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CHAPTER 31 The Urinary System © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 31-2 Learning Outcomes (cont.) 31.1 Describe the structure, location, and functions of the kidney. 31.2 Explain how nephrons filter blood and form urine. © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 31-3 Learning Outcomes (cont.) 31.3 Compare the locations, structures, and functions of the ureters, bladder, and urethra. 31.4 Describe the causes, signs and symptoms, and treatments of various diseases and disorders of the urinary system. © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 31-4 Introduction Kidneys Ureters Bladder Urethra • System functions to remove waste products from the blood • Nephrons filter the blood and form the urine © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 31-5 The Kidneys • Maintain homeostasis – Remove metabolic waste products – Secrete hormones • Erythropoietin • Renin – Retroperitoneal at level of lumbar vertebrae Kidneys © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 31-7 The Kidneys (cont.) • Renal sinus – Concave depression on the kidney's surface – Hilum • Renal pelvis – Expansion of the ureter – Divides into calyces Kidney © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 31-8 The Kidneys (cont.) • Renal cortex – outermost layer • Renal medulla – Middle portion – Divides into renal pyramids • Renal column – between pyramids Kidney © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 31-10 Nephrons • Renal corpuscle – Glomerulus ~ capillaries – Bowman’s capsule Nephron © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 31-11 Nephrons • Renal tubules – extend from Bowman’s capsule – Proximal convoluted tubule – Loop of Henle – Distal convoluted tubule Nephron © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 31-12 Nephrons (cont.) Renal artery Renal vein Afferent arterioles Peritubular Capillaries Glomerulus Efferent arterioles Nephron © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 31-14 Apply Your Knowledge What is the function of the kidney? ANSWER: Maintain hemostasis by removing metabolic waste products from the blood, secreting erythropoietin to help regulate RBC production, and secreting renin to help regulate the BP. Correct! © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 31-15 Urine Formation • Glomerular Filtration – Occurs in renal corpuscles – Fluid part of the blood • Into Bowman’s capsule • Becomes glomerular filtrate Glomerulus © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 31-16 Urine Formation (cont.) • Glomerular filtration – Filtration pressure – that needed to force filtrate from the glomerulus into Bowman’s capsule – Rate of filtration • Sympathetic nervous system control • Constriction of afferent arterioles Glomerulus © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 31-18 Tubular Reabsorption • Glomerular filtrate proximal convoluted tubule • Reabsorption of needed substances • Water reabsorption hormonal regulation – Antidiuretic hormone (ADH) – Aldosterone – water reabsorption, urine production Tubular Reabsorption © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 31-19 Tubular Secretion • Substances move from blood in the peritubular capillaries into the renal tubules • Secreted substances – Drugs – Hydrogen ions – Waste products Tubular Secretion © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 31-21 Urine Composition • Mostly water • Urea and uric acid • Trace amounts of amino acids and various ions • Secretion of waste products helps to maintain the acid-base balance © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 31-22 Apply Your Knowledge Match the following: ANSWER: B Second process in urine formation ___ C Substances move from blood ___ into renal tubules reabsorption A Depends on filtration pressure ___ A. Glomerular filtration B. Tubular Reabsorption C. Tubular Secretion C Third process of urine formation ___ A First process of urine formation ___ B Filtrate flows into the proximal convoluted tubule ___ © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 31-24 Urinary Bladder • Trigone – triangle on internal floor of bladder • Detrusor muscle – smooth muscle of bladder wall • Micturition – Process of urination – Triggered by stretching of the bladder Bladder © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 31-26 Urinary Bladder (cont.) • Micturition Brain stem and cerebral cortex Impulses to contract urethra inhibit micturition impulse until ready to urinate Spinal cord Parasympathetic nerves stimulate detrusor muscle Stretch receptors Bladder distends © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 31-27 Urethra • Moves urine from the bladder to the outside world • Shorter in females – patient education – Urinate when urge occurs – Drink adequate clear fluids – Wipe front to back – Urinate after intercourse Urethra © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 31-28 Apply Your Knowledge True or False: ANSWER: T Ureters move urine by peristalsis. ___ F The detrusor is formed by the openings of the ureters ___ and urethra. trigone T The process of micturition is triggered when the bladder ___ contains about 150 ml urine. ureters F The urethra move urine from the kidney to the bladder. ___ F The urethra is longer in females. ___ males T Contraction of the detrusor muscle pushes urine from ___ the bladder. © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 31-29 Diseases and Disorders of the Urinary System Disease/Disorder Description Acute kidney (renal) failure Chronic kidney (renal) failure Cystitis Sudden loss of kidney function; may be reversible with treatment Kidneys slowly lose ability to function; not reversible Urinary bladder infection; more common in females © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 31-30 Diseases and Disorders of the Urinary System Disease/Disorder Description Glomerulonephritis Inflammation of the glomeruli of the kidney; one cause of chronic renal failure Incontinence Inability to control urination Polycystic kidney disease Enlargement of kidneys because of the presence of many cysts within them; slow, progressive disease © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 31-31 Diseases and Disorders of the Urinary System Disease/Disorder Description Pyelonephritis Renal calculi Complicated urinary tract infection; begins with a bladder infection and spreads to both kidneys; can be acute or chronic Kidney stones; can become lodged in ducts within kidneys or ureters © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 31-32 Apply Your Knowledge Matching: ANSWER: G O B. Glomerulonephritis O C. Incontinence D D. Chronic renal failure J E. Renal calculi O F. Cystitis B G. Acute renal failure H. Polycystic kidney disease ! A Complicated urinary tract infection A. Pyelonephritis ___ ___ C Inability to control urination E Kidney stones ___ D Slow loss of kidney function ___ ___ F Bladder infection B Inflammation of the glomeruli ___ H Kidney enlargement due to cysts ___ G Sudden loss of kidney function ___ © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 31-33 In Summary 31.1 The retroperitoneal kidneys are composed of the outer renal cortex and inner renal medulla. Their function is to remove metabolic wastes from the body. © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 31-34 In Summary 31.2 A nephron is a single kidney cell. It is composed of a renal corpuscle composed of the glomerulus and the Bowman’s capsule and the three sections of the renal tubule: the proximal convoluted tubule, the loop of Henle, and the distal convoluted tubule. The nephrons filter blood and form urine through three processes: glomerular filtration, tubular reabsorption, and tubular secretion. © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 31-35 In Summary (cont.) 31.3 The ureters are long tubes extending from each renal pelvis that bring urine to the bladder for storage. The urethra is the muscular tube extending from the bladder that allows urine to be expelled from the body. © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 31-36 In Summary (cont.) 31.4 There are many common diseases and disorders of the urinary system with varied signs, symptoms, and treatments. Some of these include acute kidney (renal) failure, chronic kidney (renal) failure, cystitis, glomerulonephritis, incontinence, polycystic kidney disease, pyelonephritis, and renal calculi. © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 31-37 End of Chapter 31 This too shall pass—just like a kidney stone. ~H. Madson © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.