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GINJAL KUNCORO PUGUH S. FUNGSI Pengaturan keseimbangan air & elektrolit Pengaturan konsentrasi osmolaritas cairan tubuh & elektrolit Pengaturan keseimbangan.

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Presentasi berjudul: "GINJAL KUNCORO PUGUH S. FUNGSI Pengaturan keseimbangan air & elektrolit Pengaturan konsentrasi osmolaritas cairan tubuh & elektrolit Pengaturan keseimbangan."— Transcript presentasi:

1 GINJAL KUNCORO PUGUH S

2 FUNGSI Pengaturan keseimbangan air & elektrolit Pengaturan konsentrasi osmolaritas cairan tubuh & elektrolit Pengaturan keseimbangan asam basa Ekskresi hasil sisa metabolisme Pengaturan tekanan arteri Sekresi hormon Glukoneogenesis

3 Excretion The removal of organic waste products from body fluids Elimination The discharge of waste products into the environment Homeostatic regulation of blood plasma Regulating blood volume and pressure Regulating plasma ion concentrations Stabilizing blood pH Conserving nutrients Functions of the urinary system

4 ANATOMI FISIOLOGI GINJAL ANJING

5 ANATOMI FISIOLOGI GINJAL SAPI

6 Figure 26.3 Figure 26.3 The Urinary System in Gross Dissection

7 ANATOMI & FISOLOGI

8 Cortical nephrons ~85% of all nephrons Located in the cortex Juxtamedullary nephrons Closer to renal medulla Loops of Henle extend deep into renal pyramids Two types of nephron

9 Figure 26.7a Figure 26.7 Cortical and Juxtamedullary Nephrons

10 Figure 26.7b, c Figure 26.7 Cortical and Juxtamedullary Nephrons

11

12 Production of filtrate Reabsorption of organic nutrients Reabsorption of water and ions Secretion of waste products into tubular fluid Nephron functions include:

13 Regulating blood volume and composition Excreting waste products Urea Creatinine Uric acid Urine production maintains homeostasis

14 Filtration Blood pressure Water and solutes across glomerular capillaries Reabsorption The removal of water and solutes from the filtrate Secretion Transport of solutes from the peritubular fluid into the tubular fluid Basic processes of urine formation

15 Figure 26.9 An Overview of Urine Formation Figure 26.9

16 Filtration in the kidneys modified by carrier mediated transport Facilitated diffusion Active transport Cotransport Countertransport Carrier proteins have a transport maximum (T m ) Determines renal threshold Carrier Mediated Transport

17 Accomplished via diffusion, osmosis, and carrier-mediated transport T m determines renal threshold for reabsorption of substances in tubular fluid Reabsorption and secretion

18 Superficial outer cortex and inner medulla The medulla consists of 6-18 renal pyramids The cortex is composed of roughly 1.25 million nephrons Major and minor calyces along with the pelvis drain urine to the ureters Sectional anatomy of the kidneys

19 NEPHRON Merupakan unit fungsionil terkecil ginjal  1 Juta / Ginjal Panjang seluruh nephron = 45 – 65 mm

20 GLOMERULUS Kapsula Bowman : pars visceralis & pars parietalis Filter glomerulus : 3 lapis 1.Endhotelium kapiler :100nm 2.Lamina basalis :8 nm 3.Epithel Pars viceralis kapsula Bowman ( Podocyt) : 25 nm Luas area filtrasi  0,8 m 2 Ultra filtrat = plasma - protein

21 Figure Glomerular Filtration Figure 26.10

22 Figure 26.8 The Renal Corpuscle Figure 26.8a, b

23 Figure 26.8 The Renal Corpuscle Figure 26.8c, d

24 Figure Glomerular Filtration Figure 26.10a, b

25 Proximal convoluted tubule (PCT) Actively reabsorbs nutrients, plasma proteins and ions from filtrate Released into peritubular fluid Loop of Henle Descending limb Ascending limb Each limb has a thick and thin section Functional anatomy of the nephron Animation: Urinary System Anatomy PLAY

26 Glomerular filtration produces fluid similar to plasma without proteins The PCT reabsorbs 60-70% of the filtrate produced Reabsorption of most organic nutrients Active and passive reabsorption of sodium and other ions Reabsorption of water Secretion also occurs in the PCT Reabsorption and secretion at the PCT Animation: Early Filtrate Processing PLAY Animation: Glomerular filtration PLAY

27 TUBULUS PROKSIMALIS P = 15 mm Tight junction Lateral intercellular space Brush border Reabsorbsi 65 % Zat yg direabsorbsi tidak disekresi kecuali K + Sekresi zat diikat oleh protein plasma

28 Figure Transport Activities at the PCT Animation: Proximal Convoluted Tubule PLAY Figure 26.12

29 The loop of Henle and countercurrent multiplication Countercurrent multiplication Between ascending and descending limbs of loop Creates osmotic gradient in medulla Facilitates reabsorption of water and solutes before the DCT Permits passive reabsorption of water from tubular fluid

30 ANSA HENLE Pars decendent : mm Pars Ascendent : mithokondria >>, Sel Junxtaglomerular vas. Afferent mensekresi RENIN ANSA HENLE SEGMEN TIPIS : permeabilitas besar, metabolisme minimal ANSA HENLE SEGMEN TEBAL : tidak permeabel thd H2O & Ureum, reabsorbsi aktif Cl - & Na +

31 Figure 26.13a Figure Countercurrent Multiplication and Concentration of Urine

32 Figure 26.13b Figure Countercurrent Multiplication and Concentration of Urine

33 Figure 26.13c Figure Countercurrent Multiplication and Concentration of Urine

34 Distal convoluted tubule (DCT) Actively secretes ions, toxins, drugs Reabsorbs sodium ions from tubular fluid Functional anatomy of the nephron Animation: Urinary System Dissection and Flythrough PLAY

35 DCT performs final adjustment of urine Active secretion or absorption Absorption Tubular cells actively resorb Na + and Cl - In exchange for potassium or hydrogen ions (secreted) Reassertion and secretion at the DCT

36 TUBULUS DISTALIS P = 5 mm Ephitel lebih pipih dari ephitel tubulus proksimalis Brush border (─) Bagian proksimal = segmen tebal ansa henle Bagian distal terjadi ion exchange K+ dg Na+ : Hormon Aldosteron

37 Figure Figure Tubular Secretion and Solute Reabsorption at the DCT Animation: Distal Convoluted Tubule PLAY

38 Figure 26.14c Figure Tubular Secretion and Solute Reabsorption at the DCT

39 Reabsorption and secretion along the collecting system Water and solute loss is regulated by aldosterone and ADH Reabsorption Sodium ion, bicarbonate, and urea are resorbed Secretion pH is controlled by secretion of hydrogen or bicarbonate ions

40 DUKTUS COLLIGENTES P = 20 mm Menampung beberapa tubulus distalis Ber muara di papilla renalis Bagian Cortex : tidak permeabel thd ureum Bagian medulla ; permeabel thd ureum ADH < : tidak permeabel thd H2O

41 Figure 26.6 A Representative Nephron Figure 26.6

42 Figure 26.5 The Blood Supply to the Kidneys Figure 26.5c, d

43 Figure 26.5 The Blood Supply to the Kidneys Figure 26.5a, b

44 SUPLAI DARAH GINJAL

45

46 RENAL FRACTION Vasa afferent glomerulus membentuk vasa recta Renal Blood Flow = 1200 ml/menit Cardiac Out Put = 5000ml/ menit Renal Fraction = 1200/5000 X 100% = 24%

47 KECEPATAN ALIRAN DARAH TIAP 100 g JARINGAN ORGANBLOOD FLOW (ml / min ) Otot Skelet Otak Hati Otot Jantung Ginjal

48 ALIRAN CAIRAN DLM TUBUH JARINGANKecepatan (ml/min) Reabsorp si ( %) Tubulus Proksimal Ansa Henle Tubulus Distalis Duct. Colligentes Urine ,3 0,7

49 REABSORPSI ELEKTROLIT ( kation ) perlu dikendalikan, bila berubah : kegagalan faal ginjal K+ > : potensial membran < : paralisis K+ : paralisis Na+ << : Potensial aksi < : paralisis Ca++ : tetani

50 Amount of filtrate produced in the kidneys each minute Factors that alter filtration pressure change GFR Glomerular filtration rate (GFR)

51 GLOMERULAR FILTRATION RATE ( GFR) Jumlah filtrat yg disaring dr plasma dalam satu menit Normal :  125 ml / min Lebih dr 99% direabsorpsi Produk urine :  1 L / hari Zat yg digunakan untuk mengukur : Inulin, Manitol

52 A drop in filtration pressure stimulates Juxtaglomerular apparatus (JGA) Releases renin and erythropoietin Factors controlling the GFR

53 FAKTOR YG MEMPENGARUHI Perubahan Tek. Darah 1.Tek. Darah umum 2.Status vasa afferent / efferent Contoh : latihan jasmani : vasokontriksi vasa afferent Caffein : Vasodilatasi vasa afferent

54 Perubahan Tekanan Capsular : Obstruksi, Edema jaringan Perubahan Tek. Osmotik Koloid : Dehidrasi, Hipoprotein Perubahan Permeabilitas : Peny. Ginjal, Keracunan Obat Perubahan Luas Area Filtrasi : Peny. Ginjal, Nephrotomy

55 FILTRASI GLOMELURUS Effective Filtration Pressure (EFP) Tek. Darah – Tek Capsular – Tek Koloid Osmotik = 70 – 20 – 32 = 18 mmHg

56 DIURETIKA Zat yg dpt meningkatkan kec.pembentukan urine Cara : 1.Meningkatkan GFR 2.Mengurangi reabsorpsi cairan dlm tubuh Terapi : Edema, Hipertensi Mekanisme kerja : 1.Meningkatkan GFR 2.Meningkatkan muatan osmotik koloid tubuh 3.Menghambat ADH

57 MENINGKATKAN GFR Cara : 1.Tek darah > 2.Vasodilatasi vasa afferent 3.Vasokonstriksi vasa efferent 4.Tek. Osmotik Koloid <

58 BEBERAPA JENIS OBAT EPINEPHRINE : Tek darah   Tek Caps Bowman   GFR   Diuresis  DIGITALIS : Decompensatio Cordis  sirkulasi diperbaiki  P Bowman   GFR   Diuresis  THEOPHYLIN & CAFFEIN : Vasodilatasi Vasa Aff.  P Bowman   GFR   Diuresis 

59 MENINGKATKAN MUATAN OSMOTIK TUBULUS 1.Mempunyai efek terutama di tub. Proks: Ureum, Sukrosa, Manitol, Glukosa 2.Menghambat Reabsopsi Na+ Di Ansa Henle : Furosemide, Ethacrynil Acid Di Tub. Distal bgn Proksimal : thiazide, metalazone Di tub. Distalis bgn Distal : spironolactone, amiloride

60 Menghambat ADH ADH   reabsorpsi H2O di Ductus colligentes   diuresis  Alkohol, narkotika, anastesi

61 Figure 26.11a Figure The Response to a Reduction in the GFR

62 Figure 26.11b Figure The Response to a Reduction in the GFR

63 Figure A Summary of Renal Function Figure 26.16a

64 Figure Figure The Effects of ADH on the DCT and Collecting Ducts

65 Figure 26.15a, b Figure The Effects of ADH on the DCT and Collecting Ducts


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