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elderly patient with blood in her urine (Urinary System (Nephron (renal…
elderly patient with blood in her urine
Urinary System
General Anatomy
kidneys
filter blood, remove waste products, and convert the filtrate
into urine
synthesize the final enzyme in calcitriol formation, a hormone that increases calcium absorption of the small intestine
secrete erythropoietin, a hormone that stimulates red bone
marrow to increase erythrocyte formation.
regulate Na+, K+, Ca2+ and PO43- ion levels in the blood as well as H+ and HCO3- levels to maintain acid-base balance
regulate blood pressure by controlling fluid volume through urine loss and by releasing renin, an enzyme required for angiotensin II production, which increases blood pressure
may engage in gluconeogenesis in an attempt to maintain normal glucose levels in conditions of nutrient deprivation
ureters
Long, fibromuscular tubes that transport urine, originate from the renal pelvis of the kidneys, and enter the posterolateral wall of the bladder
urethra
epithelial-lined fibromuscular tube that exits the urinary bladder, transporting urine to the exterior of the body
Urinary Bladder
expandable, muscular, retroperitoneal organ that serves as a reservoir for urine
Nephron
microscopic filtration unit of the kidney
renal corpuscle
bulbous region of a nephron located within the renal cortex
consists of a vascular pole where arterioles attach to the glomerulus, and tubular pole where the renal tubule originates
glomerulus
A conglomeration of capillary loops
Filtration
passive separation of water and solutes from the blood plasma within the glomerular capillaries
Bowman’s capsule
formed by an internal visceral layer directly lining the
glomerular capillaries and external parietal layer composed of simple squamous epithelium
capsular space
space between the visceral layer and parietal layers that receives filtrate
Filtrate, or filtered plasma, containing certain solutes and minimal protein forms when blood moves across glomerular capillary walls, filtering out solutes and water
renal tubule
proximal convoluted tubule
composed of simple cuboidal epithelium and apical microvilli that significantly increase surface area, and thus reabsorption capacity
Filtrate that has entered the proximal convoluted tubule is called tubular fluid
nephron loop
ascending limb
returns to the renal cortex, terminating at the distal convoluted tubule
descending limb
extends from the PCT to the tip of the nephron loop
Simple squamous epithelium lines the thin segments of each limb, while simple cuboidal epithelium lines the thick segments
distal
convoluted tubule
originating from the thick ascending limb of the nephron loop lined with small, simple cuboidal epithelium and short apical microvilli
cortical nephrons
Nephrons with a relatively short nephron loop that barely penetrate the medulla and make up the bulk of the cortex
juxtamedullary nephron
Nephrons with relatively long nephron loops that extend deep into the medulla
aid in the establishment of salt concentration gradients within the interstitial space that allow for the regulation of urine concentration by ADH
Juxtaglomerular Apparatus
region of the nephron that regulates filtrate formation and blood pressure
granular cells or juxtaglomerular cells
Smooth muscle cells of the afferent arteriole that contract when stimulated by stretch or the sympathetic division and synthesize, store, and release renin
macula densa
group of epithelial cells in the wall of the DCT and tubule side of the afferent arteriole that detect changes in sodium chloride concentration within the lumen of the DCT and signal granular cells to release renin
drain into collecting tubules, series of collecting tubules drain into collecting ducts, and groups of collecting ducts drain into papillary ducts
Tubular fluid that undergoes no further changes after leaving the collecting ducts is called urine
Tubular reabsorption
when components within the tubular fluid move from across their walls and return to the blood within the peritubular capillaries and vasa recta
tubular secretion
movement of solutes out of the blood within the peritubular and vasa recta capillaries into the tubular fluid
Osteoporosis
disease that results in decrease bone mass and leads to weakened bones
Diabetes Mellitus 2
results from either decreased insulin release or decreased insulin effectiveness in peripheral tissues
Obesity plays a major role in type 2 diabetes, and patients can successfully be treated with diet, exercise, and medications that enhance insulin release or insulin sensitivity
metabolic condition marked by inadequate uptake of glucose from the blood
Hypertension
high blood pressure
can damage blood vessels and lead to cardiovascular disease
can be treated with diuretics
can cause proteinuria
Diabetes Mellitus 2
glucose build up can cause kidney damage
Hypertension
can cause damage to the blood vessels and filters in the kidney, making removal of waste from the body difficult
high blood pressure
uncontrolled high blood pressure can cause arteries around the kidneys to narrow, weaken or harden
can cause proteinuria
unable to get rid of toxins and other waste
can be a symptom of kidney disease
Diabetes Mellitus 2
excess in blood glucose
kidneys try to get rid of excess glucose
polyuria
dehydration
Osteoporosis
decrease of calcium storage in bone
more calcium to filter in kidneys
can lead to kidney stones
Kidney stones are a common cause of blood in the urine
can lead to chronic kidney disease
can lead to kidney failure
death
common effects of obesity
Osteoporosis
higher risk for Chronic Kidney Disease