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Skenario 1 Kelompok 8

Anggota kelompok :A.A.OKA SHINDU PHALGUNA ALVIN ARMANDO SANTOSO I MADE DWI ARYA PRIMAHARTA NOVA NOVITA ANGGRAENI NI MADE RATNA ANGGRAENI I MADE PUTERA ADITYA I MADE DWI LAKSEMANA INNA GITA PARAMEDITA I GUSTI AGUNG NGURAH YOGA W NI PUTU WIANDANI MADE ARYA PURWA DWITAMA PRASETYO

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Tingling sense of the index finger and middle finger Right Bu TututBu Tutut was 5 months pregnant, was 35 th. Complained of feeling numb index finger and middle finger of his right for 2 months. Currently Bu Tutut felt the tingling of his right hand felt a little muscle weakness and easy falling when holding objects, like a coffee cup. Sometimes accompanied by pain in the right palm. Other circumstances, Bu Tutut feeling well and denied that there is trauma and neck pain.

KEYWORDSPins and Needles Numbness or paresthesias in medical science, is a sensation on the surface of the body that were not triggered by stimuli from the outside world. Paresthesias that arise when there is irritation of nerve fibers that carry the sensation of tingling

Painful Pain is a subjective sensory and emotional unpleasant obtained a ssociated with actual or potential tissue damage, or described the condition of the occurrence of damage.Trauma Trauma means a collision or an event experienced by a person and leave scars. Are usually negative, in terms of psychology called post-traumatic syndrome disorder.

Pregnant

A woman said to be "pregnant" is normal when in the womb of human growth and development of new

Muscle

Weakness Muscle weakness is a common problem, but often give a different meaning to each sufferer. Some people just feel tired. But the true mus cle weakness, despite best efforts, the normal force will not be achieved

PROBLEMWe raised several issues in this scenario, such as: what is experienced by Bu Tutut? what are the causes of disease experienced by Bu Tutut? how do we fix or prevent it?

DISCUSSIONRestriction To minimize the scope of the problem in this scenario, then we make the limit problem,that is : tingling

Anatomi / Histologi / Fisiologi / Patofisiologi / Patomekanisme Anatomi

manus

N. Medianus

Anatomi

Types Related Diseases

Rheumatism or Gout. Cholesterol. Osteoporosis, Bone Flu. Tuner Syndrome Carpal Manus

linical symptoms of - Stiffness of the wrist Astronomer dextra - If the object is not strong hold and feel the muscle weakness - minimal deviation in the medial (ulnar) Checking the Physical - It feels stiff muscles and pain in the carpal region turner minimal tenderness in the joints proximal digit interfalang: II, III, IV and V MOVEMENT (MOUMENT) - Disorders of pronation movement and weakness of flexion of the wrist manus dextra - Impaired movement of flexion at the proximal joint interfalang digiti II, III, IV and V - Impaired movement of flexion at the distal joints interfalang digiti II and III - Impaired movement of flexion, abduction and opposition digiti I and flexion of the joints and metakarpofalangea digiti II and III

Checking Support Radiology MRI: thickening of the retinaculum summed image obtained in Carpal Tuner fleksorum the press N. Medianus Complete blood examination: normal blood sugar

INITIAL HYPOTHESIS (Differential Diagnosis) Bu

Tutut exposed to Rheumatism that often occur when the birth

ANALYSIS OF DIFFERENTIAL DIAGNOSISClinical Symptoms

Physical Examination

Stiffness of the wrist Astronomer dextra If the object is not strong hold and feel the muscle weakness - minimal deviation in the medial (ulnar) Feel the muscle stiffness and pain in the carpal region turner minimal tenderness in the joints proximal digit interfalang: II, III, IV and V

MOVEMENT(MOUMENT) - Impaired movements of pronation and flexion of the wrist weaknessmanus detra - Impaired movement of flexion at the proximal joint interfalang digiti II, III, IV and V - Impaired movement of flexion at the distal joints interfalang digiti II and III - Impaired movement of flexion, abduction and opposition digiti I and flexion of the jointsand metakarpofalangea digiti II and III Examination Support

Radiology MRI: thickening of the retinaculum summed image obtained in Carpal Tunerfleksorum menakan N. The median Complete blood examination: normal blood sugar

HYPOTHESIS END (diagnosis) According

to data obtained from this scenario, o ur group concluded that, Bu Tutut suff er Turner Syndrome Carpal Manus.

PATIENT DATA: Name: Mrs Tutut Age: 35 th ANAMNESIS KU: tingling RPD: Occurred since 2 months ago on the index finger and middle finger of the right Accompanied by muscle weakness of the index finger and middle finger of the right sometimes accompanied by pain RPS: Currently being 5 months pregnant felt a tingling in the index finger and right middle finger the numbness and wrist pain areas There are muscle weakness, especially on the IBI finger muscle rigidity in the right wrist FAMILY HISTORY in family there is no such MEDICATION HISTORY only given painkillers but not yet healed SOCIAL HISTORY During pregnancy weight has gone up 8 kg Diet frequently eat fast-food meals During pregnancy never exercise PHYSICAL EXAMINATION: Awareness: compos mentis Vital sign: | tension: 120/80 pulse: 80 x /minute RR: 29 x / min Temperature: 37A C GCS: 456

MEKANISME DIAGNOSIS

TROUBLESHOOTING STRATEGYManagement of Initial treatment: at night the wrist bandage and avoid excessive activity in the right hand. Surgery on the flexor retinaculum (carpal tunnel release) Medica Ventosa(Fisioteraphy) Prognosis Management, if done well, then, Bu Tutut 35th. Will recover and be able to run as usual. Turner Carpal Syndrome is associated with endocrine conditions like diabetes, hypothyroidism, hyperthyroidism, acromegaly, and pregnancy. Othe r causes include diseases auto lmun, lipoma in the canal, hematoma and carpal bone abnormaliti es. Women are more commonly affected than men by a ratio of 3:1. If not treated properly it can cause complications that harm patients.