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Urinary System (Terms (Hypercalcemia (above normal level of calcium…
Urinary System
Terms
Hypercalcemia
above normal level of calcium
Causes: Hyperparathyroidism, hypothyroidism, bone loss from cancer, immobilization, excessive intake of vitamin D or calcium antacids, renal failure
Effects: Interferes with normal muscle and nerve function and causes under excitability of muscles and nerves
Symptoms: May be asymptomatic; muscle weakness, fatigue, depression, confusion, loss of appetite, nausea, vomiting, constipation, and abnormal heart rhythms; severe calcification of soft tissue
Hypocalcemia
below normal level of calcium
Effects: Overexcitability of muscles and nerves due to hypocalcemia
Symptoms: Numbness, tingling, muscle spasms, increased heart rate; skeletal muscle also more excitable and can go into tetany, causing laryngospams and suffocation
Causes: Vitamin D deficiency, diarrhea, pregnancy, lactation; less calcium released from bone due to hypoparathyroidism, or hyperthyroidism
Hypokalemia
below normal level of potassium
Effects: Cells become hyperpolarized, interfering with neuron and muscle function
Symptoms: Nausea, vomiting: nervous and muscle tissue are less excitable, resulting in numbness, muscle weakness, decreased tone of smooth muscle, flaccid paralysis; decreased and irregular heart rate that may lead to cardiac arrest; muscle weakness can be severe enough to cause paralysis of diaphragm, leading to respiratory arrest
Causes: Diuretic abuse, aldosterone hypersecretion, chronic vomiting, diarrhea, excessive laxative or enema use, heavy sweating, alkalosis, increased insulin, or formation of new tissue since K+ is the predominant intracellular fluid cation
Hyperkalemia
above normal level of potassium
Effects: Cells become hyperpolarized, interfering with neuron and muscle function
Symptoms: Nausea, vomiting, diarrhea, skeletal muscle weakness, tingling of skin, numbness of hands or feet, and irregular heartbeat that can lead to cardiac arrest
Causes: Aldosterone hypo secretion, renal failure, acidosis, decreased insulin, extensive cellular trauma from a crushing injury or burn, transfusion of outdated blood, hemolytic anemia
Acidosis/Acidemia
build up of acid in the bloodstream or tissues
Respiratory Acidosis
Most common acid-base disturbance occurs because of impaired elimination of CO2 by the respiratory system. Occurs when the PCO2 in the arterial blood becomes elevated above 45mm Hg.
Causes: Injury to the respiratory center perhaps caused by trauma or by poliovirus infections; Disorders of the nerves or muscles involved with breathing, such as the loss of muscle strength associated with muscular dystrophy; Airway obstruction; Decreased gas exchange due to reduced respiratory surface area or thickened width of the respiratory membrane
Metabolic Acidosis
Most common metabolic acid-base disturbance occurs as a result of a decrease in HCO3-. Occurs when arterial blood levels of HCO3- fall below 22mEq/L.
Causes: Increased production of metabolic acids, such as ketoacidosis from diabetes mellitus, increased lactic acid from anaerobic respiration, or excessive production of acetic acid from excessive intake of alcohol; Decreased elimination of acid due to real dysfunction; Increased elimination of HCO3- as a result of severe diarrhea.
Hyponatremia
below normal level of sodium
Effects: Cell swelling and decrease in blood volume and blood pressure
Symptoms: Nausea, lethargy, confusion, headache, muscle cramps, seizure, coma, death
Causes: Excessive water intake, hypersecretion of ADH, diuretic abuse, severe diarrhea, burns, hyposecretion of aldosterone, excessive sweating
Hypernatremia
above normal level of sodium
Effects: cell shrinkage, resulting in neurologic impairment; may result in excess fluid causing high blood pressure or edema
Symptoms: Confusion, coma, paralysis of breathing muscles, death
Causes: Dehydration, diabete insipidus,administration of IV saline
Alkalosis/Alkalemia
an excessively alkaline condition of the body fluids or tissues
Respiratory Alkalosis
Occurs when the PCO2 decreases to levels below 35 mm Hg due to an increase in respiration
Faster breathing causes: Severe anxiety; Any condition in which an individual is not receiving sufficient oxygen (ex: might occur climbing to a high altitude; during congestive heart failure; as a result anemia; or due to low blood pressure
Metabolic Alkalosis
Occurs when arterial blood levels of HCO3- that exceed 26 mEq/L.
Causes: Vomiting; Increased loss of acids by the kidneys with overuse of diuretics; Increased alkaline input from consuming large amounts of antacid tablets
Electrolytes
Chloride
Higher in the ECF
Functions: Found in the lumen of the stomach as HCl; Participate in chloride shift with in erythrocytes
Potassium
Higher in the ICF
Functions: Required for neuromuscular activities and controlled heat rhythm
Sodium
Higher in the ECF
Functions: Determining blood plasma osmolarity and regulating fluid balance
Phosphate
Higher in the ICF
Functions: Component of DNA, RNA, and phospholipids; Intracellular buffer and urine buffer; Part of ATP
Calcium
Higher in the ECF
Functions: Needed for muscle contraction and neurotransmitter release; Participates in blood clotting;Found in bones and teeth
Nephron physiology
Reabsorption
Most reabsorption happens in the Proximal Convoluted tubule(PCT)
Sodium ions are actively transported from the nephron tubules to the interstitial space, where they diffuse into the blood.
Since sodium is positive this causes the ECF to help "pull" the negatively charge ions, like chloride , out of the nephron tubules.
This causes the ECF to be hypertonic to the filtrate, causing water to follow salt out of the nephron tubules by osmosis.
Secretion
Some waste that was not filtered in the original filtrate or were reabsorbed, must be secreted into the Distal convoluted tubule(DCT)
These materials include: hydrogen ions, potassium ions, and nitrogenous wastes such as urea, creatinine, and ammonia.
Secretion is responsible for helping the blood pH by secreting hydrogen ions, ridding the body of nitrogen wastes that become toxic as they accumulate, and ridding the body of excess ions, vitamins, or drugs.
Filtration
Pressures
Glomerular hydrostatic pressure: the pressure of the blood against the walls of the glomerulus
Capsular hydrostatic pressure: pressure of the fluid in the capsule itself
Blood colloidal osmotic pressure: due to osmotic pressure
Net filtration pressure: the total pressure when all 3 forces combined
Rate of filtration called the Glomerular filtration rate (GFR)
Primarily regulated by the juxtaglomerular apparatus
Juxtaglomerular cells: produce the enzyme renin
Macula densa: a set of chemoreceptor cells in the nephron that monitor filtrate concentration
Process of filtration is powered by blood pressure. The materials that pass through the capillary walls into the capsule include water, amino acids, glucose, sodium, and chloride ions, urea, uric acid, and other materials.
Filtration is regulated in three ways
Neural regulation which involves the sympathetic nervous system and smooth muscles that can constrict the afferent arteriole.
Hormonal which involves the enzyme renin. Renin acts on angiotensin, which then increases vasoconstriction, reabsorption, and the release of aldosterone and ADH; This increases blood pressure.
Autoregulation is accomplished by the myogenic mechanism, which consists of stretch receptors in the afferent arterioles.
These receptors sense dilation of the blood vessel due to increased blood pressure and respond by constricting blood flow into the glomerulus.
Excretion
After going to the collecting duct filtrate becomes urine.
Urine enters the papillary duct, to the renal sinus, to the minor calyx, to the major calyx, then to the renal pelvis, to the ureter, to the bladder, and then through the urethra to exit the body.
Fluid Compartments
Intracellular fluid (ICF)
fluid within our cells
A majority or approximately two thirds of the total fluid is within our cells.
Extracellular fluid (ECF)
fluid outside of our cells
Interstitial fluid
fluid that surrounds and "bathes" the cells
Blood plasma
Intravascular fluid, the fluid within the blood vessels