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An elderly female with a history of osteoporosis, chronic type 2 diabetes…

- - - - two reddish brown, bean shaped organs that are symmetrical
      - located along posterior abdominal wall
      - right kidney sits 2 cm lower than left kidney to accommodate the liver
      - partially protected by rib cage
      - positioned posterior to the parietal peritoneum in the retroperitoneal space
      - surrounding tissues
        
        fibrous capsule
        
        dense irregular connective tissue
        
        perinephric fat
        
        adipose connective tissue
        
        renal fascia
        
        dense irregular connective tissue
        
        paranephric fat
        
        adipose connective tissue
      - regions of the parenchyma
        
        outer renal cortex
        
        renal columns
        
        project into the medulla to divide renal pyramids
        
        inner renal medulla
        
        renal pyramids
        
        wide portion: corticomedullary junction
        
        apex: renal papilla
      - regions of renal sinus
        
        serves as urine drainage area
        
        minor calyces
        
        merge with other minor calyces to form a major calyx
        
        major calyces
        
        merge with other major calyces to form renal pelvis
        
        renal pelvis
        
        funnel shaped
        
        merges with ureter at medial end of kidney
        
        renal artery, renal vein, lymph vessels, and nerves found in space around renal pelvis
    - - tubes that transport urine from the kidney to the urinary bladder
    - - expandable, muscular sac that stores up to 1L of urine
    - - where urine goes to be excreted from the body
  - - - blood pressure in glomerulus
        
        glomerular hydrostatic pressure is the driving force that pushes water and some dissolved solutes out of the glomerulus and into the capsular space of the renal corpuscle
        
        promotes filtration
      - turn vitamin D into calcitriol
        
        helps the kidneys maintain blood calcium levels to promote formation of bone
    - - nephron
        
        functional filtration unit of the kidney
        
        juxtaglomerular appartassi (JG apparatus)
        
        helps regulate filtrate formation and systemic blood pressure
        
        macula densa cells
        
        modified epithelial cells in the DCT where it contacts the granular cells
        
        located only in tubular wall of afferent arteriole next to granular cells
        
        signal granular cells to release renin through paracrine stimulation
        
        detect changes in sodium chloride concentration of fluid within the lumen of the DCT
        
        granular cells
        
        modified smooth muscle cells of afferent arteriole
        
        located near afferent arteriole entrance into renal corpuscle
        
        functions
        
        contract when stimulated either by stretch or by the sympathetic division of the autonomic nervous system
        
        synthesize, store, and release renin
        
        1 more item...
        
        filtrate includes
        
        water
        
        glucose
        
        amino acids
        
        ions
        
        urea
        
        some hormones
        
        vitamins B and C
        
        ketones
        
        very small amounts of protein
        
        urine formation
        
        occurs in the kidneys
        
        glomerular filtration
        
        passively separates some water and dissolved solutes from the blood plasma within the glomerular capillaries. Water and solutes enter the capsular space of the renal corpuscle due to pressure differences across the filtration membrane
        
        1 more item...
        
        the movement of substances from the blood within the glomerulus into the capsular space
        
        tubular reabsorption
        
        occurs when components within the tubular fluid move by membrane transport processes from the lumen of the renal tubules, collecting tubules, and collecting ducts, across their walls and return to the blood within the peritubular capillaries and vasa recta.
        
        1 more item...
        
        the movement of substances from the tubular fluid back into the blood
        
        tubular secretion
        
        the movement of solutes, usually by active transport out of the blood within the peritubular and vasa recta capillaries into the tubular fluid
        
        1 more item...
        
        the movement of fluid from the blood into the tubular space
        
        parts of nephron
        
        renal corpuscle
        
        reside in the cortex
        
        glomerulus
        
        thick tangle of capillary loops called glomerular capillaries
        
        blood enters through afferent arteriole
        
        blood exits through efferent arteriole
        
        glomerular capsule
        
        internal, permeable visceral layer
        
        external, impermeable parietal layer
        
        simple squamous epithelium
        
        capsular space
        
        between the two layers of the capsule
        
        receives the filtrate which is then modified to form urine
        
        vascular pole
        
        both afferent and efferent arterioles attach to the glomerulus
        
        tubular pole
        
        where the renal tubule originates
        
        renal tubule
        
        resides in cortex except for nephron loop
        
        composed of simple single layer epithelium resting on a basement membrane
        
        3 sections
        
        proximal convoluted tubule (PCT)
        
        originates at tubular pole of renal corpuscle
        
        first region of renal tubule
        
        simple cuboidal eoithelium
        
        apical microvilli increase the surface area to increase reabsorption capacity
        
        2 more items...
        
        nephron loop (loop of Henle)
        
        originates at the sharp bend of the PCT
        
        ascending limb
        
        1 more item...
        
        descending limb
        
        1 more item...
        
        limb thickness
        
        2 more items...
        
        distal convoluted tubule (DCT)
        
        originates in the cortex at the end of the nephron loop's thick ascending limb and extends to a collecting tubule
        
        simple cuboidal epithelium
        
        sparse, short, apical microvilli
        
        cells types
        
        2 more items...
        
        cortical nephron
        
        renal corpuscles near the peripheral edge of the cortex
        
        short nephron loop
        
        85% of nephrons
        
        juxtamedullary nephrons
        
        renal corpuscles adjacent to the corticomedullary junction
        
        long nephron loops that extend deep into the medulla
        
        important in establishing a salt concentration gradient within interstitial space that lies outside of the nephron loop, collecting tubules, and collecting ducts
        
        allow for regulation of urine concentration by ADH
        
        collecting tubules
        
        nephrons drain into collecting tubules
        
        each kidney has thousands of them
        
        transition from cuboidal to columnar epithelium
        
        collecting ducts
        
        project through the renal medulla toward the renal papilla
        
        collecting tubules empty into collecting ducts
        
        empty into papillary ducts
        
        located in renal papilla
        
        most distal portion of collecting ducts
        
        empty into a minor calyx
  - - - abnormally high blood pressure
        
        leads to lack of filtration
        
        strain on cardiovascular system
    - - bone creation doesn't keep up with bone removal
      - bones become weak and brittle
    - - body doesn't produce enough insulin or it resists insulin
        
        retained sugar in blood
        
        polyuria, polydipsia, hunger, and fatigue
        
        body cannot use glucose for energy
- - - - due to high blood pressure