KOLEKSI GALAXY EXPLORER SERIES 3: THE EXCRETORY ORGANS AND FUNCTIONS

TTHHEE EEXXCCRREETTOORRYY OORRGGAANNSS AANNDD FFUUNNCCTTIIOONNSS PPISMP SAINS SJKC AMBILAN JUN 2023 CHIAM SUN MAY , PHD AINON BT HADIM LOW KEE SUN TAN CHO CHIEW KOLEKSI GALAXY EXPLORERS SIRI 3

TTHHEE EEXXCCRREETTOORRYY OORRGGAANNSS AANNDD FFUUNNCCTTIIOONNSS KOLEKSI GALAXY EXPLORERS SIRI 3

INSTITUT PENDIDIKAN GURU KAMPUS KENT, PETI SURAT 2, 89207 TUARAN, SABAH. Hak Cipta © Ins titut Pendidikan Guru Kampus Kent 2023 Cetakan Pertama 2023 Hak cipta terpelihara. Tidak dibenarkan mengeluarkan atau ulang mana-mana bahagian kandungan, illus tras i dan jadual dalam kandungan buku ini dalam apa juga bentuk dan dengan apa juga sama ada secara elektronik, fotokopi mekanik, rakaman atau cara lain sebelum mendapat i z in bertuli s daripada Ins titut Pendidikan Guru Kampus Kent. KOLEKSI GALAXY EXPLORER SERIES 3: THE EXCRETORY ORGANS AND FUNCTIONS PPISMP SAINS SJKC AMBILAN JUN 2023 CHIAM SUN MAY , PHD AINON BT HADIM LOW KEE SUN TAN CHO CHIEW elSBN: 978-967-0008-76-9 Kulit Buku:

PREFACE Welcome to the third volume of the "Koleks i Galaxy Explorer Series , " where, in thi s book titled "The Excretory Organs and Functions , " we will delve into the intricacies of our excretory sys tem, unveiling the vital organs and proces ses that play a crucial role in maintaining our health and well-being. The excretory sys tems within our bodies often work s ilently, di screetly eliminating was te product s and toxins . However, their importance cannot be emphas i zed enough, as they enable us to thrive and achieve optimal health. In thi s book, we explore the s ignificance of these sys tems and their indi spensable role in our overall wellbeing. Our journey begins with an in-depth exploration of excretory organs , primarily the kidneys and the skin. These unsung heroes tireles s ly filter and clear was te from our bodies , ensuring a delicate balance of es sential subs tances . We will meticulous ly di s sect the complex s tructures of these organs , unveiling their des ign and functions . Under s tanding the excretory proces s i s of paramount importance. Within these pages , we will di s sect the mechani sms through which our bodies expel was te, from the filtration proces ses within the kidney' s nephrons to the sweat glands in our skin. We will elaborate on the scientific principles that govern how we eliminate metabolic byproduct s and toxins . Our exploration does not s top there; we will al so confront a variety of excretory di seases that can di s rupt the equilibrium within our bodies . From the excruciating pain of kidney s tones to the gradual progres s ion of chronic kidney di sease, from the di scomfort of urinary tract infections to the perplexing mys teries of edema, urethriti s , and incontinence, we will delve deep into the causes , symptoms , treatment s , and prevention s trategies for these conditions . It i s our hope that as you read through the chapter s of thi s book, you will gain a deeper under s tanding of the intricate mechani sms that allow our bodies to maintain balance. Furthermore, armed with thi s knowledge, may we collectively journey towards health and happines s .

TABLE OF CONTENT CONTENT PAGE NUMBER Chronic Kidney Disease 6-8 Excretory system by Lenis, Tiffanie & Lai Cheng Teck 9-14 Oedema 15 Excretory system by Chai Shu Hui & Liik Hui Zhen Urethritis Excretory system by Yip Xiang Lin & Joanne Excretory system by Connie & Tie Chieng Sze 1-5 21-22 16-20 23-26 Excretory system by Irine & Felicia 31-35 Glomerulonephritis 36-38 Excretory system by Jocelyn & Wong Qian Yi 39-42 Urinary Tract Infection Excretory system by Johnny & Ung Kee Jie Incontinence Uremia 27-30 45-49 43-44 50-52 Kidney Stones 59-62 Excretory system by Stephanie & Chai Yi Lin 63 End-stage Renal Disease (ESRD) 64 Excretory system by Kelvin & Wong Sing Kai 53-58

EXCRETORY SYSTEM ●Renal artery carries oxygented blood from the heart to the kidney ●Renal Vein carries.deoxygenated blood from the kidneys back to the heart ●Urine flows to the bladder through the ureter ★Remove waste from the human body ★Excretory system helps control the concentration of ions (like sodium and potassium) ★The kidneys help regulate calcium levels in the blood by control ling its reabsorption and excretion. ★The kidneys produce erythropoietin, a hormone that stimulates the production of red blood cel ls in response to low oxygen levels. ★It plays a role in regulating blood pressure by control ling the volume of blood and the concentration of salts in the blood. ★The system helps maintain the body's pH balance by excreting hydrogen ions and reabsorbing bicarbonate ions in the kidneys. FUNCTION OF kIDNEY BY CHAI SHU HUI & LIIK HUI ZHEN 1

EXCRETORY PROCESS FOR KIDNEY 1. FILTRATION: BLOOD FROM THE RENAL ARTERY ENTERS TINY FILTERING UNITS CALLED NEPHRONS. WITHIN EACH NEPHRON, BLOOD IS FILTERED THROUGH A CLUSTER OF CAPILLARIES CALLED THE GLOMERULUS. HERE, SMALL MOLECULES LIKE WATER, SALTS, GLUCOSE, AND WASTE PRODUCTS ARE FORCED OUT OF THE BLOOD INTO THE RENAL TUBULES AS A FILTRATE. 2. REABSORPTION: AS THE FILTRATE MOVES THROUGH THE RENAL TUBULES, THE BODY REABSORBS ESSENTIAL SUBSTANCES (SUCH AS GLUCOSE AND CERTAIN IONS) BACK INTO THE BLOODSTREAM. THIS PROCESS ENSURES THAT IMPORTANT MOLECULES ARE NOT LOST IN THE URINE. 3.SECRETION: THE KIDNEYS ALSO ACTIVELY SECRETE WASTE PRODUCTS AND EXCESS IONS (E.G., HYDROGEN IONS AND POTASSIUM) FROM THE BLOOD INTO THE RENAL TUBULES TO BE EXCRETED IN URINE. THIS HELPS REGULATE THE BODY'S ACID-BASE BALANCE AND ELECTROLYTE LEVELS. 4.CONCENTRATION: THE REMAINING FILTRATE, WHICH IS NOW URINE, CONTINUES THROUGH THE TUBULES. ALONG THE WAY, WATER AND OTHER SUBSTANCES CAN BE REABSORBED TO ADJUST THE CONCENTRATION AND VOLUME OF THE URINE BASED ON THE BODY'S HYDRATION NEEDS. 5.COLLECTION: THE CONCENTRATED URINE IS COLLECTED IN THE RENAL PELVIS AND THEN FLOWS INTO THE URETER, EVENTUALLY REACHING THE BLADDER. FROM THERE, IT CAN BE ELIMINATED FROM THE BODY THROUGH URINATION. 2

The skin is divided into three main parts: a) EPIDERMIS which is found on the external part it is continually being generated. It can be seen and touched. Keratin, a protein inside skin cells makes up the skin cells and along with other proteins sticks together to form this layer. The skin is the largest external organ in the body. b) DERMIS is the middle layer of the skin. It makes up 90% of skin's thickness. c) HYPODERMIS. This subcutaneous layer is made up of fat and forms the innermost layer. FUNCTION OF THE SKIN Protection from the Environment Prevents Water Loss Sensation Regulation of Temperature Storage for fats and water Excretion STRUCTURE OF EXCRETORY ORGAN (SKIN) 3

Excretory Process for SKIN Erector muscles in the skin are less stimulated so they do not constrict and the fine hair lower towards the skin surface. As a result, a thin layer of air is trapped between the fine hair. Heat can be released quickly. Arterioles in the skin dilate (vasodilation) to allow more blood to flow to the skin surface. More heat is lost to the external environment through radiation. Skeletal muscle will contract and relax less so the body does not shiver. The sweat glands are stimulated to produce more sweat. Heat is absorbed to evaporate sweat and this cools the skin. The skin excrete sweat. Sweat contains water, salts and small quantities of urea. The epidermis contains small pores through which sweat leaves the body. The dermis contains sweat glands that produce sweat. 4

IMPORTANCE OF EXCRETORY SYSTEM AND HEALTH The excretory system is responsible for eliminating metabolic waste products and toxins from the body. For example, urea, ammonia and others. If these waste is not removed, it can be harmful to our body and disrupt normal bodily functions. The excretory system, specifically the kidneys, plays a critical role in regulating blood pressure. They adjust the volume of blood and the concentration of sodium and other electrolytes in the bloodstream, which influences blood pressure. The excretory system helps to maintain the body's pH balance. It regulates the levels of acids and bases in the blood to ensure that the body's internal environment remains within a narrow, optimal pH range for biochemical processes. 5

Stages of CKD eGFR result % of kidney function STAGE 1: Kidney damage with normal kidney function 90 or higher 90-100% STAGE 2: Kidney damage with mild loss of kidney function 89 to 60 89-60% STAGE 3a: Mild to moderate loss of kidney function 59 to 45 59-45% STAGE 3b: Moderate to severe loss of kidney function 44 to 30 44-30% STAGE 4: Severe loss of kidney function 29 to 15 29-15% STAGE 5: Kidney failure less than 15 less than 15% C h r o n i c k i d n e y d i s e a s e Chronic kidney disease (CKD) is a condition in which the kidneys are damaged and cannot filter blood as well as they should. Because of this, excess fluid and waste from blood remain in the body and may cause other health problems such as heart disease and stroke. S t a g e s o f k i d n e y d i s e a s e In Malaysia, the prevalence of end-stage renal disease (ESRD) or kidney failure patients has been steadily increasing over time, with 43,804 people receiving dialysis as of 31 December 2018, according to 2020 report by Malaysia Dialysis and Transplant Registry (MDTR). 6

MAIN CAUSES OF CHRONIC KIDNEY DISEASE? DIABETES DIABETES OCCURS WHEN YOUR BLOOD SUGAR REMAINS TOO HIGH. OVER TIME, UNMANAGED BLOOD SUGAR CAN CAUSE DAMAGE TO MANY ORGANS IN YOUR BODY, INCLUDING THE KIDNEYS AND HEART AND BLOOD VESSELS, NERVES, AND EYES. HIGH BLOOD PRESSURE HIGH BLOOD PRESSURE OCCURS WHEN YOUR BLOOD PRESSURE AGAINST THE WALLS OF YOUR BLOOD VESSELS INCREASES. IF UNCONTROLLED OR POORLY CONTROLLED, HIGH BLOOD PRESSURE CAN BE A LEADING CAUSE OF HEART ATTACKS, STROKES, AND CHRONIC KIDNEY DISEASE. ALSO, CHRONIC KIDNEY DISEASE CAN CAUSE HIGH BLOOD PRESSURE. SYMPTONS OF CHRONIC KIDNEY DISEASE Nausea and Vomiting Fatigue and Weakness Sleep Problem High blood pressure Urinating more or less Muscle cramp Chest Pain 7

QUITTING SMOKING GRAPHIC DESIGNER reallygreatsite.com HOWTOSOLVECHRONICDISEASEEAT A KIDNEYFRIENDLY DIET EXERCISE REGULARLY. REGULAR CHECK-UPS LIMITING ALCOHOL CONSUMPTION. CONTROL BLOOD PRESSURE DIAGNOSIS THROUGH BLOOD TESTS, URINE TESTS, AND IMAGING. FLUID MANAGEMENT: FOLLOW YOUR DOCTOR'S ADVICE ON HOW MUCH FLUID TO CONSUME DAILY. 8

Excretory System THE EXCRETORY SYSTEM CONSISTS OF ORGANS WHICH REMOVE METABOLIC WASTES AND TOXINS FROM THE BODY, THAT ARE KIDNEY AND SKIN. STRUCTURE: LOCATED IN THE UPPER ABDOMINAL CAVITY, ONE ON EACH SIDE OF THE SPINE. IT IS MADE OF A LARGE NUMBER OF STRUCTURAL AND FUNCTIONAL SUBUNITS CALLED NEPHRONS. FILTRATION: KIDNEYS FILTER BLOOD TO REMOVE WASTE PRODUCTS, EXCESS SALTS, AND EXCESS WATER, FORMING URINE REGULATION OF BLOOD PRESSURE: KIDNEYS CONTROL VOLUME OF BLOOD AND CONCENTRATION OF SALTS AND WATER. FUNCTION: KIDNEYS BY LENIS, TIFFANIE & LAI CHENG TECK 9

STRUCTURE: CONSISTS OF TWO LAYERS: THE EPIDERMIS AND THE DERMIS. BENEATH THE DERMIS LIES THE HYPODERMIS OR SUBCUTANEOUS FATTY TISSUE. SKIN PROTECTION: REGULATION: SENSATION: FUNCTION: PROVIDES PROTECTION FROM: MECHANICAL IMPACTS AND PRESSURE, VARIATIONS IN TEMPERATURE, MICROORGANISMS, RADIATION AND CHEMICALS. REGULATE BODY TEMPERATURE VIA SWEAT AND HAIR, AND CHANGES IN PERIPHERAL CIRCULATION AND FLUID BALANCE VIA SWEAT. CONTAINS AN EXTENSIVE NETWORK OF NERVE CELLS THAT DETECT AND RELAY CHANGES IN THE ENVIRONMENT. THERE ARE SEPARATE RECEPTORS FOR HEAT, COLD, TOUCH, AND PAIN. 10

EXCRETORY SYSTEM PROCESS (SKIN & KIDNEY) I. SKIN: SWEATING ~ SKIN RELEASES SWEAT THROUGH SWEAT GLANDS PRESENT IN THE BODY ~ SWEAT EVAPORATES AND HELPS TO KEEP THE BODY COOL WHEN IT IS WARM OUTSIDE ~ PROCESS OF EXCRETION THROUGH SWEATING BY ELIMINATING WATER, SALTS AND UREA ~ THE EPIDERMIS CONTAINS SMALL PORES THROUGH WHICH SWEAT LEAVES THE BODY ~ THE DERMIS CONTAINS SWEAT GLANDS THAT PRODUCE SWEAT ,~ SWEAT IS AN ACKNOWLEDGED EXCRETORY ROUTE FOR TOXIC METALS 11

II. KIDNEY: FORMATION OF URINE ~ Kidney is made up of millons units called nephrons ~ nephron is made up of BOWMAN’S CAPSULE, GLOMERULUS AND RENAL TUBULE FORMATION OF URINE: ~ AQUAPORINS ALLOW WATER TO PASS FROM THE FILTRATE INTO THE INTERSTITIAL FLUID GLOMERULUS ~ FILTERS SMALL SOLUTES FROM THE BLOOD PROXIMAL CONVULATED TUBULE ~ REABSORPTION OF IONS, WATER AND NUTRIENTS; REMOVES TOXINS AND ADJUSTS FILTRATE PH DESCENDING LOOP OF HENLE 12

ASCENDING LOOP OF HENLE ~ REABSORBS NA+ AND CL- FROM THE FILTRATE INTO THE INTERSTITIAL FLUID DISTAL TUBULE ~ SELECTIVELY SECRETES AND ABSORBS DIFFERENT IONS TO MAINTAIN BLOOD PH AND ELECTROLYTE BALANCE COLLECTING DUCT ~ REABSORBS SOLUTES AND WATER FROM THE FILTRATE ~ A SMALL AMOUNT OF UREA DIFFUSES OUT INTO THE SURROUNDING FLUID AND BLOOD CAPILLARIES DUE TO ITS SAMLL MOLECULAR SIZE ~ URINE CONTAINS WATER, UREA, NACL SALT, URIC ACID AND CREATININE ~ AFTER LEAVING THE COLLECTING DUCT, URINE FLOWS THROUGH THE URETER, BLADDER, URETHRA AND IS FINALLY EXCRETED IN THE LAST STEP: 13

1 Homeostasis Maintenance Thissystem regulatesthe equilibrium of vital elements within the body,such as electrolytes, water, and pH levels. This equilibrium, known as homeostasis, is crucial forinternal stability. 2 3 4 Importance of excretory and health Waste Disposal It isresponsible for eliminating waste materials and toxins from the body, encompassing substanceslike urea,surplus salts, and metabolic byproducts. Blood Pressure Control Through control over blood volume and salt concentration in the bloodstream, the kidneys help in regulating blood pressure. General Health and Vitality A well-functioning excretory system is pivotal for optimal bodily functions, directly impacting energy levels, mental clarity, and physical well-being. 14

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REMOVE WASTE PRODUCTS FROM THE BLOOD AND PRODUCE URINE STRUCTURE OF EXCRETORY ORGAN (KIDNEY) RIGHT RENAL ARTEY RIGHT KIDNEY RIGHT RENAL VEIN URETER URETHRA BLADDER LEFT RENAL VEIN LEFT RENAL ARTEY LEFT KIDNEY FUNCTIONS OF KIDNEY HELP TO CONTROL YOUR BLOOD PRESSURE MAKE AND REGULATE IMPORTANT HORMONES IN THE BODY THAT HELP TO CONTROL BLOOD PRESSURE, RED BLOOD CELL PRODUCTION AND CALCIUM UPTAKE FROM THE INTESTINE MAINTAIN BODY FLUID AT THE CORRECT LEVELS FOR THE BODY TO FUNCTION CONTROL BODY CHEMISTRY BY REGULATING THE AMOUNT OF SALT, WATER AND OTHER CHEMICALS MOVING AROUND THE BODY YIP XIANG LIN & JOANNE CHIEW 16

PROVIDES A PROTECTIVE BARRIER AGAINST MECHANICAL, THERMAL AND PHYSICAL INJURY AND HAZARDOUS SUBSTANCES PREVENTS LOSS OF MOISTURE REDUCES HARMFUL EFFECTS OF UV RADIATION ACTS AS A SENSORY ORGAN (TOUCH, DETECTS TEMPERATURE) HELPS REGULATE TEMPERATURE STRUCTURE OF EXCRETORY ORGAN (SKIN) FUNCTIONS OF SKIN EPIDERMIS DERMIS FATTY TISSUE BLOOD VESSELS FOLLICLE OIL GLAND SWEAT GLAND MELANOCYTES AN IMMUNE ORGAN TO DETECT INFECTIONS PRODUCTION OF VITAMIN D HAIR SHAFT ARTERY VEIN 17

EXCRETORY PROCESS OF SKIN Most waste is excreted via the sweat glands and consists mainly of water, salts (particularly sodium, potassium and chloride ion) lactic acid, and urea Potassium, urea, ammonia, and lactic acid concentrations are higher in sweat than in plasma, although these levels are also regulated to some extent by reabsorption in the ductal tubule of the sweat gland Additionally, the sebaceous glands secrete lipid-based substances including pheromones, some hormones and products that moisturise the surrounding skin There can also be modest amounts of lipid soluble waste products If other excretion mechanisms are inadequate, e.g., constipation is present, this encourages the potential for a greater number of substances to be excreted via the sweat or sebum through the skin Excess levels of waste products on the skin may contribute to irritation, inflammation and oxidative stress Along with essential minerals, sweat is an acknowledged excretory route for toxic metals Heavy metals such arsenic, lead, cadmium and mercury have been shown to be present in sweat It should be noted that often skin conditions worsen in the winter months It is worth highlighting that our pores are not so open, and we sweat less during the winter, potentially reducing this excretion pathway 18

EXCRETORY PROCESS OF KIDNEY FILTRATION BLOOD IS FILTERED AS IT PASSES THROUGH TINY BLOOD VESSELS CALLED GLOMERULI WITHIN THE NEPHRONS, THE FUNCTIONAL UNITS OF THE KIDNEYS. HIGH-PRESSURE FILTRATION OCCURS IN THE GLOMERULUS, ALLOWING SMALL MOLECULES SUCH AS WATER, IONS, WASTE PRODUCTS (UREA, CREATININE, AND URIC ACID), AND SOME ESSENTIAL SUBSTANCES (GLUCOSE, AMINO ACIDS) TO PASS THROUGH THE FILTRATION BARRIER INTO THE RENAL TUBULES. THE RESULTING FLUID, CALLED FILTRATE, IS SIMILAR IN COMPOSITION TO BLOOD PLASMA BUT LACKS BLOOD CELLS AND LARGE PROTEINS. REABSORPTION AFTER FILTRATION, THE FILTRATE ENTERS THE RENAL TUBULES, WHERE THE PROCESS OF REABSORPTION TAKES PLACE. MOST OF THE ESSENTIAL SUBSTANCES (GLUCOSE, AMINO ACIDS, SALTS, ETC.) AND A SIGNIFICANT AMOUNT OF WATER ARE REABSORBED FROM THE FILTRATE BACK INTO THE BLOODSTREAM. THIS REABSORPTION OCCURS PRIMARILY IN THE PROXIMAL CONVOLUTED TUBULE, THE LOOP OF HENLE, AND THE DISTAL CONVOLUTED TUBULE, DEPENDING ON THE SUBSTANCE AND ITS REGULATION. SECRETION THE RENAL TUBULES ALSO ACTIVELY SECRETE CERTAIN SUBSTANCES FROM THE BLOODSTREAM INTO THE FILTRATE. THIS SECRETION PROCESS HELPS ELIMINATE ADDITIONAL WASTE PRODUCTS AND EXCESS IONS, MAINTAINING THE BODY'S ELECTROLYTE BALANCE. SUBSTANCES LIKE HYDROGEN IONS (H+), POTASSIUM IONS (K+), AND SOME DRUGS ARE ACTIVELY SECRETED INTO THE TUBULES. EXCRETION FINALLY, THE ADJUSTED FILTRATE, NOW REFERRED TO AS URINE, FLOWS FROM THE COLLECTING DUCTS INTO THE RENAL PELVIS AND THEN INTO THE URETERS. FROM THE URETERS, URINE TRAVELS TO THE URINARY BLADDER, WHERE IT IS STORED UNTIL IT IS EXCRETED FROM THE BODY THROUGH THE URETHRA. 19

2. ACID-BASE BALANCE THE EXCRETORY SYSTEM HELPS MAINTAIN THE BODY'S ACID-BASE BALANCE (PH LEVEL) BY CONTROLLING THE SECRETION OF HYDROGEN IONS (H+) AND BICARBONATE IONS (HCO3-) INTO THE URINE. PROPER PH BALANCE IS NECESSARY FOR ENZYMATIC ACTIVITY AND OTHER BIOCHEMICAL PROCESSES. THE IMPORTANCE OF EXCRETORY AND HEALTH 1. WASTE ELIMINATION THE PRIMARY FUNCTION OF THE EXCRETORY SYSTEM IS TO REMOVE METABOLIC WASTE PRODUCTS AND TOXINS FROM THE BODY. THIS INCLUDES SUBSTANCES LIKE UREA, CREATININE, URIC ACID, AND AMMONIA, WHICH ARE BY PRODUCTS OF PROTEIN METABOLISM. FAILURE TO ELIMINATE THESE WASTE PRODUCTS CAN LEAD TO THE ACCUMULATION OF TOXIC SUBSTANCES IN THE BLOODSTREAM, WHICH CAN BE HARMFUL AND EVEN LIFE-THREATENING. 3. DETOXIFICATION IN ADDITION TO FILTERING WASTE PRODUCTS FROM THE BLOOD, THE KIDNEYS HELP DETOXIFY THE BODY BY REMOVING DRUGS, TOXINS, AND OTHER FOREIGN SUBSTANCES FROM THE BLOODSTREAM. 20

URETHRITIS DEFINITION: Gonococcal urethritis is caused by gonorrhea Nongonococcal urethritis (NGU) is caused by something other than gonorrhea. This could be from another type of STI or from repeated irritation of your urethra Non-specific urethritis (NSU) refers to urethritis that doesn’t have a known cause ~ Urethritis is an inflammation (swelling and irritation) of the urethra, the tube that takes urine (pee) from your bladder to the outside of your body ~ Typically, urethritis is caused by an infection ~ Most commonly, but not always, the cause is a sexually transmitted infection (STI) ~ There are three types of urethritis: SYMPTOMS OF URETHRITIS BLOOD IN THE URINE OR SEMEN BURNING PAIN WHILE URINATING (DYSURIA) FEVER PELVIC PAIN FREQUENT OR URGENT URINATION VAGINAL DISCHARGE 21

CAUSES OF URETHRITIS ALLERGIC REACTIONS IN RARE CASES, ALLERGIES TO SUBSTANCES THAT COME INTO CONTACT WITH THE URETHRA, LIKE LATEX CONDOMS OR LUBRICANTS, CAN LEAD TO URETHRITIS. HYGIENE PRACTICES POOR HYGIENE CAN CONTRIBUTE TO THE DEVELOPMENT OF URETHRITIS BY ALLOWING BACTERIA OR IRRITANTS TO ENTER THE URETHRA MORE EASILY. TREATMENT FOR URETHRITIS 1) ANTIBIOTICS ANTIBIOTICS ARE THE PRIMARY TREATMENT FOR BACTERIAL URETHRITIS. THE CHOICE OF ANTIBIOTICS DEPENDS ON THE SPECIFIC BACTERIA CAUSING THE INFECTION AND THEIR ANTIBIOTIC SENSITIVITY. COMMONLY PRESCRIBED ANTIBIOTICS INCLUDE CEFTRIAXONE, AZITHROMYCIN, DOXYCYCLINE PRACTICE SAFE SEX BY USING CONDOMS CONSISTENTLY AND CORRECTLY. GET REGULAR CHECK-UPS AND SCREENINGS FOR SEXUALLY TRANSMITTED INFECTIONS (STIS) IF YOU ARE SEXUALLY ACTIVE OR AT RISK. ENCOURAGE SEXUAL PARTNERS TO SEEK TESTING AND TREATMENT IF NECESSARY. MAINTAIN GOOD HYGIENE PRACTICES, ESPECIALLY IN THE GENITAL AREA. 4) PREVENTIVE MEASURES 22

STRUCTURE OF EXCRETORY ORGAN (SKIN) FUNCTION OF SKIN: SENSATION SENSE OF TOUCH ENABLES US TO FEEL, REACT. MOVE (PLEASURE/PAIN) PROTECTION PROTECTS BODY FROM OUTSIDE ELEMENTS MICROORGANISMS HEAT REGULATION AS TEMPERATURE CHANGE, SKIN ADJUSTS TO HEAT OR COOL US DOWN SECRETION OILS HELP LUBRICATE PROTECT ABSORPTION ABSORBS CHEMICALS, HORMONES, MOISTURE, OXYGEN VIT D IS ALSO PRODUCED IN SKIN UPON EXPOSURE TO SUN EXCRETION SWEAT PREVENTS FROM OVERHEATING BY CONNIE& TIE CHIENG SZE 23

Sweating AS SWEAT EVAPORATES, IT CARRIES WITH IT SOME METABOLIC WASTE PRODUCTS, SUCH AS UREA, AMMONIA, AND LACTIC ACID, ALONG WITH EXCESS SALTS AND WATER. THIS PROCESS CONTRIBUTES TO THE REMOVAL OF THESE WASTE SUBSTANCES FROM THE BODY. Excretion Process For Skin Sweat Gland Evaporation Sweat glands help eliminate certain waste products from the body. When your body metabolizes food and performs various cellular activities, it generates waste substances, including urea, ammonia, and lactic acid. Sweat glands contribute to this process by excreting these waste products in sweat. WHEN THE BODY TEMPERATURE RISES, WHETHER DUE TO PHYSICAL ACTIVITY, HEAT, OR EMOTIONAL STRESS, THE SWEAT GLANDS ARE STIMULATED TO PRODUCE SWEAT. SWEAT IS THEN RELEASED ONTO THE SURFACE OF THE SKIN THROUGH TINY DUCTS. ONCE SWEAT REACHES THE SKIN'S SURFACE, IT EVAPORATES INTO THE SURROUNDING AIR. THIS EVAPORATION PROCESS HELPS COOL THE BODY BY DISSIPATING HEAT. WHILE EVAPORATING, SWEAT CARRIES AWAY EXCESS HEAT AND CERTAIN WASTE PRODUCTS. Waste Elimination Maintaining Electrolyte Balance SWEAT ALSO HELPS MAINTAIN THE BODY'S ELECTROLYTE BALANCE BY EXCRETING EXCESS SALTS AND MINERALS. THIS IS IMPORTANT FOR OVERALL BODILY FUNCTION. 24

CALCITROLE- CALCIUM HOMEOSTASIS ERYTHROPOIETIN- PRODUCTION OF RBC AMMONIA AND UREA- AMINO ACID CREATININE-CREATININE PHOSPHATE DRUGS ECT REGULATION OF IONS IN BLOOD SODIUM-NA, POTASSIUM-K, CALCIUM-CA CL, PHOSPHATE HPO4 REGULATION OF BLOOD VOLUME ADJUST THE VOLUME OF BLOOD OR ELIMINATING IT IN THE URINE REGULATION OF BLOOD PH REGULATE BY EXCRETE A VARIABLE AMOUNT OF H+ IN THE URINE, CONSERVE BICARBONATE HCO3 PRODUCTION OF HORMONES EXCRETION OF WASTE STRUCTURE OF THE KIDNEY FUNCTION OF KIDNEY: 25

Filtration is the mass movement of water and solutes from plasma to the renal tubule that occurs in the renal corpuscle. About 20% of the plasma volume passing through the glomerulus at any given time is filtered. Filtration is primarily driven by hydraulic pressure (blood pressure) in the capillaries of the glomerulus. FILTRATION 1 Excretory Process For Kidney 2 Reabsorption is the movement of water and solutes from the tubule back into the plasma. Reabsorption of water and specific solutes occurs to varying degrees over the entire length of the renal tubule. many important solutes (glucose, amino acids, bicarbonate) are actively transported out of the proximal tubule such that their concentrations are normally extremely low in the remaining fluid. REABSORPTION Even after filtration has occured, the tubules continue to secrete additional substances into the tubular fluid. This enhances the kidney's ability to eliminate certain wastes and toxins. It is also essential to regulation of plasma potassium concentrations and pH. (See Fluid and electrolyte balance). SECRETION 3 EXCRETION 4 Excretion is what goes into the urine, the end result of the above three processes. Although the original concentration of a substance in the tubule fluid may initially be close to that of plasma, subsequent reabsorption and/or secretion can dramatically alter the final concentration in the urine. The amount of a particular substance that is excreted is determined by the formula: amount excreted = amount filtered - amount reabsorbed + amount secreted 26

WHAT IS URINARY TRACT INFECTION ? A urinary tract infection (UTI) is an infection in any part of the urinary system. The urinary system includes the kidneys, ureters, bladder and urethra. Most infections involve the lower urinary tract — the bladder and the urethra. HOW COMMON ARE URINARY TRACT INFECTIONS? UTIs are very common, especially in women and people assigned female at birth (AFAB). About 20% of people AFAB will have a UTI at some point during their lives. Men and people assigned male at birth (AMAB) can also get UTIs, as well as children, though they only affect 1% to 2% of children. Healthcare providers treat 8 million to 10 million people each year for UTIs. SYMPTOMS OF URINARY TRACT INFECTIONS A STRONG URGE TO URINATE THAT DOESN'T GO AWAY A BURNING FEELING WHEN URINATING URINATING OFTEN, AND PASSING SMALL AMOUNTS OF URINE URINE THAT LOOKS CLOUDY URINE THAT APPEARS RED, BRIGHT PINK OR COLA-COLORED — SIGNS OF BLOOD IN THE URINE STRONG-SMELLING URINE PELVIC PAIN, IN WOMEN — ESPECIALLY IN THE CENTER OF THE PELVIS AND AROUND THE AREA OF THE PUBIC BONE 27

This type of UTI can happen when GI bacteria spread from the anus to the urethra. An infection of the urethra can also be caused by sexually transmitted infections. They include herpes, gonorrhea, chlamydia and mycoplasma. This can happen because women's urethras are close to the vagina. INFECTION OF THE URETHRA IThis type of UTI is usually caused by Escherichia coli (E. coli). E. coli is a type of bacteria commonly found in the gastrointestinal (GI) tract. But sometimes other bacteria are the cause. Having sex also may lead to a bladder infection, but you don't have to be sexually active to develop one. All women are at risk of bladder infections because of their anatomy. In women, the urethra is close to the anus. And the urethral opening is close to the bladder. This makes it easier for bacteria around the anus to enter the urethra and to travel to the bladder. INFECTION OF THE BLADDER CAUSES OF URINARY TRACT INFECTION 28

01 02 Pain and Discomfort Often cause pain and discomfortin the lower abdomen or pelvic region. You may also experience a burning sensation during urination, known as dysuria. Frequent Urination Lead to a frequent and urgent need to urinate. However, only small amounts of urine may be passed at a time. 03 04 05 Pain in the Kidneys Ifthe infection spreads to the kidneys, you may experience pain in your back or side, just below the ribcage. This can be a sign of a more severe UTI, known as pyelonephritis. Fever and Chills Systemic symptoms like fever and chills can occur when the infection is more severe and has reached the bloodstream. Nausea and Vomiting In some cases, UTIs can cause nausea and vomiting, especially ifthe infection has progressed to pyelonephritis. EFFECT OF URINARY TRACT INFECTION 29

Take cranberry supplements Ways To Prevent Urinary Tract Infection Stay Hydrated Drinking plenty of water can help flush bacteria out of the urinary tract. Aim to drink at least 8 cups (64 ounces) of water daily, or more if you're physically active or live in a hot climate. Empty your bladder often Regularly emptying your bladder ensures urine is not sitting in your bladder for long periods of time. Since bacteria like warm and wet environments to grow, this takes away good living conditions for the bacteria. It's normal to empty your bladder four to eight times per day. Urinate soon after sex The act of intercourse can cause bacteria to get close to or into the urethra, the small tube that empties your bladder. Voiding after intercourse removes some of the bacteria before it can cause an infection. While cranberry supplements have not been shown in studies to prevent urinary tract infections, there is a reasonable biologic mechanism that using them could be helpful. If you would like to try this option, consider a concentrated over-the-counter cranberry supplement instead of cranberry juice. It likely provides more benefit and reduces extra sugar typically found in juice. 30

THE EXCRETORY ORGANS AND FUNCTIONS Kidney FUNCTIONS OF KIDNEY Maintain the water balance in the body by regulating the amount of water excreted through urine. Each kidney is made up of millions of functional units called nephrons. Each nephron is made up of Bowman’s capsule, Glomerulus and Renal tubule. Bowman’s capsule contains a cluster of blood capillaries called glomerulus. Renal tubule are composed of the proximal convoluted tubules, loop of Henle and distal convoluted tubule. Distal convoluted tubule join together into a collecting duct. Maintain the balance of electrolytes such as sodium, potassium, calcium, and magnesium in the body. Remove the waste products from the body such as urea, creatinine, and uric acid through urine. Regulate the pH of the blood by removing excess acids or bases from the body through urine. Produce hormones such as erythropoietin (stimulates the production of red blood cells) and renin (regulates blood pressure). Regulate blood pressure by controlling the amount of fluid in the body and producing hormones like renin (regulates blood pressure). Activation of vitamin D, which is essential for the absorption of calcium and phosphorus from the intestine. Produce glucose through a process called gluconeogenesis. This helps in maintaining the blood sugar levels within the normal range. Figure 1.1 : Anatomy of skin Prepared by : Irine and Felicia 31

The process begins in the renal corpuscles. Blood enters the afferent arteriole and flows into tiny structures called glomeruli due to high hydrostatic pressure. This pressure causes ULTRAFILTRATION to occur. In the glomeruli, the pressure forces water and small dissolved substances, including waste products like urea, creatinine, and electrolytes, out of the bloodstream and into the renal tubules. This fluid is now known as glomerular filtrate. Nonfilterable components, such as cells and serum albumins, will exit via the efferent arteriole. Normally, about 20% of the total blood pumped by the heart each minute will enter the kidneys to undergo filtration, called the filtration fraction. The remaining 80% of the blood flows through the rest of the body to facilitate tissue perfusion and gas exchange. Urine Formation Urine is mainly composed of water that has not been reabsorbed, which is the way in which the body lowers blood volume, by increasing the amount of water that becomes urine instead of becoming reabsorbed. The other main component of urine is urea, a highly soluble molecule composed of ammonia and carbon dioxide, and provides a way for nitrogen (found in ammonia) to be removed from the body. Urine also contains many salts and other waste components. Red blood cells and sugar are not normally found in urine but may indicate glomerulus injury and diabetes mellitus respectively. EXCRETION PROCESS OF KIDNEY ULTRAFILTRATION REABSORPTION Reabsorption happens along the renal tubule, where molecules and ions will be reabsorbed into the circulatory system. In the proximal convoluted tubule, sodium ions are actively pumped into the blood capillary network, and chloride ions are passively absorbed. 100% glucose and amino acid are reabsorbed through active transport. Water is reabsorbed through osmosis in the loop of Henle. In distal convoluted tubules, more water, sodium, and chloride ions are reabsorbed. Secretion of ions, acids, drugs, and toxins happens here. During secretion, some substances such as hydrogen ions, creatinine, and drugs will be removed from the blood through the peritubular capillary network into the collecting duct. The end product of all these processes is urine, which is essentially a collection of substances that have not been reabsorbed during glomerular filtration or tubular reabsorption. SECRETION Figure 2.1 : Excretion process of kidney 32

Structures Functions Epidermis (outermost layer of skin) Acts as protective barrier against microorganisms, dehydration, ultraviolet light, and mechanical damage Provides skin colour Makes new skin Fights against germs and infections Dermis (middle layer of skin) Produces sweat Supplies blood Sensitive to touch, pain, temperature, and deep pressure Grows hair Produces oil that keeps skin smooth and soft Hypodermis / subcutaneous tissue (bottom layer of skin) Cushions muscles and bones Regulates body temperature THE EXCRETORY ORGANS AND FUNCTIONS Skin Skin is the largest organ in the body and covers the body's entire external surface. It is made up of three layers, the epidermis, dermis, and the subcutaneous tissue/ hypodermis, all three of which vary significantly in their anatomy and function. Figure 3.1 : Structure of skin 33

Vasodilation – hypothalamus sends nerve impulses via parasympathetic nervous system to blood vessels near skin. Smooth muscle in vessel walls relaxes, but shunt vessel constricts so more blood goes to the surface. Increase sweat rate – more sweat secreted onto skin surface. As the water evaporates, it removes the heat from the body and so cools the skin. Pilorelaxation – little effect, parasympathetic nerve impulse to the muscles at base of hair cause them to relax, so hairs lie flat. Less air is trapped next to the skin so less insulating effect. Behavioural response – controlled by cerebral cortex become more inactive which is less respiration, so less heat released. Hormone – less thyroxine is produced and so metabolic rate lowers. When it is hot condition : EXCRETION PROCESS OF SKIN Skin plays a role in excretion besides in integumentary system. It is known as one of the excretory organs as it produces sweats through the sweat gland in the dermis layer. Figure 4.1 : Thermoregulation in the blood vessel THERMOREGULATION Vasoconstriction – sympathetic nerve impulses to blood vessels near skin. Smooth muscle in vessel wall contracts so less blood flow, shunt vessel relaxes so less blood flows to the surface capillaries. Less heat lost by radiation. Lower sweat rate – less sweat secreted onto skin, so less heat is used to evaporate water. Piloerection – muscles at bottom of hairs contract, causing hairs to stand on end and traps an insulating layer of air, reducing heat loss. Shivering – involuntary response where skeletal muscles contract and relax quickly. Increases respiration rate, so more heat generated. Hormone – adrenaline is released which increases metabolic rate. If very cold, more thyroxine produced, increasing metabolic rate. When it is cold condition : regulate body temperature (homeostasis) eliminate excess water and salts, as well as small amount of urea Sweat production helps to : 34

Maintaining Homeostasis It helps regulate the body’s internal balance by controlling the levels of ions, water, and pH. This is essential for various physiological processes. Metabolic Waste Disposal It gets rid of waste products generated during processes like protein metabolism (urea) and nucleic acid breakdown (uric acid). Toxin Removal Excretion removes harmful substances like drugs, environmental pollutants, and excess substances like bilirubin (from hemoglobin breakdown). Water Balance It controls the amount of water in the body, ensuring hydration and preventing dehydration or overhydration. IMPORTANCE OF EXCRETION AND HEALTH Waste Removal Excretion eliminates metabolic waste products and toxins from the body, preventing their accumulation, which could be harmful. 35

GLOMERULONEPHRITIS When the kidneys' filters (glomeruli) become inflamed and scarred it is called glomerulonephritis. The kidneys slowly lose their ability to remove wastes and excess fluid from the blood to make urine. CAUSES OF GLORMERULONEPHRITIS 1) Toxins or medicines 2) Viral infections, such as HIV, hepatitis B and C viruses 3) IgA nephropathy 4) Lupus-related kidney inflammation 5) Bacterial infections that commonly cause throat and skin infections, such as strep or staph bacteria SYMPTOMS OF GLOMERULONEPHRITIS Jaundice Nausea Rash Shortness of breath Weight loss or loss of appetite Blood in your pee, which may make it look brown, pink or red Peeing less often or more often than usual Pee that appears foamy or bubbly 36

EFFECTS OF GLOMERULONEPHRITIS Decreased Kidney Function Glomerulonephritis can lead to a reduction in kidney function, which may result in symptoms like fluid retention, high blood pressure, and electrolyte imbalances. Proteinuria Damage to the glomeruli can cause proteins to leak into the urine, a condition called proteinuria. This can lead to edema (swelling), especially in the face, hands, and feet. Hematuria Glomerulonephritis can cause blood to appear in the urine, a condition known as hematuria. This may lead to pink, red, or brown urine. High Blood Pressure Many cases of glomerulonephritis can lead to hypertension (high blood pressure), which can further damage the kidneys and increase the risk of heart problems. Fatigue and Weakness Reduced kidney function can result in anemia, leading to fatigue and weakness due to a decrease in red blood cell production. Fluid Retention The kidneys may not effectively remove excess fluids and waste, leading to swelling (edema) and weight gain. 37

METHODS TO SOLVE GLOMERULONEPHRITIS Immunosuppressive drugs: In cases of autoimmune glomerulonephritis, medications like corticosteroids (e.g. prednisone), cytotoxic agents (e.g. cyclophosphamide), or newer biological agents may be used to suppress the immune system's abnormal response. Antibiotics: If the glomerulonephritis is caused by an infection, such as streptococcal infection, antibiotics are prescribed to treat the infection. Blood pressure medications: Controlling blood pressure is crucial in managing glomerulonephritis. Medications like ACE inhibitors or angiotensin II receptor blockers (ARBs) can help reduce proteinuria (excess protein in the urine) and lower blood pressure. Diuretics: These medications may be prescribed to manage edema (swelling) and fluid retention associated with glomerulonephritis. 1) Symptomatic Treatment: Depending on the symptoms, additional medications or interventions may be necessary. For example, if there is severe swelling, diuretics may be used to reduce fluid retention. 2) Dialysis: In cases of advanced glomerulonephritis where kidney function is significantly impaired and waste products and fluids are not adequately eliminated from the body, dialysis may be necessary. Hemodialysis or peritoneal dialysis can help filter the blood and maintain fluid and electrolyte balance. 3) Kidney Transplant: In end-stage glomerulonephritis, when kidney function is severely compromised and dialysis is no longer effective, kidney transplantation may be the best option. This involves replacing the damaged kidney with a healthy one from a living or deceased donor. 4) Medications: 38

STRUCTURE OF KIDNEY FUNCTION OF KIDNEY EXCRETE TOXIC WASTE: UREA, URIC ACID, AMMONIA, CREATININE CONTROL THE TOTAL VOLUME OF WATER IN BODY FLUIDS CONTROL THE CONCENTRATION OF IONS IN BODY FLUIDS CONTROL BLOOD OSMOTIC PRESSURE CONTROL ELECTROLYTE CONTENT AND PH OF BLOOD AND BODY FLUIDS EXCRETE HORMONES: INSULIN, CORTISOL AND THYROID HORMONES 39

01 The kidneys filter the blood to remove waste products, excess ions, and water. Small molecules, such as urea, creatinine, electrolytes, and glucose, are filtered from the bloodstream into the renal tubules. Filtration 02 Reabsorption occurs in the renal tubules to reabsorb important ions like sodium, potassium, and calcium, as well as glucose and amino acids. Reabsorption 03 Subtances that are secreted include hydrogen ions, potassium ions, ammonium ions, urea, creatinine, toxic substance and some drugs. Secretion gets rid of toxic wastes and helps to regulate the levels of ions in the blood. Secretion 04 The final step in kidney excretion is the elimination of urine from the body. Once the filtrate has been processed through filtration, reabsorption, and secretion, it becomes urine. Urine travels from the renal tubules through the collecting ducts and into the renal pelvis, eventually entering the ureters and then the bladder for temporary storage until it is expelled from the body through urination. Excretion EXCRETORY PROCESS FOR KIDNEY 40

01 02 Acts as a sensory organ (touch, detects temperature). 03 Helps regulate temperature FUNCTION OF SKIN An immune organ to detect infections Provides a protective barrier against mechanical, thermal and physical injury 04 and hazardous substances. 41

Picnic basket or canvas bag Cooler Picnic blanket (preferably waterproof on the bottom) Picnic chairs Portable picnic table (if that's the kind of picnic you're having!) Sweat glands produce sweat that travels via sweat ducts to openings in the epidermis called pores. They play a role in temperature regulation. S w e at Gla n d S w e a t pro d u c tio n As sweat leaves the body, it absorbs heat from the skin giving the body a cooling effect. E v a p oratio n of s w e at Sweating eliminates excess water and salts, as well as a small amount of urea , a byproduct of protein catabolism. M aintain ele ctrolyte b ala n c e The skin excretes sweat. Sweat contains water, salts and small quantities of urea. The epidermis contains small pores through which sweat leaves the body. Ex cretion of w aste pro duct The dermis contains sweat glands that produce sweat. When the body temperature increases, the sweat gland is stimulated to produce sweat. EXCRETORY PROCESS OF SKIN 42

INCONTINENCE STRESS INCONTINENCE Occurs when there is an increase in abdominal pressure: laughing, coughing, sneezing, lifting, or exercising. It is often caused by a weakening of the pelvic floor muscles or the urethral sphincter. It is more common in women, especially after childbirth and menopause. URGE INCONTINENCE Also known as "overactive bladder," urge incontinence is characterized by a sudden and intense need to urinate, followed by involuntary urine leakage. It is often caused by an overactive detrusor muscle in the bladder or neurological conditions that affect bladder control. FUNCTIONAL INCONTINENCE Occurs when a person has physical or cognitive impairments that prevent them from reaching the toilet in time, even if their bladder function is normal. This type of incontinence is often seen in individuals with mobility issues, dementia, or severe arthritis. TRANSIENT INCONTINENCE Transient incontinence is temporary and is usually caused by a specific medical condition or medication. Once the underlying issue is addressed or the medication is discontinued, the incontinence typically resolves LOSS OF VOLUNTARY CONTROL OVER ONE'S BLADDER OR BOWELS, LEADING TO UNINTENTIONAL URINE OR FECAL LEAKAGE 43

Follow the prescribe medications to relax the bladder muscles (anticholinergics) or strengthen the urethral sphincter (alphablockers). Losing excess weight can relieve pressure on the bladder and reduce stress incontinence symptoms. Reducing or avoiding bladder irritants like caffeine, alcohol, and acidic foods can help manage urge incontinence. Surgical procedures include sling surgery for stress incontinence or procedures to correct anatomical issues causing overflow incontinence. Treatment of incontinence Medications Weight Management 01 02 Dietary Changes 03 Surgery 04 44

The kidney has three regions: an outer cortex, a medulla in the middle, and the renal pelvis in the region called the hilum of the kidney. The hilum is the concave part of the bean-shape where blood vessels and nerves enter and exit the kidney; it is also the point of exit for the ureters. STRUCTURE OF EXCRETORY ORGAN (KIDNEY) STRUCTURE FUNTIONS OF KIDNEY REMOVAL OF WASTE PRODUCTS REMOVAL OF EXCESS FLUID BALANCE MINERALS AND CHEMICALS CONTROL OF BLOOD PRESSURE RED BLOODTO MAINTAIN HEALTHY BONES CELLS PRODUCTION REABSORPTION OF NUTRIENTS 45