KEPERAWATAN

SENSORI & PERSEPSI

E. ANDERSON
 SENSORI & PERSEPSI

Sensory receptors are specialized to

respond to changes in their environment,
which are called stimuli. Typically,
activation of a sensory receptor by an
adequate stimulus results in graded
potentials that in turn trigger nerve
impulses along the afferent PNS fibers
coursing to the CNS. Sensation
(awareness) of the stimulus) and
perception (interpretation of the meaning
 SENSORI & PERSEPSI

Our survival depends not only on sensation

(awareness of changes in the internal and
external environments) but also on
perception (conscious interpretation of those
stimuli). For example, a pebble in your shoe
causes the sensation of localized deep
pressure, but your perception of it is an
awareness of discomfort. Perception in turn
determines how we will respond: In this case,
you take off your shoe to get rid of the pesky
pebble.
 SENSORI & PERSEPSI

Perubahan Stimulus
Stimuli
lingkungan adekuat

Aktivasi reseptor
Trigger nerve Menghasilkan
sensori (serabut
impulses satu penilaian
PNS aferen)

SENSORI &
CNS Human survival
PERSEPSI
 CLASSIFICATION BY STIMULUS TYPE

• Mechanoreceptors respond to
mechanical force such as touch, pressure
(including blood pressure), vibration, and
stretch.
• Thermoreceptors respond to temperature
changes.
• Photoreceptors, such as those of the
retina of the eye, respond to light.
 CLASSIFICATION BY STIMULUS TYPE

• Chemoreceptors respond to chemicals in

solution (molecules smelled or tasted, or
changes in blood or interstitial fluid
chemistry).
• Nociceptors (no”se-sep’torz; noci = harm)
respond to potentially damaging stimuli that
result in pain. For example, searing heat,
extreme cold, excessive pressure, and
inflammatory chemicals are all interpreted
as painful. These signals stimulate subtypes
of thermoreceptors, mechanoreceptors,
and chemoreceptors.
 CLASSIFICATION BY LOCATION

• Exteroceptors (ek”ster-o-sep’torz) are

sensitive to stimuli arising outside the
body (extero 5 outside), so most
exteroceptors are near or at the body
surface. They include touch, pressure,
pain, and temperature receptors in the
skin and most receptors of the special
senses (vision, hearing, equilibrium, taste,
smell).
 CLASSIFICATION BY LOCATION

• Interoceptors (in”ter-o-sep’torz), also called

visceroceptors, respond to stimuli within the
body (intero 5 inside), such as from the
internal viscera and blood vessels.
Interoceptors monitor a variety of stimuli,
including chemical changes, tissue stretch,
and temperature. Sometimes their activity
causes us to feel pain, discomfort, hunger,
or thirst. However, we are usually unaware
of their workings.
 CLASSIFICATION BY LOCATION

• Proprioceptors (pro”pre-o-sep’torz), like

interoceptors, respond to internal stimuli.
However, their location is much more
restricted. Proprioceptors occur in skeletal
muscles, tendons, joints, and ligaments and in
connective tissue coverings of bones and
muscles. (Some authorities include the
equilibrium receptors of the inner ear in this
class.) Proprioceptors constantly advise the
brain of our body movements (propria = one’s
own) by monitoring how much the organs
containing these receptors are stretched.
 CLASSIFICATION BY RECEPTOR
STRUCTURE

The overwhelming majority of sensory

receptors belong to the general senses
and are simply the modified dendritic
endings of sensory neurons. They are
found throughout the body and monitor
most types of general sensory information
(touch, pressure, stretch, & vibration;
temperature, pain).
 CLASSIFICATION BY RECEPTOR
STRUCTURE

Receptors for the special senses (vision,

hearing, equilibrium, smell, and taste) are
housed in complex sense organs. For
example, the sense organ we know as the
eye is composed not only of sensory
neurons but also of nonneural cells that
form its supporting wall, lens, and other
associated structures.
GENERAL SENSORY
MEKANISME SENSORI & PERSEPSI

Three main levels of

neural integration
operate in the
somatosensory (or any
sensory) system (Figure
13.2):
• Receptor level: sensory
receptors
• Circuit level: processing
in ascending pathways
• Perceptual level:
processing in cortical
sensory areas
GENERAL STRUCTURE OF A NERVE
REGENERATION OF NERVE FIBERS

Damage to nervous tissue is serious

because, as a rule, mature neurons do
not divide. If the damage is severe or
close to the cell body, the entire neuron
may die, and other neurons that are
normally stimulated by its axon may die as
well. However, if the cell body remains
intact, cut or compressed axons of
peripheral nerves can regenerate
successfully.
REGENERATION OF NERVE FIBERS
 PEOPLE ARE RESPONSIVE CREATURES

The aroma of freshly baked bread makes our mouths

water. A sudden clap of thunder makes us jump. These
stimuli and many others continually greet us and are
interpreted by our nervous systems. When people are
asked to list the senses, they usually come up with five:
vision, taste, smell, hearing, and touch. Actually, touch
reflects the combined activity of the general senses.
The remaining senses—vision, taste, smell, hearing, and
equilibrium—are called special senses.
In contrast to the widely distributed general receptors
(most of which are modified nerve endings of sensory
neurons), the special sensory receptors are distinct
receptor cells.
 ANATOMI - FISIOLOGI

Kulit
• Epidermis
• Dermis
• Hipodermis
Hairs
Nails
Sweat glands
Sebaceous glands
Skin color.
ANATOMI - FISIOLOGI
ANATOMI - FISIOLOGI
ANATOMI - FISIOLOGI
 ANATOMI - FISIOLOGI

Fungsi Kulit
• Protection (chemical-physical-biological
barriers)
• Body temperature regulation
• Cutaneous sensation
• Metabolic functions
• Blood reservoir
• Excretion
ANATOMI – FISIOLOGI
Accessory Structures of the Eye
ANATOMI - FISIOLOGI
Accessory Structures of the Eye
ANATOMI - FISIOLOGI
Accessory Structures of the Eye
ANATOMI - FISIOLOGI
Accessory Structures of the Eye
ANATOMI - FISIOLOGI
Accessory Structures of the Eye
ANATOMI - FISIOLOGI
Photoreceptors and Phototransduction
 ANATOMI - FISIOLOGI
Visual Pathways and Processing

• The Visual
Pathway to the
Brain
• Depth
Perception
• Visual
Processing
ANATOMI - FISIOLOGI
Location and Structure of Olfactory Receptors
 ANATOMI - FISIOLOGI
Physiology of Smell & The Olfactory Pathway

Rongga hidung
mengandung reseptor :
• Rasa sakit dan suhu
• Respon terhadap iritan
karena amonia,
panasnya cabai, dan
"dinginnya" mentol.

Impuls dari reseptor ini

mencapai sistem saraf
pusat melalui serabut
aferen dari saraf
trigeminal.
ANATOMI - FISIOLOGI
Location and Structure of Taste Buds
Basic Taste Sensations
• Sweet taste is elicited by many organic
substances including sugars, saccharin, alcohols,
some amino acids, and some lead salts (such as
those found in lead paint).
• Sour taste is produced by acids, specifically their
hydrogen ions (H1) in solution.
• Salty taste is produced by metal ions (inorganic
salts); table salt (sodium chloride) tastes the
“saltiest.”
• Bitter taste is elicited by alkaloids (such as
quinine, nicotine, caffeine, morphine, and
strychnine) as well as a number of nonalkaloid
substances, such as aspirin.
• Umami (u-mam9e; “delicious”), a subtle taste
discovered by the Japanese, is elicited by the
amino acids glutamate and aspartate, which
appear to be responsible for the “beef taste” of
steak, the characteristic tang of aging cheese,
and the flavor of the food additive monosodium
glutamate.
 ANATOMI - FISIOLOGI
Physiology of Taste & The Gustatory Pathway

Taste is 80% smell. When nasal

congestion (or just pinching your
nostrils) blocks access to your
olfactory receptors, food tastes
bland. Without smell, our morning
coffee would lack its richness and
simply taste bitter.

The mouth also contains

thermoreceptors,
mechanoreceptors, and nociceptors,
and the temperature and texture of
foods can enhance or detract from
their taste. “Hot” foods such as chili
peppers actually bring about their
pleasurable effects by exciting pain
receptors in the mouth.
ANATOMI - FISIOLOGI
Structure of the Ear
ANATOMI - FISIOLOGI
Structure of the Ear
ANATOMI - FISIOLOGI
Structure of the Ear
ANATOMI - FISIOLOGI
Structure of the Ear
ANATOMI - FISIOLOGI
Structure of the Ear
ANATOMI - FISIOLOGI
Physiology of Hearing
 ANATOMI - FISIOLOGI
The Auditory Pathway to the Brain

Auditory Processing
• Perception of Pitch
• Detection of
Loudness
• Localization of
Sound
ANATOMI - FISIOLOGI
Equilibrium and Orientation
ANATOMI - FISIOLOGI
Equilibrium and Orientation
 PATHOFISIOLOGI

Pemeriksaa
Nursing
n
penunjang
dx.

Proses
patologi :
Etiologi & Manifestasi
awal → Kematian
faktor” risiko klinis
kondisi
patologi

Medikasi
ASUHAN KEPERAWATAN
 ASSESSMENT

Patologi

History

Family / others

Integumen
Warna kulit, ruam (rash), skin
Physical exam lesion, vascularity & hydration,
kuku, & rambut

Skin biopsy,
immunofluorescene, patch
Diagnostic test
testing, skin scrapings, tzanck
smear
TIPE LUKA
 ASSESSMENT

Patologi

History

Family / others

Visual acuity
Eye & Vision
Physical exam

External eye

Opthalmoscopy,
Diagnostic test tonometri, tes buta
warna
VISUAL ACUITY
 ASSESSMENT

Patologi
History
Family / others

External ear

Otoscopic
Hearing & exam
balance Physical exam
Auditory acuity
exam

Balance exam

Audiometry,
Diagnostic test
tympanogram
 ASSESSMENT

Patologi
History
Family / others
Smell & taste
Nose & mouth
Physical exam
Smell & taste
acuity exam
 TUGAS PRESENTASI
 Definisi dari beberapa referensi (3)
 Skema pathofisiologi → dx. Keperawatan
 Pengkajian keperawatan secara holistik
(bio-psiko-sosio-spiritual)
 Manajemen / penatalaksanaan kasus
 Asuhan keperawatan secara holistik (bio-
psiko-sosio-spiritual) berdasarkan prioritas
masalah
 TUGAS PRESENTASI
1. Konjungtivitis : firza
2. Glaukoma : presky
3. Katarak :evelita
4. Hearing loss : junivi
5. Otitis : michelle
6. Sinusitis : febrisela
7. Kandidiasis lidah/mulut : juan
8. Dermatitis : stefani
9. Luka bakar : ariel
 MAKALAH FINAL
 Bab 1 Pendahuluan : latar belakang, tujuan
penulisan
 Bab 2 Tinjauan teoritis : penyakit, masalah
keperawatan, intervensi keperawatan yang
dipilih
 Bab 3 Tinjauan kasus : asuhan keperawatan,
satu intervensi keperawatan mandiri
berdasarkan prioritas masalah keperawataan
 Bab 4 Pembahasan : patologi-askep-intervensi
msndiri
 Bab 5 Kesimpulan