INERVASI DAN VASKULARISASI OR$AN VIS%ERA A&DOMEN dr. Ardhiyanti Puspita Ratna FAKULTAS KEDOKTERAN UNIVERSITAS ISLAM AL AZHAR MATARAM !"#
A'd()*n 'a+ian
trun,us yan+ t*r-*ta antara th(ra/ dan p*-0is. P*rsara1an dan 0asu-arisasi 0asu-arisasi a'd()*n )*-iputi dindin+ dan (r+an 0is,*ra a'd()*n
A'd()*n 'a+ian
trun,us yan+ t*r-*ta antara th(ra/ dan p*-0is. P*rsara1an dan 0asu-arisasi 0asu-arisasi a'd()*n )*-iputi dindin+ dan (r+an 0is,*ra a'd()*n
2
ESOFA$US Vasu-arisasi Art*ri
4
4
a.+astri,a
sinistra 5,a'an+
*s(1a+*a-6 a.phr*ni,a in1. sinistra
3
7
"!
V*na
4 0.a8y+(s V.+astri,a sinistra vv.oesophagica
dg v.gastrica (S) portal
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anastomose masuk sistem
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$ASTER Vasu-arisasi
4 Art*ri dr ,a'an+ a.,(*-ia,a 4 A.+astri,a sinistra A.h*pati,a ,())unis A.-i*na-is M*)'*ntu
anast()(sis pd p*r)uaan 0*ntra- 9 d(rsa- 5tu.pd )u(sa6
"#
A.+astri,a
sinistra 'a+.sup.,ur0atura )in(r 5,(rpus:,ardia:1undus6 9 'a+.,auda- (*s(pha+us A.h*pati,a ,())unis: )*)'*ri ,a'an+ 4 A.h*pati,a pr(pria: )*)'*ri ,a'an+ a.+astri,a d*/tra 'a+.in1.,ur0atura )in(r 5py-(rus6 A.+astr(du(d*na-is: )*)'*ri ,a'an+ A.+astr(*pip-(i,a d*/tra 'a+.in1.,ur0atura )a;(r 5py-(rus:,(rpus6
A.-i*na-is:
punya ,a'an+ 4
A. +astr(*pip-(i,a sinistra 'a+.iri 'a
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V*na
4
0.+astri,a
sinistra V.+astri,a d*/tra V.+astr(*pip-(i,a d*/tra V. +astr(*pip-(i,a sinistra V.+astri,a 'r*0is 0.p(rta V.)*s*nt*ri,a sup. 0.p(rta 0.-i*na-is 0.p(rta %ur0atura
"2
)in(r 4 0.,(r(naria 0*ntri,u-i anast()(s* d+. 00.(*s(pha+i,a* 5p-*/us 0*n(us (*s(pha+i,us6 %ur0atura )a;(r 4 0.+astr(*pip-(i,a d*/tra dan sinistra
"3
du(d*nu) Vas,u-arisasi @
4
Art*ri 4 A.pan,r*ati,( du(d*na-* sup. ,a'an+ A.+astr( du(d*na-is ,a'an+ A.,(*-ia,a A.pan,r*ati,( du(d*na-* in1. ,a'an+ A.)*s*nt*ri,a sup. anast()(sis 5di p*r)uaan 0*ntra9 d(rsa-6 )*)'*ntu ar,ad*n Art*ri )*-a-ui 'a+.,*un+ 5iri du(d*nu)6
"7
!
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V*na
4 B art*ri 0.)*s*nt*ri,a sup.
0.p(rta
C*;unu) dan i-*u) Vasu-arisasi
4
Art*ri dari
,a'an+ a.)*s*nt*ri,a sup*ri(r 4
Aa.;*;una-*s Aa.i-*i
Da-a)
)*s(st*niu) )*)'*ntu anast()(sis 5ar,ad*n6 ,a'an+ -an+sun+ y+ -urus * dindin+ usus 5a.r*,ta6 di dindin+ usus p*,ah ;adi )asin+ )*n+*-i-in+i usus anast()(sis
Pd
pan+a- 5p*r-*atan )*s(st*niu) d+.dindin+ usus6 anast()(sis anast()(sis -(n+itudina-
#
=
V*na B
art*ri 0.)*s*nt*ri,a sup. 0.p(rta
>
%a*,u) Vas,u-arisasi 4 Art*ri 4 @ %a'an+@,a'an+ dari A.i-*(,(-i,a V*na 4
0.i-*(,(-i,a
?
0.)*s*nt*ri,a
sup
0.p(rta
App*ndi/ 0*r)i,u-aris Vas,u-arisasi 4 Art*ri 4 a.app*ndi,u-aris V*na
4
V. I-*(,(-i,a
0.)*s*nt*ri,a
sup.
0.p(rta
%(-(n as,*nds dan trans0*rsu) @ Art*ri 4 %a'an+@,a'an+ A.)*s*nt*ri,a sup*ri(r 4 A.,(-i,a )*dia 5t*ruta)a6 A.,(-i,a d*/tra %a'an+ A.)*s*nt*ri,a in1*ri(r 4 A.,(-i,a sinistra
@ V*na 4 V.)*s*nt*ri,a sup*ri(r
)*)'*ntu
)ar+ina- art*ry s*p*rti p*riar,ad*n 0asa r*,ta dindin+ usus P*)'u-uh darah '*r;a-an r*tr(p*rit(n*a-: *,. A.,(-i,a )*dia 9 Aa.si+)(id*a 5di da-a) )*s(,(-(n trans0*rsu) 9 )*s(si+)(id6 A.,(-i,a d*/tra s*rin+ )*)'*ntu pan+ay+ sa)a d+. A.,(-i,a )*dia A.i-*(,(-i,a
%(-(n trans0*rsu) d*s,*nd*ns @ si+)(id @ Art*ria-isasi 4 %a'an+@,a'an+ A.)*s*nt*ri,a in1. 4 A.,(-i,a sinistra A.si+)(id*a @ V*na 4 0.)*s*nt*ri,a in1.
R*,tu) @ anus Art*ri
4
%a'an+@,a'an+
A.)*s*nt*ri,a in1. 4
Aa.
Si+)(id*a A.ha*)(rr(idha-is sup. V*na
4
Tdp
anast()(sis antara 4 V.ha*)(rrh(ida-is sup. 0.)*s*nt*ri,a in1. 0.p(rta V.ha*)(rrh(ida-is )*dius 0.i-ia,a int*rna V.ha*)(rrh(ida-is in1. 0.pud*nda 0.i-ia,a int*rna
PERSARAFAN ORGAN ORGAN A!"O#EN Or+an
(r+an da-a) a'd()*n dip*rsara (-*h ,a'an+ ,a'an+ p-*/us (t(n(). P-*/us p-*/us (t(n() da-a) a'd()*n P$E%&S 'OE$A'&S P$E%&S #ESENER'&S S&PEROR P$E%&S #ESENER'&S NFEROR P$E%&S AOR'&S A!"O#NA$S
#3
'A!ANG 'A!ANG P$E%&S 'OE$A'&S P-*/us
phr*ni,us G * diaphra+)a dan )*)'*ri ,a'an+ * +-andu-a suprar*na-ii )*-a-ui a.phr*ni,a in1*ri(r. P-*/us h*pati,us -*
#7
'A!ANG 'A!ANG P$E%&S #ESENER'&S S&PEROR %a'an+
,a'an+nya )*n+iuti ,a'an+ ,a'an+ a.)*s*nt*ri,a sup*ri(r * a-at a-at ahir
=!
'A!ANG 'A!ANG P$E%&S #ESENER'&S NFEROR %a'an+
,a'an+nya )*n+iuti ,a'an+ ,a'an+ a.)*s*nt*ri,a in1*ri(r )*nu;u * a-at a-at ahir.
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S*,ara u)u) 'isa di;*-asan s*'a+ai '*riut 4 Or+an
(r+an a'd()*n dapat p*rsara1an dari ,a'an+ 4 P-*/us
,(*-ia,us )*n+iuti ,a'an+ ,a'an+ a.,(*-ia,a. P-*/us )*s*nt*ri,us sup*ri(r )*n+iuti ,a'an+ ,a'an+ a.)*s*nt*ri,a sup*ri(r. P-*/us )*s*nt*ri,us in1*ri(r: )*n+iuti ,a'an+ ,a'an+ a.)*s*nt*ri,a in1*ri(r. P-*/us a(rti,us a'd()ina-is )*n+iuti ,a'an+ ,a'an+ a(rta a'd()ina-is. =
P*r*,ua-ian 4 S*)ua (r+an (r+an a'd()*n dip*-ihara (-*h s*rat s*rat si)patis p(st+an+-i(nar: *,ua-i )*du--a suprar*na-is. &atas da*rah p*rsara1an sisti) parasi)patis pars ,rania-is dan pars sa,ra-is t*r-*ta pada */ura ,(--i sinistra.
=#
