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Blood in Urine ((High Blood Pressure (chronic hypertension leads to…
Blood in Urine
High Blood Pressure
chronic hypertension leads to decrease in blood flow at the microscopic level especially at the afferent arteriole. The decrease in blood flow reduces blood flow into the glomerulus which decreases NFP and GFR, severely damaging kidney function.
DM II
high blood sugar levels can cause blood vessels to become narrow and clogged over time leading to severe damage. Also damages the filter in your kidney and leads to build up of waste and fluids that are supposed to be excreted in your urine.
Osteoporosis
patients already low calcium levels would be exacerbated by decreased kidney function. She would further lose any calcium reabsorption than she already has if her kidney function decreases.
Blood in Urine
Hematuria causes can be UTI, kidney/bladder cancer, irritation/swelling in your kidneys, blood clots, kidney stone, trauma.
Medications
what medications is the patient taking for any of her pre existing conditions? if Any? Some medications can further decrease her ability to re absorb fluids or cause further bleeding.
Hydration level
what is the patients hydration level before she came to the doctor? does she adequately intake fluid levels daily? Or does she have a poor diet with hardly any fluid intake?
Number of Kidneys
Does the patient have both of her kidneys present? Some people are born without one of their kidneys or they can lose a kidney by donating it to a person in need or by previous trauma.
Urine Formation
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Glomerular Filtration
is a passive process in which hydrostatic pressure forces fluids and solutes through a membrane. Takes place in the renal corpuscle and produces a cell and protein free filtrate.
Tubular Reabsorption
process of selectively moving substances from the filtrate back into the blood. Takes place in the renal tubules and collecting ducts. Reclaims almost everything filtred, all of the glucose, amino acids, 99% of water, salt, and other components.
Tubular Secretion
process of selectively moving substances from the blood into the filtrate. It also occurs along the length of the tubule and collecting duct.
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Reabsorption of Sodium
Sodium Ions are the single most abundant cation in the filtrate, and about 80% of the energy used for active transport is devoted to reabsorbing them
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High Blood Pressure
common condition in which the force of blood against your arteries is high and can lead to weakening of the vessels and other problems related to heart disease
Osteoporosis
a bone disease in which the body loses too much bone, or makes too little of it, or both. This leads to weak and brittle bones which can break easily
Diabetes Mellitus II
a chronic condition in which blood sugar levels are chronically high and your body becomes resistant to its own insulin
Urinary Anatomy
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Bladder
a smooth, collapsible, muscular sac that stores urine temporaily
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Anatomy of Kidney
External Anatomy
renal fascia
outer layer of dense fibrous connective tissue that anchors the kidney and the adrenal gland to surrounding structures
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Internal Anatomy
renal cortex
most superficial region, light colored and granular in appearance
renal medulla
deep to the cortex is the darker, reddish brown medulla, which exhibits cone shaped tissue masses called renal pyramids
renal pyramids
appear striped because they are formed of almost entirely of parallel bundles of microscopic urine collecting tubules and capillaries
renal columns
inward extensions of cortical tissue, separate the pyramids
renal pelvis
funnel shaoed tube, is continuous with ureter leaving hilum
Nephron
structural and functional units of the kidneys. Each kidney contains about 1 million nephrons working together to make urine
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Juxtamedullary Nephrons
play an important role in the kidneys ability to produce urine that is concentrated (which conserves water). Have long nephron loops that deeply invade the medulla, and their ascending limbs have both thin and thick segments
Juxtaglomerular Complex
each nephron has a JGC, which includes three populations of cells that help regulate the rate of filtrate formation and systemic blood pressure
macula densa
group of tall closely packed cells in the ascending limb of the nephron loop that lies adjacent to the granular cells. These cells are chemoreceptors that monitor the NaCl content of the filtrate entering the distal convoluted tubule.
Granular Cells
are in the arteriolar walls. They are enlarged smooth muscle cells with prominent secretory granules containing the enzyme renin. Granular cells act as mechanoreceptors that sense the blood pressure in the afferent arteriole.
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renal corpuscle
each renal corpuscle consists of a tuft of capillaries called a glomerulus and a cup shaped hollow structure called a glomerular capsule or Bowmans capsule
Glomerulus
endothelium of the glomerular capillaries is fenestrated, making it exceptionally porous. Allows large amounts of solute rich but protein free fluid to pass from the blood into the glomerular capsule, called filtrate the basis for urine
Glomerular Capsule
consists of podocytes which have foot processes that cling to the basement membrane of the glomerulus. Openings between foot processes are called filtration slits, through these filtrate enter the capsular space inside the glomerular capsule
renal tubule
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Distal Convoluted Tubule
made of cuboidal epithelial cells and confined to the cortex, but are thinner and lack microvilli
collecting duct
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principal cells
more numerous and have sparse, short microvilli and are responsible for maintaining the bodys water and Na+ balance.
intercalated cells
cuboidal cells with abundant microvilli, two types A and B and play a role in maintaining the acid base balance of the blood.
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