Anatomi Fisiologi Sistem Perkemihan
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Transcript of Anatomi Fisiologi Sistem Perkemihan
Anatomi Fisiologi
Sistem Urinari
Ciputat, 19 November 2014
Prastuti Waraharini, dr
Sistem Urinari
• Pengatur keseimbangan air volume dantekanan darah
• Pengatur konsentrasi garam (natrium, kalium, klorida, dan ion lain) dalam darah
• Stabilisasi pH darah• Mempertahankan nutrisi yang masih diperlukan
tubuh• Detoksifikasi racun (bersama liver)
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Organisasi Sistem Urinari
1. Ginjal
2. Ureter
3. Vesika urinaria
4. Uretra
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Posisi dan Ukuran GinjaldrPhi - Urinary - 191114
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Retroperitoneum
Vertebrae T12-L3
Ginjal kanan lebih rendah
Panjang 6-7,5 cm
Tebal 1,5-2,5 cm
Berat + 140gram
http://cnx.org/content/m46429/latest/?collection=col11496/latest
Struktur Ginjal
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Nefron
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• Unit struktural dan
fungsional ginjal
• Filtrasi, reabsorpsi, sekresi
• Besarnya jumlah alirandarahmemastikan
darah tersaring dg baik
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Filtrasi Ginjal
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• Di glomerulus
• Arteriol aferen kapilerglomerulus arterioleferen
• Kapiler sangat permeabel 10% plasma disaringke ruang interstisial
• Sel darah dan protein tidak mengalamipenyaringan
Reabsorpsi Selektif dan Sekresi Ginjal
• Di tubulus ginjal
• Dipengaruhi kerja hormon Paratiroid dan kalsitonin Anti diuretic hormone (ADH) Aldosteron
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• Filtrat mencapai pelvis ginjal dan ureter sebagaiurin
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Disaring Dikeluarkan
Air 150 L 1,5 L
Garam 700 gram 15 gram
Glukosa 170 gram -
Urea 50 gram 30 gram
Amazing Facts…
• The kidneys function as a pair of filters through which about one litre of blood circulates each minute the entire blood in the body passes through them in 5 - 6 minutes
• In a day it filters 1800 litres of blood which is 400 times the blood volume
• The human kidney contains >1.2 million nephrons• A normal adult excretes 1 - 1.8 litres of urine per day• When a kidney is damaged or diseased, the other
kidney is able to compensate for it• An artificial kidney (dialysing machine) is used for
dialysis
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Ureter• Superior
▫ Lanjutan pelvis renalis
• Inferior▫ Melalui ronggal
abdomen▫ Di belakang
peritoneum▫ Di depan m. psoas▫ Ke rongga pelvis,
masuk kandung kemih melalui dinding posteriornya
• 35-40 cm
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http://www.urologyhealth.org/urology/articles/images/anatomy_KidneySupUreter_anterior.jpg
Ureter- Cross Section
• 3 layers of tissue
▫ Outer layer Fibrous tissue
▫ Middle layer Muscle
▫ Inner layer Epithelium
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Vesica Urinaria
• 3 layers▫ Outer layer
Loose connective tissue
▫ Middle layer Smooth muscle and
elastic fibres
▫ Inner layer Lined with transitional
epithelium
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http://www.urologyhealth.org/urology/articles/images/anatomy_UretersBladder_coronal.jpg
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Urethra
• Extends from the base of the bladder to the outside world.
• Anatomical differences mean that male and female urethras are different.▫ Female: 4cm long▫ Male: 14cm long
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Urethra- structure of
• Muscle layer
• Submucosa layer
• Mucosa
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Mikturisi
• Peristiwa pembuangan urine
• Dipicu penambahan tekanan di vesika urinaria (170-230 ml cairan)
• Gerak refleks, dapat dikendalikan pusat syaraf
• Hasil dari kontraksi otot abdomen dan organ lain yang menekan vesika
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Urine Normal
• 1-2 liter/hari• Tergantung asupan cairan dan protein• Bening tanpa endapan• pH rata-rata 6• Berat jenis 1010-1025 mg/dL• Komposisi
▫ Air – 96% ▫ Ureum (hasil metabolisme protein) – 2%▫ Metabolit lain – 2%
Asam urat Kreatinin (produk metabolisme otot) Purin, oksalat, sulfat, dll Elektrolit (Na, K, Cl)
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Agar tak sekedar diucapkan…
• Allahumma inni a’udzubika minal khubutsi wal khabaits
• Alhamdulillahilladzi adzhaba ‘anil adza wa ‘afanii
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Kondisi Klinis
• Peradangan saluran kemih
• Batu saluran kemih
• Gangguan mikturisi
• Gagal ginjal
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Alhamdulillah…
• Evelyn C Pearce. Anatomi dan Fisiologi untukParamedis
• Elizabeth J Corwin. Buku Saku Patofisiologi• And some cool links…
▫ http://www.tutorvista.com/content/biology/biology-ii/excretion-and-osmoregulation/excretion-osmoregulation-man.php
▫ http://health.rush.edu/HealthInformation/BodyGuide/reftext/html/urin_sys_fin.html
▫ http://cnx.org/content/m44809/latest/?collection=col11448/latest
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