Anatomi dan Fisiologi

Ginjal

Presentan: dr. M. Haryadi Ade Kurniadi

Pembimbing: dr. Surya Darma, SpPD, FINASIM
 Lokasi Ginjal
• mass about 150 g (5 ounces).
Average dimensions : 12 ; 6 ;
and 3 cm

bf 7

• Kidneys lie in a retroperitoneal position

in the superior lumbar region.
• The right kidney is
crowded by the liver and lies slightly
lower than the left.
Struktur Ginjal
 Renal capsule
Renal cortex
Renal corpuscle

Nephrons Renal
Renal medulla cortex

Minor calyx

Major calyx

Renal sinus Renal

medulla
Renal column Renal
Collecting tubule
Fat duct
in renal sinus
Papilla

Renal pelvis Minor calyx

Renal papilla
(b) (c)
Renal pyramid

Ureter

(a)
Blood and Nerve Supply
 Slit pore Pedicel Primary process
Afferent Efferent of podocyte
arteriole arteriole
Blood
flow
Blood
flow

Glomerular
capsule

Parietal layer
of glomerular
capsule
Slit pore
Glomerulus

Visceral layer of
glomerular capsule
Proximal
convoluted
tubule Pedicel Primary process
of podocyte
© David M. Phillips/Visuals Unlimited
 Nephrons

Location and structure of nephrons.

Renal cortical tissue and renal tubules
Blood Supply of a
Nephron
Cortical and Juxtamedullary Nephrons

Cortical nephron

Renal
cortex

Juxtamedullary
nephron

Renal
medulla

Collecting
duct
Juxtaglomerular Apparatus
 Fungsi Ginjal
• Mempertahankan keseimbangan H2O di tubuh.
• Mempertahankan osmolaritas cairan tubuh yang
sesuai, terutama melalui regulasi keseimbangan
H2O. Fungsi ini penting untuk mencegah fluks-fluks
osmotik masuk atau keluar sel.
• Mengatur jumlah dan konsentrasi sebagian besar
ion CES, termasuk natrium (Na+), klorida (Cl-),
kalium (K+), bikarbonat (HCO3-).
• Mempertahankan volume plasma yang tepat.
Fungsi ini melalui peran regulatorik ginjaldalam
keseimbangan garam (Na+ dan Cl-) dan H2O.
 Fungsi Ginjal
• Membantu mempertahankan keseimbangan
asam-basa tubuh.
• Mengeluarkan produk-produk akhir (sisa)
metabolisme tubuh.
• Mengeluarkan banyak senyawa asing.
• Menghasilkan eritropoietin.
• Menghasilkan renin
• Mengubah vitamin D menjadi bentuk aktifnya.
 Urine Formation
• The main function of the nephrons and collecting ducts is to
control the composition of body fluids and remove wastes
from the blood, the product being urine
• Urine contains wastes, excess water, and electrolytes
• Urine is the final product of the processes of:
• Glomerular filtration
• Tubular reabsorption
• Tubular secretion

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 Glomerular Filtration
• Glomerular filtration
• Substances move from the blood to the glomerular capsule
 Glomerular
Filtration Rate
 Effects of Aldosterone

Aldosterone is a hormone secreted by the adrenal cortex.

It helps regulate the concentration of extracellular

electrolytes by conserving sodium and excreting potassium
ions. Its secretion is regulated by concentration of
electrolytes in body fluids and by the renin-angiotensin
mechanism.

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Effects of ANP
ATRIAL NATRIURETIC PEPTIDE (ANP)
A hormone produced by the heart, atrial
natriuretic peptide (ANP), increases sodium
excretion and decreases blood pressure and
blood volume.
ANP is released into the bloodstream in response
to stretching of the atrial muscle cells by
increased blood volume.
ANP has the following physiological effects:
• Increases glomerular filtration rate by dilating
afferent arterioles
• Inhibits the collecting ducts from reabsorbing
sodium, both directly and indirectly (by
inhibiting aldosterone secretion)
• Inhibits release of renin
The renin-angiotensin system and ANP function
antagonistically in the maintenance of
fluid/electrolyte balance and blood pressure.
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 Tubular Reabsorption
• Tubular reabsorption
• Substances move from the renal tubules into the
interstitial fluid where they then diffuse into the
peritubular capillaries
• The proximal convoluted tubule reabsorbs (70%):
• Glucose, water, urea, proteins, and creatine
• Amino, lactic, citric, and uric acids
• Phosphate, sulfate, calcium, potassium, and sodium
ions

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 Tubular Secretion
• Tubular secretion
• Substances move from the plasma of the peritubular
capillaries into the fluid of the renal tubules
• Active transport mechanisms function here
• Secretion of substances such as drugs and ions

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 Peritubular capillary

Blood flow

K+ or H+

Tubular reabsorption Tubular secretion

Na+ Na+
Na+ Na+ H+ K+
Na+
Na+
Na+ K+
K+
Na+
Na+

Na+
Tubular fluid Distal convoluted tubule H+

Na+
K+

Na+ Na+

Ascending limb Collecting duct

of nephron loop
 Tubular secretion is important
for:
• Disposing of substances, such as certain drugs and
metabolites, that are tightly bound to plasma proteins.
• Eliminating undesirable substances or end products that
have been reabsorbed by passive processes.
• Ridding the body of excess K+.
• Controlling blood pH.
Mechanisms for forming dilute
and concentrated urine.
Summary of tubular
reabsorption and
secretion.
 Daftar Pustaka
Irianto, K., 2012, Anatomi dan Fisiologi, Alfabeta,
Bandung, pp. 288-290.
Sherwood, L., 2013, Human Physiology: From
Cells to Systems, 9th Edition, Cengage
Learning, USA, pp.960-985.
Sherwood, L., 2011, Fisiologi Manusia, edisi 6,
EGC, Jakarta, pp.553-590.