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Review Anatomy And Physiology Kidney
1.
Structure and Function
of the Renal and Urologic Systems Chapter 35 1
2.
Structures of the
Kidney Kidneys Retroperitoneal Renal capsule Renal fascia Hilum 2 Mosby items and derived items © 2006 by Mosby, Inc.
3.
Structures of the
Kidney 3 Mosby items and derived items © 2006 by Mosby, Inc.
4.
Structures of the
Kidney Renal cortex Renal medulla Renal pyramids Renal columns Minor calyx Major calyx Renal pelvis 4 Mosby items and derived items © 2006 by Mosby, Inc.
5.
Structures of the
Kidney 5 Mosby items and derived items © 2006 by Mosby, Inc.
6.
Nephron
1.2 million nephrons per kidney Functional unit of the kidney Superficial cortical nephrons Midcortical nephrons Juxtamedullary nephrons 6 Mosby items and derived items © 2006 by Mosby, Inc.
7.
Nephron
Renal corpuscle Glomerulus Bowman capsule Mesangial cells Bowman space 7 Mosby items and derived items © 2006 by Mosby, Inc.
8.
Nephron
Glomerular filtration membrane Glomerular endothelium Basement membrane Capillary epithelium Also referred to as podocytes or visceral epithelium Filtration slits 8 Mosby items and derived items © 2006 by Mosby, Inc.
9.
Nephron
Juxtaglomerular apparatus Juxtaglomerular cells Macula densa 9 Mosby items and derived items © 2006 by Mosby, Inc.
10.
Juxtaglomerular Apparatus
10 Mosby items and derived items © 2006 by Mosby, Inc.
11.
Nephron
Renal tubules Proximal tubule Loop of Henle Distal tubule Collecting duct Principal cells Intercalated cells 11 Mosby items and derived items © 2006 by Mosby, Inc.
12.
Structures of the
Kidney 12 Mosby items and derived items © 2006 by Mosby, Inc.
13.
Structures of the
Kidney 13 Mosby items and derived items © 2006 by Mosby, Inc.
14.
Blood Vessels
Renal arteries Interlobar arteries Arcuate arteries Interlobular arteries Afferent arterioles Glomerular capillaries Efferent arterioles Peritubular capillaries and vasa recta 14 Mosby items and derived items © 2006 by Mosby, Inc.
15.
Structures of the
Kidney 15 Mosby items and derived items © 2006 by Mosby, Inc.
16.
Structures of the
Kidney Ureters 30 cm long Long, intertwining muscle bundles Pass obliquely though posterior aspect of bladder Peristaltic activity Micturition compresses the lower end of the ureter to avoid urine reflux 16 Mosby items and derived items © 2006 by Mosby, Inc.
17.
Structures of the
Kidney Bladder Detrusor muscle Transitional epithelium Trigone Micturition reflex Urethra Internal and external sphincters 3 to 4 cm in females 18 to 20 cm in males 17 Mosby items and derived items © 2006 by Mosby, Inc.
18.
Bladder and Urethra
18 Mosby items and derived items © 2006 by Mosby, Inc.
19.
Renal Blood Flow
Receive 1000 to 1200 mL of blood per minute Glomerular filtration rate (GFR) Autoregulation Myogenic mechanism Tubuloglomerular feedback Neural regulation Hormones Renin-angiotensin system Natriuretic peptides 19 Mosby items and derived items © 2006 by Mosby, Inc.
20.
Renal Blood Flow
20 Mosby items and derived items © 2006 by Mosby, Inc.
21.
Nephron Function
Glomerular filtration Net filtration pressure Glomerular hydrostatic pressure Capsular hydrostatic pressure Blood oncotic pressure Filtration rate 21 Mosby items and derived items © 2006 by Mosby, Inc.
22.
Glomerular Filtration
22 Mosby items and derived items © 2006 by Mosby, Inc.
23.
Nephron Function
Tubular reabsorption Tubular secretion Excretion Tubular transport Proximal tubule Loop of Henle and distal tubule Glomerulotubular balance 23 Mosby items and derived items © 2006 by Mosby, Inc.
24.
Nephron Function
24 Mosby items and derived items © 2006 by Mosby, Inc.
25.
Nephron Function
25 Mosby items and derived items © 2006 by Mosby, Inc.
26.
Nephron Function
26 Mosby items and derived items © 2006 by Mosby, Inc.
27.
Concentration and Dilution
of Urine Countercurrent exchange system Contributes to production of concentrated urine Fluid flows in opposite direction through parallel tubes Fluid moves up and down the parallel limbs of the loop of Henle The longer the loop, the greater the concentration gradient 27 Mosby items and derived items © 2006 by Mosby, Inc.
28.
Countercurrent Exchange System
28 Mosby items and derived items © 2006 by Mosby, Inc.
29.
Concentration and Dilution
of Urine Urea Catecholamines Antidiuretic hormone (ADH) Urodilantin Natriuretic peptide Diuretics 29 Mosby items and derived items © 2006 by Mosby, Inc.
30.
Renal Hormones
Vitamin D Erythropoietin 30 Mosby items and derived items © 2006 by Mosby, Inc.
31.
Tests of Renal
Function Clearance and glomerular filtration rate Inulin Creatinine Clearance and renal blood flow Blood tests Plasma creatinine concentration Plasma cystatin C concentration Blood urea nitrogen (BUN) 31 Mosby items and derived items © 2006 by Mosby, Inc.
32.
Tests of Renal
Function Urinalysis Urine color Urine pH Specific gravity Urine sediment RBCs Casts Crystals WBCs 32 Mosby items and derived items © 2006 by Mosby, Inc.
33.
Tests of Renal
Function Urinalysis Reagent strips (dipsticks) Glucose Bilirubin Urobilinogen Leukocyte esterase Nitrates Ketones Proteins RBCs, hemoglobin, and myoglobin 33 Mosby items and derived items © 2006 by Mosby, Inc.
34.
Aging and Renal
Function Decrease in kidney size Decrease in renal blood flow and GFR Number of nephrons decrease due to renal vascular and perfusion changes Glomerular capillaries atrophy Tubular transport response decreases Increased bladder symptoms Urgency, frequency, and nocturia 34 Mosby items and derived items © 2006 by Mosby, Inc.
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