DM/Renal-Self Learning Module stuff
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The organs of the endocrine system are glands that produce
The endocrine glands secrete their substances directly in to the blood stream where they eventually affect specific
The hormone recognizes target tissues through
Regulation of hormone secretion is based on
A gland responds to negative feedback by ....
increasing or decreasing the secretion of a hormone
Insulin secretion is an example of what kind of feedback? Between?
glucose and insulin
Elevated blood glucose levels stimulates the secretion of insulin from the
Decreasing blood glucose levels will decrease the stimulus for?
What part of the pancreas secretes the hormones?
Islet of Langerhans
What do Alpha cells make?
What's it in response to?
- low blood glucose, protein ingestion
- and exercise
What do Beta cells secrete? and what is it in response to?
increased blood glucose levels
How does insulin affect glucose metabolism in the liver?
It inhibits glucogenesis
What kind of hormone is insulin?
facilitates storage of nutrients after the ingestion of food
How does insulin facilitate catabolism?
when a person is sleeping or they are NPO the insulin will break down the stored fuels for energy
4 effects of normal aging on the Endocrine system
- decreased hormone production and secretion
- altered hormone metabolism and biologic activity
- decreased responsiveness of target tissues to hormones
- alterations in circadian rhythms
3 primary functions of the kidney
- remove nitrogenous and toxic waste products
- regulate fluid, electrolyte and acid base balance
- hormonal activity
What does the kidney produce?
- erythropoietin for RBC production
- vitamin D
- renin regulation
- prostaglandin synthesis
What does Renin Regulation do?
regulates our BP as a response to decreased blod flow volume, pressure or decreased Na
Also assists in the regulation by stimulating the production of angiotensin II and Aldosterone
What do prostaglandins do?
regulates glomerular filtration, vascular resistance and renin production
What are the effects of aging on the kidneys?
- decreased amount of renal tissue
- decreased number of nephrons and renal blood vessels
- decreased function of loop of Henle and tubules
BUN (Blood Urea Nitrogen) test measures what?
- the renal excretion of urea nitrogen
- Normal is 10-20mg/dL
What would an elevated BUN mean?
- renal disease
- steroid use?
- high protein diet
What is Creatinine level used to determine? What is it...and what are the norms?
- the level of a persons renal function
- It is the end product of muscle and protein metabolism
- M .6-1.2mg/dL
- F .5-1.1mg/dL
What do these Creatinine values tell you?
- 1.5mg/dL >50% of Nephron function is lost
- 4.8mg/dL >75% of Nephron function is lost
- 10mg/dL 90% of Nephron function is lost
- End stage renal Disease (ESRD)
Creatinine Clearance....what is it? and what does it do?
it is a calculation of a persons GFR and it is the BEST indicator of overall renal function
24 hr. urine collection and serum creatinine draw
What is the amount of normal creatinine clearance to maintain life without renal replacement?
What is NORMAL?
- Men 95-135mL/min
- Women 85-125 mL/min
Urinalysis provides information about....
- acidity or alkalinity
- presence or absence of waste products
- concentration or dilution of the urine
Primary function of the kidneys
- Balance solute and water transport
- Excrete metabolic waste products
- conserve nutrients
- Regulate acid/base balance
- secrete hormones
- form urine
What do the ureters do?
Transports urine from the kidneys to the bladder
a tube that channels urine to outside the body
3 ways nephron makes urine
- glomerular filtration
- tubular reabsorption
- tubular secretion
How many litres of blood derived fluid does the kidney process each day?
180 litres (47 gallons)
What's glomerular filtration?
a non selective process in which hydrostatic pressure forces fluids and solutes through a membrane
What's the GFR?
it is the amount of fluid filtered from blood into the capsule per minute
If there is an increase in systemic blood pressure, the renal vessels will.....?
If there is a decline in blood pressure, afferent arterioles will...?
What is the Renin-Angiotensin mechanism?
When there is a drop in systemic blood pressure renin will be released which acts on antiotensin to release antiotensin I which is converted to antiotensin II causing SYSTEMIC VASOCONSTRICTION and an increase in BP.
Assessment of urinary function
- urine color, odor, amt
- difficulty starting stream?
- dysuria (pain)
- oliguria (sm amt)
- polyuria (lg amt)
- Flank pain?
cloud, foul smelling urine
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