CHAPTERS 26 & 27
THE URINARY SYSTEM
FLUID, ELECTROLYTE, AND ACID-BASE BALANCE
STUDY OBJECTIVES

·         Describe the function of the kidney. Define pyelonephritis.

·         Trace the flow of blood from the renal artery to the glomerulus, then on to its exit through the renal vein.

·         Describe the juxtaglomerular apparatus. State the function of the juxtaglomerular cells and the macula densa.

·         To the level covered in lecture, explain the mechanisms that the kidneys use to form urine. Include a discussion of glomerular filtration, tubular reabsorption and tubular secretion. You will not be tested on structural details of the filtration membrane, net filtration pressure, or regulation of glomerular filtration. Define glomerular filtration rate.

·         Explain how the juxtaglomerular apparatus and the renin-angiotensin mechanism influence tubular reabsorption and regulate blood pressure. Page 638 is also helpful.

·         Explain the formation of dilute versus concentrated urine and the related function of antidiuretic hormone (ADH).

·         Define diuretic and explain the mechanism of alcohol and caffeine as diuretics.

·         State the significance of cloudy urine. Define specific gravity as it relates to urine. State pathological causes of urinalysis indicating low or high specific gravity, low or high pH, glycosuria, proteinuria, ketonuria, hematuria or bilirubinuria. Exercise 30 in the lab manual is also helpful.

·         Define renal calculi and state their common name.

·         Explain how the urinary bladder can expand to store large amounts of urine.

·         Describe the function and general location of the internal and external urethral sphincters. Explain why females are more prone to urinary bladder infections. Differentiate between cystitis and pyelonephritis.

·         Define micturition. Describe the micturition reflex (You will not be tested on nervous system details). Define incontinence and urinary retention.

·         Trace the flow of blood through the kidney.

·         Trace the flow of urine from its site of production to its exit from the body.

·         Describe dialysis by briefly explaining the mechanisms of hemodialysis and Continuous Ambulatory Peritoneal Dialysis (CAPD).

·         List several changes in the urinary system that can occur by the time we reach old age.

Identify and give the function of the following:

          kidney          

                   cortex          

                   medulla        

                             renal pyramid 

                                      collecting duct        

                             renal papillae

                             minor calyx

                             major calyx

                   renal pelvis

                   hilus

                   nephron

                             glomerulus (plural = glomeruli)

                             renal tubule

                                      glomerular capsule

                                      proximal convoluted tubule

                                      loop of Henle

                                      distal convoluted tubule

                   segmental artery

                   lobar artery

                   interlobar artery

                   arcuate artery

                   interlobular artery

                   afferent arteriole

                   efferent arteriole

                   peritubular capillary

                   interlobular vein

                   arcuate vein

                   interlobar vein

          ureters

          urinary bladder

                   detrusor muscle

                   trigone

                   rugae

          urethra