RENAL PHYSIO 2.

Proximal Straight Tubule

Paired organs that lie outside the peritoneal cavity in the
posterior abdominal wall
A.
HILUM – indented medial portion of the kidneys which
contain the renal blood vessels, nerves and the renal pelvis
RENAL PELVIS – funnel shaped continuation of the upper
ends of the ureters
- Subdivide into the major calyx which in turn subdivide into
further minor calyx which collects urine from the tubules of
the papilla
- Walls of pelvis, calices and ureters containing contractile
elements that propel urine towards the bladder
2 MAJOR REGIONS ON CUT-SECTION
1. CORTEX (outer region)
2. Medulla (Inner region)
– divided into multiple cone-shaped masses of
tissues called RENAL PYRAMIDS the base of which
originate from the border between the cortex and
the medulla while the apex (papilla) projects into a
minor calyx
Epithelium:
- Cuboidal cells with brush borders(microvilli) in the
luminal surface which serves to increase the surface
area for absorption and secretion
- Prominent basal and lateral processes which also
increase surface area
- Abundant mitochondria to supply energy for
transport processes
 65% of filtered water is reabsorbed in the proximal
tubule
 Proximal tubule is highly permeable to water
 Water reabsorption always keeps pace with Na+ and
total solute reabsorption so that concentration of Na+
and other solute (osmolality) remains unchanged and
proximal tubular fluid is isosmotic.
F.
LOOP OF HENLE
1. Thin Descending Limb
-lined by flat squamous cells
- ends in a hairpin loop then ascends as the next
segment

One lobe = 1 renal pyramid + overlying cortex 2. Thin Ascending Limb

- seen only in long-looped nephrons (juxtamedullary
B. nephrons)
The higher hydrostatic pressure in the glomerular capillaries
(60mmHg) cause rapid filtration while the much lower 3. Thick Ascending Limb
hydrostatic pressure in the peritubular capillaries (13mmHg) - begins at the junction between outer and inner
permits rapid fluid reabsorption medulla in long-looped nephrons or at the hairpin
loop in short-looped nephrons
20% of plasma entering the afferent arteriole is filtered - made up of cuboidal cells with abundant
through the glomeural capillaries, the remaining 80% of mitochondria and numerous interdigitating
plasma, all cellular elements and all large solutes (eg. Proteins processes
and lipids) flow from the glomerular capillaries in to the -no brush border
efferent arterioles. -return to its glomerulus of origin in the cortex
where it pass between and makes contact with the
C. afferent and efferent arterioles
Nephron – the functional unit of the kidney
Each kidney is made up approximately about one million MACULA DENSA – very short segment of the thick ascending
nephrons. limb that comes in contact with the vascular pole of the
Two Components: glomerulus.
1. RENAL CORPUSCLE – filtering component
2. RENAL TUBULE – where filtered fluid is converted G.
into urine DISTAL TUBULE
1. Distal Convoluted Tubule
D. Components: - Last segment of the nephron proper embryologically
1. GLOMERULUS – compact tuft of interconnected capillary 2. Connecting Tubule
loops 3. Cortical Collecting Duct
2. BOWMAN’S CAPSULE – balloon- like hallow capsule that 4. Outer Medullary Collecting Duct
surrounds or encase the glomerulus 5. Inner Medullary Collecting Duct
 BOWMAN’S SPACE/URINARY SPACE- space within 6. Papillary Collecting Duct
the bowman’s capsule into which the filtered fluid is 7. Duct of Bellini
collected from the glomerulus. -formed by the union of several papillary collecting
ducts
E. Proximal Tubule -empty into the minor calyx
1. Proximal Convoluted Tubule
H.
 Beginning in the second half of the distal conovoluted ANGIOTENSINOGEN
tubules, two cell types are found in most of the - Produced mainly in the liver
remaining segments: - Always present in plasma in high concentration
1. PRINCIPAL CELLS ANGIOTENSIN CONVERTING ENZYME (ACE)
-the predominant cell type in a particular segment - Found mostly in endothelial surface of most blood
-paucity of cellular organelle vessels
- Converts Angiotensin I to Angiotensin II
2. INTERCALATED CELLS - Pulmonary capillaries are particularly rich in this
-interspersed among the principal cells enzyme so that a large fraction of Angiotensin I is
- dark-staining due to abundant mitochondria converted to Angiotensin II in the lungs
Urine is no longer altered once it enters the calices Functions of Angiotensin II:
1. Increase Arterial Blood Pressure
I. 2. Sodium Retention
CORTEX The primary determinant of the rate of Angiotensin II
-contains all the renal corpuscles, convoluted portions of the formation is the plasma concentration of renin
proximal tubule, cortical portions of Henle’s loop, distal
convoluted tubule, connecting tubule and cortical collecting M.
ducts Control erythrocyte production in the bone marrow, major
source is the Kidney
MEDULLA Liver also secretes a small amount produced by cells in the
-contains the medullary portions of Henle’s loop and the kidney interstitium
medullary collecting ducts Stimulus for secretion: reduction in the partial pressure of
oxygen in the kidney (e.g. anemia, arterial hypoxia or
J. inadequate renal blood flow)
1. Superficial Cortical Nephrons Stimulate bone marrow to increase production of erythrocyte
-located within 1 mm of the capsular surface secretion is decreased in renal disease thereby resulting in
- short-looped nephrons which makes a hairpin loop just anemia
above the junction between the outer and inner medulla
N.
2. Midcortical nephrons Active form of Vitamin D
- either short or long-looped Important in the regulation of calcium and phosphate
metabolism
3. Juxtamedullary Nephrons
- located just above the junction between cortex and medulla O.
-long-looped nephrons which extends into the inner medulla 65% of filtered sodium is reabsorbed in the proximal tubule
Beginning of thick ascending limb in long-looped nephrons
marks the border between outer and inner medulla P.
Transfer of fluid and solute from the tubular lumen to the
K. peritubular capillary plasma
Sodium magnesium potassium sulfate chloride phosphate  Not Reabsorbed
calcium hydrogen ion  Nitrogenous waste products
Urea (from protein) o Urea
a. Uric Acid(from nucleic acid) o Uric Acid
b. Creatinine (from muscle creatine) o Creatinine
c. End-product of hemoglobin breakdown (e.g.  Excess Water
bilirubin)  Hydrogen and potassium ions
d. Metabolite of various hormones  Creatinine
GLUCONEOGENESIS Note: glomerular/filtrate composition is modified by tubular
– synthesis of glucose from proteins and other precursors reabsorption and/or secretion so that the content of the final
- Important during prolonged fasting urine is quite different from the glomerular filtrate
- Capable of producing approximately 20% as much
glucose as the liver 1. High levels of ADH
L. o Increases the permeability of the distal
RENIN tubules and collecting ducts to water
-proteolytic enzyme produced by the juxtaglomerular 2. High Osmolality of the Renal Medullary Interstitial
apparatus fluid
-catalyze the formation of Angiotensin I from
Angiotensinogen
 o Provides the osmotic gradient necessary for
water reabsorption to occur in the presence
of high levels of ADH
Inc. ADH, Inc. Reabsorption of water in collecting Duct, Dec.
Urine Volume -> concentrated urine
Dec. ADH, Dec. Reabsorption of water in collecting duct, Inc.
Urine Volume -> Dilute Urine
Dilute,regardless of the level of ADH
Results in the excretion of a large volume of dilute urine
Q.
Dilute, regardless of the level of ADH
Results in the excretion of al arge volume of dilute urine
R.
Conscious desire to drink
Thirst center in the CNS: Hypothalamus
- Anteroventral region of the third ventricle (AV3V)
- Preoptic Nuclei
Threshold for drinking : increase in sodium concentration of
about 2 meq/L above normal
- Each ureter courses obliquely through the detrusor
muscle and then passes beneath the bladder mucosa
before emptying into the bladder
V.
INTERNAL SPHINCTER
- Detrusor muscle in the bladder neck whose tone
normally keeps the bladder neck and posterior
urethra empty of urine and therefore prevents
emptying of the bladder until the pressure in the
main part of the bladder exceeds a critical level
EXTERNAL SPHINCTER
- Layer of voluntary skeletal muscle which surrounds
the urethra as it passes through the urogenital
diaphragm
- Under voluntary control and can consciously prevent
urination even when involuntary controls are
attempting to empty the bladder
W.
Motor fibers of the pelvic nerves are parasympathetic fibers
which terminate on ganglion cells in the wall of the bladder
from the postganglionic nerves arise to innervate the
detrusor muscle

ADH X.
Increase the water permeability of the collecting duct cell Ordinarily, all of the urine will be emptied during urination
(principal cell) with rarely more than 5-10ml left in the bladder
Increase water reabsorption
Decrease water excretion
Synthesized in the hypothalamus: 5/6 in the supraoptic nuclei
and 1/6 in the paraventricular nuclei
Stored and released from the posterior pituitary

S.
MICTURITION REFLEX is an autonomic spinal cord reflex but it
can also be inhibited or facilitated by centers in the cerebral
cortex or brain stem

T.
Two Main Parts
1. BODY – major part of the bladder into which urine
collects from the kidneys
2. NECK - funnel-shaped extension of the body which
connects with the urethra
-lower part is called the POSTERIOR
URETHRA
smooth muscle of the bladder is called DETRUSOR MUSCLE

U.
TRIGONE
- Small triangular area in the posterior wall of the
bladder immediately above the bladder neck
- Lower most apex is the opening of the bladder
through the bladder neck into the posterior urethra
- Uppermost angles is where the two ureters enters
the bladder