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A. Sore throat Definisi menurut dorland: sakit tenggorokan berat yang terjadi dalam epidemi, biasanya disebabkan oleh Streptococcus pyogenes, dengan hiperemia lokal yang hebat dengan atau tanpa eksudat keabu abuan dan pembesaran kelenjar limfe leher. Menurut emedicinehealth: sorethroat dinamakan sesuai anatomical site-nya, bisa: pharyngitis, laryngitis, tonsillitis, atau epiglottitis. B. Painful swallowing It means, ada rasa sakit ketika menelan. Bisa disebabkan oleh banyak hal: - Infection 1. Cytomegalovirus 2. Gum disease (gingivitis) 3. Herpes simplex virus 4. Human immunodeficiency virus (HIV) 5. Pharyngitis (sore throat usually due to infection) 6. Thrush (a fungal infection caused by Candida) 7. Tooth infection or abscess - Mouth or throat ulcers - Inflammation of the esophagus - Something stuck in the throat (for example, fish or chicken bones) - Problems with the esophagus (listed below) may cause difficulty swallowing: 1. Achalasia: kegagalan relaksasi serat otot polos saluran cerna pada persimpangan bagian yang satu dengan bagian lain, khususnya kegagalan sfingter esofagogaster untuk mengendur pada waktu menelan, akibat degenerasi sel sel ganglion pada dinding organ itu. 2. Esophageal spasms 3. Gastroesophageal reflux disease 4. Nutcracker esophagus C. Snore whilesleeping at night Defini: - Dorland: 1) pernapasan yang kasar dan ramai selama tidur, disebabkan oleh vibrasi uvula dan palatum mole. 2) menghasilkan suara selama tidur. - Dari medlineplus: loud, hoarse, or harsh breathing sound that occurs during sleep. Terkadang snore bisa menjadi sign dari sleep disorder yang bernama sleep apnea, yang artinya ketika tidur kita mengalami completely atau partly stop breathing lebih dari 10 detik. Gejala ini diikuti oleh snort atau gasp ketika nafasnya bersambung kembali. Kemudian, snore kembali. Bagi orang orang yang memiliki sleep apnea Causes: In most people, the reason for snoring is not known. Some potential causes (other than sleep apnea) include:

Being overweight, which leads to excessive neck tissue that puts pressure on the airways Last month of pregnancy Nasal congestion from colds or allergies, especially if it lasts a long time Swelling of the muscular part of the roof of the mouth (soft palate) or uvula, the piece of tissue that hangs down in the back of the mouth Swollen adenoids and tonsils that block the airways Use of sleeping pills, antihistamines, or alcohol at bedtime Prominence of the area at the base of the tongue Large tongue size compared to the mouth Abnormalities in the bones of the face

D. Nose breathing problem Beberapa hal yang dapat menyebabkan kita susah bernafas lewat hidung: Congestion Congestion is a common problem that causes difficulty breathing through the nose. Congestion is caused when the mucus membranes that line the nasal passages become inflamed and produce excess mucus. People often describe congestion as a "stuffy" nose. Congestion can be caused by infection, such as the common cold, or by an allergic reaction. There are over-the-counter medications called decongestants that can be used to help relieve nasal congestion. Deviated Septum The septum is the wall that separates the two sides of the nose. The septum is seen as the skin that separates the nostrils, and it travels up the length of the nose to the sinus cavities. The septum should divide the two sides equally. When a person has a deviated septum, the septum instead leans or curves to one side, which can cover or obstruct the opening at the top of the nasal cavities on that side. This can make it difficult to breathe through the nose on the affected side. A deviated septum is corrected with a surgery called a septoplasty. Polyps Nasal polyps are noncancerous growths inside the nasal cavity. They are shaped like a partially inflated balloon or a teardrop. Nasal polyps can develop from a lengthy infection or irritation. They can also occur without provocation in a person genetically predisposed to developing polyps. Some nasal polyps are small and don't create problems, but others can become large enough to block the nasal cavity, making it difficult to breathe. In some cases, a nasal steroid spray can be used to reduce the size of the nasal polyps. Other people may require surgery to have the polyps removed. Foreign Objects A foreign object in the nose can cause nose breathing problems. This situation is more common in children than adults, although adults can accidentally inhale a small insect or through the nose. Adults can also lodge food in the nasal cavity from the back of the mouth by coughing or sneezing while eating. If the object is visible up the nostril, a person can try to take it out with a pair of tweezers. If it is not visible or is firmly lodged in the nose, a visit to the doctor may be required for removal. Infection The skin and hairs around the opening of the nostrils is delicate and prone to irritation from a runny nose or from rubbing or blowing the nose often. This can sometimes result in an

infection of the skin or hair follicles just inside the nostril. These types of infections are called nasal vestibulitis. The inflammation caused by the infection can make it more difficult to breathe through the nose. In more serious infections, a hair follicle can develop into a boil, blocking the nostril completely. Most infections can be successfully treated with an antibiotic ointment, but excessive swelling or boils may require further medical attention. E. Refference value of vital sign for pediatric

F. Adenoid

Definisi: Dorland: 1) Mirip kelenjar. 2) hipertropi jaringan adenoid (tonsila faring), biasanya yang terdapat pada nasofaring anak.

Internet: 1. Pharyngeal tonsil. 2. Pertaining to a pharyngeal tonsil. 3. Resembling a gland. 4. Hypertrophy of the pharyngeal tonsils, usually seen in children. 5. Tonsil-like glands located at the back of the nose. Enlarged adenoid Definisi: enlarged adenoids is swelling of the lymph tissue found in the airway between your nose and the back of your throat. The tissue is similar to the tonsils. Cause of adenoid enlargement: 1. Enlarged adenoids may be a natural occurrence, beginning when the baby grows in the womb. 2. Long-term inflammation can also lead to englarged adenoids. 3. The adenoids normally shrink as a child grows older. Symptom of enlarged adenoid: 1. Nasal congestion 2. Mouth breathing 3. Difficulty breathing through the nose 4. Breathing through the mouth 5. Talking as if the nostrils are pinched 6. Noisy breathing 7. Snoring 8. Stopped breathing for a few seconds during sleep (sleepapnea) 9. Frequent "sinus" symptoms 10. Ongoing ear middle ear infections or middle ear fluid in a school-aged child

G. Blood value of pediatric