ram Entero 1

8/17/2019 ram Entero 1

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R. AURORA M. _ LBM 1

SGD 1 LBM 1 ENEROHEPATIK

STEP 1STEP 2

1. Bagaimana Anatomi Fisioogi Histoogi !a"i o"gan #$%a" &2. Bagaimana Anatomi Fisioogi Histoogi !a"i o"gan '$si(a )$$a &*. Bagaimana Anatomi Fisioogi Histoogi !a"i o"gan i$n &+. Bagaimana Anatomi Fisioogi Histoogi !a"i o"gan %an,"$as &-. Bagaimana #/ngan o"gan $nt$"o#$%ati, &0. Bagaimana $m/"ioogi o"gan $nt$"o#$%ti, &

STEP *

1. ANATOMI HEPAR + o/s !$3t"a4 sisnist"a4 (a!ats4 5a!"ats 6S$(. anatomi 7a!"ats89a!ats Lo/s !$3t"a o$# :ss"$ sagitais sinist"aS$(. :sioogii 7a!"ats89a!ats Lo/s sinist"a o$# )osa sagitais !$3t"a

Ligam$n T$"$s #$%atis4 Fa(i)o"mis4 ;$nosm A"antii4 Om$ntm Mins4 T"ianga"49o"ona"ia$a

Pa"s s%$"io" A"$a n!a t!, !ia%isi %$"iton$m4;$na %o"ta L$ta, #i%o,on!"ia sinist"a4 $%igast"im4 #i%o,on!ia !$3t"a.B$"at !$?asa 1+== g.

FISIOLOGI HEPAR @$,s,"$si $m%$! => ai"4 /ii"/in /ii'$"!in4

@$n!o,"in m$ta/oi(4 !$to,si:,asi P$"ta#anan t/#4 $,s,"$i4 sint$sis %"ot$in%asma ,oagan )a(to" ;II4 I4 4 'as(a" #ati.M$ta/oism$ ,a"/o#i!"at G,og$nKo$st"o & Li%o%"ot$in !an )os)oi%i!M$nCim%an F$"itin )$ !i #ati6 /$"i,atan !an !i,$a",an saat )$ !a"a# t"nM$nCim%an !a"a# !i#$%a" +-= 1=> !a"i !a"a# t/#6 !i '$na #$%ati(aBa,t$"i /"t$m s$ ,%$" )agositosis.F$"itin m$,anism$ /ii'!in /ii"/in !an "o/iinP"$#$%ati, %$m$(a#an #$m$ !n go/nInt"a#$%ati( /ii"/in t$",ongasiPos#$%ti, s!a# mas, ,$ ss

@HISTOLOGI HEPAR

2. Bagaimana Anatomi Fisioogi Histoogi !a"i o"gan '$si(a )$$a & TERDIRI DARI D(ts #$%ati(a !$3t"a !an sinist"a4 !(ts #$%ati(s ,omnis4!(ts (#o$!o(s4 '$si(a '$$a 4 % (m /$"at +=@- ((Ligam$ntm ig. 9Csti(s4 ig. 9Csti(oi(a4 ig. om$nt mins om$ntm maCo" !g &;as,aisasi A !an ; (Csti(a

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HISTOLOGI Din!ing m,osa4 :/"oms,a"is4 a"4 i,atE%it$ siin!"is !an s$a%is

a"ingan s$"at otot %oos

FISIOLOGIS P"o!,si !i#$%a" s$ #$%atosit6 (ai"an $m%$! !i/a?a ,$ (anais /iia"is J!i%$,at,an 1-3 m$m/t#,an #o"mon$ s$,"$tin nat"im !an ,aiam !a"i #"%a"4

K$na%a ,$a"& Kont"a,si '$si(a )$$a4s:ngt$" o!!i "$a,sasi o$# #o"mon$ ((, N'ags6 !(ts (#o$!o(s !(ts %an,"$ati,s

Asam $m%$! m$m/ant $nim i%as$

*. Bagaimana Anatomi Fisioogi Histoogi !a"i o"gan i$n &ANATOMI !i (osta @12. Fa(i$s (oi(a gast"i(a "$naisLigam$ntm gast"oinais;as,a"isasi a. i$nais4 a. gas"oom$ntais4 a. gast"i,a /"$'is4'. i$nais 4 ;. m$s$nt$"i,a s% '. %o"ta/Ma"a %! '$na %o"ta '. sisti,s4a m$s$nt$"i,a s%$"io"4a gast"i,a sinist"a4&&&

HISTOLOGI @P%a m$"a# ,/"an s$ m$"a# ,"n ", m$nCim%an s$ $"it"osit4 SDP ainCa4nt, ($"na /a#an asing4 m$manta SDM Cang ta !an m$ng#an(",an@P%a %ti# m$m/ang s$in %%a m$"a#

+. Bagaimana Anatomi Fisioogi Histoogi !a"i o"gan %an,"$as &ANATOMI9a%t4 (a!a4 (o"%s4 (om4Fa(i$s ant$"io"4 %ost$"io"4 in)$"io"Ma"go

FISIOLOGI E,so,"in $nim %$n($"naanEn!o,"in s$ a)a 4/$ta nt, insin m$n"n,an KGD !an ) nt "$a,sasi '$si()$$a4 g(agon m$nai,an ,g!4

HISTOLOGI @SEL ALFA@SEL BETA

-. Bagaimana $m/"ioogi o"gan $nt$"o#$%ti, &@LI

0. Bagaimana #/ngan o"gan $nt$"o#$%ati, &

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Anastomosis %o"tosist$mi, m/ii(s4 $so%#ags4 !an ano"$(a.STEP + 9ON9EPT MAPINGSTEP <

1. Bagaimana Anatomi Fisioogi Histoogi !a"i o"gan #$%a" &a. Anatomi

Hepar tampak ventral :

Hepar tampak dorsal :

• H$%a" t$"$ta, !i REGIO HPO9HONDRIA9A SINISTRE4 EPIGASTRI9A !anHPO9HONDRIA9A DETRE.

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• M$"%a,an o"gan INTRAPERITONEAL ,$(ai /agian AREA NUDA !a$"a#Cang ti!a, t$"tt% o$# %$"iton$m6.

• M$m%nCai igam$ntm@igam$ntm anta"a ain o Lig. )a(i)o"m$o Lig. (o"ona"imo Lig. t"ianga"$ !$3t"$ 8 sinist$"o Lig. t$"$s #$%atiso Lig. ;$nosm

• M$m%nCai 2 )as(i$s o

Fascies Diafragmatica, t$"!i"i !a"i /$/$"a%a %a"s Pa"s s%$"io" T$"!a%at ($,ngan !ata" Cng !inama,an IMPRESSIO 9ARDIA9A. S$/agian /$sa" m$"%a,an AREA NUDA.

Pa"s ant$"io" T$"!a%at %$"$,atan Lig. )a(i)o"m$ Lig. )a(i)o"m$ m$m/agi #$%a" m$na!i 2 o/s Cait LOBUS

DETRE 8 LOBUS SINISTRE.

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Pa"s %ost$"io" T$"!a%at o/s (a!ats !ianta"a o/s !$3t"$ 8 sinist$"

#$%atis6. T$"!a%at s(s '$na (a'a Cang !it$m%ati o$# ;9I !ianta"a

o/s #$%atis !$3t"$ 8 (a!ats. K$ a"a# ,anan ga t$"!a%at a"$a n!a #$%atis4 Cang /$"/$nt,

t"ianga". Pa!a a%$3 #$%atis !is$/$a# ,anan t$"!a%at ig. t"ianga"$

!$3t"$. Pa"s !$3t"$ M$"%a,an %$"m,aan !a"i o/s !$3t"$ #$%atis Cang m$n$m%$

%a!a (osta@(osta !$3t"$ t$"/a?a#.o Fascies Visceralis

T$"!a%at 2 ($a# sagitta4 Cait Fiss"$ Sagittais Sinist$"

P$misa# o/s sinist$" !$ngan o/s (a!ats 8 5a!"at$s. Dit$m%ati o$# ig. t$"$s #$%atis !an ig. '$nosm.

Fossa Sagittais D$3t"$ T$"!i"i !a"i FOSSA ;ESI9A BILLIARIS 8 FOSSA ;ENA 9A;A. P$misa# o/s !$3t"$ !i s$/$a# ,anan !$ngan o/s

5a!ats 8 5!"ats !i s$/$a# ,i"inCa. T$"!a%at ($a# t"ans'$"sa PORTA HEPATIS6 T$"$ta, !i t$nga# Fiss"a Sagittais Sinist"$ 8 Fossa Sagittais

D$3t"$. Bangnan@/angnan Cang m$$?ati Po"ta H$%atis

A"t$"i H$%ati(a P"o%"ia ;$na Po"ta D(ts H$%ati(s N$"'s !an P$m/# Lim)$

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T$"!a%at im%"$ssio@im%"$ssio Pa!a Lo/s D$3t"$ Im%"$ssio (oi(a

Im%"$ssio !o!$nais Im%"$ssio "$nais Im%"$ssio s%"a"$nais

Pa!a Lo/s Sinist"$ Im%"$ssio gast"i( Im%"$ssio o$so%#ag$a

Pa!a o/s 7a!"ats Im%"$ssio !o!$nais

• Inn$"'asi N. 'ags

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• ;as(a"isasio A"t$"i H$%ati(a P"o%"ia (a/ang !a"i A"t$"i H$%ati(a 9ommnis.o ;$na Po"ta !ima"ai o$# 2 (a/ang tama4 Cait ;$na M$s$nt$"i(a

S%$"io" !an ;$na Li$nais.

• P$m/agian H$%a"1) Secara Struktural (Anatomis)

Fissura Sagitalis Sinistra (Lig. Falciforme)

P$m/agian m$na!i o/s #$%atis sinist$" !an o/s #$%atis !$3t"aS$#ingga o/s (a!ats !an o/s 5a!"at$s t$"mas, ,$ !aam o/s#$%atis !$3t"a.

2) Secara Fungsional (Fisiologis)Fissura Sagitalis Detra (Fossa !iliaris dan Sulcus "ena #ava$nferior)P$m/agian ini /$"!asa",an %$"!a"a#an4 in$"'asi4 ai"an Cm%#$ !an!ist"i/si !(ts #$%ati(s.

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*6 #ela% &rasversalM$misa#,an o/s 5a!"at$s !an o/s (a!ats.

o Batas #$%a"o Lo/s ,anan atas s$tinggi ,osta -4 2 (m s$/$a# m$!ia in$

mi!,a'i,a !$,st"ao Lo/s ,i"i atas s$tinngi t$%i atas ,osta 04 !iin$a mi! ,a'i,a.o Batas /a?a# mi"ing ,$ atas !a"i ,a"tiago ,osta ,anan ,$ ,a"tiago

,osta < /iasanCa o/s ,i"i m$as sam%$ -(m !a"i st$"nm.

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- Anastomosis Po"ta@Sist$mi,1. 1* /a?a# $so%#ags ". $so)ag$ais '. gast"i(a sinist"a %o"ta6

/$"anastomosis !$ngan '. $so)ag$a$s sist$mi,6.Anatomi ,ini, 'a"is$s $so%#ags.

2. P$"t$nga#an atas (anais anais '. "$(tais s%$"io" %o"ta6 /$"anastomosis!gn '. "$(tais m$!ia !an '. "$(tais in)$"io" sist$mi,6.Anatomi ,ini, #$mo""#oi!.

*. Di s$,ita" m/ii(s "ams sinist"a '. %o"ta #$%atis %o"ta6 /$"anastomosis!gn '$na s%$":(ia !in!ing ant$"io" a/!om$n sist$mi,6.

Anatomi ,ini, (a%t m$!sa.+. ;$na@'$na !i (oon as($n!$ns4 (oon !$s($n!$ns4 !o!$nm4 %an("$as4

#$%a" %o"ta6 /$"anastomosis !gn '. m/ais4 '. "$nais4 !an '. %#"$ni(a$sist$mi,6.Anatomi ,ini, %$"!a"a#an (oon.

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/. Histoogi

H$%a" t$"!i"i atas satan #$,sasona !is$/t o/s #ati. Di %sat s$tia%o/s t$"!a%at '$na s$nt"ais Cang !i,$iingi $m%$ng2 s$ #ati Cait hepatosit !ansinsoi! s$(a"a "a!ia. a"ingan i,at !isini m$m/$nt, t"ia! %o"ta !a$"a# %o"tat$m%at (a/ang a"t$"i #$%ati,a4 (a/ang '$na %o"ta !an (a/ang !,ts /iia"is. Da"a#a"t$"i !an !a"a# '$na ma J ma /$"(am%" !i sinsoi! #$%a" saat m$ngai" ,$ a"a#'$na s$nt"a. Da"i sini !a"a# m$mas,i si",asi mm m$ai '$na #$%ati,a.

Sinsoi! #$%a" a!aa# sa"an !a"a# Cang /$"i, J i, !an m$$/a"4 !$ngan!iam$t$" ti!a, t$"at"4 !ia%isi s$ $n!ot$ /$"ting,at ti!a, t#4 Cang !i%isa#,an !a"i#$%atosit !i /a?a#nCa o$# "ang %$"isinsoi!a. Pa!a !in!ing sinsoi! t$"!a%atma,"o)ag t$ta% Cait s$ K%$". S$ K%$" a!aa# )agosit #ati ,#ss Cang /$"asa!a"i monosit !"a# Cang /$")ngsi nt, m$m)agositosis /$n!a2 "$ni, !an !$/"iss$a" Cang m$ngai" ,$ sinsoi!.

H$%atosit m$nC$,"$si,an $m%$! ,$ !aam sa"an2 #as !is$/t ,anai,i/iia"is Cang t$"$ta, !ianta"a #$%atosit. Kanai,i ini m$ngm% !i t$%i s$tia%o/s !i !a$"a# %o"ta s$/agai !(ts /iia"is. D(ts /iia"is ,$m!ian m$na!i!(ts #$%ati,s Cang $/i# /$sa" Cang m$m/a?a $m%$! ,$a" !a"i #$%a". Di!aam o/s #ati4 $m%$! m$ngai" !aam ,anai,i /iia"is ,$ !(ts /iia"is %a!a

!a$"a# %o"ta !an !a"a# !aam sinsoi! m$ngai" ,$ '$na s$nt"ais. a!i4 $m%$! !an!a"a# ti!a, /$"(am%".

Atas Histoogi !i Fio"$6

• H$%a" !i/agi o$# sat a"ingan i,at s$%tm int$"o/a" 6 m$na!i o/s@o/s.

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• Lo/s /$"/$nt, %oigona. Pa!a /agian t$"t$nt !a"i s$%tm t$"!a%atsat !a$"a# Cang !is$/t t"igonm ,i$"nan %o"ta t"ia! Cang m$"%a,an%$"t$man * o/s Cait a. Int$"o/a"is4 '. Int$"o/a"is4 !,ts /iia"is!an %$m/# im)$.

• T$"!a%at '$na ($nt"ais.• Dianta"a '$na ($nt"ais t$"!a%at #$%atosit Cang t$"ssn s$(a"a "a!i$"

H$%atosit /$"/$nt, %oigona4 ,"annCa /$"ma(am@ma(am4 n,$s /$sa"4/at4 ,a!ang /$"inti !a.

• Di!aam #$%atosit t$"!a%at sinosoi! Cang !ia%isi $n!ot$ s$(a"a ti!a,$ng,a% !an t$"!a%at s$ ain %a!a sinosoi! s$%$"ti4 ma,"o)ag4 s$ ,%$"4,a!ang $"it"osit !an $,osit.Histoogi Dasa"

s$(a"a mm #$%a" !i/agi o$# sat a"ingan i,at m$na!i o/s o/s.Lo/s /$"/$nt, %oCgona. Pa!a /agian t$"t$nt !a"i s$%tm t$"!a%at ($a#%o"ta Cang /$"isi %$m/# !a"a#4 %$m/# im)$ !an sa"an $m%$!

Lo/s #$%a" Pa!a %$m/$sa"an "$n!a# t$"i#at '$na s$nt"ais !an s$%tm int$"o/a"%$"i)$"6.Di anta"anCa t$"!a%at #$%atosit Cang t$"ssn "a!i$". Pa!a %$m/$sa"an,at a,an t$"i#at '$na s$nt"ais Cang !ia%isi $n!ot$. Di !aam o/s t$"!a%at$m%$ng Cang t$"!i"i !a"i #$%atosit.L$m%$ng ,a!ang /$"(a/ang !an/$"anastomosis ,$(ai amina %a!a !a$"a# %$"i)$" o/s.Di anta"a aminat$"!a%at sinsoi! Cang m$ngi,ti %$"(a/angan !an /$"anastomosis !a"i amina.Sinsoi! !ia%isi $n!ot$ s$(a"a ti!a, $ng,a% !an t$"!a%at s$ s$ ain %a!asinsoi!4 s$%$"ti ma,"o)ag4 s$ ,%)$"4 ,a!ang $"it"osit !an $,osit. Sinsoi! a,an/$"ma"a ,$ '$na ($nt"ais.

K9 ,%$" ($4 Sisinsoi!

(. FisioogiFngsi #$%a"

1. M$m/$nt, !an m$ng$,s,"$si $m%$!.

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-== J 1=== m $m%$! ,ning tia% #a"i.Uns"$ tama $m%$! a!# ai"64 $$,t"oit4 ga"am $m%$! t, %$n($"naan !an a/so"/s $ma, !mss #as64 )os)oi%i! t$"tama $sitin64 ,o$st$"o4 ga"am ano"gani,4/ii"/in t$"tama /ii"/in (ongat$!.

2. M$ta/oism$ ,a"/o#i!"at gi,og$n$sis4 gi,og$noisis4 g,on$og$n$sis6.H$%a" /$"%$"an %$nting !m m$m%$"ta#an,an ,a!a" g,osa !a"a# no"ma!an m$nC$!ia,an $n$"gC t, t/#. KH !isim%an !m #ati s$/agai gi,og$n.

*. M$ta/oism$ %"ot$in sint$sis asam amino4 %$m/$nt,an "$a4%$nCim%anan %"ot$in6.

D$aminasi asam amino %$m/angan ggs NH*6.+. M$ta/oism$ $ma, ,$tog$n$sis4 sint$sis ,o$st$"o4 %$nim/nan $ma,6.

o,si!asi asam $ma,.-. P$nim/nan 'itamin !an min$"a 'it. a"t $ma, A4 D4 E4 K64 'it. B 124

/$si.0. M$ta/oism$ st$"oi! m$ngina,ti),an !an m$nC$,"$si a!ost$"on4

g,o,o"ti,oi!4 $st"og$n4 %"og$st$"on$4 t$stost$"on$.


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P$m/$nt,an "$a

P$nCim%anan%"ot$in asamamino6

;4;II4I4!an . ;itamin K m$"%a,an,o)a,to" Cang %$nting !aam sint$siss$ma )a,to" ini ,$(ai )a,to" ;

U"$a !i/$nt, s$mata@mata !aam#ati !a"i amonia, NH*64 Cang,$m!ian !i$,s,"$si !aam "in$ !an

)$s$s.

NH* !i/$nt, a!a"i !$aminasi asamamino !an ,$"a /a,t$"i ss t$"#a!a%

asam aminoM$ta/oism$ $ma,

K$tog$n$sis

Sint$sis ,o$st$"oP$nim/nan $ma,

Hi!"oisi t"igis$"i!a4 ,o$st$"o4)os)oi%i!4 !an i%o%"ot$in !ia/so"/si

!a"i ss6 m$na!i asam $/a, !angis$"o

Hati m$m$gang %$"anan tama !aamsint$sis ,o$st$"o4 s$/agian /$sa"!i$,s,"$si !aam $m%$! s$/agai

,o$st$"o ata asam ,oatP$nim/nan 'itamin

!an min$"a

;itamin a"t $ma, A4D4E4K6 !isim%an

!aam #ati4 ga 'itamin B124 t$m/aga!an /$si

M$ta/oism$ st$"oi! Hati m$ngina,ti),an !an m$nC$,"$si

a!ost$"on4g,o,o"ti,oi!4$st"og$n4%"og$st$"on4 !an t$stost$"onD$to,si:,asi Hati /$"tanggnga?a/ atas

/iot"an)o"masi at2 /$"/a#aCa Cang

,$m!ian !i$,s,"$si o$# ginaG!ang !a"a# !an:t"asi

Sinsoi! #ati m$"%a,an !$%ot !a"a#Cang m$ngai" ,$m/ai !a"i '$na ,a'agaga antng ,anan64 ,$"a )agositi,s$ ,%$" m$m/ang /a,t$"i !an

!$/"is !a"i !a"a#P"i($4 SC'ia A. Pato:sioogi $!isi 0.a,a"ta EG9

♣ S$/agai %$nCim%an !a"a#S$ma# /$sa" !a"a# !isim%an !aam %$m/# !a"a# #ati 'om$no"ma +-= m6. #ati m$"%a,an o"gan /$sa"4 !a%at m$as !an o"gan'$nosa Cang mam% /$,$"a s$/agai t$m%at %$nam%ngan !a"a# Cang!a%at m$nam%ng !a"a# saat 'om$ !a"a# /$"$/i#an !an !a%atm$nC%ai !a"a# $,st"a saat ,$,"angan 'om$ !a"a#.

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♣ M$ta/oism$ #atiM$ta/oism$ ,a"/o#i!"at

Hati m$a,,an )ngsi

@ M$nCim%an gi,og$n !aam ma# /$sa"@ Kon'$"si gaa,tosa !an )",tosa m$na!i g,osa@ G,on$og$n$sis nt, m$m%$"ta#an,an ,ons$nt"asi no"ma

g,osa !a"a#4 g,on$og$n$sis t$"a!i i,a ,ons$nt"asi g,osa!a"a# mai m$n"n. Ma,a4 s$ma# /$sa" as.amino !an gis$"o!a"i TG !i/a# a!i g,osa4 !a%at m$m%$"ta#an,an ,ons$nt"asig,osa !a"a# Cang "$ati'$ no"ma.

@ P$m/$nt,an /anCa, s$nCa?a ,imia !a"i %"o!, anta"am$ta/oism$ ,a"/o#i!"atHati %$nting nt, m$m%$"ta#an,an ,ons$nt"asi g,osa !a"a#no"ma.P$nCim%anan gi,og$n m$mng,in,an #ati m$ngam/i

,$$/i#an g,osa !a"i !a"a# !isim%an !i,$m/ai,an agi ,$!a"a# /ia ,ons$nt"asi g,osa !a"a# m$n"n t$"a "$n!a#.

M$ta/oism$ $ma,• O,si!asi as.$ma, nt, m$nC%ai $n$"gC /agi )ngsi t/# Cang

ain.• Sint$sis ,o$st$"o4 )os)oi%i!4 !an s$/agian /$sa" i%o%"ot$in.

• Sint$sis $ma, !a"i %"ot$in !an ,a"/o#i!"at. $ma, !i%$(a# m$na!i gis$"o !an as.$ma, as.$ma,

!i%$(a# o$# o,si!asi /$ta a!i "a!i,a as$ti /$",a"/on 2 Cangm$m/$nt, as$ti Ko@A as$ti Ko@A mas, ,$ si,s asam sit"at!an !io,si!asi m$m/$/as,an s$ma# $n$"gC

=> ,o$st$"o Cang !isint$sis !i !aam #ati m$na!i ga"am$m%$! !i$,s,"$si,an agi ,$ $m%$!. SisanCa !iang,t!aam i%o%"ot$in !an !i/a?a o$# !a"a# ,$ s$ma s$ a"ingant/#.

M$ta/oism$ %"ot$in• D$aminasi as.amino4 !i/t#,an s$/$m as.amino !a%at

!igna,an nt, $n$"gC ata !i/a# m$na!i ,a"/o#i!"at ata$ma,.

• P$m/$nt,an "$m nt, m$ng$a",an ammonia !a"i (ai"an

t/#. S$ma# /$sa" ammonia !i/$nt, m$ai %"os$s !$aminasi!an ma#nCa masi# !itam/a# %$m/$nt,an /a,t$"i !i sss$(a"a ,ontin ,$m!ian !ia/so"/si ,$ !a"a#.

• P$m/$nt,an %"ot$in %asma

• Int$",on'$"si /$/$"a%a as.amino !an sint$sis s$nCa?a ain !a"ias.amino:sioogi GCton

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2. Bagaimana Anatomi Fisioogi Histoogi !a"i o"gan '$si(a )$$a &

a. Anatomi

Kan!ng empedu m$"%a,an ,antong otot ,$(i Cang /$")ngsi nt, m$nCim%an(ai"an empedu (ai"an %$n($"naan /$"?a"na ,ning ,$#iaan Cang !i#asi,an o$##ati6.Kan!ng empedu m$mii,i /$nt, s$%$"ti /a# %i" !$ngan %anang


17/43


/. HistoogiKan!ng empedu ti!a, m$mii,i s/m,osa. P$m/ng,s %a!a ,an!ng empedu t$"!i"i !a"i tiga a%is4 Ca,ni %$"m,aan a" !a"i ,an!ng empedu a!aa# ;is($"a%$"iton$m4 %a!a /agian t$nga#4 otot !a"i !in!ingnCa t$"!i"i !a"i s$"at otot #as

s$64 !an !is$/$a# !aam m$"%a,an m$m/"an m,osa Cang t$"sam/ng !$ngana%isan sa"an empedu. M$m/"an m,osanCa t$"!i"i atas s$@s$ $%it$ s$!$"#anaCang /$"/$nt, s$ tiang siin!$"64 !issn m$nC$"%ai $%it$ %a!a %$"m,aanam/ng Cang m$ng$a",an s$,"$t msin !an ($%at m$nga/so"%si ai" !an $$,t"oitt$ta%i ti!a, m$ns$,"$si,an garam@garamempedu !an %igm$n4 ,a"$na it4 (ai"anempedu m$na!i %$,at. Kont"a,si !a"i otot t$"s$/t !i%$nga"#i o$# sist$m#o"mona Cang m$nC$/a/,an isi !a"i ,an!ng empedu (ai"an empedu6 mas, ,$%$m/# (Csti(.

(. FisioogiKan!ng empedu m$mii,i )ngsi s$/agai t$m%at m$nCim%an (ai"an empedu

!an m$m$,at,an (ai"an empedu Cang a!a !i!aamnCa !$ngan (a"am$nga/so"%si ai" !an $$,t"oit. !an m$ng$a",an $m%$! !a"i ,antng $m%$!.M$,anism$ ini t$"gantng !a"i a,ti:tas t"ans)o" a,ti) nat"im !aam $%it$

1. :sioogi $m%$!$m%$! m$a,,an !a )ngsi %$nting

1. $m%$! m$main,an %$"anan %$nting !aam %$n($"naan !an a/so"%si$ma,4 ,a"$na asam $m%$! m$a,,an 2 #a 16 asam $m%$!m$m/ant m$ng$msi,an %a"ti,$ %a"ti,$ $ma, Cang /$sa" !aamma,anan m$na!i /anCa, /$nt, %a"ti,$ ,$(i Cang !a%at !is$"ang o$#$nim i%as$ Cang !is$,"$si,an g$ta# %an("$as 26 asam $m%$!

m$m/ant t"ans%o"t !an a/so"%si %"o!, a,#i" $ma, Cang !i($"nam$n !an m$ai m$m/"an$ m,osa int$stina

2. $m%$! /$,$"a s$/agai sat aat nt, m$ng$a",an /$/$"a%a %"o!,/angan Cang %$nting !a"i !a"a#. M$i%ti /ii"/in !an ,$$/i#an,o$st$"o

2. Kom%osisi $m%$!Konstit$n o"gani( ga"am@ga"am $m%$!4 ,o$st$"o4 $sitin !an /ii"/in6 /$"asa !a"i a,ti'itas #$%atosit.9ai"an a,ais $n($" Cang s$"%a !$ngan s$,"$si NaH9O* %an,"$as

Ai"Ga"am ano"gani, ain

,an!ngan Em%$! #ati Em%$! ,an!ng$m%$!

Ai"


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Asam asam $ma, =412 g"! =4* sam%ai 142 g"!L$sitin =4=+ g"! =4* g"!Na 1+-mE5 1*= mE5K - mE5 12 mE5

9a

- mE5 2* mE59@ 1== mE5 2- mE5H9O*@ 2 mE5 1= mE5

gu'ton

*. %$m/$nt,an ga"am@ga"am $m%$! !an )ngsinCa• %$m/$nt,an ga"am $m%$!

ga"am $m%$! m$"%a,an #asi t"nan !a"i ,o$st$"o. Dan ,o$st$"onCa /isa

/$"asa !a"i ma,anan ata ,o$st$"o Cang t$a# t$"sim%an !aam #$%a".S$ain itga"am $m%$! !a%at !i%$"o$# !a"i #asi si,s $nt$"o#$%ati, ga"am@ga"am$m%$!.Fngsi Ga"am $m%$! M$m/ant %$n($"naan $ma, m$ai $)$, !$t$"$n $msi:,asi6

E)$, !$t$"$n m$nga( %a!a ,$mam%an ga"am $m%$! m$ng/a#go/$s@go/s $ma, /$","an /$sa" m$na!i $msi $ma, Cang t$"!i"i!a"i /anCa, /ti"an $ma, ,$(i Cang t$"/$nam !aam (ai"an ,ims.D$ngan!$mi,ian as %$"m,aan Cang t$"s$!ia nt, a,ti'itas i%as$ %an("$asm$ning,at.Ka"$na ti!a, a"t !aam ai"4 mo$,@mo$, $ma, ($n!$"ngm$nggm%a m$na!i /ti"@/ti" /$sa" !aam ing,ngan m$n ss #as

Cang /anCa, m$ngan!ng ai". i,a ga"am $m%$! ti!a, m$ng$msi:,asi/ti"@/ti" $ma, ini4 i%as$ #anCa !a%at /$,$"a %a!a $ma, Cang t$"!a%at !i%$"m,aan /ti"an t$"s$/t4 !an %$n($"naan t"igis$"i!a a,an /$"angsngsangat ama.

Ga"am $m%$! m$m%$"i#at,an $)$, !$t$"$n s$"%a !$ngan !$t$"$nCang an!a gna,an nt, m$a"t,an minCa, s$?a,t m$n((i %i"ing.Mo$, ga"am $m%$! m$ngan!ng /agian a"t $ma, !an /agian Canga"t ai" Cang /$"matan n$gati). Bagian a"t $ma, a,an a"t !aam/ti"an $ma,4 s$#ingga /agian a"t ai" Cang /$"matan n$gati'$ m$nono!a"i %$"m,aan /iti"an $ma,. G$"a,an m$n(am%" ss a,an m$m$(a#@m$(a# /ti"an $ma, m$na!i /ti"an Cang $/i# ,$(i. Bti"an@/ti"an ,$(iini a,an ,$m/ai m$nCat a%a/ia ti!a, t$"!a%at ga"am@ga"am $m%$! !i%$"m,aannCa Cang m$m/$nt, Qs$a%t /$"matan n$gati'$ a"t ai" !i%$"m,aan s$tia% /ti" ,$(i t$"s$/t. Ka"$na matan Cang sama a,an toa,m$noa,4 ggs /$"matan n$gati'$ !i%$"m,an /ti"an $ma, a,anm$nC$/a/,an /ti"an $ma, t$"s$/t saing m$noa, sat sma ain.

M$m/ant a/so"/si $ma, m$ai %$m/$nt,an mis$

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Daam sat mis$ ga"am $m%$! !an $sitin m$nggm%a !aam,$om%o,@,$om%o, ,$(i !$ngan /agian a"t $ma, /$",$"mn !i /agiant$nga# nt, m$m/$nt, inti Q#i!"o)o/i, s$m$nta"a /agian a"t ai"m$m/$nt, s$a%t #i!"o:i, !i /agian a". Ag"$gat mis$ m$m%nCai

,"an s$,ita" s$%$"s$ta $/i# ,$(i !a"i%a!a ,"an /ti" $msi $ma,.D$ngan !$mi,ian 4 mis$ m$"%a,an '$#i(m Cang %"a,tis nt,m$ngang,t /a#an@/a#an Cang ti!a, a"t !aam ai" !i !aam m$n ssCang /anCa, m$ngan!ng ai". Ba#an a"t $ma, Cang %aing %$nting Cang!iang,t o$# mis$ a!a# %"o!, %$n($"naan $ma, monogis$"i!a !anasam $ma, /$/as6 s$"ta 'itamin@'itamin Cnag a"t !aam $ma,. i,a ti!a,m$nm%ang !i mis$ Cang a"t ai" ini4 nt"i$nt@nt"i$n t$"s$/t m$nga%ng!i%$"m,aan (ai"an ,ims s$%$"ti minCa, Cang m$nga%ng !iatas ai"6 !anti!a, %$"na# m$n(a%ai %$"m,aan a/so"%ti) ss #as.

+. Fngsi $m%$!

m$m/ant %$n($"naan !an a/so/si $ma,.M$m/ant %$ng$a"an at sisa Cang a"t !aam $ma,

-. P$ngat"an s$,"$si $m%$!• Bagian a?a !i$,"$si,an o$# s$@s$ #$%atosit #ati4 s$,"$si a?a ini m$ngan!ng

s$ma# /$sa" asam $m%$!4 ,o$st$"o4 !an at@at o"gani( ainnCa. K$m!ian$m%$! !is$,"$si,an ,$ !aam ,anai,i /iia"is ,$(i Cang t$"$ta, !ianta"a s$@s$ #ati !i !aam $m%$ng #$%ati(.

• K$m!ian $m%$! m$ngai" ,$ %$"i)$" m$n s$%ta int$"o/a"is4 t$m%at,anai,i m$ngosong,an $m%$! ,$ !aam !,ts /iia"is t$"mina !an,$m!ian s$(a"a %"og"$si) ,$ !aam !,ts Cang $/i# /$sa"4 a,#i"nCa m$n(a%ai

!,ts #$%ati,s !an !,ts /iia"is ,omonis4 !a"i sini $m%$! angsng!i,osong,an ,$ !aam !o!$nm ata ata !iai#,an ,$ !aam !,ts (isti,s,$ !aam ,an!ng $m%$!. Daam %$"aanan m$ai !,ts@!,ts /iia"is ini4/agian ,$!a !a"i s$,"$si !itam/a#,an ,$ !aam s$,"$si $m%$! %$"tama.S$,"$si tam/a#an ini /$"%a a"tan ion@ion nat"im !an /i,a"/onat $n($" Cang!is$,"$si,an o$# s$@s$ $%it$ s$,"$to"is Cang t$"$ta, !i !aam !,ts !an!,ts.

• M$,anism$ %$ngosongan $m%$! !a"i ,an!ng $m%$! Ma,an /$"$ma, !aam !o!$nm m,osa !o!$nm m$$%as,an

,o$sito,inin ,$ !aam !a"a# m$"angsang ,an!ng $m%$!/$",ont"a,si m$ng#anta",an g$om/ang %$"istati( m$ai !,ts/iia"is ,omnis m$n s%ingt$" o!!i m$nC$/a/,an g$om/ang a?a"$a,sasi t$"#a!a% s%ingt$" o!!i. s%ingt$" o!!i "$a,sasi $m%$!!a%at mas, ,$ !aam !o!$nm %a"s !$s($n!$n.

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P a g $ 2= +*


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($nteractive Atlas of #linical Anatom' Frank . etter *D)

*. Bagaimana Anatomi Fisioogi Histoogi !a"i o"gan i$n &a. Anatomi

- Mo")oogi B$")ngsi s/g sist$m R.E.S o"gan Cm%#oi! t$"/$sa" 8 t$m%at m$"sa,

H/ $"it"osit6. M$"%a,an o"gan Int"a%$"iton$a .

Pa"$n,im angsng !i/ng,s (a%sa i$nais. L$ta, R$gio HC%o(#on!"im sinist"a. Fa(i$s

o Fa(i$s Dia%#"agmati(a ($m/ng6 /$"#a!a%an !g !ia%#"agma 8(osta @ 11 sinist"a

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o Fa(i$s ;is($"ais !ata"6 m$m%nCai * im%"$ssio impressiorenalis gastrica + colica

His M$"%a,an %$"t$man !" im%"$ssio %! )a(i$s 'is($"ais4 t$m%at,$a" mas,nCa 'an i$nais.

- ;as,a"isasio$#a. lienalis mas, ,$ #is i$nais m$$?ati ig. P#"$ni(oi$nais. 9a/ang a.i$nais a. gast"i(a /"$'is 8 a. gast"o$%i%oi(a sinist"a6 m$ai ig.Gast"oi$naism$n ,$ gast$".;$na m$ngi,ti a"t$"inCa.

- Inn$"'asiSim%atis T0@T1=Pa"asim%atis n. 'ags

Fisiologi1. S$/agai RES "$ti(o$n!ot$ia sCst$m62. P$m/$nt,an !a"a# saat !i anin -@ /an6*. P$nCa"ingan !a"a# %$ng#an("an s$ !a"a# Cang a/no"ma s$%$"ti SDM !an

SDP6

HistologiB$"/$nt, s$%$"ti s%ons. T$"!a%at %%a m$"a#4%ti# !an ma"gina.

@P$m/$nt,an Bii"/in

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METABOLISME BILIRUBIN NORMAL

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1. M$ta/oism$ /ii"/in

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D$st",si SDM Bii'$"!in Bii"/in Un(ongat$!4 /$"i,atan !ng a/min ;$na Li$nais ;$na %o"ta H$%atosit Kongasi !$ngan /antan g,o"onit"ans)$"as$ m$na!i Bii"/in (ongat$! D,ts #$%ati,s D,ts (Csti(s ;$si(a F$$a D(ts 9#o$!o((s Pan,"$as Do!$nm Pa"sD$s($n!$n U"o/iinog$n Uss St$",o/iinog$n St$",o/iin F$s$s

D$st",si SDM Bii'$"!in Bii"/in Un(ongat$!4 /$"i,atan !ng a/min ;$na Li$nais ;$na %o"ta H$%atosit Kongasi !$ngan /antan g,o"oni

t"ans)$"as$ m$na!i Bii"/in (ongat$! D,ts #$%ati,s D,ts (Csti(s ;$si(a F$$a D(ts 9#o$!o((s /$"ga/ng !ng D,ts i"sngPan,"$as6 Do!$nm Pa"s D$s($n!$n U"o/iinog$n m$ %"os$s o,si!as Gina U"o/iin "in$

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+. Bagaimana Anatomi Fisioogi Histoogi !a"i o"gan %an,"$as &Anatomi

• Pan("$as m$"%a,an o"gan Cang m$mii,i )ngsi s$/agai ,$$na" $,so,"in !an$n!o,"in. Bagian E,so,"in a,an m$ng#asi,an $nim@$nim %$n($"naan s$%$"tiamCas$4 i%as$ !an t"i%sin Cang !a%at m$ng#i!!"oisis ,a"/o#i!"a4 $ma, !an%"ot$in. Bagian En!o,"innCa m$ng#asi,an #o"mon$ Insin !an G,agon.

• Pan("$as m$"%a,an o"gan Cang m$manang !an t$"$ta, %a!a $%igast"im !an

,a!"an ,i"i atas.St",t"nCa na,4 /$"o/s !an t$"$ta, %a!a !in!ing %ost$"io"a/!om$n !i /$a,an %$"iton$m.Pan("$as m$nCiang t"ans%Co"i(m.Pan("$as!a%at !i/agi !aam (a%t4 (om4 (o"%s !an (a!a.

• Pan("$as t$"mas, o"gan $,st"a%$"iton$m ,$(ai /agian (a!a6.

• Pan,"$as !a%at !i/agi !aam Caput Pancreatis /$"/$nt, s$%$"ti (a,"am !an t$"$ta, !i !aam /agian

($,ng !o!$nm. S$/agian (a%t m$as ,$ ,i"i !i /$a,ang a"t$"ia san '$nam$s$nt$"i(as%$"io" s$"ta !inama,an P"o($sss Un(inats.

Collum Pancreatis m$"%a,an /agian %an("$as Cang m$ng$(i !anm$ng#/ng,an (a%t !an (o"%s %an("$atis. 9om %an("$atis t$"$ta, !i

!$%an %ang,a '$na %o"ta$ #$%atis !an t$m%at !i%$"(a/ang,annCa a"t$"iam$s$nt$"i(a s%$"io" !a"i ao"ta.@ Corpus Pancreatis /$"aan ,$ atas !an ,i"i4 m$nCiang ga"is t$nga#.

Pa!a %otongan m$intang s$!i,it /$"/$nt, s$gitiga.@ Cauda Pancreatis /$"aan ,$ !$%an m$n igam$ntm i$no"$nais

!an m$nga!a,an #/ngan !$ngan #iim i$na$.• H/ngan Pan,"$as !$ngan o"gan ain

1. Ke anterior :!a"i ,anan ,$ ,i"i (oon t"ans'$"sm !an

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%$"$,atan m$so(oon t"ans'$"sm4 /"sa om$ntais4 !an gast$".2. Ke posterior : !a"i ,anan ,$ ,i"i !(ts (#o$!o(#s4 '$na %o"ta$

#$%atis !an '$na i$nais4 '$na (a'a in)$"io"4 ao"ta4 %ang,a a"t$"iam$s$nt$"i(a s%$"io"4 ms(s %soas mao" sinist"a4 gan!a

s%"a"$nais sinist"a4 "$n sinist$"4 !an #im i$na$.• ;as,a"isasi !an Lim)ati, A"t$"ia$

@ A"t$"i %an("$ati(o!o!$nais s%$"io" (a/ang a.gast"o!o!$nais 6@ A"t$"i %an("$ati(o!o!$nais in)$"io" (a/ang a.m$s$nt$"i(a

("aniais6@ A"t$"i %an("$ati(a magna !an a"t$"i %an("$ti(a (a!ais !an in)$"io"

(a/ang a"t$"ii$nais

• ;$na$;$na$ Cang s$sai !$ngan a"t$"ia$nCa m$ngai",an !a"a# ,$ sist$m%o"ta.

• Ai"an Lim)ati,

K$$na" im)$ t$"$ta, !i s$%anang a"t$"ia Cang m$n!a"a#i,$$na".P$m/# $)$"$n a,#i"nCa m$ngai",an (ai"an im)$ ,$ no!iim)$ (o$ia(i !an m$s$nt$"i(a s%$"io"$s.

• P$"sa"a)anB$"asa !a"i s$"a/t@s$"a/t sa"a) sim%atis gangion s$ia(a6 !an%a"asim%atis 'ags6.

• D(ts Pan,"$ati(s1. D(ts Pan("$ati(s MaCo" i"sngi6 Mai !a"i (a!a !an /$"aan !

s$%anang ,$$na" m$n ,$ (a%t4 m$n$"ima /anCa, (a/ang %a!a%$"aanannCa. D(ts ini /$"ma"a ,$ %a"s !$s$n!$ns !o!$nm !is$,ita" %$"t$nga#annCa /$"ga/ng !$ngan !(ts (#o$!o(#sm$m/$nt, %a%ia !o!$ni maCo" ;at$"i. Ka!ang@,a!ang ma"a!(ts %an("$ati(s !i !o!$nm t$"%isa# !a"i !(ts (#o$!o(#s.

2.D(ts Pan("$ati(s Mino" Santo"ini6M$ngai",an g$ta# %an("$as !a"i/agian atas (a%t %an("$as !an ,$m!ian /$"ma"a ,$ !o!$nms$!i,it !i atas ma"a !(ts %an("$ati(s %a!a %a%ia !o!$ni mino".

Feneis, Heinz, dkk. Pocket Atlas of human Anatom. !th "dition.#tuttgart :$hieme, %&&&

Diktat Anatomi #itus A'dominis FK (nissula

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/. :sioogi %an("$as@t$"!a%at * "angsangan !asa" Cang %$nting !aam m$nC$/a/,an s$,"$si %an,"$ati, as$ti,oin4 Cang !i$%as,an o$# n$"'s 'ags %a"asim%atis !$mi,ian ga !a"i sa"

,oin$"gi, !i !aam sCst$m sa"a) $nt$"i( ,o$sisto,inin4 Cang !is$,"$si,an o$# m,osa !o!$nm !an $nm /agian a

,$ti,a ma,anan mas, ,$ !aam ss #as s$,"$tin4 Cang !is$,"$si,an o$# m,osa !o!$nm !an $nm Cang sama ,$t

ma,anan Cang sangat asam mas, ,$ ss #as. As$ti,oin !an ,o$sisto,inin m$nC$/a/,an %an("$as m$ns$,"$si $nim2 %$n($"na

!$ngan ma# (ai"an Cang "$ati'$ s$!i,it s$!ang,an s$,"$tin m$"angsang s$,"a"tan nat"im /i,a"/onat .

@S$,"$si %an,"$ati, t$"a!i !aam * )as$ Cait )as$ s$)ai, sinCa2 sa"a) Cg sama !a"i ota, Cang m$nC$/a/,an as$ti,oin !i$%as

o$# ng2 n. 'ags !aam %an("$as. Ha ini m$nC$/a/,an s$ma# $n

!i$%as,an ,$ !aam !,ts %an,"$ati,s $nim !m maa# s$!ang !i $,s,"$si,$ !m asini %an("$as4 m$ng#asi,an ,"g $/i# 2=> !a"i tota s$,"$si %an("s$s!a# ma,an. Namn s$ma# ,$(i s$,"$si %an("$as ,$a" !a"i !(%an,"$ati,s ,$! m ss ,"n #nCa s$!i,it ai" !an $$,t"oit Cg !i s$,"$si,an /$"sa$nim.

)as$ gast"i( "angsangan sa"a) t$"#a!a% s$,"$si $nim /$"angsng t$m$ng#asi,an agi -@1=> !a"i $nim Cang !is$,"$si,an s$s!a# ma,an. aa%

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!$mi,ian #anCa s$ma# ,$(i Cang mas, ,$ !aam !o!$nm ,a"$na ,"angn(ai"an.

Fas$ int$stina s$s!a# ,ims #asi %$n($"naan Cg s!a# !i% "os$s !i am/mas, ,$ !aam ss #as4 s$,"$si %an("$as m$na!i sangat /anCa,4 t$"ta

s$/agai "$s%on t$"#a!a% #o"mon$ s$,"$tin.Fisiologi )uton * Hall

-. Bagaimana #/ngan o"gan $nt$"o#$%ati, &Hati m$"%a,an o"gan#om$ostasis Cang m$main,an %$"anan !aam %"os$sm$ta/oism$. Hati m$m%nCai /$"/agai )ngsi t$"mas, m$nCim%an gi,og$n4m$nsint$sis %"ot$in %asma4 !an m$nCa"ing !a"a#.Em%$! !is$,"$si,an s$(a"a t$"s@m$n$"s o$# s$@s$ #ati4 namn s$/agian /$sa" no"manCa !isim%an !aam kantungempedu Cang !igna,an !aam %$n($"naan $ma, sam%ai !i%$",an !aam !o!$nm!$ngan 'om$ ma,simm *=@0=mL. S$,"$si $m%$! s$ama 12 am s$,ita" +-=mL6!a%at !isim%an !aam ,an!ng $m%$! ,a"$na ai"4 nat"im4 ,o"i!a !an ,$/anCa,an

$$,t"oit ,$(i ainnCa s$(a"a t$"s@m$n$"s !ia/so"%si m$ai m,osa ,an!ng$m%$!4 m$m$,at,an sisa at $m%$! Cang m$ngan!ng ga"am $m%$!4 ,o$st$"o4$sitin4 !an /ii"/in. A/so"%si ,an!ng $m%$! !is$/a/,an o$# t"ans%o"t a,ti) nat"imm$ai $%it$ ,an!ng $m%$!4 !an ,$a!aan ini !ii,ti o$# a/so"%si s$,n!$" ion,o"i!a4 ai" !an ,$/aCa,an at@at t$"!i)si ainnCa.

H/ngan %$"an %an("$as !$ngan sist$m $nt$"o#$%ati,

Pan,"$as t$"/$nt, !a"i !a s$ !asa" Cang m$m%nCai )ngsi sangat /$"/$!a. S$ s$$,so,"in Cang /$",$om%o, ,$om%o, !is$/t asini m$ng#asi,an ns" ns" g$ta#%an("$as. S$ s$ $n!o,"in at Pa Lang$"#a"ns m$ng#asi,an s$,"$t $n!o,"in4 insin

!an g,agon nt, m$ta/oism$ ,a"/o#i!"at.Pato:sioogi4 SC'ia A. P"i($

H/ngan %$"an ,an!ng $m%$! !$ngan sist$m $nt$"o#$%ati,

Kan!ng $m%$! m$m%nCai %$"anan !aam %$n($"naan $ma,.Kan!ng $m%$!m$nam%ng -=m $m%$! Cang !a%at !i/at ,$m/ai !aam m$"$s%on %$n($"naanma,anan.Daam ,$a!aan %asa ,i"a@,i"a s$t$nga# !a"i $m%$! s$(a"a t$"s@m$n$"s!iai",an ,$ !aam ,an!ng $m%$! nt, !isim%an. S$ama $m%$! /$"a!a !aam,an!ng $m%$!4 ma,a a,an t$"a!i %$ning,atan ,ons$nt"asi $m%$! o$# t$"a!inCa%"os$s "$a/so"%si ion@ion Nat"im4 Kasim4 !an /i,a"/onat !ii,ti o$# !i)si ai"

s$#ingga t$"a!i %$n"nan %H int"asisti,. Kan!ng $m%$! mam% m$n"n,an'om$nCa i,a !iisi $m%$! =@= >B, Aa" IPD ii! 1$!isi I;

H/ngan %$"an i$n !$ngan sist$m $nt$"o#$%ati,Lim%a m$ng#asi,an4 m$manta4 m$nCim%an !an m$ng#an(",an s$ !a"a#. Lim %a/$")ngsi s$/agai 2 o"gan

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/agian Cang %ti# m$"%a,an sist$m ,$,$/aan nt, m$a?an in)$,si !an /agianCang m$"a# /$"tgas m$m/ang /a#an@/a#an Cang ti!a, !i%$",an !a"i !aam!a"a# misanCa s$ !a"a# m$"a# Cang "sa,6. s$ !a"a# %ti# t$"t$nt im)osit6m$ng#asi,an anti/o!i %$in!ng !an m$m$gang %$"anan %$nting !aam m$a?an

in)$,si. im)osit !a%at !i/$nt, !an m$ngaami %$matangan !i !aam /agian %ti#im%a. /agian m$"a# im%a m$ngan!ng s$ !a"a# %ti# ainnCa )agosit6 Cang m$n($"na

/a#an Cang ti!a, !iingin,an misanCa /a,t$"i ata s$ Cang "sa,6 !aam%$m/$# !a"a#. Bagian m$"a# m$manta s$ !a"a# m$"a# m$n$nt,an s$ Canga/no"ma ata t$"a ta ata s$ Cang m$ngaami ,$"sa,an6 !anm$ng#an(",annCa. ,a"$na it4 /agian m$"a# ini ,a!ang !is$/t s$/agai ,/"ans$ !a"a# m$"a#./agian m$"a# ga /$")ngsi s$/agai (a!angan nt, $$m$n@$$m$n !a"a#4t$"tama s$ !a"a# %ti# !an t"om/osit. Pa!a /anCa, /inatang4 /agian m$"a# inim$$%asa,an $$m$n !a"a# ,$ !aam !a"a# si",asi %a!a saat t/#

m$m$",annCa t$ta%i %a!a mansia %$$%asan $$m$n ini /,an m$"%a,an)ngsi im%a Cang %$nting.

i,a im%a !iang,at m$ai %$m/$!a#an s%$n$,tomi64 t/# a,an ,$#iangan/$/$"a%a ,$mam%annCa nt, m$ng#asi,an anti/o!i %$in!ng !an nt,m$m/ang /a,t$"i Cang ti!a, !iingin,an !a"i t/#. s$/agai a,i/atnCa4,$mam%an t/# !aam m$a?an in)$,si a,an /$","ang. ti!a, ama ,$m!ian4o"gan ainnCa t$"tama #ati6 a,an m$ning,at,an )ngsinCa !aam m$a?anin)$,si nt, m$ngganti,an ,$#iangan t$"s$/t4 s$#ingga %$ning,atan "$si,ot$"a!inCa in)$,si ti!a, a,an /$"angsng ama.

i,a im%a m$m/$sa" s%$nom$gai64 ,$mam%annCa nt, m$nang,a% !anm$nCim%an s$@s$ !a"a# a,an m$ning,at. S%$nom$gai !a%at m$nC$/a/,an

/$","angnCa ma# s$ !a"a# m$"a#4 s$ !a"a# %ti# !an t"om/osit !aamsi",asi.

i,a im%a Cang m$m/$sa" m$nang,a% s$ma# /$sa" s$ !a"a# Cang a/no"ma4s$@s$ ini a,an m$nCm/at im%a !an m$nggangg )ngsinCa.

P"os$s ini m$nC$/a/,an sat ing,a"an s$tan4 Cait s$ma,in /anCa, s$ Cangt$"%$"ang,a% !aam im%a4 ma,a im%a a,an s$ma,in m$m/$sa" s$ma,inm$m/$sa" im%a4 ma,a a,an s$ma,in /anCa, s$ Cang t$"%$"ang,a%.

i,a im%a t$"a /anCa, m$m/ang s$ !a"a# !a"i si",asi #i%$"s%$nism$64 /isatim/ s$ma# masaa#4 s$%$"ti@ an$mia ,a"$na ma# s$ !a"a# m$"a# /$","ang6@ s$"ing m$ngaami in)$,si ,a"$na ma# s$ !a"a# %ti# /$","ang6@ ,$ainan %$"!a"a#an ,a"$na t"om/osit /$","ang6.

Pa!a a,#i"nCa im%a Cang sangat m$m/$sa" ga m$nang,an s$ !a"a# m$"a# Cangno"ma !an m$ng#an(",annCa /$"sama !$ngan s$@s$ Cang a/no"ma.

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0. Bagaimana $m/"ioogi o"gan $nt$"o#$%ti, &a. Hepar dan Vesica Fellea

• P"imo!im #$%a" tim/ %! %$"t$nga#an mingg ,$tiga s$/agai %$"tm/#an$%it$ $nto!$"m %! ng !ista )o"$gt !is$/t di+erticulum hepartunashepar

• Tnas #$%a" /$"%"oi)$"asi !$ngan ($%at !an m$n$m/s s$%tm t"ans'$"sm

• S$m$nta"a s$2 #$%a" t$"s m$n$m/s s$%tm t"ans'$"sm4 #/ngan anta"a!i'$"ti(m #$%atis !an !o!$nm m$C$m%it !an m$m/$nt, saluranempedu

• S$/a# tonoan ,$(i ,$ '$nt"a t$"/$nt, !a"i sa"an $m%$! a,anm$m/$nt, +esica fellea atau ductus csticus

• S$2 #$%a" a,an /$"(am%" !$ngan '.'it$ina$ !an '.m/ii(a$s nt,

m$m/$nt, sinsoi!2 #$%a" !an a"ingan Cang m$a%isi !(ts /ii)$"s• S$ #$mo%o$ti,4 s$ ,%$" !an a"ingan i,at /$"asa !a"i mesoderm septum

trans+ersum

'. -ienB$"asa !a"i )o"$gt /agian ana )o"$gt tim/ in'aginasi $m/"io i$n Cang/$"mig"asi !i !aam ig.gas"toi$nais om$ntm mas6

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c. PancreasDi/$nt, o$# 2 tnas Cang /$"asa !a"i $%it$ $n!o!$"m !o!$nm • Tnas %an("$as !o"sa Tm/# !i !aam mesogastrium dorsal

• Tnas %an("$as '$nt"aB$"asa !a"i !i'$"ti(m sa"an $m%$! !an tm/# !i !aam mesogastrium+entralSaat !o!$nm /$"%ta" ,$ ,anan !an m$m/$nt, #") 94 tnas %an("$as'$nt"a /$"g$s$" ,$ !o"sa !$ngan (a"a Cang s$"%a %$"g$s$"an !(ts(#o$!o(#s tnas %an("$as '$nt"a /$"a!a t$%at !i (a!o!o"sa tnas %an("$as!o"sa"m'rilogi kedokteran langma. "disi . "gc. /akarta. %&&&

• P$m/$nt,an H$%a" !an D(ts 9#o$!o(#sH$%a" /$"asa !a"i ng !ista ss !$%an s/g tnas %a!at !a"i s$ $nto!$"m.%a!a

t$m%at asa tnas t$"$ta, %! %n(a, $ng,ng !o!$nm Cg s$!ang /$",$m/ang!an s$sai !gn titi, %$"t$nga#an /agian ,$!a !o!$nm Cg t$a# s$$sai!i/$nt,. Tnas #$%a" /$",$m/ang ,$ !$%an ,$ !aam massa m$so!$"mas%an,ni, Cg !is$/t s$%tm t"ans'$"sm. K$m!ian ng tnas m$m/agi !am$na!i "ams !$3t$" !an sinist$"4 Cg m$na!i asa /$",$m/angnCa ,oom s$@s$$nto!$"m ,$ !aam m$so!$"m 'as(a". S$%asang '$na$ 'it$ins !an '$na$m/ii(ais Cg /$"aan m$ai s$%tm t"ans'$"sm m! t$"/$a# o$# in'asi ,ooms$@s$ #$%a" !an m$m/$nt, sinsoi!@sinsoi! #$%a". Koom s$@s$ $nto!$"mm$m/$nt, %i(a$ #$%ati(a$. a"ingan i,at #$%a" !i/$nt, !a"i m$s$n,im s$%tmt"ans'$"sm.K$m!ian tnas #$%a" tama !an "ams t$"mina !$3t$" !an sinist$" m$m/$nt,

sa"an !(ts #$%ati(s (ommnis !an !(ts #$%ati(s !$3t$" !an sinist$".H$%a" /$"tam/a# /$sa" !$ngan %$sat !an m$n$m%ati s$/agian /$sa" (a'itasa/!ominais4 o/s !$3t$" m! $/i# /$sa" !a"i o/s sinist$"

;$si(a Biia"is !an !(ts (Csti(s;$si(a /iia"is /$",$m/ang !a"i tnas #$%a" s/g s$@s$ %a!at Cang tm/# ,$a".Ung !a"i %$"tm/#an ,$ a" ini m$m/$nt, '$si(a /iia"is4 s$!ang,an sisatang,ai Cang s$m%it m$m/$nt, !(ts (Csti(s. K$m!ian '$si(a /iia"is !an!(ts (Csti(s m$ngaami ,anaisasi. A,#i"nCa !(ts (Csti(s /$"ma"a ,$!(ts #$%ati(s (ommnis !an m$m/$nt, !(ts (#o$!o(#s.

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• UtamanCa men'aring dara%. Ka"$na m$m%nCai sCst$m R$ti,o$n!ot$iama,a im%a sangat $)$,ti) s$/agai %$nCa"ing antig$n4 mi,"oo"ganism$4 !an$"it"osit ta ata a/no"ma. Mat$"i Cang t$"%$"ang,a% %a!a anCaman "$$ti,a",$m!ian !i/ang !a"i !a"a# o$# ma,"o)ag !an s$ "$$ti,a" )agositi,.

• B$"%$"an !aam daur ulang ,esi. Ma,"o)ag m$ng#an(",an #$mogo/in H/6$"it"osit ta. B$si !i,$m/ai,an ,$ smsm tang nt, !i%a,ai agi !aamsint$sis ang H/ /a" o$# $"it"osit Cang s$!ang /$",$m/ang. H$m$ !a"i H/!i!$g"a!asi !an !i$,s,"$si ,$ !aam $m%$! o$# #$%atosit.

a. Semasa fetal se,agai organ %emopoietik Cang m$ng#asi,an$"it"osit !an g"anosit. K$mam%an ini ma,in m$n"n s$t$a# a#i"

/. B$"%$"an ga s$/agai reservoir dara% s$#ingga /anCa, !a"a# Cang/isa !itam%ng ,a"$na st",t"nCa ongga" mi"i% s%ons6. Bia!i%$",an4 !a"a# sim%anan it !i,$m/ai,an ,$ si",asi mmFisiologi )uton

. A%a )ngsi Pan("$as $/agai ,$$na" $,so,"in &Pan,"$as a!aa# (am%"an a"ingan $,so,"in !an $n!o,"in.Pan,"$as a!aa#,$$na" m$manang Cang t$"$ta, !i /$a,ang !an !i /a?a# am/ng4 !iatas$ng,ng %$"tama !o!$nm.Pan,"$as m$"%a,an ,$$na" (am%"an Cangm$ngan!ng a"ingan $,so,"in !an $n!o,"in.Bagian $,so,"in Cang %"$!ominan t$"!i"i !a"i ,$om%o,@,$om%o, s$ s$,"$to"i,s$%$"ti angg" Cang m$m/$nt, ,antng@,antng ata asinus Cang/$"#/ngan !$ngan !,ts Cang a,#i"nCa /$"ma"a ,$ !o!$nm.Bagian$n!o,"in Cang $/i# ,$(i t$"!i"i !a"i %a@%a a"ingan $n!o,"in t$"isoasi4%a@%a ang$"#ans 0islets of langerhans1, Cang t$"s$/a" !i s$"#%an,"$as. Ho"mon t$"%$nting Cang !is$,"$si,an o$# s$@s$ %a ang$"#ans

a!aa# insin !an g,agon.• -ksokrin :Pan,"$as $,so,"in m$ng$a",an g$ta# %an,"$as Cang t$"!i"i !a"i

!a ,om%on$n4 Cait 1. sekresi enzimatik poten !an2. sekresi alkali encer (ai"6 Cang ,aCa a,an nat"im /i,a"/onat NaH9O*6.

Enim %an,"$as !isint$sis o$# "$ti,n $n!o%asma !an ,om%$,s Gogis$ asins4 !an ,$m!ian !isim%an !i !aam g"ana imog$n !an!i,$a",an m$ai %"os$s $,sositosis /ia !i%$",an.S$ J s$ asini m$ng#asi,an /$/$"a%a $nim Cang !is$,"$si,an m$ai!(ts %an,"$as Cang /$"ma"a ,$ !o!$nm.

K$tiga $nis $nim %an,"$as Cait1. Enim@$nim %"ot$oiti,4 Cang/$"%$"an !aam %$n($"naan %"ot$in. Tiga $nim %"ot$oiti, tama Cang !is$,"$si,an o$# %an,"$as a!aa#tripsinogen, kimotripsinogen, !an prokar'oksipeptidase, Cang masing@masing !is$,"$si,an !aam /$nt, ina,ti).S$t$a# !is$,"$si,an ,$ !aamm$n !o!$nm4 tripsinogen !ia,ti),an m$na!i /$nt, a,ti)nCa4 tripsino$# enterokinase, sat $nim Cang t$"/$nam !iatas mina s$@s$Cang m$a%isi m,osa !o!$nm. T"i%sin ,$m!ian s$(a"a

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o,to,ataisism$nga,ti,an $/i# /anCa, t"i%sinog$n. T"i%sinog$n #a"st$ta% ina,ti) !aam !i!aam %an,"$as nt, m$n($ga# $nim %"ot$oiti,m$n($"na s$@s$ t$m%at ia t$"/$nt,. Kimotripsinogen !an prokar'oksipeptidase4 $nim %"ot$oiti, %an,"$as ainnCa4 !i/a# o$#

t"i%sin masing@masing m$na!i /$nt,@/$nt, a,ti) m$"$,a4 ,imot"i%sin!an ,a"/o,si%$%ti!as$4 !i!aam m$n !o!$nm. D$ngan !$mi,ians$t$a# $"it"o,inas$ m$nga,ti),an s$/agian t"i%sin4 t"i%sin ,$m!ian/$"tanggng a?a/ nt, m$nC$$sai,an %"os$s %$nga,ti)an s$antnCa.

1. Amias$ %an,"$as4 /$"%$"an %$nting !aam %$n($"naan ,a"/o#i!"at!$ngan m$ng/a# %oisa,a"i!a m$na!i !isa,a"i!a. Amias$ !is$,"$si,anm$ai g$ta# %an,"$as !aam /$nt, a,ti) ,a"$na amias$ ti!a,m$m/a#aCa,an s$@s$ s$,"$to"i,.

2. Li%as$ %an,"$as4 sangat %$nting ,a"$na m$"%a,an sat@satnCa $nimCang !is$,"$si,an !is$"# sist$m %$n($"naan Cang !a%at m$nntas,an$ma,. Li%as$ %an,"$as m$ng#i!"oisis t"igis$"i!a ma,anan m$na!i

monogis$"i!a !an asam $ma, /$/as4 Cait satan $ma, Cang !a%at!is$"a%. Ko$st$"o $st$"as$ nt, #i!"oisis $st$" ,o$st$"o s$!ang,an)os)oi%as$ nt, m$m$(a# asam $ma, !an )os)oi%i!.Tiga "angsangan!asa" Cang m$nC$/a/,an s$,"$si %an,"$ati, 1. As$ti,oin !is$,"$si,anng n$"'s 'ags %a"asim%atis !an sa"a)@sa"a) ,oin$"g$ni,.2.Ko$sisto,inin !is$,"$si,an m,osa !o!$nm !an $nm "angsanganasam. *. S$,"$tin !is$,"$si,an m,osa !o!$nm !an $nm"angsangan asam.

• -ndokrin T$"!i"i atas + s$4 Cait s$ 4 s$ V4 s$ W4 !an s$ F.Fngsi $n!o,"in,$$na" %an,"$as !i%$"an,an o$# %a ang$"#ans.S$,"$si s$ J s$ ini

/$"%a #o"mon Cang a,an angsg !iang,t m$ai %$m/# !a"a#.S$Ho"mon Ta"g$t tama E)$, Ho"mona R$gasi.

1. G,agon6 Ta"g$t a!aa# #ati4 !an a"ingan a!i%osa. E)$, a!aa#m$"om/a, (a!angan i%i!4 m$"angsang sint$sis g,osa !an %$m$(a#angi,og$n !i #ati4 m$nai,an ,a!a" g,osa. Distimasi o$# ,a!a" g,osa!a"a# Cang "$n!a#4 !i#am/at o$# somatostatin.

2. V Insin6 Ta"g$t a!aa# s$/agian /$sa" s$. E)$, a!aa# m$m/ant%$ngam/ian g,osa o$# s$4 m$nstimasi %$m/$nt,an !an%$nCim%anan gi,og$n !an i%i!4 m$n"n,an ,a!a" g,osa !a"a#.Distimasi o$# ,a!a" g,osa !a"a# Cang tinggi4 !i#am/at o$#somatostatin.

*. W Somatostatin6 Ta"g$t a!aa# s$ ang$"#ans ain4 $%it$ sa"an%$n($"naan. E)$, a!aa# m$ng#am/at s$,"$si insin !an g,agon4m$ng#am/at a/so"/si ss !an s$,"$si $nim %$n($"naan. Distimasio$# ma,anan tinggi@%"ot$in4 m$,anism$nCa /$m $as.

+. F Poi%$%ti!a %an,"$as6Ta"g$t a!aa# o"gan %$n($"naan. E)$, a!aa#m$ng#am/at ,ont"a,si ,antong $m%$!4 m$ngat" %"o!,si $nim%an,"$as4 m$m%$nga"#i a/so"/si nt"isi o$# sa"an %$n($"naan.Distimasi o$# ma,anan tinggi@%"ot$in !an "angsang

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Fisiologi GCton8Ha

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HUBUNGAN TIAP ORGAN DALAM SISTEM ENTEROHEPATIKP$m/$nt,an /ii"/in

H$%a" i$n %$m$(a#an $"it"osit %$m/$nt,an /ii"/in

H$%a" '$si(a )$$a #$%a" m$m/$nt, $m%$!4 ;F m$nCim%anm$m$,at,an!an m$ng$a",an $m%$!4 /$"sama !(ts %an("$as Cg m$ng$a",an g$ta#%an("$as

H$%a" %an("$as %an("$as nt, %$n($"naan4 #$%a" nt, m$ta/oism$nCa.

H/ngan anta"a H$%a"4 sist$m /ii$" !an %an,"$as !itina !a"i as%$, /io,imia !an%atoogi ,ini,

,an!ng $m%$! !an sa"an $m%$! $,st"a#$%ati, m$ng#/ng,an #ati !$ngant"a(ts gast"oint$stinais4 s$#ingga m$"%a,an %$ng#/ng %$nting si",as$nt$"o#$%ati,. D$ngan ata tan%a m$ai ,an!ng $m%$! ma,a $m%$! a,an!iai",an m$ai sa"an $m%$! ini. Kan!ng $m%$! ti!a, 'ita !aam ,$#i!%an

tan%a aat ini mansia /iasanCa ti!a, a,an m$ngaami ganggan :sioogi,Patologi. FK(2

$m%$! !i#asi,an o$# s$ #ati ,$ !aam sa"an $m%$!4 Cait m$ngai" ,$ !aam!o!$nm. Di anta"a ma,an4 o"i:sim !o!$nm !,ts ini t$"tt% !an $m%$!m$ngai" ,$ !aam '$si,a )$$a4 t$m%at ia !isim%an. Bia ma,anan m$mas,i mt4s:ngt$" s$,$iing o"i:sim "$a,sasi /ia isi am/ng m$mas,i !o!$nm4 ma,a#o"mon 99K ,o$sisto,inin6 !a"i m,osa ss m$nC$/a/,an '$si,a )$$a /$",ont"a,si.D,ts (Csti,s m$n!"ainas$ '$si,a )$$a4 !an !,ts #$%ati,s /$"sat !$ngan !,ts(Csti,s nt, m$m/$nt, !,ts (#o$!o(#s. Dan ,$m!ian m$mas,i !o!$nm%a!a %a%ia !o!$nm.Fisiologi Kedokteran. )anong. ")C

!,ts %an,"$as !an $m%$! ,a!ang@,a!ang m$$/a" m$m/$nt, am%a4 %anang-mm6 /$"ma"a ,$ !aam %a%ia !o!$ni maCo"4 Cang t$"$ta, %a!a sisi ($,ng!o!$nm s$,ita" (m !a"i %io"s. D,ts %an,"$ati,s as$so"is /$"ma"a ,$ !aam!o!$nm %a!a %a%ia mino" ata as$so"is4 2(m !i s$/$a# ant$"os%$"io" %a%ia!o!$ni maCo".)rant 3etode Anatomi 'erorientasi Pada Klinik. /ohn V. 4asma5ian * Charles ".#lonecker. "d. 66. 5ilid 6. FK(2

A. %$"/$!aan /ii"/n ,onngasi !an ti!a, ,onngasi'iliru'in tidak terkon5ungasi :a. m$m%nCai a:nitas t$"#a!a% ota, to,si,6

/. ti!a, m$?a"nai a"ingan ain(. ti!a, a"t !aam ai"!. /ii"/in in!i"$(t$. #$mo/ii"/in

'iliru'in terkon5ungasia. ti!a, m$m%nCai a:nitas t$"#a!a% ota,/. m$?a"nai a"ingan ain

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(. a"t !aam ai"!. /ii"/in !i"$(t$. (#o$/ii"/inPatologi. FK(2

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ram Entero 1

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