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• Consist of:
– Kidneys
– Ureters
– Bladder
– Urethra
General
Function:
• Excretory
• Regulatory
• Secretory
Specific Function:
• Urine formation
• Renal clearance
• Vitamin D synthesis
• Secretions of prostaglandins
• Urine storage
• Bladder emptying
Kidney
• Filter any products from the blood which has no use in the body.
A. Regions
1. Renal parenchyma
a. Cortex
b. Medulla
• Pyramids
8- 18 pyramids/ kidney
B. Nephrons
- Functional units of kidney:
a) Glomerulus
b) Bowman’s capsule
c) Proximal tubule
d) Distal tubule
e) Loop of Henle
f) Collecting ducts
C. Calyx
• Glomerulus
3 filtering layers:
1. Capillary endothelium
2. Basement membrane
3. Epithelium
• Ureters
3 narrowed areas:
• Ureteropelvic junction
• Ureteral segment
• Ureterovesical junction
Urinary Bladder
Urethra
• Extends from the bladder to the urinary meatus
Acids
Bases or alkalis
accept H + in solutions
Bicarbonate (HCO 3 )
A. Definition
- results because of high acid content of the blood, which also causes loss of sodium
bicarbonate
- 2 forms:
B. Compensatory Mechanism
- normal PCO2 or low if compensated in an attempt by the lungs to blow off more acid
D. Causes
-Salicylate overdose
-uremia
E. Manifestations
A. Acute
- headache - drowsiness
B. Chronic
-asymptomatic
5. Correct hypokalemia
7. Hemodialysis
8. Peritoneal dialysis
A. Definition
- marked by the heavy loss of acid from the body or by increased level of
bicarbonate
B. Compensatory Mechanism
D. Causes
- excessive diuresis
- pyloric stenosis
E. Manifestations
a. Acute
- hypertonic muscles
- tetany
- mental dullness
- dizziness
- respiratory depression
- ventricular disturbances
b. Chronic
5. Carbonic anhydrase inhibitors are useful in patients who cannot tolerate rapid
volume expansion.
B. Compensatory Mechanism
- increased ICP
- papilledema
- hyperkalemia
E. Manifestations
a. Acute
- mental cloudiness
- poor exhalation
- cerebrovascular vasodilation
b. Chronic
- overdose of sedatives
- ARDS
- muscular dystrophy
- myasthenia gravis
- Guillain-Barre Syndrome
1. Improve ventilation
2. Bronchodilators
3. Antibiotics
4. Thrombolytics
6. Adequate hydration
9. Semi-Fowler’s position
A. Definition
- clinical condition in which the arterial pH is greater than 7.45 and the PaCO2
is less than 38 mmHg
B. Compensatory Mechanism
D. Causes
- extreme anxiety
- “panic” attack
- hypoxemia
- gram-negative bacteremia
E. Manifestations
a. Acute
- lightheadedness
- inability to concentrate
- tinnitus
- tachycardia
1. Instruct patient to breathe more slowly to allow CO2 to accumulate or breathe into a
close system (such as a paper bag)
HYDRONEPHROSIS
• Is distention of the renal pelvis and calices caused by an obstruction of normal urine
flow.
Etiology
• congenital or acquired
• enlarged prostate
• urethral stricture
• ovarian tumors
General
– nausea
– vomiting
– abdominal pain
• Abdominal mass
• Feel fatigued
• Appear pale
• Diarrhea
• Respiratory distress
• Foam in the toilet water, which may be caused by excess protein in your urine
• Thromboembolism
Complications
NEPHROTIC SYNDROME
• Is a set of clinical manifestations caused by protein wasting secondary to diffuse
glomerular damage.
ETIOLOGY
Caused by:
glomerulonephritis
diabetes mellitus
Lupus erythematosus
Amylodidosis
Carcinoma
Complications
• Blood clots
• Poor nutrition
Etiology
Escherichia coli
Kleibshiella
Proteus
Pseudomonas
Complications
• Pyelonephritis
• Sepsis
ACUTE GLOMERULONEPHRITIS
• Etiology
Complications
• Sclerosis progressing toward renal failure
– Hypertensive retinopathy
– Hypertensive encephalopathy
• Nephrotic syndrome
CHRONIC GLOMERULONEPHRITIS
Etiology
• Acute glomerulonephritis
Complications
• Metabolic acidosis
• Pulmonary edema
• Pericarditis
• Uremic encephalopathy
• Uremic neuropathy
• Hyperkalemia