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DYSPHAGIA & ODYNOPHAGIA

penelanan dibagi 3 tahap. Klo ada 1 yg terganggu. dpt tjd Dysphagia! . DYSPHAGIA (SULIT MENELAN)  Adlh kesulitan atau delay lewatnya mkn yg terasa pd bbrp detik awal penelanan  Orofaringeal dysphagia : kesulitan menelan di inisiasi menelan  Esofageal dysphagia : kesulitan menelan di tengah dada  Patogenesis : ingat.

vagus lalu ke inhibitor & eksitator neuron di esophageal Myenteric Plexus). epiglotis move ke posterior.Oral Phase : voluntary. pmbntkan bolus . neuromotor defect . relaxasi UES (Upper Esophageal Sphincter) shg bolus bs lwt. larynx & hyoid bone move anterior-superior.Pharyngeal Phase : bolus ke faring. FASE MENELAN  . bs krn : obstruksi/abnormalitas struktur . palatum molle mengangkat utk mencegah nasopharyngeal regurgitation. -Esophageal Phase  Swallow stimulated Primary Peristalsis (dikontrol preganglionic neurons di N. Shg ada koordinasi kontraksi&relaksasi  Dysphagia (orofaringeal atau esofageal). Faring memendek.

ODYNOPHAGIA (NYERI MENELAN)  Burning/pain selama food/liquid moves down via esofagus. .

PENYEBAB DISFAGIA & ODYNOPHAGIA .

UTK MEMBEDAKAN DYSPHAGIA FARINGEAL & ESOFAGEAL .

g. HIV patients). ANAMNESIS DYSPHAGIA  dysphagia only to solids -> mechanical obstruction to liquids & solid : kelainan motilitas esofageal  location of dysphagia. prior surgery or radiation treatment -> bs tjd stricture  associated weight loss.. Progressive + weight loss -> malignancy  associated medical conditions (e. . duration of symptoms and whether they are progressive or intermittent. intermittent -> peptic stricture : good stuck klo mkn terllau cpt atau mknn ttt.

lymph nodes. neck. trus pasien dikasih mkn/minuman utk ditelan spy kita bs monitor penelanannya . head. PHYSICAL EXAMINATION OF DYSPHAGIA  Periksa oral cavity. thyroid.

Endoscopy : evaluasi etiologi structural/mucosal . trus dia dikasih liquid utk ditelan. dll). Barium swallow : utk obstruksi. Impedance : mengukur pengukuran intraluminal content. sambil di video dr berbagai arah (anteroposterior. Videofluoroscopy : plng baik utk suspek orofaringeal dysphagia pasien disuruh menelan mkn. strikture. High-Resolution Manometry : mengamati peristalsi  6. Manometry stlh pasien dipasang motility catheter. IMAGING OF DYSPHAGIA  1. bolus movement saat swallow  5.  4. nnt ketauan ada abnormality pd motilitynya atau egk. amati relaxasi esofageal. Amati delay g  3. hernia  2.

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MEDICATIONS IMPLICATED IN ESOPHAGEAL INJURY AND DYSPHAGIA .