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GU System (1) A&P of the Kidneys
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Functions of Urinary Systems
Urine formation F & E control Acid-base balance Excretion of waste products BP regulation RBC Regulation of Ca-Phos metabolism
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Sequence of urine flow Kidneys Ureters Urinary bladder Urethra
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Location of Kidneys Retroperitoneal on either side of the vertebral column below the diaphragm
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Kidney’s Gross Anatomy Structure
Hilus is a notch located near center of medial border. It’s where blood vessels, ureter, & nerves enter/exit the kidney Renal Capsule outer covering of kidney that’s composed of strong connective tissue
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Gross Anatomy (con’t) Renal Cortex just beneath renal capsule & contains millions of renal tubules which are part of the microscopic filtration system Medulla lies below renal cortex & contains pyramids which are triangular in shape
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Gross Anatomy (con’t) Papillae are the pointed ends of the pyramids whose main purpose is to empty urine into calyces Calyces are cup like extensions of the renal pelvis which guide urine into the renal pelvis
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Gross Anatomy (con’t) Renal Pelvis is an expansion of the upper end of the ureter Ureter drains urine into the bladder
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Recap Renal Capsule Renal Cortex Medulla Pyramids Papillae Calyces Renal Pelvis Ureter Bladder Urethra
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Microscopic Structure
Glomeruli = tightly bound network of capillaries which make the Renal corpuscle Glomeruli housed inside Bowman’s Capsule R & L renal arteries branch abdominal aorta & enter hilus
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Microscopic Structure (con’t)
R & L renal arteries branch off the Abd aorta & enter the the hilus continuing branching off until blood is delivered to glomerulus by afferent arteriole Blood leaves glomerulus via efferent arteriole to peritubular capillary
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Microscopic Structure (con’t)
Blood reaches renal veins & flows into inferior vena cava
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Microscopic Structure (con’t)
Renal tubule becomes tightly proximal convoluted tubule Loop of Henle distal convoluted tubule which the collecting tubule/duct Juxtaglomerular apparatus plays a role in BP control BP determines GFR (glomeruli filtration rate)
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IV. Nephron Unit Functional unit of the kidney
Responsible for filtering blood & processing urine
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Nephron Unit (con’t) 3 major functions
Controlling body fluid levels by selectively +/- H20 Assisting w/ pH regulation of blood Removing toxic waste from the blood
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V. Hormonal Influence on Nephron Function
BP d/t: fluid loss b/c hemorrhage or blood loss in surgery Diaphoresis Vomiting Diarrhea NGT/GT secretion
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Hormonal Influence (con’t)
Posterior pituitary releases ADH ADH causes distal convoluted tubules to rate of H20 reabsorption resulting in in BP
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VI. Nephron Role in UA Formation
See table 10-1, p. 411 (depending on version ) Glomerulus Proximal convoluted tubule Loop of Henle Distal convoluted tubule & collecting tubules
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VII. Process of UA formation
Glomerular filtration – filtration of H2O & blood occur in the glomerulus of Bowman’s capsule Tubular Reabsorption of H2O, glucose, & necessary ion back into the blood occurs in proximal convoluted tubules, Loop of Henle & distal convoluted tubules which will re-absorb needed substances back into body
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Process of UA formation (con’t)
Secretion of certain ions, nitrogenous wastes & drugs occurs mainly in distal convoluted tubule Reverse of reabsorption Substances move from blood to filtrate
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VIII. Pressure Affecting Glomerular Filtration
Net filtration pressure Hydrostatic pressure Osmotic pressure pressure that develops
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IX. Hormones Affecting Kidney Function (p. 410-411, Herlihy)
Aldosterone (Aldactone) Aldosterone is a hormone secreted by the adrenal cortex blood volume & also BP aldosterone = BP = blood volume Shock
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Hormones Affecting Kidney Function (con’t)
Renin an enzyme which initiates a series of events called the renin-angiotensin-aldosterone system Secreted by the juxtaglomerular apparatus Stimulated with either BP or blood volume
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X. Angiotensin II Production
Renin activates angiotensinogen to form Angiotensin I Angiotensinogen is secreted by the liver & circulates in the blood in an inactive form An enzyme called converting enzyme acts in the pulmonary capillaries to change Angiotension I Angiotensin II
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Angiotensin II Production (con’t)
Angiotensin II stimulates the adrenal cortex to release aldosterone which stimulates the distal tubule to reabsorb sodium & water Excretion of potassium
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RECAP Hormonal Influence
Renin activates Angiotensinogen (from the liver) converting enzyme (from the lungs) converts Angiotensin I Angiotensin II
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XI. Urine Composition & Characteristics
Forms ~ 2 L/d 95% H2O 5% nitrogenous wastes & salts Influenced by several factors What? Slightly acidic w/ pH of 4.6 8.0 Healthy urine is sterile Ammonia odor d/t break of urea
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XII. Urine Abnormalities – Albumin
Albuminuria Indicates possible Kidney disease BP Toxicity of kidney cells from heavy metals Give examples of heavy metals, please.
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Urine Abnormalities – Glucose
Glycosuria Indicates Blood sugar (glucose) level Blood glucose level rises above renal threshold which kidney tubules can no longer reabsorb Glucose spills into the urine
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Urine Abnormalities – Erythrocytes
Hematuria May indicate Infection Tumors Kidney dz or calculi (stone)
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Urine Abnormalities – Ketone Bodies
Ketonuria or ketoaciduria occurs when there is an excessive amount of fatty acid which are oxidized/ catabolized Seen with DM Starvation Anorexia Nervosa
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Urine Abnormalities – Leukocytes
Presence of WBCs (leukocytes) occurs in the presence of an infection or inflammatory process in the urinary tract
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