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Learning Outcomes 1. Identify the component parts of the renal system. 2. Describe the gross anatomy of the kidney and the anatomy of a nephron. 3. Explain the mechanisms that underpin the formation of urine; filtration, selective reabsorption, and secretion. 4. Discuss the physical characteristics and normal constituents of urine in relation to urinalysis 5. Describe the structure and functions of the ureters, bladder and urethra and describe the mechanics and control of micturition. 6. Briefly consider how renal function changes across the lifespan in healthy individuals
Kidneys form urine, the rest of system concerned with eliminating it Complete labeling exercise of urinary system (handouts to be given in class)
HAP Renal, 2012
Kidneys
2 kidney bean shaped organs in upper abdomen contain NEPHRONS involved in urine formation Blood supplied by RENAL ARTERY and drained by RENAL VEIN Covered and protected by a fibrous capsule Has 3 distinct regions (REFER TO YOUR BOOK); RENAL CORTEX (glomeruli, Bowmans capsule and convoluted tubules RENAL MEDULLA (loops of Henle and collecting ducts RENAL PELVIS central area where urine collects Divided into 8 lobes
HAP Renal, 2012
http://www.neok12.com/diagram/Urinary-System-01.htm
HAP Renal, 2012
Kidney Functions
1) Elimination of waste products 2) Control of fluids, electrolytes and acid-base balance 3) Regulation of renal and systemic BP (reninangiotensin system) 4) Stimulate RBC formation (erythropoiesis) 5) Activation of Vitamin D
Microscopic Structure
NEPHRONS are the functional unit of the kidney 2 million nephrons in each kidney and called the RENAL TUBULES Responsible for; Urine production Fluid balance Electrolyte balance Acid base balance (homeostasis of blood pH) The tubule carries out the above by way of 3 distinct processes called filtration, reabsorption and secretion which occur at specific sites along the tubule (nephron)
HAP Renal, 2012
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A Nephron in Action
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Micturition Pathway
Basically: simple reflex (easily noted in infants) Sensory pathways When 250ml urine stretch receptors are stimulated excite sensory parasympathetic fibres Information relayed to the sacral area of the spine for integration Motor pathway AT THE SAME TIME Parasympathetic motor neurones are excited contract the detrusor muscle bladder pressure internal sphincter opens Motor neurons supplying the external sphincter via the pudendal nerve are inhibited so external sphincter opens & urine flows out (gravity helps too!)
HAP Renal, 2012
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Control of Micturition
We learn to adapt this simple reflex Bladder wall: sensory fibres convey how full the bladder is via the spine higher centres of the brain, the thalamus & cerebral cortex (not established until 2yrs old) An awareness of level of urgency and you can override the micturition reflex by: Inhibiting the parasympathetic motor nerve fibres to the bladder Reinforcing contraction of the external sphincter As urine volume increases stretch receptor & nerve activity sensation of pressure more uncomfortable When convenient, brain centres remove inhibition and permit micturition under conscious control After micturition < 10ml urine remains in bladder and the cycle begins again
HAP Renal, 2012
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2. Discuss the effect these changes have on renal/urinary function 3. Feedback to the group
URINE COMPOSITION Refer to your urinalysis handout and apply in your DPS session at the end of the week.
HAP Renal, 2012
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