tugas mandiri skenario 2 neuro

Upload: ditawirasti

Post on 24-Feb-2018

245 views

Category:

Documents


0 download

TRANSCRIPT

  • 7/25/2019 tugas mandiri skenario 2 neuro

    1/26

    ` ASTRINDITA AYU WIRASTI

    FK-A / 1102013046

    1. Memahami dan Menjelaskan Penghantaran fisiologi nyeri

    1.1 Menjelaskan pusat spesifik nyeri

    Nociceptor diati!a"i o#e$ "ti%&" 'a() *erpote("i &(t& %er&"a "e# +ari()a(, Ker&"aa( +ari()a( ter"e*&tdapat di"e*a*a( o#e$ "ti%a"i %ea(i" 'a() &at te%perat&r 'a() e"tri% e&ra()a( o"i)e( da( papara( o#e$

    .at i%ia,

    Se#-"e# +ari()a( 'a() r&"a ter"e*&t dapat pa %e()e#&ara( "&*"ta("i 'a() %a%p& %e%*&a c$a((e# io( pada

    %e%*ra( (ociceptor "eperti

    rotea"e

    (.i% pe()&rai protei( i(i dapat %e()&rai peptida i(i(o)e( 'a() *erada di etra "e#ar "e$i())a ter*e(ta$

    *radii(i(, radii(i( i(i e%&dia( aa( teriat de()a( %o#e re"eptor "pe"ii &(t& %e()ati!a"i o(d&"i io(

    pada (ociceptor,

    AT

    AT dapat *eriata( #a()"&() de()a(ATP Gated Ion Channel "e$i())a ter+adi depo#ari"a"i pada (ociceptor, K5

    e(i()ata( K5etra"e#ar *erpera( #a()"&() pada depo#ari"a"i %e%*ra( (e&ro(a#,

    e(i" Nociceptor

    Tra("porta"i "ti%&" ('eri ter+adi pada &+&() "ara *e*a" 7FN8 'ait& "erat 9 ta(pa %'e#i( 7 unmyelinated C

    Fiber8da( "erat A: %'e#i( tipi" Nociceptor ter*a)i %e(+adi e%pat +e(i" 'ait&

    a, Polymodal Nociceptor %ere"po( ter$adap "ti%&" %ea(i" "&$& da( i%ia,

    *, Mechanical Nociceptor $a('a %ere"po( ter$adap tea(a( 'a() &at,

    c, Thermal Nociceptor $a('a %ere"po( ter$adap "&$& pa(a" ata& di()i(,

    d, Chemical Nociceptor %ere"po( ter$adap $i"ta%i( da( .at i%ia #ai(('a,

    Serat 9 tereci# 7ecepata( o(d&"i ;0,< %/"8 %ere"po( "e#eti ter$adap $i"ta%i( da( %e%per"ep"ia( ra"a )ata#,

    ='pera#)e"ia

    Nociceptor *ia"a('a $a('a %ere"po( "aat ter+adi "ti%&" 'a() c&&p &at &(t& %er&"a +ari()a(, =ipera#)e"ia

    ada#a$ eadaa( di%a(a it "e(di ata& otot 'a() "&da$ ter#&a %e(+adi "a()at "e("iti ter$adap "ti%&", Se*a)ai

    co(to$ pada it 'a() "e$at ra"a "e(t&$a( tida tera"a "ait (a%&( pada it 'a() %e#ep&$ ra()"a() ter"e*&t

    tera"a "ait,

    =ipera#)e"ia dapat *er&pa pe(&r&(a( a%*a() ('eri pe(i()ata( i(te("ita" "ti%&" ('eri ata& ('eri "po(ta(,

    =ipera#)e"ia +&)a di*edaa( %e(+adi d&a 'ait&

    a, ri%er $a('a ter+adi pada daera$ +ari()a( 'a() ter#&a,

    *, Se&(der +ari()a( 'a() *erada di "eitar +ari()a( 'a() ter#&a +&)a i&t %e(+adi "e("iti,

    e*erapa .at i%ia 'a() *erpera( da#a% $ipera#)e"ia

    radii(i(

    Se#ai( %e()$a"i#a( ra"a ('eri *radii(i( +&)a %e("ti%a"i per&*a$a( i(trace##ar 'a() *er#a()"&() #a%a

    "e$i())a c$a((e# io( (ociceptor %e(+adi #e*i$ "e("iti,

    ro"ta)#a(di(

    ro"ta)#a(di( tida %e('e*a*a( ('eri %e#ai(a( %e(i()ata( "e("iti!ita" (ociceptor #ai(,

    S&*"ta(ce

    >er&paa( "&*"ta("i 'a() di$a"i#a( o#e$ (ociceptor "e(diri, Ati!a"i "a#a$ "at& ca*a() ao( (ociceptor dapat

    %e('e*a*a( "ere"i "&*"ta(ce di ca*a() ao( #ai(('a, S&*"ta(ce %e('e*a*a( !a"odi#ata"i da( pe#epa"a(

    $i"ta%i( o#e$ "e# %a"t "e$i())a dapat +&)a %e('e*a*a( $ipera#)e"ia "e&(der,

    1

  • 7/25/2019 tugas mandiri skenario 2 neuro

    2/26

    Aere( ri%er da( >ea(i"%e Spi(a#

    Terdapat d&a +e(i" per"ep"i ('eri 'ait&

    a, First pain cepat da( ta+a% diati!a"i o#e$ "erat A:

    *, Secon pain ('eri 'a() %e()i&ti ir"t pai( da( *er#a()"&() #a%a diati!a"i "erat 9

    Perhubungan spinalis axon nociceptif

    Ne&rotra("%itter ('eri did&)a ada#a$ )#&ta%at (a%&( (e&ro(-(e&ro( +&)a %e()a(d&() "&*"ta(ce pada ao(

    ter%i(a#i", Tra("%i"i "i(ap" 'a() dipera(tarai o#e$ "&*"ta(ce di*&t&$a( &(t& %e()$a"i#a( ra"a ('eri,

    Nyeri Alih !eferred Pain"

    >er&paa( e(o%e(a di%a(a ati!a"i (ociceptor or)a( da#a% 7!i"era#8 diper"ep"ia( "e*a)ai "e("a"i #&ar

    7c&ta(e&"8, Di"e*a*a( are(a ao( (ociceptor dari or)a( da#a% %e%i#ii r&te 'a() "a%a de()a( (ociceptor &ta(

    da#a% %e%a"&i corda "pi(a#i" "e$i())a ter+adi#a$ pe(ca%p&ra( i(or%a"i dari ed&a i(p&t ter"e*&t,

    a#&r N'eri A"ce(de("

    1, Spi(ot$a#a%ic at$?a'

    I(or%a"i "&$& da( ('eri di"a%paia( dari corda "pi(a#i" e ora %e#a#&i +a#&r "pi(ot$a#a%ic,

    Ao( dari (e&ro( ordo II #a()"&() %e('e*era() da( %e('&"&ri tract&" "pi(ot$a#a%ic&",

    Serat "pi(ot$a#a%ic&" *er+a#a( dari corda "pi(a#i" e%&dia( %e#e?ati %ed#a po(" da( %id*rai( ta(pa

    *er"i(ap" "a%pai %erea %e(capai t$a#a%&",

    ada a$ir('a "ete#a$ %e#e?ati *ata() ota ao( "pi(ot$a#a%ic&" *erada *er"e*e#a$a( de()a( #e%(i"c&"

    %edia#i" (a%&( ed&a ao( ter"e*&t tetap terpi"a$ "at& "a%a #ai(, I(or%a"i "e(t&$a( *er+a#a( "ecara ip"i#atera#

    "eda()a( ('eri *er+a#a( co(tra#atera#,

    2, Tri)e%i(a# at$?a'

    I(or%a"i "&$& da( ('eri 'a() *era"a# dari %&a da( epa#a *er+a#a( %e#a#&i +a#&r i(i 'a() %irip de()a(

    "pi(ot$a#a%ic pat$?a',

    Serat (er!&" tri)e%i(a# *er"i(ap" pada (e&ra( orde ed&a di (&c#e&" tri)e%i(a# "pi(a#i" pada *ata() ota,

    Ao( ter"e*&t e%&dia( (ai e t$a#a%&" di #e%(i"c&" tri)e%i(a#,

    Se("a"i ('eri da( "e(t&$a( "a%a-"a%a *era$ir di t$a#a%&" 7N&c#e&" @ da( i(tra#a%i(ar8 tetapi

    %e(e%pati daera$ 'a() *er*eda, Ke%&dia( i(or%a"i dari t$a#a%&" ter"e*&t diter&"a( e *er*a)ai daera$ pada

    corte cere*ra#,

    2

  • 7/25/2019 tugas mandiri skenario 2 neuro

    3/26

    Re)a"i N'eri

    a, Re)a"i Aere(

    N'eri 'a() di$a"i#a( o#e$ ati!ita" (ociceptor dapat di&ra()i de()a( ati!ita" %ec$a(oreceptor 7Serat A8

    "ecara *er"a%aa(, I(i#a$ %e()apa ra"a ('eri pada %e%ar aa( *er&ra() apa*i#a ita #a&a( )eraa( %e%i+at,

    Gate Theory of Pain

    BTida ada o(#i "ti%&"

    Dapat di#i$at pada )a%*ar i(i *a$?a "ti%&" 'a() di*a?a o#e$ "erat 9 *er+a#a( de()a( #a(car 7tida ada

    $a%*ata( apap&(8 da( aa( "a%pai pada pro+ectio( (e&ro( 'a() e%&dia( aa( diter&"a( e ota %e('e*a*a(

    "e("a"i ('eri %a"i%a#,

    #Terdapat $onfli$ stimulus, Sti%&" ('eri di*a?a o#e$ "erat 9 %e(&+& pro+ectio( (e&ro(, Di "aat 'a() "a%a "ti%&"

    "e(t&$a( 7"ti%&" tida ('eri8 di*a?a o#e$ "erat A %e(&+& pro+ectio( (e&ro( da( i(ter(e&ro( i($i*itori,

    Ati!a"i i(ter(e&ro( i($i*itori ter"e*&t aa( %e()$a%*at pro+ectio( (e&ro( "e$i())a tida ada "ti%&" 'a()diter&"a( e ota "e$i())a %e()&ra()i "e("a"i ('eri 'a() ada, Na%&( tida "e%&a i(ter(e&ro( i($i*itori dapat

    diatia( "e$i())a %a"i$ terdapat "e("a"i ('eri 'a() diter&"a( e ota, 7arr' 200C8

    Re)a"i De"ce(de("

    %o"i 'a() &at ata& "tre" pada "e"eora() dapat %e()&ra()i ata& %e()$i#a()a( ra"a ('eri, Te#a$ dieta$&i

    *a$?a terdapat *a)ia( dari ota 'a() *erpera( da#a% "&pre"i ('eri, Sa#a$ "at&('a ada#a$ .o(a-.o(a (e&ro( di

    %id*rai( "eperti peri!e(tricar da(peria%ueductal gray matter PAG"&

    >ea(i"%e('a ada#a$ "e*a)ai *eri&t

    A %e(eri%a i(p&t e%o"io(a# dari "tr&t&r-"tr&t&r ota,

    Ne&ro(-(e&ro( di A %e()iri%a( ao( %e(&+& daera$ pada %ed#a 'ait& rap$e (&c#ei 'a() e%&dia( aa(

    %e()e#&ara( (e&rotra("%itter "eroto(i(, Ke%&dia( (e&ro( %ed#a ter"e*&t aa( %e%pro'e"ia( ao( e cor(& po"terior corda "pi(a#i" di%a(a ao(

    'a() %e%*a?a "eroto(i( ter"e*&t aa( %e(ea( ati!ita" (ociceptor,

    I(te("ita" N'eri

    a%*ara( te(ta() "e*erapa para$ ('eri dira"aa( o#e$ i(di!id& pe()&&ra( i(te("ita" ('eri "a()at "&*+eti da(

    i(di!id&a# da( e%&()i(a( ('eri da#a% i(te("ita" 'a() "a%a dira"aa( "a()at *er*eda o#e$ d&a ora() 'a() *er*eda

    o#e$ d&a ora() 'a() *er*eda, e()&&ra( ('eri de()a( pe(deata( o*+eti 'a() pa#i() %&()i( ada#a$

    %e())&(aa( re"po( i"io#o)i t&*&$ ter$adap ('eri it& "e(diri, Na%&( pe()&&ra( de()a( %etode i(i +&)a tida

    dapat %e%*eria( )a%*ara( pa"ti te(ta() ('eri it& "e(diri 7S$er?ood 20048, >e(&r&t "%e#t.er S,9 *are , 720028

    ada#a$ "e*a)ai *eri&t

    3

  • 7/25/2019 tugas mandiri skenario 2 neuro

    4/26

    1) skala intensitas nyeri deskritif

    2) Skala identitas nyeri numerik

    3) Skala analog visual

    4) Skala nyeri menurut bourbanis

    eterangan0 Tida ('eri

    1-3 N'eri ri()a( 7"ecara o*'eti pa"ie( dapat *ero%&(ia"i de()a( *ai8,

    4-6 N'eri "eda() 7"ecara o*'eti pa"ie( %e(de"i" %e('eri()ai dapat %e(&(+&a( #oa"i ('eri dapat

    %e(de"rip"ia(('a dapat %e()i&ti peri(ta$ de()a( *ai8,

    C-E N'eri *erat 7"ecara o*'eti pa"ie( terada() tida dapat %e()i&ti peri(ta$ tapi %a"i$ re"po( ter$adap

    ti(daa( dapat %e(&(+&a( #oa"i ('eri tida dapat %e(de"rip"ia(('a tida dapat diata"i de()a( a#i$ po"i"i

    (aa" pa(+a() da( di"tra"i8,

    10 N'eri "a()at *erat 7pa"ie( "&da$ tida %a%p& #a)i *ero%&(ia"i %e%&,

    Sa#a de"riti %er&paa( a#at pe()&&ra( ti()at epara$a( ('eri 'a() #e*i$ o*'eti, Sa#a pe(de"rip"i !er*a#

    7'erbal (escriptor Scale)@DS8 %er&paa( "e*&a$ )ari" 'a() terdiri dari ti)a "a%pai #i%a ata pe(de"rip"i 'a()ter"&"&( de()a( +ara 'a() "a%a di "epa(+a() )ari", e(de"rip"i i(i di&r&ta( dari tida$ terasa nyeriG "a%pai

    nyeri yang tida$ tertahan$anG, Ki(i"i %e(&(+&a( pa"ie( "a#a ter"e*&t da( %e%i(ta pa"ie( &(t& %e%i#i$

    i(te("ita" ('eri ter*ar& 'a() ia ra"aa(, K#i(i"i +&)a %e(a('aa( "e*erapa +a&$ ('eri tera"a pa#i() %e('aita( da(

    "e*erapa +a&$ ('eri tera"a pa#i() tida %e('aita(, A#at @DS i(i %e%&()i(a( pa"ie( %e%i#i$ "e*&a$ ate)ori

    &(t& %e(de"rip"ia( ('eri, 7rice 20068

    Sa#a pe(i#aia( (&%eri 7Numerical rating scales NRS8 #e*i$ di)&(aa( "e*a)ai pe())a(ti a#at pe(de"rip"i

    ata, Da#a% $a# i(i pa"ie( %e(i#ai ('eri de()a( %e())&(aa( "a#a 0-10, Sa#a pa#i() eeti di)&(aa( "aat

    %e()a+i i(te("ita" ('eri "e*e#&% da( "ete#a$ i(ter!e("i terape&ti, Apa*i#a di)&(aa( "a#a &(t& %e(i#ai ('eri

    %aa direo%e(da"ia( patoa( 10 c%,

    Sa#a a(a#o) !i"&a# 7'isual analog scale) @AS8 tida %e#e*e# "&*di!i"i, @AS ada#a$ "&at& )ari" #&r&" 'a()

    %e?ai#i i(te("ita" ('eri 'a() ter&" %e(er&" da( pe(de"rip"i !er*a# pada "etiap &+&()('a, Sa#a i(i %e%*eri #ie(e*e*a"a( pe(&$ &(t& %e()ide(tiia"i epara$a( ('eri, @AS dapat %er&paa( pe()&&ra( epara$a( ('eri 'a()

    4

  • 7/25/2019 tugas mandiri skenario 2 neuro

    5/26

    #e*i$ "e("iti are(a #ie( dapat %e()ide(tiia"i "etiap titi pada ra()aia( dari pada dipa"a %e%i#i$ "at& ata ata&

    "at& a()a,

    Fator 'a() %e%pe()ar&$i ('eri &"ia +e(i" e#a%i( *&da'a %a(a ('eri per$atia( a("ieta" pe()a#a%a( %a"a

    #a#& po#a adapta"i "&pport e#&ar)a da( "ocia#,

    a, >e(+e#a"a( %ea(i"%e pe()$a(tara( ('eriRa"a ('eri %er&paa( "&at& %ea(i"%e per#i(d&()a( 'a() dicet&"a( o#e$ "&at& er&"aa( +ari()a( 'a() aa(

    %e%('e*a*a( i(di!id& &(t& *erea"i %e%i(da$a( "ti%&" ('eri,

    Ra"a ('ari dapat di*a)i ata"

    Ra"a ('eri cepat

    o Ra"a ('eri tert&"& ta+a% a&t da( ter"etr&%

    Ra"a ('eri #a%*at

    o Ra"a ('eri ter*aar #a%*at pe)a# *erde('&t %&a# da( ro(i, Ra"a ('eri i(i &%&%('a diaita( de()a(

    er&"aa( +ari()a(,

    Re"eptor ('eri

    Re"eptor ('eri %er&paa( &+&() "ara *e*a" terdapat ti)a +e(i" "ti%a"i 'a() dapat %era()"a()a('a 'ait&

    ra()"a() %ea(i" "&$& da( i%ia?i, ada &%&%('a ra"a ('eri cepat diai*ata( %ea(i da( "&$& "eda()a( ra"a

    #a%*at diai*ata( "ti%a( i%ia

    Re"eptor ('eri %e%i#ii "ediit "ea#i e%a%p&a( &(t& *eradapta"i da( *a$a( pada *e*erapa eadaa( dapat

    ter+adi pe(i()ata( i(te"ita" ra"a ('eri 'a() di"e*&t $ipera#)e"ia , i(te("ita" ra"a ('eri +&)a *er$&*&()a( erat de()a(

    dera+at er&"aa( +ari()a(, Ada *e*erapa "ti%&" terkaiter&"aa( +ari()a( 7*&a( "ecara #a()"&() dapat ti%*

    "e*a)ai ada('a er&"aa( +ari()a(8 'a() dapat %e('e*a*a( ('eri

    radii(i( dari +ari()a( r&"a 'a() %e%('e*a*a( pe#epa"a( e(.i% proteo#iti da( %e('era() #a()"&() &+&()

    "ara de()a( %e%*&at "ara #e*i$ per%ea*e# ter$adap io(-io( A"a% #atat 'a() tera&%a"i "e*a)ai ai*at dari i"e%ia

    Apap&( *e(t&('a pada (a(ti('a $a# ter"e*&t aa( %e('e*a*a( per&*a$a( per%ea*i#ita" (e&ro() "e$i())a dapat

    ter+adi "&at& pote("ia# a"i de()a( perpi(da$a( io(-io( 'a() ti%*,

    1.2 Menjelaskan jaras spesifik nyeri

    Trat&" "pi(ota#a%i&" Hatera#i"

    o Ao( dari (eiro( orde perta%a 7)a()#io( "pi(a#i"8 %e%a"&i &+&() cor(& po"teri&" "&*"ta(tia )ri""ea %ed#a

    "pi(a#i" da( "e)era *erca*a() %e(+adi "era*&t 'a() (ai da( 'a() t&r&(

    o Se"&da$ %e%a"&ii "at& ata& d&a "e)%e( %ed#a "pi(a#i" %e%*e(t& tract&" po"tero#atera# 7#i""a&eri8 "era*&t

    i(i "e)era *er"i(ap"i" de()a( (e&ro( orde ed&a 'a() ter#eta pada e#o%po "e# "&*"ta(tia )e#ati(o"a cor(&po"teri&"

    o Ao( dari (e&ro( orde ed&a *er+a#a( %e('i#a() )ari" te()a$ pada co%i""&ra a(terior "&*"ta(tia )ri""ea da%

    "&*"ta(tia a#*a e%&dia( (ai eata" pada "i"i o(tra #atera# "e*a)ai a(teri&", Se?at& *er+a#a( eata" "era*&t "ara

    *ar& ter&" *erta%*a$ "e"&ai de()a( *a('a('a "e)%e( %ed#a "pi(a#i" de%iia( r&pa "e$i())a pada *a)ia( ata"

    cer!ica# terdapat

    Sera*&t "ra 'a() data() dari "acra# ter#eta po"tero#atera#

    Sera*&t "ara 'a() data() dari cer!ica# ter#eta a(tero%edia# 7"ere*&t "ara 'a() %e()$a(tara( ra"a "ait

    ter#eta didepa( 'a() %e()$a(tara( "e("a"i "&$&8

    o ada >ed#a o*#o()ata tract&" ter"e*&t ter#eta pada datara( #atera# a(tara (&c#e&" o#i!ari&" i(eri&" de()a(

    (&c#e&" tract&" "pi(a#i" N,Tri)e%i(&", di"i(i ia *er)a*&() de()a(

    Tract&" "pi(ot$a#a%ic&" a(teri&"

    Tract&" "pi(otecta#i"

    Ya() e%&dia( )a*&()a( dari eti)a('a di"e*&t #e%(i"c&" "pi(a#i"

    5

  • 7/25/2019 tugas mandiri skenario 2 neuro

    6/26

    o ada po(" e%&dia( (ai eata" di*a)ia( *e#aa() po("

    o ada %e"e(cep$a#o( e%&dia( #e%(i"c&" %edia#i" *er+a#a( pada te)%e(t&% #atera#i" dari #e%(i"c&" %edia#i"

    o ada die(cep$a#o( "era*&t "ara dari tract&" "pi(ot$a#a%ic&" #atera#i" aa( *er"i(ap"i" de()a( (e&ro( orde

    eti)a 'ait& (&c#e&" po"tero#atera# dari eo#o%po !e(tra# t$a#a%&" 7*a)ia( dari (&c#e&" #atera#i" t$a#a%&"8 di%a(a

    di"i(i aa( ter+adi pe(i#aia( a"ar "e("a"i "ait da( "&$& da( rea"i e%o"i %ai ti%*,

    o

    Ao( dari (e&ro( orde eti)a +a#a( %e%a"&i cr&" po"terior cap"a i(ter(a da( coro(a radiata &(t& *era$ipada )'r&" po"tce(tra#i" 7*rod%a(( 3 2 18 , dari "i(i i(or%a"i ra"a "ait da( "&$& aa( diter&"a( e area %otori

    da( area a"o"ia"i di corte #o*&" parieta#i",

    o 9orte cere!ri )'r&" p"otce(tra#i" *er&()"i &(t& %e(a"ira( "&$& da( "ait "e$i())a aa( %&(c e"adara(

    terait "e("a"i ter"*&t,

    o e%*a)ia( "ecara i"io#o)i"

    Se?at& %e%a"&i %ed#a "pi(a#i" "i('a# ra"a ('eriE %e#e?ati d&a +a#&r e ota 'ait&

    Trat&" (eo"pi(ota#a%i&"

    Trat&" (eo"pi(ota#a%i"& *er)&()"i &t(& %e('a#&ra( ('eri "ecara cepat, Ter&ta%a terdiri ata" "era*&t A-

    De#ta 'a() t'er&ta%a di#a#&i o#e$ ra"a ('eri %ea(i da( ('eri "&$& a&t, Sera*&t perier +a#&r i(i *era$ir pada

    #a%i(a I or(& dor"a#i", Da( dari "i(i aa( %era()"a() (e&ro( orde d&a dari tract&" (eo"pi(ota#a%ic&", Ne&ro( i(i

    aa( %e()iri%a( "i('a# e "era*&t pa(+a() 'a() ter#eta di deat "i"i #ai( %ed#a "pi(a#i" da#a% o%i"&ra a(terior

    da( "e#a(+&t('a *er*e#o (ai e ota da#a% o#&%(a a(tero#atera#i",

    =a('a "e*a)ia( eci# "a+a "era*&t (eopi(ota#a%i&" *era$ir di daera$ retiari" *ata() ota "i"a'a %e#e?ati

    *ata() ota da( #a()"&() *erair di o%p#e" !e(tro*a"a# t$a#a%i,

    N'eri cepat dapat di#oa#i"a"i de()a( %&da$ di da#a% t&*&$

    Ne&rotra("%iter A de#ta &%&%('a ada#a$ )#&ta%at

    Trat&" pa#eo"pi(ota#a%i&"

    a#&r i(i *e&()"i &(t& %e(+a#ara( ('eri #a%*at-ro(i "e*a)ia( "era*&t('a ada#a$ tipe 9 "e*a)ia( eci# A-

    de#ta, Da#a% +ara" i(i "era*&t-"era*&t perier *era$ri pada #a%i(a II da( II or(& dor"a#i" 'a() "ecara *er"a%a-"a%a

    di"e*&t "&*"ta("i )e#ati(o"a "era*&t 9 ter#eta #e*i$ #atera# dari A-de#ta, Sete#a$ it& aa( *er#a(+&t e #a%i(a @ da(

    (e&ro(-(e&ro(('a %era()"a() a"o(-a"o( pa(+a() 7'a() +&)a %e(+adi pe()$a(tar ('eri cepat8 'a() %a-%a

    %e#e?ati o%i"&ra a(terior e "i"i *er#a?a(a( dari %ed#a "pi(a#i" e%&dia( (ai e ota %e#a#&i +ara" a(tero#atera#

    Neotra("%iter ('a ada#a$ )#&ta%at da( S&*"ta("i "&*"ta("i *er"iat #e*i$ #a%*at dari #&ta%at 'a()

    %e%&()i(a( )#&ta%at &(t& "a%pai ter#e*i$ da$&, Ya() %e(+e#a"a( "&at& e(o%e(a ra"a "ait )a(daG

    ara" pa#eo"pi(ota#a%i&" *era$ir e*a('aa( di

    o >&c#e&" retiari" %eda po(" da( %e"e("ea#o(

    o Area teta# %e"e("ea#o( "a%pai o#&&" &"perior da( i(erior

    o Daera$ peria&ad&t&" "&*"ta("ia )ri"ea 'a() %e()e#i#i()i a&ad&ct&" "'#!ii

    Ke%a%p&a( #oa#i"a"i ra"a ('eri pada +a#&r #a%*at "a()at#a$ *&r& da( e*a('aa( $a('a dapat di#oa#i"a"i di

    *a)ia( t&*&$ 'a() #&a"

    For%a"io retiari" *er&()"i &(t& %e(i%*a( per"ep"io ('eri 'a() di"adari

    HI 2, >e%a$a%i da( >e(+e#a"a( N'eri Kepa#a

    HJ,2,1 >e%a$a%i da( >e(+e#a"a( Dei(i"i N'eri Kepa#a

    N'eri epa#a ada#a$ ('eri ata& pera"aa( tida e(a 'a() ter+adi pada daera$ "&perior epa#a 'a()

    %e('e*ar pada ?a+a$ )i)i ra$a() da( #e$er,

    HJ,2,2 >e%a$a%i da( >e(+e#a"a( K#a"iia"i N'eri Kepa#a

    erda"ara( #a""iia"i I(ter(a"io(a# N'eri Kepa#a di"i 2 dari I(ter(a"io(a# =eadac$e Societ' 7I=S8

    A, ri%ar' $eadac$e di"order"

    1, >i)rai(e

    2, Te("io(-t'pe $eadac$e3, 9#&"ter $eadac$e a(d ot$er tri)e%i(a# a&to(o%ic cep$a#a#)ia"

    4, Jt$er pri%ar' $eadac$e"

    6

  • 7/25/2019 tugas mandiri skenario 2 neuro

    7/26

    , Seco(dar' $eadac$e di"order"

    1, =eadac$e attri*&ted to $ead a(d/or (ec tra&%a

    2, =eadac$e attri*&ted to cra(ia# or cer!ica# !a"car di"order

    3, =eadac$e attri*&ted to (o(-!a"car i(tracra(ia# di"order

    4, =eadac$e attri*&ted to a "&*"ta(ce or it" ?it$dra?a#

    R

    1, >i)rai(S&at& o(di"i ('eri epa#a paro"i"%a# da( *i"a +&)a o("ta( 'a() di"e*a*a( o#e$ are(a )a())&a( pri%er ota

    *era"a# dari rea"i (e&ro!a"cer pada i(di!id& 'a() %e%i#ii predi"po"i"i )e(eti

    !ipe Migrain "

    a, >i)re( ta(pa a&ra

    *, >i)re( de()a( a&ra N'eri Kepa#a >i)re( de()a( a&ra tipia# N'eri Kepa#a (o( %i)re( de()a( a&ra tipia#

    A&ra tipia# ta(pa N'eri epa#a Fa%i#ia# =e%ip#e)i >i)re( Sporadi $e%ip#e)i >i)re( tipe a"i#er,

    #ase$fase Migrain

    1, rodro%a#

    e+a#a irita*i#ita" e"ita*i#ita" $iperati ata& depre"i 'a() ti%* da#a% 24 +a% "e*e#&% periode ('eri epa#a

    2, A&ra

    a, @i"&a# 7.i) .a)8

    *, Se("ori

    c, @i"&a# "e("ori

    d, >otori

    3, Fa"e N'eri Kepa#a

    4, Fa"e re"o#&"i 7#e#a$ irrita*#e "it o("e(tra"i8

    onsep dasar patogenesis migren"

    1, =ipere"ita*i#ita" (e&ro(a# "aat a"e i(terita# da( a"e pre-$eadac$e

    2, 9ortica# "preadi() depre""io(

    3, Ati!a"i perier da( "e(tra# (, Tri)e%i(&"4, Ker&"aa( pro)re"i peria&ad&cta# )re' %atter 7A8

  • 7/25/2019 tugas mandiri skenario 2 neuro

    8/26

    riteria %iagnosis Migrain dengan aura"

    A, >i(i%a# 2 "era()a( de()a( )e+a#a pd - D

    , Ada('a a&ra pa#i() "ediit "at& di*a?a$ i(i tetapi tida di+&%pai e#e%a$a( %otori

    1, a())&a( !i"&a# re!er"i*e#

    2, a())&a( "e("ori re!er"i*e#

    3, a())&a( *icara di"a"ia re!er"i*e# "e%p&r(a

    9, a#i() "ediit d&a di*a?a$ i(i

    1, !i"&a# $o%o(i% da(/ata& ) "e("ori &(i#atera#

    2, >i(, Ti%* 1 %aca% a&ra "ecara )rad&a# L %e(it da( / ata& +e(i" a&ra #ai(('a L < %e(it

    3, >a"i()-%a"i() ) *er#a()"&() L < da( M 60 %e(it

    D, >e%e(&$i riteria -D %i)re( ta(pa a&ra di%ai *er"a%aa( de()a( a&ra ata& "e"&da$ a&ra "e#a%a 60 %e(it

    , Tida *eraita( de()a( e#ai(a( #ai(

    Te("io( T'pe =eadac$e

    Ra"a ('eri da#a% "eperti tertea( *erat ata& teriat erat &%&%('a *i#atera# 'a() pada a?a#('a ti%* "ecara

    epi"odi da( teriat de()a( "tre" tetapi e%&dia( ('ari" "etiap $ari %&(c da#a% *e(t& ro(i" ta(pa ada #a)i aita(

    p"io#o)i" 'a() +e#a"

    lasifikasi "1, TT= epi"odi 'a() i(re&e(t 7pericra(ia# te(der(e"" 5/-8

    2, TT= epi"odi 'a() re&e(t 7pericra(ia# te(der(e"" 5/-8

    3, TT= epi"odi ro(i

    4, ro*a*#e TT=

    &tiologi "

    Di"&()"i oro%a(di*ar Stre"" p"io#o)i" A(ieta" Depre"i N'eri epa#a "e*a)ai de#&"i Stre"" otot Dr&)

    o!er&"e 7a(a#)eti8

    Patofisiologi "

    1, Ko(tra"i otot perira(ia# *erepa(+a()a(

    2, Teori !a"erpe('e%pita( A, Te%pora#i" "&peri"ia#i"

    3, Teori =&%ora#pe(&r&(a( p#ate#et i(i%a# 10 epi"ode "era()a( rata-rata ; 1 $ari / *a( 7; 12 $ari / ta$&(8 da( %e%e(&$i riteria D

    , N'eri epa#a *er#a()"&() 30 %e(it "a%pai C $ari

    9, >i(i%a# di"ertai 2 )e+a#a $a"1, Hoa"i *i#atera#

    2, >e(ea( / %e()iat 7tida *erde('&t8

    3, I(te("ita"('a ri()a( ata& "eda()

    4, Tida diper*erat o#e$ ati!ita" r&ti( "eperti *er+a#a( ata& (ai ta())a

    D, Tida didapata(

    1, >&a# da( %&(ta$ 7*i"a a(ore"ia8

    2, He*i$ dari "at& e#&$a( otoo*ia ata& o(oo*ia

    , Tida *eraita( de()a( e#ai(a( 'a() #ai(

    riteria %iagnostik !th &pisodik #reuent "

    A, >i(i%a# 10 epi"ode "era()a( da#a% 1-1< $ari/*a( pa#i() tida "e#a%a 3 *a( 712-10 $ari/ta$&(8 da(%e%e(&$i riteria D

    8

  • 7/25/2019 tugas mandiri skenario 2 neuro

    9/26

    , N'eri epa#a *er#a()"&() 30 %e(it "a%pai C $ari

    9, >i(i%a# di"ertai 2 )e+a#a $a"

    1, Hoa"i *i#atera#

    2, >e(ea( / %e()iat 7tida *erde('&t8

    3, I(te("ita"('a ri()a( ata& "eda()

    4, Tida diper*erat o#e$ ati!ita" r&ti( "eperti *er+a#a( ata& (ai ta())a

    D, Tida didapata(

    1, >&a# da( %&(ta$ 7*i"a a(ore"ia8

    2, He*i$ dari "at& e#&$a( otoo*ia ata& o(oo*ia

    , Tida *eraita( de()a( e#ai(a( 'a() #ai(

    riteria %iagnosis !th ronik "

    A, Ti%* L 1< $ari/*a( *er#a()"&() O 3 *a( 7L 10 $ari /ta$&(8 da( %e%e(&$i riteria D

    , N'eri epa#a *er#a()"&() *e*erapa +a% ata& ter&" %e(er&"

    9, >i(i%a# di"ertai 2 )e+a#a $a"

    1, Hoa"i *i#atera#

    2, >e(ea( / %e()iat 7tida *erde('&t83, I(te("ita"('a ri()a( ata& "eda()

    4, Tida diper*erat o#e$ ati!ita" r&ti( "eperti *er+a#a( ata& (ai ta())a

    D, Tida didapata(

    1, He*i$ dari 1 e#&$a( otoo*ia o(oo*ia ata& %&a# ri()a(

    2, >&a# "eda() ata& *erat %a&p&( %&(ta$

    , Tida *eraita( de()a( e#ai(a( 'a() #ai(

    3, 9#&"ter =eadac$e

    >er&paa( "a#a$ "at& *e(t& "ea#)ia oto(o%i tri)e%i(a#, roi# ('eri epa#a &(i eriodi"ita" 5 e+a#a

    oto(o%i 5 ara() 04 P popa"i &%&% Ra"io #ai-#ai pere%p&a( Q < 1

    *ejala linis "1, J("et %e(dada e"p#o"i

    2, U(i#atera# 7%e(capai p&(ca da#a% 10-1< %e(it da( *er#a()"&() $i())a 2 +a%8

    3, Seperti di*or di *e#aa() %ata *i+i %ata "pt %a& e#&ar "pt di*aar %e(etap

    4, Fre&e("i 4-6 "era()a( da#a% "e$ari

    i(i%a# < "era()a( 'a() %e%e(&$i -D

    , N'eri epa#a $e*at ata& "a()at $e*at pada or*ita "&pra or*ita ata& te%pora# &(i#atera# "e#a%a 1

  • 7/25/2019 tugas mandiri skenario 2 neuro

    10/26

    6, era"aa( e)e#i"a$a( ata& a)ita"i

    D, Fre?e("i "era()a( dari "at& a#i "etiap 2 $ari "a%pai /$ari

    , Tida *eraita( de()a( )a())&a( #ai(

    SAKIT KAHA SKUNDR

    1, Tri)e%i(a# Ne&ra#)ia / Tic doo&re&

    Sera()a( ('eri ?a+a$ &(i#atera# "po(ta( epi"odi, >e#i*ata( ca*a() N, Tri)e%i(&"

    a, N, @1 it epa#a da$i epa#a *a) depa(

    *, N,@2 pipi ra$a() ata" *i*ir ata" )i)i da( )&"i "i"i $id&()

    c, N,@3 ra$a() *a?a$ )i)i *i*ir *a?a$ )&"i

    Fator pe(cet&" "e(t&$a( *icara %aa( %i(&% %e()&('a$ "iat )i)i %e('i"ir c&&r Wa(ita pria Q 32, e('e*a*

    idiopatio%pre"i N,@ 760-0P8 de%'e#i(i"a"i tra"i )i)i >S "tre" t&%or

    *ambaran linis "

    1, Ke*a('aa( &(i#atera#

    2, Sera()a( paro"i"%a# di daera$ %&a ata& ro(ta# de()a( ('eri **rp deti tida #e*i$ dari 2 %e(it3, >i(i%a# 4 arateri"ti

    a, Di"tri*&"i pada 1 ata& #e*i$ ca*a() N,@

    *, >e(dada ta+a% "ta**i() i(te("e "pt ter*aar

    c, I(te("ita" ('eri *erat

    d, Fator pre"ipita"i dari area tri))er ata& ati!ita" "e$ari-$ari

    e, Dia(tara %a"a paro"i"%a# p a"i%to%ati

    4, Sera()a( "tereotipi

    2, Arteriti" Te%pora#i"

    =a%pir "e#a#& ter+adi pada p &%&r O

  • 7/25/2019 tugas mandiri skenario 2 neuro

    11/26

    e('e*a* dari ('eri epa#a te)a() otot i(i %a"i$ *e#&% dieta$&i, Did&)a dapatdi"e*a*aa( o#e$ ator p"ii"

    %a&p&( aor i"i, Secara p"ii" ('eri epa#a i(i dapatti%* ai*at rea"i t&*&$ ter$adap "tre"" ece%a"a( depre"i

    %a&p&( o(#i e%o"io(a#, Seda()a( "ecara i"i po"i"i epa#a 'a() %e(etap 'a() %e()ai*ata( o(tra"i otot-

    ototepa#a da( #e$er da#a% +a()a ?at& #a%a tid&r 'a() &ra() e"a#a$a( da#a% po"i"i tid&rda( e#e#a$a( +&)a dapat

    %e('e*a*a( ('eri epa#a te)a() otot i(i, Se#ai( it& po"i"i terte(t& 'a() %e('e*a*a( o(tra"i otot epa#a da( #e$er

    'a() di#a&a( *er"a%aa( de()a(e)iata(-e)iata( 'a() %e%*&t&$a( pe(i()ata( &()"i %ata da#a% +a()a ?at&

    #a%a%i"a#('a %e%*aca dapat pa %e(i%*a( ('eri epa#a +e(i" i(i,

    HJ,2,4 >e%a$a%i da( >e(+e#a"a( atoi"io#o)i N'eri Kepa#a

    N'eri ada#a$ "e("a"i "&*+eti ra"a 'a() tida ('a%a( *ia"a('a *eraita( de()a( er&"aa( +ari()a( at&a# ata&

    pote("ia# 79or?i( ,, 8, Ketia "&at& +ari()a( %e()a#a%i cedera ata& er&"aa( %e()ai*ata( di#epa"('a *a$a(

    *a$a( 'a() dapat %e("ti%&" re"eptor ('eri "eperti "eroto(i( $i"ta%i( io( a#i&% *radii(i( pro"ta)#a(di( da(

    "&*"ta("i 'a() aa( %e()ai*ata( re"po( ('eri 7Ko.ier d8, N'eri +&)a dapat di"e*a*a( "ti%&" %ea(i "eperti

    pe%*e()aa( +ari()a( 'a() %e(ea( pada re"eptor ('eri, 7Ta'#or 9, d8,

    N'eri epa#a dipe()ar&$i o#e$ (e&" tri)e%i(o"er!ia#i" 'a() %er&paa( (o"i"epti 'a() pe(ti() &(t&

    epa#a te())oroa( da( #e$er *a)ia( ata", Se%&a aere( (o"i"epti dari "ara tri)e%i(&" a"ia# )#o"oari()e&" !a)&"

    da( "ara dari 91 3 *era%iia"i pada grey matter area i(i, Ne&" tri)e%i(o"er!ia#i" terdiri dari ti)a *a)ia( 'ait& par"

    ora#i" 'a() *er$&*&()a( de()a( tra("%i"i "e("a"i tati# di"ri%i(ati dari re)io oroa"ia# par" i(terpo#ari" 'a()

    *er$&*&()a( de()a( tra("%i"i "e("a"i tati# di"ri%i(ati "eperti "ait )i)i par" a&da#i" 'a() *er$&*&()a( de()a(

    tra("%i"i (o"i"epti da( "&$&,

    Terdapat o*erlappingdari pro"e" ra%iia"i pada (e&" i(i "eperti aere( dari 92 "e#ai( *era%iia"i e 92

    +&)a *era%iia"i e 91 da( 93, Se#ai( it& aere( 93 +&)a aa( *era%iia"i e 91 da( 92, =a# i(i #a$ 'a()

    %e('e*a*a( ter+adi('a ('eri a#i$ dari pada epa#a da( #e$er *a)ia( ata",

    11

  • 7/25/2019 tugas mandiri skenario 2 neuro

    12/26

    N'eri a#i$ *ia"a('a terdapat pada o"ipita# da( re)io ro(to or*ita# dari epa#a da( 'a() +ara() ada#a$ daera$

    'a() diper"arai o#e$ (er!&" %a"i#iari" da( %a(di*ari", I(i di"e*a*a( o#e$ aere( "ara ter"e*&t tida ata& $a('a

    "ediit 'a() %e#&a" e ara$ a&da#, Hai( $a#('a de()a( "ara ota#%i&" dari tri)e%i(&", Aere( "ara i(i %e#&a" e par"

    a&da#,

    Sara tri)e%i(&" terdiri dari 3 'ait& @1 @2 da( @3, @1 ota#%i&" %e()i(er!a"i daera$ or*ita da( %ata "i(&"ro(ta#i" d&ra%ater dari o""a ra(ia# da(falx cerebri"erta pe%*&$ dara$ 'a() *er$&*&()a( de()a( *a)ia( d&ra%ater

    i(i, @2 %a"i#ari" %e()i(er!a"i daera$ $id&() "i(&" para(a"a# )i)i *a)ia( ata" da( d&ra%ater *a)ia( o""a ra(ia#

    %edia#, @3 %a(di*ari" %e()i(er!a"i daera$ d&ra%ater *a)ia( o""a cra(ia# %edia# ra$a() *a?a$ da( )i)i te#i()a

    "e(di te%poro%a(di*ar da( otot %e()&'a$,

    Se#ai( "ara tri)e%i(&" terdapat "ara ra(ia# @II I 'a() i((er!a"i %eat&" a&ditori&" e"ter(a da( %e%*ra(

    ti%a(i, Sara ra(ia# I %e()i((er!a"i ro())a te#i()a te()a$ "e#ai( it& "ara ra(ia# I da( i((er!a"i ari() da(

    #ari(),

    Ser!ia#i" 'a() ter#i*at da#a% "ait epa#a ada#a$ 91 92 da( 93, Ra%&" dor"a#i" dari 91 %e()i((er!a"i otot

    suboccipital triangle + obli%uus superior obli%uus inferiorda( rectus capitis posterior ma,or da( minor& Ra%&" dor"a#i"

    dari 92 %e%i#ii ca*a() #atera# 'a() %a"& e otot #e$er "&peri"ia# po"terior longissimus capitis da(splenius"eda()a(

    ca*a() *e"ar('a *a)ia( %edia# %e(+adi greater occipital ner*e, Sara i(i %e()e#i#i()i pi())ira( *a)ia( *a?a$ dari

    obli%uus inferior da( *a#i e *a)ia( ata" "erta e *a)ia( *e#aa() %e#a#&i semispinalis capitis 'a() %a(a "ara i(i di

    "&p#ai da( %a"& e it epa#a %e#a#&i #e()&()a( 'a() die#i#i()i o#e$ superior nuchal lineda( t$e apo(e&ro"i" o

    trape.i&", >e#a#&i o"ip&t "ara i(i aa( *er)a*&() de()a( "ara lesser occipital'a() %a(a %er&paa( ca*a() dari

    p#e"&" "er!ia#i" da( %e(capai it epa#a %e#a#&i pi())ira( po"terior dari "ter(o#eido%a"toid, Ra%&" dor"a#i" dari 93

    %e%*eri ca*a() #atera# e longissimus capitisda(splenius, Ra%&" i(i %e%*e(t& 2 ca*a() %edia#, 9a*a() "&peri"ia#

    %edia# ada#a$ (er!&" o"ipita#i" eti)a 'a() %e()e#i#i()i "e(di 92-3-ygapophysial*a)ia( #atera# da( po"terior,

    Daera$ "e("iti ter$adap ('eri epa#a dapat di*a)i %e(+adi 2 *a)ia( 'ait& i(trara(ia# da( e"trara(ia#,I(trara(ia# 'ait& "i(&" !e(o"&" !e(a orte" "ere*r&% arteri *a"a# d&ra%ater *a)ia( a(terior da( o""a te()a$ "erta

    o""a po"terior, trara(ia# 'ait& pe%*&$ dara$ da( otot dari it epa#a *a)ia( dari or*ita %e%*ra( %&o"a dari

    ro())a (a"a# da( para(a"a# te#i()a te()a$ da( #&ar )i)i da( )&"i, Seda()a( daera$ 'a() tida "e("iti ter$adap ('eri

    ada#a$ pare(i% ota !e(triar epe(di%a da( p#e"&" oroide&",

    e*erapa %ea(i"%e &%&% 'a() ta%pa('a *erta())&() +a?a* %e%ic& ('eri epa#a ada#a$ "e*a)ai *eri&t

    7Ha(ce 20008 718 pere)a()a( ata& per)e"era( pe%*&$ dara$ i(trara(i&% ata& e"trara(i&% 728 tra"i pe%*&$

    dara$ 738 o(tra"i otot epa#a da( #e$er 7 er+a *er#e*i$a( otot8 738 pere)a()a( perio"te&% 7('eri #oa#8 748 de)e(era"i

    "pi(a "er!ia#i" ata" di"ertai o%pre"i pada aar (er!&" "er!ia#i" 7%i"a#('a arteriti" !erte*ra "er!ia#i"8 dei"ie("i

    e(ea#i( 7peptida ota %irip- opiat *a$a( ati pada e(dori(8,

    HJ,2,< >e%a$a%i da( >e(+e#a"a( >a(ie"ta"i N'eri Kepa#a

    N'eri epa#a te)a() otot *ia"a *er#a()"&() "e#a%a 30 %e(it $i())a 1 %i())& pe(&$, N'eri *i"a dira"aa(

    ada() ada() ata& ter&" %e(er&", N'eri pada a?a#('a dira"aa( pa"ie( pada #e$er *a)ia( *e#aa() e%&dia( %e(+a#ar

    e epa#a *a)ia( *e#aa() "e#a(+&t('a %e(+a#ar e *a)ia( depa(, Se#ai( it& ('eri i(i +&)a dapat %e(+a#ar e *a$&, N'eri

    epa#a dira"aa( "eperti epa#a *erat pe)a# ra"a e(ca() pada daera$ *ite%pora# da( *io"ipita#ata& "eperti diiat di

    "ee#i#i() epa#a, N'eri epa#a tipe i(i tida *erde('&t,

    ada ('eri epa#a i(i tida di"ertai %&a# ata&p&( %&(ta$ tetapi a(ore"ia %&()i( "a+a ter+adi, a"ie( +&)a

    %e()a#a%i otoo*ia da( o(oo*ia, e+a#a #ai( 'a() +&)a dapat dite%&a( "eperti i("o%(ia 7)a())&a( tid&r 'a() "eri()

    ter*a()&( ata& *a()&( di(i $ari8 (aa" pe(de o("tipa"i *erat *ada( %e(&r&( pa#pita"i da( )a())&a( $aid,

    12

  • 7/25/2019 tugas mandiri skenario 2 neuro

    13/26

    ada ('eri epa#a te)a() otot 'a() ro(i" *ia"a('a %er&paa( %a(ie"ta"i o(#i p"io#o)i" 'a() %e(da"ari('a

    "eperti ece%a"a( da( depre"i, J#e$ "e*a* it& per#& die!a#&a"i ada('a "tre" e$id&pa( peer+aa( e*ia"aa( "iat

    epri*adia( tipe pere"io(i" e$id&pa( pera?i(a( e$id&pa( "o"ia# "e"&a# da( cara pa"ie( %e()ata"i('a, Ke#&$a(

    e%o"i a(tara #ai( pera"aa( *er"a#a$ p&t&" a"a tida *er$ar)a ta&t "ait ata&p&( ta&t %ati, Ke#&$a( p"ii" 'ait&

    o("e(tra"i *&r& %i(at %e(&r&( a%*i"i %e(&r&( ata& $i#a() da'a i()at *&r& da( ei()i(a( *&(&$ diri,

    HJ,2,6 >e%a$a%i da( >e(+e#a"a( Dia)(o"i" da( Dia)(o"i" *a(di() N'eri Kepa#a

    %iagnosis

    A%a(%e"i"

    erta('aa( &%&% pada a(a%(e"a e#&$a( ('eri epa#a

    1, Apaa$ ('eri epa#a it& %er&paa( ('eri epa#a biasaG

    2, Apaa$ pa"ie( per(a$ %e()a#a%i )a())&a( cedera epa#a 'a() ter+adi "e)era *e*erapa %i())& *a$a(

    *e*erapa *a( "e*e#&% ti%*('a ('eri epa#a &(t& perta%a a#i

    3, Apaa$ di"ertai )e+a#a de%a%ia 'a pe('e*a*('a $ar&" dipiira(, ada pe('ait-pe('ait i(e"i terte(t& ter&ta%a de%a% tioid da( i(e"i 'a()

    di"e*a*a( o#e$ ar*o!ir&" ('eri epa#a dapat dira"aa( "a()at $e*at "e$i())a %e(&t&pi e#&$a( de%a%('a,

    4, a)ai%a(a pa"ie( %e(+e#a"a( ('eri epa#a 7#oa"i re&e("i ?at& d&ra"i &a#ita" ator pe%ic& ator

    pereda8

  • 7/25/2019 tugas mandiri skenario 2 neuro

    14/26

    +enis atau Penyebab ,iri has Pemeriksaan %iagnostik

    .etegangan otot Sait epa#a "eri() ter+adi ('eri $i#a()

    ti%* tida ter#a#& *erat da( dira"aa( di

    epa#a *a)ia( depa( da( *e#aa() ata&

    dira"aa( ea&a( %e('e#&r&$,

    e%eri"aa( &(t&

    %e('i()ira( pe('ait i"i

    "erta pe(i#aia( ator p"ii"

    epri*adia(,

    Migren N'eri di%ai di da#a% da( di "eitar %ata

    ata& pe#ipi" %e('e*ar e "at& ata& ed&a

    "i"i epa#a *ia"a('a %e()e(ai "e#&r&$

    epa#a *erde('&t da( di"ertai de()a(

    ia dia)(o"i"('a %a"i$

    %era)&a( da( "ait epa#a

    *ar& ter+adi di#a&a( 9T "ca(

    ata& >RI/di*eria( o*at %i)re(

    Nyeri .epala Cluster Sera()a(('a "i()at 7"eitar 1 +a%8

    dira"aa( di "at& "i"i epa#a "era()a(

    ter+adi "ecara periodi- %e('era() pria 'a()

    di"ertai de()a( pe%*e()aa( %ata

    $id&() %e#er %ata *erair pada "i"i 'a()

    "a%a de()a( ('eri,

    J*at %i)re( di*eria( &(t&

    %e#i$at ee('a 7"&%atripta(

    %eti"er)id/o*at !a"oo("tritor-

    ortio"teroid i(do%eta"i(8

    ata& %e()$ir&p J2,

    /ipertensi N'eri('a *erde('&t da( dira"aa( di epa#a

    *a ia( *e#aa( ata& di &(ca e a#a,

    A(a#i"a i%ia dara$ da(

    e%eri"aa( i( a#,.elainan mata

    iritis) glau$oma"&

    N'eri dira"aa( di epa#a *a)ia( depa( ata&

    di da#a% da( di "e#&r&$ %ata *er"iat

    "eda() "a%pai *erat da( "eri()a#i

    %e%*&r& +ia %ata da#a% eadaa( #e#a$,

    e%eri"aa( %ata,

    .elainan sinus N'eri *er"iat a&t ata& "&*a&t dira"aa(

    di epa#a *a)ia( depa( *er"iat t&%p ata&

    *erat *ia"a('a %e%*&r& di pa)i $ari

    %e%*ai di "ia() $ari da( %e%*&r&da#a% eadaa( di( i( ata& #e%*a*,

    Ro(t)e( "i(&"

    Tumor ota$ N'eri $i#a()-ti%* *er"iat ri()a( "a%pai

    *erat dira"aa( di "at& titi ata& di "e#&r&$

    epa#a, Ke#e%a$a( di "a#a$ "at& "i"i t&*&$

    "e%ai( %e(i()at e+a() )a())&a(

    pe()#i$ata( e%a%p&a( *er*icara $i#a()

    >RI ata& 9T "ca(

    Infe$si ota$ N'eri $i#a()-ti%* *er"iat ri()a( "a%pai

    *erat dira"aa( di "at& titi ata& di "e#&r&$

    epa#a, Se*e#&%('a pe(derita per(a$

    %e()a#a%i i(e"i te#i()a "i(&" ata& par&-par& pe('ait +a(t&() re%ati ata&

    pe('ait +a(t&() *a?aa(,

    >RI ata& 9T "ca(

    Meningitis N'eri *ar& dira"aa( %e(etap *erat da(

    dira"aa( di "e#&r&$ epa#a "erta %e(+a#ar

    e #e$er, Sait di"ertai de%a% %&(ta$ da(

    "e*e#&%('a %e()a#a%i ('eri te())oroa(

    ata& i(e"i per(aa"a( da( #e$er "it

    dite&,

    e%eri"aa( dara$ p&()"i

    #&%*a#,

    /ematoma subdural N'eri $i#a()-ti%* ata& ter&" %e(er&"

    *er"iat ri()a( "a%pai *erat *i"a dira"aa(

    14

  • 7/25/2019 tugas mandiri skenario 2 neuro

    15/26

    HJ,2,C >e%a$a%i da( >e(+e#a"a( Tata Ha"a(a N'eri Kepa#a

    M(*-(/

    e(ata#a"a(aa( "ecara &%&% tata#a"a(a *er&pa

    1, Saat "era()a( *eri terapi "i%to%ati2, i#a actor pe(cet&" die(a#i %aa $ar&" di$i(dari

    3, A("ieta" da( depre"i $ar&" dio*ati

    4, Re#a"a"i da( #ati$a( per(aa"a(

    !erapi simtomatik

    6, a('a pa"ie( 'a() %e%*ai de()a( pe%*eria( a"piri( ata& paraceta%o#, e*erapa pa"ie( %e(dapat $a"i# 'a()

    #e*i$ *ai *i#a dita%*a$a( e(o*ar*ita# do"i" eci#,

    C, N'eri epa#a $e*at dapat dio*ati de()a( odei( 30-60 %)

    , Na&"ea da( o%it&" dapat di$i#a()a( de()a( pro%eta.i( 2

  • 7/25/2019 tugas mandiri skenario 2 neuro

    16/26

    $blokers

    Ate(o#o#

    >etapro#o#

    Nado#o#

    ropa(o#o#

    pe(',

    !a"er perier $eart

    *#oc i*& $a%i#,

    ,alium hannel

    blokers

    F#&(ari.i(e

    @erapa%i#

    et$'"er)ide

    2 %) 7%a %)/$r8 !etroperitoneal)cardiac and

    pulmonary fibrosis

    $iperte("i e$a%i#a(

    tro%*o#e*iti",

    i.ot'#i(e 7pi.otie(8 0,< %) 7%a 3-6

    % /$r

    0eight gain) Fatigue&

    !riyli analgesis

    A%itripti#i(e

    Nortripti#i(e

    10-1e#a&a( #ati$a( pere)a()a( #e$er ata& otot *a$& "ediit('a 20 "a%pai 30 %e(it,

    2, er&*a$a( po"i"i tid&r,

    3, er(aa"a( de()a( diara)%a ata& %etode re#a"a"i otot 'a() #ai(,

    4, e('e"&aia( #i()&()a( er+a %a&p&( r&%a$,

  • 7/25/2019 tugas mandiri skenario 2 neuro

    17/26

    ,5S!&- '&%,'&

    Sa"ara( terapi %e()$i#a()a( ('eri 7terapi a*orti8 %e(ce)a$ "era()a( 7proi#a"i"8,

    Strate)i terapi %e())&(aa( o*at NSAID !a"oo("tritor cere*ra#,

    J*at terapi a*orti o"i)e( er)ota%i( "&%atripta( 7do"i" "a%a de()a( do"i" %i)re(8,

    J*at terapi proi#a"i" !erapa%i# #iti&% er)ota%i( %eti"er)id ortio"teroid topira%at,

    -!&-(!(S !&MP0-

    Steroid

    1, Korti"o( 100 300 %) / $ari ata&

    2, red(i"o( do"i" ti())i 40 - 0 %) /$ari diperta$a(a( 3 4 %i())&tapperi() o

    HJ,2, >e%a$a%i da( >e(+e#a"a( Ko%p#ia"i N'eri Kepa#a

    Ko%p#ia"i TT= ada#a$ re*o&(d $eadac$e 'ait& ('eri epa#a 'a() di"e*a*a( o#e$ pe())&(aa( o*at - o*ata(

    a(a#)e"ia "eperti a"piri( a"eta%i(oe( d##'a() *er#e*i$a(, Te("io( t'pe $eadac$e epi"odi dapat *ere%*a() %e(+adi

    tipe ro(i da( depre"i ai*at )e+a#a('a dapat ter+adi "e*a)ai "&at& o%p#ia"i pada pa"ie(, Ko%p#ia"i >i)re( ada#a$

    re*o&(d $eadac$e ('eri epa#a 'a() di"e*a*a( o#e$ pe())&(aa( o*at-o*ata( a(a#)e"ia "eperti a"piri( a"eta%i(oe( d##

    'a() *er#e*i$a(,

    HJ,2,E >e%a$a%i da( >e(+e#a"a( e(ce)a$a( N'eri Kepa#a

    Terapi eri#a& %er&paa( pe(ce)a$a( 'a() *ai pada pa"ie( %e()i()at i(i ada#a$ "&at& e#ai(a( p"io)e(idi$arapa(d e()a( ada('a "&at& terapi p"io#o)i" pa"ie( dapat %e()e(a#i +ia "ait epa#a('a %ai ti%* da( %ai

    %e#a&a( per&*a$a(-per&*a$a( "iap a)ar "ait epa#a('a %ereda,

    HJ,2,10 >e%a$a%i da( >e(+e#a"a( ro)(o"i" N'eri Kepa#a

    ro)(o"i" ('eri epa#a *er)a(t&() pada +e(i" "ait epa#a('a "eda()a( i(dia"i %er&+& pada eadaa( 718

    "ait epa#a 'a() ti*a-ti*a da( ti%* ea&a( di #e$er 728 "ait epa#a de()a( de%a% da( e$i#a()a( e"adara( 738

    "ait epa#a "ete#a$ tere(a tra&%a %ea(i pada epa#a748 "ait epa#a di"ertai "ait pada *a)ia( %ata da( te#i()a 7

  • 7/25/2019 tugas mandiri skenario 2 neuro

    18/26

    >er&paa( *e(t& per&*a$a( 'a() %e()ai*ata( ada('a per&*a$a( &()"i i"i 'a() tida dapat di#aca

    "ecara %edi", a())&a( i(i %&(c da#a% o(#i ata& pe()a#a%a( tra&%ati 'a() %e%*eria( e'ai(a( aa( ada('a

    pe('e*a* p"io#o)i",

    2, =ipoo(dria"i"

    Terpa& pada e'ai(a( *a$?a diri('a %e(derita pe('ait 'a() "eri&", Keta&a( aa( ada('a pe('ait ter&"ada %e"ip&( "ecara %edi" te#a$ di'ai(a(, Se("a"i ata& ra"a ('eri i"i *ia"a('a "eri() dia"o"ia"ia( de()a( )e+a#a

    pe('ait ro(i" terte(t&,

    3, a())&a( "o%ati"a"i

    Ke#&$a( i"i 'a() %&(c *era() %e()e(ai "i%pto% i"i 'a() tida ada da"ar or)a(i" 'a() +e#a", a())&a(

    i(i %e('e*a*a( "e"eora() &(t& %e#a&a( &(+&()a( %edi" *era#i-a#i ata& %e('e*a*a( $e(da'a 'a() "i)(iia(

    da#a% &()"i,

    4, a())&a( di"%ori t&*&$

    Terpa& pada er&"aa( i"i 'a() di*a'a()a( ata& *er#e*i$-#e*i$a(, >e()a())ap ora() tida

    %e%per$atia(('a are(a er&"aa( t&*&$ 'a() di%i#ii('a 7diper"ep"ia(('a8, a())&a( i(i aa( %e%*a?a "e"eora()

    pada peri#a& o%p#&"i "eperti *era()-a() *erda(da( d##,

  • 7/25/2019 tugas mandiri skenario 2 neuro

    19/26

    d& Fa$tor 4mosi dan .ognitif

    ada ator pe('e*a* 'a() *er$&*&()a( de()a( e%o"i da( o)(iti pe('e*a* )a(da 'a() ter#i*at ada#a$

    "e*a)ai *eri&t

    1, Sa#a$ i(terpreta"i dari per&*a$a( t&*&$ ata& "i%pto% i"i "e*a)ai ta(da dari ada('a pe('ait "eri&"

    7$ipoo(dria"i"8,

    2, Da#a% teori Fre&dia( tradi"io(a# e(er)i p"ii" 'a() terpoto() dari i%p"-i%p" 'a() tida dapat diteri%adio(!er"ia( e da#a% "i%pto% i"i 7)a())&a( o(!er"i8,

    3, >e('a#a$a( i(er+a *&r& dari e"e$ata( 'a() %e(&r&( %&()i( %er&paa( "&at& "trate)i self+handicaping

    7$ipoo(dria"i"8,

    ada )a())&a( So%ati"a"i *er$&*&()a( de()a(

    A, Fator "io"o"ia#

    R&%&"a( p"io"o"ia# te(ta() pe('e*a* )a())&a( %e#i*ata( i(terpreta"i )e+a#a "e*a)ai "&t& tipe o%&(ia"i

    "o"ia# $a"i#('a ada#a$ %e()$i(dari e?a+i*a( %e()e"pre"ia( e%o"i ata& &(t& %e("i%*o#i"a"ia( "&at& pera"aa(

    ata& e'ai(a(, e*erapa pa"ie( de()a( )a())&a( "o%ati"a"i *era"a# dari r&%a$ 'a() tida "ta*i# da( te#a$

    %e()a#a%i pe('i"aa( i"i, Fator "o"ia# t&ra# da( +&)a et(i %&()i( +&)a ter#i*at da#a% pere%*a()a()a())&a( "o%ati"a"i,

    , Fator io#o)i"

    Fator )e(eti da#a% tra("%i"i )a())&a( "o%ati"a"i da( ada('a pe(&r&(a( %eta*o#i"%e 7$ipo%eta*o#i"%e8

    "&at& .at terte(t& di #o*&" ro(ta#i" da( $e%i"er (o(-do%i(a(, Se#ai( it& did&)a terdapat re)a"i a*(or%a# "i"te%

    "itoi( 'a() %&()i( %e('e*a*a( *e*erapa )e+a#a 'a() dite%&a( pada )a())&a( "o%ati"a"i,

    ada )a())&a( $ipoo(dria"i" *er$&*&()a( de()a(

    A, >ode# *e#a+ar "o"ia#, e+a#a $ipoo(dria"i" dipa(da() "e*a)ai ei()i(a( &(t& %e(dapata( pera(a( "ait o#e$

    "e"eora() &(t& %e()$adapi %a"a#a$ 'a() ta%pa('a *erat da( tida dapat dipeca$a(,

    , @aria( dari )a())&a( %e(ta# #ai(, a())&a( 'a() pa#i() "eri() di$ipote"i"a( *er$&*&()a( de()a(

    $ipoo(dria"i" ada#a$ )a())&a( depre"i da( )a())&a( ece%a"a(,

    9, "iodi(a%ia, >e('ataa( *a$?a $arapa( a)re"i da( per%&"&$a( ter$adap ora() #ai( dipi(da$a( 7%e#a#&i

    repre"i da( pe()a#i$a(8 epada e#&$a( i"i, =ipoo(dria"i" +&)a dipa(da() "e*a)ai perta$a(a( da( ra"a *er"a#a$

    ra"a e*&r&a( 'a() %e#eat "&at& e"pre"i $ar)a diri 'a() re(da$ da( ta(da per$atia( ter$adap diri "e(diri 7"e#-

    co(cer(8 'a() *er#e*i$a(,

    HJ,3,4 >e%a$a%i da( >e(+e#a"a( >a(ie"ta"i a())&a( So%atoor%

    >a(ie"ta"i #i(i" )a())&a( i(i ada#a$ ada('a e#&$a(-e#&$a( )e+a#a i"i 'a() *era() di"ertai per%i(taa(

    pe%eri"aa( %edi %e"ip&( "&da$ *era#i-a#i ter*&ti $a"i#('a (e)ati da( +&)a te#a$ di+e#a"a( doter('a *a$?a

    tida ada e#ai(a( 'a() %e(da"ari e#&$a(('a 7Kapita Se#eta 20018, e*erapa ora() *ia"a('a %e()e#&$a( %a"a#a$

    da#a% *er(aa" ata& %e(e#a( ata& ada 'a() %e(ea( di da#a% te())oroa(G, >a"a#a$-%a"a#a$ "eperti i(i dapat

    %ere#e"ia( ati!ita" 'a() *er#e*i$a( dari ca*a() "i%pati" "i"te% "ara oto(o%i 'a() dapat di$&*&()a( de()a(

    ece%a"a(, Kada() a#a "e+&%#a$ "i%to% %&(c da#a% *e(t& 'a() #e*i$ tida *ia"a "eperti e#&%p&$a(G pada

    ta()a( ata& ai 'a() tida o("i"te( de()a( er+a "i"te% "ara, Da#a% a"&"-a"&" #ai( +&)a dapat dite%&a(

    %a(ie"ta"i di %a(a "e"eora() *ero&" pada e'ai(a( *a$?a %erea %e(derita pe('ait 'a() "eri&" (a%&( tida ada

    *&ti a*(or%a#ita" i"i 'a() dapat dite%&a( 7Ne!id d 200

  • 7/25/2019 tugas mandiri skenario 2 neuro

    20/26

    a%*ara( e#&$a( )e+a#a "o%atoor%

    Ne&rop"iiatri

    ed&a *a)ia( dari ota "a'a tida dapat *er&()"i de()a( *aiG

    "a'a tida dapat %e('e*&ta( *e(da di "eitar r&%a$ etia dita('aG

    Kardiop%o(a#

    +a(t&() "a'a tera"a *erde*ar de*arX, Sa'a ira "a'a aa( %atiG

    a"troi(te"ti(a#

    "a'a per(a$ dira?at are(a "ait %aa) da( a(d&() e%ped& da( *e#&% ada doter 'a() dapat %e('e%*&$a(('aG

    e(ito&ri(aria

    "a'a %e()a#a%i e"ita( da#a% %e()o(tro# AK "&da$ di#a&a( pe%eri"aa( (a%&( tida di te%&a( apa-apaG

    >&"co"e#eta#

    "a'a te#a$ *e#a+ar &(t& $id&p da#a% e#e%a$a( da( e#e#a$a( "epa(+a() ?at&G

    Se("ori"

    pa(da()a( "a'a a*&r "eperti *era*&t tetapi doter %e()ataa(

    aca%ata tida aa( %e%*a(t&G

    e*erapa tipe &ta%a dari )a())&a( "o%atoor% ada#a$ )a())&a( o(!er"i $ipoo(dria"i" )a())&a( di"%ori

    t&*&$ da( )a())&a( "o%ati"a"i,

    a())&a( "o%ati"a"i

    1, Ada('a *e*erapa e#&$a( i"i 7%tip#e "'%pto%8 'a() *era() di%a(a etia diperi"a "ecara i"i/%edi"

    tida dite%&a( ada('a e#ai(a( tetapi ia tetap o(ti('& %e%eri"aa( diri, a())&a( tida %&(c are(a

    pe())&(aa( o*at, Ke#&$a( 'a() &%&%('a %i"a#('a "ait epa#a "ait per&t "ait dada %e"tr&a"i tida terat&r d##

    2, a"ie( %e(&(+&a( e#&$a( de()a( cara $i"trio(i *er#e*i$a( "eaa( ter"i"a/%era(a,

    3, era() %e%eri"a diri e doter ada() %e())&(aa( *er*a)ai o*at dira?at di RS *a$a( di#a&a(

    opera"i,

    4, Seri() dite%&a( %a"a#a$ peri#a& ata& $&*&()a( per"o(a# "eperti e"ita( da#a% per(ia$a(,

    a())&a( o(!er"i

    1, Ko(di"i di%a(a pa(ca i(dera ata& otot-otot tida *er&()"i ?a#a&p&( "ecara i"io#o)i" pada "i"te% "ara ata&

    or)a(-or)a( t&*&$ ter"e*&t tida terdapat )a())&a(/e#ai(a(,

    2, Secara i"io#o)i" ora() (or%a# dapat %e()a#a%i "e*a)ia( ata& e#&%p&$a( tota# pada ta()a( #e()a( ata&

    )a())&a( oordi(a"i it ra"a('a )ata# ata& "eperti dit&"&-t&"& etida peaa( ter$adap ('eri ata& $i#a()('a

    e%a%p&a( &(t& %era"aa( "e("a"i 7a(a"te"i8 e#&%p&$a( e*&taa( tida dapat %e(de()ar tida dapat %e%*a&

    "&ara $a('a *er*i"i d##,

    3, ia"a('a %&(c ti*a-ti*a da#a% eadaa( "tre" ada('a &"a$a i(di!id& &(t& %e()$i(dari *e*erapa ati!ita"

    ata& ta())&()+a?a*,

    4, Ko("ep Fre&d e(er)i dari i("ti() 'a() di repre" *er*a#i %e('era() da( %e()$a%*at &()"i "a#&ra(

    "e("ori%otor,

    20

  • 7/25/2019 tugas mandiri skenario 2 neuro

    21/26

    e#a&a( *a('a te" #a* %e())&(aa( *a('a o*at %e%eri"aa( diri e *a('a doter ata& RS

    4, Ke'ai(a( i(i ter&" *er#a(+&t tida %a& %e(eri%a (a"e$at ata& pe(+e#a"a( doter ?a#a&p&( $a"i# pe%eri"aa(

    %edi" tida %e(&(+&a( ada('a pe('ait da( "&da$ di'ai(a(,

    e%a$a%i da( >e(+e#a"a( Dia)(o"i" da( Dia)(o"i" *a(di() a())&a( So%atoor%

    .riteria diagnosis menurut (SM+I'

    Kriteria dia)(o"ti &(t& a())&a( So%ati"a"i

    A, Ri?a'at *a('a e#&$a( i"i 'a() di%ai "e*e#&% &"ia 30 ta$&( 'a() ter+adi "e#a%a periode *e*erapa ta$&(

    da( %e%*&t&$a( terapi 'a() %e('e*a*a( )a())&a( *er%a(a da#a% &()"i "o"ia# peer+aa( ata& &()"i pe(ti() #ai(,

    , Tiap riteria *eri&t i(i $ar&" dite%&a( de()a( )e+a#a i(di!id&a# 'a() ter+adi pada "e%*ara() ?at& "e#a%a

    per+a#a(a( )a())&a(

    1, 4mpat ge,ala nyeri ri?a'at ('eri 'a() *er$&*&()a( de()a( "e&ra()('a e%pat te%pat ata& &()"i 'a()

    *er#ai(a( 7%i"a#('a epa#a per&t p&())&() "e(di a())ota )era dada ret&% "e#a%a %e("tr&a"i "e#a%a

    $&*&()a( "e"&a# ata& "e#a%a %i"i8,

    2, (ua ge,ala gastrointestinal ri?a'at "e&ra()('a d&a )e+a#a )a"troi(te"ti(a# "e#ai( ('eri 7%i"a#('a %&a#

    e%*&() %&(ta$ "e#ai( dari "e#a%a e$a%i#a( diare ata& i(to#era("i ter$adap *e*erapa +e(i" %aa(a(8

    3, Satu ge,ala se$sual ri?a'at "e&ra()('a "at& )e+a#a "e"&a# ata& reprod&ti "e#ai( dari ('eri 7%i"a#('a

    i(diere("i "e"&a# di"&()"i ereti# ata& e+aa"i %e("tr&a"i tida terat&r perdara$a( %e("tr&a"i *er#e*i$a(

    %&(ta$ "epa(+a() e$a%i#a(8,4, Satu ge,ala pseudoneurologis ri?a'at "e&ra()('a "at& )e+a#a ata& dei"it 'a() %e()ara$a( pada o(di"i

    21

  • 7/25/2019 tugas mandiri skenario 2 neuro

    22/26

    (e&ro#o)i" 'a() tida ter*ata" pada ('eri 7)e+a#a o(!er"i "eperti )a())&a( oordi(a"i ata& e"ei%*a()a( para#i"i"

    ata& e#e%a$a( "ete%pat "it %e(e#a( ata& *e(+o#a( di te())oroa( ao(ia rete("i &ri( $a#&"i(a"i $i#a()('a

    "e("a"i ata& ('eri pa(da()a( )a(da e*&taa( etia( e+a())e+a#a di"o"iati "eperti a%(e"ia ata& $i#a()('a

    e"adara( "e#ai( pi()"a(8

    9, Sa#a$ "at& 718 ata& 728

    1, Sete#a$ pe(e#itia( 'a() diper#&a( tiap )e+a#a da#a% riteria tida dapat di+e#a"a( "epe(&$('a o#e$ "e*&a$o(di"i %edi" &%&% 'a()die(a# ata& ee #a()"&() da( "&at& .at 7%i"a#('a ee cedera %edia"i o*at ata&

    a#o$o#8,

    2, ia terdapat o(di"i %edi" &%&% e#&$a( i"i ata& )a())&a( "o"ia# ata& peer+aa( 'a() diti%*a(('a

    ada#a$ %e#e*i$i apa 'a()diperiraa( da( ri?a'at pe('ait pe%eri"aa( i"i ata& te%&a( #a*oratori&%,

    D, e+a#a tida diti%*a( "ecara "e()a+a ata& di*&at-*&at 7"eperti )a())&a( *&ata( ata& p&ra-p&ra8,

    Kriteria dia)(o"ti &(t& a())&a( Ko(!er"i

    A, Sat& ata& #e*i$ )e+a#a ata& dei"it 'a() %e()e(ai &()"i %otori !o#&(ter ata& "e("ori 'a() %e()ara$a( pada

    o(di"i (e&ro#o)i" ata& o(di"i %edi" #ai(,

    , Fator p"io#o)i" diperti%*a()a( *er$&*&()a( de()a( )e+a#a ata& dei"it are(a a?a# ata& e"a"er*a"i )e+a#a

    ata& dei"it ada#a$ dida$&i o#e$ o(#i ata& "tre"or #ai(,

    9, e+a#a ata& dei"it tida diti%*a( "ecara "e()a+a ata& di*&at-*&at 7"eperti pada )a())&a( *&ata( ata&

    *erp&ra-p&ra8,

    D, e+a#a ata& dei"it tida dapat "ete#a$ pe(e#itia( 'a() diper#&a( di+e#a"a( "epe(&$('a o#e$ o(di"i %edi"

    &%&% ata& o#e$ ee #a()"&() "&at& .at ata& "e*a)ai peri#a& ata& pe()a#a%a( 'a() diteri%a "ecara t&ra#,

    , e+a#a ata& dei"it %e('e*a*a( pe(deritaa( 'a() *er%a(a "ecara #i(i" ata& )a())&a( da#a% &()"i "o"ia#

    peer+aa( ata& &()"i pe(ti() #ai( ata& %e%er#&a( pe%eri"aa( %edi",

    F, e+a#a ata& dei"it tida ter*ata" pada ('eri ata& di"&()"i "e"&a# tida ter+adi "e%ata-%ata "e#a%a per+a#a(a(

    )a())&a( "o%ati"a"i da( tida dapat ditera()a( de()a( #e*i$ *ai o#e$ )a())&a( %e(ta# #ai(,

    Kriteria Dia)(o"ti &(t& =ipoo(dria"i"

    A, reo&pa"i de()a( eta&ta( %e(derita ata& ide *a$?a ia %e(derita "&at& pe('ait "eri&" dida"ara( pada

    i(terpreta"i e#ir& ora() ter"e*&t ter$adap )e+a#a-)e+a#a t&*&$,

    , ero&pa"i %e(etap ?a#a&p&( te#a$ di#a&a( pe%eri"aa( %edi" 'a() tepat da( pe(e(tra%a(,

    9, Ke'ai(a( da#a% riteria A tida %e%i#ii i(te("ita" ?a$a% 7"eperti )a())&a( de#&"io(a# tipe "o%ati8 da(

    tida ter*ata" pada e$a?atira( te(ta() pe(a%pi#a( 7"eperti pada )a())&a( di"%ori t&*&$8,

    D, reo&pa"i %e('e*a*a( pe(deritaa( 'a() *er%a(a "ecara i#(i" ata& )a())&a( da#a% &()"i "o"ia#

    peer+aa( ata& &()"i pe(ti() #ai(,

    , Ha%a )a())&a( "e&ra()('a 6 *a(,

    F, reo&pa"i tida dapat ditera()a( #e*i$ *ai o#e$ )a())&a( ece%a"a( &%&% )a())&a( o*"e"i-o%p"i

    )a())&a( pa(i )a())&a( depre"i *erat ce%a" perpi"a$a( ata& )a())&a( "o%atoor% #ai(,

    Kriteria Dia)(o"ti &(t& a())&a( Di"%ori T&*&$

    A, reo&pa"i de()a( *a'a()a( cacat da#a% pe(a%pi#a(, ia dite%&a( "ediit a(o%a#i t&*&$ e$a?atira(

    ora() ter"e*&t ada#a$ *er#e*i$a( de()a( ('ata,

    , reo&pa"i %e('e*a*a( pe(deritaa( 'a() *er%a(a "ecara #i(i" ata& )a())&a( da#a% &()"i "o"ia#

    peer+aa( ata& &()"i pe(ti() #ai(('a,

    9, reo&pa"i tida dapat ditera()a( #e*i$ *ai o#e$ )a())&a( %e(ta# #ai( 7%i"a#('a etidap&a"a( de()a(

    *e(t& da( &&ra( t&*&$ pada a(oreia (er!o"a8,

    Kriteria Dia)(o"ti &(t& a())&a( N'eri

    A, N'eri pada "at& ata& #e*i$ te%pat a(ato%i" %er&paa( p&"at )a%*ara( #i(i" da( c&&p para$ &(t&%e%er#&a( per$atia( #i(i",

    22

  • 7/25/2019 tugas mandiri skenario 2 neuro

    23/26

    , N'eri %e('e*a*a( pe(deritaa( 'a() *er%a(a "ecara #i(i" ata& )a())&a( da#a% &()"i "o"ia# peer+aa( ata&

    &()"i pe(ti() #ai(,

    9, Fator p"io#o)i" dia())ap %e%i#ii pera(a( pe(ti() da#a% o("et e%ara$a( e"a"er*a"i ata& *erta$a((('a

    ('eri,

    D, e+a#a ata& dei"it tida diti%*a( "ecara "e()a+a ata& di*&at-*&at 7"eperti pada )a())&a( *&ata( ata& *erp&ra-

    p&ra8,, N'eri tida dapat ditera()a( #e*i$ *ai o#e$ )a())&a( %ood ece%a"a( ata& )a())&a( p"ioti da( tida

    %e%e(&$i riteria di"pare&(ia,

    Kriteria Dia)(o"ti &(t& a())&a( So%atoor% 'a() Tida Di)o#o()a(

    A, Sat& ata& #e*i$ e#&$a( i"i 7%i"a#('a e#e#a$a( $i#a()('a (a"& %aa( e#&$a( )a"troi(te"ti(a# ata& "a#&ra(

    e%i$8,

    , Sa#a$ "at& 718 ata& 728

    1, Sete#a$ pe%eri"aa( 'a() tepat )e+a#a tida dapat di+e#a"a( "epe(&$('a o#e$ o(di"i %edi" &%&% 'a()

    dieta$&i ata& o#e$ ee #a()"&() da( "&at& .at 7%i"a#('a ee cedera %edia"i o*at ata& a#o$o#8,

    2, ia terdapat o(di"i %edi" &%&% 'a() *er$&*&()a( e#&$a( i"i ata& )a())&a( "o"ia# ata& peer+aa( 'a()

    diti%*a(('a ada#a$ %e#e*i$i apa 'a() diperiraa( %e(&r&t ri?a'at pe('ait pe%eri"aa( i"i ata& te%&a(

    #a*orato(i&%,

    9, e+a#a %e('e*a*a( pe(deritaa( 'a() *er%a(a "ecara #i(i" ata& )a())&a( da#a% &()"i "o"ia# peer+aa(

    ata& &()"i pe(ti() #ai(('a,

    D, D&ra"i )a())&a( "e&ra()('a e(a% *a(,

    , a())&a( tida dapat ditera()a( #e*i$ *ai o#e$ )a())&a( %e(ta# #ai( 7%i"a#('a )a())&a( "o%atoor%

    di"&()"i "e"&a# )a())&a( %ood )a())&a( ece%a"a( )a())&a( tid&r ata& )a())&a( p"ioti8,

    F, e+a#a tida diti%*a( de()a( "e()a+a ata& di*&at-*&at 7"eperti pada )a())&a( *&ata( ata& *erp&ra-p&ra8,

    Kriteria Dia)(o"ti Fator "io#o)i" 'a() >e%pe()ar&$i Ko(di"i >edi"A, Ada('a "&at& o(di"i %edi" &%&% 7diodea( da#a% A"i" III8,

    , Fator p"io#o)i" 'a() %e%pe()ar&$i o(di"i %edi" &%&% de()a( "a#a$ "at& cara *eri&t

    1, Fator 'a() %e%pe()ar&$i per+a#a(a( o(di"i %edi" &%&% dit&(+&a( o#e$ $&*&()a( erat a(tara ator

    p"io#o)i" da( pere%*a()a( ata& e"a"er*a"i da( ata& eter#a%*ata( pe('e%*&$a(da( o(di"i %edi" &%&%,

    2, Fator 'a() %e())a())& pe()o*ata( o(di"i %edi" &%&%,

    3, Fator 'a() %e%*&at ri"io e"e$ata( ta%*a$a( *a)i i(di!id&,

    4, Re"po(" i"io#o)i" 'a() *er$&*&()a( de()a( "tre" %e('e*a*a( ata& %e()e"a"er*a"i )e+a#a-)e+a#a o(di"i

    %edi" &%&%,

    DIANJSIS ANDIN

    a, a())&a( So%ati"a"i

    K#i(i"i $ar&" "e#a#& %e('i()ira( o(di"i %edi" (o(-p"iiatri 'a() dapat %e(+e#a"a( )e+a#a pa"ie(,

    a())&a( %edi" ter"e*&t ada#a$ "#ero"i" %tip#e %ia"te(ia )ra!i" #&p&" erite%ato"&" "i"te%i ro(i", Se#ai( it& +&)a

    $ar&" di*edaa( dari )a())&a( depre"i *erat )a())&a( ece%a"a( 7anxietas8 )a())&a( $ipoo(dri da( "i.ore(ia

    de()a( )a())&a( ?a$a% "o%ati,

    *, =ipoo(dria"i"

    Ko(di"i %edi" (o(p"iiatri $&"&"('a )a())&a( 'a() ta%pa de()a( )e+a#a 'a() tida %&da$ didia)(o"i",

    e('ait-pe('ait ter"e*&t ada#a$ AIDS e(dori(opati %ia"te(ia )ra!i" "ero"i" %tip#e pe('ait de)e(erati pada

    "i"te% "ara #&p&" erite%ato"&" "i"te%i da( )a())&a( (eop#a"ti 'a() tida +e#a",

    c, a())&a( Ko(!er"i

    a())&a( (e&ro#o)i" 7"eperti de%e("ia pe('ait de)e(erati8 t&%or ota pe('ait )a()#ia *a"a#i" $ar&"

    23

  • 7/25/2019 tugas mandiri skenario 2 neuro

    24/26

    diperti%*a()a( "e*a)ai dia)(o"i" *a(di(),

    d, a())&a( Di"%ori T&*&$

    ada di"tor"i citra t&*&$ ter+adi pada a(ore"ia (er!o"a )a())&a( ide(tita" +e(i" e#a%i( )a())&a( depre"i

    )a())&a( epri*adia( (ar"i"ti "i.ore(ia da( )a())&a( o*"e"i-&%p"i,

    e, a())&a( N'eri

    a())&a( ('eri $ar&" di*edaa( dari )a())&a( "o%atoor% #ai( "eperti ('eri pada$ipoo(dria# ('eri pada o(!er"i,

    HJ,3,6 >e%a$a%i da( >e(+e#a"a( Tata Ha"a(a a())&a( So%atoor%

    1, Terapi ar%ao#o)i" terapi 'a() di*eria( &(t& a"&" de()a( )a())&a( "o%atoor% *er"iat "i%to%ati "e"&ai

    de()a( e#&$a( "o%ati pa"ie( da( dapat *er&pa a(a#)etia re#a"a( otot a(ta"ida, i#a dite%&a ( )e+a#a depre"i

    ta%*a$a( a(ti depre"a( *i#a dite%&a( )e+a#a a(ieta" *eria( a(ti a(ieta"

    2, "ioterapi "&porti

    3, Terapi re%edia# / ed&ati

    4, Terapi e#&ar)a

    a, a())&a( "o%ati"a"i ditata#a"a(a de()a( iata( terape&ti per+a(+ia( terat&r da( i(ter!e("i ri"i",

    *, e(ata#a"a(aa( &(t& )a())&a( o(!er"i ada#a$ "&)e"ti da( per"&a"i de()a( *er*a)ai te(i, Strate)i

    pe(ata#a"a(aa( pada $ipoo(dria"i" %e#ip&ti pe(catata( )e+a#a ti(+a&a( p"io"o"ia# da( p"ioterapi,

    c, a())&a( di"%ori t&*&$ diterapi de()a( iata( terape&ti pe(ata#a"a(aa( "tre" p"ioterapi da( pe%*eria(

    a(tidepre"a(,

    d, Terapi pada )a())&a( ('eri %e(ca&p iata( terape&ti %e(e(t&a( e%*a#i t&+&a( terapi da( pe%*eria(

    a(tidepre"a(,

    ntidepresan

    *olongan Mekanisme erja ,ontoh

    A(ti depre"a( tri"i#i >e()$a%*at re&ptae

    AJ i($i*itor" >e()$a%*at ati!ita"

    e(.i% >AJ

    $e(e#.i(e tra('#c'pro%i(e

    HJ,3,C >e%a$a%i da( >e(+e#a"a( Ko%p#ia"i a())&a( So%atoor%

    1, Ke$id&pa( 'a() *er)a(t&() pada ora() #ai(

    2, S&icide,

    HJ,3, >e%a$a%i da( >e(+e#a"a( e(ce)a$a( a())&a( So%atoor%

    24

  • 7/25/2019 tugas mandiri skenario 2 neuro

    25/26

    erta%a %ai *ero#a$ ra)a de()a( *ai da( terat&r "erta %e(+a)a po#a %aa( de()a( a"&pa( )i.i 'a() "ei%*a(), =a# i(i

    *er)&(a &(t& %e(+a)a %eta*o#i"% t&*&$, Se$i())a %e(+adi pri%a,

    Ked&a Apa*i#a )a())&a( "era()a( ce%a" aa( ra"a "ait %e('era() ataa( pada diri a(da "top #a#& #a&a( re#a"i

    de()a( cara %e()at&r a#ira( (aa" a(da,

    Keti)a Ha&a( #a$ %edica# c$ec &p 1 ta$&( 1 a#i "ecara r&ti(, De()a( $arapa( dapat %e()eta$&i o(di"i i"i'a()

    "e*e(ar('a 7%e%*&at a(da te(a()8 da( %e#a&a( #a()a$ pe(ce)a$a( +ia dite%&a( pe('ait da#a% diri,

    Se# ta# T&*&$ "a'a "e$at da( "a'a *ai-*ai "a+aG, 7ataa( pada diri a(da "etiap $ari "aat a(da *ercer%i( "etiap "aat

    da( ataa( +&)a i(da$('a $ari i(i "a'a *er"'&&r are(a t&$a( %a"i$ %e()i+i(a( "a'a %e(i%ati "etiap ar&(iaN'aG

    HJ,3,E >e%a$a%i da( >e(+e#a"a( ro)(o"i" a())&a( So%atoor%

    ro)(o"i" pada )a())&a( "o%atoor% "a()at *er!aria"i ter)a(t&() &%&r pa"ie( da( "iat )a())&a(('a 7ro(i

    ata& epi"odi8, U%&%('a )a())&a( "o%atoor% pro)(o"i"('a *ai dapatdita()a(i "ecara "e%p&r(a, Sa()at "ediit"ea#i 'a() %e()a#a%i e"ar"e*a"i dapat *er!aria"idari %i#d-"e!ere da( ro(i", e()o*ata( 'a() #e*i$ a?a# da(

    %e(+adia( pro)(o"i" %e(+adi#e*i$ *ai, Secara i(depe(de( tida %e(i()ata( ri"io e%atia(, Ke%atia( #e*i$

    di"e*a*a(are(a &pa'a *&(&$ diri,

    >e%a$a%i da( >e(+e#a"a( N'eri So%atoor%

    N'eri pada "at& ata& #e*i$ te%pat 'a() tida "epe(&$('a di"e*a*a( o#e$ o(di"i %edi" ata& (e&ro#o)i"

    (o(p"iiatri" di"ertai o#e$ pe(deritaa( e%o"io(a# da( )a())&a( &()"io(a# da( )a())&a( %e%i#ii $&*&()a( "e*a* 'a()

    %a"& aa# de()a( actor p"io#o)i",

    Kriteria Dia)(o"ti &(t& a())&a( N'eri

    1, N'eri pada "at& ata& #e*i$ te%pat a(ato%i" %er&paa( p&"at )a%*ara( #i(i" da( c&&p para$ &(t&

    %e%er#&a( per$atia( #i(i",

    2, N'eri %e('e*a*a( pe(deritaa( 'a() *er%a(a "ecara #i(i" ata& )a())&a( da#a% &()"i "o"ia# peer+aa( ata&

    &()"i pe(ti() #ai(,

    3, Fator p"io#o)i" dia())ap %e%i#ii pera(a( pe(ti() da#a% o("et e%ara$a( e"a"er*a"i ata& *erta$a((('a

    ('eri,

    4, e+a#a ata& dei"it tida diti%*a( "ecara "e()a+a ata& di*&at-*&at 7"eperti pada )a())&a( *&ata( ata& *erp&ra-

    p&ra8,

  • 7/25/2019 tugas mandiri skenario 2 neuro

    26/26

    7(an di antara tanda+tanda $e$uasaan+Nya ialah dia mencipta$an untu$mu isteri+isteri dari ,enismu

    sendiri) supaya $amu cenderung dan merasa tenteram $epadanya) dan di,adi$an+Nya diantaramu rasa$asih dan sayang& Sesungguhnya pada yang demi$ian itu benar+benar terdapat tanda+tanda bagi $aum

    yang berfi$ir&7

    Kata SakinahG, Sai(a$ %er&paa( po(da"i dari *a()&(a( r&%a$ ta())a 'a() "a()at pe(ti(), Ta(pa('a tiada

    %a?adda$ da( ?ara$%a$, Sai(a$ it& %e#ip&ti e+&+&ra( po(da"i i%a( da( ta?a epada A##a$ SWT,

    Da#a% A# Z&r[a( p&( diataa( *a$?a "&at& "aat aa( *a('a ora() 'a() "a#i() *era"i$ "a'a() di d&(ia

    tetapi di a$irat e#a %erea aa( *er%&"&$a( %e('a#a$a( da( "a#i() %e#e%par ta())&() +a?a*, Kec&a#i ora()-

    ora() 'a() *era"i$ "a'a() di#a(da"i de()a( ci(ta epada A##a$ SWT, Kata ada#a$ ma6addah, >a?adda$ it&

    *er&pa a"i$ "a'a(), Setiap %a$#& A##a$ ira('a di*eria( "iat i(i %ai dari $e?a( "a%pai %a(&"ia, Da#a%

    o(te" per(ia$a( co(to$ %a?adda$ it& *er&pa e+&ta(G "&a%i &(t& i"tri('a *e)it& p&( "e*a#i('a, >i"a#('a

    "&at& ?at& "i "&a%i *a()&( pa)i-pa)i "ea#i %e%*ere"a( r&%a$ %e('iapa( "arapa( &(t& a(a-a(a('a, Da(

    etia "i i"tri *a()&( $a# ter"e*&t %er&paa( e+&ta( 'a() #&ar *ia"a,

    Kata tera$ir ada#a$ 6arahmah, Wara$%a$ i(i $&*&()a(('a de()a( e?a+i*a(, Ke?a+i*a( "eora() "&a%i

    %e(aa$i i"tri da( a(a-a(a('a %e(didi da( %e%*eria( co(to$ 'a() *ai, Ke?a+i*a( "eora() i"tri &(t&

    %e(a[ati "&a%i('a, I(ti('a ?ara$%a$ i(i aita(('a de()a( "e)a#a e?a+i*a(,

    Prinsip yang harus dilakukan untuk menapai rasa tenteram7 kasih dan sayang dalam rumah tangga"

    Siap 'a() "a(t&( da( *i+a 7Mu8asyarah bil Ma8ruf8 %era?at ci(ta a"i$ da#a% e#&ar)a, Ra"#a$ "a?

    %e('ataa( *a$?a Sebai$+bai$ orang diantara $amu adalah orang yang paling bai$ terhadap isterinya) dana$u !asulullah" adalah orang yang paling bai$ terhadap isteri$uG,

    Sa#i() %e()i()ata( da#a% e*aia(, Di a(tara *e(t& eta?aa( "&a%i i"tri da#a% %e%pererat "erta

    %e()oo$a( r&%a$ ta())a ada#a$ de()a( "a#i() (a"e$at %e(a"e$ati &(t& %e(+a#a(a( "&((a$ Na*i,

    7Allah merahmati seorang suami yang bangun pada malam hari untu$ mela$sana$an shalat

    malam9taha,,ud" lalu dia ,uga membangun$an istrinya hingga shalat& :i$a istrinya enggan untu$ bangun dia

    perci$an air $e1a,ahnya& (an Allah merahmati seorang istri yang bangun dimalam hari untu$ mela$sana$an

    shalat malam9taha,,ud" lalu dia membangun$an suaminya hingga shalat& :i$a suaminya enggan untu$ bangun dia

    perci$an air $e 1a,ahnya\ 7=R, A$%ad Na"ai da( I*(& >a+a$ da( dera+at('a $a"a( "$o$i$8,

    He*i$ %e()&ta%aa( &(t& %e#a"a(aa( e?a+i*a( daripada %e(&(t&t $a, Da#a% %e%*a()&( r&%a$

    ta())a "&a%i da( i"tri %e%i#ii $a da( e?a+i*a( 'a() "a#i() "i(er)i "at& "a%a #ai(, U(t& %e()$adira(

    ete(tra%a( $e(da('a "etiap i(di!id& #e*i$ %e()edepa(a( e?a+i*a( daripada $a, =a# i(i aa(%e(&%*&$a( "iap "a#i() pe()ertia( da( ra"a ta())&() +a?a*, Se*a#i('a t&(t&ta( 'a() %&(c da#a%

    e$id&pa( r&%a$ ta())a dapat %e('&t api perpeca$a( dia(tara pa"a()a( "&a%i-i"tri,

    Sa#i() %e(&t&pi e&ra()a( pa"a()a(('a, Setiap "&a%i pa"ti %e%i#ii e&ra()a( *e)it& +&)a de()a( "a()

    i"tri, De()a( "a#i() %e(&t&pi e&ra()a( diri %a"i()-%a"i() $ar%o(i"a"i da#a% r&%a$ ta())a aa( ter+a)a,

    ri("ip "a#i() %e(&t&pi i(i dida"ari o#e$ S&rat A# aara$ a'at 1C \,,mere$a adalah pa$aian bagimu) dan

    $amupun adalah pa$aian bagi mere$a,,\, F&()"i paaia( ada#a$ %e(&t&p a&rat "e$i())a dapat dipa$a%i *a$?a

    "&a%i-i"tri $e(da('a "a#i() %e(&t&pi e&ra()a(('a "at& "a%a #ai(,

    Sa#i() to#o() %e(o#o(), Ita$ ata &(ci pa"a()a( "a%ara da#a% %e()e#o#a e#&ar)a, S&a%i-i"tri it& aa(

    *er*a)i pera( da( ta())&() +a?a* da#a% %e()e#o#a e#&ar)a %erea, S&a%i pe(&$ ra"a ta())&() +a?a* i"tri

    %a%p& %e(+a)a e$or%ata( diri da( pa(dai %e(e%pata( diri,