Urinary

System
Anatomi & Fisiologi Manusia
Fakultas Farmasi
Universitas Surabaya
2017 - RIDHO ISLAMIE -
The urinary system: Major Function

01 02 03
excretion, the elimination, the homeostatic
removal of discharge of these regulation of the
organic waste waste products volume and solute
products from into the concentration of
body fluids environment; blood plasma.
FUNCTIONS OF THE
URINARY SYSTEM
u Two Kidneys: Produces
urine
u Two Ureters transport
urine from kidneys to
urinary bladder.
u One Urinary bladder
stores urine and expels
it into urethra
u One Urethra discharges
urine from body
Regulasi volume darah dan tekanan darah: Na excretion à
Plasma Volume à Blood Pressure

Regulasi konsentrasi elektrolit anorganik dlm cairan ekstrasel:

Cl, K, Mg, Ca, SO4, PO4

Regulasi osmolaritas cairan ekstrasel: Plasma osmolarity

(Tonicity) à Water excretion

Pengeluaran produk buangan hasil metabolisme: Specific

Urea, Uric Acid, Creatinin, Urobilinogen
Eksresi zat-zat asing: Drugs, food additives, pesticides,
Function of
exogenous nonnutritive materials à accumulation à TOXIC The Kidneys
Produksi hormon dan enzim:
Erythropoietin hormone à Red Cell Production),
Vitamin D conversion à 1,25-dihydroxyvitamin D3 (Calcitriol)à
Calcium balance,
Renin enzyme (RAAS) à blood pressure regulation.
Menjaga kesimbangan asam-basa à Next Slide
Maintenance of acid-base balance
à Related to Respiratory system

u By altering the excretion of hydrogen and bicarbonate

ions in the urine
u pH arterial blood normal: 7,4

Fluid Condition pH H+ HCO3-

Acidic Decrease Excreted Conversed

Extracellular
Alkaline Increase Conversed Excreted
 Kidneys Anatomy

u In the adult human, each kidney is

approximately 11 cm long, 6 cm wide, and
3 cm thick
u These organs are divided into two regions:
the inner renal medulla and the outer renal
cortex
u Approximately 1 million nephrons are in
each kidney
Blood Supply of The
Kidneys

(Renal Circulation)
The Structure of
Nephron

The Functional
Anatomy of Nephron
& The Collecting
System
 Three basic processes to produce urine

1. Filtration is the movement

of fluid and solutes from the
glomerular capillaries into
Bowman’s capsule
2. Reabsorption, which takes
place throughout the
nephron, is the movement of
filtered substances out of the
tubule and into the
surrounding peritubular
capillaries
3. Secretion is the movement
of selected unfiltered
substances from the
peritubular capillaries into the
renal tubule for excretion
Glomerulus Filtration
Tubular Reabsorption and Secretion
Reabsorption in
Tubulus Proximal
Reabsorption
in Loop of
Henle
Reabsorption
in Tubulus
Distal
Control of GFR
(Glomerular Filtration Rate)
Autoregulation
u Glomerular filtration is the vital first step for
all other kidney functions
u The glomerular filtration rate (GFR) is the
Myogenic
amount of filtrate the kidneys produce Mechanism
each minute
u Filtration depends on adequate blood Control
flow to the glomerulus and on the
maintenance of normal filtration pressures.
of GFR

Autonomic Hormonal
Regulation RAAS Regulation
 Renal Blood Flow (RBF)

u RBF increases, GFR and urine output increase

u RBF decreases, GFR and urine output decrease RBF à GFR

Resistance afferent arteriole

u Dilatation Afferent arteriole à Resistance aff art decreases à RBF increases

u Constriction Afferent arteriole à Resistance aff art increases à RBF decrease
 Myogenic Mechanism

• How arteries and arterioles react to an increase or decrease in

blood pressure —play a role in the autoregulation of blood flow.

• Changes to the diameters of afferent arterioles, efferent

arterioles, and glomerular capillaries maintain GFR

The myogenic mechanism normalizes renal blood flow and GFR within
seconds after a change in blood pressure.
 Control of GFR

Dilatation of
Afferent Arterioles
Myogenic R aff art NORMAL
Autoregulation RBF GFR
Mechanism
Constriction of
Efferent Arterioles
BP RBF GFR
RBF
1. Vasokonstriksi TPR Increase

RENIN ACE
2. Aktivasi SS-Simpatis CO & TPR Increase BP

ANGIOTENSINOGEN AT I AT II 3. Sekresi Hormon

Retensi Na & Air
Aldosteron
BV
Hormonal & Neuronal Regulation
4. Sekresi ADH Retensi Cairan
 Hormonal Regulation of Tubular Reabsorption and Tubular Secretion
Hormone Effects
Angiotensin II Increases reabsorption of Na , other solutes, and water, which
increases blood volume and blood pressure.
Aldosterone: released from the adrenal Increases secretion of K and reabsorption of Na, Cl ; increases
cortex promotes the reabsorption of reabsorption of water, which increases blood volume and blood
sodium from the distal tubule and pressure.
collecting duct

Antidiuretic hormone (ADH): synthesized Increases facultative reabsorption of water, which decreases
in the hypothalamus and released from osmolarity of body fluids.
the neurohypophysis of the pituitary
gland, promotes the

Atrial natriuretic peptide (ANP): released Increases excretion of Na in urine (natriuresis); increases urine
from myocardial cells in the atria of the output (diuresis) and thus decreases blood volume and blood
heart inhibits the reabsorption of sodium pressure.
from the collecting duct

Parathyroid hormone (PTH) Increases reabsorption of Ca

Urine Transportation,
Storage, and Elimination

Urine is transported via the ureters, stored

in the bladder, eliminated through the
urethra, aided by micturition reflex
Comparison between male and female
urethras
Normal Laboratory
Values for Solutes
in Plasma and
Urine
 Evaluation of Kidney Function

u Urinalysis: Volume, Color, Turbidity, Odor, pH, General Characteristics of Normal Urine
Density
u Blood Tests: Blood Urea Nitrogen, Creatinine
Plasma à Clearance Creatinine
u Abnormal Constituent in Urine: Albumin,
glucose, Erythrocytes, Keton bodies,
Urobilinogen, Microbes à Apakah
terminologi jika senyawa2 ini berada dalam
urin dengan kadar yang tinggi?
 Pharmacy application

Diuretics are drugs that cause

physiological action of
diuretics an increase in urine output

Pharmacy
application
Functional or structural
changes in the kidneys
drug-related
following the administration of
nephropathies
certain drugs.
 Renal Calculi: Kidney Stones

Urinary Tract Infection (UTI)

Diseases: Glomerular Disease: Glomerulonephritis,
Nephrotic Syndrome
Homeostatic Renal Failure: Acute Renal Failure (ARF)
or Chronic Renal Failure (CRF)
Imbalances
Polycystic Kidney Disease (PKD)
(Nice To
Know) Urinary Bladder Cancer

Kidney Transplant

Cystoscopy
Medical Terminology Related to
Urinary System (Nice to Know)

u Azotemia u Cystocele
u Polyuria u Enuresis
u Uremia u Stricture
u Dysuria u Intravenous pyelogram
u Hydronephrosis u Diabetic Kidney Disease
u Nephropathy u Nocturnal enuresis
u Urinary Retention
References
u Martini FH, 2012, Fundamental of
Anatomy & Physiology, 9th
edition, The Benyamin
Cummings Publishing Company,
Inc, United States of America
u Tortora GJ, 2014, Principles of
Anatomy & Physiology, 14th
edition, John Wiley & Sons, Inc,
United Stated of America
u Kelly L, 2005, Essentials of Human
Physiology for Pharmacy, 2nd
edition, CRC Press Pharmacy
Education Series, United Stated
of America