Lbm 2 Modul 7 Ok's Bgt

8/18/2019 Lbm 2 Modul 7 Ok's Bgt

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LBM 2 MODUL 7

KASUS PERKUSI PEKAK PADA DADA

STEP 1

TERMINOLOGI1. Cavum pleura : ro!!a "a#o! a#ara pleura v$%eral$% &e!a pleura par$e#al$%

2. Per"u%$ : #$&a"a me!e#u" %ua#u 'a!$a &! "e#u"a2 pe&e" &a (epa# %e'a!a$

upa)a 'a#ua &lm me&$a!o%$% "ea&aa 'a!$a2 )! 'era&a &$ 'al$")a 'er&a%ar"a %uara )! #er&e!ar

*"amu% Dorla&+

3. ,em$#,ora- : %a#u %$%$ &a&a

*"amu% Dorla&+4. lu! (ompl$a(e : &a)a "em'a! paru &a #,ora- &a &$)a#a"a %e'a!a$

pe$!"a#a volume &$ &lm paru2 u#u" %e#$ap %a#ua pe$!"a#a #e"aa

$#raalveolar

*.$%$olo!$ mau%$a &a me"a$%me pe)a"$#/Gu)#o/2000+

STEP 2

1. %e%a" apa% :

&e.$$%$

e$%2 :

• &)%pea &3e..or#

• o(#ural &)%pea

• paro-)%mal o(#ural &)%pea

• or#,opea

• #a(,$pea

• pla#$pea

me"a$%me #ea&$)a %e%a" apa% a"$'a# e.u%$ pleura

2. e$%2 perapa%a a'ormal

(,e)e %#o"e%

"u%%maul '$o#

3. apa .u!%$ &ar$ (a$ra &$ (avum pleura4

4. ela%"a 5$%$olo!$ a&a)a (a$ra &$ (avum pleura6

5. ela%"a Pa#o.$%$olo!$ a&a)a (a$ra &$ (avum pleura6

6. ela%"a e#$olo!$ a&a)a "ele'$,a (a$ra &$ (avum pleura6

7. apa a"$'a# )! &$#$m'ul"a a&a)a "ele'$,a (a$ra &$ (avum pleura4

8. apa %aa .a"#or )! memper#a,a"a #e"aa e!a#$. pa&a pleura49. ma(am2 (a$ra pa&a e.u%$ pleura

10. ma(am2 'u)$ per"u%$ pa&a pemer$"%aa paru

11. &$a!o%$% pa&a pa%$e &! e.u%$ pleura : aame%$%

pemer$"%aa .$%$"

pemer$"%aa peua!12. ma(am2 pe)a"$# )! &$%er#a$ &! e.u%$ pleura


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13. pea#ala"%aaa

14. %e'u#"a o#o#2 #am'a,a pa&a $%p$ra%$ &a e"%p$ra%$

15. pe)e'a' peurua lu! (ompl$a(e16. .a"#or apa %aa )! mee#u"a lu! (ompl$a(e

17. (ara me!u"ur lu! (ompl$a(e

18. 'erapa ,ar!a ormal lu! (ompl$a(e

STEP 7

19. %e%a" apa% : &e.$$%$

• pera%aa %ul$# 'era.a% &a merupa"a !eala u#ama &r pe)a"$#

"ar&$opulmoal

* pa#o.$%$olo!$ 2/ S)lv$a A pr$(e+

• Pera%aa #$&a" ea" )a! 'er,u'u!a &! "e%ul$#a 'era.a% )! &$%a&ar$

&a &$ra%a"a perlu upa)a #am'a,a &lm me!a#a%$ pera%a "e"ura!a

u&ara $"a mela"u"a a"#$.$#a%

*IPD 5K UI+ e$%2 :

• &)%pea &3e..or#

%e%a" apa% )! #$m'ul p& 8a"#u mela"u"a "era .$%$" #e#ap$ %e!erame!,$la! %e#ela, mela"u"a $%#$ra,a# &a #er&apa# 'u)$ a#u!

#am'a,a

• o(#ural &)%pea

!a!!ua perapa%a )! m$$mal pa&a pa!$ ,ar$ &a &apa# memper'era#%e(ara 'er#a,ap a#au me!!a!!u pa&a malam ,ar$

• paro-)%mal o(#ural &)%pea

%e%a" apa% #$m'ul %e8a"#u #$&ur pa&a malam ,ar$ %,! pa%$e #er'a!u

&a ,aru% &u&u" %elama 'e'erapa 8a"#u %ampa$ %e%a")a ,$la! 'aru pa%$e &apa# 'er'ar$! "em'al$/ %e%a" apa% $$ '$a%a)a &$%e'a'"a "r

(a$ra e"%#rava%"ular l', 'a)a" ma%u" "em'al$ "e &lm "ompar#me

$#rava%"ular *#era&$ p& pa%$e #$&ur 'er'ar$! "ura! le'$, 29 am+

• or#,opea

%e%a" apa% )! #$m'ul pa&a %aa# 'er'ar$! u#u" $#u pa%$e ,aru%

me!am'$l %$"ap &u&u" a#au %e#e!a, &u&u" u#" me!,$la!"a %e%a"

apa%)a/ '$a%a)a pa%$e #$&ur &! 'a#al )! #$!!$

• #a(,$pea

.re"ue%$ perapa%a 29 %$"lu% perme$#

• 'ra&$pea

.re"ue%$ perapa%a ; 1< %$"lu% perme$#

• apea

pe!,e#$a perapa%a

• pla#$pea

%e%a" apa% )! %ema"$ mem'uru" pa&a po%$%$ #e!a"

• p%$"o!e$" &)%pea

&)%pea )! #era&$ m$%al)a ole, "area emo%$


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*aa#om$ .$%$olo!$ %$%#em perapa%a &a "ar&$ova%"ular/ e&2/EGC+

• I%p$ra#or) &)%poe:"e%u"ara 'era.a% pa&a 8a"#u $%p$ra%$ )a!

&$%e'a'"a %ul$#)a u&ara u#u" mema%u"o paru2

• E-p$ra#or) &)%poe:"e%u"ara 'era.a% 8a"#u e"%p$ra%$ )a!

&$%e'a'"a %ul$#)a u&ara "eluar &ar$ paru2

• Car&$a( &)%poe:&$%poe )a! &$%e'a'"a pr$mer pe)a"$# a#u!• E-er#$oal &)%poe:&)%poe )a! #$m'ul "area ola, ra!a

• E-pa%$oal &)%poe:&)%poe )a! &$%e'a'"a ole, "e%ul$#a e-pa%$

ro!!a #ora"

• Or#o%#a#$( &)%poe:&)%poe )a! 'er"ura! pa&a 8a"#u po%$%$ &u&u"

*pr$%$p !a8a# paru &r= #a'ra$ Ra'+

me"a$%me #ea&$)a %e%a" apa% a"$'a# e.u%$ pleura

e.u%$ pleura a#au pe$m'ua (a$ra &alam (avum pleura a"a me!ura!$

&a)a pe!em'a!a paru %e,$!!a meuru"a (ompl$a(e paru &a a"ame!!a!!u perapa%a

*&$a!o%#$" &a #erap$ "e&o"#era pe)a"$# &alam/ La8re(e MT/2002+

20. e$%2 perapa%a a'ormal

• Pera.a%a '$o#:pera.a%a )a! #$m'ul a"$'a# "eru%a"a o#a"/%e(ara "l$$%

#erl$,a# a&ala, %a#u a#au 'e'erapa "al$ u%a,a mela"u"a pera.a%a &e!a

ampl$#u&o &a $rama )a! #$&a" #era#ur %er#a &$%el$!$ per$o&e $%#$ra,a#

• Pera.a%a (,e)e %#o"e:%ua#u %er$ pera.a%a &e!a $rama pera.a%a ma"$

lama ma"$ 'e%ar /%e#ela, me(apa$ ma"%$mum $rama pera.a%a 'eru'a, ma"$lama ma"$ "e($l &a "emu&$a &$lau#"a &e!a #a,ap apeu Tera&$ Pa&a

pe&er$#a a#u! "o!e%#$. %er#a urem$a/ pe&er$#a pe)a"$# o#a"

• Pera.a%a "u%%maull:$rama pera.a%a )a! (epa#/ &alam /&a #era#ur Terl$,a#

#eru#ama pa&a a%$&o%$% me#a'ol$" *&$are 'era#+ D$%e'a'"a %#re%%/ "e(ema%a*Da%ar&a%ar $lmu pe)a"$# paruA$rla!!a u$ver%$#) pre%%+

*"amu% Dorla&+

21. apa .u!%$ &ar$ (a$ra &$ (avum pleura4

• Memu&a,"a "e&ua permu"aa pleura u#" 'er!era" %lm perapa%a

&a u#" me(e!a, pem$%a,a #,ora- &a paru*pa#o.$%$olo!$/S)lv$a A Pr$(e/1>>?+

22. ela%"a 5$%$olo!$ a&a)a (a$ra &$ (avum pleura6

• Ca$ra pleura pa&a $&$v$&u ormal %e'a!$a 'e%ar &$'e#u" &$ permu"aa

pleura par$e#al$% &! umla, ra#a2 0/1 ml @ "! BB per,ar

*&$a!o%$% &a #erap$ "e&o"#era pe)a"$# &alam+• '$a%a)a (a$ra pleura 'er8ara a!a" "e"u$!"u$!a *%erou%

-a#,o(,rome+

IPD $l$& 2/ 5K UI23. ela%"a Pa#o.$%$olo!$ a&a)a e.u%$ pleura6

Ter!a#u! pa&a "e%e$m'a!a a#ara (a$ra &a pro#e$ &lm ro!!a

pleura Pa&a "ea&aa ormal (a$ra pleura &$'e#u" %(r lam'a# %'! .$l#ra%$ melalu$ pem'ulu, &ara, "ap$ler 5$l#ra%$ $$ #era&$ "r per'e&aa #e"aa o%mo#$" pla%ma


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&a ar$!a $#er%$%$al %,! ma%u" "e ro!!a pleura Ca$ra pleura #%' ! &apa#

ma%u" melalu$ pem'ulu, l$m.e &$ %e"$#ar pleura

*'u"u aar $lmu pe)a"$# &alam/5K UI+24. ela%"a e#$olo!$ a&a)a "ele'$,a (a$ra &$ (avum pleura *e.u%$ pleura+6

Pro%e% peumpu"a (a$ra &lm ro!!a pleura &p# &$%e'a'"a ole,

pera&a!a B$la pro%e% ra&a! &$%e'a'"a ole, "uma p$o!e$" a"a #er'e#u" pu%@aa,/ %,! #& emp$ema@p$o#,ora- B$la pro%e% $$ me!ea$ pem'ulu, &ara,

%e"$#ar pleura &p# me)e'a'"a ,emo#,ora-

*'u"u aar $lmu pe)a"$# &alam/5K UI+

1. eopla%ma *#umor !aa%+/ %eper#$ oepla%ma 'ro"o!e$" &a

me#a%#a#$"

2. "ar&$ova"ular/ %eper#$ !a!al a#u! "o!e%#$./ em'olu% pulmoal

&a per$"ar&$#$%3. pe)a"$# pa&a a'&ome/ %eper#$ a%$#e%/ pra"rea#$#$%

4. $.e"%$ )! &$%e'a'"a 'a"#er$/v$ru%/amur &a para%$#

5. #rauma6.

%$&rom e.ro#$"/ urem$a/ reuma#o$& ar#r$#$%*"ap$#a %ele"#a/$l$& 1+

a. pe!,am'a#a &ra$a%e l$m.a#$" &ar$ ro!!a pleura

b. !a!al a#u!/ )a! me)e'a'"a "ap$ler paru &a #e"aa per$.er mea&$ %a!a#

#$!!$ %e,$!!a me$m'ul"a #ra%u&a%$ (a$ra )a! 'erle'$,a "e&alam ro!a

pleura

c. Sa!a# meuru)a #e"aa o%mo#$( "olo$& pla%ma/ a&$ u!a memu!"$"a

#ra%u&a%$ (a$ra )a! 'erle'$,a

d. I.e"%$ a#au %e#$ap pe)e'a' pera&a!a apapu pa&a permu"aa pleura &ar$

ro!!a pleura/ )a! meme(a,"a mem'rae "ap$ler &a memu!"$"a pe!al$ra pro#e$ pla%ma &a (a$ra "e &alam ro!!a %e(ara (epa#

Bu"u aar .$%$olo!$ "e&o"#era/Gu)#o e# =all/ EGC/ 1>>7

25. apa a"$'a# )! &$#$m'ul"a a&a)a e.u%$ pleura4

Se%a" apa%

26. apa %aa .a"#or )! memper#a,a"a #e"aa e!a#$. pa&a pleura4

• ar$!a ela%#$% paru

• Ke"ua#a o%mo#$" )! #er&apa# &$ %eluru, mem'ra pleura

• Ke"ua#a l$m.a#$"

*pa#o.$%$olo!$/S)lv$a A Pr$(e/1>>?+

27. ma(am2 (a$ra pa&a e.u%$ pleura

E.u%$ pleura &apa# 'erupa #ra%u&a# a#au e"%u&a# Transudat #era&$ pa&a pe$!"a#a vea pulmoal$%/ m$%al)a pa&a !a!al a#u! "o!e%#$. Pa&a"a%u% $$ "e%e$m'a!a "e"ua#a me)e'a'"a pe!eluara (a$ra &ar$

pem'ulu, &ara, Tra%u&a%$ u!a &apa# #era&$ "area ,$popro#e$em$a/ %eper#$

pa&a pe)a"$# ,a#$ &a !$al Pe$m'ua #ra%u&a# &alam ro!!a pleura&$%e'u# hidrotoraks. Ca$ra pleura (e&eru! #er#$m'u pa&a &a%ar paru

a"$'a# !a)a !rav$#a%$ Pe$m'ua eksudat &$%e'a'"a ole, pera&a!a a#au

"e!aa%a pleura/ &a a"$'a# pe$!"a#a permea'$l$#a% "ap$ler a#au !a!!ua


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a'%or'%$ !e#a, 'e$! E"%u&a# &$'e&a"a &e!a #ra%u&a# &ar$ "a&ar pro#e$

)a! &$"a&u!)a &a 'era# e$% Tra%u&a# mempu)a$ 'era# e$% "ura!

&ar$ 1/01? &a "a&ar pro#e$)a "ura! &ar$ / e"%u&a# mempu)a$ 'era# e$% &a "a&ar pro#e$ le'$, #$!!$/ "area 'a)a" me!a&u! %el

Pr$(e A S/ $l%o L M/ Pa#o.$%$olo!$ Ko%ep Kl$$% Pro%e%Pro%e% Pe)a"$#/

EGC/ a"ar#a:2002 'er&a%ar"a e$% %el pa&a e.u%$ pleura (a$ra pleura &$'a!$ a#a%

a. e.u%$ l$m.o%$#/ #eru#ama &$%e'a'"a ole, pro%e% #u'er(ulo%$% a#au "e!aa%a Pa&a

"e!aa%a 'a)a" #er&apa# me%o#el &$&alam (a$ra pleura/ &$%amp$! %el l$m.o%$#/%e&a!"a pa&a #u'er(ulo%$% #$&a" &$#emu"a %el me%o#el/ ole, "area

&$,a(ur"a ole, pro%e% #u'er(ulo%$%

b. E.u%$ ,emora!$" &apa# &$%e'a'"a ole, "e!aa%a &a &apa# pula ole, "area

$.ra" paru Pa&a $.ra" paru (a$ra pleura &apa# me!a&u! me%o#el/ &$maa,aru% &$'e&a"a &e!a me%o#el$oma

c. =emo#ora"%/ #eru#ama #era&$ pa&a #rauma #ora"% Per&ara,a )a! %er$! #era&$

&$a"$'a#"a ole, "area rup#ur)a aor#ad.

Pro%e% $.e"%$ &apa# me!,a%$l"a %el PMN *Pol)morp,ou(lear Neu#rop,)lLeu"o()#e%+ &alam (a$ra pleura Pa&a emp$ema ,amp$r %emua)a #er&$r$ &ar$ %el

e#ro.$l Pa&a e.u%$ pleura )a! &$%e'a'"a ole, peumo$a ma"a )a!#er'aa)a" &$#emu"a a&ala, l$m.o%$#

e. Eo%$o.$l 8alaupu ara! #e#ap$ &apa# #era&$ ole, $.ar" paru &a $.e"%$ ole,

v$ru% a#au 'a"#er$ Sela$ $#u &apa# pula #era&$ pa&a 'er'a!a$ pe)a"$# la$)a%eper#$ ame'a pa&a a'%e% ,a#$/ pe)"$# ,e&a&$#o%a/ pol$ar#er$#$% o&o%a/ &a

mu!"$ u!a "e!aa%a/ %er#a pe)a"$# paru la$)a

f. Sel ep$#elo$& &e!a mul#$u"leu% #eru#ama #era&$ pa&a e.u%$ pleura )a!

&$%e'a'"a ole, lupu% er$#ema#o%u%Ilmu pe)a"$# paru Dr = Ta'ra$ Ra'/ ,$po"ra#e%/ 1>><

28. ma(am2 'u)$ per"u%$ pa&a pemer$"%aa paru%uara per"u%$ )a! ormal a&ala, %oor Se&a!"a %uara per"u%$ )a!

mea&a"a a&)a "ela$a pleura a#au paru )a$#u :

pe"a" : '$a%a)a &$%e'a'"a e.u%$ pleura )a! ma%$. a#au %(,8ar#ere&up : &apa# &$%e'a'"a a#ele"#a%$%/ $.$l#ra#/ .$'ro%$%/ ma%%a #umor &$

per$.er ole, e.u%$ pleura Car&$a( &ulle% *'a#a% re&up a#u!+ )a!

me!e($l &$&apa#"a pa&a em.$%ema

,$per%oor '$la#eral : &$%er#a$ #a&a2 la$ ,$per$.la%$ &$#emu"a pa&aem.$%ema =$per%oor u$la#eral &$#emu"a pa&a peumo#,ora"%/ 'ullae

)a! 'e%ar a#au "$%#a paru

* 'u"u aar $lmu pe)a"$# &alam $l$& II/5K UI+

29. &$a!o%$% pa&a pa%$e &! e.u%$ pleura :DIAGNOSIS

Manifestasi Klinik

Pa&a aame%$%

• )er$ &a&a &a %e%a"

• Ra%a )er$ mem'ua# pe&er$#a mem'a#a%$ per!era"a


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• ro!!a &a&a &e!a 'era.a% &a!"al a#au #$&ur m$r$! "e %$%$ )a! %a"$#

• Se%a" a.a% &apa# r$!a a#au 'era#/ #er!a#u! pa&a pro%e% pem'e#u"a

e.u%$/ umla, (a$ra e.u%$ pleura/ &a "ela$a )a! me&a%ar$ #$m'ul)a e.u%$

Pa&a pemer$"%aa .$%$"/

• pe&er$#a &apa# #erl$,a# %e%a" a.a% &e!a pera.a%a )a! &a!"al/

• ,em$#ora"% )a! %a"$# le'$, (em'u!/• rua! %ela $!a mele'ar/ me&a#ar &a #er#$!!al pa&a pera.a%a

• 5rem$#u% %uara melema, %ampa$ me!,$la!/ &a

• pa&a per"u%$ #er&e!ar %uara re&up %ampa$ pe"a" &$ &aera, e.u%$/

• &$#emu"a #a&a#a&a pe&oro!a a#u! &a me&$a%#$um "e ara, %$%$

)a! %e,a#

• Pa&a au%"ul#a%$/ %uara pera.a%a melema, %ampa$ me!,$la! pa&a &aera,

e.u%$ pleura

www.kalbe_farma.com

Pa&a pemer$"%aa .$%$"/ &e!a 'a#ua stetoskop a"a #er&e!ar a&a)a peurua%uara pera.a%a

pemer$"%aaa peua!

U#u" mem'a#u memper"ua# &$a!o%$%/ &$la"u"a pemer$"%aa 'er$"u#:

• Ro#!e &a&a

Ro#!e &a&a '$a%a)a merupa"a la!"a, per#ama )a! &$la"u"a u#u"

me&$a!o%$% e.u%$ pleura/ )a! ,a%$l)a meuu""a a&a)a (a$ra

• CT %(a &a&a

CT %(a &e!a ela% me!!am'ar"a paruparu &a (a$ra &a '$%a

meuu""a a&a)a pneumonia/ abses paru a#au #umor• USG &a&a

USG '$%a mem'a#u mee#u"a lo"a%$ &ar$ pe!umpula (a$ra )a!

umla,)a %e&$"$#/ %e,$!!a '$%a &$la"u"a pe!eluara (a$ra

• Torakosentesis

Pe)e'a' &a e$% &ar$ e.u%$ pleura '$a%a)a &apa# &$"e#a,u$ &e!amela"u"a pemer$"%aa #er,a&ap (o#o, (a$ra )a! &$perole, melalu$

#ora"o%e#e%$% *pe!am'$la (a$ra melalu$ %e'ua, arum )a! &$ma%u""a

&$a#ara %ela $!a "e &alam ro!!a &a&a &$'a8a, pe!aru, pem'$u%a lo"al+

• Biopsi

$"a &e!a #ora"o%e#e%$% #$&a" &apa# &$#e#u"a pe)e'a')a/ ma"a&$la"u"a '$op%$/ &$maa (o#o, lap$%a pleura %e'ela, luar &$am'$l u#u"

&$aal$%aPa&a %e"$#ar 20 pe&er$#a/ me%"$pu #ela, &$la"u"a pemer$"%aa

me)eluru,/ pe)e'a' &ar$ e.u%$ pleura #e#ap #$&a" &apa# &$#e#u"a

• Aal$%a (a$ra pleura

http://www.kalbe_farma.com/http://www.kalbe_farma.com/


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• Bronkoskopi

Bro"o%"op$ "a&a! &$la"u"a u#u" mem'a#u meemu"a %um'er (a$ra

)a! #er"umpul

Tra%u&a# E"%u&a#

Ka&ar pro#e$ &alam e.u%$ *!@&L+; Ka&ar pro#e$ &alam e.u%$

Ka&ar pro#e$ &alam %erum

;0/? 0/?

Ka&ar LD= &alam e.u%$ ;200 200

Bera# e$% (a$ra e.u%$ ;0/1< 0/1<

R$val#a Ne!a#$. Po%$#$.

Ka&ar LD= &alam e.u%$

Ka&ar LD= &alam %erum

;0/< 0/<

• Warna cairan

B$a%a)a (a$ra pleura 'er8ara a!a" "e"u$!"u$!a *%erou%

-a#,o(,rome+

'$la a!a" "emera,mera,a/ &apa# #era&$ pa&a #rauma/ $.ar" paru/

"e!aa%a &a a&a)a "e'o(ora aeur$%ma aor#a '$la "u$! "e,$aua &a a!a" purule/ $$ meuu""a a&a)a

em.$ema

'$la mera, (o"la#/ $$ meuu""a a&a)a a'%e% "area amo'a*Bu"u aar $lmu pe)a"$# &alam/5K UI/$l$& 2

30. pea#ala"%aaaPENGOBATAN

• $"a umla, (a$ra)a %e&$"$#/ mu!"$ ,a)a perlu &$la"u"a pe!o'a#a

#er,a&ap pe)e'a')a

• $"a umla, (a$ra)a 'a)a"/ %e,$!!a me)e'a'"a pee"aa maupu %e%a"

a.a%/ ma"a perlu &$la"u"a #$&a"a &ra$a%e *pe!eluara (a$ra )a!

#er"umpul+

Cara)a

Ca$ra '$%a &$al$r"a melalu$ pro%e&ur #ora"o%e#e%$%/ &$maa %e'ua, arum *a#au%ela!+ &$ma%u""a "e &alam ro!!a pleura Tora"o%e#e%$% '$a%a)a &$la"u"a

u#u" mee!a""a &$a!o%$%/ #e#ap$ pa&a pro%e&ur $$ u!a '$%a &$"eluar"a (a$ra

%e'a)a" 1/? l$#er$"a umla, (a$ra )a! ,aru% &$"eluar"a le'$, 'a)a"/ ma"a &$ma%u""a %e'ua,

%ela! melalu$ &$&$! &a&a

Pa&a empiema &$'er$"a a#$'$o#$" &a &$la"u"a pe!eluara aa,

$"a aa,)a %a!a# "e#al a#au #ela, #er"umpul &$ &alam 'a!$a .$'ro%a/ ma"a

pe!al$ra aa, le'$, %ul$# &$la"u"a &a %e'a!$a &ar$ #ula! ru%u" ,aru% &$a!"a#

%e,$!!a '$%a &$pa%a! %ela! )a! le'$, 'e%ar Ka&a! perlu &$la"u"a pem'e&a,au#u" memo#o! lap$%a #erluar &ar$ pleura *&e"or#$"a%$+


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Pa&a tuberkulosis a#au "o"%$&$o$&om$"o%$% &$'er$"a #erap$ a#$'$o#$" a!"a

paa!

Pe!umpula (a$ra "area #umor pa&a pleura %ul$# u#u" &$o'a#$ "area (a$ra

(e&eru! u#u" #er'e#u" "em'al$ &e!a (epa#Pe!al$ra (a$ra &a pem'er$a o'a# a#$#umor "a&a! me(e!a, #era&$)a

pe!umpula (a$ra le'$, lau#

$"a pe!umpula (a$ra #eru% 'erlau#/ '$%a &$la"u"a peu#upa ro!!a pleuraSeluru, (a$ra &$'ua! melalu$ %e'ua, %ela!/ lalu &$ma%u""a 'a,a $r$#a

*m$%al)a laru#a a#au %er'u" &o-$()(l$e+ "e &alam ro!!a pleura Ba,a $r$#a $$

a"a me)a#u"a "e&ua lap$%a pleura %e,$!!a #$&a" la!$ #er&apa# rua! #empa#

pe!umpula (a$ra #am'a,a

$"a darah mema%u"$ ro!!a pleura '$a%a)a &$"eluar"a melalu$ %e'ua, %ela!

Melalu$ %ela! #er%e'u# '$%a u!a &$ma%u""a o'a# u#u" mem'a#u meme(a,"a

'e"ua &ara, *m$%al)a %#rep#o"$a%e &a %#rep#o&ora%e+$"a per&ara,a #eru% 'erlau# a#au $"a &ara, #$&a" &apa# &$"eluar"a melalu$ %ela!/

ma"a perlu &$la"u"a #$&a"a pem'e&a,a* Bu"u aar Ilmu Pe)a"$# Dalam/5K UI/ $l$& 2+

31. %e'u#"a o#o#2 #am'a,a pa&a $%p$ra%$ &a e"%p$ra%$o#o# #am'a,a %aa# $%p$ra%$:

1.m%(ale$

2.m%#ero(le$&oma%#o$&eu%

3.mpe(#oral$% ma)or &a m$or 4.mla#$%$mu% &or%$

5.m%era#u% a#er$or

o#o# #am'a,a %aa# e"%p$ra%$:

1. mo'l$Fu% a'&om$$%

2. m#ra%ver%u% a'&om$$%

3. mre(#u% a'&om$$%5K UNDIP/ 1>>

32. pe)e'a' peurua lu! (ompl$a(e

Kompl$a% 'er"ura! pa&a pe)a"$# paru re%#r$"#$. )a! meam'a, "e"a"ua paru &a #ora"% %er#a mem'a#a%$ pe!em'a!a)a

Pe)e'a' u#ama peurua "ompl$a% paru a&ala, a#ele"#a%$% *"olap%

alveol$+/ e&ema paru/ peumo$a/ &a .$'ro%$% paru Kalau %ur.a"#a paru paru 'er"ura!/ "ompl$a% u!a 'er"ura! "area paru mea&$ le'$, "a"u a"$'a#

me$!"a#)a #e!a!a permu"aa *%ur.a"#a &alam "ea&aa ormal

me!ura!$ #e!a!a permu"aa+ Kompl$a% &$&$! &a&a 'er"ura! pa&ao'e%$#a%/ pere!a!a a'&ome/ &a peru'a,a 'e#u" #ula! ra!"a &a&a/

m$%al)a "a%u% "$.o%"ol$o%$%

Pr$(e A S/ $l%o L M/ Pa#o.$%$olo!$ Ko%ep Kl$$% Pro%e%Pro%e%

Pe)a"$#/ EGC/ a"ar#a:2002


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33. .a"#or apa %aa )! mee#u"a lu! (ompl$a(e "e#e'ala mem'ra re%p$ra%$pe)e'a' apapu )! &p# me$!"a#"a "e#e'ala

mem'ra %eper#$ e&ema &lm rua! $#er%#$%$al a#au $.$l#ra%$ .$'ro%a paru2 a"$'a#

pe)a"$# pulmoar &apa# me!ura!$ &$.u%$

Area permu"aa mem'ra re%p$ra%$pa&a pe)a"$# %eper#$ em.$%ema/ %e'a!$a 'e%ar permu"aa )! #er%e&$a u#u" per#u"ara !a% 'er"ura! &a per#u"ara !a%

me!alam$ !a!!ua 'era# Solu'$l$#a% !a% &alam mem'ra re%p$ra%$ Solu'$l$#a% CO2 20 "al$ le'$, 'e%ar

&ar$ O2&e!a &em$"$a/ CO2 'er&$.u%$ melalu$ mem'ra 20 "al$ le'$, (epa#

&ar$ O2

* ANATOMI DAN 5ISIOLOGI/ET=EL SLOANE +

lu! (ompla$ %$.a# ela%#$%a paru &a #,ora"

pe)a"$# paru re%#r$"#$.

%ur.a"#a pere!a!a a'&ome

peru'a,a #ula! ra!"a &a&a

*pa#o.$%$olo!$ vol 2 S)lv$a A Pr$(e Lorra$e M$l%o+

34. (ara me!u"ur lu! (ompl$a(eKompl$a% #o#al *&a)a "em'a! paru &a #ora"%+ a#au "ompl$a% paru %aa

&apa# &$#e#u"a Dua maome#er &apa# &$!ua"a u#u" me!u"ur

peru'a,a #e"aa: Sa#u &$,u'u!"a &e!a mulu# a#au lu'a! ,$&u!*u#u" me!u"ur #e"aa alveolar a#au #e"aa #o#al )a! &$,a%$l"a ole,

%$%#em paru #ora"%+ &a la$)a &e!a 'alo e%o.a!u% *u#u" me!u"ur

#e"aa $#rapleura+ Peru'a,a volume &a #e"aa *H/ HP+ "emu&$a&$u"ur pa&a 'er'a!a$ &eraa# pe!em'a!a paru &a pea,aa apa%

Kompl$a% &$per"$ra"a &e!a me!,$#u! "e(urama "urva #e"aa

volume &ar$ &a#a&a#a )a! &$perole, Kompl$a% paru ormal &a "ompl$a%

ra!"a #ora"% per T/ ma%$!ma%$! %e"$#ar 0/2 l$#er@(m =2O %e&a!"a"ompl$a% #o#al *paru &a ra!"a #ora"%+ 'e%ar)a %e"$#ar 0/1 l$#er @(m =2O:

C J H *peru'a,a volume paru &alam l$#er+

HP *peru'a,a #e"aa &alam (m =2O+Pr$(e A S/ $l%o L M/ Pa#o.$%$olo!$ Ko%ep Kl$$% Pro%e%Pro%e% Pe)a"$#/

EGC/ a"ar#a:2002


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Ca$ra pleura

e#$olo!$ pa#o.$%$olo!$

Peurua lu! (ompl$a(e

pea#ala"%aaa"ompl$"a%$&$a!o%$%

e.u%$ pleura

Berle'$, *10 ((+

Lbm 2 Modul 7 Ok's Bgt

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