cairan asambasa
DESCRIPTION
Kuliah fisiologi cairan dan asam basaTRANSCRIPT
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Keseimbangan cairan, asam dan basa
Hardian
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Fungsi Air dalam Fisiologi Manusia
1. Media semua reaksi kimia tubuh
2. Berperan dalam pengaturan distribusi kimia & biolistrik dalam sel
3. Alat transport hormon & nutrien
4. Membawa O2 dari paru-paru ke sel tubuh
5. Membawa CO2 dari sel ke paru-paru
6. Mengencerkan zat toksik dan waste product serta membawanya ke ginjal dan hati
7. Distribusi panas ke seluruh tubuh 2
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Distribusi Cairan Tubuh
Volume cairan tubuh- wanita (17-39 th) : 50% BB- pria (17-39 th): 60% BB
Distribusi cairan tubuh- cairan intrasel (CIS) = 2/3 cairan tubuh- cairan ekstrasel (CES) = 1/3 cairan tubuh * intravaskular (plasma) = 25% CES * intersisial = 75% CES
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Fluid, Electrolyte, & Acid/Base Balance
High potassium High Sodium
Movement of fluids based on ionic balance (hydrostatic pressure) & plasma proteins (colloidal osmotic pressure)
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Perpindahan Cairan & Elektrolit
1. Difusiperpindahan molekul dari tekanan/konsentrasi tinggi ke tekanan/konsentrasi rendah
2. Osmosisperpindahan air dari konsentrasi zat terlarut rendah ke konsentrasi zat terlarut tinggiosmolaritas: ukuran konsentrasi suatu larutan- isotonus konsentrasi larutan = plasma darah
3. Difusi fasilitasi molekul besar perlu carrier
4. Transport aktifperpindahan molekul dari tekanan/konsentrasi rendah ke konsntrasi tinggi dgn menggunakan energi
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Osmosis and Animal Cells
CRENATION WILL LYSENO CHANGE
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OSMOSIS AND ANIMAL CELLS
WILL LYSE CRENATE NO CHANGE
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Tekanan Cairan
1. Tekanan osmotik & onkotikTekanan osmotik: tekanan untuk mencegah aliran osmotik cairanTekanan onkotik: gaya tarik s/ koloid agar air tetap berada dalam plasma darah di intravaskular
2. Tekanan hidrostatik ( filtration force)tekanan yang digunakan oleh air dalam sistem tertutup
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Perpindahan cairan di kapiler
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Selektivitas Permeabilitas Membran
Membran sel lipid bilayer
Permeabilitas membran sel bersifat selektif terhadap: ion (kanal ion), air (aquaporin)
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Pengaturan Keseimbangan Cairan & Elektrolit
1. Pengaturan volume cairan ekstrasel* Asupan cairan* Peranan Ginjal * Pengontrolan tekanan darah - Hormon Atriopeptin (Atrial Natriuretic peptide) * Pengontrolan keseimbangan garam - Sistem Renin-Angiotensin-Aldosteron
2. Pengaturan osmolaritas cairan ekstrasel* Perubahan osmolaritas di nefron* Peranan Vasopresin
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Pengaturan volume cairan ekstrasel
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Peranan ginjal
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Filtrasi, Reabsorpsi, Sekresi & Ekskresi di Nefron
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Respons thd Peningkatan Tekanan Darah
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Respons thd Penurunan Tekanan Darah
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Peranan Atrial Natriuretik Peptide
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Peranan Renin-Angiotensin-Aldosteron
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Respons thd Asupan Garam
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Perubahan osmolaritas cairan ekstrasel oleh nefron
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Peranan Vasopresin
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Mekanisme Kerja Vasopresin/ADH
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Pengaturan Neuroendokrin dalam Keseimbangan Cairan
1. Sistem sarafReseptor - Baroreseptor di arkus aorta & sinus karotis- Reseptor regang tekanan rendah di thorakSistem saraf simpatis
2. Sistem endokrin- Angiotensin II reabsorpsi Na- Aldosteron reabsorpsi Na- Antidiuretic hormone (ADH) reabsorpsi air- Atrial natriuretic peptide (ANP/atriopeptin) ekskresi Na & air
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Perubahan Volume & Osmolaritas Cairan
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Disorders of water balance:
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Faktor yang mempengaruhi keseimbangan cairan & elektrolit
Umur
Suhu lingkungan
Diet
Stres
Penyakit
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Keseimbangan Asam & Basa
Keseimbangan asam-basa pengaturan konsentrasi ion H+ dalam cairan tubuh
Ion H+ sebagai hasil dari metabolisme: C6H12O6 + O2 CO2 + H2O H2CO3 H+ + HCO3
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[H+] dalam plasma pH plasma darah = 7,4
Sistem dapar (buffer) menghambat perubahan pH yang besar jika ada penambahan asam atau basa
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Sistem Dapar
1. Asam karbonat:Bikarbonat sistem dapar di CES untuk asam non-karbonat
2. Protein sistem dapar di CIS & CES
3. Hemoglobin sistem dapar di eritrosit untuk asam karbonat
4. Phosphat sistem dapar di ginjal dan CIS
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Keseimbangan ion H+
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CO2 + H2O H+ + HCO3- H2CO3
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Mekanisme Regulasi Keseimbangan Asam-Basa
Sistem dapar hanya mengatasi ketidakseimbangan asam-basa sementara
Ginjal: meregulasi keseimbangan ion H+ dengan menghilangkan ketidakseimbangan kadar H+ secara lambat; terdapat sistem dapar fosfat & amonia
Paru: merespons secara cepat perubahan kadar H+ dalam darah & mempertahankan kadarnya sampai ginjal menhilangkan ketidakseimbangan tersebut
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Regulasi paru dalam Keseimbangan Asam-Basa
Kadar CO2 meningkat pH menurun
Kadar CO2 menurun pH meningkat
Kadar CO2 & pH merangsang kemoreseptor yg kemudian akan mempengaruhi pusat pernapasan hipoventilasi meningkatkan kadar CO2 dalam darah hiperventilasi menurunkan kadar CO2 dalam darah
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Regulasi Pernapasan dlm Keseimbangan Asam-Basa
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Regulasi Ginjal dlm Keseimbangan Asam-Basa
Sekresi H+ ke dalam filtrat & reabsorpsi HCO3- ke CES menyebabkan pH ekstrasel meningkat
HCO3- di dlm filtrat diabsorbsi
Laju sekresi H+ meningkat akibat penurunan pH cairan tubuh atau peningkatan kadar aldosteron
Sekresi H+ dihambat jika pH urin < 4,5
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Gangguan Keseimbangan Asam-Basa
1. Asidosis respiratorihipoventilasi retensi CO2 H2CO3H+
2. Alkalosis respiratorihiperventilasi CO2 banyak yg hilang H2CO3 H+
3. Asidosis metabolikDiare, DM HCO3
- PCO2 H+
4. Alkalosis metabolikmuntah H+ HCO3
- PCO2
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faal_cairan-asam-basa/ikun/2006
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Kompensasi Sistem Pernafasan terhadap Asidosis Metabolik
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Kompensasi Ginjal terhadap Asidosis Respiratorik
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Interpretasi Analisis Gas Darah
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Lihat pH darah
pH < 7,35 pH > 7,45
ASIDOSIS ALKALOSIS
Lihat pCO2 Lihat HCO3-
< 40mmHg > 40 mmHg < 24 mM > 24 mM
METABOLIKRESPIRATORIKRESPIRATORIKMETABOLIK
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