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Histologi Sistem Urinarius
Kuliah Sistem Urogenitalia
Universitas Haluoleo
dr. Triani Hastuti Hatta, M. Kes., Sp.KK
Departemen Histologi Fakultas Kedokteran
Universitas Hasanuddin
Makassar 2015
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Sistem Urinarius 1
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Gin al
2
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Anatomi Ginjal
Sepasang
Bean-shaped
Retroperitoneal,
3
pos er or n ng
abdomen
Potongan Coronal :
Korteks Renalis
Medulla Renalis
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Dibungkus oleh kapsula fibrosa
kapsul renalis :
Luar (fibroblast & serat serat
kolagen
Dalam (myofibroblast)
4
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5Korteks Renalis
Berwarna merah gelap
dan bergranula
Menutup seluruh
medula Bertini
renal columns
mem sa an p ram a
renalis dg perluasan
korteks ke medulla
renalis
Terdiri dari tubulus
(proksimal & distal)
glomerulus, medullary
rays, arteri dan vena
interlobularis.
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7Medulla Renalis
2x lebih tebal daripadakorteks renalis
8-15 piramida renalisberada
dalam lobus renalis(5-11
lobulus)
Dasar piramida
2x lebih tebal daripadakorteks renalis
8-15 piramida renalisberada
dalam lobus renalis(5-11
lobulus)
Dasar piramida
6
berbatasan dengan
korteks renalis
Apex : papilla renalis
(1-4) kaliks minor
kaliks mayor pelvis
renalis
Papilla renalis small holes
(250) cribrosa area
Urine
berbatasan dengan
korteks renalis
Apex : papilla renalis
(1-4) kaliks minor
kaliks mayor pelvis
renalis
Papilla renalis small holes
(250) cribrosa area
Urine
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7Suplai Darah ke Ginjal 7
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Unit Fungsional Ginjal 8= Tubulus Uriniferous
@ ginjal >>> 1 jutatubulus berperan bersama
dalam pembentukan urine
Terdiri dari
Nefron
Tubulus Pengumpul
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Nefron 9
Small masses of capillaries
glomerulus
First segment after renal
corpuscle, contourtous Located in renal cortex
Korpuskel Renalis
Tubulus Proksimal
Midlle segment, straight to
medulla, make U shaped than
straght to cortex
Last segment, contourtous.
Located in cortex, start from
macula densa
Ansa Henle
Tubulus Distal
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Unit Fungsional Ginjal 10= Uriniferous tubules
Tiga mekanisme Utama
a. Filtrasi Glomerulus Cairan dikeluarkan darikapiler glomerulus
b. Reabsorpsi Tubular
Nutrient, air dan ion esensialdikembalikan ke darah dalamkapiler peritubular
c.Sekresi Tubular Pengeluaran molekul yg tdkdibutuhkan dari kapilerperitubuler ke tubulus
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Korpuskel Renalis 11
Glomerulus : Kumparan kapilerpada teks renalis, nampak sepertigranular
Bowmans (Glomerular) Capsule:
- lapisan parietal : sel gepeng
- lapisan visceral : podosit
Diantara kedua lapisanRuang urine
2 kutub:
- Kutub
(tubular) tub
proximal & lapparietal
- Kutubvaskularmasuknya arteriolafferent &keluarnya arteriolefferent
tub distal.
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12Korpuskel Renalis
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13
Sawar Filtrasi : -- Endotel kapiler berfenestrasiAQP-1 water channel- Membran basalis glomerular filtrasi albumin atau hemoglobin
- Podosite pedicele actin mengatur celah filtrasi
Air dapat melewati sawar, elemen darah dan partikel besartidak bisa.
Korpuskel Renalis
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14The capillary pores (fenestrations)restrict the passage of the largestelements such as blood cells
The basement membrane and slitdiaphragm hold back all but the smallestproteins while letting through smallmolecules such as water, ions, glucose,amino acids, and urea
Korpuskel Renalis
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15Korpuskel Renalis
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16
Membran basalis GlomerularMembran tipis yg memisahkan podosit dan endotel kapilerberfenestrasi
Korpuskel Renalis
3 lapisan
1. Lamina densa Type IV collagen filter fisik
2. Lamina rara interna sekitar lamina densa endotelkapiler
3. Lamina rara eksterna sekeliling lamina rara interna podocyte polianion (heparan sulphate ) untuk regulasimolekul negatif.
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17
Mesangial area:
terdiri dari sel mesangial terletak antara selpodosit dan kapiler glomerulus
Mesangial cells:
Mirip sel endotel, inti lebih gelap,
prosesus sitoplasma menembus kapiler stellata cells
Korpuskel Renalis
Memiliki organel microtubules, filament
Fungsi:
Penyokong kapiler
Fondasi glomerulus
Pertahankan tekanan hidrostaikoptimal
Fagosit
Sekresi sitokin inflamasi (IL-1,prostaglandin, PDGH)
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Tubulus Proksimal 18
2 segment : tourtous & straight part
Micr: -Simple cuboidal epithelium and simple low columnair
-
Acidofilic, each tubules consist of cells with spherical nucleousmiddle in the cells
-Surface of cells : brush bordermicrovili
-Cytoplasm : large lysosome, vacuola > apex, mitochondria at basal
sel, golgi complex around nucleous, rough & smooth ER.
Cell junction : - interdigitation extent lateral & basal cells surface.
- zonula occludent
connect intracellular surface
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19Proximal convoluted tubules
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Tubulus Proksimal 20
Functions :
*reabsorption 80 % ultrafiltrat:
- Na ionsactive, diffusion from lumen to intracellular,
- Cl ions
passively with Na- ,
- glucose,protein (acetoacetic acid) & vitamine solution compositionchange
*excretion (tubular secrection): organic anion (creatinine & choline) & othersubstances (drugs = penicilina & red phenol)
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Ansa Henle/Loop of Henle 21
Consist of :Straight part (to medulla) = thin descending loop
Curve part = nephronloop
Straight part (to cortex) = thick ascending loop
Micr : simple epithelia
Near cortex : cuboidal.
Deeper in medulla : squamous
EM : -thin and irregular microvilli in cell surface, zonulaoccludenceat apex intracellular
Main function:
concentrateglomerulusultrafiltrate
AH descending : impermeabel to water, not saltNa &Cl fromintracell to lumen; water into intracellular
AH ascending : on the contrary
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Tubulus Distal 22
Straight part: continuos from thin ascending loop of ansa henle- simple cuboidal epithelium acidopfilic cytoplasm, mitochondria arrange
vertically, rought/smooth ER, golgi complex in apex nucleus.
- : >> n er g a on process n a era o ce s, , ess m crov , c ear
and regular microvilli.
Makula densa: Distal tubule attach to vascular pole- micr: simple cuboidal epithelium, large nucleus, abundant organelle
- its function associated with AJG function
Convoluted part : the end of macula densa-micr:-simple cuboidal epithelium, less in number than prox tubuless cell, spherical
nucleus in apex or middle cells, less acidophilic cytoplasm, mitochondria in
basal and upright to basal membrane, less lysosome, golgi complex around
nucleous, less smooth/rought ER
-EM: Lateral interdigitation process intercellular, especially at basal, ZO, less
microvilli and few microvilli
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23
Function :
reabsorption Na+ aldosteron (bodys
waters-salt balance) -
Tubulus Distal
reabsorption CaCO3 , water ADH
secretion K+ aldosteron
secretion H+ & NH4+ acid base balance
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24Macula Densa
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25Macula Densa
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21
26
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27Collecting Duct
Microskopic Cuboidal epithelium (cortex) Columnair epithelium (papilla duct)
spherical nucleus in middle of the cell, pale cytoplasma.
Clearly borderline, convex cell surface, brush border (-).
Dark cells (intercalated cells) between pale cells (principal cells)
Rich in aquaporins
organelles, especiallymitochondria regulate acid base balance)
Function:Concentrate urine by :
reabsorption of water ADH
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28Collecting Duct
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29Apparatus Juxtaglomerular
Macula densa
Extraglomerular mesangial cells (Lacis cells)
Juxtaglumerular cells RENIN(modifikasi otot polos tunika media arteriol afferent sel
epitel di dekat glomerulus)
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30
7
Elevated arterial pressureIf Elevatedblood pressure
glomerular capillary pressure
ACE luminal concentration of Na & Cl
Makula Densa
Release ATP, adenosine & vasoactive
Lowers glomerular capillary pressure
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31
Angiotensinogen
Angiotensin I
Renin
If Decreasedblood pressure
Angiotensin II
ACE
As vasoconstrictor arteriole & vena
constrictor
Stimulate aldosteron secrection Na+ and
water reabsorption (distal tubules) raises
blood volume increase blood pressure
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Renin 2132
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33
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Ureter dan Vesika Urinaria 34
Urine dari hasil filtrasi ginjal Ureter dan Vesika Urinaria
Mikroskopik Ureter dan Vesica urinaria memiliki struktur dasar
histologis yg sama, yaitu :
Mukosa epitel transisional Urothelium :
Membran basal
Selapis sel basal
Lapisa superfisial sel polihedral yg sangat besar
umbellocytus (umbrella cells),berinti dua atau
multinuklear dan sangat berdiferensiasi
Lamina Propria dan SubmukosaLapisan Otot polos
Tunika Adventisia
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Ureter 35
Lapisan Mukosa
Urothelium
Lamina propria: Jar ikat areolarserat kolagen
Lapisan Muskularis- :
luar circular type
-1/3 bawah 3 lapis otot polos : dalam longitudinal type
tengahcircular type
luar circular type
Lapisan Adventisia: Jar ikat fibroelastis
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Ureter 36
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Vesika Urinaria37
Kapasitas 500 mlSaat kosong : bentuk pyramid dg apeks
ke arah bawah.
Lap Mukosa:
Umbellocytus berkembang baik pd vesika urinaria ini, memiliki
tautan sel luas dan mengelilingi membran apeks.
Permukaan apeks uroplakin plak kaku bersifat impermeabel
thd urin
Lap Muskularus :3 lapis otot polos
- dalam: longitudinal type- tengah: Circular type
- luar: longitudinal type
Tunika adventitia: jar ikat jarang dilapisi oleh peritonium
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38
Urinary Bladder
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Urethra
39
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Urethra 40
Lebih panjang dibanding wanita
Urethra Prostatica pjg 3-4cm, terbentang melalui kelprostat, dilapisi urothelium
Urethra Membranosasegmen pendek, melalui sfingterekxternal otot skelet, dilapisi oleh ep. bertingkat & ep blapis
Urethra Spongiosa, pjg 15 cm, terbenam dpm jar erektil penis,
dilapisi oleh :
Prox: ep berlapis kolumnair & ep bertingkat
Distal : ep berlapis gepeng.
Hanya organ perkemihan, panjang 4-5 cm
Epitel :
Superficial : ep transitional
Middle : ep bertingkat kolumnair
Distal (near pulpa) : ep. Berlapis gepeng tdk bertanduk
Bagian tengah dikelilingi sfingter eksternal otot skelet
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Urethra41
Males Female
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Urethra 42
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Urethra pars prostatika 43
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Fluid transport
in Urinary System
44
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References
Diktat Histologi I Bagian Histologi Fak. Kedokteran UniversitasHasanuddin.
Mescher AL. Junqueiras Basic Histology: Text and Atlas, 12th
ed.
Ross MH & Pawlina W. Histology: a Text and Atlas with
Correlated Cell and Molecular Biology, 5th ed.
Eroschenko VP. Atlas Histologi diFiore, dengan korelasi
fungsional. Ed. 11
Young B, Lowe JS, Stevens A, Heath JW. Wheaters Functional
Histology, A Text and Colour Atlas. 5th ed.
Please, read that referencePlease, read that referencess more..more..