The Urinary System PDF

University of Sharjah College of Health Sciences Human Anatomy & Physiology Lab 9 The Urinary System Lab: urinalysis Material Updated by Instructor: Dana Salahat, MSc. The Urinary System in Gross Dissection Major organs of urinary system 1. Kidneys 2. Ureters 3. Bladder 4....

University of Sharjah College of Health Sciences Human Anatomy & Physiology Lab 9 The Urinary System Lab: urinalysis Material Updated by Instructor: Dana Salahat, MSc. The Urinary System in Gross Dissection Major organs of urinary system 1. Kidneys 2. Ureters 3. Bladder 4. Urethra.  Blood from the heart travels down the aorta where it enters the kidney via the renal arteries.  Urine from the kidney flows through the ureter to the bladder, where it leaves the body via the urethra  The Structure of the Kidney Pathway of blood filtration Cortex Nephrons Renal Pyramids Minor Calyx Major Calyx Renal Pelvis Ureter Urinary Bladder Urethra Kidney Functions The kidney acts as a filter and regulator  Filtration: In 24 hr, kidneys filtrate 150- 180 L of blood plasma, in the same time urine output 1.0 to 1.8 L  Reabsorption: reabsorb water, organic nutrients and ions.  Regulation: 1. Excretion of waste products: Nitrogenous wastes (urea, uric acid, ammonium and creatinine) and toxins - Detoxification 2. Metabolism - Maintenance of water-salt balance and ions level - Acid-base balance: regulate blood pH - Balancing blood glucose level, electrolytes (salt, potassium and other minerals), regulating blood pH, and water levels and blood pressure in the blood.  Secretion of Hormones: Renin and erythropoietin  Superficial outer cortex and inner medulla The medulla consists of 6-18 renal pyramids The cortex is composed of roughly 1.25 million nephrons Major and minor calyces along with the pelvis drain urine to the ureters.  Nephrons are the “functional units” of the kidney; they cleanse the blood and balance the constituents of the circulation. Nephrons functions include:  Production of filtrate  Reabsorption of organic nutrients  Reabsorption of water and ions  Secretion of waste products into tubular fluid  Cortical and Juxtamedullary Nephrons  Cortical nephrons ~85% of all nephrons Located in the cortex  Juxtamedullary nephrons Closer to renal medulla Loops of Henle extend deep into renal pyramids Blood Flow in the Kidney. Filtrate Flow in the Nephron.  Urine Sample Testing (Urinalysis)  A urinalysis is a test used to detect and manage a wide range of disorders as  Urinary Tract Infections (UTI)  Kidney Disease.  Diabetes.  The test involves checking the appearance and the clarity of a urine sample (Physical exanimation ).  And the concentration and content of urine (Chemical examination).  Abnormal urinalysis results may point to a disease or illness.  A. Physical characteristics Examination  Color  Pale to deep yellow (depending on the concentration of urine and indicates the body’s hydration)  Due to a pigment( urochrome) derived from the break down of hemoglobin  Abnormal urine color is due to certain foods, drugs & presence of blood or bile.  Transparency/Clarity Clear Could be hazy, cloudy or turbid due to the presence of WBCs, mucous threads or bacterial infection. B. Chemical Examination  A urine test strip or dipstick test is a basic diagnostic tool used to determine pathological changes in a patient’s urine.  A standard urine test strip may comprise up to 10 different chemical pads or reagents which react (change color) when immersed in and then removed from a urine sample.  The analysis includes testing for the presence of proteins, glucose, bilirubin, urobilinogen, ketones, blood, nitrite, and leukocytes as well as testing of pH and specific gravity. Reagent Strip Technique 1. Mix 2. Immerse Briefly 3. Remove excess urine 5. Compare the color with 4. Blot the edge chart of the strip Continue… What dose it means ?  pH  Measures the acidity in your urine which may be a sign of kidney stones.  Bacterial UTI causes urine to become alkaline  pH varies during the day going from more acid in the am to more alkaline in the pm. It varies, depending on dietary intake (a high protein diet increases acidity)  Expected result: Low (acidic)  Specific Gravity  Evaluates the body’s water balance (hydration) and urine concentration.  High specific gravity  high solute concentration (dehydration)  Low specific gravity  low solute concentration (urine is diluted)  Expected Results: low at 1,000 but normal ranges from 1.002 to 1.030  Protein  This test is usually run to screen for kidney disease. Protein in the urine is called Proteinuria.  Damage to the glomerulus increases the permeability thus allowing the protein to pass through  Could indicate renal disease/hypertension  Expected result: Negative  Blood  Blood in the urine is called hematuria. Several conditions can cause hematuria including UTI, Kidney infection, kidney/ ureter stones, medication, menstruation, strenuous exercise  Expected result: Negative  Bilirubin  The detection of Bilirubin in the urine is an early indication of liver disease or bile duct obstruction.  Bilirubin is the breakdown product of hemoglobin. Note: These two parameters (Urobilinogen and Bilirubin) are commonly used to screen for possible liver disease.  Expected Result: negative  Urobilinogen:  Urobilinogen is the breakdown product of bilirubin.  Normal to be found in urine sample, its concentration < 0.2 µmol/l.  If the result exceeds the normal value, it suggests a possible deterioration of liver functions.  Expected result: less than 0.2 µmol/l.  Leukocyte esterase:  Leukocyte esterase is an enzyme released by activated neutrophils after they have been recruited to sites of infection.  The presence of this substance in the urine indicates the presence of white blood cells or pus cells (leukocyturia).  Positive result suggests a possible UTI.  Expected result: Negative  Nitrites:  Screening for possible asymptomatic infections caused by nitrate- reducing bacteria – Suggesting a possible UTI.  Note: These two parameters (Leukocytes and Nitrite) are commonly used to screen for possible Urinary Tract Infection (UTI)  Expected result: Negative  Ketones (Ketonuria)  It is seen in conditions in which the body produces ketones as an indication that it is using an alternative source of energy.  It is seen during starvation or more commonly in type I diabetes mellitus. The control of urinary ketone is useful in managing and monitoring type 1 diabetes. – People with Type 1, ketonuria means they’re not getting enough insulin. Insulin keeps fat from breaking down, so ketones should not form if you’re taking enough insulin. – People with Type 2 can develop ketonuria if they have severe infections, major trauma, or stress. These conditions raise the need for insulin.  Expected Results: Negative Continue…  Glucose:  Glucose in the urine could indicate diabetes or renal glycosuria.  Expected Results: Negative