Urinary System Anatomy and Physiology Part I
Urinary System Kidneys (2) Most important excretory organ Eliminate waste
Ureters (2) Bladder (1) Urethra (1) Nephron Unit Functional unit of the kidney Formation of urine Tubular and vascular structures
Kidney Location and Protection
Kidneys are located in the posterior wall of the abdominal cavity In the retrope ritoneal space Connective tissue (renal fascia) hold the kidneys in place Adipos e tissue cushion the kidneys The lower rib cage partially enclose the kidney and protect them
Urinary System ² Anterior/Posterior Views
Kidney is reddish-brown Looks like a bean Approximately 4 inches x 2 inches Hilu s ² indentation where blood vessels and structures enter or exit the kidney Three Regions in the kidney if sliced in half ² renal cortex. renal medulla. renal pelvi s
R ight kidney is lower than the left due to location of liver.Average adult kidney weighs 113-170 g.
. 2. 10 ² 12 cm long. 6 cm wide.5 cm thick.
Renal parenchyma is divided into two p arts: ~ Cortex ~ Medulla
.Adrenal gland lies on top of each kidney.
outside region Cortex means ´barkµ Contains: Nephron
.Renal Cortex Light.
Dark. triangular structure Form small cone shaped regions called renal pyramids Each pyramid is separated by renal columns The lower ends of the pyramids point to the renal pelvis
Vasa Recta and collecting ducts of the juztamedullary nephrons. 2 ² 3 major calices.
. Pyramids drain into 4 ² 13 minor calices.
Each kidney contains 8 -18 pyramids.Renal Medulla Contains: Loops of Henle.
A basin that collects the urine made by the kidney and helps form the upper end of the ureter The edges of the renal pelvis closest to the renal pyramids are ca lled calices Calices collect the urine formed in the kidney
Renal pelvis Is the beginning of collecting system and composed structures that are designed to COLLECT and TRANSPORT URINE.
How do they work?
Need a blood supply Brought to the kidney via the renal artery Renal artery stem s from the abdominal aorta 20-25% of cardiac output goes to the kidneys Smaller arteries supply blood to the nephron unit Blood leaves the kidney via the renal veins The renal veins empty into the inferior vena cava
Functions of the Kidneys Excrete nitrogenous waste from the body Urea Ammonia Creatinine
Regulate blood volume Help regulate electrolyte content of the blood Regulate ac id-base balance (pH) Regulate blood pressure Regulates red blood cell production
The Formation of Urine
The Nephron Unit Each kidney contains about 1 million nephron units The number d oes not increase after birth They cannot be replaced if damaged 2 parts Tubular component (renal tubule) Vascular component
Glomerular capsule (Bowman·s Capsule) ² ´Cµ shaped capsule surrounding the glomerulus Gl omerulus ² cluster of capillaries Proximal convoluted tubule Loop of Henle ² ascending and descending limb Distal Convoluted tubule Collecting duct
Receives blood from the renal artery Renal artery branches into the afferent art erioles (Branches to form glomerulus) Afferent arterioles feed into Bowman·s capsu le The efferent arterioles exit Bowman·s capsule The efferent arterioles form the peritubular capillaries The peritubular capillaries empty into the venules. and then into the renal veins It is imperative you know the relationshi p between the tubular and vascular structures.
. larg e veins.
Formed in the nephron unit Water and dissolved substances move through the renal tubules and vessels Three processes are involved in urine formation Glomerular filtration Tubular reabsorption Tubular secretion
K ions. and HCO3 ions (-) Glucose. ammonia.010 ² 1. urea uric acid. CHON.0 With a sp. and WBC and bile pigments
.0 ² 8. RBC.030 (+) NA. Gravity of 1.Normal Urine
Clear and pale to deep yellow or amber Slightly aromatic in odor Slightly acidic 5. creat inin.
uric acid. ammonia.Composition of Urine
Sterile 95 % water Nitrogen containing waste ² urea. creatinin e Electrolytes Light yellow color of urine is due to a pigment called urochrome Urochrome is formed from the breakdown of hemoglobin in the liver
Overhydration. dehydration Ex.Urine Specific Gravity
Ratio of the amount of solute to the total volume Solute = substance dissolved i n the urine The greater the solute = greater the specific gravity Concentrated U rine = high specific gravity Ex. diabetes insipidus
Dilute Urine = low specific gravity
straw colored. brown.0 Specific Gravity ² heavier than water (1 .030) Color ² yellow (amber. dark Overhydrated = pale y ellow. red.0101.Urine Characteristics
Amount ² 1500 ml in 24 hours pH ² average 6. orange. sediment. concentrated. clear or cloudy) Dehydrated = deep yellow. colorless
Abnormal Constituents of Urine Albumin (protein) Glucose Red blood cells Hemoglobin White blood cells Ketone bo dies Bilirubin
Urine Testing Urinalysis Microscopic exam Culture and sensitivity Urine dipstick Urine Drug an d alcohol screening 24 hour urine testing
. Urinary bladder.Your Plumbing ² The Urinary Tract (Ureters. they do not alter it in any way Urine moves in response to gravity and muscular movements called peristalsis through ureters. Urethra) Ureters Transport urine.
Bladder has 4 layers Mucous membrane Submucosa Detrusor muscle ² involuntary smooth muscle Serosa
Contain rugae to allow for stretching Trigone ² triangular area in the floor of th e bladder
Stores urine temporarily until elimination Located behind the symphasis pubis A distended bladder or full bladder can be palpated above the syphasis in the abdo minal cavity.
Urination ² ´Micturitionµ
Expelling urine from the bladder The urge to urinate (void) happened at about 20 0 ml of urine in the bladder At about 300 ml urine in the bladder. Stimulat ed by stretch receptors
. the urge beco mes more uncomfortable Moderately full = 500 ml urine Overdistended bladder may have over 1000 ml urine Bacteria in your bladder doubles every 4 hours.
involuntary External sphin cter at the upper portion of the urethra allows you to resist the urge to urinat e. composed of skeletal muscle. composed of smooth muscle. opens to the outside at the urethral meatus Male ² longer.Urethra
Carries urine from the bladder to the outside of the body Internal sphincter pre vents urine from emptying. passes through the prostate gland. voluntary Female ² short. carries urin e and sperm
anesthesia Bladder dysfunction
Suppression ² no urine formation Kidney dysfunction
.Inability to void Post operative.Urinary Retention and Suppression Retention .
Data Collection & Documentation Characteristics of urine Color Sediment Clear or cloudy Odor
How does the patient/resident void? Urinary diversions? Signs and symptoms Urgency Frequency Burning sensation Hesitancy
Kidney T12 L1 L. Kidney 12th Rib Costovertebral Angle Region to assess for kidney tenderness
.What is the Costovertebral Angle? T11 R.
Disorders of the Urinary System Glomerulonephritis Polycystic Kidney Pyelonephritis Renal Calculi ² kidney stones Renal Failure UTI ² urinary tract infection
As We Age
By age 80 there is a 50% reduction in nephron units. therefore the elderly must void frequently Bladder infection incide nce increases Increase in bladder incontinence due to weakened muscles
. therefore a decreased abili ty to concentrate urine Urinary bladder shrinks and becomes less able to contrac t and relax.
Functions of Genitourinary System Filtration Reabsorption Secretion Excretion Regulation