Week 12 Overview Musculoskeletal test Review the midterm Turn in page 112 from syllabus and 2 puzzles (handout) Review the midterm Go over Reproductive (syllabus) Urinary System Lecture pages 310-335 Endocrine Assignment page 121 Week 13- make up tests- sign up and preparation for the endocrine presentation Homework

The Urinary System Introduction The urinary system consists of the following organs Kidneys Ureters Bladder Urethra meatus

Functions Excretion of waste products of metabolism (nephrotoxic) Excrete certain drugs an other substances Control Fluid (water and electrolytes) Maintain a constant acid-base balance

Other Functions (To protect renal function, non-excretory functions) Secrete rennin to help regulate blood pressure RBC production Bone metabolism- vitamin D metabolism

Structures

Ureters 28-35 cm long Function: conduct urine to urine to urinary bladder Location: they arise from the pelvis of their own kidney c. Made of: epithelia lining d. How they work: peristaltic contractions

Urinary Bladder Function: to store urine Location: in front of the pelvis It is a muscular sac and it can hold 300-500cc of urine. When the nerve endings receive stimuli that are transmitted to the reflex centers in the spinal cord, the internal sphincter located just above the point of insertion of the urethra into the bladder relaxes and allows the expulsion of the bladder contents. The external sphincter is normally under voluntary control after the age of three years.

Function: It is a small duct that channels urine outside of the body from the bladder. Location: Female: it is 3-5 cm long and opens just above the vagina. The external opening is called the urethra meatus. The external sphincter is located in the middle of the urethra. The urethra serves simply as a tube through which the urine flowing from the bladder makes an exit from the body. Male: It is about 20 cm long, originating at the bladder and traversing the length of the penis. The urethra meatus through which urine is discharged is located at the tip of the glans penis. Urethra Meatus

Kidneys

a. Function: It is the chief regulator of homeostasis and of the body’s internal environment. b. Location: These are reddish-brown, bean-shaped, and highly vascular organs. Each kidney is located on each side of the spinal column and just below the diaphragm. They area usually about 12 cm long in the adult. The adrenal glands are located just above each kidney (supra-renal). The position of the liver causes the right kidney to be slightly lower than the left. The duodenum and ascending colon lie in front of the right kidney, while the spleen and descending colon lie in front of the left one. Each kidney is surrounded by fat and encapsulated in fibrous tissue (perirenal) a fat layer to protect it.

Kidney’s Anatomic Structure (three regions) a. Cortex- (Greek for bark, outer layer) It has a granular appearance. Most of the nephron is located here. Includes proximal convoluted and distal convoluted tubules Glomeruli- glomerular filtration, the key to urine formation Includes the renal columns ( -90% of the blood filtered by the cortex) b. Medulla Renal pyramids, Loop of Henle Pelvis Major and minor calyces (cuplike structures) It can hole 3-5

NEPHRON OF THE KIDNEY LOCATED IN THE CORTEX: This is the kidney’s functional unit. This is where the filtering process takes place. There are approximately 1,000,000 nephrons in each kidney. The nephrons are located in the cortex of the kidney. It is comprised of the glomerulus, Bowman’s capsule, proximal convoluted tubule, the loop of Henle, the distal convoluted tubule, collecting tubules, an afferent vessel, efferent vessel, and a capillary network. The work of the nephron is the formation of urine. Basically the nephrons perform two main activities; Mechanical filtration of fluids, wastes, electrolytes, acids and bases into the tubular system and selective reabsorption and secretion of ions back to the body’s system. Urination, micturition, or voiding is the normal process of excreting urine.

Diagnostic Procedures Catheterization- a technique in which a hollow, flexible tube is used to drain body fluids (such as urine) Cystoscopy- examination of the bladder using an instrument called a cystoscope IVP- intravenous pyelogram-a test that examines the urinary system using a contrast medium that can be seen on x-rays to show possible obstructions, tumors, cysts, stones, and other abnormalities. UA- urinalysis- laboratory examination of urine for various cells and chemicals, such as red blood cells, white blood cells, infection, or excessive protein

Pathology Anuria- without urine production Polyuria- much urine production Dysuria- difficult or painful urination Nocturia- urinating at night

Nephrolithiasis- kidney stones Nephritis- inflammation of the kidney Nephrosis- abnormal condition of the kidney

Nephrosclerosis- hardening of the kidney Nephroptosis- downward displacement of the kidney Glomerulonephritis- Inflammation of the Glomeruli of the kidney

Pyelitis- inflammation of the renal pelvis Pyelonephritis- inflammation of the pelvis of the kidney Cystitis- inflammation of the urinary bladder

Diuresis- Removing excess fluid from the body through increased urine output Enuresis- bedwetting Urethrorrhea- discharge from the urethra Oliguria- scanty urine production Incontinence- Loss of bladder and/or bowel control

Procedures Dialysis- the artificial process of cleaning wastes from the blood when kidneys fail Hemodialysis- the use of a machine to clean wastes from the blood after the kidneys have failed. The blood travels through tubes to a dialyzer (DY-uh-LY-zur), a machine that removes wastes and extra fluid. The cleaned blood then goes back into the body.

Hemodialysis

Lithotripsy- crushing of stone Nephrectomy- removal of a kidney Nephropexy- surgical fixation of a kidney Cystectomy- removal of the urinary bladder Lithotomy- incision to remove a stone

Abbreviations BUN- blood urea nitrogen Cr- creatinine-a substance in the blood (a piece of a protein) which should be at a constant level in the blood. IVP- intravenous pyelogram

KUB- kidney, ureter, bladder pH- acid-base balance UA- urinalysis C&S- culture and sensitivity GU- genitourinary

BPH- benign prostatic hypertrophy TURP- transurethral resection of the prostate

GTT- glucose tolerance test FBS- fasting blood sugar PSA- prostate specific antigen

Medications Cranberry Juice Pyridium Diuretic Sulfur Drugs

WEEK #12 – URINARY SYSTEM ELEMENTS (use with your textbook for CD-Rom)   Element Meaning  carcin/o cancer cyst/o bladder erythr/o red glomerul/o glomerulus, little ball gluc/o sugar glyc/o sugar hemat/o blood lith/o stone/calculus nephr/o kidney

ELEMENT MEANING noct/o night olig/o scanty/little poly- many, much py/o pus pyel/o renal pelvis rect/o rectum ren/o kidney scler/o hardening ureter/o ureter urethr/o urethra ur/o urine vesic/o bladder -al,-ic,-ous pertaining to -cele hernia- -cyte cell

ELEMENT MEANING -ectasis dilation, expansion -edema swelling -gram record, a writing -graphy process of recording -iasis abnormal condition by -lith stone, calculus -megaly enlargement -oma tumor -pathy disease -pexy fixation -ptosis prolapse, downward displacement

ELEMENT MEANING -rrhaphy suture -scope instrument to view -scopy visual examination -stenosis narrowing stricture -stomy forming a new opening -tripsy crushing -uria urine, urination a-, an- without, not dys- bad, painful, difficult poly many, much

Review- Urinary and Reproductive Test Page 119 in syllabus

Homework Complete pages 336-347 (book), Interactive CD Complete pg. 119 (syllabus) Study for make-up test Prepare for endocrine presentation