Dr. Dedi Ardinata, M.Kes.

Bagian Fisiologi FKUSU, Medan

Sistem Perkemihan
(The Urinary System)

Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings

 Fungsi Sistem Perkemihan
 Membuang sisa metabolisme :
 Sisa metabolisme Nitrogenous :
ureum, creatinin, uric acid.

 Racun-racun/Toxins

 Obat-obat/Drugs

Slide
15.1a
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 Fungsi Sistem Perkemihan
 Pengaturan homeostasis :
 Keseimbangan air
 Elektrolit
 Keseimbangan asam-basa darah
 Tekanan darah
 Produksi darah merah
 Mengaktifkan vitamin D
Slide
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings 15.1b
 Organ sistem perkemihan

 Ginjal/Kidneys
 Ureter/Ureters
 Kandung kemih
(urinary bladder)
 Uretra/Urethra

Figure 15.1a
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 Bagian Ginjal
 Renal cortex –
outer region
 Renal medulla –
inside the cortex
 Renal pelvis –
inner collecting
tube

Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Figure 15.2b Slide 15.3
 Aliran darah (Blood Flow) Ginjal

Figure 15.2c

Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 15.7
 Nephrons
 Struktur dan fungsi unit terkecil ginjal
 Bertanggungjawab membentuk urine
 Struktur nephrons :
 Glomerulus
 Renal tubule (tubulus renalis)

Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 15.8
 Bentuk Nephrons
 Cortical nephrons
 Berada pada cortex
 Sebagian besar nephrons

Figure 15.3a
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 Bentuk Nephrons
 Juxtamedullary nephrons
 Dijumpai pada batas cortex dan medulla

Figure 15.3a
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 Glomerulus
 Jaringan Kapiler khusus
 Melekat pada arterioles
kedua sisi
 afferent arteriole
 efferent arteriole

 Berada dlm glomerular

capsule (bag.pertama
renal tubule)

Figure 15.3c

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Renal Tubule

 Glomerular
(Bowman’s) capsule
 Proximal convoluted
tubule
 Loop of Henle
 Distal convoluted
tubule

Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Figure 15.3b Slide
 Proses pembentukan urine

a. Filtration
(filtrasi)
b. Reabsorption
(reabsorpsi)
c. Secretion
(sekresi)
Figure 15.4

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 Filtrasi (Filtration)
 Air dan senyawa-senyawa kecil proteins
dapat melewati dinding kapiler
 Sel-sel darah tak dapat melewati dinding
kapiler
 Filtrate (hasil filtrasi) dikumpulkan
glomerular capsule, kemudian ke renal
tubule

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 (Reabsorpsi) Reabsorption
 Peritubular capillaries menyerap :
 Air
 Glucosa
 Asam amino
 Ion-ion
 Penyerapan sebagian besar terjadi pada
proximal convoluted tubule

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 Zat yang tak direabsorbsi

 Sisa metabolisme Nitrogenous

 Urea
 Uric acid
 Creatinine
 Air yang berlebihan

Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide

 Sekresi (Secretion)
(Kebalikan Reabsorpsi)

 Beberapa zat berpindah dari peritubular

capillaries ke renal tubules
 Hydrogen and potassium ions
 Creatinine
 Zat-zat meninggalkan renal tubule
berpindah ke ureter

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 Pembentukan Urine

Figure 15.5
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 Karakteristik Urine digunakan
untuk Diagnosa
 Warna kuning disebabkan pigment
urochrome (dari penghancuran
hemoglobin) and zat-zat terlarut lain
 Steril
 Sedikit beraroma
 pH Normal sekitar 6 (4.5-8)
 Specific gravity : 1.001 to 1.035
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 Ureter
 Saluran “Tube” yang melekat pada
ginjal dan menuju ke Kandung kemih
(bladder)
 Merupakan lanjutan renal pelvis
 Masuk melalui bagian posterior kandung
kemih
 Peristalsis membantu gaya grafitasi
untuk memindahkan urine.

Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide

 Kandung kemih
(Bladder/Vesica Urinaria)
 “Smooth”, “collapsible”, kantong berotot.
 Menampung/menyimpan urine sementara

Figure 15.6
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 Kandung kemih
 Trigone – tiga pembukaan
 Dua dari ureter
 Satu ke urethrea

Figure 15.6
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 Dinding Kandung kemih

 3 Lapisan otot polos (detrusor muscle)

 Mukosa : “transitional epithelium”

 Dinding : tebal dan berlipat saat kandung

kemih kosong

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 Urethra
 Tube berdinding tipis yang memindahkan
urine dari kandung kemih ke luar tubuh
degan gerak peristalsis
 Pengeluaran urine diatur oleh dua katup
(sphincters)
 Internal urethral sphincter (tanpa
sadari/involuntary)
 External urethral sphincter (disadari/voluntary)
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 Berkemih (Micturition/Voiding)
 Kedua katup (sphincter) otot harus terbuka
agar dapat berkemih
 Internal urethral sphincter : direlakskan
setelah peregangan kandung kemih
 Pengkatifan ini berasal dari impulse
dikirim ke spinal cord dan kemudian
balik melalui saraf pelvic splanchnic
 External urethral sphincter : harus
direlakskan secara sadar

Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide