CHAPTER 16 REVIEW/KEY TERMS

Urinary System: Whole Point-Maintains the volume and composition of body fluids. Structures of the urinary system: 2 kidneys (all about regulating, retroperitoneal, surrounded by fat, one higher than the other- left one because of the liver), 2 ureters (tubes that bring urine to bladder), 1 urinary bladder (between pelvic bones) , 1 urethra (tube that allows urine to exit body) Kidneys: Production of urine, secretion of rennin, secretion of erythropoietin - Production of urine: helps maintain blood plasma volume and composition within normal limits - Secretion of rennin: increases blood pressure through rennin-angiotensin mechanism. Made in response to low blood pressure. Made by kidneys. - Secretion of erythropoietin: Made by kidneys in response to O2 levels. Stimulates RBC formation when oxygen levels fall below normal, which causes red bone marrow to make more blood Structure of Kidney: Hilum (where everything enters and exits the kidney- vein, artery, ect.) renal cortex, renal medulla (made up of: renal pyramids, collecting ducts, renal columns) renal pelvis (continuous with ureter), major and minor calyces (direct urine from renal papilla into renal pelvis), ureter, nephrons, renal papilla, renal capsule.

Nephrons: Functional units of the kidneys. All about producing urine. Located between cortex and medulla. Originate in the cortex, dip into medulla, return to cortex. Once they have made urine, join to collecting ducts. Approx 1 million per kidney. *at the bottom by the nephron loop is the medulla* - Consists of 2 MAJOR parts: Renal corpuscle, Renal tubule

Renal corpuscle-Located in the renal cortex of kidneys. -Each renal corpuscle is composed of a Glomerulus (a ball of arterial capillaries) and it is enclosed in a double-walled Glomerular (Bowmans) capsule -Glomerulus: a knot of capillaries, aka Bowmans capsules, -Glomerular capsule: around glomerulus, collecting stuff that came from the knot of capillaries

Renal Tubule- Leads away from Glomerular capsule, consists of 3 segments: Proximal Convoluted Tubule, Nephron Loop, Distal Convoluted Tubule - PCT: first part of renal tubule, leads from the Glomerular capsule to nephron loop - Nephron Loop: loop of Henley, U-shaped second part of tubule. The thin descending arm of the nephron loop, dips into the kidney medulla the ascending arm of the nephron loop returns to the region of the proximal convoluted tubule. The ascending arm of the nephron loop is continuous with the distal convoluted tubule. - DCT: third segment of renal tubule-unites with a collecting duct (several nephrons unite with a single collecting duct).

 Collecting Duct- many nephrons join here, begin in the cortex and extend the length of a renal pyramid to its papilla, where the collecting ducts open into a calyx.

Cortical and Juxtamedullary Nephrons- 2 types of nephrons in the kidney: 80% are cortical nephrons; 20% are juxtamedullary nephrons. -Cortical Nephrons: located near the outer surface of the kidney cortex, nephron loop of these nephrons located almost entirely in the cortex of the kidney. Glomerular capsule is near outer surface of cortex. Obtained in renal cortex, do not go down into medulla. Not important for water regulation. - Juxtamedullary Nephrons: located in the cortex near the medulla, nephron loops of these nephrons dig deep into the medulla, play an important role in water regulation (how much is produced, how much is urinated) content of the blood. Blood Supply- receive a large amount of blood, 1200mL per minute (about the total cardiac output). - Renal artery: receives blood, brings blood - Afferent arteriole- brings blood into Glomerulus - Efferent arteriole- take blood out of Glomerulus, and leads to a Peritubular capillary network Afferent vs. Efferent= going in diameter is smaller than going out

- Peritubular capillary network- entwined around renal tubule, blood enters a venule (progressively larger vein) Start at renal artery, branches out and goes to cortex Go to nephron, go through afferent arteriole into Glomerulus Exiting the glomerulus to efferent arteriole

Juxtaglomerular Apparatus- cluster of cells that help regulate blood pressure in glomerulus, very important to regulate blood pressure in Glomerulus!

Overview of Kidney Functions: 1. Production of urine: Major function of the kidneys is to keep the volume and composition of blood plasma within normal limits. This is accomplished by the removal of waste products and excess substances from the blood though the formation of urine 2. Secretion of renin: When systemic blood pressure decreases, the kidneys secrete rennin (an enzyme that triggers the renin-angiotension mechanism, which increases blood pressure) 3. Secretion of erythropoietin: when blood oxygen level falls below normal (hypoxia), the kidneys release more erythropoietin, which stimulates RBC formation by red bone marrow. The added RBC help increase the blood oxygen level.

Urine Formation: occurs in nephron, involves 3 physiological processes- Glomerular filtration, tubular reabsorption and secretion, water reabsorption. 1. Glomerular Filtration- creates a plasma-like filtrate of the blood 2. Rubular reabsorption- removes useful solutes from the filtrate, returns them to the blood and Tubular Secretion-blood to urine-which removes additional wastes from the blood, adds them to the filtrate 3. Water reabsorption- removes water from the filtrate and returns it to blood, concentrates wastes in the filtrate. Taking stuff out of urine, back into blood from urine, helps you concentrate waste.

Glomerular filtration- the forcing of water and small solutes from the blood in a glomerulus into a glomerular capsule. Forces water and solutes from blood and into Glomerular capsule. Caused by 2 factors: greater permeability of Glomerular capillary walls, water and most dissolved substances easily pass through. Higher blood pressure within Glomerulus. Product is filtrate. - Pores in the Glomerulus make capillary permeable to small substances (ex- ions, glucose). Pulled out of the Glomerulus and enter into the capsule, fills up with fluid (water solutes). - Produce filtrate also called Glomerulus filtrate. The water/soulutes that get pulled out of blood in the capillaries in Glomerulus is also called filtrate.

Filtrate- Fluid entering the Glomerular capsule, same as what you would call blood plasma, but without plasma proteins, no blood cells. No plasma proteins/blood cells to large to go through perm membrane (ex-very bad to get blood in urine)

Glomerular filtration rate (GFR): is 125mL/minute (4oz), most of this filtrate is reabsorbed. 7.5mL an hour 180L of filtrate a day do you urinate 180L of filtrate a day? No! even though your filtrating this much, you will absorb most of it back - 3 mechanisms that help to maintain a stable GFR: Renal autoregulation- for normal fluctuations in systemic blood pressure; regulate diameter or afferent arterioles, keeps blood flow within normal limits. Juxtaglom helps by putting pressure on the afferent vessel, by juxo vasodilation/vasoconstriction. Sympathetic Nervous System stimulation- for severe drops in systemic blood pressure; raises systemic blood pressure by causing constriction of systemic arterioles. Takes over when severe BP drop. Renin-angiotensin mechanism- for severe drops in systemic blood pressure; chemical control system; raises blood pressure by: constricting arterioles, conserving water to raise blood volume, stimulate water intake to raise blood volume. Very highly controlled methodcontains 2 hormones: Renin and angiotension. Steps of rennin-angiotensin mechanism (with severe drops in BP) A low GFR causes the

juxtaglomerular apparatus to release/secrete rennin to go into blood stream. Angiotensinogen made in liver. Kidney makes Renin. Lung capillaries make Angiotensin converting enzyme (ACE)

Renin + Angiotensinogen = Angiotensin I Angiotensin I + ACE from lung capillaries = Angiotension II Angiotension II- does vasoconstriction, increased aldosterone secretion, increased ADH secretion, increased thirst. Aldosterone = ADH tell kidneys to retain water, not to piss as much to retain water in blood; sodium potassium regulator.

Reabsorption from Nephrons: All done by tubular reabsorption: WATER-Filtered amount- 180L, Reabsorption 99%; GLUCOSE- Filtered amount- 180L, Reabsorption 100%; so there should be NO glucose in urine if found in urine- sign of diabetes.

Tubular Reabsorption and secretion: Involves 2 types of transport mechanisms - Active transport: uses ATP and carrier proteins; molecules move against their gradient

- Passive transport: diffusion, osmosis, electrochemical attraction; effectiveness depends upon-permeability of tubule to substance, concentration gradient of substance Events in Proximal Convulted Tubule: start reabsorbtion here. 65% of filtrate is reabsorbed in the PCT. Solutes being pulled out into blood. All nutrients such as Amino Acids, glucose are actively reabsorbed here. Positively charged ions such as sodium, potassium, and calcium are also actively reabsorbed. Active reabsorbtion of positively charged ions causes negatively charged ions, such as chloride and bicarbonate to be passively reabsorbed by electrochemical attraction. Reabsorbtion of these substances increases the osmotic pressure of the blood plasma in the peritubular capillary (where the blood flows) and decreases the osmotic pressure of the filtrate. This causes water to be reabsorbed from the filtrate by osmosis. - Nutrients such as amino acids and glucose plus Na+, K+, Ca+ , are actively reabsorbed. - Negatively-charged ions, such as HCO3- and Cl-, are passively reabsorbed by electrochemical attraction. - Water is reabsorbed by osmosis - Tubular Secretion is the process that extracts substances from the blood in the peritubular capillary (where the blood flows) and secretes them into the filtrate in the renal tubule. Metabolic wastes, such as urea and uric acid, drugs, and hydrogen and bicarb ions are removed from the blood in this way. It not only removes unwanted wastes but it also helps regulate the pH of body fluids.

Events in the Nephron Loop: -THIN DECENDING LIMB: Water is passively reabsorbed by osmosis from the thin descending limb of the nephron loop into the peritubilar capillary. Thin decending limb is impermeable to soulutes (not able to move solutes), and passive reabsorption of water. -THIN-SEGMENT OF ASCENDING LIMB: The thin ascending limb is impermeable to water (not able to move water), passive reabsorption of solutes (a lot of solutes, sodium and other ions, gets moved/absorbed here). -THICK-SEGMENT OF ASCENDING LIMB: Active reabsorption of Na+ with passive reabsorption of K+ and Cl- . Na+ and Cl- are reabsorbed by the think ascending limb remain in the kidney interstitial fluid (salty middle). Creates a high solute/low water environment to help in water reabsorption from a collecting duct. Still not able to move water/reabsorb here because its not permeable to water. * Sodium- active transport * Chlorine/Potassium- passive transport

Events in the Distal Convoluted Tubules: Under hormonal control. Hormone aldosterone causes active reabsorption of Na+ from the filtrate into peritubular capillaries. If sodium is low, your going to reabsorb more. Electrochemical attraction passively reabsorbs Cl- and HCO3-. Water reabsorbtion occurs due to changes in osmotic pressure of filtrate- but it is under control of hormone antidiuretic hormone (ADH). K+ are secreted in response to aldosterone. H+ are secreted to maintain normal blood pH.

Reabsorption from the collecting duct: As the duct descends through the renal pyramid (which extends from the cortex to a renal papilla) the interstitial fluid concentrations of ions increase. Causes passive reabsorption of water by osmosis, and creates concentrated urine. ADH makes the collecting duct more permeable to water. Only 1% if the original filtrate volume remains as urine. - Aldosterone stimulates active reabsorbtion of Na+ which is followrd passively by Cl- . - Antidiuretic hormone increases the permeability of the distal tubule and collecting duct to water, which is reabsorbed by osmosis. Maintenance of Blood Plasma Composition: Urine production retains essential nutrients and minerals and excretes excess and wastes. Healthy kidneys keep blood volume and composition constant despite changed caused by diet and cellular respiration. Kidneys try to keep everything normal. - Water and Electrolyte balance: you want to control, important. The concentration of water or electrolytes will affect the concentration of the other - Water intake is regulated by the Thirst center: within the hypothalamus activated by: decreases in water concentration in blood, angiotensin II when blood pressure declines Electrolytes: substances that form ions when dissolved in water, and they are so named because they can conduct an electric current when dissolved in water. (ex- Sodium chloride is

an electrolyte that forms sodium (Na+) and chloride (Cl-) ions when dissolved in water.) The concentrations of water and electrolytes in body fluids are interrelated because the concentration of one affects the concentration of the other. (ex- the concentration of electrolytes establishes the concentration gradient that enables water to be reabsorbed by osmosis). Water balance: Volume of water lost in urine depends on what is lost through other means (lost in sweat, lost in feces, lost through skin and lung, lost in urine) - Excessive loss by other means, decreases loss in urineurine volume decreases (more concentrated) - Minimal loss by other means increases loss in urine- urine volume increases (more dilute) - Most water is lost in urine - Ex- if you have the shits, water lost in urine is going to be less.

Water intake impacts water reaborption in the kidneys: INCREASE water intake = DECREASE water reabsorption, lg volume of dilute urine DECREASE water intake = INCREASE water reabsorption, sm volume concentrated urine ADH controls whether more or less water is reabsorbed then normal: (due to BP and blood volume) - Increases water reabsorption

- Increases permeability of DCT and collecting ducts to absorb more INCREASE blood water concentration = DECREASED ADH production; INCREASE ANH (less water is reabsorbed and urine volume increases) DECREASE blood water concentration = INCREASE ADH is produced; DECREASE ANH (more water is reabsorbed and urine volume decreases) ANH (water reabsorb) ADH (water absorb)

Hormones acting on the Kidneys: Hormone Aldosterone reabsorption of Na+ Source Action

Adrenal Cortex Stimulates from the filtrate into the blood; stimulates the secretion of K+ from the blood into the filtrate

-----------------------------------------------------------------------------------------------------------ADH Post Pituitary Stimulates the reabsorption of water from the fliltrate into the Blood by making the distal tubule And collecting ducts more

Permeable to water; decreases the Volume of urine produced ANH Heart Inhibits reabsorption of Na+ and water from DCT and collecting ducts -----------------------------------------------------------------------------------------------------------Parathyroid hormone Parathyroid stimulates the reabsorption of Ca++ from the filtrate into the blood; Stimulates the secretion of PO4

Electrolyte Balance: - Na+, K+, Ca2+, Cl-, PO4-, SO4-, HCO3- Balance is maintained by active reabsorption of Na+ - Passive reabsorption of negative ions occurs by electrochemical attraction - In tubules you are doing active reabsorb (Na+.), while you passively reabsorb negative HCO3-, Chloride o Aldosterone: stimulates reabsorption of Na+,and secretion of K+ in the DCT; Hormone is produced by adrenal cortex in response to- increase in blood K+, Decrease in blood Na+, Angiotensin II (can stimulate the production of aldosterone for BP)

 If Na+ and K+ are normal, aldosterone is NOT produced

Paratyroid Hormone (PTH): Increases blood Ca2+ THREE ways (all are important if you have low calcium levels) Increases Ca2+ reabsorbtion in renal tubules Increase resorbtion of Ca2+ from bone into blood Increase absorption of Ca2+ from food into small intestine

o Calcitonin: (made in thyroid, mostly just about bones) Decreases blood Ca2+ Promotes deposition of calcium into bones o Parathyroid and Calcitonin- work opposite of eachother

Nitrogenous Wastes: Kidneys remove enough to keep blood levels within tolerable limits- Produced from cellular metabolism. - Urea: wastes from amino acid metabolism, amine groups removed from amino acids turns into ammonia, ammonia is changed into less toxic urea, 40% of filtered urea is reabsorbed, only excrete 60%

- Uric Acid: waste product of nucleic acid metabolism, most filtered uric acid id reabsorbed, enough is secreted to keep blood levels within normal range - Creatinine: waste product of muscle metabolism, actively secreted by the DCT pH balance: The pH of blood must be maintained within rather narrow limits, (pH 7.35- 7.45) in order for body cells to function properly. Cellular metabolism produces products that tend to upset the pH balance (make blood more acidic). H+ is secreted into the DCT to help buffers to maintain homeostatic pH. - INCREASE of H+ in blood causes pH to DECREASE - DECREASE of H+ (removal of hydrogen ions) by the kidneys by excreting excess hydrogen ions in urine, kidneys help to maintain the normal pH of body fluids. - Kidneys work with respiratory to control pH; and the respiratory system also plays a significant role in regulating H+ concentration of body fluids.

Ureters: Wall has THREE layers- Outer fibrous layer - Middle layer: smooth muscle- uses peristalsis to move urine

- Inner Layer: mucus membrane; lubrication; when it gets to bladderforms a flap to prevent urine from moving from bladder into ureter

Urinary Bladder: Temporary storage of urine; changes in shape depending on how much urine it is holding- rugae; the internal floor of the bladder contains the TRIGON, a smooth triangular area that contains an opening at each of this angles. The openings of the ureteres are located at the two posteriorly located base angles, and the opening of the urethra is located at the anteriorly located apex angle. - Triangular area with 3 openings: 2 ureter openings, 1 urethral opening

Urethra: Carries urine from bladder to outside, Wall contains smooth muscle and connective tissue. Innermost layer: mucous membrane; Internal urethal sphincter is under involuntary control. External urethral sphincter (voluntary control)- skeletal muscle fibers. Females open anterior to vagina and are 3-4cm. Males open at tip of penis, and are 16-20cm.

Micturition uriniate: Urination. Bladder can hold 1000mL of urine. Urge to urine beings at about 200-400mL; Micturition reflex is triggerd by bladder stretching- This reflex sends

parasympathetic impulses to the detrusor muscle, causing rhythmic contractions. As this reflex continues, it causes involuntarily controlled internal urethral sphincter to open. If the voluntarily controlled external urethral sphincter is relaxed, micturition occurs- if it is not relaxed miturition is postponed. Micturition cannot be postponed for long periods of time. After a while the reflex overwhelms voluntary control, and micturition occurs, ready or not. Piss in yo pants. Characteristics of Urine: - 1.5-2L of urine are produced every 24hours - Clear - Pale-yellow to light amber due to urochrome (caused by break down of bile in intestine) - Odor (metabolic breakdown of products) - Slighty acidic (pH6 but varies with diet) - Specific gravity of urine is greater than water Substances not usually found in urine: (when found, a pathology/issue is indicated.) - Glucose (diabetes) - Proteins - RBCs and WBCs (glomeular nephritis, kidney stones) - Hemoglobin - Bile Pigments

Glomerulus- The cluster of capillaries enveloped by the glomerular capsule

Juxtaglomerular apparatus-specialized cells next to the glomerulus that help to regulate blood pressure Micturition- urination Nephron- the structural and functional unit of the kidneys; composed of a renal corpuscle and tubule Peritubular capillaries- capillaries surrounding a renal tubule Renal corpuscle- the portion of a nephron composed of a glomerulus and its enveloping glomeruluar capsule Renal tubule- the portion of a nephron composed of a proximal convoluted tubule, a nephron loop, and a distal convoluted tubule. Tubular reabsorption- The movement of substances from the filtrate in a renal tubule into blood in the peritubular capillaries. Tubular secretion- the movement of substances from blood in peritubular capillaries into the filtrate in a renal tubule Ureter- A narrow tube that carries urine from a kidney to the urinary bladder Urethra- a tube carrying urine from the bladder to outside the body Renal cortex - outer layer layer of kidney Renal pyramid Calyx- a funnel-like receptacle receiving urine from a renal pyramids papilla Renal pelvis- a cavity within a kidney that is continuous with a ureter Afferent arteriole- the arteriole carrying blood to the glomerulus of a nephron

Efferent arteriole- an arteriole carrying blood from a glomerulus Rennin-a gastric enzyme that curdles milk proteins Erythropoietin- the hormone that stimulates erythrocyte production Filtrate- the substances removed by filtration Urea- the nitrogenous waste formed by the liver as a result of protein metabolism Uric acid- a nitrogenous waste produced from nucleic acid metabolism Creatinine- a nitrogenous waste produced by muscle metabolism