Anatomy and Physiology

The Urinary System is a system of organs that produces and excretes urine
from the body. Urineis a transparent yellow fluid containing unwanted wastes,
mostly excess water, salts, and nitrogen compounds.

An average adult produces about 1.5 liters (3 pt) of urine each day, and the
body needs, at a minimum, to excrete about 0.5 liter (1 pint) of urine daily to get rid
of its waste products. Excessive or inadequate production of urine may indicate
illness and doctors often use urinalysis (examination of a patients urine) as part of
diagnosing disease. For instance, the presence of glucose, or blood sugar, in the
urine is a sign of diabetes mellitus; bacteria in the urine signal an infection of the
urinary system; and red blood cells in the urine may indicate cancer of the urinary
tract.
Functions of the urinary system

Excretion. The kidneys are the major excretory organs of the body. They
remove waste products, many of which are toxic, from the blood. Most waste
products are metabolic by products of cells and substances absorbed from
the intestine. The skin, liver, lungs, and intestines eliminate some of these
waste products, but they cannot compensate if the kidneys fail to function.

Blood volume control. The kidneys play an essential role in controlling blood
volume by regulating the volume of water removed from the blood to produce
urine.

Ion concentration regulation. The kidneys help regulate the concentrate of

the major ion in the body fluids.

pH regulation. The kidneys help regulate the pH of the body fluids. Buffers in
the blood and the respiratory system also play important roles in the
regulation of pH.

Red blood cell concentration. The kidneys participate in the regulation of red
blood cell production and, therefore, in controlling the concentration of red
blood cells in the blood.

Vitamin D synthesis. The kidneys, along with the skin and the liver,
participate in the synthesis of vitamin D.

Kidneys
The kidneys are bean-shaped organs, each about the size of a tightly
clenched fist. They lie on the posterior abdominal wall, behind the peritoneum, with
one kidney on either side of the vertebral column. Structures that are behind the
peritoneum are said to be retroperitoneal.

The kidneys are abundantly supplied with blood vessels- they process blood
the kidneys receive 20 25% of the resting cardiac output via the right and left
renal arteries. In adults, blood flow through both kidneys (renal blood flow) is about
1200 ml per minute
Function of the kidneys

Regulation of blood ionic

composition

Regulation of blood pH

Regulation of blood volume

Regulation of blood pressure

Maintenance of blood
osmolarity

Production of hormones

Regulation of blood glucose level

Excretion of wastes and foreign substances

Three layers of tissue surround each kidney

The renal capsule. The deep layer, smooth, transparent sheet of dense
irregular connective tissue. Serves as a barrier against trauma and helps
maintain the shape of the kidneys. Continuous with the outer coat of the
ureter.

The adipose capsule. Middle layer, a mass of fatty tissue surrounding the
renal capsule. Protects kidney from trauma and holds it firmly in place in the
abdominal cavity.

The renal fascia. The superficial layer, thin layer of dense irregular connective
tissue. anchors the kidney to surrounding structures and to the abdominal
wall

Internal anatomy of the kidneys

Two regions

The renal cortex superficial, smooth-textured reddish area

The renal medulla deep, reddish-brown inner region. Consists of 8 to 18

cone-shaped renal pyramids

Renal pyramids. The base faces the renal cortex. The apex (renal papilla) points
toward the renal hilum
Renal columns. Portions of the renal cortex that extend between renal pyramids
Renal lobe. A renal pyramind + its overlying area of renal cortex + 1/2 of each
adjacent renal column
The parenchyma. The functional portion of the kidney. Consists of the renal cortex
and renal pyramids of the renal medulla. Contains about 1 million mircoscopic
structures called nephrons.
Ureters
The ureters are two slender tubes that run from the sides of the kidneys to the
bladder. Their function is to transport urine from the kidneys to the bladder.
Bladder
The bladder is a muscular organ and serves as a reservoir for urine. Located just
behind the pubic bone, it can extend well up into the abdominal cavity when full.
Near the outlet of the bladder is a small muscle called the internal sphincter, which
contract involuntarily to prevent the emptying of the bladder?
Urethra
The urethra is a tube that extends from the bladder to the outside world. It is
through this tube that urine is eliminated from the body.

Etiology/Symptomatology/Pathophysiology
Predisposing Factors

Diabetes, which is the most common risk factor for chronic kidney failure in
the United States

Age 60 or older

Kidney disease present at birth (congenital)

Family history of kidney disease

Autoimmune Disorder (Lupus erythematosus)

Bladder outlet obstruction (BPH and Prostatitis)

Race (Sickle cell disease)

Precipitating Factors

Occupational Hazard (overexposure to toxins and to some medications)

Sedentary Lifestyle (hypertension, atherosclerosis)

Diet (High residue diet)

Signs and Symptoms

Nausea

Vomiting

Loss of appetite

Fatigue and weakness

Sleep problems

Changes in urine output

Decreased mental sharpness

Muscle twitches and cramps

Swelling of feet and ankles

Persistent itching

Chest pain, if fluid builds up around the lining of the heart

Shortness of breath, if fluid builds up in the lungs

High blood pressure (hypertension) that's difficult to control