Proses Berkemih

Moganasivan S 1301-1211-3074

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Proses mikturasi  The basic process of normal urination (or "micturition") can be broken down to: Urine is made in the kidneys II. The bladder muscle (detrusor) contracts V. The sphincter muscles relax IV. I. The bladder is emptied through the urethra and urine is removed from the body. Urine is stored in the bladder III. .

These receptors are stimulated by the sympathetic component of the autonomic nervous system (ANS). parasympathetic stimulation. The body is rich in beta adrenergic receptors. by fibers in the pelvic nerve. cause the detrusor to contract. via fibers of the hypogastric nerve. suppress contraction of the detrusor. Beta stimulation. The innervation of the body of the bladder is different from that of the bladder neck. and . Conversely. Sympathetic stimulation is predominant during bladder filling.Bladder The bladder is composed of bands of interlaced smooth muscle (detrusor).

Storage  The filling of the bladder is enabled by:  contraction of the striated sphincter (somatic innervation)  contraction of smooth muscle sphincter (sympathetic innervation)  inhibition of detrusor activity (sympathetic innervation) .

Emptying  Voiding (micturition) is enabled by:  relaxation of the striated sphincter (somatic innervation)  relaxation of the smooth muscle sphincter and opening of the bladder neck (sympathetic innervation)  detrusor contraction (parasympathetic innervation) .

Like the detrusor. The internal sphincter is composed of smooth muscle like the detrusor and extends into the bladder neck. . Sympathetic stimulation of these alpha receptors. The primary receptors in the bladder neck are alpha-adrenergic. the internal sphincter is controlled by the ANS and is normally closed. contributes to urinary continence. via fibers in the hypogastric nerve.Internal Sphincter  Two sphincters control the bladder outlet.

This relaxes the internal and external sphincters and removes the sympathetic inhibition of the parasympathetic receptors. supraspinal centers block stimulation by the hypogastric and pudendal nerves. arising from the ventral horns of the sacral cord. Like skeletal muscle. It is striated muscle. The result is unobstructed passage of urine when the detrusor contracts. .External Sphincter  The external sphincter is histologically different from the detrusor and internal sphincter. It receives its innervation from the pudendal nerve. During micturition. it's under voluntary control.

In response to afferent stimulation. If the sacral reflex is unrestrained. This is largely because the cerebrum is able to suppress the sacral micturition reflex.Summary  Normally. . blocks sympathetic inhibition. If it is appropriate. the bladder contracts and urine is expelled. we are able to control where and when we void. Detrusor contraction is suppressed by alpha and beta sympathetic stimulation via the hypogastric nerve. the cerebrum becomes aware of the need to void. parasympathetic stimulation via the pelvic nerve causes detrusor contraction. the cerebrum relaxes the external sphincter.

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