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BEN-KAK Se%ra#$ 'aki,'aki. umur && tahu# /er%/at ke(%kter (e#$a# ke'uha# erut mem/esar (a# tu#$kai /aah /e#$kak seak 1 /u'a# a#$ 'a'u3 Pemeriksaa# 4isik (i(aatka# a(a#a asites (a# e(ema a(a ke(ua tu#$kai /aah3 D%kter me#ataka# asie# me#$a'ami ke'e/iha# 5aira# tu/uh3 Pemeriksaa# 'a/%rat%rium : ka(ar r%tei# a'/umi#7 (i (a'am 'asma ( arah a#$ re#(ah 2.0 $8' #%rma' 9 ".& $8'73 kea(aa# i#i me#u#ukka# a(a#a $a#$$ua# teka#a# k%'%i( %sm%ti5 (a# teka#a# hi(r%statik (i (a'am kai'er (arah3
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LI31 emahami (a# e#e'aska# Sirku'asi Kai'er Darah LO3131 De4i#isi Kai'er Darah Kai'er (arah a(a'ah temat ertukara# /aha# a#tara (arah (a# se' ari#$a#. /er5a/a#$,5a/a#$ se5ara ekste#si4 u#tuk mem/aa (arah a$ar (aat (ia#$kau %'eh setia se'3 LO3132 Struktur (a# )u#$si Pem/u'uh Kai'er Kai'er meruaka# em/u'uh (arah /erukura# ke5i' se/a$ai era#a#$a# arteri (a# ;e#a3 Di#(i#$ se' em/u'uh i#i /ersi4at ermea/e' sehi#$$a 5aira# tu/uh (a#
(ari (arah a#$ /ere(ar (i (a'am kai'er. #amu# &> /a$ia# i#i'ah a# tere#ti#$ (ari ;%'ume (arah kare#a O2 (a# #utrie#t masuk ke 5aira# i#terstisia' (a# CO2 (a# r%(uk sisa masuk ke a'ira# (arah me'a'ui (i#(i#$ kai'er sistemik3 Pertkara# me'eati (i#(i#$ kai'er i#i e#ti#$ u#tuk kee#ti#$a# ari#$a#3
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LI32 emahami (a# e#e'aska# Asek Kimia (a# )isi%'%$is Ke'e/iha# Caira# ?u/uh LO3231 )akt%r *a#$ eme#$aruhi eta/%'isme Air Pe#$atura# keseim/a#$a# 5aira# er'u memerhatika# 2 (ua7 arameter e#ti#$. aitu: ;%'ume 5aira# ekstrase' (a# %sm%'aritas 5aira# ekstrase'3 -i#a' me#$%#tr%' ;%'ume 5aira# ekstrase' (e#$a# memertaha#ka# keseim/a#$a# $aram (a# me#$%#tr%' %sm%'aritas 5aira# ekstrase' (e#$a# memertaha#ka# keseim/a#$a# 5aira#3 -i#a' memertaha#ka# keseim/a#$a# i#i (e#$a# me#$atur ke'uara# $aram (a# air (a'am uri# sesuai ke/utuha# u#tuk me#$k%me#sasi asua# (a# kehi'a#$a# a/#%rma' (ari air (a# $aram terse/ut3 -i#a' u$a turut /erera# (a'am memertaha#ka# keseim/a#$a# asam,/asa (e#$a# me#$atur ke'uara# i%# hi(r%$e# (a# i%# /ikar/%#at (a'am uri# sesuai ke/utuha#3 Se'ai# $i#a'. a#$ turut /erera# (a'am keseim/a#$a# asam,/asa a(a'ah aru,aru (e#$a# me#$ekskresi i%# hi(r%$e# (a# CO2. (a# sistem (aar /u44er7 kimia (a'am 5aira# tu/uh3 LO3232 K%reksi eme/a/ Ke'e/iha# Air Ke'e/iha# ;%'ume EC) (aat tera(i ika Na (a# air tertaha# (e#$a# r%%rsi a#$ 'e/ih kura#$ sama seiri#$ (e#$a# terkumu'#a 5aira# is%t%#ik /er'e/iha# (i EC) hier;%'emia7 maka 5aira# aka# /eri#(ah ke k%marteme# 5aira# i#tersitia' > E(ema3 Ke'e/iha# 5aira# ;%'ume se'a'u tera(i seku#(er aki/at e#i#$kata# ka(ar Na tu/uh t%ta' a#$ aka# me#e/a/ka# tera(i#a rete#si air3 Pe#e/a/ ;%'ume EC) /er'e/iha# : 13 eka#isme e#$atura# a#$ /eru/ah 23 -a$a' a#tu#$ "3 Sir%sis hati !3 Si#(r%m #e4r%tik &3 -a$a' $i#a' -ea'a : 13 Diste#si ;e#a u$u'aris 23 Pe#i#$kata# teka#a# a#$ se#tra' "3 Pe#i#$kata# teka#a# (arah !3 De#ut #a(i e#uh / kuat &3 E(ema eri4er (a# eri%/ita 63 Asitesis @3 E4usi 'eura +3 E(ema aru akut 3 Pe#am/aha# /erat /a(a# se5ara 5eat
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LO323" Per$eraka# Caira# Per$eraka# 5aira# tu/uh hi(r%(i#amika7 me#5aku e#eraa# air (a'am usus. masuk ke em/u'uh (arah. (a# /ere(ar ke se'uruh tu/uh3 Pa(a em/u'uh (arah kai'ar. air me#$a'ami 4i'trasi ke rua#$ i#terstisium (a# se'a#ut#a masuk ke (a'am se' me'a'ui r%ses (is4usi. se/a'ik#a air (ari (a'am se' ke'uar ke m/a'i ke rua#$ i#terstisium (a# masuk ke em/u'uh (arah3 Per$eraka# air u$a me'iuti 4i'trasi (i $i#a' se/a$ia# ke5i' (i/ua#$ se/a$ai uri#7. eksresi air ke sa'ura# ser#a se/a$ai 'iur e#5er#aa# umum#a (isera kem/a'i7 serta er$eraka# air ke ku'it (a# sa'ura# #aas a#$ ke'uar se/a$ai keri#$at (a# ua air3 Per$eraka# 5aira# terse/ut /er$a#tu#$ kea(a teka#a# hi(r%statik (a# teka#a# %sm%ti53 ?eka#a# hi(r%statik : ?eka#a# hi(r%statik a(a'ah teka#a# (i (a'am em/u'uh (arah a#$ sa#$at (ite#tuka# %'eh teka#a# (arah3 ?eka#a# i#i semaki# me#uru# kea arah eri4er3 ?eka#a# %sm%ti5 : ?eka#a# %sm%ti5 ter/a$i me#a(i (ua. %sm%ti5 krista'%i( (a# %sm%ti5 k%'%i(3 ?eka#a# %sm%ti5 krista'%i( a(a'ah teka#a# a#$ (ie#$aruhi %'eh i%# (a# mi#era'3 ?eka#a# %sm%ti5 k%'%i( teka#a# %#k%tik7 a(a'ah teka#a# %sm%ti5 a#$ (ihasi'ka# %'eh m%'eku' k%'%i( a#$ ti(ak (aat /er(i4usi. misa'#a r%tei#. a#$ /ersi4at me#arik air ke (a'am kai'ar (a# me'aa# teka#a# 4i'trasi3 Peri#(aha# 5aira# (ari rua#$ i#tra;as5u'ar ke i#terstisium atau se/a'ik#a sa#$at %'eh ka(ar a'/umi# (a'am 'asma3 Pa(a kea(aa# #%rma'. a'/umi# ti(ak (aat ke'uar (ari em/u'uh (arah3 A'/umi# a(a'ah r%tei# utama (a'am 'asma +0> r%tei# 'asma7. mem/erika# +&> teka#a# %#k%tik 'asma3 Pr%tei# 'asma me#$hasi'ka# teka#a# %#k%tik sekitar 2&mm$3 E4ek %sm%ti5 a5ke( re( /'%%( 5e''s a(a'ah #%' kare#a se' (arah /era(a (a'am suse#se /uka# (i (a'am s%'uti%#. sehi#$$a ti(ak /ereaksi (e#$a# air3
LO323! E(ema Se5ara )isi%'%$is Pa(a Kai'er. =e#u'a. (a# Lim4e3 13 Permea/i'itas kai'er a#$ /ertam/ah E#(%te' kai'er meruaka# suatu mem/ra# semi e rmea/e' a#$ (aat (i'a'ui %'eh air (a# e'ektr%'it se5ara /e/as. se(a#$ka# r%tei# 'asma ha#a (aat me'a'ui#a se(ikit atau ter/atas3 ?eka#a# %sm%ti5 (arah 'e/ih /esar (ari a(a 'im4e3 Daa ermea/i'itas i#i /er$a#tu#$ kea(a su/sta#si a#$ me#$ikat se',se' 5
e#(%te' terse/ut3 Pa(a kea(aa# terte#tu. misa'#a aki/at e#$aruh t%ksi# a#$ /ekera terha(a e#(%te'. ermea/i'itas kai'er (aat /ertam/ah3 Aki/at#a ia'ah r%tei# 'asma ke'uar kai'er. sehi#$$a teka#a# %sm%ti5 k%'%i( (arah me#uru# (a# se/a'ik#a teka#a# %sm%ti5 5aira# i#terstitium /ertam/ah3 a' i#i me#$aki/atka# maki# /a#ak 5aira# a#$ me#i#$$a'ka# kai'er (a# me#im/u'ka# e(ema3 Bertam/ah#a ermea/i'itas kai'er (aat tera(i a(a k%#(isi i#4eksi /erat (a# reaksi a#a4i'aktik 23 e#i#$kat#a teka#a# ;e#a. seerti ketika (arah ter/e#(u#$ (i ;e#a. me#e/a/ka# e#i#$kata# teka#a# (arah kai'er me#$a'irka# isi#a ke (a'am ;e#a3 Pe#i#$kata# teka#a# ke'uar kai'er i#i /ereera# /esar me#e/a/ka# e(ema a(a $a$a' a#tu#$ k%#$esti43 E(ema re$i%#a' u$a (aat tera(i aki/at restriski '%5a' a'ira# /a'ik ;e#a3 C%#t%h#a a(a'ah em/e#$kaka# a#$ seri#$ tera(i (i tu#$kai (a# kaki se'ama kehami'a#3 Uterus a#$ mem/esar me#eka# ;e#a,;e#a /esar a#$ me#a'urka# (arah (ari ekstremitas /aah seaktu em/u'uh,em/u'uh terse/ut masuk ke r%#$$a a/(%me#3 Be#(u#$a# (arah (i ;e#a i#i me#i#$katka# teka#a# (arah (i kai'er tu#$kai(#a kaki. me#(%r%#$ e(ema re$i%#a' ekstremitas /aah3
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Sum/ata# em/u'uh 'im4e me#e/a/ka# e(ema kare#a ke'e/iha# 5aira# 4i'trasi tertaha# (i i#terstitium (a# ti(ak (aat (ikem/a'ika# ke (arah me'a'ui em/u'uh 'im4e3 Akumu'asi r%tei# (i 5aira# i#terstitium memerarah masa'ah me'a'ui e4ek %sm%tik#a3 Sum/ata# em/u'uh 'im4e '%5a' (aat tera(i. se/a$ai 5%#t%h (i 'e#$a# a#ita a#$ sa'ura#,sa'ura# (rai#ase 'im4e utama#a (ari 'e#$a# te'ah tersum/at aki/at e#$a#$kata# ke'e#ar 'im4e a(a em/e(aha# kare#a ka#ker au(ara3 Pe#um/ata# em/u'uh 'im4e a#$ 'e/ih 'uas tera(i a(a 4i'ariasis. suatu e#akit arasit a#$ (itu'arka# me'a'ui #amuk a#$ terutama (itemuka# (i (aerah a#tai tr%is3 Pa(a e#akit i#i. 5a5i#$ 4i'aria' a#$ ha'us miri /e#a#$ me#$i#4eksi em/u'uh 'im4e (a# me#um/at (rai#ase 'im4e3 Ba$ia# tu/uh a#$ terke#a. terutama skr%tum (a# ekstremitas. me#$a'ami e(ema /erat3 Pe#akit i#i seri#$ (i#amai e'eha#tiasis kare#a kaki a#$ mem/e#$kak seerti kaki $aah3
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LI3" emahami (a# e#e'aska# E(ema Da# Asites LO3"31 De4i#isi E(ema (a# Asites E(ema
E(ema a(a'ah suatu kea(aa# (e#$a# akumu'asi 5aira# (iari#$a# i#terstisium se5ara /er'e/iha# aki/at e#am/aha# ;%'ume a#$ me'e/ihi kaasitas e#eraa# em/u'uh 'im4e3 Pem/a$ia# e(ema me#urut '%kasi : a3 E(ema umum $e#era'isata7 : (ise/a/ka# %'eh e#uru#a# teka#a# %sm%ti5 k%'%i( a(a hi%r%tei#emia /3 E(ema '%ka' : (ise/a/ka# %'eh kerusaka# kai'ar. k%#striksi sirku'asi ;e#are$i%#a'7 atau sum/ata# (rai#ase 'im4atik3 Asites
Asites a(a'ah e#im/u#a# 5aira# se5ara a/#%rma' (ir%#$$a erut seri#$ (ikataka# e#im/u#a# asites meruaka# ta#(a r%$#%sis a#$ kura#$ /aik LO3"32 -ea'a Asites ?er(aat $ea'a a#$ khas a#$ (aat (itemuka# a(a a#am#esis (a# emeriksaa# 4isis a#$ /isa mem/e(aka# (e#$a# asti a#tara e#akit hati sta(ium 'a#ut (e#$a# ke$a#asa#3 Seka'iu# (emikia#. tia riaat a#$ me#u#uka# a(a#a e#akit hati teta e#ti#$3 Asites masih /isa Namak e'as a(a i#seksi (e#$a# a(a#a (iste#si a/(%me#. seri#$ (isertai um/i'i5us me#%#%' ke 'uar3 Deraat asites a#$ 'e/ih ri#$a# se5ara k'i#is Namak (e#$a# (itemuka##a ekak /eri#(ah3 LO3"3" )a5t%r Pe#e#tu ?era(i#a E(ema : 13 Peru/ahha# hem%(i#amik (a'am kai'er a#$ memu#$ki#ka# ke'uar#a 5aira# i#tra;asku'er ke(a'am ari#$a# i#terstisium3 em%(i#amik (a'am kai'er (ie#$aruhi : Permea/i'itas kai'er • Se'isih teka#a# hi(r%'ik (a'am kai'er (e#$a# teka#a# hi(r%'ik (a'am • •
i#terstisium Se'isih teka#a# %#k%tik (a'am 'asma (e#$a# teka#a# %#k%tik (a'am i#tersisium
23 Rete#si #atrium (a'am $i#a' 7
Die#$aruhi %'eh : Akti;itas sistem re#i# a#$i%te#si# a'(%ster%# • Akti;itas ANP atria' #atriureti5 eti(e7 • Akti;itas sara4 simatis • Osm%reset%r (ihi%ta'amus • LO3"3! Pe#e/a/ E(ema (a# Asites E(ema E(ema tera(i se/a$ai aki/at keti(akseim/a#$a# 4a5t%r,4akt%r a#$ me#$%#tr%' eri#(aha# 5aira# tu/uh. a#tara 'ai# $a#$$ua# hem%(i#amik sstem kai'er a#$ me#e/a/ka# rete#si #atrium (a# air. e#akit $i#a'. serta /eri#(ah#a air (ari i#ter;asku'ar ke i#terstitium3 Asites
Pe#e/a/ asites a#tara 'ai#. i#4eksi erit%#itis /a5teria'8 ?BC8 4u#$a'. erit%#itis terkait I=3 D''7 Perit%#itis a(a'ah era(a#$a# a#$ /iasa#a (ise/a/ka# %'eh i#4eksi a(a se'aut r%#$$a erut erit%#eum73 LO3"3& Pe#$%/ata# E(ema Da# Asites Pe#$%/ata# ke'e/iha# 5aira# tu/uh e(ema7 : • • • • •
?irah /ari#$ Diet re#(ah #atrium &00m$ 8 hari7 St%5ki#$ su%rti4 (a# e'e;asi kaki Retreksi 5aira# 1&00m' 8 hari Diureti5
Pe#$%/ata# asites : •
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k%#sumsi $aram NaC'7 erhari se/aik#a (i/atasi !0,60mEF8 hari Diuretika : a#$ (ia#urka# a(a'ah a#$ /ekera se/a$ai a#tia'(%ster%#
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ku#% Pe#$%/ata# terha(a e#akit a#$ me(asari3 8
DA)?AR PUS?AKA http://www.scribd.com/doc/76541627/Penyebab-Edema-Dapat-Die!ompoan"en#adi-Empat-$ate%ori-&m'm (
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