ORGANS OF THE URINARY pyramids that collect

and funnel urine

SYSTEM towards the renal
KIDNEYS 2 pelvis
URETERS 2
URINARY 1
BLADDER
URETHER 1

LOCATION OF THE KIDNEYS

 DIMENSION
 Reddish brown, bean shape
 12cm long, 6cm wide, 3cm thick
 High on posterior abdominal wall
 At the level of T12 to L3-superior
lumbar region
 Retroperitoneal and againts the dorsal body
wall
 The right kidney is slightly lower than the
left, convex laterally
 Attached to ureters, renal blood vessels,
and nerves at renal; hilus (medial
indention)
 Atop each kidney is a an adrenal gland FUNCTIONS OF THE URINARY
SYSTEM
COVERINGS OF THE KIDNEY  Eliminations of waste products
 ADIPOSE CAPSULE  Filtering gallons of fluid from the
 Surrounds the kidney bloodstream everyday creating
 Provides protection to the kidney “filtrate”
 Helps keeps the kidney in its correct  “filtrate” include: metabolic wastes,
location against muscles of posterior ionic salts, toxins, drugs
trunk wall  Maintenance of blood
 Ptosis-kidneys drop to a lower  Red blood cell production - by
position due to rapid fat loss, producing hormone erythropoietin to
creating problems with the ureters stimulate RBC production in bone
 Ptosis can lead to hydronephrosis, marrow
a condition where urine backs up  Blood pressure(vessel size) - by
the ureters and exerts pressure on producing renin which causes
the kidney tissue vasoconstriction
 RENAL CAPSULE  Blood volume (water balance)- ADH
 Surrounds each kidney release from anterior pituitary targets
the kidney to limit water loss when
REGIONS OF THE KIDNEY blood pressure decreases or changes in
blood composition
 Three regions of kidneys
 Blood composition(electrolyte
Renal cortex Renal columns-
balance)- water follows salt;
extensions of cortex-
aldeterone reclaims sodium to the
material inward
blood
Renal medulla Medulla pyramids-  Blood pH- regulates H+ ions and
triangular regions of HCO3- ions
tissue in the medulla,
appear striated
Renal pelvis Calyces- cup shaped
structures enclosing
the tips of the
BLOOD FLOW IN THE
KIDNEYS
 Rich blood supply to filter blood and adjust
blood composition
 ~ 1/4 blood supply passes through the
kidneys each minute
 Blood enters the kidneys under extremely
high pressure
 Renal artery arises from abdominal aorta,
divides into segmental artery at hilus
 Inside renal pelvis, Segmental artery
divides into lobar artery, which branch into
interlobar artery travelling thru the renal
column to reach the renal cortex
 At the medulla-cortex junction, the
interlobar artery causes over the medullary
pyramids as the arcuate artery
 Small interlobular arterioles branch off of
the arcuate artery and move away from the
renal cortex and into the nephron of the
kidney
 The final brnaches of the interlobular
arteries are called afferent arterioles
 Afferent arterioles lead to the glomerulus, a
network of capillaries that are involved in
filtration
 Leading away from the glomerulus, blood
less filtrate travels through the efferent
arterioles and into the peritubular
capillaries
 From there, the blood moves through
similar veins that parallel the arteries at
their respective locations
NEPHRONS
 The structural and functional units of the
kidneys
 Over 1 million
 Responsible for forming urine
 Consist of renal corpuscle and renal tubule
 Renal corpuscle composed of a knot of
capillaries called the Glomerulus (a.k.a.
Browman’s capsule)
 Renal tubule- enlarged, closed,
cup-shaped end giving rise to the PCT,
dLOH, aLOH, DCT, and CD
GLOMERULUS
 A specialized capillary bed fed and drained
by arterioles
 Glomerular capillaries filter fluid from
the blood into the renal tubule
 GC is attached to arterioles on both sides in
order to maintain high pressure
 Large afferent arteriole-arises from
interlobular artery(feeder vessel); large
in diameter, high resistance vessels
that force fluid and solutes(filtrate) out
of the blood into the glomelular
capsule
 99% of the filtrate will be
reclaimed by the renal tubule cells
and returned to the blood in the
peritubular capillary beds(blood
vessels surrounding renal tubule)
 Narrow efferent arteriole-merges to
become the interlobular vein; draining
vessel.
 Glomerular capillaries are covered with
podocytes from the inner (visceral) layer of
the glomerular capsule.
 Podocytes have long, branching
processes called pedicels tha
intertwine with one another
and cling to the glomerular
capillaries.
 Filtration slits between the
pedicels form a porous
membrane around the
glomerular capillaries.
 The glomerular capillaries sit
within a glomerular capsule
(Bowman’s capsule)
 Expansion of renal tubule
 Receives filtered fluid
 Renal tubule coils into the
PCT, then the dLOH, aLOH, DCT and
finally, the CD.
 Along the PCT, much of the filtrate is
reclaimed
RENAL TUBULE
 Glomerular (Bowman’s) capsule enlarged
beginning of renal tubule
 Proximal convoluted tubule- lumen surface
(surface exposed to filtrate) is covered with
dense microvilli to increase surface area.
 The descending limb of the nephron - Loop
of Henle
 The ascending limb of the nephron coils
tightly again into the distal convoluted
tubule
 Many DCT’s merge in renal cortex to form
a collecting duct
 Collecting ducts not a part of nephron
 Collecting ducts receive urine from
nephrons and deliver it to the major
calyx and renal pelvis.
 CD run downward through the
medullary pyramids, giving them their
striped appearance.
from the filtrate are reabsorbed into the
blood.
 Juxtaglomerular apparatus
 At origin of the DCT it contacts
afferent and efferent arterioles
 Epithelial cells of DCT narrow and
densely packed, called macula densa
 Together with smooth muscle cells,
comprise the juxtaglomerular
apparatus
 Control renin secretion &
indirectly, aldosterone secretion

TYPES OF NEPHRONS
 Cortical nephrons
 Located entirely in the cortex
 Includes most nephrons
 Juxtamedullary nephrons
 Found at the boundary of the
cortex and medulla and their LOH
dip deep into the medulla.

BLOOD SUPPLY OF A
NEPHRON
 Peritubular capillary
 Efferent arteriole braches into a second
capillary bed
 Blood under low pressure
 Capillaries adapted for
reabsorption instead of filtration.
 Attached to a venule and eventually
lead to the interlobular veins to drain
blood from the glomerulus
 Cling close to the renal tubule where
they receive solutes and water from the
renal tubule cells as these substances
URINE FORMATION
PROCESSES
 Filtration- Water & solutes smaller than
proteins are forced through the capillary
walls and pores (of the glomerulus) into the
renal tubule (Bowman’s capsule).
 Reabsorption- Water, glucose, amino acids
& needed ions are transported out of the
filtrate into the peritubular capillary cells
and then enter the capillary blood.
 Secretion- Hydrogen ions, Potassium ions,
creatinine & drugs are removed from the
peritubular capillaries (blood) and secreted
by the peritubular capillary cells into the
filtrate.
FILTRATION
 Beginning step of urine formation
 Occurs at the glomerulus, nonselective
passive process
 Water and solutes smaller than
proteins are forced through capillary
walls of the glomerulus, which act as a
filter.
 Fenestrations – (openings in glomerular
walls) make glomerulus more permeable
than other arterioles.
 Podocytes cover capillaries, make
membrane impermeable to plasma proteins.
 Blood cells cannot pass out to the
capillaries; filtrate is essentially blood
plasma w/o blood proteins, blood cells.
 Filtrate is collected in the glomerular
(Bowman’s) capsule and leaves via the
renal tubule
FILTRATION PRESSURE
 Hydrostatic pressure of blood forces
substances through capillary wall.
 Net filtration pressure normally always
positive
 Hydrostatic pressure of blood is
greater than the hydrostatic pressure of
the glomerulus capsule and the
osmotic pressure of glomerulus plasma
 If arterial blood pressure falls
dramatically, the glomerular
hydrostatic pressure falls below level
needed for filtration.
 The epithelial cells of renal
tubules lack nutrients and cells die.
Can lead to renal failure.
FILTRATION RATE
 Rate of filtration is directly proportional to
net filtration pressure.
 Regulation of filtration rate
 Rate typically constant; may need to
increase or decrease to maintain
homeostasis
1. Sympathetic nervous system reflexes
 Respond to drops in blood pressure
and blood volume
 As pressure drops, sympathetic
nerves cause vasoconstriction of
afferent arterioles.
 Decreases rate of filtration
 Less urine produced, water
is conserved
 As pressure rises, sympathetic
nerves cause vasoconstriction of
efferent arterioles.
 Increases rate of filtration
 More urine produced, water
is removed
2. Renin production by JGA
 Renin is an enzyme controlling
filtration rate
 Juxtaglomerular cells secrete renin in
response to 3 stimuli
 Sympathetic stimulation (fast
response)
 Specialized pressure receptors in
afferent arterioles sense decrease
in blood pressure
 Macula densa senses decrease in
chloride, potassium, and sodium
ions reaching distal tubule
 Released renin reacts with
angiotensinogen in bloodstream to
form angiotensin I which is
 converted into angiotensin II by the
angiotensin I converting enzyme, ACE
 Angiotensin II acts to vasoconstrict
efferent arteriole
 Blood backs up into glomerulus,
increasing pressure and maintains
filtration rate
 Angiotension II also stimulates
secretion of aldosterone from adrenal
glands
 Stimulates tubular reabsorption of
sodium & H2O follows
REABSORPTION
 The composition of urine is different than
the composition of glomerular filtrate.
 Tubular reabsorption returns
substances to the internal environment
of the blood by moving substances
through the renal tubule walls into the
peritubular capillaries (99%)
 Some water, ions, glucose, amino
acids
 Some reabsorption is passive
= water > osmosis
= small ions > diffusion
 Most is active using protein carriers > by
active transport
 Most reabsorption occurs in the
proximal convoluted tubule, where
microvilli cells act as transporters,
taking up needed substances from the
filtrate and absorbing them into the
peritubular capillary blood.
 Substances that remain in the renal tubule
become more concentrated as water is
reabsorbed from the filtrate.
REABSORPTION - SODIUM
AND WATER
 The sodium potassium pump reabsorbs
70% of sodium ions in the PCT.
 The positive sodium ions attract
negative ions across the membrane as
well
 Water reabsorption occurs passively
across the membrane to areas of high
solute concentration
 Therefore, more sodium
reabsorption = more water
reabsorption
 Active transport of sodium ions occurs
along remainder of nephron and collecting
duct
 Almost all sodium ions and water are
reabsorbed.
MATERIALS NOT
REABSORBED
 Nitrogenous waste products
 Urea – formed by liver; end product of
protein breakdown when amino acids
are used to produce energy
 Uric acid – released when nucleic
acids are metabolized
 Creatinine – associated with creatine
metabolism in muscle tissue
 Excess water
SECRETION - REABSORPTION
IN REVERSE
 Some materials move from the peritubular
capillaries into the renal tubules to be
eliminated in urine.
 Example:
 Hydrogen ions; potassium ions
 Creatinine
 Drugs; penicillin; histamine
 Process is important for getting rid of
substances not already in the filtrate or for
controlling pH.
 Materials left in the renal tubule move
toward the ureter
FORMATION OF URINE
Summary:
 glomerular filtration of materials from
blood plasma
 Reabsorption of substances, including
glucose; water, sodium
 Secretion of substances, including
penicillin, histamine, hydrogen and
potassium ions
MAINTAINING WATER
BALANCE
 Normal amount of water in the human body
 Young adult females – 50%
 Young adult males – 60%
 Babies – 75%
 Old age – 45%
 Water is necessary for many body functions
and levels must be maintained
DISTRIBUTION OF BODY REGULATION OF WATER AND
FLUID ELECTROLYTE
 Intracellular fluid (inside cells) REABSORPTION
 Extracellular fluid (outside cells)  Regulation is primarily by hormones
 Interstitial fluid  Antidiuretic hormone (ADH) prevents
 Blood plasma excessive water loss in urine
 Neurons in the hypothalamus
produce ADH, which are released
by the anterior pituitary gland in
response to a decrease in blood
volume or water concentration
 ADH increases the water
permeability of the distal
convoluted tubule epithelium to
the peritubular capillaries
 Decreases volume of urine,
increasing concentrationof
solutes
 Negative feedback control
 Aldosterone regulates sodium ion
content of extracellular fluid
 Triggered by the
renin-angiotensin mechanism
 Stimulates the DCT to
reabsorb sodium and excrete
THE LINK BETWEEN WATER potassium
AND SALT  Cells in the kidneys and hypothalamus are
 Changes in electrolyte balance causes water active monitors
to move from one compartment to another
 Alters blood volume and blood MAINTAINING WATER AND
pressure (think of aldosterone) ELECTROLYTE BALANCE
 Can impair the activity of cells
(swelling/edema)
 Water intake must equal water
output
 Sources for water intake/output:
 Intake: Ingested foods and fluids,
Water produced from metabolic
processes (glycolysis)
 Output: Vaporization out of the
lungs, Lost in perspiration,
Leaves the body in the feces,
Urine production
 Dilute vs. Concentrated Urine
 Dilute urine is produced if water
intake is excessive
 Less urine (concentrated) is
produced if large amounts of
water are lost
 Proper concentrations of various
electrolytes must be present
MAINTAING ACID-BASED
BALANCE IN BLOOD
 Blood pH must remain between 7.35 and
7.45 to maintain homeostasis
 Alkalosis – pH above 7.45
 Acidosis – pH below 7.35
 Most acid-base balance is maintained by
the kidneys
 Excrete bicarbonate ions if needed
 Conserve / generate new bicarbonate
ions if needed
 Excrete hydrogen ions if needed
 Conserve / generate new hydrogen
ions if needed
 Regulation of these ions results in a urine
pH range of 4.5 to 8.0
 Acidic urine: protein-rich diet,
starvation, diabetes
 Basic urine: bacterial infections,
vegetarian diet
CHARACTERISTICS OF URINE
USED FOR MEDICAL
DIAGNOSIS
 Colored somewhat yellow due to the
pigment urochrome (from the destruction of
hemoglobin/bilirubin by- product) and
solutes
 Sterile
 Slightly aromatic
 Normal pH of around 6
 Specific gravity of 1.001 to 1.035
 Mucosal lining is continuous with that
lining the renal pelvis and the bladder
below.
 Enter the posterior aspect of the
bladder at a slight angle
 Runs behind the peritoneum
 Peristalsis aids gravity in urine transport
from the kidneys to the bladder.
 Smooth muscle layers in the ureter walls
contract to propel urine.
 There is a valve-like fold of bladder
mucosa that flap over the ureter openings to
prevent backflow.
 Renal calculi= calculus means little stone;
result of precipitated uric acid salts created
by bacterial infections, urinary retention,
and alkaline urine. Lithotripsy or surgery
are common treatments.
URINARY BLADDER
 Smooth, collapsible, muscular sac
 Temporarily stores urine
 Located retroperitoneally in the pelvis
posterior to the pubic symphysis.
 Trigone – three openings
 Two from the ureters (ureteral orifices)
 One to the urethra (internal urethral
orifice) which drains the bladder.
 Common site for bacterial infections
 In males, prostate gland surrounds the
neck of the bladder where it empties
into the urethra.

URINE COMPOSITION
 Composition differs considerably based
upon diet, metabolic activity, urine output.
 ~95% water, contains urea and uric acid,
electrolytes and amino acids (trace amount)
 Volume produced ranges from 0.6-2.5 liters
per day (1.8L average).
 Depends on fluid intake, body and
ambient air temperature, humidity,
respiratory rate, emotional state
 Output of 50-60ml per hour normal, less
than 30ml per hour may indicate kidney
failure
URINARY BLADDER WALL
 Three layers of smooth muscle (detrusor
URETERS muscle)
 Slender tubes attaching the kidney to the  Mucosa made of transitional epithelium
bladder 10-12” long & 1⁄4” diameter  Walls are thick and folded in an empty
 Superior end is continuous with the bladder 2-3” long
renal pelvis of the kidney
 Bladder can expand significantly without  •Fever
increasing internal pressure  •Cloudy urine
 As it fills, the bladder rises superiorly in the  •Bloody urine
abdominal cavity becoming firm and pear  Males
shaped.  •Prostatic, membranous and spongy
 A moderately full bladder can hold (penile) urethrae
~500mL (1 pint) of urine.  •Enlargement of the prostate gland
 A full bladder can stretch to hold more than causes urinary retention
twice that amount.  •can be corrected with a catheter

URETHRA MICTURITION (VOIDING)

 Thin-walled tube that carries urine from the
 Both sphincter muscles must open to allow
bladder to the outside of the body by
voiding
peristalsis
 The internal urethral sphincter is
 Release of urine is controlled by two
relaxed after stretching of the bladder
sphincters
~200mL
 Internal urethral sphincter (involuntary)
 Activation is from an impulse sent to
– a thickening of smooth muscle at the
the spinal cord and then back via the
bladder-urethra jxn. Keeps urethra
pelvic nerves
closed when urine is not being passed.
 The external urethral sphincter must be
 External urethral sphincter (voluntary)
voluntarily relaxed
--skeletal muscle that controls urine as
 Incontinence-inability to control
the urethra passes through the pelvic
micturition
floor.
 Retention-inability to micturate
URETHRA GENDER
DIFFERENCES
 Length
 Females – 3–4 cm (1-1.5 inches)
 Males – 20 cm (7-8 inches)
 Location
 Females – along wall of the vagina
 Males – through the prostate and penis
 Function
 Females – only carries urine
 Males – carries urine and is a
passageway for sperm cells

URETHRA GENDER
DIFFERENCES
 Females:
 Feces can enter urethral opening
causing
 •Uretritis-inflammation of the
urethra
 •Pyelitis or
pyelonephritis-inflammation of
the kidneys
 •Urinary tract infections-bacterial
infection
 •Dysuria
 •Urgency
 •Frequency