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Urinary System
  • consists of two kidneys, two ureters, one bladder and one urethra
  • aka excertory, genitourinary (GU) or urogenital (UG) system
The vital function of the urinary system is
  • to extract wastes from the bloodstream
  • convert these materials into urine
  • transport the urine from the kidneys via the ureters to the bladder and elminate it at appropriate intervals via the urethra
What is maintained through the urinary system?
homeostasis of body fluids
the kidneys
produce urine and help regulate body fluids
transport urine from the kidneys to the bladder
urinaey bladder
serves as a reservoir for urine
  • conveys urine to the outside of the body
  • in males, conveys both urine and semen
The internal structure of the kidney is comprised of ____ and _____.
  • the cortex, the outer layer, which contains the arteries, veins, convoluted tubules and glomerular capsules

and the
  • medulla or inner portion which contains the renal pyramids (cone like masses with papillae projecting into calyces of the pelvis)
Microscopic examination of the kidney reveals about one million ______ which consists of a ________ and _______.
  • nephrons (structural and functional units of an organ)
  • renal corpuscle and tubule
What dies the renal corpuscle or malpighian body consist of?
A glomerulus and a Bowman's capsule
What does a Bowman's capsule consist of?
  • a tubule consisting of the proximal convoluted portion
  • the loop of Henle
  • a distal convoluted portion that opens into a collecting tubule
What is the vital function of nephrons?
  • to remove waste products of metabolism from the blood plasma

What are the waste products that the nephrons remove?
urea, uric acid, creatine as well as any excess sodium, chloride and potassium ions and ketone bodies.
The nephron plays a vital role in the maintenance of normal fluid balance in the body by ____
allowing for reabsorption of water and some electrolytes back into the blood.
Approximately how much blood flows through the kideys and at what rate does blood flow per minute?
1000 ti 1200 mL of blood at a rate of 1000 mL per minute
  • are narrow muscular tubes that transport urine from the kidneys to the bladder
  • are 28 to 34 cm long and vary in diameter from 1 mm to 1 cm
The walls of the ureters consists of three layers
  • an inner coat of mucous membrane
  • a middle coat of smooth muscle
  • and outer coat of fibrous tissue
Urinary bladder
  • is the muscular, membranous sac that serves as a reservoir for urine
  • located in the anterior portion of the pelvic cavity
The urinary bladder consists of
  • a lower portion or neck that is continuous with the urethra

and an
  • upper portion, the apex, which is connected with the unilicus by the median unbilical ligament
is a small triangular area near the base of the bladder
The wall of the bladder consists of four layers
  • an inner layer of epithelium
  • a muscular coat of smooth muscle
  • and outer layer commposed of lonitudinal muscle (detrusor urinae)
  • and a fibrous layer
An empty bladder feels firm as the muscular wall becomes thick.

As the bladder fills with urine, the muscular wall tins and distends according to the amount of urine present.
is the musculomembranous tube extending from the bladder to the outside of the body
urinary metus
is the external urinary opening
The male urethra
  • is approximately 20 cm long and is divided into three sections
  • prostatic, membranous and penile
  • converys nothe urine and semen
The female urethra
  • approximately 3 cm long
  • the urinary metus is situated between the clitoris and opening of the vagina
  • conveys only urine
is formed by the process of filtration and reabsorption in the nephrone
Formation of urine
  • blood enters the nephraon through the afferent arteriole
  • as it passes through the glomerulus, water and dissolved substances are filtered through the glomerular membrane and collect in the Bowman's capsule
  • the filtrate passes through the proximal tubule into the loop of the Henel, the distal tubule and then the collecting tubule
  • uric acid and hydrogen ions may be added to the urine which consists of 95% water and 5% solid substances
  • it's secreted by the kidneys and trasnported by the ureters to the bladder where it is stored before being discharged from the body by the urethra
Average dult feels the need to void when the bladder contains around 300 to 350 mL of urine. An average of 1000 to 1500 mL of urine is voided daily.
Normal urine is clear and yellow to amber in color and has a faintly aromatic ordor, a specific gravity of 1.003 to 1.03 and a slightly acid pH (hydrogen inon concentration)
  • an inflammation of the bladder, usually occuring secondarily to ascending URIs
  • occurs when the lower urinary tract (urethr and bladder) is infected by bacteria dn becomes irritated and inflammed
  • can be acute or chronic
  • more than 85% of cases are caused by Escherichia coli, a bacillus found int he lower gastrointestinal tract
  • Cystitis occurs in over 6 million patients a year
  • frequently affects sexually active women in which during sexual activity, bacteria can be introduced into the bladder through the urethra
  • once bacteria enters the bladder they are normally removed through urnination
  • when bacteria multiply faster than they are removed by urination, infection results
  • females are more prone to cystitis due to their shorter urethra and due to the short distance between the opening of the urethra and anus
  • cystitis in men is usually secondary to some other tyoe of infection such as epididymitis, prostatitis, gonorrhea, syphilis or kidney stones
Common symptoms of cystitis are
  • painful and frequent urination
  • burning sensation during urination chills
  • fever
  • with chronic cystitis, pyuria may be the only symptom
Interstitial cystitis
  • a painful inflammation of the bladder wall
  • approximately 450,000 people suffer from the condition with 90% of them women
  • symptoms vary from mild to severe
  • the cause is unknown and IC does not respond to antibiotic therapy
Kidney stones

  • are deposits of mineral salts called clculi in the kidney
  • sontes can pass into the ureter, irritate kidney tissue and black urine flow
  • occur when the urine has high levels of minerals (usually calcium) that form stones
  • most kidney stones pass with out aide but those who cause lasting symptoms or complications can be treated by ESWL or PUL
Symptoms of Kidney Stones
  • extreme pain which begins suddenly when a stone moves in the urinary tract, causing irriation or blockage
  • a sharp, cramping pain in the back and side in the area of the kidney or lower abdomen is felt
  • nausea and vomiting may occue
  • if the stone is too large to pass easily, pain continues and blood may appear in the urine
Renal Failure
  • there are two types of renal failure: acute and chronic
Acute Renal Failure

  • occurs when the filtering function of the kidneys changes so that they kidneys are not able to maintina healthy body function
  • people who have preexisting kideny disease or damage are at higher risk
Conditions that may lead to ARF
  • a blockage of urine flow out of the kidneys to the bladder
  • exposure to certain durgs or toxic substances
  • significant loos of blood or sudden drop in blood flow to the kidneys
Symptoms of ARF
  • at first, there are no specific signs or symptoms
  • as the disease progesses the urine output can decrease
  • fluid builds up in the body tissues and organs
  • which may cause irregular heartbeat (arrhythmias)
  • excess fluid in the abdomen (ascites)
  • and swelling of the extremities (edema)
Chronic Renale Failure

  • gradual and progressive loss of kidney function
  • results from any disease that causes gradual loss of kidney function
  • affects more than 2 out of 1,000 people in the US
  • diabetes and hypertension are th two most common causes and account for approximately 2/3s of the cases of CRF
  • syndrome or group of syndromes associated with end-stage renal disease (ESRD)
  • chlinical and metabolic abnormalities of fluid, electrolyte and hormonal imbalnces develop in parallel with derterioration of renal function
  • regulatory and endocrine functions of the kidney are impaired and accumulated metabolic waste products affect essentially every organ in the body
What is the goal of treatment of acute and chronic renal failure?
  • to identify and treat reversible causes of kidney failure
  • treatment also focuses on preventing excess accumulation of fluids and wastes while allwing the kidneys to heal and gradually reume their normal function
acute glomerulonephritis
acute renal failure
blood urea nitrogen
chronic renal failure
end stage renal failure
glomerular filtration rate
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