BIOH 370 Anatomy and Physiology IILecture 29 4/20/2015Outline of Last Lecture Urinary System Day 3I. Formation of Dilute/Concentrated Urine- Countercurrent Multiplier- Countercurrent ExchangeII. Summary of Filtration, Reabsorption, and Secretion in the Nephron and Collecting DuctIII. Urine- Collection and Flow through Kidney- Kidney Function- Characteristics of Normal Urine ChartIV. Renal ClearanceV. Chart of Abnormal Constituents of UrineVI. Ureters, Bladder and Urethra in FemaleVII. Male and Female UrethrasVIII. Micturition= urinationIX. Pontine Control Centers X. Urinary System Developmental AspectsOutline of Current Lecture These notes represent a detailed interpretation of the professor’s lecture. GradeBuddy is best used as a supplement to your own notes, not as a substitute.Urinary System Day 4/ Fluid, Electrolyte, and Acid-Base BalanceI. Kidney StonesII. Urinary IncontinenceIII. Fluid CompartmentsIV. Water Balance and ECF OsmolalityV. Regulation of Water IntakeVI. Regulation (hormonal) of Renal Na and Cl Reabsorption After High Sodium IntakeVII. Fluid Compartments and Fluid Homeostasis ChartVIII. Influence of Other HormonesIX. Water Balance Disordersa. Dehydrationb. Hypotonic Hydration (water intoxication) Current LectureUrinary System Day 4/ Fluid, Electrolyte, and Acid-Base BalanceI. Kidney Stones- Calcification, crystaline structures- Can be caused by taking too many tums while drinking little water. Causes a builup of crystals (calcium bicarbonate)- Sharp- why painful- Vary in size - Can block ureter=urine gets backed up into kidney- Ureter might also spasm- Risk factors:o Low fluid intakeo High intake of animal proteino High dietary calciumo High dietary sodiumo Excessive intake of refined sugarso Foods rich in oxalateo High intake of grapefruit juice, apple juice and sodao Caldium moxalate stones (59%)o Calcium phosphate (10%)o Uric Acid (17%)o Struvite or infection stones (12%)o Cystine and other stones (2%)- Shock Wave Lithotripsyo Might be able to pass kidney stones through urine if small enougho Try to break them down to smaller pieces o Sometimes use Flomax to relax ureters= causes them to increase in diameterII. Urinary Incontinencea. Temporary- Alcohol- Overhydration- Dehydration- Caffeine- Bladder irritation- Medicationsb. Persistent- Pregnancy and childbirth- Changes with agingHysterectomy- Painful bladder syndrome (interstitial cystitis)- Prostatitis- Enlarged prostate- Prostate cancer- Bladder cancer or bladder stones- Neurological disorders- ObstructionIII. Fluid Compartmentsa. Total body water = 40 LTotal body mass (female) (a) Distribution of body solids and fluids in average lean, adult female and male (b) Exchange of water among body fluid compartments Total body mass (male) 45%Solids 40% Solids 55% Fluids 60% Fluids 2/3Intracellularfluid (ICF)80%Interstitialfluid 1/3Extracellularfluid (ECF) 20% Plasma Blood capillary Tissuecells Total body fluid Extracellularfluid- Intracellular fluid (ICF) compartment: 2/3 or 25 L in cells- Extracellular fluid (ECF) compartment: 1/3 or 15 L Plasma: 3 L Interstitial fluid (IF): 12 L in spaces between cells Other ECF: lymph, CSF, humors of the eye, synovial fluid, serous fluid, and gastrointestinal secretionsIV. Water Balance and ECF Osmolality- Water intake = water output = 2500 ml/day- Water intake: beverages, food, andmetabolic water- Water output: urine, insensible water loss(skin and lungs), perspiration, and fecesV. Regulation of Water Intake- Concentration of blood increases, blood Volume decreases=increase renin release (RAA pathway)= thirst center will be stimulatedVI. Regulation (hormonal) of Renal Na and Cl Reabsorption After High Sodium Intake- Elimination of excess body wateroccurs through urine production.- The amount of urinary salt loss isthe main factor determining bodyfluid volume.- The two main solutes in urine are sodium ions (Na+) and chloride ions (Cl–).- Wherever solutes go, water follows.- Increase salt= you will feel swollen because movement of water from cells to interstitial fluid= increase in blood volume= increase BP= loss of water in urine= decrease renin= increase strength of atria wall= decrease angiotensin IIVII. Fluid Compartments and Fluid Homeostasis ChartVIII. Influence of Other Hormones- Estrogens: NaCl reabsorption (like aldosterone)o ® H2O retention during menstrual cycles and pregnancy- Progesterone: ¯ Na+ reabsorption (blocks aldosterone)o Promotes Na+ and H2O loss- Glucocorticoids: Na+ reabsorption and promote edemao Cushing’s Diseaseo Inflammation= sometimes use steroids= can cause fluid retention= weight gainIX. Water Balance Disordersa. Dehydration Negative fluid balance- ECF water loss due to: hemorrhage, severe burns, prolonged vomiting or diarrhea, profuse sweating, water deprivation, diuretic abuse- Signs and symptoms: thirst, dry flushed skin, oliguria- May lead to weight loss, fever, mental confusion, hypovolemic shock, and loss of electrolytes1 2 3 Excessive loss of H2O from ECF ECF osmotic pressure rises Cells lose H2O to ECF by osmosis; cells shrink (a) Mechanis m of dehydration b. Hypotonic Hydration (water intoxication) - Cellular overhydration, or water intoxication- Occurs with renal insufficiency or rapid excess water ingestion - ECF is diluted ® hyponatremia ® net osmosis into tissue cells ® swelling of cells ® severe metabolic disturbances (nausea, vomiting, muscular cramping, cerebral edema) ® possible death- Alexa Linboom= as a punishment for drinking her mother’s grape soda, this little girl was forced to drink so much liquids that caused her to die from water/liquid intoxication- Exercise-Associated Hyponatremiaoo Cynthia Lucera died at the finsh line of the Boston Marathon from drinking too much water- Treatment for water intoxication= hypertonic saline solution3 H2O moves into cells by osmosis; cells swell 2 ECF osmotic pressure falls 1 Excessive H2O enters the ECF (b) Mechanism of hypotonic