KELENJAR PARATIROID

TIROID

CHIEF CELL

OXYPHIL CELL

PARATIROID

METABOLISME TULANG

TULANG : - ORGANIK MATRIX : 30%

- GARAM-GARAM : 70%

* ORGANIK MATRIX

95% : KOLAGEN

5% : GROUND SUBSTANCE

- MUKO PROTEIN

(CHONDROITIN SULFAT &

ASAM HIALURON)

* GARAM-GARAM TULANG

T.U. : CALCIUM

PHOSPHAT

HYDROXYAPATITIES :

Ca w-x (H O ) (PO ) (OH )

RATIO Ca/P : 1.3 / 2.0``

TULANG : STATIS

DINAMIS

DEPOSISI

PEMBENTUKAN

TULANG

RESORPSI

LARUTNYA GARAM-

GARAM TULANG

SOLUBILITY PRODUCT

(HASIL KELARUTAN)

Ca DARAH X PANORGANIK

S.P. = 1DEPOSISI RESORPSI

PENGATURAN CALCIUM DARAH

9.8 - 10.2 mg %

TURUN (HIPOCALCEMIA)

7MG % : TETANI

4MG % : KEMATIAN

9 - 7 : LATENT TETANI

CHOVSTEK’S SIGN

CARPOPEDAL SPASM

MENINGGI (HIPECALCEMIA)

PROSES CALCIFIKASI : EXTERNA TULANG

17 mg % : KEMATIAN

* PENGATURAN

1. PARAT HORMON (HORMON PARATHYROID)

2. CALCITONIN “C” CELL (CLEAR CELL)

KELENJAR THYROID DIANTARA SEL-SEL

FOLIKEL

3. VIT. D : CALCIFEROL

4. DIHYDROTACHYSTEROL (A T10)

EXCHANGEABLE CALCIUM

CaHPO4

TULANG : 0.4 - 1 %

- SEMUA SEL JARINGAN

- LIVER + G.I TRACT

(PERMEABLE SEL)

METABOLISME CALCIUM & PHOSPHAT

CA :SUMBER : SUSU

ABSORPSI : INTESTINAL

1.000mg Ca MASUK/HARI

100mg ABSORPSI

700mg AKTIF & PASIF

600mg SEKRESI KEMBALI

900mg EKSKRESI PADA FECES

EKSKRESI : FECES

URINE

CHOLECALCIFEROL (VIT. D3)

IN HIBITION

25-HYDROXYCHOLECALCIFEROL

PARATHYROID

HORMON

1,25- HYDROXYCHOLECALCIFEROL

CALCIUM CALCIUM ALKALINE

BINDING STIMUL PHOSPHATASE

PROTEIN ATPase INHIBITION

INTESTINAL ABSORPTION OF CALCIUM

PLASMA CALCIUM ION CONCENTRATION

PHOSPHAT :

SUMBER : SUSU, DAGING

ABSORSI : INTESTINAL

DIHALANGI CALCIUM

EKSRESI : FECES

URINE

DEPOSISI

OSTEOBLAST ALKALI PHOSPHATASE

P. ORGANIK P. ANORGANIK

CA P.ANORGANIK

60

(KEADAAN JENUH)

DEPOSISI PERLU VIT.C

YANG CUKUP

RESORPSI

OSTEOCLAST

1. PROTEOLYTIC ENZYM

(LYSOSOME)

MELARUTKAN ORGANIK MATRIX

2. ASAM-ASAM

SITRAT -LAKTAT

MELARUTKAN GARAM2

SP. 30 50

MATRIX

1. BAHAN

`GARAM TULANG

CA; P

DEPOSISI2. PROSES

RESORPSI

VIT. C

3. FAKTOR LAIN VIT. D

STRESS

CA : - TULANG

- E,C.F

FUNGSI : 1. METABOLISME TULANG

2. NEURO-MUSCULAR

EXCITABILITY

3. JANTUNG

- DARAH : 1. NON DISSFUSABLE

10 mg/% TERIKAT PROTEIN 50%

5 mEg% 2. DIFFUSABLE - NON 10 NESED

CITRAT 5%

3. DISFUSABLE - 10 NESED : 45%

FISIOLOGIS ARTIK

DIPENGARUHI HORMON

P. - TULANG

- INTRA SELULER : ORGANIK

FUNGSI : BAGIAN PLASMA

BAGIAN NUKLEUS

ENZYM

METABOLISME

KARBOHIDRAT

- DARAH :

3-4mg% 1. HPO4 ; H2 PO4

ANORGANIK

SINTESA

ASAM AMINO

PRE-PRO PTH(115)

PRO PTH 90

DEGRADASI

PTH 80_+

CA++ CA

PLASMA PTH +

EFEK FISIOLOGIS

- ABSORPSI USUS : CA

- RESORPSI CA TULANG

- PHOSPHATURIE

- ANTICALCIURIE

KULIT

TIROID PARATIROID VIT.D3 CALCITONIN PTH

LIVER

25 (OH)D3

RESORBSI TULANG

TULANG USUS GINJAL GINJAL

[CA++] [CA++] 1.25 {OH} 2D3