6. Histologi Urinarius_UNHALU Urogen 2015

7/24/2019 6. Histologi Urinarius_UNHALU Urogen 2015

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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

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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..

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6. Histologi Urinarius_UNHALU Urogen 2015