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Peachy Mae A. Pineda. Osmoregulation and Routine Urinalysis. Urinary System . The urinary system (also called excretory system) is the organ system that produces, stores, and eliminates urine. It consist of the kidneys , ureters , urinary bladder , and urethra. Urinary System.

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urinary system
Urinary System
  • The urinary system(also called excretory system) is the organ system that produces, stores, and eliminates urine.
  • It consist of the kidneys,ureters, urinary bladder, and urethra.
urinary system1
Urinary System

Renal artery

Kidneys

Renal vein

re

Aorta

Ureters

Inferior vena cava

Urinary bladder

Urethra

kidney
Kidney
  • is a compact, bean-shaped organ attached to the dorsal body wall outside the peritoneum.
  • its main roles are to regulate volume and composition of the body fluids.
  • the structure of the kidney consists of the cortex, medulla (inner and outer zones of outer medulla and papilla or inner medulla), pyramids,renal calyxes and pelvis, and ureters. 
kidneys
Kidneys

CORTEX

MEDULLA

RENAL PYRAMID

MINOR CALYXES

MAJOR CALYXES

RENAL PELVIS

URETER

slide6

General Functions of the Kidney

  • Blood Filtering
  • Excretion of Waste
  • Homeostasis
    • Acid-base balance
    • Blood pressure
    • Plasma volume
  • Hormone Secretion
general functions of the kidney blood filtering
General Functions of the Kidney *Blood Filtering
  • Takes place in the nephron.
  • Blood pathway in the kidney (entering)
    • renal artery in the renal sinus
    • branches into segmental arteries
    • further divide into interlobar arteries
    • then supply blood to the arcuate arteries
    • supply a variety of additional interlobar arteries
    • afferent arterioles to be filteredthrough.
general functions of the kidney blood filtering1
General Functions of the Kidney *Blood Filtering
  • Blood pathway in the kidney (exiting)
    • blood moves through a small network of venulesthat converge into interlobar veins
    • the interlobar provide blood to the arcuate veins
    • back to the interlobar veins
    • form the renal vein exiting the kidney for transfusion for blood
general functions of the kidney excretion of waste products
General Functions of the Kidney *Excretion of Waste Products
  • The excreted product came from the waste produced by metabolism.
  • Mostly nitrogenous waste: UREA and URIC ACID,and Water.
  • It is excreted through urine.
general functions of the kidney homeostasis
General Functions of the Kidney *Homeostasis
  • The kidney is one of the major organs involved in whole-body homeostasis.
  • Among its homeostatic functions are acid-base balance, regulation of electrolyte concentrations, control of blood volume, and regulation of blood pressure.
general functions of the kidney homeostasis1
General Functions of the Kidney *Homeostasis
  • Acid-base balance
    • The kidneys regulate the pH of blood by adjusting H+ ion levels, referred as augmentation of mineral ion concentration, as well as water composition of the blood.
  • Blood pressure
    • Sodium ions are controlled in a homeostatic process involving aldosterone which increases sodium ion reabsorption in the distal convoluted tubules.
general functions of the kidney homeostasis2
General Functions of the Kidney *Homeostasis
  • Plasma volume
    • Controlled by hypothalamus.
    • (together with posterior pituitary gland) hypothalamus secretes antidiuretic hormone.
    • resulting in water reabsorptionby the kidney and an increase in urine concentration.
    • The two factors work together to return the plasma osmolarity to its normal levels
general functions of the kidney hormone secretions
General Functions of the Kidney *Hormone Secretions
  • The kidneys secrete a variety of hormones.
    • Erythropoietin is released in response to low levels of O2 in the renal circulation. It stimulates erythrocyte production in red bone marrow.
    • Renin is involved in the regulation of aldosterone secretion.
    • Calcitriol, the activated form of vitamin D, promotes the absorption of Ca2+ from the blood and the excretion of PO32-. They both help to increase Ca2+ levels.
kidneys nephrons
Kidneys *Nephrons
  • Nephrons are microscopic tube-likestructures in the kidneys which mainly facilitates the functions of the kidney.
  • They are the most basic structural and functional unit of the kidney, and are an integral part of the urinary system.
  • Each kidney contains approximately one million of them.
slide15

Kidney

*Nephrons

  • Glomerulus
  • Proximal

convoluted tubule

  • Loop of Henle
  • Distal Convoluted tubule
  • Collecting ducts
kidney glomerulus
Kidney *Glomerulus
  • A capillary network enclosed by the a cup-shaped tructure called the Bowman's capsule.
  • Together with the Bowman’s capsule, glomerulus is called the Renal corpuscle.
  • The renal corpuscle (or Malpighian corpuscle) is the beginning of the nephron.
kidney glomerulus1
Kidney *Glomerulus
  • It is the nephron's initial filtering component.
  • It regulates the concentration of essential substances, and removes substances not produced by the body.
  • Blood enters the glomerulus, it is filtered out to the space made by the Bowman’s capsule.
  • The blood then enters the convoluted tubules through the interstitial space, combines with efferent venules of other glomerulus then rejoins the main blood stream.
kidney renal tubule
Kidney *Renal Tubule
  • Renal tubule or the convoluted tubules is composed of proximal convoluted tubule, (2) loop of Henle, and (3) distal convoluted tubule.
renal tubule proximal convoluted tubule
Renal tubule *Proximal Convoluted tubule
  • Can be divided into an initial convoluted portion and a following straight (descending) portion.
  • Fluid entering the proximal convoluted tubule is reabsorbed into the peritubular capillaries, including filtered salt and water and all filtered organic solutes.
renal tubule loop of henle
Renal Tubule *Loop of Henle
  • Also called the nephron loop, is a U-shaped tube that extends from the proximal tubule.
  • The primary role of the loop of Henle is to concentrate the salt in the interstitium, the tissue surrounding the loop.
  • It consists of a descending limb and ascending limb.
renal tubule loop of henle1
Renal Tubule *Loop of Henle
  • It begins in the cortex, receiving filtrate from the proximal tubule, extends into the medulla as the descending limb, and then returns to the cortex as the ascending limb (hairpin turn)to empty into the distal convoluted tubule.
  • The descending limb is permeable to water but completely impermeable to salt, and thus making the interstitiumhypertonic.
  • The ascending limb is impermeable to water, a critical feature of the countercurrent mechanism. It actively pumps sodium outof the filtrate, because of this the fluid became more hypotonic.
renal tubule distal convoluted tubule
Renal Tubule *Distal Convoluted Tubule
  • Cells lining the tubule have numerous mitochondria to produce enough energy (ATP) for active transport to take place.
  • Regulated by the endocrine system.
renal tubule distal convoluted tubule1
Renal Tubule *Distal Convoluted Tubule
  • In the presence of parathyroid hormone, the distal convoluted tubule reabsorbs more calcium and excretes more phosphate.
  • Aldosterone promotes more sodium to be reabsorbed and more potassium to be excreted.
  • Atrialnatriuretic peptide causes the distal

convoluted tubule to excrete more sodium.

  • In addition, the tubule also secretes hydrogen and ammonium to regulate pH.
collecting ducts
Collecting Ducts
  • The distal convoluted tubules of several nephrons empty into a single collecting duct.
  • Collecting ducts then unite and converge to form papillary ducts.
collecting ducts1
Collecting Ducts
  • As the filtrate moves through the renal tubule, the osmolarity of the filtrate changes. 
  • As it moves deeper into the medulla, it increases, and when it ascends the loop of Henle, it decreases only to increase again while going down the collecting duct. 
  • It is this hyperosmotic condition in the medulla that allows passive transport to occur. 
  • Collecting duct is normally impermeable to water, it becomes permeable in the presence of antidiuretic hormone (ADH). Lower portions of the collecting duct are also permeable to urea..
urine formation what is urine
Urine Formation *What is Urine?
  • The waste product secreted by the kidneys that in mammals is a yellow to amber-colored, slightly acid fluid discharged from the body through the urethra.
  • An aqueous solution of organic and inorganic substances, mostly waste products of metabolism.
  • It consists of water, carrying in solution the body's

waste products such as urea, uric acid, creatinine, organic acids, and also other solutes such as Na+, K+, Ca2+, Mg2+, Cl-, the body fluid concentrations of which are regulated by the kidneys.

urine formation
Urine formation
  • The production of urine is vital to the health of the body.
  • “Cleaning" of the blood takes place in the kidneys and, in particular, in the nephrons, where the blood is filtered to produce the urine.
  • The kidneys' 2 million or more nephrons form urine by three precisely regulated processes.
urine formation1
Urine Formation
  • The three processes are the following:

A. Glomerulus Filtration

B. Tubular Reabsorption

C. Tubular Secretion

Expressed mathematically as:

Urinary excretion rate = Filtration rate – Reabsorption rate + Secretion rate

urine formation 1 glomerular filtration
Urine Formation *1.Glomerular Filtration
  • Urine formation begins with the process of filtration, which goes on continually in the renal corpuscles (glomerulus and Bowman’s capsule).
  • As blood courses through the glomeruli, much of its fluid soaks out of the blood through the membranes (by osmosis and diffusion) where it is filtered and then flows into the Bowman's capsule.
  • The water, waste products, salt, glucose, and other chemicals that have been filtered out of the blood are known collectively as glomerular filtrate
urine formation 1 glomerular filtration1
Urine Formation *1.Glomerular Filtration
  • The glomerular filtrate consists primarily of water, excess salts (primarily Na+ and K+), glucose, and a waste product of the body called urea.
  • The total rate of glomerular filtration (glomerular filtration rate or GFR) for the whole body is normally about 125 ml per minute. That is, about 125 ml of water and dissolved substances are filtered out of the blood per minute.
urine formation glomerular filtration
Urine Formation *GlomerularFiltration
  • The GFR per hour is:
    • 125 ml/min X 60min/hr= 7500 ml/hr.
  • The GFR per day is:
    • 7500 ml/hr X 24 hr/day = 180,000 ml/day or 180 litres/day.
urine formation 2 tubular reabsorption
Urine Formation *2.Tubular Reabsorption
  • Reabsorptionis the movement of substances out of the renal tubules and collecting ducts back into the blood capillaries located around the tubules (called the peritubularcopillaries).
  • Substances reabsorbed are water, glucose and other nutrients, and sodium (Na+) and other ions.
  • Reabsorption begins in the proximal convoluted tubules and continues in the loop of Henle, distal convoluted tubules, and collecting tubules.
urine formation 2 tubular reabsorption1
Urine formation *2.Tubular Reabsorption
  • Large amounts of water about 99% of the 180 liters of water that leave the blood each day by glomerular filtration returns to the blood from the proximal tubule through the process of passive reabsorption.
  • The nutrient glucose (blood sugar) is entirely reabsorbed back into the blood from the proximal tubules. In fact, it is actively transportedout of the tubules and into the peritubular capillary blood.
urine formation 2 tubular reabsorption2
Urine Formation *2.Tubular Reabsorption
  • Sodium ions (Na+) and other ions are only partially reabsorbed from the renal tubules back into the blood.
  • Sodium ions are actively transportedback into blood from the tubular fluid.
  • The amount of sodium reabsorbed varies from time to time; it depends largely on how much salt we take in from the foods that we eat.
urine formation 3 tubular secretion
Urine Formation *3.Tubular Secretion
  • Secretion is the process by which substances move into the distal and collecting tubules from blood in the capillaries around these tubules.
  • Secretion is reabsorption in reverse.
  • Whereas reabsorption moves substances out of the tubules and into the blood, secretion moves substances out of the blood and into the tubules where they mix with the water and other wastes and are converted into urine.
urine formation 3 tubular secretion1
Urine Formation *3.Tubular Secretion
  • These substances are secreted through either an active transportmechanism or as a result of diffusion across the membrane.
  • Substances secreted are hydrogen ions (H+), potassium ions (K+), ammonia (NH3), and certain drugs.
  • Kidney tubule secretion plays a crucial role in maintaining the body's acid-base balance
osmoregulation1
Osmoregulation
  • Regulation of the concentration of dissolved substances in the cells and body fluids (e.g. blood) of an animal.
  • Importance: Maintains homeostasis
    • cells being bathed in tissue fluid which has the correct amount of water, mineral salts, glucose and temperature.
osmoregulation2
Osmoregulation
  • the physiological processes that an organism uses to maintain water balance; that is, to compensate for water loss, avoid excess water gain, and maintain the proper osmotic concentration (osmolarity) of the body fluids
  • Most humans are about 55 to 60 percent water by weight (45 percent in elderly and obese people and up to 75 percent in newborn infants).
results and discussions
Results and Discussions

Volume of Urine Produced

results and discussions2
Results and Discussions

Total Volume of Urine Produced

results and discussions3
Results and Discussions
  • Diuretics
    • Increase urine output by the kidney
    • Promote diuresis
results and discussions4
Results and Discussions
  • Caffeine is a natural diuretic.
    • It makes you secrete more urine.
    • It is found in coffee, tea, soft drinks, and chocolate.
results and discussions5
Results and Discussions
  • If caffeine promotes diuresis, then why does coffee and soft drinks which contain caffeine only ranked fourth and third respectively in volume of urine excreted?
results and discussions6
Results and Discussions
  • Subsequent studies have further shown that the mechanism of caffeine diuresis is dubious in nature, as caffeine containing beverages did not impact urinary output any differently, when compared to other beverages that do not contain caffeine. However, this does not mean that caffeine does not increase your need or urge to urinate.
results and discussions7
Results and Discussions
  • The antidiuretic hormone (ADH) or vasopressin stimulates the kidney tubules to absorb water from the filtered plasma that passes through the kidneys and thus regulates the amount of urine secreted by the kidneys
  • Sodium chloride is antidiuretic in a sense that it stimulates ADH production
results and discussions8
Results and Discussions
  • When the amount of salt and other substances in the bloodstream becomes too high, the pituitary gland releases ADH into the bloodstream. When it enters the kidney, ADH makes the walls of the renal tubules and collecting ducts more permeable to water, so that more water is reabsorbed into the bloodstream  decreased urine output
conclusion
Conclusion
    • Osmoregulation: control of the concentration of dissolved substances in the cells and body fluids (e.g. blood) of an animal and is important because it helps maintain homeostasis.
  • Kidneys are delicate organs needed in the excretion of wastes.
  • Two types of substances that can affect osmoregulation: diuretics and antidiuretics
  • Diuretics, increases urine output
  • Antidiuretics decreases urine output
practical application
Practical Application
  • Medicines:
  • antidiureticsand diuretics (furosemide)
  • Diuretics are administered to patients with diseases relating to high water retention and those with congenital heart diseases.
  • Antidiuretics (synthetic vasopressin) is given to patients with Diabetes insipidus (deficiency of vasopressin)
    • Patients often experience increased thirst and urination. Treatment is with drugs, such as synthetic vasopressin, that help the body maintain water and electrolyte balance.
practical applications
Practical Applications
  • Clinical tests: Measurements of the composition of urine are useful in the diagnosis of a wide variety of conditions, including kidney disease, diabetes, and pregnancy.
routine urinalysis1
Routine Urinalysis
  • Urinalysis, or examination of the urine, indicates whether any abnormal substances are present in the urine.
  • This is done to screen for possible presence of diseases that could be detected in the urine sample.
  • A complete urinalysis has three stages:

1.Physical Examination

2. Chemical Examination

3. Microscopic Examination

procedure1
Procedure
  • I. Physical Examination of Urine
slide59

Results

  • Physical Examination of Urine Samples
procedure2
Procedure
  • Chemical Examination of Urine
    • Benedict’s test
results
Results
  • None of the urine samples is positive to Benedicts test, it simply implies that glucose is not present in the urine.
procedure3
Procedure
  • Chemical Examination of Urine
    • Heat and Acetic Acid Test
results1
Results
  • Normally, only small plasma proteins filtered at the glomerulus are reabsorbed by the renal tubule. The detection of protein in urine may indicate that the permeability of the glomerulus is abnormally increased.
  • May be caused by renal infections or it may be caused by other diseases that have secondarily affected the kidneys such as diabetes mellitus, jaundice, or hyperthyroidism.
  • Normal total protein excretion does not usually exceed 150 mg/24 hours or 10 mg/100 ml in any single specimen. More than 150 mg/day is defined as proteinuria.
  • Proteinuria > 3.5 gm/24 hours is severe and known as nephrotic syndrome.
microscopic examination1
Microscopic Examination

Casts

  • Urinary casts are formed only in the distal convoluted tubule (DCT) or the collecting duct (distal nephron).
  • Their presence indicates inflammation of the kidney, because such casts will not form except in the kidney.

Conditions which may lead to:

  • lupus nephritis
  • malignant hypertension
  • diabetic glomerulosclerosis
  • rapidly progressive glomerulonephritis
microscopic examination2
Microscopic Examination
  • RBC (Red Blood Cells) Casts
  • RBC in urine - indicative of glomerulonephritis, with leakage of RBC's from glomeruli, or severe tubular damage.
  • Hematuria - the presence of red blood cells (erythrocytes) in the urine.
microscopic examination3
Microscopic Examination
  • White blood cell casts

Sterile pyuria is urine which contains white blood cells while appearing sterile by standard culturing techniques. Sterile pyuria is listed as a side effect from some medications such as paracetamol (acetaminophen). Its occurrence is also associated with certain disease processes, such as Kawasaki Disease and renal TB

microscopic examination4
Microscopic Examination

Renal Tubular Epithelial Cells

  • usually larger than granulocytes, contain a large round or oval nucleus and normally slough into the urine in small numbers.
  • smaller and rounder than transitional epithelium

Transitional Epithelial Cells

  • from the renal pelvis, ureter, or bladder have more regular cell borders, larger nuclei, and smaller overall size than squamous epithelium.

Squamous Epithelial Cells

  • from the skin surface or from the outer urethra can appear in urine. Their significance is that they represent possible contamination of the specimen with skin flora.
microscopic examination5
Microscopic Examination

Yeast

  • Yeast cells may be contaminants or represent a true yeast infection. They are often difficult to distinguish from red cells and amorphous crystals but are distinguished by their tendency to bud. Most often they are Candida, which may colonize bladder, urethra, or vagina.
microscopic examination6
Microscopic Examination

Crystals

  • Common crystals seen even in healthy patients include calcium oxalate, triple phosphate crystals and amorphous phosphates.
  • Very uncommon crystals include: cystine crystals in urine of neonates with congenital cystinuria or severe liver disease, tyrosine crystals with congenital tyrosinosis or marked liver impairment, or leucine crystals in patients with severe liver disease or with maple syrup urine disease.
microscopic examination7
Microscopic Examination
  • Amorphous crystals
    • appear as aggregates of finely granular material without any defining shape
    • Amorphous urates of Na, K, Mg or Ca tend to form in acidic urine
    • Amorphous phosphates tend to form in alkaline urine
microscopic examination8
Microscopic Examination

Bacteria

  • Bacteria are common in urine specimens because of the abundant normal microbial flora of the vagina or external urethral meatus and because of their ability to rapidly multiply in urine standing at room temperature.
  • Therefore, microbial organisms found in all but the most scrupulously collected urines should be interpreted in view of clinical symptoms.
results and discussions10
Results and Discussions
  • Subject 1(water)
slide75

Results and DDcussions

  • Subject 2(brine)
slide77

Results and Discussions

Results and Discussions

  • Subject 4( Coffee)
results and discussions12
Results and Discussions

White bloods cells

results and discussions13
Results and Discussions

Red bloods cells

conclusion1
Conclusion
  • The presence of glucose in the urine usually indicates that the individual has diabetes mellitus, a condition in which either the liver fails to store glucose as glycogen or the cells fail to take up glucose. In both cases, the blood glucose level is abnormally high.
  • This makes the filtrate level of glucose high, and because the proximal convoluted

tubule cannot absorb all of it, glucose appears in the urine.

practical applications1
Practical Applications
  • Diabetes insipidus
    • Diabetes insipidus (DI) is a rare disease that causes frequent urination and excessive thirst.
    • DI is not related to diabetes mellitus (DM).
    • excessive intake of fluid
    • a defect in ADH production
    • a defect in the kidneys’ response to ADH
practical applications2
Practical Applications
  • Central DI results from damage to the pituitary gland which disrupts the normal storage and release of ADH
  • Nephrogenic DI results when the kidneys are unable to respond to ADH
  • Dipsogenic DI, which is caused by a defect in the thirst mechanism.
  • Gestational DI results when an enzyme made by the placenta destroys ADH
practical applications3
Practical Applications
  • Polyuria
    • The excessive passage of urine (at least 2.5 liters per day for an adult) resulting in profuse urination and urinary frequency (the need to urinate frequently).
    • Caused by DI, increase uptake of water, or uptake of diuretics
practical applications4
Practical Applications
  • Anuria and oliguria
    • The absent or decreased urine production, respectively
    • failure in the function of kidneys
    • severe obstruction like kidney stones or tumours