Chapter 15 jk.pptx

urinary system ppt

1. Cha p t er 1 5 T h e Ur i n a r y S ystem S l i des 15.1 – 15.20 L e cture S l i d e s i n P ow e r P o i nt b y J e rry L . C ook Cop y r i ght © 2003 P ea r s on E du c at i on, I n c . pub l i s h i ng as B en j a m i n Cu m m i ngs E s s entia l s of H uman Anato m y & P h y s i o l o gy S e v e n t h E di t i o n E l a i ne N . Ma r i e b

2.  E l i m in a t ion o f w a s t e p r o d u c t s  N i t r ogenous w as t es  T ox i ns  D r ugs S l i d e 1 5 . 1 a Cop y r i ght © 2003 P ea r s on E du c at i on, I n c . pub l i s h i ng as B en j a m i n Cu m m i ngs F unc t ions of t he U rinary S y s t em

3.  R e g u late a s p e c t s o f h o me o s t a s is  W a t er ba l ance  E l ec t r o l y t es  Ac i d - base ba l ance i n t he b l ood  B l ood p r essu r e  R ed b l ood ce l l p r oduc t i on  Ac t i va t i on of v i t a m i n D S l i d e 1 5 . 1 b Cop y r i ght © 2003 P ea r s on E du c at i on, I n c . pub l i s h i ng as B en j a m i n Cu m m i ngs F unc t ions of t he U rinary S y s t em

4.   K i d n e y s U r e t e rs   U ri n a ry U r e t h ra b la d d e r Fi g u r e 1 5 . 1 a Cop y r i ght © 2003 P ea r s on E du c at i on, I n c . pub l i s h i ng as B en j a m i n Cu m m i ngs S l i d e 1 5 . 2 Orga n s of t he U rinary s y s t em

5.    Ag a in s t t h e d o rsal b o d y w a ll At t h e le v e l o f T 12 t o L 3 The ri g h t k id n e y is s l i g h t ly lo w e r t h e left t h a n  A t t a c h e d t o u r e t e rs, r e n a l b lo o d v e s s e l s , a n d n e rves a t r e n a l h i l u s A t o p e a c h k id n e y is a n a d r e n a l g la n d  S l i d e 1 5 . 3 Cop y r i ght © 2003 P ea r s on E du c at i on, I n c . pub l i s h i ng as B en j a m i n Cu m m i ngs Loca t ion of t he Kid n e y s

6.  R e n a l c a p s u le  Sur r ounds each k i dney Adi p o s e c a p s u le   Sur r ounds t he k i dney  Prov i des p r o t ec t i on t o t he k i dney  H e l ps keep t he k i dney i n i t s co r r ect l oca t i on S l i d e 1 5 . 4 Cop y r i ght © 2003 P ea r s on E du c at i on, I n c . pub l i s h i ng as B en j a m i n Cu m m i ngs C o v erings of t he Kid n e y s

7.  Re n a l c o rt e x – o u t e r r e g i o n  Re n a l m e d u l l a – i n s i d e Re n a l t h e c o rt e x p e l v i s –  i n n e r c o l l e c t i n g t u b e Fi g u r e 1 5 . 2 b S l i d e 1 5 . 5 Cop y r i ght © 2003 P ea r s on E du c at i on, I n c . pub l i s h i ng as B en j a m i n Cu m m i ngs R egi o ns of t he Kid n ey

8.  Me d u l l a ry p y r a m i d s – t ri a n g u lar r e g io n s o f t i s s u e in t h e me d u l l a R e n a l c o lumns – e x t e n s io n s o f c o rte x - l i k e mate r ial in w a rd C a l y c e s – c u p -sh a p e d s t r u c t u r e s t h a t f u n n e l u ri n e t o w a r d s t h e r e n a l p e l v is   S l i d e 1 5 . 6 Cop y r i ght © 2003 P ea r s on E du c at i on, I n c . pub l i s h i ng as B en j a m i n Cu m m i ngs Kid n ey St r u c t ures

9. Fi g u r e 1 5 . 2 c S l i d e 1 5 . 7 Cop y r i ght © 2003 P ea r s on E du c at i on, I n c . pub l i s h i ng as B en j a m i n Cu m m i ngs Blo o d F low in t he Kid n e y s

10.  The s t r u c t u r a l a n d f u n c t io n a l u n i t s k id n e y s o f t h e   R e s p o n s ible f o r Main s t r u c t u r e s  G l o m e r u l us  R enal t ubu l e f o rming u ri n e o f t h e n e p h r o n s S l i d e 1 5 . 8 Cop y r i ght © 2003 P ea r s on E du c at i on, I n c . pub l i s h i ng as B en j a m i n Cu m m i ngs N ep h rons

11.  A s p e c iali z e d c a p i l la r y b e d A t t a c h e d t o a rte r iol e s o n b o t h s id e s (m a intai n s  h igh p r e s s u r e )  La r ge a f f e r ent a r t e r i o l e  N a r r ow e f f e r ent a r t e r i o l e Fi g u r e 1 5 . 3 c S l i d e 1 5 . 9 a Cop y r i ght © 2003 P ea r s on E du c at i on, I n c . pub l i s h i ng as B en j a m i n Cu m m i ngs Glo m erulus

12.  C a p i l la r ies a re c o v e r e d w i t h p o d o c y t e s f r o m t h e r e n a l t u b u le  The g lome r u lus s i t s w i t h in a g lome r u lar c a p s u le (the f ir s t p a rt o f t h e r e n a l t u b u le) Fi g u r e 1 5 . 3 c S l i d e 1 5 . 9 b Cop y r i ght © 2003 P ea r s on E du c at i on, I n c . pub l i s h i ng as B en j a m i n Cu m m i ngs Glo m erulus

13.  Gl o me r u lar (B o w ma n ’ s ) c a p s u le Pr o x i m a l c o n v o luted  t u b u le L o o p o f H e n le D i s t a l c o n v o luted t u b u le   S l i d e 1 5 . 1 Fi g u r e 1 5 . 3 b Cop y r i ght © 2003 P ea r s on E du c at i on, I n c . pub l i s h i ng as B en j a m i n Cu m m i ngs R en a l T ub u le

14.  C o rti c a l n e p h r o n s  Loca t ed en t i r e l y i n t he co r t ex  I nc l udes m ost neph r ons Fi g u r e 1 5 . 3 a S l i d e 1 5 . 1 1 a Cop y r i ght © 2003 P ea r s on E du c at i on, I n c . pub l i s h i ng as B en j a m i n Cu m m i ngs T y pes of N ep h rons

15.  J u x t a me d u l l a ry n e p h r o n s  Found at m edu l l a t he bounda r y of t he co r t ex and Fi g u r e 1 5 . 3 a S l i d e 1 5 . 1 1 b Cop y r i ght © 2003 P ea r s on E du c at i on, I n c . pub l i s h i ng as B en j a m i n Cu m m i ngs T y pes of N ep h rons

16.  Ari s e f r o m e f f e r e n t a rte r iole o f t h e g lome r u lus N o rm a l, low p r e s s u re c a p i l la r ies A t t a c h e d t o a v e n u le C l i n g c lo s e t o t h e r e n a l t u b u le R e a b s o rb ( r e c laim) s o me s u b s t a n c e s f r o m c o l l e c t ing t u b e s     S l i d e 1 5 . 1 2 Cop y r i ght © 2003 P ea r s on E du c at i on, I n c . pub l i s h i ng as B en j a m i n Cu m m i ngs Peri t ub u lar C apillaries

17.    Fi l t r a t ion R e a b s o r p t ion Se c r e t ion Fi g u r e 1 5 .4 S l i d e 1 5 . 1 3 Cop y r i ght © 2003 P ea r s on E du c at i on, I n c . pub l i s h i ng as B en j a m i n Cu m m i ngs U rine F or m at i on Pro c e s s es

18.   N o n s e le c t i v e p a s s i v e p r o c e s s W a t e r a n d s o lutes s maller t h a n p r o t e ins a re f o rced t h r o u g h c a p i l la r y w a l l s  B l o o d c e l l s c a n n o t p a s s o u t t o t h e c a p i l la r ies Fi l t r a t e is c o l l e c t e d in t h e g lome r u lar c a p s u le a n d le a v e s v ia t h e r e n a l t u b u le  S l i d e 1 5 . 1 4 Cop y r i ght © 2003 P ea r s on E du c at i on, I n c . pub l i s h i ng as B en j a m i n Cu m m i ngs F il t ra t ion

19.  The pe r i t ubu l ar m a t e r i a l s  S o me wa t e r  G l u c o s e  A mi n o a c i d s  I o n s cap i l l a r i e s r eabso r b seve r al   Some r eabso r p t i on i s pass i ve, m ost i s ac t i ve M ost r eabso r p t i on occu r s i n t he p r ox i m al convo l u t ed t ubu l e S l i d e 1 5 . 1 5 Cop y r i ght © 2003 P ea r s on E du c at i on, I n c . pub l i s h i ng as B en j a m i n Cu m m i ngs R ea b s orption

20.  N i t r o g e n o u s w a s t e  U r ea  U r i c ac i d  C r ea t i n i ne E x c e s s w a t e r p r o d u c t s  S l i d e 1 5 . 1 6 Cop y r i ght © 2003 P ea r s on E du c at i on, I n c . pub l i s h i ng as B en j a m i n Cu m m i ngs M aterials N ot R ea b s orb e d

21. R e v er s e  Some mate r ials mo v e f r o m t h e p e ritu b u lar c a p i l la r ies into t h e r e n a l t u b u les  H yd r ogen and po t ass i um i ons  C r ea t i n i ne  Mate r ials left in t h e r e n a l t u b u le t o w a rd t h e u r e t e r mo v e S l i d e 1 5 . 1 7 Cop y r i ght © 2003 P ea r s on E du c at i on, I n c . pub l i s h i ng as B en j a m i n Cu m m i ngs Sec r et i on – R ea b s orption in

22. Fi g u r e 1 5 .5 Cop y r i ght © 2003 P ea r s on E du c at i on, I n c . pub l i s h i ng as B en j a m i n Cu m m i ngs S l i d e 1 5 . 1 8 F or m at i on of U rine

23. M edical D iag n o s is  C o lo r e d s o me w h a t y e l l o w d u e t o t h e p igme n t u r o c h r o me (fr o m t h e d e s t r u c t ion o f h e mo g lo b in) S t e rile S l ig h t ly a r o mat i c N o rm a l p H o f a r o u n d 6 Sp e c i f ic g r a v i t y o f 1 . 1 t o a n d s o lutes     1 . 3 5 S l i d e 1 5 . 1 9 Cop y r i ght © 2003 P ea r s on E du c at i on, I n c . pub l i s h i ng as B en j a m i n Cu m m i ngs C har a c t eri s t i c s of U rine U s ed f or

24.  S l e n d e r t u b e s a t t a c h ing t h e k id n e y t o t h e b la d d e r  C on t i nuo u s w i t h t he r enal pe l v i s  En t er t he pos t e r i or aspect of t he R u n s b e h ind t h e p e rito n e u m Pe r i s t a l s is a ids g r a v i t y in u ri n e b l adder   t r a n s p o rt S l i d e 1 5 . 2 Cop y r i ght © 2003 P ea r s on E du c at i on, I n c . pub l i s h i ng as B en j a m i n Cu m m i ngs U re t ers

25.   S m o o t h , c o l l a p s ibl e , mu s c u lar s a c T e mp o r a rily s t o r e s u ri n e Fi g u r e 1 5 .6 Cop y r i ght © 2003 P ea r s on E du c at i on, I n c . pub l i s h i ng as B en j a m i n Cu m m i ngs S l i d e 1 5 . 2 1 a U rinary Bla d der

26.  T ri g o n e – t h r e e o p e n in g s  T w o  O ne f r om t he u r e t e r s t o t he u r e t h r ea Fi g u r e 1 5 .6 Cop y r i ght © 2003 P ea r s on E du c at i on, I n c . pub l i s h i ng as B en j a m i n Cu m m i ngs S l i d e 1 5 . 2 1 b U rinary Bla d der

27.  Th r e e la y e rs o f s mo o t h mu s c le ( d e t r u s o r mu s c le)  Mu c o s a ma d e o f t r a n s i t io n a l e p i t h e l i u m  W a l l s a re t h i c k a n d f o ld e d in b la d d e r a n e mpty  B l a d d e r c a n e x p a n d s ig n i f i c a n t ly w i t h o u t in c r e a s ing inte r n a l p r e s s u re S l i d e 1 5 . 2 2 Cop y r i ght © 2003 P ea r s on E du c at i on, I n c . pub l i s h i ng as B en j a m i n Cu m m i ngs U rinary Bla d der W all

28.  Thi n - w a l l e d t u b e t h a t c a r r ies u ri n e f r o m t h e b la d d e r t o t h e o u t s ide o f t h e b o d y p e ri s t a l s is R e le a s e o f u ri n e is c o n t r o l l e d b y t w o s p h in c t e rs  I n t e r nal u r e t h r al sph i nc t er ( i nvo l un t a r y)  Ex t e r nal u r e t h r al sph i nc t er ( vo l un t a r y) b y  S l i d e 1 5 . 2 3 Cop y r i ght © 2003 P ea r s on E du c at i on, I n c . pub l i s h i ng as B en j a m i n Cu m m i ngs U re t hra

29.  L e n g t h  Fema l es – 3–4 cm ( 1 i nch)  M a l es – 20 cm ( 8 i nches) L o c a t ion  Fema l es – a l ong w a l l of t he  vag i na  M a l es – t h r ough t he p r os t a t e and pen i s S l i d e 1 5 . 2 4 a Cop y r i ght © 2003 P ea r s on E du c at i on, I n c . pub l i s h i ng as B en j a m i n Cu m m i ngs U re t hra Ge n der D i f f ere n c es

30.  Fu n c t ion  Fema l es – on l y ca r r i es u r i ne  M a l es – ca r r i es f or spe r m ce l l s u r i ne and i s a passage w ay S l i d e 1 5 . 2 4 b Cop y r i ght © 2003 P ea r s on E du c at i on, I n c . pub l i s h i ng as B en j a m i n Cu m m i ngs U re t hra Ge n der D i f f ere n c es

31.  Both s p h in c t e r mu s c les mu s t o p e n t o a l l o w v o idi n g  The i n t e r nal u r e t h r al sph i nc t er i s r e l axed a f t er s t r e t ch i ng of t he b l adder  Ac t i va t i on i s f r om an i m pu l se sent t o t he sp i nal co r d and t hen back v i a t he pe l v i c sp l anchn i c ne r ves  The ex t e r nal u r e t h r al sph i nc t er m ust be vo l un t a r i l y r e l axed S l i d e 1 5 . 2 5 Cop y r i ght © 2003 P ea r s on E du c at i on, I n c . pub l i s h i ng as B en j a m i n Cu m m i ngs M i c t uri t ion (Voidin g )

32.  N o rm a l b o d y  Y oung  Y oung a mo u n t o f w a t e r in t h e h u man adu l t f e m a l es adu l t m a l es – – 50% 60%  Bab i es – 75%  O l d age – 45% W a t e r is n e c e s s a ry f o r ma n y f u n c t io n s a n d le v e ls mu s t b e  b o d y maint a in e d S l i d e 1 5 . 2 6 Cop y r i ght © 2003 P ea r s on E du c at i on, I n c . pub l i s h i ng as B en j a m i n Cu m m i ngs M aintaining W ater Bal a n c e

33.  I n t r a c e l l u lar f luid (i n s ide c e l l s ) E x t r a c e l l u lar  f luid ( o u t s ide c e l l s )  I n t e r s t i t i al f l u i d  B l ood p l as m a Fi g u r e 1 5 .7 S l i d e 1 5 . 2 7 Cop y r i ght © 2003 P ea r s on E du c at i on, I n c . pub l i s h i ng as B en j a m i n Cu m m i ngs D i s t ribut i on of Bo d y F luid

34.  C h a n g e s in e le c t r o l y t e b a la n c e c a u s e s w a t e r t o mo v e f r o m o n e c o mp a rt m e n t t o a n o t h e r  A l t e r s b l ood vo l u m e and b l ood  C an i m pa i r t he ac t i v i t y of ce l l s p r essu r e S l i d e 1 5 . 2 8 Cop y r i ght © 2003 P ea r s on E du c at i on, I n c . pub l i s h i ng as B en j a m i n Cu m m i ngs T he Link Betw e en W ater and Salt

35.   W a t e r inta k e mu s t e q u a l w a t e r o u t p u t So u rces f o r w a t e r inta k e  I n g e s t e d f o o d s a n d f l u i d s  W a t e r p r o d u c e d f r o m m e t a b o l i c p r o c e s s e s  So u rces f o r w a t e r o u t p u t  V a p o r i z a t i o n o u t o f t h e l u n g s  L o s t i n p e r s p i r a t i o n  L e a v e s t h e b o d y i n t h e f e c e s  Ur i n e p r o d u c t i o n S l i d e 1 5 . 2 9 Cop y r i ght © 2003 P ea r s on E du c at i on, I n c . pub l i s h i ng as B en j a m i n Cu m m i ngs M aintaining W ater Bal a n c e

36.  D i l u t e u ri n e is p r o d u c e d if w a t e r inta k e is e x c e s s i v e L e s s u ri n e (co n c e n t r a t e d ) is p r o d u c e d la r g e a mo u n t s o f w a t e r a re lo s t Pr o p e r c o n c e n t r a t io n s o f v a ri o u s e le c t r o l y t e s mu s t b e p r e s e n t  if  S l i d e 1 5 . 3 Cop y r i ght © 2003 P ea r s on E du c at i on, I n c . pub l i s h i ng as B en j a m i n Cu m m i ngs M aintaining W ater Bal a n c e

37. R ea b s orption  R e g u lat i o n is p rima r i l y b y h o rm o n e s  An t i d i u r e t i c ho r m one ( A D H ) p r even t s excess i ve w a t er l oss i n u r i ne  A l dos t e r one r egu l a t es sod i um i on con t ent ex t r ace l l u l a r f l u i d  T r i gge r ed by t he r enn i n - ang i o t ens i n m echan i sm C e l l s in t h e k id n e y s a n d h y p o t h a lamus a re a c t i v e mo n i t o rs of  S l i d e 1 5 . 3 1 Cop y r i ght © 2003 P ea r s on E du c at i on, I n c . pub l i s h i ng as B en j a m i n Cu m m i ngs R eg u la t ion of W ater and Elec t rol y t e

38. Fi g u r e 1 5 .9 S l i d e 1 5 . 3 2 Cop y r i ght © 2003 P ea r s on E du c at i on, I n c . pub l i s h i ng as B en j a m i n Cu m m i ngs M a in t a ini n g W a t e r a n d E l e ct r o lyte Bala n ce

39. Blo o d  B l o o d p H mu s t r e main b e t w e e n 7 . 3 5 a n d 7 . 4 5 t o maint a in h o me o s t a s is  A l ka l os i s – pH above 7 . 45  Ac i dos i s – pH be l ow 7 . 35  Mo s t io n s o ri g in a t e a s b y p r o d u c t s c e l l u lar meta b o l i s m o f S l i d e 1 5 . 3 3 a Cop y r i ght © 2003 P ea r s on E du c at i on, I n c . pub l i s h i ng as B en j a m i n Cu m m i ngs M aintaining A c id- B ase Bal a n c e in

40. Blo o d  Mo s t a c id - b a s e b a la n c e is maint a in e d b y t h e k id n e y s  Oth e r a c id - b a s e  B l ood bu f f e r s  R esp i r a t i on c o n t r o l l ing s y s t e ms S l i d e 1 5 . 3 3 b Cop y r i ght © 2003 P ea r s on E du c at i on, I n c . pub l i s h i ng as B en j a m i n Cu m m i ngs M aintaining A c id- B ase Bal a n c e in

41.  Molecul e s r e a c t t o p r e v e n t d r a mat i c c h a n g e s in h y d r o g e n ion ( H + ) c o n c e n t r a t io n s H +  B i nd t o w hen pH d r ops H +  R e l ease w hen pH r i ses  Th r e e major c h e m i c a l b u f f e r  B i ca r bona t e bu f f er sys t em  Phospha t e bu f f er sys t em  Pro t e i n bu f f er sys t em s y s t e ms S l i d e 1 5 . 3 4 Cop y r i ght © 2003 P ea r s on E du c at i on, I n c . pub l i s h i ng as B en j a m i n Cu m m i ngs Blo o d Buf f ers

42.  M i x t u re o f c a r b o n ic a c id ( H 2 C O 3 ) a n d s o d ium b i c a r b o n a t e ( N a H C O 3 ) B i c a r b o n a t e io n s ( H C O 3 ) r e a c t w i t h –  s t r o n g a c ids t o c h a n g e t h e m t o w e a k a c ids C a r b o n ic a c id d i s s o c iates in t h e p r e s e n c e o f a s t r o n g b a s e t o f o rm a w e a k b a s e a n d w a t e r  S l i d e 1 5 . 3 5 Cop y r i ght © 2003 P ea r s on E du c at i on, I n c . pub l i s h i ng as B en j a m i n Cu m m i ngs T he Bi c arb o nate Buf f er S y s t em

43. A c id- B ase Bal a n c e  C a r bon d i ox i de i n t he b l ood i s conve r t ed t o b i ca r bona t e i on and t r anspo r t ed i n t he p l as m a I nc r eases i n hyd r ogen i on concen t r a t i on p r oduces m o r e ca r bon i c ac i d Excess hyd r ogen i on can be b l o w n o f f w i t h   t he r e l ease of ca r bon d i ox i de f r om t he l ungs  R esp i r a t o r y r a t e can r i se and f a l l depend i ng on chang i ng b l ood pH S l i d e 1 5 . 3 6 Cop y r i ght © 2003 P ea r s on E du c at i on, I n c . pub l i s h i ng as B en j a m i n Cu m m i ngs R e s piratory S y s t em C ontrols of

44. Bal a n c e   E x c r e t e b i c a r b o n a t e io n s if n e e d e d C o n s e rve o r g e n e r a t e n e w b i c a r b o n a t e io n s if n e e d e d  U ri n e p H v a ri e s f r o m 4 . 5 t o 8 . S l i d e 1 5 . 3 7 Cop y r i ght © 2003 P ea r s on E du c at i on, I n c . pub l i s h i ng as B en j a m i n Cu m m i ngs R en a l M e c ha n i s m s of A c id- B ase

45. U rinary S y s t em  Fu n c t io n a l k id n e y s t h e t h ird mo n t h a re d e v e lo p e d b y  U ri n a ry s y s t e m o f a n e w b o rn  B l adder i s s m a l l  U r i ne cannot be concen t r a t ed S l i d e 1 5 . 3 8 a Cop y r i ght © 2003 P ea r s on E du c at i on, I n c . pub l i s h i ng as B en j a m i n Cu m m i ngs D e v elo p m ental A s pec t s of t he

46. U rinary S y s t em  C o n t r o l o f t h e v o lu n t a ry s p h in c t e r d o e s n o t s t a rt u r e t h r a l u n t il a g e 1 8 mo n t h s U ri n a ry infe c t io n s a re t h e o n ly c o m m o n p r o b lems b e f o re o ld a g e  S l i d e 1 5 . 3 8 b Cop y r i ght © 2003 P ea r s on E du c at i on, I n c . pub l i s h i ng as B en j a m i n Cu m m i ngs D e v elo p m ental A s pec t s of t he

47.  Th e re is a p r o g r e s s i v e d e c l i n e in u ri n a ry f u n c t ion The b la d d e r s h ri n k s w i t h a g ing   U ri n a ry r e t e n t ion is c o m m o n in males S l i d e 1 5 . 3 9 Cop y r i ght © 2003 P ea r s on E du c at i on, I n c . pub l i s h i ng as B en j a m i n Cu m m i ngs Agi n g and t he U rinary S y s t em