![Page 1: 2.Kuliah 1 (Gangguan Miksi, Diuesis, Hematuria)](https://reader033.vdocuments.site/reader033/viewer/2022052223/55cf94cb550346f57ba47204/html5/thumbnails/1.jpg)
GANGGUAN MIKSI
DIURESIS
HEMATURIA
Maria R Iryaningrum
Bag IPD FK Atma Jaya
![Page 2: 2.Kuliah 1 (Gangguan Miksi, Diuesis, Hematuria)](https://reader033.vdocuments.site/reader033/viewer/2022052223/55cf94cb550346f57ba47204/html5/thumbnails/2.jpg)
PROSES PEMBENTUKAN URIN :
Anatomi : - ginjal
- ureter
- kandung kemih
- uretra
![Page 3: 2.Kuliah 1 (Gangguan Miksi, Diuesis, Hematuria)](https://reader033.vdocuments.site/reader033/viewer/2022052223/55cf94cb550346f57ba47204/html5/thumbnails/3.jpg)
![Page 4: 2.Kuliah 1 (Gangguan Miksi, Diuesis, Hematuria)](https://reader033.vdocuments.site/reader033/viewer/2022052223/55cf94cb550346f57ba47204/html5/thumbnails/4.jpg)
![Page 5: 2.Kuliah 1 (Gangguan Miksi, Diuesis, Hematuria)](https://reader033.vdocuments.site/reader033/viewer/2022052223/55cf94cb550346f57ba47204/html5/thumbnails/5.jpg)
![Page 6: 2.Kuliah 1 (Gangguan Miksi, Diuesis, Hematuria)](https://reader033.vdocuments.site/reader033/viewer/2022052223/55cf94cb550346f57ba47204/html5/thumbnails/6.jpg)
![Page 7: 2.Kuliah 1 (Gangguan Miksi, Diuesis, Hematuria)](https://reader033.vdocuments.site/reader033/viewer/2022052223/55cf94cb550346f57ba47204/html5/thumbnails/7.jpg)
![Page 8: 2.Kuliah 1 (Gangguan Miksi, Diuesis, Hematuria)](https://reader033.vdocuments.site/reader033/viewer/2022052223/55cf94cb550346f57ba47204/html5/thumbnails/8.jpg)
![Page 9: 2.Kuliah 1 (Gangguan Miksi, Diuesis, Hematuria)](https://reader033.vdocuments.site/reader033/viewer/2022052223/55cf94cb550346f57ba47204/html5/thumbnails/9.jpg)
![Page 10: 2.Kuliah 1 (Gangguan Miksi, Diuesis, Hematuria)](https://reader033.vdocuments.site/reader033/viewer/2022052223/55cf94cb550346f57ba47204/html5/thumbnails/10.jpg)
![Page 11: 2.Kuliah 1 (Gangguan Miksi, Diuesis, Hematuria)](https://reader033.vdocuments.site/reader033/viewer/2022052223/55cf94cb550346f57ba47204/html5/thumbnails/11.jpg)
![Page 12: 2.Kuliah 1 (Gangguan Miksi, Diuesis, Hematuria)](https://reader033.vdocuments.site/reader033/viewer/2022052223/55cf94cb550346f57ba47204/html5/thumbnails/12.jpg)
![Page 13: 2.Kuliah 1 (Gangguan Miksi, Diuesis, Hematuria)](https://reader033.vdocuments.site/reader033/viewer/2022052223/55cf94cb550346f57ba47204/html5/thumbnails/13.jpg)
![Page 14: 2.Kuliah 1 (Gangguan Miksi, Diuesis, Hematuria)](https://reader033.vdocuments.site/reader033/viewer/2022052223/55cf94cb550346f57ba47204/html5/thumbnails/14.jpg)
![Page 15: 2.Kuliah 1 (Gangguan Miksi, Diuesis, Hematuria)](https://reader033.vdocuments.site/reader033/viewer/2022052223/55cf94cb550346f57ba47204/html5/thumbnails/15.jpg)
![Page 16: 2.Kuliah 1 (Gangguan Miksi, Diuesis, Hematuria)](https://reader033.vdocuments.site/reader033/viewer/2022052223/55cf94cb550346f57ba47204/html5/thumbnails/16.jpg)
Fungsi ginjal :
Mempertahankan vol dan cairan ekstra sel dalam batas normal
Dikontrol oleh :
filtrasi glomerulusreabsorbsi & sekresi tubulus
![Page 17: 2.Kuliah 1 (Gangguan Miksi, Diuesis, Hematuria)](https://reader033.vdocuments.site/reader033/viewer/2022052223/55cf94cb550346f57ba47204/html5/thumbnails/17.jpg)
ULTRAFILTRASI GLOMERULUS :
Aliran darah ginjal : 1200 ml/mnt
Komposisi = plasma kec protein
Cairan 173 l/hari disaring glomerulus
1,5 l/hari sebagai urin
![Page 18: 2.Kuliah 1 (Gangguan Miksi, Diuesis, Hematuria)](https://reader033.vdocuments.site/reader033/viewer/2022052223/55cf94cb550346f57ba47204/html5/thumbnails/18.jpg)
Proses filtrasi pasif
perbedaan tekanan antara - kapiler glomerulus - kapsula bowman
GFR : 125 15 ml/mnt per 173 m2
GFR : 110 15 ml/mnt per 173 m2
3 zat : - elektrolit- non elektrolit- air
![Page 19: 2.Kuliah 1 (Gangguan Miksi, Diuesis, Hematuria)](https://reader033.vdocuments.site/reader033/viewer/2022052223/55cf94cb550346f57ba47204/html5/thumbnails/19.jpg)
REABSORBSI & SEKRESI TUBULUS:
Mekanisme aktif dan pasif
Glu & as amino transport aktif•
•K & as urat aktifreabsreabs
reabs
sekresi tub distal•Na 2/3 aktif di tubulus prox
lengkung henle tub distal koligen< 1% diekskresi ke urin
![Page 20: 2.Kuliah 1 (Gangguan Miksi, Diuesis, Hematuria)](https://reader033.vdocuments.site/reader033/viewer/2022052223/55cf94cb550346f57ba47204/html5/thumbnails/20.jpg)
• Ca & P reabs Tub prox scr aktif
• Air, Cl, urea reabs
Tub prox scr pasif
Fungsi tubulus distal :
pengaturan tahap akhir keseimbanganAir dan asam basa
![Page 21: 2.Kuliah 1 (Gangguan Miksi, Diuesis, Hematuria)](https://reader033.vdocuments.site/reader033/viewer/2022052223/55cf94cb550346f57ba47204/html5/thumbnails/21.jpg)
Hormon yang dihasilkan ginjal :
•Renin (mengaktifkan Ang I II)
Konstriksi p.d TD
•Pengaktifan vit D
Mempromosikan abs Ca dr sal cerna
• eritropoetin
•prostaglandin Aliran drh ginjalPengeluaran reninReabsorbsi Na
![Page 22: 2.Kuliah 1 (Gangguan Miksi, Diuesis, Hematuria)](https://reader033.vdocuments.site/reader033/viewer/2022052223/55cf94cb550346f57ba47204/html5/thumbnails/22.jpg)
Fungsi utama ginjal :
ekskresi Non sekresi
Pertahankan osmolalitas (285 mosm) eksr air
Menghasilkan renin (mengatur TD)
Perthnkan konsentrasi elektrolit plasma dbn
Menghasilkan eritropoetin
Perthnkan pH plasma 7,4 H+ HCO3
Metabolisme Vit D bentuk aktif
Eksr hsl akhir met prot (yg mengandung Nitrogen t/u urea, asam urat dan kreatinin
Degradasi insulin
Membntk prostaglandin
![Page 23: 2.Kuliah 1 (Gangguan Miksi, Diuesis, Hematuria)](https://reader033.vdocuments.site/reader033/viewer/2022052223/55cf94cb550346f57ba47204/html5/thumbnails/23.jpg)
Disuria
Inkontinentia
Enuresis
![Page 24: 2.Kuliah 1 (Gangguan Miksi, Diuesis, Hematuria)](https://reader033.vdocuments.site/reader033/viewer/2022052223/55cf94cb550346f57ba47204/html5/thumbnails/24.jpg)
disuria
- uretritis- sistitis- prostatitis
![Page 25: 2.Kuliah 1 (Gangguan Miksi, Diuesis, Hematuria)](https://reader033.vdocuments.site/reader033/viewer/2022052223/55cf94cb550346f57ba47204/html5/thumbnails/25.jpg)
inkontinentia
Pengisian VU dinding VUleher VUuretra
Pengosongan VU relaksasi sfingteruretra
kontraksi otot VUkontrol
cortex cerebribatang otakmedula spinalis
![Page 26: 2.Kuliah 1 (Gangguan Miksi, Diuesis, Hematuria)](https://reader033.vdocuments.site/reader033/viewer/2022052223/55cf94cb550346f57ba47204/html5/thumbnails/26.jpg)
Gangguan - tumor otak- strok- trauma kepala- parkinson
kemampuan mengon-trol VU hilang
Kerusakan medula spinalis
sinergi VU & uretra terganggu
Kegagalan penyimpanan
Kegagalan pengosongan
![Page 27: 2.Kuliah 1 (Gangguan Miksi, Diuesis, Hematuria)](https://reader033.vdocuments.site/reader033/viewer/2022052223/55cf94cb550346f57ba47204/html5/thumbnails/27.jpg)
Klasifikasi inkontinensia :
Transient EstablishedDeliriumInfection-urinary (symp)Atrophic urethritis/vaginitisPharmaceuticalsPsychological (depression)Excessive urine outputRestricted mobilityStool impaction
Detrusor overactivity Detrusor underactivity Urethral obstruction Urethral incompetence
![Page 28: 2.Kuliah 1 (Gangguan Miksi, Diuesis, Hematuria)](https://reader033.vdocuments.site/reader033/viewer/2022052223/55cf94cb550346f57ba47204/html5/thumbnails/28.jpg)
enuresis
![Page 29: 2.Kuliah 1 (Gangguan Miksi, Diuesis, Hematuria)](https://reader033.vdocuments.site/reader033/viewer/2022052223/55cf94cb550346f57ba47204/html5/thumbnails/29.jpg)
oliguria
poliuria
nokturia
Urin 500 ml
anuria Urin (-)
Urin 3 L/24 jam
![Page 30: 2.Kuliah 1 (Gangguan Miksi, Diuesis, Hematuria)](https://reader033.vdocuments.site/reader033/viewer/2022052223/55cf94cb550346f57ba47204/html5/thumbnails/30.jpg)
OLIGURIA
penyakit ginjal
dehidrasi
obstruksi
![Page 31: 2.Kuliah 1 (Gangguan Miksi, Diuesis, Hematuria)](https://reader033.vdocuments.site/reader033/viewer/2022052223/55cf94cb550346f57ba47204/html5/thumbnails/31.jpg)
POLIURIA
Diabetes melitus
Diabetes insipidus
![Page 32: 2.Kuliah 1 (Gangguan Miksi, Diuesis, Hematuria)](https://reader033.vdocuments.site/reader033/viewer/2022052223/55cf94cb550346f57ba47204/html5/thumbnails/32.jpg)
POLIURIA
OSMOLALITAS URIN
250 mosmol 300 mosmol
Diabetes Insipidus DM
![Page 33: 2.Kuliah 1 (Gangguan Miksi, Diuesis, Hematuria)](https://reader033.vdocuments.site/reader033/viewer/2022052223/55cf94cb550346f57ba47204/html5/thumbnails/33.jpg)
NOKTURIA
Insufisiensi renal
Hipertrofi prostat
![Page 34: 2.Kuliah 1 (Gangguan Miksi, Diuesis, Hematuria)](https://reader033.vdocuments.site/reader033/viewer/2022052223/55cf94cb550346f57ba47204/html5/thumbnails/34.jpg)
hematuria
pyuria
![Page 35: 2.Kuliah 1 (Gangguan Miksi, Diuesis, Hematuria)](https://reader033.vdocuments.site/reader033/viewer/2022052223/55cf94cb550346f57ba47204/html5/thumbnails/35.jpg)
HEMATURIA
Penyakit ginjal
Tumor
TBC saluran kemih
Sistitis
![Page 36: 2.Kuliah 1 (Gangguan Miksi, Diuesis, Hematuria)](https://reader033.vdocuments.site/reader033/viewer/2022052223/55cf94cb550346f57ba47204/html5/thumbnails/36.jpg)
HEMATURIA
2 – 5 SDM/LPB
Isolated hematuria :
- Batu- Neoplasma- TBC- Trauma- Prostatitis
Isolated glom hem-uria :
- IgA nefropati- Nefritis herediter- Peny mbrn basalis
![Page 37: 2.Kuliah 1 (Gangguan Miksi, Diuesis, Hematuria)](https://reader033.vdocuments.site/reader033/viewer/2022052223/55cf94cb550346f57ba47204/html5/thumbnails/37.jpg)
PYURIA
Infeksi traktus urinarius
![Page 38: 2.Kuliah 1 (Gangguan Miksi, Diuesis, Hematuria)](https://reader033.vdocuments.site/reader033/viewer/2022052223/55cf94cb550346f57ba47204/html5/thumbnails/38.jpg)
PYURIA 10 SDP/ml urin
5 SDP/LPB
BACTERIURIA105 CFU/ml
108 CFU/L
Asymptomatic bacteriuria :
2 X pemeriksaan 105 CFU/ml
atau 1 X pemeriksaan dng kateter/punksi supra pubic
![Page 39: 2.Kuliah 1 (Gangguan Miksi, Diuesis, Hematuria)](https://reader033.vdocuments.site/reader033/viewer/2022052223/55cf94cb550346f57ba47204/html5/thumbnails/39.jpg)