Anamnesis Pemeriksaan Fisik Paru

7/17/2019 Anamnesis Pemeriksaan Fisik Paru

http://slidepdf.com/reader/full/anamnesis-pemeriksaan-fisik-paru 1/38

ANAMNESIS & PEMERIKSAAN FISIK

(ILMU PENYAKIT PARU)

Dr.dr.Tahan P.H.,SpP.,DTCE.,MARS

FK UWK SURABAYA!.".!#



DIAGNOSISDITE$AKKAN DARI INF%RMASI

. R'aa* P+na'* - Anan+/'/

!. Tanda P+na'* - P++r'/aan F'/'

0. P++r'/aan Ta1ahan 2 P++r'/aan+3+n4ap' A5 & PD

- p++r'/aan daha

- p++r'/aan 6a'ran p3+ra (a/7/ EF) - p++r'/aan h7/7/ p+r37 d'+*ah7'

+47naannna.



ANAMNESIS+r7paan Ba4'an p+r*aa dan *+rp+n*'n4

1+r/aa p++r'/aan 8/' 4 /+/aa +r7paan

9da3 da/ar 4 *'n44' n'3a'na (*'n4a*na) d3

pra*+ +d9*+ran.

M+n47p73an da*a, aan6ara **4 +37han P5,

+nanaan p+na'* d4n 6+ra*

Cara D5 4 1a' har7/ d'arahan *+r7*aa pd+7n4'nan-+7n4'nan : DD

+1+r' 4a1aran +arah DS : *'ndaan /+4+ra

- S*r7*7r & T7;7an A<

-.P+n6a*a*an da*a P5- . *43 A5

- . Id+n*'*a/ U7r, S+5,S77,T+pa* 3ah'r, P++r;aan

- . S71+r A5 A7*9 A5 3a4/7n4 dar' P5

- H+*+r9 A5 dar' /71+r 3a'n



!. K+37han U*aa (KU)- /'*9 : = : /+/7a*7 4 1+rh71 d4n

p+n+1a1 P5 da*an4 + D9*+r>RS K+adaan /a'* pd /aa* A5 +r7p.p+r7;7dan

KU

0. R'aa* Ma/a La37- +3a37' +/p39ra/' 9nd'/' /+1+37 /a'*,

+6+3aaan >*'ndaan +d'/ 4 p+rnah

d'a3a'?. S*a*7/ +adaan pada /aa* /a'*- K9nd'/' 3'n47n4an, +1'a/aan, a3+r4',

'7n'/a/', p+n491a*an *+rah'r



". R'aa* K+37ar4a

- U* +n'3a' r+/'9 P5 pd p+n.*+r*+n*7@. R'aa* P/'9/9/'a3

T+n' A5 - R+/+p*'3 +3'ha*>+nd+n4ar>+n6a*a* r+a/'

+9/'9na3

- Man'p73a*' +17a* r'n4a/an

K+37han U*aa- Apa 4 +n+1a1an da*an4 + d9*+r>RS

- //d 'd+n*'8a/' KUp+r*anaan *+r97/ pd KU */1

L9a/'> K7a3'*a/> K7an*'*a/> Wa*7>K9nd'/'

> Fa*9r 4 1+rp+n4ar7h > 4+;a3a p+ndap'n4.



Pada P+n.Par7 > R+/p'ra/', KU 4 /+r'n4 (@). Ba*7

- /a*7 6ara *717h +1+r/'han /a3.naa/ dar' 3+nd'r

(77/) dan 1ahan : 1+nda a/'n4. - S+ra* a. R++/ 1a*7 *+r3+*a pada /ara *r'4+'n',

439//9ar'n4, 3ar'n4 /7p+r'9r dan a47/.- S+ra* +. R++/ 1a*7 pada

(). n.r+67rr+n*p+n7*7pan 439*'/ (!).n.phr+n'67/9n*ra/' d'ara4a

(0).n./p'na39n*ra/' 9*9* p+rnaa/an 4 3a'n 7*+3aan>+17a 439**'/ 4 *+r*7*7p.

.+ndada ar'n4'*'/,*ra+'*'/,C99n C93d (CC) .r9n'PP%K,BK .+r'n4CC,ar'n4'*'/ a7*,3ar'n4'*'/ a7*,,*ra+'*'/a7*,BA

.1+rdahaBK,TB,B.E*a/'/



!.Daha .;73ah > har' .arna ;+rn'h :+n*a3 p7*'h (969'd) 7n'n4 : h';a7

(p7r73+n*) : 4a17n4an arna */1. .6ap7r darah /+d''* (1399d /*r+a'n4) : 1ana (ranh+9p*/'/). . Wa*7 pa4' har' BK, B.E

. Daha N 769'd (1+n'n4 *d 1+rarna)K7n'n4 +n4and7n4 nanah (3+9/'*)H';a7 daha +n4a3a' /*a4na/' /h4 *'173+dr9p+r9/'da/+ dar' 3+9/'* PMN, '/. pd.B.E, a1/+/,'n+/' /'n7/ parana/a3'/, 'n+/' P/+7d99na/

. BK 3an;7* B.E (G/a6673ar) *'ap har'daha p7r73+==

darah . A/a (Ca/*/ 9 *h+ 1r9n6h'a3 *r++) 79'd +n*a3

1+r1+n*7



0.Ba*7 darah ./a3ah /a*7 $5 pa3'n4 p+n*'n4 pd IPP 9 . +r7p.1ahaa p9*+n/'a3 adana p+rdarahan 4aa*

!. hap'r /+3a37 d'/+1a1an p+na'* 1r9n9p739na3.

.a/a3 /a3.naa/ 1aah>a*a/ .1+daan d4n h+a*++/'/

.dp* d'/+1a1an TB,Ca 1r9n94+n' (=?" *hn),Pn+79n'a,B.E ,'nar par7,

/*+n9/'/ '*ra3, a1/+/ par7,

+radan4an : n+9p3a/a ar'n4,

3ar'n4 a*a7 *ra+a.

*



- apa* a4 49 9n4an. P3+r9p739na3 1'a/ana a7*, *a;a,*+r39a3'/'r

'n*+r'*+n dan d'p+rh+1a* d4n p+rnaa/an dan/+r'n4

a'n h+1a* d4n 4+raan. P+n+1a1 pn+9n'a 1a*+r' (*+r7*.97/ 4ra

n+4a*'dan K3+1/'+3a), 'nar par7, p3+r'*'/ +r'n4>/'66a. P3+ra par'+*a3'/ +n4and7n4 1ana /+a3'7;7n4-7;7n4

/ara 7* n+r', /+1a3'na p3+ra '/6+ra3'/ *dp+a *hd

ran4/an4an n+r'. P+na'* par+n' par7, 1a4a'anap7n

1+ra*na *d aan +n+1a1an n+r' p3+r'*' ;'a



!.Tra+91r9n'a3N+r' *ra+'*'/ a7* 1+r7pa ra/a *+r1aar d'

/71/*+rna3 dan ra/a *d +na 4 /+r'n4

1+r*a1ah h+1a* 1'3a anar' naa/ da3a.S+r'n4 d'/+1a1an *ra+'*'/ a7* dan*ra+a1r9n'*'/ a7*

0. Kard'9a/73+r1'a/a *+ra/a /71/*+rna3 : pd./'/' 'r'. S+r'n4

d'ra/aan /+p+r*' *+r*+an,*+r;+p'* : *+rd+/a :p+ra/aan 1+ra* da3a

dada.K+rap +n;a3ar + 1ah7 'r' dan/+pan;an4 /'/' +d'a3 3+n4an 'r' *+r7/ + /'7.N+r' dp* +n;a3ar + 3+h+r : rahan4 : +d7a

1ah7.Inar an*7n n +r' h+1a1,+n6+a / *



?. E/9a4+a3>+d'a/*'na3N+r' +/9a4+a3 n+r' dada 4 da3a, dp*

d'ra/aan (r++r+d) pd /+4+n /9a*' , *d

d'/+r*a' 45 3a'n.S7ar d'1+daan d4n n+r'Kard'9a/673+r : +7r97/739/+3+*a3. B'a/anad'/+r*a' d/a4'a, r+47r4'*a/' aanan pada* 41ar7 d'aan. +/9a4'*'/. N+r' +d'a/*'na3

aa* ;aran4. pn+9+d'a/*'n7

". N+7r97/739/+3+*a3M'r'p d4n n+r' dada 4 3a'n.

D'an*ara p+n+1a1 n+r' dada 4 1+ra/a3 dar'/+3+*a3

G%/*a34' n+r' *73an4 d'/+1a1an *+anan,

+r9/' : ran4/an4an p+r'9/*+7.N +r' +d7a G a3 'a, 1a' 9*9*-9*9*



".S+/a naa/. A7* pn+9*9ra/, pn+9n'a,

a*+3+*a/'/, +d+a par7. Kr9n' PP%K, 4a4a3 ;an*7n4, BK, TB

@. S+/a naa/ 1+r73an4. Hana *+r;ad' pd * /+ran4an. d'37ar /+ran4an N9ra3. Ada h717n4an d4n paparan a3+r4+n. T+rdapa* pd A/a Br9n'a3



Ur7*an +17a* A5 ;ad' 7dah

1 Tanyakan KU, uraikan sifat-sifat KU : kapantimbul, cara timbul: menaak ! pelan-pelan"saat kelu#an memberat ! lebi# rin$an ! tetap! makin lama makin berat, kenapa timbulkelu#an tai%

! Apa1'3a ada +37han 3a'n ;74a d'7ra'an d4n ;+3a/

0 S+*+3ah da*a *+r7p73, '*a +17a* ana3'/'/ dar'/+7a +37han 4 ada dan d'a1'3 +/'p73an+7n4'nan DD

? Dar' a/'n4-a/'n4 DD '*a *anaan

a). P+n+1a1 p+n.*/1 *+ra/7 3'n47n4anp++r;aan>r7ah

: +1'a/aan 4 7n4'n +n;ad' p+n+1a1.1). $5 3'n'/ 4 ha/ dar' a/'n4-a/'n4 DD

6). K9p3'a/' 4 7n4'n *'173 dar' a/'n4-a/'n4 DD



P ' d P A3 * 1 *



- P++r'/aan pd P5 A3a* 1an*7P+n4+*ah7an T+9r' da/ar Par7P+na'* pd ar.par7>p3+ra : d'nd'n4 dada

p+r71ahan- 1+n*7 4+raan- p+n4han*aran 4+*aran

B+n*7

- p+rha*'an p+r71ahan 1+n*7 dan 77ran*9ra/- D'a+*+r dada 1arr+3 6h+/* pd PP%K - S'+*r'/>a/'+*r'/. A/'+*r'/E7/',Pn+9*9ra/,F'1r9/'/- Ran4 an*ar I4a . +3+1ar PP%K,E7/',Pn+9*9ra/

. M+n+p'* S6har*+, F'1r9/'/, A*+3+*a/'/-



P+r4+raan Dada

P+n'3a'an p+r4+raan dada 4+raan

h+'*9ra/ anan dan 'r' /'+*r'/ a*a7*'da

P+r4+raan +n7r7n

-$an447an 9*9* *ahanan dd4 dada

+n'n4a*

-d'/*+n/' par7 +n7r7n 9pr+/' ;ar'n4an

par7.

-P+n4han*aran 4+*aran

-Dapa* d'+*ah7' +3a37' a3a* p+ra1a a*a7

K 3 ' D P



K+3a'nan Da/ar Par7

D'1+daan a*a/ 0 9p9n+n

. K+3a'nan Sa37ran naa/

. P+n+p'*an

. S+r+* d3 37+n

. Sa37ran naa/ *+r*7*7p *9*a3

!. K+3a'nan par+n' par7 . K9n/93'da/' a3+93' *+r'/' 6a'ran a*a7 /+3

. E8/+a p+3+1aran d'/*a3 1r9n'93'

par+n' par7 +n4and7n4

7dara =N

. Ka'*a/ +r7/aan ;ar.par7-= *+r1+n*7r9n44a

7dara d4n dd4 *+1a3



0. K+3'anan P3+ra. Pn+9*9ra/ p3+ra 1+r'/' 7dara E7/' p3+raCa'ran (J) F37'd9pn.*9ra/ (Ca'ran J 7dara (J) F'1r9/'/p3+ra (/6har*+) ar.p3+ra ;ar.par7*

&'(')IKSAAN *ISIK



&'(')IKSAAN *ISIK

INSPEKSIP++r'/aan

*anpa a3a*

1an*7,P+rha*'an

PALPASI

P+r'/a

PERKUSI

P+r'/a>U7

r

AUSKULTASID+n4aran

S7ara

naa/,/7ara*a1ahan,/7ara1'/',/7arap+r6aapan

-B+n*7 dan

77ran*9ra/-P+r7aandada-%*9* 1an*7

p+rnaa/an-I4a danr7an4 an*ar'4a

T'p+ danr+.naa/

-P9/'/'

+d'a/*'n7-D+n7*an,4+*aran,1+n;93an,+d+a, r+p'*a/'

-N+r' *+an-r+'*7/ 9a3-4+/+an p3+ra

-Ba*a/

;an*7n4-Ba*a/par7-ha*'-L+1ar+d'a/*'n7

-1a*a/1aahpar7

1+3aan4

N+rmales

ikuler:In/p'ra/'*+rd+n4arp+n7h,E/p'ra/'

L+1'h 3+ahdan p+nd+In/pE/p0



.eberapa macamp+la pernafasany$ abn+rmal:Dispnea: kelu#ansesak y$

sub/ektif Ort+pnea: sesakbertama# beratbila berberin$&+lipnea:frekuensi

pernafasan y$menin$kat,selalu iserati$n ispnea0iperpnea:alamnya nafas

y$ menin$kat.raipnea:pernafasanlambat, puremi, k+maD(#eyne-St+ke:

ritme pernafasanmenaak

*remitus+kal+n'n4a* k+ns+liasi"

(enurun: atelektasis,efusi"pnem+t+raks

S+n+r:Nada>a*7>PA+d'aN>N>N(pada*7dara)

)eup: T'n44'>P+nd+>7daraN&ekak:=*'n44'>=p+nd+>pada*(

Ca'r)*d ada7dara0ipers+n+r:R+ndah>pan;an4>7dara=NTimpani:

=r+ndah>=pan/an$uara sa/a

.r+nk+-askuler:Insp teren$arpenu#'ksp%penu#

2silent $ap3 4-5

.r+nkial:Insp 6 'ksp%&enu#2silent $ap7

485

SUARA TAMBAHAN



SUARA TAMBAHAN d'*'173an 93+h /+r+*>p+n+p'*an

+n'/ S7ara Ta1ahan

C'r'-6'r'

R9n'

Ba/ah T+rp7*7/-p7*7/ Kasar d'/a3.p+rnaa/an, rn 4+3+17n4 7dara

1+/ar 4 p+6ah Sean$:d'/a3. P+rna.+6'3>/+dan4, 94+3+17n4 7dara +6'3 4 p+6ah (B.+*/'/, 1r9n9p9n')0alusr+p'*a/'

K+r'n4 S7ara *'da *+rp7*7/. S+n+r+us,nada r+ndah %1/*r7/'par/'a3 /a3.p+rnaa/an 1+/ar Sibilan (h++), nada *'n44'91/*r7/' /a3.naa/ +6'3, +n6'6'* (/7a+'n4), pada a/a.

S7ara Ka'*a/ -Nada r+ndah -E/p'ra/' 3+1'h r+ndah dar' In/p'ra/'OPada Ka'*a/, Pn+9*9ra/

K+3a'anan P3+ra B'/'n4 4+/+ p3+ra (P3+7ra3 Fr'6*'9n R71)-+3a/ pd 'n/p'ra/' $+/+an +r*a/. P3+r'*'/ S'a>F'1r'n9/a

Cr7n6h'n4O/ /'4n T+rp7*7/-p7*7/ S+'raa d4n d+*a ;an*7n4. PadaPn+9+d'a/*'n7

Sr'd9r -rn a3'ran 4 7a* ,Wh++ +ra/ *+rd+n4ar *anpa /*+*9/9p.-/7ara 7/'a3 9.91/*r7/' 3ar'n4, *ra+a.: 1r9n7/ 1+/ar ,D'p*h+r'

S7ara B'/' -Br9n'a3>h'/p+r+d p+6*9r'397+ -D+n4an 1+r1'/' (a*a d+/'/)-N9ra3 ;+3a/ pada 3ar'n4 - +3a/, nada *'n44' 9n/93'da/',a*+3+*a/'/.

S7araP+r6aa an

- D+n4an /7ara /a*7, d7a, *'4a - +3a/,1r9n9p9n' (J),pada9n/93'da/', a*+3+*a/'/ -Br9n9 9n' d n 7a3'*a/ na/a3 d'/+17*

Anamnesis Pemeriksaan Fisik Paru

Documents

Transcript of Anamnesis Pemeriksaan Fisik Paru