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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