cederakepala
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![Page 1: cederakepala](https://reader035.fdocuments.us/reader035/viewer/2022062618/54e069ac4a7959846d8b4745/html5/thumbnails/1.jpg)
Cedera Kepala
![Page 2: cederakepala](https://reader035.fdocuments.us/reader035/viewer/2022062618/54e069ac4a7959846d8b4745/html5/thumbnails/2.jpg)
Anatomi
Calvaria
Basis Cranii
![Page 3: cederakepala](https://reader035.fdocuments.us/reader035/viewer/2022062618/54e069ac4a7959846d8b4745/html5/thumbnails/3.jpg)
Anatomi
Brain StemPons Cerebellum
Mes.
MO
Cerebrum
![Page 4: cederakepala](https://reader035.fdocuments.us/reader035/viewer/2022062618/54e069ac4a7959846d8b4745/html5/thumbnails/4.jpg)
TIK : tekanan intra kranial ditentukan :
• Volume Otak• Volume LCS• Volume Vaskular
Monro Kelly : TIK V otak+V LCS + V Vask. ( + Massa !)
Fisiologi
![Page 5: cederakepala](https://reader035.fdocuments.us/reader035/viewer/2022062618/54e069ac4a7959846d8b4745/html5/thumbnails/5.jpg)
CPP = MAP - TIK
TIK
MAP
CPP=Cerbral Perfusion PressueMAP= 1 sistolik + 2 diastolik 3
Fisiologi
![Page 6: cederakepala](https://reader035.fdocuments.us/reader035/viewer/2022062618/54e069ac4a7959846d8b4745/html5/thumbnails/6.jpg)
Cedera kepala :
1. Menurut beratnya :• Ringan GCS 14-15 • Sedang GCS 9-13 • Berat GCS 8 atau <
2. Morfologis :• Fraktur• Cedera fokal• Cedera difus
![Page 7: cederakepala](https://reader035.fdocuments.us/reader035/viewer/2022062618/54e069ac4a7959846d8b4745/html5/thumbnails/7.jpg)
Cedera kepala :
Primer : akibat trauma
Sekunder , akibat :• Hipoksia• Hiperkarbia• Hipovolemia
![Page 8: cederakepala](https://reader035.fdocuments.us/reader035/viewer/2022062618/54e069ac4a7959846d8b4745/html5/thumbnails/8.jpg)
Mengapa penderita tidak boleh hipoksia ?
Hipoksia
Metabolisme anerobik
Perubahan dd. Sel otak
Edema sel otak
Edema serebri
Monro Kelly :
TIK V otak+V LCS + V Vask.
CPP = MAP - TIK
![Page 9: cederakepala](https://reader035.fdocuments.us/reader035/viewer/2022062618/54e069ac4a7959846d8b4745/html5/thumbnails/9.jpg)
Mengapa penderita tidak boleh hiperkarbia ?
Hiperkarbia
Vasodilatasi
Monro Kelly :
TIK V Vask. + V LCS + V otak
CPP = MAP - TIK
![Page 10: cederakepala](https://reader035.fdocuments.us/reader035/viewer/2022062618/54e069ac4a7959846d8b4745/html5/thumbnails/10.jpg)
Mengapa penderita tidak boleh hipovolemia ?
Hipovolemia CPP = MAP - TIK
![Page 11: cederakepala](https://reader035.fdocuments.us/reader035/viewer/2022062618/54e069ac4a7959846d8b4745/html5/thumbnails/11.jpg)
Ada autoregulasi, tetapi
sering terganggu pada
cedera kepala
![Page 12: cederakepala](https://reader035.fdocuments.us/reader035/viewer/2022062618/54e069ac4a7959846d8b4745/html5/thumbnails/12.jpg)
AB C
Karena itu :
agresif !
![Page 13: cederakepala](https://reader035.fdocuments.us/reader035/viewer/2022062618/54e069ac4a7959846d8b4745/html5/thumbnails/13.jpg)
Cedera Kepala Berat :
Airway : definitifBreathing : oksigenasi k.p. ventilasiCirculation : atasi syokDisability : re-evaluasi
Sat O2 >95%pCO2 25-35
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Konsul Bedah Syaraf saatcedera kepala dikenali !
![Page 15: cederakepala](https://reader035.fdocuments.us/reader035/viewer/2022062618/54e069ac4a7959846d8b4745/html5/thumbnails/15.jpg)
Terima Kasih