The Urinary System.pdf

The Urinary System TERM DEFINITION Azotemia Excess blood nitrogen levels Cystitis Inflammation of the urinary bladder Glomerulonephritis Inflammation of the glomerulus Hypoalbuminemia Decrease in albumin as a result of urinary los...

The Urinary System TERM DEFINITION Azotemia Excess blood nitrogen levels Cystitis Inflammation of the urinary bladder Glomerulonephritis Inflammation of the glomerulus Hypoalbuminemia Decrease in albumin as a result of urinary loss Micturition The physiological process of urination Uremia Kidney dysfunction that causes constituents of urine to go into the blood Urethritis Inflammation of the urethra Proteinuria Protein in the urine Hematuria Blood in the Urine Structures That Make Up the Urinary System Two kidneys. The two kidneys are located in the posterior portion of the abdominopelvic cavity. The kidneys filter wastes out of the blood and return needed chemicals and water back to the blood. Two ureters. The two ureters send the waste products (urine) to the urinary bladder, where they are stored. Urinary bladder. The urinary bladder is located in the pelvic cavity and stores urine until it is ready to be passed out of the body. Urethra. The urethra is a tube that eliminates urine from the body. This process is called urination, voiding, or micturation. Waste Products That Are Eliminated or Excreted from the Kidney The toxic substances excreted from the kidneys are wastes from the metabolism of foods and excess chemicals in blood. Examples of these chemicals include: vAmmonia vUrea vUric acid. What Is the Function of the Urinary System? The urinary system functions by: vRegulating blood volume and blood pressure. vStimulating the production of red blood cells by secreting erythropoietin. vHelping in the making of vitamin D. Vitamin D aids in the regulation of calcium homeostasis. It aids in the absorption of calcium in the ileum of the small intestine.  Vitamin D vIf there is a deficiency of vitamin D, the bones will become soft and bend. This condition is called rickets in children. vIf there is a deficiency of vitamin D in adults, the bones will also become soft. This condition is called osteomalacia in adults  The Kidneys There are three layers that surround each kidney. vThe innermost layer is called the renal capsule. This layer maintains the shape of the kidney. vThe middle layer is called the adipose capsule. This layer provides protection to the kidney. vThe outermost layer is called the renal fascia. This layer anchors the kidney to the abdomen. vBlood enters the kidneys through the renal artery and exits through the renal vein. External Structures of the Kidney vThe external medial portion of the kidney has a concave shape. This region is called the hilum. v The hilum region is important because the two ureters, the nerves of the kidney, the blood vessels of the kidney, and the lymphatic vessels of the kidney all enter and exit at this region. Internal Structures of the Kidneys Renal cortex. This is the outer portion of the kidney. Renal medulla. This is the middle or inner portion of the kidney. Renal pyramids. These are the pyramid- (triangle-) shaped structures located in the middle portion of the kidney. Renal columns. These are the structures located in between the renal pyramids, separating them. Renal papillae. The papillae project into the renal pelvis, which projects into the minor calyx. Minor calyx. The minor calyx or calyces (if there are many) enters the major calyx. Major calyx. The major calyces, in turn, come together and form the renal pelvis. Renal pelvis. This structure collects all the urine from the major calyces and funnels it into the ureters.  What Is a Nephron? The nephron is the structural and functional unit of the kidney and are located in the pyramids of the renal cortex. Nephrons consist of two structures: 1. Glomerulus. The glomerulus is a network of capillaries that contain both afferent and efferent arterioles surrounded by the glomerular (Bowman’s) capsule. 2. Glomerular (Bowman’s) capsule. Bowman’s capsule is a double- walled cup containing epithelial cells. This cup collects the filtrate from the glomerulus (capillary network). Bowman’s capsule is the place where the kidneys filter the blood. This filtering process takes place because of hydrostatic pressure and blood pressure. After the filtrate leaves Bowman’s capsule, it passes through the following parts: vProximal convoluted tubules.- reabsorption and secretion of certain ions and molecules occur. vLoop of Henle (also called the nephron loop).- These structures reabsorb certain ions and water and secrete urea. vDistal convoluted tubules. These structures are involved in the reabsorption of certain ions and molecules  What Are Kidney Stones? Kidney stones, also called renal calculi, can be the result of gout, a defect in one or both ureters, frequent urinary tract infections, urine that is very concentrated, or not drinking enough water. Many times the crystals of salts in the urine solidify or turn hard, causing a stone. Lytic metastases, hyperparathyroidism (which can cause hypercalcemia), and even a person’s diet can cause a kidney stone. Kidney stones are more common in males than in females. Kidney stones are mostly acid stones, being made of either calcium oxalate or calcium phosphate crystals. However, some kidney stones are alkaline stones, being made of ammonium magnesium phosphate. What are the signs and symptoms of kidney stones? The signs and symptoms of kidney stones include back pain and abdominal pain, which can be very severe, nausea, fever, urgency to void, and blood in the urine (hematuria) What Is Acute Renal Failure? Acute renal failure is the sudden, immediate loss of kidney function. Acute renal failure can be caused by low blood pressure (hypotension), trauma to the kidneys, burns, bleeding, dehydration, infections, allergies, poison, kidney stones, an enlarged prostate, childbirth, and alcoholism. What are the signs and symptoms of acute renal failure? Acute renal failure presents with a decrease in the output of urine, no urine, an increase in the output of urine, inflammation (edema) of the extremities, back or abdominal pain, high blood pressure (hypertension), and an increase in potassium levels during urinalysis. What Is Chronic Renal Failure? Chronic renal failure occurs over a large period of time. The kidneys will slowly stop functioning. In some cases, the patient will have no symptoms (be asymptomatic). Chronic renal failure can be caused by high blood pressure (hypertension), diabetes, obstructed ureters, renal calculi (kidney stones), glomerulonephritis, and polycystic kidney disease. What Is Glomerulonephritis? Glomerulonephritis is the inflammation of the glomerulus of the nephron. This inflammation is commonly the result of a streptococcal infection, most commonly Streptococcus pyogenes. S. pyogenes gives off a toxin causing an antigen-antibody response, resulting in the inflammation of the glomerulus. If it is severe and untreated, scar tissue can form, causing chronic renal failure. What are the signs and symptoms of glomerulonephritis? Glomerulonephritis will present with bloody urine (hematuria), high blood pressure (hypertension), nausea, anemia, tiredness, seizures, and even a coma.  Types of Glomerulonephritis CONDITION CHARACTERISTICS Acute glomerulonephritis Is benign and resolves quickly Rapid progressive glomerulonephritis Is quick to advance and can lead to death Chronic glomerulonephritis Is long term, taking years or even decades to cause damage Diffuse glomerulonephritis Affects most or all of the glomeruli Focal glomerulonephritis Affects only some of the glomeruli Segmental glomerulonephritis Affects some of the capillaries in a given glomerulus What Is Polycystic Kidney Disease? Polycystic kidney disease, or PKD, is a genetic disorder that is inherited from one parent. This disease occurs between the ages of 15 and 30 years. In polycystic kidney disease, the kidneys become enlarged, and the tissue is partially replaced by cysts. This condition develops rather slowly. Signs and symptoms become more severe over time. What are the signs and symptoms of PKD? Polycystic kidney disease presents with hypertension (high blood pressure), blood in the urine (hematuria), anemia, back and abdominal pain, fatigue and tiredness, the formation of renal calculi, and even liver disease.  What Is Pyelonephritis? Pyelonephritis is a bacterial infection of the kidney tissue (parenchyma). It can be either acute or chronic. Pyelonephritis is a type of urinary tract infection that starts in the urinary bladder and spreads to either one or both kidneys. Pyelonephritis is caused by a bacterial infection, a clogged duct in the urinary tract, or renal calculi (stones). Bacteria that are blood-borne can travel through the blood into the kidney from another infected area of the body. This can cause an abscess and lead to necrosis of the renal cortex. Pyelonephritis, which starts in the urinary bladder, is commonly caused by feces containing Escherichia coli, Proteus species, or Enterococcus species. What are the signs and symptoms of pyelonephritis? The signs and symptoms of pyelonephritis include white blood cell casts in the urine; pain in the back, flank, and abdomen; fever; fatigue and tiredness; and blood and pus in the urine (the urine will appear either dark brown or cloudy). What Is a Urinary Tract Infection? A urinary tract infection, also called a UTI, is more frequent in females because of the shortness of the urethra. Males will have fewer urinary tract infections because of the acidity of prostate secretions. However, after the age of about 40, enlargement of the prostate gland can occur, limiting the complete emptying of the bladder, and this can lead to an increase in urinary tract infections. Urinary tract infections are commonly caused by bacterial infections, E. coli being the most common. What are the signs and symptom of UTIs? The signs and symptoms of urinary tract infections include an increase in urinary frequency, pain during urination, and urine that contains blood or pus. What Is Nephrotic Syndrome? Nephrotic syndrome is a group of kidney diseases that cause an increase in basement membrane permeability, which leads to urinary protein loss. The protein that is most affected is albumin. Nephrotic syndrome can be caused by diabetic kidney disease, systemic lupus erythematosus (SLE), or glomerulonephritis. What are the signs and symptoms of nephrotic syndrome? The signs and symptoms of nephrotic syndrome include proteinuria (protein in the urine), hypoalbuminemia (a decrease in albumin as a result of urinary loss), and generalized systemic edema (because of the loss of protein). After glomerular damage and hypoalbuminemia occur, blood osmotic pressure decreases dramatically. The interstitial fluid that would normally be drawn into the blood stays in the tissue spaces, causing edema. Hyperlipidemia also occurs. The liver tries to compensate and makes lipoproteins to replace the low plasma proteins. What Is Nephritic Syndrome? Nephritic syndrome is a condition in which inflammatory damage to the glomerulus (glomerulonephritis) causes a restriction of glomerular filtration and enables red blood cells to pass into the urine (hematuria). The restriction of filtration causes a reduction in the quantity of urine (oliguria), high blood pressure (hypertension), and an accumulation of nitrogen waste in the blood (azotemia). Another condition is called Goodpasture’s syndrome. This is a defect in the immune system. The immune system makes antibodies against the glomerular basement membrane, also causing glomerulonephritis. The anti- bodies in Goodpasture’s syndrome also attack the pulmonary basement membrane in the lungs, causing bloody sputum (hemoptysis). What are the signs and symptoms of nephritic syndrome? The signs and symptoms of nephritic syndrome include glomerulonephritis, hematuria, oliguria, hypertension, and azotemia (failure of the kidney to remove urea and nitrogen compounds from the blood). What Is Cystitis? Cystitis is an infection of the urinary bladder. Cystitis is more frequent in females than in males because of the shorter urethra and the proximity of the urethral orifice to the anus. This allows bacteria from the anus easy access to the urinary tract. Cystitis can be caused by bacteria, the placement of a catheter into the urinary bladder, improper hygiene (women should always wipe anterior to posterior to prevent infection), and holding urination and not voiding when the urgency first occurs. What are the signs and symptoms of cystitis? The signs and symptoms of cystitis present with the frequent urge to urinate, pain during urination, fatigue, fever, and chills. The urine can be cloudy because of the presence of pus and smoky or reddish/brown because of the presence of blood.  Matching 1. Nephroticsyndrome 2. UTI 3. Cystitis 4. Glomerulonephritis 5. Calcium phosphate 6. Acuterenal failure 7. Urethra 8. Adipose capsule 9.Renal pelvis 10. Polycystic kidney disease A. An infection of the urinary bladder B. Kidney tissue becomes replaced by cysts C. Inflammation of the glomerulus D. A group of kidney diseases that cause an increase in basement membrane permeability E. Immediate loss of kidney function F. Urinary tract infection G. Expels urine from the urinary bladder H. Middle protective layer around the kidney I. Collects urine from the major calyces J. Kidney stones 1. Inflammation of the glomerulus of a nephron is called _________________. 2. A genetic kidney disorder is called ___________________. 3. A bacterial infection of the urinary bladder that spreads to one or both kidneys is called ___________. 4. A UTI is a(n)________________. 5. The bacterium that most commonly causes urinary tract infections is _____________. 6. The protein that is most affected by nephrotic syndrome is __________________. 7. An infection of the urinary bladder is called ____________________. 8. Renal calculi are _____