBEB KBSBL ZBOH TBNB TFQFSUJ QBEB DBIBZB TFKBKBS
%FOHBO LBUB MBJO CJMB CFSLBT DBIBZB ZBOH UFMBI NFOZFCBS NFNBTVLJ
MFOTB LPOWFLT KBSBL GPLVT ZBOH EJIBTJMLBO BLBO MFCJI KBVI EBSJ MFOTB
EBSJQBEBKBSBLGPLVTMFOTBQBEBDBIBZBTFKBKBS
%JBHSBNQBMJOHCBXBIQBEB(BNCBSNFNQFSMJIBULBOCFSLBT
DBIBZBNFOZFCBSZBOHCFSKBMBONFOVKVTFCVBIMFOTBLPOWFLTEFOHBO
LFMFOHLVOHBOZBOHKBVIMFCJICFTBSEJCBOEJOHLFEVBMFOTBEJBUBTOZB
1BEBEJBHSBNJOJ KBSBLGPLVTBEBMBITBNBEFOHBOZBOHUFSEBQBUQBEB
EJBHSBN QFSUBNB EJNBOB MFOTB LVSBOH DFNCVOH OBNVO CFSLBT
DBIBZB ZBOH EBUBOH TFKBKBS 1FSJTUJXB JOJ NFNQFSMJIBULBO CBIXB
DBIBZB TFKBKBS EBO DBIBZB NFOZFCBS EBQBU EJGPLVTLBO QBEB KBSBL
ZBOH TBNB EJ CFMBLBOH MFOTB EFOHBO DBSB NFOHVCBI LFDFNCVOHBO
MFOTB
598
Bab 49 Mata: I. Sifat Optik Mata
UNIT X
B
(BNCBS " NFNQFSMJIBULBO MFOTB LPOWFLT EFOHBO EVB UJUJL

TVNCFS DBIBZB EJ TFCFMBI LJSJ 0MFI LBSFOB DBIBZB ZBOH NFMBMVJ
QVTBUMFOTBLPOWFLTUJEBLNFOHBMBNJQFNCJBTBONBLBDBIBZBEBSJ
TFUJBQUJUJLTVNCFSDBIBZBUFSMJIBUNFOVKVLFTVBUVUJUJLGPLVTQBEB
TJTJMFOTBZBOHMBJO UFQBUEJHBSJTZBOHNFMBMVJUJUJLTVNCFSDBIBZB
)VCVOHBO BOUBSB KBSBL GPLVT MFOTB KBSBL TVNCFS DBIBZB EBO
EBOQVTBUMFOTB
KBSBLCBZBOHBOEJOZBUBLBOEFOHBOSVNVTCFSJLVU
4FUJBQ CFOEB ZBOH UFSMFUBL EJ EFQBO MFOTB QBEB LFOZBUBBOOZB
1 1 1 NFSVQBLBOLVNQVMBOEBSJCFCFSBQBUJUJLTVNCFSDBIBZB4FCBHJBO
= +
f a b EBSJUJUJLJOJNFSVQBLBODBIBZBZBOHTBOHBULVBU TFCBHJBOMBHJMBHJ
EFOHBO G BEBMBI KBSBL GPLVT MFOTB VOUVL DBIBZB TFKBKBS B KBSBL TBOHBU MFNBI EFOHBO XBSOB ZBOH CFSBHBN 4FUJBQ UJUJL TVNCFS
TVNCFSDBIBZBEBOMFOTB EBOCKBSBLGPLVTMFOTBQBEBTJTJZBOHMBJO DBIBZB QBEB CFOEB NFNCFOUVL UJUJL GPLVT ZBOH UFSQJTBI QBEB TJTJ
MBJO MFOTB TFHBSJT EFOHBO QVTBU MFOTB #JMB TFDBSJL LFSUBT QVUJI
A EJMFUBLLBOQBEBKBSBLGPLVTMFOTBJOJ UBNQBLCBZBOHBOEBSJCFOEB
599
Unit X Sistem Saraf.• B. Indra Khusus
TFQFSUJ ZBOH UFSMJIBU EBMBN (BNCBS # /BNVO CBZBOHBO JOJ

UFSCBMJL EJCBOEJOHLBO CFOEB BTMJOZB EFNJLJBO QVMB LFEVB TJTJ Susunan Optik Mata
MBUFSBMOZB*OJBEBMBINFUPEFQBEBMFOTBLBNFSBVOUVLNFNGPLVTLBO
CBZBOHBOQBEBGJMN Mata sebagai Kamera
.BUB TFQFSUJ UFSMVLJT EBMBN (BNCBS TFDBSB PQUJL EBQBU
Ukuran Daya Bias Lensa—"Dioptri" EJTBNBLBO EFOHBO TFCVBI LBNFSB GPUPHSBGJ CJBTB .BUB
NFNQVOZBJ TJTUFN MFOTB EJBGSBHNB ZBOH EBQBU CFSVCBIVCBI
.BLJOCFTBSTVBUVMFOTBNFNCFMPLLBODBIBZB NBLJOCFTBSEBZBCJBT
QVQJM
EBO SFUJOB ZBOH EBQBU EJTBNBLBO EFOHBO GJMN 4JTUFN
MFOTBUFSTFCVU6LVSBOEBZBCJBTMFOTBEJTFCVUEJPQUSJ%BZBCJBTMFOTB
LPOWFLT EBMBN EJPQUSJ TBNB EFOHBO NFUFS EJCBHJ KBSBL GPLVTOZB MFOTB NBUB UFSEJSJ BUBT FNQBU QFSCBUBTBO SFGSBLTJ
QFSCBUBTBO
+BEJ TFCVBIMFOTBTGFSJTNFNQVOZBJEBZBCJBTEJPQUSJCJMBMFOTBJUV BOUBSB QFSNVLBBO BOUFSJPS LPSOFB EBO VEBSB
QFSCBUBTBO
NFNVTBULBODBIBZBTFKBKBSNFOVKVTBUVUJUJLGPLVTNFUFSEJCFMBLBOH BOUBSB QFSNVLBBO QPTUFSJPS LPSOFB EBO IVNPS BRVFPVT

MFOTB TFQFSUJ ZBOH EJMVLJTLBO EBMBN (BNCBS #JMB NBNQV QFSCBUBTBO BOUBSB IVNPS BRVFPVT EBO QFSNVLBBO BOUFSJPS MFOTB
NFNCFMPLLBO CFSLBT DBIBZB TFKBKBS TFCFTBS EVB LBMJ LFLVBUBO MFOTB NBUB EBO
QFSCBUBTBO BOUBSB QFSNVLBBO QPTUFSJPS MFOTB EBO
ZBOH CFSEBZB CJBT EJPQUSJ NBLB MFOTB JUV EJTFCVU CFSLFLVBUBO IVNPS WJUSFPVT *OEFLT JOUFSOBM VEBSB BEBMBI LPSOFB
EJPQUSJ EBOCFSLBTDBIBZBBLBOEJGPLVTLBO NFUFSEJCFMBLBOHMFOTB IVNPSBRVFPVT MFOTBLSJTUBMJOB SBUBSBUB
EBOIVNPS
-FOTBZBOHNBNQVNFNVTBUMBODBIBZBTFKBKBSLFUJUJLGPLVTIBOZB WJUSFPVT
DN NFUFS
EJ CFMBLBOH MFOTB EJTFCVU NFNQVOZBJ EBZB CJBT
EJPQUSJ Mempertimbangkan Seluruh Permukaan Refraksi Mata
%BZBCJBTMFOTBLPOLBGUJEBLEBQBUEJOZBUBLBOEFOHBOKBSBLGPLVT sebagai Lensa Tunggal—Mata "Sederhana". #JMB TFMVSVI
EJCFMBLBOHMFOTB LBSFOBDBIBZBNFOZFCBS EBOCVLBOUFSGPLVTQBEB QFSNVLBBOSFGSBLTJNBUBEJKVNMBILBOTFDBSBBMKBCBSEBOEJBOHHBQ
TBUVUJUJL/BNVO KJLBTVBUVMFOTBLPOLBGNFOZFCBSLBOCFSLBTDBIBZB TFCBHBJ TBUV MFOTB UVOHHBM TVTVOBO PQUJL NBUB OPSNBM EBQBU
EFOHBO LFLVBUBO ZBOH TBNB EFOHBO MFOTB LPOWFLT CFSLFLVBUBO EJTFEFSIBOBLBO EBO EJUBNQJMLBO TFDBSB TLFNBUJT TFCBHBJ NBUB
EJPQUSJ MFOTB LPOLBG JUV EJTFCVU NFNQVOZBJ EBZB CJBT EJPQUSJ
TFEFSIBOB SFEVDFE FZF
4LFNB JOJ CFSHVOB VOUVL QFSIJUVOHBO
%FNJLJBOQVMB CJMBMFOTBLPOLBGUFSTFCVUNFOZFCBSLBOCFSLBTDBIBZB
TFEFSIBOB1BEBNBUBTFEFSIBOB SFEVDFEFZF
UFSTFCVUEJBOHHBQ
TFLVBUQFNVTBUBODBIBZBPMFIMFOTBLPOWFLTCFSLFLVBUBOEJPQUSJ
MFOTBLPOLBGJUVEJTFCVUCFSLFLVBUBOEJPQUSJ
UFSEBQBU TVBUV QFSNVLBBO SFGSBLTJ UVOHHBM EFOHBO UJUJL QVTBU
NN EJ EFQBO SFUJOB EFOHBO EBZB CJBT UPUBM EJPQUSJ QBEB TBBU
-FOTB LPOLBG EBQBU NFOFUSBMLBO EBZB CJBT MFOTB LPOWFLT +BEJ MFOTBCFSBLPNPEBTJVOUVLNFMJIBUKBVI
EFOHBONFMFUBLLBOMFOTBLPOLBGCFSLFLVBUBOEJPQUSJUFQBUEJEFQBO
MFOTBLPOWFLTCFSLFLVBUBOEJPQUSJBLBONFOHIBTJMLBOTJTUFNMFOTB 4FLJUBS EVB QFSUJHB EBSJ EBZB CJBT NBUB EJPQUSJ EJIBTJMLBO
CFSEBZBCJBTOPM PMFIQFSNVLBBOBOUFSJPSLPSOFB CVLBOPMFIMFOTBNBUB
"MBTBO
VUBNBOZB JBMBI LBSFOB JOEFLT CJBT LPSOFB TBOHBU CFSCFEB EBSJ
,FLVBUBO MFOTB TJMJOESJT EJVLVS EFOHBO DBSB ZBOH TBNB TFQFSUJ
NFOHVLVSLFLVBUBOMFOTBTGFSJT OBNVOTFMBJOLFLVBUBOMFOTB TVNCV JOEFLT CJBT VEBSB TFNFOUBSB JOEFLT CJBT MFOTB NBUB UJEBL KBVI
MFOTB TJMJOESJT KVHB IBSVT EJOZBUBLBO +JLB TVBUV MFOTB TJMJOESJT CFSCFEBEFOHBOJOEFLTCJBTIVNPSBRVFPVTEBOIVNPSWJUSFPVT
NFNGPLVTLBO DBIBZB TFKBKBS QBEB TVBUV HBSJT GPLVT NFUFS EJ %BZB CJBT UPUBM MFOTB EBMBN NBUB LBSFOB OPSNBM UFSMFUBL EJ
CFMBLBOH MFOTB MFOTB JOJ EJTFCVU NFNQVOZBJ LFLVBUBO EJPQUSJ EBMBNNBUBEJLFMJMJOHJDBJSBO IBOZBEJPQUSJ LJSBLJSBTFQFSUJHB
4FCBMJLOZB KJLB MFOTB TJMJOESJT LPOLBG NFOZFCBSLBO DBIBZB EFOHBO EBSJ EBZB CJBT UPUBM NBUB /BNVO QFOUJOHOZB MFOTB EBMBN JOJ
LFLVBUBO TBNB TFQFSUJ QFNVTBUBO DBIBZB PMFI MFOTB TJMJOESJT BEBMBI LBSFOB TFCBHBJ SFTQPOT UFSIBEBQ TJOZBM TBSBG EBSJ PUBL
CFSLFLVBUBO EJPQUSJ MFOTB JOJ EJTFCVU NFNQVOZBJ LFLVBUBO
MFOHLVOH QFSNVLBBOOZB EBQBU NBLJO DFNCVOH TFIJOHHB
EJPQUSJ+JLBHBSJTGPLVTOZBIPSJ[POUBM TVNCVOZBEJLBUBLBOEFSBKBU
+JLBHBSJTJOJWFSUJLBM TVNCVOZBEJTFCVUEFSBKBU
NFNVOHLJOLBO UFSKBEJOZB BLPNPEBTJhh ZBOH BLBO EJCBIBT
LFNVEJBOEBMBNCBCJOJ
10
1.40 1.38 1.00

1.34 1.33
1 meter
600
Pembentukan Bayangan di Retina. 4BNB TFQFSUJ MJHBNFO UFSIBEBQ MFOTB 4FSBU TJSLVMBS UFSTVTVO NFMJOHLBS
QFNCFOUVLBO CBZBOHBO PMFI MFOTB LBDB QBEB TFDBSJL LFSUBT NFOHFMJMJOHJ QFMFLBUBO MJHBNFO TFIJOHHB QBEB XBLUV
TJTUFN MFOTB NBUB KVHB EBQBU NFNCFOUVL CBZBOHBO EJ SFUJOB CFSLPOUSBLTJ UFSKBEJ HFSBL TFQFSUJ TGJOHUFS NFOHVSBOHJ
#BZBOHBOJOJUFSCBMJLEJCBOEJOHLBOCFOEBOZB/BNVOEFNJLJBO EJBNFUFS MJOHLBSBO QFMFLBUBO MJHBNFO IBM JOJ KVHB
QFSTFQTJ PUBL UFSIBEBQ CFOEB UFUBQ EBMBN LFBEBBO UFHBL NFOZFCBCLBO UBSJLBO MJHBNFO UFSIBEBQ LBQTVM MFOTB
UNIT X
NFTLJQVOUFSEBQBUPSJFOUBTJUFSCBMJLEJSFUJOB LBSFOBPUBLTVEBI CFSLVSBOH
EJMBUJI NFOBOHLBQ CBZBOHBO ZBOH UFSCBMJL JUV TFCBHBJ LFBEBBO
+BEJ LPOUSBLTJTBMBITBUVTFUTFSBUPUPUQPMPTEBMBNPUPUTJMJBSJT
OPSNBM
BLBO NFOHFOEVSLBO MJHBNFO LBQTVM MFOTB EBO MFOTB BLBO
CFSCFOUVL MFCJI DFNCVOH TFQFSUJ CBMPO BLJCBU TJGBU FMBTUJTJUBT
Mekanisme "Akomodasi"
BMBNJLBQTVMMFOTB
1BEBBOBLBOBL EBZBCJBTMFOTBNBUBEBQBUEJUJOHLBULBOEBSJ
EJPQUSJ NFOKBEJ LJSBLJSB EJPQUSJ JOJ CFSBSUJ UFSKBEJ Akomodasi Diatur oleh Saraf Parasimpatis. 0UPUTJMJBSJT
BLPNPEBTJ TFCFTBS EJPQUSJ 6OUVL JUV CFOUVL MFOTB EJVCBI IBNQJS TFMVSVIOZB EJBUVS PMFI TJOZBM TBSBG QBSBTJNQBUJT ZBOH
EBSJ ZBOH UBEJOZB LPOWFLTTFEBOH NFOKBEJ MFOTB ZBOH TBOHBU EJIBOUBSLBOLFNBUBNFMBMVJTBSBGLSBOJBM***EBOOVLMFVTTBSBG
LPOWFLT.FLBOJTNFOZBBEBMBITFCBHBJCFSJLVU *** QBEB CBUBOH PUBL TFQFSUJ ZBOH EJKFMBTLBO EBMBN #BC
1FSBOHTBOHBOTBSBGQBSBTJNQBUJTNFOJNCVMLBOLPOUSBLTJLFEVB
1BEB PSBOH NVEB MFOTB UFSEJSJ BUBT LBQTVM FMBTUJT ZBOH LVBU TFU TFSBU PUPU TJMJBSJT ZBOH BLBO NFOHFOEVSLBO MJHBNFO MFOTB
CFSJTJ DBJSBO LFOUBM ZBOH NFOHBOEVOH CBOZBL QSPUFJO OBNVO TFIJOHHB NFOZFCBCLBO MFOTB NFOKBEJ MFCJI UFCBM EBO
USBOTQBSBO #JMB CFSBEB EBMBN LFBEBBO SFMBLTBTJ UBOQB UBSJLBO NFOJOHLBULBO EBZB CJBTOZB %FOHBO NFOJOHLBUOZB EBZB CJBT
UFSIBEBQLBQTVMOZB MFOTBBLBOCFSCFOUVLIBNQJSTGFSJT UFSVUBNB NBUBNBNQVNFMJIBUPCKFLMFCJIEFLBUEJCBOEJOHTFXBLUVEBZB
BLJCBUSFUSBLTJFMBTUJTLBQTVMMFOTB/BNVO TFQFSUJUFSMJIBUEBMBN CJBTOZBSFOEBI"LJCBUOZB EFOHBONFOEFLBUOZBPCKFLLFBSBI
(BNCBS UFSEBQBU LJSBLJSB MJHBNFO TVTQFOTPSJVN ZBOH NBUB KVNMBI JNQVMT QBSBTJNQBUJT ZBOH TBNQBJ LF PUPU TJMJBSJT
NFMFLBU EJ TFLFMJMJOH MFOTB TFDBSB SBEJBM NFOBSJL UFQJ MFOTB LF IBSVT EJUJOHLBULBO TFDBSB QSPHSFTJG BHBS PCKFL UFUBQ EBQBU
BSBI MJOHLBS MVBS CPMB NBUB -JHBNFO JOJ TFDBSB LPOTUBO EJMJIBU EFOHBO KFMBT 1FSBOHTBOHBO TJNQBUJT NFNCFSJLBO FGFL
EJSFHBOHLBO PMFI QFMFLBUBOOZB QBEB UFQJ BOUFSJPS LPSPJE EBO UBNCBIBO UFSIBEBQ SFMBLTBTJ PUPU TJMJBSJT UBQJ FGFL JOJ TBOHBU
SFUJOB3FHBOHBOQBEBMJHBNFOJOJNFOZFCBCLBOMFOTBUFUBQSFMBUJG LFDJM TFIJOHHB IBNQJS UJEBL CFSQFSBO EBMBN NFLBOJTNF
EBUBSEBMBNLFBEBBONBUBJTUJSBIBU BLPNPEBTJ OPSNBM NFLBOJTNF OFVSPMPHJT NFOHFOBJ IBM JOJ
EJCBIBTEBMBN#BC
8BMBVQVOEFNJLJBO EJUFNQBUQFMFLBUBOMBUFSBMMJHBNFOMFOTB
QBEB CPMB NBUB KVHB UFSEBQBU PUPU TJMJBSJT ZBOH NFNJMJLJ EVB TFU Presbiopia—Hilangnya Daya Akomodasi Lensa. %FOHBO
TFSBUPUPUQPMPTZBOHUFSQJTBITFSBUNFSJEJPOBMEBOTFSBUTJSLVMBS
4FSBU NFSJEJPOBM NFNCFOUBOH EBSJ VKVOH QFSJGFS MJHBNFO NFOJOHLBUOZB VTJB MFOTB TFNBLJO CFTBS EBO NFOFCBM TFSUB
TVTQFOTPSJVN TBNQBJ QFSBMJIBO LPSOFBTLMFSB #JMB TFSBU PUPU JOJ NFOKBEJ LVSBOH FMBTUJT TFCBHJBO EJTFCBCLBO PMFI EFOBUVSBTJ
CFSLPOUSBLTJ JOTFSTJ QFSJGFS EBSJ MJHBNFO MFOTB UBEJ BLBO UFSUBSJL QSPHSFTJG QSPUFJO MFOTB ,FNBNQVBO MFOTB VOUVL CFSVCBI
LFNFEJBMLFBSBIUFQJLPSOFB TFIJOHHBNFOHVSBOHJSFHBOHBO CFOUVLBLBOCFSLVSBOHTFJSJOHEFOHBOCFSUBNCBIOZBVTJB%BZB
BLPNPEBTJ CFSLVSBOH EBSJ EJPQUSJ QBEB VTJB BOBLBOBL
NFOKBEJ LVSBOH EBSJ EJPQUSJ QBEB TBBU LJUB NFODBQBJ VTJB
TBNQBJUBIVOLFNVEJBOEBZBBLPNPEBTJCFSLVSBOHNFOKBEJ
EJPQUSJQBEBVTJBUBIVO4FTVEBIJUV EBQBUEJLBUBLBOMFOTB
IBNQJS TBNB TFLBMJ UJEBL EBQBU CFSBLPNPEBTJ EBO LFBEBBO JUV
EJTFCVUQSFTCJPQJB
4FHFSB TFUFMBI NFODBQBJ LFBEBBO QSFTCJPQJB NBUB BLBO
UFSGPLVTTFDBSBQFSNBOFOQBEBTVBUVKBSBLZBOHLPOTUBOKBSBL
JOJ CFSHBOUVOH QBEB LFBEBBO GJTJL NBUB PSBOH UFSTFCVU .BUB
UJEBLEBQBUCFSBLPNPEBTJMBHJVOUVLQFOHMJIBUBOEFLBUNBVQVO
Circular KBVI "HBS EBQBU NFMJIBU EFLBU NBVQVO KBVI EFOHBO KFMBT
fibers TFPSBOH UVB IBSVT NFNBLBJ LBDBNBUB CJGPLVT CBHJBO BUBT
VOUVL QFOHMJIBUBO KBVI EBO CBHJBO CBXBI VOUVL QFOHMJIBUBO
EFLBU NJTBMOZB VOUVLNFNCBDB

Diameter Pupil
'VOHTJ VUBNB JSJT JBMBI VOUVL NFOJOHLBULBO KVNMBI DBIBZB
ZBOH NBTVL LF EBMBN NBUB QBEB XBLUV HFMBQ EBO VOUVL
NFOHVSBOHJ KVNMBI DBIBZB ZBOH NBTVL LF EBMBN NBUB QBEB
XBLUV UFSBOH 3FGMFLTSFGMFLT VOUVL NFOHBUVS NFLBOJTNF JOJ
BLBOEJCBIBTQBEBCBHJBOOFVSPMPHJNBUBEBMBN#BC
601
Unit X Sistem Saraf: B Indra Khusus
+VNMBI DBIBZB ZBOH NFNBTVLJ NBUB NFMBMVJ QVQJM

TFCBOEJOH EFOHBO MVBT QVQJM BUBV LVBESBU EJBNFUFS QVQJM
%JBNFUFS QVQJM NBOVTJB EBQBU NFOHFDJM TBNQBJ NN EBO
NFNCFTBSTBNQBJNN+VNMBIDBIBZBZBOHNFNBTVLJNBUB
EBQBU CFSVCBI TFLJUBS LBMJ MJQBU TFCBHBJ BLJCBU EBSJ
QFSVCBIBOQVQJM Emmetropia
"Kedalaman Ftkus" Sistem Lensa Meningkat dengan

Menurunnya Diameter Pupil(BNCBSNFNQFSMJIBULBO
EVBNBUBZBOHTBNBLFDVBMJEJBNFUFSQVQJMOZB1BEBNBUBBUBT
QVQJMOZBLFDJM TFEBOHLBOQBEBNBUBCBXBI QVQJMOZBCFTBS%J
EFQBOTFUJBQNBUBUFSEBQBUEVBUJUJLTVNCFSDBIBZBZBOHLFDJM
DBIBZBEBSJTFUJBQUJUJLTVNCFSDBIBZBNBTVLNFMBMVJQVQJMEBO
H peropia
EJGPLVTLBOEJSFUJOB"LJCBUOZB EJLFEVBNBUB SFUJOBNFMJIBU
EVB UJUJL DBIBZB EFOHBO GPLVT CBJL /BNVO UFSMJIBU QBEB
EJBHSBN CJMB SFUJOB EJQJOEBILBO LF EFQBO BUBV LF CFMBLBOH
QBEB QPTJTJ UJEBLGPLVT NBLB QBEB NBUB BUBT CFTBS UJBQ UJUJL
DBIBZB UJEBL BLBO CFSVCBI CBOZBL UFUBQJ QBEB NBUB CBXBI
VLVSBO UJBQ UJUJL DBIBZB BLBO TBOHBU NFNCFTBS NFOKBEJ
MJOHLBSBO LBCVShh %FOHBO LBUB MBJO TJTUFN MFOTB BUBT
NFNQVOZBJLFEBMBNBOGPLVTKBVIMFCJICFTBSEJCBOEJOHTJTUFN M opia
MFOTB ZBOH EJ CBXBI #JMB TJTUFN MFOTB NFNQVOZBJ LFEBMBNBO
GPLVT ZBOH CFTBS SFUJOB EBQBU EJQJOEBILBO KBVI EBSJ CJEBOH
GPLVTBUBVLFLVBUBOMFOTBOZBEBQBUTBOHBUCFSVCBIEBSJOPSNBM
EBO CBZBOHBO UFUBQ BLBO UFHBT TFCBMJLOZB CJMB TJTUFN MFOTB
NBUBFNFUSPQEBQBUNFMJIBUTFNVBPCKFLKBVITFDBSBKFMBTEFOHBOPUPU
NFNJMJLJ LFEBMBNBO GPLVT ZBOH EBOHLBMh QFSQJOEBIBO SFUJOB
TJMJBSJT ZBOH SFMBLT /BNVO VOUVL NFMJIBU PCKFL EFLBU PUPU TJMJBSJT
TFEJLJU TBKB EBSJ CJEBOH GPLVT BLBO TBOHBU NFOHBCVSLBO IBSVTCFSLPOUSBLTJBHBSNBUBEBQBUCFSBLPNPEBTJEFOHBOCBJL
CBZBOHBO
,FEBMBNBO GPLVT UFSCFTBS EBQBU UFSKBEJ CJMB QVQJM TBOHBU Hiperopia (Penglihatan Jauh). )JQFSPQJB EJLFOBM QVMB
LFDJM "MBTBOOZB JBMBI EFOHBO QVQJM ZBOH TBOHBU LFDJM IBNQJS TFCBHBJ QFOHMJIBUBO KBVIh CJBTBOZB BLJCBU CPMB NBUB UFSUBMV QFOEFL
TFMVSVICFSLBTDBIBZBNFMBMVJCBHJBOUFOHBIMFOTB EBODBIBZB BUBVLBEBOHLBEBOHLBSFOBTJTUFNMFOTBUFSMBMVMFNBI1BEBLFBEBBO
TFOUSBMTFMBMVUFSGPLVTCBJL TFQFSUJUFMBIEJKFMBTLBOTFCFMVNOZB JOJ TFQFSUJ ZBOH EJUVOKVLLBO PMFI (BNCBS CBHJBO UFOHBI
UFSMJIBU CBIXB DBIBZB TFKBKBS LVSBOH EJCFMPLLBO PMFI TJTUFN MFOTB
ZBOH SFMBLT TFIJOHHB UJEBL UFSGPLVT EJ SFUJOB 6OUVL NFOHBUBTJ
LFMBJOBO JOJ PUPU TJMJBSJT CFSLPOUSBLTJ VOUVL NFOJOHLBULBO LFLVBUBO
MFOTB%FOHBONFOHHVOBLBONFLBOJTNFBLPNPEBTJ QBTJFOIJQFSPQJB
EBQBU NFNGPLVTLBO CBZBOHBO EBSJ PCKFL KBVI EJ SFUJOB #JMB QBTJFO
Kelainan Refraksi IBOZB NFOHHVOBLBO TFCBHJBO EBSJ LFLVBUBO PUPU TJMJBSJTOZB VOUVL
Emetropia (Penglihatan Normal). 4FQFSUJ UFSMJIBU EBMBN NFMBLVLBO BLPNPEBTJ KBSBL KBVI JB NBTJI NFNQVOZBJ TJTB EBZB
(BNCBS NBUB BLBO EJBOHHBQ OPSNBM BUBV FNFUSPQ BLPNPEBTJ EBO PCKFL ZBOH TFNBLJO NFOEFLBUJ NBUB EBQBU KVHB
CJMBDBIBZBTFKBKBSEBSJPCKFLKBVIEJGPLVTLBOEJSFUJOBQBEB UFSGPLVT KFMBT TBBU PUPU TJMJBSJT UFMBI CFSLPOUSBLTJ NBLTJNVN 1BEB
LFBEBBOPUPUTJMJBSJTSFMBLTBTJUPUBM*OJCFSBSUJCBIXB PSBOH UVB TFXBLUV MFOTB NFOKBEJ QSFTCJPQ TFPSBOH EFOHBO NBUB
KBVI TFSJOH UJEBL EBQBU CFSBLPNPEBTJ DVLVQ LVBU VOUVL
NFNGPLVTLBOPCKFLKBVITFLBMJQVO BQBMBHJVOUVLPCKFLEFLBU
Miopia (Penglihatan Dekat). 1BEB NJPQJB BUBV QFOHMJIBUBO

EFLBUh TFXBLUV PUPU TJMJBSJT SFMBLTBTJ UPUBM DBIBZB EBSJ PCKFL KBVI
EJGPLVTLBOEJEFQBOSFUJOB TFQFSUJUFSMJIBUQBEB(BNCBSCBHJBO
CBXBI,FBEBBOJOJCJBTBOZBBLJCBUCPMBNBUBUFSMBMVQBOKBOH UFUBQJ
EBQBUEJTFCBCLBOEBZBCJBTTJTUFNMFOTBZBOHUFSMBMVLVBU
5JEBL BEB NFLBOJTNF CBHJ NBUB NJPQJB VOUVL NFOHVSBOHJ

LFLVBUBO MFOTBOZB TBNQBJ MFCJI LFDJM EBSJ LFLVBUBOOZB CJMB PUPU
TJMJBSJT EBMBN LFBEBBO SFMBLTBTJ TFNQVSOB 1BTJFO NJPQJB UJEBL
NFNQVOZBJ NFLBOJTNF VOUVL NFNGPLVTLBO CBZBOHBO EBSJ PCKFL
KBVI EFOHBO KFMBT EJ SFUJOB /BNVO CJMB PCKFL EJEFLBULBO LF NBUB
CFOEBUFSTFCVUBLIJSOZBNFOKBEJDVLVQEFLBUTFIJOHHBCBZBOHBOOZB
EBQBU EJGPLVTLBO ,FNVEJBO CJMB PCKFL UFSVT EJEFLBULBO LF NBUB
QBTJFO NJPQJB EBQBU NFOHHVOBLBO NFLBOJTNF BLPNPEBTJ BHBS
CBZBOHBOZBOHUFSCFOUVLUFUBQUFSGPLVTEFOHBOKFMBT4FPSBOHEFOHBO
NJPQJBNFNQVOZBJUJUJLKBVIZBOHUFSCBUBTVOUVLQFOHMJIBUBOKFMBT
602
Koreksi Miopia dan Hiperopia dengan Menggunakan

Lensa.1FSMVEJJOHBUMBHJCBIXBDBIBZBZBOHNFMBMVJMFOTBLPOLBGBLBO
EJTFCBSLBO #JMB QFSNVLBBO SFGSBLTJ NBUB NFNQVOZBJ EBZB CJBT ZBOH
UFSMBMVCFTBS TFQFSUJQBEBNJPQJB LFMFCJIBOEBZBCJBTJOJEBQBUEJLPSFMDTJ A B
EFOHBO NFMFUBLLBO MFOTB TGFSJT LPOLBG EJ EFQBO NBUB ZBOH BLBO
UNIT X
NFOZFCBSLBO CFSLBT DBIBZB ,PSFLTJ TFQFSUJ JOJ UBNQBL QBEB EJBHSBN
CBHJBOBUBT(BNCBS C
D
4FCBMJLOZB QBEB PSBOH EFOHBO IJQFSPQJB ZBOH NFNQVOZBJ TJTUFN AC
MFOTB UFSMBMV MFNBI QFOHMJIBUBO BCOPSNBMOZB EBQBU EJLPSFLTJ EFOHBO BD
NFOBNCBILBO EBZB CJBT NFOHHVOBLBO MFOTB LPOWFLT EJ EFQBO NBUB
,PSFLTJJOJEJQFSMJIBULBOQBEBEJBHSBNCBHJBOCBXBI(BNCBS
#JBTBOZB LFLVBUBO MFOTB LPOLBG BUBV LPOWFLT ZBOH EJQFSMVLBO
TFTFPSBOH VOUVL QFOHMJIBUBO KFMBT EJUFOUVLBO EFOHBO DBSB USJBM BOE
FSSPS ZBJUV NVMBNVMB NFMFUBLLBO TFCVBI MFOTB LVBU EBO LFNVEJBO
EJHBOUJEFOHBOMFOTBZBOHMFCJILVBUBUBVMFCJIMFNBITBNQBJEJQFSPMFI
MFOTBZBOHNFNCFSJLBOUBKBNQFOHMJIBUBOUFSCBJL
Astigmatisma. "TUJHNBUJTNB NFSVQBLBO LFMBJOBO SFGSBLTJ NBUB
ZBOH NFOZFCBCLBO CBZBOHBO QFOHMJIBUBO QBEB TBUV CJEBOH EJGPLVTLBO
QBEB KBSBL ZBOH CFSCFEB EBSJ CJEBOH ZBOH UFHBL MVSVT UFSIBEBQ CJEBOH EJCFMPLLBO UJEBL TFLVBU DBIBZB ZBOH NFMFXBUJ CJEBOH WFSUJLBM #%
UFSTFCVU)BMJOJQBMJOHTFSJOHEJTFCBCLBOPMFIUFSMBMVCFTBSOZBMFOHLVOH +FMBTMBI CBIXB DBIBZB ZBOH NFMBMVJ MFOTB BTUJHNBUJL UJEBL
LPSOFB QBEB TBMBI TBUV CJEBOH EJ NBUB $POUPI MFOTB BTUJHNBUJT BEBMBI TFMVSVIOZB EJCJBTLBO NFOVKV TBUV UJUJL GPLVT LBSFOB DBIBZB ZBOH
QFSNVLBBOMFOTBTFQFSUJUFMVSZBOHUFSMFUBLQBEBTJTJEBUBOHOZBDBIBZB NFMBMVJ TBUV CJEBOH MFOTB UFSGPLVT MFCJI KBVI EJ EFQBO EBSJ DBIBZB
%FSBKBU LFMFOHLVOHBO CJEBOH ZBOH NFMBMVJ TVNCV QBOKBOH UFMVS UJEBL ZBOHNFMBMVJCJEBOHZBOHMBJO
TBNB CFTBS EFOHBO EFSBKBU LFMFOHLVOHBO QBEB CJEBOH ZBOH NFMBMVJ
%BZB BLPNPEBTJ NBUB UJEBL EBQBU NFOHPNQFOTBTJ LFMBJOBO
TVNCVQFOEFL
BTUJHNBUJTNB LBSFOB TFMBNB BLPNPEBTJ MFOHLVOH MFOTB NBUB
0MFI LBSFOB MFOHLVOH MFOTB BTUJHNBUJT QBEB TBUV CJEBOH MFCJI LFDJM CFSVCBI LVSBOH MFCJI TBNB LVBUOZB EJ LFEVB CJEBOH PMFI LBSFOB
EBSJQBEB MFOHLVOH QBEB CJEBOH ZBOH MBJO DBIBZB ZBOH NFNCFOUVS JUV QBEB BTUJHNBUJTNB LFEVB CJEBOH NFNFSMVLBO EFSBKBU
CBHJBOQFSJGFSMFOTBQBEBTBUVTJTJUJEBLEJCFMPLLBOTBNBLVBUOZBEFOHBO BLPNPEBTJ ZBOH CFSCFEB %FOHBO EFNJLJBO UBOQB CBOUVBO
DBIBZB ZBOH NFNCFOUVS CBHJBO QFSJGFS CJEBOH ZBOH MBJO )BM UFSTFCVU LBDBNBUB TFPSBOH EFOHBO BTUJHNBUJTNB UJEBL QFSOBI NFMJIBU
EJUVOKVLLBO QBEB (BNCBS ZBOH NFNQFSMJIBULBO CFSLBT DBIBZB EFOHBOGPLVTUBKBN
ZBOHCFSBTBMEBSJUJUJLTVNCFSEBOCFSKBMBONFMBMVJMFOTBBTUJHNBUJTZBOH Koreksi Astigmatisma dengan Lensa Silindris. ,JUB
MPOKPOH $BIBZB EBMBN CJEBOH WFSUJLBM ZBOH EJUBOEBJ PMFI CJEBOH #%
EBQBU NFOHBOHHBQ NBUB BTUJHNBUJT NFNQVOZBJ TJTUFN MFOTB ZBOH
EJCJTTLBO EFOHBO LVBU PMFI MFOTB BTUJHNBUJT LBSFOB LFMFOHLVOHBO QBEB
UFSEJSJ BUBT EVB MFOTB TJMJOESJT EFOHBO LFLVBUBO CFSCFEB ZBOH
CJEBOHWFSUJLBMMFCJICFTBSEBSJQBEBQBEBCJEBOHIPSJ[POUBM4FCBMJLOZB
EJMFUBLLBO TBMJOH UFHBL MVSVT 6OUVL NFOHPSFLTJ BTUJHNBUJTNB
DBIBZBEBMBNCJEBOHIPSJ[POUBM ZBOHEJUBOEBJPMFICJEBOH"$
QSPTFEVS ZBOH CJBTBOZB EJHVOBLBO JBMBI TFDBSB USJBM BOE FSSPS
NFOFNVLBOMFOTBTGFSJTZBOHDPDPLVOUVLNFOHPSFLTJGPLVTQBEB
TBMBI TBUV CJEBOH MFOTB BTUJHNBUJTNB 4FUFMBI JUV MFOTB TJMJOESJT
UBNCBIBOEJHVOBLBOVOUVLNFOHPSFLTJLFMBJOBOQBEBCJEBOHZBOH
MBJO 6OUVL IBM JOJ TVNCV EBO LFLVBUBO MFOTB TJMJOESJT ZBOH
EJQFSMVLBOIBSVTEJUFUBQLBO
"EB CFCFSBQB DBSB VOUVL NFOFOUVLBO TVNCV EBSJ LPNQPOFO
TJMJOESJT ZBOH BCOPSNBM QBEB TJTUFN MFOTB NBUB 4BMBI TBUV DBSB
JBMBIEFOHBONFOHHVOBLBOBMBUZBOHCFSHBNCBSHBSJTHBSJTIJUBN
QBSBMFMTFQFSUJUFSMJIBUEBMBN(BNCBS(BSJTHBSJTQBSBMFMJOJ
BEB ZBOH WFSUJLBM EBO BEB ZBOH IPSJ[POUBM EBO TJTBOZB UFSMFUBL
BOUBSB ZBOH WFSUJLBM EBO IPSJ[POUBM 4FUFMBI NFODPCB NFOHPSFLTJ
EFOHBOCFSCBHBJMFOTBTGFSJT EJQFSPMFILFLVBUBOMFOTBZBOHTFTVBJ
TFIJOHHB TBMBI TBUV HBSJT NFOKBEJ KFMBT UFSMJIBU PMFI NBUB ZBOH
BTUJHNBUJT UFUBQJUJEBLNFOHPSFLTJLFUJEBLKFMBTBOQBEBHBSJTZBOH
UFHBL MVSVT UFSIBEBQ HBSJT ZBOH UFSMJIBU UFHBT JOJ %BSJ QSJOTJQ
QSJOTJQ GJTJLB PQUJL ZBOH UFMBI EJCBIBT TFCFMVNOZB QBEB CBC JOJ
UFSMJIBU CBIXB TVNCV CJEBOH TJMJOESJT NBUB ZBOH UJEBL UFSGPLVT
TFKBKBS EFOHBO HBSJT ZBOH UFSMJIBU LBCVS 4FUFMBI TVNCV JOJ
EJUFNVLBO QFNFSJLTB NFODBSJ MFOTB TJMJOESJT QPTJUJG BUBV OFHBUJG
ZBOH LFLVBUBOOZB TFTVBJ EBO LFNVEJBO TVNCV MFOTB JOJ
EJMFUBLLBOTFKBKBSEFOHBOHBSJTZBOHUJEBLUFSGPLVT TBNQBJQBTJFO
EBQBU NFMJIBU TFNVB HBSJT TBNB KFMBTOZB 4FUFMBI JOJ UFSDBQBJ
QFNFSJLTB NFNJOUB BIMJ PQUJL VOUVL NFNCVBU MFOTBLIVTVTZBOH
NFOHHBCVOHLBO LPSFLTJ TGFSJT EBO LPSFLTJ TJMJOESJT QBEB TVNCV
ZBOHUFQBU
603
Unit X Sistem Saraf. B. Indra Khusus
12 #JMB LBUBSBL UFMBI TBOHBU NFOHIBMBOHJ DBIBZB TFIJOHHB TBOHBU

11 1 NFOHHBOHHVQFOHMJIBUBO EBQBUEJQFSCBJLJEFOHBONFOHBOHLBUMFOTB
NFMBMVJ PQFSBTJ #JMB JOJ EJMBLVLBO NBUB LFIJMBOHBO TFCBHJBO CFTBS
EBZBCJBTOZB EBOIBSVTEJHBOUJLBOEFOHBOMFOTBLPOWFLTZBOHLVBU
EJEFQBONBUBOBNVO CJBTBOZBTFCVBIMFOTBQMBTUJLCVBUBOEJUBOBN
10
EJEBMBNNBUBTFCBHBJQFOHHBOUJMFOTBZBOHEJLFMVBSLBO
2
,FUBKBNBO1FOHMJIBUBO
3
9
4FDBSBUFPSFUJT DBIBZBZBOHEBUBOHEBSJTVNCFSUJUJLKBVI LFUJLB

EJGPLVTLBO EJ SFUJOB TFIBSVTOZB NFOKBEJ ZBOH TBOHBU LFDJM
/BNVO LBSFOBTJTUFNMFOTBNBUBUJEBLQFSOBITFNQVSOB CJOUJL
EJ SFUJOB TFNBDBN JUV CJBTBOZB NFNQVOZBJ EJBNFUFS UPUBM LJSB
4
8
LJSBN XBMBVQVOEFOHBOSFTPMVTJNBLTJNBMEBSJTJTUFNPQUJL
NBUBZBOHOPSNBM#JOUJLJUVQBMJOHUFSBOHEJCBHJBOTFOUSBMEBO
5 CFSBOHTVS NFOHBCVS LF BSBIUFQJ TFQFSUJZBOH EJQFSMJIBULBO
NFMBMVJCBZBOHBOEVBCJOUJLQBEB(BNCBS
7
%JBNFUFS SBUBSBUB TFM LFSVDVU EJ GPWFB SFUJOB CBHJBO TFOUSBM

6
SFUJOB UFNQBU UFSCFOUVLOZB QFOHMJIBUBO ZBOH QBMJOH UBKBN

CFTBSOZBLJSBLJSB NZBLOJTFQFSUVKVIEJBNFUFSUJUJLDBIBZB
/BNVO LBSFOB UJUJL DBIBZB JUV NFNQVOZBJ UJUJL TFOUSBM ZBOH
,PSFLTJ,FMBJOBO0QUJLEFOHBO1FOHHVOBBO-FOTB,POUBL UFSBOH EBO CBHJBO UFQJ ZBOH HFMBQ LJUB EBQBU NFNCFEBLBO EVB
UJUJLZBOHUFSQJTBICJMBCBHJBOTFOUSBMEBSJLFEVBUJUJLJUVUFSQJTBI
,POUBL-FOTBLPOUBLEBSJLBDBBUBVQMBTUJLZBOHQBTEBQBUEJMFUBLLBO TBNQBJ N EJ SFUJOB TFEJLJU MFCJI CFTBS EBSJQBEB MFCBS TFM
EJ QFSNVLBBO EFQBO LPSOFB -FOTBMFOTB JOJ EJQFSUBIBOLBO EJ LFSVDVUGPWFB1FNCFEBBOLFEVBUJUJLJOJKVHBEJQFSMJIBULBOQBEB
UFNQBUOZBPMFIMBQJTBOUJQJTBJSNBUBZBOHNFOHJTJSVBOHBOUBSBMFOTB (BNCBS
LPOUBLEBOQFSNVLBBOEFQBONBUB
4JGBU LIVTVT MFOTB LPOUBL EBQBU NFOHIJMBOHLBO IBNQJS TFNVB ,FUBKBNBO QFOHMJIBUBO OPSNBM QBEB NBUB NBOVTJB VOUVL
QFNCJBTBOZBOHUFSKBEJEJQFSNVLBBOBOUFSJPSLPSOFB4FCBCOZBJBMBI NFNCFEBLBO UJUJL TVNCFS DBIBZB BEBMBI TFLJUBS EFUJL CVTVS
BJS NBUB EJ BOUBSB MFOTB LPOUBL EBO LPSOFB NFNQVOZBJ JOEFLT CJBT EFSBKBU "SUJOZB CJMB CFSLBT DBIBZB EBSJ EVB UJUJL UFSQJTBI
IBNQJS TBNB EFOHBO LPSOFB TFIJOHHB QFSNVLBBO BOUFSJPS LPSOFB
NFNCFOUVSNBUBEFOHBOTVEVUBOUBSBLFEVBUJUJLUFSTFCVUQBMJOH
UJEBL MBHJ CFSQFSBO QFOUJOH QBEB TJTUFN PQUJL NBUB %FOHBO
TFEJLJU EFUJL CJBTBOZB LFEVB UJUJL JUV EBQBU EJLFOBMJ TFCBHBJ
EFNJLJBO QFSNVLBBO MVBS MFOTB LPOUBLMBI ZBOH CFSQFSBO QFOUJOH
+BEJ QFNCJBTBO PMFI QFSNVLBBO MFOTB LPOUBL JOJ NFOHHBOUJLBO EVBUJUJLCVLBOTFCBHBJTBUVUJUJL*OJCFSBSUJCBIXBPSBOHEFOHBO
QFNCJBTBO ZBOH CJBTBOZB EJMBLVLBO PMFI LPSOFB )BM JOJ QFOUJOH LFUBKBNBO QFOHMJIBUBO OPSNBM TFXBLUV NFMJIBU EVB UJUJL UFSBOH
UFSVUBNBQBEBLFMBJOBOSFGSBLTJNBUBZBOHEJTFCBCLBOPMFILFMBJOBO TFKBVINFUFS IBNQJSUJEBLEBQBUNFNCFEBLBOLFEVBUJUJLJUV
CFOUVL LPSOFB NJTBMOZB CFOUVL LPSOFB ZBOH UJEBL MB[JN EBO TFCBHBJ EVB UJUJL ZBOH UFSQJTBI CJMB LFEVB UJUJL JUV UFSQJTBI
NFOPOKPMZBOHEJTFCVULFSBUPLPOVT5BOQBMFOTBLPOUBL LPSOFBZBOH TBNQBJNN
NFOPOKPM NFOJNCVMLBO BCOPSNBMJUBT QFOHMJIBUBO ZBOH CFSBU
TFIJOHHB IBNQJS UJEBL BEB LBDBNBUB ZBOH EBQBU NFOHPSFLTJ 'PWFB CFSEJBNFUFS LVSBOH EBSJ NN N
ZBOH
QFOHMJIBUBO EFOHBO NFNVBTLBO XBMBVQVO EFNJLJBO EFOHBO CFSBSUJCBIXBLFUBKBNBOQFOHMJIBUBOZBOHNBLTJNBMUFSKBEJQBEB
NFOHHVOBLBO MFOTB LPOUBL QFNCJBTBO LPSOFB EJUJBEBLBO EBO LVSBOH EBSJ EFSBKBU MBQBOH QBOEBOH %J MVBS BSFB GPWFB
TFCBHBJ HBOUJOZB QFNCJBTBO OPSNBM EJMBLTBOBLBO PMFI QFSNVLBBO LFUBKBNBO QFOHMJIBUBO CFSLVSBOH TFDBSB QSPHSFTJG TFNBLJO LF
MVBSMFOTB QFSJGFS TFNBLJO NFOVSVO TBNQBJ TFQVMVI LBMJ MJQBU )BM JOJ
EJTFCBCLBO PMFI BEBOZB IVCVOHBO BOUBSB NBLJO CBOZBL TFM
-FOTB LPOUBL KVHB NFNQVOZBJ CFCFSBQB LFVOUVOHBO MBJO CBUBOHEBOLFSVDVUEFOHBOTFUJBQTFSBUTBSBGPQUJLEJCBHJBOOPO
UFSNBTVL
MFOTB LPOUBL JLVU TFSUB EFOHBO QFSHFSBLBO NBUB EBO
NFNCFSJLBOQFOHMJIBUBOKFMBTEFOHBOMBQBOHQBOEBOHZBOHMFCJIMVBT
EJCBOEJOHLBDBNBUB EBO
MFOTBLPOUBLCFSQFOHBSVILFDJMUFSIBEBQ
VLVSBO PCKFL ZBOH EJMJIBU TFTFPSBOH NFMBMVJ MFOTB TFEBOHLBO MFOTB
ZBOHEJMFUBLLBOLVSBOHMFCJIDNEJEFQBONBUBNFNFOHBSVIJCFTBS
CBZBOHBOTFMBJONFOHPSFLTJGPLVT
2 Mm 1 mm
Katarak Daerah Keruh di Lensa
,BUBSBLBEBMBILFMBJOBONBUBZBOHUFSVUBNBUFSKBEJQBEBPSBOHUVB
,BUBSBL BEBMBI BSFB CFSLBCVU BUBV LFSVI EJ EBMBN MFOTB 1BEB
TUBEJVN EJOJ QFNCFOUVLBO LBUBSBL 1SPUFJO EBMBN TFCBHJBO TFSBU 17 mm 10 meters
TFSBU MFOTB NFOHBMBNJ EFOBUVSBTJ -FCJI MBOKVU QSPUFJO UBEJ
CFSLPBHVMBTJ NFNCFOUVL BSFB LFSVI NFOHHBOUJLBO TFSBUTFSBU
QSPUFJOOPSNBMZBOHUSBOTQBSBO
604
GPWFB ZBJUVCBHJBOSFUJOBZBOHMFCJIQFSJGFS TFQFSUJZBOHEJCBIBT CFSKBSBL LBLJ EJ EFQBO IJEVOH BLBO NFNCFOUVL CBZBOHBO
QBEB#BC QBEB UJUJL ZBOH TBOHBU CFSEFLBUBO EJ CBHJBO TFOUSBM LFEVB
.FUPEF ,MJOJT VOUVL .FOZBUBLBO #FTBSOZB ,FUBKBNBO SFUJOB1BSBMBLTNBDBNJOJEJQFSMJIBULBOEBMBN(BNCBS
1FOHMJIBUBO%JBHSBNVOUVLNFNFSJLTBNBUBCJBTBOZBUFSEJSJBUBT ZBOH NFNQFSMJIBULBO BEBOZB CBZBOHBO TVBUV CVMBUBO NFSBI
IVSVGIVSVG EFOHBO CFSCBHBJ VLVSBO EJMFUBLLBO LBLJ KBVIOZB EBO CVKVS TBOHLBS LVOJOH ZBOH TFCFOBSOZB UFSCBMJL EJ LFEVB
UNIT X
EBSJPSBOHZBOHEJVKJ#JMBEBQBUNFMJIBUEFOHBOCBJLIVSVGIVSVG SFUJOB LBSFOB KBSBL LFEVB CFOUVL UFSTFCVU CFSCFEB EJ EFQBO
EFOHBOVLVSBOZBOHTFIBSVTOZBEBQBUEJMJIBUQBEBKBSBLLBLJ NBUB,FBEBBOJOJBLBONFOHIBTJMLBOTVBUVQBSBMBLTZBOHBLBO
PSBOH UFSTFCVU EJLBUBLBO NFNJMJLJ QFOHMJIBUBO BSUJOZB NVODVM QBEB TFUJBQ LBMJ LFEVB NBUB EJHVOBLBO 1BSBMBLT
QFOHMJIBUBO OPSNBM #JMB IBOZB EBQBU NFMJIBU IVSVGIVSVG ZBOH CJOPLVMBS BUBV TUFSFPQTJT
JOJMBI ZBOH NFNVOHLJOLBO
TFIBSVTOZB NBNQV EJMJIBU QBEB KBSBL LBLJ EJLBUBLBO PSBOH TFTFPSBOH EFOHBO EVB NBUB KBVI MFCJI NBNQV NFOFOUVLBO
JUV NFNQVOZBJ QFOHMJIBUBO TFCFTBS %FOHBO LBUB MBJO KBSBLSFMBUJGCJMBPCKFLUFSMFUBLEFLBUEBSJQBEBPSBOHZBOHIBOZB
NFUPEF LMJOJT ZBOH EJQBLBJ VOUVL NFOZBUBLBO CFTBSOZB NFNQVOZBJ TBUV NBUB /BNVO TUFSFPQTJT UJEBL CFSHVOB QBEB
LFUBKBNBO QFOHMJIBUBO BEBMBI EFOHBO NFOHHVOBLBO BOHLB QFSTFQTJLFEBMBNBOZBOHCFSKBSBLMFCJIEBSJIJOHHBLBLJ
QFDBIBONBUFNBUJTZBOHNFOZBUBLBOSBTJPBOUBSBEVBKBSBL ZBOH
KVHB NFSVQBLBO SBTJP LFUBKBNBO QFOHMJIBUBO TFTFPSBOH
EJCBOEJOHLBOEFOHBOLFUBKBNBOQFOHMJIBUBOPSBOHOPSNBM
Oftalmoskop
Penentuan Jarak Suatu Objek dari Mata— "Persepsi 0GUBMNPTLPQ NFSVQBLBO BMBU ZBOH EJQBLBJ QFNFSJLTB VOUVL
Kedalaman" NFMJIBULFEBMBNNBUBPSBOHMBJOEBONFMJIBUSFUJOBEFOHBOKFMBT
4FDBSB OPSNBM TFTFPSBOH NFSBTBLBO KBSBL NFMBMVJ UJHB DBSB
8BMBVQVO PGUBMNPTLPQ NFSVQBLBO BMBU ZBOH SFMBUJG SVNJU
VLVSBO CBZBOHBO EBSJ PCKFL ZBOH UFMBI EJLFOBMJ QBEB SFUJOB
QSJOTJQOZB TFEFSIBOB ,PNQPOFO EBTBSOZB EJQFSMJIBULBO EBMBN
(BNCBSEBOEBQBUEJKFMBTLBOTFCBHBJCFSJLVU
GFOPNFOB QFSHFSBLBO QBSBMBLT EBO
GFOPNFOB TUFSFPQTJT
,FNBNQVBONFOFOUVLBOKBSBLJOJEJTFCVUQFSTFQTJLFEBMBNBO #JMB TVBUV UJUJL DBIBZB ZBOH UFSBOH KBUVI QBEB SFUJOB NBUB
Penentuan Jarak melalui Ukuran Bayangan FNFUSPQ DBIBZBBLBONFOZFCBSNFMBMVJTJTUFNMFOTBNBUB4FTVEBI
NFMFXBUJ TJTUFN MFOTB DBIBZB JOJ BLBO CFSKBMBO TFKBKBS TBUV TBNB
Retina dari Objek yang Telah Dikenali. #JMB UFMBI EJLFUBIVJ MBJOOZB TFCBC SFUJOB UFSMFUBL UFQBU QBEB KBSBL QBOKBOH GPLBM EJ
CBIXB PSBOH ZBOH EJBNBUJ NFNJMJLJ UJOHHJ LBLJ EBQBU CFMBLBOHTJTUFNMFOTB4FMBOKVUOZB TFXBLUVNFMFXBUJNBUBFNFUSPQ
EJUFOUVLBO KBSBLOZB NFMBMVJ CFTBS CBZBOHBO PSBOH UFSTFCVU PSBOHMBJO DBIBZBQBSBMFMJOJBLBOEJGPLVTLBOMBHJQBEBTVBUV
QBEB SFUJOB *BUJEBLTFDBSBTBEBSNFNJLJSLBOVLVSBOPSBOHJUV
OBNVO PUBLOZB UFMBI CFMBKBS NFOHIJUVOH TFDBSB PUPNBUJT
KBSBL PCKFL NFMBMVJ VLVSBO CBZBOHBO CJMB EJNFOTJOZB UFMBI
EJLFUBIVJ
Penentuan Jarak melalui Pergerakan Paralaks.$BSB 1.

QFOUJOH MBJO ZBOH EJQBLBJ NBUB VOUVL NFOFOUVLBO KBSBL BEBMBI
QFSHFSBLBO QBSBMBLT #JMB NFMJIBU EBSJ LFKBVIBO EFOHBO LFEVB
NBUBOZB EBMBN LFBEBBO CFOBSCFOBS EJBN JB UJEBL NFSBTBLBO
QFSHFSBLBO QBSBMBLT OBNVO CJMB PSBOH JUV NFOHHFSBLLBO
LFQBMBOZBLFTBUVTJTJBUBVTFCBMJLOZB CBZBOHBOPCKFLZBOHEFLBU
EFOHBOOZB CFSHFSBL EFOHBO DFQBU NFOZJMBOH SFUJOB TFEBOHLBO
CBZBOHBO PCKFL ZBOH KBVI DFOEFSVOH NFOFUBQ $POUPI EFOHBO 2.
NFOHHFSBLLBOLFQBMBJODJLFTBNQJOHLFUJLBKBSBLTVBUVPCKFL
IBOZB JODJ EJ EFQBO NBUB CBZBOHBO JUV CFSHFSBL NFMFXBUJ
SFUJOB TFEBOHLBO CBZBOHBO PCKFL ZBOH MFUBLOZB LBLJ EBSJ
NBUB UBNQBL TFQFSUJ UJEBL CFSHFSBL +BEJ EFOHBO NFOHHVOBLBO
NFLBOJTNFQFSHFSBLBOQBSBMBLTJOJ LJUBEBQBUNFOHFUBIVJKBSBL
SFMBUJG EBSJ CFSCBHBJ PCKFL NFTLJQVO IBOZB NFOHHVOBLBO TBUV
NBUB
Penentuan Jarak melalui Stereopsis—Penglihatan

Binokular. $BSB MBJO ZBOH EBQBU EJQBLBJ VOUVL NFNBIBNJ
QBSBMBLTBEBMBIEFOHBOQFOHMJIBUBOCJOPLVMBS0MFILBSFOBNBUB
ZBOHTBUVCFSKBSBLLVSBOHMFCJIJODJEBSJNBUBZBOHMBJO NBLB
CBZBOHBOEJLFEVBSFUJOBCFSCFEBTBUVTBNBMBJO4FCBHBJDPOUPI
TFCVBI PCKFL ZBOH MFUBLOZB JODJ EJ EFQBO IJEVOH BLBO
NFNCFOUVLTVBUVCBZBOHBOEJTJTJLJSJEBSJSFUJOBNBUBLJSJUFUBQJ
EJTJTJLBOBOEBSJSFUJOBNBUBLBOBO TFEBOHLBOTVBUVPCKFLLFDJM
ZBOH
605
Unit X Sistem Sara f. 8. Indra Khusus
UJUJL SFUJOB PSBOH LFEVB TFCBC SFUJOB PSBOH LFEVB KVHB NFNQVOZBJ IVNPSWJUSFPVT ZBOHCFSBEBEJBOUBSBQFSNVLBBOQPTUFSJPSMFOTBEBO
KBSBL TBUV QBOKBOH GPLBM EJ CFMBLBOH MFOTB 4FUJBQ UJUJL DBIBZB QBEB SFUJOB)VNPSBRVFPVTBEBMBIDBJSBOZBOHNFOHBMJSCFCBT TFEBOHLBO
SFUJOB NBUB ZBOH EJQFSJLTB NFOKBEJ TVBUV UJUJL GPLVT EJ SFUJOB NBUB IVNPS WJUSFVT LBEBOHLBEBOH EJTFCVU TFCBHBJ CBEBO WJUSFVT BEBMBI
QFNFSJLTB %FNJLJBO KVHB CJMB UJUJL UFSBOH DBIBZB EJQJOEBILBO LF TFCVBI NBTTB EBSJ HFMBUJO EJMFLBULBO PMFI TFCVBI KBSJOHBO GJCSJMFS
CFSCBHBJUJUJLSFUJOBZBOHEJQFSJLTB UJUJLGPLVTQBEBSFUJOBQFNFSJLTB IBMVT ZBOH UFSVUBNB UFSTVTVO EBSJ NPMFLVM QSPUFPHMJLBO ZBOH TBOHBU
KVHB BLBO CFSHFSBL EFOHBO KVNMBI ZBOH TFTVBJ +BEJ CJMB SFUJOB QBOKBOH "JS EBO TVCTUBOTJ ZBOH UFSMBSVU EBQBU CFSEJGVTJ TFDBSB
TFTFPSBOH EJCVBU NFNBODBSLBO DBIBZB CBZBOHBO SFUJOBOZB BLBO QFSMBIBOMBIBO EBMBN IVNPS WJUSFVT UFUBQJ IBOZB BEB TFEJLJU BMJSBO
EJGPLVTLBOQBEBSFUJOBQFNFSJLTB EFOHBOTZBSBULFEVBNBUBFNFUSPQ DBJSBO
EBOTBMJOHNFMJIBUTBUVTBNBMBJO )VNPS BRVFPVT TFDBSB UFSVTNFOFSVT EJCFOUVL EBO EJSFBCTPSCTJ
6OUVL NFNCVBU TFCVBI PGUBMNPTLPQ IBOZB QFSMV NFNCVBU BMBU ,FTFJNCBOHBOBOUBSBQFNCFOUVLBOEBOSFBCTPSQTJNFOHBUVSWPMVNF
VOUVLNFOZJOBSJSFUJOBZBOHBLBOEJQFSJLTB4FMBOKVUOZB DBIBZBZBOH UPUBMEBOUFLBOBODBJSBOJOUSBPLVMBS
EJQBOUVMLBO EBSJ SFUJOB EBQBU EJMJIBU PMFI QFNFSJLTB EFOHBO
NFOEFLBULBOLFEVBNBUBTBUVTBNBMBJO6OUVLNFOFSBOHJNBUBZBOH Pembentukan Humor Aqueous oleh Korpus Siliaris
EJQFSJLTB EJHVOBLBO LBDB CFSTVEVU BUBV QSJTNB ZBOH EJMFUBLLBO EJ
EFQBONBUBZBOHEJQFSJLTB EFOHBODBSBZBOHTFEFNJLJBOSVQBTFQFSUJ )VNPS BRVFPVT EJCFOUVL EBMBN NBUB EFOHBO LFDFQBUBO SBUBSBUB
ZBOHUBNQBLEBMBN(BNCBS TFIJOHHBDBIBZBZBOHCFSBTBMEBSJ TBNQBJ NJLSPMJUFS UJBQ NFOJU 1BEB EBTBSOZB TFMVSVI DBJSBO JOJ
CPMB MBNQV EJQBOUVMLBO LF NBUB ZBOH EJQFSJLTB +BEJ SFUJOB EJTJOBSJ EJCFOUVLPMFIQSPTFTVTTJMJBSJT ZBOHNFSVQBLBOTFCVBIMJQBUBOMJOJFS
NFMBMVJ QVQJM EBO QFNFSJLTB NFMJIBU LF EBMBN QVQJM TVCKFL EFOHBO ZBOH NFOPOKPM EBSJ LPSQVT TJMJBSJT LF SVBOH EJ CFMBLBOH JSJT UFNQBU
DBSB NFMJIBU UFQJ LBDB BUBV QSJTNB BUBV NFMBMVJ TVBUV QSJTNB ZBOH MJHBNFOMJHBNFO MFOTB EBO PUPUPUPU TJMJBSJT NFMFLBU QBEB CPMB NBUB
EJCVBUTFEFNJLJBOSVQB *SJTBO NFMJOUBOH QSPTFTVT TJMJBSJT JOJ EJQFSMJIBULBO QBEB (BNCBS
EBO IVCVOHBO QSPTFTVT JOJ EFOHBO SVBOH DBJSBO NBUB EBQBU
+FMBTMBICBIXBQSJOTJQJOJIBOZBEBQBUEJUFSBQLBOQBEBPSBOHZBOH EJMJIBU QBEB (BNCBS 0MFI LBSFOB TUSVLUVS MJQBUBO QSPTFTVT
NBUBOZB CFOBSCFOBS FNFUSPQ #JMB EBZB CJBT LFEVB NBUB ZBOH UFSTFCVU EBFSBIQFSNVLBBOQSPTFTVTTJMJBSJTNFNQVOZBJMVBTLVSBOH
EJQFSJLTBBUBVQFNFSJLTBJUVBCOPSNBM QFSMVEJLPSFLTJBHBSQFNFSJLTB MFCJIDNQBEBTFUJBQNBUBTVBUVBSFBZBOHCFTBSCJMBEJCBOEJOHLBO
EBQBU NFMJIBU CBZBOHBO SFUJOB ZBOH EJQFSJLTB EFOHBO KFMBT EFOHBO VLVSBO LPSQVT TJMJBSJT ZBOH LFDJM 1FSNVLBBO QSPTFTVT JOJ
0GUBMNPTLPQ CJBTB NFNQVOZBJ SBOHLBJBO MFOTB TBOHBU LFDJM ZBOH EJUVUVQJ PMFI TFM FQJUFM ZBOH CFSTJGBU TBOHBU TFLSFUPSJL EBO UFQBU EJ
EJTVTVOQBEBTVBUVQVUBSBOTFIJOHHBEBQBUEJQVUBSEBSJTBUVMFOTBLF CBXBIOZB UFSEBQBUEBFSBIZBOHNFNJMJLJCBOZBLQFNCVMVIEBSBI
MFOTB MBJO EBO LPSFLTJ EBZB CJBT BCOPSNBM EBQBU EJMBLVLBO EFOHBO
DBSB NFNJMJI MFOTB EFOHBO LFLVBUBO MFOTB ZBOH TFTVBJ 1BEB PSBOH
EFXBTB NVEB OPSNBM UFSKBEJ SFGMFLT BLPNPEBTJ ZBOH BMBNJBI )VNPSBRVFPVTIBNQJSTFMVSVIOZBUFSCFOUVLTFCBHBJTFLSFTJBLUJG
TFIJOHHB NFOZFCBCLBO QFOJOHLBUBO LFLVBUBO MFOTB LVSBOH MFCJI EBSJ MBQJTBO FQJUFM QSPTFTVT TJMJBSJT 4FLSFTJ EJNVMBJ EFOHBO USBOTQPS
TFCFTBS EJPQUSJ QBEB UJBQ NBUB 6OUVL NFOHPSFLTJ LFBEBBO JOJ BLUJG JPO OBUSJVN LF EBMBN SVBOHBO EJ BOUBSB TFMTFM FQJUFM *PO
MFOTBIBSVTEJQVUBSTBNQBJLPSFLTJLJSBLJSBoEJPQUSJ OBUSJVNLFNVEJBONFOBSJLJPOLMPSJEBEBOCJLBSCPOBU EBOCFSTBNB
TBNBNFNQFSUBIBOLBOTJGBUOFUSBMJUBTMJTUSJL,FNVEJBOTFNVBJPOJOJ
CFSTBNBTBNB NFOZFCBCLBO PTNPTJT BJS EBSJ LBQJMFS EBSBI ZBOH
Sistem Cairan Mata—Cairan Intraokular UFSMFUBL EJ CBXBIOZB LF EBMBN SVBOH JOUFSTFMVMBS FQJUFM ZBOH TBNB
EBO MBSVUBO ZBOH EJIBTJMLBO NFNCFSTJILBO SVBOHBO QSPTFTVT TJMJBSJT
.BUB EJJTJ EFOHBO DBJSBO JOUSBPLVMBS ZBOH NFNQFSUBIBOLBO TBNQBJ LF LBNFSB PLVMJ BOUFSJPS NBUB 4FMBJO JUV CFCFSBQB OVUSJFO
UFLBOBO ZBOH DVLVQ QBEB CPMB NBUB VOUVL NFOKBHB EJTUFOTJOZB KVHB EJCBXB NFMBMVJ FQJUFMFQJUFM EFOHBO USBOTQPS BLUJG BUBV EJGVTJ
(BNCBSNFOHHBNCBSLBOCBIXBDBJSBOJOJEBQBUEJCBHJBUBTEVB UFSGBTJMJUBTJ OVUSJFO JOJ UFSNBTVL BTBN BNJOP BTBN BTLPSCBU EBO
CBHJBOIVNPSBRVFPVT ZBOHCFSBEBEJEFQBOMFOTB EBO HMVLPTB
Iris
Formation
of aqueous
humor
606
Bab 49 Mata I. sifat Optik Mata
Aliran Keluar HumorAqueous dan Mata

4FUFMBI EJCFOUVL PMFI QSPTFTVT TJMJBSJT IVNPS BRVFPVT NFOHBMJS TFQFSUJ
EJQFSMJIBULBO QBEB (BNCBS NFMBMVJ QVQJM LF EBMBN LBNFSB PLVMJ
BOUFSJPS %BSJ TJOJ DBJSBO NFOHBMJS LF CBHJBO EFQBO MFOTB EBO LF EBMBN
TVEVUBOUBSBLPSOFBEBOJSJT LFNVEJBONFMBMVJSFUJLVMVNUSBCFLVMB EBO
BLIJSOZBNBTVLLFEBMBNLBOBMJT4DIMFNN ZBOHLFNVEJBOEJBMJSLBOLF
UNIT X
EBMBN WFOB FLTUSBPLVMBS (BNCBS NFOHHBNCBSLBO TUSVLUVS
BOBUPNJT QBEB TVEVU LPSOFB JSJT NFNQFSMJIBULBO CBIXB SVBOH BOUBSB
USBCFLVMBUSBCFLVMB NFMVBT EBSJ LBNFSB PLVMJ BOUFSJPS LF LBOBMJT
4DIMFNN ,BOBMJT 4DIMFNN TFCBMJLOZB BEBMBI TFCVBI WFOB ZBOH
CFSEJOEJOHUJQJTZBOHNFMVBTTFDBSBTJSLVNGFSFOTJBMLFTFMVSVIBSBIQBEB
NBUB .FNCSBO FOEPUFMOZB CFSQPSJQPSJ TFIJOHHB CBILBO NPMFLVM
QSPUFJO ZBOH CFTBS EBO KVHB QBSUJLFM LFDJM TBNQBJ TFVLVSBO TFM EBSBI
NFSBI EBQBU MFXBU EBSJ SVBOH BOUFSJPS LF EBMBN LBOBMJT 4DIMFNN
8BMBVQVO LBOBMJT 4DIMFNN TFCFUVMOZB BEBMBI TFCVBI QFNCVMVI EBSBI
WFOB OPSNBMOZB IVNPS BRVFPVT ZBOH NFOHBMJS LF EBMBNOZB TBOHBU
CBOZBL TFIJOHHB LBOBMJT JOJ UFSJTJ MFCJI CBOZBL PMFI IVNPS BRVFPVT
EJCBOEJOHLBO EFOHBO EBSBI 7FOB LFDJM ZBOH CFSBTBM EBSJ LBOBMJT
4DIMFNN LF WFOB ZBOH MFCJI CFTBS QBEB NBUB CJBTBOZB IBOZB CFSJTJ
IVNPSBRVFPVT EBOEJTFCVUWFOBBRVFPVT
Tekanan Intraokular USBCFLVMB ZBOH EJMFXBUJ UFNQBU QFOZBSJOHBO DBJSBO ZBOH NFOHBMJS
5FLBOBOJOUSBPLVMBSOPSNBMSBUBSBUBTFLJUBSNN)H EFOHBOLJTBSBO EBSJ TVEVU MBUFSBM SVBOH BOUFSJPS LF EJOEJOH LBOBMJT 4DIMFNN
BOUBSBTBNQBJNN)H 5SBCFLVMB JOJ NFNQVOZBJ DFMBI UFSCVLB ZBOH TBOHBU LFDJM ZBJUV
BOUBSB TBNQBJ N ,FDFQBUBO BMJSBO DBJSBO LF EBMBN LBOBMJT
Tonometri. 0MFI LBSFOB UJEBL QSBLUJT VOUVL NFNBTVLLBO NFOJOHLBU TFDBSB OZBUB LBSFOB UFLBOBO ZBOH NFOJOHLBU %FOHBO
KBSVN LF EBMBN NBUB QBTJFO HVOB QFOHVLVSBO UFLBOBO UFLBOBOLVSBOHMFCJINN)HQBEBNBUBOPSNBM CJBTBOZBKVNMBI
JOUSBPLVMBS UFLBOBOJOJEJVLVSTFDBSBLMJOJTEFOHBONFOHHVOBLBO DBJSBO ZBOH NFOJOHHBMLBO NBUB NFMBMVJ LBOBMJT 4DIMFNN SBUBSBUB
TFCVBI UPOPNFUFShh EBTBSEBTBSOZB EJMVLJTLBO QBEB (BNCBS MNFOJUEBOCFHJUVKVHBEFOHBOKVNMBIBMJSBONBTVLDBJSBOEBSJ
,PSOFBNBUBEJBOFTUFTJEFOHBOBOFTUFTJMPLBM EBOGPPUQMBUF LPSQVTTJMJBSJT/PSNBMOZBUFLBOBONFOFUBQQBEBUJOHLBUTFLJUBS
EBSJ UPOPNFUFS EJMFUBLLBO QBEB LPSOFB ,FNVEJBO EJCFSJLBO NN)H
TFEJLJU UFLBOBO LF TFCVBI BMBU QFOHJTBQ ZBOH CFSBEB EJ UFOHBI
ZBOH NFOZFCBCLBO CBHJBO LPSOFB ZBOH EJ CBXBI BMBU QFOHJTBQ Mekanisme untuk Pencucian Ruang Trabekula dan
Cairan lntraokular.#JMBEJUFNVLBOTFKVNMBICFTBSEFCSJTEBMBN
EJQJOEBI LF EBMBN #BOZBLOZB QFSQJOEBIBO UFSTFCVU BLBO
IVNPSBRVFPVT TFQFSUJTFUFMBIUFSKBEJQFSEBSBIBOEBMBNNBUBBUBV
EJSFLBN QBEB TLBMB UPOPNFUFS LFNVEJBO EJLBMJCSBTJLBO EFOHBO
TFMBNB JOGFLTJ JOUSBPLVMBS EFCSJT UFSTFCVU LFNVOHLJOBO
LFUFOUVBOLFUFOUVBOUFLBOBOJOUSBPLVMBS EJBLVNVMBTJEBMBNSVBOHUSBCFLVMBZBOHCFSBTBMEBOLBNFSBPLVMJ
Pengaturan Tekanan Intraokular. 5FLBOBO JOUSBPLVMBS UFUBQ BOUFSJPS NFOVKV LBOBMJT 4DIMFNN EFCSJT JOJ EBQBU NFODFHBI
LPOTUBO QBEB NBUB ZBOH OPSNBM CJBTBOZB TBNQBJ NN )H EBSJ SFBCTPSQTJ DBJSBO ZBOH BEFLVBU EBSJ LBNFSB PLVMJ BOUFSJPS EBO
OJMBJOPSNBMOZB ZBOHSBUBSBUBTFLJUBSNN)H#FTBSOZBUFLBOBO LBEBOHLBEBOH NFOZFCBCLBO HMBVLPNBhh TFQFSUJ ZBOH BLBO
JOJ EJUFOUVLBO UFSVUBNB PMFI UBIBOBO UFSIBEBQ BMJSBO LFMVBS IVNPS EJUFSBOHLBO LFNVEJBO #FHJUV KVHB QBEB QFSNVLBBO SFUJLVMVN
BRVFPVT EBSJ LBNFSB PLVMJ BOUFSJPS LF EBMBN LBOBMJT 4DIMFNN USBCFLVMB BEB CBOZBL TFM GBHPTJU +VHB UFQBU EJ MVBS LBOBMJT
5BIBOBOBMJSBOLFMVBSJOJEJIBTJMLBOEBSJSFUJLVMVN 4DIMFNN BEB TFCVBI MBQJTBO HFM JOUFSTUJTJBM ZBOH CFSJTJ TFKVNMBI
CFTBS TFM SFUJLVMPFOEPUFMJBM ZBOH NFNJMJMDJ LBQBTJUBT MVBS CJBTB
VOUVL NFOFMBO EFCSJT EBO NFODFSOBOZB NFOKBEJ TVCTUBOTJ
TVCTUBOTJ NPMFLVM LFDJM ZBOH LFNVEJBO EBQBU EJBCTPSCTJ +BEJ
TJTUFN GBHPTJUJL JOJ NFOKBHB BHBS SVBOH USBCFLVMB UFUBQ CFSTJI
1FSNVLBBO JSJT EBO QFSNVLBBO MBJO EBSJ NBUB EJ CFMBLBOH JSJT
EJMBQJTJ PMFI FQJUFM ZBOH NBNQV NFNGBHPTJU QSPUFJO EBO QBSUJLFM
LFDJM EBSJ IVNPS BRVFPVT TFIJOHHB NFNCBOUV NFNQFSUBIBOLBO
DBJSBOBHBSCFSTJI
"(laukoma"1enyebab Utama Kebutaan. (MBVLPNB

BEBMBITBMBITBUVQFOZFCBCLFCVUBBOZBOHQBMJOHTFSJOH(MBVLPNB
BEBMBIQFOZBLJUNBUBZBOHEJUBOEBJEFOHBONFOJOHLBUOZBUFLBOBO
JOUSBPLVMBS TFDBSB QBUPMPHJT LBEBOHLBEBOH NFOJOHLBU TFDBSB
Iris
DFQBU TBNQBJ IJOHHB NN )H 5FLBOBO ZBOH NFOJOHLBU EJ
BUBT TBNQBJ NN )H EBQBU NFOZFCBCLBO IJMBOHOZB
QFOHMJIBUBOCJMBEJQFSUBIBOLBOVOUVLKBOHLBXBLUVMBNB5FLBOBO
ZBOH TBOHBU UJOHHJ EBQBU NFOZFCBCLBO LFCVUBBO EBMBN CFCFSBQB
IBSJ BUBV CBILBO CFCFSBQB KBN 4FJSJOH EFOHBO NFOJOHLBUOZB
UFLBOBO QBEB UFNQBU BLTPO TBSBG PQUJL NFOJOHHBMLBO CPMB NBUB
NFMBMVJMFNQFOHPQUJLBLBONFOHBMBNJLPNQSFTJ
607
Unit X Sistem Saraf. B. Indra Khusus
,PNQSFTJ JOJ EJEVHB NFOHIBNCBU BMJSBO BLTPOBM TJUPQMBTNB EBSJ Buznego C, Trattler WB: Presbyopia-correcting intraocular lenses, Curr Opin
CBEBO TFM OFVSPO SFUJOB LF TFSBU TBSBG PQUJL ZBOH TFMBOKVUOZB Ophthalmol 20:13, 2009.
NFNBTVLJPUBL"LJCBUOZBBEBMBIUJEBLBEBOZBOVUSJTJZBOHNFNBEBJ Candia OA, Alvarez LJ: Fluid transport phenomena in ocular epithelia, Prog
CBHJ TFSBUTFSBU ZBOH QBEB BLIJSOZB NFOHBLJCBULBO LFNBUJBO TFSBU Retin Eye Res 27:197, 2008.
ZBOHUFSLFOB.VOHLJOQVMBCBIXBLPNQSFTJBSUFSJSFUJOB ZBOHKVHB Congdon NG, Friedman DS, Lietman T: Important causes of visual impair-
NFNBTVLJ CPMB NBUB NFMBMVJ MFNQFOH PQUJL NFOBNCBI LFSVTBLBO ment in the world today, JAMA 290:2057, 2003.
OFVSPOEFOHBONFOVSVOLBOOVUSJTJLFSFUJOB Doane JF: Accommodating intraocular lenses, Curr Opin Ophthalmol 15:16,
2004.
1BEBTFCBHJBOCFTBSLBTVTHMBVLPNB UFLBOBOUJOHHJZBOHBCOPSNBM Khaw PT, Shah P, Elkington AR: Glaucoma-1: diagnosis, BMJ 328:97, 2004. Krag
EJTFCBCLBO PMFI QFOJOHLBUBO UBIBOBO UFSIBEBQ BMJSBO LFMVBS DBJSBO S, Andreassen TT: Mechanical properties of the human lens capsule,
ZBOH NFMBMVJ SVBOH USBCFLVMB LF EBMBN LBOBMJT 4DIMFNN QBEB UBVU Prog Retin Eye Res 22:749, 2003.
JSJEPLPSOFBM 4FCBHBJ DPOUPI QBEB QFSBEBOHBO NBUB BLVU TFM EBSBI Kwon YH, Fingert JH, Kuehn MH, et al: Primary open-angle glaucoma, N
QVUJI EBO KBSJOHBO NBUJ EBQBU NFOHIBNCBU SVBOH USBCFLVMB JOJ EBO Engl J Med 360:1113, 2009.
NFOZFCBCLBO QFOJOHLBUBO UFLBOBO JOUSBPLVMBS TFDBSB BLVU 1BEB Mathias RT, Rae JL, Baldo GJ: Physiological properties of the normal lens,
LFBEBBOZBOHLSPOJT UFSVUBNBQBEBQBTJFOMBOKVUVTJB PLMVTJGJCSPTB Physiol Rev 77:21, 1997.
SVBOHUSBCFLVMBUBNQBLOZBDFOEFSVOHNFOKBEJQFOZFCBC Sakimoto T, Rosenblatt MI, Azar DT: Laser eye surgery for refractive errors,
Lancet 367:1432, 2006.
(MBVLPNB LBEBOHLBEBOH EBQBU EJPCBUJ EFOHBO NFNCFSJ UFUFTBO Schaeffel F, Simon P, Feldkaemper M, et al: Molecular biology of myopia,
NBUBZBOHNFOHBOEVOHPCBUZBOHCFSEJGVTJLFEBMBNCPMBNBUBEBO Clin Exp Optom 86:295, 2003.
NFOVSVOLBOTFLSFTJBUBVNFOJOHLBULBOBCTPSQTJIVNPSBRVFPVT#JMB Schwartz K, Budenz D: Current management of glaucoma, Curr Opin
UFSBQJPCBUHBHBM UFLOJLPQFSBTJVOUVLNFNCVLBSVBOHUSBCFLVMBBUBV Ophthalmol 15:119, 2004.
NFNCVBUTBMVSBOVOUVLNFOHBMJSLBODBJSBOTFDBSBMBOHVOHEBSJSVBOH Smith G: The optical properties of the crystalline lens and their signifi-
DBJSBO CPMB NBUB NFOVKV SVBOH TVCLPOKVOHUJWB EJ MVBS CPMB NBUB cance, Clin Exp Optom 86:3, 2003.
TFSJOHLBMJEBQBUNFOVSVOLBOUFLBOBOTFDBSBFGFLUJG Tan JC, Peters DM, Kaufman PL: Recent developments in understanding the
pathophysiology of elevated intraocular pressure, Curr Opin Ophthalmol
17:168, 2006.
Weber AJ, Harman CD, Viswanathan S: Effects of optic nerve injury, glau-
Daftar Pustaka coma, and neuroprotection on the survival, structure, and function of ganglion
Buisseret P: Influence of extraocular muscle proprioception on cells in the mammalian retina, J Physiol 586:4393, 2008.
vision, Weinreb RN, Khaw PT: Primary open-angle glaucoma, Lancet 363:1711,
Physiol Rev 75:323, 1995. 2004.
608
BAB 50
UNIT X
.BUB**3FTFQUPSEBO'VOHTJ
/FVSBM3FUJOB
3FUJOB NFSVQBLBO CBHJBO NBUB NFNCBOUV NFOEFUFLTJ CBZBOHBO QFOHMJIBUBO TFDBSB MFCJI EFUBJM
ZBOH QFLB UFSIBEBQ DBIBZB NF 4FMTFMLFSVDVUZBOHUFSMFUBLEJGPWFBTFOUSBMJTJOJNFNJMJLJCFOUVL
OHBOEVOH
TFMTFMLFSVDVU ZBOH ZBOH QBOKBOH EBO SBNQJOH CFSCFEB EFOHBO TFM LFSVDVU ZBOH CFS
CFOUVL MFCJI HFNVL ZBOH UFSMFUBL QBEB SFUJOB EJ CBHJBO ZBOH MFCJI
CFSGVOHTJVOUVLQFOHMJIBUBOXBS
QFSJGFS4FMBJOJUV EJCBHJBOGPWFB QFNCVMVIQFNCVMVIEBSBI TFM
OB EBO
TFMTFMCBUBOHZBOHEB
TFMHBOHMJPO MBQJTBOTFMTFMJOUJEBMBN EBOMBQJTBOQMFLTJGPSNUFS
QBUNFOEFUFLTJDBIBZBSFEVQEBO TJOHLBQLFTBNQJOHEBOUJEBLUFSMFUBLUFQBUEJBUBTLFSVDVU,FBEB
UFSVUBNB CFSGVOHTJ VOUVL QFOHMJIBUBO IJUBN EBO QVUJI EBO BOJOJNFNVOHLJOLBODBIBZBTBNQBJEJLFSVDVUUBOQBIBNCBUBO
QFOHMJIBUBO EJ EBMBN HFMBQ #JMB TFM CBUBOH BUBVQVO LFSVDVU 4FM #BUBOH EBO ,FSVDVU (BNCBS NFSVQBLBO HBNCBSBO
UFSBOHTBOH TJOZBM BLBO EJIBOUBSLBO NFMBMVJ MBQJTBO TFM TBSBG EJBHSBNBUJL LPNQPOFO VUBNB GPUPSFTFQUPS CBJL TFM CBUBOH BUBV
ZBOH CFSVSVUBO EBMBN SFUJOB EBO BLIJSOZB LF EBMBN TFSBU LFSVDVU
4FQFSUJ EJQFSMJIBULBO QBEB (BNCBS TFHNFO MVBS
OFSWVT PQUJLVT EBO LPSUFLT TFSFCSJ 5VKVBO CBC JOJ BEBMBI LFSVDVU CFSCFOUVL NFSVODJOH 1BEB VNVNOZB TFM CBUBOH MFCJI
VOUVLNFOKFMBTLBONFOHFOBJNFLBOJTNFZBOHEJHVOBLBOPMFI QJQJI EBO MFCJI QBOKBOH EBSJQBEB LFSVDVU OBNVO UJEBL TFMBMV
EFNJLJBO 1BEB CBHJBO QFSJGFS SFUJOB TFM CBUBOH CFSEJBNFUFS
TFM CBUBOH EBO LFSVDVU VOUVL NFOEFUFLTJ DBIBZB QVUJI EBO
TBNQBJ TFEBOHLBO EJBNFUFS TFM LFSVDVU TBNQBJ VN QBEB
DBIBZB CFSXBSOB TFSUB TFMBOKVUOZB NFOHVCBI CBZBOHBO WJTVBM CBHJBOUFOHBISFUJOB ZBLOJEJEBMBNGPWFB UFSEBQBUTFMCBUBOH EBO
NFOKBEJTJOZBMTFSBUPQUJLVT TFMLFSVDVUOZBMFCJISBNQJOHEBONFNJMJLJEJBUFNFSIBOZB NN
4FHNFOGVOHTJPOBMVUBNBTFMCBUBOHBUBVLFSVDVUEBQBUEJMJIBU
QBEB(BNCBS
TFHNFOMVBS
TFHNFOEBMBN
OVLMFVT
Anatomi dan Fungsi Unsur Struktural Retina EBO
CBEBOTJOBQT'PUPLJNJBZBOHQFLBDBIBZBEJUFNVLBOQBEB
TFHNFO MVBS %BMBN TFM CBUBOH UFSEBQBU SPEPQTJO EBO EBMBN TFM
-BQJTBO 3FUJOB (BNCBS NFOVOKVLLBO LPNQPOFO GVOH LFSVDVUUFSEBQBUTBUVEBSJUJHBGPUPLJNJBXBSOB CJBTBOZBEJTFCVU
TJPOBMSFUJOBZBOHEJTVTVOEBMBNMBQJTBOEBSJMVBSLFEBMBNTFCBHBJ QJHNFOXBSOBTBKB ZBOHGVOHTJOZBIBNQJSTBNBEFOHBOSPEPQTJO
CFSJLVU
MBQJTBO QJHNFO
MBQJTBO CBUBOH EBO LFSVDVU ZBOH LFDVBMJ BEBOZB QFSCFEBBO EBMBN LFQFLBBO UFSIBEBQ TQFLUSVN
NFOPOKPM QBEB MBQJTBO QJHNFO
MBQJTBO OVLMFVT MVBS ZBOH DBIBZB
NFOHBOEVOHCBEBOTFMCBUBOHEBOLFSVDVU
MBQJTBOQMFLTJGPSN 1FSIBUJLBOTFMTFMCBUBOHEBOLFSVDVUQBEBTFHNFOMVBSEJEBMBN
MVBS
MBQJTBO OOVLMFVTEBMBN
MBQJTBO QMFLTJGPSN EBMBN
(BNCBS EBO UFSEBQBU MFNQFOHBO EBMBN KVNMBI CFTBS 5J
MBQJTBO HBOHMJPO
MBQJTBO TFSBU TBSBG PQUJLVT EBO
NFNCSBO BQ MFNQFOHBO UFSTFCVU TFCFOBSOZB TVBUV TVTVOBO MJQBUBO EBO NFN
MJNJUBOEBMBN CSBOTFM5FSEBQBUQJSJOHBOEBMBNTFUJBQTFMCBUBOHBUBVLFSVDVU
4FTVEBI NFMFXBUJ TVTVOBO MFOTB NBUB EBO TFMBOKVUOZB NFMBMVJ 3PEPQTJO EBO QJHNFO XBSOB NFSVQBLBO QSPUFJO UFSLPOKVHBTJ
IVNPS WJUSFPVT DBIBZB NFNBTVLJ SFUJOB EBSJ TFCFMBI EBMBN NBUB ,FEVBOZB CFSHBCVOH EBMBN NFNCSBO MFNQFOHBO EBMBN CFOUVL
MJIBU(BNCBS
KBEJ DBIBZBJUVBLBONFMFXBUJTFMTFMHBOHMJPO QSPUFJO USBOTNFNCSBO %J EBMBN MFNQFOHBO LPOTFOUSBTJ QJHNFO
MBQJTBO QMFLTJGPSN EBO MBQJTBO OVLMFVT TFCFMVN BLIJSOZB TBNQBJ GPUPTFOTJUJGJOJCFHJUVCFTBSTFIJOHHBQJHNFOJUVTFOEJSJLJSBLJSB
QBEBMBQJTBOCBUBOHEBOLFSVDVUZBOHUFSMFUBLEJTFQBOKBOHTJTJMVBS QFSTFOEBSJTFMVSVINBTTBTFHNFOMVBS
SFUJOB+BSBLZBOHEJUFNQVIJOJNFSVQBLBOLFUFCBMBOZBOHCFTBSOZB 4FHNFO EBMBN CBUBOH EBO LFSVDVU NFOHBOEVOH TJUPQMBTNB
CFCFSBQB SBUVT VN LFUBKBNBO QFOHMJIBUBO KFMBT CFSLVSBOH LBSFOB CJBTB EFOHBO PSHBOFM TJUPQMBTNJL #BHJBO ZBOH UFSQFOUJOH BEBMBI
QFSKBMBOBO NFMBMVJ KBSJOHBO OPOIPNPHFO JOJ /BNVO EJ CBHJBO NJUPLPOESJBTFCBHBJNBOBBLBOEJKFMBTLBOLFNVEJBO NJUPLPOESJB
GPWFB TFOUSBMJT SFUJOB TFQFSUJ ZBOH BLBO EJCBIBT LFNVEJBO MBQJTBO TBOHBU CFSQFSBO EBMBN NFOZFEJBLBO FOFSHJ VOUVL CFSGVOHTJOZB
EBMBN BLBO UFSTJOHLBQ LF TBNQJOH HVOB NFOHVSBOHJ IJMBOHOZB GPUPSFTFQUPS
UBKBNQFOHMJIBUBOJOJ
#BEBO TJOBQT NFSVQBLBO CBHJBO EBSJ TFM CBUBOH EBO LFSVDVU
%BFSBI 'PWFB 3FUJOB EBO 1FSBOOZB EBMBN ,FUBKBNBO QFOH
ZBOH CFSIVCVOHBO EFOHBO TFM OFVSPO CFSJLVUOZB ZBLOJ TFM
MJIBUBO'PWFBNFSVQBLBOTVBUVEBFSBIZBOHTBOHBULFDJMEJCBHJBO
IPSJ[POUBMEBOTFMCJQPMBS ZBOHCFSQFSBOEBMBNUBIBQTFMBOKVUOZB
UFOHBISFUJOB TFQFSUJUFSMJIBUEBMBN(BNCBS ZBOHNFOFNQBUJ
QBEBSBOUBJQFOHMJIBUBO
TVBUV EBFSBI ZBOH MVBTOZB LVSBOH EBSJ NN QFSTFHJ UFSVUBNB
CFSGVOHTJ VOUVL QFOHMJIBUBO DFQBU EBO EFUBJM 'PWFB TFOUSBMJT EF -BQJTBO1JHNFO3FUJOB1JHNFOIJUBNNFMBOJOEBMBNMBQJTBO
OHBOEJBNFUFSIBOZB NNIBNQJSTFMVSVIOZBUFSEJSJBUBTTFMTFM QJHNFONFODFHBIQBOUVMBODBIBZBEBSJCBHJBOMFOHLVOHCPMBNB
LFSVDVUTFMTFMLFSVDVUJOJNFNQVOZBJTUSVLUVSLIVTVTZBOHNFN UBJOJTBOHBUCFSHVOBVOUVLQFOHMJIBUBOZBOHKFMBT%JEBMBNNBUB
609
Unit X Sistem Saraf: B. lndra Khusus
610
Bab 50 Mata: II. Reseptor dan Fungsi Neural Retina
QJHNFOJOJNFNQVOZBJGVOHTJZBOHTBNBEFOHBOXBSOBIJUBNZBOH 1BEB CBHJBO JOJ LJUB BLBO NFNCJDBSBLBO UFSVUBNB NFOHF

BEBEJCBHJBOEBMBNTFCVBILBNFSB5BOQBQJHNFOJOJ DBIBZBBLBO OBJ GPUPLJNJB SPEPQTJO OBNVO QSJOTJQQSJOTJQ ZBOH TBNB
EJQBOUVMLBOLFTFNVBKVSVTBOEBMBNCPMBNBUBEBONFOZFCBCLBO EBQBUQVMBEJUFSBQLBOQBEBQJHNFOLFSVDVU
QFOZFCBSBO TJOBS EJ SFUJOB TFIJOHHB UJEBL NFOJNCVMLBO LPOUSBT
UJUJL HFMBQ EBO UFSBOH ZBOH EJCVUVILBO VOUVL NFNCFOUVL CBZB
OHBOZBOHUFQBU 4JLMVT1FOHMJIBUBO3PEPQTJO3FUJOB EBO1FSBOHTBOHBO
UNIT X
1FOUJOHOZB NFMBOJO EBMBN MBQJTBO QJHNFO EJQFSMJIBULBO 4FM#BUBOH
EFOHBOKFMBTQBEBLFBEBBOUJBEBOZBQJHNFOJOJQBEBBMCJOP ZBLOJ 3PEPQTJOEBO1FOHVSBJBOOZBPMFI&OFSHJ$BIBZB4FHNFO
PSBOHPSBOH ZBOH TFDBSB IFSFEJUFS LFLVSBOHBO QJHNFO NFMBOJO EJ MVBS TFM CBUBOH ZBOH NFOPOKPM LF MBQJTBO QJHNFO SFUJOB
TFMVSVICBHJBOUVCVIOZB4FXBLUVTFPSBOHBMCJOPNFNBTVLJTVBUV NFOHBOEVOH TFLJUBS QFSTFO QJHNFO QFLB DBIBZB ZBOH
SVBOH ZBOH UFSBOH DBIBZB ZBOH NFOHFOBJ SFUJOB EJQBOUVMLBO LF EJTFCVU SPEPQTJO BUBV WJTVBM QVSQMF 4VCTUBOTJ JOJ NFSVQBLBO
TFHBMB BSBI EJ EBMBN CPMB NBUB PMFI QFSNVLBBO SFUJOB ZBOH UJEBL LPNCJOBTJQSPUFJOTLPUPQTJOEFOHBOQJHNFOLBSPUFOPJESFUJOBM
CFSQJHNFO EBO PMFI MBQJTBO TLMFSB TFIJOHHB TFCVBI UJUJL DBIBZB KVHBEJTFCVUSFUJOFOF
4FMBOKVUOZB SFUJOBMUFSTFCVUNFSVQB
ZBOH OPSNBMOZB IBOZB NFSBOHTBOH CFCFSBQB TFM CBUBOH BUBV
LBO UJQF LIVTVT ZBOH EJTFCVU DJT SFUJOBM #FOUVL DJT EBO
LFSVDVU BLBO EJQBOUVMLBO LF TFHBMB BSBI EBO NFSBOHTBOH CBOZBL
SFTFQUPS 0MFI LBSFOB JUV LFUBKBNBO QFOHMJIBUBO TFPSBOH BMCJOP
SFUJOBMBEBMBICFOUVLZBOHQFOUJOHTFCBCIBOZBCFOUVLJOJTBKB
XBMBVQVOEFOHBOLPSFLTJPQUJLZBOHUFSCBJL KBSBOHMFCJICBJLEBSJ ZBOH EBQBU CFSJLBUBO EFOHBO TLPUPQTJO BHBS EBQBU CFSTJOUFTJT
TBNQBJEJCBOEJOHLBOEFOHBOOJMBJOPSNBM NFOKBEJSPEPQTJO
-BQJTBO QJHNFO KVHB NFOZJNQBO TFKVNMBI CFTBS WJUBNJO " #JMBTVEBINFOHBCTPSCTJFOFSHJDBIBZB TFQFSUJZBOHUBNQBL
7JUBNJO"JOJNFOHBMBNJQFSUVLBSBOLFMVBSNBTVLNFMFXBUJNFN EJ CBHJBO BUBT (BNCBS SPEPQTJO TFHFSB UFSVSBJ EBMBN
CSBO TFM QBEB TFHNFO MVBS TFM CBUBOH EBO LFSVDVU TFM CBUBOH EBO XBLUV TFQFSTFLJBO EFUJL 1FOZFCBCOZB BEBMBI GPUPBLUJWBTJ
LFSVDVU JOJ TFOEJSJ UFSUBOBN EJ EBMBN MBQJTBO QJHNFO ,JUB BLBO FMFLUSPOQBEBCBHJBOSFUJOBMEBOSPEPQTJO ZBOHNFOZFCBCLBO
NFMJIBULFNVEJBOCBIXBWJUBNJO"NFSVQBLBOQSFLVSTPSQFOUJOH QFSVCBIBO TFHFSB QBEB CFOUVL DJT EBO SFUJOBM NFOKBEJ CFOUVL
CBHJCBIBOLJNJBTFMTFMCBUBOHEBOLFSVDVUZBOHGPUPTFOTJUJG BMMUSBOT ZBOH UFUBQ NFNQVOZBJ TUSVLUVS LJNJBXJ ZBOH TBNB
4VQMBJ %BSBI 3FUJOB"SUFSJ 3FUJOB 4FOUSBMJT EBO ,PSPJE EFOHBOCFOUVLDJTOBNVOTUSVLUVSGJTJLOZBCFSCFEBNFSVQBLBO
4VQMBJEBSBICFSOVUSJTJVOUVLMBQJTBOEBMBNSFUJOBCFSBTBMEBOBSUF NPMFLVM ZBOH CFSCFOUVL MVSVT CVLBO NPMFLVM ZBOH CFSCFOUVL
SJBSFUJOBTFOUSBMJT ZBOHNFNBTVLJCPMBNBUBNFMBMVJQVTBUTBSBGPQ
MFOHLVOH0MFILBSFOBPSJFOUBTJUJHBEJNFOTJEBOUFNQBUSFBLTJ
UJLVTEBOTFMBOKVUOZBNFNQFSDBCBOHLBOEJSJVOUVLNFOZVQMBJTFMV
SVIQFSNVLBBOEBMBNSFUJOB+BEJ MBQJTBOEBMBNSFUJOBNFNQVOZBJ
SFUJOBM BMMUSBOT UJEBL MBHJ TFTVBJ EFOHBO UFNQBU SFBLTJ QSPUFJO
TVQMBJEBSBITFOEJSJZBOHUFSMFQBTEBSJTUSVLUVSMBJOQBEBNBUB TLPUPQTJO NBLB BMMUSBOT SFUJOBM NVMBJ UFSMFQBT EBSJ TLPUPQTJO
/BNVO MBQJTBO UFSMVBS SFUJOB NFMFLBU QBEB LPSPJE ZBOH KVHB 1SPEVL ZBOH TFHFSB UFSCFOUVL BEBMBI CBUPSP EPQTJO ZBOH
NFSVQBLBO KBSJOHBO LBZB QFNCVMVI EBSBI EJ BOUBSB SFUJOB EBO NFSVQBLBO LPNCJOBTJ UFSQJTBI TFCBHJBO EBO BMMUSBOT SFUJOBM
TLMFSB+VHB MBQJTBOMVBSSFUJOB UFSVUBNBTFHNFOMVBSTFMCBUBOHEBO EBOTLPUPQTJO#BUPSPEPQTJOTFOEJSJNFSVQBLBOTFOZBXBZBOH
LFSVDVU TBOHBU CFSHBOUVOH UFSVUBNB QBEB EJGVTJ QFNCVMVI EBSBI TBOHBU UJEBL TUBCJM EBO EBMBN XBLUV TFLJBO OBOPEFUJL BLBO
LPSPJEVOUVLOVUSJTJOZB UFSVUBNBVOUVLPLTJHFO SVTBL NFOKBEJ MVNJSPEPQTJO %BMBN XBLUV TFLJBO NJLSPEFUJL
"CMBTJP 3FUJOB ,BEBOHLBMB TBSBG SFUJOB UFSMFQBT EBSJ FQJUFMJVN TFOZBXB JOJ MBMV BLBO SVTBL MBHJ EBO NFOKBEJ NFUBSPEPQTJO *
QJHNFO1BEBCFCFSBQBLBTVT QFOZFCBCBCMBTJPSFUJOBBEBMBISVEBQBL ZBOH TFMBOKVUOZB EBMBN XBLUV LJSBLJSB TBUV NJMJEFUJL BLBO
TBQBEBCPMBNBUBZBOHNFOZFCBCLBODBJSBOBUBVEBSBICFSLVNQVMEJ NFOKBEJNFUBSPEPQTJO*-EBOBLIJSOZB EBMBN
BOUBSBTBSBGSFUJOBEBOFQJUFMJVNQJHNFO"CMBTJPLBEBOHLBEBOHKVHB
EJTFCBCLBO PMFI LPOUSBLUVS EBO TFSBUTFSBU IBMVT LPMBHFO EBMBN
IVNPSWJUSFPVT ZBOHNFOBSJLSFUJOBLFBSBICBHJBOEBMBNCPMBNBUB
4FCBHJBOEJTFCBCLBOPMFIEJGVTJZBOHNFMJOUBTJDFMBIBCMBTJEBO
TFCBHJBOPMFIBEBOZBTVQMBJEBSBIUFSTFOEJSJLFTBSBGSFUJOBNFMBMVJ
BSUFSJ SFUJOB CBHJBO SFUJOB ZBOH UFSMFQBT EBQBU CFSUBIBO UFSIBEBQ
EFHFOFSBTJ TFMBNB CFCFSBQB IBSJ EBO EBQBU CFSGVOHTJ LFNCBMJ CJMB
EJIVCVOHLBO LFNCBMJ EFOHBO FQJUFMJVN QJHNFO NFMBMVJ
QFNCFEBIBO /BNVO CJMB UJEBL TFHFSB EJLFNCBMJLBO BLIJSOZB
SFUJOB BLBO SVTBL EBO TFMBOKVUOZB UBL NBNQV CFSGVOHTJ MBHJ
XBMBVQVOTFUFMBIEJMBLVLBOCFEBIQFSCBJLBO
Fotokimia Penglihatan
#BJL TFM CBUBOH NBVQVO LFSVDVU NFOHBOEVOH CBIBO LJNJB
ZBOHBLBOUFSVSBJCJMBUFSQBKBODBIBZBEBO EBMBNQSPTFTOZB
BLBO NFSBOHTBOH TFSBUTFSBU TBSBG ZBOH CFSBTBM EBO NBUB
#BIBO LJNJB QFLB DBIBZB EJ EBMBN TFM CBUBOH EJTFCVU Isomerase
SPEPQTJO CBIBO LJNJB QFLB DBIBZB EJ EBMBN TFM LFSVDVU
EJTFCVU QJHNFO LFSVDVU BUBV QJHNFO XBSOB NFNJMJLJ
LPNQPTJTJTFEJLJUCFSCFEBEBSJSPEPQTJO Gambar 50-5 Siklus penglihatan rodopsin-retina pada sel batang, mem-
perlihatkan dekomposisi rodopsin selama terpajan cahaya dan pemben-
tukan kembati rodopsin lambat selanjutnya melalui proses kimia .
611
Unit X Sistem Saraf: B. Indra Khusus
XBLUVZBOHKBVIMFCJIMBNCBU EBMBNCFCFSBQBEFUJL
BLBONFO SVQBLBO TVBUV LFBEBBO IJQFSQPMBSJTBTJ ZBOH CFSBSUJ CBIXB
KBEJQSPEVLQFDBIBOBLIJS TLPUPQTJOEBOBMMUSBOTSFUJOBM UFSEBQBU OFHBUJWJUBT ZBOH MFCJI CFTBS EJ EBMBN NFNCSBO TFM
.FUBSPEPQTJO** ZBOHKVHBEJTFCVUSPEPQTJOUFSBLUJWBTJ NF CBUBOH )BM JOJ CFSMBXBOBO EFOHBO QFOVSVOBO OFHBUJWJUBT
SBOHTBOH QFSVCBIBO MJTUSJL EBMBN TFM CBUBOH ZBOH LFNVEJBO QSPTFTEFQPMBSJTBTJ
ZBOHUFSKBEJQBEBIBNQJSTFNVBSFTFQUPS
NFOHIBOUBSLBOCBZBOHBOQFOHMJIBUBOLFTJTUFNTBSBGQVTBUEB TFOTPSJL
MBNCFOUVLQPUFOTJBMBLTJOFSWVTPQUJLVT ZBOHBLBOLJUBCBIBT #BHBJNBOBBLUJWBTJSPEPQTJONFOZFCBCLBOUFSKBEJOZBIJQFS
LFNVEJBO QPMBSJTBTJ +BXBCBOOZB BEBMBI CBIXB LFUJLB SPEPQTJO UFSVSBJ
QFOHVSBJBOOZB NFOVSVOLBO LPOEVLUBOT NFNCSBO TFM CBUBOH
1FNCFOUVLBO ,FNCBMJ 3PEPQTJO 4FQFSUJ ZBOH UBNQBL VOUVL JPOJPO OBUSJVN EJ TFHNFO MVBS TFM CBUBOH ,FBEBBO JOJ
EBMBN (BNCBS UBIBQ QFSUBNB EBMBN QFNCFOUVLBO NFOZFCBCLBO IJQFSQPMBSJTBTJ EJ TFMVSVI NFNCSBO TFM CBUBOH
LFNCBMJ SPEPQTJO BEBMBI NDOHVCBI LFNCBMJ BMMUSBOT SFUJOBM EFOHBODBSBTFCBHBJCFSJLVU
NFOKBEJDJTSFUJOBM1SPTFTJOJNFNFSMVLBOFOFSHJNFUBCPMJL %BMBN(BNCBSEJKFMBTLBOQFSHFSBLBOJPOOBUSJVNEBO
EBOEJLBUBMJTJTPMFIFO[JNSFUJOBMJTPNFSBTF,FUJLBDJTSFUJOBM LBMJVN EBMBN TJSLVJU MJTUSJL ZBOH MFOHLBQ NFMFXBUJ TFHNFO
UFSCFOUVL NBLB TFDBSB PUPNBUJT BLBO CFSHBCVOH LFNCBMJ EBMBNEBOTFHNFOMVBSTFMCBUBOH4FHNFOEBMBNTFDBSBUFSVT
EFOHBO TLPUPQTJO VOUVL NFNCFOUVL LFNCBMJ SPEPQTJO ZBOH NFOFSVTNFNPNQBOBUSJVNEBSJTJTJEBMBNTFMCBUBOHNFOVKV
TFMBOKVUOZB UFUBQ TUBCJM TBNQBJ UFSVSBJ LFNCBMJ PMFI BEBOZB TJTJMVBSEBOLBMJVNEJQPNQBLFEBMBNTFM*POLBMJVNCPDPSLF
BCTPSQTJFOFSHJDBIBZB
1FSBO 7JUBNJO " VOUVL 1FNCFOUVLBO 3PEPQTJO 1BEB

(BNCBS IFOEBLOZB EJQFSIBUJLBO CBIXB UFSEBQBU SFBLTJ
LJNJB LFEVB ZBOH NFSVCBI BMMUSBOT SFUJOBM NFOKBEJ DJT
SFUJOBM )BM JOJ EJEBQBU NVMBNVMB EFOHBO NFOHVCBI BMMUSBOT
SFUJOBM NFOKBEJ BMMUSBOT SFUJOPM ZBOH NFSVQBLBO TBMBI TBUV
CFOUVL WJUBNJO " 4FMBOKVUOZB EJ CBXBI QFOHBSVI FO[JN
JTPNFSBTF BMMUSBOT SFUJOPM JOJ EJVCBI NFOKBEJ DJT SFUJOPM
"LIJSOZB DJT SFUJOPM EJVCBI NFOKBEJ DJT SFUJOBM ZBOH
CFSHBCVOHEFOHBOTLPUPQTJOVOUVLNFNCFOUVLSPEPQTJOCBSV
7JUBNJO " EBQBU EJKVNQBJ CBJL EJ EBMBN TJUPQMBTNB TFM CB
UBOH NBVQVO EJ EBMBN MBQJTBO QJHNFO SFUJOB 0MFI LBSFOB JUV
TFDBSB OPSNBM WJUBNJO " TFMBMV UFSTFEJB CJMB EJQFSMVLBO VOUVL
QFNCFOUVLBOSFUJOBMZBOHCBSV4FCBMJLOZB CJMBEJEBMBNSFUJOB
UFSEBQBU LFMFCJIBO SFUJOBM LFMFCJIBO JOJ BLBO EJVCBI LFNCBMJ
NFOKBEJ WJUBNJO " TFIJOHHB BLBO NFOHVSBOHJ KVNMBI QJHNFO
QFLB DBIBZB EJ EBMBN SFUJOB ,JUB BLBO NFMJIBU OBOUJ CBIXB
QFSVCBIBOQFSVCBIBO BOUBSB SFUJOBM EBO WJUBNJO " JOJ CFSHV
OB UFSVUBNB EBMBN BEBQUBTJ SFUJOB KBOHLB QBOKBOH UFSIBEBQ
CFSCBHBJJOUFOTJUBTDBIBZB
3BCVO4FOKB3BCVOTFOKBEBQBUUFSKBEJQBEBTFUJBQPSBOHZBOH
NFOHBMBNJ EFGJTJFOTJ CFSBU WJUBNJO " 1FOZFCBC UFSKBEJOZB SBCVO
TFOKBBEBMBITBOHBUNFOVSVOOZBKVNMBISFUJOBMEBOSPEPQTJOZBOH
EBQBU EJCFOUVL UBOQB WJUBNJO " ,FBEBBO JOJ EJTFCVU SBCVO TFOKB
TFCBCKVNMBIDBIBZBQBEBXBLUVNBMBNUFSMBMVTFEJLJUVOUVLEBQBU
NFOJNCVMLBO QFOHMJIBUBO ZBOH BEFLVBU CBHJ PSBOHPSBOH ZBOH
NFOHBMBNJEFGJTJFOTJWJUBNJO"
6OUVL UFSKBEJOZB SBCVO TFOKB TFTFPSBOH CJBTBOZB IBSVT
NFOHBMBNJ EJFU EFGJTJFOTJ WJUBNJO " TFMBNB CFCFSBQB CVMBO
UFSVUBNB LBSFOB TFKVNMBI CFTBS WJUBNJO " EBMBN LFBEBBO OPSNBM
EJTJNQBOEJIBUJEBOEBQBUEJHVOBLBOVOUVLNBUB#JMBUFMBIUFSKBEJ
SBCVO TFOKB UFSLBEBOH EBQBU EJTFNCVILBO EBMBN XBLUV LVSBOH
EBSJ*KBNNFMBMVJQFNCFSJBOWJUBNJO"JOUSBWFOB
Perangsangan Sel Batang Sewaktu Rodopsin Diaktivasi

oleh Cahaya tu
1PUFOTJBM 3FTFQUPS 4FM #BUBOH #FSIJQFSQPMBSJTBTJ 5JEBL
#FSEFQPMBSJTBTJ#JMBTFMCBUBOHUFSQBKBODBIBZB IBTJMQPUFOTJBM
SFTFQUPSOZBCFSCFEBEBOQPUFOTJBMSFTFQUPSQBEBIBNQJSTFNVB
SFTFQUPS TFOTPSJL MBJOOZB 1FSBOHTBOHBO TFM CBUBOH NFOZFCBC
LBOQFOJOHLBUBOOFHBUJWJUBTEBSJQPUFOTJBMNFNCSBO ZBOHNF
612
MVBS TFM NFMBMVJ LBOBM LBMJVN UBL CFSQJOUV ZBOH UFSCBUBT EJ EBO TFNBLJO CBOZBL KVNMBI FOFSHJ DBIBZB ZBOH NFOHFOBJ TFM
TFHNFO MVBS CBUBOH 4FQFSUJ QBEB TFM MBJOOZB QPNQB OBUSJVN CBUBOH TFNBLJO CFTBS NVBUBO FMFLUSPOFHBUJGOZB KBEJ TFNBLJO
LBMJVN NFNCFOUVL QPUFOTJBM OFHBUJG EJ TJTJ EBMBN TFMVSVI TFM CFTBS QVMB EFSBKBU IJQFSQPMBSJTBTJOZB 1BEB JOUFOTJUBT DBIBZB
/BNVO TFHNFO MVBS CBUBOH UFNQBU MFNQFOHBO GPUPSFTFQUPS NBLTJNVN QPUFOTJBM NFNCSBO NFOEFLBUJ o TBNQBJ
CFSBEB TFMVSVIOZB CFSCFEB QBEB LFBEBBO HFMBQ NFNCSBO NJMJWPMU ZBOHNFOEFLBUJQPUFOTJBMFLVJMJCSJVNBHBSJPOLBMJVN
UNIT X
CBUBOH CPDPS VOUVL JPO OBUSJVN ZBOH NFOHBMJS NFMBMVJ LBOBM EBQBUNFMFXBUJNFNCSBO
CFSQJOUV D(.1 1BEB LFBEBBO HFMBQ LBEBS D(.1 UJOHHJ %VSBTJ 1PUFOTJBM 3FTFQUPS EBO )VCVOHBO -PHBSJUNB
NFNVOHLJOLBO JPO OBUSJVN TFDBSB UFSVTNFOFSVT CPDPS BOUBSB 1PUFOTJBM 3FTFQUPS EFOHBO *OUFOTJUBT $BIBZB #JMB
LFNCBMJLFEBMBNTFMCBUBOHEBOEFOHBOEFNJLJBONFOFUSBMLBO SFUJOB NFOEBEBL UFSLFOB DBIBZB IJQFSQPMBSJTBTJ TFNFOUBSB
TFCBHJBO CFTBS OFHBUJWJUBT EJ EBMBN TFMVSVI TFM +BEJ QBEB ZBOH UJNCVM EBMBN TFM CBUBOH ZBJUV QPUFOTJBM SFTFQUPS ZBOH
LFBEBBO HFMBQ OPSNBM CJMB TFM CBUBOH UJEBL EJSBOHTBOH UJNCVM NFODBQBJ QVODBLOZB EBMBN XBLUV LVSBOH MFCJI
UFSKBEJQFOHVSBOHBO NVBUBO FMFLUSPOFHBUJWJUBT EJ TJTJ EBMBN EFUJL EBO CFSMBOHTVOH MFCJI EBSJ TBUV EFUJL 1BEB TFM LFSVDVU
NFNCSBO TFM CBUBOH ZBOH CFTBSOZB LJSBLJSB o NJMJWPMU QFSVCBIBO JOJ UFSKBEJ FNQBU LBMJ MFCJI DFQBU EBSJ TFM CBUBOH
TFEBOHLBOQBEBLFCBOZBLBOSFTFQUPSTFOTPSJLCJBTBOZBTFCFTBS #BZBOHBO WJTVBM ZBOH NFOHFOBJ TFM CBUBOH EJ SFUJOB IBOZB
oTBNQBJoNJMJWPMU TFMBNBTFQFSTFKVUBEFUJL UFSLBEBOHEBQBUNFOJNCVMLBOTFOTBTJ
,FNVEJBO TFXBLUVSPEPQTJOZBOHBEBEJTFHNFOMVBSCBUBOH QFOHMJIBUBOCBZBOHBOTFMBNBMFCJIEBSJTBUVEFUJL
UFSQBKBO DBIBZB BLBO UFSBLUJWBTJ EBO NVMBJ UFSVSBJ LBOBM
OBUSJVN CFSQJOUV D(.1 UFSUVUVQ EBO LPOEVLUBOT OBUSJVN $JSJMBJOQPUFOTJBMSFTFQUPSBEBMBICBIXBQPUFOTJBMJOJLJSB
NFNCSBO TFHNFO MVBS LF EBMBN TFM CBUBOH CFSLVSBOH NFMBMVJ LJSB TFCBOEJOH EFOHBO MPHBSJUNB JOUFOTJUBT DBIBZB )BM JOJ
QSPTFT UJHB MBOHLBI (BNCBS

DBIBZB EJBCTPSQTJ PMFI TBOHBU QFOUJOH LBSFOB NFNCVBU NBUB NBNQV NFNCFEBLBO
SPEPQTJO NFOZFCBCLBO GPUPBLUJWBTJ FMFLUSPO QBEB CBHJBO JOUFOTJUBT DBIBZB NFMBMVJ LJTBSBO SJCVBO LBMJ EBSJ ZBOH
SFUJOBM TFQFSUJ ZBOH UFMBI EJCBIBT TFCFMVNOZB
BLUJWBTJ NVOHLJOUFSKBEJ
SPEPQTJO NFSBOHTBOH TVBUV (QSPUFJO ZBOH EJTFCVU USBOTEVTJO
.FLBOJTNF 1FOVSVOBO ,POEVLUBOT .FNCSBO /BUSJVN
ZBOH LFNVEJBO NFOHBLUJWBTJ GPTGPEJFTUSBTF D(.1 FO[JN JOJ
BLJCBU 1FOHVSBJBO 3PEPQTJO,BTLBEF 1FSBOHTBOHBO
NFOHBUBMJTJT QFNFDBIBO D(.1 NFOKBEJ hD(.1 EBO

%BMBN LFBEBBO ZBOH PQUJNBM TBUV GPUPO DBIBZB VOJU LVBOUBM
QFOVSVOBO D(.1 JOJ NFOVUVQ LBOBM OBUSJVN CFSQJOUV D(.1
ZBOH QBMJOH LFDJM EBSJ FOFSHJ DBIBZB EBQBU NFOJNCVMLBO
EBONFOHVSBOHJBSVTOBUSJVNLFEBMBN/BUSJVNUFSVTEJQPNQB
QPUFOTJBM SFTFQUPS ZBOH EBQBU UFSVLVS QBEB TFMTFM CBUBOH
LF MVBS NFKBMVJ NFNCSBO EBO TFHNFO EBMBN +BEJ TFLBSBOH
LVSBOH MFCJI NJMJWPMU %FOHBO IBOZB GPUPO DBIBZB EBQBU
MFCJI CBOZBL JPO OBUSJVN ZBOH NFOJOHHBMLBO TFM CBUBOH
NFOZFCBCLBOTFQBSVITBUVSBTJQBEBTFMTFMCBUBOH#BHBJNBOB
EBSJQBEB ZBOH LFNCBMJ NBTVL 0MFI LBSFOB JPO OBUSJVN
TFKVNMBI LFDJM DBIBZB TFQFSUJ JUV EBQBU NFOJNCVMLBO
CFSNVBUBOQPTJUJG CFSLVSBOHOZBJPOJPOJOJEBOJEBMBNTFMCB
QFSBOHTBOHBO ZBOH TFEFNJLJBO CFTBS +BXBCBOOZB BEBMBI
UBOHNFODJQUBLBOQFOJOHLBUBOOFHBUJWJUBTEJEBMBNNFNCSBO
CBIXB GPUPSFTFQUPS NFNJMJLJ LBTLBEF LJNJBXJ ZBOH TBOHBU
TFOTJUJGZBOHNFNQFSLVBUFGFLQFSBOHTBOHBOTFLJUBSTFKVUBLBMJ
ZBJUVTFCBHBJCFSJLVU
'PUPONFOHBLUJWBTJFMFLUSPOQBEBCBHJBODJTSFUJOBMQBEB
SPEPQTJOIBMJOJNFOJNCVMLBOQFNCFOUVLBONFUBSPEPQTJO
** ZBOH NFSVQBLBO CFOUVL BLUJG SPEPQTJO TFQFSUJ ZBOH
UFMBIEJCBIBTEBOEJQFSMJIBULBOQBEB(BNCBS
'VOHTJ SPEPQTJO UFSBLUJWBTJ BEBMBI TFCBHBJ FO[JN ZBOH
CFSHVOB VOUVL NFOHBLUJWBTJ CBOZBL NPMFLVM USBOTEVTJO
ZBJUV QSPUFJO ZBOH UFSEBQBU EBMBN CFOUVL JOBLUJG QBEB
NFNCSBOMFNQFOHPQUJLEBONFNCSBOTFMCBUBOH
5SBOTEVTJO UFSBLUJWBTJ BLBO NFOHBLUJWBTJ CBOZBL TFLBMJ
NPMFLVMGPTGPEJFTUFSBTF
'PTGPEJFTUFSBTFUFSBLUJWBTJBEBMBICFOUVLFO[JNMBJOFO[JN
JOJ EFOHBO TFHFSB NFOHIJESPMJTJT CBOZBL TFLBMJ NPMFLVM
HVBOPTJONPOPGPTGBUTJLMJL D(.1
TFIJOHHBNFOHIBODVS
LBOOZB 4FCFMVN EJIBODVSLBO D(.1 UFMBI CFSJLBUBO EF
OHBO QSPUFJO LBOBM OBUSJVN EBO NFNCSBO MVBS TFMTFM
CBUBOH VOUVL NFOZBOHHBOZB BHBS UFUBQ UFSCVLB 5FUBQJ
QBEBLFBEBBOUFSBOH LFUJLBGPTGPEJFTUFSBTFNFOHIJESPMJTJT
D(.1 IBM JOJ BLBO NFOHIJMBOHLBO QFOZBOHHBBO UFSTFCVU
EBO NFOZFCBCLBO LBOBM OBUSJVN UFSUVUVQ #FSBUVTSBUVT
LBOBMUFSUVUVQQBEBTBBUTFUJBQLBMJNPMFLVMSPEPQTJOUFSBL
UJWBTJ0MFILBSFOBBMJSBOOBUSJVNZBOHNFMBMVJLBOBMLBOBM
JOJUFSKBEJTFEFNJLJBODFQBU BMJSBOEBSJTFKVUBBUBVMFCJIJPO
613
OBUSJVN EJIBNCBU PMFI QFOVUVQBO LBOBM JOJ TBNQBJ LBOBM

UFSCVLB MBHJ 1FOVSVOBO BMJSBO OBUSJVN JOJMBI ZBOH
NFOHFLTJUBTJTFMTFMCBUBOH TFQFSUJZBOHUFMBIEJCBIBT
5. %BMBNXBLUVTFLJUBSTBUVEFUJL FO[JNMBJO SPEPQTJOLJOBTF
ZBOHTFMBMVUFSEBQBUQBEBTFMTFMCBUBOH NFNCVBUSPEPQTJO
UFSBLUJWBTJ NFUBSPEPQTJO **
NFOKBEJ UJEBL UFSBLUJWBTJ EBO
TFMVSVI LBTLBEF LFNCBMJ LF LFBEBBO OPSNBM EFOHBO
QFNCVLBBOLBOBMOBUSJVN
+BEJ TFMTFMCBUBOHNFSVQBLBOLBTLBEFLJNJBXJQFOUJOHZBOH
NFNQFSLVBUFGFLTBUVGPUPODBIBZBVOUVLNFOZFCBCLBOQFSHFSB
LBO KVUBBO JPO OBUSJVN )BM JOJ EBQBU NFOKFMBTLBO NFOHFOBJ
TFOTJUJWJUBTTFMTFMCBUBOHZBOHFLTUSFNEBMBNLFBEBBOHFMBQ
4FM LFSVDVU LVSBOH MFCJI TBNQBJ LBMJ LVSBOH TFOTJUJG
EBSJQBEB TFMTFM CBUBOH UFUBQJ TFMTFM JOJ NFNVOHLJOLBO QFOHMJ
IBUBO XBSOB QBEB TFUJBQ LFBEBBO EFOHBO JOUFOTJUBT DBIBZB ZBOH
MFCJILVBUEBSJQBEBDBIBZBSFNBOHSFNBOH
Fotokimia Penglihatan Warna oleh Kerucut

%J CBHJBO QFSNVMBBO QFNCBIBTBO JOJ UFMBI EJUFLBOLBO CBIXB
GPUPLJNJBXJ EBMBN TFM LFSVDVU NFNJMJLJ LPNQPTJTJ LJNJBXJ
ZBOHIBNQJSTBNBEFOHBOSPEPQTJOEBMBNTFMCBUBOH1FSCFEB 4FCBMJLOZB CJMB PSBOH UFSTFCVU UFSVT CFSBEB EJ UFNQBU HFMBQ
BOOZB IBOZB UFSMFUBL QBEB CBHJBO QSPUFJO BUBV PQTJO ZBOH VOUVL XBLUV ZBOH MBNB SFUJOBM EBO PQTJO ZBOH BEB EJ EBMBN TFM
EJTFCVU GPUPQTJO EBMBN TFM LFSVDVU TFEJLJU CFSCFEB EFOHBO CBUBOH EBO LFSVDVU EJVCBI LFNCBMJ NFOKBEJ QJHNFO ZBOH QFLB
TLPUPQTJOEBMBNTFMCBUBOH#BHJBOSFUJOBMTFNVBQJHNFOWJTVBM UFSIBEBQDBIBZB4FMBOKVUOZB WJUBNJO"EJVCBILFNCBMJNFOKBEJ
ZBOHBEBEBMBNTFMLFSVDVUTBNBEFOHBOTFMCBUBOH0MFILBSF SFUJOBM VOUVL NFOBNCBI QJHNFO QFLB DBIBZB CBUBT BLIJSOZB
OBJUV QJHNFOQFLBUFSIBEBQXBSOBEBOTFMLFSVDVUNFOVQBLBO EJUFOUVLBO PMFI KVNMBI PQTJO ZBOH BEB EJ EBMBN TFM CBUBOH EBO
LPNCJOBTJBOUBSBSFUJOBMEBOGPUPQTJO LFSVDVU VOUVL CFSHBCVOH EFOHBO SFUJOBM ,FBEBBO JOJ EJTFCVU
%BMBNQFNCJDBSBBONFOHFOBJQFOHMJIBUBOXBSOBEBMBNCBC BEBQUBTJHFMBQ
JOJ OBOUJ BLBO KFMBT CBIXB IBOZB TBUV EBO LFUJHB KFOJT QJHNFO (BNCBS NFMVLJTLBO QSPTFT BEBQUBTJ HFMBQ TFXBLUV
XBSOBZBOHUFSEBQBUEBMBNTFUJBQTFMLFSVDVUZBOHCFSCFEB KBEJ TFTFPSBOH CFSBEB QBEB UFNQBU ZBOH CFOBSCFOBS HFMBQ TFTVEBI
NFOZFCBCLBO TFM LFSVDVU NFNQVOZBJ LFQFLBBO ZBOH TFMFLUJG CFSBEB EJ UFNQBU ZBOH UFSBOH VOUVL CFCFSBQB KBN MBNBOZB
UFSIBEBQ CFSCBHBJ XBSOB TFQFSUJ XBSOB CJSV IJKBV EBO NFSBI 1FSIBUJLBOCBIXBTFOTJUJWJUBTSFUJOBTBOHBUSFOEBITFXBLUVNVMB
.BTJOHNBTJOH QJHNFO XBSOB JOJ EJTFCVU QJHNFO QFLB XBSOB NVMB NFNBTVLJ UFNQBU HFMBQ OBNVO EBMBN XBLUV NFOJU
CJSV QJHNFOQFLBXBSOBIJKBV EBOQJHNFOQFLBXBSOBNFSBI TFOTJUJWJUBTOZB NFOJOHLBU TBNQBJ LBMJ MJQBU KBEJ SFUJOB EBQBU
4JGBUBCTPSQTJEBOQJHNFOZBOHUFSEBQBUEJEBMBNLFUJHBNBDBN CFSFBLTJ UFSIBEBQ DBIBZB EFOHBO TFQFSTFQVMVI JOUFOTJUBT EBO
LFSVDVU JUV NFOVOKVLLBO CBIXB QVODBL BCTPSQTJ BEBMBI QBEB ZBOHTFCFMVNOZBEJQFSMVLBO1BEBBLIJSNFOJULF TFOTJUJWJUBT
QBOKBOHHFMPNCBOHDBIBZB CFSUVSVUUVSVUTFCFTBS EBO JOJ BLBO NFOJOHLBU TBNQBJ LJSBLJSB LBMJ MJQBU EBO QBEB
OBOPNFUFS 1BOKBOH HFMPNCBOH JOJ KVHB NFSVQBLBO QBO BLIJSNFOJULFNFOKBEJTFLJUBSLBMJMJQBU
KBOH HFMPNCBOH VOUVL QVODBL TFOTJUJWJUBT DBIBZB VOUVL TFUJBQ ,VSWB ZBOH UFSHBNCBS EBMBN (BNCBS EJTFCVU TFCBHBJ
UJQFTFMLFSVDVU ZBOHEBQBUNVMBJEJHVOBLBOVOUVLNFOKFMBTLBO LVSWBBEBQUBTJHFMBQ/BNVO QFSIBUJLBOMBIBEBOZBJOGMFLTJQBEB
CBHBJNBOB SFUJOB EBQBU NFNCFEBLBO XBSOB 1FSLJSBBO LVSWB
BCTPSQTJ VOUVL LFUJHB QJHNFO JOJ EJMVLJTLBO EBMBN (BNCBS
(BNCBS JOJ KVHB NFOVOKVLLBO LVSWB BCTPOQTJ VOUVL
SPEPQTJOEBOTFM
Pengaturan Otomatis Sensitivitas Retina-Adaptasi dalam

Gelap dan Terang
"EBQUBTJ(FMBQEBO5FSBOH#JMBTFTFPSBOHCFSBEBEJUFNQBU
ZBOH TBOHBU UFSBOH VOUVL XBLUV ZBOH MBNB CBOZBL TFLBMJ
GPUPLJNJBXJ ZBOH UFSEBQBU EJ EBMBN TFM CBUBOH EBO LFSVDVU
NFOKBEJ CFSLVSBOH LBSFOB EJVCBI NFOKBEJ SFUJOBM EBO PQTJO
4FMBOKVUOZB TFCBHJBOCFTBSSFUJOBMEBMBNTFMCBUBOHEBOLFSVDVU
BLBO EJVCBI NFOKBEJ WJUBNJO " 0MFI LBSFOB LFEVB FGFL JO
LPOTFOUSBTJ CBIBO LJNJB GPUPTFOTJUJG ZBOH NFOFUBQ EBMBN TFM
CBUBOH EBO LFSVDVU BLBO CBOZBL TFLBMJ CFSLVSBOH BLJCBUOZB
TFOTJUJWJUBT NBUB UFSIBEBQ DBIBZB KVHB UVSVU CFSLVSBOH
,FBEBBOJOJEJTFCVUBEBQUBTJUFSBOH
614
LVSWBNJ#BHJBOBXBMLVSWBJOJ EJTFCBCLBO PMFI BEBQUBTJ TFM BEBMBI JOUFOTJUBT DBIBZB NBUBIBSJ LJSBLJSB NJMJBS LBMJ
LFSVDVU LBSFOB TFNVB QFSJTUJXB LJNJB QBEB QFOHMJIBUBO EBSJQBEBJOUFOTJUBTDBIBZBCJOUBOH OBNVONBUBEBQBUCFSGVOHTJ
UFSNBTVLBEBQUBTJ UFSKBEJLVSBOHMFCJIFNQBULBMJMFCJIDFQBUEJ EFOHBOCBJLQBEBDBIBZBNBUBIBSJZBOHUFSBOHTFTVEBIBEBQUBTJ
TFMLFSVDVUEBSJQBEBTFMCBUBOH8BMBVQVOEFNJLJBO TFMLFSVDVU UFSBOHEBOQBEBDBIBZBCJOUBOHTFTVEBIBEBQUBTJHFMBQ
UJEBL EBQBU NFODBQBJ EFSBKBU TFOTJUJWJUBT ZBOH NFOEFLBUJ
UNIT X
TFOTJUJWJUBT TFM CBUBOH EBMBN LFBEBBO HFMBQ 0MFI LBSFOB JUV Penglihatan Warna
XBMBVQVO BEBQUBTJOZB DFQBU TFM LFSVDVU CFSIFOUJ CFSBEBQUBTJ
TFUFMBI CFCFSBQB NFOJU TBKB TFEBOHLBO BEBQUBTJ PMFI CBUBOH %BSJ CBHJBO CBC ZBOH UFSEBIVMV LJUB UFMBI NFNQFMBKBSJ CBIXB
TFDBSB QFSMBIBO CFSMBOHTVOH UFSVT TFMBNB CFCFSBQB NFOJU EBO TFMLFSVDVUZBOHCFSCFEBCFEBQFLBUFSIBEBQXBSOBDBIBZBZBOH
CBILBO CFSKBNKBN TFOTJUJWJUBTOZB BLBO NFOJOHLBU TFDBSB CFSCFEBCFEBQVMB#BHJBOCBCJOJBLBONFNCJDBSBLBONFLBOJT
IFCBU 4FMBJO JUV NBTJI CBOZBL TFOTJUJWJUBT TFM CBUBOH ZBOH NF ZBOH EJQBLBJ PMFI SFUJOB VOUVL NFOEFUFLTJ QFSCFEBBO HSB
EJTFCBCLBO PMFI NFOZBUVOZB TJOZBM OFVSPO EBSJ BUBV MFCJI EBTJXBSOBEBMBNTQFLUSVNQFOHMJIBUBO
TFMCBUBOHNFOKBEJTBUVTFMHBOHMJPOUVOHHBMEJEBMBNSFUJOBTFM
TFM CBUBOH JOJ NFOHBEBLBO TVNBTJ VOUVL NFOJOHLBULBO Mekanisme Pengenalan Tiga Warna
TFOTJUJWJUBTOZB TFQFSUJZBOHBLBOEJCBIBTOBOUJEBMBNCBCNJ 4FNVB UFPSJ NFOHFOBJ QFOHMJIBUBO XBSOB CFSEBTBSLBO QBEB
.FLBOJTNF -BJO "EBQUBTJ 5FSBOH EBO (FMBQ 4FMBJO QSPTFT PCTFSWBTJ ZBOH UFMBI EJLFOBM TFDBSB CBJL ZBLOJ CBIXB NBUB
BEBQUBTJZBOHEJTFCBCLBOPMFIQFSVCBIBOLPOTFOUSBTJSPEPQTJOBUBV NBOVTJB TFCFOBSOZB EBQBU NFOEFUFLTJ IBNQJS TFNVB HSBEBTJ
GPUPLJNJBXJ XBSOB NBUB NFNQVOZBJ EVB NFLBOJTNF MBJO VOUVL XBSOBCJMBDBIBZBNPOPLSPNBUJLEBOXBSOBNFSBI IJKBV EBO
BEBQUBTJ UFSBOH EBO HFMBQ )BM ZBOH QFSUBNB BEBMBI BEBOZB CJSVEJQFSTBUVLBOEBMBNCFSNBDBNNBDBNLPNCJOBTJ
QFSVCBIBO QBEB VLVSBO QVQJM TFQFSUJ ZBOH EJCBIBT EBMBN #BC
*OJ EBQBU NFOZFCBCLBO UJNCVMOZB UJOHLBU BEBQUBTJ TFLJUBS LBMJ
4FOTJUJWJUBT 4FOTJUJWJUBT 4QFLUSVN EBSJ ,FUJHB 5JQF 4FM
MJQBUEBMBNXBLUVTFQFSTFLJBOEFUJLLBSFOBBEBOZBQFSVCBIBOQBEB ,FSVDVU #FSEBTBSLBO VKJ QFOHMJIBUBO XBSOB TFOTJUJWJUBT
KVNMBIDBIBZBZBOHNBTVLNFMBMVJQFMFCBSBOQVQJMUFSTFCVU TQFLUSVN LFUJHB UJQF TFM LFSVDVU QBEB NBOVTJB UFMBI UFSCVLUJ
.FLBOJTNF ZBOH MBJO BEBMBI BEBQUBTJ TBSBG ZBOH NFMJCBULBO TFM QBEBEBTBSOZBTBNBTFQFSUJLVSWBBCTPSQTJDBIBZBVOUVLLFUJHB
TBSBGZBOHCFLFSKBQBEBSBOHLBJBOUBIBQQFOHMJIBUBOEJEBMBNSFUJOB UJQFQJHNFOZBOHEJUFNVLBOEJEBMBNTFMLFSVDVU,VSWBLVSWB
TFOEJSJEBOPUBL+BDMJ CJMBNVMBNVMBJOUFOTJUBTDBIBZBNFOJOHLBU NM EJHBNCBSLBO EBMBN (BNCBS EBO TFEJLJU CFSCFEB
TJOZBM ZBOH EJIBOUBSLBO PMFI TFMTFM CJQPMBS TFM IPSJ[POUBM TFM EBMBN (BNCBS ,VSWB JOJ EBQBU NFOKFMBTLBO IBNQJS
BNBLSJO EBO TFM HBOHMJPO UFSTFCVU TBOHBU CFTBS /BNVO TFCBHJBO TFNVBGFOPNFOBQFOHMJIBUBOXBSOB
CFTBSTJOZBMJOJBLBOCFSLVSBOHEFOHBODFQBUQBEBCFSCBHBJUJOHLBU
EJIBOUBSLBO EBMBN TJSLVJU TBSBG 8BMBVQVO CFTBSOZB BEBQUBTJ JOJ *OUFSQSFUBTJ 8BSOB EBMBN 4JTUFN 4BSBG %FOHBO NFMJIBU
IBOZB CFCFSBQB LBMJ MJQBU EJCBOEJOHLBO EFOHBO SJCVBO LBMJ MJQBU LFNCBMJ (BNCBS LJUB EBQBU NFMJIBU CBIXB DBIBZB
ZBOHUFSKBEJTFMBNBBEBQUBTJTJTUFNGPUPLJNJB"EBQUBTJTBSBGIBOZB NPOPLSPNBUJLCFSXBSOBKJOHHBUVBEFOHBOQBOKBOHHFMPNCBOH
UFSKBEJ EBMBN TFQFSTFLJBO EFUJL CFSCFEB EFOHBO BEBQUBTJ QFOVI TFCFTBSOBOPNFUFSJUVBLBONFSBOHTBOHTFMLFSVDVUNFSBI
PMFIGPUPLJNJBXJZBOHNFNCVUVILBOXBLUVCFSNFOJUNFOJUIJOHHB
EFOHBOOJMBJZBOHCFTBSOZBLJSBLJSB QFSTFOSBOHTBOHBO
CFSKBNKBN
QVODBL QBEB QBOKBOH HFMPNCBOH ZBOH PQUJNVN
TFEBOHLBO
.BLOB"EBQUBTJ5FSBOHEBO(FMBQCBHJ1FOHMJIBUBO"OUBSB TFMLFSVDVUIJKBVBLBOUFSBOHTBOHPMFIOJMBJLJSBLJSB UFUBQJ
CBUBT BEBQUBTJ HFMBQ NBLTJNBM EBO BEBQUBTJ UFSBOH NBLTJNBM TFM LFSVDVU CJSV UJEBL UFSBOHTBOH TBNB TFLBMJ +BEJ QFSCBOEJ
NBUB EBQBU NFOHVCBI TFOTJUJWJUBTOZB UFSIBEBQ DBIBZB TFCFTBS OHBOSBOHTBOHBOEBSJLFUJHBUJQFTFMLFSVDVUQBEBDPOUPIEJBUBT
TBNQBJ KVUB LBMJ TFOTJUJWJUBT JOJ TFDBSB PUPNBUJT BEBMBI 4JTUFN TBSBG BLBO NFOHJOUFSQSFUBTJLBO TVTVOBO
CFSVCBITFTVBJEFOHBOQFSVCBIBOJMVNJOBTJ SBTJP JOJ TFCBHBJ TVBUV TFOTBTJ KJOHHB 4FCBMJLOZB DBIBZB CJSV
0MFI LBSFOB QFSFLBNBO CBZBOHBO PMFI SFUJOB NFNCVUVILBO NPOPLSPNBUJL EFOHBO QBOKBOH HFMPNCBOH TFCFTBS
QFOHFOBMBO UJUJL HFMBQ EBO UJUJL UFSBOH EBOJ CBZBOHBO UFSTFCVU OBOPNFUFSNFSBOHTBOHTFMLFSVDVUEFOHBOSBOHTBOHBOTFCFTBS
TFOTJUJWJUBT SFUJOB QFSMV TFMBMV EJBUVS TFIJOHHB SFTFQUPSOZB EBQBU
NFSFTQPOTBSFBZBOHMFCJIUFSBOHUFUBQJUJEBLUFSIBEBQBSFBZBOH
MFCJI HFMBQ $POUPI BEBQUBTJ SFUJOB ZBOH TBMBI BEBMBI CJMB TFTF
PSBOH CBSV NFOJOHHBMLBO HFEVOH CJPTLPQ EBO NFNBTVLJ UFN
QBUEFOHBODBIBZBNBUBIBSJZBOHTBOHBUUFSBOH4FMBOKVUOZB CBI
LBOUJUJLHFMBQEBMBNCBZBOHBOQVONFOKBEJUFSMJIBUTBOHBUUFSBOH
EBO BLJCBUOZB TFMVSVI CBZBOHBO WJTVBM UFSTFCVU BLBO NFNVUJI
TFIJOHHB IBOZB TFEJLJU LPOUSBT EJ BOUBSB CBHJBOCBHJBOOZB *OJ
BEBMBI QFOHMJIBUBO ZBOH CVSVL EBO BLBO UFUBQ CVSVL TBNQBJ
SFUJOB UFMBI DVLVQ CFSBEBQUBTJ TFIJOHHB EBFSBI HFMBQ QBEB
CBZBOHBOUJEBLMBHJNFSBOHTBOHSFTFQUPSTFDBSBCFSMFCJIBO
4FCBMJLOZB CJMBTFTFPSBOHNVMBNVMBNFNBTVLJUFNQBUZBOH
MFCJI HFMBQ TFOTJUJWJUBT SFUJOB CJBTBOZB NFOKBEJ TBOHBU SFOEBI
TFIJOHHB CBILBO UJUJL UFSBOH EBMBN CBZBOHBOQVO UJEBL EBQBU
NFSBOHTBOHSFUJOB4FUFMBIBEBQUBTJHFMBQ UJUJLUFSBOHBLBONVMBJ
UFSFLBN$POUPIEBOBEBQUBTJUFSBOHEBOHFMBQZBOHFLTUSFNBEB
615
LFSVDVU IJKBV TFCFTBS EBO LFSVDVU CJSV EFOHBO SBOHTBOHBO

TFCFTBS .BLB TVTVOBO QFSCBOEJOHBOOZB BLBO EJJO
UFSQSFUBTJLBO PMFI TJTUFN TBSBG TFCBHBJ XBSOB CJSV %FNJLJBO
KVHB QFSCBOEJOHBOTFCFTBSBLBOEJJOUFSQSFUBTJLBOTFCB
HBJXBNBLVOJOHEBOTFCBHBJXBSOBIJKBV
1FSTFQTJUFSIBEBQ$BIBZB1VUJI3BOHTBOHBOZBOHLVSBOHMF
CJITBNBCFTBSQBEBTFMLFSVDVUNFSBI IJKBV EBOCJSVBLBONFN
CFSJLBO TFOTBTJ QFOHMJIBUBO XBSOB QVUJI /BNVO UJEBL BEB TBUV
QBOKBOHHFMPNCBOHDBIBZBQVOZBOHTFTVBJEFOHBOXBSOBQVUJI
XBSOB QVUJI KVTUSV NFSVQBLBO TVBUV LPNCJOBTJ EBO TFNVB
QBOKBOHHFMPNCBOHTQFLUSVNDBIBZB4FMBOKVUOZB QFSTFQTJUFSIB
EBQXBSOBQVUJIJOJEBQBUEJUJNCVMLBOCJMBSFUJOBEJSBOHTBOHPMFI
LPNCJOBTJUJHBXBSOBUFSQJMJITFDBSBUFQBUZBOHBLBONFSBOHTBOH
NBTJOHNBTJOHTFMLFSVDVUUFSTFCVUIBNQJSTBNBCFTBS
Buta Warna
#VUB8BSOB.FSBI)JKBV#JMBNBUBUBLNFNQVOZBJTFLFMPNQPLTFM
LFSVDVU QFOFSJNB XBSOB PSBOH JUV UBL BLBO EBQBU NFNCFEBLBO
CFCFSBQB XBSOB EBSJ XBSOB MBJOOZB 4FCBHBJ DPOUPI TFQFSUJ ZBOH EBQBU
EJMJIBU QBEB (BNCBS CBIXB XBSOB IJKBV LVOJOH KJOHHB UVB EBO
NFSBI BEBMBI XBSOBXBSOB EFOHBO QBOKBOH HFMPNCBOH BOUBSB
TBNQBJ OBOPNFUFS ZBOH TFDBSB OPSNBM EJCFEBLBO PMFI TFM LFSVDVU
NFSBI EBO IJKBV +JLB TBMBI TBUV EBSJ LFEVB TFM LFSVDVU JOJ IJMBOH
TFTFPSBOH UJEBL EBQBU MBHJ NFOHHVOBLBO NFLBOJTNF JOJ VOUVL
NFNCFEBLBO LFFNQBU XBSOB UFSTFCVU PSBOH JOJ LIVTVTOZB UJEBL EBQBU
NFNCFEBLBO XBSOB NFSBI EBO IJKBV TFIJOHHB EJB EJLBUBLBO CVUB
XBSOBNFSBIIJKBV
0SBOH ZBOH UBL NFNQVOZBJ TFM LFSVDVU NFSBI EJTFCVU QSPUBOP QJB
TFMVSVI TQFLUSVN QFOHMJIBUBOOZB BLBO NFNFOEFL TFDBSB OZBUB QBEB
BLIJS QBOKBOH HFMPNCBOH ZBOH QBOKBOH LBSFOB LVSBOHOZB TFM LFSVDVU
NFSBI NJ 1FOZBOEBOH CVUB XBSOB ZBOH UJEBL NFNQVOZBJ TFM LFSVDVU
IJKBV EJTFCVU EFVUFSBOPQJB PSBOH JOJ NFNQVOZBJ MFCBS TQFLUSVN
QBOKBOH HFMPNCBOH ZBOH CFOBSCFOBS OPSNBM TFCBC UFSTFEJB TFM LFSVDVU
NFSBIVOUVLNFOEFMFLTJQBOKBOHHFMPNCBOHXBSOBNFSBIZBOHQBOKBOH
#VUBXBSOBNFSBIIJKBVBEBMBILFMBJOBOHFOFUJLZBOHUJNCVMIBNQJS
IBOZB QBEB MBLJMBLJ (FOHFO QBEB LSPNPTPN 9 QFSFNQVBO NFOZBOEJ
VOUVL NBTJOHNBTJOH TFM LFSVDVU /BNVO CVUB XBSOB IBNQJS UJEBL
QFSOBI UFSKBEJ QBEB QFSFNQVBO LBSFOB TFUJEBLOZB TBUV EBO EVB
LSPNPTPN9BLBOIBNQJSTFMBMVNFNJMJLJHFOOPSNBMVOUVLTFUJBQKFOJT
TFMLFSVDVU0MFILBSFOBMBLJMBLJIBOZBNFNJMJLJTBUVLSPNPTPN9 HFO
ZBOHIJMBOHEBQBUNFOZFCBCLBOCVUBXBSOB
0MFILBSFOBLSPNPTPN9QBEBMBLJMBLJTFMBMVEJUVSVOLBOEBSJJCV EBO
UJEBL QFSOBI EBSJ BZBIOZB CVUB XBSOB EJUVSVOLBO EBSJ JCV LF BOBL MBLJ
MBLJOZB EBO JCV UFSTFCVU EJLBUBLBO TFCBHBJ DBSSJFS CVUB XBSOB LFBEBBO
UFSTFCVUUFSKBEJQBEBTFLJUBSQFSTFOEBSJTFNVBQFSFNQVBO
,FMFNBIBO 8BSOB #JSV +BSBOH UFSKBEJ LFLVSBOHBO TFM LFSVDVU CJSV
TBKB NFTLJQVO NVOHLJO LVSBOH UFSXBLJMJ ZBOH NFSVQBLBO LFBEBBO
HFOFUJLUVSVOBOEFOHBOGFOPNFOBLFMFNBIBOCJSV
,BSUV 6KJ 8BSOB .FUPEF DFQBU VOUVL NFOFOUVLBO TVBUV LFMBJOBO
CVUBXBSOBEJEBTBSLBOQBEBQFOHHVOBBOLBSUVCFSUJUJLUJUJLTFQFSUJZBOH
UFSMJIBU EBMBN (BNCBS ,BSUV JOJ EJTVTVO EFOHBO NFOZBUVLBO
UJUJLUJUJL ZBOH NFNQVOZBJ CFSNBDBNNBDBN XBSOB 1BEB LBSUV ZBOH
BUBT PSBOHEFOHBOQFOHMJIBUBOXBSOBZBOHOPSNBMBLBONFNCBDBBOHLB Fungsi Neural Retina
TFEBOHLBO QFOZBOEBOH CVUB XBSOB NFSBIIJKBV BLBO NFNCBDB
BOHLB h 1BEB LBSUV ZBOH CBXBI PSBOH EFOHBO QFOHMJIBUBO XBSOB Sirkuit Saraf di Retina
ZBOH OPSNBM BLBO NFNCBDB BOHLB TFEBOHLBO QFOZBOEBOH CVUB
XBSOB NFSBI BLBO NFNCBDB BOHLB EBO QFOZBOEBOH CVUB XBSOB (BNCBS NFNQFSMJIBULBO EBTBSEBTBS IVCVOHBO TBSBG
IJKBVBLBONFNCBDBBOHLBh SFUJOB EJ TFCFMBI LJSJ BEBMBI TJSLVJU EBMBN SFUJOB CBHJBO QFSJGFS
#JMBLJUBQFMBKBSJLBSUVJOJTBNCJMQBEBTBBUZBOHTBNBNFNQFSIBUJLBO EBO EJ TFCFMBI LBOBO TJSLVJU EJ GPWFB SFUJOB +FOJTKFOJT TFM TBSBG
LVSWBTFOTJUJWJUBTTQFLUSVNEBOCFSCBHBJTFMLFSVDVUZBOHUBNQBLEBMBN UFSTFCVUBEBMBITFCBHBJCFSJLVU
(BNCBS LJUBBLBOEBQBUEFOHBONVEBINFOHFSUJNFOHBQBQFOZB
LJUCVUBXBSOBNFNCFSJLBOQFOFLBOBOCFSMFCJIBOQBEBUJUJLUJUJLEFOHBO 1. 'PUPSFTFQUPS JUV TFOEJSJTFM CBUBOH EBO TFM LFSVDVUZBOH
XBSOBZBOHUFSUFOUVEJCBOEJOHLBOEFOHBOPSBOHOPSNBM NFOHIBOUBSLBOTJOZBMLFMBQJTBOQMFLTJGPSNMVBS UFNQBUTFMCB
616
Bab 50 Mata: II Reseptor dan Fungsi Neural Retina
LBOLFPUBLEVBTBNQBJMJNBLBMJMFCJIDFQBU4FMBJOJUV TJSLVJU
VOUVLLFEVBTJTUFNJOJTFEJLJUCFSCFEBTFCBHBJCFSJLVU
#BHJBO QBMJOH LBOBO QBEB (BNCBS NFNQFSMJIBULBO
KBSBT QFOHMJIBUBO EBSJ CBHJBO GPWFB SFUJOB NFOHHBNCBSLBO
TJTUFNLFSVDVUZBOHCBSVEBODFQBU(BNCBSJOJNFNQFSMJIBU
UNIT X
LBOUJHBOFVSPOEBMBNKBSBTMBOHTVOH
LFSVDVU
TFMCJQP
MBS EBO
TFM HBOHMJPO 4FMBJO JUV TFM IPSJ[POUBM NFOHIBUBS
LBOTJOZBMJOIJCJTJTFDBSBMBUFSBMEJMBQJTBOQMFLTJGPSNMVBS EBO
TFM BNBLSJO NFOHIBOUBSLBO TJOZBM TFDBSB MBUFSBM EJ MBQJTBO
QMFLTJGPSNEBMBN
#BHJBO TFCFMBI LJSJ QBEB (BNCBS NFNQFSMJIBULBO
IVCVOHBOTBSBGVOUVLSFUJOBCBHJBOQFSJGFSUFNQBUUFSEBQBUOZB
TFMCBUBOHEBOTFMLFSVDVU%JQFSMJIBULBOUJHBTFMCJQPMBSZBOH
UFOHBI EBSJ LFUJHB JOJ IBOZB CFSIVCVOHBO EFOHBO TFM CBUBOH
NFOHHBNCBSLBO KFOJT TJTUFN QFOHMJIBUBO ZBOH UFSEBQBU QBEB
CBOZBLIFXBOUJOHLBUSFOEBI,FMVBSBOEBSJTFMCJQPMBSIBOZB
EJIBOUBSLBO LF TFM BNBLSJO ZBOH NFOFSVTLBO TJOZBM LF TFM
HBOHMJPO +BEJ VOUVL QFOHMJIBUBO TFM CBUBOH ZBOH NVSOJ
UFSEBQBU FNQBU OFVSPO EBMBN KBSBT QFOHMJIBUBO MBOHTVOH

TFMCBUBOH
TFMCJQPMBS
TFMBNBLSJO EBO
TFMHBOHMJPO
4FMBJO JUV NBTJI BEB TFM IPSJ[POUBM EBO TFM BNBLSJO ZBOH
NFNVOHLJOLBOIVCVOHBOMBUFSBM
UBOH EBO TFM LFSVDVU CFSTJOBQT EFOHBO TFM CJQPMBS EBO TFM %VB TFM CJQPMBS MBJOOZB ZBOH EJQFSMJIBULBO QBEB TJSLVJU
IPSJ[POUBM SFUJOBCBHJBOQFSJGFSQBEB(BNCBSCFSIVCVOHBOEFOHBO
4FM IPSJ[POUBM ZBOH NFOHIBOUBSLBO TJOZBM TFDBSB IPSJ[POUBM TFM CBUBOH EBO TFM LFSVDVU IBTJM LFMVBSBO EBSJ TFM CJQPMBS JOJ
MBOHTVOH NFOVKV TFM HBOHMJPO EBO KVHB NFMBMVJ KBMVS EBSJ TFM
QBEBMBQJTBOQMFLTJGPSNMVBSEBSJTFMCBUBOHEBOTFMLFSVDVU
BNBLSJO
LFTFMCJQPMBS
4FM CJQPMBS ZBOH NFOHIBOUBSLBO TJOZBM TFDBSB WFSUJLBM EBO /FVSPUSBOTNJUFS ZBOH %JMFQBTLBO PMFI /FVSPO 3FUJOB
TFM CBUBOH TFM LFSVDVU EBO TFM IPSJ[POUBM LF MBQJTBO QMFLTJ /FVSPUSBOTNJUFS ZBOH EJHVOBLBO VOUVL QFOHIBOUBSBO TJOBQT
GPSNEBMBN UFNQBUTFMTFMJUVCFSTJOBQTEFOHBOTFMHBOHMJPO EJ SFUJOB UJEBL TFMVSVIOZB EJCFEBLBO /BNVO CBJL TFM CBUBOH
EBOTFMBNBLSJO NBVQVO TFM LFSVDVU NFMFQBTLBO HMVUBNBU QBEB UFNQBUOZB
CFSTJOBQTEFOHBOTFMCJQPMBS
4FM BNBLSJO ZBOH NFOHIBOUBSLBO TJOZBM EBMBN EVB BSBI
%BSJQFOFMJUJBOIJTUPMPHJTEBOGBSNBLPMPHJTUFMBIEJCVLUJLBO
CBJL TFDBSB MBOHTVOH EBO TFM CJQPMBS LF TFM HBOHMJPO BUBV
UFSEBQBUCBOZBLKFOJTTFMBNBLSJOZBOHFOZFLSFTJQBMJOHTFEJLJU
TFDBSBIPSJ[POUBMEBMBNMBQJTBOQMFLTJGPSNEBMBNEBOBLTPO
EFMBQBO KFOJT TVCTUBOTJ USBOTNJUFS BOUBSB MBJO BTBN HBNNB
TFMCJQPMBSLFEFOESJUTFMHBOHMJPOBUBVTFMBNBLSJOMBJOOZB
BNJOPCVUJSBU HMJTJO EPQBNJO BTFUJMLPMJO EBO JOEPMBNJO
4FMHBOHMJPO ZBOHNFOHIBOUBSLBOTJOZBMLFMVBSEBOJSFUJOB TFNVBJOJTFDBSBOPSNBMCFSGVOHTJTFCBHBJUSBOTNJUFSJOIJCJUPS
NFMBMVJTBSBGPQUJLVTLFPUBL 5SBOTNJUFS TFM CJQPMBS TFM IPSJ[POUBM EBO TFM JOUFSQMFLTJGPSN
+FOJT TFM TBSBG LFFOBN EJ EBMBN SFUJOB ZBOH UJEBL UFSMBMV CFMVN KFMBT UFUBQJ QBMJOH TFEJLJU CFCFSBQB TFM IPSJ[POUBM
NFOPOKPM EBO UJEBL EJQFSMJIBULBO EBMBN HBNCBS BEBMBI TFM NFMFQBTLBOUSBOTNJUFSJOIJCJUPS
JOUFSQMFLTJGPSN 4FM JOJ NFOHIBOUBSLBO TJOZBM EBMBN BSBI 1FOKBMBSBO 4FCBHJBO #FTBS 4JOZBM ZBOH 5JNCVM EBMBN
SFUSPHSBE EBSJ MBQJTBO QMFLTJGPSN EBMBN LF MBQJTBO QMFLTJGPSN /FVSPO 3FUJOB NFMBMVJ ,POEVLTJ &MFLUSPUPOJL EBO #VLBO
MVBS 4JOZBM JOJ CFSTJGBU NFOHIBNCBU EBO EJEVHB VOUVL NFMBMVJ1PUFOTJBM"LTJ4BUVTBUVOZBOFVSPOSFUJOBZBOHTFMBMV
NFOHFOEBMJLBO QFOZFCBSBO MBUFSBM EBOJ TJOZBM QFOHMJIBUBO PMFI NFOKBMBSLBO TJOZBM QFOHMJIBUBO NFMBMVJ QPUFOTJBM BLTJ BEBMBI
TFM IPSJ[POUBM EJ MBQJTBO QMFLTJGPSN MVBS 1FSBO TJOZBM UFSTFCVU TFM HBOHMJPO ZBOH NFOHJSJNLBO TJOZBMOZB NFOVKV LF PUBL
NVOHLJO EBQBU NFNCBOUV NFOHBUVS EFSBKBU LPOUSBT EBMBN NFMBMVJTBSBGPQUJL,BEBOHLBEBOHQPUFOTJBMBLTJKVHBUFSDBUBU
CBZBOHBOQFOHMJIBUBO EJEBMBNTFMBNBLSJO XBMBVQVOQFSBOQPUFOTJBMBLTJJOJNBTJI
EJQFSUBOZBLBO/BNVOEFNJLJBO TFNVBOFVSPOSFUJOBNFOH
+BSBT1FOHMJIBUBOZBOH#FSBTBMEBSJ4FM,FSVDVUNFOVKV4FM IBOUBSLBOTJOZBMQFOHMJIBUBOOZBNFMBMVJLPOEVLTJFMFLUSPUPOJL
(BOHMJPO #FSCFEB EFOHBO +BSBT ZBOH #FSBTBM EBSJ 4FM #BUBOH ZBOHEBQBUEJKFMBTLBOTFCBHBJCFSJLVU
4FQFSUJCBOZBLTJTUFNTFOTPSJLMBJOZBOHLJUBNJMJLJ SFUJOBNFNJ ,POEVLTJ FMFLUSPUPOJL CFSBSUJ BMJSBO BSVT MJTUSJL TFDBSB
MJLJKFOJTQFOHMJIBUBOMBNBZBOHCFSEBTBSLBOQBEBQFOHMJIBUBOTFM MBOHTVOH CVLBO QPUFOTJBM BLTJ EBMBN TJUPQMBTNB OFVSPO EBO
CBUBOHEBOKFOJTQFOHMJIBUBOCBSVZBOHEJEBTBSLBOQBEBQFOHMJ TBSBG BLTPO EBSJ UJUJL FLTJUBTJ NFMBMVJ TFNVB KBMVS LF TJOBQT
IBUBO TFM LFSVDVU /FVSPO EBO TFSBU TBSBG ZBOH NFOHIBOUBSLBO TJOBQT LFMVBSBO #BILBO QBEB CBUBOH NBVQVO LFSVDVU QFOH
TJOZBMQFOHMJIBUBOVOUVLQFOHMJIBUBOLFSVDVUCFSTJGBUMFCJICFTBS IBOUBSBOEBSJTFHNFOMVBS UFNQBUQFNCFOUVLBOTJOZBMQFOHMJ
EBSJQBEB ZBOH EJHVOBLBO VOUVL NFOHIBOUBSLBO TJOZBM QFOHMJ IBUBO TBNQBJ LF TJOBQT UFSKBEJ NFMBMVJ LPOEVLTJ FMFLUSPUPOJL
IBUBOVOUVLQFOHMJIBUBOCBUBOH EBOTJOZBMTJOZBMJOJEJIBOUBS "SUJOZB LFUJLBUFSKBEJIJQFSQPMBSJTBTJBLJCBUSFTQPOUFSIBEBQDB
617
Unit X Sistem Saraf; B. indra Khusus
DBIBZBQBEBTFHNFOMVBSTFMCBUBOHBUBVLFSVDVU IJQFSQPMBSJTBTJ #FCFSBQB TFM BNBLSJO NVOHLJO NFNCFSJ JOIJCJTJ MBUFSBM

EFOHBOEFSBKBUZBOHIBNQJSTBNBEJIBOUBSLBOPMFIBMJSBOBSVT UBNCBIBO EBO QFOHVBUBO LPOUSBT QFOHMJIBUBO MFCJI MBOKVU EJ
MJTUSJL MBOHTVOH EBMBN TJUPQMBTNB EJ TFQBOKBOH KBMVS NFOVKV MBQJTBOQMFLTJGPSNEBMBNQBEBSFUJOB
CBEBOTJOBQT EBOUJEBLNFNFSMVLBOQPUFOTJBMBLTJ,FNVEJBO
LFUJLB USBOTNJUFS ZBOH CFSBTBM EBSJ TFM CBUBOH BUBV TFM LFSVDVU
NFSBOHTBOH TFM CJQPMBS BUBV TFM IPSJ[POUBM TFLBMJ MBHJ TJOZBM
EJKBMBSLBOEBOJOQVULFPVUQVUPMFIBMJSBOBSVTMJTUSJLMBOHTVOH
CVLBOPMFIQPUFOTJBMBLTJ "EB EVB KFOJT TFM CJQPMBS ZBOH NFNCFSJ TJOZBM CFSMBXBOBO
1FSBO LPOEVLTJ FMFLUSPUPOJL BEBMBI NFOJNCVMLBO LPOEVLTJ CFSVQBFLTJUBUPSJLEBOJOIJCJUPSJLEJKBSBTQFOHMJIBUBO ZBJUV

CFSKFOKBOH EBO LFLVBUBO TJOZBM +BEJ VOUVL TFM CBUBOH EBO TFM TFM CJQPMBS ZBOH CFSEFQPMBSJTBTJ EBO
TFM CJQPMBS ZBOH
LFSVDVU LFLVBUBO TJOZBM PVUQVU ZBOH CFSIJQFSQPMBSJTBTJ TFDBSB CFSIJQFSQPMBSJTBTJ "SUJOZB CFCFSBQB TFM CJQPMBS CFSEFQPMBSJTBTJ
MBOHTVOH CFSLBJUBO EFOHBO JOUFOTJUBT JMVNJOBTJ TJOZBM UJEBL LFUJLB TFM CBUBOH EBO TFM LFSVDVU UFSFLTJUBTJ EBO ZBOH MBJO
CFSTJGBUHBHBMBUBVUVOUBTTBNBTFLBMJ TFQFSUJZBOHCFSMBLVQBEB CFSIJQFSQPMBSJTBTJ
TFUJBQQPUFOTJBMBLTJ 5FSEBQBU EVB QFOKFMBTBO LFNVOHLJOBO UFSIBEBQ QFSCFEBBBO
JOJ 1FOKFMBTBO QFSUBNB BEBMBI CBIXB LFEVB TFM CJQPMBS NFSV
QBLBOKFOJTZBOHTFMVSVIOZBCFSCFEBZBOHTBUVNFSFTQPOTEFOHBO
CFSEFQPMBSJTBTJ BLJCBU OFVSPUSBOTNJUFS HMVUBNBU ZBOH EJMFQBTLBO
PMFI TFM CBUBOH EBO TFM LFSVDVU EBO ZBOH MBJOOZB NFSFTQPOT
4FMIPSJ[POUBM TFQFSUJZBOHUFSMJIBUQBEB(BNCBS NFOH EFOHBO CFSIJQFSQPMBSJTBTJ ,FNVOHLJOBO ZBOH MBJO BEBMBI CBIXB
IVCVOHLBO CBEBOCBEBO TJOBQT TFM CBUBOH EBO TFM LFSVDVU TBMBI TBUV EBSJ LFEVB TFM CJQPMBS UFSTFCVU NFOFSJNB SBOHTBOHBO
TFDBSB MBUFSBM EBO KVHB NFOHIVCVOHLBO EFOESJUEFOESJU TFM MBOHTVOH EBSJ TFM CBUBOH EBO TFM LFSVDVU TFEBOHLBO ZBOH MBJO
CJQPMBS "QB ZBOH LFMVBS EBSJ TFM IPSJ[POUBM TFMBMV CFSTJGBU NFOFSJNB TJOZBMOZB TFDBSB UJEBL MBOHTVOH NFMBMVJ TFM IPSJ[POUBM
JOIJCJTJ 0MFI LBSFOB JUV IVCVOHBO MBUFSBM JOJ NFNCFSJLBO 0MFI LBSFOB TFM IPSJ[POUBM NFSVQBLBO TFM JOIJCJUPS TFM JOJ BLBO
GFOPNFOBJOIJCJTJMBUFSBMZBOHTBNBZBOHCFSTJGBUQFOUJOHQBEB NFNCBMJLLBOQPMBSJUBTEBOSFTQPOTMJTUSJL
TFNVB TJTUFN TFOTPSJL MBJO ZBJUV VOUVL NFNCBOUV NFNBTUJ
5BOQB NFNQFSIBUJLBO LFEVB KFOJT NFLBOJTNF SFTQPOT CJ
LBOQFOHIBOUBSBOQPMBQFOHMJIBUBOEFOHBOLPOUSBTQFOHMJIBUBO
QPMBSJOGFOPNFOBUFSTFCVUNFNJMJLJNBLOBCBIXBIBMJOJEBQBU
ZBOH TFTVBJ 'FOPNFOB JOJ EJUVOKVLLBO QBEB (BNCBS
NFOHBLJCBULBO TFQBSVI TFMTFM CJQPMBS NFOHIBOUBSLBO TJOZBM
ZBOHNFNQFSMJIBULBOTFUJUJLLFDJMDBIBZBZBOHEJGPLVTLBOQBEB
QPTJUJG EBO TFQBSVI ZBOH MBJO NFOKBMBSLBO TJOZBM OFHBUJG ,JUB
SFUJOB+BSBTQFOHMJIBUBOZBOHCFSBTBMEBOEBFSBIQBMJOHUFOHBI
BLBO MJIBU OBOUJ CBIXB LFEVB TJOZBM QPTJUJG EBO OFHBUJG EBQBU
UFNQBU DBIBZB EBUBOH UFSFLTJUBTJ TFEBOHLBO EBFSBI MFCJI LF
EJHVOBLBOEBMBNNFOHIBOUBSLBOJOGPSNBTJQFOHMJIBUBOLFPUBL
TBNQJOH EJIBNCBU%FOHBOLBUBMBJO QFOHIBOUBSBONFMBMVJTFM
IPSJ[POUBMCFSIFOUJTBNQBJEJTJOJBLJCBUBEBOZBJOIJCJTJMBUFSBM "TQFL QFOUJOH MBJOOZB EBSJ IVCVOHBO UJNCBM CBMJL BOUBSB TFM
EJ EBFSBI TFLJUBSOZB CFSCFEB EFOHBO TJOZBM FLTJUBUPSJL ZBOH CJQPMBS ZBOH CFSEFQPMBSJTBTJ EBO CFSIJQFSQPMBSJTBTJ JOJ BEBMBI
NFOZFCBS TFDBSB MVBT EBMBN SFUJOB BLJCBU QFOZFCBSBO KBMVS CBIXB IBM JOJ NFOJNCVMLBO NFLBOJTNF LFEVB VOUVL JOIJCJTJ
EFOESJUJLEBOBLTPOBMEBMBNMBQJTBOQMFLTJGPSN)BMJOJQFOUJOH MBUFSBM TFMBJO NFLBOJTNF TFM IPSJ[POUBM 0MFI LBSFOB TFM CJQPMBS
VOUVL NFOHIBTJMLBO QFOHMJIBUBOZBOH TBOHBU BLVSBU QBEB XBL ZBOH CFSEFQPMBSJTBTJ EBO ZBOH CFSIJQFSQPMBSJTBTJ UFSMFUBL UFQBU
UVQFOHIBOUBSBOCBUBTCBUBTLPOUSBTQBEBCBZBOHBOQFOHMJIBUBO TBMJOHCFSIBEBQBOTBUVTBNBMBJO BLBONFOZFCBCLBOUJNCVMOZB
NFLBOJTNFQFNJTBIBOCBUBTLPOUSBTQBEBCBZBOHBOQFOHMJIBUBO
NFTLJQVOCJMBCBUBTUFSTFCVUUFSMFUBLUFQBUEJBOUBSBEVBGPUPSF
TFQUPS ZBOH TBMJOH CFSEFLBUBO 4FCBMJLOZB NFLBOJTNF TFM IPSJ
[POUBMVOUVLJOIJCJTJMBUFSBMCFLFSKBQBEBKBSBLZBOHMFCJIKBVI
4FLJUBS KFOJT TFM BNBLSJO UFMBI EJJEFOUJGJLBTJ TFDBSB NPSGPMP

HJT BUBV IJTUPLJNJBXJ 'VOHTJ TFLJUBS TFUFOHBI MVTJO UJQF TFM
BNBLSJO UFMBI EJDJSJLBO EBO TFNVB JUV CFSCFEB TBUV TBNB MBJO
4BMBI TBUV KFOJT TFM BNBLSJO BEBMBI CBHJBO EBSJ KBSBT MBOHTVOH
VOUVLQFOHMJIBUBOTFMCBUBOHZBJUV EBSJTFMCBUBOHLFTFMCJQPMBS
MBMVLFTFMBNBLSJOEBOLFNVEJBOLFTFMHBOHMJPO
+FOJTTFMBNBLSJOMBJONFNCFSJSFTQPOTLVBUQBEBPOTFUTJOZBM
QFOHMJIBUBO ZBOH LPOUJOV UFUBQJ SFTQPOTOZB NFOHIJMBOH EFOHBO
DFQBU
4FM BNBLSJO MBJO CFSFTQPOT EFOHBO LVBU QBEB IJMBOHOZB PGG
TFU
TJOZBM QFOHMJIBUBO UFUBQJ MBHJMBHJ SFTQPOTOZB NFOHIJMBOH
EFOHBODFQBU
.BTJIBEBTFMBNBLSJOMBJOZBOHCFSFTQPOTTBBUDBIBZBEJOZBMB
LBONBVQVOTBBUEJNBUJLBO EFOHBONFNCFSJLBOTJOZBMTFDBSBTF
EFSIBOBNFOHFOBJQFSVCBIBOJMNJOBTJUBOQBNFNQFSIBUJLBOBSBI
618
.BTJI BEB TFM BNBLSJO UJQF MBJO ZBOH CFSFTQPOT UFSIBEBQ 1FOHIBOUBSBO #BZBOHBO 1FOHMJIBUBO EBO 8BSOB PMFI
HFSBLBO DBIBZB ZBOH NFMJOUBTJ SFUJOB QBEB BSBI ZBOH TQFTJGJL 4FM94FCBHJBOCFTBSTFMHBOHMJPOBEBMBITFM9 NFSVQBLBO
LBSFOBJUV TFMBNBLSJOJOJEJTFCVUTFCBHBJQFLBBSBI QFSTFO EBSJ LFTFMVSVIBO 4FM JOJ NFNJMJLJ EJBNFUFS TFEBOH
4FMBOKVUOZB EBMBNQFOHJOESBBO CBOZBLBUBVTFCBHJBOCFTBS BOUBSB TBNQBJ VUN EBO NFOHIBOUBSLBO TJOZBM EBMBN
TFMBNBLSJONFSVQBLBOJOUFSOFVSPOZBOHNFNCBOUVNFOHBOBMJ TFSBCVUTBSBGPQUJLVTOZBEFOHBOLFDFQBUBOTFLJUBSNEFUJL
UNIT X
TJTTJOZBMQFOHMJIBUBOTFCFMVNNFOJOHHBMLBOSFUJOB 4FM 9 NFNJMJLJ MBQBOHBO ZBOH TFNQJU LBSFOB EFOESJUOZB
UJEBL NFOZFCBS TFDBSB MVBT EBMBN SFUJOB 0MFI LBSFOB IBM JO
TJOZBM TFM 9 NFNQFSMJIBULBO MPLBTJMPLBTJ SFUJOB UFSTFOEJSJ
4FM(BOHMJPOEBO4FSBU4BSBG0QUJL 0MFI LBSFOB JUV QFSJODJBO CBZBOHBO QFOHMJIBUBO ZBOH IBMVT
4FUJBQSFUJOBNFOHBOEVOHLJSBLJSBKVUBTFMCBUBOHEBOKVUB UFSVUBNBEJIBOUBSLBONFMBMVJTFM9+VHB LBSFOBTFUJBQTFM9
TFM LFSVDVU OBNVO KVNMBI TFM HBOHMJPO IBOZB TFLJUBS KVUB NFOFSJNB NBTVLBO JOQVU
QBMJOH TFEJLJU EBO TBUV TFM
+BEJ SBUBSBUB UFSEBQBU TFM CBUBOH EBO TFM LFSVDVU ZBOH LFSVDVU QFOHIBOUBSBOTFM9LFNVOHLJOBOCFSUBOHHVOHKBXBC
CFSLVNQVMQBEBTFUJBQTFMHBOHMJPOEBOTFSBUTBSBGPQUJLVTZBOH VOUVLQFOHMJIBUBOTFMVSVIXBSOB
CFSBTBMEBSJTFMHBOHMJPONFOVKVLFPUBL 'VOHTJ 4FM: VOUVL .FOHIBOUBSLBO 1FSV CBIBO 4FLFUJLB
8BMBVQVO EFNJLJBO UFSEBQBU QFSCFEBBO ZBOH CFTBS BOUBSB QBEB#BZBOHBO1FOHMJIBUBO4FM:BEBMBITFMZBOHQBMJOHCF
SFUJOB QFSJGFS EBO SFUJOB TFOUSBMJT 0MFI LBSFOB TFNBLJO EFLBU TBS EJBNFUFS NFODBQBJ SJN EBO NFOHIBOUBSLBO TJOZBMOZB
EFOHBO GPWFB MFCJI TFEJLJU TFM CBUBOH EBO TFM LFSVDVU ZBOH LF PUBL EFOHBO LFDFQBUBO NEFUJL BUBV MFCJI DFQBU 4FMTFM
CFSLPOWFSHFOTJQBEBTFUJBQTFSBUPQUJLVT EBOTFMCBUBOHTFSUBTFM JOJ CFSKVNMBI QBMJOH TFEJLJU EBO TFNVB TFM HBOHMJPO IBOZB
LFSVDVU NFOKBEJ MFCJI UJQJT ,FEVB FGFL JOJ TFDBSB QSPHSFTJG TFLJUBS QFSTFO EBSJ LFTFMVSVIBO 4FMBJO JUV TFM : NFNJMJLJ
NFOJOHLBULBO LFUBKBNBO QFOHMJIBUBO EJ SFUJOB TFOUSBMJT 1BEB MBQBOHBOEFOESJUJLZBOHMVBT TFIJOHHBTJOZBMZBOHEJCBXBPMFI
CBHJBO ZBOH UFOHBI EJ GPWFB TFOUSBMJT IBOZB UFSEBQBU TFMTFM TFMJOJCFSBTBMEBOEBFSBISFUJOBZBOHMVBT
LFSVDVUZBOHUJQJTLJSBLJSBEBOUJEBLBEBTFMCBUBOH-BMV 4FQFSUJ LFCBOZBLBO TFM BNBLSJO TFM HBOHMJPO : CFSFTQPOT
KVHB KVNMBITFSBUTBSBGPQUJLVTZBOHLFMVBSEBOCBHJBOSFUJOBJOJ UFSIBEBQ QFSVCBIBO CBZBOHBO QFOHMJIBUBO ZBOH DFQBU CBJL
IBNQJS TBNB EFOHBO KVNMBI TFM LFSVDVU TFQFSUJ ZBOH CFSVQB HFSBLBO DFQBU NBVQVO QFSVCBIBO JOUFOTJUBT DBIBZB
EJQFSMJIBULBO QBEB CBHJBO LBOBO (BNCBS )BM JOJ ZBOH DFQBU EFOHBO NFOHJSJNLBO SFOUFUBO TJOZBM IBOZB EBMBN
NFOKFMBTLBONFOHFOBJEFSBKBULFUBKBNBOQFOHMJIBUBOZBOHUJOHHJ XBLUVTFQFSTFLJBOEFUJL4FMHBOHMJPOJOJLJSBOZBEBQBUNFNCF
EJ SFUJOB TFOUSBMJT EJCBOEJOHLBO EFOHBO LFUBKBNBO QFOHMJIBUBO SJUBIVLBOTJTUFNTBSBGQVTBUIBNQJSEFOHBOTFHFSBLFUJLBUJN
ZBOHMFCJICVSVLEJCBHJBOQFSJGFS CVM QFOHMJIBUBO CBSV EJ TFHBMB UFNQBU EBMBN MBQBOHBO QBO
1FSCFEBBOMBJOBOUBSBSFUJOBCBHJBOQFSJGFSEBOCBHJBOTFOUSBM EBOH UFUBQJUJEBLTFDBSBLIVTVTNFOVOKVLLBOMPLBTJQFSJTUJXB
BEBMBI BEBOZB TFOTJUJWJUBT ZBOH KBVI MFCJI CFTBS QBEB SFUJOB UFSTFCVU EFOHBO UJOHLBU BLVSBTJ ZBOH UJOHHJ NFMBJOLBO NFN
CBHJBO QFSJGFS UFSIBEBQ DBIBZB ZBOH MFNBI )BM JOJ TFCBHJBO CFSJQFUVOKVLZBOHUFQBUTFIJOHHBNFOZFCBCLBONBUBCFSHFSBL
EJTFCBCLBO PMFI LFOZBUBBO CBIXB TFM CBUBOH TBNQBJ LBMJ NFOVKVHBNCBSBOZBOHNFOHFLTJUBTJOZB
MFCJITFOTJUJGUFSIBEBQDBIBZBEBSJQBEBTFMLFSVDVU UFUBQJIBMJOJ
TFMBOKVUOZB EJQFSLVBU PMFI LFOZBUBBO CBIXB UFSEBQBU TFCBOZBL Eksitasi Sel Ganglion
TFMCBUBOHCFSLVNQVMQBEBTBUVTFSBUTBSBGPQUJLVTEJCBHJBO
1PUFOTJBM "LTJ ZBOH 4QPOUBO EBO 5FSVT.FOFSVT EBMBN 4FM
SFUJOB ZBOH MFCJI QFSJGFS TFIJOHHB TJOZBM ZBOH CFSBTBM EBO TFM
(BOHMJPO 4FSBU QBOKBOH TBSBG PQUJLVT ZBOH NBTVL LF EBMBN PUBL
CBUBOH CFSTVNBTJ VOUVL NFNCFSJ SBOHTBOHBO ZBOH MFCJI LVBU
CFSBTBM EBSJ TFM HBOHMJPO 0MFI LBSFOB KBSBL ZBOHUFSMJCBU NFUPEF
UFSIBEBQTFMHBOHMJPOQFSJGFSEBOTFSBUTBSBGPQUJLVTOZB
LPOEVLTJ ZBOH CFSTJGBU FMFLUSPUPOJL ZBOH EJHVOBLBO PMFI TFM
CBUBOH TFMLFSVDVUEBOTFMCJQPMBSEJEBMBNSFUJOBUJEBLMBHJTFTVBJ
5JHB+FOJT4FM(BOHMJPO3FUJOBEBO-BQBOHBOOZB PMFI LBSFOB JUV TFMTFM HBOHMJPO NFOHIBOUBSLBO TJOZBMTJOZBMOZB
5FSEBQBU UJHB LFMPNQPL TFM HBOHMJPO ZBOH CFSCFEB KFMBT EJTFCVU EFOHBO NFOHHVOBLBO QPUFOTJBM BLTJ ZBOH CFSVMBOH 4FMBOKVUOZB
TFCBHBJTFM8 9 EBO:5JBQUJBQTFMJOJNFMBLVLBOGVOHTJZBOH XBMBVQVO UJEBL EJTUJNVMBTJ TFMTFM HBOHMJPO JOJ UFUBQ NFOHIBO
CFSCFEB LBO JNQVMTOZB UFSVTNFOFSVT EFOHBO LFDFQBUBO ZBOH CFSLJTBS
1FOHIBOUBSBO 1FOHMJIBUBO 4FM #BUBOH PMFI 4FM 8 4F 8 LV BOUBSB TBNQBJ QFS EFUJL ,FNVEJBO TJOZBM QFOHMJIBUBO
SBOHMFCJINFSVQBLBOQFSTFOEBSJTFMVSVITFMHBOHMJPO NFSVQB CFSUVNQBOHUJOEJIEFOHBOQFODFUVTBOTFMHBOHMJPONJ
LBOTFMLFDJMEBONFNJMJLJEJBNFUFSLVSBOHEBSJMJSOTFSUBNFOH 1FOHIBOUBSBO1FSVCBIBO*OUFOTJUBT$BIBZB3FTQPOT.BUJ
IBOUBSLBO TJOZBM EBMBN TFSBU TBSBG PQUJLVTOZB EFOHBO LFDFQBUBO )JEVQ 4FQFSUJ ZBOH UFMBI EJTFCVULBO TFCFMVNOZB CBOZBL TFM
MBNCBU ZBJUVIBOZBNEFUJL4FMTFMHBOHMJPOJOJNFOFSJNBTFCB HBOHMJPO TFDBSB TQFTJGJL EJSBOHTBOH PMFI QFSVCBIBO JOUFOTJUBT
HJBOCFTBSFLTJUBTJOZBEBSJTFMCBUBOH EJIBOUBSLBONFMBMVJKBMVSTFM DBIBZB )BM JOJ EJQFSMJIBULBO NFMBMVJ QFODBUBUBO JNQVMT TBSBG
CJQPMBS LFDJM EBO TFM BNBLSJO 4FM HBOHMJPO JOJ NFNJMJLJ MBQBOHBO QBEB (BNCBS #BHJBO BUBT HBNCBS NFNQFSMJIBULBO
ZBOHUFSMVBTEJSFUJOBLBSFOBEFOESJUTFMHBOHMJPONFOZFCBSTFDBSB JNQVMTJNQVMT DFQBU TFMBNB TFQFSTFLJBO EFUJL LFUJLB DBIBZB
MVBTEJMBQJTBOQMFLTJGPSNEBMBN ZBOHNFOFSJNBTJOZBMEBOEBFSBI NVMBNVMBEJOZBMBLBO UFUBQJEFOHBODFQBUQVMBNFOVSVOEBMBN
ZBOHMVBT XBLUV TFQFSTFLJBO EFUJL (BNCBS CBHJBO CBXBI BEBMBI HBNCB
#FSEBTBSLBO QFSDPCBBO IJTUPMPHJT NBVQVO UBNQBLOZB TFM 8 SBOEBSJTFMHBOHMJPOZBOHUFSMFUBLEJTFCFMBIMBUFSBMUFSIBEBQUJUJL
TBOHBU TFOTJUJG VOUVL NFOEFUFLTJ BSBI QFSHFSBLBO EJ MBQBOH DBIBZB TFM JOJ TFDBSB KFMBT UFSIBNCBU LFUJLB DBIBZB EJOZBMBLBO
QBOEBOHBO EBO TFM 8 UFSTFCVU NVOHLJO KVHB QFOUJOH VOUVL BLJCBU BEBOZB JOIJCJTJ MBUFSBM ,FNVEJBO LFUJLB DBIBZB EJNBUJ
TFCBHJBOCFTBSQFOHMJIBUBOCBUBOHZBOHLBTBSEBMBNLFBEBBOHFMBQ LBO UFSKBEJFGFLZBOHTFCBMJLOZB+BEJ QFODBUBUBOJOJEJTFCVUSFT
619
Unit X Sistem Saraf; B. indra Khusus
QPOT NBUJOZBMB EBO OZBMBNBUJh 4FDBSB CFSVSVUBO SFTQPOT

DBIBZB ZBOH CFSMBXBOBO BSBI JOJ EJTFCBCLBO PMFI TFMTFM CJQPMBS
ZBOH CFSEFQPMBSJTBTJ EBO CFSIJQFSQPMBSJTBTJ EBO TJGBU TFNFOUBSB
EBOSFTQPOTSFTQPOTJOJLFNVOHLJOBOTFCBHJBOEJUJNCVMLBOPMFI
TFMTFM BNBLSJO ZBOH LFCBOZBLBO NFNJMJLJ SFTQPOT TFNFOUBSB
ZBOHTFSVQB
,FNBNQVBO NBUB VOUVL NFOEFUFLTJ QFSVCBIBO JOUFOTJUBT
DBIBZBTFDBSBLVBUEJCFOUVLEJSFUJOBCBHJBOQFSJGFSEBOEJCBHJBO
TFOUSBM 4FCBHBJ DPOUPI BHBT LFDJM ZBOH UFSCBOH NFMJOUBTJ MBQB
OHBO QBOEBOH EBQBU EFOHBO TFHFSB EJEFUFLTJ 4FCBMJLOZB BHBT
ZBOH TBNB ZBOH TFEBOH CFSEJBN UFOEGHBOH NBTJI EJ CBXBI
BNCBOHSBOHTBOHEFUFLTJQFOHMJIBUBO
1FOHIBOUBSBO 4JOZBM ,POUSBT QBEB 1BOEBOHBO 1FOHMJIBUBO

1FSBOMOIJCJTJ-BUFSBM
#BOZBLTFMHBOHMJPOUFSVUBNBCFSFTQPOTUFSIBEBQUFQJQBOEBOHBO
ZBOH LPOUSBT 0MFI LBSFOB IBM JOJ UBNQBLOZB NFSVQBLBO DBSB
VUBNBQFOHIBOUBSBOCFOUVLQPMBQBOEBOHBOLFPUBL LBNJBLBO EJ TFCFMBI MBUFSBM BLBO UFSBOHTBOH TFXBLUV EBMBN LFBEBBO
KFMBTLBOCBHBJNBOBUFSKBEJOZBQSPTFTJOJ HFMBQ5JUJLDBIBZBZBOHUFSBOHJOJBLBONFSBOHTBOHKBSBTMBOH
4FXBLUV TFMVSVI SFUJOB UFSLFOB DBIBZB EBUBS ZBLOJ TFXBLUV TVOH ZBOH NFMFXBUJ TFMTFM CJQPMBS "EBOZB GBLUB CBIXB TBMBI
TFMVSVIGPUPSFTFQUPSEJSBOHTBOHPMFIDBIBZBZBOHNFOEBEBLKFOJT TBUV GPUPSFTFQUPS ZBOH MFUBLOZB EJ TFCFMBI MBUFSBM UFSBOHTBOH
TFM HBOHMJPO ZBOH CFSLPOUSBT UJEBL UFSBOHTBOH BUBV UFSIBN CBU EBMBN LFBEBBO HFMBQ BLBO NFOZFCBCLBO TBMBI TBUV TFM
)BMJOJLBSFOBTJOZBMTJOZBMZBOHTFDBSBMBOHTVOHEJIBOUBSLBOEBO IPSJ[POUBM UFUBQ UJEBL UFSBOHTBOH 0MFI LBSFOB JUV TFM JOJ UJEBL
GPUPSFTFQUPS NFMBMVJ TFMTFM CJQPMBS ZBOH CFSEFQPMBSJTBTJ CFSTJGBU NFOHIBNCBU TFM CJQPMBS EBO LFBEBBO JOJ BLBO NFOZFCBCLBO
NFSBOHTBOH TFEBOHLBO TJOZBMTJOZBM ZBOH EJIBOUBSLBO TFDBSB FLTJUBTJ ZBOH MFCJI CBOZBL MBHJ QBEB TFM CJQPMBS +BEJ EJ UFNQBU
MBUFSBM NFMFXBUJ TFMTFM CJQPMBS ZBOH CFSIJQFSQPMBSJTBTJ EBO KVHB UJNCVMOZB LPOUSBT WJTVBM TJOZBMOZB BLBO NFMFXBUJ KBSBT
TFMTFMIPSJ[POUBM TFCBHJBOCFTBSCFSTJGBUNFOHIBNCBU+BEJ TJOZBM MBOHTVOH EBO KBSBT MBUFSBM ZBOH BLBO TBMJOH NFOPOKPMLBO TBUV
FLTJUBTJ CFSTJGBU MBOHTVOH ZBOH NFMFXBUJ TBUV KBSBT LFNVOHLJOBO TBNBMBJO
BLBO EJUJBEBLBO PMFI TJOZBMTJOZBM JOIJCJTJ ZBOH NFMFXBUJ KBSBT ,FTJNQVMBOOZB NFLBOJTNFGVOHTJJOIJCJTJMBUFSBMZBOHBEBEJ
MBUFSBM4FQFSUJZBOHUFSMJIBUEBMBN(BNCBS BEBTBUVTJSLVJU EBMBN NBUB NJSJQ EFOHBO GVOHTJ ZBOH UFSEBQBU QBEB TFCBHJBO
EFOHBOUJHBGPUPSFTFQUPSQBEBCBHJBOBUBTHBNCBS3FTFQUPSZBOH CFTBS TJTUFN TFOTPSJL ZBLOJ VOUVL NFOHFNFOHFUBIVJ EBO
UFSMFUBL EJ UFOHBI BLBO NFSBOHTBOH TFMTFM CJQPMBS ZBOH NFNQFSCFTBSLPOUSBT
CFSEFQPMBSJTBTJ ,FEVB SFTFQUPS MBJO ZBOH UFSMFUBL EJ TFCFMBIOZB
BLBO EJIVCVOHLBO LF TFM CJQPMBS ZBOH TBSOB NFMBMVJ TFMTFM
IPSJ[POUBM ZBOH CFSTJGBU NFOHIBNCBU TFIJOHHB BLBO NFOJBEBLBO 4BUV TFM HBOHMJPO NVOHLJO TBKB BLBO UFSBOHTBOH PMFI CFCFSBQB
TJOZBM FLTJUBTJ ZBOH TJGBUOZB MBOHTVOH JOJ UFSKBEJ CJMB LFUJHB BUBV IBOZB TFEJLJU TFM LFSVDVU ,FUJLB LFUJHB UJQF LFSVDVU UJQF
SFTFQUPSUFSBOHTBOHPMFIDBIBZBTFDBSBCFSTBNBBO NFSBI CJSV EBO IJKBV NFSBOHTBOH TFMTFM HBOHMJPO ZBOH TBNB
4FLBSBOH NBSJMBILJUBQFSIBUJLBOBQBZBOHUFSKBEJCJMBUJNCVM TJOZBMZBOHBLBOEJIBOUBSLBONFMFXBUJTFMHBOHMJPOTBNBVOUVL
UFQJ ZBOH CFSLPOUSBT QBEB QFOHMJIBUBO %FOHBO NFMJIBU LFNCBMJ TFUJBQ XBSOB EBMBN TQFLUSVN XBSOB 0MFI LBSFOB JUV TJOZBM
(BNCBS LJUB EBQBU NFOHBOHHBQ CBIXB GPUPSFTFQUPS ZBOH ZBOHCFSBTBMEBSJTFMHBOHMJPOJUVUJEBLCFSQFSBOEBMBNNFOEF
MFUBLOZB EJ UFOHBI JUV EBQBU UFSBOHTBOH PMFI TVBUV UJUJL DBIBZB UFLTJ CFSNBDBNNBDBN XBSOB 4JOZBM JUV KVTUSV EJLBUBLBO
ZBOHUFSBOH TFEBOHLBOTBMBITBUVEBSJEVBSFTFQUPSZBOHMFUBLOZB TFCBHBJTJOZBMQVUJIh
620
4FCBMJLOZB CBOZBLTFMHBOHMJPOZBOHEBQBUUFSBOHTBOHIBOZB 2008.

PMFI TBUV NBDBN UJQF XBSOB TFM LFSVDVU OBNVO EJIBNCBU PMFI Carroll J: Focus on molecules: the cone opsins, Exp Eye Res 86:865, 2008.
D’Amico DJ: Clinical practice. Primary retinal detachment, N Engl J Med
UJQF ZBOH LFEVB $POUPIOZB IBM JOJ TFSJOH LBMJ UFSKBEJ QBEB TFM 359:2346, 2008.
LFSVDVUNFSBIEBOIJKBV TFMLFSVDVUNFSBIBLBONFOZFCBCLBO Fain GL, Matthews HR, Cornwall MC, Koutalos Y: Adaptation in vertebrate
QFSBOHTBOHBOEBOZBOHIJKBVBLBONFOHIBNCBU BUBVTFCBMJLOZB photoreceptors, Physiol Rev 81:117, 2001.
UNIT X
&GFL UJNCBMCBMJL ZBOH NJSJQ EBQBU KVHB UFSKBEJ QBEB TFM Garriga P, Manyosa J: The eye photoreceptor protein rhodopsin: structural
LFSVDVU CJSV EBO HBCVOHBO LFSVDVU NFSBI EBO LFSVDVU IJKBV implications for retinal disease, FEBS Lett 528:17, 2002.
Gegenfurtner KR: Cortical mechanisms of colour vision, Nat Rev Neurosci
ZBOH LFEVBOZB EJSBOHTBOH PMFI LFSVDVU LVOJOH
TFIJOHHB NF
4:563, 2003.
OJNCVMLBO IVCVOHBO UJNCBMCBMJL BOUBSB QSPTFT QFOHIBNCBUBO Gegenfurtner KR, Kiper DC: Color vision, Annu Rev Neurosci 26:181, 2003.
EBOQFSBOHTBOHBOBOUBSBXBNBCJSVEBOXBSOBLVOJOH Hankins MW, Peirson SN, Foster RG: Melanopsin: an exciting photopig-
.FLBOJTNF UFSKBEJOZB FGFL ZBOH TBMJOH CFSMBXBOBO EBO ment, Trends Neurosci 31:27, 2008.
XBSOBXBSOBJOJBEBMBITFCBHBJCFSJLVU4BMBITBUVUJQFTFMLFSV Hardie RC: Phototransduction: shedding light on translocation, Curr Biol
13:R775, 2003.
DVU NFSBOHTBOH TFM HBOHMJPO NFMBMVJ FLTJUBTJ MBOHTVOH NFMFXBUJ
Hartzell HC, Qu Z, Yu K, et al: Molecular physiology of bestrophins: multi-
TFCVBI TFM CJQPMBS ZBOH EBMBN LFBEBBO EFQPMBSJTBTJ TFEBOHLBO functional membrane proteins linked to Best disease and other retin-
UJQFXBSOBMBJONFOHIBNCBUTFMHBOHMJPOUFSTFCVUNFMBMVJQFOH opathies, Physiol Rev 88:639, 2008.
IBNCBUBOUBLMBOHTVOHNFMFXBUJTFCVBITFMCJQPMBSEBMBNLFBEB Kandel ER, Schwartz JH, Jessell TM: Principles of Neural Science, 4th ed,
BOIJQFSQPMBSJTBTJ New York, 2000, McGraw-Hill.
Kolb H, Nelson R, Ahnelt P, Cuenca N: Cellular organization of the verte-
1FOUJOHOZB NFLBOJTNF LPOUSBTXBSOB JOJ BEBMBI CBIXB
brate retina, Prog Brain Res 131:3, 2001.
NFLBOJTNFUFSTFCVUNFOHHBNCBSLBOTVBUVDBSBZBOHNFOZFCBC Luo DG, Xue T, Yau KW: How vision begins: an odyssey, Proc Natl Acad Sci
LBO SFUJOB EBQBU NFNCFEBLBO XBSOB +BEJ TFUJBQ UJQF TFM HBOH U S A 105:9855, 2008.
MJPOLPOUSBTXBSOBEJSBOHTBOHPMFITBUVXBSOBUBQJBLBOEJIBN Masland RH: The fundamental plan of the retina, Nat Neurosci 4:877, 2001.
CBU PMFI XBSOB MBXBOOZB 0MFI LBSFOB JUV BOBMJTJT XBSOB JOJ Okawa H, Sampath AP: Optimization of single-photon response transmis-
sion at the rod-to-rod bipolar synapse, Physiology (Bethesda) 22:279,
EJNVMBJEJSFUJOBEBOUJEBLTFMVSVIOZBNFSVQBLBOGVOHTJPUBL
2007.
Schwartz EA: Transport-mediated synapses in the retina, Physiol Rev
82:875, 2002.
Solomon SG, Lennie P: The machinery of colour vision, Nat Rev Neurosci
8:276, 2007.
Daftar Pustaka
Taylor WR, Vaney DI: New directions in retinal research, Trends Neurosci
Artemyev NO: Light-dependent compartmentalization of transducin in rod 26:379, 2003.
photoreceptors, Mol Neurobiol 37:44, 2008. Wensel TG: Signal transducing membrane complexes of photoreceptor
Bloomfield SA, B: The diverse functional roles and regulation of neu- outer segments, Vision Res 48:2052, 2008.
ronal gap junctions in the retina, Nat Rev Neurosci 10:495, 2009. Bowmaker Westheimer G: The ON-OFF dichotomy in visual processing: from recep-
JK: Evolution of vertebrate visual pigments, Vision Res 48:2022, tors to perception, Prog Retin Eye Res 26:636, 2007.
621
BAB 51
UNIT X
.BUB***/FVSPGJTJPMPHJ1FOHMJIBUBO4FOUSBM
NVT EBO KVHB EJTFCVU LPSQVT HFOJLVMBUB MBUFSBMJT TFQFSUJ ZBOH

Jaras Penglihatan
EJQFSMJIBULBOQBEB(BNCBS/VLMFVTHFOJLVMBUVNMBUFSBMJT
EPSTBMJT NFMBLVLBO EVB GVOHTJ VUBNB 1FSUBNB OVLMFVT JOJ
(BNCBS NFNQFSMJIBULBO
NFOFSVTLBO SFMBJ
JOGPSNBTJQFOHMJIBUBOEBSJUSBLUVTPQUJLVTLF
KBSBT VUBNB QFOHMJIBUBO EBSJ
LPSUFLTQFOHMJIBUBONFMBMVJSBEJBTJPPQUJLVT KVHBEJTFCVUUSBLUVT
LFEVB SFUJOB LF LPSUFLT
HFOJLVMPLBMLBSJOB
'VOHTJ SFMBJ JOJ TBOHBU BLVSBU TFIJOHHB
QFOHMJIBUBO4JOZBMTBSBGQFOHMJ
EJEBQBULBO QFOKBMBSBO UJUJL LF UJUJL TFDBSB UFQBU EFOHBO EFSBKBU
IBUBO NFOJOHHBMLBO SFUJOB NFMBMVJ OFSWVT PQUJLVT %J LJBTNB LFUFMJUJBOTQBTJBMUJOHHJEBSJSFUJOBLFLPSUFLTQFOHMJIBUBO
PQUJLVN TFSBU OFSWVT PQUJLVT EBSJ CBHJBO OBTBM SFUJOB 4FUFMBI NFMFXBUJ LJBTNB PQUJLVN TFQBSVI EBSJ TFSBUTFSBU
NFOZFCFSBOHJ HBSJT UFOHBI UFNQBU TFSBU OFSWVT PQUJLVT USBLUVT PQUJLVT CFSBTBM EBSJ TBUV NBUB EBO TFQBSVI MBJOOZB
CFSHBCVOH EFOHBO TFSBUTFSBU ZBOH CFSBTBM EBSJ CBHJBO UFNQPSBM CFSBTBMEBONBUBZBOHMBJO IBMJOJNFXBLJMJUJUJLLPSFTQPOEFOTJ
SFUJOBNBUBZBOHMBJOTFIJOHHBUFSCFOUVLMBIUSBLUVTPQUJLVT4FSBU QBEB LFEVB SFUJOB /BNVO TJOZBM EBSJ LFEVB NBUB UFUBQ
TFSBU EBSJ UJBQ USBLUVT PQUJLVT CFSTJOBQT EJ OVLMFVT HFOJLVMBUVN UFSQJTBI EJ OVLMFVT HFOJLVMBUVN MBUFSBMJT EPSTBMJT /VLMFVT JOJ
MBUFSBMJT EPSTBMJT QBEB UBMBNVT EBO EBSJ TJOJ TFSBUTFSBU UFSEJSJ BUBT FOBN MBQJTBO OVLMFVT -BQJTBO ** *** EBO 7 EBSJ
HFOJLVMPLBMLBSJOB CFSKBMBO NFMBMVJ SBEJBTJP PQUJLVT BUBV USBLUVT WFOUSBM LF EPSTBM
NFOFSJNB TJOZBM EBSJ CBHJBO MBUFSBM TFQBSVI
HFOJLVMPLBMLBSJOB
LF LPSUFLT QFOHMJIBUBO QSJNFS ZBOH UFSMFUBL SFUJOB JQTJMBUFSBM TFEBOHLBO MBQJTBO * *7 EBO 7* NFOFSJNB
EJGJTVSBLBMLBSJOBMPCVTPLTJQJUBMJT TJOZBM EBSJ CBHJBO NFEJBM TFQBSVI SFUJOB NBUB CFSIVCVOHBO
4FSBU QFOHMJIBUBO KVHB NFMBMVJ CFCFSBQB EBFSBI ZBOH MFCJI EFOHBOTFMTFMTBSBGZBOHUVNQBOHUJOEJIEBMBNMBQJTBOMBQJTBO
QSJNJUJG EJ PUBL
EBSJ USBLUVT PQUJLVT NFOVKV OVLMFVT ZBOH CFSQBTBOHBO EBO QFOHIBOUBSBO QBSBMFM TFSVQB UFSKBEJ
TVQSBLJBTNBUJLEJIJQPUBMBNVT NVOHLJOVOUVLQFOHBUVSBOJSBNB QBEBTFMVSVIKBMVSLFLPSUFLTQFOHMJIBUBO
TJSLBEJBO ZBOH NFOZJOLSPOJTBTJLBO CFSCBHBJ QFSVCBIBO GJTJPMPHJ
UVCVI EFOHBO TJBOH EBO NBMBN
LF OVLMFJ QSFUFLUBMJT EJ PUBL
UFOHBI VOUVL NFOEBUBOHLBO HFSBLBO SFGMFLT NBUB BHBS NBUB
EBQBU EJGPLVTLBO LF BSBI PCKFL ZBOH QFOUJOH EBO VOUVL
NFOHBLUJGLBO SFGMFLT QVQJM UFSIBEBQ DBIBZB
LF LPMJLVMVT
TVQFSJPS VOUVL NFOHBUVS QFSHFSBLBO BSBI LFEVB NBUB ZBOH
DFQBU EBO
NFOVKV OVLMFVT HFOJLVMBUVN MBUFSBMJT WFOUSBMJT
QBEB UBMBNVT EBO EBFSBI CBTBM PUBL TFLJUBSOZB EJEVHB VOUVL
NFNCBOUVNFOHFOEBMJLBOCFCFSBQBGVOHTJTJLBQUVCVI
+BEJ KBSBT QFOHMJIBUBO TFDBSB LBTBS EBQBU EJCBHJ NFOKBEJ TJTUFN
QSJNJUJG VOUVL PUBL UFOHBI EBO EBTBS PUBL EFQBO TFSUB TJTUFN CBSV
VOUVL QFOHIBOUBSBO TJOZBM QFOHMJIBUBO TFDBSB MBOHTVOH LF LPSUFLT
QFOHMJIBUBOZBOHUFSMFUBLEJMPCVTPLTJQJUBMJT1BEBNBOVTJB TJTUFN
CBSV CFSUBOHHVOH KBXBC VOUVL QFSTFQTJ TFMVSVI BTQFL CFOUVL
QFOHMJIBUBO XBSOB EBOQFOHMJIBUBOTBEBSMBJOOZB4FCBMJLOZBQBEB
CBOZBL IFXBO QSJNJUJG CFOUVL QFOHMJIBUBO CBILBO EJEFUFLTJ PMFI
TJTUFN ZBOH MFCJI QSJNJUJG ZBJUV EFOHBO NFOHHVOBLBO LPMJLVMVT
TVQFSJPS EFOHBO DBSB ZBOH TBNB TFQFSUJ IFXBO NBNBMJB
NFOHHVOBLBOLPSUFLTQFOHMJIBUBO
Fungsi Nukleus Genikulatum Lateralis Dorsalis
di Talamus
4FSBUTBSBGPQUJLEBSJTJTUFNQFOHMJIBUBOCBSVCFSBLIJSEJOVLMFVT
HFOJLVMBUVNMBUFSBMJTEPSTBMJT ZBOHUFSMFUBLEJVKVOHEPSTBMUBMB
623
Unit X Sistem Saraf : B. Indra Khusus
'VOHTJVUBNBZBOHLFEVBEBSJOVLMFVTHFOJLVMBUVNMBUFSBMJT
EPSTBMJT BEBMBI TFCBHBJ QJOUV QFOHIBOUBSBO TJOZBMTJOZBM LF
LPSUFLT QFOHMJIBUBO ZBLOJ VOUVL NFOHFOEBMJLBO TFCFSBQB
CBOZBL TJOZBM ZBOH EJQFSCPMFILBO NFMFXBUJ LPSUFLT /VLMFVT ,
NFOFSJNBTJOZBMTJOZBMQFOHBUVSBOQJOUVJOJEBSJEVBTVNCFS
VUBNB
TFSBU LPSUJLPGVHBM ZBOH LFNCBMJ CBMJL EBSJ LPSUFLT
QFOHMJIBUBO QSJNFS LF OVLMFVT HFOJLVMBUVN MBUFSBMJT EBO

EBFSBI SFUJLVMBS NFTFOTFGBMPO ,FEVBOZB JOJ CFSTJGBU JOIJCJUPS
EBO CJMB EJSBOHTBOH EBQBU NFNBUJLBO QFOHIBOUBSBO ZBOH
NFMBMVJ CBHJBOCBHJBO UFSUFOUV EBSJ OVLMFVT HFOJLVMBUVN
MBUFSBMJT EPSTBMJT ,FEVB TJSLVJU QFNCFOUFOHBO JOJ NFNCBOUV
NFOFLBOLBOJOGPSNBTJQFOHMJIBUBOZBOHEJQFSCPMFILBOVOUVL
MFXBU
"LIJSOZB OVLMFVT HFOJLVMBUVN MBUFSBMJT EPSTBMJT UFSCBHJ
EBMBN CFOUVL MBJO
-BQJTBO * EBO ** ZBOH EJTFCVU MBQJTBO
NBHOPTFMVMBS LBSFOB MBQJTBO JOJ CFSJTJ TFMTFM TBSBG CFTBS
-BQJTBO JOJ NFOFSJNB NBTVLBO IBNQJS TFMVSVIOZB EBO TFM
HBOHMJPO SFUJOB UJQF : ZBOH CFTBS 4JTUFN NBHOPTFMVMBS JOJ l
NFOZFEJBLBOKBSBTQFOHIBOUBSBOZBOHCFSTJGBUDFQBULFLPSUFLT
QFOHMJIBUBO /BNVO TJTUFN JOJ NFSVQBLBO TJTUFN ZBOH CVUB
XBSOB TFIJOHHB IBOZB NFOHIBOUBSLBO JOGPSNBTJ IJUBN EBO
QVUJI 1FOHIBOUBSBO EBSJ UJUJL LF UJUJLOZB KVHB CFSTJGBU LVSBOH
CBJL LBSFOB UJEBL UFSEBQBU CFHJUV CBOZBL TFM HBOHMJPO : EBO
EFOESJUEFOESJUOZBNFOZFCBSTFDBSBMVBTEJSFUJOB
-BQJTBO
*** TBNQBJ MBQJTBO 7* EJTFCVU MBQJTBO QBSWPTFMVMBS LBSFOB
QFOHMJIBUBO KVHB UFSCBHJ NFOKBEJ LPSUFLT QFOHMJIBUBO QSJNFS EBO
NFOHBOEVOH CBOZBL TFLBMJ TFM TBSBG CFSVLVSBO LFDJM TBNQBJ
LPSUFLTQFOHMJIBUBOTFLVOEFS
TFEBOH4FMTFMTBSBGJOJNFOFSJNBNBTVLBOIBNQJSTFMVSVIOZB
EBSJTFMHBOHMJPOSFUJOBUJQF9ZBOHNFOHIBOUBSLBOXBSOBEBO Korteks Penglihatan Primer,PSUFLTQFOHMJIBUBOQSJNFS MJIBU
NFOZBNQBJLBOJOGPSNBTJTQBTJBMZBOHBLVSBUEBSJUJUJLLFUJUJL (BNCBS
UFSMFUBLQBEBBSFBGJTVSBLBMLBSJOB ZBOHNFMVBTLF
UFUBQJ IBOZB QBEB LFDFQBUBO QFOHIBOUBSBO ZBOH TFEBOH EBO BSBIEFQBOEBSJVKVOHPLTJQJUBMQBEBCBHJBONFEJBMTFUJBQLPSUFLT
UJEBLEFOHBOLFDFQBUBOUJOHHJ PLTJQJUBM "SFB JOJ BEBMBI UFNQBU CFSBLIJSOZB TJOZBMTJOZBM
QFOHMJIBUBO MBOHTVOH ZBOH CFSBTBM EBSJ NBUB 4JOZBMTJOZBM ZBOH
CFSBTBM EBSJ EBFSBI NBLVMB SFUJOB CFSBLIJS EJ EFLBU VKVOH
Susunan dan Fungsi Korteks Penglihatan PLTJQJUBM TFQFSUJ ZBOH EJQFSMJIBULBO EBMBN (BNCBS
TFEBOHLBO TJOZBMTJOZBM ZBOH CFSBTBM EBSJ EBFSBI QFSJGFS SFUJOB
(BNCBS EBO NFNQFSMJIBULBO LPSUFLT QFOHMJIBUBO CFSBLIJSQBEBBUBVEJTFQBSVIMJOHLBSBOLPOTFOUSJLZBOHUFSMFUBL
ZBOH UFSVUBNB UFSMFUBL EJ CBHJBO NFEJBM MPCVT PLTJQJUBMJT EJ EFQBO VKVOH PLTJQJUBM OBNVO NBTJI EJ TFQBOKBOH GJTVSB
4FQFSUJSFQSFTFOUBTJLPSUJLBMTJTUFNTFOTPSJLMBJOOZB LPSUFLT LBMLBSJOBQBEBCBHJBONFEJBMMPCVTPLTJQJUBMJT3FUJOBCBHJBOBUBT
CFSBLIJSEJTVQFSJPS EBOCBHJBOCBXBIEJJOGFSJPS
1FSIBUJLBO QBEB HBNCBS EBFSBI MVBT ZBOH NFSFQSFTFOUBTJLBO
NBLVMB,FQBEBEBFSBIJOJ GPWFBSFUJOBNFOHIBOUBSLBOTJOZBMOZB
'PWFB CFSUBOHHVOH KBXBC BUBT UBKBN QFOHMJIBUBO EFOHBO EFSBKBU
QBMJOHUJOHHJ#FSEBTBSLBOEBFSBISFUJOB GPWFBNFNJMJLJCFCFSBQB
SBUVTLBMJMFCJICBOZBLSFQSFTFOUBTJEJLPSUFLTQFOHMJIBUBOQSJNFS
EJCBOEJOHLBOTFCBHJBOCFTBSCBHJBOQFSJGFSSFUJOB
,PSUFLT QFOHMJIBUBO QSJNFS KVHB EJTFCVU BSFB QFOHMJIBUBO *
/BNB MBJOOZB MBHJ BEBMBI LPSUFLT TUSJBUB LBSFOB EBFSBI JOJ
NFNJMJLJUBNQJMBOHBSJTHBSJTZBOHLBTBS
Area Penglihatan Sekunder pada Korteks. "SFB QFOHMJIBUBO
TFLVOEFS ZBOH KVHB EJTFCVU BSFB BTPTJBTJ QFOHMJIBUBO UFSMFUBL EJ
TFCFMBIMBUFSBM BOUFSJPS TVQFSJPS EBOJOGFSJPSLPSUFLTQFOHMJIBUBO
QSJNFS 4FCBHJBO CFTBS EBFSBI JOJ KVHB NFMJQBU LF BSBI MVBS
NFMFXBUJ QFSNVLBBO MBUFSBM LPSUFLT PLTJQJUBMJT EBO LPSUFLT
QBSJFUBMJT TFQFSUJ ZBOH EJQFSMJIBULBO QBEB (BNCBS 4JOZBM
TFLVOEFS ZBOH EJIBOUBSLBO LF EBFSBI JOJ EJHVOBLBO VOUVL
NFOHOBMJTJT BSUJ QFOHMJIBUBO 4FCBHBJ DPOUPI TFNVB TJTJ LPSUFLT
QFOHMJIBUBO QSJNFS NFSVQBLBO BSFB #SPENBOO MJIBU (BNCBS

ZBOHNFSVQBLBOUFNQBUIBNQJSTFNVBTJOZBMZBOHCFSBTBM
624
Bab 51 Mata: III. Neurofisiologi Penglihatan Sentral
CFSBTBM EBSJ LPSUFLT QFOHMJIBUBO QSJNFS MFXBU 0MFI LBSFOB JUV CBHJBOZBOHQBMJOHTFNQJUEBOQBMJOHEBMBNEBSJMBQJTBO*7
BSFB #SPENBOO EJTFCVU BSFB QFOHMJIBUBO ** BUBV TFDBSB ZBOHEJQFSMJIBULBOQBEBCBHJBOLBOBO(BNCBS%BSJTJOJ
TFEFSIBOB 7 4FMBJO JOJ UFSEBQBU BSFB QFOHMJIBUBO TFLVOEFS TJOZBMTJOZBMUFSTFCVUKVHBEJIBOUBSLBOTFDBSBWFSUJLBMLFBSBI
ZBOHMFUBLOZBMFCJIKBVIEBONFNJMJLJTFCVUBOZBOHTQFTJGJL7 QFSNVLBBO LPSUFLT EBO LF BSBI MBQJTBO ZBOH MFCJI EBMBN
7 EBO TFMBOKVUOZB TBNQBJ MFCJI EBSJ TFMVTJO BSFB .BLOB EBSJ +BSBTHBOHMJPO9JOJNFOKBMBSLBOKFOJTQFOHMJIBUBOBLVSBUEBSJ
UNIT X
TFNVB BSFB JOJ BEBMBI CBIXB UFSEBQBU CFSCBHBJ NBDBN BTQFL UJUJLLFUJUJLTFQFSUJQBEBQFOHMJIBUBOXBSOB.
CBZBOHBO QFOHMJIBUBO ZBOH TFDBSB QSPHSFTJG EJCFEBI EBO
Kolom Sel Saraf pada Korteks Penglihatan.
EJBOBMJTJT
,PSUFLT QFOHMJIBUBO UFSTVTVO TFDBSB TUSVLUVSBM NFOKBEJ
Struktur Berlapis pada Korteks Penglihatan Primer CFCFSBQB KVUB LPMPN WFSUJLBM TFMTFM TBSBG TFUJBQ LPMPN
Mempunyai Enam Lapisan Utama NFNJMJLJEJBNFUFSTBNQBJNJLSPNFUFS4VTVOBOLPMPN
4FQFSUJ QBEB IBNQJS TFNVB CBHJBO MBJO QBEB LPSUFLT TFSFCSJ WFSUJLBMZBOHTBNBKVHBEJUFNVLBOEJTFMVSVILPSUFLTTFSFCSBM
LPSUFLTQFOHMJIBUBOQSJNFSNFNJMJLJFOBNMBQJTBOZBOHCFSCFEB VOUVL QFOHJOESBBO ZBOH MBJO EBO KVHB EJ EBFSBI LPSUFLT
TFQFSUJ ZBOH EJQFSMJIBULBO QBEB (BNCBS +VHB TFQFSUJ QBEB NPUPSJL EBO BOBMJUJT
4FUJBQ LPMPN NFXBLJMJ TBUV VOJU
TJTUFNTFOTPSJLMBJO TFSBUHFOJLVMPLBMLBSJOBUFSVUBNBCFSBLIJSEJ GVOHTJPOBM4FDBSBLBTBS LJUBEBQBUNFOHIJUVOHTFMTFMTBSBGEJ
MBQJTBO *7 5FUBQJ MBQJTBO JOJ KVHB UFSTVTVO EBMBN CFCFSBQB TFUJBQ LPMPN WFSUJLBM QFOHMJIBUBO JOJ CBSBOHLBMJ CFSKVNMBI
EJWJTJ 4JOZBM ZBOH EJIBOUBSLBO TFDBSB DFQBU EBSJ TFM HBOHMJPO : BUBVMFCJI
SFUJOB CFSBLIJS EJ MBQJTBO *7cA, EBO EBSJ TJOJ TJOZBMTJOZBM 4FUFMBI TJOZBM PQUJL CFSBLIJS EJ MBQJTBO *7 TFMBOKVUOZB
UFSTFCVU EJIBOUBSLBO TFDBSB WFSUJLBM LF MVBS LF BSBI QFSNVLBBO TJOZBMJOJEJQSPTFTLFUJLBTJOZBMTJOZBMNFOZFCBSLFBSBIMVBS
LPSUJLBMEBOLFEBMBNLFBSBIUJOHLBUZBOHMFCJIEBMBN EBO LF BSBI EBMBN TFQBOKBOH TFUJBQ VOJU LPMPN WFSUJLBM
4JOZBMTJOZBM QFOHMJIBUBO ZBOH CFSBTBM EBO TFSBU TBSBG PQUJL 1FNSPTFTBO TJOZBM JOJ EJEVHB NFOHVSBJLBO TFDBSB UFSQJTBI
VLVSBO TFEBOH ZBOH CFSBTBM EBSJ TFM HBOHMJPO 9 EJ SFUJOB KVHB CFOUVLCFOUVLLFDJMJOGPSNBTJQFOHMJIBUBOQBEBUFNQBUZBOH
CFSBLIJS EJ MBQJTBO *7 UFUBQJ QBEB UJUJL ZBOH CFSCFEB EFOHBO CFSVSVUBO EJ TFQBOKBOH KBSBT 4JOZBMTJOZBM ZBOH CFSKBMBO LF
TJOZBM:4JOZBMTJOZBMJOJCFSBLIJSQBEBMBQJTBO*7BEBO*7DϠ BSBI MVBS NFOVKV MBQJTBO * ** EBO *** QBEB BLIJSOZB
NFOHIBOUBSLBO TJOZBM VOUVL KBSBL QFOEFL TFDBSB MBUFSBM
EBMBNLPSUFLT4FCBMJLOZB TJOZBMZBOHCFSKBMBOLFBSBIEBMBN
I NFOVKV MBQJTBO 7 EBO 7* NFSBOHTBOH TFMTFM TBSBG ZBOH
NFOHIBOUBSLBOTJOZBMZBOHKBSBLOZBKBVIMFCJIQBOKBOH
II
"Blobs Warna" pada Korteks Penglihatan. 5FSEBQBU
III
EBFSBI LIVTVT TFQFSUJ LPMPN ZBOH UFSMFUBL CFSTFMBOHTFMJOH
EJ BOUBSB LPMPNLPMPN QFOHMJIBUBO QSJNFS EBO KVHB EJ
(a) BOUBSB LPMPNLPMPN CFCFSBQB EBFSBI QFOHMJIBUBO
TFLVOEFS EBFSBI JOJ EJTFCVU CMPCT XBSOB DPMPS CMPCT

(b)
IV
%BFSBIJOJNFOFSJNBTJOZBMMBUFSBMZBOHCFSBTBMEBSJLPMPN
(ca) QFOHMJIBUBO EJ EFLBUOZB EBO EJBLUJWBTJ TFDBSB TQFTJGJL PMFI
TJOZBM XBSOB 0MFI LBSFOB JUV EJEVHB CMPCT JOJ NFSVQBLBO
(cb) EBFSBIQSJNFSVOUVLQFOHVSBJBOXBSOB
V
Interaksi Sinyal Penglihatan dari Kedua Mata.
*OHBUMBI LFNCBMJ CBIXB TJOZBM QFOHMJIBUBO ZBOH CFSBTBM EBSJ
LFEVB NBUB ZBOH UFSQJTBI EJQBODBSLBO NFMBMVJ MBQJTBO TFM
VI TBSBG ZBOH UFSQJTBI EJ OVLMFVT HFOJLVMBUVN MBUFSBMJT 4JOZBM
TJOZBM JOJ NBTJI UFUBQ UFSQJTBI TBUV TBNB MBJO LFUJLB UJCB EJ
MBQJTBO *7 LPSUFLT QFOHMJIBUBO QSJNFS 1BEB LFOZBUBBOOZB
( )
MBQJTBO *7 UFSKBMJO EFOHBO HBSJTHBSJT LPMPN TFM TBSBG TFUJBQ
HBSJT MFCBSOZB LVSBOH MFCJI NM TJOZBMTJOZBM ZBOH CFSBTBM
EBSJ TBUV NBUB NFNBTVLJ LPMPN TFUJBQ HBSJT ZBOH MBJO
CFSHBOUJBO EFOHBO TJOZBM ZBOH CFSBTBM EBSJ NBUB LFEVB
"Y" "X" %BFSBI LPSUFLT JOJ NFOHVSBJLBO BQBLBI NBTJOHNBTJOH BSFB
LFEVB CBZBOHBO QFOHMJIBUBO EBSJ LFEVB NBUB UFSDBUBU TBUV
TBNB MBJO BSUJOZB BQBLBI UJUJL LPSFTQPOEFOTJ EBSJ LFEVB
SFUJOB JUV TFTVBJ TBUV TBNB MBJO ,FNVEJBO JOGPSNBTJ ZBOH
UFMBI UFSVSBJ JOJ EJHVOBLBO VOUVL NFOZFTVBJLBO BSBI
QBOEBOHBO EBO LFEVB NBUB ZBOH UFSQJTBI TFIJOHHB LFEVB
BSBI QBOEBOHBO NBUB TBMJOH CFSTBUV EJCBXB LF DBUBUBO

*OGPSNBTJ ZBOH EJBNBUJ BEBMBI NFOHFOBJ EFSBKBU QFODBUBUBO
CBZBOHBO ZBOH CFSBTBM EBSJ LFEVB NBUB TFIJOHHB
NFNVOHLJOLBO TFTFPSBOH VOUVL NFNCFEBLBO KBSBL PCKFL
NFMBMVJNFLBOJTNFTUFSFPQTJT
625
Dua Jaras Utama untuk Analisis Informasi Penglihatan—

(1) Jaras "Posisi" Cepat dan Jaras "Gerakan"; (2) Jaras
Warna yang Akurat
(BNCBS NFNQFSMJIBULBO CBIXB TFUFMBI NFOJOHHBMLBO
LPSUFLT QFOHMJIBUBO QSJNFS JOGPSNBTJ QFOHMJIBUBO EJBOBMJT
EBMBNEVBKBSBTVUBNBQBEBEBFSBIQFOHMJIBUBOTFLVOEFS
1. Analisis Posisi Tiga-Dimensi, Bentuk Umum dan Gerakan
Objek. 4BMBITBUVKBSBTZBOHCFSTJGBUBOBMJUJT EJQFSMJIBULBO
QBEB (BNCBS PMFI QBOBI IJUBN ZBOH CFTBS
NFOHBOBMJTJT QPTJTJ UJHB EJNFOTJ PCKFL QFOHMJIBUBO EJ
TFLJUBS UVCVI +BSBT JOJ KVHB NFOHBOBMJTJT CFOUVL GJTJL
VNVN QFOHMJIBUBO TFSUB HFSBLBO EBMBN QFOHMJIBUBO
UFSTFCVU %FOHBO LBUB MBJO KBSBTKBSBT JOJ NFNCFSJUBIV QBEBTFCBHJBOCFTBSTFMHBOHMJPOSFUJOB LBSFOBSFTFQUPSSFTFQUPS
MFUBLTFUJBQPCKFLQBEBTBUVTBBUUFSUFOUVEBOBQBLBIPCKFL SFUJOB ZBOH CFSEFLBUBO UFSBOHTBOH TBNB LVBU EBO TBMJOH
UFSTFCVU CFSHFSBL 4FUFMBI NFOJOHHBMLBO LPSUFLT NFOHIBNCBU TBUV TBNB MBJO 5FUBQJ QBEB TFUJBQ UFQJ QBOEBOHBO
QFOHMJIBUBO QSJNFS TJOZBMTJOZBM JOJ CFSKBMBO LF EBFSBI UFNQBUUFSKBEJOZBQFSVCBIBOEBSJHFMBQLFUFSBOHBUBVEBSJUFSBOH
NJEUFNQPSBMJT QPTUFSJPS EBO LF BSBI BUBT NFOVKV LPSUFLT LFHFMBQ TBMJOHJOIJCJTJUJEBLUFSKBEJEBOJOUFOTJUBTQFSBOHTBOHBO
PLTJQJUPQBSJFUBM ZBOH MVBT 1BEB UFQJ BOUFSJPS LPSUFLT QBEB TFCBHJBO CFTBS TFM TBSBG NFOJOHLBU TFTVBJ EFOHBO UJOHLBU
QBSJFUBMJT TJOZBMTJOZBM JOJ CFSUVNQBOH UJOEJI EFOHBO LPOUSBTBSUJOZB TFNBLJOUFHBTTVBUVLPOUSBTEBOTFNBLJOCFTBS
TJOZBM ZBOH CFSBTBM EBSJ EBFSBI BTPTJBTJ TPNBUJL QPTUFSJPS QFSCFEBBO JOUFOTJUBT BOUBSB CBHJBO HFMBQ EFOHBO CBHJBO UFSBOH
ZBOH NFOHBOBMJTJT BTQFL UJHB EJNFOTJ EBSJ TJOZBM TFNBLJOUJOHHJQVMBEFSBKBUQFSBOHTBOHBOOZB
TPNBUPTFOTPSJL 4JOZBMTJOZBM HFSBL JOJ UFSVUBNB CFSBTBM
EBSJ TFSBU TBSBG PQUJL : CFTBS TFM HBOHMJPO : SFUJOB
Korteks Penglihatan Juga Mengenali Orientasi Garis
NFOHIBOUBSLBO TJOZBMTJOZBM DFQBU UFUBQJ IBOZB
dan Batas—Sel "Sederhana". ,PSUFLT QFOHMJIBUBO JUV UJEBL
NFOHHBNCBSLBOIJUBNEBOQVUJIUBOQBXBSOB
IBOZB NFOHFOBMJ LFCFSBEBBO HBSJT EBO CBUBT ZBOH UFSEBQBU EJ
2. Analisis Detail Penglihatan dan Warna. 1BOBI BCVBCV EBMBN CBZBOHBO SFUJOB UFUBQJ KVHB NFOHFOBMJ BSBI PSJFOUBTJ EBSJ
QBEB(BNCBS ZBOHCFSKBMBOEBSJLPSUFLTQFOHMJIBUBO TFUJBQ HBSJT BUBV CBUBT ZBJUV BQBLBI CFSCFOUVL WFSUJLBM BUBV
QSJNFSLFEBFSBIQFOHMJIBUBOTFLVOEFSEJEBFSBIJOGFSJPS IPSJ[POUBM BUBV BHBL NJSJOH )BM JOJ EJEVHB EJTFCBCLBO PMFI
WFOUSBM EBO NFEJBM LPSUFLT PLTJQJUBMJT EBO LPSUFLT TVTVOBO MJOFBS TFMTFM ZBOH TBMJOH NFOHIBNCBU ZBOHNFSBOHTBOH
UFNQPSBMJT NFNQFSMJIBULBO KBSBT VUBNB VOUVL BOBMJTJT TFMTFM TBSBG LFEVB LFUJLB UFSKBEJ QFOHIBNCBUBO EJ TFQBOKBOH UFQJ
EFUBJM QFOHMJIBUBO #BHJBO UFSQJTBI QBEB KBSBT JOJ TFDBSB TFM UFNQBU UFQJ LPOUSBT CFSBEB +BEJ VOUVL TFUJBQ PSJFOUBTJ HBSJT
TQFTJGJLNFOHBOBMJTJTXBSOBKVHB0MFILBSFOBJUV KBSBTJOJ TFNBDBN JOJ TFMTFM TBSBG TQFTJGJL EJSBOHTBOH (BSJT ZBOH
EJLBJULBO EFOHBO HBNCBSBO QFOHMJIBUBO UFSUFOUV TFQFSUJ UFSPSJFOUBTJEBMBNCFSCBHBJBSBINFSBOHTBOHTFLVNQVMBOTFMZBOH
NFOHFOBMJ IVSVG NFNCBDB NFOFOUVLBO UFLTUVS CFSCFEB4FMTFMTBSBGJOJEJTFCVUTFMTFEFSIBOB4FMTFMJOJUFSVUBNB
QFSNVLBBO NFOFOUVLBO EFUBJM XBSOB EBO TVBUV PCKFL EJUFNVLBOEJMBQJTBO*7LPSUFLTQFOHMJIBUBOQSJNFS
EBONFOHVSBJLBOTFNVBJOGPSNBTJJOJVOUVLNFOFOUVLBO
BQBPCKFLUFSTFCVUEBOBQBNBLOBOZB Pengenalan Orientasi Garis ketika Garis Bergeser ke
Lateral atau Vertikal pada Lapang Pandang—Sel
Pola Perangsangan Sel Saraf Setama "Kompleks". ,FUJLB TJOZBM QFOHMJIBUBO CFSHFSBL NFOKBVI EBO
Anatisis Bayangan Penglihatan MBQJTBO*7 CFCFSBQBTFMTBSBGNFNCFSJLBOSFTQPOTUFSIBEBQHBSJT
ZBOH PSJFOUBTJ BSBIOZB TBNB OBNVO QPTJTJOZB UJEBL TQFTJGJL
"SUJOZB TFLBMJQVO HBSJT UFSTFCVU UFSMFUBL BHBL KBVI EJ TFCFMBI
+JLB PSBOH NFNQFSIBUJLBO EJOEJOH ZBOH LPTPOH IBOZB
MBUFSBM BUBV WFSUJLBM QBEB MBQBOHBO QBOEBOH CFCFSBQB TFM TBSBG
CFCFSBQB TFM TBSBG EJ LPSUFLT QFOHMJIBUBO QSJNFS ZBOH BLBO
ZBOH TBNB BLBO UFUBQ EJSBOHTBOH KJLB HBSJT NFNJMJLJ BSBI ZBOH
EJSBOHTBOH UJEBL CFSHBOUVOH QBEB UJOHLBU QFODBIBZBBO
TBNB4FMTFMTBSBGJUVEJTFCVUTFMLPNQMFLT
EJOEJOH UFSTFCVU BQBLBI UFSBOH BUBV UJEBL %FOHBO EFNJLJBO
BQBZBOHEJEFUFLTJPMFILPSUFLTQFOHMJIBUBOQSJNFSJUV 6OUVL
EBQBU NFOKBXBC QFSUBOZBBO JOJ LJUB MFUBLLBO TFCVBI UBOEB Pengenalan Garis dengan Bentuk Panjang, Bentuk atau
QBUBOH ZBOH CFTBS EJ EJOEJOH TFQFSUJ ZBOH UFSMJIBU QBEB Bentuk Lainnya. #FCFSBQB TFM TBSBG EJ MBQJTBO MVBS LPMPN
(BNCBS CBHJBO LJSJ #BHJBO LBOBO NFOVOKVLLBO TVBUV QFOHMJIBUBO QSJNFS TFQFSUJ KVHB TFMTFM TBSBG QBEB CFCFSBQB BSFB
QPMB SVBOH EBO TFCBHJBO CFTBS TFM TBSBG LPSUFLT QFOHMJIBUBO QFOHMJIBUBOTFLVOEFS IBOZBUFSBOHTBOHPMFIHBSJTHBSJTBUBVUFQJ
ZBOH UFSBOHTBOH 1FSIBUJLBOMBI BSFB FLTJUBTJ NBLTJNVN ZBOH UFQJEBSJCFOUVLQBOKBOHZBOHTQFTJGJL BUBVPMFICFOUVLCFSTVEVU
UFSKBEJ QBEB CBZBOHBO UFSTFCVU NFSVQBLBO CBUBTCBUBT EBSJ ZBOHTQFTJGJL BUBVPMFICBZBOHBOZBOHNFNJMJLJLBSBLUFSJTUJLMBJO
CFOEB ZBOH TFEBOH LJUB QFSIBUJLBO +BEJ TJOZBM QFOHMJIBUBO +BEJ TFMTFM TBSBG JOJ EBQBU NFOHFOBMJ CFOUVLCFOUVL JOGPSNBTJ
QBEB LPSUFLT QFOHMJIBUBO QSJNFS UFSVUBNB MFCJI ZBOH MFCJI UJOHHJ EBSJ QBOEBOHBO +BEJ TFNBLJO KBVI LJUB
NFNQFSIBUJLBO CBHJBO LPOUSBT QBEB MBQBOHBO QFOHMJIBUBO NFOEBMBNJ NFOHFOBJ KBSBT BOBMJUJT LPSUFLT QFOHMJIBUBO TFDBSB
EBSJQBEBEBFSBIZBOHUJEBLCFSLPOUSBT,JUBQFSIBUJLBOQBEB QSPHSFTJGTFNBLJOLIBTQVMBTFUJBQQFOHMJIBUBOZBOHEJVSBJLBO
626
Pengenalan Warna 105 90 75

80 60
8BSOBEJLFOBMJEFOHBODBSBZBOHTBOHBUNJSJQEFOHBOQFOHFOBMBO 120
70
HBSJTZBJUVEFOHBONFOHHVOBLBOLPOUSBTXBSOB4FCBHBJDPOUPI 135 60 45
EBFSBI NFSBI TFSJOH LBMJ EJLPOUSBTLBO EFOHBO EBFSBI IJKBV 50
EBFSBI CJSV EFOHBO EBFSBI NFSBI BUBV EBFSBI IJKBV EFOHBO 150 40 30
UNIT X
EBFSBILVOJOH4FNVBXBSOBJOJEBQBUKVHBEJLPOUSBTLBOEFOHBO 30
EBFSBI QVUJI EBMBN 1BEB LFOZBUBBOOZB QFOHPOUSBTBO EFOHBO 165 20 15
EBFSBI QVUJI JOJ EJEVHB NFSVQBLBO QFOZFCBC VUBNB VOUVL 10
GFOPNFOBZBOHEJTFCVULFNBOUBQBOXBSOBBSUJOZB LFUJLBXBSOB 180 80 70 60 50 40 30 20 10 20 30 40 50 60 70 80 0
EBSJ DBIBZB ZBOH CFSJMVNJOBTJ UFSTFCVU CFSVCBI XBSOB QVUJI 10
CFSVCBICFSTBNBEFOHBODBIBZB EBOQFOHVSBJBOZBOHUFQBUEBMBN 195 20 345
PUBL NFNVOHLJOLBO XBSOB NFSBI EJJOUFSQSFUBTJLBO TFCBHBJ 30
NFSBIXBMBVQVODBIBZBZBOHCFSJMVNJOBTJUFMBINFOHVCBIXBSOB 40 330
210
ZBOHNFNBTVLJNBUB 50
60
.FLBOJTNF BOBMJTJT LPOUSBT XBSOB CFSHBOUVOH LFQBEB XBSOB 225 315
70
XBSOB ZBOH LPOUSBT ZBOH EJTFCVU XBSOBXBSOB ZBOH 240 300
80
CFSMBXBOBO NFSBOHTBOHTFMTFMTBSBGTQFTJGJL"EBEVHBBOCBIXB 255 270 285
EFUBJM QFSNVMBBO EBO LPOUSBT XBSOB EJLFOBMJ PMFI TFMTFM
TFEFSIBOB TFEBOHLBO LPOUSBT ZBOH MFCJI LPNQMFLT EJLFOBMJ PMFI
TFMTFMLPNQMFLTEBOTFMTFMIJQFSLPNQMFLT
SFBLTJ BMFSHJ QBEB SFUJOB BUBV BLJCBU LFBEBBO UPLTJL TFQFSUJ
Efek Pengangkatan Korteks Penglihatan Primer LFSBDVOBOUJNBIEBOQFNBLBJBOUFNCBLBVZBOHCFSMFCJIBO
1FOHBOHLBUBO LPSUFLT QFOHMJIBUBO QSJNFS QBEB NBOVTJB ,POEJTJ MBJO ZBOH EBQBU EJEJBHOPTJT EFOHBO QFSJNFUSJ BEBMBI
NFOZFCBCLBO IJMBOHOZB EBZB QFOHMJIBUBO ZBOH EJTBEBSJ ZBJUV SFUJOJUJTQJHNFOUPTB1BEBQFOZBLJUJOJ UFSEBQBUCBHJBOSFUJOBZBOH
NFOHBMBNJLFCVUBBO/BNVO QFOFMJUJBOQTJLPMPHJTNFOVOKVLLBO NFOHBMBNJEFHFOFSBTJ EBOEJBSFBUFSTFCVUUFSKBEJEFQPTJUQJHNFO
CFCFSBQB PSBOH CVUB TFQFSUJ JUV LBEBOHLBEBOH NBTJI EBQBU NFMBOJOZBOHCFSMFCJIBO#JBTBOZBSFUJOJUJTQJHNFOUPTBNVMBNVMB
CFSFBLTJ TFDBSB UBL TBEBS UFSIBEBQ QFSVCBIBO JOUFOTJUBT DBIBZB NFOZFCBCLBOLFCVUBBOQBEBCBHJBOQFSJGFSMBQBOHBOQBOEBOHEBO
UFSIBEBQ HFSBLBO QBEB QFOHMJIBUBO BUBV CBILBO UFSIBEBQ TFMBOKVUOZBTFDBSBCFSUBIBQNFOZFCBSTBNQBJLFBSFBTFOUSBM
CFCFSBQB QPMB QFOHMJIBUBO ZBOH LBTBS XBMBVQVO KBSBOH 3FBLTJ
ZBOH UJNCVM BEBMBI NFNVUBSOZB CPMB NBUB NFNVUBSOZB LFQBMB Efek Lesi di Jaras Optik terhadap Lapang pandang.
,FSVTBLBOQBEBTFMVSVIOFSWVTPQUJLVTNFOZFCBCLBOUJNCVMOZB
EBOHFSBLBONFOHIJOEBS%BZBQFOHMJIBUBOJOJEJBOHHBQEJCBOUV
LFCVUBBOQBEBNBUBZBOHUFSLFOB
PMFIBEBOZBKBSBTTFMTBSBGZBOHCFSKBMBOEBSJUSBLUVTPQUJLVTZBOH
,FSVTBLBOQBEBLJBTNBPQUJLVNNFOHIBNCBUQFOHIBOUBSBO
UFSVUBNB NFOVKV LPMJLVMVT TVQFSJPS EBO CBHJBO MBJO EBSJ TJTUFN
JNQVMT EBSJ TFQBSVI CBHJBO OBTBM LFEVB SFUJOB ZBOH NFOVKV LF
QFOHMJIBUBO
USBLUVT PQUJLVT TJTJ MBJOOZB 0MFI LBSFOB JUV TFQBSVI CBHJBO
OBTBM SFUJOB LFEVB NBUB UFSTFCVU NFOKBEJ CVUB ZBOH CFSBSUJ
Lapang Pandang; Perimetri CBIXBPSBOHUFSTFCVUBLBONFOHBMBNJLFCVUBBOEJLFEVBCBHJBO
UFNQPSBM MBQBOHBO QBOEBOH LBSFOB CBZBOHBO EBSJ MBQBOHBO
-BQBOHQBOEBOH NFSVQBLBOTVBUVBSFBQFOHMJIBUBOZBOHEJMJIBUPMFI QBOEBOH NFOKBEJ UFSCBMJL EJ SFUJOB PMFI TJTUFN PQUJL NBUB
TBMBITBUVNBUBQBEBTVBUVKBSBLUFSUFOUV"SFBZBOHUFSMJIBUEJCBHJBO
LFBEBBO JOJ EJTFCVU IFNJBOPQTJB CJUFNQPSBM -FTJ TFQFSUJ JOJ
OBTBM EJTFCVU MBQBOHBO QBOEBOH CBHJBO OBTBM EBO BSFB ZBOH UFSMJIBU
EJTJTJMBUFSBMEJTFCVU-BQBOHBOQBOEBOHCBHJBOUFNQPSBM
TFSJOH LBMJ EJTFCBCLBO BEBOZB UVNPS QBEB LFMFOKBS IJQPGJTJT
6OUVLNFOEJBHOPTJTBEBOZBLFCVUBBOQBEBCBHJBOSFUJOBUFSUFOUV ZBOH NFOFLBO LF BSBI BUBT EBO TFMMB UVSDJDB LF CBHJBO CBXBI
EBQBUEJMBLVLBOEFOHBONFNFUBLBOMBQBOHQBOEBOHEBSJTFUJBQNBUB LJBTNBPQUJLVN
NFMBMVJ TVBUV QSPTFT ZBOH EJTFCVU QFSJNFUSJ *OJ EBQBU EJMBLVLBO (BOHHVBO QBEB USBLUVT PQUJLVT NFNVUVTLBO QFSTBSBGBO
EFOHBO NFOZVSVI QBTJFO NFMJIBU EFOHBO TBUV NBUBOZB UFSUVUVQ EBO TFQBSVI CBHJBO NBTJOHNBTJOH SFUJOB QBEB TJTJ ZBOH TBNB
TBUVOZB MBHJ NFMJIBU MBOHTVOH QBEB TVBUV UJUJL TFOUSBM EJ EFQBOOZB EFOHBO MFUBL MFTJ BLJCBUOZB LFEVB NBUB UJEBL EBQBU NFMJIBU
-BMVTVBUVCJOUJLLFDJMDBIBZBBUBVTFCVBICFOEBZBOHLFDJMEJHFSBLLBO PCKFL EJ TJTJ LFQBMB ZBOH CFSMBXBOBO ,FBEBBO JOJ EJTFCVU
NBKV NVOEVS EJ TFMVSVI MBQBOH QBOEBOH EBO PSBOH UFSTFCVU TFCBHBJIFNJBOPQTJBIPNPOJN
NFNCFSJUBIV LFUJLB CJOUJL DBIBZB BUBV CFOEB JUV EBQBU EJMJIBU EBO
LFUJLB UJEBL EBQBU EJMJIBU %FOHBO EFNJLJBO MBQBOH QBOEBOH VOUVL Gerakan Mata dan Pengaturannya
NBUBLJSJEJHBNCBSLBOTFQFSUJUBNQBLQBEB(BNCBS1BEBTFNVB
QFUB QFSJNFUSJ TVBUV CJOUJL CVUB ZBOH EJTFCBCLBO PMFI TFEJLJUOZB TFM 6OUVL NFNBOGBBULBO LFNBNQVBO WJTVBM NBUB ZBOH IBNQJS
CBUBOHEBOLFSVDVUEJSFUJOBEJBUBTQBQJMBOFSWJPQUJTJEJKVNQBJLJSB TBNBQFOUJOHOZBEFOHBOTJTUFNJOUFSQSFUBTJTJOZBMQFOHMJIBUBO
LJSBQBEBEFSBKBUTFCFMBIMBUFSBMEBOUJUJLQVTBUQFOHMJIBUBO TFQFSUJ EBO NBUB BEBMBI EFOHBO NFOHHVOBLBO TJTUFN QFOHBUVSBO
ZBOHEJMVLJTLBOEBMBNHBNCBSUFSTFCVU
TFSFCSBM VOUVL NFOHBSBILBO NBUB NFOVKV PCKFL ZBOH BLBO
Kelainan Lapang pandang. 4FMBJO EJ BSFB QBQJMB OFSWJ PQUJTJ
EJQBOEBOH
LBEBOHLBMB CJOUJL CVUB EBQBU KVHB EJKVNQBJ EJ CBHJBO MBQBOHBO
QBOEBOH ZBOH MBJO #JOUJL CVUB ZBOH EFNJLJBO EJTFCVU TLPUPNBUB Pengaturan Otot-Otot untuk Gerakan Mata 4FQFSUJ ZBOH
TFSJOH LBMJ EJTFCBCLBO PMFI LFSVTBLBO OFSWVT PQUJLVT BLJCBU UBNQBL EBMBN (BNCBS QFSHFSBLBO NBUB EJBUVS PMFI UJHB
HMBVLPNB UFLBOBODBJSBOEBMBNCPMBNBUBUFSMBMVUJOHHJ
BLJCBU QBTBOHPUPU
SFLUVTNFEJBMJTEBOMBUFSBMJT
SFLUVTTVQFSJPS
627
NFMFXBUJ KBSBT QFSTBSBGBO EJTFCVU GBTJLVMVT MPOHJUVEJOBMJT NFEJBM

.BTJOHNBTJOH EBSJ LFUJHB TVTVOBO PUPU VOUVL UJBQ NBUB
EJJOFSWBTJTFDBSBUJNCBMCBMJLTFIJOHHBTBUVPUPUEBSJTFUJBQQBTBOH
PUPUJUVBLBOCFSFMBLTBTJTFNFOUBSBPUPUZBOHMBJOOZBCFSLPOUSBLTJ
(BNCBS NFNQFSMJIBULBO QFOHBUVSBO LPSUJLBM UFSIBEBQ
BQBSBUVT PLVMPNPUPS NFOVOKVLLBO QFOZFCBSBO TJOZBM ZBOH
CFSBTBM EBSJ BSFB QFOHMJIBUBO EJ LPSUFLT PLTJQJUBMJT NFMFXBUJ
USBLUVT PLTJQJUPUFLUBM EBO USBLUVT PLTJQJUPLPMJLVMBS NFOVKV BSFB
QSFUFLUBM EBO LPMJLVMVT TVQFSJPS QBEB CBUBOH PUBL %BSJ BSFB
QSFUFLUBM EBO BSFB LPMJLVMVT TVQFSJPS TJOZBM QFOHBUVSBO
PLVMPNPUPS NFOVKV OVMFVT PLVMPNPUPS EJ CBUBOH PUBL +VHB BEB
TJOZBM LVBU ZBOH EJIBOUBSLBO EBSJ QVTBU QFOHBUVS LFTFJNCBOHBO
UVCVI EJ CBUBOH PUBL LF TJTUFN PLVMPNPUPS ZBOH BTBMOZB EBSJ
OVLMFVTWFTUJCVMBSNFMFXBUJGBTJLVMVTMPOHJUVEJOBMNFEJBM

Gerakan Fiksasi Mata

.VOHLJOHFSBLBONBUBZBOHQBMJOHQFOUJOHBEBMBIHFSBLBOZBOH
NFOZFCBCLBO NBUB JUV UFSGJLTBTJ QBEB CBHJBO ZBOH MVBT EBSJ
MBQBOH QBOEBOH (FSBLBO GJLTBTJ JOJ EJBUVS PMFI EVB NFLBOJTNF
EBOJOGFSJPS EBO
PCMJLVTTVQFSJPSEBOJOGFSJPS0UPUSFLUVT TBSBG .FLBOJTNF ZBOH QFSUBNB BEBMBI QFOHBUVSBO ZBOH
NFEJBMJTEBOMBUFSBMJTCFSLPOUSBLTJVOUVLNFOHHFSBLLBONBUB NFOZFCBCLBO PSBOH EBQBU NFOHHFSBLLBO NBUB TFDBSB WPMVOUFS
EBOTBUVTJTJLFTJTJMBJOOZB0UPUSFLUVTTVQFSJPSEBOJOGFSJPS VOUVL NFOFNVLBO PCKFL EBMBN QFOHMJIBUBOOZB ZBOH LFNVEJBO
KVHB CFSLPOUSBLTJ VOUVL NFOHHFSBLLBO NBUB LF BUBT EBO LF BLBO EJGJLTBTJOZB HFSBLBO JOJ EJTFCVU TFCBHBJ NFLBOJTNF GJLTBTJ
CBXBI 0UPU PCMJRVT UFSVUBNB CFSGVOHTJ VOUVL NFNVUBS CPMB WPMVOUFS .FLBOJTNF LFEVB BEBMBI NFLBOJTNF ZBOH EBQBU
NBUBBHBSMBQBOHQBOEBOHUFUBQQBEBQPTJTJUFHBL NFOBIBO NBUB TFDBSB UFUBQ QBEB PCKFL TFLFUJLB PCKFL JUV
EJUFNVLBO PMFI NBUB LFBEBBO JOJ EJTFCVU TFCBHBJ NFLBOJTNF
Jaras Saraf untuk Pengaturan Gerakan Mata. GJLTBTJJOWPMVOUFS
(BNCBS KVHB NFNQFSMJIBULBO OVLMFVT TBSBG LSBOJBM *** 4FQFSUJ ZBOH UFSMJIBU EBMBN (BNCBS HFSBLBO GJLTBTJ
*7 EBO 7* EJ CBUBOH PUBL EBO IVCVOHBO LFUJHB TBSBG EFOHBO WPMVOUFSEJBUVSPMFICBHJBOLPSUJLBMZBOHUFSMFUBLCJMBUFSBMEJSFHJP
TBSBG QFSJGFS ZBOH NFOVKV LF PUPUPUPU NBUB %BMBN HBNCBS QSFNPUPS LPSUJLBM MPCVT GSPOUBMJT %JTGVOHTJ CJMBUFSBM BUBV
UFSTFCVUKVHBUBNQBLIVCVOHBOBOUBSBLFUJHBOVLMFVTJOJZBOH LFSVTBLBOQBEBBSFBJOJNFOZFCBCLBOPSBOHJUVTVLBSNFNJO
628
EBILBONBUBOZBEBSJUJUJLGJLTBTJEBOTFMBOKVUOZBNFOHHFSBLLBO
NBUB LF UJUJL ZBOH MBJO #JBTBOZB PSBOH UFSTFCVU QFSMV
NFOHFEJQLBO NBUB BUBV NFOVUVQ NBUB EFOHBO UBOHBO VOUVL
XBLUVZBOHTJOHLBU TFUFMBIJUVCBSVEBQBUNFOHHFSBLLBONBUB
4FCBMJLOZB NFLBOJTNF GJLTBTJ ZBOH NFOZFCBCLBO NBUB EBQBU
UNIT X
UFSQBLV QBEB TVBUV PCKFL ZBOH NFOKBEJ QFSIBUJBOOZB LFUJLB
PCKFL JUV EJUFNVLBO EJBUVS PMFI BSFB QFOHMJIBUBO TFLVOEFS EJ
LPSUFLT PLTJQJUBMJT ZBOH UFSVUBNB UFSMFUBL EJ TFCFMBI BOUFSJPS
LPSUFLT QFOHMJIBUBO QSJNFS #JMB BSFB GJLTBTJ JOJ NFOHBMBNJ
LFSVTBLBO CJMBUFSBM QBEB CJOBUBOH CJOBUBOH BLBO NFOHBMBNJ
LFTVMJUBO VOUVL NFNGJLTBTJ NBUBOZB LF UJUJL GJLTBTJ BUBV EBQBU
NFOKBEJCFOBSCFOBSUBLNBNQVNFMBLVLBOHFSBLBOUFSTFCVU
3JOHLBTOZB MBQBOH NBUB JOWPMVOUFS EJ LPSUFLT PLTJQJUBMJT
TFCFMBIQPTUFSJPSTFDBSBPUPNBUJTBLBONFNBLVNBUBQBEBTVBUV
UJUJL QBEB MBQBOH QBOEBOH ZBOH EJJOHJOLBO TFIJOHHB EBQBU
NFODFHBI UFSKBEJOZB HFSBLBO CBZBOHBO NFOZJMBOH SFUJOB 6OUVL
NFMFQBTLBOEJSJEBSJGJLTBTJQFOHMJIBUBOJOJ TJOZBMWPMVOUFSIBSVT
EJIBOUBSLBOEBSJMBQBOHNBUBWPMVOUFSLPSUJLBMZBOHUFSMFUBLEJ
LPSUFLTGSPOUBM
Mekanisme Fiksasi Terpaku Involunter—Peran Kolikuli
Superior. +FOJT GJLTBTJ UFSQBLV JOWPMVOUFS ZBOH UFMBI EJCBIBT
QBEB CBHJBO TFCFMVNOZB CFSBTBM EBSJ NFLBOJTNF VNQBO CBMJL SBLLBO NBUB UFSTFCVU UJEBL MFCJI EBSJ QFSTFO XBLUV UPUBM
OFHBUJG ZBOH NFODFHBI PCKFL QFSIBUJBO BHBS UJEBL TBNQBJ TFEBOHLBO QFSTFOOZB EJQBLBJ VOUVL NFNGJLTBTJ +VHB
NFOJOHHBMLBOCBHJBOGPWFBSFUJOB4FDBSBOPSNBM NBUBNFNJMJLJ TFMBNB UJNCVM HFSBLBO TBLBEJL JOJ PUBL BLBO NFOFLBO
UJHBNBDBNHFSBLBOZBOHCFSKBMBOTFDBSBLPOUJOVOBNVOIBNQJS CBZBOHBO QFOHMJIBUBO TFIJOHHB PSBOH JUV UJEBL NFSBTBLBO
UBL UFSBTB
USFNPS ZBOH UFSVTNFOFSVT EFOHBO LFDFQBUBO BEBOZBHFSBLBOQFSQJOEBIBOEBSJTBUVUJUJLLFUJUJLMBJO
TBNQBJ TJLMVT QFS EFUJL ZBOH EJTFCBCLBO PMFI LPOUSBLTJ ZBOH Gerakan Sakadik Selama Membaca. 4FMBNB NFNCBDB
CFSVOUVOEBSJVOJUNPUPSPUPUPUPUNBUB
QFOZJNQBOHBOZBOH CJBTBOZB PSBOH NFMBLVLBO CFCFSBQB HFSBLBO TBLBEJL QBEB
MBNCBU CPMB NBUB LF TBUV KVSVTBO BUBV LF KVSVTBO ZBOH MBJOOZB NBUBOZB VOUVL TFUJBQ CBSJT 1BEB LFBDMBBO JOJ CBZBOHBO
EBO
HFSBLBO DFLMJLBO UJCBUJCB ZBOH EJBUVS PMFI NFLBOJTNF QBOEBOHBOOZBUJEBLBLBOCFSHFSBLNFMFXBUJNBUB OBNVONBUB
GJLTBTJJOWPMVOUFS JUV BLBO EJMBUJI VOUVL CFSHFSBL EFOHBO NFNBLBJ CFCFSBQB
#JMBTFCVBIUJUJLDBIBZBTVEBIEJGJLTBTJLBOQBEBEBFSBIGPWFB HFSBLBO TBLBEJL ZBOH CFSVSVUBO NFMFXBUJ CBZBOHBO
SFUJOB BEBOZBHFSBLBOUSFNPSBLBONFOZFCBCLBOUJUJLDBIBZBJUV QFOHMJIBUBO VOUVL NFOZBSJOH JOGPSNBTJ QFOUJOH (FSBLBO
CFSHFSBL LF LJSJ LF LBOBO EFOHBO DFQBU NFMFXBUJ LFSVDVU EBO TBLBEJLZBOHNJSJQKVHBUFSKBEJTFXBLUVPSBOHNFNQFSIBUJLBO
HFSBLBO QFOZJNQBOHBO BLBO NFOZFCBCLBO UJUJL JUV NFMFXBUJ TVBUV MVLJTBO IBOZB TBKB HFSBLBO TBLBEJLOZB UFSKBEJ LF BSBI
LFSVDVUTFDBSBQFSMBIBO4FUJBQLBMJUJUJLDBIBZBNFMFXBUJTBNQBJ BUBT LF TBNQJOH LF CBXBI EBO NFOZVEVU EBSJ TBUV TPSPUBO
QBEB UFQJ GPWFB UJNCVM TVBUV SFBLTJ SFGMFLT ZBOH NFOEBEBL QBEBMVLJTBOJUVNFOVKVBSBIMBJOOZB EBOTFUFSVTOZB
TFIJOHHB NFOZFCBCLBO HFSBLBO DFLMJLBO ZBOH OBOUJOZB BLBO
NFNJOEBILBO UJUJL JUV NFOKBVIJ UFQJ EBO LFNCBMJ LF CBHJBO Fiksasi pada Objek yang Bergerak—"Gerakan Mengejar".
UFOHBIGPWFBMBHJ+BEJ SFTQPOTPUPNBUJTNFNJOEBILBOCBZBOHBO .BUB EBQBU KVHB UFUBQ EJGJLTBTJ QBEB PCKFL ZBOH TFEBOH
LFNCBMJLFCBHJBOUFOHBIGPWFB CFSHFSBL ZBOH EJTFCVU TFCBHBJ HFSBLBO NFOHFKBS .FLBOJTNF
(FSBLBO QFOZJNQBOHBO EBO DFLMJLBO JOJ EJQFSMJIBULBO QBEB LPSUJLBM TBOHBU CFSLFNCBOH TFIJOHHB TFDBSB PUPNBUJT EBQBU
(BNCBS HBSJT QVUVTQVUVT NFOVOKVLLBO HFSBLBO MBNCBU NFOEFUFLTJ SBOHLBJBO HFSBLBO TVBUV PCKFL EBO TFMBOKVUOZB
NFMFXBUJ SFUJOB EBO HBSJT VUVI NFOVOKVLLBO HFSBLBO DFLMJLBO TFDBSB DFQBU NFNCVBU TFSBOHLBJBO HFSBLBO ZBOH TBNB QBEB
ZBOH NFODFHBI CBZBOHBO NFOJOHHBMLBO EBFSBI GPWFB NBUB$POUPIOZB CJMBBEBPCKFLZBOHCFSHFSBLLFBUBTEBOLF
,FNBNQVBO GJLTBTJ JOWPMVOUFS TFCBHJBO CFTBS IJMBOH LFUJLB CBXBI TFQFSUJ CFOUVL HFMPNCBOH EFOHBO LFDFQBUBO CFCFSBQB
LPMJLVMVTTVQFSJPSEJSVTBL LBMJ QFS EFUJL NVMBNVMB NBUB UJEBL NBNQV CFSGJLTBTJ QBEB
PCKFL UFSTFCVU /BNVO TFUFMBI TBUV EFUJL BUBV MFCJI NBUB
Gerakan Sakadik pada Mata—Mekanisme yang Terjadi BLBO NVMBJ NFMPNQBU EFOHBO NFNBLBJ HFSBLBO TBLBEJL
Berturut-Turut pada Fiksasi Titik#JMB CBZBOHBO QFOHMJIBUBO NFOVSVUTVBUVQPMBZBOHNJSJQEFOHBOQPMBQFOHFSBLBOPCKFL
CFSHFSBL TFDBSB UFSVTNFOFSVT EJ EFQBO NBUB NJTBMOZB TFXBLUV UFSTFCVU -BMV TFTVEBI CFCFSBQB EFUJL LFNVEJBO TFDBSB
TFTFPSBOH TFEBOH NFOHFOEBSBJ NPCJM NBUB BLBO UFSGJLTBTJ QBEB QSPHSFTJG NBUB NVMBJ TFNBLJO MBODBS EBO TFNBLJO IBMVT
TBUV TPSPUBO LF TPSPUBO MBJO EBMBN MBQBOH QBOEBOH NFMPNQBU CFSHFSBL EBO BLIJSOZB NFOHJLVUJ QFSHFSBLBO HFMPNCBOH
MPNQBU EBSJ TBUV UFNQBU LF UFNQBU MBJO EFOHBO LFDFQBUBO EVB UFSTFCVU EFOHBO LFDFQBUBO ZBOH IBNQJS TBNB ,FBEBBO JOJ
TBNQBJUJHBMPNQBUBOQFSEFUJL-PNQBUBOJOJEJTFCVUTBLBEF EBO NFOVOKVLLBO BEBOZB LFNBNQVBO TFDBSB PUPNBUJT EBO UBL
HFSBLBOOZB EJTFCVU HFSBLBO PQUJLPLJOFUJL (FSBLBO TBLBEJL JOJ EJTBEBSJ TFSUB QFOVI QFSIJUVOHBO ZBOH EJMBLVLBO PMFI TJTUFN
CFHJUVDFQBUOZBTFIJOHHBXBLUVZBOHEJCVUVILBOVOUVLNFOHHF QFOHFKBSBOVOUVLNFOHFOEBMJLBOHFSBLBONBUB
629
Kolikulus Superior Terutama Bertanggung Jawab EFOTJLFEVBSFUJOBEJDBUBU FLTJUBTJHBOHHVBOEBMBNTFMTQFTJGJL

untuk Menggerakkan Mata dan Kepala ke Arah EJLPSUFLTQFOHMJIBUBOBLBONFOHIJMBOH
Objek yang Mengganggu Penglihatan Mekanisme Saraf dari Stereopsis untuk Menetapkan Jarak
0CKFLZBOHUJCBUJCBNFOHHBOHHVQFOHMJIBUBOEJEBFSBIMBUFSBM
Objek Penglihatan
MBQBOHBO QBOEBOH TFSJOH LBMJ NFOZFCBCLBO NBUB TFHFSB
5FMBIEJCJDBSBLBOEBMBN#BCLBSFOBLFEVBNBUBUFSQJTBIMFCJI
CFSHFSBLLFBSBIUFSTFCVU CBILBOCJMBLPSUFLTQFOHMJIBUBOUFMBI
EBSJJODJ CBZBOHBOQBEBLFEVBSFUJOBUJEBLUFQBUTBNB"SUJOZB
SVTBL )BM JOJ UJEBL UFSKBEJ KJLB LPMJLVMVT TVQFSJPS KVHB UFMBI
NBUBLBOBONFMJIBUTFEJLJUMFCJICBOZBLTJTJTFCFMBILBOBOPCKFL
SVTBL 6OUVL NFOEVLVOH GVOHTJ JOJ CFSCBHBJ UJUJL EJ SFUJOB EBONBUBLJSJNFMJIBUTFEJLJUMFCJICBOZBLTFCFMBILJSJPCKFLEBO
EJSFQSFTFOUBTJLBOTFDBSBUPQPHSBGJTEJLPMJLVMVTTVQFSJPSEFOHBO TFNBLJO EFLBU KBSBL TVBUV PCKFL TFNBLJO CFTBS QVMB
DBSBZBOHTBNBTFQFSUJEJLPSUFLTQFOHMJIBUBOQSJNFS XBMBVQVO QFSCFEBBOOZB 0MFI LBSFOB JUV CJMB LFEVB NBUB EJTBUVLBO TBUV
EFOHBOUJOHLBULFBLVSBUBOZBOHMFCJISFOEBI.FTLJQVOCFHJUV TBNB MBJO TFNVB UJUJL LPSFTQPOEFOTJ EJ LFEVB CBZBOHBO
BSBI VUBNB EBSJ LJMBUBO DBIBZB ZBOH EBUBOH EJ EBFSBI QFSJGFS QFOHMJIBUBOUFUBQUJEBLNVOHLJOUFSDBUBUEBMBNXBLUVZBOHTBNB
MBQBOHBO SFUJOB EJQFUBLBO PMFI LPMJLVMJ EBO TJOZBMTJOZBM -FCJI MBOKVU TFNBLJO EFLBU PCKFL EFOHBO NBUB TFNBLJO SFOEBI
TFLVOEFS EJIBOUBSLBO LF OVLMFVT PLVMPNPUPS VOUVL EFSBKBUQFODBUBUBOOZB%FSBKBULFUJEBLUFSDBUBUBOJOJNFOHIBTJMLBO
NFOHHFSBLLBO NBUB 6OUVL NFNCBOUV QFSHFSBLBO NBUB LF NFLBOTJNF VOUVL TUFSFPQTJT ZBJUV NFLBOTJNF ZBOH QFOUJOH
BSBI JOJ LPMJLVMJ TVQFSJPS KVHB NFNJMJLJ QFUB UPQPMPHJ TFOTBTJ VOUVLNFOFOUVLBOKBSBLPCKFLQFOHMJIBUBOTBNQBJTFKBVILVSBOH
TPNBUJL ZBOH CFSBTBM EBSJ UVCVI EBO TJOZBMTJOZBM BLVTUJL EBSJ MFCJILBLJ NFUFS

UFMJOHB .FLBOJTNFOFVSPOBMTFMVMBSVOUVLTUFSFPQTJTEJEBTBSLBOQBEB
4FSBUTFSBU TBSBG PQUJL ZBOH CFSBTBM EBSJ NBUB NFOVKV LF
CFCFSBQB KBSBT TFSBU ZBOH CFSBTBM EBSJ SFUJOB EBO NFOVKV LPSUFLT
LPMJLVMJ ZBOH CFSUBOHHVOH KBXBC VOUVL HFSBLBOHFSBLBO
QFOHMJIBUBO NFOZJNQBOH TFCFTBS TBNQBJ EFSBKBU QBEB TFUJBQ
CFSCFMPL DFQBU JOJ NFSVQBLBO DBCBOH EBSJ TFSBUTFSBU :
TJTJKBSBTTFOUSBM0MFILBSFOBJUV CFCFSBQBKBSBTPQUJLZBOHCFSBTBM
CFSLFDFQBUBO IBOUBS UJOHHJ TBMBI TBUV DBCBOHOZB CFSKBMBO LF
EBSJ LFEVB NBUB EBQBU NFODBUBU PCKFLPCKFL TFDBSB UFQBU QBEB
LPSUFLT QFOHMJIBUBO EBO DBCBOH ZBOH MBJO LF BSBI LPMJLVMVT
KBSBL NFUFS TFMBJO JUV NBTJI BEB SBOHLBJBO KBSBT QFODBUBUBO
TVQFSJPS ,PMJLVMVTTVQFSJPSEBOEBFSBIMBJOEJCBUBOHPUBLKVHB
VOUVL PCKFLPCKFL EFOHBO KBSBL NFUFS +BEJ KBSBL EJUFOUVLBO
TFDBSB NFOEBQBU CBOZBL TJOZBMTJOZBM QFOHMJIBUBO ZBOH
PMFI SBOHLBJBO KBSBT NBOB ZBOH CFSJOUFSBLTJ EFOHBO ZBOH MBJO
EJIBOUBSLBOEBMBNTFSBUTFSBUTBSBGPQUJLUJQF84FSBUTFSBUJOJ
'FOPNFOBJOJEJTFCVUQFSTFQTJLFEBMBNBO ZBOHNFSVQBLBOOBNB
NFXBLJMJ KBSBT QFOHMJIBUBO ZBOH QBMJOH UVB UFUBQJ GVOHTJOZB
MBJOVOUVLTUFSFPQTJT
NBTJICFMVNKFMBT
4FMBJO NFOZFCBCLBO NBUB CFSHFSBL LF BSBI PCKFL ZBOH Strabismus—Tidak Adanya Fusi Mata
NFOHHBOHHVQFOHMJIBUBO TJOZBMTJOZBMJOJCFSBTBMEBSJLPMJLVMVT 4USBCJTNVT ZBOH KVHB EJTFCVU KVMJOH BUBV DSPTTFZF NBUB ZBOH
TVQFSJPSNFMBMVJGBTJLVMVTMPOHJUVEJOBMNFEJBMJTLFUJOHLBUMBJOEJ NFOZJMBOH
CFSBSUJLVSBOHOZBQFOZBUVBONBUBEBMBNTBUVBUBVMFCJI
CBUBOH PUBL VOUVL NFOZFCBCLBO CFSHFSBLOZB TFMVSVI LFQBMB LPPSEJOBTJ QFOHMJIBUBO IPSJ[POUBM WFSUJLBM BUBV SPUBTJ 5JQFUJQF
EBTBS TUSBCJTNVT EJQFSMJIBULBO EBMBN (BNCBS
TUSBCJTNVT
EBO CBILBO TFMVSVI UVCVI LF BSBI PCKFL UFSTFCVU 4FMBJO
IPSJ[POUBM
TUSBCJTNVT UPSTJPOBM EBO
TUSBCJTNVT WFSUJLBM
QFOHMJIBUBO BEB KFOJT HBOHHVBO MBJO TFQFSUJ TVBSB ZBOH LFSBT ,PNCJOBTJEBSJEVBBUBVCBILBOUJHBUJQFTUSBCJTNVTZBOHCFSCFEBJOJ
BUBVCBILBOQVLVMBOQBEBTJTJUVCVI ZBOHEBQBUNFOZFCBCLBO TFSJOHLBMJUFSKBEJ
CFSHFSBLOZBNBUB LFQBMB EBOUVCVITFDBSBTFSVQBUFUBQJIBOZB 4USBCJTNVT TFSJOH LBMJ EJTFCBCLBO PMFI QFOHBUVSBO BCOPSNBM
KJLB LPMJLVMVT TVQFSJPS NBTJI VUVI 0MFI LBSFOB JUV LPMJLVMVT QBEB NFLBOJTNF GVTJ TJTUFN QFOHMJIBUBO %FOHBO EFNJLJBO QBEB
TVQFSJPS NFNBJOLBO QFSBO VNVN EBO NFOZFMVSVI VOUVL VTBIB QFSUBNB TFPSBOH BOBL VOUVL NFNGJLTBTJ LFEVB NBUBOZB QBEB
NFOHBSBILBO NBUB LFQBMB EBO UVCVI TFTVBJ EFOHBO BSBI PCKFL ZBOH TBNB TBUV NBUB UFSGJLTBTJ EFOHBO TBOHBU NFNVBTLBO
HBOHHVBOFLTUFSOBM CBJLCFSVQBQFOHMJIBUBO QFOEFOHBSBO BUBV TFEBOHLBO ZBOH MBJOOZB HBHBM VOUVL NFNGJLTBTJ BUBV LFEVBOZB
TPNBUJL UFSGJLTBTJ EFOHBO NFNVBTLBO UFUBQJ UJEBL QFSOBI TFDBSB CFSTBNBBO
4FTVEBIOZB QPMB HFSBLBO QFOHHBCVOHBO NBUB EJBUVS TFDBSB
"Fusi" Bayangan Penglihatan dari Kedua Mata BCOPSNBM EBMBN KBSBT QFOHBUVSBO TFMTFM TBSBG JUV TFOEJSJ TFIJOHHB
NBUBUJEBLQFSOBICFSGVTJ
6OUVL NFNCFSJLBO QFSTFQTJ QFOHMJIBUBO ZBOH MFCJI CFSBSUJ
CBZBOHBOQFOHMJIBUBOLFEVBNBUBOPSNBMCFSGVTJTBUVTBNBMBJO Penekanan Bayangan Penglihatan dari Mata yang Direpresi.
QBEBUJUJLLPSFTQPOEFOTJEJLFEVBSFUJOB,PSUFLTQFOHMJIBUBO 1BEB CFCFSBQB QBTJFO EFOHBO TUSBCJTNVT NBUB TFDBSB CFSHBOUJBO
CFSQFSBO QFOUJOH EBMBN GVTJ 5FMBI EJKFMBTLBO TFCFMVNOZB NFMBLVLBO GJLTBTJ QBEB PCKFL ZBOH EJQFSIBUJLBO 1BEB QBTJFO MBJO
EBMBNCBCJOJUJUJLLPSFTQPOEFOTJLFEVBSFUJOBNFOHIBOUBSLBO IBOZB TBUV NBUB ZBOH EJQBLBJ TFUJBQ TBBU TFEBOHLBO NBUB MBJOOZB
EJSFQSFTJ EBO UJEBL QFSOBI EJQBLBJ VOUVL QFOHMJIBUBO TBLTBNB
TJOZBM QFOHMJIBUBO LF CFSCBHBJ MBQJTBO TFM TBSBG EJ LPSQVT
,FUBKBNBOQFOHMJIBUBONBUBZBOHEJSFQSFTJIBOZBCFSLFNCBOHTFEJ
HFOJLVMBUVN MBUFSBMJT EBO TJOZBM JOJ LFNVEJBO EJIBOUBSLBO LF
TFM TBSBG ZBOH TFKBKBS EBMBN LPSUFLT QFOHMJIBUBO 5FSKBEJ
JOUFSBLTJBOUBSBTFMTFMTBSBGLPSUFLTZBOHNFOZFCBCLBOFLTJUBTJ
HBOHHVBO JOUFSGFSFODF FYDJUBUJPO
EBMBN TFM TBSBG ZBOH TQFTJGJL
CJMB LFEVB HBNCBSBO QFOHMJIBUBO UJEBL UFSDBUBU ZBLOJ UJEBL
UFSKBEJ GVTJ EFOHBO UFQBU 3BOHTBOH JOJ NVOHLJO NFNCFSJLBO
TJOZBM ZBOH EJIBOUBSLBO LF BQBSBUVT PLVMPNPUPS ZBOH
NFOZFCBCLBO HFSBLBO NBUB LPOWFSHFO EJWFSHFO BUBV SPUBTJ
TVQBZBGVTJEBQBUEJCFOUVLLFNCBMJ4FLBMJUJUJLLPSFTQPO
630
LJU UFSLBEBOH UFUBQ BUBV LVSBOH +JLB NBUB ZBOH EPNJOBO TBSBG UFSTFCVU NFODBQBJ NBUB 4FSBU TJNQBUJT JOJ
NFOKBEJ CVUB QFOHMJIBUBO QBEB NBUB ZBOH EJSFQSFTJ EBQBU TFEJLJU NFNQFSTBSBGJ TFSBU PUPU SBEJBM JSJT ZBOH NFNCVLB QVQJM

CFSLFNCBOH QBEB PSBOH EFXBTB UFUBQJ KBVI MFCJI CFSLFNCBOH QBEB EBO CFCFSBQB PUPU FLTUSBPLVMBS NBUB ZBOH EJCJDBSBLBO
BOBLBOBL *OJ NFOVOKVLLBO CBIXB LFUBKBNBO QFOHMJIBUBO TBOHBU LFNVEJBOEBMBNIVCVOHBOOZBEFOHBOTJOESPN)PSOFS
CFSHBOUVOH QBEB QFSLFNCBOHBO ZBOH CBJL QBEB IVCVOHBO TJOBQTJT
TJTUFN TBSBG QVTBU EBSJ NBUB #BILBO TFDBSB BOBUPNJL QVO KVNMBI
UNIT X
IVCVOHBOTFMTFMTBSBGJOJNFOVSVOQBEBEBFSBILPSUFLTQFOHMJIBUBO Pengaturan Akomodasi (Memfokuskan Mata)
ZBOHOPSNBMOZBNFOFSJNBTJOZBMEBSJNBUBZBOHEJSFQSFTJ .FLBOJTNFBLPNPEBTJZBJUV NFLBOJTNFZBOHNFNGPLVTLBO
TJTUFN MFOTB NBUB QFOUJOH VOUVL UBKBN QFOHMJIBUBO UJOHLBU
UJOHHJ "LPNPEBTJ UFSKBEJ BLJCBU LPOUSBLTJ BUBV SFMBLTBTJ
Pengaturan Otonom Akomodasi dan NVTLVMVTTJMJBSJTNBUB,POUSBLTJNFOZFCBCLBOQFOJOHLBUBO
Diameter Pupil LFLVBUBO CJBT MFOTB TFQFSUJ EJKFMBTLBO EBMBN #BC EBO
SFMBLTBTJ NFOZFCBCLBO QFOVSVOBO LFLVBUBO #BHBJNBOB
Saraf Otonom Mata.BUBEJQFSTBSBGJPMFITFSBUTBSBGTJNQBUJT
TFTFPSBOH EBQBU NFOHBUVS BLPNPEBTJ VOUVL
EBO QBSBTJNQBUJT TFQFSUJ EJMVLJTLBO EBMBN (BNCBS 4FSBU
NFNQFSUBIBOLBOGPLVTNBUBTFUJBQTBBU
QSFHBOHMJPO QBSBTJNQBUJT NVODVM EBSJ OVLMFVT &EJOHFS8FTUQIBM
"LPNPEBTJ MFOTB EJBUVS PMFI NFLBOJTNF VNQBO CBMJL
CBHJBO OVLMFVT WJTFSBM TBSBG LFUJHB
EBO LFNVEJBO CFSKBMBO
OFHBUJG ZBOH TFDBSB PUPNBUJT NFOHBUVS LFLVBUBO CJBT MFOTB
EBMBN OFSWVT LFUJHB LF HBOHMJPO TJMJBSJT ZBOH UFSMFUBL UFQBU EJ
VOUVL NFODBQBJ UJOHLBU LFUBKBNBO QFOHMJIBUBO ZBOH QBMJOH
CFMBLBOH NBUB %J TJOJ TFSBU QSFHBOHMJPO CFSTJOBQT EFOHBO TFM
UJOHHJ#JMBNBUBZBOHEJGPLVTLBOQBEBCFCFSBQBPCKFLZBOH
TBSBG QBSBTJNQBUJT QPTUHBOHMJPOJL ZBOH LFNCBMJ NFOHJSJNLBO
KBVI LFNVEJBO UJCBUJCB EJGPLVTLBO QBEB PCKFL ZBOH EFLBU
TFSBUTFSBUNFMBMVJOFSWVTTJMJBSJTLFEBMBNCPMBNBUB/FSWVTJOJ
CJBTBOZB MFOTB BLBO CFSBLPNPEBTJ VOUVL UBKBN QFOHMJIBUBO
NFSBOHTBOH
PUPU TJMJBSJT ZBOH NFOHBUVS MFOTB NBUB VOUVL
ZBOH UFSCBJL EBMBN XBLUV LVSBOH EBSJ EFUJL 8BMBVQVO
CFSGPLVTEBO
TGJOHUFSJSJTZBOHNFOZFCBCLBOLPOTUSJLTJQVQJM
NFLBOJTNFQFOHBUVSBOTFCFOBSOZBZBOHNFOJNCVMLBOGPLVT
1FSTBSBGBO TJNQBUJT NBUB CFSBTBM EBSJ EBMBN TFM LPSOV NBUBTFDBSBDFQBUEBOBLVSBUJOJNBTJIUJEBLKFMBT CFCFSBQB
JOUFSNFEJPMBUFSBM TFHNFO UPSBLBM QFSUBNB NFEVMB TQJOBMJT %BSJ HBNCBSBONFLBOJTNFZBOHEJLFUBIVJBEBMBITFCBHBJCFSJLVU
TJOJ TFSBUTJNQBUJTNFNBTVLJSBOUBJTJNQBUJTEBOCFSKBMBOLFBUBT
1FSUBNB CJMB NBUB TFLPOZPOHLPOZPOH NFOHVCBI KBSBL
LF HBOHMJPO TFSWJLBMJT TVQFSJPS UFNQBU TFSBU TJNQBUJT UFSTFCVU
UJUJL GJLTBTJ MFOTB NFOHVCBI LFLVBUBOOZB EBMBN BSBI ZBOH
CFSTJOBQT EFOHBO TFU TBSBG QPTUHBOHMJPOJL 4FSBU TJNQBUJT
TFTVBJ VOUVL NFODBQBJ GPLVT ZBOH CBSV EBMBN XBLUV
QPTUHBOHMJPOJLLFNVEJBONFOZFCBSTFQBOKBOHQFSNVLBBOBSUFSJB
TFQFSTFLJBO EFUJL ,FEVB CFSCBHBJ QFUVOKVL MBJO ZBOH EBQBU
LBSPUJTEBOCFSUVSVUUVSVUEBSJBSUFSJZBOHMFCJILFDJMTBNQBJTFSBU
NFNCBOUVMFOTBVOUVLNFOHVCBILFLVBUBOEBMBNBSBIZBOH
TFTVBJ
1. "CFSBTJ LSPNBUJL UBNQBLOZB QFOUJOH %FOHBO EFNJLJBO
TJOBS DBIBZB NFSBI EJGPLVTLBO TFEJLJU EJ QPTUFSJPS TJOBS
DBIBZB CJSV LBSFOB MFOTB MFCJI NFNCJBTLBO TJOBS CJSV
EBSJQBEB TJOBS NFSBI .BUB UBNQBLOZB EBQBU NFOEFUFLTJ
NBOB EBSJ LFEVB UJQF TJOBS JOJ ZBOH NFNQVOZBJ GPLVT
MFCJI CBJL EBO QFUVOKVL JOJ NFNCFSJ JOGPSNBTJ LFQBEB
NFLBOJTNF BLPNPEBTJ VOUVL NFNCVBU MFOTB NFOKBEJ
MFCJILVBUBUBVMFCJIMFNBI
2. #JMB CFOEB EJGJLTBTJ QBEB PCKFL ZBOH EFLBU NBUB IBSVT
CFSLPOWFSHFOTJ .FLBOJTNF TBSBG VOUVL LPOWFSHFOTJ
NFOJNCVMLBO TJOZBM TFDBSB TFSFOUBL VOUVL NFNQFSLVBU
MFOTBNBUB
3. 0MFILBSFOBGPWFBUFSMFUBLQBEBMFLVLBOMVCBOHZBOHBHBL
MFCJIEBMBNEBSJQBEBCBHJBOSFUJOBMBJO LFKFMBTBOGPLVTEJ
CBHJBO EBMBN GPWFB CFSCFEB EFOHBO LFKFMBTBO GPLVT QBEB
UFQJUFQJOZB*OJKVHBNFNCFSJQFUVOKVLNFOHFOBJLFBSBI
NBOBLFLVBUBOMFOTBIBSVTEJVCBI
4. UJOHLBUBLPNPEBTJMFOTBCFSPTJMBTJTFEJLJUTFUJBQTBBUQBEB
GSFLVFOTJTBNQBJEVBLBMJQFSEFUJL#BZBOHBOQFOHMJIBUBO
NFOKBEJMFCJIKFMBTCJMBPTJMBTJLFLVBUBOMFOTBLVBUEJVCBI
EBMBN BSBI ZBOH TFTVBJ EBO NFOKBEJ MFCJI MFNBI CJMB
LFLVBUBO MFOTB EJVCBI EBMBN BSBI ZBOH TBMBI *OJ EBQBU
NFNCFSJ QFUVOKVL ZBOH DFQBU NFOHFOBJ QFSVCBIBO BSBI
LFLVBUBO MFOTB ZBOH IBSVT EJMBLVLBO BHBS EBQBU
NFOHIBTJMLBOGPLVTZBOHTFTVBJ
631
"SFB LPSUFLT PUBL ZBOH NFOHBUVS BLPNPEBTJ UFSMFUBL LBO SFTQPOT UFSIBEBQ DBIBZB UFUBQJ EBQBU NFOJNCVMLBO BLPNPEBTJ
QBSBMFM EFOHBO BSFB ZBOH NFOHBUVS QFSHFSBLBO GJLTBTJ NBUB EBO ZBOH KVHB CFSVLVSBO TBOHBU LFDJM QVQJM "SHZMM 3PCFSUTPO

EFOHBOJOUFHSBTJBLIJSCFSVQBTJOZBMQFOHMJIBUBOEBMBNBSFB NFSVQBLBOUBOEBEJBHOPTUJLZBOHQFOUJOHQFOZBLJUTJTUFNTBSBGQVTBU
EBOLPSUFLT#SPENBOOEBONFOHIBOUBSLBOTJOZBMNPUPSJL TFQFSUJTJGJMJT
LF NVTLVMVT TJMJBSJT NFMBMVJ BSFB QSFUFLUBM EBMBN CBUBOH PUBL Sindrom Horner 4BSBG TJNQBUJT LF NBUB LBEBOHLBEBOH
EBOLFNVEJBONBTVLLFEBMBNOVLMFVT&EJOHFS8FTUQIBMEBO NFOHBMBNJ HBOHHVBO (BOHHVBO JOJ TFSJOH LBMJ UFSKBEJ EBMBN SBOUBJ
BLIJSOZBNFMBMVJTFSBUTBSBGQBSBTJNQBUJTNFOVKVNBUB TJNQBUJTTFSWJLBM"LJCBUOZB UFSKBEJTVBUVLPOEJTJLMJOJTZBOHEJTFCVU
TJOESPN )PSOFS ZBOH NFOZFCBCLBO UJNCVMOZB FGFLFGFL CFSJLVU
1FSUBNB LBSFOB SJOUBOHBO TFSBUTFSBU LF NVTLVMVT EJMBUPS QVQJM
QVQJM UFUBQ NFOZFNQJU EFOHBO EJBNFUFS ZBOH MFCJI LFDJM EBSJQBEB
Pengaturan Diameter Pupil QVQJMNBUBZBOHCFSMBXBOBO,FEVB LFMPQBLNBUBBUBTNFOKBEJKBUVI
3BOHTBOH TBSBG QBSBTJNQBUJT KVHB NFSBOHTBOH PUPU TGJOHUFS TFCBC LFMPQBL NBUB JOJ OPSNBMOZB EJQFSUBIBOLBO EBMBN QPTJTJ
QVQJM TFIJOHHB NFNQFSLFDJM DFMBI QVQJM JOJ EJTFCVU NJPTJT UFSCVLBTFMBNBCBOHVOTFCBHJBOPMFILPOUSBLTJTFSBUPUPUQPMPTZBOH
4FCBMJLOZB SBOHTBOH TBSBG TJNQBUJT NFSBOHTBOH TFSBU PUPU NFOHFMJMJOHJLFMPQBLNBUBBUBTEBOEJTBSBGJPMFITBSBGTJNQBUJT0MFI
LBSFOB JUV LFSVTBLBO TFSBU TBSBG TJNQBUJT NFNCVBU LFMPQBL NBUB
SBEJBM JSJT EBO NFOJNCVMLBO EJMBUBTJ QVQJM ZBOH EJTFCVU
TVQFSJPS UJEBL CJTB EJCVLB TFCFTBS NBUB OPSNBM ,FUJHB QFNCVMVI
NJESJBTJT
EBSBIZBOHCFSIVCVOHBOEFOHBOTJTJNVLBEBOLFQBMBNFOKBEJUFUBQ
Refleks Cahaya Pupil+JLBNBUBEJTJOBSJPMFIDBIBZB QVQJM EBMBN LFBEBBO EJMBUBTJ ,FFNQBU UJEBL EBQBU CFSLFSJOHBU ZBOH
BLBO NFOHFDJM SFBLTJ JOJ EJTFCVU SFGMFLT DBIBZB QVQJM +BSBT NFNCVUVILBOTJOZBMTBSBGTJNQBUJT
QBEBTJTJNVLBEBOLFQBMBZBOH
TBSBG VOUVL SFGMFLT JOJ EJQFSMJIBULBO PMFI EVB QBOBI IJUBN UFSLFOBTJOESPN)PSOFS
QBEBCBHJBOBUBT(BNCBS#JMBDBIBZBNFOHFOBJSFUJOB
UFSKBEJ CFCFSBQB JNQVMT ZBOH NVMBNVMB CFSKBMBO NFMBMVJ
OFSWVT PQUJLVT NFOVKV OVLMFVT QSFUFLUBM %BSJ TJOJ JNQVMT
TFLVOEFS CFSKBMBO LF OVLMFVT &EJOHFS8FTUQIBM EBO BLIJSOZB Daftar Pustaka
LFNCBMJ NFMBMVJ TBSBG QBSBTJNQBUJT VOUVL NFOHPOTUSJLTJLBO Bridge H, Cumming BG: Representation of binocular surfaces by cortical
TGJOHUFS JSJT 4FCBMJLOZB EBMBN LFBEBBO HFMBQ SFGMFLT JOJ neurons, Curr Opin Neurobiol 18:425, 2008.
EJIBNCBUTFIJOHHBNFOHBLJCBULBOEJMBUBTJQVQJM Buttner-Ennever JA, Eberhorn A, Horn AK: Motor and sensory innervation of
extraocular eye muscles, Ann N Y Acad Sci 1004:40, 2003.
'VOHTJ SFGMFLT DBIBZB BEBMBI NFNCBOUV NBUB VOUVL Collewijn H, Kowler E: The significance of microsaccades for vision and
CFSBEBQUBTJ TFDBSB TBOHBU DFQBU UFSIBEBQ LFBEBBO QFSVCBIBO oculomotor control, J Vis 8:20, 1–21, 2008.
Crawford JD, Martinez-Trujillo JC, Klier EM: Neural control of three-dimen-
DBIBZB TFQFSUJ ZBOH EJKFMBTLBO QBEB #BC #BUBT EJBNFUFS
sional eye and head movements, Curr Opin Neurobiol 13:655, 2003. Derrington
QVQJM LJSBLJSB NN UFSLFDJM EBO NN UFSCFTBS 0MFI AM, Webb BS: Visual system: how is the retina wired up to the
LBSFOB JUV LBSFOB UFSBOH DBIBZB LF SFUJOB BLBO NFOJOHLBU cortex? Curr Biol 14:R14, 2004.
CFSCBOEJOH MVSVT EFOHBO CFTBSOZB EJBNFUFS QVQJM CBUBT Guyton DL: Ocular torsion reveals the mechanisms of cyclovertical strabis-
BEBQUBTJUFSBOHEBOHFMBQZBOHEBQBUEJUJNCVMLBOPMFISFGMFLT mus: the Weisenfeld lecture, Invest Ophthalmol Vis Sci 49:847, 2008. Hikosaka O,
Takikawa Y, Kawagoe R: Role of the basal ganglia in the control
QVQJM BEBMBI TFLJUBS TBNQBJ ZBJUV NFODBQBJ LBMJ
of purposive saccadic eye movements, Physiol Rev 80:953, 2000. Kandel ER,
QFSVCBIBOKVNMBIDBIBZBZBOHNFNBTVLJNBUB Schwartz JH, Jessell TM: Principles of Neural Science, ed 4,
New York, 2000, McGraw-Hill.
Kingdom FA: Perceiving light versus material, Vision Res 48:2090, 2008. Klier EM,
Angelaki DE: Spatial updating and the maintenance of visual con-
Refleks atau Reaksi Pupil pada Penyakit Sistem Saraf Pusat. stancy, Neuroscience 156:801, 2008.
#FCFSBQB QFOZBLJU TJTUFN TBSBG QVTBU NFSVTBL QFOHIBOUBSBO Krauzlis RJ: Recasting the smooth pursuit eye movement system,
TJOZBM TBSBG QFOHMJIBUBO EBSJ SFUJOB LF OVLMFVT &EJOHFS8FTUQIBM J Neurophysiol 91:591, 2004.
TFIJOHHB UFSLBEBOH NFOHIBNCBU SFGMFLT QVQJM )BNCBUBO ZBOH Luna B, Velanova K, Geier CF: Development of eye-movement control, Brain
EFNJLJBO NVOHLJO UFSKBEJ TFCBHBJ BLJCBU EBSJ TJGJMJT TJTUFN TBSBG Cogn 68:293, 2008.
Martinez-Conde S, Macknik SL, Hubel DH: The role of fixational eye move-
QVTBU QFNJOVN BMLPIPM FOTFGBMJUJT EBO TFCBHBJOZB )BNCBUBO
ments in visual perception, Nat Rev Neurosci 5:229, 2004.
CJBTBOZB UFSKBEJ EBMBN SFHJP QSFUFLUBM CBUBOH PUBL EBQBU KVHB Munoz DP, Everling S: Look away: the anti-saccade task and the voluntary
BLJCBULFSVTBLBOTFSBULFDJMEBMBNOFSWVTPQUJLVT control of eye movement, Nat Rev Neurosci 5:218, 2004.
4FCBHJBOCFTBSTFSBUTBSBGBLIJSEBMBNKBSBTZBOHNFMBMVJBSFB Nassi JJ, Callaway EM: Parallel processing strategies of the primate visual
QSFUFLUBM NFOVKV OVLMFVT &EJOHFS8FTUQIBM BEBMBI UJQF JOIJCJTJ system, Nat Rev Neurosci 10:360, 2009.
Parker AJ: Binocular depth perception and the cerebral cortex, Nat Rev
#JMB FGFL JOIJCJTJOZB IJMBOH OVLMFVT NFOKBEJ BLUJG TFDBSB LSPOJT
Neurosci 8:379, 2007.
NFOZFCBCLBOQVQJMTFCBHJBOUFUBQNFOZFNQJU TFCBHBJUBNCBIBO Peelen MV, Downing PE: The neural basis of visual body perception, Nat Rev
BEBLFHBHBMBOSFTQPOTUFSIBEBQDBIBZB Neurosci 8:636, 2007.
/BNVO QVQJM EBQBU CFSLPOTUSJLTJ MFCJI MBNB KJLB OVLMFVT Pelli DG: Crowding: a cortical constraint on object recognition, Curr Opin
&EJOHFS8FTUQIBM EJSBOHTBOH NFMBMVJ CFCFSBQB KBMBO MBJOOZB Neurobiol 18:445, 2008.
.JTBMOZB CJMB NBUB EJGJLTBTJ QBEB TVBUV PCKFL ZBOH EFLBU TJOZBM Pierrot-Deseilligny C, Milea D, Muri RM: Eye movement control by the
cerebral cortex, Curr Opin Neurol 17:17, 2004.
ZBOHNFOZFCBCLBOBLPNPEBTJMFOTBEBOKVHBZBOHNFOZFCBCLBO
Roe AW, Parker AJ, Born RT, et al: Disparity channels in early vision, J
LPOWFSHFOTJ LFEVB NBUB BLBO NFOJNCVMLBO QFOZFNQJUBO QVQJM Neurosci 27:11820, 2007.
EBMBN EFSBKBU ZBOH SJOHBO QBEB XBLUV ZBOH CFSTBNBBO *OJ Sharpe JA: Neurophysiology and neuroanatomy of smooth pursuit: lesion
EJTFCVUSFBLTJQVQJMVOUVLBLPNPEBTJ1VQJMZBOHHBHBMNFNCFSJ studies, Brain Cogn 68:241, 2008.
632
BAB 52
UNIT X
*OESB1FOEFOHBSBO
#BC JOJ NFOHHBNCBSLBO NBMFVT0MFILBSFOBJUV TJTUFNQFOHVOHLJUUVMBOHQFOEFOHBSBO

NFLBOJTNF UFMJOHB NFOFSJNB UJEBL NFNQFSCFTBS KBSBL QFSHFSBLBO TUBQFT TFQFSUJ ZBOH
HFMPNCBOH CVOZJ NFNCFEBLBO VNVNOZB EJZBLJOJ 4FCBMJLOZB TJTUFN UFSTFCVU TFCFOBSOZB
GSFLVFOTJOZB EBO NFOHJSJNLBO NFOHVSBOHJKBSBLUFUBQJNFOJOHLBULBOUFOBHBHFSBLTFLJUBS
JOGPSNBTJQFOEFOHBSBOLFTJTUFN LBMJOZB 4FMBJO JUV MVBT EBFSBI QFSNVLBBO NFNCSBO UJNQBOJ
TBSBGQVTBU UFNQBUVOUVLNFOB BEBMBI TFLJUBS NSO TFEBOHLBO MVBT EBFSBI QFSNVLBBO
GTJSBSUJOZB TUBQFTSBUBSBUB NN3BTJPQFSCFEBBOZBOHLBMJMJQBUJOJ
EJLBMJ EFOHBO SBTJP LBMJ EBSJ TJTUFN QFOHVOHLJU
Membran Timpani dan Sistem Tutang NFOHIBTJMLBO QFOFLBOBO UPUBM TFLJUBS LBMJ MJQBU UFSIBEBQ
Pendengaran DBJSBO LPLMFB TFQFSUJ QFOFLBOBO PMFI HFMPNCBOH CVOZJ
UFSIBEBQ NFNCSBO UJNQBOJ 0MFI LBSFOB DBJSBO NFNQVOZBJ
Konduksi Bunyi dari Membran Timpani ke Koklea JOFSTJB ZBOH KBVI MFCJI CFTBS EBSJQBEB VEBSB QFOJOHLBUBO
KVNMBI UFLBOBO EJQFSMVLBO VOUVL NFOJNCVMLBO HFUBSBO QBEB
(BNCBS NFOHHBNCBSLBO NFNCSBO UJNQBOJ VNVNZB
DBJSBO 0MFI LBSFOB JUV NFNCSBO UJNQBOJ EBO TJTUFN UVMBOH
EJTFCVU HFOEBOH UFMJOHB
EBO UVMBOHUVMBOH QFOEFOHBSBO ZBOH
QFOEFOHBSBO NFNCFSJLBO LFTFTVBJBO JNQFEBOTJ JNQFEBODF
NFOHIBOUBSLBO CVOZJ EBSJ NFNCSBO UJNQBOJ NFMFXBUJ UFMJOHB
NBUDIJOH
BOUBSB HFMPNCBOHCVOZJ EJ VEBSB EBO HFUBSBO CVOZJ
UFOHBI LF LPLMFB UFMJOHB EBMBN
.FMFLBU QBEB NFNCSBO
EJ EBMBN DBJSBO LPLMFB 4FTVOHHVIOZB LFTFTVBJBO JNQFEBOTJ
UJNQBOJ BEBMBI UBOHLBJ EBSJ NBMFVT .BMFVT UFSJLBU QBEB JOLVT
BEBMBI TFLJUBS TBNQBJ QFSTFO EBSJ TFNQVSOB VOUVL
PMFI MJHBNFO ZBOH LFDJM TFIJOHHB QBEB TBBU NBMFVT CFSHFSBL
GSFLVFOTJCVOZJBOUBSBEBOTJLMVTQFSEFUJL TFIJOHHB
JOLVT JLVU CFSHFSBL 6KVOH CFSMBXBOBO EBSJ JOLVT CFSBSUJLVMBTJ
IBNQJS TFNVB FOFSHJ EJHVOBLBO VOUVL HFMPNCBOH CVOZJ ZBOH
EFOHBO CBUBOH TUBQFT EBO CJEBOH EFQBO TUBQFT UFSMFUBL
EBUBOH
CFSIBEBQBO EFOHBO NFNCSBO MBCJSJO LPLMFB EJ NVBSBGFOFTUSB
PWBMJT 5BOQB TJTUFN UVMBOH QFOEFOHBSBO EBO NFNCSBO UJNQBOJ
HFMPNCBOHCVOZJUFUBQEBQBUCFSHFSBLMBOHTVOHNFMBMVJVEBSB
6KVOH UBOHLBJ NBMFVT NFMFLBU EJ CBHJBO UFOHBI NFNCSBO
EJ UFMJOHB UFOHBI EBO NBTVL LF LPLMFB NFMBMVJ GFOFTUSB PWBMJT
UJNQBOJ EBO UFNQBU QFMFLBUBO JOJ TFDBSB LPOTUBO BLBO UFSUBSJL
/BNVO TFOTJUJWJUBTQFOEFOHBSBOLFNVEJBONFOKBEJIJOHHB
PMFI NVTLVMVT UFOTPS UJNQBOJ ZBOH NFOZFCBCLBO NFNCSBO
EFTJCFMMFCJISFOEBIEBSJQBEBQFOHIBOUBSBONFMBMVJUVMBOH
UJNQBOJUFUBQUFHBOH*OJNFNVOHLJOLBOHFUBSBOEJTFUJBQCBHJBO
NFNCSBO UJNQBOJ EJLJSJN LF UVMBOHUVMBOH QFOEFOHBSBO ZBOH
UJEBLBLBOUFSKBEJCJMBNFNCSBOUFSTFCVUMPOHHBS
5VMBOHUVMBOH QFOEFOHBSBO UFMJOHB UFOHBI EJUVOKBOH PMFI
MJHBNFOMJHBNFO TFEFNJLJBO SVQB TFIJOHHB HBCVOHBO NBMFVT
EBO JOLVT CFLFSKB TFCBHBJ QFOHVOHLJU UVOHHBM EFOHBO GVMLSVN
UFSMFUBLLJSBLJSBEJQFSCBUBTBONFNCSBOUJNQBOJ
"SUJLVMBTJ JOLVT EFOHBO TUBQFT NFOZFCBCLBO TUBQFT
NFOEPSPOH GFOFTUSB PWBMJT LF EFQBO EBO EJ TJTJ MBJO KVHB
NFOEPSPOH DBJSBO LPLMFB LF EFQBO TFUJBQ TBBU NFNCSBO
UJNQBOJ CFSHFSBL LF EBMBN EBO TFUJBQ NBMFVT CFSHFSBL LFMVBS
BLBONFOBSJLDBJSBOLFCFMBLBOH
"Kesesuaian Impedansi" oleh Sistem Tulang

Pendengaran."NQMJUVEPHFSBLBOCJEBOHEFQBOTUBQFTEJTFUJBQ
HFUBSBOCVOZJ IBOZBUJHBQFSFNQBUEBSJBNQMJUVEPUBOHLBJ
633
QFOEFOHBSBO TFUBSB EFOHBO QFOVSVOBO UJOHLBU CVOZJ EBSJ TFMVSVI UVMBOH UFOHLPSBL EBQBU NFOZFCBCLBO HFUBSBO DBJSBO
TFEBOHTBNQBJIBNQJSUJEBLUFSEFOHBS EBMBN LPLMFB 0MFI LBSFOB JUV QBEB LPOEJTJ ZBOH TFTVBJ HBSQV
UBMB BUBV QFOHHFUBS FMFLUSPOJL ZBOH EJMFUBLLBO QBEB UJBQ
Penguatan Bunyi melalui Kontraksi Muskulus Tensor QSPUVCFSBOTJB UVMBOH UFOHLPSBL UFUBQJ UFSVUBNB QBEB QSPTFTVT
Timpani dan Muskulus Stapedius. ,FUJLB CVOZJ ZBOH LFSBT NBTUPJEFVT NFOZFCBCLBO TFTFPSBOH NFOEFOHBS CVOZJ UFSTFCVU
EJUSBOTNJTJLBO NFMBMVJ TJTUFN UVMBOH QFOEFOHBSBO EBO EBSJ /BNVO FOFSHJ ZBOH UFSTFEJB CBILBO QBEB CVOZJ ZBOH LFSBT EJ
UFNQBU JOJ LF TJTUFN TBSBG QVTBU TFUFMBI QFSJPEF MBUFO ZBOH VEBSB UJEBL DVLVQ VOUVL NFOJNCVMLBO QFOEFOHBSBO NFMBMVJ
IBOZB TFMBNB TBNQBJ NJMJEFUJL UJNCVM SFGMFLT ZBOH LPOEVLTJ UVMBOH LFDVBMJ CJMB BMBU QFOHVBUCVOZJ FMFLUSPNFLBOJL
NFOZFCBCLBO LPOUSBLTJ NVTLVMVT TUBQFEJVT EBO TFEJLJU MFCJI LIVTVTEJMFUBLLBOQBEBUVMBOH
MFNBI NVTLVMVT UFOTPS UJNQBOJ .VTLVMVT UFOTPS UJNQBOJ
NFOBSJL UBOHLBJ NBMFVT LF BSBI EBMBN TFEBOHLBO NVTLVMVT Koklea
TUBQFEJVT NFOBSJL TUBQFT LFMVBS %VB UFOBHB JOJ TBMJOH
CFSMBXBOBO TFIJOHHB NFOZFCBCLBO TFMVSVI TJTUFN UVMBOH Anatomi Fungsional Koklea
QFOEFOHBSBO NFOJOHLBULBO LFLBLVBOOZB EFOHBO EFNJLJBO
,PLMFB BEBMBI TVBUV TJTUFN TBMVSBO ZBOH NFMJOHLBSMJOHLBS
TBOHBU NFOHVSBOHJ LPOEVLTJ UVMBOH QFOEFOHBSBO QBEB CVOZJ
EJQFSMJIBULBOQBEB (BNCBSEBOEBMBNQPUPOHBONFMJOUBOH
CFSGSFLVFOTJ SFOEBI UFSVUBNB GSFLVFOTJ EJ CBXBI TJLMVT
QBEB (BNCBS EBO ,PLMFB UFSEJSJ BUBT UJHB TBMVSBO
QFSEFUJL
NFMJOHLBS ZBOH TBMJOH CFSTFCFMBIBO
TLBMB WFTUJCVMJ
TLBMB
3FGMFLTQFSFEBNBOJOJEBQBUNFOHVSBOHJJOUFOTJUBTUSBOTNJTJ NFEJB EBO
TLBMB UJNQBOJ 4LBMB WFTUJCVMJ EBO TLBMB NFEJB
CVOZJCFSGSFLVFOTJSFOEBITFCBOZBLTBNQBJEFTJCFM ZBOH EJQJTBILBOTBUVTBNBMBJOPMFINFNCSBO3FJTTOFS EJTFCVUKVHB
MFCJILVSBOHTFQFSUJQFSCFEBBOBOUBSBCVOZJLFSBTEBOCJTJLBO
'VOHTJNFLBOJTNFJOJEJEVHBSBOHLBQ
1. 6OUVLNFMJOEVOHJLPLMFBEBSJHFUBSBONFSVTBLZBOH
EJTFCBCLBOPMFICVOZJZBOHTBOHBULFSBT
2. 6OUVLNFOVUVQJCVOZJCFSGSFLVFOTJSFOEBIQBEBMJOHLVOHBO
ZBOHHBEVI*OJCJBTBOZBNFOHIJMBOHLBOTFCBHJBOCFTBSMBUBS
CFMBLBOHLFHBEVIBO TFIJOHHBTFTFPSBOHEBQBUCFSLPOTFOUSBTJ
QBEB CVOZJ EJ BUBT TJLMVT QFS EFUJL UFNQBU TFCBHJBO
CFTBS JOGPSNBTJ ZBOH CFSIVCVOHBO EBMBN LPNVOJLBTJ CVOZJ
EJIBOUBSLBO
'VOHTJ MBJO NVTLVMVT UFOTPS UJNQBOJ EBO TUBQFEJVT BEBMBI
NFOVSVOLBO TFOTJUJWJUBT QFOEFOHBSBO TFTFPSBOH UFSIBEBQ
QFNCJDBSBBOOZB TFOEJSJ 1FOHBSVI JOJ EJBLUJWBTJ PMFI TJOZBM
TJOZBM TBSBG LPMBUFSBM ZBOH EJIBOUBSLBO LF PUPUPUPU UFSTFCVU
CFSTBNBBOEFOHBOTBBUPUBLNFOHBLUJWBTJNFLBOJTNFCVOZJ
Transmisi Bunyi atau Suara melalui Tulang

0MFI LBSFOB UFMJOHB EBMBN LPLMFB UFSUBOBN QBEB SPOHHB EJ
EBMBNUVMBOHUFNQPSBMJTZBOHEJTFCVUMBCJSJOUVMBOH HFUBSBOEJ
634
Bab 52 Indra Pendengaran
"LBO UFUBQJ EJBNFUFS TFSBUNFOVSVO EBSJ GFOFTUSB PWBMJT LF

IFMJLPUSFNB TFIJOHHB TFDBSB LFTFMVSVIBO LFLBLVBO BLBO
NFOVSVOIJOHHBMFCJIEBSJLBMJMJQBU"LJCBUOZB TFSBUZBOH
LBLV EBO QFOEFL EJ EFLBU GFOFTUSB PWBMJT LPLMFB CFSHFUBS
UFSCBJL QBEB GSFLVFOTJ UJOHHJ TFEBOHLBO TFSBU ZBOH QBOKBOH
UNIT X
EBO MFOUVS EJ EFLBU VKVOH LPLMFB CFSHFUBS UFSCBJL QBEB
GSFLVFOTJSFOEBI
+BEJ SFTPOBOTJ GSFLVFOTJ UJOHHJ NFNCSBO CBTJMBS UFSKBEJ EJ
EFLBUCBTJT UFNQBUHFMPNCBOHCVOZJNFNBTVLJLPLMFBNFMBMVJ
GFOFTUSB PWBMJT /BNVO SFTPOBOTJ GSFLVFOTJ SFOEBI UFSKBEJ EJ
EFLBU IFMJLPUSFNB UFSVUBNB LBSFOB TFSBU ZBOH LVSBOH LBLV
NFNCSBO WFTUJCVMBS
ZBOH EJQFSMJIBULBO QBEB (BNCBS UFUBQJ KVHB LBSFOB QFOJOHLBUBO QFOHJTJBO NBTTB DBJSBO
TLBMB UJNQBOJ EBO TLBMB NFEJB EJQJTBILBO TBUV TBNB MBJO PMFI UBNCBIBOZBOHIBSVTCFSHFUBSEJTFQBOKBOHUVCVMVTLPLMFB
NFNCSBO CBTJMBS 1BEB QFSNVLBBO NFNCSBO CBTJMBS UFSMFUBL
PSHBO $PSUJ ZBOH NFOHBOEVOH TFSBOHLBJBO TFM ZBOH TFOTJUJG Transmisi Gelombang Bunyi di dalam Koklea
TFDBSBFMFLUSPNFLBOJL ZBJUVTFMTFMSBNCVU4FMTFMJOJNFSVQBLBO "Gelombang Berjalan"
PSHBO BLIJS SFTFQUJG ZBOH NFNCBOHLJULBO JNQVMT TBSBG TFCBHBJ
SFTQPOTUFSIBEBQHFUBSBOCVOZJ +JLBLBLJTUBQFTCFSHFSBLLFEBMBNNFOHIBEBQGFOFTUSBPWBMJT
GFOFTUSB SPUVOEVN IBSVT NFOPOKPM LF MVBS LBSFOB TFNVB TJTJ
(BNCBS NFOHHBNCBSLBO CBHJBO GVOHTJPOBM LPLMFB LPLMFB EJLFMJMJOHJ PMFI EJOEJOH ZBOH CFSUVMBOH &GFL BXBM
ZBOH UJEBL NFMJOHLBS VOUVL LPOEVLTJ HFUBSBO CVOZJ 1FSUBNB HFMPNCBOH CVOZJ ZBOH NBTVL GFOFTUSB PWBMJT BEBMBI
QFSIBUJLBOCBIXBNFNCSBO3FJTTOFSNFOHIJMBOHEBSJ (BNCBS NFOZFCBCLBONFNCSBOCBTJMBSQBEBCBTJTLPLMFBNFOFLVLLF
JOJ .FNCSBO JOJ CFHJUV IBMVT EBO CFHJUV NVEBI CFSHFSBL BSBI GFOFTUSB SPUVOEVN /BNVO UFHBOHBO FMBTUJT ZBOH
TFIJOHHB TBNB TFLBMJ UJEBL NFOHIBMBOHJ KBMBOOZB HFUBSBO CVOZJ UFSCFOUVL EBMBN TFSBU CBTJMBS QBEB XBLUV TFSBU NFOFLVL LF
EBSJ TLBMB WFTUJCVMJ LF EBMBN TLBMB NFEJB 0MFI LBSFOB JUV BSBI GFOFTUSB SPUVOEVN NFODFUVTLBO HFMPNCBOH DBJSBO ZBOH
TFQBOKBOH NFOZBOHLVU LPOEVLTJ CVOZJ NFMBMVJ DBJSBO TLBMB CFSKBMBO EJ TFQBOKBOH NFNCSBO CBTJMBS LF BSBI IFMJLPUSFNB
WFTUJCVMJ EBO TLBMB NFEJB EJBOHHBQ TFCBHBJ SVBOH UVOHHBM TFQFSUJ ZBOH EJQFSMJIBULBO QBEB (BNCBS (BNCBS
.BLOB ZBOH QFOUJOH EBSJ NFNCSBO 3FJTTOFS BEBMBI VOUVL "NFNQFSMJIBULBOHFSBLBOHFMPNCBOHCFSGSFLVFOTJUJOHHJ
NFNQFSUBIBOLBO DBJSBO LIVTVT EBMBN TLBMB NFEJB ZBOH TFQBOKBOH NFNCSBO CBTJMBS (BNCBS # HFMPNCBOH
EJCVUVILBO VOUVL GVOHTJ OPSNBM TFM SBNCVU QFOFSJNBCVOZJ CFSGSFLVFOTJ TFEBOH EBO (BNCBS $ HFMPNCBOH
TFQFSUJZBOHBLBOEJCBIBTLFNVEJBO
CFSGSFLVFOTJ TBOHBU SFOEBI 1FSHFSBLBO HFMPNCBOH EJ
(FUBSBO CVOZJ NFNBTVLJ TLBMB WFTUJCVMJ EBSJ CJEBOH EFQBO TFQBOKBOH NFNCSBO CBTJMBS TFCBOEJOH EFOHBO QFSHFSBLBO
TUBQFTQBEBGFOFTUSBPWBMJT#JEBOHEFQBOBLBONFOVUVQJGFOFTUSB HFMPNCBOH UFLBOBO EJ TFQBOKBOH EJOEJOH BSUFSJ ZBOH UFMBI
JOJ EBO EJIVCVOHLBO EFOHBO UFQJ GFOFTUSB PMFI MJHBNFOUVN EJEJTLVTJLBO QBEB #BC BUBV KVHB TFCBOEJOH EFOHBO
BOVMBSJTZBOHMPOHHBS TFIJOHHBGFOFTUSBEBQBUCFSHFSBLLFEBMBN HFMPNCBOHZBOHCFSKBMBOEJTFQBOKBOHQFSNVLBBOLPMBN
EBO LFMVBS CFSTBNB HFUBSBO CVOZJ 1FSHFSBLBO LF EBMBN
NFOZFCBCLBODBJSBOCFSHFSBLLFEBMBNTLBMBWFTUJCVMJEBOTLBMB Pola Getaran Membran Basilar di Berbagai Frekuensi
NFEJB EBO QFSHFSBLBO LFMVBS NFOZFCBCLBO DBJSBO CFSHFSBL LF Bunyi.1FSIBUJLBOQBEB (BNCBS UFSEBQBUQFSCFEBBO
BSBITFCBMJLOZB QPMB
Membran Basilar dan Resonansi di Dalam Koklea.

.FNCSBO CBTJMBS BEBMBI NFNCSBO GJCSPTB ZBOH NFNJTBILBO
TLBMB NFEJB EBO TLBMB UJNQBOJ .FNCSBO CBTJMBS NFOHBOEVOH
A
TBNQBJTFSBUCBTJMBSZBOHLFMVBSEBSJTVNCVUVMBOH
EJLPLMFB ZBJUVNPEJPMVT NFOVKVLFEJOEJOHMVBS4FSBUJOJLBLV
FMBTUJT CFSTUSVLUVS TFQFSUJ CVMVI ZBOH UFSGJLTBTJ QBEB VKVOH
CBTBMOZBEJTUSVLUVSTVNCVUVMBOHLPLMFB NPEJPMVT
UFUBQJUJEBL
QBEB VKVOH EJTUBMOZB LFDVBMJ CJMB VKVOH EJTUBM UFSUBOBN EBMBN
NFNCSBO CBTJMBS ZBOH MPOHHBS 0MFI LBSFOB TFSBU JOJ LBLV EBO
QBEB TBMBI TBUV VKVOHOZB CFCBT NBLB EBQBU CFSHFUBS TFQFSUJ B
CVMVIIBSNPOJLB
1BOKBOH TFSBU CBTJMBS NFOJOHLBU TFDBSB QSPHSFTJG NVMBJ EBSJ
GFOFTUSB PWBMJT EBO EBSJ CBTJT LPLMFB NFOVKV LF BQFLT EBSJ
QBOKBOH TFLJUBS NN EJ EFLBU GFOFTUSB PWBMJT EBO SPUVOEVN
NFOJOHLBU NFOKBEJ NN QBEB VKVOH LPLMFB IFMJLPUSFNB
C
ZBLOJQFOJOHLBUBOQBOKBOHIJOHHBLBMJMJQBU
635
Unit X Sistem Saraf.• B. lndra Khusus
USBOTNJTJ VOUVL HFMPNCBOH CVOZJ EFOHBO GSFLVFOTJ ZBOH OFUSBM D

TFEBOHCFSHFSBLLFMVBS EBO E
UFMBICFSHFSBLLFNCBMJ
CFSCFEB 4FUJBQ HFMPNCBOH SFMBUJG MFNBI QBEB QFSNVMBBO UJUJLOFUSBMUFUBQJTFEBOHCFSHFSBLLFEBMBN%BFSBICBZBOHBOEJ
UFUBQJ NFOKBEJ LVBU LFUJLB NFODBQBJ CBHJBO NFNCSBO CBTJMBS TFLFMJMJOHHFMPNCBOHZBOHCFSCFEBJOJNFOHHBNCBSLBOQFSMVBTBO
ZBOH NFNQVOZBJ LFTFJNCBOHBO SFTPOBOTJ GSFLVFOTJ BMBNJ HFUBSBONFNCSBOCBTJMBSTFMBNBTJLMVTHFUBSBOMFOHLBQ*OJBEBMBI
UFSIBEBQ NBTJOHNBTJOH GSFLVFOTJ CVOZJ 1BEB UJUJL JOJ QPMB BNQMJMVEP HFUBSBO NFNCSBO CBTJMBS VOUVL GSFLVFOTJ CVOZJ
NFNCSBO CBTJMBS EBQBU CFSHFUBS LF CFMBLBOH EBO LF EFQBO UFSUFOUV
EFOHBO NVEBI TFIJOHHB FOFSHJ EBMBN HFMPNCBOH
(BNCBS # NFNQFSMJIBULBO QPMB BNQMJUVEP HFUBSBO
EJIBNCVSLBO "LJCBUOZB HFMPNCBOH BLBO CFSIFOUJ QBEB UJUJL VOUVL GSFLVFOTJ ZBOH CFSCFEB NFOVOKVLLBO CBIXB BNQMJUVEP
JOJ EBO HBHBM VOUVL NFOKBMBOJ KBSBL NFNCSBO CBTJMBS ZBOH NBLTJNVN VOUVL CVOZJ TJLMVT QFS EFUJL UFSKBEJ EFLBU
UFSTJTB+BEJ HFMPNCBOHCVOZJGSFLVFOTJUJOHHJIBOZBNFOKBMBOJ EFOHBOCBTJTLPLMFB TFEBOHLBOVOUVLGSFLVFOTJZBOHLVSBOHEBSJ
KBSBL QFOEFL EJ NFNCSBO CBTJMBS TFCFMVN HFMPNCBOH JOJ TJLMVT QFS EFUJL UFSEBQBU EJ TFQBOKBOH KBMVS QBEB VKVOH
NFODBQBJ UJUJL SFTPOBOTJOZB EBO NFOHIJMBOH HFMPNCBOH NFNCSBOCBTJMBSEFLBUEFOHBOIFMJLPUSFNB UFNQBUTLBMBWFTUJCVMJ
CVOZJ GSFLVFOTJ TFEBOH CFSKBMBO TFLJUBS TFUFOHBI QFSKBMBOBO NFNCVLBLFEBMBNTLBMBUJNQBOJ
EBO LFNVEJBO NFOHIJMBOH EBO HFMPNCBOH CVOZJ GSFLVFOTJ
TBOHBUSFOEBICFSKBMBOEJTFQBOKBOHNFNCSBOCBTJMBS .FUPEFVUBNBVOUVLNFNCFEBLBOGSFLVFOTJCVOZJBOUBSBTBUV
EFOHBO ZBOH MBJO EJEBTBSLBO QBEB UFNQBU QFSBOHTBOHBO
(BNCBSBO MBJO EBSJ HFMPNCBOH CFSKBMBO BEBMBI CBIXB NBLTJNVNTFSBUTBSBGZBOHCFSBTBMEBSJPSHBO$PSUJZBOHUFSMFUBL
HFMPNCBOH UFSTFCVU CFSKBMBO DFQBU EJ TFQBOKBOH CBHJBO BXBM QBEB NFNCSBO CBTJMBS TFQFSUJ ZBOH BLBO EJKFMBTLBO QBEB CBHJBO
NFNCSBO CBTJMBS UFUBQJ TFDBSB QSPHSFTJG NFMBNCBU CJMB CFSJLVUJOJ
QFSKBMBOBONBLJOKBVILFEBMBNLPLMFB1FOZFCBCQFSJTUJXBJOJ
BEBMBI LPFGJTJFO FMBTUJTJUBT ZBOH UJOHHJ EBSJ TFSBU CBTJMBS ZBOH
EFLBU EFOHBO GFOFTUSB PWBMJT EBO LPFGJTJFO TFDBSB QSPHSFTJG Fungsi Organ Corti
BLBO NFOVSVO CJMB TFNBLJO KBVI EBSJ NFNCSBO 5SBOTNJTJ 0SHBO $PSUJ ZBOH EJQFSMJIBULBO QBEB (BNCBS EBO
HFMPNCBOH BXBM ZBOH DFQBU JOJ NFNVOHLJOLBO CVOZJ BEBMBI PSHBO SFTFQUPS ZBOH NFNCBOHLJULBO JNQVMT TBSBG TFCBHBJ
CFSGSFLVFOTJUJOHHJCFSKBMBODVLVQKBVILFEBMBNLPLMFBVOUVL SFTQPOT UFSIBEBQ HFUBSBO NFNCSBO CBTJMBS 1FSIBUJLBO CBIXB
LFNVEJBO NFOZFCBS EBO CFSQJTBI TBUV TBNB MBJO QBEB PSHBO $PSUJ UFSMFUBL QBEB QFSNVLBBO TFSBU CBTJMBS EBO NFNCSBO
NFNCSBO CBTJMBS 5BOQB QFOZFCBSBO JOJ TFNVB HFMPNCBOH CBTJMBS 3FTFQUPS TFOTPSJL ZBOH TFCFOBSOZB EJ EBMBN PSHBO $PSUJ
GSFLVFOTJ UJOHHJ BLBO CFSLVNQVM NFOKBEJ TBUV EJ NFNCSBO BEBMBIEVBUJQFTFMTBSBGZBOHLIVTVT ZBOHEJTFCVUTFMSBNCVUCBSJT
CBTJMBS EBMBN CFCFSBQB NJMJNFUFS QFSUBNB BUBV MFCJI EBO UVOHHBMTFMSBNCVUJOUFSOB BUBVEBMBN
CFSKVNMBITFLJUBS
GSFLVFOTJOZBUJEBLEBQBUEJCFEBLBOTBUVEFOHBOMBJOOZB EFOHBO EJBNFUFS ZBOH CFSVLVSBO TFLJUBS HN EBO UJHB TBNQBJ
FNQBU CBSJT TFM SBNCVU FLTUFSOB BUBV MVBS
CFSKVNMBI TFLJUBS
Pola Amplitudo Getaran Membran Basilar.,VSWBEFOHBO EBONFNQVOZBJEJBNFUFSIBOZBTFLJUBSHN#BHJBOEBTBS
HBSJT UFSQVUVTQVUVT QBEB (BNCBS " NFNQFSMJIBULBO EBO TBNQJOH TFM SBNCVU CFSTJOBQT EFOHBO KBSJOHBO VKVOH OFSWVT
QPTJTJHFMPNCBOHCVOZJQBEBNFNCSBOCBTJMBSLFUJLBTUBQFT B
LPLMFBSJT4FLJUBSTBNQBJQFSTFOVKVOHJOJCFSBLIJSEJTFMTFM
TFEBOHCFSHFSBLLFEBMBN C
UFMBICFSHFSBLLFNCBMJLFUJUJL SBNCVU EBMBN ZBOH NFNQFSLVBU QFSBO LIVTVT TFM JOJ EBMBN
NFOEFUFLTJCVOZJ
b 4FSBU TBSBG ZBOH EJSBOHTBOH PMFI TFM SBNCVU NFOVKV HBOHMJPO
a TQJSBMJT$PSUJ ZBOHUFSMFUBLEJNPEJPMVT QVTBU
LPLMFB4FMOFVSPO
c HBOHMJPOTQJSBMJTNFOHJSJNLBOBLTPOTFMVSVIOZBTFLJUBSLF
OFSWVTLPLMFBSJTLFNVEJBOLFTJTUFNTBSBGQVTBUEJUJOHLBU
d
A
8000 4000 2000 1000 600 400 200
0 5 10 15 20 25 30 35
B
636
NFEVMB TQJOBMJT CBHJBO BUBT )VCVOHBO PSHBO $PSUJ EFOHBO SFTFQUPS 6OUVL NFOEVLVOH LPOTFQ JOJ TFKVNMBI CFTBS TFSBU
HBOHMJPOTQJSBMJTEBOEFOHBOOFSWVTLPLMFBSJTEJQFSMJIBULBOQBEB TBSBG CFSKBMBO SFUSPHSBE EBSJ CBUBOH PUBL LF TFLJUBS TFMTFM
(BNCBS SBNCVU MVBS 1FSBOHTBOHBO TFSBU TBSBG JOJ TFCFOBSOZB EBQBU
NFOZFCBCLBOQFNFOEFLBOTFMSBNCVUMVBSEBONVOHLJOKVHB
Eksitasi Sel Rambut. 1FSIBUJLBOQBEB (BNCBS CBIXB NFOHVCBIEFSBKBULFLBLVBOOZB&GFLJOJNFOVOKVLLBOCBIXB
UNIT X
SBNCVU IBMVT BUBV TUFSFPTJMJB NFOPOKPM LF BUBT EBSJ TFMTFM NFLBOJTNFTBSBGSFUSPHSBEVOUVLNFOHBUVSTFOTJUJWJUBTUFMJOHB
SBNCVU EBO NFOZFOUVI BUBV UFSUBOBN QBEB QFSNVLBBO MBQJTBO EJ CFSCBHBJ UJOHHJSFOEBI CVOZJ EJBLUJWBTJ NFMBMVJ TFMTFM
HFMNFNCSBOUFLUPSJBM ZBOHUFSMFUBLEJBUBTTUFSFPTJMJBEBMBNTLBMB SBNCVUMVBS
NFEJB 4FMTFM SBNCVU JOJ TBNB EFOHBO TFMTFM SBNCVU ZBOH
EJUFNVLBO EBMBN NBLVMB EBO LSJTUB BNQVMBSJT QBEB BQBSBUVT Potensial Reseptor Sel Rambut dan Eksitasi Serat
WFTUJCVMBS ZBOH BLBO EJCJDBSBLBO EBMBN #BC 1FNCFMPLBO Saraf Auditorik. 4UFSFPTJMJB SBNCVU ZBOH NFOPOKPM EBSJ
SBNCVUSBNCVULFTBUVBSBIBLBONFOEFQPMBSJTBTJTFMTFMSBNCVU VKVOHVKVOHTFMSBNCVU
NFSVQBLBOTUSVLUVSZBOHLBLVLBSFOB
EBO QFNCFMPLBO LF BSBI ZBOH CFSMBXBOBO NFOZFCBCLBO TFUJBQTUFSFPTJMJBJOJNFNJMJLJKBSJOHBOQSPUFJOZBOHLBLV4FUJBQ
IJQFSQPMBSJTBTJ TFM SBNCVU JOJ ,FBEBBO JOJ TFMBOKVUOZB BLBO TFMSBNCVUNFNJMJLJTFLJUBSTUFSFPTJMJBQBEBUFQJBQJLBMOZB
NFOHFLTJUBTJTFSBUTBSBGZBOHCFSTJOBQTEFOHBOEBTBSOZB 4UFSFPTJMJB JOJ NFOKBEJ TFNBLJO QBOKBOH QBEB TJTJ TFM SBNCVU
ZBOH NFOKBVIJ NPEJPMVT EBO VKVOHVKVOH TUFSFPTJMJB ZBOH
(BNCBSNFOHHBNCBSLBONFLBOJTNFHFUBSBONFNCSBO
QFOEFL BLBO EJMFLBULBO PMFI GJMBNFO UJQJT LF TJTJ CFMBLBOH
CBTJMBS ZBOH NFOHFLTJUBTJ VKVOH SBNCVU 6KVOH MVBS TFMTFM
TUFSFPTJMJB EJ EFLBUOZB ZBOH MFCJI QBOKBOH 0MFI LBSFOB JUV
SBNCVU UFSGJLTBTJ TFDBSB FSBU EBMBN TUSVLUVS ZBOH LBLV ZBOH
TFUJBQ TJMJB NFNCFMPL LF BSBI TJMJB ZBOH MFCJI QBOKBOH VKVOH
UFSEJSJ BUBT MFNQFOH EBUBS ZBOH EJTFCVU MBNJOB SFUJLVMBSJT EBO
TUFSFPTJMJBZBOHMFCJILFDJMBLBOUFSUBSJLLFMVBSEBSJQFSNVLBBO
EJUVOKBOH PMFI CBUBOH $PSUJ TFHJUJHB ZBOH NFMFLBU EFOHBO FSBU
TFM SBNCVU )BM JOJ NFOZFCBCLBO NFLBOJTNF USBOTEVLTJ ZBOH
QBEBTFSBUCBTJMBS0MFILBSFOBJUV TFSBUCBTJMBS CBUBOH$PSUJ EBO
NFNCVLB TBNQBJ LBOBM QFOHIBOUBS LBUJPO ZBOH
MBNJOBSFUJLVMBSJTCFSHFSBLTFCBHBJVOJUZBOHLBLV
NFNVOHLJOLBO JPO LBMJVN ZBOH CFSNVBUBO QPTJUJG CFSHFSBL
1FSHFSBLBOTFSBUCBTJMBSLFBUBTNFOHHVODBOHMBNJOBSFUJLVMBSJT EFOHBO DFQBU EBSJ DBJSBO TLBMB NFEJB NBTVL LF TUFSFPTJMJB
LF BUBT EBO LF EBMBN LF BSBI NPEJPMVT ,FNVEJBO LFUJLB TFIJOHHBNFOZFCBCLBOEFQPMBSJTBTJQBEBNFNCSBOTFMSBNCVU
NFNCSBO CBTJMBS CFSHFSBL LF CBXBI MBNJOB SFUJLVMBSJT BLBO
+BEJ CJMBTFSBUCBTJMBSCFSCFMPLLFBSBITLBMBWFTUJCVMJ TFMTFM
UFSHVODBOH LF CBXBI EBO LF MVBS (FSBLBO LF EBMBN EBO LF MVBS
SBNCVUBLBOCFSEFQPMBSJTBTJ EBOEBMBNBSBIZBOHCFSMBXBOBO
NFOZFCBCLBOSBNCVUSBNCVUTFMSBNCVUNFNFOEFLLFEFQBOEBO
BLBO NFOHBMBNJ IJQFSQPMBSJTBTJ EFOHBO NFOJNCVMLBO
CFMBLBOH UFSIBEBQ NFNCSBO UFLUPSJBM +BEJ TFMTFM SBNCVU BLBO
QPUFOTJBM SFTFQUPS TFM SBNCVU CPMBLCBMJL )BM JOJ LFNVEJBO
UFSFLTJUBTJTFUJBQNFNCSBOCBTJMBSCFSHFUBS
NFSBOHTBOH VKVOHVKVOH TBSBG LPLMFB ZBOH CFSTJOBQT EFOHBO
EBTBS TFMTFM SBNCVU %JEVHB CBIXB OFVSPUSBOTNJUFS LFSKB
Sinyal Auditorik Terutama Dihantarkan oleh Sel-Sel DFQBU BLBO EJMFQBTLBO PMFI TFMTFM SBNCVU QBEB TJOBQT
Rambut Bagian Dalam. 8BMBVQVO TFMTFM SBNCVU CBHJBO MVBS TJOBQTOZB TFMBNB EFQPMBSJTBTJ ,FNVOHLJOBO TVCTUBOTJ [BU
UFSEBQBU MFCJI CBOZBL UJHB TBNQBJ FNQBU LBMJ EBSJQBEB TFMTFM USBOTNJUFSUFSTFCVUBEBMBIHMVUBNBU UFUBQJIBMJOJUJEBLQBTUJ
SBNCVU CBHJBO EBMBN UFUBQJ LVSBOH MFCJI QFSTFO TFSBU TBSBG
BVEJUPSJL EJSBOHTBOH PMFI TFMTFM CBHJBO EBMBN CVLBO TFMTFM
Potensial Endokoklea. 6OUVL NFOKFMBTLBO TFDBSB MFCJI
CBHJBO MVBS .FTLJQVO EFNJLJBO KJLB TFMTFM CBHJBO MVBS EJSVTBL EFUBJM NFOHFOBJ QPUFOTJBM MJTUSJL ZBOH EJCBOHLJULBO PMFI TFM
TFNFOUBSBTFMTFMCBHJBOEBMBNUFUBQCFSGVOHTJTFNQVSOB UJNCVM SBNCVU LJUBQFSMVNFOKFMBTLBOGFOPNFOBMJTUSJLMBJOZBOHEJTFCVU
LFIJMBOHBOQFOEFOHBSBOZBOHDVLVQCFSBU0MFILBSFOBJUV UFMBI QPUFOTJBM FOEPLPLMFB 4LBMB NFEJB UFSJTJ DBJSBO ZBOH EJTFCVU
EJBKVLBO CBIXB TFMTFM SBNCVU MVBS EFOHBO DBSB UFSUFOUV FOEPMJNGF ZBOH CFSCFEB EFOHBO QFSJMJNGF ZBOH EJUFNVLBO EBMBN
NFOHBUVS TFOTJUJWJUBT TFMTFM SBNCVU EBMBN EJ CFSCBHBJ UJOHHJ TLBMBWFTUJCVMJEBOTLBMBUJNQBOJ4LBMBWFTUJCVMJEBOTLBMBUJNQBOJ
SFOEBICVOZJ NFSVQBLBOGFOPNFOBZBOHEJTFCVUQFOZFTVBJBO CFSIVCVOHBOMBOHTVOHEFOHBOSVBOHTVCBSBLIOPJEEJTFLJUBSPUBL
TFIJOHHB QFSJMJNGF IBNQJS TBNB EFOHBO DBJSBO TFSFCSPTQJOBM
4FCBMJLOZB FOEPMJNGF ZBOH NFOHJTJ TLBMB NFEJB BEBMBI DBJSBO
ZBOH TBNB TFLBMJ CFSCFEB ZBOH EJTFLSFTJLBO PMFI TUSJB WBTLVMBSJT
EBFSBI EFOHBO WBTLVMBSJTBTJ ZBOH UJOHHJ QBEB EJOEJOH MVBS TLBMB
NFEJB &OEPMJNGF NFOHBOEVOH LBMJVN EFOHBO LPOTFOUSBTJ ZBOH
TBOHBUUJOHHJEBOOBUSJVNEFOHBOLPOTFOUSBTJZBOHTBOHBUSFOEBI
ZBOHTBOHBUCFSMBXBOBOEFOHBOLBOEVOHBOQFSJMJNGF
1PUFOTJBM MJTUSJL TFLJUBS NJMJWPMU UFSKBEJ TFUJBQ TBBU BOUBSB
FOEPMJNGFEBOQFSJMJNGF EFOHBOLFQPTJUJGBOEJEBMBNTLBMBNFEJB
EBO LFOFHBUJGBO BEB EJ MVBS *OJ EJTFCVU QPUFOTJBM FOEPLPLMFB EBO
EJCBOHLJULBO PMFI TFLSFTJ JPO LBMJVN ZBOH CFSNVBUBO QPTJUJG
TFDBSBUFSVTNFOFSVTLFEBMBNTLBMBNFEJBPMFITUSJBWBTLVMBSJT
.BLOBQFOUJOHQPUFOTJBMFOEPLPLMFBBEBMBIQVODBLTFMSBNCVU
NFOPOKPMNFMBMVJMBNJOBSFUJLVMBSJTEBOUFSFOEBNPMFIFOEPMJNGF
EJTLBMB NFEJB TFEBOHLBO QFSJMJNGF NFSFOEBN CBEBO TFMTFM
SBNCVUQBEBCBHJBOZBOHMFCJICBXBI4FMBOKVUOZB TFMTFMSBNCVU
637
Unit X Sistem Sarat B. Indra Khusus
NFNQVOZBJ QPUFOTJBM JOUSBTFM OFHBUJG TFCFTBS o NJMJWPMU EFOHBO CBOZBLTFSBUTBSBG EBOCVLBONFMBMVJIBOZBCFCFSBQBTFSBUTBSBG
QFOZFTVBJBO UFSIBEBQ QFSJMJNGF UFUBQJ o NJMJWPMU EFOHBO
,FUJHB TFMTFM SBNCVU MVBS UJEBL UFSBOHTBOH TFDBSB CBSNBLOB
QFOZFTVBJBO UFSIBEBQ FOEPMJNGF QBEB QFSNVLBBO BUBTOZB ZBOH
NFSVQBLBO UFNQBU SBNCVUSBNCVU JOJ NFOPOKPM NFMBMVJ MBNJOB TBNQBJHFUBSBONFNCSBOCBTJMBSNFODBQBJJOUFOTJUBTZBOHUJOHHJ
SFUJLVMBSJT LF EBMBN FOEPMJNGF %JEVHB CBIXB QPUFOTJBM MJTUSJL ZBOH EBOQFSBOHTBOHBOTFMTFMJOJUBNQBLOZBZBOHNFOHBCBSLBOQBEB
UJOHHJ JOJ QBEB VKVOH TUFSFPTJMJB BLBO NFOJOHLBULBO LFQFLBBO TFM TJTUFNTBSBGCBIXBCVOZJUFSTFCVUTBOHBULFSBT
TFIJOHHB NFOJOHLBULBO LFNBNQVBO TFM VOUVL CFSFTQPOT UFSIBEBQ
CVOZJZBOHQBMJOHIBMVT Deteksi Perubahan Kekerasan Bunyi-Hukum Tenaga.
5FMBI EJKFMBTLBO EBMBN #BC CBIXB TFTFPSBOH
Penentuan Frekuensi Bunyi-Prinsip "Tempar NFOHJOUFSQSFUBTJLBOQFSVCBIBOJOUFOTJUBTSBOHTBOHTFOTPSJTLJSB
4FKBL BXBM QFNCBIBTBO EBMBN CBC JOJ KFMBT CBIXB CVOZJ LJSBCFSCBOEJOHUFSCBMJLEFOHBOGVOHTJUFOBHBEBSJJOUFOTJUBTZBOH
CFSGSFLVFOTJ SFOEBI NFOZFCBCLBO BLUJWBTJ NBLTJNBM QBEB TFCFOBSOZB 1BEB CVOZJ TFOTBTJ JOUFSQSFUBTJ UFSTFCVU CFSVCBI
NFNCSBO CBTJMBS EJ EFLBU BQFLT LPLMFB EBO CVOZJ LVSBOH MFCJI TFCBOEJOH BLBS QBOHLBU UJHB EBSJ JOUFOTJUBT CVOZJ
CFSGSFLVFOTJ UJOHHJ NFOHBLUJWBTJ NFNCSBO CBTJMBS EJ EFLBU TFCFOBSOZB %FOHBO LBUB MBJO UFMJOHB EBQBU NFOFOUVLBO
CBTJT LPLMFB #VOZJ EFOHBO GSFLVFOTJ EJ BOUBSBOZB BLBO QFSCFEBBO JOUFOTJUBT CVOZJ EBSJ CJTJLBO ZBOH QBMJOH MFNCVU
NFOHBLUJWBTJ NFNCSBO QBEB KBSBL EJ BOUBSB LFEVB LFBEBBO TBNQBJCVOZJHBEVIZBOHQBMJOHLFSBT NFXBLJMJTFLJUBSUSJMJVO
ZBOH FLTUSFN JOJ 4FMBOKVUOZB UFSEBQBU QFOHBUVSBO TQBTJBM LBMJ QFOJOHLBUBO FOFSHJ CVOZJ BUBV KVUB LBMJ QFOJOHLBUBO
QBEB TFSBU TBSBG EJ KBSBT LPLMFBSJT EBSJ LPLMFB TBNQBJ LPSUFLT BNQUJUVEP QFSHFSBLBO NFNCSBO CBTJMBS 1BEB TBBU JOJ UFMJOHB
TFSFCSJ 1FSFLBNBO TJOZBM EJ USBLUVT BVEJUPSJVT CBUBOH PUBL NFOHJOUFSQSFUBTJLBO QFSCFEBBO UJOHLBU CVOZJ TFLJUBS LBMJ
EBO EJ BSFB QFOFSJNB QFOEFOHBSBO LPSUFLT TFSFCSJ NFN MJQBU QFSVCBIBO +BEJ TLBMB JOUFOTJUBT TBOHBU EJQBEBULBO PMFI
QFSMJIBULBO OFVSPOOFVSPO PUBL ZBOH TQFTJGJL EJBLUJWBTJ PMFI NFLBOJTNF QFSTFQTJ CVOZJ TJTUFN QFOEFOHBSBO )BM JOJ
GSFLVFOTJCVOZJUFOUFOUV0MFILBSFOBJUV NFUPEFVUBNBZBOH NFNVOHLJOLBO LJUB NFOHJOUFSQSFUBTJLBO QFSCFEBBO JOUFOTJUBT
EJHVOBLBO PMFI TJTUFN TBSBG VOUVL NFOEFUFLTJ QFSCFEBBO CVOZJ EBMBN SFOUBOH ZBOH KBVI MFCJI MVBT EBSJQBEB ZBOH
GSFLVFOTJ CVOZJ BEBMBI EFOHBO NFOFOUVLBO QPTJTJ EJ EJNVOHLJOLBOKJLBUJEBLLBSFOBQFNBEBUBOTLBMBJOUFOTJUBT
TFQBOKBOH NFNCSBO CBTJMBS ZBOH QBMJOH UFSBOHTBOH *OJ
EJTFCVUQSJOTJQUFNQBUVOUVLNFOFOUVLBOGSFLVFOTJCVOZJ Satuan Desibel. 0MFI LBSFOB CFSCBHBJ QFSVCBIBO FLTUSFN
JOUFOTJUBT CVOZJ EBQBU EJEFUFLTJ EBO EJCFEBLBO PMFI UFMJOHB
.FTLJQVO EFNJLJBO NFSVKVL MBHJ QBEB (BNCBS JOUFOTJUBTCVOZJCJBTBOZBEJOZBUBLBOEBMBNCFOUVLMPHBSJUNBEBSJ
UBNQBLCBIXBVKVOHEJTUBMNFNCSBOCBTJMBSQBEBIFMJLPUSFNB JOUFOTJUBT TFCFOBSOZB 1FOJOHLBUBO LBMJ MJQBU FOFSHJ CVOZJ
EJSBOHTBOH PMFI TFNVB GSFLVFOTJ CVOZJ EJ CBXBI TJLMVT EJTFCVUCFM EBO CFMEJTFCVUEFTJCFM4BUVEFTJCFMNFXBLJMJ
QFS EFUJL 0MFI LBSFOB JUV CFSEBTBSLBO QSJOTJQ UFNQBU TVMJU QFOJOHLBUBOFOFSHJCVOZJZBOHTFCFOBSOZBZBLOJTFCFTBS LBMJ
EJNFOHFSUJ CBHBJNBOB LJUB EBQBU NFNCFEBLBO BOUBSB
GSFLVFOTJ CVOZJ ZBOH SFOEBI QBEB LJTBSBO TBNQBJ "MBTBO MBJO NFOHHVOBLBO TJTUFN EFTJCFM EBMBN NFOZBUBLBO
'SFLVFOTJ ZBOH SFOEBI JOJ EJEVHB UFSVUBNB EJCFEBLBO PMFI QFSVCBIBOLFLFSBTBOCVOZJBEBMBI QBEBLJTBSBOJOUFOTJUBTCVOZJ
QSJOTJQ ZBOH EJTFCVU QSJOTJQ CFSVOUVO BUBV QSJOTJQ GSFLVFOTJ CJBTBVOUVLLPNVOJLBTJ UFMJOHBIBNQJSUJEBLEBQBUNFNCFEBLBO
"SUJOZB CVOZJ CFSGSFLVFOTJ SFOEBI EBSJ TBNQBJ QFSVCBIBOJOUFOTJUBTCVOZJTFLJUBSTBUVEFTJCFM
IJOHHBTJLMVTQFSEFUJL EBQBUNFOZFCBCLBOJNQVMTTBSBG
CFSVOUVO ZBOH UFSTJOLSPOJTBTJ QBEB GSFLVFOTJ ZBOH TBNB EBO Ambang Bunyi Pendengaran di Berbagai Frekuensi.
JNQVMT CFSVOUVO JOJ BLBO EJUSBOTNJTJLBO NFMBMVJ OFSWVT (BNCBS NFNQFSMJIBULBO BNCBOH UFLBOBO EJ CFSCBHBJ GSFLVFOTJ
LPLMFBSJT LF EBMBN JOUJ LPLMFBS EJ PUBL 4FMBOKVUOZB EJEVHB CVOZJ ZBOH IBNQJS UJEBL UFSEFOHBS PMFI UFMJOHB (BNCBS JOJ
CBIXB JOUJ LPLMFBS EBQBU NFNCFEBLBO CFSCBHBJ NBDBN NFNQFSMJIBULBO CBIXB CVOZJ TJLMVT QFS EFUJL EBQBU EJEFOHBS
GSFLVFOTJ CFSVOUVO JOJ 1BEB LFOZBUBBOOZB LFSVTBLBO QBEB NFTLJQVOJOUFOTJUBTOZBTFSFOEBIEFTJCFMEJCBXBIEZOFDNUJOHLBU
TFMVSVI BQJLBM EBSJ TFQBSVI LPLMFB ZBOH NFOHIBODVSLBO UFLBOBOCVOZJ ZBJUVTBUVQFSTFQVMVIKVUBNJLSPXBUUQFSTFOUJNFUFS
NFNCSBO CBTJMBS UFNQBU TFNVB CVOZJ CFSGSFLVFOTJ SFOEBI
TFDBSB OPSNBM UFSEFUFLTJ UJEBL TFMVSVIOZB NFOHIJMBOHLBO 100
LFNBNQVBONFNCFEBLBOCVOZJCFSGSFLVFOTJSFOEBI 80
60
40
Menentukan Kekerasan Bunyi
20
,FLFSBTBOCVOZJEJUFOUVLBOPMFITJTUFNQFOEFOHBSBONFMBMVJ 0
TFUJEBLOZBUJHBDBSB –20
1FSUBNB LFUJLB CVOZJ NBLJO LFSBT BNQMJUVEP HFUBSBO –40
NFNCSBOCBTJMBSEBOTFMTFMSBNCVUKVHBNFOJOHLBU TFIJOHHB –60
TFMTFMSBNCVUNFOHFLTJUBTJVKVOHTBSBGEFOHBOMFCJIDFQBU – 80 -
= 73.8
,FEVB LFUJLB BNQMJUVEP HFUBSBO NFOJOHLBU NFOZFCBCLBO 1 2 5 10 20 100 500 2000 10,000
TFNBLJOCBOZBLTFMTFMSBNCVUEJQJOHHJSCBHJBONFNCSBOCB
TJMBS ZBOH CFSFTPOBOTJ NFOKBEJ UFSBOHTBOH TFIJOHHB NFOJN
CVMLBOQFOKVNMBIBOTQBTJBMJNQVMTZBJUV USBOTNJTJNFMBMVJ
638
QFSTFHJ4FCBMJLOZB CVOZJTJLMVTQFSEFUJLEBQBUEJEFUFLTJIBOZBKJLB
JOUFOTJUBTOZBLBMJMFCJICFTBS
Rentang Frekuensi Pendengaran.'SFLVFOTJCVOZJZBOHEBQBU

EJEFOHBS PMFI PSBOH NVEB BEBMBI BOUBSB EBO TJLMVT QFS EFUJL
UNIT X
/BNVO NFSVKVL LFNCBMJ LF (BNCBS UBNQBL CBIXB SFOUBOH
CVOZJ TBOHBU CFSHBOUVOH LFQBEB LFLFSBTBO CVOZJ +JLB LFLFSBTBOOZB
EFTJCFMEJCBXBIEZOFDNUJOHLBUUFLBOBOCVOZJ SFOUBOHCVOZJBEBMBI
TBNQBJ TJLMVT QFS EFUJL IBOZB EFOHBO CVOZJ ZBOH LVBU EBQBU
EJDBQBJ SFOUBOH TBNQBJ TJLMVT ZBOH MFOHLBQ 1BEB VTJB UVB
SFOUBOHGSFLVFOTJCJBTBOZBNFNFOEFLNFOKBEJTBNQBJTJLMVTQFS
EFUJLBUBVLVSBOH TFQFSUJZBOHBLBOEJCBIBTLFNVEJBOQBEBCBCJOJ
Mekanisme Pendengaran Sentral
Jaras Persarafan Pendengaran

(BNCBS NFOHHBNCBSLBO KBSBT QFOEFOHBSBO VUBNB
5BNQBL CBIXB TFSBU TBSBG EBO HBOHMJPO TQJSBMJT $PSUJ NFNBTVLJ
OVLMFVT LPLMFBSJT EPSTBMJT EBO WFOUSBMJT ZBOH UFSMFUBL EJ CBHJBO
BUBT NFEVMB %JTJOJ TFNVB TFSBU CFSTJOBQT EBO OFVSPO UJOHLBU
EVB CFSKBMBO UFSVUBNB LF TJTJ ZBOH CFSMBXBOBO EBSJ CBUBOH PUBL
EBOCFSBLIJSEJOVLMFVTPMJWBSJVTTVQFSJPS#FCFSBQBTFSBUUJOHLBU
LFEVB MBJO KVHB CFSKBMBO LF OVLMFVT PMJWBSJVT TVQFSJPS QBEB TJTJ
ZBOHTBNB
%BSJOVLMFVTPMJWBSJVTTVQFSJPS KBSBTQFOEFOHBSBOCFSKBMBOLF
BUBT NFMBMVJ MFNOJTLVT MBUFSBMJT 4FCBHJBO TFSBU CFSBLIJS EJ
OVLMFVT MFNOJTLVT MBUFSBMJT UFUBQJ TFCBHJBO CFTBS NFMFXBUJ
OVLMFVTJOJEBOCFSKBMBOUFSVTLFLPMJLVMVTJOGFSJPS UFNQBUTFNVB
BUBVIBNQJSTFNVBTFSBUQFOEFOHBSBOCFSTJOBQT%BSJTJOJ KBSBT
CFSKBMBO LF OVLMFVT HFOJLVMBUVN NFEJBM UFNQBU TFNVB TFSBU
CFUVMCFUVM CFSTJOBQT "LIJSOZB KBSBT CFSMBOKVU NFMBMVJ SBEJBTJP
BVEJUPSJVT LF LPSUFLT BVEJUPSJL ZBOH UFSVUBNB UFSMFUBL EJ HJSVT
TVQFSJPSMPCVTUFNQPSBMJT
#FCFSBQBIBMQFOUJOHIBSVTEJQFSIBUJLBO1FSUBNB TJOZBMEBSJ
LFEVB UFMJOHB EJIBOUBSLBO NFMBMVJ KBSBT LFEVB TJTJ PUBL EFOHBO
QFOHIBOUBSBO ZBOH MFCJI CFTBS QBEB KBSBT LPOUSBMBUFSBM 1BEB
TFLVSBOHLVSBOHOZB UJHB UFNQBU EJ CBUBOH PUBL UFSKBEJ
QFSTJMBOHBOBOUBSBLFEVBKBSBTJOJ
EJLPSQVTUSBQF[PJE
EJ N. VIlI
LPNJTVSBBOUBSBEVBJOUJMFNOJTLVTMBUFSBMJT EBO
EJLPNJTVSB
ZBOHNFOHIVCVOHLBOEVBLPMJLVMVTJOGFSJPS
,FEVB CBOZBL TFSBU LPMBUFSBM EBSJ USBLUVT BVEJUPSJVT CFSKBMBO
MBOHTVOHLFEBMBNTJTUFNBLUJWBTJSFUJLVMBSEJCBUBOHPUBL4JTUFN
JOJNFOPOKPMTFDBSBEJGVTLFBUBTEBMBNCBUBOHPUBLEBOLFCBXBI
LF EBMBN NFEVMB TQJOBMJT EBO NFOHBLUJWBTJ TFMVSVI TJTUFN TBSBG
VOUVL CFSFTQPOT UFSIBEBQ CVOZJ ZBOH LFSBT ,PMBUFSBMLPMBUFSBM Kecepatan Pelepasan Impuls di Berbagai Tingkat
MBJONFOVKVLFWFSNJTTFSFCFMVN ZBOHKVHBEJBLUJWBTJTFLFUJLBJUV Jaras Pendengaran. 4FSBU TBSBG UVOHHBM ZBOH NFNBTVLJ JOUJ
KVHBKJLBBEBCVOZJLFSBTZBOHNFOEBEBL LPLMFB EBSJ OFSWVT BVEJUPSJVT EBQBU NFMFQBTLBO JNQVMT EFOHBO
LFDFQBUBO TBNQBJ JNQVMT QFS EFUJL LFDFQBUBO JOJ UFSVUBNB
,FUJHB PSJFOUBTJTQBTJBMCFSEFSBKBUUJOHHJEJQFSUBIBOLBOEBMBN
EJUFOUVLBO PMFI LFLFSBTBO CVOZJ 1BEB CVOZJ CFSGSFLVFOTJ
USBLUVT TFSBU ZBOH CFSBTBM EBSJ LPLMFB TBNQBJ LF LPSUFLT 1BEB
TBNQBJ TJLMVT QFS EFUJL JNQVMT OFSWVT BVEJUPSJVT TFSJOHLBMJ
LFOZBUBBOOZB UFSEBQBU UJHB QPMB TQBTJBM VOUVL NFOHIFOUJLBO TJOLSPO EFOHBO HFMPNCBOH CVOZJ UFUBQJ UJEBL TFMBMV UFSKBEJ QBEB
CFSCBHBJ GSFLVFOTJ CVOZJ EJ JOUJ LPLMFB EVB QPMB EJ LPMJLVMVT TFUJBQHFMPNCBOH
JOGFSJPS TBUVQPMBZBOHUFQBUVOUVLCFSCBHBJGSFLVFOTJCVOZJZBOH
%BMBN USBLUVT BVEJUPSJVT EJ CBUBOH PUBL QFMFQBTBO JNQVMT
LIBT EJ LPSUFLT BVEJUPSJL EBO TFLVSBOHLVSBOHOZB MJNB QPMB
CJBTBOZB UJEBL MBHJ TJOLSPO EFOHBO GSFLVFOTJ CVOZJ LFDVBMJ QBEB
MBJOOZB ZBOH LVSBOH UFQBU EJ LPSUFLT BVEJUPSJL EBO BSFB BTPTJBTJ GSFLVFOTJ CVOZJ EJ CBXBI TJLMVT QFS EFUJL %J BUBT UJOHLBU
BVEJUPSJL LPMJLVMVTJOGFSJPS CBILBOTJOLSPOJTBTJJOJTFCBHJBOCFTBStIJMBOH
639
1FOFNVBOJOJNFNQFSMJIBULBOCBIXBTJOZBMCVOZJUJEBLEJIBOUBSLBO XBOBO 1BEB VNVNOZB CVOZJ CFSGSFLVFOTJ SFOEBI UFSMFUBL EJ

TFDBSBMBOHTVOHUBOQBEJVCBIEBSJUFMJOHBLFUJOHLBUZBOHMFCJIUJOHHJ BOUFSJPS TFQFSUJ ZBOH UFSMJIBU QBEB (BNCBS EBO CVOZJ
EJPUBLNFMBJOLBO JOGPSNBTJEBSJTJOZBMCVOZJNVMBJEJVSBJLBOEBSJ CFSGSFLVFOTJ UJOHHJ UFSMFUBL EJ QPTUFSJPS *OJ UJEBL CFSMBLV VOUVL
KBMVS JNQVMT QBEB UJOHLBU TFSFOEBI OVLMFVT LPLMFBSJT )BM JOJ BLBO TFNVBQFUB
EJKFMBTLBOMFCJIMBOKVU UFSVUBNBEBMBNIVCVOHBOOZBEFOHBOQFSTFQTJ
BSBITVNCFSCVOZJ .FOHBQB LPSUFLT BVEJUPSJL NFNQVOZBJ CFHJUV CBOZBL QFUB
UPOPUPQJL +BXBCBOOZB CBSBOH LBMJ BEBMBI TFUJBQ BSFB ZBOH
Fungsi Korteks Serebri pada Pendengaran UFSQJTBI NFNJMBI CFCFSBQB HBNCBSBO TQFTJGJL CVOZJ 4FCBHBJ
DPOUPI TBUV EBSJ QFUB CFTBS EBMBN LPSUFLT BVEJUPSJL QSJNFS
1SPZFLTJ BSFB TJOZBM QFOEFOHBSBO QBEB LPSUFLT TFSFCSJ IBNQJSQBTUJNFNCFEBLBOGSFLVFOTJCVOZJJUVEBONFOJNCVMLBO
EJQFSMJIBULBOQBEB (BNCBS ZBOHNFOVOKVLLBOCBIXB TFOTBTJ QTJLJT NFOHFOBJ UJOHHJSFOEBIOZB CVOZJ 1FUB MBJO
LPSUFLTBVEJUPSJLUFSVUBNBUFSMFUBLQBEBCJEBOHTVQSBUFNQPSBM NVOHLJO EJHVOBLBO VOUVL NFOEFUFLTJ BSBI EBUBOHOZB CVOZJ
HJSVT UFNQPSBMJT TVQFSJPS UFUBQJ KVHB NFMVBT TBNQBJ LF TJTJ "SFB LPSUFLT BVEJUPSJL MBJO NFOEFUFLTJ LVBMJUBT LIVTVT TFQFSUJ
MBUFSBMMPCVTUFNQPSBMJT QBEBLPSUFLTJOTVMBSJT EBOCBILBOLF CVOZJZBOHEBUBOHUJCBUJCB BUBVCBSBOHLBMJNPEVMBTJCVOZJZBOH
CBHJBOMBUFSBMEBSJPQFSLVMVNQBSJFUBMJT LIVTVT TFQFSUJ BOUBSB GSFLVFOTJ HBEVI EFOHBO GSFLVFOTJ CVOZJ
5FSEBQBU EVB CBHJBO UFSQJTBI ZBOH EJQFSMJIBULBO QBEB NVSOJ
(BNCBS LPSUFLT BVEJUPSJL QSJNFS EBO LPSUFLT BTPTJBTJ 3FOUBOH GSFLVFOTJ SFTQPOT NBTJOHNBTJOH OFVSPO EBMBN
BVEJUPSJL EJTFCVU KVHB LPSUFLT BVEJUPSJLTFLVOEFS
,PSUFLT LPSUFLT BVEJUPSJL KBVI MFCJI TFNQJU EBSJQBEB ZBOH EJ OVLMFVT
BVEJUPSJL QSJNFS TFDBSB MBOHTVOH EJSBOHTBOH PMFI QSPZFLTJ
LPLMFB EBO OVLMFVT SFMBZ EJ CBUBOH PUBL .FSVKVL LF (BNCB5
EBSJ LPSQVT HFOJLVMBUVN NFEJBM TFEBOHLBO BSFB BTPTJBTJ
# QFSIBUJLBO CBIXB NFNCSBO CBTJMBS EJ EFLBU EBTBS LPLMFB
BVEJUPSJLEJSBOHTBOHLFNVEJBOPMFIJNQVMTZBOHCFSBTBMEBSJ
EJSBOHTBOH PMFI TFNVB GSFLVFOTJ CVOZJ EBO QBEB JOUJ OVLMFVT
LPSUFLT BVEJUPSJL QSJNFS EBO PMFI QSPZFLTJ EBSJ EBFSBI
LPLMFB UFSEBQBU SFOUBOH CVOZJ ZBOH TBNB /BNVO QBEB TBBU
BTPTJBTJUBMBNVTZBOHCFSEFLBUBOEFOHBOLPSQVTHFOJLVMBUVN
SBOHTBOH NFODBQBJ LPSUFLT TFSFCSJ TFCBHJBO CFTBS OFVSPO ZBOH
NFEJBM
SFTQPOTJG UFSIBEBQ CVOZJ IBOZB CFSFTQPOT EBMBN SFOUBOH
GSFLVFOTJZBOHTFNQJU EBOCVLBOSFOUBOHZBOHMFCJIMFCBS0MFI
Persepsi Frekuensi Bunyi dalam Korteks Auditorik LBSFOB JUV QBEB TVBUV UFNQBU EJ KBSBT UFSKBEJ NFLBOJTNF
Primer. 4FLVSBOHLVSBOHOZB UFMBI EJUFNVLBO FOBN QFUB QFOBKBNBO UFSIBEBQ SFTQPOT GSFLVFOTJ %JEVHB CBIXB FGFL
UPOPUPQJL EBMBN LPSUFLT BVEJUPSJL QSJNFS EBO BSFB BTPTJBTJ QFOBKBNBO JOJ UFSVUBNB EJTFCBCLBO PMFI GFOPNFOB JOIJCJTJ
BVEJUPSJL %BMBN TFUJBQ QFUB CVOZJ CFSGSFLVFOTJ UJOHHJ MBUFSBM ZBOH UFMBI EJCBIBT QBEB #BC EBMBN LBJUBOOZB EFOHBO
NFSBOHTBOHOFVSPOEJTBMBITBUVVKVOHQFUB TFEBOHLBOCVOZJ NFLBOJTNF QFOHIBOUBSBO JOGPSNBTJ EJ TBSBG "SUJOZB
CFSGSFLVFOTJSFOEBINFSBOHTBOHOFVSPOEJVKVOHZBOHCFSMB QFSBOHTBOHBO LPLMFB QBEB TBUV GSFLVFOTJ NFOHIBNCBU GSFLVFOTJ
CVOZJEJLFEVBTJTJGSFLVFOTJQSJNFSIBMJOJEJTFCBCLBOPMFITFSBU
TFSBU LPMBUFSBM ZBOH NFNCFMPLLBO KBSBT TJOZBM QSJNFS EBO
NFODFUVTLBOQFOHBSVIJOIJCJTJQBEBKBSBTZBOHCFSEFLBUBO&GFL
ZBOHTBNBKVHBEJQFSMJIBULBONFNJMJLJNBLOBZBOHQFOUJOHQBEB
QPMB QFOBKBNBO LFTBO TPNFTUFUJL LFTBO QFOHMJIBUBO EBO KFOJT
TFOTBTJMBJOOZB
#BOZBL OFVSPO EJ LPSUFLT BVEJUPSJL UFSVUBNB EBMBN LPSUFLT
BTPTJBTJBVEJUPSJL UJEBLIBOZBCFSFTQPOTUFSIBEBQGSFLVFOTJCVOZJ
UFOUFOUVEJUFMJOHB%JBOHHBQCBIXBOFVSPOJOJNFOHBTPTJBTJLBO
CFSCBHBJ GSFLVFOTJ CVOZJ BOUBSB TBUV EFOHBO ZBOH MBJOOZB BUBV
NFOHBTPTJBTJLBO JOGPSNBTJ CVOZJ EFOHBO JOGPSNBTJ EBSJ BSFB
TFOTPSJT MBJO EJ LPSUFLT 4FTVOHHVIOZB CBHJBO QBSJFUBM LPSUFLT
BTPTJBTJ BVEJUPSJL TFCBHJBO CFSUVNQBOH UJOEJI EFOHBO BSFB
TPNBUPTFOTPSJL ** ZBOH EBQBU NFNVEBILBO BTPTJBTJ JOGPSNBTJ
QFOEFOHBSBOEFOHBOJOGPSNBTJTPNBUPTFOTPSJL
Diskriminasi "Pola" Bunyi oleh Korteks Auditorik.

1FNCVBOHBO UPUBM LPSUFLT BVEJUPSJL CJMBUFSBM UJEBL NFODFHBI
TFFLPS LVDJOH BUBV LFSB VOUVL NFOEFUFLTJ CVOZJ BUBV CFSFBLTJ
EFOHBOTJLBQLBTBSUFSIBEBQCVOZJ"LBOUFUBQJ LFBEBBOUFSTFCVU
TBOHBU NFOHVSBOHJ BUBV LBEBOHLBEBOH CBILBO NFOHIJMBOHLBO
LFNBNQVBO IFXBO VOUVL NFNCFEBLBO CFSCBHBJ UJOHHJ
SFOEBIOZBCVOZJEBOUFSVUBNBQPMBCVOZJ4FCBHBJDPOUPI IFXBO
ZBOH UFMBI EJMBUJI VOUVL NFOHFOBM LPNCJOBTJ BUBV VSVUBO OBEB
OBEB ZBOH TBUV NFOHJLVUJ OBEB ZBOH MBJO EFOHBO QPMB UFSUFOUV
BLBOLFIJMBOHBOLFNBNQVBOJOJKJLBLPSUFLTBVEJUPSJLOZBEJ
640
SVTBL EBO TFMBOKVUOZB IFXBO UFSTFCVU UJEBL EBQBU NFNQFMBKBSJ Mekanisme Saraf untuk Mendeteksi Arah Bunyi.
LFNCBMJ KFOJT SFTQPOT JOJ 0MFI LBSFOB JUV LPSUFLT BVEJUPSJL ,FSVTBLBO LPSUFLT BVEJUPSJL EJ LFEVB TJTJ PUBL CBJL QBEB
UFSVUBNB QFOUJOH EBMBN NFNCFEBLBO UJOHHJSFOEBIOZB CVOZJ NBOVTJB NBVQVO NBNBMJB SFOEBI NFOZFCBCLBO IJMBOHOZB
EBOQPMBVSVUBOCVOZJ IBNQJS TFNVB LFNBNQVBO VOUVL NFOEFUFLTJ BSBI EBUBOHOZB
,FSVTBLBO LFEVB LPSUFLT BVEJUPSJL QSJNFS QBEB NBOVTJB CVOZJ"OBMJTJTTBSBGVOUVLQSPTFTEFUFLTJJOJEJNVMBJEJOVLMFVT
UNIT X
TBOHBU NFOVSVOLBO TFOTJUJWJUBT QFOEFOHBSBO TFTFPSBOH PMJWBSJVT TVQFSJPS EJ CBUBOH PUBL NFTLJQVO EJCVUVILBO KBSBT
,FSVTBLBO QBEB TBUV TJTJ IBOZB BLBO TFEJLJU NFOVSVOLBO QFSTBSBGBOQBEBTFNVBKBMVSEBSJOVLMFVTJOJLFLPSUFLTVOUVL
LFNBNQVBO QFOEFOHBSBO QBEB UFMJOHB ZBOH CFSMBXBOBO UFUBQJ NFOHJOUFSQSFUBTJLBO TJOZBM .FLBOJTNFOZB EJBOHHBQ UFSKBEJ
UJEBLNFOZFCBCLBOLFUVMJBOQBEBUFMJOHB LBSFOBUFSEBQBUCBOZBL TFCBHBJCFSJLVU
IVCVOHBO TJMBOH EBSJ TBUV TJTJ LF TJTJ MBJOOZB QBEB KBSBT TBSBG /VLMFVT PMJWBSJVT TVQFSJPS EJCBHJ NFOKBEJ EVB CBHJBO

BVEJUPSJL /BNVO EFNJLJBO LFSVTBLBO JOJ BLBO NFNFOHBSVIJ OVLMFVT PMJWBSJVT TVQFSJPS NFEJBM EBO
OVLMFVT PMJWBSJVT
LFNBNQVBOTFTFPSBOHVOUVLNFOFOUVLBOTVNCFSCVOZJ LBSFOB TVQFSJPS MBUFSBM /VLMFVT MBUFSBM CFSQFSBO EBMBN NFOEFUFLTJ
EJCVUVILBO QFSCBOEJOHBO TJOZBMTJOZBM LFEVB LPSUFLT VOUVL BSBITVNCFSCVOZJ LFNVOHLJOBOIBOZBEFOHBONFNCBOEJOH
GVOHTJMPLBMJTBTJ LBO QFSCFEBBO JOUFOTJUBT CVOZJ ZBOH NFODBQBJ LFEVB UFMJOHB
-FTJ ZBOH NFOHFOBJ BSFB BTPTJBTJ BVEJUPSJL UFUBQJ UJEBL EBO NFOHJSJN TJOZBM ZBOH UFQBU LF LPSUFLT BVEJUPSJL VOUVL
NFOHFOBJ LPSUFLT BVEJUPSJL QSJNFS UJEBL NFOVSVOLBO NFNQFSLJSBLBOBSBIOZB
LFNBNQVBOTFTFPSBOHVOUVLNFOEFOHBSEBONFNCFEBLBOOBEB /BNVO EFNJLJBO OVLMFVT PMJWBSJVT TVQFSJPS NFEJBM
CVOZJ BUBV CBILBO VOUVL NFOHJOUFSQSFUBTJLBO TFLVSBOH NFNQVOZBJ NFLBOJTNF TQFTJGJL VOUVL NFOEFUFLTJ KFEB XBLUV
LVSBOHOZB QPMB CVOZJ ZBOH TFEFSIBOB /BNVO PSBOH UFSTFCVU BOUBSB TJOZBMTJOZBM BLVTUJL ZBOH NFNBTVLJ LFEVB UFMJOHB
TFSJOH UJEBL NBNQV NFOHJOUFSQSFUBTJLBO BSUJ EBSJ CVOZJ ZBOH /VLMFVT JOJ UFSEJSJ BUBT TFKVNMBI CFTBS OFVSPO EFOHBO EVB
EJEFOHBSOZB 4FCBHBJ DPOUPI MFTJ QBEB CBHJBO QPTUFSJPS HJSVT EFOESJU VUBNB TBUV EJQSPZFLTJLBO LF LBOBO EBO TBUV
UFNQPSBMJT TVQFSJPS ZBOH EJTFCVU BSFB 8FSOJDLF EBO KVHB EJQSPZFLTJLBOLFLJSJ4JOZBMBLVTUJLEBSJUFMJOHBLBOBOTBNQBJ
NFSVQBLBO CBHJBO EBSJ LPSUFLT BTPTJBTJ BVEJUPSJL TFSJOH LFEFOESJULBOBO EBOTJOZBMEBSJUFMJOHBLJSJTBNQBJLFEFOESJU
NFNCVBU PSBOH UFSTFCVU UJEBL EBQBU NFOHJOUFSQSFUBTJLBO BSUJ LJSJ *OUFOTJUBT QFSBOHTBOHBO TFUJBQ OFVSPO TBOHBU CFSHBOUVOH
LBUBLBUB NFTLJQVO JB NFOEFOHBS EFOHBO CBJL TFNVB LBUBLBUB LFQBEBKFEBXBLUVZBOHTQFTJGJLBOUBSBEVBTJOZBMBLVTUJLZBOH
UFSTFCVU EBO CBILBO EBQBU NFOHVMBOHJOZB 'VOHTJ BSFB BTPTJBTJ CFSBTBM EBSJ LFEVB UFMJOHB /FVSPO ZBOH EFLBU EFOHBO TBMBI
BVEJUPSJL JOJ EBO IVCVOHBOOZB EFOHBO LFTFMVSVIBO GVOHTJ TBUV UFQJ OVLMFVT BLBO CFSFTQPOT TFDBSB NBLTJNVN UFSIBEBQ
JOUFMFLUVBMPUBLEJCBIBTTFDBSBMFCJIEFUBJMQBEB#BC KFEB XBLUV ZBOH TJOHLBU TFEBOHLBO ZBOH EFLBU EFOHBO UFQJ
ZBOH CFSMBXBOBO BLBO CFSFTQPOT UFSIBEBQ KFEB XBLUV ZBOH
Penentuan Arah Sumber Bunyi TBOHBU QBOKBOH OFVSPO ZBOH CFSBEB EJ BOUBSB LFEVBOZB BLBO
4FTFPSBOH NFOFOUVLBO TVNCFS CVOZJ EBMBN BSBI IPSJ[POUBM CFSFTQPOT UFSIBEBQ KFEB XBLUV TFEBOH +BEJ UFSEBQBU QPMB
NFMBMVJEVBQSJOTJQZBJUV
KFEBXBLUVBOUBSBNBTVLOZBCVOZJ TQBTJBM QFSBOHTBOHBO OFVSPO EJ EBMBN OVLMFVT PMJWBSJVT
LF EBMBN TBUV UFMJOHB EBO NBTVLOZB LF EBMBN UFMJOHB ZBOH MBJO TVQFSJPS NFEJBM EFOHBO CVOZJ ZBOH EBUBOH MBOHTVOH EBSJ
EBO
QFSCFEBBOJOUFOTJUBTCVOZJEJLFEVBUFMJOHB EFQBO LFQBMB NFSBOHTBOH TBUV QFSBOHLBU OFVSPO PMJWBSJVT
TFDBSB NBLTJNBM EBO CVOZJ EBSJ TVEVU TJTJ ZBOH CFSCFEB
.FLBOJTNFQFSUBNBCFSGVOHTJQBMJOHCBJLVOUVLGSFLVFOTJEJ NFSBOHTBOH QFSBOHLBU OFVSPO MBJOOZB QBEB TJTJ ZBOH UFQBU
CBXBI TJLMVT QFS EFUJL EBO NFLBOJTNF LFEVB CFLFSKB CFSMBXBOBO 0SJFOUBTJ TQBTJBM TJOZBM JOJ LFNVEJBO EJIBOUBSLBO
QBMJOH CBJL QBEB GSFLVFOTJ ZBOH MFCJI UJOHHJ LBSFOB LFQBMB LF LPSUFLT BVEJUPSJL UFNQBU BSBI CVOZJ EJUFOUVLBO PMFI MPLVT
CFSUJOEBL TFCBHBJ QFOHIBMBOH CVOZJ ZBOH MFCJI CBJL QBEB OFVSPOZBOHEJSBOHTBOHTFDBSBNBLTJNBM%JEVHBCBIXBTFNVB
GSFLVFOTJGSFLVFOTJ JOJ .FLBOJTNF KFEB XBLUV EBMBN TJOZBM ZBOH EJHVOBLBO VOUVL QFOFOUVBO BSBI CVOZJ
NFNCFEBLBO BSBI KBVI MFCJI UFQBU EBSJQBEB NFLBOJTNF EJIBOUBSLBO NFMBMVJ KBSBT ZBOH CFSCFEB EBO NFSBOHTBOH
JOUFOTJUBT LBSFOB NFLBOJTNF JOJ UJEBL CFSHBOUVOH QBEB GBLUPS UFNQBUZBOHCFSCFEBEBMBNLPSUFLTTFSFCSJ EBSJKBSBTQFOHIBO
GBLUPS MVBS NFMBJOLBO IBOZB CFSHBOUVOH QBEB JOUFSWBM XBLUV UBSBOEBOUFNQBUUFSBLIJSVOUVLQPMBUJOHHJSFOEBIOZBCVOZJ
ZBOHUFQBUBOUBSBEVBTJOZBMBLVTUJL+JLBTFTFPSBOHNFMJIBUMVSVT
.FLBOJTNF VOUVL NFOEFUFLTJ BSBI EBUBOHOZB CVOZJ
LF BSBI TVNCFS CVOZJ CVOZJ BLBO NFODBQBJ LFEVB UFMJOHB QBEB
NFOVOKVLLBO LFNCBMJ CBHBJNBOB JOGPSNBTJ TQFTJGJL EBMBN
TBBUZBOHTBNB TFEBOHLBOKJLBUFMJOHBLBOBOMFCJIEFLBUEFOHBO
TJOZBMTFOTPSJLEJVSBJLBOLFUJLBTJOZBMNFMBMVJCFSCBHBJUJOHLBU
CVOZJEBSJQBEBUFMJOHBLJSJ TJOZBMCVOZJEBSJUFMJOHBLBOBONBTVL
BLUJWJUBT OFVSPO %BMBN IBM JOJ LVBMJUBT BSBI CVOZJ
PUBLMFCJIEBIVMVEBSJQBEBTJOZBMEBSJUFMJOHBLJSJ
EJQJTBILBO EBSJ LVBMJUBT UJOHHJ SFOEBIOZB CVOZJ EJ UJOHLBU
,FEVB NFLBOJTNF ZBOH UFMBI EJTFCVULBO UJEBL EBQBU OVLMFVTPMJWBSJVTTVQFSJPS
NFOKFMBTLBOBQBLBICVOZJCFSBTBMEBSJEFQBOBUBVEBSJCFMBLBOH
EBSJ BUBT BUBV EBSJ CBXBI TFTFPSBOH 1FNCFEBBO JOJ UFSVUBNB Sinyal Sentrifugal dari Sistem Saraf Pusat ke Pusat
EJQFSPMFI NFMBMVJ BVSJLVMB LFEVB UFMJOHB #FOUVL BVSJLVMB
Pendengaran Bagian Bawah
NFOHVCBI LVBMJUBT CVOZJ ZBOH NBTVL LF UFMJOHB CFSHBOUVOH
QBEB BSBI TVNCFS CVOZJ )BM JOJ UFSKBEJ NFMBMVJ QFOHVBUBO +BSBT SFUSPHSBE UFMBI EJQFSMJIBULBO QBEB TFUJBQ UJOHLBU TJTUFN TBSBG
GSFLVFOTJCVOZJTQFTJGJLZBOHCFSBTBMEBSJCFSCBHBJBSBI QFOEFOHBSBOEBSJLPSUFLTBVEJUPSJLTBNQBJLFLPLMFBEJUFMJOHB+BSBT
UFSBLIJS UFSVUBNB CFSBTBM EBSJ OVLMFVT PMJWBSJVT TVQFSJPS LF SFTFQUPS
CVOZJTFMSBNCVUEJPSHBO$PSUJ
641
4FSBU SFUSPHSBE JOJ CFSTJGBU JOIJCJTJ 4FTVOHHVIOZB QFSBOHTBOHBO 10

MBOHTVOH QBEB UJUJLUJUJL ZBOH CFSCFEB EJ OVLMFVT PMJWBSJVT Normal
EJQFSMJIBULBO NFOHIBNCBU BSFB TQFTJGJL EJ PSHBO $PSUJ NFOHVSBOHJ 10 * * * * * *
TFOTJUJWJUBTCVOZJTBNQBJEFTJCFM.VEBIEJNFOHFSUJCBHBJNBOB 20
IBMJOJNFNVOHLJOLBOTFTFPSBOHNFOHBSBILBOQFSIBUJBOOZBLFQBEB X
30 X
CVOZJ EFOHBO LVBMJUBT UFSUFOUV TBNCJM NFOPMBL CVOZJ EFOHBO X
40 X X X X
LVBMJUBT MBJO )BM JOJ EBQBU EFOHBO NVEBI EJUVOKVLLBO LFUJLB 50
TFTFPSBOHNFOEFOHBSLBOCVOZJTBUVJOTUSVNFOEBMBNPSLFTTJNGPOJ 60
70
X
Kelainan Pendengaran 80
90 *
Tipe-Tipe Tuli 100
5VMJ CJBTBOZB EJCBHJ NFOKBEJ EVB UJQF
ZBOH EJTFCBCLBO PMFI 125 250 500 1000 2000 4000 8000
LFSVTBLBOLPLMFBOFSWVTBVEJUPSJVT BUBVTJSLVJUTVTVOBOTBSBGQVTBU
EBSJ UFMJOHB ZBOH CJBTBOZB EJHPMPOHLBO TFCBHBJ UVMJ TBSBG EBO

ZBOHEJTFCBCLBOPMFILFSVTBLBOTUSVLUVSGJTJLUFMJOHBZBOHNFOHIBO
UBSLBOCVOZJLFLPLMFB ZBOHCJBTBOZBEJTFCVUUVMJLPOEVLTJh
+JLB LPLMFB BUBV OFSWVT BVEJUPSJVT SVTBL PSBOH UFSTFCVU NFOKBEJ Audiogram pada Tuli Saraf. 1BEB UVMJ TBSBG ZBOH NFODBLVQ
UVMJ QFSNBOFO /BNVO KJLB LPLMFB EBO OFSWVT UFUBQ VUVI UFUBQJ LFSVTBLBO LPLMFB OFSWVT BVEJUPSJVT BUBV TJSLVJU TJTUFN TBSBG QVTBU EBSJ
TJTUFN UVMBOH QFOEFOHBSBO UJNQBOJ UFMBI IBODVS BUBV NFOHBMBNJ UFMJOHB PSBOH UFSTFCVU NFOHBMBNJ QFOVSVOBO BUBV LFIJMBOHBO
BOLJMPTJT NFNCFLV BLJCBU GJCSPTJT BUBV LBMTJGJLBTJ
HFMPNCBOH LFNBNQVBO UPUBM VOUVL NFOEFOHBS CVOZJ QBEB QFOHVKJBO LPOEVLTJ
CVOZJNBTJIEBQBUEJLPOEVLTJLBOLFLPLMFBNFMBMVJLPOEVLTJUVMBOH VEBSBEBOLPOEVLTJUVMBOH
EBSJQFNCBOHLJUCVOZJZBOHEJMFUBLLBOEJLFQBMBEJBUBTUFMJOHB "VEJPHSBN ZBOH NFOHHBNCBSLBO UVMJ TBSBG TFCBHJBO EJQFSMJIBULBO
EBMBN (BNCBS%BMBN (BNCBSJOJ UVMJUFSVUBNBVOUVLCVOZJ
Audiometer. 6OUVL NFOFOUVLBO TJGBU LFMBJOBO QFOEFOHBSBO CFSGSFLVFOTJ UJOHHJ 5VMJ TFQFSUJ JUV EBQBU EJTFCBCLBO LFSVTBLBO CBTJT
EJHVOBLBO BVEJPNFUFS )BOZB NFSVQBLBO FBSQIPOF ZBOH LPLMFB 5JQF UVMJ JOJ QBEB UJOHLBU UFSUFOUV UFSKBEJ QBEB IBNQJS TFNVB
EJIVCVOHLBO EFOHBO PTJMBUPS FMFLUSPOJL ZBOH NBNQV NFNBODBSLBO PSBOHUVB
OBEB NVSOJ EFOHBO LJTBJBO EBSJ GSFLVFOTJ SFOEBI TBNQBJ GSFLVFOTJ 1PMB MBJO UVMJ TBSBG TFSJOHLBMJ UFSKBEJ TFCBHBJ CFSJLVU
UVMJ VOUVL
UJOHHJ JOTUSVNFO JOJ EJLBMJCSBTJ TFEFNJLJBO TFIJOHHB CVOZJ EFOHBO CVOZJCFSGSFLVFOTJSFOEBIZBOHEJTFCBCLBOPMFIQBKBOBOCFSMFCJIBOEBO
UJOHLBUJOUFOTJUBTOPMQBEBTFUJBQGSFLVFOTJNFSVQBLBOLFLFSBTBOCVOZJ CFSLFQBOKBOHBO UFSIBEBQ CVOZJ ZBOH TBOHBU LFSBT NVTJL SPDL BUBV
ZBOH IBNQJS UJEBL EBQBU EJEFOHBS PMFI UFMJOHB OPSNBM 1FOHBUVS NFTJOQFTBXBUUFSCBOH
LBSFOBCVOZJCFSGSFLVFOTJSFOEBICJBTBOZBMFCJI
WPMVNFZBOHUFSLBMJCSBTJEBQBUNFOJOHLBULBOLFLFSBTBOEJBUBTUJOHLBU LFSBTEBOMFCJINFSVTBLPSHBO$PSUJ EBO
UVMJVOUVLTFNVBGSFLVFOTJ
OPM+JLBLFLFSBTBOIBSVTEJUJOHLBULBOTBNQBJEFTJCFMEJBUBTOPSNBM ZBOH EJTFCBCLBO PMFI TFOTJUJWJUBT PSHBO $PSUJ UFSIBEBQ PCBU LIVTVTOZB
VOUVLEBQBUEJEFOHBS PSBOHUFSTFCVUEJLBUBLBONFOHBMBNJLFIJMBOHBO TFOTJUJWJUBTUFSIBEBQCFCFSBQBBOUJCJPUJL TFQFSUJTUSFQUPNJTJO LBOBNJTJO
QFOEFOHBSBOEFTJCFMVOUVLGSFLVFOTJUFSTFCVU EBOLMPSBNGFOJLPM
%BMBN NFMBLVLBO VKJ QFOEFOHBSBO NFOHHVOBLBO BVEJPNFUFS
TFTFPSBOHEJVKJEFOHBOTFLJUBSTBNQBJGSFLVFOTJEBMBNTQFLUSVN Audiogram pada Tuli Konduksi Telinga Tengah. 5JQF UVMJ
QFOEFOHBSBO EBOLFIJMBOHBOQFOEFOHBSBOEJUFOUVLBOVOUVLNBTJOH ZBOH TFSJOH EJUFNVLBO BEBMBI UVMJ ZBOH EJTFCBCLBO PMFI GJCSPTJT
NBTJOH GSFLVFOTJ UFSTFCVU ,FNVEJBO BQB ZBOH EJTFCVU BVEJPHSBN UFMJOHB UFOHBI TFUFMBI JOGFLTJ CFSVMBOH BUBV GJCSPTJT ZBOH UFSKBEJ
EJQMPULBO TFQFSUJ UBNQBL QBEB (BNCBS EBO NFOH QBEB QFOZBLJU IFSFEJUFS ZBOH EJTFCVU PUPTLMFSPTJT 1BEB LFEVB
HBNCBSLBOLFIJMBOHBOQFOEFOHBSBOVOUVLNBTJOHNBTJOHGSFLVFOTJ LFBEBBOUFSTFCVU HFMPNCBOHCVOZJUJEBLEBQBUEJIBOUBSLBOEFOHBO
EBMBNTQFLUSVNQFOEFOHBSBO"VEJPNFUFS TFMBJOEJMFOHLBQJEFOHBO NVEBINFMBMVJUVMBOHUVMBOHQFOEFOHBSBOEBSJNFNCSBOUJNQBOJ
FBSQIPOFVOUVLNFOHVKJLPOEVLTJVEBSBPMFIUFMJOHB KVHBEJMFOHLBQJ
LF GFOFTUSB PWBMJT (BNCBS NFNQFSMJIBULBO BVEJPHSBN
EFOHBO WJCSBUPS NFLBOJL VOUVL NFOHVKJ LPOEVLTJ UVMBOH EBSJ
TFTFPSBOH EFOHBO UVMJ LPOEVLTJ VEBSB UFMJOHB UFOHBI %BMBN IBM
QSPTFTVTNBTUPJEFVTEJLFQBMBLFEBMBNLPLMFB
JOJ LPOEVLTJUVMBOHQBEBEBTBSOZBOPSNBM UFUBQJLPOEVLTJNFMBMVJ
10 TJTUFN UVMBOHUVMBOH QFOEFOHBSBO TBOHBU NFOVSVO QBEB TFNVB
Normal GSFLVFOTJ UFSVUBNB QBEB GSFLVFOTJGSFLVFOTJ SFOEBI 1BEB
10 X X X
X X
CFCFSBQB LBTVT UVMJ LPOEVLTJ CJEBOH EFQBO TUBQFT NFOHBMBNJ
20 * * * * * X
BOLJMPTJT LBSFOB QFSUVNCVIBO UVMBOH ZBOH CFSMFCJIBO LF UFQJ
30
* GFOFTUSB PWBMJT %BMBN IBM JOJ PSBOH UFSTFCVU NFOKBEJ UVMJ UPUBM
40 X VOUVL LPOEVLTJ NFMBMVJ UVMBOH QFOEFOHBSBO UFUBQJ EBQBU
50 NFOEFOHBS LFNCBMJ IBNQJS OPSNBM NFMBMVJ PQFSBTJQFOHBOHLBUBO
60 TUBQFT EBO NFOHHBOUJOZB EFOHBO 5FGMPO ZBOH TBOHBU LFDJM BUBV
70 QSPTUFTJT MPHBN ZBOH NFOHIBOUBSLBO CVOZJ EBSJ JOLVT LF GFOFTUSB
X
80 PWBMJT
90 *
100
1 250 500 1000 2000 4000 8000
Daftar Pustaka
642
Bab 52 Indm Pendengaran
UNIT X
643
BAB 53
UNIT X
*OESB,JNJB1FOHFDBQBO
EBO1FOHIJEV
*OESB QFOHFDBQBO EBO QFOHIJEV VUBNB,FMJNBLBUFHPSJUFSTFCVUBEBMBIBTBN BTJO NBOJT

NFNCVBU LJUB NBNQV NFNCFEB QBIJU EBOVNBNJhh
LBO NBLBOBO ZBOH UJEBL LJUB
JOHJOLBO BUBV CBILBO NBLBOBO 4FTFPSBOH EBQBU NFOFSJNB CFSBUVTSBUVT QFOHFDBQBO ZBOH
ZBOH EBQBU NFNBUJLBO EBSJ CFSCFEB 4FNVB JUV TFIBSVTOZB NFSVQBLBO LPNCJOBTJ EBSJ
NBLBOBO ZBOH MF[BU VOUVL EJ TFOTBTJTFOTBTJQFOHFDBQBOEBTBS CFHJUVKVHBEFOHBODBSBZBOH
NBLBOEBOCFSHJ[J.FSFLBKVHB TBNB TFQFSUJ LJUB NFMJIBU TFNVB XBSOB ZBOH NFSVQBLBO
NFOFSJNB SFTQPOT GJTJPMPHJT ZBOH UFSMJCBU EBMBN QFODFSOBBO EBO LPNCJOBTJ EBSJ LFUJHB XBSOB VUBNB TFQFSUJ EJCJDBSBLBO QBEB
QFNBOGBBUBO NBLBOBO *OESB QFOHIJEV KVHB NFNCVBU CJOBUBOH #BC
NBNQVNFOHFOBMJLFEFLBUBOCJOBUBOHMBJOOZB BUBVCBIMDBOTBUV
CJOBUBOHEJBOUBSBTFLJBOCBOZBLCJOBUBOH"LIJSOZB LFEVBJOESB Rasa Asam. 3BTB BTBN EJTFCBCLBO PMFI BTBN ZBLOJ
JOJ TBOHBU CFSLBJUBO EFOHBO GVOHTJ FNPTJPOBM EBO UJOHLBI MBLV LPOTFOUSBTJ JPO IJESPHFO EBO JOUFOTJUBT TFOTBTJ BTBN JOJ
QSJNJUJG TJTUFN TBSBG LJUB %BMBN CBC JOJ LJUB NFNCBIBT IBNQJSTFCBOEJOHEFOHBOMPHBSJUNBLPOTFOUSBTJJPOIJESPHFO
CBHBJNBOB SBOHTBOH QFOHFDBQBO EBO QFOHIJEV EJEFUFLTJ EBO "SUJOZB TFNBLJO BTBN TVBUV NBLBOBO TFNBLJO LVBU QVMB
CBHBJNBOB NFSFLB EJTBOEJ TFCBHBJ TJOZBM TBSBG ZBOH EJLJSJN LF TFOTBTJBTBNZBOHUFSCFOUVL
PUBL
Rasa Asin. 3BTB BTJO EJIBTJMLBO EBO HBSBN ZBOH
Indra Pengecap UFSJPOJTBTJ UFSVUBNB LBSFOB LPOTFOUSBTJ JPO OBUSJVN ,VBMJUBT
SBTBOZB CFSCFEBCFEB BOUBSB HBSBN ZBOH TBUV EFOHBO ZBOH
1FOHFDBQBO UFSVUBNB NFSVQBLBO GVOHTJ EBSJ UBTUF CVET ZBOH MBJO LBSFOB CFCFSBQB HBSBN KVHB NFOHIBTJMLBO TFOTBTJ SBTB
UFSEBQBU EJ EBMBN NVMVU UFUBQJ QFOHBMBNBO KVHB NFOZBUBLBO TFMBJO SBTB BTJO ,BUJPO HBSBN LIVTVTOZB LBUJPO OBUSJVN
JOESB QFOHIJEV TBOHBU CFSQFSBO QBEB QFSTFQTJ QFOHFDBQBO UFSVUBNBCFSQFSBONFNCFOUVLSBTBBTJO UFUBQJBOJPOKVHBJLVU
4FMBJO JUV UFLTUVS NBLBOBO TFQFSUJ ZBOH EJEFUFLTJ PMFI JOESB CFSQFSBOXBMBVQVOMFCJILFDJM
UBLUJMEJSPOHHBNVMVU EBOBEBOZB[BUEJEBMBNNBLBOBOTFQFSUJ
NFSJDB ZBOH NFSBOHTBOH VKVOHVKVOH TBSBG OZFSJ BLBO TBOHBU Rasa Manis. 3BTBNBOJTUJEBLEJCFOUVLPMFITBUVHPMPOHBO
NFOHVCBI QFOHBMBNBO EBMBN QFOHFDBQBO .BLOB QFOUJOH [BULJNJBTBKB#FCFSBQBUJQF[BULJNJBZBOHNFOZFCBCLBOSBTB
QFOHFDBQBOUFSMFUBLQBEBLFOZBUBBOQFOHFDBQBONFNVOHLJOLBO JOJNFODBLVQHVMB HMJLPM BMLPIPM BMEFIJE LFUPO BNJEB FTUFS
NBOVTJB NFNJMJI NBLBOBO TFTVBJ EFOHBO LFJOHJOBOOZB EBO CFCFSBQB BTBN BNJOP CFCFSBQB QSPUFJO LFDJM BTBN TVMGPOBU
NVOHLJO KVHB TFTVBJ EFOHBO LFCVUVIBO NFUBCPMJL EJ KBSJOHBO BTBN IBMPHFOBTJ EBO HBSBNHBSBN BOPSHBOJL EBSJ UJNBI EBO
UVCVIUFSIBEBQ[BU[BUUFSUFOUV CFSJMJVN 1FSIBUJLBO CBIXB LFCBOZBLBO [BU ZBOH NFNCFOUVL
Sensasi Pengecapan Utama SBTBNBOJTBEBMBI[BULJNJBPSHBOJL4VOHHVITBOHBUNFOBSJL
CBIXBQFSVCBIBOZBOHTBOHBULFDJMQBEBTUSVLUVSLJNJB TFQFSUJ
1FOHFOBMBO CBIBO LJNJB TQFTJGJL ZBOH NBNQV NFSBOHTBOH
QFOBNCBIBOSBEJLBMTFEFSIBOB TFSJOHLBMJEBQBUNFOHVCBI[BU
CFSCBHBJ SFTFQUPS QFOHFDBQBOCFMVN EBQBU EJLFUBIVJ TFNVBOZB
EBOSBTBNBOJTNFOKBEJQBIJU
8BMBVQVO CFHJUV QFOFMJUJBO ZBOH CFSTJGBU QTJLPGJTJPMPHJT EBO
OFVSPGJTJPMPHJTUFMBINFOHFOBMJTFEJLJUOZBSFTFQUPSLJNJBZBOH
Rasa Pahit. 3BTB QBIJU TFQFSUJ SBTB NBOJT UJEBL EJCFOUVL
NVOHLJO BEB QBEB TFMTFM QFOHFDBQ TFQFSUJ EJVSBJLBO TFCBHBJ
IBOZB PMFI TBUV UJQF BHFO LJNJB %J TJOJ TFLBMJ MBHJ [BU ZBOH
CFSJLVUSFTFQUPSOBUSJVN SFTFQUPSLBMJVN SFTFQUPSLMPSJEB
NFNCFSJLBO SBTB QBIJU IBNQJS TFMVSVIOZB NFSVQBLBO [BU
SFTFQUPSBEFOPTJO SFTFQUPSJOPTJO SFTFQUPSNBOJT SFTFQ
PSHBOJL%VBHPMPOHBO[BUUFSUFOUVZBOHDFOEFSVOHNFOJNCVM
UPSQBIJU SFTFQUPSHMVUBNBU EBOSFTFQUPSJPOIJESPHFO
LBO SBTB QBIJU BEBMBI
[BU PSHBOJL SBOUBJ QBOKBOH ZBOH
6OUVLNFNCVBUBOBMJTJTQFOHFDBQBOZBOHQSBLUJT LFNBNQV NFOHBOEVOH OJUSPHFO EBO
BMLBMPJE "MLBMPJE NFMJQVUJ
BO SFTFQUPS ZBOH UFMBI EJTFCVULBO EJ BUBT KVHB EJLVNQVMLBO CBOZBLPCBUZBOHEJHVOBLBOEBMBNPCBUPCBUBO TFQFSUJLVJOJO
NFOKBEJMJNBLBUFHPSJVNVNZBOHEJTFCVUTFOTBTJQFOHFDBQBO LBGFJO TUSJLOJO EBOOJLPUJO
645
#FCFSBQBTVCTUBOTJZBOHNVMBNVMBUFSBTBNBOJTKVHBEBQBU 5BCFMNFNQFSMJIBULBOJOEFLTLFDBQSFMBUJG LFCBMJLBOEBSJ

CFSVCBINFOKBEJQBIJUTFTVEBIOZB*OJCFSMBLVVOUVLTBLBSJO BNCBOHCBUBTQFOHFDBQBO
CFSCBHBJ[BU1BEBUBCFMJOJ JOUFOTJUBT
TFIJOHHBNFNCVBU[BUJOJUJEBLEJTVLBJPMFICFCFSBQBPSBOH LFFNQBUTFOTBTJQFOHFDBQBOVUBNBNBTJOHNBTJOHNFOHBDVQBEB
3BTB QBIJU CJMB UJNCVM EFOHBO JOUFOTJUBT ZBOH UJOHHJ JOUFOTJUBT SBTB BTBN IJESPLMPSJEB LVJOJO TVLSPTB EBO OBUSJVN
CJBTBOZB BLBO NFNCVBU NBOVTJB BUBV IFXBO NFNCVBOH LMPSJEB ZBOH NBTJOHNBTJOH EJUFUBQLBO TFDBSB TFNCBSBOH
NBLBOBO UFSTFCVU 4FOTBTJ SBTB QBIJU JOJ UJEBL EJSBHVLBO MBHJ NFNQVOZBJJOEFLTSBTB
NFSVQBLBO GVOHTJ ZBOH QFOUJOH LBSFOB CBOZBL UPLTJO
NFNBUJLBO ZBOH EJUFNVLBO EBMBN UBOBNBO CFSBDVO Pengecapan yang Tidak Peka. #FCFSBQBPSBOHNFNQVOZBJ
NFSVQBLBO BMLBMPJE EBO TFNVB JOJ EBQBU NFOJNCVMLBO SBTB QFOHFDBQBO ZBOH UJEBL QFLB UFSIBEBQ [BU UFSUFOUV LIVTVTOZB
ZBOH TBOHBU QBIJU ZBOH CJBTBOZB EJJLVUJ EFOHBO NFNCVBOH VOUVL CFSCBHBJ UJQF TFOZBXB UJPVSFB ;BU ZBOH TFSJOH EJHVOBLBO
NBLBOBOUFSTFCVU PMFI QTJLPMPH VOUVL NFOHVKJ LFUJEBLQFLBBO QFOHFDBQBO BEBMBI
GFOJMUJPLBSCBNJEB EBO TFLJUBS TBNQBJ QFSTFO NBOVTJB
Rasa Umami 6NBNJ BEBMBI LBUB EBMBN CBIBTB +FQBOH NFNQFSMJIBULBOLFUJEBLQFLBBOQFOHFDBQBOQFSTFOUBTFZBOHUFQBU
ZBOH CFSBSUJ MF[BU
VOUVL NFOZBUBLBO SBTB LFDBQ ZBOH CFSHBOUVOHQBEBNFUPEFQFOHVKJBOEBOLPOTFOUSBTJ[BU
NFOZFOBOHLBO ZBOH TFDBSB LVBMJUBUJG CFSCFEB EBO SBTB BTBN
BTJO NBOJT BUBVQBIJU6NBNJNFSVQBLBOSBTBZBOHEPNJOBO Taste bud dan Fungsi nya
EJUFNVLBO QBEB NBLBOBO ZBOH NFOHBOEVOH -HMVUBNBU
TFQFSUJ QBEB FLTUSBL EBHJOH EBO LFKV ZBOH NFOVB EBO (BNCBS NFNQFSMJIBULBO UBTUF CVE ZBOH NFNQVOZBJ
CFCFSBQB BIMJ GJTJPMPHJ NFOHBOHHBQ SBTB JOJ IBSVT EJQJTBILBO EJBNFUFS TFLJUBS NN EBO QBOKBOH TFLJUBS NN 5BTUF CVE
TFIJOHHB NFOKBEJ LBUFHPSJ LFMJNB EBSJ QFSBOHTBOHBO UFSEJSJ BUBT LVSBOH MFCJI TFMTFM FQJUFM ZBOH UFSNPEJGJLBTJ
QFOHFDBQBOVUBNB CFCFSBQBEJBOUBSBOZBBEBMBITFMQFOZPLPOHZBOHEJTFCVUTFCBHBJ
TFMTVTUFOUBLVMBS TFMQFOZBOHHB
EBOZBOHMBJOOZBEJTFCVUTFCBHBJ
3FTFQUPSSBTBVOUVL-HMVUBNBUNVOHLJOCFSLBJUBOEFOHBO
TFM QFOHFDBQ 4FMTFM QFOHFDBQ UFSVTNFOFSVT EJHBOUJLBO NFMBMVJ
TBMBITBUVSFTFQUPSHMVUBNBUZBOHKVHBEJFLTQSFTJLBOEJTJOBQT
QFNCFMBIBO NJUPTJT EBO TFMTFM FQJUFM EJ TFLJUBSOZB TFIJOHHB
OFVSPO PUBL /BNVO NFLBOJTNF NPMFLVMFS UFQBU ZBOH
CFCFSBQB TFM QFOHFDBQ BEBMBI TFM NVEB 4FM QFOHFDBQ MBJOOZB
CFSQFSBOEBMBNSBTBVNBNJNBTJICFMVNKFMBT
BEBMBI TFM NBUBOH ZBOH UFSMFUBL LF BSBI CBHJBO UFOHBI CVE ZBOH
Ambang Batas Pengecapan BLBO TFHFSB UFSVSBJ EBO MBSVU .BTB IJEVQ TFUJBQ TFM QFOHFDBQ
BEBMBI TFLJUBS IBSJ QBEB NBNBMJB UJOHLBU SFOEBI UFUBQJ NBTJI
"NCBOH CBUBT VOUVL NFSBOHTBOH SBTB BTBN PMFI BTBN UJEBLEJLFUBIVJQBEBNBOVTJB
IJESPLMPSJEB SBUBSBUB / VOUVL NFSBOHTBOH SBTB BTJO
PMFI OBUSJVN LMPSJEB . VOUVL SBTB NBOJT PMFI TVLSPTB 6KVOHVKVOH MVBS TFM QFOHFDBQ UFSTVTVO EJ TFLJUBS QPSJQPSJ
.EBOVOUVLSBTBQBIJUPMFILVJOJO .4FQFSUJ QFOHFDBQ ZBOH TBOHBU LFDJM TFQFSUJ UFSMJIBU QBEB (BNCBS
ZBOH TVEBI EJQFSLJSBLBO LFQFLBBO UFSIBEBQ SBTB QBIJU MFCJI %BSJ VKVOHVKVOH TFUJBQ TFM QFOHFDBQ CFCFSBQB NJLSPWJMJ BUBV
UJOHHJEJCBOEJOHLBOZBOHMBJO LBSFOBTFOTBTJJOJNFNCFSJLBO SBNCVUQFOHFDBQ BLBO NFOPOKPM LFMVBS NFOVKV QPSJQPSJ
GVOHTJQFSMJOEVOHBOVOUVLNFMBXBOCFSCBHBJUPLTJOCFSCBIBZB QFOHFDBQ VOUVLNFOVKVSPOHHBNVMVU.JLSPWJMJJOJNFNCFSJLBO
ZBOHUFSEBQBUEBMBNNBLBOBO QFSNVLBBOSFTFQUPSVOUVLQFOHFDBQBO
Tabel 53-Indeks Rasa Kecap Relatif Berbagai Zat
Zat Asam Indeks Zat Pahit Indeks Zat Manis Indeks Zat Asin Indeks
Asam hidroklorida 1 Kuinin 1 Sukrosa 1 NaCl 1

Asam format 1.1 Brusin 11 1-Propoksi-2- 5000 NaF 2
amino-4-
nitrobenzena
Asam klorasetat 0.9 Striknin 3.1 Sakarin 675 CaCl2 1
Asam asetilasetat 0.85 Nikotin 1.3 Kloroform 40 NaBr 0.4
Asam laktat 0.85 Feniltiourea 0.9 Fruktosa 1.7 NaI 0.35
Asam tartrat 0.7 Kafein 0.4 Alanin 1.3 LiCl 0.4
Asam malat 0.6 Veratrin 0.2 Glukosa 0.8 NH4Cl 2.5
Kalium H tartrat 0.58 Pilokarpin 0.16 Maltosa 0.45 KCl 0.6
Asam asetat
Asam asetat 0.55 Atropin 0.13 Galaktosa 0.32
Asam sitrat 0.46 Kokain 0.02 Lactose 0.3
Asam karbonat 0.06 Morfin 0.02
Data dari Pfaffman C: Handbook ofPhysiology, vol .1. Baltimore: Williams & Wilkins, 1959, Hfm. 507.
646
Bab 53 Indra Kimia Pengecapan dan Penghidu
LFBEBBO CJBTBOZB QFOVSVOBO QPUFOTJBM IBNQJS TFCBOEJOH

EFOHBOMPHBSJUNBEBOLPOTFOUSBTJ[BUQFSBOHTBOH1FSVCBIBO
QPUFOTJBMMJTUSJLQBEBTFMQFOHFDBQJOJEJTFCVUQPUFOTJBMSFTFQUPS
VOUVLQFOHFDBQBO
UNIT X
.FLBOJTNF SFBLTJ VOUVL NFNVMBJ QPUFOTJBM SFTFQUPS EJ
TFCBHJBO CFTBS [BU ZBOH UFSBOHTBOH PMFI WJMJ QFOHFDBQ BEBMBI
EFOHBO QFOHJLBUBO [BU LJNJB LFDBQ QBEB NPMFLVM SFTFQUPS
QSPUFJOZBOHEFLBUBUBVNFOPOKPMNFMBMVJNFNCSBOWJMVT)BM
JOJLFNVEJBOBLBONFNCVLBMDBOBMJPO TFIJOHHBJPOOBUSJVN
ZBOH NFNJMJLJ NVBUBO QPTJUJG NBTVL EBO NFOEFQPMBSJTBTJ
LFOFHBUJGBOOPSNBMEJEBMBNTFM4FMBOKVUOZB [BULJNJBLFDBQ
TFDBSB CFSUBIBQ EJCFSTJILBO EBSJ WJMVT QFOHFDBQ PMFI TBMJWB
TFIJOHHBBLBONFOHIJMBOHLBOSBOHTBOHBO
5JQFQSPUFJOSFTFQUPSEJTFUJBQWJMVTQFOHFDBQNFOFOUVLBO
UJQF SBTB ZBOH BLBO EJUFSJNB 6OUVL JPO OBUSJVN EBO JPO
IJESPHFO ZBOH TFDBSB CFSVSVUBO NFMFQBTLBO TFOTBTJ LFDBQ
"OZBNBO EJ TFLJUBS CBEBO TFMTFM QFOHFDBQ NFSVQBLBO SBTBBTJOEBOBTBN QSPUFJOSFTFQUPSBLBONFNCVLBLBOBMJPO
SBOHLBJBO QFSDBCBOHBO UFSBLIJS EBSJ TFSBUTFSBU TBSBG QFOHFDBQ ZBOH TQFTJGJL QBEB NFNCSBO TFM LFDBQ EJ CBHJBO BQJLBM
ZBOH EJSBOHTBOH PMFI TFMTFM SFTFQUPS QFOHFDBQ #FCFSBQB EBSJ EFOHBODBSBNFOHBLUJGLBOSFTFQUPS/BNVOEFNJLJBO VOUVL
TFSBUTFSBUJOJCFSJOWBHJOBTJNFOKBEJMJQBUBOMJQBUBONFNCSBOTFM TFOTBTJSBTBNBOJTEBOQBIJU CBHJBONPMFLVMQSPUFJOSFTFQUPS
QFOHFDBQ #FCFSBQB WFTJLFM UFSCFOUVL EJ CBXBI NFNCSBO TFM EJ ZBOH NFOPOKPM LF NFNCSBO EJ CBHJBO BQJLBM BLBO
EFLBU TFSBU %JEVHB WFTJLFM JOJ NFOHBOEVOH OFVSPUSBOTNJUFS NFOHBLUJGLBO USBOTNJUFS DBSBLB LFEVB TFDPOE NFTTFOHFS
ZBOHEJMFQBTLBONFMBMVJNFNCSBOTFMVOUVLNFSBOHTBOHVKVOH USBOTNJUUFS
EJ EBMBN TFM EBO DBSBLB LFEVB JOJ BLBO
VKVOHTFSBUTBSBGTFCBHBJSFTQPOTUFSIBEBQSBOHTBOHLFDBQ NFOZFCBCLBO QFSVCBIBO LJNJB VOUVL NFMFQBTLBO TJOZBM
QFOHFDBQBO
Lokasi Taste Bud.5BTUFCVEEJUFNVLBOQBEBUJHBUJQFQBQJMB
MJEBI ZBLOJTFCBHBJCFSJLVU
4FCBHJBOCFTBSUBTUFCVEUFSMFUBL Pembentukan Impuls Saraf oleh Taste Bud 1BEB
EJ EJOEJOH TBMVSBO ZBOH NFOHFMJMJOHJ QBQJMB TJSLVNWBMBUB ZBOH QFNCFSJBO SBOHTBOHBO LFDBQ ZBOH QFSUBNB LBMJ LFDFQBUBO
NFNCFOUVLHBSJT7EJQFSNVLBBOMJEBIQPTUFSJPS
4FKVNMBI QFMFQBTBO JNQVMT EJ TFSBU TBSBG EBO UBTUF CVE BLBO NFOJOHLBU
UBTUF CVE UFSMFUBL QBEB QBQJMB GVOHJGPSNJT EJ BUBT QFSNVLBBO TBNQBJ QVODBLOZB EBMBN XBLUV CFCFSBQB EFUJL UFUBQJ
BOUFSJPS MJEBI
4FKVNMBI MBJOOZB UFSMFUBL QBEB QBQJMB GPMJBUB LFNVEJBO BLBO CFSBEBQUBTJ EBMBN XBLUV CFCFSBQB EFUJL
ZBOH UFSEBQBU EJ MJQBUBOMJQBUBO TFQBOKBOH QFSNVLBBO MBUFSBM CFSJLVUOZB TBNQBJ LF UJOHLBU ZBOH MFCJI SFOEBI EBO TUBCJM
MJEBI 5BTUF CVE UBNCBIBO UFSMFUBL QBEB QBMBUVN EBO CFCFSBQB TFMBNBSBOHTBOHBOLFDBQOZBUFUBQBEB+BEJ TJOZBMZBOHDFQBU
EJUFNVLBOQBEBQJMBSUPOTJMBS FQJHMPUJT EBOCBILBOEJFTPGBHVT EBO LVBU BLBO EJIBOUBSLBO PMFI TBSBG QFOHFDBQ EBO TJOZBM
CBHJBO QSPLTJNBM 0SBOH EFXBTB NFNQVOZBJ TBNQBJ CFSMBOKVUZBOHMFCJIMFNBIBLBOEJIBOUBSLBOTFMBNBUBTUFCVE
UBTUFCVE TFEBOHLBOBOBLBOBLNFNQVOZBJMFCJITFEJLJU UFUBQUFSQBKBOEFOHBOSBOHTBOHBOLFDBQ
%J BUBT VTJB UBIVO TFCBHJBO CFTBS UBTUF CVE NFOHBMBNJ
EFHFOFSBTJ ZBOH NFOZFCBCLBO TFOTBTJ QFOHFDBQBO NFOKBEJ Transmisi Sinyal Pengecap ke Sistem Saraf Pusat
TFNBLJOLVSBOHQFLBQBEBVTJBUVB
(BNCBSNFNQFSMJIBULBOKBSBTTBSBGVOUVLUSBOTNJTJTJOZBM
Spesifisitas Taste Bud untuk Rangsangan Pengecapan QFOHFDBQEBSJMJEBIEBOEBFSBIGBSJOHFBMLFTJTUFNTBSBGQVTBU
Utama 1FOFMJUJBO NJLSPFMFLUSPEB QBEB TBUV UBTUF CVE *NQVMT QFOHFDBQ EBSJ EVB QFSUJHB BOUFSJPS MJEBI NVMBNVMB
NFNQFSMJIBULBOUBTUFCVECJBTBOZBCFSFTQPOTUFSIBEBQTBUVEBSJ BLBO EJUFSVTLBO LF OFSWVT MJOHVBMJT LFNVEJBO NFMBMVJ LPSEB
MJNBSBOHTBOHBOQFOHFDBQBOVUBNB CJMB[BULFDBQCFSBEBEBMBN UJNQBOJ NFOVKV OFSWVT GBTJBMJT EBO BLIJSOZB LF USBLUVT
LPOTFOTUSBTJ ZBOH SFOEBI /BNVO QBEB LPOTFOUSBTJ ZBOH UJOHHJ TPMJUBSJVT EJ CBUBOH PUBL 4FOTBTJ QFOHFDBQ EBSJ QBQJMB
TFCBHJBO CFTBS UBTUF CVEEBQBU EJSBOHTBOH PMFI EVB BUBV MFCJI TJSLVNWBMBUBEJCBHJBOCFMBLBOHMJEBIEBOEBSJEBFSBIQPTUFSJPS
SBOHTBOHBO QFOHFDBQBO VUBNB EBO KVHB PMFI CFCFSBQB SPOHHB NVMVU EBO UFOHHPSPLBO MBJOOZB BLBO EJUSBOTNJTJLBO
SBOHTBOHBO LFDBQ MBJOOZB ZBOH UJEBL UFSNBTVL EBMBN LBUFHPSJ NFMBMVJ OFSWVT HMPTTPGBSJOHFVT KVHB LF USBLUVT TPMJUBSJVT UFUBQJ
VUBNB QBEB UFNQBU ZBOH TFEJLJU MFCJI QPTUFSJPS "LIJSOZB CFCFSBQB
TJOZBM QFOHFDBQ EBSJ EBTBS MJEBI EBO CBHJBOCBHJBO MBJO EJ
EBFSBI GBSJOH BLBO EJIBOUBSLBO LF USBLUVT TPMJUBSJVT NFMBMVJ
Mekanisme Perangsangan Taste Bud OFSWVTWBHVT
Potensial Reseptor. .FNCSBOTFMTFM QFOHFDBQ TFQFSUJ
LFCBOZBLBO TFMTFM SFTFQUPS TFOTPSJL MBJOOZB NFNQVOZBJ 4FNVB TFSBU QFOHFDBQBO CFSTJOBQT EJ CBUBOH PUBL CBHJBO
NVBUBOOFHBUJGEJCBHJBOEBMBNZBOHCFSMBXBOBOEFOHBOCBHJBO QPTUFSJPS EBMBN OVLMFVT USBLUVT TPMJUBSJVT /VLMFVT JOJ
MVBS 1FNCFSJBO [BU QFOHFDBQ QBEB SBNCVUSBNCVU QFOHFDBQ NFOHJSJNLBO OFVSPO PSEFLFEVB LF EBFSBI LFDJM EJ OVLMFVT
BLBO NFOZFCBCLBO IJMBOHOZB TFCBHJBO QPUFOTJBM OFHBUJG NFEJBMQPTUFSJPSWFOUSBMUBMBNVT ZBOHUFSMFUBLTFEJLJULFNFEJBM
TFIJOHHBTFMQFOHFDBQNFOHBMBNJEFQPMBSJTBTJ%JTFCBHJBOCFTBS %BSJUBMBNVT OFVSPOPSEFLFUJHBEJIBOUBSLBOLFVKVOH
647
Pilihan Pengecapan dan Pengaturan Pola Makan

1JMJIBO QFOHFDBQBO IBOZB CFSBSUJ CBIXB TFFLPS IFXBO BLBO
NFNJMJI KFOJT NBLBOBO UFSUFOUV ZBOH MFCJI EJTVLBJOZB EBSJQBEB
ZBOH MBJO EBO IFXBO UFSTFCVU TFDBSB PUPNBUJT NFOHHVOBLBOOZB
VOUVL NFNCBOUV NFOHBUVS NBLBOBO ZBOH EJNBLBOOZB 4FMBJO
JUV QJMJIBO QFOHFDBQBO TFSJOH LBMJ CFSVCBI TFTVBJ EFOHBO
LFCVUVIBOUVCVIBLBO[BULIVTVTUFOUFOUV
1FSDPCBBO CFSJLVU JOJ NFOHHBNCBSLBO LFNBNQVBO IFXBO
VOUVL NFNJMJI NBLBOBO TFTVBJ EFOHBO LFCVUVIBO UVCVIOZB
1FSUBNBUBNB IFXBOIFXBO ZBOH NFOHBMBNJ BESFOBMFLUPNJ EBO
LFLVSBOHBO HBSBN TFDBSB PUPNBUJT BLBO NFNJMJI BJS ZBOH
NFNQVOZBJLBOEVOHBOOBUSJVNLMPSJEBZBOHUJOHHJEJCBOEJOHLBO
BJSNVSOJ EBOLFBEBBOJOJTFSJOHLBMJDVLVQNFNFOVIJLFCVUVIBO
UVCVI EBO NFODFHBI LFNBUJBO BLJCBU LFLVSBOHBO HBSBN ,FEVB
N. VII IFXBO ZBOH EJTVOUJL EFOHBO JOTVMJO EBMBN KVNBI CFTBS BLBO
NFOHBMBNJ LFLVSBOHBO HVMB EBSBI EBO IFXBO UFSTFCVU TFDBSB
N. IX PUPNBUJTBLBONFNJMJINBLBOBOZBOHQBMJOHNBOJTEBSJCFSCBHBJ
TBNQFM ,FUJHB IFXBO ZBOH NFOHBMBNJ QBSBUJSPJEFLUPNJ EBO
N. X
LFLVSBOHBO LBMTJVN TFDBSB PUPNBUJT BLBO NFNJMJI BJS NJOVN
EFOHBOLBOEVOHBOLBMTJVNLMPSJEBZBOHUJOHHJ
'FOPNFOB TFSVQB KVHB EJUFNVLBO EJ LFIJEVQBO TFIBSJIBSJ
4FCBHBJ DPOUPI CBUV HBSBN EJ EBFSBI HVSVO UFSCVLUJ BLBO
NFOBSJLIFXBOIFXBOEBSJEBFSBIZBOHKBVI.BOVTJBKVHBBLBO
NFOPMBL TFUJBQ NBLBOBO ZBOH NFNQVOZBJ TFOTBTJ BGFLUJG ZBOH
UJEBL FOBL )BM UFSTFCVU EJ CFSCBHBJ LFBEBBO EBQBU NFMJOEVOHJ
UVCVILJUBEBSJ[BUZBOHNFNBOHUJEBLEJLFIFOEBLJ
CBXBIHJSVTQPTUTFOUSBMJTQBEBLPSUFLTTFSFCSJQBSJFUBMJT UFNQBU 'FOPNFOB QJMJIBO QFOHFDBQBO IBNQJS TFMBMV CFSBTBM EBSJ
OFVSPOJOJNFMJQBULFEBMBNGJTVSBTZMWJJ EBOLFEBMBNEBFSBI CFCFSBQB NFLBOJTNF ZBOH UFSEBQBU QBEB TJTUFN TBSBG QVTBU EBO
PQFSLVMBSJOTVMBS%BFSBIJOJUFSMFUBLTFEJLJULFMBUFSBM WFOUSBM CVLBO EBSJ NFLBOJTNF QBEB SFTFQUPSP QFOHFDBQBO JUV TFOEJSJ
EBOSPTUSBMEBSJEBFSBIVOUVLTJOZBMUBLUJMMJEBIEJBSFBTPNBUJL XBMBVQVO SFTFQUPS NFNBOH TFSJOH LBMJ NFOKBEJ QFLB UFSIBEBQ
TFSFCSJ * %BSJ QFOKFMBTBO NFOHFOBJ KBSBT QFOHFDBQ JOJ EBQBU OVUSJFOZBOHEJCVUVILBO"MBTBOZBOHQFOUJOHVOUVLCFSQFOEBQBU
UFSMJIBU KBSBT JOJ NFOHJLVUJ EFOHBO LFUBU KBSBT TPNBUPTFOTPSJL QJMJIBO QFOHFDBQBO NFSVQBLBO GFOPNFOB TJTUFN TBSBG QVTBU
EBSJMJEBI BEBMBICBIXBQFOHBMBNBOUFSEBIVMVEFOHBOSBTBZBOHUJEBLFOBL
BUBVFOBLBLBOTBOHBUCFSQFSBOQFOUJOHEBMBNNFOFOUVLBOQJMJIBO
Refleks Pengecapan Bergabung di dalam Batang Otak QFOHFDBQBOTFTFPSBOH4FCBHBJDPOUPI KJLBTFTFPSBOHNFSBTBTBLJU
TFHFSB TFTVEBI NBLBO KFOJT NBLBOBO UFSUFOUV PSBOH UFSTFCVU
%BSJ USBLUVT TPMJUBSJVT TFKVNMBI CFTBS JNQVMT QFOHFDBQBO
VNVNOZBBLBONFNCFOUVLQJMJIBOQFOHFDBQBOZBOHOFHBUJG BUBV
EJIBOUBSLBO LF EBMBN CBUBOH PUBL JUV TFOEJSJ MBOHTVOH LF
NFOHIJOEBSJ QFOHFDBQBO NBLBOBO UFSUFOUV EJ LFNVEJBO IBSJ IBM
OVLMFVT TBMJWBUPSJVT JOGFSJPS EBO TVQFSJPS ,FNVEJBO BSFB JOJ
TFSVQBKVHBEBQBUEJUFNVLBOQBEBIFXBOUJOHLBUSFOEBI
BLBO NFOHIBOUBSLBO TJOZBM LF LFMFOKBS TVCNBOEJCVMBSJT
TVCMJOHVBMJT EBO QBSPUJT VOUVL NFNCBOUV NFOHFOEBMJLBO
TFLSFTJTBMJWBTFMBNBQSPTFTNFOFMBOEBOQFODFSOBBONBLBOBO
Indra Penghidu
Kecepatan Adaptasi Pengecapan.4FUJBQPSBOHNFOHFUBIVJ 1FOHIJEV BEBMBI JOESB ZBOH QBMJOH TFEJLJU EJNFOHFSUJ ,FBEBBO
TFOTBTJQFOHFDBQBOEBQBUCFSBEBQUBTJEFOHBODFQBU TFSJOHLBMJ JOJ TFCBHJBO EJTFCBCLBO LBSFOB JOESB QFOHIJEV NFSVQBLBO
IBNQJS TFMVSVIOZB EBMBN XBLUV TBUV BUBV CFCFSBQB NFOJU GFOPNFOB TVCKFLUJG ZBOH UJEBL NVEBI EJQFMBKBSJ QBEB IFXBO
TFMBNB BEB SBOHTBOHBO ZBOH CFSLFTJOBNCVOHBO /BNVO EBSJ IFXBO UJOHLBU SFOEBI ,FOEBMB MBJO ZBOH NFOBNCBI LFSVNJUBO
QFOFMJUJBOFMFLUSPGJTJPMPHJUFSIBEBQTFSBUTBSBGQFOHFDBQ UFSMJIBU BEBMBIQBEBNBOVTJBJOESBQFOHIJEVUJEBLCFSLFNCBOHTFNQVSOB
CBIXB BEBQUBTJ UBTUF CVE TFOEJSJ CJBTBOZB IBOZB NFNCFSJLBO EJCBOEJOHLBOTFCBHJBOCFTBSIFXBOUJOHLBUSFOEBI
QFSBO UJEBL MFCJI EBSJ TFLJUBS TFQBSVIOZB 0MFI LBSFOB JUV
BEBQUBTJ BLIJS ZBOH TBOHBU MVBS CJBTB QBEB TFOTBTJ QFOHFDBQBO Membran Olfaktorius
IBNQJS TFMVSVIOZB UFSKBEJ QBEB TJTUFN TBSBG QVTBU JUV TFOEJSJ .FNCSBO PMGBLUPSJVT ZBOH HBNCBSBO IJTUPMPHJOZB EJQFSMJIBULBO
XBMBVQVONFLBOJTNFEBOEBFSBIOZBCFMVNEJLFUBIVJ/BNVO QBEB (BNCBS UFSMFUBL EJ CBHJBO TVQFSJPS EJ TFUJBQ SPOHHB
NFLBOJTNFOZB CFSCFEB EBSJ LFCBOZBLBO TJTUFN TFOTPSJL IJEVOH%JTFCFMBINFEJBM NFNCSBOPMGBLUPSJVTUFSMJQBULFCBXBI
MBJOOZB ZBOHIBNQJSTFMVSVIOZBCFSBEBQUBTJEJUJOHLBUSFTFQUPS EJ TFQBOKBOH QFSNVLBBO TFQUVN TVQFSJPS EJ TFCFMBI MBUFSBM
UFSMJQBUEJBUBTLPOLIBTVQFSJPSEBOCBILBOEJBUBTTFCBHJBOLFDJM
EBSJ QFSNVLBBO BUBT LPOLIB NFEJBM %J TFUJBQ SPOHHB IJEVOH
NFNCSBOPMGBLUPSJVTNFNQVOZBJMVBTQFSNVLBBOTFLJUBS DN
648
UNIT X
Na+
G
A
4FM4FM 0MGBLUPSJVT 4FMTFM SFTFQUPS VOUVL TFOTBTJ QFOHIJEV B Na+
BEBMBITFMTFMPMGBLUPSJVT MJIBU(BNCBS
ZBOHQBEBEBTBSOZB
NFSVQBLBO TFM TBSBG CJQPMBS ZBOH CFSBTBM EBSJ TJTUFN TBSBG QVTBU
ATP cAMP
JUV TFOEJSJ 5FSEBQBU TFLJUBS KVUB TFM TFQFSUJ JOJ QBEB FQJUFM
PMGBLUPSJVT ZBOH UFSTFCBS EJ BOUBSB TFMTFM TVTUFOUBLVMBS TFM
QFOZBOHHB
TFQFSUJ UFSMJIBU QBEB (BNCBS 6KVOH NVLPTB
EBOTFMPMGBLUPSJVTNFNCFOUVLUPOKPM ZBOHEBSJUFNQBUJOJBLBO
EJLFMVBSLBO TBNQBJ SBNCVU PMGBLUPSJVT KVHB EJTFCVU TJMJB
PMGBLUPSJVT
ZBOHCFSEJBNFUFS NEBOQBOKBOHOZBTBNQBJ
N UFSQSPZFLTJLFEBMBNNVLVTZBOHNFMBQJTJQFSNVLBBOEBMBN
SPOHHB IJEVOH 4JMJB PMGBLUPSJVT ZBOH UFSQSPZFLTJ JOJ BLBO
NFNCFOUVLBMBTZBOHQBEBUQBEBNVLVT EBOJOJBEBMBITJMJBZBOH EFLBUOZB ZBJUV HFSCBOH LBOBM JPO OBUSJVN ZBOH BLBO
BLBO CFSFBLTJ UFSIBEBQ CBV EJ VEBSB EBO LFNVEJBO BLBO NFNCVLB HFSCBOH EBO NFNVOHLJOLBO TFKVNMBI CFTBS JPO
NFSBOHTBOH TFMTFM PMGBLUPSJVT TFQFSUJ ZBOH BLBO EJCJDBSBLBO OBUSJVN NFOHBMJS NFMFXBUJ NFNCSBO LF EBMBN TJUPQMBTNB TFM
CFSJLVU 1BEB NFNCSBO PMGBLUPSJVT EJ BOUBSB TFMTFM PMGBLUPSJVT SFTFQUPS *PO OBUSJVN BLBO NFOJOHLBULBO QPUFOTJBM MJTUSJL LF
UFSTFCBS CBOZBL LFMFOKBS #PXNBO ZBOH LFDJM ZBOH NFOZFLSFTJ BSBI QPTJUJG EJ TJTJ EBMBN NFNCSBO TFM TFIJOHHB NFSBOHTBOH
NVLVTLFQFSNVLBBONFNCSBOPMGBLUPSJVT OFVSPOPMGBLUPSJVTEBONFOHIBOUBSLBOQPUFOTJBMBLTJLFTJTUFN
TBSBGQVTBUNFMBMVJOFSWVTPMGBLUPSJVT
.FLBOJTNF &LTJUBTJ QBEB 4FM4FM 0MGBLUPSJVT #BHJBO TFM .BLOBZBOHQFOUJOHEBSJNFLBOJTNFJOJQBEBBLUJWBTJTBSBG

PMGBLUPSJVT ZBOH NFNCFSJ SFTQPOT UFSIBEBQ SBOHTBOH LJNJB TBSBG PMGBLUPSJVT BEBMBI CBIXB NFLBOJTNF UFSTFCVU TBOHBU
PMGBLUPSJVTBEBMBITJMJBPMGBLUPSJVT;BUZBOHCFSCBV ZBOHUFSDJVN NFMJQBUHBOEBLBO FGFL QFSBOHTBOHBO CBILBO EBSJ CBV ZBOH
QBEBTBBULPOUBLEFOHBOQFSNVLBBONFNCSBOPMGBLUPSJVT NVMB QBMJOHMFNBITFLBMJQVO6OUVLSJOHLBTOZB
"LUJWBTJQSPUFJO
NVMBNFOZFCBSTFDBSBEJGVTLFEBMBNNVLVTZBOHNFOVUVQJTJMJB SFTFQUPS PMFI TVCTUBOTJ CBV EBQBU NFOHBLUJWBTJ LPNQMFLT
4FMBOKVUOZB BLBOCFSJLBUBOEFOHBOQSPUFJOSFTFQUPSEJNFNCSBO QSPUFJO(
)BMJOJLFNVEJBONFOHBLUJWBTJCBOZBLNPMFLVM
TFUJBQ TJMJVN (BNCBS
4FUJBQ QSPUFJO SFTFQUPS TFCFOBSOZB BEFOJMBU TJLMBTF EJ CBHJBO EBMBN NFNCSBO TFM PMGBLUPSJVT

NFSVQBLBO NPMFLVM QBOKBOH ZBOH EJ NFNCSBO NFMJQBU LF BSBI 4FMBOKVUOZB IBM JOJ BLBO NFOZFCBCLBO QFNCFOUVLBO KVNMBI
EBMBNEBOLFBSBIMVBSLJSBLJSBTFCBOZBLUVKVILBMJ#BVUFSTFCVU NPMFLVM D".1 NFOKBEJ CFSLBMJ MJQBU MFCJI CBOZBL

CFSJLBUBO EFOHBO CBHJBO QSPUFJO SFTFQUPS ZBOH NFMJQBU LF BSBI "LIJSOZB D".1 UFUBQ NFNCVLB LBOBM JPO OBUSJVN ZBOH
MVBS /BNVO EFNJLJBO CBHJBO EBMBN QSPUFJO ZBOH NFMJQBU BLBO KVNMBIOZB TFNBLJO CBOZBL 0MFI LBSFOB JUV CBV UFSUFOUV
TBMJOH CFSQBTBOHBO VOUVL NFNCFOUVL QSPUFJO( ZBOH EFOHBO LPOTFOUSBTJ ZBOH QBMJOH LFDJM UFUBQ EBQBU NFNVMBJ
NFSVQBLBO LPNCJOBTJ EBSJ UJHB TVCVOJU 1BEB QFSBOHTBOHBO SBOHLBJBO FGFL ZBOH BLBO NFNCVLB CBOZBL TFLBMJ LBOBM
QSPUFJOSFTFQUPS TVCVOJUBMGBBLBONFNFDBILBOEJSJEBSJQSPUFJO OBUSJVN )BM JOJ NFOJNCVMLBO TFOTJUJWJUBT ZBOH TBOHBU CFTBS
(EBOTFHFSBNFOHBLUJWBTJBEFOJMBUTJLMBTF ZBOHNFMFLBUQBEBTJTJ QBEB OFVSPOOFVSPO PMGBLUPSJVT NFTLJQVO KVNMBI CBV JUV
EBMBN NFNCSBO TJMJBS EJ EFLBU CBEBO TFM SFTFQUPS 4JLMBTF ZBOH TFEJLJUTFLBMJ
UFSBLUJWBTJ LFNVEJBO NFOHVCBI CBOZBL NPMFLVM BEFOPTJO 6OUVL NFSBOHTBOH TFMTFM PMGBLUPSJVT TFMBJO NFLBOJTNF
USJGPTGBU JOUSBTFM NFOKBEJ BEFOPTJO NPOPGPTGBU TJLMJL D".1
LJNJBXJ EBTBS NBTJI UFSEBQBU CFCFSBQB GBLUPS GJTJL ZBOH
"LIJSOZB D".1JOJNFOHBLUJWBTJQSPUFJONFNCSBOMBJOEJ NFNFOHBSVIJEFSBKBUQFSBOHTBOHBO1FSUBNB IBOZB[BU
649
ZBOHEBQBUNFOHVBQZBOHEBQBUUFSDJVNCBVOZB ZBJUVZBOH NFOHLMBTJGJLBTJLBOTFOTBTJTFOTBTJJOJNFOKBEJTFCBHBJCFSJLVU

EBQBU UFSIJSVQ LF EBMBN IJEVOH ,FEVB [BU ZBOH
NFSBOHTBOHUFSTFCVUQBMJOHUJEBLIBSVTCFSTJGBUTFEJLJUMBSVU 1. #BVLBNQFS
EBMBN BJS TFIJOHHB CBV UFSTFCVU EBQBU NFMFXBUJ NVLVT 2. #BVNVTL
VOUVL NFODBQBJ TJMJB PMGBLUPSJVT ,FUJHB MFCJI CBJL CJMB JOJ
3. )BSVNCVOHBCVOHBBO GMPSBM
BLBO TBOHBU NFNCBOUV CBHJ CBV TFEJLJU MBSVU EBMBN MFNBL

EJEVHB LBSFOB CBHJBO MJQJE QBEB TJMJVN JUV TFOEJSJ 4. #BVQFQFSNJO
NFSVQBLBOQFOHIBMBOHZBOHMFNBIUFSIBEBQCBVZBOHUJEBL 5. &UIFSFBM
MBSVUEBMBNMFNBL 6. #BVZBOHUBKBN QVOHFOU
7. #VTVL QVUSJE
Potensial Membran dan Potensial Aksi pada Sel-Sel

0MGBLUPSJVT 1PUFOTJBM NFNCSBO EJ EBMBN TFMTFM PMGBLUPSJVT 1FSMVEJQFSIBUJLBOEBGUBSJOJUJEBLCFOBSCFOBSNFXBLJMJTFOTBTJ
ZBOH UFSBOHTBOH ZBOH EJVLVS PMFI NJLSPFMFLUSPEB SBUBSBUB QFOHIJEV VUBNB ZBOH TFTVOHHVIOZB 1BEB UBIVOUBIVO UFSBLIJS
TFLJUBSoNJMJWPMU1BEBOJMBJQPUFOTJBMJOJ TFCBHJBOCFTBSTFM JOJ CFCFSBQBQFUVOKVLUFSNBTVLQFOFMJUJBOZBOHTQFTJGJLUFSIBEBQ
TFDBSBUFSVTNFOFSVTBLBONFOHIBTJMLBOQPUFOTJBMBLTJEFOHBO HFOHFO ZBOH NFOZBOEJ QSPUFJOQSPUFJO SFTFQUPS NFOVOKVLLBO
LFDFQBUBO ZBOH TBOHBU MBNCBU EFOHBO WBSJBTJ NVMBJ EBSJ TBUV TFEJLJUOZB TFOTBTJ QFOHIJEV VUBNB QFSCFEBBO ZBOH TBOHBU
LBMJTFUJBQEFUJLTBNQBJEVBBUBVUJHBLBMJQFSEFUJL NFODPMPL CJMB EJCBOEJOHLBO EFOHBO IBOZB UJHB TFOTBTJ XBSOB
,FCBOZBLBOCBVNFOZFCBCLBOEFQPMBSJTBTJQBEBNFNCSBO VUBNB ZBOH EJEFUFLTJ NFMBMVJ QFOHMJIBUBO EBO IBOZB MJNB TFOTBTJ
TFMPMGBLUPSJVT EFOHBONFOVSVOLBOQPUFOTJBMOFHBUJGEJEBMBN QFOHFDBQBO VUBNB ZBOH EBQBU EJEFUFLTJ PMFI MJEBI #FCFSBQB
TFM EBSJ OJMBJ OPSNBM ZBLOJ o NJMJWPMU TBNQBJ o NJMJWPMU QFOFMJUJBO CFSQFOEBQBU NVOHLJO BEB QBMJOH TFEJLJU UJQF
BUBV CBILBO MFCJI SFOEBI MBHJ TFIJOHHB NFOHVCBI WPMUBTF LF SFTFQUPS CBV )BMIBM QFOEVLVOH TFMBOKVUOZB VOUVL CFSCBHBJ
BSBIZBOHQPTJUJG#FSTBNBBOEFOHBOJOJ KVNMBIQPUFOTJBMBLTJ TFOTBTJQFOHIJEVVUBNB BEBMBICBIXBBEBPSBOHZBOHUJEBLQFLB
NFOJOHLBU TBNQBJ IJOHHB QFS EFUJL ZBOH NFSVQBLBO UFSIBEBQCBVEBSJTBUV[BUUFSUFOUVLFUJEBLQFLBBOTFQFSUJJOJTVEBI
LFDFQBUBO ZBOH UJOHHJ VOUVL OFSWVT PMGBLUPSJVT ZBOH UFSJEFOUJGJLBTJVOUVLMFCJIEBSJ[BUZBOHCFSCFEB%JQFSLJSBLBO
CFSVLVSBOLFDJM LFUJEBLQFLBBO CBV VOUVL TFUJBQ [BU NFODFSNJOLBO LVSBOHOZB
%BMBN LJTBSBO ZBOH MFCJI MVBT LFDFQBUBO JNQVMT OFSWVT QSPUFJO SFTFQUPS ZBOH DPDPL QBEB TFMTFM PMGBLUPSJVT VOUVL [BU
PMGBLUPSJVT BLBO CFSVCBI TFDBSB IBNQJS TFCBOEJOH EFOHBO UFSUFOUV
MPHBSJUNB LFLVBUBO SBOHTBOH ZBOH NFNQFSMJIBULBO SFTFQUPS Sifat Afektif Penghidu 1FOHIJEV XBMBVQVO MFCJI CBOZBL
PMGBLUPSJVTJOJNFOHJLVUJQSJOTJQQSJOTJQUSBOTEVLTJZBOHNJSJQ QBEB QFOHFDBQBO NFNQVOZBJ LVBMJUBT BGFLUJG CFSVQB
EFOHBOZBOHUFSKBEJQBEBSFTFQUPSTFOTPSJLMBJOOZB NFOZFOBOHLBO BUBV UJEBL NFOZFOBOHLBO 0MFI LBSFOB JUVMBI
"EBQUBTJ$FQBU4FOTBTJ1FOHIJEV4FLJUBSQFSTFOSFTFQUPS QFOHIJEV CBILBO MFCJI QFOUJOH EBSJQBEB QFOHFDBQBO EBMBN
NFNJMBI NBLBOBO 4FMBJO JUV PSBOH ZBOH TFCFMVNOZB QFSOBI
PMGBLUPSJVT BLBO CFSBEBQUBTJ QBEB EFUJL QFSUBNB BUBV TFUFMBI
NFNBLBONBLBOBOZBOHEJSBTBLBOOZBUJEBLFOBLTFSJOHLBMJBLBO
SBOHTBOH4FTVEBIJUV SFTFQUPSBLBOTBOHBUTFEJLJUEBOMBNCBU
NFSBTB NVBM IBOZB EFOHBO NFODJVN CBV NBLBOBO ZBOH TBNB
CFSBEBQUBTJ/BNVOEBSJQFOHBMBNBO LJUBTFNVBUBIVTFOTBTJ
VOUVL LFEVB LBMJOZB /BNVO TFCBMJLOZB CBV QBSGVN EFOHBO
CBV EBQBU CFSBEBQUBTJ EFOHBO KFMBT IBNQJS EBMBN XBLUV TBUV
LVBMJUBT ZBOH TFTVBJ EBQBU NFOKBEJ QFSBOHTBOH LVBU VOUVL FNPTJ
NFOJU BUBV TFHFSB TFTVEBI NFNBTVLJ MJOHLVOHBO ZBOH CFSCBV
TFTFPSBOH 4FMBJO JUV QBEB CFCFSBQB IFXBO UJOHLBU SFOEBI CBV
LVBU 0MFI LBSFOB BEBQUBTJ QTJLPMPHJT JOJ KBVI MFCJI CFTBS
NFSVQBLBOQFSBOHTBOHHBJSBITFLTVBMZBOHVUBNB
EBSJQBEB EFSBKBU BEBQUBTJ SFTFQUPS JUV TFOEJSJ IBNQJS EBQBU
EJQBTUJLBO CBIXB TFCBHJBO CFTBS BEBQUBTJ UBNCBIBO UFSKBEJ Ambang Batas Penghidu. 4BMBI TBUV LBSBLUFSJTUJL EBTBS
EBMBNTJTUFNTBSBGQVTBU)BMJOJUBNQBLOZBKVHBUFSKBEJQBEB QFOHIJEVBEBMBI[BUQFSBOHTBOHEJVEBSBEBMBNKVNMBIZBOHTFEJLJU
TFOTBTJQFOHFDBQBO TBKB TVEBI EBQBU NFOJNCVMLBO TFOTBTJ QFOHIJEV 4FCBHBJ DPOUPI
[BU NFUJMNFSLBQUBO EBQBU UFSDJVN XBMBVQVO IBOZB EJUFNVLBO
.FLBOJTNFQFSTBSBGBOVOUVLBEBQUBTJZBOHEJBKVLBOBEBMBI USJMJVO QFS HSBN EJ EBMBN TFUJBQ NJMJMJUFS VEBSB 0MFI LBSFOB
TFCBHBJCFSJLVU4FKVNMBICFTBSTFSBUTBSBGTFOUSJGVHBMNFMJOUBT BNCBOH CBUBT ZBOH TBOHBU SFOEBI JOJ [BU UFSTFCVU EJDBNQVSLBO
EBSJ EBFSBI PMGBLUPSJVT EJ PUBL LF CFMBLBOH TFQBOKBOH USBLUVT QBEB HBT BMBN VOUVL NFNCFSJ CBV QBEB HBT TFIJOHHB EBQBU
PMGBLUPSJVT EBO CFSBLIJS QBEB TFMTFM JOIJCJUPS LIVTVT QBEB NFOEFUFLTJBQBCJMBBEBTFKVNMBILFDJMHBTCPDPSEBSJQJQBOZB
CVMCVTPMGBLUPSJVT ZBJUVTFMHSBOVMB%JEVHBTFTVEBISBOHTBOH Gradasi Intensitas Penghidu. 8BMBVQVO BNCBOH CBUBT
PMGBLUPSJVT TJTUFN TBSBG QVTBU EFOHBO TFHFSB NFNCFOUVL LPOTFOUSBTJ[BUZBOHNFOHFMVBSLBOCBVTBOHBULFDJM VOUVLCBOZBL
QFOHIBNCBUBO VNQBO CBMJL ZBOH LVBU VOUVL NFOFLBO CBVCBVBO CBILBO NVOHLJO TFCBHJBO CFTBS
IBOZB EFOHBO
QFOFSVTBOTJOZBMQFOHIJEVNFMBMVJCVMCVTPMGBLUPSJVT LPOTFOUSBTJ TBNQBJ LBMJ EJ BUBT OJMBJ BNCBOH CBUBT EBQBU
NFOHIBTJMLBO JOUFOTJUBT CBV ZBOH NBLTJNBM *OJ CFSCFEB EFOHBO
Mencari Sensasi Utama Penghidup LFCBOZBLBO TJTUFN TFOTPSJL UVCVI ZBOH MBJOOZB ZBOH
NFNFSMVLBO LJTBSBO QFSCFEBBO JOUFOTJUBT ZBOH TBOHBU CFTBS
%BIVMV TFCBHJBO CFTBS BIMJ GJTJPMPHJ QFSDBZB CBIXB TFCBHJBO NJTBMOZB CFSCBOEJOH VOUVL NBUB EBO USJMJVO
CFTBS TFOTBTJ QFOHIJEV CFSBTBM EBSJ TFKVNMBI LFDJM TFOTBTJ CFSCBOEJOH VOUVL UFMJOHB 1FSCFEBBO JOJ NVOHLJO EBQBU
VUBNB EFOHBO DBSB ZBOH TBNB TFQFSUJ QBEB QFOHMJIBUBO EBO EJKFMBTLBO PMFI LFOZBUBBO CBIXB TJTUFN QFOHIJEV MFCJI
QFOHFDBQBO ZBOH UFSEJSJ BUBT CFCFSBQB TFOTBTJ VUBNB EJIVCVOHLBO EFOHBO QSPTFT EFUFLTJ BEB BUBV UJEBL BEBOZB CBV
#FSEBTBSLBOQFOFMJUJBOQTJLPMPHJT UFMBIEJVTBIBLBOVOUVL EBSJQBEBEFUFLTJLVBOUJUBUJGJOUFOTJUBTOZB
650
Penghantaran Sinyal-Sinyal Penghidu ke Sistem Saraf Jaras-Jaras Olfaktorius yang Paling Tua, yang Kurang
Pusat Tua, dan yang Paling Baru Masuk ke Sistem Saraf pusat
#BHJBOPMGBLUPSJVTPUBLNFSVQBLBOTBMBITBUVTUSVLUVSPUBLZBOH 5SBLUVT PMGBLUPSJVT NFNBTVLJ PUBL QBEB TBNCVOHBO BOUFSJPS
QFSUBNB CFSLFNCBOH QBEB IFXBO QSJNJUJG EBO TFCBHJBO CFTBS BOUBSB NFTFOTFGBMPO EBO TFSFCSVN EJ TJOJ USBLUVT BLBO UFSCBHJ
PUBL MBJOOZB ZBOH UFSTJTB CFSLFNCBOH EJ TFLJUBS PMGBLUPSJVT JOJ NFOKBEJEVBKBSBT TFQFSUJZBOHUBNQBLEBMBN(BNCBS TBUV
UNIT X
1BEBLFOZBUBOOZB CBHJBOPUBLZBOHNFSVQBLBOBTBMNVMBPMGBLTJ CFSKBMBO EJ TFCFMBI NFEJBM NFOVKV BSFB PMGBLUPSJVT NFEJBM EBO
JOJ LFNVEJBO CFSLFNCBOH NFOKBEJ TUSVLUVS EBTBS PUBL ZBOH ZBOH MBJO CFSKBMBO EJ TFCFMBI MBUFSBM NFOVKV BSFB PMGBLUPSJVT
NFOHFOEBMJLBOFNPTJEBSJBTQFLQFSJMBLVMBJOOZBQBEBNBOVTJB MBUFSBM"SFBPMGBLUPSJVTNFEJBMNFXBLJMJTJTUFNPMGBLUPSJVTZBOH
TJTUFNJOJLJUBTFCVUTJTUFNMJNCJL EJCBIBTQBEB#BC QBMJOH UVB TFEBOHLBO BSFB PMGBLUPSJVT MBUFSBM NFSVQBLBO JOQVU
VOUVL
TJTUFNPMGBLUPSJVTZBOHUVBEBO
TJTUFNZBOHQBMJOH
Penghantaran Sinyal-Sinyal Olfaktorius ke Bulbus Olfak- CBSV
torius #VMCVT PMGBLUPSJVT EJQFSMJIBULBO QBEB (BNCBS 4FSBU
TBSBG ZBOH LFNCBMJ EBSJ CVMCVT EJTFCVU OFSWVT LSBOJBMJT BUBV
USBLUVT PMGBLJPSJVT /BNVO EFNJLJBO TFCFOBSOZB LFEVB USBLUVT Sistem Olfaktorius yang PalingTua—Area Olfaktorius Medial.
"SFB PMGBLUPSJVT NFEJBM UFSEJSJ BUBT TFLFMPNQPL OVLMFJ ZBOH
EBO CVMCVT NFSVQBLBO QFSUVNCVIBO KBSJOHBO PUBL EBSJ EBTBS
UFSMFUBL EJ CBHJBO UFOHBI CBTBM PUBL UFQBU EJ BOUFSJPS
PUBL LF BSBI BOUFSJPS QFNCFTBSBO ZBOH CFSCFOUVL CVMBU QBEB
IJQPUBMBNVT 4FCBHJBO CFTBS CFOUVL ZBOH NFODPMPL JOJ BEBMBI
VKVOHOZB EJTFCVU CVMCVT PMGBLUPSJVT UFSMFUBL QBEB MBNJOB
OVLMFJ TFQUVN ZBOH NFSVQBLBO OVLMFJ EJ HBSJT UFOHBI ZBOH
LSJCSJGPSNJT ZBOH NFNJTBILBO SPOHHB PUBL EBSJ CBHJBO BUBT
NBTVLLFEBMBNIJQPUBMBNVTEBOCBHJBOQSJNJUJGMBJOOZBEBMBN
SPOHHB IJEVOH -BNJOB LSJCSJGPSNJT NFNJMJLJ CBOZBL MVCBOH
TJTUFN MJNCJL PUBL 4JTUFN JOJ NFSVQBLBO BSFB EJ PUBL ZBOH
LFDJM ZBOH NFSVQBLBO UFNQBU NBTVLOZB TBSBGTBSBG LFDJM EBMBN
QBMJOHCFSLBJUBOEFOHBOQFSJMBLVEBTBS EJCBIBTEBMBN#BC

KVNMBI ZBOH TBNB OBJL EBSJ NFNCSBO PMGBLUPSJVT EJ SPOHHB
IJEVOH NFNBTVLJ CVMCVT PMGBLUPSJVT EJ SPOHHB LSBOJBM (BNCBS
NFOHHBNCBSLBO IVCVOHBO ZBOH FSBU BOUBSB TFMTFM .BLOBQFOUJOHBSFBPMGBLUPSJVTNFEJBMJOJQBMJOHCBJLEJNF
PMGBLUPSJVT EJ NFNCSBO PMGBLUPSJVT EFOHBO CVMCVT PMGBLUPSJVT OHFSUJ EFOHBO NFNQFSIBUJLBO BQB ZBOH UFSKBEJ QBEB CJOBUBOH
ZBOH NFNQFSMJIBULBO BLTPOBLTPO QFOEFL EBO TFM PMGBLUPSJVT LFUJLBBSFBPMGBLUPSJVTMBUFSBMQBEBLFEVBTJTJPUBLOZBEJBOHLBU
CFSBLIJSEJTUSVLUVSHMPCVMBSNVMUJQFMEJEBMBNCVMCVTPMGBLUPSJVT EBOIBOZBTJTUFNNFEJBMZBOHUFSTJTB+BXBCBOOZBBEBMBICBI
ZBOH EJTFCVU HMPNFSVMJ 4FUJBQ CVMCVT NFNJMJLJ CFCFSBQB SJCV XBBSFBJOJIBNQJSUJEBLCBOZBLNFNFOHBSVIJSFTQPOTQSJNJUJG
NBDBN HMPNFSVMJ NBTJOHNBTJOH NFSVQBLBO VKVOH EBSJ TFLJUBS UFSIBEBQ PMGBLTJ TFQFSUJ NFOKJMBU CJCJS TBMJWBTJ EBO SFTQPOT
BLTPO ZBOH CFSBTBM EBSJ TFMTFM PMGBLUPSJVT 4FUJBQ NBLBO MBJOOZB ZBOH EJTFCBCLBO PMFI CBV NBLBOBO BUBV
HMPNFSVMVT KVHB NFSVQBLBO VKVOH VOUVL EFOESJU ZBOH CFSBTBM EPSPOHBO FNPTJ QSJNJUJG ZBOH CFSLBJUBO EFOHBO CBV 4FCBMJL
EBSJ TFLJUBS TFMTFM NJUSBM ZBOH CFTBS EBO TFLJUBS TFMTFM OZB QFOHBOHLBUBOBSFBMBUFSBMBLBONFOHIBQVTSFGMFLTSFGMFLT
CFSVNCBJ ZBOH MFCJI LFDJM EFOHBO CBEBO TFM ZBOH UFSMFUBL EJ PMGBLUPSJVTZBOHUFMBIUFSLPOEJTJEBOMFCJILPNQMFLT
CVMCVT PMGBLUPSJVT QBEB CBHJBO TVQFSJPS HMPNFSVMJ %FOESJU JOJ
NFOFSJNB TJOBQT EBSJ TBSBG TFM PMGBLUPSJVT TFM NJUSBM EBO TFM Sistem Olfaktorius yang Kurang Tua—Area Olfaktorius
CFSVNCBJ ZBOH NFOHJSJNLBO BLTPOBLTPO NFMBMVJ USBLUVT Lateral. "SFB PMGBLUPSJVT MBUFSBM UFSVUBNB UFSEJSJ BUBT LPSUFLT
PMGBLUPSJVT VOUVL NFOHIBOUBSLBO TJOZBMTJOZBM PMGBLUPSJVT LF QSFQJSJGPSNJT EBO LPSUFLT QJSJGPSNJT EJUBNCBI CBHJBO LPSUJLBM
OVLMFJ BNJHEBMPJE %BSJ EBFSBI JOJ KBSBT TJOZBM CFSKBMBO LF
UJOHLBUZBOHMFCJIUJOHHJEJTJTUFNTBSBGQVTBU
IBNQJS TFNVB CBHJBO TJTUFN MJNCJL UFSVUBNB LF CBHJBO ZBOH
#FCFSBQBQFOFMJUJBONFOVOKVLLBOHMPNFSVMJZBOHCFSCFEBBLBO LVSBOHQSJNJUJG TFQFSUJIJQPLBNQVT ZBOHUBNQBLOZBNFOKBEJ
NFNCFSJSFTQPOTCBVZBOHCFSCFEBQVMB,FNVOHLJOBOHMPNFSVMJ IBM QBMJOH QFOUJOH EBMBN QSPTFT CFMBKBS VOUVL NFOZVLBJ BUBV
NFSVQBLBO UFNQBU TFCFOBSOZB VOUVL NFOHBOBMJTJT CFSCBHBJ UJEBL NFOZVLBJ NBLBOBO UFSUFOUV ZBOH CFSHBOUVOH QBEB
TJOZBMCBVZBOHEJIBOUBSLBOLFTJTUFNTBSBGQVTBU QFOHBMBNBO TFTFPSBOH UFSIBEBQ NBLBOBO 4FCBHBJ DPOUPI
EJZBLJOJ CBIXB BSFB PMGBLUPSJVT MBUFSBM JOJ EBO IVCVOHBOOZB
ZBOH CBOZBL EFOHBO TJTUFN QFSJMBLV MJNCJL NFOZFCBCLBO
TFTFPSBOH NFOHFNCBOHLBO TJLBQ BOUJQBUJOZB UFSIBEBQ
NBLBOBOZBOHNFOZFCBCLBONVBMEBONVOUBI
(BNCBSBO QFOUJOH BSFB PMGBLUPSJVT MBUFSBM BEBMBI TFCBHJBO
CFTBS KBSBT TJOZBM EBSJ BSFB JOJ MBOHTVOH NBTVL LF CBHJBO
LPSUFLTTFSFCSJZBOHMFCJIUVB ZBOHEJTFCVUQBMFPLPSUFLTEBMBN
CBHJBO BOUFSPNFEJBM MPCVT UFNQPSBMJT *OJ BEBMBI TBUVTBUVOZB
BSFB EBSJ TFMVSVI LPSUFLT TFSFCSJ ZBOH NFSVQBLBO UFNQBU
TJOZBM TFOTPSJL CFSKBMBO MBOHTVOH LF LPSUFLT UBOQB UFSMFCJI
EBIVMVNFMFXBUJUBMBNVT
Jaras yang Lebih Baru.4VBUVKBSBTPMGBLUPSJVTZBOHMFCJI
CBSV ZBOH CFSKBMBO NFMBMVJ UBMBNVT NFMFXBUJ EPSTPNFEJBM
OVLMFVT UBMBNJ LFNVEJBO LF LVBESBO MBUFSPQPTUFSJPS LPSUFLT
PSCJUPGSPOUBMJT UFMBI EJUFNVLBO #FSEBTBSLBO QFOFMJUJBO QBEB
NPOZFU TJTUFN ZBOH MFCJI CBSV JOJ LFNVOHLJOBO NFNCBOUV
EBMBNNFOHBOBMJTJTCBVTFDBSBTBEBS
651
Unit X Sistem Saraf B. lndra Khusus
Ringkasan. +BEJ UFSEBQBU TJTUFN PMGBLUPSJVT QBMJOH UVB sensory neuron impulse traffic, Prog Neurobiol 86:245, 2008.
ZBOHNFODFUVTLBOSFGMFLTPMGBLUPSJVTEBTBS TJTUFNLVSBOHUVB Gaillard D, Passilly-Degrace P, Besnard P: Molecular mechanisms of fat
ZBOHNFNCFSJLBOQFOHBUVSBOPUPNBUJTUFUBQJTFCBHJBOCFSBTBM preference and overeating, Ann N Y Acad Sci 1141:163, 2008.
EBSJ QFOHFOEBMJBO ZBOH UFMBI EJQFMBKBSJ NFOHFOBJ BTVQBO Housley GD, Bringmann A, Reichenbach A: Purinergic signaling in special
NBLBOBO EBO QFOPMBLBO UFSIBEBQ NBLBOBO ZBOH UJEBL TFIBU senses, Trends Neurosci 32:128, 2009.
Keller A, Vosshall LB: Better smelling through genetics: mammalian odor
EBO CFSBDVO EBO TJTUFN ZBOH MFCJI CBSV ZBOH TFCBOEJOH perception, Curr Opin Neurobiol 18:364, 2008.
EFOHBO TFCBHJBO CFTBS TJTUFN TFOTPSJL LPSUJLBM MBJOOZB EBO Lowe G: Electrical signaling in the olfactory bulb, Curr Opin Neurobiol
EJHVOBLBOVOUVLQFSTFQTJEBOBOBMJTJTPMGBLTJTFDBSBTBEBS 13:476, 2003.
Mandairon N, Linster C: Odor perception and olfactory bulb plasticity in
Pengendalian Sentrifugal terhadap Aktivitas di Bulbus adult mammals, J Neurophysiol 101:2204, 2009.
Olfaktorius oleh Sistem Saraf Pusat. #BOZBL TFSBU TBSBG Margolskee RF: Molecular mechanisms of bitter and sweet taste transduc-
ZBOH CFSBTBM EBSJ CBHJBO PMGBLUPSJVT PUBL BLBO CFSKBMBO LFMVBS tion, J Biol Chem 277:1, 2002.
EBSJ PUBL LF USBLUVT PMGBLUPSJVT NFOVKV CVMCVT PMGBLUPSJVT Matthews HR, Reisert J: Calcium, the two-faced messenger of olfactory
ZBJUV TFDBSB TFOUSJGVHBM EBSJ PUBL LF CBHJBO QFSJGFS
4FSBU transduction and adaptation, Curr Opin Neurobiol 13:469, 2003. Menini A,
Lagostena L, Boccaccio A: Olfaction: from odorant molecules to
TFSBUJOJBLBOCFSBLIJSQBEBTFKVNMBICFTBSTFMTFMHSBOVMBLFDJM the olfactory cortex, News Physiol Sci 19:101, 2004.
ZBOHUFSMFUBLEJBOUBSBTFMTFMNJUSBMEBOTFMTFMCFSVNCBJQBEB Mombaerts P: Genes and ligands for odorant, vomeronasal and taste recep-
CVMCVTPMGBLUPSJVT4FMTFMHSBOVMBNFOHJSJNLBOTJOZBMLFTFMTFM tors, Nat Rev Neurosci 5:263, 2004.
NJUSBM EBO TFMTFM CFSVNCBJ )BNCBUBO VNQBO CBMJL EJBOHHBQ Montmayeur JP, Matsunami H: Receptors for bitter and sweet taste, Curr
NFSVQBLBO DBSB VOUVL NFNCBOUV NFNQFSUBKBN LFNBNQVBO Opin Neurobiol 12:366, 2002.
Mori K, Takahashi YK, Igarashi KM, et al: Maps of odorant molecular features
TFTFPSBOH VOUVL NFNCFEBLBO BOUBSB CBV ZBOH TBUV EFOHBO in the mammalian olfactory bulb, Physiol Rev 86:409, 2006.
ZBOHMBJO Nei M, Niimura Y, Nozawa M: The evolution of animal chemosensory
receptor gene repertoires: roles of chance and necessity, Nat Rev Genet
Daftar Pustaka 9:951, 2008.
Roper SD: Signal transduction and information processing in mammalian
Bermudez-Rattoni F: Molecular mechanisms of taste-recognition memory, taste buds, Pflugers Arch 454:759, 2007.
Nat Rev Neurosci 5:209, 2004. Simon SA, de Araujo IE, Gutierrez R, et al: The neural mechanisms of
Chandrashekar J, Hoon MA, Ryba NJ, et al: The receptors and cells for mam- gustation: a distributed processing code, Nat Rev Neurosci 7:890,
malian taste, Nature 444:288, 2006. 2006.
Frank ME, Lundy RF Jr, Contreras RJ: Cracking taste codes by tapping into Smith DV, Margolskee RF: Making sense of taste, Sci Am 284:32, 2001.
652
XI
UNIT
4JTUFN4BSBG$/FVSPGJTJPMPHJ
.PUPSJLEBO*OUFHSBUJG
54. Fungsi Motorik Medula Spinalis;
Refleks-Refleks Medula Spinalis
55. Pengaturan Fungsi Motorik oleh Korteks
dan Batang Otak
56. Kontribusi Serebelum dan Ganglia Basalis
pada Seluruh Pengendalian Motorik
57. Korteks Serebri, Fungsi Intelektual Otak,
Proses Belajar dan Memori
58. Mekanisme Perilaku dan Motivasi pada
Otak-Sistem Limbik dan Hipotalamus
59. Aktivitas Otak-Tidur; Gelombang
Otak, Epilepsi, Psikosis
60. Sistem Saraf Otonom dan Medula
Adrenal
61. Aliran Darah Serebral, Cairan
Serebrospinal, dan Metabolisme Otak
BAB 54
UNIT XI
'VOHTJ.PUPSJL.FEVMB4QJOBMJT
3FGMFLT3FGMFLT.FEVMB4QJOBMJT
*OGPSNBTJTFOTPSJLBLBOEJJOUF TFUFMBI NFNBTVLJ TVCTUBOTJB HSJTFB NFEVMB TQJOBMJT EBO BLBO

HSBTJLBO EJ TFNVB UJOHLBU NFNVMBJSFGMFLTMPLBMEJTFHNFOZBOHCFSTBOHLVUBOTFSUBFGFL
TJTUFN TBSBG EBO NFOZFCBCLBO FGFLMPLBMMBJOOZB
$BCBOHMBJOOZBNFOUSBOTNJTJLBOTJOZBM
SFTQPOT NPUPSJL UFQBU ZBOH LF TJTUFN TBSBG QVTBU ZBOH MFCJI UJOHHJ LF UJOHLBU ZBOH MFCJI
EJNVMBJ EJ NFEVMB TQJOBMJT UJOHHJEJNFEVMBTQJOBMJTTFOEJSJ LFCBUBOHPUBL BUBVCBILBO
EFOHBOSFGMFLTSFGMFLTPUPUZBOH LF LPSUFLT TFSFCSJ TFQFSUJ ZBOH UFMBI EJKFMBTLBO EBMBN CBC
SFMBUJGTFEFSIBOB NFMVBTLFCB TFCFMVNOZB
UBOH PUBL EFOHBO SFTQPOT ZBOH MFCJI LPNQMFLT EBO BLIJSOZB 4FUJBQ TFHNFO NFEVMB TQJOBMJT QBEB UJOHLBU TFUJBQ TBSBG
NFMVBT LF TFSFCSVN UFNQBU LFUFSBNQJMBO PUPU ZBOH QBMJOH TQJOBM
NFNQVOZBJ CFCFSBQB KVUB OFVSPO EBMBN TVCTUBOTJB
LPNQMFLTEJLFOEBMJLBO HSJTFBOZB%JTBNQJOHOFVSPOTFOTPSJLQFNBODBSTFQFSUJZBOH
%BMBN CBC JOJ LJUB BLBO NFNCBIBT NFOHFOBJ QFSBUVSBO UFMBI EJCJDBSBLBO EBMBN #BC EBO OFVSPOOFVSPO JOJ
GVOHTJPUPUPMFINFEVMBTQJOBMJT5BOQBTJSLVJUOFVSPOBMLIVTVT UFSEBQBUEBMBNEVBKFOJT JBJUV
OFVSPONPUPSJLBOUFSJPSEBO
QBEB NFEVMB CBILBO TJTUFN QFOHBUVS NPUPSJL ZBOH QBMJOH
JOUFSOFVSPO
LPNQMFLT TFLBMJ QVO EBMBN PUBL UJEBL EBQBU NFOHIBTJMLBO Neuron Motorik Anterior. 1BEB TFUJBQ TFHNFO SBEJLT
HFSBLBO PUPU EFOHBO UVKVBOUVKVBO UFSUFOUV 4FCBHBJ DPOUPI BOUFSJPSTVCTUBOTJBHSJTFBUFSEBQBUCFCFSBQBSJCVOFVSPOZBOH
UJEBL BEB TJSLVJU OFVSPOBM EJ NBOB QVO EBMBN PUBL ZBOH CFSVLVSBOTBNQBJQFSTFOMFCJICFTBS EBSJQBEBOFVSPO
NFOHIBTJMLBO HFSBLBO TQFTJGJL UVOHLBJ LF EFQBO LF CFMBLBOH OFVSPO MBJOOZB EBO EJTFCVU TFCBHBJ OFVSPO NPUPSJL BOUFSJPS
UPBOEGSP
ZBOHEJQFSMVLBOQBEBXBLUVCFSKBMBO+VTUSVTJSLVJU (BNCBS
/FVSPOOFVSPO JOJ LFMVBS NFOJOHHBMLBO
VOUVL QFSHFSBLBO JOJ BEB EJ EBMBN NFEVMB EBO PUBL TFDBSB NFEVMB TQJOBMJT NFMBMVJ SBEJLT BOUFSJPS EBO MBOHTVOH NFOHJ
TFEFSIBOB NFOHJSJNLBO TJOZBM QFSJOUBI LF NFEVMB TQJOBMJT OFSWBTJTFSBUTFSBUPUPUSBOHLB/FVSPOOFVSPOUFSTFCVUUFSEJSJ
VOUVLNFNCVBUQSPTFTCFSKBMBONFOKBEJHFSBLBO BUBT EVB KFOJT OFVSPO ZBJUV OFVSPO NPUPSJL BMGB EBO OFVSPO
8BMBVEFNJLJBO LJUBUJEBLCPMFINFSFNFILBOQFSBOBOPUBL NPUPSJLHBNNB
LBSFOB PUBL NFNCFSJ BSBIBO ZBOH NFOHBUVS VSVUVSVUBO
BLUJWJUBT NFEVMB TQJOBMJT VOUVL NFNVMBJ HFSBLBO EFOHBO
QFSVCBIBO BSBI LFLVBUBO BUBV LFDFQBUBO CJMB EJQFSMVLBO
NFODPOEPOHLBO UVCVI LF EFQBO TFMBNB UFSKBEJ QFSDFQBUBO
VOUVL NFOHVCBI HFSBLBO EBSJ CFSKBMBO NFOKBEJ NFMPNQBU CJMB
EJQFSMVLBO EBO UFSVTNFOFSVT NFOHBXBTJ EBO NFOHBUVS
LFTFJNCBOHBO 4FNVB IBM JOJ EJMBLVLBO NFMBMVJ BOBMJTJT EBO
QFSJOUBI ZBOH EJCBOHLJULBO EJ EBMBN PUBL 5FUBQJ IBM JOJ KVHB
NFNFSMVLBOCBOZBLTJSLVJUOFVSPOBMQBEBNFEVMBTQJOBMJTZBOH
NFSVQBLBO PCKFL QFSJOUBI UFSTFCVU 4JSLVJU JOJ NFNVOHLJOLBO
UFSKBEJOZBTFNVBLFOEBMJNPUPSJL LFDVBMJTFCBHJBOLFDJMLFOEBMJ
MBOHTVOHQBEBPUPU
Organisasi Medula Spinatis untuk
Fungsi Motorik
4VCTUBOTJB HSJTFB NFEVMB NFSVQBLBO BSFB JOUFHSBTJ CBHJ SFGMFLT
SFGMFLT NFEVMB (BNCBS NFOHHBNCBSLBO TVTVOBO ZBOH
LIBTTVCTUBOTJBHSJTFBNFEVMBTQJOBMJTEBMBNTBUVTFHNFO4JOZBM
TJOZBM TFOTPSJL IBNQJS TFMVSVIOZB NFNBTVLJ NFEVMB TQJOBMJT Gambar 54-1
NFMBMVJ SBEJLT TFOTPSJL QPTUFSJPS
4FTVEBI NFNBTVLJ NFEVMB
TQJOBMJT TFUJBQ TJOZBM TFOTPSJL BLBO NFOVKV EVB UFNQBU UVKVBO
ZBOHUFSQJTBI
4BUVDBCBOHTBSBGTFOTPSJLBLBOCFSBLIJSTFHF
655
Unit XI Sistem Saraf: C.Neurofisiologi Motorik dan Integratif
A G Ia II G
14 Mm 5 Mm 17 Mm 8 Mm 5 Mm
Descending
fibers
+
+ +
Sheath Primary
ending
1 cm
54-3
UBOHHVOHKBXBCVOUVLTFCBHJBOCFTBSGVOHTJJOUFHSBTJNFEVMB
TQJOBMJTTFQFSUJZBOHEJCJDBSBLBOQBEBBLIJSCBCJOJ
54-2 1BEB EBTBSOZB TFMVSVI UJQF TJSLVJU OFVSPO TFQFSUJ ZBOH UFMBI
EJVSBJLBO EBMBN #BC EBQBU EJKVNQBJ EBMBN LVNQVMBO TFM
JOUFSOFVSPO NFEVMB TQJOBMJT NFMJQVUJ TJSLVJU KFOJT EJWFSHFO
Neuron Motorik Alfa. /FVSPO NPUPSJL BMGB NFOKVMVSLBO LPOWFSHFO TJSLVJU ZBOH NFOHFMVBSLBO SBOHTBOH TFDBSB CFSVMBOH
TFSBCVU TBSBG NPUPSJL UJQF " BMGB "B
ZBOH CFTBS CFSEJBNFUFS EBOTJSLVJUKFOJTMBJO1BEBCBCJOJ LJUBBLBONFNQFMBKBSJCBOZBL
HN TFSBCVU UFSTFCVU CFSDBCBOH CFCFSBQB LBMJ TFUFMBI BQMJLBTJEBSJCFSNBDBNNBDBNTJSLVJUEBMBNIBMHBNCBSBOLFSKB
NFNBTVLJ PUPU EBO NFNQFSTBSBGJ TFSBUTFSBU PUPU SBOHLB ZBOH SFGMFLTTQFTJGJLPMFINFEVMBTQJOBMJT
CFTBS1FSBOHTBOHBOQBEBTBUVTFSBUTBSBGBMGBBLBONFOHFLTJUBTJ )BOZB CFCFSBQB TJOZBM TFOTPSJL ZBOH EBUBOH EBSJ TBSBGTBSBG
UJHB TBNQBJ CFCFSBQB SBUVT TFSBU PUPU SBOHLB ZBOH TFDBSB TQJOBM BUBV TJOZBM EBSJ PUBL CFSBLIJS TFDBSB MBOHTVOH EJ OFVSPO
LPMFLUJG EJTFCVU TFCBHBJ VOJU NPUPSJL 1FOKBMBSBO JNQVMT TBSBG NPUPSJL BOUFSJPS 4FCBMJLOZB IBNQJS TFMVSVI TJOZBM UFSTFCVU
ZBOH NFOVKV PUPU SBOHLB EBO QFSBOHTBOHBOOZB QBEB VOJU NVMBNVMBBLBOEJIBOUBSLBONFMBMVJJOUFSOFVSPO UFNQBUTJOZBM
NPUPSJLPUPUUFMBIEJCJDBSBLBOQBEB#BCEBO UFSTFCVUEJPMBITFDBSBUFQBU+BEJ TFQFSUJZBOHEJQFSMJIBULBOQBEB
(BNCBS USBLUVT LPSUJLPTQJOBMJT EBO PUBL EJQFSMJIBULBO
Neuron Motorik Gamma. #FSTBNB EFOHBO OFVSPO IBNQJS TFMVSVIOZB CFSBLIJS EJ JOUFSOFVSPO TQJOBMJT UFNQBU
NPUPSJL BMGB ZBOH NFOZFCBCLBO LPOUSBLTJ TFSBU PUPU SBOHLB TJOZBMTJOZBM EBSJ USBLUVT UFSTFCVU EJHBCVOHLBO EFOHBO USBLUVT
OFVSPO NPUPSJL HBNNB ZBOH CFSVLVSBO KBVI MFCJI LFDJM EBO TQJOBMJT MBJO BUBV TBSBGTBSBG TQJOBM TFCFMVN BLIJSOZB
KVNMBIOZBTFLJUBSTBUVTFUFOHBILBMJMFCJICBOZBL CFSMPLBTJEJ CFSLPOWFSHFOTJ NFOVKV LF OFVSPO NPUPSJL BOUFSJPS VOUVL
SBEJLT BOUFSJPS NFEVMB TQJOBMJT /FVSPO NPUPSJL HBNNB JOJ NFOHBUVSGVOHTJPUPU
NFOHJSJNLBO JNQVMT NFMBMVJ TFSBU TBSBG NPUPSJL KFOJT "
HBNNB "Z
ZBOH MFCJI LFDJM CFSEJBNFUFS SBUBSBUB HSO LF Sel-Sel Renshaw Mentransmisi Sinyal-Sinyal Inhibisi ke
TFSBU PUPU SBOHLB LIVTVT ZBOH LFDJM ZBOH EJTFCVU TFSBU Neuron Motorik di Sekitarnya. Dalam %BMBN SBEJLT BOUFSJPS
JOUSBGVTBM EJQFSMJIBULBOQBEB(BNCBSEBO4FSBUJOJ NFEVMBTQJOBMJT CFSEFLBUBO EFOHBO OFVSPO NPUPSJL UFSEBQBU KVHB
NFNCFOUVL CBHJBO UFOHBI LVNQBSBO PUPU ZBOH NFNCBOUV OFVSPOOFVSPO LFDJM ZBOH KVNMBIOZB CBOZBL ZBOH EJTFCVU TFM
NFOHBUVS UPOVT PUPU EBTBS TFQFSUJ BLBO EJCJDBSBLBO 3FOTIBX4FUFMBIBLTPOOFVSPONPUPSJLBOUFSJPSNFOJOHHBMLBOCBEBO
LFNVEJBOQBEBCBCJOJ OFVSPO DBCBOHDBCBOH LPMBUFSBM EBSJ BLTPO JOJ MBOHTVOH
CFSIVCVOHBOEFOHBOTFM3FOTIBXEJEFLBUOZB4FMJOJNFSVQBLBOTFM
JOIJCJTJZBOHNFOHJSJN TJOZBM JOIJCJTJ LF OFVSPO NPUPSJL
TFLFMJMJOHOZB +BEJ QFSBOHTBOHBOQBEBTFUJBQOFVSPONPUPSJL
Interneuron. *OUFSOFVSPOEBQBUEJKVNQBJEJTFNVBEBFSBI
DFOEFSVOHNFOJNCVMLBOJOIJCJTJ QBEB OFVSPOOFVSPO NPUPSJL ZBOH
TVCTUBOTJBHSJTFBNFEVMBTQJOBMJTEBMBNLPSOVEPSTBMJT LPSOV
CFSEFLBUBO TVBUV FGFLZBOHEJTFCVUJOIJCJTJMBUFSBM&GFLJOJQFOUJOH
BOUFSJPS EBOBSFBBSFBMBJOZBOHUFSMFUBLEJBOUBSBLFEVBBSFB LBSFOBBMBTBOCFSJLVU4JTUFN NPUPSJL UFSTFCVU NFOHHVOBLBO
UFSTFCVU TFQFSUJZBOHEJQFSMJIBULBOQBEB(BNCBS+VNMBI JOIJCJTJ MBUFSBM VOUVLNFNGPLVTLBO BUBV NFNQFSUBKBN TJOZBM
TFMTFM JOJ LJSBLJSB LBMJ KVNMBI OFVSPO NPUPSJL BOUFSJPS TJOZBMOZB TFQFSUJ KVHB TJTUFN TFOTPSJL EBMBN NFOHHVOBLBO QSJOTJQ
/FVSPO JOJ LFDJM EBO TBOHBU NVEBI EJSBOHTBOH TFSJOH LBMJ ZBOH TBNB UFSTFCVU TFIJOHHB NFNVOHLJOLBO USBOTNJTJ TJOZBMTJOZBM
NFOHFMVBSLBO BLUJWJUBT TQPOUBO EBO NBNQV NFOHJSJNLBO VUBNBQSJNFS NFSBNCBU UBOQB IBNCBUBO LF BSBI ZBOH EJJOHJOLBO
JNQVMTEFOHBOLFDFQBUBOTBNQBJLBMJQFSEFUJL/FVSPO EBO NFOFLBOLFDFOEFSVOHBONFOZFCBSOZBTJOZBMTJOZBMLFBSBIMBUFSBM
JOJ TBMJOH CFSIVCVOHBO TBUV TBNB MBJO EBO TFCBHJBO CFTBS Hubungan Multisegmen dari Satu Tingkat Medula
TFDBSB MBOHTVOH NFNQFSTBSBGJ OFVSPO NPUPSJL BOUFSJPS Spinatis ke Tingkat Lainnya—Serat Propriospinal
TFQFSUJ ZBOH EJHBNCBSLBO QBEB (BNCBS )VCVOHBO EJ -FCJIEBSJTFQBSVITFSBUTBSBGBTFOEFOTEBOEFTFOEFOTQBEBNFEVMB
BOUBSBJOUFSOFVSPOEBOOFVSPONPUPSJLBOUFSJPSCFS TQJOBMJTNFSVQBLBOTFSBUQSPQSJPTQJOBM4FSBUTFSBUJOJCFSKBMBOEBSJTBUV
TFHNFONFEVMBNFOVKVTFHNFOMBJOOZB4FMBJOJUV TFQFSUJTFSBU
656
Bab 54 Fungsi Motorik Medula Spinalis; Refteks-Refteks Medula Spinatis
TFOTPSJL TFXBLUV NFNBTVME NFEVMB TQJOBMJT EBSJ SBEJLT QPTUFSJPS Persarafan Sensorik Kumparan Otot. #BHJBO
TFSBCVU UFSTFCVU BLBO UFSCBHJ EVB EBO CFSDBCBOH LF BUBT EBO LF SFTFQUPSEBSJLVNQBSBOPUPUBEBMBICBHJBOUFOHBIOZB1BEB
CBXBI NFEVMB TQJOBMJT CFCFSBQB DBCBOHOZB IBOZB NFOHJSJNLBO EBFSBI JOJ CBHJBO JOUSBGVTBM TFSBU PUPU UJEBL NFNQVOZBJ
TJOZBMNFOVKVTBUVBUBVEVBTFHNFO TFNFOUBSBDBCBOHMBJOOZBBLBO FMFNFO LPOUSBLUJM BLUJO EBO NJPTJO 4FQFSUJ ZBOH UBNQBL
NFOHJSJNLBO TJOZBM LF CBOZBL TFHNFO 4FSBU QSPQSJPTQJOBM QBEB (BNCBS EBO TFDBSB MFCJI EFUBJM QBEB (BNCBS
UNIT XI
BTFOEFOT EBO EFTFOEFOT NFEVMB BLBO NFNCFOUVL KBSBT VOUVL
TFSBUTFSBU TFOTPSJL EJNVMBJ EJ TJOJ #BHJBO JOJ BLBO
SFGMFLTSFGMFLT NVMUJTFHNFO ZBOH OBOUJOZB BLBO EJKFMBTLBO EBMBN
CBC JOJ NFMJQVUJ SFGMFLTSFGMFLT ZBOH NFOHPPSEJOBTJLBO HFSBLBO
UFSBOHTBOH CJMB BEB SFHBOHBO EJ CBHJBO UFOHBI LVNQBSBO
HFSBLBOMFOHBOEBOUVOHLBJTFDBSBCFSTBNBBO PUPU ,JUB EBQBU NFMJIBU CBIXB SFTFQUPSSFTFQUPS ZBOH
UFSEBQBU EBMBN LVNQBSBO PUPU EBQBU EJSBOHTBOH NFMBMVJ
Reseptor-Reseptor Sensorik Otot-- Kumparan EVBDBSBCFSJLVU
Otot dan Organ Tendon Golgi serta Perannya 1. 1FNBOKBOHBO TFMVSVI PUPU NFSFHBOHLBO CBHJBO UFOHBI
dalam Pengaturan Otot LVNQBSBOTFIJOHHBNFSBOHTBOHSFTFQUPS
2. .FTLJQVO QBOKBOH TFMVSVI PUPU UBL CFSVCBI LPOUSBLTJ EJ
1FOHBUVSBO GVOHTJ PUPU ZBOH UFQBU UJEBL IBOZB NFNCVUVILBO CBHJBO VKVOH LVNQBSBO EBO TFSBU JOUSBGVTBM BLBO
FLTJUBTJ PUPU PMFI OFVSPOOFVSPO NPUPSJL BOUFSJPS NFEVMB NFSFHBOHLBO CBHJBO UFOHBI TFSBU TFIJOHHB NFSBOHTBOH
TQJOBMJT OBNVO KVHB NFNCVUVILBO JOGPSNBTJ VNQBO CBMJL SFTFQUPS
GFFECBDL
ZBOHEJLJSJNLBOTFDBSBUFSVTNFOFSVTEBSJTFUJBQPUPU
,FEVB NBDBN VKVOH TFOTPSJL EBQBU EJKVNQBJ QBEB EBFSBI
LFNFEVMBTQJOBMJT NFOVOKVLLBOLFBEBBOGVOHTJPOBMTFUJBQPUPU
SFTFQUPS UFOHBI LVNQBSBO PUPU %BFSBI JUV BEBMBI VKVOH
QBEB TFUJBQ TBBU #BHBJNBOB QBOKBOH PUPU CBHBJNBOB LFBEBBO
QSJNFSEBOVKVOHTFLVOEFS
UFHBOHBO TBBU JUV EBO TFCFSBQB DFQBU QFSVCBIBO QBOKBOH BUBV
UFHBOHBOOZB 6OUVL NFOZFEJBLBO JOGPSNBTJ JOJ PUPU EBO
UFOEPOOZB EJQBTPL TFDBSB CFSMFCJIBO PMFI EVB NBDBN SFTFQUPS Ujung Primer. %J CBHJBO UFOHBI EBFSBI SFTFQUPS UFSEBQBU
TFOTPSJL ZBOH LIVTVT ZBLOJ
LVNQBSBO PUPU MJIBU (BNCBS TFSBUTBSBGTFOTPSJLCFTBSZBOHNFMJOHLBSJCBHJBOUFOHBITFUJBQ

ZBOH UFSTFCBS EJ TFMVSVI CBHJBO QFSVU CFMMZ
PUPU EBO TFSBU JOUSBGVTBM NFNCFOUVL ZBOH EJTFCVU VKVOH QSJNFS BUBV
NFOHJSJNLBO JOGPSNBTJ NFOHFOBJ QBOKBOH PUPU BUBV LFDFQBUBO VKVOH BOVMPTQJSBM 4FSBU TBSBG JOJ NFSVQBLBO TFSBU UJQF *B ZBOH
EJBNFUFSOZB LJSBLJSB N EBO TFSBU JOJ NFOHJSJNLBO TJOZBM
QFSVCBIBO QBOKBOH PUPU NFOVKV TJTUFN TBSBG EBO
PSHBO
TFOTPSJL EFOHBO LFDFQBUBO BOUBSB TBNQBJ NEFU UJL LF
UFOEPO (PMHJ MJIBU (BNCBS EBO
ZBOH UFSMFUBL EJ
NFEVMB TQJOBMJT TFTVBJ EFOHBO LFDFQBUBO TFUJBQ NBDBN TFSBU
UFOEPO PUPU EBO NFOHJSJNLBO JOGPSNBTJ NFOHFOBJ UFHBOHBO
TBSBGEJTFMVSVIUVCVI
BUBVLFDFQBUBOQFSVCBIBOUFHBOHBO
4FCBHJBO BUBV TFMVSVI TJOZBM ZBOH CFSBTBM EBSJ LFEVB SFTFQUPS
EJHVOBLBO VOUVL QFOHBUVSBO PUPU JOUSJOTJL JUV TFOEJSJ 3FTFQUPS Ujung Sekunder. 4FQFSUJZBOHEJQFSMJIBULBOQBEB(BNCBS
UFSTFCVU IBNQJS TFMVSVIOZB CFLFSKB TFDBSB UBL TBEBS 8BMBVQVO EBO CJBTBOZBBEBTBUVOBNVOLBEBOHBEBEVBTFSBU
CFHJUV SFTFQUPSSFTFQUPSJOJNFOHJSJNLBOCBOZBLTFLBMJJOGPSNBTJ TBSBGTFOTPSJLZBOHMFCJILFDJMTFSBCVUUJQF**ZBOHCFSEJBNFUFS
UJEBL IBOZB LF NFEVMB TQJOBMJT UFUBQJ KVHB LF TFSFCFMVN EBO LJSBLJSBNNFNQFSTBSBGJEBFSBISFTFQUPSEJTBMBITBUVBUBV
CBILBO LF LPSUFLT TFSFCSJ NFNCBOUV GVOHTJ TFUJBQ CBHJBO TJTUFN LFEVB TJTJ VKVOH QSJNFS 6KVOH TFOTPSJL JOJ EJTFCVU VKVOH
TBSBGVOUVLNFOHBUVSLPOUSBLTJPUPU TFLVOEFS TFSBU JOJ LBEBOH NFMJOHLBSJ TFSBU JOUSBGVTBM TFQFSUJ
IBMOZB TFSBU UJQF *B OBNVO TFSJOH NFOZFCBS TFQFSUJ DBCBOH
QBEBTFNBLTFNBL
Fungsi Reseptor Kumparan Otot
Struktur dan Inervasi Motorik Kumparan Otot. Pembagian Serat-Intrafusal menjadi Serat Kantong
(BNCBS NFNQFSMJIBULBO TVTVOBO GJTJPMPHJ LVNQBSBO Nuklear dan Serat Rantai Nuklear—Respons Dinamik
PUPU 4FUJBQ LVNQBSBO QBOKBOHOZB TBNQBJ NJMJNFUFS
EJCBOHVOPMFITBNQBJTFSBUPUPUJOUSBGVTBMZBOHTBOHBULFDJM dan Statik Kumparan Otot. "EBEVBNBDBNTFSBUJOUSBGVTBM
ZBOHVKVOHOZBNFMJOHLBSEBONFMFLBUQBEBHMJLPLBMJLTTUSVLUVS HFMFOEPOH PUPU ZBLOJ
TFSBU PUPU LBOUPOH OVLMFBS EBMBN
FLTUSBGVTBMCFTBSZBOHNFOHFMJMJOHJTFSBUPUPUSBOHLB TFUJBQ LVNQBSBO BEB TBUV TBNQBJ UJHB TFSBU
CFSJTJ CFCFSBQB
OVLMFJTFSBUPUPUZBOHUFSLVNQVMEBMBNLBOUPOHNFOHHFN
4FUJBQTFSBUPUPUJOUSBGVTBMNFSVQBLBOTFSBUPUPUSBOHLBZBOH
TBOHBULFDJM#JBSQVOCFHJUV EBFSBIQVTBUEBSJTFUJBQTFSBCVUJOJ
ZBLOJ EBFSBI QFSUFOHBIBO BOUBSB LFEVB VKVOHOZB TBNB TFLBMJ G G
UJEBL NFNQVOZBJ BUBV NFNQVOZBJ TFEJLJU GJMBNFO BLUJO EBO
NJPTJO0MFILBSFOBJUV CBHJBOUFOHBIJOJUBLBLBOCFSLPOUSBLTJ
TFXBLUV VKVOH VKVOHOZB CFSLPOUSBLTJ .BMBIBO CFSGVOHTJ
TFCBHBJSFTFQUPSTFOTPSJL EBOIBMJOJBLBOEJCBIBTOBOUJ#BHJBO
VKVOH ZBOH CFSLPOUSBLTJ EBQBU EJSBOHTBOH PMFI TFSBCVU TBSBG
NPUPSJL HBNNB LFDJM ZBOH CFSBTBM EBSJ OFVSPO NPUPSJL HBNNB
LFDJMUJQF"EJSBEJLTBOUFSJPSNFEVMBTQJOBMJT TFQFSUJZBOHUFMBI
EJKFMBTLBOTFCFMVNOZB4FSBUTFSBUTBSBGNPUPSJLHBNNBJOJKVHB
EJTFCVUTFSBUFGFSFOHBNNB ZBOHCFSCFEBEFOHBOTFSBUFGFSFOBMGB 54-4
CFTBS TFSBU TBSBG BMGB UJQF "
ZBOH NFNQFSTBSBGJ CBHJBO
FLTUSBGVTBMPUPUSBOHLB
657
Unit XI Sistem Saraf:C. Neurofisiologi Motorik dan Integratif
CVOH ZBOH MFUBLOZB EJ CBHJBO UFOHBI EBFSBI SFTFQUPS nya, QFSBOHTBOHBO QBEB TFSBU HBNNBT ZBOH NFSBOHTBOH TFSBU
EJQFSMJIBULBO QBEB CBHJBO BUBT (BNCBS EBO
TFSBU SBOUBJ OVLMFBS BLBO NFOJOHLBULBO SFTQPOT TUBUJL OBNVO TFEJLJU
SBOUBJOVLMFBS KVNMBIOZBUJHBTBNQBJTFNCJMBO
EJBNFUFSEBO NFNFOHBSVIJ SFTQPOT EJOBNJL 1BSBHSBG TFMBOKVUOZB BLBO
QBOKBOHOZB LJSBLJSB TFUFOHBI EJBNFUFS EBO QBOKBOH TFSBU NFOHHBNCBSLBO CBIXB LFEVB UJQF SFTQPOT LVNQBSBO PUPU JOJ
LBOUPOH OVLMFBS EBO NFNQVOZBJ OVLMFJ ZBOH UFSTVTVO MVSVT QFOUJOHCBHJCFSNBDBNNBDBNQFOHBUVSBOPUPU
TFQFSUJSBOUBJEJTFMVSVIEBFSBISFTFQUPS UFSMJIBUTFCBHBJTFSBU
QBEBCBHJBOCBXBIHBNCBS6KVOHTBSBGTFOTPSJLQSJNFS TFSBU Pengeluaran Impuls secara Terus-Menerus oleh
TFOTPSJL VN
EJSBOHTBOH PMFI TFSBU JOUSBGVTBM LBOUPOH Kumparan Otot dalam Keadaan Normal. %BMBN LFBEBBO
OVLMFBS EBO TFSBU SBOUBJ OVLMFBS 4FCBMJLOZB VKVOH TFLVOEFS OPSNBM LIVTVTOZB LFUJLB BEB TFEJLJU QFSBOHTBOHBO QBEB TFSBU
TFSBU TFOTPSJL VN
CJBTBOZB EJSBOHTBOH IBOZB PMFI TFSBU HBNNBNPUPSJL LVNQBSBOPUPUBLBONFNBODBSLBOJNQVMTTBSBG
SBOUBJOVLMFBS)VCVOHBOJOJEJKFMBTLBOEBMBN(BNCBS TFOTPSJL TFDBSB UFSVTNFOFSVT 1FSFHBOHBO QBEB LVNQBSBO PUPU
NFOJOHLBULBO LFDFQBUBO QFMFUVQBO GJSJOH
TFEBOHLBO
Respons Ujung Primer dan Ujung Sekunder terhadap QFNFOEFLBO LVNQBSBO PUPU NFOVSVOLBO LFDFQBUBO QFMFUVQBO
Panjang Reseptor—Respons "Statik." +BEJ LVNQBSBOUBEJEBQBUNFOHJSJNLBOTJOZBMQPTJUJGLFNFEVMB
CBHJBOSFTFQUPSLVNQBSBOPUPUEJSFHBOHTFDBSBMBNCBU KVNMBI TQJOBMJT BSUJOZB QFOJOHLBUBO KVNMBI JNQVMT NFOVOKVLLBO
JNQVMTZBOHEJKBMBOLBOCBJLEBSJVKVOHQSJNFSNBVQVOVKVOH BEBOZB QFSFHBOHBO PUPU BUBV NFOHJSJNLBO TJOZBM OFHBUJG ZBJUV
TFLVOEFSBLBOMFCJICBOZBLTFTVBJEFOHBOCFTBSOZBSFHBOHBO QFOVSVOBO KVNMBI JNQVMT EJ CBXBI OJMBJ OPSNBM NFOVOKVLLBO
EBO VKVOHVKVOH UBEJ TFMBNB CFCFSBQB NFOJU UFSVTNFOFSVT CBIXBPUPUCFOBSCFOBSUJEBLNFOHBMBNJQFSFHBOHBO
NFOHJSJNLBO JNQVMT UFSTFCVU &GFL JOJ EJTFCVU SFTQPOT TUBUJL
SFTFQUPS LVNQBSBO ZBOH CFSBSUJ CBIXB CBJL VKVOH QSJNFS
NBVQVO VKVOH TFLVOEFS UFSVTNFOFSVT NFOHJSJNLBO TJOZBM Refleks Regang Otot
TJOZBMOZB TFMBNB TFLVSBOHLVSBOHOZB CFCFSBQB NFOJU KJLB .BOJGFTUBTJQBMJOHTFEFSIBOBGVOHTJLVNQBSBOPUPUBEBMBISFGMFLT
LVNQBSBOPUPUJUVTFOEJSJUFUBQUFSFHBOH SFHBOH PUPU ,BQBO QVO PUPU EJSFHBOH TFDBSB UJCBUJCB FLTJUBTJ
ZBOH UJNCVM QBEB LVNQBSBO NFOZFCBCLBO SFGMFLT LPOUSBLTJ
Respons Ujung Primer (tetapi Tidak Ujung Sekunder) TFSBCVUPUPUSBOHLBZBOHCFTBSEBSJPUPUZBOHUFSFHBOHEBOPUPU
terhadap Kecepatan Perubahan Panjang PUPUTJOFSHJTOZB
Resept or - Respons "Dinamik." #JMBQBOKBOHSFTFQUPSLVN
QBSBO UJCBUJCB NFOJOHLBU VKVOH QSJNFS UFUBQJ UJEBL VKVOH Sirkuit Neuron Refleks Regang. (BNCBS
TFLVOEFS
BLBO UFSBOHTBOH KBVI MFCJI LVBU 3BOHTBOHBO ZBOH NFOHHBNCBSLBO TJSLVJU EBTBS SFGMFLT SFHBOH LVNQBSBO PUPU
CFSMFCJIBO EBSJ VKVOH QSJNFS JOJ EJTFCVU SFTQPOT EJOBNJL UBNQBL TFSBU TBSBG QSPQSJPTFQUPS UJQF *B ZBOH CFSNVMB EJ LVN
ZBOH CFSBSUJ CBIXB VKVOH QSJNFS JUV TFDBSB BLUJG EBO FLTUSFN QBSBOPUPUEBONFNBTVLJSBEJLTEPSTBMJTNFEVMBTQJOBMJT$BCBOH
BLBO CFSFTQPOT UFSIBEBQ LFDFQBUBO QFSVCBIBO QBOKBOH LVN TFSBUUFSTFCVULFNVEJBOCFSKBMBOMBOHTVOHNFOVKVSBEJLTBOUFSJPS
QBSBO ZBOH CFSMBOHTVOH DFQBU #BILBO CJMB QBOKBOH SFTFQUPS TVCTUBOTJB HSJTFB NFEVMB EBO CFSTJOBQT EFOHBO OFVSPO NPUPSJL
LVNQBSBO NFOJOHLBU IBOZB TFQFSTFLJBO EBMBN XBLUV TFQFS BOUFSJPSZBOHNFOHJSJNLBOTFSBUTFSBUTBSBGNPUPSJLOZBLFNCBMJ
EFUJL SFTFQUPS QSJNFS BLBO NFOHJSJNLBO CBOZBL TFLBMJ LF PUPU ZBOH TBNB UFNQBU TFSBUTFSBU LVNQBSBO PUPU CFSNVMB
JNQVMTNFOVKVTFSBUTBSBGTFOTPSJLNZBOHCFTBS OBNVO +BEJ TJSLVJU JOJ NFSVQBLBO KBSBT NPOPTJOBQUJL ZBOH BLBO
IBM JOJ IBOZB UFSKBEJ TBBU QBOKBOH SFTFQUPS UBEJ CFOBSCFOBS NFOHJSJNLBO TJOZBM SFGMFLT BHBS PUPU EBQBU LFNCBMJ UBOQB BEB
NFOJOHLBU4FHFSBTFUFMBIQFOBNCBIBOQBOKBOHUFSIFOUJ LFDF LFNVOHLJOBO QFSMBNCBUBO XBLUV LF PUPU TFTVEBI QFSBOHTBOHBO
QBUBOQFOHFMVBSBOJNQVMTUBNCBIBOUFSTFCVUBLBOLFNCBMJLF QBEBLVNQBSBO,FCBOZBLBOTFSBUUJQF**ZBOHCFSBTBMEBSJLVN
OJMBJSFTQPOTTUBUJLZBOHKBVIMFCJILFDJMTFNFOUBSBTJOZBMNB
TJIBEB
4FCBMJLOZB CJMB SFTFQUPS LVNQBSBO NFNFOEFL UJNCVM
TJOZBM TFOTPSJL ZBOH TFDBSB UFQBU CFSMBXBOBO +BEJ VKVOH
QSJNFSBLBONFOHJSJNLBOTJOZBM CBJLQPTJUJGBUBVOFHBUJG ZBOH
TBOHBULVBULFNFEVMBTQJOBMJTVOUVLNFNCFSJUBIVLBOBEBOZB
TFUJBQQFSVCBIBOQBOKBOHSFTFQUPS
Pengaturan Intensitas Respons Statik dan Dinamik

oleh Saraf Motorik Gamma. 4BSBG NPUPSJL HBNNB ZBOH
NFOVKVLVNQBSBOPUPUEBQBUEJCBHJNFOKBEJEVBUJQFHBNNB
EJOBNJL HBNNBE
EBO HBNNBTUBUJL HBNNBT
4FSBU
HBNNBEJOBNJL UFSVUBNB NFSBOHTBOH TFSBU JOUSBGVTBM LBO
UPOHOVLMFBS TFEBOHLBOTFSBUHBNNBTUBUJLUFSVUBNBNFSBOH
TBOH TFSBU JOUSBGVTBM SBOUBJ OVLMFBS 4BBU TFSBU HBNNBE
NFSBOHTBOH TFSBU LBOUPOH OVLMFBS SFTQPOT EJOBNJL ZBOH
EJLFMVBSLBO PMFI LVNQBSBO PUPU NFOKBEJ MFCJI CFTBS MBHJ
TFEBOHLBOSFTQPOTTUBUJLIBNQJSUJEBLUFSQFOHBSVI4FCBMJL 54-5
658
QBSBO PUPU CFSBLIJS QBEB JOUFSOFVSPOJOUFSOFVSPO ZBOH

( )
UFSEBQBU EBMBN TVCTUBOTJB HSJTFB NFEVMB TQJOBMJT EBO
JOUFSOFVSPO JOJ NFOHJSJNLBO TJOZBM QFSMBNCBUBO LF OFVSPO
NPUPSJLBOUFSJPSBUBVNFMBZBOJGVOHTJGVOHTJMBJOOZB
UNIT XI
Refleks Regang Dinamik dan Refleks Regang
Statik. 3FGMFLT SFHBOH EBQBU EJCBHJ NFOKBEJ EVB LPNQPOFO
SFGMFLT SFHBOH EJOBNJL EBO SFGMFLT SFHBOH TUBUJL 3FGMFLT SFHBOH
EJOBNJL EJDFUVTLBO PMFI TJOZBM EJOBNJL ZBOH LVBU ZBOH A B
EJLJSJNLBO EBSJ VKVOH TFOTPSJL QSJNFS LVNQBSBO PUPU BLJCBU
SFHBOHBO BUBV QFNBNQBUBO ZBOH CFSMBOHTVOH DFQBU +BEJ CJMB 0 1 2 3
PUPU UJCBUJCB EJSFHBOH BUBV EJNBNQBULBO BLBO BEB TJOZBM LVBU
ZBOH EJLJSJNLBO LF NFEVMB TQJOBMJT IBM JOJ BLBO TFHFSB 54-6
NFOJNCVMLBO SFGMFLT LPOUSBLTJ ZBOH LVBU BUBV NFOVSVOBO
LPOUSBLTJ
QBEBPUPUZBOHTBNBEBOUFNQBUTJOZBMUBEJLFMVBS
%FOHBO EFNJLJBO GVOHTJ SFGMFLT JOJ BEBMBI VOUVL NFMBXBO
QFSVCBIBOQBOKBOHPUPU
3FGMFLT SFHBOH EJOBNJL CFSBLIJS EBMBN XBLUV LVSBOH EBSJ
TBUV EFUJL TFTVEBI PUPU EJSFHBOH BUBV MFQBT EBSJ SFHBOHBO

IJOHHBNFODBQBJQBOKBOHOZBZBOHCBSV OBNVOLFNVEJBOBLBO Peran Kumparan Otot pada Aktivitas Motorik
EJMBOKVULBO PMFI SFGMFLT SFHBOHTUBUJL ZBOH MFCJI MFNBI EBMBN Volunter
XBLUV ZBOH MBNB 3FGMFLT JOJ EJDFUVTLBO PMFI TJOZBM SFTFQUPS
TUBUJL UFSVTNFOFSVT ZBOH EJLJSJNLBO PMFI VKVOH QSJNFS EBO 6OUVL NFNBIBNJ NBLOB TJTUFN FGFSFO HBNNB LJUB QFSMV
VKVOH TFLVOEFS .BLOB SFGMFLT SFHBOH TUBUJL BEBMBI CBIXB NFOHFUBIVJ CBIXB QFSTFO EBSJ TFNVB TFSBU TBSBG NPUPSJL
SFGMFLT JOJ NFOJNCVMLBO EFSBKBU UFSUFOUV LPOUSBLTJ PUPU ZBOH ZBOHNFOVKVPUPUNFSVQBLBOTFSBUFGFSFOHBNNBUJQF"ZBOH
EJQFSUBIBOLBO EBMBN LFBEBBO LPOTUBO LFDVBMJ LFUJLB TJTUFN LFDJMEBOCVLBOTFSBUNPUPSJLBMGBZBOHCFTBS#JMBTJOZBMEBSJ
TBSBGTFTFPSBOHNFNFSJOUBILBOTFCBMJLOZB LPSUFLT NPUPS BUBV TFUJBQ EBFSBI PUBL EJLJSJNLBO LF OFVSPO
NPUPSJL BMGB LFCBOZBLBO OFVSPO NPUPSJL HBNNB UFSBOHTBOH
Fungsi "Peredam" Refleks Regang Statik TFDBSB CFSTBNBBO FGFL JOJ EJTFCVU TFCBHBJ LFBEBBO LPBLUJWBTJ
dan Dinamik. EBSJ OFVSPO NPUPSJL BMGB EBO HBNNB ,FBEBBO JOJ
NFOZFCBCLBO TFSBU PUPU SBOHLB FLTUSBGVTBM EBO TFSBU PUPU
'VOHTJ QFOUJOH VUBNB SFGMFLT SFHBOH BEBMBI LFNBNQVBOOZB JOUSBGVTBMLVNQBSBOPUPUCFSLPOUSBLTJTFDBSBCFSTBNBBO
VOUVL NFODFHBI HFSBLBO UVCVI ZBOH CFSHPZBOH PTDJMMBUJPO

5VKVBO TFSBU JOUSBGVTBM LVNQBSBO PUPU CFSLPOUSBLTJ
BUBV NFOZFOUBLOZFOUBL KFSLJOFTT
*OJ BEBMBI GVOHTJ QFSFEBN
TFDBSB TFSFOUBL CFSTBNBBO EFOHBO LPOUSBLTJ TFSBU PUPU
EBNQJOH
BUBVQFMBODBS TNPPUIJOH
TFQFSUJZBOHEJKFMBTLBOQBEB
SBOHLBZBOHCFTBSBEBMBIEVBLBMJMJQBU1FSUBNB LFBEBBOJOJ
QBSBHSBGCFSJLVU
BLBO NFNQFSUBIBOLBO QBOKBOH CBHJBO SFTFQUPS LVNQBSBO
PUPU EBSJ QFSVCBIBO TFMBNB CFSKBMBOOZB TFMVSVI LPOUSBLTJ
Mekanisme Peredaman untuk Melancarkan Kontraksi PUPU 0MFI LBSFOB JUV LPBLUJWBTJ NFNQFSUBIBOLBO SFGMFLT
Otot. 4JOZBM ZBOH CFSBTBM EBSJ NFEVMB TQJOBMJT TFSJOH LBMJ LVNQBSBO PUPU NFMBXBO LPOUSBLTJ PUPU ,FEVB LFBEBBO JOJ
EJLJSJNLBO LF PUPU UJEBL EBMBN CFOUVL ZBOH MBODBS TFMBNB NFNQFSUBIBOLBO GVOHTJ QFSFEBN LVNQBSBO PUPU BHBS UFUBQ
CFCFSBQBNJMJEFUJLJOUFOTJUBTOZBNFOJOHLBU LFNVEJBOJOUFOTJUBT TFTVBJ UBOQB NFNQFEVMJLBO TFUJBQ QFSVCBIBO QBOKBOH PUPU
NFOVSVO MBMV CFSVCBI LF UBIBQ JOUFOTJUJBT ZBOH MBJO EBO $POUPI CJMB LVNQBSBO PUPU UJEBL CFSLPOUSBLTJ EBO
TFUFSVTOZB#JMBBMBULVNQBSBOPUPUUJEBLCFSGVOHTJEFOHBOCBJL CFSFMBLTBTJCFSTBNBEFOHBOTFSBUPUPUCFTBS CBHJBOSFTFQUPS
TFMBNB JTZBSBU CFSMBOHTVOH BLBO UFSKBEJ LPOUSBLTJ PUPU ZBOH LVNQBSBO PUPU LBEBOHLBEBOH BLBO UFSTFOUBL EBO LBEBOH
NFOZFOUBLOZFOUBL &GFL JOJ EJQFSMJIBULBO EBMBN (BNCBS BLBO UFSMBMV UFSFHBOH EBO UJEBL TBUV QVO EBSJ LFEVB IBM JOJ
1BEB LVSWB " SFGMFLT LVNQBSBO PUPU EBSJ PUPU ZBOH UFSBOHTBOH UFSKBEJTFDBSBPQUJNVNCBHJGVOHTJLVNQBSBO
CFSTJGBU VUVI 1FSIBUJLBO CBIXB LPOUSBLTJ ZBOH UJNCVM CFSTJGBU
SFMBUJG MBODBS XBMBVQVO TBSBG NPUPSJL LF PUPU EJFLTJUBTJ QBEB Daerah Otak untuk Pengaturan Sistem
GSFLVFOTJ MBNCBU ZBLOJ IBOZB EFMBQBO TJOZBM QFSEFUJL ,VSWB # Motorik Gamma
NFOHHBNCBSLBO QFOFMJUJBO ZBOH TBNB QBEB IFXBO EFOHBO TBSBG
TFOTPSJL LVNQBSBO PUPU UFMBI EJQPUPOH CVMBO TFCFMVNOZB 4JTUFNFGFSFOHBNNBEJSBOHTBOHTFDBSBLIVTVTPMFITJOZBMEBSJ
1FSIBUJLBO LPOUSBLTJ PUPU ZBOH UBL MBODBS +BEJ LVSWB " TFDBSB SFHJP GBTJMJUBTJ CVMCPSFUJLVMBS EBMBN CBUBOH PUBL EBO TFDBSB
HSBGJL NFOHHBNCBSLBO LFNBNQVBO NFLBOJTNF QFSFEBN VOUVL TFLVOEFS PMFI JNQVMTJNQVMT ZBOH EJLJSJNLBO LF EBFSBI JOJ
NFNQFSMBODBSLPOUSBLTJPUPU XBMBVQVOTJOZBMNBTVLLBOQSJNFS EBSJ
TFSFCFMVN
HBOHMJB CBTBM EBO CBILBO EBSJ

LF TJTUFN NPUPSJL PUPUOZB TFOEJSJ NFOZFOUBLOZFOUBL &GFL JOJ LPSUFLTTFSFCSJ
EBQBUKVHBEJTFCVUGVOHTJQFNFSBUBTJOZBMQBEBSFGMFLTLVNQBSBO )BOZB TFEJLJU ZBOH EJLFUBIVJ UFOUBOH NFLBOJTNF QBTUJ
PUPU QFOHBUVSBO TJTUFN HBNNB FGFSFO #JBSQVO CFHJUV LBSFOB EBF
SBIGBTJMJUBTJCVMCPSFUJLVMBSJOJCJBTBOZBCFSIVCVOHBOEFOHBO
659
LPOUSBLTJNFMBXBOHBZBCFSBU BOUJHSBWJUZDPOUSBDUJPOT
EBO Patellar tendon struck
KVHB LBSFOB PUPUPUPU VOUVL NFMBXBO HBZB CFSBU NFNQVOZBJ
LVNQBSBOPUPUZBOHEFOTJUBTOZBUJOHHJ EJUFLBOLBONFOHFOBJ
Muscle length
QFOUJOHOZB NFLBOJTNF FGFSFO HBNNB JOJ VOUVL NFSFEBN
HFSBLBOHFSBLBO CFSCBHBJ CBHJBO UVCVI TFMBNB CFSKBMBO EBO
CFSMBSJ
Sistem Kumparan Otot Menstabilkan Posisi Tubuh

selama Aktivitas Kuat
4BMBI TBUV GVOHTJ UFSQFOUJOH TJTUFN LVNQBSBO PUPU BEBMBI
0 200 400 600 800
VOUVLNFOTUBCJMLBOLFEVEVLBOUVCVITFMBNBLFSKBNPUPSJL
ZBOH LVBU 6OUVL NFMBLVLBO IBM JOJ SFHJP GBTJMJUBUPSJL 54-7
CVMCPSFUJLVMBS EBO EBFSBIEBFSBI ZBOH CFSEFLBUBO
EFOHBOOZB EJ CBUBOH PUBL BLBO NFOKBMBOLBO TJOZBMTJOZBM
FLTJUBUPSJL NFMBMVJ TFSBU TBSBG HBNNB LF TFSBUTFSBU PUPU
JOUSBGVTBM LVNQBSBO PUPU )BM JOJ NFNFOEFLLBO VKVOH 4FOUBLBO PUPU EJQBLBJ PMFI QBSB BIMJ OFVSPMPHJ VOUVL NFOJMBJ
VKVOH LVNQBSBO EBO NFSFHBOHLBO SFHJP SFTFQUPS QVTBU EFSBKBUGBTJMJUBTJQVTBUQVTBUZBOHUFSMFUBLEJNFEVMBTQJOBMJT#JMBBEB
EFOHBO EFNJLJBO NFOJOHLBULBO TJOZBM LFMVBSBOOZB CBOZBL TFLBMJ JNQVMT GBTJMJUBTJ EJLJSJNLBO EBSJ CBHJBO BUBT TJTUFN
/BNVO KJLB LVNQBSBO QBEB LFEVB TJTJ TFUJBQ TFOEJ TBSBG QVTBU LF NFEVMB TFOUBLBO MVUVU BLBO TFNBLJO CFSMFCJIBO
EJBLUJGLBO QBEB XBLUV ZBOH TBNB SFGMFLT FLTJUBTJ PUPUPUPU 4FCBMJLOZB CJMB JNQVMT GBTJMJUBTJ EJUFLBO BUBV EJSFEBN NBLB
SBOHLB QBEB LFEVB TJTJ TFOEJ KVHB NFOJOHLBU TFIJOHHB TFOUBLBO MVUVU BLBO NFOKBEJ MFNBI BUBV IJMBOH TBNB TFLBMJ 3FGMFLT
JOJ LFCBOZBLBO EJQBLBJ VOUVL NFOFOUVLBO BEB UJEBLOZB TQBTUJTJUBT
NFOJNCVMLBO LFLVBUBO EBO UFHBOHBO PUPU ZBOH TBMJOH
PUPU ZBOH EJTFCBCLBO PMFI TVBUV MFTJ EBMBN TBMBI TBUV BSFB NPUPSJL
CFSMBXBOBOTBUVTBNBMBJOQBEBTFOEJ)BTJMBLIJSOZBBEBMBI PUBLBUBVQFOZBLJUZBOHNFOHFLTJUBTJEBFSBIGBTJMJUBTJCVMCPSFUJLVMBS
CBIXB LFEVEVLBO TFOEJ NFOKBEJ TBOHBU TUBCJM EBO TFUJBQ QBEB CBUBOH PUBL #JBTBOZB MFTJ ZBOH MVBT EJ EBFSBI NPUPSJL
LFLVBUBO ZBOH DFOEFSVOH NFOHHFSBLLBO TFOEJ EBSJ QPTJTJ LPOUSBMBUFSBM LPSUFLT TFSFCSJ UFUBQJ CVLBO EJ EBMBN EBFSBI QFOHBUVS
BTBMOZB EJMBXBO PMFI SFGMFLT SFHBOH ZBOH TBOHBU QFLB ZBOH NPUPSJLZBOHMFCJICBXBI UFSVUBNBMFTJZBOHEJTFCBCLBOPMFITUSPLF
CFLFSKBQBEBLFEVBTJTJQFSTFOEJBO BUBVUVNPSPUBL
BLBOTBOHBUNFNQFSLFSBTTFOUBLBOQBEBPUPUZBOH
4FUJBQ LBMJ TFTFPSBOH IBSVT NFMBLVLBO GVOHTJ PUPU ZBOH CFSBEBQBEBTJTJUVCVICFSMBXBOBO
NFNFSMVLBOLFEVEVLBOTBOHBUTVMJUEBOTBOHBUUFQBU FLTJUBTJ
QBEB LVNQBSBO PUPU ZBOH TFTVBJ PMFI TJOZBM EBO SFHJP Klonus—Osilasi Sentakan Otot. 1BEB CFCFSBQB LPOEJTJ
GBTJMJUBUPSJL CVMCPSFUJLVMBS CBUBOH PUBL NFOTUBCJMLBO QPTJTJ TFOUBLBOPUPUEBQBUCFSPTJMBTJ ZBJUVTVBUVGFOPNFOBZBOHEJTFCVU
TFOEJVUBNB#BOUVBOJOJTBOHBUNFOPMPOHEBMBNNFNCFOUVL LMPOVT MJIBU NJPHSBN (BNCBS CBHJBO CBXBI
,FBEBBO
HFSBLBO WPMVOUFS UBNCBIBO ZBOH EFUBJM QBEB KBSJKBSJ BUBV PTJMBTJEBQBUEJKFMBTLBOTFDBSBLIVTVTCFSIVCVOHEFOHBOLFBEBBO
CBHJBOCBHJBO UVCVI MBJOOZB
ZBOH EJQFSMVLBO VOUVL LMPOVTQFSHFMBOHBOLBLJ TFCBHBJCFSJLVU
QSPTFEVSNPUPSJLZBOHSVNJU #JMB TFTFPSBOH CFSEJSJ EJ BUBT VKVOHVKVOH KBSJ LBLJOZB UJCB
UJCB NFOVSVOLBO CBEBO LF CBXBI EBO NFSFHBOHLBO PUPU
Penerapan Klinis Refleks Regang HBTUSPLOFNJVT JNQVMTSFGMFLTSFHBOHEJLJSJNLBOEBSJLVNQBSBO
4FUJBQ LBMJ NFMBLVLBO QFNFSJLTBBO GJTJL QBEB TFPSBOH QBTJFO PUPU NFOVKV NFEVMB TQJOBMJT *NQVMTJNQVMT JOJ TFDBSB SFGMFLT
TFPSBOH EPLUFS NFOJNCVMLBO CBOZBL SFGMFLT SFHBOH 5VKVBOOZB BLBONFSBOHTBOHPUPUZBOHUFSFHBOH TFIJOHHBBLBONFOHBOHLBU
BEBMBI VOUVL NFOFOUVLBO CFSBQB CFTBS FLTJUBTJ ZBOH UFSKBEJ BUBV UVCVILFBUBTMBHJ4FTVEBITFQFSEFUJL SFGMFLTLPOUSBLTJPUPUBLBO
UPOVT ZBOH EJLJSJNLBO PMFI PUBL LF NFEVMB TQJOBMJT 3FGMFLT ZBOH IJMBOH EBO UVCVI BLBO KBUVI MBHJ KBEJ BLBO NFSFHBOHLBO
EJIBTJMLBOBEBMBITFCBHBJCFSJLVU LVNQBSBO VOUVL ZBOH LFEVB LBMJOZB 3FGMFLT SFHBOH EJOBNJL
Sentakan Lutut (Knee Jerk) dan Sentakon Otot BLBO NFOHBOHLBU UVCVI MBHJ OBNVO EBMBN NBTB TFQFSEFUJL
lainnya Dapat Digunakan untuk Menitai Sensitivitas Refleks LFBEBBO JOJ QVO BLBO IJMBOH EBO UVCVI BLBO KBUVI MBHJ VOUVL
Regang. 4FDBSBLMJOJT BEBTVBUVNFUPEBZBOHEJQFSHVOBLBOVOUVL NFNVMBJ LFNCBMJ TJLMVT ZBOH CBSV %FOHBO DBSB JOJ SFGMFLT
NFOFOUVLBO LFQFLBBO SFGMFLT SFHBOH ZBLOJ EFOHBO DBSB SFHBOH EBSJ PUPU HBTUSPLOFNJVT BLBO UFSVTNFOFSVT CFSPTJMBTJ
NFOJNCVMLBO TFOUBLBO MVUVU EBO TFOUBLBO PUPU MBJOOZB 4FOUBLBO EBOTFSJOHLBMJCFSMBOHTVOHVOUVLXBLUVZBOHMBNBLFBEBBOJOJ
MVUVUJOJEBQBUEJUJNCVMLBOEFOHBODBSBNFNVLVMQFMBOQFMBOUFOEP EJTFCVULMPOVT
QBUFMB EFOHBO QBMV SFGMFLT QVLVMBO JOJ BLBO TFDBSB UJCBUJCB ,MPOVT CJBTBOZB IBOZB UFSKBEJ LFUJLB SFGMFLT SFHBOH EBMBN
NFSFHBOHLBO PUPU LVBESJTFQT EBO NFSBOHTBOH UFSKBEJOZB SFGMFLT LFBEBBO TBOHBU QFLB BLJCBU BEBOZB JNQVMT GBTJMJUBTJ ZBOH CFSBTBM
SFHBOH EJOBNJL ZBOH LFNVEJBO BLBO NFOZFCBCLBO UVOHLBJ CBXBI EBSJ PUBL $POUPIOZB QBEB IFXBO EFTFSFCSBTJ ZBOH SFGMFLT
NFOZFOUBL LF EFQBO #BHJBO BUBT (BNCBS NFNQFSMJIBULBO SFHBOHOZB EBMBN LFBEBBO TBOHBU UFSGBTJMJUBTJ NBLB BLBO TFHFSB
TFCVBI HBNCBSBO NJPHSBN PUPU LVBESJTFQT ZBOH EJSFLBN TFMBNB UJNCVMLFBEBBOLMPOVTEJBUBT6OUVLNFOFOUVLBOTFCFSBQBCFTBS
UFSKBEJOZBTFOUBLBOMVUVU EFSBKBU GBTJMJUBTJ NFEVMB TQJOBMJT QBEB QBTJFO BIMJ TBSBG NFOHVKJ
3FGMFLT ZBOH TFSVQB EBQBU KVHB EJUJNCVMLBO EJ TFUJBQ CBHJBO
LMPOVT QBTJFO EFOHBO NFSFHBOHLBO PUPU TFDBSB NFOEBEBL EBO
UVCVI ZBLOJ EFOHBO DBSB NFNVLVM UFOEP PUPU BUBV QFSVU PUPUOZB
%FOHBO LBUB MBJO QFSFHBOHBO ZBOH NFOEBEBL QBEB LVNQBSBO PUPU
NFOHHVOBLBO HBZB SFHBOH ZBOH NFOFUBQ UFSIBEBQ PUPU UFSTFCVU
EJQFSMVLBOVOUVLNFOJNCVMLBOSFGMFLTSFHBOHEJOBNJL #JMBLFNVEJBOUJNCVMLMPOVT CFSBSUJEFSBKBUGBTJMJUBTJQBEBTBBUJUV
TBOHBUUJOHHJ
660
Refleks Tendon Golgi IJCJTJ +BEJ SFGMFLT JOJ NFODFUVTLBO TVBUV NFLBOJTNF VNQBO
0SHBO5FOEPO(PMHJ.FNCBOUV.FOHBUVS,FUFHBOHBO CBMJLOFHBUJGZBOHNFODFHBIBHBSUFHBOHBOQBEBPUPUUJEBLUFSMBMV
CFTBS
Otot. 0SHBO UFOEPO (PMHJ TFQFSUJ ZBOH UBNQBL QBEB (BNCBS
#JMBUFHBOHBOQBEBPUPUZBOHNFOHBLJCBULBOUFHBOHBOQBEB
EJTFMVCVOHJ PMFI SFTFQUPSSFTFQUPS TFOTPSJL ZBOH EJMFXBUJ
UFOEPO NFOKBEJ FLTUSFN FGFL QFOHIBNCBU EBSJ PSHBO UFOEPO
UNIT XI
PMFITFSBCVUUFOEPOPUPU3BUBSBUBBEBIJOHHBTFSBCVUPUPU
BLBO NFOKBEJ TFEFNJLJBO CFTBSOZB TFIJOHHB NFOJNCVMLBO
ZBOH CJBTBOZB CFSLBJUBO EFOHBO UJBQ PSHBO UFOEPO (PMHJ EBO
SFBLTJ NFOEBEBL QBEB NFEVMB TQJOBMJT ZBOH NFOZFCBCLBO
PSHBOJOJEBQBUUFSBOHTBOHLFUJLBCFSLBTLFDJMTFSBCVUPUPULFDJM
SFMBLTBTJ DFQBU TFMVSVI PUPU &GFL JOJ EJTFCVU SFBLTJ QFNBOKB
UFSTFCVUEJSBOHTBOHPMFIPUPUZBOHCFSLPOUSBLTJBUBVUFSFHBOH
OHBO ZBOH NFSVQBLBO NFLBOJTNF QFMJOEVOH BHBS PUPU UJEBL
+BEJ QFSCFEBBO VUBNB BOUBSB FLTJUBTJ PSHBO UFOEPO (PMHJ
NFMBXBO LVNQBSBO PUPU BEBMBI CBIXB LVNQBSBO EBQBU SPCFL BUBV BHBS UFOEPOOZB UJEBL UFSUBSJL EBSJ UFNQBU QFMFLB
NFOEFUFLTJ QBOKBOH PUPU EBO QFSVCBIBOOZB TFNFOUBSB PSHBO UBOOZBQBEBUVMBOH$POUPIOZB LJUBUBIVCBIXBQFSBOHTBOHBO
UFOEPO EBQBU NFOEFUFLTJ UFHBOHBO PUPU TFQFSUJ UFSDFSNJO EBSJ MJTUSJL TFDBSB MBOHTVOH QBEB PUPU EJ MBCPSBUPSJVN ZBOH UBL
UFHBOHBOPSHBOUFOEPOJUVTFOEJSJ EBQBUEJMBXBOPMFISFGMFLTOFHBUJGJOJ CFSFGFLEFTUSVLUJG
0SHBO UFOEPO TFQFSUJ IBMOZB SFTFQUPS QSJNFS ZBOH UFSEBQBU
EBMBNLVNQBSBOPUPU NFNQVOZBJSFTQPOTEJOBNJLEBOSFTQPOT Kemungkinan Peran Refteks Tendo untuk
TUBUJL ZBOH CFSFBLTJ TBOHBU LVBU TBBU UFHBOHBO PUPU UJCBUJCB Menyamaratakan Kekuatan Kontraksi di antara Serat-
NFOJOHLBU SFTQPOT EJOBNJL
OBNVO NFOKBEJ UFOBOH EBMBN Serat Otot. 4FQFSUJ GVOHTJ MBJO SFGMFLT UFOEP (PMHJ BEBMBI
XBLUV TFQFSEFUJL EBO UVSVO LF UJOHLBU ZBOH MFCJI SFOEBI EBSJ VOUVL NFOZBNBSBUBLBO LFLVBUBO LPOUSBLTJ QBEB TFSBUTFSBU
LFBEBBO TJBQ NFMFUVQ ZBOH NFOFUBQ TFIJOHHB IBNQJS TFTVBJ PUPU ZBOH UFSQJTBI "SUJOZB TFSBUTFSBU JOJ ZBOH NFOHBMBNJ
EFOHBO CFTBSOZB UFHBOHBO PUPU SFTQPOT TUBUJL
+BEJ PSHBO UFHBOHBO CFSMFCJIBO NFOKBEJ UFSJOIJCJTJ PMFI SFGMFLT TFEBOH
UFOEPO (PMHJ NFOHJSJNLBO JOGPSNBTJ DFQBU ZBOH TFTVBJ EFOHBO LBO TFSBCVU ZBOH NFOHBMBNJ UFSMBMV TFEJLJU UFHBOHBO NFOKBEJ
UJBQTFHNFOZBOHLFDJMEBSJTFUJBQPUPULFTJTUFNTBSBG MFCJI UFSBOHTBOH LBSFOB UJEBL BEBOZB QFOHIBNCBUBO SFGMFLT
)BM JOJ NFOZFCBSLBO CFCBO PUPU LF TFMVSVI TFSBU EBO NFODF
HBI LFSVTBLBO QBEB EBFSBI PUPU UFSUFOUV EJ NBOB TFKVNMBI
Penjalaran Impuls dari Organ Tendo ke Dalam Sistem
LFDJMTFSBUNVOHLJONFNQVOZBJCFCBOMFCJI
Sar af Pusat . 4JOZBM EBSJ PSHBO UFOEP EJLJSJNLBO NFMBMVJ
TFSBU TBSBG UJQF *C ZBOH CFTBS EBO QFOKBMBSBOOZB DFQBU ZBOH
Fungsi Kumparan Otot dan Organ Tendon Golgi dalam
SBUBSBUB CFSEJBNFUFS TFLJUBS N TFEJLJU MFCJI
LFDJM EBSJQBEB VKVOH QSJNFS LVNQBSBO PUPU 4FSBUTFSBU JOJ
Hubungannya dengan Pengatur Motorik dari Tingkat yang
TFQFSUJ IBMOZB VKVOH LVNQBSBO QSJNFS NFOHJSJNLBO TJOZBM
Lebih Tinggi di Otak
CBMJL LF BSFB MPLBM NFEVMB TFUFMBI CFSTJOBQT EJ EBMBN LPSOV 8BMBVQVO LJUB UFMBI NFOFLBOLBO NFOHFOBJ GVOHTJ LVNQBSBO
EPSTBMJT NFEVMB NFMBMVJ KBSBT TFSBU QBOKBOH TFQFSUJ USBLUVT PUPU EBO PSHBO UFOEPO (PMHJ QBEB QFOHBUVS NPUPSJL NFEVMB
TQJOPTFSFCFMBSJTLFTFSFCFMVNEBOKVHBNFMBMVJUSBLUVTUSBLUVT TQJOBMJT UFSOZBUB LFEVB PSHBO TFOTPSJL JOJ KVHB NFNCFSJUBIV
ZBOH MBJOOZB LF LPSUFLT TFSFCSJ 4JOZBM NFEVMB MPLBM QVTBUQVTBU QFOHFOEBMJ NPUPSJL ZBOH MFCJI UJOHHJ VOUVL UVSVU
NFSBOHTBOHTVBUVJOUFSOFVSPOQFOHIBNCBUZBOHNFOHIBNCBU NFOHBNCJM CBHJBO EBMBN NFOHIBEBQJ QFSVCBIBO ZBOH NFOEB
OFVSPO NPUPSJL BOUFSJPS 4JSLVJU MPLBM JOJ MBOHTVOH EBL QBEB PUPU 4FCBHBJ DPOUPI USBLUVT TQJOPTFSFCFMBSJT EPSTBMJT
NFOHIBNCBU TFUJBQ PUPU UBOQB NFNFOHBSVIJ PUPUPUPU EJ TFDBSBMBOHTVOHNFNCBXBJOGPSNBTJTFHFSBEBSJLVNQBSBOPUPU
EFLBUOZB )VCVOHBO BOUBSB TJOZBM LF PUBL EBO GVOHTJ EBOPSHBOUFOEPO(PMHJLFTFSFCFMVNQBEBLFDFQBUBOQFOHIBO
TFSFCFMVNTFSUBCBHJBOMBJOPUBLVOUVLQFOHBMJSBOPUPUEJCBIBT UBSBO NFOEFLBUJ NEFUJL LPOEVLTJ QBMJOH DFQBU EJ BOUBSB
QBEB#BC LPOEVLTJZBOHBEBEJEBMBNPUBLNBVQVONFEVMBTQJOBMJT+BSBT
UBNCBIBONFOHJSJNLBOJOGPSNBTJZBOHTFSVQBLFSFHJPSFUJLVMBS
CBUBOH PUBL EBO LF EBFSBI ZBOH MFCJI TFNQJU NFMBMVJ TFNVB
Sifat Inhibisi Refteks Tendon dan Makna Pentingnya KBMVSLFBSFBNPUPSJLLPSUFLTTFSFCSJ4FQFSUJZBOHUFMBIEJQFMBKBSJ
#JMB PSHBO UFOEPO (PMHJ TFCVBI UFOEPO PUPU EJSBOHTBOH PMFI EBMBN #BC EBO JOGPSNBTJ ZBOH CFSBTBM EBSJ SFTFQUPS JOJ
LFOBJLBOUFHBOHBOQBEBPUPUZBOHCFSIVCVOHBO TJOZBMOZBEJLJ QFOUJOHTFLBMJTFCBHBJQFOHBUVSZBOHCFSTJGBUVNQBOCBMJLUFSIB
SJNLBOLFNFEVMBTQJOBMJTHVOBNFOJNCVMLBOSFGMFLTZBOHBLBO EBQTJOZBMNPUPSJLEBSJTFNVBBSFBJOJ
NFNFOHBSVIJPUPUZBOHTFTVBJ3FGMFLTJOJTFMVSVIOZBCFSTJGBUJO
Refleks Fleksor dan Refteks Menarik Diri
(16 Mm)
1BEB IFXBO TQJOBM BUBV IFXBO EFTFSFCSBTJ IBNQJS TFUJBQ
KFOJT SBOHTBOH TFOTPSJL LVMJU EBO BOHHPUB UVCVI UBNQBLOZB
NFOZFCBCLBO PUPUPUPU BOHHPUB UVCVI CFSLPOUSBLTJ
TFIJOHHB NFOBSJL BOHHPUB UVCVI NFOKBVIJ PCKFL ZBOH
NFSBOHTBOH)BMJOJEJTFCVUSFGMFLTGMFLTPS
%BMBN CFOUVL LMBTJLOZB SFGMFLT GMFLTPS EBQBU EJDFUVTLBO
QBMJOHLVBUEFOHBODBSBNFSBOHTBOHVKVOHVKVOHTBSBGOZFSJ
NJTBMOZB EFOHBO UVTVLBO KBSVN BUBV SBTB QBOBT BUBV TVBUV
MVLB ZBOH EFOHBO CFCFSBQB BMBTBO TFSJOH LBMJ EJTFCVU SFGMFLT
54-8 OPTJTFQUJGBUBVTFDBSBMFCJITFEFSIBOBEFOHBOTFCVUBOSF
661
GMFLT OZFSJ 3BOHTBOHBO QBEB SFTFQUPS SBCB BEBLBMBOZB EBQBU

NFOJNCVMLBOSFGMFLTGMFLTPSZBOHMFCJIMBNBEBOMFCJIMFNBI
#JMBCFCFSBQBCBHJBOUVCVITFMBJOTBMBITBUVBOHHPUBHFSBL
EJSBOHTBOHEFOHBOSBOHTBOHBOZBOHTBOHBUNFOZBLJULBO NB
LBCBHJBOUFSTFCVUEFOHBOQPMBZBOHTFSVQB BLBONFOBSJLEJSJ
EBSJSBOHTBOHUFSTFCVU OBNVONFTLJQVOQBEBEBTBSOZBNFSV
QBLBOSFGMFLTZBOHTBNB SFGMFLTJOJNVOHLJOUBLIBOZBUFSCB
UBT QBEB GMFLTPS PUPU TBKB 0MFI LBSFOB JUV LFCBOZBLBO QPMB
0 1 2 3
SFGMFLTUJQFJOJEJCFSCBHBJEBFSBIUVCVIZBOHCFSCFEBEJTFCVU Seconds
SFGMFLTNFOBSJLEJSJ XJUIESBXBM
54-10
Mekanisme Neuronal Refleks Fleksor. #BHJBO LJSJ

(BNCBS NFOKFMBTLBO KBSBT OFVSPOBM ZBOH EJQBLBJ SFGMFLT
GMFLTPS 1BEB DPOUPI JOJ SBOHTBOH ZBOH TBOHBU NFOZBLJULBO TVEBIUJEBLBEB
EJCFSJLBOQBEBUBOHBOBLJCBUOZB PUPUPUPUGMFLTPSMFOHBOBUBT (BNCBSNFOHHBNCBSLBOTVBUVNJPHSBNZBOHLIBTEBSJ
BLBO UFSBOHTBOH EFOHBO EFNJLJBO BLBO NFOBSJL UBOHBO UBEJ TFCVBIPUPUGMFLTPSTFMBNBCFSMBOHTVOHOZBSFGMFLTGMFLTPS%BMBN
NFOKBVIJSBOHTBOHZBOHTBOHBUNFOZBLJULBO XBLUV CFCFSBQB NJMJEFUJL TFTVEBI TVBUV TBSBG OZFSJ NVMBJ
+BSBTZBOHEJQBLBJVOUVLNFOJNCVMLBOSFGMFLTGMFLTPSUJEBL EJSBOHTBOH UJNCVM SFTQPOT GMFLTPS 4FMBOKVUOZB EBMBN XBLUV
TFDBSB MBOHTVOH NFMFXBUJ OFVSPO NPUPSJL BOUFSJPS OBNVO CFCFSBQBEFUJL SFGMFLTNVMBJNFOHBMBNJLFMFMBIBO ZBOHNFSVQB
NVMBNVMB CFSKBMBO NFOVKV LVNQVMBO JOUFSOFVSPO NFEVMB LBO TJGBU NFOEBTBS EBSJ TFNVB SFGMFLT JOUFHSBTJ ZBOH LPNQMFLT
TQJOBMJTEBOTFMBOKVUOZBLFOFVSPONPUPSJL4JSLVJUUFSQFOEFL EBSJNFEVMBTQJOBMJT"LIJSOZB CFHJUVSBOHTBOHTFMFTBJ LPOUSBLTJ
ZBOH NFNVOHLJOLBO BEBMBI MFOHLVOHBO ZBOH IBOZB UFSEJSJ PUPU BLBO LFNCBMJ MBHJ LF LFBEBBO EBTBSOZB OBNVO LBSFOB BEB
BUBT UJHB TBNQBJ FNQBU KBSBT OFVSPO OBNVO TFCBHJBO CFTBS BGUFSEJTDIBSHF FGFL JLVUBO
QFOHFNCBMJBO UFSTFCVU NFNCVUVI
TJOZBMTJOZBM SFGMFLT JOJ BLBO NFMJOUBTJ MFCJI CBOZBL OFVSPO LBO CFCFSBQB NJMJEFUJL TFIJOHHB UFSKBEJ LPOUSBLTJ PUPU ZBOH
MBHJ EBO NFODBLVQ KFOJTKFOJT EBTBS EBSJ TJSLVJU CFSJLVU
LFNCBMJ LF LFBEBBO EBTBS -BNBOZB BGUFSEJTDIBSHF CFSHBOUVOH
TJSLVJUCFSDBCBOH EJWFSHJOHDJSDVJUT
VOUVLNFOZFCBSLBOSFG QBEB JOUFOTJUBT SBOHTBOH TFOTPSJL ZBOH NFODFUVTLBO SFGMFLT
MFLTUBEJLFPUPUPUPUZBOHEJQFSMVLBOVOUVLNFOBSJLEJSJ
SBOHTBOHUBLUJMZBOHMFNBIIBNQJSTBNBTFLBMJUJEBLNFOJNCVM
TJSLVJUVOUVLNFOHIBNCBUPUPUPUPUBOUBHPOJT EJTFCVUTJSLVJU LBOBGUFSEJTDIBSHF OBNVOTFUFMBIQFNCFSJBOSBOHTBOHOZFSJZBOH
JOIJCJTJ UJNCBMCBMJL SFDJQSPDBM JOIJCJUJPO DJSDVJUT
EBO
LVBU BGUFSEJTDIBSHF EBQBU CFSMBOHTVOH TFMBNB CFCFSBQB EFUJL
TJSLVJU ZBOH NFOZFCBCLBO BGUFSEJTDIBSHF FGFL JLVUBO
BUBVMFCJI
CFSMBOHTVOHTFMBNBCFCFSBQBNJMJEFUJLTFUFMBISBOHTBOHOZB 1FSJTUJXBBGUFSEJTDIBSHFZBOHUJNCVMQBEBSFGMFLTGMFLTPSIBN
1&/()".#"55*.#"-#"-*,
QJS QBTUJ CFSBTBM EBSJ LFEVB NBDBN TJSLVJU QFOHFMVBSBO JNQVMT
ZBOHCFSVOUVOTFQFSUJZBOHUFMBIEJCJDBSBLBOQBEB#BC1FSJT
UJXBBGUFSEJTDIBSHFZBOHCFSMBOHTVOHEFOHBOTFHFSBEBQBUEJUVO
KVLLBONFMBMVJQFOFMJUJBOFMFLUSPGJTJPMPHJ ZBOHCFSMBOHTVOHTFMB
NBLJSBLJSBTBNQBJNJMJEFUJL EJTFCBCLBOPMFIMFUVQBOCFSVO
UVOH EBMBN JOUFSOFVSPOOZB TFOEJSJ ZBOH UFSFLTJUBTJ 1FSJTUJXB
BGUFSEJTDIBSHFZBOHCFSMBOHTVOHMBNB ZBOHUFSKBEJTFTVEBISBOH
TBOHOZFSJZBOHLVBU KVHBIBNQJSTFMVSVIOZBBEBMBIBLJCBUKBSBT
SFLVSFOZBOHNFNVMBJPTJMBTJQBEBTJSLVJUJOUFSOFVSPOSFWFSCFSBTJ
SFWFSCFSBUJOH DJSDVJUT
KBSBT UFSTFCVU TFMBOKVUOZB NFOFSVTLBO
JNQVMTLFOFVSPONPUPSJLBOUFSJPS LBEBOHLBMBTFMBNBCFCFSBQB
EFUJLTFTVEBITJOZBMTFOTPSJLZBOHCBSVNBTVLTVEBICFOBSCFOBS
TFMFTBJ
%FOHBO EFNJLJBO SFGMFLT GMFLTPS UFSTVTVO TFDBSB UFQBU VOUVL
EBQBUNFOBSJLCBHJBOUVCVIZBOHNFOHBMBNJOZFSJBUBVUFSJSJUBTJ
EBSJ SBOHTBOH 4FMBOKVUOZB LBSFOB BEB QFSJTUJXB BGUFSEJTDIBSHF
SFGMFLT EBQBU NFOBIBO CBHJBO UVCVI ZBOH UFSJSJUBTJ VOUVL
NFOKBVILBOEJSJEBSJSBOHTBOHTFMBNB TBNQBJEFUJLTFTVEBI
JSJUBTJ TFMFTBJ %BO TFMBNB XBLUV JOJ SFGMFLT EBO LFSKB MBJO ZBOH
BTBMOZB EBSJ TJTUFN TBSBG QVTBU EBQBU NFOKBVILBO TFMVSVI UVCVI
EBSJSBOHTBOHZBOHNFOZBLJULBO
Pola Menarik Diri. 1PMB NFOBSJL EJSJ XJUIESBXBM

ZBOH
3&'-&,4 3&'-&,44*-"/( UJNCVM TBBU SFGMFLT GMFLTPS EJSBOHTBOH CFSHBOUVOH QBEB TBSBG
'-&,403 &,45&/403
TFOTPSJLZBOHEJSBOHTBOH+BEJ SBOHTBOHOZFSJQBEBCBHJBOEBMBN
54-9 MFOHBO UJEBL IBOZB NFOJNCVMLBO LPOUSBLTJ PUPUPUPU BCEVLUPS
VOUVLNFOBSJLMFOHBOUBEJNFOKBVI%FOHBOLBUBMBJO QVTBUJOUF
662
HSBTJEBMBNNFEVMBTQJOBMJTNFOZFCBCLBOPUPUPUPUCFSLPOUSBLTJ Hambatan Timbal Balik dan Persarafan Timbal

TFIJOHHB TFDBSB TBOHBU FGFLUJG EBQBU NFNJOEBILBO CBHJBO Balik
UVCVI ZBOH OZFSJ NFOKBVIJ TVBUV PCKFL ZBOH NFOJNCVMLBO
OZFSJUFSTFCVU8BMBVQVOQSJOTJQZBOHEJTFCVUQSJOTJQUBOEB 4FCFMVNOZB UFMBI LJUB UFLBOLBO CFCFSBQB LBMJ CBIXB FLTJUBTJ
MPLBM JOJ EJUFSBQLBO EJ TFUJBQ CBHJBO UVCVI QSJOTJQ UFSTFCVU QBEB TBUV LFMPNQPL PUPU TFSJOH LBMJ CFSIVCVOHBO EFOHBO
UNIT XI
LIVTVT EJQBLBJ QBEB BOHHPUB HFSBL TFCBC CBHJBO JOJ QBMJOH QFOHIBNCBUBO QBEB LFMPNQPL PUPU MBJOOZB 4FCBHBJ DPOUPI
CBOZBLNFOJNCVMLBOSFGMFLTGMFLTPS TFXBLUVSFGMFLTSFHBOHNFSBOHTBOHTVBUVPUPU TFSJOHLBMJTFDB
SB CFSTBNBBO KVHB UJNCVM QFOHIBNCBUBO QBEB PUPU BOUBHPOJT
OZB 'FOPNFOB JOJ EJTFCVU IBNCBUBO UJNCBM CBMJL SFDJQSPDBM
Refleks Ekstensor Silang JOIJCJUJPO
EBO NFLBOJTNF OFVSPO ZBOH NFOJNCVMLBO IVCV
,JSBLJSB TBNQBJ EFUJL TFTVEBI TVBUV SBOHTBOH NFOJN OHBOUJNCBMCBMJLJOJEJTFCVUQFSTBSBGBOUJNCBMCBMJL SFDJQSPDBM
CVMLBO SFGMFLT GMFLTPS QBEB TBMBI TBUV BOHHPUB UVCVI BOHHPUB JOOFSWBUJPO
4FMBJOJUV IVCVOHBOUJNCBMCBMJLJOJTFSJOHUFSKBEJ
UVCVI EJ TJTJ ZBOH CFSMBXBOBO NVMBJ CFSFLTUFOTJ ,FBEBBO JOJ EJBOUBSBPUPUQBEBLFEVBTJTJUVCVI TFQFSUJZBOHEJUVOKVLLBO
EJTFCVU SFGMFLT FLTUFOTPS TJMBOH DSPTTFE FYUFOTPS SFGMFY
&LTUFOTJ PMFI SFGMFLT PUPU GMFLTPS EBO FLTUFOTPS ZBOH UFMBI EJKFMBTLBO
ZBOHUFSKBEJQBEBBOHHPUBUVCVIEJTJTJZBOHCFSMBXBOBOUFSTFCVU UFSMFCJIEBIVMV
(BNCBS NFNQFSMJIBULBO TVBUV DPOUPI QFOHIBNCB
EBQBU NFOEPSPOH TFMVSVI UVCVI NFOKBVIJ PCKFL ZBOH
UBO UJNCBM CBMJL ZBOH LIBT 1BEB LFBEBBO JOJ SFGMFLT GMFLTPS
NFOJNCVMLBOSBOHTBOHOZFSJQBEBBOHHPUBUVCVIZBOHEJUBSJL
NPEFSBU UJOHLBUTFEBOH
UFUBQJMBNBEJUJNCVMLBOEBSJTBUVFLT
USFNJUBT UVCVI TFXBLUV SFGMFLT JOJ NBTJI CFSMBOHTVOH UJNCVM
Mekanisme Neuronal Refleks Ekstensor Silang. SFGMFLT GMFLTPS ZBOH MFCJI LVBU QBEB BOHHPUB UVCVI TJTJ ZBOH
#BHJBO LBOBO (BNCBS NFNQFSMJIBULBO TJSLVJU OFVSPOBM CFSMBXBOBO 3FGMFLT ZBOH MFCJI LVBU UFSTFCVU NFOHJSJN TJOZBM
ZBOH CFSQFSBO VOUVL UFSKBEJOZB SFGMFLT FLTUFOTPS TJMBOH EJ TJOJ QFOHIBNCBUBOUJNCBMCBMJLLFBOHHPUBUVCVIZBOHQFSUBNBEBO
UBNQBL TJOZBM EBSJ TBSBG TFOTPSJL NFOZJMBOH LF CBHJBO TJTJ MBJO NFOFLBOEFSBKBUGMFLTJOZB,FNVEJBO CJMBSFGMFLTGMFLTPSZBOH
EBSJNFEVMBVOUVLNFOHFLTJUBTJPUPUPUPUFLTUFOTPS0MFILBSFOB MFCJILVBUJOJIJMBOH JOUFOTJUBTSFGMFLTZBOHTFNVMBBLBOUJNCVM
CJBTBOZBSFGMFLTFLTUFOTPSTJMBOHUJEBLUJNCVMTBNQBJIJOHHB MBHJ
NJMJEFUJL TFTVEBI POTFU SBOHTBOH BXBM ZBOH NFOJNCVMLBO
OZFSJ NBLBQBTUJTFCBHJBOCFTBSJOUFSOFVSPOZBOHUFSMJCBU ZBOH
Refleks Sikap Tubuh dan Pergerakan
UFSMFUBL EBMBN TJSLVJU BOUBSB OFVSPO TFOTPSJL ZBOH CBSV NBTVL Refleks Sikap Tubuh dan Refleks Pergerakan Medula
EBO OFVSPO NPUPSJL EBSJ TJTJ MBJO NFEVMB CFSUBOHHVOH KBXBC Spinalis
UFSIBEBQ UJNCVMOZB FLTUFOTJ TJMBOH 4FTVEBI SBOHTBOH OZFSJ Reaksi Penyangga Positif (Positive Supportive Reaction).
EJQJOEBILBO UFSOZBUB SFGMFLT FLTUFOTPS TJMBOH CBILBO NBTJI 5FLBOBO ZBOH EJCFSJLBO QBEB UFMBQBL LBLJ IFXBO EFTFSFCSBTJ
NFNQVOZBJ QFSJPEF BGUFSEJTDIBSHF ZBOH MFCJI MBNB EBSJQBEB NFOZFCBCLBO FLTUSFNJUBT NFOKBVILBO EJSJ EBSJ UFLBOBO ZBOH
XBLUV ZBOH EJQFSMVLBO VOUVL SFGMFLT GMFLTPS 4FLBMJ MBHJ EJUFSBQLBO QBEB LBLJ UFSTFCVU 5FOUV TBKB SFGMFLT JOJ CFHJUV
NVOHLJO QFSJPEF BGUFSEJTDIBSHF ZBOH MFCJI MBNB JOJ EJTFCBCLBO LVBU TFIJOHHB KJLB IFXBO ZBOH NFOHBMBNJ USBOTFLTJ QBEB
PMFITJSLVJUSFWFSCFSBTJEJBOUBSBTFMTFMJOUFSOFVSPOBM NFEVMB TQJOBMJT CFCFSBQB CVMBO TFCFMVNOZB ZBJUV TFUFMBI
(BNCBS NFNQFSMJIBULBO SFLBNBO NJPHSBN ZBOH LIBT SFGMFLTSFGMFLTOZBTVEBINFOKBEJCFSMFCJIBOEJCFSEJSJLBOQBEB
EBSJ TFCVBI PUPU ZBOH NFOHBMBNJ SFGMFLT FLTUFOTPS TJMBOH %BMBN LFEVB LBLJOZB SFGMFLT UFSTFCVU TFSJOH LBMJ NFOHFSBTLBO
HBNCBS UBNQBL NBTB MBUFO ZBOH SFMBUJG MBNB TFCFMVN SFGMFLT NFNCVBULBLV
FLTUSFNJUBTTFIJOHHBNBNQVNFOZBOHHBCF
EJNVMBJ KVHBBEBOZBXBLUVBGUFSEJTDIBSHFZBOHCFSMBOHTVOHMBNB SBUCBEBO3FGMFLTJOJEJTFCVUTFCBHBJSFBLTJQFOZBOHHBQPTJUJG
QBEBTBBUSBOHTBOHCFSBLIJS"GUFSEJTDIBSHFZBOHCFSMBOHTVOHMBNB 3FBLTJ QFOZBOHHB QPTJUJG NFMJCBULBO TJSLVJU ZBOH LPNQMFLT
JOJCFSNBOGBBUVOUVLNFOBIBOUVCVIZBOHUFSBTBOZFSJNFOKBVIJ EJ EBMBN JOUFSOFVSPO TFQFSUJ IBMOZB TJSLVJU ZBOH CFSUBOHHVOH
PCKFLZBOHNFOJNCVMLBOOZFSJTBNQBJSFBLTJTBSBGMBJONFOZFCBC KBXBCEBMBNSFGMFLTGMFLTPSEBOSFGMFLTFLTUFOTPSTJMBOH-PLBTJ
LBOTFMVSVIUVCVINFOKBVIEBSJSBOHTBOHUBEJ UFMBQBL LBLJ ZBOH EJCFSJ UFLBOBO UBEJ NFOFOUVLBO LF BSBI
NBOB BOHHPUB UVCVI BLBO CFSHFSBL UFLBOBO ZBOH EJCFSJLBO
QBEBTBMBITBUVTJTJBLBONFOZFCBCLBOFLTUFOTJBOHHPUBUVCVI
LFBSBIUFLBOBOUBEJ FGFLJOJEJTFCVUSFBLTJNBHOFU3FBLTJJOJ
EBQBUNFNCBOUVIFXBOBHBSUJEBLKBUVILFTJTJJUV
0 1 2 3
0 1 2 3 4
54-12
54-11
663
Refleks Medula Spinalis untuk "Menegakkan Langkah Diagonal Keempat Anggota Tubuh—Refleks
Tubuh". "Berjalan di Tempat". #JMB IFXBO TQJOBM ZBOH UFMBI TFIBU
#JMB EJMFUBLLBO QBEB TBMBI TBUV TJTJ UVCVIOZB TFFLPS IFXBO ZBOHNFOHBMBNJUSBOTFLTJTQJOBMQBEBEBFSBIMFIFSEJBUBTEBF
BLBONFMBLVLBOHFSBLBOHFSBLBOUBLUFSLPPSEJOBTJ CFSVTBIB SBI BOHHPUB UVCVI EFQBO QBEB NFEVMB TQJOBMJT
EJBOHLBU EBSJ
VOUVL NFOFHBLLBO UVCVIOZB LF QPTJTJ CFSEJSJ 1FSJTUJXB JOJ MBOUBJEBOLBLJLBLJOZBEJCJBSLBOCFSHBOUVOH BEBLBMBOZBSFHB
EJTFCVUSFGMFLTNFOFHBLLBOUVCVIEBSJNFEVMB3FGMFLTTFNB OHBOQBEBBOHHPUBUVCVINFOJNCVMLBOSFGMFLTNFMBOHLBIZBOH
DBNJOJNFOHHBNCBSLBO CBIXBTFDBSBSFMBUJGCFCFSBQBSFGMFLT NFMJCBULBOLFFNQBUBOHHPUBUVCVI1BEBVNVNOZB UJNCVMHF
LPNQMFLTZBOHCFSIVCVOHBOEFOHBOTJLBQUVCVIEJJOUFHSBTJ SBLBO NFMBOHLBI EJBHPOBM BOUBSB BOHHPUB UVCVI EFQBO EBO
LBO EBMBN NFEVMB TQJOBMJT 5FOUV TBKB TFFLPS IFXBO ZBOH CFMBLBOH3FTQPOTEJBHPOBMJOJNFSVQBLBONBOJGFTUBTJQFSTBSB
TVEBI TFNCVI EBSJ UJOEBLBO USBOTFLTJ CBHJBO UPSBLBM NFEVMB GBOUJNCBMCBMJLZBOHEBMBNIBMJOJCFSMBOHTVOHOBJLEBOUVSVO
TQJOBMJTEJBOUBSBQFSTBSBGBOVOUVLBOHHPUBUVCVIEFQBOEBO TFQBOKBOH KBSBL QFSTBSBGBO NFEVMB TQJOBMJT VOUVL LBLJ EFQBO
BOHHPUB UVCVI CFMBLBOH EBQBU NFOFHBLLBO UVCVIOZB TFDBSB EBOCFMBLBOH1PMBCFSKBMBOTFQFSUJJOJEJTFCVUSFGMFLTCFSKBMBOEJ
TFNQVSOB EBSJ QPTJTJ CFSCBSJOH CBILBO CFSKBMBO EFOHBO UFNQBU
BOHHPUB UVCVI CFMBLBOHOZB VOUVL NFNCBOUV BOHHPUB UVCVI Refleks Derap (Galloping Reflex). 5JQFSFGMFLTMBJOZBOH
EFQBOOZB1BEBLBTVTTFFLPSPQPTTVNZBOHNFOHBMBNJUJOEB LBEBOH UJNCVM QBEB IFXBO TQJOBM BEBMBI SFGMFLT EFSBQ LFUJLB
LBO USBOTFLTJ QBEB NFEVMB CBHJBO UPSBLBM UFSOZBUB HFSBLBO LFEVBUVOHLBJEFQBOCFSHFSBLLFCFMBLBOHTFDBSBTFSFOUBLTBBU
KBMBOZBOHEJMBLVLBOPMFIBOHHPUBUVCVICFMBLBOHOZBIBNQJS LFEVBUVOHLBJCFMBLBOHCFSHFSBLNBKV1FSJTUJXBJOJTFSJOHLBMJ
UBL CFSCFEB EFOHBO HFSBLBO ZBOH EJMBLVLBO PMFI PQPTTVN UFSKBEJ CJMB QBEB TBBU ZBOH TBNB EJCFSJLBO SBOHTBOH SFHBOHBO
OPSNBM LFDVBMJ CBIXB HFSBLBO CFSKBMBO BOHHPUB UVCVI CFMB BUBVUFLBOBOZBOHTBNBCFTBSOZBQBEBLFEVBUVOHLBJQBEBLF
LBOHOZBUJEBLTJOLSPOEFOHBOHFSBLBOBOHHPUBUVCVIEFQBO EVB TJTJ UVCVI SBOHTBOH ZBOH UJEBL TBNB CFTBSOZB BLBO NF
Gerakan Melangkah dan Berjalan OJNCVMLBOSFGMFLTNFMBOHLBIEJBHPOBM)BMJOJEJQFSMVLBOVO
Gerakan Melangkah Berirama Satu Ekstremitas. UVL NFNQFSUBIBOLBO QPMB KBMBO EBO QPMB EFSBQ ZBOH OPSNBM
(FSBLBONFMBOHLBICFSJSBNBTFSJOHLBMJEBQBULJUBPCTFSWBTJ
TFCBCTBBUCFSKBMBO IBOZBTBUVUVOHLBJEFQBOEBOTBUVUVOHLBJ
QBEBFLTUSFNJUBTIFXBOTQJOBM.FNBOH CBILBOCJMBCBHJBO
CFMBLBOH ZBOH UFSBOHTBOH QBEB XBLUV CFSTBNBBO ZBOH EBQBU
MVNCBM NFEVMB TQJOBMJT EJQJTBILBO EBSJ CBHJBOCBHJBO MBJO
NFOZFCBCLBO IFXBO UFSTFCVU CFSKBMBO UFSVT 4FCBMJLOZB CJMB
NFEVMB TQJOBMJT EBO TFMBOKVUOZB EJCVBU JSJTBO MPOHJUVEJOBM
LFUJLB CFSEFSBQ IFXBO UBEJ NFOZFOUBLLBO LBLJOZB LF UBOBI
NVMBJEBSJCBHJBOUFOHBINFEVMBLFBSBICBXBIVOUVLNFN
LFEVB UVOHLBJ EFQBO NBVQVO LFEVB UVOHLBJ CFMBLBOH UFSBOH
CMPL IVCVOHBO OFVSPOBM BOUBSB LFEVB TJTJ NFEVMB TQJOBMJT
TBOH TFDBSB TFJNCBOH LFBEBBO JOJ BLBO NFOJNCVMLBO LFDFO
EBOBOUBSBLFEVBBOHHPUBUVCVI TFUJBQFLTUSFNJUBTCFMBLBOH
EFSVOHBO IFXBO UFSTFCVU VOUVL NFMBLVLBO EFSBQBO TFMBOKVU
NBTJI UFUBQ EBQBU NFMBLVLBO HFSBLBO NFMBOHLBI (FSBLBO
OZBTFIJOHHBQPMBHFSBLBOJOJCFSMBOKVUMBHJion.
GMFLTJLFEFQBOEBSJFLTUSFNJUBTUFSTFCVUBLBOEJJLVUJEFOHBO
HFSBLBO FLTUFOTJ LF CFMBLBOH EBMBN XBLUV TBUV EFUJL BUBV Refleks Menggaruk (Scratch Reflex)
MFCJI 4FMBOKVUOZB UFSKBEJ HFSBLBO GMFLTJ MBHJ EBO TJLMVT JOJ
BLBOCFSVMBOHUFSVTNFOFSVT 3FGMFLT NFEVMB TQJOBMJT ZBOH QFOUJOH EBO LIVTVT QBEB CFCFSBQB IFXBO
(FSBLBOPTJMBTJNBKVNVOEVSZBOHUJNCVMBOUBSBPUPUPUPU BEBMBI SFGMFLT NFOHHBSVL 3FGMFLT JOJ EJQJDV PMFI TFOTBTJ HBUBM BUBVHFMJ
GMFLTPSEBOFLTUFOTPSEBQBUUFSKBEJCBILBOTFTVEBITBSBGTFO 3FGMFLT JOJ NFMJCBULBO EVB NBDBN GVOHTJ
TFOTBTJ QPTJTJ ZBOH BLBO
TPSJLOZB EJQPUPOH EBO UBNQBLOZB IBM JOJ UFSVUBNB EJTFCBC NFNVEBILBO DBLBSOZB VOUVL NFOFNVLBO MPLBTJ JSJUBTJ ZBOH UFQBU EJ
LBOPMFIBEBOZBTJSLVJUQFOHIBNCBUBOUJNCBMCBMJLZBOHCFS QFSNVLBBO UVCVI EBO
HFSBLBO NFOHHBSVL LJBO LFNBSJ UPBOEGSP
TDSBUDIJOHNPWFNFOU

TJGBUNVUVBMEJEBMBNNBUSJLTNFEVMBTQJOBMJTJUVTFOEJSJ ZBOH 4FOTBTJQPTJTJQBEBSFGMFLTNFOHHBSVLNFSVQBLBOGVOHTJZBOHTBOHBU
CFSPTJMBTJEJBOUBSBOFVSPOOFVSPOZBOHNFOHFOEBMJLBOPUPU CFSLFNCBOH #JMB BEB LVUV ZBOH TFEBOH NFSBOHLBL LF EFQBO NFOVKV
PUPUBHPOJTEBOBOUBHPOJT QVOEBL TFFLPS IFXBO TQJOBM DBLBS LBLJ CFMBLBOH IFXBO TQJOBM UFUBQ
4JOZBMTFOTPSJLZBOHCFSBTBMEBSJUFMBQBLLBLJEBOTFOTPS EBQBU NFOFNVLBO UFNQBU LVUV JUV NFTLJQVO NBDBN PUPU LBLJ
QPTJTJ ZBOH UFSMFUBL EJ TFLFMJMJOH TFOEJ TBOHBU CFSQFSBO EB UFSTFCVU IBSVT CFSLPOUSBLTJ TFDBSB CFSTBNBBO EBMBN QPMB ZBOH UFQBU
MBN QFOHBUVSBO UFLBOBO LBLJ EBO GSFLVFOTJ TBBU LBLJ CFS VOUVL NFOHBSBILBO DBLBSOZB LF UFNQBU LVUV UFSTFCVU NFSBOHLBL
KBMBONFMFXBUJTVBUVQFSNVLBBO5FSOZBUB NFLBOJTNFNF 6OUVLNFNCFOUVLSFGMFLTZBOHMFCJISVNJUMBHJ LFUJLBLVUVJUVCFSHFSBL
EVMBTQJOBMJTZBOHEJQBLBJVOUVLNFOHBUVSHFSBLBONFMBOH NFOZJMBOH HBSJT UFOHBI UVCVI NBLB LBLJ IFXBO UBEJ BLBO CFSIFOUJ
LBI JOJ TBOHBU LPNQMFLT $POUPIOZB CJMB VKVOH LBLJ UFS NFOHHBSVL EBO LBLJ TJTJ MBJOOZB NVMBJ CFSHFSBL LJBO LFNBSJ EBO
TBOEVOHTFMBNBNFMBLVLBOHFSBLBONBKV VOUVLTFNFOUBSB BLIJSOZBEBQBUNFOFNVLBOLVUVJUV
(FSBLBONFOHHBSVLLJBOLFNBSJ TFQFSUJHFSBLBONFMBOHLBIVOUVL
HFSBLBONBKVUFSIFOUJLFNVEJBO EBMBNVSVUBOZBOHDFQBU
CFSHFSBL NFMJCBULBOTJSLVJUQFSTBSBGBOUJNCBMCBMJLZBOHNFOZFCBCLBO
LBLJ BLBO UFSBOHLBU MFCJI UJOHHJ EBO LBLJ BLBO UFSVT NBKV
PTJMBTJ
BHBS EBQBU EJUFNQBULBO EJ EFQBO IBNCBUBO *OJ BEBMBI SFG
MFLTTBOEVOH+BEJ NFEVMBTQJOBMJTNFSVQBLBOQFOHBUVSHF Refleks-Refteks Medula Spinalis yang Menimbulkan
SBLBONFMBOHLBIZBOHDFSEBT Spasme Otot
Gerakan Melangkah Timbal Balik pada Ekstremitas 1BEBNBOVTJB TFSJOHLBMJEBQBULJUBMJIBUBEBOZBTQBTNFMPLBMQBEB
yang Berlawanan. #JMBNFEVMBTQJOBMJTCBHJBOMVNCBMUJEBL PUPU1BEBCBOZBLQFSJTUJXB OZFSJZBOHCFSTJGBUMPLBMNFSVQBLBOQF
EJQJTBILBOEBSJQVTBUOZB TFUJBQBEBHFSBLBONFMBOHLBINBKV OZFCBCTQBTNFMPLBM
TBUV FLTUSFNJUBT CJBTBOZB FLTUSFNJUBT TJTJ MBJO BLBO CFSHFSBL Spasme Otot Akibat Patah Tulang. 4BUVKFOJTTQBTNFZBOHQFOUJOH
LF CFMBLBOH &GFL JOJ EJTFCBCLBO PMFI BEBOZB QFSTBSBGBO TFDBSB LMJOJT UFSKBEJ QBEB PUPU ZBOH NFOHFMJMJOHJ UVMBOH ZBOH QBUBI
UJNCBMCBMJLEJBOUBSBLFEVBFLTUSFNJUBT 4QBTNFUFSTFCVUEJTFCBCLBOPMFIJNQVMTOZFSJZBOHEJNVMBJEBSJUFQJ
664
QBUBIBOUVMBOH EBONFOZFCBCLBOPUPUPUPUTFLFMJMJOHOZBCFSLPOUSBLTJ 0MFI LBSFOB SFGMFLT NBTTB IBOZB CFSMBOHTVOH CFCFSBQB NFOJU
TFDBSB UPOJL 1FOHIJMBOHBO OZFSJ EFOHBO TVOUJLBO BOFTUFTJ MPLBM QBEB EJEVHBNVOHLJOEJTFCBCLBOPMFIQFOHBLUJGBOTFKVNMBITJSLVJUCFS
VKVOH UVMBOH ZBOH QBUBI NFOHVSBOHJ TQBTNF PCBU BOFTUFTJ VNVN HBVOH SFWFSCFSBUPSZ
ZBOHCFTBSZBOHOBOUJOZBTFDBSBTFSFOUBLEB
VOUVL TFMVSVI UVCVI TFQFSUJ BOFTUFTJ FUFS KVHB EBQBU EJQBLBJ VOUVL QBUNFSBOHTBOHTFCBHJBOCFTBSEBFSBINFEVMB)BMJOJNJSJQEFOHBO
NFOHVSBOHJTQBTNF4BMBITBUVEBSJLFEVBUJOEBLBOBOFTUFTJJOJTFSJOH NFLBOJTNFLFKBOHFQJMFQUJL ZBOHKVHBNFMJCBULBOTJSLVJUCFSHBVOH
UNIT XI
LBMJ EJQFSMVLBO TFCFMVN LFBEBBO TQBTNF EBQBU EJBUBTJ TFQFOVIOZB UFUBQJUFSKBEJEBMBNPUBLEBOCVLBOOZBEJNFEVMBTQJOBMJT
EBMBNSBOHLBNFOHFNCBMJLBOLFEVBVKVOHUVMBOHZBOHQBUBILFQPTJTJ
OZBZBOHUFQBU
Spasme Otot Abdomen pada Peritonitis. "EB UJQF TQBTNF MPLBM Transeksi Medula Spinalis dan Syok Spinal
MBJOOZB ZBOH EJTFCBCLBO PMFI SFGMFLT NFEVMB TQJOBMJT ZBLOJ TQBTNF #JMB NFEVMB TQJOBMJT TFDBSB NFOEBEBL EJUSBOTFLTJ QBEB MFIFS
BCEPNFOBLJCBUJSJUBTJQFSJUPOFVNQBSJFUBMJTQBEBQFSJUPOJUJT4FLBMJ CBHJBOBUBT QBEBBXBMOZB TFTVOHHVIOZBTFMVSVIGVOHTJNFEVMB
MBHJEJTJOJ UJOEBLBOVOUVLNFOHVSBOHJSBTBOZFSJBLJCBUQFSJUPOJUJT TQJOBMJT UFSNBTVL SFGMFLTSFGMFLT NFEVMB TQJOBMJT BLBO TFHFSB
EBQBU NFOZFCBCLBO SFMBLTBTJ PUPU ZBOH TQBTNF 1BEB UJOEBLBO UFSUFLBO TBNQBJ UJUJL CFUVMCFUVM IJMBOH SFBLTJ JOJ EJTFCVU TZPL
PQFSBTJ EBQBU UFSKBEJ TQBTNF PUPU ZBOH TFSVQB TFCBHBJ DPOUPI TQJOBM"MBTBOVOUVLLFBEBBOJOJBEBMBICBIXBBLUJWJUBTOPSNBM
TFMBNB PQFSBTJ BCEPNFO JNQVMT OZFSJ EBSJ QFSJUPOFVN QBSJFUBMJT OFVSPOOFVSPO NFEVMB TBOHBU CFSHBOUVOH QBEB FLTJUBTJ UPOJL
TFSJOH LBMJ EBQBU NFOZFCBCLBO PUPUPUPU BCEPNFO CFSLPOUSBLTJ ZBOH UFSVTNFOFSVT PMFI JNQVMT ZBOH LFMVBS EBSJ TFSBUTFSBU
EFOHBOIFCBU LBEBOHEBQBUNFOPOKPMLBOVTVTLFMVBSNFMFXBUJMVLB TBSBGZBOHNFNBTVLJNFEVMBEBSJQVTBUQVTBUZBOHMFCJIUJOHHJ
PQFSBTJ %FOHBO BMBTBO JOJ QBEB PQFSBTJ JOUSBBCEPNFO CJBTBOZB UFSVUBNBJNQVMTZBOHEJLJSJNLBONFMBMVJUSBLUVTSFUJLVMPTQJOBM
EJQFSMVLBOQFNCFSJBOBOFTUFTJZBOHEBMBN USBLUVTWFTUJCVMPTQJOBM EBOUSBLUVTLPSUJLPTQJOBMJT
Kram Otot. .BTJI BEB KFOJT TQBTNF MPLBM MBJO ZBLOJ LSBN PUPU
4FTVEBI CFCFSBQB KBN TBNQBJ CFCFSBQB NJOHHV FLTJUBCJMJUBT
.FMBMVJQFOFMJUJBOFMFLUSPNJPHSBGJLEBQBUEJKFMBTLBOTFEJLJUOZBCFCFSBQB
OFVSPOOFVSPO TQJOBM UBEJ TFDBSB CFSUBIBQ BLBO QVMJI ,FBEBBO
QFOZFCBC ZBOH NFOJNCVMLBO LSBN PUPU BEBMBI TFCBHBJ CFSJLVU 4FUJBQ
JOJUBNQBLOZBNFSVQBLBOTJGBUBMBNJOFVSPOEBMBNTFMVSVITJT
GBLUPS MPLBM ZBOH NFOZFCBCLBO JSJUBTJ BUBV LFBEBBO NFUBCPMJTNF
UFN TBSBG ZBLOJ TFTVEBI OFVSPO JOJ UFSMFQBT EBSJ QFOHBSVI
BCOPSNBMQBEBPUPU TFQFSUJTBOHBULFEJOHJOBO LVSBOHOZBBMJSBOEBSBI
TVNCFS JNQVMT GBTJMJUBUPSJL TJGBU FLTJUBCJMJUBT EFOHBO TFOEJSJOZB
BUBV MBUJIBO ZBOH CFSMFCJIBO EBQBU NFOJNCVMLBO OZFSJ BUBV TJOZBM
BLBO NFOJOHLBU LFNCBMJ TFUJEBLOZB NFOHHBOUJ TFCBHJBO LFIJMB
TFOTPSJL MBJOOZB ZBOH BLBO EJIBOUBSLBO EBSJ PUPU LF NFEVMB TQJOBMJT
OHBOZBOHUFSKBEJ1BEBLFCBOZBLBOIFXBOOPOQSJNBUB FLTJUBCJ
ZBOH TFMBOKVUOZB NFOJNCVMLBO SFGMFLT VNQBO CBMJL LPOUSBLTJ PUPU
MJUBT QVTBUQVTBU EJ NFEVMB EBMBN XBLUV CFCFSBQB KBN TBNQBJ
,POUSBLTJ JOJ EJQFSDBZB NFSBOHTBOH SFTFQUPS TFOTPSJL ZBOH TBNB MFCJI
TFIBSJ BUBV MFCJI BLBO LFNCBMJ OPSNBM OBNVO QBEB NBOVTJB
IFCBU MBHJ EBO NFOZFCBCLBO NFEVMB TQJOBMJT NFOJOHLBULBO JOUFOTJUBT
QSPTFT LFNCBMJ JOJ TFSJOH LBMJ UFSMBNCBU TBNQBJ CFCFSBQB NJOH
LPOUSBLTJOZB +BEJ UJNCVM TVBUV NFLBOJTNF VNQBO CBMJL QPTJUJG
HVEBOBEBLBMBOZBUJEBLQFSOBIMFOHLBQTFCBMJLOZB LBEBOHQF
TFIJOHHB TFEJMEU TBKB JSJUBTJ TVEBI EBQBU NFOJNCVMLBO LPOUSBLTJ ZBOH
OZFNCVIBO UFSTFCVU TBOHBU CFSMFCJIBO TFIJOHHB TFNVB BUBV
UFSVTNFOFSVTTBNQBJBLIJSOZBUJNCVMLSBNPUPUZBOHNFOZFMVSVI
IBNQJSTFNVBGVOHTJNFEVMBTQJOBMJTBLIJSOZBNFOKBEJIJQFSFL
TJUBCJMJUBT
Refleks-Refleks Otonom pada Medula Spinalis 4FMBNBBUBVTFTVEBIUFSKBEJTZPLTQJOBM BEBCFCFSBQBGVOHTJ
TQJOBMZBOHEBQBUUFSQFOHBSVI ZBJUVTFCBHBJCFSJLVU
%BMBN NFEVMB TQJOBMJT UFSJOUFHSBTJ CBOZBL NBDBN SFGMFLT PUPOPN 1. 1BEBPOTFUUFSKBEJOZBTZPLTQJOBM UFLBOBOEBSBIBSUFSJNFOV
TFHNFOUBM ZBOH TFCBHJBO CFTBS UFMBI EJCJDBSBLBO EBMBN CBC MBJO SVOTFDBSBDFQBUEBOESBTUJTLBEBOHLBMBTBNQBJNN)HKBEJ
4JOHLBUOZB SFGMFLTSFGMFLTJOJNFMJQVUJ
QFSVCBIBOUPOVTQFNCVMVI LFBEBBO JOJ NFOHHBNCBSLBO CBIXB BLUJWJUBT TJTUFN TBSBG
EBSBI WBTDVMBSUPOF
BLJCBUQFSVCBIBOTVIVLVMJUTFUFNQBU MJIBU#BC TJNQBUJTNFOKBEJUFSIBNCBUTBNQBJIBNQJSIJMBOHTBNBTFLBMJ

CFSLFSJOHBU ZBOH EJTFCBCLBO PMFI QBOBT ZBOH UFSMPLBMJTBTJ #JBTBOZBEBMBNXBLUVCFCFSBQBIBSJLFNVEJBOUFLBOBOEBSBI
QBEB QFSNVLBBO UVCVI MJIBU #BC

SFGMFLT JOUFTUJOPJOUFTUJOBM
JOJLFNCBMJOPSNBM CBILBOEFNJLJBOQBEBNBOVTJB
ZBOH NFOHBUVS CFCFSBQB GVOHTJ NPUPSJL VTVT MJIBU #BC

2. 1BEB TBBU NVMBJ UFSKBEJOZB TZPL TFNVB SFGMFLT PUPU SBOHLB
SFGMFLT QFSJUPOFPJOUFTUJOBM ZBOH NFOHIBNCBU NPUJMJUBT HBTUSPJOUFT
ZBOH EJJOUFHSBTJLBO EBMBN NFEVMB TQJOBMJT NFOKBEJ
UJOBM TFCBHBJ SFTQPOT UFSIBEBQ JSJUBTJ QFSJUPOFVN MJIBU #BC
EBO
UFSIBNCBU)FXBOZBOHMFCJISFOEBINFNCVUVILBOXBLUVCF

SFGMFLT FWBLVBTJ VOUVL NFOHPTPOHLBO LBOEVOH LFNJI MJIBU #BC
CFSBQB KBN TBNQBJ CFCFSBQB IBSJ VOUVL NFNVMJILBO LFNCBMJ

EBO LPMPO MJIBU #BC
4FMBJO JUV TFNVB SFGMFLT TFHNFOUBM JOJ
SFGMFLTSFGMFLT JOJ NFOKBEJ OPSNBM QBEB NBOVTJB CJBTBOZB
QBEB TVBUV TBBU EBQBU EJ UJNCVMLBO TFDBSB CFSTBNBBO ZBLOJ EBMBN
EJCVUVILBOXBLUVNJOHHVTBNQBJCFCFSBQBCVMBO#BJLQBEB
CFOUVLSFGMFLTNBTTB BLBOEJKFMBTLBOLFNVEJBO
IFXBO NBVQVO NBOVTJB BEB CFCFSBQB SFGMFLT ZBOH BLIJSOZB
EBQBU NFNQVOZBJ FLTJUBCJMJUBT CFSMFCJIBO IJQFSFLTJUBCJMJUBT

Refleks Massa. 1BEB IFXBO TQJOBM BUBV NBOVTJB UFSJTUJNFXBTFLBMJCJMBCFCFSBQBKBSBTGBTJMJUBUPSJLZBOHUFSMFUBL
LBEBOHLBMB NFEVMB TQJOBMJT NFOEBEBL NFOKBEJ TBOHBU BLUJG BOUBSB PUBL EBO NFEVMB TQJOBMJT UFUBQ VUVI TFEBOHLBO TJTB
TFIJOHHB NFOZFCBCLBO QFOHFMVBSBO SBOHTBOH TFDBSB NBTJG QBEB NFEVMB TQJOBMJTOZB TVEBI EJUSBOTFLTJ 3FGMFLT ZBOH QFSUBNB
TFCBHJBO CFTBS NFEVMB TQJOBMJT 6NVNOZB SBOHTBOH ZBOH UBNBQVMJIBEBMBISFGMFLTSFHBOH TUSFUDISFGMFY
LFNVEJBOEJJ
NFOZFCBCLBO LFBEBBO JOJ BEBMBI SBOHTBOH SBTB OZFSJ ZBOH LVBU LVUJ TFDBSB QSPHSFTJG PMFI SFGMFLTSFGMFLT ZBOH MFCJI LPNQMFLT
QBEB LVMJU BUBV SBTB QFOVI CFSMFCJIBO QBEB WJTFSB NJTBMOZB SFGMFLT GMFLTPS SFGMFLT BOUJHSBWJUBTJ ZBOH CFSQFSBO QBEB TJLBQ
LBOEVOH LFNJI BUBV VTVT ZBOH NFOHFNCBOH TFDBSB CFSMFCJIBO UVCVI QPTUVSBM BOUJHSBWJUZ SFGMFYFT
EBO TJTBTJTB SFGMFLT NF
5BOQB NFNQFSIBUJLBO KFOJT SBOHTBOH SFGMFLT ZBOH UJNCVM JOJ MBOHLBI
EJTFCVUSFGMFLTNBTTB ZBOHNFMJCBULBOTFCBHJBOCFTBSBUBVCBILBO 3. 1BEBNBOVTJB TFMBNBNJOHHVNJOHHVQFSUBNBTFTVEBIUSBO
TFMVSVI NFEVMB TQJOBMJT &GFLFGFLOZB BEBMBI
CBHJBO VUBNB TFLTJ NFEVMB TQJOBMJT SFGMFLT TBLSBM VOUVL QFOHBUVSBO QFOHP
PUPU SBOHLB UVCVI NFOHBMBNJ TQBTNF GMFLTPS ZBOH IFCBU
TPOHBO LBOEVOH LFNJI EBO LPMPO NFOKBEJ UFSUFLBO OBNVO
LPMPO EBO LBOEVOH LFNJI NFOHPTPOHLBO EJSJ
TFSJOH LBMJ QBEBLFCBOZBLBOLBTVTBLIJSZBBLBOLFNCBMJOPSNBM&GFLJOJ
UFLBOBO BSUFSJ NFOJOHLBU TBNQBJ LF OJMBJ NBLTJNBM LBEBOHLBMB UFMBIEJCJDBSBLBOEBMBN#BCEBO
UFLBOBO TJTUPMJLOZB NFMFCJIJ NN )H EBO
TFCBHJBO CFTBS
EBFSBIUVCVICFSLFSJOHBUTFDBSBCFSMFCJIBO
665
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666
BAB 55
UNIT XI
1FOHBUVSBO'VOHTJ.PUPSJL
PMFI,PSUFLTEBO#BUBOH0UBL
,FCBOZBLBOHFSBLBOWPMVOUFSZBOH
EJBXBMJ PMFI LPSUFLT TFSFCSJ EJDBQBJ
LFUJLB LPSUFLT NFOHBLUJGLBO QPMB
GVOHTJ ZBOH UFSTJNQBO QBEB BSFB
PUBLZBOHMFCJISFOEBINFEVMB
TQJOBMJT CBUBOHPUBL HBOHMJBCBTBMJT EBOTFSFCFMVN1VTBUQVTBU

ZBOHMFCJISFOEBIJOJ LFNVEJBO NFOHJSJNLBOCBOZBLTJOZBM
4 7
QFOHBLUJWBTJTQFTJGJLLFPUPU
/BNVO VOUVL CFCFSBQB UJQF HFSBLBO UFSUFOUV LPSUFLT 5
6
NFNJMJLJKBSBTMBOHTVOHLFOFVSPONPUPSJLBOUFSJPSQBEBNFEVMB
1
3, 2,
TQJOBMJT CFCFSBQB QVTBU NPUPSJL IBOZB EJMFXBUJ EBMBN
QFSKBMBOBOOZB )BM JUV UFSVUBNB CFSMBLV VOUVL QFOHBUVSBO
HFSBLBOUBOHLBTZBOHIBMVTEBSJKBSJKBSJEBOUBOHBO#BCJOJEBO
CBC NFNCBIBT NFOHFOBJ BEBOZB TJGBU TBMJOH NFNFOHBSVIJ EJ
BOUBSBCFSCBHBJBSFBNPUPSJLQBEBPUBLEBONFEVMBTQJOBMJTVOUVL
NFOHIBTJMLBOTJOUFTJTLFTFMVSVIBOGVOHTJNPUPSJLWPMVOUFS Premotor
area
Korteks Motorik dan Traktus Kortikospinalis

(BNCBSNFNQFSMJIBULBOBSFBGVOHTJPOBMLPSUFLTTFSFCSJ%J
TFCFMBIBOUFSJPSTVMLVTTFOUSBMJTLPSUFLT NFOFNQBUJLVSBOHMFCJI
TFQFSUJHB CBHJBO QPTUFSJPS MPCVT GSPOUBMJT UFSEBQBU LPSUFLT
NPUPSJL %J TFCFMBI QPTUFSJPS TVMLVT TFOUSBMJT UFSEBQBU LPSUFLT (BNCBS NFODBOUVNLBO HBNCBSBO ZBOH NFOEFLBUJ
TPNBUPTFOTPSJL TVBUV BSFB ZBOH UFMBI EJCBIBT TFDBSB EFUBJM QBEB TFDBSB UPQPHSBGJT EBSJ CFSCBHBJ BSFB PUPU UVCVI QBEB LPSUFLT
CBCCBC TFCFMVNOZB
ZBOH NFOHJSJN CBOZBL TJOZBM LF LPSUFLT NPUPSJMLQSJNFS EJNVMBJEBSJEBFSBIXBKBIEBONVMVU EJEFLBU
NPUPSJLZBOHNFOHBXBMJBLUJWJUBTNPUPSJL GJTVSB TZMWJJ BSFB MFOHBO EBO UBOHBO EJ CBHJBO UFOHBI LPSUFLT
,PSUFLTNPUPSJLTFOEJSJUFSCBHJNFOKBEJUJHBTVCBSFB NBTJOH NPUPSJL QSJNFS CBUBOH UVCVI EJ EFLBU BQFLT PUBL EBO BSFB
NBTJOH NFNJMJLJ QFSXBLJMBO UPQPHSBGJTOZB TFOEJSJ QBEB UVOHLBJEBOLBLJ EJCBHJBOLPSUFLTNPUPSJLQSJNFSZBOHNBTVL
LFMPNQPLLFMPNQPLPUPUEBOGVOHTJNPUPSJLTQFTJGJL
LPSUFLT LF EBMBN GJTVSB MPOHJUVEJOBMJT 4VTVOBO UPQPHSBGJT JOJ
NPUPSJL QSJNFS
BSFB QSFNPUPSJL EBO
BSFB NPUPSJL EJQFSMJIBULBO TFDBSB MFCJI HSBGJT QBEB (BNCBS ZBOH
TVQMFNFOUFS QFMFOHLBQ
NFOVOKVLLBO EFSBKBU QFSXBLJMBO EBSJ CFSCBHBJ BSFB PUPU ZBOH
EJQFUBLBO PMFI 1FOGJFME EBO 3BTNVTTFO 1FNFUBBO JOJ
Korteks Motorik Primer EJMBLVLBO EFOHBO DBSB QFSBOHTBOHBO MJTUSJL EJ CFSCBHBJ BSFB
5BNQBLQBEB(BNCBS LPSUFLTNPUPSJLQSJNFSUFSMFUBLQBEB LPSUFLTNPUPSJLQBEBNBOVTJBZBOHTFEBOHNFOHBMBNJPQFSBTJ
MJQBUBO QFSUBNB CBHJBO GSPOUBM MPCVT BOUFSJPS TBNQBJ LF TVMLVT QFNCFEBIBOTBSBG1FSIBUJLBOCBIXBMFCJIEBSJTFQBSVILPSUFLT
TFOUSBMJT %BFSBI JOJ CFSNVMB EBSJ CBHJBO MBUFSBM GJTVSB TZMWJJ NPUPSJL QSJNFS EJLBJULBO EFOHBO QFOHFOEBMJBO PUPUPUPU
NFOZFCBS LF BSBI TVQFSJPS NFOVKV CBHJBO QBMJOH BUBT PUBL UBOHBO EBO PUPUPUPU CJDBSB 4UJNVMBTJ UJUJL QBEB CFSCBHBJ BSFB
LFNVEJBO NBTVL LF EBMBN LF GJTVSB MPOHJUVEJOBMJT "SFB JOJ NPUPSJL UBOHBO EBO BSFB NPUPSJL CJDBSB JOJ TBOHBU KBSBOH
BEBMBIBSFBZBOHTBNBEFOHBOBSFBEBMBNLMBTJGJLBTJ#SPENBOO NFOZFCBCLBOLPOUSBLTJPUPUUVOHHBMZBOHQBMJOHTFSJOH KVTUSV
QBEBBSFBLPSUJLBMPUBL UBNQBLQBEB(BNCBS
TUJNVMBTJNFOZFCBCLBOTFLFMPNQPLPUPUEBQBUCFSLPOUSBLTJ
667
Unit Xl Sistem Saraf C. Neurofislologi.s Motorik dan Integratif
Area Premotorik TQFTJGJL BUBV LFUJLB JB NFOHPCTFSWBTJ LFSKB ZBOH TBNB ZBOH
"SFB QSFNPUPSJL KVHB EJQFSMJIBULBO QBEB (BNCBS EJMBLVLBO PMFI PSBOH MBJO +BEJ BLUJWJUBT OFVSPOOFVSPO UFSTFCVU
UFSMFUBL TBNQBJ DN EJ BOUFSJPS LPSUFLT NPUPSJL QSJNFS NFODFSNJOLBO QFSJMBLV PSBOH MBJO TFPMBIPMBI TJ QFOHBNBU
NFMVBT LF BSBI JOGFSJPS NFOVKV GJTVSB TZMWJJ EBO LF BSBI TFEBOHNFMBLVLBOLFSKBNPUPSJLTQFTJGJLUFSTFCVU/FVSPOOFVSPO
TVQFSJPSLFGJTVSBMPOHJUVEJOBMJT UFNQBUEBFSBIJOJCFSCBUBTBO DFSNJOUFSEBQBUEJLPSUFLTQSFNPUPSJLEBOLPSUFLTQBSJFUBMJOGFSJPS
EFOHBO BSFB NPUPSJL TVQMFNFOUFS ZBOH NFNQVOZBJ GVOHTJ EBO NVOHLJO EJ CBHJBO MBJO PUBL
EBO QFSUBNB EJUFNVLBO QBEB
TFSVQBEFOHBOBSFBQSFNPUPS4FDBSBLBTBS TVTVOBOUPQPHSBGJT LFSB /BNVO TUVEJ QFODJUSBBO PUBL NFOVOKVLLBO CBIXB OFVSPO
LPSUFLT QSFNPUPSJL TBNB EFOHBO ZBOH UFSEBQBU QBEB LPSUFLT OFVSPO UFSTFCVU KVHB BEB QBEB NBOVTJB EBO NVOHLJO NFMBZBOJ
NPUPSJL QSJNFS EFOHBO BSFB NVMVU EBO XBKBI UFSMFUBL EJ GVOHTJ ZBOH TBNB TFQFSUJ ZBOH UFSPCTFSWBTJ QBEB LFSB
QBMJOHMBUFSBMEBOLFNVEJBOLFBSBIBUBT EBQBUEJUFNVJBSFB NFOUSBOTGPSNBTJSFQSFTFOUBTJTFOTPSJLEBSJHFSBLBOZBOHEJEFOHBS
UBOHBO MFOHBO CBUBOHUVCVI EBOUVOHLBJ BUBV EJMJIBU NFOKBEJ SFQSFTFOUBTJ NPUPSJL EBSJ HFSBLBO UFSTFCVU
#BOZBL BIMJ OFVSPGJTJPMPHJ QFSDBZB CBIXB OFVSPO DFSNJO UFSTFCVU
4JOZBMTJOZBM TBSBG ZBOH EJCFOUVL EJ BSFB QSFNPUPSJL
NVOHLJOQFOUJOHVOUVLNFNBIBNJHFSBLBOPSBOHMBJOEBOVOUVL
NFOZFCBCLBO MFCJI CBOZBL QPMB QFSHFSBLBO ZBOH MFCJI
NFNQFMBKBSJ LFUFSBNQJMBO CBSV EFOHBO DBSB NFOJSV +BEJ LPSUFLT
LPNQMFLT EBSJQBEB QPMB LIVTVT ZBOH UFSCFOUVL EJ EBMBN
QSFNPUPSJL HBOHMJB CBTBMJT UBMBNVT EBO LPSUFLT NPUPSJL QSJNFS
LPOUFLT NPUPSJL QSJNFS $POUPIOZB QPMB UFSTFCVU NFOHBUVS
NFNCFOUVL TVBUV TJTUFN ZBOH LPNQMFLT EBO NFOZFMVSVI VOUVL
QPTJTJ CBIV EBO MFOHBO TFIJOHHB UBOHBO UFSBSBI TFDBSB CFOBS
NFOHBUVSQPMBLPNQMFLTBLUJWJUBTPUPUZBOHUFSLPPSEJOBTJ
VOUVLNFOKBMBOLBOUVHBTTQFTJGJL6OUVLNFODBQBJUVKVBOJOJ
BSFB QSFNPUPSJL ZBOH MFUBLOZB QBMJOH BOUFSJPS QFSUBNB
NFNCVBU TVBUV HBNCBS NPUPSJL HFSBLBO TFMVSVI PUPU ZBOH "SFBNPUPSJLTVQMFNFOUFSKVHBNFNJMJLJTVTVOBOUPQPHSBGJTMBJO
BLBO EJLFSKBLBO ,FNVEJBO QBEB LPSUFLT QSFNPUPSJL VOUVL NFOHBUVS GVOHTJ NPUPSJL "SFB JOJ UFSVUBNB UFSMFUBL EJ
QPTUFSJPS HBNCBS UFSTFCVU NFSBOHTBOH TFUJBQ QPMB BLUJWJUBT GJTVSB MPOHJUVEJOBMJT UFUBQJ NFMVBT CFCFSBQB DN LF LPSUFLT
PUPU CFSVSVUBO ZBOH EJCVUVILBO VOUVL NFOEBQBULBO HBNCBS GSPOUBMJT TVQFSJPS ,POUSBLTJ ZBOH UJNCVM BLJCBU QFSBOHTBOHBO
NPUPSJL UFSTFCVU ,PSUFLT QSFNPUPSJL CBHJBO QPTUFSJPS BSFB JOJ MFCJI TFSJOH CFSTJGBU CJMBUFSBM EBSJQBEB IBOZB VOJMBUFSBM
UFSTFCVU NFOHJSJNLBO TJOZBMTJOZBMOZB MBOHTVOH LF LPSUFLT 4FCBHBJ DPOUPI QFSBOHTBOHBO EBFSBI JOJ TFSJOH LBMJ
NPUPSJL QSJNFS VOUVL NFSBOHTBOH PUPU TQFTJGJL BUBV MFCJI NFOJNCVMLBO HFSBLBO NFODFOHLFSBN CJMBUFSBM QBEB LFEVB
TFSJOH NFSBNCBU LF HBOHMJB CBTBMJT EBO UBMBNVT VOUVL UBOHBO TFDBSB CFSTBNBBO HFSBLBO JOJ NVOHLJO NFSVQBLBO TJTB
LFNCBMJLFLPSUFLTNPUPSJLQSJNFS TJTB GVOHTJ UBOHBO ZBOH UJEBL CFSLFNCBOH
ZBOH EJCVUVILBO
VOUVL NFNBOKBU 1BEB VNVNOZB GVOHTJ BSFB JOJ CFSLBJUBO
EFOHBO BSFB QSFNPUPSJL VOUVL NFOHIBTJMLBO HFSBLBO TJLBQ
UVCVI ZBOH MVBT GJLTBTJ HFSBLBO EBSJ CFSCBHBJ TFHNFO UVCVI
HFSBLBO QPTJTJPOBM UBOHBO EBO NBUB EBO TFCBHBJOZB TFCBHBJ
QFOEVLVOH VOUVL NFOHBUVS HFSBLBO NPUPSJL IBMVT QBEB MFOHBO
EBOUBOHBOPMFIBSFBQSFNPUPSJLEBOLPSUFLTNPUPSJLQSJNFS
#FCFSBQBSFHJPNPUPSJLZBOHTBOHBULIVTVTQBEBLPSUFLTTFSFCSJ
NBOVTJB UBNQBL QBEB (BNCBS
NFOHFOEBMJLBO GVOHTJ
GVOHTJ NPUPSJL TQFTJGJL 3FHJP JOJ EJUFOUVLBO MPLBTJOZB NFMBMVJ
QFSBOHTBOHBO MJTUSJL BUBV NFMBMVJ IJMBOHOZB GVOHTJ NPUPSJL CJMB
UFSKBEJMFTJEFTUSVLUJGEJBSFBTQFTJGJLQBEBLPSUFLT#FCFSBQBSFHJP
ZBOHMFCJIQFOUJOHBEBMBITFCBHBJCFSJLVU
"SFB #SPDB EBO #JDBSB (BNCBS NFNQFSMJIBULBO BSFB
QSFNPUPSJL EFOHBO UVMJTBO QFNCFOUVLBO LBUB ZBOH UFSMFUBL
UFQBU EJ TFCFMBI BOUFSJPS LPSUFLT NPUPSJL QSJNFS EBO UFQBU EJ
BUBT GJTVSB TZMWJJ %BFSBI JOJ EJTFCVU BSFB #SPDB ,FSVTBLBO EJ
EBFSBIJOJUJEBLNFOHIBMBOHJQFOEFSJUBOZBVOUVLNFOHFMVBSLBO
TVBSB OBNVO UJEBL NVOHLJO QFOEFSJUB EBQBU NFOHVDBQLBO
TFMVSVI LBUBLBUB QBMJOHQBMJOH IBOZB VDBQBOVDBQBO UBL
UFSLPPSEJOBTJBUBVUFSLBEBOHLBUBLBUBTFEFSIBOBTFQFSUJUJEBL
BUBV ZB "SFB LPSUFLT ZBOH FSBU IVCVOHBOOZB EFOHBO EBFSBI
JOJBEBMBIBSFBZBOHCFSGVOHTJVOUVLQFSOBQBTBO TFIJOHHBTBBU
4FLFMPNQPL OFVSPO LIVTVT ZBOH EJTFCVU OFVSPO DFSNJO QBTJFO CJDBSB BLBO UJNCVM BLUJWBTJ QJUB TVBSB CFSTBNBTBNB
NFOKBEJBLUJGLFUJLBTFTFPSBOHNFMBLVLBOTVBUVLFSKBNPUPSJL EFOHBOHFSBLBONVMVUEBOMJEBI+BEJ BLUJWJUBTOFVSPO
668
Bab 55 Pengaturan Fungsi Motorik oleh Korteks dan Batang Otak
QFSTFO EBSJ BSFB QSFNPUPSJL EBO BSFB NPUPSJL TVQMFNFOUFS

EBO QFSTFO EBSJ BSFB TPNBUPTFOTPSJL ZBOH UFSMFUBL EJ
UNIT XI
TFCFMBIQPTUFSJPSTVMLVTTFOUSBMJT
+BSBTJOJTFUFMBINFOJOHHBMLBOLPSUFLTBLBONFMFXBUJCBHJBO
QPTUFSJPS LBQTVMB JOUFSOB EJ BOUBSB OVLMFVT LBVEBUVT EBO
QVUBNFOHBOHMJBCBTBMJT
EBOTFMBOKVUOZBUVSVONFMFXBUJCBUBOH
PUBL VOUVLNFNCFOUVLCBHJBOQJSBNJEEBSJNFEVMB4FCBHJBO
CFTBS TFSBU QJSBNJEBM BLBO NFOZJMBOH QBEB NFEVMB EJ CBHJBO
ZBOH MFCJI SFOEBI UVSVO LF USBLUVT LPSUJLPTQJOBMJT MBUFSBMJT
NFEVMB TQJOBMJT BLIJSOZB CFSBLIJS UFSVUBNB QBEB JOUFSOFVSPO
EJ SFHJP JOUFSNFEJBU EBO TVCTUBOTJB HSJTFB NFEVMB TQJOBMJT
CFCFSBQB CFSBLIJS EJ OFVSPOOFVSPO SFMBJ TFOTPSJL EJ SBEJLT
EPSTBMJT EBO TFEJLJU TFLBMJ ZBOH CFSBLIJS TFDBSB MBOHTVOH EJ
OFVSPOOFVSPO NPUPSJL BOUFSJPS ZBOH NFOZFCBCLBO LPOUSBLTJ
QSFNPUPSJLZBOHUFSLBJUEFOHBOQSPTFTCJDBSBTBOHBUMBI PUPU
LPNQMFLT 4FCBHJBO LFDJM TFSBU JOJ UJEBL NFOZJMBOH LF TJTJ ZBOH MBJO
QBEB NFEVMB OBNVO CFSKBMBO TFDBSB JQTJMBUFSBM LF CBXBI
Lapang Gerakan Mata "Volunter". 1BEB BSFB QSFNPUPSJL NFEVMB QBEB USBLUVT LPSUJLPTQJOBMJT WFOUSBMJT 8BMBV UJEBL
UFQBU EJ BUBT BSFB #SPDB UFSEBQBU EBFSBI ZBOH EJQBLBJ VOUVL TFNVB CBOZBLTFSBUJOJBLIJSOZBNFOZJMBOHLFTJTJCFSMBXBOBO
NFOHBUVS HFSBLBO NBUB WPMVOUFS #JMB EBFSBI JOJ SVTBL QBTJFO UFSVUBNB EJ EBFSBI MFIFS BUBV SFHJP UPSBLT CBHJBO BUBT 4FSBU
TFDBSB WPMVOUFS UJEBL EBQBU NFOHHFSBLLBO NBUBOZB LF CFSCBHBJ JOJ LFNVOHLJOBO CFSQFSBO QBEB QFOHFOEBMJBO HFSBLBO
PCKFL+VTUSV NBUBQBTJFODFOEFSVOHUFSGJLTBTJTFDBSBJOWPMVOUFS QPTUVSBMCJMBUFSBMPMFILPSUFLTNPUPSJLTVQMFNFOUFS
QBEBPCKFLZBOHTQFTJGJLTBKB EBOJOJNFSVQBLBOFGFLZBOHEJBUVS )BM ZBOH TBOHBU NFOHFTBOLBO EBSJ TFSBUTFSBU ZBOH BEB
PMFI TJOZBM ZBOH CFSBTBM EBO LPSUFLT WJTVBM PLTJQJUBMJT TFQFSUJ EBMBN USBLUVT QJSBNJEBM BEBMBI CBOZBLOZB TFSBU CFTBS
ZBOH EJKFMBTLBO EBMBN #BC "SFB GSPOUBM JOJ KVHB NFOHBUVS CFSNJFMJO EFOHBO EJBNFUFS TFLJUBS 4FSBU JOJ CFSBTBM EBSJ
HFSBLBOLFMPQBLNBUBTFQFSUJCFSLFEJQ TFMTFM QJSBNJEBM SBLTBTB ZBOH EJTFCVU TFMTFM #FU[ 4FM JOJ
IBOZB EBQBU EJKVNQBJ EBMBN LPSUFLT NPUPSJL QSJNFS
Area Rotasi Kepala.1FSBOHTBOHBOMJTUSJLQBEBEBFSBIBHBL %JBNFUFS TFM #FU[ LJSBLJSB HN EBO TFSBUTFSBUOZB
TFEJLJU EJ BUBT BSFB BTPTJBTJ NPUPSJL BLBO NFOJNCVMLBO SPUBTJ
NFOHJSJNLBO JNQVMT LF NFEVMB TQJOBMJT EFOHBO LFDFQBUBO
LFQBMB"SFBJOJFSBUIVCVOHBOOZBEFOHBOMBQBOHHFSBLBONBUB
LJSBLJSB NEFUJL ZBOH NFSVQBLBO LFDFQBUBO
NFOHBSBILBOLFQBMBLFCFSCBHBJPCKFL
QFOHJSJNBOUFSCFTBSEBSJTFUJBQTJOZBMZBOHCFSBTBMEBSJPUBL
Area untuk Keterampilan Tangan. 1BEB BSFB QSFNPUPSJL LF NFEVMB TQJOBMJT %BMBN TFUJBQ USBLUVT LPSUJLPTQJOBMJT
UFQBU EJ TFCFMBI BOUFSJPS LPSUFLT NPUPSJL QSJNFS ZBOH EJQBLBJ LJSBLJSB BEB TFSBCVU TFMTFM #FU[ CFTBS +VNMBI UPUBM
VOUVLHFSBLBOUBOHBOEBOKBSJUFSEBQBUTVBUVEBFSBIZBJUVTVBUV TFSBCVUEBMBNTFUJBQUSBLUVTLPSUJLPTQJOBMJTMFCJIEBSJKVUB
BSFBZBOHQFOUJOHVOUVLLFUFSBNQJMBOUBOHBO+BEJ CJMBEBFSBI EFOHBO EFNJLJBO TFSBUTFSBU CFTBS JOJ IBOZB NFSVQBLBO
JOJ SVTBL BLJCBU UVNPS BUBV MFTJ MBJO HFSBLBO UBOHBO BLBO QFSTFO EBSJ KVNMBI LFTFMVSVIBO 4FLJUBS QFSTFO MBJOOZB
NFOKBEJ UJEBL UFSLPPSEJOBTJ EBO UBL CFSUVKVBO TVBUV LPOEJTJ UFSVUBNBUFSEJSJBUBTTFSBUTFSBUEFOHBOEJBNFUFSMFCJILFDJM
ZBOHEJTFCVUBQSBLTJBNPUPSJL EBSJHNZBOHNFOHPOEVLTJTJOZBMTJOZBMUPOJLQFOZFSUBLF
Pengiriman Sinyal dari Korteks Motorik ke Otot-Otot BSFBNPUPSJLNFEVMBTQJOBMJT
Jaras Serat Lain dari Korteks Motorik. ,PSUFLT NPUPSJL
4JOZBM NPUPSJL EJLJSJNLBO TFDBSB MBOHTVOH EBSJ LPSUFLT LF NFOHFMVBSLBOCBOZBLTFLBMJTFSBULFDJMUBNCBIBOZBOHQFSHJLFSFHJP
NFEVMB TQJOBMJT NFMBMVJ USBLUVT LPSUJLPTQJOBMJT EBO TFDBSB UJEBL TFSFCSVN ZBOH MFCJI EBMBN EBO LF CBUBOH PUBL ZBOH NFMJQVUJ IBM
MBOHTVOH NFMBMVJ CFSCBHBJ KBSBT UBNCBIBO ZBOH NFMJCBULBO CFSJLVU
HBOHMJB CBTBMJT TFSFCFMVN EBO CBOZBL OVLMFJ CBUBOH PUBL 1BEB 1. "LTPOEBSJTFMTFM#FU[SBLTBTBNFOHJSJNLBOTFSBUTFSBULPMBUFSBM
VNVNOZB KBSBT MBOHTVOH MFCJI CFSLBJUBO EFOHBO HFSBLBO ZBOH QFOEFL LFNCBMJ LF LPSUFLT UFNQBU BTBMOZB 4FSBUTFSBU LPMBUFSBM
KFMBT EBO EFUBJM UFSVUBNB HFSBLBO TFHNFO EJTUBM BOHHPUB HFSBL EJEVHB NFOHIBNCBU EBFSBI LPSUFLT ZBOH BEB EJ EFLBUOZB LFUJLB
LIVTVTOZBUBOHBOEBOKBSJ TFMTFM #FU[ NFOHFMVBSLBO JNQVMT TFIJOHHB BLBO NFNQFSUBKBN
Traktus Kortikospinalis (Piramidal) CBUBTCBUBTTJOZBMFLTJUBTJUFSTFCVU
2. 4FSBUTFSBUEBMBNKVNMBICFTBSZBOHCFSKBMBOEBSJLPSUFLTNPUPSJL
+BSBT LF MVBS ZBOH QBMJOH QFOUJOH EBSJ LPSUFLT NPUPSJL BEBMBI
LF OVLMFVT LBVEBUVT EBO QVUBNFO %BSJ EBFSBI UFSTFCVU BEB
USBLUVT LPSUJLPTQJOBMJT EJTFCVU KVHB USBLUVT QJSBNJEBM TFQFSUJ KBSBTKBSBT UBNCBIBO ZBOH NFOZFCBS LF CBUBOH PUBL EBO NFEVMB
ZBOHEJQFSMJIBULBOEBMBN(BNCBS,JSBLJSBQFSTFOEBSJ TQJOBMJT TFQFSUJZBOHEJCJDBSBLBOQBEBCBCTFMBOKVUOZB UFSVUBNB
USBLUVTLPSUJLPTQJOBMJTCFSBTBMEBSJLPSUFLTNPUPSJLQSJNFS NFOHBUVSLPOUSBLTJPUPUQPTUVSBMUVCVI
669
Unit Xl Sistem Saraf C. Neurofislologi.s Motorik dan Integratif
Jaras Serat Sensorik yang Menuju Korteks Motorik

'VOHTJ LPSUFLT NPUPSJL UFSVUBNB EJLFOEBMJLBO PMFI TJOZBM TBSBG EBO
TJTUFN TPNBUPTFOTPSJL UFUBQJ KVHB EBMBN CBUBT UFSUFOUV EBSJ TJTUFN
TFOTPSJL MBJO TFQFSUJ EBSJ QFOEFOHBSBO EBO QFOHMJIBUBO 4FHFSB
TFUFMBI JOGPSNBTJ TFOTPSJL EJUFSJNB LPSUFLT NPUPSJL CFLFSKB EBMBN
LBJUBOOZB EFOHBO HBOHMJB CBTBMJT EBO TFSFCFMVN VOUVL NFSBOHTBOH
KBMBOOZB LFSKB NPUPSJL ZBOH TFTVBJ +BSBT TFSBU ZBOH MFCJI QFOUJOH
ZBOHNFNBTVLJLPSUFLTNPUPSJLBEBMBITFCBHBJCFSJLVU
1. 4FSBUTVCLPSUJLBMEBSJSFHJPEJTFLJUBSLPSUFLTTFSFCSJ UFSVUBNBEBSJ
B
BSFB TPNBUPTFOTPSJL LPSUFLT QBSJFUBMJT C
BSFB EJ TFLJUBS LPSUFLT
GSPOUBMJT EJ TFCFMBI BOUFSJPS LPSUFLT NPUPSJL EBO D
LPSUFLT WJTVBM
EBOBVEJUPSJL
2. 4FSBUTFSBUTVCLPSUJLBMZBOHEBUBOHNFMFXBUJLPSQVTLBMPTVNEBSJ
IFNJTGFS TJTJ ZBOH CFSMBXBOBO 4FSBUTFSBU JOJ NFOHIVCVOHLBO BSFB
LPSUFLTQBEBLFEVBTJTJPUBL
3. 4FSBUTFSBU TPNBUPTFOTPSJL ZBOH MBOHTVOH UJCB EBSJ LPNQMFLT
WFOUSPCBTBM UBMBNVT 4FSBUTFSBU JOJ UFSVUBNB NFOHJSJNLBO TJOZBM
UBLUJMEBSJLVMJU TFSUBTJOZBMTFOEJEBOPUPUEBSJUVCVIQFSJGFS
4. 5SBLUVT ZBOH BTBMOZB EBSJ OVLMFJ WFOUSPMBUFSBM EBO WFOUSPBOUFSJPS
UBMBNVT ZBOHTFMBOKVUOZBNFOFSJNBTJOZBMEBSJTFSFCFMVNEBOHBOHMJB
CBTBMJT 5SBLUVT JOJ NFOHJSJNLBO TJOZBMTJOZBM ZBOH EJQFSMVLBO VOUVL
LPPSEJOBTJ EJ BOUBSB GVOHTJ QFOHBUVSBO NPUPSJL LPSUFLT NPUPSJL
HBOHMJBCBTBMJT EBOTFSFCFMVN
5. 4FSBUTFSBU EBO OVLMFJ JOUSBMBNJOFS UBMBNVT 4FSBUTFSBU JOJ
NFOHBUVS QFSBOHTBOHBO VNVN LPSUFLT NPUPSJL EFOHBO DBSB ZBOH
TBNB EBMBN NFOHBUVS QFSBOHTBOHBO VNVN QBEB TFCBHJBO CFTBS
SFHJPMBJOOZBEJLPSUFLTTFSFCSJ
Nukleus Rubra Berperan sebagai Jaras Alternatif untuk

Mengirimkan Sinyal-Sinyal Kortikal menuju Medula
Spinalis
/VLMFVT SVCSB UFSMFUBL EJ EBMBN NFTFOTFGBMPO EBO GVOHTJOZB
CFSIVCVOHBOFSBUEFOHBOUSBLUVTLPSUJLPTQJOBMJT4FQFSUJZBOH
EJQFSMJIBULBO QBEB (BNCBS OVLMFVT JOJ NFOFSJNB
CBOZBL TFLBMJ TFSBCVUTFSBCVU MBOHTVOH ZBOH CFSBTBM EBSJ
LPSUFLTNPUPSJLQSJNFSNFMBMVJUSBLUVTLPSUJLPSVCSBMJT TFQFSUJ
KVHB TFSBCVUTFSBCVU ZBOH CFSDBCBOH EBSJ USBLUVT
LPSUJLPTQJOBMJT LFUJLB TFSBCVU JOJ CFSKBMBO NFMFXBUJ
3. 4FSBUTFSBUNPUPSJLDVLVQCBOZBLZBOHCFSKBMBOLFOVLMFVTSVCSB NFTFOTFGBMPO 4FSBCVUTFSBCVU JOJ CFSTJOBQT EJ OVLMFVT SVCSB
PUBL UFOHBI %BSJ EBFSBI JOJ BEB TFSBUTFSBU UBNCBIBO ZBOH CBHJBO CBXBI ZBOH EJTFCVU CBHJBO NBHOPTFMVMBS ZBOH
NFMBMVJUSBLUVTSVCSPTQJOBMJTUVSVOLFNFEVMBTQJOBMJT NFOHBOEVOH OFVSPOOFVSPO CFTBS ZBOH VLVSBOOZB
4. 4FSBUTFSBU NPUPSJL EBMBN KVNMBI ZBOH DVLVQ CFSCFMPL LF
NFOZFSVQBJTFM#FU[EJLPSUFLTNPUPSJL/FVSPOOFVSPOCFTBS
TVCTUBOTJB SFUJLVMBSJT EBO OVLMFJ WFTUJCVMBS CBUBOH PUBL EBSJ TBOB
TJOZBMTJOZBM NFMBMVJ USBLUVT SFUJLVMPTQJOBMJT EBO USBLUVT JOJLFNVEJBONFOKBEJUSBLUVTSVCSPTQJOBMJTZBOHNFOZJMBOHLF
WFTUJCVMPTQJOBMJT NFOVKV NFEVMB TQJOBMJT EBO TFSBUTFSBU MBJOOZB TJTJMBJOEBMBNCBUBOHPUBLCBHJBOCBXBIEBONFOHJLVUJTVBUV
NFMBMVJ USBLUVT SFUJLVMPTFSFCFMBSJT EBO USBLUVT WFTUJCVMPTFSFCFMBSJT KBMVS ZBOH CFSBEB UFQBU EJ BOUFSJPS USBLUVT LPSUJLPTQJOBMJT
NFOVKVTFSFCFMVN NFOVKVLPMVNOBMBUFSBMJTNFEVMBTQJOBMJT
5. 4FSBUTFSBUNPUPSJLEBMBNKVNMBICBOZBLTFLBMJZBOHCFSTJOBQTEJ
4FSBU SVCSPTQJOBM JOJ UFSVUBNB CFSBLIJS QBEB JOUFSOFVSPO
OVLMFJ QPOT ZBOH NFOHFMVBSLBO TFSBUTFSBU QPOUPTFSFCFMBS
NFNCBXBTJOZBMTJOZBMLFIFNJTGFSTFSFCFMVN ZBOH UFSEBQBU QBEB BSFB JOUFSNFEJBU EBSJ TVCTUBOTJB HSJTFB
NFEVMBTQJOBMJTCFSTBNBEFOHBOTFSBCVULPSUJLPTQJOBM UFUBQJ
6. 4FSBUTFSBU LPMBUFSBM KVHB CFSBLIJS QBEB OVLMFJ PMJWBSJVT JOGFSJPS
EBO EBSJ TBOB TFSBCVU PMJWPTFSFCFMBS TFDBSB TFLVOEFS
CFCFSBQB TFSBU SVCSPTQJOBM JOJ KVHB CFSBLIJS TFDBSB MBOHTVOH
NFOHJSJNLBOTJOZBMLFCFSBHBNEBFSBIEJTFSFCFMVN EJ OFVSPO NPUPSJL BOUFSJPS ZBOH KVHB CFSKBMBO CFSTBNB
EFOHBO CFCFSBQB TFSBU LPSUJLPTQJOBM /VLMFVT SVCSB KVHB
%FOHBO EFNJLJBO TFUJBQ LBMJ BEB TJOZBM ZBOH CFSKBMBO LF NFNJMJLJ IVCVOHBO FSBU EFOHBO TFSFCFMVN NFOZFSVQBJ
NFEVMB TQJOBMJT VOUVL NFOJNCVMLBO BLJUJWJUBT NPUPSJL NBLB IVCVOHBOBOUBSBLPSUFLTNPUPSJLEBOTFSFCFMVN
HBOHMJBCBTBMJT CBUBOHPUBL EBOTFSFCFMVNKVHBNFOFSJNBTJOZBM
TJOZBMNPUPSJLZBOHLVBUEBSJTJTUFNLPSUJLPTQJOBM
670
WFTUJCVMBSJT EBO TFSJOH LBMJ KVHB OVLMFVT SVCSB 4JTUFN JOJ

NFMJCBULBO TFMVSVI EBO CFSCBHBJ LFMPNQPL BSFB QFOHBUVS NPUPSJL
NBLB UBNQBLOZB TVLBS VOUVL NFNCBOEJOHLBO GVOHTJ
OFVSPGJTJPMPHJTOZB ZBOH LIBT EFOHBO TJTUFN ZBOH EJTFCVU TFCBHBJ
TJTUFN FLTUSBQJSBNJEBM TFDBSB LFTFMVSVIBO 1BEB LFOZBUBBOOZB
UNIT XI
TJTUFN QJSBNJEBM EBO FLTUSBQJSBNJEBM TBMJOH CFSIVCVOHBO TFDBSB
MVBT EBO CFSJOUFSBLTJ VOUVL NFOHFOEBMJLBO QFSHFSBLBO %FOHBO
BMBTBO JOJ JTUJMBI FLTUSBQJSBNJEBM MFCJI KBSBOH EJHVOBLBO CBJL
TFDBSBLMJOJTNBVQVOGJTJPMPHJT
Eksitasi Area Pengendalian Motorik Medula Spinalis oleh
Korteks Motorik Primer dan Nukleus Rubra
Susunan Kolom Vertikal Neuron-Neuron dalam
Korteks Motorik. 1BEB #BC EBO LJUB UFMBI
NFOHFUBIVJCBIXBTFMTFMEJEBMBNLPSUFLTTPNBUPTFOTPSJL
EBOLPSUFLTWJTVBMUFSTVTVOEBMBNLPMPNLPMPNWFSUJLBMTFM
,FBEBBO JOJ TFSVQB EFOHBO TFMTFM LPSUFLT NPUPSJL ZBOH
KVHBUFSTVTVOEBMBNLPMPNLPMPNWFSUJLBMEFOHBOEJBNFUFS
TFQFSTFLJBO NJMJNFUFS NFOHBOEVOH SJCVBO OFVSPO EBMBN
TFUJBQLPMPNOZB
4FUJBQ LPMPN TFM JOJ CFLFSKB TFCBHBJ TVBUV VOJU CJBTBOZB
NFSBOHTBOH TFLFMPNQPL PUPU ZBOH TJOFSHJL UFUBQJ LBEBOH
LBEBOHNFSBOHTBOHIBOZBTBUVPUPU4FMBJOJUV TFUJBQLPMPN
TFM JOJ NFNQVOZBJ FOBN MBQJTBO ZBOH CFSCBUBT KFMBT TFSVQB
EFOHBOIBNQJSTFNVBTVTVOBOMBQJTBOLPSUFLTTFSFCSJ4FMTFM
Fungsi Sistem Kortikorubrospinal. #BHJBO NBHOPTFMVMBS
QJSBNJEBM ZBOH NFOHFMVBSLBO TFSBUTFSBU LPSUJLPTQJOBM
OVLMFVT SVCSB NFNQVOZBJ HBNCBSBO TPNBUPHSBGJL TFMVSVI PUPU
TFNVBOZB UFSMFUBL EBMBN MBQJTBO LFMJNB EBSJ QFSNVLBBO
UVCVI TFQFSUJ ZBOH UFSEBQBU QBEB LPSUFLT NPUPSJL 0MFI LBSFOB
LPSUFLT 4FCBMJLOZB TFNVB TJOZBM ZBOH BLBO NBTVL NFMBMVJ
JUV QFSBOHTBOHBO TBUV UJUJL EJ CBHJBO OVLMFVT SVCSB JOJ
MBQJTBO LF TBNQBJ MBQJTBO LF 4FNFOUBSB MBQJTBO LFFOBN
NFOJNCVMLBOLPOUSBLTJQBEBTBUVPUPUNBVQVOTFLFMPNQPLLFDJM
UFSVUBNB NFOHFMVBSLBO TFSBUTFSBU ZBOH CFSIVCVOHBO
PUPU /BNVO LFUBKBNBO HBNCBSBO CFSCBHBJ PUPU LVSBOH
EFOHBOEBFSBIEBFSBIMBJOEJLPSUFLTTFSFCSJ
CFSLFNCBOH EJCBOEJOHLBO EFOHBO EJ LPSUFLT NPUPSJL ,FBEBBO
JOJ LIVTVTOZB UFSEBQBU QBEB PUBL NBOVTJB ZBOH NFNQVOZBJ Fungsi Setiap Kolom Neuron. /FVSPO TFUJBQ LPMPN
OVLMFJ SVCSB SFMBUJG LFDJM +BSBT LPSUJLPSVCSPTQJOBM NFSVQBLBO CFLFSKB TFCBHBJ TVBUV TJTUFN QFOHPMBI UFSQBEV ZBOH
KBMBO UBNCBIBO VOUVL QFOHJSJNBO TJOZBM ZBOH SFMBUJG LIBT EBO NFOHHVOBLBOJOGPSNBTJEBOCBOZBLTVNCFSNBTVLBOHVOB
LPSUFLT NPUPSJL LF NFEVMB TQJOBMJT #JMB TFSBUTFSBU QJSBNJEBM NFOFOUVLBO SFTQPOT LFMVBSBO EBSJ LPMPN JUV 4FMBJO JUV
EJSVTBL OBNVO KBSBT LPSUJLPSVCSPTQJOBM UFUBQ VUVI QFSHFSBLBO TFUJBQ LPMPN EBQBU CFSGVOHTJ TFCBHBJ TVBUV TJTUFN QFOHVBU
ZBOH LIBT NBTJI UFUBQ UFSKBEJ LFDVBMJ CBIXB HFSBLBO VOUVL VOUVL NFSBOHTBOH CBOZBL TFLBMJ TFSBU QJSBNJEBM ZBOH
QFOHBUVSBO IBMVT KBSJ EBO UBOHBO BLBO TBOHBU UFSHBOHHV NFOVKV PUPU ZBOH TBNB BUBV LF PUPUPUPU ZBOH TJOFSHJL
1FSHFSBLBO QFSHFMBOHBO UBOHBO NBTJI CFSTJGBU GVOHTJPOBM ZBOH TFDBSBCFSTBNBBO,FBEBBOJOJQFOUJOHLBSFOBQFSBOHTBOHBO
UJEBLBLBOUFSKBEJCJMBMJOUBTBOLPSUJLPSVCSPTQJOBMKVHBEJCMPL TBUVTFMQJSBNJEBMKBSBOHTFLBMJEBQBUNFSBOHTBOHTVBUVPUPU
#JBTBOZB VOUVL EBQBU NFOJNCVMLBO LPOUSBLTJ PUPU TFDBSB
0MFILBSFOBJUV MJOUBTBOZBOHNFMFXBUJOVLMFVTSVCSBNFOVKV EFGJOJUJG EJCVUVILBO QFSBOHTBOHBO TBNQBJ TFM
NFEVMB TQJOBMJT EJLBJULBO EFOHBO TJTUFN LPSUJLPTQJOBM QJSBNJEBMTFDBSBCFSTBNBBO
4FMBOKVUOZB USBLUVT SVCSPTQJOBM UFSMFUBL EJ EBMBN LPMVNOB Sinyal Dinamik dan Statik Dikirimkan oleh Neuron-
MBUFSBMJT NFEVMB TQJOBMJT EBO CFSKBMBO CFSTBNB EFOHBO USBLUVT Neuron Piramidal. #JMBTVBUVTJOZBMLVBUEJLJSJNLBOLFPUPU
LPSUJLPTQJOBMJT LFNVEJBOCFSBLIJSQBEBJOUFSOFVSPOEBOOFVSPO VOUVL NFOJNCVMLBO LPOUSBLTJ BXBM ZBOH DFQBU ZBOH KBVI
NPUPSJL ZBOH NFOHBUVS PUPUPUPU EJTUBM BOHHPUB UVCVI 0MFI MFCJIMFNBIEBQBUNFNQFSUBIBOLBOLPOUSBLTJUFSTFCVUVOUVL
LBSFOB JUV USBLUVT LPSUJLPTQJOBMJT CFSTBNB EFOHBO USBLUVT KBOHLBXBLUVZBOHMBNB,FBEBBOJOJNFSVQBLBOTVBUVQPMB
SVCSPTQJOBMJT EJTFCVU TJTUFN NPUPSJL NFEVMB TQJOBMJT CBHJBO VNVN LFUJLB TVBUV FLTJUBTJ EJQFSMVLBO VOUVL NFOZFCBCLBO
MBUFSBM ZBOH CFSMBXBOBO EFOHBO TJTUFN WFTUJCVMPSFUJLVMPTQJOBM LPOUSBLTJ PUPU "HBS EBQBU UFSKBEJ IBM JOJ TFUJBQ LPMPN TFM
ZBOH UFSVUBNB UFSMFUBL EJ CBHJBO NFEJBM NFEVMB TQJOBMJT EBO IBSVTNFSBOHTBOHEVBLFMPNQPLTFUOFVSPOQJSBNJEBMZBOH
EJTFCVU TJTUFN NPUPSJL NFEVMB TQJOBMJT CBHJBO NFEJBM TFQFSUJ UFSQJTBI ZBLOJOFVSPOEJOBNJLEBOZBOHMBJOCFSVQBOFVSPO
ZBOHBLBOEJCBIBTLFNVEJBOEBMBNCBCJOJ TUBUJL /FVSPOOFVSPO EJOBNJL UFSTFCVU UFSBLUJWBTJ EFOHBO
Sistem "Ekstrapiramidal" LFDFQBUBO ZBOH UJOHHJ EBMBN QFSJPEF TJOHLBU QBEB BXBM
%BMBN MJOHLVQ LMJOJL JTUJMBI TJTUFN NPUPSJL FLTUSBQJSBNJEBM EJHVOBLBO LPOUSBLTJ NFOZFCBCLBO BXBM QFOJOHLBUBO DFQBU EBSJ HBZB
TFDBSBMVBTVOUVLNFOVOKVLLBOTFNVBCBHJBOPUBLEBOCBUBOHPUBLZBOH LFLVBUBO 4FMBOKVUOZB OFVSPO TUBUJL BLBO NFMFUVQ EFOHBO
JLVU CFSQFSBO EBMBN QFOHBUVSBO NPUPSJL OBNVO CVLBO NFSVQBLBO LFDFQBUBO ZBOH KBVI MFCJI MBNCBU OBNVO OFVSPO TUBUJL
CBHJBO MBOHTVOH EBSJ TJTUFN QJSBNJEBM 4JTUFN JOJ NFMJQVUJ KBSBTKBSBT UFSTFCVU BLBO UFSVT NFMFUVQ QBEB LFDFQBUBO SFOEBI VOUVL
ZBOHNFMBMVJHBOHMJBCBTBMJT GPSNBTJPSFUJLVMBSJTCBUBOHPUBL OVLMFJ NFOKBHBLFLVBUBOLPOUSBLTJTFMBNBEJCVUVILBO
671
Unit Xl Sistem Saraf C. Neurofisiologis Motorik dan lntegratif
/FVSPO OVLMFVT SVCSB KVHB NFNQVOZBJ TJGBU ZBOH TBNB

EFOHBOOFVSPOEJOBNJLEBOOFVSPOTUBUJL LFDVBMJCBIXBQBEB
OVLMFVT SVCSB EJEBQBULBO QFSTFOUBTF OFVSPO EJOBNJL ZBOH
MFCJI CFTBS EBO EBMBN LPSUFLT NPUPSJL QSJNFS EJEBQBULBO
OFVSPO TUBUJL EBMBN QFSTFOUBTF ZBOH MFCJI CFTBS ,FBEBBO JOJ
EBQBU UFSLBJU EFOHBO LFOZBUBBO CBIXB OVLMFVT SVCSB TBOHBU
FSBU IVCVOHBOOZB EFOHBO TFSFCFMVN EBO TFSFCFMVN KVHB
CFSQFSBO QFOUJOH EBMBN NFNQFSDFQBU BXBM UJNCVMOZB
LPOUSBLTJPUPU TFQFSUJZBOHEJKFMBTLBOEBMBNCBCTFMBOKVUOZB
Umpan Balik Somatosensorik ke Korteks Motorik
Membantu Mengatur Ketepatan Kontraksi Otot
4BBU TJOZBM TBSBG EBSJ LPSUFLT NPUPSJL NFOJNCVMLBO
LPOUSBLTJ PUPU TJOZBM TPNBUPTFOTPSJL LFNCBMJ TFQBOKBOH
KBMBO EBSJ EBFSBI UVCVI ZBOH UFSBLUJWBTJ NFOVKV OFVSPO
OFVSPO EBMBN LPSUFLT NPUPSJL ZBOH NFOJNCVMLBO LFSKB
,FCBOZBLBO TJOZBM TPNBUPTFOTPSJL JOJ UJNCVM EJ

LVNQBSBO PUPU
PSHBO UFOEP PUPU BUBV
SFTFQUPS
SFTFQUPSUBLUJMQBEBLVMJUZBOHNFOVUVQJPUPU4JOZBMTPNBUJL
TFSJOH NFOZFCBCLBO UJNCVMOZB QFOJOHLBUBO VNQBO CBMJL TQJOBMJTEBQBUNFOHFMVBSLBOQPMBSFGMFLTUFSUFOUVZBOHLIBTTFCBHBJ
QPTJUJG QPTJUJWF GFFECBDL FOIBODFNFOU
EBSJ LPOUSBLTJ PUPU SFTQPOT UFSIBEBQ QFSBOHTBOHBO TBSBG TFOTPSJL #BOZBL QPMB ZBOH
ZBLOJ EFOHBO DBSB CFSJLVU JOJ 1BEB LVNQBSBO PUPU CJMB TBNB JOJ KVHB QFOUJOH LFUJLB OFVSPO NPUPSJL BOUFSJPS NFEVMB
LPOUSBLTJ TFSBUTFSBU PUPU GVTJNPUPS EBMBN LVNQBSBO MFCJI TQJOBMJTUFSBOHTBOHPMFITJOZBMTJOZBMEBSJPUBL$POUPIOZB SFGMFLT
CFTBS EBSJQBEB LPOUSBLTJ TFSBUTFSBU PUPU SBOHLB CFTBS SFHBOH ZBOH TFMBMV CFSGVOHTJ TFUJBQ XBLUV NFNCBOUV NFSFEBN
CBHJBO UFOHBI LVNQBSBO NFOKBEJ UFSFHBOH TFIJOHHB BLBO TFUJBQPTJMBTJEBOHFSBLBOHFSBLBONPUPSJLZBOHEJNVMBJEBSJPUBL
UFSFLTJUBTJ 4JOZBMTJOZBM EBSJ LVNQBSBO PUPU JOJ LFNVEJBO EBONVOHLJOQBMJOHTFEJLJUKVHBBLBONFOHIBTJMLBOLFLVBUBOZBOH
LFNCBMJ TFDBSB DFQBU LF TFMTFM QJSBNJEBM EJ EBMBN LPSUFLT EJCVUVILBO BHBS UJNCVM LPOUSBLTJ PUPU CJMB TFSBUTFSBU JOUSBGVTBM
NPUPSJL VOUVL NFNCFSJLBO TJOZBM LF TFM QJSBNJEBM CBIXB LVNQBSBO PUPU CFSLPOUSBLTJ MFCJI LVBU EBSJQBEB ZBOH EJMBLVLBO
TFSBU PUPU CFTBS UJEBL DVLVQ CFSLPOUSBLTJ 4FMTFM QJSBNJEBM PMFI TFSBUTFSBU PUPU SBOHLB ZBOH CFTBS EFOHBO EFNJLJBO
TFMBOKVUOZB BLBO MFCJI NFSBOHTBOH PUPU NFNCBOUV PUPU NFOJNCVMLBOTUJNVMBTJSFGMFLTTFSWPBTTJTU TJTUFNLPOUSPMVNQBO
CFSLPOUSBLTJ BHBS EBQBU NFOZBNBJ LPOUSBLTJ LVNQBSBO CBMJLPUPNBUJT
QBEBPUPU TFMBJOQFSBOHTBOHBOMBOHTVOHPMFITFSBU
1BEB SFTFQUPS UBLUJM CJMB LPOUSBLTJ PUPU NFOZFCBCLBO TFSBULPSUJLPTQJOBM
QFOFLBOBO LVMJU QBEB TVBUV PCKFL NJTBMOZB QFOFLBOBO KBSJ +VHB TBBU TJOZBM PUBL NFSBOHTBOH PUPU CJBTBOZB QBEB TBBU ZBOH
UBOHBO TFLFMJMJOH PCKFL ZBOH TFEBOH EJHFOHHBN TJOZBM TBNB UBL QFSMV BEB QFOHJSJNBO TJOZBM CBMJL VOUVL NFSFMBLTBTJ PUPU
SFTFQUPSSFTFQUPS LVMJU JOJ KJLB EJCVUVILBO EBQBU MFCJI BOUBHPOJTIBMJOJEBQBUEJQFSPMFIEBSJTJSLVJUQFSTBSBGBOUJNCBMCBMJL
NFSBOHTBOHPUPU EBOBLJCBUOZB HFOHHBNBOUBOHBOTFNBLJO ZBOHTFMBMVUFSTFEJBEBMBNNFEVMBTQJOBMJTVOUVLNFOHPPSEJOBTJLBO
NFODFOHLFSBN GVOHTJQBTBOHBOPUPUBOUBHPOJT
Perangsangan Neuron Motorik Spinal "LIJSOZB NFLBOJTNF SFGMFLT MBJOOZB QBEB NFEVMB TQJOBMJT
TFQFSUJ NFLBOJTNF NFOBSJL EJSJ NFMBOHLBI EBO CFSKBMBO
(BNCBS NFNQFSMJIBULBO QPUPOHBO NFMJOUBOH TFHNFO
NFOHHBSVL EBO TJLBQ UVCVI EBQBU EJBLUJGLBO TFOEJSJTFOEJSJ PMFI
NFEVMB TQJOBMJT ZBOH NFOVOKVLLBO
CFSBHBN USBLUVT
TJOZBMQFSJOUBIEBSJPUBL+BEJ TJOZBMQFSJOUBITFEFSIBOBEBSJPUBL
QFOHFOEBMJ NPUPSJL EBO TFOTPSJL NFNBTVLJ TFHNFO NFEVMB
EBQBU NFNJDV CBOZBL BLUJWJUBT NPUPSJL OPSNBM UFSVUBNB GVOHTJ
TQJOBMJTEBO
OFVSPONPUPSJLBOUFSJPSZBOHTFTVBJEJUFOHBI
CFSKBMBOEBONFMBLVLBOCFSNBDBNNBDBNTJLBQUVCVI
LPSOV BOUFSJPS TVCTUBOTJB HSJTFB 5SBLUVT LPSUJLPTQJOBMJT EBO
USBLUVT SVCSPTQJOBMJT UFSMFUBL EJ CBHJBO EPSTBM LPMVNOB BMCB Efek Lesi pada Korteks Motorik atau pada Jaras Kortikospinal
MBUFSBMJT 4FSBUTFSBU UFSVUBNB CFSBLIJS EJ JOUFSOFVSPO EBMBN —"Stroke"
BSFBJOUFSNFEJBUTVCTUBOTJBHSJTFBNFEVMB 4JTUFN QFOHFOEBMJ NPUPSJL EBQBU NFOHBMBNJ LFSVTBLBO LIVTVTOZB PMFI
1BEB NFEVMB TQJOBMJT CBHJBO TFSWJLBM ZBOH NFNCFTBS LFMBJOBO VNVN ZBOH EJTFCVU TUSPLF ,FMBJOBO JOJ EJTFCBCLBO PMFI
UBNQBL HBNCBSBO UBOHBO EBO KBSJ TFCBHJBO CFTBS TFSBU QFDBIOZB QFNCVMVI EBSBI TFIJOHHB UJNCVM QFSEBSBIBO EBMBN PUBL BUBV
PMFIBEBOZBUSPNCPTJTEBSJTBMBITBUVBSUFSJVUBNBZBOHNFOZVQMBJPUBL
LPSUJLPTQJOBM EBO SVCSPTQJOBM KVHB MBOHTVOH CFSBLIJS EJ
,FEVB LBTVT UFSTFCVU NFOZFCBCLBO IJMBOHOZB TVQMBJ EBSBI LF LPSUFLT
OFVSPO NPUPSJL BOUFSJPS TFIJOHHB UFSTFEJB MJOUBTBO MBOHTVOH BUBV USBLUVT LPSUJLPTQJOBMJT UFNQBU QFNCVMVI EBSBI UFSTFCVU CFSKBMBO
EBSJ PUBL HVOB NFOHBLUJGLBO LPOUSBLTJ PUPU )BM JOJ UFSCVLUJ NFMBMVJ LBQTVMB JOUFSOB EJ BOUBSB OVLMFVT LBVEBUVT EBO QVUBNFO
EFOHBOLFOZBUBBOCBIXBLPSUFLTNPUPSJLQSJNFSNFNQVOZBJ 1FOFMJUJBO KVHB UFMBI EJMBLVLBO QBEB CJOBUBOH VOUVL NFNCVBOH TFDBSB
HBNCBSBOQFOHBUVSBOLFSKBZBOHTBOHBUCBJLUFSIBEBQUBOHBO TFMFLUJGCFSCBHBJCBHJBOLPSUFLTNPUPSJL
KBSJ EBOJCVKBSJ
Pembuangan Korteks Motorik Primer (Area Piramidalis).
Pola Gerakan Akibat Rangsangan oleh Pusat-Pusat 1FNCVBOHBOTFCBHJBOLPSUFLTNPUPSJLQSJNFSBSFBZBOHNFOHBOEVOHTFM
Medula Spinalis.%BSJ#BC EJJOHBULBOMBHJCBIXBNFEVMB TFMQJSBNJEBMSBLTBTB#FU[NFOZFCBCLBOCFSCBHBJEFSBKBU
672
LFMVNQVIBO QBEB CFCFSBQB PUPU ZBOH EJSFQSFTFOUBTJLBOOZB #JMB OVLMFVT Penyangga Tubuh dalam Melawan Gravitasi¬Peran
LBVEBUVT ZBOH UFSMFUBL EJ CBXBIOZB EBO BSFB QSFNPUPSJL TFSUB BSFB Nuklei Retikular dan Nuklei Vestibular
QSFNPUPSJL TVQMFNFOUFS EJ EFLBUOZB UJEBL EJSVTBL HFSBLBO LBTBS HSPTT
(BNCBS NFOVOKVLLBO MPLBTJ OVLMFJ SFUJLVMBS EBO
QPTUVSBM
EBO HFSBLBO GJLTBTJ BOHHPUB CBEBO UFUBQ UFSKBEJ OBNVO
WFTUJCVMBSEJEBMBNCBUBOHPUBL
UNIT XI
UFSEBQBULFIJMBOHBOQFOHFOEBMJBOHFSBLBOWPMVOUFSZBOHUFHBTQBEBTFHNFO
EJTUBMBOHHPUBCBEBO LIVTVTOZBUBOHBOEBOKBSJ/BNVOLFBEBBOJOJUBL Antagonisme Eksitasi-Inhibisi antara Nuklei Retikular
CFSBSUJ CBIXB PUPUPUPU UBOHBO EBO KBSJ JUV UBL EBQBU CFSLPOUSBLTJ Pons dan Nuklei Retikular Medula
BHBLOZB LFNBNQVBO NFOHBUVS HFSBLBO ZBOH IBMVT IJMBOH %BSJ
/VLMFJ SFUJLVMBS UFSCBHJ NFOKBEJ EVB LFMPNQPL VUBNB

QFOHBNBUBOUFSTFCVU LJUBEBQBUNFOZJNQVMLBOCBIXBBSFBQJSBNJEBMJTJUV
CFSQFSBO EBMBN NFNVMBJ UJNCVMOZB HFSBLBO WPMVOUFS EBO IBMVT
OVLMFJ SFUJLVMBS QPOT ZBOH UFSMFUBL TFEJLJU LF BSBI QPTUFSJPS
LIVTVTOZBQBEBUBOHBOEBOKBSJ EBO MBUFSBM EBSJ QPOT EBO NFMVBT LF NFTFOTFGBMPO EBO

Spastisitas Otot Akibat Lesi yang Merusak Area Besar OVLMFJ SFUJLVMBS NFEVMB ZBOH NFMVBT LF TFMVSVI NFEVMB
UFSMFUBLEJTFCFMBIWFOUSBMEBONFEJBMNFOEFLBUJHBSJTUFOHBI
yang Berdekatan dengan Korteks Motorik. ,PSUFLT NPUPSJL
,FEVB SBOHLBJBO OVLMFJ JOJ UFSVUBNB CFSGVOHTJ TFDBSB
QSJNFSTFDBSBOPSNBMNFOHFMVBSLBOFGFLTUJNVMBTJUPOJLUFSVTNFOFSVT
QBEB OFVSPO NPUPSJL NFEVMB TQJOBMJT CJMB FGFL TUJNVMBTJ UFSTFCVU BOUBHPOJTUJL TBUV TBNB MBJO EFOHBO OVLMFJ QPOT ZBOH
EJIJMBOHLBO BLBO UFSKBEJ IJQPUPOJB ,FCBOZBLBO MFTJ QBEB LPSUFLT NFSBOHTBOH PUPUPUPU BOUJHSBWJUBTJ EBO OVLMFJ NFEVMB
NPUPSJL LIVTVTOZB ZBOH EJTFCBCLBO PMFI TUSPLF NFMJCBULBO UJEBL NFSFMBLTBTJPUPUZBOHTBNB
IBOZB LPSUFLT NPUPSJL QSJNFS UFUBQJ KVHB CBHJBO PUBL TFQFSUJ HBOHMJB Sistem Retikular Pons. /VLMFJ SFUJLVMBS QPOT
CBTBMJT1BEBDPOUPIJOJ TQBTNFPUPUIBNQJSTFMBMVUFSKBEJQBEBBSFBBSFB NFOHJSJNLBO TJOZBMTJOZBM FLTJUBTJ LF CBXBI NFOVKV NFEVMB
PUPUZBOHUFSQFOHBSVIQBEBTJTJUVCVIZBOHCFSMBXBOBO LBSFOBMJOUBTBO NFMBMVJ USBLUVT SFUJLVMPTQJOBMJT QPOT QBEB LPMVNOB BOUFSJPS
NPUPSJLBLBONFOZJMBOHLFTJTJZBOHCFSMBXBOBO
4QBTNFJOJUFSVUBNB NFEVMB TQJOBMJT TFQFSUJ ZBOH UBNQBL QBEB (BNCBS
EJBLJCBULBO PMFI LFSVTBLBO KBSBT BTFTPSJT ZBOH CFSBTBM EBSJ CBHJBO 4FSBCVUTFSBCVU EBO KBSBT JOJ CFSBLIJS QBEB OFVSPOOFVSPO
OPOQJSBNJEBM QBEB LPSUFLT NPUPSJL +BSBT JOJ TFDBSB OPSNBM
NPUPSJL CBHJBO BOUFSJPS EBO NFEJBM ZBOH NFSBOHTBOH PUPU
NFOHIBNCBU OVLMFJ NPUPSJL CBUBOH PUBL WFTUJCVMBS EBO SFUJLVMBS #JMB
PUPU BLTJBM UVCVI ZBOH NFOEVLVOH UVCVI NFMBXBO HSBWJUBTJ
OVLMFJ JOJ NFOHIJMBOHLBO LFBEBBO JOIJCJTJOZB BSUJOZB EJTJOIJCJTJ

PUPUPUPU TFDBSB TQPOUBO NFOKBEJ BLUJG EBO NFOHIBTJMLBO UPOVT TQBTUJL ZBJUV PUPUPUPU LPMVNOB WFSUFCSB EBO PUPUPUPU FLUFOTPS
ZBOHMVBTQBEBPUPUZBOHUFSMJCBUIBMJOJBLBOLJUBCJDBSBLBOMFCJIMBOKVU BOHHPUBUVCVI
LFNVEJBO *OJ BEBMBI TQBTUJTJUBT ZBOH TFDBSB OPSNBM UFSKBEJ CFSTBNBBO /VLMFJ SFUJLVMBS QPOT NFNJMJLJ EFSBKBU FLTJUBCJMJUBT BMBNJ
EFOHBOTUSPLFQBEBNBOVTJB ZBOHUJOHHJ4FMBJOJUV OVLMFJUFSTFCVUNFOFSJNBTJOZBMTJOZBM
FLTJUBUPSJL ZBOH LVBU EBSJ OVLMFJ WFTUJCVMBS TFQFSUJ KVHB EBSJ
OVLMFJEJCBHJBOEBMBNTFSFCFMVN0MFILBSFOBJUV CJMBTJTUFN
Peran Batang Otak dalarn Mengatur Fungsi Motorik FLTJUBUPSJL SFUJLVMBS QPOT UJEBL EJMBXBO PMFI TJTUFN SFUJLVMBS
NFEJBM NBLB IBM JOJ BLBO NFOZFCBCLBO QFSBOHTBOHBO PUPU
#BUBOH PUBL UFSEJSJ BUBT NFEVMB QPOT EBO NFTFOTFGBMPO PUPUBOUJHSBWJUBTJZBOHTBOHBULVBUEJTFMVSVIUVCVI CFHJUV
5FSEBQBU QBOEBOHBO ZBOH NFOHBUBLBO CBIXB CBUBOH PUBL
NFSVQBLBO QFSMVBTBO EBSJ NFEVMB TQJOBMJT LF BSBI BUBT NFOVKV
SPOHHB LSBOJBM LBSFOB CBUBOH PUBL KVHB NFOHBOEVOH OVLMFJ
TFOTPSJL EBO NPUPSJL ZBOH NFNCFOUVL GVOHTJ NPUPSJL EBO
TFOTPSJLVOUVLSFHJPXBKBIEBOLFQBMB TBNBTFQFSUJDBSBNFEVMB
TQJOBMJT NFMBLVLBO GVOHTJOZB VOUVL EBFSBI MFIFS LF CBXBI
5FUBQJ QBOEBOHBO MBJO NFOHBUBLBO CBIXB CBUBOH PUBL
NFSVQBLBONBTUFSCBHJCBUBOHPUBLTFOEJSJ LBSFOBCBUBOHPUBL
NFNJMJLJCBOZBLGVOHTJLFOEBMJLIVTVT TFQFSUJCFSJLVU
1. .FOHFOEBMJLBOQFSOBQBTBO
2. .FOHFOEBMJLBOTJTUFNLBSEJPWBTLVMBS
3. .FOHFOEBMJLBOTFCBHJBOGVOHTJHBTUSPJOUFTUJOBM
4. .FOHFOEBMJLBO CBOZBL HFSBLBO UVCVI ZBOH
TUFSFPUJQ
5. .FOHFOEBMJLBOLFTFJNCBOHBO
6. .FOHFOEBMJLBOHFSBLBONBUB
"LIJSOZB CBUBOHPUBLNFSVQBLBOTUBTJVO XBZTUBUJPO
VOUVL
QFOHJSJNBO TJOZBM QFSJOUBI EBSJ QVTBU QFSTBSBGBO ZBOH MFCJI
UJOHHJ 1BEB CBHJBO CFSJLVU LJUB BLBO NFNCJDBSBLBO NFOHFOBJ
QFSBOCBUBOHPUBLEBMBNNFOHFOEBMJLBOHFSBLBOTFMVSVIUVCVI
EBO LFTFJNCBOHBO #BHJBO UFSQFOUJOH VOUVL UVKVBO UFSTFCVU
BEBMBIOVLMFJSFUJLVMBSEBOOVLMFJWFTUJCVMBSCBUBOHPUBL
673
CFSCBHBJPUPUBOUJHSBWJUBTJVOUVLNFOKBHBLFTFJNCBOHBO
TFCBHBJSFTQPOTUFSIBEBQTJOZBMEBSJBQBSBUVTWFTUJCVMBS,JUB
BLBONFNCBIBTIBMUFSTFCVUMFCJIMBOKVUEBMBNCBCJOJ
Hewan Deserebrasi Mengalami Kekakuan Spastik
#JMB CBUBOH PUBL TFFLPS CJOBUBOH EJQPUPOH EJ CBXBI MFWFM UFOHBI
NFTFOTFGBMPO UFUBQJTJTUFNSFUJLVMBSQPOTEBONFEVMB EFNJLJBOQVMB
TJTUFN WFTUJCVMBS EJCJBSLBO UFUBQ VUVI CJOBUBOH UFSTFCVU NFOHBMBNJ
LFBEBBO ZBOH EJTFCVU LFLBLVBO EFTFSFCSBTJ ,FLBLVBO JOJ UJEBL
UJNCVMEJTFNVBPUPUUVCVIUFUBQJIBOZBQBEBPUPUBOUJHSBWJUBTJZBJUV
PUPUMFIFSEBOCBUBOHUVCVITFSUBFLTUFOTPSUVOHLBJ
1FOZFCBC LFLBLVLBO EFTFSFCSBTJ JOJ BEBMBI QFOHIBNCBUBO JOQVU
LVBU ZBOH TFDBSB OPSNBM NFNBTVLJ OVLMFJ SFUJLVMBS NFEVMB EBSJ
LPSUFLT TFSFCSJ OVLMFJ SVCSB EBO HBOHMJB CBTBMJT %FOHBO LFUJBEBBO
JOQVU UFSTFCVU TJTUFN JOIJCJUPSJL SFUJLVMBS NFEVMB NFOKBEJ UJEBL
CFSGVOHTJ UFSKBEJMBI BLUJWJUBT ZBOH TBOHBU CFSMFCJIBO QBEB TJTUFN
LVBUOZB TFIJOHHB CJOBUBOH CFSLBLJ FNQBU EBQBU EJMFUBLLBO FLTJUBUPSJLQPOTEBOUFSKBEJLFLBLVBO4FMBOKVUOZB LJUBBLBONFMJIBU
EBMBN QPTJTJ CFSEJSJ NFOEVLVOH UVCVI NFMBXBO HSBWJUBTJ QFOZFCBCLFLBLVBOZBOHUFSKBEJQBEBQFOZBLJUOFVSPNPUPSJLMBJOOZB
UBOQBTJOZBMBQBQVOEBSJUJOHLBUPUBLZBOHMFCJIUJOHHJ UFSVUBNBQBEBMFTJEJHBOHMJBCBTBMJT
Sistem Retikular Medula. /VLMFJ SFUJLVMBS NFEVMB
NFOHJSJNTJOZBMJOIJCJUPSJLLFOFVSPOOFVSPONPUPSJLBOUFSJPS Sensasi Vestibular dan Pemetiharaan
BOUJHSBWJUBTJ ZBOH TBNB NFMBMVJ USBLUVT ZBOH CFSCFEB ZBJUV Keseimbangan
USBLUVTSFUJLVMPTQJOBMJTNFEVMB UFSMFUBLQBEBLPMVNOBMBUFSBMJT
NFEVMB TQJOBMJT ZBOH KVHB EJQFSMJIBULBO EBMBN (BNCBS Aparatus Vestibular
/VLMFJ SFUJLVMBS NFEVMB NFOFSJNB JOQVU LPMBUFSBM ZBOH LVBU
"QBSBUVT WFTUJCVMBS UBNQBL QBEB (BNCBS NFSVQBLBO
EBSJ
USBLUVT LPSUJLPTQJOBMJT
USBLUVT SVCSPTQJOBMJT EBO
PSHBO TFOTPSJL VOUVL NFOEFUFLTJ TFOTBTJ LFTFJNCBOHBO "MBU

KBSBT NPUPSJL MBJOOZB 4FNVB JOJ TFDBSB OPSNBM
JOJUFSCVOHLVTEBMBNTVBUVTJTUFNUBCVOHUVMBOHEBOSVBOHBO
NFOHBLUJGLBO TJTUFN JOIJCJUPSJL SFUJLVMBS NFEVMB VOUVL
SVBOHBO ZBOH UFSMFUBL EBMBN CBHJBO QFUSPTB CBHJBO TFQFSUJ
NFOHJNCBOHJTJOZBMFLTJUBTJEBSJTJTUFNSFUJLVMBSQPOT TFIJOHHB
CBUV CBHJBO LFSBT
UVMBOH UFNQPSBM ZBOH EJTFCVU MBCJSJO
EBMBN LFBEBBO OPSNBM PUPUPUPU UVCVI UJEBL UFHBOH TFDBSB
UVMBOH %J EBMBN TJTUFN JOJ UFSEBQBU UBCVOH NFNCSBO EBO
BCOPSNBM
SVBOHBO ZBOH EJTFCVU MBCJSJO NFNCSBOPTB ZBOH NFSVQBLBO
5FSOZBUB CFCFSBQBTJOZBMZBOHCFSBTBMEBOBSFBPUBLZBOH
CBHJBOGVOHTJPOBMBQBSBUVTWFTUJCVMBS
MFCJI UJOHHJ EBQBU NFOHBEBLBO EJTJOIJCJTJ TJTUFN NFEVMB
CJMB PUBL NFOHJOHJOLBO VOUVL NFSBOHTBOH TJTUFN QPOT #BHJBO BUBT (BNCBS NFNQFSMJIBULBO MBCJSJO
VOUVL NFOHIBTJMLBO LFBEBBO CFSEJSJ %J MBJO XBLUV NFNCSBOPTB -BCJSJO JOJ UFSVUBNB UFSEJSJ BUBT LPLMFB EVLUVT
QFSBOHTBOHBO TJTUFN SFUJLVMBS NFEVMB EBQBU NFOHIBNCBU LPLMFBSJT
UJHB LBOBMJT TFNJTJSLVMBSJT EBO EVB SVBOHBO CFTBS
PUPUPUPU BOUJHSBWJUBTJ QBEB QPTJTJ UVCVI UFSUFOUV VOUVL ZBOHEJLFOBMTFCBHBJVUSJLVMVTEBOTBLVMVT,PLMFBNFSVQBLBO
NFNVOHLJOLBO CBHJBOCBHJBO JOJ NFNCFOUVL BLUJWJUBT PSHBO TFOTPSJL VUBNB VOUVL QFOEFOHBSBO MJIBU #BC
EBO
NPUPSJL LIVTVT /VLMFJ SFUJLVMBS FLTJUBTJ EBO JOIJCJTJ IBNQJS UJEBL CFSIVCVOHBO EFOHBO LFTFJNCBOHBO #JBSQVO
NFSVQBLBO TVBUV TJTUFN UFSLFOEBMJ ZBOH EJNBOJQVMBTJ PMFI CFHJUV LBOBMJT TFNJTJSLVMBSJT VUSJLVMVT EBO TBLVMVT
TJOZBMTJOZBMNPUPSJLEBSJLPSUFLTTFSFCSJEBOUFNQBUUFNQBU TFNVBOZB NFSVQBLBO CBHJBO JOUFHSBM NFLBOJTNF
MBJOOZB VOUVL NFOJNCVMLBO LPOUSBLTJ MBUBS CFMBLBOH EBSJ LFTFJNCBOHBO
PUPUPUPU VOUVL EBQBU CFSEJSJ NFMBXBO HSBWJUBTJ EBO "Makula"—Organ Sensorik Utrikulus dan Sakulus untuk
NFOHIBNCBU TFLFMPNQPL PUPUPUPU UFSUFOUV TFTVBJ ZBOH Mendeteksi Orientasi Kepala terhadap Gravitasi.%JCBHJBO
EJQFSMVLBOTFIJOHHBGVOHTJGVOHTJMBJOOZBEBQBUEJMBLVLBO QFSNVLBBO EBMBN EBSJ TFUJBQ VUSJLVMVT EBO TBLVMVT UFSMJIBU
Peran Nuklei Vestibular untuk Merangsang Otot-Otot QBEB CBHJBO BUBT (BNCBS UFSEBQBU EBFSBI TFOTPSJL LFDJM
Antigravitasi ZBOH EJBNFUFSOZB TFEJLJU MFCJI CFTBS EBSJ NN EBO EJTFCVU
4FMVSVI OVLMFJ WFTUJCVMBS UBNQBL EBMBN (BNCBS TFCBHBJ NBLVMB .BLVMB QBEB VUSJLVMVT UFSVUBNB UFSMFUBL QBEB
GVOHTJOZB CFSLBJUBO EFOHBO OVLMFJ SFUJLVMBS QPOT VOUVL CJEBOH IPSJ[POUBM QFSNVLBBO JOGFSJPS VUSJLVMVT EBO CFSQFSBO
NFOHFOEBMJLBO PUPUPUPU BOUJHSBWJUBTJ /VLMFJ WFTUJCVMBS QFOUJOHEBMBNNFOFOUVLBOPSJFOUBTJLFQBMBLFUJLBLFQBMBEBMBN
NFOHJSJN TJOZBM FLTJUBTJ ZBOH LVBU LF PUPUPUPU BOUJHSBWJUBTJ QPTJTJUFHBL4FCBMJLOZB NBLVMBQBEBTBLVMVTUFSVUBNBUFSMFUBL
NFMBMVJ USBLUVT WFTUJCVMPTQJOBMJT NFEJBMJT EBO MBUFSBMJT EBMBN EBMBN CJEBOH WFSUJLBM EBO NFNCFSJLBO TJOZBM PSJFOUBTJ LFQBMB
LPMVNOBBOUFSJPSNFEVMBTQJOBMJT TFQFSUJZBOHUBNQBLEBMBN TBBUTFTFPSBOHCFSCBSJOH
(BNCBS 5BOQB EVLVOHBO OVLMFJ WFTUJCVMBS TJTUFN
SFUJLVMBS QPOT BLBO NFOVSVO UJOHLBU FLTJUBTJOZB LF PUPUPUPU 4FUJBQNBLVMBEJUVUVQJPMFIMBQJTBOHFMBUJOPTBZBOHEJMFLBUJ
BOUJHSBWJUBTJBLTJBM PMFI CBOZBL LSJTUBM LBMTJVN LBSCPOBU LFDJMLFDJM ZBOH EJTFCVU
/BNVO QFSBO TQFTJGJL OVLMFJ WFTUJCVMBS BEBMBI VOUVL TUBUPLPOJB %BMBN NBLVMB KVHB EJEBQBUJ CFSJCVSJCV TFM
NFOHFOEBMJLBOTFDBSBTFMFLUJGTJOZBMTJOZBMFLTJUBUPSJL SBNCVU ZBOHTBMBITBUVOZBEJQFSMJIBULBOQBEB(BNCBS
TFMJOJBLBONFOPOKPMLBOTJMJBLFEBMBNMBQJTBOHFMBUJOPTBUBEJ
674
Ma ula
UNIT XI
#BHJBOCBTJTEBOTJTJTFMTFMSBNCVUCFSTJOBQTEFOHBOVKVOH
VKVOHTFOTPSJLTBSBGWFTUJCVMBS EBSJ DBJSBO FOEPMJNGF EJ TFLFMJMJOHOZB NFOJNCVMLBO
4UBUPLPOJB ZBOH NFOHBOEVOH LBMTJVN NFNJMJLJ HSBWJUBTJ EFQPMBSJTBTJ NFNCSBO SFTFQUPS 4FCBMJLOZB QFNCFOHLPLBO
TQFTJGJLEVBTBNQBJUJHBLBMJMFCJICFTBSEBSJQBEBHSBWJUBTJTQFTJGJL UBOHLBJ TUFSFPTJMJB LF BSBI ZBOH CFSMBXBOBO LF CFMBLBOH
DBJSBOEBOKBSJOHBOTFLJUBSOZB#FSBUTUBUPLPOJBNFNCFOHLPLLBO LJOPTJMJVN
NFOVSVOLBO UFHBOHBO QBEB QFMFLBUBO EBO
TJMJBEBMBNBSBIEPSPOHBOHSBWJUBTJ LFBEBBO JOJ BLBO NFOVUVQ TBMVSBO JPO EFOHBO EFNJLJBO
Sensitivitas Arah Sel Rambut—Kinosilium. 4FUJBQ TFM NFOJNCVMLBOIJQFSQPMBSJTBTJSFTFQUPS
SBNCVUNFNJMJLJTBNQBJTJMJBLFDJM ZBOHEJTFCVUTUFSFPTJMJB %BMBN LFBEBBO JTUJSBIBU OPSNBM TFSBUTFSBU TBSBG ZBOH
EJUBNCBITBUVTJMJVNCFTBS ZBJUVLJOPTJMJVN TFQFSUJZBOHUBNQBL LFMVBS EBSJ TFMTFM SBNCVU NFOHIBOUBSLBO JNQVMT TBSBG UFSVT
EBMBN(BNCBS,JOPTJMJVNTFMBMVUFSMFUBLEJTBUVTJTJ EBO NFOFSVTEFOHBOLFDFQBUBOTFLJUBSQFSEFUJL#JMBTUFSFPTJMJB
TUFSFPTJMJB TFDBSB QSPHSFTJG NFOKBEJ TFNBLJO QFOEFL LF BSBI TJTJ NFNCFOHLPL LF BSBI LJOPTJMJVN QFSKBMBOBO JNQVMT
MBJOQBEBTFM1FMFLBUBOGJMBNFOUPTBZBOHUJQJT ZBOHIBNQJSUJEBL NFOJOHLBU TFSJOH LBMJ TBNQBJ CFCFSBQB SBUVT QFS EFUJL
EBQBU UFSMJIBU CBILBO EFOHBO NJLSPTLPQ FMFLUSPO TFLBMJ QVO TFCBMJLOZB QFNCFOHLPLBO TJMJB ZBOH NFOKBVIJ LJOPTJMJB
NFOHIVCVOHLBO VKVOH TFUJBQ TUFSFPTJMJVN EFOHBO TUFSFPTJMJVN NFOVSVOLBOQFSKBMBOBOJNQVMT TFSJOHLBMJCBILBONFNBUJLBO
TFMBOKVUOZBZBOHMFCJIQBOKBOHEBO BLIJSOZB LFLJOPTJMJVN TFMVSVIOZB 0MFI LBSFOB JUV LFUJLB PSJFOUBTJ LFQBMB EBMBN IBM
0MFI LBSFOB QFMFLBUBOJOJ LBMBV TUFSFPTJMJB EBO LJOPTJMJVN JOJ CFSVCBI EBO CFSBU TUBUPLPOJB NFOZFCBCLBO TJMJB
NFMFLVLLFBSBILJOPTJMJVN QFMFLBUBOGJMBNFOUPTBBLBONFOBSJL NFNCFOHLPL TJOZBMTJOZBM ZBOH TFTVBJ BLBO EJIBOUBSLBO LF
TUFSFPTJMJB CFSJLVUOZB NFOEPSPOHOZB LF BSBI MVBS CBEBO TFM PUBLVOUVLNFOHBUVSLFTFJNCBOHBO
,FBEBBOJOJBLBONFNCVLBCFCFSBQBSBUVTTBMVSBODBJSBOEBMBN 1BEBTFUJBQNBLVMB TFUJBQTFMSBNCVUEJBSBILBOLFCFSCBHBJ
NFNCSBO TFM OFVSPO EJ TFLFMJMJOH EBTBS TUFSFPTJMJB EBO TBMVSBO KVSVTBO TFIJOHHBCFCFSBQBTFMSBNCVUUFSBOHTBOHLFUJLBLFQBMB
TBMVSBO UFSTFCVU NBNQV NFOHIBOUBSLBO JPO QPTJUJG EBMBN NFOVOEVL LF EFQBO EBO CFCFSBQB ZBOH MBJOOZB BLBO
KVNMBICFTBS0MFILBSFOBJUV JPOQPTJUJGNFOHBMJSLFEBMBNTFM UFSBOHTBOHLFUJLBLFQBMBNFOFOHBEBILFCFMBLBOH EBOZBOH
675
MBJOMBHJBLBOUFSBOHTBOHLFUJLBLFQBMBNJSJOHLFTBUVTJTJ EBO ,FEBMBNLVQVMBUFSEBQBUSBUVTBOQFOKVMVSBOTJMJBEBSJTFM

TFUFSVTOZB 0MFI LBSFOB JUV UJNCVM CFSCBHBJ QPMB FLTJUBTJ EJ TFMSBNCVUZBOHUFSMFUBLEJQVODBLLSJTUBBNQVMBSJT,JOPTJMJB
TFSBCVU TBSBG NBLVMB VOUVL TFUJBQ QPTJTJ LFQBMB EJ EBMBN TFMTFM SBNCVU JOJ TFNVBOZB CFSPSJFOUBTJ LF BSBI TJTJ ZBOH
MBQBOHBO HSBWJUBTJ QPMB JOJMBI ZBOH NFNCFSJUBIVLBO LF PUBL TBNB EBMBN LVQVMB EBO QFNCFOHLPLBO LVQVMB EBMBN BSBI
UFOUBOHQPTJTJLFQBMBEBMBNSVBOHBO UFSTFCVU NFOZFCBCLBO EFQPMBSJTBTJ TFMTFM SBNCVU TFEBOHLBO
Kanalis Semisirkularis. 5JHB LBOBMJT TFNJTJSLVMBSJT QBEB QFNCFOHLPLBO LF BSBI ZBOH CFSMBXBOBO NFOHBLJCBULBO
TFUJBQBQBSBUVTWFTUJCVMBS ZBJUVLBOBMJTTFNJTJSLVMBSJTBOUFSJPS IJQFSQPMBSJTBTJ TFM SBNCVU ,FNVEJBO EBSJ TFMTFM SBNCVU
QPTUFSJPS EBO MBUFSBM IPSJ[POUBM
UFSTVTVO TBMJOH UFHBL MVSVT TJOZBMTJOZBM UFSTFCVU EJLJSJN NFMBMVJ OFSWVT WFTUJCVMBSJT
TBUV TBNB MBJO TFIJOHHB LFUJHB LBOBMJT JOJ NFSFQSFTFOUBTJLBO VOUVL NFNCFSJUBIV TJTUFN TBSBG QVTBU NFOHFOBJ QFSVCBIBO
LFUJHB CJEBOH EBMBN SVBOH #JMB LFQBMB UVOEVL LJSBLJSB QFSQVUBSBO LFQBMB EBO LFDFQBUBO QFSVCBIBO QBEB TFUJBQ UJHB
EFSBKBU LF EFQBO LBOBMJT TFNJTJSLVMBSJT MBUFSBM LJSBLJSB BEB CJEBOHSVBOHBO
QBEB CJEBOH IPSJ[POUBM TFTVBJ EFOHBO QFSNVLBBO CVNJ 'VOHTJ6USJLVMVTEBO4BLVMVTEBMBN.FOKBHB,FTFJNCB
LFNVEJBOLBOBMJTBOUFSJPSBEBQBEBCJEBOHWFSUJLBMZBOHBSBI OHBO4UBUJL
QSPZFLTJOZB LF EFQBO EBO EFSBKBU LF MVBS EBO LBOBMJT 1FOFNQBUBO CFSNBDBNNBDBN TFM SBNCVU QBEB CFSNBDBN
QPTUFSJPS BEB QBEB CJEBOH WFSUJLBM ZBOH CFSQSPZFLTJ LF NBDBNBSBIEBMBNNBLVMBVUSJLVMVTEBOTBLVMVTNFSVQBLBOIBM
CFMBLBOHEBOEFSBKBULFMVBS ZBOH QFOUJOH TFIJOHHB QBEB CFSCBHBJ QPTJTJ LFQBMB BLBO
1BEB VKVOH BLIJS TFUJBQ LBOBMJT TFNJTJSLVMBSJT UFSEBQBU UFSBOHTBOH CFSNBDBNNBDBN TFM SBNCVU 1PMB QFSBOHTBOHBO
QFNCFTBSBO ZBOH EJTFCVU BNQVMB EBO LBOBMJT TFSUB BNQVMB CFSNBDBNNBDBN TFM SBNCVU BLBO NFOHHBNCBSLBO QBEB PUBL
JOJUFSJTJPMFIDBJSBOZBOHEJTFCVUFOEPMJNGF"MJSBODBJSBOEJ UFOUBOH QPTJTJ LFQBMB TFIVCVOHBO EFOHBO HBZB UBSJL HSBWJUBTJ
EBMBN LBOBMJT EBO BNQVMBOZB NFSBOHTBOH PSHBO TFOTPSJL 4FMBOKVUOZB TJTUFN TBSBG NPUPSJL WFTUJCVMBS TFSFCFMVN EBO
BNQVMB NFMBMVJ DBSB CFSJLVU JOJ (BNCBS SFUJLVMBSPUBLNFSBOHTBOHPUPUPUPUZBOHNFOKBHBLFTFJNCBOHBO
NFNQFSMJIBULBO QBEB TFUJBQ BNQVMB UFSEBQBU UPOKPMBO LFDJM 4JTUFN VUSJLVMVT EBO TBLVMVT UFSTFCVU CFSGVOHTJ TBOHBU
ZBOH EJTFCVU LSJTUB BNQVMBSJT 1BEB QVODBL LSJTUB JOJ FGFLUJG EBMBN NFOKBHB LFTFJNCBOHBO TBBU LFQBMB QBEB QPTJTJ
UFSEBQBU KBSJOHBO MPOHHBS NBTTB HFMBUJOPTB ZBOH EJTFCVU IBNQJS WFSUJLBM .FNBOH TFTFPSBOH EBQBU NFOFOUVLBO
LVQVMB#JMBLFQBMBTFTFPSBOHNVMBJNFNVUBSLFTVBUVBSBI NFSBTBLBO LFBEBBO UJEBL TFJNCBOH IJOHHB TFLFDJM TFUFOHBI
JOFSTJBDBJSBOEJEBMBNTBUVBUBVMFCJILBOBMJTTFNJTJSLVMBSJT EFSBKBU CJMB UVCVI CFSVCBI DPOEPOH EBSJ QPTJTJ TFCFMVNOZB
BLBO NFNQFSUBIBOLBO DBJSBO VOUVL UFUBQ UBL CFSHFSBL ZBOHUFQBUUFHBL
TFNFOUBSB LBOBMJT TFNJTJSLVMBSJT CFSQVUBS TFBSBI EFOHBO Deteksi Percepatan Linear oleh Makula Utrikulus dan
LFQBMB )BM JOJ NFOZFCBCLBO DBJSBO NFOHBMJS EBSJ LBOBMJT Sakulus. #JMB UVCVI UJCBUJCB EJEPSPOH LF EFQBO ZBLOJ TBBU
NFOVKV LF BNQVMB NFNCFOHLPLLBO LVQVMB LF TBUV TJTJ UVCVI NFOHBMBNJ QFSDFQBUBO TUBUPLPOJB ZBOH NFNQVOZBJ
TFQFSUJ ZBOH EJQFSMJIBULBO PMFI QPTJTJ LVQVMB UFSXBSOBJ LFMFNCBNBO JOFSTJB
NBTTB ZBOH MFCJI CFTBS EBSJ DBJSBO
EBMBN (BNCBS 1VUBSBO LFQBMB EBMBN BSBI ZBOH TFLFMJMJOHOZB KBUVI LF CFMBLBOH CFSTBNB EFOHBO TJMJB TFMTFM
CFSMBXBOBO NFOZFCBCLBO LVQVMB NFNCFOHLPL LF TJTJ ZBOH SBNCVU EBO JOGPSNBTJ NFOHFOBJ LFUJEBLTFJNCBOHBO BLBO
CFSMBXBOBOQVMB EJLBCBSLBO LF QVTBUQVTBU TBSBG TFIJOHHB PSBOH NFSBTB TFQFSUJ
KBUVI LF CFMBLBOH ,FBEBBO JOJ BLBO NFOZFCBCLBO PSBOH TFDBSB
PUPNBUJTNFODPOEPOHLBOCBEBOOZBLFEFQBOTBNQBJQFSHFTFSBO
TUBUPLPOJBLFBOUFSJPSUFQBUNFOZBNBJLFDFOEFSVOHBOTUBUPLPOJB
VOUVLKBUVILFCFMBLBOHBLJCBUBLTFMFSBTJUFSTFCVU1BEBUJUJLJOJ
TJTUFN TBSBG BLBO EBQBU NFSBTBLBO LFBEBBO LFTFJNCBOHBO ZBOH
UFQBU EBO UJEBL MFCJI KBVI MBHJ EBMBN NFODPOEPOHLBO UVCVI LF
EFQBO +BEJ NBLVMB CFSUVHBT VOUVL NFOKBHB LFTFJNCBOHBO
TFMBNB UFSKBEJ QFSDFQBUBO MJOFBS EFOHBO QPMB ZBOH UFQBU TBNB
TFQFSUJLFUJLBNBLVMBCFLFSKBQBEBLFTFJNCBOHBOTUBUJL
.BLVMB UJEBL CFLFSKB VOUVL NFOEFUFLTJ LFDFQBUBO MJOFBS #JMB
TFPSBOHQFMBSJNVMBJCFSMBSJ JBIBSVTNFODPOEPOHLBOEJSJOZBKBVI
LFEFQBOEVMVBHBSUBLTBNQBJKBUVILFCFMBLBOHBLJCBUNFOHBMBNJ
QFSDFQBUBO BXBM UFUBQJ TBBU JB UFMBI NFODBQBJ LFDFQBUBO ZBOH
NBLTJNVN CJMB MBSJ EBMBN SVBOH IBNQB JB UBL MBHJ IBSVT
NFODPOEPOHLBOCBEBOOZBLFEFQBO#JMBCFSMBSJEJVEBSBUFSCVLB
JB BLBO NFODPOEPOHLBO EJSJOZB LF EFQBO IBOZB VOUVL NFOKBHB
LFTFJNCBOHBO BLJCBU UBIBOBO VEBSB ZBOH NFMBXBO UVCVIOZB
QBEBDPOUPIJOJ CVLBONBLVMBZBOHNFOZFCBCLBOJBDPOEPOHLF
EFQBOUBQJUFLBOBOVEBSBZBOHCFLFSKBQBEBSFTFQUPSUFLBOBOQBEB
LVMJU ZBOHNFNVMBJQFOFOUVBOLFTFJNCBOHBOZBOHTFTVBJBHBSUBL
TBNQBJKBUVI
676
Deteksi Rotasi Kepala oleh Kanalis Semisirkularis LBOBMJT TFNJTJSLVMBSJT ZBOH TFCFOBSOZB EBMBN NFOKBHB
LFTFJNCBOHBO "QB ZBOH EJEFUFLTJ LBOBMJT UFSTFCVU BEBMBI
#JMB LFQBMB UJCBUJCB NVMBJ CFSQVUBS LF TVBUV BSBI EJTFCVU
CBIXBLFQBMBTFTFPSBOHNVMBJBUBVCFSIFOUJCFSQVUBSQBEBTBMBI
QFSDFQBUBOTVEVU
FOEPMJNGFEBMBNLBOBMJTTFNJTJSLVMBSJT BLJCBU
TBUV BSBI BUBV BSBI MBJOOZB 0MFI LBSFOB JUV UBNQBLOZB GVOHTJ
FGFL JOFSTJBOZB DFOEFSVOH NFOFUBQ TFEBOHLBO LBOBMJT
LBOBMJT TFNJTJSLVMBSJT CVLBOMBI VOUVL NFOKBHB LFTFJNCBOHBO
UNIT XI
TFNJTJSLVMBSJT BLBO CFSQVUBS ,FBEBBO JOJ NFOZFCBCLBO DBJSBO
TUBUJL BUBV NFOKBHB LFTFJNCBOHBO TFMBNB BEBOZB HFSBLBO
TFDBSB SFMBUJG NFOHBMJS EBMBN LBOBMJT EFOHBO BSBI ZBOH
CFSQVUBS BUBV MVSVT ZBOH NFOFUBQ 5FSOZBUB CJMB GVOHTJ LBOBMJT
CFSMBXBOBOEFOHBOQFSQVUBSBOLFQBMB
TFNJTJSLVMBSJTIJMBOH LFTFJNCBOHBOPSBOHJUVBLBOMFNBITFLBMJ
(BNCBS NFOVOKVLLBO TVBUV TJOZBM LIBT ZBOH
TFXBLUV JB NFODPCB NFMBLVLBO HFSBLBO UVCVI ZBOH DFQBU EBO
EJLFMVBSLBOPMFITBUVTFMSBNCVUEBMBNLSJTUBBNQVMBSJTTFXBLUV
SVNJU
IFXBO EJQVUBS TFMBNB EFUJL EJQFSMJIBULBO CBIXB
'VOHTJLBOBMJTTFNJTJSLVMBSJTEBQBUEJKFMBTLBONFMBMVJJMVTUSBTJ
XBMBVQVO LVQVMB EBMBN QPTJTJ JTUJSBIBU TFM SBNCVUOZB CFSJLVU#JMBTFTFPSBOHCFSMBSJLFEFQBOEFOHBODFQBUTFLBMJ EBO
NFMFQBTLBO JNQVMT ZBOH LVBU TFLJUBS JNQVMT QFS EFUJL
EFOHBO UJCBUJCB JB NVMBJ CFSQVUBS LF TBMBI TBUV TJTJ TFDBSB UBL
TBBUIFXBONVMBJEJQVUBS SBNCVUSBNCVUCFSCFMPLLFTBMBITBUV UFSEVHB EBMBN XBLUV TBUV EFUJL BUBV MFCJI JB BLBO LFIJMBOHBO
TJTJ EBO LFDFQBUBO QFOHFMVBSBO JNQVMT BLBO TBOHBU NFOJOHLBU LFTFJNCBOHBO LFDVBMJ KJLB EJMBLVLBO LPSFLTJ CFCFSBQB XBLUV
EBO
CJMB QVUBSBO EJUFSVTLBO NBLB QFOHFMVBSBO JNQVMT ZBOH TFCFMVNOZB /BNVO NBLVMB ZBOH UFSEBQBU EJ EBMBN VUSJLVMVT
CFSMFCJIBO EBO TFM SBNCVU TFDBSB CFSUBIBQ LFNCBMJ LF OJMBJ EBO TBLVMVT UBL EBQBU NFOEFUFLTJ LFUJEBLTFJNCBOHBO UBEJ
JTUJSBIBUTFMBNBCFCFSBQBEFUJLCFSJLVUOZB TBNQBJTFTVEBIUFSKBEJLFBEBBOLFUJEBLTFJNCBOHBO4FCBMJLOZB
1FOZFCBC UJNCVMOZB BEBQUBTJ JOJ QBEB SFTFQUPS BEBMBI CBIXB LBOBMJT TFNJTJSLVMBSJT CBSV EBQBU NFOEFUFLTJ TFUFMBI PSBOH JUV
TBBUEJQVUBSTFMBNBCFCFSBQBEFUJLQFSUBNB UBIBOBOLFCFMBLBOH TVEBI CFSQVUBS EBO JOGPSNBTJ JOJ EFOHBO NVEBI EBQBU
UFSIBEBQ BMJSBO DBJSBO QBEB LBOBMJT TFNJTJSLVMBSJT EBO NFMFXBUJ NFOHBCBSLBO QBEB TJTUFN TBSBG QVTBU CBIXB PSBOH JUV EBMBN
LVQVMBZBOHTFEBOHNFNCFOHLPLNFOZFCBCLBOFOEPMJNGFNVMBJ XBLUV CFCFSBQB EFUJL BUBV MFCJI CFSJLVUOZB BLBO LFIJMBOHBO
CFSQVUBS EFOHBO LFDFQBUBO ZBOH TBNB DFQBUOZB EFOHBO LFTFJNCBOHBO LFDVBMJCJMBEJCVBUTVBUVLPSFLTJVOUVLBOUJTJQBTJ
LFDFQBUBO LBOBMJT TFNJTJSLVMBSJT JUV TFOEJSJ TFMBOKVUOZB EBMBN %FOHBO LBUB MBJO NFLBOJTNF LBOBMJT TFNJTJSLVMBSJT EBQBU
XBLUV TBNQBJ EFUJL LVQVMB TFDBSB QFSMBIBO LFNCBMJ LF NFSBNBMLBO CBIXB BLBO UFSKBEJ LFUJEBLTFJNCBOHBO TFIJOHHB
QPTJTJJTUJSBIBU ZBLOJEJCBHJBOUFOHBIBNQVMB BLJCBUTJGBUMFOUJOH NFOZFCBCLBO QVTBU LFTFJNCBOHBO NFOHBEBLBO UJOEBLBO
FMBTUJLOZB QFODFHBIBO BOUJTJQBTJ ZBOH TFTVBJ )BM JOJ EBQBU NFNCBOUV
#JMB QVUBSBO EFOHBO UJCBUJCB EJIFOUJLBO KFMBT BLBO UJNCVM PSBOH NFNQFSUBIBOLBO LFTFJNCBOHBO TFCFMVN TJUVBTJ LFBEBBO
BLJCBU ZBOH TFCBMJLOZB $BJSBO FOEPMJNGF UFUBQ UFSVT CFSQVUBS UJEBLTFJNCBOHEBQBUEJLPSFLTJ
TFEBOHLBO LBOBMJT TFNJTJSLVMBSJTOZB CFSIFOUJ 1BEB TBBU JOJ 1FNCVBOHBO MPCVT GMPLVMPOPEVMBSJT TFSFCFMVN EBQBU
LVQVMBBLBONFNCFOHLPLLFBSBIZBOHCFSMBXBOBO TFIJOHHBTFM NFOHIBNCBU QFSBO EFUFLTJ TJOZBM LBOBMJT TFNJTJSLVMBSJT UBQJ
TFM SBNCVU UBL NFOHFMVBSLBO JNQVMT TBNB TFLBMJ 4FTVEBI FGFLOZB QBEB EFUFLTJ TJOZBM NBLVMBS MFCJI LFDJM )BM ZBOH
CFCFSBQB EFUJL DBJSBO FOEPMJNGF CFSIFOUJ CFSHFSBL EBO LVQVMB NFOBSJL BEBMBI CBIXB TFSFCFMVN EBQBU CFSMBLV TFCBHBJ PSHBO
TFDBSB CFSUBIBQ BLBO LFNCBMJ LFQPTJTJ JTUJSBIBU KBEJ QFOHFMVBSBO QSFEJLTJ CBHJ TFCBHJBO CFTBS HFSBLBO UVCVI ZBOH DFQBU
JNQVMT EBO TFMTFM SBNCVU BLBO LFNCBMJ LF OJMBJ UPOJL ZBOH EFNJLJBO QVMB VOUVL TFNVB LFBEBBO ZBOH CFSLBJUBO EFOHBO
OPSNBM TFQFSUJ ZBOH UBNQBL QBEB CBHJBO LBOBO (BNCBS LFTFJNCBOHBO 'VOHTJ QSFEJLTJ TFSFCFMVN UFSTFCVU BLBO
+BEJ LBOBMJT TFNJTJSLVMBSJT BLBO NFOHJSJN TJOZBM EFOHBO EJCJDBSBLBOEBMBNCBCTFMBOKVUOZB
QPMBSJUBT UFSUFOUV CJMB LFQBMB NVMBJ CFSQVUBS EBO EFOHBO Mekanisme Vestibular untuk Menstabilkan Mata
QPMBSJUBTZBOHCFSMBXBOBOCJMBLFQBMBCFSIFOUJCFSQVUBS #JMB TFTFPSBOH NFOHVCBI BSBI HFSBLBOOZB EFOHBO DFQBU BUBV
Fungsi "Prediksi" Sistem Kanalis Semisirkularis dalam NFODPOEPOHLBOLFQBMBOZBLFTBMBITBUVTJTJ NJTBMOZBLFEFQBOBUBV
LFCFMBLBOH PSBOHJUVUBLNVOHLJOEBQBUNFNQFSUBIBOLBOCBZBOHBO
Menjaga Keseimbangan.0MFILBSFOBLBOBMJTTFNJTJSLVMBSJTUBL
ZBOH TUBCJM QBEB SFUJOBOZB LFDVBMJ CJMB JB NFNQVOZBJ CFCFSBQB
NFOEFUFLTJCBIXBUVCVIEBMBNLFBEBBOUBLTFJNCBOHTFXBLUV NFLBOJTNF QFOHFOEBMJBO ZBOH TFDBSB PUPNBUJT EBQBU
NFNQFSUBIBOLBO BSBI QBOEBOHBO NBUBOZB 4FMBJO JUV TFCFOBSOZB
400 VOUVL NFOEFUFLTJ TVBUV CBZBOHBO EJQFSMVLBO TFEJLJU TBKB CBOUVBO
NBUB LFDVBMJ CJMB NBUB JUV EBQBU EJQFSUBIBOLBO VOUVL UFSGJLTBTJ
300 NFNBOEBOH TVBUV PCKFL EBMBN XBLUV ZBOH DVLVQ MBNB TBNQBJ
NFNQFSPMFI CBZBOHBO ZBOH KFMBT 6OUVOHOZB TFUJBQ LBMJ LFQBMB
CFSQVUBS UJCBUJCB TJOZBM ZBOH CFSBTBM EBSJ LBOBMJT TFNJTJSLVMBSJT
200 NFOZFCBCLBO NBUB CFSQVUBS EFOHBO BSBI ZBOH CFSMBXBOBO EFOHBO
BSBI QVUBSBO LFQBMB ,FBEBBO JOJ UJNCVM BLJCBU BEBOZB SFGMFLT ZBOH
100 EJLJSJNLBO NFMBMVJ OVLMFJ WFTUJCVMBS EBO GBTJLVMVT MPOHJUVEJOBMJT
NFEJBMJT NFOVKV OVLMFJ PLVMPNPUPS 3FGMFLT UFSTFCVU UFMBI EJCBIBT
Begin rotation QBEB#BC
0
0 10 20 30 40 50 60 70 80 90
Faktor-Faktor Lain yang Berhubungan dengan
Keseimbangan Proprioseptor Leher.
"QBSBUVT WFTUJCVMBS IBOZB NFOEFUFLTJ PSJFOUBTJ EBO HFSBLBO LFQBMB
0MFI LBSFOB JUV QBEB QSJOTJQOZB QVTBUQVTBU TBSBG KVHB NFOFSJNB
JOGPSNBTJ ZBOH TFTVBJ NFOHFOBJ PSJFOUBTJ LFQBMB TFIVCVOHBO EFOHBO
CFSHFSBL LF BSBI EFQBO LF BSBI TBMBI TBUV TJTJ BUBV LF BSBI LFBEBBO UVCVI *OGPSNBTJ JOJ EJLJSJNLBO EBSJ QSPQSJPTFQUPS EJ MFIFS
CFMBLBOHNBLBQFSUBOZBBOZBOHEJBKVLBOBEBMBI"QBGVOHTJ EBO UVCVI MBOHTVOH NFOVKV OVLMFJ WFTUJCVMBS EBO OVLMFJ SFUJLVMBS EJ
CBUBOHPUBLEBOTFDBSB
677
Unit Xl Sistem Saraf C. Neurofisiologis Motorik dan integratif
TFDBSBUBLMBOHTVOHLFTFSFCFMVN
%JBOUBSBJOGPSNBTJQSPQSJPTFQUJGQFOUJOHZBOHEJQFSMVLBOVOUVL
NFOKBHB LFTFJNCBOHBO BEBMBI ZBOH EJLJSJNLBO PMFI SFTFQUPS
SFTFQUPS QFSTFOEJBO EJ MFIFS #JMB LFQBMB DPOEPOH LF TBMBI TBUV TJTJ
BLJCBU NFOFLVLOZB MFIFS JNQVMT ZBOH CFSBTBM EBO QSPQSJPTFQUPS
MFIFS EBQBU NFODFHBI TJOZBM ZBOH UFSCFOUVL EJ EBMBN BQBSBUVT
WFTUJCVMBS NFODFUVTLBO SBTB LFUJEBLTFJNCBOHBO QBEB TFTFPSBOH
$BSBOZBBEBMBIEFOHBONFOHJSJNLBOTJOZBMTJOZBMZBOHCFSMBXBOBO
EFOHBOTJOZBMZBOHEJLJSJNLBOEBSJBQBSBUVTWFTUJCVMBS/BNVO CJMB
TFMVSVI UVCVI DPOEPOH LF TBMBI TBUV TJTJ JNQVMT ZBOH CFSBTBM EBSJ
BQBSBUVTWFTUJCVMBSUBLEJMBXBOPMFITJOZBMEBSJQSPQSJPTFQUPSMFIFS
TFIJOHHB QBEB LFBEBBO JOJ PSBOH UFSTFCVU BLBO NFSBTBLBO BEBOZB
QFSVCBIBOLFBEBBOLFTFJNCBOHBOQBEBTFMVSVIUVCVI
Informasi Proprioseptif dan Eksteroseptif dari Bagian-
Bagian Tubuh Lainnya *OGPSNBTJ QSPQSJPTFQUJG ZBOH CFSBTBM
EBSJ CBHJBO UVCVI TFMBJO MFIFS KVHB QFOUJOH VOUVL NFOKBHB
LFTFJNCBOHBO $POUPIOZB TFOTBTJ UFLBO ZBOH CFSBTBM EBSJ UFMBQBL
LBLJ NFNCFSJLBO JOGPSNBTJ
BQBLBI TVEBI BEB QFNCBHJBO CFSBU
ZBOH NFSBUB EJ BOUBSB LFEVB LBLJ EBO
BQBLBI CFSBU QBEB LBLJ
UBEJMFCJIDPOEPOHLFEFQBOBUBVLFCFMBLBOH
KBEJTFDBSBPUPNBUJTNFOHBUVSLFTFJNCBOHBO
*OGPSNBTJ FLTUFSPTFQUJG UFSVUBNB CFSHVOB VOUVL NFOKBHB
LFTFJNCBOHBO ZBLOJ TBBU TFTFPSBOH TFEBOH CFSMBSJ 5FLBOBO VEBSB -PCVT GMPLVMPOPEVMBSJT TFSFCFMVN TFDBSB LIVTVT CFSIVCVOHBO
UFSIBEBQ CBHJBO EFQBO UVCVI NFSVQBLBO TJOZBM ZBOH NFOEPSPOH EFOHBO TJOZBM LFTFJNCBOHBO EJOBNJT ZBOH CFSBTBM EBSJ LBOBMJT
UVCVI EBMBN BSBI ZBOH CFSCFEB EFOHBO UFLBOBO BLJCBU EPSPOHBO TFNJTJSLVMBSJT 4FTVOHHVIOZB LFSVTBLBO MPCVT UFSTFCVU
HSBWJUBTJ 4FIJOHHB VOUVL NFMBXBO HSBWJUBTJ JOJ PSBOH NFOHBLJCBULBO HFKBMBHFKBMB LMJOJT ZBOH IBNQJS TBNB EFOHBO HFKBMB
NFODPOEPOHLBOCBEBOOZBLFEFQBO BLJCBU LFSVTBLBO LBOBMJT TFNJTJSLVMBSJT JUV TFOEJSJ "SUJOZB DFEFSB
Makna Informasi Visual dalam Menjaga Keseimbangan. CFSBU QBEB TBMBI TBUV PSHBO BQBLBI MPCVT BUBV QVO LBOBMJT BLBO
4FTVEBI LFSVTBLBO BQBSBUVT WFTUJCVMBS EBO CBILBO TFTVEBI NFOZFCBCLBO IJMBOHOZB LFTFJNCBOHBO EJOBNJL TFMBNB QFSVCBIBO
TFCBHJBOCFTBSJOGPSNBTJQSPQSJPTFQUJGUVCVIIJMBOH UFSOZBUBQBTJFO BSBI HFSBL ZBOH DFQBU UFUBQJ UJEBL TFDBSB TFSJVT NFOHHBOHHV
NBTJI CJTB NFOHHVOBLBO NFLBOJTNF WJTVBMOZB TFDBSB BHBL FGFLUJG LFTFJNCBOHBO QBEB LFBEBBO TUBUJL %JEVHB CBIXB VWVMB TFSFCFMVN
VOUVL NFOKBHB LFTFJNCBOHBO #BILBO HFSBLBO MJOFBS BUBV HFSBLBO NFNQVOZBJQFSBOQFOUJOHZBOHNJSJQQBEBLFTFJNCBOHBOTUBUJL
SPUBTJUVCVIBLBOTFHFSBNFOHHFTFSCBZBOHBOQFOHMJIBUBOZBOHBEB 4JOZBMTJOZBM EBSJ OVLMFJ WFTUJCVMBS EBO TFSFCFMVN NFMBMVJ
EJ SFUJOB EBO TFMBOKVUOZB JOGPSNBTJ JOJ BLBO EJLJSJNLBO LF QVTBU GBTJLVMVTMPOHJUVEJOBMJTNFEJBMJTZBOHEJLJSJNLFBUBTNFOVKVCBUBOH
LFTFJNCBOHBO#FCFSBQBQBTJFOZBOHNFOHBMBNJLFSVTBLBOCJMBUFSBM PUBL NFOZFCBCLBO QFSCBJLBO HFSBLBO NBUB TFUJBQ LBMJ LFQBMB
BQBSBUVT WFTUJCVMBS NBTJI NFNQVOZBJ LFTFJNCBOHBO ZBOH IBNQJS CFSQVUBS TFIJOHHB NBUB UFUBQ UFSGJLTBTJ QBEB TVBUV PCKFL
TFMVSVIOZB OPSNBM TFMBNB LFEVB NBUBOZB UFSCVLB EBO TFMBNB QFOHMJIBUBO ZBOH TQFTJGJL 4JOZBMTJOZBM KVHB EJLJSJN LF BUBT CBJL
HFSBLBOHFSBLBO UVCVI EJMBLVLBO TFDBSB MBNCBU /BNVO CJMB NFMBMVJ USBLUVT ZBOH TBNB BUBV NFMBMVJ USBLUVT SFUJLVMBSJT
NFOVKV
QFOHFSBLBO DFQBU TFLBMJ BUBV CJMB NBUB QBTJFO EJUVUVQ LPSUFLT TFSFCSJ CFSBLIJS EJ QVTBU LPSUFLT QSJNFS VOUVL
LFTFJNCBOHBOTFHFSBIJMBOH LFTFJNCBOHBO ZBOH UFSMFUBL EJ CBHJBO EBMBN GJTVSB 4ZMWJJ MPCVT
QBSJFUBMJT ZBLOJ EJ TJTJ MBJO GJTVSB EBO BSFB BVEJUPSJL HJSVT
Hubungan Neuronal antara Aparatus Vestibutar dengan Sistem UFNQPSBMJTTVQFSJPS4JOZBMTJOZBMJOJBLBONFNCFSJUBIVLBOUFOUBOH
Saraf Pusat LFBEBBOKJXBTUBUVTLFTFJNCBOHBOUVCVI
(BNCBS NFMVLJTLBO IVCVOHBO OFSWVT WFTUJCVMBSJT QBEB PUBL
CFMBLBOH4FCBHJBOCFTBSTFSBUTFSBUTBSBGWFTUJCVMBSUFSTFCVUCFSBLIJS
Fungsi Nuktel Batang Otak dalam Pengendalian
QBEB CBUBOH PUBL EJ OVLMFJ WFTUJCVMBS ZBOH UFSMFUBL EJ TFLJUBS
QFSUFNVBO BOUBSB NFEVMB EBO QPOT #FCFSBQB TFSBUTFSBU TBSBG JOJ Gerakan Stereotipik Tidak Disadari
MFXBUTFDBSBMBOHTVOHLFOVLMFJSFUJLVMBSCBUBOHPUBLUBOQBCFSTJOBQT
EBO KVHB LF OVLMFJ MPCVT GBTUJHJVT TFSFCFMVN VWVMB EBO ,BEBOH TFPSBOH CBZJ EJMBIJSLBO UBOQB CBHJBO PUBL EJ BUBT SFHJP
GMPLVMPOPEVMBSJT4FSBUTFSBUZBOHCFSBLIJSEJOVLMFJWFTUJCVMBSCBUBOH NFTFOTFGBMJL EJTFCVUBOFOTFGBMJ#FCFSBQBEJBOUBSBCBZJCBZJUFSTFCVU
PUBL CFSTJOBQT EFOHBO OFVSPO LF EVB ZBOH KVHB NFOHJSJNLBO TFSBU EBQBU IJEVQ TBNQBJ CFCFSBQB CVMBO 1BEB VNVNOZB BOBLBOBL JOJ
TFSBU NFOVKV TFSFCFMVN USBLUVT WFTUJCVMPTQJOBMJT GBTJLVMVT EBQBU NFMBLVLBO CFCFSBQB HFSBLBO TUFSFPUJQJL VOUVL NBLBO TFQFSUJ
MPOHJUVEJOBMJT NFEJBMJT EBO CBHJBOCBHJBO MBJO CBUBOH PUBL NFOHJTBQ NFNCVBOH NBLBOBO ZBOH UBL NFOZFOBOHLBO EBSJ
LIVTVTOZBOVLMFJSFUJLVMBSJT NVMVUOZB EBO NFOHHFSBLLBO UBOHBO LF NVMVUOZB VOUVL NFOHJTBQ
+BSBT QSJNFS SFGMFLTSFGMFLT LFTFJNCBOHBO EJNVMBJ EBMBN OFSWVT KBSJ 4FMBJO JUV BOBL UFSTFCVU EBQBU NFOHVBQ EBO NFSFOUBOHLBO
WFTUJCVMBSJT ZBJUV TBSBG ZBOH EJSBOHTBOH PMFI BMBU WFTUJCVMBS +BSBT CBEBOOZB "OBL UFSTFCVU EBQBU NFOBOHJT EBO NFOHJLVUJ PCKFL
UFSTFCVU CFSKBMBO LF OVLMFJ WFTUJCVMBS EBO TFSFCFMVN 4FMBOKVUOZB EFOHBONBUBEBOEFOHBONFOHHFSBLLBOLFQBMB+VHB CJMBCBHJBOBUBT
TJOZBMTJOZBM EJLJSJN LF OVLMFJ SFUJLVMBS CBUBOH PUBL NBVQVO LF BOUFSJPS LBLJOZB EJUFLBO BOBL JUV BLBO NFOBSJL EBO NFOFNQBULBO
NFEVMB TQJOBMJT NFMBMVJ USBLUVT WFTUJCVMPTQJOBMJT EBO USBLUVT LBLJ LF QPTJTJ EVEVL +BEJ KFMBTMBI CBIXB TFCBHJBO CFTBS GVOHTJ
SFUJLVMPTQJOBMJT 4JOZBMTJOZBM LF NFEVMB NFOHBUVS GBTJMJUBTJ EBO NPUPSJLNBOVTJBZBOHTUFSFPUJQJLEJJOUFHSBTJLBOEJCBUBOHPUBL
JOIJCJTJCBOZBLPUPUBOUJHSBWJUBTJZBOHTBMJOHNFOHBUVSTBUVTBNBMBJO
678
Bab 55 Pengaturan fungsi Motorik oleh Korteks dan Batang Otak
Daftar Pustaka Nishitani N, Schürmann M, Amunts K, et al: Broca’s region: from action to
language, Physiology (Bethesda) 20:60, 2005.
Angelaki DE, Cullen KE: Vestibular system: the many facets of a multimodal Nielsen JB, Cohen LG: The Olympic brain. Does corticospinal plasticity play
sense, Annu Rev Neurosci 31:125, 2008. a role in acquisition of skills required for high-performance sports?
Baker SN: Oscillatory interactions between sensorimotor cortex and the J Physiol 586:65, 2008.
UNIT XI
periphery, Curr Opin Neurobiol 17:649, 2007. Pierrot-Deseilligny C: Effect of gravity on vertical eye position, Ann N Y Acad
Briggs F, Usrey WM: Emerging views of corticothalamic function, Curr Opin Sci 1164:155, 2009.
Neurobiol 18:403, 2008. Raineteau O: Plastic responses to spinal cord injury, Behav Brain Res
Cullen KE, Roy JE: Signal processing in the vestibular system during active 192:114, 2008.
versus passive head movements, J Neurophysiol 91:1919, 2004. Robles L, Ruggero MA: Mechanics of the mammalian cochlea, Physiol Rev
Fabbri-Destro M, Rizzolatti G: Mirror neurons and mirror systems in mon- 81:1305, 2001.
keys and humans, Physiology (Bethesda) 23:171, 2008. Schieber MH: Motor control: basic units of cortical output? Curr Biol
Holtmaat A, Svoboda K: Experience-dependent structural synaptic plastic- 14:R353, 2004.
ity in the mammalian brain, Nat Rev Neurosci 10:647, 2009. Scott SH: Inconvenient truths about neural processing in primary motor
Horak FB: Postural compensation for vestibular loss, Ann N Y Acad Sci cortex, J Physiol 586:1217, 2008.
1164:76, 2009. Scott SK, McGettigan C, Eisner F: A little more conversation, a little less
Klier EM, Angelaki DE: Spatial updating and the maintenance of visual con- action—candidate roles for the motor cortex in speech perception, Nat
stancy, Neuroscience 156:801, 2008. Rev Neurosci 10:295, 2009.
Lemon RN: Descending pathways in motor control, Annu Rev Neurosci Stepien AE, Arber S: Probing the locomotor conundrum: descending the ‘V’
31:195, 2008. interneuron ladder, Neuron 60:1, 2008.
Müller U: Cadherins and mechanotransduction by hair cells, Curr Opin Cell Umilta MA: Frontal cortex: goal-relatedness and the cortical motor system,
Biol 5:557, 2008. Curr Biol 14:R204, 2004.
Nachev P, Kennard C, Husain M: Functional role of the supplementary and
pre-supplementary motor areas, Nat Rev Neurosci 9:856, 2008.
679
BAB 56
UNIT XI
,POUSJCVTJ4FSFCFMVNEBO(BOHMJB#BTBMJT
QBEB4FMVSVI1FOHFOEBMJBO.PUPSJL
4FMBJO BSFBBSFB QBEB LPSUFLT NFNPOJUPS EBO NFNQFSCBJLJ QFOZFTVBJBO BLUJWJUBT NPUPSJL
TFSFCSJ ZBOH NFSBOHTBOH UVCVILFUJLBBLUJWJUBTUFSTFCVUTFEBOHEJKBMBOLBOTFIJOHHBEBQBU
LPOUSBLTJ PUPU NBTJI UFSEBQBU NFOZFTVBJLBO EJSJ UFSIBEBQ TJOZBMTJOZBM NPUPSJL ZBOH
EVB TUSVLUVS MBJO QBEB PUBL EJDFUVTLBOPMFILPSUFLTNPUPSJLTFSFCSJEBOCBHJBOPUBLMBJOOZB
ZBOHKVHBQFOUJOHVOUVLGVOHTJ 4FSFCFMVN JOJ UFSVTNFOFSVT NFOFSJNB JOGPSNBTJ UFSCBSV
NPUPSJL OPSNBM ,FEVB NFOHFOBJVSVUBOLPOUSBLTJPUPUTFTVBJEFOHBOZBOHEJJOHJOLBO
TUSVLUVSUFSTFCVUBEBMBI EBSJ BSFB QFOHFOEBMJ NPUPSJL PUBL TFSFCFMVN KVHB UFSVT
TFSFCFMVNEBOHBOHMJBCBTBMJT5FUBQJUJEBLTBUVQVOEBSJLFEVB NFOFSVT NFOFSJNB JOGPSNBTJ TFOTPSJL EBSJ CBHJBO QFSJGFS
TUSVLUVS JOJ TFDBSB NBOEJSJ EBQBU NFOHFOEBMJLBO GVOHTJ PUPU UVCVI ZBOHNFNCFSJUBIVNFOHFOBJCFSCBHBJQFSVCBIBOTFUJBQ
4FCBMJLOZB LFEVB TUSVLUVS UFSTFCVU TFMBMV CFSGVOHTJ EBMBN CBHJBO UVCVI QPTJTJ LFDFQBUBO HFSBL LFLVBUBO HFSBLOZB EBO
LBJUBOEFOHBOTJTUFNMBJOOZBQBEBQFOHFOEBMJBONPUPSJL TFCBHBJOZB 4FSFCFMVN LFNVEJBO NFNCBOEJOHLBO LFBEBBO
4FSFCFMVNCFSQFSBOQFOUJOHEBMBNNFOFOUVLBOTBBUBLUJWJUBT TFUJBQCBHJBOUVCVIQBEBTBBUTFLBSBOH ZBOHEJUJNCVMLBOPMFI
NPUPSJLEBOQFOHBMJIBOZBOHDFQBUEBONVMVTEBSJTBUVHFSBLBO JOGPSNBTJ TFOTPSJL ZBOH CFSTJGBU VNQBO CBMJL EBSJ QFSJGFS
PUPU LF HFSBLBO CFSJLVUOZB 4FSFCFMVN KVHB NFNCBOUV EBMBN EFOHBO HFSBLBO ZBOH EJJOHJOLBO PMFI TJTUFN NPUPSJL #JMB
QFOHFOEBMJBO JOUFOTJUBT LPOUSBLTJ PUPU LFUJLB CFCBO PUPU LFEVBEVBOZBUBLTFSBTJNBLBEFOHBOTFHFSBBLBOEJLFMVBSLBO
CFSVCBI EFNJLJBO QVMB EBMBN QFOHFOEBMJBO JOUFSBLTJ TFTBBU TJOZBM QFSCBJLBO CBXBI TBEBS ZBOH EJLJSJNLBO LFNCBMJ LF
BOUBSBLFMPNQPLPUPUBHPOJTEBOBOUBHPOJT TJTUFNNPUPSJLHVOBNFOJOHLBULBOBUBVNFOHVSBOHJCFTBSOZB
(BOHMJBCBTBMJTNFNCBOUVNFSFODBOBLBOEBONFOHFOEBMJLBO BLUJWJUBTPUPUZBOHTQFTJGJL
QPMB HFSBLBO PUPU ZBOH LPNQMFLT NFOHFOEBMJLBO JOUFOTJUBT 4FMBJO JUV TFSFCFMVN NFNCBOUV LPSUFLT TFSFCSJ VOUVL
SFMBUJG EBSJ HFSBLBO ZBOH UFSQJTBI BSBI HFSBLBO EBO NFSFODBOBLBO VSVUBO HFSBLBO CFSJLVUOZB EBMBN XBLUV
QFOHVSVUBO HFSBLBO QBSBMFM ZBOH NVMUJQFM EBO CFSUVSVUUVSVU TFQFSTFLJBO EFUJL TFCFMVNOZB TFNFOUBSB HFSBLBO BXBM NBTJI
VOUVL NFODBQBJ UVKVBO NPUPSJL TQFTJGJL ZBOH SVNJU #BC JOJ CFSMBOHTVOH KBEJ NFNCBOUV PSBOH UFSTFCVU CFSHFSBL NBKV
NFOKFMBTLBO NFOHFOBJ EBTBS GVOHTJ TFSFCFMVN EBO HBOHMJB TFDBSB MBODBS EBSJ TBUV HFSBLBO LF HFSBLBO CFSJLVUOZB
CBTBMJT TFSUB NFNCBIBT NFOHFOBJ NFLBOJTNF PUBL TFDBSB 4FSFCFMVN KVHB NBNQV CFMBKBS EBSJ LFTBMBIBO ZBOH EJCVBU
LFTFMVSVIBO VOUVL NFODBQBJ LPPSEJOBTJ ZBOH SVNJU EBSJ BSUJOZB KJLB HFSBLBO ZBOH UFSKBEJ UJEBL UFQBU TFQFSUJ ZBOH
TFMVSVIBLUJWJUBTNPUPSJL EJJOHJOLBO TJSLVJU TFSFCFMVN CFMBKBS NFNCVBU HFSBLBO ZBOH
MFCJI LVBU BUBV MFCJI MFNBI QBEB XBLUV TFMBOKVUOZB 6OUVL
Sereblum dan Fungsi Motoriknya NFMBLVLBO IBM JOJ UFSKBEJ QFSVCBIBO FLTJUBCJMJUBT OFVSPO
OFVSPO TFSFCFMVN ZBOH TFTVBJ TFIJOHHB TFMBOKVUOZB
4FKBLEBIVMV TFSFCFMVNZBOHEJHBNCBSLBOQBEB(BNCBS NFOHIBTJMLBOLPOUSBLTJPUPUZBOHMFCJICBJLTFIVCVOHBOEFOHBO
EBOEJTFCVUTFCBHBJBSFBTVOZJQBEBPUBL UFSVUBNBLBSFOB HFSBLBOZBOHEJJOHJOLBO
QFSBOHTBOHBOMJTUSJLTFSFCFMVNUBLBLBONFOJNCVMLBOTFOTBTJ Area-Area Serebelum yang secara Anatomis bersifat
TBEBS BQB QVO EBO KBSBOH NFOJNCVMLBO HFSBLBO NPUPSJL Fungsional
/BNVO QFNCVBOHBO TFSFCFMVN BLBO NFOZFCBCLBO
4FDBSB BOBUPNJT TFQFSUJ ZBOH UBNQBL EBMBN (BNCBS EBO
QFSHFSBLBO UVCVI NFOKBEJ TBOHBU UJEBL OPSNBM 4FSFCFMVN TFSFCFMVN UFSCBHJ NFOKBEJ UJHB MPCVT PMFI EVB GJTVSB ZBOH
UFSVUBNB QFOUJOH LFUJLB NFMBLVLBO BLUJWJUBT PUPU ZBOH DFQBU EBMBN ZBLOJ
MPCVT BOUFSJPS
MPCVT QPTUFSJPS EBO
MPCVT
TFQFSUJ CFSMBSJ NFOHFUJL NBJO QJBOP EBO CBILBO VOUVL GMPLVMPOPEVMBSJT %BSJ TFMVSVI CBHJBO TFSFCFMVN MPCVT
CJDBSB )JMBOHOZB BSFB PUBL JOJ EBQBU NFOJNCVMLBO GMPLVMPOPEVMBSJT NFSVQBLBO MPCVT ZBOH UFSUVB MPCVT JOJ UVNCVI
JOLPPSEJOBTJ EBSJ IBNQJS TFMVSVI BLUJWJUBT JOJ XBMBVQVO UBL CFSTBNBTBNB EFOHBO EBO CFSGVOHTJ EFOHBO
TJTUFN WFTUJCVMBS
BEBLFMVNQVIBOPUPU EBMBN NFOHBUVS LFTFJNCBOHBO UVCVI TFQFSUJ ZBOH UFMBI EJCBIBT
5FUBQJ CBHBJNBOB TFSFCFMVN NFOKBEJ CFHJUV QFOUJOH CJMB EBMBN#BC
TFSFCFMVN UJEBL NFNQVOZBJ LFNBNQVBO MBOHTVOH VOUVL Pembagian Fungsional Lobus Anterior dan Lobus
NFOZFCBCLBO LBOUSBLTJ PUPU +BXBCBOOZB UJEBL MBJO LBSFOB Posterior secara Longitudinal. #FSEBTBSLBO GVOHTJOZB MPCVT
TFSFCFMVNNFNCBOUVNFOHVSVULBOBLUJWJUBTNPUPSJLEBOKVHB BOUFSJPSEBOQPTUFSJPSUBLUFSTVTVOTFCBHBJMPCVTMPCVTNFMBJOLBOUFS
681
Unit Xl Sistem Sarat C. Neurofisiologis Motorik dan Integratif
Gambaran Topografik Tubuh pada Vermis dan Zona

Intermedia. 4FQFSUJ IBMOZB EBMBN LPSUFLT TFOTPSJL TFSFCSJ
LPSUFLT NPUPSJL HBOHMJB CBTBMJT OVLMFJ SVCSB EBO GPSNBTJP
SFUJLVMBSJT ZBOH NFNQVOZBJ HBNCBSBO UPQPHSBGJL EBSJ CBHJBO
CBHJBO UVCVI EBMBN WFSNJT EBO [POB JOUFSNFEJB TFSFCFMVN KVHB
EBQBU EJKVNQBJ HBNCBSBO ZBOH TBNB (BNCBS NFMVLJTLBO
EVB CBHJBO ZBOH TBMJOH UFSQJTBI 1FSIBUJLBO CBIXB CBHJBO BLTJBM
UVCVI UFSMFUBL EJ CBHJBO WFSNJT TFSFCFMVN TFEBOHLBO CBHJBO
BOHHPUB CBEBO EBO XBKBI QBEB [POB JOUFSNFEJB 3FQSFTFOUBTJ
UPQPHSBGJL JOJ NFOFSJNB TJOZBMTJOZBM TBSBG BGFSFO EBSJ TFMVSVI
CBHJBO UVCVI ZBOH TFTVBJ KVHB EBSJ BSFB NPUPSJL EBMBN LPSUFLT
TFSFCSJ EBO CBUBOH PUBL ZBOH CFSIVCVOHBO TFDBSB UPQPHSBGJT
4FCBMJLOZB CBHJBO JOJ NFOHJSJNLBO TJOZBMTJOZBM NPUPSJL LF
EBFSBIEBFSBIUPQPHSBGJLZBOHTBNBQBEBLPSUFLTNPUPSJLTFSFCSJ
EFNJLJBO QVMB LF BSFB UPQPHSBGJT OVMEFVT SVCSB EBO GPSNBTJP
SFUJLVMBSJTQBEBCBUBOHPUBL
1FSIBUJLBO CBIXB TFCBHJBO CFTBS EBFSBI MBUFSBM IFNJTGFS
TFSFCFMVNUJEBLNFNQVOZBJHBNCBSBOUPQPHSBGJLUVCVI%BFSBI
EBFSBI TFSFCFMVN NFOFSJNB TJOZBM NBTVLBO IBNQJS TFDBSB
FLTLMVTJG EBSJ LPSUFLT TFSFCSJ UFSVUBNB EBSJ BSFB QSFNPUPSJL
LPSUFLT GSPOUBMJT EBO BSFB TPNBUPTFOTPSJL NBVQVO BSFB BTPTJBTJ
TFOTPSJL MBJO QBEB LPSUFLT QBSJFUBMJT %JEVHB CBIXB IVCVOHBO
EFOHBO LPSUFLT TFSFCSJ JOJ BLBO NFOZFCBCLBO CBHJBO MBUFSBM
IFNJTGFS TFSFCFMVN TBOHBU CFSQFSBO EBMBN QFSFODBOBBO EBO
QFOHPPSEJOBTJBO SBOHLBJBO BLUJWJUBT PUPU UVCVI ZBOH DFQBU ZBOH
UFSKBEJTBUVEFNJTBUVEBMBNXBLUVTFQFSTFLJBOEFUJL
Sirkuit Neuron Serebelum

,PSUFLT TFSFCFMVN NBOVTJB TFCFOBSOZB NFSVQBLBO TVBUV
MFNCBSBO CFTBS ZBOH CFSMJQBUMJQBU QBOKBOH TFLJUBS DN EBO
MFCBS TFLJUBS DN EFOHBO BSBI MJQBUBO ZBOH NFOZJMBOH TFQFSUJ
EJUVOKVLLBO QBEB (BNCBS EBO TFUJBQ MJQBUBO EJTFCVU
TFCBHBJ GPMJVN 1BEB CBHJBO EBMBN NBTTB LPSUFLT TFSFCFMVN ZBOH
CFSMJQBUMJQBUUFSEBQBUOVLMFJTFSFCFMJQSPGVOEB
Jaras-Jaras yang Masuk ke Serebelum

Jaras Aferen dari Bagian-Bagian Otak. +BSBTKBSBT
VUBNB ZBOH NBTVL LF TFSFCFMVN EJQFSMJIBULBO EBMBN (BNCBS
+BSBT BGFSFO ZBOH MVBT EBO QFOUJOH BEBMBI KBSBT
LPSUJLPQPOUPTFSFCFMVN ZBOH CFSBTBM EBSJ LPSUFLT NPUPSJL TFSFCSJ
TVTVO TFQBOKBOH TFQBOKBOH TVNCV MPOHJUVEJOBM TFQFSUJ ZBOH EBO LPSUFLT QSFNPUPSJL TFSUB LPSUFLT TPNBUPTFOTPSJL TFSFCSJ
EJMVLJTLBO QBEB (BNCBS ZBOH NFNQFSMJIBULBO CBHJBO +BSBTUFSTFCVUNFMFXBUJOVLMFJEJQPOTEBOUSBLUVTQPOUPTFSFCFMBSJT
QPTUFSJPS TFSFCFMVN NBOVTJB TFTVEBI CBHJBO VKVOH CBXBI UFSVUBNBLFCBHJBOMBUFSBMIFNJTGFSTFSFCFMVNQBEBTJTJPUBLEBSJ
TFSFCFMVN QPTUFSJPS EJHVMVOH LF CBXBI EBSJ QPTJTJ OPSNBMOZB BSFBTFSFCSVNZBOHCFSMBXBOBO
ZBOH UFSTFNCVOZJ 1FSIBUJLBO EJ TFCFMBI CBXBI EBSJ QVTBU
TFSFCFMVN UBNQBL TVBUV QJUB TFNQJU EJOBNBLBO WFSNJT ZBOH
EJQJTBILBO EBSJ CBHJBO TFSFCFMVN ZBOH UFSTJTB PMFI TVBUV DFMBI
EBOHLBM 1BEB BSFB JOJ UFSMFUBL TFCBHJBO CFTBS GVOHTJ QFOHBUVS
TFSFCFMVN VOUVL QFSHFSBLBOQFSHFSBLBO PUPU NFOVSVU TVNCV
UVCVI MFIFS CBIV TFSUBQJOHHVM
1BEBUJBQTJTJWFSNJTBEBCBHJBOZBOHCFTBS NFOPOKPMLFMBUFSBM
ZBOH EJTFCVU IFNJTGFS TFSFCFMVN EBO TFUJBQ IFNJTGFS JOJ EJCBHJ
NFOKBEJ[POBJOUFSNFEJBEBO[POBMBUFSBM
;POB JOUFSNFEJB IFNJTGFS CFSIVCVOHBO EFOHBO QFOHBUVSBO
LPOUSBLTJ PUPU ZBOH UFSMFUBL EJ CBHJBO EJTUBM BOHHPUB CBEBO BUBT
EBOBOHHPUBCBEBOCBXBI LIVTVTOZBUBOHBOEBOKBSJUBOHBOTFSUB
LBLJEBOKBSJLBLJ
;POB MBUFSBM IFNJTGFS CFLFSKB QBEB UFNQBU ZBOH MFCJI KBVI
LBSFOBUBNQBLOZBBSFBJOJJLVUCFSQFSBOEBMBNTFMVSVISBOHLBJBO
HFSBLBO NPUPSJL 5BOQB BEBOZB [POB MBUFSBM JOJ TFCBHJBO CFTBS
BLUJWJUBT HFSBLBO UVCVI ZBOH LIBT BLBO UJEBL UFQBU MBHJ TFIJOHHB
NFOKBEJTBOHBUUBLUFSBUVS TFQFSUJZBOHBLBOLJUBCJDBSBLBOTFDBSB
MFCJIMFOHLBQOBOUJ
682
Bab 56 Kontribusi Serebelum dan Ganglia Basalis pada Seluruh Pengendalian Motorik
EBO CFSBLIJS QBEB WFSNJT EBO [POB JOUFSNFEJB TFSFCFMVN TJTJ

ZBOH TBNB EFOHBO UFNQBU LFMVBSOZB ,FEVB USBLUVT WFOUSBMJT
NFNBTVLJ EBFSBI ZBOH TBNB QBEB TFSFCFMVN NFMBMVJ
QFEVOLVMVT TFSFCFMJ TVQFSJPS UFUBQJ CFSBLIJS QBEB LFEVB TJTJ
TFSFCFMVN
UNIT XI
4JOZBMTJOZBM ZBOH CFSKBMBO EBMBN USBLUVT TQJOPTFSFCFMBSJT
EPSTBMJTUFSVUBNBCFSBTBMEBSJLVNQBSBOPUPUEBOTFCBHJBOLFDJM
CFSBTBM EBSJ SFTFQUPS TPNBUJL EJ TFMVSVI UVCVI TFQFSUJ PSHBO
UFOEP(PMHJ SFTFQUPSUBLUJMZBOHCFTBSQBEBLVMJU EBOSFTFQUPS
SFTFQUPSTFOEJ4FNVBTJOZBMJOJNFNCFSJUBIVTFSFCFMVNUFOUBOH
CBHBJNBOBLFBEBBO
LPOUSBLTJPUPU
TFCFSBQBCFTBSEFSBKBU
UFHBOHBO UFOEP PUPU
QPTJTJ EBO LFDFQBUBO HFSBLBO CBHJBO
UVCVI EBO
LFLVBUBOLFSKBQBEBQFSNVLBBOUVCVI
5SBLUVT TQJOPTFSFCFMBSJT WFOUSBMJT NFOFSJNB MFCJI TFEJLJU
JOGPSNBTJ EBSJ SFTFQUPSSFTFQUPS QFSJGFS 5SBLUVT JOJ UFSVUBNB
EJSBOHTBOH PMFI TJOZBMTJOZBM NPUPSJL ZBOH EBUBOH EJ SBEJLT
BOUFSJPS NFEVMB TQJOBMJT EBSJ
PUBL NFMBMVJ USBLUVT
LPSUJLPTQJOBMJT EBO USBLUVT SVCSPTQJOBMJT EBO
QPMB NPUPSJL
JOUFSOBM ZBOH UJNCVM EJ NFEVMB TQJOBMJT JUV TFOEJSJ +BEJ KBSBT
4FMBJOJUV USBLUVTUSBLUVTBGFSFOQFOUJOHUFSVUBNBCFSBTBMEBSJ TFSBU WFOUSBM JOJ NFNCFSJUBIV TFSFCFMVN UFOUBOH TJOZBMTJOZBM
TFUJBQTJTJCBUBOHPUBLBOUBSBMBJO
USBLUVTPMJWPTFSFCFMBSJTZBOH NPUPSJL ZBOH UFMBI TBNQBJ EJ SBEJLT BOUFSJPS VNQBO CBMJL JOJ
MVBT ZBOHCFSKBMBOEBSJPMJWBJOGFSJPSLFTFMVSVICBHJBOTFSFCFMVN EJTFCVUTBMJOBOFGFSFOEBSJLFOEBMJNPUPSJLLPSOVBOUFSJPS
EBOEJSBOHTBOHEJEBMBNPMJWBPMFITFSBUTFSBUEBSJLPSUFLTNPUPSJL +BSBT TQJOPTFSFCFMVN EBQBU NFHJSJNLBO JNQVMT EFOHBO
TFSFCSJ HBOHMJB CBTBMJT EBFSBI ZBOH MVBT EBSJ GPSNBTJP SFUJLVMBSJT LFDFQBUBO TBNQBJ NEFUJL ZBOH NFSVQBLBO LFDFQBUBO
EBO NFEVMB TQJOBMJT
TFSBUTFSBU WFTUJCVMPTFSFCFMVN ZBOH QBMJOH UJOHHJ QBEB TFUJBQ KBSBT EJ TJTUFN TBSBG QVTBU ,FDFQBUBO
TFCBHJBO CFSBTBM EBSJ BQBSBUVT WFTUJCVMBS CBUBOH PUBLIBNQJS QFOKBMBSBO ZBOH TBOHBU FLTUSFN JOJ CFSHVOB VOUVL TFHFSB
TFNVB TFSBUTFSBU UFSTFCVU CFSBLIJS EJ MPCVT GMPLVMPOPEVMBSJT EBO NFNCFSJUBIVLBO TFSFCFMVN UFOUBOH QFSVCBIBO QBEB LFSKB PUPU
OVLMFVT GBTUJHJVT TFSFCFMVN EBO
TFSBCVUTFSBCVU QFSJGFS
SFUJLVMPTFSFCFMVN ZBOH EJNVMBJ EBSJ CFSCBHBJ CBHJBO GPSNBTJP 4FMBJOTJOZBMEBSJUSBLUVTTQJOPTFSFCFMBSJT BEBTJOZBMTJOZBMMBJO
SFUJLVMBSJT CBUBOH PUBL EBO CFSBLIJS EJ CBHJBO UFOHBI BSFB ZBOH EJLJSJN LF TFSFCFMVN EBSJ QFSJGFS UVCVI NFMBMVJ LPMVNOB
TFSFCFMVN UFSVUBNBEJWFSNJT
EPSTBMJTTQJOBMJTLFOVLMFJLPMVNOBEPSTBMJTNFEVMBTQJOBMJTEBO
TFMBOKVUOZB EJLJSJNLBO LF TFSFCFMVN %FNJLJBO KVHB TJOZBM
Jaras Aferen dari Perifer. 4FSFCFMVN KVHB NFOFSJNB TJOZBM EJLJSJNLBO LF NFEVMB TQJOBMJT NFMBMVJ KBSBT
TJOZBMTJOZBM TFOTPSJL QFOUJOH TFDBSB MBOHTVOH EBSJ CBHJBO QFSJGFS TQJOPSFUJLVMBSJT LF GPSNBTJP SFUJLVMBSJT CBUBOH PUBL EBO KVHB
UVCVI UFSVUBNB NFMBMVJ FNQBU USBLUVT EJ TFUJBQ TJTJ EVB EJ NFMBMVJ KBSBT TQJOPPMJWBSJVT LF OVLMFVT PMJWBSJVT JOGFSJPS
BOUBSBOZB UFSMFUBL EJ CBHJBO EPSTBM NFEVMB TQJOBMJT EBO EVB ZBOH ,FNVEJBOTJOZBMEBSJLFEVBEBFSBIJOJEJLJSJNLBOLFTFSFCFMVN
MBJO EJ TFCFMBI WFOUSBM NFEVMB TQJOBMJT %VB USBLUVT ZBOH QBMJOH +BEJ TFDBSB UFSVTNFOFSVT TFSFCFMVN NFOHVNQVMLBO JOGPSNBTJ
QFOUJOHEJHBNCBSLBOEBMBN(BNCBSUSBLUVTTQJOPTFSFCFMBSJT UFOUBOH QFSHFSBLBO EBO QPTJTJ EBSJ TFNVB CBHJBOCBHJBO UVCVI
EPSTBMJT EBO USBLUVT TQJOPTFSFCFMBSJT WFOUSBMJT 5SBLUVTUSBLUVT XBMBVQVO TFSFCFMVN CFLFSKB QBEB UJOHLBU CBXBI TBEBS
EPSTBMJTNFNBTVLJTFSFCFMVNNFMBMVJQFEVOLVMVTTFSFCFMJJOGFSJPS TVCDPOTDJPVT

Sinyal-Sinyal yang Keluar dari Serebelum.

Nuklei di Bagian dalam Serebelum dan Jaras-Jaras
Eferen. %J CBHJBO EBMBN NBTTB TFSFCFMVN QBEB TFUJBQ TJTJ
UFSEBQBU UJHB OVLMFJ TFSFCFMVN OVLMFJ EFOUBUVT JOUFSQPTJUVT EBO
GBTUJHJVT /VLMFJ WFTUJCVMBSJT EJ NFEVMB TQJOBMJT GVOHTJOZB KVHB
TFSVQB EFOHBO GVOHTJ OVLMFJ EJ CBHJBO EBMBN TFSFCFMVN TFCBC
OVLMFJ JOJ MBOHTVOH CFSIVCVOHBO EFOHBO LPSUFLT MPCVT
GMPLVMPOPEVMBSJT
4FMVSVI OVLMFJ EJ CBHJBO EBMBN TFSFCFMVN
NFOFSJNBTJOZBMTJOZBMZBOHCFSBTBMEBSJEVBTVNCFS
LPSUFLT
TFSFCFMJEBO
USBLUVTBGFSFOTFOTPSJLCBHJBOEBMBNLFTFSFCFMVN
4FUJBQTJOZBMZBOHNBTVLLFTFSFCFMVN TJOZBMBLBOUFSCBHJEVB
EBONFOVKVLFEVBBSBI
MBOHTVOHNFOVKVTBMBITBUVOVLMFJEJ
CBHJBO EBMBN TFSFCFMVN EBO
NFOVKV BSFB ZBOH CFSLBJUBO
EFOHBO LPSUFLT TFSFCFMJ ZBOH NFMJOHLVQJ OVLMFJ CBHJBO EBMBN
4FMBOKVUOZB EBMBN XBLUV LVSBOH EBSJ TBUV EFUJL LFNVEJBO
LPSUFLT TFSFCFMJ NFOHJSJNLBO TJOZBMTJOZBM PVUQVU JOIJCJTJOZB
LFNCBMJ LF OVLMFVT EJ CBHJBO EBMBN +BEJ TFMVSVI TJOZBM ZBOH
NBTVL LF TFSFCFMVN BLIJSOZB BLBO CFSBLIJS EJ OVLMFJ CBHJBO
EBMBN TFCBHBJ TJOZBM FLTJUBTJ BXBM ZBOH EBMBN XBLUV LVSBOH EBSJ
TBUVEFUJLEJJLVUJTFQFSEFUJLPMFITJOZBMJOIJCJTJ%BSJOVLMFJCBHJBO
EBMBN TJOZBM LFMVBS NFOJOHHBMLBO TFSFCFMVN EBO LFNVEJBO
EJEJTUSJCVTJLFCBHJBOMBJOEBSJPUBL
683
4FDBSB VNVN KBSBTKBSBT FGFSFO VUBNB ZBOH NFOJOHHBMLBO

TFSFCFMVNEJQFSMJIBULBOQBEB(BNCBSEBOUFSEJSJBUBTIBMIBM
CFSJLVU Sirkuit Neuronal Unit Fungsional. 1BEB CBHJBO LJSJ (BNCBS
KVHB EJMVLJTLBO TJSLVJU OFVSPOBM TVBUV VOJU GVOHTJPOBM
1. +BSBTZBOHEJNVMBJEBSJTUSVLUVSUFOHBITFSFCFMVN WFSNJT
EBO
ZBOHCFSVMBOHKVUBLBMJEJTFSFCFMVNEFOHBOTFEJLJUWBSJBTJ
LFNVEJBOCFSKBMBONFMBMVJOVLMFJGBTUJHJVTLFSFHJPNFEVMBEBO
0VUQVU ZBOH CFSBTBM EBSJ VOJU GVOHTJPOBM BEBMBI IBTJM EBSJ TFM
QPOTCBUBOHPUBL4JSLVJUJOJGVOHTJOZBTBOHBUCFSLBJUBOEFOHBO
BMBU LFTFJNCBOHBO EBO OVLMFJ WFTUJCVMBS CBUBOH PUBL HVOB OVLMFBS CBHJBO EBMBN 4FM JOJ UFSVTNFOFSVT EBMBN QFOHBSVI
NFOHFOEBMJLBO LFTFJNCBOHBO EBO KVHB CFSIVCVOHBO EFOHBO FLTJUBTJ EBO JOIJCJTJ 1FOHBSVI FLTJUBTJ CFSBTBM EBSJ IVCVOHBO
GPSNBTJP SFUJLVMBSJT CBUBOH PUBL HVOB NFOHFOEBMJLBO TJLBQ MBOHTVOH EFOHBO TFSBUTFSBU BGFSFO ZBOH NFNBTVLJ TFSFCFMVN
UVCVI)BMJOJUFMBIEJKFMBTLBOTFDBSBEFUBJMQBEB#BCEBMBN EBSJPUBLBUBVQFSJGFS1FOHBSVIJOIJCJTJTFMVSVIOZBUJNCVMEBSJ
IVCVOHBOOZBEFOHBOLFTFJNCBOHBO TFM1VSLJOKFZBOHBEBEJEBMBNLPSUFLTTFSFCFMVN
2. +BSBTZBOHCFSBTBMEBSJ
[POBJOUFSNFEJBIFNJTGFSTFSFCFMVN 4JOZBM BGFSFO ZBOH NBTVL LF TFSFCFMVN UFSVUBNB BEB EVB
EBO LFNVEJBO CFSKBMBO NFMBMVJ
OVLMFVT JOUFSQPTJUVT LF
NBDBN TBMBI TBUVOZB EJTFCVU TFSBU UJQF QFNBOKBU EBO ZBOH
OVLMFJ WFOUSPMBUFSBM EBO OVLMFJ WFOUSPBOUFSJPS UBMBNVT EBO MBJOOZBEJTFCVUTFSBUUJQFNPTTZ MVNVU

TFMBOKVUOZB LF
LPSUFLT TFSFCSJ LF
CFCFSBQB TUSVLUVS 4FSBUQFNBOKBUTFMVSVIOZBCFSBTBMEBSJPMJWBJOGFSJPSNFEVMB
UFOHBIUBMBNVTEBOTFMBOKVUOZBLF
HBOHMJBCBTBMJT EBO
LF "EB TBUV TFSBU QFNBOKBU VOUVL LJSBLJSB TBNQBJ TFM
OVLMFVTSVCSBEBOGPSNBTJPSFUJLVMBSJTCBHJBOBUBTCBUBOHPUBL 1VSLJOKF4FTVEBINFOHJSJNLBODBCBOHDBCBOHLFCFCFSBQBTFM
4JSLVJU LPNQMFLT JOJ UFSVUBNB NFNCBOUV NFOHPPSEJOBTJLBO OVLMFBSCBHJBOEBMBN TFSBUQFNBOKBUCFSMBOKVUNFMBMVJTFMVSVI
LPOUSBLTJUJNCBMCBMJLEBSJPUPUPUPUBHPOJTEBOBOUBHPOJTQBEB KBMBOLFMBQJTBOMVBSQBEBLPSUFLTTFSFCFMJ EJNBOBVOUVLTFUJBQ
CBHJBO QFSJGFS BOHHPUB CBEBO LIVTVTOZB UBOHBO KBSJ EBO JCV
TFM1VOLJOKFBLBOUFSCFOUVLLJSBLJSBTJOBQTEFOHBOTPNB
KBSJ
EBO EFOESJU 4FSBU QFNBOKBU JOJ EBQBU EJCFEBLBO NFMBMVJ GBLUB
3. +BSBT ZBOH EJNVMBJ EBSJ [POB MBUFSBM LPSUFLT TFSFCFMVN QBEB CBIXBTBUVJNQVMTEBMBNMBQJTBOJOJBLBOTFMBMVNFOZFCBCLBO
IFNJTGFSTFSFCFMVNLFNVEJBOLFOVLMFVTEFOUBUVT MBMVLFOVLMFJ QPUFOTJBM BLTJ UVOHHBM TBOHBU MBNB TBNQBJ EFUJL
EBO
WFOUSPMBUFSBMEBOOVLMFJWFOUSPBOUFSJPSUBMBNVT EBOBLIJSOZBLF CFSUJQF LIBT QBEB TFUJBQ TFM 1VSLJOKF EBO ZBOH CFSIVCVOHBO
LPSUFLT TFSFCSJ +BSBT JOJ TBOHBU CFSQFSBO EBMBN NFNCBOUV
EFOHBOOZB EJBXBMJ EFOHBO MPOKBLBO LVBU EJJLVUJ EFOHBO
NFOHPPSEJOBTJLBOVSVUBOBLUJWJUBTNPUPSJLZBOHEJDFUVTLBOPMFI
MPOKBLBO TFLVOEFS ZBOH NFMFNBI 1PUFOTJBM BLTJ JOJ EJTFCVU
LPSUFLTTFSFCSJ
MPOKBLBOLPNQMFLT
4FSBU UJQF NPTTZ NFSVQBLBO TFNVB TFSBU UJQF MBJO ZBOH
Unit Fungsional Korteks Serebelum-Sel Purkinje dan Sel NFNBTVLJ TFSFCFMVN EBSJ CFSCBHBJ TVNCFS EBSJ CBHJBO PUBL
Nuklear Bagian Dalam ZBOH MFCJI UJOHHJ CBUBOH PUBL EBO NFEVMB TQJOBMJT 4FSBCVU
4FSFCFMVN NFNQVOZBJ LJSBLJSB KVUB VOJU GVOHTJPOBM ZBOH TFSBCVU JOJ KVHB NFOHJSJNLBO DBCBOHDBCBOH LPMBUFSBM VOUVL
IBNQJSJEFOUJL TBMBITBUVVOJUJOJEJHBNCBSLBOEJCBHJBOLJSJ NFSBOHTBOHTFMTFMOVLMFBSCBHJBOEBMBN,FNVEJBOTFSBUTFSBU
(BNCBS 1VTBU VOJU GVOHTJPOBM JOJ UFSMFUBL QBEB TFM UFSTFCVU NFMBOKVULBO EJSJ LF MBQJTBO TFM HSBOVMB EBSJ LPSUFLT
1VSLJOKF UVOHHBM ZBOH TBOHBU CFTBS EBO CFSIVCVOHBO EFOHBO UFNQBUTFSBUTFSBUUFSTFCVUKVHBCFSTJOBQTEFOHBOCFSBUVTSBUVT
TFMOVLMFBSCBHJBOEBMBN TBNQBJ CFSJCVSJCV TFM HSBOVMB 4FCBMJLOZB TFMTFM HSBOVMB
%JCBHJBOLBOBOBUBT(BNCBSUBNQBLUJHBMBQJTBOVUBNB NFOHJSJNLBO BLTPOBLTPO ZBOH TBOHBU LFDJM CFSEJBNFUFS
LPSUFLTTFSFCFMVNMBQJTBONPMFLVMFS MBQJTBOTFM1VSLJOKF EBO LVSBOHEBON LFBUBTLFMBQJTBONPMFLVMFSQBEBQFSNVLBBO
MBQJTBOTFMHSBOVMB%JCBXBIMBQJTBOLPSUJLBMJOJ UBNQBLOVLMFJ MVBS LPOUFLT TFSFCFMVN 1BEB MBQJTBO JOJ BLTPOBLTPO
TFSFCFMVN CBHJBO EBMBN ZBOH NFOHJSJNLBO TJOZBM PVUQVU LF CFSDBCBOH EVB NFOZFCBS TFKBKBS EFOHBO KBSBL TBNQBJ NN
CBHJBOMBJOTJTUFNTBSBG UFSMFUBLEJQVTBUNBTTBTFSFCFMVN UFSIBEBQGPMJB5FSEBQBUCFSKVUBKVUBTFSBUTBSBGQBSBMFMLBSFOB
684
VOUVL TFUJBQ TFM 1VSLJOKF BEB LJSBLJSB 00 TBNpBJ 00 TFM Sinyal-Sinyal Keluaran Nyala/Mati dan Mati/Nyala dari
HSBOVMB -BQJTBO NPMFLVMFS JOJ NFSVQBLBO UFNpBU QSPZFLTJ Serebelum
EFOESJUTFMTFM1VSLJOKF EBOTFUJBQTFM1VOLJOKFCFSTJOBQTEFOHBO 'VOHTJ LIBT TFSFCFMVN BEBMBI NFNCBOUV NFOZFEJBLBO TJOZBM
0.000 TBNpBJ00.000TFSBUTFSBUQBSBMFM OZBMBTFDBSBDFQBUVOUVLPUPUPUPUBHPOJT EBOTFDBSBCFSTBNBBO
UNIT XI
.BTVLBO TFSBU UJQF NPTTZ LF TFM 1VSLJOKF BHBL CFSCFEB EBSJ NFOHJSJNLBO QVMB TJOZBM NBUJ ZBOH CFSTJGBU UJNCBM CBMJL VOUVL
NBTVLBO TFSBUTFSBU UJQF QFNBOKBU LBSFOB IVCVOHBO TJOBQTOZB PUPUPUPU BOUBHPOJT QBEB TBBU HFSBLBO EJNVMBJ ,FNVEJBO QBEB
ZBOH MFNBI NBLB TFKVNMBI CFTBS TFSBUTFSBU NPTTZ IBSVT TBBU NFOEFLBUJ BLIJS QFSHFSBLBO TFSFCFMVN UFSVUBNB
EJSBOHTBOH TFDBSB TJNVMUBO VOUVL EBQBU NFOJNCVMLBO FLTJUBTJ CFSUBOHHVOH KBXBC VOUVL NFNVMBJ BUBV NFOHIFOUJLBO TJOZBM
QBEB TFM 1VSLJOKF 4FMBOKVUOZB QSPTFT QFOHBLUJGBO JOJ CJBTBOZB NBUJ VOUVL PUPU BHPOJT EBO TJOZBM IJEVQ VOUVL PUPU BOUBHPOJT
NFOHBNCJM CFOUVL QPUFOTJBM BLTJ TFM 1VSLJOKF CFSEVSBTJ QFOEFL 8BMBVQVO SJODJBO QBTUJ NFLBOJTNF JOJ CFMVN TFMVSVIOZB
ZBOH KBVI MFCJI MFNBI ZBOH EJTFCVU MPOKBLBO TFEFSIBOB CVLBO EJLFUBIVJ LJUB EBQBU NFNQFSLJSBLBO EBSJ TJSLVJU EBTBS
QPUFOTJBMBLTJLPNQMFLTCFSEVSBTJQBOKBOHZBOHEJTFCBCLBOPMFI TFSFCFMVNQBEB(BNCBSUFOUBOHCBHBJNBOBLFNVOHLJOBO
NBTVLBOTFSBUQFNBOKBU LFSKBIBMJOJ ZBJUVTFCBHBJCFSJLVU
.BSJLJUBQFSLJSBLBOCBIXBQPMBOZBMBNBUJLPOUSBLTJBHPOJT
Sel Purkinje dan Sel Nuklear Bagian Dalam Meletup
BOUBHPOJTUFSKBEJQBEBTBBUEJNVMBJOZBQFSHFSBLBOZBOHEJBXBMJ
secara Kontinu pada Keadaan Istirahat Normal. 4BUV EFOHBO TJOZBM EBSJ LPSUFLT TFSFCSJ 4JOZBMTJOZBM JOJ CFSKBMBO
HBNCBSBO LIBT EBSJ TFM 1VSLJOKF EBO TFM OVLMFBS CBHJBO EBMBN
NFMBMVJ CBUBOH PUBL OPOTFSFCFMVN EBO KBSBT NFEVMB TQJOBMJT
BEBMBI CBIXB LFEVBOZB UFSVTNFOFSVT EBMBN LFBEBBO NFMFUVQ
ZBOH TFDBSB MBOHTVOH LF PUPU BHPOJT VOUVL NFNVMBJ LPOUSBLTJ
TFM 1VSLJOKF NFMFUVQ QBEB LFDFQBUBO TFLJUBS TBNQBJ
BXBM
QPUFOTJBMBLTJEFUJLEBOTFMOVLMFBSCBHJBOEBMBNQBEBLFDFQBUBO
1BEB TBBU ZBOH CFSTBNBBO TJOZBM QBSBMFM EJLJSJNLBO NFMBMVJ
ZBOH KBVI MFCJI UJOHHJ 4FMBOKVUOZB IBTJM BLUJWJUBT LFEVB TFM JOJ
TFSBUTFSBU NPTTZ QPOT NFOVKV TFSFCFMVN 4BMBI TBUV DBCBOH
EBQBUEJNPEVMBTJOBJLBUBVUVSVO
EBSJ TFUJBQ TFSBU NPTTZ CFSKBMBO MBOHTVOH LF TFM OVLMFBS CBHJBO
Keseimbangan antara Eksitasi dan Inhibisi pada Nuklei EBMBNEJOVLMFVTEFOUBUVTBUBVOVLMFVTTFSFCFMVNCBHJBOEBMBN
Serebelum Bagian Dalam. .FSVKVL LFNCBMJ LF TJSLVJU QBEB MBJOOZBLFNVEJBOOVLMFJJOJEFOHBOTFHFSBNFOHJSJNLBOTJOZBM
(BNCBS QFSIBUJLBO CBIXB TFM OVLMFBS CBHJBO EBMBN FLTJUBTJLFNCBMJLFTJTUFNNPUPSJLLPSUJLPTQJOBMTFSFCSVN CBJL
EJSBOHTBOH TFDBSB MBOHTVOH PMFI TFSBUTFSBU UJQF QFNBOKBU EBO NFMBMVJ TJOZBMTJOZBM LFNCBMJ ZBOH NFMBMVJ UBMBNVT LF LPSUFLT
UJQF NPTTZ 4FCBMJLOZB TJOZBM ZBOH EBUBOH EBSJ TFM 1VSLJOKF TFSFCSJ NBVQVO NFMBMVJ TJSLVJU OFVSPOBM EJ CBUBOH PUBL VOUVL
NFOHIBNCBU TFM OVLMFBS CBHJBO EBMBN /PSNBMOZB NFOEVLVOH TJOZBM LPOUSBLTJ PUPU ZBOH EJNVMBJ PMFI LPSUFLT
LFTFJNCBOHBO BOUBSB LFEVB FGFL JOJ CFSTJGBU TFEJLJU LF BSBI TFSFCSJ 4FCBHBJ BLJCBUOZB TJOZBM OZBMB TFUFMBI CFCFSBQB
FLTJUBTJ TFIJOHHB QBEB LPOEJTJ ZBOH UFOBOH LFMVBSBO EBSJ TFM NJMJEFUJL CBILBO NFOKBEJ MFCJI LVBU EBSJQBEB TBBU QFSNVMBBO
OVLMFBS CBHJBO EBMBN SFMBUJG LPOTUBO QBEB QFSBOHTBOHBO TFEBOH LBSFOBTJOZBMJOJTFLBSBOHNFSVQBLBOKVNMBILFEVBTJOZBMZBJUV
ZBOHUFSVTNFOFSVT EBSJ LPSUFLT EBO TFSFCFMVN *OJ BEBMBI FGFL ZBOH OPSNBM CJMB
1BEBQFMBLTBOBBOQFSHFSBLBONPUPSJLZBOHDFQBU TJOZBMTJOZBM TFSFCFMVN VUVI UFUBQJ CJMB UJEBL UFSEBQBU TFSFCFMVN TJOZBM
BXBMEBSJLPSUFLTNPUPSJLTFSFCSVNBUBVCBUBOHPUBLNVMBNVMB QFOEVLVOH UBNCBIBO TFLVOEFS JOJ UJEBL BEB #BOUVBO
TBOHBU NFOJOHLBULBO FLTJUBTJ TFM OVLMFBS CBHJBO EBMBN TFSFCFMVNJOJNFNCVBUTJOZBMOZBMBLPOUSBLTJPUPUNFOKBEJKBVI
4FMBOKVUOZB CFCFSBQBNJMJEFUJLLFNVEJBO NVODVMTJOZBMJOIJCJTJ MFCJILVBUEBSJQBEBCJMBUJEBLUFSEBQBUTFSFCFMVN
VNQBOCBMJLEBSJTFM1VSLJOKF%FOHBODBSBJOJ NVMBNVMBTJOZBM 4FLBSBOH BQBZBOHNFOZFCBCLBOUJNCVMOZBTJOZBMNBUJCBHJ
FLTJUBTJ DFQBU EJLJSJNLBO PMFI TFM OVLMFBS CBHJBO EBMBN LF KBSBT PUPU BHPOJT QBEB BLIJS QFSHFSBLBO *OHBUMBI CBIXB TFNVB
LFMVBSBO NPUPSJL VOUVL NFNQFSLVBU HFSBLBO NPUPSJL OBNVO TFSBCVU NPTTZ NFNJMJLJ DBCBOH LFEVB ZBOH NFOKBMBSLBO TJOZBM
EBMBN XBLUV CFCFSBQB TFQFSEFUJL LFNVEJBO HFSBLBO JOJ BLBO NFMBMVJTFMTFMHSBOVMBLFLPSUFLTTFSFCFMVN EBOBLIJSOZB MFXBU
EJJLVUJPMFITJOZBMJOIJCJTJ4JOZBMJOIJCJTJJOJNJSJQEFOHBOHBSJT KBMBO TFSBU QBSBMFM LF TFM 1VSLJOKF 4FM 1VSLJOKF JOJ LFNVEJBO
QFSMBNCBUBOEBSJTJOZBMVNQBOCBMJLOFHBUJG TFCBCTJOZBMUJQFJOJ NFOHIBNCBUTFMOVLMFBSCBHJBOEBMBN+BSBTJOJCFSKBMBONFMBMVJ
TBOHBU FGFLUJG VOUVL NFOJNCVMLBO QFSFEBNBO EBNQJOH
:BJUV CFCFSBQB TFSBU TBSBG QBMJOH LFDJM EBO EFOHBO QFOHIBOUBSBO
CJMB TJTUFN NPUPSJL UFSBOHTBOH TFTVEBI GBTF QFSMBNCBUBO ZBOH QBMJOHMBNCBUEBMBNTJTUFNTBSBGZBJUVTFSBUTFSBUQBSBMFMMBQJTBO
TJOHLBU UJNCVM TJOZBM VNQBO CBMJL OFHBUJG VOUVL NFOHIFOUJLBO NPMFLVMLPSUJLBMTFSFCFMVN ZBOHNFNJMJLJEJBNFUFSLVSBOHEBSJ
HFSBLBO PUPU ZBOH CFSMFCJIBO +JLB UJEBL BLBO UJNCVM PTJMBTJ NN 4FMBJO JUV TJOZBM EBSJ TFSBUTFSBU JOJ CFSTJGBU MFNBI
CFSHPZBOH
QFSHFSBLBO TFIJOHHB TJOZBMTJOZBM UFSTFCVU NFNFSMVLBO NBTB XBLUV
UFSUFOUV VOUVL NFNCBOHVO FLTJUBTJ ZBOH DVLVQ LVBU QBEB
Sel-Sel Inhibisi Lain di Serebelum. 4FMBJO TFMTFM OVLMFBS EFOESJU TFM 1VSLJOKF HVOB NFSBOHTBOH TFM 1VSLJOKF UFSTFCVU
CBHJBO EBMBN TFMTFM HSBOVMB EBO TFMTFM 1VSLJOKF BEB EVB UJQF 5FUBQJLFUJLBUFSBOHTBOH TFMBOKVUOZB TFM1VSLJOZFNFOHJSJNLBO
OFVSPO MBJO ZBOH KVHB UFSMFUBL EJ TFSFCFMVN TFM CBTLFU EBO TFM TJOZBMJOIJCJTJZBOHLVBULFTFMOVLMFBSCBHJBOEBMBNZBOHTBNB
TUFMBUB4FMTFMJOJNFSVQBLBOTFMJOIJCJTJEFOHBOBLTPOQFOEFL4FM ZBJUVTFMZBOHUFMBINFOHIJEVQLBOQFSHFSBLBO0MFILBSFOBJUV
CBTLFU EBO TFM TUFMBUB UFSMFUBL EJ MBQJTBO NPMFLVMFS LPSUFLT LFBEBBO JOJ NFNCBOUV NFNBUJLBO QFSHFSBLBO EBMBN XBLUV
TFSFCFMVN UFSMFUBL EJ BOUBSB EBO EJSBOHTBOH PMFI TFSBUTFSBU TJOHLBU
QBSBMFM LFDJM 4FCBMJLOZB TFMTFM JOJ NFOHJSJN BLTPOOZB TFDBSB %FOHBO EFNJLJBO LJUB EBQBU NFMJIBU CBHBJNBOB TFMVSVI
UFHBLMVSVTNFMJOUBOHTFSBUTFSBUQBSBMFMEBONFOZFCBCLBOJOIJCJTJ TJSLVJU TFSFCFMVN EBQBU NFOHIJEVQLBO LPOUSBLTJ PUPU BHPOJT
MBUFSBM QBEB TFMTFM 1VSLJOKF EJ EFLBUOZB TFIJOHHB NFNQFSUBKBN TFDBSB DFQBU QBEB TBBU EJNVMBJOZB QFSHFSBLBO EBO UFOUVOZB
TJOZBMEFOHBODBSBZBOHTBNBTFQFSUJJOIJCJTJMBUFSBMNFNQFSUBKBN NFOFOUVLBO KVHB TBBU ZBOH UFQBU VOUVL NFNBUJLBO LPOUSBLTJ
LPOUSBTTJOZBMTJOZBMEJCBOZBLTJSLVJUOFVSPOTJTUFNTBSBG BHPOJTZBOHTBNBTFUFMBIQFSJPEFXBLUVUFSUFOUV
685
4FLBSBOH NBSJ LJUB NFNQFSLJSBLBO TJSLVJU ZBOH UFSKBEJ VN EJEVHB CFSGVOHTJ VOUVL QFOFOUVBO XBLUV EBO BTQFLBTQFL
VOUVL PUPUPUPU BOUBHPOJT 1BMJOH QFOUJOH JOHBUMBI CBIXB MBJOQBEBQFOHFOEBMJBOHFSBLBOZBOHNFOEFLBUJTFNQVSOBPMFI
TFCFUVMOZB EJ TFMVSVI NFEVMB TQJOBMJT UFSEBQBU TJSLVJU BHPOJT TFSFCFMVN#JMBIBMJOJUFMBIUFSDBQBJ TFSBUQFNBOKBUUJEBLQFSMV
BOUBHPOJT UJNCBM CBMJL VOUVL TFUJBQ HFSBLBO ZBOH EBQBU MBHJ NFOHJSJNLBO TJOZBM FSSPS OZB LF TFSFCFMVN VOUVL
EJDFUVTLBO PMFI NFEVMB TQJOBMJT 0MFI LBSFOB JUV TJSLVJU JOJ NFOJNCVMLBOQFSVCBIBOTFMBOKVUOZB
NFSVQBLBO CBHJBO EBTBS VOUVL NFNBUJLBO LPOUSBLTJ PUPU
Fungsi Serebelum datam Seturuh Pengendalian Motorik
BOUBHPOJT QBEB TBBU EJNVMBJOZB HFSBLBO LFNVEJBO
NFOZBMBLBOOZBQBEBTBBUBLIJSHFSBLBO NFOJSVBQBQVOZBOH 4JTUFN TBSBG NFOHHVOBLBO TFSFCFMVN VOUVL NFOHPPSEJOBTJLBO
UFSKBEJ QBEB PUPU BHPOJT 5FUBQJ LJUB IBSVT JOHBU KVHB CBIXB GVOHTJ QFOHFOEBMJBO NPUPSJL QBEB UJHB UJOHLBUBO TFCBHBJ
TFSFCFMVN NFNJMJLJ CFCFSBQB KFOJT TFM JOIJCJUPS MBJO TFMBJO TFM CFSJLVU
1VSLJOKF 'VOHTJ CFCFSBQB TFM JOJ NBTJI IBSVT EJTFMJEJLJ MBHJ 1. 7FTUJCVMPTFSFCFMVN #BHJBO JOJ QBEB QSJOTJQOZB UFSEJSJ BUBT
TFMTFM JOJ KVHB EBQBU CFSQFSBO QBEB QSPTFT JOIJCJTJ BXBM
MPCVT GMPLVMPOPEVMBSJT TFSFCFMVN LFDJM ZBOH UFSMFUBL EJ
UFSIBEBQ PUPU BOUBHPOJT TBBU EJNVMBJOZB HFSBLBO EBO
CBXBI TFSFCFMVN QPTUFSJPS
EBO CBHJBO WFSNJT ZBOH
TFMBOKVUOZBNFSBOHTBOHQBEBBLIJSHFSBLBO
CFSEFLBUBO #BHJBO JOJ NFOZFEJBLBO TJSLVJU OFVSPO VOUVL
.FLBOJTNF JOJ UFSVUBNB TFCBHJBO NBTJI CFSVQB EVHBBO
TFCBHJBOCFTBSHFSBLBOLFTFJNCBOHBOUVCVI
)BM UFSTFCVU EJOZBUBLBO EJ TJOJ UFSVUBNB VOUVL
NFOHHBNCBSLBO KBMBO BQB ZBOH EJMBLVLBO PMFI TFSFCFMVN 2. 4QJOPTFSFCFMVN#BHJBOJOJTFCBHJBOCFTBSUFSEJSJBUBTWFSNJT
VOUVL NFOJNCVMLBO TJOZBM OZBMB EBO TJOZBM NBUJ NFOHBUVS TFSFCFMVN QPTUFSJPS EBO BOUFSJPS EJUBNCBI [POB JOUFSNFEJB
PUPUBHPOJTEBOBOUBHPOJT EBOKVHBNFOHBUVSQFOHHVOBBOOZB ZBOHCFSEFLBUBOQBEBLFEVBTJTJWFSNJT#BHJBOJOJUFSVUBNB
NFSVQBLBO TJSLVJU VOUVL NFOHPPSEJOBTJLBO HFSBLBO
Sel Purkinje "Belajar" Mengoreksi Kesalahan Motorik- HFSBLBO CBHJBO EJTUBM BOHHPUB UVCVI LIVTVTOZB UBOHBO EBO
Peran Serat-Serat Pemanjat KBSJ
,FNBNQVBO TFSFCFMVN VOUVL NFNVMBJ EBO NFOHBLIJSJ 3. 4FSFCSPTFSFCFMVN #BHJBO JOJ UFSEJSJ BUBT [POB MBUFSBM CFTBS
LPOUSBLTJ PUPU TFQFSUJ KVHB QFOFOUVBO TBBU EJNVMBJOZB IFNJTGFS TFSFCFMVN EJ TFCFMBI MBUFSBM [POB JOUFSNFEJB
LPOUSBLTJ IBSVT EJQFMBKBSJ PMFI TFSFCFMVN 4FDBSB LIBT CJMB #BHJBO JOJ TFCFOBSOZB NFOFSJNB TFNVB JOQVUOZB EBSJ
TFTFPSBOHQFSUBNBLBMJNFMBLVLBOBLUJWJUBTNPUPSJLZBOHCBSV LPSUFLT TFSFCSJ NPUPSJL EBO LPSUFLT QSFNPUPSJL TFSUB
CFTBSOZB QFOHVBUBO NPUPSJL PMFI TFSFCFMVN QBEB TBBU LPSUFLTTFSFCSJTPNBUPTFOTPSJLZBOHCFSEFLBUBO#BHJBOJOJ
EJNVMBJOZB LPOUSBLTJ CFTBSOZB BUBV QFOHIBNCBUBO QBEB TBBU NFOHJSJNLBOJOGPSNBTJPVUQVUOZBLFBSBIBUBT LFNCBMJLF
LPOUSBLTJ CFSBLIJS EBO QFOFOUVBO TBBU EJMBLVLBOOZB TFNVB PUBL CFSGVOHTJ TFCBHBJ BMBU VNQBO CBMJL CFSTBNB EFOHBO
JUV IBNQJS TFMBMV CFMVN UFQBU CFUVM VOUVL NFOHIBTJMLBO TFMVSVI TJTUFN TFOTPSJNPUPSJL LPSUFLT TFSFCSJ VOUVL
HFSBLBO ZBOH CFOBS 5FUBQJ TFUFMBI EJMBLVLBO CFSVMBOH LBMJ NFSFODBOBLBO HFSBLBO WPMVOUFS UVCVI EBO BOHHPUB UVCVI
HFSBLBO UFSTFCVU TFDBSB QSPHSFTJG NFOKBEJ TFNBLJO UFQBU ZBOH CFSVSVUBO NFSFODBOBLBO TFNVB JOJ TFDFQBU
LBEBOHLBEBOHIBOZBQFSMVNFOHVMBOHCFCFSBQBLBMJTFCFMVN TFQFSTFQVMVIEFUJLTFCFMVNHFSBLBOUFSKBEJ)BMJOJEJTFCVU
BQBZBOHEJJOHJOLBOEBQBUUFSDBQBJ UFUBQJQBEBTBBUMBJOKVTUSV QFOHFNCBOHBO HBNCBSBO NPUPSJL HFSBLBO ZBOH BLBO
QFSMVNFOHVMBOHSBUVTBOLBMJ EJMBLVLBO
#BHBJNBOBLJSBLJSBQFOJMBJBOJOJEBQBUEJMBLVLBO +BXBCBO
QBTUJOZB CFMVN EJLFUBIVJ XBMBVQVO LJUB UFMBI NFOHFUBIVJ Vestibuloserebelum Berfungsi dalam Kaitannya dengan
CBIXB UJOHLBU TFOTJUJWJUBT TJSLVJU TFSFCFMVN TFOEJSJ TFDBSB Batang Otak dan Medula Spinalis untuk Mengendalikan
QSPHSFTJG EBQBU CFSBEBQUBTJ TFMBNB QSPTFT QFMBUJIBO Keseimbangan dan Pergerakan Postur
LIVTVTOZB TFOTJUJWJUBT TFM 1VSLJOKF VOUVL CFSFTQPOT UFSIBEBQ 7FTUJCVMPTFSFCFMVN TFDBSB GJMPHFOFUJL EJNVMBJ QBEB TBBU ZBOH
SBOHTBOHBOTFMHSBOVMB4FMBOKVUOZB QFSVCBIBOTFOTJUJWJUBTJOJ TBNB EFOHBO TBBU UFSCFOUVLOZB BQBSBUVT WFTUJCVMBS BMBU
EJCBXB PMFI TJOZBMTJOZBM ZBOH CFSBTBM EBSJ TFSBUTFSBU LFTFJNCBOHBO
QBEB UFMJOHB EBMBN 4FMBOKVUOZB TFQFSUJ ZBOH
QFNBOKBU ZBOH NFNBTVLJ TFSFCFMVN EBO CBHJBO JOGFSJPS UFMBI LJUB CJDBSBLBO QBEB #BC IJMBOHOZB MPCVT
LPNQMFLTPMJWBSJVT GMPLVMPOPEVMBSJTEBOCBHJBOWFSNJTTFSFCFMVNEJEFLBUOZBZBOH
%BMBN LFBEBBO JTUJSBIBU TFSBUTFSBU QFNBOKBU NFMFUVQ NFNCBOUV WFTUJCVMPTFSFCFMVN NFOZFCBCLBO UJNCVM HBOHHVBO
LVSBOH MFCJI TBUV LBMJ QFS EFUJL 5FUBQJ TFSBCVU JOJ LFTFJNCBOHBOEBOHFSBLBOUVCVIZBOHFLTUSFN
NFOZFCBCLBO EFQPMBSJTBTJ ZBOH FLTUSFN QBEB TFMVSVI 4FCFOBSOZBLJUBNBTJIIBSVTNFNQFSUBOZBLBO BQBQFSBOTFSUB
SBOHLBJBO EFOESJU TFM 1VSLJOKF ZBOH CFSMBOHTVOH TBNQBJ TBUV WFTUJCVMPTFSFCFMVN QBEB LFTFJNCBOHBO ZBOH UBL EBQBU
EFUJL TFUJBQ LBMJ NFMFUVQ 4FMBNB IBM JOJ UFSKBEJ TFM 1VSLJOKF EJMBLTBOBLBO PMFI NFLBOJTNF OFVSPO MBJOOZB EBMBN CBUBOH
NFMFUVQ EFOHBO MPOKBLBO PVUQVU BXBM ZBOH LVBU EBO EJJLVUJ PUBL 1FUVOKVL ZBOH OZBUB BEBMBI CBIXB TFTFPSBOH EFOHBO
PMFI TFSBOHLBJBO MPOKBLBO ZBOH MFCJI MFNBI #JMB TFTFPSBOH EJTGVOHTJ WFTUJCVMPTFSFCFMVN LFTFJNCBOHBOOZB KBVI MFCJI
NFNCFOUVL HFSBLBO CBSV VOUVL QFSUBNB LBMJ TJOZBMTJOZBM UFSHBOHHVTFMBNBNFMBLVLBOHFSBLBODFQBUEBSJQBEBTBBUEBMBN
VNQBOCBMJLEBSJQSPQSJPTFQUPSPUPUEBOTFOEJBLBONFNCFSJ LFBEBBOEJBN UFSVUBNBTFLBMJCJMBHFSBLBOUFSTFCVUNFMJCBULBO
JOGPSNBTJLFTFSFCFMVNUFOUBOHTFCFSBQBCBOZBLHFSBLBOZBOH QFSVCBIBO BSBI HFSBLBO UVCVI ZBOH NFSBOHTBOH LBOBMJT
UJEBL TFTVBJ EFOHBO HFSBLBO ZBOH EJJOHJOLBO 4FSBUTFSBU TFNJTJSLVMBSJT )BM JOJ NFNCFSJLBO LFTBO CBIXB
QFNBOKBU NFNCFSJLBO TJOZBM TFEFNJLJBO SVQB TFIJOHHB WFTUJCVMPTFSFCFMVN CFSHVOB VOUVL NFOHBUVS LFTFJNCBOHBO
NFOHVCBI TFOTJUJWJUBT KBOHLB QBOKBOH TFM 1VSLJOKF 4FUFMBI BOUBSBLPOUSBLTJPUPUBHPOJTEBOPUPUBOUBHPOJTQBEBQVOHHVOH
CFCFSBQB XBLUV MBNBOZB QFSVCBIBO TFOTJUJWJUBT JOJ CFSTBNB QJOHHVM EBO CBIV TBBU QPTJTJ UVCVI CFSVCBI DFQBU TFQFSUJ ZBOH
EFOHBOUFSKBEJOZBLFNVOHLJOBOGVOHTJCFMBKBSQBEBTFSFCFM EJQFSMVLBOPMFIBQBSBUVTWFTUJCVMBS
686
4BMBI TBUV NBTBMBI VUBNB EBMBN QFOHBUVSBO LFTFJNCBOHBO

BEBMBIKVNMBIXBLUVZBOHEJQFSMVLBOVOUVLNFOHJSJNLBOTJOZBM
QPTJTJEBOLFDFQBUBOTJOZBMHFSBLBOEBSJCFSCBHBJCBHJBOUVCVI
LF PUBL #BILBO CJMB EJHVOBLBO KBSBT QFOHIBOUBS TFOTPSJL ZBOH
QBMJOH DFQBU ZBLOJ NEFUJL QBEB USBLUVT BGFSFO
UNIT XI
TQJOPTFSFCFMVN UFUBQ NBTJI BEB QFSMBNCBUBO ZBOH EJQFSMVLBO
VOUVLQFOKBMBOBOJNQVMTEBSJLBLJTBNQBJPUBL ZBLOJBOUBSB
TBNQBJ NJMJEFUJL 4FMBNB XBLUV JOJ LBLJ TFTFPSBOH ZBOH T
TFEBOHCFSMBSJDFQBUEBQBUCFSHFSBLTFMFCBSJODJ0MFILBSFOB
JUV TJOZBMTJOZBMLFNCBMJZBOHCFSBTBMEBSJCBHJBOQFSJGFSUVCVI
UJEBLNVOHLJONFODBQBJPUBLQBEBTBBUZBOHCFSTBNBBOEFOHBO
HFSBLBO ZBOH TFEBOH UFSKBEJ 4FMBOKVUOZB CBHBJNBOB PUBL
NFOHFUBIVJ LBQBO IBSVT NFOHIFOUJLBO HFSBLBO EBO VOUVL
NFNCFOUVL VSVUBO HFSBLBO TFMBOKVUOZB CJMB HFSBLBO EJCFOUVL
TFDBSB DFQBU +BXBCBOOZB BEBMBI CBIXB TJOZBMTJOZBM EBSJ
EBFSBI QFSJGFS NFNCFSJUBIV PUBL NFOHFOBJ TFCFSBQB DFQBU EBO
LF BSBI NBOB CBHJBO UVCVI JOJ CFSHFSBL ,FNVEJBO GVOHTJ
WFTUJCVMPTFSFCFMVN ZBOH CFSQFSBO NFOHIJUVOH TFCFMVNOZB EBSJ
LFDFQBUBOEBOLFNBOBBSBICFSCBHBJCBHJBOUVCVIBLBOCFSBEB
TFMBNB CFCFSBQB NJMJEFUJL ZBOH BLBO EBUBOH )BTJM
QFOHIJUVOHBOJOJBEBMBILVODJVOUVLLFNBKVBOPUBLCBHJVSVUBO
HFSBLTFMBOKVUOZB
%FOHBO EFNJLJBO TFMBNB QFOHBUVSBO LFTFJNCBOHBO
EJQFSLJSBLBO CBIXB JOGPSNBTJ CBJL EBSJ QFSJGFS UVCVI NBVQVO
BQBSBUVTWFTUJCVMBSEJHVOBLBOPMFITJSLVJUQFOHFOEBMJBOVNQBO
CBMJL ZBOH LIVTVT HVOB NFOZFEJBLBO LPSFLTJ BOUJTJQBTJ TJOZBM
NPUPSJL VOUVL LPSFLTJ TJLBQ ZBOH EJQFSMVLBO EBMBN NFOKBHB QFOHFOEBMJNPUPSJLUJOHLBUZBOHMFCJIUJOHHJ LFUJLBEJLJSJNLBO
LFTFJNCBOHBO TBBU BEB HFSBLBO ZBOH TBOHBU DFQBU UFSNBTVL LF [POB JOUFSNFEJBU TFSFCFMVN NFMBMVJ USBLUVT
QFSVCBIBOBSBIHFSBLBOZBOHDFQBU LPSUJLPQPOUPTFSFCFMBSJT EFOHBO LJOFSKB CBHJBOCBHJBO UVCVI
Spinoserebelum-Pengendalian Umpan Balik terhadap ZBOH CFSTBOHLVUBO TFQFSUJ ZBOH EJLJSJNLBO LFNCBMJ LF
Gerakan-Gerakan Anggota Tubuh Bagian Distal melalui TFSFCFMVN EBSJ EBFSBI QFSJGFS 1BEB LFOZBUBBOOZB USBLUVT
Korteks Serebeli Intermedia dan Nukleus Interpositus TQJOPTFSFCFMBSJTWFOUSBMCBILBONFOHJSJNLFNCBMJTVBUVTBMJOBO
FGFSFOEBSJTJOZBMQFOHBUVSNPUPSJL ZBOHTFEBOHUFSKBEJ
ZBOH
4FQFSUJ ZBOH UBNQBL EBMBN (BNCBS [POB JOUFSNFEJB QBEB
NFODBQBJ OFVSPO NPUPSJL BOUFSJPS EBO TJOZBMTJOZBM JOJ KVHB
TFUJBQ IFNJTGFS TFSFCFMVN NFOFSJNB EVB KFOJT JOGPSNBTJ LFUJLB
EJJOUFHSBTJLBOEFOHBOTJOZBMZBOHUJCBEBSJLVNQBSBOPUPUEBO
HFSBLBOEJMBLVLBO
JOGPSNBTJEBSJLPSUFLTNPUPSJLTFSFCSJEBO
PSHBO TFOTPSJL QSPQSJPSFTFQUPS MBJOOZB ZBOH UFSVUBNB
EBSJ OVLMFVT SVCSB PUBL UFOHBI ZBOH NFNCFSJUBIV TFSFCFMVN
EJLJSJNLBO NFMBMVJ USBLUVT TQJOPTFSFCFMBSJT EPSTBMJT 4JOZBM
NFOHFOBJ VSVUBO SFODBOB HFSBLBO ZBOH EJJOHJOLBO EBMBN XBLUV
LPNQBSBTJ ZBOH TFSVQB KVHB EJLJSJN LF LPNQMFLT PMJWBSJVT
LVSBOHEBSJTBUVEFUJLLFNVEJBO EBO
JOGPSNBTJVNQBOCBMJL
JOGFSJPS KJLB TJOZBMTJOZBM UFSTFCVU UJEBL TFCBOEJOH TJTUFN TFM
EBSJ CBHJBO QFSJGFS UVCVI UFSVUBNB EBSJ QSPQSJPTFQUPS EJTUBM
1VSLJOKFPMJWBSJVT CFSTBNB EFOHBO NFLBOJTNF QFNCFMBKBSBO
BOHHPUB UVCVI ZBOH NFNCFSJUBIV TFSFCFMVN NFOHFOBJ IBTJM
TFSFCFMVN MBJOOZB BLBO NFOHPSFLTJ HFSBLBO TBNQBJ UFSCFOUVL
HFSBLBOTFLBSBOH
HFSBLBOTFTVBJEFOHBOZBOHEJIBSBQLBO
4FUFMBI [POB JOUFSNFEJB QBEB TFSFCFMVN NFNCBOEJOHLBO
HFSBLBOZBOHEJJOHJOLBOEFOHBOHFSBLBOTFLBSBOH TFMTFMOVLMFBS 'VOHTJ4FSFCFMVNVOUVL.FODFHBI(FSBLBO#FSMFCJIBOEBO
EBMBN EFFQOVDMFBSDFMMT
QBEBOVLMFVTJOUFSQPTJUVTNFOHJSJNLBO VOUVL .FSFEBN (FSBLBO )BNQJS TFNVB HFSBLBO UVCVI
TJOZBM LFMVBSBO ZBOH CFSTJGBU LPSFLUJG
LFNCBMJ LF LPSUFLT CFSTJGBU TFQFSUJ HFSBLBO CBOEVM QFOEVMVN
$POUPIOZB CJMB
NPUPSJL TFSFCSJ NFMBMVJ OVLMFJ SJMBJ EJ UBMBNVT EBO
LF CBHJBO MFOHBO EJHFSBLLBO UJNCVM NPNFOUVN EBO NPNFOUVN JOJ
NBHOPTFMVMBS CBHJBO MFCJI CBXBI
QBEB OVLMFVT SVCSB ZBOH IBSVT EBQBU EJBUBTJ TFCFMVN HFSBLBO EBQBU EJIFOUJLBO ,BSFOB
NFNCFOUVL USBLUVT SVCSPTQJOBMJT 5SBLUVT SVCSPTQJOBMJT BEBOZB NPNFOUVN JOJ TFNVB HFSBLBO CBOEVM DFOEFSVOH
LFNVEJBO CFSHBCVOH EFOHBO USBLUVT LPSUJLPTQJOBMJT VOUVL CFSHFSBL TFDBSB CFSMFCJIBO PWFSTIPPU
#JMB HFSBLBO ZBOH
NFNQFSTBSBGJ OFVSPO NPUPSJL ZBOH QBMJOH MBUFSBM QBEB SBEJLT CFSMFCJIBO JOJ UFSKBEJ QBEB PSBOH ZBOH NFOHBMBNJ LFSVTBLBO
BOUFSJPS TVCTUBOTJB HSJTFB NFEVMB TQJOBMJT ZBJUV OFVSPO ZBOH TFSFCFMVN QVTBU LFTBEBSBO ZBOH BEB EJ EBMBN TFSFCFMVN
NFOHFOEBMJLBOCBHJBOEJTUBMBOHHPUBUVCVI UFSVUBNBUBOHBOEBO BLIJSOZBEBQBUNFOHFOBMJIBMJOJEBONFNVMBJHFSBLBOEFOHBO
KBSJKBSJ BSBI ZBOH CFSMBXBOBO NFODPCB BHBS MFOHBO EBQBU EJCBXB LF
#BHJBO TJTUFN QFOHBUVS NPUPSJL TFSFCFMVN JOJ NFOJNCVMLBO TJLBQ ZBOH EJJOHJOLBO /BNVO TFLBMJ MBHJ PMFI TJGBU
HFSBLBO ZBOH IBMVT EBO UFSLPPSEJOBTJ QBEB PUPUPUPU BHPOJT EBO NPNFOUVNOZB QBEB MFOHBO UJNCVM MBHJ HFSBLBO ZBOH
BOUBHPOJTBOHHPUBUVCVICBHJBOEJTUBMVOUVLNFMBLVLBOHFSBLBO CFSMFCJIBO EFOHBO BSBI ZBOH CFSMBXBOBO EBO TJOZBM QFSCBJLBO
UFSQPMB EFOHBO UVKVBO UFSUFOUV ZBOH CFSTJGBU TFHFSB 5BNQBLOZB ZBOHTFTVBJIBSVTLFNCBMJEJUJNCVMLBO+BEJ TFTVEBIUJUJLZBOH
TFSFCFMVNNFNCBOEJOHLBONBLTVEUVKVBOEBSJTJTUFN EJJOHJOLBOUFSDBQBJ MFOHBOBLBOCFSHPZBOHNBKVNVOEVSVOUVL
687
CFCFSBQB LBMJ TFCFMVN BLIJSOZB CFSIFOUJ BUBV UFSGJLTBTJ QBEB UFUBQJ KVTUSV EFOHBO BSFB QSFNPUPSJL EBO BSFB BTPTJBTJ
UFNQBU ZBOH EJJOHJOLBO &GFL JOJ EJTFCVU TFCBHBJ USFNPS BLTJ TPNBUPTFOTPSJLTFSUBBSFBBTPTJBTJQSJNFS
BUBVUSFNPSJOUFOTJ 8BMBVQVO EFNJLJBO LFSVTBLBO QBEB [POB MBUFSBM IFNJTGFS
/BNVO CJMBTFSFCFMVNNBTJIVUVI TJOZBMUBLEJTBEBSJZBOH TFSFCFMVN CFSTBNB EFOHBO OVLMFJ CBHJBO EBMBN ZBJUV OVLMFJ
UFMBI EJQFMBKBSJ NFOHIFOUJLBO HFSBLBO UFQBU QBEB UJUJL ZBOH EFOUBUVT EBQBU NFOJNCVMLBO JOLPPSEJOBTJ ZBOH FLTUSFN EBSJ
EJJOHJOLBO TFIJOHHB BLBO NFODFHBI UJNCVMOZB HFSBLBO ZBOH HFSBLBOHFSBLBO CFSUVKVBO ZBOH LPNQMFLT QBEB UBOHBO KBSJ
CFSMFCJIBOEBOUSFNPS)BMUFSTFCVUNFSVQBLBOTJGBUEBTBSEBSJ LBLJ EBO BMBU CJDBSB ,FBEBBO JOJ TVLBS EJNFOHFSUJ LBSFOB
TVBUV TJTUFN QFSFEBN 4FNVB TJTUFN QFOHFOEBMJ ZBOH LVSBOHOZB IVCVOHBO MBOHTVOH BOUBSB CBHJBO TFSFCFMVN JOJ
NFOHBUVS FMFNFO CBOEVM ZBOH NFNQVOZBJ JOFSTJB IBSVTMBI EFOHBO LPSUFLT NPUPSJL QSJNFS /BNVO EBSJ QFOFMJUJBO
NFNQVOZBJ TJSLVJU QFSFEBN EBMBN NFLBOJTNFOZB 1BEB FLTQFSJNFOUBM EJEVHB CBIXB CBHJBO TFSFCFMVN JOJ CFSLBJUBO
QFOHFOEBMJBO NPUPSJL PMFI TJTUFN TBSBG QVTBU TFSFCFMVN EFOHBO EVB BTQFL QFOHBUVSBO NPUPSJL ZBOH QFOUJOH UFUBQJ
NFSVQBLBOQFOZFEJBGVOHTJQFSFEBNJOJ CFSTJGBU UJEBL MBOHTVOH
QFSFODBOBBO HFSBLBO ZBOH
CFSVSVUBO EBO
QFOHBUVSBOXBLUVEBSJHFSBLBOCFSVSVUBO
Pengaturan Gerakan Balistik oleh Serebelum. 4FCBHJBO
CFTBS HFSBLBO UVCVI ZBOH DFQBU TFQFSUJ HFSBLBO KBSJ TFXBLUV Perencanaan Pergerakan Berurutan. 1FSFODBOBBO
NFOHFUJL CFSMBOHTVOH TBOHBU DFQBU TFIJOHHB UBL NVOHLJO HFSBLBO CFSVSVUBO NFNCVUVILBO LPNVOJLBTJ BOUBSB [POB
EBQBUEJUFSJNBJOGPSNBTJVNQBOCBMJLZBOHCFSBTBMEBSJQFSJGFS MBUFSBMIFNJTGFSEFOHBOCBHJBOQSFNPUPSJLEBOCBHJBOTFOTPSJL
NFOVKV TFSFCFMVN BUBV ZBOH CFSBTBM EBSJ TFSFCFMVN LFNCBMJ LPSUFLTTFSFCSJ EBOIBMUFSTFCVUNFNCVUVILBOIVCVOHBOEVB
LFLPSUFLTNPUPSJL(FSBLBOJOJEJTFCVUHFSBLBOCBMJTUJL ZBOH BSBIBOUBSBBSFBBSFBEJLPSUFLTTFSFCSJUFSTFCVUEFOHBOEBFSBI
CFSBSUJ CBIXB TFMVSVI HFSBLBO JUV TFCFMVNOZB UFMBI EJ HBOHMJB CBTBMJT ZBOH UFSLBJU 5BNQBLOZB SFODBOB HFSBLBO
EJSFODBOBLBO EVMV EBO EJTVTVO NFOKBEJ TVBUV HFSBLBO ZBOH CFSVSVUBO JOJ TFCFOBSOZB EJNVMBJ EBSJ BSFB TFOTPSJL EBO BSFB
NFNQVOZBJ KBSBL UFSUFOUV BUBV ZBOH TQFTJGJL EBO TFMBOKVUOZB QSFNPUPSJL LPSUFLT TFSFCSJ EBO EBSJ TJOJ SFODBOB EJLJSJNLBO
BLBOCFSIFOUJ$POUPIQFOUJOHMBJOOZBBEBMBIHFSBLBOTBLBEJL LF[POBMBUFSBMIFNJTGFSTFSFCFMVN,FNVEJBO EJQFSUFOHBIBO
QBEB NBUB TBBU NFNCBDB NBUB TFBLBOBLBO NFMPNQBU EBSJ MBMVMJOUBT EVB BSBI BOUBSB TFSFCFMVN EBO LPSUFLT TFSFCSJ
TBUV QPTJTJ LF QPTJTJ CFSJLVUOZB BUBV TBBU NBUB NFMJIBU UJUJL TJOZBM NPUPSJL ZBOH TFTVBJ EJCFSJLBO VOUVL UFSKBEJOZB QSPTFT
UJUJLZBOHCFSVOUVOEJTFQBOKBOHKBMBO ZBLOJLFUJLBPSBOHOBJL USBOTJTJEBSJTBUVHFSBLBOLFHFSBLBOCFSJLVUOZB
NPCJM 4VBUV PCTFSWBTJ NFOBSJL ZBOH NFOEVLVOH QFOEBQBU JOJ
#BOZBL ZBOH EBQBU EJNFOHFSUJ NFOHFOBJ GVOHTJ TFSFCFMVN NFOZBUBLBO CBIXB CBOZBLOZB OFVSPO QBEB OVLMFJ EFOUBUVT
ZBJUV EFOHBO DBSB NFNQFMBKBSJ QFSVCBIBOQFSVCBIBO ZBOH TFSFCFMVN NFNQFSMJIBULBO QPMB BLUJWJUBT QFSHFSBLBO
UFSKBEJQBEBTBBUUJNCVMOZBHFSBLBOCBMJTUJLCJMBTFSFCFMVNOZB CFSVSVUBO CFSJLVUOZB ZBOH CFMVN UFSKBEJ TFEBOHLBO
EJBOHLBU "EB UJHB QFSVCBIBO VUBNB ZBOH UFSKBEJ ZBLOJ
QFSHFSBLBO TBBU JOJ NBTJI CFSMBOHTVOH +BEJ [POB TFSFCFMVN
HFSBLBOCFSLFNCBOHMBNCBUEBOUJEBLNFNJMJLJMPOKBLBOBXBM MBUFSBMUBNQBLOZBUJEBLJLVUUFSMJCBUEBMBNHFSBLBOZBOHUFSKBEJ
UBNCBIBOZBOHCJBTBEJTFEJBLBOPMFITFSFCFMVN
LFLVBUBO QBEB TBBU JUV UFUBQJ UFSMJCBU EBMBN HFSBLBO CFSVSVUBO
ZBOH EJCFOUVL CFSTJGBU MFNBI EBO
QFSHFSBLBO TBOHBU CFSJLVUOZBZBOHBLBOUFSKBEJLFNVEJBOEBMBNXBLUVTBUVEFUJL
MBNCBUVOUVLEJIFOUJLBO CJBTBOZBHFSBLBOBLBONFMFXBUJUJUJL BUBVLVSBOH
ZBOHEJJOHJOLBO0MFILBSFOBJUV CJMBTJSLVJUTFSFCFMVNJOJUBL 3JOHLBTOZB TBMBITBUVHBNCBSBOUFSQFOUJOHGVOHTJNPUPSJL
BEB LPSUFLT NPUPSJL IBSVT CFOBSCFOBS NFNJLJSLBO VOUVL ZBOH OPSNBM BEBMBI LFNBNQVBO TFTFPSBOH VOUVL CFSHFSBL
NFNVMBJQFSHFSBLBOCBMJTUJL EBOLFNVEJBOCFSQJLJSLFSBTEBO MBODBS EBSJ TBUV HFSBLBO LF HFSBLBO CFSJLVUOZB TFDBSB
MBNBVOUVLNFOHIFOUJLBOQFSHFSBLBOUBEJ%FOHBOEFNJLJBO CFSVSVUBO #JMB [POB MBUFSBM IFNJTGFS TFSFCFMVN MVBT JOJ UJEBL
TJGBUPUPNBUJTQFSHFSBLBOCBMJTUJLIJMBOH BEB LFNBNQVBO UFSTFCVU BLBO UFOHBOHHV QBEB QFSHFSBLBO
%FOHBONFNQFSIBUJLBOTJSLVJUTFSFCFMVN LJUBEBQBUNFMJIBU ZBOHDFQBU
CBIXB TJSLVJU UFSTFCVU UFSPSHBOJTBTJ TBOHBU CBJL VOUVL
NFMBLTBOBLBOGVOHTJZBOHCFSTJGBUCJGBTJL GVOHTJFLTJUBTJQBEB Fungsi Pengaturan Waktu. 'VOHTJMBJOZBOHQFOUJOHEBSJ
BXBMOZBEBOLFNVEJBOJOIJCJTJMBNCBU ZBOHEJQFSMVLBOVOUVL [POB MBUFSBM IFNJTGFS TFSFCFMVN BEBMBI VOUVL NFOFOUVLBO
HFSBLBOCBMJTUJLUFSFODBOB XBLUV ZBOH TFTVBJ CBHJ TFUJBQ HFSBLBO TFMBOKVUOZB #JMB [POB
MBUFSBM TFSFCFMVN JOJ UJEBL BEB TFTFPSBOH BLBO LFIJMBOHBO
Serebroserebelum-Fungsi Zona Lateral Hemisfer LFNBNQVBO UBL EJTBEBSJ
VOUVL NFNQFSLJSBLBO TFCFSBQB
Serebelum yang Besar untuk Merencanakan, Urutan, KBVI CBHJBOCBHJBO UVCVI BLBO EJHFSBLLBO QBEB TVBUV TBBU
dan Waktu Gerakan-Gerakan Kompleks #JMBLFNBNQVBOVOUVLNFOFOUVLBOXBLUVJOJUJEBLBEB PSBOH
1BEB NBOVTJB [POB MBUFSBM LFEVB IFNJTGFS TFSFCFMVN NFOKBEJ UJEBL NBNQV NFOFOUVLBO LBQBO HFSBLBO CFSJLVUOZB
UFSCFOUVL TBOHBU TFNQVSOB EBO TBOHBU CFTBS )BM JUV TFTVBJ QFSMV EJNVMBJ "LJCBUOZB SBOHLBJBO QFSHFSBLBO NVOHLJO
EFOHBO LFNBNQVBO NBOVTJB VOUVL NFSFODBOBLBO EBO EJNVMBJ UFSMBMV BXBM BUBV MFCJI TFSJOH KVTUSV UFSMBNCBU 0MFI
NFOHBEBLBO QPMB HFSBLBO ZBOH CFSVSVUBO UFSVUBNB QBEB LBSFOB JUV MFTJ QBEB [POB MBUFSBM TFSFCFMVN NFOJNCVMLBO
UBOHBO EBO KBSJ TFSUB VOUVL CJDBSB /BNVO [POB MBUFSBM ZBOH HFSBLBO LPNQMFLT TFQFSUJ ZBOH EJQFSMVLBO TFXBLUV NFOVMJT
CFTBS QBEB IFNJTGFS TFSFCFMVN JOJ UJEBL NFOEBQBU JOGPSNBTJ CFSMBSJ BUBVCBILBOCFSCJDBSB
NFOKBEJUJEBLUFSLPPSEJOBTJEBO
MBOHTVOH EBSJ CBHJBO QFSJGFS UVCVI +VHB IBNQJS TFNVB LFIJMBOHBO LFNBNQVBO VOUVL NFOHFNCBOHLBO SBOHLBJBO
LPNVOJLBTJ BOUBSB BSFBBSFB MBUFSBM TFSFCFMVN EBO LPSUFLT EBSJ TBUV HFSBLBO LF HFSBLBO CFSJLVUOZB -FTJ TFSFCFMVN
TFSFCSJUJEBLEFOHBOLPSUFLTNPUPSJLQSJNFSTFSFCSVNTFOEJSJ TFNBDBN JOJ EJLBUBLBO NFOZFCBCLBO LFHBHBMBO
NFOHFNCBOHLBOHFSBLBOHFSBLBOTFDBSBMBODBS
688
Fungsi Prediksi Ekstramotorik Serebroserebelum. Kegagalan Perkembangan

4FSFCSPTFSFCFMVN MPCVT MBUFSBM CFTBS
KVHB NFNCBOUV VOUVL Disdiadokokinesia-Kegagalan Melakukan Pergerakan Bolak-
NFOHIJUVOH XBLUV QFSJTUJXBQFSJTUJXB TFMBJO QFSHFSBLBO Balik. #JMB TJTUFN QFOHBUVS NPUPSJL HBHBM NFSBNBMLBO EJ NBOB MFUBL
UVCVI $POUPIOZB PUBL NBNQV NFNQSFEJLTJ LFDFQBUBO CFSCBHBJ CBHJBO UVCVI QBEB XBLUV ZBOH BLBO EBUBOH NBLB TFMBNB
UNIT XI
QFOHFNCBOHBO GFOPNFOB BVEJUPSJL EBO GFOPNFOB WJTVBM QFSHFSBLBO NPUPSJL ZBOH DFQBU TJTUFN QFOHFOEBMJ NPUPSJL LFIJMBOHBO
OBNVO LFEVB GFOPNFOB JOJ NFNFSMVLBO QBSUJTJQBTJ QFSTFQTJCBHJBOUVCVIUFSTFCVUTFMBNBHFSBLBODFQBU"LJCBUOZB SBOHLBJBO
TFSFCFMVN 4FCBHBJ DPOUPI TFTFPSBOH EBQBU NFNQSFEJLTJ HFSBLBOBLBOEJNVMBJMFCJIBXBMBUBVNBMBIBOUFSMBNCBU TFIJOHHBUBLBLBO
QFSVCBIBO HBNCBS WJTVBM TFDFQBU JB NFOEFLBUJ TVBUV PCKFL UJNCVM LFNBKVBO HFSBLBO ZBOH CFSBUVSBO )BM JOJ EBQBU EJQFSBHBLBO
4VBUV QFOFMJUJBO ZBOH NFODPMPL ZBOH EBQBU NFNQFSBHBLBO EFOHBO DBSB NFOZVSVI QBTJFO ZBOH NFOHBMBNJ LFSVTBLBO TFSFCFMVN
NFNCBMJLLBO UBOHBOOZB EFOHBO DFQBU NFOHIBEBQ LF BUBT EBO LF CBXBI
QFSBO TFSFCFMVN EBMBN LFNBNQVBO UFSTFCVU BEBMBI FGFL
1BTJFOEFOHBODFQBUNFSBTBLFIJMBOHBOTFMVSVIQFSTFQTJQPTJTJUBOHBOOZB
QFOHBOHLBUBO CBHJBO MBUFSBM CFTBS TFSFCFMVN QBEB TFFLPS
TFMBNB TFUJBQ CFOUVL QFSHFSBLBO "LJCBUOZB UJNCVM TFSBOHLBJBO VTBIB
NPOZFU .POZFU UFSTFCVU LBEBOH LBMB NFOZFSBOH EJOEJOH VOUVLNFNQFSMBNCBUUFUBQJNBMBINFOKBEJQFSHFSBLBOZBOHUBLUFSBUVSEBO
TVBUV MPSPOH EBO PUBLOZB LFMVBS EBSJ UFNQVSVOH LFQBMB CVLBO TFCBHBJ QFSHFSBLBO UFSLPPSEJOBTJ NFOHIBEBQ LF BUBT EBO LF CBXBI
LBSFOB UJEBL NBNQV NFSBNBMLBO LBQBO EJSJOZB BLBO ,FBEBBOJOJEJTFCVUEJTEJBEPLPLJOFTJB
NFODBQBJEJOEJOHUFSTFCVU Disartria-Kegagalan Perkembangan dalam Berbicara.
4FLBSBOH JOJ LJUB CBSV NVMBJ NFNQFMBKBSJ NFOHFOBJ GVOHTJ $POUPIMBJOLFHBHBMBOLFNBKVBOQFSHFSBLBOBEBMBITFXBLUVCJDBSB LBSFOB
NFSBNBM FLTUSBNPUPSJL TFSFCFMVN 4BOHBU NVOHLJO CBIXB QFNCFOUVLBO LBUBLBUB CFSHBOUVOH QBEB LFDFQBUBO EBO VSVUBO SBOHLBJBO
TFSFCFMVN CFSQFSBO TFCBHBJ QFOZFEJB CBTJT XBLUV NVOHLJO QFSHFSBLBOTFDBSBJOEJWJEVBMPUPUQBEBMBSJOH NVMVU EBOTJTUFNQFSOBQBTBO
EFOHBO NFOHHVOBLBO TJSLVJU MBNCBUBO XBLUV ZBOH TJOZBM (BOHHVBO LPPSEJOBTJ EJ BOUBSB QFSHFSBLBO PUPUPUPU UFSTFCVU EBO
TJOZBMOZB EBQBU EJHVOBLBO TFCBHBJ QFNCBOEJOH UFSIBEBQ LFUJEBLNBNQVBO VOUVL TFMBOKVUOZB NFOZFTVBJLBO JOUFOTJUBT TVBSB BUBV
TJOZBMTJOBZBM EBSJ CBHJBO TJTUFN TBSBG QVTBU MBJOOZB 4FSJOH MBNBOZBTFUJBQSFOUFUBOTVBSBBLBONFOZFCBCLBOUJNCVMOZBWPLBMJTBTJZBOH
EJOZBUBLBO CBIXB TFSFCFMVN LIVTVTOZB CFSHVOB VOUVL DBNQVS BEVL EFOHBO CFCFSBQB QFOHVDBQBO QFOHHBMBO LBUB TFDBSB LFSBT
CFCFSBQB QFOHVDBQBOOZB TFDBSB MFNBI LFNVEJBO TFQFSUJ UFSUBIBO EBMBN
NFOBGTJSLBO QFSVCBIBO IVCVOHBO TQBTJPUFNQPSBM ZBOH TBOHBU
XBLUV MBNB CFCFSBQB UFSUBIBO EBMBN XBLUV TJOHLBU EBO SFTVMUBOUF TVBSB
DFQBUEBMBNJOGPSNBTJTFOTPSJL ZBOHLFMVBSTFSJOHLBMJUBLEBQBUEJQBIBNJ,FBEBBOJOJEJTFCVUEJTBSUSJB
Kelainan-Kelainan Klinis Serebelum Tremor Intensi. ,FUJLB QBTJFO ZBOH UFMBI LFIJMBOHBO TFSFCFMVNOZB
,FSVTBLBO CBHJBOCBHJBO LFDJM LPSUFLT MBUFSBM TFSFCFMVN KBSBOH
EJQFSJOUBILBO VOUVL NFMBLVLBO TVBUV LFSKB WPMVOUFS QFSHFSBLBOOZB
NFOJNCVMLBO BCOPSNBMJUBT GVOHTJ NPUPSJL ZBOH EBQBU EJEFUFLTJ
DFOEFSVOH CFSPTJMBTJ UFSVUBNB LFUJLB QFSHFSBLBO JOJ NFOEFLBUJ UJUJL ZBOH
5FSOZBUB CFCFSBQBCVMBOTFUFMBITFQBSVICBHJBOLPSUFLTMBUFSBMTFSFCFMVN
EJJOHJOLBO NVMBNVMB NFMFCJIJ UJUJL UFSTFCVU LFNVEJBO CFSHFUBS LF
EJCVBOH QBEB TBUV TJTJ PUBL CJMB OVLMFJ TFSFCFMVN CBHJBO EBMBN UBL
CFMBLBOH EBO LF EFQBO CFCFSBQB LBMJ TBBU TFCFMVN NFOFUBQ QBEB UJUJL
EJCVBOH CFSTBNB EFOHBO QFNCVBOHBO LPSUFLT GVOHTJ NPUPSJL IFXBO
UFSTFCVU3FBLTJJOJEJTFCVUUSFNPSJOUFOTJBUBVUSFNPSBLTJ EBONFSVQBLBO
UFSTFCVU UBNQBLOZB IBNQJS OPSNBM TFMBNB IFXBO UFSTFCVU NFMBLVLBO
BLJCBU EBSJ HFSBLBO CFSMFCJIBO TFSFCFMVN EBO LFHBHBMBO TJTUFN TFSFCFMVN
TFNVBHFSBLBOTFDBSBMBNCBU+BEJ CBHJBOTJTUFNQFOHFOEBMJNPUPSJLZBOH
VOUVLNFSFEBNQFSHFSBLBONPUPSJL
UFSTJTB NBNQV NFOHPNQFOTBTJLBO TFDBSB IFCBU TFNVB GVOHTJ CBHJBO
TFSFCFMVNZBOHUFMBIIJMBOH Nistagmus Serebelum-Tremor Bola Mata. /JTUBHNVTTFSFCFMVN
6OUVLNFOJNCVMLBOHBOHHVBOGVOHTJTFSFCFMVNZBOHTFSJVTEBOUFSVT NFSVQBLBO USFNPS CPMB NBUB ZBOH CJBTBOZB UFSKBEJ CJMB TFTFPSBOH JOHJO
NFOFSVT MFTJTFSFCFMVNCJBTBOZBIBSVTNFMJCBULBOTBUVBUBVMFCJIOVLMFJ NFNGJLTBTJNBUBOZBQBEBTVBUVPCKFLEJTBMBITBUVTJTJLFQBMBOZB5JQFPGG
TFSFCFMVN CBHJBO EBMBN OVLMFJ EFOUBUVT OVLMFJ JOUFSQPTJUVT BUBV OVLMFJ DFOUFS EBSJ GJLTBTJ NFOHIBTJMLBO QFSHFSBLBO CPMB NBUB ZBOH TBOHBU DFQBU
GBTUJHJVT TFSUBCFSVMBOHCPMBLCBMJL EBOCVLBOGJLTBTJNBUBZBOHNFOFUBQ EBOIBMJOJ
Dismetria dan Ataksia. %VB HFKBMB UFSQFOUJOH QFOZBLJU NFSVQBLBO NBOJGFTUBTJ MBJO EBSJ LFHBHBMBO GVOHTJ QFSFEBN TFSFCFMVN
TFSFCFMVNBEBMBIEJTNFUSJBEBOBUBLTJB#JMBTFSFCFMVNUJEBLBEB TJTUFN ,FBEBBO JOJ UFSVUBNB UFSKBEJ QBEB LFSVTBLBO MPCVT GMPLVMPOPEVMBSJT
QFOHBUVS NPUPSJL UBL EJTBEBSJ UJEBL NBNQV NFNQFSLJSBLBO TFCFSBQB TFSFCFMVN QBEB DPOUPI LBTVT JOJ OJTUBHNVT TFSFCFMVN KVHB CFSLBJUBO
KBVIQFSHFSBLBOZBOHBLBOUJNCVM0MFILBSFOBJUV CJBTBOZBQFSHFSBLBO EFOHBOIJMBOHOZBLFTFJNCBOHBOBLJCBUHBOHHVBOGVOHTJKBSBTZBOHNFMFXBUJ
ZBOH UJNCVM BLBO CFSMFCJIBO BUBV NFMFCJIJ TBTBSBO ZBOH EJJOHJOLBO MPCVTGMPLVMPOPEVMBSJTTFSFCFMVNEBSJLBOBMJTTFNJTJSLVMBSJT
TFMBOKVUOZB CBHJBO LFTBEBSBO PUBL NFOHPNQFOTBTJ EFOHBO BSBI ZBOH Hipotonia-Menurunnya Tonus Otot-otot. )JMBOHOZB OVLMFJ
CFSMBXBOBO VOUVL QFSHFSBLBO LPNQFOTBUPSJL TFMBOKVUOZB &GFL JOJ TFSFCFMVN CBHJBO EBMBN UFSVUBNB QBEB OVLMFJ EFOUBUVT EBO OVLMFJ
EJTFCVUEJTNFUSJB EBONFOJNCVMLBOQFSHFSBLBOUBLUFSLPPSEJOBTJZBOH JOUFSQPTJUVT NFOZFCBCLBO QFOVSVOBO UPOVT PUPUPUPU UVCVI QFSJGFS QBEB
EJTFCVU BUBLTJB %JTNFUSJB EBO BUBLTJB KVHB EBQBU UJNCVM EBSJ MFTJ QBEB TJTJ ZBOH TBNB EFOHBO TJTJ MFTJ TFSFCFMVN )JQPUPOJB EJTFCBCLBO PMFI
USBLUVTTQJOPTFSFCFMBSJT LBSFOBJOGPSNBTJVNQBOCBMJLZBOHCFSBTBMEBSJ IJMBOHOZB GBTJMJUBTJ TFSFCFMVN QBEB LPSUFLT NPUPSJL EBO OVLMFJ NPUPSJL
CBHJBO UVCVI ZBOH CFSHFSBL LF TFSFCFMVN CFSHVOB VOUVL QFOHBUVSBO CBUBOHPUBLPMFITJOZBMUPOJLEBSJOVLMFJTFSFCFMVNCBHJBOEBMBN
XBLUVZBOHUFQBUEBMBNNFOHBLIJSJHFSBLBO
Penunjukan yang Terlewat (Past Pointing). 1BTU QPJOUJOH Ganglia Basalis-Fungsi Motorik
CFSBSUJ CBIXB UBOQB TFSFCFMVN TFTFPSBOH CJBTBOZB NFOHHFSBLLBO
UBOHBOOZBBUBVCBHJBOUVCVIZBOHMBJONFMFXBUJUJUJLZBOHEJJOHJOLBO)BM
(BOHMJB CBTBMJT TFQFSUJ TFSFCFMVN NFNCFOUVL TJTUFN BTFTPSJ
JOJEJUJNCVMLBOPMFILFOZBUBBOCBIXBTFDBSBOPSNBMTFSFCFMVNNFNVMBJ
NPUPSJLMBJOZBOHCJBTBOZBUJEBLNFMBLVLBOTFOEJSJGVOHTJOZB
TFCBHJBO CFTBS TJOZBM NPUPSJL ZBOH NFOHIFOUJLBO QFSHFSBLBO TFTVEBI
QFSHFSBLBO JUV EJNVMBJ CJMB TFSFCFMVN UBL EBQBU NFMBLVLBO GVOHTJ UFUBQJ CFSLBJUBO FSBU EFOHBO LPSUFLT TFSFCSJ EBO TJTUFN
UFSTFCVU CJBTBOZBHFSBLBOZBOHUJNCVMBLBONFMBOKVUNFMFXBUJUJUJLZBOH QFOHFOEBMJ NPUPSJL LPSUJLPTQJOBM 1BEB LFOZBUBBOOZB
EJJOHJOLBO 0MFI LBSFOB JUV HFKBMB QBTUQPJOUJOH TFCFOBSOZB NFSVQBLBO TFCFOBSOZB HBOHMJB CBTBMJT NFOFSJNB TFCBHJBO CFTBS TJOZBM
NBOJTGFTUBTJEJTNFUSJB JOQVU EBSJ LPSUFLT TFSFCSJ EBO KVHB NFOHFNCBMJLBO IBNQJS
TFMVSVITJOZBMPVUQVUOZBLFLPSUFLTKVHB
689
(BNCBSNFNQFSMJIBULBOIVCVOHBOBOBUPNJTBOUBSB
HBOHMJBCBTBMJTEFOHBOTUSVLUVSTUSVLUVSMBJOQBEBPUBL1BEB
TFUJBQ TJTJ PUBL HBOHMJB JOJ UFSEJSJ BUBT OVLMFVT LBVEBUVT
QVUBNFO HMPCVT QBMJEVT TVCTUBOTJB OJHSB EBO OVLMFVT
TVCUBMBNJLVT 4FNVBOZB JOJ UFSVUBNB UFSMFUBL EJ TFCFMBI
MBUFSBM UFSIBEBQ EBO NFOHFMJMJOHJ UBMBNVT NFOFNQBUJ
TFCBHJBO CFTBS SFHJP JOUFSJPS LFEVB IFNJTGFS TFSFCSVN
1FSIBUJLBO KVHB CBIXB IBNQJS TFNVB TFSBCVU TBSBG NPUPSJL
EBO TFOTPSJL ZBOH NFOHIVCVOHLBO LPSUFLT TFSFCSJ EBO
NFEVMBTQJOBMJTCFSKBMBONFMBMVJSVBOHZBOHUFSMFUBLEJBOUBSB
CBHJBO VUBNB HBOHMJB CBTBMJT ZBJUV OVLMFVT LBVEBUVT EBO
QVUBNFO3VBOHJOJEJTFCVULBQTVMBJOUFSOBEBSJPUBL3VBOH
JOJ QFOUJOH VOUVL QFNCJDBSBBO LJUB TFMBOKVUOZB LBSFOB
BEBOZB LBJUBO FSBU BOUBSB HBOHMJB CBTBMJT EFOHBO TJTUFN
LPSUJLPTQJOBMHVOBQFOHFOEBMJBONPUPSJL
Sirkuit Neuron Ganglia Basalis. )VCVOHBO BOBUPNJT
BOUBSB HBOHMJB CBTBMJT EBO FMFNFOFMFNFO PUBL MBJO ZBOH
NFOZFEJBLBOQFOHBUVSBONPUPSJLCFSTJGBULPNQMFLT TFQFSUJ
ZBOH EJQFSMJIBULBO QBEB (BNCBS %J TFCFMBI LJSJ
HBNCBS UBNQBLLPSUFLTNPUPSJL UBMBNVT EBOCBUBOHPUBL
TFSUB TJSLVJU VUBNB TJTUFN HBOHMJB CBTBMJT NFNQFSMJIBULBO
CFSCBHBJ IVCVOHBO ZBOH MVBS CJBTB CBOZBLOZB EJBOUBSB
HBOHMJBCBTBMJTTFOEJSJEJUBNCBIKBSBTJOQVUEBOPVUQVUZBOH
MVBTBOUBSBSFHJPNPUPSJLMBJOQBEBPUBLEBOHBOHMJBCBTBMJT
%BMBNQFNCBIBTBOTFMBOKVUOZB LJUBBLBOCFSLPOTFOUSBTJ
QBEBEVBVUBNB TJSLVJUQVUBNFOEBOTJSLVJULBVEBUVT
Fungsi Ganglia Basalis dalam Melaksanakan Pola
Aktivitas Motorik-Sirkuit putamen
Q_rs npgl qgn s r_k _ e_l ejg_ ` _q_jgq b_j_k ncl e_rs p_l
k mrmpgi _b_j_f * i cph_l w_ ` cpi _gr_l bcl e_l qgqrck
i mprgi mqngl _j s l rs i k cl e_rs p nmj_+nmj_ _i rgt gr_q
k mrmpgi w_l e i mk njci q, Qc` _e_gaml rmf _b_j_f n_b_ u _i rs
k cl s jgq f s ps d+f s ps d_jd_` cr, @gj_ rcph_bgLFSVTBLBO ZBOH 1PMB MBJO ZBOH NFNFSMVLB HBOHMJB CBTBMJT BEBMBI
QBEB HBOHMJB CBTBMJT TJTUFN LPSUJLBM QFOHFOEBMJBO NPUPSJL NFMPNQBU NFOFOEBOH CPMB LBLJ NFNVLVM CPMB LBTUJ
UJEBL EBQBU MBHJ NFOZFEJBLBO QPMBQPMB IVSVG 5FOUVOZB HFSBLBO NFOHJCBTLBO LPUPSBO CFSCBHBJ BTQFL WPLBMJTBTJ
UVMJTBOPSBOHUFSTFCVUNFOKBEJLBTBS TFQFSUJKJLBTFTFPSBOH QFSHFSBLBO NBUB ZBOH UFSLFOEBMJ EBO QFSHFSBLBO UFSMBUJI
CBSVQFSUBNBLBMJNFOVMJT MBJOZBOHLFCBOZBLBOEJMBLVLBOUBOQBEJTBEBSJ
690
-FTJMFTJLFDJMEJQVUBNFONFOJNCVMLBOHFSBLBOUFSTFOUBL
TFOUBL GMJDLJOH
QBEB UBOHBO XBKBI EBO CBHJBO MBJO UVCVI
ZBOHEJTFCVULPSFB
-FTJ QBEB TVCTUBOTJB OJHSB NFOJNCVMLBO HBOHHVBO VNVN
ZBOH TBOHBU CFSBU CFSVQB SJHJEJUBT BLJOFTJB EBO USFNPS ZBOH
UNIT XI
EJLFOBM TFCBHBJ QFOZBLJU 1BSLJOTPO ZBOH BLBO LJUB CJDBSBLBO
MFCJIEFUBJMLFNVEJBO
Peran Ganglia Basalis dalam Pengendalian Kognitif

terhadap Pola Gerakan Motorik yang Berurutan-Sirkuit
Kaudatus
*TUJMBI LPHOJTJ CFSBSUJ QSPTFT CFSQJLJS QBEB PUBL EFOHBO
NFOHHVOBLBO JOQVU TFOTPSJL ZBOH NFOVKV PUBL EJUBNCBI
Putamen
JOGPSNBTJZBOHUFMBIEJTJNQBOTFCBHBJNFNPSJ4FCBHJBOCFTBS
LFSKBNPUPSJLBEBMBIBLJCBUEBSJQJLJSBOZBOHEJCFOUVLEJPUBL
ZBJUVTVBUVQSPTFTZBOHEJTFCVUQFOHFOEBMJBOLPHOJUJGUFSIBEBQ
BLUJWJUBTNPUPSJL/VLMFVTLBVEBUVTNFNBJOLBOQFSBOVUBNB
EBMBNQFOHFOEBMJBOLPHOJUJGUFSIBEBQBLJUJWJUBTNPUPSJLJOJ
)VCVOHBO QFSTBSBGBO BOUBSB OVLMFVT LBVEBUVT EBO TJTUFN
QFOHFOEBMJ NPUPSJL LPSUJLPTQJOBM ZBOH UBNQBL EBMBN
(BNCBS TFEJLJU CFSCFEB EFOHBO ZBOH UFSEBQBU QBEB
TJSLVJUQVUBNFO4FCBHJBOQFOZFCBCOZBBEBMBICBIXBOVLMFVT
Jaras Neuron Sirkuit Putamen. (BNCBS LBVEBUVT ZBOH UFSMJIBU QBEB (BNCBS NFMVBT LF TFMVSVI
NFNQFSMJIBULBO KBSBT VUBNB ZBOH NFMBMVJ HBOHMJB CBTBMJT MPCVT QBEB TFSFCSVN NVMBJ CBHJBO BOUFSJPS MPCVT GSPOUBMJT
CFSGVOHTJ VOUVL NFMBLTBOBLBO QPMBQPMB QFSHFSBLBO ZBOH UFMBI LFNVEJBOCFSKBMBOEJTFCFMBIQPTUFSJPSNFMBMVJMPCVTQBSJFUBMJT
EJQFMBKBSJ +BSBTKBSBT JOJ UFSVUBNB EJBXBMJ EJ BSFB TVQMFNFOUFS EBO MPCVT PLTJQJUBMJT EBO BLIJSOZB CFSCFMPL LF EFQBO MBHJ
EBO BSFB QSFNPUPSJL QBEB LPSUFLT NPUPSJL EBO EJ BSFB TFQFSUJ NFNCFOUVL IVSVG $ LF EBMBN MPCVT UFNQPSBMJT
TPNBUPTFOTPSJL QBEB LPSUFLT TFOTPSJL ,FNVEJBO KBSBTKBSBT JUV 4FMBOKVUOZB OVLMFVT LBVEBUVT NFOFSJNB TFKVNMBI CFTBS
CFSKBMBO NFOVKV QVUBNFO UFSVUBNB EFOHBO NFMJOUBTJ OVLMFVT JOQVUOZBEBSJBSFBBTPTJBTJQBEBLPSUFLTTFSFCSJZBOHNFOVUVQJ
LBVEBUVT
LFNVEJBO LF CBHJBO JOUFSOBM EBSJ HMPCVT QBMJEVT OVLMFVT LBVEBUVT UFSVUBNB BSFB ZBOH KVHB NFOHJOUFHSBTJLBO
TFMBOKVUOZB LF OVLMFJ SFMBJQFOHJSJN WFOUSPBOUFSJPS EBO CFSCBHBJ KFOJT JOGPSNBTJ TFOTPSJL NBVQVO NPUPSJL LF EBMBN
WFOUSPMBUFSBM QBEB UBMBNVT EBO BLIJSOZB LFNCBMJ LF LPSUFLT QPMBQJLJSZBOHEBQBUEJHVOBLBO
NPUPSJL QSJNFS TFSFCSJ EBO LF CBHJBO BSFB QSFNPUPSJL EBO BSFB 4FUFMBI TJOZBM NFSBNCBU EBSJ LPSUFLT TFSFCSJ LF OVLMFVT
TFSFCSVN TVQMFNFOUFS ZBOH CFSLBJUBO FSBU EFOHBO LPSUFLT LBVEBUVT TJOZBM UFSTFCVU LFNVEJBO EJLJSJNLBO LF HMPCVT
NPUPSJL QSJNFS +BEJ TJSLVJU QVUBNFO NFOEBQBULBO JOQVUOZB QBMJEVTJOUFSOBM LFNVEJBOLFOVLMFJQFOHJSJNEJCBHJBO
UFSVUBNB EBSJ CBHJBOCBHJBO PUBL UFSTFCVU ZBOH CFSEFLBUBO
EFOHBOLPSUFLTNPUPSJLQSJNFS UFUBQJUJEBLCBOZBLEBSJLPSUFLT
NPUPSJL QSJNFS TFOEJSJ ,FNVEJBO PVUQVUOZB CFSKBMBO UFSVUBNB
LFNCBMJLFLPSUFLTNPUPSJLQSJNFSBUBVLPSUFLTQSFNPUPSJLEBO
TVQMFNFOUFS ZBOH CFSLBJUBO %J TBNQJOH KBSBT VUBNB UFSEBQBU
KVHBTJSLVJUUBNCBIBOZBOHCFSKBMBOEBSJQVUBNFONFMBMVJHMPCVT
QBMJEVT FLTUFSOB TVCUBMBNVT EBO TVCTUBOTJB OJHSB BLIJSOZB
LFNCBMJLFLPSUFLTNPUPSJLNFMBMVJUBMBNVT
Fungsi Abnormal pada Sirkuit Putamen: Atetosis,

Hemibalismus, dan Korea. #BHBJNBOBLBI DBSB TJSLVJU
QVUBNFO CFLFSKB EBMBN NFNCBOUV NFMBLTBOBLBO QPMBQPMB
QFSHFSBLBO +BXBCBO VOUVL IBM JUV TBOHBU TFEJLJU EJLFUBIVJ
/BNVO LFUJLBTVBUVCBHJBOEBSJTJSLVJUJOJNFOKBEJSVTBLBUBV
UFSCFOEVOH QPMBQPMB HFSBLBO UFSUFOUV NFOKBEJ TBOHBU
BCOPSNBM 4FCBHBJ DPOUPI MFTJ EJ HMPCVT QBMJEVT TFSJOH LBMJ
NFOZFCBCLBO HFSBLBO NFOHHFMJBU QBEB UBOHBO MFOHBO MFIFS
BUBV XBKBI ZBOH CFSMBOHTVOH TQPOUBO EBO TFSJOH LBMJ UFSVT
NFOFSVTHFSBLBOZBOHEJTFCVUBUFUPTJT
-FTJ EJ TVCUBMBNVT TFSJOH LBMJ NFOJNCVMLBO HFSBLBO
NFOHIFNQBTIFNQBT GMBMMJOH
EJ TFMVSVI BOHHPUB UVCVI ZBOH
CFSMBOHTVOH UJCBUJCB ZBJUV TVBUV LPOEJTJ ZBOH EJTFCVU
IFNJCBMJTNVT
691
WFOUSPNFEJBMEBOWFOUSPMBUFSBMUBMBNVT EBOBLIJSOZBLFNCBMJLFBSFB
QSFGSPOUBM QSFNPUPSJL EBO TVQMFNFOUFS LPSUFLT TFSFCSJ OBNVO
IBNQJS UJEBL BEB TJOZBM ZBOH LFNCBMJ TFDBSB MBOHTVOH NFOVKV LF 12
LPSUFLT QSJNFS UFSTFCVU 4FCBMJLOZB TJOZBMTJOZBM LFNCBMJ UFSTFCVU
CFSKBMBO LF SFHJP NPUPSJL BTFTPSJVT EJ EBMBN BSFB QSFNPUPSJL EBO
NPUPSJL TVQMFNFOUFS ZBOH CFSIVCVOHBO EFOHBO QFOZVTVOBO QPMB 9
VSVUBO QFSHFSBLBO ZBOH CFSEVSBTJ EFUJL BUBV MFCJI EBO UJEBL
NFSBOHTBOHQFSHFSBLBOPUPUTFDBSBJOEJWJEVBM
$POUPIZBOHCBHVTVOUVLIBMJOJJBMBITFTFPSBOHZBOHTFEBOHNFMJIBU
TFFLPS TJOHB NFOEFLBU LFNVEJBO NFNCFSJ SFTQPOT TFDBSB DFQBU EBO
PUPNBUJT ZBJUV EFOHBO
CFSCBMJL NFNCFMBLBOHJ TJOHB UFSTFCVU

NVMBJ CFSMBSJ EBO
NVOHLJO CBILBO CFSVTBIB VOUVL NFNBOKBU
QPIPO 5BOQB GVOHTJ LPHOJUJG TFTFPSBOH NVOHLJO UJEBL NFNJMJLJ
QFOHFUBIVBO OBMVSJBI UBOQB CFSQJLJS UFSMBMV MBNB VOUVL EBQBU
CFSFTQPOTTFDBSBDFQBUEBOTFTVBJ%FOHBOEFNJLJBO QFOHBUVSLPHOJUJG
VOUVL BLUJWJUBT NPUPSJL NFOFOUVLBO TFDBSB UBOQB EJTBEBSJ EBMBN
IJUVOHBOEFUJL QPMBQPMBHFSBLBOZBOHBLBOEJHVOBLBOTFDBSBCFSTBNB
VOUVLNFODBQBJTVBUVUVKVBOZBOHLPNQMFLT ZBOHNVOHLJOCFSEVSBTJ
CFCFSBQBEFUJL
Fungsi Ganglia Basalis dalam Mengubah Waktu dan
Skala Intensitas Pergerakan
%VB LFNBNQVBO PUBL ZBOH QFOUJOH VOUVL NFOHBUVS QFSHFSBLBO
BEBMBI
NFOFOUVLBOTFCFSBQBDFQBUTVBUVHFSBLBOEJMBLVLBO EBO

NFOHBUVS TFCFSBQB CFTBS HFSBLBO ZBOH BLBO UFSKBEJ 4FCBHBJ
DPOUPI TFTFPSBOHEBQBUNFOVMJTIVSVGBTFDBSBMBNCBUBUBVTFDBSB
DFQBU 0SBOH UFSTFCVU KVHB EBQBU NFOVMJT IVSVG B EFOHBO VLVSBO GVOHTJEJEBMBNHBOHMJBCBTBMJTNBTJICFMVNUFQBUTFIJOHHBCBOZBL
LFDJMQBEBTFIFMBJLFSUBT BUBVIVSVGBCFSVLVSBOCFTBSQBEBQBQBO LFTJNQVMBO BUBV PQJOJ QBEB CFCFSBQB QFNCBIBTBO UFSEBIVMV
UVMJT 5BOQB NFNQFSIBUJLBO QJMJIBO QFOVMJTBO LBSBLUFSJTUJL NBTJI CFSTJGBU LFTJNQVMBO BOBMJUJT CVLBO GBLUB ZBOH TVEBI
QSPQPSTJPOBMIVSVGUFSTFCVUUFUBQIBNQJSTBNB UFSCVLUJ
1BEB QBTJFO EFOHBO MFTJ ZBOH CFSBU QBEB HBOHMJB CBTBMJT GVOHTJ
XBLUV EBO TLBMB JOUFOTJUBTOZB NFOKBEJ CVSVL GBLUBOZB LBEBOH Fungsi Neurotransmiter Spesifik pada Sistem Ganglia
LBEBOHGVOHTJUFSTFCVUIJMBOHTBNBTFLBMJ4FLBMJMBHJ HBOHMJBCBTBMJT Basalis
UJEBLMBI CFSGVOHTJ TFOEJSJBO HBOHMJB CBTBMJT CFSGVOHTJ EBMBN LBJUBO
(BNCBSNFNQFSMJIBULBOCFCFSBQBOFVSPUSBOTNJUFSTQFTJGJL
ZBOHEFLBUEFOHBOLPSUFLTTFSFCSJ4VBUVCBHJBOLPSUFLTZBOHTBOHBU
ZBOHUFMBIEJLFUBIVJCFSGVOHTJEJHBOHMJBCBTBMJT UFSMJIBU
KBSBT
QFOUJOHBEBMBILPSUFLTQBSJFUBMQPTUFSJPS ZBOHNFSVQBLBOMPLVTEBSJ
EPQBNJO EBSJ TVCTUBOTJB OJHSB NFOVKV OVLMFVT LBVEBUVT EBO
LPPSEJOBU TQBTJBM VOUVL QFOHFOEBMJBO NPUPSJL TFNVB CBHJBO UVCVI
QVUBNFO
KBSBTBTBNHBNNBBNJOPCVUJSBU ("#"
EBSJOVLMF
EFNJLJBO QVMB VOUVL SFMBTJ BOUBSB UVCVI CFTFSUB CBHJBOCBHJBOOZB
UFSIBEBQMJOHLVOHBOOZB,FSVTBLBOQBEBBSFBJOJUJEBLNFOJNCVMLBO
HBOHHVBOTFEFSIBOBQBEBQFSTFQTJTFOTPSJL TFQFSUJIJMBOHOZBTFOTBTJ
UBLUJM LFCVUBBO BUBV LFUVMJBO /BNVO MFTJ QBEB LPSUFLT QBSJFUBM
QPTUFSJPS NFOJNCVMLBO LFUJEBLNBNQVBO EBMBN QFSTFQTJ PCKFL
TFDBSB BLVSBU NFMBMVJ NFLBOJTNF GVOHTJ TFOTPSJL OPSNBM TVBUV
LPOEJTJ ZBOH EJTFCVU BHOPTJB (BNCBS NFNQFSMJIBULBO DBSB
TFTFPSBOH EFOHBO MFTJ EJ LPSUFLT QBSJFUBM QPTUFSJPS LBOBO NFODPCB
NFOZBMJO HBNCBS 1BEB LBTVTLBTVT JOJ LFNBNQVBO QBTJFO EBMBN
NFOZBMJOTJTJLJSJHBNCBSUFSHBOHHVTFDBSBTBOHBUCFSBU+VHB PSBOH
ZBOHEFNJLJBOBLBOTFMBMVNFODPCBNFOHIJOEBSJQFOHHVOBBOMFOHBO
LJSJ UBOHBOLJSJ BUBVCBHJBOMBJOEBSJUVCVILJSJOZBVOUVLNFMBLVLBO
CFSCBHBJUVHBT BUBVCBILBONFOHBCBJLBOUVCVITJTJLJSJOZB QFSTPOBM
OFHMFDU TZOESPNF
EBO IBNQJS UJEBL UBIV CBIXB CBHJBO UVCVI
UFSTFCVUBEB
0MFI LBSFOB GVOHTJ TJSLVJU LBVEBUVT QBEB TJTUFN HBOHMJB CBTBMJT
CFLFSKBUFSVUBNBUFSLBJUFSBUEFOHBOBSFBZBOHCFSIVCVOHBOEFOHBO
LPSUFLT TFSFCSJ TFQFSUJ CBHJBO QPTUFSJPS LPSUFLT QBSJFUBMJT BLBO
UFSMJIBU CBIXB GVOHTJ QFOFOUVBO TBBU EBO TLBMB HFSBLBO KVHB
NFSVQBLBOGVOHTJGVOHTJEBSJTJSLVJULBVEBUVTZBOHCFSTJGBULPHOJUJG
UFSIBEBQQFOHFOEBMJBONPUPSJLJOJ/BNVO QFOHFSUJBOLJUBUFOUBOH
692
VT LBVEBUVT EBO QVUBNFO NFOVKV HMPCVT QBMJEVT EBO #FCFSBQB TJSLVJU VNQBO CBMJL NVOHLJO EFOHBO NVEBI CFSPTJMBTJ
TVCTUBOTJB OJHSB
KBSBT BTFUJMLPMJO EBSJ LPSUFLT LF BLJCBU VNQBO CBMJL ZBOH LVBU TFUFMBI JOIJCJTJOZB IJMBOH TFIJOHHB
OVLMFVT LBVEBUVT EBO QVUBNFO
KBSBT VNVN ZBOH NFOJNCVMLBO USFNPS QFOZBLJU 1BSLJOTPO 5SFNPS JOJ TBOHBU CFSCFEB
CBOZBL EBSJ CBUBOH PUBL ZBOH NFOZFLSFTJ OPSFQJOFGSJO EFOHBOUSFNPSQBEBQFOZBLJUTFSFCFMVN LBSFOBUSFNPSJOJUJNCVMUFSVT
NFOFSVT TFQBOKBOH KBNKBN TBEBS KBEJ NFSVQBLBO USFNPS JOWPMVOUFS
TFSPUPOJO FOLFGBMJO EBOCFCFSBQBOFVSPUSBOTNJUFSMBJOEJ
UNIT XI
CFSCFEB EFOHBO USFNPS TFSFCFMVN ZBOH IBOZB UFSKBEJ LFUJLB TFTFPSBOH
HBOHMJBCBTBMJTEBOCBHJBOMBJOEBSJTFSFCSVN4FMBJOKBSBT
NFMBLVLBOHFSBLBOZBOHEJNVMBJTFDBSBTFOHBKB TFIJOHHBEJTFCVUUSFNPS
KBSBT JOJ NBTJI UFSEBQBU KBSBT HMVMBNBU NVMUJQFM ZBOH JOUFOTJ
NFOHIBTJMLBO CBOZBL TJOZBM FLTJUBTJ UJEBL EJQFSMJIBULBO "LJOFTJB ZBOH UFSKBEJ QBEB QFOZBLJU 1BSLJOTPO TFSJOH LBMJ NFNCVBU
EBMBNHBNCBS
ZBOHNFOHJNCBOHJTFKVNMBICFTBSTJOZBM QBTJFO KBVI MFCJI UFSUFLBO EBSJQBEB HFKBMBHFKBMB SJHJEJUBT PUPU EBO
TJOZBM JOIJCJTJ ZBOH UFSVUBNB EJLJSJNLBO PMFI USBOTNJUFS USFNPS LBSFOB QBEB QBSLJOTPOJTNF CFSBU CBILBO VOUVL NFNCFOUVL
JOIJCJUPS EPQBNJO ("#" EBO TFSPUPOJO ,JUB BLBO HFSBLBOZBOHQBMJOHTFEFSIBOBQVO QBTJFOIBSVTNFMBLVLBOLPOTFOUSBTJ
NFNCJDBSBLBO OFVSPUSBOTNJUFS UFSTFCVU EBO TJTUFN QFOVI 6TBIB NFOUBM CBILBO UFLBOBO NFOUBM ZBOH EJQFSMVLBO VOUVL
IPSNPOQBEBQFNCBIBTBOCFSJLVUOZBTBBULJUBNFNCBIBT UFSKBEJOZB TVBUV HFSBLBO ZBOH EJJOHJOLBO TFSJOH LBMJ NFODBQBJ CBUBT
NFOHFOBJ QFOZBLJU HBOHMJB CBTBMJT KVHB QBEB CBCCBC EBZBLFNBVBOQBTJFO,FNVEJBO CJMBHFSBLBOUFSTFCVUUJNCVM CJBTBOZB
TFMBOKVUOZB CJMB LJUB NFNCJDBSBLBO NFOHFOBJ UJOHLBI CFSTJGBU LBLV EBO UFSTFOEBUTFOEBU EBO UJEBL UJNCVM TFDBSB MBODBS
1FOZFCBCBLJOFTJBJOJNBTJICFSTJGBUEVHBBO/BNVO TFLSFTJEPQBNJOEJ
MBLV LFBEBBOUJEVS LFBEBBOTJBHB EBOGVOHTJTJTUFNTBSBG
TJTUFN *JNCJL UFSVUBNB QBEB OVLMFVT BLVNCFOT TFSJOH LBMJ NFOVSVO
PUPOPN
CFSTBNB EFOHBO NFOVSVOOZB TFLSFTJ EPQBNJO EJ HBOHMJB CBTBMJT "EB
4BBU JOJ IBSVT EJJOHBU LFNCBMJ CBIXB OFVSPUSBOTNJUFS EVHBBO CBIXB IBM JOJ NVOHLJO NFOVSVOLBO EPSPOHBO GJTJL VOUVL
("#"TFMBMVCFSGVOHTJTFCBHBJJOIJCJUPS0MFILBSFOBJUV BLUJWJUBTNPUPSJLCFHJUVCFTBSOZBTFIJOHHBUJNCVMBLJOFTJB
OFVSPO("#"EBMBNMFOHLVOHVNQBOCBMJLZBOHCFSBTBM
EBSJLPSUFLTNFMBMVJHBOHMJBCBTBMJTEBOLFNVEJBOLFNCBMJ
Pengobatan dengan L-Dopa. 1FNCFSJBOPCBU-EPQBUFSIBEBQ
QBTJFO1BSLJOTPOCJBTBOZBEBQBUNFNQFSCBJLJCBOZBLHFKBMB LIVTVTOZB
LF LPSUFLT TFCFOBSOZB NFNCVBU TFMVSVI MFOHLVOH JOJ
LFLBLVLBO EBO BLJOFTJB 1FOKFMBTBO VOUVL IBM UFSTFCVU BEBMBI BEBOZB
NFOKBEJ MFOHLVOH VNQBO CBMJL OFHBUJG EBO CVLBO EVHBBO CBIXB EJ EBMBN PUBL -EPQB EJVCBI NFOKBEJ EPQBNJO EBO
MFOHLVOH VNQBO CBMJL QPTJUJG EFOHBO EFNJLJBO IBM JOJ EPQBNJO LFNVEJBO NFNVMJILBO LFTFJNCBOHBO OPSNBM BOUBSB JOIJCJTJ
BLBO NFNCFSJ TUBCJMJUBT CBHJ TJTUFN QFOHFOEBMJ NPUPSJL EBOFLTJUBTJEBMBNOVLMFVTLBVEBUVTEBOQVUBNFO1FNCFSJBOEPQBNJO
%PQBNJOKVHBCFSGVOHTJTFCBHBJOFVSPUSBOTNJUFSJOIJCJUPS TFOEJSJUJEBLNFNCFSJFGFLZBOHTBNB EPQBNJONFNJMJLJTUSVLUVSLJNJB
QBEB IBNQJS TFNVB CBHJBO PUBL KBEJ EPQBNJO KVHB ZBOH UJEBL NFNVOHLJOLBOOZB CFSKBMBO NFMFXBUJ TBXBS EBSBIPUBL
CFSGVOHTJTFCBHBJTUBCJMJTBUPSQBEBCFCFSBQBLFBEBBO TFEBOHLBO TUSVLUVS -EPQB ZBOH TFEJLJU CFSCFEB NBMBI NFNCVBUOZB
EBQBUMFXBU
Sindrom Klinis Akibat Kerusakan Ganglia Basalis. Pengobatan dengan L-Deprenil. 1FOHPCBUBO MBJO VOUVL
4FMBJO BUFUPTJT EBO IFNJCBMJTNVT ZBOH UFMBI EJCJDBSBLBO QFOZBLJU 1BSLJOTPO BEBMBI EFOHBO PCBU -EFQSFOJM 0CBU JOJ
EBMBN IVCVOHBOOZB EFOHBO MFTJ EJ HMPCVT QBMJEVT EBO NFOHIBNCBU PLTJEBTF NPOPBNJO ZBOH CFSUBOHHVOH KBXBC VOUVL
TVCUBMBNVT NBTJI BEB EVB QFOZBLJU VUBNB MBJO ZBOH QFOHIBODVSBO TFCBHJBO CFTBS EPQBNJO TFUFMBI EPQBNJO EJTFLTSFTJLBO
EJTFCBCLBO PMFI LFSVTBLBO HBOHMJB CBTBMJT ,FEVB QFOZBLJU 0MFI LBSFOB JUV TFUJBQ EPQBNJO ZBOH EJMFQBTLBO UFUBQ CFSBEB EBMBN
JUVBEBMBIQFOZBLJU1BSLJOTPOEBOQFOZBLJU)VOUJOHUPO KBSJOHBOHBOHMJBCBTBMJTVOUVLXBLUVZBOHMBNB4FMBJOJUV VOUVLBMBTBO
ZBOHUJEBLEJNFOHFSUJ QFOHPCBUBOJOJEBQBUNFNCBOUVNFNQFSMBNCBU
Penyakit Parkinson QFOHIBODVSBO OFVSPO ZBOH NFOZFLSFTJ EPQBNJO EJ TVCTUBOTJB OJHSB
1FOZBLJU 1BSLJOTPO KVHB EJLFOBM TFCBHBJ QBSBMJTJT BHJUBOT 0MFI LBSFOB JUV LPNCJOBTJ ZBOH TFTVBJ EBSJ UFSBQJ -EPQB CFSTBNB
NFSVQBLBO BLJCBU EBSJ LFSVTBLBO ZBOH NFOZFCBS EJ CBHJBO EFOHBO UFSBQJ -EFQSFOJM CJBTBOZB NFSVQBLBO QFOHPCBUBO ZBOH KBVI
TVCTUBOTJB OJHSB QBST LPNQBLUB
ZBOH NFOHJSJN TFSBUTFSBU TBSBG MFCJICBJLEBSJQBEBQFOHHVOBBOTBMBITBUVPCBUTBKB
QFMFQBTEPQBNJO LF OVLMFVT LBVEBUVT EBO QVUBNFO 1FOZBLJU JOJ
Pengobatan dengan Transplantasi Sel Dopamin Janin.
EJUBOEBJ PMFI
SJHJEJUBTLFLBLVBO PUPUPUPU UVCVI
USFNPS
5SBOTQMBOUBTJ TFM ZBOH NFOZFLSFTJ EPQBNJO TFM ZBOH EJQFSPMFI EBSJ PUBL
JOWPMVOUFS QBEB BSFB ZBOH UFSLFOB CBILBO QBEB TBBU JTUJSBIBU
KBOJOZBOHBCPSUVT
LFEBMBNOVLMFVTLBVEBUVTEBOQVUBNFOUFMBINFNCFSJ
EFOHBOLFDFQBUBOUFUBQ UJHBTBNQBJFOBNTJLMVTQFSEFUJL EBO

CFCFSBQB LFCFSIBTJMBO EBMBN NFOHPCBUJ QFOZBLJU 1BSLJOTPO /BNVO TFM
LFTVMJUBO CFTBS VOUVL NFOHBXBMJ QFSHFSBLBO EJTFCVU BLJOFTJB

TFMJOJIBOZBEBQBUNFOFUBQTFMBNBCFCFSBQBCVMBO+JLBEBQBUEJVTBIBLBO
QPTUVS ZBOH UBL TUBCJM EJTFCBCLBO PMFI HBOHHVBO QBEB SFGMFLT
VOUVLNFOFUBQMBNB CBSBOHLBMJDBSBJOJBLBONFOKBEJCFOUVLQFOHPCBUBO
SFGMFLT QPTUVS ZBOH NFOZFCBCLBO LFTFJNCBOHBO ZBOH CVSVL EBO
UFSQJMJIEJNBTBZBOHBLBOEBUBOH
KBUVI EBO
HFKBMB NPUPSJL MBJOOZB UFSNBTVL EJTGBHJB HBOHHVBO
NFOFMBO
HBOHHVBO CJDBSB HBOHHVBO NFMBOHLBI EBO LFMFMBIBO Pengobatan dengan Merusak Bagian Sirkuit Umpan Balik
GBUJH di Ganglia Basalis. 0MFI LBSFOB TJOZBM BCOPSNBM ZBOH CFSBTBM EBSJ
1FOZFCBC FGFL NPUPSJL ZBOH BCOPSNBM JOJ UJEBL EJLFUBIVJ HBOHMJB CBTBMJT LF LPSUFLT NPUPSJL EBQBU NFOJNCVMLBO CBOZBL
/BNVO EPQBNJOZBOHEJTFLSFTJEJOVLMFVTLBVEBUVTEBOQVUBNFO BCOPSNBMJUBT QBEB QFOZBLJU 1BSLJOTPO CFSCBHBJ VTBIB UFMBI EJMBLVLBO
CFSGVOHTJ TFCBHBJ USBOTNJUFS JOIJCJUPS PMFI LBSFOB JUV LFSVTBLBO VOUVLNFOHPCBUJQBTJFOUFSTFCVUEFOHBODBSBNFOHIBNCBUTJOZBMTJOZBM
OFVSPOOFVSPO EPQBNJOFSHJL EJ TVCTUBOTJB OJHSB QBEB QBTJFO JOJ EFOHBO QFNCFEBIBO 4FMBNB CFSUBIVOUBIVO UFMBI EJMBLVLBO
QBSLJOTPOTFDBSBUFPSFUJTBLBONFOZFCBCLBOOVLMFVTLBVEBUVTEBO QFOHPCBUBO EFOHBO NFNCVBU MFTJ CFEBI EJ OVLMFJ WFOUSPMBUFSBM EBO
QVUBNFO NFOKBEJ TBOHBU BLUJG EBO LFNVOHLJOBO NFOHIBTJMLBO WFOUSPBOUFSJPS UBMBNVT ZBOH NFOHIBNCBU CBHJBO EBSJ TJSLVJU VNQBO
TJOZBM PVUQVU FLTJUBTJ ZBOH UFSVTNFOFSVT LF TJTUFN QFOHFOEBMJ CBMJL HBOHMJB CBTBMJT LF LPSUFLT CFSCBHBJ UJOHLBU LFCFSIBTJMBO UFMBI
NPUPSJL LPSUJLPTQJOBM 4JOZBMTJOZBM JOJ BLBO TBOHBU NFSBOHTBOH EJDBQBJEFNJLJBOKVHBUFSKBEJOZBLFSVTBLBOOFVSPMPHJTZBOHTFSJVT1BEB
CBOZBL PUPU BUBV CBILBO TFMVSVI PUPU UVCVI KBEJ NFOJNCVMLBO TFFLPS NPOZFU EFOHBO QFOZBLJU 1BSLJOTPO EFOHBO NFNCVBU MFTJ EJ
SJHJEJUBT LFLBLVBO
TVCUBMBNVT LBEBOHNFNCFSJLFCFSIBTJMBOZBOHNFOHFKVULBO
693
Penyakit Huntington (Korea Huntington) Tingkat Korteks Motorik

1FOZBLJU )VOUJOHUPO NFSVQBLBO HBOHHVBO IFSFEJUFS ZBOH CJBTBOZB 4JTUFN LPSUFLT NPUPSJL NFOZFEJBLBO CBOZBL TFLBMJ TJOZBM NPUPSJL
NVMBJ NFOJNCVMLBO HFKBMBHFKBMB BXBM QBEB VTJB TBNQBJ UBIVO BLUJWBTJ CBHJ NFEVMB TQJOBMJT 4FCBHJBO LFSKBOZB EJMBLVLBO NFMBMVJ
1FOZBLJU JOJ NVMBNVMB EJUBOEBJ EFOHBO QFSHFSBLBO UFSTFOUBLTFOUBL QFSJOUBI CFSVSVUBO EBO QBSBMFM ZBOH UFSBOHLBJ NFOKBEJ CFSNBDBN
QBEB PUPUPUPU LFNVEJBO QFSHFSBLBO NFOZJNQBOH ZBOH TBOHBU
NBDBNQPMBQFSHFSBLBONFEVMBTQJOBMJTQBEBBLTJNPUPSJL4JTUFNJOJ
QSPHSFTJGEJTFMVSVIUVCVI4FMBJOJUV UJNCVMEFNFOTJBCFSBUCFSTBNBBO
KVHBEBQBUNFOHVCBIJOUFOTJUBTCFSCBHBJQPMBBUBVNFNPEJGJLBTJTBBU
EFOHBOEJTGVOHTJNPUPSJL
1FSHFSBLBO BCOPSNBM QFOZBLJU )VOUJOHUPO EJEVHB EJTFCBCLBO PMFI QFMBLTBOBBOOZB BUBV TJGBUTJGBU ZBOH MBJOOZB #JMB EJQFSMVLBO TJTUFN
IJMBOHOZB TFCBHJBO CFTBS CBEBO TFM OFVSPO QFOZFLSFTJ("#" EJ LPSUJLPTQJOBM EBQBU NFOHIJOEBSJ UJEBL NFOHHVOBLBO QPMB
NFEVMB
OVLMFVT LBVEBUVT EBO QVUBNFO EBO OFVSPO QFOZFLSFTJ BTFUJMLPMJO EJ TQJOBMJT NFOHHBOUJLBOOZBEFOHBOQPMBQPMBUJOHLBUMFCJIUJOHHJZBOH
CFSCBHBJ CBHJBO PUBL 6KVOH BLTPO OFVSPO ("#" TFDBSB OPSNBM CFSBTBM EBSJ CBUBOH PUBL BUBV LPSUFLT TFSFCSJ 1PMB LPSUJLBM CJBTBOZB
NFOHIBNCBU CBHJBO HMPCVT QBMJEVT EBO TVCTUBOTJB OJHSB )JMBOHOZB CFSTJGBU LPNQMFLT QPMB JOJ KVHB EBQBU EJQFMBKBSJ TFEBOHLBO QPMB
JOIJCJTJ JOJ EJEVHB NFOZFCBCLBO MFEBLBO BLUJWJUBT ZBOH LVBU TFDBSB NFEVMB UFSVUBNB EJUFOUVLBO PMFI LFUVSVOBO EBO EJLBUBLBO TFCBHBJ
TQPOUBO EJ HMPCVT QBMJEVT EBO TVCTUBOTJB OJHSB ZBOH NFOZFCBCLBO UFSBOHLBJLVBU IBSEXJSFE

QFSHFSBLBONFOZJNQBOH
%FNFOTJB QBEB QFOZBLJU )VOUJOHUPO CBSBOHLBMJ CVLBO IBTJM EBSJ Fungsi Serebelum yang Saling Berkaitan. 'VOHTJ
IJMBOHOZB OFVSPO ("#" UFUBQJ BLJCBU IJMBOHOZB OFVSPO ZBOH TFSFCFMVN CFSIVCVOHBO EFOHBO TFNVB UJOHLBU QFOHFOEBMJBO
NFOZFLSFTJBTFUJMLPMJO LIVTVTOZBQBEBBSFBCFSQJLJSEJLPSUFLTTFSFCSJ NPUPSJL #FSTBNB NFEVMB TQJOBMJT TFSFCFMVN UFSVUBNB CFSGVOHTJ
5FMBI EJUFNVLBO HFO BCOPSNBM ZBOH NFOZFCBCLBO QFOZBLJU VOUVL NFOHVBULBO SFGMFLT SFHBOH TFIJOHHB CJMB PUPU ZBOH
)VOUJOHUPO HFO JOJ NFNJMJLJ QFSVMBOHBO LPEPO CFSLBMJ MJQBU ZBJUV CFSLPOUSBLTJ NFOEBQBULBO CFCBO ZBOH CFSMFCJIBO TJOZBM SFGMFLT
$"( ZBOH NFOZBOEJ VOUVL UBNCBIBO BTBN BNJOP HMVUBNJO TFDBSB SFHBOH ZBOH MBNB EJLJSJNLBO LF TFNVB BSBI NFMBMVJ TFSFCFMVN EBO
CFSMJQBUHBOEBQBEBTUSVLUVSNPMFLVMTVBUVQSPUFJOTFMTBSBGBCOPSNBM LFNCBMJMBHJLFNFEVMBTQJOBMJTZBOHEFOHBOLVBUNFOJOHLBULBOFGFL
EJTFCVU )VOUJOHUPO ZBOH NFOZFCBCLBO UJNCVMOZB HFKBMBHFKBMB QFOBIBOCFCBOQBEBSFGMFLTSFHBOHEBTBS
UFSTFCVU 5FOUBOH CBHBJNBOB QSPUFJO JOJ NFOZFCBCLBO FGFLFGFL
1BEB UJOHLBU CBUBOH PUBL TFSFCFMVN CFSGVOHTJ VOUVL NFNCVBU
QFOZBLJU TFLBSBOH NBTJI NFSVQBLBO QFSUBOZBBO CBHJ CFSCBHBJ VTBIB
QFSHFSBLBOTJLBQUVCVI UFSVUBNBQFSHFSBLBODFQBUZBOHEJCVUVILBO
QFOFMJUJBO
PMFI TJTUFN LFTFJNCBOHBO VOUVL LFMBODBSBO HFSBLBO ZBOH
CFSMBOHTVOHUFSVTNFOFSVTUBOQBEJTFSUBJPTJMBTJZBOHBCOPSNBM
Integrasi Berbagai Bagian Sistem 1BEB UJOHLBU LPSUFLT TFSFCSJ TFSFCFMVN CFLFSKB CFSIVCVOHBO
Pengatur Motorik Total EFOHBOLPSUFLTVOUVLNFOHIBTJMLBOCBOZBLGVOHTJNPUPSJLBTFTPSJT
UFSVUBNBVOUVLNFOJNCVMLBOUFOBHBNPUPSJLFLTUSBZBOHLFNVEJBO
"LIJSOZB LJUB QFSMV NFOZJNQVMLBO TFCBJL ZBOH LJUB NBNQV BQB NFOHPOUSBLTJLBO PUPU TFDBSB DFQBU QBEB TBBU EJNVMBJOZB TVBUV
ZBOHUFMBIEJLFUBIVJUFOUBOHTFMVSVIQFOHBUVSBOQFSHFSBLBO6OUVL QFSHFSBLBO .FOEFLBUJ BLIJS QFSHFSBLBO TFSFCFMVN NFOHIJEVQLBO
NFMBLVLBOIBMJOJ NBSJMBILJUBNVMBNVMBNFNCVBUTJOPQTJTEBSJ PUPUPUPU BOUBHPOJT QBEB TBBU ZBOH UFQBU EBO EFOHBO LFLVBUBO ZBOH
CFSCBHBJUJOHLBUQFOHFOEBMJBO TFTVBJ VOUVL NFOHIFOUJLBO QFSHFSBLBO QBEB UJUJL ZBOH EJJOHJOLBO
4FMBOKVUOZB UFSEBQBUCVLUJQTJLPMPHJTZBOHCBJLCBIXBTFNVBBTQFL
Tingkat Spinal EBSJ QPMB OZBMBNBUJ PMFI TFSFCFMVN JOJ EBQBU EJQFMBKBSJ MFXBU
1BEB NFEVMB TQJOBMJT UFMBI UFSQSPHSBN QPMBQPMB MPLBM HFSBLBO QFOHBMBNBO
VOUVL TFNVB EBFSBI PUPU QBEB UVCVI TFCBHBJ DPOUPI SFGMFLT 4FSFCFMVNCFSTBNBEFOHBOLPSUFLTTFSFCSJCFSGVOHTJQBEBUJOHLBU
NFOHIJOEBS ZBOH UFMBI UFSQSPHSBN ZBOH NFOEPSPOH TFUJBQ QFOHBUVSBO NPUPSJL MBJOOZB TFSFCFMVN NFNCBOUV VOUVL
CBHJBOUVCVIVOUVLNFOKBVIEBSJTVNCFSSBTBOZFSJ.FEVMB KVHB NFNQSPHSBNUFSMFCJIEBIVMVLPOUSBLTJPUPUZBOHEJCVUVILBOVOUVL
NFSVQBLBOMPLVTCBHJQPMBQPMBLPNQMFLTHFSBLBOSJUNJT TFQFSUJ LFMBODBSBO QFSLFNCBOHBO EBSJ HFSBLBO TBBU JOJ LF HFSBLBO DFQBU
HFSBLBOBOHHPUBUVCVILFEFQBOEBOLFCFMBLBOHVOUVLCFSKBMBO CFSJLVUOZBQBEBBSBIZBOHMBJO TFNVBJOJUFSKBEJEBMBNXBLUVLVSBOH
EJUBNCBI HFSBLBO UJNCBM CBMJL EBSJ TJTJ UVCVI ZBOH CFSMBXBOBO EBSJ TBUV EFUJL 4JSLVJU TBSBGTBSBG VOUVL JOJ CFSKBMBO EBSJ LPSUFLT
BUBV HFSBLBO UVOHLBJ EFQBO ZBOH CFSMBXBOBO EFOHBO HFSBLBO TFSFCSJ LF [POB MBUFSBM ZBOH CFTBS QBEB IFNJTGFS TFSFCFMVN EBO
UVOHLBJCFMBLBOHQBEBTFFLPSIFXBOCFSLBLJFNQBU LFNVEJBOLFNCBMJLFLPSUFLTTFSFCSJ
4FNVB QSPHSBN QBEB NFEVMB JOJ EBQBU EJQFSJOUBILBO NFOKBEJ 4FSFCFMVNUFSVUBNBCFSGVOHTJKJLBHFSBLBOPUPUIBSVTCFSMBOHTVOH
TVBUV BLTJ PMFI NPUPSJL UJOHLBU ZBOH MFCJI UJOHHJ BUBV QSPHSBN DFQBU 5BOQB LFJLVUTFSUBBO TFSFCFMVN HFSBLBO ZBOH MBNCBU EBO
UFSTFCVUEBQBUEJIBNCBULFUJLBUJOHLBUQFOHBUVSZBOHMFCJIUJOHHJ EJQFSIJUVOHLBO NBTJI EBQBU UFSKBEJ UFUBQJ IBM JOJ NFOKBEJ TVMJU CBHJ
NFOHBNCJMBMJILFOEBMJ TJTUFN LPSUJLPTQJOBM VOUVL NFODBQBJ HFSBLBO DFQBU EBO CFSVCBI
VCBI TFQFSUJ ZBOH EJJOHJOLBO VOUVL NFMBLTBOBLBO UVKVBO UFSUFOUV
Tingkat Otak Belakang BUBV UFSVUBNB VOUVL LFMBODBSBO QFSQJOEBIBO EBSJ TBUV QFSHFSBLBO
DFQBULFQFSHFSBLBOCFSJLVUOZB
0UBL CFMBLBOH NFMBLVLBO EVB GVOHTJ VUBNB VOUVL
QFOHFOEBMJBO NPUPSJL VNVN QBEB UVCVI
NFNFMJIBSB Fungsi-Fungsi Ganglia Basalis yang Saling Berkaitan.
UPOVT BLTJBM UVCVI EFOHBO UVKVBO VOUVL CFSEJSJ UFHBL EBO (BOHMJB CBTBMJT NFSVQBLBO QFOHFOEBMJ NPUPSJL QFOUJOH ZBOH

UFSVTNFOFSVT NFMBLVLBO NPEJGJLBTJ UFSIBEBQ TFMVSVIOZBCFSCFEBEFOHBOZBOHUFSEBQBUQBEBTFSFCFMVN4FCBHJBO
QFOJOHLBUBO UPOVT QBEB PUPUPUPU EBMBN SFTQPOTOZB CFTBSGVOHTJOZBZBOHQFOUJOHBEBMBI
VOUVLLPSUFLTNFMBLTBOBLBO
UFSIBEBQ JOGPSNBTJ ZBOH EBUBOH EBSJ BQBSBUVT WFTUJCVMBS QPMBQPMB HFSBLBO UBL EJTBEBSJ UFUBQJ ZBOH UFMBI EJQFMBKBSJ EBO

VOUVLUVKVBONFNFMJIBSBLFTFJNCBOHBOUVCVI NFSFODBOBLBOQPMBQPMBHFSBLBOZBOHQBSBMFMEBO
694
CFSVSVUBO LFUJLB QJLJSBO IBSVT NFOZVTVOOZB VOUVL NFOZFMFTBJLBO Bloom F, Lazerson A: Brain, Mind and Behavior, ed 2, New York, 1988, W.H.
Freeman, p 300.
UVHBTEFOHBONBLTVEUFSUFOUV
Breakefield XO, Blood AJ, Li Y, et al: The pathophysiological basis of
+FOJTQPMBNPUPSJLZBOHNFNFSMVLBOHBOHMJBCBTBMJTBOUBSBMBJOQPMB dystonias, Nat Rev Neurosci 9:222, 2008.
VOUVL NFOVMJT IVSVG ZBOH CFSCFEBCFEB EBMBN BMGBCFU VOUVL Cheron G, Servais L, Dan B: Cerebellar network plasticity: from genes to fast
NFMFNQBSCPMB EBOVOUVLNFOHFUJL(BOHMJBCBTBMJTKVHBEJQFSMVLBO
UNIT XI
oscillation, Neuroscience 153:1, 2008.
DeKosky ST, Marek K: Looking backward to move forward: early detection of
VOUVL NFNPEJGJLBTJ QPMBQPMB VOUVL NFOVMJT IVSVG CFSVLVSBO LFDJM
neurodegenerative disorders, Science 302:830, 2003.
BUBV NFOVMJT IVSVG CFSVLVSBO TBOHBU CFTBS KBEJ NFOHFOEBMJLBO Fuentes CT, Bastian AJ: 'Motor cognition'-what is it and is the cerebellum
EJNFOTJQPMBUFSTFCVU involved? Cerebellum 6:232, 2007.
5FSEBQBUUJOHLBUQFOHBUVSBOZBOHMFCJIUJOHHJ ZBJUVLPNCJOBTJMBJO Gibson AR, Horn KM, Pong M: Inhibitory control of olivary discharge, Ann N
YAcad Sci 978:219, 2002.
TJSLVJUTFSFCSVNEBOHBOHMJBCBTBMJT ZBOHEJNVMBJEBSJQSPTFTCFSQJLJS
Hasnain M, Vieweg WV, Baron MS, et Pharmacological management
TFSFCSVNVOUVLNFOHIBTJMLBOTFMVSVIVSVUBOLFSKBEBMBNNFSFTQPOT of psychosis in elderly patients with parkinsonism, Am J Med
TFUJBQ TJUVBTJ ZBOH CBSV TFQFSUJ LFUJLB TFTFPSBOH NFSFODBOBLBO 122:614, 2009.
SFTQPOT NPUPSJL TFHFSB UFSIBEBQ TFPSBOH QFOZFSBOHZBOH NFNVLVM lto M: Cerebellar iong-term depression: characterization, signal transduction,
and functional roles, Physiol Rev 81:1143, 2001.
XBKBIOZB BUBV SFTQPOT CFSVSVUBO EBSJ TFTFPSBOH UFSIBEBQ QFMVLBO
DJOUBZBOHEBUBOHTFDBSBNFOHFKVULBO York, 2000, McGraw-Hill.
Kreitzer AC, Malenka RC: Striatal plasticity and basal ganglia circuit
Apa yang Mendorong Kita untuk Beraksi? function,Neuron 60:543, 2008.
"QB ZBOH NFOZBEBSLBO LJUB EBSJ TJUVBTJ UJEBL BLUJG EBO NFOHVCBIOZB Lees AJ, Hardy J, Revesz T: Parkinson's disease, Lancet 373:2055, 2009.
Li JY, Plomann M, Brundin P: Huntington's disease: a synaptopathy? Trends
BHBS LJUB NFMBLVLBO TVBUV HFSBLBO ,JUB NVMBJ EFOHBO NFNQFMBKBSJ Mol Med 9:414, 2003.
TJTUFNNPUJWBTJQBEBPUBL1BEBEBTBSOZB PUBLNFNJMJLJJOUJZBOHMFCJI Mustari MJ, Ono S, Das VE: Signal processing and distribution in cortical
UVB ZBOH UFSMFUBL EJ UBMBNVT CBHJBO CBXBI BOUFSJPS EBO MBUFSBM brainstem pathways for smooth pursuit eye movements, Ann N Y Acad
UFSNBTVLIJQPUBMBNVT BNJHEBMB IJQPLBNQVT SFHJPTFQUBMBOUFSJPSEBO Sci 1164:147, 2009.
Nambu A: Seven problems on the basal ganglia, Curr Opin Neurobiol
IJQPUBMBNVT EBO UBMBNVT EBO CBILBO SFHJP UVB UBMBNVT EBO LPSUFLT 18:595, 2008.
TFSFCSJ TFOEJSJ TFNVBOZB CFSGVOHTJ CFSTBNBTBNB VOUVL NFNVMBJ Pugh JR, Raman IM: Nothing can be coincidence: synaptic inhibition and
TFCBHJBO CFTBS BLUJWJUBT NPUPSJL EBO GVOHTJPOBM MBJOOZB EBSJ PUBL plasticity in the cerebellar nuclei, Trends Neurosci 32:170, 2009.
4FDBSB LFTFMVSVIBO BSFBBSFB JOJ EJTFCVU TJTUFN MJNCJL PUBL ,JUB Ramnani N: The primate cortico-cerebellar system: anatomy and function,
Nat Rev Neurosci 7:511, 2006.
NFNCBIBTTJTUFNJOJTFDBSBEFUBJMQBEB#BC Rosas HD, Salat DH, Lee SY, et Complexity and heterogeneity: what
drives the ever-changing brain in Huntington's disease? Ann N Y Acad
Daftar Pusaka Sci 1147:196, 2008.
Spruston N: Pyramidal neurons: dendritic structure and synaptic integration,
Bastian AJ: Learning to predict the future: the cerebellum adapts feedforward Nat Rev Neurosci 9:206, 2008.
movement control, Curr Opin Neurobiol 16:645, 2006. Sethi KD:Tremor, Curr Opin Neurol 16:481, 2003.
695
BAB 57
UNIT XI
,PSUFLT4FSFCSJ 'VOHTJ*OUFMFLUVBM
0UBL 1SPTFT#FMBKBS EBO.FNPSJ
4VBUV IBM ZBOH JSPOJT CBIXB EBSJ 4FM QJSBNJEBM EBO TFM GVTJGPSNJT NFSVQBLBO TVNCFS EBSJ
TFNVB CBHJBO PUBL LJUB IBOZB IBNQJS TFNVB TFSBU TBSBG ZBOH LFMVBS EBSJ LPSUFLT 4FM
NFOHFUBIVJ TFEJLJU UFOUBOH GVOHTJ QJSBNJEBMMFCJICBOZBLEBOMFCJICFTBSEBSJQBEBTFMGVTJGPSNJT
LPSUFLT TFSFCSJ XBMBVQVO TFCFOBS ,FEVB TFM UFSTFCVU NFSVQBLBO TVNCFS EBSJ TFSBUTFSBU ZBOH
OZB CBHJBO JOJ NFSVQBLBO CBHJBO CFTBS EBO QBOKBOH ZBOH CFSKBMBO LF TFHBMB BSBI NFOVKV LF
UFSCFTBSQBEBTJTUFNTBSBG5FUBQJ NFEVMB TQJOBMJT 4FMTFM JUV KVHB NFOKVMVSLBO CBOZBL CFSLBT
LJUB UFMBI NFOHFUBIVJ QFOHBSVI LFSVTBLBO BUBV QFSBOHTBOHBO TFSBUTFSBU BTPTJBTJ TVCLPSUJLBM CFTBS ZBOH CFSKBMBO EBSJ TBUV
LIVTVT QBEB CFSCBHBJ CBHJBO LPSUFLT 1BEB CBHJBO QFSUBNB CBC CBHJBOVUBNBPUBLLFCBHJBOZBOHMBJO
JOJ EJCJDBSBLBO GVOHTJGVOHTJ LPSUFLT ZBOH UFMBI EJLFUBIVJ %J CBHJBO LBOBO (BNCBS UBNQBL TVTVOBO LIVTVT
LFNVEJBO CFCFSBQB UFPSJ NFOEBTBS NFOHFOBJ NFLBOJTNF TFSBUTFSBU TBSBG EJ EBMBN CFSCBHBJ MBQJTBO LPSUFLT TFSFCSJ
QFSTBSBGBO ZBOH UFSMJCBU EBMBN QSPTFT CFSQJLJS NFOHJOHBU 5FSVUBNBQFSIBUJLBOTFKVNMBICFTBSTFSBUTFSBUIPSJ[POUBM
BOBMJTJTJOGPSNBTJTFOTPSJL EBOTFCBHBJOZBBLBOEJTBKJLBOTFDBSB
TJOHLBU
Anatomi Fisiologi Korteks Serebri
#BHJBOGVOHTJPOBMLPSUFLTTFSFCSJNFSVQBLBOTFCVBIMBQJTBOUJQJT
ZBOH NFOHBOEVOH OFVSPOOFVSPO ZBOH NFOVUVQJ QFSNVLBBO
TFMVSVI CBHJBO TFSFCSVN ZBOH CFSMFLVLMFLVL -BQJTBO JOJ
UFCBMOZB IBOZB TBNQBJ NN EFOHBO MVBT BSFB LJSBLJSB
TFQFSFNQBU NFUFS QFSTFHJ 4FMVSVI LPSUFLT TFSFCSJ NFOHBOEVOH
LJSBLJSBNJMJBSOFVSPO
(BNCBS NFNQFSMJIBULBO TUSVLUVS IJTUPMPHJ LIVTVT
QFSNVLBBOZBOHNFOHBOEVOHOFVSPOQBEBLPSUFLTTFSFCSJ TFSUB
SBOHLBJBOMBQJTBOZBOHNFOHBOEVOHCFSNBDBNNBDBNOFVSPO
/FVSPOOFVSPOJOJBEBUJHBNBDBN ZBLOJ
HSBOVMBS EJTFCVU
KVHB TUFMBUB

GVTJGPSNJT EBO
QJSBNJEBM ZBOH UFSBLIJS
EJOBNBLBO EFNJLJBO LBSFOB CFOUVLOZB ZBOH NFOZFSVQBJ
QJSBNJE
/FVSPO HSBOVMBS QBEB VNVNOZB NFNJMJLJ BLTPOBLTPO
QFOEFL TFIJOHHB UFSVUBNB CFSGVOHTJ TFCBHBJ JOUFSOFVSPO ZBOH
NFOHIBOUBSLBO TJOZBMTJOZBM OFVSPO QBEB KBSBL QFOEFL EJ
LPSUFLT TBKB #FCFSBQB OFVSPO CFSTJGBU FLTJUBUPSJL UFSVUBNB
NFMFQBTLBO OFVSPUSBOTNJUFS FLTJUBUPSJL HMVUBNBU ZBOH MBJO
CFSTJGBU JOIJCJUPSJL EBO UFSVUBNB NFMFQBTLBO OFVSPUSBOTNJUFS
JOIJCJUPSJL BTBN HBNNBBNJOPCVUJSBU ("#"
"SFB TFOTPSJL
QBEB LPSUFLT TFQFSUJ KVHB BSFB BTPTJBTJ BOUBSB BSFB NPUPSJL EBO
TFOTPSJL NFOHBOEVOH TFMTFM HSBOVMB JOJ EBMBN LPOTFOUSBTJ
UJOHHJ IBM UFSTFCVU NFOVOKVLLBO BEBOZB QFOHPMBIBO JOUSB
LPSUJLBM EFSBKBU UJOHHJ EBSJ TJOZBM TFOTPSJL ZBOH NBTVL LF BSFB
TFOTPSJLEBOBTPTJBTJ
697
ZBOH NFOZFCBS EJ BOUBSB EBFSBI LPSUFLT ZBOH CFSEFLBUBO
OBNVO QFSIBUJLBO KVHB TFSBUTFSBU WFSUJLBM ZBOH NFOZFCBS LF
Fungsi Area Kortikal Khusus
EBO EBSJ LPSUFLT LF EBFSBI PUBL ZBOH MFCJI SFOEBI EBO
CFCFSBQBCFSKBMBOLFNFEVMBTQJOBMJTBUBVLFEBFSBIZBOHKBVI 1FOFMJUJBO QBEB NBOVTJB UFMBI NFNQFSMJIBULBO CBIXB EBFSBI
EBMBN LPSUFLT TFSFCSJ NFMBMVJ CFSLBT TFSBUTFSBU BTPTJBTJ LPSUFLT TFSFCSJ ZBOH CFSCFEB NFNJMJLJ GVOHTJ ZBOH UFSQJTBI QVMB
QBOKBOH (BNCBS BEBMBI QFUB CFCFSBQB GVOHTJ JOJ TFQFSUJ ZBOH UFMBI
EJJEFOUJGJLBTJ EFOHBO DBSB NFNCFSJ SBOHTBOHBO MJTUSJL QBEB
'VOHTJ MBQJTBO TQFTJGJL QBEB LPSUFLT TFSFCSJ UFMBI EJCJDBSB LPSUFLT TFPSBOH QBTJFO ZBOH TBEBS BUBV TFMBNB QFNFSJLTBBO
LBO QBEB #BC EBO %FOHBO NFSVKVL QBEB CBCCBC OFPSPMPHJT QBEB QBTJFO ZBOH TFCBHJBO LPSUFLTOZB UFMBI EJCVBOH
UFSTFCVU LJUB JOHBU LFNCBMJ CBIXB TFCBHJBO CFTBS TJOZBM 1BTJFOQBTJFO ZBOH EJTUJNVMBTJ TFDBSB MJTUSJL NFNCFSJUBIVLBO
TFOTPSJL TQFTJGJL EBSJ UVCVI ZBOH NBTVL BLBO CFSBLIJS EJ NFOHFOBJQJLJSBOQJLJSBOZBOHUJNCVMBLJCBUSBOHTBOHBOUFSTFCVU
MBQJTBOLPSUJLBM*7,FCBOZBLBOTJOZBMLFMVBSBONFOJOHHBMLBO EBO LBEBOHLBEBOH QBTJFO UFSTFCVU NFOHBMBNJ HFSBLBOHFSBLBO
LPSUFLTNFMBMVJOFVSPOOFVSPOZBOHUFSMFUBLEJMBQJTBO7EBO UFSUFOUV ,BEBOH QBTJFO UFSTFCVU TFDBSB TQPOUBO NFOHFMVBSLBO
7*TFSBUTFSBUZBOHTBOHBUCFTBSZBOHCFSKBMBOLFBSBICBUBOH CVOZJBUBVCBILBOLBUBLBUB BUBVNFNCFSJLBOCVLUJMBJOBEBOZB
PUBLEBONFEVMBTQJOBMJTVNVNOZBCFSBTBMEBSJMBQJTBO7EBO QFSBOHTBOHBO
TFSBUTFSBUZBOHMVBSCJBTBCBOZBLOZBZBOHNFOVKVLFUBMBNVT
%FOHBONFMFUBLLBOTFKVNMBICFTBSJOGPSNBTJTFDBSBCFSTBNB
CFSBTBM EBSJ MBQJTBO 7* -BQJTBO * ** EBO *** NFNCFOUVL
TBNBEBSJCBOZBLTVNCFSZBOHCFSCFEB BLBONFOHIBTJMLBOQFUB
TFCBHJBOCFTBSGVOHTJBTPTJBTJJOUSBLPSUJLBM EFOHBOLFLIVTVT
ZBOH MFCJI VNVN TFQFSUJ UBNQBL EBMBN (BNCBS (BNCBS
BO QBEB TFKVNMBI CFTBS OFVSPO QBEB MBQJTBO ** EBO *** ZBOH
JOJ NFNQFSMJIBULBO BSFB NPUPSJL QSFNPUPSJL NBVQVO TVQMF
NFNCVBU IVCVOHBO IPSJ[POUBM QFOEFL EFOHBO BSFB LPSUJLBM
NFOUFSQSJNFSEBOTFLVOEFSZBOHVUBNBQBEBLPSUFLT EFNJLJBO
ZBOHCFSEFLBUBO
KVHB BSFB TFOTPSJL QSJNFS NBVQVO TFLVOEFS ZBOH VUBNB VOUVL
Hubungan Anatomis dan Fungsi Korteks Serebri TFOTBTJTPNBUJL QFOHMJIBUBO EBOQFOEFOHBSBO ZBJUVTFNVBZBOH
dengan Talamus dan Pusat-Pusat yang Lebih Rendah UFMBIEJCJDBSBLBOQBEBCBCCBCTFCFMVNOZB"SFBNPUPSJLQSJNFS
Lainnya. 4FNVB BSFB EBMBN LPSUFLT TFSFCSJ NFNQVOZBJ NFNJMJLJ IVCVOHBO MBOHTVOH EFOHBO PUPUPUPU TQFTJGJL VOUVL
IVCVOHBOBGFSFOEBOFGFSFOZBOHMVBTTFSUBCPMBLCBMJLEFOHBO NFOJNCVMLBO HFSBLBO PUPU UFSUFOUV "SFB TFOTPSJL QSJNFS
TUSVLUVSTUSVLUVSPUBLZBOHMFCJIEBMBN)BMJOJQFOUJOHVOUVL CFSGVOHTJ VOUVL NFOHFOBMJ TFOTBTJ TQFTJGJL QFOHMJIBUBO QFO
NFNQFSLVBU IVCVOHBO BOUBSB LPSUFLT TFSFCSJ EBO UBMBNVT EFOHBSBO BUBV TPNBUJL ZBOH EJKBMBSLBO MBOHTVOH LF PUBL EBSJ
#JMB UBMBNVT EBO LPSUFLT EJSVTBL IJMBOHOZB GVOHTJ TFSFCSBM PSHBOTFOTPSJLQSJNFS
KBVIMFCJICFTBSEBSJQBEBCJMBLPSUFLTTBKBZBOHEJSVTBL LBSFOB "SFB TFLVOEFS NFOHBSUJLBO TFOTBTJ EBSJ TJOZBM BSFB QSJNFS
QFSBOHTBOHBO UBMBNJL QBEB LPSUFLT EJQFSMVLBO CBHJ IBNQJS 4FCBHBJ DPOUPI GVOHTJ BSFB TVQMFNFOUFS EBO BSFB QSFNPUPSJL
TFNVBBLUJWJUBTLPSUJLBM CFSTBNB EFOHBO LPSUFLT NPUPSJL QSJNFS EBO HBOHMJB CBTBMJT
(BNCBS NFNQFSMJIBULBO BSFBBSFB EBMBN LPSUFLT BEBMBI NFOZFEJBLBO QPMB BLUJWJUBT NPUPSJL 1BEB TJTJ TFOTPSJL
TFSFCSJ ZBOH CFSIVCVOHBO EFOHBO CBHJBO LIVTVT UBMBNVT BSFBTFOTPSJLTFLVOEFSZBOHUFSMFUBLCFCFSBQBTFOUJNFUFSEBSJBSFB
)VCVOHBO JOJ NFNQVOZBJ EVB BSBI ZBOH LFEVBOZB CFSBTBM QSJNFS NFOHBOBMJTJTBSUJTJOZBMTJOZBMTFOTPSJLTQFTJGJL TFQFSUJ

EBSJ UBMBNVT NFOVKV LPSUFLT EBO TFMBOKVUOZB EBSJ LPSUFLT NFOHJOUFSQSFUBTJLBO CFOUVL BUBV UFLTUVS TVBUV PCKFL ZBOH BEB
LFNCBMJ LF BSFB UBMBNVT ZBOH TBNB 4FMBOKVUOZB CJMB QBEBUBOHBOTFTFPSBOH
NFOHJOUFSQSFUBTJLBOXBSOB JOUFOTJUBT
IVCVOHBO UBMBNJL JOJ UFSQVUVT IBNQJS TFMVSVI GVOHTJ DBIBZB BSBI HBSJT EBO TVEVU EBO BTQFLBTQFL QFOHMJIBUBO MBJO
BSFBLPSUFLTZBOHUFSLBJUNFOKBEJIJMBOH0MFILBSFOBJUV LFSKB OZBTFSUB
JOUFSQSFUBTJBSUJOBEBTVBSB VSVUBOOBEB EBOTJOZBM
LPSUFLT CFSLBJUBO FSBU EFOHBO UBMBNVT EBO TFDBSB BOBUPNJT TJOZBMQFOEFOHBSBO
EBO GVOHTJPOBM IBNQJS NFSVQBLBO TBUV LFTBUVBO EFOHBO
UBMBNVT LBSFOB BMBTBO JOJ LBEBOHLBEBOH UBMBNVT EBO
LPSUFLT CFSTBNBTBNB EJTFCVU TJTUFN UBMBNPLPSUJLBM )BNQJS
TFNVB KBSBT EBO SFTFQUPS TFOTPSJL EBO PSHBO TFOTPSJL ZBOH
NFOVKVLPSUFLTNFMFXBUJUBMBNVT EFOHBOQFOHFDVBMJBOVUBNB
UFSIBEBQCFCFSBQBKBSBTTFOTPSJLQFOHIJEV
698
Bab 57 Korteks Serebri, Fungsi Intetektual Otak, Proses Belajar, dan Memori
UJOHHJ VOUVL NFOHBSUJLBO TJOZBMTJOZBM EBSJ TFMVSVI BSFB

TFOTPSJL TFLJUBSOZB /BNVO BSFB BTPTJBTJ QBSJFUPPLTJQJUP
UFNQPSBM JOJ NFNJMJLJ TVCBSFB GVOHTJPOBMOZB TFOEJSJ TFQFSUJ
ZBOHUBNQBLEBMBN(BNCBS
UNIT XI
1. Analisis terhadap Koordinat Spasial Tubuh. 4VBUV BSFB
ZBOH EJNVMBJ EJ CBHJBO QPTUFSJPS LPSUFLT QBSJFUBMJT EBO
NFMVBT LF LPSUFLT PLTJQJUBMJT TVQFSJPS UFSVTNFOFSVT
NFMBLVLBOBOBMJTJTUFSIBEBQLPPSEJOBUTFMVSVIUVCVITFDBSB
TQBTJBM EFNJLJBO KVHB UFSIBEBQ TFLFMJMJOH UVCVI "SFB JOJ
NFOFSJNB JOGPSNBTJ TFOTPSJL QFOHMJIBUBO EBSJ LPSUFLT
PLTJQJUBMJTQPTUFSJPSEBOKVHBJOGPSNBTJTPNBUPTFOTPSJLEBSJ
LPSUFLTQBSJFUBMJTBOUFSJPSTFDBSBCFSTBNBBO%BSJJOGPSNBTJ
JOJ BSFB UFSTFCVU NFOHIJUVOH LPPSEJOBTJ QFOHMJIBUBO
QFOEFOHBSBO EBOTFLFMJMJOHUVCVI
2. Area Wernicke Penting untuk Pemahaman Bahasa.
"SFB VUBNB VOUVL QFNBIBNBO CBIBTB EJTFCVU BSFB
8FSOJDLF UFSMFUBL EJ CFMBLBOH LPSUFLT BVEJUPSJL QSJNFS
QBEB CBHJBO QPTUFSJPS HJSVT UFNQPSBMJT EJ MPCVT UFNQPSBMJT
,FMBL LJUBBLBONFNCBIBTBSFBJOJTFDBSBMFCJINFOEBMBN
Area Asosiasi JOJBEBMBISFHJPZBOHQBMJOHQFOUJOHEJTFMVSVIPUBLVOUVL
GVOHTJ JOUFMFLUVBM ZBOH MFCJI UJOHHJ LBSFOB IBNQJS
(BNCBS KVHB NFNQFSMJIBULBO CFCFSBQB EBFSBI ZBOH MVBT TFNVBOZBEJEBTBSLBOQBEBCBIBTB
QBEBLPSUFLTTFSFCSJZBOHUJEBLUFSNBTVLEBMBNQFNCBHJBOLBLV
3. Girus Angularis, Area yang Diperlukan untuk Proses
BSFBTFOTPSJLEBONPUPSJLQSJNFSEBOTFLVOEFS"SFBJOJEJTFCVU
BSFB BTPTJBTJ LBSFOB BSFBBSFB UFSTFCVU NFOFSJNB EBO NFOH Awat Bahasa Visual (Membaca).1BEBCBHJBOQPTUFSJPS
BOBMJTJT TJOZBMTJOZBM TFDBSB CFSTBNBBO EBSJ CFSCBHBJ SFHJP CBJL BSFB QFNBIBNBO CBIBTB UFSVUBNB UFSMFUBL EJ SFHJP
EBSJ LPSUFLT NPUPSJL NBVQVO LPSUFLT TFOTPSJL EFNJLJBO KVHB BOUFSPMBUFSBM QBEB MPCVT PLTJQJUBMJT UFSEBQBU BSFB BTPTJBTJ
EBSJ TUSVLUVSTUSVLUVS TVCLPSUJLBM 5FSOZBUB BSFB BTPTJBTJ JOJ QFOHMJIBUBO ZBOH NFNBTPL JOGPSNBTJ QFOHMJIBUBO EBSJ
NFNJMJLJ GVOHTJ LIVTVTOZB TFOEJSJ "SFB BTPTJBTJ QFOUJOH LBUBLBUB ZBOH EJCBDB EBSJ CVLV LF EBMBN BSFB 8FSOJDLF
NFMJQVUJ
BSFB BTPTJBTJ QBSJFUPPLTJQJUPUFNQPSBM
BSFB ZBJUVBSFBQFNBIBNBOCBIBTB(JSVTZBOHEJOBNBLBOHJSVT
BOHVMBSJT EJQFSMVLBO VOUVL NFOHBSUJLBO LBUBLBUB ZBOH
BTPTJBTJQSFGSPOUBM EBO
BSFBBTPTJBTJMJNCJL1FOKFMBTBOGVOHTJ
EJUFSJNB TFDBSB WJTVBM #JMB EBFSBI JOJ UJEBL BEB TFTFPSBOH
BSFBBSFBJUVBEBMBITFCBHBJCFSJLVU
NBTJIEBQBUNFNJMJLJQFNBIBNBOCBIBTBZBOHTBOHBUCBJL
Area Asosiasi Parieto-oksipitotemporal. "SFB BTPTJBTJ JOJ EFOHBODBSBNFOEFOHBS UFUBQJUJEBLEFOHBODBSBNFNCBDB
UFSMFUBL EBMBN SVBOH LPSUJLBM QBSJFUBM EBO PLTJQJUBM CFTBS ZBOH 4. Area untuk Penamaan Objek. %J EBFSBI QBMJOH MBUFSBM
EJCBUBTJ PMFI LPSUFLT TPNBUPTFOTPSJL CBHJBO BOUFSJPS LPSUFLT MPCVT PLTJQJUBMJT BOUFSJPS EBO MPCVT UFNQPSBMJT QPTUFSJPS
QFOHMJIBUBO CBHJBO QPTUFSJPS EBO LPSUFLT QFOEFOHBSBO CBHJBO UFSEBQBU BSFB VOUVL NFNCFSJ OBNB TVBUV PCKFL /BNB
MBUFSBM4FQFSUJZBOHEJIBSBQLBO BSFBJOJNFNCFSJUBGTJSBOEFSBKBU OBNBJOJUFSVUBNBEJQFMBKBSJNFMBMVJJOQVUQFOEFOHBSBO
TFEBOHLBO
699
Unit XI Sistem Saraf. C. Neurofisiologis Motorik dan Integratif
TJGBUGJTJLTVBUVPCKFLEJQFMBKBSJUFSVUBNBNFMBMVJJOQVUWJTVBM SFCSJ "SFBBSFB UFSTFCVU TFDBSB QSJNFS CFSIVCVOHBO EFOHBO

4FMBOKVUOZB OBNBOBNB QFOUJOH VOUVL QFNBIBNBO CBIBTB UJOHLBIMBLV FNPTJ EBONPUJWBTJ,JUBNFNCJDBSBLBOEBMBN#BC
WJTVBMEBOQFOEFOHBSBO GVOHTJGVOHTJZBOHEJMBLVLBOEJBSFB CBIXB LPSUFLT MJNCJL BEBMBI CBHJBO EBSJ TJTUFN ZBOH TBOHBU
8FSOJDLFUFSMFUBLUFQBUEJTVQFSJPSEBOSFHJPOBNBBVEJUPSJL MVBT ZBJUV TJTUFN MJNCJL ZBOH NFMJQVUJ SBOHLBJBO LPNQMFLT
EBOEJBOUFSJPSBSFBQFNSPTFTBOLBUBWJTVBM
TUSVLUVS OFVSPO EJ SFHJP NJECBTBM PUBL 4JTUFN MJNCJL JOJ
NFOHIBTJMLBO CBOZBL TFLBMJ EPSPOHBOEPSPOHBO FNPTJ VOUVL
Area Asosiasi Prefrontal. 4FQFSUJ ZBOH UFMBI EJCBIBT NFOHBLUJGLBOBSFBBSFBMBJOEJPUBLLFEBOCBILBONFOHIBTJMLBO
EBMBN#BC BSFBBTPTJBTJQSFGSPOUBMGVOHTJOZBCFSLBJUBOFSBU EPSPOHBOCFSEBTBSLBONPUJWBTJVOUVLQSPTFTCFMBKBSJUVTFOEJSJ
EFOHBOLPSUFLTNPUPSJLVOUVLNFSFODBOBLBOQPMBQPMBZBOH
LPNQMFLT EBO CFSVSVUBO EBSJ HFSBLBO NPUPSJL 6OUVL
NFNCBOUV GVOHTJ UFSTFCVU EBFSBI JOJ NFOFSJNB JOQVU ZBOH Area untuk Pengenalan Wajah
LVBU NFMBMVJ CFSLBT TVCLPSUJLBM NBTJG EBSJ TFSBUTFSBU TBSBG "EB TVBUV LFMBJOBO PUBL ZBOH EJTFCVU QSPTPQBHOPTJB ZBOH
ZBOH NFOHIVCVOHLBO BSFB BTPTJBTJ QBSJFUPPLTJQJUPUFNQPSBM NFSVQBLBO LFUJEBLNBNQVBO VOUVL NFOHFOBMJ XBKBI ,FBEBBO
EFOHBO BSFB BTPTJBTJ QSFGSPOUBM .FMBMVJ CFSLBT JOJ LPSUFLT JOJ UFSKBEJ QBEB QBTJFO ZBOH NFOHBMBNJ LFSVTBLBO MVBT QBEB TJTJ
QSFGSPOUBM NFOFSJNB CBOZBL JOGPSNBTJ TFOTPSJL ZBOH CFMVN CBXBI NFEJBM EBSJ LFEVB MPCVT PLTJQJUBMJT EBO TFQBOKBOH
EJBOBMJTJT LIVTVTOZB JOGPSNBTJ NFOHFOBJ LPPSEJOBU TQBTJBM QFSNVLBBO NFEJPWFOUSBM MPCVT UFNQPSBMJT TFQFSUJ ZBOH UBNQBL
UVCVIZBOHEJQFSMVLBOVOUVLNFSFODBOBLBOQFSHFSBLBOZBOH QBEB (BNCBS )JMBOHOZB BSFB VOUVL NFOHFOBMJ XBKBI JOJ
FGFLUJG,FCBOZBLBOLFMVBSBOEBSJBSFBQSFGSPOUBMZBOHNBTVL NFNBOHDVLVQBOFI NFOHBLJCBULBOTFEJLJUBCOPSNBMJUBTGVOHTJ
LF TJTUFN QFOHFOEBMJ NPUPSJL ZBOH CFSKBMBO NFMBMVJ CBHJBO PUBL
LBVEBUVT EBSJ TJSLVJU VNQBO CBMJL HBOHMJB CBTBMJTUBMBNVT ,JUB CJTB TBKB CFSUBOZBUBOZB NFOHBQB CFHJUV CBOZBL CBHJBO
HVOB NFMBLVLBO QFSFODBOBBO NPUPSJL ZBOH NFOHIBTJMLBO LPSUFLTTFSFCSJZBOHIBSVTEJQBLBJVOUVLUVKVBOQFOHFOBMBOXBKBI
CBOZBL LPNQPOFO SBOHTBOHBO QFSHFSBLBO ZBOH CFSVSVUBO ZBOH TFEFSIBOB 4FCBHJBO CFTBS UVHBT LJUB TFIBSJIBSJ BEBMBI
EBOCFSTJGBUQBSBMFM CFSIVCVOHBOEFOHBOPSBOHMBJO NBLBLJUBEBQBUNFOHFSUJNBLOB
"SFB BTPTJBTJ QSFGSPOUBM KVHB QFOUJOH VOUVL NFMBLVLBO BUBVLFQFOUJOHBOGVOHTJJOUFMFLUVBMJOJ
QSPTFT CFSQJLJS EBMBN QJLJSBO "EB BOHHBQBO CBIXB JOJ #BHJBOPLTJQJUBMBSFBQFOHFOBMBOXBKBIJOJUFSMFUBLCFSEFLBUBO
BEBMBI IBTJM EBSJ CFCFSBQB LFNBNQVBO LPSUFLT QSFGSPOUBM EFOHBOLPSUFLTWJTVBM EBOCBHJBOUFNQPSBMCFSLBJUBOFSBUEFOHBO
ZBOH TBNB ZBOH NFNVOHLJOLBOOZB NFSFODBOBLBO BLUJWJUBT TJTUFN MJNCJL ZBOH KVHB CFSQFSBO EBMBN QSPTFT FNPTJ BLUJWBTJ
NPUPSJL ,FNBNQVBO VOUVL NFNQSPTFT JOGPSNBTJ OPO PUBL EBO QFOHBUVSBO SFTQPOT QFSJMBLV TFTFPSBOH UFSIBEBQ
NPUPSJL EBO NPUPSJL EBSJ EBFSBI ZBOH MVBT QBEB PUBL TFLFMJMJOHOZB TFQFSUJZBOHEJCJDBSBLBOQBEB#BC
TFIJOHHB EBQBU NFOHIBTJMLBO UJQF QFNJLJSBO OPONPUPSJL
TFQFSUJ KVHB UJQF NPUPSJL 1BEB LFOZBUBBOOZB BSFB BTPTJBTJ
QSFGSPOUBM TFSJOH LBMJ EJKBCBSLBO TFDBSB TFEFSIBOB TFCBHBJ Fungsi Interpretasi Komprehensif Lobus Temporalis Bagian
EBFSBI ZBOH QFOUJOH VOUVL QFSMVBTBO QJLJSBO EBO EJLBUBLBO Posterior superior—"Area Wernicke" (Area Interpretasi
EBQBU NFOZJNQBO NFNPSJ LFSKB TFDBSB TJOHLBU ZBOH Umum)
EJHVOBLBO VOUVL NFOHHBCVOHLBO QFNJLJSBO CBSV LFUJLB "SFB BTPTJBTJ TPNBUJL WJTVBM EBO BVEJUPSJL TFNVBOZB TBMJOH
QFNJLJSBOUFSTFCVUNFNBTVLJPUBL CFSUFNV TBUV TBNB MBJO EJ CBHJBO QPTUFSJPS MPCVT UFNQPSBMJT
TVQFSJPS TFQFSUJZBOHUBNQBLEBMBN(BNCBS UFNQBUMPCVT
Area Broca Menyediakan Sirkuit Persarafan untuk
UFNQPSBMJT QBSJFUBMJT EBOPLTJQJUBMJTCFSUFNV%BFSBIQFSUFNVBO
Pembentukan Kata. "SFB #SPDB TFQFSUJ ZBOH UBNQBL EBMBN
(BNCBS TFCBHJBO UFSMFUBL EJ LPSUFLT QSFGSPOUBM CBHJBO CFSCBHBJBSFBJOUFSQSFUBTJTFOTPSJLJOJUFSVUBNBCFSLFNCBOHQBEB
QPTUFSJPS MBUFSBM EBO TFCBHJBO MBHJ EJ BSFB QSFNPUPSJL %J
TJOJMBI SFODBOB EBO QPMBQPMB NPUPSJL VOUVL NFOZBUBLBO
LBUBLBUB BUBV CBILBO LBMJNBU QFOEFL EJDFUVTLBO EBO
EJMBLTBOBLBO "SFB JOJ LFSKBOZB KVHB CFSLBJUBO FSBU EFOHBO
QVTBU QFNBIBNBO CBIBTB 8FSOJDLF EJ LPSUFLT BTPTJBTJ
UFNQPSBM ZBOH BLBO LJUB CBIBT MFCJI NFOEBMBN QBEB CBC
TFMBOKVUOZB
#FSJLVU BEBMBI QFOFNVBO ZBOH TBOHBU NFOBSJL LFUJLB
TFTFPSBOH TVEBI NFNQFMBKBSJ TBUV CBIBTB EBO LFNVEJBO
CFMBKBS CBIBTB CBSV BSFB QBEB PUBL UFNQBU CBIBTB CBSV
UFSTFCVU EJTJNQBO TFEJLJU UFSQJTBI EBSJ BSFB QFOZJNQBOBO
CBIBTB QFSUBNB +JLB LFEVB CBIBTB UFSTFCVU EJQFMBKBSJ
CFSTBNBTBNB EJ EBMBN PUBL CBIBTBCBIBTB UFSTFCVU BLBO
UFSTJNQBOEJBSFBZBOHTBNB
Area Asosiasi Limbik. (BNCBS EBO NFN

QFSMJIBULBO BSFB BTPTJBTJ MBJO ZBOH NBTJI UFSTJTB ZBJUV ZBOH
EJTFCVU BSFB BTPTJBTJ MJNCJL "SFB JOJ EJUFNVLBO EJ CFMBIBO
BOUFSJPS MPCVT UFNQPSBMJT EJ CBHJBO WFOUSBM MPCVT GSPOUBMJT
EBO EJ HJSVT TJOHVMJ ZBOH UFSMFUBL EJ CBHJBO EBMBN GJTVSB
MPOHJUVEJOBMJTEJQFSNVLBBOUFOHBITFUJBQIFNJTGFSJVNTF
700
Bab 57 Korteks Serebri, Fungsi Intelektual Otak, Proses Betajar, dan Memori
MPCVT UFNQPSBMJT UFUBQ VUVI QBTJFO NBTJI EBQBU NFOHJOUFS

QSFUBTJLBO QFOHBMBNBO BVEJUPSJL TFQFSUJ CJBTBOZB OBNVO
SBOHLBJBOQFOHBMBNBOWJTVBMZBOHCFSKBMBOEBSJLPSUFLTWJTVBM
LF BSFB 8FSOJDLF CFOBSCFOBS UFSIBNCBU 0MFI LBSFOB JUV
QBTJFO NVOHLJO NBTJI NBNQV NFMJIBU LBUBLBUB EBO CBILBO
UNIT XI
UBIV NFOHFOBJ LBUBLBUB JUV UFUBQJ UJEBL EBQBU NFOHJOUFS
QSFUBTJLBOBSUJLBUBLBUBJUV,FBEBBOJOJEJTFCVUEJTMFLTJB BUBV
CVUBLBUBLBUB XPSECMJOEOFTT

.BSJMBI LJUB NFOFHBTLBO NBLOB LFTFMVSVIBO BSFB
8FSOJDLFCBHJTFMVSVIGVOHTJJOUFMFLUVBMPUBL)JMBOHOZBBSFB
JOJ QBEB PSBOH EFXBTB CJBTBOZB BLBO NFOHBLJCBULBO IJEVQ
PSBOHJUVTFQFSUJPSBOHHJMB
Konsep Hemisfer Dominan

'VOHTJ JOUFSQSFUBTJ VNVN EBSJ BSFB 8FSOJDLF EBO HJSVT
BOHVMBSJT TFQFSUJ KVHB GVOHTJ BSFB CJDBSB EBO BSFB QFOHBUVSBO
NPUPSJL CJBTBOZB KBVI MFCJI CFSLFNCBOH QBEB TBMBI TBUV
IFNJTGFS TFSFCSJ EBSJQBEB ZBOH MBJOOZB 0MFI LBSFOB JUV
IFNJTGFS JOJ EJTFCVU IFNJTGFS EPNJOBO 1BEB LJSBLJSB
QFSTFONBOVTJB ZBOHEPNJOBOBEBMBIIFNJTGFSLJSJ
#BILBO QBEB XBLUV MBIJS MFCJI EBSJ TFQBSVI KVNMBI
TJTJPUBLZBOHEPNJOBOTJTJLJSJQBEBIBNQJSTFNVBPSBOHEFOHBO OFPOBUVTNFNJMJLJBSFBLPSUFLTQBEBIFNJTGFSLJSJ ZBOHLFMBL
UBOHBOLBOBOEBOBSFBJOJNFNQVOZBJQFSBOQBMJOHCFTBSEBMBN BLBONFOKBEJBSFB8FSOJDLF
QFSTFOMFCJICFTBSEBSJQBEBEJ
GVOHTJ QFNBIBNBO PUBL UJOHLBU UJOHHJ GVOHTJ MVIVS
ZBOH LJUB TFCFMBILBOBO0MFILBSFOBJUV NVEBIEJNFOHFSUJCBIXBTJTJ
TFCVUJOUFMFHFOTJB LFDFSEBTBO
0MFILBSFOBJUV EBFSBIJOJTFSJOH LJSJPUBLNFOKBEJMFCJIEPNJOBOEBSJQBEBTJTJLBOBO/BNVO
EJTFCVU EFOHBO CFSCBHBJ OBNB ZBOH NFOZBUBLBO CBIXB BSFB JUV KJLB LBSFOB CFCFSBQB BMBTBO BSFB TJTJ LJSJ JOJ EJSVTBL BUBV
NFNQVOZBJ LFQFOUJOHBO NFOZFMVSVI BSFB JOUFSQSFUBTJ VNVN EJBOHLBU QBEB BXBM NBTB LBOBLLBOBL TJTJ ZBOH CFSMBXBOBO
BSFB HOPTUJL BSFB QFOHFUBIVBO BSFB BTPTJBTJ UFSTJFS EBO QBEB PUBL CJBTBOZB BLBO CFSLFNCBOH TFNQVSOB EFOHBO TJGBU
TFCBHBJOZB/BNVO BSFBJOJMFCJIEJLFOBMTFCBHBJBSFB8FSOJDLF TJGBUEPNJOBOOZB
HVOBNFOHIPSNBUJBIMJOFVSPMPHJZBOHQFSUBNBLBMJNFOKFMBTLBO
"EBTVBUVUFPSJZBOHEBQBUNFOKFMBTLBOLFNBNQVBOTBMBI
NBLOBLIVTVTOZBQBEBQSPTFTJOUFMFLUVBM
TBUVIFNJTGFSVOUVLNFOEPNJOBTJIFNJTGFSMBJO ZBLOJTFCBHBJ
#JMB BSFB 8FSOJDLF NFOHBMBNJ LFSVTBLBO ZBOH TBOHBU QBSBI CFSJLVU 5BNQBLOZB LFTBEBSBO NFOHFOBJ QFNJLJSBO
QBTJFO NVOHLJO NBTJI EBQBU NFOEFOHBS EFOHBO TFNQVSOB EBO MBOHTVOH CFSLBJUBO EFOHBO TBMBI TBUV CBHJBO PUBL QBEB TVBUV
CBILBO NBTJI EBQBU NFOHFOBMJ LBUBLBUB OBNVO UFUBQ UBL TBBU "EB EVHBBO LBSFOB QBEB XBLUV MBIJS CJBTBOZB MPCVT
NBNQVNFOZVTVOLBUBLBUBJOJNFOKBEJTVBUVQJLJSBOZBOHMPHJT UFNQPSBMJT QPTUFSJPS LJSJ TFEJLJU MFCJI CFTBS EBSJQBEB ZBOH
%FNJLJBO KVHB QBTJFO NBTJI NBNQV NFNCBDB LBUBLBUB ZBOH LBOBOEBOTFDBSBOPSNBM TJTJLJSJNFNBOHNVMBJMFCJICBOZBL
UFSUVMJTOBNVOUJEBLNBNQVNFOHFOBMJHBHBTBOZBOHEJTBNQBJ EJQBLBJ EBSJQBEB TJTJ LBOBO 4FMBOKVUOZB LBSFOB BEB
LBO LFDFOEFSVOHBO VOUVL NFNCFSJ QFSIBUJBO LF BSBI UFSUFOUV
1FSBOHTBOHBOMJTUSJLBSFB8FSOJDLFQBEBTFTFPSBOHZBOHTBEBS TFTVBJ EFOHBO SFHJP NBOB ZBOH CFSLFNCBOH MFCJI CBJL
LBEBOHLBEBOHNFOJNCVMLBOQJLJSBOZBOHTBOHBULPNQMFLT)BM LFDFQBUBO QFNCFMBKBSBO ZBOH TVEBI EJNVMBJ QBEB TBMBI TBUV
JOJ UFSVUBNB UFSKBEJ CJMB FMFLUSPEB QFSBOHTBOHOZB EJNBTVLLBO IFNJTGFSTFSFCSJNFOJOHLBUEFOHBODFQBU TFEBOHLBOQBEBTJTJ
DVLVQ EBMBN EJ PUBL TFIJOHHB NFODBQBJ BSFB UBMBNVT ZBOH ZBOH CFSMBXBOBO ZBOH MFCJI TFEJLJU EJHVOBLBO QFNCFMBKBSBO
CFSLBJUBO EFOHBO BSFB 8FSOJDLF .BDBN QJLJSBO ZBOH NVOHLJO OZB UFUBQ MBNCBU 0MFI LBSFOB JUV TFDBSB OPSNBM TJTJ LJSJ
EJBMBNJQBTJFONFMJQVUJHBNCBSBOWJTVBMZBOHTBOHBUSVNJUZBOH NFOKBEJMFCJIEPNJOBOEBSJQBEBTJTJMBJOOZB
NFOHJOHBULBO QBTJFO BLBO NBTB LBOBLLBOBLOZB IBMVTJOBTJ 1BEBLJSBLJSBQFSTFONBOVTJB MPCVTUFNQPSBMJTLJSJEBO
QFOEFOHBSBO TFQFSUJ NFOEFOHBS QFUJLBO MBHV ZBOH TQFTJGJL BUBV HJSVT BOHVMBSJT NFOKBEJ EPNJOBO EBO TJTBOZB ZBOH QFSTFO
CBILBO QFSOZBUBBO ZBOH EJCVBU PSBOH UFSUFOUV %FOHBO BMBTBO QFSUVNCVIBO LFEVB TJTJ UFSKBEJ TFDBSB CFSTBNBBO TFIJOHHB
JOJ EJBOHHBQ CBIXB BLUJWBTJ BSFB 8FSOJDLF EBQBU NFNBOHHJM UFSKBEJGVOHTJHBOEB BUBVZBOHMFCJIKBSBOH PUBLTJTJLBOBOTBKB
LFNCBMJQPMBJOHBUBOZBOHSVNJU ZBOHNFMJCBULBOMFCJIEBSJTBUV ZBOHMFCJICBJLQFSLFNCBOHBOOZB
NPEBMJUBT TFOTPSJL XBMBVQVO TFCBHJBO CFTBS JOHBUBO JOEJWJEVBM 4FQFSUJ ZBOH BLBO EJCBIBT EBMBN CBC JOJ BSFB CJDBSB
EJTJNQBO EJ EBFSBI NBOB TBKB )BM JOJ EJBOHHBQ TFTVBJ EFOHBO QSFNPUPSJL BSFB #SPDB
ZBOH UFSMFUBL KBVI EJ TFCFMBI MBUFSBM
LFQFOUJOHBOBSFB8FSOJDLFEBMBNNFOHJOUFSQSFUBTJLBOBSUJZBOH QBEB MPCVT GSPOUBMJT JOUFSNFEJB KVHB IBNQJS TFMBMV EPNJOBO
SVNJUEBSJCFSNBDBNNBDBNQFOHBMBNBOTFOTPSJL QBEB TJTJ PUBL TFCFMBI LJSJ "SFB CJDBSB JOJ CFSUBOHHVOH KBXBC
VOUVLQFNCFOUVLBOLBUBLBUBEFOHBODBSBNFOHBLUJGLBOPUPU
Girus Angularis—Interpretasi Informasi Visual. (JSVT PUPU MBSJOH PUPU QFSOBQBTBO EBO PUPUPUPU NVMVU TFDBSB
BOHVMBSJTNFSVQBLBOCBHJBOMPCVTQBSJFUBMJTQPTUFSJPSZBOHQBMJOH TJNVMUBO
JOGFSJPS UFSMFUBLUFQBUEJCFMBLBOHBSFB8FSOJDLFEBOEJTFCFMBI ,JSBLJSB EBSJ PSBOH BSFB NPUPSJL VOUVL QFOHBUVSBO
QPTUFSJPS CFSHBCVOH EFOHBO BSFB WJTVBM MPCVT PLTJQJUBMJT #JMB UBOHBOOZB KVHB MFCJI EPNJOBO QBEB TJTJ LJSJ PUBL TFIJOHHB
EBFSBIJOJNFOHBMBNJLFSVTBLBOTFEBOHLBOBSFB8FSOJDLFEJ LFCBOZBLBOPSBOHEPNJOBOUBOHBOLBOBO SJHIUIBOEFEOFTT

701
Unit Xl Sistem Saraf.• C. Neurofisiologis Motorik dan Integratif
8BMBVQVO BSFB JOUFSQSFUBTJ MPCVT UFNQPSBMJT EBO HJSVT Fungsi Intelektual Tingkat Tinggi pada Area Asosiasi
BOHVMBSJT TFQFSUJ IBMOZB LFCBOZBLBO BSFB NPUPSJL CJBTBOZB Prefrontal
MFCJI CFSLFNCBOH QBEB IFNJTGFS LJSJ TBKB BSFB JOJ NFOFSJNB
JOGPSNBTJ TFOTPSJL EBSJ LFEVB IFNJTGFS EBO KVHB NBNQV 4FMBNBCFSUBIVOUBIVO UFMBIEJQJLJSLBOCBIXBLPSUFLTQSFGSPOUBM
NFOHBUVS BLUJWJUBT NPUPSJL EJ LFEVB IFNJTGFS 6OUVL UVKVBO BEBMBI MPLVT CBHJ LFDFSEBTBO UJOHLBU UJOHHJ QBEB NBOVTJB
JOJ UFSVUBNB EJHVOBLBO KBSBTKBSBT TFSBU EJ LPSQVT LBMPTVN LBSFOB QFSCFEBBO VUBNB BOUBSB PUBL LFSB EBO PUBL NBOVTJB
HVOB NFOHIVCVOHLBO LFEVB IFNJTGFS (BCVOHBO JOJ BEBMBICBIXBBSFBQSFGSPOUBMNBOVTJBJOJNFNQVOZBJLFVOHHVMBO
NFSVQBLBO TVTVOBO MJOUBOH ZBOH NFODFHBI JOUFSGFSFOTJ ZBOHMFCJICBOZBL5FSOZBUB VTBIBVOUVLNFNQFSMJIBULBOCBIXB
BOUBSB LFEVB TJTJ PUBL TFQFSUJ JOUFSGFSFOTJ ZBOH EBQBU LPSUFLT QSFGSPOUBM NFNQVOZBJ GVOHTJ JOUFMFLUVBM ZBOH MFCJI
NFOJNCVMLBO LFSVTBLBO QBEB QJLJSBO NFOUBM EBO SFTQPOT QFOUJOH EBO MFCJI UJOHHJ EBSJQBEB CBHJBO MBJO PUBL NBTJI CFMVN
NPUPSJL KVHB CFSIBTJM #BILBO LFSVTBLBO BSFB QFNBIBNBO CBIBTB QBEB
MPCVT UFNQPSBMJT CBHJBO QPTUFSJPS TVQFSJPS BSFB 8FSOJDLF
EBO
SFHJP HJSVT BOHVMBSJT ZBOH CFSEFLBUBO QBEB IFNJTGFS EPNJOBO
Peran Bahasa dalam Fungsi Area Wernicke dan NFOZFCBCLBO KBVI MFCJI CBOZBL LFSVTBLBO QBEB JOUFMFLUVBM
Fungsi Intelektual EBSJQBEBLFSVTBLBOQBEBBSFBQSFGSPOUBM/BNVO BSFBQSFGSPOUBM
4FCBHJBO CFTBS QFOHBMBNBO TFOTPSJL LJUB EJVCBI NFOKBEJ NFNJMJLJ MFCJI TFEJLJU GVOHTJ ZBOH EBQBU EJVSBJLBO NFTLJQVO
CBIBTB ZBOH TFTVBJ TFCFMVN EJTJNQBO EJ EBMBN BSFB NFNPSJ GVOHTJJOUFMFLUVBMZBOHEJNJMJLJOZBCFSTJGBUQFOUJOH'VOHTJGVOHTJ
PUBL EBO TFCFMVN EJPMBI VOUVL UVKVBO QFNCFOUVLBO UFSTFCVUEBQBUEJKFMBTLBOTFDBSBTBOHBUCBJLEFOHBONFOHHBNCBS
JOUFMFLUVBM MBJOOZB $POUPI CJMB NFNCBDB TFCVBI CVLV LJUB LBOBQBZBOHUFSKBEJQBEBTFPSBOHQBTJFOZBOHBSFBQSFGSPOUBMOZB
UJEBL NFOZJNQBO LFTBO WJTVBM EBSJ LBUBLBUB ZBOH UFSUVMJT SVTBL ZBJUVTFCBHBJCFSJLVU
NFMBJOLBO NFOZJNQBO LBUBLBUB JUV BUBV QJLJSBO ZBOH #FCFSBQB BCBE MBMV ZBJUV TFCFMVN EJUFNVLBOOZB PCBUPCBU
EJTBNQBJLBOOZBTFSJOHEBMBNCFOUVLCBIBTB NPEFSO VOUVL NFOHPCBUJ LFBEBBO QTJLJBUSJL UFMBI EJUFNVLBO
"SFB TFOTPSJL EBSJ IFNJTGFS EPNJOBO VOUVL JOUFSQSFUBTJ CBIXB CFCFSBQB QBTJFO EFQSFTJ QTJLPUJL CFSBU NFOHBMBNJ
CBIBTB BEBMBI BSFB 8FSOJDLF EBO BSFB JOJ FSBU IVCVOHBOOZB QFSCBJLBO HFKBMB ZBOH DVLVQ KFMBT EFOHBO NFSVTBL IVCVOHBO
EFOHBO BSFB QFOEFOHBSBO QSJNFS EBO BSFB QFOEFOHBSBO QFSTBSBGBO BOUBSB BSFB QSFGSPOUBM PUBL EFOHBO CBHJBO PUBL ZBOH
TFLVOEFS QBEB MPCVT UFNQPSBMJT )VCVOHBO ZBOH FSBU JOJ NBTJI UFSTJTB ZBJUV NFMBMVJ QSPTFEVS ZBOH EJOBNBLBO MPCPUPNJ
NVOHLJO BLJCBU QFSJTUJXB QFOHFOBMBO CBIBTB ZBOH EJBXBMJ QSFGSPOUBM)BMJOJEJMBLVLBOEFOHBONFNBTVLLBOQJTBVCFSNBUB
PMFI QFOEFOHBSBO 4VBUV TBBU OBOUJ CJMB QFSTFQTJ WJTVBM UJQJTUFUBQJUVNQVMNFMBMVJTVBUVQFNCVLBBOEJUVMBOHUFOHLPSBL
UFSIBEBQ CBIBTB ZBOH NFMBMVJ NFEJVN CBIBO CBDBBO UFMBI GSPOUBM CBHJBO MBUFSBM QBEB TFUJBQ TJTJ LFQBMB EBO NFOZBZBU PUBL
UVNCVI NVOHLJO JOGPSNBTJ WJTVBM ZBOH EJBOUBS PMFI LBUB QBEBQJOHHJSCFMBLBOHMPCVTQSFGSPOUBMEBSJQVODBLLFBSBIEBTBS
UFSUVMJT TFMBOKVUOZB EJTBMVSLBO NFMBMVJ HJSVT BOHVMBSJT ZBJUV 1FOFMJUJBOTFMBOKVUOZBQBEBQBTJFOJOJNFNQFSMJIBULBOQFSVCBIBO
BSFB ZBOH CFSLBJUBO EFOHBO QFOHMJIBUBO LF BSFB JOUFSQSFUBTJ NFOUBMTFCBHBJCFSJLVU
CBIBTB 8FSOJDLF ZBOH UFMBI UVNCVI EBMBN MPCVT UFNQPSBMJT
ZBOHEPNJOBO 1. 1BTJFO LFIJMBOHBO LFNBNQVBOOZB VOUVL NFNFDBILBO
NBTBMBIZBOHLPNQMFLT
Fungsi Korteks Parieto-oksipitotemporal pada Hemisfer
Nondominan 2. 1BTJFOUFSTFCVUNFOKBEJUJEBLNBNQVNFSBOHLBJTVBUVUVHBT
ZBOHCFSVSVUBOHVOBNFODBQBJUVKVBOZBOHLPNQMFLT
#JMB BSFB 8FSOJDLF QBEB IFNJTGFS EPNJOBO TFPSBOH EFXBTB
NFOHBMBNJ LFSVTBLBO OPSNBMOZB QBTJFO BLBO LFIJMBOHBO 3. 1BTJFOJUVNFOKBEJUJEBLNBNQVCFMBKBSNFMBLVLBOCFCFSBQB
IBNQJS TFMVSVI GVOHTJ JOUFMFLUVBM ZBOH CFSIVCVOHBO EFOHBO UVHBTUVHBTQBSBMFMQBEBXBLUVZBOHCFSTBNBBO
CBIBTBBUBVTJNCPMJTNFWFSCBM TFQFSUJLFNBNQVBONFNCBDB 4. 5JOHLBU BHSFTJWJUBT NFOVSVO LBEBOHLBEBOH TBOHBU KFMBT
LFNBNQVBO NFNFDBILBO QFSIJUVOHBO NBUFNBUJLB EBO EBO QBEBVNVNOZBQBTJFOUFSTFCVULFIJMBOHBOBNCJTJOZB
CBILBO LFNBNQVBO VOUVL CFSQJLJS NFMBMVJ QSPCMFN ZBOH
MPHJT#BOZBLUJQFLFNBNQVBOJOUFSQSFUBTJMBJO ZBOHCFCFSBQB 5. 3FTQPOT TPTJBMOZB TFSJOH LBMJ UJEBL TFTVBJ VOUVL TVBUV
EJBOUBSBOZBNFOHHVOBLBOEBFSBIMPCVTUFNQPSBMJTEBOHJSVT QFSJTUJXB TFSJOH LBMJ UFSNBTVL LFIJMBOHBO NPSBM EBO TFEJLJU
BOHVMBSJTEBSJIFNJTGFSTJTJZBOHCFSMBXBOBO NBTJIVUVI CFSTJLBQ QBTJG EBMBN IVCVOHBOOZB EFOHBO NBTBMBI BLUJWJUBT
%BSJ QFOFMJUJBO QTJLPMPHJT QBEB QBTJFOQBTJFO EFOHBO TFLTVBMEBOFLTLSFTJ
LFSVTBLBOIFNJTGFSOPOEPNJOBOUJNCVMTVBUVEVHBBOCBIXB 6. 1BTJFO NBTJI EBQBU CFSCJDBSB EBO NFNBIBNJ CBIBTB UFUBQJ
NVOHLJOIFNJTGFSJOJNFNQVOZBJLFQFOUJOHBOLIVTVTVOUVL
UJEBL NBNQV CFSQJLJS MBNB EBO TVBTBOB IBUJOZB EBQBU
QFOHFSUJBO EBO NFOHJOUFSQSFUBTJLBO NVTJL QFOHBMBNBO
CFSVCBIDFQBUEBSJNBOJTNFOKBEJNBSBIMBMVLFSBTBHFNCJSB
WJTVBM OPOWFSCBM LIVTVTOZB QPMB WJTVBM
IVCVOHBO TQBTJBM
MBMVNFOHBNVL
BOUBSB TFTFPSBOH EFOHBO MJOHLVOHBOOZB NBLOB CBIBTB
UVCVI EBO JOUPOBTJ TVBSB TFTFPSBOH EBO NVOHLJO TFCBHJBO 7. 1BTJFO KVHB NBTJI EBQBU NFNCFOUVL TFCBHJBO CFTBS QPMB
CFTBSQFOHBMBNBOTPNBUJLZBOHCFSLBJUBOEFOHBOQFOHHVOBBO VNVN GVOHTJ NPUPSJL ZBOH UFMBI EJMBLVLBO TFQBOKBOH
BOHHPUB CBEBO EBO UBOHBO +BEJ BQB ZBOH LJUB OBNBLBO IJEVQOZB UFUBQJTFSJOHLBMJUBOQBUVKVBO
IFNJTGFSEPNJOBO IBMJOJUFSVUBNBVOUVLGVOHTJJOUFMFLUVBM
CFSCBTJT CBIBTB EBO IFNJTGFS ZBOH LJUB TFCVU OPOEPNJOBO
%BSJJOGPSNBTJJOJ NBSJMBILJUBNFODPCBNFSBOHLBJCFSTBNB
NVOHLJO TFCFOBSOZB NFOKBEJ EPNJOBO VOUVL CFCFSBQB
QFOHFSUJBOLPIFSFONFOHFOBJGVOHTJBSFBBTPTJBTJQSFGSPOUBM
NBDBNJOUFMFHFOTJBMBJOOZB
702
Bab 57 Korteks Serebri, Fungsi Intetektuat 0tak, Proses Belajar, dan Memori
Penurunan Agresivitas dan Respons Sosial yang Tidak Fungsi Otak dalam Proses Komunikasi—input Bahasa
Sesuai.%VBHBNCBSBOLIBTJOJNVOHLJOUJNCVMBLJCBUIJMBOHOZB dan Output Bahasa
CBHJBO WFOUSBM MPCVT GSPOUBMJT QBEB TJTJ CBXBI PUBL 4FQFSUJ ZBOH
UFMBIEJKFMBTLBOTFCFMVNOZB EBOEJQFSMJIBULBOQBEB(BNCBS 4BMBITBUVQFSCFEBBOUFSQFOUJOHBOUBSBNBOVTJBEBOIFXBOUJOHLBU
UNIT XI
EBO(BNCBS BSFBJOJNFSVQBLBOCBHJBOEBSJLPSUFLTBTPTJBTJ SFOEBIBEBMBIBEBOZBGBTJMJUBTQBEBNBOVTJBVOUVLCFSLPNVOJLBTJ
MJNCJL EBO CVLBO CBHJBO LPSUFLT BTPTJBTJ QSFGSPOUBM "SFB MJNCJL EFOHBOTFTBNBOZB4FMBOKVUOZB LBSFOBUFTOFVSPMPHJEBQBUEFOHBO
JOJ NFNCBOUV NFOHFOEBMJLBO UJOHLBI MBLV ZBOH BLBO EJCBIBT NVEBI NFOBLTJS TFCFSBQB CFTBS LFNBNQVBO TFTFPSBOH VOUVL
TFDBSBEFUBJMQBEB#BC CFSLPNVOJLBTJTBUVTBNBMBJO LJUBEBQBUNFOHFUBIVJMFCJICBOZBL
UFOUBOHTJTUFNTFOTPSJLEBOTJTUFNNPUPSJLZBOHCFSLBJUBOEFOHBO
Ketidakmampuan untuk Maju ke Arah Sasaran atau QSPTFT LPNVOJLBTJ EBSJQBEB NFOHFOBJ GVOHTJ TFHNFO LPSUFLT PUBL
Melaksanakannya dengan Pemikiran yang Berurutan. ,JUB MBJOOZB0MFILBSFOBJUV LJUBBLBONFOHVMBOHMBHJ%FOHBOCBOUVBO
UFMBI NFNQFMBKBSJ TFCFMVNOZB QBEB CBC JOJ CBIXB BSFB BTPTJBTJ QFUBBOBUPNJTKBSBTKBSBTTBSBGQBEB(BNCBS NFOHFOBJGVOHTJ
QSFGSPOUBM NFNJMJLJ LFNBNQVBO VOUVL NFNBOHHJM JOGPSNBTJ MBJO LPSUFLT EBMBN QSPTFT LPNVOJLBTJ %BSJ TJOJ LJUB BLBO TFHFSB
EBSJ CFSCBHBJ EBFSBI QBEB PUBL EBO NFOHHVOBLBO JOGPSNBTJ NFOHFUBIVJ CBHBJNBOB QSJOTJQQSJOTJQ BOBMJTJT TFOTPSJL EBO
UFSTFCVU VOUVL NFNQFSPMFI QPMB QJLJSBO ZBOH MFCJI EBMBN VOUVL QFOHBUVSBONPUPSJLZBOHCFLFSKBQBEBQSPTFTJOJ
NFODBQBJUVKVBO
5FSEBQBU EVB BTQFL VOUVL EBQBU CFSLPNVOJLBTJ QFSUBNB
8BMBVQVO PSBOHPSBOH ZBOH UJEBL NFNJMJLJ LPSUFLT QSFGSPOUBM BTQFL TFOTPSJL JOQVU CBIBTB
ZBOH NFMJCBULBO UFMJOHB EBO NBUB
NBTJI EBQBU CFSQJLJS UFSMJIBU CBIXB PSBOH UFSTFCVU EBMBN EBO LFEVB BTQFL NPUPSJL PVUQVU CBIBTB
ZBOH NFMJCBULBO
NFOZFMFOHHBSBLBO QSPTFT CFSQJLJS EFOHBO VSVUBO ZBOH MPHJT WPLBMJTBTJEBOQFOHBUVSBOOZB
NFNBLBO XBLUV MFCJI EBSJ CFCFSBQB EFUJL BUBV TBUV NFOJU BUBV
Aspek Sensorik pada Komunikasi.1BEBCBHJBOBXBMCBCJOJ LJUB
LFCBOZBLBO CBILBO MFCJI MBNB MBHJ 4BMBI TBUV IBTJMOZB BEBMBI UFMBI NFNCBIBT CBIXB LFSVTBLBO QBEB CBHJBO BSFB BTPTJBTJ
CBIXBPSBOHPSBOHZBOHUJEBLNFNJMJLJLPSUFLTQSFGSPOUBMCFSTJGBU BVEJUPSJLEBOBSFBBTPTJBTJWJTVBMQBEBLPSUFLTEBQBUNFOJNCVMLBO
NVEBICFSBMJIEBSJUPQJLQJLJSBOOZBZBOHVUBNB TFEBOHLBOPSBOH LFUJEBLNBNQVBO VOUVL NFOHFSUJ LBUBLBUB ZBOH EJVDBQLBO EBO
PSBOH ZBOH LPSUFLT QSFGSPOUBMOZB NBTJI CFSGVOHTJ EBQBU LBUBLBUBZBOHUFSUVMJT&GFLJOJTFDBSBCFSUVSVUUVSVUEJTFCVUTFCBHBJ
NFOEPSPOHEJSJOZBTFOEJSJVOUVLNFOZFMFTBJLBOUVKVBOQJLJSBOOZB BGBTJBSFTFQUJGBVEJUPSJLEBOBGBTJBSFTFQUJGWJTVBMBUBVMFCJIVNVN
UFSMFQBTEBSJSBTBCJOHVOH UVMJLBUBLBUBEBOCVUBLBUBLBUB EJTFCVUKVHBEJTMFLTJB

Penjabaran Pikiran, Memperkirakan Masa Depan, dan
Kinerja Fungsi Intetektual Tingkat Tinggi oleh Area Prefrontal
Konsep "Memori Kerja". 'VOHTJ MBJO EBSJ BSFB QSFGSPOUBM ZBOH
UFMBI EJOZBUBLBO BEBMBI QFOKBCBSBO QJLJSBO 4FDBSB TFEFSIBOB JOJ
CFSBSUJ BEBOZB QFOJOHLBUBO LFEBMBNBO EBO LFBCTUSBLBO CFSCBHBJ
QJLJSBO ZBOH UFSCFOUVL CFSTBNBTBNB EBSJ CFSCBHBJ TVNCFS
JOGPSNBTJ 5FT GJTJPMPHJT UFMBI NFOVOKVLLBO CBIXB QBEB IFXBO
UJOHLBU SFOEBI ZBOH NFOHBMBNJ MPCFLUPNJ QSFGSPOUBM EBO
NFOFSJNB QPUPOHBOQPUPOHBO JOGPSNBTJ TFOTPSJL HBHBM NFN
QFSUBIBOLBO KFKBL QPUPOHBOQPUPOHBO LFDJM JOJ CBILBO VOUVL
NFNPSJ TFNFOUBSB CBSBOH LBMJ LBSFOB IFXBO UFSTFCVU CFHJUV
NVEBI NFOKBEJ CJOHVOH TFIJOHHB UJEBL EBQBU NFNQFSUBIBOLBO
QJLJSBOOZBDVLVQMBNBBHBSJOHBUBOUFSTFCVUEBQBUEJTJNQBOQBEB
UFNQBUOZB
,FNBNQVBO BSFB QSFGSPOUBM VOUVL NFNQFSUBIBOLBO KFKBL
QPUPOHBO LFDJM JOGPSNBTJ TFDBSB TJNVMUBO EBO LFNVEJBO
NFODFUVTLBO QFNBOHHJMBO LFNCBMJ JOGPSNBTJ JOJ TFDBSB TFHFSB
TFCBHBJNBOBZBOHEJQFSMVLBOVOUVLQFNJLJSBOTFMBOKVUOZB EJTFCVU
NFNPSJLFSKBPUBL)BMJOJBLBONFOKFMBTLBOCFSCBHBJGVOHTJPUBL
ZBOH CFSLBJUBO EFOHBO JOUFMFHFOTJB UJOHLBU UJOHHJ 5FSOZBUB
QFOFMJUJBO UFMBI NFOVOKVLLBO CBIXB BSFB QSFGSPOUBM UFSCBHJ
NFOKBEJ CFCFSBQB TFHNFO UFSQJTBI VOUVL NFOZJNQBO CFSCBHBJ
KFOJT NFNPSJ TFNFOUBSB TFQFSUJ BSFB VOUVL NFOZJNQBO NFNPSJ
NFOHFOBJ VLVSBO EBO CFOUVL TVBUV PCKFL BUBV CBHJBO UVCVI EBO
QFOZJNQBOBONFNPSJMBJOOZB
%FOHBO NFOHHBCVOHLBO TFNVB QPUPOHBO LFDJM NFNPSJ LFSKB
ZBOH CFSTJGBU TFNFOUBSB LJUB NFNJMJLJ LFNBNQVBO VOUVL

NFNQFSLJSBLBO NBTB EFQBO
NFNCVBU SFODBOB VOUVL NBTB
ZBOHBLBOEBUBOH
QFSMBNCBUBOLFSKBTFCBHBJSFTQPOTUFSIBEBQ
TJOZBM TFOTPSJL ZBOH NBTVL TFIJOHHB JOGPSNBTJ TFOTPSJL JOJ EBQBU
EJQFSUJNCBOHLBOTBNQBJCFOUVLSFTQPOTZBOHUFSCBJLEJQVUVTLBO

NFNQFSUJNCBOHLBOBLJCBULFSKBNPUPSJLCBILBOTFCFMVNLFSKB
UFSTFCVUEJMBLVLBO
NFOZFMFTBJLBONBTBMBINBUFNBUJL IVLVN
BUBV GJMTBGBU ZBOH LPNQMFLT
NFOHIVCVOHLBO TFNVB KBMVS
JOGPSNBTJ EBMBN NFOEJBHOPTJT QFOZBLJU ZBOH KBSBOH EBO

NFOHFOEBMJLBO BLUJWJUBT LJUB EBMBN LBJUBOOZB EFOHBO IVLVN
NPSBM 703
Unit XI Sistem Saraf: C. Neurofisiologis Motorik dan Integratif
Afasia Wernicke dan Afasia Global. #FCFSBQB PSBOH (BNCBSCBHJBOCBXBINFOVOKVLLBOUBIBQUBIBQEBMBNNFNCBDB

NBNQVNFOHFSUJLBUBLBUBZBOHEJVDBQLBOBUBVZBOHEJUVMJTLBO VOUVL LFNVEJBO NFOHVDBQLBO LBUBLBUB JUV TFCBHBJ SFTQPOTOZB
OBNVO UBL NBNQV NFOHJOUFSQSFUBTJLBO QJLJSBO ZBOH 1BEB NVMBOZB QFOFSJNBBO LBUBLBUB MFCJI CBOZBL QBEB BSFB WJTVBM
EJFLTQSFTJLBO,FBEBBOJOJTFSJOHUFSKBEJCJMBBSFB8FSOJDLFZBOH QSJNFS EBSJQBEB EJ BSFB BVEJUPSJL QSJNFS 4FMBOKVUOZB JOGPSNBTJ JUV
UFSEBQBU EJ QPTUFSJPS HJSVT UFNQPSBMJT TVQFSJPS QBEB IFNJTGFS CFSKBMBO NFMBMVJ TUBEJVN BXBM JOUFSQSFUBTJ EJ SFHJP HJSVT BOHVMBSJT
EPNJOBO NFOHBMBNJ LFSVTBLBO BUBV LFIBODVSBO 0MFI LBSFOB EBOBLIJSOZBNFODBQBJTUBEJVNQFOHFOBMBOQFOVIEJBSFB8FSOJDLF
JUV UJQFBGBTJBJOJEJTFCVUBGBTJB8FSOJDLF %BSJ EBFSBI JOJ SBOHLBJBOOZB TBNB TFQFSUJ VOUVL CFSCJDBSB TFCBHBJ
#JMBMFTJQBEBBSFB8FSOJDLFJOJNFMVBTEBONFOZFCBS
LF SFTQPOTUFSIBEBQLBUBLBUBZBOHEJVDBQLBO
CFMBLBOH LF SFHJP HJSVT BOHVMBS
LF JOGFSJPS LF BSFB CBXBI
MPCVTUFNQPSBMJTEBO
LFTVQFSJPSLFUFQJTVQFSJPSGJTVSBTZMWJJ
NBLBQBTJFOUBNQBLTFQFSUJCFOBSCFOBSUFSCFMBLBOHTFDBSBUPUBM
UPUBMMZ EFNFOUFE
VOUVL NFOHFSUJ CBIBTB BUBV CFSLPNVOJLBTJ
Fungsi Korpus Kalosum dan Komisura Anterior
EBOLBSFOBJUVEJLBUBLBONFOEFSJUBBGBTJBHMPCBM untuk Memindahkan Pikiran, Memori, Pelatihan,
dan Informasi Lainnya antara Kedua Hemisfer
Aspek Motorik Komunikasi.1SPTFTCJDBSBNFMJCBULBOEVBTUB
EJVNVUBNBBLUJWJUBTNFOUBM
NFNCFOUVLCVBIQJLJSBOVOUVL
Serebri
EJFLTQSFTJLBO CFSJLVU NFNJMJI LBUBLBUB ZBOH BLBO EJHVOBLBO
LFNVEJBO
QFOHBUVSBO NPUPSJL WPLBMJTBTJ EBO LFSKB ZBOH 4FSBUTFSBU EJ LPSQVT LBMPTVN NFOZFEJBLBO CBOZBL IVCVOHBO
OZBUBEBSJWPLBMJTBTJJUVTFOEJSJ TBSBG EVB BSBI BOUBSB BSFB LPSUJLBM LFEVB IFNJTGFS TFSFCSJ TBUV
1FNCFOUVLBO CVBI QJLJSBO EBO CBILBO QFNJMJIBO LBUBLBUB TBNB MBJO LFDVBMJ CBHJBO QPTUFSJPS MPCVT UFNQPSBMJT EBO BSFB
NFSVQBLBO GVOHTJ BSFB BTPTJBTJ TFOTPSJL PUBL 4FLBMJ MBHJ BSFB UFNQPSBMJT JOJ UFSNBTVL LIVTVTOZB BNJHEBMB EJIVCVOHLBO PMFI
8FSOJDLF QBEB CBHJBO QPTUFSJPS HJSVT UFNQPSBMJT TVQFSJPS TFSBUTFSBUZBOHNFMFXBUJLPNJTVSBBOUFSJPS
NFSVQBLBOIBMZBOHQBMJOHQFOUJOHVOUVLLFNBNQVBOJOJ0MFI
LBSFOB JUV QBTJFO ZBOH NFOHBMBNJ BGBTJB 8FSOJDLF BUBV BGBTJB %JTFCBCLBOEFNJLJBOCBOZBLOZBTFSBUEJLPSQVTLBMPTVN EBSJ
HMPCBM UBL NBNQV NFNGPSNVMBTJLBO CVBI QJLJSBOOZB VOUVL QFSNVMBBO EJBOHHBQ CBIXB TUSVLUVS NBTJG JOJ QBTUJ NFNQVOZBJ
EJLPNVOJLBTJLBO "UBV CJMB MFTJOZB UBL CFHJUV QBSBI QBTJFO CFCFSBQB GVOHTJ QFOUJOH VOUVL NFOHIVCVOHLBO BLUJWJUBT LFEVB
NBTJINBNQVNFNGPSNVMBTJLBOQJLJSBOOZBOBNVOUBLNBNQV IFNJTGFS TFSFCSJ /BNVO CJMB EJMBLVLBO QFNPUPOHBO LPSQVT
NFOZVTVO LBUBLBUB ZBOH TFTVBJ TFDBSB CFSVSVUBO EBO CFSTBNB LBMPTVN QBEB IFXBO QFSDPCBBO QBEB NVMBOZB QFSVCBIBO
TBNB VOUVL NFOHFLTQSFTJLBO QJLJSBOOZB ,BEBOH LBMB QBTJFO
GBTJI CFSLBUBLBUB OBNVO LBUBLBUB ZBOH EJLFMVBSLBOOZB UJEBL
QFSVCBIBO GVOHTJ PUBL ZBOH UFSKBEJ TVLBS EJMJIBU EFOHBO KFMBT
CFSBUVSBO 0MFI LBSFOB JUV GVOHTJ LPSQVT LBMPTVN NBTJI NFSVQBLBO TVBUV
NJTUFSJVOUVLXBLUVZBOHMBNB
Hilangnya Area Broca Menyebabkan Afasia
Motorik. ,BEBOH QBTJFO NBNQV NFOFOUVLBO BQB ZBOH JOHJO .FMBMVJQFSDPCBBOZBOHUFMBIEJSBODBOHEFOHBOCBJL TFLBSBOH
EJLBUBLBOOZB OBNVOUBLEBQBUNFOHBUVSTJTUFNWPLBMOZBVOUVL UFMBI EBQBU EJQFSBHBLBO GVOHTJ ZBOH TBOHBU QFOUJOH EBSJ LPSQVT
NFOHIBTJMLBOLBUBLBUBTFMBJOTVBSBSJCVU&GFLJOJ EJTFCVUBGBTJB LBMPTVNEBOLPNJTVSBBOUFSJPS1FOKFMBTBOUFSCBJLVOUVLGVOHTJ
NPUPSJL EJTFCBCLBOPMFILFSVTBLBOQBEBBSFBCJDBSB#SPDBZBOH GVOHTJ JOJ BEBMBI EFOHBO NFODFSJUBLBO QFSDPCBBO JUV 4FFLPS
UFSMFUBL EJ SFHJP GBTJBM QSFGSPOUBM EBO QSFNPUPSJL LPSUFLT TFSFCSJ NPOZFU NVMBNVMB EJQFSTJBQLBO EFOHBO DBSB NFNPUPOH LPSQVT
TFLJUBS QFSTFO CFSBEB EJ IFNJTGFS LJSJ TFQFSUJ ZBOH UBNQBL LBMPTVN EBO NFNJTBILBO LJBTNB PQUJLVNOZB TFDBSB
EBMBN(BNCBSEBO0MFILBSFOBJUV QPMBLFUFSBNQJMBO MPOHJUVEJOBM TFIJOHHB TJOZBMTJOZBM ZBOH CFSBTBM EBO NBTJOH
NPUPSJLZBOHEJQBLBJVOUVLNFOHBUVSMBSJOH CJCJS NVMVU TJTUFN
NBTJOHNBUBIBOZBEBQBUNFOVKVIFNJTGFSTFSFCSJQBEBTJTJNBUB
SFTQJSBTJ EBO PUPUPUPU MBJO ZBOH EJQBLBJ VOUVL CJDBSB EJNVMBJ
EBSJEBFSBIJOJ
UFSTFCVU -BMV NPOZFU EJBKBSLBO VOUVL NFOHFOBM CFSNBDBN
Artikulasi. "LIJSOZB LJUB NFNCJDBSBLBO LFSKB BSUJLVMBTJ NBDBN PCKFL EFOHBO NBUB LBOBOOZB TFNFOUBSB NBUB LJSJOZB
ZBOHCFSBSUJHFSBLBOPUPUPUPUNVMVU MJEBI MBSJOH QJUBTVBSB EBO EJUVUVQ 4FMBOKVUOZB NBUB LBOBO EJUVUVQ EBO NPOZFU EJVKJ
TFCBHBJOZB ZBOH CFSUBOHHVOH KBXBC VOUVL JOUPOBTJ XBLUV EBO BQBLBI JB EBQBU BUBV UJEBL NFOHFOBM PCKFL ZBOH TBNB EFOHBO
QFSVCBIBO JOUFOTJUBT ZBOH DFQBU EBSJ VSVUBO TVBSB 3FHJP GBTJBM NBUB LJSJOZB +BXBCBO VOUVL IBM JOJ BEBMBI CBIXB NBUB LJSJOZB
EBO MBSJOHFBM LPSUFLT NPUPSJL NFOHBLUJGLBO PUPUPUPU JOJ EBO UJEBL EBQBU NFOHFOBM PCKFL JUV /BNVO CJMB QFSDPCBBO ZBOH
TFSFCFMVN HBOHMJB CBTBMJT EBO LPSUFLT TFOTPSJL TFNVBOZB TBNB EJMBLVLBO QBEB NPOZFU MBJO ZBOH LJBTNB PQUJLVNOZB
NFNCBOUV NFOHBUVS VSVUBO EBO JOUFOTJUBT LPOUSBLTJ PUPU EJQJTBILBO OBNVO LPSQVT LBMPTVNOZB UFUBQ VUVI UFSOZBUB
EFOHBO NFLBOJTNF VNQBO CBMJL TFSFCFMVN EBO GVOHTJ HBOHMJB EJUFNVLBO LFBEBBO ZBOH UBL CFSVCBI ZBLOJ QSPTFT QFOHFOBMBO
CBTBMJT TFQFSUJ ZBOH EJKFMBTLBO EBMBN #BC EBO ,FSVTBLBO ZBOH UJNCVM EJ TBMBI TBUV IFNJTGFS KVHB NFOJNCVMLBO QSPTFT
TFUJBQSFHJPJOJEBQBUNFOZFCBCLBOLFUJEBLNBNQVBOQBSTJBMBUBV
QFOHFOBMBOEJIFNJTGFSTJTJMBJOOZB
UPUBMVOUVLCFSCJDBSBEFOHBOKFMBT
Ringkasan.(BNCBSNFNQFSMJIBULBOEVBKBSBTVUBNB %FOHBO EFNJLJBO TBMBI TBUV GVOHTJ LPSQVT LBMPTVN EBO
ZBOH EJHVOBLBO VOUVL CFSLPNVOJLBTJ (BNCBS CBHJBO BUBT LPNJTVSB BOUFSJPS BEBMBI NFNCVBU JOGPSNBTJ ZBOH EJTJNQBO
NFOVOKVLLBO KBSBT ZBOH UFSMJCBU TBBU NFOEFOHBS EBO CFSCJDBSB EBMBNLPSUFLTTBMBITBUVIFNJTGFSCFSMBLVKVHBCBHJBSFBLPSUJLBM
6SVUBO QSPTFT JOJ BEBMBI TFCBHBJ CFSJLVU
TJOZBM CVOZJ NVMB IFNJTGFS TJTJ MBJOOZB ZBOH TFTVBJ %BSJ LFSKB TBNB BOUBSB LFEVB
NVMB EJUFSJNB PMFI BSFB BVEJUPSJL QSJNFS ZBOH OBOUJOZB BLBO IFNJTGFSJOJBEBUJHBDPOUPIQFOUJOH
NFOZBOEJLBO TJOZBM UBEJ EBMBN CFOUVL LBUBLBUB
LBUBLBUB
MBMV EJJOUFSQSFUBTJLBO EJ BSFB 8FSOJDLF
QFOFOUVBO CVBI
QJLJSBO EBO LBUBLBUB ZBOH BLBO EJVDBQLBO KVHB UFSKBEJ EJ BSFB 1. 1FNPUPOHBO LPSQVT LBMPTVN NFOHIBNCBU QFNJOEBIBO
8FSOJDLF
QFOHJSJNBO TJOZBMTJOZBM EBSJ BSFB 8FSOJFLF LF JOGPSNBTJ EBSJ BSFB 8FSOJDLF IFNJTGFS EPNJOBO LF LPSUFLT
BSFB #SPDB NFMBMVJ GBTJLVMVT BSLVBUVT
BLUJWBTJ QSPHSBN NPUPSJL PUBL TJTJ MBJOOZB 0MFI LBSFOB JUV GVOHTJ JOUFMFLUVBM
LFUFSBNQJMBO NPUPSJL ZBOH UFSEBQBU EJ BSFB #SPDB VOUVL BSFB 8FSOJDLF ZBOH UFSMFUBL EJ IFNJTGFS LJSJ LFIJMBOHBO
NFOHBUVS QFNCFOUVLBO LBUB EBO
QFOHJSJNBO TJOZBM ZBOH QFOHBUVSBOOZBQBEBLPSUFLTNPUPSJLLBOBOZBOHNFNVMBJ
TFTVBJLFLPSUFLTNPUPSJLVOUVLNFOHBUVSPUPUPUPUCJDBSB
704
Bab 57 Korteks Serebri, Fungsi Intetektuat 0tak, Proses Belajar, dan Memori
GVOHTJ NPUPSJL WPMVOUFS UBOHBO LJSJ EBO MFOHBO XBMBVQVO OZB CFSHBOUVOH QBEB QVTBUQVTBU ZBOH MFCJI SFOEBI DPOUPI
HFSBLBO UBL EJTBEBSJ ZBOH CJBTB EBSJ UBOHBO LJSJ EBO MFOHBO ZBOH CBJL NJTBMOZB QJLJSBO UFSIBEBQ SBTB OZFSJ LBSFOB
NBTJIOPSNBM QFSBOHTBOHBO MJTUSJL QBEB LPSUFLT NBOVTJB KBSBOH NFOJNCVM
2. 1FNPUPOHBO LPSQVT LBMPTVN NFODFHBI QFNJOEBIBO LBOSBTBOZFSJZBOHIFCBUTFMBJOSBTBOZFSJSJOHBO TFEBOHLBO
UNIT XI
JOGPSNBTJ TPNBUJL EBO WJTVBM EBSJ IFNJTGFS LBOBO LF BSFB QFSBOHTBOHBO QBEB BSFB UFSUFOUV EJ IJQPUBMBNVT BNJHEBMB
8FSOJDLFQBEBIFNJTGFSLJSJZBOHEPNJOBO0MFILBSFOBJUV EBO NFTFOTFGBMPO EBQBU NFOJNCVMLBO SBTB OZFSJ ZBOH MVBS
JOGPSNBTJ TPNBUJL EBO WJTVBM EBSJ TJTJ LJSJ UVCVI TFSJOH LBMJ CJBTB 4FCBMJLOZB BEB TVBUV UJQF QPMB QJLJSBO ZBOH NFNBOH
HBHBM NFODBQBJ BSFB JOUFSQSFUBTJ VNVN PUBL JOJ TFIJOHHB NFNCVUVILBOCBOZBLLFUFSMJCBUBOLPSUFLTTFSFCSJ ZBJUVZBOH
UJEBLEBQBUEJHVOBLBOVOUVLNFNCVBULFQVUVTBO NFMJCBULBOQFOHMJIBUBO LBSFOBIJMBOHOZBLPSUFLTWJTVBMBLBO
3. "LIJSOZB PSBOH ZBOH TFMVSVI LPSQVT LBMPTVNOZB EJQPUPOH NFOZFCBCLBOQBTJFOUBLNBNQVNFOHFSUJCFOUVLWJTVBMBUBV
XBSOB
NFNQVOZBJ EVB CBHJBO TBEBS EBSJ PUBL ZBOH TFQFOVIOZB
,JUB NVOHLJO EBQBU NFSVNVTLBO TVBUV EFGJOJTJ TFNFOUBSB
UFSQJTBI4FCBHBJDPOUPI TFPSBOHSFNBKBMBLJMBLJZBOHLPSQVT
UFOUBOH QJLJSBO TFTVBJ EFOHBO JTUJMBI BLUJWJUBT QFSTBSBGBOOZB
LBMPTVNOZB UFSQPUPOH IBOZB PUBL CBHJBO LJSJ ZBOH EBQBU
NFOHFSUJ LBUBLBUB ZBOH EJVDBQLBO EBO EJUVMJT TFCBC PUBL TFCBHBJ CFSJLVU 1JLJSBO BEBMBI IBTJM EBSJ QPMB QFSBOHTBOHBO
CBHJBO LJSJ NFSVQBLBO IFNJTGFS ZBOH EPNJOBO 4FCBMJLOZB CFSCBHBJ CBHJBO TJTUFN TBSBG QBEB TBBU ZBOH CFSTBNBBO
PUBL TJTJ LBOBO NBTJI EBQBU NFOHFSUJ LBUBLBUB ZBOH UFSUVMJT NVOHLJOUFSVUBNBNFMJCBULBOLPSUFLTTFSFCSJ UBMBNVT TJTUFN
UFUBQJ UJEBL NFOHFSUJ LBUBLBUB ZBOH EJVDBQLBO 4FMBOKVUOZB MJNCJL EBOCBHJBOBUBTGPSNBTJPSFUJLVMBSJTCBUBOHPUBL1SPTFT
LPSUFLT LBOBO EBQBU NFOJNCVMLBO SFTQPOT BLTJ NPUPSJL JOJEJTFCVUUFPSJIPMJTUJTQJLJSBO%BFSBITJTUFNMJNCJL UBMBNVT
VOUVL LBUBLBUB ZBOH UFSUVMJT UBOQB LPSUFLT LJSJ QFSOBI EBO GPSNBTJP SFUJLVMBSJT ZBOH UFSBOHTBOH EJEVHB NFOFOUVLBO
NFOHFUBIVJNFOHBQBUFSKBEJSFTQPOT TJGBUTJGBUVNVNEBSJQJLJSBO TFIJOHHBNFOJNCVMLBOCFCFSBQB
TJGBU TFQFSUJ SBTB TFOBOH SBTB UBL TFOBOH SBTB TBLJU SBTB UBL
&GFLJOJBLBOTBOHBUCFSCFEBCJMBQBEBPUBLTFCFMBILBOBOOZB FOBL NPEFM TFOTBTJ ZBOH TFEFSIBOB MPLBMJTBTJ EBSJ TFCBHJBO
UFSCBOHLJUKVHBSFTQPOTFNPTJ1BEBLBTVTJOJ EJPUBLTFCFMBILJSJ CFTBSEBFSBIUVCVI EBOTJGBUTJGBUVNVNMBJOOZB/BNVO BSFB
UJNCVM SFTQPOT FNPTJ UBL EJTBEBSJ )BM JOJ UJEBL EJSBHVLBO MBHJ LPSUFLT TFSFCSJ ZBOH UFSBOHTBOH TFDBSB TQFTJGJL NFOFOUVLBO
UFSKBEJ LBSFOB BSFBBSFB LFEVB TJTJ PUBL VOUVL FNPTJ ZBJUV TJGBUTJGBULIVTVTEBSJQJLJSBO TFQFSUJ
MPLBMJTBTJTFOTBTJZBOH
LPSUFLT UFNQPSBM BOUFSJPS EBO BSFB ZBOH CFSEFLBUBO NBTJI TQFTJGJL QBEB QFSNVLBBO UVCVI EBO CFOEBCFOEB ZBOH BEB
CFSIVCVOHBOTBUVTBNBMBJONFMBMVJLPNJTVSBBOUFSJPSZBOHUJEBL EBMBN MBQBOH QFOHMJIBUBO
NFSBTBLBO UFLTUVS TVUSB

UFSQPUPOH$POUPIOZB CJMBEJUVMJTLBOQFSJOUBIDJVN EBOEJMJIBU QFOHFOBMBO WJTVBM UFSIBEBQ QPMB FNQBU QFSTFHJ QBOKBOH EBO
PMFIPUBLTFCFMBILBOBO BOBLMBLJMBLJUFSTFCVUEFOHBODFQBUEBO CBMPL EJOEJOH CFUPO EBO
TJGBUTJGBU JOEJWJEVBM ZBOH
QFOVI FNPTJ NFOHVDBQLBO 5JEBL NBV 3FTQPOT JOJ KFMBT UFSVUBNB NFNFSMVLBO LFTJBHBBO QFOVI ,FTBEBSBO NVOHLJO
NFNCVUVILBO GVOHTJ BSFB 8FSOJDLF EBO BSFB NPUPSJL VOUVL EBQBU EJHBNCBSLBO TFCBHBJ LFTJBHBBO ZBOH UFSVTNFOFSVT
CJDBSB ZBOH UFSEBQBU EJ IFNJTGFS LJSJ LBSFOB BSFB TJTJ LJSJ JOJ UFSIBEBQLFBEBBOMJOHLVOHBOBUBVSFOUFUBOQJLJSBOLJUB
EJQFSMVLBO VOUVL NFOHVDBQLBO LBUBLBUB 5JEBL NBV 5BQJ
CJMB EJUBOZB NFOHBQB JB CFSLBUB EFNJLJBO BOBL JOJ UBL EBQBU Memori—Peran Fasilitasi Sinaps dan Inhibisi Sinaps
NFOKFMBTLBO BMBTBOOZB +BEJ VOUVL LFTBEBSBO QFOZJNQBOBO .FNPSJUFSTJNQBOEJPUBLEBMBNCFOUVLQFSVCBIBOTFOTJUJWJUBT
NFNPSJ QSPTFT LPNVOJLBTJ EBO QFOHBUVSBO BLUJWJUBT NPUPSJL EBTBS USBOTNJTJ TJOBQT EJ BOUBSB OFVSPOOFVSPO TFCBHBJ BLJCBU
LFEVBCBHJBOQFSUFOHBIBOPUBLJOJNFNQVOZBJLFNBNQVBOZBOH BLUJWJUBT QFSTBSBGBO ZBOH UFSKBEJ TFCFMVNOZB +BSBT ZBOH CBSV
UBL CFSHBOUVOH TBUV TBNB MBJO ,PSQVT LBMPTVN EJCVUVILBO BUBV ZBOH UFSGBTJMJUBTJ EJTFCVU KFKBLKFKBL NFNPSJ NFNPSZ
VOUVLUJNCVMOZBLFSKBTBNBBOUBSBLFEVBTJTJPUBLQBEBLFBEBBO USBDFT
+BSBTKBSBT JOJ QFOUJOH LBSFOB CJMB NFOFUBQBEB BLBO
UBL TBEBS ZBOH TVQFSGJTJBM EBO LPNJTVSB BOUFSJPS NFNQVOZBJ EJBLUJGLBO TFDBSB TFMFLUJG PMFI QJLJSBO VOUVL NFSFQSPEVLTJ
QFSBO UBNCBIBO ZBOH QFOUJOH EBMBN NFNQFSTBUVLBO SFTQPOT NFNPSJZBOHBEB
NPUPSJLLFEVBTJTJPUBL
1FSDPCBBOQBEBIFXBOUJOHLBUSFOEBIUFMBINFNQFSMJIBULBO
CBIXB KFKBL NFNPSJ EBQBU UJNCVM QBEB TFNVB UJOHLBU TJTUFN
Pikiran, Kesadaran, dan Memori TBSBG #BILBO SFGMFLTSFGMFLT NFEVMB TQJOBMJT EBQBU NFOHVCBI
TFUJEBLOZB TFEJLJU SFTQPOT UFSIBEBQ BLUJWBTJ NFEVMB TQJOBMJT
.BTBMBI LJUB ZBOH QBMJOH TVLBS EBMBN NFNCJDBSBLBO LFTBEBSBO ZBOH CFSUVSVUUVSVU EBO QFSVCBIBO SFGMFLTSFGMFLT UFSTFCVU
QJLJSBO NFNPSJ EBO CFMBKBS BEBMBI CBIXB TBNQBJ TBBU JOJ LJUB NFSVQBLBOCBHJBOEBSJQSPTFTNFNPSJ.FNPSJKBOHLBQBOKBOH
CFMVN NFOHFUBIVJ NFLBOJTNF QFSTBSBGBO QJLJSBO EBO LJUB IBOZB KVHBNFSVQBLBOIBTJMEBSJQFSVCBIBOUSBOTNJTJTJOBQTEJQVTBU
NFOHFUBIVJ TFEJLJU UFOUBOH NFLBOJTNF NFNPSJ ,JUB UBIV CBIXB QVTBUPUBLCBHJBOCBXBI/BNVO TFCBHJBOCFTBSNFNPSJZBOH
LFSVTBLBOTFCBHJBOCFTBSLPSUFLTTFSFCSJUJEBLNFODFHBITFTFPSBOH LJUB LBJULBO EFOHBO QSPTFT JOUFMFLUVBM EJEBTBSLBO QBEB KFKBL
VOUVL NFNQVOZBJ QJLJSBO OBNVO CJBTBOZB NFOVSVOLBO LF NFNPSJZBOHUFSEBQBUEJLPSUFLTTFSFCSJ
EBMBNBO QJLJSBO EBO KVHB UJOHLBU LFTBEBSBO UFSIBEBQ LFBEBBO
TFLFMJMJOHOZB Memori Positif dan Negatif "Sensitisasi" atau "Habi-
4FUJBQ QJLJSBO IBNQJS TFMBMV NFMJCBULBO TJOZBMTJOZBM ZBOH tuasi" Transmisi Sinaps.8BMBVQVOLJUBTFSJOHCFSQJLJSCBIXB
NFSBNCBU TFDBSB CFSTBNBBO EJ EBMBN TFCBHJBO CFTBS LPSUFLT NFNPSJ NFSVQBLBO SFLPMFLTJ QPTJUJG EBSJ QJLJSBOQJLJSBO BUBV
TFSFCSJ UBMBNVT TJTUFN MJNCJL EBO GPSNBTJP SFUJLVMBSJT CBUBOH QFOHBMBNBO UFSEBIVMV NVOHLJO CBHJBO UFSCFTBS EBSJ NFNPSJ
PUBL#FCFSBQBQJLJSBOZBOHNFOEBTBSNVOHLJOIBNQJSTFMVSVI LJUBBEBMBIOFHBUJG CVLBOQPTJUJG"SUJOZB PUBLLJUBEJHFOBOHJ
705
Unit Xl Sistem Saraf.• C. Neurofisiologis Motorik dan Integratif
PMFIJOGPSNBTJTFOTPSJLZBOHCFSBTBMEBSJTFMVSVIQBODBJOESB TFHFSB CFSEBTBSLBO QFSNBJOBO UFOJT ZBOH UFMBI EJQFMBKBSJ

+JLB QJLJSBO LJUB EJVTBIBLBO VOUVL NFOHJOHBU TFNVB TFCFMVNOZB LFNVEJBO CFSBMJI LF QVLVMBO CFSJLVUOZB EBMBN
JOGPSNBTJ JOJ LBQBTJUBT JOHBUBO PUBL BLBO TFHFSB QFOVI QFSNBJOBOTFSBZBNFMVQBLBOEFUBJMQVLVMBOTFCFMVNOZB
6OUVOHMBI PUBL NFNJMJLJ LFNBNQVBO VOUVL CFMBKBS
NFOHBCBJLBOJOGPSNBTJZBOHUJEBLNFNCFSJBLJCBU*OJBEBMBI Memori Jangka Pendek
IBTJMEBSJJOIJCJTJKBSBTKBSBTTJOBQTVOUVLJOGPSNBTJTFNBDBN .FNPSJ KBOHLB QFOEFL EJDJSJLBO PMFI NFNPSJ TFTFPSBOH
JOJ FGFL ZBOH EJIBTJMLBO EJTFCVU IBCJUVBTJ )BM UFSTFCVU NFOHFOBJTBNQBJBOHLBEBMBNOPNPSUFMFQPO BUBVTBNQBJ
NFSVQBLBOUJQFNFNPSJOFHBUJG GBLUB KFMBT MBJOOZB
TFMBNB CFCFSBQB EFUJL TBNQBJ CFCFSBQB
4FCBMJLOZB VOUVL KFOJTKFOJT JOGPSNBTJ NBTVL EBO NFO NFOJU QBEB TBBU UFSTFCVU UFUBQJ IBOZB BLBO CFSMBOHTVOH TFMBNB
ZFCBCLBO BLJCBU ZBOH QFOUJOH TFQFSUJ SBTB OZFSJ BUBV TFOBOH TFTFPSBOH UFSVTNFOFSVT NFNJLJSLBO BOHLBBOHLB BUBV GBLUB
PUBL NFNJMJLJ LFNBNQVBO PUPNBUJT ZBOH CFSCFEB EBMBN IBM GBLUBUFSTFCVU
QFOHVBUBOEBOQFOZJNQBOBOKFKBLNFNPSJ*OJBEBMBINFNPSJ #BOZBL BIMJ GJTJPMPHJ UFMBI NFNQFSLJSBLBO CBIXB NFNPSJ
QPTJUJG.FNPSJQPTJUJGJOJBEBMBIIBTJMEBSJGBTJMJUBTJKBSBTKBSBT KBOHLB QFOEFL JOJ EJTFCBCLBO PMFI BLUJWJUBT TBSBG ZBOH
TJOBQT EBO QSPTFTOZB EJTFCVU TFOTJUJTBTJ NFNPSJ ,JUB CFSLFTJOBNCVOHBO ZBOHNFSVQBLBOIBTJMEBSJTJOZBMTJOZBMTBSBG
EJTLVTJLBOLFNVEJBOCBIXBEBFSBILIVTVTQBEBSFHJPMJNCJL ZBOH UFSVT CFSKBMBO CFSLFMJMJOH QBEB KFKBL JOHBUBO NFNPSJ
CBTBM PUBL NBNQV NFOFOUVLBO BQBLBI TVBUV JOGPSNBTJ TFNFOUBSB EJ EBMBN TVBUV TJSLVJU OFVSPO SFWFSCFSBTJ 5FPSJ JOJ
CFSTJGBU QFOUJOH BUBV UJEBL QFOUJOH EBO NFNCVBU LFQVUVTBO NBTJI CFMVN EBQBU EJCVLUJLBO ,FNVOHLJOBO QFOKFMBTBO MBJO
TFDBSBUJEBLTBEBSBQBLBIJOGPSNBTJJOJBLBOEJTJNQBOTFCBHBJ NFOHFOBJNFNPSJKBOHLBQFOEFLJOJBEBMBIGBTJMJUBTJBUBVJOIJCJTJ
KFKBLNFNPSJZBOHEJTFOTJUJTBTJBUBVKVTUSVNFOFLBOOZB QSBTJOBQUJL)BMJOJUFSKBEJQBEBTJOBQTTJOBQTZBOHUFSMFUBLQBEB
Klasifikasi Memori. ,JUB UBIV CBIXB NFNPSJ UFSUFOUV GJCSJMGJCSJM TBSBG UFSNJOBM TFHFSB TFCFMVN GJCSJMGJCSJM UFSTFCVU
IBOZB CFSMBOHTVOH CFCFSBQB EFUJL TFNFOUBSB ZBOH MBJOOZB CFSTJOBQT EFOHBO OFVSPOOFVSPO CFSJLVUOZB #BIBOCBIBO
CFSMBOHTVOH CFCFSBQB KBN CFSIBSJIBSJ BUBV CBILBO LJNJBXJOFVSPUSBOTNJUFSZBOHEJTFLSFTJLBOQBEBUFSNJOBMTFQFSUJ
CFSUBIVOUBIVO%FOHBOUVKVBOVOUVLNFNCBIBTNBTBMBIJOJ JUV TFSJOH LBMJ NFOZFCBCLBO GBTJMJUBTJ BUBV JOIJCJTJ ZBOH
NBSJ LJUB HVOBLBO LMBTJGJLBTJ VNVN NFOHFOBJ NFNPSJ ZBOH CFSMBOHTVOH TFMBNB CFCFSBQB EFUJL TBNQBJ CFCFSBQB NFOJU
NFNCBHJ NFNPSJ NFOKBEJ
NFNPSJ KBOHLB QFOEFL ZBJUV -JOUBTBO KFOJT TFQFSUJ JOJ EBQBU NFOJNCVMLBO NFNPSJ KBOHLB
NFNPSJ ZBOH CFSMBOHTVOH CFCFSBQB EFUJL BUBV QBMJOH MBNB QFOEFL
CFCFSBQB NFOJU LFDVBMJ KJLB NFNPSJ JOJ EJVCBI NFOKBEJ
NFNPSJ KBOHLB QBOKBOH
NFNPSJ KBOHLB NFOFOHBI ZBOH Memori Jangka Menengah
CFSMBOHTVOH CFCFSBQB IBSJ TBNQBJ CFCFSBQB NJOHHV UFUBQJ .FNPSJ KBOHLB NFOFOHBI CFSMBOHTVOH CFSNFOJUNFOJU BUBV
LFNVEJBO NFOHIJMBOH EBO
NFNPSJ KBOHLB QBOKBOH ZBOH CBILBO CFSNJOHHVNJOHHV .FNPSJ JOJ LBEBOHLBEBOH BLBO
TFLBMJEJTJNQBOEBQBUEJJOHBULFNCBMJTFMBNBCFSUBIVOUBIVO IJMBOH LFDVBMJKJLBKFKBLNFNPSJNFNQFSPMFIBLUJWBTJTFDVLVQOZB
LFNVEJBOBUBVCBILBOTFVNVSIJEVQ TFIJOHHBNFOKBEJMFCJIQFSNBOFOZBOHLFNVEJBOEJLMBTJGJLBTJLBO
4FMBJO LMBTJGJLBTJ NFNPSJ ZBOH VNVN UFSTFCVU LJUB KVHB TFCBHBJ NFNPSJ KBOHLB QBOKBOH 1FSDPCBBO QBEB IFXBO QSJNJUJG
TFCFMVNOZB UFMBI NFNCBIBT EBMBN IVCVOHBOOZB EFOHBO UFMBI NFOVOKVLLBO CBIXB NFNPSJ KFOJT KBOHLB NFOFOHBI JOJ
MPCVT QSFGSPOUBMJT
TVBUV KFOJT MBJO EBSJ NFNPSJ ZBOH EJTFCVU EBQBU NFSVQBLBO IBTJM EBSJ QFSVCBIBO GJTJL BUBV LJNJBXJ ZBOH
NFNPSJ LFSKB ZBOH UFSVUBNB NFMJQVUJ NFNPSJ KBOHLB CFSTJGBU TFNFOUBSB BUBV LFEVBOZB CBJL QBEB VKVOH QSBTJOBQUJL
QFOEFL ZBOH EJHVOBLBO TFMBNB CFSMBOHTVOHOZB QFNJLJSBO BUBV QBEB NFNCSBO QBTDBTJOBQUJL QFSVCBIBO JOJ EBQBU NFOFUBQ
JOUFMFLUIBM OBNVO QFOHHVOBBOOZB CFSBLIJS TBBU TFUJBQ UBIBQ TFMBNB CFSNFOJUNFOJU TBNQBJ CFCFSBQB NJOHHV .FLBOJTNF JOJ
QFSNBTBMBIBOUFSTFMFTBJLBO CFSTJGBU TBOHBU QFOUJOH TFIJOHHB MBZBL EJEFTLSJQTJLBO TFDBSB
.FNPSJ TFSJOH LBMJ EJHPMPOHLBO CFSEBTBSLBO KFOJT JOGPS LIVTVT
NBTJZBOHEJTJNQBOOZB4BMBITBUVQFOHHPMPOHBOJOJNFNCBHJ
NFNPSJNFOKBEJNFNPSJEFLMBSBUJGEBONFNPSJLFUFSBNQJMBO Memori Berdasarkan Perubahan Kimiawi di
ZBJUVTFCBHBJCFSJLVU Ujung Prasinaptik atau Membran Pascasinaptik
1. .FNPSJ EFLMBSBUJG QBEB EBTBSOZB CFSBSUJ NFNPSJ UFOUBOH (BNCBSNFNQFSMJIBULBONFLBOJTNFNFNPSJZBOHEJQFMBKBSJ
CFSBHBN EFUBJM NFOHFOBJ TVBUV QJLJSBO UFSJOUFHSBTJ TFQFSUJ LIVTVTOZBPMFI,BOEFMEBOLBXBOLBXBO ZBOHEBQBUNFOJNCVM
NFNPSJ TVBUV QFOHBMBNBO QFOUJOH ZBOH NFMJQVUJ
LBOQFSQBOKBOHBONFNPSJEBSJCFCFSBQBNFOJUTBNQBJNJOHHV
NFNPSJ BLBO LFBEBBO TFLFMJMJOH
NFNPSJ UFOUBOH QBEBLFPOH"QMZTJBCFTBS1BEBHBNCBSJOJ UFSMJIBUEVBUFSNJOBM
IVCVOHBO XBLUV
NFNPSJ UFOUBOH QFOZFCBC QFOH QSBTJOBQUJL4BMBITBUVOZBCFSBTBMEBSJOFVSPOJOQVUTFOTPSJLEBO
BMBNBO UFSTFCVU
NFNPSJ UFOUBOH NBLOB QFOHBMBNBO CFSBLIJS TFDBSB MBOHTVOH QBEB QFSNVLBBO OFVSPO ZBOH BLBO
UFSTFCVU EBO
NFNPSJ UFOUBOH LFTJNQVMBO NFOHFOBJ EJSBOHTBOH LFBEBBO JOJ EJTFCVU UFSNJOBM TFOTPSJL 5FSNJOBM
TFTFPSBOHZBOHUFSUJOHHBMQBEBQJLJSBOTFTFPSBOH MBJOOZB ZBJUV VKVOH QSBTJOBQUJL ZBOH UFSMFUBL QBEB QFSNVLBBO
UFSNJOBM TFOTPSJL EBO EJTFCVU UFSNJOBM GBTJMJUBUPS #JMB UFSNJOBM
2. .FNPSJ LFUFSBNQJMBO TFSJOH LBMJ EJIVCVOHLBO EFOHBO TFOTPSJL UFSBOHTBOH TFDBSB CFSVMBOHVMBOH UBOQB QFSBOHTBOHBO
BLUJWJUBT NPUPSJL UVCVI TFTFPSBOH TFQFSUJ LFUFSBNQJMBO QBEB UFSNJOBM GBTJMJUBUPS TJOZBM ZBOH EJLJSJN QFSUBNB LBMJ DVLVQ
ZBOH UFSCFOUVL VOUVL NFNVLVM CPMB UFOJT UFSNBTVL CFTBS UBQJ LFNVEJBO NFMFNBI TFTVBJ EFOHBO QFOHVMBOHBO
NFNPSJ PUPNBUJT QBEB
QBOEBOHBO LF CPMB
SBOHTBOH TBNQBJ BLIJSOZB IBNQJS IJMBOH 'FOPNFOB JOJ
NFOHIJUVOHIVCVOHBOEBOLFDFQBUBOCPMBLFSBLFU EBO
NFSVQBLBO IBCJUVBTJ TFQFSUJ ZBOH UFMBI EJKFMBTLBO TFCFMVNOZB
NFOHBNCJM LFTJNQVMBO TFDBSB DFQBU QFSHFSBLBO UVCVI )BCJUVBTJBEBMBIUJQFNFNPSJOFHBUJGZBOHNFOHBLJCBULBOTJSLVJU
MFOHBO EBO SBLFU ZBOH EJCVUVILBO VOUVL NFNVLVM CPMB QFSTBSBGBO LFIJMBOHBO SFTQPOTOZB UFSIBEBQ QFSJTUJXB CFSVMBOH
TFQFSUJZBOHEJJOHJOLBOTFNVBIBMUFSTFCVUUFSBLUJWBTJ ZBOHUBLCFSBSUJ
706
Bab 57 Korteks Serebri, Fungsi Intelektual Otak, Proses Belajar, dan Memori
1FOHIBNCBUBO JOJ EBQBU CFSMBOHTVOH TFMBNB CFCFSBQB

NFOJUTBNQBJCFCFSBQBNJOHHV
4. #FSLVSBOHOZB LPOEVLUBOT LBMJVN NFOZFCBCLBO UJNCVMOZB
QPUFOTJBMBLTJZBOHTFNBLJOMBNBQBEBUFSNJOBMQSBTJOBQUJL
UNIT XI
LBSFOBLFMVBSOZBJPOLBMJVNEBSJUFSNJOBMUFSTFCVUEJQFSMVL
BOVOUVLQFNVMJIBO SFQPMBSJTBTJ
DFQBUQPUFOTJBMBLTJ
5. 1PUFOTJBM BLTJ ZBOH MBNB NFOZFCBCLBO BLUJWBTJ ZBOH
TFNBLJO MBNB QBEB LBOBMLBOBM LBMTJVN TFIJOHHB CBOZBL
TFLBMJJPOLBMTJVNNFNBTVLJUFSNJOBMTJOBQTTFOTPSJL*PO
LBMTJVNJOJTFMBOKVUOZBNFOZFCBCLBOQFOJOHLBUBOQFMFQBT
BO USBOTNJUFS PMFI TJOBQTTJOBQT TFIJOHHB NFOHBLJCBULBO
GBTJMJUBTJ USBOTNJTJ TJOBQT TFDBSB CFSNBLOB LF OFVSPO
TFMBOKVUOZB
%FOHBOEFNJLJBO EFOHBODBSBZBOHTBOHBUUJEBLMBOHTVOH
FGFL BTPTJBUJG QFSBOHTBOHBO UFSNJOBM GBTJMJUBUPS QBEB TBBU
4FCBMJLOZB CJMB TUJNVMVT OPLTJVT NFSBOHTBOH UFSNJOBM GBTJMJ CFSTBNBBO EFOHBO UFSBOHTBOHOZB UFSNJOBM TFOTPSJL
UBUPS QBEB TBBU ZBOH TBNB EFOHBO QFSBOHTBOHBO UFSNJOBM NFOZFCBCLBOQFOJOHLBUBOTFOTJUJWJUBTFLTJUBTJZBOHMBNBQBEB
TFOTPSJL UFSOZBUB CVLBOOZB TJOZBM ZBOH EJLJSJNLBO LF OFVSPO UFSNJOBM TFOTPSJL EBO IBM JUV NFNCBOHVO KFKBL NFNPSJ
QBTDBTJOBQUJL TFNBLJO NFMFNBI TFDBSB QSPHSFTJG QFOHJSJNBO 1FOFMJUJBO PMFI #ZSOF EBO LBXBOLBXBO KVHB QBEB LFPOH
TJOZBM CBILBO NFOKBEJ LVBU EBO TFNBLJO LVBU EBO IBM JUV BLBO "QMZTJB NFOZBUBLBO CBIXB NBTJI BEB NFLBOJTNF MBJO
UFUBQNFOKBEJLVBUTFMBNBCFSNFOJUNFOJU CFSKBNKBN CFSIBSJ NFOHFOBJ NFNPSJ TJOBQT 1FOFMJUJBO #ZSOF EBO LBXBOLBXBO
IBSJ BUBV EFOHBO QFMBUJIBO ZBOH MFCJI LFSBT MBHJ EBQBU TBNQBJ NFNQFSMJIBULBOCBIXBTUJNVMVTZBOHCFSBTBMEBSJEVBTVNCFS
TFLJUBS NJOHHV UBOQB BEBOZB QFSBOHTBOHBO MFCJI MBOKVU EBSJ UFSQJTBI CFLFSKB QBEB TVBUV OFVSPO EBO QBEB LFBEBBO ZBOH
UFSNJOBM GBTJMJUBUPS +BEJ TUJNVMVT ZBOH TBOHBU NFOHHBOHHV TFTVBJ EBQBU NFOZFCBCLBO QFSVCBIBO KBOHLB QBOKBOH QBEB
NFOZFCBCLBOKBSBTNFNPSJNFOKBEJUFSGBTJMJUBTJTFMBNBCFCFSBQB TJGBU NFNCSBO OFVSPO QBTDBTJOBQUJL EBO CVLBO EJ EBMBN
IBSJ BUBV CFCFSBQB NJOHHV TFTVEBIOZB %BMBN IBM JOJ ZBOH NFNCSBO OFVSPO QSBTJOBQUJL UFUBQJ NFOJNCVMLBO FGFL
NFOBSJL BEBMBI CBIXB XBMBVQVO TFUFMBI UFSKBEJ IBCJUVBTJ KBSBT NFNPSJZBOHQBEBEBTBSOZBTBNB
UFSTFCVUEBQBUEJBMJILBOLFKBSBTUFSGBTJMJUBTJEFOHBOIBOZBTFEJLJU
SBOHTBOHZBOHTBOHBUNFOHHBOHHV Memori Jangka Panjang
5JEBL BEB CBUBTBO ZBOH KFMBT BOUBSB KFOJT NFNPSJ KBOHLB
Mekanisme Molekuler pada Memori Jangka Menengah NFOFOHBI ZBOH MFCJI MBNB EFOHBO NFNPSJ KBOHLB QBOKBOH
ZBOH TFTVOHHVIOZB /BNVO NFNPSJ KBOHLB QBOKBOH QBEB
Mekanisme Habituasi. 1BEB UJOHLBU NPMFLVMFS XBMBVQVO
VNVNOZB EJZBLJOJ TFCBHBJ IBTJM QFSVCBIBO TUSVLUVSBM QBEB
QFOZFCBC UBL TFMVSVIOZB EJLFUBIVJ FGFL IBCJUVBTJ QBEB UFSNJOBM
TBBUJOJ CVLBOIBOZBQFSVCBIBOLJNJBXJ QBEBTJOBQTTJOBQT
TFOTPSJL UFSKBEJ BLJCBU QFOVUVQBO TFDBSB QSPHSFTJG LBOBMLBOBM
EBOIBMIBMUFSTFCVUNFNQFSLVBUBUBVNFOFLBOQFOHIBOUBSBO
LBMTJVNQBEBNFNCSBOUFSNJOBM.FTLJQVOEFNJLJBO QFOVUVQBO
TJOZBMTJOZBM 4FLBMJ MBHJ NBSJMBI LJUB NFOHJOHBU LFNCBMJ
LBOBMLBMTJVNUFSTFCVUUJEBLTFQFOVIOZBEJNFOHFSUJ JPOLBMTJVN
QFSDPCBBO QBEB IFXBO QSJNJUJG ZBOH TJTUFN TBSBGOZB KBVI
EBQBU CFSEJGVTJ LF EBMBN UFSNJOBM UFSIBCJUVBTJ JOJ MFCJI TFEJLJU
MFCJI NVEBI EJQFMBKBSJ
ZBOH TBOHBU NFNCBOUV LJUB VOUVL
EBSJQBEB KVNMBI OPSNBM EBO BLBO TFNBLJO TFEJLJU USBOTNJUFS
NFOHFSUJ NFOHFOBJ NFLBOJTNF ZBOH NVOHLJO UFSKBEJ QBEB
TFOTPSJLUFSNJOBMZBOHEJMFQBTLBOLBSFOBQFNBTVLBOJPOLBMTJVN
NFNPSJKBOHLBQBOKBOH
NFSVQBLBO TUJNVMVT VUBNB CBHJ QFMFQBTBO USBOTNJUFS TFQFSUJ
ZBOHUFMBIEJCJDBSBLBOQBEB#BC

Perubahan Struktur yang Terjadi di Sinaps-
Mekanisme Fasilitasi. 1BEB LBTVT GBTJMJUBTJ NFLBOJTNF Sinaps selama Terbentuknya Memori Jangka Panjang
NPMFLVMFSEJBOHHBQCFSMBLVTFCBHBJCFSJLVU
(BNCBSBOTFDBSBNJLSPTLPQFMFLUSPOZBOHEJBNCJMEBSJIFXBO
1. 1FSBOHTBOHBO UFSNJOBM GBTJMJUBUPS QSBTJOBQUJL QBEB TBBU ZBOH JOWFSUFCSBUB UFMBI NFOVOKVLLBO CBOZBL QFSVCBIBO HBNCBSBO
TBNB EFOHBO QFSBOHTBOHBO TFOTPSJL NFOZFCBCLBO QFMFQBTBO GJTJL QBEB CBOZBL TJOBQT TFMBNB UFSCFOUVLOZB KFKBL NFNPSJ
TFSPUPOJO QBEB TJOBQT GBTJMJUBUPS EJ QFSNVLBBO UFSNJOBM KBOHLB QBOKBOH 1FSVCBIBO TUSVLUVSBM UJEBL BLBO UFSKBEJ KJLB
TFOTPSJL IFXBO UFSTFCVU EJCFSJ PCBU ZBOH NFOHIBNCBU TUJNVMBTJ %/"
2. 4FSPUPOJO CFLFSKB QBEB SFTFQUPS TFSPUPOJO EJ NFNCSBO QBEBSFQMJLBTJQSPUFJOEJOFVSPOQSBTJOBQUJLEFOHBOEFNJLJBO
UFSNJOBM TFOTPSJL EBO TFSPUPOJO JOJ NFOHBLUJGLBO FO[JN UJEBLUFSCFOUVLKFKBLNFNPSJZBOHQFSNBOFO0MFILBSFOBJUV
BEFOJM TJLMBTF EJ EBMBN NFNCSBO "EFOJM TJLMBTF UFSTFCVU LFMJIBUBOOZB QFNCFOUVLBO NFNPSJ KBOHLB QBOKBOH ZBOH
LFNVEJBO NFOZFCBCLBO UFSCFOUVLOZB FO[JN BEFOPTJO TFCFOBSOZB CFSHBOUVOH QBEB SFTUSVLUVSJTBTJ TJOBQTTJOBQT JUV
NPOPGPTGBU TJLMJL D".1
KVHB EJ EBMBN UFSNJOBM QSBTJOBQUJL TFOEJSJ TFDBSB GJTJL EBMBN DBSBDBSB UFSUFOUV VOUVL NFOHVCBI
TFOTPSJL TFOTJUJWJUBTOZBEBMBNNFOHJSJNTJOZBMTJOZBMTBSBG
3. ".1 TJLMJL NFOHBLUJGLBO QSPUFJO LJOBTF ZBOH NFOZFCBCLBO 1FSVCBIBOTUSVLUVSGJTJLQBMJOHQFOUJOHZBOHUFSKBEJBEBMBI
TFCBHBJCFSJLVU
GPTGPSJMBTJ QSPUFJO ZBOH NFSVQBLBO CBHJBO EBSJ LBOBM LBMJVN
EJ NFNCSBO UFSNJOBM TJOBQT TFOTPSJL JUV TFOEJSJ LFBEBBO JOJ 1. 1FOJOHLBUBO UFNQBUUFNQBU QFMFQBTBO WFTJLFM VOUVL
TFMBOKVUOZBNFOHIBNCBULPOEVLUBOTLBMJVNQBEBLBOBM NFOZFLSFTJLBOCBIBOCBIBOUSBOTNJUFS
707
Unit Xl Sistem Saraf:C. Neurofisiologis Motorik dan lntegratif
2. 1FOJOHLBUBO KVNMBI WFTJLFMWFTJLFM USBOTNJUFS ZBOH EJ 1SPTFT LPOTPMJEBTJ EBO XBLUV ZBOH EJCVUVILBO VOUVL UFSKBEJ
MFQBTLBO OZB QSPTFT UFSTFCVU NVOHLJO EBQBU EJUFSBOHLBO NFMBMVJ
3. 1FOJOHLBUBOKVNMBIUFSNJOBMQSBTJOBQUJL GFOPNFOBMBUJIBO SFIFBSTBM
NFNPSJKBOHLBQFOEFLCFSJLVUJOJ
4. 1FSVCBIBOQBEBTUSVLUVSTQJOBEFOESJUZBOHNFNVOHLJO Latihan Meningkatkan Pemindahan Memori Jangka

LBOUFSKBEJOZBUSBOTNJTJTJOZBMZBOHMFCJILVBU Pendek menjadi Memori Jangka Panjang.
%FOHBO EFNJLJBO EBMBN CFCFSBQB IBM ZBOH CFSCFEB 1FOFMJUJBO NFOVOKVLLBO CBIXB MBUJIBO BUBV QFOHVMBOHBO
LFNBNQVBO TUSVLUVSBM EBSJ TJOBQTTJOBQT VOUVL NFOHJSJN JOGPSNBTJ ZBOH TBNB CFSLBMJLBMJ LF EBMBN QJLJSBO EBQBU
TJOZBM UBNQBLOZB NFOKBEJ NFOJOHLBU TFMBNB BEBOZB KFKBL NFNQFSDFQBU EBO NFNQFSLVBU UJOHLBU QFOHBMJIBO NFNPSJ
NFNPSJKBOHLBQBOKBOHZBOHTFCFOBSOZB KBOHLB QFOEFL NFOKBEJ NFNPSJ KBOHLB QBOKBOH EFOHBO
EFNJLJBO NFNQFSDFQBU EBO NFOJOHLBULBO LPOTPMJEBTJ 0UBL
Jumlah Neuron dan Hubungan-Hubungannya Sering
NFNQVOZBJ LFDFOEFSVOHBO VOUVL NFOHVMBOH JOGPSNBTJ ZBOH
Berubah secara Bermakna selama Proses Belajar
CBSV EJUFSJNB UFSVUBNB JOGPSNBTJ ZBOH NFOZJUB QFSIBUJBO
4FMBNBCFCFSBQBNJOHHV CFCFSBQBCVMBO CBILBOQBEBUBIVO QJLJSBO 0MFI LBSFOB JUV TFTVEBI NFMFXBUJ TBUV QFSJPEF XBLUV
UBIVO QFSUBNB LFIJEVQBO BUBV XBLUVXBLUV TFMBOKVUOZB HBNCBSBO QFOUJOH NFOHFOBJ QFOHBMBNBO TFOTPSJL NFOKBEJ
CBOZBLCBHJBOPUBLNFOHIBTJMLBOOFVSPOEBMBNKVNMBIZBOH UFSGJLTBTJ TFDBSB QSPHSFTJG EBMBN HVEBOH NFNPSJ )BM JOJ
TBOHBUCBOZBL EBOOFVSPOOFVSPOJOJNFOKVMVSLBOTFKVNMBI NFOKFMBTLBO NFOHBQB TFTFPSBOH EBQBU NFOHJOHBU EFOHBO MFCJI
DBCBOH BLTPO VOUVL NFNCFOUVL IVCVOHBO EFOHBO OFVSPO CBJL TFEJLJU JOGPSNBTJ ZBOH EJQFMBKBSJ TFDBSB NFOEBMBN EBSJQBEB
OFVSPOMBJO+JLBBLTPOZBOHCBSVHBHBMCFSIVCVOHBOEFOHBO CBOZBL JOGPSNBTJ ZBOH IBOZB EJQFMBKBSJ TFDBSB TVQFSGJTJBM
OFVSPO ZBOH TFTVBJ EFOHBO TFMTFM PUPU BUBV TFMTFM LFMFOKBS ,FBEBBO JOJ KVHB NFOKFMBTLBO NFOHBQB PSBOH ZBOH EBMBN
BLTPOBLTPOZBOHCBSVJUVTFOEJSJBLBONVTOBIEBMBNXBLUV LFBEBBO TFHBS EBQBU NFOHPOTPMJEBTJLBO NFNPSJOZB TFDBSB KBVI
CFCFSBQB NJOHHV +BEJ KVNMBI IVCVOHBO OFVSPO EJUFOUVLBO MFCJI CBJL EBSJQBEB EBMBN LFBEBBO LFMFMBIBO NFOUBM NFOUBM
PMFI GBLUPS QFSUVNCVIBO TBSBG ZBOH TQFTJGJL ZBOH EJMFQBTLBO GBUJHVF

TFDBSBSFUSPHSBEPMFITFMTFMZBOHUFSBOHTBOH4FMBOKVUOZB CJMB Memori Baru Disusun Selama Konsolidasi. 4BMBI TBUV
UFSKBEJ IVCVOHBO ZBOH UJEBL DPDPL TFMVSVI OFVSPO ZBOH HBNCBSBO UFSQFOUJOH LPOTPMJEBTJ BEBMBI CBIXB NFNPSJ CBSV
NFOKVMVSLBODBCBOHDBCBOHBLTPOBLBOMFOZBQ EJTVTVO NFOKBEJ CFSNBDBNNBDBN HPMPOHBO JOGPSNBTJ 4FMBNB
0MFILBSFOBJUV TFHFSBTFUFMBICBZJNBOVTJBMBIJS UFSEBQBU QSPTFT JOJ CFSMBOHTVOH KFOJT JOGPSNBTJ ZBOH TFSVQB EJUBSJL
QSJOTJQ HVOBLBO JUV BUBV IJMBOHLBO JUV ZBOH NFOFOUVLBO LFNCBMJEBSJUFNQBUQFOZJNQBOBONFNPSJEBOEJHVOBLBOVOUVL
KVNMBIBLIJSOFVSPOEBOIVCVOHBOIVCVOHBOOZBEJCFSCBHBJ NFNCBOUVQSPTFTJOGPSNBTJZBOHCBSV1FSCFEBBOEBOLFTBNBBO
CBHJBOTJTUFNTBSBGNBOVTJBZBOHUFSLBJU*OJNFSVQBLBOTVBUV JOGPSNBTJZBOHCBSVEBOZBOHMBNBLFNVEJBOEJCBOEJOHLBO EBO
KFOJTQSPTFTCFMBKBS4FCBHBJDPOUPI KJLBTBUVNBUBEBSJIFXBO TFCBHJBO QSPTFT QFOZJNQBOBO JOJ MFCJI CBOZBL EJQBLBJ VOUVL
ZBOHCBSVMBIJSEJUVUVQTFMBNBCFCFSBQBNJOHHVTFUFMBIMBIJS NFOZJNQBO LFTBNBBO EBO QFSCFEBBO JOGPSNBTJ EBSJQBEB VOUVL
OFVSPOOFVSPO EJ HBSJTHBSJT BMUFSOBUJG EBSJ LPSUFLT TFSFCSJ NFOZJNQBO JOGPSNBTJ CBSV ZBOH UJEBL EJQSPTFT +BEJ TFMBNB
QFOHMJIBUBO OFVSPOOFVSPO ZBOH OPSNBMOZB CFSIVCVOHBO LPOTPMJEBTJ NFNPSJZBOHCBSVUJEBLEJTJNQBOTFDBSBBDBLEJPUBL
EFOHBONBUBZBOHEJUVUVQBLBOCFSEFHFOFSBTJ EBONBUBZBOH UBQJ EJTJNQBO EBMBN LBJUBO MBOHTVOH EFOHBO NFNPSJ MBJO ZBOH
UFSUVUVQJUVTFDBSBTFCBHJBOBUBVTFDBSBUPUBMBLBOCVUBTFMBNB NBDBNOZB TBNB )BM JOJ EJQFSMVLBO BHBS LFMBL PSBOH UFSTFCVU
TJTB IJEVQOZB 4BNQBJ TFLBSBOH EJQFSDBZB CBIXB TBOHBU NBNQVNFODBSJNFNPSJZBOHEJTJNQBOQBEBTVBUVXBLUVZBOH
TFEJLJU QSPTFT CFMBKBS ZBOH EJQFSPMFI NBOVTJB EFXBTB EBO MFCJILFNVEJBO UFSBLIJSEJTJNQBO
VOUVLNFOFNVLBOJOGPSNBTJ
IFXBO EFOHBO DBSB NPEJGJLBTJ KVNMBI OFVSPO QBEB TJSLVJU ZBOHEJQFSMVLBO
NFNPSJ OBNVO EFNJLJBO QFOFMJUJBO UFSCBSV NFOZBUBLBO
CBIXB CBILBO PSBOH EFXBTB NFOHHVOBLBO NFLBOJTNF Peran Bagian-Bagian Spesifik Otak dalam Pemrosesan
UFSTFCVUTFUJEBLOZBQBEBCFCFSBQBIBM Memori
Proses Konsolidasi Memori Hipokampus Mendorong Penyimpanan Memori
+JLB NFNPSJ KBOHLB QFOEFL EJVCBI NFOKBEJ NFNPSJ KBOHLB Amnesia Anterograd Setelah Lesi Hipokampus.
QBOKBOH EBO EBQBU EJQBOHHJM LFNCBMJ CFCFSBQB NJOHHV BUBV )JQPLBNQVT NFSVQBLBO CBHJBO ZBOH QBMJOH NFEJBM EBSJ LPSUFLT
CFCFSBQB UBIVO LFNVEJBO NBLB NFNPSJ UFSTFCVU IBSVT MPCVT UFNQPSBMJT ZBOH NVMBNVMB NFMJQBU LF BSBI NFEJBM EJ
NFOHBMBNJLPOTPMJEBTJ"SUJOZB NFNPSJKBOHLBQFOEFLKJLB CBXBIPUBLEBOTFMBOKVUOZBOBJLLFQFSNVLBBOEBMBN EJCBXBI
EJBLUJGLBO CFSVMBOHVMBOH BLBO NFOJNCVMLBO QFSVCBIBO WFOUSJLFM MBUFSBMJT 1BEB QFOHPCBUBO CFCFSBQB QBTJFO FQJMFQTJ
LJNJB GJTJL EBO BOBUPNJT QBEB TJOBQTTJOBQT ZBOH LFEVBIJQPLBNQVTUFSTFCVUEJBOHLBU5FSOZBUB UJOEBLBOJOJUJEBL
CFSUBOHHVOHKBXBCVOUVLNFNPSJUJQFKBOHLBQBOKBOH1SPTFT UFSMBMV TFSJVT NFNFOHBSVIJ NFNPSJ QBTJFO UFSIBEBQ JOGPSNBTJ
JOJ NFNFSMVLBO XBLUV TBNQBJ NFOJU VOUVL LPOTPMJEBTJ ZBOHEJTJNQBOEJEBMBNPUBLTFCFMVNQFOHBOHLBUBOIJQPLBNQVT
NJOJNBMEBOTBUVKBNBUBVMFCJIVOUVLLPOTPMJEBTJNBLTJNBM /BNVO TFTVEBI QFOHBOHLBUBO QBTJFO JOJ CFUVMCFUVM UJEBL
4FCBHBJDPOUPI CJMBBEBLFTBOTFOTPSJLZBOHLVBUEJUBOBNLBO NFNQVOZBJ LFNBNQVBO VOUVL NFOZJNQBO NFNPSJ UJQF WFSCBM
QBEB PUBL OBNVO LFNVEJBO EBMBN XBLUV TBUV NFOJU BUBV
EBO TJNCPMJL NFNPSJ UJQF EFLMBSBUJG
EBMBN NFNPSJ KBOHLB
MFCJIEJJLVUJPMFILFKBOHPUBLBLJCBUBMJSBOMJTUSJL QFOHBMBNBO
QBOKBOHOZB BUBV CBILBO EBMBN NFNPSJ JOUFSNFEJB ZBOH
TFOTPSJL UFSTFCVU UJEBL EBQBU EJJOHBU TBNB TFLBMJ %FNJLJBO
CFSMBOHTVOHMFCJIEBSJCFCFSBQBNFOJU0MFILBSFOBJUV QBTJFOJOJ
KVHB QBEB HFHBS PUBL CSBJO DPODVTTJPO
QFNCFSJBO BOFTUFTJ
VNVNZBOHEBMBNTFDBSBNFOEBEBL BUBVFGFLFGFLMBJOZBOH UBLNBNQVNFOZVTVONFNPSJKBOHLBQBOKBOHZBOHCBSVEBOUJQF
NFOHIBNCBU GVOHTJ EJOBNJL PUBL TFDBSB TFNFOUBSB EBQBU JOGPSNBTJ UFSTFCVU NFSVQBLBO EBTBS JOUFMFHFOTJ ,FBEBBO JOJ
NFOHIBNCBUQSPTFTLPOTPMJEBTJ EJTFCVUBNOFTJBBOUFSPHSBE
708
Bab 57 Korteks Serebri, Fungsi Intetektual Otak, Proses Belajar, dan Memori
5FUBQJNFOHBQBIJQPLBNQVTCFHJUVQFOUJOHVOUVLNFNCBOUV Hipokampus Tidak Penting dalam Proses Belajar

PUBL EBMBN NFOZJNQBO NFNPSJ ZBOH CBSV ,FNVOHLJOBO Refleksif. 0SBOHPSBOH EFOHBO MFTJ IJQPLBNQVT CJBTBOZB
KBXBCBOOZB BEBMBI CBIXB IJQPLBNQVT NFSVQBLBO TBMBI TBUV UJEBL NFOHBMBNJ LFTVMJUBO EBMBN NFNQFMBKBSJ LFUFSBNQJMBO
EBSJ TFLJBO CBOZBL KBSBT LFMVBS ZBOH QFOUJOH ZBOH CFSBTBM EBSJ GJTJL ZBOH UJEBL NFMJCBULBO WFSCBMJTBTJ BUBV UJQF JOUFMFHFOTJB
BSFBHBOKBSBOEBOIVLVNBOQBEBTJTUFNMJNCJL TFQFSUJBLBO
UNIT XI
TJNCPMJL 4FCBHBJ DPOUPI PSBOHPSBOH JOJ NBTJI EBQBU
EJKFMBTLBO QBEB #BC 3BOHTBOHBO TFOTPSJL BUBV QJLJSBO ZBOH NFNQFMBKBSJ LFUFSBNQJMBO HFSBL DFQBU UBOHBO EBO
NFOZFCBCLBO SBTB OZFSJ BUBV BOUJQBUJ BLBO NFSBOHTBOH QVTBU LFUFSBNQJMBOGJTJLTFQFSUJZBOHEJQFSMVLBOEBMBNCBOZBLKFOJT
IVLVNBO MJNCJL EBO SBOHTBOHBO ZBOH NFOZFCBCLBO SBTB PMBISBHB +FOJT QSPTFT CFMBKBS JOJ EJTFCVU LFUFSBNQJMBO CFMBKBS
TFOBOH CBIBHJB BUBV SBTB HBOKBSBO BLBO NFSBOHTBOH QVTBU BUBV QSPTFT CFMBKBS SFGMFLTUG IBM JOJ MFCJI CFSHBOUVOH QBEB
HBOKBSBO MJNCJL 4FNVB JOJ CFSTBNBTBNB NFOJNCVMLBO MBUBS QFOHVMBOHBO LFHJBUBO TFDBSB GJTJL ZBOH UFSVTNFOFSVT CVLBO
CFMBLBOH TVBTBOB IBUJ EBO NPUJWBTJ TFTFPSBOH %J BOUBSB QFMBUJIBOTJNCPMJTEBMBNQJLJSBO
NPUJWBTJNPUJWBTJ JOJ UFSEBQBU EPSPOHBO EBMBN PUBL VOUVL
NFOHJOHBU QFOHBMBNBOQFOHBMBNBO EBO QJLJSBOQJLJSBO ZBOH Daftar Pusaka
NFOZFOBOHLBO BUBV ZBOH UJEBL NFOZFOBOHLBO )JQPLBNQVT Bailey CH, Kandel ER: Synaptic remodeling, synaptic growth and the storage
LIVTVTOZB EBO EBMBN EFSBKBU ZBOH MFCJI LFDJM QBEB OVLMFJ of long-term memory in Aplysia, Prog Brain Res 169:179, 2008.
Glickstein M: Paradoxical inter-hemispheric transfer after section of the
EPSTBMJT NFEJBMJT QBEB UBMBNVT ZBJUV TUSVLUVS MJNCJL ZBOH MBJO
cerebral commissures, Exp Brain Res 192:425, 2009.
UFMBI UFSCVLUJ NFNJMJLJ LFQFOUJOHBO LIVTVT EBMBN NFNCVBU Haggard P: Human volition: towards a neuroscience of will, Nat Rev
LFQVUVTBO NFOHFOBJ QJLJSBO NBOB ZBOH DVLVQ QFOUJOH QBEB Neurosci 9:934, 2008.
EBTBS HBOKBSBO BUBV IVLVNBO VOUVL NFOKBEJ NFNPSJ ZBOH Hickok G, Poeppel D: The cortical organization of speech processing, Nat
CFSGBFEBI Rev Neurosci 8:393, 2007.
Kandel ER: The molecular biology of memory storage: a dialogue between
genes and synapses, Science 294:1030, 2001.
Amnesia Retrograd Ketidakmampuan Memanggil Memori Kandel ER, Schwartz JH, Jessell TM: Principles of Neural Science, ed 4, New
Masa Lalu. ,FUJLB UFSKBEJ BNOFTJB SFUSPHSBE EFSBKBU BNOFTJB LaBar KS, Cabeza R: Cognitive neuroscience of emotional memory, Nat Rev
VOUVL QFSJTUJXBQFSJTUJXB ZBOH CBSV TBKB UFSKBEJ NVOHLJO MFCJI Neurosci 7:54, 2006.
CFTBSEBSJQBEBQFSJTUJXBNBTBMBMVZBOHUFMBIMBNBUFSKBEJ"MBTBO Lee YS, Silva AJ: The molecular and cellular biology of enhanced cognition,
QFSCFEBBO JOJ NVOHLJO LBSFOB NFNPSJ ZBOH MBNB UFMBI CBOZBL Nat Rev Neurosci 10:126, 2009.
EJVMBOHVMBOH TFIJOHHB KFKBL NFNPSJ UFMBI NFMFLBU LVBU EBO Lynch MA: Long-term potentiation and memory, Physiol Rev 84:87, 2004.
Mansouri FA, Tanaka K, Buckley MJ: Conflict-induced behavioural
CBHJBOCBHJBO NFNPSJ JOJ UFMBI UFSTJNQBO EJ EBFSBI ZBOH MFCJI
adjustment: a clue to the executive functions of the prefrontal cortex,
MVBTEBMBNPUBL Nat Rev Neurosci 10:141, 2009.
Nader K, Hardt O: A single standard for memory: the case for reconsolida-
1BEBCFCFSBQBQBTJFOZBOHNFOEFSJUBMFTJIJQPLBNQVT UFSKBEJ
tion, Nat Rev Neurosci 10:224, 2009.
CFCFSBQB NBDBN EFSBKBU BNOFTJB SFUSPHSBE CFSTBNB EFOHBO Osada T, Adachi Y, Kimura HM, et al: Towards understanding of the cortical
BNOFTJB BOUFSPHSBE ZBOH NFOJNCVMLBO EVHBBO CBIXB QBMJOH network underlying associative memory, Philos Trans R Soc Lond B Biol
TFEJLJUTFCBHJBOEBSJLFEVBNBDBNBNOFTJBJOJTBMJOHCFSLBJUBO Sci 363:2187, 2008.
EBO MFTJ IJQPLBNQVT EBQBU NFOZFCBCLBO UFSKBEJOZB LFEVB Roth TL, Sweatt JD: Rhythms of memory, Nat Neurosci 11:993, 2008.
Shirvalkar PR: Hippocampal neural assemblies and conscious remembering,
LFMBJOBO JOJ /BNVO LFSVTBLBO CFCFSBQB BSFB TQFTJGJL QBEB
J Neurophysiol 101:2197, 2009.
UBMBNVT NVOHLJO NFOZFCBCLBO UJNCVMOZB BNOFTJB SFUSPHSBE Tanji J, Hoshi E: Role of the lateral prefrontal cortex in executive behavioral
UBOQBUFSKBEJOZBBNOFTJBBOUFSPHSBEZBOHCFSBSUJ,FNVOHLJOBO control, Physiol Rev 88:37, 2008.
QFOKFMBTBO EBO LFBEBBO JOJ BEBMBI CBIXB UBMBNVT NVOHLJO Tronson NC, Taylor JR: Molecular mechanisms of memory reconsolidation,
CFSQFSBO EBMBN NFNCBOUV PSBOH VOUVL NFODBSJ EBSJ HVEBOH Nat Rev Neurosci 8:262, 2007.
van Strien NM, Cappaert NL, Witter MP: The anatomy of memory: an
NFNPSJOZB TFIJOHHB NBNQV NFNCBDB NFNPSJ UFSTFCVU +BEJ
interactive overview of the parahippocampal-hippocampal network,
QSPTFT NFOHJOHBU JUV UBL IBOZB NFNCVUVILBO HVEBOH Nat Rev Neurosci 10:272, 2009.
QFOZJNQBOBO NFNPSJ OBNVO KVHB NFNCVUVILBO LFNBNQVBO Wilson DA, Linster C: Neurobiology of a simple memory, J Neurophysiol
VOUVL NFODBSJ EBO NFOFNVLBO NFNPSJ EJ LFNVEJBO IBSJ 100:2, 2008.
,FNVOHLJOBOGVOHTJUBMBNVTEBMBNQSPTFTJOJBLBOEJCJDBSBLBO Zamarian L, Ischebeck A, Delazer M: Neuroscience of learning arithmetic—
evidence from brain imaging studies, Neurosci Biobehav Rev 33:909,
EBMBN#BC
2009.
709
BAB 58
UNIT XI
.FLBOJTNF1FSJMBLVEBO.PUJWBTJ
QBEB0UBL4JTUFN-JNCJLEBO)JQPUBMBNVT
1FOHFOEBMJBO QFSJMBLV BEBMBI HSBWJUBTJEBONFOHBUVSUJOHLBUBLUJWJUBTSFGMFLTNFEVMBTQJOBMJT

GVOHTJ TFMVSVI TJTUFN TBSBG 4FMBJOTJOZBMTJOZBMZBOHUVSVOLFCBXBIUFSTFCVU BSFBJOJKVHB
#BILBOLFBEBBOTJBHBEBOTJLMVT NFOHJSJNLBO CBOZBL TJOZBM LF BSBI BUBT ,FCBOZBLBO TJOBQT
UJEVS ZBOH EJCJDBSBLBO EBMBN EBOTJOZBMJOJQFSUBNBUBNBNFOVKVLFUBMBNVT UFNQBUTJOBQT
#BC BEBMBI TBMBI TBUV QPMB UFSTFCVU NFSBOHTBOH CFSCBHBJ TVTVOBO OFVSPO ZBOH
QFSJMBLV LJUB ZBOH QBMJOH NFOHJSJNLBO TJOZBM TBSBG LF TFMVSVI SFHJP LPSUFLT TFSFCSJ EBO
QFOUJOH CFSCBHBJBSFBTVCLPSUJLBM
%BMBNCBCJOJ LJUBNVMBNVMBNFOHVSBJLBONFLBOJTNFZBOH "EB EVB KFOJT TJOZBM ZBOH CFSKBMBO NFMBMVJ UBMBNVT +FOJT
NFOHFOEBMJLBO UJOHLBU BLUJWJUBT QBEB CFSCBHBJ CBHJBO PUBL ZBOH QFSUBNB NFOHJSJN QPUFOTJBM BLTJ EFOHBO DFQBU EBO
,FNVEJBO LJUB NFNCJDBSBLBO NFOHFOBJ QFOZFCBC EPSPOHBO NFSBOHTBOH TFSFCSVN IBOZB EBMBN XBLUV CFCFSBQB NJMJEFUJL
NPUJWBTJ UFSVUBNBQFOHFOEBMJBONPUJWBTJUFSIBEBQQSPTFTCFMBKBS 1PUFOTJBM BLTJ JOJ CFSBTBM EBSJ CBEBO TFM OFVSPOOFVSPO CFTBS
EBOQFSBTBBOTFOBOHEBOIVLVNBO'VOHTJGVOHTJTJTUFNTBSBGJOJ ZBOHUFSMFUBLEJTFMVSVIBSFBSFUJLVMFSCBUBOHPUBL6KVOHVKVOH
UFSVUBNB EJMBLVLBO PMFI SFHJP CBTBM PUBL ZBOH CFSTBNBTBNB TBSBGOZB NFMFQBTLBO TVCTUBOTJ OFVSPUSBOTNJUFS BTFUJMLPMJO
EJTFCVUTJTUFNMJNCJL ZBOHCFSBSUJTJTUFNQFSCBUBTBOh ZBOH CFSUJOEBL TFCBHBJ TVBUV BHFO FLTJUBTJ EBO CFSMBOHTVOH
IBOZBEBMBNXBLUVCFCFSBQBNJMJEFUJLTFCFMVNEJIBODVSLBO
Sistem Pendorong—Aktivitas Otak 4JOZBM FLTJUBTJ KFOJT LFEVB CFSBTBM EBSJ TFKVNMBI CFTBS
OFVSPOLFDJMZBOHUFSTFCBSEJTFMVSVIBSFBFLTJUBUPSJLSFUJLVMFS
5BOQB BEBOZB QFOHJSJNBO TJOZBM TBSBG ZBOH UFSVTNFOFSVT EBSJ
CBUBOH PUBL 4FLBMJ MBHJ TFCBHJBO CFTBS TJOZBM JOJ NFOVKV LF
PUBLEJCBHJBOZBOHMFCJISFOEBILFTFSFCSVN TFSFCSVNNFOKBEJ
UBMBNVT UFUBQJ ZBOH TFLBSBOH EJIBOUBSLBO TFDBSB MBNCBU
UJEBL CFSNBOGBBU 1BEB LFOZBUBBOOZB LPNQSFTJ CFSBU QBEB
NFMBMVJ TFSBUTFSBU LFDJM ZBOH UFSVUBNB CFSTJOBQT EJ OVLMFJ
CBUBOH PUBL EJ QFSUFNVBO BOUBSB NFTFOTFGBMPO EBO TFSFCSVN
JOUSBMBNJOBSQBEBUBMBNVTEBOEJOVLMFJSFUJLVMFSQBEBTFMVSVI
ZBOH LBEBOH NFSVQBLBO BLJCBU EBSJ UVNPS QJOFBM TFSJOH LBMJ
QFSNVLBBO UBMBNVT %BSJ TJOJ TFSBUTFSBU UBNCBIBO LFDJM
NFOZFCBCLBO PSBOH UFSTFCVU NBTVL EBMBN LFBEBBO LPNB ZBOH
EJEJTUSJCVTJLBOLFTFUJBQUFNQBUEJLPSUFLTTFSFCSJ&GFLFLTJUBTJ
UJEBLQVMJILFNCBMJTFMBNBTJTBIJEVQOZB
ZBOH EJTFCBCLBO PMFI TJTUFN TFSBUTFSBU JOJ EBQBU UFSCFOUVL
4JOZBMTJOZBM TBSBG QBEB CBUBOH PUBL NFOHBLUJGLBO CBHJBO TFDBSB QSPHSFTJG TFMBNB CFSEFUJLEFUJL TBNQBJ CFSNFOJUNFOJU
TFSFCSVN PUBL NFMBMVJ EVB DBSB
EFOHBO QFSBOHTBOHBO BUBV MFCJI ZBOH NFOVOKVLLBO CBIXB TJOZBMOZB UFSVUBNB
MBOHTVOHUFSIBEBQUJOHLBUEBTBSBLUJWJUBTQFSTBSBGBOQBEBEBFSBI QFOUJOH VOUVL NFOHFOEBMJLBO UJOHLBU FLTJUBCJMJUBT KBOHLB
ZBOH MVBT EJ PUBL EBO
EFOHBO NFOHBLUJGLBO TJTUFN QBOKBOHQBEBPUBL
OFVSPIPSNPOBM ZBOH NFMFQBTLBO TVCTUBOTJ OFVSPUSBOTNJUFS
NFOZFSVQBJ IPSNPO TVCTUBOTJ JOJ NFNCFSJ QFOHBSVI GBTJMJUBTJ Perangsangan Area Eksitatorik oleh Sinyal Sensorik
BUBVJOIJCJTJTQFTJGJLLFBSFBBSFBUFSUFOUVQBEBPUBL
Perifer. 5JOHLBUBLUJWJUBTQBEBBSFBFLTJUBUPSJLEJCBUBOHPUBL
EBO EFOHBO EFNJLJBO KVHB UJOHLBU BLUJWJUBT TFMVSVI PUBL
Pengendalian Aktivitas Serebrum oleh Sinyal Eksitasi
EJUFOUVLBO TFCBHJBO CFTBS PMFI KVNMBI EBO KFOJT TJOZBMTJOZBM
Berkesinambungan dari Batang Otak
TFOTPSJT ZBOH NFNBTVLJ PUBL EBSJ QFSJGFS 4JOZBMTJOZBM OZFSJ
Area Eksitatorik Retikuler Batang Otak LIVTVTOZB NFOJOHLBULBO BLUJWJUBT BSFB FLTJUBUPSJL JOJ EBO
(BNCBS NFNQFSMJIBULBO TJTUFN VNVN VOUVL EFOHBO EFNJLJBO NFOHFLTJUBTJ PUBL TFDBSB LVBU VOUVL
NFOHFOEBMJLBO UJOHLBU BLUJWJUBT CBUBOH PUBL ,PNQPOFO QVTBU UFSKBEJOZBBUFOTJ QFSIBUJBO

QFOEPSPOHEBSJTJTUFNJOJBEBMBIBSFBFLTJUBUPSJLZBOHUFSMFUBLEJ "SUJ QFOUJOH TJOZBMTJOZBM TFOTPSJL JOJ EBMBN NFOHBLUJGLBO
TVCTUBOTJBSFUJLVMFSQPOTEBONFTFOTFGBMPO"SFBJOJKVHBEJLFOBM BSFB FLTJUBUPSJL EJQFSMJIBULBO PMFI QFOHBSVI QFNPUPOHBO
EFOHBO OBNB BSFB GBTJMJUBTJ CVMCPSFUJLVMFS ,JUB UFMBI NFNCBIBT CBUBOHPUBLEJBUBTUJUJLUFNQBUTBSBGPUBLLFMJNBTFDBSBCJMBUFSBM
NFOHFOBJ BSFB JOJ QBEB #BC LBSFOB BSFB JOJ BEBMBI KVHB BSFB NFNBTVLJ QPOT /FSWVT UFSTFCVU BEBMBI OFSWVT UFSUJOHHJ ZBOH
SFUJLVMFS CBUBOH PUBL ZBOH NFOHJSJN TJOZBMTJOZBM GBTJMJUBTJ LF NFNBTVLJ PUBL ZBOH NFOHJSJN TFKVNMBI CFTBS TJOZBM
BSBICBXBINFOVKVNFEVMBTQJOBMJTVOUVLNFNFMJIBSBUPOVTBOUJ TPNBUPTFOTPSJLLFPUBL#JMBTFMVSVITJOZBMTFOTPSJLJOQVUJOJ
711
Unit Xl Sistem Sarat C. Neurofisiologi Motorik dan Integratif
Talamus UFSBUVS CFSKBMBO CPMBLCBMJL BOUBSB UBMBNVT EBO LPSUFLT TFSFCSJ

UBMBNVTNFSBOHTBOHLPSUFLTEBOLPSUFLTLFNVEJBONFSBOHTBOH
LFNCBMJ UBMBNVT NFMBMVJ TFSBUTFSBU CBMJL "EB EVHBBO CBIXB
QSPTFT CFSQJLJS NFOFUBQLBO NFNPSJ KBOHLB QBOKBOH EFOHBO
NFOHBLUJGLBOTJOZBMTJOZBMCPMBLCBMJLUFSTFCVU
%BQBU KVHBLBI UBMBNVT CFSGVOHTJ VOUVL NFNBOHHJM NFNPSJ
TQFTJGJL MBJOOZB EBSJ LPSUFLT BUBV VOUVL NFOHBLUJGLBO QSPTFT
CFSQJLJS ZBOH TQFTJGJL #VLUJ IBM UFSTFCVU NBTJI TBOHBU TFEJLJU
OBNVOUFOUVOZBUBMBNVTNFNJMJLJMJOUBTBOQFSTBSBGBOZBOHTFTVBJ
VOUVLUVKVBOJUV
Suatu Area Inhibisi Terletak di Batang Otak Bagian Bawah
(BNCBSKVHBNFNQFSMJIBULBOBSFBMBJOZBOHQFOUJOHEBMBN
NFOHFOEBMJLBO BLUJWJUBT PUBL "SFB JOJ BEBMBI BSFB JOIJCJTJ
Area eksitatorik SFUJLVMFS ZBOH UFSMFUBL EJ TFCFMBI NFEJBM EBO TFCFMBI WFOUSBM
NFEVMB 1BEB #BC LJUB UFMBI QFMBKBSJ CBIXB BSFB JOJ EBQBU
Nervus kranialis V NFOHIBNCBUBSFBGBTJMJUBTJSFUJLVMFSQBEBCBUBOHPUBLCBHJBOBUBT
EBO EFOHBO EFNJLJBO NFOVSVOLBO BLUJWJUBT EJ CBHJBO TVQFSJPS
Area inhibitorik PUBLKVHB4BMBITBUVNFLBOJTNFVOUVLIBMJUVBEBMBINFLBOJTNF
VOUVL NFSBOHTBOH OFVSPOOFVSPO TFSPUPOFSHJL ZBOH LFNVEJBO
NFOZFLSFTJLBO TFSPUPOJO OFVSPIPSNPO JOIJCJUPS QBEB UJUJLUJUJL
ZBOH QFOUJOH EJ PUBL IBM JOJ LJUB CBIBT LFNVEJBO TFDBSB MFCJI
EFUBJM
Pengaturan Neurohormonal pada Aktivitas Otak
i e i i e i i otak. Diperlihatkan juga
suatu e i i i i pada medula yang dapat menghambat atau 4FMBJOQFOHBUVSBOBLUJWJUBTPUBLTFDBSBMBOHTVOHPMFIQFOKBMBSBO
menekan sistem aktivasi ini. TJOZBM TBSBG ZBOH TQFTJGJL EBSJ BSFB PUBL CBHJBO CBXBI LF SFHJP
LPSUJLBM PUBL NBTJI UFSEBQBU NFLBOJTNF GJTJPMPHJT MBJO ZBOH
IJMBOH UJOHLBU BLUJWJUBT QBEB BSFB FLTJUBUPSJL PUBL BLBO TFSJOHEJHVOBLBOVOUVLNFOHBUVSBLUJWJUBTPUBL.FLBOJTNFJOJ
NFOVSVOTFDBSBUJCBUJCBLFLFBEBBOBLUJWJUBTPUBLZBOHTBOHBU BEBMBI VOUVL NFMFQBTLBO CBIBOCBIBO IPSNPOBM
NFOVSVO TBNQBJ IBNQJS NFOEFLBUJ LFBEBBO LPNB ZBOH OFVSPUSBOTNJUFS JOIJCJTJ BUBV FLTJUBTJ LF TVCTUBOTJ PUBL
QFSNBOFO /BNVO CJMB CBUBOH PUBL EJUSBOTFLTJ EJ CBXBI /FVSPIPSNPO JOJ TFSJOH LBMJ NFOFUBQ TFMBNB CFCFSBQB NFOJU
UFNQBU NBTVLOZB OFSWVT LFMJNB ZBOH NFOHIBTJMLBO CBOZBL BUBV CFCFSBQB KBN EBO EFOHBO EFNJLJBO NFOHIBTJMLBO NBTB
JOQVU TJOZBM TFOTPSJL EBSJ EBFSBI XBKBI EBO EBFSBI NVMVU QFOHFOEBMJBO ZBOH QBOKBOH UJEBL IBOZB BLUJWBTJ BUBV JOIJCJTJ
LPNBUJEBLUFSKBEJ ZBOHTFLFKBQ
Peningkatan Aktivitas Area Eksitatorik yang Disebab- (BNCBSNFNQFSMJIBULBOUJHBTJTUFNOFVSPIPSNPOBMZBOH
kan oleh Sinyal-Sinyal Umpan Balik yang Kembali dari UFMBIEJQFMBKBSJTFDBSBEFUBJMQBEBPUBLUJLVT
TJTUFNOPSFQJOFGSJO
Korteks Serebri. 4JOZBMTJOZBM FLTJUBTJ EBSJ BSFB FLTJUBUPSJL
TJTUFNEPQBNJO EBO
TJTUFNTFSPUPOJO /PSFQJOFGSJOCJBTBOZB
CVMCPSFUJLVMFS CBUBOH PUBL UJEBL IBOZB NFOVKV LF LPSUFLT CFSGVOHTJ TFCBHBJ IPSNPO FLTJUBTJ TFEBOHLBO TFSPUPOJO CJBTBOZB
TFSFCSJ UFUBQJ TJOZBM VNQBO CBMJL KVHB LFNCBMJ EBSJ LPSUFLT CFSTJGBUJOIJCBTJ EBOEPQBNJOCFSTJGBUFLTJUBTJQBEBCFCFSBQBBSFB
TFSFCSJ LF BSFB ZBOH TBNB 0MFI LBSFOB JUV TFUJBQ LBMJ LPSUFLT UFUBQJ JOIJCBTJ QBEB BSFB MBJOOZB 4FQFSUJ ZBOH EJIBSBQLBO LFUJHB
TFSFCSJ NFOKBEJ UFSBLUJWBTJ PMFI QSPTFT QJLJSBO PUBL BUBV QSPTFT TJTUFNJOJNFNJMJLJFGFLCFSCFEBCFEBQBEBUJOHLBUFLTJUBCJMJUBTEJ
NPUPSJL TJOZBMTJOZBMJOJQVOBLBOEJLJSJNEBSJLPSUFLTLFNCBMJ CFSCBHBJCBHJBOPUBL4JTUFNOPSFQJOFGSJOTFCFOBSOZBNFOZFCBSLF
LF BSFB FLTJUBUPSJL CBUBOH PUBL ZBOH LFNVEJBO NBTJI TFUJBQ BSFB PUBL TFNFOUBSB TJTUFN TFSPUPOJO EBO EPQBNJO
NFOHJSJNLBO CBOZBL TJOZBM FLTJUBTJ LF LPSUFLT )BM JOJ EBQBU EJBSBILBO UFSVUBNB LF SFHJP HBOHMJB CBTBMJT EBO TJTUFN TFSPUPOJO
NFNCBOUVNFNQFSUBIBOLBOUJOHLBUFLTJUBTJQBEBLPSUFLTTFSFCSJ MFCJILFTUSVLTUVSHBSJTUFOHBI NJEMJOF
BUBVCBILBONFNQFSLVBUOZB*OJNFSVQBLBONFLBOJTNFVNVN
VNQBO CBMJL QPTJUJG ZBOH NFNVOHLJOLBO TFUJBQ BLUJWJUBT ZBOH Sistem Neurohormonal pada Otak Manusia. (BNCBS
CFSNVMBEJLPSUFLTTFSFCSJUFUBQEBQBUNFOEVLVOHBLUJWJUBTZBOH NFNQFSMJIBULBO BSFB CBUBOH PUBL QBEB PUBL NBOVTJB ZBOH
MBJOOZB EFOHBOEFNJLJBONFOHIBTJMLBOQJLJSBOXBTQBEB CFSGVOHTJ VOUVL NFOHBLUJWBTJ FNQBU TJTUFN OFVSPIPSNPOBM
Talamus adalah Pusat Distribusi yang Mengendalikan ZBOH UJHB CFOUVL UFMBI EJCJDBSBLBO VOUVL UJLVT EBO TBUV MBHJ
BEBMBI TJTUFN BTFUJMLPMJO #FCFSBQB GVOHTJ TQFTJGJL EBO LFFNQBU
Aktivitas di Regio-Regio Spesifik pada Korteks. 4FQFSUJ
TJTUFNUFSTFCVUBEBMBITFCBHBJCFSJLVU
ZBOH UFMBI EJUFLBOLBO QBEB #BC EBO EJQFSMJIBULBO QBEB
(BNCBS IBNQJS TFMVSVI BSFB LPSUFLT TFSFCSJ 1. -PLVTTFSVMFVTEBOTJTUFNOPSFQJOFGSJO-PLVTTFSVMFVTBEBMBI
CFSIVCVOHBO EFOHBO BSFB ZBOH TBOHBU TQFTJGJL EJ UBMBNVT BSFBLFDJMZBOHUFSMFUBLCJMBUFSBMEBOEJTFCFMBIQPTUFSJPSQBEB
0MFI LBSFOB JUV SBOHTBOHBO MJTUSJL QBEB UJUJL ZBOH TQFTJGJL EJ QFSUFNVBO BOUBSB QPOT EBO NFTFOTFGBMPO 4FSBUTFSBU TBSBG
UBMBNVT TFDBSB VNVN EBQBU NFOHBLUJGLBO SFHJP LFDJM BSFBJOJNFOZFCBSLFTFMVSVIPUBL TBNBTFQFSUJZBOHUFSMJIBU
TQFTJGJLOZBTFOEJSJEJLPSUFLT4FMBOKVUOZB TJOZBMTJOZBMTFDBSB QBEB UJLVT ZBJUV QBEB HBNCBS QBMJOH BUBT EBO (BNCBS
UFSBUVSCFSKBMBOCPMBLCBMJLBOUBSBUBMBNVTEBOLPSUFLTTFSFCSJ EBONFOZFLSFTJLBOOPSFQJOFGSJO
712
Bab 58 Mekanisme Perilaku dan Motivasi pada Otak—Sistem Limbik dan Hipotalamus
Serebelum /PSFQJOFGSJO VNVNOZB NFSBOHTBOH PUBL VOUVL

NFMBLVLBO QFOJOHLBUBO BLUJWJUBT /BNVO OPSFQJOFGSJO
ri NFNJMJLJ FGFL JOIJCJTJ QBEB CFCFSBQB BSFB PUBL BLJCBU
ereb
teks s
Kor BEBOZB SFTFQUPSSFTFQUPS JOIJCJTJ QBEB TJOBQT QFSTBSBGBO
UFSUFOUV #BC NFODBLVQ LFNVOHLJOBO QFSBO QFOUJOH
UNIT XI
TJTUFN JOJ EBMBN NFOZFCBCLBO NJNQJ KBEJ NFOHIBTJMLBO
UJQF UJEVS ZBOH EJTFCVU UJEVS SBQJE FZF NPWFNFOU UJEVS
3&.

Batang otak
Regio 2. 4VCTUBOTJBOJHSBEBOTJTUFNEPQBNJO4VCTUBOTJBOJHSBUFMBI
olfaktorius Area basal otak EJCBIBT QBEB #BC EBMBN IVCVOHBOOZB EFOHBO HBOHMJB
Lokus seruleus
CBTBMJT "SFB JOJ UFSMFUBL EJ TFCFMBI BOUFSJPS QBEB
NFTFOTFGBMPO TVQFSJPS EBO OFVSPOOFVSPOOZB UFSVUBNB
NFOHJSJNLBO VKVOHVKVOH TBSBG LF OVLMFVT LBVEBUVT EBO
QVUBNFO TFSFCSVN UFNQBU OVLMFVT LBVEBUVT EBO QVUBNFO
Korteks UFSTFCVU NFOZFLSFTJ EPQBNJO /FVSPOOFVSPO MBJO ZBOH
frontalis Korteks
singulata UFSMFUBL QBEB SFHJP ZBOH CFSEFLBUBO KVHB NFOZFLSFTJ
Nukleus kaudatus EPQBNJO UFUBQJ OFVSPO UFSTFCVU NFOHJSJNLBO VKVOHVKVOH
TBSBGOZB LF BSFB ZBOH MFCJI WFOUSBM QBEB PUBL UFSVUBNB LF
IJQPUBMBNVT EBO TJTUFN MJNCJL %PQBNJO EJEVHB CFLFSKB
TFCBHBJ USBOTNJUFS JOIJCJUPS EJ HBOHMJB CBTBMJT UFUBQJ QBEB
CFCFSBQB BSFB MBJO EJ PUBL NVOHLJO NFOHFLTJUBTJ *OHBUMBI
KVHBEBSJ#BCCBIXBLFSVTBLBOOFVSPOEPQBNJOFSHJLEJ
TVCTUBOTJB OJHSB NFSVQBLBO EBTBS QFOZFCBC QFOZBLJU
1BSLJOTPO
bri 3. /VLMFJSBGFEBOTJTUFNTFSPUPOJO%JCBHJBOUFOHBIQPOTEBO
ks sere
Korte NFEVMB UFSEBQBU CFCFSBQB OVLMFJ LFDJM ZBOH EJTFCVU OVLMFJ
SBGF ,FCBOZBLBO OFVSPO QBEB OVLMFJ JOJ NFOZFLSFTJ
TFSPUPOJO /FVSPO UFSTFCVU NFOHJSJNLBO TFSBUTFSBU LF
EJFOTFGBMPO EBO TFEJLJU TFSBU LF LPSUFLT TFSFCSJ EBO TFSBCVU
ZBOH MBJO MBHJ UVSVO LF NFEVMB TQJOBMJT 4FSPUPOJO ZBOH
EJTFLSFTJLBO QBEB VKVOH TFSBUTFSBU NFEVMB TQJOBMJT NFNJ
Nuklei garis tengah MJLJLFNBNQVBOVOUVLNFOFLBOSBTBOZFSJ ZBOHUFMBIEJCJ
DBSBLBOQBEB#BC4FSPUPOJOZBOHEJMFQBTLBOEJEJFOTFGB
Tiga sistem neurohormonal yang telah dipetakan MPO EBO TFSFCSVN IBNQJS QBTUJ CFSQFSBO TFCBHBJ JOIJCJUPS
dalam otak tikus: i e oe i e i , i e o i , dan i e QFOUJOH VOUVL NFNCBOUV NFOHIBTJMLBO UJEVS ZBOH OPSNBM
e o o i (Diadaptasi dari Kelly, setelah Cooper, Bloom, dan TFQFSUJZBOHLJUBCBIBTQBEB#BC
Roth: Dalam: Kandel ER, Schwartz JH (ed): i i le o e l
Science, 2 ed. New ork: Elsevier, 1985.) 4. /FVSPOHJHBOUPTFMVMBSQBEBBSFBFLTJUBUPSJLSFUJLVMFSEBOTJTUFN
BTFUJMLPMJO 4FCFMVN JOJ LJUB UFMBI NFNCJDBSBLBO NFOHFOBJ
Menuju diensefalon OFVSPO HJHBOUPTFMVMBS TFM SBLTBTB
QBEB BSFB FLTJUBUPSJL
dan serebrum SFUJLVMFS QBEB QPOT EBO NFTFOTFGBMPO 4FSBUTFSBU ZBOH CFSBTBM
EBSJ TFMTFM CFTBS JOJ TFHFSB UFSCBHJ NFOKBEJ EVB DBCBOH ZBOH
TBUVCFSKBMBOLFBUBTNFOVKVUJOHLBUPUBLZBOHMFCJIUJOHHJ EBO
ZBOH MBJO CFSKBMBO LF CBXBI NFMBMVJ USBLUVT SFUJLVMPTQJOBMJT
Subtansi nigra Mesensefalon NFOVKVNFEVMBTQJOBMJT/FVSPIPSNPOZBOHEJTFLSFTJLBOQBEB
(dopamin)
VKVOHVKVOHOZB BEBMBI BTFUJMLPMJO 1BEB LFCBOZBLBO UFNQBU
Nukleus gigantoselular Ke serebelum
BTFUJMLPMJO CFSGVOHTJ TFCBHBJ OFVSPUSBOTNJUFS FLTJUBTJ "LUJWBTJ
pada formasio retikularis OFVSPO BTFUJMLPMJO JOJ NFOHIBTJMLBO LFXBTQBEBBO QJLJSBO EBO
(asetikolin) Pons UFSBOHTBOHOZBTJTUFNTBSBG
Lokus seruleus Substansi Neurotransmiter dan Neurohormon Lain yang

(norepinefrin) %JTFLSFTJLBO EJ 0UBL 5BOQB NFOKFMBTLBO GVOHTJOZB CFSJLVU JOJ
BEBMBI EBGUBS TFCBHJBO TVCTUBOTJ OFVSPIPSNPO MBJO ZBOH
Nukleus rafe Medulla
CFSGVOHTJQBEBTJOBQTUFSUFOUVBUBVEFOHBODBSBNFMFQBTLFEBMBN
(serotonin)
DBJSBO PUBL FOLFGBMJO BTBN HBNNBBNJOPCVUJSBU HMVUBNBU
WBTPQSFTJO IPSNPO BESFOPLPSUJLPUSPQJL A- NFMBOPDZUF
Ke medula spinalis TUJNVMBUJOH IPSNPOF (A- MSH), OFVSPQFQUJEB: /1:

Berbagai pusat di batang otak, yang neuron- FQJOFGSJO IJTUBNJO FOEPSGJO BOHJPUFOTJO ** EBO OFVSPUFOTJO
neuronnya menyekresi berbagai transmiter (diperje as dalam +BEJ UFSEBQBU CFSCBHBJ TJTUFN OFVSPIPSNPO EBMBN PUBL ZBOH
tanda kurung). Neuron-neuron ini mengirimkan sinyal pengendali
ke atas menuju diensefalon dan serebrum dan ke bawah menuju
BLUJWJUBTOZB NBTJOHNBTJOH NFNQVOZBJ QFSBO TFOEJSJTFOEJSJ
medula spinalis. EBMBNQFOHFOEBMJBOCFSCBHBJLVBMJUBTGVOHTJPUBL
713
Unit Xl Sistem Saraf.• C. Neurofisiologi Motorik dan Integratif
Sistem Limbik
Girus singuli
,BUB MJNCJL CFSBSUJ QFSCBUBTBO "TMJOZB JTUJMBI MJNCJL
EJHVOBLBO VOUVL NFOKFMBTLBO TUSVLUVS UFQJ EJ TFLFMJMJOH SFHJP Bagian Nukleus i s
CBTBMEBSJTFSFCSVN UFUBQJTFQFSUJZBOHUFMBILJUBQFMBKBSJMFCJI bagian anterior ea se m s kalosal
MBOKVU NFOHFOBJ GVOHTJGVOHTJ TJTUFN MJNCJL JTUJMBI TJTUFN ganglia talamus
MJNCJL UFMBI EJQFSMVBT BSUJOZB NFOKBEJ TFMVSVI MJOUBTBO basalis
OFVSPOBM ZBOH NFOHBUVS UJOHLBI MBLV FNPTJ EBO EPSPOHBO ea o eks
NPUJWBTJ a aol ak o i s o i o on al
#BHJBO VUBNB TJTUFN MJNCJL BEBMBI IJQPUBMBNVT EFOHBO Hi okam s
nk s
TUSVLUVSTUSVLUVSOZB ZBOH CFSLBJUBO 4FMBJO QFSBOOZB EBMBN migdala
NFOHBUVS QFSJMBLV BSFB JOJ NFOHBUVS CBOZBL LPOEJTJ JOUFSOBM
UVCVI TFQFSUJ TVIV UVCVI PTNPMBMJUBT DBJSBO UVCVI EBO
EPSPOHBO VOUVL NBLBO EBO NJOVN TFSUB QFOHBUVSBO CFSBU i s a a i okam s
CBEBO'VOHTJJOUFSOBMJOJTFDBSBCFSTBNBTBNBEJTFCVUGVOHTJ
WFHFUBUJG PUBL EBO QFOHBUVSBOOZB CFSLBJUBO FSBU EFOHBO is em lim ik mem e li a kan osisi k n i
QFSJMBLV i o alam s
Anatomi Fungsional Sistem Limbik; Peran Kunci QPTJTJ LVODJ IJQPUBMBNVT EBMBN TJTUFN MJNCJL JOJ EBO UBNQBL EJ
Hipotalamus TFLFMJMJOHIJQPUBMBNVTTUSVLUVSTVCLPSUJLBMMBJOEBSJTJTUFNMJNCJL
ZBOH NFMJQVUJ TFQUVN BSFB QBSBPMGBLUPSJB FQJUBMBNVT OVLMFJ
(BNCBSNFOHHBNCBSLBOTUSVLUVSBOBUPNJTJTUFNMJNCJL BOUFSJPS UBMBNVT CBHJBO HBOHMJB CBTBMJT IJQPLBNQVT EBO
NFOVOKVLLBO CBIXB TUSVLUVS JOJ NFSVQBLBO LPNQMFLT BNJHEBMB
IVCVOHBO EBSJ FMFNFOFMFNFO EBTBS PUBL %J CBHJBO UFOHBI %J TFLFMJMJOH BSFB TVCLPSUJLBM MJNCJL UFSEBQBU LPSUFLT MJNCJL
TUSVLUVSTUSVLUVS JOJ UFSMFUBL IJQPUBMBNVT ZBOH TBOHBU LFDJM ZBOHUFSEJSJBUBTTFCVBIDJODJOLPSUFLTTFSFCSJQBEBTFUJBQCFMBIBO
ZBOHCJMBEJQBOEBOHEBSJTFHJGJTJPMPHJT NFSVQBLBOTBMBITBUV PUBL
ZBOH EJNVMBJ EBSJ BSFB PSCJUPGSPOUBM QBEB QFSNVLBBO
FMFNFO QVTBU TJTUFN MJNCJL (BNCBS NFMVLJTLBO TFDBSB WFOUSBM MPCVT GSPOUBMJT
NFOZFCBS LF BUBT LF EBMBN HJSVT
TLFNBUJTQPTJTJLVODJIJQPUBMBNVTEBMBNTJTUFNMJNCJLJOJEBO TVCLBMPTBM
LFNVEJBONFMFXBUJVKVOHBUBTLPSQVTLBMPTVNLF
Girus singuli dan singulum

Stria medularis
talamus
ndusium griseum dan
Badan forniks
striae longitudinalis
o niks do salis Septum pelusidum (septum

suprakomisura)
Kelompok nukleus
raktus anterior talamus
mamilotalamikus
Kemisura anterior
raktus
mamilotegmentalis Girus subkalosal
smus Girus paraterminalis

(septum
Girus prakomisura)
fasiolaris Korteks orbitofrontalis
im ia Sisa perkembangan prehipokampal
forni
Area paraolfaktorius
Stria terminalis
Bulbus olfaktorius
edula spinalis
penghubung Kolumna forniks (forniks
pascakomisura)
Girus dentatus nkus
Badan amigdaloid
Girus parahipokampus
Badan mamilaris
Anatomi sistem limbik digambarkan sebagai area ang e a na (igambar ulang dari a i k A illiams
y o y Br ed ondon ongman Group d
714
Bab 58 Mekanisme Perilaku dan Motivasi pada Otak Sistem Limbik dan Hipotalamus
CBHJBONFEJBMIFNJTGFSTFSFCSJEBMBNHJSVTTJOHVMJ EBOBLIJSOZB CJDBSBLBO GVOHTJ IJQPUBMBNVT VOUVL NFMJIBU CBHBJNBOB DBSB

CFSKBMBO EJ CFMBLBOH LPSQVT LBMPTVN EBO LF CBXBI NFOVKV LFEVBGVOHTJJOJCFLFSKBTBNB
QFSNVLBBO WFOUSPNFEJBM MPCVT UFNQPSBMJT LF HJSVT
QBSBIJQPLBNQVTEBOVOLVT Pengaturan Fungsi Vegetatif dan Fungsi Endokrin
UNIT XI
-BMV QBEBQFSNVLBBONFEJBMEBOWFOUSBMEBSJTFUJBQIFNJTGFS Hipotalamus
TFSFCSJBEBTFCVBIDJODJO UFSVUBNBNFSVQBLBOQBMFPLPSUFLTZBOH #FSCBHBJ NFLBOJTNF IJQPUBMBNJL VOUVL QFOHBUVSBO
NFOHFMJMJOHJ TFLFMPNQPL TUSVLUVS EBMBN EBO TBOHBU CFSLBJUBO CFSBHBN GVOHTJ UVCVI CFSTJGBU TBOHBU QFOUJOH TFIJOHHB IBM
EFOHBOQFSJMBLVTFSUBFNPTJ4FCBMJLOZB DJODJOLPSUFLTMJNCJLJOJ UFSTFCVU EJCBIBT EBMBN CBOZBL CBC QBEB CVLV JOJ
KVHBCFSGVOHTJTFCBHBJBMBULPNVOJLBTJEVBBSBIEBONFSVQBLBO $POUPIOZB QFSBO IJQPUBMBNVT EBMBN NFNCBOUV
UBMJQFOHIVCVOHBOUBSBOFPLPSUFLTEBOTUSVLUVSMJNCJLZBOHMFCJI NFOHFOEBMJLBO UFLBOBO BSUFSJ UFMBI EJCJDBSBLBO EBMBN #BC
SFOEBI SBTB IBVT EBO QFOZJNQBOBO BJS EBMBN #BC OBGTV
#BOZBLGVOHTJQFSJMBLVZBOHEJDFUVTLBOEBSJIJQPUBMBNVTEBO NBLBO EBO QFOHHVOBBO FOFSHJ EBMBN #BC QFOHBUVSBO
TUSVLUVSTUSVLUVSMJNCJLMBJOOZBKVHBEJLJSJNLBONFMBMVJOVLMFJ TVIV EBMBN #BC EBO QFOHFOEBMJBO FOEPLSJO EBMBN #BC
SFUJLVMFS EJ CBUBOH PUBL EBO OVLMFJ BTPTJBTJOZB %BMBN #BC 6OUVL NFOHHBNCBSLBO TVTVOBO IJQPUBMBNVT TFCBHBJ
EBO CBC UFSEBIVMV UFMBI EJUFLBOLBO CBIXB QFSBOHTBOHBO QBEB TVBUV VOJU GVOHTJPOBM NBSJMBI LJUB SJOHLBTLBO GVOHTJ
CBHJBO FLTJUBTJ GPSNBTJP SFUJLVMBSJT EBQBU NFOZFCBCLBO WFHFUBUJGEBOGVOHTJFOEPLSJOOZBZBOHMFCJIQFOUJOH
UJNCVMOZB FLTJUBCJMJUBT TFSFCSVN EFSBKBU UJOHHJ TFNFOUBSB JUV (BNCBS EBO NFNQFSMJIBULBO QFNCFTBSBO
KVHB NFOJOHLBULBO FLTJUBCJMJUBT LFCBOZBLBO TJOBQT NFEVMB IJQPUBMBNVT EBSJ QBOEBOHBO TBHJUBM EBO LPSPOBM ZBOH EJXBLJMJ
TQJOBMJT 1BEB #BC LJUB NFMJIBU CBIXB TFCBHJBO CFTBS TJOZBM PMFI BSFB LFDJM TBKB EBMBN (BNCBS 4JMBLBO NFNQFMBKBSJ
IJQPUBMBNVT ZBOH EJQBLBJ VOUVL NFOHBUVS TJTUFN TBSBG PUPOPN EJBHSBN JOJ TFMBNB CFCFSBQB NFOJU LIVTVTOZB DFSNBUJMBI
KVHBLJSJNLBONFMBMVJOVLMFJTJOBQTZBOHUFSMFUBLEBMBNCBUBOH (BNCBS CFUBQB CBOZBL BLUJWJUBT ZBOH EJFLTJUBTJ BUBV
PUBL EJIBNCBU TFXBLUV BEB QFSBOHTBOHBO OVMEFJ IJQPUBMBNJL ZBOH
+BMVS LPNVOJLBTJ ZBOH QFOUJOH BOUBSB TJTUFN MJNCJL EBO TFTVBJ4FMBJOQVTBUQVTBUZBOHEJUVOKVLLBOEBMBN(BNCBS
CBUBOH PUBL BEBMBI CFSLBT PUBL EFQBO CBHJBO NFEJBM NFEJBM QBEB TFUJBQ TJTJ IJQPUBMBNVT UBNQBL BEBOZB TVBUV BSFB
GPSFCSBJO CVOEMF
ZBOH NFOZFCBS EBSJ SFHJP TFQUVN EBO IJQPUBMBNVT MBUFSBM ZBOH CFTBS UBNQBL EBMBN (BNCBS

PSCJUPGSPOUBM LPSUFLT TFSFCSJ LF CBXBI NFMBMVJ CBHJBO UFOHBI "SFBMBUFSBMJOJUFSVUBNBCFSHVOBVOUVLQFOHFOEBMJBOSBTBIBVT
IJQPUBMBNVT LF GPSNBTJP SFUJLVMBSJT CBUBOH PUBL #FSLBT JOJ SBTBMBQBS EBOTFCBHJBOCFTBSIBTSBUFNPTJPOBM
NFNCBXB TFSBUTFSBU EBMBN EVB BSBI NFNCFOUVL HBSJT CBUBOH )BUJIBUJTFXBLUVNFNQFMBKBSJEJBHSBNUFSTFCVULBSFOBBSFB
TJTUFN LPNVOJLBTJ USVOLMJOF DPNNVOJDBUJPO TZTUFN
+BMVS ZBOH NFOZFCBCLBO UJNCVMOZB BLUJWJUBT TQFTJGJL MFUBLOZB UJEBL
LPNVOJLBTJ ZBOH LFEVB BEBMBI NFMBMVJ KBSBT QFOEFL ZBOH CFHJUVBLVSBUEBMBNHBNCBS+VHB CFMVNEJLFUBIVJBQBLBIFGFL
NFMFXBUJGPSNBTJPSFUJLVMBSJTCBUBOHPUBL UBMBNVT IJQPUBMBNVT ZBOH UFSUFSB EBMBN HBNCBS EJTFCBCLBO PMFI QFSBOHTBOHBO
EBO TFCBHJBO CFTBS BSFB MBJOOZB ZBOH CFSIVCVOHBO EFOHBO OVLMFJ QFOHFOEBMJ TQFTJGJL BUBV BQBLBI IBOZB EJTFCBCLBO PMFI
CBHJBOCBTBMPUBL BLUJWBTJ KBSBT TFSBUTFSBU ZBOH NFOHBSBI LF BUBV CFSBTBM EBSJ
OVLMFJQFOHBUVSZBOHMFUBLOZBEJUFNQBUMBJO%FOHBOCFSTJLBQ
Hipotalamus, Daerah Pengatur Utama untuk IBUJIBUJ LJUB CJTB NFOEBQBULBO HBNCBSBO VNVN GVOHTJ
Sistem Limbik WFHFUBUJGEBOGVOHTJQFOHFOEBMJBOPMFIIJQPUBMBNVT
Pengaturan Kardiovaskular. 1FSBOHTBOHBO CFSCBHBJ BSFB EJ
)JQPUBMBNVT NFTLJQVO CFSVLVSBO LFDJM IBOZB CFCFSBQB IJQPUBMBNVTEBQBUNFOJNCVMLBOCBOZBLFGFLOFVSPHFOJLQBEB
TFOUJNFUFS LVCJL NFNQVOZBJ KBSBT LPNVOJLBTJ EVB BSBI ZBOH TJTUFN LBSEJPWBTLVMBS NFMJQVUJ LFOBJLBO UFLBOBO BSUFSJ
CFSIVCVOHBO EFOHBO TFNVB UJOHLBU TJTUFN MJNCJL 4FCBMJLOZB QFOVSVOBO UFLBOBO BSUFSJ QFOJOHLBUBO GSFLVFOTJ EFOZVU
IJQPUBMBNVT EBO TUSVLUVSTUSVLUVS ZBOH CFSLBJUBO EFOHBOOZB KBOUVOH EBO QFOVSVOBO GSFLVFOTJ EFOZVU KBOUVOH 1BEB
NFOHJSJNLBO TJOZBMTJOZBM LFMVBSBO EBMBN UJHB BSBI
LF VNVNOZB QFSBOHTBOHBO IJQPUBMBNVT CBHJBO QPTUFSJPS EBO
CFMBLBOH EBO LF CBXBI NFOVKV CBUBOH PUBL UFSVUBNB LF BSFB MBUFSBM NFOJOHLBULBO UFLBOBO BSUFSJ EBO GSFLVFOTJ EFOZVU
SFUJLVMFSNFTFOTFGBMPO QPOT EBONFEVMB TFSUBEBSJBSFBUFSTFCVU KBOUVOH TFEBOHLBO QFSBOHTBOHBO QBEB BSFB QSFPQUJL TFSJOH
LFTBSBGQFSJGFSTJTUFNTBSBGPUPOPN
LFBUBTNFOVKVTFCBHJBO NFOJNCVMLBO FGFL ZBOH CFSMBXBOBO TFIJOHHB NFOZFCBCLBO
CFTBS BSFB ZBOH MFCJI UJOHHJ EJ EJFOTFGBMPO EBO TFSFCSVN QFOVSVOBO GSFLVFOTJ EFOZVU KBOUVOH EBO UFLBOBO BSUFSJ &GFL
LIVTVTOZB CBHJBO BOUFSJPS UBMBNVT EBO CBHJBO MJNCJL LPSUFLT JOJ UFSVUBNB EJLJSJNLBO NFMBMVJ QVTBU QFOHFOEBMJ
TFSFCSJ EBO
LF JOGVOEJCVMVN IJQPUBMBNVT VOUVL NFOHBUVS LBSEJPWBTLVMBSUFSUFOUVEJSFHJPSFUJLVMFSEBSJQPOTEBONFEVMB
BUBV NFOHBUVS TFDBSB TFCBHJBO GVOHTJ TFLSFUPSJL QBEB CBHJBO Pengaturan Suhu Tubuh. #BHJBO BOUFSJPS IJQPUBMBNVT
QPTUFSJPSEBOBOUFSJPSLFMFOKBSIJQPGJTJT LIVTVTOZB BSFB QSFPQUJL CFSIVCVOHBO EFOHBO QFOHBUVSBO
TVIV UVCVI 1FOJOHLBUBO TVIV EBSBI ZBOH NFOHBMJS NFMFXBUJ
+BEJ IJQPUBMBNVT NFXBLJMJLVSBOHEBSJQFSTFONBTTBPUBL
BSFB JOJ NFOJOHLBULBO BLUJWJUBT OFVSPOOFVSPO QFLB TVIV
OBNVO NFSVQBLBO CBHJBO QBMJOH QFOUJOH EBSJ KBSBT QFOHBUVSBO
TFNFOUBSB QFOVSVOBO TVIV BLBO NFOVSVOLBO BLUJWJUBTOZB
TJTUFNMJNCJL#BHJBOJOJNFOHBUVSTFCBHJBOCFTBSGVOHTJWFHFUBUJG
4FCBMJLOZB OFVSPOOFVSPO JOJ NFOHFOEBMJLBO NFLBOJTNF
EBOGVOHTJFOEPLSJOUVCVITFQFSUJIBMOZBCBOZBLBTQFLQFSJMBLV
ZBOH EJQBLBJ VOUVL NFOJOHLBULBO BUBV NFOVSVOLBO TVIV
FNPTJ .BSJMBI LJUB CJDBSBLBO MFCJI EVMV QFOHBUVSBO GVOHTJ
UVCVI TFQFSUJZBOHEJCBIBTEBMBN#BC
WFHFUBUJGEBOGVOHTJFOEPLSJO EBOTFMBOKVUOZBLFNCBMJNFN
715
Unit Xl Sistem Sarat C. Neurofisiologi Motorik dan lntegratif
Pusat-pusat
pengendali di hipotalamus Nukleus dorsomedialis Nukleus paraventrikularis
(pandangan sagital). (Perangsangan gastrointestinal) (Pelepasan oksitosin)
(Konservasi air)
(Kenyang)
Hipotalamus posterior Area preoptik medial
(Peningkatan tekanan darah) (Kontraksi kandung kemih)
(Dilatasi pupil) (Penurunan frekuensi denyut jantung)
(Menggil) (Penurunan tekanan darah)
Nukleus periforniks Area preoptik posterior dan
(Lapar) hipotalamus anterior
(Peningkatan tekanan darah) (Pengaturan suhu tubuh)
(Kemarahan) (Terengah-engah)
(Berkeringat)
Nukleus ventromedialis (Penghambatan tirotropin)
(Kenyang)
(Kontrol neuroendokrin) Klasma optikum (nervus optikus)
Nukleus supraoptikus
Badan mamilaris
(Pelepasan vasopresin)
(Refleks makan)
Nukleus arkuatus dan zona periventrikularis nfundibulum
(Lapar)
(Kenyang)
(Kontrol neuroendokrin)
Area hipotalamus lateral
(Haus dan lapar) Pengaturan Kontraktilitas Uterus dan Pengeluaran
Air Susu oleh Payudara. 1FSBOHTBOHBO OVLMFJ QBSBWFOUSJLVMFS
NFOZFCBCLBO TFMTFM OFVSPOOZB NFOZFLSFTJ IPSNPO PLTJUPTJO
Talamus
4FMBOKVUOZB IPSNPO JOJ NFOZFCBCLBO QFOJOHLBUBO LPOUSBLUJMJUBT
Paraventrikularis VUFSVT TFSUB LPOUSBLTJ TFMTFM NJPFQJUFMJBM ZBOH NFOHFMJMJOHJ BMWFPMJ
Periventrikularis QBZVEBSB ZBOH TFMBOKVUOZB NFOZFCBCLBO BMWFPMJ NFOHPTPOHLBO BJS
Dorsomedialis TVTVNFMBMVJQVUJOHTVTV
Hipotalamus Forniks 1BEB BLIJS NBTB LFIBNJMBO BLBO EJTFLSFTJLBO CBOZBL TFLBMJ
anterior PLTJUPTJO EBO TFLSFTJ JOJ NFNCBOUV NFNVMBJ LPOUSBLTJ QFSTBMJOBO
Hipotalamus
lateralis VOUVL NFOHFMVBSLBO CBZJ ,FNVEJBO LBQBO QVO CBZJ NFOHJTBQ
Traktus
Supraoptikus QBZVEBSB JCVOZB TJOZBM SFGMFLT EBSJ QVUJOH TVTV LF IJQPUBMBNVT
optikus
QPTUFSJPSKVHBBLBONFOZFCBCLBOQFMFQBTBOPLTJUPTJO EBOPLTJUPTJO
JOJ TFLBSBOH NFOKBMBOLBO GVOHTJ ZBOH QFOUJOH EBMBN NFNCVBU
Arkuatus Ventromedialis EVLUVMVT QBZVEBSB CFSLPOUSBLTJ TFIJOHHB NFOHFMVBSLBO BJS TVTV
Hipotalamus dilihat dari pandangan koronat NFMBMVJQVUJOHTVTVEFOHBOEFNJLJBOCBZJEBQBUNFNQFSPMFINBLBO
memperlihatkan posisi medio ateral dan nuklei hipotalamus CBHJEJSJOZBTFOEJSJ'VOHTJJOJEJCBIBTEBMBN#BC
yang berurutan. Pengaturan Gastrointestinal dan Hasrat Makan.
1FSBOHTBOHBO CFCFSBQB BSFB QBEB IJQPUBMBNVT NFOZFCBCLBO IFXBO
Pengaturan Cairan Tubuh. )JQPUBMBNVT NFOHBUVS DBJSBO NFOHBMBNJ SBTB MBQBS ZBOH BNBU TBOHBU TFMFSB NBLBO ZBOH UBL BEB
UVCVI NFMBMVJ EVB DBSB
EFOHBO NFODFUVTLBO TFOTBTJ IBVT ZBOH QVBTQVBTOZB EBO IBTSBU ZBOH CFTBS TFLBMJ VOUVL NFODBSJ NBLBOBO
NFOEPSPOH IFXBO BUBV TFTFPSBOH NJOVN BJS EBO
EFOHBO 4BUV BSFB ZBOH CFSIVCVOHBO EFOHBO SBTB MBQBS BEBMBI BSFB
NFOHBUVS FLTLSFTJ BJS LF EBMBN VSJOF %J IJQPUBMBNVT CBHJBO MBUFSBM IJQPUBMBNVT MBUFSBM 4FCBMJLOZB CJMB BSFB JOJ SVTBL QBEB LFEVB TJTJ
UFSEBQBUBSFBZBOHEJTFCVUQVTBUSBTBIBVT#JMBFMFLUSPMJUDBJSBOZBOH IJQPUBMBNVTBLBONFOZFCBCLBOIFXBOLFIJMBOHBOOBGTVNBLBO ZBOH
UFSEBQBUEJQVTBUJOJBUBVEJEBFSBIZBOHCFSLBJUBOEFOHBOIJQPUBMBNVT LBEBOH NFOZFCBCLBO LFNBUJBO LBSFOB LFMBQBSBO MFUIBM TUBSWBUJPO

NFOKBEJ TBOHBU QFLBU QBEB IFXBO BLBO CFSLFNCBOH IBTSBU VOUVL TFQFSUJZBOHEJCJDBSBLBOEBMBN#BC
NJOVN BJS IFXBO JOJ BLBO NFODBSJ BJS EBSJ TVNCFS BJS UFSEFLBU EBO
1VTBU ZBOH CFSMBXBOBO EFOHBO IBTSBU NBLBO EJTFCVU QVTBU
NJOVN TFDVLVQOZB VOUVL NFOHFNCBMJLBO LPOTFOUSBTJ FMFLUSPMJU
LFOZBOH UFSMFUBL EJ OVLMFJ WFOUSPNFEJBMJT #JMB QVTBU JOJ EJSBOHTBOH
EBMBNQVTBUSBTBIBVTNFOKBEJOPSNBMLFNCBMJ
1FOHBUVSBOFLTLSFTJBJSPMFIHJOKBMUFSVUBNBEJMBLVLBOPMFIOVLMFJ EFOHBO MJTUSJL IFXBO ZBOH TFEBOH NBLBO UJCBUJCB NFOHIFOUJLBO
TVQSBPQUJL #JMB DBJSBO UVCVI NFOKBEJ TBOHBU QFLBU OFVSPOOFVSPO NBLBOEBOCFOBSCFOBSNFOHBCBJLBONBLBOBOUFSTFCVU/BNVO CJMB
EBMBNBSFBBSFBJOJNFOKBEJUFSBOHTBOHTFSBUTFSBUTBSBGZBOHCFSBTBM BSFB JOJ EJSVTBL TFDBSB CJMBUFSBM IFXBO UFSTFCVU UJEBL EBQBU
EBSJOFVSPOOFVSPOJOJEJQSPZFLTJLBOLFCBXBINFMBMVJJOGVOEJCVMVN UFSQVBTLBO NBMBIBO QVTBU SBTB MBQBS ZBOH UFSEBQBU EJ IJQPUBMBNVT
IJQPUBMBNVT LF LFMFOKBS IJQPGJTJT QPTUFSJPS UFNQBU VKVOHVKVOH TBSBG NFOKBEJ TBOHBU BLUJG TFIJOHHB IFXBO NFOKBEJ TBOHBU SBLVT EBO
NFOZFLSFTJLBOTVBUVIPSNPO ZBJUVIPSNPOBOUJEJVSFUJL EJTFCVUKVHB BLIJSOZB NFOJNCVMLBO PCFTJUBT ZBOH IFCBU "SFB IJQPUBMBNVT
WBTPQSFTJO
4FMBOKVUOZB IPSNPO JOJ EJBCTPSCTJ LF EBMBN EBSBI EBO MBJOOZB ZBOH UFSNBTVL EBMBN QFOHBUVS TFMVSVI BLUJWJUBT
EJBOHLVU LF HJOKBM UFNQBU IPSNPO UFSTFCVU CFLFSKB QBEB EVLUVT HBTUSPJOUFTUJOBM BEBMBI CBEBO NBNJMBSJT ZBOH TFEJLJUOZB UVSVU
LPMJHFOTHJOKBMHVOBNFOJNCVMLBOQFOJOHLBUBOSFBCTPSQTJBJS)BMJOJ NFOHBUVS TFCBHJBO QPMB EBSJ TFLJBO CBOZBL SFGMFLT NBLBO TFQFSUJ
NFOVSVOLBO KVNMBI BJS ZBOH IJMBOH LF EBMBN VSJOF OBNVO NFOKJMBUKJMBUCJCJSEBONFOFMBO
NFOZFCBCLBO CFSMBOKVUOZB FLTLSFTJ FMFLUSPMJUFMFLUSPMJU TFIJOHHB Pengendalian Hipotalamus terhadap Sekresi
NFOVSVOLBO LPOTFOUSBTJ DBJSBO UVCVI LFNCBMJ LF LFBEBBO OPSNBM Hormon Endokrin oleh Kelenjar Hipofisis Anterior.
'VOHTJJOJEJKFMBTLBOQBEB#BC 1FSBOHTBOHBO BSFB UFSUFOUV IJQPUBMBNVT KVHB NFOZFCBCLBO
LFMFOKBSIJQPGJTJTCBHJBOBOUFSJPS
716
NFOZFLSFTJLBO IPSNPOIPSNPOOZB .BTBMBI JOJ UFMBI EJCJDBSBLBO EJTFCBCLBO PMFI MFTJ IJQPUBMBNVT MBUFSBM NFOJNCVMLBO
TFDBSB EFUBJM QBEB #BC TFIVCVOHBO EFOHBO QFOHBUVSBO LFMFOKBS IBTSBU NJOVN EBO OBGTV NBLBO ZBOH CFSMFCJIBO EJTFSUBJ
FOEPLSJO NFMBMVJ TBSBG 4FDBSB SJOHLBT NFLBOJTNF EBTBSOZB BEBMBI LFBEBBO IJQFSBLUJG EBO TFSJOH LBMJ NFOKBEJ TBOHBU CVBT
TFCBHBJCFSJLVU
EJTFSUBJ LFJOHJOBO NFOZFSBOH XBMBVQVO IBOZB NFOEBQBU
,FMFOKBS IJQPGJTJT BOUFSJPS NFOFSJNB TVQMBJ EBSBIOZB UFSVUBNB QSPWPLBTJSJOHBO
UNIT XI
EBSJ EBSBI ZBOH NVMBNVMB NFOHBMJS NFMBMVJ IJQPUBMBNVT CBHJBO
CBXBI EBO TFMBOKVUOZB NFMBMVJ TJOVTTJOVT WBTLVMFS IJQPGJTJT -FTJBUBVQFSBOHTBOHBOQBEBSFHJPMJNCJLMBJOOZB UFSVUBNB
BOUFSJPS4FCFMVNBMJSBOEBSBIZBOHNFMFXBUJIJQPUBMBNVTNFODBQBJ QBEBBNJHEBMB BSFBTFQUVN EBOBSFBBSFBQBEBNFTFOTFGBMPO
IJQPGJTJTBOUFSJPS CFSCBHBJOVLMFJIJQPUBMBNVTNFOZFLSFTJIPSNPO TFSJOH LBMJ NFOJNCVMLBO FGFL ZBOH TFSVQB EFOHBO ZBOH
IPSNPO QFMFQBT EBO IPSNPOIPSNPO QFOHIBNCBU TQFTJGJL LF EBMBN EJDFUVTLBO EBSJ IJQPUBMBNVT ,JUB NFNCJDBSBLBO CFCFSBQB
EBSBI 4FMBOKVUOZB IPSNPOIPSNPO JOJ EJBOHLVU MFXBU EBSBI FGFLJOJOBOUJTFDBSBMFCJINFOEFUBJM
NFOVKV LFMFOKBS IJQPGJTJT BOUFSJPS UFNQBU IPSNPO UFSTFCVU
NFNFOHBSVIJ TFMTFM HMBOEVMFS VOUVL NFOHFOEBMJLBO QFMFQBTBO Fungsi "Ganjaran" dan Fungsi "Hukuman"
IPSNPOIPSNPOIJQPGJTJTBOUFSJPSTQFTJGJL Sistem Limbik
Ringkasan. #FCFSBQB BSFB IJQPUBMBNVT NFOHFOEBMJLBO GVOHTJ %BSJ QFNCJDBSBBO TFKBVI JOJ TVEBI KFMBT CBIXB CFCFSBQB
WFHFUBUJGEBOFOEPLSJOLIVTVT"SFBBSFBUFSTFCVUNBTJICFMVNKFMBT TUSVLUVS MJNCJL UFSVUBNB CFSIVCVOHBO EFOHBO TJGBUTJGBU BGFLUJG
CBUBTCBUBTOZB TFIJOHHB JEFOUJGJLBTJ TQFTJGJL ZBOH UFMBI EJMBLVLBO
EBSJTFOTBTJTFOTPSJLZBLOJ BQBLBITFOTBTJZBOHNFOZFOBOHLBO
NFOHFOBJ CFSCBHBJ BSFB EFOHBO GVOHTJ ZBOH CFSCFEBCFEB TFCBHJBO BUBV ZBOH UBL NFOZFOBOHLBO ,VBMJUBT BGFLUJG JOJ KVHB EJTFCVU
NBTJICFSTJGBUUFOUBUJG HBOKBSBO BUBV IVLVNBO BUBV LFQVBTBO BUBV BOUJQBUJ
Fungsi Perilaku oleh Hipotalamus dan Struktur 1FSBOHTBOHBO MJTUSJL QBEB BSFB MJNCJL UFSUFOUV NFOJNCVMLBO
Limbik yang Berkaitan SBTBTFOBOHBUBVSBTBQVBTQBEBIFXBO TFEBOHLBOQFSBOHTBOHBO
Efek yang Disebabkan oleh Perangsangan Hipotalamus MJTUSJL QBEB SFHJP MBJOOZB NBMBI NFOJNCVMLBO SBTB QBOJL SBTB
4FMBJO GVOHTJ WFHFUBUJG EBO GVOHTJ FOEPLSJO IJQPUBMBNVT OZFSJ SBTB UBLVU VTBIB NFNQFSUBIBOLBO EJSJ SFBLTJ
QFSBOHTBOHBO BUBV BEBOZB MFTJ QBEB IJQPUBMBNVT TFSJOH LBMJ NFOHIJOEBS EBO FMFNFOFMFNFO IVLVNBO MBJOOZB %FSBKBU
NFNCFSJ FGFL ZBOH NFOZFMVSVI QBEB QFSJMBLV FNPTJ TFFLPS QFSBOHTBOHBO LFEVB TJTUFN ZBOH TBMJOH CFSMBXBOBO JOJ TBOHBU
IFXBOEBONBOVTJB NFNFOHBSVIJQPMBQFSJMBLVIFXBOPusat Ganjaran
#FCFSBQBFGFLQFSJMBLVBLJCBUQFSBOHTBOHBOBEBMBITFCBHBJ 4UVEJ FLTQFSJNFO QBEB NPOZFU UFMBI NFOHHVOBLBO
CFSJLVU QFSBOHTBOHBO MJTUSJL VOUVL NFNFUBLBO QVTBU HBOKBSBO EBO
1. 1FSBOHTBOHBO QBEB IJQPUBMBNVT MBUFSBM UJEBL IBOZB IVLVNBOEJPUBL$BSBOZBBEBMBIEFOHBOJNQMBOUBTJFMFLUSPEB
NFOHBLJCBULBO UJNCVMOZB SBTB IBVT EBO OBGTV NBLBO TFQFSUJ QBEBCFSCBHBJBSFBEJPUBLTFIJOHHBIFXBOEBQBUNFSBOHTBOH
ZBOH UFMBI EJCJDBSBLBO UFUBQJ KVHB NFOJOHLBULBO CFTBSOZB BSFB UFSTFCVU EFOHBO NFOFLBO TVBUV QFOHVOHLJU ZBOH
BLUJWJUBT VNVN IFXBO UFSTFCVU ZBOH LBEBOH NFOZFCBCLBO NFNCVBU LPOUBL MJTUSJL EFOHBO TVBUV TUJNVMBUPS +JLB
UJNCVM SBTB NBSBI ZBOH TBOHBU IFCBU EBO LFJOHJOBO VOUVL QFSBOHTBOHBO TVBUV BSFB UFSUFOUV NFNCFSJ TFOTBTJ HBOKBSBO
CFSLFMBIJ TFQFSUJZBOHBLBOLJUBCJDBSBLBOOBOUJ IFXBO BLBO NFOFLBO QFOHVOHLJU UFSTFCVU CFSVMBOHVMBOH
2. 1FSBOHTBOHBO QBEB OVLMFVT WFOUSPNFEJBMJT EBO BSFB EJ UFSLBEBOH IJOHHB SBUVTBO CBILBO SJCVBO LBMJ QFS KBN
TFLFMJMJOHOZB UFSVUBNB NFOHBLJCBULBO FGFL ZBOH CFSMBXBOBO 4FMBOKVUOZB LFUJLB EJUBXBSJ NBLBOBO MF[BU TFCBHBJ MBXBO
EFOHBO FGFL ZBOH EJTFCBCLBO PMFI QFSBOHTBOHBO QBEB UFSIBEBQ LFTFNQBUBO VOUVL NFSBOHTBOH QVTBU HBOKBSBO
IJQPUBMBNVT MBUFSBM ZBLOJ NFOJNCVMLBO SBTB LFOZBOH IFXBOUFSTFCVUTFSJOHNFNJMJIQFSBOHTBOHBOMJTUSJL
NFOVSVOOZBOBGTVNBLBO EBOIFXBONFOKBEJUFOBOH %FOHBO NFOHHVOBLBO DBSB JOJ UFMBI EJUFNVLBO QVTBU
3. 1FSBOHTBOHBO QBEB TVBUV [POB UJQJT EBSJ OVLMFJ QFSJWFOUSJLVMBS QVTBU HBOKBSBO VUBNB ZBOH UFSOZBUB UFSMFUBL EJ TFQBOKBOH
ZBOHUFSMFUBLTBOHBUCFSEFLBUBOEFOHBOWFOUSJLFMLFUJHB BUBVCJMB SBOHLBJBO CFSLBT CBHJBO NFEJBM PUBL EFQBO LIVTVTOZB QBEB
EJTFSUBJEFOHBOQFSBOHTBOHBOQBEBBSFBBCVBCVEJCBHJBOUFOHBI OVLMFJ MBUFSBMJT EBO OVLMFJ WFOUSPNFEJBMJT IJQPUBMBNVT
NFTFOTFGBMPO ZBOH NFSVQBLBO MBOKVUBO EBSJ CBHJBO IJQPUBMBNVT 4FCFUVMOZB BOFI CBIXB OVLMFJ MBUFSBMJT JOJ KVHB EJNBTVLLBO
JOJ
CJBTBOZBNFOJNCVMLBOSBTBUBLVUEBOSFBLTJUFSIVLVN EBMBN BSFB HBOKBSBO CBILBO NFSVQBLBO ZBOH QBMJOH QPUFO
4. %PSPOHBO TFLTVBM EBQBU UJNCVM CJMB BEB SBOHTBOHBO QBEB EBSJ TFMVSVIOZB LBSFOB CJMB BSFB JOJ EJCFSJ SBOHTBOHBO ZBOH
MFCJI LVBU UJNCVM SBTB NBSBI /BNVO LFBEBBO JOJ NFNBOH
CFCFSBQB BSFB IJQPUBMBNVT LIVTVTOZB QBEB TFCBHJBO CFTBS
CFSMBLVVOUVLTFCBHJBOCFTBSBSFB ZBOHCJMBEJCFSJSBOHTBOHBO
CBHJBOBOUFSJPSEBOQPTUFSJPSIJQPUBMBNVT
MFCJIMFNBIEBQBUNFOJNCVMLBOSBTBHBOKBSBOEBOCJMBEJCFSJ
Efek yang Disebabkan oleh Lesi Hipotalamus. 1BEB SBOHTBOHBO MFCJI LVBU BLBO UJNCVM SBTB IVLVNBO 1VTBU
VNVNOZB MFTJ QBEB IJQPUBMBNVT BLBO NFOJNCVMLBO FGFL ZBOH HBOKBSBO ZBOH LVSBOH QFLB ZBOH NVOHLJO NFSVQBLBO QVTBU
CFSMBXBOBO EFOHBO ZBOH EJUJNCVMLBO PMFI QFSBOHTBOHBO LFEVB EBMBN IJQPUBMBNVT EBQBU EJKVNQBJ QBEB TFQUVN
DPOUPIOZBBEBMBITFCBHBJCFSJLVU BNJHEBMB CFCFSBQB BSFB UFSUFOUV EBMBN UBMBNVT EBO HBOHMJB
1. -FTJ CJMBUFSBM QBEB IJQPUBMBNVT MBUFSBM BLBO NFOHVSBOHJ IBTSBU CBTBMJT EBONFMVBTLFCBXBILFCBHJBOUFHNFOUVNCBTBMEBSJ
NJOVN EBO OBGTV NBLBO IBNQJS TBNQBJ IJMBOH TBNB TFLBMJ NFTFOTFGBMPO
TFIJOHHB TFSJOH NFOJNCVMLBO NBUJ LFMBQBSBO -FTJ JOJ
NFOJNCVMLBO TJLBQ QBTJG ZBOH FLTUSFN QBEB IFXBO EJTFSUBJ Pusat Hukuman
EFOHBOIJMBOHOZBTFCBHJBOCFTBSEPSPOHBOCFSUJOEBL 4UJNVMBUPS ZBOH UFMBI EJCJDBSBLBO TFCFMVNOZB EBQBU KVHB
2. -FTJ CJMBUFSBM QBEB BSFB WFOUSPNFEJBM IJQPUBMBNVT EJCFSJ TBNCVOHBO TFIJOHHB TUJNVMVT LF PUBL CFSMBOHTVOH
NFOJNCVMLBOFGFLZBOHUFSVUBNBCFSMBXBOBOEFOHBOZBOHEJ UFSVTNFOFSVTLFDVBMJCJMBQFOHVOHLJUEJUFLBO1BEBLBTVTJOJ
717
Unit Xl Sistem Sarat C. Neurofisiologi Motorik dan Integratif
IFXBO UFSTFCVU UBL BLBO NFOFLBO QFOHVOHLJU VOUVL LMPSQSPNB[JO CJBTBOZB NFOHIBNCBU QVTBUQVTBU SBTB HBOKBSBO
NFNBUJLBO TUJNVMVT CJMB UFSOZBUB FMFLUSPEBOZB EJUFNQBULBO EBO SBTB UFSIVLVN TFIJOHHB NFOHVSBOHJ SFBLTJ BGFLUJG IFXBO
QBEB TBMBI TBUV BSFB HBOKBSBO OBNVO CJMB FMFLUSPEB UFSTFCVU 0MFI LBSFOB JUV EJBOHHBQ CBIXB LFSKB PCBU QFOFOBOH QBEB
CFSBEB EJ BSFB UFSUFOUV MBJOOZB IFXBO UFSTFCVU TFHFSB CFMBKBS LFBEBBO QTJLPUJL JBMBI EFOHBO DBSB NFOFLBO TFCBHJBO CFTBS BSFB
NFOHIFOUJLBO TUJNVMVT 1FSBOHTBOHBO QBEB BSFB JOJ QFSJMBLV ZBOH QFOUJOH EBMBN IJQPUBMBNVT EBO SFHJP PUBL MJNCJL
NFOZFCBCLBO IFXBO UFSTFCVU NFOVOKVLLBO HFKBMBHFKBMB UJEBL ZBOHCFSLBJUBOEFOHBOBSFBUFSTFCVU
TFOBOH UBLVU QBOJL SBTB TBLJU SBTB UFSIVLVN EBO CBILBO
QFOZBLJU Makna Ganjaran atau Hukuman pada Proses Belajar dan
Memori—Habituasi atau Penguatan
%FOHBO NFOHHVOBLBO DBSB JOJ EBQBU EJUFNVLBO BSFB ZBOH
QBMJOH QPUFO CBHJ SBTB UFSIVLVN EBO LFDFOEFSVOHBO VOUVL 1FOFMJUJBO UFSIBEBQ IFXBO UFMBI NFOVOKVLLBO CBIXB TFNVB
NFOHIJOEBS ZBJUVUFSEBQBUEJBSFBBCVBCVTFOUSBMEJTFLFMJMJOH QFOHBMBNBO TFOTPSJL ZBOH NFOJNCVMLBO SBTB HBOKBSBO BUBV SBTB
BLVBEVLUVT 4ZMWJJ EJ NFTFOTFGBMPO EBO ZBOH NFOZFCBS LF BUBT UFSIVLVNIBNQJSUJEBLEBQBUEJJOHBUTBNBTFLBMJ3FLBNBOMJTUSJL
LF [POB QFSJWFOUSJLVMFS IJQPUBMBNVT EBO UBMBNVT "SFB SBTB EBSJPUBLNFNQFSMJIBULBOCBIXBTUJNVMVTTFOTPSJLZBOHCBSVTBKB
UFSIVLVN ZBOH UBL CFHJUV LVBU EJUFNVLBO EJ CFCFSBQB MPLBTJ EJSBTBLBO IBNQJS TFMBMV NFSBOHTBOH CFSBHBN BSFB QBEB LPSUFLT
BNJHEBMBEBOIJQPLBNQVT4BOHBUMBINFOBSJLUFSVUBNBCBIXB TFSFCSJ/BNVO CJMBQFOHBMBNBOTFOTPSJLUJEBLNFOJNCVMLBOSBTB
QFSBOHTBOHBO QBEB QVTBU SBTB UFSIVLVN JOJ TFSJOH LBMJ EBQBU HBOKBSBO BUBV SBTB UFSIVLVN QFOHVMBOHBO TUJNVMVT ZBOH UFSVT
NFOHIBNCBUQVTBUQVTBUHBOKBSBOEBOQVTBUSBTBTFOBOHTFDBSB NFOFSVT DFOEFSVOH NFNBEBNLBO TFMVSVI SFTQPOT LPSUJLBM
TFNQVSOB ZBOH NFOVOKVLLBO CBIXB SBTB UFSIVLVN EBO SBTB TFSFCSJ :BJUV IFXBO UFSTFCVU NFOKBEJ UFSIBCJUVBTJ UFSIBEBQ
UBLVUEBQBUUFSKBEJNFOEBIVMVJSBTBTFOBOHEBOSBTBHBOKBSBO TUJNVMVT TFOTPSJL TQFTJGJL UFSTFCVU EBO TFMBOKVUOZB
NFOHBCBJLBOOZB
Rasa Marah—Hubungannya dengan Pusat Rasa
#JMB TUJNVMVT UFSOZBUB NFOJNCVMLBO SBTB HBOKBSBO BUBV SBTB
Terhukum. 1PMB NBSBI SBHF QBUUFSO
NFSVQBLBO TVBUV QPMB UFSIVLVN CVLBO TJLBQ BDVI UBL BDVI EFOHBO SBOHTBOHBO
FNPTJZBOHNFMJCBULBOQVTBUSBTBUFSIVLVNQBEBIJQPUBMBNVT CFSVMBOHVMBOH SFTQPOT LPSUJLBM TFSFCSJ KVTUSV NFOKBEJ TFNBLJO
EBO TUSVLUVS MJNCJL MBJO QPMB JOJ KVHB NFNQVOZBJ DJSJDJSJ LVBU EBO SFTQPOT JUV EJLBUBLBO NFOHBMBNJ QFOHVBUBO +BEJ QBEB
UFSTFOEJSJZBOHEBQBUEJHBNCBSLBOTFCBHBJCFSJLVU IFXBO JUV MBMV UJNCVM KFKBL NFNPSJ ZBOH LVBU UFSIBEBQ TFOTBTJ
1FSBOHTBOHBO ZBOH LVBU QBEB QVTBU SBTB UFSIVLVN EJ PUBL HBOKBSBO BUBV TFOTBTJ UFSIVLVN OBNVO TFCBMJLOZB NFNCFOUVL
LIVTVTOZB QBEB [POB QFSJWFOUSJLVMBS IJQPUBMBNVT EBO QBEB SBTBUFSCJBTBUFSIBEBQCFSCBHBJTUJNVMVTTFOTPSJL
IJQPUBMBNVTMBUFSBM NFOZFCBCLBOIFXBO
NFNCBOHVOTJLBQ
+FMBTMBICBIXBQVTBUQVTBUSBTBHBOKBSBOEBOSBTBUFSIVLVNEJ
NFNQFSUBIBOLBO EJSJ
NFOHFMVBSLBO DBLBSOZB

TJTUFN MJNCJL TBOHBU CFSQFSBO VOUVL NFOZBSJOH JOGPSNBTJ
NFOHBOHLBU FLPS
NFOEFTJT
NFMVEBI
NFOHHFSBN
JOGPNBTJ ZBOH LJUB QFMBKBSJ CJBTBOZB NFOZJOHLJSLBO MFCJI EBSJ
EBO
NFOEJSJLBO CVMVCVMV UVCVI NFNCVLB NBUBOZB MFCBS
QFSTFOEBONFNJMJILVSBOHEBSJQFSTFOVOUVLEJTJNQBO
MFCBS EBO NFMFCBSLBO QVQJM 4FMBOKVUOZB HBOHHVBO ZBOHQBMJOH
SJOHBO TBKB TVEBI EBQBU NFOZFCBCLBO IFXBO JUV JOHJO
NFOZFSBOHEFOHBOCVBT1FSJMBLVJOJIBNQJSTFMBMVUJNCVMQBEB Fungsi Spesifik Bagian-Bagian Lain Sistem Limbik
IFXBO ZBOH EJIVLVN EFOHBO CFHJUV LFKBNOZB EBO NFSVQBLBO
QPMBQFSJMBLVZBOHEJTFCVUSBTBNBSBI Fungsi Hipokampus
6OUVOHOZB QBEB IFXBO OPSNBM GFOPNFOB SBTB NBSBI JOJ
)JQPLBNQVTNFSVQBLBOCBHJBOLPSUFLTTFSFCSJZBOHNFNBOKBOH
UFSVUBNB EJDFHBI PMFI BEBOZB TJOZBM JOIJCJTJ EBSJ OVLMFJ
NFMJQBU LF EBMBN VOUVL NFNCFOUVL MFCJI CBOZBL CBHJBO EBMBN
WFOUSPNFEJBM IJQPUBMBNVT 4FMBJO JUV CBHJBO IJQPLBNQVT EBO
WFOUSJLFM MBUFSBMJT 4BMBI TBUV VKVOH IJQPLBNQVT CFSCBUBTBO
LPSUFLTMJNCJLBOUFSJPS UFSVUBNBQBEBHJSVTTJOHVMJBOUFSJPSEBO
EFOHBO OVLMFJ BNJHEBMPJE TFSUB TFQBOKBOH QFSCBUBTBO MBUFSBMOZB
HJSVT TVCLBMPTVN EBQBU NFNCBOUV NFOFLBO GFOPNFOB SBTB
CFSTBUV EFOHBO HJSVT QBSBIJQPLBNQVT ZBOH NFSVQBLBO LPSUFLT
NBSBIJOJ
TFSFCSJQBEBQFSNVLBBOMVBSWFOUSPNFEJBMMPCVTUFNQPSBMJT
Ketenangan dan Kejinakan. 4FCFOBSOZB QPMB FNPTJPOBM
)JQPLBNQVT EBO TUSVLUVS MPCVT UFNQPSBMJT EBSJ QBSJFUBMJT
ZBOH CFSMBXBOBO EBQBU KVHB UFSKBEJ CJMB QVTBU SBTB HBOKBSBO
EJSBOHTBOHZBLOJUJNCVMLFUFOBOHBO QMBDJEJUZ
EBOLFKJOBLBO ZBOH CFSEFLBUBO EFOHBOOZB CFSTBNBTBNB EJTFCVU GPSNBTJP
UBNFOFTT
IJQPLBNQVT
NFNQVOZBJ CBOZBL TFLBMJ IVCVOHBO UFUBQJ
LFCBOZBLBOUJEBLMBOHTVOH EFOHBOTFCBHJBOCFTBSLPSUFLTTFSFCSJ
Makna Rasa Ganjaran atau Rasa Terhukum pada Perilaku TFQFSUJ IBMOZB EFOHBO TUSVLUVSTUSVLUVS CBTBMJT TJTUFN MJNCJL
)BNQJSTFHBMBTFTVBUVZBOHLJUBMBLVLBOCFSLBJUBOEFOHBOSBTB BNJHEBMB IJQPUBMBNVT TFQUVN EBO LPSQVT NBNJMBSJB )BNQJS
HBOKBSBO EBO SBTB UFSIVLVN #JMB NFMBLVLBO UJOEBLBO ZBOH TFUJBQ KFOJT QFOHBMBNBO TFOTPSJL NFOZFCBCLBO BLUJWBTJ
UFSOZBUB NFOEBQBU HBOKBSBO LJUB BLBO NFOFSVTLBO UJOEBLBO TFEJLJUOZB EJ CFCFSBQB CBHJBO IJQPLBNQVT EBO IJQPLBNQVT
UFSTFCVU OBNVOCJMBUFSOZBUBNFOZFCBCLBOLJUBUFSIVLVN LJUB LFNVEJBO NFOZFCBSLBO TJOZBMTJOZBM LFMVBS NFOVKV UBMBNVT
BLBO NFOHIFOUJLBO UJOEBLBO UFSTFCVU 0MFI LBSFOB JUV UBL BOUFSJPS IJQPUBMBNVT EBO CBHJBO MBJO TJTUFN MJNCJL UFSVUBNB
EJSBHVLBO MBHJ CBIXB QVTBU SBTB HBOKBSBO EBO QVTBU SBTB NFMBMVJGPSOJLT ZBJUVKBSBTQFOHIVCVOHVUBNB+BEJ IJQPLBNQVT
UFSIVLVN NFSVQBLBO TBMBI TBUV IBM QFOHFOEBMJ QFOUJOH VOUVL NFSVQBLBO TBMVSBO UBNCBIBO ZBOH EJMFXBUJ PMFI TJOZBM TFOTPSJL
TFMVSVIBLUJWJUBTUVCVI IBTSBU SBTBFOHHBO EBONPUJWBTJLJUB ZBOHNBTVL ZBOHEBQBUNFNVMBJSFBLTJQFSJMBLVEFOHBOUVKVBO
Efek Tranquilizer terhadap Pusat Ganjaran atau Pusat ZBOHCFSCFEB4FQFSUJIBMOZBQBEBTUSVLUVSTUSVLUVSMJNCJLMBJO
Terhukum. 1FNCFSJBOUSBORVJMJ[FS PCBUQFOFOBOH
NJTBMOZB QFSBOHTBOHBOQBEBCFSCBHBJBSFBEBMBNIJQPLBNQVTIBNQJS
718
TFMBMVEBQBUNFOZFCBCLBOTBMBITBUVEBSJCFSCBHBJQPMBQFSJMBLV QFOHBMBNBO TFOTPSJL ZBOH EBQBU NFOJNCVMLBO SBTB TFOBOH

NJTBMOZB LFQVBTBO SBTB NBSBI LFUJEBLQFEVMJBO BUBV EPSPOHBO BUBV SBTB TBLJU /BNVO TFQFSUJ BQBLBI NFLBOJTNF UFSKBEJOZB
TFLTZBOHCFSMFCJIBO IBM UFSTFCVU 5FMBI EJEVHB CBIXB IJQPLBNQVT ZBOH
(BNCBSBO MBJO EBSJ IJQPLBNQVT JBMBI CBIXB IJQPLBNQVT NFOZFCBCLBO UJNCVMOZB EPSPOHBO VOUVL NFOHVCBI NFNPSJ
KBOHLB QFOEFL NFOKBEJ NFNPSJ KBOHLB QBOKBOH BSUJOZB
UNIT XI
EBQBU NFOKBEJ UFSBOHTBOH TFDBSB CFSMFCJIBO 4FCBHBJ DPOUPI
SBOHTBOHBO MJTUSJL ZBOH MFNBI EBQBU NFOZFCBCLBO LFKBOH IJQPLBNQVT NFOHJSJNLBO TJOZBM BUBV TJOZBMTJOZBM ZBOH
FQJMFQTJ UFSGPLVT EJ BSFB LFDJM IJQPLBNQVT )BM JUV TFSJOH UBNQBLOZBNFNCVBUQJLJSBOCFSVMBOHVMBOHNFMBUJIJOGPSNBTJ
CFSMBOHTVOH TFMBNB CFCFSBQB EFUJL TFTVEBI SBOHTBOHBO TFMFTBJ CBSV TBNQBJ NFOKBEJ NFNPSJ ZBOH UFSTJNQBO QFSNBOFO "QB
)BMJOJNFOJNCVMLBOLFTBOCBIXBQBEBLPOEJTJGVOHTJPOBMZBOH QVO NFLBOJTNFOZB UBOQB IJQPLBNQVT UBL BLBO UJNCVM
OPSNBM IJQPLBNQVT EBQBU NFNQFSQBOKBOH TJOZBMTJOZBM ZBOH LPOTPMJEBTJNFNPSJKBOHLBQBOKBOHEBSJKFOJTWFSCBMBUBVKFOJT
LFMVBS 4FMBNB CFSMBOHTVOHOZB LFKBOH IJQPLBNQVT PSBOH TJNCPMJL
UFSTFCVU NFOHBMBNJ CFSCBHBJ FGFL QTJLPNPUPS UFSNBTVL
QFOHIJEV QFOHMJIBUBO QFOEFOHBSBO QFSBCBBO EBO UJQF Fungsi Amigdala
IBMVTJOBTJ MBJO ZBOH UBL EBQBU EJUFLBO TFMBNB CFSMBOHTVOHOZB "NJHEBMB NFSVQBLBO LPNQMFLT CFSBHBN OVLMFVT LFDJM ZBOH
LFKBOH XBMBVQVO TFCFOBSOZB QBTJFO QBEB TBBU JUV UJEBL UFSMFUBL UFQBU EJ CBXBI LPSUFLT TFSFCSJ EBO UJBOH QPMF
NFEJBM
BOUFSJPS TFUJBQ MPCVT UFNQPSBMJT "NJHEBMB NFNQVOZBJ CBOZBL
LFIJMBOHBO LFTBEBSBOOZB EBO JB NFOHFUBIVJ CBIXB IBMVTJOBTJ
TFLBMJIVCVOHVOEVBKBMVSEFOHBOIJQPUBMBNVTTFQFSUJKVHBEFOHBO
ZBOHEJBMBNJOZBJUVUJEBLCFSEBTBSLBOLFOZBUBBO.VOHLJOTBMBI EBFSBITJTUFNMJNCJLMBJOOZB
TBUV BMBTBO UJNCVMOZB IJQFSFLTJUBCJMJUBT IJQPLBNQVT JOJ BEBMBI
1BEBIFXBOUJOHLBUSFOEBI BNJHEBMBTBOHBUCFSLBJUBOEFOHBO
LBSFOB IJQPLBNQVT NFNJMJLJ CFSCBHBJ UJQF LPSUFLT EBSJ TFUJBQ
SBOHTBOHBO PMGBLUPSJ EBO ZBOH CFSIVCVOHBO EFOHBO PUBL MJNCJL
CBHJBOTFSFCSVN EBOIBOZBNFNQVOZBJUJHBMBQJTBOTFMTBSBGEJ #BILBO EBMBN #BC UFMBI EJUFLBOLBO CBIXB TBMBI TBUV CBHJBO
CFCFSBQBBSFBUFSTFCVU KBEJUJEBLTFQFSUJCBHJBOLPSUFLTTFSFCSVN VUBNBUSBLUVTPMGBLUPSJVTCFSBLIJSEJCBHJBOBNJHEBMBZBOHEJTFCVU
MBJOOZBZBOHNFOHBOEVOHFOBNMBQJTBOTFMTBSBG OVLMFJ LPSUJLPNFEJBM ZBOH UFSMFUBL UFQBU EJ CBXBI LPSUFLT TFSFCSJ
Peran Hipokampus dalam Pembelajaran EJ EBMBN BSFB QJSJGPSNJT PMGBLUPSJVT MPCVT UFNQPSBMJT 1BEB
NBOVTJB BEB CBHJBO MBJO EBSJ BNJHEBMB ZBLOJ OVLMFJ CBTPMBUFSBM
Efek Pengangkatan Bilateral Hipokampus-Ketidak
ZBOHKBVIMFCJICFSLFNCBOHEBSJQBEBCBHJBOPMGBLUPSJVTUFSTFCVU
mampuan Belajar. 1BEB QFOHPCBUBO CFCFSBQB QBTJFO FQJMFQTJ EBO QFSBOBOOZB QFOUJOH QBEB CBOZBL BLUJWJUBT QFSJMBLV ZBOH
UFMBI EJMBLVLBO UJOEBLBO PQFSBTJ QFOHBOHLBUBO CBHJBO VNVSOOZBUJEBLCFSIVCVOHBOEFOHBOTUJNVMVTPMGBLUPSJVT
IJQPLBNQVT EJ LFEVB TJTJ CJMBUFSBM
5FSOZBUB QBTJFO EBQBU
"NJHEBMB NFOFSJNB TJOZBM QFSTBSBGBO EBSJ TFNVB CBHJBO
NFNBOHHJM LFNCBMJ TFCBHJBO CFTBS JOHBUBO ZBOH UFMBI EJQFMBKBSJ LPSUFLT MJNCJL TFQFSUJ KVHB EBSJ OFPLPSUFLT MPCVT UFNQPSBMJT
TFCFMVNOZB EFOHBO NFNVBTLBO /BNVO TFSJOH LBMJ QBTJFO UBL QBSJFUBMJTEBOPLTJQJUBMJTUFSVUBNBEBSJBSFBBTPTJBTJBVEJUPSJLEBO
EBQBU NFNQFMBKBSJ JOGPSNBTJ CBSV ZBOH EJEBTBSLBO QBEB TJNCPM BSFB BTPTJBTJ WJTVBM 0MFI LBSFOB IVCVOHBO ZBOH NVMUJQFM JOJ
WFSCBM 1BEB LFOZBUBBOOZB TFSJOH LBMJ QBTJFO CBILBO UBL EBQBU BNJHEBMBEJTFCVUKFOEFMB ZBOHEJQBLBJPMFITJTUFNMJNCJLVOUVL
NFNQFMBKBSJOBNBBUBVXBKBIPSBOHZBOHEJUFNVJOZBTFUJBQIBSJ NFMJIBU LFEVEVLBO TFTFPSBOH EJ EVOJB 4FCBMJLOZB BNJHEBMB
1BTJFO VOUVL TFTBBU NBTJI EBQBU NFOHJOHBU QFSJTUJXB ZBOH NFOHJSJNLBOTJOZBMTJOZBM
LFNCBMJLFBSFBLPSUJLBMZBOHTBNB
CFSMBOHTVOH TFMBNB JB NFMBLVLBO TVBUV BLUJWJUBT +BEJ QBTJFO JUV JOJ
LF IJQPLBNQVT
LF TFQUVN
LF UBMBNVT EBO

NBTJINFNQVOZBJNFNPSJKBOHLBQFOEFLTFMBNBCFCFSBQBEFUJL LIVTVTOZBLFIJQPUBMBNVT
TBNQBJ TBUV BUBV EVB NFOJU XBMBVQVO LFNBNQVBOOZB VOUVL Efek Perangsangan Amigdala. 1BEB VNVNOZB
NFNCFOUVL NFNPSJ TFMBNB MFCJI EBSJ CFCFSBQB NFOJU UFMBI QFSBOHTBOHBO QBEB BNJHEBMB EBQBU NFOZFCBCLBO FGFL ZBOH
TFMVSVIOZB BUBV IBNQJS TFMVSVIOZB IJMBOH MOJ BEBMBI GFOPNFOB IBNQJS TFSVQB EFOHBO FGFL BLJCBU QFSBOHTBOHBO MBOHTVOH
ZBOHEJTFCVUBNOFTJBBOUFSPHSBEZBOHUFMBIEJCBIBTQBEB#BC IJQPUBMBNVT EJUBNCBI EFOHBO FGFL MBJO &GFL ZBOH EJBXBMJ EBSJ
BNJHEBMB LFNVEJBO EJLJSJN NFMBMVJ IJQPUBMBNVT NFMJQVUJ

Fungsi Teoretis Hipokampus pada Pembelajaraan QFOJOHLBUBO BUBV QFOVSVOBO UFLBOBO BSUFSJ
NFOJOHLBULBO
)JQPLBNQVT QBEB NVMBOZB NFSVQBLBO CBHJBO LPSUFLT BUBV NFOVSVOLBO GSFLVFOTJ EFOZVU KBOUVOH
NFOJOHLBULBO
PMGBLUPSJVT1BEBCBOZBLIFXBOUJOHLBUSFOEBI LPSUFLTUFSTFCVU BUBV NFOVSVOLBO NPUJMJUBT EBO TFLSFTJ HBTUSPJOUFTUJOBM

TBOHBU CFSQFSBO EBMBN NFOFOUVLBO BQBLBI IFXBO BLBO EFGFLBTJ BUBV NJLUVSJTJ
EJMBUBTJ QVQJM BUBV LBEBOHLBMB
NFNBLBO NBLBOBO UFSUFOUV BQBLBI CBV EBO CFOEB UFSUFOUV LPOTUSJLTJ
QJMPFSFLTJ
TFLSFTJ CFSCBHBJ IPSNPO IJQPGJTJT
NFOVOKVLLBO CBIBZB BUBV BQBLBI CBV JOJ NFOJNCVMLBO NJOBU BOUFSJPS UFSVUBNB IPSNPO HPOBEPUSPQJO EBO
TFLTVBM KBEJ EBMBN NFNCVBU LFQVUVTBO ZBOH CFSIVCVOHBO BESFOPLPSUJLPUSPQJL
EFOHBOIJEVQBUBVNBUJ1BEBFWPMVTJQFNCFOUVLBOPUBLEJNBTB %J TBNQJOH FGFL ZBOH EJLJSJNLBO NFMBMVJ IJQPUBMBNVT JOJ
ZBOHTBOHBUBXBM IJQPLBNQVTNVOHLJONFSVQBLBOTFLVNQVMBO QFSBOHTBOHBOBNJHEBMBKVHBEBQBUNFOJNCVMLBOCFCFSBQBNBDBN
OFVSPO ZBOH NFNQVOZBJ NFLBOJTNF QFOFOUV QBEB LFBEBBO QFSHFSBLBO JOWPMVOUFS ZBLOJ
QFSHFSBLBO UPOJL TFQFSUJ
LSJUJT ZBOH NFOFOUVLBO NBLOB TJOZBM TFOTPSJL QFOUJOH ZBOH NFOHBOHLBU LFQBMB BUBV NFNCVOHLVLLBO CBEBO
QFSHFSBLBO
NFMJOHLBS
LBEBOHQFSHFSBLBOLMPOJL SJUNJTEBO
CFSCBHBJ
NBTVL 4FHFSB TFUFMBI LFNBNQVBO VOUVL NFNCVBU LFQVUVTBO
NBDBNQFSHFSBLBOZBOHCFSLBJUBOEFOHBOQFODJVNBOEBONBLBO
LSJUJT JOJ UFSCFOUVL EJEVHB TJTB CBHJBO PUBL MBJOOZB KVHB NVMBJ TFQFSUJNFOKJMBU NFOHVOZBI EBONFOFMBO
CFSIVCVOHBO EFOHBO IJQPLBNQVT VOUVL QFNCVBUBO LFQVUVTBO
4FMBJO JUV QFSBOHTBOHBO QBEB OVLMFJ BNJHEBMB UFSUFOUV EBQBU
0MFI LBSFOB JUV KJLB IJQPLBNQVT NFNCFSJLBO TJOZBM CBIXB NFOJNCVMLBO QPMB NBSBI NFMBSJLBO EJSJ SBTB UFSIVLVN OZFSJ
NBTVLBO OFVSPO UFSUFOUV CFSTJGBU QFOUJOH LFNVOHLJOBO CFTBS ZBOH TBOHBU EBO SBTB UBLVU TFQFSUJ QPMB SBTB NBSBI ZBOH
JOGPSNBTJUFSTFCVUBLBOEJTJNQBONFOKBEJNFNPSJ EJDFUVTLBO PMFI IJQPUBMBNVT TFQFSUJ ZBOH UFMBI EJKFMBTLBO
+BEJ TFTFPSBOH EFOHBO DFQBU NFOKBEJ UFSCJBTB UFSIBEBQ TFCFMVNOZB 1FSBOHTBOHBO QBEB OVLMFJ BNJHEBMPJE MBJOOZB EBQBU
TUJNVMVTZBOHTBNBOBNVOJBEFOHBOUFLVONFNQFMBKBSJTFUJBQ NFOJNCVMLBOSFBLTJSBTBHBOKBSBOEBOSBTBTFOBOH
719
Unit XI Sistem Sarat C. Neurofisiologi Motorik dan Integratif
"LIJSOZB QFSBOHTBOHBO QBEB CBHJBO BNJHEBMB ZBOH MBJO EBQBU EFOHBO TUSVLUVSTUSVLUVS MJNCJL TVCLPSUJLBM ,FSVTBLBO LFEVB TJTJ
NFOJNCVMLBO BLUJWJUBT TFLTVBM TFQFSUJ FSFLTJ QFSHFSBLBO HJSVT JOJ NFOZFCBCLBO QVTBU NBSBI EJ TFQUVN EBO IJQPUBMBNVT
QFSTFUVCVIBO FKBLVMBTJ PWVMBTJ BLUJWJUBT VUFSVT EBO QFSTBMJOBO UFSJFQBTEBSJQFOHBSVIIBNCBUBOQSFGSPOUBM0MFILBSFOBJUV IFXBO
QSFNBUVS NFOKBEJ HBOBT EBO NFOZFSBOH TFHBMB TFTVBUV NFMFCJIJ LFBEBBO
OPSNBMOZB
Efek Ablasi Amigdala Bilateral — Sindroma Bucy.
1BEB TFFLPS NPOZFU CJMB CBHJBO BOUFSJPS LFEVB MPCVT UFNQPSBMJTOZB Ringkasan. 4BNQBJ UFSTFEJB JOGPSNBTJ MFCJI MBOKVU NVOHLJO
EJSVTBL LFBEBBO JOJ UJEBL IBOZB NFOHIJMBOHLBO CBHJBO LPSUFLT MFCJI CBJL NFOZBUBLBO CBIXB SFHJP LPSUJLBM EBSJ TJTUFN MJNCJL
UFNQPSBMOBNVOKVHBCBHJBOBNJHEBMBZBOHUFSMFUBLEJEBMBNCBHJBO NFOFNQBUJ QPTJTJ IVCVOHBO JOUFSNFEJB BOUBSB GVOHTJ BSFB TQFTJGJL
MPCVT UFNQPSBMJT JOJ ,FBEBBO UFSTFCVU NFOZFCBCLBO UJNCVMOZB LPSUFLT TFSFCSJ EBO GVOHTJ TUSVLUVSTUSVLUVS MJNCJL TVCLPSUJLBM
QFSVCBIBO QFSJMBLV ZBOH EJTFCVU TJOESPN ,MJJWFS#VDZ ZBOH VOUVL QFOHBUVSBO QPMB QFSJMBLV +BEJ QBEB LPSUFLT UFNQPSBMJT
EJUVOKVLLBOPMFITFFLPSIFXBOZBOH
CFSTJGBUUJEBLUBLVUUFSIBEBQ BOUFSJPS UFSVUBNB EBQBU LJUB KVNQBJ BEBOZB BTPTJBTJ QFOHFDBQBO
BQB QVO
NFNQVOZBJ LFJOHJOUBIVBO ZBOH FLTUSFN UFOUBOH TFHBMB HVTUBUPSJ
EBO QFOHIJEV PMGBLUPSJ
%BMBN HJSVT QBSBIJQPLBNQVT
TFTVBUV
DFQBUNFOKBEJMVQB
NFNQVOZBJLFDFOEFSVOHBOVOUVL EBQBU EJKVNQBJ BEBOZB LFDFOEFSVOHBO CBHJ BTPTJBTJ BVEJUPSJL
NFOBSVITFHBMBTFTVBUVQBEBNVMVUOZBEBOLBEBOHCBILBONFODPCB LPNQMFLT EBO KVHB BTPTJBTJ QJLJSBO LPNQMFLT ZBOH EJDFUVTLBO PMFI
NFNBLBOCFOEBZBOHQBEBU EBO
TFSJOHLBMJNFNQVOZBJEPSPOHBO BSFB 8FSOJDLF MPCVT UFNQPSBMJT QPTUFSJPS %J CBHJBO UFOHBI EBO
TFLTVBMZBOHLVBUTFIJOHHBCFSVTBIBNFOZFUVCVIJIFXBOZBOHNBTJI QPTUFSJPSLPSUFLTTJOHVMJ DVLVQCFSBMBTBOCJMBEJEVHBUFSKBEJBTPTJBTJ
JNBUVS IFXBO EFOHBO KFOJT LFMBNJO ZBOH TBMBI BUBV CBILBO IFXBO TFOTPSJNPUPSJLQFSJMBLV
ZBOH CFSCFEB TQFTJFTOZB 8BMBVQVO QBEB NBOVTJB KBSBOH EJKVNQBJ
MFTJ ZBOH TBNB QBTJFO LFMBJOBO JOJ BLBO NFOVOKVLLBO QPMB QFSJMBLV
ZBOHUBLCFHJUVCFSCFEBEFOHBONPOZFU Daftar Pustaka
Adell A, Celada P, Abellan MT, et al: Origin and functional role of the extra-
Fungsi Keseluruhan Amigdala. 5BNQBLOZB BNJHEBMB cellular serotonin in the midbrain raphe nuclei, Brain Res Brain Res Rev
NFSVQBLBO BSFB QFSJMBLV LFTBEBSBO ZBOH CFLFSKB QBEB UJOHLBU UBL 39:154, 2002.
TBEBS"NJHEBMBKVHBUBNQBLOZBCFSQSPZFLTJQBEBKBMVSTJTUFNMJNCJL Bechara A, Damasio H, Damasio AR: Role of the amygdala in decision-
TFTFPSBOHEBMBNIVCVOHBOOZBEFOHBOBMBNTFLJUBSEBOBMBNQJLJSBO making, Ann N Y Acad Sci 985:356, 2003.
#FSMBOEBTLBO QBEB JOGPSNBTJ JOJ BNJHEBMB EJBOHHBQ NFNCVBU Bird CM, Burgess N: The hippocampus and memory: insights from spatial
SFTQPOTQFSJMBLVTFTFPSBOHTFTVBJEFOHBOTFUJBQLFBEBBO processing, Nat Rev Neurosci 9:182, 2008.
Ehrlich I, Humeau Y, Grenier F, et al: Amygdala inhibitory circuits and the
Fungsi Korteks Limbik control of fear memory, Neuron 62:757, 2009.
#BHJBO TJTUFN MJNCJL ZBOH QBMJOH TFEJLJU EJNFOHFSUJ BEBMBI DJODJO Guillery RW: Branching thalamic afferents link action and perception, J
LPSUFLT TFSFCSJ ZBOH EJTFCVU LPSUFLT MJNCJL ZBOH NFOHFMJMJOHJ Neurophysiol 90:539, 2003.
TUSVLUVSTUSVLUVS TVCLPSUJLBM MJNCJL ,PSUFLT JOJ CFSGVOHTJ TFCBHBJ Heinricher MM, Tavares I, Leith JL, et al: Descending control of nociception:
[POB USBOTJTJ ZBOH EJMFXBUJ PMFI TJOZBMTJOZBM ZBOH EJLJSJNLBO EBSJ Specificity, recruitment and plasticity, Brain Res Rev 60:214, 2009. Holland PC,
CBHJBO MBJO LPSUFLT PUBL LF TJTUFN MJNCJL EBO KVHB LF BSBI ZBOH Gallagher M: Amygdala—frontal interactions and reward
CFSMBXBOBO 0MFI LBSFOB JUV LPSUFLT MJNCJL CFSGVOHTJ TFCBHBJ BSFB expectancy, Curr Opin Neurobiol 14:148, 2004.
Joels M, Verkuyl JM, Van Riel E: Hippocampal and hypothalamic function
BTPTJBTJTFSFCSVNVOUVLNFOHFOEBMJLBOQFSJMBLV
after chronic stress, Ann N Y Acad Sci 1007:367, 2003.
1FSBOHTBOHBO CFSCBHBJ SFHJP LPSUFLT MJNCJL BLBO NFOHHBHBMLBO Jones EG: Synchrony in the interconnected circuitry of the thalamus and
GVOHTJ LPSUFLT MJNCJL JOJ /BNVO TFQFSUJ IBMOZB SFHJPSFHJP MBJO cerebral cortex, Ann N Y Acad Sci 1157:10, 2009.
TJTUFN MJNCJL QPMB QFSJMBLV UFSTFCVU EBQBU KVHB EJDFUVTLBO EFOHBO Kandel ER, Schwartz JH, Jessell TM: Principles of Neural Science, ed 4, New
NFSBOHTBOH EBFSBI TQFTJGJL QBEB LPSUFLT MJNCJL %FNJLJBO KVHB York, 2000, McGraw-Hill.
BCMBTJ CFCFSBQB BSFB LPSUFLT MJNCJL EBQBU NFOJNCVMLBO QFSVCBIBO LeDoux JE: Emotion circuits in the brain, Annu Rev Neurosci 23:155, 2000. Lumb
ZBOHQFSTJTUFOQBEBQFSJMBLVIFXBO ZBJUVTFCBHBJCFSJLVU BM: Hypothalamic and midbrain circuitry that distinguishes between
escapable and inescapable pain, News Physiol Sci 19:22, 2004.
Ablasi Korteks Temporalis Anterior. #JMBEJMBLVLBOBCMBTJ Neves G, Cooke SF, Bliss TV: Synaptic plasticity, memory and the hip-
LFEVB TJTJ CJMBUFSBM
LPSUFLT UFNQPSBMJT BOUFSJPS BNJHEBMB IBNQJS pocampus: a neural network approach to causality, Nat Rev Neurosci
TFMBMVJLVUSVTBL)BMJOJUFMBIEJCJDBSBLBOTFCFMVNOZBQBEBCBCJOJ 9:65, 2008.
EBO UFMBI EJUFLBOLBO CBIXB EBQBU UFSKBEJ TJOESPN ,MJJZFS#VDZ Pessoa L: On the relationship between emotion and cognition, Nat Rev
1FSJMBLV IFXBO UFSTFCVU UFSVUBNB NFOKBEJ MJBS NBV NFOZFMJEJLJ Neurosci 9:148, 2008.
TFHBMB PCKFL NFNQVOZBJ EPSPOHBO TFLTVBM ZBOH CFTBS UFSIBEBQ Phelps EA, LeDoux JE: Contributions of the amygdala to emotion process-
ing: from animal models to human behavior, Neuron 48:175, 2005. Roozendaal B,
IFXBO ZBOH UJEBL TFTVBJ BUBV CBILBO UFSIBEBQ CFOEBCFOEB NBUJ
McEwen BS, Chattarji S: Stress, memory and the amygdala,
EBO LFIJMBOHBO TFNVB SBTB UBLVUOZB EBO TFLBMJHVT NFNCVBU IFXBO
Nat Rev Neurosci 10:423, 2009.
JUVNFOKBEJKJOBL Sah P, Faber ES, Lopez De Armentia M, et al: The amygdaloid complex: anat-
Ablasi Korteks Frontal Orbital Posterior. 1FOHBOHLBUBO omy and physiology, Physiol Rev 83:803, 2003.
TFDBSB CJMBUFSBM CBHJBO QPTUFSJPS LPSUFLT GSPOUBM PSCJUBM TFSJOH LBMJ Sara SJ: The locus coeruleus and noradrenergic modulation of cognition,
NFOZFCBCLBO IFXBO UBL CJTB UJEVS JOTPNOJB
ZBOH CFSIVCVOHBO Nat Rev Neurosci 10:211, 2009.
Ulrich-Lai YM, Herman JP: Neural regulation of endocrine and autonomic
EFOHBO LFHFMJTBIBO NPUPSJL ZBOH IFCBU NFOKBEJ UBL EBQBU EVEVL
stress responses, Nat Rev Neurosci 10:397, 2009.
UFOBOHEBOUFSVTNFOFSVTCFSHFSBL
Vann SD, Aggleton JP: The mammillary bodies: two memory systems in
Ablasi Girus Singuli Anterior dan Girus Subkalosum one? Nat Rev Neurosci 5:35, 2004.
(JSVTTJOHVMJBOUFSJPSEBOHJSVTTVCLBMPTVNNFSVQBLBOCBHJBO Woods SC, D’Alessio DA: Central control of body weight and appetite, J Clin
LPSUFLTMJNCJLZBOHNFOHIVCVOHLBOLPSUFLTQSFGSPOUBMTFSFCSJ Endocrinol Metab 93(11 Suppl 1):S37, 2008.
720
BAB 59
UNIT XI
"LUJWJUBT0UBL5JEVS (FMPNCBOH
0UBL &QJMFQTJ 1TJLPTJT
,JUB TFNVB NFOZBEBSJ BEBOZB Tidur Gelombang-Lambat
CFSCBHBJ LFBEBBO BLUJWJUBT PUBL ,FCBOZBLBO EBSJ LJUB EBQBU NFOHFSUJ TJGBUTJGBU UJEVS HFMPN
ZBOH NFMJQVUJ LFHJBUBO UJEVS CBOH MBNCBU ZBOH EBMBN EFOHBO NFOHJOHBU TBBUTBBU UFSBLIJS
LFBEBBO TJBHB QFSBOHTBOHBO LJUBUFUBQUFSKBHBTFMBNBMFCJIEBSJKBN EBOLFNVEJBOUJEVS
ZBOH FLTUSFN EBO CBILBO OZFOZBL ZBOH UFSKBEJ EBMBN TBUV KBN QFSUBNB TFUFMBI NVMBJ
CFSCBHBJNBDBNTVBTBOBIBUJ UJEVS 5BIBQ UJEVS JOJ CFHJUV UFOBOH EBO EBQBU EJIVCVOHLBO
TFQFSUJ SBTB SJBOH HFNCJSB EFQSFTJ EBO SBTB UBLVU 4FNVB EFOHBO QFOVSVOBO UPOVT QFNCVMVI EBSBI QFSJGFS EBO GVOHTJ
LFBEBBO JOJ BEBMBI BLJCBU CFSCBHBJ EBZB QFOHBLUJWBTJ BUBV GVOHTJWFHFUBUJGUVCVIMBJO$POUPIOZB UFLBOBOEBSBI GSFLVFO
QFOHJOIJCJTJZBOHCJBTBOZBUJNCVMEBMBNPUBLJUVTFOEJSJ1BEB TJ QFSOBQBTBO EBO MBKV NFUBCPMJTNF CBTBM BLBO CFSLVSBOH
#BC LJUBNVMBJNFNCJDBSBLBOTFCBHJBOTVCKFLJOJLFUJLBLJUB TBNQBJQFSTFO
NFNCBIBT NFOHFOBJ CFSCBHBJ TJTUFN ZBOH NBNQV 8BMBVQVO UJEVS HFMPNCBOH MBNCBU TFSJOH EJTFCVU UJEVS
NFOHBLUJGLBO TFKVNMBI CFTBS CBHJBO PUBL %BMBN IBM JO LJUB UBOQBNJNQJ OBNVOTFCFOBSOZBQBEBUBIBQUJEVSJOJTFSJOH
NFNCBIBT TFDBSB TJOHLBU NFOHFOBJ LFBEBBO ZBOH TQFTJGJL EBSJ UJNCVMNJNQJEBOLBEBOHLBEBOHCBILBONJNQJCVSVLUFSKB
BLUJWJUBTPUBL EJNVMBJEFOHBOUJEVS EJ TFMBNB UJEVS HFMPNCBOH MBNCBU 1FSCFEBBO BOUBSB NJNQJ
NJNQJ ZBOH UJNCVM TFXBLUV UBIBQ UJEVS HFMPNCBOH MBNCBU
Tidur EBONJNQJQBEBUJEVS3&.BEBMBICBIXBNJNQJZBOHUJNCVM
QBEB UBIBQ UJEVS 3&. MFCJI TFSJOH NFMJCBULBO BLUJWJUBT PUPU
5JEVSEJEFGJOJTJLBOTFCBHBJTVBUVLFBEBBOUBLTBEBSZBOHEBQBU
UVCVI EBONJNQJQBEBUBIBQUJEVSHFMPNCBOHMBNCBUCJBTB
EJCBOHVOLBOEFOHBOQFNCFSJBOSBOHTBOHTFOTPSJLBUBVEFOHBO
OZB UBL EBQBU EJJOHBU +BDMJ TFMBNB UJEVS HFMPNCBOH MBNCBU
SBOHTBOH MBJOOZB 5JEVS IBSVT EJCFEBLBO EFOHBO LPNB ZBOH
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NFSVQBLBO LFBEBBO UBL TBEBS ZBOH UJEBL EBQBU EJCBOHVOLBO
5FSEBQBUCFSCBHBJUBIBQEBMBNUJEVS EBSJUJEVSZBOHTBOHBUSJ
OHBO TBNQBJ UJEVS ZBOH TBOHBU EBMBN QBSB QFOFMJUJ UJEVS KVHB Tidur REM (Tidur Paradoksal, Tidur Desinkronisasi)
NFNCBHJUJEVSNFOKBEJEVBUJQFZBOHTFDBSBLFTFMVSVIBOCFSCF 4FQBOKBOHUJEVSNBMBNZBOHOPSNBM UJEVS3&.ZBOHCFSMBOH
EB ZBOH NFNJMJLJ LVBMJUBT ZBOH CFSCFEB QVMB ZBLOJ TFCBHBJ TVOH TBNQBJ NFOJU CJBTBOZB NVODVM SBUBSBUB TFUJBQ
CFSJLVU NFOJU #JMB TFTFPSBOH TBOHBU NFOHBOUVL TFUJBQ UJEVS 3&.
CFSMBOHTVOH TJOHLBU EBO CBILBO NVOHLJO UBL BEB 4FCBMJLOZB
%VB 5JQF 5JEVS5JEVS (FMPNCBOH-BNCBU EBO 5JEVS TBBUPSBOHNFOKBEJNBLJOMFCJIOZFOZBLTFQBOKBOHNBMBNOZB
3BQJE&ZF.PWFNFOU 3&.
4FUJBQNBMBN TFTFPSBOHNFOHBMB EVSBTJUJEVS3&.KVHBNBLJOMBNB
NJEVBUJQFUJEVSZBOHTBMJOHCFSHBOUJBOTBUVTBNBMBJO5JQFJOJ 5JEVS3&.NFNQVOZBJCFCFSBQBLBSBLUFSJTUJLQFOUJOHTFCB
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UJEVS HFMPNCBOHMBNCBU ZBOH HFMPNCBOH PUBLOZB HBJCFSJLVU
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UJEVS EFOHBO QFSHFSBLBO NBUB ZBOH DFQBU 1. 5JEVS3&.NFSVQBLBOCFOUVLUJEVSBLUJGZBOHCJBTBOZB
3&. TMFFQ
QBEB UJQF UJEVS JOJ NBUB CFSHFSBL EFOHBO DFQBU EJTFSUBJNJNQJEBOQFSHFSBLBOPUPUUVCVIZBOHBLUJG
NFTLJQVOPSBOHUFUBQUJEVS
2. 4FTFPSBOH MFCJI TVLBS EJCBOHVOLBO PMFI SBOHTBOHBO TFOTP
4FUJBQ NBMBNOZB TFCBHJBO CFTBS NBTB UJEVS UFSEJSJ BUBT
SJL TFMBNB UJEVS HFMPNCBOH MBNCBU OBNVO PSBOHPSBOH
HFMPNCBOH MBNCBU ZBOH CFSWBSJBTJ ZBLOJ UJEVS ZBOH OZFOZBL
UFSCBOHVOTFDBSBTQPOUBOEJQBHJIBSJTBBUFQJTPEFUJEVS3&.
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UJEVSTFTVEBIUFSKBHBTFMBNBCFCFSBQBKBNTFCFMVNOZB%JQJIBL
MBJO UJEVS 3&. UJNCVM EBMBN FQJTPEFFQJTPEF EBO NFMJQVUJ OVOKVLLBOBEBOZBIBNCBUBOZBOHLVBUQBEBBSFBQFOHFOEB
TFLJUBS QFSTFO EBOJ TFMVSVI NBTB UJEVS QBEB PSBOH EFXBTB MJBOPUPUEJTQJOBM
TFUJBQ FQJTPEF OPSNBMOZB UFSKBEJ LFNCBMJ TFUJBQ NFOJU 5JQF 4. 'SFLVFOTJ EFOZVU KBOUVOH EBO QFSOBQBTBO CJBTBOZB NFOKBEJ
UJEVS JOJ UBL CFHJUV UFOBOH EBO CJBTBOZB CFSIVCVOHBO EFOHBO UBL UFSBUVS EBO JOJ NFSVQBLBO TJGBU EBOJ LFBEBBO UJEVS EF
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721
Unit XI Sistem Saraf C. Neurofisiologi Motorik dan Integratif
5. 8BMBVQVO BEB IBNCBUBO ZBOH TBOHBU LVBU QBEB PUPUPUPU 1FSBOHTBOHBO CFCFSBQB BSFB EJ OVLMFVT USBLUVT TPMJUBSJVT
QFSJGFS NBTJI UJNCVM HFSBLBO PUPU ZBOH UJEBL UFSBUVS KVHB EBQBU NFOJNCVMLBO UJEVS /VLMFVT JOJ NFSVQBLBO
,FBEBBOJOJLIVTVTOZBNFODBLVQHFSBLBONBUBZBOHDFQBU EBFSBI UFSNJOBM EJ NFEVMB EBO QPOT ZBOH EJMFXBUJ PMFI
6. 1BEBUJEVS3&. PUBLNFOKBEJTBOHBUBLUJG EBONFUBCPMJT TJOZBMTFOTPSJLWJTFSBMZBOHNBTVLNFMBMVJOFSWVTWBHVTEBO
NF EJ TFMVSVI PUBL NFOJOHLBU TFCBOZBL QFSTFO 1BEB OFSWVTHMPTTPGBSJOHFVT
FMFLUSPFOTFGBMPHSBN &&(
UFSMJIBU QPMB HFMPNCBOH PUBL 5JEVS EBQBU EJUJNCVMLBO NFMBMVJ QFSBOHTBOHBO CFCFSB QB
ZBOH TFSVQB EFOHBO ZBOH UFSKBEJ TFMBNB LFBEBBO TJBHB SFHJP QBEB EJFOTFGBMPO UFSNBTVL
CBHJBO SPTUSBM
5JEVS UJQF JOJ EJTFCVU KVHB UJEVS QBSBEPLTBM LBSFOB IBM JOJ IJQPUBMBNVT UFSVUBNBBSFBTVQSBLJBTNB EBO
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CFSTJGBU QBSBEPLT ZBJUV TFTFPSBOH EBQBU UFUBQ UFSUJEVS ZBOHUFSLBEBOHEJKVNQBJEJOVLMFVTEJGVTUBMBNVT
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3JOHLBTOZB UJEVS 3&. NFSVQBLBO UJQF UJEVS TBBU PUBL ,FBEBBO 4JBHB ZBOH 5FSVTNFOFSVT -FTJ CFSMBJOBO EJ OVLMFJ
CFOBSCFOBSEBMBNLFBEBBOBLUJG/BNVO BLUJWJUBTPUBLUJEBL SBGFNFOJNCVMLBOLFBEBBOTJBHBZBOHFLTUSFN,FBEBBOJOJKV
EJTBMVSLBO LF BSBI ZBOH TFTVBJ BHBS PSBOH JUV TJBHB QFOVI HBUJNCVMCJMBBEBMFTJCJMBUFSBMEJBSFBTVQSBLJBTNBCBHJBONF
UFSIBEBQLFBEBBOTFLFMJMJOHOZBTFIJOHHB PSBOHUFSTFCVUCFOBS EJBM EBO SPTUSBM QBEB IJQPUBMBNVT BOUFSJPS 1BEB LFEVB DPOUPI
CFOBSUFSUJEVS UFSTFCVU OVLMFJSFUJLVMFSFLTJUBUPSJLQBEBNFTFOTFGBMPOEBOQPOT
CBHJBO BUBT UBNQBLOZB UFSCFCBT EBSJ IBNCBUBO TFIJOHHB NF
Teori Dasar Tidur OJNCVMLBO LFBEBBO TJBHB QFOVI #BILBO LBEBOHLBEBOH MFTJ
1SPTFT 1FOHIBNCBUBO "LUJG %JEVHB TFCBHBJ 1FOZFCBC IJQPUBMBNVT BOUFSJPS EBQBU NFOZFCBCLBO UJNCVMOZB LFBEBBO
5JEVS "EB UFPSJ MBNB ZBOH NFOZBUBLBO CBIXB BSFB FLTJUBTJ ZBOHTBOHBUTJBHBTFIJOHHBIFXBOEBQBUNBUJBLJCBULFMFMBIBO
QBEB CBUBOH PUBL CBHJBO BUBT ZBOH EJTFCVU TJTUFN BLUJWBTJ 4VCTUBOTJ5SBOTNJUFS-BJOZBOH.VOHLJO#FSLBJUBOEFOHBO
SFUJLVMFS NFOHBMBNJ LFMFMBIBO TFUFMBI TFIBSJBO UFSKBHB 5JEVS 1FOFMJUJBO UFMBI NFNCVLUJLBO CBIXB LFBEBBO UJEVS EBQBU
TFIJOHHB NFOKBEJ UJEBL BLUJG ,FBEBBO JOJ EJTFCVU UFPSJ QBTJG EJDFUVTLBOCJMBLFEBMBNTJTUFNWFOUSJLFMPUBLTFFLPSIFXBOEJTVOUJLLBO
DBJSBO TFSFCSPTQJOBM EBO EBSBI BUBV VSJOF ZBOH NFOHBOEVOH TVBUV [BU
EBSJUJEVS1FSDPCBBOQFOUJOHUFMBINFOHVCBIQBOEBOHBOJOJ
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LF UFPSJ ZBOH MFCJI CBSV CBIXB UJEVS EJTFCBCLBO PMFI QSPTFT MBJO ZBOH EJCVBU UFSKBHB TFMBNB CFCFSBQB IBSJ 4VBUV [BU ZBOH UFMBI
QFOHIBNCBUBO BLUJG IBM JOJ UFSCVLUJ CBIXB QFNPUPOHBO EJJEFOUJGJLBTJBEBMBINVSBNJMQFQUJEB ZBJUVTVBUVTVCTUBOTJEFOHBOCFSBU
CBUBOH PUBL TFUJOHHJ SFHJP NJEQPOT NFOHIBTJMLBO PUBL NPMFLVMSFOEBIZBOHNFOVNQVLEBMBNDBJSBOTFSFCSPTQJOBMEBOVSJOF
EFOHBO LPSUFLT ZBOH UBL QFSOBI UJEVS %FOHBO LBUB MBJO IFXBO ZBOH UFSKBHB TFMBNB CFCFSBQB IBSJ #JMB TVCTUBOTJ QFODFUVT UJEVS
TVBUV QVTBU ZBOH UFSMFUBL EJ CBXBI UJOHLBU NJEQPOT QBEB JOJ EJTVOUJLLBO CFCFSBQB NJLSPHSBN TBKB LF EBMBN WFOUSJLFM LFUJHB
CBUBOH PUBL ZBOH EJQFSMVLBO VOUVL NFOZFCBCLBO UJEVS EBMBN XBLUV CFCFSBQB NFOJU BLBO UJNCVM LFBEBBO UJEVS BMBNJ EBO
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TFSVQB EBMBN NFOZFCBCLBO UJEVS BEBMBI TVBUV OPOBQFQUJEB ZBOH
EJJTPMBTJEBSJEBSBIIFXBOZBOHUFSUJEVS%BSJKBSJOHBOOFVSPOEJCBUBOH
Pusat-Pusat Persarafan, Substansi Neurohumoral, dan PUBL IFXBO ZBOH EJCVBU UFSKBHB TFMBNB CFCFSBQB IBSJ NBTJI EBQBU
Mekanisme yang dapat Menyebabkan Tidur kemungki- EJJTPMBTJLBO GBLUPS UJEVS ZBOH LFUJHB ZBOH CFMVN EJJEFOUJGJLBTJ TFDBSB
nan Peran Spesifik Serotonin NPMFLVMBS ,FBEBBO TJBHB ZBOH CFSLFQBOKBOHBO EBQBU NFOZFCBCLBO
BLVNVMBTJQSPHSFTJGTVBUVGBLUPSQFODFUVTUJEVSBUBVCFCFSBQBGBLUPSEJ
1FSBOHTBOHBO QBEB CFCFSBQB EBFSBI TQFTJGJL PUBL EBQBU CBUBOHPUBLBUBVDBJSBOTFSFCSPTQJOBMZBOHEBQBUNFOZFCBCLBOLFBEBBO
NFOJNCVMLBOLFBEBBOUJEVSEFOHBOTJGBUTJGBUZBOHNFOEFLBUJ UJEVS
LFBEBBO UJEVS BMBNJ #FCFSBQB DBSB QFSBOHTBOHBO JOJ BEBMBI ,FNVOHLJOBO1FOZFCBC5JEVS3&.4BNQBJTBBUJOJ NBTJI
TFCBHBJCFSJLVU CFMVN EJNFOHFSUJ NFOHBQB LFBEBBO UJEVS EFOHBO HFMPNCBOH
1. %BFSBI QFSBOHTBOHBO ZBOH QBMJOH NFODPMPL ZBOH EBQBU MBNCBU TFDBSB QFSJPEJL EJTFMJOHJ PMFI LFBEBBO UJEVS 3&. "LBO
UFUBQJ PCBU ZBOH LFSKBOZB NFOZFSVQBJ BTFUJMLPMJO BLBO
NFOJNCVMLBOLFBEBBOUJEVSBMBNJBEBMBIOVLMFJSBGF SBQIF
NFOJOHLBULBO UJNCVMOZB UJEVS 3&. 0MFI LBSFOB JUV NVODVM

ZBOH UFSMFUBL EJ TFQBSVI CBHJBO CBXBI QPOT EBO EJ NFEVMB
QPTUVMBU CBIXB OFVSPOOFVSPO CFTBS QBEB GPSNBTJP SFUJLVMBSJT
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CBUBOH PUBL CBHJBO BUBT ZBOH NFOZFLSFTJ BTFUJMLPMJO NVOHLJO
ZBOH UFSMFUBL QBEB HBSJT UFOHBI TFSBUTFSBU TBSBG EBSJ OVLMFJ
NFMBMVJ TFSBU FGFSFOOZB ZBOH QBOKBOH NFOHBLUJGLBO TFCBHJBO
JOJ NFOZFCBS TFUFNQBU EJ GPSNBTJP SFUJLVMBSJT CBUBOH PUBL
CFTBSEBFSBIPUBL,FBEBBOJOJTFDBSBUFPSFUJTEBQBUNFOJNCVM
EBO KVHB LF BUBT NFOVKV UBMBNVT IJQPUBMBNVT TFCBHJBO CF
LBO BLUJWJUBT ZBOH CFSMFCJIBO QBEB EBFSBIEBFSBI UFSUFOUV EJ
TBS EBFSBI TJTUFN MJNCJL EBO CBILBO OFPLPSUFLT TFSFCSVN
PUBL TFMBNB CFSMBOHTVOHOZB UJEVS 3&. XBMBVQVO TJOZBM
4FMBJO JUV TFSBUTFSBU JOJ KVHB NFOZFCBS LF CBXBI NFOVKV
TJOZBMOZB UJEBL EJLJSJNLBO LF EBFSBI PUBL ZBOH TFTVBJ VOUVL
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NFOJNCVMLBO LFBEBBO UFSKBHB ZBOH EJTBEBSJ ZBOH NFSVQBLBO
JOJ EBQBU NFOHIBNCBU TJOZBMTJOZBM ZBOH NBTVL UFSNBTVL
TJGBULFBEBBOTJBHB
OZFSJ TFQFSUJ ZBOH UFMBI EJCJDBSBLBO QBEB #BC #BOZBL
VKVOH TFSBUTFSBU EBO OFVSPO SBGF JOJ NFOZFLSFTJLBO
TFSPUPOJO #JMB TFFLPS IFXBO EJCFSJ PCBU ZBOH NFOHIBNCBU Siklus antara Keadaan Tidur dan Keadaan jaga
QFNCFOUVLBO TFSPUPOJO IFXBO UFSTFCVU TFSJOH LBMJ UJEBL %BMBN QFNCJDBSBBO TFCFMVNOZB IBOZB EJLFUBIVJ UFOUBOH BSFB
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Bab 59 Aktivitas Otak Tidur, Gelombang Otak, Epitepsi, Psikosis
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TFSUB DBSB LFSKB UJNCBM CBMJL TJLMVT UJEVS UFSKBHB .FOHFOBJ QFSJMBLV ZBOH BCOPSNBM ,JUB TFNVB UFMBI NFOHFUBIVJ CBIXB
LFBEBBO JOJ CFMVN BEB QFOKFMBTBO ZBOH QBTUJ 0MFI LBSFOB JUV LFMBNCBOBO QJLJSBO TFNBLJO CFSUBNCBI NFOKFMBOH BLIJS QFSJ
LJUB EBQBU NFOEVHB BEBOZB LFNVOHLJOBO NFLBOJTNF ZBOH PEF KBHB ZBOH CFSLFQBOKBOHBO OBNVO TFMBJO JUV TFTFPSBOH EB
QBU NFOKBEJ NVEBI UFSTJOHHVOH BUBV CBILBO NFOKBEJ QTJLPUJL
UNIT XI
NFOJNCVMLBOTJLMVTUJEVSUFSKBHB
#JMBQVTBUUJEVSUJEBLEJBLUJGLBO OVLMFJQFOHBLUJWBTJSFUJLV TFTVEBI LFBEBBO KBHB ZBOH EJQBLTBLBO 0MFI LBSFOB JUV LJUB
MBS EJ NFTFOTFGBMPO EBO QPOT CBHJBO BUBT BLBO UFSCFCBT EBSJ EBQBU NFOHBOHHBQ CBIXB UJEVS NFMBMVJ CFSCBHBJ DBSB EBQBU
JOIJCJTJ ZBOH NFNVOHLJOLBO OVLMFJ QFOHBLUJWBTJ SFUJLVMBS JOJ NFNVMJILBO UJOHLBU BLUJWJUBT OPSNBM EBO LFTFJNCBOHBO
NFOKBEJ BLUJG TFDBSB TQPOUBO ,FBEBBO JOJ TFMBOKVUOZB BLBO OPSNBM EJ BOUBSB CFSCBHBJ CBHJBO TJTUFN TBSBG QVTBU )BM JOJ
NFSBOHTBOH LPSUFLT TFSFCSJ EBO TJTUFN TBSBG QFSJGFS ZBOH UBNQBLOZB TFQFSUJ LFBEBBO LFNCBMJ LF UJUJL OPM SF[FSPJOH

LFEVBOZB LFNVEJBO NFOHJSJNLBO CBOZBL TJOZBM VNQBO CBMJL QBEB TFCVBI LPNQVUFS ZBOH BLUJWJUBT MJTUSJLOZB BOBMPH EFOHBO
QPTJUJG LFNCBMJ LF OVLMFJ SFUJLVMFS ZBOH TBNB BHBS TJTUFN JOJ PUBL ZBOHEJQBLBJUFSVTNFOFSVT LBSFOBTFNVBKFOJTLPNQVUFS
UFUBQBLUJG0MFILBSFOBJUV CFHJUVUJNCVMLFBEBBOUFSKBHB BEB JOJ TFDBSB CFSUBIBQ BLBO LFIJMBOHBO HBSJT EBTBS LFSKBOZB
LFDFOEFSVOHBO TFDBSB BMBNJ VOUVL NFNQFSUBIBOLBO LFBEBBO DVLVQCFSBMBTBOVOUVLNFOHBOHHBQCBIXBFGFLFGFLZBOHTBNB
JOJNFMBMVJBLUJWJUBTVNQBOCBMJLQPTJUJGUFSTFCVU KVHB UJNCVM QBEB TJTUFN TBSBG QVTBU LBSFOB QFOHHVOBBO ZBOH
CFSMFCJIBO CFCFSBQB BSFB PUBL TFMBNB TJBHB EFOHBO NVEBI
,FNVEJBO TFTVEBI PUBL UFUBQ BLUJG TFMBNB CFCFSBQB KBN
NFOHHBOHHVLFTFJNCBOHBOTJTUFNTBSBGZBOHUFSTJTB
OFVSPOOFVSPO JUV TFOEJSJ EBMBN TJTUFN BLUJWBTJ NVOHLJO
NFOKBEJ MFUJI "LJCBUOZB TJLMVT VNQBO CBMJL QPTJUJG EJ BOUBSB 5JEVSEJQPTUVMBULBOVOUVLNFMBZBOJCBOZBLGVOHTJUFSNBTVL
OVLMFJ SFUJLVMBS NFTFOTFGBMPO EBO LPSUFLT BLBO NFNVEBS EBO
NBUVSBTJ QFSTBSBGBO
GBTJMJUBTJ QSPTFT CFMBKBS BUBV NFNP
QFOHBSVI QFSBOHTBOH UJEVS EBSJ QVTBU UJEVS BLBO NFOHBNCJM SJ
LPHOJTJ EBO
MBMVMJOUBT EBOJ FOFSHJ NFUBCPMJTNF
BMJI TFIJOHHB UJNCVM QFSBMJIBO ZBOH DFQBU EBSJ LFBEBBO KBHB 5FSEBQBUCFCFSBQBCVLUJVOUVLTFUJBQGVOHTJUFSTFCVU EFNJLJBO
NFOKBEJLFBEBBOUJEVS QVMBUVKVBOGJTJPMPHJTUJEVS OBNVOCVLUJZBOHNFOEVLVOHTFUJBQ
JEFUFSTFCVUNFSVQBLBOUBOUBOHBO,JUBEBQBUNFOHBOHHBQCBI
4FMVSVI UFPSJ JOJ EBQBU NFOKFMBTLBO UJNCVMOZB QFSBMJIBO
XB OJMBJ VUBNB UJEVS BEBMBI VOUVL NFNVMJILBO LFTFJNCBOHBO
ZBOH DFQBU EBSJ LFBEBBO UJEVS NFOKBEJ LFBEBBO KBHB EBO EBSJ
BMBNJ EJ BOUBSB QVTBUQVTBU OFVSPO /BNVO EFNJLJBO GVOHTJ
LFBEBBO KBHB NFOKBEJ LFBEBBO UJEVS 5FPSJ JOJ KVHB EBQBU
GJTJPMPHJT ZBOH TQFTJGJL EBSJ UJEVS NBTJI NFOKBEJ TVBUV NJTUFSJ
NFOKFMBTLBO LFBEBBO UFSCBOHVO EBSJ UJEVS BSPVTBM
LFBEBBO
EBOCBOZBLZBOHEBQBUEJUFMJUJEBSJLFHJBUBOUJEVSJOJ
JOTPNOJB ZBOH UJNCVM LFUJLB QJLJSBO TFTFPSBOH EJQFOVIJ PMFI
TVBUV QJLJSBO EBO LFBEBBO KBHB ZBOH EBQBU EJUJNCVMLBO PMFI
Gelombang Otak
BLUJWJUBTGJTJLUVCVI 1FSFLBNBNMJTUSJLEBSJQFSNVLBBOPUBLBUBVCBILBOEBOJQFSNVLB
BO MVBS LFQBMB EBQBU NFOVOKVLLBO BEBOZB BLUJWJUBT MJTUSJL ZBOH
Fungsi Fisiologis Tidur Belum Diketahui UFSVTNFOFSVT UJNCVM EBMBN PUBL *OUFOTJUBT EBO QPMB BLUJWJUBT MJT
USJL EJUFOUVLBO PMFI CFTBSOZB EFSBKBU FLTJUBTJ CFSCBHBJ CBHJBO PUBL
5FSEBQBU LFSBHVBO CBIXB UJEVS NFNQVOZBJ GVOHTJ QFOUJOH
ZBOHEJTFCBCLBOPMFIUJEVS LFBEBBOTJBHB EBOQFOZBLJUPUBLTFQFS
5JEVS UFSEBQBU QBEB TFNVB NBNBMJB EBO TFUFMBI UJEBL UJEVS
UJFQJMFQTJBUBVCBILBOQTJLPTJT(FMPNCBOHZBOHUFSFLBNEBMBNQP
TFDBSB UPUBM CJBTBOZB UFSEBQBU QFSJPEF LPNQFOTBTJ BUBV UFOTJBMMJTUSJL EBOEJQFSMJIBULBOEBMBN(BNCBS EJTFCVUHFMPN
CBOZBL UJEVS TFUFMBI LFLVSBOHBO UJEVS 3&. BUBV UJEVS CBOHPUBL EBOTFMVSVISFLBNBOEJTFCVUFMFLUSPFOTFGBMPHSBN &&(

HFMPNCBOHMBNCBU KVHB UFSEBQBU QFOJOHLBUBO QBEB UJOHLBUBO *OUFOTJUBT HFMPNCBOH PUBL ZBOH UFSFLBN EBSJ QFSNVLBBO LVMJU
UJEVS TQFTJGJL UFSTFCVU #BILBO IBNCBUBO SJOHBO VOUVL UJEVS LFQBMB CFSLJTBS BOUBSB TBNQBJ NJLSPWPMU EBO GSFLVFOTJOZB
ZBOH CFSMBOHTVOH CFCFSBQB IBSJ EBQBU NFOVSVOLBO LJOFSKB CFSLJTBSEBSJTBUVLBMJTFUJBQCFCFSBQBEFUJLTBNQBJLBMJBUBVMFCJI
LPHOJUJG NBVQVO GJTJL LFTFMVSVIBO QSPEVLUJWJUBT EBO LFTFIB QFS EFUJLOZB 4JGBU HFMPNCBOH JOJ CFSHBOUVOH QBEB CFTBSOZB
UBO TFTFPSBOH 1FOUJOHOZB UJEVS EBMBN IPNFPTUBTJT NVOHLJO BLUJWJUBT LPSUFLT TFSFCSJ ZBOH EJVLVS EBO HFMPNCBOH PUBL KFMBT
QBMJOH OZBUB EJEFNPOTUSBTJLBO PMFI BEBOZB GBLUB CBIXB UJLVT NFOHBMBNJQFSVCBIBOQBEBLFBEBBOTJBHBEBOUJEVSTFSUBLPNB
ZBOH LFLVSBOHBO UJEVS VOUVL TBNQBJ NJOHHV EBQBU NBUJ
-FQBT EBSJ LFOZBUBBO CBIXB UJEVS NFNBOH QFOUJOH QFOHFUB
IVBO LJUB UFOUBOH NFOHBQB UJEVS NFSVQBLBO CBHJBO FTFOTJBM
EBSJLFIJEVQBONBTJITBOHBUUFSCBUBT
,FBEBBO UJEVS NFOJNCVMLBO EVB NBDBN FGFL GJTJPMPHJT
VUBNB QFSUBNB FGFL QBEB TJTUFN TBSBGOZB TFOEJSJ EBO LFEVB
FGFL QBEB TJTUFN GVOHTJPOBM UVCVI MBJOOZB &GFL QBEB TJTUFN
TBSBG QVTBU UBNQBLOZB KBVI MFCJI QFOUJOH TFCBC TFUJBQ PSBOH
ZBOH NFOHBMBNJ USBOTFLTJ NFEVMB TQJOBMJT TFUJOHHJ MFIFS EBO
LBSFOBOZBUBLNFNQVOZBJTJLMVTUJEVSUFSKBHBEJCBXBIEBFSBI
QFNPUPOHBO
UJEBLBLBONFNQFSMJIBULBOFGFLZBOHCFSCBIBZB
50 mV
QBEB UVCVI EJ CBXBI UJOHLBU QFNPUPOHBO ZBOH EJBOHHBQ
NFSVQBLBOUFNQBUBTBMUJNCVMOZBTJLMVTUJEVSUFSKBHB
"LBO UFUBQJ LFLVSBOHBO UJEVS UFOUV TBKB BLBO NFNFOHBSVIJ
GVOHTJ TJTUFN TBSBG QVTBU ,FBEBBO UFSKBHB ZBOH CFSLFQBOKBOHBO
TFSJOHEJIVCVOHLBOEFOHBOHBOHHVBOQSPTFTCFSQJLJSZBOHQSPH
723
Unit XI Sistem Saraf: C. Neurofisiologi Motorik dan Integratif
4FDBSB VNVN HFMPNCBOH PUBL CFSTJGBU UBL UFSBUVS EBO UJEBL

NFNQVOZBJ QPMB TQFTJGJL ZBOH EBQBU UFSMJIBU EFOHBO KFMBT EBMBN
HBNCBSBO &&( 1BEB TBBU ZBOH MBJO UJNCVM QFSCFEBBO ZBOH KFMBT
EBO CFCFSBQB LFBEBBO JOJ NFSVQBLBO TJGBU ZBOH TQFTJGJL QBEB Gambar 59- 2 Pengertian gelombang alfa dengan gelombang
LFMBJOBOPUBL NJTBMOZBFQJMFQTJ ZBOHBLBOEJCJDBSBLBOOBOUJ beta bervoltase rendah yang asinkron sewaktu membuka mata.
1BEB PSBOH ZBOH TFIBU TFDBSB VNVN HFMPNCBOH &&( EBQBU
EJLMBTJGJLBTJLBO TFCBHBJ HFMPNCBOH BMGB CFUB UFUB EBO EFMUB ZBOH
UFSMJIBUQBEB(BNCBS PMFI OJMBJ UPUBM BLUJWJUBT MJTUSJL EBMBN PUBL 1BEB LFOZBUBBOOZB
(FMPNCBOH BMGB NFSVQBLBO HFMPNCBOH CFSJSBNB ZBOH UJNCVM TJOZBMTBSBGLVBUZBOHOPOTJOLSPOTFSJOHLBMJCFSTJGBUNFOJBEBLBO
QBEB GSFLVFOTJ BOUBSB EBO TJLMVT QFS EFUJL EBO EJKVNQBJ EJ TBUVTBNBMBJOEBMBNQFSFLBNBOHFMPNCBOHPUBLBLJCBUQPMBSJUBT
IBNQJSTFNVBSFLBNBO&&(PSBOHEFXBTBOPSNBMTBBUCBOHVOEBO ZBOHCFSMBXBOBO)BMJOJEJUVOKVLLBOEBMBN(BNCBS ZBOH
LFBEBBOUFOBOH ZBJUVJTUJSBIBUCFSQJLJS(FMPNCBOHJOJMFCJITFSJOH NFNQFSMJIBULBO CJMB NBUB EJUVUVQ QFMFQBTBO TJOLSPO CBOZBL
UFSKBEJ QBEB SFHJP PLTJQJUBM OBNVO EBQBU KVHB EJSFLBN EBSJ SFHJP OFVSPOEBMBNLPSUFLTTFSFCSJQBEBGSFLVFOTJTFLJUBSQFSEFUJL
QBSJFUBMEBOSFHJPGSPOUBMLVMJULFQBMB#FTBSWPMUBTFCJBTBOZBTFLJUBS TFIJOHHB NFOHIBTJMLBO HFMPNCBOH BMGB ,FNVEJBO LFUJLB NBUB
NJLSPWPMU4FMBNBUJEVSZBOHEBMBN HFMPNCBOHBMGBNFOHIJMBOH UFSCVLB BLUJWJUBT PUBL NFOKBEJ TBOHBU NFOJOHLBU OBNVO
TJOLSPOJTBTJ TJOZBM NFOKBEJ TBOHBU LFDJM TFIJOHHB HFMPNCBOH
#JMB QFSIBUJBO PSBOH ZBOH TVEBI CBOHVO EJUVKVLBO CBHJ CFCF
PUBL BLBO TBUJOH NFOJBEBLBO TBUV TBNB MBJO )BTJMOZB BEBMBI
SBQB UJQF BLUJWJUBT NFOUBM ZBOH TQFTJGJL HFMPNCBOH BMGB BLBO
HFMPNCBOH EFOHBO WPMUBTF ZBOH SFOEBI TFSUB GSFLVFOTJ ZBOH
EJHBOUJLBO PMFI HFMPNCBOH CFUB ZBOH BTJOLSPO EFOHBO GSFLVFOTJ
VNVNOZBMFCJIUJOHHJOBNVOUBLUFSBUVS ZBJUVHFMPNCBOHCFUB
ZBOHMFCJIUJOHHJEBOWPMUBTFZBOHMFCJISFOEBI(BNCBSNF
"TBM6TVM (FMPNCBOH "MGB (FMPNCBOH BMGB JOJ UJEBL BLBO
OVOKVLLBOFGFLQBEBHFMPNCBOHBMGBCJMBPSBOHNFNCVLBNBUBOZB
UJNCVM EJ LPSUFLT TFSFCSJ UBOQB BEBOZB IVCVOHBO LPSUFLT EFOHBO
EBMBNDBIBZBUFSBOHEBOLFNVEJBONFOVUVQNBUBOZBMBHJ1FSIBUJ
UBMBNVT 4FCBMJLOZB QFSBOHTBOHBO QBEB MBQJTBO OPOTQFTJGJL EJ
LBOCBIXBTFOTBTJWJTVBMTFHFSBNFOHIFOUJLBOHFMPNCBOHBMGBEBO
OVLMFJSFUJLVMFSZBOHNFOHFMJMJOHJUBMBNVTBUBVEJOVLMFJEBMBNZBOH
LFBEBBO JOJ EJHBOUJLBO PMFI HFMPNCBOH CFUB ZBOH BTJOLSPO EBO
EJGVTEJEBMBNUBMBNVT TFSJOHLBMJEBQBUNFODFUVTLBOHFMPNCBOH
CFSWPMUBTFSFOEBI
HFMPNCBOH MJTUSJL EBMBN TJTUFN UBMBNPLPSUJLBM QBEB GSFLVFOTJ
(FMPNCBOH CFUB UJNCVM QBEB GSFLVFOTJ MFCJI EBSJ TJLMVT QFS
BOUBSBEBOQFSEFUJL ZBOHNFSVQBLBOGSFLVFOTJBMBNJBIQBEB
EFUJL EBO EBQBU NFODBQBJ TJLMVT QFS EFUJL (FMPNCBOH JOJ
HFMPNCBOH BMGB 0MFI LBSFOB JUV EJZBLJOJ CBIXB HFMPNCBOH BMGB
UFSFLBN LIVTVTOZB EBSJ SFHJP QBSJFUBM EBO SFHJP GSPOUBM TFMBNB
UJNCVM LBSFOB BEBOZB PTJMBTJ VNQBO CBMJL TQPOUBO EBMBN TJTUFN
CBHJBOCBHJBOPUBLUFSTFCVUNFMBLVLBOBLUJWBTJZBOHTQFTJGJL
UBMBNPLPSUJLBM ZBOH EJGVT JOJ EBO LFNVOHLJOBO NFODBLVQ TJTUFN
(FMPNCBOH UFUB NFNQVOZBJ GSFLVFOTJ BOUBSB FNQBU EBO UVKVI
QFOHBLUJWBTJ SFUJLVMBS EJ CBUBOH PUBL KVHB 0TJMBTJ JOJ EJEVHB
TJLMVT QFS EFUJLOZB (FMPNCBOH JOJ OPSNBMOZB UJNCVM EJ SFHJP
NFOZFCBCLBO UJNCVMOZB QFSJPEJTJUBT HFMPNCBOH BMGB EBO BLUJWJUBT
QBSJFUBMEBOUFNQPSBMBOBLBOBL OBNVOEBQBUKVHBUFSKBEJTFMBNB
ZBOHTJOLSPOQBEBCFSKVUBKVUBOFVSPOLPSUJLBMEJTFUJBQHFMPNCBOH
TUSFT FNPTJPOBM QBEB PSBOH EFXBTB UFSVUBNB TFMBNB NFOHBMBNJ
"TBM6TVM(FMPNCBOH%FMUB1FNPUPOHBOUSBLUVTUSBLUVTTFSBU
LFLFDFXBBOEBOGSVTUSBTJ(FMPNCBOHUFUBKVHBUJNCVMQBEBCBOZBL
TBSBG EBSJ UBMBNVT LF LPSUFLT TFSFCSJ ZBOH NFOHIBNCBU BLUJWBTJ
HBOHHVBOPUBL TFSJOHLBMJQBEBLFBEBBOPUBLZBOHCFSEFHFOFSBTJ
UBMBNVT EJ LPSUFLT EBO ZBOH NFOHIJMBOHLBO HFMPNCBOH BMGB
(FMPNCBOH EFMUB NFMJQVUJ TFNVB HFMPNCBOH &&( EFOHBO CBHBJNBOBQVO KVHB UJEBL BLBO NFOHIBNCBU HFMPNCBOH EFMUB EJ
GSFLVFOTJ LVSBOH EBO TJLMVT QFS EFUJL EBO NFNJMJLJ WPMUBTF LPSUFLT ,FBEBBO JOJ NFOVOKVLLBO BEBOZB NFLBOJTNF ZBOH
TFCFTBSEVBTBNQBJFNQBULBMJWPMUBTFUJQFHFMPNCBOHPUBLMBJOOZB CFSKBMBO TJOLSPO EBMBN TJTUFN OFVSPOOFVSPO LPSUJLBM JUV TFOEJSJ
(FMPNCBOHJOJUFSKBEJQBEBTBBUUJEVSOZFOZBL QBEBCBZJ EBOQBEB ZBOH UFSVUBNB UJEBL CFSHBOUVOH QBEB TUSVLUVS PUBL CBHJBO CBXBI
QFOZBLJUPSHBOJLPUBLZBOHQBSBI(FMPNCBOHJOJKVHBUFSKBEJQBEB VOUVLNFOJNCVMLBOHFMPNCBOHEFMUB
IFXBOZBOHUFMBINFOHBMBNJUSBOTFLTJTVCLPSUJLBMZBOHNFNJTBI
(FMPNCBOH EFMUB KVHB UJNCVM TFMBNB UJEVS HFMPNCBOH MBNCBU
LBOLPSUFLTTFSFCSJEBSJUBMBNVT0MFILBSFOBJUV HFMPNCBOHEFMUB
ZBOH OZFOZBL LFBEBBO JOJ NFOJNCVMLBO EVHBBO CBIXB TFMBOKVU
EBQBU UJNCVM QBEB LPSUFLT EBO UBL CFSHBOUVOH QBEB BLUJWJUBT EJ
OZBLPSUFLTUFSVUBNBUFSCFCBTEBSJQFOHBSVIBLUJWBTJUBMBNVTEBO
SFHJPCBXBIPUBL
QVTBUQVTBUCBHJBOCBXBIMBJOOZB
Asal-Usul Gelombang Otak
Pengaruh Bermacam-Macam Tingkat Aktivasi
1FMFQBTBO HFMPNCBOH PMFI OFVSPO UVOHHBM BUBV TFSBU TBSBG
Serebrum pada Frekuensi EEG
UVOHHBMEBMBNPUBLUJEBLQFSOBIEBQBUEJSFLBNEBOJQFSNVLBBO
LFQBMB #BILBO SJCVBO CBILBO KVUBBO OFVSPO BUBV TFSBUTFSBU 5FSEBQBULPSFMBTJZBOHVNVNBOUBSBUJOHLBUBLUJWJUBTTFSFCSVNEBO
TBSBG IBSVT NFMFUVQ TFDBSB TJOLSPO CBSV LFNVEJBO QPUFOTJBM GSFLVFOTJ SBUBSBUB JSBNB &&( ZBJUV GSFLVFOTJ SBUBSBUB ZBOH NF
TFUJBQ OFVSPO BUBV TFSBUTFSBU CFSHBCVOH TFIJOHHB DVLVQ VOUVL OJOHLBUTFDBSBQSPHSFTJGTFTVBJEFOHBOQFOJOHHJBOCFTBSOZBBLUJWJ
EJSFLBN NFMBMVJ UVMBOH UFOHLPSBL +BEJ JOUFOTJUBT HFMPNCBOH UBT ,FBEBBO JOJ EJQFSMJIBULBO QBEB (BNCBS ZBOH
PUBL UFSVUBNB EJUFOUVLBO PMFI TFKVNMBI OFVSPO EBO TFSBU TBSBG NFOVOKVLLBO BEBOZB HFMPNCBOH EFMUB QBEB LFBEBBO TUVQPS
ZBOHNFMFUVQTFDBSBTJOLSPOTBUVTBNBMBJO EBOUJEBLEJUFOUVLBO BOFTUFTJB XBLUV QFNCFEBIBO EBO UJEVS ZBOH EBMBN HFMPNCBOH
UFUBQBEBLFBEBBO
724
Bab 59 Aktivitas Otak Tidur, Gelombang Otak, Epitepsi, Psikosis
QTJLPNPUPS EBO QBEB CBZJ HFMPNCBOH BMGB TFMBNB LFBEBBO TBOUBJ &QJMFQTJ EBQBU EJCBHJ EBMBN UJHB HPMPOHBO VUBNB FQJMFQTJ
EBO HFMPNCBOH CFUB TFMBNB QFSJPEF BLUJWJUBT NFOUBM ZBOH IFCBU HSBOENBM FQJMFQTJQFUJUNBM EBOFQJMFQTJGPLVT
4FMBNB QFSJPEF BLUJWJUBT NFOUBM HFMPNCBOH CJBTBOZB NFOKBEJ
BTJOLSPO EBO CVLBO TJOLSPO TFIJOHHB CFTBS WPMUBTF BLBO TBOHBU Epilepsi Grand mal
NFOVSVO XBMBVQVO BEB LFOBJLBO BLUJWJUBT LPSUJLBM ZBOH OZBUB &QJMFQTJ HSBOE NBM EJUBOEBJ EFOHBO QFMFQBTBO NVBUBO MJTUSJL ZBOH
UNIT XI
TFQFSUJZBOHUFSMJIBUEBMBN(BNCBS CFSMFCJIBOEBSJOFVSPOEJTFMVSVIBSFBPUBLEBMBNLPSUFLTTFSFCSJ
EJCBHJBOEBMBNTFSFCSVN EBOCBILBOEJCBUBOHPUBL+VHB NVBUBO
Perubahan EEG pada Berbagai Tahap Siaga dan Tidur MJTUSJL ZBOH EJLJSJNLBO NFMBMVJ TFNVB KBSBT LF NFEVMB TQJOBMJT
LBEBOHLBEBOHNFOJNCVMLBOLFKBOHUPOJLVNVNEJTFMVSVIUVCVI
(BNCBSNFNQFSMJIBULBOQPMB&&(EBSJTFTFPSBOHZBOHNFOHB TFSUBNFOKFMBOHBLIJSTFSBOHBOZBOHEJJLVUJPMFILPOUSBLTJPUPUPUPU
MBNJ UBIBQUBIBQ TJBHB EBO UJEVS ,FBEBBO TJBQ TJBHB EJUBOEBJ EF UPOJL EBO LFNVEJBO TQBTNPEJL TFDBSB CFSHBOUJBO ZBOH EJTFCVU
OHBOBEBOZBHFMPNCBOHCFUBCFSGSFLVFOTJUJOHHJ TFEBOHLBOLFBEBBO LFKBOHUPOJLLMPOJL4FSJOHLBMJQBTJFONFOHHJHJUBUBVNFOHVOZBI
TJBHBUFOBOHCJBTBOZBEJUBOEBJEFOHBOBEBOZBHFMPNCBOHBMGB ZBOH MJEBIOZB EBO EBQBU NFOHBMBNJ LFTVMJUBO EBMBN CFSOBQBT ZBOH
EJQFSMJIBULBOPMFIEVBSFLBNBO&&(QFSUBNBQBEBHBNCBSUFSTFCVU UFSLBEBOH NFOJNCVMLBO TJBOPTJT 4JOZBM ZBOH EJKBMBSLBO EBSJ PUBL
5BIBQ UJEVS HFMPNCBOH MBNCBU EJCBHJ EBMBN FNQBU UBIBQ 1BEB LFWJTFSBKVHBTFSJOHLBMJNFOJNCVMLBOQSPTFTNJLTJEBOEFGFLBTJ
UBIBQQFSUBNB ZBOHNFSVQBLBOUBIBQUJEVSSJOHBO OJMBJWPMUBTFHF ,FKBOH HSBOE NBM CJBTBOZB CFSMBOHTVOH TFMBNB CFCFSBQB EFUJL
MPNCBOH &&( NFOKBEJ SFOEBI (FMPNCBOH EJTFMJOHJ PMFI LVNQB TBNQBJNFOJU,FKBOHJOJKVHBEJUBOEBJEFOHBOLFBEBBOEFQSFTJ
SBO UJEVS TMFFQ TQJOEMFT
ZBLOJ MFUVQBO LVNQBSBO QFOEFL QBEB QBTDBLFKBOHEJTFMVSVITJTUFNTBSBGQBTJFOUFUBQEBMBNLFBEBBOTUV
HFMPNCBOHBMGB ZBOHUJNCVMTFDBSBQFSJPEJL1BEBUBIBQ EBO QPSTFMBNBTBNQBJCFCFSBQBNFOJUTFTVEBITFSBOHBOLFKBOHCFSBL
EBSJUJEVSHFMPNCBOHQFOEFL GSFLVFOTJ&&(TFDBSBQSPHSFTJGNFMBN IJSEBOLFNVEJBOTFSJOHLBMJUFUBQMFMBIEBOUFSUJEVSTFMBNBCFSKBN
CBU IJOHHB NFODBQBJ GSFLVFOTJ TFCFTBS TBUV TBNQBJ UJHB HFMPNCBOH KBNTFTVEBIOZB
QFSEFUJLQBEBUBIBQHFMPNCBOHJOJNFSVQBLBOHFMPNCBOHEFMUB 1BEBCBHJBOBUBT(BNCBSUBNQBLSFLBNBO&&(ZBOHLIBT
"LIJSOZB SFLBNBOQBEBCBHJBOCBXBI(BNCBS NFNQFSMJ QBEBIBNQJSTFNVBSFHJPLPSUFLTTFMBNBGBTFUPOJLTFSBOHBOHSBOE
IBULBO&&(TFMBNBUJEVS3&.,JUBTFSJOHLBMJTVMJUVOUVLNFNCF NBM (BNCBS JOJ NFOKFMBTLBO BEBOZB QFMFQBTBO JNQVMT CFSWPMUBTF
EBLBOBOUBSBQPMBHFMPNCBOHJOJEFOHBOQPMBZBOHUFSEBQBUQBEBTBBU EBO CFSGSFLVFOTJ UJOHHJ ZBOH UFSKBEJ EJ TFMVSVI LPSUFLT 4FMBOKVU
TFTFPSBOH TFEBOH BLUJG EBO UFSCBOHVO 1PMB HFMPNCBOH JOJ UJEBL ZB QBEB TBBU ZBOH CFSTBNBBO KVHB UJNCVM QFMFQBTBO JNQVMT ZBOH
UFSBUVS EBO CFSGSFLVFOTJ UJOHHJ ZBOH TFDBSB OPSNBM NFOVOKVLLBO TBNBEJLFEVBTJTJPUBL ZBOHNFOHHBNCBSLBOBEBOZBTJSLVJUOFV
BEBOZB EFTJOLSPOJTBTJ BLUJWJUBT TBSBG TFQFSUJ ZBOH EJUFNVLBO QBEB SPOBCOPSNBMZBOHCFSUBOHHVOHKBXBCBUBTUJNCVMOZBTFSBOHBOIF
LFBEBBO TJBHB 0MFI LBSFOB JUV UJEVS 3&. TFSJOH LBMJ EJTFCVU UJEVS CBU ZBOH NFMJCBULBO SFHJP CBTBM PUBL ZBOH NFOHFOEBMJLBO LFEVB
EFTJOLSPOJTBTJ LBSFOB UJEBL BEBOZB TJOLSPOJTBTJ EBMBN QFMFUVQBO TJTJTFSFCSVNTFDBSBCFSTBNBBO
OFVSPOOFVSPO NFTLJQVOBLUJWJUBTPUBLOZBDVLVQKFMBT 1BEB IFXBO QFSDPCBBO EBO CBILBO QBEB NBOVTJB TFSBOHBO
HSBOE NBM JOJ EBQBU EJUJNCVMLBO NFMBMVJ QFNCFSJBO [BU QFSBOH
TBOH OFVSPO TFQFSUJ PCBU QFOUJMFOUFUSB[PM 4FSBOHBO UFSTFCVU KVHB
Epilepsi EBQBU EJTFCBCLBO PMFI LFBEBBO IJQPHMJLFNJB BLJCBU JOTVMJO BUBV
PMFIBEBOZBBMJSBOMJTUSJLMBOHTVOHNFMBMVJPUBL1FSFLBNBOMJTUSJL
&QJMFQTJ ZBOHKVHBEJTFCVULFKBOHBZBO
EJUBOEBJEFOHBOBLUJWJUBT
QBEB UBMBNVT TFSUB QBEB GPSNBTJP SFUJLVMBSJT CBUBOH PUBL TFMBNB
CFSMFCJIBO ZBOH UJEBL UFSLFOEBMJ EBSJ TFCBHJBO BUBV TFMVSVI TJTUFN
TFSBOHBO HSBOE NBM NFOVOKVLLBO HBNCBSBO BLUJWJUBT CFSWPMUBTF
TBSBG QVTBU 0SBOH ZBOH NFNQVOZBJ GBLUPS QSFEJTQPTJTJ UJNCVMOZB
UJOHHJ ZBOH LIBT EJ LFEVB BSFB UFSTFCVU ZBOH TFSVQB EFOHBO
FQJMFQTJ BLBO NFOEBQBU TFSBOHBO CJMB OJMBJ CBTBM FLTJUBCJMJUBT TJTUFN
HBNCBSBOSFLBNBOEBSJLPSUFLTTFSFCSJ0MFILBSFOBJUV TFSBOHBO
TBSBG BUBV CBHJBO ZBOH QFLB UFSIBEBQ LFBEBBO FQJMFQTJ
NFOJOHLBU
HSBOENBMJOJNVOHLJOUJEBLIBOZBEJTFCBCLBOPMFIBLUJWBTJZBOH
EJBUBTOJMBJBNCBOHLSJUJTOZB4FMBNBCFTBSOZBFLTJUBCJMJUBTUFUBQEJ
BCOPSNBMQBEBUBMBNVTEBOLPSUFLTTFSFCSJUFUBQJKVHBEJTFCBCLBO
KBHBEJCBXBIOJMBJBNCBOHJOJ TFSBOHBOFQJMFQTJUJEBLBLBOUFSKBEJ
PMFI BLUJWBTJ ZBOH BCOPSNBM EJ CBHJBO CBUBOH PUBL QBEB TJTUFN
BLUJWBTJPUBLJUVTFOEJSJZBOHUFSMFUBLEJCBXBIUBMBNVT
100 mV
50 mV
l
50 mV
50 mV
725
Unit XI Sistem Saraf: C. Neurofisiologi Motorik dan Integratif
"QBZBOH.FNJDV5JNCVUOZB4FSBOHBO(SBOE.BM 4FCBHJBO OHBUDFQBUQBEBOFVSPOTFUFNQBUCJMBLFDFQBUBOQFMFQBTBOJNQVMT

CFTBS QBTJFO ZBOH NFOHBMBNJ TFSBOHBO HSBOE NBM NFNQVOZBJ JOJ NFMFCJIJ CFCFSBQB SBUVT QFS EFUJL HFMPNCBOH TJOLSPO BLBO
GBLUPS QSFEJTQPTJTJ IFSFEJUFS VOUVL FQJMFQTJ ZBLOJ LJSBLJSB EBSJ NVMBJNFOZFCBSEJTFMVSVISFHJPLPSUJLBMEJEFLBUOZB(FMPNCBOH
TFUJBQ TBNQBJ QFOEFSJUB 1BEB QBTJFO TFNBDBN JOJ GBLUPS JOJ NVOHLJO CFSBTBM EBOJ TJSLVJU SFWFSCFSBTJ TFUFNQBU ZBOH TFDBSB
GBLUPSZBOHEBQBUNFOJOHLBULBOFLTJUBCJMJUBTTJSLVJUFQJMFQUPHFOJL CFSUBIBQ NFNCVBU BSFB LPSUFLT EJ EFLBUOZB NFOKBEJ [POB MFQBT
BCOPSNBM ZBOH DVLVQ VOUVL NFOJNCVMLBO TFSBOHBO NFMJQVUJ
NVBUBOFQJMFQUJL1SPTFTJOJNFOZFCBSLFEBFSBIEJEFLBUOZBOHBO
SBOHTBOHBOFNPTJZBOHIFCBU
BMLBMPTJTBLJCBUQFSOBQBTBOZBOH LFDFQBUBOQBMJOHMBNCBUCFCFSBQBNJMJNFUFSQFSNFOJUEBOQBMJOH
CFSMFCJIBO
PCBUPCBUBO
EFNBN EBO
TVBSB CJTJOH BUBV DFQBUCFCFSBQBTFOUJNFUFSQFSEFUJL#JMBHFMPNCBOHFLTJUBTJTFNB
DBIBZBZBOHNFOZJMBVLBO DBN JOJ NFOZFCBS LF TFMVSVI LPSUFLT NPUPSJL HFMPNCBOH JOJ
#BILBO QBEB CFCFSBQB PSBOH ZBOH UJEBL NFNQVOZBJ GBLUPS OZFCBCLBO CBSJTBO LPOUSBLTJ PUPU ZBOH QSPHSFTJG EJ TFMVSVI TJTJ
QSFEJTQPTJTJHFOFUJL MFTJUSBVNBUJLEFOHBOKFOJTUFSUFOUVEJIBNQJS UVCVIZBOHCFSMBXBOBO ZBOHTFDBSBLIBTEJNVMBJEBSJSFHJPNVMVU
TFNVBCBHJBOPUBLEBQBUNFOJNCVMLBOLFMFCJMIBOFLTJUBCJMJUBTBSFB EBOTFDBSBQSPHSFTJGCFSVOUVONFOKBMBSLFCBXBITBNQBJLFUVOH
PUBL TFUFNQBU ZBOH BLBO LJUB CJDBSBLBO OBOUJ TFDBSB TJOHLBU LF LBJ OBNVOQBEBTBBUMBJOEBQBUNFOKBMBSLFBSBIZBOHCFSMBXBOBO
BEBBOJOJ KVHBLBEBOHLBEBOHNFOHIBOUBSLBOTJOZBMTJOZBMLFEB ,FBEBBOJOJEJTFCVUFQJMFQTJ+BDLTPO
MBNTJTUFNBLUJWBTJPUBLVOUVLNFOJNCVMLBOLFKBOHHSBOENBM 4FSBOHBOFQJMFQTJGPLVTEBQBUUFSCBUBTIBOZBEJTVBUVBSFBPUBL
OBNVO QBEB TFCBHJBO CFTBS LBTVT TJOZBM ZBOH LVBU EBOJ EBFSBI
"QBZBOH.FOHIFOUJLBO4FSBOHBO(SBOE.BM 1FOZFCBCUJN LPSUFLTZBOHNFOHBMBNJLFKBOHEBQBUNFSBOHTBOHCBHJBONFTFOTF
CVMOZB BLUJWJUBT ZBOH CFSMFCJIBO QBEB OFVSPO TFMBNB TFSBOHBO GBMJL TJTUFN BLUJWBTJ PUBL TFEFNJLJBO LVBUOZB TFIJOHHB TFSBOHBO
HSBOENBMNVOHLJOEJTFCBCLBOPMFIBLUJWBTJTJNVMUBOZBOHNBTJGEJ FQJMFQTJHSBOENBMKVHBUFSKBEJ
TFCBHJBO CFTBS KBSBT TBSBG ZBOH UFSKBMJO TBUV TBNB MBJO EJ TFMVSVI "EBUJQFMBJOFQJMFQTJGPLVTZBOHEJTFCVULFKBOHQTJLPNPUPSZBOH
PUBL 'BLUPS VUBNB ZBOH EJBOHHBQ EBQBU NFOHIFOUJLBO TFSBOHBO EBQBU NFOZFCBCLBO UJNCVMOZB
QFSJPEF BNOFTJB TJOHLBU

TFTVEBI CFCFSBQB NFOJU BEBMBI LFMFMBIBO OFVSPO 'BLUPS LFEVB TFSBOHBOLFNBSBIBOZBOHBCOPSNBM
BOTJFUBT SBTBUBLOZBNBO
ZBOH NVOHLJO BEBMBI JOIJCJTJ BLUJG PMFI OFVSPOOFVSPO JOIJCJUPS BUBVSBTBUBLVUZBOHUJNCVMNFOEBEBLEBOBUBV
CJDBSBJOLPIF
ZBOHEJBLUJWBTJPMFITFSBOHBOTFCFMVNOZB SFO ZBOH TJOHLBU BUBV CFSHVNBN EBSJ VOHLBQBO ZBOH CFSUFMFUFMF
USJUFQISBTF
,BEBOH QBTJFOUJEBLEBQBUNFOHJOHBUBLUJWJUBTZBOH
Epilepsi Petit Mal UFMBIEJMBLVLBOOZBTFMBNBTFSBOHBO OBNVOQBEBTBBUMBJO JBNF
&QJMFQTJQFUJUNBMIBNQJSTFMBMVNFMJCBULBOTJTUFNBLUJWBTJUBMBNP OZBEBSJ TFHBMB TFTVBUV ZBOH UFMBI EJMBLVLBO UFUBQJ UJEBL NBNQV
LPSUJLBM PUBL &QJMFQTJ JOJ CJBTBOZB EJUBOEBJ EFOHBO UJNCVMOZB NFOHFOEBMJLBOOZB4FSBOHBOLFKBOHUJQFJOJTFSJOHLBMJNFMJCBULBO
LFBEBBO UJEBL TBEBS BUBV QFOVSVOBO LFTBEBSBO
TFMBNB TBNQBJ CBHJBO MJNCJL PUBL TFQFSUJ IJQPLBNQVT BNJHEBMB TFQUVN EBO
EFUJL EBO TFMBNB XBLUV TFSBOHBO QBTJFO NFSBTBLBO LPOUSBLTJ BUBVCBHJBOLPSUFLTUFNQPSBMJT
BXBM TFQFSUJ LFEVUBO UXJUDIMJLF
ZBOH CJBTBOZB UFSKBEJ EJ EBFSBI #BHJBO UFSCBXBI (BNCBS NFMVLJTLBO &&( ZBOH LIBT
LFQBMB UFSVUBNB QFOHFEJQBO NBUB LFBEBBO JOJ TFMBOKVUOZB EJJLVUJ TFMBNB LFKBOH QTJLPNPUPS UFSKBEJ ZBOH NFNQFSMJIBULBO BEBOZB
EFOHBO LFNCBMJOZB LFTBEBSBO EBO UJNCVMOZB LFNCBMJ BLUJWJUBT HBNCBSBO HFMPNCBOH SFLUBOHVMFS CFSGSFLVFOTJ SFOEBI ZBLOJ
TFCFMVNOZB 3BOHLBJBO LFKBEJBO LFTFMVSVIBO JOJ EJTFCVU BCTFODF BOUBSB TBNQBJ HFMPNCBOH QFS EFUJL EBO UFSLBEBOH EJTFMJOHJ
TZOESPNFBUBVBCTFODFFQJMFQTZ1BTJFONFOHBMBNJTFSBOHBOTFQFSUJ EFOHBOHFMPNCBOHCFSGSFLVFOTJHFMPNCBOHQFSEFUJL
JOJ TBUV LBMJ EBMBN CFCFSBQB CVMBO BUBV QBEB LBTVT ZBOH KBSBOH &LTJTJ 1FNCFEBIBO QBEB 'PLVT'PLVT &QJMFQTJ 4FSJOH ,BMJ
EBQBU NFOHBMBNJ TFSBOHLBJBO TFSBOHBO ZBOH DFQBU ZBJUV TBUV EBQBU.FODFHBI,FKBOH&&(TFSJOHLBMJEBQBUEJQBLBJVOUVLNF
TFSBOHBOEJJLVUJPMFITFSBOHBOMBJOOZB4FSBOHBOQFUJUNBMCJBTBOZB OFOUVLBOUFNQBUBTBMEBSJHFMPNCBOHQBLVBCOPSNBM ZBOHUFSEB
UFSKBEJQFSUBNBLBMJQBEBBOBLBOBLNBTBQVCFSUBTEBONFOHIJMBOH QBUQBEBLFMBJOBOPUBLPSHBOJLZBOHNFSVQBLBOGBLUPSQSFEJTQPTJTJ
QBEB VNVS UBIVO ,BEBOH TFSBOHBO FQJMFQTJ QFUJU NBM EBQBU TFSBOHBOFQJMFQTJGPLVT#JMBUFNQBUJOJEBQBUEJUFNVLBO UJOEBLBO
NFNJDVUJNCVMOZBTFSBOHBOHSBOENBM FLTJTJQFNCFEBIBOQBEBGPLVTUFSTFCVUTFSJOHLBMJEBQBUNFODFHBI
1PMB HFMPNCBOH PUBL QBEB FQJMFQTJ QFUJU NBM EJQFSMJIBULBO TFSBOHBOCFSJLVUOZB
QBEB SFLBNBO EJ CBHJBO UFOHBI (BNCBS ZBOH EJUBOEBJ
EFOHBO BEBOZB QPMB LVCBI EBO QBLV TQJLF BOE EPNF QBUUFSO

(BNCBSBO LVCBI EBO QBLV JOJ EBQBU EJSFLBN EJ TFCBHJBO CFTBS Perilaku Psikosis dan Demensia--Peran Sistem
BUBV TFMVSVI CBHJBO LPSUFLT TFSFCSJ EBO NFOVOKVLLBO CBIXB Neurotransmiter Spesifik
LFKBOH ZBOH UJNCVM NFMJCBULBO TFCBHJBO CFTBS TJTUFN BLUJWBTJ
UBMBNPLPSUJLBM PUBL #BILBO QFSDPCBBO EFOHBO IFXBO NFOVO 1FOFMJUJBOLMJOJTUFSIBEBQCFSCBHBJQBTJFOEFOHBOHBOHHVBOQTJLP
KVLLBO CBIXB IBM JOJ EJIBTJMLBO EBOJ HFSBLBO PTJMBTJ EBSJ
TJT BUBV QBEB CFCFSBQB UJQFEFNFOTJB UFMBI NFOVOKVLLBO CBIXB
OFVSPO SFUJLVMFS UBMBNVT JOIJCJUPS ZBOH NFSVQBLBO OFVSPO LFCBOZBLBO LPOEJTJ UFSTFCVU EJTFCBCLBO PMFI QFOVSVOBO GVOHTJ
QFOHIBTJM<("#">BTBNHBNNBBNJOPCVUJSBUJOIJCJUPS
EBO
OFVSPOZBOHNFOZFLSFTJOFVSPUSBOTNJUFSTQFTJGJL0CBUPCBUBOUFS
OFVSPOUBMBNPLPSUJLBMEBOLPSUJLPUBMBNJLFLTJUBUPSJL UFOUV ZBOH NFOHBUBTJ LVSBOHOZBUSBOTNJUFS ZBOH CFSTBOHLVUBOJOJ
UFMBICFSIBTJMEJHVOBLBOVOUVLNFOHPCBUJCFCFSBQBQBTJFO
1BEB#BC LJUBUFMBINFNCBIBTNFOHFOBJQFOZFCBCQFOZBLJU
Epilepsi Fokus
1BSLJOTPO 1FOZBLJU JOJ EJTFCBCLBO IJMBOHOZB OFVSPOOFVSPO EJ
&QJMFQTJGPLVTEBQBUNFMJCBULBOIBNQJSTFUJBQCBHJBOPUBL CBJLSF TVCTUBOTJBOJHSBZBOHVKVOHTBSBGOZBNFOZFLSFTJEPQBNJOEJOVLMF
HJPTFUFNQBUQBEBLPSUFLTTFSFCSJBUBVTUSVLUVSTUSVLUVSZBOHMFCJI VT LBVEBUVT EBO QVUBNFO 1BEB #BC LJUB KVHB NFOFLBOLBO
EBMBNQBEBTFSFCSVSOEBOCBUBOHPUBL&QJMFQTJGPLVTQBMJOHTFSJOH CBIXBQBEBQFOZBLJU)VOUJOHUPO IJMBOHOZBOFVSPOZBOHNFOZFL
EJTFCBCLBOPMFIMFTJPSHBOJLTFUFNQBUBUBVBEBOZBLFMBJOBOGVOHTJ SFTJ("#"EBOOFVSPOZBOHNFOZFLSFTJBTFUJMLPMJONFOJNCVMLBO
POBM TFQFSUJ
KBSJOHBO QBSVU EJ PUBL ZBOH NFOEPSPOH KBSJOHBO QPMB NPUPSJL BCOPSNBM ZBOH LIBT CFTFSUB EFSOFOTJB QBEB QBTJFO
OFVSPOEJEFLBUOZB
BEBOZBUVNPSZBOHNFOFLBOEBFSBIPUBL ZBOHTBNB

SVTBLOZB TVBUV BSFB QBEB KBSJOHBO PUBL BUBV
LFMBJOBO TJS
LVJUTFUFNQBUZBOHEJQFSPMFITFDBSBLPOHFOJUBM
Depresi dan Psikosis Manik-Depresif—Penurunan
-FTJTFNBDBNJOJEBQBUNFOZFCBCLBOQFMFQBTBOJNQVMTZBOHTB Aktivitas Sistem Neurotransrniter Norepinefrin dan
Serotonin
726
Bab 59 Aktivitas Otak Tidur, Gelombang Otak, Epilepsi, Psikosi
%BSJ CBOZBL CVLUJ ZBOH UFMBI EJLVNQVMLBO UFSMJIBU CBIXB QTJLPTJT SFO EJTPTJBTJ QJLJSBO EBO VSVUBO CFSQJLJS ZBOH BCOPSNBM EBO
EFOHBOEFQSFTJNFOUBM ZBOHNFOHFOBJTFLJUBSKVUBPSBOHEJ"NFSJLB NFSFLB TFSJOH LBMJ NFOBSJL EBO LBEBOHLBEBOH EFOHBO TJLBQ
4FSJLBU NVOHLJO EJTFCBCLBO PMFI CFSLVSBOHOZB QFNCFOUVLBO UVCVIZBOHBCOPSNBMEBOCBILBOLBLV
OPSFQJOFGSJOBUBVTFSPUPOJOBUBVLFEVBOZBEJPUBL 4FLBSBOHUFMBIBEB 5FSEBQBU CFCFSBQB BMBTBO VOUVL NFNQFSDBZBJ CBIXB TLJ[P
CVLUJ ZBOH NFOVOKVLLBO TFDBSB UJEBL MBOHTVOH CBIXB NBTJI BEB GSFOJBEJTFCBCLBOPMFITBMBITBUVBUBVMFCJIEBSJUJHBLFNVOHLJ
UNIT XI
OFVSPUSBOTNJUFS MBJO ZBOH KVHB UFSMJCBU
1BTJFO EFQSFTJ NFOHBMBNJ OBOCFSJLVU
IBNCBUBOUFSIBEBQTJOZBMTJOZBMTBSBGEJCFSCB
HFKBMBHFKBMB SBTB TFEJI UJEBL CBIBHJB QVUVT BTB EBO TFOHTFOHTBSB HBJ BSFB QBEB MPCVT QSFGSPOUBMJT LPSUFLT TFSFCSJ BUBV LFHBHBMBO
4FMBJO JUV QBTJFO UFSTFCVU LFIJMBOHBO OBGTV NBLBO EBO EPSPOHBO GVOHTJ QFOHPMBIBO TJOZBM LBSFOB CBOZBL TJOBQT ZBOH UFSFLTJUBTJ
TFLTVBM TFSUB NFOHBMBNJ JOTPNOJB ZBOH CFSBU "HJUBTJ QTJLPNPUPS TFDBSB OPSNBM PMFI OFVSPUSBOTNJUFS HMVUBNBU LFIJMBOHBO SFT
TFSJOHLBMJEJIVCVOHLBOEFOHBOIBMIBMUFSTFCVUTFMBJOEFQSFTJ QPOTOZB UFSIBEBQ OFVSPUSBOTNJUFS JOJ
QFSBOHTBOHBO ZBOH
4FKVNMBI OFVSPO QFOZFLSFTJ OPSFQJOFGSJO UFSMFUBL EJ CBUBOH PUBL CFSMFCJIBO UFSIBEBQ TFLFMPNQPL OFVSPO ZBOH NFOZFLSFTJ
UFSVUBNB QBEB MPLVT TFSVMFVT /FVSPOOFVSPO JOJ NFOHJSJNLBO EPQBNJO EJ QVTBUQVTBU QFSJMBLV PUBL UFSNBTVL EJ MPCVT
TFSBCVUTFSBCVUOZBLFBUBTNFOVKVTFCBHJBOCFTBSTJTUFNMJNCJLPUBL GSPOUBMJT EBOBUBV
BCOPSNBMJUBT GVOHTJ EJ CBHJBOCBHJBO
UBMBNVT EBOLPSUFLTTFSFCSJ4FMBJOJUV CBOZBLOFVSPOQFOHIBTJMTFSP QFOUJOH QBEB TJTUFN QFOHBUVS QFSJMBLV MJNCJL ZBOH UFSQVTBU EJ
UPOJOZBOHUFSMFUBLEJQFSUFOHBIBOOVLMFJSBGFQBEBCBHJBOCBXBIQPOT TFLJUBSIJQPLBNQVT
EBO NFEVMB NFOHJSJNLBO TFSBCVUTFSBCVU LF TFKVNMBI CFTBS BSFB "MBTBOVOUVLNFNQFSDBZBJCBIXBMPCVTQSFGSPOUBMJTUFSMJCBU
TJTUFNMJNCJLEBOCFCFSBQBBSFBMBJOEJPUBL EBMBN TLJ[PGSFOJB BEBMBI CBIXB QPMB BLUJWJUBT NFOUBM ZBOH
"MBTBO VUBNB VOUVL NFNQFSDBZBJ CBIXB EFQSFTJ NVOHLJO NFOZFSVQBJ TLJ[PGSFOJB EBQBU EJDFUVTLBO QBEB LFSB EFOHBO
EJTFCBCLBOPMFIQFOVSVOBOBLUJWJUBTOFVSPOQFOZFLSFTJOPSFQJOFGSJO NFNCVBUMFTJMFTJLFDJMEJBSFBZBOHMVBTQBEBMPCVTQSFGSPOUBMJT
EBO TFSPUPOJO BEBMBI CBIXB PCBU ZBOH NFOHIBNCBU TFLSFTJ OPSFQJ %PQBNJO UFMBI EJEVHB TFCBHBJ LFNVOHLJOBO QFOZFCBC
OFGSJOEBOTFSPUPOJO TFQFSUJSFTFSQJO TFSJOHLBMJNFOZFCBCLBOEFQSF TLJ[PGSFOJBTFDBSBUJEBLMBOHTVOH LBSFOBCBOZBLQBTJFOEFOHBO
TJ 4FCBMJLOZB TFLJUBS QFSTFO QBTJFO EFQSFTJ EBQBU EJPCBUJ TFDBSB QFOZBLJU 1BSLJOTPO NFOHBMBNJ HFKBMBHFKBMB TFQFSUJ TLJ[PGSFOJB
FGFLUJGEFOHBOPCBUZBOHNFOJOHLBULBOFGFLFLTJUBTJOPSFQJOFGSJOEBO LFUJLBEJPCBUJEFOHBOPCBUZBOHEJTFCVU-EPQB0CBUJOJNFMF
TFSPUPOJOQBEBVKVOHVKVOHTBSBGDPOUPIOZB
JOIJCJUPSNPOPBNJO QBTLBO EPQBNJO EBMBN PUBL ZBOH TBOHBU CFSNBOGBBU VOUVL
PLTJEBTF ZBOH NFOHIBNCBU QFOHIBODVSBO OPSFQJOFGSJO EBO NFOHPCBUJQFOZBLJU1BSLJOTPO UFUBQJQBEBXBLUVZBOHCFSTBNB
TFSPUPOJO CFHJUV LFEVBOZB UFSCFOUVMD EBO
BOUJEFQSFTBO USJTJLMJL BOPCBUJOJKVHBNFOFLBOCFSCBHBJCBHJBOMPCVTQSFGSPOUBMJTEBO
TFQFSUJ JNJQSBNJO EBO BNJUSJQUJMJO ZBOH NFOHIBNCBU BNCJMBO BSFBMBJOZBOHUFSLBJU
LFNCBMJOPSFQJOFGSJOEBOTFSPUPOJOPMFIVKVOHVKVOHTBSBG TFIJOHHB 5FMBI EJEVHB CBIXB QBEB TLJ[PGSFOJB UFSKBEJ LFMFCJIBO
USBOTNJUFSUSBOTNJUFS JOJ EBQBU UFUBQ BLUJG VOUVL KBOHLB XBLUV MBNB EPQBNJOZBOHEJTFLSFTJLBOPMFITFLFMPNQPLOFVSPOQFOZFLSFTJ
TFUFMBIEJTFLSFTJ EPQBNJO ZBOH CBEBO TFMOZB UFSMFUBL EJ UFHNFOUVN WFOUSBM EJ
%FQSFTJ NFOUBM EBQBU EJPCBUJ EFOHBO UFSBQJ FMFLUSPLPOWVMTJG NFTFOTFGBMPO TFCFMBI NFEJBM EBO TVQFSJPS TVCTUBOTJB OJHSB
VNVNOZBEJTFCVUUFSBQJLFKUF1BEBUFSBQJJOJ BSVTMJTUSJLEJNBTVLLBO /FVSPOOFVSPO JOJ NFOHIBTJMLBO TJTUFN EPQBNJOFSHJL
LF PUBL VOUVL NFOJNCVMLBO LFKBOH VNVN ZBOH NJSJQ EFOHBO TFSB NFTPMJNCJL ZBOH NFOKVMVSLBO TFSBUTFSBU TBSBG EBO TFLSFTJ
OHBOFQJMFQTJ)BMJOJKVHBUFSCVLUJEBQBUNFNQFSLVBUBLUJWJUBTOPSF EPQBNJO LF CBHJBO NFEJBM EBO BOUFSJPS EBOJ TJTUFN MJNCJL
QJOFGJO LIVTVTOZB LF EBMBN IJQPLBNQVT BNJHEBMB OVLMFVT LBVEBUVT
#FCFSBQBQBTJFONFOEFSJUBEFQSFTJNFOUBMCFOUVLMBJOZBJUVEFQ BOUFSJPS EBOTFCBHJBOMPCVTQSFGSPOUBMJT4FNVBJOJNFSVQBLBO
SFTJEBONBOJBTFDBSBCFSHBOUJBO ZBOHEJTFCVUHBOHHVBOCJQPMBSBUBV QVTBUQVTBUQFOHBUVSUJOHLBIMBLVZBOHTBOHBUCFSQFOHBSVI
QTJLPTJT NBOJLEFQSFTJG EBO TFEJLJU QBTJFO ZBOH IBOZB NFNQFSMJIBU 4VBUV BMBTBO ZBOH MFCJI NFZBLJOLBO VOUVL NFNQFSDBZBJ
LBOFQJTPEFNBOJBUBOQBFQJTPEFEFQSFTJG0CBUPCBUZBOHNFOHVSB CBIXB TLJ[PGSFOJB NVOHLJO EJTFCBCLBO PMFI QSPEVLTJ EPQBNJO
OHJQFNCFOUVLBOBUBVNFOVSVOLBOLFSKBOPSFQJOFGSJOEBOTFSPUPOJO ZBOH CFSMFCJIBO BEBMBI CBOZBLOZB PCBU ZBOH CFSTJGBU FGFLUJG
TFQFSUJTFOZBXBMJUJVN EBQBUNFOKBEJPCBUZBOHFGFLUJGEBMBNNFOHP VOUVL NFOHPCBUJ TLJ[PGSFOJB TFQFSUJ LMPSQSPNB[JO IBMPQFSJEPM
CBUJGBTFNBOJLQBEBHBOHHVBOJOJ EBO UIJPUIJYFOF TFNVBOZB EBQBU NFOHVSBOHJ TFLSFTJ EPQBNJO
"EBBOHHBQBOCBIXBTJTUFNOPSFQJOFGSJOEBOTFSPUPOJOOPSNBM QBEB VKVOHVKVOH TBSBG EPQBNJOFSHJL BUBV NFOHVSBOHJ FGFL
OZBNFOJNCVMLBOEPSPOHBOCBHJBSFBMJNCJLEBMBNPUBLVOUVLNFN EPQBNJOQBEBOFVSPOCFSJLVUOZB
QFSLVBUSBTBOZBNBOTFTFPSBOH NFODJQUBLBOSBTBCBIBHJB SBTBQVBT "LIJSOZB CBSVCBSV JOJ UFMBI EJUFNVLBO LFNVOHLJOBO
OBGTVNBLBOZBOHCBJL EPSPOHBOTFLTVBMZBOHTFTVBJ EBOLFTFJNCB LFUFSMJCBUBO IJQPLBNQVT QBEB TLJ[PGSFOJB LBSFOB EBOJ
OHBOQTJLPNPUPSXBMBVQVOUFSMBMVCBOZBLIBMCBJLEBQBUNFOZFCBC QFOFMJUJBO UFMBI EJQFMBKBSJ CBIXB QBEB TLJ[PGSFOJB VLVSBO
LBO NBOJB ,FOZBUBBO ZBOH NFOEVLVOH LPOTFQ JOJ BEBMBI CBIXB IJQPLBNQVTTFSJOHLBMJCFSLVSBOHUFSVUBNBQBEBIFNJTGFSZBOH
QVTBUQVTBU HBOKBSBO EBO LFQVBTBO EJ IJQPUBMBNVT EBO EBFSBI TFLJ EPNJOBO
UBSOZBNFOFSJNBTFKVNMBICFTBSVKVOHTBSBGEBSJTJTUFNOPSFQJOFGSJO Penyakit Alzheimer—Plak Amiloid dan Berkurangnya
EBOTFSPUPOJO Memori
1FOZBLJU "M[IFJNFS EJOZBUBLBO TFCBHBJ QFOVBBO QSFNBUVS PUBL
CJBTBOZBEJNVMBJQBEBVTJBEFXBTBQFSUFOHBIBOEBOCFSMBOHTVOH
EFOHBODFQBUTBNQBJQBTJFONFOHBMBNJLFNVOEVSBONFOUBMZBOH
Skizofrenia—Mungkin Terjadi Fungsi yang Berlebihan pada IFCBUNJSJQEFOHBOZBOHUFSMJIBUQBEBPSBOHZBOHTBOHBU TBOHBU
Bagian Sistem Dopamin UVB (BNCBSBO LMJOJT QFOZBLJU "M[IFJNFS NFMJQVUJ
UJQF
BNOFTJB EFOHBO HBOHHVBO NFNPSJ
LFNVOEVSBO LFNBNQV
4LJ[PGSFOJB EBQBU UJNCVM EBMBN CBOZBL WBSJBTJ 1BEB TBMBI TBUV UJQF BO CFSCBIBTB EBO
EFGJTJU WJTVPTQBTJBM "COPSNBMJUBT NPUPSJL
UFSTFSJOH TFTFPSBOHNFSBTBNFOEFOHBSTVBSBTVBSBEBONFNJMJLJXB EBO TFOTPSJL HBOHHVBO EBMBN NFMBOHLBI EBO LFKBOH KBSBOH
IBNLFCFTBSBO SBTBUBLVUZBOHTBOHBUIFCBU BUBVKFOJTQFSBTBBOMBJO EJKVNQBJTBNQBJQBEBUBIBQMBOKVUQFOZBLJUJO4BUVUFNVBOZBOH
ZBOHUJEBLOZBUB,FCBOZBLBOPSBOHZBOHNFOEFSJUBTLJ[PGSFOJBCFSTJ LPOTJTUFO QBEB QFOZBLJU "M[IFJNFS BEBMBI IJMBOHOZB OFVSPO
GBUTBOHBUQBSBOPJE EJTFSUBJEFOHBOQFSBTBBOUFSTBLJUJBLJCBUIBMIBMEJ OFVSPOZBOHNFOKBEJCBHJBOEBSJTJTUFNMJNCJLZBOHNFOEVLVOH
MVBSEJSJOZB1FOEFSJUBEBQBUNFOHBMBNJLFBEBBOCJDBSBZBOHJOLPIF QSPTFT NFOHJOHBU )JMBOHOZB GVOHTJ NFNPSJ JOJ TBOHBU NFOH
HBOHHVQFOEFSJUB
727
Unit XI Sistem Sarat C. Neurofisiologi Motorik dan Integratif
1FOZBLJU"M[IFJNFSBEBMBITVBUVLFMBJOBOEFHFOFSBTJTBSBGZBOH TJ EJBCFUFT EBO IJQFSMJQJEFNJB KVHB EJZBLJOJ EBQBU NFOJOHLBULBO

QSPHSFTJG EBO GBUBM ZBOH CFSBLJCBU QBEB UJNCVMOZB HBOHHVBO LF SJTJLPUFSLFOBQFOZBLJU"M[IFJNFS
NBNQVBO TFTFPSBOH VOUVL NFMBLVLBO BLUJWJUBT TFIBSJIBSJ TFSUB
CFSCBHBJ HFKBMB OFVSPQTJLJBUSJL EBO HBOHHVBO QFSJMBLV QBEB UBIBQ Daftar Pusataka
ZBOHMFCJIMBOKVUEBOJQFOZBLJUJOJ1BTJFOEFOHBOQFOZBLJU"M[IFJ Beenhakker MP, Huguenard JR: Neurons that fire together also conspire
NFSCJBTBOZBNFNCVUVILBOQFSBXBUBOZBOHLPOUJOVTFMBNBCFCSB together: is normal sleep circuitry hijacked to generate epilepsy?
QBUBIVOCFHJUVQFOZBLJUJOJUJNCVM Neuron 62:612, 2009.
1FOZBLJU"M[IFJNFSNFSVQBLBOCFOUVLEFNFOTJBUFSTFSJOHQBEB Brayne C: The elephant in the room—healthy brains in later life, epidemiol-
MBOTJB EBO MFCJI EBSJ KVUB PSBOH EJ "NFSJLB 4FSJLBU EJQFSLJSBLBO ogy and public health, Nat Rev Neurosci 8:233, 2007.
NFOEFSJUBLFMBJOBOJOJ1FSTFOUBTFPSBOHEFOHBOQFOZBLJU"M[IFJNFS Canli T, Lesch KP: Long story short: the serotonin transporter in emotion
LJSBLJSB OBJL EVB LBMJ MJQBU TFUJBQ MJNB UBIVO LFOBJLBO VTJB ZBJUV regulation and social cognition, Nat Neurosci 10:1103, 2007.
TFLJUBSQFSTFOQBEBVTJBUBIVOEBOTFLJUBSQFSTFOQBEBVTJB Casserly I, Topol E: Convergence of atherosclerosis and Alzheimer’s disease:
inflammation, cholesterol, and misfolded proteins, Lancet 363:1139,
UBIVO
2004.
1FOZBLJU "M[IFJNFS %JTFCBCLBO PMFI "LVNVMBTJ 1FQUJEB Cirelli C: The genetic and molecular regulation of sleep: from fruit flies to
"NZMPJE#FUB EJ 0UBL 4FDBSB IJTUPQBUPMPHJ LJUB NFOFNVLBO humans, Nat Rev Neurosci 10:549, 2009.
Cummings JL: Alzheimer’s disease, N Engl J Med 351:56, 2004.
QFOJOHLBUBOKVNMBIQFQUJEBBNZMPJECFUBEJPUBLTFTFPSBOHEFOHBO
de la Torre JC: Is Alzheimer’s disease a neurodegenerative or a vascular dis-
QFOZBLJU "M[IFJNFS 1FQUJEB UFSTFCVU NFOVNQVL TFCBHBJ QMBL
order? Data, dogma, and dialectics, Lancet Neurol 3:184, 2004.
BNZMPJE EFOHBO EJBNFUFS ZBOH CFSWBSJBTJ EBSJ VN TBNQBJ Golde TE: Alzheimer disease therapy: can the amyloid cascade be halted?,
CFCFSBQBSBUVTNJLSPNFUFSEBOEJUFNVLBOTFDBSBMVBTEJPUBL ZBOH J Clin Invest 111:11, 2003.
NFMJQVUJ LPSUFLT TFSFCSJ IJQPLBNQVT HBOHMJB CBTBMJT UBMBNVT EBO Iadecola C, Park L, Capone C: Threats to the mind: aging, amyloid, and
CBILBOTFSFCFMVN+BEJ QFOZBLJU"M[IFJNFSUBNQBLOZBNFSVQBLBO hypertension, Stroke 40(3 Suppl):S40, 2009.
TVBUVQFOZBLJUEFHFOFSBUJGNFUBCPMJL Iadecola C: Neurovascular regulation in the normal brain and in Alzheimer’s
1FSBOVUBNBVOUVLBLVNVMBTJCFSMFCJIQFQUJEBBNZMPJECFUBQBEB disease, Nat Rev Neurosci 5:347–360, 2004.
QBUPHFOFTJT QFOZBLJU "M[IFJNFS EJQFSLJSBLBO PMFI QFOHBNBUBO Jacob TC, Moss SJ, Jurd R: GABA(A) receptor trafficking and its role in the
CFSJLVU JOJ
TFNVB NVUBTJ ZBOH EJLFUBIVJ BLIJSBLIJS JOJ EBO dynamic modulation of neuronal inhibition, Nat Rev Neurosci 9:331, 2008.
UFSLBJU EFOHBO QFOZBLJU "M[IFJNFS NFOZFCBCLBO QFOJOHLBUBO Kilduff TS, Lein ES, de la Iglesia H, et al: New developments in sleep
research: molecular genetics, gene expression, and systems neurobiol-
QSPEVLTJ QFQUJEB BNZMPJECFUB
QBTJFO EFOHBO USJTPNJ
ogy, J Neurosci 28:11814, 2008.
TJOESPN%PXO
NFNJMJLJUJHBTBMJOBOHFOVOUVLQSPUFJOQSFLVSTPS Krueger JM, Rector DM, Roy S, et al: Sleep as a fundamental property of
BNZMPJE EBO NFOHBMBNJ HFKBMB OFVSPMPHJT ZBOH LIBT QBEB QFOZBLJU neuronal assemblies, Nat Rev Neurosci 9:910, 2008.
"M[IFJNFS QBEB VTJB QFSUFOHBIBO
QBTJFO EFOHBO LFMBJOBO HFO McCormick DA, Contreras D: On the cellular and network bases of epileptic
ZBOH NFOHFOEBMJLBO BQPMJQPQSPUFJO & ZBJUV TVBUV QSPUFJO EBSBI seizures, Annu Rev Physiol 63:815, 2001.
ZBOH NFOHBOHLVU LPMFTUFSPM LF KBSJOHBO MFCJI DFQBU NFOVNQVL Ressler KJ, Mayberg HS: Targeting abnormal neural circuits in mood and
BNZMPJE EBO TBOHBU NFOJOHLBULBO SJTJLP VOUVL UFSLFOB QFOZBLJU anxiety disorders: from the laboratory to the clinic, Nat Neurosci
"M[IFJNFS
UJLVTUSBOTHFOJLZBOHNFNQSPEVLTJQSPUFJOQSFLVS 10:1116, 2007.
TPS BNZMPJE TFDBSB CFSMFCJIBO NFNJMJLJ QFOVSVOBO LFNBNQVBO Seeman P: Glutamate and dopamine components in schizophrenia,
CFMBKBS EBO NFOHJOHBU BLJCBU BLVNVMBTJ QMBL BNZMPJE EBO
J Psychiatry Neurosci 34:143, 2009.
Selkoe DJ: Alzheimer disease: mechanistic understanding predicts novel
QFNCFSJBO BOUJCPEJ BOUJBNZMPJE QBEB PSBOH EFOHBO QFOZBLJU
therapies, Ann Intern Med 140:627, 2004.
"M[IFJNFSUBNQBLOZBEBQBUNFOHIBNCBUQFSKBMBOBOQFOZBLJUJOJ
Smith EE, Greenberg SM: Beta-amyloid, blood vessels, and brain function
,FMBJOBO 7BTLVMBS EBQBU MLVU .FNQFSQBSBI 1FOZBLJU 40:2601, 2009.
"M[IFJNFS "EB TFKVNMBI CFTBS CVLUJ ZBOH NFOVOKVLLBO CBIXB Steinlein OK: Genetic mechanisms that underlie epilepsy, Nat Rev Neurosci
5:400–408, 2004.
QFOZBLJU TFSFCSPWBTLVMFS BLJCBU IJQFSUFOTJ EBO BUFSPTLMFSPTJT EBQBU
Tononi G, Cirelli C: Staying awake puts pressure on brain arousal systems,
JLVU CFSQFSBO QBEB QFSKBMBOBO QFOZBLJU "M[IFJNFS 1FOZBLJU TFSF J Clin Invest 117:3648, 2007.
CSPWBTLVMFS NFSVQBLBO QFOZFCBC UFSCBOZBL LFEVB EBSJ EFNFOTJB Viswanathan A, Rocca WA, Tzourio C: Vascular risk factors and dementia:
EBOHBOHHVBOLPHOJUJGZBOHEJEBQBUEBOBHBLOZBJLVUNFOJNCVMLBO how to move forward? Neurology 72:368, 2009.
QFOVSVOBO LPHOJUJG QBEB QFOZBLJU "M[IFJNFS #BILBO CBOZBL GBL Zacchigna S, Lambrechts D, Carmeliet P: Neurovascular signalling defects
UPSSJTJLPUFSTFSJOHVOUVLQFOZBLJUTFSFCSPWBTLVMFS TFQFSUJIJQFSUFO in neurodegeneration, Nat Rev Neurosci 9:169, 2008.
728
BAB 60
UNIT XI
4JTUFN4BSBG0UPOPNEBO.FEVMB"ESFOBM
4JTUFN TBSBG PUPOPN BEBMBI Anatomi Fisiologi Sistem Saraf Simpatis

CBHJBO TJTUFN TBSBG ZBOH (BNCBSNFOVOKVLLBOTVTVOBOVNVNCBHJBOQFSJGFSTJTUFN
NFOHBUVS TFCBHJBO CFTBS TBSBGTJNQBUJT5BNQBLTFDBSBLIVTVTEJEBMBNHBNCBSBEBMBI

GVOHTJWJTFSBMUVCVI4JTUFNJOJ TBMBI TBUV EBSJ EVB SBOUBJ HBOHMJB QBSBWFSUFCSBM TJNQBUJT ZBOH
UFSTBNCVOH EFOHBO TBSBG TQJOBM EJ TJTJ LPMVNOB WFSUFCSBMJT

NFNCBOUV NFOHBUVS UFLBOBO
EVBHBOHMJBQSFWFSUFCSBM TFMJBLBEBOIJQPHBTUSJLVT
EBO
TBSBG
BSUFSJ NPUJMJUBT EBO TFLSFTJ
TBSBGZBOHNFOZFCBSEBSJHBOHMJBLFCFSCBHBJPSHBOJOUFSOBM
HBTUSPJOUFTUJOBM QFOHPTPOHBO
LBOEVOH LFNJI CFSLFSJOHBU TVIV UVCVI TFSUB CBOZBL BLUJWJUBT 4FSBUTFSBU TBSBG TJNQBUJT CFSBXBM EJ NFEVMB TQJOBMJT CFSTBNB
MBJOCFCFSBQBEJBOUBSBOZBIBNQJSTFQFOVIOZBEJBUVSPMFITJTUFN EFOHBOTBSBGTBSBGTQJOBMEJBOUBSBTFHNFONFEVMBTQJOBMJT5EBO
- EBOCFSKBMBONVMBNVMBLFSBOUBJTJNQBUJT VOUVLTFMBOKVUOZB
TBSBGPUPOPN TFEBOHLBOZBOHMBJOTFCBHJBOTBKB
LF KBSJOHBOKBSJOHBO EBO PSHBOPSHBO ZBOH EJSBOHTBOH PMFI TBSBG
4BMBI TBUV TJGBU TJTUFN TBSBG PUPOPN ZBOH QBMJOH NFOPOKPM TBSBGTJNQBUJT
BEBMBI LFDFQBUBO EBO JOUFOTJUBTOZB EBQBU NFOHVCBI GVOHTJ
WJTFSBMEBMBNXBLUVTJOHLBU$POUPIOZB EBMBNXBLUVTBNQBJ
EFUJL TBKB TJTUFN JOJ EBQBU NFOJOHLBULBO GSFLVFOTJ EFOZVU Neuron Simpatis Preganglion dan Postganglion
4BSBG TJNQBUJT CFSCFEB EFOHBO TBSBG NPUPSJL TLFMFUBM EBMBN IBM
KBOUVOH EVB LBMJ EBSJ OPSNBM EBO UFLBOBO BSUFSJ EBQBU
CFSJLVU4FUJBQKBSBTTJNQBUJTEBSJNFEVMBTQJOBMJTLFKBSJOHBOZBOH
EJHBOEBLBOEBMBNXBLUVTBNQBJEFUJLBUBV QBEBDPOUPI
UFSBOHTBOHUFSEJSJBUBTEVBOFVSPO OFVSPOQSFHBOHMJPOEBOOFVSPO
FLTUSFN MBJO UFLBOBO BSUFSJ EBMBN XBLUV TBNQBJ EFUJL QPTUHBOHMJPO CFSCFEB EFOHBO KBSBT NPUPSJL TLFMFUBM ZBOH IBOZB
EBQBU EJUVSVOLBO CFHJUV SFOEBI TFIJOHHB NFOZFCBCLBO NFNJMJLJTBUVOFVSPO#BEBOTFMTFUJBQOFVSPOQSFHBOHMJPOUFSMFUBL
QJOHTBO#FSLFSJOHBUEBQBUUFSKBEJEBMBNXBLUVCFCFSBQBEFUJL EJ LPSOV JOUFSNFEJPMBUFSBM NFEVMB TQJOBMJT TFSBUTFSBUOZB TFQFSUJ
EBO QFOHPTPOHBO LBOEVOH LFNJI TFDBSB JOWPMVOUFS KVHB UBNQBL EBMBN (BNCBS CFSKBMBO NFMBMVJ SBEJLT BOUFSJPS
UFSKBEJEBMBNXBLUVCFCFSBQBEFUJL NFEVMBTQJOBMJTNFOVKVTBSBGTQJOBMZBOHUFSLBJU
4FHFSB TFUFMBI TBSBG TQJOBM NFOJOHHBMLBO LBOBMJT TQJOBMJT
TFSBUTFSBU QSFHBOHMJPO TJNQBUJT NFOJOHHBMLBO TBSBG TQJOBM EBO
CFSKBMBO NFMBMVJ SBNVT QVUJI NBTVL LF TBMBI TBUV HBOHMJB SBOUBJ
Susunan Umum Sistem Saraf Otonom TJNQBUJT 4FMBOKVUOZB TFSBUTFSBU JOJ EBQBU NFOFNQVI TBMBI TBUV
EBSJ UJHB QFSKBMBOBO TFCBHBJ CFSJLVU
4FSBUTFSBU EBQBU
CFSTJOBQTEFOHBOOFVSPOQPTUHBOHMJPOTJNQBUJTEJHBOHMJPOZBOH
4JTUFN TBSBG PUPOPN UFSVUBNB EJBLUJGLBO PMFI QVTBUQVTBU EJNBTVLJOZB
4FSBUTFSBUEBQBUCFSKBMBOLFBUBTBUBVLFCBXBI
ZBOHUFSMFUBLEJNFEVMBTQJOBMJT CBUBOHPUBL EBOIJQPUBMBNVT EBMBN SBOUBJ EBO CFSTJOBQT EJ TBMBI TBUV HBOHMJB MBJO SBOUBJ
+VHB CBHJBO LPSUFLT TFSFCSJ LIVTVTOZB LPSUFLT MJNCJL EBQBU UFSTFCVU BUBV
TFSBU JUV EBQBU CFSKBMBO NFOFNQVI KBSBL ZBOH
NFOHIBOUBSLBO TJOZBM LF QVTBUQVTBU ZBOH MFCJI SFOEBI CFSCFEBCFEBNFMBMVJSBOUBJUFSTFCVUEBOLFNVEJBONFMBMVJTBMBI
TFIJOHHBEFOHBOEFNJLJBONFNFOHBSVIJQFOHBUVSBOPUPOPN TBUV TBSBG TJNQBUJT NFOZFCBS LFMVBS EBSJ SBOUBJ VOUVL BLIJSOZB
4JTUFN TBSBG PUPOPN TFSJOH LBMJ KVHB CFLFSKB NFMBMVJ SFGMFLT CFSTJOBQTEJTVBUVHBOHMJPOTJNQBUJTQFSJGFS
WJTFSBM "SUJOZB TJOZBMTJOZBM TFOTPSJL CBXBI TBEBS EBSJ TVBUV +BEJ OFVSPO QPTUHBOHMJPO TJNQBUJT CFSBTBM EBSJ TBMBI TBUV
HBOHMJBSBOUBJTJNQBUJTBUBVEBSJTBMBITBUVHBOHMJBTJNQBUJTQFSJGFS
PSHBOWJTFSBMEBQBUNFNBTVLJHBOHMJBPUPOPN CBUBOHPUBL BUBV
%BSJLFEVBTVNCFSJOJ TFSBUTFSBUQPTUHBOHMJPOLFNVEJBOCFSKBMBO
IJQPUBMBNVT EBO LFNVEJBO NFOHFNCBMJLBO SFTQPOT SFGMFLT LFUFNQBUUVKVBOOZBEJCFSCBHBJPSHBO
CBXBI TBEBS MBOHTVOH LF PSHBO WJTFSBM JUV VOUVL NFOHBUVS
BLUJWJUBTOZB Serat-Serat Saraf Simpatis pada Saraf 4LFMFU 4FCBHJBO TFSBU
QPTUHBOHMJPOJL CFSKBMBO LFNCBMJ EBSJ SBOUBJ TJNQBUJT LF TBSBGTBSBG
4JOZBMPUPOPNJLFGFSFOEJIBOUBSLBOLFCFSCBHBJPSHBOUVCVI TQJOBMNFMBMVJSBNJLFMBCVEJTFNVBUJOHLBUNFEVMBTQJOBMJT TFQFSUJ
NFMBMVJ EVB TVCEJWJTJ VUBNB ZBOH EJTFCVU TJTUFN TBSBG TJNQBUJT UBNQBL EBMBN (BNCBS 4FNVB TFSBU TJNQBUJT JOJ NFSVQBLBO
EBO TJTUFN TBSBG QBSBTJNQBUJT ZBOH TJGBUTJGBU EBO GVOHTJOZB TFSBU UJQF $ ZBOH TBOHBU LFDJM EBO NFOZFCBS LF TFMVSVI CBHJBO
BLBOEJKFMBTLBOCFSJLVUJOJ UVCVICFSTBNBEFOHBOTBSBGTLFMFUBM4FSBUTFSBUJOJNFOHBUVSQFN
729
Unit Xl Sistem Saraf: C. Neurofisiologi Motorik dan lntegratif
CVMVIEBSBI LFMFOKBSLFSJOHBU EBOPUPUQJMPFSFLUPSSBNCVU,JSBLJSB

QFSTFOTFSBUEBMBNTBSBGTLFMFUBMBEBMBITFSBUTJNQBUJT NFOVOKVLLBO
QFOUJOHOZBTFSBUTFSBUTJNQBUJT
8
Pembagian Segmental Serat Saraf Simpatis.
T-1
+BSBT TJNQBUJT ZBOH CFSBTBM EBSJ CFSCBHBJ TFHNFO NFEVMB TQJOBMJT
UJEBL TFMBMV UFSTFCBS LF CBHJBO UVCVI ZBOH TBNB TFQFSUJ IBMOZB
TBSBGTBSBG TQJOBM TPNBUJL EBSJ TFHNFO ZBOH TBNB +VTUSV TFSBU
TJNQBUJT EBSJ NFEVMB TQJOBMJT QBEB TFHNFO 5 VNVNOZB OBJL
12 NFMFXBUJSBOUBJTJNQBUJTVOUVLCFSBLIJSEJEBFSBILFQBMBEBSJ5
CFSBLIJS EJ MFIFS EBSJ 5 5 54 EBO 5 LF UPSBLT EBSJ 5
5 5 5 EBO5LFBCEPNFOEBOEBSJ5 - EBO-
LF UVOHLBJ 1FNCBHJBO JOJ IBOZB LVSBOH MFCJI EFNJLJBO EBO
TFCBHJBOCFTBSTBMJOHUVNQBOHUJOEJI
L-1 4FCBSBOTBSBGTJNQBUJTLFTFUJBQPSHBOEJUFOUVLBOTFCBHJBOPMFI
MPLVTEJEBMBNFNCSJP UFNQBUPSHBOUFSTFCVUCFSBTBM$POUPIOZB
5 KBOUVOHNFOFSJNBCBOZBLTFSBUTBSBGTJNQBUJTEBSJSBOUBJTJNQBUJT
CBHJBO MFIFS LBSFOB KBOUVOH CFSBTBM EBSJ EBFSBI MFIFS FNCSJP
TFCFMVN NFOHBMBNJ USBOTMPLBTJ LF EBMBN UPSBLT %FNJLJBO QVMB
PSHBOPSHBO BCEPNFO NFOFSJNB TFCBHJBO CFTBS QFSTBSBGBO
5 TJNQBUJTOZB EBSJ NFEVMB TQJOBMJT TFHNFO UPSBLBM CBHJBO CBXBI
LBSFOBTFCBHJBOCFTBSVTVTQSJNJUJGCFSBTBMEBSJEBFSBIJOJ
Sifat-Sifat Khusus Ujung Saraf Simpatis dalam Medula
Adrenal.
4FSBU TBSBG QSFHBOHMJPO TJNQBUJT CFSKBMBO UBOQB CFSTJOBQT TFKBL EBSJ
TFMTFM LPSOV JOUFSNFEJPMBUFSBM NFEVMB TQJOBMJT NFMBMVJ SBOUBJ
TJNQBUJT LFNVEJBO NFMFXBUJ OFSWVT TQMBOHOJLVT EBO CFSBLIJS EJ
EVBNFEVMBBESFOBM%JNFEVMBBESFOBM TFSBUTFSBUTBSBGJOJMBOHTVOH
CFSBLIJS QBEB TFMTFM OFVSPO LIVTVT ZBOH NFOZFLSFTJ FQJOFGSJO EBO
OPSFQJOFGSJO LF EBMBN BMJSBO EBSBI 4FDBSB FNCSJPMPHJT TFMTFM
TFLSFUPSJLJOJCFSBTBMEBSJKBSJOHBOTBSBGEBOTFCFOBSOZBNFSVQBLBO
OFVSPOQPTUHBOHMJPOCBILBOTFMTFMJOJNBTJINFNQVOZBJTFSBUTFSBU
TBSBGZBOHSVEJNFOUFS EBOVKVOHTFSBUTFSBUJOJMBIZBOHNFOZFLSFTJ
IPSNPOBESFOBM FQJOFGSJOEBOOPSFQJOFGSJO
Posterior root
Anatomi Fisiologi Sistem Saraf Parasimpatis
Intermedio- 4JTUFN TBSBG QBSBTJNQBUJT TFQFSUJ UBNQBL EBMBN (BNCBS
lateral horn NFNQFSMJIBULBO TFSBUTFSBU QBSBTJNQBUJT NFOJOHHBMLBO TJTUFN
TBSBG QVTBU NFMBMVJ TBSBG LSBOJBM *** 7** *9 EBO 9 TFSBU
QBSBTJNQBUJT MBJOOZB NFOJOHHBMLBO CBHJBO QBMJOH CBXBI NFEVMB
TQJOBMJT NFMBMVJ TBSBG TBLSBM TQJOBM LFEVB EBO LFUJHB EBO LBEBOH
TBSBG TBLSBM QFSUBNB EBO LFFNQBU ,JSBLJSB QFSTFO EBSJ
TFMVSVI TFSBU TBSBG QBSBTJNQBUJT UFSEBQBU EBMBN OFSWVT WBHVT
TBSBG LSBOJBM 9
CFSKBMBO LF TFMVSVI SFHJP UPSBLT EBO BCEPNFO
0MFI LBSFOB JUV ZBOH UFSVUBNB EJBOHHBQ TFCBHBJ TJTUFN TBSBG
QBSBTJNQBUJTPMFIQBSBQBLBSGJTJPMPHJBEBMBILFEVBOFSWVTWBHVT
/FSWVT WBHVT NFOZVQMBJ TBSBG QBSBTJNQBUJT LF KBOUVOH QBSV
FTPGBHVT MBNCVOH TFMVSVIVTVTIBMVT TFUFOHBICBHJBOQSPLTJNBM
LPMPO IBUJ LBOEVOH FNQFEV QBOLSFBT HJOKBM EBO CBHJBO BUBT
VSFUFS
4FSBCVUQBSBTJNQBUJTEJTBSBGLSBOJBMUJHBCFSKBMBOLFTGJOHUFSQVQJM
EBOPUPUTJMJBSJTNBUB4FSBUTFSBUZBOHCFSBTBMEBSJTBSBGLSBOJBMUVKVI
CFSKBMBO LF LFMFOKBS MBLSJNBMJT OBTBMJT EBO TVCNBOEJCVMBSJT
4FNFOUBSBTFSBUTFSBUZBOHCFSBTBMEBSJTBSBGLSBOJBMTFNCJMBOCFSKBMBO
LFLFMFOKBSQBSPUJT
730
Bab 60 Sistem Saraf Otonom dan Medula Adrenal
Sifat-Sifat Dasar Fungsi Simpatis dan

Parasimpatis
UNIT XI
Serat-Serat Kolinergik dan Adrenergik - Sekresi
Asetilkolin atau Norepinefrin
4FSBU TBSBG TJNQBUJT EBO QBSBTJNQBUJT UFSVUBNB NFOZFLSFTJ
TBMBITBUVEBSJEVBCBIBOUSBOTNJUFSTJOBQT BTFUJMLPMJOBUBV
OPSFQJOFGSJO4FSBUTFSBUZBOHNFOZFLSFTJBTFUJMLPMJOEJTFCVU
TFSBU LPMJOFSHJL 4FSBUTFSBU ZBOH NFOZFLSFTJ OPSFQJOFGSJO
EJTFCVUTFSBUBESFOFSHJL TVBUVJTUJMBIZBOHCFSBTBMEBSJLBUB
BESFOBMJO OBNBMBJOCBHJFQJOFGSJO
4FNVB OFVSPO QSFHBOHMJPO CFSTJGBU LPMJOFSHJL QBEB
TJTUFN TBSBG TJNQBUJT NBVQVO QBSBTJNQBUJT "TFUJMLPMJO
BUBV [BU NFOZFSVQBJ BTFUJMLPMJO CJMB EJCFSJLBO QBEB
HBOHMJB BLBO NFSBOHTBOH OFVSPO QPTUHBOHMJPO TJNQBUJT
EBO QBSBTJNQBUJT 4FNVB BUBV IBNQJS TFNVB OFVSPO
QPTUHBOHMJPO TJTUFN QBSBTJNQBUJT KVHB CFSTJGBU LPMJOFSHJL
4FCBMJLOZB TFCBHJBO CFTBS OFVSPO QPTUHBOHMJPO TJNQBUJT
CFSTJGBU BESFOFSHJL /BNVO TFSBUTFSBU TBSBG QPTUHBOHMJPO
TJNQBUJTZBOHLFLFMFOKBSLFSJOHBU LFPUPUPUPUQJMPFSFLUPS
SBNCVU EBOLFTFEJLJUQFNCVMVIEBSBICFSTJGBULPMJOFSHJL
+BEJ VKVOHTBSBGUFSNJOBMEBOTJTUFNQBSBTJNQBUJTTFNVB
BUBV TVOHHVITVOHHVI TFNVB NFOZFLSFTJ BTFUJMLPMJO
4FCBHJBO CFTBS VKVOH TBSBG TJNQBUJT NFOZFLSFTJ
OPSFQJOFGSJO OBNVO IBOZB TFEJLJU NFOZFLSFTJ BTFUJMLPMJO
/FVSPUSBOTNJUFSOFVSPUSBOTNJUFS JOJ TFCBMJLOZB CFLFSKB
QBEBCFSCBHBJPSHBOVOUVLNFOJNCVMLBOFGFLTJNQBUJTBUBV
QBSBTJNQBUJTZBOHTFTVBJ0MFILBSFOBJUV BTFUJMLPMJOEJTFCVU
USBOTNJUFSQBSBTJNQBUJT EBOOPSFQJOFGSJOEJTFCVUUSBOTNJUFS
TJNQBUJT 4USVLUVS NPMFLVMBS BTFUJMLPMJO EBO OPSFQJOFGSJO
BEBMBITFCBHBJCFSJLVU
4FSBUTFSBUQBSBTJNQBUJTTBLSBMCFSBEBEJTBSBGQFMWJL ZBOHCFSKBMBO
NFMBMVJTBSBGTQJOBMQMFLTVTTBLSBMJTEJTFUJBQTJTJNFEVMBTQJOBMJTQBEB
TFHNFO4EBO44FSBUUFSTFCVULFNVEJBONFOZFCBSLBOTFSBUTFSBU
QFSJGFSOZB LF LPMPO EFTFOEFO SFLUVN LBOEVOH LFNJI EBO CBHJBO
CBXBIVSFUFS,FMPNQPLTFSBUQBSBTJNQBUJTTBLSBMJOJKVHBNFOZVQMBJ
TJOZBMTJOZBMTBSBGLFHFOJUBMJBFLTUFSOBVOUVLNFOJNCVMLBOFSFLTJ +
CH3
Neuron Preganglion dan Postganglion Parasimpatis.
4FQFSUJ IBMOZB TJTUFN TJNQBUJT TJTUFN QBSBTJNQBUJT KVHB NFNQVOZBJ
CH3 C O CH2 CH2 N
OFVSPOQSFHBOHMJPOEBOQPTUHBOHMJPO/BNVO LFDVBMJQBEBCFCFSBQB CH3
TBSBG LSBOJBM QBSBTJNQBUJT TFSBU QSFHBOHMJPO UBOQB NFOHBMBNJ O CH3
IBNCBUBOCFSKBMBONFOVKVPSHBOPSHBOZBOHEJBUVSOZB1BEBEJOEJOH Asetilkolin
PSHBO UFSEBQBU OFVSPO QPTUHBOHMJPO 4FSBU QSFHBOHMJPO CFSTJOBQT
EFOHBO OFVSPO QPTUHBOHMJPO EBO TFSBU QPTUHBOHMJPO ZBOH TBOHBU
HO
QFOEFL CFSVLVSBOQBOKBOHTBUVQFSTFLJBONJMJNFUFSTBNQBJCFCFSBQB
TFOUJNFUFS NFOJOHHBMLBO OFVSPO VOUVL NFOZBSBGJ KBSJOHBO PSHBO
-FUBL OFVSPO QPTUHBOHMJPO QBSBTJNQBUJT EBMBN PSHBO WJTFSBM TBOHBU HO CH CH2 NH2
CFSCFEB EFOHBO TVTVOBO HBOHMJB TJNQBUJT LBSFOB CBEBO TFM OFVSPO
QPTUHBOHMJPO TJNQBUJT IBNQJS TFMBMV UFSMFUBL EBMBN HBOHMJB SBOUBJ OH
TJNQBUJTBUBVEBMBNCFSCBHBJHBOHMJBMBJOOZBZBOHNFNBOHBEBEBMBN
Norepinefrin
BCEPNFO CVLBOEBMBNPSHBOZBOHEJSBOHTBOHOZB
731
Mekanisme Sekresi dan Pemindahan Transmiter 3. Pengangkutan dopamin ke vesikel

Selanjutnya pada Ujung Postganglion Hidroksilasi
Sekresi Asetilkolin dan Norepinefrin oleh Ujung Saraf 4. Dopamin ææææ Norepinefrin
Postganglion. #FCFSBQB VKVOH TBSBG PUPOPN QPTUHBOHMJPO
UFSVUBNB EBSJ TBSBG QBSBTJNQBUJT NFNBOH NJSJQ OBNVO %J NFEVMB BESFOBM SFBLTJ JOJ CFSMBOKVU TBUV UBIBQ MBHJ VOUVL
VLVSBOOZB KBVI MFCJI LFDJM EBSJQBEB UBVU OFVSPNVTLVMBS NFOHVCBITFLJUBSQFSTFOOPSFQJOFGSJONFOKBEJFQJOFGSJO ZBLOJ
TLFMFUBM /BNVO CBOZBL TFSBU TBSBG QBSBTJNQBUJT EBO IBNQJS TFCBHBJCFSJLVU
TFNVB TFSBU TJNQBUJT IBOZB CFSTJOHHVOHBO EFOHBO TFMTFM Metilasi
FGFLUPS EBSJ PSHBO ZBOH EJQFSTBSBGJOZB BUBV QBEB CFCFSBQB 5. Norepinefrin æææææ Epinrfrin
DPOUPI TFSBUTFSBUJOJCFSBLIJSQBEBKBSJOHBOJLBUZBOHMFUBLOZB
CFSEFLBUBO EFOHBO TFMTFM ZBOH EJSBOHTBOHOZB %J UFNQBU 4FUFMBI OPSFQJOFGSJO EJTFLSFTJLBO PMFI VKVOHVKVOH TBSBG
GJMBNFO JOJ NFOZFOUVI BUBV CFSKBMBO BUBV NFOEFLBUJ TFM ZBOH UFSNJOBM LFNVEJBO EJQJOEBILBO EBSJ UFNQBU TFLSFTJOZB NFMBMVJ
BLBO EJSBOHTBOH CJBTBOZB UFSEBQBU TVBUV QFNCFTBSBO UJHB DBSB
NFMBMVJ QSPTFT USBOTQPS BLUJG EJBNCJM LFNCBMJ LF
NFNCVMBU EJTFCVU WBSJLPTJUBT EJ EBMBN WBSJLPTJUBT JOJ WFTJLFM EBMBN VKVOH TBSBG BESFOFSHJL NFOZFCBCLBO QFOZJOHLJSBO
USBOTNJUFSBTFUJMLPMJOBUBVOPSFQJOFGSJOEJTJOUFTJTEBOEJTJNQBO TBNQBJ QFSTFO OPSFQJOFGSJO ZBOH EJTFLSFTJ
CFSEJGVTJ LFMVBS
%J EBMBN WBSJLPTJUBT JOJ KVHB UFSEBQBU TFKVNMBI CFTBS EBSJ VKVOH TBSBG LF EBMBN DBJSBO UVCVI EJ TFLFMJMJOHOZB EBO
NJUPLPOESJB ZBOH NFOZVQMBJ BEFOPTJO USJGPTGBU ZBOH LFNVEJBO LF EBMBN EBSBI NFOZFCBCLBO QFOZJOHLJSBO TFCBHJBO
EJCVUVILBO VOUVL FOFSHJ QBEB TJOUFTJT BTFUJMLPMJO BUBV CFTBS TJTB OPSFQJOFGSJO ZBOH BEB EBO
TFKVNMBI LFDJM
OPSFQJOFGSJO EJIBODVSLBOPMFIFO[JN TBMBITBUVOZBBEBMBINPOPBNJOPLTJEBTF
ZBOH UFSEBQBU EJ VKVOHVKVOH TBSBG EBO FO[JN LBUFLPM0NFUJM
#JMBBEBQFOKBMBSBOQPUFOTJBMBLTJEJTFQBOKBOHTFSBUUFSNJOBM
USBOTGFSBTF ZBOHNFOZFCBSEJTFMVSVIKBSJOHBO

QSPTFTEFQPMBSJTBTJNFOJOHLBULBOQFSNFBCJMJUBTNFNCSBOTFSBU
TBSBG UFSIBEBQ JPO LBMTJVN TFIJOHHB NFNQFSNVEBI JPOJPO #JBTBOZB OPSFQJOFGSJO ZBOH EJTFLSFTJ MBOHTVOH LF EBMBN
UFSTFCVU CFSEJGVTJ LF VKVOH TBSBG BUBV WBSJLPTJUBT TBSBG *PO KBSJOHBO UFUBQ BLUJG IBOZB VOUVL CFCFSBQB EFUJL NFOVOKVLLBO
LBMTJVN TFMBOKVUOZB NFOZFCBCLBO VKVOHVKVOH TBSBG BUBV CBIXB QSPTFT QFOHBNCJMBO LFNCBMJ OPSFQJOFGSJO EBO
WBSJLPTJUBT NFOHPTPOHLBO JTJOZB LFMVBS %FOHBO EFNLJBO QFOZFCBSBOOZB LFMVBS EBSJ KBSJOHBO CFSMBOHTVOH DFQBU /BNVO
USBOTNJUFSEJTFLSFTJ OPSFQJOFGSJO EBO FQJOFGSJO ZBOH EJTFLSFTJ LF EBMBN EBSBI PMFI
NFEVMB BESFOBM UFUBQ BLUJG TBNQBJ CFSEJGVTJ LF TVBUV KBSJOHBO
Sintesis Asetilkolin, Penghancurannya Setelah Sekresi, UFNQBU NFSFLB EBQBU EJIBODVSLBO PMFI LBUFLPM0NFUJM
dan Lama Kerjanya. "TFUJMLPMJOEJTJOUFTJTEJVKVOHUFSNJOBMEBO USBOTGFSBTFQFSJTUJXBJOJUFSVUBNBUFSKBEJEJIBUJ0MFILBSFOBJUV
WBSJLPTJUBT TFSBU TBSBG LPMJOFSHJL UFNQBU CBIBO UFSTFCVU CJMBEJTFLSFTJLFEBMBNEBSBI CBJLOPSFQJOFGSJONBVQVOFQJOFGSJO
EJTJNQBO EFOHBO LFQFLBUBO UJOHHJ EJ EBMBN WFTJLFM TFCFMVN BLBO UFUBQ BLUJG TFMBNB TBNQBJ EFUJL OBNVO BLUJWJUBTOZB
EJMFQBTLBO 3FBLTJ LJNJB EBTBS TJOUFTJT JOJ BEBMBI TFCBHBJ NFOVSVOTBNQBJIJMBOHEBMBNXBLUVTBNQBJCFCFSBQBNFOJU
CFSJLVU
Transferasi Reseptor pada Organ Efektor
Asetil-KoA+Kolin asetil kolin Asetilkolin 4FCFMVNBTFUJMLPMJO OPSFQJOFGSJO BUBVFQJOFGSJOZBOHEJTFLSFTJEJ
VKVOH TBSBG PUPOPN EBQBU NFSBOHTBOH TVBUV PSHBO FGFLUPS
#FHJUV EJTFLSFTJLBO LF EBMBN KBSJOHBO PMFI VKVOH TBSBG UFSMFCJIEBIVMVIBSVTCFSJLBUBOEFOHBOSFTFQUPSTQFTJGJLQBEBTFM
LPMJOFSHJL BTFUJMLPMJO BLBO NFOFUBQ EBMBN KBSJOHBO TFMBNB TFM FGFLUPS 3FTFQUPS JOJ UFSEBQBU EJ CBHJBO MVBS NFNCSBO TFM
CFCFSBQB EFUJL TFNFOUBSB NFMBLVLBO GVOHTJ USBOTNJTJ TJOZBM UFSJLBU TFCBHBJ LFMPNQPL QSPTUFUJL QBEB NPMFLVM QSPUFJO ZBOH
TBSBG,FNVEJBOTFCBHJBOCFTBSEJQFDBINFOKBEJJPOBTFUBUEBO NFOFNCVT TFMVSVI NFNCSBO TFM ,FUJLB [BU USBOTNJUFS CFSJLBUBO
LPMJO EJLBUBMJTJT PMFI FO[JN BTFUJMLPMJOFTUFSBTF ZBOH CFSJLBUBO EFOHBOSFTFQUPS UFSKBEJQFSVCBIBOLPOGPSNBTJPOBMQBEBTUSVLUVS
EFOHBO LPMBHFO EBO HMJLPTBNJOPHMJLBOT EBMBN KBSJOHBO JLBU NPMFLVM QSPUFJO ,FNVEJBO NPMFLVM QSPUFJO ZBOH CFSVCBI JOJ
TFUFNQBU .FLBOJTNF JOJ TBNB EFOHBO NFLBOJTNF USBOTNJTJ NFSBOHTBOH BUBV NFOHIBNCBU TFM QBMJOH TFSJOH EFOHBO

TJOZBMBTFUJMLPMJOEBOQFOHIBODVSBOBTFUJMLPMJOTFMBOKVUOZBZBOH NFOZFCBCLBO QFSVCBIBO QFSNFBCJMJUBT NFNCSBO TFM UFSIBEBQ
UFSKBEJ QBEB UBVU OFVSPNVTLVMBS EJ TFSBU TBSBG TLFMFUBM ,PMJO TBUV BUBV MFCJI JPO BUBV
NFOHBLUJGLBO BUBV NFOPOBLUJGLBO
ZBOH UFSCFOUVL LFNVEJBO EJBOHLVU LFNCBMJ LF VKVOH TBSBG FO[JN ZBOH NFMFLBU QBEB VKVOH MBJO QSPUFJO SFTFQUPS EJ NBOB
UFSNJOBM UFNQBU CBIBO JOJ EJQBLBJ LFNCBMJ VOUVL TJOUFTJT SFTFQUPSJOJNFOPOKPMLFCBHJBOEBMBNTFM
BTFUJMLPMJOZBOHCBSV
Sintesis Norepinefrin, Penyingkirannya, dan Lama Perangsangan atau Penghambatan Sel Efektor dengan
Kerjanya 4JOUFTJT OPSFQJOFGSJO EJNVMBJ EJ BLTPQMBTNB VKVOH Mengubah Permeabilitas Membran. 0MFI LBSFOB QSPUFJO
TBSBG UFSNJOBM EBSJ TFSBU TBSBG BESFOFSHJL OBNVO SFTFQUPSNFSVQBLBOCBHJBOJOUFHSBMEBSJNFNCSBOTFM QFSVCBIBO
EJTFNQVSOBLBOEJEBMBNWFTJLFMTFLSFTJ5BIBQUBIBQEBTBSOZB LPOGPSNBTJPOBM QBEB TUSVLUVS QSPUFJO SFTFQUPS TFSJOH LBMJ
BEBMBITFCBHBJCFSJLVU NFNCVLB BUBV NFOVUVQ LBOBM JPO NFMBMVJ TFMBTFMB NPMFLVM
Hidroksilasi
QSPUFJO EFOHBO EFNJLJBO NFOHVCBI QFSNFBCJMJUBT NFNCSBO TFM
1. Tirosin ææææÆ Dopa UFSIBEBQCFSCBHBJJPO4FCBHBJDPOUPI LBOBMJPOOBUSJVNEBOBUBV
Dekarboksilasi LBMTJVN TFSJOH LBMJ NFOKBEJ UFSCVLB EBO NFNVOHLJOLBO
2. Dopa æææÆ Dopamin NBTVLOZBJPOJPOUFSTFCVUEFOHBODFQBULFEBMBNTFM ZBOHCJBTB
732
Bab 60 Sistem Saraf Otonom dari Medula Adrenal
OZBBLBONFOEFQPMBSJTBTJNFNCSBOTFMEBONFSBOHTBOHTFM1BEB UPSCFUB CFUB EBOCFUBLBSFOBBEBCBIBOLJNJBUFSUFOUVZBOH

TBBU MBJO LBOBM LBMJVN UFSCVLB TFIJOHHB NFNVOHLJOLBO JPO IBOZB NFNFOHBSVIJ SFTFQUPS CFUB UFSUFOUV +VHB UFSEBQBU
LBMJVN CFSEJGVTJ LFMVBS EBSJ TFM EBO CJBTBOZB IBM JOJ BLBO QFNCBHJBOSFTFQUPSBMGB NFOKBEJSFTFQUPSBMGBEBOBMGB
NFOHIBNCBU TFM LBSFOB LFIJMBOHBO JPO LBMJVN FMFLUSPQPTJUJG
NFOZFCBCLBO IJQFSOFHBUJWJUBT EJ EBMBN TFM 1BEB TFCBHJBO TFM /PSFQJOFGSJO EBO FQJOFGSJO LFEVBOZB EJTFLSFTJ LF EBMBN
UNIT XI
QFSVCBIBO MJOHLVOHBO JPO JOUSBTFM BLBO NFOZFCBCLBO LFSKB TFM EBSBIPMFINFEVMBBESFOBM NFNQVOZBJQFOHBSVIZBOHTFEJLJU
JOUFSOBM TFQFSUJ FGFL MBOHTVOH JPO LBMTJVN EBMBN NFOJNCVMLBO CFSCFEBEBMBNNFSBOHTBOHSFTFQUPSBMGBEBOCFUB/PSFQJOFGSJO
LPOUSBLTJPUPUQPMPT UFSVUBNBNFSBOHTBOHSFTFQUPSBMGBOBNVOLVSBOHNFSBOHTBOH
SFTFQUPSCFUB4FCBMJLOZB FQJOFGSJONFSBOHTBOHLFEVBSFTFQUPS
Kerja Reseptor melalui Pengubahan Enzim "Caraka JOJ IBNQJS TBNB LVBUOZB 0MFI LBSFOB JUV QFOHBSVI SFMBUJG
Kedua" Intrasel. $BSBMBJOTVBUVSFTFQUPSEBQBUCFSGVOHTJTFSJOH OPSFQJOFGSJO EBO FQJOFGSJO QBEB CFSCBHBJ PSHBO FGFLUPS
LBMJ BEBMBI EFOHBO NFOHBLUJGLBO BUBV NFOPOBLUJGLBO TVBUV EJUFOUVLBO PMFI KFOJT SFTFQUPS ZBOH UFSEBQBU EBMBN PSHBO
FO[JN BUBV[BULJNJBJOUSBTFMMBJOOZB
EJEBMBNTFM&O[JNTFSJOH UFSTFCVU #JMB TFMVSVI SFTFQUPS BEBMBI SFTFQUPS CFUB NBLB
LBMJNFMFLBUQBEBQSPUFJOSFTFQUPSEJNBOBSFTFQUPSNFOPOKPMLF FQJOFGSJOBLBONFOKBEJQFSBOHTBOHZBOHMFCJIFGFLUJG
CBHJBO EBMBN TFM 4FCBHBJ DPOUPI QFOHJLBUBO OPSFQJOFGSJO 5BCFMNFOHHBNCBSLBOEJTUSJCVTJSFTFQUPSBMGBEBOCFUB
EFOHBO SFTFQUPSOZB QBEB CBHJBO MVBS TFM NFOJOHLBULBO BLUJWJUBT EBMBNCFSCBHBJPSHBOEBOTJTUFNZBOHEJLFOEBMJLBOPMFITBSBG
FO[JN BEFOJMJM TJLMBTF QBEB CBHJBO EBMBN TFM EBO IBM JOJ TJNQBUJT 1FSIBUJLBO CBIXB SFTFQUPS BMGB UFSUFOUV CFSGVOHTJ
NFOZFCBCLBO QFNCFOUVLBO BEFOPTJO NPOPGPTGBU TJLMJL D".1
FLTJUBTJ TFEBOHLBO ZBOH MBJOOZB CFSGVOHTJ JOIJCJTJ %FNJLJBO
D".1 LFNVEJBO EBQBU NFOHBXBMJ TBMBI TBUV LFSKB EBSJ TFLJBO KVHB SFTFQUPSCFUBUFSUFOUVCFSGVOHTJFLTJUBTJEBOZBOHMBJOOZB
CBOZBL BLUJWJUBT JOUSBTFM ZBOH CFSCFEBCFEB FGFL QBTUJOZB CFSGVOHTJJOIJCJTJ0MFILBSFOBJUV SFTFQUPSBMGBEBOCFUBUJEBL
CFSHBOUVOHQBEBNFTJOLJNJBXJTFMFGFLUPS IBSVT CFSLBJUBO EFOHBO FLTJUBTJ BUBV JOIJCJTJ UFUBQJ IBOZB
CFSLBJUBOEFOHBOBGJOJUBTIPSNPOUFSIBEBQSFTFQUPSQBEBPSHBO
.VEBIEJNFOHFSUJCBHBJNBOBTVCTUBOTJUSBOTNJUFSPUPOPNJL FGFLUPSUFSUFOUV
EBQBU NFOZFCBCLBO JOIJCJTJ QBEB TFCBHJBO PSHBO BUBV FLTJUBTJ )PSNPO TJOUFUJL ZBOH TFDBSB LJNJBXJ NJSJQ EFOHBO
QBEB PSHBO MBJO )BM JOJ CJBTBOZB EJUFOUVLBO PMFI TJGBU QSPUFJO FQJOFGSJO EBO OPSFQJOFGSJO JTPQSPQJM OPSFQJOFGSJO
SFTFQUPS QBEB NFNCSBO TFM EBO FGFL QFOHJLBUBO SFTFQUPS QBEB NFNQVOZBJ LFSKB ZBOH TBOHBU LVBU UFSIBEBQ SFTFQUPS CFUB
LFBEBBO LPOGPSNBTJPOBMOZB 1BEB TFUJBQ PSHBO FGFL ZBOH OBNVOTBNBTFLBMJUBLCFLFSKBQBEBSFTFQUPSBMGB
EJIBTJMLBO DFOEFSVOH CFSCFEB EFOHBO ZBOH UFSEBQBU QBEB PSHBO
MBJO Efek Eksitasi dan Inhibisi Perangsangan Simpatis dan
Parasimpatis
Dua Tipe Dasar Reseptor Asetilkolin—Reseptor 5BCFMNFODBOUVNLBOCFSCBHBJFGFLQBEBCFSCBHBJGVOHTJ
Muskarinik dan Nikotinik WJTFSBM UVCVI CBJL BLJCBU QFSBOHTBOHBO TBSBG QBSBTJNQBUJT
"TFUJMLPMJO UFSVUBNB NFOHBLUJGLBO EVB NBDBN SFTFQUPS ZBLOJ NBVQVO TJNQBUJT %BSJ UBCFM JOJ EBQBU EJMJIBU MBHJ CBIXB
SFTFQUPS NVTLBSJOJL EBO SFTFQUPS OJLPUJOJL "MBTBO VOUVL QFSBOHTBOHBO TJNQBUJT NFOJNCVMLBO FGFL FLTJUBTJ QBEB
QFOBNBBO JOJ BEBMBI LBSFOB CBIBO NVTLBSJO ZBOH NFSVQBLBO TFCBHJBOPSHBOOBNVONFOJNCVMLBOFGFLJOIJCJTJQBEBPSHBO
TFKFOJT SBDVO QBEB KBNVS QBZVOH IBOZB NFOHBLUJGLBO SFTFQUPS MBJOOZB %FNJLUBO QVMB QFSBOHTBOHBO QBSBTJNQBUJT BLBO
NVTLBSJOJL EBO UJEBL BLBO NFOHBLUJGLBO SFTFQUPS OJLPUJOJL NFOHFLTJUBTJ TFCBHJBO PSHBO OBNVO NFOHIBNCBU PSHBO
TFEBOHLBO CBIBO OJLPUJO IBOZB NFOHBLUJGLBO SFTFQUPS OJLPUJOJL MBJOOZB +VHB CJMB QFSBOHTBOHBO TJNQBUJT TBNQBJ
BTFUJMLPMJONFOHBLUJGLBOLFEVBKFOJTSFTFQUPSUFSTFCVU NFOHHJBULBOTVBUVPSHBOUFSUFOUVQFSBOHTBOHBOQBSBTJNQBUJT
3FTFQUPS NVTLBSJOJL EJKVNQBJ QBEB TFNVB TFM FGFLUPS ZBOH
EJSBOHTBOHPMFIOFVSPOLPMJOFSHJLQPTUHBOHMJPOCBJLEBSJTJTUFN Tabel 60-1 Reseptor Adrenergik dan Fungsinya
TBSBGTJNQBUJTBUBVQBSBTJNQBUJT
Reseptor Alfa Reseptor Beta
3FTFQUPS OJLPUJOJL EJKVNQBJ EJ HBOHMJB PUPOPN QBEB TJOBQT
BOUBSB OFVSPO QSFHBOHMJPO EBO QPTUHBOHMJPO EBSJ TJTUFN TJNQBUJT Vasokontriksi Vasodilatasi (B2 )
EBO QBSBTJNQBUJT 3FTFQUPS OJLPUJOJL KVHB UFSEBQBU QBEB CBOZBL Dilatasi iris Kardioakselerasi (B1)
VKVOH TBSBG PUPOPN TFCBHBJ DPOUPI QBEB UBVU OFVSPNVTLVMBS EJ
Relaksi usus Peningkatan kekuatan miokardial(B1)
PUPUSBOHLB<UFMBIEJCJDBSBLBOEBMBN#BC>

Kontraksi sfingter Relaksasi usus (B2 )
1FNBIBNBONFOHFOBJLFEVBKFOJTSFTFQUPSJOJTBOHBUQFOUJOH usus Relaksasi uterus (B2 )
LBSFOB CFSCBHBJ PCBU UFSUFOUV LFSBQ EJQBLBJ TFCBHBJ PCBU VOUVL
Kontraksi pilomotor Bronkodilatasi (B2 )
NFSBOHTBOH BUBV NFOHIBNCBU TBMBI TBUV EBSJ LFEVB KFOJT
SFTFQUPSUFSTFCVU Kontraksi sfingter Kalorigenesis (B2 )
kandung kemih
Menghambat pelepasan Glikogenolisis (B2 )
Reseptor Adrenergik—Reseptor Alfa dan Beta
neurotransmiter (A2 ) Lipolisis (B1)
5FSEBQBU KVHB EVB KFOJT VUBNB SFTFQUPS BESFOFSHJL SFTFQUPS BMGB Relaksasi kandung kemih (B2 )
EBOSFTFQUPSCFUB4FMBOKVUOZBSFTFQUPSCFUBEJCBHJNFOKBEJSFTFQ Termogenesis (B3 )
733
Unit Xl Sistem Saraf: C. Neurofisiologi Motorik dan Integratif
Tabel 60-2 Efek Otonomik pada Berbagai Organ Tubuh
Organ Efek Perangsangan Simpatis Efek Perangsangan Parasimpatis
Mata
Pupil Dilatasi Konstriksi
Otot sitiaris Retaksasi ringan (pengtihatan jauh) Konstriksi (penglihatan dekat)
Kelenjar Vasokonstriksi dan sekresi ringan Merangsang sejurntah besar sekresi (mengandung
Nasal banyak enzim untuk kelenjar penyekresi enzim)
Lakrimalis
Parotis
Submandibularis
Lambung
Pankreatik
Kelenjar keringat Banyak sekali keringat (kolinergik) Berkeringat pada telapak tangan
Kelenjar apokrin Kentat, sekresi yang berbau Tidak ada
Pembuluh darah Sering kati konstriksi Sering kali memberi sedikit efek atau tidak sama sekali
Jantung
Otot Peningkatan kecepatan Pengurangan kecepatan
Penurunan kekuatan kontraksi
Peningkatan kekuatan kontraksi
(khususnya atrium)
Pembuluh koroner Dilatasi(B2 ); konstriksi (A) Ditatasi
Paru
Bronkus Dilatasi Konstriksi
Pembuluh darah Konstriksi sedang Dilatasi
Usus
Lumen Penurunan peristatsis dan tonus Peningkatan peristatsis dan tonus
Sfingter Peningkatan tonus (sering kali) Relaksasi (sering kati)
Hati Pelepasan glukosa Sintesis glikogen ringan
Kandung kemih dan saluran Relaksasi Kontraksi
empedu Berkurangnya pengeluaran dan Tidak ada
Ginjal sekresi renin
Kandung kemih
Detrusor Retaksasi (ringan) Kontraksi
Trigonum Kontraksi Relaksasi
Penis Ejakulasi Ereksi
Arteriol sistemik
Visera abdomen Konstriksi Tidak ada
Otot Konstriksi(adrenergik A) Tidak ada
Dilatasi (adrenergik B2 )
Dilatasi ((kolinergik)
Kulit Konstriksi Tidak ada
Darah
Koagulasi Meningkat Tidak ada
Glukosa Meningkat Tidak ada
Lipid Meningkat Tidak ada
Metabolisme basal Meningkat sampai 100% Tidak ada
Sekresi medula adrenal Meningkat Tidak ada
Aktivitas mental Meningkat Tidak ada
Otot pitorektor Peningkatan glikogenesis Tidak ada
Otot rangka Peningkatan kekuatan Tidak ada
Sel-sel lemak Liplisis Tidak ada
734
Bab 60 Sistem Saraf Otonom dari Medula Adrenal
KVTUSV NFOHIBNCBUOZB NFOVOKVLLBO CBIXB LFEVB TJTUFN JOJ PMFITFSBUTFSBUTBSBGZBOHTFDBSBBOBUPNJTUFSTFCBSNFMBMVJTJTUFN

BEBLBMBOZBCFLFSKBTFDBSBTBMJOHCFSMBXBOBO/BNVO LFCBOZBLBO TBSBGTJNQBUJT
PSHBO EJLFOEBMJLBO UFSVUBNB PMFI TBMBI TBUV EBSJ LFEVB TJTUFN ,FMFOKBS BQPLSJO EJ BLTJMB NFOZFLSFTJ TFLSFU ZBOH LFOUBM EBO
UFSTFCVU CFSCBV BLJCBU QFSBOHTBOHBO TJNQBUJT OBNVO LFMFOKBS JOJ UJEBL
NFSFTQPOT SBOHTBOH QBSBTJNQBUJT 4FLSFTJ UFSTFCVU TFCFOBSOZB
UNIT XI
5JEBL BEB HFOFSBMJTBTJ ZBOH EBQBU EJQBLBJ VOUVL NFOKFMBTLBO
CFSGVOHTJ TFCBHBJ QFMVNBT VOUVL NFNVEBILBO HFSBLBO CFSHFTFS
BQBLBI SBOHTBOHBO TJNQBUJT BUBV QBSBTJNQBUJT EBQBU QBEB QFSNVLBBO EBMBN EJ CBXBI TFOEJ CBIV ,FMFOKBS BQPLSJO
NFOJNCVMLBO FLTJUBTJ BUBV JOIJCJTJ QBEB TVBUV PSHBO UFSUFOUV XBMBVQVOFNCSJPMPHJTOZBCFSLBJUBOFSBUEFOHBOLFMFOKBSLFSJOHBU
0MFI LBSFOB JUV VOUVL EBQBU NFNBIBNJ GVOHTJ TJNQBUJT EBO EJBLUJGLBO PMFI TFSBUTFSBU BESFOFSHJL CVLBO PMFI TFSBUTFSBU
QBSBTJNQBUJT LJUBIBSVTNFNQFMBKBSJNBTJOHNBTJOHGVOHTJLFEVB LPMJOFSHJLEBOKVHBEJLFOEBMJLBOPMFIQVTBUQVTBUTJNQBUJTTJTUFN
TJTUFNTBSBGJOJQBEBUJBQPSHBO TFQFSUJZBOHUFSUFSBEBMBN5BCFM TBSBGQVTBU CVLBOPMFIQVTBUQBSBTJNQBUJT
#FCFSBQB EBSJ GVOHTJ JOJ QFSMV EJKFMBTLBO MFCJI EFUBJM ZBJUV
Pleksus Saraf Intramural Sistem Gastrointestinal.
TFCBHBJCFSJLVU
4JTUFNHBTUSPJOUFTUJOBMNFNQVOZBJTVTVOBOTBSBGJOUSJOTJLTFOEJSJ
Efek Perangsangan Simpatis dan Parasimpatis pada Organ ZBOH EJLFOBM TFCBHBJ QMFLTVT JOUSBNVSBM BUBV TJTUFN TBSBG FOUFSJL
Tertentu VTVT ZBOH UFSMFUBL EJ EJOEJOH VTVT +VHB SBOHTBOH QBSBTJNQBUJT
Mata 5FSEBQBU EVB GVOHTJ NBUB ZBOH EJBUVS PMFI TJTUFN TBSBG EBOTJNQBUJTZBOHCFSBTBMEBSJPUBLEBQBUNFNFOHBSVIJBLUJWJUBT
PUPOPN ZBJUV
EJMBUBTJQVQJMEBO
GPLVTMFOTB HBTUSPJOUFTUJOBM UFSVUBNB NFMBMVJ QFOJOHLBUBO BUBV QFOVSVOBO
3BOHTBOH TJNQBUJT NFOZFCBCLBO TFSBUTFSBU NFSJEJPOBM JSJT LFSKB TQFTJGJL EBMBN QMFLTVT JOUSBNVSBM HBTUSPJOUFTUJOBM 1BEB
CFSLPOUSBLTJ TFIJOHHB QVQJM CFSEJMBUBTJ TFEBOHLBO SBOHTBOH VNVNOZB SBOHTBOH QBSBTJNQBUJT NFOJOHLBULBO TFMVSVI UJOHLBU
QBSBTJNQBUJT NFOZFCBCLBO LPOUSBLTJ PUPUPUPU TJSLVMBS JSJT TFIJOHHB BLUJWJUBT TBMVSBO HBTUSPJOUFTUJOBM ZBLOJ EFOHBO NFOJOHLBULBO
UFSKBEJLPOTUSJLTJQVQJM HFSBLBO QFSJTUBMUJL EBO NFSFMBLTBTJ TGJOHUFS TFIJOHHB
NFNVOHLJOLBO QFOHFMVBSBO JTJ VTVT EFOHBO DFQBU NFMBMVJ
1BSBTJNQBUJT ZBOH NFOHFOEBMJLBO QVQJM BLBO UFSBOHTBOH TFDBSB TBMVSBO QFODFSOBBO 1FOHBSVI EPSPOHBO JOJ CFSLBJUBO EFOHBO
SFGMFLT CJMB DBIBZB CFSMFCJIBO NBTVL LF EBMBN NBUB TFQFSUJ ZBOH QFOBNCBIBO LFDFQBUBO TFLSFTJ ZBOH UFSKBEJ TFDBSB CFSTBNBBO
EJKFMBTLBOEBMBN#BCSFGMFLTJOJNFOHFDJMLBOQFNCVLBBOQVQJMEBO QBEB TFCBHJBO CFTBS LFMFOKBS HBTUSPJOUFTUJOBM TFQFSUJ ZBOH UFMBI
NFOHVSBOHJKVNMBIDBIBZBZBOHNFODBQBJSFUJOB4FCBMJLOZB TJNQBUJT EJKFMBTLBOTFCFMVNOZB
UFSBOHTBOH QBEB TBBU FLTJUBTJ EBO QBEB XBLUV ZBOH CFSTBNBBO 'VOHTJ OPSNBM TBMVSBO HBTUSPJOUFTUJOBM UJEBL UFSMBMV
NFOBNCBIQFNCVLBBOQVQJM CFSHBOUVOHLFQBEBSBOHTBOHTJNQBUJT/BNVO SBOHTBOHTJNQBUJT
,FNBNQVBONFNGPLVTLBOMFOTBIBNQJSTFMVSVIOZBEJLFOEBMJLBO ZBOH LVBU NFOHIBNCBU QFSJTUBMUJL EBO NFOJOHLBULBO UPOVT
PMFI TJTUFN TBSBG QBSBTJNQBUJT 1BEB VNVNOZB MFOTB EJQFSUBIBOLBO TGJOHUFS )BTJM BLIJSOZB BEBMBI EPSPOHBO QBEB NBLBOBO ZBOH
EBMBN LFBEBBO QJQJI PMFI UFHBOHBO FMBTUJL JOUSJOTJL EBSJ MJHBNFO TBOHBU NFMBNCBU EBMBN TBMVSBO QFODFSOBBO EBO LBEBOHLBEBOH
SBEJBMOZB 1FSBOHTBOHBO QBSBTJNQBUJT NFOHLPOUSBLTJLBO PUPU TJMJBSJT KVHB NFOHVSBOHJ TFLSFTJ CBILBO LBEBOH IJOHHB NFOZFCBCLBO
ZBJUVTFSBUTFSBUPUPUQPMPTCFSCFOUVLDJODJOZBOHNFMJOHLBSJQJOHHJSBO LPOTUJQBTJ
MJHBNFOSBEJBMMFOTB,POUSBLTJUFSTFCVUNFMFQBTLBOUFHBOHBOMJHBNFO Jantung. 1BEB VNVNOZB QFSBOHTBOHBO TJNQBUJT BLBO
UBEJ EBO NFOZFCBCLBO MFOTB NFOKBEJ MFCJI LPOWFLT TFIJOHHB NFOJOHLBULBO TFMVSVI BLUJWJUBT KBOUVOH ,FBEBBO JOJ UFSDBQBJ
NFNCVBU NBUB NFNGPLVTLBO PCKFLOZB MFCJI EFLBU .FLBOJTNF EFOHBONFOJOHLBUOZBGSFLVFOTJEBOLFLVBUBOLPOUSBLTJKBOUVOH
LFNBNQVBONFNGPLVTLBOJOJEJCJDBSBLBOMFCJINFOEBMBNQBEB#BC 1FSBOHTBOHBO QBSBTJNQBUJT UFSVUBNB NFOJNCVMLBO FGFL ZBOH
EBOCFSLBJUBOEFOHBOGVOHTJNBUB CFSMBXBOBO QFOVSVOBO GSFLVFOTJ EFOZVU EBO LFLVBUBO LPOUSBLTJ
KBOUVOH 6OUVL NFOHVOHLBQLBO CFSCBHBJ FGFL UFSTFCVU EFOHBO
Kelenjar-Kelenjar Tubuh. ,FMFOKBS OBTBMJT MBLSJNBMJT TBMJWB
DBSB MBJO QFSBOHTBOHBO TJNQBUJT NFOJOHLBULBO FGFLUJWJUBT
EBOCBOZBLLFMFOKBSHBTUSPJOUFTUJOBMUFSBOHTBOHLVBUPMFITJTUFNTBSBG
KBOUVOH TFCBHBJ QPNQB ZBOH EJQFSMVLBO TFMBNB LFSKB CFSBU
QBSBTJNQBUJT TFIJOHHB NFOHFMVBSLBO CBOZBL TFLBMJ TFLSFTJ DBJSBO
TFEBOHLBO QFSBOHTBOHBO QBSBTJNQBUJT NFOVSVOLBO QFNPNQBBO
,FMFOKBSLFMFOKBS TBMVSBO QFODFSOBBO ZBOH QBMJOH LVBU EJSBOHTBOH
KBOUVOH NFNCVBU KBOUVOH EBQBU CFSJTUJSBIBU EJ BOUBSB BLUJWJUBT
PMFI QBSBTJNQBUJT BEBMBI ZBOH UFSMFUBL EJ TBMVSBO CBHJBO BUBT
LFSKBZBOHCFSBU
UFSVUBNB LFMFOKBS EJ NVMVU EBO MBNCVOH 4FCBMJLOZB LFMFOKBS VTVT
IBMVT EBO VTVT CFTBS UFSVUBNB EJBUVS PMFI GBLUPSGBLUPS MPLBM EJ Pembuluh Darah Sistemik. 4FCBHJBO CFTBS QFNCVMVI
TBMVSBOVTVTEBOPMFITJTUFNTBSBGFOUFSJLVTVTTFSUBTFEJLJUPMFITBSBG EBSBITJTUFNJL LIVTVTOZBZBOHUFSEBQBUEJWJTFSBBCEPNFOEBO
PUPOPN LVMJUBOHHPUBHFSBLUVCVI CFSLPOTUSJLTJPMFISBOHTBOHTJNQBUJT
3BOHTBOHTJNQBUJTCFSQFOHBSVIMBOHTVOHQBEBTFCBHJBOCFTBSTFM 3BOHTBOH QBSBTJNQBUJT IBNQJS TBNB TFLBMJ UJEBL CFSQFOHBSVI
TFM LFMFOKBS QFODFSOBBO EBMBN QFNCFOUVLBO TFLSFTJ QFLBU ZBOH QBEBQFNCVMVIEBSBILFDVBMJNFMFCBSLBOQFNCVMVIEBSBIQBEB
NFOHBOEVOH FO[JN EBO NVLVT EBMBN LBEBS UJOHHJ /BNVO EBFSBIEBFSBI UFSUFOUV TFQFSUJ EJ EBFSBI NFNFSBI XBKBI 1BEB
SBOHTBOHBOTJNQBUJTJOJKVHBNFOZFCBCLBOWBTPLPOTUSJLTJQFNCVMVI CFCFSBQB LFBEBBO GVOHTJ CFUB TJNQBUJT BLBO NFOZFCBCLBO
EBSBIZBOHNFOZVQMBJLFMFOKBSLFMFOKBSTFIJOHHBLBEBOHNFOHVSBOHJ EJMBUBTJ QFNCVMVI EBSBI CVLBO LPOTUSJLTJ TJNQBUJT TFQFSUJ
LFDFQBUBOTFLSFTJOZB CJBTBOZB UFUBQJIBMJOJKBSBOHUFSKBEJ LFDVBMJTFUFMBIEJCFSJPCBU
#JMB TBSBG TJNQBUJT UFSBOHTBOH LFMFOKBS LFSJOHBU NFOZFLSFTJ PCBUBO ZBOH EBQBU NFMVNQVILBO SFTFQUPS BMGB TJNQBUJT ZBOH
CBOZBL TFLBMJ LFSJOHBU UFUBQJ QFSBOHTBOHBO QBEB TBSBG QBSBTJNQBUJT NFOJNCVMLBO WBTPLPOTUSJLTJ ZBOH QBEB LFCBOZBLBO QFNCVMVI
UJEBLNFOHBLJCBULBOQFOHBSVIBQBQVO/BNVO TFSBUTFSBUTJNQBUJT EBSBI CJBTBOZBMFCJINFSVQBLBOFGFLCFUB
ZBOH NFOVKV LF TFCBHJBO CFTBS LFMFOKBS LFSJOHBU CFSTJGBU LPMJOFSHJL Efek Perangsangan Simpatis dan Parasimpatis
LFDVBMJCFCFSBQBTFSBUBESFOFSHJLZBOHLFUFMBQBLUBOHBOEBOUFMBQBL pada Tekanan Arteri.5FLBOBO BSUFSJ EJUFOUVLBO PMFI EVB
LBLJ
CFSCFEB EFOHBO IBNQJS TFNVB TFSBU TJNQBUJT MBJOOZB ZBOH GBLUPS EBZB EPSPOH EBSBI PMFI KBOUVOH EBO UBIBOBO UFSIBEBQ
CFSTJGBU BESFOFSHJL 4FMBOKVUOZB LFMFOKBS LFSJOHBU UFSVUBNB BMJSBO EBSBI ZBOH NFMFXBUJ QFNCVMVI EBSBI QFSJGFS
EJSBOHTBOH PMFI QVTBUQVTBU EJ IJQPUBMBNVT ZBOH CJBTBOZB EJBOHHBQ 1FSBOHTBOHBO TJNQBUJT NFOJOHLBULBO EBZB EPSPOH PMFI KBOUVOH
TFCBHBJ QVTBU QBSBTJNQBUJT 0MFI LBSFOB JUV CFSLFSJOHBU EBQBU EBO UBIBOBO UFSIBEBQ BMJSBO EBSBI ZBOH CJBTBOZB NFOZFCBCLBO
EJBOHHBQTFCBHBJGVOHTJQBSBTJNQBUJT XBMBVQVOIBMJOJEJLFOEBMJLBO QFOJOHLBUBO BLVU ZBOH CFSNBLOB QBEB UFLBOBO BSUFSJ /BNVO
KBSBOHTFLBMJUFSKBEJQFSV
735
CBIBO UFLBOBO EBMBN XBLUV MBNB LFDVBMJ TJNQBUJT NFSBOHTBOH 1FSCFEBBO LFUJHB BOUBSB LFSKB FQJOFGSJO EBO OPSFQJOFGSJO
HJOKBMVOUVLNFOBIBOHBSBNEBOBJSQBEBTBBUCFSTBNBBO CFSLBJUBO EFOHBO FGFLOZB UFSIBEBQ NFUBCPMJTNF KBSJOHBO
4FCBMJLOZB QFSBOHTBOHBO QBSBTJNQBUJT TFEBOH ZBOH MFXBU TBSBG &QJOFGSJONFNQVOZBMFGFLNFUBCPMJLTBNQBJLBMJMFCJICFTBS
WBHVT BLBO NFOVSVOLBO EBZB QPNQB KBOUVOH UFUBQJ TBNB TFLBMJ EBSJQBEB OPSFQJOFGSJO 5FOUV TBKB FQJOFGSJO ZBOH EJTFLSFTJ PMFI
UJEBL NFNFOHBSVIJ UBIBOBO WBTLVMBS QFSJGFS 0MFI LBSFOB JUV FGFL NFEVMB BESFOBM EBQBU NFOJOHLBULBO LFDFQBUBO NFUBCPMJTNF EJ
ZBOHVNVNBEBMBIUFSKBEJTFEJLJUQFOVSVOBOUFLBOBOBSUFSJ/BNVO TFMVSVI UVCVI LFSBQ LBMJ TBNQBJ QFSTFO EJ BUBT OPSNBM
QFSBOHTBOHVO QBSBTJNQBUJT WBHBM ZBOH TBOHBU LVBU IBNQJS TFMBMV
TFIJOHHBEFOHBODBSBJOJNFOJOHLBULBOBLUJWJUBTEBOFLTJUBCJMJUBT
EBQBU NFOHIFOUJLBO BUBV LBEBOH CFOBSCFOBS NFOHIFOUJLBO
UVCVI &QJOFGSJO KVHB NFOJOHLBULBO LFDFQBUBO BLUJWJUBT
TFMVSVIKBOUVOHTFMBNBCFCFSBQBEFUJLEBONFOZFCBCLBOLFIJMBOHBO
TFNFOUBSBTFMVSVIBUBVTFCBHJBOCFTBSUFLBOBOBSUFSJ NFUBCPMJL MBJOOZB TFQFSUJ HMJLPHFOPMJTJT EJ IBUJ EBO PUPU TFSUB
QFMFQBTBOHMVLPTBLFEBMBNEBSBI
Efek Perangsangan Simpatis dan Parasimpatis
terhadap Fungsi-Fungsi Tubuh Lainnya. 3JOHLBTOZB QFSBOHTBOHBO NFEVMB BESFOBM NFOZFCBCLBO
0MFI LBSFOB CFHJUV QFOUJOHOZB TJTUFN QFOHBUVSBO TJNQBUJT EBO QFMFQBTBO IPSNPO FQJOFGSJO EBO OPSFQJOFGSJO ZBOH CFSTBNB
QBSBTJNQBUJT LFEVBOZB EJCJDBSBLBO CFSLBMJLBMJ EBMBN CVLV JOJ TBNB NFNQVOZBJ FGFL IBNQJS TBNB LF TFMVSVI UVCVI TFQFSUJ
CFSLBJUBO EFOHBO GVOHTJ UVCVI ZBOHCFSBHBN 1BEB VNVNOZB QBEBQFSBOHTBOHBOMBOHTVOHTFSBUTJNQBUJT IBOZBTBKBFGFLZBOH
TFCBHJBO CFTBS TUSVLUVS FOUPEFSNBM TFQFSUJ IBUJ LBOEVOH EJUJNCVMLBOOZB KBVI MFCJI MBNB CFSMBOHTVOH TBNQBJ NFOJU
FNQFEV VSFUFS LBOEVOH LFNJI EBO CSPOLVT EJIBNCBU PMFI TFUFMBIQFSBOHTBOHBOTFMFTBJ
SBOHTBOH TJNQBUJT OBNVO EJSBOHTBOH PMFI SBOHTBOHQBSBTJNQBUJT
3BOHTBOH TJNQBUJT KVHB NFNQVOZBJ CFSCBHBJ FGFL NFUBCPMJL Peran Medula Adrenal terhadap Fungsi Sistem Saraf
TFQFSUJ QFMFQBTBO HMVLPTB EBSJ IBUJ NFOJOHLBULBOLPOTFOUSBTJ
Simpatis. &QJOFGSJO EBO OPSFQJOFGSJO IBNQJS TFMBMV EJMFQBTLBO
HMVLPTB EBSBI NFOJOHLBULBO QSPTFT HMJLPHFOPMJTJTEBMBN IBUJ
EBO PUPU NFOJOHLBULBO LFLVBUBO PUPU SBOHLB
PMFI NFEVMB BESFOBM QBEB XBLUV ZBOH CFSTBNBBO EFOHBO TBBU
NFOJOHLBULBO LFDFQBUBO NFUBCPMJTNF CBTBM EBO NFOJOHLBULBO PSHBOPSHBO MBJO UFSBOHTBOH MBOHTVOH PMFI BLUJWBTJ TJNQBUJT
BLUJWJUBT NFOUBM "LIJSOZB TJNQBUJT EBO QBSBTJNQBUJT KVHB UFSMJCBU VNVN0MFILBSFOBJUV TFCFOBSOZBPSHBOPSHBOJOJEJSBOHTBOH
EBMBNLFHJBUBOTFLTVBMBOUBSBMBLJMBLJEBOQFSFNQVBO TFQFSUJZBOH NFMBMVJEVBDBSBTFDBSBMBOHTVOHPMFITBSBGTJNQBUJTEBOTFDBSB
BLBOEJCJDBSBLBOEBMBN#BCEBO UBLMBOHTVOHPMFIIPSNPOIPSNPONFEVMBBESFOBM,FEVBDBSB
Fungsi Medula Adrenal QFSBOHTBOHBO JOJ TBMJOH NFOEVLVOH BUBV EBQBU KVHB QBEB
1FSBOHTBOHBO TBSBG TJNQBUJT ZBOH NFOVKV NFEVMB BESFOBM VNVNOZB TBMJOH NFOHHBOUJLBO $POUPIOZB LFSVTBLBO QBEB
NFOZFCBCLBO TFKVNMBI CFTBS FQJOFGSJO EBO OPSFQJOFGSJO KBSBT TJNQBUJT MBOHTVOH ZBOH CFSKBMBO LF CFSCBHBJ PSHBO UVCVI
EJMFQBTLBO LF EBMBN TJSLVMBTJ EBSBI EBO LFEVB IPSNPO JOJ UJEBL NFNCBUBMLBO FLTJUBTJ TJNQBUJT PSHBO UFSTFCVU TFCBC
LFNVEJBOEJCBXBEBMBNEBSBILFTFNVBKBSJOHBOUVCVI3BUB OPSFQJOFGSJO EBO FQJOFGSJO NBTJI EJMFQBTLBO LF EBMBN EBSBI
SBUB TFLJUBS QFSTFO IPSNPO ZBOH EJTFLSFTJLBO BEBMBI TJSLVMBTJ EBO TFDBSB UBL MBOHTVOH NFOJNCVMLBO QFSBOHTBOHBO
FQJOFGSJO EBO QFSTFOOZB BEBMBI OPSFQJOFGSJO XBMBVQVO %FNJLJBO QVMB IJMBOHOZB LFEVB NFEVMB BESFOBM CJBTBOZB
QFSCBOEJOHBO SFMBUJG UFSTFCVU EBQBU TBOHBU CFSVCBI QBEB NFNCFSJTFEJLJUFGFLTBKBQBEBLFSKBTJTUFNTBSBGTJNQBUJT TFCBC
CFSCBHBJLFBEBBOGJTJPMPHJTZBOHCFSCFEB KBSBTMBOHTVOHNBTJIEBQBUNFMBLVLBOIBNQJSTFNVBLFSKBZBOH
&QJOFGSJO EBO OPSFQJOFGSJO EBMBN QFSFEBSBO EBSBI EJQFSMVLBO +BEJ NFLBOJTNF HBOEB QFSBOHTBOHBO TJNQBUJT
NFNQVOZBJ FGFL ZBOH IBNQJS TBNB UFSIBEBQ CFSCBHBJ PSHBO NFSVQBLBO GBLUPS QFOZFMBNBU NFLBOJTNF ZBOH TBUV
TFQFSUJ FGFL ZBOH EJTFCBCLBO PMFI QFSBOHTBOHBO MBOHTVOH NFOHHBOUJLBONFLBOJTNFZBOHMBJOKJLBTBMBITBUVIJMBOH
TJNQBUJT LFDVBMJ CBIXB FGFL JOJ CFSMBOHTVOH TBNQBJ LBMJ .BLOB QFOUJOH MBJO NFEVMB BESFOBM BEBMBI LFNBNQVBO
MFCJIMBNBLBSFOBIPSNPOIPSNPOJOJEJTJOHLJSLBOEBSJEBSBI FQJOFGSJO EBO OPSFQJOFGSJO VOUVL NFSBOHTBOH TUSVLUVSTUSVLUVS
TFDBSBMBNCBUEBMBNXBLUVTBNQBJNFOJU UVCVI ZBOH UJEBL EJTBSBGJ PMFI TFSBCVU TJNQBUJT MBOHTVOH
/PSFQJOFGSJO EBMBN EBSBI NFOZFCBCLBO LPOTUSJLTJ QBEB $POUPIOZB LFEVB IPSNPO JOJ EBQBU NFOJOHLBULBO LFDFQBUBO
LFCBOZBLBO QFNCVMVI EBSBI UVCVI KVHB NFOZFCBCLBO NFUBCPMJTNF TFUJBQ TFM UVCVI LIVTVTOZB PMFI FQJOFGSJO
QFOJOHLBUBO BLUJWJUBT KBOUVOH QFOHIBNCBUBO TBMVSBO XBMBVQVO IBOZB TFEJLJU TFLBMJ TFM UVCVI ZBOH EJQFSTBSBGJ TFDBSB
HBTUSPJOUFTUJOBM QFMFCBSBOQVQJMNBUB EBOTFCBHBJOZB MBOHTVOHPMFITFSBCVUTJNQBUJT
&QJOFGSJO NFOJNCVMLBO FGFL ZBOH LVSBOH MFCJI TBNB
EFOHBO OPSFQJOFGSJO UFUBQJ FGFLOZB CFSCFEB EBMBN CFCFSBQB Hubungan Kecepatan Perangsangan dengan
IBM CFSJLVU JOJ 1FSUBNB FQJOFGSJO LBSFOB FGFLOZB ZBOH MFCJI Besarnya Efek Simpatis dan Parasimpatis
CFTBS EBMBN NFSBOHTBOH SFTFQUPS CFUB NFNCFSJ FGFL ZBOH
MFCJI CFTBS UFSIBEBQ QFSBOHTBOHBO KBOUVOH EBSJQBEB 1FSCFEBBOVUBNBBOUBSBTJTUFNTBSBGPUPOPNEFOHBOTJTUFNTBSBG
OPSFQJOFGSJO,FEVB FQJOFGSJONFOZFCBCLBOLPOTUSJLTJMFNBI TLFMFUBM BEBMBI CBIXB VOUVL NFOJNCVMLBO BLUJWBTJ TFNQVSOB
QBEB QFNCVMVI EBSBI PUPU EJCBOEJOHLBO EFOHBO LPOTUSJLTJ QBEB FGFLUPS PUPOPN IBOZB EJCVUVILBO SBOHTBOH CFSGSFLVFOTJ
ZBOH KBVI MFCJI LVBU ZBOH EJTFCBCLBO PMFI OPSFQJOFGSJO 0MFI SFOEBI1BEBVNVNOZB IBOZBTBUVJNQVMTTFUJBQCFCFSBQBEFUJL
LBSFOB QFNCVMVI EBSBI PUPU NFSVQBLBO TFHNFO VUBNB DVLVQ VOUVL NFNQFSUBIBOLBO FGFL TJNQBUJT BUBV QBSBTJNQBUJT
QFNCVMVI EBSBI UVCVI NBLB QFSCFEBBO JOJ TBOHBUMBI QFOUJOH UFUBQ OPSNBM EBO BLUJWBTJ TFNQVSOB UFSKBEJ CJMB MFQBT NVBUBO
TFCBC OPSFQJOFGSJO TBOHBU NFOJOHLBULBO UBIBOBO QFSJGFS UPUBM TFSBCVU TBSBG TFCFTBS TBNQBJ LBMJ QFS EFUJL *OJ TFCBOEJOH
EBOUFLBOBOBSUFSJ TFEBOHLBOFQJOFGSJONFOJOHLBULBOUFLBOBO EFOHBO BLUJWBTJ TFNQVSOB EBMBN TJTUFN TBSBG TLFMFUBM QBEB MFQBT
BSUFSJMFCJITFEJLJUUFUBQJMFCJINFOJOHLBULBODVSBIKBOUVOH NVBUBOTBNQBJBUBVMFCJIJNQVMTQFSEFUJL
736
"Tonus" Simpatis dan Parasimpatis 1BEB EBTBSOZB FGFL ZBOH TBNB UFSKBEJ EJ TFCBHJBO CFTBS
PSHBO FGFLUPS MBJO CJMB UPOVT TJNQBUJT BUBV QBSBTJNQBUJT
#JBTBOZB TJTUFN TJNQBUJT EBO QBSBTJNQBUJT CFSTJGBU BLUJG UFSVT
IJMBOH "SUJOZB TFHFSB UJNCVM LPNQFOTBTJ JOUSJOTJL VOUVL
NFOFSVT EBO OJMBJ BLUJWJUBT CBTBMOZB UFMBI EJLFOBM EFOHBO
NFOHFNCBMJLBO GVOHTJ PSHBO UFSTFCVU NFOEFLBUJ OJMBJ
TFCVUBOUPOVTTJNQBUJTEBOUPOVTQBSBTJNQBUJT
CBTBMOZB ZBOH OPSNBM /BNVO QBEB TJTUFN QBSBTJNQBUJT
UNIT XI
"SUJ QFOUJOH UPOVT BEBMBI CBIXB UPOVT JOJ NFNVOHLJOLBO LPNQFOTBTJ JOJ LBEBOHLBEBOH NFNCVUVILBO XBLUV
TJTUFNTBSBGUVOHHBMVOUVLNFOJOHLBULBONBVQVONFOVSVOLBO CFCFSBQB CVMBO 4FCBHBJ DPOUPI QBEB TFFLPS BOKJOH
BLUJWJUBT PSHBO ZBOH UFSBOHTBOH $POUPIOZB TFDBSB OPSNBM IJMBOHOZB UPOVT QBSBTJNQBUJT LF KBOUVOH TFUFMBI WBHPUPNJ
UPOVT TJNQBUJT NFOKBHB BHBS IBNQJS TFNVB BSUFSJPM TJTUFNJL KBOUVOHNFOJOHLBULBOGSFLVFOTJEFOZVUKBOUVOHTBNQBJ
CFSLPOTUSJLTJ TBNQBJ LJSBLJSB TFQBSVI EJBNFUFS LBMJ QFS NFOJU ZBOH BLBO UFUBQ NFOJOHLBU TFCBHJBO QBEB
NBLTJNVNOZB %FOHBO NFOJOHLBULBO SBOHTBOH TJNQBUJT EJ CVMBOLFNVEJBO
BUBT OPSNBM QFNCVMVI EBSBI JOJ EBQBU EJLPOTUSJLTJLBO MFCJI
LVBU MBHJ TFCBMJLOZB EFOHBO NFOVSVOLBO SBOHTBOHBO LF Supersensitivitas Denervasi pada Organ-Organ
CBXBI OJMBJ OPSNBM BSUFSJPM EBQBU CFSEJMBUBTJ #JMB UJEBL BEB Simpatis dan Parasimpatis setelah Denervasi
UPOVT TJNQBUJT ZBOH LPOUJOV TJTUFN TJNQBUJT IBOZB EBQBU 4FMBNB TBUV NJOHHV BUBV MFCJI TFTVEBI LFSVTBLBO TBSBG TJNQBUJT
NFOJNCVMLBOWBTPLPOTUSJLTJ UJEBLQFSOBIWBTPEJMBUBTJ BUBV QBSBTJNQBUJT PSHBO ZBOH EJQFSTBSBGJOZB NFOKBEJ MFCJI QFLB
UFSIBEBQ QFOZVOUJLBO OPSFQJOFGSJO BUBV BTFUJMLPMJO &GFL JOJ
$POUPI MBJO ZBOH NFOBSJL EBSJ UPOVT BEBMBI UPOVT EJHBNCBSLBO QBEB (BNCBS UBNQBL BMJSBO EBSBI QBEB
QBSBTJNQBUJT ZBOH NFOFUBQ EJ TBMVSBO HBTUSPJOUFTUJOBM 5JOEBLBO MFOHBO BUBT TFCFMVN QFNPUPOHBO TFSBCVU TJNQBUJT LJSBLJSB
QFNCFEBIBO NFOHBOHLBU TFSBCVU QBSBTJNQBUJT ZBOH NM NFOJU QFNCFSJBO EPTJT VKJ DPCB OPSFQJOFGSJO IBOZB
NFNQFSTBSBGJTFCBHJBOCFTBSVTVTEFOHBONFNPUPOHTBSBGWBHVT NFOZFCBCLBO TFEJLJU QFOVSVOBO BMJSBO EBSBI TFMBNB TFNFOJU
EBQBU NFOZFCBCLBO BUPOJ MBNCVOH EBO VTVT ZBOH TFSJVT EBO BUBV MFCJI 4FMBOKVUOZB HBOHMJPO TUFMBUVN EJCVBOH EBO UPOVT
MBNB EFOHBOBLJCBUUFSKBEJOZBIBNCBUBOTFCBHJBOCFTBSEPSPOHBO TJNQBUJT ZBOH OPSNBM NFOKBEJ IJMBOH 1BEB BXBMOZB BMJSBO
HBTUSPJOUFTUJOBM ZBOH OPSNBM EBO NFOJNCVMLBO LPOTUJQBTJ ZBOH EBSBI TBOHBU NFOJOHLBU LBSFOB IJMBOHOZB UPOVT QFNCVMVI
CFSBU EFOHBO EFNJLJBO NFOVOKVLLBO CBIXB UPOVT QBSBTJNQBUJT EBSBI OBNVO TFTVEBI CFCFSBQB IBSJ TBNQBJ CFCFSBQB NJOHHV
TBOHBU EJCVUVILBO CBHJ VTVT VOUVL GVOHTJ OPSNBMOZB 5POVT JOJ BMJSBO EBSBI LFNCBMJ NFOEFLBUJ OPSNBM LBSFOB QFOJOHLBUBO
EBQBU EJMFNBILBO PMFI PUBL TFIJOHHB NFOHIBNCBU NPUJMJUBT QSPHSFTJG UPOVT JOUSJOTJL PUPU QFNCVMVI EBSBI TFIJOHHB
NFOHPNQFOTBTJ TFCBHJBO IJMBOHOZB UPOVT TJNQBUJT 4FMBOKVUOZB
HBTUSPJOUFTUJOBM BUBV EBQBU KVHB EJQFSLVBU TFIJOHHB
EJCFSJLBO EPTJT VKJ DPCB OPSFQJOFGSJO ZBOH MBJO EBO BMJSBO EBSBI
NFOJOHLBULBOBLUJWJUBTHBTUSPJOUFTUJOBM CFSLVSBOH MFCJI CBOZBL EBSJQBEB TFCFMVNOZB NFOVOKVLLBO
CBIXB QFNCVMVI EBSBI NFOKBEJ EVB TBNQBJ FNQBU LBMJ MFCJI
QFLB UFSIBEBQ OPSFQJOFGSJO EBSJQBEB TFCFMVNOZB 'FOPNFOB JOJ
Tonus yang Ditimbulkan oleh Sekresi Basal Epinefrin EJTFCVU TVQFSTFOTJUJWJUBT EFOFSWBTJ 1FSJTUJXB JOJ EBQBU UFSKBEJ
dan Norepinefrin dari Medula Adrenal. ,FDFQBUBOJTUJSBIBU QBEB PSHBOPSHBO TJNQBUJT NBVQVO PSHBOPSHBO QBSBTJNQBUJT
OPSNBM TFLSFTJ NFEVMB BESFOBM LJSBLJSB ϪHLHNJO UFUBQJ QBEB CFCFSBQB PSHBO UFSUFOUV KBVI MFCJI OZBUB EBSJQBEB
FQJOFGSJOEBOLJSBLJSB ϪHLHNJO OPSFQJOFGSJO+VNMBIJOJ PSHBOMBJOOZB ZBOHLBEBOHQFOJOHLBUBOLFQFLBBOOZBMFCJIEBSJ
TBOHBU CBOZBL TFIJOHHB DVLVQ VOUVL NFNQFSUBIBOLBO BHBS LBMJMJQBU
UFLBOBOEBSBIIBNQJSNFODBQBJOPSNBM XBMBVQVOTFNVBKBSBT Mekanisme Supersensitivitas Denervasi.
)BOZB TFCBHJBO TBKB ZBOH EJLFUBIVJ NFOHFOBJ QFOZFCBC UJNCVMOZB
TJNQBUJT ZBOH MBOHTVOH LF TJTUFN LBSEJPWBTLVMBS EJCVBOH
TVQFSTFOTJUJWJUBT EFOFSWBTJ 4FCBHJBO KBXBCBOOZB BEBMBI LBSFOB
%FOHBO EFNJLJBO KFMBT CBIXB CBOZBL EBSJ UPOVT LFTFMVSVIBO
KVNMBI SFTFQUPS QBEB NFNCSBO QBTDBTJOBQUJL EJ TFMTFM FGFLUPS
TJTUFN TBSBG TJNQBUJT UFSKBEJ BLJCBU BEBOZB TFLSFTJ CBTBM CBIBO NFOJOHLBULBEBOHLBMBTBNQBJCFCFSBQBLBMJMJQBUCJMBOPSFQJOFGSJO
FQJOFGSJO EBO OPSFQJOFGSJO EJTBNQJOH UPOVT ZBOH UJNCVM BUBV BTFUJMLPMJO UJEBL MBHJ EJMFQBTLBO EJ TJOBQT QSPTFTOZB EJTFCVU
BLJCBUSBOHTBOHTJNQBUJTMBOHTVOH VQSFHVMBUJPO SFTFQUPS 0MFI LBSFOB JUV CJMB IPSNPOIPSNPO JOJ
EBMBN EPTJT UFSUFOUV EJTVOUJLLBO LF EBMBN EBSBI NBLB SFBLTJ
Efek Hilangnya Tonus Simpatis atau Parasimpatis FGFLUPSBLBOTBOHBUNFOJOHLBU
sesudah Denervasi. 4FHFSB TFTVEBI TBSBG TJNQBUJT BUBV
QBSBTJNQBUJT EJQPUPOH PSHBO ZBOH EJQFSTBSBGJ BLBO LFIJMBOHBO
UPOVT TJNQBUJT BUBV QBSBTJNQBUJT 1BEB QFNCVMVI EBSBI
NJTBMOZB QFNPUPOHBO TFSBCVU TJNQBUJT NFOHBLJCBULBO
WBTPEJMBUBTJ ZBOH IBNQJS NBLTJNBM EBMBN XBLUV TBNQBJ
EFUJL/BNVO TFTVEBICFCFSBQBNFOJU CFCFSBQBKBN CFCFSBQB
IBSJ BUBV CFCFSBQB NJOHHV UPOVT JOUSJOTJL QBEB PUPU QPMPT
QFNCVMVI EBSBI NFOJOHLBU BSUJOZB QFOJOHLBUBO UPOVT ZBOH
UFSKBEJBEBMBIBLJCBUQFOJOHLBUBOEBZBLPOUSBLTJPUPUQPMPTZBOH
CVLBONFSVQBLBOIBTJMQFSBOHTBOHBOTJNQBUJT NFMBJOLBOBLJCBU 0 1 2 3 4 5 6
BEBQUBTJ LJNJBXJ TFSBCVU PUPU QPMPT JUV 5POVT JOUSJOTJL JOJ
BLIJSOZBNFNVMJILBOWBTPLPOTUSJLTJNFOKBEJIBNQJSOPSNBM
737
Refleks Otonom UJNCVMCJMBIJQPUBMBNVTEJBLUJWJUBTPMFIUJNCVMOZBSBTBUBLVUBUBV

DFNBT BUBV SBTB OZFSJ ZBOH IFCBU "LJCBU ZBOH UJNCVM CFSVQB
#BOZBL GVOHTJ WJTFSBM UVCVI EJBUVS PMFI SFLMFLT PUPOPN %BMBN SFBLTJZBOHNFOZFCBSLFTFMVSVIUVCVI EJTFCVUSFTQPOTTUSFTBUBV
CVLV JOJ BLBO EJCBIBT GVOHTJ SFGMFLTSFGMFLT UFSTFCVU CFSLBJUBO SFTQPOTBMBSN ZBOHEJCBIBTTFDBSBTJOHLBU
EFOHBO NBTJOHNBTJOH TJTUFN PSHBO VOUVL NFOHHBNCBSLBO
NBLOBOZB CFCFSBQBSFGMFLTBLBOEJQBQBSLBOTFDBSBTJOHLBUEJTJOJ 1BEB TBBU MBJO BLUJWBTJ UFSKBEJ EJ CBHJBO UFSQJTBI TJTUFN TBSBG
Refleks Otonom Kardiovaskular #FCFSBQB SFGMFLT EBMBN TJNQBUJT$POUPIDPOUPIQFOUJOHBEBMBITFCBHBJCFSJLVU
4FMBNB
TJTUFN LBSEJPWBTLVMBS NFNCBOUV NFOHBUVS UFLBOBO EBSBI BSUFSJ QSPTFT QFOHBUVSBO TVIV TFSBCVU TJNQBUJT NFOHBUVS QFOHFMVBSBO
EBO GSFLVFOTJ EFOZVU KBOUVOH 4BMBI TBUVOZB BEBMBI SFGMFLT LFSJOHBUEBOBMJSBOEBSBIEJLVMJUUBOQBNFNFOHBSVIJPSHBOPSHBO
CBSPSFTFQUPS ZBOH UFMBI EJKFMBTLBO QBEB #BC CFSTBNB EFOHBO MBJOOZB ZBOH EJQFSTBSBGJ PMFI TFSBCVU TJNQBUJT KVHB
#BOZBL
SFGMFLTLBSEJPWBTLVMBSMBJOOZB4FDBSBTJOHLBU SFTFQUPSSFHBOHZBOH SFGMFLT MPLBM ZBOH NFMJCBULBO TFSBCVU BGFSFO TFOTPSJL ZBOH
EJTFCVUCBSBSPTFQUPSUFSMFUBLEJEBMBNEJOEJOHCFCFSBQBBSUFSJCFTBS CFSKBMBOTFDBSBTFOUSBMEJTBSBGQFSJGFSNFOVKVHBOHMJBTJNQBUJTEBO
NFMJQVUJ LIVTVTOZB BSUFSJB LBSPUJT JOUFSOB EBO BSLVT BPSUB #JMB NFEVMB TQJOBMJT EBO NFOZFCBCLBO SFTQPOT SFGMFLT ZBOH TBOHBU
SFTFQUPS JOJ UFSFHBOH PMFI UFLBOBO ZBOH UJOHHJ TJOZBM BLBO UFSMPLBMJTBTJ 4FCBHBJ DPOUPI QFNBOBTBO QBEB TVBUV EBFSBI LVMJU
EJKBMBSLBO LF CBUBOH PUBL UFNQBU SFTFQUPS UFSTFCVU NFOHIBNCBU
NFOZFCBCLBOWBTPEJMBUBTJEBONFOJOHLBUOZBQFOHFMVBSBOLFSJOHBU
JNQVMT TJNQBUJT LF KBOUVOH EBO QFNCVMVI EBSBI EBO NFSBOHTBOH
TFUFNQBU TFEBOHLBO QFOEJOHJOBO NFOJNCVMLBO BLJCBU ZBOH
QBSBTJNQBUJTIBMUFSTFCVUNFNCVBUUFLBOBOBSUFSJUVSVOLFNCBMJLF
OJMBJOPSNBM TFCBMJLOZB
4FCBHJBO CFTBS SFGMFLT TJNQBUJT ZBOH NFOHBUVS
GVOHTJ HBTUSPJOUFTUJOBM CFLFSKB NFMBMVJ KBSBT TBSBG OBNVO UJEBL
Refleks Otonom Gastrointestinal. #BHJBO UFSBUBT USBLUVT
HBTUSPJOUFTUJOBM EBO SFLUVN UFSVUBNB EJBUVS PMFI SFGMFLT PUPOPN
NFNBTVLJ NFEVMB TQJOBMJT IBOZB CFSKBMBO EBSJ VTVT UFSVUBNB LF
4FCBHBJ DPOUPI CBV ZBOH NFOJNCVMLBO TFMFSB NBLBO BUBV BEBOZB HBOHMJBQSFWFSUFCSBM EBOLFNVEJBOLFNCBMJLFVTVTNFMBMVJTBSBG
NBLBOBO EBMBN NVMVU BLBO NFNJDV UJNCVMOZB TJOZBM EBSJ IJEVOH TBSBGTJNQBUJTHVOBNFOHBUVSBLUJWJUBTNPUPSJLBUBVTFLSFUPSJL
EBO NVMVU NFOVKV OVLMFJ WBHVT HMPTPGBSJOHFVT EBO TBMJWBSJVT EJ
CBUBOHPUBL/VLMFJJOJLFNVEJBONFOKBMBSLBOTJOZBMNFMBMVJTBSBG Sistem Parasimpatis Biasanya Menyebabkan
QBSBTJNQBUJT LF LFMFOKBS TFLSFUPSJL EJ NVMVU EBO MBNCVOH Respons Setempat yang Spesifik. 'VOHTJ QFOHBUVSBO TJTUFN
NFOZFCBCLBO TFLSFTJ HFUBI QFODFSOBBO LBEBOH CBILBO TFCFMVN QBSBTJNQBUJT TFSJOH LBMJ MFCJI TQFTJGJL $POUPIOZB SFGMFLT
NBLBOBONBTVLLFEBMBNNVMVU QBSBTJNQBUJTLBSEJPWBTLVMBSCJBTBOZBIBOZBCFLFSKBQBEBKBOUVOH
#JMB CBIBO GFLBM NFOHJTJ SFLUVN EJ VKVOH MBJO TBMVSBO VOUVLNFOJOHLBULBOBUBVNFOVSVOLBOGSFLVFOTJEFOZVUKBOUVOH
QFODFSOBBO JNQVMTTFOTPSJLZBOHUJNCVMBLJCBUQFSFHBOHBOSFLUVN %FNJLJBOKVHB SFGMFLTQBSBTJNQBUJTMBJOOZBNFOJNCVMLBOTFLSFTJ
BLBOEJLJSJNLBOLFNFEVMBTQJOBMJTCBHJBOTBLSBM EBOTVBUVTJOZBM UFSVUBNB PMFI LFMFOKBS NVMVU EBO QBEB LFBEBBO MBJO
SFGMFLT EJKBMBSLBO LFNCBMJ NFMBMVJ QBSBTJNQBUJT TBLSBM LF LPMPO NFOJNCVMLBO TFLSFTJ UFSVUBNB PMFI LFMFOKBS MBNCVOH "LIJSOZB
CBHJBO EJTUBM TJOZBM JOJ NFOJNCVMLBO LPOUSBLTJ QFSJTUBMUJL LVBU
SFGMFLT QFOHPTPOHBO SFLUVN UJEBL CFHJUV NFNFOHBSVIJ CBHJBO
ZBOHNFOHBLJCBULBOEFGFLBTJ
VTVTMBJOOZB
Refleks Otonom Lainnya 1FOHPTPOHBO LBOEVOH LFNJI EJBUVS .FTLJQVO EFNJLJBO UFSEBQBU IVCVOHBO BOUBSB GVOHTJGVOHTJ
EFOHBO DBSB ZBOH TBNB EFOHBO QFOHPTPOHBO SFLUVN QFSFHBOHBO QBSBTJNQBUJT ZBOH CFSLBJUBO FSBU $POUPIOZB XBMBVQVO TFLSFTJ
LBOEVOHLFNJINFOHJSJNLBOJNQVMTLFCBHJBOTBLSBMNFEVMBTQJOBMJT
TBMJWB EBQBU UFSKBEJ UBOQB BEBOZB TFLSFTJ MBNCVOH LFEVBOZB
ZBOH LFNVEJBO NFOZFCBCLBO SFGMFLT LPOUSBLTJ LBOEVOH LFNJI EBO
SFMBLTBTJTGJOHUFSVSJOBSJB TFIJOHHBNFNVMBJNJLTJ TFSJOH LBMJ UFSKBEJ TFDBSB CFSTBNBBO EBO TFSJOH LBMJ KVHB EBQBU
)BMZBOHKVHBQFOUJOHBEBMBISFGMFLTTFLTVBM ZBOHEBQBUEJQJDV UFSKBEJ CFSTBNBBO EFOHBO TFLSFTJ LFMFOKBS QBOLSFBT +VHB SFGMFLT
PMFI SBOHTBOH QTJLJT EBSJ PUBL NBVQVO EBSJ PSHBO TFLTVBM *NQVMT QFOHPTPOHBO SFLUVN TFSJOH LBMJ NFNJDV UJNCVMOZB SFGMFLT
EBSJTVNCFSJOJCFSUFNVEJNFEVMBTQJOBMJTCBHJBOTBLSBMEBO QBEB QFOHPTPOHBO LBOEVOH LFNJI NFOHBLJCBULBO QFOHPTPOHBO
MBLJMBLJ NVMBNVMB UJNCVM FSFLTJ UFSVUBNB NFSVQBLBO GVOHTJ LBOEVOHLFNJIEBOSFLUVNTFDBSBCFSTBNBBO4FCBMJLOZB SFGMFLT
QBSBTJNQBUJT EBO TFMBOKVUOZB FKBLVMBTJ ZBOH TFCBHJBO NFSVQBLBO QFOHPTPOHBO LBOEVOH LFNJI EBQBU NFNCBOUV NFNJDV
GVOHTJTJNQBUJT UJNCVMOZBQFOHPTPOHBOSFLUVN
'VOHTJ QFOHBUVSBO PUPOPN MBJO ZBOH NFMJQVUJ SFGMFLT ZBOH
NFNCBOUV QFOHBUVSBO TFLSFTJ LFMFOKBS QBOLSFBT QFOHPTPOHBO Respons "Tanda Bahaya" atau Respons "Stres"
LBOEVOHFNQFEV FLTLSFTJVSJOFHJOKBM CFSLFSJOHBU LBEBSHMVLPTB pada Sistem Saraf Simpatis
EBSBI EBO CFSCBHBJ GVOHTJ WJTFSBM MBJO TFNVB TVEBI EJCBIBT #JMB TFCBHJBO CFTBS TJTUFN TBSBG TJNQBUJT NFMFQBTLBO JNQVMT QBEB
EFOHBOEFUBJMEJCBHJBOMBJOCVLVJOJ
TBBUZBOHCFSTBNBBOZBLOJ QFMFQBTBOJNQVMTTFDBSBNBTTBEFOHBO
CFSCBHBJDBSB LFBEBBOJOJBLBONFOJOHLBULBOLFNBNQVBOUVCVI
Perangsangan Organ-Organ Tertentu pada VOUVL NFMBLVLBO BLUJWJUBT PUPU ZBOH IFCBU .BSJMBI LJUB
Beberapa Keadaan, dan Perangsangan Massal SJOHLBTLBOLFKBEJBOJOJ
pada Keadaan Lain oleh Sistem Simpatis dan
1. 1FOJOHLBUBOUFLBOBOBSUFSJ
Parasimpatis
2. 1FOJOHLBUBO BMJSBO EBSBI VOUVL NFOHBLUJGLBO PUPUPUPU
Sistem Simpatis Kadang Memberikan Respons CFSTBNBBO EFOHBO QFOVSVOBO BMJSBO EBSBI LF PSHBOPSHBO
Berupa Pelepasan Impuls secara Massal. 1BEB TFQFSUJ USBLUVT HBTUSPJOUFTUJOBM EBO HJOKBM ZBOH UJEBL
CFCFSBQB LFBEBBO IBNQJS TFNVB CBHJBO TJTUFN TBSBG NFNCVUVILBOBLUJWJUBTNPUPSJLZBOHDFQBU
TJNQBUJT TFDBSB TJNVMUBO NFMFQBTLBO JNQVMT TFCBHBJ TVBUV 3. 1FOJOHLBUBOMBKVNFUBCPMJTNFTFMEJTFMVSVIUVCVI
VOJU MFOHLBQ TVBUV GFOPNFOB ZBOH EJTFCVU QFMFQBTBO
JNQVMT NBTTBM NBTTEJTDIBSHF
1FSJTUJXBJOJTFSJOHLBMJ 4. 1FOJOHLBUBOLBEBSHMVLPTBEBSBI
738
5. 1FOJOHLBUBOHMJLPMJTJTEJIBUJEBOPUPU 5FOUVTBKB USBOTFLTJCBUBOHPUBLEJBUBTUJOHLBUNJEQPOUJOUFUBQ

6. 1FOJOHLBUBOLFLVBUBOPUPU UJEBL NFOHHBOHHV QFOHBUVSBO EBTBS UFLBOBO BSUFSJ OBNVO
NFODFHBI QFOHBUVSBOOZB PMFI QVTBU TBSBG ZBOH MFCJI UJOHHJ
7. 1FOJOHLBUBOBLUJWJUBTNFOUBM
TFQFSUJ IJQPUBMBNVT 4FCBMJLOZB USBOTFLTJ UFQBU EJ CBXBI
8. 1FOJOHLBUBOLFDFQBUBOLPBHVMBTJEBSBI
NFEVMB PCMPOHBUB NFOZFCBCLBO UFLBOBO BSUFSJ UVSVO TBNQBJ
UNIT XI
LVSBOHEBSJTFUFOHBILBMJOPSNBM
4FMVSVIFGFLUFSTFCVUNFNVOHLJOLBOTFTFPSBOHNFMBLTBOBLBO 4BOHBU CFSLBJUBO EFOHBO QVTBUQVTBU QFOHBUVSBO
BLUJWJUBTGJTJLZBOHKBVIMFCJICFSBUEBSJQBEBCJMBUJEBLBEBFGFLEJ LBSEJPWBTLVMBS EJ CBUBOH PUBL BEBMBI QVTBUQVTBU NFEVMB
BUBT 0MFI LBSFOB CBJL TUSFT NFOUBM NBVQVO GJTJL EBQBU PCMPOHBUB EBO QPOUJO VOUVL QFOHBUVSBO QFSOBQBTBO TFQFSUJ
NFOHHJBULBOTJTUFNTJNQBUJT TFSJOHLBMJEJLBUBLBOCBIXBUVKVBO ZBOH EJCBIBT EBMBN #BC 8BMBVQVO IBM UFSTFCVU UJEBL
TJTUFN TJNQBUJT BEBMBI VOUVL NFOZFEJBLBO BLUJWJUBT UBNCBIBO EJBOHHBQ TFCBHBJ TVBUV GVOHTJ PUPOPN OBNVO NFSVQBLBO
CBHJ UVCVI QBEB TBBU TUSFT LFBEBBO JOJ EJTFCVU SFTQPOT TUSFT TBMBITBUVEBSJGVOHTJJOWPMVOUFSUVCVI
TJNQBUJT
Pengaturan Pusat Otonom Batang Otak oleh Area
4JTUFN TJNQBUJT UFSVUBNB UFSBLUJWBTJ EFOHBO LVBU QBEB yang lebih Tinggi. 4JOZBMTJOZBM EBSJ IJQPUBMBNVT EBO
CFSCBHBJLFBEBBOFNPTJ$POUPIOZB QBEBLFBEBBOTBOHBUNBSBI CBILBO EBSJ TFSFCSVN EBQBU NFNFOHBSVIJ BLUJWJUBT IBNQJS
SBHF
ZBOH MFCJI EJUJNCVMLBO PMFI QFSBOHTBOHBO IJQPUBMBNVT TFNVB QVTBU QFOHBUVS PUPOPN CBUBOH PUBL $POUPIOZB
TJOZBM NFOKBMBS LF CBXBI NFMBMVJ GPSNBTJP SFUJLVMBSJT PUBL EBO QFSBOHTBOHBOEBFSBIZBOHTFTVBJUFSVUBNBQBEBIJQPUBMBNVT
NBTVL LF NFEVMB TQJOBMJT NFOJNCVMLBO QFMFQBTBO JNQVMT QPTUFSJPS EBQBU NFOHBLUJGLBO QVTBU QFOHBUVS LBSEJPWBTLVMBS
TJNQBUJTZBOHNBTJGTFCBHJBOCFTBSQFSJTUJXBTJNQBUJTUFSEBIVMV NFEVMB PCMPOHBUB EFOHBO DVLVQ LVBU VOUVL NFOJOHLBULBO
UFSKBEJ EFOHBO TFHFSB ,FBEBBO JOJ EJTFCVU SFBLTJ UBOEB CBIBZB UFLBOBO BSUFSJ TBNQBJ MFCJI EBSJ EVB LBMJ OPSNBM %FNJLJBO
BMBSN SFBDUJPO
TJNQBUJT ,FBEBBO JOJ KVHB EJTFCVU SFBLTJ KVHB QVTBUQVTBU IJQPUBMBNJL MBJOOZB EBQBU NFOHBUVS TVIV
NFOHIBEBQJ BUBV NFOHIJOEBS GJHIU PS GMJHIU SFBDUJPO
TFCBC UVCVI NFOJOHLBULBO BUBV NFOVSVOLBO TBMJWBTJ EBO BLUJWJUBT
TFFLPSIFXBOQBEBLFBEBBOJOJIBSVTNFNVUVTLBOEFOHBOTFHFSB HBTUSPJOUFTUJOBM EBO NFOJNCVMLBO QFOHPTPOHBO LBOEVOH
BQBLBI BLBO UFUBQ CFSEJSJ EBO CFSLFMBIJ BUBV MBSJ 1BEB LFEVB LFNJI 0MFI LBSFOB JUV QBEB CFCFSBQB LFBEBBO QVTBUQVTBU
QFSJTUJXB UFSTFCVU SFBLTJ UBOEB CBIBZB TJNQBUJT TFMBOKVUOZB PUPOPN EJ CBUBOH PUBL CFLFSKB TFCBHBJ TUBTJVO QFNBODBS
NFNCVBUIFXBOJUVNFMBLVLBOBLUJWJUBTZBOHIFCBU VOUVL NFOHBUVS BLUJWJUBT ZBOH EJNVMBJ EJ UJOHLBU PUBL ZBOH
MFCJIUJOHHJ UFSVUBNBEJIJQPUBMBNVT
Pengaturan Medula, Pons, dan Mesensefalon pada
%BMBN #BC EBO KVHB EJUFLBOLBO CBIXB TFCBHJBO
Sistem Saraf Otonom
CFTBSSFTQPOTQFSJMBLVLJUBUFSCFOUVLNFMBMVJ
IJQPUBMBNVT
#BOZBL BSFB OFVSPO EBMBN TVCTUBOTJB SFUJLVMBS CBUBOH PUBL EBO

BSFB SFUJLVMBS CBUBOH PUBL EBO
TJTUFN TBSBG PUPOPN
TFQBOKBOH USBLUVT TPMJUBSJVT NFEVMB QPOT EBO NFTFOTFGBMPO
.FNBOH CFCFSBQB BSFB PUBL ZBOH MFCJI UJOHHJ EBQBU
TFQFSUJ IBMOZB QBEB CBOZBL OVLMFJ LIVTVT (BNCBS

NFOHVCBI GVOHTJ TFMVSVI TJTUFN TBSBG PUPOPN BUBV TFCBHJBO
NFOHBUVS CFSCBHBJ GVOHTJ PUPOPN TFQFSUJ UFLBOBO BSUFSJ
EBSJOZB EFOHBO DVLVQ LVBU VOUVL NFOJNCVMLBO QFOZBLJU
GSFLVFOTJ EFOZVU KBOUVOH TFLSFTJ LFMFOKBS EJ USBLUVT
ZBOH EJJOEVLTJ PUPOPN TFQFSUJ UVLBL MBNCVOH BUBV
HBTUSPJOUFTUJOBM HFSBLBO QFSJTUBMUJL HBTUSPJOUFTUJOBM EBO LVBUOZB
EVPEFOVN LPOTUJQBTJ QBMQJUBTJ KBOUVOH BUBV CBILBO
LPOUSBLTJ LBOEVOH LFNJI 1FOHBUVSBO TFUJBQ GVOHTJ JUV
TFSBOHBOKBOUVOH
EJCJDBSBLBO EBMBN CBC ZBOH TFTVBJ QBEB CVLV JOJ #FCFSBQB
GBLUPS QBMJOH QFOUJOH ZBOH EJLFOEBMJLBO PMFI CBUBOH PUBL BEBMBI
UFLBOBO BSUFSJ GSFLVFOTJ EFOZVU KBOUVOH EBO GSFLVFOTJ Farmakologi Sistem Saraf Otonom
QFSOBQBTBO
Obat-Obatan yang Bekerja pada Organ Efektor

Adrenergik—Obat-Obat Simpatomimetik
%BSJ QFNCJDBSBBO ZBOH UFSEBIVMV TVEBI KFMBT CBIXB
QFOZVOUJLBO OPSFQJOFGSJO TFDBSB JOUSBWFOB QBEB EBTBSOZB
NFOZFCBCLBOFGFLEJTFMVSVIUVCVIZBOHTFSVQBEFOHBOFGFL
BLJCBU QFSBOHTBOHBO TJNQBUJT 0MFI LBSFOB JUV OPSFQJOFGSJO
EJTFCVU PCBU TJNQBUPNJNFUJL BUBV PCBU BESFOFSHJL &QJOFGSJO
EBO NFUPLTBNJO KVHB UFSNBTVL PCBU TJNQBUPNJNFUJL EBO
NBTJI CBOZBL ZBOH MBJOOZB ,FLVBUBO PCBUPCBU JOJ EBMBN
NFSBOHTBOH CFSCBHBJ PSHBO FGFLUPS TJNQBUJT EBO MBNB
LFSKBOZB UJEBL TBNB /PSFQJOFGSJO EBO FQJOFGSJO NFNJMJLJ
LFSKBTJOHLBU ZBLOJBOUBSBTBNQBJNFOJU TFEBOHLBOLFSKB
CFCFSBQB PCBU TJNQBUPNJNFUJL MBJO ZBOH VNVN EJQBLBJ
CFSMBOHTVOHNFOJUTBNQBJKBN
0CBUPCBU QFOUJOH ZBOH NFSBOHTBOH SFTFQUPS BESFOFSHJL
TQFTJGJL BEBMBI GFOJMFGSJO SFTFQUPS BMGB
JTPQSPUFSFOPM
SFTFQUPSCFUB
EBOBMCVUFSPM IBOZBSFTFQUPSCFUB

739
Obat-Obat yang Menyebabkan Pelepasan Norepinefrin Obat-Obat yang Merangsang atau Menghambat Neuron-
dari Ujung Saraf. 0CBUPCBU UFSUFOUV NFNQVOZBJ FGFL Neuron Postganglion Simpatis dan Parasimpatis
TJNQBUPNJNFUJL UJEBL MBOHTVOH EBO CVLBO TFDBSB MBOHTVOH Obat yang Merangsang Neuron Postganglion Otonom.
NFSBOHTBOH PSHBO FGFLUPS BESFOFSHJL 0CBUPCBU UFSTFCVU /FVSPO QSFHBOHMJPO TJTUFN TBSBG QBSBTJNQBUJT NBVQVO TJNQBUJT
NFMJQVUJFGFESJO UJSBNJO EBOBNGFUBNJO&GFLOZBNFOZFCBCLBO NFOZFLSFTJBTFUJMLPMJOEJVKVOHVKVOHTFSBUTBSBGOZB EBOBTFUJMLPMJO
QFMFQBTBOOPSFQJOFGSJOEBSJWFTJLFMQFOZJNQBOOZBEJVKVOHTBSBG JOJ LFNVEJBO NFSBOHTBOH OFVSPO QPTUHBOHMJPO 4FMBOKVUOZB
TJNQBUJT /PSFQJOFGSJO ZBOH EJMFQBTLBO JOJ LFNVEJBO QFOZVOUJLBOBTFUJMLPMJOEBQBUKVHBNFSBOHTBOHOFVSPOQPTUHBOHMJPO
LFEVBTJTUFNUFSTFCVU EFOHBOEFNJLJBOQBEBXBLUVZBOHCFSTBNBBO
NFOJNCVMLBOFGFLTJNQBUJT
NFOJNCVMLBOFGFLTJNQBUJTEBOQBSBTJNQBUJTEJTFMVSVIUVCVI
Obat-Obat yang Menghambat aktivitas Adrenergik. 4FQFSUJIBMOZBBTFUJMLPMJO OJLPUJONFSVQBLBOPCBUMBJOZBOHEBQBU
"LUJWJUBT BESFOFSHJL EBQBU EJIBNCBU EJCFCFSBQB UFNQBU QBEB NFSBOHTBOH OFVSPO QPTUHBOHMJPO LBSFOB NFNCSBO OFVSPO JOJ
QSPTFTQFSBOHTBOHBO TFCBHBJCFSJLVU TFMVSVIOZB NFOHBOEVOH SFTFQUPS BTFUJMLPMJO UJQF OJLPUJOJL 0MFI
1. 4JOUFTJTEBOQFOZJNQBOBOOPSFQJOFGSJOEJVKVOHTBSBGTJNQBUJT LBSFOB JUV PCBUPCBU ZBOH NFOZFCBCLBO FGFL PUPOPNJL EFOHBO
EBQBU EJDFHBI 0CBU QBMJOH UFSLFOBM ZBOH EBQBU NFOJNCVMLBO NFSBOHTBOH OFVSPO QPTUHBOHMJPO EJTFCVU PCBU OJLPUJOJL #FCFSBQB
FGFLJOJBEBMBISFTFSQJO PCBU MBJO TFQFSUJ NFUBLPMJO NFNQVOZBJ LFSKB OJLPUJOJL NBVQVO
NVTLBSJOJL TFEBOHLBO QJMPLBSQJO IBOZB NFNQVOZBJ LFSKB
2. 1FMFQBTBO OPSFQJOFGSJO EBSJ VKVOH TBSBG TJNQBUJT EBQBU NVTLBSJOJL
EJIBNCBU,FBEBBOJOJEBQBUEJTFCBCLBOPMFIHVBOFUJEJO
/JLPUJO NFSBOHTBOH OFVSPO QPTUHBOHMJPO TJNQBUJT NBVQVO
3. 3FTFQUPS TJNQBUJT BMGB EBQBU EJIBNCBU %VB PCBU ZBOH QBSBTJNQBUJTQBEBTBBUZBOHCFSTBNBBO NFOJNCVMLBOWBTPLPOTUSJLTJ
NFOZFCBCLBOFGFLJOJBEBMBIGFOPLTJCFO[BNJOEBOGFOUPMBNJO TJNQBUJT ZBOH LVBU QBEB PSHBOPSHBO BCEPNFO EBO BOHHPUB HFSBL
4. 3FTFQUPS TJNQBUJT CFUB EBQBU EJIBNCBU 0CBU ZBOH EBQBU OBNVO QBEB TBBU ZBOH CFSTBNBBO KVHB NFOJNCVMLBO FGFL
NFOHIBNCBUSFTFQUPSCFUB EBOCFUBBEBMBIQSPQSBOPMPM0CBU QBSBTJNQBUJT TFQFSUJ NFOJOHLBULBO BLUJWJUBT HBTUSPJOUFTUJOBM EBO
ZBOHUFSVUBNBNFOHIBNCBUSFTFQUPSCFUB BEBMBINFUBQSPMPM LBEBOHLBMB NFNQFSMBNCBULFSKBKBOUVOH
5. "LUJWJUBT TJNQBUJT EBQBU EJIBNCBU PMFI PCBUPCBU ZBOH Obat-Obat Penghambat Ganglion. #BOZBL PCBU QFOUJOH
NFOHIBNCBU USBOTNJTJ JNQVMT TBSBG NFMBMVJ HBOHMJB PUPOPN ZBOH NFOHIBNCBU QFOKBMBSBO JNQVMT EBSJ OFVSPO QSFHBOHMJPO
0CBUPCBU JOJ EJCBIBT QBEB CBHJBO TFMBOKVUOZB OBNVO PCBU PUPOPNLFOFVSPOQPTUHBOHMJPO UFSNBTVLJPOBNPOJVNUFUSBFUJM JPO
QBMJOH QFOUJOH VOUVL NFOHIBNCBU USBOTNJTJ TJNQBUJT NBVQVO IFLTBNFUPOJVN EBO QFOUPMJOJVN 0CBUPCBU JOJ NFOHIBNCBU
QBSBTJNQBUJTNFMBMVJHBOHMJBBEBMBIIFLTBNFUPOJVN QFSBOHTBOHBO BTFUJMLPMJO UFSIBEBQ OFVSPO QPTUHBOHMJPO QBEB TJTUFN
TJNQBUJT NBVQVO QBSBTJNQBUJT TFDBSB CFSTBNBBO 0CBUPCBU JOJ
Obat-Obat yang Bekerja pada Organ Efektor Kolinergik
TFSJOH EJQBLBJ VOUVL NFOHIBNCBU BLUJWJUBT TJNQBUJT OBNVO KBSBOH
Obat-Obat Parasimpatomimetik (Obat-Obat EJHVOBLBO VOUVL NFOHIBNCBU BLUJWJUBT QBSBTJNQBUJT LBSFOB FGFL
Kolinergik). "TFUJMLPMJO ZBOH EJTVOUJLLBO TFDBSB JOUSBWFOB QFOHIBNCBUBO TJNQBUJT CJBTBOZB BLBO TBOHBU NFOVUVQJ FGFL
CJBTBOZB UJEBL NFOZFCBCLBO FGFL ZBOH QFSTJT TBNB EJ TFMVSVI QFOHIBNCBUBO QBSBTJNQBUJT 0CBUPCBU QFOHIBNCBU HBOHMJPO JOJ
UVCVI TFQFSUJ QFSBOHTBOHBO QBSBTJNQBUJT LBSFOB TFCFMVN TFDBSBLIVTVTEBQBUNFOVSVOLBOUFLBOBOBSUFSJQBEBCBOZBLQBTJFO
NFODBQBJ TFMVSVI PSHBO FGFLUPS TFCBHJBO CFTBS BTFUJMLPMJO BLBO IJQFSUFOTJ OBNVO PCBUPCBU JOJ UJEBL CFSIBTJM TFDBSB LMJOJT LBSFOB
EJSVTBLPMFILPMJOFTUFSBTFEBMBNEBSBIEBODBJSBOUVCVI/BNVO QFOHBUVSBOFGFLOZBZBOHTVMJU
BEB TFKVNMBI PCBU MBJO ZBOH UJEBL CFHJUV DFQBU EJSVTBL EBQBU
NFOJNCVMLBO FGFL MVBT QBSBTJNQBUJT ZBOH LIBT EBO PCBU JOJ
EJTFCVUPCBUQBSBTJNQBUPNJNFUJL
%VB PCBU QBSBTJNQBUPNJNFUJL ZBOH TFSJOH EJQBLBJ BEBMBI
QJMPLBSQJO EBO NFUBLPMJO 0CBUPCBU JOJ MBOHTVOH CFLFSKB QBEB
SFTFQUPSLPMJOFSHJLUJQFNVTLBSJOJL Daftar Pustaka
Cannon WB: Organization for physiological homeostasis, Physiol Rev 9:399,
Obot-Obat yang Memiliki Efek Memperkuat Kerja 1929.
Parasimpatis—Obat Antikolinesterase. #FCFSBQB PCBU Dajas-Bailador F, Wonnacott S: Nicotinic acetylcholine receptors and the
UJEBL NFNQVOZBJ FGFL MBOHTVOH QBEB PSHBO FGFLUPS QBSBTJNQBUJT regulation of neuronal signalling, Trends Pharmacol Sci 25:317, 2004. Dampney
OBNVO NFNQFSLVBU FGFL BTFUJMLPMJO ZBOH EJTFLSFTJ TFDBSB BMBNJ RA, Horiuchi J, McDowall LM: Hypothalamic mechanisms coor-
EJ VKVOHTFSBCVUQBSBTJNQBUJT(PMPOHBOPCBUJOJTBNBEFOHBOPCBU dinating cardiorespiratory function during exercise and defensive
behaviour, Auton Neurosci 142:3, 2008.
PCBU ZBOH EJCJDBSBLBO EBMBN #BC ZBOH NFNQFSLVBU FGFL
DiBona GF: Physiology in perspective: The Wisdom of the Body. Neural
BTFUJMLPMJO QBEB UBVU OFVSPNVTLVMBS (PMPOHBO PCBU JOJ NFMJQVUJ
control of the kidney, Am J Physiol Regul Integr Comp Physiol 2005.
BOUBSB MBJO OFPTUJHNJO QJSJEPTUJHNJO EBO BNCFOPNJVN 0CBUPCBU Eisenhofer G, Kopin IJ, Goldstein DS: Catecholamine metabolism: a contem-
JOJNFOHIBNCBUBTFUJMLPMJOFTUFSBTF TFIJOHHB NFODFHBI LFSVTBLBO porary view with implications for physiology and medicine, Pharmacol
DFQBU BTFUJMLPMJO ZBOH EJCFCBTLBO EJ VKVOH TBSBG QBSBTJNQBUJT Rev 56:331, 2004.
"LJCBUOZB KVNMBI BTFUJMLPMJO NFOJOHLBU BLJCBU SBOHTBOH ZBOH Goldstein DS, Sharabi Y: Neurogenic orthostatic hypotension: a pathophys-
CFSVOUVO EBO FGFLLFSKBOZBKVHBNFOJOHLBU iological approach, Circulation 119:139, 2009.
Obat-Obat yang Menghambat Aktivitas Kolinergik Goldstein DS, Robertson D, Esler M, et al: Dysautonomias: clinical disorders
of the autonomic nervous system, Ann Intern Med 137:753, 2002. Guyenet PG:
pada Organ Efektor—Obat Antimuskarinik. "USPQJO The 2008 Carl Ludwig Lecture: retrotrapezoid nucleus, CO2
EBO PCBUPCBUTFKFOJT TFQFSUJ IPNBUSPQJO EBO TLPQPMBNJO homeostasis, and breathing automaticity, J Appl Physiol 105:404, 2008. Guyenet
NFOHIBNCBU LFSKBBTFUJMLPMJO QBEB PSHBO FGFLUPS LPMJOFSHJL UJQF PG: The sympathetic control of blood pressure, Nat Rev Neurosci
NVTLBSJOJL 0CBUPCBU JOJ UJEBL NFNFOHBSVIJ LFSKB 7:335, 2006.
OJLPUJOJL BTFUJMLPMJO QBEBOFVSPOQPTUHBOHMJPOBUBVQBEBPUPU
SBOHLB
740
Chapter 60 The Autonomic Nervous System and the Adrenal Medulla
Hall JE, Hildebrandt DA, Kuo J: Obesity hypertension: role of leptin and Saper CB: The central autonomic nervous system: conscious visceral per-
sympathetic nervous system, Am J Hypertens 14:103S, 2001. Kvetnansky ception and autonomic pattern generation, Annu Rev Neurosci 25:433,
R, Sabban EL, Palkovits M: Catecholaminergic systems in stress: 2002.
structural and molecular genetic approaches, Physiol Rev 89:535, 2009. Taylor EW, Jordan D, Coote JH: Central control of the cardiovascular and
Lohmeier TE: The sympathetic nervous system and long-term blood pres- respiratory systems and their interactions in vertebrates, Physiol Rev
UNIT XI
sure regulation, Am J Hypertens 14:147S, 2001. 79:855, 1999.
Lohmeier TE, Hildebrandt DA, Warren S, et al: Recent insights into the inter- Ulrich-Lai YM, Herman JP: Neural regulation of endocrine and autonomic
actions between the baroreflex and the kidneys in hypertension, Am J stress responses, Nat Rev Neurosci 10:397, 2009.
Physiol Regul Integr Comp Physiol 288:R828, 2005. Wess J: Novel insights into muscarinic acetylcholine receptor function
Olshansky B, Sabbah HN, Hauptman PJ, et al: Parasympathetic nervous using gene targeting technology, Trends Pharmacol Sci 24:414, 2003.
system and heart failure: pathophysiology and potential implications for
therapy, Circulation 118:863, 2008.
741
BAB 61
UNIT XI
"MJSBO%BSBI4FSFCSBM $BJSBO
4FSFCSPTQJOBM EBO.FUBCPMJTNF0UBL
4BNQBJ TBBU JOJ LJUB UFMBI NFNCBIBT ZBOH NFSVQBLBO TFMTFM OPOOFVSPOBM LIVTVT ZBOH UBNQBL QBEB
GVOHTJ PUBL TFPMBIPMBI PUBL UJEBL BLUJWJUBTOFVSPOEFOHBOQFOHBUVSBOBMJSBOEBSBIMPLBM
CFSHBOUVOH QBEB BMJSBO EBSBI Peningkatan Aliran Darah sebagai Respons
NFUBCPMJTNF EBODBJSBOOZB/BNVO BQB terhadap Kelebihan Konsentrasi Karbon Dioksida atau
ZBOH LJUB CJDBSBLBO UFSTFCVU KBVI EBSJ
lon Hidrogen.1FOJOHLBUBOLPOTFOUSBTJLBSCPOEJPLTJEBEBMBN
LFOZBUBBO LBSFOB BCOPSNBMJUBT EBSJ
EBSBI BSUFSJ ZBOH NFNBTVLJ PUBL BLBO TBOHBU NFOJOHLBULBO
TFUJBQ GBLUPS UFSTFCVU EBQBU TBOHBU
BMJSBO EBSBI TFSFCSBM )BM JOJ EJUVOKVLLBO QBEB (BNCBS
NFNFOHBSVIJGVOHTJPUBL.JTBMOZB
ZBOHNFNQFSMJIBULBOCBIXBQFOJOHLBUBOTFCFTBSQFSTFOQBEB
QFOHIFOUJBO UPUBM BMJSBO EBSBI LF PUBL BLBO NFOZFCBCLBO IJMBOHOZB
1$0 BSUFSJ LJSBLJSB BLBO NFOJOHLBULBO BMJSBO EBSBI PUBL
LFTBEBSBO EBMBN XBLUV TBNQBJ EFUJL )BM JOJ UFSKBEJ LBSFOB
TFCBOZBLEVBLBMJMJQBU
LFUJBEBBO QFOHJSJNBO PLTJHFO LF TFMTFM PUBL IBNQJS NFOHIFOUJLBO
NFUBCPMJTNFEJTFMTFMJOJ#JMBIBMJOJUFSVTCFSMBOKVU BCOPSNBMJUBTDBJSBO
TFSFCSPTQJOBM CBJL LPNQPTJTJ NBVQVO UFLBOBO DBJSBOOZB EBQBU
NFNCFSJQFOHBSVIZBOHTBNBCVSVLOZBUFSIBEBQGVOHTJPUBL
Aliran Darah Serebral Pia mater
"MJSBOEBSBIPUBLEJTVQMBJPMFIFNQBUBSUFSJCFTBSEVBBSUFSJLBSPUJTEBO
EVB BSUFSJ WFSUFCSBMJT ZBOH CFSHBCVOH NFNCFOUVL TJSLVMVT 8JMMJTJ EJ
EBTBS PUBL "SUFSJBSUFSJ ZBOH EJQFSDBCBOHLBO EBSJ TJSLVMVT 8JMMJTJ
CFSKBMBO TFQBOKBOH QFSNVLBBO PUBL EBO NFNCFOUVL BSUFSJBSUFSJ QJBM
ZBOH CFSDBCBOHDBCBOH NFOKBEJ QFNCVMVIQFNCVMVI MFCJI LFDJM ZBOH
EJOBNBLBOBSUFSJBSUFSJEBOBSUFSJPMBBSUFSJPMBQFOFNCVT (BNCBS

1FNCVMVIQFNCVMVI QFOFNCVT TFEJLJU UFSQJTBI EBSJ KBSJOHBO PUBL PMFI
QFSQBOKBOHBO SPOHHB TVCBSBLIOPJE ZBOH EJOBNBLBO SPOHHB 7JSDIPX
3PCJO 1FNCVMVIQFNCVMVI QFOFNCVT NBTVL LF EBMBN KBSJOHBO PUBL
NFNQFSDBCBOHLBO BSUFSJPMBBSUFSJPMB JOUSBTFSFCSBMJT ZBOH BLIJSOZB
CFSDBCBOHNFOKBEJLBQJMFSLBQJMFSUFNQBUUFSKBEJOZBQFSUVLBSBOPLTJHFO
OVUSJFO LBSCPOEJPLTJEB EBONFUBCPMJUNFUBCPMJU BOUBSBEBSBIEFOHBO
KBSJOHBO
Kecepatan Normal Aliran Darah Serebral

"MJSBO EBSBI OPSNBM ZBOH NFMBMVJ PUBL QBEB PSBOH EFXBTB SBUBSBUB
TFLJUBS TBNQBJ NM QFS HSBN KBSJOHBO PUBL QFS NFOJU 6OUVL
LFTFMVSVIBO PUBL CFSKVNMBI TBNQBJ NMNFOJU +BEJ PUBL ZBOH
UFSEJSJIBOZBLVSBOHMFCJIQFSTFOEBSJCFSBUCBEBOUFUBQJNFOFSJNB
QFSTFODVSBIKBOUVOHQBEBLFBEBBOJTUJSBIBU
Pengaturan Aliran Darah Serebral

4FQFSUJ QBEB LFCBOZBLBO BSFB WBTLVMBS UVCVI MBJO BMJSBO EBSBI TFSFCSBM
TBOHBU CFSLBJUBO EFOHBO NFUBCPMJTNF KBSJOHBO #FCFSBQB GBLUPS
NFUBCPMJL EJZBLJOJ UVSVU EBMBN QFOHBUVSBO BMJSBO EBSBI TFSFCSBM

LPOTFOUSBTJ LBSCPO EJPLTJEB
LPOTFOUSBTJ JPO IJESPHFO

LPOTFOUSBTJPLTJHFO TFSUB
[BU[BUZBOHEJMFQBTLBOEBSJBTUSPTJU
743
NFLBOJTNFPLTJHFOVOUVLQFOHBUVSBOBMJSBOEBSBITFSFCSBMTFUFNQBU
NFSVQBLBO SFTQPOT QSPUFLUJG ZBOH QFOUJOH VOUVL NFMJOEVOHJ EBSJ
QFOVSVOBO BLUJWJUBT OFVSPO PUBL TFIJOHHB KVHB NFMJOEVOHJ EBSJ
UFSKBEJOZBHBOHHVBOLFNBNQVBONFOUBM
Zat-Zat yang Dilepaskan dari Astrosit sebagai Pengatur Aliran
Darah Serebral. 4FNBLJO CBOZBL CVLUJ NFOVOKVLLBO CBIXB
LBJUBOFSBUBOUBSBBLUJWJUBTOFVSPOBMEFOHBOBMJSBOEBSBITFSFCSBM
Normal EJTFCBCLBO TFCBHJBO PMFI [BU[BU ZBOH EJMFQBTLBO EBSJ BTUSPTJU
KVHBEJOBNBLBOTFMTFMBTUSPHMJBM
ZBOHNFOZFMVCVOHJQFNCVMVI
QFNCVMVI EBSBI TJTUFN TBSBG QVTBU "TUSPTJU BEBMBI TFMTFM OPO
OFVSPOBM CFSCFOUVL CJOUBOH ZBOH NFOZPLPOH EBO NFMJOEVOHJ
OFVSPO EJ TBNQJOH KVHB NFOZFEJBLBO OVUSJTJ .FSFLB
20 40 60
NFNQVOZBJ CBOZBL UPOKPMBO ZBOH NFOZVTVO IVCVOHBO EFOHBO
OFVSPOOFVSPO EBO QFNCVMVIQFNCVMVI EBSBI TFLJUBSOZB ZBOH
NFNCFSJ LFNVOHLJOBO NFLBOJTNF LPNVOJLBTJ OFVSPWBTLVMBS
"TUSPTJU TVCTUBOTJB LFMBCV BTUSPTJU QSPUPQMBTNJL
NFOHFMVBSLBO
UPOKPMBOUPOKPMBO IBMVT ZBOH NFMJOHLVQ IBNQJS TFNVB TJOBQT
"EB EVHBBO CBIXB LFNBNQVBO LBSCPO EJPLTJEB VOUVL EBO UPOKPMBOUPOKPMBO LBLJ ZBOH CFTBS ZBOH TBOHBU CFSEFLBUBO
NFOJOHLBULBO BMJSBO EBSBI TFSFCSBM EJBXBMJ EFOHBO EFOHBOEJOEJOHWBTLVMBS MJIBU(BNCBS

QFOHHBCVOHBOOZB EFOHBO BJS EBMBN DBJSBO UVCVI VOUVL ,BKJBO FLTQFSJNFOUBM UFMBI NFOVOKVLLBO CBIXB QFSBOHTBOHBO
NFNCFOUVL BTBN LBSCPOBU EBO TFMBOKVUOZB UFSKBEJ EJTPTJBTJ BTBN MJTUSJLQBEBOFVSPOOFVSPOHMVUBNJOFSHJLFLTJUBUPSJLNFOZFCBCLBO
UFSTFCVU VOUVL NFNCFOUVL JPO IJESPHFO *PO IJESPHFO JOJ QFOJOHLBUBO LPOTFOUSBTJ JPO LBMTJVN JOUSBTFMVMBS EJ UPOKPMBO
LFNVEJBO NFOZFCBCLBO WBTPEJMBUBTJ QFNCVMVI EBSBI TFSFCSBM UPOKPMBO BTUSPTJU EBO WBTPEJMBUBTJ BSUFSJPMBBSUFSJPMB ZBOH
EJMBUBTJ IBNQJS TFMVSVIOZB CFSCBOEJOH MVSVT EFOHBO QFOJOHLBUBO CFSEFLBUBO 1FOFMJUJBOQFOFMJUJBO MBJO NFOZJNQVMLBO CBIXB
LPOTFOUSBTJJPOIJESPHFO EBONFODBQBJCBUBTOZBLJSBLJSBIJOHHB WBTPEJMBUBTJJOJEJQFSBOUBSBJPMFICFCFSBQBNFUBCPMJUWBTPBLUJGZBOH
BMJSBOEBSBINFODBQBJEVBLBMJOPSNBM EJMFQBTLBOEBSJBTUSPTJU.FTLJQVONFEJBUPSZBOHUFQBUCFMVNKFMBT
4FUJBQ [BU MBJO ZBOH NFOJOHLBULBO LFBTBNBO KBSJOHBO PUBL PLTJEBOJUSBU NFUBCPMJUNFUBCPMJUBTBNBSBLJEPOBU JPOJPOLBMJVN
TFIJOHHB NFOJOHLBULBO LPOTFOUSBTJ JPO IJESPHFO KVHB BLBO BEFOPTJO EBO [BU[BU MBJO ZBOH EJIBTJMLBO BTUSPTJU TFCBHBJ SFTQPOT
NFOJOHLBULBO BMJSBO EBSBI TFSFCSBM ;BU TFNBDBN JOJ NFMJQVUJ BTBN UFSIBEBQQFSBOHTBOHBOOFVSPOOFVSPOFLTJUBUPSJLZBOHCFSEFLBUBO
MBLUBU BTBN QJSVWBU EBO TFUJBQ [BU BTBN MBJO ZBOH UFSCFOUVL TFMBNB UFMBIEJBOHHBQCFSQFSBOQFOUJOHEBMBNNFNQFSBOUBSBJWBTPEJMBUBTJ
UFSKBEJOZBNFUBCPMJTNFKBSJOHBO MPLBM
Pentingnya Pengaturan Aliran Darah Serebral oteh Pengukuran Aliran Darah Serebral, dan Efek Aktivitas Serebral
Karbon Dioksida dan lon Hidrogen. 1FOJOHLBUBO LPOTFOUSBTJ terhadap Aliran.4VBUVNFUPEFUFMBIEJLFNCBOHLBOVOUVLNFSFLBN
JPO IJESPHFO TBOHBU NFOVSVOLBO BLUJWJUBT OFVSPO 0MFI LBSFOB JUV BMJSBO EBSBI EJ TFHNFO ZBOH UFSQJTBI QBEB LPSUFLT TFSFCSJ
BEB NBOGBBUOZB CBIXB QFOJOHLBUBO LPOTFOUSBTJ JPO IJESPHFO KVHB NBOVTJB TFDBSB TJNVMUBO 6OUVL NFMBLVLBO IBM UFSTFCVU [BU
NFOJNCVMLBO QFOJOHLBUBO BMJSBO EBSBI ZBOH LFNVEJBO NFNCBXB SBEJPBLUJG TFQFSUJ YFOPO SBEJPBLUJG EJTVOUJLLBO LF EBMBN BSUFSJ
JPO IJESPHFO LBSCPO EJPLTJEB EBO TVCTUBOTJ BTBN MBJOOZB NFOKBVI LBSPUJT LFNVEJBO SBEJPBLUJWJUBT TFUJBQ TFHNFO LPSUFLT EJSFLBN
EBSJ KBSJOHBO PUBL )JMBOHOZB LBSCPO EJPLTJEB BLBO NFOZJOHLJSLBO TFXBLUV [BU SBEJPBLUJG CFSKBMBO NFMFXBUJ KBSJOHBO PUBL 6OUVL
BTBN LBSCPOBU EBSJ KBSJOHBO IBM JOJ CFSTBNB EFOHBO QFOZJOHLJSBO UVKVBO UFSTFCVU EFUFLUPS TDJOUJMMBUJPO SBEJPBLUJG LFDJM EJUFLBO
BTBNBTBN MBJO BLBO NFOVSVOLBO LPOTFOTUSBTJ JPO IJESPHFO QBEB QFSNVLBBO LPSUFLT ,FDFQBUBO QFOJOHLBUBO EBO QFOVSVOBO
LFNCBMJ NFOKBEJ OPSNBM +BEJ NFLBOJTNF JOJ EBQBU NFNCBOUV SBEJPBLUJWJUBT EJ TFUJBQ TFHNFO KBSJOHBO NFOKBEJ VLVSBO MBOHTVOH
NFNQFSUBIBOLBOLPOTFOUSBTJJPOIJESPHFOBHBSUFUBQLPOTUBOEBMBN LFDFQBUBOBMJSBOEBSBIZBOHNFMBMVJTFHNFOUFSTFCVU
DBJSBO TFSFCSBM EBO EFOHBO EFNJLJBO NFNCBOUV NFOKBHB BLUJWJUBT %FOHBO NFOHHVOBLBO UFLOJL JOJ KFMBT CBIXB BMJSBO EBSBI EJ
OFVSPOQBEBUJOHLBUZBOHLPOTUBOEBOOPSNBM TFUJBQ TFHNFO PUBL CFSVCBI TFCBOZBL TBNQBJ QFSTFO EBMBN
Defisiensi Oksigen sebagai Pengatur Aliran Darah XBLUV CFCFSBQB EFUJL TFCBHBJ SFTQPOT UFSIBEBQ QFSVCBIBO BLUJWJUBT
Serebral. ,FDVBMJ TFMBNB BLUJWJUBT PUBL ZBOH CFSBU LFDFQBUBO OFVSPO TFUFNQBU $POUPIOZB IBOZB EFOHBO NFOHFQBMLBO UBOHBO
MBOHTVOHUFSKBEJQFOJOHLBUBOBMJSBOEBSBIEJLPSUFLTNPUPSJLTJTJPUBL
QFOHHVOBBO PLTJHFO PMFI KBSJOHBO PUBL UFUBQ CFSBEB EBMBN CBUBT
ZBOH TFNQJU IBNQJS NFODBQBJ
NM PLTJHFO QFS HSBN ZBOH CFSMBXBOBO .FNCBDB CVLV NFOJOHLBULBO BMJSBO EBSBI
KBSJOHBO PUBL QFS NFOJU +JLB BMJSBO EBSBI LF PUBL UJEBL NFODVLVQJ LIVTVTOZB EJ BSFB WJTVBM LPSUFLT PLTJQJUBMJT EBO EJ BSFB QFSTFQTJ
VOUVL NFNFOVIJ KVNMBI PLTJHFO ZBOH EJQFSMVLBO LFLVSBOHBO CBIBTBQBEBLPSUFLTUFNQPSBMJT1SPTFEVSQFOHVLVSBOJOJKVHBEBQBU
PLTJHFOEFOHBOIBNQJSTFHFSBNFOZFCBCLBOWBTPEJMBUBTJ ZBOHBLBO EJHVOBLBO VOUVL NFOFOUVLBO MPLBTJ BTBM TFSBOHBO FQJMFQTJ LBSFOB
NFOHFNCBMJLBO BMJSBO EBSBI PUBL EBO USBOTQPS PLTJHFO LF KBSJOHBO BMJSBOEBSBIPUBLMPLBMBLBONFOJOHLBUTFDBSBBLVUEBOCFSNBLOBEJ
PUBL TBNQBJ NFOEFLBUJ OPSNBM +BEJ NFLBOJTNF QFOHBUVSBO BMJSBO UJUJLGPLBMQBEBTFUJBQTFSBOHBO
EBSBITFUFNQBUQBEBPUBLJOJIBNQJSTBNBEFOHBOZBOHUFSKBEJQBEB 6OUVL NFOVOKVLLBO FGFL BLUJWJUBT OFVSPO TFUFNQBU UFSIBEBQ
QFNCVMVI EBSBI LPSPOBSJB EJ PUPUPUPU SBOHLB EBO TFCBHJBO CFTBS BMJSBO EBSBI TFSFCSBM (BNCBS NFNQFSMJIBULBO QFOJOHLBUBO
BSFBTJSLVMBTJUVCVIMBJOOZB ZBOHLIBTQBEBBMJSBOEBSBIMPCVTPLTJQJUBMJTZBOHEJSFLBNQBEBPUBL
1FSDPCBBO NFOVOKVLLBO CBIXB QFOVSVOBO 10KBSJOHBO TFSFCSBM LVDJOH LFUJLB NBUBOZB EJTJOBSJ DBIBZB ZBOH LVBU TFMBNB TFUFOHBI
LJSBLJSBEJCBXBINN)H OJMBJOPSNBMBEBMBITBNQBJNN NFOJU
)H
EFOHBO TFHFSB NFNVMBJ QFOJOHLBUBO BMJSBO EBSBI TFSFCSBM *OJ Otoregulasi Atiran Darah Serebral Melindungi Otak dari Fluktuasi
CFSTJGBU LFCFUVMBO LBSFOB GVOHTJ PUBL NFOKBEJ LBDBV QBEB OJMBJ 10 Perubahan Tekanan Arterial. 4FMBNB LFHJBUBO OPSNBM TFIBSJIBSJ
ZBOH MFCJI SFOEBI LIVTVTOZB QBEB OJMBJ 10 EJ CBXBI NN )H UFLBOBO BSUFSJ EBQBU CFSGMVLUVBTJ MVBT NFOJOHLBU UJOHHJ EBMBN
#BILBOLPNBEBQBUUFSKBEJQBEBOJMBJZBOHSFOEBIJOJ+BEJ LFBEBBOCFSTFNBOHBUBUBVLFHJBUBOGJTJLCFSBU EBONFOVSVO
744
Bab 61 Aliran Darah Serebral, Cairan Serebrospinal, dan Metabolisme Otak
,FUJLB UFLBOBO BSUFSJ SBUBSBUB NFOJOHLBU BLVU IJOHHB OJMBJ

ZBOH TBOHBU UJOHHJ TFQFSUJ TFMBNB LFSKB GJTJL CFSBU BUBV EBMBN
CFSCBHBJ BLUJWJUBT TJSLVMBTJ ZBOH CFSMFCJIBO TJTUFN TBSBG
TJNQBUJT CJBTBOZB BLBO NFOHPOTUSJLTJLBO BSUFSJ PUBL VLVSBO
TFEBOH EBO CFTBS ZBOH DVLVQ VOUVL NFODFHBI UFLBOBO UJOHHJ
UNIT XI
BHBSUJEBLNFODBQBJQFNCVMVIEBSBIPUBLZBOHMFCJILFDJM)BM
JOJQFOUJOHVOUVLNFODFHBIQFSEBSBIBOWBTLVMBSLFEBMBNPUBL
ZBJUV VOUVLNFODFHBIUFSKBEJOZBTUSPLFTFSFCSBMMikrosirkulasi
Serebral
4FQFSUJ QBEB IBNQJS TFNVB KBSJOHBO UVCVI MBJOOZB KVNMBI
0 0.5 1.0 1.5
LBQJMFSEBSBIEBMBNPUBLBEBMBIZBOHUFSCBOZBL EJUFNQBUZBOH
QBMJOHCBOZBLNFNCVUVILBONFUBCPMJTNF-BKVNFUBCPMJTNFEJ
TVCTUBOTJB HSJTFB PUBL UFNQBU CBEBO TFM TBSBG CFSBEB TFDBSB
LFTFMVSVIBO LJSBLJSB FNQBU LBMJ MFCJI CFTBS EBSJ MBKV
NFUBCPMJTNF TVCTUBOTJB BMCB EFOHBO CFHJUV KVNMBI LBQJMFS EBO
LFDFQBUBO BMJSBO EBSBI QBEB TVCTUBOTJB HSJTFB LJSBLJSB KVHB
SFOEBI TFMBNB UJEVS /BNVO BMJSBO EBSBI TFSFCSBM UFSPUPSFHVMBTJ
FNQBULBMJ*JQBUMFCJICFTBSEJCBOEJOHLBOTVCTUBOTJBHSJTFB
EFOHBO TBOHBU CBJL QBEB CBUBT UFLBOBO BSUFSJ BOUBSB EBO NN
$JSJ TUSVLUVSBM ZBOH QFOUJOH EBSJ LBQJMFSLBQJMFS PUBL BEBMBI
)H "SUJOZB UFLBOBO BSUFSJ SBUBSBUB EBQBU EJUVSVOLBO TFDBSB DFQBU
CBIXB LFCBOZBLBO EBSJ NFSFLB CFSTJGBU LVSBOH CPDPS EBSJQBEB
TBNQBJ NN )H BUBV EJOBJLLBO TBNQBJ TFUJOHHJ NN )H UBOQB
LBQJMFS EBSBI EJ IBNQJS TFUJBQ KBSJOHBO UVCVI MBJO 4BMBI TBUV
UFSKBEJ QFSVCBIBO BMJSBO EBSBI TFSFCSBM ZBOH CFSNBLOB %BO QBEB
QFOZFCBCOZB BEBMBI CBIXB LBQJMFSLBQJMFS JOJ EJTBOHHB EJ TFNVB
PSBOHPSBOH ZBOH NFOEFSJUB IJQFSUFOTJ PUPSFHVMBTJ BMJSBO EBSBI PUBL
TJTJOZBPMFILBLJLBLJHMJB ZBJUVUPOKPMBOUPOKPMBOLFDJMEBSJTFMTFM
UFSKBEJ NFTLJQVO UFLBOBO BSUFSJ SBUBSBUB NFOJOHLBU NFODBQBJ
HMJBTFLJUBSOZB NJTBMOZBTFMTFMBTUSPHMJB
ZBOHCFSCBUBTBOEFOHBO
TBNQBJ NN )H &GFL JOJ EJQFSMJIBULBO QBEB (BNCBS ZBOH
TFMVSVI QFSNVLBBO LBQJMFS EBO NFOKBEJ QFOZBOHHB GJTJL VOUVL
NFOVOKVLLBO QFOHVLVSBO BMJSBO EBSBI TFSFCSBM QBEB PSBOH EFOHBO
NFODFHBIQFSFHBOHBOZBOHCFSMFCJIBOQBEBLBQJMFSLFUJLBUFLBOBO
UFLBOBO EBSBI OPSNBM EBO QBEB QBTJFO IJQFSUFOTJ TFSUB IJQPUFOTJ
EBSBILBQJMFSNFOJOHLBU
1FSIBUJLBO BMJSBO EBSBI TFSFCSBM ZBOH TBOHBU LPOTUBO BOUBSB CBUBT %JOEJOH BSUFSJPM LFDJM ZBOH NFOVKV LBQJMFS PUBL NFOKBEJ
UFLBOBOBSUFSJSBUBSBUBEBONN)H"LBOUFUBQJ KJLBUFLBOBO TBOHBU UFCBM QBEB QFOEFSJUB UFLBOBO EBSBI UJOHHJ EBO BSUFSJPM
BSUFSJ UVSVO TBNQBJ EJ CBXBI NN )H BMJSBO EBSBI TFSFCSBM BLBO BSUFSJPM UFSTFCVU UFUBQ TFMBMV EBMBN LFBEBBO LPOTUSJLTJ VOUVL
TBOHBUNFOVSVO NFODFHBI QFOKBMBSBO UFLBOBO ZBOH UJOHHJ LF LBQJMFSLBQJMFS
Peran Sistem Saraf Simpatis dalam Mengatur Aliran Darah "LBO LJUB MJIBU EBMBN CBC JOJ CBIXB BQBCJMB TJTUFN ZBOH
Serebral. 4JTUFN TJSLVMBTJ TFSFCSBM NFNJMJLJ QFSTBSBGBO TJNQBUJT NFODFHBI USBOTVEBTJ DBJSBO LF EBMBN PUBL JOJ UFSHBOHHV BLBO
ZBOH LVBU ZBOH CFSKBMBO LF BUBT EBSJ HBOHMJB TJNQBUJT TFSWJLBMJT UFSKBEJ FEFNB PUBL ZBOH TFSJVT ZBOH EFOHBO DFQBU EBQBU
TVQFSJPS EJ MFIFS EBO LFNVEJBO LF EBMBN PUBL CFSTBNB EFOHBO NFOZFCBCLBOLPNBEBOLFNBUJBO
BSUFSJB TFSFCSBMJT 4JTUFN JOJ NFNQFSTBSBGJ BSUFSJ PUBL ZBOH CFTBS "Stroke" Serebral Terjadi Ketika Pembutuh Darah Serebral
EBO BSUFSJBSUFSJ ZBOH NFOFNCVT TVCTUBOTJB PUBL "LBO UFUBQJ Tersumbat
QFNPUPOHBO TBSBG TJNQBUJT BUBV SBOHTBOHBO TBSBG EFOHBO EFSBKBU )BNQJS TFNVB PSBOH MBOKVU VTJB NFNJMJLJ TVNCBUBO QBEB
SJOHBOTBNQBJTFEBOHCJBTBOZBUJEBLNFOZFCBCLBOQFSVCBIBOZBOH CFCFSBQB BSUFSJ LFDJM EJ PUBL EBO TFCBOZBL QFSTFO QBEB
CFSNBLOBQBEBBMJSBOEBSBITFSFCSBM LBSFOBNFLBOJTNFPUPSFHVMBTJ BLIJSOZBNFNJMJLJDVLVQCBOZBLTVNCBUBOVOUVLNFOZFCBCLBO
BMJSBOEBSBIEBQBUNFOHIJMBOHLBOFGFLTBSBG HBOHHVBO GVOHTJ PUBL ZBOH TFSJVT ZBJUV TVBUV LPOEJTJ ZBOH
EJTFCVUTUSPLFh
,FCBOZBLBO LBTVT TUSPLF EJTFCBCLBO PMFI QMBL
BSUFSJPTLMFSPUJL ZBOH UFSKBEJ QBEB TBUV BUBV MFCJI BSUFSJ ZBOH
NFNCFSJ OVUSJTJ LF PUBL 1MBL EBQBU NFOHBLUJGLBO NFLBOJTNF
60 QFNCFLVBO EBSBI ZBOH NFOHIBTJMLBO CFLVBO EBSBI EBO
NFOHIBNCBUBMJSBOEBSBIEJBSUFSJ TFIJOHHBBLBONFOZFCBCLBO
IJMBOHOZBGVOHTJPUBLTFDBSBBLVUQBEBBSFBZBOHUFSCBUBT
40
1BEB TFLJUBS TFQFSFNQBU QBTJFO ZBOH NFOHBMBNJ TUSPLF
UFLBOBOEBSBIUJOHHJNFNCVBUTBMBITBUVQFNCVMVIEBSBIQFDBI
LFNVEJBO UFSKBEJ QFSEBSBIBO NFOFLBO KBSJOHBO PUBL TFUFNQBU
EBO TFMBOKVUOZB UFSKBEJ HBOHHVBO GVOHTJ PUBL &GFL OFVSPMPHJT
20 TUSPLF EJUFOUVLBO PMFI BSFB PUBL ZBOH UFSLFOB 4BMBI TBUV UJQF
TUSPLFZBOHQBMJOHTFSJOHBEBMBIUFSKBEJOZBTVNCBUBOQBEBBSUFSJB
TFSFCSJNFEJBZBOHNFOEBSBIJCBHJBOUFOHBITBMBITBUVIFNJTGFS
PUBL$POUPIOZB KJLBBSUFSJTFSFCSJNFEJBUFSTVNCBUQBEBTJTJLJSJ
0
0 50 100 150 PUBL PSBOH UFSTFCVU IBNQJS TFDBSB UPUBM DFOEFSVOH NFOHBMBNJ
Mean arterial blood pressure (mm Hg)
EFNFOTJB LBSFOB IJMBOHOZB GVOHTJ EJ BSFB QFNBIBNBO CJDBSB
8FSOJDLF EJ IFNJTGFS PUBL LJSJ EBO EJB KVHB UJEBL NBNQV
NFOHVDBQLBO LBUBLBUB LBSFOB IJMBOHOZB BSFB NPUPSJL #SPDB
VOUVL QFNCFOUVLBO LBUBLBUB 4FMBJO JUV IJMBOHOZB GVOHTJ BSFB
QFOHBUVS TBSBG NPUPSJL QBEB IFNJTGFS LJSJ EBQBU NFOJNCVMLBO
QBSBMJTJT TQBTUJL EJ TFNVB BUBV TFCBHJBO CFTBS PUPU EJ TJTJ UVCVI
ZBOHCFSMBXBOBO
745
%FOHBODBSBZBOHIBNQJSTFSVQB TVNCBUBOBSUFSJTFSFCSJQPTUFSJPS UFOHLPSBL UJEBL MBHJ NFOHBMBNJ BLTFMFSBTJ PMFI CFOUVSBO SVBOH
BLBO NFOZFCBCLBO JOGBSL LVUVC PLTJQJUBM IFNJTGFS EJ TJTJ ZBOH TBNB IBNQB UFSTFCVU UJCBUJCB LPMBQT EBO PUBL NFNCFOUVS QFSNVLBBO
EFOHBOTVNCBUBO ZBOHNFOZFCBCLBOIJMBOHOZBQFOHMJIBUBOEJLFEVB EBMBNUFOHLPSBL
NBUBQBEBTFQBSVISFUJOBEJTJTJZBOHTBNBEFOHBOMFTJTUSPLF4USPLF ,VUVC EBO QFSNVLBBO JOGFSJPS MPCVT UFNQPSBMJT EBO GSPOUBMJT
ZBOH CFSTJGBU NFSVTBL LIVTVTOZB BEBMBI TUSPLF ZBOH NFMJCBULBO UFNQBUPUBLNFOZFOUVIQSPUVCFSBOTJBUVMBOHEJEBTBSUFOHLPSBL TFSJOH
TVQMBJ EBSBI LF PUBL UFOHBI LBSFOB IBM JOJ EBQBU NFOHIBNCBU LBMJ NFOHBMBNJ DFEFSB EBO LPOUVTJP NFNBS
TFUFMBI NFOHBMBNJ
IBOUBSBO TBSBG EJ KBSBTKBSBT VUBNB BOUBSB PUBL EBO NFEVMB TQJOBMJT CFOUVSBO IFCBU EJ LFQBMB TFQFSUJ ZBOH EJBMBNJ TFPSBOH QFUJOKV +JLB
ZBOHNFOZFCBCLBOLFMBJOBOTFOTPSJLEBONPUPSJL LPOUVTJP UFSKBEJ EJ TJTJ ZBOH TBNB EFOHBO TJTJ DFEFSB EJTFCVU DFEFSB
DPVQ KJLB UFSKBEJ EJ TJTJ ZBOH CFSMBXBOBO BSBI LPOUVTJP JOJ EJTFCVU
Sistem Cairan Serebrospinal DFEFSBDPOUSFDPVQ
$FEFSB DPVQ EBO DPOUSFDPVQ KVHB EBQBU EJTFCBCLBO IBOZB PMFI
QFSDFQBUBOBUBVQFSMBNCBUBOZBOHDFQBUUBOQBBEBOZBCFOUVSBOGJTJL
4FMVSVI SPOHHB PUBL ZBOH NFMJOHLVQJ PUBL EBO NFEVMB TQJOBMJT
BLJCBU QVLVMBO QBEB LFQBMB %BMBN LFBEBBO TFQFSUJ JOJ PUBL EBQBU
NFNJMJLJ LBQBTJUBT LJSBLJSB TBNQBJ NM EBO TFLJUBS
UFSQFMBOUJOHEBSJEJOEJOHUFOHLPSBLZBOHNFOHBLJCBULBODFEFSBDPVQ
NM LBQBTJUBT JOJ EJUFNQBUJ PMFI DBJSBO TFSFCSPTQJOBM EBO TJTBOZB
EBO LFNVEJBO KVHB UFSQFMBOUJOH EBSJ TJTJ CFSMBXBOBO ZBOH
PMFI PUBL NBVQVO NFEVMB $BJSBO JOJ TFQFSUJ ZBOH UBNQBL QBEB
NFOZFCBCLBO LPOUVTJP DPOUSFDPVQ $FEFSB TFQFSUJ JOJ EBQBU UFSKBEJ
(BNCBS UFSEBQBU EJ WFOUSJLFM PUBL EBMBN TJTUFSOB EJ TFLJUBS
NJTBMOZB QBEB TJOESPNB NFOHBZVO CBZJ BUBV QBEB LFDFMBLBBO
CBHJBO MVBS PUBL EBO EBMBN SVBOH TVCBSBLIOPJE TFLJUBS PUBL EBO
LFOEBSBBO
NFEVMB TQJOBMJT 4FMVSVI SVBOH UFSTFCVU TBMJOH CFSIVCVOHBO EBO Pembentukan, Aliran, dan Absorpsi Cairan Serebrospinal
UFLBOBODBJSBOEJQFSUBIBOLBOQBEBTVBUVUJOHLBUZBOHLPOTUBO
$BJSBO TFSFCSPTQJOBM EJCFOUVL EFOHBO LFDFQBUBO TFLJUBS NM QFS
Fungsi Peredaman Cairan Serebrospinal IBSJ ZBJUV TFCBOZBL UJHB TBNQBJ FNQBU LBMJ WPMVNF UPUBM DBJSBO EJ
'VOHTJ VUBNB DBJSBO TFSFCSPTQJOBM BEBMBI VOUVL NFMJOEVOHJ PUBL TFMVSVI TJTUFN DBJSBO TFSFCSPTQJOBM ,JSBMESB EVB QFSUJHB BUBV MFCJI
EBMBNSVBOHOZBZBOHQBEBU0UBLEBODBJSBOTFSFCSPTQJOBMNFNJMJLJ DBJSBOJOJCFSBTBMEBSJTFLSFTJQMFLTVTLPSPJEFVTEJLFFNQBUWFOUSJLFM
HBZB CFSBU KFOJT ZBOH LVSBOH MFCJI TBNB IBOZB CFSCFEB TFLJUBS UFSVUBNB EJ LFEVB WFOUSJLFM MBUFSBM 4FKVNMBI LFDJM DBJSBO UBNCBIBO
QFSTFO
TFIJOHHB PUBL UFSBQVOH EBMBN DBJSBO JOJ 0MFI LBSFOB JUV EJTFLSFTJLBO PMFI QFSNVLBBO FQFOEJN WFOUSJLFM EBO NFNCSBO
CFOUVSBO QBEB LFQBMB KJLB UBL UFSMBMV LFSBT BLBO NFOHHFSBLLBO BSBLIOPJE 4FCBHJBO LFDJM CFSBTBM EBSJ PUBL JUV TFOEJSJ NFMBMVJ SVBOH
TFMVSVI PUBL EBO UFOHLPSBL TFDBSB TFSFOUBL TFIJOHHB UJEBL BEB QFSJWBTLVMBSZBOHNFOHFMJMJOHJQFNCVMVIEBSBIZBOHNBTVLLFEBMBN
CBHJBOPUBLZBOHCFSVCBICFOUVLBLJCBUCFOUVSBOUBEJ PUBL
$POUSFDPVQ#JMBCFOUVSBOQBEBLFQBMBTBOHBULVBU NVOHLJOUJEBL 1BOBIQBEB(BNCBSNFOVOKVLLBOCBIXBTBMVSBOVUBNBBMJSBO
NFSVTBL PUBL QBEB TJTJ LFQBMB ZBOH UFSCFOUVS UFUBQJ KVTUSV QBEB TJTJ DBJSBO CFSKBMBO EBSJ QMFLTVT LPSPJEFVT EBO LFNVEJBO NFMFXBUJ TJTUFN
ZBOH CFSMBXBOBO 'FOPNFOB JOJ EJLFOBM TFCBHBJ DPOUSFDPVQ EBO DBJSBO TFSFCSPTQJOBM $BJSBO ZBOH EJTFLSFTJLBO EJ WFOUSJLFM MBUFSBM
QFOKFMBTBO EBSJ FGFL JOJ BEBMBI TFCBHBJ CFSJLVU ,FUJLB CFOUVSBO NVMBNVMB NFOHBMJS LF EBMBN WFOUSJLFM LFUJHB LFNVEJBO TFUFMBI
NFOHFOBJ LFQBMB DBJSBO QBEB TJTJ LFQBMB ZBOH UFSCFOUVS UFSUBIBO NFOEBQBU TFKVNMBI LFDJM DBJSBO EBSJ WFOUSJLFM LFUJHB DBJSBO UFSTFCVU
TFIJOHHBDBJSBOUFSTFCVUNFOEPSPOHPUBLQBEBTBBUZBOHCFSTBNBBO NFOHBMJS LF CBXBI EJ TFQBOKBOH BLVBEVLUVT 4ZMWJJ LF EBMBN WFOUSJLFM
TFDBSB TJOFSHJT EFOHBO UVMBOH UFOHLPSBL 1BEB TJTJ ZBOH CFSMBXBOBO LFFNQBU UFNQBU TFKVNMBI LFDJM DBJSBO EJUBNCBILBO "LIJSOZB DBJSBO
HFSBLBO LFTFMVSVIBO UVMBOH UFOHLPSBL ZBOH UJCBUJCB NFOZFCBCLBO JOJ LFMVBS EBSJ WFOUSJLFM LFFNQBU NFMBMVJ UJHB QJOUV LFDJM ZBJUV EVB
UFOHLPSBLUFSUBSJLEBSJPUBLVOUVLTFNFOUBSBXBLUVBLJCBUTJGBUTJGBU GPSBNFO -VTDILB EJ MBUFSBM EBO TBUV GPSBNFO .BHFOEJF EJ UFOHBI
JOFSTJBPUBL EBONFODJQUBLBOTVBUVSVBOHIBNQBTFTBBUEJBSFBZBOH NBTVL LF TJTUFSOB NBHOB ZBJUV TVBUV SPOHHB DBJSBO ZBOH UFSMFUBL EJ
CFSMBXBOBOBSBIEFOHBOBSFBCFOUVSBO,FNVEJBO LFUJLBUVMBOH CFMBLBOHNFEVMBPCMPOHBUBEBOEJCBXBITFSFCFMVN
746
Bab 61 Aliran Darah Serebral, Cairan Serebrospinal. dan Metabolisme Otak
4JTUFSOB NBHOB CFSIVCVOHBO EFOHBO SVBOH TVCBSBLIOPJE ZBOH NBLSPTLPQJTZBOHEJTFCVUHSBOVMBTJBSBLIOPJEBMJTZBOHUFSMJIBU

NFOHFMJMJOHJ TFMVSVI PUBL EBO NFEVMB TQJOBMJT )BNQJS TFMVSVI DBJSBO NFOPOKPM LF EBMBN TJOVT %FOHBO NFOHHVOBLBO NJLSPTLPQ
TFSFCSPTQJOBM LFNVEJBO NFOHBMJS LF BUBT EBSJ TJTUFSOB NBHOB NFMBMVJ FMFLUSPO UFSMJIBU CBIXB WJMJ EJUVUVQJ PMFI TFM FOEPUFM ZBOH
SVBOH TVCBSBLIOPJE ZBOH NFOHFMJMJOHJ TFSFCSVN %BSJ TJOJ DBJSBO NFNJMJLJ KBMVS WFTJLVMBS ZBOH MBOHTVOH NFOFNCVT CBEBO TFM
NFOHBMJS LF EBMBN WJMJ BSBLIOPJEBMJT ZBOH NFOKPSPL LF EBMBN TJOVT +BMVS UFSTFCVU DVLVQ CFTBS VOUVL NFNVOHLJOLBO BMJSBO ZBOH
UNIT XI
WFOPTVTTBHJUBMJTZBOHCFTBSEBOTJOVTWFOPTVTMBJOOZBEJTFSFCSVN+BEJ SFMBUJG CFCBT EBSJ
DBJSBO TFSFCSPTQJOBM
NPMFLVM QSPUFJO
TFUJBQ DBJSBO FLTUSB BLBO CFSNVBSB LF EBMBN EBSBI WFOB NFMBMVJ QPSJ UFSMBSVU EBO
CBILBO QBSUJLFMQBSUJLFM TFCFTBS FSJUSPTJU EBO
QPSJWJMJUFSTFCVU MFVLPTJULFEBMBNEBSBIWFOB
Sekresi Pleksus Koroideus. 1MFLTVT LPSPJEFVT ZBOH JSJTBOOZB Ruang Perivaskular dan Cairan Serebrospinal. "SUFSJ CFTBS
EJMVLJTLBOQBEB(BNCBS NFSVQBLBOQFOVNCVIBOQFNCVMVIEBSBI EBO WFOB PUBL UFSMFUBL QBEB QFSNVLBBO PUBL OBNVO VKVOHOZB
TFQFSUJLFNCBOHLPMZBOHEJMBQJTJPMFITFMBQJTUJQJTTFMFQJUFM1MFLTVTJOJ NFOFNCVTLFEBMBN ZBOHNFOFNQFMCFSTBNBTFMBQJTQJBNBUFS
NFOPOKPM LF EBMBN LPSOV UFNQPSBMJT EJ TFUJBQ WFOUSJLFM MBUFSBM CBHJBO ZBJUV NFNCSBO ZBOH NFOVUVQJ PUBL ZBOH EJQFSMJIBULBO QBEB
QPTUFSJPSWFOUSJLFMLFUJHB EBOBUBQWFOUSJLFMLFFNQBU (BNCBS 1JB NBUFS IBOZB NFMFLBU MPOHHBS QBEB QFNCVMVI
4FLSFTJ DBJSBO LF EBMBN WFOUSJLFM PMFI QMFLTVT LPSPJEFVT UFSVUBNB EBSBI TFIJOHHB UFSEBQBU TFCVBI SVBOHBO ZBJUV SVBOH
CFSHBOUVOH LFQBEB USBOTQPS BLUJG JPO OBUSJVN NFMFXBUJ TFM FQJUFM ZBOH QFSJWBTLVMBS ZBOH BEB EJ BOUBSB QJB NBUFS EBO TFUJBQ QFNCVMVI
NFMBQJTJ CBHJBO MVBS QMFLTVT *PO OBUSJVN TFMBOKVUOZB BLBO NFOBSJL EBSBI 0MFI LBSFOB JUV SVBOH QFSJWBTLVMBS NFOHJLVUJ BSUFSJ EBO
TFKVNMBI CFTBS JPO LMPSJEB LBSFOB JPO OBUSJVN ZBOH CFSNVBUBO QPTJUJG WFOBLFEBMBNPUBLTBNQBJEJBSUFSJPMEBOWFOVMB
BLBONFOBSJLJPOLMPSJEBZBOHCFSNVBUBOOFHBUJG(BCVOHBOLFEVBJPO Fungsi Limfatik Ruang Perivaskular. 4BNB IBMOZB EFOHBO EJ
NFOJOHLBULBO KVNMBI OBUSJVN LMPSJEB ZBOH BLUJG TFDBSB PTNPTJT EBMBN UFNQBU MBJO EBMBN UVCVI TFKVNMBI LFDJM QSPUFJO LFMVBS EBSJ
DBJSBO TFSFCSPTQJOBM ZBOH LFNVEJBO TFHFSB NFOZFCBCLBO PTNPTJT BJS LBQJMFS PUBL LF EBMBN SVBOH JOUFSTUJTJBM PUBL 0MFI LBSFOB UJEBL
NFMBMVJNFNCSBO EBOEFOHBOEFNJLJBONFOZJBQLBODBJSBOTFLSFTJ BEB QFNCVMVI MJNGF EJ KBSJOHBO PUBL LFMFCJIBO QSPUFJO EJ
1SPTFT USBOTQPS ZBOH LVSBOH QFOUJOH NFNJOEBILBO TFKVNMBI LFDJM KBSJOHBO PUBL BLBO NFOZFCBCLBO QSPUFJO NFOHBMJS CFSTBNB
HMVLPTB LF EBMBN DBJSBO TFSFCSPTQJOBM EBO NFOHFMVBSLBO JPO LBMJVN EBO DBJSBONFMBMVJSVBOHQFSJWBTLVMBSLFEBMBNSVBOHTVCBSBLIOPJE
CJLBSCPOBU EBSJ DBJSBO TFSFCSPTQJOBM LF EBMBN LBQJMFS 0MFI LBSFOB JUV ,FUJLB NFODBQBJ SVBOH TVCBSBLIOPJE QSPUFJO LFNVEJBO
LBSBLUFSJTUJL DBJSBO TFSFCSPTQJOBM BEBMBI TFCBHBJ CFSJLVU UFLBOBO PTNPUJL NFOHBMJSCFSTBNBDBJSBOTFSFCSPTQJOBM VOUVLEJBCTPSQTJNFMBMVJ
LJSBLJSBTBNBEFOHBOQMBTNBLPOTFOUSBTJJPOOBUSJVNKVHBLJSBLJSBTBNB WJMJBSBLIOPJEBMJTLFEBMBNWFOBWFOBPUBLZBOHCFTBS0MFITFCBC
EFOHBO QMBTNB JPO LMPSJEB LVSBOH MFCJI QFSTFO MFCJI CFTBS EBSJQBEB JUV SVBOH QFSJWBTLVMBS QBEB EBTBSOZB NFSVQBLBO TJTUFN
QMBTNBJPOLBMJVNLJSBLJSBQFSTFOMFCJILFDJMEBOHMVLPTBLJSBLJSB MJNGBUJLZBOHLIVTVTVOUVLPUBL
QFSTFOMFCJITFEJLJU 4FMBJONFOZBMVSLBODBJSBOEBOQSPUFJO SVBOHQFSJWBTLVMBS
KVHB NFOHBOHLVU QBSUJLFM BTJOH LFMVBS EBSJ PUBL .JTBMOZB
Absorpsi Cairan Serebrospinal melalui Vili Arakhnoidalis. 7JMJ
LFUJLB UFSKBEJ JOGFLTJ EJ PUBL TFM EBSBI QVUJI EBO TBNQBI
BSBLIOPJEBMJT TFDBSB NJLSPTLPQJT NFSVQBLBO QFOPOKPMBO LF EBMBN
JOGFLTJVTMBJOOZBEJCBXBLFMVBSNFMBMVJSVBOHQFSJWBTLVMBS
TFQFSUJ KBSJ EBSJ NFNCSBO BSBLIOPJE NFMBMVJ EJOEJOH TJOVT WFOPTVT LF
EBMBNTJOVTUFSTFCVU(BCVOHBOWJMJJOJNFNCFOUVLTUSVLUVS Tekanan Cairan Serebrospinal
5FLBOBO OPSNBM QBEB TJTUFN DBJSBO TFSFCSPTQJOBM LFUJLB
TFTFPSBOH CFSCBSJOH QBEB QPTJTJ IPSJ[POUBM SBUBSBUB NN
)0 NN )H
NFTLJQVO EBQBU NFODBQBJ NN )0 BUBV
TFUJOHHJNN)0QBEBPSBOHTFIBU
Pengaturan Tekanan Cairan Serebrospinal oleh Vili
Arakhnoidalis. ,FDFQBUBO OPSNBM QFNCFOUVLBO DBJSBO
TFSFCSPTQJOBM UFUBQ NFOEFLBUJ LPOTUBO TFIJOHHB QFSVCBIBO
QFNCFOUVLBODBJSBOKBSBOHNFOKBEJGBLUPSQFOFOUVQFOHBUVSBO
choroidea
Taenia
747
UFLBOBO 4FCBMJLOZB WJMJ BSBLIOPJEBMJT CFSGVOHTJ TFQFSUJ LBUVQ ZBOH CBHJBOEBMBNCPMBNBUB

UFLBOBOZBOHUJOHHJJOJKVHBNFOHVSBOHJ
NFNVOHLJOLBO DBJSBO TFSFCSPTQJOBM EBO JTJOZB NFOHBMJS LF EBMBN BMJSBO EBSBI LFMVBS EJ OFSWVT PQUJLVT ZBOH NFOJNCVMLBO BLVNVMBTJ
EBSBI EBMBN TJOVT WFOPTVT EBO UJEBL NFNVOHLJOLBO BMJSBO LFMFCJIBO DBJSBO EJ EJTLVT PQUJL QBEB CBHJBO UFOHBI SFUJOB EBO

TFCBMJLOZB 1BEB LFBEBBO OPSNBM LFSKB LBUVQ WJMJ UFSTFCVU UFLBOBO EJ TFMVCVOH TBSBG KVHB NFOHIBNCBU BMJSBO EBSBI EJ WFOB
NFNVOHLJOLBO DBJSBO TFSFCSPTQJOBM NVMBJ NFOHBMJS LF EBMBN EBSBI SFUJOB TFIJOHHB BLBO NFOJOHLBULBO UFLBOBO LBQJMFS SFUJOB EJ TFMVSVI
LFUJLBUFLBOBODBJSBOTFSFCSPTQJOBMTFLJUBS NN)HMFCJICFTBSEBSJ NBUB ZBOHBLBONFNQFSCVSVLFEFNBSFUJOB
UFLBOBO EBSBI EBMBN TJOVT WFOPTVT ,FNVEJBO KJLB UFLBOBO DBJSBO +BSJOHBOEJTLVTPQUJLKBVIMFCJINVEBIUFSFHBOHEJCBOEJOHEFOHBO
TFSFCSPTQJOBMNBTJINFOJOHLBUUFSVT LBUVQBLBOUFSCVLBMFCJIMFCBS CBHJBO MBJO EJ SFUJOB TFIJOHHB EJTLVT NFOKBEJ MFCJI FEFNB EBSJQBEB
%BMBN LFBEBBO OPSNBM UFLBOBO DBJSBO TFSFCSPTQJOBM UJEBL QFSOBI CBHJBO MBJO EJ SFUJOB EBO NFNCFOHLBL LF EBMBN SPOHHB NBUB
NFOJOHLBU MFCJI EBSJ CFCFSBQB NN )H EJCBOEJOH UFLBOBO EBMBN 1FNCFOHLBLBOEJTLVTEBQBUEJBNBUJEFOHBOPGUBMNPTLPQEBOEJTFCVU
TJOVTWFOPTVTTFSFCSJ QBQJMFEFNB 4FPSBOH OFVSPMPH EBQBU NFNQFSLJSBLBO OJMBJ UFLBOBO
4FCBMJLOZB EBMBN LFBEBBO TBLJU WJMJ UFSTFCVU LBEBOHLBEBOH DBJSBO TFSFCSPTQJOBM EFOHBO NFOJMBJ QBOKBOHOZB QFOPOKPMBO EJTLVT
NFOKBEJ UFSTVNCBU PMFI QBSUJLFMQBSUJLFM CFTBS GJCSPTJT BUBV PQUJLLFEBMBNCPMBNBUB
LFMFCJIBO TFM EBSBI ZBOH CPDPS LF EBMBN DBJSBO TFSFCSPTQJOBM QBEB Obstruksi Aliran Cairan Serebrospinal dapat Menyebabkan
QFOZBLJU PUBL 4VNCBUBO TFQFSUJ JOJ EBQBU NFOZFCBCLBO UJOHHJOZB Hidrosefalus
UFLBOBODBJSBOTFSFCSPTQJOBM TFCBHBJCFSJLVU )JESPTFGBMVTCFSBSUJLFMFCJIBOBJSEBMBNSPOHHBUFOHLPSBL,FBEBBO
Tekanan Cairan Serebrospinal Tinggi pada Keadaan Patologis JOJ TFSJOH LBMJ EJCBHJ NFOKBEJ IJESPTFGBMVT LPNVOJLBOT EBO
Otak. 4VBUV UVNPS PUBL ZBOH CFTBS TFSJOH NFOJOHLBULBO UFLBOBO IJESPTFGBMVTOPOLPNVOJLBOT1BEBIJESPTFGBMVTLPNVOJLBOT DBJSBO
DBJSBO TFSFCSPTQJOBM EFOHBO NFOVSVOLBO SFBCTPSQTJ DBJSBO NFOHBMJS EFOHBO NVEBI EBSJ TJTUFN WFOUSJLFM LF EBMBN SVBOH
TFSFCSPTQJOBM LFNCBMJ LF EBMBN EBSBI "LJCBUOZB UFLBOBO DBJSBO TVCBSBLIOPJE TFNFOUBSB QBEB IJESPTFGBMVT OPOLPNVOJLBOT UFSKBEJ
TFSFCSPTQJOBM EBQBU NFOJOHLBU TBNQBJ TFUJOHHJ NN )0 QFOZVNCBUBOBMJSBOLFMVBSDBJSBOEBSJTBUVWFOUSJLFMBUBVMFCJI
NNBUBVLJSBLJSBFNQBULBMJOJMBJOPSNBM #JBTBOZB IJESPTFGBMVT UJQF OPOLPNVOJLBOT EJTFCBCLBO PMFI
5FLBOBO DBJSBO TFSFCSPTQJOBM KVHB BLBO NFOJOHLBU LFUJLB UFSKBEJ BEBOZB TVNCBUBO QBEB BLVBEVLUVT 4ZMWJJ BLJCBU BUSFTJB
QFSEBSBIBOBUBVJOGFLTJEJSVBOHUFOHLPSBL1BEBLFEVBLFBEBBOJOJ QFOVUVQBO
TFCFMVN MBIJS QBEB CFCFSBQB CBZJ BUBV BLJCBU UVNPS
TFKVNMBI CFTBS TFM EBSBI NFSBI EBO BUBV EBSBI QVUJI UJCBUJCB PUBL QBEB TFNVB VNVS ,FUJLB DBJSBO EJCFOUVL PMFI QMFLTVT
NVODVM EBMBN DBJSBO TFSFCSPTQJOBM EBO IBM JOJ EBQBU NFOZFCBCLBO LPSPJEFVT QBEB LFEVB WFOUSJLFM MBUFSBM EBO WFOUSJLFM LFUJHB
TVNCBUBOZBOHTFSJVTQBEBTBMVSBOTBMVSBOBCTPSQTJZBOHCFSVLVSBO WPMVNF LFUJHB WFOUSJLFM JOJ BLBO TBOHBU NFOJOHLBU )BM JOJ BLBO
LFDJM NFMBMVJ WJMJ BSBLIOPJEBMJT )BM JOJ LBEBOHLBEBOH KVHB NFOFLBO PUBL LF UFOHLPSBL TFIJOHHB NFOKBEJ TVBUV MBQJTBO UJQJT
NFOJOHLBULBO UFLBOBO DBJSBO TFSFCSPTQJOBM TBNQBJ TFUJOHHJ 1BEB OFPOBUVT QFOJOHLBUBO UFLBOBO KVHB BLBO NFOZFCBCLBO
NN)0 TFLJUBSFNQBULBMJOPSNBM
TFMVSVI LFQBMB NFNCFOHLBL LBSFOB UVMBOH UFOHLPSBL CFMVN
#FCFSBQB CBZJ EJMBIJSLBO EFOHBO UFLBOBO DBJSBO TFSFCSPTQJOBM NFOZBUV
ZBOH UJOHHJ )BM JOJ TFSJOH LBMJ EJTFCBCLBO PMFI UBIBOBO BCOPSNBM )JESPTFGBMVTUJQFLPNVOJLBOTCJBTBOZBEJTFCBCLBOPMFITVNCBUBO
ZBOH UJOHHJ UFSIBEBQ SFBCTPSQTJ DBJSBO NFMBMVJ WJMJ BSBLIOPJEBMJT BMJSBO DBJSBO EBMBN SVBOH TVCBSBLIOPJE EJ TFLJUBS EBFSBI EBTBS PUBL
BLJCBU UFSMBMV TFEJLJUOZB WJMJ BSBLIOPJEBMJT BUBV BLJCBU WJMJ EFOHBO BUBV TVNCBUBO WJMJ BSBLIOPJEBMJT UFNQBU CFSMBOHTVOHOZB BCTPSCTJ
GVOHTJ BCTPSQTJ ZBOH BCOPSNBM )BM JOJ BLBO EJCJDBSBLBO EBMBN DBJSBOLFEBMBNTJOVTWFOPTVTQBEBLFBEBBOOPSNBM0MFILBSFOBJUV
LBJUBOOZBEFOHBOIJESPTFGBMVT DBJSBOUFSLVNQVMEJMVBSPUBLEBOEBMBNKVNMBIZBOHMFCJITFEJLJUEJ
Pengukuran Tekanan Cairan Serebrospinal.1SPTFEVSZBOHCJBTB EBMBN WFOUSJLFM )BM JOJ KVHB BLBO NFOZFCBCLBO QFNCFOHLBLBO
EJHVOBLBO VOUVL NFOHVLVS UFLBOBO DBJSBO TFSFCSPTQJOBM BEBMBI LFQBMB ZBOH IFCBU CJMB UFSKBEJ QBEB CBZJ TBBU UFOHLPSBLOZB NBTJI
TFEFSIBOB1FSUBNB PSBOHCFSCBSJOHIPSJ[POUBMQBEBTJTJUVCVIOZB MVOBLEBOEBQBUUFSFHBOH EBOLFBEBBOJOJEBQBUNFSVTBLPUBLQBEB
TFIJOHHB UFLBOBO DBJSBO EJ NFEVMB TQJOBMJT TBNB EFOHBO UFLBOBO TFHBMB VNVS 1FOHPCBUBO VOUVL CBOZBL KFOJT IJESPTFGBMVT BEBMBI
EBMBNSVBOHUFOHLPSBL4FCVBIKBSVNTQJOBMLFNVEJBOEJNBTVLLBO UJOEBLBO QFNCFEBIBO EFOHBO NFMFUBLLBO QJQB TJMJLPO TFCBHBJ
LF EBMBN LBOBMJT TQJOBMJT MVNCBM EJ CBXBI VKVOH UFSFOEBI NFEVMB QJOUBTBO TBMBI TBUV WFOUSJLFM PUBL LF SPOHHB QFSJUPOFVN UFNQBU
TQJOBMJT EBOKBSVNUFSTFCVUEJIVCVOHLBOEFOHBOTFCVBIQJQBLBDB LFMFCJIBODBJSBOEBQBUEJBCTPSQTJLFEBMBNEBSBI
WFSUJLBM ZBOH UFSCVLB LF BUBT $BJSBO TQJOBM UFSTFCVU EJCJBSLBO Sawar Darah-Cairan Serebrospinal dan Sawar Darah-Otak
NBTVL LF QJQB LBDB TFUJOHHJ NVOHLJO +JLB DBJSBO JOJ OBJL TBNQBJ
5FMBI EJKFMBTLBO CBIXB LPOTFOUSBTJ CFCFSBQB VOTVS QFOUJOH DBJSBO
TFUJOHHJ NN EJ BUBT UJOHLBU KBSVN UFSTFCVU UFLBOBO EJBOHHBQ
TFSFCSPTQJOBMUJEBLTBNBEFOHBOLPOTFOUSBTJVOTVSDBJSBOFLTUSBTFMEJ
TFCFTBSNN)BUBVCJMBEJCBHJEFOHBO ZBOHNFSVQBLBO
UFNQBUMBJOEBMBNUVCVI-BHJQVMB CBOZBL[BUZBOHCFSNPMFLVMCFTBS
CFSBUKFOJTBJSSBLTB BLBOTFCFTBSLJSBLJSBNN)H
IBNQJS UJEBL EBQBU MFXBU EBSJ EBSBI LF EBMBN DBJSBO TFSFCSPTQJOBM
Tekanan Cairan Serebrospinal yang Tinggi Menyebabkan Edema
BUBVLFEBMBNDBJSBOJOUFSTUJTJBMPUBL NFTLJQVO[BUJOJEBQBUEFOHBO
pada Diskus Optikus-Papiledema4FDBSBBOBUPNJT MBQJTBOEVSBPUBL
NVEBINFMFXBUJDBJSBOJOUFSTUJTJBMUVCVIZBOHCJBTB0MFILBSFOBJUV
NFMVBT TFCBHBJ TVBUV TFMVCVOH ZBOH NFOHFMJMJOHJ OFSWVT PQUJLVT
EJBOHHBQ CBIXB TBXBS ZBOH EJTFCVU TBXBS EBSBI DBJSBO
LFNVEJBO CFSIVCVOHBO EFOHBO TLMFSB NBUB ,FUJLB UFLBOBO EBMBN
TFSFCSPTQJOBM EBOTBXBSEBSBIPUBL CFSUVSVUUVSVUUFSEBQBUEJBOUBSB
TJTUFN DBJSBO TFSFCSPTQJOBM NFOJOHLBU UFLBOBO EJ EBMBN TFMVCVOH
EBSBIEBODBJSBOTFSFCSPTQJOBMTFSUBDBJSBOPUBL
OFSWVT PQUJLVT KVHB NFOJOHLBU "SUFSJ EBO WFOB SFUJOB NFOFNCVT
TFMVCVOH JOJ CFCFSBQB NJMJNFUFS EJ CFMBLBOH NBUB EBO LFNVEJBO 4BXBSKVHBUFSEBQBUQBEBQMFLTVTLPSPJEFVTEBONFNCSBOLBQJMFS
CFSKBMBOCFSTBNBTBNBEFOHBOTFSBUTBSBGPQUJLLFEBMBNNBUB0MFI KBSJOHBO QBEB EBTBSOZB EJ TFMVSVI EBFSBI QBSFOLJN PUBL LFDVBMJ EJ
LBSFOB JUV
UFLBOBO DBJSBO TFSFCSPTQJOBM ZBOH UJOHHJ NFOEPSPOH CFCFSBQB EBFSBI IJQPUBMBNVT LFMFOKBS QJOFBM EBO BSFB QPTUSFNB
DBJSBO NVMBNVMB LF EBMBN TFMVCVOH TBSBG PQUJL LFNVEJBO UFNQBU [BU CFSEJGVTJ EFOHBO MFCJI NVEBI LF EBMBN SVBOH KBSJOHBO
NFOEPSPOHDBJSBOEJTFQBOKBOHSVBOHBOUBSTFSBCVUTBSBGPQUJLLF %JGVTJZBOHNVEBIEJEBFSBIJOJCFSTJGBUQFOUJOHLBSFOBEBFSBI
748
Bab 61 Aliran Darah Serebral, Cairan Serebrospinal. dan Metabolisme Otak
EBFSBI UFSTFCVU NFNJMJLJ SFTFQUPS TFOTPSJL ZBOH CFSFBLTJ UFSIBEBQ NFOHFMVBSLBO DBJSBO TFDBSB DFQBU EBSJ WFOUSJLFM MBUFSBM PUBL
QFSVCBIBOTQFTJGJLZBOHUFSKBEJEBMBNDBJSBOUVCVI TFQFSUJQFSVCBIBO EFOHBO NFOHHVOBLBO QVOHTJ KBSVN WFOUSJLFM TFIJOHHB UFLBOBO
PTNPMBMJUBT EBO LPOTFOUSBTJ HMVLPTB EBO QFSVCBIBO SFTFQUPS VOUVL JOUSBTFSFCSBMEBQBUEJUVSVOLBO
IPSNPOQFQUJEBZBOHNFOHBUVSSBTBIBVT TFQFSUJBOHJPUFOTJO**4BXBS
UNIT XI
EBSBI PUBL KVHB NFNJMJLJ NPMFLVM QFNCBXB ZBOH NFNGBTJMJUBTJ Metabolisme Otak
QFOHBOHLVUBO IPSNPO TFQFSUJ *FQUJO EBSJ EBSBI LF EBMBN
IJQPUBMBNVT UFNQBU IPSNPO UFSTFCVU CFSJLBUBO EFOHBO SFTFQUPS
4FQFSUJCFSCBHBJKBSJOHBOMBJO PUBLNFNFSMVLBOPLTJHFOEBO[BU
TQFTJGJL ZBOH NFOHPOUSPM GVOHTJGVOHTJ MBJOOZB TFQFSUJ SBTB MBQBS EBO
OVUSJTJ VOUVL NFNFOVIJ LFCVUVIBO NFUBCPMJTNFOZB /BNVO
BLUJWJUBTTJTUFNTBSBGTJNQBUJT
UFSEBQBULFVOJLBONFUBCPMJTNFPUBLZBOHQFSMVEJQFSIBUJLBO
1BEB VNVNOZB TBXBS EBSBI DBJSBO TFSFCSPTQJOBM EBO TBXBS EBSBI Laju Metabolisme Otak Total dan Laju Metabolisme Neuron.
PUBL TBOHBU QFSNFBCFM UFSIBEBQ BJS LBSCPO EJPLTJEB PLTJHFO EBO %BMBNLFBEBBOJTUJSBIBUOBNVOTBEBS NFUBCPMJTNFPUBLLJSBLJSB
TFCBHJBO CFTBS [BU MBSVU MJQJE TFQFSUJ BMLPIPM EBO [BU BOFTUFTJ TFEJLJU NFODBQBJ QFSTFO EBSJ TFMVSVI NFUBCPMJTNF EBMBN UVCVI
QFSNFBCFMUFSIBEBQFMFLUSPMJU TFQFSUJOBUSJVN LMPSJEB EBOLBMJVNEBO XBMBVQVONBTTBPUBLIBOZBQFSTFOEBSJNBTTBUVCVIUPUBM0MFI
IBNQJS UJEBL QFSNFBCFM UFSIBEBQ QSPUFJO QMBTNB EBO CBOZBL NPMFLVM LBSFOB JUV EBMBN LFBEBBO JTUJSBIBU NFUBCPMJTNF PUBL QFS VOJU
PSHBOJLCFSVLVSBOCFTBSZBOHUJEBLMBSVUMJQJE0MFILBSFOBJUV EFOHBO NBTTB KBSJOHBO LJSBLJSB LBMJ NFUBCPMJTNF SBUBSBUB KBSJOHBO
BEBOZB TBXBS EBSBI DBJSBO TFSFCSPTQJOBM EBO TBXBS EBSBI PUBL PCBU TFMBJOTJTUFNTBSBG
PCBUBO TFQFSUJ BOUJCPEJ QSPUFJO EBO PCBUPCBU ZBOH UJEBL MBSVU MJQJE 4FCBHJBO CFTBS LFMFCJIBO NFUBCPMJTNF PUBL UFSKBEJ EJ OFVSPO
TFSJOH LBMJ UJEBL EBQBU NFODBQBJ LPOTFOUSBTJ ZBOH FGFLUJG EBMBN DBJSBO CVLBO EJ KBSJOHBO QFOZBOHHB HMJB ,FCVUVIBO VUBNB VOUVL
TFSFCSPTQJOBMBUBVQBSFOLJNPUBL CFSMBOHTVOHOZB NFUBCPMJTNF EJ OFVSPO BEBMBI QFNPNQBBO JPO
1FOZFCBC SFOEBIOZB QFSNFBCJMJUBT TBXBS EBSBI DBJSBO NFMBMVJ NFNCSBO OFVSPO UFSVUBNB VOUVL NFOHBOHLVU JPO
TFSFCSPTQJOBMEBOTBXBSEBSBIPUBLBEBMBIDBSBTFMTFMFOEPUFMLBQJMFS OBUSJVN EBO LBMTJVN LF CBHJBO MVBS NFNCSBO OFVSPO EBO JPO
KBSJOHBOPUBLUFSTFCVUTBMJOHCFSIVCVOHBO)VCVOHBOJOJEJTFCVUUBVU LBMJVN LF CBHJBO EBMBN 4FUJBQ LBMJ OFVSPO NFOHIBOUBSLBO
FSBU UJHIU KVODUJPO
ZBJUV NFNCSBO TFM FOEPUFM ZBOH CFSEFLBUBO QPUFOTJBM BLTJ JPOJPO JOJ CFSHFSBL NFMBMVJ NFNCSBO ZBOH
CFSTBUVEFOHBOFSBUTBUVTBNBMBJOEBO UJEBL NFNQVOZBJDFMBIQPSJ NFOJOHLBULBO LFCVUVIBO USBOTQPS NFNCSBO VOUVL NFNVMJILBO
QPSJ ZBOH MFCBS EJ BOUBSB TFMTFM UFSTFCVU TFQFSUJ IBMOZB LFCBOZBLBO LPOTFOUSBTJJPOZBOHTFTVBJ0MFILBSFOBJUV LFUJLBBLUJWJUBTPUBL
LBQJMFSMBJOEBMBNUVCVI CFSMFCJI NFUBCPMJTNF OFVSPO EBQBU NFOJOHLBU TFCFTBS
TBNQBJQFSTFO
Edema Otak Kebutuhan Khusus Otak terhadap Oksigen—Tidak Ada
4BMBI TBUV LPNQMJLBTJ ZBOH QBMJOH TFSJVT EBSJ BCOPSNBMJUBT EJOBNJLB Metabolisme Anaerob yang Bermakna. ,FCBOZBLBO KBSJOHBO
DBJSBOPUBLBEBMBIUFSCFOUVLOZBFEFNBPUBL0MFILBSFOBPUBLCFSBEB UVCVI EBQBU IJEVQ UBOQB PLTJHFO TFMBNB CFCFSBQB NFOJU EBO
EJ EBMBN SVBOH LSBOJBM ZBOH QBEBU BLVNVMBTJ DBJSBO FEFNB FLTUSB TFCBHJBO KBSJOHBO MBJO TBNQBJ NFOJU 4FMBNB XBLUV JOJ
NFOFLBOQFNCVMVIEBSBI TFSJOHLBMJNFOZFCBCLBOQFOVSVOBOBMJSBO KBSJOHBO TFM NFNQFSPMFI FOFSHJOZB NFMBMVJ QSPTFT NFUBCPMJTNF
EBSBIEBOLFSVTBLBOKBSJOHBOPUBLZBOHTFSJVT BOBFSPC ZBOH CFSBSUJ QFMFQBTBO FOFSHJ EBSJ QFNFDBIBO TFCBHJBO
1FOZFCBC VNVN FEFNB PUBL BEBMBI QFOJOHLBUBO UFLBOBO LBQJMFS HMVLPTBEBOHMJLPHFOUBOQBBEBOZBQFOHHBCVOHBO[BU[BUUFSTFCVU
ZBOH CFTBS BUBV LFSVTBLBO EJOEJOH LBQJMFS ZBOH NFNCVBU EJOEJOH EFOHBO PLTJHFO 1FOHJSJNBO FOFSHJ JOJ IBOZB UFSKBEJ QBEB
NFOKBEJ QFSNFBCFM UFSIBEBQ DBJSBO 1FOZFCBC ZBOH VNVN EJKVNQBJ QFNBLBJBOTFKVNMBICFTBSHMVLPTBEBOHMJLPHFO"LBOUFUBQJ IBM
BEBMBICFOUVSBOZBOHLVBUQBEBLFQBMB ZBOHNFOJNCVMLBOHFHBSPUBL JOJEBQBUNFOKBHBKBSJOHBOUFUBQIJEVQ
ZBJUV KBSJOHBO EBO LBQJMFS PUBL NFOHBMBNJ USBVNB EBO DBJSBO LBQJMFS 0UBLUJEBLNBNQVNFMBLVLBOCBOZBLNFUBCPMJTNFBOBFSPC
NFSFNCFTLFEBMBNKBSJOHBOZBOHUFSLFOBUSBVNB 4BMBI TBUV QFOZFCBCOZB BEBMBI UJOHHJOZB MBKV NFUBCPMJTNF
#FHJUV QSPTFT EJNVMBJ FEFNB TFSJOH LBMJ NFNJDV EVB MJOHLBSBO OFVSPO TFIJOHHB TFCBHJBO CFTBS BLUJWJUBT OFVSPO CFSHBOUVOH
TFUBO ZBOHEJTFCBCLBOPMFIVNQBOCBMJLQPTJUJGCFSJLVUJOJ
&EFNB QBEB QFOHJSJNBO PLTJHFO EFUJL EFNJ EFUJL EBSJ EBSBI %FOHBO
NFOFLBOQFNCVMVIEBSBI)BMJOJLFNVEJBONFOVSVOLBOBMJSBOEBSBI NFSBOHLVN GBLUPS JOJ CFSTBNBTBNB LJUB EBQBU NFOHFSUJ
EBO NFOZFCBCLBO JTLFNJB PUBL *TLFNJB TFMBOKVUOZB NFOZFCBCLBO NFOHBQB QFOHIFOUJBO BMJSBO EBSBI LF PUBL BUBV LFIJMBOHBO
EJMBUBTJ BSUFSJPM EFOHBO QFOJOHLBUBO UFLBOBO LBQJMFS MFCJI MBOKVU PLTJHFO ZBOH UJCBUJCB EBMBN EBSBI EBQBU NFOZFCBCLBO
1FOJOHLBUBO UFLBOBO LBQJMFS LFNVEJBO NFOZFCBCLBO MFCJI CBOZBL IJMBOHOZBLFTBEBSBOEBMBNXBLUVTBNQBJEFUJL
DBJSBOFEFNBZBOHUFSCFOUVL TFIJOHHBFEFNBTFNBLJONFNCVSVL
Dalam Kondisi Normal, Sebagian Besar Energi Otak Disuplai
1FOVSVOBO BMJSBO EBSBI TFSFCSJ PUBL KVHB NFOVSVOLBO QFOHJSJNBO oleh Glukosa. %BMBN LPOEJTJ OPSNBM IBNQJS TFMVSVI FOFSHJ
PLTJHFO )BM JOJ BLBO NFOJOHLBULBO QFSNFBCJMJUBT LBQJMFS ZBOH ZBOH EJHVOBLBO PMFI TFM PUBL EJTVQMBJ PMFI HMVLPTB ZBOH
NFOHBLJCBULBO MFCJI CBOZBL MBHJ DBJSBO ZBOH CPDPS ,FBEBBO JOJ KVHB EJQFSPMFI EBSJ EBSBI 4FQFSUJ PLTJHFO TFCBHJBO CFTBS HMVLPTB
LFNVEJBONFNBUJLBOQPNQBOBUSJVNTFMKBSJOHBOOFVSPO TFIJOHHBTFM EJQFSPMFI EBSJ EBSBI LBQJMFS NFOJU EFNJ NFOJU EBO EFUJL EFNJ
LFNVEJBONFNCFOHLBL EFUJL EFOHBO KVNMBI UPUBM IBOZB TFLJUBS NFOJU TVQMBJ HMVLPTB
ZBOHOPSNBMOZBEJTJNQBOTFCBHBJHMJLPHFOEBMBNOFVSPOTFUJBQ
4BBU LFEVB MJOHLBSBO TFUBO JOJ EJNVMBJ TFTVBUV IBSVT TFHFSB TBBU
EJMBLVLBOVOUVLNFODFHBIUFSKBEJOZBLFSVTBLBOUPUBMQBEBPUBL4BMBI $JSJ LIBT QFOHJSJNBO HMVLPTB LF OFVSPO BEBMBI CBIXB
TBUV DBSB ZBOH EJUFSBQLBO BEBMBI EFOHBO NFOHJOGVT [BU PTNPUJL QFLBU USBOTQPSOZB LF EBMBN OFVSPO NFMBMVJ NFNCSBO TFM UJEBL
TFDBSBJOUSBWFOB NJTBMOZBDBJSBONBOJUPMZBOHQFLBU)BMUFSTFCVUBLBO CFSHBOUVOH QBEB JOTVMJO NFTLJQVO JOTVMJO EJCVUVILBO VOUVL
NFOBSJL DBJSBO EBSJ KBSJOHBO PUBL EFOHBO DBSB PTNPTJT EBO NFNVUVT QFOHBOHLVUBOHMVLPTBLFEBMBNTFKVNMBICFTBSTFMUVCVIMBJOOZB
LFEVBMJOHLBSBOTFUBOUFSTFCVU1SPTFEVSMBJOBEBMBIEFOHBO 0MFILBSFOBJUV QBEBQBTJFOZBOHNFOEFSJUBEJBCFUFTCFSBU
749
EFOHBO TFLSFTJ JOTVMJO ZBOH NFODBQBJ OPM HMVLPTB NBTJI CFSEJGVTJ

Faraci FM: Reactive oxygen species: influence on cerebral vascular tone,
EFOHBO NVEBI LF EBMBN OFVSPO ZBOH TBOHBU CFSNBOGBBU VOUVL
NFODFHBIIJMBOHOZBGVOHTJNFOUBMQBEBQBTJFOEJBCFUFT"LBOUFUBQJ Gore JC: Principles and practice of functional MRI of the human brain, J Clin
CJMB QBTJFO EJBCFUFT EJCFSJ JOTVMJO CFSMFCJIBO LPOTFOUSBTJ HMVLPTB Invest 112:4, 2003.
EBSBI EBQBU NFOKBEJ TBOHBU SFOEBI LBSFOB LFMFCJIBO JOTVMJO Haydon PG, Carmignoto G: Astrocyte control of synaptic transmission and
NFOZFCBCLBO IBNQJS TFMVSVI HMVLPTB EBMBN EBSBI EJUSBOTQPS neurovascular coupling, Physiol Rev 86:1009, 2006.
EFOHBO DFQBU LF EBMBN TFKVNMBI CFTBS TFM TFMBJO TBSBG ZBOH QFLB Iadecola C, Davisson RL: Hypertension and cerebrovascular dysfunction,
JOTVMJO LF TFMVSVI UVCVI LIVTVTOZB LF EBMBN TFM PUPU EBO TFM IBUJ Cell Metab 7:476, 2008.
#JMB IBM JOJ UFSKBEJ HMVLPTB ZBOH UFSTJTB EBMBN EBSBI UJEBL DVLVQ Iadecola C, Nedergaard M: Glial regulation of the cerebral microvascula-
VOUVL NFOZVQMBJ OFVSPO EFOHBO CBJL EBO GVOHTJ NFOUBM NFOKBEJ ture, Nat Neurosci 10:1369, 2007.
Iadecola C, Park L, Capone C: Threats to the mind: aging, amyloid,
TBOHBU UFSHBOHHV LBEBOHLBEBOH TBNQBJ NFOZFCBCLBO LPNB EBO
and hypertension, Stroke 40(Suppl 3):S40, 2009.
CBILBO MFCJI TFSJOH NFOJNCVMLBO LFUJEBLTFJNCBOHBO NFOUBM EBO
Johnston M, Papaiconomou C: Cerebrospinal fluid transport: a lymphatic
HBOHHVBO QTJLPUJL TFNVB HBOHHVBO UFSTFCVU EJTFCBCLBO PMFI UFSBQJ perspective, News Physiol Sci 17:227, 2002.
CFSMFCJIBOEFOHBOJOTVMJO Koehler RC, Roman RJ, Harder DR: Astrocytes and the regulation of cerebral
Daftar Pustaka blood flow, Trends Neurosci 32:160, 2009.
Moore CI, Cao R: The hemo-neural hypothesis: on the role of blood flow in
Ainslie PN, Duffin J: Integration of cerebrovascular CO2 reactivity and information processing, J Neurophysiol 99:2035, 2008.
chemoreflex control of breathing: mechanisms of regulation, mea- Murkin JM: Cerebral autoregulation: the role of CO2 in metabolic homeo-
surement, and interpretation, Am J Physiol Regul Integr Comp Physiol stasis, Semin Cardiothorac Vasc Anesth 11:269, 2007.
296:R1473, 2009. Paulson OB: Blood-brain barrier, brain metabolism and cerebral blood flow,
Alawneh JA, Moustafa RR, Baron JC: Hemodynamic factors and perfusion Eur Neuropsychopharmacol 12:495, 2002.
abnormalities in early neurological deterioration, Stroke 40:e443–e450, Syková E, Nicholson C: Diffusion in brain extracellular space, Physiol Rev
2009. 88:1277, 2008.
Barres BA: The mystery and magic of glia: a perspective on their roles in Toda N, Ayajiki K, Okamura T: Cerebral blood flow regulation by nitric oxide:
health and disease, Neuron 60:430, 2008. recent advances, Pharmacol Rev 61:62, 2009.
Chesler M: Regulation and modulation of pH in the brain, Physiol Rev Yenari M, Kitagawa K, Lyden P, Perez-Pinzon M: Metabolic downregulation:
83:1183, 2003. a key to successful neuroprotection?, Stroke 39:2910, 2008.
Duelli R, Kuschinsky W: Brain glucose transporters: relationship to local
energy demand, News Physiol Sci 16:71, 2001.
750
XII
UNIT
(BTUSPJOUFTUJOBM1IZTJPMPHZ
62. Prinsip-Prinsip Fungsi Gastrointestinal-
Motilitas, Pengaturan Saraf, dan
Sirkulasi Darah
63. Propulsi dan Pencampuran Makanan
dalam Saluran Pencernaan
64. Fungsi Sekresi Saluran Pencernaan
65. Pencernaan dan Absorpsi dalam

Traktus Gastrointestinal
66. Fisiologi Gangguan Gastrointestinal
BAB 62
UNIT XII
1SJOTJQ1SJOTJQ6NVN'VOHTJ
(BTUSPJOUFTUJOBM.PUJMJUBT 1FOHBUVSBO
4BSBG EBO4JSLVMBTJ%BSBI
4BMVSBO DFSOB NFNCFSJ UVCVI

QFSTFEJBBO BJS FMFLUSPMJU WJUBNJO
WJUBNJO EBO [BU NBLBOBO TFDBSB
UFSVTNFOFSVT 6OUVL NFODBQBJ
IBM JOJ EJCVUVILBO
HFSBLBO
NBLBOBONFMBMVJTBMVSBODFSOB

TFLSFTJ HFUBI QFODFSOBBO EBO QFODFSOBBO NBLBOBO

BCTPSQTJ BJS CFSCBHBJ FMFLUSPMJU WJUBNJOWJUBNJO EBO IBTJM
QFODFSOBBO
TJSLVMBTJ EBSBI NFMBMVJ PSHBOPSHBO
HBTUSPJOUFTUJOBMVOUVLNFNCBXB[BU[BUZBOHEJBCTPSCTJEBO

QFOHBUVSBO TFNVB GVOHTJ JOJ PMFI TJTUFN MPLBM TBSBG EBO
IPSNPO
(BNCBS NFOVOKVLLBO TFMVSVI TBMVSBO DFSOB 4FUJBQ
CBHJBO EJTFTVBJLBO UFSIBEBQ GVOHTJ TQFTJGJLOZB CFCFSBQB VOUVL
MJOUBTBO NBLBOBO ZBOH TFEFSIBOB TFQFSUJ FTPGBHVT ZBOH MBJO
VOUVL QFOZJNQBOBO NBLBOBO TFNFOUBSB TFQFSUJ MBNCVOH EBO
ZBOH MBJO VOUVL QFODFSOBBO EBO BCTPSQTJ TFQFSUJ VTVT IBMVT
%BMBN CBC JOJ LJUB NFOEJTLVTJLBO QSJOTJQQSJOTJQ GVOHTJPOBM
EBTBS EJ TFMVSVI TJTUFN QFODFSOBBO EBO EBMBN CBCCBC
CFSJLVUOZB LJUB NFOEJTLVTJLBO GVOHTJGVOHTJ LIVTVT CFSCBHBJ
TFHNFOTBMVSBO
Prinsip-Prinsip Umum Motilitas

Gastrointestinal
Otot Polos Gastrointestinal yang Berfungsi sebagai
Sinsitium. 4FSBUTFSBU PUPU QPMPT USBLUVT HBTUSPJOUFTUJOBM
Anatomi Fisiologis Dinding Gastrointestinal
NFNQVOZBJ QBOKBOH TBNQBJ HSO EBO EJBNFUFS
TBNQBJ EBO TFSBUTFSBU PUPU QPMPT UFSTFCVU UFSTVTVO EBMBN
(BNCBS NFOVOKVLLBO QPUPOHBO NFMJOUBOH ZBOH LIBT
CFSLBT TFCBOZBL TFSBU QBSBMFM %BMBN MBQJTBO PUPU
EJOEJOH VTVT NFMJQVUJ MBQJTBOMBQJTBO EBSJ QFSNVLBBO MVBS
MPOHJUVEJOBM CFSLBTCFSLBT UFSTFCVU NFNCFOUBOH QBOKBOH
TBNQBJ LF EBMBN
MBQJTBO TFSPTB
MBQJTBO PUPU QPMPT
NFOVSVOJUSBLUVTJOUFTUJOBMEBMBNMBQJTBOPUPUTJSLVMBS CFSLBT
MPOHJUVEJOBM
MBQJTBO PUPU QPMPT TJSLVMBS
MBQJTBO
CFSLBTUFSTFCVUNFNCFOUBOHNFOHFMJMJOHJVTVT
TVCNVLPTB EBO
MBQJTBO NVLPTB 4FMBJO JUV UFSEBQBU CFSLBT
UJQJT TFSBUTFSBU PUPU QPMPT ZBJUV PUPU NVLPTB ZBOH UFSMFUBL EJ %BMBN TFUJBQ CFSLBT TFSBUTFSBU PUPU EJIVCVOHLBO TFDBSB
MBQJTBO QBMJOH EBMBN EBSJ NVLPTB 'VOHTJ NPUPSJL VTVT MJTUSJLTBUVUFSIBEBQZBOHMBJONFMBMVJTFKVNMBICFTBSUBVUFSBU
EJMBLVLBOPMFICFSCBHBJMBQJTBOPUPUQPMPTUBEJ HBQ KVODUJPO
ZBOH NFOJNCVMLBO HFSBLBO JPO ZBOH
CFSUBIBOBO SFOEBI EBSJ TBUV TFM PUPU LF TFM PUPU CFSJLVUOZB
$JSJDJSJVNVNEBOGVOHTJPUPUQPMPTEJEJTLVTJLBOEBMBN#BC 0MFILBSFOBJUV TJOZBMTJOZBMMJTUSJLZBOHNFOHBXBMJLPOUSBLTJ
ZBOH TFCBJLOZB EJMJIBU LFNCBMJ TFCBHBJ MBUBS CFMBLBOH VOUVL PUPU EBQBU TFHFSB CFSKBMBO EBSJ TBUV TFSBU LF TFSBU CFSJLVUOZB
CBHJBOCBHJBOCFSJLVUEBSJCBCJOJ$JSJDJSJLIBTPUPUQPMPTVTVT EBMBN TFUJBQ CFSLBT UFUBQJ QFOKBMBSBO JOJ CFSMBOHTVOH TFDBSB
BEBMBITFCBHBJCFSJLVU MFCJIDFQBUEJTFQBOKBOHCFSLBTEBSJQBEBEJTJTJCFSLBT
753
Unit Xll Fisiologi Gastrointestinal
Slow
waves
EBMBN LPSQVT MBNCVOH TFCBOZBL EBMBN EVPEFOVN TFSUB

LJSBLJSB BUBV EJ EBMBN JMFVN UFSNJOBMJT 0MFI LBSFOB JUV
4FUJBQCFSLBTTFSBUPUPUQPMPTTFCBHJBOEJQJTBILBOEBSJZBOH JSBNBLPOUSBLTJLPSQVTMBNCVOHCJBTBOZBLJSBLJSBQFSNFOJU EJ
MBJO PMFI KBSJOHBO JLBU MPOHHBS UFUBQJ CFSLBT PUPU UFSTFCVU EVPEFOVN LJSBLJSB QFS NFOJU EBO EJ JMFVN TBNQBJ QFS
CFSTBUV EFOHBO ZBOH MBJO QBEB CBOZBL UJUJL TFIJOHHB EBMBN NFOJU
LFBEBBO TFCFOBSOZB TFUJBQ MBQJTBO PUPU NFXBLJMJ LJTJLJTJ
1FOZFCBC QBTUJ HFMPNCBOH MBNCBU UJEBL TFQFOVIOZB
DBCBOH CFSLBT PUPU QPMPT 0MFI LBSFOB JUV TFUJBQ MBQJTBO PUPU
EJNFOHFSUJ XBMBV HFMPNCBOH MBNCBU JUV UBNQBLOZB EJTFCBCLBO
CFSGVOHTJ TFQFSUJ TJOTJUJVN ZBJUV CJMB UFSCFOUVL TFCVBI
PMFIJOUFSBLTJZBOHLPNQMFLTBOUBSBTFMPUPUQPMPTEBOTFMLIVTVT
QPUFOTJBM BLTJ EJ NBOB QVO EBMBN NBTTB PUPU QPUFOTJBM BLTJ ZBOHEJTFCVUTFMJOUFSTUJTJBM$BKBM ZBOHEJZBLJOJCFSGVOHTJTFCBHBJ
CJBTBOZB CFSKBMBO LF TFNVB BSBI EBMBN PUPU +BSBL ZBOH QBDFNBLFS MJTUSJL VOUVL TFM PUPU QPMPT 4FMTFM JOUFSTUJTJBM JOJ
EJUFNQVI CFSHBOUVOH QBEB FLTJUBCJMJUBT PUPU LBEBOHLBEBOH NFNCFOUVL TVBUV KBSJOHBO TBUV TBNB MBJO EBO UFSTJTJQ EJ BOUBSB
QPUFOTJBM BLTJ JOJ CFSIFOUJ TFUFMBI CFSKBMBO IBOZB CFCFSBQB MBQJTBO PUPU QPMPT EFOHBO LPOUBL NJSJQ TJOBQT LF TFM PUPU QPMPT
NJMJNFUFS EBOQBEBTBBUMBJOTFUFMBICFCFSBQBTFOUJNFUFSBUBV 4FM JOUFSTUJTJBM $BKBM NFOKBMBOJ QFSVCBIBO TJLMJL QBEB QPUFOTJBM
CBILBOTFUFMBITFMVSVIQBOKBOHEBOUFCBMUSBLUVTJOUFTUJOBM NFNCSBO BLJCBU LBOBM JPO ZBOH VOJL ZBOH TFDBSB CFSLBMB
+VHB UFSEBQBU CFCFSBQB IVCVOHBO BOUBSB MBQJTBO PUPU NFNCVLB EBO NFOHIBTJMLBO BMJSBO NBTVL QBDFNBLFS
ZBOH
MPOHJUVEJOBM EBO TJSLVMBS TFIJOHHB QFSBOHTBOHBO TBMBI TBUV EBQBUNFNCBOHLJULBOBLUJWJUBTHFMPNCBOHMBNCBU
MBQJTBOBLBONFSBOHTBOHMBQJTBOZBOHMBJO (FMPNCBOHMBNCBUCJBTBOZBUJEBLNFOZFCBCLBOLPOUSBLTJPUPU
TFDBSB UFSTFOEJSJ QBEB TFCBHJBO CFTBS USBLUVT HBTUSPJOUFTUJOBM
Aktivitas Listrik pada Otot Polos Gastrointestinal LFDVBMJNVOHLJOEJMBNCVOH4FCBMJLOZB HFMPNCBOHJUVUFSVUBNB
NFSBOHTBOH NVODVMOZB QPUFOTJBM QBLV ZBOH JOUFSNJUFO EBO
0UPU QPMPT USBLUVT HBTUSPJOUFTUJOBM IBNQJS UFSVTNFOFSVT QPUFOTJBM QBLV JOJ LFNVEJBO NFSBOHTBOH UFSKBEJOZB LPOUSBLTJ
UFSFLTJUBTJ PMFI BLUJWJUBT MJTUSJL JOUSJOTJL ZBOH MBNCBU NFMBMVJ PUPU
NFNCSBO TFSBCVU PUPU "LUJWJUBT JOJ NFNJMJLJ EVB UJQF EBTBS
HFMPNCBOH MJTUSJL
HFMPNCBOH MBNCBU EBO
HFMPNCBOH
Potensial Paku.1PUFOTJBMQBLVNFSVQBLBOQPUFOTJBMBLTJZBOH
QBLV LFEVBOZB EJUVOKVLLBO EBMBN (BNCBS 4FMBJO JUV
TFCFOBSOZB 1PUFOTJBM JOJ UJNCVM TFDBSB PUPNBUJT CJMB QPUFOTJBM
UFHBOHBOQPUFOTJBMNFNCSBOJTUJSBIBUPUPUQPMPTHBTUSPJOUFTUJOBM
NFNCSBOJTUJSBIBUPUPUQPMPTHBTUSPJOUFTUJOBMNFOKBEJMFCJIQPTJUJG
EBQBU EJVCBIVCBI NFOKBEJ UJOHLBU ZBOH CFSCFEBCFEB EBO EBSJTFLJUBSNJMJWPMU QPUFOTJBMNFNCSBOJTUJSBIBUOPSNBMEJ
LFBEBBOJOJEBQBUQVMBNFNQVOZBJQFOHBSVIQFOUJOHUFSIBEBQ TFSBUTFSBUPUPUQPMPTVTVTBEBMBIBOUBSBEBONJMJWPMU

QFOHBUVSBOBLUJWJUBTNPUPSJLUSBLUVTHBTUSPJOUFTUJOBM 1FSIBUJLBO EBMBN (BNCBS CBIXB TFUJBQ LBMJ QVODBL
HFMPNCBOH TFDBSB UFNQPSFS NFOKBEJ MFCJI QPTJUJG EBSJ OJMBJ
Gelombang Lambat. 4FCBHJBO CFTBS LPOUSBLTJ HBTUSP NJMJWPMU QPUFOTJBM QBLV UJNCVM QBEB QVODBLOZB 4FNBLJO UJOHHJ
JOUFTUJOBM CFSMBOHTVOH TFDBSB CFSJSBNB EBO JSBNB JOJ UFSVUBNB QPUFOTJBM HFMPNCBOH MBNCBU NFOJOHLBU BLBO TFNBLJO CFTBS
EJUFOUVLBO PMFI GSFLVFOTJ EBSJ BQB ZBOH EJTFCVU HFMPNCBOH GSFLVFOTJ QPUFOTJBM QBLV CJBTBOZB CFSLJTBS BOUBSB EBO
MBNCBU EBMBN QPUFOTJBM NFNCSBO PUPU QPMPT (FMPNCBOH JOJ HFMPNCBOH QBLV QFS EFUJL 1BEB PUPU HBTUSPJOUFTUJOBM QPUFOTJBM
ZBOHEJUVOKVLLBOEBMBN(BNCBS CVLBOMBITVBUVQPUFOTJBM QBLV CFSMBOHTVOH TBNQBJ LBMJ MFCJI MBNB TFQFSUJ IBMOZB
BLTJ 4FCBMJLOZB HFMPNCBOHHFMPNCBOH UFSTFCVU NFSVQBLBO QPUFOTJBM BLTJ EJ TFSBU TBSBG ZBOH CFTBS TFUJBQ HFMPNCBOH QBLV
QFSVCBIBO QPUFOTJBM NFNCSBO JTUJSBIBU ZBOH MBNCBU EBO HBTUSPJOUFTUJOBMCFSMBOHTVOHTFMBNBTBNQBJNJMJEFUJL
CFSHFMPNCBOH*OUFOTJUBTOZBCJBTBOZBCFSWBSJBTJBOUBSBEBO 1FSCFEBBO QFOUJOH MBJO BOUBSB QPUFOTJBM BLTJ PUPU QPMPT
NJMJWPMU EBO LJTBSBO GSFLVFOTJOZB EBSJ TBNQBJ QFS NFOJU HBTUSPJOUFTUJOBM EBO QPUFOTJBM BLTJ EJ TFSBUTFSBU TBSBG BEBMBI DBSB
QBEBCFSCBHBJCBHJBOUSBLUVTHBTUSPJOUFTUJOBMNBOVTJBLJSBLJSB QPUFOTJBMUFSTFCVUEJCBOHLJULBO1BEBTFSBUTFSBUTBSBG QPUFOTJBM
754
Bab 62 Prinsip-Prinsip Umum Fungsi Gastrointestinal Motilitas, Pengaturan Saraf, dan Sirkulasi Darah
BLTJ IBNQJS TFMVSVIOZB EJTFCBCLBO PMFI NBTVLOZB JPOJPO MBNCBU NFMBJOLBO TFSJOH CFSMBOHTVOH CFCFSBQB NFOJU BUBV
OBUSJVNZBOHCFSMBOHTVOHDFQBUNFMBMVJLBOBMOBUSJVNLFCBHJBO CBILBO CFSKBNKBN *OUFOTJUBT LPOUSBLTJ UPOJL TFSJOH
EBMBN TFSBUTFSBU 1BEB TFSBUTFSBU PUPU QPMPT HBTUSPJOUFTUJOBM NFOJOHLBUBUBVNFOVSVOUFUBQJCFSMBOHTVOHLPOUJOV
LBOBMZBOHCFSUBOHHVOHKBXBCVOUVLQPUFOTJBMBLTJBHBLCFSCFEB ,POUSBLTJ UPOJL LBEBOHLBEBOH EJTFCBCLBO PMFI QPUFOTJBM
UNIT XII
LBOBM JOJ LIVTVTOZB NFOHJ[JOLBO TFKVNMBI CFTBS JPO LBMTJVN QBLV CFSVMBOHVMBOH ZBOH LPOUJOV NBLJO CFTBS GSFLVFOTJ
VOUVL NBTVL CFSTBNB EFOHBO TFKVNMBI LFDJM JPO OBUSJVN EBO NBLJOCFTBSEFSBKBULPOUSBLTJ1BEBTBBUMBJO LPOUSBLTJUPOJL
LBSFOBJUVEJTFCVULBOBMLBMTJVNOBUSJVN,BOBMJOJUFSCVLBEBO EJTFCBCLBO PMFI IPSNPOIPSNPO BUBV GBLUPS MBJO ZBOH
UFSUVUVQ KBVI MFCJI MBNCBU EBSJQBEB LBOBM OBUSJVN DFQBU QBEB NFOJNCVMLBO EFQPMBSJTBTJ TFCBHJBO ZBOH LPOUJOV QBEB
TFSBUTFSBU TBSBG CFTBS -BNCBUOZB QFNCVLBBO EBO QFOVUVQBO NFNCSBOPUPUQPMPTUBOQBNFOJNCVMLBOQPUFOTJBMBLTJ.BTJI
LBOBM LBMTJVNOBUSJVN NFOJNCVMLBO QPUFOTJBM BLTJ MFCJI MBNB BEBQFOZFCBCLFUJHBZBOHNFOJNCVMLBOLPOUSBLTJUPOJL ZBJUV
+VHB QFSHFSBLBO TFKVNMBI CFTBS JPO LBMTJVN LF CBHJBO EBMBN NBTVLOZB JPO LBMTJVN ZBOH UFSVTNFOFSVT LF CBHJBO EBMBN
TFSBU PUPU TFMBNB QPUFOTJBM BLTJ NFNBJOLBO TVBUV QFSBOBO TFM ZBOH UJEBL CFSIVCVOHBO EFOHBO QFSVCBIBO QPUFOTJBM
QFOUJOHEBMBNNFOJNCVMLBOLPOUSBLTJTFSBUTFSBUPUPUJOUFTUJOBM NFNCSBO ,FUFSBOHBO ZBOH MFCJI EFUBJM EBSJ NFLBOJTNF JOJ
TFQFSUJZBOHLJUBCJDBSBLBOTFDBSBTJOHLBU NBTJICFMVNKFMBT
Perubahan Voltase Potensial Membran Istirahat.4FMBJOQPUFO

TJBM HFMPNCBOH MBNCBU EBO QBLV UJOHLBU EBTBS WPMUBTF QPUFOTJBM Kontrol Saraf terhadap Fungsi Gastrointestinal
NFNCSBOJTUJSBIBUPUPUQPMPTKVHBEBQBUCFSVCBI1BEBLFBEBBO Sistem Saraf Enterik
OPSNBM QPUFOTJBM NFNCSBO JTUJSBIBU LJSBLJSB TFLJUBS o
NJMJWPMU UFUBQJCBOZBLGBLUPSZBOHEBQBUNFOHVCBIOJMBJJOJ#JMB 5SBLUVT HBTUSPJOUFTUJOBM NFNJMJLJ TJTUFN QFSTBSBGBO TFOEJSJ
QPUFOTJBM NFOKBEJ LVSBOH OFHBUJG ZBOH EJTFCVU EFQPMBSJTBTJ ZBOHEJTFCVUTJTUFNTBSBGFOUFSJL4JTUFNJOJTFMVSVIOZBUFSMFUBL
NFNCSBO TFSBU PUPU NFOKBEJ MFCJI NVEBI EJSBOHTBOH #JMB EJEJOEJOHVTVT NVMBJEBSJFTPGBHVTEBONFNBOKBOHTBNQBJLF
QPUFOTJBM NFOKBEJ MFCJI OFHBUJG ZBOH EJTFCVU IJQFSQPMBSJTBTJ BOVT +VNMBI OFVSPO QBEB TJTUFN FOUFSJL JOJ TFLJUBS KVUB
TFSBUTFSBUPUPUNFOKBEJLVSBOHNVEBIEJSBOHTBOH IBNQJS TBNB EFOHBO KVNMBI QBEB LFTFMVSVIBO NFEVMB
#FCFSBQB GBLUPS ZBOH NFOJNCVMLBO EFQPMBSJTBTJ NFNCSBO TQJOBMJT 4JTUFN TBSBG FOUFSJL ZBOH TBOHBU CFSLFNCBOH JOJ
BSUJOZB ZBOH EBQBU NFNCVBU NFNCSBO MFCJI QFLB SBOHTBOH CFSTJGBUQFOUJOH UFSVUBNBEBMBNNFOHBUVSGVOHTJQFSHFSBLBO
BEBMBI
QFSFHBOHBO PUPU
QFSBOHTBOHBO PMFI BTFUJMLPMJO EBOTFLSFTJHBTUSPJOUFTUJOBM
ZBOH EJMFQBTLBO EBSJ VKVOHVKVOH TBSBGTBSBG QBSBTJNQBUJT EBO 4JTUFN TBSBG FOUFSJL UFSVUBNB UFSEJSJ BUBT EVB QMFLTVT ZBOH

QFSBOHTBOHBOPMFICFCFSBQBIPSNPOHBTUSPJOUFTUJOBMLIVTVT EJUVOKVLLBO EBMBN (BNCBS
TBUV QMFLTVT CBHJBO MVBS
'BLUPSGBLUPSQFOUJOHZBOHNFNCVBUQPUFOTJBMNFNCSBOMFCJI ZBOH UFSMFUBL EJ BOUBSB MBQJTBO PUPU MPOHJUVEJOBM EBO TJSLVMBS
OFHBUJG ZBJUV IJQFSQPMBSJTBTJ NFNCSBO EBO NFNCVBU TFSBU PUPU EJTFCVUQMFLTVTNJFOUFSJLVTBUBVQMFLTVT"VFSCBDI EBO
TBUV
LVSBOH QFLB SBOHTBOH BEBMBI
QFOHBSVI OPSFQJOFGSJO BUBV QMFLTVT CBHJBO EBMBN EJTFCVU QMFLTVT TVCNVLPTB BUBV QMFLTVT
FQJOFGSJOQBEBNFNCSBOTFSBCVUEBO
QFSBOHTBOHBOTBSBGTBSBG .FJTTOFS ZBOHUFSMFUBLEJEBMBNTVCNVLPTB)VCVOHBOTBSBGEJ
TJNQBUJT ZBOH UFSVUBNB NFOZFLSFTJ OPSFQJOFGSJO QBEB VKVOH EBMBN EBO BOUBSB LFEVB QMFLTVT KVHB EJUVOKVLLBO EBMBN
VKVOHOZB (BNCBS
1MFLTVTNJFOUFSJLVTUFSVUBNBNFOHBUVSQFSHFSBLBOHBTUSP
lon Kalsium dan Kontraksi Otot. ,POUSBLTJ PUPU QPMPT UFSKBEJ JOUFTUJOBM EBO QMFLTVT TVCNVLPTB UFSVUBNB NFOHBUVS TFLSFTJ
TFCBHBJ SFTQPOT UFSIBEBQ NBTVLOZB JPO LBMTJVN LF EBMBN TFSBU HBTUSPJOUFTUJOBMEBOBMJSBOEBSBIMPLBM
PUPU 4FQFSUJ ZBOH UFMBI EJUFSBOHLBO QBEB #BC JPOJPO LBMTJVN 1FSIBUJLBO UFSVUBNB QBEB (BNCBS UFSEBQBU TFSBU
ZBOH CFLFSKB NFMBMVJ NFLBOJTNF LPOUSPM LBMNPEVMJO NFOHBLUJG TFSBUTJNQBUJT EBO QBSBTJNQBUJT FLTUSJOTJL ZBOH CFSIVCVOHBO
LBOGJMBNFOGJMBNFONJPTJOEBMBNTFSBU NFOZFCBCLBOUFSDJQUBOZB LF LFEVB QMFLTVT NJFOUFSJLVT EBO TVCNVLPTB 8BMBVQVO
HBZB UBSJLNFOBSJL BOUBSB GJMBNFO NJPTJO EBO GJMBNFO BLUJO TJTUFN TBSBG FOUFSJL EBQBU CFSGVOHTJ EFOHBO UJEBL CFSHBOUVOH
TFIJOHHBNFOHBLJCBULBOPUPUCFSLPOUSBLTJ LFQBEB TBSBGTBSBG FLTUSJOTJL JOJ QFSBOHTBOHBO PMFI TJTUFN
(FMPNCBOHMBNCBUUJEBLNFOZFCBCLBOJPOLBMTJVNNFNBTVLJ QBSBTJNQBUJT EBO TJNQBUJT EBQBU TBOHBU NFOJOHLBULBO BUBV
TFSBU PUPU QPMPT IBOZB JPO OBUSJVN TBKB
0MFI LBSFOB JUV NFOHIBNCBU GVOHTJ HBTUSPJOUFTUJOBM MFCJI MBOKVU ZBOH BLBO
HFMPNCBOH MBNCBU JUV TFOEJSJ CJBTBOZB UJEBL NFOJNCVMLBO LJUBEJTLVTJLBOLFNVEJBO
LPOUSBLTJ PUPU +VTUSV NBTVLOZB JPO LBMTJVN EBMBN KVNMBI +VHB EJUVOKVLLBO QBEB (BNCBS BEBMBI VKVOHVKVOH
CFSNBLOBLFEBMBNTFSBUJUVUFSKBEJTFMBNBQPUFOTJBMQBLV ZBOH TBSBG TJNQBUJT ZBOH CFSBTBM EBSJ FQJUFM HBTUSPJOUFTUJOBM BUBV
UJNCVM QBEB QVODBL HFMPNCBOH MBNCBU EBO NFOJNCVMLBO EJOEJOH VTVT EBO NFOHJSJNLBO TFSBUTFSBU BGFSFO LF LFEVB
TFCBHJBOCFTBSLPOUSBLTJ QMFLTVT TJTUFN FOUFSJL EBO
LF HBOHMJB QSFWFSUFCSB EBSJ
TJTUFNTBSBGTJNQBUJT
LFNFEVMBTQJOBMJT EBO
LFEBMBN
Kontraksi Tonik Beberapa Otot Polos Gastrointestinal.#FCFSBQB TBSBG WBHVT NFOVKV LF CBUBOH PUBL 4BSBGTBSBG TFOTPSJL JOJ
PUPUQPMPTUSBLUVTHBTUSPJOUFTUJOBMNFNQFSMJIBULBOLPOUSBLTJUPOJL EBQBUNFOHBEBLBOSFGMFLTSFGMFLTMPLBMEJEBMBNEJOEJOHVTVT
EBOBUBVNFOHHBOUJLBOLPOUSBLTJSJUNJT,POUSBLTJUPOJLCFSTJGBU JUV TFOEJSJ EBO SFGMFLTSFGMFLT MBJO ZBOH EJIBOUBSLBO LF VTVT
LPOUJOV UJEBLCFSIVCVOHBOEFOHBOJSBNBMJTUSJLEBTBSHFMPNCBOH CBJLEBSJHBOHMJBQSFWFSUFCSBNBVQVOEBSJEBFSBICBTBMPUBL
755
Perbedaan antara Pleksus Mienterikus dan Pleksus Jenis-Jenis Neurotransmiter yang Disekresi oleh Neuron-
Submukosa Neuron Enterik
1MFLTVTNJFOUFSJLVTUFSVUBNBUFSEJSJBUBTTVBUVSBOUBJMJOJFSEBSJ %BMBN VTBIB VOUVL MFCJI NFNBIBNJ CFSCBHBJ GVOHTJ TJTUFN
CBOZBL OFVSPO ZBOH TBMJOH CFSIVCVOHBO ZBOH NFNCFOUBOH EJ TBSBG FOUFSJL HBTUSPJOUFTUJOBM QBSB QFOFMJUJ EBSJ TFMVSVI EVOJB
TFQBOKBOH USBLUVT HBTUSPJOUFTUJOBM 1PUPOHBO SBOUBJ JOJ UFMBINFOHJEFOUJGJLBTJTFMVTJOBUBVMFCJI[BU[BUOFVSPUSBOTNJUFS
EJUVOKVLLBOEBMBN(BNCBS ZBOH CFSCFEB ZBOH EJMFQBTLBO PMFI VKVOHVKVOH TBSBG CFSCBHBJ
0MFI LBSFOB QMFLTVT NJFOUFSJLVT NFNCFOUBOH TFQBOKBOH UJQF OFVSPO FOUFSJL %VB EBSJ OFVSPUSBOTNJUFS ZBOH UFMBI LJUB
EJOEJOH VTVT EBO LBSFOB UFSMFUBL EJ BOUBSB MBQJTBO PUPU QPMPT LFOBMBEBMBI
BTFUJMLPMJOEBO
OPSFQJOFGSJO-BJOOZBBEBMBI
MPOHJUVEJOBM EBO TJSLVMBS VTVT QMFLTVT JOJ UFSVUBNB CFSQFSBO
BEFOPTJO USJGPTGBU
TFSPUPOJO
EPQBNJO
LPMFTJT
QBEB QFOHBUVSBO BLUJWJUBT PUPU EJ TFQBOKBOH VTVT #JMB QMFLTVT UPLJOJO
TVCTUBOTJ 1
QPMJQFQUJEB JOUFTUJOBM WBTPBLUJG

JOJ EJSBOHTBOH FGFLOZB ZBOH VUBNB BEBMBI
QFOJOHLBUBO TPNBUPTUBUJO
MFVFOLFGBMJO
NFUFOLFGBMJO EBO

LPOUSBLTJ UPOJL BUBV UPOVT EJOEJOH VTVT
QFOJOHLBUBO CPNCFTJO 'VOHTJGVOHTJ LIVTVT EBSJ CBOZBL OFVSPUSBOTNJUFS
JOUFOTJUBT LPOUSBLTJ SJUNJT
TFEJLJU QFOJOHLBUBO LFDFQBUBO JOJ UJEBL UFSMBMV EJLFOBM VOUVL EBQBU EJCBIBT EJ TJOJ TFMBJO
JSBNB LPOUSBLTJ EBO
QFOJOHLBUBO LFDFQBUBO LPOEVLTJ QFNCBIBTBOIBMCFSJLVU
HFMPNCBOHFLTJUBUPSJTEJTFQBOKBOHEJOEJOHVTVT NFOZFCBCLBO "TFUJMLPMJO QBMJOH TFSJOH NFSBOHTBOH BLUJWJUBT HBTUSP
HFSBLBOHFMPNCBOHQFSJTUBMUJLVTVTZBOHMFCJIDFQBU JOUFTUJOBM /PSFQJOFGSJO IBNQJS TFMBMV NFOHIBNCBU BLUJWJUBT
4FIBSVTOZB QMFLTVT NJFOUFSJLVT UJEBL TFMVSVIOZB CJTB HBTUSPJOUFTUJOBM )BM JOJ KVHB CFSMBLV QBEB FQJOFGSJO ZBOH
EJBOHHBQ CFSTJGBU FLTJUBUPSJL LBSFOB CFCFSBQB OFVSPOOZB NFODBQBJ USBLUVT HBTUSPJOUFTUJOBM UFSVUBNB MFXBU BMJSBO EBSBI
CFSTJGBU NFOHIBNCBU VKVOHVKVOH TFSBUOZB NFOZFLSFTJLBO TFUFMBI EJTFLSFTJLBO PMFI NFEVMB BESFOBM LF EBMBN TJSLVMBTJ
TVBUV USBOTNJUFS JOIJCJUPS LFNVOHLJOBO QPMJQFQUJEB JOUFTUJOBM 4VCTUBOTJUSBOTNJUFSMBJOZBOHEJTFCVULBOUBEJBEBMBIHBCVOHBO
WBTPBLUJGBUBVCFCFSBQBQFQUJEBJOIJCJUPSMBJO)BTJMEBSJTJOZBM CBIBOCBIBOFLTJUBUPSEBOJOIJCJUPS CFCFSBQBEJBOUBSBOZBLJUB
JOIJCJUPS UFSVUBNB CFSHVOB VOUVL NFOHIBNCBU CFCFSBQB PUPU CBIBTQBEBCBCTFMBOKVUOZB
TGJOHUFS JOUFTUJOBM ZBOH NFOHIBNCBU HFSBLBO NBLBOBO
TFQBOKBOH TFHNFOTFHNFO USBLUVT HBTUSPJOUFTUJOBM ZBOH Pengaturan Otonom Traktus Gastrointestinal
CFSUVSVUBO TFQFSUJTGJOHUFSQJMPSJL ZBOHNFOHBUVSQFOHPTPOHBO
MBNCVOH NFOVKV LF EVPEFOVN EBO TGJOHUFS LBUVQ JMFPDFDBM Perangsangan Parasimpatis Meningkatkan Aktivitas
ZBOHNFOHBUVSQFOHPTPOHBOEBSJVTVTIBMVTLFEBMBNDBFDVN Sistem Saraf Enterik. 1FSTBSBGBO QBSBTJNQBUJT LF VTVT EJCBHJ
#FSCFEB EFOHBO QMFLTVT NJFOUFSJLVT QMFLTVT TVCNVLPTB BUBTEJWJTJLSBOJBMEBOEJWJTJTBLSBM ZBOHUFMBIEJCJDBSBLBOEBMBN
CFSQFSBO QBEB QFOHBUVSBO GVOHTJ EJ EBMBN EJOEJOH TFCFMBI #BC
EBMBN EBSJ UJBQ CBHJBO LFDJM TFHNFO VTVT 4FCBHBJ DPOUPI ,FDVBMJ VOUVL CFCFSBQB TFSBUTFSBU QBSBTJNQBUJT LF SFHJP
CBOZBL TJOZBM TFOTPSJL CFSBTBM EBSJ FQJUFM HBTUSPJOUFTUJOBM EBO NVMVU EBO GBSJOH EBSJ TBMVSBO QFODFSOBBO TFSBUTFSBU TBSBG
LFNVEJBO CFSTBUV EBMBN QMFLTVT TVCNVLPTB VOUVL NFNCBOUV QBSBTJNQBUJT LSBOJBM IBNQJS TFMVSVIOZB EJ EBMBN TBSBG WBHVT
NFOHBUVS TFLSFTJ JOUFTUJOBM MPLBM BCTPSQTJ MPLBM EBO LPOUSBLTJ 4FSBUTFSBU JOJ NFNCFSJ JOFSWBTJ ZBOH MVBT QBEB FTPGBHVT
PUPU TVCNVLPTB MPLBM ZBOH NFOZFCBCLBO CFSCBHBJ UJOHLBU MBNCVOH QBOLSFBT EBO TFEJLJU LF VTVT TBNQBJ TFQBSVI CBHJBO
QFMJQBUBONVLPTBHBTUSPJOUFTUJOBM QFSUBNBVTVTCFTBS
756
1BSBTJNQBUJT TBLSBM CFSBTBM EBSJ TFHNFO TBLSBM LFEVB LFUJHB 4FMBJO JUV TJOZBM TFOTPSJL MBJO ZBOH CFSBTBM EBSJ VTVT
EBOLFFNQBUNFEVMBTQJOBMJTTFSUBCFSKBMBONFMBMVJTBSBGQFMWJTLF CFSKBMBOLFCFSCBHBJBSFBNFEVMBTQJOBMJTCBILBOCBUBOHPUBL
TFQBSVI CBHJBO EJTUBM VTVT CFTBS EBO TFQBOKBOH BOVT "SFB 4FCBHBJ DPOUPI QFSTFO TFSBU TBSBG EJ EBMBN TBSBG WBHVT
TJHNPJE SFLUVN EBO BOVT EJQFSLJSBLBO NFOEBQBU QFSTBSBGBO CFSTJGBU BGFSFO CVLBO FGFSFO 4FSBUTFSBU BGFSFO JOJ NFOHJSJN
UNIT XII
QBSBTJNQBUJT ZBOH MFCJI CBJL EBSJQBEB CBHJBO VTVT ZBOH MBJO TJOZBM TFOTPSJL EBSJ USBLUVT HBTUSPJOUFTUJOBM LF EBMBN NFEVMB
'VOHTJTFSBUTFSBUJOJUFSVUBNBNFOKBMBOLBOSFGMFLTEFGFLBTJ ZBOH PUBL ZBOH LFNVEJBO NFODFUVTLBO TJOZBM SFGMFLT WBHBM ZBOH
BLBOEJCJDBSBLBOEBMBN#BC LFNCBMJ LF USBLUVT HBTUSPJOUFTUJOBM VOUVL NFOHBUVS CFSCBHBJ
GVOHTJOZB
/FVSPOOFVSPOQPTUHBOHMJPOJLEBOTJTUFNQBSBTJNQBUJTHBTUSP
JOUFTUJOBM UFSMFUBL UFSVUBNB EJ QMFLTVT NJFOUFSJLVT EBO QMFLTVT
TVCNVLPTB 1FSBOHTBOHBO TBSBG QBSBTJNQBUJT JOJ NFOJNCVMLBO Refleks-Refleks Gastrointestinal
QFOJOHLBUBOVNVNBLUJWJUBTTFMVSVITJTUFNTBSBGFOUFSJL)BMJOJ 1FOHBUVSBO BOBUPNJT TJTUFN TBSBG FOUFSJL TFSUB IVCVOHBOOZB
LFNVEJBO BLBO NFNQFSLVBU BLUJWJUBT TFCBHJBO CFTBS GVOHTJ EFOHBOTJTUFNTBSBGTJNQBUJTEBOQBSBTJNQBUJTNFOEVLVOHUJHB
HBTUSPJOUFTUJOBM KFOJT SFGMFLT HBTUSPJOUFTUJOBM ZBOH TBOHBU CFSHVOB VOUVL
QFOHBUVSBO HBTUSPJOUFTUJOBM 3FGMFLT UFSTFCVU BEBMBI TFCBHBJ
Perangsangan Simpatis Biasanya Menghambat Aktivitas Trak- CFSJLVU
tus Gastrointestinal.4FSBUTFSBU TJNQBUJT ZBOH CFSKBMBO LF USBLUVT 1. 3FGMFLTSFGMFLT ZBOH TFMVSVIOZB UFSJOUFHSBTJ EJ EBMBN TJTUFN
HBTUSPJOUFTUJOBM CFSBTBM EBSJ NFEVMB TQJOBMJT BOUBSB TFHNFO 5 TBSBG FOUFSJL EJOEJOH VTVT 3FGMFLTSFGMFLT UFSTFCVU NFMJQVUJ
EBO - 4FCBHJBO CFTBS TFSBU QSFHBOHMJPOJL ZBOH NFNQFSTBSBGJ SFGMFLTSFGMFLTZBOHNFOHBUVSCBOZBLTFLSFTJHBTUSPJOUFTUJOBM
VTVT TFTVEBI NFOJOHHBMLBO NFEVMB NFNBTVLJ SBOUBJ TJNQBUJT QFSJTUBMUJL LPOUSBLTJNFODBNQVS FGFLQFOHIBNCBUBOMPLBM
ZBOHUFSMFUBLEJTJTJMBUFSBMLPMVNOBTQJOBMJT EBOCBOZBLEBSJTFSBU EBOTFCBHBJOZB
JOJLFNVEJBOCFSKBMBONFMBMVJSBOUBJLFHBOHMJBZBOHUFSMFUBLKBVI 2. 3FGMFLTSFGMFLT EBSJ VTVT LF HBOHMJB TJNQBUJT QSFWFSUFCSB EBO
TFQFSUJ HBOHMJPO TFMJBLB TFSUB CFSCBHBJ HBOHMJPO NFTFOUFSJLB LFNVEJBOLFNCBMJLFUSBLUVTHBTUSPJOUFTUJOBM3FGMFLTSFGMFLT
,FCBOZBLBO CBEBO OFVSPO TJNQBUJT QPTUHBOHMJPOJL CFSBEB EJ JOJ NFOHJSJN TJOZBM KBSBL KBVI LF EBFSBI USBLUVT
HBOHMJBJOJ EBOTFSBUTFSBUQPTUHBOHMJPOJLMBMVNFOZFCBSNFMBMVJ HBTUSPJOUFTUJOBM MBJO TFQFSUJ TJOZBM EBSJ MBNCVOH VOUVL
TBSBG TJNQBUJT QPTUHBOHMJPOJL LF TFNVB CBHJBO VTVT 4JTUFN NFOZFCBCLBOQFOHPTPOHBOLPMPO SFGMFLTHBTUSPLPMJL
TJOZBM
TJNQBUJT QBEB EBTBSOZB NFOHJOFSWBTJ TFMVSVI USBLUVT HBTUSP EBSJ LPMPO EBO VTVT IBMVT VOUVL NFOHIBNCBU NPUJMJUBT
JOUFTUJOBM UJEBL IBOZB NFMVBT EFLBU EFOHBO SPOHHB NVMVU EBO MBNCVOH EBO TFLSFTJ MBNCVOH SFGMFLT FOUFSPHBTUSJL
EBO
BOVT TFCBHBJNBOBZBOHCFSMBLVQBEBTJTUFNQBSBTJNQBUJT6KVOH SFGMFLTSFGMFLT EBSJ LPMPO VOUVL NFOHIBNCBU QFOHPTPOHBO
VKVOH TBSBG TJNQBUJT TFCBHJBO CFTBS NFOZFLSFTJLBO OPSFQJOFGSJO
JTJJMFVNLFEBMBNLPMPO SFGMFLTLPMPOPJMFBM

EBOKVHBFQJOFGSJOEBMBNKVNMBITFEJLJU
3. 3FGMFLTSFGMFLTEBSJVTVTLFNFEVMBTQJOBMJTBUBVCBUBOHPUBL
1BEB VNVNOZB QFSBOHTBOHBO TJTUFN TBSBG TJNQBUJT NFOH EBO LFNVEJBO LFNCBMJ LF USBLUVT HBTUSPJOUFTUJOBM 3FGMFLT
IBNCBU BLUJWJUBT USBLUVT HBTUSPJOUFTUJOBM NFOJNCVMLBO CBOZBL SFGMFLTJOJUFSVUBNBNFMJQVUJ
SFGMFLTSFGMFLTZBOHCFSBTBM
FGFL ZBOH CFSMBXBOBO EFOHBO ZBOH EJUJNCVMLBO PMFI TJTUFN EBSJ MBNCVOH EBO EVPEFOVN LF CBUBOH PUBL EBO LFNCBMJ
QBSBTJNQBUJT4JTUFNTJNQBUJTNFOHIBTJMLBOQFOHBSVIOZBNFMBMVJ LF MBNCVOH NFMBMVJ TBSBG WBHVT VOUVL NFOHBUVS BLUJWJUBT
EVB DBSB
QBEB UBIBQ ZBOH LFDJM NFMBMVJ QFOHBSVI MBOHTVOH NPUPSJL EBO TFLSFUPSJL MBNCVOH
SFGMFLTSFGMFLT OZFSJ
TFLSFTJ OPSFQJOFGSJO VOUVL NFOHIBNCBU PUPU QPMPT USBLUVT ZBOH NFOJNCVMLBO IBNCBUBO VNVN QBEB TFMVSVI USBLUVT
JOUFTUJOBM LFDVBMJ PUPU NVLPTB ZBOH UFSFLTJUBTJ PMFI HBTUSPJOUFTUJOBM EBO
SFGMFLTSFGMFLT EFGFLBTJ ZBOH
OPSFQJOFGSJO
EBO
QBEB UBIBQ ZBOH CFTBS NFMBMVJ QFOHBSVI CFSKBMBO EBSJ LPMPO EBO SFLUVN LF NFEVMB TQJOBMJT EBO
JOIJCJTJ OPSFQJOFGSJO QBEB OFVSPOOFVSPO TFMVSVI TJTUFN TBSBG LFNCBMJMBHJVOUVLNFOJNCVMLBOLPOUSBLTJZBOHLVBUQBEB
FOUFSJL LPMPO SFLUVN EBO BCEPNFO ZBOH EJQFSMVLBO VOUVL
1FSBOHTBOHBO ZBOH LVBU QBEB TJTUFN TJNQBUJT EBQBU EFGFLBTJ SFGMFLTEFGFLBTJ

NFOHJOIJCJTJ HFSBLBO NPUPS VTVT CFHJUV IFCBU TFIJOHHB CFOBS
CFOBS EBQBU NFOHIFOUJLBO QFSHFSBLBO NBLBOBO NFMBMVJ USBLUVT Pengaturan Hormon terhadap Motilitas Gastrointestinal
HBTUSPJOUFTUJOBM
)PSNPOIPSNPOHBTUSPJOUFTUJOBMEJMFQBTLBOLFEBMBNTJSLVMBTJ
QPSUBMEBOUFSKBEJBLUJWJUBTGJTJPMPHJTQBEBTFMTFMUBSHFUEFOHBO
Serat Saraf Sensorik Aferen yang Berasal dari Usus SFTFQUPSSFTFQUPS LIVTVT VOUVL IPSNPO UFSTFCVU &GFL
#BOZBL TFSBU TBSBG TFOTPSJL BGFSFO NFOZBSBGJ VTVT #FCFSBQB EJ IPSNPOIPSNPO UFSTFCVU UFUBQ CFSMBOHTVOH CBILBO TFUFMBI
BOUBSBOZBNFNQVOZBJCBEBOTFMEJEBMBNTJTUFNTBSBGFOUFSJLJUV TFNVB IVCVOHBO TBSBG BOUBSB UFNQBU QFMFQBTBO EBO UFNQBU
TFOEJSJ EBO CFCFSBQB QBEB BLBS EPSTBM HBOHMJB NFEVMB TQJOBMJT LFSKB IPSNPO UFMBI EJQVUVT 5BCFM BEBMBI HBSJT CFTBS
4BSBGTBSBG TFOTPSJLJOJ EBQBU EJSBOHTBOH PMFI
JSJUBTJ NVLPTB BLUJWJUBT EBSJ TFUJBQ IPSNPO HBTUSPJOUFTUJOBM UFSNBTVL
VTVT
QFSFHBOHBO VTVT ZBOH CFSMFCJIBO BUBV
BEBOZB [BU QFSBOHTBOHVOUVLTFLSFTJEBOUFNQBUTFLSFTJCFSMBOHTVOH
LJNJB ZBOH TQFTJGJL EBMBN VTVT 4JOZBMTJOZBM ZBOH EJLJSJNLBO %BMBN #BC LJUB NFNCJDBSBLBO NFOHFOBJ CFCFSBQB
NFMBMVJ TFSBUTFSBU UFSTFCVU LFNVEJBO EBQBU NFOJNCVMLBO IPSNPO ZBOH TBOHBU QFOUJOH VOUVL QFOHBUVSBO TFLSFTJ
FLTJUBTJ BUBV QBEB CFCFSBQB LFBEBBO MBJO JOIJCJTJ HFSBLBO HBTUSPJOUFTUJOBM 4FCBHJBO EBSJ IPSNPO JOJ KVHB NFNFOHBSVIJ
JOUFTUJOBMBUBVTFLSFTJJOUFTUJOBM NPUJMJUBTQBEBCFCFSBQBCBHJBOUSBLUVTHBTUSPJOUFTUJOBM8BMBV
757
Table 62-1 Kerja Hormon Gastrointestinal, Rangsang untuk Sekresi, dan Tempat Sekresi
Hormon Rangsang untuk Sekresi Tempat Sekresi Kerja
Gastrin Protein Set-set G di antrum, duodenum, Merangsang

Distensi dan yeyunum Sekresi asam lambung
Saraf Pertumbuhan mukosa
(Acid inhibits release)
Kolesistokinin Protein Sel-sel I duodenum, yeyunum, Merangsang

Lemak dan iteum Sekresi enzim pankreas
Asam Sekresi bikarbonat pankreas
Kontraksi kandung empedu
Pertumbuhan kelenjar eksokrin pankreas
Menghambat
Pengosongan lambung
Sekretin Asam Set-set S duodenum, yeyunum, Merangsang
Lemak dan ileum Sekresi pepsin
Sekresi bikarbonat pankreas
Sekresi biakrbonat empedu
Pertumbuhan kelenjar eksokrin pankreas
Menghambat
Sekresi asam lambung
Peptida penghambat lambung Protein Sel-sel K duodenum dan yeyunum Merangsang
Lemak Petepasan insulin
Karbohidra Menghambat
Sekresi asam lambung
Motilin Lemak Set-sel M duodenum dan yeyunum Merangsang
Asam Gerakan lambung
Saraf Gerakan usus
QVO FGFL NPUJMJUBT CJBTBOZB LVSBOH QFOUJOH EJCBOEJOHLBO TFSBUJOJ TFMBOKVUOZB NFOHJSJNTJOZBMNFMBMVJTBSBGWBHVTVOUVL
EFOHBO FGFL TFLSFUPSJT IPSNPO CFCFSBQB ZBOH MFCJI QFOUJOH NFOHIBNCBU QVTBU NBLBO EJ PUBL TFQFSUJ ZBOH EJ EJTLVTJLBO
EBSJLVNQVMBOIPSNPOUFSTFCVUBEBMBITFCBHBJCFSJLVU QBEB#BC
(BTUSJO EJTFLSFTJPMFITFM(CBHJBOBOUSVNMBNCVOHTFCBHBJ 4FLSFUJO NFSVQBLBO IPSNPO HBTUSPJOUFTUJOBM ZBOH QFSUBNB
SFTQPOTUFSIBEBQSBOHTBOHZBOHCFSIVCVOHBOEFOHBOQFOFMBOBO LBMJ EJUFNVLBO EBO EJTFLSFTJ PMFI TFM 4 EBMBN NVLPTB
NBLBOBO TFQFSUJEJTUFOTJMBNCVOH QSPEVLQSPEVLQSPUFJO EBO EVPEFOVNTFCBHBJSFTQPOTUFSIBEBQHFUBIBTBNMBNCVOHZBOH
QFQUJEBQFMFQBTHBTUSJO ZBOHEJLFMVBSLBOPMFITBSBGTBSBGNVLPTB EJLPTPOHLBO LF EBMBN EVPEFOVN EBO QJMPSVT MBNCVOH
MBNCVOH TFMBNB QFSBOHTBOHBO TBSBG WBHVT ,FSKB VUBNB HBTUSJO 4FLSFUJONFNQVOZBJFGFLQFOHIBNCBUBOZBOHSJOHBOUFSIBEBQ
BEBMBI
QFSBOHTBOHBO TFLSFTJ BTBN MBNCVOH EBO
NPUJMJUBTUSBLUVTHBTUSPJOUFTUJOBMEBOCFLFSKBNFNCBOUVTFLSFTJ
QFSBOHTBOHBOQFSUVNCVIBONVLPTBMBNCVOH CJLBSCPOBU QBOLSFBT ZBOH TFMBOKVUOZB NFNCBOUV NFOFUSBMJTBTJ
BTBNEJEBMBNVTVTIBMVT
,PMFTJTUPLJOJO $$,
EJTFLSFTJ PMFI TFM * EBMBN NVLPTB
EVPEFOVN EBO ZFZVOVN UFSVUBNB TFCBHBJ SFTQPOT UFSIBEBQ 1FQUJEBQFOHIBNCBUBTBNMBNCVOH HBTUSJDJOIJCJUPSZQFQUJEF
BEBOZB QFNFDBIBO QSPEVL MFNBL BTBN MFNBL EBO <(*1>
EJTFLSFTJPMFINVLPTBVTVTIBMVTCBHJBOBUBT UFSVUBNB
NPOPHMJTFSJEB EJ EBMBN JTJ VTVT )PSNPO JOJ NFOJNCVMLBO TFCBHBJ SFTQPOT UFSIBEBQ BTBN MFNBL EBO BTBN BNJOP UFUBQJ
LPOUSBLTJ LVBU LBOEVOH FNQFEV NFOHFMVBSLBO FNQFEV LF QBEB UJOHLBU ZBOH MFCJI LFDJM TFCBHBJ SFTQPOT UFSIBEBQ
EBMBNVTVTIBMVT UFNQBUFNQFEVLFNVEJBONFNBJOLBOQFSBO LBSCPIJESBU 1FQUJEB JOJ NFNQVOZBJ FGFL ZBOH SJOHBO EBMBN
QFOUJOH EBMBN NFOHFNVMTJGJLBTJLBO [BU MFNBL TFIJOHHB [BU NFOVSVOLBO BLUJWJUBT NPUPSJL MBNCVOH EBO LBSFOB JUV
MFNBL UFSTFCVU EBQBU EJDFSOB EBO EJBCTPSCTJ $$, KVHB NFNQFSMBNCBU QFOHPTPOHBO JTJ MBNCVOH LF EBMBN EVPEFOVN
NFOHIBNCBULPOUSBLTJMBNCVOHTFDBSBTFEBOH0MFILBSFOBJUV LFUJLB CBHJBO BUBT VTVT IBMVT TVEBI TBOHBU QFOVI EFOHBO
QBEB TBBU ZBOH CFSTBNBBO LFUJLB IPSNPO JOJ NFOZFCBCLBO QSPEVL NBLBOBO (*1 QBEB LBEBS EBMBN EBSBI ZBOH CBILBO
QFOHPTPOHBO LBOEVOH FNQFEV IPSNPO JOJ KVHB NFN MFCJI SFOEBI EBSJ ZBOH EJCVUVILBO VOUVL NFOHIBNCBU
QFSMBNCBUQFOHPTPOHBONBLBOBOEBSJMBNCVOHVOUVLNFNCFSJ NPUJMJUBT MBNCVOH KVHB NFSBOHTBOH TFLSFTJ JOTVMJO TFIJOHHB
DVLVQ XBLUV TVQBZB UFSKBEJ QFODFSOBBO MFNBL EJ USBLUVT EJLFOBMKVHBTFCBHBJQFQUJEBJOTVMJOPUSPQJLCFSHBOUVOHHMVLPTB
JOUFTUJOBM CBHJBO BUBT $$, KVHB NFOHIBNCBU TFMFSB NBLBO .PUJMJO EJTFLSFTJ PMFI MBNCVOH EBO EVPEFOVN CBHJBO BUBT
VOUVL NFODFHBI NBLBO CFSMFCJI QBEB TBBU NBLBO NFMBMVJ TFMBNB QVBTB EBO TBUVTBUVOZB GVOHTJ IPSNPO JOJ ZBOH
QFSBOHTBOHBOTFSBUTBSBGBGFSFOTFOTPSJTEJEVPEFOVNTFSBU EJLFUBIVJBEBMBIVOUVLNFOJOHLBULBONPUJMJUBTHBTUSPJOUFTUJOBM
758
.PUJMJO EJMFQBTLBO TFDBSB TJLMJL EBO NFSBOHTBOH HFMPNCBOH KBEJQFOFLBOBOIFCBUBUBVQFOHIBNCBUBOUPUBMQFSJTUBMUJLQBEB

NPUJMJUBT HBTUSPJOUFTUJOBM ZBOH EJTFCVU LPNQMFLT NJPFMFLUSJL TFMVSVI VTVT CJMB TFTFPSBOH EJPCBUJ EFOHBO BUSPQJO VOUVL
JOUFSEJHFTUJGZBOHCFSHFSBLNFMBMVJMBNCVOHEBOVTVTIBMVTTFUJBQ NFMVNQVILBO VKVOHVKVOH TBSBG LPMJOFSHJL EBO QMFLTVT
NFOJU QBEB PSBOH ZBOH CFSQVBTB 4FLSFTJ NPUJMJO EJIBNCBU NJFOUFSJLVT0MFILBSFOBJUV QFSJTUBMUJLZBOHFGFLUJGNFNFSMV
UNIT XII
TFTVEBINBLBOPMFINFLBOJTNFZBOHCFMVNEJLFUBIVJTFQFOVI LBOTFCVBIQMFLTVTNJFOUFSJLVTZBOHBLUJG
OZB
Pergerakan Terarah Gelombang Peristaltik Menuju
Jenis Gerakan Fungsional pada Traktus Gastro- Anus. 4FDBSB UFPSFUJT QFSJTUBMUJL EBQBU UFSKBEJ LF BSBI NBOB
intestinal QVO EBSJ UJUJL QFSBOHTBOHBO UFUBQJ TFDBSB OPSNBM IJMBOH
EFOHBO DFQBU LF BSBI PSBE LF BSBI NVMVU
TFNFOUBSB ZBOH
5FSKBEJ EVB KFOJT HFSBLBO EJ EBMBN USBLUVT HBTUSPJOUFTUJOBM
NFOVKVBOVTUFSVTCFSMBOHTVOHTBNQBJKBSBLZBOHDVLVQKBVI
HFSBLBO QSPQVMTJG ZBOH NFOZFCBCLBO NBLBOBO CFSHFSBL NBKV 1FOZFCBC QBTUJ QFOKBMBSBO UFSBSBI QFSJTUBMUJL JOJ UJEBL QFSOBI
TFQBOKBOHTBMVSBOEFOHBOLFDFQBUBOZBOHTFTVBJVOUVLNFNCBOUV EJQBTUJLBO XBMBVQVOLFNVOHLJOBOUFSVUBNBBLJCBUEBSJGBLUB
UFSKBEJOZBQFODFSOBBOEBOBCTPSQTJ EBO
HFSBLBONFODBNQVS CBIXBQMFLTVTNJFOUFSJLVTJUVTFOEJSJUFMBIEJQPMBSJTBTJLBOLF
ZBOH NFOKBHB BHBS JTJ VTVT TVOHHVITVOHHVI UFSDBNQVS TFUJBQ BSBIBOVT ZBOHEBQBUEJKFMBTLBOTFCBHBJCFSJLVU
XBLUV
Refleks Peristaltik dan "Hukum Usus". #JMB TVBUV TFHNFO
Gerakan Propulsif—Peristaltik USBLUVTJOUFTUJOBMEJSBOHTBOHPMFIEJTUFOTJEBOEFOHBOEFNJLJBO
(FSBLBOQSPQVMTJG NFOEPSPOH
EBTBSQBEBUSBLUVTHBTUSPJOUFTUJOBM NFOJNCVMLBO QFSJTUBMUJL DJODJO LPOUSBLTJ ZBOH NFOJNCVMLBO
BEBMBI QFSJTUBMUJL ZBOH EJUVOKVLLBO QBEB (BNCBS 4VBUV QFSJTUBMUJL TFDBSB OPSNBM NVMBJ CFSHFSBL TFEJLJU QBEB TJTJ PSBM
DJODJO LPOUSBLTJ UJNCVM EJ TFLJUBS VTVT EBO LFNVEJBO CFSHFSBL TFHNFO ZBOH UFSFHBOH EBO CFSHFSBL LF BSBI TFHNFO ZBOH
NBKV IBM JOJ BOBMPH EFOHBO NFMFUBLLBO KBSJKBSJ TFTFPSBOH UFSFHBOH NFOEPSPOH JTJ VTVT LF BSBI BOVT TFKBVI TBNQBJ
NFOHFMJMJOHJ TFCVBI UBCVOH UJQJT ZBOH UFSFHBOH EBO LFNVEJBO DN TFCFMVN NFOHIJMBOH 1BEB XBLUV ZBOH CFSTBNBBO VTVT
NFOHPOTUSJLTJLBO KBSJKBSJ UFSTFCVU EBO NFOHHFTFSOZB NBKV LBEBOHLBEBOH CFSFMBLTBTJ CFCFSBQB TFOUJNFUFS LF BSBI BOVT
TFQBOKBOH UBCVOH 4FUJBQ CBIBO ZBOH UFSMFUBL EJ EFQBO DJODJO ZBOH EJTFCVU SFMBLTBTJ SFTFQUJG TFIJOHHB NFNVOHLJOLBO
LPOUSBLTJBLBOUFSEPSPOHLFEFQBO NBLBOBOUFSEPSPOHMFCJINVEBILFBSBIBOVTEBSJQBEBLFBSBI
1FSJTUBMUJLNFSVQBLBOTJGBUCBXBBOZBOHEJNJMJLJPMFICBOZBL NVMVU
TBMVSBOTJOTJUJVNPUPUQPMPTQFSBOHTBOHBO QBEBUJUJLNBOBQVO 1PMB ZBOH LPNQMFLT JOJ UJEBL UFSKBEJ CJMB UJEBL BEB QMFLTVT
EBMBN VTVT EBQBU NFOZFCBCLBO NVODVMOZB DJODJO LPOUSBLTJ NJFOUFSJLVT 0MFI LBSFOB JUV LPNQMFLT JOJ EJTFCVU SFGMFLT
EBMBNPUPUTJSLVMBS EBODJODJOJOJLFNVEJBONFOKBMBSTFQBOKBOH NJFOUFSJLVT BUBV SFGMFLT QFSJTUBMUJL 3FGMFLT QFSJTUBMUJL EJUBNCBI
TBMVSBO VTVT 1FSJTUBMUJL KVHB UFSKBEJ EJ EBMBN EVLUVT CJMJBSJT HFSBLBOQFSJTUBMUJLLFBSBIBOVTEJTFCVUIVLVNVTVTh
EVLUVTLFMFOKBS VSFUFS EBOCBOZBLTBMVSBOPUPUQPMPTMBJOEBMBN
UVCVI
Gerakan Mencampur
3BOHTBOHBOVNVNVOUVLQFSJTUBMUJLVTVTBEBMBIEJTUFOTJVTVT
:BJUV CJMB TFKVNMBI CFTBS NBLBOBO UFSLVNQVM QBEB UJUJL NBOB (FSBLBO NFODBNQVS CFSCFEB QBEB CFSCBHBJ CBHJBO TBMVSBO
QVOEBMBNVTVT QFSFHBOHBOEJOEJOHVTVTBLBONFSBOHTBOHTJTUFN QFODFSOBBO 1BEB CFCFSBQB UFNQBU LPOUSBLTJ QFSJTUBMUJL
TBSBGFOUFSJLVOUVLNFOJNCVMLBOLPOUSBLTJEJOEJOHVTVTTBNQBJ TFOEJSJ NFOZFCBCLBO TFCBHJBO CFTBS QFODBNQVSBO )BM JOJ
DNEJCFMBLBOHUJUJLUFSTFCVU EBOUJNCVMTFCVBIDJODJOLPOUSBLTJ LIVTVTOZB UFSKBEJ CJMB HFSBLBO NBKV JTJ VTVT EJIBNCBU PMFI
ZBOH NFOJNCVMLBO HFSBLBO QFSJTUBMUJL 3BOHTBOHBO MBJO ZBOH TFCVBI TGJOHUFS TFIJOHHB HFMPNCBOH QFSJTUBMUJL LFNVEJBO
EBQBUNFOJNCVMLBOQFSJTUBMUJLBOUBSBMBJOJSJUBTJLJNJBXJBUBVGJTJL IBOZBEBQBUNFOHBEVLJTJVTVT EBOCVLBONFOEPSPOHOZBLF
QBEBFQJUFMZBOHNFMBQJTJVTVT+VHBTJOZBMTBSBGQBSBTJNQBUJTZBOH EFQBO 1BEB TBBU MBJO LPOUSBLTJ LPOTUSJLUJG JOUFSNJUFO MPLBM
LVBULFVTVTBLBONFOJNCVMLBOQFSJTUBMUJLLVBU UFSKBEJ TFUJBQ CFCFSBQB TFOUJNFUFS EBMBN EJOEJOH VTVT
,POTUSJLTJ JOJ CJBTBOZB CFSMBOHTVOH IBOZB TBNQBJ EFUJL
Fungsi Pleksus Mienterikus pada Peristaltik. 1FSJTUBMUJL LFNVEJBO LPOTUSJLTJ ZBOH CBSV BLBO UJNCVM QBEB UFNQBU MBJO
UJNCVM TFDBSB MFNBI BUBV UJEBL UFSKBEJ TBNB TFLBMJ QBEB CBHJBO EBMBN VTVT KBEJ QSPTFT NFODBDBI EBO NFNPUPOH JTJ VTVT
NBOB QVO EBSJ USBLUVT HBTUSPJOUFTUJOBM ZBOH UJEBL NFNQVOZBJ QFSUBNB LBMJ EJ TJOJ EBO LFNVEJBO EJ UFNQBU MBJO (FSBLBO
QMFLTVTNJFOUFSJLVTTFDBSBLPOHFOJUBM%FNJLJBOQVMB BLBOUFS QFSJTUBMUJL EBO LPOTUSJLUJG EJNPEJGJLBTJ EBMBN CFSCBHBJ CBHJBO
USBLUVT HBTUSPJOUFTUJOBM VOUVL NFOEPSPOH EBO NFODBNQVS
EFOHBO CBJL TFQFSUJ ZBOH EJEJTLVTJLBO VOUVL NBTJOHNBTJOH
CBHJBOTBMVSBOEBMBN#BC
Aliran Darah Gastrointestinal "Sirkulasi Splanknik"
1FNCVMVIEBSBITJTUFNHBTUSPJOUFTUJOBMNFSVQBLBOCBHJBOEBSJ
TJTUFN ZBOH MFCJI MVBT ZBOH EJTFCVU TJSLVMBTJ TQMBOLOJL
EJUVOKVLLBO EBMBN (BNCBS 4JSLVMBTJ JOJ NFMJQVUJ BMJSBO
EBSBIZBOHNFMBMVJVTVTTFOEJSJEJUBNCBIBMJSBOEBSBINFMBMVJ
MJNQB QBOLSFBT EBOIBUJ
759
CFSBLIJSLFEBMBNWFOBDBWBEBSJTJSLVMBTJTJTUFNJL"MJSBOEBSBI
ZBOHNFMBMVJIBUJJOJTFCFMVNNBTVLWFOBDBWB NFNCJBSLBOTFM
TFM SFUJLVMPFOEPUFM ZBOH NFNCBUBTJ TJOVTPJETJOVTPJE IBUJ
NFOHFMVBSLBO CBLUFSJ EBO CBIBO QBSUJLFM MBJOOZB ZBOH NVOHLJO
NFNBTVLJEBSBIEBSJUSBLUVTHBTUSPJOUFTUJOBM TFIJOHHBNFODFHBI
USBOTQPSUBTJ MBOHTVOH BHFOBHFO ZBOH CFSCBIBZB LF EBMBN
KBSJOHBOUVCVIZBOHMBJO
;BUNBLBOBOOPOMFNBLEBOMBSVUBJSZBOHEJBCTPSCTJEBSJVTVT
TFQFSUJ LBSCPIJESBU EBO QSPUFJO
EJUSBOTQPS EBMBN EBSBI WFOB
QPSUB LF TJOVTPJETJOVTPJE IBUJ ZBOH TBNB %J TJOJ TFM
SFUJLVMPFOEPUFM EBO TFM QBSFOLJN VUBNB IBUJ ZBJUV TFMTFM IBUJ
NFOZFSBQEBONFOZJNQBOVOUVLTFNFOUBSBTFUFOHBITBNQBJUJHB
QFSFNQBUEBSJTFMVSVI[BUNBLBOBOZBOHEJBCTPSCTJ+VHB CBOZBL
QFNSPTFTBO [BU[BU NBLBOBO ZBOH EJQFSBOUBSBJ TFDBSB LJNJBXJ
UFSKBEJEJEBMBNTFMIBUJ,JUBNFNCBIBTGVOHTJGVOHTJOVUSJTJIBUJ
JOJEBMBN#BCTBNQBJ)BNQJSTFNVBMFNBLZBOHEJBCTPSCTJ
EBSJ USBLUVT JOUFTUJOBM UJEBL EJCBXB LF EBMBN EBSBI QPSUB
NFMBJOLBO EJBCTPSCTJ LF EBMBN TBMVSBO MJNGBUJL VTVT EBO
LFNVEJBO EJBMJSLBO LF EBMBN TJSLVMBTJ EBSBI TJTUFNJL NFMBMVJ
EVLUVTUPSBTJLVT NFMJOUBTJIBUJ
Anatomi Suplai Darah Gastrointestinal

(BNCBS NFOVOKVLLBO HBNCBSBO VNVN TVQMBJ EBSBI BSUFSJ
.PEFMTJTUFNJOJTFEFNJLJBOSVQBIJOHHBTFNVBEBSBIZBOH LF VTVT UFSNBTVL BSUFSJ NFTFOUFSJLB TVQFSJPS EBO BSUFSJ
NFMFXBUJVTVT MJNQB EBOQBOLSFBTLFNVEJBOTFHFSBNFOHBMJS NFTFOUFSJLBJOGFSJPSZBOHNFOZVQMBJEJOEJOHVTVTIBMVTEBOVTVT
LF EBMBN IBUJ NFMBMVJ WFOB QPSUB %J EBMBN IBUJ EBSBI CFTBS NFMBMVJ TJTUFN BSLVT BSUFSJ 5JEBL EJUVOKVLLBO EBMBN
NFOHBMJSNFMFXBUJCFSKVUBKVUBTJOVTPJEIBUJZBOHTBOHBULFDJM HBNCBS BEBMBI BSUFSJ TFMJBLB ZBOH NFOZFEJBLBO TVQMBJ EBSBI
EBOBLIJSOZBNFOJOHHBMLBOIBUJNFMBMVJWFOBIFQBUJLBZBOH TFSVQBLFMBNCVOH
760
4BBUNFNBTVLJEJOEJOHVTVT BSUFSJCFSDBCBOHEBONFOHJSJN EJOEJOH VTVT NFOJOHLBU CFSTBNBBO EFOHBO QFOJOHLBUBO

LBO BSUFSJBSUFSJ LFDJM NFOHFMJMJOHJ VTVT EFOHBO VKVOH BSUFSJ BLUJWJUBT NPUPSJL EBMBN VTVT 4FCBHBJ DPOUPI TFUFMBI NBLBO
BSUFSJJOJCFSUFNVQBEBTJTJEJOEJOHVTVTZBOHCFSMBXBOBOEFOHBO BLUJWJUBT NPUPSJL TFLSFUPSJL EBO BCTPSQUJG TFNVBOZB
QFMFLBUBO BSUFSJ NFTFOUFSJLB %BSJ BSUFSJ ZBOH CFSLFMJMJOH NBTJI NFOJOHLBU EFNJLJBO KVHB BMJSBO EBSBI TBOHBU NFOJOHLBU
UNIT XII
BEB BSUFSJBSUFSJ MFCJI LFDJM ZBOH NFMBLVLBO QFOFUSBTJ LF EBMBN OBNVO LFNVEJBO LFNCBMJ UVSVO LF UJOHLBU JTUJSBIBU TFUFMBI
EJOEJOH VTVT EBO NFOZFCBS EJ
TFQBOKBOH CFSLBT PUPU
LF TBNQBJKBNLFNVEJBO
EBMBN WJMJ JOUFTUJOBM EBO
LF EBMBN QFNCVMVI TVCNVLPTB EJ
CBXBI FQJUFMJVN VOUVL NFOZFEJBLBO GVOHTJ TFLSFUPSJT EBO Kemungkinan Penyebab Peningkatan Aliran Darah
BCTPSQTJQBEBVTVT Selama Aktivitas Gastrointestinal. 8BMBVQVO QFOZFCBC
(BNCBS NFOVOKVLLBO QFOHBUVSBO LIVTVT BMJSBO EBSBI QFOJOHLBUBO BMJSBO EBSBI TFMBNB QFOJOHLBUBO BLUJWJUBT
NFMBMVJ WJMVT JOUFTUJOBM UFSNBTVL BSUFSJPM EBO WFOVMB LFDJM ZBOH HBTUSPJOUFTUJOBM NBTJI CFMVN KFMBT CFCFSBQB GBLUB TVEBI
EJLFUBIVJ
CFSIVCVOHBO EFOHBO TJTUFN CFSCBHBJ MFOHLVOH LBQJMFS %JOEJOH
BSUFSJPMCFSTJGBUTBOHBUNVTLVMBSEBOTBOHBUBLUJGEBMBNNFOHBUVS 1FSUBNB CFCFSBQB [BU WBTPEJMBUPS EJ MFQBTLBO EBSJ NVLPTB
BMJSBOEBSBIWJMVT USBLUVTJOUFTUJOBMTFMBNBQSPTFTQFODFSOBBO4FCBHJBOCFTBS[BU
WBTPEJMBUPSJOJBEBMBIIPSNPOQFQUJEB UFSNBTVLLPMFTJTUPLJOJO
QFQUJEB JOUFTUJOBM WBTPBLUJG HBTUSJO EBO TFLSFUJO )PSNPO
Pengaruh Aktivitas Usus dan Faktor Metabolik terhadap IPSNPO JOJ KVHB NFOHPOUSPM BLUJWJUBT NPUPSJL EBO TFLSFUPSJL
Aliran Darah Gastrointestinal TQFTJGJLEBSJVTVT TFQFSUJZBOHEJEJTLVTJLBOEBMBN#BCEBO
%BMBN LPOEJTJ OPSNBM BMJSBO EBSBI EBMBN TFUJBQ EBFSBI USBLUVT
HBTUSPJOUFTUJOBM EBO EBMBN TFUJBQ MBQJTBO EJOEJOH VTVT TFDBSB ,FEVB CFCFSBQB LFMFOKBS HBTUSPJOUFTUJOBM KVHB NFMFQBTLBO
MBOHTVOHCFSIVCVOHBOEFOHBOUJOHLBUBLUJWJUBTTFUFNQBU4FCBHBJ EVBLJOJO LBMMJEJO EBOCSBEJLJOJOLFEBMBNEJOEJOHVTVT QBEB
DPOUPI TFMBNBBCTPSQTJBLUJG[BUNBLBOBO BMJSBOEBSBIEJEBMBN TBBUZBOHCFSTBNBBOLFUJLBLFMFOKBSNFOHFMVBSLBO[BU[BUZBOH
WJMJEBOEBFSBITVCNVLPTBZBOHCFSEFLBUBONFOJOHLBUTFCBOZBL MBJO LF EBMBN MVNFO ,JOJOLJOJO JOJ NFSVQBLBO WBTPEJMBUPS
EFMBQBOLBMJMJQBU%FNJLJBOKVHB BMJSBOEBSBIEBMBNMBQJTBOPUPU LVBU ZBOH EJZBLJOJ NFOZFCBCLBO QFOJOHLBUBO WBTPEJMBUBTJ
NVLPTBZBOHUFSKBEJTFQBOKBOHTFLSFTJ
,FUJHB QFOVSVOBO LPOTFOUSBTJ PLTJHFO EBMBN EJOEJOH VTVT
EBQBU NFOJOHLBULBO BMJSBO EBSBI JOUFTUJOBM QBMJOH TFEJLJU
TBNQBJ QFSTFO LBSFOB JUV QFOJOHLBUBO LFDFQBUBO
NFUBCPMJL NVLPTB EBO EJOEJOH VTVT TFMBNB BLUJWJUBT VTVT
NVOHLJO NFOVSVOLBO LPOTFOUSBTJ PLTJHFO IJOHHB DVLVQ
VOUVL NFOZFCBCLBO WBTPEJMBUBTJ 1FOVSVOBO PLTJHFO EBQBU
KVHB NFOJNCVMLBO QFOJOHLBUBO BEFOPTJO TFCBOZBL FNQBU LBMJ
MJQBU TVBUV WBTPEJMBUPS UFSLFOBM ZBOH EBQBU NFOJNCVMLBO
QFOJOHLBUBOBMJSBO
+BEJ QFOJOHLBUBOBMJSBOEBSBITFMBNBQFOJOHLBUBOBLUJWJUBT
HBTUSPJOUFTUJOBMNVOHLJONFSVQBLBOLPNCJOBTJCBOZBLGBLUPS
UFSTFCVUEJBUBTEJUBNCBIGBLUPSGBLUPSMBJOZBOHNBTJICFMVN
EJUFNVLBO
"Countercurrent" Aliran Darah dalam Vili. 1FSIBUJLBO

(BNCBSCBIXBBMJSBOBSUFSJLFEBMBNWJMVTEBOBMJSBOWFOB
LFMVBSEBSJWJMVTCFSBEBEBMBNBSBIZBOHCFSMBXBOBOTBUVTBNB
MBJO EBOCBIXBQFNCVMVIEBSBIUFSMFUBLCFSEFLBUBOTBUVTBNB
MBJO 0MFI LBSFOB QFOHBUVSBO QFOEBSBIBO JOJ TFCBHJBO CFTBS
PLTJHFO EBSBI CFSEJGVTJ LFMVBS EBSJ BSUFSJPM TFDBSB MBOHTVOH
NBTVL LF EBMBN WFOVMB ZBOH CFSEFLBUBO UBOQB UFSCBXB EBMBN
EBSBILFVKVOHVKVOHWJMJ4FCBOZBLQFSTFOPLTJHFONVOHLJO
NFOHBNCJMKBMVSTJSLVJUQFOEFLJOJEBOLBSFOBJUVUJEBLUFSTFEJB
VOUVLGVOHTJNFUBCPMJLMPLBMQBEBWJMJ1FNCBDBBLBONFOHFOBMJ
CBIXB UJQF NFLBOJTNF DPVOUFSDVSSFOU EBMBN WJMJ JOJ BOBMPH
EFOHBO NFLBOJTNF DPVOUFSDVSSFOU EBMBN WBTB SFLUB NFEVMB
HJOKBM EJEJTLVTJLBOTFDBSBNFOEBMBNEBMBN#BC
%BMBNLPOEJTJOPSNBM QJSBVPLTJHFOEBSJBSUFSJPMLFWFOVMB
JOJ UJEBL CFSCBIBZB CBHJ WJMJ UFUBQJ QBEB LFBEBBO TBLJU LFUJLB
BMJSBOEBSBILFVTVTNFOKBEJTBOHBUUFSCBUBT TFQFSUJQBEBTZPL
TJSLVMBTJ EFGJTJUPLTJHFOQBEBVKVOHWJMJEBQBUNFOKBEJTBOHBU
761
Unit XII Fisiologi Gastrointestinal
CFTBSTFIJOHHBVKVOHWJMJBUBVCBILBOTFMVSVIWJMJNFOHBMBNJ Daftar Pustaka

LFNBUJBO BLJCBU JTLFNJL EBO EBQBU NFOHBMBNJ EJTJOUFHSBTJ Adelson DW, Million M: Tracking the moveable feast: sonomicrometry and
0MFI LBSFOB JUV VOUVL BMBTBO JOJ EBO MBJOOZB QBEB CBOZBL gastrointestinal motility, News Physiol Sci 19:27, 2004.
QFOZBLJU HBTUSPJOUFTUJOBM WJMJ NFOKBEJ TBOHBU UVNQVM Daniel EE: Physiology and pathophysiology of the interstitial cell of Cajal:
NFOJNCVMLBO QFOVSVOBO LBQBTJUBT BCTPSQUJG JOUFTUJOBM ZBOH from bench to bedside. III. Interaction of interstitial cells of Cajal with
TBOHBUCFTBS neuromediators: an interim assessment, Am J Physiol Gastrointest
Liver Physiol 281:G1329, 2001.
Grundy D, Al-Chaer ED, Aziz Q, et al: Fundamentals of neurogastroenterol-
Pengontrolan Saraf terhadap Aliran Darah Gastro-
ogy: basic science, Gastroenterology 130:1391, 2006.
intestinal Hobson AR, Aziz Q: Central nervous system processing of human visceral
3BOHTBOH TBSBG QBSBTJNQBUJT ZBOH NFOKBMBS LF MBNCVOH EBO pain in health and disease, News Physiol Sci 18:109, 2003.
Holst JJ: The physiology of glucagon-like peptide 1, Physiol Rev 87:1409,
LPMPOCBHJBOCBXBIBLBONFOJOHLBULBOBMJSBOEBSBITFUFNQBU
2009.
ZBOHQBEBTBBUCFSTBNBBOSBOHTBOHBOJOJKVHBNFOJOHLBULBO Huizinga JD: Physiology and pathophysiology of the interstitial cell of Cajal:
TFLSFTJ LFMFOKBS 1FOJOHLBUBO BMJSBO JOJ LFNVOHLJOBO from bench to bedside. II. Gastric motility: lessons from mutant
NFSVQBLBOBLJCBUTFLVOEFSQFOJOHLBUBOBLUJWJUBTLFMFOKBSEBO mice on slow waves and innervation, Am J Physiol Gastrointest
UJEBLTFCBHBJFGFLMBOHTVOHQFSBOHTBOHBOTBSBG Liver Physiol 281:G1129, 2001.
Huizinga JD, Lammers WJ: Gut peristalsis is governed by a multitude of
1FSBOHTBOHBO TJNQBUJT TFCBMJLOZB NFNCFSJ FGFL MBOHTVOH cooperating mechanisms, Am J Physiol Gastrointest Liver Physiol 296:G1,
QBEBIBNQJSTFMVSVIUSBLUVTHBTUSPJOUFTUJOBMZBOHNFOZFCBCLBO 2009.
WBTPLPOTUSJLTJZBOHLVBUQBEBBSUFSJPMEFOHBOQFOVSVOBOBMJSBO Jeays AD, Lawford PV, Gillott R, et al: A framework for the modeling
EBSBI ZBOH CFTBS 4FUFMBI CFCFSBQB NFOJU NFOHBMBNJ of gut blood flow regulation and postprandial hyperaemia, World J
WBTPLPOTUSJLTJ BMJSBOTFSJOHLFNCBMJNFOEFLBUJOPSNBMNFMBMVJ Gastroenterol 13:1393, 2007.
NFLBOJTNF ZBOH EJTFCVU BVUPSFHVMBUPSZ FTDBQF "SUJOZB Johnson LR: Gastrointestinal Physiology, ed 3, St. Louis, 2001, Mosby. Kim
W, Egan JM: The role of incretins in glucose homeostasis and diabetes
NFLBOJTNF WBTPEJMBUPS NFUBCPMJL MPLBM ZBOH EJUJNCVMLBO PMFI
treatment, Pharmacol Rev 60:470, 2009.
JTLFNJB NFOJBEBLBO WBTPLPOTUSJLTJ TJNQBUJT NFOHFNCBMJLBO Kolkman JJ, Bargeman M, Huisman AB, Geelkerken RH: Diagnosis and
LF BSBI OPSNBM BMJSBO EBSBI CBIBO NBLBOBO ZBOH QFOUJOH LF management of splanchnic ischemia, World J Gastroenterol 14:7309,
LFMFOKBSLFMFOKBSHBTUSPJOUFTUJOBMEBOPUPU 2008.
Makna Penting Depresi Saraf terhadap Aliran Darah Lammers WJ, Slack JR: Of slow waves and spike patches, News Physiol
Sci16:138, 2001.
Gastrointestinal saat Bagian Lain Tubuh Membutuhkan
Moran TH, Dailey MJ: Minireview: Gut peptides: targets for antiobesity drug
Aliran Darah Tambahan. .BLOB VUBNB WBTPLPOTUSJLTJ development? Endocrinology 150:2526, 2009.
TJNQBUJT EBMBN VTVT BEBMBI CBIXB WBTPLPOTUSJLTJ UFSTFCVU Nauck MA: Unraveling the science of incretin biology, Am J Med 122(Suppl
NFNCVBU BMJSBO EBSBI HBTUSPJOUFTUJOBM EBO BMJSBO EBSBI 6):S3, 2009.
TQMBOLOJLMBJOUFSUVUVQEBMBNXBLUVTJOHLBUTFMBNBLFSKBGJTJL Powley TL, Phillips RJ: Musings on the wanderer: what’s new in our under-
ZBOH IFCBU LFUJLB PUPU SBOHLB EBO KBOUVOH NFNCVUVILBO standing of vago-vagal reflexes? I. Morphology and topography of
vagal afferents innervating the GI tract, Am J Physiol Gastrointest
QFOJOHLBUBOBMJSBOEBSBI+VHB QBEBTZPLTJSLVMBTJ TBBUTFNVB
KBSJOHBO WJUBM UVCVI EBMBN LFBEBBBO CBIBZB LFNBUJBO TFM Phillips RJ, Powley TL: Innervation of the gastrointestinal tract: patterns of
LBSFOB UJEBL BEBOZB BMJSBO EBSBI UFSVUBNB PUBL EBO KBOUVOH aging, Auton Neurosci 136:1, 2007.
QFSBOHTBOHBO TJNQBUJT EBQBU NFOHVSBOHJ BMJSBO EBSBI Sanders KM, Ordog T, Ward SM: Physiology and pathophysiology of the
TQMBOLOJLEBSJTBOHBUTJOHLBUTBNQBJCFSKBNKBN interstitial cells of Cajal: from bench to bedside. IV. Genetic and animal
models of GI motility disorders caused by loss of intersti-tial cells of
1FSBOHTBOHBO TJNQBUJT KVHB NFOZFCBCLBO WBTPLPOTUSJLTJ Cajal, Am J Physiol Gastrointest Liver Physiol 282:G747,
LVBUQBEBWFOBWFOBJOUFTUJOBMEBONFTFOUFSJLCFSWPMVNFCFTBS 2002.
)BM JOJ NFOVSVOLBO WPMVNF WFOBWFOB JOJ EFOHBO EFNJLJBO Schubert ML, Peura DA: Control of gastric acid secretion in health and dis-
NFNJOEBILBO TFKVNMBI CFTBS EBSBI LF CBHJBO MBJO TJSLVMBTJ ease, Gastroenterology 134:1842, 2008.
1BEBTZPLIFNPSBHJLBUBVLFBEBBOWPMVNFEBSBIZBOHSFOEBI Vanden Berghe P, Tack J, Boesmans W: Highlighting synaptic commu-
MBJO NFLBOJTNF JOJ EBQBU NFOZFEJBLBO TFCBOZBL TBNQBJ nication in the enteric nervous system, Gastroenterology 135:20,
2008.
NMEBSBIFLTUSBVOUVLNFNQFSUBIBOLBOTJSLVMBTJTJTUFNJL
762
BAB 63
UNIT XII
1SPQVMTJEBO1FODBNQVSBO.BLBOBO
EBMBN4BMVSBOU1FSJDFSOBBO
4BBU NBLBOBO CFSBEB EJ TFUJBQ MFLTNFOHVOZBI"EBOZBCPMVTNBLBOBOEJEBMBNNVMVUQBEB

CBHJBOTBMVSBOQFODFSOBBONF BXBMOZB NFOJNCVMLBO JOIJCJTJ SFGMFLT PUPUPUPU QFOHVOZBIBO
SVQBLBO TBBU ZBOH QFOUJOH VO ZBOHNFOZFCBCLBOSBIBOHCBXBIUVSVOLFCBXBI1FOVSVOBO
UVL NFNQSPTFT TFDBSB PQUJNBM JOJ LFNVEJBO NFOJNCVMLBO SFGMFLT SFHBOH QBEB PUPUPUPU SB
EBO NFOHBCTPSQTJ CBIBO NB IBOH CBXBI ZBOH NFOJNCVMLBO LPOUSBLTJ SFCPVOE ,FBEBBO
LBOBO4FMBJOJUV QFODBNQVSBO JOJTFDBSBPUPNBUJTNFOHBOHLBUSBIBOHCBXBIZBOHNFOJNCV
ZBOHUFQBUKVHBIBSVTCFSMBOH MLBO QFOHBUVQBO HJHJ HFMJHJ UFUBQJ KVHB NFOFLBO CPMVT QBEB
TVOH "LBO UFUBQJ LBSFOB LFCVUVIBO VOUVL QFODBNQVSBO EBO NVLPTB NVMVU ZBOH NFOHIBNCBU PUPUPUPU SBIBOH CBXBI TF
QSPQVMTJ QFOEPSPOHBO
TBOHBU CFSCFEB QBEB UJBQ UJOHLBU QSPTFT LBMJMBHJ NFOZFCBCLBOSBIBOHCBXBIUVSVOEBOLFNCBMJSFCP
CFSCBHBJ NFLBOJTNF VNQBO CBMJL IPSNPOBM EBO TBSBG PUPNBUJT VOEQBEBTBBUZBOHMBJO EBOJOJUFSKBEJCFSVMBOHVMBOH
BLBO NFOHPOUSPM XBLUV EBSJ UJBQ BTQFL QSPTFT JOJ TFIJOHHB .FOHVOZBIQFOUJOHVOUVLQFODFSOBBOTFNVBNBLBOBO UF
QFODBNQVSBOEBOQFOEPSPOHBOBLBOUFSKBEJTFDBSBPQUJNBM UJEBL UBQJ UFSVUBNB TFLBMJ VOUVL TFCBHJBO CFTBS CVBICVBIBO EBO
UFSMBMVDFQBUUJEBLUFSMBMVMBNCBU TBZVSTBZVSBO NFOUBI LBSFOB NFSFLB NFNQVOZBJ NFNCSBO
5VKVBOCBCJOJBEBMBIVOUVLNFOEJTLVTJLBOHFSBLBOHFSBLBO TFMVMPTBZBOHUJEBLEBQBUEJDFSOB.FNCSBOJOJNFMJOHLVQJCB
JOJ UFSVUBNBNFLBOJTNFPUPNBUJTQFOHPOUSPMBOJOJ HJBOCBHJBO [BU OVUSJTJ TFIJOHHB IBSVT EJVSBJLBO TFCFMVN NB
LBOBO EBQBU EJDFSOB 4FMBJO JUV NFOHVOZBI BLBO NFNCBOUV
Pencernaan Makanan QFODFSOBBO NBLBOBO VOUVL BMBTBO TFEFSIBOB CFSJLVU &O[JN
FO[JN QFODFSOBBO IBOZB CFLFSKB QBEB QFSNVLBBO QBSUJLFM
+VNMBI NBLBOBO ZBOH EJLPOTVNTJ PMFI TFTFPSBOH UFSVUBNB NBLBOBOTFIJOHHB LFDFQBUBOQFODFSOBBOTFMVSVIOZBCFSHBO
EJUFOUVLBOPMFILFJOHJOBOJOUSJOTJLBLBONBLBOBOZBOHEJTFCVU UVOH QBEB BSFB QFSNVLBBO UPUBM ZBOH UFSQBQBS EFOHBO TFLSFTJ
MBQBS +FOJT NBLBOBO ZBOH EJDBSJ PSBOH EJUFOUVLBO PMFI TFMFSB QFODFSOBBO 4FMBJO JUV NFOHHJMJOH NBLBOBO IJOHHB NFOKBEJ
.FLBOJTNF JOJ TBOHBU QFOUJOH VOUVL NFOKBHB TVQMBJ NBLBOBO QBSUJLFMQBSUJLFM EFOHBO LPOTJTUFOTJ TBOHBU IBMVT BLBO NFODF
ZBOHBEFLVBUVOUVLUVCVIIBMUFSTFCVUEJCJDBSBLBOQBEB#BC HBI FLTLPSJBTJ USBLUVT HBTUSPJOUFTUJOBM EBO NFOJOHLBULBO LF
CFSLBJUBO EFOHBO OVUSJTJ UVCVI %JTLVTJ QFODFSOBBO NBLBOBO NVEBIBOQFOHPTPOHBONBLBOBOEBSJMBNCVOHLFEBMBNVTVT
QBEB CBC JOJ UFSCBUBT QBEB NFLBOJTNF QFODFSOBBO NBLBOBO IBMVT LFNVEJBOLFTFNVBTFHNFOVTVTCFSJLVUOZB
UFSVUBNBNBTUJLBTJ QFOHVOZBIBO
EBOQFOFMBOBO
Proses Menelan (Deglutasi)
Mastikasi (Mengunyah)
.FOFMBO BEBMBI NFLBOJTNF ZBOH LPNQMFLT UFSVUBNB LBSFOB
(JHJ TVEBI EJSBODBOH EFOHBO TBOHBU UFQBU VOUVL NFOHVOZBI GBSJOHNFNCBOUVGVOHTJQFSOBQBTBOEBONFOFMBO'BSJOHEJV
(JHJHFMJHJBOUFSJPS JOTJTJWJ
CFLFSKBTFCBHBJQFNPUPOHZBOHLVBU CBI IBOZB EBMBN CFCFSBQB EFUJL NFOKBEJ USBLUVT VOUVL NFO
EBO HJHJ HFMJHJ QPTUFSJPS NPMBS
CFLFSKB VOUVL NFOHHJMJOH EPSPOH NBTVL NBLBOBO )BM ZBOH UFSVUBNB QFOUJOH BEBMBI
4FNVBPUPUSBIBOHZBOHCFLFSKBCFSTBNBTBNBEBQBUNFOHIBTJM CBIXBSFTQJSBTJUJEBLUFSHBOHHVLBSFOBQSPTFTNFOFMBO
LBO LFLVBUBO HJHJU TFCFTBS QPO QBEB JOTJTJWVT EBO QPO 1BEB VNVNOZB NFOFMBO EBQBU EJCBHJ NFOKBEJ
UBIBQ
QBEBNPMBS WPMVOUFSZBOHNFODFUVTLBOQSPTFTNFOFMBO
UBIBQGBSJOHFBM
1BEBVNVNOZBPUPUPUPUQFOHVOZBIEJQFSTBSBGJPMFIDBCBOH ZBOHCFSTJGBUJOWPMVOUFSEBONFNCBOUVKBMBOOZBNBLBOBONF
NPUPSJL TBSBG LSBOJBM LFMJNB EBO QSPTFT NFOHVOZBI EJLPOUSPM MBMVJ GBSJOH LF EBMBN FTPGBHVT EBO
UBIBQ FTPGBHFBM ZBJUV
PMFIOVLMFVTEBMBNCBUBOHPUBL1FSBOHTBOHBOEBFSBISFUJLVMBSJT GBTF JOWPMVOUFS MBJO ZBOH NFOHBOHLVU NBLBOBO EBSJ GBSJOH LF
TQFTJGJLQBEBQVTBUQFOHFDBQBOEJCBUBOHPUBLBLBONFOJNCVM MBNCVOH
LBOHFSBLBONFOHVOZBIZBOHSJUNJT%FNJLJBOQVMB QFSBOHTB
OHBOBSFBEJIJQPUBMBNVT BNJHEBMB EBOCBILBOEJLPSUFLTTFSF Tahap Volunter dan Proses Menelan. #JMB NBLBOBO
CSJ EFLBU BSFB TFOTPSJT VOUVL QFOHFDBQBO EBO QFOHIJEV TFSJOH TVEBITJBQVOUVLEJUFMBO TFDBSBTBEBSNBLBOBOEJUFLBOBUBV
LBMJEBQBUNFOJNCVMLBOHFSBLBONFOHVOZBI EJEPSPOHLFBSBIQPTUFSJPSLFEBMBNGBSJOHPMFIUFLBOBOMJEBI
,FCBOZBLBOQSPTFTNFOHVOZBIEJTFCBCLBOPMFITVBUVSFG LFBUBTEBOLFCFMBLBOHUFSIBEBQQBMBUVN TFQFSUJZBOHEJUVOKV
763
4. (FSBLBO MBSJOH LF BUBT KVHB NFOBSJL EBO NFMFCBSLBO

QFNCVLBBOLFFTPGBHVT1BEBTBBUZBOHCFSTBNBBO DNEJ
BUBT EJOEJOH PUPU FTPGBHVT ZBOH EJOBNBLBO TGJOHUFS FTPGBHVT
BUBT KVHB EJTFCVU TGJOHUFS GBSJOHPFTPGBHFBM
CFSFMBLTBTJ
%FOHBO EFNJLJBO NBLBOBO EBQBU CFSHFSBL EFOHBO NVEBI
EBOCFCBTEBSJGBSJOHQPTUFSJPSLFEBMBNFTPGBHVTCBHJBOBUBT
%J BOUBSB QFOFMBOBO TGJOHUFS JOJ UFUBQ CFSLPOUSBLTJ EFOHBO
LVBU TFIJOHHB NFODFHBI VEBSB NBTVL LF FTPGBHVT TFMBNB
SFTQJSBTJ (FSBLBO MBSJOH LF BUBT KVHB NFOHBOHLBU HMPUJT
LFMVBSEBSJKBMBOVUBNBNBLBOBO TFIJOHHBNBLBOBOUFSVUBNB
IBOZBNFMFXBUJTFUJBQTJTJFQJHMPUJTEBOCVLBONFMJOUBTEJBUBT
QFSNVLBBOOZB IBM JOJ NFOBNCBI QFODFHBIBO UFSIBEBQ
NBTVLOZBNBLBOBOLFEBMBNUSBLFB
5. 4FUFMBI MBSJOH UFSBOHLBU EBO TGJOHUFS GBSJOHPFTPGBHFBM
NFOHBMBNJSFMBLTBTJ TFMVSVIPUPUEJOEJOHGBSJOHCFSLPOUSBLTJ
NVMBJ EBSJ CBHJBO TVQFSJPS GBSJOH MBMV NFOZFCBS LF CBXBI
NFMJOUBTJ EBFSBI GBSJOH NFEJB EBO JOGFSJPS ZBOH NFOEPSPOH
NBLBOBOLFEBMBNFTPGBHVTNFMBMVJQSPTFTQFSJTUBMUJL
4FCBHBJSJOHLBTBONFLBOJTNFUBIBQBOQFOFMBOBOEBSJGBSJOH
LLBO QBEB (BNCBS %BSJ TJOJ QSPTFT NFOFMBO NFOKBEJ 5SBLFB UFSUVUVQ FTPGBHVT UFSCVLB EBO TVBUV HFMPNCBOH
TFMVSVIOZB BUBV IBNQJS TFMVSVIOZB CFSMBOHTVOH TFDBSB PUP QFSJTUBMUJL DFQBU EJDFUVTLBO PMFI TJTUFN TBSBG GBSJOH NFOEPSPOH
NBUJTEBOVNVNOZBUJEBLEBQBUEJIFOUJLBO CPMVT NBLBOBO LF EBMBN FTPGBHVT CBHJBO BUBT TFMVSVI QSPTFT
UFSKBEJEBMBNXBLUVLVSBOHEBSJEFUJL
Tahap Faringeal dan Proses Menelan. 4BBU CPMVT
NBLBOBO NFNBTVLJ CBHJBO QPTUFSJPS NVMVU EBO GBSJOH CPMVT Pencetusan Saraf pada Tahap Faringeal dan Proses
NFSBOHTBOH EBFSBI FQJUFM SFTFQUPS NFOFMBO EJ TFLFMJMJOH QJOUV Menelan. %BFSBI UBLUJM QBMJOH TFOTJUJG EBSJ CBHJBO QPTUFSJPS
GBSJOH LIVTVTOZB QBEB UJBOHUJBOH UPOTJM EBO TJOZBMTJOZBM NVMVU EBO GBSJOH VOUVL NFOHBXBMJ UBIBQ GBSJOHFBM QBEB QSPTFT
EBSJ TJOJ CFSKBMBO LF CBUBOH PUBL VOUVL NFODFUVTLBO TFSBOH NFOFMBOUFSMFUBLQBEBTVBUVDJODJOZBOHNFOHFMJMJOHJQFNCVLBBO
LBJBOLPOUSBLTJPUPUGBSJOHFBMTFDBSBPUPNBUJTTFCBHBJCFSJLVU GBSJOH EFOHBOTFOTJUJWJUBTUFSCFTBSQBEBUJBOHUJBOHUPOTJM4JOZBM
1. 1BMBUVN NPMF UFSUBSJL LF BUBT VOUVL NFOVUVQJ OBSFT EJKBMBSLBOEBSJEBFSBIJOJNFMBMVJCBHJBOTFOTPSJTTBSBGUSJHFNJOBM
QPTUFSJPS VOUVL NFODFHBI SFGMVLT NBLBOBO LF SPOHHB EBO HMPTPGBSJOHFBM LF NFEVMB PCMPOHBUB CBJL LF EBMBN BUBV
IJEVOH CFSIVCVOHBO FSBU EFOHBO USBLUVT TPMJUBSJVT ZBOH UFSVUBNB
2. -JQBUBO QBMBUPGBSJOHFBM QBEB TFUJBQ TJTJ GBSJOH UFSUBSJL LF NFOFSJNBTFNVBJNQVMTTFOTPSJTEBSJNVMVU
BSBINFEJBMVOUVLTBMJOHNFOEFLBUTBUVTBNBMBJO%FOHBO 5BIBQ CFSJLVUOZB QSPTFT NFOFMBO TFDBSB PUPNBUJT EJDFUVTLBO
DBSB JOJ MJQBUBOMJQBUBO UFSTFCVU NFNCFOUVL DFMBI TBHJUBM EBMBNVSVUBOZBOHUFSBUVSPMFIEBFSBIEBFSBIOFVSPOTVCTUBOTJB
ZBOH IBSVT EJMFXBUJ PMFI NBLBOBO VOUVL NBTVL LF EBMBN SFUJLVMBSJT NFEVMB EBO CBHJBO CBXBI QPOT 6SVUBO SFGMFLT
GBSJOHQPTUFSJPS$FMBIJOJNFMBLVLBOLFSKBTFMFLUJG TFIJOHHB QFOFMBOBOJOJTBNBEBSJTBUVQFOFMBOBOLFQFOFMBOBOCFSJLVUOZB
NBLBOBO ZBOH UFMBI DVLVQ EJLVOZBI EBQBU MFXBU EFOHBO EBO XBLUV VOUVL TFMVSVI TJLMVT KVHB UFUBQ TBNB EBSJ TBUV
NVEBI 0MFI LBSFOB UBIBQ QFOFMBOBO JOJ CFSMBOHTVOH LV QFOFMBOBOLFQFOFMBOBOCFSJLVUOZB%BFSBIEJNFEVMBEBOQPOT
SBOH EBSJ EFUJL TFUJBQ CFOEB CFTBS BQB QVO CJBTBOZB TB CBHJBO CBXBI ZBOH NFOHBUVS QFOFMBOBO TFDBSB LFTFMVSVIBO
OHBUEJIBNCBUVOUVLMFXBUNBTVLLFFTPGBHVT EJTFCVUQVTBUNFOFMBOBUBVEFHMVUBTJ
3. 1JUBTVBSBQBEBMBSJOHNFOKBEJTBOHBUCFSEFLBUBO EBOMBSJOH *NQVMT NPUPSJL EBSJ QVTBU NFOFMBO LF GBSJOH EBO FTPGBHVT
CBHJBO BUBT ZBOH NFOZFCBCLBO QFOFMBOBO EJIBOUBSLBO TFDBSB
UFSUBSJL LF BUBT EBO BOUFSJPS PMFI PUPUPUPU MFIFS )BM JOJ
CFSVSVUBO PMFI TBSBG LSBOJBM LFMJNB LFTFNCJMBO LFTFQVMVI EBO
EJHBCVOH EFOHBO BEBOZB MJHBNFO ZBOH NFODFHBI HFSBLBO
LFEVBCFMBT TFSUBCBILBOCFCFSBQBTBSBGTFSWJLBMTVQFSJPS
FQJHMPUJT LF BUBT NFOZFCBCLBO FQJHMPUJT CFSHFSBL LF
CFMBLBOHEJBUBTQFNCVLBBOMBSJOH4FMVSVIFGFLJOJCFLFSKB 3JOHLBTOZB UBIBQ GBSJOHFBM QFOFMBOBO QBEB EBTBSOZB
CFSTBNB NFODFHBI NBTVLOZB NBLBOBO LF EBMBN IJEVOH NFSVQBLBO TVBUV SFGMFLT )BM JOJ IBNQJS TFMBMV EJBXBMJ PMFI
EBO USBLFB )BM ZBOH QBMJOH QFOUJOH BEBMBI TBOHBU HFSBLBO NBLBOBO TFDBSB WPMVOUFS NBTVL LF CBHJBO CFMBLBOH
CFSEFLBUBOOZB QJUB TVBSB OBNVO FQJHMPUJT NFNCBOUV NVMVU ZBOH LFNVEJBO NFSBOHTBOH SFTFQUPSSFTFQUPS TFOTPSJT
NFODFHBI NBLBOBO BHBS TFKBVI NVOHLJO EBSJ QJUB TVBSB GBSJOHFBMJOWPMVOUFSVOUVLNFOJNCVMLBOSFGMFLTNFOFMBO
,FSVTBLBO QJUB TVBSB BUBV PUPUPUPU ZBOH NFNCVBUOZB
CFSEFLBUBOEBQBUNFOZFCBCLBOTUSBOHVMBTJ
764
Bab 63 Propulsi dan Pencampuran Makanan dalam Saluran Pencernaan
Pengaruh Tahap Faringeal dan Proses Menelan TBNQBJ CBUBT UFSUFOUV CBILBO EVPEFOVN NFOKBEJ UFSFMBLTBTJ
terhadap Pernapasan. 4FMVSVIUBIBQGBSJOHFBMEBOQSPTFTNF TFXBLUV HFMPNCBOH JOJ NFODBQBJ CBHJBO BLIJS FTPGBHVT EBO
OFMBOUFSKBEJEBMBNXBLUVLVSBOHEBSJEFUJL EFOHBOEFNJLJBO EFOHBO EFNJLJBO NFNQFSTJBQLBO MFCJI BXBM VOUVL NFOFSJNB
NFOHHBOHHV QFSOBQBTBO IBOZB TFLFKBQ TBKB EBMBN TJLMVT QFSOB NBLBOBOZBOHEJEPSPOHLFFTPGBHVTTFMBNBQSPTFTNFOFMBO
UNIT XII
QBTBO ZBOH CJBTB 1VTBU NFOFMBO TFDBSB LIVTVT NFOHIBNCBU
QVTBUQFSOBQBTBONFEVMBTFMBNBXBLUVJOJ NFOHIFOUJLBOQFSOB Fungsi Sfingter Esofagus Bagian Bawah (Sfingter
QBTBOQBEBUJUJLUFSUFOUVEBMBNTJLMVTOZBVOUVLNFNVOHLJOLBO Gastroesofageal). 1BEB VKVOH CBXBI FTPGBHVT NFMVBT LF
CFSMBOHTVOHOZBQFOFMBOBO#BILBO LFUJLBTFTFPSBOHTFEBOHCFS BUBT TFLJUBS DN EJ BUBT QFSCBUBTBO EFOHBO MBNCVOH PUPU
CJDBSB QFOFMBOBO BLBO NFOHIFOUJLBO QFSOBQBTBO TFMBNB XBLUV TJSLVMBS FTPGBHVT CFSGVOHTJ TFCBHBJ TGJOHUFS FTPGBHVT CBXBI
ZBOHTFEFNJLJBOTJOHLBUTFIJOHHBTVMJUVOUVLEJQFSIBUJLBO ZBOHMFCBS BUBVEJTFCVUKVHBTGJOHUFSHBTUSPFTPGBHFBM/PSNBM
OZB TGJOHUFS JOJ UFUBQ CFSLPOTUSJLTJ TFDBSB UPOJL EFOHBO
Tahap Esofageal Proses Menelan. &TPGBHVT UFSVUBNB UFLBOBOJOUSBMVNJOBMQBEBUJUJLJOJEJFTPGBHVTTFLJUBSNN
CFSGVOHTJ VOUVL NFOZBMVSLBO NBLBOBO TFDBSB DFQBU EBSJ GBSJOH )H CFSCFEBEFOHBOCBHJBOUFOHBIFTPGBHVTZBOHOPSNBMOZB
LF MBNCVOH EBO HFSBLBOOZB EJBUVS TFDBSB LIVTVT VOUVL GVOHTJ UFUBQ CFSFMBLTBTJ 4FXBLUV HFMPNCBOH QFSJTUBMUJL QFOFMBOBO
UFSTFCVU NFMFXBUJ FTPGBHVT UFSEBQBU SFMBLTBTJ SFTFQUJG EBSJ TGJOHUFS
/PSNBMOZB FTPGBHVTNFNQFSMJIBULBOEVBUJQFHFSBLBOQFSJT FTPGBHVTCBHJBOCBXBIZBOHNFOEBIVMVJHFMPNCBOHQFSJTUBM
UBMUJL QFSJTUBMUJL QSJNFS EBO QFSJTUBMUJL TFLVOEFS 1FSJTUBMUJL UJL ZBOHNFNQFSNVEBIQFOEPSPOHBONBLBOBOZBOHEJUFMBO
QSJNFS IBOZB NFSVQBLBO LFMBOKVUBO EBSJ HFMPNCBOH QFSJTUBMUJL LFEBMBNMBNCVOH,BEBOHTGJOHUFSUJEBLCFSFMBLTBTJEFOHBO
ZBOH EJNVMBJ EJ GBSJOH EBO NFOZFCBS LF FTPGBHVT TFMBNB UBIBQ CBJL TFIJOHHBNFOHBLJCBULBOLFBEBBOZBOHEJTFCVUBLBMBTJB
GBSJOHFBMEBSJQSPTFTNFOFMBO(FMPNCBOHJOJCFSKBMBOEBSJGBSJOH )BMJOJEJEJTLVTJLBOEBMBN#BC
LF MBNCVOH EBMBN XBLUV TFLJUBS TBNQBJ EFUJL .BLBOBO 4FLSFTJ MBNCVOH CFSTJGBU TBOHBU BTBN EBO NFOHBOEVOH
ZBOHEJUFMBOTFTFPSBOHQBEBQPTJTJUFHBLCJBTBOZBEJIBOUBSLBOLF CBOZBL FO[JN QSPUFPMJUJL .VLPTB FTPGBHVT LFDVBMJ QBEB
VKVOH CBXBI FTPGBHVT CBILBO MFCJI DFQBU EBSJQBEB HFMPNCBOH TFQFSEFMBQBO CBHJBO CBXBI FTPGBHVT UJEBL NBNQV CFSMBNB
QFSJTUBMUJLJUVTFOEJSJ TFLJUBSTBNQBJEFUJL BLJCBUBEBOZBFGFL MBNB NFOBIBO BLTJ QFODFSOBBO EBSJ TFLSFTJ MBNCVOH
HSBWJUBTJUBNCBIBOZBOHNFOBSJLNBLBOBOLFCBXBI 6OUVOHOZB LPOTUSJLTJ UPOJL TGJOHUFS FTPGBHVT CBHJBO CBXBI
+JLB HFMPNCBOH QFSJTUBMUJL QSJNFS HBHBM NFOEPSPOH NFNCBOUV NFODFHBI SFGMVLT ZBOH CFSNBLOB EBSJ JTJ MBNCVOH
TFNVB NBLBOBO ZBOH UFMBI NBTVL FTPGBHVT LF EBMBN MBN LFEBMBNFTPGBHVTLFDVBMJQBEBLFBEBBOBCOPSNBM
CVOH UFSKBEJHFMPNCBOHQFSJTUBMUJLTFLVOEFSZBOHEJIBTJMLBO
EBSJ QFSFHBOHBO FTPGBHVT PMFI NBLBOBO ZBOH UFSUBIBO HF
Pencegahan Tambahan terhadap Refluks dengan
MPNCBOH JOJ UFSVT CFSMBOKVU TBNQBJ TFNVB NBLBOBO EJLP
Penutup Seperti Katup di Ujung Distal Esofagus.
TPOHLBOLFEBMBNMBNCVOH(FMPNCBOHQFSJTUBMUJLTFLVOEFS
'BLUPS MBJO ZBOH NFNCBOUV NFODFHBI SFGMVLT BEBMBI
JOJTFCBHJBOEJNVMBJPMFITJSLVJUTBSBGJOUSJOTJLEBMBNTJTUFN
NFLBOJTNFTFQFSUJLBUVQQBEBCBHJBOFTPGBHVTZBOHQFOEFL
TBSBG NJFOUFSJLVT EBO TFCBHJBO PMFI SFGMFLTSFGMFLT ZBOH
ZBOH NFNBOKBOH TFEJLJU LF EBMBN MBNCVOH 1FOJOHLBUBO
EJNVMBJ QBEB GBSJOH MBMV EJIBOUBSLBO LF BUBT NFMBMVJ TFSBU
UFLBOBO JOUSBBCEPNFO BLBO NFOEFTBL FTPGBHVT LF EBMBN
TFSBU BGFSFO WBHVT LF NFEVMB EBO LFNCBMJ MBHJ LF FTPGBHVT
QBEB UJUJL JOJ +BEJ QFOVUVQ TFQFSUJ LBUVQ QBEB
NFMBMVJTFSBUTFSBUTBSBGBGFSFOHMPTPGBSJOHFBMEBOWBHVT
FTPGBHVT CBHJBO CBXBI JOJ NFNCBOUV NFODFHBI UFLBOBO
4VTVOBO PUPU EJOEJOH GBSJOH EBO TFQFSUJHB CBHJBO BUBT JOUSBBCEPNFO ZBOH UJOHHJ ZBOH CFSBTBM EBSJ EFTBLBO JTJ
FTPGBHVTBEBMBIPUPUMVSJL0MFILBSFOBJUV HFMPNCBOHQFSJTUBMUJL MBNCVOHLFNCBMJ LF FTPGBHVT ,BMBV UJEBL TFUJBQ LBMJ LJUB
EJ EBFSBI JOJ EJBUVS PMFI TJOZBM TBSBG SBOHLB EBSJ TBSBG CFSKBMBO CBUVL BUBV CFSOBQBT LVBU LJUB NVOHLJO
HMPTPGBSJOHFBM EBO TBSBG WBHVT 1BEB EVB QFSUJHB CBHJBO CBXBI NFOHFMVBSLBOBTBNMBNCVOHLFFTPGBHVT
FTPGBHVT TVTVOBOPUPUOZBNFSVQBLBOPUPUQPMPT OBNVOCBHJBO
FTPGBHVTJOJKVHBTFDBSBLVBUEJBUVSPMFITBSBGWBHVTZBOHCFLFSKB
NFMBMVJQFSIVCVOHBOEFOHBOTJTUFNTBSBGNJFOUFSJLVTFTPGBHFBM
+JLB TBSBG WBHVT ZBOH NFOVKV FTPGBHVT EJQPUPOH TFUFMBI
CFCFSBQBIBSJQMFLTVTTBSBGNJFOUFSJLVTFTPGBHVTNFOKBEJDVLVQ Fungsi Motorik Lambung
QFLB SBOHTBOH VOUVL NFOJNCVMLBO HFMPNCBOH QFSJTUBMUJL
TFLVOEFS ZBOH LVBU CBILBO UBOQB CBOUVBO SFGMFLT WBHBM 0MFI 'VOHTJ NPUPSJL MBNCVOH BEB UJHB
QFOZJNQBOBO TFKVNMBI
LBSFOB JUV CBILBO TFTVEBI QBSBMJTJT SFGMFLT QFOFMBOBO CBUBOH CFTBS NBLBOBO TBNQBJ NBLBOBO EBQBU EJQSPTFT EJ EBMBN
PUBL NBLBOBO ZBOH EJNBTVLLBO NFMBMVJ TFMBOH BUBV EFOHBO MBNCVOH EVPEFOVN EBO USBLUVT JOUFTUJOBM CBXBI

DBSBMBJOLFEBMBNFTPGBHVTUFUBQTJBQNFNBTVLJMBNCVOH QFODBNQVSBO NBLBOBO JOJ EFOHBO TFLSFTJ EBSJ MBNCVOH
TBNQBJNFNCFOUVLTVBUVDBNQVSBOTFUFOHBIDBJSZBOHEJTFCVU
Relaksasi Reseptif Lambung. #JMB HFMPNCBOH QFSJTUBMUJL LJNVT EBO
QFOHPTPOHBO LJNVT EFOHBO MBNCBU EBSJ
FTPGBHVT NFOEFLBU LF BSBI MBNCVOH UJNCVM TVBUV HFMPNCBOH MBNCVOHLFEBMBNVTVTIBMVTQBEBLFDFQBUBOZBOHTFTVBJVOUVL
SFMBLTBTJ ZBOHEJIBOUBSLBONFMBMVJOFVSPOQFOHIBNCBUNJFOUF QFODFSOBBOEBOBCTPSQTJZBOHUFQBUPMFIVTVTIBMVT
SJLVT NFOEBIVMVJQFSJTUBMUJL4FMBOKVUOZB TFMVSVIMBNCVOHEBO
765
Fundus CVOH 4BBU HFMPNCBOH LPOTUSJLUPS CFSKBMBO EBSJ LPSQVT MBNCVOH

LFEBMBNBOUSVN HFMPNCBOHUFSTFCVUNFOKBEJMFCJILVBU CFCFSB
QBNFOKBEJTBOHBULVBUEBONFOJNCVMLBODJODJOLPOTUSJLUPSZBOH
EJHFSBLLBO PMFI QPUFOTJBM BLTJ QFSJTUBMUJL ZBOH LVBU ZBOH
NFOEPSPOHJTJBOUSVNEJCBXBIUFLBOBOZBOHTFNBLJOMBNBTF
NBLJOUJOHHJLFBSBIQJMPSVT
$JODJO LPOTUSJLUPS JOJ KVHB NFNBJOLBO QFSBO QFOUJOH EBMBN
NFODBNQVS JTJ MBNCVOH NFMBMVJ DBSB CFSJLVU 4FUJBQ LBMJ HFMPN
CBOH QFSJTUBMUJL NFMFXBUJ EJOEJOH BOUSVN CFSHFSBL LF CBXBI
NFOVKV QJMPSVT HFMPNCBOH JUV NFOFNCVT JTJ NBLBOBO TFNBLJO
EBMBNQBEBBOUSVN5FUBQJQFNCVLBBOQJMPSVTNBTJIDVLVQTFN
QJUTFIJOHHBIBOZBCFCFSBQBNJMJMJUFSBUBVLVSBOHJTJBOUSVNZBOH
EJLFMVBSLBOLFEBMBNEVPEFOVNQBEBTFUJBQHFMPNCBOHQFSJTUBM
UJL%FNJLJBOKVHB LFUJLBTFUJBQHFMPNCBOHQFSJTUBMUJLNFOEFLBUJ
QJMPSVT PUPUQJMPSVTJUVTFOEJSJTFSJOHCFSLPOUSBLTJ ZBOHTFMBOKVU
Rugae OZB NFOHIBMBOHJ QFOHPTPOHBO NFMBMVJ QJMPSVT 0MFI LBSFOB JUV
( TFCBHJBO CFTBS JTJ BOUSVN BLBO EJQFSBT UFSCBMJL BSBIOZB NFMBMVJ
DJODJOQFSJTUBMUJLNFOVKVLPSQVTMBNCVOH UJEBLNFOVKVQJMPSVT
4FIJOHHB HFSBLBODJODJOLPOTUSJLUJGQFSJTUBMUJL EJHBCVOHEFOHBO
LFSKB NFNFSBT EFOHBO BSBI UFSCBMJL EJTFCVU SFUSPQVMTJ BEBMBI
(BNCBSNFOVOKVLLBOBOBUPNJEBTBSMBNCVOH4FDBSB NFLBOJTNFQFODBNQVSBOZBOHTBOHBUQFOUJOHEBMBNMBNCVOH
BOBUPNJT MBNCVOHCJBTBOZBUFSCBHJNFOKBEJEVBCBHJBOCFTBS

LPSQVTEBO
BOUSVN4FDBSBGJTJPMPHJT MFCJIUFQBUEJCBHJ Kimus. 4FTVEBI NBLBOBO EBMBN MBNCVOH TFMVSVIOZB
NFOKBEJ
CBHJBOPSBE ZBOHNFSVQBLBOTFLJUBSEVBQFSUJHB CFSDBNQVS EFOHBO TFLSFTJ MBNCVOH IBTJM DBNQVSBO ZBOH
QFSUBNBLPSQVT EBO
CBHJBOLBVEBE ZBOHNFSVQBLBOTJTB CFSKBMBO LF VTVT EJTFCVU LJNVT %FSBKBU LFFODFSBO LJNVT
EBSJLPSQVTEJUBNCBIBOUSVN CFSHBOUVOH QBEB KVNMBI SFMBUJG NBLBOBO BJS EBO TFLSFTJ
MBNCVOH TFSUB QBEB EFSBKBU QFODFSOBBO ZBOH UFMBI UFSKBEJ $JSJ
Fungsi Penyimpanan Lambung DJSJLJNVTBEBMBIDBJSBOLFSVITFUFOHBIDBJSBUBVTFQFSUJQBTUB
4BBU NBLBOBO NBTVL LF EBMBN MBNCVOH NBLBOBO NFNCFO
UVL MJOHLBSBO LPOTFOUSJT NBLBOBO EJ CBHJBO PSBE MBNCVOH Kontraksi Lapar. 4FMBJO LPOUSBLTJ QFSJTUBMUJL ZBOH UFSKBEJ
NBLBOBO ZBOH QBMJOH CBSV UFSMFUBL QBMJOH EFLBU EFOHBO LFUJLBNBLBOBOUFSEBQBUEJEBMBNMBNCVOH UFSEBQBUTVBUVKFOJT
QFNCVLBBO FTPGBHVT EBO NBLBOBO ZBOH QBMJOH MBNB UFSMFUBL LPOUSBLTJ MBJO ZBOH LVBU EJTFCVU LPOUSBLTJ MBQBS TFSJOH UFSKBEJ
QBMJOH EFLBU EFOHBO EJOEJOH MVBS MBNCVOH /PSNBMOZB CJMB CJMB MBNCVOH UFMBI LPTPOH TFMBNB CFCFSBQB KBN BUBV MFCJI
NBLBOBO NFSFHBOHLBO MBNCVOH SFGMFLT WBTPWBHBM EBSJ ,POUSBLTJ JOJ BEBMBI LPOUSBLTJ QFSJTUBMUJL ZBOH SJUNJT EJ EBMBN
MBNCVOH LF CBUBOH PUBL EBO LFNVEJBO LFNCBMJ LF MBNCVOH LPSQVT MBNCVOH ,FUJLB LPOUSBLTJ CFSUVSVUBO UFSTFCVU NFOKBEJ
BLBONFOHVSBOHJUPOVTEJEBMBNPUPUEJOEJOHLPSQVTMBNCVOH TBOHBULVBU LPOUSBLTJLPOUSBLTJJOJBLBONFOJNCVMLBOLPOUSBLTJ
TFIJOHHB EJOEJOH NFOPOKPM LFMVBS TFDBSB QSPHSFTJG NFOBN UFUBOJLZBOHLPOUJOVZBOHLBEBOHCFSMBOHTVOHTFMBNBNFOJU
QVOHKVNMBINBLBOBOZBOHNBLJOMBNBNBLJOCBOZBLTBNQBJ ,POUSBLTJ MBQBS UFSKBEJ QBMJOH LVBU QBEB PSBOH NVEB TFIBU
TVBUV CBUBT TBBU MBNCVOH CFSFMBLTBTJ TFNQVSOB ZBJUV ZBOHNFNJMJLJEFSBKBUUPOVTHBTUSPJOUFTUJOBMZBOHUJOHHJLPOUSBL
TBNQBJ - 5FLBOBO EBMBN MBNCVOH UFUBQ SFOEBI TBNQBJ TJKVHBEBQBUTBOHBUNFOJOHLBUKJLBPSBOHUFSTFCVUNFNJMJLJLBEBS
CBUBTJOJUFSDBQBJ HVMB EBSBI ZBOH MFCJI SFOEBI EBSJ OPSNBM #JMB LPOUSBLTJ MBQBS
UFSKBEJEJEBMBNMBNCVOH PSBOHLBEBOHBLBONFOHBMBNJTFOTBTJ
Pencampuran dan Propulsi Makanan dalam Lambung
OZFSJ SJOHBO QBEB CBHJBO CBXBI MBNCVOH EJTFCVU IVOHFS QBOHT
—Irama Listrik Dasar Dinding Lambung
SBTBOZFSJNFOEBEBLXBLUVMBQBS
)VOHFSQBOHTCJBTBOZBUJEBL
(FUBIQFODFSOBBOMBNCVOHEJTFLSFTJLBOPMFILFMFOKBSHBTUSJL UFSKBEJ TBNQBJ IJOHHB KBN TFTVEBI NBTVLOZB NBLBOBO
ZBOH CFSBEB QBEB IBNQJS TFMVSVI EJOEJOH LPSQVT MBNCVOH ZBOH UFSBLIJS QBEB LPOEJTJ LFMBQBSBO IVOHFS QBOHT NFODBQBJ
LFDVBMJ TFQBOKBOH HBSJT TFNQJU EJ LVSWBUVSB NJOPS MBNCVOH JOUFOTJUBT UFSCFTBS EBMBN XBLUV TBNQBJ IBSJ EBO NFMFNBI
4FLSFTJJOJUFSKBEJEFOHBOTFHFSBTBBUCFSLPOUBLEFOHBOCBHJBO TFDBSBCFSUBIBQQBEBIBSJIBSJCFSJLVUOZB
NBLBOBO ZBOH EJTJNQBO UFSMFUBL CFSIBEBQBO EFOHBO QFSNV
LBBO NVLPTB MBNCVOH 4FMBNB MBNCVOH CFSJTJ NBLBOBO
HFMPNCBOH LPOTUSJLUPS QFSJTUBMUJL MFNBI KVHB EJTFCVU HFMPN
Pengosongan Lambung
CBOH QFODBNQVS NVMBJ UJNCVM EJ CBHJBO UFOHBI TBNQBJ LF 1FOHPTPOHBO MBNCVOH EJUJNCVMLBO PMFI LPOUSBLTJ QFSJTUBMUJL
CBHJBOZBOHMFCJIBUBTEJOEJOHMBNCVOHEBOCFSHFSBLLFBSBI ZBOH LVBU EJ EBMBN BOUSVN MBNCVOH 1BEB TBBU ZBOH TBNB
BOUSVNTFLJUBSTBUVLBMJTFUJBQTBNQBJEFUJL(FMPNCBOH QFOHPTPOHBO EJMBXBO PMFI CFSCBHBJ UJOHLBU SFTJTUBOTJ UFSIBEBQ
JOJEJUJNCVMLBOPMFIJSBNBMJTUSJLEBTBSEJOEJOHMBNCVOH ZBOH CFSMBMVOZBLJNVTEJQJMPSVT
UFMBI EJEJTLVTJLBO EBMBN #BC UFSEJSJ BUBT HFMPNCBOH
QFOEFLMJTUSJLZBOHUFSKBEJTFDBSBTQPOUBOQBEBEJOEJOHMBN
766
Kontraksi Peristaltik Antrum yang Kuat Selama MFLTSFGMFLT NJFOUFSJL TFUFNQBU EBMBN EJOEJOH ZBOH TBOHBU
Pengosongan Lambung—"Pompa Pilorus". 1BEB VNVN NFNQFSLVBUBLUJWJUBTQPNQBQJMPSVT EBOQBEBTBBUCFSTBNBBO
OZB LPOUSBLTJLPOUSBLTJ SJUNJT MBNCVOH CFSTJGBU MFNBI EBO NFOHIBNCBUQJMPSVT
UFSVUBNBCFSGVOHTJVOUVLNFOZFCBCLBOQFODBNQVSBONBLBOBO
UNIT XII
EBOTFLSFTJMBNCVOH"LBOUFUBQJ TFLJUBSQFSTFOEBSJTFMVSVI Efek Hormon Gastrin terhadap Pengosongan
XBLUVLFUJLBNBLBOBOCFSBEBEBMBNMBNCVOH LPOUSBLTJNFOKB Lambung. %BMBN #BC LJUB NFOEJTLVTJLBO CBHBJNBOB
EJLVBU CFSNVMBQBEBCBHJBOQFSUFOHBIBOMBNCVOHEBONFOZF QFSFHBOHBO EJOEJOH MBNCVOH EBO BEBOZB KFOJT NBLBOBO UFS
CBSNFMBMVJCBHJBOLBVEBMMBNCVOH LPOUSBLTJJOJBEBMBIQFSJTUBM UFOUV EBMBN MBNCVOH UFSVUBNB IBTJM QFODFSOBBO EBHJOH
UJL ZBOH LVBU TBOHBU LFUBU TFQFSUJ LPOUSBLTJ DJODJO TFIJOHHB NFOZFCBCLBOQFMFQBTBOIPSNPOHBTUSJOEBSJNVLPTBBOUSVN
EBQBUNFOZFCBCLBOQFOHPTPOHBOMBNCVOH4BBUMBNCVOHTFDBSB (BTUSJONFNQVOZBJFGFLZBOHLVBUVOUVLNFOZFCBCLBOLFMFO
QSPHSFTJG NFOKBEJ TFNBLJO LPTPOH LPOTUSJLTJ JOJ NVMBJ NBLJO KBSMBNCVOHNFOZFLSFTJHFUBIMBNCVOHZBOHTBOHBUBTBN(BT
NFOKBVI EBMBN LPSQVT MBNCVOH TFDBSB CFSBOHTVSBOHTVS USJOKVHBNFNQVOZBJFGFLQFSBOHTBOHBOGVOHTJNPUPSJLEBSJSJ
NFOKFQJU NBLBOBO QBEB LPSQVT MBNCVOH EBO NFOBNCBILBO OHBO TBNQBJ TFEBOH QBEB LPSQVT MBNCVOH )BM ZBOH QBMJOH
NBLBOBO QBEB LJNVT EJ EBMBN BOUSVN ,POUSBLTJ QFSJTUBMUJL QFOUJOH HBTUSJO SVQBOZB NFOJOHLBULBO BLUJWJUBT QPNQB QJMP
ZBOHLVBUJOJTFSJOHNFOJNCVMLBOUFLBOBOBJSTBNQBJDN SVT+BEJ HBTUSJO NVOHLJONFNCBOUVUFSKBEJOZBQFOHPTPOHBO
ZBOH LJSBLJSB FOBN LBMJ MFCJI LVBU EBSJ KFOJT HFMPNCBOH MBNCVOH
QFSJTUBMUJLQFODBNQVSBOZBOHCJBTB
#JMB UPOVT QJMPSVT OPSNBM TFUJBQ HFMPNCBOH QFSJTUBMUJL ZBOH Faktor-Faktor Duodenum yang Kuat Menghambat
LVBUBLBONFOEPSPOHCFCFSBQBNJMJMJUFSLJNVTLFEBMBNEVPEF Pengosongan Lambung
OVN +BEJ HFMPNCBOH QFSJTUBMUJL TFMBJO NFOZFCBCLBO QFODBN Pengaruh Penghambatan oleh Refleks-Refleks
QVSBO EJ EBMBN MBNCVOH KVHB NFOZFEJBLBO LFSKB QFNPNQBBO Saraf Enterogastrik dari Duodenum. 4BBU NBLBOBO NBTVL
ZBOHEJTFCVUQPNQBQJMPSVT LFEBMBNEVPEFOVN CFSCBHBJSFGMFLTTBSBGUJNCVMEBSJEJOEJOH
EVPEFOVN.FSFLBLFNCBMJNFMFXBUJMBNCVOHVOUVLNFMBN
Peranan Pilorus dalam Mengontrol Pengosongan CBULBOBUBVCBILBONFOHIFOUJLBOQFOHPTPOHBOMBNCVOHKJLB
Lambung. 1FNCVLBBOCBHJBOEJTUBMMBNCVOHBEBMBIQJMPSVT%J WPMVNF LJNVT EJ EBMBN EVPEFOVN NFOKBEJ UFSMBMV CBOZBL
TJOJLFUFCBMBOEJOEJOHPUPUTJSLVMBSNFOKBEJTBNQBJQFS 3FGMFLTSFGMFLTJOJEJQFSBOUBSBPMFIUJHBKBMVS
MBOHTVOHEBSJ
TFO MFCJI CFTBS EBSJQBEB CBHJBO BXBM BOUSVN MBNCVOH EBO EVPEFOVN LF MBNCVOH NFMBMVJ TJTUFN TBSBG FOUFSJL QBEB EJO
TFDBSB UPOJL UFUBQ CFSLPOUSBLTJ TFDBSB SJOHBO IBNQJS TFQBOKBOH EJOH MBNCVOH
NFMBMVJ TBSBGTBSBG FLTUSJOTJL ZBOH CFSKBMBO
XBLUV 0MFI LBSFOB JUV PUPU TJSLVMBS QJMPSVT EJTFCVU TGJOHUFS LF HBOHMJB TJNQBUJT QSFWFSUFCSB EBO LFNVEJBO LFNCBMJ LF
QJMPSVT MBNCVOHNFMBMVJTFSBUTFSBUTBSBGTJNQBUJTQFOHIBNCBUEBO

8BMBVQVO UFSEBQBU LPOUSBLTJ UPOJL TGJOHUFS QJMPSVT ZBOH NVOHLJO MFCJI KBVI MBHJ NFMBMVJ OFSWVT WBHVT LF CBUBOH PUBL
OPSNBM QJMPSVTCJBTBOZBDVLVQUFSCVLBCBHJBJSEBODBJSBOMBJO TFIJOHHB NFOHIBNCBU TJOZBM FLTJUBUPSJL OPSNBM ZBOH EJUSBOT
VOUVL EJLPTPOHLBO EBSJ MBNCVOH LF EBMBN EVPEFOVN EFOHBO NJTJLBOLFMBNCVOHNFMBMVJOFSWVTWBHVT4FNVBSFGMFLTQBSB
NVEBI 4FCBMJLOZB LPOTUSJLTJ CJBTBOZB NFODFHBI QBTBTF MF MFM JOJ NFNQVOZBJ EVB FGFL QBEB QFOHPTPOHBO MBNCVOH
XBUOZB
QBSUJLFMNBLBOBOIJOHHBQBSUJLFMUFSTFCVUUFMBIUFSDBN 1FSUBNB SFGMFLT QBSBMFM UFSTFCVU EFOHBO LVBU NFOHIBNCBU
QVS EBMBN LJNVT TFIJOHHB NFNJMJLJ LPOTJTUFOTJ IBNQJS DBJS LPOUSBLTJ QFOEPSPOHBO QPNQB QJMPSVT EBO LFEVB SFGMFLT
%FSBKBU LPOTUSJLTJ QJMPSVT EJUJOHLBULBO BUBV EJUVSVOLBO EJ CB UFSTFCVUNFOJOHLBULBOUPOVTTGJOHUFSQJMPSVT
XBI QFOHBSVI TJOZBM SFGMFLT TBSBG EBO IVNPSBM EBSJ MBNCVOH +FOJTKFOJT GBLUPS ZBOH UFSVTNFOFSVT EJNPOJUPS EJ EBMBN
EBOEVPEFOVN TFQFSUJZBOHBLBOEJEJTLVTJLBOTFDBSBTJOHLBU EVPEFOVN EBO ZBOH EBQBU NFOHBXBMJ SFGMFLT QFOHIBNCBUBO
FOUFSPHBTUSJLBEBMBITFCBHBJCFSJLVU
Pengaturan Pengosongan Lambung 1. %FSBKBUQFSFHBOHBOEVPEFOVN
,FDFQBUBO QFOHPTPOHBO MBNCVOH EJBUVS PMFI TJOZBM EBSJ 2. "EBOZBJSJUBTJEFOHBOEFSBKBUCFSBQBQVOEBMBN
MBNCVOH EBO EVPEFOVN "LBO UFUBQJ EVPEFOVN NFNCFSJ NVLPTBEVPEFOVN
TJOZBM ZBOH MFCJI LVBU NFOHPOUSPM QFOHPTPOHBO LJNVT LF 3. %FSBKBULFBTBNBOLJNVTEVPEFOVN
EBMBN EVPEFOVN QBEB LFDFQBUBO ZBOH UJEBL NFMFCJIJ
4. %FSBKBUPTNPMBMJUBTLJNVT
LFDFQBUBOLJNVTEJDFSOBEBOEJBCTPSCTJEBMBNVTVTIBMVT
5. "EBOZB IBTJMIBTJM QFNFDBIBO QSPEVL UFSUFOUV EBMBN LJ
NVT UFSVUBNBIBTJMQFNFDBIBOQSPUFJOEBONVOHLJOTFEJLJU
Faktor-Faktor Lambung yang Mendorong Pengosongan
MFNBL
Efek Volume Makanan pada Lambung terhadap 3FGMFLTSFGMFLTQFOHIBNCBUFOUFSPHBTUSJLUFSVUBNB
Kecepatan Pengosongan. 1FOJOHLBUBO WPMVNF NBLBOBO TFOTJUJG UFSIBEBQ BEBOZB [BU[BU JSJUBO EBO BTBN EJ EBMBN
EBMBN MBNCVOH NFOJNCVMLBO QFOJOHLBUBO QFOHPTPOHBO MBN LJNVTEVPEFOVN EBOSFGMFLTUFSTFCVUTFSJOHLBMJNFOKBEJUFS
CVOH/BNVO QFOJOHLBUBOQFOHPTPOHBOJOJUJEBLUFSKBEJTFQFSUJ BLUJWBTJ EFOHBO LVBU EBMBN XBLUV TFTJOHLBU EFUJL 4FCBHBJ
ZBOHEJQFSLJSBLBOPSBOH#VLBOMBIQFOJOHLBUBOUFLBOBONBLB DPOUPI LBQBO QVO Q) LJNVT EBMBN EVPEFOVN UVSVO EJ CB
OBOZBOHEJTJNQBOEBMBNMBNCVOHZBOHNFOZFCBCLBOQFOJOH XBITFLJUBS TBNQBJSFGMFLTTFSJOHLBMJNFOHIBNCBUQFMF
LBUBOQFOHPTPOHBO LBSFOBEBMBNLJTBSBOWPMVNFOPSNBMCJBTB QBTBOMFCJIMBOKVUJTJMBNCVOHZBOHBTBNLFEBMBNEVPEFOVN
QFOJOHLBUBO WPMVNF UJEBL DVLVQ NFOJOHLBULBO UFLBOBO 4FCB IJOHHBLJNVTEVPEFOVNEBQBUEJOFUSBMJTBTJPMFITFLSFTJQBOL
MJLOZB QFSFHBOHBOEJOEJOHMBNCVOHUFSOZBUBNFOHIBTJMLBOSFG SFBTBUBVTFLSFTJ*BJOOZB
767
1FNFDBIBOQSPEVLQFODFSOBBOQSPUFJOKVHBNFOJNCVMLBO Ringkasan Pengaturan Pengosongan Lambung

SFGMFLTSFGMFLTQFOHIBNCBUFOUFSPHBTUSJLJOJEFOHBONFNQFS 1FOHPTPOHBO MBNCVOH IBOZB EJBUVS EBMBN EFSBKBU TFEBOH PMFI
MBNCBU LFDFQBUBO QFOHPTPOHBO MBNCVOH EJQBTUJLBO UFSEBQBU GBLUPSGBLUPSMBNCVOHTFQFSUJEFSBKBUQFOHJTJBOMBNCVOHEBOFGFL
DVLVQXBLUVVOUVLQFODFSOBBOQSPUFJOZBOHBEFLVBUEJEVP QFSBOHTBOHBOHBTUSJOQBEBQFSJTUBMUJLMBNCVOH.VOHLJOLPOUSPM
EFOVNEBOVTVTIBMVT QFOHPTPOHBO MBNCVOH ZBOH MFCJI QFOUJOH UFSMFUBL QBEB TJOZBM
"LIJSOZB CBJLDBJSBOIJQPUPOJLNBVQVOIJQFSUPOJL UFSV
VNQBO CBMJL QFOHIBNCBU EBSJ EVPEFOVN UFSNBTVL SFGMFLT
UBNBIJQFSUPOJL
KVHBNFOJNCVMLBOSFGMFLTSFGMFLTQFOHIBN
VNQBO CBMJL TBSBG QFOHIBNCBU FOUFSPHBTUSJL EBO VNQBO CBMJL
CBUJOJ%FOHBOEFNJLJBO NFODFHBIBMJSBODBJSBOOPOJTPUPOJL
IPSNPOBM PMFI $$, .FLBOJTNF QFOHIBNCBU VNQBO CBMJL JOJ
ZBOHUFSMBMVDFQBULFEBMBNVTVTIBMVT KVHBNFODFHBIQFSVCB
CFLFSKB CFSTBNBTBNB NFNQFSMBNCBU LFDFQBUBO QFOHPTPOHBO
IBOLPOTFOUSBTJFMFLUSPMJUZBOHDFQBUEBMBNDBJSBOFLTUSBTFMV
CJMB
LJNVT ZBOH UFSEBQBU EBMBN VTVT IBMVT TVEBI UFSMBMV
MBSTFMVSVIUVCVITFMBNBBCTPSQTJJTJVTVT
CBOZBL
LJNVT CFSTJGBU UFSMBMV BTBN NFOHBOEVOH UFSMBMV
Umpan Balik Hormon dari Duodenum Menghambat CBOZBLQSPUFJOBUBVMFNBLZBOHCFMVNEJDFSOB CFSTJGBUIJQPUPOJL
Pengosongan Lambung—Peran Lemak dan Hormon BUBV IJQFSUPOJL BUBV NFOHJSJUBTJ %BMBN LFBEBBO JOJ LFDFQBUBO
Kolesistokinin.5JEBL IBOZB SFGMFLT TBSBG EBSJ EVEFOVN LF QFOHPTPOHBO MBNCVOH EJCBUBTJ TBNQBJ TFKVNMBI LJNVT EBQBU
MBNCVOH ZBOH NFOHIBNCBU QFOHPTPOHBO MBNCVOH UFUBQJ EJQSPTFTEJEBMBNVTVTIBMVT
IPSNPOIPSNPO ZBOH EJMFQBTLBO EBSJ VTVT CBHJBO BUBT KVHB
NFOHIBNCBUQFOHPTPOHBOMBNCVOH3BOHTBOHBOZBOHNFMF
QBTLBO IPSNPOIPSNPO QFOHIBNCBU UFSTFCVU UFSVUBNB EJ Gerakan Usus Halus
UJNCVMLBO PMFI MFNBL ZBOH NBTVL LF EVPEFOVN XBMBVQVO
KFOJTNBLBOBOMBJOEBQBUNFOJOHLBULBOIPSNPOUFSTFCVUEB (FSBLBO VTVT IBMVT TFQFSUJ HFSBLBO MBJOOZB EBMBN USBLUVT
MBNUBSBGZBOHMFCJILFDJM HBTUSPJOUFTUJOBM EBQBU EJCBHJ NFOKBEJ LPOUSBLTJ QFODBNQVSBO
1BEB TBBU NBTVL EVPEFOVN MFNBL NFOHFLTUSBL CFSCBHBJ EBO LPOUSBLTJ QSPQVMTJG %BMBN BSUJ ZBOH MVBT QFNCBHJBO JOJ
IPSNPOEBSJFQJUFMEVPEFOVNEBOZFZVOVN CBJLCFSHBCVOH CFSTJGBUBSUJGJTJBMLBSFOBQBEBEBTBSOZBTFNVBHFSBLBOVTVTIBMVT
EFOHBO SFTFQUPS QBEB TFMTFM FQJUFM BUBV EFOHBO DBSB MBJO NFOZFCBCLBO QBMJOH TFEJLJU CFCFSBQB EFSBKBU QFODBNQVSBO EBO
,FNVEJBO IPSNPO EJCBXB PMFI BMJSBO EBSBI LF MBNCVOH QSPQVMTJG,MBTJGJLBTJVNVNEBSJQSPTFTJOJBEBMBITFCBHBJCFSJLVU
UFNQBU IPSNPO UFSTFCVU NFOHIBNCBU QPNQB QJMPSVT EBO
QBEBXBLUVZBOHCFSTBNBBONFOJOHLBULBOLFLVBUBOLPOUSBL
TJ TGJOHUFS QJMPSVT &GFL JOJ QFOUJOH LBSFOB MFNBL KBVI MFCJI Kontraksi Pencampuran (Kontraksi Segmentasi)
MBNCBUVOUVLEJDFSOBEBSJQBEBNBLBOBOMBJO
#JMB CBHJBO UFSUFOUV VTVT IBMVT UFSFHBOH PMFI LJNVT QFSFHBOHBO
4FDBSBUFQBU IPSNPONBOBZBOHNFOZFCBCLBOQFOHIBN
EJOEJOH VTVT NFOJNCVMLBO LPOUSBLTJ LPOTFOUSJT MPLBM EFOHBO
CBUBOVNQBOCBMJLIPSNPOMBNCVOHUJEBLTFQFOVIOZBEJLF
KBSBL JOUFSWBM UFSUFOUV TFQBOKBOH VTVT EBO CFSMBOHTVOH TFTBBU
UBIVJ)PSNPOZBOHQBMJOHNVOHLJOLFMJIBUBOOZBBEBMBILP
EBMBN TFNFOJU ,POUSBLTJ JOJ NFOJNCVMLBO TFHNFOUBTJ QBEB
MFTJTUPLJOJO $$,
ZBOH EJMFQBTLBO EBSJ NVLPTB ZFZVOVN
VTVT IBMVT TFQFSUJ EJUVOKVLLBO QBEB (BNCBS "SUJOZB
TFCBHBJSFTQPOTUFSIBEBQ[BUMFNBLEBMBNLJNVT)PSNPOJOJ
LPOUSBLTJ NFNCBHJ VTVT NFOKBEJ TFHNFOTFHNFO SVBOH ZBOH
CFSUJOEBLTFCBHBJTVBUVJOIJCJUPSVOUVLNFOHIBNCBUQFOJOH
NFNQVOZBJ CFOUVL SBOUBJ TPTJT #JMB TBUV SBOHLBJBO LPOUSBLTJ
LBUBONPUJMJUBTMBNCVOHZBOHEJTFCBCLBOPMFIHBTUSJO
TFHNFOUBTJ CFSFMBLTBTJ TFSJOH UJNCVM TBUV SBOHLBJBO CBSV UFUBQJ
,FNVOHLJOBO JOIJCJUPS QFOHPTPOHBO MBNCVOH MBJO BEBMBI
LPOUSBLTJ LBMJ JOJ UFSKBEJ UFSVUBNB QBEB UJUJL CBSV EJ BOUBSB
IPSNPO TFLSFUJO EBO QFQUJEB QFOHIBNCBU HBTUFS (*1
KVHB
LPOUSBLTJLPOUSBLTJ TFCFMVNOZB 0MFI LBSFOB JUV LPOUSBLTJ
EJTFCVU QFQUJEB JOTVMJOPUSPQJL CFSHBOUVOH HMVLPTB HMVDPTF
TFHNFOUBTJJOJNFNPUPOHLJNVTTFLJUBSEVBTBNQBJUJHBLBMJQFS
EFQFOEFOU JOTVMJOPUSPQJD QFQUJEF
4FLSFUJO UFSVUBNB EJMFQBT
NFOJU EFOHBODBSBJOJNFNCBOUVQFODBNQVSBONBLBOBOEFOHBO
LBO EBSJ NVLPTB EVPEFOVN TFCBHBJ SFTQPOT UFSIBEBQ BTBN
TFLSFTJVTVTIBMVT
MBNCVOH ZBOH NFOHBMJS EBSJ MBNCVOH NFOVKV QJMPSVT (*1
NFNQVOZBJFGFLNFOZFMVSVIUFUBQJMFNBIVOUVLNFOVSVOLBO
NPUJMJUBTHBTUSPJOUFTUJOBM
(*1EJMFQBTLBOEBSJCBHJBOBUBTVTVTIBMVTUFSVUBNBTFCBHBJ
SFTQPOTUFSIBEBQMFNBLEBMBNLJNVT EBOKVHBUFSIBEBQLBS
CPIJESBU EBMBN KVNMBI ZBOH MFCJI TFEJLJU 8BMBVQVO (*1
NFOHIBNCBU NPUJMJUBT MBNCVOH QBEB CFCFSBQB LFBEBBO UFS
UFOUV QFOHBSVI VUBNBOZB QBEB LPOTFOUSBTJ GJTJPMPHJT NVOH
LJOUFSVUBNBVOUVLNFSBOHTBOHTFLSFTJJOTVMJOPMFIQBOLSFBT
)PSNPOIPSNPO UFSTFCVU EJCJDBSBLBO MFCJI MBOKVU QBEB
CBHJBOMBJOEBMBNCVLVJOJ UFSVUBNBQBEB#BCTFIVCVOHBO
EFOHBO LPOUSPM QFOHPTPOHBO LBOEVOH FNQFEV EBO QFOHPO
USPMBOLFDFQBUBOTFLSFTJQBOLSFBT
3JOHLBTOZB IPSNPOIPSNPO UFSVUBNB$$, EBQBUNFOH
IBNCBU QFOHPTPOHBO MBNCVOH CJMB UFSEBQBU TFKVNMBI LJNVT
ZBOH CFSMFCJIBO UFSVUBNB LJNVT ZBOH BTBN BUBV CFSMFNBL
NFNBTVLJEVPEFOVNEBOMBNCVOH
768
'SFLVFOTJ NBLTJNBM LPOUSBLTJ TFHNFOUBTJ EBMBN VTVT IBMVT NFOHPOTVNTJ NBLBOBO ZBOH MBJO QBEB XBLUV JUV SFGMFLT
EJUFOUVLBO PMFI GSFLVFOTJ HFMPNCBOH MBNCBU MJTUSJL EBMBN HBTUSPJMFBM BLBO NFOJOHLBULBO QFSJTUBMUJL EBMBN JMFVN TFSUB
EJOEJOHVTVT ZBOHNFSVQBLBOJSBNBMJTUSJLEBTBSZBOHEJUFSBOH NFOEPSPOH LJNVT ZBOH UFSIBNCBU UBEJ NFMFXBUJ LBUVQ
LBO QBEB #BC 0MFI LBSFOB CFTBS GSFLVFOTJ JOJ OPSNBMOZB JMFPTFLBMNBTVLLFEBMBNTFLVNQBEBVTVTCFTBS
UNIT XII
UJEBL NFMFCJIJ QFS NFOJU EBMBN EVPEFOVN EBO ZFZVOVN
QSPLTJNBM GSFLVFOTJ NBLTJNVN QBEB LPOUSBLTJ TFHNFOUBTJ EJ Efek Menclorong Gerakan Segmentasi.
EBFSBI JOJ KVHB LJSBLJSB LPOUSBLTJ QFS NFOJU UFUBQJ IBM JOJ (FSBLBO TFHNFOUBTJ NFTLJQVO IBOZB CFSMBOHTVOH TFMBNB
UFSKBEJ IBOZB QBEB LFBEBBO QFSBOHTBOHBO ZBOH FLTUSFN 1BEB CFCFSBQB EFUJL QBEB TVBUV XBLUV TFSJOH KVHB CFSKBMBO
JMFVNUFSNJOBMJT GSFLVFOTJNBLTJNVNCJBTBOZBEFMBQBOTBNQBJ TFQBOKBOH TFOUJNFUFS BUBV MFCJI LF BSBI BOVT EBO QBEB TBBU
TFNCJMBOLPOUSBLTJQFSNFOJU JUV NFNCBOUV NFOEPSPOH NBLBOBO NFOVSVOJ VTVT
,POUSBLTJ TFHNFOUBTJ NFOKBEJ TBOHBU MFNBI CJMB BLUJWJUBT 1FSCFEBBO BOUBSB HFSBLBO TFHNFOUBTJ EBO QFSJTUBMUJL UJEBLMBI
QFSBOHTBOHBO TJTUFN TBSBG FOUFSJL EJIBNCBU PMFI PCBU BUSPQJO TFEFNJLJBO CFTBS TFQFSUJ ZBOH EJOZBUBLBO PMFI QFNCBHJBOOZB
0MFI LBSFOB JUV XBMBVQVO HFMPNCBOH MBNCBU EBMBN PUPU QPMPT NFOKBEJEVBLMBTJGJLBTJJOJ
JUV TFOEJSJ ZBOH NFOZFCBCLBO LPOUSBLTJ TFHNFOUBTJ LPOUSBLTJ
UFSTFCVU UJEBL FGFLUJG UBOQB EJMBUBS CFMBLBOHJ PMFI QFSBOHTBOHBO Desakan Peristaltik. .FTLJQVO QFSJTUBMUJL EBMBN VTVT
ZBOHUFSVUBNBCFSBTBMEBSJQMFLTVTTBSBGNJFOUFSJLVT IBMVT TFDBSB OPSNBM CFSTJGBU MFNBI JSJUBTJ ZBOH LVBU QBEB
NVLPTB VTVT TFQFSUJ ZBOH UFSKBEJ QBEB CFCFSBQB LBTVT EJBSF
Gerakan Propulsif JOGFLTJZBOHCFSBU EBQBUNFOJNCVMLBOQFSJTUBMUJLZBOHTBOHBU
Peristaltik dalam Usus Halus. ,JNVT EJEPSPOH NFMBMVJ LVBU EBO DFQBU EJTFCVU EFTBLBO QFSJTUBMUJL QFSJTUBMUJD SVTI

VTVT IBMVT PMFI HFMPNCBOH QFSJTUBMUJL *OJ EBQBU UFSKBEJ QBEB ,FBEBBO JOJ TFCBHJBO EJDFUVTLBO PMFI SFGMFLT TBSBG ZBOH
CBHJBOVTVTIBMVTNBOBQVO EBOCFSHFSBLNFOVKVBOVTEFOHBO NFMJCBULBOTJTUFNTBSBGPUPOPNEBOCBUBOHPUBL EBOTFCBHJBO
LFDFQBUBO TBNQBJ DNEFUJL MFCJI DFQBU EJ VTVT CBHJBO MBHJ PMFI QFOJOHLBUBO SFGMFLT QMFLTVT NJFOUFSJLVT JOUSJOTJL EJ
QSPLTJNBMEBOMFCJIMBNCBUEJVTVTCBHJBOUFSNJOBM(FMPNCBOH EBMBN EJOEJOH VTVT JUV TFOEJSJ ,POUSBLTJ QFSJTUBMUJL ZBOH
QFSJTUBMUJL UFSTFCVU TFDBSB OPSNBM MFNBI EBO CJBTBOZB CFSIFOUJ TBOHBU LVBU JOJ CFSKBMBO KBVI EJ EBMBN VTVT IBMVT EBMBN
TFTVEBI NFOFNQVI KBSBL TBNQBJ DN KBSBOH MFCJI KBVI EBSJ IJUVOHBONFOJU NFOZBQVJTJVTVTLFEBMBNLPMPOEBOLBSFOB
DN TFIJOHHB QFSHFSBLBO NBKV LJNVT TBOHBU MBNCBU CFHJUV JUVNFNCFCBTLBOVTVTIBMVTEBSJLJNVTZBOHNFOHJSJUBTJEBO
MBNCBUOZB TFIJOHHB QFSHFSBLBO OFUP TFQBOKBOH VTVT IBMVT SBUB QFSFHBOHBOCFSMFCJIBO
SBUB IBOZB DNNFOJU *OJ CFSBSUJ CBIXB EJCVUVILBO XBLUV
TBNQBJ KBN VOUVL QFSKBMBOBO LJNVT EBSJ QJMPSVT TBNQBJ LF Gerakan-Gerakan yang Disebabkan oleh Muskularis Mukosa dan
LBUVQJMFPTFLBM Serat-serat Otot Viti. .VTLVMBSJT NVLPTB EBQBU NFOJNCVMLBO
MJQBUBOMJQBUBO QFOEFL QBEB NVLPTB VTVT 4FMBJO JUV TFSBUTFSBU
UVOHHBMPUPUJOJNFMVBTLFEBMBNWJMJVTVTEBONFOZFCBCLBOWJMJ
Pengaturan Peristaltik oleh Sinyal Saraf dan Hormon. CFSLPOUSBLTJ TFDBSB JOUFSNJUFO -JQBUBOMJQBUBO NVLPTB BLBO
"LUJWJUBTQFSJTUBMUJLVTVTIBMVTTBOHBUNFOJOHLBUTFTVEBINBLBO NFNQFSMVBT BSFB QFSNVLBBO ZBOH UFSQBQBS LJNVT TFIJOHHB
)BMJOJTFCBHJBOEJTFCBCLBOPMFIBXBMNBTVLOZBLJNVTLFEBMBN NFOJOHLBULBO BCTPSQTJ +VHB LPOUSBLTJ WJMJNFNFOEFL
EVPEFOVN ZBOH NFOZFCBCLBO QFSFHBOHBO EJOEJOH EVPEFOVN NFNBOKBOH EBO NFNFOEFL LFNCBMJBLBO NFNFSBT WJMJ
+VHB BLUJWJUBTQFSJTUBMUJLNFOJOHLBUPMFIBQBZBOHEJTFCVUSFGMFLT TFIJOHHBDBJSBOMJNGFNFOHBMJSCFCBTEBSJMBLUFBMTFOUSBMQBEBWJMJ
HBTUSPFOUFSJL ZBOH EJNVMBJ EFOHBO EJTUFOTJ MBNCVOH EBO LF EBMBN TJTUFN MJNGF ,POUSBLTJ NVLPTB EBO WJMJ JOJ UFSVUBNB
EJUFSVTLBO UFSVUBNB NFMBMVJ QMFLTVT NJFOUFSJLVT EBSJ MBNCVOH EJDFUVTLBOPMFISFGMFLTTBSBGMPLBMEBMBNQMFLTVTTBSBGTVCNVLPTB
UVSVOEJTFQBOKBOHEJOEJOHVTVTIBMVT ZBOHUFSKBEJTFCBHBJSFTQPOTUFSIBEBQLJNVTEBMBNVTVTIBMVT
4FMBJO TJOZBM TBSBG ZBOH EBQBU NFNFOHBSVIJ QFSJTUBMUJL VTVT
IBMVT UFSEBQBUCFCFSBQBGBLUPSIPSNPOZBOHKVHBNFNFOHBSVIJ Fungsi Katup Ileosekal.
QFSJTUBMUJL )PSNPOIPSNPO UFSTFCVU NFMJQVUJ HBTUSJO $$,
'VOHTJ VUBNB LBUVQ JMFPTFLBM BEBMBI VOUVL NFODFHBI BMJSBO
JOTVMJO NPUJMJO EBO TFSPUPOJO TFNVBOZB NFOJOHLBULBO
CBMJL JTJ GFLBM EBSJ LPMPO LF EBMBN VTVT IBMVT 4FQFSUJ ZBOH
NPUJMJUBTVTVTEBOEJTFLSFTJLBOTFMBNBCFSCBHBJGBTFQFODFSOBBO
EJUVOKVLLBO QBEB (BNCBS LBUVQ JMFPTFLBM JUV TFOEJSJ
NBLBOBO 4FCBMJLOZB TFLSFUJO EBOHMVLBHPO NFOHIBNCBU
NFOPOKPMLFEBMBNMVNFOTFLVNEBOLBSFOBJUVUFSUVUVQFSBU
NPUJMJUBTVTVT.BLOBGJTJPMPHJTNBTJOHNBTJOHGBLUPSIPSNPOBM
CJMB UFSCFOUVL UFLBOBO ZBOH CFSMFCJIBO EJ EBMBN TFLVN EBO
JOJVOUVLQFOHBUVSBONPUJMJUBTNBTJIEJQFSUBOZBLBO
NFODPCB NFOEPSPOH JTJ GFLBM LF CFMBLBOH NFMBXBO CJCJS
'VOHTJ HFMPNCBOH QFSJTUBMUJL EBMBN VTVT IBSVT UJEBL IBOZB LBUVQ#JBTBOZBLBUVQEBQBUNFOBIBOUFLBOBOCBMJLTFUJEBLOZB
NFOZFCBCLBOQFOEPSPOHBOLJNVTLFBSBILBUVQJMFPTFLBMUFUBQJ TFCFTBSTBNQBJDN)0
KVHBNFOZFCBSLBOLJNVTEJTFQBOKBOHNVLPTBVTVT4BBULJNVT 4FMBJOJUV EJOEJOHJMFVNCFCFSBQBTFOUJNFUFSTFEJLJUEJBUBT
NFNBTVLJ VTVT EBSJ MBNCVOH EBO NFOJNCVMLBO QFSJTUBMUJL IBM LBUVQJMFPTFLBMNFNQVOZBJQFOFCBMBOPUPUTJSLVMBSZBOHEJTF
JOJ BLBO TFHFSB NFOZFCBSLBO LJNVT LF TFQBOKBOH VTVT EBO CVUTGJOHUFSJMFPTFLBM4GJOHUFSJOJEBMBNLFBEBBOOPSNBMUFUBQ
QSPTFT JOJ NBLJO NFOJOHLBU LFUJLB LJNVT UBNCBIBO NBTVL LF CFSLPOTUSJLTJ EBMBN UJOHLBU TFEBOH EBO NFOHPTPOHLBO JTJ
EVPEFOVN1BEBXBLUVNFODBQBJLBUVQJMFPTFLBM LJNVTLBEBOH JMFVN LF EBMBN TFLVN /BNVO TFHFSB TFUFMBI NBLBO SFGMFLT
EJIBNCBUTFMBNBCFCFSBQBKBNTBNQBJPSBOHUFSTFCVUNFOHPO HBTUSPJMFBM UFMBI EJCBIBT TFCFMVNOZB
NFOJOHLBULBO QFSJTUBM
UJLEJEBMBNJMFVN EBOQFOHPTPOHBOJTJJMFVNLFEBMBNTFLVN
CFSMBOKVU
769
Semi-
mush
Poor motility causes

Colon greater absorption, and
hard feces in transverse
colon cause
Valve constipation Semi-
solid
5BIBOBO VOUVL QFOHPTPOHBO QBEB LBUVQ JMFPTFLBM SJTUJLZBOHTFSVQBEFOHBOQFOHFSBLBOVTVTIBMVTEBOTFLBMJMBHJ

NFNQFSMBNB UJOHHBMOZB LJNVT EBMBN JMFVN EBO EFOHBO EBQBU EJCBHJ NFOKBEJ HFSBLBO NFODBNQVS EBO HFSBLBO
EFNJLJBO NFNQFSNVEBI BCTPSQTJ /PSNBMOZB IBOZB NFOEPSPOH
TBNQBJ NM LJNVT EJLPTPOHLBO LF EBMBN TFLVN TFUJBQ
IBSJOZB Gerakan Mencampur—"Haustrasi". .FMBMVJ DBSB ZBOH
TBNB EFOHBO UFSKBEJOZB HFSBLBO TFHNFOUBTJ EBMBN VTVT IBMVT
Pengaturan Umpan Balik Sfingter Ileosekal. %FSBKBU LPOTUSJLTJLPOTUSJLTJTJSLVMBSZBOHCFTBSUFSKBEJEBMBNVTVTCFTBS
LPOUSBLTJ TGJOHUFS JMFPTFLBM EBO JOUFOTJUBT QFSJTUBMUJL EJ JMFVN 1BEB TFUJBQ LPOTUSJLTJ JOJ LJSBLJSB DN PUPU TJSLVMBS BLBO
UFSNJOBM EJBUVS TFDBSB LVBU PMFI SFGMFLTSFGMFLT EBSJ TFLVN CFSLPOUSBLTJ LBEBOHNFOZFNQJULBOMVNFOLPMPOTBNQBJIBNQJS
#JMB TFLVN EJSFHBOHLBO LPOUSBLTJ TGJOHUFS JMFPTFLBM NFOKBEJ UFSTVNCBU 1BEB TBBU ZBOH TBNB PUPU MPOHJUVEJOBM LPMPO ZBOH
MFCJILVBUEBOQFSJTUBMUJLJMFVNNFOKBEJUFSIBNCBU,FEVBIBM UFSLVNQVMNFOKBEJUJHBQJUBMPOHJUVEJOBMZBOHEJTFCVUUBFOJBDPMJ
UFSTFCVU TBOHBU NFOVOEB QFOHPTPOHBO LJNVT UBNCBIBO EBSJ BLBOCFSLPOUSBLTJ,POUSBLTJHBCVOHBOEBSJQJUBPUPUTJSLVMBSEBO
JMFVN LF EBMBN TFLVN %FNJLJBO QVMB [BU JSJUBO BQB QVO MPOHJUVEJOBM NFOZFCBCLBO CBHJBO VTVT CFTBS ZBOH UJEBL
EBMBN TFLVN BLBO NFOVOEB QFOHPTPOHBO 4FCBHBJ DPOUPI UFSBOHTBOHNFOPOKPMLFMVBSNFNCFSJLBOCFOUVLTFSVQBLBOUVOH
CJMB TFTFPSBOH NFOEFSJUB BQFOEJTJUJT JSJUBTJ TJTB QFOJOHHBMBO ZBOHEJTFCVUIBVTUSBTJ
TFLVN JOJ EBQBU NFOJNCVMLBO TQBTNF ZBOH EFNJLJBO LVBU 4FUJBQ IBVTUSBTJ CJBTBOZB NFODBQBJ JOUFOTJUBT QVODBL QBEBU
QBEB TGJOHUFS JMFPTFLBM EBO QBSBMJTJT TFCBHJBO JMFVN TFIJOHHB EBMBN XBLUV TFLJUBS EFUJL EBO LFNVEJBO NFOHIJMBOH TFMBNB
LFEVBFGFLJOJCFSTBNBTBNBBLBONFOHIBNCBUQFOHPTPOHBO EFUJL CFSJLVUOZB ,BEBOHLBEBOH LPOUSBLTJ KVHB CFSHFSBL
JMFVN LF EBMBN TFLVN 3FGMFLTSFGMFLT EBSJ TFLVN LF TGJOHUFS MBNCBUNFOVKVLFBOVTTFMBNBNBTBLPOUSBLTJOZB UFSVUBNBQBEB
JMFPTFLBM EBO JMFVN JOJ EJQFSBOUBSBJ PMFI QMFLTVT NJFOUFSJLVT TFLVNEBOLPMPOBTFOEFO EBOLBSFOBJUVNFOZFCBCLBOTFKVNMBI
EBMBN EJOEJOH VTVT JUV TFOEJSJ EBO KVHB PMFI TBSBGTBSBG LFDJM EPSPOHBO JTJ LPMPO LF EFQBO #FCFSBQB NFOJU LFNVEJBO
PUPOPN FLTUSJOTJL LIVTVTOZB ZBOH NFMBMVJ HBOHMJB TJNQBUJT UJNCVM LPOUSBLTJ IBVTUSBF ZBOH CBSV QBEB EBFSBI MBJO ZBOH
QSFWFSUFCSB CFSEFLBUBO0MFILBSFOBJUV CBIBOGFTFTEBMBNVTVTCFTBSTFDBSB
MBNCBUEJBEVLEBOEJQVUBSEFOHBODBSBZBOHIBNQJSTBNBTFQFSUJ
Gerakan Kolon PSBOHNFOZFLPQUBOBI%FOHBODBSBJOJTFNVBCBIBOGFTFTTFDBSB
CFSUBIBQCFSTFOUVIBOEFOHBOQFSNVLBBONVLPTBVTVTCFTBS EBO
'VOHTJ VUBNB LPMPO BEBMBI
BCTPSQTJ BJS EBO FMFLUSPMJU DBJSBO TFSUB [BU[BU UFSMBSVU TFDBSB QSPHSFTJG EJBCTPSCTJ IJOHHB
LJNVT VOUVL NFNCFOUVL GFTFT ZBOH QBEBU EBO
IBOZB UFSEBQBU TBNQBJ NM GFTFT ZBOH EJLFMVBSLBO TFUJBQ
QFOJNCVOBO CBIBO GFTFT TBNQBJ EBQBU EJLFMVBSLBO 4FUFOHBI IBSJ
CBHJBO QSPLTJNBM LPMPO EJUVOKVLLBO QBEB (BNCBS
UFSVUBNB CFSIVCVOHBO EFOHBO BCTPSQTJ EBO TFUFOHBI CBHJBO Gerakan Mendorong—"Gerakan Massa."
EJTUBM CFSIVCVOHBO EFOHBO QFOZJNQBOBO 0MFI LBSFOB UJEBL #BOZBLEPSPOHBOEJEBMBNTFLVNEBOLPMPOBTFOEFOEJIBTJMLBO
EJQFSMVLBO QFSHFSBLBO LVBU EBSJ EJOEJOH LPMPO VOUVL GVOHTJ PMFILPOUSBLTJIBVTUSBFZBOHMBNCBUUFUBQJCFSMBOHTVOHQFSTJTUFO
GVOHTJ JOJ NBLB QFSHFSBLBO LPMPO TFDBSB OPSNBM MBNCBU ZBOHNFNCVUVILBOXBLUVTBNQBJKBNVOUVLNFOHHFSBLLBO
.FTLJQVOMBNCBU QFSHFSBLBOOZBNBTJINFNQVOZBJLBSBLUF LJNVT EBSJ LBUVQ JMFPTFLBM NFMBMVJ LPMPO TFNFOUBSB LJNVTOZB
TFOEJSJNFOKBEJGFTFTEFOHBOLBSBLUFSJTUJLMVNQVSTFUFOHBIQBEBU
CVLBOMBHJTFUFOHBIDBJS
770
%BSJTFLVNTBNQBJTJHNPJE HFSBLBONBTTBEBQBUNFOHBNCJM Refleks Defekasi. #JBTBOZB EFGFLBTJ EJUJNCVMLBO PMFI

BMJIQFSBOQFOEPSPOHBOVOUVLCFCFSBQBNFOJUEBMBNTBUVXBLUV SFGMFLTEFGFLBTJ4BUVEBSJSFGMFLTSFGMFLTJOJBEBMBISFGMFLTJOUSJOTJL
(FSBLBO JOJ CJBTBOZB IBOZB UFSKBEJ TBUV TBNQBJ UJHB LBMJ TFUJBQ ZBOH EJQFSBOUBSBJ PMFI TJTUFN TBSBG FOUFSJL TFUFNQBU EJ EBMBN
IBSJQBEBLFCBOZBLBOPSBOH UFSVUBNBVOUVLLJSBLJSBNFOJU EJOEJOH SFLUVN )BM JOJ EBQBU EJKFMBTLBO TFCBHBJ CFSJLVU #JMB
UNIT XII
TFMBNBKBNQFSUBNBTFTVEBINBLBOQBHJ GFTFT NFNBTVLJ SFLUVN EJTUFOTJ EJOEJOH SFLUVN NFOJNCVMLBO
(FSBLBONBTTBBEBMBIKFOJTQFSJTUBMUJLZBOHEJNPEJGJLBTJZBOH TJOZBMTJOZBM BGFSFO ZBOH NFOZFCBS NFMBMVJ QMFLTVT NJFOUFSJLVT
EJUBOEBJPMFISBOHLBJBOQFSJTUJXBTFCBHBJCFSJLVU1FSUBNB UJN VOUVL NFOJNCVMLBO HFMPNCBOH QFSJTUBMJL EJ EBMBN LPMPO
CVM TFCVBI DJODJO LPOTUSJLTJ TFCBHBJ SFTQPOT EBSJ UFNQBU ZBOH EFTFOEFO TJHNPJE EBOSFLUVN NFOEPSPOHGFTFTLFBSBIBOVT
UFSFHBOH BUBV UFSJSJUBTJ EJ LPMPO CJBTBOZB QBEB LPMPO USBOTWFS 1BEB TBBU HFMPNCBOH QFSJTUBMUJL NFOEFLBUJ BOVT TGJOHUFS BOJ
TVN,FNVEJBO EFOHBODFQBULPMPO TFQBOKBOHDNBUBVMFCJI JOUFSOVT SFMBLTBTJ PMFI TJOZBMTJOZBM QFOHIBNCBU EBSJ QMFLTVT
QBEBCBHJBOEJTUBMDJODJOLPOTUSJLTJUBEJBLBOLFIJMBOHBOIBVTUSB NJFOUFSJLVT KJLB TGJOHUFS BOJ FLTUFSOVT KVHB TFDBSB TBEBS EBO
TJOZBEBOKVTUSVCFSLPOUSBLTJTFCBHBJTBUVVOJU NFOEPSPOHNBKV WPMVOUFS CFSFMBLTBTJ QBEB XBLUV ZBOH CFSTBNBBO UFSKBEJMBI
NBUFSJ GFTFT QBEB TFHNFO JOJ TFLBMJHVT VOUVL MFCJI NFOVSVOJ EFGFLBTJ
LPMPO ,POUSBLTJ TFDBSB QSPHSFTJG NFOJNCVMLBO UFLBOBO ZBOH 3FGMFLT EFGFLBTJ NJFOUFSJL JOUSJOTJL ZBOH CFSGVOHTJ EFOHBO
MFCJICFTBSTFMBNBLJSBLJSBEFUJL EBOUFSKBEJSFMBLTBTJTFMBNB TFOEJSJOZB TFDBSB OPSNBM CFSTJGBU SFMBUJG MFNBI "HBS NFOKBEJ
TBNQBJ NFOJU CFSJLVUOZB -BMV UJNCVM QFOHFSBLBO NBTTB FGFLUJG EBMBN NFOJNCVMLBO EFGFLBTJ SFGMFLT CJBTBOZB IBSVT
ZBOHMBJO LBMJJOJNVOHLJOCFSKBMBOMFCJIKBVITFQBOKBOHLPMPO EJQFSLVBUPMFISFGMFLTEFGFLBTJKFOJTMBJO TVBUVSFGMFLTEFGFLBTJ
4BUV SBOHLBJBO HFSBLBO NBTTB CJBTBOZB NFOFUBQ TFMBNB QBSBTJNQBUJT ZBOH NFMJCBULBO TFHNFO TBLSBM NFEVMB TQJOBMJT
TBNQBJ NFOJU -BMV NFSFEB EBO NVOHLJO UJNCVM LFNCBMJ EJUVOKVLLBO QBEB (BNCBS #JMB VKVOHVKVOH TBSBG EBMBN
TFUFOHBI IBSJ LFNVEJBO #JMB HFSBLBO TVEBI NFOEPSPOH NBTTB SFLUVN EJSBOHTBOH TJOZBMTJOZBM EJIBOUBSLBO QFSUBNB LF
GFTFTLFEBMBNSFLUVN BLBOUJNCVMLFJOHJOBOVOUVLEFGFLBTJ EBMBNNFEVMBTQJOBMJTEBOLFNVEJBOTFDBSBSFGMFLTLFNCBMJLF
LPMPOEFTFOEFO TJHNPJE SFLUVN EBOBOVTNFMBMVJTFSBUTFSBU
Pencetusan Gerakan Massa oleh Refleks Gastrokolik TBSBG QBSBTJNQBUJT EBMBN OFSWVT QFMWJLVT 4JOZBMTJOZBM
dan Refleks Duodenokolik. 5JNCVMOZBHFSBLBONBTTBTFTVEBI QBSBTJNQBUJTJOJTBOHBUNFNQFSLVBUHFMPNCBOHQFSJTUBMUJLEBO
NBLBO EJQFSNVEBI PMFI SFGMFLT HBTUSPLPMJL EBO EVPEFOPLPMJL KVHB NFSFMBLTBTJLBO TGJOHUFS BOJ JOUFSOVT EFOHBO EFNJLJBO
3FGMFLT JOJ EJTFCBCLBO PMFI EJTUFOTJ MBNCVOH EBO EVPEFOVN NFOHVCBISFGMFLTEFGFLBTJNJFOUFSJLJOUSJOTJLEBSJTVBUVVTBIB
3FGMFLT UFSTFCVU UJEBL UJNCVM TBNB TFLBMJ BUBV IBNQJS UJEBL ZBOH MFNBI NFOKBEJ TVBUV QSPTFT EFGFLBTJ ZBOH LVBU ZBOH
UJNCVM TBNB TFLBMJ CJMB TBSBGTBSBG PUPOPN FLTUSJOTJL ZBOH LBEBOHFGFLUJGEBMBNNFOHPTPOHLBOVTVTCFTBSTFQBOKBOHKBMBO
NFOVKV LPMPO UFMBI EJBOHLBU PMFI LBSFOB JUV SFGMFLT UFSTFCVU EBSJGMFLTVSBTQMFOJLVTLPMPOTBNQBJLFBOVT
IBNQJSTFDBSBQBTUJEJKBMBSLBONFMBMVJKBMVSTJTUFNTBSBGPUPOPN 4JOZBMTJOZBM EFGFLBTJ ZBOH NBTVL LF NFEVMB TQJOBMJT
*SJUBTJ EBMBN LPMPO EBQBU KVHB NFOJNCVMLBO HFSBLBO NBTTB NFOJNCVMLBO FGFLFGFL MBJO TFQFSUJ NFOHBNCJM OBQBT EBMBN
ZBOHLVBU4FCBHBJDPOUPI TFTFPSBOHZBOHNFOEFSJUBUVLBLQBEB QFOVUVQBO HMPUJT EBO LPOUSBLTJ PUPUPUPU EJOEJOH BCEPNFO
NVLPTBLPMPO LPMJUJTVMTFSBUJWB
TFSJOHNFOHBMBNJHFSBLBONBTTB VOUVLNFOEPSPOHJTJGFTFTEBSJLPMPOLFCBXBIEBOQBEBTBBU
ZBOHNFOFUBQIBNQJSTFUJBQTBBU ZBOHCFSTBNBBONFOZFCBCLBOEBTBSQFMWJTNFOHBMBNJSFMBLTBTJ
LFCBXBIEBONFOBSJLLFMVBSDJODJOBOVTVOUVLNFOHFMVBSLBO
GFTFT
Defekasi
1BEB TFCBHJBO CFTBS XBLUV SFLUVN UJEBL CFSJTJ GFTFT )BM JOJ
TFCBHJBO BEBMBI BLJCBU EBSJ LFOZBUBBO CBIXB UFSEBQBU TGJOHUFS
GVOHTJPOBM ZBOH MFNBI TFLJUBS DN EBSJ BOVT QBEB QFSCBUBTBO
BOUBSB LPMPO TJHNPJE EBO SFLUVN %J TJOJ UFSEBQBU KVHB TFCVBI
TVEVU UBKBN ZBOH NFOBNCBI SFTJTUBOTJ UFSIBEBQ QFOHJTJBO
SFLUVN
#JMBHFSBLBONBTTBNFOEPSPOHGFTFTNBTVLLFEBMBNSFLUVN
TFHFSB UJNCVM LFJOHJOBO VOUVL EFGFLBTJ UFSNBTVL SFGMFLT
LPOUSBLTJSFLUVNEBOSFMBLTBTJTGJOHUFSBOVT
1FOEPSPOHBO NBTTB GFTFT ZBOH UFSVTNFOFSVT NFMBMVJ BOVT
EJDFHBIPMFILPOTUSJLTJUPOJLEBSJ
TGJOHUFSBOJJOUFSOVT QFOF
CBMBOPUPUQPMPTTJSLVMBSTFQBOKBOHCFCFSBQBTFOUJNFUFSZBOHUFS
MFUBLUFQBUEJTFCFMBIEBMBNBOVT EBO
TGJOHUFSBOJFLTUFSOVT
ZBOH UFSEJSJ BUBT PUPU MVSJL WPMVOUFS ZBOH NFOHFMJMJOHJ TGJOHUFS
JOUFSOVT EBO NFMVBT LF TFCFMBI EJTUBM 4GJOHUFS FLTUFSOVT EJBUVS
PMFI TFSBUTFSBU TBSBG EBMBN OFSWVT QVEFOEVT ZBOH NFSVQBLBO
CBHJBO TJTUFN TBSBG TPNBUJT EBO LBSFOB JUV EJ CBXBI QFOHBSVI
WPMVOUFS EBMBN LFBEBBO TBEBS BUBV TFUJEBLOZB EBMBN CBXBI
TBEBS TFDBSB CBXBI TBEBS TGJOHUFS FLTUFSOBM CJBTBOZB TFDBSB
UFSVTNFOFSVT NFOHBMBNJ LPOTUSJLTJ LFDVBMJ CJMB BEB JNQVMT 63-6
LFTBEBSBOZBOHNFOHIBNCBULPOTUSJLTJ
771
#JMBLFBEBBONFNVOHLJOLBOVOUVLEFGFLBTJ SFGMFLTEFGFLBTJ Gonella J, Bouvier M, Blanquet F: Extrinsic nervous control of motility of

small and large intestines and related sphincters, Physiol Rev 67:902,
TFDBSB TBEBS EBQBU EJBLUJGLBO EFOHBO NFOHBNCJM OBQBT EBMBN
1987.
VOUVLNFOHHFSBLLBOEJBGSBHNBUVSVOLFCBXBIEBOLFNVEJBO Grundy D, Al-Chaer ED, Aziz Q, et al: Fundamentals of neurogastroenter-
NFOHPOUSBLTJLBO PUPUPUPU BCEPNFO VOUVL NFOJOHLBULBO UF ology: basic science, Gastroenterology 130:1391, 2006.
LBOBOEBMBNBCEPNFO KBEJNFOEPSPOHJTJGFTFTLFEBMBNSFL Hall KE: Aging and neural control of the GI tract. II. Neural control of the
UVN VOUVL NFOJNCVMLBO SFGMFLTSFGMFLT ZBOH CBSV 3FGMFLT aging gut: can an old dog learn new tricks? Am J Physiol Gastrointest
SFGMFLTZBOHEJUJNCVMLBOEFOHBODBSBJOJIBNQJSUJEBLTFFGFLUJG
Hatoum OA, Miura H, Binion DG: The vascular contribution in the patho-
TFQFSUJSFGMFLTZBOHUJNCVMTFDBSBBMBNJBI LBSFOBBMBTBOJOJMBI genesis of inflammatory bowel disease, Am J Physiol Heart Circ
PSBOHZBOHUFSMBMVTFSJOHNFOHIBNCBUSFGMFLTBMBNJBIOZBDFO Physiol 285:H1791, 2003.
EFSVOHNFOHBMBNJLPOTUJQBTJCFSBU Huizinga JD, Lammers WJ: Gut peristalsis is governed by a multitude of
1BEB CBZJ CBSV MBIJS EBO QBEB CFCFSBQB PSBOH EFOHBO cooperating mechanisms, Am J Physiol Gastrointest Liver Physiol 296:G1,
2009.
NFEVMBTQJOBMJTZBOHEJQPUPOH SFGMFLTEFGFLBTJTFDBSBPUPNBUJT
Laroux FS, Pavlick KP, Wolf RE, Grisham MB: Dysregulation of intestinal
NFOZFCBCLBOQFOHPTPOHBOVTVTCBHJBOCBXBIQBEBTBBUZBOH mucosal immunity: implications in inflammatory bowel disease, News
UJEBL UFQBU TFQBOKBOH IBSJ LBSFOB UJEBL BEBOZB QFOHPOUSPMBO Physiol Sci 16:272, 2001.
TFDBSB TBEBS NFMBMVJ LPOUSBLTJ BUBV SFMBLTBTJ WPMVOUFS TGJOHUFS Orr WC, Chen CL: Aging and neural control of the GI tract: IV. Clinical and
BOJFLTUFSOVT physiological aspects of gastrointestinal motility and aging, Am J
Physiol Gastrointest Liver Physiol 283:G1226, 2002.
Parkman HP, Jones MP: Tests of gastric neuromuscular function,
Refleks-Refleks Otonom Lain yang Gastroenterology 136:1526, 2009.
Memengaruhi Aktivitas Usus Sanders KM, Ordog T, Koh SD, Ward SM: A novel pacemaker mechanism
drives gastrointestinal rhythmicity, News Physiol Sci 15:291, 2000. Sarna SK:
4FMBJOSFGMFLTEVPEFOPLPMJL HBTUSPLPMJL HBTUSPJMFBM FOUFSPHBT Molecular, functional, and pharmacological targets for the
development of gut promotility drugs, Am J Physiol Gastrointest Liver
USJL EBOEFGFLBTJZBOHUFMBIEJCJDBSBLBOEBMBNCBCJOJ CFCF
Physiol 291:G545, 2006.
SBQB SFGMFLT TBSBG QFOUJOH MBJOOZB KVHB EBQBU NFNFOHBSVIJ Sarna SK: Are interstitial cells of Cajal plurifunction cells in the gut? Am J
TFMVSVI UJOHLBU BLUJWJUBT VTVT 3FGMFLTSFGMFLT UFSTFCVU BEBMBI Physiol Gastrointest Liver Physiol 294:G372, 2008.
SFGMFLT QFSJUPOFPJOUFTUJOBM SFGMFLT SFOPJOUFTUJOBM EBO SFGMFLT Sharma A, Lelic D, Brock C, Paine P, Aziz Q: New technologies to investigate
WFTJLPJOUFTUJOBM the brain-gut axis, World J Gastroenterol 15:182, 2009.
Szarka LA, Camilleri M: Methods for measurement of gastric motility, Am J
3FGMFLT QFSJUPOFPJOUFTUJOBM EJIBTJMLBO EBSJ JSJUBTJ QFSJUPOF
Physiol Gastrointest Liver Physiol 296:G461, 2009.
VNSFGMFLTJOJTBOHBULVBUNFOHIBNCBUTBSBGTBSBGQFSBOHTBOH Timmons S, Liston R, Moriarty KJ: Functional dyspepsia: motor abnormali-
FOUFSJL EBO EFOHBO EFNJLJBO EBQBU NFOJNCVMLBO QBSBMJTJT ties, sensory dysfunction, and therapeutic options, Am J Gastroenterol
VTVT UFSVUBNBQBEBQBTJFOEFOHBOQFSJUPOJUJT3FGMFLTSFOPJO 99:739, 2004.
UFTUJOBMEBOWFTJLPJOUFTUJOBMNFOHIBNCBUBLUJWJUBTVTVTTFCBHBJ Wood JD: Neuropathophysiology of functional gastrointestinal disorders,
World J Gastroenterol 13:1313, 2007.
BLJCBUEBSJCFSUVSVUUVSVUJSJUBTJHJOKBMBUBVLBOEVOHLFNJI
Xue J, Askwith C, Javed NH, Cooke HJ: Autonomic nervous system and
secretion across the intestinal mucosal surface, Auton Neurosci 133:55,
Daftar Pustaka 2007.
Adelson DW, Million M: Tracking the moveable feast: sonomicrometry and
gastrointestinal motility, News Physiol Sci 19:27, 2004.
Cooke HJ, Wunderlich J, Christofi FL: “The force be with you”: ATP in gut
mechanosensory transduction, News Physiol Sci 18:43, 2003.
772
BAB 64
UNIT XII
'VOHTJ4FLSFTJ4BMVSBO1FODFSOBBO
%J TFQBOKBOH USBLUVT HBTUSPJOUFTUJ LFMFOKBSLFMFOKBS JOJ NFOHIBTJMLBO TFLSFTJ VOUVL QFODFSOBBO BUBV
OBM LFMFOKBS TFLSFUPSJT NFNQVOZBJ FNVMTJGJLBTJ NBLBOBO )BUJ NFNQVOZBJ TUSVLUVS ZBOH TBOHBU LIVTVT
EVB GVOHTJ VUBNB 1FSUBNB cl xgk + ZBOH BLBO EJCJDBSBLBO QBEB #BC ,FMFOKBS TBMJWB EBO QBOLSFBT
cl xgk ncl acpl __l EJTFLSFTJ QBEB BEBMBIKFOJTLFMFOKBSBTJOVTTFQFSUJUFSMJIBUQBEB(BNCBS,FMFOKBS
JOJ UFSMFUBL EJ MVBS EJOEJOH TBMVSBO QFODFSOBBO EBO EBMBN IBM JOJ
TFCBHJBO CFTBS EBFSBI TBMVSBO
CFSCFEBEBSJTFNVBLFMFOKBSQFODFSOBBOMBJOOZB,FMFOKBSLFMFOKBSJOJ
QFODFSOBBO EBOSPOHHBNVMVU UFSEJSJ EBSJ CFSKVUBKVUB BTJOVT ZBOH EJCBUBTJ PMFI TFMTFM LFMFOKBS
TBNQBJ VKVOH EJTUBM JMFVN ,FEVB LFMFOKBS NVLVT EBSJ SPOHHB TFLSFTJ BTJOVT JOJ NBTVL LF EBMBN TJTUFN EVLUVT ZBOH BLIJSOZB
NVMVUTBNQBJLFBOVT NFOHFMVBSLBOk s i s q VOUVLNFMVNBTLBO CFSBLIJSLFEBMBNTBMVSBOQFODFSOBBOJUVTFOEJSJ
EBONFMJOEVOHJTFNVBCBHJBOTBMVSBOQFODFSOBBO
Mekanisme Dasar Rangsangan Kelenjar Saluran
,FCBOZBLBO TFLSFTJ QFODFSOBBO UFSCFOUVL IBOZB TFCBHBJ Pencernaan
SFTQPOT UFSIBEBQ LFCFSBEBBO NBLBOBO EJ EBMBN TBMVSBO
QFODFSOBBO EBO KVNMBI ZBOH EJTFLSFTJ QBEB TFUJBQ TFHNFO Kontak Makanan dengan Epitel Merangsang Sekresi—
USBLUVTCJBTBOZBKVNMBIZBOHUFQBUEJQFSMVLBOVOUVLQFODFSOBBO Fungsi Perangsangan Saraf Enterik.
ZBOH TFTVBJ 4FMBOKVUOZB QBEB CFCFSBQB CBHJBO USBLUVT ,FCFSBEBBO NFLBOJT NBLBOBO EBMBN TVBUV TFHNFO UFSUFOUV
HBTUSPJOUFTUJOBM CBILBO KFOJT FO[JN EBO [BU[BU MBJOOZB ZBOH USBLUVT HBTUSPJOUFTUJOBM CJBTBOZB NFOZFCBCLBO LFMFOKBS
EJTFLSFTJ CFSWBSJBTJ TFTVBJ EFOHBO UJQF NBLBOBO ZBOH BEB 0MFI LFMFOKBS QBEB EBFSBI JUV EBO EBFSBIEBFSBI ZBOH CFSEFLBUBO
LBSFOB JUV UVKVBO EBSJ CBC JOJ BEBMBI VOUVL NFNCJDBSBLBO NFOZFLSFTJLBO HFUBI KVJDFT
EBMBN KVNMBI TFEBOH TBNQBJ
TFLSFTJ TBMVSBO QFODFSOBBO ZBOH CFSCFEBCFEB GVOHTJ EBO CFTBS4FCBHJBOEBSJFGFLFGFLMPLBMJOJ UFSVUBNBTFLSFTJNVLVT
QFOHBUVSBOQSPEVLTJOZB PMFI TFM NVLVT EJIBTJMLBO EBSJ SBOHTBOHBO LPOUBL MBOHTVOH
TFMTFMLFMFOKBSQFSNVLBBOEFOHBONBLBOBO
4FCBHBJ UBNCBIBO QFSBOHTBOHBO FQJUFM MPLBM KVHB
Prinsip-Prinsip Umum Sekresi Saluran Pencernaan NFOHBLUJGLBO TJTUFN TBSBG FOUFSJL EJOEJOH VTVT +FOJTKFOJT
Anatomi Berbagai Jenis Kelenjar QFSBOHTBOHBOZBOHNFMBLVLBOIBMJOJBEBMBI
QFSBOHTBOHBO
#FCFSBQB KFOJT LFMFOKBS NFOHIBTJMLBO CFSCBHBJ KFOJT TFLSFTJ TBMVSBO UBLUJM
JSJUBTJ LJNJBXJ EBO
EJTUFOTJ EJOEJOH VTVT )BTJM
QFODFSOBBO ZBOH CFSCFEBCFEB 1FSUBNB QBEB QFSNVLBBO FQJUFM EBSJ SFGMFLTSFGMFLT TBSBG BLBO NFSBOHTBOH CBJL TFMTFM NVLVT QBEB
TFCBHJBO CFTBS CBHJBO USBLUVT HBTUSPJOUFTUJOBM UFSEBQBU CFSKVUBKVUB QFSNVLBBO FQJUFM VTVT EBO LFMFOKBS ZBOH UFSMFUBL EJ EBMBN
LFMFOKBSNVLVTTFMUVOHHBMZBOHEJTFCVUTFDBSBTJOHLBUTFCBHBJTFMNVLVT EJOEJOHVTVTVOUVLNFOJOHLBULBOTFLSFTJOZB
BUBV LBEBOH EJTFCVU TFM HPCMFU LBSFOB TFM UFSTFCVU CFSCFOUVL TFQFSUJ
HPCMFU DBXBO
,FMFOKBSJOJUFSVUBNBCFSGVOHTJTFCBHBJSFTQPOTUFSIBEBQ Rangsang Otonom pada Sekresi
JSJUBTJ MPLBM QBEB FQJUFM ,FMFOKBS JUV NFOHFMVBSLBO NVLVT TFDBSB
MBOHTVOH LF QFSNVLBBO FQJUFM VOUVL CFLFSKB TFCBHBJ QFMVNBT ZBOH KVHB Rangsang Parasimpatis Meningkatkan Laju Sekresi
NFMJOEVOHJQFSNVLBBOEBSJFLTLPSJBTJEBOQFODFSOBBO Kelenjar Saluran Pencernaan1FSBOHTBOHBOTBSBGQBSBTJNQBUJT
LF TBMVSBO QFODFSOBBO IBNQJS TFMBMV NFOJOHLBULBO MBKV
,FEVB CBOZBL EBFSBI QFSNVLBBO USBLUVT HBTUSPJOUFTUJOBM EJLFMJMJOHJ
LFDFQBUBO TFLSFTJ LFMFOKBS QFODFSOBBO *OJ UFSVUBNB UFSKBEJ
PMFI DFSVL QJUT
ZBOH NFSVQBLBO JOWBHJOBTJ EBSJ FQJUFM LF EBMBN
TVCNVLPTB1BEBVTVTIBMVT DFSVLJOJ EJTFCVULSJQUB-JFCFSLVIO ZBJUV QBEB LFMFOKBS EJ CBHJBO BUBT TBMVSBO ZBOH EJQFSTBSBGJ PMFI
DFSVLZBOHEBMBNEBONFOHBOEVOHTFMTFMTFLSFUPSJTLIVTVT4BMBITBUV OFSWVT HMPTPGBSJOHFVT EBO WBHVT QBSBTJNQBUJT
TFQFSUJ LFMFOKBS
EJBOUBSBOZBBLBOEJQFSMJIBULBOLFNVEJBOQBEB(BNCBS TBMJWB LFMFOKBS FTPGBHVT LFMFOKBS HBTUSJL QBOLSFBT EBO
,FUJHB EJ EBMBN MBNCVOH EBO CBHJBO BUBT EVPEFOVN UFSEBQBU LFMFOKBS #SVOOFS QBEB EVPEFOVN )BM JOJ KVHB UFSKBEJ QBEB
TFKVNMBICFTBSLFMFOKBSUVCVMBSZBOHEBMBN,FMFOKBSUVCVMBSZBOHLIBT CFCFSBQB LFMFOKBS EJ CBHJBO EJTUBM VTVT CFTBS ZBOH EJQFSTBSBGJ
EBQBU EJMJIBU QBEB (BNCBS ZBOH NFNQFSMJIBULBO HBNCBS LFMFOKBS PMFI TBSBG QBSBTJNQBUJT QFMWJT 4FLSFTJ QBEB CBHJBO VTVT IBMVT
MBNCVOHZBOHNFOZFLSFTJBTBNEBOQFQTJOPHFO LFMFOKBSPLTJOUJL
MBJOOZB EBO QBEB EVB QFSUJHB CBHJBO QFSUBNB VTVT CFTBS
,FFNQBU CFCFSBQBLFMFOKBSZBOHLPNQMFLT ZBJUVLFMFOKBSTBMJWB UFSVUBNBUFSKBEJTFCBHBJSFTQPOTUFSIBEBQSBOHTBOHBOTBSBGEBO
QBOLSFBT EBOEBOIBUJKVHBCFSIVCVOHBOEFOHBOTBMVSBOQFODFSOBBO IPSNPOBMTFUFNQBUQBEBNBTJOHNBTJOHTFHNFOVTVT
773
SFTQPOT UFSIBEBQ LFCFSBEBBO NBLBOBO EBMBN MVNFO VTVT

)PSNPO LFNVEJBO EJBCTPSCTJ LF EBMBN EBSBI EBO EJCBXB LF
LFMFOKBS UFNQBUIPSNPONFSBOHTBOHTFLSFTJ5JQFSBOHTBOHBOJOJ
UFSVUBNB CFSNBOGBBU VOUVL NFOJOHLBULBO QFOHFMVBSBO HFUBI
HBTUSJL EBO HFUBI QBOLSFBT LFUJLB NBLBOBO NBTVL LF MBNCVOH
BUBVEVPEFOVN
4FDBSBLJNJBXJ IPSNPOIPSNPOHBTUSPJOUFTUJOBMNFSVQBLBO
QPMJQFQUJEBBUBVEFSJWBUQPMJQFQUJEB
Mekanisme Dasar Sekresi Sel-Sel Kelenjar

4FLSFTJ ;BU 0SHBOJL 8BMBVQVO TFNVB NFLBOJTNF EBTBS
GVOHTJ TFMTFM LFMFOKBS NBTJI CFMVN EJLFUBIVJ CVLUJCVLUJ
QFOFMJUJBO UFSOZBUB NFOHBSBI QBEB QSJOTJQQSJOTJQ EBTBS TFLSFTJ
CFSJLVUJOJ TFQFSUJZBOHEJUVOKVLLBOQBEB(BNCBS
1. ;BU OVUSJTJ ZBOH EJCVUVILBO VOUVL QFNCFOUVLBO TFLSFTJ

QFSUBNB IBSVT CFSEJGVTJ BUBV EJQJOEBILBO TFDBSB BLUJG PMFI
EBSBIEJEBMBNLBQJMFSLFEBTBSTFMLFMFOKBS
1.
2.
2. #BOZBL NJUPLPOESJB ZBOH UFSMFUBL EJ EBMBN TFM LFMFOKBS ZBOH
3. CFSEFLBUBO EFOHBO EBTBSOZB NFOHHVOBLBO FOFSHJ PLTJEBTJ
VOUVLNFNCFOUVLBEFOPTJOUSJGPTGBU "51

3. &OFSHJ EBSJ "51 CFSTBNB EFOHBO [BU[BU ZBOH UFQBU ZBOH
EJTFEJBLBOPMFI[BUOVUSJTJ LFNVEJBOEJHVOBLBOVOUVLTJOUFTJT
[BU[BUTFLSFUPSJTPSHBOJLTJOUFTJTJOJUFSKBEJIBNQJSTFMVSVIOZB
EBMBNSFUJLVMVNFOEPQMBTNJLEBOLPNQMFLT(PMHJTFMLFMFOKBS
3JCPTPN ZBOH NFMFLBU QBEB SFUJLVMVN JOJ UFSVUBNB CFSQFSBO
QBEBQFNCFOUVLBOQSPUFJOZBOHEJTFLSFTJLBO
4. #BIBO TFLSFUPSJT LFNVEJBO EJCBXB NFMBMVJ UVCVMVT SFUJLVMVN
FOEPQMBTNJL NFOVKVWFTJLFMEBSJLPNQMFLT(PMHJTFMBNBLJSB
Saliva LJSBNFOJU
5. %BMBN LPNQMFLT (PMHJ [BU[BU UFSTFCVU LFNVEJBO
EJNPEJGJLBTJ EJUBNCBILBO EJQFLBULBO EBO EJLFMVBSLBO LF
EBMBN TJUPQMBTNB EBMBN CFOUVL WFTJLFM TFLSFUPSJT ZBOH
Rangsang Simpatis Mempunyai Efek Ganda pada Laju UFSTJNQBOQBEBVKVOHBQJLBMTFMTFMTFLSFUPSJT
4FLSFTJ ,FMFOKBS 4BMVSBO 1FODFSOBBO 1FSBOHTBOHBO TBSBG
TJNQBUJT ZBOH NFOVKV USBLUVT HBTUSPJOUFTUJOBM BLBO 6. 7FTJLFMWFTJLFM JOJ UFUBQ UFSTJNQBO TBNQBJ TJOZBMTJOZBM
NFOHBLJCBULBO UFSKBEJOZB QFOJOHLBUBO SJOHBO TBNQBJ TFEBOH QFOHPOUSPM TBSBG BUBV IPSNPOBM NFOZFCBCLBO TFM
TFLSFTJ CFCFSBQB LFMFOKBS TFUFNQBU /BNVO SBOHTBOHBO NFOHFMVBSLBO JTJ WFTJLFM NFMBMVJ QFSNVLBBO TFM ,FBEBBO JOJ
TJNQBUJTKVHBEBQBUNFOHBLJCBULBOLPOTUSJLTJQFNCVMVIEBSBI NVOHLJO UFSKBEJ EFOHBO DBSB CFSJLVU 4JOZBM LPOUSPM QFSUBNB
ZBOH NFOZVQMBJ LFMFOKBS 0MFI LBSFOB JUV QFSBOHTBOHBO UBNB BLBO NFOJOHLBULBO QFSNFBCJMJUBT NFNCSBO TFM UFSIBEBQ
TJNQBUJTEBQBUNFNQVOZBJEVBFGFL
SBOHTBOHBOTJNQBUJT JPOLBMTJVN EBOLBMTJVNNBTVLLFEBMBNTFM,BMTJVNUFSTFCVU
TFOEJSJ CJBTBOZB TFEJLJU NFOJOHLBULBO TFLSFTJ EBO
KJLB LFNVEJBO NFOZFCBCLBO CBOZBL WFTJLFM CFSGVTJ EFOHBO
QFSBOHTBOHBOBO QBSBTJNQBUJT BUBV IPSNPOBM TVEBI NFNCSBO TFM BQJLBM -BMV NFNCSBO TFM BQJLBM QFDBI EBO
NFOHBLJCBULBO TFLSFTJ LFMFOKBS ZBOH TBOHBU CBOZBL BEBOZB UFSCVLB TFIJOHHB NFOHFMVBSLBO JTJ WFTJLFM LF CBHJBO MVBS
UVNQBOHUJOEJI SBOHTBOHBO TJNQBUJT CJBTBOZB BLBO QSPTFTJOJEJTFCVUFLTPTJUPTJT
NFOHVSBOHJTFLSFTJ LBEBOHTFDBSBCFSNBLOB UFSVUBNBLBSFOB
4FLSFTJ "JS EBO &MFLUSPMJU ,FQFOUJOHBO LFEVB TFLSFTJ LFMFOKBS
SFEVLTJWBTPLPOTUSJLUJGEBOTVQMBJEBSBI
BEBMBI TFLSFTJ BJS EBO FMFLUSPMJU EBMBN KVNMBI DVLVQ BHBS EBQBU
NFNCBXB TFSUB [BU[BU PSHBOJL 4FLSFTJ PMFI LFMFOKBSLFMFOKBS
Pengaturan Sekresi Kelenjar oleh Hormon 1BEB MBNCVOH TBMJWB BLBOEJEJTLVTJLBOMFCJISJODJLFNVEJBO ZBOHNFNQFSMJIBU
EBO VTVT CFCFSBQB IPSNPO HBTUSPJOUFTJOBM ZBOH CFSCFEB LBO NFNQFSMJIBULBO TFCVBI DPOUPI DBSB SBOHTBOHBO TBSBG
NFNCBOUV NFOHBUVS WPMVNF EBO TJGBU TFLSFTJ )PSNPO NFOZFCBCLBO BJS EBO HBSBN NFMFXBUJ TFMTFM LFMFOKBS EBMBN
IPSNPOJOJEJLFMVBSLBOEBSJNVLPTBHBTUSPJOUFTUJOBMTFCBHBJ KVNMBICFTBS NFNCFSTJILBO[BU[BUPSHBOJLNFMBMVJUFQJTFM
774
Bab 64 Fungsi Sekresi Saluran Pencernaan
QBEBCFCFSBQBTFMTFMLFMFOKBSEJZBLJOJKVHBEBQBUNFOJNCVMLBO Tabel64-1 Sekresi Harian Getah Usus

FGFL TFLSFUPSJL TFSVQB TFQFSUJ ZBOH EJUJNCVMLBO PMFI
QFSBOHTBOHBOTBSBG 7PMVNF)BSJBO NM
pH
UNIT XII
Saliva 1000 6.0-7.0
Sifat Pelumasan dan Perlindungan Mukus, serta Kegunaan Mukus dalam
4FLSFTJMBNCVOH 1500 1.0-3.5
Traktus Gastrointestinal
.VLVTBEBMBITFLSFTJLFOUBMZBOHUFSVUBNBUFSEJSJBUBTBJS FMFLUSPMJU EBO Sekresi pankreas 1000 8.0-8.3
DBNQVSBO CFCFSBQB HMJLPQSPUFJO ZBOH UFSEJSJ BUBT TFKVNMBI CFTBS Empedu 1000 7.8
QPMJTBLBSJEB ZBOH CFSJLBUBO EFOHBO QSPUFJO EBMBN KVNMBI ZBOH MFCJI
TFEJLJU .VLVT TFEJLJU CFSCFEB QBEB CFSCBHBJ CBHJBO USBLUVT Sekresi usus halus 1800 7.5-8.0
HBTUSPJOUFTUJOBM UFUBQJ EJ NBOB QVO MFUBLOZB NVLVT NFNQVOZBJ Sekresi kelenjar Brunner 200 8.0-8.9
CFCFSBQB LBSBLUFSJTUJL QFOUJOH ZBOH NFNCVBUOZB TFCBHBJ QFMVNBT EBO Sekresi usus besar 200 7.5-8.0
QFMJOEVOH ZBOH CBJL CBHJ EJOEJOH VTVT 1FSUBNB NVLVT NFNQVOZBJ
LVBMJUBT QFMFLBU ZBOH NFNCVBUOZB NFMFLBU FSBU QBEB NBLBOBO BUBV Totat 6700
QBSUJLFMMBJOEBONFOZFCBSTFCBHBJTVBUVMBQJTBOUJQJTEJBUBTQFSNVLBBO
,FEVB NVLVT NFNQVOZBJ NBTTB ZBOH DVLVQ CFTBS TFIJOHHB EBQBU
4FLSFTJ MPO EBMBN 4BMJWB 4BMJWB UFSVUBNB NFOHBOEVOH
NFMBQJTJEJOEJOHVTVTEBONFODFHBILPOUBLZBOHTFTVOHHVIOZBBOUBSB TFKVNMBI CFTBS JPO LBMJVN EBO JPO CJLBSCPOBU 4FCBMJLOZB
TFCBHJBO CFTBS QBSUJLFM NBLBOBO EFOHBO NVLPTB ,FUJHB NVLVT LPOTFOUSBTJJPOOBUSJVNEBOLMPSJEBCFCFSBQBLBMJMFCJISFOEBI
NFNJMJLJ SFTJTUFOTJ SFOEBI UFSIBEBQ LFNVOHLJOBO TFMJQ TFIJOHHB QBEB TBMJWB EBSJQBEB EJ EBMBN QMBTNB ,JUB EBQBU NFNBIBNJ
QBSUJLFM EFOHBO NVEBI EBQBU NFMVODVS TFQBOKBOH FQJUFM ,FFNQBU LPOTFOUSBTJ LIVTVT JPOJPO JOJ EJ EBMBN TBMJWB NFMBMVJ
NVLVT NFOZFCBCLBO QBSUJLFM GFTFT NFMFLBU TBUV TBNB MBJO VOUVL EFTLSJQTJCFSJLVUJOJNFOHFOBJNFLBOJTNFTFLSFTJTBMJWB
NFNCFOUVL GFTFT ZBOH BLBO EJLFMVBSLBO TFMBNB QFSHFSBLBO VTVT
,FMJNB NVLVT TBOHBU SFTJTUBO UFSIBEBQ QFODFSOBBO PMFI FO[JNFO[JN (BNCBS NFOVOKVLLBO TFLSFTJ PMFI LFMFOKBS
HBTUSPJOUFTUJOBM ,FFOBN HMJLPQSPUFJO NVLVT NFNQVOZBJ TJGBU TVCNBOEJCVMBSJT TVBUV LFMFOKBS DBNQVSBO LIVTVT ZBOH
BNGPUFSJL ZBOH CFSBSUJ CBIXB NVLVT NBNQV NFOEBQBS CVGGFSJOH
NFOHBOEVOHEVLUVTBTJOVTNBVQVOEVLUVTTBMJWBSJVT4FLSFTJ
TFKVNMBI LFDJM BTBN BUBV CBTB KVHB NVLVT TFSJOH LBMJ NFOHBOEVOH TBMJWB UFSKBEJ NFMBMVJ EVB UBIBQ 5BIBQ QFSUBNB NFMJCBULBO
TFKVNMBIJPOCJLBSCPOBU ZBOHLIVTVTOZBNFOFUSBMLBOBTBN BTJOVT EBO ZBOH LFEVB EVLUVT TBMJWBSJVT 4FM BTJOVT
3JOHLBTOZB NVLVT NFNQVOZBJ LFNBNQVBO VOUVL NFNQFSNVEBI NFOZFLSFTJ TFLSFTJ QSJNFS ZBOH NFOHBOEVOH QUJBMJO EBOBUBV
NFMVODVSOZB NBLBOBO EJ TFQBOKBOH USBLUVT HBTUSPJOUFTUJOBM EBO KVHB NVTJO EBMBN MBSVUBO JPO EFOHBO LPOTFOUSBTJ ZBOH UJEBL KBVI
NFODFHBI FLTLPSJBTJ BUBV LFSVTBLBO LJNJBXJ FQJUFM 4FTFPSBOH BLBO CFSCFEB EBSJ ZBOH EJTFLSFTJLBO EBMBN DBJSBO FLTUSBTFM CJBTB
NFOZBEBSJ TJGBU QFMVNBT NVLVT LFUJLB LFMFOKBS TBMJWB HBHBM NFOZFLSFTJ 1BEB TBBU TFLSFTJ QSJNFS NFOHBMJS NFMBMVJ EVLUVT UFSKBEJ EVB
TBMJWB LBSFOB QBEB TJUVBTJ JOJ NBLBOBO QBEBU TBOHBU TVMJU EJUFMBO QSPTFTUSBOTQPSBLUJGVUBNBZBOHNFNPEJGJLBTJLPNQPTJTJJPO
XBMBVQVONBLBOBOUFSTFCVUEJLPOTVNTJCFSTBNBEFOHBOTFKVNMBICFTBS QBEBDBJSBOTBMJWBTFDBSBOZBUB
BJS
1FSUBNB JPOJPOOBUSJVNTFDBSBBLUJGEJSFBCTPSCTJEBSJTFNVB
EVLUVTTBMJWBSJVT EBOJPOJPOLBMJVNEJTFLSFTJTFDBSBBLUJGTFCBHBJ
Sekresi Saliva QFOHHBOUJ OBUSJVN 0MFI LBSFOB JUV LPOTFOUSBTJ JPO OBUSJVN
TBMJWB TBOHBU CFSLVSBOH TFEBOHLBO LPOTFOUSBTJ JPO LBMJVN
Saliva Mengandung Sekresi Serosa dan Mukus NFOJOHLBU "LBO UFUBQJ BEB LFMFCJIBO SFBCTPSQTJ JPO OBUSJVN
TBMJWB ZBOH VUBNB BEBMBI LFMFOKBS QBSPUJT TVCNBOEJCVMBSJT EBO ZBOH NFMFCJIJ TFLSFTJ JPO LBMJVN EBO JOJ NFNCVBU LFOFHBUJGBO
TVCMJOHVBMJT TFMBJO JUV KVHB BEB CFCFSBQB LFMFOKBS CVLBMJT ZBOH MJTUSJL TFLJUBS NJMJWPMU EJ EBMBN EVLUVT TBMJWBSJVT EBO
LFDJM4FLSFTJTBMJWBOPSNBMIBSJBOCFSLJTBSTBNQBJNM LFBEBBO JOJ LFNVEJBO NFOZFCBCLBO JPO LMPSJEB EJSFBCTPSQTJ
TFQFSUJ ZBOH EJUVOKVLLBO EFOHBO OJMBJ SBUBSBUB NM QBEB TFDBSBQBTJG0MFILBSFOBJUV LPOTFOUSBTJJPOLMPSJEBQBEBDBJSBO
5BCF TBMJWB UVSVO TFLBMJ TFSVQB EFOHBO QFOVSVOBO LPOTFOUSBTJ JPO
OBUSJVNQBEBEVLUVT
4BMJWB NFOZFLSFTJ EVB KFOJT QSPUFJO ZBOH VUBNB
TFLSFTJ
TFSPTB ZBOH NFOHBOEVOH QUJBMJO TVBUV BBNJMBTF
ZBOH ,FEVB JPOJPO CJLBSCPOBU EJTFLSFTJ PMFI FQJUFM EVLUVT LF
NFSVQBLBO FO[JN VOUVL NFODFSOBLBO LBSCPIJESBU EBO
EBMBN MVNFO EVLUVT )BM JOJ TFEJLJUOZB TFCBHJBO EJTFCBCLBO
TFLSFTJNVLVTZBOHNFOHBOEVOHNVTJOVOUVLUVKVBOQFMVNBTBO PMFIQFSUVLBSBOQBTJGJPOCJLBSCPOBUEFOHBOJPOLMPSJEB UFUBQJ
EBOQFSMJOEVOHBOQFSNVLBBO NVOHLJOKVHBTFCBHJBOIBTJMEBSJQSPTFTTFLSFTJBLUJG
*FMFOKBS QBSPUJT IBNQJS TFMVSVIOZB NFOZFLSFTJ KFOJT TFSPTB )BTJM BLIJS QSPTFT USBOTQPS JOJ BEBMBI CBIXB QBEB LPOEJTJ
TFNFOUBSBLFMFOKBSTVCNBOEJCVMBSJTEBOTVCMJOHVBMJTNFOZFLSFTJ JTUJSBMSBU LPOTFOUSBTJ NBTJOHNBTJOH JPO OBUSJVN EBO LMPSJEB
NVLVT EBO TFSPTB ,FMFOKBS CVLBMJT IBOZB NFOZFLSFTJ NVLVT EBMBNTBMJWBIBOZBTFLJUBSN&R- TFLJUBSTFQFSUVKVITBNQBJ
4BMJWB NFNQVOZBJ Q) BOUBSB EBO TVBUV LJTBSBO ZBOH TFQFSTFQVMVI LPOTFOUSBTJOZB EBMBN QMBTNB 4FCBMJLOZB
NFOHVOUVOHLBOVOUVLLFSKBQFODFSOBBOQUJBMJO LPOTFOUSBTJ JPO LBMJVN BEBMBI TFLJUBS N&R- UVKVI LBMJ
MFCJICFTBSEBSJLPOTFOUSBTJOZBEBMBNQMBTNBEBOLPOTFOUSBTJ
JPOCJLBSCPOBUBEBMBITBNQBJN&R- TFLJUBSEVBTBNQBJ
UJHBLBMJMFCJICFTBSEBSJLPOTFOUSBTJOZBEBMBNQMBTNB
775
4FMBNB TBMJWBTJ NBLTJNBM LPOTFOUSBTJ JPO TBMJWB LFMFOKBS TBMJWB UFSVUBNB EJLPOUSPM PMFI TJOZBM TBSBG QBSBTJNQBUJT
TBOHBU CFSVCBI LBSFOB LFDFQBUBO QFNCFOUVLBO TFLSFTJ TFQBOKBOH KBMBO EBSJ OVLMFVT TBMJWBUPSJVT TVQFSJPS EBO JOGFSJOS
QSJNFS PMFI TFM BTJOJ EBQBU NFOJOHLBU TFCFTBS LBMJ MJQBU QBEBCBUBOHPUBL
4FLSFTJ BTJOBS JOJ LFNVEJBO BLBO NFOHBMJS NFMBMVJ EVLUVT /VLMFVT TBMJWBUPSJVT UFSMFUBL LJSBLJSB QBEB QFSUFNVBO BOUBSB
CFHJUVDFQBUOZBTFIJOHHBQFOZFTVBJBO SFDOOEJUJPOJOH
TFLSFTJ NFEVMBEBOQPOTEBOBLBOUFSFLTJUBTJPMFISBOHTBOHBOUBLUJMEBO
EVLUVT EJQFSLJSBLBO NFOVSVO 0MFI LBSFOB JUV CJMB TBMJWB QFOHFDBQBO QBEB MJEBI EBO EBFSBIEBFSBI SPOHHB NVMVU EBO
TFEBOH EJTFLSFTJ EBMBN KVNMBI TBOHBU CBOZBL LPOTFOUSBTJ GBSJOH MBJOOZB #FCFSBQB SBOHTBOHBO QFOHFDBQBO UFSVUBNB SBTB
OBUSJVN LMPSJEB LVSBOH MFCJI IBOZB CFSLJTBS TFUFOHBI TBNQBJ BTBN EJTFCBCLBO PMFI BTBN
NFSBOHTBOH TFLSFTJ TBMJWB EBMBN
EVBQFSUJHBLPOTFOUSBTJEBMBNQMBTNB EBOLPOTFOUSBTJLBMJVN KVNMBI TBOHBU CBOZBL TFSJOH LBMJ TBNQBJ LBMJ LFDFQBUBO
NFOJOHLBUIBOZBFNQBULBMJLPOTFOUSBTJEBMBNQMBTNB TFLSFTJ CBTBM +VHB SBOHTBOHBO UBLUJM UFSUFOUV TFQFSUJ BEBOZB
'VOHTJ 4BMJWB VOUVL ,FCFSTJIBO .VMVU 1BEB LPOEJTJ CBTBM TBBU CFOEB IBMVT EBMBN SPOHHB NVMVU NJTBMOZB TFCVBI CBUV LSJLJM

TFTFPSBOH UFSKBHB TFLJUBS NJ TBMJWB IBNQJS TFMVSVIOZB UJQF NFOZFCBCLBO TBMJWBTJ ZBOH OZBUB TFEBOHLBO CFOEB ZBOH LBTBS
NVLVT EJTFLSFTJLBO TFUJBQ NFOJU UFUBQJ TFMBNB UJEVS IBOZB MBSSBOH NFOZFCBCLBO TBMJWBTJ EBO LBEBOH CBILBO NFOHIBNCBU
UFSKBEJ TFEJLJU TFLSFTJ 4FLSFTJ JOJ CFSQFSBO TBOHBU QFOUJOH VOUVL TBMJWBTJ
NFNQFSUBIBOLBO LFTFIBUBO KBSJOHBO SPOHHB NVMVU 3POHHB 4BMJWBTJKVHBEBQBUEJSBOHTBOHBUBVEJIBNCBUPMFITJOZBMTJOZBM
NVMVUCFSJTJCBLUFSJQBUPHFOZBOHEFOHBONVEBIEBQBUNFSVTBL TBSBG ZBOH UJCB QBEB OVLMFVT TBMJWBUPSJVT EBSJ QVTBUQVTBU TJTUFN
KBSJOHBO EBO KVHB NFOJNCVMLBO LBSJFT HJHJ 4BMJWB NFNCBOUV TBSBG QVTBU ZBOH MFCJI UJOHHJ 4FCBHBJ DPOUPI CJMB TFTFPSBOH
NFODFHBIQSPTFTLFSVTBLBONFMBMVJCFCFSBQBDBSB NFODJUVO BUBV NBLBO NBLBOBO ZBOH EJTVLBJOZB QFOHFMVBSBO
1FSUBNB BMJSBO TBMJWB TFOEJSJ NFNCBOUV NFNCVBOH CBLUFSJ TBMJWB MFCJI CBOZBL EBSJQBEB CJMB JB NFODJVN BUBV NFNBLBO
QBUPHFO KVHB QBSUJLFMQBSUJLFM NBLBOBO ZBOH NFNCFSJ EVLVOHBO NBLBOBOZBOHUJEBLEJTVLBJO ZB%BFSBIOBGTVNBLBOQBEBPUBL
NFUBCPMJLCBHJCBLUFSJ ZBOH NFOHBUVS TFCBHJBO FGFL JOJ UFSMFUBL EJ EFLBU QVTBU
,FEVB TBMJWB NFOHBOEVOH CFCFSBQB GBLUPS ZBOH QBSBTJNQBUJT IJQPUBMBNVT BOUFSJPS EBO CFSGVOHTJ UFSVUBNB
NFOHIBODVSLBO CBLUFSJ 4BMBI TBUVOZB BEBMBI JPO UJPTJBOBU EBO TFCBHBJ SFTQPOT UFSIBEBQ TJOZBM EBSJ EBFSBI QFOHFDBQBO EBO
ZBOHMBJOOZBBEBMBICFCFSBQBFO[JSOQSPUFPMJUJLUFSVUBNB MJTP[J:O QFODJVNBOEBSJLPSUFLTTFSFCSBMBUBVBNJHEBMB
ZBOH B
NFOZFSBOH CBLUFSJ C
NFNCBOUV JPO UJPTJBOBU 4BMJWBTJKVHBEBQBUUFSKBEJTFCBHBJSFTQPOTUFSIBEBQSFGMFLTZBOH
NFNBTVLJ CBLUFSJ UFNQBU JPO JOJ LFNVEJBO NFOKBEJ CBLUFSJTJE CFSBTBM EBSJ MBNCVOH EBO VTVT IBMVT CBHJBO BUBT LIVTVTOZB TBBU
EBO D
NFODFSOB QBSUJLFMQBSUJLFM NBLBOBO KBEJ NFNCBOUV NFOFMBO NBLBOBO ZBOH TBOHBU NFOHJSJUBTJ BUBV CJMB TFTFPSBOH
NFOHIJMBOHLBOQFOEVLVOHNFUBCPMJTNFCBLUFSJMFCJIMBOKVU NVBM LBSFOB BEBOZB CFCFSBQB LFMBJOBO HBTUSPJOUFTUJOB- 4BMJWB
,FUJHB TBMJWB TFSJOH NFOHBOEVOH TFKVNMBI CFTBS BOUJCPEJ LFUJLBEJUFMBO BLBONFNCBOUVNFOHIJMBOHLBOGBLUPSJSJUBOQBEB
QSPUFJO ZBOH EBQBU NFOHIBODVSLBO CBLUFSJ SPOHHB NVMVU USBLUVT HBTUSPJOUFTUJOBM EFOHBO DBSB NFOHFODFSLBO BUBV
UFSNBTVL IFCFSBQB ZBOH NFOZFCBCLBO LBSJFT HJHJ 1BEB LFBEBBO NFOFUSBMLBO[BUJSJUBO
UJEBLBEBTBMJWB KBSJOHBOSPOHHBNVMVUTFSJOHNFOHBMBNJVMTFSBTJ 1FSBOHTBOHBOTJNQBUJTKVHBEBQBUNFOJOHLBULBOTBMJWBTJEBMBN
EBOBUBVNFOKBEJUFSJOGFLTJ EBOLBSJFTHJHJEBQBUNFMVBT KVNMBI TFEJLJU MFCJI TFEJLJU EBSJ QFSBOHTBOHBO QBSBTJNQBUJT
Pengaturan Sekresi Saliva oleh Saraf 4BSBGTBSBG TJNQBUJT CFSBTBM EBSJ HBOHMJB TFSWJLBMJT TVQFSJPS EBO
CFSKBMBO TFQBOKBOH QFSNVLBBO EJOEJOH QFNCVMVI EBSBI LF
(BNCBS NFOVOKVLLBO KBMVS TBSBG QBSBTJNQBUJT VOUVL LFMFOKBSLFMFOKBSTBMJWB
NFOHBUVSQFOHFMVBSBOTBMJWB NFOVOKVLLBOCBIXB 'BLUPS TFLVOEFS ZBOH KVHB NFNFOHBSVIJ TFLSFTJ TBMJWB BEBMBI
TVQMBJ EBSBI LF LFMFOKBS LBSFOB TFLSFTJ TFMBMV NFNCVUVILBO
OVUSJTJ ZBOH BEFLVBU EBSJ EBSBI 4JOZBMTJOZBM TBSBG QBSBTJNQBUJT
ZBOH TBOHBU NFSBOHTBOH TBMJWBTJ EBMBN EFSBKBU TFEBOH KVHB
NFMFCBSLBOQFNCVMVIQFNCVMVIEBSBI4FMBJOJUV TBMJWBTJTFOEJSJ
TFDBSBMBOHTVOHNFMFCBSLBOQFNCVMVIQFNCVMVIEBSBI TFIJOHHB
NFOZFEJBLBOQFOJOHLBUBOOVUSJTJLFMFOKBSTBMJWBTFQFSUJZBOHKVHB
EJCVUVILBO TFM QFOZFLSFTJ 4FCBHJBO EBSJ UBNCBIBO FGFL
WBTPEJMBUPS JOJ EJTFCBCLBO PMFI LBMJLSFJO ZBOH EJTFLSFTJ PMFI TFM
TFM TBMJWB ZBOH BLUJG ZBOH LFNVEJBO CFLFSKB TFCBHBJ TVBUV FO[JN
VOUVLNFNJTBILBOTBUVQSPUFJOEBSBI ZBJUVBMGBHMPCVMJO VOUVL
NFNCFOUVLCSBEJLJOJO TVBUVWBTPEJMBUPSZBOHLVBU
Sekresi Esofagus
4FLSFTJ FTPGBHVT TFMVSVIOZB NVLVT EBO UFSVUBJOB CFSGVOHTJ TFCBHBJ
QFMVNBT QBEB TBBU NFOFMBO #BHJBO VUBNB FTPGBHVT EJLFMJMJOHJ PMFI
CFCFSBQB LFMFOKBS NVLVT TFEFSIBOB 1BEB CBHJBO VKVOH MBNCVOH EBO
EBMBN KVNMBI MFCJI LFDJM QBEB CBHJBO BXBM FTPGBHVT UFSEBQBU KVHB
CFCFSBQB LFMFOKBS NVLVT DBNQVSBO .VLVT ZBOH EJTFLSFTJ PMFI LFMFOKBS
DBNQVSBO QBEB FTPGBHVT CBHJBO BUBT BLBO NFODFHBI FLTLPSJBTJ NVLPTB
BLJCBUNBLBOBOZBOHCBSVTBKBNBTVL TFEBOHLBOLFMFOKBS
776
DBNQVSBO ZBOH CFSBEB EJ EFLBU TBNCVOHBO FTPGBHPHBTUSJL BLBO IJESPHFOEBMBNEBSBIBSUFSJ6OUVLNFNFLBULBOJPOIJESPHFO

NFMJOEVOHJ EJOEJOH FTPGBHVT EBSJ QFODFSOBBO PMFI BTBN HFUBI KVNMBI ZBOH CFTBS JOJ NFNFSMVLBO MFCJI EBSJ LBMPSJ
MBNCVOHZBOHTFSJOHNFOHBMBNJSFGMVLTEBSJMBNCVOHLFNCBMJMBHJ
UNIT XII
FOFSHJ- HFUBI MBNCVOH 1BEB XBLUV ZBOH TBNB JPO IJESPHFO
LFCBHJBOCBXBIFTPGBHVT8BMBVQVOBEBGVOHTJQFMJOEVOH UVLBL EJTFLSFTJ JPO CJLBSCPOBU CFSEJGVTJ LF EBMBN EBSBI TFIJOHHB
MBNCVOHLBEBOHNBTJIEBQBUUFSKBEJQBEBVKVOHHBTUSJLFTPGBHVT
EBSBI WFOB MBNCVOH NFNJMJLJ Q) ZBOH MFCJI UJOHHJ
EJCBOEJOHLBOEBSBIBSUFSJQBEBTBBUMBNCVOHNFOZFLSFTJBTBN
(BNCBS NFOVOKVLLBO TFDBSB TLFNBUJT TUSVLUVS
Sekresi Lambung GVOHTJPOBMTVBUVTFMQBSJFUBM KVHBEJTFCVUTFCBHBJTFMPLTJOUJL

NFOVOKVLLBO CBIXB TFM EBQBU NFOHBOEVOH CBOZBL
Karakteristik Sekresi Lambung QFSDBCBOHBO CFTBS LBOBMJLVMVT JOUSBTFM "TBN IJESPLMPSJEB
4FMBJO TFMTFM QFOZFLSFTJ NVLVT ZBOH NFOHFMJMJOHJ TFMVSVI EJCFOUVLQBEBQFOPOKPMBONJSJQWJMVTEBSJLBOBMJLVMVTJOJEBO
QFSNVLBBO MBNCVOH NVLPTB MBNCVOH NFNQVOZBJ EVB UJQF LFNVEJBO EJTBMVSLBO NFMBMVJ LBOBMJLVMVT LF VKVOH TFLSFUPSJ
LFMFOKBS UVCVMBS ZBOH QFOUJOH LFMFOKBS PLTJOUJL EJTFCVU KVHB TFM
LFMFOKBS HBTUSJL
EBO LFMFOKBS QJMPSVT ,FMFOKBS PLTJOUJL ,FLVBUBOQFOEPSPOHVUBNBTFLSFTJBTBNIJESPLMPSJEBPMFI
QFNCFOUVL BTBN
NFOZFLSFTJ BTBN IJESPLMPSJEB QFQTJOPHFO TFMTFM QBSJFUBM BEBMBI QPNQB IJESPHFOLBMJVN ),
GBLUPSJOUSJOTJL EBONVLVT,FMFOKBSQJMPSVTUFSVUBNBNFOZFLSFTJ "51BTF
.FLBOJTNF LJNJB QFNCFOUVLBO BTBN IJESPLMPSJEB
NVLVT VOUVL NFMJOEVOHJ NVLPTB QJMPSVT EBSJ BTBN MBNCVOH EJQFSMJIBULBOQBEB(BNCBSEBONFMJQVUJMBOHLBIMBOHLBI
,FMFOKBSUFSTFCVUKVHBNFOZFLSFTJIPSNPOHBTUSJO CFSJLVU
,FMFOKBS PLTJOUJL UFSMFUBL QBEB CBHJBO EBMBN LPSQVT EBO 1. "JSEJEBMBNTFMQBSJFUBMCFSEJTPTJBTJNFOKBEJ)EBO0)EJ
GVOEVT MBNCVOH NFMJQVUJ QFSTFO CBHJBO QSPLTJNBM MBNCVOH EBMBN TJUPQMBTNB TFM *POJPO IJESPHFO LFNVEJBO TFDBSB
,FMFOKBSQJMPSVTUFSMFUBLQBEBCBHJBOBOUSVNMBNCVOH QFSTFO BLUJG EJTFLSFTJLBO LF EBMBN LBOBMJLVMVT TFCBHBJ QFSUVLBSBO
CBHJBOEJTUBMMBNCVOH UFSIBEBQ JPOJPO LBMJVN QSPTFT QFSUVLBSBO BLUJG JOJ
EJLBUBMJTJTPMFI),"51BTF*POJPOLBMJVNEJUSBOTQPSLF
Sekresi Kelenjar Oksintik (Gastrik) EBMBN TFM PMFI QPNQB /B,"51BTF QBEB TJTJ CBTPMBUFSBM
FLTUSBTFMVMFS
NFNCSBO ZBOH DFOEFSVOH CPDPS LF EBMBN
,FMFOKBSPLTJOUJLMBNCVOHZBOHLIBTEJUVOKVLLBOQBEB(BNCBS MVNFO UFUBQJ BLBO EJLFNCBMJLBO LF EBMBN TFM PMFI ),
,FMFOKBSUFSEJSJBUBTUJHBUJQFTFM
TFMMFIFSNVLVT ZBOH "51BTF /B,"51BTF CBTPMBUFSBM NFOHBLJCBULBO /B
UFSVUBNB NFOZFLSFTJ NVLVT
TFM QFQUJL BUBV VUBNB
ZBOH JOUSBTFMSFOEBI ZBOHCFSLPOUSJCVTJUFSIBEBQSFBCTPSQTJ/B
NFOZFLSFTJTFKVNMBICFTBSQFQTJOPHFOEBO
TFMQBSJFUBM BUBV EBSJMVNFOLBOBMJLVMVT+BEJ LFCBOZBLBOEBSJ,EBO/BEJ
TFM PLTJOUJL
ZBOH NFOZFLSFTJ BTBN IJESPLMPSJEB EBO GBLUPS LBOBMJLVMVT EJSFBCTPSQTJ LF EBMBN TJUPQMBTNB TFM EBO JPO
JOUSJOTJL 4FLSFTJ BTBN IJESPLMPSJEB PMFI TFM QBSJFUBM NFMJQVUJ IJESPHFONFOHBNCJMUFNQBUOZBEJLBOBMJLVMVT
NFLBOJTNFLIVTVTTFCBHBJCFSJLVU
2. 1FNPNQBBO ) LFMVBS TFM PMFI ),"51BTF NFOHBLJCBU
Mekanisme Dasar Sekresi Asam Hidroklorida. #JMBEJSBOHTBOH LBO 0) UFSBLVNVMBTJ EBO NFNCFOUVL )$0 EBSJ $0
TFM QBSJFUBM BLBO NFOZFLSFTJ MBSVUBO BTBN ZBOH NFOHBOEVOH EBO EJCFOUVL TFMBNB NFUBCPMJTNF EJ EBMBN TFM BUBV
TFLJUBS NNPM- BTBN IJESPLMPSJEB ZBOH NFOEFLBUJ NFNBTVLJTFMEBSJEBSBI3FBLTJJOJEJLBUBMJTJTPMFI
JTPUPOJLOZB DBJSBO UVCVI Q) MBSVUBO BTBN JOJ LJSBLJSB
NFOVOKVLLBO LFBTBNBO ZBOH FLTUSFN 1BEB Q) JOJ LPOTFOUSBTJ
JPOIJESPHFOTFLJUBSKVUBLBMJLPOTFOUSBTJJPO
777
CO2 CO2 H2O

H+ (155 mEq/L)
HCO 3- HCO 3- CO2 + OH- + H+

P
Cl- Cl-
K+ K+ K+ K+ (15 mEq/L)
P
Na+ Na+ Na+ Na+ (3 mEq/L)
Cl- Cl- Cl- Cl- (173 mEq/L)
(Osmosis)
H2O H2O
LBSCPOJLBOIJESBTF)$0MBMVEJUSBOTQPSNFMFXBUJNFNCSBO LFMFOKBSHBTUSJL8BMBVQVOEFNJLJBO TFNVBQFQTJOPHFO

CBTPMBUFSBM LF EBMBN DBJSBO FLUSBTFMVMBS TFCBHBJ QFSUVLBSBO NFMBLVLBOGVOHTJZBOHTBNB
EFOHBO JPOJPO LMPSJEB ZBOH NFNBTVLJ TFM EBO EJTFLSFTJ ,FUJLB QFQTJOPHFO QFSUBNB LBMJ EJTFLSFTJLBO QFQTJOPHFO JOJ
NFMBMVJ LBOBM LMPSJEB LF EBMBN LBOBMJLVMVT NFNCFSJLBO UJEBLNFNQVOZBJBLUJWJUBTQFODFSOBBO"LBOUFUBQJ TFHFSBTFUFMBI
MBSVUBO BTBN IJESPLMPSJEB ZBOH LVBU EJ EBMBN LBOBMJLVMVT CFSLPOUBL EFOHBO BTBN IJESPLMPSJEB QFQTJOPHFO BLBO TFHFSB
"TBN IJESPLMPSJEB LFNVEJBO EJTFLSFTJ LFMVBS NFMBMVJ VKVOH EJBLUJGLBO VOUVL NFNCFOUVL QFQTJO ZBOH BLUJG 1BEB QSPTFT JOJ
UFSCVLBLBOBMJLVMVTLFEBMBNMVNFOLFMFOKBS NPMFLVMQFQTJOPHFO ZBOHNFNQVOZBJCFSBUNPMFLVMBLBO
3. "JS NBTVL LF EBMBN LBOBMJLVMVT TFDBSB PTNPTJT BLJCBU UFSQFDBINFOKBEJNPMFLVMQFQTJO ZBOHNFNQVOZBJCFSBUNPMFLVM
TFLSFTJJPOJPOUBNCBIBOLFEBMBNLBOBMJLVMVT+BEJ TFLSFTJ
BLIJS EBSJ LBOBMJLVMVT NFOHBOEVOH BJS BTBN IJESPLMPSJEB 1FQTJOCFSGVOHTJTFCBHBJFO[JNQSPUFPMJUJLBLUJGEBMBNNFEJVN
QBEB LPOTFOUSBTJ TFLJUBS TBNQBJ N&R- LBMJVN ZBOHTBOHBUBTBN Q)PQUJNBM TBNQBJ
UFUBQJEJBUBTQ)
LMPSJEB QBEB LPOTFOUSBTJ N&R- EBO TFKVNMBI LFDJM QFQTJOIBNQJSUJEBLNFNQVOZBJBLUJWJUBTQSPUFPMJUJLEBONFOKBEJ
OBUSJVNLMPSJEB UJEBL BLUJG EBMBN XBLUV ZBOH TJOHLBU "TBN IJESPLMPSJEB TBNB
QFOUJOHOZB EFOHBO QFQTJO ZBOH EJCVUVILBO VOUVL NFODFSOB
6OUVL NFOHIBTJMLBO JPOJPO IJESPHFO EFOHBO LPOTFOUSBTJ QSPUFJOEBMBNMBNCVOHTFQFSUJZBOHEJCJDBSBLBOQBEB#BC
ZBOH UFQBU TFTVBJ EFOHBO ZBOH EJUFNVLBO EJ EBMBN HFUBI
MBNCVOHNFNCVUVILBOLFCPDPSBOLFNCBMJZBOHNJOJNVNLF Sekresi Faktor Intrinsik oleh Sel-Sel Parietal. 4VCTUBOTJ GBLUPS
EBMBN NVLPTB ZBOH NFOZFLSFTJ BTBN )BM VUBNB EBSJ JOUSJOTJL ZBOH TBOHBU QFOUJOH VOUVL BCTPSCTJ WJUBNJO # EJ EBMBN
LFNBNQVBO MBNCVOH NFODFHBI LFCPDPSBO CBMJL BTBN EBQBU JMFVN EJTFLSFTJ PMFI TFM QBSJFUBM CFSTBNB EFOHBO TFLSFTJ BTBN
EJLBJULBO EFOHBO QFMJOEVOH MBNCVOH PMFI BEBOZB IJESPLMPSJEB 0MFI LBSFOB JUV KJLB TFM QBSJFUBM MBNCVOH QFNCFOUVL
QFNCFOUVLBONVLVTZBOHBMLBMJEBOUBVUFSBU UJHIUKVODUJPOT
BTBN SVTBL ZBOH TFSJOH UFSKBEJ QBEB HBTUSJUJT LSPOJT PSBOH UFSTFCVU
EJBOUBSBTFMTFMFQJUFMTFQFSUJZBOHBLBOEJKFMBTLBOLFNVEJBO UJEBL IBOZB NFOHBMBNJ BLMPSIJESJB LFLVSBOHBO TFLSFTJ BTBN
"QBCJMB QFMJOEVOH JOJ SVTBL PMFI [BU [BU UPLTJL TFQFSUJ ZBOH MBNCVOH
UFUBQJ KVHB TFSJOH NFOHBMBNJ BOFNJB QFSOJTJPTB BLJCBU
UFSKBEJQBEBQFOHHVOBBOBTQJSJOZBOHCFSMFCJIBOBUBVBMLPIPM LFHBHBMBO NBUVSBTJ TFMTFM EBSBI NFSBI QBEB LFBEBBO UJEBL BEBOZB
BTBN ZBOH EJTFLSFTJ BLBO CPDPS NFOHJLVUJ HSBEJFO SBOHTBOHBO WJUBNJO #* QBEB TVNTVN UVMBOH )BM JOJ TVEBI
FMFLUSPLJNJB LF EBMBN NVLPTB NFOZFCBCLBO LFSVTBLBO EJCJDBSBLBOTFDBSBEFUBJMQBEB#BC
NVLPTBMBNCVOH Kelenjar Pilorus—Sekresi Mukus dan Gastrin
Faktor-Faktor Dasar yang Merangsang Sekresi Lambung ,FMFOKBSLFMFOKBS QJMPSVT TUSVLUVSOZB NFNJMJLJ LFNJSJQBO EFOHBO
LFMFOKBSPLTJOUJL UFUBQJNFOHBOEVOHCFCFSBQBTFMQFQUJLEBOIBNQJS
Adalah Asetilkolin, Gastrin, dan Histamin. "TFUJMLPMJO
EJMFQBTLBO PMFI BEBOZB SBOHTBOHBO QBSBTJNQBUJT NFSBOHTBOH UJEBL BEB TFM QBSJFUBM 4FCBMJLOZB LFMFOKBS QJMPSVT UFSVUBNB
TFLSFTJ QFQTJOPHFO PMFI TFMTFM QFQUJL BTBN IJESPLMPSJEB PMFI NFOHBOEVOHTFMTFMNVLVTZBOHJEFOUJLEFOHBOTFMTFMMFIFSNVLVT
TFMTFM QBSJFUBM EBO NVLVT PMFI TFMTFM NVLVT 4FCBHBJ QBEB LFMFOKBS PLTJOUJL 4FMTFM JOJ NFOZFLSFTJLBO TFKVNMBI LFDJM
QFNCBOEJOH LFEVBOZB HBTUSJO EBO IJTUBNJO TFDBSB LVBU QFQTJOPHFO TFQFSUJ ZBOH UFMBI EJEJTLVTJLBO EBIVMV EBO UFSVUBNB
NFSBOHTBOHTFLSFTJBTBNPMFITFMTFMQBSJFUBMUFUBQJNFNQVOZBJ TFKVNMBI CFTBS NVLVT FODFS ZBOH NFNCBOUV NFMVNBTJ QFSHFSBLBO
TFEJLJUFGFLUFSIBEBQTFMTFMMBJO NBLBOBO EBOVOUVLNFMJOEVOHJEJOEJOHMBNCVOHEBSJQFODFSOBBO
FO[JNFO[JN MBNCVOH ,FMFOKBS QJMPSVT KVHB NFOZFLSFTJ IPSNPO
Sekresi dan Aktivasi Pepsinogen#FCFSBQBUJQFQFQTJOPHFO HBTUSJO ZBOH NFNQVOZBJ QFSBO LVODJ EBMBN NFOHBUVS TFLSFTJ
ZBOHTFEJLJUCFSCFEBEJTFLSFTJPMFITFMQFQUJLEBOTFMNVLVT HBTUSJL TFQFSUJZBOHCBSVTBKBEJCJDBSBLBO
778
Sel-Sel Mukus Permukaan EJ EBMBN LFMFOKBS QJMPSVT VOUVL NFMFQBTLBO HBTUSJO LF
4FMVSVI QFSNVLBBO NVLPTB MBNCVOH EJ BOUBSB LFMFOKBSLFMFOKBS EBMBN EBSBI VOUVL EJUSBOTQPS LF TFMTFM &$- 1SPTFT
NFNJMJLJMBQJTBOCFSLFTJOBNCVOHBOTFMNVLVTKFOJTLIVTVT ZBOH QFODBNQVSBO HFUBI MBNCVOH ZBOH IFCBU NFNCBXB HBTUSJO
EFOHBO DFQBU LF TFM &$- ZBOH CFSBEB EJ EBMBN LPSQVT
UNIT XII
EJTFCVU TFMTFM NVLVT QFSNVLBBO 4FMTFM UFSTFCVU NFOZFLSFTJ
TFKVNMBI CFTBS NVLVT LFOUBM ZBOH NFMBQJTJ NVLPTB MBNCVOH MBNCVOH NFOZFCBCLBO QFMFQBTBO IJTUBNJO MBOHTVOH LF
EFOHBOTVBUVMBQJTBOHFMNVLVTTFSJOHLBMJEFOHBOLFUFCBMBOMFCJI LFMFOKBS PLTJOUJL ZBOH EBMBN )JTUBNJO MBMV CFLFSKB DFQBU
EBSJNN TFIJOHHBNFOZFEJBLBOTVBUVDBOHLBOHQSPUFLTJVUBNB NFSBOHTBOHTFLSFTJBTBNIJESPLMPSJEBMBNCVOH
CBHJ EJOEJOH MBNCVOH ZBOH KVHB CFSQFSBO VOUVL NFMVNBTJ
Pengaturan Sekresi Pepsinogen
USBOTQPSNBLBOBO
1FOHBUVSBOTFLSFTJQFQTJOPHFOPMFITFMQFQUJLEJEBMBNLFMFOKBS
$JSJ MBJO NVLVT BEBMBI JB CFSTJGBU BMLBMJT 0MFI LBSFOB JUV
PLTJOUJL UFSKBEJ TFCBHBJ SFTQPOT UFSIBEBQ EVB KFOJT TJOZBM
EJOEJOH MBNCVOH OPSNBM UJEBL TFDBSB MBOHTVOH UFSQBQBS QBEB
VUBNB
QFSBOHTBOHBO TFMTFM QFQUJL PMFI BTFUJMLPMJO ZBOH
TFLSFTJMBNCVOHZBOHTBOHBUBTBNEBOQSPUFPMJUJL#BILBOLPOUBL
EJMFQBTLBO PMFI OFSWVT WBHVT BUBV PMFI QMFLTVT TBSBG FOUFSJL
ZBOH SJOHBO TFLBMJ QVO EFOHBO NBLBOBO BUBV JSJUBTJ NVLPTB BQB
HBTUSJL EBO
QFSBOHTBOHBOTFLSFTJTFMQFQUJLTFCBHBJSFTQPOT
QVO TFDBSB MBOHTVOH BLBO NFSBOHTBOH TFMTFM NVLVT QFSNVLBBO
UFSIBEBQBEBOZBBTBNEJEBMBNMBNCVOH"TBNLFNVOHLJOBO
VOUVL NFOZFLSFTJLBO NVLVT UBNCBIBO ZBOH MFOHLFU BMLBMJT EBO
UJEBL NFSBOHTBOH TFMTFM QFQUJL TFDBSB MBOHTVOH UFUBQJ KVTUSV
LFOUBMJOJ
NFOJNCVMLBO SFGMFLTSFGMFLT TBSBG FOUFSJL UBNCBIBO ZBOH
Perangsangan Sekresi Asam Lambung NFOEVLVOH TJOZBM TBSBG BTMJ LF TFMTFM QFQUJL 0MFI LBSFOB JUV
LFDFQBUBO TFLSFTJ QFQTJOPHFO QSFLVSTPS FO[JN QFQTJO ZBOH
Sel Parietal pada Kelenjar Oksintik adalah Satu-Satunya
NFOZFCBCLBO QFODFSOBBO QSPUFJO EJQFOHBSVIJ LVBU PMFI
Sel yang Menyekresi Asam Hidroklorida. 4FMTFMQBSJFUBM ZBOH KVNMBI BTBN EJ EBMBN MBNCVOH 1BEB PSBOH ZBOH UJEBL
UFSMFUBL EBMBN QBEB LFMFOKBS PLTJOUJL LPSQVT VUBNB MBNCVOH
NFNJMJLJLFNBNQVBOVOUVLNFOZFLSFTJLBOKVNMBIBTBNZBOH
BEBMBI TBUVTBUVOZB TFM ZBOH NFOZFLSFTJ BTBN IJESPLMPSJEB
OPSNBM TFLSFTJ QFQTJOPHFO KVHB CFSLVSBOH XBMBVQVO TFMTFM
4FQFSUJ ZBOH UFMBI EJTFCVULBO TFCFMVNOZB EBMBN CBC JOJ
QFQUJLTFCBMJLOZBNVOHLJOUBNQBLOPSNBM
LFBTBNBODBJSBOZBOHEJTFLSFTJPMFITFMTFMJOJEBQBUTBOHBUBTBN
EFOHBO Q) TFSFOEBI /BNVO TFLSFTJ BTBN JOJ CFSBEB EBMBN
QFOHBUVSBO UFSVTNFOFSVT PMFI TJOZBM FOEPLSJO EBO TBSBG -FCJI Fase Sekresi Lambung
MBOKVUMBHJ TFMQBSJFUBMCFSIVCVOHBOFSBUEFOHBOTFMKFOJTMBJOZBOH 4FLSFTJ MBNCVOH EJLBUBLBO UFSKBEJ EBMBN UJHB GBTF 4FQFSUJ ZBOH
EJTFCVU TFM NJSJQFOUFSPLSPNBGJO TFM &$-
ZBOH GVOHTJ VUBNBOZB EJUVOKVLLBO QBEB (BNCBS
GBTF TFGBMJL GBTF HBTUSJL EBO GBTF
JOUFTUJOBM
NFOZFLSFTJIJTUBNJO
4FM &$- UFSMFUBL EBMBN EJ SFTFTVT LFMFOKBS PLTJOUJL TFIJOHHB Fase Sefalik.'BTFTFGBMJLTFLSFTJMBNCVOHCFSMBOHTVOHCBILBO
TFCFMVN NBLBOBO NBTVL LF EBMBN MBNCVOH UFSVUBNB TFXBLUV
IJTUBNJO ZBOH EJMFQBTLBO TFDBSB MBOHTVOH CFSIVCVOHBO EFOHBO
NBLBOBO TFEBOH EJLPOTVNTJ 'BTF JOJ UJNCVM BLJCBU NFMJIBU
TFM QBSJFUBM LFMFOKBS ,FDFQBUBO QFNCFOUVLBO EBO TFLSFTJ BTBN
NFNCBVJ NFNCBZBOHLBO BUBVNFODJDJQJNBLBOBOEBOTFNBLJO
IJESPLMPSJEB PMFI TFM QBSJFUBM CFSIVCVOHBO MBOHTVOH EFOHBO CFTBS OBGTV NBLBO TFNBLJO LVBU SBOHTBOHBO JUV UJNCVM 4JOZBM
KVNMBIIJTUBNJOZBOHEJMFQBTLBOPMFITFM&$-4FMBOKVUOZB TFMTFM OFVSPHFOJL ZBOH NFOZFCBCLBO GBTF TFGBMJL TFLSFTJ MBNCVOH
&$- EBQBU EJSBOHTBOH VOUVL NFOZFLSFTJ IJTUBNJO PMFI [BU CFSBTBM EBSJ LPSUFLT TFSFCSJ EBO QBEB QVTBU OBGTV NBLBO EJ
IPSNPO HBTUSJO ZBOH EJCFOUVL IBNQJS TFMVSVIOZB EJ CBHJBO BNJHEBMBEBOIJQPUBMBNVT4JOZBMEJUSBOTNJTJLBONFMBMVJOVLMFVT
BOUSVNNVLPTBMBNCVOHTFCBHBJSFTQPOTUFSIBEBQQSPUFJOEBMBN NPUPSJLEPSTBMJTOFSWVTWBHVTEBOLFNVEJBONFMBMVJTBSBGWBHVT
NBLBOBO ZBOH TFEBOH EJDFSOB 4FMTFM &$- NVOHLJO EBQBU LF MBNCVOH 'BTF TFLSFTJ JOJ OPSNBMOZB NFOHIBTJMLBO TFLJUBS
EJSBOHTBOHKVHBPMFI[BUIPSNPOZBOHEJTFLSFTJPMFITJTUFNTBSBG QFSTFO TFLSFTJ MBNCVOH ZBOH CFSLBJUBO EFOHBO LPOTVNTJ
FOUFSJL EJOEJOH MBNCVOH 1FSUBNBUBNB NBSJ LJUB CBIBT NBLBOBO
NFLBOJTNF HBTUSJO EBMBN NFOHBUVS TFM &$- EBO TFMBOKVUOZB Fase Gastrik 4FLBMJ NBLBOBO NBTVL LF MBNCVOH NBLBOBO
QFOHBUVSBOTFMJUVUFSIBEBQQFOZFLSFTJBOBTBNIJESPLMPSJEBPMFI BLBO NFNCBOHLJULBO
SFGMFLT WBHPWBHBM ZBOH QBOKBOH EBSJ
TFMQBSJFUBM MBNCVOH LF PUBL EBO LFNCBMJ LF MBNCVOH
SFGMFLT FOUFSJL
TFUFNQBU EBO
NFLBOJTNF HBTUSJO ZBOH TFNVBOZB LFNVEJBO
Perangsangan Sekresi Asam oleh Gastrin.(BTUSJOTFOEJSJ
NFOZFCBCLBO UFSKBEJOZB TFLSFTJ HFUBI MBNCVOH TFMBNB CFCFSBQB
NFSVQBLBO TVBUV IPSNPO ZBOH EJTFLSFTJLBO PMFI TFMTFM HBTUSJO
KBNLFUJLBNBLBOBOCFSBEBEJEBMBNMBNCVOH'BTFHBTUSJLTFLSFTJ
KVHBEJTFCVUTFMTFM(4FMTFMJOJCFSBEBEJEBMBNLFMFOKBSQJMPSVT NFNCFOUVL TFLJUBS QFSTFO EBSJ UPUBM TFLSFTJ MBNCVOH ZBOH
EJ VKVOH EJTUBM MBNCVOH (BTUSJO BEBMBI TVBUV QPMJQFQUJEB CFTBS CFSLBJUBO EFOHBO LPOTVNTJ NBLBOBO EBO LBSFOB JUV NFSVQBLBO
ZBOH EJTFLSFTJLBO EBMBN EVB CFOUVL TBUV CFOUVL CFTBS EJTFCVU TFCBHJBO CFTBS EBSJ UPUBM TFLSFTJ MBNCVOH TFIBSJIBSJ ZBJUV
( ZBOH NFOHBOEVOH BTBN BNJOP EBO TBUV CFOUVL ZBOH TFCBOZBLNM
MFCJI LFDJM ( ZBOH NFOHBOEVOH BTBN BNJOP 8BMBVQVO
Fase Intestinal ,FCFSBEBBO NBLBOBO EJ CBHJBO
LFEVBOZB QFOUJOH CFOUVL ZBOH MFCJI LFDJM KVNMBIOZB MFCJI
BUBT VTVT IBMVT LIVTVTOZB QBEB EVPEFOVN BLBO UFSVT
CBOZBL NFOHBLJCBULBO MBNCVOH NFOZFLSFTJ TFKVNMBI LFDJM HFUBI
,FUJLB EBHJOH BUBV NBLBOBO MBJO ZBOH NFOHBOEVOH QSPUFJO QFODFSOBBO NVOHLJO TFCBHJBO BLJCBU TFKVNMBI LFDJM HBTUSJO
NFODBQBJVKVOHBOUSVNMBNCVOH CFCFSBQBQSPUFJOEBSJNBLBOBO ZBOH EJMFQBTLBO PMFI NVLPTB EVPEFOVN *OJ NFMJQVUJ LVSBOH
UFSTFCVUNFNQVOZBJFGFLNFSBOHTBOHLIVTVTQBEBTFMHBTUSJO MFCJIQFSTFOSFTQPOTBTBNUFSIBEBQNBLBOBO
779
1.
2.
3.
Gastrin
1.
2.
Hambatan Sekresi Lambung oleh Faktor Intestinal Pasca- Lambung /BNVO SBOHTBOHBO FNPTJPOBM TFSJOH NFOJOHLBULBO TFLSFTJ
Lainnya MBNCVOHBOUBSQFODFSOBBO TBOHBUQFQUJLEBOBTBN
TBNQBJNM
8BMBVQVO LJNVT JOUFTUJOBM TFEJLJU NFSBOHTBOH TFLSFTJ MBNCVOH KBN BUBV MFCJI EFOHBO DBSB ZBOH TBNB TFQFSUJ GBTF TFGBMJL TFLSFTJ
TFMBNB GBTF JOUFTUJOBM BXBM TFLSFTJ MBNCVOH LJNVT TFCBMJLOZB MBNCVOH NFSBOHTBOH TFLSFTJ QBEB BXBM NBTVLOZB NBLBOBO
NFOHIBNCBUTFLSFTJMBNCVOHQBEBXBLUVZBOHMBJO)BNCBUBOJOJ 1FOJOHLBUBOTFLSFTJEBMBNSFTQPOTOZBUFSIBEBQSBOHTBOHFNPTJPOBM
TFLVSBOHLVSBOHOZBEJTFCBCLBOPMFIEVBQFOHBSVI ZBOH LVBU JOJ EJBOHHBQ TFCBHBJ TBMBI TBUV GBLUPS QFOZFCBC
QFSLFNCBOHBO UVLBL MBNCVOH TFQFSUJ ZBOH BLBO EJCJDBSBLBO QBEB
1. ,FCFSBEBBO NBLBOBO EJ EBMBN VTVT IBMVT NFSBOHTBOH SFGMFLT
#BC
FOUFSPHBTUSJLUFSCBMJL ZBOHEJUSBOTNJTJLBONFMBMVJTJTUFNTBSBG
NJFOUFSJL EBO OFSWVT TJNQBUJT FLTUSJOTJL EBO OFSWVT WBHVT
ZBOH NFOHIBNCBU TFLSFTJ MBNCVOH 3FGMFLT JOJ EBQBU ,PNQPTJTJ,JNJBXJ(BTUSJOEBO)PSNPO(BTUSPJOUFTUJOBM
EJNVODVMLBOEFOHBONFSFHBOHLBOVTVTIBMVT PMFILFCFSBEBBO -BJOOZB
BTBN QBEB VTVT CBHJBO BUBT PMFI LFCFSBEBBO QSPEVL
QFNFDBIBOQSPUFJO BUBVPMFIJSJUBTJNVLPTB3FGMFLTJOJBEBMBI (BTUSJO LPMFTJTUPLJOJO DIPMFDZTUPLJOJOF$$,
EBO TFLSFUJO
CBHJBO EBSJ NFLBOJTNF LPNQMFLT ZBOH EJCJDBSBLBO EBMBN #BC TFNVBOZB NFSVQBLBO QPMJQFQUJEB CFTBS EFOHBO CFSBU NPMFLVM
VOUVL NFNQFSMBNCBU QFOHPTPOHBO MBNCVOH LFUJLB VTVT CFSUVSVUUVSVUTFLJUBS EBO,FMJNBBTBNBNJOP
TVEBIUFSJTJ
UFSNJOBM EBMBN SBOUBJ NPMFLVMFS HBTUSJO EBO $$, BEBMBI TBNB
2. ,FCFSBEBBO BTBN MFNBL QSPEVL QFNFDBIBO QSPUFJO DBJSBO "LUJWJUBT GVOHTJPOBM HBTUSJO UFSMFUBL QBEB LFFNQBU BTBN BNJOP
IJQFSPTNPUJLBUBVIJQPPTNPUJL BUBVTFUJBQGBLUPSJSJUBOQBEB UFSNJOBM EBO BLUJWJUBT $$, CFSBEB QBEB LFEFMBQBO BTBN BNJOP
VTVT IBMVT CBHJBO BUBT NFOZFCBCLBO QFMFQBTBO CFCFSBQB
UFSNJOBM4FNVBBTBNBNJOPEBMBNNPMFLVMTFLSFUJONFSVQBLBO
IPSNPO VTVT 4BUV EJ BOUBSBOZB BEBMBI TFLSFUJO ZBOH
UFSVUBNB QFOUJOH EBMBN NFOHPOUSPM TFLSFTJ QBOLSFBT
BTBNBNJOPFTFOTJBM
/BNVO TFLSFUJO NFMBXBO TFLSFTJ MBNCVOH 5JHB IPSNPO 4VBUV HBTUSJO TJOUFUJT UFSEJSJ BUBT FNQBU BTBN BNJOP UFSNJOBM
MBJO ZBJUV QFQUJEB QFOHIBNCBUHBTUSJL HMVDPTFEFQFOEFOU HBTUSJOBMBNJEJUBNCBIBTBNBNJOPBMBOJO NFNJMJLJTFNVBGBLUPS
JOTVMJOPUSPQJD QFQUJEF
QPMJQFQUJEB JOUFTUJOBM WBTPBLUJG EBO
GJTJPMPHJTTFQFSUJZBOHEJNJMJLJPMFIHBTUSJOBMBNJ#FOUVLTJOUFUJL
TPNBUPTUBUJO TFNVBOZBKVHBNFNQVOZBJFGFLSJOHBOTBNQBJ
TFEBOHEBMBNNFOHIBNCBUTFLSFTJMBNCVOH JOJEJTFCVUQFOUBHBTUSJO
5VKVBOGVOHTJPOBMGBLUPSGBLUPSJOUFTUJOBMZBOHNFOHIBNCBU
TFLSFT MBNCVOH LFNVOHLJOBO BLBO NFNQFSMBNCBU QFSKBMBOBO Sekresi Pankreas
LJNVT EBSJ MBNCVOH LFUJLB VTVT IBMVT TVEBI UFSJTJ BUBV BLUJG
TFDBSB CFSMFCJIBO ,FOZBUBBOOZB SFGMFLT QFOHIBNCBU
FOUFSPHBTUSJL EBO IPSNPOIPSNPO QFOHIBNCBU CJBTBOZB KVHB 1BOLSFBT ZBOH UFSMFUBL TFKBKBS EBO EJ CBXBI MBNCVOH
NFOHVSBOHJ NPUJMJUBT MBNCVOH QBEB TBBU ZBOH CFSTBNBBO LFUJLB EJUVOKVLLBOQBEB(BNCBS
NFSVQBLBOLFMFOKBSDBNQVSBO
SFGMFLT JUV NFOHVSBOHJ TFLSFTJ MBNCVOH TFQFSUJ ZBOH TVEBI ZBOH CFTBS ZBOH LFCBOZBLBO TUSVLUVS CBHJBO EBMBNOZB IBNQJS
EJCJDBSBLBOQBEB#BC TBNB TFQFSUJ LFMFOKBS TBMJWB TFQFSUJ EJUVOKVLLBO EBMBN (BNCBS
Sekresi Gastrik Selama Periode Antar-Pencernaan. -BNCVOH &O[JNFO[JN QFODFSOBBO QBOLSFBT EJTFLSFTJ PMFI BTJOJ
IBOZB NFOZFLSFTJ CFCFSBQB NJMJMJUFS HFUBI MBNCVOH QFS KBNOZB QBOLSFBT EBOTFKVNMBICFTBSMBSVUBOOBUSJVNCJLBSCPOBUEJTFLSFTJ
TFMBNB QFSJPEF BOUBS QFODFSOBBO LFUJLB UJEBL BEB BUBV IBOZB PMFIEVLUVMVTLFDJMEBOEVLUVTMFCJICFTBSZBOHCFSBTBMEBSJBTJOJ
TFEJLJU LFHJBUBO QFODFSOBBO CFSMBOHTVOH EJ VTVT 4FLSFTJ ZBOH 1SPEVL LPNCJOBTJ CFSVQB FO[JN EBO OBUSJVN CJLBSCPOBU JOJ
UFSCFOUVL CJBTBOZB IBNQJS TFMVSVIOZB CFSBTBM EBSJ KFOJT OPO LFNVEJBO NFOHBMJS NFMBMVJ EVLUVT QBOLSFBUJLVT ZBOH QBOKBOH
PLTJOUJL UFSVUBNB UFSEJSJ BUBT NVLVT UBQJ IBOZB TFEJLJU QFQTJO ZBOH OPSNBMOZB CFSHBCVOH EFOHBO EVLUVT IFQBUJLVT UFQBU
EBOIBNQJSUJEBLNFOHBOEVOHBTBN TFCFMVNNFOHPTPOHLBOJTJOZBLFEVPEFOVN
780
NFMBMVJQBQJMB7BUFSJZBOHEJLFMJMJOHJPMFITGJOHUFS0EEJ TBNQBJ FO[JN EJTFLSFTJLBO LF EBMBN VTVT LBSFOB USJQTJO EBO
MBJOOZB BLBO NFODFSOB QBOLSFBT JUV TFOEJSJ 6OUVOHOZB TFM
(FUBI QBOLSFBT EJTFLSFTJ QBMJOH CBOZBL TFCBHBJ SFTQPOT TFMZBOHNFOZFLSFTJFO[JNQSPUFPMJUJLLFEBMBNBTJOJQBOLSFBT
UFSIBEBQ LFCFSBEBBO LJNVT EJ CBHJBO BUBT VTVT IBMVT EBO TFLBMJHVT KVHB NFOZFLSFTJ [BU MBJO ZBOH EJTFCVU QFOHIBNCBU
UNIT XII
LBSBLUFSJTUJL HFUBI QBOLSFBT EJUFOUVLBO TBNQBJ CBUBT UFSUFOUV USJQTJO ;BU JOJ EJCFOUVL EJ EBMBN TJUPQMBTNB TFM LFMFOKBS EBO
PMFI KFOJT NBLBOBO EBMBN LJNVT 1BOLSFBT KVHB NFOZFLSFTJ [BU JOJ NFODFHBI QFOHBLUJGBO USJQTJO CBJL EJ EBMBN TFM
JOTVMJO OBNVO JOTVMJO JOJ UJEBL EJTFLSFTJLBO PMFI KBSJOHBO TFLSFUPSJT NBVQVO EJ EBMBN BTJOJ EBO EVLUVT QBOLSFBUJLVT
QBOLSFBT ZBOH NFOZFLSFTJ HFUBI QBOLSFBT VTVT 4FCBMJLOZB 5SJQTJO JOJMBI ZBOH BLBO NFOHBLUJGLBO FO[JNFO[JN
JOTVMJOEJTFLSFTJMBOHTVOHLFEBSBIUJEBLLFVTVTPMFIQVMBVQVMBV QSPUFPMJUJL QBOLSFBT ZBOH MBJO NBLB QFOHIBNCBU USJQTJO KVHB
-BOHFSIBOT ZBOH UFSKBEJ EJ CBHJBOCBHJBO QVMBV QBEB QBOLSFBT BLBONFODFHBIQFOHBLUJGBOFO[JNZBOHMBJO
)BMJOJBLBOEJCBIBTMFCJINFOEFUBJMQBEB#BC
+JLB QBOLSFBT NFOKBEJ TBOHBU SVTBL BUBV KJLB EVLUVT
UFSTVNCBU TFKVNMBI CFTBS TFLSFTJ QBOLSFBT LBEBOH BLBO
Enzim-Enzim Pencernaan Pankreas CFSUVNQVL QBEB EBFSBI QBOLSFBT ZBOH SVTBL 1BEB LPOEJTJ
4FLSFTJ QBOLSFBT NFOHBOEVOH CBOZBL FO[JN VOUVL NFODFSOB JOJ FGFL QFOHIBNCBU USJQTJO TFSJOH TBOHBU LVBU EBO QBEB
UJHB KFOJT NBLBOBO VUBNB QSPUFJO LBSCPIJESBU EBO MFNBL LBTVT UFSTFCVU TFLSFTJ QBOLSFBT TFDBSB DFQBU NFOKBEJ BLUJG
4FLSFTJJOJKVHBNFOHBOEVOHTFKVNMBICFTBSJPOCJLBSCPOBU ZBOH EBO EBQBU CFOBSCFOBS NFODFSOB TFNVB QBOLSFBT EBMBN
NFNFHBOHQFSBOBOQFOUJOHEBMBNNFOFUSBMLBOLFBTBNBOLJNVT XBLUV CFCFSBQB KBN NFOHBLJCBULBO LPOEJTJ ZBOH EJTFCVU
ZBOHEJLFMVBSLBOEBSJMBNCVOHLFEBMBNEVPEFOVN QBOLSFBUJUJT BLVU ,FBEBBO JOJ LBEBOH NFNBUJLBO LBSFOB
EJTFSUBJ TZPL TJSLVMBTJ EBO CBILBO CJMB UJEBL NFNBUJLBO
&O[JNFO[JN QBOLSFBT ZBOH QBMJOH QFOUJOH VOUVL NFODFSOB EBQBU NFOHBLJCBULBO JOTVGJTJFOTJ QBOLSFBT ZBOH NFOFUBQ
QSPUFJOBEBMBIUSJQTJO LJNPUSJQTJO EBOLBSCPLTJQPMJQFQUJEBTF4FKBVI TFVNVSIJEVQ
JOJ ZBOHQBMJOHCBOZBLBEBMBIUSJQTJO
Sekresi lon-lon Bikarbonat
5SJQTJO EBO LJNPUSJQTJO NFNFDBI TFMVSVI EBO TFCBHJBO
QSPUFJO ZBOH EJDFSOB NFOKBEJ QFQUJEB CFSCBHBJ VLVSBO UFUBQJ 8BMBVQVO FO[JN HFUBI QBOLSFBT TFMVSVIOZB EJTFLSFTJLBO PMFI
UJEBL NFOZFCBCLBO QFMFQBTBO BTBNBTBN BNJOP /BNVO BTJOJ EBO LFMFOKBS QBOLSFBT EVB LPNQPOFO QFOUJOH MBJO EBSJ
LBSCPLTJQPMJQFQUJEBTF UFSOZBUB NFNFDBILBO CFCFSBQB QFQUJEB HFUBI QBOLSFBT ZBJUV JPO CJLBSCPOBU EBO BJS EJTFLSFTJLBO
NFOKBEJ BTBNBTBN BNJOP TFIJOHHB NFOZFMFTBJLBO QFODFSOBBO UFSVUBNB PMFI TFMTFM FQJUFM EBO EVLUVMVT EBO EVLUVT ZBOH
CFCFSBQBQSPUFJONFOKBEJCFOUVLBTBNBNJOP LFMVBS EBSJ BTJOJ +JLB QBOLSFBT EJSBOHTBOH VOUVL
NFOZFLSFTJLBO TBOHBU CBOZBL HFUBI QBOLSFBT LPOTFOUSBTJ JPO
&O[JN QBOLSFBT VOUVL NFODFSOB LBSCPIJESBU BEBMBI
CJLBSCPOBU BLBO NFOJOHLBU TBNQBJ TFUJOHHJ N&R- TVBUV
BNJMBTF QBOLSFBT ZBOH BLBO NFOHIJESPMJTJT QBUJ HMJLPHFO
BOHLB TFLJUBS MJNB LBMJ MFCJI CFTBS EBSJ JPO CJLBSCPOBU EBMBN
EBO TFCBHJBO CFTBS LBSCPIJESBU MBJO LFDVBMJ TFMVMPTB
VOUVL
QMBTNB ,FBEBBO JOJ NFOHIBTJMLBO TFKVNMBI CFTBS JPO BMLBMJ
NFNCFOUVL TFCBHJBO CFTBS EJTBLBSJEB EBO CFCFSBQB
QBEB HFUBI QBOLSFBT ZBOH CFSGVOHTJ VOUVL NFOFUSBMLBO BTBN
USJTBLBSJEB
IJESPLMPSJEB ZBOH EJLFMVBSLBO EBSJ MBNCVOH LF EBMBN
&O[JN VUBNB VOUVL NFODFSOB MFNBL BEBMBI
MJQBTF EVPEFOVN
QBOLSFBT ZBOH NBNQV NFOHIJESPMJTJT MFNBL OFUSBM NFOKBEJ -BOHLBIMBOHLBIEBTBSNFLBOJTNFTFMVOUVLTFLSFTJMBSVUBO
BTBN MFNBL EBO NPOPHMJTFSJEB
LPMFTUFSPM FTUFSBTF ZBOH OBUSJVN CJLBSCPOBU LF EBMBN EVLUVMVT EBO EVLUVT
NFOZFCBCLBO IJESPMJTJT FTUFS LPMFTUFSPM EBO
GPTGPMJQBTF QBOLSFBUJLVT EJQFSMJIBULBO QBEB (BNCBS -BOHLBI
ZBOHNFNFDBIBTBNMFNBLEBSJGPTGPMJQJE MBOHLBIUFSTFCVUBEBMBITFCBHBJCFSJLVU
4BBU QFSUBNB LBMJ EJTJOUFTJT EBMBN TFMTFM QBOLSFBT FO[JN 1. ,BSCPO EJPLTJEB CFSEJGVTJ EBSJ EBSBI LF CBHJBO EBMBN TFM
FO[JN QFODFSOBBO QSPUFPMJUJL JOJ UFSEBQBU EBMBN CFOUVL UJEBL EBO EJ CBXBI QFOHBSVI LBSCPOJL BOIJESBTF CFSHBCVOH
BLUJG CFSVQB USJQTJOPHFO LJNPUSJQTJOPHFO EBO QSPLBSCPLTJ EFOHBO BJS VOUVL NFNCFOUVL BTBN LBSCPOBU )$0

QPMJQFQUJEBTF ZBOHTFNVBOZBTFDBSBFO[JNBUJLUJEBLBLUJG4FNVB "TBN LBSCPOBU LFNVEJBO CFSEJTPTJBTJ NFOKBEJ JPO
FO[JN JOJ BLBO NFOKBEJ BLUJG IBOZB TFTVEBI EJTFLSFTJ LF EBMBN CJLBSCPOBU EBO JPO IJESPHFO )$0 EBO )
,FNVEJBO
TBMVSBO QFODFSOBBO 5SJQTJOPHFO EJBLUJGLBO PMFI FO[JN ZBOH JPOCJLBSCPOBUTFDBSBBLUJGEJUSBOTQPSCFSTBNBEFOHBOJPO
EJTFCVU FOUFSPLJOBTF ZBOH EJTFLSFTJ PMFI NVLPTB VTVT LFUJLB OBUSJVN /B
NFMBMVJ UFQJ MVNJOBM TFM LF EBMBN MVNFO
LJNVT CFSLPOUBL EFOHBO NVLPTB +VHB USJQTJOPHFO EBQBU EVLUVT
EJBLUJGLBO TFDBSB PUPLBUBMJTBTJ PMFI USJQTJO ZBOH TVEBI UFSCFOUVL
EBSJ USJQTJOPHFO ZBOH TFCFMVNOZB EJTFLSFTJ ,JNPUSJQTJOPHFO 2. *POIJESPHFOZBOHUFSCFOUVLNFMBMVJEJTPTJBTJBTBNLBSCPOBU
EJBLUJGLBO PMFI USJQTJO VOUVL NFNCFOUVL LJNPUSJQTJO EBO EJ EBMBN TFM EJUVLBS EFOHBO JPO OBUSJVN NFMBMVJ CBHJBO TFM
QSPLBSCPLTJQPMJQFQUJEBTFEJBLUJGLBOEFOHBODBSBZBOHTFSVQB ZBOH CFSCBUBTBO EFOHBO EBSBI NFMBMVJ QSPTFT USBOTQPS BLUJG
TFLVOEFS 1SPTFT JOJ NFOZFCBCLBO UFSTFEJBOZB JPO OBUSJVN
Sekresi Penghambat Tripsin Mencegah Pencernaan /B
ZBOH LFNVEJBO EJUSBOTQPS NFMBMVJ UFQJ MVNJOBM LF
Pankreas itu Sendiri. "EBMBI QFOUJOH CBIXB FO[JNFO[JN EBMBN MVNFO EVLUVT QBOLSFBUJLVT VOUVL NFOFUSBMLBO
QSPUFPMJUJLHFUBIQBOLSFBTUJEBLNFOKBEJBLUJGFO[JNFO[JN LFMJTUSJLBOJPOCJLBSCPOBUZBOHEJTFLSFTJ
781
NFMJQBUHBOEBLBOBUBVNFNQFSLVBUTBUVTBNBMBJO+BEJ TFLSFTJ
Lumen
QBOLSFBT OPSNBMOZB EJIBTJMLBO EBSJ FGFL HBCVOHBO CFSCBHBJ
SBOHTBOHEBTBS UJEBLIBOZBEBSJTBUVSBOHTBOH
Fase-Fase Sekresi Pankreas

Na+ Na+ Na+ 4FLSFTJ QBOLSFBT UFSKBEJ EBMBN UJHB GBTF TBNB EFOHBO TFLSFTJ
H+ H+ HCO 3 HCO 3 HBTUSJL GBTF TFGBMJL GBTF HBTUSJL EBO GBTF JOUFTUJOBM $JSJDJSJOZB
H2CO3 BEBMBITFCBHBJCFSJLVU
(Carboni anh drase)
H2O
Fase Sefalik dan Gastrik 4FMBNB GBTF TFGBMJL TFLSFTJ
+ QBOLSFBT TJOZBMTJOZBM TBSBG ZBOH TBNB EBSJ PUBL ZBOH
CO2 CO2 NFOZFCBCLBO TFLSFTJ EBMBN MBNCVOH KVHB NFOZFCBCLBO
H2O H2O BTFUJMLPMJO EJMFQBTLBO PMFI VKVOHVKVOH OFSWVT WBHVT EBMBN
QBOLSFBT )BM JOJ NFOZFCBCLBO FO[JN EBMBN KVNMBI TFEBOH
EJTFLSFTJ LF EBMBN BTJOJ QBOLSFBT NFOHIBTJMLBO LVSBOH MFCJI
QFSTFOEBSJUPUBMTFLSFTJFO[JNQBOLSFBTTFTVEBINBLBO/BNVO
TFKVNMBI LFDJM TFLSFTJ TFHFSB NFOHBMJS LFMVBS NFMBMVJ EVLUVT
QBOLSFBUJLVTLFEBMBNVTVTLBSFOBIBOZBTFEJLJUBJSEBOFMFLUSPMJU
ZBOHEJTFLSFTJCFSTBNBBOEFOHBOFO[JN
3. ,FTFMVSVIBOHFSBLBOJPOOBUSJVNEBOCJLBSCPOBUEBSJEBSBI
4FMBNB GBTF HBTUSJL SBOHTBOH TBSBG UFSIBEBQ TFLSFTJ FO[JN
LFMVNFOEVLUVTNFNCFOUVLHSBEJFOUFLBOBOPTNPUJLZBOH
CFSMBOKVU UFSVT NFOHIBTJMLBO MBHJ TFCBOZBL TBNQBJ QFSTFO
NFOZFCBCLBO PTNPTJT BJS KVHB LF EBMBN EVLUVT QBOLSFBUJ
FO[JN QBOLSFBT ZBOH EJTFLSFTJ TFTVEBI NBLBO 8BMBVQVO
LVT TFIJOHHB NFNCFOUVL MBSVUBO CJLBSCPOBU ZBOH IBNQJS
EFNJLJBO IBOZBTFKVNMBILFDJMZBOHNFODBQBJEVPEFOVNLBSFOB
TFMVSVIOZBJTPTNPUJL
UJEBLBEBOZBTFLSFTJDBJSBOTFDBSBUFSVTNFOFSVT
Pengaturan Sekresi Pankreas Fase Intestinal. 4FTVEBI LJNVT NFOJOHHBMLBO MBNCVOH
Rangsangan Dasar yang Menyebabkan Sekresi Pankreas NBTVL LF EBMBN VTVT IBMVT TFLSFTJ QBOLSFBT NFOKBEJ TBOHBU
CBOZBL UFSVUBUOBTFCBHBJSFTQPOTUFSIBEBQIPSNPOTFLSFUJO
5JHBSBOHTBOHBOEBTBSZBOHQFOUJOHEBMBNNFOZFCBCLBOTFLSFTJ
QBOLSFBT Sekretin Merangsang Sekresi lon Bikarbonat dalam
Jumlah Sangat Banyak yang menetralisasi Kimus
1. "TFUJMLPMJO ZBOH EJMFQBTLBO EBSJ VKVOHVKVOH OFSWVT WBHVT
Lambung yang Asam. 4FLSFUJO BEBMBI QPMJQFQUJEB ZBOH
QBSBTJNQBUJT EBO EBSJ TBSBGTBSBG LPMJOFSHJL MBJO EJ EBMBN
NFOHBOEVOHBTBNBNJOP CFSBUNPMFLVMTFLJUBS
EBMBN
TJTUFNTBSBGFOUFSJL
CFOUVL ZBOH UJEBL BLUJG ZBJUV QSPTFLSFUJO KVHB EJTFCVU TFM 4 EJ
2. ,PMFTJTUPLJOJO ZBOH EJTFLSFTJ PMFI NVLPTB EVPEFOVN EBO EBMBN NVLPTB EVPEFOVN EBO ZFZVOVN #JMB LJNVT ZBOH BTBN
ZFZFOVNCBHJBOBUBTLFUJLBNBLBOBONBTVLLFEBMBNVTVT EFOHBO Q) LVSBOH EBSJ TBNQBJ NBTVL EBSJ MBNCVOH LF
IBMVT EBMBN EVPEFOVN LJNVT UFSTFCVU NFOZFCBCLBO NVLPTB
3. 4FLSFUJO ZBOH KVHB EJTFLSFTJ PMFI NVLPTB EVPEFOVN EBO EVPEFOVN NFMFQBTLBO EBO NFOHBLUJGLBO TFLSFUJO ZBOH TFUFMBI
ZFZVOVN LFUJLB NBLBOBO ZBOH TBOHBU BTBN NBTVL LF VTVT JUVEJBCTPSCTJLFEBMBNEBSBI4BMBITBUVVOTVSQPLPLLJNVTZBOH
IBMVT CFOBSCFOBS NFOZFCBCLBO QFMFQBTBO TFLSFUJO JOJ BEBMBI BTBN
IJESPLMPSJEBMBNCVOH
,FEVBTUJNVMVTQFSUBNBUFSTFCVU BTFUJMLPMJOEBOLPMFTJTUP
LJOJO NFSBOHTBOH TFMTFM BTJOBS QBOLSFBT NFOZFCBCLBO 4FLSFUJO LFNVEJBO NFOZFCBCLBO QBOLSFBT NFOZFLSFTJ
EJIBTJMLBOOZB FO[JNFO[JN QFODFSOBBO QBOLSFBT EBMBN TFKVNMBI CFTBS DBJSBO ZBOH NFOHBOEVOH JPO CJLBSCPOBU
KVNMBICFTBSUFUBQJEFOHBOKVNMBIBJSEBOFMFLUSPMJUZBOH

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Guyton and Hall

Textbook of Medical Physiology

Library of Congress Cataloging-in-Publication Data

Publishing Director: William Schmitt

UNIT I Apoptosis Kematian Sel yang Terprogram 40

Fisiologi Pengobatan Syok 280 Kelainan Mikturisi 310

PengaturanEkskresi Kalsium oleh Ginjal dan BAB 31

UNIT IX Reseptor Nyeri dan Rangsangannya 583

BAB 53 Fungsi Otak dalam Proses Komunikasi Inpus

UNIT XII Gangguan-Gangguan Lambung 799

Vitamin D, dan Penyakit Tulang 967 Fungsi Plasenta 1005

Fisiologi Manusia 1BEB 'JTJPMPHJ .BOVTJB LJUB CFSVQBZB

$BJSBO JOUSBTFMVMBS TBOHBU CFSCFEB EBSJ DBJSBO

Mekanisme “Homeostatik” Berbagai Sistem

Sistem Transportasi dan Pencampuran

Pengaturan Fungsi Tubuh

5VKVBO CBC JOJ BEBMBI NFOFOLBOLBO QFSUBNB TVTVOBO UVCVI

Protein 4FUFMBI BJS [BU LFEVB UFSCBOZBL EBMBN TFM BEBMBI

lon*POQFOUJOHEBMBNTFMNFODBLVQLBMJVN NBHOFTJVN GPTGBU

DNA dan kromosom

Mitokondria Retikulum Retikulum Mikrofilamen

#BEBO (PMHJ CFLFSKB TBNB EFOHBO SFUJLVMVN FOEPQMBTNB

.JUPLPOESJB EBQBU NFSFQMJLBTJ EJSJ ZBOH CFSBSUJ TBUV

ik o l s ang diam il da i lagela se a

Sistem Fungsional Sel

Sintesis Lipid oleh Retikulum Endoplasma Halus.

Jenis Vesikel yang Dibentuk oleh Badan Golgi-Vesikel NH2

"51 1SPTFT SFBLTJ UFSTFCVU TBOHBU SVNJU EBO NFNCVUVILBO

Jenis Sel yang Memperlihatkan Gerakan Ameboid. 4FM

Silia dan Gerakan Silia

Gen-Gen dalam Inti Sel

%/" UFSTVTVO EBSJ BTBN GPTGBU EBO NPMFLVM EFPLTJSJCPTB TFDBSB

Penyusunan Nukleotida untuk Membentuk Dua Untai

EBO NFNJMJOOZB NFOKBEJ TFCVBI IFMJLT 4FQVMVI QBTBOH

#BTB%/" #BTB%/"  3/" NJLSP NJ3/"

Asam Amino RNA Kodon

Alanin GCU GCC GCA GCG

CI, pemulai-rantai; CT, pengakhir-rantai

SFUJLVMVNEBONBTVLLFEBMBNNBUSJLTSFUJLVMVNFOEPQMBTNB TFCBHBJ CFSJLVU 

AA1 AA2 AA20

asi AA1 AA2 AA20

AA1 AA2 AA20

AA1 AA5 AA3 AA9 AA2 AA13 AA20

5SBOTLSJQTJ HFO QBEB FVLBSJPUB KVHB EJQFOHBSVIJ PMFI PMFIQSPUFJOMBJO4FMBNB%/"CFSBEBEBMBNLFBEBBOQBEBU %/"

4FCVBI DPOUPI NFOBSJL MBJO NFOHFOBJ QFOHIBNCBUBO FO[JN

Ringkasan 3JOHLBTBOOZB BEB EVB NFUPEF VUBNB CBHJ TFM

Sistem Genetik DNA juga Mengendalikan Reproduksi Sel

3FQSPEVLTJ TFM NFSVQBLBO TVBUV DPOUPI MBJO EBSJ QFSBO ZBOH

. ,FEVBVOUBJIFMJLT%/"TFMVSVIOZBEJSFQMJLBTJEBSJVKVOHLF Kromosom dan Replikasinya

TBUVTBNBMBJO1BEBXBLUVZBOHTBNB NJLSPUVCVMVTMBJOUVNCVI Pengendalian Pertumbuhan Sel dan Reproduksi Sel

6. Kontraksi Otot Rangka

7. Eksitasi Otot Rangka: Penghantaran

4USVLUVS NFNCSBO ZBOH NFOZFMVCVOHJ CBHJBO MVBS TFUJBQ TFM

CFSCFEB TBNB TFLBMJ EBMBN NFOUSBOTQPS [BU[BU 4USVLUVS

HFSBLBO NPMFLVM " NFOKBEJ MBNCBU ZBOH NFOHBMBNJ LFIJMBOHBO

Difusi Air dan Molekul Tidak Larut-Lipid Lainnya melalui

.PMFLVM UJEBL MBSVUMJQJE MBJOOZB EBQBU MFXBU NFMBMVJ LBOBM

Difusi melalui Pori-pori dan Kanal Protein-Permeabilitas

LBOJTNF JOJ UJEBL QFSOBI EBQBU NFMFCJIJ LFDFQBUBO QFSVCBIBO

JOJTBNBEFOHBOUFLBOBOPTNPUJLMBSVUBOZBOHNFOHBOEVOH[BU BLJCBUOZB LFEVBJPOUFSTFCVUUJEBLEBQBUCFSHFSBLEFOHBOCFCBT

CFSEJGVTJEFOHBONVEBILFEBMBNTFM,FNVEJBO QBEBCBHJBO tension, Hypertension 53:291, 2009.

Transpor Aktif lon Natrium dan Kalium melalui

Na+ (di dalam): 14 mEq/L

Fisiologi Manusia 1BEB 'JTJPMPHJ .BOVTJB LJUB CFSVQBZB

Protein 4FUFMBI BJS [BU LFEVB UFSCBOZBL EBMBN TFM BEBMBI

lon*POQFOUJOHEBMBNTFMNFODBLVQLBMJVN NBHOFTJVN GPTGBU

#BEBO (PMHJ CFLFSKB TBNB EFOHBO SFUJLVMVN FOEPQMBTNB

"51 1SPTFT SFBLTJ UFSTFCVU TBOHBU SVNJU EBO NFNCVUVILBO

EBO NFNJMJOOZB NFOKBEJ TFCVBI IFMJLT 4FQVMVI QBTBOH

#BTB%/" #BTB%/" 3/" NJLSP NJ3/"

SFUJLVMVNEBONBTVLLFEBMBNNBUSJLTSFUJLVMVNFOEPQMBTNB TFCBHBJ CFSJLVU

5SBOTLSJQTJ HFO QBEB FVLBSJPUB KVHB EJQFOHBSVIJ PMFI PMFIQSPUFJOMBJO4FMBNB%/"CFSBEBEBMBNLFBEBBOQBEBU %/"

Ringkasan 3JOHLBTBOOZB BEB EVB NFUPEF VUBNB CBHJ TFM

. ,FEVBVOUBJIFMJLT%/"TFMVSVIOZBEJSFQMJLBTJEBSJVKVOHLF Kromosom dan Replikasinya

TBUVTBNBMBJO1BEBXBLUVZBOHTBNB NJLSPUVCVMVTMBJOUVNCVI Pengendalian Pertumbuhan Sel dan Reproduksi Sel

CFSCFEB TBNB TFLBMJ EBMBN NFOUSBOTQPS [BU[BU 4USVLUVS

.PMFLVM UJEBL MBSVUMJQJE MBJOOZB EBQBU MFXBU NFMBMVJ LBOBM

CFSEJGVTJEFOHBONVEBILFEBMBNTFM,FNVEJBO QBEBCBHJBO tension, Hypertension 53:291, 2009.

Kontribusi Pompa Na+-K+.1BEB(BNCBS$ QPNQB/B,

WPMUBTF JOUSBTFMVMBS UFUBQ QBEB OJMBJ OPM ZBOH EJQFSMVLBO 6OUVL

UVCVI VOUVL NFODFUVTLBO QPUFOTJBM BLTJ TBSBG BUBV PUPU UFLBOBO

1BEB UJUJL $ EBMBN (BNCBS SBOHTBOHBO CBILBO MFCJI LVBU

'JMBNFO NJPTJO EJCFOUVL PMFI BUBV MFCJI NPMFLVM NJPTJO

,FBEBBOUFSTFCVUNFNCBXBLJUBLFQBEBQFSBOJPOLBMTJVN PUPUCFSLPOUSBLTJ UJNCVMTVBUVLFSKBEBONFNCVUVILBOFOFSHJ

PUPU ,FBEBBO JOJ EJTFCVU LFMFMBIBO GBUJHVF

CFCFSBQBPCBUBOUJLPMJOFTUFSBTFMBJOOZB ZBOHBLBONFNVEBILBO 3. ,FDFQBUBO QFOHIBOUBSBO TBNQBJ NFUFSEFUJL LJSB

(BNCBS EBO NFOVOKVLLBO CBIXB QPUFOTJBM BLTJ EBSJ

QFSJPEFMBUFOTFCFMVNLPOUSBLTJNVMBJUFSKBEJQFSJPEFMBUFOJOJ Pompa Kalsium Dibutuhkan untuk Menimbulkan Relaksasi

UJNCVMOZB QPUFOTJBM BLTJ )BTJMOZB QFNCFOUVLBO QPUFOTJBM BLTJ

,POEVLTJ 4BUV "SBI NFMBMVJ #FSLBT "7 4FCVBI LBSBLUFSJTUJL

4BEBQBO 6OUVL NFSFLBN TBEBQBO BOHHPUB CBEBO

LBSFOB JTJ QFSVU BLBO NFOFLBO EJBGSBHNB LF BUBT EBO

EJBOBMJTJT QBEB (BNCBS ZBOH NFNQFSMJIBULBO TFCVBI

LBQBO UJEBL BEB BSVT NFOHBMJS EJ TFLFMJMJOH KBOUVOH /BNVO

"OBMJTJT JOJ KFMBT LPNQMFLT /BNVO NBIBTJTXB IBSVT

#FCFSBQB UJQF LFMBJOBO GVOHTJ EFOZVU QFS EFSBKBU $FMTJVT

EFUJL TFCBMJLOZBQBEBZBOHOPSNBM EFUJLBUBVLVSBOH+BEJ Sindrom Stokes-Adams—Ventricular Escape.