ANATOMI-FISIOLOGI SISTEM

KEMIH
DIANA IRAWATI
Anatomy: Urogenital tract
 FISIOLOGI GINJAL

• Regulasi volume darah melalui proses sekresi air

• Regulasi elektrolit darah
• Regulasi keseimbangan asam-basa melalui
eksresi ion H+ dan HCO3
• Produksi dan sekresi hormon
• Ekskresi produk sisa metabolisme
• Regulasi tekanan darah
KIDNEY
 NEPHRON
• Unit fungsional ginjal
• Berjumlah 1-1.2 juta
• Proses pembentukan urin:
 Filtrasi
 Sekresi
 Reabsorpsi
 Filtrasi Plasma

• Komponen plasma akan melewati 3 lapisan glomerulus

selama proses filtrasi
1. Kapiler endotelium
2. Membran basal
3. Epitel kapsula bowman
• Kemampuan molekul melewati membran sangat
dipengaruhi oleh ukuran, bentuk dan pengeluaran
• Proses filtrasi yang melewati barier glomerulus belum
berupa urin
Glomerular Filtration Rate (GFR)
Measure of functional capacity of the kidney
Dependent on difference in pressures between
capillaries and Bowman’s space
Normal = 120 ml/min =7.2 L/h=180 L/day!!
(99% of fluid filtered is reabs.)
Reabsorption
and secretion
 Reabsorption
• Active Transport –requires ATP
▫ Na+, K+ ATP pumps
• Passive Transport-
▫ Na+ symporters (glucose, a.a., etc)
▫ Na+ antiporters (H+)
▫ Ion channels
▫ Osmosis
 What is Reabsorbed Where?
• Proximal tubule - reabsorbs 65 % of filtered Na+ as
well as Cl-, Ca2+, PO4, HCO3-. 75-90% of H20. Glucose,
carbohydrates, amino acids, and small proteins are
also reabsorbed here.
• Loop of Henle - reabsorbs 25% of filtered Na+.
• Distal tubule - reabsorbs 8% of filtered Na+.
Reabsorbs HCO3-.
• Collecting duct - reabsorbs the remaining 2% of Na+
only if the hormone aldosterone is present. H20
depending on hormone ADH.
Sekresi

• Proximal tubule – uric acid, bile salts,

metabolites, some drugs, some creatinine
• Distal tubule – Most active secretion
takes place here including organic acids,
K+, H+, drugs.
URETER
• Mengalirkan urin  vesika urinaria P: 25-
30 cm
• 3 lapisan
• * Luar : jaringan ikat
• * Tengah : longitudinal & sirkuler
• * Dalam : selaput lendir
Urethra
• Perempuan : P  4 cm
• Laki –laki : P  ± 15-20 cm
• Letak : retroperioneal torakal 12-
lumbal 3
TERIMA KASIH