Objectives 51, 55, & 62. Kidney function, Path of blood, and Renal anatomy

Describing kidney function, tracing the path of blood flow through the kidneys and describing internal and external gross renal anatomy.......

So, as you know, we weren't able to do our in-class lecture on the urinary system, and we had to do an online lecture for this portion of the text.  Well, I have to say that I'm really glad that I didn't take this class online.  I enjoy the online lectures, but they always leave me feeling like I've missed ALOT!  (I think I actually told you this when I came into the class a week late and had to do the endocrine lectures online!)  Anyway, so I went to YouTube looking for videos to help me get a better grasp on the urinary system and this is what I came across.  I think that it really helped! Watching this video from the Greater Pacific Company helped me to get a visual understanding of how the kidneys function including understanding how they receive blood from the arterioles and send it into the Bowmans capsule portion of the nephrons for filtering in the Glomerulus, a mass of intertwined capillaries.  In the Glomerulus there's a bit of a slow down that allows substances to be filtered due to the fact that the arteriole ENTERING is larger than the arteriole EXITING (I sort of think of a lymph node here where the fact that there are more afferent vessels than efferent vessels gives the lymph fluid time to be filtered).

Nurse's Note: Diabetes Mellitus and Hypertension are the most common causes of End Stage Renal Disease, where the kidneys stop forming filtrate and metabolic wastes build up in the blood stream.  The most common treatment for this is hemodialysis where the patient is hooked up to a machine that actually pulls the blood from their bodies in order to filter the wastes from it before the blood is returned into the body.  Fluid and Electrolyte testing is done on the patient prior to dialysis being performed so that any electrolytes that are missing or lacking from the blood can be added into the filtered blood as it is returned to the body.  Often in a patient that requires frequent dialysis, a fistula is done.  A fistula is the connection of an artery and a vein inside the body to provide a permanent port for dialysis.  This port helps to strengthen the blood vessel so that insertion of needles for dialysis treatments are easier.  Fistula's are commonly tested for Thrill ,a constant palpable vibration at the fistula site, and Bruit, a soft, low-pitched noise heard through the stethoscope when placed on the fistula to ensure that the blood is still flowing properly through the fistula.