Renal System

Components

Nephrons
 Functional unit of the kidney
 1 M per kidney
 Responsible for urine formation
 Cortex: cortical collecting tubule
 Medulla: medulla collecting tubule

[KUBU]
 Kidneys (2) – responsible for urine formation
 [The following are passageways]
 Ureter (2)
 Bladder (1)
 Urethra (1)
General Functions
 Elimination of waste products
 Control the plasma volume in the body
 Acid-base balance
 Controls BP
o Enzyme: Renin – activates the Renin Angiotensin
Aldosterone system (RAAS)
 Dehydration/excessive bleeding  dec in blood
volume and dec in BP  activation of the
juxtoglomerular cells  release of Renin 
Increase in Renin (converts Angiotensinogen to
Angiotensin I)  Inc in Angiotensin I  As
blood flow occurs in the capillaries of the lungs
and meets angiotensin converting enzyme
(ACE)  (converts AI to AII) Angiotensin II
(potent vasoconstrictor)  stimulates adrenal
cortex to release Aldosterone (reabsorption of
the H20 and maintaining electrolytes)  Inc in
blood volume  Normalize BP
 Produce hormones
o Calcitriole: Active form of Vit D (for Ca++
rebasoprtion)  Aka 1, 25 Dihydroxylcholcalfierol  2 main structures of the nephron
 Vs. Calcitonin which dec Ca++ levels o Renal corpuscle: glomerulus + bowman’s capsule
o Erythropoietin stimulates new RBCs in the bone o Renal tubules: DCT + PCT + Loop of Henle +
marrow collecting tubule
Anatomy  2 types of nephron
 Bean shaped o Cortical nephron: part of a nephron that lies in the
 Level: T12- L 3 renal cortex
 Location: retroperitoneal o Juxtamedullary nephron: part of a nephron that
 R is lower dt presence of liver lies in the renal medulla
 External anatomy Urine formation
o Layers of Tissue  Glomerular filtration
 Renal Capsule: barrier to trauma o Filtration membrane: allow H2O and small solute
 Adipose tissue: composed of fats; middle to pass thru
layer o Does not allow:
 Renal fascia: anchors kidney to the  Proteins
abdominal wall  Platelets
 Internal anatomy  Blood cells
o Renal cortex: outer region o Net filtration pressure: 10 mmHg
o Renal medulla: inner regions, (+) renal pyramids o Glomerular filtration rate: amount of filtrate
formed in all renal corpuscle in both kidneys in
each minuet
 Male: 125 mL/min (on average)
 Female: 105 mL/min
 No gender: over GFR = 125 mL

Renal system || OTPT Boards Review LOPEZ 1

  Filtration membrane: H2O, small solutes:
Luminal fluid
 Tubular reabsorption – H2O back to the body
o Proximal convoluted tubule
 Workhorse of the nephron
 65% reabsorption of H2O  most
permeable to H2O
 luminal fluid becomes: concentrated
o Thin descending loop of henle
 Reabsorption of H20 (10%)
 Luminal fluid: concentrated
 Part with highest concentration of
luminal fluid
 Thin ascending loop of Henle
 Reabsorption of solutes (Na, Cl)
 Luminal fluid: diluted
 Thick ascending loop of henle
 Reabsorption of solutes (Na, Cl, K,
other ions)
 Luminal fluid is more diluted
 Distal convoluted tubule
 LF: Diluted  minor calyx  major
calyx  urethra
 Urine – diluted in nature
o Urobilin/Urochromo
 Responsible for color of urine
o Pale yellow to orange
o If dehydrated:
 ADH/Vasopression
 Reabsorption of H20 (kidneys)
 Attachment at Distal convoluted
tubule (DCT), Cortical convoluted
tubule (CCT), Medullary convoluted
tubule (MCT) [MCT is most
concentrated LF in presence of ADH]
 PCT – most permeable to H2O
Ureter
 25-30 cm long
 Composed of smooth muscle (contraction: peristalsis)
Urinary Bladder
 Smooth muscle: detrusor muscle
 Storage of urine: N: 500 mL
o Max: 700 – 800 mL; At 800 mL, patient experiences
dribbles
 Innervation: sacral plexus: S2, S3, S4
 Reflex: micturition reflex
o 200 – 300 mL of urine
o voiding
Urethra
 Terminal portion of renal system
 Male: ~20 cm long
 Female: 3-4 cm long
 2 sphincters
o external urethral sphincter: voluntary sphincter
Renal system || OTPT Boards Review
o Internal urethral sphincter: involuntary sphincter
Types of incontinence
 Overflow incontinence
o Atonic bladder
o Inability of urinary bladder to empty completely
o (+) dribbles
o Mgt: credes (push downward manual pressure on
superpubic region
 Stress incontinence
o N urinary bladder
o Weakness of supporting structures (pelvic floor
muscles)
o Activities: laughing, lifting, sneezing, coughing
(increase abdominal pressure)
o Ms: Kegel’s exercise
 Urge incontinence
o Overactive bladder
o Neurogenic bladder
o Involuntary contraction of urinary bladder
o Causes: secondary to drugs, alcoholism, bladder
infection, bladder tumor
Endocrine System
 2nd great controlling center
 Hormones: to arouse, to activate the activity of the cell
Pituitary gland
 Hypophysis
 Lies in the sella turcica
 2 lobes: anterior and posterior
 Anterior pituitary gland
o Adenohypophysis
o Origin: pharyngeal epithelium
o Control: hypothalamic releasing and inhibitor
hormones
o 7 hormones:
 Prolactin: production of milk
 Inc in prolactin
o F: Amenorrhea; present even
when not pregnant
o M: Erectile Dysfunction;
present in males but very few
and fxn is unknown
 Growth hormone (GH)
 Growth of long bones and soft tissues
 Increase GH at adult life: acromegaly
o Thickening of nose, ears,
vertebra
o Enlargement of hands (2x),
(kyphotic), feet
o Inc GH at childhood: gigantism
o Dec GH at childhood: Dwarfism
 Thyroid Stimulating Hormone (TSH)
 Stimulates the thyroid
 Melanocyte stimulating hormone (MSH)
 Stimulates the skin pigmentation
(melanin)
 Adrenocorticotropic hormone (ACTH)
 Stimulates the cortisol
 Follicle Stimulating Hormones (FSH)
 Female: stimulates estrogen (for
feminine effect and deposition of fat)
and progesterone (development of
breasts)
 Male: Stimulates sperm
 Lutenizing hormone
 Female: triggers ovulation
 Male: stimulates testosterone
o Masculinity effect
o Deposition of protein
o Posterior pituitary gland
 Neurohypophysis
 Origin: neural tissues
 Control: hypothalamus
LOPEZ 2
  Storage of hormones Location Hormone Action
 Hormones: Pituitary gland
 Oxytocin: milk ejection (with sucking Anterior Prolactin Milk
reflexes); contraction of urine wall GH Long bones, soft
 Antidiuretic hormone/vasopressin – tissues
reabsorption of H2O from kidneys MSH Stimulates
Thyroid Gland melatonin
 Inferior to the larynx ACTH Stimulates cortex
 Thyroid hormone: FSH F: stimulates
o T3: triiodothyronine estrogen
o T4: Tetraiodothyronine/thyroxine M: Sperm
o Maturation, growth and development of CNS LH F: ovulation
o Dec Th at birth: cretinism M: testosterone
 Mental retardation Posterior Thyroid hormone CNS
o Dec TH at adult life: myxedema -T3
 Lethargic -T4
 Cold intolerance Calcitonin Dec Ca 2++ in
 Calcitonin blood
o Ca++ in blood stream Parathyroid Parathormone Inc Ca2++in the
Parathyroid gland blood
 Posterior surface of the lateral lobe of the thyroid gland Adrenal gland
 Parathromone: increase Ca++ in the blood
Cortex Aldosterone Reabsorption of
Adrenal gland
H2O; electrolytes
 Superior to each kidney
Cortisol stress
 Cortex
Medulla Androgen Hair
o Zona Glomerulosa
 Aldoesterone: reabsorption of H2O and Norepinephrine
maintaining electrolytes Epinephrine
o Zona Fasciculata Pancreas Glucagon Inc blood sugar
 Cortisol: resistance to stress Insulin Dec glucagon
o Zona Reticularis Somatostatin Equalizes
 Androgen: growth of hair (axillary, pubic, Glucagon and
chest, linea alba) insulin
 Increase in androgen: more pronounced in Thymus Thymosin T-cells
females; broad shoulders, deep voice and Pineal Melatonin Sleep; biological
enlargement of clitoris clock
Pancreas Gonads Estrogen
 Greater curvature of stomach Progesterone
 Both exocrine (enzyme production) and endocrine Relaxin
(hormone production) Testosterone
 Cells: Islets of Langerhans
 [GABiDS]
o Alpha cells: glucagon (blood sugar)
o Beta cells: insulin (lowers the # of glucagon—
source of ATP)
o Delta cells – somatostatin (equalizes # of
glucagon and insulin)
Thymus gland
 Behind the sternum between two lungs
 Thymosin: maturation of T cells
Pineal Gland
 Roof of the 3rd ventricle of brain
 Melatonin: body’s biological clock
o Inc: dark
o Dec: bright
Gonads
 Ovary  oocyte
 Testes  sperm
 Estrogen
 Progesterone
 Testosterone
 Relaxin – increases flexibility of symphysis pubis
 Sexual rehabilitation stages [EPOR]
o Excitement
o Plateau
o Orgasm
o Resolution

Renal system || OTPT Boards Review LOPEZ 3