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 MAINTAIN HOMEOSTASIS OF pH, COMPOSITION AND VOLUME OF BODY FLUIDS  REMOVES:  METABOLIC WASTE, EXCESS MATERIAL,  FOREIGN SUBSTANCES (DRUGS)

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Presentation on theme: " MAINTAIN HOMEOSTASIS OF pH, COMPOSITION AND VOLUME OF BODY FLUIDS  REMOVES:  METABOLIC WASTE, EXCESS MATERIAL,  FOREIGN SUBSTANCES (DRUGS)"— Presentation transcript:

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2  MAINTAIN HOMEOSTASIS OF pH, COMPOSITION AND VOLUME OF BODY FLUIDS  REMOVES:  METABOLIC WASTE, EXCESS MATERIAL,  FOREIGN SUBSTANCES (DRUGS)

3  KIDNEYS  URETER S  URINARY BLADDER  URETHRA  FUNCTIONS?

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5  LOCATED RETROPERITONEALLY  12 TH THORACIC TO 3 RD LUMBAR VERTEBRAE  RENAL SINUS AT HILUM: BLOOD VESSELS, URETER, NERVES, LYMPHATIC VESSELS  RELEASES ERYTHROPOIETIN ?  RELEASES RENIN ?  BLOOD PRESSURE  ACTIVATES VITAMIN D ?  CALCIUM ABSORPTION

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8  RENAL PELVIS  FUNNEL SHAPED SAC AT URETER ORIGIN  WHERE MAJOPR CALYCES MERGE  RENAL MEDULLA:  RENAL PYRAMIDS  MINOR CALYCES TO MAJOR CALYCES  RENAL CORTEX:  OUTER LAYER  DIPS IN BETWEEN PYRAMIDS = RENAL COLUMNS RENAL CAPSULE FIBROUS CONNECTIVE TISSUE PROTECTION, MAINTAIN SHAPE

9 AARTERIES CAN CARRY 30% OF BLOOD TO KIDNEYS ? RRENAL ARTERY HAS _________________ BLOOD RRENAL VEIN HAS _________________ BLOOD

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11  Descending aorta  Renal artery  Interlobar artery  Arciform arteries  Interlobular arteries  Afferent arterioles  Glomerulus  Efferent arteriole  Capillary net

12  FUNCTIONAL UNIT OF KIDNEY  1 MILLION PER  PARTS  RENAL CORPUSCLE  GLOMERULUS  GLOMERULAR OR BOWMAN’S CAPSULE  2 LAYERS OF SQUAMOUS EPITHELIAL  VISCERAL AND PARIETAL TO TUBULE  VISCERAL CELLS: PODOCYTES  HAVE PROCESS AND SECONDARY PROCESSES = PEDICELS, INTERDIGITATE TO FORM SLIT PORES  FUNCTION  AFFERENT AND EFFERENT ARTERIOLES

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16 PPROXIMAL CONVOLUTED TUBULE NNEPHRON LOOP/ LOOP OF HENLE DDESCENDING LIMB AASCENDING LIMB DDISTAL CONVOLUTED TUBULE CCOLLECTING DUCT/ COLLECTING TUBULE TTHROUGH RENAL PAPILAE TO MINOR CALYX

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18  ASCENDING LIMB PASSES BETWEEN AFFERENT AND EFFERENT ARTERIOLE  MACULA DENSA = TALL DENSELY PACKED CELLS OF ASCENDING LOOP TOUCHING ASCENDING LIMB  JUXTAGLOMERULAR CELLS IN WALL OF AFFERENT ARTERIOLE (LARGE VASCULAR SMOOTH MUSCLE CELLS)  REGULATES SECRETION OF RENIN (CHAP 13)

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20  CORTICAL  80%  CORPUSCLE IN CORTEX CLOSE TO SURFACE  SHORT NEPHRON LOOPS  JUXTAMEDULLARY  20%  CORPUSCLE CLOSE TO MEDULLA  LONG LOOP  MOST RESPONSIBLE FOR H2O HOMEOSTASIS

21  AFFERENT ARTERIOLE DIAMETER LARGER THAN EFFERENT ?  PERITUBULAR CAPILLARY SYSTEM  VASA RECTA AROUND JUXTAMEDULLARY NEPHRON LOOP: LOW PRESSURE

22  WASTES, EXCESS WATER, ELECTROLYTES  GLOMERULAR FILTRATION  FILTERS INTO NEPHRON RATHER THAN INTERSTITIAL SPACE  PRODUCES 180 L OF FLUID/DAY SO MOST?  TUBULAR REABSORPTION  PICKS UP RIGHT AMOUNT OF WATER, ELECTROLYTES, GLUCOSE  TUBULAR SECRETION  REMOVES H+, TOXINS FASTER  URINARY SECRETION = GLOMERULAR FILTRATION + TUBULAR SECRETION – TUBULAR REABSORPTION

23  MORE PERMEABLE TO SMALL MOLECULES: FENESTRATED CAPILLARIES  = WATER,GLUCOSE, AMINO ACIDS, UREA, URIC ACID, CREATINE, CREATININE, SODIUM, CHLORIDE, POTASSIUM, CALCIUM, BICARBONATE, PHOSPHATE, SULFATE

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25  HYDROSTATIC PRESSURE CAUSES FILTRATION  ALSO AFFECTED BY HYDROSTATIC PRESSURE IN CAPSULE AND OSMOTIC PRESSURE IN PLASMA ?  NET FILTRATION RATE = GLOMERULAR CAPILLARY HYDROSTATIC PRESSURE – CAPSULAR HYDROSTATIC PRESSURE AND GLOMERULAR CAPILLARY OSMOTIC PRESSURE

26  UQQ UQQ

27  1115/the-urinary-system 1115/the-urinary-system

28  KkdE8&NR=1&feature=endscreen KkdE8&NR=1&feature=endscreen

29  FILTRATION RATE AFFECTED BY ANYTHING THAT AFFECTS GLOMERULAR HYDROSTATIC PRESSURE, GLOMERULAR PLASMA OSMOTIC PRESSURE, OR CAPSULAR HYDROSTATIC PRESSURE  GLOMERULAR HYDROSTATIC PRESSURE IS MOST IMPORTANT: ANY CHANGE IN DIAMETER OF ARTERIOLES, VASODILATION? VASOCONSTRICTION?  MORE FLUID IS FILTERED BECAUSE OF HIGHER HYDROSTATIC PRESSURE SO COLLOIND OSMOTIC PRESSURE DOESN’T AFFECT FILTRATION AS MUCH, UNLESS IT IS LOWERED ?

30  ANY OBSTRUCTION (?) WOULD BACK UP FLUID RAISING THE HYDROSTATIC PRESSURE OF CAPSULE AND REDUCING FILTRATION  FILTERS: 25% CARDIAC OUTPUT; 20% OF PLASMA = 125 ml/MIN; 180 L/DAY : SO PLASMA IS FILTERED 60X/DAY = 45G  SURFACE AREA OF GLOMERULAR CAPILLARIES = 2 sq m = SKIN’S SURFACE

31  MAINLY AUTOREGULATION  BP/VOLUME DROP STIMULATES SYMPATHETIC NS = VASOCONSTRICTION OF AFFERENT ARTERIOLES = ? IF BP/VOLUME INCREASE = ?  RENIN-ANGIOTENSIN SYSTEM: RENAL BAROMETERS OF AFFERENT ARTERIOLES STIMULATE SYMPATHETIC NS TO STIMULATE JUXTAGLOMERULAR CELLS SECRETE RENIN

32  DECREASING LEVELS OF SODIUM, POTASSIUM, CHLORIDE STIMULATE MACULA DENSA TO SECRETE RENIN  RENIN STIMULATES ANGIOTENSINOGEN  ANGIOTENSIN I; ANGIOTENSIN- CONVERTING ENZYME CAHNGES ANGIOTENSIN I  ANGIOTENSIN II  ANGIOTENSIN II: MAINTAINS SODIUM BALANCE, WATER BALANCE, BLOOD PRESSURE  CONSTRICTS AFFERENT OR EFFERENT ARTERIOLES, STIMULATES SECRETION OF ALDOSTERONE FROM ADRENAL CORTEX

33  ANGIOTENSIN II:  VASOCONSTRICTOR OF AFFERENT AND EFFERENT ARTERIOLES  STIMULATE PRODUCTIN OF ALDOSTERONE: (FROM?) CAUSES RETENTION OF SODIUM IN DISTAL TUBULE: LOSES LESS WATER  STIMULATES RELEASE OF ADH: INCREASES PERMEABILITY OF DISTAL TUBULE AND COLLECTING DUCT  ANP: (FROM?) RELEASED WHEN BLOOD VOLUME INCREASES: SO ?

34  REABSORPTION: MATERIAL TRANSPORTED OUT TO INTER STITIAL FLIUD AND DIFFUSE INTO PERITUBULAR CAPILLARIES  PASSIVE AND ACTIVE MECHANISMS  CAUSED BY: LOW HYDROSTATIC PRESSURE OF PERITUBULAR CAPILLARIES, HIGH PERMEABILITY OF CAPILLARIES, HIGHER COLLOID OSMOTIC PRESSURE OF PERITUBULAR CAPILLRIES

35  MOSTLY IN PROXIMAL TUBULE, HAVE MICOVILLI (?)  GLUCOSE:  PROXIMAL: ACTIVE TRANSPORT  UNLESS RENAL PLASMA THRESHOLD IN REACHED (DIABETES)  WATER:  PROXIMAL: OSMOSIS  AMINO ACIDS:  PROXIMAL: ACTIVE TRANSPORT  SMALL PROTEINS:  PROXIMAL: ACTIVE TRANSPORT: ENDOCYTOSIS  CREATINE, LACTIC, CITRIC, URIC AND ASCORBIC ACID:  ACTIVE TRANSPORT  ACTIVE TRANSPORT REQUIRES CARRIER MOLECULES

36  WATER: OSMOSIS  TIED IN WITH RETENTION OF SODIUM  SODIUM PUMP IN PROXIMAL SECTION  CHLORIDE, PHOSPHATE AND BICARBONATE MOVE WITH SODIUM IONS  MOST REABSORPTION IN PROXIMAL TUBULE (70%)  MOST SODIUM IS RETAINED (97-99%)

37  EPITHELIAL CELLS OF TUBULES SECRETE SUBSTANCES  ACTIVE TRANSPORT:  ORGANIC COMPOUNDS LIKE PENICILLIN, HISTAMINE  HYDROGEN IONS: WHY?  POTASSIUM: WHEN ALDOSTERONE CAUSES REABSORPTION OF SODIUM = NEGATIVE CHARGE AND POTASSIUM IS SECRETED

38  HORMONES: ANP; ALDOSTERONE; ADH  ADH FROM ?  POSTERIOR PITUITARY  CAUSES DISTAL CONVOLUTED TUBULE AND COLLECTING DUCTS TO ADD PROTEINS – AQUAORINS: WATER CHANNELS: OSMOSIS BECAUSE OF HYPERTONIC MEDULLA COUNTERCURRENT EFFECT: ASCENDING LOOP IMPERMEABLE TO WATER BUT LETS ELECTROLYTES OUT SO INSIDE IS HYPOTONIC AND OUTSIDE IS HYPERTONIC

39  DECENDING LOOP IS PERMEABLE TO WATER NOT SOLUTES, HYPERTONIC OUTSIDE SO WATER DIFFUSES OUT: TUBULAR FLUID IS CONCENTRATED  ASCENDING LOOP REABSORBS MORE SALT, SALT CONCENTRATION KEEPS MULTIPLYING: COUNTERCURRENT MULTIPLIER  MORE THAN 4X SOLUTE CONCENTRATION THAN PLASMA  SALT DIFFUSES INTO DESCENDING VASA RECTA BUT DIFFUSES OUT OF ASCENDING: MAINTAINS SALT GRADIENT IN MEDULLA

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41  UREA  AMINO ACID BREAKDOWN FOR GLUCONEOGENESIS  URIC ACID  METABOLISM OF A AND G  10% EXCRETED/ MOST REABSORBED

42  VARIES ?  95% ?;UREA, URIC ACID, CREATINE, TRACE AMINO ACIDS, ELECTROLYTES  DIET & PHYSICAL ACTIVITY

43 .6-2.5L  ml/MIN  LESS THAN 30 ml/min = KIDNEY FAILURE

44  DEFINITION: KIDNEY’S EFFICIENCY AT REMOVING A SUBSTANCE  TESTED TO SEE IF DISEASE OR DAMAGE  INSULIN CLEARANCE TEST: GFR  CREATININE CLEARANCE TEST: GFR: KIDNEY FUNCTION: USUALLY ALL REMOVED FROM BLOOD TO URINE

45  25 cm  BEHIND PARIETAL PERITONEUM TO URINARY BLADDER  3 LAYERS:  MUCOUS COAT: TRANSITIONAL EPITHELIUM  MUSCULAR COAT: SMOOTH MUSCLE: CIRCULAR AND LONGITUDINAL LAYERS  FIBROUS COAT: CONNECTIVE TISSUE  MOVES BY PERISTALSIS: STARTED BY PRESENCE OF URINE  VALVE AT URINARY BLADDER ?  KIDNEY STONE COULD INCREASE PERISTALSIS OR SYMPATHETIC NS CONSTRICTS URETER AND KIDNEY SHUTS DOWN

46  HOLLOW, BEHIND PARIETAL PERITONEUM  TRIGONE: OPENINGS TO URETER AND URETHRA  MUCOUS COAT: TRANSITIONAL EPITHELIUM  SUBMUCOSA: CONNECTIVE TISSUE WITH GLAND CELLS  MUSCULAR COAT: SMOOTH MUSCLE: DETRUSOR MUSCLE: FORMS INTERNAL URETHRAL NECK

47  ALWAYS SUSTAINED CONTRACTION  PARASYMPATHETIC NS: REFLEX FOR URINATION SEROUS COAT: PARIETAL PERITONEUM AT TOP, FIBROUS CONNECTIVE TISSUE REST

48  MUCOUS MEMBRANE  LONGITUDINAL SMOOTH MUSCLE FIBERS  URETHRAL GLANDS: MUCOUS GLANDS  MALES: PROSTATIC URETHRA PASSES THROUGH PROSTATE; MEMBRANOUS URETHRA EXTERNAL URETHRAL SPHINCTER; PENILE URETHRA

49  MICTURITION REFLEX:  STRETCH RECEPTORS STIMULATED; SIGNAL MICTURITION REFLEX CENTER: IN SACRAL SPINAL CORD  PARASYMPATHETIC NS IMPULSE TO DETRUSOR MUSCLE TO CONTRACT  CAN STILL BE CONTROLED: EXTERNAL URETHRAL SPHINCTER, IMPULSES FROM BRAIN STEM AND CEREBRAL CORTEX  EXTERNAL URETHRAL SPHINCTER RELAXES: IMPULSES FROM HYPOTHALAMUS AND PONS  DETRUSOR MUSCLE CONTRACTS: MICTURITION  IMPULSES STOP; DETRUSOR MUSCLE RELAXES, BLADDER FILLS

50  KIDNEY CELLS START TO DIE AT 20 BUT NOT NOTICED TILL AFTER 40; 1/3 LOSS BY 80  GLOMERULI SHUT DOWN: LOSS; DAMAGE;  GFR DROPS AT 40; 75: 125ml  60ml  RENAL TUBULES THICKEN WITH FATTY ACIDS; DON’T PROCESS DRUGS AND ORGANICE MATERIAL AS WELL  BLOOD FLOW DECREASES BY 80

51  SLOWER TO RESPOND FOR HOMEOSTASIS:  ARTERIOLES DON’T DILATE AS QUICK  RELEASE OF RENIN DECREASES  CAN’T ACTIVATE VITAMIN D  URETER, URINARY BLADDER AND URETHRA AREN’T AS ELASTIC: BLADDER HOLDS 50% LESS AND RETAINS MORE: MORE FREQUENT URINATION AND MORE URGENT  INCONTINENCE: LOSS OF MUSCLE TONE OF BLADDER


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