urinary system a&p 2

8/13/2019 Urinary System a&p 2

1/187

URINARY SYSTEM


2/187

FUNCTIONS OF THESYSTEM URINARY

1. FILTERING OF BLOOD

2. REGULATION OF BLOOD VOLUME3. REGULATION OF BLOOD SOLUTES4. RBC SYNTHESIS

5. VITAMIN D SYNTHESIS6. GLUCONEOGENESIS


3/187

KIDNEY ANATOMY


4/187

ORGANS OF THEURINARY SYSTEM

1. KIDNEYS2. URETERS3. URINARY BLADDER

4. URETHRA


5/187

ORGANS OF THEURINARY SYSTEM

5. INTERNAL URETHRALSPHINCTER.6. EXTERNAL URETHRAL

SPHINCTER.


6/187

LOCATION AND EXTERNALANATOMYOF KIDNEYS

Th !"#$ %& '"( h"$# ) *"+,$ -,$ +h ),&+ *",*/(#, "$/' 0/'' ,$"+h * &"# ,*+ (*/' ,'- $.

Th *" h+ !"#$ % "&&'" h+'% ',0 * +h/$+h ' +.


7/187

EXTERNAL ANATOMY OF THEKIDNEY

Th , *"$ , !"#$ % ,$&"&+&, +h* '/% *&. Th "$$ *

'/% * +h * $/' /)&-' +h"##' '/% * +h /#"),&

/)&-' /$# +h ,-+ * * $/'/& "/ .


8/187

INTERNAL ANATOMY OF THEKIDNEY

A FRONTALSECTIONS OF A

KIDNEY REVEALS3 REGIONS

1. RENAL CORTEX2. RENAL MEDULLA3. RENAL PELVIS


9/187



10/187

RENAL CORTEX

7 Th ,-+ * '/% *, +h !"#$ %+h/+ ,$+/"$ ,&+, +h $ )h*,$&.

7 I+ "& +h /"$ &"+

,* "'+*/+",$* /(&,*)+",$ /$#& * +",$.


11/187

RENAL MEDULLA

8"+h"$ +h * $/'#-''/ /*

', /+ # +h * $/')%*/ "#& * $/'

)/)"''/ /$# * $/','- $&.


12/187

RENAL MEDULLA

7Th -$ +",$ , +h

* $/' ,'- $& "& +,)*, "# +h &)/ +,)/&& (',,# && '&+, /$# *, +h

$ )h*,$&.


13/187

RENAL MEDULLA7 T*"/$ -'/* &h/) #

-$"+& "$ +h #-''/+h/+ h,-& +h L,,)&, H $' /$#,'' +"$ #- +& ,+h $ )h*,$.

7 S"+ ,* +h,-$+ *9 -** $+&%&+ +h/+,$ $+*/+ & &/'+/$# ,$& * & 0/+ */$# -* /


14/187

RENAL MEDULLA

7 Th +") , +h* $/' )%*/ "#.

7 R ' /& & -*"$"$+, / /'%:.


15/187


Th $ )h*,$& , +h!"#$ %& )*,#- & -*"$ . I+',0& *, +h * $/' )/)"''/+, +h "$,* /'% +, +h/;,* /'% +, +h * $/'

) ' "& /$# "$/''% :"+& +h!"#$ % 0"+h"$ +h -* + *.


16/187

RENAL PELVIS

7Th -$ +",$ , +h* $/' ) ' "& ,'' +&-*"$ *, /'' , +h/'% &.

7Th -*"$ +h $ "&,$#- + # *, +h

!"#$ % +, +h-*"$/*% ('/## *-&"$ +h -* + *.


17/187


T0, /;,* (',,# && '& /*/&&, "/+ # 0"+h +h !"#$ %.

Th * $/' /*+ *% / (*/$ h ,+h /(#, "$/' /,*+/ /$# +h* $/' "$ 0h" h )+" & "$+,

+h "$ *",* $/ / /.


18/187

THE NEPHRON


19/187


20/187

THE NEPHRON


21/187

THE NEPHRON

STRUCTURES OF THE NEPHRON

1. BO8MAN=S CAPSULE2. PROXIMAL CONVOLUTED TUBULE3. LOOP OF HENLE

A. DESCENDING LIMBB. ASCENDING LIMB

4. DISTAL CONVOLUTED TUBULETHESE EMPTY INTO THE COLLECTINGDUCT OR TUBULES.


22/187


23/187


24/187


25/187

PROXIMAL CONVOLUTEDTUBULE


26/187

PROXIMAL CONVOLUTEDTUBULES

S" )' -(,"#/'

)"+h '"/' ''& 0"+h)*, "$ $+ (*-&h(,*# *& ,

" *, "''".


27/187

DECENDING LIMB OF THELOOP OF HENLE


28/187

DECENDING LIMB OF THELOOP OF HENLE

S" )' &>-/ ,-&)"+h '"/' ''&


29/187

ASCENDING LIMB OF THELOOP OF HENLE


30/187

ASCENDING LIMB OF THELOOP OF HENLE

S" )' -(,"#/')+h '"/' +, ',0,'- $/* ''&.


31/187

DISTAL CONVOLUTED TUBULE


32/187

DISTAL CONVOLUTEDTUBULES

S" )' -(,"#/')+h '"/' ''&.


33/187

THE NEPHRON

1. P*,:" /' ,$ ,'-+ #+-(-'

2. D & $#"$ '" ( ,L,,) , H $'

3. A& $#"$ L" ( ,

L,,) , H $'4. D"&+/' ,$ ,'-+ #

+-(-' &

1. S" )' -(,"#/')"+h '"/' ''& 0"+h)*, "$ $+ (*-&h(,*# *& , " *, "''".

2. S" )' &>-/ ,-&)"+h '"/' ''&3. S" )' -(,"#/' +,

',0 ,'- $/*)"+h '"/' ''&.

4. S" )' -(,"#/')+h '"/' ''&.


34/187

THE NEPHRON

BLOOD VESSELS OF THE NEPHRON

1. AFFERENT ARTERIOLE2. GLOMERULUS3. EFFERENT ARTERIOLE4. PERITUBULAR CAPILLARIES5. VASA RECTA


35/187


36/187


37/187

JUXTAGLOMERULARAPPARATUS


38/187


SOME THE SMOOTH MUSCLE CELLSOF THE AFFERENT ARTERIOLES

ENLARGE AND HAVEPROMINENT SECRETORY GRANULESCONTAINING RENIN. THESE

CELLS ARE TERMED


39/187


40/187


THE MACULA DENSA CELLSTRIGGER THE RELEASE OF

LOCALLY ACTING CHEMICALS8HICH EITHER VASOCONSTRICT OR VASODILATE THE AFFERENT ARTERIOLE. THIS RESULTS IN A

CHANGE THE GFR.


41/187

KIDNEY PHYSIOLOGY


42/187

KIDNEY PHYSIOLOGY

URINE FORMATION AND THESIMULTANEOUS AD


43/187

KIDNEY PHYSIOLOGY


44/187

KIDNEY PHYSIOLOGY

FILTRATION "& +h , $+ ,

&-(&+/$ & *, +h', *-'-& "$+, +h '- $

, (,0 /$=& /)&-' . Th"&,* & "'+*/+ .


45/187

KIDNEY PHYSIOLOGY

REABSORPTION "& +h, $+ , &-(&+/$ &

&,'-+ & /$# 0/+ */ *,&& +h 0/''& ,

$ )h*,$ "$+, +h /)"''/*" &/&&, "/+ # 0"+h +h $ )h*,$.


46/187

KIDNEY PHYSIOLOGY

SECRETION "& +h , $+, &-(&+/$ & *, +h

/)"''/*" & /&&, "/+ #0"+h +h $ )h*,$ / *,&& +h 0/''& ,

$ )h*,$ "$+, +h "'+*/+ 0"+h +h$ )h*,$.


47/187

OSMOTIC EFFECTS

8/+ * & * & /& +h-$" *&/' &,' $+ "$ 0h" h

/ /*" +% , &,'-+ & /*#"&&,' #. S,'-+ & /$ ('/&&" " # /& ' +*,'%+ &

/$# $,$ ' +*,'%+ &.


48/187


49/187

ELECTROLYTES

E:/ )' & , ' +*,'%+ &

"$ '-# "$,* /$" &/'+&"$,* /$" /$# ,* /$"

/ "#& /$# (/& & /$# &, )*,+ "$&.


50/187

NONELECTROLYTES

N,$ ' +*,'%+ & h/ (,$#&-&-/''% , /' $+ (,$#& +h/+

)* $+ +h *,#"&&, "/+"$ "$ &,'-+",$.Th * ,* +h % h/$, ' +*" /' h/* .


51/187

NONELECTROLYTES

E:/ )' & , $,$ ' +*,'%+ &

"$ '-# '- ,& '")"#&* /+"$"$ /$# -* /.


52/187

OSMOTIC EFFECTS

A'' #"&&,' # &,'-+ &,$+*"(-+ +, +h ,& ,+"

/ +" "+% , / '-"#. H,0 *' +*,'%+ & h/ * /+ *

),0 * ( /-& / h ' +*,'%+,' -' #"&&, "/+ & "$+, /+

' /&+ 2 ",$&.


53/187

OSMOTIC EFFECTS

8/+ * , & / ,*#"$ +,

,& ,+" */#" $+&? *,/* /& , ' && * ,& ,'/'"+% +, /* /& , * /+ * ,& ,'/'"+%.


54/187

OSMOLALITY

A &,'-+",$=& ,& ,'/'"+%"& $- ( * , &,'-+ )/*+" ' &

#"&&,' # "$ ,$ '"+ * ,0/+ *. O& ,+" / +" "+% "&

# + * "$ # ,$'% (% +h $- ( * , &,'-+ )/*+" ' &.


55/187


56/187

OSMOLALITY

8/+ * , & / ,*#"$ +,,& ,+" */#" $+&?

*, /* /& , ' && * +,h" h * ,& ,'/'"+%.


57/187

GLOMERULAR FILTRATION

@U*"$ ,* /+",$ ( "$& 0"+h', *-'/* "'+*/+",$.

I+ "& / )/&&" )*, &&"$ 0h" h '-"#& /$# &,'-+ &

/* ,* # +h*,- h +h', *-'/* (*/$ .


58/187


S-(&+/$ & 0h" h )/&& *,+h ', *-'-& "$+, +h

$ )h*,$ "$ '-# 0/+ *' +*,'%+ & '- ,& / "$,

/ "#& "+/ "$& & /'')*,+ "$& * /+"$"$-*/+ ",$& /$# -* /.


59/187



60/187


Th $ + "'+*/+",$ )* &&-*

NFP "& * &),$&"(' ,*"'+*/+ ,* /+",$.

NFP=HP g- (OP g+ HP c)


61/187


G', *-'/* "'+*/+",$*/+ GFR "& +h +,+/' / ,-$+

, "'+*/+ ,* # ) *"$-+ (% +h !"#$ %&.A $,* /' GFR "$ (,+h

!"#$ %& "& 12 9125 ' "$ ,*/(,-+ 1 ' #/%


62/187

GLOMERULAR FILTRATIONRATE

FACTORS GOVERNINGFILTRATION RATE

T,+/' &-* / /* // /"'/(' ,* "'+*/+",$.F"'+*/+",$ (*/$) * /("'"+%N + F"'+*/+",$ P* &&-*


63/187


GFR IS HELD RELATIVELYCONSTANT BY T8O IMPORTANT

MECHANISMS THATREGULATE RENAL BLOOD FLO8

1. INSTRINICALLY BY RENALAUTOREGULATION

2. EXTRINICALLY BY NEURAL ANDHORMONAL CONTROLS


64/187

RENAL AUTOREGULATION OF


65/187

RENAL AUTOREGULATION OFGFR

THE KIDNEY USES T8O MECHANISMS TO PREFORM

AUTOREGULATION

1. MYOGENIC MECHANISM

2. TUBULOGLOMERULAR FEEDBACK


66/187

MYOGENIC MECHANISM

Th %, $" h/$"& "& (/& # ,$+h + $# $ % , /& -'/*

& ,,+h -& ' +, ,$+*/ + 0h $ &+* + h #. I B.P. "& ' /+ # +h

& ,,+h -& ' "$ +h / * $+ /*+ *",' & /* &+* + h #. I$ * &),$& +h & ,,+h

-& ' ,$+*/ +& 0h" h $/**,0& +h /*+ *",' =& '- $ /$# * $/' (',,# ',0

# * /& & 0h" h * #- & GFR +, "& )* ",-& ' '. Th"& h/$"& $,* /'" & * $/' (',,# ',0

/$# GFR 0"+h"$ & ,$#& / + * (',,# )* &&-* h/$ &.


67/187

TUBULOGLOMERULAR


68/187

TUBULOGLOMERULARFEEDBACK

Th"& * &-'+& "$ +h & * +",$, h " /'& 0h" h )*,#-

', /' /&, ,$&+*" +",$ ,+h / * $+ /$# * $+/*+ *",' &. E:/ )' & "$ '-# $"+*" ,:"# /# $,&"$ $#,+h '"$ /$# )*,&+/ '/$#"$&.Th"& h/$"& ,) */+ & ,* &',0'% +h/$

+h %, $" h/$"& .


69/187

EXTRINIC CONTROL OF GFR

THE GFR CAN ALSO BECONTROLLED EXTRINICALLY

BY:

1. SYMPATHETIC NERVOUS SYSTEM

2. RENIN ANGIOTENSIONALDOSTERONE MECHANISM


70/187

TUBULAR REABSORPTION

Th )*,:" /' ,$ ,'-+ #+-(-' & /* +h ,&+ / +"

"$ +-(-'/* * /(&,*)+",$.A'' '- ,& '/ +/+ /$#

/ "$, / "#& /* * /(&,*( # "$ +h"&/* /.


71/187


A(,-+ 65 , &,#"- ,

0/+ * /* /'&, * /(&,*( # J , (" /*(,$/+ ",$& 5 , h',*"# ",$& /$# 55 ,

),+/&&"- /* * /(&,*( # "$+h )*,:" /' ,$ ,'-+ #

+-(-' &.


72/187

REABSORPTION IN


73/187

REABSORPTION INPROXIMAL NEPHRON


74/187


T-(-'/* * /(&,*)+",$*, +h ',,) , H $'

* &-'+& "$ 1 , 0/+ *( "$ * /(&,*( # *, +h# & $#"$ '" ( 3 ,

),+/&&"- ",$& 2 , &,#"-/$# 35 , h',*"# *, +h

/& $#"$ '" (.


75/187

REABSORPTION IN LOOP OF


76/187

REABSORPTION IN LOOP OFHENLE


77/187


F'-"#& $+ *& +h #"&+/',$ ,'-+ # +-(-' & /+ /

*/+ , /(,-+ 25 ' "$.( /-& /(,-+ , +h

0/+ * "$ +h "'+*/+ h/& ( $* /(&,*( #.


78/187

THE COUNTER CURRENT


79/187

THE COUNTER CURRENTMECHANISM

O$ , +h -$ +",$& , +h!"#$ %& "& +, * -'/+ -*"$

,$ $+*/+",$ /$# ,'- .Th !"#$ %& / , )'"&h +h"& (%

+h ,-$+ * -** $+h/$"& .


80/187

THE COUNTER CURRENT


81/187


Th ',0 "$ +h & +0,

&+*- +-* & "& ,)),&"+ "$#"* +",$.

THE COUNTER CURRENT


82/187


THE COUNTER CURRENT


83/187


Th N/C' ,$ $+*/+",$, +h #-''/ / +& /& /$

,& ,+" ,* 0h" h @#*/0&0/+ * *, +h # & $#"$'" ( , +h ',,) , H $' .

THE COUNTER CURRENT


84/187


Th"& "& ),&&"(' ( /-&+h # & $#"$ '" ( "& '"$ # 0"+h

&" )' &>-/ ,-& )"+h '"/' ''& +h/+ /* ) * /('

+, 0/+ * (-+ " ) * /('+, N/C' /$# ,+h * &,'-+ &.

THE COUNTER CURRENT


85/187


Th , $+ , 0/+ * /-& &

+h ,& ,'/*"+% , +h "'+*/+ +, "$ * /& *, 3 +, 1 2

OSM L .

THE COUNTER CURRENT


86/187


THE COUNTER CURRENT


87/187


Th /& $#"$ '" ( , +h',,) , H $' * /(&,*(&

h',*"# (% / +" +*/$&),*+.I$ /##"+",$ /& h',*"# , &

*, +h "'+*/+ "+ @)-''&&,#"- /',$ "$+, +h

#-''/.

THE COUNTER CURRENT


88/187


Th"& "& ),&&"(' ( /-&

+h /& $#"$ '" ( "& " ) * /(' +, 0/+ *.

THE COUNTER CURRENT


89/187


Th , $+ , N/C'"$+, +h #-''/ # * /& &

+h ,& ,'/*"+% , +h"'+*/+ *, 1 2 +, 1

O& L.

THE COUNTER CURRENT


90/187


THE COUNTER CURRENT


91/187


Th h%) *,& ,+" #-''//'&, @)-''& 0/+ * *, +h

,'' +"$ #- +&. Th"& /*" ) $#"$ ,$ +h / ,-$+ ,ADH. A& 0/+ * , & *,

+h ,'' +"$ #- + -* / ,'',0&.

THE COUNTER CURRENT


92/187


Th-& 0/+ * "& ,$& * # /& 0 '' /&

/ *+/"$ / ,-$+, -* /. Th-* / ,$+*"(-+ & +, +hh" h ,& ,'/*"+% , +h

#-''/.

THE COUNTER CURRENT


93/187


Th /&+/ * +/ "& , ),& #, /)"''/*" & 0h" h

&-**,-$# +h ',,) , h $' .Th && '& ',0

,-$+ * ,)),&"+ +, +h',,) , H $' /$# / + /& /,-$+ * -** $+ : h/$ *.

THE COUNTER CURRENT


94/187


A& (',,# ',0& +h*,- h +h

/&/ * +/ "+ )" !& -) 0/+ */$# ' / & ( h"$# N/C'.


95/187

THE COUNTER CURRENT


96/187

MECHANISM


97/187

TUBULAR SECRETION

T-(-'/* & * +",$ "& +h, $+ , h " /'&

*, +h (',,# "$+, +h$ )h*,$. Th"& )*, && /$

, -* "$ +h )*,:" /' ,*#"&+/' ,$ ,'-+ # +-(-' &.


98/187


99/187

TUBULAR SECRETION

M,&+ & * +",$ , -*& 0"+h"$+h PCT. S-(&+/$ & &- h /&

$ -*,+*/$& "++ *& ("')" $+ -*" / "# ) $" "''"$

/+*,)"$ ,*)h"$ H K

/$# / ,$"/ /* & * + #.


100/187

TUBULAR SECRETION

Th DCT * " & /"$'%

KK

/$# HK

",$& *,+h (',,#.

SECRETION OF HYDROGEN


101/187

AND POTASSIUM


102/187

KIDNEY PHYSIOLOGY

AMOUNT AMOUNT AMOUNT

FILTERED = REABSORBED + EXCRETED


103/187

KIDNEY PHYSIOLOGY

I +h !"#$ %& "'+ *& 16 */ & , N/C' ) * #/% /$#

* /(&,*( 14 */ & , N/C' ) * #/% +h $ 2 */ & , N/C'

0,-'# ( : * + # (% +h!"#$ %& ) * #/%.


104/187

KIDNEY PHYSIOLOGY

R $/' ' /*/$ * *&+, +h ,'- , )'/& /

+h/+ "& ' /* # , /)/*+" -'/* &-(&+/$ "$ /

" $ +" -&-/''% 1 "$-+ .


105/187

KIDNEY PHYSIOLOGY

RENAL CLEARANCE CANBE CALCULATED USING:

RC = UV/P

U=CONCENTRATION OF SUBSTANCE IN URINE ( g/ !)

V= FLO" RATE OF URINE FOR#ATION ( !/ $%)

P=CONCENTRATION OF SUBSTANCE IN PLAS#A ( g/ !)


106/187

RENAL CLEARANCE

&UESTIONS:1. I +h * $/' ' /*/$ */+ "& +,

GFR

2. I +h * $/' ' /*/$ */+ "& * /+ *+h/$ GFR

3. I +h * $/' ' /*/$ */+ "& ' && +h/$GFR


107/187

RENAL CLEARANCE

1. A'' , +h &-(&+/$ "& "'+ * #?"$-'"$.

2. A'' , +h &-(&+/$ "& "'+ * # /$#/##"+",$ "& & * + #?PAH.

3. S, , +h &-(&+/$ "& * /(&,*( #?-* /.


108/187

RENAL CLEARANCE


109/187

HORMONAL CONTROLOF THE KIDNEYS


110/187

ANTIDIURETICHORMONE


111/187


112/187

ANTIDURETIC HORMONE

A$+"#-* +" h,* ,$

)* $+& 0"# /*"/+",$ "$0/+ * (/'/$ h ')"$ +,/ ,"# # h%#*/+",$ ,* # / .


113/187

ADH "& &%$+h &" #(% $ -*,& * +,*%''& 0h,& ''&

(,#" & /* ', /+ #"$ +h &-)*/,)+"$- ' " , +hh%),+h/'/ -&.


114/187

Th ADH "& @)/ !/ #0"+h"$ / -,' &. Th/ -,' & , (%/:,$/' +*/$&),*+ +, +h

/:,$/' + * "$/'& , +h$ -*,& * +,*% ''&0h" h /! -) +hh%),+h/'/ "h%),)h%& /' +*/ +. Th/ -,' & /* &+,* # "$+h ),&+ *",* ',( ,+h )"+-"+/*%.


115/187

ANTIDURETIC HORMONE

Th h " /' '/&& , ADH"& / )*,+ "$


116/187

ANTIDURETIC HORMONE

S,'-+,$ $+*/+",$& "$+h (',,# /*,$"+,* # (%,& ,* )+,*&"$ +h h%),+h/'/ -&.

Th"& "& /$ :/ )', h- *,' ,$+*,'.


117/187


118/187

ANTIDURETIC HORMONE

Th ,& ,* )+,*&

"$ +-*$ &+" -'/+h%),+h/'/ " $ -*,$& "$ +h&-)*/,)+" $- ' -& 0h" h

&%$+h &" ADH.


119/187


120/187

ANTIDURETIC HORMONE

N * / +",$ ),+ $+"/'&

+*" * +h * ' /& , ADH*, +h /:,$/' + * "$/'&"$ +h ),&+ *",* ',( , +h

)"+-"+/*%.


121/187

ENDOCRINE SYSTEMENDOCRINE SYSTEM


122/187

ANTIDURETIC HORMONE


123/187

ANTIDURETIC HORMONE

ADH +*/ '& +h*,- h+h &%&+ ""* -'/+",$ +, +h#"&+/' ,$ ,'-+ #

+-(-' & , +h $ )h*,$/$# +h ,'' +"$#- +&.

ANTIDURETIC HORMONE


124/187

ANTIDURETIC HORMONE

ADH /-& & 0/+ * +, (

* /(&,*( # *, +hD.C.T. /$# +h ,'' +"$ #- +& "$+, +h /)"''/*" &

0h" h &-**,-$# +h $ )h*,$.

ANTIDURETIC HORMONE


125/187

ANTIDURETIC HORMONE

THE RESULTS OF ADH

1. A # * /& "$ ,& ,'/'"+%2. A$ "$ * /& "$ (',,# ,'-3. A # * /& "$ -*"$ ,-+)-+

4. A$ "$ * /& "$ +h ,$ $+*/+",$, +h -*"$ .

ANTIDURETIC HORMONE


126/187

ANTIDURETIC HORMONE

Th"& h/*+ "& / ,,#&- /*% , +h

$+& , ADH.

ANTIDURETIC HORMONE


127/187

ANTIDURETIC HORMONE

ADH "& * -'/+ # (%

$ /+" #(/ ! 0h $&,'-+ ,$ $+*/+",$& /** #- # +, $,* /' ' '& +h

/ ,-$+ , ADH "& * #- #.

ANTIDURETIC HORMONE


128/187

ANTIDURETIC HORMONE

PATHOLOGY

1. H%) *& * +",$ /$ )*,#- SIADH.

2. H%),& * +",$ /$ )*,#- #"/( + &

"$&")"#-&.


129/187

ALDOSTERONE

ALDOSTERONE


130/187

ALDOSTERONE

A'#,&+ *,$ =& -$ +",$ "& +,h ') /"$+/"$ N/ K",$

(/'/$ /$# "$#"* +'% 0/+ * (/'/$ /$# K K

0"+h"$ +h '-"# , )/*+ $+& , +h (,#%.

ALDOSTERONE


131/187

ALDOSTERONE

Th h " /' '/&& , /'#,&+ *,$ "& &+ *,"#

ALDOSTERONE


132/187

ALDOSTERONE

A ' c * $% ,! '

ALDOSTERONE


133/187

ALDOSTERONE

A'#,&+ *,$ "&&%$+h &" # (% +h''& , +h ,$/', *-',&/ "$ +h/#* $/' ,*+ :.

ALDOSTERONE


134/187

ALDOSTERONE

A'#,&+ *$,$ +/* +& +hD.C.T. , +h $ )h*,$.

ALDOSTERONE


135/187

ALDOSTERONE

EFFECTS OF ALDOSTERONE

1. REABSORPTION OF N/K IONS.

2. 8ATER IS REABSORB USING THESAME TRANSPORT MECHANISM.

3. KK IONS ARE SECRETION INTO THEDCT FROM THE CAPILLARIES.

ALDOSTERONE


136/187

ALDOSTERONE

A'#,&+ *,$ & * +",$ "&,$+*,'' # (% $ /+"F #(/ !.

ALDOSTERONE


137/187

ALDOSTERONE

PATHOLOGY

1. H%) *& * +",$ /$ )*,#-/'#,&+ *,$"& .

2. H%),& * +",$ /$ )*,#- /##"&,$#"& /& .


138/187

ESTROGEN


139/187

ESTROGEN

E&+*, $ "& / /' & :

h,* ,$ )*,#- # (%+h , /*" &.

ESTROGEN


140/187

ESTROGEN

EFFECTS OF ESTROGEN

1. R /(&,*)+",$ , N/ K ",$&.

2. 8/+ * "& * /(&,*( -&"$ +h &/+*/$&),*+ h/$"& .

3. C/ 2K # ),&"+",$ "$+, (,$ .


141/187

CORTISOL

CORTISOL


142/187

CORTISOL

C,*+"&,' "& / h,* ,$)*,#- # (% +h ,*+ : ,+h /#* $/' '/$#.

I+ h ')& "$ +h ,$ *&",$, '")"#& /$# )*,+ "$& +,,* '- ,&

'- ,$ , $&"& .


143/187


144/187

CALCITONIN


145/187

CALCITONIN

C/' "+,$"$ "& / h,* ,$

)*,#- # (% +h +h%*,"#'/$# "$ * &),$& +, h" h' '& , C/ 2K ",$& "$ +h

(',,#.

CALCITONIN


146/187

CALCITONIN

EFFECTS OF CALCITONIN

1. C/2K",$ # ),&"+",$ "$+, (,$ .

2. I$h"("+ ,&+ , '/&+&.


147/187

PARATHYROID HORMONE


148/187

PARATHYROID HORMONE

P/*/+h%*,"# h,* ,$

"& )*,#- # (% +h)/*/+h%*,"# '/$# "$ * &),$&+, ',0 ' '& , C/ 2K",$&

"$ +h (',,#.

PARATHYROID HORMONE


149/187

PARATHYROID HORMONE

EFFECTS OF PTH

1. C/-& & +h (* /! #,0$ , +h "$,* /$" /+*":

, (,$ * ' /&"$ C/2K

",$&.

2. I$ * /& /(&,*)+",$ , C/ 2K ",$&.

3. R /(&,*)+",$ , C/ 2K",$& *, +h DCT.

PARATHYROID HORMONE


150/187

PARATHYROID HORMONE

Calciu


151/187

ACID BASE BALANCEBLOOD )H REGULATED BY1. KIDNEYS2. LUNGS

3. BUFFERS IN BLOOD

KIDNEY REGULATION


152/187

KIDNEY REGULATION

Th !"#$ % /$ * -'/+

)H (% * +/"$"$ ,* : * +"$h%#*, $ ,* (" /*(,$/+",$&.

ACID!BASE BALANCE


153/187

ACID!BASE BALANCE

B! '

0$'% 1 N 2 %HCO 3-

H+

U"i#$

RESPIRATORY REGULATION


154/187


Th * &)"*/+,*% &%&+

* -'/+ & )H (%* -'/+"$ +h / ,-$+, /*(,$ #",:"# "$

+h (',,#.

CARBON DIOXIDE a#% &H


155/187

CARBON DIOXIDE a#% &H

CO 4 + H 4O H 4CO 3 H+

+ HCO 3-

C/*(,$" A "#



156/187


I +h )H "& ',0 +h

* &)"*/+,*% */+ 0"''( # * /& # /$# " +h)H "& h" h +h * &)"*/+,*%

*/+ 0"'' ( "$ * /& #.


157/187

ACIDOSIS


158/187

1. )H ( ',0 .35

2. D )* && & +h $ * ,-& &%&+ .

ALKALOSIS


159/187

1. )H /(, .45.

2. O * : "+ & +h $ * ,-& &%&+ .

RESPIRATORY ACIDOSIS


160/187

A$% ,$#"+",$ +h/+" )/"*& (* /+h"$ /$

/-& * &)"*/+,*% / "#,&"&.Th"& /$ * &-'+ "$ /$ "$ * /&"$ +h / ,-$+ , /*(,$

#",:"# "$ +h (',,# /$# /* #- +",$ "$ +h )H.

RESPIRATORY ALKALOSIS


161/187

A$% ,$#"+",$ +h/+ ' /#&+, h%) * $+"'/+",$ /$

/-& * &)"*/+,*% /'!/',&"&.Th"& /$ * &-'+ "$ /$ # * /&"$ +h / ,-$+ , /*(,$

#",:"# "$ +h (',,# /$# /"$ * /& "$ +h )H.

METABOLIC ACIDOSIS


162/187

M +/(,'" / "#,&"& "&/-& # (% : && / "#& "$

+h (',,#. Th"& /$ ( +h* &-'+ , * $/' #"& /"/( + & ''"+-& ,* /

# * /& "$ +h $- ( * ,(" /*(,$/+ ",$& "$ +h (',,#.

METABOLIC ALKALOSIS


163/187

M +/(,'" /'!/',&"& "&/-& # (% / * #- +",$ "$ +h/ ,-$+ , / "# "$ +h (',,#.Th"& /$ ( +h * &-'+ ,

, "+"$ #"-* +" & ,*: &&" (" /*(,$/+ ",$&

"$ +h (',,#.

SODIUM


164/187

FUNCTIONS

1. A++*/ +& 0/+ * "$+, +h ECF.

2. N * " )-'& &.

3. M-& ' ,$+*/ +",$.

HYPERNATREMIA


165/187

EXCESS SODIUM

1. H%) *+ $&",$2. M-& ' +0"+ h"$3. M $+/' ,$ -&",$4. C, /

HYPONATREMIA


166/187

DEFICIENCY OF SODIUM

1. H%),+ $&",$2. T/ h% /*#"/3. M-& ' 0 /!$ &&

POTASSIUM


167/187

FUNCTIONS

1. A++*/ +& 0/+ * "$+, +h ICF.

2. N * " )-'&

3. M-& ' ,$+*/ +",$&

HYPERKALEMIA


168/187

EXCESS POTASSIUM

1. C/$ ' /# +, / /*#"/ /**h%+h "/

2. E' /+ # + 0/ &

3. M-& ' 0 /!$ &&

HYPOKALEMIA


169/187

DEFICIENCY OF POTASSIUM

1. C/$ ' /# +, /*#"/ /**h%+h "/.

2. D )* && # '/+ $ # + 0/ &

3. M-& ' 0 /!$ &&

CALCIUM


170/187

FUNCTIONS

1. M/+*": , (,$ & /$# + +h

2. N * " )-'&

3. M-& ' ,$+*/ +",$

HYPERCALCEMIA


171/187

EXCESS CALCIUM

1. E: && "$ /' "- "$ (',,#

2. K"#$ % &+,$ &

3. C/*#"/ /**h%+h "/

HYPOCALCEMIA


172/187

DEFICIENCY OF CALCIUM

1. T +/$%

2. 8 /! h /*+ -& ' ,$+*/ +",$&.

3. I$ * /& # ',++"$ +" .

URINARY DISEASES


173/187

RENAL CALCULI KIDNEY STONES

1. C/-& # (% +h *%&+/''" /+",$ , C/ 2K /$#M 2K&/'+& "$ +h * $/' ) ' "&.

2. I +h &+,$ +*/ ' #,0$ +h -* + *

+h )/+" $+ 0"'' ( "$ )/"$.


174/187


175/187

URINARY DISEASES


176/187

INCONTINENCE

1. C/-& # (% ',&& , +h /("'"+% +, ,$+*,','-$+/*% " +-*"+",$ #- +, /,+",$/' #"&,*# *& )* $/$ % ,*

#/ / +, +h $ * ,-& &%&+ .

2. L /#& +, 0 + ',+h"$ .

URINARY DISEASES


177/187

GOUT1. C/-& # (% / "$ * /& # (',,#' ' , -*" / "#. Th"& ' /#& +,"$ '/ /+",$ , +h &, + +"&&-/&&, "/+ # 0"+h ;,"$+&.

2. D * /& # /$# )/"$ -' , $+.

ALDOSTERONISM


178/187

EXCESS ALDOSTERONE

1. E' /+ # &,#"- ' '&

2. D )* && # ),+/&&"- ' '&

3. H%) *+ $&",$

ADDISON(S DISEASE


179/187

DEFICIENCY OF ALDOSTERONE

1. H%),+ $&",$

2. L,0 (',,# '- ,& ' '&.

3. C,',* , &!"$.

CUSHING(S SYNDROME


180/187

EXCESSIVE GLUCOCORTICOIDS

1. H%) * '% "/

2. F/+ / - -'/+",$

DIABETES MELLITUS


181/187

HYPOSECRETION OR ACTIVITY OFINSULIN

1. H%) * '% "/2. P,'%-* /3. Th"*&+

4. B,#% (-*$& /+9! +,$ &5. V/& -'/* )*,(' &

INSULIN


182/187

G! c

C !!

B! '

DIABETES INSIPIDUS


183/187

HYPOSECRETION OF ADH

1. I$ * /& # -*"$ ,'- .

2. P,'%-* /

ADH


184/187

ADH

H)&$"* #ic I#*$",*i*ial

Flui%

C !! c5$%g D c5

H - O

U $%

DIALYSIS THERAPY


185/187

D"/'%&"& "& / )*, && +h/+ /*+" " "/''%* , & +/(,'" 0/&+ & *, +h (',,#"$ ,*# * +, , ) $&/+ ,* !"#$ % * $/'/"'-* . K"#$ % /"'-* * &-'+& "$ +h */)"#/ - -'/+",$ , $"+*, $ 0/&+ -* / + . .

U* "/ /$# ",$ #"&+-*(/$ & /$ /'&,, -*. Th"& ,$#"+",$ /$ /-& / "#,&"&'/(,* # (* /+h"$ ,$ -'&",$& , / /$## /+h.

DIALYSIS THERAPY


186/187

Th ,&+ , ,$ ,* , #"/'%&"&"&h ,#"/'%&"& 0h" h -& & / / h"$ +,+*/$& * )/+" $+=& (',,# +h*,- h /

& ") * /(' +-( +h/+ "& ) * /(',$'% +, & ' + # &-(&+/$ &. Th #"/'%&"&/ h"$ ,$+/"$& /$ /))*,)*"/+ #"/'%&"&'-"# +h/+ )*,#- & / #" -&",$ */#" $+.

DIALYSIS THERAPY


187/187

Th"& */#" $+ /'',0& /($,* /' &-(&+/$ &+, #" -& *, +h )/+" $+=& (',,# /$#)*,#- / @ ' /$"$ +.

urinary system a&p 2

Documents