EXCRETORY FINALS ANAPHY

Kidneys

2 paired, bean-shaped structures located just below the ribcage on either side of the spine.

Organ that sorts the substances from the blood for either removal in the urine or return to the blood.

Nephron

Is the functional unit of the kidney, which filters out the blood (~1M - 1.5M).

Ureters

A small muscular tubule lined with transitional epithelium (Urothelium).

It carries urine from the renal pelvis to the urinary bladder.

Urinary Bladder

It acts as a reservoir for urine; it can stretch to hold a large urine volume.

Lined with transitional epithelium, giving it the capability to stretch.

1L

The maximum urine volume

500mL

The urine volume of noticeable discomfort

Urethra

A fibromuscular tube that carries urine from the bladder to the exterior of the body.

Male urethra

Which urethra is longer?

Renal Cortex, Renal Medulla, Renal Pelvis, Renal Arteries, Renal Veins

What are the anatomical parts of the Kidney?

Renal Cortex

Outer kidney region, which is lighter in color

Renal Medulla

Deep to the cortex; a darker, reddish-brown color

Renal Pelvis

A relatively flat, basin like cavity that is continuous with the ureter

Renal Arteries

Delivers blood to kidneys

Renal Vein

Drains blood out of the kidneys

Renal artery

Production of urine in nephron: starting with blood going to kidneys through ______.

Glomerulus

The filtering of blood

Proximal Convoluted tubule

Reabsorption of glucose, amino acid, salts, and urea reabsorption

Hydrogen and ammonium ion secretion

Descending loop of henle and Collecting Duct

Water reabsorption

Ascending loop of henle

Sodium, chloride, and urea reabsorption; impermeable to water.

Distal convoluted tubule

Sodium reabsorption

Hydrogen and potassium ion secretion

Glomerular Filtration

Water and solutes smaller than proteins are forced through the capillary walls and pores of the glomerular capsule into the renal tubule.

Tubular Reabsorption

Water, glucose, amino acids, and needed ions are transported out of the filtrate into the tubule cells and then enter the capillary blood.

Tubular Recreation

Occurs in proximal and distal convoluted tubule; H+, K+, creatinine, and drugs are removed from the peritubular blood and secreted by the tubule cells into the filtrate.

Colorless or Straw

Recent fluid consumption

Pale Yellow

• Polyuria or Diabetes insipidus

• Diabetes mellitus

• Dilute random specimen

Dark Yellow

• Concentrated specimen

• B complex vitamin

• Dehydration

• Bilirubin

Orange-Yellow

• Phenazophyridine

• Phenindione

Green

Pseudomonas infection

Red

• Hemoglobin

• Myoglobin

• Beets

• Rifampin

• Menstrual contamination

Port Wine

Poryphyrin

Brown-Black

• Homogentisic acid (alkaptonuria)

• Malignant melanoma

Clear

No visible particulates, transparent

Hazy

Few particulates, print easily seen through urine

Cloudy

Many particulates, print blurred through urine

Turbid

Print cannot be seen through urine

Nonpathologic causes of Urine Turbidity

• Squamous epithelial cells

• Mucus

• Amorphous, phosphates, carbonates, urates

• Semen, spermatozoa

• Fecal contamination

• Radiographic contrast media

• Talcum powder

• Vagina creams

Pathologic causes of Urine Turbidity

• RBCs - nonsquamous epithelial

  cells

• WBCs - abnormal crystals

• Bacteria - lymph fluid

• Yeast - lipids

Milky

May precipitate or be clotted

Reagent Strips

Consists of a chemical impregnated absorbent pads attached to a plastic strip.

A color-producing chemical reaction takes place when the absorbent pad comes in contact with urine and this is interpreted by comparing the color produced with a chart supplied by the manufacturer with a required time frame.

60 seconds

Specified amount of time for the reaction of Protein and pH

30 seconds

Specified amount of time for the reaction of Glucose

45 seconds

Specified amount of time for the reaction of Specific gravity

Glucose, pH, Specific Gravity, Protein

The order of manufacturer’s color chart (Top to Bottom)

Stored at room temperature (below 30°C)

What temperature should the bottles be stored?

Double indication system

Principle of pH

5.0-6.0 (slightly acidic)

First morning specimen for pH

More alkaline (alkaline tide)

After a meal for pH

4.5-8.0

Normal random samples for pH

>8.5

Freshly collected urine does not reach __ in physiological and pathological conditions in pH

pH >8.5

Improperly preserved specimen

Albumin

Principle of protein where in indicator is sensitive only to ____.

Negative, trace, 1+, 2+, 3+, and 4+

Reporting of Protein and Glucose

Prerenal

1. Intravascular hemolysis

2. Muscle injury

3. Acute phase reactants

4. Multiple myeloma

Tubular disorders

1. Fanconi syndrome

2. Toxic agents/heavy metals

3. Severe viral infections

Renal

1. Glomerular disorders

2. Immune complex disorders

3. Amyloidosis

4. Toxic agents

5. Diabetic nephropathy

6. Strenuous exercise

7. Dehydration

8. Hypertension

9. Pre-eclampsia

10. Orthostatic or postural proteinuria

Postrenal

1. Lower urinary tract

   infections/inflammations

2. injury/trauma

3. Menstrual contamination

4. Prostatic fluid/spermatozoa

5. Vaginal secretions

Glucose

Most frequently performed chemical analysis on urine.

Fasting is recommended prior to sample collection.

160-180 mg/dl

Renal threshold of Glucose

2

Diabetes monitoring for glucose, specimens are collected __ hours after meals.

Glucose oxidase reaction

Principle of glucose

Hyperglycemia-associated

1. Diabetes Mellitus

2. Cushing’s syndrome

3. Pheochromocytoma

4. Acromegaly

5. Hyperthyroidism

Renal-Associated

1. Fanconi Syndrome

2. Renal Tubular Dysfunction

3. Tubular Necrosis

4. Osteomalacia

5. Pregnancy

Specific Gravity

Density of a solution compared with the density of a similar volume of distilled water (SG 1.000) at a similar temperature.

Measures only ionic solutes.

Higher urine concentration = more hydrogen ions released = low pH

blue-green-yellow

Color of specific gravity

Diabetes insipidus

What is the diagnosis for Specific Gravity