examination of urine 1&2

8/7/2019 Examination of Urine 1&2

http://slidepdf.com/reader/full/examination-of-urine-12 1/21

BY .Beshoy William LouizUNDER SUPERVISION :- DR.DR. Marwa Elbiltagy



� The simple examination of the Urine.

� To detect some of the normal organic

constituents of urine.� To detect some of the normal inorganic ions

present in urine.



� Urine formation :-

The basic steps in urine

formation are :1. Filtration. ( Glomerular)2. Reabsorption.(Tubular)3. Secretion. .(Tubular)

4. Excretion.



� The main f unction of kidney is Homeostasis

which means :

-maintain internal environment constant-excretion of all metabolic west product.



� In a healthy adult about 650 ml of plasma

(1200 ml of blood ) pass through f unctioning

renal excretory tissue every minute, andabout 125 ml of glomerular filtrate is formed.



� Water passes freely from the plasma through the glomeruli , and those unbound

constituents of the plasma that have a molecular weight of less than about 70,000are present in the glomerular filtrate at the

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� Substances of a higher molecular weight thanabout 70,000 do not pass freely through the

glomeruli and are present in the glomerlarfiltrate at a lower concentration than in

plasma



� The renal tubules conserve water and soluble constituent of the body by reabsorption using

both passive ( high conc.To low conc. )� And the active transport ( useATP + carrier )

from the glomerular filtrate.



� Volume :

The normal 24 hours Urine volume of an adult is

between 750 and 2000 ml . This depend on

the fluid intake

loss of fluid by other routes.



� In Disease :

Oliguria :

Urine output less than 500ml/day Causese :

deficient intake of water ,

or excessive loss of fluid by other routes ,

�

for example : by :haemorrhage , diarrhea

vomiting



� Polyuria

Urine output more than 2000m/day.

Physiological causes chronic renal insufficiency .

Polyuria of low osmolality is also found in diabetes

insipidus

Polyuria occur as an osmotic diuresis in any disease where there is an increased excretion of metabolites(diabetes mellitus ).



� Polyuria

Physiological causes

Excessive water intake Diuretic as tea, Cola, Coff ee

Excessive salt intake



� Colour :

Due to urinary pigments (urochromes).

Pale (low specific gravity ) to dark yellow (high specific gravity)

Coloured urines occur in :

certain disease

metabolic disorders,

af ter the administration of many drugs:

Beta carotine supplement ( orange urine )



� Appearance :

Casts : The tubules secrete an

1-glycoprotein (Tamm-

Horsf all protein ) , which , in the presence of albumin , comes out of solution in gel form as casts.



� Appearance :

Mucus protein :

This may be from semen or from vaginal discharge. Pathologically , it may be due to disease of the lowerurinary tract or pus.



Appearance :

Crystals :

These are not normally pathological Uric acid ( reddish yellow) & calcium oxalate

(colourless ) fromacid urine

phosphate ( whitish) from alkaline urine .

Pathological

cystine crystals

dark reddish deposit of blood.



� Smell:

unpleasant smell : urine inf ected withGram-

negative organisms . ammonical smell: urine inf ected with urea

splitting organisms

maple syrup disease (H.W)



� pH:

Normal between 5.5 and 8

Alkalosis : Vegetarine diet

Bacterial inf ection



� SpecificGravity :

normal specific gravity in 24 hour urine sample is

between 1.025 and 1.010 Wt of the sample /Wt of the water

High urine volume ( low Sp.gravity )

low urine volume ( highSp.gravity )

examination of urine 1&2

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