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WELCOME
University of Baghdad
College of Nursing
Department of Basic Medical Sciences
Overview of
Anatomy and Physioloy –II
Second Year Students
Asaad Ismail Ahmad , Ph.D.
Electrolyte and Mineral Physiology
[email protected]
2012 - 2013
ANATOMY AND PHYSIOLOGY - II
Brief Contents
1- Cardiovascular System
2- Blood
3- Lymphatic System
4- Urinary System
5- Male Reproductive System
6- Female Reproductive System
7- Sensory Function
Asaad Ismail Ahmad, Ph.D in Electrolyte and Mineral Physiology
College of Nursing – University of Baghdad / 2012 – 2013
[email protected]
Text book
Martini FH. Fundamentals of Anatomy and
Physiology, 5th ed. Prentice Hall, New Jersey,
2001.
References:
1.Barrett KE, Barman SM, Boitano S, Brooks HL. Ganong's Review of Medical
Physiology, 23rd ed. McGraw Hill, Boston, 2010.
2.Drake RL, Vogl W, Mitchell AWM. Gray's Anatomy for Students. Elsevier,
Philadelphia, 2005.
3.Goldberger ,E. 1975.A Primer of Water Electrolyte and Acid-Base
Syndromes. 5th ed., Lea and Febiger ,Philadelphia.
4. Martini, FH and Welch K. Applications Manual Fundamentals of Anatomy
and Physiology,4th ed., Prentice Hall, NewJersey, 1998.
5.Maxwell, MH and Kleeman CR. 1980.Clinical Disorders of Fluid and
Electrolyte Metabolism. McGraw-Hill Book Company, New York.
6.McKinley M, and O'Loughlin VD. Human Anatomy, McGraw Hill, Boston,
2006.
7.Nutrition Foundation.1984.Present Knowledge in Nutrition. 5th ed.,
Nutrition Foundation, Inc , Washington, D.C.
8.Vander A, Sherman J, Luciano D., Human Physiology, 7th ed., McGraw Hill,
Boston, 1998.
TENTH LECTURE
Physiology of Urinary System
1. Urine Formation
2. Micturation
3. Composition of Urine and
Urinalysis
Asaad Ismail Ahmad, Ph.D in Electrolyte and Mineral Physiology
College of Nursing – University of Baghdad / 2012 – 2013
[email protected]
GENERAL KIDNEYS FUNCTIONS
1-Maintaining volume of body fluids
(ECF & ICF)
2-Maintaining composition of body
fluids
3-Formation of urine (organization of
waste products)
KIDNEYS FUNCTIONS
(Formation of Urine)
MECHANISMS OF KIDNEY FUNCTIONS
p.953
1234-
FILTRATION
REABSORPTION
SECRETION
EXCRETION
Schematic of relations between blood
vessels and tubular structures
FILTRATION
Factors Glomerular Filtration
Depends on
1- Pressure gradient across the filtration slit(
endothelium, basal membrane,
epithelium”podocytes”.
2- Blood circulation through out the kidneys.
3- Permeability of filtration barrier.
4- Filtration surface.
Hormones affecting filtration
1- Antidiuretic hormone (ADH):
reabsorption of H2O.
2- Aldosterone: reabsorption of
Na+
3-Atrial natriuretic peptide:
decrease reabsorption of Na+
HORMONES EFFECT ON RENAL
FUNCTIONS
12345-
ADH ‘Antiduretic hormone’
PTH ‘Parathyroid hormone’
Aldosterone
Angeotinsin II
ANP ‘ Atrial Natriuretic hormone “
Hormones Secreted by Kidneys
1234-
Renin
Erythropoietin (EPO)
Calcitriol (Active vitamin D)
Prostaglandins
REABSORPTION
Reabsorption – Proximal convoluted
tubules
2/3 of filtered salt and water, and all filtered
organic solutes (primarily glucose and amino
acid)
1- 75 – 80 % water
2- Na+, Cl-, HCO3-, K+ , Ca2++ , Mg2++, HPO4—
3- Glucose and Amino acids
MECHANISMS OF TUBULAR
REABSORPTION p.958
12345-
Passive mechanism
Active mechanism
Paracellular route
Diffusion
Osmosis
SECRETION
Substances Secreted by
Renal Tubules p.965
1- Hydrogen ion (H+)
2- Potassium ion (K+)
3- Organic cation ( OC+) e.g.
epinephrine, choline, serotonin, atropine,
quinine, cimitidine, morphine, etc
4- Organic anion (OA-) e.g.
PAH, phenol red, hippurate, urate,
penicillin, barbiturate, diuretics,conjugates,
etc
SIGNIFICANT DIFFERENCES BETWEEN SOLUTE CONCENTRATIONS OF
URNE AND PLASMA P. 953
RENIN: Proteolytic enzyme synthesized,
stored, and secreted by the juxtaglomerular
cells of the kidney, it play a role in
regulation of blood pressure by catalyzing
the conversion of the plasma
angeotinsinogen to angeotinsin I.
ANGEOTINSIN - I. Convert to angeotinsin II in
the lungs .
ANGEOTINSIN - II. IS A POTENT
VASOCONSTRICTORS , and a powerful stimulus
of aldosterone secretion
Structure of the juxtaglomerular
apparatusfunction.
Urination (Micturation)
Process of disposing urine from urinary bladdder through the
urethra to outside the body
The process of urination is usually under voluntary control
Urinary incontinence :is the inability to control urination,
and is more common in women than men
Urinary retention: is the inability to urinate
Nocturia : is the incontenence during the night (effects of
emotions)
Micturition Reflex
1- Activated when the urinary bladder wall is stretched, it result
in urination.
2- This reflex occur in spinal cord, especially in the sacral region,
that is modefied by higher center in the brain, the pons and
cerebrum.
3-The presence of urine in the bladder stimulate stretch
receptors ,which produces action potential.
4- The action potential is carried by sensory neurons to the
sacral segments of the spinal cord through the pelvic nerves,
the parasympathetic fibers carry action potentials to the
urinary bladder in the pelvic nerves.
5- The pressure in urinary bladder increases rapidly once its
volume exceeds approximately 400- 500 ml.
Steps of Micturition
1- Distention of urinary bladder.
2- Stimulation of sensory fiber (afferent),send impulses
to micturition center in spinal cord.
3- Stimulation of parasympathetic nerve fiber (motor)
to :
a- to stimulate detrusor muscle in U.B.
b- relax internal urethral sphincter.
4- Sensation for urination as urgent.
Continue: Steps of Micturition
5- Urination prevented by
a- contraction of external urethral sphincter.
b- inhibition of micturition reflex by cerebral
cortex
6- Micturition (urination) occur after decision to
a- voluntry relaxation of external urethral
sphincter.
b- facilitation by impulsee from
hypothalamus.
7- Inactivation of micturition reflex center, and
relaxation of detrusor muscle
Measurement of renal function
A simple means of estimating renal function is
to measure pH, blood urea nitrogen,
creatinine, and basic electrolytes (including
sodium, potassium, chloride, and
bicarbonate). As the kidney is the most
important organ in controlling these values,
any derangement in these values could
suggest renal impairment.
Clearance
1- Ability of the kidneys to clear plasma from
different products.
2- Glomerular Filtration Rate (GFR )
3- GFR = U x V / P
U = concentration of inulin in urine
V = volume of urine
P = concentration of inulin in the plasma
Normal GFR is around 125 ml/min (7.5 l/h)
Assessing Renal function/
Measures of dialysis
1- Glomerular filtration rate
2- Creatinine clearance
3- Renal clearance ratio
4- Urea reduction ratio
5- Kt/V
6- Standardized Kt/V
7- Hemodialysis product
8- PAH clearance (Effective renal plasma flow
Extraction ratio)
Hemodialysis Process p.970
Plugged into dialysis
Urinary Tract Infection
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