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Urinary System

Urinary System. CHAPTER 15. Urinary System Overview. Functions of urinary system Removes waste products from blood Produces and eliminates urine Kidneys produce hormone Erythropoietin (EPO) Stimulates production of red blood cells within bone marrow Kidneys produce enzyme Renin

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Urinary System

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  1. Urinary System CHAPTER 15

  2. Urinary System Overview • Functions of urinary system • Removes waste products from blood • Produces and eliminates urine • Kidneys produce hormone Erythropoietin (EPO) • Stimulates production of red blood cells within bone marrow • Kidneys produce enzyme Renin • Aids in raising blood pressure

  3. Structures of the Urinary System • Kidneys • Reddish-brown, bean-shaped organs located on either side of the vertebral column at back of upper abdominal cavity • Cortex • Outer layer of kidney • Contains millions of microscopic units called nephrons • Functional units of kidneys

  4. Structures of the Urinary System • Kidneys: Components of Nephron • Glomerulus • Ball-shaped collection of very tiny, coiled, and intertwined capillaries • Bowman’s capsule (renal capsule) • Double-walled cup surrounding the glomerulus • Renal tubule • Proximal convoluted tubule • Loop of Henle • Distal convoluted tubule • Peritubular capillaries

  5. Structures of the Urinary System • Kidneys • Medulla • Inner layer of kidney • Consist of triangular tissues called renal pyramids- loops and collecting tubules of nephron • Pyramids extend into a cuplike urine collection cavity called minor calyx • Minor calyces merge to form major calyx • Major calyces merge to form renal pelvis

  6. Structures of the Urinary System • Ureters • Muscular tubes lined with mucous membrane • One leads from each kidney down to urinary bladder • Urine is propelled from renal pelvis through ureters by wavelike contractions known as peristalsis

  7. Structures of the Urinary System • Bladder • Hollow, muscular sac in pelvic cavity • Between pubic symphysis and rectum in men • Between pubic symphysis and uterus and vagina in women • Serves as a temporary reservoir for urine • Spherical shaped when full • Resembles inverted pyramid when empty

  8. Structures of the Urinary System • Urethra • Mucous membrane-lined tube that leads from bladder to exterior of body • Urine exits bladder through urethra • External opening of urethra is the urinary meatus • Female urethra carries only urine • Male urethra carries both urine and semen during ejaculation

  9. Formation of Urine • Formation of urine consists of three distinct processes: glomerular filtration, tubular reabsorption, and tubular secretion • Process begins as blood enters kidneys via left and right renal arteries • Renal arteries branch out into smaller vessels throughout kidney tissue, until these arteriolesreach cortex of kidney • Each arteriole leads to a glomerulus

  10. Formation of Urine • Glomerular filtration • As blood passes through the glomeruli, blood pressure forces materials through glomerular walls into Bowman’s capsule • Glomerular Filtrate = water, sugar, salts, and nitrogenous waste products such as urea, creatinine, and uric acid that filter out of blood through thin walls of glomeruli

  11. Formation of Urine • Tubular reabsorption • As glomerular filtrate passes through renal tubules, water, sugar, and salts are returned to bloodstream through network of capillaries that surround them • Tubular secretion • Materials are selectively transferred from blood into the filtrate to be excreted in the urine

  12. Formation of Urine • Urine • Urine consists of water and other materials that were filtered or secreted into the tubules but not reabsorbed • Normally one percent of glomerular filtrate is excreted as urine

  13. Characteristics of Normal Urine • Color • From pale yellow to a deep golden color • Darker the urine, greater the concentration • Clarity • Normal urine is clear • Cloudy, turbid appearance to the urine may be due to presence of pus, bacteria, presence of bladder or kidney infection, or a specimen that has been standing for more than an hour

  14. Characteristics of Normal Urine • Odor • Normal urine is aromatic • Has a strong but agreeable odor • Specific gravity • Normal urine has specific gravity of 1.003 – 1.030 • Specific gravity = measurement of the amount of solids in the urine

  15. Characteristics of Normal Urine • pH • Normal urine is slightly acid, pH of 6.0 • pH range is 4.5 – 8.0 • pH represents relative acidity or alkalinity of a solution • pH of 7.0 is neutral • pH below 7.0 is acid • pH above 7.0 is alkaline (base)

  16. Characteristics of Normal Urine • Protein • Normal urine may have small amounts of protein present • Only in insignificant amounts, too small to be detected by reagent strip • Glucose • Normal urine does not contain glucose

  17. Characteristics of Normal Urine • Ketones • Normal urine does not contain ketone bodies • Ketones result from the breakdown of fats

  18. Common Signs and Symptoms • Albuminuria • Presence in urine of abnormally large quantities of protein, usually albumin • Also known as proteinuria • Anuria • Cessation (stopping) of urine production, or a urinary output of less than 100 ml per day

  19. Common Signs and Symptoms • Bacteriuria • Presence of bacteria in urine • Dysuria • Painful urination • Enuresis • Condition of urinary incontinence, especially at night in bed • Bedwetting

  20. Common Signs and Symptoms • Fatigue • State of exhaustion or loss of strength or endurance • May follow strenuous physical activity • Frequency • In case of urinary frequency = urination at short intervals (frequently) without increase in the daily volume of urinary output due to reduced bladder capacity

  21. Common Signs and Symptoms • Glycosuria • Abnormal presence of sugar, especially glucose, in urine • Hematuria • Abnormal presence of blood in urine

  22. Common Signs and Symptoms • Ketonuria • Presence of excessive amounts of ketone bodies in urine • Lethargy • State or quality of being indifferent, apathetic (without emotion), or sluggish

  23. Common Signs and Symptoms • Malaise • Vague feeling of bodily weakness or discomfort, often marking the onset of disease of infection • Nocturia • Urination, especially excessive, at night • Also called nycturia

  24. Common Signs and Symptoms • Oliguria • Secretion of a diminished amount of urine in relation to fluid intake • Scanty urine output • Polydipsia • Excessive thirst

  25. Common Signs and Symptoms • Polyuria • Excretion of abnormally large amounts of urine • Pyuria • Pus in urine, usually a sign of an infection of urinary tract • Urgency • Feeling to void urine immediately

  26. PATHOLOGICAL CONDITIONS Urinary System

  27. Cystitis • Pronounced • (siss-TYE-tis) • Defined • Inflammation of urinary bladder • Characterized by urgency and frequency of urination, and by hematuria

  28. Glomerulonephritis (Acute) • Pronounced • (gloh-mair-yoo-loh-neh-FRYE-tis) • Defined • Inflammation of glomerulus of kidneys • Condition characterized by proteinuria, hematuria, and decreased urine production

  29. Hydronephrosis • Pronounced • (high-droh-neh-FROH-sis) • Defined • Distension of pelvis and calyces of the kidney caused by urine that cannot flow past an obstruction in a ureter

  30. Hydronephrosis

  31. Nephrotic Syndrome • Pronounced • (neh-FROT-ic SIN-drohm) • Defined • Clinical symptoms occurring when damage to glomerulus of the kidney is present and large quantities of protein are lost through the glomerular membrane into urine • Results in severe proteinuria • Also called nephrosis

  32. Polycystic Kidney Disease • Pronounced • (pol-ee-SISS-tic kidney dih-ZEEZ) • Defined • Hereditary disorder of kidneys in which grapelike, fluid-filled sacs or cysts, replace normal kidney tissue

  33. Pyelonephritis (Acute) • Pronounced • (pye-eh-loh-neh-FRY-tis) • Defined • Bacterial infection of the renal pelvis of the kidney • Infection begins in the bladder and travels up the ureters to the renal pelvis

  34. Renal Calculi • Pronounced • (REE-nal KAL-kew-lye) • Defined • Stone formations in kidney

  35. Renal Cell Carcinoma • Pronounced • (REE-nal SELL car-sin-OH-mah) • Defined • Malignant tumor of kidney occurring in adulthood • Patient is asymptomatic (symptom free) until latter stages of disease

  36. Renal Failure, Chronic • Pronounced • (REE-nal FAIL-yoor, KRON-ik) • Defined • Progressively slow development of kidney failure occurring over a period of years • Late stages of chronic renal failure known as end-stage renal disease (ESRD)

  37. Vesicoureteral Reflux • Pronounced • (vess-ih-koh-yoo-REE-ter-al REE-fluks) • Defined • Abnormal backflow (reflux) of urine from the bladder to the ureter

  38. Wilm’s Tumor • Pronounced • (VILMZ TOO-mor) • Defined • Malignant tumor of the kidney occurring predominately in childhood • Most frequent finding is palpable mass in the abdomen

  39. Treatment of Renal Failure • Peritoneal Dialysis • Mechanical filtering process • Used to cleanse blood of waste products, draw off excess fluids, and regulate body chemistry when kidneys fail to function properly • Peritoneal membrane is used as filter

  40. Treatment of Renal Failure • Continuous Ambulatory Peritoneal Dialysis (CAPD) • Requires transfer set, connected to bag of dialysate solution • Dialysate solution remains in abdomen for approximately four hours after exchange • Process is repeated 3 to 5 times daily • Advantage: No machine, convenient for travel

  41. Treatment of Renal Failure Continuous Ambulatory Peritoneal Dialysis

  42. Treatment of Renal Failure • Continuous Cycling Peritoneal Dialysis (CCPD) • Uses a machine that warms the solution and cycles it in and out of the peritoneal cavity at evenly spaced intervals at night while the patient sleeps • Process takes 8 to10 hours • Last exchange remains in abdomen during the day for approximately 12 to15 hours

  43. Treatment of Renal Failure Continuous Cycling Peritoneal Dialysis

  44. Treatment of Renal Failure • Hemodialysis • Process of removing excess fluids and toxins from blood by continually shunting patient’s blood from body into a dialysis machine for filtering, and returning clean blood to patient’s bloodstream • Usually three treatments a week, 3 – 4 hours at a time • May be performed at dialysis center or at home

  45. Treatment of Renal Failure Hemodialysis

  46. Treatment of Renal Failure • Arteriovenous fistula • Access vessel created for use with hemodialysis • Opening or fistula is created between an artery and a vein in the forearm • Flow of arterial blood into venous system at point of fistula causes vein to become distended • Provides a large enough vessel with a strong blood flow for the hemodialysis connection

  47. Treatment of Renal Failure Arteriovenous fistula for hemodialysis

  48. Treatment of Renal Failure • Kidney transplantation • Surgical implantation of a healthy, human donor kidney into the body of a patient with irreversible renal failure • Kidney function is restored with a successful transplant and the patient is no longer dependent on dialysis • Donor kidney may come from living donor (usually blood relatives) or cadaver donors (nonliving matches)

  49. Treatment of Renal Failure • Kidney transplantation • Donor kidney surgically placed in iliac fossa • Donor renal artery connected to recipient’s iliac artery • Donor renal vein connected to recipient’s iliac vein • Donor ureter connected to recipient’s bladder • Donor kidney usually functions once it is in place

  50. DIAGNOSTIC TECHNIQUES, TREATMENTS AND PROCEDURES Urinary System

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