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REFLEKS & ARCUS REFLEKS

By
Dr. May Valzon MSc

A reflex is a fast, automatic, unplanned


sequence of actions that occurs in response to
a particular stimulus
Klasifikasi: inborn (bawaan lahir) dan
aquiared/learned (dapatan; dipelajari); refleks
cerebral/cranial vs refleks spinal; refleks
somatik vs refleks visceral (autonom)
The pathway followed by nerve impulses that
produce a reflex is a reflex arc (reflex circuit)

Komponen Arcus Refleks

Empat Refleks Somatik Spinal


The Stretch Reflex (refleks renggangan)
A stretch reflex causes contraction of a skeletal
muscle (the effector) in response to stretching of
the muscle

The Tendon Reflex (refleks tendon)


Refleks Fleksor (Withdrawal Refleks)
Crossed Extensor Reflexes

The Stretch Reflex (Refleks Renggang)

Refleks ipsilateral

The Tendon Reflex (refleks tendon)

Refleks Fleksor/withdrawal

Crossed Extensor
Reflexes

Berjalan (walking) = The Gait Cycle


Pergerakan ekstrimitas inferior selama berjalan terdiri
dari 2 fase:
Stance phases
Swing phases

Gait cycle one cycle of swing and stance by one limb


Stance phase begins with heel strike and ends with
push off from the forefoot 60%
The swing phase begins after push off and ends when
the heel strikes the ground 40%
Berlari stance phase berkurang

Siklus Berjalan

Articulatio Ekstrimitas Inferior


Coxa
Genus
Tallo-cruralis
A. Normal; B. Genu varum; C. Genu valgum

Knee Joint = Artic. Genus = Lutut


Tipe gynglimus + kemampuan rotasi (trochoid)
melibatkan dua condylus artic. Bicondylaris
Facies articularis condylus lateral et medial os femur dan
tibia
Facies patellaris os. Femur dan facies articularis patella
Plg sering cedera pada olahragawan distabilkan dengan
pemanasan m. quadriceps femoris
Ligamentum: 5 extracapsularis (intrinsik)

Lig. patellae
LCF
LCT
Lig. popliteum obliquum
Lig. popliteum arcuatum

Intra-articular ligaments:
Lig.cruciatum anterius (LCA)
Lig. cruciatum posterius (LCP)
Meniscus

Gerakan

Struktur yang membatasi gerakan

Flexion (femoropatellar and


femorotibial)

Soft tissue apposition posteriorly


Tension of vastus lateralis, medialis,
and intermedius
Tension of rectus femoris (especially
with hip joint extended)

Extension (femoropatellar and


femorotibial)

Ligaments: anterior cruciate and


posterior cruciate, fibular and tibial
collateral, posterior joint capsule, and
oblique popliteal ligament
Ligaments: anterior cruciate and
posterior cruciate

Internal rotation (femorotibial with


knee flexed)
External rotation (femorotibial with
knee flexed)

Ligaments: fibular and tibial collateral

Bursae disekitar lutut: ada setidaknya 12 bursae:


b. Prepatellaris , b. Infrapatellris profunda, b.
Supra patellaris, bursa subpoplitea, b. anserina
Arteri : ada 10 cabang anastomosis (rate
articularis genus)
A. femoralis a. descendens genus
A. poplitea a. superior medial genus dan a.inferior
medialis genus, a.superior lateralis genus, a.inferior
lateralis genus
R. reccurens a.tibialis ant
A. circumflexa fibularis

Nervus : branches from the femoral, tibial, and


common fibular nerves and the obturator and
saphenous nerves

Genu Valgum (kaki X) dan Genu Varum (kaki


O)

arthrosis

Knee Joint Injuries


ligament sprain
Knee Replacement
osteoarthritis
Bursitis in the Knee
Region

Ankle Joint (Artic. Talocruralis) =


Gelang Kaki

Tipe gynglimus; uni-axial;


Gerakan: platar fleksi (fleksi) dan dorsifleksi (ekstensi)
Malleolar mortise vs trochlea tali
Ligamentum
lateral: lig. talofibulare anterius; lig. talofibulare posterius;
lig. calcaneofibularis
medial: Lig. collaterale mediale (deltoideum) stabilisasi
sendi sewaktu eversi (mencegah subluksasi)

Arteri: ramus maleolaris a.tibialis ant, post, dan


fibularis
Nervus: cabang n.tibialis dan n. fibularis profundus

Ankle Joint (Artic. Talocruralis) =


Gelang Kaki
Cedera artic. Talocruralis

Sendi yg paling sering cedera


Plg seirng: Ankle sprains inversion
injury
Robek lig. talofibulare anterius
Pott fracture (dislocation of the ankle)
eversi
tarsal tunnel syndrome Entrapment
and compression of the tibial nerve

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