Urinary System (Ch. 7) Chapter Goals

1. Urinary System (Ch. 7)Chapter Goals • Name essential organs of the urinary system and describe their locations and functions. • Identify common pathological conditions. • Recognize how urinalysis is used and interpreted as a diagnostic test. • Define urinary-system-related combining forms, prefixes, and suffixes. • List and explain clinical procedures, laboratory tests, and abbreviations that pertain to the urinary system. • Understand medical terms in their proper contexts, such as medical reports and records.

2. Introduction • Functions of the kidney • Filter nitrogenous wastes to form urine; about 200 quarts of blood are filtered every day to form 2 quarts of urine • Maintain proper balance of water, electrolytes (sodium, potassium), and acids • Release hormones: • Renin: enzymatic hormone important in adjusting blood pressure • Erythropoietin (EPO): hormone that stimulates red blood cell production in the bone marrow • Calciferol: active form of vitamin D necessary for the absorption of calcium from the intestine • Degrade and eliminate hormones from the bloodstream

3. Anatomy of the Major Organs Organs of the urinary system in a male

4. Anatomy of the Major Organs Female urinary system

5. How Kidneys Produce Urine • Blood enters the kidneys through the right and left renal arteries • Arterioles carry blood to the capillaries • Glomeruli filter the blood

6. Video Clip of the Urinary System • Clip

7. How Kidneys Produce Urine Glomerulus and glomerular/Bowman capsule • Blood passes through the glomeruli • Glomerular (Bowman) capsule surrounds each glomerulus • Renal tubule is attached to each Bowman capsule

8. How Kidneys Produce Urine Three steps in the formation of urine • Glomerular filtration • Tubular reabsorption • Tubular secretion

9. How Kidneys Produce Urine • The glomerulus and a renal tubule combine to form a unit called a nephron.

10. How Kidneys Produce Urine All collecting tubules lead to therenal pelvis Calyces or calices are small, cuplike regions of the renal pelvis; the term comes from the Greek, kalux, meaning a cup or case surrounding a flower bud Illustration shows section of kidney

11. How Kidneys Produce Urine Process of forming and expelling urine

12. Terminology: Structures,Substances, and Urinary Symptoms STRUCTURES cyst/ocystitis inflammation of the urinary bladder Combining Form Terminology Meaning Bacterial infections often cause acute or chronic cystitis. In acute cystitis, the bladder contains blood as a result of mucosal hemorrhage (see figure, Acute cystitis).

13. Terminology: Structures,Substances, and Urinary Symptoms Combining Form TerminologyMeaning Obstruction of urine flow may be caused by renal calculi (stones) as shown in the figure. Notice the buildup of excess fluid in the kidney. STRUCTURES nephr/o hydronephrosis Condition of excess fluid(water) in the kidney

14. Pathologic Conditions-Kidney • Glomerulonephritis (Inflammation of the glomeruli within the kidney) • Interstitial nephritis (Inflammation of the connective tissue that lies between the renal tubules) • Nephrolithiasis (Kidney Stones) • Nephrotic syndrome (excessive protein in urine) • Polycystic kidneys (PKD) (fluid sacs in kidney)

15. Pathologic Conditions Kidney • Polycystic kidney disease(PKD) PKD—The kidneys contain masses of cysts. Typically polycystic kidneys weigh 20 times more than their usual weight.

16. Laboratory Tests and Clinical Procedures Other clinical procedures • Dialysis- artificial kidney machine, filters waste from bloodstream, returns dialyzed blood to the patient’s body. • Lithotripsy- urinary tract stones are crushed. The extracorporeal method uses shock waves directed toward the stone from the outside of the body (extra=outside, corpor/o= body). Patient recevies sedation or an anesthetic. Stones pass from body in urine after procedure. Abbreviation is ESWL (Extracorporeal Shock Wave Lithotripsy)

17. Laboratory Tests and Clinical Procedures Other clinical procedures • Renal angioplasty- Dilation of narrowed areas in renal arteries. Balloon inserted into artery, then inflated to enlarge vessel. Stent inserted to keep vessel open. Used to treat renal hypertension and preserve kidney function. • Renal biopsy-Removal of tissue for examination. Performed 2 ways. • 1. performed during surgery (open) • 2. or through the skin (closed). Patient lies PRONE, receives local anesthesia, and physician inserts needle into kidney. Tissue viewed.

18. Laboratory Tests and Clinical Procedures Other clinical procedures • Renal transplantation- surgical transfer of kidney from a donor to a recipient. • Urinary catheterization-used for both short and long term drainage of urine (with tube). A “foley catheter” has a balloon on the end to hold it in place and can deliver solutions into the bladder as well as drain it.

19. Laboratory Tests and Clinical Procedures Cytoscopy—direct visual examination of urinary bladder with an endoscope. Can be performed 2 ways; 1. diagnosis and check-ups. 2. take biopsy, remove polyps, or perform laser treatments.

20. Laboratory Tests and Clinical Procedures Hemodialysis (HD)