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Urinary System Endocrine System Male Reproductive System Female Reproductive System Urinary System Anatomical structures – Kidneys – Adrenal glands – Ureters – Bladder – Urethra – CVA • Costovertebral angle • Kidney – gross anatomy – Cortex – Medulla • Pyramids • Papilla – Hilum – Pelvis • Calyx • Ureter • Kidney – microanatomy – Nephron • Glomerulus • Bowman’s capsule • Proximal collecting tubule • Henle’s loop • Distal collecting tubule • Collecting duct Note: cortex has everything medulla has only: loop of Henle Collecting tubules Functions of the kidney 1. Removes nitrogenous wastes – – – – Urea Uric acid Creatinine Ammonia 2. Maintains homeostasis – Fluid balance – Electrolyte balance – Acid-base balance 3. Excretory organ – Via blood filtration & formation of urine 4. Regulation of blood pressure – Juxtaglomerular apparatus (JGA) • Urine formation 1. Filtration – 2. Reabsorption – – 3. Occurs in proximal convoluted tubule It takes things back into blood Secretion – – 4. Occurs in renal corpuscle Occurs in distal convoluted tubule Blood gives things up to the urine Concentration – Occurs in collecting tubules Terms reflective of urinary function • • • • • • • • • Polyuria Oligouria Anuria Hematuria Pyuria Nocturia Dysuria Urinary retention Urinary incontinence Pathology of the Urinary System • • • • • • Urethritis Cystitis Glomerulonephritis Pyelonephritis Renal calculus (stones) Urine outflow obstruction – Hydronephrosis – Hydroureter Endocrine System 2 kind of glands 1. Exocrine --- have ducts to lead secretions to where they going 2. Endocrine --- no ducts; secretions (hormones) into bloodstream “official” Endocrine Glands – – – – – – – – – – Pineal Hypothalamus Pituitary Thyroid Parathyroids Thymus Pancreas Adrenals Ovaries Testes • Concept: – Many organs produce hormones (chemical messengers) Endocrine glands in `mixed function' organs and in exclusive function glands. Pineal Gland • Located near roof of third ventricle just above the thalamus • as one ages this gland becomes fibrous & calcifies • called “third eye” • because its secretion of melatonin is dependent on amount of light one sees (less light; more melatonin) • Melatonin’s actions: » may inhibit anterior pituitary gonadotropins » regulates the body’s internal clock • Also secretes Serotonin • serotonin levels effect depression • serotonin is a neurotransmitter Hypothalmus • Two things it does relating to the endocrine system – it makes the posterior pituitary hormones » oxytocin (OT) » antidiuretic hormone (ADH) – it controls the anterior pituitary by means of hormones it makes » Releasing Hormones * exp = GnRH (gonadotropin releasing hormone) » Inhibiting Hormones • It also acts as a connector between the nervous & endocrine system – For example, emotions originate there & stimulate the endocrine system – emotions = hunger, sex, pain, pleasure, anger, fear Pituitary Gland • Also called hypophysis – 2 parts: Anterior Pituitary (adenohypophysis) Posterior Pituitary (neurohypophysis) • Anterior Pituitary Posterior Pituitary • TSH * ADH (vasopressin) • ACTH * OT • FSH • LH • GH • PRL KNOW THE NAMES & FUNCTIONS OF EACH HORMONE • Key Point: the Posterior Pituitary is an extension of the Hypothalmus – Its two hormones are made in the hypothalmus and secreted from the axon terminals in the posterior pituitary. Diseases of the pituitary • • • • TSH – hypersecretion = hyperthyroidism – hyposecretion = hypothyroisism ACTH – hyposecretion = Addisonian synd. – hypersecretion = Cushingoid synd FSH – hyposecretion • F = low estrogen, amenorrhea • M = poor sperm production – hypersecretion • F = menopause LH – hyposecretion • F = no ovulation • M = low testosterone • GH – hypersecretion • during growth = giantism • after growth = acromegaly – hyposecretion = dwarfism • PRL – hypersecretion = galactorrhea, infertility – hyposecretion = poor milk production • ADH – hyposecretion = diabetes insipidus Thyroid Gland • 3 hormones • Thyroxine (T4) = more abundant than T3, but less potent • Triiodothyronine (T3) = more potent than T4 • Calcitonin • Thyroid hormones (T4 & T3) – function is to increase the metabolic rate – hyperthyoidism • Grave’s disease = one type; inherited; get exopthalmos – hypothyroidism • cretinism = congenital type • myxedema = adult type • Hashimoto’s disease = autoimmune; chronic inflam. produces fibrosis • Calcitonin – lowers serum calcium by preventing the bones from giving it up – works in harmony with the parathyroid & parathormone Parathyroid Glands • • Normally 4 glands located on posterior surface of thyroid • may have up to 8 glands produces hormone: Parathormone (PTH) – it increases calcium in blood by breaking down bone to release calcium – it works in conjunction & opposite calcitonin – hypersecretion = hypercalcemia (get hyperparathyroidism) • symptoms = muscle weakness + SOUP • Secondary Hyperparathyroidism more common – Etiology = decrease serum calcium secondary to: » Renal disease » Cancer » Endocrine diseases (Grave’s & Addison’s) – hyposecretion = hypocalcemia ( get hypoparathyroidism) » symptoms = tetany + hyperexcitible nervous system » Commonest etiology = metastatic cancer to bone (gives increase in serum calcium) Thymus • Located behind the manubrium • prominent in the newborn; by age 21 it atrophies • produces hormone: Thymosin • it matures T- lymphocytes – after they have been acted upon by the thymus, they are sent for storage & future activation » this occurs in the lymph nodes & spleen Pancreas • Pancreas is both endocrine & exocrine gland – exocrine = digestive enzymes secreted via duct into duodenum – endocrine located in Islets of Langerhans • has 2 types of cells each producing its own hormone – alpha cells produce glucagon » it raises blood sugar by increasing liver glycogenolysis – beta cells produce insulin » it lowers blood sugar by escorting glucose into the cells – lack or improper response to insulin gives diabetes mellitus • Insulin Dependent Diabetes Mellitus(IDDM) = Type I – autoimmune; get decreased production of insulin • Non Insulin Dependent Diabetes Mellitus(NIDDM) = Type II – get cellular insensitivity to insulin Diabetes Mellitus • As cells deprived of sugar, they begin to metabolize fats & proteins • This process allows wastes(ketone bodies) to accumulate • Etiology = autoimmune process triggered by an infection early in life • Main systems affected: » Vascular » Renal » Eye • Symptoms = polyuria, polyphagia, & polydipsia • Fruity odor to breath • Complications – Diabetic coma ---- lethargy, dry (dehydrated) – Insulin shock ---- anxiety, sweating Adrenal, Cortex & Medulla Adrenal Cortex • Has 3 distinct layers or zones – from outside towards middle: • secretes mineralcorticoids (Aldosterone) • secretes glucocorticoids (Cortisol) • secretes gonadocorticoids (sex steroids) • Mineralcorticoids retain water + sodium & excrete potassium – purpose = to maintain blood volume & electrolyte balance • Glucocorticoids make glucose especially in times of prolonged stress – this glucose made by increased metabolic breakdown of protein & fat » Thus cortisol is catabolic, not anabolic – also is anti-inflammatory – also maintains blood pressure Adrenal Medulla • Produces 2 hormones » Epinephrine (Adrenalin) » Nor-epinephrine (Nor-Adrenalin) • These very important during stressful situations • They are under the control of the sympathetic nervous system – also known as the adrenergic nervous system – deals with Fear, Flight, or Fight » It produces excess epinephrine Diseases of the Adrenal Cortex – even though there are 3 different classes of hormones, most diseases affect primarily the glucocorticoids – Hypersecretion • Cushing’s Disease (MOODIAH) – Moon face; Obesity & edema from salt & water retention; Osteoporosis; Diabetes; Infections; Atherosclerosis; Hypertension – Hyposecretion • Addison’s Disease – get hypotension, fatigue, weakness, & weight loss – get dehydration & hyperkalemia* (from lack of aldosterone) – get bronze skin color & pigmentation * This can become life threatening The Gonads Testes • Secretes testosterone • Produces sperm Ovaries • Secretes estrogen • Secretes progesterone • Produces mature ova Male Reproductive System • Scrotum • Testes – Seminiferous tubules • • • • Epididymis Vas deferens Ejaculatory duct Penis • Urethra • Glans penis • Prepuce • • • • Seminal vesicles Prostate Bulbourethral glands Semen • Testis – Seminiferous tubules – Hormones produced • Pathology – BPH • Benign prostatic hypertrophy – Testicular cancer Female Reproductive System • • • • • • • • • Vulva Vagina Vestibule Labia majora Labia minora Clitoris Bartholin’s glands Perineum Breasts – Lactiferous ducts – Areola & nipple • Ovaries • Fallopian tubes • Uterus – Fundus, corpus, cervix • Menstrual cycle – – – – Menses Proliferative phase Ovulation Secretory phase • Breast – Ducts – Areola – Nipple • Pathology – Cancer • • • • Breast Uterus Cervix Ovarian – Endometriosis – PID – PMS STD’s • • • • • • • • • causative agent comments Chlamydia bacteria most common, “silent” STD Gonorrhea bacteria Penicillin resistant At birth, Crede procedure is done to the baby’s eyes Syphilis bacteria 3 stages, penicillin treats it Hepatitis B virus babies vaccinated at birth Hepatitis C virus Herpes virus HPV (papilloma) virus warts, causes cervical ca HIV virus use condoms, test frequency Vaginitis – Monilia – BV – Trichomonas fungus bacteria protozoa All these vaginal infections may or may not be STD’s!!
