College of Nursing

ANATOMY AND PHYSIOLOGY

LABORATORY

ACTIVITY # 17
THE URINARY SYSTEM

I. OBJECTIVES:

1. To identify the major organs of the urinary system.

2. To describe the gross anatomical features of the kidney and their functions.

II. MATERIALS

Chart or model of the kidney, reference books

III. DRAW AND LABEL

o The kidney in diagrammatic view showing the large arteries supplying the kidney tissue.
o The renal blood vessels
o The renal corpuscle
o The detailed anatomy of the nephron and its associated blood supply
o The internal structures of the kidney

IV. QUESTIONS FOR RESEARCH

1. Describe the location and anatomy do the kidney and give its role.

The kidneys lie against the posterior abdominal wall and underneath the 12th rib. They are also
retroperitoneal, meaning that they are posterior to the parietal peritoneum. The ribs offer some protection
to the kidneys, as does a heavy cushion of fat encasing each organ. Each kidney measures about 4 inches
(10 cm) long, 2 inches (5 cm) wide, and 1 inch (2.5 cm) thick; they extend from the level of the T12
vertebra to the L3 vertebra. The right kidney sits lower than the left because of the space occupied by the
liver just above it

2. How does the kidney function?

Kidneys regulate blood volume and composition; help regulate blood pressure, pH, and glucose levels;
produce two hormones (calcitriol and erythropoietin); and excrete wastes in urine.

3. List the structures that make up the urinary system and describe the overall function is performs.

The kidneys, ureters, bladder, and urethra are the primary structures of the urinary system. They
filter blood and remove waste from the body in the form of urine. The size and position of lower
urinary structures vary with male and female anatomy.

4. List the components of filtration barrier and describe the composition of the filtrate. What are the
substances that do not pass through it?

Filterable blood components include water, nitrogenous waste, and nutrients that will be transferred into
the glomerulus to form the glomerular filtrate. Non-filterable blood components include blood cells,
albumins, and platelets, that will leave the glomerulus through the efferent arteriole.

5. Identify some factors that influence filtration pressure and explain how they affect the rate of
filtrate formation.
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The factors that influence net filtration pressure are net hydrostatic pressure and blood colloid
osmotic pressure. The factors that influence the rate of filtrate formation are the filtrate
pressure across glomerular capillaries, plus interactions among autoregulation, hormonal regulation
and autonomic regulation.

6. Describe and differentiate the effect as to fluid and electrolyte balance if a person experiences
continuous vomiting and diarrhea.

Diarrhea can cause dehydration (when your body loses large amounts of water), electrolyte imbalance
(loss of sodium, potassium and magnesium that play a key role in vital bodily functions) and kidney
failure (not enough blood/fluid is supplied to the kidneys). The vomiting of gastric or intestinal contents
most commonly involves the loss of fluid that contains chloride, potassium, sodium, and bicarbonate. The
sequelae of these losses include dehydration along with hyponatremia, hypochloremia, and hypokalemia

7. What substances are absorbed in the nephron?

Most of the Ca++, Na+, glucose, and amino acids must be reabsorbed by the nephron to maintain
homeostatic plasma concentrations. Other substances, such as urea, K+, ammonia (NH3), creatinine,
and some drugs are secreted into the filtrate as waste products.

8. Where are ADH produced and what effect does it have on urine volume?

Antidiuretic hormone (ADH) is a chemical produced in the brain that causes the kidneys to release less
water, decreasing the amount of urine produced. A high ADH level causes the body to produce less urine.
A low-level result in greater urine production.

9. Describe how sodium and potassium levels are regulated in the body fluids.

Potassium and sodium are electrolytes that help your body function normally by maintaining fluid and
blood volume. However, consuming too little potassium and too much sodium can raise your blood
pressure. Increasing potassium intake can help decrease your blood pressure if you have high blood
pressure. By lowering blood pressure, increasing potassium intake can also reduce your risk for heart
disease and stroke. In contrast, consuming too much sodium can raise your blood pressure. Limiting
sodium intake is especially important if you have high blood pressure, also known as hypertension. High
blood pressure increases your risk of heart disease and stroke.

10. Define the following terms and relate it to disease entities.

a. Albuminuria

Albuminuria is a sign of kidney disease and means that you have too much albumin in your urine.
Albumin
is a protein found in the blood. A healthy kidney doesn't let albumin pass from the blood into the urine.
A damaged kidney lets some albumin pass into the urine.

b. Hydronephrosis

Hydronephrosis is swelling of one or both kidneys. Kidney swelling happens when urine can't drain from
a kidney and builds up in the kidney as a result. This can occur from a blockage in the tubes that drain
urine from the kidneys (ureters) or from an anatomical defect that doesn't allow urine to drain properly.

c. Anuria

Anuria literally means no urine, or without urine. In practical terms, it means that your kidneys aren't
producing urine (pee) or that you aren't peeing (anuresis). Anuria's the most severe form of oliguria,
which means that your kidneys aren't producing enough urine.
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 d. Polyuria

Polyuria has generally been defined as a urine output exceeding 3 L/day in adults and 2 L/m2 in
children. It must be differentiated from the more common complaints of frequency or nocturia, which
may not be associated with an increase in the total urine output.

e. Oliguria

Oliguria is defined as urinary output less than 400 ml per day or less than 20 ml per hour and is one
of the earliest signs of impaired renal function.

f. Cystitis

Cystitis is inflammation of the bladder, usually caused by a bladder infection. It's a common type of
urinary tract infection (UTI), particularly in women, and is usually more of a nuisance than a cause
for serious concern.

g. Pyelitis nephritis

Pyelonephritis occurs as a complication of an ascending urinary tract infection (UTI) which spreads
from the bladder to the kidneys and their collecting systems. Symptoms usually include fever, flank
pain, nausea, vomiting, burning on urination, increased frequency, and urgency.

h. Pyuria

Pyuria is a condition in which you have pus in your pee. UTIs are the most common cause, but other
causes include STIs, viral infections and chronic use of some medications. The most common symptom
is cloudy, foul-smelling pee.

i. Glycosuria

Glycosuria is the excretion of glucose into the urine. Ordinarily, urine contains no glucose because
the kidneys are able to reabsorb all of the filtered glucose from the tubular fluid back into
the bloodstream. Glycosuria is nearly always caused by elevated blood glucose levels, most commonly
due to untreated diabetes mellitus. Rarely, glycosuria is due to an intrinsic problem with glucose
reabsorption within the kidneys (such as Fanconi syndrome), producing a condition termed renal
glycosuria. Glycosuria leads to excessive water loss into the urine with resultant dehydration, a
process called osmotic diuresis.

j. Nephrosis

Nephrosis is a kidney disorder that causes your body to pass too much protein in your urine. Nephrosis
is usually caused by damage to the clusters of small blood vessels in your kidneys that filter waste
and excess water from your blood.

k. Hematuria

Hematuria is the presence of blood in a person's urine. The hematuria may be painless or cause pain
in the area of the kidney and/or a burning feeling during urination.

l. Proteinuria

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Proteinuria is high levels of protein in your urine. Causes may include relatively harmless conditions,
including dehydration or intense exercise, or more serious, including kidney disease or immune disorders.

m. Azotemia

Azotemia is a condition that occurs when your kidneys have been damaged by disease or an injury.
You get it when your kidneys are no longer able to get rid of enough nitrogen waste.

11. Discuss the pathophysiology of renal stone and UTI.

Urinary calculi may remain within the renal parenchyma or renal collecting system or be passed into the
ureter and bladder. During passage, calculi may irritate the ureter and may become lodged, obstructing
urine flow and causing hydroureter and sometimes hydronephrosis. How rapidly obstruction develops
determines the severity of renal colic. Common areas of lodgment include the Ureteropelvic junction,
Distal ureter (at the level of the iliac vessels) and Ureterovesical junction. Larger calculi are more likely
to become lodged. Typically, a calculus must have a diameter > 5 mm to become lodged. Calculi ≤ 5 mm
are more likely to pass spontaneously. Even partial obstruction causes decreased glomerular filtration,
which may persist briefly after the calculus has passed. With hydronephrosis and elevated glomerular
pressure, renal blood flow declines, further worsening renal function. Generally, however, in the absence
of infection, permanent renal dysfunction occurs only after about 28 days of complete obstruction.
Secondary infection can occur with long-standing obstruction, but most patients with calcium-containing
calculi do not have infected urine.

Total score: ______________

Lomioan, Heinrich L. BSN 1-J Viduya, Beth

Student’s Name Yr & Sec Date Clinical Instructor

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