darah & cairan cerebrospinal

8/20/2019 DARAH & Cairan Cerebrospinal

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3/71

Hr) d!da2a$ a$tara p()*a d"$)+r*.

3 P(a)*a darah ad( !a"#a$ 'a#r dr

darah 4" td2 *$""*pa( *#) %

darah 4" !rada d(* )#)t+* 5a)2(+r / p+*!.darah 1 t!h

a6 darah #$ 5#tr0 4a$" )!(*$4a

d#!+r# a$t# 20a"(a$)#a / 4# )+$4a7a 4" *$'+"ah darah

*$""*pa( 1.


4/71

3 S+r* ad( !a"#a$ 'a#r darah

4a$" *$""*pa(.

B!rapa #)t#(ah 4" p+r(d#pa*aha*# ad( %

&. H+*at02r#t / Ht 1 )+r#$" d)!t 8Pa'2+d C+(( V0(*+9/ PCV 1

ad( pr+)+$ta)+ )+( darah.

P+$+$ta$$4a d#"$a2a$ darah

4" )!(*$4a d#!r#2a$ a$t#

20a"(a$)#a.


5/71

. La: +$dap darah / LED 1 4# %

K+'+pata$ p$"+$dapa$ )+(

darah d(* 7a2t )at :a*. P+$$ta$ LED :" d#"$a2a$

darah 4" )!(*$4a d!r#2a$ a$t#

20a"(a$)#a.


6/71

Komposisi darah

K0*p0)#)# darah →

(#hat d#a"ra* &.

K0*p0$+$ 4" (art d(* p(a)*a darah !rpa %

3 E$;#* %


7/71

a(2a(#,"(ta*at p#r5at

tra$)a*#$a)+, "(ta*at

02)a(0a)+tat,Tra$)a*#$a)+ d((. 3 NPN % N0$ pr0t+#$ $#tr0"+$

/r+a,a)a* rat, 2r+at#$, a)a*

a*#$0 1.


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3 G(20)a % 3 pr0t+#$ / a(!*#$, "(0!(#$,


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10/71

a. M2a$a$ 4" d#!a7a dr *20)a )) a6 d#a$"2t 2+ :ar. 4a$"

**+r(2a$$4a.

!. H0r*0$ dr 2+(. +$d02r#$ 2+

)+( tar"+t.

'. M+ta!0(#t 2+ a(at +2)2r+)# )prt# "#$:a(, par - (a#$$4a.


11/71

. A)p+2 p+$"atra$

3 M+$"atr pH darah a6 *$"atr 2+)+#*!a$"a$ a)a*

!a)a d(* t!h.

3 M+$"atr 2+)+#*!a$"a$ C.

t!h a$tara darah d"$ :ar.

)2#tar$4a. 3 M+$"atr )h t!h t+tap

$0r*a(, => ? =@ ⁰ C.


12/71

=. A)p+2 p+$'+"aha$

M+$'+"ah tr:d$4a p+rdaraha$

!r(!#ha$ d"$ ada$4a )#)t+*p$""*pa(a$ drah pd )aat

tr:d$4a (2a 2+'+(a2aa$.


13/71

. A)p+2 p+rtaha$a$

M*p+rtha$2a$ trhdp #$


14/71

PLASMA.

50 – 60 Vol % 8,9 %

SOLID 8,9 %

BD 1,026 VISKOSITAS 1,7 – 2

Tek. Osmo!k 25 мм"# $ P &7⁰' 7,6 ATM (

)" 7,&& – 7,51 $ *++ 7,- (

DAA" $ ++/ ole loo (

6 – 8 % * BB ++/ 66 – 78 ml 3 k# BB

BD 1,0601 V!skos!+s &,6 – 5,&

)" 7,&& – 7,51 $ *++ 7,- (

S4L DAA"

-0 -5 Vol %

TOMBOSIT 200.000 – -00.000 3 MM , D!+mee* 2,5μ

L4KOSIT 5000 – 10.000 3 MM T*!*! * A:LOSIT, LIM;OSIT, MOOSIT

4ITOSIT -.500.000 – 6.000.000 3 MM

B4B4T:K 'AKAM BIKOKA; DIAM4T4 6 9μ

BD < 1.090

SOLID < &5 %

" < &1 && %


15/71

Protein darah

T0ta( pr0t+#$ p(a)*a darah %

@ ? @, d"$ ra)#0 a(!*#$ %

"(0!(#$ &, % &,.


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P+*#)aha$ pr0t, d#(a22a$ d"$'ara %

&. 8 Sa(t#$" 0t 8

D"$ **!+r#2a$ (ar. "ara* a6

+(+2tr0(#t d"$ 2adar 4" !+r5ar#a)#.

. E(+2tr0


17/71

trt$t *#) % +(+2tr0


18/71

. Fra2)#$a)#

d"$ *(a22a$ pr+)#p#ta)# d#


19/71

Sumber prot.

Plasma S*!+r pr0t. p(a)*a ad( %

&. Hat# Mrpa2a$ )*!+r

a(!*#$,pr0t0*!#$,


20/71

Mrupakan sumber albumin,

protombin, fibrinogen, globulin alfa,

globulin beta. 2. Sel plasma & jar. limfoid mrupa-→

kan sumber gamma globulin.

Fungsi umum

prot. Darah1. Prot. Darah mrupakan “osmoti subs !

tane"

Shingga mmegang pran sbagai peng-

atur distribusi airan di antara -


21/71

#ntra$askuler dgn jar. sekitarn%a.

Peran ini trutama diperlihatkan oleh

albumin darah.2. Sebagai sen%aa proteinat %g turut

sistem dapar darah, dgn dmikian ikut

serta dlm mmperthankan keseim !

bangan asam basa tubuh.

'. Mmpun%ai peran dlm sistem imuno !

globin, %g diperlihatkan o( gamma

globulin.

). Sbagai alat transpor *at trtntu didlm !


22/71

darah. Mis + P retinol binding

protein /. Mntransport $it 0, tranferin

mngangkut besi, seruloplasmin mngangkut tembaga.

ELEKTROFORETROGR! PLS!

"R#


23/71

ila kita mlakukan elektroforesis mis +

elektroforesis krtas saring trhdp

plasma drh, maka didptkan gmbaran

elektroforesis elektroforetogram /

sbb + gbr 1.

%kn%a masing fraksi prot. Darah sbgai

hasil elektroforesis trntum dlm tabel1.


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POT4I DAA" % POT. TOTAL

ALBUMIN 52 – 65

GLOBULIN 29.5 – 41.0

ALFA₁ 2.5 – 5 %

ALFA₂ 7 – 13 %

BETA 8 – 14 %

GAMMA 12 – 22 %

FIBRINOGEN 6.5

Tabel $ % K&'T(TS#S(L

ELEKTROFORES(S


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ALBUMIN

umlahn%a pling besar diantara sluruh

prot. darah, sb%ak 32 ! 435 prot. total plasma darah.

Disintesis di hati, M 6 47.888,struktur

primern%a trdr dr 418 as.amino.


26/71

9rn jmlhn%a pling b%k & bsar

molekuln%a %g plng kil, muka

albumin trglong“osmoti substane":3 ! ;85 efek osmotik plasma/ %g

ikut mngatur distribusi airan tbuh

ingat hipotesa starling.


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brapa 'a#ra$ 4" !+r)#


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K0*p0)#)# dr 'a#ra$ t)!, tr'a$t*

d(* ta!+( .

K#ra a(!. !rada d(* )#r2(a)#.)(!#h$4a !rada +2)tra5a)2(+r d# :ar.

trta*a 0tat, 2(#t - #$t+)t#$*. L!h

2ra$" a(!*#$ *+$#$""a(2a$ drh

)t#ap :a* - d#2+*!a(#2a$ 2+ d(*

(#*


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d#a$tara$4a %

3 A). (+*a2 !+!a) tr#2at 2at 06 a(!*#$

- d#a$"2t dr hat# 2+ :ar. p+r#


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Globulin

S"t 20*p(+2), trdpt )!a"a# *0(+2( *20pr0t+#$, "(#20pr0t+#$,

(#p0pr0t+#$,"a**a "(0!(#$ d)!.

Retinal binding

rotein

Ad( #2. "(0!(#$ a(


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Trans*ortin Ad( #2ata$ "(0!(#$ a(


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Hapt0"(0!#$ trdpt = 5ar#a$ 4# t#p+ &3&,

t#p+ 3& - t#p+ 3.

Trans+erin Ad( #2. "(0!(#$ !+ta d"$ !+)#, !t2

!+)# 4" d#a$"2t d(* darah.

*. Rea,ti-e

Protein Mrpa2a$ "(0!(#$ ? !+ta 4" !+(*

d#2+tah#


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!u,oprotein

Gli,oprotein

K+da$4a *rpa2a$ "a!$"a$ pr0t. d"$ h#drat ara$". K0*p0$+$ pr0t.$4a

ad( "(0!(#$ ? a(


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B#(a 2a$d$"a$ h+2)0)a*#$$4a )a*a

a6 2ra$" dr , tr*)2 "(#20pr0t+#$

ttap# a2h#r #$# 2+da$4a d#$a*a2a$

)!"a# GLIKOSAMINOGLIKAN.

Lipoprotein Mrpa2a$ "a!$"a$ pr0t. d"$ (#p#d,

= pr0t.$4a ad( "(0!(#$ ? a(


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&. HDL /8H#"h D+$)#t4 L#p0pr0t+#$91

. LDL /8L07 D+$)#t4 L#p0pr0t+#$91

=. VLDL /8V+r4 L07 D+$)#t4

L#p0pr0t+#$91.

L#p0pr0t+#$ *rpa2a$ p$"+*!a$

(*a2 'arr#+r d(* darah.


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K0*p0)#)# *a)#$"


39/71

(+*a2. LDL *+$#$"2at d"$ *+$#$"2at3

$4a *r ))+0ra$" !a#2 pd 1 *ap$

2. Kadar (#p0pr0t+#$ darah d#p+rtaha$

2a$ / d#atr 1 06 hat#.

Globulin 3 gamma B+rh! +rat d"$


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&. I**$0"(0!(#$ G / I" G 1, BM %

&.

. I**$0"(0!(#$ A / I" A 1, MM %

&>. - .

=. I**$0"(0!(#$ M / I" M 1, BM % .

. I**$0"(0!(#$ D / I" D, BM.

&. 1. . I**$0"(0!(#$ E / I" E 1 % BM.

&..


41/71

Ha$4a I" G 4" d#tra$)


42/71

Fibrinogen Ad( pra;at dr dr pr0t. t0ta( p(a)*adarah - d#!$t2 d#hat#.

P l d h


43/71

Proses pnggumpalan darah M$rt H07+((,p$""*p(a$ drh !r(")

$" *(a(# = tahap r % &. P*!+$t2a$ tr0*!0p(a)t#$.

Tr0*!0p(a)t#$ !2$ ha$4a

*rpa2a$ )$4a7a t$""a(, ttp# (!h dr )at )+$4a7a 4" **p$4a#

a2t#5#ta) )rpa, 4# *$"2ata(#)#) r

tahap .

. Pr!aha$ pr0tr0*!#$ tr0*!#$→


44/71

d#hat#, p*!+$t2a$ pr0t0*!#$

**+r(2a$ 5#t K.

Pr!aha$ pr0tr0*!#$ tr0*!#$,→

pr( #0$ Ca)4 tr0*!#$ 4" tr!$t2

!r)#


45/71

F#!r#$ !rpa a$4a*a$ 4"

*$tp# (2a, )h#$""a darah t#da2 3

*$"a(#r (".S!+$ar$4a


46/71

;AKTO AMA LAI=A

I FIBRINOGEN

II PROTROMBIN

III TROMBOPLASTIN

IV C!!

V F"#$ &'(&) P$&*+&+(,) G&$'-&(, "*+&+#$

VI

VII P$"$/+#(,) S+-/ P$#$/'(, C$,+*($, A+&+#$SPCA) $ – #$/'$&*#(,) A-#$ $#$/'(,

VIII FA. ANTI EMOFILI)AG ANTI EMOFILI GLOBULIN

I P&*/ T$/'$&*#(, C$/$,+,# PTC ) F"#$ C(*#/*

FATOR STUART PRO:ER

I PLASMA TROMBOSIT ANTECE;ENT PTA

II FATOR AGEMAN

III FATOR LAI LORAN;


47/71

A"ti#itas tromboplastin S+$4a7a !+r)#


48/71

8 Fa2t. Tr0*!0p(a)t#2 a6 Tr0*!0 ?

p(a)t#$0"+$a)+ 8.

=. JARINGAN Ad( )*!+r tr0*!0p(a)t#$ +2)tra ?

5a)2(+r.

Fa"$or% &g bersi'at (A. M*p+r'+pat P$""*pa(a$ Darah

&. At02ata(#)at0r Tr0*!#$

. Va)020$)tr#2)# 06 % a. R+


49/71

!. P+$+2a$a$ *a))a "*pa(a$

d#da+rah (2a.

'. P(+pa)a$ )+r0t0$#$ 4" !r)#


50/71

. D#2*ar0( 4# )+$4a7a !r)#


51/71

)istem *brinolitis


52/71

)istem *brinolitis Ad( )#)t#* 4" *$"ha$'r2a$


53/71

D#a"ra* = % SISTEM FIBRINOLISIS

)i t d


54/71

)istem dapar S#)t+* dapar d#:*pa# d(* +r#tr0)#t -

p(a)*a darah. M$"apa pr0t. !r)#


55/71

!.CO+,

N!.CO+

N!₂PO-, N%!.PO-

!. PROT.,

N!. PROT.,

!.CO+,

!.CO+,

!.₂PO-, %! PO-

!' !.'O₂,

!' !.'O₂,

"ara*$4a ad( "ara* $atr#*.

S(rh )#)t+* dapar +r0tr0)#t *ap$

p(a)*a trdpt pada ta!+( .


56/71

andungan protein plasma patologi" Pat0(0"#2 *$"arah 2+ h#p0 a6 h#p+r

pr0t+#$+*#a. albumin

&. HIPERALBUMINEMIA

Jara$" tr:d, 2'a(# !#(a tr:d h+*020$3 )+$tra)#.

. HIPOALBUMINEMIA

D#:*pa# pd %


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A. K+2ra$"a$ "#;# 4" (a*a d# )+!a!

2a$ 06 % 3 I$ta2+ pr0t+#$ 2ra$".

3 Ga$""a$ p$'+r$aa$ pr0t+#$.

B. Kh#(a$"a$ pr0t+#$ 4" !r(!#ha$ pd %

3 S#$dr. $+


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D. Id#0pat#2 h#p0pr0t+#$+*#a % Pr0t. L!h 'pat d#p+'ah - )+!a!

4" pa)t# td2 d#2+tah#.

globulin HIPERALFAGLOBULINEMIA %

D#2+tah# d"$ d+*a* a2t, d+)tr2)#

:ar, p+rada$"a$ )p+rt# 4" d#:*pa#

pd TBC (a$:t a6 2ar)#$0*a (a$:t.


59/71

/airan 0erebrospinal Pr0d2 (tra


60/71

C. '+r+!r0)p#$a( % 3 J+r$#h

3 V#)20)#ta) r+$dah

3 Td2 !+r7ar$a

Kadar pr0t+#$$4a r+$dah % & ? *"

, dr pr0t. tr)!t !rpa a(!*#$ -

!rpa "(0!(#$. Td2 d#dapat2a$


61/71

d"$ darah, !"#t p(a 2adar C(.

T+tap# 2adar p(a)*a :a5a )d#2#t d# ? !a$d#$"2a$ p(a)*a darah.→

Kadar !#2ar!0$at d"$ p(a)*a darah.

pH :" td2 !r!+da d"$ pH darah.

5airan sino-ial Ad( '. p+r)+$d#a$, !r


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at 0r"a$#2 !rpa %

3 Pr0t+#$, tr*a)2 +$;#*

→ a*#(a)+, pr0t+a)+, (#pa)+, *)#$.

3 KH "(20)a.→

3 )+$4a7a 0r"a$#2 (a#$ !rpa %

→

r+a, a). Urat, a). h#a(r0$at.

5airan ruang depan bla,angmata

C. d#d+pa$ *ata !rpa '. :+r$#h, !+r3 p+ra$ **p+rtha$2a$ t+2. #$tra02(+r -


63/71

*+$)p(a# *2a$a$ 6 (+$)a - 20r$+a

*ata d#*a$a !a"#a$ *ata #$# t#da2

*+*p. S#r2(a)# t+r)+$d#r#.

Ca#ra$ !ra)a( dr )+2r+t !ada$ )#(#+r d# ?

#r#) *ata, 4" *+$"a(#r 2+ !a"#a$ ? a$t+r#0r *+(a(# 2a$a( )'h(+h*.

Prta*!aha$ pr0d. 'a#ra$ *$4+!a!2a$

t+2. #$tra02(+r *$a#2 - d#:*pa# pd

"(a20*a.


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Semen

Y# % ))p+$)# )p+r$at0;0a p(a)*a

)+r#$" *rpa2a$ '*pra$ )+2r+t

pr0)tat, 5+)#'+ )+*#$a(#), +p#d#d#*#),

2+(. r+tra, 2+( '07p+r - 5a)a d+


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)#trat *" +.


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H/N ? / CH/ 16 ? NH ? / CH/ 17 NH/

SPERMIDIN

5airan

(nterstisiel

Mrpa2a$ )at (tra


67/71

r+a - "(2. )a*a d"$ 2a$d$"a$

p(a)*a darah, 2a$d. #0$ $+"at#< )prt# C(84 HCO68 )d#2#t t#$""# - #0$ p0)#t#


68/71

J*(h - 20*p0)#)# !r5ar#a)# tr"$t$"

(02a)# )a(. t)!t, *#) % )a(. (#* = % & )*pa# % &.


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Keringat

Mrpa2a$ )+2r+t 2+(. +$d02r#$ 2r#$"at - !r)#


70/71

ir mata

Mrpa2a$ )+2r+t 2+(. (a2r#*a(, !rpa

'. :+r$#h. Pd *(a$4a !r)#


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darah & cairan cerebrospinal

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