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Download Kidney Failure - North Buncombe High School
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HS I Warm up • Urinary System Video http://www.youtube.com/watch?v=QT5S4h TdigU&feature=related • Worksheet Functions of Urinary System • To remove waste products from the • • • • body. Excretion – removing nitrogenous wastes, certain salts and excess water from blood. Maintain acid-base balance Secrete waste products in the form of urine Eliminate urine from bladder KIDNEYS • Bean-shaped organs • Located between peritoneum and the back muscles (RETROPERITONEAL) • RENAL PELVIS – funnel shaped structure at the beginning of the ureter MEDULLA • Inner, striated • • layer Striated cones are RENAL PYRAMIDS Base of each pyramid faces cortex, while apex empties into cuplike cavities called CALYCES CORTEX • Composed of millions of microscopic functional units called nephrons • Outer layer of the kidney NEPHRON • Functional unit of the kidney • Parts include: • – Bowman’s capsule (double walled, surrounds the glomerulus) – Cluster of capillaries that the Bowmans capsule surrpounds is the Glomerulus – Glomerulus- filters substances from the blood. – Proximal convoluted tubule – Loop of Henle – Distal convoluted tubule – Collecting tubule Urine Formation in the Nephron • Filtration • Reabsorption • Secretion FILTRATION • First step in urine formation • Blood from renal artery enters glomerulus • High blood pressure in glomerulus forces fluid • • • • (FILTRATE) to filter into Bowman’s capsule Filtrate does not contain plasma proteins or RBCs – they’re too big Bowman’s capsule filters out 125cc of fluid/min. – 7500cc/hour As filtrate continues through nephron, 90% of water is reabsorbed Production of urine is controlled by the hormones ADH and Aldosterone REABSORPTION • Water and useful substances are reabsorbed • If blood levels of certain substances are high (glucose, amino acids, vitamins, sodium) then those substances will not be reabsorbed • Useful substances filter out of the renal tubules and back into the capillaries SECRETION • Opposite of reabsorption • Secretion transports substances from blood into collecting tubules • Substances include creatinine, hydrogen ions, potassium ions, and some drugs • Electrolytes are selectively secreted to maintain body’s acid-base balance Path of the Formation of Urine • Glomerulus • Bowman’s Capsule • Proximal Convoluted Tubule • Loop of Henle • Distal Convoluted Tubule • Collecting Tubule URETERS • Connects the kidneys to the bladder. • One from each kidney • Carry urine from kidney to bladder • Smooth muscle tube with mucous membrane lining • Peristalsis pushes urine down ureters URINARY BLADDER • Located in the pelvic • • • • cavity. Hollow, elastic, muscular organ Made of elastic fibers and involuntary muscle Stores urine – usually about 500cc Emptying urine (voiding) is involuntary but controlled through nervous system (voluntary) • Urine leaves through URETHRA to outside opening = URINARY MEATUS Control of Urinary Secretion • Chemical Control – Reabsorption of H20 in distal convoluted tubule controlled by ADH (antidiuretic hormone) – Secretion and regulation of ADH controlled by hypothalamus – DIURETICS inhibit reabsorption of H20 • Nervous Control – Direct control through nerve impulses on kidney blood vessels – Indirect control though stimulation of endocrine glands Processing • Labeling activities • Quiz 1 Warm Up • Kidney Failure• • • http://www.youtube.com/watch?v=BodnYcHGtiA Hemodialysishttp://www.youtube.com/watch?v=shFSW8VE3 Gs , http://www.youtube.com/watch?v=TJsVjtsTFBQ Kidney Transplanthttp://www.youtube.com/watch?v=wBBlJh1vIZc Kidney Stoneshttp://www.youtube.com/watch?v=mTR35kSDB so Common Urinary Terms • • • • • • • • ENURESIS – bedwetting GLYCOSURIA – sugar in urine NOCTURIA – frequent urination at night POLYURIA – large amounts of urine PYURIA – pus in urine ANURIA – no urine produced HEMATURIA – blood in urine Incontinence- urinating involuntarilyelderly, stroke patients Urinary Output • Average = 1500 ml/day • Kidney’s filter 120 ml (1/2 cup) per minute • URINALYSIS – test to check for glucose, protein, blood and specific gravity of urine. Abnormal if any of these is present. • Normal urine color is pale yellow • What could make the urine dark amber colored? Urinary Disorders… • CYSTITIS – Inflammation of the mucous membrane lining of the urinary bladder – Most common cause bacteria – E. Coli – Where does E. Coli live? – Symptoms – DYSURIA (painful urination) and frequency – Usually in females (shorter urethra) – Rx – antibiotics Glomerulonephritis Disease which injures the glomerulus. What will the kidney’s not be able to do if the glomerulus is damaged? • If glomerulonephritis occurs on its own, it's known as primary glomerulonephritis. • If another disease, such as lupus or diabetes, is the cause, it's called secondary glomerulonephritis. • If severe or prolonged, the inflammation associated with glomerulonephritis can damage your kidneys. Causes Hypertension Kidney Infections Lupus Goodpasture’s Syndrome- rare immunological lung disorder- causes bleeding into the lungs and kidney’s Glomerulonephritis Symptoms • Pink or cola-colored urine from red blood cells in your urine (hematuria) • Foamy urine due to excess protein (proteinuria) • High blood pressure (hypertension) • Fluid retention (edema) with swelling evident in your face, hands, feet and abdomen • Fatigue from anemia or kidney failure Glomerulonephritis Treatment • Anti-hypertensive drugs- hypertension • Strep or bacterial infection- antibiotics • Lupus- steroids • Goodpasture’s Syndrome- Plasmapheresismechanical process that removes antibodies from your blood by taking some of your plasma out of your blood and replacing it with other fluid or donated plasma. RENAL CALCULI or NEPHROLITHIASIS • Made of crystals of calcium phosphate and uric • • • • • acid Gradually they get larger until they block ureters and the flow of urine First symptom – severe pain Other symptoms – nausea and vomiting, frequency, chills, fever, hematuria Diagnosis – by symptoms, ultrasound, or x-ray Rx – increase fluids to flush out stone, medications, and if needed – LITHOTRIPSY LITHOTRIPSY • Breaks up renal calculi using shock waves. • Surgical procedure to remove kidney stones • Done on outpatient basis • If this does not work, a ureoscopy will be done. Kidney Failure • Toxic waste accumulate in the cells poisoning the them • An early sign of acute kidney failure is oliguria. Causes • Diabetes- most common cause • Damaged Glomeruli • High Blood Pressure • Glomerular Diseases • Inherited and Congenital Kidney Diseases • Poison and Trauma Symptoms • Changes in urination • Swelling • Skin rash/ itching • Leg, back and side pain • Metallic taste/ ammonia breath • Nausea and vomiting • Feeling cold • Shortness of breath • Fatigue • Dizziness and trouble concentrating Test for Kidney Failure • Blood pressure measurement • Urine test to measure waste removal (can be done by a dipstick or more complete urinalysis) • Blood test to measure waste removal Treatment for Kidney Failure DIALYSIS (HEMODIALYSIS) – Treatment for kidney failure – Involves the passage of blood through device with semipermeable membrane – Dialysis serves as substitute kidney – Blood from patient flows through machine and is filtered – Can be done at home or in clinic – Takes 2-4 hours, 2-3 times a week Peritoneal Dialysis • KIDNEY TRANSPLANT – As a last resort – Involves donor organ from someone with a similar immune system, tissue match and same blood type. – Main complication – rejection Processing • Processing Questions- Disorders • Read the article – Kidney Transplantation • With the group at your table, read the Medical Decisions Worksheet. With the information you have been given in the article, decide which person should get the kidney. Be able to support your decision and share with the class.
