4.02 Understand the Functions and Disorders of the Urinary System

1. 4.02 Understand the Functions and Disorders of the Urinary System

2. 4.01 Remember the structures of the urinary systemEssential Question What are the structures of the urinary system? 4.01 Remember the structures of the urinary system 2

3. Warm up I 4.01 Structures of the Urinary System Warm up I • What is the functional unit of the kidney? • What are the different structures of the nephron? • What is the opening of the urethera to the outside of the body? • What is the hollow muscular sac that can greatly expand in the urinary system? • What is the inner layer of the kidney called? • What is the outer layer of the kidney called? • What are the triangular shaped structures in the kidney that are in the renal medulla? • What are the two structures called that lead from the kidney’s to the bladder? • What are the shape are the kidney’s • In what body region are the kidney’s located?

4. 4.02 Understand the functions and disorders of the urinary system Essential Questions • What are the functions of the urinary system? • What are some disorders of the urinary system? • How are disorders of the urinary system treated? • How do you relate the body’s hormone control to the urinary system? 4.02 Understand the functions and disorders of the urinary system

5. Understand the functions of the urinary system Functions: • Excretion • Formation of urine • Fluid and electrolyte balance • Elimination of urine • http://www.youtube.com/watch?v=oCQ-5iwTQvM 4.02 Understand the functions and disorders of the urinary system

6. Understand the functions of the urinary system Excretion (p.566) • What is excretion? • Why does the body have excretory functions? • What is the composition of wastes excreted by the urinary system? 4.02 Understand the functions and disorders of the urinary system

7. Understand the functions of the urinary system 4.02 Understand the functions and disorders of the urinary system

8. Filtration • First step in urine formation • Blood from renal artery enters glomerulus- cluster of capillaries that are responsible for filtration the blood Filtrate- Fluid consisting of water, glucose, amino acids some salts and urea • High blood pressure in glomerulus forces fluid to filter into Bowman’s capsule • Filtrate does not contain plasma proteins or RBCs – they’re too big • Bowman’s capsule filters out 120cc of fluid/min. – 7500cc/hour • As filtrate continues through nephron, 80% of water is reabsorbed • Production of urine is controlled by the hormones ADH and Aldosterone

9. Filtration BOWMAN’S CAPSULE • As the filtrate continues through nephron, 90% of water is reabsorbed in the proximal convoluted tubule—what would happen if reabsorption here failed? 4.02 Understand the functions and disorders of the urinary system

10. Water and useful substances are reabsorbed • If blood levels of certain substances are high (glucose, amino acids, vitamins, sodium) then those substances will not be reabsorbed • Useful substances filter out of the renal tubules and back into the capillaries

11. Secretion • Opposite of reabsorption • Secretion transports substances from blood into collecting tubules • Substances include creatinine, hydrogen ions, potassium ions, toxins and some drugs • Electrolytes are selectively secreted to maintain body’s acid-base balance 4.02 Understand the functions and disorders of the urinary system

12. Secretion What substances are secreted into the collecting tubules? Drugs, sodium and potassium http://www.youtube.com/watch?v=kVF65d1X8SU 4.02 Understand the functions and disorders of the urinary system

13. Understand the functions of the urinary system Common electrolytes include: Calcium Chloride Magnesium Phosphorous Potassium Sodium Fluid and electrolyte balance • Electrolytes are selectively secreted to maintain body’s acid-base balance. • What are electrolytes? • Electrolytes are minerals in your blood and other body fluids that carry an electric charge. • Electrolytes affect the amount of water in your body, the acidity of your blood (pH), your muscle function, and other important processes. You lose electrolytes when you sweat. You must replace them by drinking fluids. 4.02 Understand the functions and disorders of the urinary system

14. Understand the functions of the urinary system Nervous Control Direct control through nerve impulses on kidney blood vessels Indirect control though stimulation of endocrine glands Fluid and electrolyte balance Chemical control (p. 583) • Reabsorption of H20 in distal convoluted tubule controlled by ADH (antidiuretic hormone) • Secretion and regulation of ADH controlled by hypothalamus • DIURETICS inhibit reabsorption of H20 4.02 Understand the functions and disorders of the urinary system

15. Understand the functions of the urinary system Fluid and electrolyte balance Chemical control • ADH – Antidiuretic hormone • Aldosterone • Diuretics • Renin 4.02 Understand the functions and disorders of the urinary system

16. Understand the functions of the urinary system Fluid and electrolyte balance Chemical control • ADH- Secretion and regulation of ADH controlled by hypothalamus • Increases the permeability of water in the distal and collecting tubules. 4.02 Understand the functions and disorders of the urinary system

17. Understand the functions of the urinary system Fluid and electrolyte balance Chemical control • The amount of ADH produced is related to the level of body hydration • What factors regulate the release of ADH? 4.02 Understand the functions and disorders of the urinary system

18. Understand the functions of the urinary system Fluid and electrolyte balance Chemical control Aldosterone • Comes from the adrenal glands that are located on top of the kidney’s • Controls urinary secretion Renin • Hormone released by the kidney’s when blood pressure drops. 4.02 Understand the functions and disorders of the urinary system

19. Understand the functions of the urinary system Diuretics • Increases urinary output by inhibiting the reabsorption of water. • Important medication given for the treatment of hypertension. • Makes you urinate a lot! • Lasix . 4.02 Understand the functions and disorders of the urinary system

20. Understand the functions of the urinary system What effect does this cycle have on your blood pressure? Fluid and electrolyte balance 4.02 Understand the functions and disorders of the urinary system

21. Understand the functions of the urinary systemThe flow of electrolytes Review urine formation, electrolyte exchange, and some factors that effect urine volume. 4.02 Understand the functions and disorders of the urinary system

22. Understand the functions of the urinary system Elimination of urine • Nerves in the bladder tell you when it is time to urinate, or empty your bladder. As the bladder first fills with urine, you may notice a feeling that you need to urinate. The sensation to urinate becomes stronger as the bladder continues to fill and reaches its limit. At that point, nerves from the bladder send a message to the brain that the bladder is full, and your urge to empty your bladder intensifies. • When you urinate, the brain signals the bladder muscles to tighten, squeezing urine out of the bladder. At the same time, the brain signals the sphincter muscles to relax. As these muscles relax, urine exits the bladder through the urethra. When all the signals occur in the correct order, normal urination occurs. 4.02 Understand the functions and disorders of the urinary system

23. Processing • Urinary System Matching • Urinary Terms Matching

24. Assignment for Friday 11/22/13 Get information from the internet, textbook or power point on the NBHS website. • Common Disorders of the Urinary System • 4.02 Urinalysis and Disorders Worksheet • Turn both in at end of class for notebook grade!!!

25. Warm up • What are the three steps of urine formation? • How much blood is filtered through the kidney per minute? • What are the cluster of capillaries called that are surrounded by the Bowman’s Capsule and filter the blood? • What is a medication that you take for hypertension that makes you urinate a lot? • What happens in the proximal convoluted tubule? • Excessive substances in urinary filtrate such as electrolytes and toxins are eliminated by the body. What function of the urinary system is this? • If you had blood in the urine, which function of the urinary system is affected? • What is the medical term for excessive urination? • What is the medical term for frequently urinating at night? • What is the function of the ADH( Antidiuretic Hormone)? • What is enuresis?

26. Video http://www.rachaelrayshow.com/tips/11021_What_Your_Pee_Is_Telling_You/index.html

27. Understand the functions of the urinary system Average urinary output = 1500 ml per day How much blood is filtered through the kidney per minute? What effects the color of your urine? Elimination of urine Urinary output 4.02 Understand the functions and disorders of the urinary system

28. Urinalysis • Test: Urinalysis: Appearance • Clinical Implications: • Turbidity and other terms are used to characterize the appearance of a urine specimen. Urine may contain red or white blood cells, bacteria, fat, or chyle and may reflect renal or urinary tract infection. • Some drugs can change the color of the urine. Normal urine color is a light yellow to a dark amber color. Inflammation may also cloud the urine as well as other pathological conditions can. Dorban can color the urine red; phenolphthalein can color it red; pyridium can color the urine dark orange. Of course, the patient should be "warned" of these changes. Hospitalization is stressful enough without the added shock of unexpected orange urine. • The odor of a urine specimen is also noted. In diabetes mellitus, starvation, and dehydration, a fruity odor accompanies formation of ketone bodies. In urinary tract infections, a fetid odor commonly is associated with E. coli. Maple syrup urine disease and phenylketonuria (PKU) also cause distinctive odors. Certain foods may also give urine certain color and odor. A patient diet history is important if the urine has an odor. • Test: Urinalysis: pH • Clinical Implications: • Urine is normally slightly acid (4.5 - 7.2 normal range). If alkaline, it can be indicative of infection. However, the urine pH does change during the day due to dietary influences and water intake. A 24-hour specimen would reveal an optimum pH of about 6.0. • Test: Specific Gravity • Specific gravity is the weight of the urine as compared to water. • Normal Values: 1.005 to 1.025

29. Clinical implications: • Specific Gravity will increase with the amount of dissolved particles (concentrated) in it. Specific gravity will decrease when the water content is high and the dissolved particles are low (less concentrated). Low specific gravity (<1.005) is characteristic of diabetes insipidus, nephrogenic diabetes insipidus, acute tubular necrosis, or pyelonephritis. Fixed specific gravity, in which values remain 1.010 regardless of fluid intake, occurs in chronic glomerulonephritis with severe renal damage. High specific gravity(>1.035) occurs in nephrotic syndrome, dehydration, acute glomerulonephritis, heart failure, liver failure, or shock. • Test: Urinalysis: Protein • Clinical Implications: • Only a very small amount of protein should be excreted into the urine in a 24-hour period (normal is 0-trace). Albumin is usually the first protein to be excreted in disease conditions. Some non-disease conditions such as extreme muscle exertion and pregnancy may cause proteinuria. Some of the disease conditions which can cause proteinuria are renal disease, fever, CHF, hypertension, tumors, and others. • Test: Urinalysis: Glucose and ketones • Clinical Implications: • The how and why glucose gets into the urine is dependent upon several factors. Without disease, it is possible to "spill" glucose after eating a large meal. Once serum glucose reaches 180 mg/100ml and above, it is possible to spill small amounts of glucose into the urine. This is a normal condition. However, some people have a higher or lower threshold for spilling glucose into the urine. A normal urine glucose is 0 to trace amounts. • Serum glucose levels are obviously important in diabetes, and so is the spilling of glucose into the urine. Glucose levels may also be raised or lowered in several other disease conditions as well as in diabetes. • Ketonuria occurs in diabetes mellitus when cellular energy needs exceed available cellular glucose. In the absence of glucose, cells metabolize fat for energy. Ketone bodies--the end products of incomplete fat metabolism--accumulate in plasma and are excreted in the urine. Ketonuria may also occur in starvation states and following diarrhea or vomiting.

30. Urinalysis An examination of urine • What does normal urine look like? • What constitutes an abnormal urinalysis? 4.02 Understand the functions and disorders of the urinary system

31. Urinalysis What could the presence of blood in urine indicate? What is the medical term for this condition? 4.02 Understand the functions and disorders of the urinary system

32. Urinalysis Where would excess glucose show up? What does this mean? 4.02 Understand the functions and disorders of the urinary system

33. Urinalysis 4.02 Understand the functions and disorders of the urinary system

34. Disorders of the urinary system 4.02 Understand the functions and disorders of the urinary system

35. Warm up- Urinary Disorders • Kidney Failure- http://www.youtube.com/watch?v=BodnYcHGtiA • Hemodialysis- http://www.youtube.com/watch?v=shFSW8VE3Gs , http://www.youtube.com/watch?v=TJsVjtsTFBQ • Kidney Transplant- http://www.youtube.com/watch?v=wBBlJh1vIZc • Kidney Stones- http://www.youtube.com/watch?v=mTR35kSDBso

36. Disorders of the urinary system Cystitis • What is cystitis (cyst= medical term for ____ +itis =___ ) • Most common cause: E. Coli • What are the major symptoms of cystitis? 4.02 Understand the functions and disorders of the urinary system

37. Disorders of the urinary system Rx= antibiotics Cystitis • More common in females—Why ?? 4.02 Understand the functions and disorders of the urinary system

38. Disorders of the urinary system • Disease which injures the glomerulus. • What will happen as a result of damaged glomeruli? Glomerulonephritis 4.02 Understand the functions and disorders of the urinary system

39. Disorders of the urinary system Glomerulonephritis • Two types: • Acute • Chronic • Define these terms. • How do these terms relate to glomerulonephritis symptoms? • What is the prognosis for each? 4.02 Understand the functions and disorders of the urinary system

40. Disorders of the urinary system Renal calculi Also known as nephrolithiasis nephro lith iasis What are renal calculi made of? What are the symptoms? 4.02 Understand the functions and disorders of the urinary system

41. Disorders of the urinary system Renal calculi • What will happen if the ureters are blocked? 4.02 Understand the functions and disorders of the urinary system

42. Disorders of the urinary system Renal calculi • How is it treated? 4.02 Understand the functions and disorders of the urinary system

43. Disorders of the urinary system Renal calculi • How does lithotripsy work? • Is it a cure? 4.02 Understand the functions and disorders of the urinary system

44. Disorders of the urinary system Renal failure • Acute • What causes it? • What are the symptoms? 4.02 Understand the functions and disorders of the urinary system

45. Disorders of the urinary system Renal failure chronic • May be none in early stages, urinalysis may reveal proteinuria • Why would protein be present in the urine? • Why is this not normal? 4.02 Understand the functions and disorders of the urinary system

46. Disorders of the urinary system Renal Failure • Chronic kidney disease leads to a buildup of fluid and waste products in the body. • How are these systems affected by renal failure? 4.02 Understand the functions and disorders of the urinary system

47. Disorders of the urinary system Renal Failure • How is it treated? • Peritonealdialysis • What is the process involved in this treatment? 4.02 Understand the functions and disorders of the urinary system

48. Disorders of the urinary system Renal Failure • How is it treated? • Hemodialysis • What is hemodialysis? • What determines the patient’s treatment schedule? 4.02 Understand the functions and disorders of the urinary system

49. Disorders of the urinary system Renal Failure • Compare the treatment of acute and chronic renal failure. 4.02 Understand the functions and disorders of the urinary system

50. Disorders of the urinary system How does hemodialysis mimic glomerular function? 4.02 Understand the functions and disorders of the urinary system