KATA PENGANTAR

Puji dan syukur penulis panjatkan kepada Tuhan Yang Maha Esa karena berkat rahmat
dan karunia-Nya, penulis telah mendapatkan kesempatan sehingga referat yang berjudul
“Asma” ini dapat diselesaikan tepat pada waktunya.
Penulis mengucapkan terimakasih kepada:
1. Direktur RSUD RAA Soewondo Pati yang telah memberikan kesempatan penulis
untuk mengikuti kegiatan kepaniteraan dan mempelajari ilmu kesehatan anak di
RSUD RAA Soewondo Pati.
2. dr. Isfandiyar Fahmi, Msi, Med. Sp.A, selaku ketua SMF Ilmu kesehatan anak di
RSUD RAA Soewondo Pati.
3. dr. Hesti Kartika Sari, Sp.A, selaku pembimbing Kepaniteraan Ilmu kesehatan
anak di RSUD RAA Soewondo Pati.
4. dr. Suranti, Sp.A, selaku pembimbing Kepaniteraan Ilmu kesehatan anak di RSUD
RAA Soewondo Pati.
5. Seluruh dokter dan staf RSUD RAA Soewondo Pati yang telah membantu penulis
selama kepaniteraan di di RSUD RAA Soewondo Pati.
6. Semua pihak yang telah membantu dalam proses penyusunan referat ini.
Penulis menyadari masih terdapat banyak kekurangan dalam referat ini. Oleh karena
itu, penulis mengharapkan kritik dan saran yang membangun agar dapat memperbaiki
kekurangan tersebut. Referat ini juga disusun dengan tujuan untuk meningkatkan ilmu
pengetahuan bagi penulis serta pembaca agar bermanfaat bagi masyarakat.

Pati, Mei 2017

Penulis

UNIVERSITAS TARUMANAGARA i
 DAFTAR ISI

KATA PENGANTAR ......................................................................................................... i

DAFTAR ISI ........................................................................................................................ ii

DAFTAR GAMBAR ........................................................................................................... iv

DAFTAR TABEL ............................................................................................................... v
BAB 1. PENDAHULUAN .................................................................................................. 1
1.1 Latar Belakang ................................................................................................................ 1

BAB 2. TINJAUAN PUSTAKA ........................................................................................ 2

2.1 Anatomi sistem respirasi .................................................................................................. 2

2.1.1 Hidung ........................................................................................................................... 2

2.1.2 Faring ............................................................................................................................ 3

2.1.3 Laring ............................................................................................................................ 4

2.1.4 Trakea dan bronkus ........................................................................................................ 4

2.1.5 Alveolus ......................................................................................................................... 6

2.2 Fisiologi sistem respirasi .................................................................................................... 6

2.2.1 Mekanisme ventilasi pulmonal ........................................................................................ 6

2.2.2 Ventilasi alveolar ............................................................................................................. 9

2.3 Asma ................................................................................................................................. 10

2.3.1 Definisi asma.................................................................................................................. 10

2.3.2 Epidemiologi asma......................................................................................................... 10

2.3.3 Faktor resiko asma.......................................................................................................... 11

2.3.4 Patofisiologi asma........................................................................................................... 15

2.3.4.1 Mekanisme airway remodeling .................................................................................. 16

2.3.5 Klasifikasi asma.............................................................................................................. 18

2.3.6 Diagnosis asma............................................................................................................... 22

2.3.6.1 Anamnesis asma.......................................................................................................... 22

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2.3.6.2 Pemeriksaan Fisik asma.............................................................................................. 23

2.3.6.3 Pemeriksaan Penunjang asma...................................................................................... 24

2.3.6.4 Penulisan Diagnosis asma.......................................................................................... 27

2.3.7 Tatalaksana asma............................................................................................................ 28

2.3.7.1 Pengobatan asma......................................................................................................... 28

2.3.7.2 Step pengobatan asma................................................................................................. 29

2.3.7.3 Tatalaksana serangan asma.......................................................................................... 32

2.3.7.4 Status asmatikus ........................................................................................................ 32

2.3.8 Komplikasi asma............................................................................................................ 33

2.3.9 Prognosis asma............................................................................................................... 33

Rekam medis kasus ............................................................................................................... 34

Analisis kasus ........................................................................................................................ 44

BAB 3. KESIMPULAN ....................................................................................................... 50

3.1 Kesimpulan ..................................................................................................................... 50

DAFTAR PUSTAKA ........................................................................................................... 51

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 DAFTAR GAMBAR

Gambar 1 Anatomi Hidung ...................................................................................................... 3

Gambar 2 Skema Percabangan Bronkus..................................................................................... 5

Gambar 3 Skema Anatomi Bronkus dan Bronkiolus.................................................................... 5

Gambar 4 Pengembangan Rangka Pada Saat Inspirasi dan Ekspirasi............................................ 7

Gambar 5 Perjalanan alergi...................................................................................................... 14

Gambar 6 perbandingan klasifikasi asma PNAA 2004 dengan PNAA 2015........................ 22

Gambar 7 kriteria diagnosis asma pada dewasa, remaja, dan anak 6-11 tahun..................... 26

Gambar 8 Alur diagnosis asma anak .................................................................................... 27

Gambar 9 Dosis berbagai preparat steroid inhalasi pada anak asma ................................... 31

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 DAFTAR TABEL

Tabel 2.1 tabel berdasarkan derajat beratnya serangan...................................................... 21

Tabel 2.2 tabel derajat keparahan serangan asma............................................................... 21

Tabel 2.3 Diagnosis Asma Anak <5 tahun......................................................................... 25

Tabel 2.4 Kriteria Diagnosis Asma Anak >5 Tahun........................................................... 25

Tabel 2.5 Penulisan diagnosis pasien asma......................................................................... 27

Tabel 2.6 Derajat kendali penyakit asma ............................................................................ 28

Tabel 2.7 Penentuan derajat kendali ................................................................................... 31

UNIVERSITAS TARUMANAGARA v