Anatomi Fisiologi Sistem Perkemihan

ANATOMI
FISIOLOGI
SISTEM
PERKEMIHAN
The urinary system consists of two
kidneys, two ureters, the urinary bladder,
and the urethra.
The formation of urine is the mayor

function of The urinary system (Kidneys)
The kidneys form urine to excrete these
waste products, as urea, creatinine, and
ammonia, which must be removed from
the blood before they accumulate to
toxic levels.
FUNGSI GINJAL
1. Pengeluaran zat sisa organik : urea, asam urat, kreatinin,

produk penguraian Hb dan hormon
2. Pengaturan konsentrasi ion : Na, K, Ca, Mg, Sulfat, fosfat
3. Pengaturan keseimbangan asam basa : mengendalikan
kskresi H+, HCO3-, NH4+
4. Pengaturan produksi sel darah merah : melepas eritropoetin.
5. Pengaturan tekanan darah : RAA System
6. Pengendalian konsentrasi glukosa darah dan asam amino
7. Mengeluarkan zat racun
8. Activasi vitamin D
STRUKTUR ANATOMI GINJAL
Bentuk dan ukuran : seperti kacang bewarna

merah tua, panjang 12.5 cm, tebal 2.5 cm
berat : laki 125-175 gr, wanita 115-155
Letak : ginjal kiri lebih tinggi
Lapisan ginjal : fasia renal, lemak perirenal,
kapsul fibrosa
STRUKTUR INTERNAL GINJAL
1.Hilus
2.Sinus ginjal
3.Pelvis ginjal : kalik mayor dan minor
4.Parenkim ginjal : medula dan kortek
5.Lobus ginjal : Piramida, kolumna,
kortek
NEFRON
• Unit fungsional ginjal  pembentukan urin

• 1 ginjal terdiri dari 1-4 juta nefron
• Struktur nefron :
1. Glomurolus : viseral dan parietal
2. Tubulus kontortus proksimal
3. Ansa hanle
4. Tubulus kotortus distal
5. Tubulus dan ductus kolektikus
SUPLAI DARAH
1. Arteri renalis
2. Arteri interlobaris
3. a. Arkuata
4. Interlobularis
5. Arteriol aferen
6. Arteriol eferen
7. Vena kortek, vena interlobularis
8. Vena arkuata
Pembentukan urine
Fungsi ekskresi urine :
– Mengeluarkan sisa metabolik
– Mengatur komposisi cairan tubuh
Proses pembentukan urine :

1. Filtrasi glumerulus
2. Reabsorbsi tubulus
3. Sekresi tubulus
FORMATION OF URINE
1. GLOMERULAR FILTRATION
 filtration is the process in which blood pressure

forces plasma and dissolved material out of
capillaries.
 In glomerular filtration, blood pressure forces
plasma, dissolved substances, and small
proteins out of the glomeruli and into
Bowman’s capsules.
 This fluid is called renal filtrate.
GFR:
► Jumlah filtrat permenit

► Laki-laki 125 ml/mnt, wanita 110/mnt
► Faktor yang mempengaruhi :
 EFP
 Autoregulasi ginjal  dipicu perubahan rerata
tekanan darah arteri
 Stimulasi simpatis
 Obstruksi aliran urin
 Kelaparan, kurang protein, penyakit hati
 Penyakit ginjal
Komposisi filtrat :
► Dalam kapsula bowman = filtrat plasma,

yaitu air+zat terlarut dengan molekul
rendah ( glukosa, Cl, Na, K, Fosfat, urea,
asam urat, kreatinin)
► Sedikit albumin  direabsorbsi kembali
► Eritrosit dan protein tidak terfiltrasi
Fungsi Klirens Ginjal :
► Membersihkan plasma darah dari
sisa metabolisme : urea, nitrogen
► Dalam ml/mnt  volume darah / mnt
yang terbersihkan
Plasma Klirens (ml/mnt) = Laju ekskresi urin

( mg/mnt)
Konsentrasi plasma
(mg/mnt)
Konsentrasi urin dan pengenceran :
► Volume urine = 600 – 2500 ml

► Semakin banyak urin = semakin
encer
► Pengaturan volume urin :
 Mekanisme hormon : ADH, aldosteron
 Sistem arus bolak-balik dalam ansa
henle dan vena recta
2. TUBULAR REABSORPTION
 Tubular reabsorption :
takes place from the renal
tubules into the peritubular
capillaries.
 In a 24-hour period, the
kidneys form 150 to 180
liters of filtrate, and normal
urinary output in that time is
1 to 2 liters
Mechanisms of Reabsorption
1. Active transport—use ATP to transport :

These useful materials include glucose,
amino acids, vitamins, and positive ions.
2. Passive transport— many of the

negative ions that are returned to the
blood are reabsorbed following the
reabsorption of positive ions.
3. Osmosis—the reabsorption of water
follows the reabsorption of minerals,
especially sodium ions.
4. Pinocytosis—small proteins are too large

to be reabsorbed by active transport. They
become adsorbed to the membranes of
the cells of the proximal convoluted
tubulus.
HORMONES THAT INFLUENCE
REABSORPTION OF WATER
1. Aldosterone is secreted by the adrenal cortex in

response to a high blood potassium level, to a low
blood sodium level, or to a decrease in blood
pressure.
2. Atrial natriuretic peptide (ANP), which is secreted

by the atria of the heart when the atrial walls are
stretched by high blood pressure or greater blood
volume. ANP decreases the reabsorption of Na ions
by the kidneys;
3. Antidiuretic hormone (ADH) is released by the

posterior pituitary gland when the amount of water
in the body decreases.
3. TUBULAR SECRETION
► Changes the composition of urine.

► Substances are actively secreted from the
blood in the peritubular capillaries into the
filtrate in the renal tubules.
► Waste products, such as ammonia and
some creatinine, and the metabolic
products of medications may be secreted
into the tubulus
THE KIDNEYS AND
ACID–BASE BALANCE
 The kidneys maintaining the pH of blood

and tissue fluid within normal ranges.
 If body fluids are becoming too acidic, the
kidneys will secrete more H ions into the
renal filtrate and will return more HCO3
ions to the blood. This will help raise the
pH of the blood back to normal.
OTHER FUNCTIONS
OF THE KIDNEYS
► Secretion of renin When blood pressure
decreases  RAA Sistem.
► Secretion of erythropoietinThis hormone
is secreted whenever the blood oxygen level
decreases(a state of hypoxia)
► Activation of vitamin D—This vitamin
exists in several structural forms that are
converted to calcitriol (D2) by the kidneys.
ELIMINATION OF URINE
► The ureters, urinary bladder, and

urethra do not change the composition
or amount of urine, but are responsible
for the periodic elimination of urine.
THE URINATION REFLEX
 The stimulus for the reflex is stretching of
the detrusor muscle of the bladder. The
bladder can hold as much as 800 mL of
urine, or even more.
 When urine volume reaches 200 to 400 mL,

the stretching is sufficient to generate
sensory impulses that travel to the sacral
spinal cord.
 parasympathetic nerves to the detrusor

muscle, causing contraction. At the same
time, the internal urethral sphincter relaxes.

Anatomi Fisiologi Sistem Perkemihan

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ANATOMI

The formation of urine is the mayor

1. Pengeluaran zat sisa organik : urea, asam urat, kreatinin,

Bentuk dan ukuran : seperti kacang bewarna

• Unit fungsional ginjal  pembentukan urin

Proses pembentukan urine :

 filtration is the process in which blood pressure

► Jumlah filtrat permenit

► Dalam kapsula bowman = filtrat plasma,

Plasma Klirens (ml/mnt) = Laju ekskresi urin

► Volume urine = 600 – 2500 ml

1. Active transport—use ATP to transport :

2. Passive transport— many of the

4. Pinocytosis—small proteins are too large

1. Aldosterone is secreted by the adrenal cortex in

2. Atrial natriuretic peptide (ANP), which is secreted

3. Antidiuretic hormone (ADH) is released by the

► Changes the composition of urine.

 The kidneys maintaining the pH of blood

► The ureters, urinary bladder, and

 When urine volume reaches 200 to 400 mL,

 parasympathetic nerves to the detrusor

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