SISTEM SENSORIK

dr. Astri Handayani M.Biomed

Bagian Fisiologi
Fakultas Kedokteran Universitas Trisakti
Somatosensory system
◦ The somatosensory system is composed of the neurons that make
sensing touch, temperature, and position in space possible
◦ Receptors that could be designated "somatosensory" are distributed
all over the body rather than concentrated at specific locations.
◦ The different types of receptors respond to many different kinds of
stimuli.
Area somatosensorik pada korteks
serebri
Viscerosensory
◦ In parallel to somatosensory system conveying info from external environment,
viscerosensory system conveys info about internal environment
◦ Viscerosensory receptors, fibers, ascending sympathetic and parasympathetic
pathways
Viscerosensory receptors
2 types
1. Nociceptors
◦ Free nerve endings of Aδ and C fibers located in heart, respiratory, GI and GU
tracts
◦ Project to Lamina 1 and 5 in dorsal horn
◦ Mediate visceral pain, e.g. angina pectoris
2. Physiologic receptors
◦ Mechanoreceptors
◦ Rapidly adapting, e.g. cough
◦ Slowly adapting, e.g. full stomach or urinary bladder
◦ Baroreceptors, e.g. baroreflex
◦ Chemoreceptors, e.g. in carotid and aortic bodies
◦ Osmoreceptors, e.g. osmolarity and ADH production
◦ Internal thermal receptors, e.g. core temperature in hypothalamus
Classification of viscerosensory receptors
and their respective stimuli
A) Baroreceptor

B) Chemoreceptor
Viscerosensory afferents
1. Sympathetic
◦ Mostly nociceptors
◦ Referred pain due to collaterals with somatosensory afferents
2. Parasympathetic
◦ Mostly physiologic receptors
◦ Bowel, bladder, baroreflex
◦ Information goes to reticular formation, periaqueductal gray,
VPL (ventral posterior lateral) and intralaminar nuclei of
thalamus, hypothalamus, and cortex
Jalur penjalaran sinyal reflek viserosensorik
SPECIAL SENSES
Sistem Sensorik Indra Khusus
Sistem
Olfaktorius
Olfactorius Tract
Taste Buds
Signal Transduction
Anatomy of
the ear
Sound waves
Sound waves
Transmission
Cochlea
Transduksi
Sinyal di Sel
Rambut
Auditoric
pathway
THE EYE
Photo
transductio
PHOTORECEPTORS:
RODS AND CONES
Astri Handayani
Definition of Pain
◦ Unpleasant sensory and emotional experience associated with actual or potential
tissue damage.(IASP)
◦ Pain serves as important protective function, alerting us to injuries that required
evasion or treatment
◦ Perception of pain is Subjective and influence by many factors.

Ganong, Review of Medical Physiology, 23 rd ed,2010

Classification of Pain
◦ Based on Pathophysiology
Nociceptive pain
◦ Transient pain in response to noxious stimulus
◦ Arises from a stimulus outside of the nervous system
◦ Pain proportionate to the stimulation of nociceptors
◦ Serves as a protective function
Inflammatory pain
◦ Initiated by tissue damage and/or inflammation
◦ Arises from a stimulus that is outside of the nervous system
◦ Spontaneous pain and hypersensitivity to noxious stimulus
◦ Disproportionate to the stimulation of nociceptors
◦ Serves no protective function
Neuropathic pain
◦ Initiated or caused by a primary lesion or dysfunction in the nervous system
◦ No nociceptive stimulation
◦ Disproportionate to the stimulation of receptors
◦ Other evidence of nerve damage (eg, postherpetic neuralgia)

Woolf CJ. Ann Intern Med. 2004;140:441-451

Classification of Pain
Based on Pain duration
ACUTE PAIN
• Physiologic pain
• Sudden onset
• Recedes during the healing process
• “good Pain” as it serves an important protective mechanism
• pain of less than 3 to 6 months duration

CHRONIC PAIN
• Can result from nerve injuries (neuropathic pain)
• pain lasting for more than 3-6 months
• persisting beyond the course of an acute disease, or after
tissue healing is complete
Pain Assessment Scales
 NOCICEPTORS
Thermal nociceptors
• Sctivated by extremes in temperature
• Greater than 45C or less 5C

Mechanical nociceptors
• Activated by intense pressure

Polymodal nociceptors
• Activated by high intencity
mechanical, chemical, or thermal
stimuli

Silent nociceptors
• Found in visera
• Activated by inflammation and various
chemical agents

Kandell, Principles of NeuroScience, 5th

Higher level processing of pain
input
◦ Multiple structure are involved in pain structure.
◦ In response to stimulus-induced action potential, afferent pain fibers release
neuromitters that influence these next neuron in line.
◦ Two best known pain neurotransmitter are substance P and Glutamate.
Sherwood, 9th ed,2016
REGULATION
OF PAIN
GATE CONTROL MODEL

Silverthorne,Human
Physiology Integrated
 Endogenous Opioids
Produced from the sama
◦ 1. Endorphin prehormones as ACTH (Pro-
opiomelanocortin) in
neuroendocrine cells in
hypothalamus.

◦ 2. Enkephalin
Secreted by neurons associated
with pain pathways.
◦ 3. Dynorphin
Sherwood, 9th ed,2016
REFERRED PAIN
Irritation of viceral organ frequently produces pain that is feel not at that
site but in some somatic structure that may be considerable distant
away.

Ex : cardiac pain may be referred to the right arm.

Dermatomal Rule of Referred Pain
Allodynia
Patient with allodynia feel pain in response to stimuli that normally
innocuous
Example :
• the movement of joints in patients with rheumatoid arthritis
• by the act of getting out of bed in the morning after a vigorous
workout

Hyperalgesia
an exaggerated response to noxious stimuli—typically report persistent
pain in the absence of sensory stimulate
Bear,Neuroscience Exploring The Brain, 4th ed,2016