SISTEM

PERKEMIHAN
Rahayu Ningtyas, SKp., M.Kep.
ANATOMI GINJAL

Terdiri dari :
 Ginjal
 Ureters
 Urinary
bladder/kandung
kemih
 Urethra
Functions

 Three Basic Processes

 1. Filtration
 2. Reabsorption
 3. Secretion :
Urea ( hasil dr pemakaian asam amino )
Asam uric ( hasil dr pemakaian asam nukleic )
Kreatinin ( hasil dr pemakaian kreatinin phosphat )
Hasil dr pemakaian hemoglobin ( bilirubunurobilin ) 
Kuning
LOKASI :
 Dibagian belakang
abdomen
 Retroperitoneal
 BENTUK : biji
kacang/biji kopi
 Panjang 12 cm,
lebar 6 cm, tebal 3
cm
 Renal a & v, ureter
 Kapsul : lemak &
kelenjar adrenal
FRONTAL SECTION

 Cortex
 Medulla
 Renal sinus
Medulla
 Renal pyramids:
bangunan bebentuk
kerucut
 Renal papilla :
apeks/puncak yg
mengarah ke bag
dalam ginjal
 Renal columns: jar.
Korteks diantara
piramid
Renal sinus

 Dimulai dari ureter

berbentuk corong
lebar disebut : Renal
pelvis bercabang 2 or
3  Major calyces yg
masing2 bercabang
Minor calyces
urine: Minor calyces
Major calyces 
Renal pelvis
 Fat
 Renal artery & vein
MICROSCOPIC
KIDNEY

 Uriniferous tubule
 ~1 juta per ginjal
 Komponen
 Nephron
 Collecting duct

 Lokasi
 Cortex and medulla
KOMPONEN NEPHRON

 Tempat pembentukan urine

awal.
 Tdr atas komponen vaskuler
Glomerulus, komponen
tubuler berawal dr Glomerular
(Bowman’s) capsule
 Renal corpuscle : gab.
Glomerolus & Glomerular
(Bowman’s) capsule
 Bag tubulus yg keluar dari
Renal corpuscle Proximal
convoluted tubule (PCT)
 Loop of Henle/Ansa henle
 Distal convoluted tubule (DCT)
NEPHRON FUNCTIONS

 Filtrasi darah di
renal corpuscle
 Reabsorption by
PCT and DCT
 Concentration of
urine by loop of
Henle and DCT
 Excretion by PCT
and DCT
Excretory systems

Water and Solutes

Non-selective

Selective
Circulation to nephrons

 Afferent arteriole :
bercabang membentuk
skelompok gelungan
kapiler  glomerolus :
darah di saring, keluar
 Efferent arteriole
 Efferent arteriole <
Afferent arteriole
meningk TD di
glomeroluspenting u
proses filtrasi
Hormones

 Aldosterone  distal tubule

 ADH  water reabsorb in collecting duct - may create pores for entry
 Renin-angiotensin  juxtaglomerular apparatus
 ANP - secreted from atria of heart
 Hemodialysis
 kidney no longer functions to regulate pH
and N wastes
 Dialysis
 Continuous ambulatory peritoneal dialysis
Ureter
 Lokasi: posterior abdomen
dibelakang peritoneal
 Retroperitoneal
 Menghantarkan urine dr
ginjal ke vesika urinaria. Di
dlm pelvis menurun ke arah
luar & dlm & menembus
dinding posterior vesika
urinaria secara
oblik(serong) agar urine
tdk kembali ke ureter saat
vesika penuh.
 ~25 cm long

23.1a
 Urinary bladder /
vesika urinaria

 Location: pelvic
floor
 Covered by
parietal
peritoneum
 Posterior to
pubic
symphysis
Urethra Pria

 Panjang ~20 cm
 Saluran perkemihan
maupun reproduksi
Urethra Wanita

 ~3-4 cm long
 Sistem perkemihan
WASSALAM