oct 2008 tahani al-shehri. the simple examination of the urine. to detect some of the normal...
TRANSCRIPT
Objective :
The simple examination of the Urine. To detect some of the normal organic
constituents of urine. To detect some of the normal
inorganic ions present in urine.
Introduction and Principle:
Urine formation :-The basic steps in urine formation are : 1. Filtration. ( Glomerular)2. Reabsorption.( Tubular) 3. Secretion. .( Tubular) 4. Excretion.
Kidney Function
The main function of kidney is Homeostasis which means :
-maintain internal environment constant
-excretion of all metabolic west product.
Glomerular filtration
In a healthy adult about 650 ml of plasma (1200 ml of blood ) pass through functioning renal excretory tissue every minute, and about 125 ml of glomerular filtrate is formed.
Glomerular filtration
Water passes freely from the plasma through the glomeruli , and those unbound constituents of the plasma that have a molecular weight of less than about 70,000 are present in the glomerular filtrate at the same concentration as in the plasma .
Glomerular filtration
Substances of a higher molecular weight than about 70,000 do not pass freely through the glomeruli and are present in the glomerlar filtrate at a lower concentration than in plasma
Tubular effect
The renal tubules conserve water and soluble constituent of the body by reabsorption using both passive ( high conc. To low conc. )
And the active transport ( use ATP + carrier ) from the glomerular filtrate.
Simple examination of the urine
Volume : The normal 24 hours Urine volume of an
adult is between 750 and 2000 ml . This depend on▪ the fluid intake ▪ loss of fluid by other routes.
Simple examination of the urine
In Disease : Oliguria : ▪ Urine output less than 500ml/day▪ Causese : ▪ deficient intake of water ,▪ or excessive loss of fluid by other routes ,
for example : by :haemorrhage , diarrhea vomiting
Simple examination of the urine
Polyuria Urine output more than 2000m/day. Physiological causes▪ chronic renal insufficiency .▪ Polyuria of low osmolality is also found in
diabetes insipidus▪ Polyuria occur as an osmotic diuresis in any
disease where there is an increased excretion of metabolites (diabetes mellitus ).
Simple examination of the urine
Polyuria Physiological causes▪ Excessive water intake▪ Diuretic as tea, Cola, Coffee▪ Excessive salt intake
Simple examination of the urine
Colour : Due to urinary pigments (urochromes). Pale (low specific gravity ) to dark
yellow (high specific gravity) Coloured urines occur in :▪ certain disease ▪ metabolic disorders,▪ after the administration of many drugs:▪ Beta carotine supplement ( orange urine )
Simple examination of the urine
Appearance :
Casts : ▪ The tubules secrete an α1-glycoprotein
(Tamm-Horsfall protein ) , which , in the presence of albumin , comes out of solution in gel form as casts.
Simple examination of the urine
Appearance : Mucus protein :▪ This may be from semen or from
vaginal discharge.▪ Pathologically , it may be due to disease of
the lower urinary tract or pus.
Simple examination of the urine
Appearance : Crystals :▪ These are not normally pathological ▪ Uric acid ( reddish – yellow) & calcium
oxalate (colourless ) from acid urine▪ phosphate ( whitish) from alkaline
urine .
▪ Pathological▪ cystine crystals ▪ dark reddish deposit of blood.
Simple examination of the urine
Smell: unpleasant smell : urine infected with
Gram-negative organisms . ammonical smell: urine infected with
urea splitting organisms maple syrup disease (H.W)
Simple examination of the urine
pH: Normal between 5.5 and 8 Alkalosis : ▪ Vegetarine diet ▪ Bacterial infection