ANAPHY MIDTERM

RESPIRATORY SYSTEM
Respiration includes the following processes:

1. Ventilation, or breathing, which is the movement of air into and out

of the lungs;

2. The exchange of oxygen (O2) and carbon dioxide (CO2) between the
air in the lungs

and the blood

3. The transport of O2 and CO2 in the blood

4. The exchange of O2 and CO2 between the blood and the tissues.

FUNCTIONS:

The respiratory system performs the following functions:

1. Regulation of blood pH. The respiratory system can alter blood pH by

changing blood CO2 levels.

2. Voice production. Air movement past the vocal cords makes sound
and speech possible.

3. Olfaction. The sensation of smell occurs when airborne molecules are

drawn into the nasal cavity.

4. Innate immunity. The respiratory system protects against some

microorganisms and other pathogens, such as viruses, by preventing
them from entering the body and by removing them from respiratory
surfaces.
Anatomy of Respiratory System

Upper Respiratory Tract – Nasal cavity, Pharynx(throat), External

nose.

Lower Respiratory Tract – Larynx, Trachea, Bronchi, Lungs.

Nose - Upper Respiratory Tract (URT)

• Nose - consists of the external nose and the nasal cavity

1. External Nose
• The visible structure that forms a prominent feature of the
face. Most of the external nose is composed of hyaline cartilage
2. Nasal Cavity - extends from the nares to the choanae
• Nares or Nostrils - are the external opening of the nose
• Choanae - are the openings into the pharynx
• Hard palate - forms the floor of the nasal cavity separating the
nasal cavity from the oral cavity
• Air can flow through the nasal cavity when the oral cavity is
closed or full of food
o Conchae - The three prominent ridges present on lateral walls on
each side of the nasal cavity.
o Paranasal Sinuses - Air-filled spaces within bone. • They include
the maxillary, frontal, ethmoidal, and sphenoidal sinuses.
o Nasolacrimal ducts - Carry tears from the eyes, also open into
the nasal cavity.

Pharynx (URT)

• Air from the nasal cavity and air, food, and water from
the mouth pass through the pharynx.
Divided into 3 regions:

1. Nasopharynx

2. Oropharynx

3. Laryngopharynx

Nasopharynx

• Superior part of pharynx

• Located posterior to the choanae and superior to the soft

palate.

• Soft palate is an incomplete muscle and connective

tissue partition separating the nasopharynx from the
oropharynx

• Uvula

• Pharyngeal tonsil

Oropharynx
• Food, drink, and air all pass through this area

• Lined with stratified squamous epithelium to protects from

abrasion

• Two sets of tonsils:

• Palatine tonsils - lateral walls near the border of the

oral cavity and the oropharynx
 • Lingual tonsils - is located on the surface of the
posterior part of the tongue.

Laryngopharynx
• Food and drink pass through the laryngopharynx to the
esophagus.

• Lined with stratified squamous epithelium and ciliated

columnar epithelium.

o It is a passageway for air between the pharynx and the

trachea.
o Consists of an outer casing of nine cartilages connected
to one another by muscles and ligaments.
o Three of the nine cartilages are unpaired, and six of
them form three pairs:
• Thyroid - the largest cartilage; unpaired
• Cricoid - the most inferior cartilage of the larynx
• Epiglottis - elastic cartilage; helps prevent swallowed
materials from entering the larynx

2 pairs of Ligaments:
• Vestibular folds - false vocal cords

• Vocal folds - true vocal cords

• Primary source of voice production

• Air moving past the vocal folds causes them to vibrate,

producing sound.
Trachea (LRT)
Trachea or windpipe

• Is a membranous tube attached to the larynx.

• Projects through the mediastinum and divides into the

right and left primary bronchi at the level of the fifth
thoracic vertebra

• The smooth muscle can alter the diameter of the

trachea.

Bronchi (LRT)

• Left Main bronchus

• More horizontal because it is displaced by the heart

• Right Main Bronchus

• Wider, shorter, more ventrical and in direct line with

the trachea

• Lined with pseudostratified ciliated columnar

epithelium, supported by C-shaped pieces of cartilage.

Lungs (LRT)

• The principal organs of respiration

 • Cone-shaped, with its base resting on the diaphragm and
its apex extending superiorly to a point about 2.5 cm
above the clavicle

• Right lung - 3 lobes

• Left lung - 2 lobes

o There are 7 bronchopulmonary segments in the left lung

and 8 in the right lung.
o Tracheobronchial tree
o Lobar bronchi (or secondary bronchi)
o Segmental bronchi (or tertiary bronchi)

▪ Brochioles
• Terminal bronchioles
• Repiratory bronchioles
• Alveolar ducts -long, branching hallways with many open
doorways.
• Alveoli - small air sacs
▪ The trachea and bronchi have pseudostratified ciliated
columnar epithelium, the bronchioles have ciliated simple
columnar epithelium, and the terminal bronchioles have
ciliated simple cuboidal epithelium. The ciliated
epithelium of the air passageways functions as a mucus-
cilia escalator, which traps debris from the inhaled air
and removes it from the respiratory system.

▪ RESPIRATORY MEMBRANE
 • Gas exchange between air and blood takes place.
• It is formed mainly by the walls of the alveoli and the
surrounding capillaries.
• The respiratory membrane is very thin to facilitate the
diffusion of gases.
• It consists of six layers:
1. A thin layer of fluid lining the alveolus
2. The alveolar epithelium, composed of simple
squamous epithelium
3. The basement membrane of the alveolar
epithelium
4. A thin interstitial space
5. The basement membrane of the capillary
endothelium
6. The capillary endothelium, composed of simple
squamous epithelium
▪ The elastic fibers surrounding the alveoli allow them to
expand during inspiration and recoil during expiration.
▪ The lungs are very elastic and, when inflated, are capable
of expelling the air and returning to their original,
uninflated state.
▪ Specialized secretory cells within the walls of the alveoli
secrete a chemical, called surfactant, that reduces the
tendency of alveoli to recoil.

Pleural Cavities
 • Pleural cavity- surrounds the lung
• Pleura - serous membrane that lined the pleural
cavity
• Parietal pleura - lines the walls of the thorax,
diaphragm, and mediastinum, is continuous with the
visceral pleura
• Visceral pleura - covers the surface of the lung
• Pleural fluid
• Produced by pleural membranes
• It performs two functions:
1. It acts as a lubricant
2. It helps hold the pleural membranes together

• Lungs have two lymphatic supplies:

1. Superficial lymphatic vessels
• Deep to the visceral pleura;
• They drain lymph from the superficial lung tissue and
the visceral pleura.
2. Deep lymphatic vessels

• Follow the bronchi

• They drain lymph from the bronchi and associated

connective tissues
 • Both the superficial and deep lymphatic vessels exit the
lungs at the main bronchi.
• No lymphatic vessels are located in the walls of the
alveoli.
• Phagocytic cells within the lungs phagocytize most carbon
particles and other debris from inspired air and move
them to the lymphatic vessels.

VENTILATION
Ventilation, or breathing, is the process of moving air into
and out of the lungs.
There are two phases of ventilation:
1. Inspiration, or inhalation
2. Expiration, or exhalation
Ventilation is regulated by changes in thoracic volume,
which produce changes in air pressure within the lungs.

Changing Thoracic Volume

• The muscles associated with the ribs are responsible for

ventilation.

• Muscles of inspiration include the diaphragm and the muscles

that elevate the ribs and sternum, such as the external
intercostals.

• Diaphragm is a large dome of skeletal muscle that separates

the thoracic cavity from the abdominal cavity.
• The muscles of expiration, such as the internal intercostals,
depress the ribs and sternum.

- Inspiration
• Elevation of ribs and sternum
• Contraction of diaphragm causes the top of the dome to
move inferiorly
- Expiration
• Depress the ribs and sternum
• End of quite expiration - the respiratory muscles are
relaxed
- Contraction = ↑ thoracic volume by ↑ diameter of the
thoracic cage
- Relaxation = ↓ in thoracic volume

Quiet vs Labored breathing

Labored Breathing

• All the inspiratory muscles are active, and they

contract more forcefully than during quiet breathing,
causing a greater increase in thoracic volume

• Forceful contraction of the internal intercostals and

the abdominal muscles produces a faster and greater
decrease in thoracic volume than would be produced by
the passive recoil of the thorax and lungs.
Pressure Changes and Airflow

- Two physical principles govern the flow of air into and out
of the lungs:
1. Changes in volume result in changes in pressure.
2. Air flows from an area of higher pressure to an area
of lower pressure.

- The volume and pressure changes responsible for one cycle

of inspiration and expiration can be described as follows:

1. At the end of expiration, alveolar pressure, which is the air

pressure within the alveoli, is equal to atmospheric pressure,
which is the air pressure outside the body.

- No air moves into or out of the lungs because alveolar

pressure and atmospheric pressure are equal.

2. During inspiration, contraction of the muscles of inspiration

increases the volume of the thoracic cavity.

- The increased thoracic volume causes the lungs to

expand, resulting in an increase in alveolar volume.
- As the alveolar volume increases, alveolar pressure
becomes less than atmospheric pressure, and air flows
from outside the body through the respiratory passages
to the alveoli

3. At the end of inspiration, the thorax and alveoli stop

expanding.
 - When the alveolar pressure and atmospheric pressure
become equal, airflow stops.

4. During expiration, the thoracic volume decreases, producing

a corresponding decrease in alveolar volume.

- Consequently, alveolar pressure increases above

atmospheric pressure, and air flows from the alveoli
through the respiratory passages to the outside

Lung Recoil
• During quiet expiration, thoracic volume and lung volume
decrease because of lung recoil, the tendency for an
expanded lung to decrease in size.
• The thoracic wall also recoils due to the elastic
properties of its tissues.
• Lung recoil is able to occur because the connective tissue
of the lungs contains elastic fibers and because the film
of fluid lining the alveoli has surface tension.
• Surface tension exists because the oppositely charged
ends of water molecules are attracted to each other.
• As the water molecules pull together, they also pull on
the alveolar walls, causing the alveoli to recoil and
become smaller.

Two factors keep the lungs from collapsing:

(1) Surfactant
 • Is a mixture of lipoprotein molecules produced by
secretory cells of the alveolar epithelium.
• Decreases tension thus greatly reduces the tendency
of the lungs to collapse
(2) Pressure in the pleural cavity
• Pleural pressure, the pressure in the pleural cavity, is
less than alveolar pressure, the alveoli tend to expand.
• Normally, the alveoli are in the expanded state
because pleural pressure is lower than alveolar
pressure.
• Pleural pressure is lower than alveolar pressure
because of a suction effect caused by fluid removal by
the lymphatic system and by lung recoil.

Changing Alveolar Volume

• The events of inspiration and expiration can be
summarized as follows:
1. During inspiration, pleural pressure decreases because
of increased thoracic volume and increased lung recoil.
• As pleural pressure decreases, alveolar volume
increases, alveolar pressure decreases, and air flows
into the lungs.

2. During expiration, pleural pressure increases because

of decreased thoracic volume and decreased lung recoil.
 • As pleural pressure increases, alveolar volume
decreases, alveolar pressure increases, and air flows
out of the lungs.

Respiratory Volumes and Capacities

• Spirometry

• Is the process of measuring volumes of air that move

into and out of the respiratory system

• Spirometer is the device that measures these

respiratory volumes.

• Respiratory volumes are measures of the amount of air

movement during different portions of ventilation

• Respiratory capacities are sums of two or more respiratory

volumes.

Respiratory Volumes
The four respiratory volumes and their normal values for a
young adult male:

1. Tidal volume is the volume of air inspired or expired with

each breath. At rest, quiet breathing results in a tidal
volume of about 500 milliliters (mL).
 2. Inspiratory reserve volume is the amount of air that can
be inspired forcefully beyond the resting tidal volume
(about 3000 mL).
3. Expiratory reserve volume is the amount of air that can
be expired forcefully beyond the resting tidal volume
(about 1100 mL).
4. Residual volume is the volume of air still remaining in the
respiratory passages and lungs after maximum expiration
(about 1200 mL).

Respiratory Capacities
1. Functional residual capacity is the expiratory reserve
volume plus the residual volume. This is the amount of air
remaining in the lungs at the end of a normal expiration
(about 2300 mL at rest).
2. Inspiratory capacity is the tidal volume plus the
inspiratory reserve volume. This is the amount of air a
person can inspire maximally after a normal expiration
(about 3500 mL at rest).
3. Vital capacity is the sum of the inspiratory reserve
volume, the tidal volume, and the expiratory reserve
volume. It is the maximum volume of air that a person can
expel from the respiratory tract after a maximum
inspiration (about 4600 mL)
4. Total lung capacity is the sum of the inspiratory and
expiratory reserves and the tidal and residual volumes
 (about 5800 mL). The total lung capacity is also equal to
the vital capacity plus the residual volume.
• Forced expiratory vital capacity
• Is the rate at which lung volume changes during direct
measurement of the vital capacity
• It is a simple and clinically important pulmonary test

GAS EXCHANGE
• Major area of gas exchange is in the alveoli

• Some takes place in the respiratory bronchioles and alveolar

ducts.

• Anatomical dead space

• Bronchioles, bronchi, and trachea.

• The exchange of gases across the respiratory membrane

is influenced by:

• The thickness of the membrane

• The total surface area of the respiratory membrane

• The partial pressure of gases

• The pressure exerted by a specific gas in a

mixture of gases, such as air.

Diffusion Of Gases in the Lungs

• The cells of the body use O2 and produce CO2.

• Blood returning from tissues and entering the lungs has a
decreased Po2 and an increased Pco2

• O2 diffuses from the alveoli into the pulmonary capillaries

• CO2 diffuses from the pulmonary capillaries into the alveoli

• When blood enters a pulmonary capillary, the Po2 and Pco2 in

the capillary are different from the Po2 and Pco2 in the
alveolus.

• By the time blood flows through the first third of the

pulmonary capillary, an equilibrium is achieved, and the Po2 and
Pco2 in the capillary are the same as in the alveolus. Thus, in
the lungs, the blood gains O2 and loses CO2

• During breathing, atmospheric air mixes with alveolar air.

• The air entering and leaving the alveoli keeps the Po2 higher
in the alveoli than in the pulmonary capillaries.

• Increasing the breathing rate makes the Po2 even higher in

the alveoli than it is during slow breathing.

• During labored breathing, the rate of O2 diffusion into the

pulmonary capillaries increases because the difference in
partial pressure between the alveoli and the pulmonary
capillaries has increased.

• There is a slight decrease in Po2 in the pulmonary veins due

to mixing with deoxygenated blood from veins draining the
bronchi and bronchioles; however, the Po2 in the blood is still
higher than that in the tissues.
• Increasing the rate of breathing also makes the Pco2 lower
in the alveoli than it is during normal, quiet breathing.

Diffusion Of Gases in the Tissues

• Blood flows from the lungs through the left side of the
heart to the tissue capillaries.

• Oxygen diffuses from the capillary into the interstitial fluid

because the Po2 is lower in the interstitial fluid than in the
capillary. Oxygen diffuses from the interstitial fluid into
cells, in which the Po2 is less than in the interstitial fluid

• Within the cells, O2 is used in cellular respiration.

• There is also a constant diffusion gradient for CO2 from the

cells.

• Carbon dioxide therefore diffuses from cells into the

interstitial fluid and from the interstitial fluid into the tissue
capillaries, and an equilibrium between the blood and tissues is
achieved

Carbon Dioxide Transport and Blood Ph

• CO2 reacts with water to form carbonic acid which then
dissociates to form H+ and bicarbonate ions (HCO3-)

• Carbonic Anhydrase
 •An enzyme located inside red blood cells and on the
surface of capillary epithelial cells.

• It increases the rate of CO2 to reacts with H2O to

form H+ and bicarbonate ion

• Promotes CO2 uptake by RBC

• Carbon dioxide has an important effect on the pH of blood.

• Increased CO2 levels = decrease blood pH (acidic)

• Decreased CO2 = increased blood pH (basic)

Rhythmic Breathing
• The medullary respiratory center consists of two dorsal
respiratory groups, each forming a longitudinal column of cells
located bilaterally in the dorsal part of the medulla oblongata,
and two ventral respiratory groups, each forming a
longitudinal column of cells located bilaterally in the ventral
part of the medulla oblongata

• Dorsal respiratory group

• responsible for stimulating contraction of the

diaphragm

• Ventral respiratory group

• is primarily responsible for stimulating the external

intercostal, internal intercostal, and abdominal muscles
• pre-Bötzinger complex

• is now known to establish the basic rhythm of breathing

• part of the ventral respiratory group

Regulation Blood pH

- ACID-BASE REGULATION
Respiratory Regulation

When breathing is increased the blood carbon dioxide level

decreases and the blood becomes more BASE.

When breathing is decreased the blood carbon dioxide level

increases and the blood becomes more ACIDIC.

By adjusting the speed and depth of breathing, the

respiratory control centers and lungs are able to regulate the
blood pH minute by minute.

THE URINARY SYSTEM

Functions of the Urinary System

• Kidneys dispose of waste products in urine

▪ Nitrogenous wastes
▪ Toxins
▪ Drugs
▪ Excess ions
 • Kidneys’ regulatory functions include:
▪ Production of renin to maintain blood pressure
▪ Production of erythropoietin to stimulate red blood cell
production
▪ Conversion of vitamin D to its active form

Organs of the Urinary System

▪Kidneys

▪Ureters

▪Urinary bladder

▪Urethra

Kidneys
• Location and structure
▪The kidneys are situated against the dorsal body wall in
a retroperitoneal position (behind the parietal
peritoneum)
▪The kidneys are situated at the level of the T12 to L3
vertebrae
▪The right kidney is slightly lower than the left (because
of position of the liver)
• Kidney structure
▪An adult kidney is about 12 cm (5 in) long and 6 cm (2.5
in) wide
▪Renal hilum
 - A medial indentation where several structures
enter or exit the kidney (ureters, renal blood
vessels, and nerves)
• An adrenal gland sits atop each kidney
• Three protective layers enclose the kidney:
1. Fibrous capsule encloses each kidney
2. Perirenal fat capsule surrounds the kidney and
cushions against blows
3. Renal fascia is the most superficial layer that
anchors the kidney and adrenal gland to surrounding
structures
• Three regions revealed in a longitudinal section
1. Renal cortex—outer region
2. Renal medulla—deeper region
▪Renal (medullary) pyramids—triangular regions of
tissue in the medulla
▪Renal columns—extensions of cortexlike material
that separate the pyramids
3. Renal pelvis—medial region that is a flat, funnel-
shaped tube
▪Calyces form cup-shaped ―drains that enclose the
renal pyramids
▪Calyces collect urine and send it to the renal pelvis,
on to the ureter, and to the urinary bladder for
storage
• Blood supply
 ▪One-quarter of the total blood supply of the body
passes through the kidneys each minute
▪Renal artery provides each kidney with arterial blood
supply
▪Renal artery divides into segmental arteries →
interlobar arteries → arcuate arteries → cortical radiate
arteries
• Venous blood flow
▪Cortical radiate veins → arcuate veins → interlobar
veins → renal vein
▪There are no segmental veins
▪Renal vein returns blood to the inferior vena cava

Nephrons
• Structural and functional units of the kidneys
• Each kidney contains over a million nephrons
• Each nephron consists of two main structures
1.Renal corpuscle
2.Renal tubule
• Renal corpuscle consists of:
1. Glomerulus, a knot of capillaries made of podocytes
▪ Podocytes make up the inner (visceral) layer of the
glomerular capsule
▪ Foot processes cling to the glomerulus
▪ Filtration slits create a porous membrane— ideal for
filtration
 2. Glomerular (Bowman’s) capsule is a cup-shaped
structure that surrounds the glomerulus
▪ First part of the renal tubule
• Renal tubule
▪Extends from glomerular capsule and ends when it
empties into the collecting duct
▪From the glomerular (Bowman’s) capsule, the
subdivisions of the renal tubule are:
1.Proximal convoluted tubule (PCT)
2.Nephron loop (loop of Henle)
3.Distal convoluted tubule (DCT)
• Cortical nephrons
▪Located entirely in the cortex
▪Include most nephrons
• Juxtamedullary nephrons
▪Found at the cortex-medulla junction
▪Nephron loop dips deep into the medulla
▪Collecting ducts collect urine from both types of
nephrons, through the renal pyramids, to the calyces, and
then to the renal pelvis
• Two capillary beds associated with each nephron:
1.Glomerulus
2.Peritubular capillary bed
• Glomerulus
▪Fed and drained by arterioles
▪Afferent arteriole—arises from a cortical radiate
artery and feeds the glomerulus
 ▪Efferent arteriole—receives blood that has passed
through the glomerulus

▪Specialized for filtration

▪High pressure forces fluid and solutes out of blood and

into the glomerular capsule

• Peritubular capillary beds

▪Arise from the efferent arteriole of the glomerulus
▪Low-pressure, porous capillaries
▪Adapted for absorption instead of filtration
▪Cling close to the renal tubule to receive solutes and
water from tubule cells
▪Drain into the interlobar veins

URINARE FORMATION
➢ Urine formation is the result of three processes:
1. Glomerular filtration
2. Tubular reabsorption
3. Tubular secretion

Urine Formation and Characteristics:

➢ Glomerular filtration
▪ The glomerulus is a filter
▪ Filtration is a nonselective passive process
▪ Water and solutes smaller than proteins are
forced through glomerular capillary walls
 ▪ Proteins and blood cells are normally too large to
pass through the filtration membrane
▪ Once in the capsule, fluid is called filtrate
▪ Filtrate leaves via the renal tubule
➢ Glomerular filtration (continued)
▪Filtrate will be formed as long as systemic blood
pressure is normal
▪If arterial blood pressure is too low, filtrate
formation stops because glomerular pressure will be
too low to form filtrate

➢ Overview of Tubular – Reabsorption, Secretion, Excretion

➢ Tubular reabsorption
▪The peritubular capillaries reabsorb useful substances
from the renal tubule cells, such as:
▪Water
▪ Glucose
▪ Amino acids
▪ Ions
▪ Some reabsorption is passive; most is active (ATP)
▪ Most reabsorption occurs in the proximal convoluted
tubule
➢ Tubular secretion
▪Reabsorption in reverse
 ▪Some materials move from the blood of the peritubular
capillaries into the renal tubules to be eliminated in
filtrate
▪Hydrogen and potassium ions
▪Creatinine
▪Secretion is important for:
▪Getting rid of substances not already in the
filtrate
▪Removing drugs and excess ions
▪Maintaining acid-base balance of blood
▪Materials left in the renal tubule move toward the
ureter
➢ Nitrogenous wastes
▪ Nitrogenous waste products are poorly reabsorbed, if
at all
▪Tend to remain in the filtrate and are excreted from
the body in the urine
▪Urea—end product of protein breakdown
▪Uric acid—results from nucleic acid metabolism
▪Creatinine—associated with creatine metabolism in
muscles
➢ In 24 hours, about 1.0 to 1.8 liters of urine are produced
➢ Urine and filtrate are different
▪Filtrate contains everything that blood plasma does
(except proteins)
 ▪Urine is what remains after the filtrate has lost most
of its water, nutrients, and necessary ions through
reabsorption
▪Urine contains nitrogenous wastes and substances that
are not needed
➢ Urine characteristics
▪Clear and pale to deep yellow in color
▪Yellow color is normal and due to the pigment urochrome
(from the destruction of hemoglobin) and solutes
▪Dilute urine is a pale, straw color
▪Sterile at the time of formation
▪Slightly aromatic, but smells like ammonia with
time
▪Slightly acidic (pH of 6)
▪Specific gravity of 1.001 to 1.035
➢ Solutes normally found in urine
▪Sodium and potassium ions
▪Urea, uric acid, creatinine
▪Ammonia
▪Bicarbonate ions
➢ Solutes NOT normally found in urine:
▪Glucose
▪Blood proteins
▪Red blood cells
▪Hemoglobin
▪WBCs (pus)
▪Bile
Ureters
➢ Slender tubes 25–30 cm (10–12 inches) attaching the
kidney to the urinary bladder
▪Continuous with the renal pelvis
▪Enter the posterior aspect of the urinary bladder
▪Run behind the peritoneum
➢ Peristalsis aids gravity in urine transport

Urinary Bladder
➢ Smooth, collapsible, muscular sac situated posterior to
the pubic symphysis
➢ Stores urine temporarily
➢ Trigone—triangular region of the urinary bladder base
based on three openings
▪Two openings from the ureters (ureteral orifices)
▪One opening to the urethra (internal urethral orifice)
➢ In males, the prostate surrounds the neck of the urinary
bladder
➢ Wall of the urinary bladder
▪Three layers of smooth muscle collectively called the
detrusor muscle
▪ Mucosa made of transitional epithelium
▪Walls are thick and folded in an empty urinary bladder
▪Urinary bladder can expand significantly without
increasing internal pressure
➢ Capacity of the urinary bladder
 ▪A moderately full bladder is about 5 inches long and
holds about 500 ml of urine
▪Capable of holding twice that amount of urine

Urethra
➢ Thin-walled tube that carries urine from the urinary
bladder to the outside of the body by peristalsis
➢ Function
▪Females—carries only urine
▪Males—carries urine and sperm
➢ Release of urine is controlled by two sphincters
1. Internal urethral sphincter
▪Involuntary and made of smooth muscle
2. External urethral sphincter
▪Voluntary and made of skeletal muscle
➢ Length
▪In females: 3 to 4 cm (1.5 inches long)
▪In males: 20 cm (8 inches long)
➢ Location
▪Females—anterior to the vaginal opening
▪Males—travels through the prostate and penis
▪Prostatic urethra
▪Membranous urethra
▪Spongy urethra

Micturition
➢ Voiding, or emptying of the urinary bladder
 ➢ Two sphincters control the release of urine, the internal
urethral sphincter and external urethral sphincter
➢ Bladder collects urine to 200 ml
➢ Stretch receptors transmit impulses to the sacral region
of the spinal cord
➢ Impulses travel back to the bladder via the pelvic
splanchnic nerves to cause bladder contractions
➢ When contractions become stronger, urine is forced past
the involuntary internal sphincter into the upper urethra
➢ Urge to void is felt
➢ The external sphincter is voluntarily controlled, so
micturition can usually be delayed

FLUID, ELECRTOLYTE, AND ACID-BASE BALANCE.

o Blood composition depends on three factors:

1. Diet
2. Cellular metabolism
3. Urine output
o Kidneys have four roles in maintaining blood
composition
1. Excreting nitrogen - containing wastes (previously
discussed)
2. Maintaining water balance of the blood
3. Maintaining electrolyte balance of the blood
 4. Ensuring proper blood pH

Maintaining Water Balance of the Blood

o Normal amount of water in the human body

▪Young adult females = 50%
▪Young adult males = 60%
▪Babies = 75%
▪The elderly = 45%
o Water is necessary for many body functions, and levels
must be maintained
o Water occupies three main fluid compartments
1. Intracellular fluid (ICF)
▪Fluid inside cells
▪Accounts for two-thirds of body fluid
2. Extracellular fluid (ECF)
▪Fluids outside cells; includes blood plasma,
interstitial fluid
(IF), lymph, and transcellular fluid

3. Plasma (blood) is ECF, but accounts for 3L of total

body water.
▪Links external and internal environments

THE 2 FLUID COMPARTMENTS

1. INTRACELLULAR SPACE
• 2/3 of the total body fluid
 • Located primarily in skeletal muscle mass
2. EXTRACELLULAR SPACE
• 1/3 of the total body fluids
• Extracellular compartments are divided into 3:
• Intravascular
• Interstitial
• Transcellular

EXTRACELLULAR SPACE
1. INTRAVASCULAR
❖Fluid inside the blood vessels
❖Contains plasma for circulating blood volume
❖3L Plasma
❖3L made up of erythrocytes, leukocytes,
thrombocytes
2. INTERSTITIAL
❖Contains the fluid that surrounds the cell
❖Totals about 11 - 12L
❖Lymph is an interstitial fluid- a fluid that flows
through the lymphatic system
3. TRANSCELLULAR
❖The smallest division of the ECF compartment
❖Contains approx. 1L fluid
❖Example:
❖Cerebrospinal fluid
❖Pericardial
 ❖Synovial
❖Intraocular

Maintaining Water Balance of the Blood

▪The link between water and electrolytes

▪Electrolytes are charged particles (ions) that conduct

electrical current in an aqueous solution

▪Sodium, potassium, and calcium ions are electrolytes

▪ Regulation of water intake and output

▪ Water intake must equal water output if the body is to

remain properly hydrated

▪ Sources for water intake

▪ Ingested foods and fluids

▪ Water produced from metabolic processes (10%)

▪ Thirst mechanism is the driving force for water intake

▪ Thirst mechanism

▪ Osmoreceptors are sensitive cells in the hypothalamus

that become more active in reaction to small changes in
plasma solute concentration

▪ When activated, the thirst center in the hypothalamus

is notified
 ▪ A dry mouth due to decreased saliva also promotes the
thirst mechanism

▪ Both reinforce the drive to drink

▪Sources of water output

▪Lungs (insensible since we cannot sense the water

leaving)

▪Perspiration

▪Feces

▪Urine

▪Hormones are primarily responsible for reabsorption of

water and electrolytes by the kidneys

▪Antidiuretic hormone (ADH) prevents excessive water

loss in the urine and increases water reabsorption

▪ADH targets the kidney’s collecting ducts

Maintaining Electrolyte Balance

▪Small changes in electrolyte concentrations cause water to
move from one fluid compartment to another

▪ A second hormone, aldosterone, helps regulate blood

composition and blood volume by acting on the kidney

▪ Increased secretion of aldosterone causes sodium and

water retention and potassium loss
 ▪ Decreased secretion of aldosterone causes sodium and
water loss and potassium retention

Electrolyte Balance
▪ Renin-angiotensin mechanism

▪ Most important trigger for aldosterone release

▪ Mediated by the juxtaglomerular (JG) apparatus of the

renal tubules

▪ When cells of the JG apparatus are stimulated by low

blood pressure, the enzyme renin is released into blood

▪ Renin is an enzyme that converts angiotensinogen to

angiotensin I

▪ Renin is released by the juxtaglomerular cells of the

kidneys in response to decreased renal perfusion

▪ Angiotensinogen is a substance that formed by the

liver

▪ Angiotensin – converting enzymes (ACE) converts

angiotensin I to angiotensin II

▪ Angiotensin II is a potent vasoconstrictor

▪ It increases arterial perfusion pressure and stimulates

thirst
 ▪ As a response to sympathetic nervous system
stimulation, aldosterone is released in response to the
release of renin

▪ Aldosterone is a volume regulator and is also released

as serum sodium decreases.

Maintaining Acid-Base Balance of Blood

▪Blood pH must remain between 7.35 and 7.45 to maintain
homeostasis

▪Alkalosis—pH above 7.45

▪Acidosis—pH below 7.35

▪Physiological acidosis— pH between 7.0 and 7.35

▪Kidneys play greatest role in maintaining acid- base balance

▪Other acid-base controlling systems

▪Blood buffers

▪Respiration

▪ Buffers

▪ Buffers are the fastest acting regulatory system.

▪ Provide immediate protection against changes in

hydrogen ion concentration in the extracellular fluid.
 ▪ Buffers are reactors that function only to keep the pH
within the narrow limits of stability when too much acid
or base is released into the system, and buffers absorb
or release hydrogen ions as needed.

▪ Blood buffers

▪ Acids

▪ Acids are produced as end products of

metabolism.

▪ Acids contain hydrogen ions and are hydrogen ion

donors, which means that acids give up hydrogen ions
to neutralize or decrease the strength of an acid or
to form a weaker base.

▪ The strength of an acid is determined by the

number of hydrogen ions it contains

▪Bases

▪Contain no hydrogen ions.

▪Are hydrogen ion

acceptors

▪They accept hydrogen ions from acids to neutralize

or decrease the strength of a base or to form a
weaker acid.

▪Molecules react to prevent dramatic changes in hydrogen ion

(H+) concentrations
 ▪Bind to H+ when pH drops

▪Release H+ when pH rises

▪Three major chemical buffer systems

1. Bicarbonate buffer system

2. Phosphate buffer system

3. Protein buffer system

▪ The bicarbonate buffer system

▪ Carbonic Acid – Bicarbonate system

▪ Primary buffer system in the body

▪ The system maintains a pH of 7.4 with a ratio of 20

parts

bicarbonate to 1part carbonic acid

▪ This ratio (20:1) determines the hydrogen ion

concentration of body fluid.

▪ Carbonic acid concentration is controlled by the

excretion of CO2 by the lungs; the rate and depth of
respiration change in response to changes in the CO2

▪ The kidneys control the bicarbonate concentration and

selectively retain or excrete bicarbonate in response to
bodily needs.

▪Phosphate Buffer System

 ▪Is present in the cells and body fluids and is especially
active in the kidneys.

▪Acts like bicarbonate and neutralizes excess hydrogen

ions.

▪Plasma Protein System

▪The system functions along with the liver to vary the

amount of hydrogen ions in the chemical structure of
plasma proteins.

▪Plasma proteins have the ability to attract or release

hydrogen ions

▪ Respiratory mechanisms

▪ The lungs are the second defense of the body and

interact with the buffer system to maintain acid-base
balance.

▪ In acidosis, the pH decreases and the respiratory rate

and depth increase in an attempt to exhale acids.

▪ The carbonic acid created by the neutralizing action of

bicarbonate can be carried to the lungs, where it is
reduced to CO2 and water and is exhaled; thus, hydrogen
ions are inactivated and exhaled.

▪ In alkalosis, the pH increases and the respiratory rate

and

depth decrease
 ▪CO2 is retained and carbonic acid increases to
neutralize and

decrease the strength of excess bicarbonate

▪The action of the lungs is reversible in controlling an

excess or deficit

▪ The lungs can hold hydrogen ions until the deficit is

corrected or can inactivate hydrogen ions, changing the
ions to water molecules to be exhaled along with CO2 ,
thus correcting the excess.

▪ The process of correcting a deficit or excess

takes 10 to 30 seconds to complete.

▪ The lungs are capable of inactivating only hydrogen ions

carried by carbonic acid; excess hydrogen ions created
by other mechanisms must be excreted by the kidneys.

▪Renal mechanisms

▪When blood pH rises:

▪Bicarbonate ions are excreted

▪Hydrogen ions are retained by kidney tubules

▪When blood pH falls:

▪Bicarbonate ions are reabsorbed

▪Hydrogen ions are secreted

▪Urine pH varies from 4.5 to 8.0

▪ The kidneys provide a more inclusive corrective
response to acid-base disturbances than other corrective

mechanisms, even though the renal excretion of acids and

alkalis occurs more slowly.

▪ Compensation requires a few hours to several days;

however, the compensation is more thorough and
selective than that of other regulators

▪ In acidosis, the pH decreases and excess hydrogen ions

are secreted into the tubules and combine with buffers
for excretion in the urine.

▪ In alkalosis, the pH increases and excess bicarbonate

ions move into the tubules, combine with sodium, and are
excreted in the urine.

▪ The kidneys restore bicarbonate by excreting

hydrogen ions and retaining bicarbonate ions.

▪ Excess hydrogen ions are excreted in the urine in the

form of phosphoric acid.

▪ The alteration of certain amino acids in the renal

tubules results in a diffusion of ammonia into the
kidneys; the ammonia combines with excess hydrogen ions
and is excreted in the urine.