The Urinary System. Kidneys, ureters, urinary bladder & urethra Urine flows from each kidney, down...
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Transcript of The Urinary System. Kidneys, ureters, urinary bladder & urethra Urine flows from each kidney, down...
The Urinary System
The Urinary System
•Kidneys, ureters, urinary bladder & urethra
• Urine flows from each kidney, down its ureter to the bladder and to the outside via the urethra
• Filter the blood and return most of water and solutes to the bloodstream
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Organs of the
Urinary System
Organs of the
Urinary System
kidneys
ureters
urinary bladder
urethra
کلیههاعضوپشتصفاقیازمهره،دوازدهمپشتیتاسومیناندشدهواقعکمریمهره
شریانکلیویازآئورتشکمیووریدکلیوینیزبهوریداجوریزدمیتحتانیف
اعصابمثانهسمپاتیکوپاراسمپاتیکدفعادراردقیقترینراهاندازهگیریفیلتراسیونگلومرولیکلیرانس
استساعتهادرارتوسطکراتینین
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Urinary systemUrinary system
• Organ system that produces, stores, and carries urine• Includes two kidneys, two ureters, the urinary bladder, two
sphincter muscles, and the urethra. • Humans produce about 1.5 liters of urine over 24 hours,
although this amount may vary according to the circumstances. • Increased fluid intake generally increases urine production.• Increased perspiration and respiration may decrease the amount
of fluid excreted through the kidneys. • Some medications interfere directly or indirectly with urine
production, such as diuretics.
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Function
1. Remove nitrogenous wastes2. Maintain electrolyte, acid-base,
and fluid balance of blood3. Homeostatic organ4. Acts as blood filter5. Release hormones: calcitriol &
erythropoietin
Kidneys as Filters
• Diuretic- loose water; coffee, alcohol• Antidiuretic- retain water; ADH• Aldosterone- sodium & water reabsorption,
and K+ excretion• GFR= 180 liters of blood/day• 178-179 liters are reabsorbed back into
blood• Excrete a protein free filtrate
Maintaining Chemical
Homeostasis
The Urinary System
The Urinary System
urine
blood
filtration
tubular reabsorption and secretion
General Functioning of
the Kidney
General Functioning of
the Kidney
“refreshed” blood
renal capsule
renal cortex
renal medulla
renal pelvis
renal pyramids
ureter
Kidney AnatomyKidney
Anatomy
Kidney AnatomyKidney
Anatomy
renal artery
renal vein
nephronnephron
urine
blood
filtration
tubular reabsorption and secretion
Nephron Functioning
Nephron Functioning
“refreshed” blood
vein
artery
afferent arteriole
efferent arteriole
glomerulus
peritubular capillaries
Bowman’s capsule
proximal convoluted tubuledistal convoluted tubule
loop of Henle
collecting duct
renal cortex
renal medulla
Each kidney contains over 1 million nephrons and thousands of collecting ducts
Collecting duct
Loop of Henle
PCT
DCTGlomerulus
Glomerular Filtration
Glomerular Filtration
afferent arteriole
glomerulus
efferent arteriole
Bowman’s capsule
Filters blood; proteins can’t pass through
Composition of Glomerular Filtrate
• WaterWater• Small Soluble Organic Small Soluble Organic
MoleculesMolecules• Mineral IonsMineral Ions
Proximal Convoluted Tubule
Reabsorbs: water, glucose, Reabsorbs: water, glucose, amino acids, and sodium.amino acids, and sodium.
•65% of Na+ is reabsorbed•65% of H2O is reabsorbed
•90% of filtered bicarbonate (HCO3-)
•50% of Cl- and K+
Loop of Henle
Creates a gradient of increasing Creates a gradient of increasing sodium ion concentration towards sodium ion concentration towards the end of the loop within the the end of the loop within the interstitial fluid of the renal pyramid.interstitial fluid of the renal pyramid.
•25% Na+ is reabsorbed in the loop•15% water is reabsorbed in the loop•40% K is reabsorbed in the loop
Distal Convoluted Tubule
Under the influence of the hormone Under the influence of the hormone aldosterone, reabsorbs sodium and aldosterone, reabsorbs sodium and secretes potassium. Also regulates secretes potassium. Also regulates pH by secreting hydrogen ion when pH by secreting hydrogen ion when pH of the plasma is low.pH of the plasma is low.
• only 10% of the filtered NaCl and 20% of water remains
Collecting Duct
Allows for the osmotic Allows for the osmotic reabsorption of water.reabsorption of water.
ADH (antidiuretic hormone)- makes collecting ducts more permeable to water-- produce concentrated urine
From the original 1800 g NaCl, only 10 g appears in the urine
Urine
Water- 95%Nitrogenous waste:
• urea• uric acid• creatinine
Ions:• sodium• potassium• sulfate• phosphate
Hormonal Control of
Kidney Function
Hormonal Control of Kidney Function
low blood volumelow blood volumehigh plasma high plasma solute solute
concentrationconcentration
hypothalamushypothalamus
heart receptorsheart receptors
Hormonal Control of Kidney Function
hypothalamushypothalamus
posterior pituitaryposterior pituitary
antidiuretic hormoneantidiuretic hormone
collecting ductscollecting ducts
Hormonal Control of
Kidney Function
Hormonal Control of Kidney Function
reduced blood pressure and reduced blood pressure and glomerular filtrateglomerular filtrate
juxtaglomerular apparatusjuxtaglomerular apparatus
reninrenin
Hormonal Control of Kidney Function
reninreninangiotensinogenangiotensinogen
angiotensin Iangiotensin I
angiotensin IIangiotensin II
Hormonal Control of Kidney Function
adrenal cortexadrenal cortex
aldosteronealdosterone
angiotensin IIangiotensin II
convoluted tubulesconvoluted tubules
Urinary BladderUrinary Bladder
uretersinternal sphinctersexternal
sphinctersurethra
Bladder
1. Mucosa (transitional epithelium)2. Muscular layer (detrusor muscle):
3 layers of smooth muscle3. Fibrous adventia
Internal urethral sphincter:• Smooth muscle• Involuntary control• More superiorly located
External Urethral sphincter:• Skeletal muscle• Voluntary control• Posteriorly located
Sphincter Muscles on Bladder
When bladder fills with 200 ml of urine, stretch receptors transmit impulses to the CNS and produce a reflex contraction of the bladder (PNS)
Diuresis (Micturition)
When is incontinence normal?
Distension of the Urinary
Bladder
Why do doctors ask for a urine sample?
Urinalysis
characteristics:• smell- ammonia-like• pH- 4.5-8, ave 6.0• specific gravity– more than 1.0; ~1.001-
1.003 • color- affected by what we eat: salty foods,
vitamins
odor- normal is ammonia-like
diabetes mellitus- smells fruity or acetone like due to elevated ketone levels
diabetes insupidus- yucky
asparagus---
Odor
pH- range 4.5-8 ave 6.0
vegetarian diet- urine is alkaline
protein rich and wheat diet- urine is acidic
Color- pigment is urochromeYellow color due to metabolic breakdown of hemoglobin (by bile or bile pigments)
Beets or rhubarb- might give a urine pink or smoky color
Vitamins- vitamin C- bright yellow
Infection- cloudy
Color
Water: s.g. = 1g/liter; Urine: s.g. ~ 1.001 to 1.030
Pyelonephritus- urine has high s.g.; form kidney stones
Diabetes insipidus- urine has low s.g.; drinks excessive water; injury or tumor in pituitary
Specific Gravity
Glucose- when present in urine condition called glycosuria (nonpathological) [glucose not normally found in urine]
Indicative of:• Excessive carbohydrate intake• Stress• Diabetes mellitus
Abnormal Constitutes of Urine
Albumin-abnormal in urine; it’s a very large molecule, too large to pass through glomerular membrane > abnormal increase in permeability of membrane
Albuminuria- nonpathological conditions- excessive exertion, pregnancy, overabundant protein intake-- leads to physiologic albuminuria
Pathological condition- kidney trauma due to blows, heavy metals, bacterial toxin
Abnormal Constitutes of Urine
Ketone bodies- normal in urine but in small amts
Ketonuria- find during starvation, using fat stores
Ketonuria is couples w/a finding of glycosuria-- which is usually diagnosed as diabetes mellitus
RBC-hematuria
Hemoglobin-
Hemoglobinuria- due to fragmentation or hemolysis of RBC; conditions: hemolytic anemia, transfusion reaction, burns or renal disease
Abnormal Constitutes of Urine
Bile pigments-
Bilirubinuria (bile pigment in urine)- liver pathology such as hepatitis or cirrhosis
WBC-
Pyuria- urinary tract infection; indicates inflammation of urinary tract
Casts- hardened cell fragments, cylindrical, flushed out of urinary tract
WBC casts- pyelonephritus
RBC casts- glomerulonephritus
Fatty casts- renal damage
Abnormal Constitutes of Urine
Uc :از کمتر طبیعی =1000اگر کولونیمشکوک=10000کمتراز کولونی
عفونی=100000باالی کولونیماده کلیرانس: تقسیم Aغلظت معین ادراردرزمان حجم ضربدر درادرار
ماده غلظت درپالسماAبرResidual urine
KUBIVP کرچک روغن با روده ،تخلیه مایعات مصرف عدم
رتروگراد پیلوگرافیCTS
سیستویورتروگرافیکلیه آنژیوگرافی
اولتراسونوگرافیایزوتوپ رادیو بررسی
کلیه بیوپسیسیستوسکوپینفروسکوپی
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