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Elderly Female/ blood in urine/ history of osteoporosis, chronic type II…

- - - - Nephron
        
        microscopic filtration unit of kidney
        
        Renal Tubule
        
        Nephron loop
        
        connect at a "hairpin turn" within the medulla, lining changes from simple cuboidal to simple squamous then back
        
        Distal convoluted tubule (DCT)
        
        originates in renal cortex at end of ascending limb, extends to collecting ducts, lined by simple cuboidal w/o microvilli
        
        Proximal convoluted tubule(PCT)
        
        originates at tubular pole of renal corpuscle, lined by simple cuboidal epithelium, has microvilli increasing surface area and reabsorption capacity
        
        Renal Corpuscle
        
        Glomerulus; tangle of capillary loops,glomerular capillaries
        
        blood entering by afferent arteriole; exits by efferent arteriole
        
        Glomerular capsule
        
        internal permeable visceral layer; external impermeable parietal layer;capsular space between two layers
        
        Cortical nephrons
        
        oriented with renal corpuscles near peripheral cortex; have short nephron loop; bulk resides in cortex; 85% of nephrons
        
        Juxtamedullary nephrons
        
        renal corpuscles adjacent to corticomedullary junction; long nephron loops; critical to kidney's ability to produce concentrated urine
        
        Filtration
        
        The movement of substances from the blood within the glomerulus into the capsular space
        
        in glomerular capillaries; some water and solutes entering capsular space of renal corpuscle
        
        separated fluid termed filtrate
        
        Reabsorption & Secretion
        
        The movement of substances from the tubular fluid back into the blood
        
        The movement of substances from blood into the tubular fluid
        
        Movement of Potassium
        
        60% to 80% reabsorbed in tubular fluid
        
        net secretion or reabsorption in collecting ducts; principal cells secrete K+ at varying rates
        
        based on aldosterone level which stimulate principal cells to secrete K+
        
        most powerful stimulant for aldosterone, elavated K+ levels
        
        Nutrient reabsorption
        
        some 100% reabsorbed; nutrients normally completely reabsorbed in PCT
        
        each nutrient with its own specific transport protein
        
        Calcium and phosphate balance
        
        parathyroid hormone regulates excretion of Ca2+
        
        stimulates Ca2+ reabsorption in DCT; Ca2+ blood levels increased
        
        Transport of protein
        
        most not freely filtered; some small and medium sized in filtrate
        
        reabsorbed from tubular fluid in PCT back into blood
        
        Water
        
        nephron loop= only 10% of filtered water reabsorbed
        
        DCT and collecting ducts- controlled by aldosterone and ADH
        
        180L filtered daily; all but 1.5 L reabsorbed; 65% reabsorbed in PCT
        
        Aquaporins regulated by ADH near end of tubule; tubular reabsorption termed facultative water reabsorption
        
        Antidiuretic hormone increases water absorption; results in smaller volume of more concentrated urine; with decrease of ADH, urine less concentrates
        
        Sodium reabsorption
        
        majority reabsorbed in PCT; regulated by hormones near end of tubule
        
        Aldosterone; steroid hormone produced by adrenal cortex
        
        increase in Na+ reabsorption; decrease urine production, increasing blood volume and pressure
        
        Atrial natriuretic peptide: hormone released from cardiac muscle cells
        
        inhibits reabsorption of Na+ in PCT and collecting ducts; inhibits release of aldosterone; more Na+ and water excreted in urine
        
        Bicarbonate ions, hydrogen ions, & pH
        
        pH of urine and blood regulated in collecting ducts
        
        if blood in acidic state
        
        synthesize HCO3- reabsorbed into blood; H+ secreted into filtrate by type A intercalated cells; increased blood pH and decrease urine pH
        
        if blood in alkaline state
        
        type B intercalated cells active; secrete HCO3- and reabsorb H+; lower blood pH and increase urine pH
      - Collecting ducts
        
        Principal cells
        
        responsive to hormones aldosterone and antidiuretic hormone; responsible for maintaining body's water and Na+ balance
        
        Intercalated cells (types A & B)
        
        both specialized epithelial cells; help regulate urine pH and blood pH
        
        Nephron drainage
        
        ducts project medially toward renal papilla; ducts fuse together and deliver urine into minor calyces via papillae of medulla pyramids
  - - - chronic disease characterized by high levels of sugar in the blood, due to body's inability to effectively break glucose down
      - body stops responding to normal or high levels of insulin
    - - blood flowing through blood vessels, or arteries, at a higher than normal pressure
    - - disease characterized by low bone mass and structural deterioration of bone tissue
      - leads to bone fragility and an increased risk of fractures of the hip, spine, and wrist