Batuk = Cough

Batuk = CoughHP, FKUWKS, 2012

1

FAAL :

Inspirasi ekspirasi :CoughSubstances

Iritans

Destruktive Cairann XEkspulsif (2.5 L ) Inflate / Ekspansi Chest wall

1.Rec. batuk : Rec: pada trakeo bronkial treeBatuk : merupakan mekanisme reflek / proteksi thd bahan yang masuk ( cairan ), iritan , atau bahan destruktif. Merupakan defense mekanisme awal/ primer.Fisiologi : bahan iritans / lainnya : menyebabkan rec. pada dinding trakeobronchial vagus pusat batuk ( medularry) eff(motor) penutupan epiglotis Kontraksi otot abdominal dan otot interkostalis. ( dengan vol udara +- 2.5L di ekspansi dan dikeluarkan ) Rapid opening dari epiglotis. Buku mattson porth, http://www.health.harvard.edu/newsletters/Harvard_Mens_Health_Watch/2010/September/that-nagging-cough

3Others receptor 2. Bahan iritan : Epitel bronkus : Bronkokonstriksi

3. Tekanan Inspirasi : otot polos: Herring Brauer Rflx

4. Congestif : capillary Alveoli/ Juxta capillary Rec. Sensasi tenggelamPathophysiology: concepts altered health state: carol mattson porth5. Chemo Rec Central : Medulla (LCS ) H+ Perifer : A carotis ( pO2 < 60 mmhg) hiperkapnea peningkatan RR:

http://www.google.co.id/imgres?q=respiratory+rate&um=1&hl=id&biw=1182&bih=696&tbm=isch&tbnid=Tz8wo1WCCXwiYM:&imgrefurl=http://bestpractice.bmj.com/best-practice/monograph/1098/diagnosis/step-by-step.html&docid=kTXO0LgypphATM&imgurl=http://eso-cdn.bestpractice.bmj.com/best-practice/images/bp/en-gb/1098-2-iline_default.gif&w=350&h=152&ei=jYSDT5HlDovzrQfqyIDhBg&zoom=1&iact=hc&vpx=770&vpy=4&dur=4266&hovh=121&hovw=280&tx=141&ty=95&sig=113880569944229015181&page=5&tbnh=96&tbnw=221&start=76&ndsp=22&ved=1t:429,r:9,s:76,i:2545

Laringo trakeo bronkitisCroup syndromeBarking CoughHoarsenessStridor Inspiration

Barking cough : masalah epiglotis menebal, Hoarsness: / parau : krn Vocal cord penuh cairan, Stridor Inspirasi: jalan nafas laring terisi cairan. http://stefanwirawan1.hubpages.com/hub/Medical-symptom-checker-Barking-cough-Overview6BatukAkut

KronikLebih dari 3-8 mingguBronkitis kronikBronkiectasisEmfisemaAsthmaPneumoni GERDACE-inhibitor ( pril)Infeksi TBC, mycoplasmaMasalah2 JantungStressKanker ParuRhinitisFaringitisCroup

Bronkitis akutBronkiolitis

Pneumoni akutGERD: Gastroesofagial reflux disease: Adanya sakit maag , yng menyebabkan esofagus 1/3 distal terangsang asam. Meyebabkan reflek saraf vagus dgn gejala batuk7BatukAsthma, CHF, GERD( anak ) : Croup

Stress ( batuk hilang saat tidur) Bronkitis Kronis. BronkiectasisPagi hariMalam hariSeasonal AllergiBatukDahakKeringputihKuningHijauCoklatAbu2MerahAllergiBakteriPneumoniDarahPolusiDarahSinusitisFaringitisTrakeitisCorup ( ?)ACE inhibitorPneumonia intersitial

BronkusBronkioliAlveoli ( pneumoni )http://www.nativeremedies.com/ailment/coughing-mucus-phlegm-and-sputum.htmlhttp://www.healthhype.com/dry-cough-causes-of-a-persistent-constant-non-productive-cough.html9Batuk = Barking Hoarsness Stridor inspirasi Epiglotis Vocal Cords Laring

DDSnorringGurgling

BatukSesak/ DyspneuBerapa Lama ? < 3mgg

Kering / dahak ? ( warna )

Pagi/ malam

Batuknya spt apa ( lokasi )

Nyeri dada/ Chest pain11Dyspneu(breatlessness,shortness of breath)Primary Lung diseaseHeart diseaseNeuromuscular disorderEmphisemaAsthmapneumoniaPulmonary congestionMystenia gravisMuscular dystrophy4 mekanisme sesakStimulasi dari Lung Rec.Transformasi informasi dari Rec ke otakBerkurangnya cadangan ventilasiStimulasi dari otot dan tension yg mempengaruhi TVDyspneu: persepsi seseorang krn kesulitan bernapas12Chest PainNon spesific chest painPleuritic Pain : breathing

Bronkitis Bronkiolitis Pneumonia kanker paru Pneumothorax Pleural effusion Pulmonary emboli

Productive CoughBronchus Bronchitis Bronchiolitis Bronchiectasis Asthma bronchial Lung CaAlveoli Pneumonia Lung Ca

bronchitis

Acut - ChronicAwal : ISPA berlanjut, bahan iritanBronkitis akut : demam, batk dahak kuningBronkitis chronis: + 15Bronchitis is a condition which is clinically defined as a chronic cough with mucus production most months of the year. The mucus secretions and inflammation in the bronchi tend to narrow the airways and provide an obstacle to airflow, thus increasing the resistance of the airways. In this manner bronchitis may cause obstructive pulmonary symptoms.Radiographic AppearanceChronic bronchitis cannot be diagnosed radiologically. Although findings such as increased lung markings or tubular opacities, bronchial wall cuffing (thickening) can be seen with bronchitis, they are nonspecific.The main reason for getting a chest X-ray is to exclude other conditions, such as bronchiectasis, which can mimic the disease clinically.Bronchiectasis

Et: TBC, Immunocompromise ISPA, RA, Aspirasi pneumoni

http://en.wikipedia.org/wiki/Bronchiectasishttp://www.learningradiology.com/archives03/COW%20058-Cystic%20fibrosis/cysticfibrosiscorrect.htm17

Cystic fibrosis

Gen cacat , pengaturan H20 dan garam pada proses pembuanganAsthma bronchial

Hiperreaktifitas bronchus Makrofag mediator lepas Neutrofil Histamin, bradikinin dan LT Eosinofil kebocoran vaskuler Limfosit T ( CD4) Limfosit BPGBradikinin HistaminBronko konstriksiTeori Steroid dan NE menurun pada malam hari :Pneumonia

Gejala frekuensi pneumonia[12]GejalaFrekuensiBatuk79-91%Kelelahan90%Demam71-75%Sesak napas67-75%Dahak60-65%Nyeri dada39-49%PneumoniaPneumonia lobarisBroncho pneumoniPneumonia interstitialis/bronchiolitis

Komplikasi

EmfisemaAteletaksisPleural effusionpleuritisAlogoritmeBatukAkut/ ChronikRinganBerat Malam hari/pagi hari Non produktive - ProduktiveKuningHijauDarahKentel- lengket sesakMengiAsthma BronkialAsthma CardialeCroupBukan mengiRPD AllergiRiwayat : CHFAtau gejala Right-LeftAnak2, Tanda Croup syndrMuscular problemNerve ?Parenkim- PleuraChest pain Non spesific Chest pain

ParuDDTerima kasihBronkitis akutBronkitis kronikBronkiolitisBronchiectasisPneumonia/ Broncho pneumoniaPneumonia TBCPleuritisMasalah jantungMasalah obat ACE inhibitorTumor paruStressPost nasal drip : Rhinitis, Sinusitis, faringitis

Hasil fotoEmfisemaAteletaksisCTR > 50Hasil lab :Anemia Kronis