URINARY SYSTEM

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created 9 months ago by sunshineb777
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updated 9 months ago by sunshineb777
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1

FUNCTIONS

  • FLUID HOMEOSTASIS
  • REGULATE BLOOD:
    • COMPOSITION
    • CONCENTRATION
    • VOLUME
    • pH
    • PRESSURE
  • MAKES:
    • EPO (ERYTHROPOETIN) (HORMONE)
    • RENIN (ENZYME)
  • EXCRETION OF FLUID WASTE
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3 MAJOR PROCESSES THAT TAKE PLACE IN THE KIDNEYS

  • FILTRATION
  • REABSORPTION
  • SECRETION
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PATHWAY OF BLOOD THROUGH KIDNEY

RENAL ARTERY>SEGMENTAL ARTERY>INTERLOBAR ARTERY>ARCUATE ARTERY>CORDICAL RADIATE ARTERY>AFFERENT ARTERIOLE>GLOMERULUS> EFFERENT ARTERIOLE>PERTIBULAR CAPILLARIES> VASA RECTA>CORDICAL RADIATE VEIN>ARCUATE VEIN>INTERLOBAR VEIN>RENAL VEIN

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NEPHRON ANATOMY

  • BOWMANS CAPSULE
  • GLOMERULUS
  • AFFERENT ARTERIOLE=BLOOD MOVES INTO GLOMERULUS
  • EFFERENT ARTERIOLE=BLOOD MOVES OUT
  • PROXIMAL CONVOLUTED TUBULE(CLOSEST TO BOWMANS CAPSULE)
  • DISTAL CONVOLUTED TUBULE
  • LOOP OF HENLE (CONNECTS THESE 2)
  • PERITUBULAR CAPILLARIES
  • COLLECTING DUCT
  • CORTICAL NEPHRON, VEIN, ARTERY, VENULE, VASA RECTA
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FILTRATION

  • HAPPENS IN THE GLOMERULUS
  • MOVEMENT OF FLUID FROM INSIDE THE GLOMERULUS INTO THE BOWMANS CAPSULE
  • FILTRATION MEMBRANE: PODOCYTES & FENESTRE
  • FILTRATION ONLY WORKS IF THERE IS A DIFFERENCE IN PRESSURE BETWEEN THE FLUID IN THE GLOMERULUS & THE FLUID ON THE OTHER SIDE OF THE PODOCYTES
    • INCREASE OF PRESSURE IN GLOMERULUS CAUSES FILTRATION TO OCCUR
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PODOCYTES

  • FILTRATION SLITS, PART OF THE BOWMANS CAPSULE
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FENESTRE

  • LITTLE HOLES FOUND ON THE GLOMERULUS
  • MAKES THEM EXTRA LEAKY
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REABSORPTION

  • MAIN SITE AT PCT(PROXIMAL CONVOLUTED TUBULE)
  • H2O FOLLOWS NA WHEN IT CAN, WHEN ITS ALLOWED, & WHEN CELL MEMBRANE ALLOWS IT
  • NA GETS PUMPED VIA ACTIVE TRANSPORT
  • CELL MEMBRANES HAVE AQUAPORINS ALLOWING H2O TO FOLLOW NA
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COTRANSPORT

  • PROTEIN PUMPS OUT CL- AS LONG AS NA IS BEING PUMPED OUT
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COUNTERTRANSPORT

  • NA/K PUMP
  • NA PUMPED OUT, PUMPS K IN THE OPPOSITE DIRECTION
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REABSORPTION IN THE PCT

  • WHERE THE MAJORITY OF REABSORPTION OCCURS
  • 65% NA= REABSORB VIA ACTIVE TRANSPORT
  • 65% H2O=REABSORB VIA OSMOSIS (IF PCT IS COMPLETELY PERMEABLE TO WATER)
  • 99-100% ORGANIC MOLECULES= REABSORBED BY COTRANSPORT WITH NA
  • 60% CL & 90% HCO3= REABSORBED BY ELECTRICAL TRANSPORT WITH NA
  • FILTRATE ENTERING PCT IS SIMILAR TO BLOOD PLASMA IT WAS BEFORE
  • FILTRATE ENTERING LOOP OF HENLE IS NOT REMOTELY SIMILAR TO THE BLOOD PLASMA IT WAS BEFORE
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REABSORPTION IN THE LOOP OF HENLE

  • DESCENDING LIMB IS HIGHLY PERMEABLE TO WATER & MODERATELY PERMEABLE TO UREA, NA+, & MANY OTHER IONS
  • ASCENDING LIMB IS PERMEABLE TO SOLUTES BUT IMPERMEABLE TO WATER
  • NA/CL IS PUMPED OUT OF ASCENDING LIMB WHICH INCREASES THE CONCENTRATION WITHIN THE LOOP (THE U)
    • THIS CAUSES H2O TO GO OUT OF THE DESCENDING LIMB VIA OSMOSIS BECAUSE IT WANTS TO FOLLOW THE NA
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TUBULAR SECRETION

  • PCT SECRETIONS:
    • H+ VIA COUNTERTRANSPORT W/NA
    • K+, SOME DRUGS/TOXINS, URIC ACID, AMMONIUM (NH4)
  • DCT SECRETIONS:
    • H+ VIA COUNTERTRANSPORT W/NA
    • K+
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FILTRATION PRESSURE

  • GLOMERULAR CAPILLARY PRESSURE
  • CAPSULAR HYDROSTATIC PRESSURE
  • BLOOD COLLOID OSMOTIC PRESSURE
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GLOMERULAR CAPILLARY PRESSURE

  • BLOOD PRESSURE INSIDE CAPILLARY TENDS TO MOVE FLUID/SOLUTES OUT OF CAPILLARY INTO BOWMANS CAPSULE
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CAPSULAR HYDROSTATIC PRESSURE

  • INWARD PRESSURE THAT OPPOSES FILTRATION
  • PRESSURE DUE TO THE FORCE OF FILTRATE VOLUME ON THE WALL OF THE BOWMAN CAPSULE
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BLOOD COLLOID OSMOTIC PRESSURE

  • INWARD PRESSURE/OPPOSES FILTRATION
  • DUE TO OSMOTIC PRESSURE OF BLOOD IN GLOMERULUS CAPILLARIES
  • PRESENCE OF PROTEINS DRAWS WATER BACK IN TO THE GLOM CAPS FROM BOWMANS AS FLUID TRIES TO LEAVE
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ADH (ANTIDIURETIC HORMONE)

  • MADE BY: HYPOTHALAMUS, RELEASED BY POSTERIOR PITUITARY GLAND
  • TARGET: DISTAL CONVOLUTED TUBE/COLLECTING DUCT
  • COMMAND: INCREASE H2O REABSORPTION BY MAKING AQUAPORIN-2
  • URINE: VOLUME DECREASES, CONCENTRATION INCREASES
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ALDOSTERONE

  • MADE BY: ADRENAL GLAND
  • TARGET: DCT/CD
  • COMMAND: INCREASE SODIUM REABSORPTION, MORE NA FOR ACTIVE TRANSPORT
  • URINE: VOLUME: STAYS THE SAME
  • URINE: CONCENTRATION: DECREASES. H2O FOLLOWS IF ADH IS PRESENT
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ANH (ATRIAL NATRIURETIC HORMONE)

  • MADE BY: RIGHT ATRIUM WHEN IT IS OVERSTRETCHED
  • TARGET: DCT/CD AND POST PIT.
  • COMMAND: DECREASES SODIUM REABSORPTION & ADH RELEASE "DUMP EM BOTH"
  • URINE: VOLUME INCREASES, CONCENTRATION STAYS THE SAME
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STRUCTURE OF BLADDER

  • FUNDUS
  • TRIGONE: 3 HOLES, 2 FOR URETERS, 1 FOR URETHRA
  • PARIETAL PERITONEUM
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URETHRA DIFFERENCES IN MEN & WOMEN

  • MEN: 20 CM
  • WOMEN: 3 CM
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MICTURITION REFELX

3 MUSCLES IN PLAY

  • EXTERNAL URETHRAL SPHINCTER(SKELETAL MUSCLE)
  • INTERNAL URETHRAL SPHINCTER(SMOOTH MUSCLE)
  • DETRUSOR MUSCLE: WALL OF BLADDER: 3 LAYERS: 2 LONGITUDINAL LAYERS WITH A CIRCULAR LAYER IN BETWEEN
  1. URINE COMES IN (250-300ML), STRETCHES WALL, STARTS REFELX
  2. DETRUSOR MUSCLE RECEIVES STIMULUS, CONTRACTS
  3. INTERNAL URETHRAL SPHINCTER: RELAXES
  4. EXTERNAL URETHRAL SPHINCTER: CONTRACTS UNTIL IT IS TIME TO URINATE
  5. CAN ACCOMMODATE MORE THAN ONCE
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RENAL CALCULI

  • KIDNEY STONES
  • COMMON CAUSE OF BLOOD IN THE URINE & PAIN IN THE ABDOMEN
  • DEVELOPED BY DECREASED URINE VOLUME OR INCREASED EXCRETION OF STONE-FORMING COMPONENTS (CALCIUM, OXALATE, URATE, CYSTINE, XANTHINE, & PHOSPHATE)
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DIABETES INSIPIDUS

  • DISORDER THAT CAUSES AN IMBALANCE OF WATER IN THE BODY
  • LEADS TO INTENSE THIRST EVEN AFTER DRINKING FLUIDS
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GLOMERULONEPHRITIS

  • INFLAMMATION OF THE GLOMERULI
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CHRONIC RENAL FAILURE

  • GRADUAL LOSS OF KIDNEY FUNCTION
  • CAUSES DANGEROUS LEVELS OF FLUID, ELECTROLYTES, & WASTES BUILD UP IN YOUR BODY
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DIURETICS

  • SOMETHING THAT PROMOTES THE FORMATION OF URINE BY THE KIDNEY (REDUCE THE AMOUNT OF WATER IN THE BODY)
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INCONTINENCE

  • LACK OF VOLUNTARY CONTROL OVER URINATION OR DEFACATION
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HEMODIALYSIS

  • PROCESS BY WHICH WASTE PRODUCTS ARE FILTERED DIRECTLY FROM THE PATIENTS BLOOD
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PERITONEAL DIALYSIS

  • DIALYSATE PLACED INTO ABDOMINAL CAVITY (PERITONEUM) & DRAINED OUT BY GRAVITY FLOW
  • PERITONEAL MEMBRANE ACTS AS FILTER
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END STAGE RENAL DISEASE

  • LATE STAGES OF CHRONIC RENAL FAILURE WHICH THERE IS IRREVERSIBLE LOSS OF THE FUNCTION OF BOTH KIDNEYS
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COUNTER-CURRENT SYSTEM

(EXCHANGE/MULTIPLICATION)

  • COUNTERCURRENT EXCHANGE
    • TRADE OF SUBSTANCES (NA & CL FOR H2O)
  • COUNTERCURRENT MULTIPLICATION
    • DEALS WITH CHANGES IN THE CONCENTRATION OF FILTRATE
    • AS FILTRATE FALLS DOWN THE DESCENDING LIMB, LOSES H2O=INCREASE IN CONCENTRATION
    • AS IT MAKES THE U-TURN INTO THE ASCENDING LIMB, LOSES SOLUTE (NA/CL) BECOMES MORE DILUTED
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UREA CYCLING

  • COLLECTING DUCT & DESCENDING LIMB PERMEABLE TO UREA
  • UREA LEAKS OUT OF CD, ENTERS ISF(INCREASING CONCENTRATION), THEN ENTERS DESCENDING LIMB, ENTERS CD AND REPEATS
  • HELPS MAINTAIN OSMOTIC GRADIENT
  • WRINGS OUT MORE H2O BY INCREASING CONCENTRATION IN THE ISF
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RENIN-ANGIOTENSIN-ALDOSTERONE-ADH SYSTEM

  1. BP DECREASED (LOWERED KIDNEY PERFUSION)
  2. JUXTAGLOMERULAR CELL OF KIDNEY RELEASES RENIN
  3. RENIN CONVERTS ANGIOTENSINOGEN TO ANGIOTENSIN I
  4. ANGIOTENSIN I CONVERTED TO ANGIOTENSIN II VIA ACE (ANGIO CONVERTING ENZYME)
  5. ANGIOTENSIN II IS A POWERFUL VASOCONSTRICTOR
    1. INCREASES ALDOSTERONE RELEASE
    2. INCREASES ADH RELEASE
    3. INCREASES BLOOD VOLUME
    4. INCREASES BLOOD PRESSURE
    5. INCREASED VESSEL WALL TENSION, BODY RETAINS H2O & NA+
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JUXTAGLOMERULAR CELLS

  • SMOOTH MUSCLE CELLS AROUND THE AFFERENT ARTERIOLE
  • CONTAINS GRAINS
  • FILLED WITH RENIN
  • MONITORS BLOOD PRESSURE
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MACULA DENSA CELLS

  • CELLS IN THE DISTAL CONVOLUTED TUBULE
  • MONITOR FILTRATE CONCENTRATION