System system check

Urinary systemExcretory system- removes waste and excess water

from the body and is important for maintaining the body’s acid-base balance.

What makes up the urinary system2 kidneys2 ureters1 bladder1 urethra

This system is sterile!!!!

kidneysLocated in the upper part of the abdominal cavityEach kidney is surrounded by an adipose capsuleDivided into cortex- outer part with nephrons and

medulla-inner part with collection tubules

nephronsMicroscopic filtering unitsMore than a million per kidneyEach nephron contains:

Glomerulous-(high pressure coiled capillaries)---filters water, mineral salts, sugar, metabolic product, and other crud, but not RBC’s and protein. Then goes out the renal vein to go back to the heart

Bowman’s capsule- c- shaped structure that surrounds glomerulous it picks up the bad stuff that is filtered out, and takes it to the convoluted tubule……. To be continued

nephronConvoluted tubule- it collects the crud that was

filtered out and returns the things the body needs back into the blood by the capillaries- water, sugar, salt

Excess water sugar and salt stay in the tubule and form urine which go to the collecting ducts

Collecting ducts- other tubules that dump urine into the renal pelvis-a funnel at the top of the ureter.

Drawing Billy the kidneyMake a beautiful most beautiful drawing of the

nephron for yourself!

ureters2 tubes that are 10-12 inches in length that goes from

the kidney to the bladderPeristalsis moves the urine through the ureter from

the kidney to the bladder.

bladderHollow muscular sac located behind the symphysis

pubis midlineUrge to void bladder occurs when there is 250 cc or 1

cup of urineWhen the bladder is full, receptors in the wall of the

bladder signal muscles to open- a reflex

urethraUrethra is a tube that carries urine from the bladder

to the outside opening called the urinary meatus

Blood pressure and the kidneyAndy gets shotAndy is bleeding outAndy’s BP dropsInside Andy, his kidneys have a cell that detects

changes in the system. They release renin- a hormone that floats around in the body and finds angiotensin. This is a chemical that when touched by renin turns into angiotensin I. To be continued……

Blood pressure and Billy the kidneyAngiotensin I as a hormone can change blood

pressure a little, but it has to convert to Angiotensin II.

Angiotensin II is much more powerful, and can change blood pressure more dramatically

This change over happens in the lungs- remember when we talked about blowing off CO2? It just came back around to bite you in the gluteus!

Blood pressure and Billy the kidneyWant to know how angiotensin coverts itself from I

to II? Angiotensin Converting Enzyme of course! It is called ACE

That is why people take ACE inhibitors-it controls high blood pressure!!!!!

Light bulb! kill angiotensin II=reduced blood pressure

PathopathopathopathopathoKidney stones- no these are not rocks you

swallowed…This may be called renal calculus- it is when minerals

from our diets build up in the kidneys and form stones……..

Rolling kidney stonesSigns and symptoms of kidney stones:extreme pain in your back or side that will not go

awayblood in your urinefever and chillsvomitingurine that smells bad or looks cloudya burning feeling when you urinate

What do they look like?Kidney stones may be as small as a grain of sand or as

large as a pearl. Some stones are even as big as golf balls. Stones may be smooth or jagged. They are usually yellow or brown.

Golf ball size brown jagged and yellow small smooth

How to get rid of themShoot shock waves transdermally into the kidney to

break up stones to pass them called lithotripsy-stone crushing

Tunnel surgery makes an incision into the kidney through the back to pull the kidney stone out

Uteroscope- doctor sends a wire device through the urethra and a cage and pull it out

Urinary tract infectionsUTI most common in women due to shorter structure

of the urinary tract, and proximity of the meatus to the vagina and rectum

Remember the urinary tract is sterile, but the GI system is not

Most common infections are from the e.coli bacteria common to the intestines

UTISigns and symptoms of UTI:Frequent urinationBurning with urinationStrange odorCloudy color to blood tinged called hematuriaTreatment- antibiotics to kill bacteria and increase

fluid intake

pyelonephritisThis is inflammation of the kidney tissue and renal pelvis.

This is usually caused by the strep bacteria, and forms pus in the kidney which is excreted with urine

Signs and symptoms:High feverChills severe back painGeneralized weakness and painLoss of appetite and nauseaTreatment: antibiotics and increased fluid intake

Renal failureRenal failure is when the kidneys shut down and stop

filtering the blood.ARF= acute renal failure, sudden drop in urine

production due to infection, trauma or blood loss, this is sudden, and most of the time not permanent

Feels like:

ARFLittle or no urine when you urinate.Swelling, especially in your legs and feet. Not feeling like eating.Nausea and vomiting.Feeling confused, anxious and restless, or sleepy.Pain in the back just below the rib cage. This is called

flank pain.Treatment- dialysis- a machine filters the blood

where the body can’t

dialysis

Chronic renal failure stagesStage I= slight kidney damage- observation and

control BPStage II= mild decrease in kidney function-

observation and control BPStage III= moderate decrease in kidney function

observation and control BPStage IV= severe decrease in function-planning on

end-stage renal failureStage V= dialysis and kidney transplant

End stage kidney failure

Stage 4 pitting edema

AV fistula

AV fistula

Cannulation of AV fistula

Port for dialysis