Chapter 68 Nursing Assessment Urinary System (1).docx

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Chapter 68 Nursing Assessment Urinary System Urinary System Structures and Functions of Urinary System The upper urinary system consists of two kidneys and two ureters. The lower urinary system consists of a urinary bladder and a urethra. Urine is formed in the kidneys, drains through the ureters to be stored in the bladder, and then passes from the body through the urethra. Kidneys o The primary functions of the kidneys are to (1) regulate the volume and composition of extracellular fluid (ECF) (2) excrete waste products from the body. The kidneys also function to control blood pressure, produce erythropoietin, activate vitamin D, and regulate acid-base balance. o Macrostructure Bean-shaped organs (kidneys) Located retroperitoneally (behind the peritoneum) on either side of the vertebral column at about the level of the twelfth thoracic (T12) vertebra to the third lumbar (L3) vertebra. Each kidney weighs 4 to 6 oz (113 to 170 g) and is about 5 in (12.5 cm) long. The right kidney, positioned at the level of the twelfth rib, is lower than the left. Adrenal gland lies on top of each kidney Cushioned by fat and connective tissue; supports, and maintains its position. Capsule is a fibrous membrane covers the surface of each kidney. Serves as a shock absorber when this area is traumatized from a sudden force or strike. Hilus on the medial side Arteries and nerves enter Veins and ureters exit The parenchyma (actual tissue) of the kidney can be visualized on a longitudinal section of the kidney The outer layer is the cortex, and the inner layer is the medulla. The medulla consists of a number of pyramids. The apices (tops) of these pyramids are called papillae, through which urine passes to enter the calyces. The minor calyces widen and merge to form major calyces, which form a funnel- shaped sac called the renal pelvis. The minor and major calyces transport urine to the renal pelvis, from which it drains through the ureter to the bladder. The renal pelvis can store a small volume of urine o Microstructure Nephron is functional unit, approximately 1 million nephrons, composed of: Glomerulus Bowman’s capsule
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Tubular system-consists of the proximal convoluted tubule, loop of Henle, distal convoluted tubule, and collecting tubules The glomerulus, Bowman’s capsule, proximal tubule, and distal tubule are located in the cortex of the kidney The loop of Henle and collecting tubules are located in the medulla Several collecting tubules join to form a single collecting duct. The collecting ducts eventually merge into a pyramid that empties via the papilla into a minor calyx. o Blood supply Blood flow to the kidneys, approximately 1200 mL/min, accounts for 20% to 25% of the cardiac output Renal artery arises from the aorta and enters the kidney through the hilus The renal artery divides into secondary branches and then Divides into smaller branches Each forms an afferent arteriole
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  • Spring '17
  • Acevedo
  • Urinary

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