Urinary System

The human urinary system, also known as the urinary tract or renal system, consists of
the kidneys, ureters, bladder, and the urethra. It refers to the structures that produce and
transport urine to the point of excretion. In the human urinary system there are two kidneys that
are located between the dorsal body wall and parietal peritoneum on both the left and right sides.
The purpose of the urinary system is to eliminate waste from the body, regulate blood volume
and blood pressure, control levels of electrolytes and metabolites, and regulate blood pH. The
urinary tract is the body's drainage system for the eventual removal of urine. The kidneys have
an extensive blood supply via the renal arteries which leave the kidneys via the renal vein. Each
kidney consists of functional units called nephrons. Following filtration of blood and further
processing, wastes (in the form of urine) exit the kidney via the ureters, tubes made of smooth
muscle fibres that propel urine towards the urinary bladder, where it is stored and subsequently
expelled through the urethra during urination. The female and male urinary system are very
similar, differing only in the length of the urethra. 800–2,000 milliliters (mL) of urine are
normally produced every day in a healthy human. This amount varies according to fluid intake
and kidney function.

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 Kidney Physiology

The kidneys are vital organs responsible for clearing waste products, salts, and water
from the body. They perform several crucial functions: excretion of wastes, such as urea and
uric acid, which are byproducts of metabolism; reabsorption of vital nutrients, including
glucose (at normal plasma levels), amino acids, water, sodium, chloride, potassium, magnesium,
calcium, bicarbonate, and phosphate; acid-base homeostasis, maintaining the balance between
chemical acids and bases, also known as body pH; maintenance of electrolyte-water balance,
referred to as plasma osmolarity; and hormone secretion, including erythropoietin (regulates red
blood cell production in bone marrow), renin (controls blood pressure), and calcitriol (the active
form of vitamin D, which strengthens bones).
 Definitions of Terms

Dysuria is a medical term that refers to painful or uncomfortable urination. It can feel like
burning, stinging, or itching, and is often felt in the urethra or around the genitals. Dysuria can
occur at any age, but it's more common in women.

Nocturia- Is defined as the need for patients to get up at night regularly to urinate. A sleep
period must precede and follow the urinary episode to count as a nocturnal void. Nocturia is
often described as the most bothersome of all urinary symptoms and is also one of the most
common.

Hematuria- Means there is blood in your urine. The two types of hematuria are gross hematuria
when you can see the blood in your urine. microscopic hematuria when you cannot see the blood
in your urine, but it can be seen under a microscope or is found using a urine test called a
urinalysis.

Frequency- A common response to emotional stress, urinary frequency can also be caused by
low or high urinary pH. Urinary urgency is a related condition that can be caused by
inflammation, trauma, calculi, bladder tumors, and other conditions.

Urinary urgency- Or an urgent need to urinate, can have many causes. Urinary urgency can
sometimes indicate a urinary tract infection (UTI) or a problem with the bladder or prostate. In
other cases, it may be a medication side effect.

Urinary incontinence- Is the involuntary loss of urine, which can occur due to a variety of
factors affecting the urinary system. It is a common condition that can significantly impact a
person's quality of life and is often associated with the gross anatomy of urine transport.

Enuresis- Is defined as normal micturition that occurs at an inappropriate or socially

unacceptable time or place. As recommended by International Children's Continence Society, in
this topic 'enuresis' is reserved for micturition during sleep, or bedwetting. Daytime wetting is
called 'incontinence.'

Proteinuri- Also called albuminuria, is elevated protein in the urine. It is not a disease in and of
itself but a symptom of certain conditions affecting the kidneys. Typically, too much protein in
the urine means that the kidneys’ filters the glomeruli are not working properly and are allowing
too much protein to escape in the urine.

Micturition- Is the process of eliminating water and electrolytes from the urinary system,
commonly known as urinating. It has two discrete phases: the storage/continence phase, when
urine is stored in the bladder; and the voiding phase, where urine is released through the urethra.
 Laboratory values related to Kidney

Laboratory values related to kidney function include:

1. Blood serum creatinine

A blood test that measures the amount of creatinine in your blood. A normal level
depends on your age, sex, and muscle mass. A level above 1.2 mg/dL for women and 1.4 mg/dL
for men could indicate kidney problems.

2. Blood urea nitrogen (BUN)

A blood test that measures the amount of urea nitrogen in your blood. Urea nitrogen is a
waste product created by the liver when the body breaks down proteins. A normal level is 8–20
mg/dL.

3. Glomerular filtration rate (GFR)

A measurement of how well your kidneys remove waste from your body. A normal GFR
is 90 ml/min or above. A GFR below 60 ml/min could indicate kidney disease.

4. Urine albumin-to-creatinine ratio (UACR)

A ratio of more than 30 milligrams per gram could be a warning sign of kidney disease.
Creatinine-based estimates of kidney function, like GFR, should not be used in certain
circumstances, including:
•When serum creatinine levels are changing.
•In people with acute kidney injury.
•In people with extreme muscle mass, body size, or altered diets.
•In people taking medications that affect creatinine excretion .
 Urine Formation

Urine formation three main steps:

1. Glomerular Filtration: Blood is filtered in the glomerulus, allowing water and smell
molecules to pass into the renal tubules.

2. Reabsorption: Essential substances (such as glucose, amino acids, and ions) are selectively
reabsorbed from the renal tubules back into the blood.

3. Secretion: Waste producs (such as creatinine, urea, and ammonia) are actively transported
from the blood into the renal tubules to be excreted as urine.

Disease Related Signs & Symptoms Treatment/MGT

ACUTE KIDNEY •Nausea The primary goals of treatment and
INJURY (AKI) •Vomiting may include the following measures:
•Weakness
•Myoclonic jerks •Correction of fluid overload with
•Seizures furosemide.
•Confusion •Correction of severe acidosis with
•Coma bicarbonate administration, which can
be important as a bridge to dialysis.
•Correction of hyperkalemia
•Correction of hematologic
abnormalities (eg, anemia, uremic
platelet dysfunction) with measures
such as transfusions and administration
of desmopressin or estrogens.

NEPHROTIC Signs and symptoms of nephrotic Treatment for nephrotic syndrome

SYNDROME syndrome include: includes:

•Severe swelling (edema), •Treating the underlying condition

particularly around your eyes and in causing it.
your ankles and feet. •Taking medications.
•Foamy urine, a result of excess •Reducing salt intake to reduce
protein in your urine. swelling
•Weight gain due to fluid retention. •Eating a diet low in saturated fats and
•Fatigue cholesterol.
•Loss of appetite. •Managing hypertension and
hyperlipidemia.
•Relieving edem
•Stopping or lessening the loss of
protein in the urine.
•In some cases, dialysis may be needed.

CHRONIC KIDNEY Many people living with CKD do There's no cure for chronic kidney
DISEASE (CKD) not have any symptoms until the disease (CKD), but treatment can help
more advanced stages and/or relieve the symptoms and stop it getting
complications develop. If symptoms worse.
do happen, they may include:

•Foamy urine Your treatment will depend on the

 •Urinating (peeing) more often or stage of your CKD.
less often than usual
•Itchy and/or dry skin The main treatments are:
•Feeling tired •lifestyle changes – to help you stay as
•Nausea healthy as possible
•Loss of appetite
•Weight loss without trying to lose •medicine – to control associated
weight. problems, such as high blood pressure
and high cholesterol
People who have more advanced
•dialysis – treatment to replicate some
stages of CKD may also notice:
of the kidney's functions, which may be
necessary in advanced (stage 5) CKD
•Trouble concentrating
•Numbness or swelling in your arms, •kidney transplant – this may also be
legs, ankles, or feet necessary in advanced (stage 5) CKD
•Achy muscles or cramping
•Shortness of breath
•Vomiting
•Trouble sleeping
•Breath smells like ammonia (also
described as urine-like or “fishy”)
UTI •Pain or burning while urinating Taking antibiotics, prescribed by a
•Frequent urination healthcare provider, at home can treat
•Feeling the need to urinate despite most UTIs. Your healthcare provider
having an empty bladder might also recommend medicine to
•Bloody urine help lessen the pain or discomfort.
•Pressure or cramping in the groin or Some cases may require treatment in a
lower abdomen hospital.

RENAL CALCULI Contact your provider if you have If you have a small stone that’s likely
symptoms of a kidney stone: to pass on its own, your provider will
•Severe pain in your back or side have you monitor your symptoms until
that will not go away. it passes in your pee. They might
•Blood in your urine. prescribe medications that keep you
•Fever and chills. comfortable and help the stone pass on
•Vomiting. its own.
•Urine that smells bad or looks
cloudy. Larger stones need treatment depending
•A burning feeling when you urinate. on their size, location, whether they’re
causing infections or symptoms, and
other factors. If you have a large stone
or a blockage, or if a stone isn’t passing
on its own in a few weeks, your
provider will recommend procedures to
break up or remove it.
 Types of Dialysis

HEMODIALYSIS DIALYSIAS

Hemodialysis is a life-saving treatment for people with kidney failure.

Hemodialysis is a treatment to filter wastes and water from your blood, as your kidneys
did when they were healthy. Hemodialysis helps control blood pressure and balance important
minerals, such as potassium, sodium, and calcium, in your blood.

Hemodialysis can help you feel better and live longer, but it’s not a cure for kidney failure.

Hemodialysis can be an outpatient or inpatient therapy. Routine hemodialysis is

conducted in a dialysis outpatient facility, either a purpose-built room in a hospital or a
dedicated, stand-alone clinic. Less frequently hemodialysis is done at home. Dialysis treatments
in a clinic are initiated and managed by specialized staff made up of nurses and technicians;
dialysis treatments at home can be self-initiated and managed or done jointly with the assistance
of a trained helper who is usually a family member.

PRITONEAL DIALYSIS

Peritoneal dialysis (per-ih-toe-NEE-ul die-AL-uh-sis) is a way to remove waste products

from the blood. It's a treatment for kidney failure, a condition where the kidneys can't filter blood
well enough any longer.

During peritoneal dialysis, a cleansing fluid flows through a tube into part of the stomach
area, also called the abdomen. The inner lining of the abdomen, known as the peritoneum, acts as
a filter and removes wastes from blood. After a set amount of time, the fluid with the filtered
waste flows out of the abdomen and is thrown away.

Because peritoneal dialysis works inside the body, it's different from a more-common
procedure to clean the blood called hemodialysis. That procedure filters blood outside the body
in a machine.
URINARY SYSTEM
_________________
A Laboratory Research
Presented to the
Faculty of the Department of Nursing
Bachelor of Science in Nursing
Palawan Polytechnic College, Inc.
Puerto Princesa City

__________________________________

In Partial Fulfillment
of the Requirements for the Course
Anatomy and Physiology
Laboratory

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Submitted by

Vivialyn Cabanig

BSN Level I
Block G – Mercury

November 19, 2024