Fisiologi Sistem Urinaria 2.2-2015-II

8/17/2019 Fisiologi Sistem Urinaria 2.2-2015-II

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Fisiologi SisUrinariaC h a p t e r

26



Capaian Pembelajaran

Mahasiswa mampu menjelaskan:

1. komponen system urinarius beserta fungsi utamanya2. proses pembentukan urin dalam nefron

3. laju filtrasi glomerulus beserta faktor-faktor yang mempe

4. mekanisme reabsorpsi dan sekretorik yang diperankan

. pengaruh hormone antidiuretik dan aldosteron terhadap

dan konsentrasi urin



Capaian Pembelajaran

Mahasiswa mampu menjelaskan:

". karakteristik urin yang normal

7. fungsi ureter, vesica urinaria, dan uretra

8. mekanisme control volunteer dan involunter serta m

refleks berkemih

#. integrasi antara system urinarius dengan system lainnya



$rine %torage and &limination

• $reters

• from renal pel!is passes dorsal to bladder and enters it from beabout 2 (m long

• 3 layers

• ad!entitia

• mus(ularis - 2 layers of smooth mus(le

• urine enters' it stret(hes and (ontra(ts in peristalti( wa!e

• mu(osa - transitional epithelium

• lumen !ery narrow' easily obstru(ted







$rinary )ladder

• *o(ated in pel!i( (a!ity' posterior to pubi( symphysis

• 3 layers• parietal peritoneum' superiorly+ fibrous ad!entitia rest

• mus(ularis: detrusor mus(le' 3 layers of smooth mus(le

• mu(osa: transitional epithelium

• trigone: openings of ureters and urethra' triangular

• rugae: rela,ed bladder wrinkled' highly distensible

• (apa(ity: moderately full - ml' ma,. - ml



/emale $rethra

• 3 to 4 (m long

•

&,ternal urethral orifi(e• between !aginal orifi(e and (li

• 0nternal urethral sphin(ter

• detrusor mus(le thi(kened' sm

mus(le' in!oluntary (ontrol

• External urethral sphincter

– skeletal muscle, voluntary co



Male )ladder and $rethra

• 1 (m long• 0nternal urethral sphin(ter

• &,ternal urethral sphin(ter

• 3 regions

– prostatic urethra

• during orgasm receives semen

– membranous urethra

• passes through pelvic cavity

–

penile urethra



oiding $rine - Mi(turition

• Mi(turition refle,

1 2 ml urine in bladder' stret(h re(eptors send signal to spinal %2' %3

2 parasympatheti( refle, ar( from spinal (ord' stimulates (ontra(

detrusor mus(le

3 rela,ation of internal urethral sphin(ter

4 this refle, predominates in infants



0nfant Mi(turition efle, 5iagram



oluntary 6ontrol of Mi(turition

mi(turition (enter in pons re(ei!es stret(h signals and

integrates (orti(al input !oluntary (ontrol" sends signal for stimulation of detrussor and rela,es inte

urethral sphin(ter

7 to delay urination impulses sent through pudendal ner!e

e,ternal urethral sphin(ter keep it (ontra(ted until you wi

urinate

!alsal!a maneu!er

• aids in e,pulsion of urine by ↑ pressure on bladder

• (an also a(ti!ate mi(turition refle, !oluntarily



8dult Mi(turition efle, 5iagram



egulation

• 8utoregulation

• %ympati( ner!ous system

• &ndo(rine system



9u,taglomerular 8pparatus

vasomotio

monitor sa



enal 8utoregulation of /

• ↑ ); → (onstri(t afferent

arteriole' dilate efferent

• ↓ ); → dilate afferent

arteriole' (onstri(t efferent

• %table for ); range of t

17 mm<g systoli(

• 6annot (ompensate fore,treme );



=egati!e /eedba(k 6ontrol of /



%ympatheti( 6ontrol of /

• %trenuous e,er(ise or a(ute (onditions (ir(ulatory sho(k

stimulate afferent arterioles to (onstri(t• ↓ / and urine produ(tion' redire(ting blood flow to hea

brain and skeletal mus(les



<ormonal 6ontrol of /



&ffe(ts of 8ngiotensin 00

f



eferensi

• *uka(> &% et. 8ll' 211. 8 healthy bladder: a (onsensus statement

Clin Pract. "1: 12"?13".

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Fisiologi Sistem Urinaria 2.2-2015-II