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URINARY SYSTEM
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FUNCTIONS OF THE SYSTEM URINARY
1. FILTERING OF BLOOD2. REGULATION OF BLOOD VOLUME3. REGULATION OF BLOOD SOLUTES4. RBC SYNTHESIS5. VITAMIN D SYNTHESIS6. GLUCONEOGENESIS
KIDNEY ANATOMY
ORGANS OF THEURINARY SYSTEM
1. KIDNEYS2. URETERS3. URINARY BLADDER4. URETHRA
ORGANS OF THEURINARY SYSTEM
5. INTERNAL URETHRAL SPHINCTER.
6. EXTERNAL URETHRAL SPHINCTER.
LOCATION AND EXTERNALANATOMYOF KIDNEYS
The kidneys liebehind peritoneumon the posteriorabdominal wall oneither side ofvertebral column. The right kidney isslightly lower thanthe left.
EXTERNAL ANATOMY OF THE KIDNEY
The covering of kidney consistsof three layers. The inner
layer, the renal capsule, themiddle layer, the adipose
capsule, and the outer, renalfascia.
INTERNAL ANATOMY OF THE KIDNEY
A FRONTAL SECTIONS OF A
KIDNEY REVEALS 3 REGIONS:
1. RENAL CORTEX2. RENAL MEDULLA3. RENAL PELVIS
INTERNAL ANATOMY OF THE KIDNEY
RENAL CORTEX
• The outer layerof the kidneythat contain mostof the nephrons.
• It is the main sitefor filtration,reabsorption andsecretion.
RENAL MEDULLA
Within the renalmedulla arelocated the renalpyramids, renalpapilla, and renalcolumns.
RENAL MEDULLA
•The function of the renal columns is to provide the space to pass blood vessels to and from the nephrons.
RENAL MEDULLA
• Triangular shaped units in the medulla that house the Loops of Henle and collecting ducts of the nephron.
• Site for the counter-current system that concentrates salt and conserves water and urea
RENAL MEDULLA
• The tip of the renal pyramid.
• Releases urine into a calyx.
INTERNAL ANATOMY OF THE KIDNEY
The nephrons of thekidneys produces urine. It flows from the renal papilla,to the minor calyce, to the major calyce, to the renal pelvis, and finally exits the
kidney within the ureter.
RENAL PELVIS
•The function of the renal pelvis collects urine from all of the calyces. •The urine then is conducted from the kidney to the urinary bladder using the ureter.
INTERNAL ANATOMY OF THE KIDNEY
Two major blood vessels areassociated with the kidney. The renal artery, a branch of the abdominal aorta, and the renal vein, which empties into
the inferior vena cava.
THE NEPHRON
TYPES OF NEPHRONS
Cortical nephron: Originates in outer
2/3 of cortex. Involved in solute
reabsorption.
Juxtamedullary nephron: Originates in inner
1/3 cortex. Important in the
ability to produce a concentrated urine.
Has longer Loop of Henle.
Insert fig. 17.6
THE NEPHRON
THE NEPHRON
STRUCTURES OF THE NEPHRON
1. BOWMAN’S CAPSULE2. PROXIMAL CONVOLUTED TUBULE3. LOOP OF HENLE
A. DESCENDING LIMBB. ASCENDING LIMB
4. DISTAL CONVOLUTED TUBULETHESE EMPTY INTO THE COLLECTINGDUCT OR TUBULES.
PROXIMAL CONVOLUTED TUBULE
PROXIMAL CONVOLUTED TUBULES
Simple cuboidalepithelial cells
withprominent brushborders of microvilli.
DECENDING LIMB OF THE LOOP OF HENLE
DECENDING LIMB OF THE LOOP OF HENLE
Simple squamous epithelial cells
ASCENDING LIMB OF THE LOOP OF HENLE
ASCENDING LIMB OF THE LOOP OF HENLE
Simple cuboidalepthelial to lowcolumnar cells.
DISTAL CONVOLUTED TUBULE
DISTAL CONVOLUTED TUBULES
Simple cuboidal epthelial cells.
THE NEPHRON
1. Proximal convoluted tubule
2. Descending limb of Loop of Henle
3. Ascending Limb of Loop of Henle
4. Distal convoluted tubules
1. Simple cuboidal epithelial cells with prominent brush borders of microvilli.
2. Simple squamous epithelial cells
3. Simple cuboidal to low columnar epithelial cells.
4. Simple cuboidal epthelial cells.
THE NEPHRON
BLOOD VESSELS OF THE NEPHRON
1. AFFERENT ARTERIOLE2. GLOMERULUS3. EFFERENT ARTERIOLE4. PERITUBULAR CAPILLARIES5. VASA RECTA
JUXTAGLOMERULAR APPARATUS
THE JGA IS LOCATED WHERETHE INITIAL PORTION OF THE
DISTAL CONVOLUTED TUBULE LIES AGAINST THE AFFERENT,
AND SOMETIMES THE EFFERENT,ARTERIOLE.
JUXTAGLOMERULAR APPARATUS
JUXTAGLOMERULAR APPARATUS
SOME THE SMOOTH MUSCLE CELLS OF THE AFFERENT ARTERIOLES
ENLARGE AND HAVE PROMINENT SECRETORY GRANULES
CONTAINING RENIN. THESE CELLS ARE TERMED JG CELLS, ANDTHEY ACT AS BARORECEPTORS.
JUXTAGLOMERULAR APPARATUS
THE CELLS OF THE DISTAL CONVOLUTED TUBULE WHICH
CONTACT THE ARTERIOLES ARE TERMED THE MACULA DENSA.
THESE CELLS DETECT CHANGES IN THE RATE AT WHICH URINE FLOW
PAST THEM AND THE CONCENTRATION OF SOLUTES IN THE URINE.
JUXTAGLOMERULAR APPARATUS
THE MACULA DENSA CELLS TRIGGER THE RELEASE OF
LOCALLY ACTING CHEMICALS WHICH EITHER VASOCONSTRICT OR VASODILATE THE AFFERENTARTERIOLE. THIS RESULTS IN A
CHANGE THE GFR.
KIDNEY PHYSIOLOGY
KIDNEY PHYSIOLOGY
URINE FORMATION AND THE SIMULTANEOUS ADJUSTMENT OF BLOOD COMPOSITION INVOLVES
THREE MAJOR PROCESSES:
1. GLOMERULAR FILTRATION2. TUBULAR REABSORPTION3. SECRETION
KIDNEY PHYSIOLOGY
KIDNEY PHYSIOLOGY
FILTRATION is the movement of substances from the
glomerulus into the lumenof bowman’s capsule. This
forms filtrate.
KIDNEY PHYSIOLOGY
REABSORPTION is the movement of substances,
solutes and water, across the walls of
nephron into the capillariesassociated with the nephron.
KIDNEY PHYSIOLOGY
SECRETION is the movementof substances from the capillaries, associated
with the nephron, across the walls of nephron into the filtrate with
the nephron.
OSMOTIC EFFECTS
Water serves as the universal solvent in which
a variety of solutes aredissolved. Solutes can beclassified as electrolytes
and nonelectrolytes.
ELECTROLYTES
Electrolytes have ionic bonds which allow the compounds
to dissociate into ions in water. Because ions are
charged particles, they can conduct an electrical current.
ELECTROLYTES
Examples of electrolytesinclude inorganic salts,inorganic and organic
acids and bases, and some proteins.
NONELECTROLYTES
Nonelectrolytes have bonds,usually covalent bonds, that
prevent them from dissociating in solution.
Therefore, they have no electrical charge.
NONELECTROLYTES
Examples of nonelectrolytesinclude glucose, lipids,creatinine, and urea.
OSMOTIC EFFECTS
All dissolved solutescontribute to the osmotic
activity of a fluid. However,electrolytes have greater
power because each electrolyte molecule dissociates into at
least 2 ions.
OSMOTIC EFFECTS
Water moves according toosmotic gradients—from
areas of lesser osmolality to areas of greater osmolality.
OSMOLALITY
A solution’s osmolality is number of solute particles
dissolved in one liter of water. Osmotic activity is
determined only by the number of solute particles.
OSMOLALITY
Ten sodium ions have thesame osmotic activity as ten
glucose molecules or ten amino acids in the same
volume of solution.
OSMOLALITY
Water moves according to osmotic gradients—
from areas of lesser to higher osmolality.
GLOMERULAR FILTRATION
“Urine” formation begins withglomerular filtration. It is a passive process
in which fluids and solutes are forced through the glomerular membrane.
GLOMERULAR FILTRATION
Substances which pass fromthe glomerulus into thenephron include: water,
electrolytes, glucose, aminoacids, vitamins, smallproteins, creatinine, urate ions, and urea.
GLOMERULAR FILTRATION
GLOMERULAR FILTRATION
The net filtration pressure(NFP) is responsible for
filtrate formation.
NFP=HPg- (OPg+ HPc)
GLOMERULAR FILTRATION
Glomerular filtrationrate, GFR, is the total amount
of filtrate formed per minute by the kidneys. A normal GFR in both
kidneys is 120-125 ml/min orabout 180 l/day
GLOMERULAR FILTRATION RATE
FACTORS GOVERNINGFILTRATION RATE
Total surface area available for filtration.
Filtration membrane permeability
Net Filtration Pressure
GLOMERULAR FILTRATION
GFR IS HELD RELATIVELY CONSTANT BY TWO IMPORTANT
MECHANISMS THAT REGULATE RENAL BLOOD FLOW:
1. INSTRINICALLY BY RENALAUTOREGULATION
2. EXTRINICALLY BY NEURAL AND HORMONAL CONTROLS
RENAL AUTOREGULATION OF GFR
To maintain a stable GFR, the kidney regulates the diameter
of the afferent arteriole.therefore, when B.P. decreases
the vessel dilates, and whenB.P. increases the vessel
constricts. This results in a stable G.F.R.
RENAL AUTOREGULATION OF GFR
THE KIDNEY USES TWO MECHANISMS TO PREFORM
AUTOREGULATION:
1. MYOGENIC MECHANISM2. TUBULOGLOMERULAR FEEDBACK
MYOGENIC MECHANISM
The myogenic mechanism is based onthe tendency of vascular
smooth muscle to contract when stretched. If B.P. is elevated, the
smooth muscle in the afferent arterioles are stretched. In response, the smooth
muscle contracts, which narrows the arteriole’s lumen, and renal blood flow
decreases, which reduces GFR to is previous level. This mechanism normalizes renal blood flow
and GFR within seconds after blood pressure changes.
TUBULOGLOMERULAR FEEDBACK
The macula densa cells of the juxtaglomerular apparatusrespond to changes in theosmolarity and changes in flow rate of the filtrate at
the junction of the D.C.T. and the ascending limb of the loop of
Henle.
TUBULOGLOMERULAR FEEDBACK
This results in the secretion of chemicals which produce
local vasoconstriction of the afferent and efferent
arterioles. Examples include nitric oxide, adenosine, endothelin, and prostaglandins.This mechanism operates more slowly than
the myogenic mechanism.
EXTRINIC CONTROL OF GFR
THE GFR CAN ALSO BE CONTROLLED EXTRINICALLY
BY:
1. SYMPATHETIC NERVOUS SYSTEM2. RENIN, ANGIOTENSION,
ALDOSTERONE MECHANISM
TUBULAR REABSORPTION
The proximal convolutedtubules are the most active
in tubular reabsorption.All glucose, lactate, and
amino acids are reabsorbed in this area.
TUBULAR REABSORPTION
About 65% of sodium, 70% ofwater, are also reabsorbed
90% of bicarbonate ions, 50% of chloride ions, and 55% of
potassium are reabsorbed in the proximal convoluted
tubules.
TUBULAR REABSORPTION
This large amount oftubular reabsorption
associated with the pct, results in the GFR
being reduced from 120 ml/minto about 40 ml/min.
REABSORPTION IN PROXIMAL NEPHRON
TUBULAR REABSORPTION
Tubular reabsorption from the loop of Henleresults in 10% of water
being reabsorbed from thedescending limb, 30% of
potassium ions, 20% of sodium,and 35% of chloride from the
ascending limb.
REABSORPTION IN LOOP OF HENLE
REABSORPTION IN LOOP OF HENLE
TUBULAR REABSORPTION
Fluids enters the distalconvoluted tubules at a rate of about 25 ml/min.
because about 80% of the water in the filtrate has been
reabsorbed.
TUBULAR REABSORPTION
As fluid flows throughthe DCT, sodium and chlorideare reabsorbed. By the time fluids reaches the end of the DCT, about 90% of the filtered solutes and water has been
returned to the blood.
THE COUNTER CURRENTMECHANISM
One of the functions of thekidneys is to regulate urineconcentration and volume.
The kidneys accomplish this bythe countercurrent
mechanism.
THE COUNTER CURRENTMECHANISM
In the kidneys the countercurrent mechanism
involves the interaction between the flow of filtratethrough the loops of Henle,
and the flow of blood through the adjacent vasa recta
blood vessels.
THE COUNTER CURRENTMECHANISM
The flow in these two structures is opposite in
direction.
THE COUNTER CURRENTMECHANISM
THE COUNTER CURRENTMECHANISM
The NaCl concentrationof the medulla acts as an
osmotic force which “draws”water from the descendinglimb of the loop of Henle.
THE COUNTER CURRENTMECHANISM
This is possible because the descending limb is lined with simple squamous epithelial cells,
that are permeableto water, but, impermeableto NaCl and other solutes.
THE COUNTER CURRENTMECHANISM
The movement of water causesthe osmolarity of the filtrate
to increase from 300 to 1,200
mOSM/L.
THE COUNTER CURRENTMECHANISM
THE COUNTER CURRENTMECHANISM
The ascending limb of the loop of Henle reabsorbs
chloride by active transport.In addition, as chloride moves
from the filtrate it “pulls”sodium along into the
medulla.
THE COUNTER CURRENTMECHANISM
This is possible because the ascending limb is
impermeable to water.
THE COUNTER CURRENTMECHANISM
The movement of NaCl into the medulla decreases
the osmolarity of the filtrate from 1,200 to 100
mOsm/L.
THE COUNTER CURRENTMECHANISM
THE COUNTER CURRENTMECHANISM
The hyperosmotic medulla also “pulls” water from the collecting ducts. This variesdepending on the amount ofADH. As water moves from
the collecting duct, urea follows.
THE COUNTER CURRENTMECHANISM
Thus, water is conserved, as well as,
a certain amountof urea. The urea contributes to the high osmolarity of the
medulla.
THE COUNTER CURRENTMECHANISM
The vasta recta is composedof capillaries which
surround the loop of henle.The vessels flow
counter (opposite) to theloop of Henle and act as a counter current exchanger.
THE COUNTER CURRENTMECHANISM
As blood flows through thevasa recta it picks up waterand leaves behind NaCl.
THE COUNTER CURRENTMECHANISM
Therefore, the vasa recta returns water back to the
body and the NaClmaintains the hyperosmotic
medulla.
THE COUNTER CURRENTMECHANISM
TUBULAR SECRETION
Tubular secretion is themovement of chemicals from the blood into the
nephron. This process can occur in the proximal or distal convoluted tubules.
TUBULAR SECRETION
THIS PROCESS IS IMPORTANT FOR:
1. Disposing of substances which were not filtered.
2. Removal of excess K+ .3. Controlling blood ph.4. Eliminating substances which have
been reabsorbed.
TUBULAR SECRETION
Most secretion occurs withinthe PCT. Substances such as
neurotransmitters, bile pigment, uric acid, penicillin,
atropine, morphine, H+ ,and ammonia are secreted.
TUBULAR SECRETION
The DCT receives mainlyK+ and H+ ions from
the blood.
SECRETION OF HYDROGEN AND POTASSIUM
KIDNEY PHYSIOLOGY
AMOUNT AMOUNT AMOUNT
FILTERED = REABSORBED + EXCRETED
KIDNEY PHYSIOLOGY
If the kidneys filters 16 grams of NaCl per day, and
reabsorb 14 grams of NaCl per day, then 2 grams of NaCl
would be excreted by the kidneys per day.
KIDNEY PHYSIOLOGY
Renal clearance refersto the volume of plasma
that is cleared of a particular substance in a
given time, usually 1 minute.
KIDNEY PHYSIOLOGY
RENAL CLEARANCE CAN BE CALCULATED USING:
RC = UV/P
U=CONCENTRATION OF SUBSTANCE IN URINE (mg/ml)
V= FLOW RATE OF URINE FORMATION (ml/min)
P=CONCENTRATION OF SUBSTANCE IN PLASMA (mg/ml)
RENAL CLEARANCE
QUESTIONS:1. If the renal clearance rate is = to
GFR?
2. If the renal clearance rate is greater than GFR?
3. If the renal clearance rate is less than GFR?
RENAL CLEARANCE
1. All of the substance is filtered—inulin.
2. All of the substance is filtered and addition is secreted—PAH.
3. Some of the substance is reabsorbed—urea.
RENAL CLEARANCE
HORMONAL CONTROL OF THE KIDNEYS
ANTIDIURETIC HORMONE
HORMONAL CONTROL OF URINE CONCENTRATION
One of the most important hormones in
the control of urine concentration and
volume is antidiuretic hormone, ADH.
ANTIDURETIC HORMONE
Antiduretic hormone prevents wide variation in water balance, helping to
avoid dehydration or edema.
ADH is synthesized by neurosecretory cells whose cells bodies are located in the supraoptic nuclei of the hypothalamus.
The ADH is “packaged” within vacuoles. The vacuoles move by axonal transport to the axonal terminals of the neurosecretory cells which make up the hypothalamic hypophyseal tract. The vacuoles are stored in the posterior lobe of the pituitary.
ANTIDURETIC HORMONE
The chemical class of ADHis a protein
ANTIDURETIC HORMONE
Solute concentrations in the blood are monitored by osmoreceptorsin the hypothalamus.
This is an example of humerol control.
ANTIDURETIC HORMONE
When solute concentrationsincrease, thereby, increasing
osmotic pressure, the receptors are stimulated.
ANTIDURETIC HORMONE
The osmoreceptors,in turn, stimulate
hypothalamic neurons in the supraoptic nucleus, which
synthesize ADH.
ENDOCRINE SYSTEMENDOCRINE SYSTEM
ANTIDURETIC HORMONE
Nerve action potentials trigger the release of ADHfrom the axonal terminalsin the posterior lobe of the
pituitary.
ENDOCRINE SYSTEMENDOCRINE SYSTEM
ANTIDURETIC HORMONE
ADH travels through the systemic circulation to the distal convolutedtubules of the nephronand the collecting ducts.
ANTIDURETIC HORMONE
ADH causes water to bereabsorbed from the
D.C.T. and the collecting ducts into the capillaries
which surround the nephron.
ANTIDURETIC HORMONE
THE RESULTS OF ADH:
1. A decrease in osmolality2. An increase in blood volume3. A decrease in urine output4. An increase in the
concentration of the urine.
ANTIDURETIC HORMONE
This chart is a good summary of the events of ADH.
ANTIDURETIC HORMONE
ADH is regulated by negative feedback; when solute concentrations are
reduced to normal levels the amount of ADH is reduced.
ANTIDURETIC HORMONE
PATHOLOGY
1. Hypersecretion can produce SIADH.
2. Hyposecretion can produce diabetes insipidus.
ALDOSTERONE
ALDOSTERONE
Aldosterone’s function is tohelp maintain Na+ ion
balance, and indirectly water balance and K+,
within the fluid compartments of the body.
ALDOSTERONE
The chemical class of aldosterone is steroid
ALDOSTERONE
A decrease in blood pressure
ALDOSTERONE
Aldosterone is synthesized by the cells of the zonaglomerulosa in theadrenal cortex.
ALDOSTERONE
Aldosternone targets the D.C.T.
of the nephron.
ALDOSTERONE
EFFECTS OF ALDOSTERONE:
1. REABSORPTION OF Na+ IONS.
2. WATER IS REABSORB USING THESAME TRANSPORT MECHANISM.
3. K+ IONS ARE SECRETION INTO THE DCT FROM THE CAPILLARIES.
ALDOSTERONE
Aldosterone secretion is controlled by negative
Feedback.
ALDOSTERONE
PATHOLOGY:
1. Hypersecretion can producealdosteronism.
2. Hyposecretion can produce addison disease.
ESTROGEN
ESTROGEN
Estrogen is a female sexhormone produced by
the ovaries.
ESTROGEN
EFFECTS OF ESTROGEN:
1. Reabsorption of Na+ ions.
2. Water is reabsorb using the same transport mechanism.
3. Ca2+ deposition into bone.
CORTISOL
CORTISOL
Cortisol is a hormone produced by the cortex ofthe adrenal gland. It helps in the conversion of lipids and proteins to form glucose (gluconeogensis).
CORTISOL
EFFECTS OF CORTISOL:
1. Reabsorption of Na+ ions.
2. Water is reabsorb using the same transport mechanism.
3. Can cause edema.
BONE CALCIUM REGULATION
CALCITONIN
Calcitonin is a hormoneproduced by the thyroid gland in response to highlevels of Ca2+ ions in the
blood.
CALCITONIN
EFFECTS OF CALCITONIN:
1. Ca2+ ion deposition into bone.
2. Inhibit osteoclasts.
CALCITONIN
Calcium
PARATHYROID HORMONE
Parathyroid hormoneis produced by the
parathyroid gland in responseto low levels of Ca2+ ions
in the blood.
PARATHYROID HORMONE
EFFECTS OF PTH:
1. Causes the break down of the inorganic matrix of bone, releasing Ca2+ ions.
2. Increase absorption of Ca2+ ions.
3. Reabsorption of Ca2+ ions from the DCT.
PARATHYROID HORMONE
Calcium
ACID BASE BALANCE
BLOOD pH REGULATED BY:1. KIDNEYS2. LUNGS3. BUFFERS IN BLOOD
KIDNEY REGULATION
The kidney can regulatepH by retaining or excreting
hydrogen or bicarbonateions.
ACID-BASE BALANCE
Blood
Kidney NephronHCO3
-
H+
Urine
RESPIRATORY REGULATION
The respiratory systemregulates pH by
regulating the amountof carbon dioxide in
the blood.
CARBON DIOXIDE and pH
CO2 + H2O H2CO3 H+ + HCO3-
Carbonic Acid
RESPIRATORY REGULATION
If the pH is low, therespiratory rate will
be decreased, and if thepH is high, the respiratory
rate will be increased.
DISEASES and ABNORMALITIES ASSOCIATED WITH THE URINARY SYSTEM
ACIDOSIS
1. pH below 7.35
2. Depresses the nervous system.
ALKALOSIS
1. pH above 7.45.
2. Overexcites the nervous system.
RESPIRATORY ACIDOSIS
Any condition that impairs breathing can
cause respiratory acidosis.This can result in an increase
in the amount of carbondioxide in the blood and a
reduction in the pH.
RESPIRATORY ALKALOSIS
Any condition that leadsto hyperventilation can
cause respiratory alkalosis.This can result in an decrease
in the amount of carbondioxide in the blood and a
increase in the pH.
METABOLIC ACIDOSIS
Metabolic acidosis iscaused by excess acids in the blood. This can be the
result of renal disease, diabetes mellitus, or a
decrease in the number of bicarbonate ions in the blood.
METABOLIC ALKALOSIS
Metabolic alkalosis is caused by a reduction in the amount of acid in the blood.
This can be the result of vomiting, diuretics, or
excessive bicarbonate ionsin the blood.
SODIUM
FUNCTIONS:
1. Attracts water into the ECF.
2. Nerve impulses.
3. Muscle contraction.
HYPERNATREMIA
EXCESS SODIUM:
1. Hypertension2. Muscle twitching3. Mental confusion4. Coma
HYPONATREMIA
DEFICIENCY OF SODIUM:
1. Hypotension2. Tachycardia3. Muscle weakness
POTASSIUM
FUNCTIONS:
1. Attracts water into the ICF.
2. Nerve impulse
3. Muscle contractions
HYPERKALEMIA
EXCESS POTASSIUM:
1. Can lead to a cardiac arrhythmia
2. Elevated t waves
3. Muscle weakness
HYPOKALEMIA
DEFICIENCY OF POTASSIUM:
1. Can lead to cardiac arrhythmia.
2. Depressed (flatened) t waves
3. Muscle weakness
CALCIUM
FUNCTIONS:
1. Matrix of bones and teeth
2. Nerve impulse
3. Muscle contraction
HYPERCALCEMIA
EXCESS CALCIUM:
1. Excess in calcium in blood
2. Kidney stones
3. Cardiac arrhythmia
HYPOCALCEMIA
DEFICIENCY OF CALCIUM:
1. Tetany
2. Weak heart muscle contractions.
3. Increased clotting time.
URINARY DISEASES
RENAL CALCULI (KIDNEY STONES)
1. Caused by the crystallization of Ca2+ and Mg2+ salts in the renal pelvis.
2. If the stone travel down the ureter, the patient will be in pain.
URINARY DISEASES
CYSTITIS
1. Caused by bacteria, usually E. coli, Klebsiella, or Proteus.
2. Leads to inflammation, fever, increased urgency and frequency of urination and pain.
URINARY DISEASES
GLOMERULONEPHRITIS:1. Caused by inflammation of theglomerulus due to streptococcalantibody complexes.
2. Inflammation of the glomerulusleads to faulty filtration.
URINARY DISEASES
INCONTINENCE:
1. Caused by loss of the ability to control voluntary micturition due to age, emotional disorders, pregnancy, or damage to the nervous system.
2. Leads to wet clothing.
URINARY DISEASES
GOUT:1. Caused by a increased blood level of uric acid. This leads toinflammation of the soft tissue associated with joints.
2. Decreased and painful movement.
ALDOSTERONISM
EXCESS ALDOSTERONE:
1. Elevated sodium levels
2. Depressed potassium levels
3. Hypertension
ADDISON’S DISEASE
DEFICIENCY OF ALDOSTERONE:
1. Hypotension
2. Low blood glucose levels.
3. Color of skin.
CUSHING’S SYNDROME
EXCESSIVE GLUCOCORTICOIDS:
1. Hyperglycemia
2. Fat accumulation
DIABETES MELLITUS
HYPOSECRETION OR ACTIVITY OFINSULIN:
1. Hyperglycemia2. Polyurea3. Thirst4. Body burns fat-ketones5. Vascular problems
INSULIN
Glucose
Cell
Blood
DIABETES INSIPIDUS
HYPOSECRETION OF ADH:
1. Increased urine volume.
2. Polyurea
ADH
ADH
Hypertonic Interstitial Fluid
Collecting Duct
H2O
Urine
DIALYSIS THERAPY
Dialysis is a process that artificiallyremoves metabolic wastes from the blood in order to compensate for kidney (renal)failure. Kidney failure results in the rapidaccumulation of nitrogen waste
(urea,etc.). Uremia and ion disturbances can also occur. This condition can cause acidosis,labored breathing, convulsions, coma and death.
DIALYSIS THERAPY
The most common form of dialysisishemodialysis which uses a machine to transfer patient’s blood through a semipermeable tube that is permeable only to selected substances. The
dialysismachine contains an appropriate
dialysis fluid that produces a diffusion gradient.
DIALYSIS THERAPY
This gradient allows abnormal substances
to diffuse from the patient’s blood and produce a “cleaning” effect.
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