Urinary System Endocrine System Male Reproductive System Female Reproductive System

1. Urinary System Endocrine System Male Reproductive System Female Reproductive System

2. Urinary System Anatomical structures • Kidneys • Adrenal glands • Ureters • Bladder • Urethra • CVA • Costovertebral angle

3. Kidney – gross anatomy Cortex Medulla Pyramids Papilla Hilum Pelvis Calyx Ureter

4. Kidney – microanatomy Nephron Glomerulus Bowman’s capsule Proximal collecting tubule Henle’s loop Distal collecting tubule Collecting duct Note: cortex has everything medulla has only: loop of Henle Collecting tubules

5. Functions of the kidney • Removes nitrogenous wastes • Urea • Uric acid • Creatinine • Ammonia • Maintains homeostasis • Fluid balance • Electrolyte balance • Acid-base balance • Excretory organ • Via blood filtration & formation of urine • Regulation of blood pressure • Juxtaglomerular apparatus (JGA)

6. Urine formation Filtration Occurs in renal corpuscle Reabsorption Occurs in proximal convoluted tubule It takes things back into blood Secretion Occurs in distal convoluted tubule Blood gives things up to the urine Concentration Occurs in collecting tubules

7. Terms reflective of urinary function • Polyuria • Oligouria • Anuria • Hematuria • Pyuria • Nocturia • Dysuria • Urinary retention • Urinary incontinence

8. Pathology of the Urinary System • Urethritis • Cystitis • Glomerulonephritis • Pyelonephritis • Renal calculus (stones) • Urine outflow obstruction • Hydronephrosis • Hydroureter

9. Endocrine System 2 kind of glands • Exocrine --- have ducts to lead secretions to where they going • Endocrine --- no ducts; secretions (hormones) into bloodstream “official” Endocrine Glands • Pineal • Hypothalamus • Pituitary • Thyroid • Parathyroids • Thymus • Pancreas • Adrenals • Ovaries • Testes

10. Concept: Many organs produce hormones (chemical messengers) Endocrine glands in `mixed function' organs and in exclusive function glands.

11. Pineal Gland • Located near roof of third ventricle just above the thalamus • as one ages this gland becomes fibrous & calcifies • called “third eye” • because its secretion of melatonin is dependent on amount of light one sees (less light; more melatonin) • Melatonin’s actions: • may inhibit anterior pituitary gonadotropins • regulates the body’s internal clock • Also secretes Serotonin • serotonin levels effect depression • serotonin is a neurotransmitter

12. Hypothalmus • Two things it does relating to the endocrine system • it makes the posterior pituitary hormones • oxytocin (OT) • antidiuretic hormone (ADH) • it controls the anterior pituitary by means of hormones it makes • Releasing Hormones * exp = GnRH (gonadotropin releasing hormone) • Inhibiting Hormones • It also acts as a connector between the nervous & endocrine system • For example, emotions originate there & stimulate the endocrine system • emotions = hunger, sex, pain, pleasure, anger, fear

13. Pituitary Gland • Also called hypophysis • 2 parts: Anterior Pituitary (adenohypophysis) Posterior Pituitary (neurohypophysis) • Anterior PituitaryPosterior Pituitary • TSH * ADH (vasopressin) • ACTH * OT • FSH • LH • GH • PRL KNOW THE NAMES & FUNCTIONS OF EACH HORMONE • Key Point: the Posterior Pituitary is an extension of the Hypothalmus • Its two hormones are made in the hypothalmus and secreted from the axon terminals in the posterior pituitary.

15. TSH hypersecretion = hyperthyroidism hyposecretion = hypothyroisism ACTH hyposecretion = Addisonian synd. hypersecretion = Cushingoid synd FSH hyposecretion F = low estrogen, amenorrhea M = poor sperm production hypersecretion F = menopause LH hyposecretion F = no ovulation M = low testosterone GH hypersecretion during growth = giantism after growth = acromegaly hyposecretion = dwarfism PRL hypersecretion = galactorrhea, infertility hyposecretion = poor milk production ADH hyposecretion = diabetes insipidus Diseases of the pituitary

16. 3 hormones Thyroxine (T4) = more abundant than T3, but less potent Triiodothyronine (T3) = more potent than T4 Calcitonin Thyroid hormones (T4 & T3) function is to increase the metabolic rate hyperthyoidism Grave’s disease = one type; inherited; get exopthalmos hypothyroidism cretinism= congenital type myxedema = adult type Hashimoto’s disease = autoimmune; chronic inflam. produces fibrosis Calcitonin lowers serum calcium by preventing the bones from giving it up works in harmony with the parathyroid & parathormone Thyroid Gland

18. Parathyroid Glands • Normally 4 glands located on posterior surface of thyroid • may have up to 8 glands • produces hormone: Parathormone (PTH) • it increases calcium in blood by breaking down bone to release calcium • it works in conjunction & opposite calcitonin • hypersecretion = hypercalcemia (get hyperparathyroidism) • symptoms = muscle weakness + SOUP • Secondary Hyperparathyroidism more common • Etiology = decrease serum calcium secondary to: • Renal disease • Cancer • Endocrine diseases (Grave’s & Addison’s) • hyposecretion = hypocalcemia ( get hypoparathyroidism) • symptoms = tetany + hyperexcitible nervous system • Commonest etiology = metastatic cancer to bone (gives increase in serum calcium)

20. Thymus • Located behind the manubrium • prominent in the newborn; by age 21 it atrophies • produces hormone: Thymosin • it matures T- lymphocytes • after they have been acted upon by the thymus, they are sent for storage & future activation • this occurs in the lymph nodes & spleen

21. Pancreas • Pancreas is both endocrine & exocrine gland • exocrine = digestive enzymes secreted via duct into duodenum • endocrine located in Islets of Langerhans • has 2 types of cells each producing its own hormone • alpha cells produceglucagon • it raises blood sugar by increasing liver glycogenolysis • beta cells produce insulin • it lowers blood sugar by escorting glucose into the cells • lack or improper response to insulin gives diabetes mellitus • Insulin Dependent Diabetes Mellitus(IDDM) = Type I • autoimmune; get decreased production of insulin • Non Insulin Dependent Diabetes Mellitus(NIDDM) = Type II • get cellular insensitivity to insulin

24. Diabetes Mellitus • As cells deprived of sugar, they begin to metabolize fats & proteins • This process allows wastes(ketone bodies) to accumulate • Etiology = autoimmune process triggered by an infection early in life • Main systems affected: • Vascular • Renal • Eye • Symptoms = polyuria, polyphagia, & polydipsia • Fruity odor to breath • Complications • Diabetic coma ---- lethargy, dry (dehydrated) • Insulin shock ---- anxiety, sweating

25. Adrenal Cortex Has 3 distinct layers or zones from outside towards middle: secretes mineralcorticoids(Aldosterone) secretes glucocorticoids(Cortisol) secretes gonadocorticoids (sex steroids) Mineralcorticoids retain water + sodium & excrete potassium purpose = to maintain blood volume & electrolyte balance Glucocorticoids make glucose especially in times of prolonged stress this glucose made by increased metabolic breakdown of protein & fat Thus cortisol is catabolic, not anabolic also is anti-inflammatory also maintains blood pressure Adrenal, Cortex & Medulla

26. Adrenal Medulla • Produces 2 hormones • Epinephrine (Adrenalin) • Nor-epinephrine (Nor-Adrenalin) • These very important during stressful situations • They are under the control of the sympathetic nervous system • also known as the adrenergic nervous system • deals with Fear, Flight, or Fight • It produces excess epinephrine

27. Diseases of the Adrenal Cortex • even though there are 3 different classes of hormones, most diseases affect primarily the glucocorticoids • Hypersecretion • Cushing’s Disease (MOODIAH) • Moon face; Obesity & edema from salt & water retention; Osteoporosis; Diabetes; Infections; Atherosclerosis; Hypertension • Hyposecretion • Addison’s Disease • get hypotension, fatigue, weakness, & weight loss • get dehydration & hyperkalemia* (from lack of aldosterone) • get bronze skin color & pigmentation * This can become life threatening

28. Testes Secretes testosterone Produces sperm Ovaries Secretes estrogen Secretes progesterone Produces mature ova The Gonads

29. Male Reproductive System • Scrotum • Testes • Seminiferous tubules • Epididymis • Vas deferens • Ejaculatory duct • Penis • Urethra • Glans penis • Prepuce • Seminal vesicles • Prostate • Bulbourethral glands • Semen

30. Testis Seminiferous tubules Hormones produced

31. Pathology BPH Benign prostatic hypertrophy Testicular cancer

32. Vulva Vagina Vestibule Labia majora Labia minora Clitoris Bartholin’s glands Perineum Breasts Lactiferous ducts Areola & nipple Ovaries Fallopian tubes Uterus Fundus, corpus, cervix Female Reproductive System

33. Menstrual cycle Menses Proliferative phase Ovulation Secretory phase

34. Breast Ducts Areola Nipple

35. Pathology Cancer Breast Uterus Cervix Ovarian Endometriosis PID PMS

36. STD’s causative agentcomments • Chlamydia bacteria most common, “silent” STD • Gonorrhea bacteria Penicillin resistant At birth, Crede procedure is done to the baby’s eyes • Syphilis bacteria 3 stages, penicillin treats it • Hepatitis B virus babies vaccinated at birth • Hepatitis C virus • Herpes virus • HPV (papilloma) virus warts, causes cervical ca • HIV virus use condoms, test frequency • Vaginitis • Monilia fungus • BV bacteria All these vaginal infections may • Trichomonas protozoa or may not be STD’s!!