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Audrey - GNA PS Plus Basic Science - 20160311 - 0001
Audrey - GNA PS Plus Basic Science - 20160311 - 0001
|1.
Date
Arcuate artery
Arcuate vein
Juxi:.--: -
Cortical . e ah-a
radiate
veins
Cortical
radiale
arteries
lnlrlobar
arteries
Segmental
artery
Suprarenal
artry
Flenal
anery
Renal
vein
Pe':-tt-,:.
afteflole c3p 3:S
At erent
a*eriole Drs::
Renal -
iio: a
corpuscle
. ouc:
Fer:-,:-.:,
. ca:lrra:
:- Nephron
' lmp
(b) Corticai nephron
Renal cortex
Renal medulla -
lnner layer of -
Renal pyramid Prox.ma
fibrous capsule co.rcl! t:c
Peritubular t!brle rPa -
capillaries
Fenal sinus
Ccnnection to Glomerulus
minor calyx D,sra
Ad jpose tissue allli tr i.ia:
Minor calyx
in renal sinus
Major calyx
Fenal pelvi6
Hilum Hilur
Henal lobe
Benai papilla
Uretet Collecting
duct
Renal columns
- Peritubular
capiilaries
Nephron
Fibrous capsule toop
. Eonskari
Edlsitfl'ot a
\
[il;;- (Na+, ct-, r.*, &'*, Hn , Hcor- , ?oq'', a.
J
intrrlobc,{an!
t
v. lnterioh[ans /
Soqt- , M42+ ) "-t mcitiq , :bn C! L/a -LorhGqtis mdr'ata) raciu tcr
IT
l<or:
xd,?,,l t fud)
) jatr.,r a. renaiir hinqqa .agcu malrng ! npfon
- refogcrrtonza! [cLntarr^ otot Punqqung * f:+arurt\ r - atur Lcohn @nrasr un'n d4n ubah ([au: 9 yrcssurt
Wt-)
J ql. sogmrcnal dtaft"s t,ap gtn3a-Q @ noJ.zn
drgoteksi 1fiL,asi , 3 r#l kolsuto 6b*sa t"* e'L stimr.rtasi Do\epasan ro.nto--a--) retensi Na{ t air
\a . phr. adigaca I
I
. NErrorrl
c. (tscra onoJG oua,,
r) rormajnq^ tdo^lasa). rnemh lcecok[atan, t l0crn { F'Scm t Zca, *n( fungsiona\ qi,rja-Q. C *n,t i.,tzec,l d["r
/ ' -::-- suafu o,nao Vg
l
P
J isog (O-? : izs-t1oqr ; o* ' t,t-,ofi i nr*p" taLscrnalzan reorua 6/aqs\ otqan kb )
Pelvrrunat i qcrbu.q6,r e -3 -.- maiJor i#,T l#t;. tri"g hi"qqa m&{^ --+ kpiicr fedtubotr,tnua *Va.sa'
Lobr\us : \nrfton 'i I dubiug h\ebtilus Cdianto* 2 a . kod adtht*) . u-' nasLotar
baalcunq RECrh "
-r ... - Pt i,5,
meq-bnenkcsi 't-n (r"IiLtron) *.0
o
I
Glommlar capsule L)
capsular Glomsurur
tc"p"rr*-liooJ Podocyte
sprce capillary epithelium epithslium
Pores
Mffingial
cell
Efferent
aderiole Capillary
sdothelial
Di5lal cell
convolu'ted Dense
l!bule lay.'r
I-Macuta densa
t
[l Juxlaglomerular
II cells
l-
Juxtaglomsule
complex
Figure ?6-8 The Renal (orpuscle. (a) lmportanl structural features of a renal corpuxle- (b) This cross section throuqh a \c(11x1rl el llrr'
glomerulus shows the componenis of the filtration membrane of the nephron.
Renal tubule
I
'-i
i; Collecting duct
Capsular space
Glomerulus
Efferent arteriole
Afferent arteriole Variable reabsorption
of water and
Glomerular capsule
reabsorption or
Ascending secretion of sodlunr.
Descending
limb of potassium, hydrogen.
limb of
loop ends and bicarbonate ions
loop begins
I
I
Descending Ascending
llmb limb
KEY
Delivery of urine
Solutes to minor calyx
Fr ltrate Minor
Furlher reabsorption of $/ater calyx
Variabie
(descending limb) and both
reabsorption
cr secretiou
sodium and chloride
ions (ascending limb)
@
L) korp,.,s n'olph.a6'' ? nrciabot0 I otryc^o,c uasl< Dkr irn l.rs d eicr(t res, :
L to-2roiim Cdtana*cr) \;-URe^ { : t1q ptq bqk , orostiS r hasrl. pe.mecaha-i as -amiro
\ ,;{'#' = peges_ii- --.7 ada pedflca{ Cffi"e r a, t-lric .ao&-5-' tJ;trrE-EaF ir ulang basa nihoqen n o1ul61i KNA
\\.yzrr/aot Jt
L Sgu stxnto,at >) @ antara t*tit".' !-rro/a^,) 4*o *qr(n.,
L r' Gtor-, vnirip arctin _-) br \ronfrol dr'anetzr krpri'o-r ?.
Esx
il *:i
,i: .e'
'L.gon boru. ,)grrrruobc( {hd HLO
*d^ BlhSgS e
4sTlolar ,
glilcogcoLao
7 TkD L'Iltru(us LonLothus Distaa ) evm thouqh uJzvran pod blrir X berubah
Lr f p6sesyftaQ: L!) Sekrest atch{ ion],&samr, obat,toksln 4 Sinjai lennra 2D -z;o[u dt fol.aJ- Cardto6 69arr3
,^.a^
G) Reobs seteLh-( Alit \- Cat{ zrZ hrftrr,z.si inko kagsota boornan :) Fl nnnt
f- ",{"
(9) sc\tLttf air &) pon,a\catan rrrin Lao% nqrltr 41* a.ekx,4.^ G\ k"p- penfubtilus
Fro"bs O nornol "ga
LrJru\.^^ot" anhaua a,aftrcn I a,efercn => frpp"*lrt ],'^lr,gto'^e., *L lr*t,
*'S'5*'* --/*
[eOO Fr(kari ,
c60nt/do\)
o*unt"- O fYlo,vuh. l*rwa .ogftr,t Tro u >I & @,uvr*r^4o eW '""/','n
?@ t0l$Eoqb*rlar-. modlf"d srabut aloF yolos @a-a$-renogcn
ftrin
y,?o e- @ gil gotLfon Ltu,as / nuanqth.Q e*qhaXlornt,tlar)
' '- -- / @ ReabsorQei
j "- ',,- =per,rioc{ahonse(elch{bohao}beroa"["r"t drtomen fubu{uEkemheti
\r. ylam* kagier 7erifub*rloe ---r t}Z}.o -7 )tg tresirL,,'tari)
1 sa\masang,a{ t-eu,h%6* --/ *^'lll,E/n". t*ri['tl^'*
\ rnhogto-=fgsi , S,qosiFosis , g-ngokong paosrf , U d, LBD-yh,; + =V
ssk*riatDtcfo (trt,gpqp;, toq.rl^,; L,^rl-;)
d ' "
Ga^t'ln
rzgutaci blood (too qramrru[,.,s,
I @ go'*i
I
l, lrUrfr, koletchv,.rs CCot(ecii.g duct) , ganinclohao szleLh( tohanr d. k p gartubotus ft tu-u, frbrlrs
L" qrtct kolrrno,1 - doo/o '4q
x rZ6tt*si
Lt afur [a&tr*) l.omposi.i 6p.lran * tentulron lroocmkrasi osorohlc
ko,1,-,s rn,^ipl" ia6'' l{o Tnnsport * Z mclabotrt forqc.nic pastt pq Uq hrs dir[cshres,:
Medrmifr
L t<l - 2to ijrr)
( bn, lons Urea
, rnostig ; harrl pgmerahar: as .Gmino
. Na,al < K-, H', CA] 'vVater l
t?
,
lcreohhin ps@t @ eal oLot sLeleia{
ta?isan
1- f c" , .,r
-
Po,t Urob;iinogen
\ v.so_,'.
HCC Bilip"bin rr viqng ba:a nihagen polekoi trNA
Wastes
I
Crealinine
L, SEL MxAN6tA M","boti,", Ammonia 't+ro^x1*
L v 6t*n", o'':"t" Organi{ aclds and bares
\ - Ar:aO a( d5
Proteinl
L, h0,,..
Miscellaneous
NPurofiansilil10rs 3 ?*ro, c\.r.ca. e Gi^;a-a- ( P"mb"nlrko" L[..o )
iACl, NE, t, dopamine)
Histam:nr
@) tritt'"sr"
--? 1-Kp tT.rLuLs konlortus Pok-etmaA / P.. convo[,rled - fub,.,b ) "l Bbod Kdd6ral Barrio. K-- clmdio6 tcagiter qtomerr.rtus Cena*oi)
*--
'.'tot'
L, absorLsi nuFn'en orna-nrlc
, bnt , 4(r ' Frot'Pttsrnq (Trrada)
-)/Podos;L
'-,-, [ra'' "
'Y*."i*^'ilI::r,":TH"^-i^rl:::ff"
xsz\masonq,ar ,-"*w^-)
\ ,^*n*=f1<i , pd,ostl, *^'r+a,rL/ur". + *'\j['t/^'*
$qosrForis , p-r,r.1otong U a, Bo-t/u,i +
sdcrzsigftolcl. (tL1 ,foep), tttlrll^;n)
"
rcLnilhn
L'-r/-;)
reguta.i blood (too 4rawuru(o, "'
1f, luUur* Ieolalchvus Ccottecting d.uct ) "*' . ganindohao selerchf tohqn
r d. kug garitubulus ft lrmun frbrlrs
{"^l
i uir{,rt trno akl'r-. 6-@ n@ ,V fkrLresi
v
c.nn
Renal tubule
;l:rrnal cortvciuted '14 mnr 60 pnr Reabsorption o{ rons, Cuboidal cells with microvii i
-,.r.rie lPC i) organic molecules,
vitamins, water; secretion
of drugs, toxins, acids
tulicrovilli
Diiiai .on,loiLrted trrbLrle iDCT' 30-50 pm Reabsorption of sodium ions Cuboidal cells with few
and calcium ions; secretion if any microvilli
of acids, ammonia, drugs,
toxins
COTTECTING SYSTEM ,-
ioltcc:.rrrq duct 'I
5 mm 50-i 00 pm Reabsorption of water, Cuboldai to colun nar cel,:
sodium ions; secretion or
'-a.. reabsorption of bicarbonate tatic &lood)
: ions or hydroqen ions rcross capillary
;e layer.
r.:p larv ciuai 5mm 10G-200 pm Conduction of tubular fluid Columnar cells r,ransport, including
to minor calyx; contributes
! It (glucose, amino
to concentration gradient ,; (glucose, ions), and
of the medulla :with secretion of H')
: or osmosis (water)
with sodium ions
ions. lipid-soluble materlals, water
Secretion: HYdrogen ions,
ammonium ions. creatinine,
drugs, and toxins (as at DCT)
water Reabsorption" Sodium and Active transport via Nar-K./2 Cl*
I'lt.lllrron loop Reabsorption ol 25o/o of the
(45 Udai) and 20-25% of the chloride ions transporter
sodium and chloride ions present in Water Osmosis
the original filtrate; creation of the
concenlration gradient in the medulla
I )i\l.al convoluted Reabsorption of a variable amount Reabsorption" Sodium and Cotransport
ttrbule (DCT) of watei (usually 5%, or 9 Uday),
- chloride ions
lOl stimulation, and a Sodium ions (variable) Countertransport with Potassium
unOer
ions; aldosterone-regulated
variable amount of sodium ions,
stimulation Calcium ions (variable) Carrier-mediated transPort
under aldosterone
stimulated by ParathYroid
hormone and calotriol
Water (variable) Osmosis; ADH regulated
Secretion'. Hydrogen ions, Countertransport with
ammonium ions sodium ions
Creatinine, drugs, toxtns C arrier-mediated transport
Reabsorption of a variable amount of Reabsorption: Sodium ions (variable) Countertransport with Potassium
Collecting system
water (usually 9.3%, or 16.8 UdaY)
or hydrogen ions; aldosterone-
reoulated
under ADH stimulation, and a
variable amount o{ sodium ions. Bicarbonate ions (variable) Diifusion, generated within tubular cells
Water (variable) Osmosis; ADH*egulated
under aldosterone stimulation
Urea (distal portions only) Diffusion
Seffetron: Potassium and Carrier-mediated transPort
hydrogen ions (variable)
Return of water and solutes osmosis and diffusion
Peritubular caPillaries Redistribution of water and solutes
reabsorbed in the cortex to the general circulation
Return of water and solutes to Osmosis and diffusion
Vatarecta Redistribution of water and solutes
reabsorbed in the medulla and the general circulation
stabilization of the concentration
gradient of the medulla
Region Length Diameter Primary Fun(tion Histological Characteristics
NEPHRON
'l5S-250 pm
Renal corpuscle
Capsular
150-250 pm Filtration of plasma Glomerulus (capillary knot),
(spherical)
space mesangial cells, and dense layeq
enclosed by the glomerular
Capsular -:.' capsule; visceral epithelium
,.ollhelium
(podocytes) and capsular
Capillaries epithelium separated by
ot glomerulus \ capsular space
y;"s.;d _)
:! lrel Lltr
Renal tubule
: .,. ..1 atrt,,C tieCl 14 mm 60 pm Reabsorption of ions,
ir. .:,.i ri l Cuboidal cells with microvilti
organiC molecules,
vitamins, water; secretion
of drugs. toxins, acids
i.lrcrov rlli -....-.......-
Date
KONTRDL AFK
--.--^..---.:.
@ Aoro<equLasi (wto,o'ne niryn&c)
G saa* b? (btmd ?cessure) \ : t . Aifo;la;i a- aferen
:. re{qt.sasi sc( yenyoVmg r d(aFasi
lapiter gloaerrtbe
3. lcoFstnlci a-eQrn
Lrroo.t.g,t' ; @nstnki a.aferal \ 6fn
' has,1 lrzbe.adr,tr sr,,sgensi grolern , enderung rn.nc.i{c air te lihtban agpmkus /csraltomeota.
-r a1:"1t =) sistm Mft
d.r fttfrat '\ glasma I U.,Q aepdeonq ginc{ah ...1r,:r'1 i clradt(-'. ti ki4g<t- eglL;6t:* h( :
' dftrbrlkoo coican @ aroai tubutos I olrtz;t tzsrslensi ahean a. % Lonscnkusi osmohk calran fubuler @ qqtq!6( &n'*':i:l:'2
catcan sqanjcmg ,retrcn & 'condoclf
I
efstem oq'
'r q** *-f :| makora deasa,fszvrerib- f1)lu*t^'
1v ade oo s in
-//v'?
L"Tj+g:a- r ? *,bfo*
Geauniu C\zaan s- =- 2m[h unn n
t, / onk ksr'
t
) G
k&r glosma
\ e rr<
,.tf,""{iu.
CC.CI
u
|
{\'l ir.r^sitiv(tcm s{rum c( J
*rt*l hnqoik6varftzo-tto'[,
dab6 irrom?Q.rlanrLal t"Ju p,;&L*- 61hr.&
) ,t"p dan ka1,i{ct
'"
g > arorut t9 = Jnottn c[eoraoce , h ) tq dttotcuk*"t d.f d mqlffisme aukareg,-.r!rir'
Lr"r g,*.ftto.r' 1
o
<0
a?z:
fr eftrt' b ao,na{k"{;];';,il
n @ Vrod'aon noroal , AHP 19 {* Atalur ; ,C / "\ Lrq
I qa uoaoon c GHP ig bs bonlbah sh9 itut
pnqorutri ^1 L-i:-q @,1 iL rr peru6. {c\., a.rltx csia6 dr' [r,,ar Lieatz.,r rrufo,zqr:lr.si , rntka,rLlire
ffi ;isii.ffi#
geCorA
han teLih
di c6E
ct)
I
I
oleh tubukcs
(t
mengikuti
pasif),
*--l*
Vasopresrn Haus I Vasokonstriksi
_t afteriol
i
I
I Reabsorpsi H2O
oleh lubulus ginlal
Gambar 14*tE
Sistem renin-angiotensin-aldoJteron'(SRAA). Ginjal mengeluarkan hormon renin sebagai respons terhadap r.o NS,
volume CES. dan tekanan darah arteri. Renin mengaktifkan angiotensinogen. suatu protein plasma yang dr h.rh,
rrrenjadi angiotensin l. Angiotensin I diubah menjadi angiotensin ll oleh angrotensin-conveiting enzylne drqrod,-rrr dr
'
paru. Angiotensin ll merangsang korteks adrenal untuk mengeluarkan hormon aldosteron, yang merangsa*q Ua+
oteh ginlat. Rentesi Na' yang teriadi menimbulkan efek osmotik yang menahan lebih banyak HrO di CES. Be{S!
t(onservasi Na'dan H.O membantu mengoreksi rangsangan semula yang mengaktifkan sistem hormon ini. rxs 3 lrg.,
rrremitiki efek lain yang membantu mengoreksi rangsangan semula, misalnya dengan mendorong
- shmutasi reabs. loo l\la+ !' l[,D @ 11.P / @ p*^ pemharra N-lat-kr ATPcree
kt dlm memt'ran b,so tatera^e4iko
i. kote{cliws
)1. .
= PentaLL 6o*wlu, =
?at-oqenrri.'
'- giome,zirs =i-q Lrn mzkarr&nrr i,rrun (e.p.hruro*l )
gr\c.s
hge 1 + ln situ 1m.rne Grgt", Do4osihbn u)cio . tr'mhl abrl , I1*toni (6tiyio(ik Rtsc) add, ?f'nh'
G lcjar tm anhbodfglzredar dlm drh bz.x dgn annqen@g{oorerulos b:ffiI1*
D ti0onh
t-tttormot't\
'nfnri N6* $ftrnoiar
cast5
L) &nhlrn
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A
p
iahemia
rohzinuna 6nngm
-redan6)
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Slcin
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@^q'h\
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;b,,)
ptanted)
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v
clh : ohat , Uua lsq51- , ,rt Caianaoi
^l tiltr Aso l Asro
L, ).:* t - cndagrn lcoarplzics anhqo -anhbodt Xlaner-ulus khn , nrcmh lrr.robtop1o + trbL ptccftiae hal,,rs
L- anr'qeJZ;q;7 . .Jr^ DNA (stE) / Lr milcorkotrr! : miLraskog chg : 0toeha-- rhinlbecar , hipexelolnr,
\ + -r
.'{_gtr,j,C , ct{a 6ru Eoc" (hqloLokus ,ll l\ alirao /6qb barkoana
, matorrh
-
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' K l,rstnrr^si Im,?r.etfmn: qumplan amotf subeprfukie{ t'ffi:i
. iu sca skePtD
'p \>as cv;ot.oq
- 6N Vnn*r 1 , 6N prolrfcctif dtps aLot ( nDD -pasa tu
6 bd* ron,1t t Sindorna oc(th'f. : kutt poli(totive.6[V (po,r,infzcr,ars 4miloidolts , korrbor,\ vc.na 6cna1i5 )
Ltinila -- r-\
il\- n" poqr-uifcrpctt tRPoN) e's1-sn pi'n2,- ( uol, t
Q9 r,
/ \\ s"a,* ufroh. r MoN, McD , Fs6s , MPa^,
,\ I
/ lsot"tca (n'mn1 Abru'uatrhee : ne$apah XgA , At1lotl t,and, @o*1 , neghth'c neghroht
thh -ihto
crlntor'ahk
f Lklainao ) baswnt marbmne dtsgart
I6rU k.n,ir. t&n'go Imitru! {leruronu) .1.
Dr-gr. , f:) Bonnn \c,.ririrrr di . S?Fo ?o e NU O -roobt e !q Med. (mor v,dtcx, " [\rep!roh-< vs lVef hn'hr \nd Erolunecl tiearl4
fO i?D (q'"i*l Hixrknri ) 9*t' n4 O, tu.l-ubc b9 USMuE i\h\ar Cnq . 6lonreruiooephrrh! l\kfin'h, lynritt,.u * U!qLE
@ Ro'bbint I Co{no falholoqic ba$ oe D,vox. gthea 1,. t\ .- Nlphoh? ,,
o
No.
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o) dfdahutri inf skcgtokotros p-'trenr\rhlcus 6rup LUdq ?A
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U
I
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-t{'/o
5 Vt-ndnLa ft,ingrhi -;) 6run
to'/u 1
fasrlo ,a.ilb'qo
olo Lrr4anlung saoh'pe I fu.nPae io&k,i
insidcns.
' |- 7Z
f* tr1"r!i -/ @ f-wp& A! icut'dens \ lP 57.,5O)Uow rouncu[ @ c. qernbenfulrao [<omp\cbs lmun in st']v atlatq. antibodi aotir]rzptokokos
ne4aw: lcurang kr{conrlnnq '. Ainto, ltcaur frrqoh, ffi dg. Otomo.,,to. &pstted ant\oo
L', fr"ArU dqo slafus nrrtnli , hig-err?a s t d. atctivari \:omplruo /,irtcF 6 anhgen sf,-cpto^ gg tz,{qosisi
?o,ngqu?aan Utf:tf,
H rouncu{ b.rrooro* ogn $on$}Eot" bfi hfort'a
")G\4r.{atlns I MorllttGas . Kli,ri5
Vft.n,-ttrLot FI,r'5| qnboh &
to eorlr4 dto*l^ , ll'L @ a"au! , )5o1o @ du'tatcn o) umuo.qA si.don ntfttis atur m\;nco\ l-1 u'E ?ctscalg;ngihs /
I ..*.crhvc
oatcfuot Ci'e
|qrL.
'"f azotetnia
,- Z'L u*. fn gi,rde...a- stw4tato*a
La prcteinunh nzphcoht -,-anqc. . 2oolo a&)19 , tt,'loob chtld.e" j) {qt- dc.ra3clt b?ralu;n kcf,usakan gtnjalnga I
lpnqfuria norrul aross h(metun'^
" d4n
nLro*"pilc l4o n*I
carrnptornofilc 0tr A1<1
-) Usca t gcn&^-
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ry X e[rna gulrnor"r. J q1t:
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\____--.' Ir
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vV rtsoploc
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(to)
, hipe.tgn., ,
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) -)
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