𝐙𝐀𝐆 𝐃𝐨𝐜𝐭𝐨𝐫𝐬 57 || Scheme

أعرف إزاي أعد ال vertebrae؟ أول حاجة الأسهل ابدأ بال sacrum (اللي لونه أصفر) و بعدها أبدأ أعد في ال lumbar vertebrae من 5 ل 1 تنازليا L5, L4, L3, L2, L1 و قبلهم كلهم T12 طيب مش عارف أحدد ال sacrum من L5 و كلهم سايحين في بعض؟ الحل إن نبص على القوسين اللي على الجمب (اللي لونه أحمر) و دا ال illiac crest بيبقا ال sacrum عادة منتهي عنده مش عايز أعتمد على ال sacrum خالص .. أعمل ايه؟ نطلع فوق لل kidney لو ظاهرة في الصورة و نشوف مثلث لونه أبيض (ال Renal pelvis) و دا عادة بيبقا بين L1 و L2 (الخط الأخضر) فنبدأ نعد المرة دي تصاعديا L1, L2, L3, L4, L5

#renal_practical

أهم الأرقام (بايو) • Midstream urine sample required for most tests: 10–20 ml • Normal daily urine excretion for adults: 1 to 2 liters (average 1.5) • Minimum daily urine volume under normal dietary conditions: 500 ml • Polyuria definition: Volume above 2 liters/day • Oliguria definition: Volume below 500 ml/day • Normal specific gravity of urine: 1.015 to 1.025 • Fixed specific gravity in chronic nephritis: 1.010 • Major homeostatic mechanisms maintaining acid-base balance: 3 • Normal range for blood pH: 7.35–7.45 • Target pH for suitable body enzyme function: 7.4 • Normal PCO2 level: 35–45 mEq/L • Normal HCO3- level: 22–26 mEq/L • Normal ratio of bicarbonate (NaHCO3) to carbonic acid (H2CO3): 20/1 • PKU (Phenylketonuria) treatment start: Within the first 7 to 10 days of life • Recommended window after birth for PKU testing: 24–72 hours • Glucosuria definition (glucose levels): Greater than 0.5 g/day • Renal threshold for blood glucose: 160–180 mg/dl • Normal pregnant women experiencing pregnancy glucosuria: 20% • Increase in glomerular filtration rate (GFR) during pregnancy: 50% • Proteinuria definition (protein levels): Greater than 120 mg/day • Bence Jones protein precipitation temperature: 60 °C • Bence Jones protein redissolving temperature: 100 °C • Microalbuminuria definition: 30–300 mg/24 hours OR 20–200 mg/L • Normal daily urobilinogen in urine: Less than 4 mg/day • Normal daily ketone bodies in urine: 15 mg/day • Normal blood urea: 20–40 mg/dl • Normal urinary urea: 20–40 gm/day • Normal serum uric acid (Men): 3–7 mg/dl • Normal serum uric acid (Women): 2–6 mg/dl • Normal serum creatinine (Men): 0.9–1.6 mg/dl • Normal serum creatinine (Women): 0.6–1.2 mg/dl • Normal creatinine excretion in urine: 1–1.5 gm/day • Normal creatinine clearance: 98–150 ml/min • Isotonic saline dilution for creatinine assay: 49 parts saline to 1 part urine • Multiplication factor to compensate for urine dilution: 50 • Width of diagnostic urine test strips: 5 millimeters • Standard time to read urine strip test results: 60 to 120 seconds • Number of chemical reagents on a standard urine strip: Up to 10 #renal_practical

🚨 Take Care • PAHA --> Totally secreted (high extraction 90%) • Inulin --> Freely filtered • Effective Renal Plasma Flow = PAHA clearance • GFR = Inulin clearance • Low Anion Gap --> Low Albumin • High Anion Gap --> High Acid • Tmax unit is ml/min • Plasma glucose at Tmax unit is mg/dl • Deaffrentiation --> Dribbling of urinre (retention with over flow) • Denervation --> Hypersensitive Neurogenic Bladder • Complete transection--> Automatic Bladder (recovery stage) #renal_practical

حالات اللي بيحصل بسببها Turbid Urine ABC - Alkaline urine - Blood (Hematuria) - Bacteuria - Pyuria - Chyluria - Crystaluria #renal_practical

أهم الأرقام (فسيو) - ​Fraction of plasma filtered into Bowman’s space (Filtration Fraction)= 20% - ​Fraction of plasma leaving via efferent arteriole unfiltered = 80% - ​Proximal tubule creatinine over-secretion (balancing blood overestimation) = 10% - ​Total renal plasma flow perfusing non-excretory kidney regions = 10% - ​Plasma PAHA extracted by excretory kidney regions = 90% - ​Hematocrit value used in sample renal blood flow calculation= 45% - ​Calculated inulin clearance / GFR from sample values= 126 mL/min - ​Effective renal plasma flow (ERPF) from sample calculation: 630 mL/min - ​Actual renal plasma flow from sample values: 700 mL/min - ​Actual renal blood flow (RBF) from sample values: 1273 mL/min - ​Chronic Kidney Disease (CKD) Stages (by eGFR) * ​GFR threshold for Stage 1 CKD: 90 or greater mL/min/1.73m². * ​GFR range for Stage 2 CKD: between 60 and 89 mL/min/1.73m². * ​GFR range for Stage 3 CKD: between 30 and 59 mL/min/1.73m². * ​GFR range for Stage 4 CKD: between 15 and 29 mL/min/1.73m². * ​GFR threshold for Stage 5 CKD: less than 15 mL/min/1.73m². - ​Glucose transport maximum (Tm_G) in * males: 375 mg/min * females: 300 mg/min ​ - Renal threshold for glucose: 180 mg/dL ​ - Plasma sodium concentration = 142 mmol/L - ​Combined concentration of principal plasma anions (Chloride and Bicarbonate) = 130 mmol/L - ​Normal range for blood anion gap= 8–16 mmol/L - ​Normal human blood pH= 7.35 to 7.45 - ​Target median blood pH maintained by the body = 7.40 - ​Normal arterial blood partial pressure of carbon dioxide (PCO2)= 35–45 mmHg - ​Normal blood bicarbonate (HCO3-) range: 22–26 mEq/L - ​First sensory awareness of bladder filling = 150 mL urine volume - Micturation reflex = 400 mL urine volume - Pain in urinary bladder = 500 to 700 mL urine volume #renal_practical

تجميعة قوانين الفسيولوجي #renal_practical

Take care🚨 1⃣ - Anterior lobe of prostate --> where prostatic urethra pass - Median lobe of prostate --> forms uvula vesica impression 2⃣ - Inter-uretric ridge --> locate uretric orifices during cystoscopy - Uvula vesica --> locate urethral orifices during cystoscopy 3⃣ - Median umbilical ligament --> from urachus obliteration - Medial umbilical fold --> from umbilical artery obliteration

Test yourself in Physiology notes we shared 👇

Reflexes ☆Volume Reflex: Baroreceptors (in big arteries) and stretch receptors (in atria and veins) are stimulated by increased blood volume → reflex inhibition of sympathetic tone→ V.D of renal arterioles →↑urinary output. ☆ Storage reflex (Voluntary delay of micturition): This delay occurs by: -Inhibition of spinal centers (sacral 2,3,4) -Contraction of the external sphincter ☆ Voiding reflex (Voluntary initiation of micturition): This initiation occurs by: - Facilitation of spinal center (sacral 2,3,4). - Relaxation of the external sphincter. - Contraction of abdominal muscles increases intra vesical pressure - Relaxation of perineal muscle & pelvic floor muscles.

أسماء مختلفة لنفس ال structures في الهستو - Renal corpuscle = Malpighian corpuscle - Secondary process of podocytes = minor process = feet process = pedicles - Extra glomerular mesangial cell = Lacis cell = polkessen cell = pole cushion cell - Principal cells = light cells - Intercalated cells = dark cells - Collecting ducts = large ducts of Bellini - Cortical columns of Bertini = Medullary interstisium - Para urethral gland = Littre gland

Effect of different hormones on different parts of nephron ADH (H2O & Urea) --> Collecting Duct PTH (PO4) --> PCT PTH (Ca) --> DCT Aldosterone (Na & HCO3) --> DCT

تجميعه لسكيمات الamino acids