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Bellringer:

• Urine formation begins with: a. Filtration

b. Osmosis

c. Respiration

d. Secretion

o Production of urine is controlled by 2 hormones: a. Epinephrine and norepinephrine

b. ADH and aldosterone

c. FSH and oxytocin

d. TSH and thyroxine

4.02 Understand the functions and disorders

of the urinary system 1

4.02 Understand the Functions and Disorders of the Urinary System

4.02 Understand the functions and disorders of the urinary system

Essential Questions

What are the functions of the urinary system?

What are some disorders of the urinary system?

How are disorders of the urinary system treated?

How do you relate the body’s hormone control to the

urinary system?

4.02 Understand the functions and disorders of the urinary system 3

Understand the functions of the urinary system

Functions: removes waste products from the

body

Excretion

Formation of urine

Fluid and electrolyte balance

Elimination of urine



Excretion

The removal of nitrogenous wastes as well as excess

salts and water from the blood, forming urine.

Excretory functions are necessary for the body to

regulate the chemical composition of body fluids by

removing metabolic wastes and retaining the proper

amounts of water, salts, and nutrients.


Understand the functions of

the urinary system

Begins with Filtration

Reabsorption

Secretion


• Filtration in the kidney occurs in the glomerulus • Blood from renal artery

enters glomerulus • High pressure in

glomerulus forces fluid into Bowman’s capsule, where it is filtered (filters substances from the blood)

• Filtrate does not contain plasma proteins or RBC’s – they’re too big

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BOWMAN’S CAPSULE

Bowman’s capsule filters out 125cc of fluid/min. …how many cc’s per hour is this? As the filtrate continues through nephron, 90% of

water is reabsorbed


Reabsorption

Water, glucose, amino acids, vitamins and other useful substances are reabsorbed from the urine back into the blood

If blood levels of certain substances are high, the substances will not be reabsorbed.

These substances are then eliminated in the urine. The limit of reabsorption is called ‘threshold’ . Ex: people who have diabetes spilling glucose into their

urine (glycosuria)


Secretion


o Opposite of

reabsorption. Secretion

transports substances from

blood into the urine

through the collecting

tubules.

• Substances transported through secretion: ammonia creatinine, K+, hydrogen ions, and some drugs.

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Fluid and electrolyte balance Electrolytes are selectively secreted to maintain body’s

acid-base balance. – Electrolytes are electrically charged particles that help determine

fluid and acid-base balance. • Calcium • Chloride • Magnesium • Phosphorous • Potassium • Sodium

– Electrolytes affect the amount of water in your body, the acidity of your blood (pH), your muscle function, and other important processes.

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Fluid and electrolyte balance: Chemical and Nervous control

Chemical control • Reabsorption of H20 in distal convoluted tubule controlled by ADH (antidiuretic hormone)

• Secretion and regulation of ADH controlled by Hypothalamus

o ALDOSTERONE – secreted by adrenal cortex, promotes excretion of potassium and hydrogen ions,

reabsorption of sodium, chlorine ions and H20



Fluid and electrolyte balance Chemical control The amount of ADH produced is related to the

level of body hydration It regulates the body's retention of water; it is

released when the body is dehydrated and it causes the kidneys to conserve water, which in turn concentrates the urine and reducing urine volume



Forming more dilute urine: “dilute urine” – a less concentrated formof urine. Diuretics: any substance that promotes the production of

urine/ inhibit reabsorption of H20

Examples of substances that have diuretic effects:

Coffee Tea Water Certain medicines



• Fluid and electrolyte balance

Nervous Control

– Direct control through nerve impulses on kidney blood vessels

– Indirect control though stimulation of endocrine glands




Fluid and electrolyte balance


What effect does this cycle have on your blood pressure?


The flow of electrolytes


Review urine formation, electrolyte exchange,

and some factors that effect urine volume.


the urinary system Urinary bladder – stores and aids in the elimination of urine Emptying of the bladder takes place by muscular contractions of the bladder which are involuntary. This can be controlled to some extent through the nervous system. Urinary retention can be caused by an obstruction in the urinary tract or by nerve problems that interfere with signals between the brain and the bladder. Treatment for urinary retention: catheterization, medication, pelvic muscle exercises



the urinary system

Elimination of urine Urinary output


Average urinary output = 1500 ml per day *How many ounces is this?

Water, certain

foods and

medications

can effect the

color of your

urine?




Medical terminology regarding

urination:

Enuresis – bedwetting/common in children

Glycosuria – sugar in urine

Nocturia – frequent urination at night

Polyuria – large amounts of urine

Pyuria – pus in urine

Anuria – no urine produced

Hematuira – blood in urine

Urinalysis An examination of urine

Normal urine: pale yellow to deep amber, clear not

cloudy, little to no odor Abnormal urinalysis: red tint to urine (blood in

urine), cloudy and foul odor


Urinalysis


Disorders of the urinary system


Bellringer:



Hemodialysis is used to treat:

a. kidney failure

b. nephrolithiasis

c. pyelonephritis

d. urinary incontinence

Lithotripsy can break up renal calculi using:

a. Clamps and wrenches

b. Medications

c. Radiation

d. Shockwaves


Cystitis (cyst= medical term for ____ +itis =___ ) o Inflammation of the mucous membrane lining of the urinary bladder Most common cause: E. Coli Major symptoms: Dysuria (painful urination) Frequency

Treatment: Antibiotics



Cystitis More common in females—Why ??



Glomerulonephritis


Disease which injures

the glomerulus.

What will happen as a result of damaged glomeruli?


Glomerulonephritis Two types:

– Acute - rapid onset and/or a short course

– Chronic – develops and worsens over an extended period of time

Acute glomerulonephritis – occurs in some children 1-3

weeks after a bacterial infection Treated with antibiotics/full recovery expected

Chronic glomerulonephritis – occurs when the filtration membrane may be permanently affected May result in kidney failure



Renal calculi Also known as nephrolithiasis nephro lith iasis Made of calcium phosphate, uric acid and other substances Symptoms: sudden extreme pain that starts in the kidney area or lower abdomen amd moves to the groin; nausea/vomiting; frequent urge to void; hematuria; chills; fever; weakness



Renal calculi Kidney damage can

occur if the ureters are blocked.



Renal calculi Treatment: Drink water Pain medication Utereroscope –

retrieval method Lithotripsy



Renal calculi Lithotripsy - shock waves hit dense stones

and break them up Is not a cure



Renal failure Acute

–Causes: nephritis (inflammation of a nephron, shock, injury, bleeding, or poisoning

– Symptoms: oliguria (reduced production of urine) is an early sign of acute kidney failure; anuria (absence of urine)



Renal failure chronic

Causes: long-term disease, such as high blood pressure or diabetes,

that slowly damages the kidneys and reduces their function over time.

Symptoms: may be none in early stages, urinalysis may reveal proteinuria

Healthy kidneys filter fluid, minerals and wastes from the blood, they

normally don’t allow large amounts of serum protein to escape into the urine. But when your kidneys aren’t filtering properly, proteinuria can occur, which means that an abnormal amount of protein is present in the urine.



Renal Failure Chronic kidney disease leads

to a buildup of fluid and waste products in the body.

Our kidneys also produce hormones and vitamins that affect the function of other organs (ex: hormones produced by the kidneys help regulate blood pressure and others help control calcium metabolism.



Renal Failure

How is it treated? – Peritoneal dialysis • blood vessels in your abdominal

lining (peritoneum) fill in for your kidneys, with the help of a fluid (dialysate) that flows into and out of the peritoneal space via a catheter implanted into the abdomen. Several hours later the dialysate is drained from the abdomen taking the wastes from the blood with it.



Renal Failure

How is it treated? – Hemodialysis • A machine filters wastes, salts

and fluid from your blood via a semi-permeable membrane

• The patient is connected to a filter (dialyzer) by tubes attached to their blood vessels. Their blood is slowly pumped from their body into the dialyzer, where waste products and extra fluid is removed. The filtered blood is then pumped back into their body.

– Takes 2-4 hours, 2-3 times a week



Renal Failure Compare the treatment of acute and

chronic renal failure.



How does hemodialysis mimic glomerular function? The patient’s blood is continuously circulated through a hemodialyzer (an artificial semi permeable membrane which mimics the glomerular membrane of the kidney), and then is returned to the patient.



Renal transplant – last resort Requires a donor organ from someone with a similar

immune system To be eligible for a transplant, your kidney

function can be no more than 20 percent of normal.



Renal transplant


Major

complication of

renal

transplantation

is rejection.

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