1
volume
osmolarity
blood
toxins
internal
Removal
of
,
metabolic
wastes
,
and
excess
ions
from
the
.
Maintain
the
body
?
s
environment
.
Regulate
total
water
and
(
concentration
of
solutes
)
of
the
body
.
Regulate
concentrations
of
ions
in
ECF
(
ex
.
Na
+
,
K
+
,
Ca
+
,
Cl
-
)
3
Gluconeogenesis
D
calcitriol
erythropoietin
RBC
pressure
Hormone
production
(
for
regulating
production
and
renin
for
regulating
blood
)
.
Converts
vitamin
to
(
its
active
form
)
.
during
prolonged
fasting
4
Ureters
Kidneys
Urethra
Nephrons
are
major
excretory
organs
.
are
the
functional
excretory
units
.
Urinary
bladder
is
the
temporary
storage
reservoir
for
urine
.
transport
urine
from
the
kidneys
to
the
bladder
.
transports
urine
out
of
the
body
5
hilum
Retroperitoneal
lower
helium
lower
The
Kidneys
.
,
in
the
superior
lumbar
region
.
Right
kidney
is
than
the
left
.
Convex
lateral
surface
,
concave
medial
surface
.
Renal
hilum
leads
to
the
renal
sinus
.
Ureters
,
renal
blood
vessels
,
lymphatics
,
and
nerves
enter
and
exit
at
the
6
Cortical
Juxtamedullary
Glomerulus
capillaries
Renal
functional
1
85%
Nephrons
medulla
Structural
and
units
that
form
urine
Each
kidney
contains
about
million
nephrons
Two
main
parts
:
1
.
(
renal
corpuscle
)
:
a
tuft
of
2
.
tubule
:
begins
as
cup
-
shaped
glomerular
(
Bowman
?
s
)
capsule
surrounding
the
glomerulus
Two
Classes
1
.
About
of
all
nephrons
,
almost
completely
in
cortex
2
.
Nephrons
Originate
at
cortex
-
interface
,
long
loops
that
dip
into
the
medulla
;
allow
for
production
of
concentrated
urine
&
conserving
water
7
loop
glomerulus
systemic
Region
where
ascending
portion
of
nephron
lies
against
the
afferent
arterioles
that
feeds
the
Both
the
nephron
loop
and
afferent
arteriole
cells
are
modified
at
point
of
contact
JGC
helps
to
regulate
rate
of
filtrate
formation
&
blood
pressure
8
mesangial
densa
Granular
Macula
Extraglomerular
cells
?
modified
cells
of
ascending
nephron
loop
;
packed
beside
granular
cells
;
chemoreceptor
cells
that
monitor
NaCl
concentrations
of
filtrate
entering
the
distal
convoluted
tubule
cells
?
found
in
arteriole
walls
;
act
as
mechanoreceptors
,
releasing
renin
when
changes
in
blood
pressure
occur
cells
?
lie
between
the
nephron
loop
and
arterioles
;
allows
communication
between
macula
densa
and
granular
cells
via
chemical
signal
s
9
filtered
creatinine
95%
pathology
5%
Chemical
Composition
of
Urine
water
and
solutes
Nitrogenous
wastes
:
urea
,
uric
acid
,
and
Other
normal
solutes
Na
+
,
K
+
,
PO43
?
,
and
SO42
?
,
Ca2
+
,
Mg2
+
and
HCO3
?
Abnormally
high
concentrations
of
any
constituent
may
indicate
Chemically
balancing
and
cleansing
of
the
blood
leads
to
urine
formation
?
urine
is
literally
just
blood
!
10
Glomerular
reabsorption
secretion
Three
Steps
:
filtration
"
dumping
filtrate
into
the
waste
container
"
Tubular
"
reclaiming
what
the
body
needs
to
keep
"
Tubular
"
selectively
adding
to
the
waste
container
"
11
Filtration
Hydrostatic
osmotic
Net
Pressure
(
NFP
)
is
determined
by
the
differences
in
outward
and
inward
pressures
pressure
of
the
glomerular
capillaries
(
HPgc
)
aka
glomerular
BP
,
promotes
filtrate
formation
,
"
the
push
"
forcing
water
and
solutes
out
of
blood
Colloid
pressure
of
the
glomerular
capillaries
(
OPgc
)
,
"
the
pull
"
by
blood
proteins
keeping
water
and
solutes
in
Kidney
form
in
pelvis
Crystallized
calcium
,
magnesium
,
or
uric
acid
salts
Larger
stones
block
ureter
,
cause
pressure
and
pain
in
kidneys
May
be
due
to
bacterial
infection
,
urine
retention
,
?
Ca2
+
in
blood
,
?
pH
of
urine
13
detrusor
external
internal
Urination
or
voiding
Three
simultaneous
events
Contraction
of
muscle
by
ANS
Opening
of
urethral
sphincter
by
ANS
Opening
of
urethral
sphincter
by
somatic
nervous
system
Blood
composition
depends
on
:
diet
,
cellular
metabolism
and
urinary
In
24
hours
,
million
nephrons
of
the
kidneys
filter
150
-
180
liters
of
blood
plasma
;
resulting
in
0
.
8
-
1
liter
of
urine
output
daily
In
healthy
individuals
,
kidneys
maintain
urine
consistancy
despite
variation
in
diet
and
metabolic
activity
Urinalysis
allows
testing
to
determine
substances
present
in
a
urine
specimen
?
this
can
be
used
to
assess
health
of
a
patient
must
be
done
within
30
minutes
after
urine
is
voide
d
Color
and
Transparency
Should
be
clear
and
pale
yellow
to
amber
in
color
,
due
to
(
pigment
metabolite
of
bilirubin
)
Color
variations
indicate
the
relative
concentration
of
solutes
to
water
in
the
urine
Abnormal
urine
color
may
be
due
to
certain
foods
,
such
as
beets
,
various
drugs
,
bile
,
or
blood
Cloudy
urine
may
indicate
a
?
slightly
aromatic
Bacteria
action
gives
it
an
ammonia
-
like
odor
Some
drugs
,
vegetables
and
various
disease
processes
alter
the
characteristic
odor
or
urine
.
Example
:
someone
with
uncontrolled
diabetes
mellitus
makes
urine
smell
fruity
or
acetone
-
like
.
ranges
from
4
.
5
-
8
.
0
(
average
of
6
)
Diet
can
influence
pH
or
urine
A
diet
high
in
protein
and
whole
wheat
raise
the
acidity
of
urine
.
The
foods
that
can
increase
the
urine
pH
are
called
acid
ash
foods
.
A
vegetarian
diet
(
alkaline
ash
diet
)
increases
the
alkalinity
of
the
urine
.
A
urinary
tract
infection
may
also
result
in
urine
with
a
high
pH
.
17
Specific
gravity
urinprober
gravity
gravity
hydrometer
Low
specific
High
crystallize
specific
is
the
relative
weight
of
a
specific
volume
of
liquid
compared
with
an
equal
volume
of
distilled
water
.
The
specific
gravity
of
distilled
water
is
1
.
000
,
because
1
ml
weighs
1
gram
.
Measured
using
a
/
Urine
weighs
more
because
it
has
solutes
?
normal
is
1
.
001
-
1
.
030
.
=
more
solutes
Limited
fluid
intake
,
fever
,
kidney
inflammation
=
less
solutes
Excessive
water
intake
,
diabetes
insipidus
or
chronic
renal
failure
If
urine
becomes
excessively
concentrated
,
some
substances
normally
held
in
solution
begin
to
precipitate
or
forming
kidney
stones
(
renal
calculi
)
.
18
Casts
Glucose
Bodies
Ketone
Albumin
Hardened
cell
fragments
,
formed
in
distal
convoluted
tubules
&
collecting
ducts
Hyaline
,
red
blood
cell
and
white
blood
cell
casts
Always
indicate
a
pathological
condition
(
Glucosuria
)
High
blood
sugar
levels
due
to
inadequate
insulin
levels
;
or
can
result
when
active
transport
mechanisms
for
glucose
are
exceeded
temporarily
Excessive
carbohydrate
intake
Uncontrolled
diabetes
mellitus
Aka
Glycosuria
(
Albuminuria
)
-
albumin
in
urine
Normally
albumin
is
too
big
to
pass
through
the
glomerulus
?
so
when
it
does
you
have
an
abnormally
increased
permeability
of
the
membrane
.
Nonpathological
conditions
:
excessive
exertion
,
pregnancy
,
overabundant
protein
intake
Pathological
conditions
usually
events
that
damage
the
glomerular
membrane
kidney
trauma
Poisons
Toxins
Hypertension
(
Ketonuria
)
Acetoacetic
acid
,
beta
-
hydroxybutyric
acid
and
acetone
are
ketone
bodies
.
Normally
found
in
small
amounts
in
urine
If
larger
amounts
usually
indicates
abnormal
metabolic
processes
are
occurring
.
The
result
is
acidosis
.
Expect
to
see
this
during
starvation
or
diets
very
low
in
carbohydrates
?
inadequate
food
forces
the
body
to
use
its
stored
fat
.
Finding
both
ketones
and
glucose
usually
indicates
diabetes
mellitus
19
Hemoglobinuria
Hemoglobin
Blood
Red
Cells
(
hematuria
)
Indicates
pathology
of
the
urinary
tract
?
rbc
are
too
big
to
pass
through
glomerular
pores
Kidney
stones
Infection
Tumors
Physical
trauma
to
urinary
organs
(
)
Hemoglobin
in
urine
as
a
result
of
hemolysis
(
bursting
)
of
RBCs
Indicates
Hemolytic
anemias
Transfusion
reactions
Burns
Venomous
snake
bites
Renal
disease
20
White
Pigments
Blood
Cells
Nitrites
Bile
May
indicate
a
bacterial
infection
(
E
.
coli
)
Valuable
for
early
indicators
of
bladder
infection
(
Bilirubinuria
)
bilirubin
in
urine
(
bile
pigments
)
Usually
indicates
liver
pathology
hepatitis
cirrhosis
bile
duct
blockage
Usually
yellow
foam
forms
when
urine
is
shaken
(
Pyuria
)
presence
of
white
blood
cells
in
urine
(
pus
)
Indicates
inflammation
of
urinary
tract
21
insipidus
Gonorrhea
Diabetes
Diabetes
Pyelonephritis
Glomerulonephritis
mellitus
-
kidney
infection
-
"
glomerular
disease
"
acute
inflammation
of
the
kidney
,
typically
caused
by
an
immune
response
-
sexually
transmitted
bacterial
infection
-
diabetes
-
too
much
sugar
in
the
blood
-
rare
-
caused
by
a
deficiency
of
the
pituitary
hormone
ADH
(
vasopressin
)
which
regulates
kidney
function
.
|
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