Professional Documents
Culture Documents
Excretory system
Identifiers
TA98 A08.0.00.000
Anatomical terminology
[edit on Wikidata]
Contents
1Systems
o 1.1Urinary system
1.1.1Kidneys
1.1.2Ureter
1.1.3Urinary bladder
1.1.4Urethra
o 1.2Respiratory system
o 1.3Gastrointestinal tract
o 1.4Biliary system
o 1.5Integumentary system
1.5.1Skin
1.5.2Eccrine
2Substances
o 2.1Bile
o 2.2Urine
o 2.3Faeces
o 2.4Sweat
o 2.5Breath
3Clinical signifiance
o 3.1Kidney Stones
3.1.1Treatment
o 3.2Pyelonephritis
3.2.1Acute Pyelonephritis
3.2.2Chronic Pyelonephritis
3.2.3Xanthogranulomatous Pyelonephritis
3.2.4Treatment
3.2.5Epidemiology
4References
5External links
Systems
Urinary system
Main article: Urinary system
The kidneys are large, bean-shaped organs which are present on each side of
the vertebral column in the abdominal cavity. Humans have two kidneys and each
kidney is supplied with blood from the renal artery. The kidneys remove from the blood
the nitrogenous wastes such as urea, as well as salts and excess water, and excrete
them in the form of urine. This is done with the help of millions of nephrons present in
the kidney. The filtrated blood is carried away from the kidneys by the renal vein (or
kidney vein). The urine from the kidney is collected by the ureter (or excretory tubes),
one from each kidney, and is passed to the urinary bladder. The urinary bladder collects
and stores the urine until urination. The urine collected in the bladder is passed into the
external environment from the body through an opening called the urethra.
Kidneys
Main article: Kidneys
The kidney's primary function is the elimination of waste from the bloodstream by
production of urine. They perform several homeostatic functions such as:-
Substances
Bile
Main article: Bile
After bile is produced in the liver, it is stored in the gall bladder. It is then secreted within
the small intestine where it helps to emulsify fats in the same manner as a soap. Bile
also contains bilirubin, which is a waste product.
Bile salts can be considered waste that is useful for the body given that they have a role
in fat absorption from the stomach. They are excreted from the liver and along with
blood flow they help to form the shape of the liver where they are excreted. For
instance, if biliary drainage is impaired than that part of the liver will end up wasting
away.
Biliary obstruction is typically due to masses blocking the ducts of the system such as
tumors. The consequences of this depend on the site of blockage and how long it goes
on for. There is inflammation of the ducts due to the irritation from the bile acids and this
can cause infections. If rupture of the duct takes place it is very traumatic and even
fatal.[7]
Urine
Main article: Urine
Within the kidney, blood first passes through the afferent artery to the capillary formation
called a glomerulus and is collected in the Bowman's capsule, which filters the blood
from its contents—primarily food and wastes. After the filtration process, the blood then
returns to collect the food nutrients it needs, while the wastes pass into the collecting
duct, to the renal pelvis, and to the ureter, and are then secreted out of the body via the
urinary bladder.
Faeces
Main article: Faeces
Sweat
Main article: Sweat
Breath
Main article: Breath
Clinical signifiance
Kidney Stones
Main article: Kidney stone disease
Scientifically, masses referred to as a renal calculus or nephrolith, or more commonly,
“kidney stones,” are solid masses of crystals that may be a variety of shapes, sizes, and
textures, that can reside within one or both of the kidneys. [8] Kidney stones form when
the balance is off between the concentration of substances that pass through urine, and
the substances that are supposed to dissolve them. When substances are not properly
dissolved, they have the ability to build up, and form these kidney stones. These stones
are most commonly made up of substances such as calcium, cystine, oxalate, and uric
acid, as these are the substances that normally would dissolve within the urine. When
they do not dissolve correctly and further build up, they will commonly lodge themselves
in the urinary tract and in this case, are usually small enough to pass through urine. In
extreme situations, however, these stones may lodge themselves within the tube that
connects the kidney and the bladder, called the ureter. In this case, they become very
large in size and will most likely cause great pain, bleeding, and possibly even block the
flow of urine.[9] These can occur in both men and women, and studies show that around
12% of men, and 8% of women in America will develop kidney stones within their
lifetime.[10]
Treatment
In those extreme situations, in which kidney stones are too large to pass on their own,
patients may seek removal. Most of these treatments involving kidney stone removal
are done by a urologist; a physician who specializes in the organs of the Urinary
system.[11] A common way of removal is shock wave lithotripsy, in which the urologist will
shock the kidney stone into smaller pieces via laser, allowing these pieces to further
pass through the urine on their own, as a normal case of kidney stones. Larger, more
serious cases may demand Cystoscopy, Ureteroscopy, or Percutaneous
Nephrolithotomy, in which the doctor will use a viewing tool or camera to locate the
stone, and based on the size or situation, may either chose to continue with surgical
removal, or use the shock wave lithotripsy treatment. Once the kidney stone(s) are
successfully eliminated, the urologist will commonly suggest medication to prevent
future recurrences.[8]
Pyelonephritis
Main article: Pyelonephritis
Pyelonephritis is a type of urinary tract infection that occurs when bacteria enters the
body through the urinary tract. It causes an inflammation of the renal parenchyma,
calyces, and pelvis.[12] There are three main classifications of pyelonephritis: acute,
chronic and xanthogranulomatous.
Acute Pyelonephritis
In acute pyelonephritis, the patient experiences high fever, abdominal pain and pain
while passing urine. Treatment for acute pyelonephritis is provided via antibiotics and an
extensive urological investigation is conducted to find any abnormalities and prevent
recurrence.[13]
Chronic Pyelonephritis
In chronic pyelonephritis, patients experience persistent abdominal and flank pain, high
fever, decreased appetite, weight loss, urinary tract symptoms and blood in the urine.
Chronic pyelonephritis can also lead to scarring of the renal parenchyma caused by
recurrent kidney infections.[14]
Xanthogranulomatous Pyelonephritis
Xanthogranulomatous pyelonephritis is an unusual form of chronic pyelonephritis. It
results in severe destruction of the kidney and causes granulomatous abscess
formation. Patients infected with Xanthogranulomatous pyelonephritis experience
recurrent fevers, anemia, kidney stones and loss of function in the affected kidney. [14]
Treatment
A urine culture and antibiotics sensitivity test is issued for patients who are believed to
have pyelonephritis. Since most cases of pyelonephritis are caused from bacterial
infections, antibiotics are a common treatment option. Depending on the species of the
infecting organism and the antibiotics sensitivity profile of the organism, treatments may
include fluoroquinolones, cephalosporins, aminoglycosides, or trimethoprim individually
or in combination.[15] For patients with xanthogranulomatous pyelonephritis, treatment
might include antibiotics as well as surgery. Nephrectomy is the most common surgical
treatment for a majority of cases involving xanthogranulomatous pyelonephritis. [14]
Epidemiology
In men, roughly 2-3 cases per 10,000 are treated as outpatients and 1 in 10,000 cases
require admission to the hospital. In women, approximately 12–13 in 10,000 cases are
treated as outpatients and 3-4 cases are admitted to a hospital. [16] The most common
age group affected by Xanthogranulomatous pyelonephritis is middle-aged women.
[17]
Infants and elderly are also at an increased risk because of hormonal and anatomical
changes.[18]
References