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Urinary system anatomy and physiology
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Urinary system anatomy and physiology

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  • 1. Urinary System Anatomy and Physiology Part I
  • 2. 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
  • 3. Kidney Location and Protection
    • Kidneys are located in the posterior wall of the abdominal cavity
    • In the retroperitoneal space
    • Connective tissue (renal fascia) hold the kidneys in place
    • Adipose tissue cushion the kidneys
    • The lower rib cage partially enclose the kidney and protect them
  • 4. Urinary System – Anterior/Posterior Views
  • 5.  
  • 6. Kidney Structures
    • Kidney is reddish-brown
    • Looks like a bean
    • Approximately 4 inches x 2 inches
    • Hilus – indentation where blood vessels and structures enter or exit the kidney
    • Three Regions in the kidney if sliced in half – renal cortex, renal medulla, renal pelvis
  • 7. Renal Cortex
    • Light, outside region
    • Cortex means “bark”
  • 8. Renal Medulla
    • 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
  • 9. Renal pelvis
    • 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 called calyces
    • Calyces collect the urine formed in the kidney
  • 10.  
  • 11. How do they work?
    • Need a blood supply
    • Brought to the kidney via the renal artery
    • Renal artery stems 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
  • 12.  
  • 13. Functions of the Kidneys
    • Excrete nitrogenous waste from the body
      • Urea
      • Ammonia
      • Creatinine
    • Regulate blood volume
    • Help regulate electrolyte content of the blood
    • Regulate acid-base balance (pH)
    • Regulate blood pressure
    • Regulates red blood cell production
  • 14. The Formation of Urine
    • The Nephron Unit
    • Each kidney contains about 1 million nephron units
    • The number does not increase after birth
    • They cannot be replaced if damaged
    • 2 parts
      • Tubular component (renal tubule)
      • Vascular component
  • 15. Renal Tubules
    • Glomerular capsule (Bowman’s Capsule) – “C” shaped capsule surrounding the glomerulus
    • Glomerulus – cluster of capillaries
      • Proximal convoluted tubule
      • Loop of Henle – ascending and descending limb
      • Distal Convoluted tubule
      • Collecting duct
  • 16. Nephron
  • 17.  
  • 18. Renal Vasculature
    • Receives blood from the renal artery
    • Renal artery branches into the afferent arterioles
    • Afferent arterioles feed into Bowman’s capsule
    • The efferent arterioles exit Bowman’s capsule
    • The efferent arterioles form the peritubular capillaries
    • The peritubular capillaries empty into the venules, large veins, and then into the renal veins
    • It is imperative you know the relationship between the tubular and vascular structures.
  • 19. Urine Formation
    • 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
  • 20. Composition of Urine
    • Sterile
    • 95 % water
    • Nitrogen containing waste – urea, uric acid, ammonia, creatinine
    • Electrolytes
    • Light yellow color of urine is due to a pigment called urochrome
    • Urochrome is formed from the breakdown of hemoglobin in the liver
  • 21. Urine Specific Gravity
    • Ratio of the amount of solute to the total volume
    • Solute = substance dissolved in the urine
    • The greater the solute = greater the specific gravity
    • Concentrated Urine = high specific gravity
      • Ex. dehydration
    • Dilute Urine = low specific gravity
      • Ex. Overhydration, diabetes insipidus
  • 22. Urine Characteristics
    • Amount – 1500 ml in 24 hours
    • pH – average 6.0
    • Specific Gravity – heavier than water (1.001-1.035)
    • Color – yellow (amber, straw colored, concentrated, orange, brown, red, sediment, clear or cloudy)
    • Dehydrated = deep yellow, dark
    • Overhydrated = pale yellow, colorless
  • 23. Abnormal Constituents of Urine
    • Albumin (protein)
    • Glucose
    • Red blood cells
    • Hemoglobin
    • White blood cells
    • Ketone bodies
    • Bilirubin
  • 24. Urine Testing
    • Urinalysis
    • Microscopic exam
    • Culture and sensitivity
    • Urine dipstick
    • Urine Drug and alcohol screening
    • 24 hour urine testing
  • 25. Your Plumbing – The Urinary Tract (Ureters, Urinary bladder, Urethra)
    • Ureters
    • Transport urine, they do not alter it in any way
    • Urine moves in response to gravity and muscular movements called peristalsis through ureters.
  • 26. Your “Plumbing”
  • 27. The 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 abdominal cavity.
    • Bladder has 4 layers
      • Mucous membrane
      • Submucosa
      • Detrusor muscle – involuntary smooth muscle
      • Serosa
    • Contain rugae to allow for stretching
    • Trigone – triangular area in the floor of the bladder
  • 28.  
  • 29. Urination – “Micturition”
    • Expelling urine from the bladder
    • The urge to urinate (void) happened at about 200 ml of urine in the bladder
    • At about 300 ml urine in the bladder, the urge becomes more uncomfortable
    • Moderately full = 500 ml urine
    • Overdistended bladder may have over 1000 ml urine
    • Bacteria in your bladder doubles every 4 hours.
    • Stimulated by stretch receptors
  • 30. Urethra
    • Carries urine from the bladder to the outside of the body
    • Internal sphincter prevents urine from emptying; composed of smooth muscle; involuntary
    • External sphincter at the upper portion of the urethra allows you to resist the urge to urinate; composed of skeletal muscle; voluntary
    • Female – short, opens to the outside at the urethral meatus
    • Male – longer, passes through the prostate gland; carries urine and sperm
  • 31.  
  • 32. Urinary Retention and Suppression
    • Retention - Inability to void
      • Post operative; anesthesia
      • Bladder dysfunction
    • Suppression – no urine formation
      • Kidney dysfunction
  • 33. 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
  • 34. What is the Costovertebral Angle? Costovertebral Angle T12 T11 L1 12 th Rib R. Kidney L. Kidney Region to assess for kidney tenderness
  • 35. Disorders of the Urinary System
    • Glomerulonephritis
    • Polycystic Kidney
    • Pyelonephritis
    • Renal Calculi – kidney stones
    • Renal Failure
    • UTI – urinary tract infection
  • 36. As We Age
    • By age 80 there is a 50% reduction in nephron units; therefore a decreased ability to concentrate urine
    • Urinary bladder shrinks and becomes less able to contract and relax; therefore the elderly must void frequently
    • Bladder infection incidence increases
    • Increase in bladder incontinence due to weakened muscles