Urinalysis AES Notes

  1. ureter- attached to each of the two kidneys, muscular tube, uses peristalsis to move the urine to the bladder
  2. bladder- hollow muscular sac. receives and stores urine
  3. kidney functions- filters blood to remove waste products from it, excrete waste products from the body, maintenance of blood pressure (blood pressure- how much force heart has to pump to transport blood around the body & electrolytes balance & blood pH- acid base balance, hydro-regulation
  4. kidneys structure- two bean-shaped organs on either side of the vertebral column (cortex &)
  5. kidney nephrons- tiny structures in the kidneys made up of glomerulus, bowman’s capsules, convoluted tubules, collecting tubules
  6. urine- aqueous waste product of human body’s metabolism of food, forms in nephrons of kidneys, contains urea, uric acid, creatinine (byproducts of proteins), ammonia (main byproduct of amino acids). salts, & mainly water as a solvent,
  7. random urine specimen- collected at any time of day or night; doesn’t yield consistent results
  8. mid-stream urine specimen- middle of urine stream
  9. first void urine specimen- first urine of the day, best bc concentrated
    1. refrigerate urine- what to do if unable to analyze urine specimen immediately
    2. 2 hrs- how long should urine be refrigerated
    3. decomposes- what happens if urine is left out
    4. 750-1500 ml/day- normal urine volume range
    5. 1200-1500 ml- average urine volume range
    6. polyuria- > 2500 ml/day (alcohol, caffeine, diuretic drugs, diabetes)
    7. oliguria- < minimum range (dehydration, shock, renal failure, kidney stones, enlarged prostate)
    8. anuria- no urine (renal failure)
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      Urine Color Range
    10. normal- straw-amber, avg: light to dark yellow, clear
    11. red- presence of blood
    12. orange-gold- bilirubin (liver damage)
    13. white- pus, bacteria, UTI
    14. black- malaria, malignant, melanoma
    15. cloudy/turbid- WBC, bacteria, epithelial cells
    16. hazy- mucous
    17. smokey- RBCs
    18. milky- fat, chyle (fat droplets)

red: fire

yellow: uncontrolled individual/threatening situation

blue: respiratory

green: designated people report to designated area

  1. specific gravity- indicates ability of kidney to concentrate urine (1.003-1.035, avg 1.015-1.025)

  2. hyposthenia- S.G. below 1.007 (hypertension, diabetes)

  3. hypersthenuria- S.G. above 1.030 (proteinuria)

  4. hyperglycemia- high level of glucose inside the blood

  5. 70-120 mg/dl- normal fasting blood glucose

  6. renal threshold- for glucose: 160-180 mg/dl: max amount of of glc that can be reabsorbed from renal filtrate, back into the blood stream

  7. glycosuria- due to hyperglycemia, when higher than renal threshold

  8. diabetes mellitus- most common disease associated with hyperglycemia + glycosuria, condition in which insulin is defective or produced in reduced amounts. Symptoms: polyuria, polydipsia polyphagia

  9. Insulin- produced by B cells in pancreas, allows glucose to enter cells, to produce energy necessary for cellular growth + metabolism, lack = hyperglycemia

    1. ketones- substances formed from fats, when CH is not available, the body uses fats, then proteins as sources of energy. Fats (lipid molecules) produce fatty acids and glycerol which produce 3 ketones that can be detected in the urine.
    2. severe ketosis- when insulin levels becomes out of control due to failure to take insulin, trauma. anxiety. pregnancy, infection. Patient becomes drowsy, dull, unconscious, may lapse into coma
    3. ketonuria- ketones in urine
    4. acetest tablet: sodium nitroprusside detects acetone and diacetic acid
    5. ketonemia- excess of ketones in the blood, 2.0-40 mg/dl
    6. acidosis- condition in which pH of blood drops, becomes more acidic
    7. ketoacidosis/ketosis: when acidosis due to excess of ketones
    8. ketosis- when no glucose is available, body breaks down fats for energy. ketones build up in the blood, resulting in this. diabetes mellitus, fad diet, starvation, vomiting, + diarrhea causes this
    9. neurotoxicity- activity in the brain is depressed, can result in coma. and even death. pH of blood drops, respiration is adversely affected
    10. proteinuria: “proteins in urine, significant indicator of renal disease.

    - causes glomerular damage (walls pf capillaries become more permeable and allow large molecules to pass through into urine filtrate). conditions associated with this: hypertension, diabetes mellitus, toxemia of pregnancy, UTI, glomerulonephritis (inflammation of glomerulus in nephrons)”

    1. Liver: functions to help support metabolism, immunity, digestion, detoxification, vitamin storage (water soluble/lipid soluble)

    2. @@bile production@@: helps in absorption, digestion, and excretion of lipid molecules.

    3. ==fat-soluble vitamins==: storage and metabolism. Vit A.D.E.K.

    4. ==drug metabolism====:== and detoxification

    5. **==bilirubin ==**metabolism for excretion

    6. synthesis of ==plasma proteins==: albumin, globulins, protein C

    7. Bilituin & Uribinogen

    8. products of RBC’s catabolism

    9. RBC avg lifespan: 90-120 days

    10. RBC’s→ Hemoglobin → Heme & globin → bilirubin

    11. Jaundice: excess of biliburin in blood

    12. jaundice: sin, sclera, and bail bed become yellow

    13. bilirubin is neurotoxic

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types of jjaundiceURINE BILIRUBINUURINE UROBILICONDITIONS
healthy-normaln/a
pre hep-+more RBC’s destroyed than normal
post hep+below normalgallstones, tumors, spasms
hepatic++hepatic, cirrhosis, liver cancer infections. mononcleosis