Water, Electrolyte, Acid-Base Balance Flashcards
Describe the main components of extracellular fluid
Extracellular (outside cell membrane): increased Na+ (90% of sodium), Ca+2,Cl-, HCO3
How much of the water is extracellular
1/3
Most important component of extracellular fluid is
Na
Describe the main components of intracellular fluid
Increased amounts of K,
Mg, PO4 -3, SO4 -2,
Most important component of intracellular fluid
K
Percentage of water in intracellular fluid
75%
What makes molecules move from intracellular to extracellular regions?
Osmotic pressure
Extracellular components
Na, Ca, Cl, HCO3, water
Intracellular components
K, Mg, PO4, SO4, water
Discuss sodium potassium output in the renal system
Na + your body conserves
Renal tubules increase the reabsorption of Na and excrete the K
Discuss Ca +2 balance in the renal system
Renal tubules conserve the Calcium for bones and muscle flexion
2. Phosphate is excreted
Ca +2 is regulated by which gland?
Parathyroid gland
Kidneys function in electrolyte balance
Regulate Na and K, Ca and PO4,
Help make sure you have perfect amount of ions to maintain homeostasis
Discuss the bicarbonate buffer system in detail
- One of three ways in which blood pH is maintained
- H+ HCO3—> H2CO3 —> H+ HCO3
- The bicarbonate ions convert a strong acid to a weak acid. Meanwhile, the carbonic acid converts a strong base to a weak base.
Helping maintain pH in the blood.
Acids have an excess amount of
Hydrogen ions
Bases have an excess of
OH
Human blood pH
7.35-7.45
Three ways in which blood pH is maintained
- Bicarbonate buffer system
- Phosphate buffer system
- Protein buffer system
Why is it bad for people’s blood pH to change?
People can die
List three ways to regulate hydrogen concentration
- Bicarbonate system
- Phosphate system
- Protein system
How does the bicarbonate system help regulate hydrogen concentration
Uses the Carbon and hydrogens, goes back and forth between bicarbonate and carbonic acid
How does the phosphate system help regulate hydrogen ion concentration
Uses phosphates
Goes back and forth with hydrogen
What are the acidic values on the pH scale
0 to 7
What are the basic values on the pH scale
7 to 14
What is a neutral pH
7
Which value represents severe acidosis in the blood
6.8
Which value represents severe alkalinity in the blood
8
List the four types of pH clinical problems giving symptoms
- Respiratory acidosis
- Respiratory alkalosis
- Metabolic acidosis
4.Metabolic Alkalosis
CO2 is
Acidic
Respiratory acidosis
Patient is not breathing well and removing carbon dioxide from body
- increased CO2 and increased carbonic acid
What are the symptoms of respiratory acidosis
- Not breathing well
Respiratory alkalosis
Hyperventilation
Getting CO2 out but not getting Oxygen in well
Symptoms of respiratory alkalosis
-lightheadedness
-dizziness
-agitation
-hyperventilation
Metabolic acidosis
Think digestion
-Kidneys start to fail during metabolic acidosis
-diarrhea and vomiting
Metabolic alkalosis
-think about diuretics
-vomiting
-decrease in gastric acid
Homeostasis
Bodies tendency to maintain a stable internal balance
How do water and electrolytes enter and exit the body
Water and electrolytes have equal amounts that enter and leave the body intake equals output
Water and electrolyte balance are interdependent true or false
True
Detrustors
Muscles that contract to control urination are
Electrolytes
Substances that release ions in water
Acids
Electrolytes that dissociate to release hydrogen ions into water
Bases
Substances that release ions that can combine with hydrogen ions
Salts
Electrolytes formed by the reaction between an acid and a base
Anaerobic respiration body makes energy without
Oxygen , helps release H+ in process
Anytime anaerobic respiration occurs to make energy , it’s going to release
H+ ,
What rises when we break down sulfur and amino acids
H+
Indicates concentration of hydrogen ions in solution
pH
Indicates concentration of hydrogen ions in solution
PH
Indicates equal concentrations of hydrogen and hydroxide
Neutral pH 7
Occurs when blood pH rises to 7.5 to 7.8
Alkalosis occurs
Occurs when blood pH drops to 7.0 to 7.3
Acidosis
Chemicals which act to resist pH changes
Buffers
Inorganic substances
Small compounds that do not contain the atoms carbon and hydrogen
Water
-Polar molecule that demonstrates hydrogen bonding
-universal solvent
Blood moves around inorganic salts t/f?
True
Amount of Intracellular water
2/3 of water
Amount of extracellular water
One-third
Interstitial
Within tissue spaces
Transcellular
Includes CSF, aqueous and vitreous humor synovial fluid serous fluid within body cavities, fld secretions of exocrine glands
What helps you maintain water balance?
ADH: makes kidneys store urine
ALDOSTERONE
Greatest electrolyte output source is
Kidneys
Electrolytes come from
Foods
Fluids
Metabolic reactions
How are electrolytes lost?
Perspiration, feces, urine
Ions that are vital for nerve impulse conduction, muscle fiber contraction, and maintenance of cell membrane permeability
Na+
K-
Ca 2+
Which ions account for nearly 90% of the positively charged ions in extracellular fluids
Na
How is potassium and sodium balance regulated
- Potassium ion concentration increases
- Adrenal cortex is signaled
- Aldosterone is secreted
- Renal tubules increase reabsorption of sodium ions and increase secretion of potassium ions
- Sodium ions are conserved and potassium ions are excreted
4 functions of Calcium
1.Muscle contraction
2.nervous system
3. Bone development
4. Blood clotting
How does calcium regulate muscle contraction
Binds to muscle cell and opens up the channel for depolarization
How does calcium help the nervous system
Helps signals jump the synapse
Hypercalcemia
High concentration of calcium
What causes hypercalcemia
-hyperparathyroidism
-cancers
Cancer induced symptoms of hypercalcemia
Weakness
Fatigue
Impaired mental function
Polyuria
Polydipsia
Hypocalcemia
Low calcium
Causes of hypocalcemia
-removal of parathyroid gland
-vitamin d deficiency
-may be life threatening- muscle spasms in airways, cardiac arrhythmias
What increases blood calcium
Parathyroid hormone
Vitamin D
Regulates calcium absorption
Calcitonin from thyroid function
Decreases Calcium in the blood
Five sources of H+ ions
1-2. Glucose metabolism (Aerobic and anaerobic)-carbonic and lactic acid
3.breaking down amino acids -sulfuric acids
4. Breaking down fats. Fatty acids. Acidic ketone bodies
5. Breaking down nucleic acids& phosphoproteins- phosphoric acid
Strong acids
Release more H+ , ionize more completely
Weak acids
Ionize less completely, release fewer H+
Strong bases
Ionize more completely and release more OH-
Weak bases
Ionize less completely and release fewer OH
Regulation of H+ ion concentration
1.Acid base buffer systems
2.Respiratory excretion of carbon dioxide
3.Renal excretion of hydrogen ions
Physiological buffers
1.Respiratory mechanism (CO2 excretion)
2. Renal mechanism (H+ excretion)
Phosphate system equation
H+HPO4-2—->H2PO4—>H+HPO4-2
Explain how the phosphate system works
1.The monohydrogen phosphate ion converts a strong acid to a weak acid
2. The dihydrogen phosphate ion converts a strong base to a weak base
Protein buffer system equation
-NH2+H+<—>-NH3+
NH3+ group releases a H ion in the presence of excess base
-COOH<—> -COO-+H+
COO- group accepts a hydrogen ion in the presence of excess acid
Respiratory excretion of CO2 is controlled by
Brainstem
What does the brainstem do?
-respiratory center
-controls the rate and depth of breathing
-INCREASES PRODUCTION OF CO2
What does increased CO2 do?
Stimulate the brain stem
CO2 reacts with H2O to produce
H2CO3
How does the body get rid of the excess H+ free radical?
Stimulating respiratory center in the brainstem
Survival range of pH
6.8-8.0
Respiratory acidosis
-Increased CO2,
-Increased carbonic acid
-Not breathing well
-excess breathing
-excessive CO2 coming out
-too few carbonic acid
Respiratory alkalosis
Metabolic acidosis
Kidneys may fail at excreting H+
Digestive
Diuretic, vomiting, decreased gastric juices
Metabolic alkalosis
Drowsiness, disorientation, stupor, labored breathing
Respiratory acidosis
What happens as CO2 levels rise?
Carbonic acid levels rise
What happens as carbonic acid levels rise?
pH decreases
Diuretic drugs and antacid intake
Metabolic alkalosis
Decrease in breathing rate and depth
Metabolic alkalosis
Decrease in breathing rate and depth results in
Increased concentration of carbon dioxide in blood
Dehydration
Lack of water
Who is more susceptible to dehydration
Infants and the elderly
Organs of the urinary system
Kidneys, ureters, urinary bladder, urethra
Filter blood and remove toxins , makes urine
Kidneys
Kidneys
Filter blood and form urine
Ureters
Transport urine from the kidneys to urinary bladder
Urinary bladder
Collects and stores urine
Urethra
Conveys urine from urinary bladder to outside of body
Functions of urinary system
Maintain composition, pH and volume of fluids within normal limits
Order or urinary system
Kidneys
Ureters
Urinary bladder
Urethra
Location of kidneys
-lateral to vertebral column
-behind abdominal cavity
Retroperitoneal
Behind the peritoneum of the abdominal cavity
Describe the surface of the kidney
Convex lateral surface and concave medial surface
Renal sinus
Hollow chamber in medial depression
Hilum
Entrance to renal sinus
Renal pelvis
Funnel-shaped sac; superior end of ureter
Major calyces
Large tubes that merge to form renal pelvis
Minor calyces
Small tubes that merge to form major calyces
Renal medulla
Inner region; composed of renal pyramids
Renal cortex
Outer region of kidney
Renal columns
Extensions of the cortex that dip into medulla
Renal capsule
Fibrous capsule around kidney
Renal capsule
Fibrous capsule around kidney
Nephrons:
functional units of kidney, each of which is a site of urine production
How many nephrons in each kidney
Over a million
Part of the nephron is in
The cortex, but it dips down into medulla
The left kidney is slightly superior to
The right kidney
What does the renal pelvis do?
Collects all of the urine from the kidney and then narrows as it leaves the kidney to become the ureter
All functions of the kidney
1.Filters blood and excretes waste
2. Regulates volume, composition, and pH of body fluids
3. Secretes erythropoietin
4. Secretes renin
5. Metabolizes vitamin D to active form to active form for Calcium absorption
Renin
Enzyme regulate blood pressure and kidney fx
Erythropoietin
Hormone that stimulates RBC production in bone marrow
Hemodialysis
Person’s blood is re-routed so person’s blood is re-routed so it crosses an artificial membrane that cleans out and filters the blood.
Usually occurs 3 times a week
Renal artery
Enters each kidney through the hilum and continues to branch through the nephrons
Describe the branching of the renal arteries
RIACA
1. Renal artery
2. Interlobar artery
3. Arcuate artery (arciform)
4.Cortical radiate (interlobular artery)
5. Afferent arteriole
Each enters a nephron
Afferent arteriole
From the nephron, venous blood returns to the
Renal vein
Branching of the renal vein
CAIR
1.Cortical radiate (interlobular) vein
2. Arcuate (arciform) vein
3. Interlobar vein
4. Renal vein
Renal artery comes from
Abdominal aorta
Hilum contains
Renal arteries, renal veins and the location where the ureters meet.
The abdominal aorta separates out into
Renal artery
Afferent arterioles go into
Glomerulus
Afferent arteriole leads to
Glomerulus
Describe the blood flow inside of each nephron
1.Afferent arteriole 2.glomerulus
3. efferent arteriole 4.peritubular capillaries
Interlobar artery branches into
ACAGE
1.Arcuate artery
2.Cortical radiate artery
3.Afferent arteriole
4. Glomerular capillaries
5. Efferent arteriole
Parts of a nephron
Renal corpuscle
Renal tubule
Parts of the renal corpuscle
- Glomerulus
- Glomerular bowman’s capsule
Glomerulus
Cluster of capillaries
Filters blood
First step in urine formation
Glomerulus
Flow from afferent arteriole
Afferent arteriole>glomerulus>efferent arteriole
Glomerular (Bowman’s) capsule
Receives filtrate from glomerulus
Renal tubule
Extends from the glomerular capsule to the collecting duct
Pathway of filtrate inside renal tubule
1.Glomerular capsule
2. Proximal convoluted tubule
3.Nephron loop (loop of Henle)
4. Distal convoluted tubule
Nephron loop is composed of
Ascending and descending limb
The distal convoluted tubules of several nephrons empty into each
Collecting duct
The collecting duct continues …
The collecting duct continues through the medulla and joins other collecting ducts to drain through renal papillae into a minor calyx
Around the glomerulus
Bowman’s capsule
What releases renin
Renal tubule
Renin
Hormone that regulates water balance and stimulates aldosterone which helps regulate BP
Helps with water balance and blood pressure
Renin
Site of blood filtration in the kidney
glomerulus
Flow of filtrate through renal tubule
- Proximal convoluted tubule
- Nephron loop
- Distal convoluted tubule
- Collecting duct
Which tubule is closest to glomerulus
Proximal convoluted tubule
The blood vessels associated with the nephron are unique to the
Kidney
Sequence of structures involved in the process of urine formation
- Glomerulus
- Glomerular capsule
- Proximal convoluted tubule
- Nephron loop (descending, ascending)
- Distal convoluted tubule
- Collecting duct
Sequence of structures involved in the process of urine elimination
1.Minor calyx
2. major calyx
3. renal pelvis
4. ureter
5. urinary bladder
6. urethra
Types of nephrons in the kidney
1.Cortical nephron 2.juxtamedullary nephron
The majority of nephrons are
Cortical nephrons
Cortical nephrons
Sit high in cortex with short nephron loops
Sit low in cortex and have long nephron loops
Juxtamedullary nephrons
Function of juxtamedullary nephrons
Important in regulating water balance and urine concentration
Which nephrons make up a small percentage of nephrons
Juxtamedullary nephrons
Which nephrons dip down into the medulla
The juxtamedullary nephrons
Which nephrons are more important
The juxtamedullary nephrons are the most important
Juxtaglomerular apparatus
A structure that regulates the secretion of renin
What forms the juxtaglomerular apparatus
The point where the ascending limb comes into contact with the afferent arteriole
The top portion of the ascending limb of the nephron loop of each nephron passes between the
Afferent and efferent arterioles
Macula densa
Tall closely packed cells of the ascending limb
Juxtaglomerular cells
Large vascular smooth muscle cells of the afferent arteriole
What regulates the renin angiotensin system which increases blood pressure
Renin secreted by the juxtaglomerular apparatus
Which system increases blood pressure
The renin angiotensin system increases blood pressure
Renin stimulates aldosterone to be released this is called
Renin angiotensin system
Nephritis
Inflammation of the kidney
Glomerulonephritis
Inflammation of the glomeruli, acute or chronic
Results of abnormal immune reaction one to three weeks after infection by the beta hemolytic streptococcus
Acute glomerulonephritis AGN
What occurs in acute glomerulonephritis AGN
-Infection does not start in kidney
-antigen-antibody complexes form insoluble immune complexes which lodge in the kidneys
-complexes deposit in and block glomeruli
Chronic glomerulonephritis
-progressive disease
- more and more nephrons are damaged until kidneys cannot function
-prolonged inflammation
-fibrous tissue replaces glomerular membranes disabling nephrons
-progressive disease
- more and more nephrons are damaged until kidneys cannot function
-prolonged inflammation
-fibrous tissue replaces glomerular membranes disabling nephrons
Chronic glomerulonephritis
Which glomerulonephritis is short lasted
Acute , comes from strep
Do kidneys regain function after glomerulonephritis
The kidneys regain function in acute glomerulonephritis AGN
What does urine contain
Wastes,
excess water,
and electrolytes
What are the three processes of urine formation
- Glomerular filtration
- Tubular reabsorption
- Tubular secretion
Glomerular filtration
Blood is filtered in the glomerulus
Where does tubular reabsorption occur
Tubular reabsorption occurs in the proximal convoluted tubule and the descending loop of Henle
Where does the most of the tubular reabsorption occur
In the proximal convoluted tubule
Where does tubular secretion occur
In the ascending loop of Henley
First step in making urine
Glomerular filtration
What happens during glomerular filtration
Movement of water and small solutes from the glomerulus into the glomerular capsule.
Fenestrae allow small molecules to leave the glomerular capillaries
Glomerulus
Tangled blood capillaries from which plasma and chemicals leave the bloodstream and enter the renal tubule system
Tangled blood capillaries from which plasma and chemicals leave the bloodstream and enter the renal tubule system
Glomerulus
Pressure behind glomerular filtration
Hydrostatic pressure
Pressure behind glomerular filtration
Hydrostatic pressure
As long as the net filtration pressure in the glomerulus is positive ________ will occur
Filtration
If the arterial BP drops…
The glomerular hydrostatic pressure falls
Can lead to acute renal failure
Glomerular hydrostatic pressure pushes in what direction
Out
The plasma colloid osmotic pressure pushes in what direction
Inward
What does the renin angiotensin system respond to
decrease in blood pressure
What does the renin angiotensin system use to regulate blood pressure
1.Vasoconstriction
2. secretion of ADH 3.aldosterone
What does the renin angiotensin system result in
Conservation of:
1.sodium
2. water
3. increase in blood pressure
What helps keep GFR constant
The renin angiotensin system
Renin stimulates the formation of
Aldosterone
ADH
Anti diuretic hormone
Stimulates nephrons to store water, put water back into the blood. Increases BP
How much glucose should be in your urine
None
What does glucose in the urine likely indicate
Diabetes
Tubular reabsorption
Movement of substances from the renal tubules into the interstitial fluid where they diffuse into the peritubular capillaries
Substances go out of the tube and into the blood
Direction of glomerular filtration
Out of the blood and into the tubule
Direction of tubular reabsorption
From the tubule back into the blood
Tubular secretion
Movement of waste from Peritubular capillaries into renal tubules
Most tubular reabsorption occurs in
The proximal convoluted tubule which is lined with microvilli
What percentage of tubular reabsorption occurs in the proximal convoluted tubule
70%
The proximal convoluted tubule is lined with
Microvilli
Just puts a little bit back
Tubular secretion
Different parts of the renal tubule reabsorb specific
Substances
Different substances are transported back into the internal environment by different methods of transport t/f?
True
Movement of substances against their concentration gradients limited transport capacity due to number of carrier proteins
Active transport
When is the renal plasma threshold reached?
When there is more transported substance in the plasma then the active transport mechanism can handle; excess spills into forming urine
Which substances are moved by active transport during tubular reabsorption
Glucose,
amino acids,
creatine,
lactic,
citric,
uric,
ascorbic acid,
ions
How is osmosis used in tubular reabsorption
Water reabsorption
How is endocytosis used in tubular reabsorption
Small protein reabsorption
Substances are transported out of the tubular fluid and into the peritubular capillaries
Tubular reabsorption
Percentage of water in the urine
95%
Nephrotic syndrome
A set of symptoms that occur in people with renal disease
-loss of plasma proteins,
-edema
-loss of plasma proteins into urine causes widespread edema and increased likelihood of infection
Kidneys maintain internal environment by reabsorbing
Water
In the proximal convoluted tubule sodium ions are reabsorbed by
Active transport
In the proximal convoluted tubule water is reabsorbed by
Osmosis
Substances move from the plasma of the peritubular capillaries into the fluid of the renal tubules
Tubular secretion
Substances move from the plasma of the peritubular capillaries into the fluid of the renal tubules
Tubular secretion
What is secreted during tubular secretion
waste destined to be excreted in the urine
Active transport mechanisms function in tubular secretion, but
Active transport happens in the opposite direction as tubular reabsorption
Secretion of substances such as drugs and ions such as potassium occurs in
Tubular secretion
Secretion of hydrogen ions important in regulating the pH of body fluids occurs in
Tubular secretion
Examples of drugs excreted during tubular secretion
Penicillin
Phenylbardenaul
Final secretions of hydrogen and potassium
Tubular secretion
Tubular secretion of potassium ions occurs in
The distal convoluted tubule
What occurs simultaneously as tubular secretion of potassium ions occurs
Sodium ions are reabsorbed as potassium ions are secreted
Antidiuretic hormone
Responsible for reabsorption of water
ADH comes from which gland
pituitary gland
If antidiuretic hormone is present the segments
Become permeable and water is reabsorbed by osmosis into the extremely hypertonic medullary interstitial fluid
Urine becomes very concentrated under the direction of
ADH
Juxtamedullary nephrons are more important in the regulation of
Water reabsorption
Urine becomes very concentrated under the direction of
ADH
The distal convoluted tubule and the collecting duct are impermeable to water in the presence of
ADH
What causes water to be excreted as dilute urine
The absence of antidiuretic hormone
The ability of the kidneys to maintain the internal environment depends on their ability to concentrate urine by
Reabsorbing large volumes of water
Which hormones affect the solute concentration of urine particularly sodium
Aldosterone and cardiac natriuretic peptides
What happens when you have toxins I your blood like alcohol
You don’t release ADH, so you pee a lot
What causes your head to hurt during a hangover
Dehydration
It’s important to drink water while you
Drink alcohol
Counter current multiplier
The water, when there is ADH, it leaves the tubule and goes back into the capillaries
Filtration of water and dissolved substances from plasma
Glomerulus
Receives the glomerular filtrate
Glomerular capsule
Where does the Reabsorption of the following substances happen glucose, amino acids, creatine, lactic acid, uric acid, ascorbic acid, phosphate, sulfate, calcium, potassium, and sodium ions by active transport
Proximal convoluted tubule
Reabsorption of proteins by endocytosis
Proximal convoluted tubule
Reabsorption of water by osmosis happens in
Descending loop, distal convoluted tubule & collecting duct
Reabsorption of chloride ions and other negatively charged ions by electrochemical attraction
Proximal convoluted tubule
Act of secretion of substances such as penicillin, histamine, creatinine, and hydrogen ions
Proximal convoluted tubule
In which part of the nephron does Reabsorption of water by osmosis occur?
Descending limb of the nephron loop
Reabsorption of sodium, chloride, and potassium ions by active transport
Ascending limb of the nephron loop
Reabsorption of sodium ions by active transport
Distal & proximal convoluted tubule
Reabsorption of water by osmosis
Distal convoluted tubule
Active secretion of hydrogen ions
Distal convoluted tubule
Secretion of potassium ions both actively and by electrochemical attraction
Distal convoluted tubule
Collecting duct
Reabsorption of water by osmosis
Not anatomically part of the nephron but functionally linked in the process of urine formation
The collecting duct
Urea is a by-product of
Amino acid catabolism
The plasma concentration reflects the amount of
Protein in the diet
Describe the movement of urea
1.Enters the renal tubules through glomerular filtration,
2. undergoes both tubular reabsorption and
3. tubular secretion
Percentage of urea that is reabsorbed
80%
Percentage of urea that is excreted in the urine
20%
Product of nucleic acid catabolism
Uric acid
Describe the movement of uric acid
It enters the renal tubules through glomerular filtration
Active transport completely reabsorbed the
Filtered uric acid
What percentage of uric acid enters the urine through tubular secretion and is excreted
10%
Urea
A byproduct of amino acid catabolism
Uric acid
A product of nucleic acid metabolism
The majority of urine composition is
Water
Which metabolic waste products are normally found in the urine
Urea uric acid and creatinine
Trace amounts of amino acids and varying amounts of electrolytes
What is the typical urine volume
0.6-2.5 L/day; 50-60 mL of urine output/hr is normal
Urine volume varies with
Fluid intake and environmental factors
Less than 30 ml an hour indicates
Kidney failure
Renal clearance
-The rate at which chemical is removed from the plasma by kidney
-indicates kidney efficiency glomerular damage and progression of renal disease
-The rate at which chemical is removed from the plasma by kidney
-indicates kidney efficiency glomerular damage and progression of renal disease
Renal clearance
Renal clearance tests
- Inulin clearance test(a polysaccharide of some plant roots)
- Creatinine clearance test
Why can we use renal clearance test to calculate the glomerular filtration rate GFR
The substances are both filtered by the glomerulus but neither is reabsorbed nor secreted
Measures glomerular filtration rate
Renal clearance tests
Ureters
Tubular organs that join the urinary bladder in the pelvic cavity
Each ureter begins as
Renal pelvis in kidney
How long are the ureters
About 25 cms long
Layers of the walls of the ureter
- Inner mucous coat (transitional epithelium)
- Middle muscular coat
- Outer fibrous coat
What transports urine along the ureters
Peristaltic waves
Kidney stone (renal calculus)
Stone
Renal calculus
Kidney stone
What triggers the ureterorenal reflex
An obstruction such as a kidney stone in a ureter
Ureterorenal reflex
-Strong peristaltic waves in the obstructed ureter to move Stone toward the urinary bladder.
- reduced urine production in affected kidney
What can make a kidney stone
1.Uric acid
2.calcium oxalate
3. calcium phosphate
4. magnesium phosphate
Where do kidney stones form
In the collecting ducts or renal pelvis of kidney
Symptoms of a kidney stone
1.Severe pain
2. nausea
3. vomiting
4. blood in urine
What percentage of kidney stones pass on their own
60%
Lithotripsy
Shattering of a kidney stone with a laser
How can you get rid of a kidney stone
-60% pass on their own
-lithotripsy
-surgical removal
Can the tendency to form kidney stones be inherited
Yes, especially calcium stones
What are the causes of a kidney stone
1.Calcium supplements (in people with inherited tendency)
2. Excess vitamin D
3. Urinary tract blockage 4.urinary tract infections
Urinary bladder
Hollow dispensable muscular organ located within the pelvic cavity
Stores urine
What is the location of the urinary bladder
Posterior to the pubic symphysis and inferior to the parietal peritoneum
Trigone
Triangle at the floor of the bladder that has openings at each of its three corners: two to the ureters and one to the urethra
Detrusor muscle is made of
Smooth muscle fibers of muscular coat
What surrounds the neck of the bladder
Internal urethral sphincter
Micturition
Process of urinating
Bladder is anterior to
Uterus
Prostate gland is inferior to the
Male urinary bladder
Urethra
Tubular organ that conveys urine from the urinary bladder to the outside of the body
The urethra is lined with
The urethra is lined with a mucus membrane and has a thick layer of longitudinal smooth muscle fibers
Urethral glands
Many mucus glands in the urethra
Describe the female urethra
-4 cm long
- external urethral orifice is anterior to the vaginal opening
Describe the male urethra
-19.5 cm long
-functions in urination and reproduction
Three sections of the male urethra
- Prostatic Urethra
- Membranous urethra
- Spongy urethra: terminates at the external urethral orifice in penis
Cystitis
Bladder infection
More common in females
Urine leaves the urinary bladder
Micturition urination reflex
Fused kidneys that lie on one side of the midline
Crossed fused ectopia
Fusion of kidneys at one pole, usually lower, with most of each kidney on opposing side of midline
Horseshoe kidney
Proteinuria (protein in urine) due to abnormal glomeruli
Nephrotic syndrome
Reduced number of nephrons that are abnormally large
Oligomeganephronia
Polycystic Kidney Disease
Cysts form in renal tubules and or collecting ducts
Renal agenesis
Absence of a kidney
Renal displasia
Abnormal kidney structure
Renal hypoplasia
Small kidney with fewer nephrons but development normal
Tubular dysgenesis
Abnormal formation of proximal tubules
Vesicoureteral reflux
Urine backs up from bladder to ureter of kidney
The urinary bladder holds how much urine
600 mL
The urge to urinate begins when the bladder contains
150 ml
Urinalysis
Can be used to diagnose certain diseases or disorders and check for drug usage
Why is urinalysis helpful
There are several harmful inherited disorders that alter the urine color and sometimes viscosity
Beeturia
urine turns pink after eating beets
Asparagus can cause
Urinary excretion of odiferous component of asparagus
People with untreated diabetes mellitus might have____ in their urine
Glucose
People with untreated diabetes mellitus might have____ in their urine
Glucose
What happens to urinary system as you get older
-Bladder, ureters and urethra lose elasticity.
- Bladder holds less urine
When does dehydration occur
When water output exceeds input
Who is most susceptible to dehydration
Infants and the elderly
What happens to the extracellular fluid when dehydration occurs
The extracellular fluid becomes concentrated
What happens to the skin and mucus membranes when a person is dehydrated
The skin and mucous membranes and mouth feel dry
What happens to body temperature during dehydration
Hyperthermia develops because it upsets the sweating mechanisms
What happens to cognition during dehydration
Cerebral circumstances, mental confusion,
delirium,
coma
Water intoxication
Hyponatremia as a result of excessive fluid intake can result in death
Often seen in runners with excessive fluid intake
Water intoxication
More likely with longer race time low or high body mass index significant weight gain during race
Water intoxication
What can happen to body weight during dehydration
Lower
Hyponatremia
Low sodium, result of excess fluid intake can cause death
Common causes of hyponatremia
- Prolonged sweating
- Vomiting
3.diarrhea
Can all decrease sodium levels
Common causes of hyponatremia
- Prolonged sweating
- Vomiting
3.diarrhea
Can all decrease sodium levels
Does drinking sports drinks prevent water intoxication
No significant difference
Does drinking sports drinks prevent water intoxication
No significant difference
Edema
Abnormal accumulation of extracellular fluid within interstitial spaces
Edema
Abnormal accumulation of extracellular fluid within interstitial spaces
What are the five causes of edema
1.Hypoprotenemia
2. Obstruction of lymph vessels
3. Increased venous pressure
4. Inflammation
5. Blood pressure meds
Hypoprotenemia
Low plasma proteins
-emia
Presence in the blood
Swelling
Edema
Hyponatremia causes
1.Prolonged sweating 2.vomiting
3.diarrhea
4.renal disease
5.adrenal cortex disease 6.drinking too much water
Renal disease
Inadequate reabsorption
Adrenal cortex diseases ex
Inadequate aldosterone such as Addison disease
What happens to cells during hyponatremia
- Hypotonic extracellular fluid and resulting movement of water into cells by osmosis- water intoxication
Aldosterone
Hormone that comes from adrenal cortex and increases renal secretion of potassium
Hypernatremia is caused by
1.Excessive water loss 2.evaporation
3. fever
4. diabetes
5. insufficient ADH
What are the effects of hypernatremia
-CNS disturbances
-confusion
-stupor
-coma
Hypokalemia causes
- Excessive release of aldosterone by the adrenal cortex- Cushing syndrome
- Diuretics that promote potassium excretion
3.kidney disease - Prolonged vomiting or diarrhea
What are the effects of hypokalemia
Severe cardiac disturbances such as atrial or ventricular arrhythmias
Example of a disease that causes excessive release of aldosterone by adrenal cortex
Cushing syndrome
Hyperkalemia causes
1.Renal diseases that decrease potassium excretion
2. Drugs that promote renal conservation of potassium
3. Insufficient aldosterone secretion- Addison’s Dx
4. Acidosis- causes shift in K
What are the effects of hyperkalemia
1.Paralysis of skeletal muscles
2. cardiac disturbances cardiac arrest
Natremia
Na+ ions
Calcemia
Ca +2 in blood
Kalemia
Potassium in blood
Why is hypocalcemia dangerous
-may be life threatening- muscle spasms in airways, cardiac arrhythmias
-explain the amine part of the protein buffer system
-NH2+H+<—>-NH3+
NH3+ group releases a H ion in the presence of excess base
Explain the COOH part of the protein buffer system
-COOH<—> -COO-+H+
COO- group accepts a hydrogen ion in the presence of excess acid
What branches off the renal artery
Interlobar artery
What branches off the renal artery
2.Interlobar artery
What branches off the interlobar artery?
- Arcuate artery (arciform)
What branches off the arcuate arciform artery?
4.Cortical radiate (interlobular artery)
What branches off the arcuate arciform artery?
4.Cortical radiate (interlobular artery)
What branches off the cortical radiate interlobular artery
- Afferent arteriole
How do collecting ducts drain?
collecting ducts drain through renal papillae into a minor calyx
Which kidney is higher up
Left kidney
Large vascular smooth muscle cells of the afferent arteriole
Juxtaglomerular cells
Tall closely packed cells of the ascending limb
Macula densa
Fenestrae
Fenestrae allow small molecules to leave the glomerular capillaries
Fenestrae
Fenestrae allow small molecules to leave the glomerular capillaries
Tangled blood capillaries from which plasma and chemicals leave the bloodstream and enter the renal tubule system
Glomerulus
Tangled blood capillaries from which plasma and chemicals leave the bloodstream and enter the renal tubule system
Glomerulus
Tangled blood capillaries from which plasma and chemicals leave the bloodstream and enter the renal tubule system
Glomerulus
Why is it bad to have a loss of plasma proteins?
loss of plasma proteins into urine causes widespread edema and increased likelihood of infection
What is impermeable to water in the presence of ADH
The distal convoluted tubule and the collecting duct
Why is the reabsorption of water important?
kidneys maintain the internal environment depends on their ability to concentrate urine
Why is the reabsorption of water important?
kidneys maintain the internal environment depends on their ability to concentrate urine
Cells of afferent arteriole
Juxtaglomerular cells
Cells of the ascending limb
Macula densa
Where does the reabsorption of water by osmosis happen?
Collecting duct
Where does the reabsorption of water by osmosis happen?
Collecting duct
Diuretics function
Get rid of potassium
Diuretics function
Get rid of potassium