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URINARY SYSTEM

URINARY SYSTEM. Urology is the branch of medicine that deals with the urinary system and the male reproductive tract. Function. Regulates volume, composition, and pH of body fluids Excretes metabolic wastes

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URINARY SYSTEM

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  1. URINARY SYSTEM Urology is the branch of medicine that deals with the urinary system and the male reproductive tract

  2. Function • Regulates volume, composition, and pH of body fluids • Excretes metabolic wastes • Regulates blood pressure, RBC production, activates calcitriol (vitamin D), and perform gluconeogenesis

  3. Major structures • Located retroperitoneally on each side of the vertebral column between T12-L3 • Left kidney lower than right one • Connective tissue layers: renal capsule, adipose capsule and renal fascia • Ureters • Bladder • Urethra

  4. Internal Anatomy • Cortex • Medulla • Renal pyramids • Renal columns • Renal pelvis • Calyces

  5. Renal artery Segmental artery Interlobar artery Arccuate artery Interlobular arteries Afferent artery Glomerular capillaries Efferent arteries Peritubular/vasa recta Interlobular veins Arcuate veins Interlobar veins Segmental veins Renal vein Blood Supply

  6. NEPHRON FUNCTIONAL UNIT OF THE KIDNEY

  7. Nephron • Renal corpuscle • glomerulus • Bowman’s capsule • Renal tubule • proximal convoluted tubule • Loop of Henle • distal convoluted tubule

  8. Types of Nephrons • Cortical nephron - contained almost entirely in the cortex • Juxtamedullary nephron - go deep into the renal medulla; able to produce more concentrated urine

  9. Glomerulus - Bowman’s capsule • Glomerulus = network of capillaries arising from an afferent arteriole that empties into an efferent arteriole • Bowman’s capsule is a double layer structure that receives the filtrate • Consists of parietal and visceral layer

  10. Endothelial - Capsular Membrane • Glomerular endothelium - fenestrated • Podocytes “foot cells” - intertwining processes cling to basement membrane of glomerulus

  11. Renal Physiology

  12. Filtration • Glomerular filtration forces plasma and wastes products out of capillaries and into the Bowman’s capsule • Net filtration pressure is primarily controlled by glomerular blood hydrostatic pressure • Glomerular filtration rate is the amount of filtrate formed in both kidneys per minute 125 ml/min (180 L/day!!!)

  13. Reabsorption • Tubular reabsorption is the movement of water and other substances back into the blood such as glucose, amino acids, sodium, potassium, and other ions • 99% of filtrate reabsorbed • Occurs mainly in proximal tubule • Both active and passive transport used • Transport maximum

  14. Secretion • Occurs mainly in the DCT • Acid-base balance and water adjustment • Tubular secretion involves the movement of substances out of the blood into the tubules • K+ ions, urea, uric acid, drugs

  15. Composition of Urine • Color = clear to yellow; varies on concentration and diet • Odor = develops ammonia odor • pH = 6.0 (varies 4.5-8.0) • Specific gravity = 1.001-1.035 • Chemical composition = 95% water, 5% solutes (urea, Na+, K+, PO4, SO4,creatinine, uric acid)

  16. Diuretics • Enhance urinary output • Common diuretics include: Caffeine, Alchol • Usually inhibit sodium ion reabsorption

  17. Urine Elimination • Ureters • Bladder • Transitional epithelium • Trigone • Detrusor muscle • Can hold 500-1,000 ml • Urethra • internal & external sphincters

  18. Micturition = Urination = Voiding • 200 ml = urge to void • Voiding reflex relaxes internal sphincter • If suppressed, 200-300 ml more will accumulate before reflex returns • Incontinence - inability to control voiding • Urinary retention - inability to void

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