SISTEM MUSKULOSKELETAL

Kelompok 6
Kelompok
01 Luky Septi Ardila
(P17240211010)

02 Tiara Permata Putri

(P17240211020)

03 Yuliana Wahyu Pratiwi

(P17240211027)

04 Ayu Dwi Indriyani

(P17240213036)
Sistem
Muskuloskeletal
 Definisi
Sistem muskuloskeletal merupakan sistem
tubuh yang terdiri dari otot atau muskulos dan
tulang-tulang yang membentuk rangka atau
skelet. Otot adalah jaringan tubuh yang
mempunyai kemampuan mengubah energi
kimia menjadi energi mekanik atau gerak.
Sedangkan rangka adalah bagian tubuh yang
terdiri dari tulang-tulang yang memungkinkan
tubuh mempertahankan bentuk, sikap dan
posisi. Sistem sekolah skeletal memberi bentuk
bagi tubuh. Sistem sekolah skeletal melindungi
organ-organ penting, misalnya otak dilindungi
oleh tulang-tulang tengkorak jantung dan paru-
paru terdapat pada rongga dada (cavum
thorax) dibentuk oleh tulang-tulang costae (iga).

Modern PowerPoint Presentation

LOREM IPSUM
DOLOR SIT AMET
 01 Data demografi

Anamnesis 02 Riwayat perkembangan

03 Riwayat sosial

04 Riwayat keturunan

05 Riwayat diet

06 Aktivitas sehari hari

07 Riwayat penyakit terdahulu

08 Riwayat penyakit sekarang

Pemeriksaan fisik
Pemeriksaan fisik harus dilakukan secara sistematis untuk menghindari kesalahan. Jika
mungkin, gunakan ruang yang cukup luas sehingga pasien dapat bergerak bebas saat
pemeriksaan gerakan atau berjalan. Pengkajian keperawatan merupakan evaluasi
fungsional. Teknik inspeksi dan rotasi dilakukan untuk mengevaluasi integritas tulang,
postur tubuh, fungsi sendi, kekuatan otot, cara berjalan, kemampuan pasien melakukan
aktivitas hidup sehari-hari.
Dasar penggajian adalah perbandingan simetris bagian tubuh. Kedalaman pengkajian
bergantung pada keluhan fisik pasien dan riwayat kesehatan dan semua petunjuk fisik
yang ditemukan. Pemeriksaan harus melakukan eksplorasi lebih jauh. Hasil pemeriksaan
fisik harus didokumentasikan dengan cermat dan informasi tersebut diberitahukan kepada
dokter yang akan menentukan diagnosis dan penatalaksanaan lebih lanjut.
Fraktur
 Definisi
Fraktur merupakan suatu patahan
pada kontinuitas struktur jaringan tulang
atau tulang rawan yang umumnya
disebabkan trauma, baik trauma langsung
ataupun tidak langsung. Akibat dari suatu
trauma pada tulang dapat bervariasi
tergantung pada jenis, kekuatan dan
arahnya trauma. Patahan tadi mungkin tidak
lebih dari suatu retakan, suatu pengisutan
atau perimpilan korteks biasanya patahan
itu lengkap dan fragmen tulang bergeser.
Kalau kulit diatasnya masih utuh, keadaan
ini disebut fraktur tertutup (fraktura
sederhana) kalau kulit atau salah satu dari
rongga tubuh tertembus keadaan ini disebut
faktor terbuka (faktor compound) yang
cenderung mengalami kontaminasi dan
infeksi.
Modern PowerPoint Presentation
LOREM IPSUM
DOLOR SIT AMET
 01 Kekerasan langsung
Etiologi Kekerasan langsung menyebabkan patah tulang pada
titik terjadinya kekerasan. Fraktur demikian sering
bersifat fraktur terbuka dengan garis patah melintang
atau miring

02 Kekerasan tidak langsung

Kekerasan tidak langsung menyebabkan patah tulang di
tempat yang jauh dari tempat terjadinya kekerasan.
Yang patah biasanya adalah bagian yang paling lemah
dalam jalur hantaran vektor kekerasan

03 Kekerasan akibat tarikan otot

Patah tulang akibat tarikan otot sangat jarang terjadi
kekuatan dapat berupa pemuntiran, penekukan dan
penekanan, kombinasi dari ketiganya dan penarikan.
 Asuhan Keperawatan
Pengkajian
1. Biodata
2. Keluhan utama :keterbatasan aktivitas , gangguan sirkulasi , rasa nyeri , dan gangguan
neurosensori .
3. Riwayat perkembangan.
4. Riwayat kesehatan masa lalu : kelainan muskuloskeletal ( jatuh , in penanggulangan , dan
penyakit ( dia feksi , trauma dan fraktur ) , cara betes melitus )
5. Riwayat kesehatan sekarang : kapan timbul masalah , riwayat trauma penyebab , gejala timbul
tiba - tiba / perlahan , lokasi , obat yang minum , dan cara penanggulangan.
6. Pemeriksaan fisik : keadaan umum dan kesadaran , keadaan inte gumen ( kulit dan kuku ) ,
kardiovaskular ( hipertensi dan takikardia ) , neurologis ( spasme otot dan kebas / kesemutan ) ,
keadaan ekstre mitas , dan hematologi .
7. Riwayat psikososial : reaksi emosional , citra tubuh , dan sistem pen dukung.
8. Pemeriksaan diagnostik : rontgen untuk mengetahui lokasi dan luas cedera , CT scan , MRI ,
arteriogram , pemindaian tulang , darah lengkap , kreatinin , dan pemeriksaan laboratorium
lengkap untuk per siapan operasi.
9. Pola kebiasaan sehari - hari atau hobi.
Diagnosis Keperawatan
Diagnosis keperawatan yang mungkin muncul meliputi:
1. Gangguan rasa nyaman ( nyeri ) yang berhubungan dengan spasme
otot , edema , kerusakan jaringan , dan patah tulang.
2. Hambatan mobilitas fisik yang berhubungan dengan kerusakan
jaringan.
3. Perubahan perfusi jaringan.
4. Cemas / takut / berduka.
5. Kurang pengetahuan.
6. Risiko tinggi infeksi.
7. Risiko tinggi kerusakan integritas kulit.
8. Gangguan citra tubuh.
9. Gangguan pemenuhan kebutuhan sehari – hari.
10. Perubahan fungsi peran.
Intervensi Keperawatan Fraktur
Diagnosis keperawatan Tujuan keperawatan Kriteria hasil Intervensi keperawatan

Gangguan rasa Rasa nyaman Klien tidak Kaji intensitas nyeri

nyaman ( nyeri ) meningkat sehingga mengeluh Atur posisi klien yang nyaman durasi
nyeri berkurang atau nyeri/nyeri Anjurkan relaksasi/distraksi
hilang berkurang Anjurkan melakukan imajinasi
Kolaborasi dengan dokter untuk terapi
analgetik

Hambatan mobilitas Meningkatkan mobilitas Klien mampu Kaji derajat imobilitas

fisik pada tingkat yang bergerak dan Dorong partisipasi pada aktivitas
paling mungkin kekuatan otot terapeutik
meningkat Bantu dalam mobilisasi dengan kursi
roda, kruk, dan tongkat
Dekatkan dengan alat-alat yang
dibutuhkan klien
Evaluasi Keperawatan

Setelah melakukan intervensi keperawatan diharapkan klien :

1. Mengalami peredaan nyeri.
• Melaporkan penurunan nyeri.
• Tidak mengalami nyeri tekan di tempat terjadinya infeksi.
• Menunjukkan perilaku yang lebih rileks.
• Memperagakan keterampilan reduksi nyeri yang dipelajari dengan
peningkatan keberhasilan.
2. Mempertahankan mobilitas fisik
• Berpartisipasi pada program latihan dan aktivitas perawatan diri.
• Mencari bantuan sesuai kebutuhan.
• Mempertahankan koordinasi dan mobilitas secara optimal.
Dislokasi
 Definisi
Dislokasi adalah cedera
struktur ligameno di sekitar sendi,
Akibat gerakan menjepit atau
memutar/keadaan di mana tulang-
tulang yang membentuk sendi
tidak lagi berhubungan, secara
anatomis (Tulang lepas dari sendi).
(Brunner & Suddarth.2001)
Dislokasi adalah keluarnya
(bercerai nya) Kepala sendi dari
Mangkuknya, dislokasi merupakan
suatu kedaruratan yang
membutuhkan pertolongan segara.
( Arif Mansyur, 2000)
Modern PowerPoint Presentation
LOREM IPSUM
DOLOR SIT AMET
 01 Cedera olahraga
Etiologi Olahraga yang biasanya menyebabkan dislokasi adalah
sepakbola dan Hoki, serta olahraga yang beresiko jatuh
misalnya: terperosok akibat bermain ski, senam, voli

Trauma yang tidak

02 berhubungan dengan olahraga
Benturan keras pada sendi saat kecelakaan motor
biasanya menyebabkan Dislokasi

03 Terjatuh

Terjatuh dari tangga atau terjatuh saat berdansa di atas

lantai yang licin
 04 Umur
Etiologi Faktor umur sangat menentukan karena mempengaruhi
kekuatan serta kekenyalan jaringan.

05 Pukulan
Dislokasi lutut dapat terjadi apabila mendapat pukulan
pada bagian lututnya dan menyebabkan dislokasi

06 Tidak melakukan pemanasan

Pada atlet olahraga sering terjadi keseleo karena

kurangnya pemanasan
Asuhan Keperawatan
Pengkajian
1. Biodata
2. Keluhan utama: keterbatasan aktivitas, gangguan sirkulasi, rasa nyeri, dan gangguan
neurosensory.
3. Riwayat perkembangan. Data ini menggambarkan sejauh mana tingkat perkembangan
pada neonatus, bayi, prasekolah, usia sekolah, remaja, dewasa, tua, dan kebutuhan
beraktivitas pada setiap tahap, serta gangguan /kejadian yang memengaruhi sistem
muskuloskeletal pada tiap tahapnya.
4. Riwayat kesehatan masa lalu: kelainan muskuloskeletal (jatuh, infeksi, trauma, fraktur), cara
penanggulangan, penyakit ( diabetes melitus ).
5. Riwayat kesehatan sekarang: kapan timbul masalah, riwayat trauma, penyebab, gejala
timbul secara tiba - tiba /perlahan, lokasi, obat yang diminum, dan cara penanggulangan.
6. Pemeriksaan fisik: keadaan umum dan kesadaran, keadaan inte gumen (kulit, kuku),
kardiovaskular (hipertensi, takikardia), neurologis (spasme otot, kebas/kesemutan),
keadaan ekstremitas, dan hematologi.
7. Riwayat psikososial: reaksi emosional, citra tubuh, sistem pendukung.
8. Pemeriksaan diagnostik: rontgen untuk mengetahui lokasi/luas cedera, CT scan, MRI,
arteriogram, pemindaian tulang, darah lengkap, dan kreatinin.
9. Pola kebiasaan sehari - hari atau hobi.
Diagnosa Keperawatan

Diagnosis keperawatan yang mungkin muncul pada

gangguan ini:
1. Gangguan rasa nyaman (nyeri) yang berhubungan
spasme otot, edema, kerusakan jaringan, dan patah tu-
lang.
2. Hambatan mobilitas fisik yang berhubungan dengan
kerusakan jaringan.
 Intervensi Keperawatan Dislokasi
Diagnosis keperawatan Tujuan keperawatan Kriteria hasil Intervensi keperawatan

Gangguan rasa Rasa nyaman Klien tidak mengeluh Kaji intensitas nyeri, karakteristik nyeri,
lokasi nyeri, dan durasi
nyaman ( nyeri ) meningkat sehingga nyeri/nyeri berkurang
Atur posisi yang nyaman
nyeri berkurang atau Klien tampak tenang, Ajarkan dan anjurkan relaksasi/distraksi
hilang skala nyeri 0-4 Anjurkan melakukan imajinasi
Kolaborasi dengan dokter untuk terapi
analgetik
 

Hambatan Meningkatkan Klien mampu bergerak Kaji derajat imobilitas

Dorong partisipasi pada aktivitas
mobilitas fisik yang mobilitas pada tingkat dan kekuatan otot
terapeutik
berhubungan yang paling mungkin meningkat Bantu dalam mobilisasi dengan kursi
dnegan kerusakan roda , kruk , dan tongkat
Dekatkan alat - alat yang dibutuhkan
jaringan
klien
 
Osteoporosis
 Definisi
Osteoporosis adalah gangguan
metabolisme tulang sehingga massa
tulang berkurang. komponen matriks
tulang yaitu mineral dan protein
berkurang. Resorpsi terjadi lebih cepat
daripada formasi tulang, sehingga
tulang menjadi tipis
(Pusdiknakes,1995).
Osteoporosis adalah kelainan dengan
penurunan massa tulang total. Pada
kondisi ini terdapat perubahan
pergantian tulang homeostatis normal,
kecepatan resorpsi tulang lebih besar
daripada kecepatan pembentukan
tulang, yang mengakibatkan penurunan
massa tulang (Brunner & Suddarth,
2000).
Modern PowerPoint Presentation
LOREM IPSUM
DOLOR SIT AMET
 01 Difisiensi kalsium
Etiologi Disebabkan oleh asupan kalsium dalam makanan yang tidak
adekuat sehingga mempercepat penurunan massa tulang.

Kurangnya latihan fisik teratur

02
Imobilisasi dapat menyebabkan menurunnya massa tulang.
Olahraga atau latihan fisik yang teratur dapat mencegah
penurunan massa tulang.

03 Jenis Kelamin

wanita lebih cepat mengalami osteoporosis daripada pria.

Asuhan Keperawatan
Pengkajian
1. Riwayat keperawatan
Dalam pengkajian riwayat keperawatan perawat perlu mengidentifikasi adanya:
a. Rasa nyeri atau sakit tulang punggung bagian bawah, leher dan pinggang
b. Berat badan menurun
c. Biasanya di atas 45 tahun
d. Jenis kelamin sering pada wanita
e. Pola latihan dan aktivitas
f. Keadaan nutrisi (misalnya kurang vitamin D dan C, serta kalsium)
g. Merokok, mengkonsumsi alkohol dan kafein.
h. Adanya penyakit endokrin: diabetes melitus, hipertiroid, hiperparatiroid, sindrom cushing, akromegali,
hipogonadisme.
2. Pemeriksaan fisik:
a. Lakukan penekanan pada tulang punggung terdapat nyeri tekan atau nyeri pergerakan
b. Periksa mobilitas pasien
c. Amati posisi pasien yang nampak membungkuk
3. Riwayat psikososial. Penyakit ini sering terjadi pada wanita biasanya sering timbul kecemasan, takut
melakukan aktivitas, dan perubahan konsep diri. Perawat perlu mengkaji masalah psikologis yang timbul
akibat proses ketuaan dan efek penyakit yang menyertainya.
Diagnosa Keperawatan
Berdasarkan data pengkajian, diagnosis keperawatan untuk pasien osteoporosis yang mengalami fraktur
vertebrata spontan sebagai berikut:
1. Mobilitas fisik yang berhubungan dengan proses penyakit.
2. Konsep diri: perubahan citra tubuh dan harga diri yang berhubungan dengan proses penyakit.
3. Nyeri yang berhubungan dengan fraktur dan spasme otot.
4. Cedera atau fraktur yang berhubungan dengan tulang osteoporosis.
5. Kurang pengetahuan tentang perawatan di rumah.
Intervensi Keperawatan Osteoporosis
Diagnosis keperawatan
Nyeri yang berhubungan dengan
fraktur dan spasme otot
Tujuan keperawatan Intervensi keperawatan
Nyeri reda Anjurkan istirahat di tempat tidur dengan posisi terlentang atau miring
Atur posisi lutut fleksi, meningkatkan rasa nyaman dengan merelaksasi
otot
Kompres hangat intermiten dan bijak punggung dapat memperbaiki
relaksasi otot
Anjurkan posisi tubuh yang baik dan ajarkan mekanika tubuh
Gunakan korset/Brace punggung saat pasien turun dari tempat tidur
Kolaborasi dalam pemberian analgesik untuk mengurangi nyeri

Risiko cedera (fraktur) yang Cedera tidakl terjadi Anjurkan melakukan aktivitas fisik untuk memperkuat otot mencegah
atrofi dan memperlambat demineralisasi tulang progresif
berhubungan dengan tulang
Latihan isometrik dapat digunakan untuk memperkuat otot batang tubuh
osteoporosis
Anjurkan pasien untuk berjalan, mekanika tubuh yang baik dan postur
tubuh yang baik
Hindari aktivitas membungkuk mendadak, melengok dan mengangkat
beban lama
Melakukan aktivitas di luar ruangan dan di bawah sinar matahari untuk
memperbaiki kemampuan tubuh menghasilkan vitamin D
Evaluasi Keperawatan
Setelah dilakukan intervensi keperawatan diharapkan:
1. Aktivitas dan mobilitas fisik terpenuhi
a. Melakukan ROM secara teratur
b. Menggunakan alat bantu saat aktivitas
c. Menggunakan brace atau korset saat aktivitas
2. Koping pasien positif
a. Mengekspresikan perasaan
b. Memilih alternatif pemecahan masalah
c. Meningkatkan komunikasi
3. Nyeri berkurang atau hilang
a. Mengalami peredaan nyeri saat istirahat
b. Mengalami ketidaknyamanan minimal selama aktivitas sehari-hari
c. Menunjukkan berkurangnya nyari tekan pada tempat fraktur
Anamnesis 01 PowerPoint Presentation
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THANK YOU
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