ANPH111 REVIEWER [FINALS] 1.

Glomerulus
LESSON: URINARY SYSTEM 2. Bowman's capsule
3. Proximal convoluted tubule
URINARY SYSTEM 4. Loop of Henle
 The body's filtration and elimination 5. Distal convoluted tubule
system responsible for removing
waste products, excess water, and
other substances from the blood to
produce urine.
 The urinary system helps maintain
the body's fluid balance, regulate
blood pressure, and remove waste
products from metabolism.

KIDNEY
 Paired, reddish-brown organs
located retroperitoneally.
 Coverings:
o Renal capsule
o Perirenal fat (perinephric fat)
Bowman's capsule:
o Renal fascia (Gerota's fascia) -
continuous with transversalis 1. Inner visceral layer - Composed of
fascia podocytes, octopus-like cells that
o Pararenal (paranephric fat) terminate in branching pedicles.
2. Parietal layer - Simple squamous
 Parts of the kidney: epithelium.
o Cortex - Outer region
o Medulla - Inner region

Pelvis: Union of major calyces

Major calyx: Union of minor calyces

Renal (Malpighian) corpuscle:

 Glomerulus plus Bowman's capsule.
 Juxtaglomerular apparatus:
o Juxtaglomerular (JG) cells
o Macula densa
NEPHRON
o Mesangial cells
 Structural and functional unit of
the kidney.
 Each kidney contains approximately
one million nephrons.
 Consists of the following structures:

Mechanism of urine formation:
1. Glomerular filtration
 Acts as a filter.
 Approximately one-fifth of the blood
flowing through the kidneys is filtered
from the glomeruli.
 Filtration occurs through the filtration
membrane.
[Pressures acting on the glomerulus]
 Glomerular hydrostatic pressure -
A force that pushes water and
solutes across the filtration
membrane.
 Glomerular osmotic pressure -
Opposes filtration and is exerted by
plasma proteins, holding fluid inside
the glomerulus.
 Capsular hydrostatic pressure -
Opposes filtration and is the force
exerted by the fluid inside Bowman's
capsule.
Net Filtration Pressure (NFP)
 The force responsible for filtrate
formation.
NFP = Glomerular hydrostatic pressure -
(Glomerular oncotic pressure +
Capsular hydrostatic pressure)
Glomerular Filtration Rate (GFR)
 Refers to the amount of filtrate
formed per minute.
 Normally equal to 125 ml/min.
 GFR is directly proportional to the
net filtration pressure.
2. Tubular reabsorption
 The process of returning needed
substances from the filtrate to the
capillary blood.
 Reabsorption can be active or
passive, depending on the particular
substance.
 The proximal convoluted tubule
(PCT) is the most active site of
reabsorption, where nutrients, water,
and sodium ions are actively
transported and reabsorbed.
 Reabsorption in the distal convoluted
tubule (DCT) and collecting duct is
controlled by aldosterone and
antidiuretic hormone.
3. Tubular secretion
 The process of adding substances to
the filtrate from the blood or tubular
cells.
 Secretion can be active or passive.
 Tubular secretion plays an important
role in eliminating urea, excess ions,
drugs, and maintaining acid-base
balance.
Regulation of urine concentration
and volume:
o Urine osmolarity ranges from 50-
1200 mOsm.
o The hyperosmolarity of the medullary
fluid ensures that the urine reaching
the distal convoluted tubule (DCT) is
hypo-osmolar.
o In the absence of antidiuretic
hormone (ADH), urine becomes
diluted.
o When blood ADH increases, the
permeability of the DCT and
collecting duct to water increases.
Renal Clearance b. Membranous urethra - Traverses
the urogenital diaphragm, the
 The rate at which the kidneys clear a
shortest and least dilatable part.
particular solute from the plasma.
c. Penile (spongy) urethra - The
longest part, traverses the corpus
spongiosum.
URETER
 A 10-inch long muscular tube.
 It has three anatomical constrictions:
1. Ureteropelvic junction
2. Where iliac vessels cross the
ureter
3. Where it joins the urinary
bladder

2. Female urethra:
 Approximately 4 cm in length.
 Opens into the vestibule.

URINARY BLADDER
 A hollow muscular organ.
 The wall consists of the detrusor
muscle.
 The inner part called the trigone is
occupied by the ureteral orifices and
the urethral orifice.

LESSON: ENDOCRINE SYSTEM

ENDOCRINE GLANDS
 Are responsible for the synthesis and
URETHRA secretion of chemical messengers
1. Male: known as hormones, which are
disseminated throughout the body
a. Prostatic urethra - The widest and via the bloodstream where they act
most dilatable part. on specific target organs.
 They are also called ductless glands.
 The secretory cells release their
hormones into the interstitial space
from which they are rapidly absorbed
into the circulation.
 Unlike exocrine glands, endocrine
glands have no duct system and are
therefore sometimes called ductless
glands.
I. PITUITARY GLAND
 Also known as Hypophysis or
Hypophysis Cerebri.
 A specialized appendage of the brain
which secretes several hormones.
 It is a small slightly elongated gland
approximately 1 cm in diameter
situated in the sella turcica of the
sphenoid and it is connected to the
base of the brain via the
infundibulum or stalk.
 It is a pea-shaped structure
measuring 1-1.5 cm in diameter.
 Formerly regarded as the master
gland because it influences the rest
of the endocrine glands; however,
the hypothalamus regulates the
function of the anterior lobe of the
pituitary gland, hence this was
regarded as untrue.
[Divisions of the Pituitary Gland]
1. Anterior Pituitary
 Makes up 75% of the total weight
of the gland.
 Also called the adenohypophysis.
 Arises as an epithelial outgrowth
from the roof of the primitive oral
cavity known as Rathke's pouch.
2. Posterior Pituitary
 Also called neurohypophysis.
 Derived from downgrowth of
nervous tissue from the
hypothalamus to which it remains
joined by the pituitary stalk.
Hormones secreted by the anterior
pituitary:
o Growth hormone
o Thyroid-stimulating hormone
o GnRH (follicle-stimulating hormone,
luteinizing hormone)
o Prolactin
o ACTH (adrenocorticotropic hormone)
o MSH (melanocyte-stimulating
hormone)
POSTERIOR PITUITARY
 The neurohypophysis does not
synthesize hormones. Instead, it
stores and releases two hormones.
 Secretions from this lobe are
produced by the cell bodies of the
supraoptic nucleus (produces
vasopressin or ADH) and the
paraventricular nucleus (produces
oxytocin) of the hypothalamus and
are moved by axonal transport to the
axon terminals in the posterior
pituitary.
 Pituicytes: Modified neuroglial cells
found in the pars nervosa.
o Pitocin (oxytocin): Stimulates
uterine contraction and stimulates
milk ejection (milk "letdown") from
the mammary glands in response
to the mechanical stimulation
provided by the suckling infant.
o Pitressin or ADH (antidiuretic
hormone, vasopressin):
Increases water reabsorption at
the distal convoluted tubules of
the kidneys and has a
vasopressor effect, hence also
called vasopressin. It raises blood
pressure by constricting
arterioles.
Hormones stored by the posterior
pituitary:
o ADH (antidiuretic hormone,
vasopressin)
o Oxytocin (pitocin)
II. PINEAL GLAND
 Also called the epiphysis cerebri or
conarium.
 It is a small organ, 6-8 mm long,
located at the caudal end of the
diencephalon of the brain.
 It consists of cells called
pinealocytes.
 Hormones secreted: Melatonin
derived from serotonin, which may
promote sleepiness.

IV. PARATHYROID GLAND

III. THYROID GLAND
 A lobulated gland lying in front of the
neck at the upper part of the trachea.
 There are 2 lobes connected at the
midline by the isthmus.
 Contains follicles, which secrete two
thyroid hormones: thyroxine and
triiodothyronine.
 Actions of the thyroid hormones:
o Increase basal metabolic rate.
o Help maintain normal body
temperature.
 Also secretes thyrocalcitonin
secreted by the parafollicular cells,
which helps regulate calcium
homeostasis.
 Histologically, it is formed by various
follicles of different sizes and shapes
lined by simple cuboidal cells
containing colloid material containing
thyroglobulin.
 Between capillaries are dense
capillary networks supported by
reticular fibers.
 Secretes thyroid hormones:
o Triiodothyronine (T3)
o Tetraiodothyronine (T4)
o Calcitonin
 Small oval endocrine glands closely
associated posteriorly with the
thyroid gland.
 Supplied by the inferior thyroid
artery.
 Secretes parathormone, which
directly elevates blood calcium
levels.
 Usually, there are two superior
parathyroid glands and two inferior
parathyroid glands.
V. ADRENAL (SUPRARENAL) GLAND
 Small flattened endocrine glands
closely applied to the upper pole of
the kidneys.
 Two components of the adrenal
gland:
1. Adrenal Cortex: Outer and
thicker portion. Secretes:
a. Mineralocorticoids
(aldosterone and
deoxycortisones): Regulate
fluids and electrolytes, help
adjust blood pressure and
blood volume.
b. Glucocorticoids (e.g.,
cortisone): Regulate
metabolism and resistance to
stress.
 c. Androgens: Promote libido in
females and are converted to
estrogen, also stimulate the
growth of axillary and pubic
hairs in boys and girls and
contribute to the prepubertal
growth spurt.
2. Adrenal Medulla:
o Secretes the catecholamines,
epinephrine, and
norepinephrine.
o Produces effects that enhance
those of the sympathetic
division of the autonomic
nervous system during stress.
VI. PANCREAS
 Pistol-shaped flattened organ, the
head part of which is enclosed by the
duodenum, the body at the back of
the stomach, and the tail related to
the spleen.
 It is not only an exocrine gland but
also has important endocrine
functions.
 The endocrine portion is the Islets of
Langerhans.
 Pancreatic islets vary in size and are
most numerous at the tail of the
pancreas.
Cells in the Islets of Langerhans:
1. Alpha cells: Less numerous
containing acidophilic granules.
Found at the periphery of the islet
and secrete glucagon, which
increases blood sugar.
2. Beta cells: Found at the center of
the islets. They secrete insulin, which
decreases blood sugar.
3. D cells: Secrete somatostatin, which
inhibits the secretion of insulin and
glucagon and slows absorption of
nutrients from the gastrointestinal
tract.
4. F cells: Secrete pancreatic
polypeptide.
VII. TESTIS
 Paired organs lodging in the
scrotum, responsible for the
production of male gametes,
spermatozoa, and male sex
hormones.
 The endocrine portion is the
interstitial cells of Leydig, which
secrete androgens such as
testosterone, dihydrotestosterone,
and androstenedione.
 Testosterone regulates the
production of sperm and stimulates
the development and maintenance of
masculine secondary sex
characteristics, such as beard growth
and deepening of the voice.
VIII. OVARIES hump, osteoporosis, hypertension,
and hyperglycemia.
 The follicular cells of the ovarian
follicle secrete estrogen, and the
corpus luteum secretes
progesterone.
 These hormones regulate the female
reproductive cycle, including
oogenesis, maintenance of
pregnancy, preparation of the
mammary glands for lactation, and
the development and maintenance of
female secondary sex
characteristics.

4. Addison's Disease
 A disorder caused by the
destruction of the adrenal cortices,
characterized by chronic
deficiency of cortisol, aldosterone,
and androgens, leading to skin
pigmentation.
[ENDOCRINE GLAND DISEASES]
1. Grave's Disease
 An autoimmune disorder
associated with increased
circulating levels of thyroid
hormones.

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2. Diabetes Mellitus
 A disorder of metabolism
characterized by chronic
hyperglycemia.

3. Cushing's Syndrome
 Refers to the manifestations of
excessive corticosteroids, such as
central obesity, moon face, buffalo