7 12 urinary system
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7:12 Urinary System. Excretory system Removes certain wastes and excess water from the body Maintains homeostasis – a state of equilibrium in the internal environment of the body Maintains acid-base balance Parts of the urinary system include: 2 kidneys, 2 ureters, 1 bladder , and

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7:12 Urinary System

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7 12 urinary system

7:12 Urinary System

  • Excretory system

    • Removes certain wastes and excess water from the body

    • Maintains homeostasis – a state of equilibrium in the internal environment of the body

    • Maintains acid-base balance

  • Parts of the urinary system include:

    • 2 kidneys,

    • 2 ureters,

    • 1 bladder, and

    • 1 urethra


Kidneys

Kidneys

  • Bean-shaped organs

  • Location

    • On either side of the vertebral column,

    • Behind the upper part of the abdominal cavity,

    • Separated from this cavity by the peritoneum.

    • Location often called retroperitoneal

  • Protection by ribs and enclosed in a heavy cushion of fat (adipose capsule)

    • Held in place by connective tissue,

    • Covered externally by tough fibrous tissue called renal fascia or fibrous capsule


Kidneys1

Kidneys

Each kidney is divided into 2 main sections:

  • Cortex

    • Outer section of the kidney

    • Contains most of the nephrons, which aid in the production of urine

  • Medulla –

    • Inner section of the kidney

    • Contains most of the collecting tubules that carry urine from the nephrons through each kidney


Kidneys cont

Kidneys(cont.)

  • Hilum – the notched area through which the ureter, nerves, blood vessels and lymph vessels enter and leave the kidney

  • Nephrons– microscopic filtering units in the kidneys

    • More than 1 million nephrons per kidney


Nephrons

Nephrons

  • Each nephron consists of a

    • Glomerulus

    • Bowman’s capsule

    • A proximal convoluted tubule

    • A distal convoluted tubule

    • Collecting duct (tubule)


Process of filtration

Process of Filtration

  • Renal artery carries blood to the kidney.

  • Branches of renal artery pass through the medulla to the cortex where blood enters first part of the nephron, the glomerulus.

  • The glomerulus is a cluster of capillaries

  • As blood passes through:

    • Water, salts, glucose (sugar), metabolic products and other substances are filtered out of the blood

    • Erythrocytes and proteins are notfiltered out.


Process of filtration cont

Process of Filtration(cont.)

  • Filtered blood returnsto the renal vein and away from the kidney

  • Filtered out substances enter the next section of the nephron – the Bowman’s capsule


Process of filtration cont1

Process of Filtration(cont.)

  • Bowman’s Capsule

    • C-shaped structure that surrounds the glomerulus and is the start of the convoluted tubule

    • Picks up the material and passes it into the convoluted tubule


Process of filtration cont2

Process of Filtration(cont.)

  • Convoluted Tubules

    • As material passes through the various sections of the tubule, substances needed by the body are reabsorbed and returned to the capillaries

    • By the time all materials go through, most of the water, glucose, vitamins and mineral salts have been reabsorbed


Process of filtration cont3

Process of Filtration(cont.)

  • Excess glucose, mineral salts, some water, and wastes (including urea, uric acid and creatinine) remain in the tubule and become known as the concentrated liquid called urine

  • The urine enters the collecting ducts in the medullas and empty into the renal pelvis, a funnel-shaped structure that is the first section of the ureter.


Ureters

Ureters

  • Muscular tubes about 10–12 inches long

  • Extend from renal pelvis of each kidney to bladder

  • Peristalsis moves urine through tube to bladder


Bladder

Bladder

  • Hollow, muscular sac

  • Lies behind the symphysis pubis at midline of the pelvic cavity

  • Lined with mucous membranes arranged in a series of folds called rugae which disappear as the bladder expands with urine

  • Three layers of visceral muscle form walls of bladder


Bladder cont

Bladder (cont.)

  • Urge to void occurs when approx 250 ml of urine is present, but it can hold more

  • Circular sphincter muscle controls opening of bladder to prevent emptying

  • Receptors in the bladder wall send signal (a reflex action) to the sphincter muscle, which opens to release the urine

  • Infants cannot control this reflex action – they learn control in toddlerhood.


Urethra

Urethra

  • Carries urine from bladder to the outside

  • External opening is the urinary meatus

  • Female and male systems differ

    • 1.5 inches long in females

    • 8 inches long in males


Composition of urine

Composition of Urine

  • Liquid waste product produced by urinary system

  • About 95% water

  • 5% nitrogenous waste(urea, uric acid), toxins, and mineral salts

  • Excess useful products, such as sugar, can also be found in urine, but it usually indicates a disease


Amount of urine

Amount of Urine

  • Normal = 1500 - 2000 ml each 24 hours

  • Oliguria (scanty production of urine) = less than 400 ml/24 hrs

  • Anuria (absence of urine formation) = considered less than 75ml/24 hrs

  • Polyuria (excessive production of urine) = over 2500 ml/24 hrs


More terms to describe conditions affecting urination

More Terms to describe conditions affecting urination

  • Hematuria: blood in the urine

  • Pyuria: pus in the urine

  • Nocturia: urination at night

  • Dysuria: painful urination

  • Retention: inability to empty the bladder

  • Incontinence: involuntary urination

  • Proteinuria: protein in the urine

  • Albuminuria: albumin (a blood protein) in the urine


Diseases and abnormal conditions

Diseases and Abnormal Conditions

  • Cystitis

  • Glomerulonephritis or nephritis

  • Pyelonephritis

  • Renal calculus or urinary calculus

  • Renal failure: Acute vs. Chronic

  • Uremia

  • Urethritis


Cystitis

Cystitis

  • Inflammation of the urinary bladder

  • Usually caused by pathogens entering the urinary meatus

    • More common in females due to shortness of urethra

  • Symptom – frequent urination, dysuria, burning sensation during urination, hematuria, lower back pain, bladder spasm, fever

  • Treatment – antibiotics and increased fluid intake


Glomerulonephritis or nephritis

Glomerulonephritis, or Nephritis

  • Inflammation of the glomerulus of the kidney

  • Two types: acute or chronic

  • Acute – usually follows a streptococcal infection such as strep throat, scarlet fever, or rheumatic fever.

    Symptoms

    Chills, fever, fatigue, edema, oliguria, hematuria, and albuminuria

    Treatment

    Rest, restriction of salt, maintenance of fluid and electrolyte balance, antipyretics, diuretics, antibiotics, if needed.

    With treatment, function is restored, prognosis is good


Glomerulonephritis or nephritis cont

Glomerulonephritis, or Nephritis (cont.)

  • Chronic

    • Progressive disease that causes scarring and sclerosing (hardening) of the glomeruli

      Symptoms

    • Similar to acute, but later with hypertension, anorexia, weight loss, congestive heart failure, pyuria, and finally, renal failure and death.

      Treatment

    • Similar to acute with hemodialysis

    • When both kidneys are severely damaged, a kidney transplant can be performed.


Pyelonephritis

Pyelonephritis

  • Inflammation of the kidney tissue and renal pelvis (upper end to the ureter)

  • Usually caused by pyogenic (pus-forming) bacteria

  • Symptoms

    • Chills, fever, back pain, fatigue, dysuria, hematuria, pyuria

  • Treatment

    • Antibiotics, increased fluid intake


Renal calculus

Renal Calculus

  • A Renal calculus, or urinary calculus, is a kidney stone

  • Stone formed when salts in the urine precipitate (settle out of solution)

  • Small ones are eliminated in the urine, larger ones become lodged in the renal pelvis or ureter


Kidney stones

“Kidney Stones”


Renal calculus cont

Renal Calculus (cont.)

  • Symptoms

    • Sudden intense pain

    • Hematuria

    • Nausea and vomiting

    • Frequent urge to void

    • In some cases, urinary retention

  • Treatment

    • Increase fluids

    • Pain meds

    • Strain urine to detect stones

    • Extracorporeal shock-wave lithotripsy


Renal failure

Renal Failure

  • This is when the kidney stops functioning --- there are two types: Acute and Chronic

  • Acute Renal Failure (ARF)

    • Causes

      • Hemorrhage, shock, injury, poisoning, nephritis, or dehydration

    • Symptoms

      • Oliguria or anuria, headache, ammonia odor to breath, edema, cardiac arrhythmia, and uremia

    • Prompt treatment involving dialysis , restricted fluid intake and correction of the condition causing the failure results in a good prognosis.


Renal failure cont

Renal Failure (cont.)

  • Chronic Renal Failure (CRF)

    • Results from progressive los of kidney function

    • Causes

      • Chronic glomerulonephritis, hypertension, toxins, and endocrine disease such as diabetes mellitus, and long-term substance abuse and alcoholism

    • Waste product enter the blood system and affect many body systems

    • Symptom

      • Nausea, vomiting, diarrhea, weight loss,

      • Decreased mental ability, convulsions,

      • Muscle irritability, ammonia odor to the breath,

      • uremic frost (deposit of white crystals on the skin)

      • Late stages - Coma prior to death


Uremia azotemia

Uremia (Azotemia)

  • Toxic condition when the kidneys fail and urinary wastes are present in the bloodstream

  • Symptoms

    • Headache, dizziness, nausea, vomiting, ammonia odor to breath, oliguria or anuria, mental confusion, convulsions, coma, and eventually death

  • Treatment

    • Restricted diet, cardiac meds to increase BP and cardiac output, and dialysis until a kidney transplant is performed


Urethritis

Urethritis

  • Inflammation of the urethra

  • Usually caused by bacteria, viruses, or chemicals

  • More common in males

  • Symptoms

    • Frequent, painful urination

    • Redness and itching at the urinary meatus

    • Purulent (pus) discharge

  • Treatment

    • Sitz baths

    • Warm moist compresses

    • Antibiotics

    • Increased fluid intake


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