1. System system check

2. Urinary system Excretory system- removes waste and excess water from the body and is important for maintaining the body’s acid-base balance.

3. What makes up the urinary system 2 kidneys 2 ureters 1 bladder 1 urethra This system is sterile!!!!

4. kidneys Located in the upper part of the abdominal cavity Each kidney is surrounded by an adipose capsule Divided into cortex- outer part with nephrons and medulla-inner part with collection tubules

5. nephrons Microscopic filtering units More than a million per kidney Each nephron contains: Glomerulus-(high pressure coiled capillaries)---filters water, mineral salts, sugar, metabolic product, and other crud, but not RBC’s and protein. Then goes out the renal vein to go back to the heart Bowman’s capsule- c- shaped structure that surrounds glomerulous it picks up the bad stuff that is filtered out, and takes it to the convoluted tubule……. To be continued

6. nephron Convoluted tubule- it collects material that was filtered out and returns the things the body needs back into the blood by the capillaries- water, sugar, salt Excess water sugar and salt stay in the tubule and form urine which go to the collecting ducts Collecting ducts- other tubules that dump urine into the renal pelvis-(the funnel at the top of the ureter.)

7. Drawing Billy the kidney Make a beautiful most beautiful drawing of the nephron for yourself!

8. ureters 2 tubes that are 10-12 inches in length that goes from the kidney to the bladder Peristalsis moves the urine through the ureter from the kidney to the bladder.

9. bladder Hollow muscular sac located behind the symphysis pubis midline Urge to void bladder occurs when there is 250 cc or 1 cup of urine When the bladder is full, receptors in the wall of the bladder signal muscles to open- a reflex

10. urethra Urethra is a tube that carries urine from the bladder to the outside opening called the urinary meatus

11. Blood pressure and the kidney Andy gets shot Andy is bleeding out Andy’s BP drops Inside Andy, his kidneys have a cell that detects changes in the system. They release renin- a hormone that floats around in the body and finds angiotensin. This is a chemical that when touched by renin turns into angiotensin I. To be continued……

12. Blood pressure and Billy the kidney Angiotensin I as a hormone can change blood pressure a little, but it has to convert to Angiotensin II. Angiotensin II is much more powerful, and can change blood pressure more dramatically This change over happens in the lungs- remember when we talked about blowing off CO2?

13. Blood pressure and Billy the kidney Angiotensin Converting Enzyme changes A1 into A2.- It is called ACE That is why people take ACE inhibitors-it controls high blood pressure because drug killed ACE!!

14. Pathopathopathopathopatho Kidney stones- ouch!!!… This may be called renal calculus- it is when minerals from our diets build up in the kidneys and form stones…….. Pyelogram---xray of renal pelvis after contract liquid is injected.

15. Rolling kidney stones Signs and symptoms of kidney stones: extreme pain in your back or side that will not go away blood in your urine fever and chills vomiting urine that smells bad or looks cloudy a burning feeling when you urinate

16. What do they look like? Kidney stones may be as small as a grain of sand or as large as a pearl. Some stones are even as big as golf balls. Stones may be smooth or jagged. They are usually yellow or brown. Golf ball size brown jagged and yellow small smooth

17. How to get rid of them Shoot shock waves transdermally into the kidney to break up stones to pass them called lithotripsy-stone crushing Tunnel surgery makes an incision into the kidney through the back to pull the kidney stone out Uteroscope- doctor sends a wire device through the urethra and a cage and pull it out

18. Urinary tract infections UTI most common in women due to shorter structure of the urinary tract, and proximity of the meatus to the vagina and rectum Remember the urinary tract is sterile, but the GI system is not Most common infections are from the e.coli bacteria common to the intestines

19. UTI Signs and symptoms of UTI: Frequent urination Burning with urination Strange odor Cloudy color to blood tinged called hematuria Treatment- antibiotics to kill bacteria and increase fluid intake

20. pyelonephritis This is inflammation of the kidney tissue and renal pelvis. This is usually caused by the strep bacteria, and forms pus in the kidney which is excreted with urine Signs and symptoms: High fever Chills severe back pain Generalized weakness and pain Loss of appetite and nausea Treatment: antibiotics and increased fluid intake

21. Renal failure Renal failure is when the kidneys shut down and stop filtering the blood. ARF= acute renal failure, sudden drop in urine production due to infection, trauma or blood loss, this is sudden, and most of the time not permanent

22. ARF Little or no urine when you urinate. Swelling, especially in your legs and feet.feet Not feeling like eating. Nausea and vomiting. Nausea Feeling confused, anxious and restless, or sleepy. Pain in the back just below the rib cage. This is called flank pain. Treatment- dialysis- a machine filters the blood where the body can’t

23. dialysis

24. Chronic renal failure stages Stage I= slight kidney damage- observation and control BP Stage II= mild decrease in kidney function- observation and control BP Stage III= moderate decrease in kidney function observation and control BP Stage IV= severe decrease in function-planning on end-stage renal failure Stage V= dialysis and kidney transplant

25. End stage kidney failure

26. Stage 4 pitting edema

27. AV fistula

29. Cannulation of AV fistula

30. Port for dialysis