Urinary system

What is the structure of the Urinary system?

Adrenal gland, kidney, ureter, bladder, urethra

What is the function of the renal calacies?

Renal calices collect urine as it passes out of the apex of the medullary pyramid and down into the renal pelvis

Where should urine go and what is a risk of happening?

Urine should travel downwards and flush any bacteria out. However ascending bacteria can successfully colonise in the calices and renal pelivis

What is an infection in the cortex and medulla called?

Nephritis

What is an infection of all parts called?

pyelonephritis - needs an aggressive treatment

What are the 5 steps of cascade of RAAS?

Trigger: Low renal perfusion

• juxtaglomerular cells in afferent arterioles detect low perfusion

Response: Rennin release

• Juxtaglomerular cells secrete rennin

• Renin converts angiosinogen to Angiotensin I

Conversion to angiotensin II

• Angiotensin-converting enzyme converts Angiotensin I to Angiotensin II

Effect of Angiotensin II

• Vasoconstriction of arterioles - increased BP

• Aldosterone release in adrenal cortex

• ADH release from posterior pituitary

• The kidneys constrict efferent arteriole (increases GFR to maintain filtration)

Aldosterone: sodium retention

• Distal tubule and collecting duct

• Na reabsorbsion

• Secretion of K

• Water follows Sodium and increased fluid volume and increased BP

What are causes for low perfusion of the kidneys?

• Haemorrhage

• Dehydration

• Hypotension

• Renal Artery stenosis

What are the signs and symptoms for a UTI?

• Dysuria

• Urgency

• Frequency

• Suprapubic pain

• Cloudy or foul smelling urine

• Confusion

• Fever

What are the investigations for UTI?

• Urinalysis (leucocytes and nitrates)

• MSU culture and sensitivity

• Temperature

• CRP

• Blood cultures