EXCRETORY SYSTEM

Function
1. Remove nitrogenous wastes 2. Maintain electrolyte, acid-base, and fluid balance of blood 3. Homeostatic organ 4. Acts as blood filter 5. Release hormones: calcitriol & erythropoietin

THE EXCRETORY SYSTEM

blood filtration tubular reabsorption and secretion

GENERAL FUNCTIONING OF THE KIDNEY

urine refreshed blood

NITROGENOUS WASTES

urea

uric acid

ammonia

kidneys ureters urinary bladder urethra

ORGANS OF THE EXCRETOTY SYSTEM

KIDNEY ANATOMY

renal pyramids

renal pelvis ureter

renal cortex renal capsule renal medulla

nephron

renal artery renal vein

KIDNEY ANATOMY

blood
NEPHRON FUNCTIONING

filtration tubular reabsorption and secretion

urine refreshed blood

efferent arteriole

afferent arteriole

GLOMERULAR FILTRATION

Bowmans capsule
Filters blood; proteins cant pass through

glomerulus

COMPOSITION OF GLOMERULAR FILTRATE

Water Small Soluble Organic Molecules Mineral Ions

PROXIMAL CONVOLUTED TUBULE

Reabsorbs: water, glucose, amino acids, and sodium.

65% of Na+ is reabsorbed 65% of H2O is reabsorbed 90% of filtered bicarbonate (HCO3-) 50% of Cl- and K+

LOOP OF HENLE

Creates a gradient of increasing sodium ion concentration towards the end of the loop within the interstitial fluid of the renal pyramid.
25% Na+ is reabsorbed in the loop 15% water is reabsorbed in the loop 40% K is reabsorbed in the loop

DISTAL CONVOLUTED TUBULE

Under the influence of the hormone aldosterone, reabsorbs sodium and secretes potassium. Also regulates pH by secreting hydrogen ion when pH of the plasma is low.
only 10% of the filtered NaCl and 20% of water remains

COLLECTING DUCT
Allows for the osmotic reabsorption of water.
ADH (antidiuretic hormone)- makes collecting ducts more permeable to water-- produce concentrated urine

Urine
Water- 95% Nitrogenous waste: urea uric acid creatinine Ions: sodium potassium sulfate phosphate
From the original 1800 g NaCl, only 10 g appears in the urine

URINARY BLADDER

ureters external sphincters

internal sphincters urethra

Bladder

1. Mucosa (transitional epithelium) 2. Muscular layer (detrusor muscle): 3 layers of smooth muscle 3. Fibrous adventia

Sphincter Muscles on Bladder

Internal urethral sphincter: Smooth muscle Involuntary control More superiorly located External Urethral sphincter: Skeletal muscle Voluntary control Posteriorly located

Diuresis (Micturition)
When bladder fills with 200 ml of urine, stretch receptors transmit impulses to the CNS and produce a reflex contraction of the bladder (PNS) When is incontinence normal?

DISTENSION OF THE URINARY BLADDER

URINALYSIS
Why do doctors ask for a urine sample?
characteristics: smell- ammonia-like pH- 4.5-8, ave 6.0 specific gravity more than 1.0; ~1.0011.003 color- affected by what we eat: salty foods, vitamins

ODOR

odor- normal is ammonia-like diabetes mellitus- smells fruity or acetone like due to elevated ketone levels diabetes insupidus- yucky asparagus---

pH- range 4.5-8 ave 6.0 vegetarian diet- urine is alkaline protein rich and wheat dieturine is acidic

Color
Color- pigment is urochrome Yellow color due to metabolic breakdown of hemoglobin (by bile or bile pigments) Beets or rhubarb- might give a urine pink or smoky color Vitamins- vitamin C- bright yellow Infection- cloudy

Specific Gravity Water: s.g. = 1g/liter; Urine: s.g. ~ 1.001 to 1.030

Pyelonephritus- urine has high s.g.; form kidney stones Diabetes insipidus- urine has low s.g.; drinks excessive water; injury or tumor in pituitary

Abnormal Constitutes of Urine

Glucose- when present in urine condition called glycosuria (nonpathological) [glucose not normally found in urine] Indicative of: Excessive carbohydrate intake Stress Diabetes mellitus

Abnormal Constitutes of Urine

Albumin-abnormal in urine; its a very large molecule, too large to pass through glomerular membrane > abnormal increase in permeability of membrane Albuminuria- nonpathological conditionsexcessive exertion, pregnancy, overabundant protein intake-- leads to physiologic albuminuria Pathological condition- kidney trauma due to blows, heavy metals, bacterial toxin

Abnormal Constitutes of Urine

Ketone bodies- normal in urine but in small amts Ketonuria- find during starvation, using fat stores Ketonuria is couples w/a finding of glycosuria-- which is usually diagnosed as diabetes mellitus RBC-hematuria HemoglobinHemoglobinuria- due to fragmentation or hemolysis of RBC; conditions: hemolytic anemia, transfusion reaction, burns or renal disease

Abnormal Constitutes of Urine

Bile pigmentsBilirubinuria (bile pigment in urine)- liver pathology such as hepatitis or cirrhosis WBCPyuria- urinary tract infection; indicates inflammation of urinary tract Casts- hardened cell fragments, cylindrical, flushed out of urinary tract WBC casts- pyelonephritus RBC casts- glomerulonephritus Fatty casts- renal damage

DESEASES AND TREATMENTS

1.

URETHRITIS

-Urethritis is an inflammation of the urethra caused by a bacterial or viral infection.

The infection can be caused by : Gonorrhea Chlamydia Herpes simplex.

SIGNS AND SYMPTOMS

Symptoms in men include: blood in the urine or semen, burning during urination, discharge, frequent urination, pain and swelling of the penis and pain during ejaculation. Symptoms in women include: Abdominal pain, pain during urination, fever, chills, frequent urination, pain in the pelvis and vaginal discharge.

TREATMENTS
Antibiotics or anti-viral medication. Pain medications may also be prescribed to reduce symptoms associated with urethritis. During treatment, sexual intercourse should be avoided.

KIDNEY STONE
2.

Kidney stones are hard masses that form in the urinary tract from crystals that have separated from the urine.

SIGNS AND SYMPTOMS

The exact cause of kidney stones is unknown, but those with certain genetic disorders, kidney disorders and recurrent urinary tract infections are more likely to develop kidney stones.

Symptoms of kidney stones include extreme pain, cramping in the back and lower abdomen, nausea and vomiting.

TREATMENTS
Renal dialysis- to filter the waste out of the blood. This is a temporary fix for the condition Kidney transplant is the only cure for this condition.

3.

DIARRHEA

Diarrhea is the opposite of constipation; the body experiences stomach cramps and frequent loose, watery bowel movements.

SIGNS AND SYMPTOMS

If you has a bad case of diarrhea, be sure to watch for signs of dehydration. Keep the fluids replenished even though it seems like it is not staying in your system. If you suspe ctdehydration, it is time to talk to your doctor.

TREATMENTS
Other natural ingredients for diarrhea home cures include: * Peppermint * Boiled sweet potatoes * Coriander leaves * Lemons * Pomegranates * Honey, garlic, and carrot soup

4.

CONSTIPATION

Constipation is the loss of regular and easy bowel movements. Stool passed through constipation is often hard.

SIGNS AND SYMPTOMS

Common Causes Sometimes the large intestine absorbs too much water, leaving hard, dry feces that cannot be passed without straining. Listed below are some common causes of constipation. Not drinking enough fluids. Your colon will absorb more water to prevent dehydration, resulting in drier, harder stools. Not having a bowel movement when you have the urge. This keeps stool in the colon longer, where more water is absorbed and stools get harder. Anything slowing movement of food through your colon.

TREATMENTS
Citrucel FiberCon Senokot, Senokot S, and Senokot Childrens Fleet Glycerin Suppositories and Fleet Babylax See a doctor if you have hemorrhoids that dont respond to self-treatment or cause you significant pain.

5.

CYSTITIS

Cystitis is an inflammatory condition that affects the bladder. It is caused by a bacterial infection which typically enters the body through the urethra.

SIGNS AND SYMPTOMS

Symptoms: include the need for frequent urination, pelvic pain, suprapublic pain (pain that occurs above the pelvic area) and blood in the urine (hematuria).

TREATMENTS
Unrelated or predisposing causes of cystitis always need to be addressed. Antibiotics, often for 3-6 weeks may be needed, anti-inflammatory medications to reduce swelling and bleeding are often used;

special diets and giving canned foods or broth to help flush the bladder are also usually employed. All cases of recurrent cystitis should have a more complete diagnostic work-up performed if treatment is to be successful.