URINARY SYSTEM

FUNCTIONS OF THE
SYSTEM URINARY
1.
2.
3.
4.
5.
6.

FILTERING OF BLOOD
REGULATION OF BLOOD VOLUME
REGULATION OF BLOOD SOLUTES
RBC SYNTHESIS
VITAMIN D SYNTHESIS
GLUCONEOGENESIS

KIDNEY ANATOMY

ORGANS OF THE
URINARY SYSTEM

1.
2.
3.
4.

KIDNEYS
URETERS
URINARY BLADDER
URETHRA

ORGANS OF THE
URINARY SYSTEM

5. INTERNAL URETHRAL
SPHINCTER.
6. EXTERNAL URETHRAL
SPHINCTER.

LOCATION AND EXTERNAL

ANATOMYOF KIDNEYS
The kidneys lie
behind peritoneum
on the posterior
abdominal wall on
either side of
vertebral column.
The right kidney is
slightly lower than
the left.

EXTERNAL ANATOMY OF THE

KIDNEY
The covering of kidney consists
of three layers. The inner
layer, the renal capsule, the
middle layer, the adipose
capsule, and the outer, renal
fascia.

INTERNAL ANATOMY OF THE

KIDNEY
A FRONTAL
SECTIONS OF A
KIDNEY REVEALS
3 REGIONS:
1. RENAL CORTEX
2. RENAL MEDULLA
3. RENAL PELVIS

INTERNAL ANATOMY OF THE

KIDNEY

RENAL CORTEX
The outer layer
of the kidney
that contain most
of the nephrons.

It is the main site

for filtration,
reabsorption and
secretion.

RENAL MEDULLA
Within the renal
medulla are
located the renal
pyramids, renal
papilla, and renal
columns.

RENAL MEDULLA
The

function of the
renal columns is to
provide the space to
pass blood vessels
to and from the
nephrons.

RENAL MEDULLA

Triangular shaped
units in the medulla
that house the Loops
of Henle and
collecting ducts of
the nephron.
Site for the
counter-current
system that
concentrates salt
and conserves water
and urea

RENAL MEDULLA

The tip of the

renal pyramid.

Releases urine
into a calyx.

INTERNAL ANATOMY OF THE

KIDNEY
The nephrons of the
kidneys produces urine. It
flows from the renal papilla,
to the minor calyce, to the
major calyce, to the renal
pelvis, and finally exits the
kidney within the ureter.

RENAL PELVIS
The

function of the
renal pelvis collects
urine from all of the
calyces.
The urine then is
conducted from the
kidney to the
urinary bladder
using the ureter.

INTERNAL ANATOMY OF THE

KIDNEY
Two major blood vessels are
associated with the kidney.
The renal artery, a branch of
the abdominal aorta, and the
renal vein, which empties into
the inferior vena cava.

THE NEPHRON

TYPES OF NEPHRONS
Cortical nephron:

Originates in outer
2/3 of cortex.
Involved in solute
reabsorption.

Juxtamedullary
nephron:

Originates in inner
1/3 cortex.

Important in the
ability to produce
a concentrated
urine.

Has longer Loop of

Henle.

Insert fig. 17.6

THE NEPHRON

THE NEPHRON
STRUCTURES OF THE NEPHRON
1. BOWMANS CAPSULE
2. PROXIMAL CONVOLUTED TUBULE
3. LOOP OF HENLE
A. DESCENDING LIMB
B. ASCENDING LIMB

4. DISTAL CONVOLUTED TUBULE

THESE EMPTY INTO THE COLLECTING
DUCT OR TUBULES.

PROXIMAL CONVOLUTED
TUBULE

PROXIMAL CONVOLUTED
TUBULES
Simple cuboidal
epithelial cells with
prominent brush
borders of
microvilli.

DECENDING LIMB OF THE

LOOP OF HENLE

DECENDING LIMB OF THE

LOOP OF HENLE

Simple squamous
epithelial cells

ASCENDING LIMB OF THE

LOOP OF HENLE

ASCENDING LIMB OF THE

LOOP OF HENLE

Simple cuboidal
epthelial to low
columnar cells.

DISTAL CONVOLUTED TUBULE

DISTAL CONVOLUTED
TUBULES

Simple cuboidal
epthelial cells.

THE NEPHRON
1.

2.

3.

4.

Proximal convoluted
tubule

1.

Descending limb of
Loop of Henle

2.

Ascending Limb of
Loop of Henle
Distal convoluted
tubules

3.

4.

Simple cuboidal
epithelial cells with
prominent brush
borders of microvilli.
Simple squamous
epithelial cells
Simple cuboidal to
low columnar
epithelial cells.
Simple cuboidal
epthelial cells.

THE NEPHRON
BLOOD VESSELS OF THE NEPHRON
1.
2.
3.
4.
5.

AFFERENT ARTERIOLE
GLOMERULUS
EFFERENT ARTERIOLE
PERITUBULAR CAPILLARIES
VASA RECTA

JUXTAGLOMERULAR
APPARATUS
THE JGA IS LOCATED WHERE
THE INITIAL PORTION OF THE
DISTAL CONVOLUTED TUBULE
LIES AGAINST THE AFFERENT,
AND SOMETIMES THE EFFERENT,
ARTERIOLE.

JUXTAGLOMERULAR
APPARATUS

JUXTAGLOMERULAR
APPARATUS
SOME THE SMOOTH MUSCLE CELLS
OF THE AFFERENT ARTERIOLES
ENLARGE AND HAVE
PROMINENT SECRETORY GRANULES
CONTAINING RENIN. THESE
CELLS ARE TERMED JG CELLS, AND
THEY ACT AS BARORECEPTORS.

JUXTAGLOMERULAR
APPARATUS
THE CELLS OF THE DISTAL
CONVOLUTED TUBULE WHICH
CONTACT THE ARTERIOLES ARE
TERMED THE MACULA DENSA.
THESE CELLS DETECT CHANGES IN
THE RATE AT WHICH URINE FLOW
PAST THEM AND THE CONCENTRATION
OF SOLUTES IN THE URINE.

JUXTAGLOMERULAR
APPARATUS
THE MACULA DENSA CELLS
TRIGGER THE RELEASE OF
LOCALLY ACTING CHEMICALS
WHICH EITHER VASOCONSTRICT
OR VASODILATE THE AFFERENT
ARTERIOLE. THIS RESULTS IN A
CHANGE THE GFR.

KIDNEY PHYSIOLOGY

KIDNEY PHYSIOLOGY
URINE FORMATION AND THE
SIMULTANEOUS ADJUSTMENT OF
BLOOD COMPOSITION INVOLVES
THREE MAJOR PROCESSES:
1. GLOMERULAR FILTRATION
2. TUBULAR REABSORPTION
3. SECRETION

KIDNEY PHYSIOLOGY

KIDNEY PHYSIOLOGY
FILTRATION is the movement of
substances from the
glomerulus into the lumen
of bowmans capsule. This
forms filtrate.

KIDNEY PHYSIOLOGY
REABSORPTION is the
movement of substances,
solutes and water,
across the walls of
nephron into the capillaries
associated with the nephron.

KIDNEY PHYSIOLOGY
SECRETION is the movement
of substances from the
capillaries, associated
with the nephron, across the walls of
nephron into the filtrate with the
nephron.

OSMOTIC EFFECTS
Water serves as the
universal solvent in which
a variety of solutes are
dissolved. Solutes can be
classified as electrolytes
and nonelectrolytes.

ELECTROLYTES
Electrolytes have ionic bonds
which allow the compounds
to dissociate into ions in
water. Because ions are
charged particles, they can
conduct an electrical current.

ELECTROLYTES
Examples of electrolytes
include inorganic salts,
inorganic and organic
acids and bases, and some proteins.

NONELECTROLYTES
Nonelectrolytes have bonds,
usually covalent bonds, that
prevent them from
dissociating in solution.
Therefore, they have
no electrical charge.

NONELECTROLYTES
Examples of nonelectrolytes
include glucose, lipids,
creatinine, and urea.

OSMOTIC EFFECTS
All dissolved solutes
contribute to the osmotic
activity of a fluid. However,
electrolytes have greater
power because each electrolyte
molecule dissociates into at
least 2 ions.

OSMOTIC EFFECTS
Water moves according to
osmotic gradientsfrom
areas of lesser osmolality to
areas of greater osmolality.

OSMOLALITY
A solutions osmolality
is number of solute particles
dissolved in one liter of
water. Osmotic activity is
determined only by the
number of solute particles.

OSMOLALITY
Ten sodium ions have the
same osmotic activity as ten
glucose molecules or
ten amino acids in the same
volume of solution.

OSMOLALITY
Water moves according to
osmotic gradients
from areas of lesser to
higher osmolality.

GLOMERULAR FILTRATION
Urine formation begins with
glomerular filtration.
It is a passive process
in which fluids and solutes
are forced through the
glomerular membrane.

GLOMERULAR FILTRATION
Substances which pass from
the glomerulus into the
nephron include: water,
electrolytes, glucose, amino
acids, vitamins, small
proteins, creatinine,
urate ions, and urea.

GLOMERULAR FILTRATION

GLOMERULAR FILTRATION
The net filtration pressure
(NFP) is responsible for
filtrate formation.
NFP=HPg- (OPg+ HPc)

GLOMERULAR FILTRATION
Glomerular filtration
rate, GFR, is the total amount
of filtrate formed per
minute by the kidneys.
A normal GFR in both
kidneys is 120-125 ml/min or
about 180 l/day

GLOMERULAR FILTRATION
RATE
FACTORS GOVERNING
FILTRATION RATE

Total surface area

available for filtration.
Filtration membrane
permeability
Net Filtration Pressure

GLOMERULAR FILTRATION
GFR IS HELD RELATIVELY
CONSTANT BY TWO IMPORTANT
MECHANISMS THAT
REGULATE RENAL BLOOD FLOW:
1. INSTRINICALLY BY RENAL
AUTOREGULATION
2. EXTRINICALLY BY NEURAL AND
HORMONAL CONTROLS

RENAL AUTOREGULATION
OF GFR
To maintain a stable GFR, the
kidney regulates the diameter
of the afferent arteriole.
therefore, when B.P. decreases
the vessel dilates, and when
B.P. increases the vessel
constricts. This results in a
stable G.F.R.

RENAL AUTOREGULATION OF
GFR
THE KIDNEY USES TWO
MECHANISMS TO PREFORM
AUTOREGULATION:
1. MYOGENIC MECHANISM
2. TUBULOGLOMERULAR FEEDBACK

MYOGENIC MECHANISM
The myogenic mechanism is based on
the tendency of vascular
smooth muscle to contract
when stretched. If B.P. is elevated, the
smooth muscle in the afferent arterioles
are stretched. In response, the smooth
muscle contracts, which narrows the
arterioles lumen, and renal blood flow
decreases, which reduces GFR to is previous
level. This mechanism normalizes renal blood flow
and GFR within seconds after blood pressure changes.

TUBULOGLOMERULAR
FEEDBACK
The macula densa cells of the
juxtaglomerular apparatus
respond to changes in the
osmolarity and changes in
flow rate of the filtrate at
the junction of the D.C.T. and
the ascending limb of the loop of
Henle.

TUBULOGLOMERULAR
FEEDBACK
This results in the secretion
of chemicals which produce
local vasoconstriction of
the afferent and efferent
arterioles. Examples include nitric oxide,
adenosine, endothelin, and prostaglandins.
This mechanism operates more slowly than
the myogenic mechanism.

EXTRINIC CONTROL OF GFR

THE GFR CAN ALSO BE
CONTROLLED EXTRINICALLY
BY:
1. SYMPATHETIC NERVOUS SYSTEM
2. RENIN, ANGIOTENSION,
ALDOSTERONE MECHANISM

TUBULAR REABSORPTION
The proximal convoluted
tubules are the most active
in tubular reabsorption.
All glucose, lactate, and
amino acids are reabsorbed in this
area.

TUBULAR REABSORPTION
About 65% of sodium, 70% of
water, are also reabsorbed
90% of bicarbonate ions, 50% of
chloride ions, and 55% of
potassium are reabsorbed in
the proximal convoluted
tubules.

TUBULAR REABSORPTION
This large amount of
tubular reabsorption
associated with the pct,
results in the GFR
being reduced from 120 ml/min
to about 40 ml/min.

REABSORPTION IN
PROXIMAL NEPHRON

TUBULAR REABSORPTION
Tubular reabsorption
from the loop of Henle
results in 10% of water
being reabsorbed from the
descending limb, 30% of
potassium ions, 20% of sodium,
and 35% of chloride from the
ascending limb.

REABSORPTION IN LOOP OF
HENLE

REABSORPTION IN LOOP OF
HENLE

TUBULAR REABSORPTION
Fluids enters the distal
convoluted tubules at a
rate of about 25 ml/min.
because about 80% of the
water in the filtrate has been
reabsorbed.

TUBULAR REABSORPTION
As fluid flows through
the DCT, sodium and chloride
are reabsorbed. By the time
fluids reaches the end of the
DCT, about 90% of the filtered
solutes and water has been
returned to the blood.

THE COUNTER CURRENT

MECHANISM
One of the functions of the
kidneys is to regulate urine
concentration and volume.
The kidneys accomplish this by
the countercurrent
mechanism.

THE COUNTER CURRENT

MECHANISM
In the kidneys the
countercurrent mechanism
involves the interaction
between the flow of filtrate
through the loops of Henle,
and the flow of blood
through the adjacent vasa recta
blood vessels.

THE COUNTER CURRENT

MECHANISM
The flow in these two
structures is opposite in
direction.

THE COUNTER CURRENT

MECHANISM

THE COUNTER CURRENT

MECHANISM
The NaCl concentration
of the medulla acts as an
osmotic force which draws
water from the descending
limb of the loop of Henle.

THE COUNTER CURRENT

MECHANISM
This is possible because
the descending limb is lined with
simple squamous epithelial cells,
that are permeable
to water, but, impermeable
to NaCl and other solutes.

THE COUNTER CURRENT

MECHANISM
The movement of water causes
the osmolarity of the filtrate
to increase from 300 to 1,200
mOSM/L.

THE COUNTER CURRENT

MECHANISM

THE COUNTER CURRENT

MECHANISM
The ascending limb of the
loop of Henle reabsorbs
chloride by active transport.
In addition, as chloride moves
from the filtrate it pulls
sodium along into the
medulla.

THE COUNTER CURRENT

MECHANISM
This is possible because
the ascending limb is
impermeable to water.

THE COUNTER CURRENT

MECHANISM
The movement of NaCl
into the medulla decreases
the osmolarity of the
filtrate from 1,200 to 100
mOsm/L.

THE COUNTER CURRENT

MECHANISM

THE COUNTER CURRENT

MECHANISM
The hyperosmotic medulla
also pulls water from the
collecting ducts. This varies
depending on the amount of
ADH. As water moves from
the collecting duct, urea
follows.

THE COUNTER CURRENT

MECHANISM
Thus, water is conserved, as well as,
a certain amountof urea. The
urea contributes to the
high osmolarity of the
medulla.

THE COUNTER CURRENT

MECHANISM
The vasta recta is composed
of capillaries which
surround the loop of henle.
The vessels flow
counter (opposite) to the
loop of Henle and act as a
counter current exchanger.

THE COUNTER CURRENT

MECHANISM
As blood flows through the
vasa recta it picks up water
and leaves behind NaCl.

THE COUNTER CURRENT

MECHANISM
Therefore, the vasa recta
returns water back to the
body and the NaCl
maintains the hyperosmotic
medulla.

THE COUNTER CURRENT

MECHANISM

TUBULAR SECRETION
Tubular secretion is the
movement of chemicals
from the blood into the
nephron. This process can
occur in the proximal or
distal convoluted tubules.

TUBULAR SECRETION
THIS PROCESS IS IMPORTANT FOR:
1. Disposing of substances which were not
filtered.
2. Removal of excess K+ .
3. Controlling blood ph.
4. Eliminating substances which have been
reabsorbed.

TUBULAR SECRETION
Most secretion occurs within
the PCT. Substances such as
neurotransmitters, bile
pigment, uric acid, penicillin,
atropine, morphine, H+ ,
and ammonia are secreted.

TUBULAR SECRETION
The DCT receives mainly
K+ and H+ ions from
the blood.

SECRETION OF HYDROGEN
AND POTASSIUM

KIDNEY PHYSIOLOGY

AMOUNT
AMOUNT
AMOUNT
FILTERED = REABSORBED + EXCRETED

KIDNEY PHYSIOLOGY
If the kidneys filters 16 grams
of NaCl per day, and
reabsorb 14 grams of NaCl
per day, then 2 grams of NaCl
would be excreted by the
kidneys per day.

KIDNEY PHYSIOLOGY
Renal clearance refers
to the volume of plasma
that is cleared of a
particular substance in a
given time, usually 1 minute.

KIDNEY PHYSIOLOGY
RENAL CLEARANCE CAN
BE CALCULATED USING:
RC = UV/P
U=CONCENTRATION OF SUBSTANCE IN URINE (mg/ml)
V= FLOW RATE OF URINE FORMATION (ml/min)
P=CONCENTRATION OF SUBSTANCE IN PLASMA (mg/ml)

RENAL CLEARANCE
QUESTIONS:
1. If the renal clearance rate is = to
GFR?
2. If the renal clearance rate is greater
than GFR?
3. If the renal clearance rate is less than
GFR?

RENAL CLEARANCE
1. All of the substance is filteredinulin.
2. All of the substance is filtered and
addition is secretedPAH.
3. Some of the substance is reabsorbed
urea.

RENAL CLEARANCE

HORMONAL CONTROL
OF THE KIDNEYS

ANTIDIURETIC
HORMONE

HORMONAL CONTROL OF
URINE CONCENTRATION
One of the most
important hormones in
the control of urine
concentration and
volume is antidiuretic
hormone, ADH.

ANTIDURETIC HORMONE
Antiduretic hormone
prevents wide variation in
water balance, helping to
avoid dehydration or edema.

ADH is synthesized
by neurosecretory
cells whose cells
bodies are located
in the supraoptic
nuclei of the
hypothalamus.

The ADH is packaged

within vacuoles. The
vacuoles move by
axonal transport to the
axonal terminals of the
neurosecretory cells
which make up the
hypothalamic
hypophyseal tract. The
vacuoles are stored in
the posterior lobe of
the pituitary.

ANTIDURETIC HORMONE

The chemical class of ADH

is a protein

ANTIDURETIC HORMONE
Solute
concentrations in
the blood are
monitored by
osmoreceptors
in the hypothalamus.
This is an example
of humerol control.

ANTIDURETIC HORMONE
When solute concentrations
increase, thereby, increasing
osmotic pressure,
the receptors are stimulated.

ANTIDURETIC HORMONE
The osmoreceptors,
in turn, stimulate
hypothalamic neurons in the
supraoptic nucleus, which
synthesize ADH.

ENDOCRINE SYSTEM

ANTIDURETIC HORMONE
Nerve action potentials
trigger the release of ADH
from the axonal terminals
in the posterior lobe of the
pituitary.

ENDOCRINE SYSTEM

ANTIDURETIC HORMONE
ADH travels through
the systemic
circulation to the
distal convoluted
tubules of the nephron
and the collecting
ducts.

ANTIDURETIC HORMONE
ADH causes water to be
reabsorbed from the
D.C.T. and the collecting
ducts into the capillaries
which surround the nephron.

ANTIDURETIC HORMONE
THE RESULTS OF ADH:
1.
2.
3.
4.

A decrease in osmolality
An increase in blood volume
A decrease in urine output
An increase in the concentration
of the urine.

ANTIDURETIC HORMONE

This chart is a good

summary of the
events of ADH.

ANTIDURETIC HORMONE
ADH is regulated by
negative feedback; when
solute concentrations are
reduced to normal levels the
amount of ADH is reduced.

ANTIDURETIC HORMONE
PATHOLOGY
1. Hypersecretion can produce SIADH.
2. Hyposecretion can produce diabetes
insipidus.

ALDOSTERONE

ALDOSTERONE
Aldosterones function is to
help maintain Na+ ion
balance, and indirectly water
balance and K+,
within the fluid compartments
of the body.

ALDOSTERONE

The chemical class of

aldosterone is steroid

ALDOSTERONE
A decrease in blood pressure

ALDOSTERONE
Aldosterone is
synthesized by the
cells of the zona
glomerulosa in the
adrenal cortex.

ALDOSTERONE

Aldosternone targets the

D.C.T.
of the nephron.

ALDOSTERONE
EFFECTS OF ALDOSTERONE:
1. REABSORPTION OF Na+ IONS.
2. WATER IS REABSORB USING THE
SAME TRANSPORT MECHANISM.
3. K+ IONS ARE SECRETION INTO THE
DCT FROM THE CAPILLARIES.

ALDOSTERONE

Aldosterone secretion is
controlled by negative
Feedback.

ALDOSTERONE
PATHOLOGY:
1. Hypersecretion can produce
aldosteronism.
2. Hyposecretion can produce addison
disease.

ESTROGEN

ESTROGEN
Estrogen is a female sex
hormone produced by
the ovaries.

ESTROGEN
EFFECTS OF ESTROGEN:
1. Reabsorption of Na+ ions.
2. Water is reabsorb using the same
transport mechanism.
3. Ca2+ deposition into bone.

CORTISOL

CORTISOL
Cortisol is a hormone
produced by the cortex of
the adrenal gland.
It helps in the conversion
of lipids and proteins to
form glucose
(gluconeogensis).

CORTISOL
EFFECTS OF CORTISOL:
1. Reabsorption of Na+ ions.
2. Water is reabsorb using the same
transport mechanism.
3. Can cause edema.

BONE CALCIUM
REGULATION

CALCITONIN
Calcitonin is a hormone
produced by the thyroid
gland in response to high
levels of Ca2+ ions in the
blood.

CALCITONIN
EFFECTS OF CALCITONIN:
1. Ca2+ ion deposition into bone.
2. Inhibit osteoclasts.

CALCITONIN

Calcium

PARATHYROID HORMONE
Parathyroid hormone
is produced by the
parathyroid gland in response
to low levels of Ca2+ ions
in the blood.

PARATHYROID HORMONE
EFFECTS OF PTH:
1. Causes the break down of the inorganic matrix
of bone, releasing Ca2+ ions.
2. Increase absorption of Ca2+ ions.
3. Reabsorption of Ca2+ ions from the DCT.

PARATHYROID HORMONE

Calcium

ACID BASE BALANCE

BLOOD pH REGULATED BY:
1. KIDNEYS
2. LUNGS
3. BUFFERS IN BLOOD

KIDNEY REGULATION
The kidney can regulate
pH by retaining or excreting
hydrogen or bicarbonate
ions.

ACID-BASE BALANCE

Blood
Kidney Nephron

H+

HCO3-

Urine

RESPIRATORY REGULATION
The respiratory system
regulates pH by
regulating the amount
of carbon dioxide in
the blood.

CARBON DIOXIDE and pH

CO2 + H2O

H2CO3

H+ + HCO3-

Carbonic Acid

RESPIRATORY REGULATION
If the pH is low, the
respiratory rate will
be decreased, and if the
pH is high, the respiratory
rate will be increased.

DISEASES and ABNORMALITIES

ASSOCIATED WITH THE
URINARY SYSTEM

ACIDOSIS
1. pH below 7.35
2. Depresses the nervous system.

ALKALOSIS
1. pH above 7.45.
2. Overexcites the nervous system.

RESPIRATORY ACIDOSIS
Any condition that
impairs breathing can
cause respiratory acidosis.
This can result in an increase
in the amount of carbon
dioxide in the blood and a
reduction in the pH.

RESPIRATORY ALKALOSIS
Any condition that leads
to hyperventilation can
cause respiratory alkalosis.
This can result in an decrease
in the amount of carbon
dioxide in the blood and a
increase in the pH.

METABOLIC ACIDOSIS
Metabolic acidosis is
caused by excess acids in
the blood. This can be the
result of renal disease,
diabetes mellitus, or a
decrease in the number of
bicarbonate ions in the blood.

METABOLIC ALKALOSIS
Metabolic alkalosis is
caused by a reduction in the
amount of acid in the blood.
This can be the result of
vomiting, diuretics, or
excessive bicarbonate ions
in the blood.

SODIUM
FUNCTIONS:
1. Attracts water into the ECF.
2. Nerve impulses.
3. Muscle contraction.

HYPERNATREMIA
EXCESS SODIUM:
1.
2.
3.
4.

Hypertension
Muscle twitching
Mental confusion
Coma

HYPONATREMIA
DEFICIENCY OF SODIUM:
1. Hypotension
2. Tachycardia
3. Muscle weakness

POTASSIUM
FUNCTIONS:
1. Attracts water into the ICF.
2. Nerve impulse
3. Muscle contractions

HYPERKALEMIA
EXCESS POTASSIUM:
1. Can lead to a cardiac arrhythmia
2. Elevated t waves
3. Muscle weakness

HYPOKALEMIA
DEFICIENCY OF POTASSIUM:
1. Can lead to cardiac arrhythmia.
2. Depressed (flatened) t waves
3. Muscle weakness

CALCIUM
FUNCTIONS:
1. Matrix of bones and teeth
2. Nerve impulse
3. Muscle contraction

HYPERCALCEMIA
EXCESS CALCIUM:
1. Excess in calcium in blood
2. Kidney stones
3. Cardiac arrhythmia

HYPOCALCEMIA
DEFICIENCY OF CALCIUM:
1. Tetany
2. Weak heart muscle contractions.
3. Increased clotting time.

URINARY DISEASES
RENAL CALCULI (KIDNEY STONES)
1. Caused by the crystallization of Ca2+ and
Mg2+ salts in the renal pelvis.
2. If the stone travel down the ureter,
the patient will be in pain.

URINARY DISEASES
CYSTITIS
1. Caused by bacteria, usually E. coli,
Klebsiella, or Proteus.
2. Leads to inflammation, fever, increased
urgency and frequency of urination and
pain.

URINARY DISEASES
GLOMERULONEPHRITIS:

1. Caused by inflammation of the

glomerulus due to streptococcal
antibody complexes.
2. Inflammation of the glomerulus
leads to faulty filtration.

URINARY DISEASES
INCONTINENCE:
1. Caused by loss of the ability to control
voluntary micturition due to age,
emotional disorders, pregnancy, or
damage to the nervous system.
2. Leads to wet clothing.

URINARY DISEASES
GOUT:

1. Caused by a increased blood

level of uric acid. This leads to
inflammation of the soft tissue
associated with joints.
2. Decreased and painful movement.

ALDOSTERONISM
EXCESS ALDOSTERONE:
1. Elevated sodium levels
2. Depressed potassium levels
3. Hypertension

ADDISONS DISEASE
DEFICIENCY OF ALDOSTERONE:
1. Hypotension
2. Low blood glucose levels.
3. Color of skin.

CUSHINGS SYNDROME
EXCESSIVE GLUCOCORTICOIDS:
1. Hyperglycemia
2. Fat accumulation

DIABETES MELLITUS
HYPOSECRETION OR ACTIVITY OF
INSULIN:
1.
2.
3.
4.
5.

Hyperglycemia
Polyurea
Thirst
Body burns fat-ketones
Vascular problems

INSULIN

Cell

Glucose

Blood

DIABETES INSIPIDUS
HYPOSECRETION OF ADH:
1. Increased urine volume.
2. Polyurea

ADH
Collecting Duct
ADH
H2O

Urine

Hypertonic Interstitial
Fluid

DIALYSIS THERAPY
Dialysis is a process that artificially
removes metabolic wastes from the blood
in order to compensate for kidney (renal)
failure. Kidney failure results in the rapid
accumulation of nitrogen waste (urea,etc.).
Uremia and ion disturbances can also
occur. This condition can cause acidosis,
labored breathing, convulsions, coma and
death.

DIALYSIS THERAPY
The most common form of dialysisis
hemodialysis which uses a machine to
transfer patients blood through a
semipermeable tube that is permeable
only to selected substances. The dialysis
machine contains an appropriate dialysis
fluid that produces a diffusion gradient.

DIALYSIS THERAPY
This gradient allows abnormal substances
to diffuse from the patients blood and
produce a cleaning effect.