Funda SL

• Kidneys


  • Two bean-shaped organs located retroperitoneally at the level of the twelfth thoracic and third lumbar vertebra
  • The right kidney is slightly lower than the left kidney due to the presence of the liver on the right side of the abdomen
  • Divided into renal cortex, medulla and pelvis
  • Medulla is composed of series of pyramids
• Nephrons


  • Functional units of the kidneys
  • Composed of glomerulus and the renal tubules
  • Glomerulus is a turf of semi-permeable capillaries, surrounded by the bowman's capsule
  • Renal tubules have three regions: proximal convoluted tubules, loop of henle and the distal convoluted tubules
• Primary function of nephrons

  Formation of urine
• About 1200 ml of blood flows to the kidneys per minute, which is 20-25% of the cardiac output
• Functions of the kidneys

  • Remove waste products from the body
  • Regulate fluid volume
  • Maintain electrolytes concentration
  • Maintain blood pressure
  • Maintain pH within the body
• Glomerular filtration rate (GFR)


  • 125 ml/min
  • Kidneys form 0.5 to 1 ml per minute, 60 ML per hour, approximately 1500 ml per day of urine
• Ureters


  • Two small tubes about 25 cm long
  • Transport urine from the renal pelvis to the urinary bladder
  • Enter the urinary bladder obliquely and are guarded by ureter vesicular sphincter
• Urinary bladder


  • Serves as reservoir for urine
  • Composed of three layers of detrusor muscles
  • Contraction of the these muscle expels urine from the bladder
  • Guarded by internal urethral sphincter
  • Trigone is triangular region in the floor marked by the openings for the two ureters and the internal urethral orifice
  • Approximate maximum capacity of 1000 ml of urine
• Urethra


  • Passageway of the urine into the external environment
  • Internal urethral sphincter is an involuntary muscle, while the external urethral sphincter is a voluntary muscle
  • Female urethra is 1 ½ to 2 ½ inches, male urethra is 5 ½ to 6 ½ inches up to 8 inches in length
  • Shorter urethra among females increase propensity to urinary tract infection
• Urine formation


  1. Glomerular filtration: Water and solutes move from the blood to the glomerular capsule

  2. Tubular reabsorption: Movement of substances from the filtrate in the kidney tubules into the blood in the peritubular capillaries

  3. Tubular secretion: Transport of substances from the blood into the renal tubules
• Micturition


  • The act of expelling urine from the bladder
  • Synonymous to urination or voiding
  • Parasympathetic nervous system initiates voiding, sympathetic nervous system inhibits voiding
  • Micturition reflex is involuntary, but can be inhibited by higher brain centers
• Normal characteristics of urine

  • Color: amber/straw
  • Odor: aromatic-upon voiding
  • Transparency: Clear
  • pH: slightly acidic (range:4.6-8 average of 6)
  • Specific gravity: 1.010-1.025 (measured by urinometer)
• Problems in urinary elimination

  • Altered urine composition: Hematuria, Urinary Tract Infection, Pyuria, Bacteriuria, Albuminuria, Proteinuria, Glycosuria, Ketonuria
  • Altered urine production: Polyuria, Oliguria, Anuria
  • Altered urinary frequency: Frequency, Nocturia, Urgency, Dysuria, Hesistancy, Enuresis, Pollakuria
  • Urinary incontinence: Total incontinence, Stress incontinence, Urge incontinence, Functional incontinence, Reflex incontinence
  • Retention: Accumulation of urine in the bladder with inability to empty
• Bedside commode


  • Portable toilet with no water supply or drainage
  • Used by people unable to walk to the toilet due to illness, injury or incontinence
• Sitz bath


  • Warm, shallow bath to relieve pain, burning or itching in the perineum
  • Soaking the perineal area in warm water reduces muscle spasms by relaxing the anal sphincter, improving blood circulation and promoting healing
  • Can be taken in a bathtub or using a small plastic tub over the toilet
  • Water temperature should be warm, around 104°F (40°C), not too hot