URINARY SYSTEM

1
URINARY SYSTEM
Medical ppt
http//hastaneciyiz.blogspot.com
2
FUNCTIONS OF THE SYSTEM URINARY

• 1. FILTERING OF BLOOD
• 2. REGULATION OF BLOOD VOLUME
• 3. REGULATION OF BLOOD SOLUTES
• 4. RBC SYNTHESIS
• 5. VITAMIN D SYNTHESIS
• 6. GLUCONEOGENESIS

3
KIDNEY ANATOMY
4
ORGANS OF THEURINARY SYSTEM

• 1. KIDNEYS
• 2. URETERS
• 3. URINARY BLADDER
• 4. URETHRA

5
ORGANS OF THEURINARY SYSTEM

• 5. INTERNAL URETHRAL SPHINCTER.
• 6. EXTERNAL URETHRAL SPHINCTER.

6
LOCATION AND EXTERNALANATOMYOF KIDNEYS

• The kidneys lie
• behind peritoneum
• on the posterior
• abdominal wall on
• either side of
• vertebral column.
• The right kidney is
• slightly lower than
• the left.

7
EXTERNAL ANATOMY OF THE KIDNEY

• The covering of kidney consists
• of three layers. The inner
• layer, the renal capsule, the
• middle layer, the adipose
• capsule, and the outer, renal
• fascia.

8
INTERNAL ANATOMY OF THE KIDNEY

• A FRONTAL SECTIONS OF A
• KIDNEY REVEALS 3 REGIONS
• 1. RENAL CORTEX
• 2. RENAL MEDULLA
• 3. RENAL PELVIS

9
INTERNAL ANATOMY OF THE KIDNEY
10
RENAL CORTEX

• The outer layer
• of the kidney
• that contain most
• of the nephrons.
• It is the main site
• for filtration,
• reabsorption and
• secretion.

11
RENAL MEDULLA

• Within the renal
• medulla are
• located the renal
• pyramids, renal
• papilla, and renal
• columns.

12
RENAL MEDULLA

• The function of the renal columns is to provide
  the space to pass blood vessels to and from the
  nephrons.

13
RENAL MEDULLA

• Triangular shaped units in the medulla that
  house the Loops of Henle and collecting ducts of
  the nephron.
• Site for the counter-current system that
  concentrates salt and conserves water and urea

14
RENAL MEDULLA

• The tip of the renal pyramid.
• Releases urine into a calyx.

15
INTERNAL ANATOMY OF THE KIDNEY

• The nephrons of the
• kidneys produces urine. It
• flows from the renal papilla,
• to the minor calyce, to the
• major calyce, to the renal
• pelvis, and finally exits the
• kidney within the ureter.

16
RENAL PELVIS

• The function of the renal pelvis collects urine
  from all of the calyces.
• The urine then is conducted from the kidney to
  the urinary bladder using the ureter.

17
INTERNAL ANATOMY OF THE KIDNEY

• Two major blood vessels are
• associated with the kidney.
• The renal artery, a branch of
• the abdominal aorta, and the
• renal vein, which empties into
• the inferior vena cava.

18
THE NEPHRON
19
TYPES OF NEPHRONS

• Cortical nephron
• Originates in outer 2/3 of cortex.
• Involved in solute reabsorption.
• Juxtamedullary nephron
• Originates in inner 1/3 cortex.
• Important in the ability to produce a
  concentrated urine.
• Has longer Loop of Henle.

Insert fig. 17.6
20
THE NEPHRON
21
THE NEPHRON

• STRUCTURES OF THE NEPHRON
• 1. BOWMANS CAPSULE
• 2. PROXIMAL CONVOLUTED TUBULE
• 3. LOOP OF HENLE
• A. DESCENDING LIMB
• B. ASCENDING LIMB
• 4. DISTAL CONVOLUTED TUBULE
• THESE EMPTY INTO THE COLLECTING
• DUCT OR TUBULES.

22
(No Transcript)
23
(No Transcript)
24
(No Transcript)
25
PROXIMAL CONVOLUTED TUBULE
26
PROXIMAL CONVOLUTED TUBULES

• Simple cuboidal
• epithelial cells with
• prominent brush
• borders of
• microvilli.

27
DECENDING LIMB OF THE LOOP OF HENLE
28
DECENDING LIMB OF THE LOOP OF HENLE

• Simple squamous epithelial cells

29
ASCENDING LIMB OF THE LOOP OF HENLE
30
ASCENDING LIMB OF THE LOOP OF HENLE

• Simple cuboidal
• epthelial to low
• columnar cells.

31
DISTAL CONVOLUTED TUBULE
32
DISTAL CONVOLUTED TUBULES

• Simple cuboidal epthelial cells.

33
THE NEPHRON

• Simple cuboidal epithelial cells with prominent
  brush borders of microvilli.
• Simple squamous epithelial cells
• Simple cuboidal to low columnar epithelial cells.
• Simple cuboidal epthelial cells.

• Proximal convoluted tubule
• Descending limb of Loop of Henle
• Ascending Limb of Loop of Henle
• Distal convoluted tubules

34
THE NEPHRON

• BLOOD VESSELS OF THE NEPHRON
• 1. AFFERENT ARTERIOLE
• 2. GLOMERULUS
• 3. EFFERENT ARTERIOLE
• 4. PERITUBULAR CAPILLARIES
• 5. VASA RECTA

35
(No Transcript)
36
JUXTAGLOMERULAR APPARATUS

• THE JGA IS LOCATED WHERE
• THE INITIAL PORTION OF THE
• DISTAL CONVOLUTED TUBULE
• LIES AGAINST THE AFFERENT,
• AND SOMETIMES THE EFFERENT,
• ARTERIOLE.

37
JUXTAGLOMERULAR APPARATUS
38
JUXTAGLOMERULAR APPARATUS

• SOME THE SMOOTH MUSCLE CELLS
• OF THE AFFERENT ARTERIOLES
• ENLARGE AND HAVE
• PROMINENT SECRETORY GRANULES
• CONTAINING RENIN. THESE
• CELLS ARE TERMED JG CELLS, AND
• THEY ACT AS BARORECEPTORS.

39
JUXTAGLOMERULAR APPARATUS

• THE CELLS OF THE DISTAL
• CONVOLUTED TUBULE WHICH
• CONTACT THE ARTERIOLES ARE
• TERMED THE MACULA DENSA.
• THESE CELLS DETECT CHANGES IN
• THE RATE AT WHICH URINE FLOW
• PAST THEM AND THE CONCENTRATION
• OF SOLUTES IN THE URINE.

40
JUXTAGLOMERULAR APPARATUS

• THE MACULA DENSA CELLS
• TRIGGER THE RELEASE OF
• LOCALLY ACTING CHEMICALS
• WHICH EITHER VASOCONSTRICT
• OR VASODILATE THE AFFERENT
• ARTERIOLE. THIS RESULTS IN A
• CHANGE THE GFR.

41
KIDNEY PHYSIOLOGY
42
KIDNEY PHYSIOLOGY

• URINE FORMATION AND THE
• SIMULTANEOUS ADJUSTMENT OF
• BLOOD COMPOSITION INVOLVES
• THREE MAJOR PROCESSES
• 1. GLOMERULAR FILTRATION
• 2. TUBULAR REABSORPTION
• 3. SECRETION

43
KIDNEY PHYSIOLOGY
44
KIDNEY PHYSIOLOGY

• FILTRATION is the movement of substances from the
  
• glomerulus into the lumen
• of bowmans capsule. This
• forms filtrate.

45
KIDNEY PHYSIOLOGY

• REABSORPTION is the
• movement of substances,
• solutes and water,
• across the walls of
• nephron into the capillaries
• associated with the nephron.

46
KIDNEY PHYSIOLOGY

• SECRETION is the movement
• of substances from the
• capillaries, associated
• with the nephron, across the walls of nephron
  into the filtrate with the nephron.

47
OSMOTIC EFFECTS

• Water serves as the
• universal solvent in which
• a variety of solutes are
• dissolved. Solutes can be
• classified as electrolytes
• and nonelectrolytes.

48
ELECTROLYTES

• Electrolytes have ionic bonds
• which allow the compounds
• to dissociate into ions in
• water. Because ions are
• charged particles, they can
• conduct an electrical current.

49
ELECTROLYTES

• Examples of electrolytes
• include inorganic salts,
• inorganic and organic
• acids and bases, and some proteins.

50
NONELECTROLYTES

• Nonelectrolytes have bonds,
• usually covalent bonds, that
• prevent them from
• dissociating in solution.
• Therefore, they have
• no electrical charge.

51
NONELECTROLYTES

• Examples of nonelectrolytes
• include glucose, lipids,
• creatinine, and urea.

52
OSMOTIC EFFECTS

• All dissolved solutes
• contribute to the osmotic
• activity of a fluid. However,
• electrolytes have greater
• power because each electrolyte
• molecule dissociates into at
• least 2 ions.

53
OSMOTIC EFFECTS

• Water moves according to
• osmotic gradientsfrom
• areas of lesser osmolality to
• areas of greater osmolality.

54
OSMOLALITY

• A solutions osmolality
• is number of solute particles
• dissolved in one liter of
• water. Osmotic activity is
• determined only by the
• number of solute particles.

55
OSMOLALITY

• Ten sodium ions have the
• same osmotic activity as ten
• glucose molecules or
• ten amino acids in the same
• volume of solution.

56
OSMOLALITY

• Water moves according to
• osmotic gradients
• from areas of lesser to
• higher osmolality.

57
GLOMERULAR FILTRATION

• Urine formation begins with
• glomerular filtration.
• It is a passive process
• in which fluids and solutes
• are forced through the
• glomerular membrane.

58
GLOMERULAR FILTRATION

• Substances which pass from
• the glomerulus into the
• nephron include water,
• electrolytes, glucose, amino
• acids, vitamins, small
• proteins, creatinine,
• urate ions, and urea.

59
GLOMERULAR FILTRATION
60
GLOMERULAR FILTRATION

• The net filtration pressure
• (NFP) is responsible for
• filtrate formation.
• NFPHPg- (OPg HPc)

61
GLOMERULAR FILTRATION

• Glomerular filtration
• rate, GFR, is the total amount
• of filtrate formed per
• minute by the kidneys.
• A normal GFR in both
• kidneys is 120-125 ml/min or
• about 180 l/day

62
GLOMERULAR FILTRATION RATE

• FACTORS GOVERNING
• FILTRATION RATE
• Total surface area available for filtration.
• Filtration membrane permeability
• Net Filtration Pressure

63
GLOMERULAR FILTRATION

• GFR IS HELD RELATIVELY
• CONSTANT BY TWO IMPORTANT
• MECHANISMS THAT
• REGULATE RENAL BLOOD FLOW
• 1. INSTRINICALLY BY RENAL
• AUTOREGULATION
• 2. EXTRINICALLY BY NEURAL AND HORMONAL CONTROLS

64
RENAL AUTOREGULATION OF GFR

• To maintain a stable GFR, the
• kidney regulates the diameter
• of the afferent arteriole.
• therefore, when B.P. decreases
• the vessel dilates, and when
• B.P. increases the vessel
• constricts. This results in a
• stable G.F.R.

65
RENAL AUTOREGULATION OF GFR

• THE KIDNEY USES TWO
• MECHANISMS TO PREFORM
• AUTOREGULATION
• 1. MYOGENIC MECHANISM
• 2. TUBULOGLOMERULAR FEEDBACK

66
MYOGENIC MECHANISM

• The myogenic mechanism is based on
• the tendency of vascular
• smooth muscle to contract
• when stretched. If B.P. is elevated, the
• smooth muscle in the afferent arterioles
• are stretched. In response, the smooth
• muscle contracts, which narrows the
• arterioles lumen, and renal blood flow
• decreases, which reduces GFR to is previous
• level. This mechanism normalizes renal blood
  flow
• and GFR within seconds after blood pressure
  changes.

67
TUBULOGLOMERULAR FEEDBACK

• The macula densa cells of the
• juxtaglomerular apparatus
• respond to changes in the
• osmolarity and changes in
• flow rate of the filtrate at
• the junction of the D.C.T. and
• the ascending limb of the loop of
• Henle.

68
TUBULOGLOMERULAR FEEDBACK

• This results in the secretion
• of chemicals which produce
• local vasoconstriction of
• the afferent and efferent
• arterioles. Examples include nitric oxide,
• adenosine, endothelin, and prostaglandins.
• This mechanism operates more slowly than
• the myogenic mechanism.

69
EXTRINIC CONTROL OF GFR

• THE GFR CAN ALSO BE CONTROLLED EXTRINICALLY BY
• 1. SYMPATHETIC NERVOUS SYSTEM
• 2. RENIN, ANGIOTENSION,
• ALDOSTERONE MECHANISM

70
TUBULAR REABSORPTION

• The proximal convoluted
• tubules are the most active
• in tubular reabsorption.
• All glucose, lactate, and
• amino acids are reabsorbed in this area.

71
TUBULAR REABSORPTION

• About 65 of sodium, 70 of
• water, are also reabsorbed
• 90 of bicarbonate ions, 50 of
• chloride ions, and 55 of
• potassium are reabsorbed in
• the proximal convoluted
• tubules.

72
TUBULAR REABSORPTION

• This large amount of
• tubular reabsorption
• associated with the pct,
• results in the GFR
• being reduced from 120 ml/min
• to about 40 ml/min.

73
REABSORPTION IN PROXIMAL NEPHRON
74
TUBULAR REABSORPTION

• Tubular reabsorption
• from the loop of Henle
• results in 10 of water
• being reabsorbed from the
• descending limb, 30 of
• potassium ions, 20 of sodium,
• and 35 of chloride from the
• ascending limb.

75
REABSORPTION IN LOOP OF HENLE
76
REABSORPTION IN LOOP OF HENLE
77
TUBULAR REABSORPTION

• Fluids enters the distal
• convoluted tubules at a
• rate of about 25 ml/min.
• because about 80 of the
• water in the filtrate has been
• reabsorbed.

78
TUBULAR REABSORPTION

• As fluid flows through
• the DCT, sodium and chloride
• are reabsorbed. By the time
• fluids reaches the end of the
• DCT, about 90 of the filtered
• solutes and water has been
• returned to the blood.

79
THE COUNTER CURRENTMECHANISM

• One of the functions of the
• kidneys is to regulate urine
• concentration and volume.
• The kidneys accomplish this by
• the countercurrent
• mechanism.

80
THE COUNTER CURRENTMECHANISM

• In the kidneys the
• countercurrent mechanism
• involves the interaction
• between the flow of filtrate
• through the loops of Henle,
• and the flow of blood
• through the adjacent vasa recta
• blood vessels.

81
THE COUNTER CURRENTMECHANISM

• The flow in these two
• structures is opposite in
• direction.

82
THE COUNTER CURRENTMECHANISM
83
THE COUNTER CURRENTMECHANISM

• The NaCl concentration
• of the medulla acts as an
• osmotic force which draws
• water from the descending
• limb of the loop of Henle.

84
THE COUNTER CURRENTMECHANISM

• This is possible because
• the descending limb is lined with
• simple squamous epithelial cells,
• that are permeable
• to water, but, impermeable
• to NaCl and other solutes.

85
THE COUNTER CURRENTMECHANISM

• The movement of water causes
• the osmolarity of the filtrate
• to increase from 300 to 1,200
• mOSM/L.

86
THE COUNTER CURRENTMECHANISM
87
THE COUNTER CURRENTMECHANISM

• The ascending limb of the
• loop of Henle reabsorbs
• chloride by active transport.
• In addition, as chloride moves
• from the filtrate it pulls
• sodium along into the
• medulla.

88
THE COUNTER CURRENTMECHANISM

• This is possible because
• the ascending limb is
• impermeable to water.

89
THE COUNTER CURRENTMECHANISM

• The movement of NaCl
• into the medulla decreases
• the osmolarity of the
• filtrate from 1,200 to 100
• mOsm/L.

90
THE COUNTER CURRENTMECHANISM
91
THE COUNTER CURRENTMECHANISM

• The hyperosmotic medulla
• also pulls water from the
• collecting ducts. This varies
• depending on the amount of
• ADH. As water moves from
• the collecting duct, urea
• follows.

92
THE COUNTER CURRENTMECHANISM

• Thus, water is conserved, as well as,
• a certain amountof urea. The
• urea contributes to the
• high osmolarity of the
• medulla.

93
THE COUNTER CURRENTMECHANISM

• The vasta recta is composed
• of capillaries which
• surround the loop of henle.
• The vessels flow
• counter (opposite) to the
• loop of Henle and act as a
• counter current exchanger.

94
THE COUNTER CURRENTMECHANISM

• As blood flows through the
• vasa recta it picks up water
• and leaves behind NaCl.

95
THE COUNTER CURRENTMECHANISM

• Therefore, the vasa recta
• returns water back to the
• body and the NaCl
• maintains the hyperosmotic
• medulla.

96
THE COUNTER CURRENTMECHANISM
97
TUBULAR SECRETION

• Tubular secretion is the
• movement of chemicals
• from the blood into the
• nephron. This process can
• occur in the proximal or
• distal convoluted tubules.

98
TUBULAR SECRETION

• THIS PROCESS IS IMPORTANT FOR
• 1. Disposing of substances which were not
  filtered.
• 2. Removal of excess K .
• 3. Controlling blood ph.
• 4. Eliminating substances which have been
  reabsorbed.

99
TUBULAR SECRETION

• Most secretion occurs within
• the PCT. Substances such as
• neurotransmitters, bile
• pigment, uric acid, penicillin,
• atropine, morphine, H ,
• and ammonia are secreted.

100
TUBULAR SECRETION

• The DCT receives mainly
• K and H ions from
• the blood.

101
SECRETION OF HYDROGEN AND POTASSIUM
102
KIDNEY PHYSIOLOGY

• AMOUNT AMOUNT AMOUNT
• FILTERED REABSORBED EXCRETED

103
KIDNEY PHYSIOLOGY

• If the kidneys filters 16 grams
• of NaCl per day, and
• reabsorb 14 grams of NaCl
• per day, then 2 grams of NaCl
• would be excreted by the
• kidneys per day.

104
KIDNEY PHYSIOLOGY

• Renal clearance refers
• to the volume of plasma
• that is cleared of a
• particular substance in a
• given time, usually 1 minute.

105
KIDNEY PHYSIOLOGY

• RENAL CLEARANCE CAN
• BE CALCULATED USING
• RC UV/P
• UCONCENTRATION OF SUBSTANCE IN URINE (mg/ml)
• V FLOW RATE OF URINE FORMATION (ml/min)
• PCONCENTRATION OF SUBSTANCE IN PLASMA (mg/ml)

106
RENAL CLEARANCE

• QUESTIONS
• 1. If the renal clearance rate is to GFR?
• 2. If the renal clearance rate is greater than
  GFR?
• 3. If the renal clearance rate is less than GFR?

107
RENAL CLEARANCE

• 1. All of the substance is filteredinulin.
• 2. All of the substance is filtered and addition
  is secretedPAH.
• 3. Some of the substance is reabsorbedurea.

108
RENAL CLEARANCE
109
HORMONAL CONTROL OF THE KIDNEYS
110
ANTIDIURETIC HORMONE
111
HORMONAL CONTROL OF URINE CONCENTRATION

• One of the most
• important hormones in
• the control of urine
• concentration and
• volume is antidiuretic
• hormone, ADH.

112
ANTIDURETIC HORMONE

• Antiduretic hormone
• prevents wide variation in
• water balance, helping to
• avoid dehydration or edema.

113

• ADH is synthesized by neurosecretory cells whose
  cells bodies are located in the supraoptic nuclei
  of the hypothalamus.

114

• The ADH is packaged within vacuoles. The
  vacuoles move by axonal transport to the axonal
  terminals of the neurosecretory cells which make
  up the hypothalamic hypophyseal tract. The
  vacuoles are stored in the posterior lobe of the
  pituitary.

115
ANTIDURETIC HORMONE

• The chemical class of ADH
• is a protein

116
ANTIDURETIC HORMONE

• Solute concentrations in the blood are monitored
  by osmoreceptors
• in the hypothalamus.
• This is an example of humerol control.

117
ANTIDURETIC HORMONE

• When solute concentrations
• increase, thereby, increasing
• osmotic pressure,
• the receptors are stimulated.

118
ANTIDURETIC HORMONE

• The osmoreceptors,
• in turn, stimulate
• hypothalamic neurons in the
• supraoptic nucleus, which
• synthesize ADH.

119
ENDOCRINE SYSTEM
120
ANTIDURETIC HORMONE

• Nerve action potentials
• trigger the release of ADH
• from the axonal terminals
• in the posterior lobe of the
• pituitary.

121
ENDOCRINE SYSTEM
122
(No Transcript)
123
ANTIDURETIC HORMONE

• ADH travels through the systemic circulation to
  the
• distal convoluted
• tubules of the nephron
• and the collecting ducts.

124
ANTIDURETIC HORMONE

• ADH causes water to be
• reabsorbed from the
• D.C.T. and the collecting
• ducts into the capillaries
• which surround the nephron.

125
ANTIDURETIC HORMONE

• THE RESULTS OF ADH
• 1. A decrease in osmolality
• 2. An increase in blood volume
• 3. A decrease in urine output
• 4. An increase in the concentration of the urine.

126
ANTIDURETIC HORMONE

• This chart is a good summary of the events of ADH.

127
ANTIDURETIC HORMONE

• ADH is regulated by
• negative feedback when
• solute concentrations are
• reduced to normal levels the
• amount of ADH is reduced.

128
ANTIDURETIC HORMONE

• PATHOLOGY
• 1. Hypersecretion can produce SIADH.
• 2. Hyposecretion can produce diabetes insipidus.

129
ALDOSTERONE
130
ALDOSTERONE

• Aldosterones function is to
• help maintain Na ion
• balance, and indirectly water
• balance and K,
• within the fluid compartments
• of the body.

131
ALDOSTERONE

• The chemical class of
• aldosterone is steroid

132
ALDOSTERONE

• A decrease in blood pressure

133
ALDOSTERONE

• Aldosterone is synthesized by the cells of the
  zona
• glomerulosa in the
• adrenal cortex.

134
ALDOSTERONE

• Aldosternone targets the
• D.C.T.
• of the nephron.

135
ALDOSTERONE

• EFFECTS OF ALDOSTERONE
• 1. REABSORPTION OF Na IONS.
• 2. WATER IS REABSORB USING THE
• SAME TRANSPORT MECHANISM.
• 3. K IONS ARE SECRETION INTO THE DCT FROM THE
  CAPILLARIES.

136
ALDOSTERONE

• Aldosterone secretion is
• controlled by negative
• Feedback.

137
ALDOSTERONE

• PATHOLOGY
• 1. Hypersecretion can produce
• aldosteronism.
• 2. Hyposecretion can produce addison disease.

138
ESTROGEN
139
ESTROGEN

• Estrogen is a female sex
• hormone produced by
• the ovaries.

140
ESTROGEN

• EFFECTS OF ESTROGEN
• 1. Reabsorption of Na ions.
• 2. Water is reabsorb using the same transport
  mechanism.
• 3. Ca2 deposition into bone.

141
CORTISOL
142
CORTISOL

• Cortisol is a hormone
• produced by the cortex of
• the adrenal gland.
• It helps in the conversion of lipids and proteins
  to form glucose (gluconeogensis).

143
CORTISOL

• EFFECTS OF CORTISOL
• 1. Reabsorption of Na ions.
• 2. Water is reabsorb using the same transport
  mechanism.
• 3. Can cause edema.

144
BONE CALCIUM REGULATION
145
CALCITONIN

• Calcitonin is a hormone
• produced by the thyroid
• gland in response to high
• levels of Ca2 ions in the
• blood.

146
CALCITONIN

• EFFECTS OF CALCITONIN
• 1. Ca2 ion deposition into bone.
• 2. Inhibit osteoclasts.

147
CALCITONIN
Calcium
148
PARATHYROID HORMONE

• Parathyroid hormone
• is produced by the
• parathyroid gland in response
• to low levels of Ca2 ions
• in the blood.

149
PARATHYROID HORMONE

• EFFECTS OF PTH
• 1. Causes the break down of the inorganic matrix
  of bone, releasing Ca2 ions.
• 2. Increase absorption of Ca2 ions.
• 3. Reabsorption of Ca2 ions from the DCT.

150
PARATHYROID HORMONE
Calcium
151
ACID BASE BALANCE

• BLOOD pH REGULATED BY
• 1. KIDNEYS
• 2. LUNGS
• 3. BUFFERS IN BLOOD

152
KIDNEY REGULATION

• The kidney can regulate
• pH by retaining or excreting
• hydrogen or bicarbonate
• ions.

153
ACID-BASE BALANCE
Blood
H
Kidney Nephron
Urine
HCO3-
154
RESPIRATORY REGULATION

• The respiratory system
• regulates pH by
• regulating the amount
• of carbon dioxide in
• the blood.

155
CARBON DIOXIDE and pH
CO2 H2O H2CO3 H HCO3-
156
RESPIRATORY REGULATION

• If the pH is low, the
• respiratory rate will
• be decreased, and if the
• pH is high, the respiratory
• rate will be increased.

157
DISEASES and ABNORMALITIES ASSOCIATED WITH THE
URINARY SYSTEM
158
ACIDOSIS

• 1. pH below 7.35
• 2. Depresses the nervous system.

159
ALKALOSIS

• 1. pH above 7.45.
• 2. Overexcites the nervous system.

160
RESPIRATORY ACIDOSIS

• Any condition that
• impairs breathing can
• cause respiratory acidosis.
• This can result in an increase
• in the amount of carbon
• dioxide in the blood and a
• reduction in the pH.

161
RESPIRATORY ALKALOSIS

• Any condition that leads
• to hyperventilation can
• cause respiratory alkalosis.
• This can result in an decrease
• in the amount of carbon
• dioxide in the blood and a
• increase in the pH.

162
METABOLIC ACIDOSIS

• Metabolic acidosis is
• caused by excess acids in
• the blood. This can be the
• result of renal disease,
• diabetes mellitus, or a
• decrease in the number of
• bicarbonate ions in the blood.

163
METABOLIC ALKALOSIS

• Metabolic alkalosis is
• caused by a reduction in the
• amount of acid in the blood.
• This can be the result of
• vomiting, diuretics, or
• excessive bicarbonate ions
• in the blood.

164
SODIUM

• FUNCTIONS
• 1. Attracts water into the ECF.
• 2. Nerve impulses.
• 3. Muscle contraction.

165
HYPERNATREMIA

• EXCESS SODIUM
• 1. Hypertension
• 2. Muscle twitching
• 3. Mental confusion
• 4. Coma

166
HYPONATREMIA

• DEFICIENCY OF SODIUM
• 1. Hypotension
• 2. Tachycardia
• 3. Muscle weakness

167
POTASSIUM

• FUNCTIONS
• 1. Attracts water into the ICF.
• 2. Nerve impulse
• 3. Muscle contractions

168
HYPERKALEMIA

• EXCESS POTASSIUM
• 1. Can lead to a cardiac arrhythmia
• 2. Elevated t waves
• 3. Muscle weakness

169
HYPOKALEMIA

• DEFICIENCY OF POTASSIUM
• 1. Can lead to cardiac arrhythmia.
• 2. Depressed (flatened) t waves
• 3. Muscle weakness

170
CALCIUM

• FUNCTIONS
• 1. Matrix of bones and teeth
• 2. Nerve impulse
• 3. Muscle contraction

171
HYPERCALCEMIA

• EXCESS CALCIUM
• 1. Excess in calcium in blood
• 2. Kidney stones
• 3. Cardiac arrhythmia

172
HYPOCALCEMIA

• DEFICIENCY OF CALCIUM
• 1. Tetany
• 2. Weak heart muscle contractions.
• 3. Increased clotting time.

173
URINARY DISEASES

• RENAL CALCULI (KIDNEY STONES)
• 1. Caused by the crystallization of Ca2 and
  Mg2 salts in the renal pelvis.
• 2. If the stone travel down the ureter, the
  patient will be in pain.

174
URINARY DISEASES

• CYSTITIS
• 1. Caused by bacteria, usually E. coli,
  Klebsiella, or Proteus.
• 2. Leads to inflammation, fever, increased
  urgency and frequency of urination and pain.

175
URINARY DISEASES

• GLOMERULONEPHRITIS
• 1. Caused by inflammation of the
• glomerulus due to streptococcal
• antibody complexes.
• 2. Inflammation of the glomerulus
• leads to faulty filtration.

176
URINARY DISEASES

• INCONTINENCE
• 1. Caused by loss of the ability to control
  voluntary micturition due to age, emotional
  disorders, pregnancy, or damage to the nervous
  system.
• 2. Leads to wet clothing.

177
URINARY DISEASES

• GOUT
• 1. Caused by a increased blood
• level of uric acid. This leads to
• inflammation of the soft tissue
• associated with joints.
• 2. Decreased and painful movement.

178
ALDOSTERONISM

• EXCESS ALDOSTERONE
• 1. Elevated sodium levels
• 2. Depressed potassium levels
• 3. Hypertension

179
ADDISONS DISEASE

• DEFICIENCY OF ALDOSTERONE
• 1. Hypotension
• 2. Low blood glucose levels.
• 3. Color of skin.

180
CUSHINGS SYNDROME

• EXCESSIVE GLUCOCORTICOIDS
• 1. Hyperglycemia
• 2. Fat accumulation

181
DIABETES MELLITUS

• HYPOSECRETION OR ACTIVITY OF
• INSULIN
• 1. Hyperglycemia
• 2. Polyurea
• 3. Thirst
• 4. Body burns fat-ketones
• 5. Vascular problems

182
INSULIN
Cell
Glucose
Blood
183
DIABETES INSIPIDUS

• HYPOSECRETION OF ADH
• 1. Increased urine volume.
• 2. Polyurea

184
ADH
Collecting Duct
Hypertonic Interstitial Fluid
Urine
185
DIALYSIS THERAPY

• Dialysis is a process that artificially
• removes metabolic wastes from the blood
• in order to compensate for kidney (renal)
• failure. Kidney failure results in the rapid
• accumulation of nitrogen waste (urea,etc.).
• Uremia and ion disturbances can also
• occur. This condition can cause acidosis,
• labored breathing, convulsions, coma and
• death.

186
DIALYSIS THERAPY

• The most common form of dialysisis
• hemodialysis which uses a machine to
• transfer patients blood through a
• semipermeable tube that is permeable
• only to selected substances. The dialysis
• machine contains an appropriate dialysis
• fluid that produces a diffusion gradient.

187
DIALYSIS THERAPY

• This gradient allows abnormal substances
• to diffuse from the patients blood and
• produce a cleaning effect.

Medical ppt
http//hastaneciyiz.blogspot.com