泌尿系统A10643.ppt

单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,泌尿系统A_10643,Objectives,1.,Structure and function of each,component of a,nephron,.,2.,Ultrastructure of the,filtration,barrier,of the renal glomerulus.,3.Components,structure and function,of the,juxtaglomerular complex,.,Urinary System,Components,kidney,ureters,bladder,urethra,Functions:,remove waste products of metabolism,regulate the homeostasis,secrete some bioactive factors,1.1,General structure,capsule,:DCT,parenchyma,:,cortex,:medullary ray,cortical labyrinth,renal columns,medulla,:renal pyramid,interstitium,:CT,BV,N,1.,Kidney,According to function,renal parenchyma is made up of numerous,nephron,and,collecting duct,.A nephron consists of two components:the,renal corpuscle,and the,renal tubule,.Each renal tubule and collecting duct is made up of numerous epithelial-line tubules termed,uriniferous tubules.,cortical labyrinth,medullary ray,cortex,medulla,renal lobe,:one renal pyramid and its,bounding cortical tissue,renal lobule,:renal tissue including one,medullary ray and cortical tissue,surround it.,1.2,N,ephron,The,nephron,is the structural and functional unit of the kidney,composed of two parts:,renal corpuscle,and,renal tubule.,There are about one to two million nephrons in each kidney.,Depending on the location of the renal corpuscle,nephrons may be classified as,cortical,or,juxtamedullary nephron,.,renal corpuscle,:,renal glomerulus,renal capsule,renal tubule,:,proximal tubule,:,-convoluted portion,-straight portion,thin segment,distal tubule,:,-straight portion,-convoluted portion,1.2.1,renal corpuscle,spherical,200,m in diameter.,two poles:vascular pole and urinary pole,two parts:,glomerulus,renal capsule(,Bowman,s capsule),renal corpuscle,Afferent arteriole,Efferent arteriole,Capillary network,Bowman,s capsule,Parietal layer,Podocyte,Urinary pole,Vascular pole,1.2.1.1,glomerulus,afferent arteriolescapillary network,efferent arterioles,capillary network:,endothelial cell:pore,50-100 nm,no diaphragm,intraglomerular mesangium,mesangial cell,:,LM:small,irregular,with processes,EM:RER,Golgi,lysosome,phagocytic vesicles,Functions:,i.produce ground substance,ii.phagocytosis,1.2.1.2,renal capsule,two layers capsule formed by beginning part of renal tubule which is enlarged and invaginated.,parietal layer,simple squamous epi.,visceral layer,podocytes,renel capsular cavity,podocyte,Primary process,Secondary process,Slit pore,Slit membrane,1.2.1.3,basal lamina,basal lamina:330nm,type IV collagen,proteoglycan,filtration barrier,or,membrane,the structure for filtration is located between the podocytes and the endothelial cells of the glomerulus.,including:,fenestrated,endothelial cell,basal lamina,slit membrane,1.2.2,renal tubule,50-60,m in D,14 mm long,proximal tubule,convoluted portion,straight portion,thin segment,distal tubule,straight portion,convoluted portion,1.2.2.1,proximal tubule,LM structure,pyramidal or cuboidal,eosinophilic,round nuclear,brush border,longitudinal striation,no clear boundary,EM structure:,Microvilli,plasma membrane infolding,lateral extension,Function:,reabsorption:,85%Na,+,ions and water.,All of glucose,aminoacid,polypeptide,proteins and vitamin.,secrete H,+,NH,3,hippuric acid and creatinine.,1.2.2.2,thin segment,10-15,m,simple squamous epithelial.,facilitate the passage of water and ions,1.2.2.3,distal tubule,LM structure:,cuboidal,slight-stained,round nuclear,no brush border,EM structure:,less microvilli,well-developed longitudinal striation,plasma membrane infolding,Function:,i.reabsorption of 8%water,Na,+,ions,ii.excretion of K,+,H,+,NH,3,1.3,collecting tubule,Arched collecting tubules,Straight collecting tubules,Papillary ducts,Epi.From simple cuboidal to simple columnar,slight stained,have clear boundary,Function:reabsorb water,1.4,Juxtaglomerular complex,It is located at the vascular pole of the renal corpuscle.,It consists of three structures:,juxtaglomerular cell,macula densa,and,extraglomerular mesangial cell,.,1.4.1,juxtaglomerular cell,Juxtaglomerular cells,are derived from smooth muscle cells in the wall of the afferent arteriole.,structure:larger,cuboidal in shaped,contain secretory granules.,function:,i.secrete renin,ii.secrete erythropoietin,1.4.2,macula densa,a group of cells derived from epithelium of distal tubule.,cell becomes taller,narrow,with round nuclear apical part arranged.,cells have processes connecting with other cells.,function:,chemoreceptors,feel the Na,+,ions concentration.,1.4.3,extraglomerular mesangial cell,(polar cushion cell),similar to intraglomerular mesangial cell,transfer the information,1.5,Blood supply to the kidney(self-study),Very large blood flow(1.2L/min),To form cap.two times,Glomerular cap.have a high blood pressure,Form vasa recta loop near medullary loop,More larger blood flow in renal cortex,2.,Urinary bladder,(self-study),2.1,Mucosa,epithelium：,transitional epithelium,lamina propria,2.2,Muscularis,2.3,Adventitia,questions,1.,state the conception and components of,nephron?,2.,describe the components and structure of,renal corpuscle.,3.,state the conception and components of,filtration barrier?,4.,Name the components of the juxtaglomerular,complex,and describe their structure and,function.,1,、病毒性肝炎：,由病毒造成的肝炎按照其病毒系列不同分为甲、乙、丙、丁、戊和庚共六种类型病毒性肝炎。能引起肝脏细胞肿胀，是世界上流传广泛，危害很大的,传染病,之一。,1908,年，才发现病毒也是肝炎的致病因素之一。,1947,年，将原来的传染性肝炎（,infectious hepatitis,）称为甲型肝炎（,Hepatitis A,HA,）；血清性肝炎（,serum hepatitis,）称为,乙型肝炎,（,Hepatitis B,HB,）。,1965,年人类首次检测到乙型肝炎的表面抗原。我国经济和科学技术日益发展，学术文化领域百家争鸣，（,df,高血压,958,心脏病,983u6,糖尿病,87fr,）特别是思想家的革新精神，为中医学理论的创新和突破性进展，提供了有利的文化背景。宋代陈无择著,三因极一病证方论,一书，（,45,传染病,q566,丙肝,964jo,乙肝,28jgsx,甲肝,gh,）提出三因学说；并产生了最具盛名四大学派，刘完素倡导火热论；张从正力倡“攻邪论”；李杲提出“内伤脾胃，百病由生”的理论；朱震亨创造性地阐明了相火的演变规律。,编辑本段明清时期（,df,肺,25s,血液,f369,血小板,t5172,红血球,gdf55m,白血球,fd2,）,是中医学理论综合汇编、深化发展，临床各科辨证体系丰富、提高阶段。如明代楼英的,医学纲目,和王肯堂的,证治准绳,，清代吴谦等编著的,医宗金鉴,和陈梦雷主编的,古今图书集成,医部全录,等。王清任著,医林改错,，注重实证研究，（,df,高血压,958,心脏病,983u6,糖尿病,87fr,）纠正了古医籍中关于解剖知识的某些错误，肯定了“脑主思维”，发展了瘀血理论。温病学说的形成和发展，标志着中医理论的创新与突破，吴有性著,温疫论,，叶天士著,温热病篇,，吴鞠通著,温病条辨,等，在药物学研究方面，（,45,传染病,q566,丙肝,964jo,乙肝,28jgsx,甲肝,gh,）李时珍著的,本草纲目,，总结了,16,世纪以前我国药物学研究的成就。医的诊察疾病能参考现代医学的微观分析，将辨证与辨病相结合，实现宏观与微观的统一，使中医诊断客观化，即把分析与综合相结合的方法引入中医理、法、方、药的研究，使二者有机结合，互相借鉴、补充，避免各自的片面性、局限性，这将有利于中西医学的优势互补，“和而不同”，多元发展。近年来，中医药在防治非典、禽流感和艾滋病方面发挥的独特作用也证实了二者的有机结合，具有肯定的临床疗效。,编辑本段东西方医学交融,不管是中医学还是西医学，从二者现有的思维方式的发展趋势来看，均是走向现代系统论思维，中医药学理论与现代科学体系之间具有系统同型性，属于本质相同而描述表达方式不同的两种科学形式。可望在现代系统论思维上实现交融或统一，成为中西医在新的发展水平上实现交融或统一的支撑点，希冀籍此能给中医学以至生命科学带来良好的发展机遇，进而对医学理论带来新的革命。,编辑本段现代中医史,上个世纪末,本世纪初，,1996,年,清华学界对中医气本质，经络实质，阴阳，五行，藏象，中医哲学观等都有了新的全面整体创造性的认识和解说。如，邓宇等发现的,:,气是流动着的信息能量物质的混合统一体；分形分维的经络解剖结构；数理阴阳；中医分形集：分形阴阳集阴阳集的分形分维数，五行分形集五行集的分维数；分形藏象五系统暨心系统、肝系统、脾系统、肺系统、肾系统；中医三个哲学观新提出的第三哲学观：相似观分形论等。还包括近代针灸经络的发展史,近代中医气的进展简史,中西医结合史,中医中药史等,.,六种类型的病毒性肝炎遗传因子不同，除乙型肝炎遗传因子是,DNA,外，其余几型肝炎遗传因子均为,RNA,。其中,甲型肝炎,的传播途径是粪口传播，乙型肝炎的传播途径是血液传播、性传播和母婴传播。疫苗。,2,、酒精性肝炎：,酒精性,肝炎,早期可无明显症状，但,肝脏,已有病理改变，发病前往往有短期内大量饮酒史，有明显体重减轻，,食欲不振,，,恶心,，,呕吐,，全身倦怠乏力，,发热,，,腹痛,及,腹泻,，上,消化道出血,及精神症状。体征有,黄疸,，肝肿大和压痛，同时有脾肿大，面色发灰，腹水浮肿及,蜘蛛痣,，,食管静脉曲张,。从实验室检查看，有,贫血,和中性,白细胞,增多，,红细胞,容积测定（,MCV,）大于,95FL,血清,胆红素,增高，可达,17.1moL/L,或以上，,转氨酶,中度升高，常大于,2.0,，测定线粒体,AST,（,mAST,）及其与总,AST,（,tAST,）的比值，其升高可达,12.5+5.2%,。并有,-GT,，谷氨酸脱氢酶和,碱性磷酸酶,活力增高，凝血酶原时间延长。,此外，病毒性肝炎还有丙型肝炎、丁型肝炎、戊型肝炎和庚型肝炎。过去被定为己型肝炎病毒的病毒现在被确定为,乙型肝炎病毒,的一个属型，因此己型肝炎不存在。,在病毒肝炎的疫苗，,A,型、,B,型、,D,型的疫苗已研发成功；,C,型、,E,型、,F,型的目前无编辑本段宋金元时期,精品课件文档，欢迎下载，下载后可以复制编辑。,更多精品文档，欢迎浏览。,