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an elderly patient has a history of osteoporosis, chronic type 2 diabetes…

- - - - glomerulus
        
        tangle of capillary loops
        
        afferent arteriole
        
        blood entering by
        
        efferent arteriole
        
        exits by
      - glomerular capsule
        
        external impermeable parietal layer
        
        composed of simple squamous epithelium
        
        capsular space between two layers
        
        receives filtrate, motified to form urine
        
        has internal permeab le visceral layer
        
        directly overlieds glomerular capillaries
    - - nephron loop
        
        connect at a "hairpin turn" with the medulla
        
        lining charges from simple cuboidal epithelium (thick segment) to (thin segment)
        
        contains decending limb and ascending limb
      - distal convoluted tubule (DCT)
        
        extends to collecting duct
        
        lined by simple cuboidal epithelium without microvilli
        
        originates in renal cortex at end of ascending limb
      - proximal convoluted tubule (PCT)
        
        originates at tubular pole of renal tubule
        
        lined by simple cuboidal epitheliun
        
        first region of renal tubule
        
        have microvilli increasing surface area and reabsorbtion capacity
    - - consists of renal corpucle and renal tubule
      - all of corpuscle and most of tubules residing in cortex
      - microscopic functional filtration unit of kidney
    - - length of loop
      - cortical nephrons
        
        oriented with renal corpuscles near peripheral cortex
        
        85% of nephrons
      - based on position of nephron in cortex
      - juxtamedullary nephrons
        
        play important role in kidneys ability to produce concentrated urine
        
        water convervation tactic
  - - - filter
      - electrolye balance
    - - muscular tubes extending from the kidneys to urinary bladder
      - two : one for each kidney
    - - collects urine before it is excreted from body
      - can store 1 liter of urine
    - - tube that connects the urinary bladder to external genitalia
    - - major organ of urinary system
      - maintain electrolytes and acqid bases
      - filters the blood
  - - - some substances reabsorbed from tubular fluid back into blood
      - 320 mg/min
      - some substances 100 reabsorbed
      - two major classes
        
        filtered plasma proteins
        
        nutrients
      - competely reabsorbed through PCT
    - - some subsrtances not orginally filtered in glomerulus become components of urine through tubular secretion
    - - both water and solutes filtered from blood plasma
      - moves across wall of glomerular capillaries and into capsular space
      - blood flowing through glomerulus
      - filtered plasma with certian soultes and minimal amounts of protiens
      - freely filtered
        
        water glucose amio acids ions
        
        small substances
      - not filtered
        
        formed elements
        
        most protiens
  - - - prevents body from properly using the energy from the food you eat
      - pancreas produces
        
        little insulin
        
        no insulin
    - - high blood pressure
      - can cause significant cardiovascular and organ damage
      - systolic blood pressure is higher than 120mmHg and your distolic blood pressure is abov e 80mmHGg
    - - can result in painful fractures
      - conditions that affects the bones
      - thinning of bones
      - ''silent disease''
      - brittle bones