The Urinary System

The Urinary System
STRUCTURE Kidney FUNCTION Filtration, regulation of blood volume, regulation of solutes, pH of extra cellular fluid, RBC synthesis, Vit. D synthesis Urine flows from kidneys to urinary bladder Storage of urine Transports urine out from the urinary bladder

Ureters Urinary bladder Urethra

The Urinary System

Kidneys (Anatomy)
‡ Bean shaped, retroperitoneal, and located in the superior lumbar region, approx. size 11 x 5 x 3 cm. ‡ Renal capsule ± layer of fibrous connective tissue ‡ Perirenal fat (Adipose capsule) ± dense layer of adipose tissue, engulfs the renal capsule. (Shock absorber) ‡ Renal fascia ± anchors the kidneys and surrounding adipose tissues to the abdominal wall.

Kidneys (Anatomy)
‡ Hilum ± medial side of kidney where the renal artery and nerve enter; renal vein and urethra exit. ‡ Renal sinus ± a cavity at the opening of the Hilum filled with fat and connective tissue. ‡ Adrenal (or suprarenal) gland ± sits on top of both kidneys

Kidneys (Anatomy)

Kidneys (Internal Anatomy)
A. Cortex B. Medulla C. Pelvis

Kidneys (Internal Anatomy)
A. Cortex
± Superficial region

B. Inner medulla
± Renal pyramids ± cone shaped structures that make up the medulla. Medullary rays ± extend from the renal pyramids into the cortex.

±

Kidneys (Internal Anatomy)
± Renal columns ± consists of the same tissue as the cortex that projects between the renal pyramids.
‡ The bases of the pyramids form the boundary between the cortex and the medulla.

± Renal papillae ± tips of the pyramids project toward renal sinus.

Kidneys (Internal Anatomy)
C. Pelvis
‡ Occupies a large portion of the renal sinus ‡ An open space which forms the ureter as it exits the kidney ‡ Forms the major and minor calyces which enclose the papillae of the renal pyramids

Kidneys (Internal Anatomy)
± Minor calyces ± funnel shaped chambers into which the renal papillae extend. ± Major calyces ± a larger funnel formed by the minor calyces of several pyramids.

Kidneys (Internal Anatomy)
± Each kidney contains 8 to 20 minor calyces and 2 to 3 major calyces. ± Renal pelvis ± convergence of the major calyces to form this enlarged chamber. ± Ureter ± narrowed renal pelvis into a small diameter tube exits at the Hilum and connects to urinary bladder.

Kidneys (Blood Supply)

Kidneys (Blood Supply)
‡ Renal artery - branches from abdominal aorta. ‡ Segmental arteries - diverge from renal arteries. ‡ Lobar arteries - branch from segmental arteries and ascend within the renal columns toward the renal cortex. ‡ Interlobular arteries - branch to form arcuate arteries which project into cortex.

Kidneys (Blood Supply)
‡ Arcuate arteries - branch from interlobar arteries, diverge near the base of each renal pyramid and arch over the bases of the pyramids. ‡ Afferent arterioles - branch from interlobular arteries supply blood to the glomerular capillaries. ‡ Efferent arteriole - arise from glomerular capillaries and carry blood away from the glomeruli. ‡ Peritubular capillaries - as efferent arterioles exits the glomerulus joins a plexus of capillaries around the proximal and distal tubules. Low pressure capillaries which are porous aswell.

Kidneys (Blood Supply)

Kidneys (Blood Supply)
‡ Vasa recta - specialized parts of the peritubullar capillaries that course into the medulla along the loops of Henle and then back toward the cortex. ‡ Interlobular veins - drainage of peritubullar capillaries. ‡ Arcuate veins - drainage of the interlobular veins. ‡ Interlobar veins - drainage of arcuate veins. ‡ Renal vein - drainage of interlobar veins. Exits the kidney at the hilum empties into inferior vena cava.

Kidneys (Blood Supply)

Kidneys (Histology)

Kidneys (Histology)
Nephron
‡ Histological and functional unit of the kidney. ‡ Tube like structure which serves a the site for filtration, reabsorption, and secretion

Kidneys (Histology)
‡ Juxtamedullary nephron ± nephrons whose renal corpuscles lie near the medulla. With long loops of Henle extending deep into the medulla, account for 15% of nephrons. ‡ Cortical nephrons ± loops of Henle do not extend deep into medulla.

Kidneys (Histology)
‡ Renal corpuscle ± consists of the enlarged end of the nephron (Bowman¶s capsule), and a network of capillaries (glomerulus). ‡ Bowman¶s capsule ± enlarged terminal end of the nephron. Indented to form a double walled chamber. ‡ Glomerulus ± capillary within Bowman¶s capsule.

Kidneys (Histology)
Filtration membrane
‡ Filtration slits ± consists of capillary endothelial fenestrae and podocyte cells of the visceral layer of the Bowman¶s capsule which wrap around the glomerular capillaries.

Kidneys (Histology)
Afferent arteriole ± supplies blood to the glomerulus. Efferent arteriole ± drains blood from the capillary.

Kidneys (Histology)
Proximal tubule ± simple cuboidal epithelium with microvilli projecting from the luminal surface. Loops of Henle ± continuations of the proximal tubules, consists of two loops:
± descending and ascending loops.

Kidneys (Histology)
Descending loop of Henle ± first part is similar in structure to the proximal tubule the loop that extends into the medulla become very thin near the end of the loop.
± There is an abrupt change to simple squamous epithelium.

Kidneys (Histology)
Ascending loop ± continuous in diameter of the descending loop then thickens with simple cuboidal cells near the renal corpuscle.

Kidneys (Histology)
Distal tubule ± shorter than proximal tubules, simple cuboidal epithelium,
± do not posses a large number of microvilli.

Kidneys (Histology)
Collecting ducts ± connection of many distal tubules of many nephrons. Forms much of the medullary rays and extend through the medulla towards the tips of the renal pyramids.

Urine Production
‡ Filtration ± movement of fluid across the filtration membrane as a result of a pressure difference.
± Filtrate ± fluid entering the nephron.

‡ Reabsorption ± movement of substances from the filtrate back into the blood. ‡ Secretion ± active transport of solutes into the nephron

Urine Production

Urine Production (Filtration)
‡ Renal fraction ± the part of the cardiac output that passes through the kidneys. Average 21% of cardiac output. ‡ Filtration fraction ± part of the plasma flowing through the kidney that is filtered through the filtration membrane into the lumen of Bowmen¶s capsule to become filtrate. ‡ Glomerular filtration rate ± the amount of filtrate produced each minute. 120-125ml/min.
± 1 to 2 liters of urine are produced per day.

Urine Production (Filtration)
‡ Filtration pressure ± pressure gradient which forces fluid from the glomerular capillary across the filtration membrane into the lumen of Bowmen¶s capsule.
± Smooth muscle in the walls of the afferent and efferent arterioles can alter the vessel diameter and the glomerular filtration pressure. ± The diameter of the afferent arteriole is greater than the diameter of the efferent arteriole. ± High hydrostatic pressure ± Glumerular endothelium is highly permeable

Urine Production (Filtration)

Urine Production (Reabsorption)
‡ 99% of the filtrate leaves the nephron (proximal and distal tubules, and loop of Henle) to enter the interstitial fluid. ‡ These substances then enter the low pressure peritubullar capillaries and flow through the renal veins back to general circulation. ‡ Solutes reabsorbed from the lumen of the nephron to the interstitial fluid include; Potassium, Sodium, Calcium, Magnesium, Chloride, Phosphate ‡ Organic nutrients: Glucose and Amino acids

Urine Production (Reabsorption)

Urine Production (Reabsorption)
‡ Sodium reabsorption
± Active transport via Na+/K pump

‡ Water reabsorption
± Obligatory due to osmotic gradient created by Na+ reabsorption

Urine Production (Reabsorption)
‡ Glucose reabsorption
± secondary active transport or cotransport

Urine Production (Reabsorption)

Urine Production (Reabsorption)
‡ Proximal convoluted tubule
± Highest concentration of reabsortion ± NaCl and H2O

‡ Loop of Henle
± NaCl and H2Oreabsorption will be crucial for the creation of an osmotic gradient between the renal cortex and renal medulla.

‡ DCT
± NaCl and H2O reabsorption influenced by the presence of aldosterone.

‡ Collecting duct
± reabsorption of H2O due to ADH

Urine Production (Secretion)
‡ The movement of some substances, such as by products of metabolism that become toxic in high concentrations and drugs or molecules not normally produced by the body, into the nephron. ‡ Some of the secreted products include:
± Ammonia, Potassium, Hydroxybenzoates, Neurotransmitters, Bile pigments, Uric acid, Drugs, Toxins

Thinking back«
1. 2. 3. Glumerular Filtration Rate (GFR) Filtration Pressure Filtration Membrane

Thinking back«

Thinking new!

Urine Concentration
‡ Osmolarity
± A solution's osmolarity is the number of solute particles dissolved in the volume of solvent. ± It's indicative of the solution's ability to cause osmosis. ± Normal plasma osmolality: 300 milliosmoles per liter

Urine Concentration
‡ The loops of Henle in the juxtamedullary nephrons creates this osmotic gradient
± As filtrate passes through the ascending limb of the loop of Henle, sodium is pumped out into the interstitial fluid. ± As the filtrate reaches the distal tubule, the filtrate is dilute or hyposmotic.
‡ Ascending limb of the loop is impermeable to water, so water can't follow the pumped sodium. ‡ The urine osmolarity falls to about 100 mOsm/L. ‡ The salt pumped out raises the ISF osmolarity to as high as 1200 mOsm/L in the medulla of the kidney.
± This creates a gradient with the cortex isotonic to plasma (300 mOsm/L) and the medulla very hypertonic (1200 mOsm/L).

Urine Concentration

Urine Concentration

Urine Concentration
‡ When large amounts of water are ingested it is necessary to excrete large amounts of water but not large amounts of solutes. Thus, the urine excreted is of low concentration. ‡ When small amounts of fluid are ingested, the urine must be concentrated with the small amount of water excreted to avoid dehydration.

Urine Concentration
‡ These are accomplished by;
± Medullary concentration gradient ± maintains a high concentration of solutes in the medulla, this is dependent on the function of the loops of Henle, the vasa recta, and on the distribution of urea. ± Countercurrent system ± the vasa recta perform this function. It is a system of parallel tubes in which fluid flows in opposite directions. The walls of the vasa recta are permeable to water and solutes. ± Urea ± responsible for a substantial part of the high osmolality in the medulla.

Regulation (ADH)
‡ Acts on distal tubules and collecting ducts. ‡ Absence of ADH results in impermeability of water at the distal tubule and collecting ducts. ‡ Diabetes insipidus ± insufficient secretion of ADH, production of up to 20 liters of dilute urine per day.

Regulation (ADH)
‡ Stimulation of ADH secreting neurons is regulated by osmolality of the blood and the interstitial fluid, and blood pressure.
± Reduced osmolality and increasing blood pressure inhibits secretion of ADH. ± Increased osmolality and decreased blood pressure increase secretion of ADH.

Regulation (Aldosterone)
‡ Increases the transport of sodium out of the filtrate and back into the blood ‡ Resulting in increased urine volume and increased sodium concentration.

Renin-Angiotensin-Aldoeterone Axis

Renin-Angiotensin-Aldoeterone Axis
During low [Na] or low BP
‡ Juxtaglumerular cells secrete renin which converts angiotensinogen into angiotensin I ‡ Angiotensin I will be converted into angiotensin II by Angiotensin Converting Enzyme (ACE) ‡ Angiotensin II is a potent vasoconstrictor and thus increases BP
± The increase in BP will increase Filtration pressure and GFR. ± Stimulate the release of aldosterone from the adrenal glands and ADH from the posterior pituitary

Regulation (Autoregulation)
‡ Involves changes in the degree of vasoconstriction of the afferent arterioles. ‡ Maintenance, within the kidneys, of a relatively stable glomerular filtration rate. ‡ Glomerular filtration rate is relatively constant as systemic blood pressure changes between 90 and 180 mmhg.

Regulation (Autoregulation)
‡ Increases in blood pressure causes the vasoconstriction of the afferent arterioles to prevent an increase in renal blood flow and the filtration pressure across the filtration membrane. ‡ Decreased blood pressure results in less vasodilation of the afferent arterioles thus preventing a decrease in renal blood flow and filtration pressure across the filtration membrane.

Regulation (Autoregulation)

Regulation (Autoregulation)

Micturation Reflex
‡ Activated by stretching of the urinary bladder wall, resulting elimination of urine. ‡ Micturition center is located in the pons and cerebrum. ‡ Parasympathetic stimulation causes the walls to contract and the external urinary sphincter to relax.

Urethers
‡ Slender tubes which serves to conduct urine from the kidneys to the bladder ‡ Histology: Transitional epithelium with smooth muscles and a fibrous adventitia

Urinary Bladder
‡ A muscular sac which is located anterior to the rectum in males and in females, is anterior to the vagina and uterus. ‡ Trigone: Triangular region within the bladder which forms the opening for 2 urethers and urethra ‡ Histology: Transitional epithelium with a muscular layer (detrusor muscle)

Urinary Bladder and Urethra
‡ A thin walled muscular tube which drains the urine out from the bladder ‡ Histology:
± Proximal, transitional epithelium ± Middle, pseudostratified columnar epthelium ± Distlally, stratified squamous

‡ Sphincters
± Internal ± junction between the bladder and urethra (involuntary) ± Extrenal - voluntary

Urethra

END

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