gastroenterologi
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Transcript of gastroenterologi
![Page 1: gastroenterologi](https://reader035.fdokumen.com/reader035/viewer/2022062410/5695d0c01a28ab9b0293bbdb/html5/thumbnails/1.jpg)
Pemeriksaan FisikABDOMEN
Umar Zein
Bagian Penyakit Dalam
FK USU
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Regio Abdomen
Linea mid Clavicularis
Arcus costae
SIAS
Proc.xypoideus
Symphisis pubis
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Regio Abdomen
Hypochondrium kiri
Epigastrium
Hypochondrium kanan
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Regio Abdomen
Hypochondrium kanan
• Hepar
• Gall Bladder
• pylorus
• duodenum
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Regio Abdomen
Epigastrium
• Hepar
• Gall Bladder
• Pankreas
• Gaster
• Aorta abdominal
• Duodenum
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Regio Abdomen
Hypochondrium kiri
• Lien
• Hepar Lob.kiri
• Gaster
• Pankreas
• Plexura lienika
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Regio Abdomen
Lumbal kanan
Umbilical
Lumbal kiri
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Regio Abdomen
Lumbal kanan
• Ginjal kanan
• Adrenal kanan
• Colon ascendens
• Colon transversum
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Regio Abdomen
Umbilical
• Intestinum
• Colon transversum
• Aorta abdominalis
• Uterus (kalau hamil)
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Regio Abdomen
Lumbal kiri
• Colon descendens
• Ginjal kiri
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Regio Abdomen
Inguinal Kanan Inguinal Kiri
Supra pubic
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Regio Abdomen
Inguinal Kanan
• Caecum/Appendix
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Regio Abdomen
Supra pubic
• Blaas
• Uterus
• Rectum
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Regio Abdomen
Inguinal Kiri
• Colon sigmoid
• Ovarium kiri
• Tuba falopii kiri
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Keluhan Abdomen
1. Nyeri : mulas, kolik, tenesmus, perut tegang, nyeri ulu hati
2. Mual, muntah : sifat muntah, isi muntah (darah, sisa makanan, feses, dll), rasa muntah (asam, pahit)
3. Mencret : frekwensi, volume, warna4. Tidak bisa bab, flatus : ileus5. Perhatikan juga adanya kelainan organ
Thorax
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Keluhan Abdomen
6. Pembengkakan, massa
7. Gatal / priritus
8. Ikterus
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Usia Muda : kelainan pada abdomen
keluhan di thorax, Usia lanjut : kelainan di thorax, keluhan
di abdomen
Ada Non cardiac chest pain
Regurgitasi asam lambung nyeri
dada
Sesak nafas keluhan di abdomen
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Regio AbdomenKolesistitis akut
Angina
Nyeri ulkus
Nyeri
Pleuritik
Appendisitis akut
Infark lien
Iskemik usus
Appendisitis
Sistitis
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Anamnese Nyeri Abdomen
Dimana ? Penjalaran ? Kapan ?, kapan-kapan ? Intensitas : sampai bagaimana ? Riwayat nyeri sebelumnya ? Haid terakhir ? Keluhan lain ? Yang memperberat / memperingan keluhan ?
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Inspeksi Abdomen
Simetris / asimetris
Pembengkakan, pembesaran, penonjolan
Gerakan peristaltik
Posisi penderita : diam, gelisah, membungkuk, serangan nyeri
Keadaan dinding perut : tegang, berisi cairan ?
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Palpasi Abdomen
Menentukan pembesaran organ : hati, limpa, Kandung empedu, Uterus, ginjal, Kolon
Menentukan lokasi nyeri tekan
Mengetahui adanya asites
Mengetahui adanya massa intra abdomen
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Perkusi Abdomen
Menentukan adanya cairan intra abdominal
Menentukan batas organ yang membesar
Menentukan batas massa intra abdominal
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Auskultasi Abdomen
Mendengar peristaltik usus : menghilang, melemah, atau meningkat (borborigmi)
Menghilang : ileus paralitik, peritonitis
Meningkat : ileus obstruktif, hiperperistaltik
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