Functions of Urinary System

The function of the kidneys are as follows:

• Filter. Every day, the kidneys filter gallons of fluid from the

bloodstream.
• Waste processing. The kidneys then process this filtrate, allowing

wastes and excess ions to leave the body in urine while returning
needed substances to the blood in just the right proportions.
• Elimination. Although the lungs and the skin also play roles in

excretion, the kidneys bear the major responsibility for eliminating

nitrogenous wastes, toxins, and drugs from the body.
 Functions of Urinary System

• Regulation. The kidneys also regulate the blood’s volume and

chemical makeup so that the proper balance between water and
salts and between acids and bases is maintained.
• Other regulatory functions. By producing the enzyme renin, they
help regulate blood pressure, and their hormone erythropoietin
stimulates red blood cell production in the bone marrow.
• Conversion. Kidney cells also convert vitamin D to its active form.
 Anatomy of the Urinary System

 The urinary system consists of two kidneys, two ureters, a urinary

bladder, and a urethra.
 The kidneys alone perform the functions just described and
manufacture urine in the process, while the other organs of the
urinary system provide temporary storage reservoirs for urine or
serve as transportation channels to carry it from one body region to
another.
Anatomy of the Urinary System
 Anatomy of the Urinary System
The kidneys, which maintain the purity and constancy of our internal fluids, are
perfect examples of homeostatic organs.
• Location. These small, dark red organs with a kidney-bean shape lie against the
dorsal body wall in a retroperitoneal position (beneath the parietal peritoneum)
in the superior lumbar region; they extend from the T12 to the L3 vertebra, thus
they receive protection from the lower part of the rib cage.
• Positioning. Because it is crowded by the liver, the right kidney is positioned
slightly lower than the left.
• Size. An adult kidney is about 12 cm (5 inches) long, 6 cm (2.5 inches) wide, and
3 cm (1 inch) thick, about the size of a large bar of soap.
 Anatomy of the Urinary System

• Adrenal gland. A top each kidney is an adrenal gland, which is part of the
endocrine system is a distinctly separate organ functionally.
• Fibrous capsule. A transparent fibrous capsule encloses each kidney and gives a
fresh kidney a glistening appearance.
• Perirenal fat capsule. A fatty mass, the perirenal fat capsule, surrounds each
kidney and acts to cushion it against blows.
• Renal fascia. The renal fascia, the outermost capsule, anchors the kidney and
helps hold it in place against the muscles of the trunk wall.
• Renal cortex. The outer region, which is light in color, is the renal cortex.
 Anatomy of the Urinary System
• Renal medulla. Deep to the cortex is a darker, reddish-brown area, the renal
medulla.
• Renal pyramids. The medulla has many basically triangular regions with a striped
appearance, the renal, or medullary pyramids; the broader base of each pyramid
faces toward the cortex while its tip, the apex, points toward the inner region of
the kidney.
• Renal columns. The pyramids are separated by extensions of cortex-like tissue,
the renal columns.
• Renal pelvis. Medial to the hilum is a flat, basinlike cavity, the renal pelvis, which
is continuous with the ureter leaving the hilum.
 Anatomy of the Urinary System

• Calyces. Extensions of the pelvis, calyces, form cup-shaped areas that enclose the
tips of the pyramid and collect urine, which continuously drains from the tips of the
pyramids into the renal pelvis.
• Renal artery. The arterial supply of each kidney is the renal artery, which divides into
segmental arteries as it approaches the hilum, and each segmental artery gives off
several branches called interlobar arteries.
• Arcuate arteries. At the cortex-medulla junction, interlobar arteries give off arcuate
arteries, which curve over the medullary pyramids.
• Cortical radiate arteries. Small cortical radiate arteries then branch off the arcuate
arteries and run outward to supply the cortical tissue.
Anatomy of the Urinary System
 Anatomy of the Urinary System

Nephrons
Nephrons are the
structural
and functional units
of the kidneys.
 Anatomy of the Urinary System
• Nephrons. Each kidney contains over a million tiny structures called nephrons, and
they are responsible for forming urine.
• Glomerulus. One of the main structures of a nephron, a glomerulus is a knot of
capillaries.
• Renal tubule. Another one of the main structures in a nephron is the renal tubule.
• Bowman’s capsule. The closed end of the renal tubule is enlarged and cup-shaped
and completely surrounds the glomerulus, and it is called the glomerular or
Bowman’s capsule.
• Podocytes. The inner layer of the capsule is made up of highly modified octopus-
like cells called podocytes.
 Anatomy of the Urinary System
• Foot processes. Podocytes have long branching processes called foot processes
that intertwine with one another and cling to the glomerulus.
• Collecting duct. As the tubule extends from the glomerular capsule, it coils and
twists before forming a hairpin loop and then again becomes coiled and twisted
before entering a collecting tubule called the collecting duct, which receives urine
from many nephrons.
• Proximal convoluted tubule. This is the part of the tubule that is near to the
glomerular capsule.
• Loop of Henle. The loop of Henle is the hairpin loop following the proximal
convoluted tubule.
• Distal convoluted tubule. After the loop of Henle, the tubule continues to coil and
twist before the collecting duct, and this part is called the distal convoluted tubule.
 Anatomy of the Urinary System
• Cortical nephrons. Most nephrons are called cortical nephrons because they are
located almost entirely within the cortex.
• Juxtamedullary nephrons. In a few cases, the nephrons are called juxtamedullary
nephrons because they are situated next to the cortex-medullary junction, and
their loops of Henle dip deep into the medulla.
• Afferent arteriole. The afferent arteriole, which arises from a cortical radiate artery,
is the “feeder vessel”.
• Efferent arteriole. The efferent arteriole receives blood that has passed through
the glomerulus.
• Peritubular capillaries. They arise from the efferent arteriole that drains the
glomerulus.
 Anatomy of the Urinary System
URETERS
The ureters do play an active role in urine transport.
• Size. The ureters are two slender tubes each 25 to 30 cm (10 to 12 inches) long
and 6 mm (1/4 inch) in diameter.
• Location. Each ureter runs behind the peritoneum from the renal hilum to the
posterior aspect of the bladder, which it enters at a slight angle.
• Function. Essentially, the ureters are passageways that carry urine from the
kidneys to the bladder through contraction of the smooth muscle layers in their
walls that propel urine into the bladder by peristalsis and is prevented from
flowing back by small valve-like folds of bladder mucosa that flap over the ureter
openings.
 Anatomy of the Urinary System
Urinary Bladder
The urinary bladder is a smooth, collapsible, muscular sac that stores urine
temporarily.
• Location. It is located retroperitoneally in the pelvis just posterior to the
symphysis pubis.
• Function. The detrusor muscles and the transitional epithelium both make the
bladder uniquely suited for its function of urine storage.
• Trigone. The smooth triangular region of the bladder base outlined by these three
openings is called the trigone, where infections tend to persist.
• Detrusor muscles. The bladder wall contains three layers of smooth muscle,
collectively called the detrusor muscle, and its mucosa is a special type of
epithelium, transitional epithelium.
 Anatomy of the Urinary System

Urethra
The urethra is a thin-walled tube that carries urine by peristalsis from the
bladder to the outside of the body.
• Internal urethral sphincter. At the bladder-urethral junction, a
thickening of the smooth muscle forms the internal urethral sphincter,
an involuntary sphincter that keeps the urethra closed when the urine is
not being passed.
• External urethral sphincter. A second sphincter, the external urethral
sphincter, is fashioned by skeletal muscle as the urethra passes through
the pelvic floor and is voluntarily controlled.
 Anatomy of the Urinary System

Urethra
• Female urethra. The female urethra is about 3 to 4 cm (1 1/2
inches) long, and its external orifice, or opening, lies anteriorly to
the vaginal opening.

• Male urethra. In male, the urethra is approximately 20 cm (8

inches) long and has three named regions: the prostatic,
membranous, and spongy (penile) urethrae; it opens at the tip of
the penis after traveling down its length.
 Physiology of the Urinary System

Every day, the kidneys filter gallons of

fluid from the bloodstream. The normal
physiology that takes place in the urinary
system is as follows:
Physiology of the Urinary System
 Physiology of the Urinary System

Process of Urine Formation

1. Glomerular filtration. Water and solutes smaller than proteins are forced

through the capillary walls and pores of the glomerular capsule into the
renal tubule.
2. Tubular reabsorption. Water, glucose, amino acids, and needed ions are

transported out of the filtrate into the tubule cells and then enter the
capillary blood.
3. Tubular secretion. Hydrogen, potassium, creatinine, and drugs are

removed from the peritubular blood and secreted by the tubule cells into
the filtrate.
 Physiology of the Urinary System

Characteristics of Urine
In 24 hours, the marvelously complex kidneys filter some 150 to 180 liters of
blood plasma through their glomeruli into the tubules.

• Daily volume. In 24 hours, only about 1.0 to 1.8 liters of urine are produced.
• Components. Urine contains nitrogenous wastes and unneeded
substances.
• Color. Freshly voided urine is generally clear and pale to deep yellow.
• Odor. When formed, urine is sterile and slightly aromatic, but if allowed
to stand, it takes on an ammonia odor caused by the action of bacteria on
the urine solutes.
 Physiology of the Urinary System

Characteristics of Urine

• pH. Urine pH is usually slightly acidic (around 6), but changes in body metabolism
and certain foods may cause it to be much more acidic or basic.
• Specific gravity. Whereas the specific gravity of pure water is 1.0, the specific
gravity of urine usually ranges from 1.001 to 1.035.
• Solutes. Solutes normally found in urine include sodium and potassium ions, urea,
uric acid, creatinine, ammonia, bicarbonate ions, and various other ions.
 Physiology of the Urinary System
Micturition
Micturition or voiding is the act of emptying the bladder.
• Accumulation. Ordinarily, the bladder continues to collect urine until about 200 ml have
accumulated.
• Activation. At about this point, stretching of the bladder wall activates stretch receptors.
• Transmission. Impulses transmitted to the sacral region of the spinal cord and then back to
the bladder via the pelvic splanchnic nerves cause the bladder to go into reflex
contractions.
• Passage. As the contractions become stronger, stored urine is forced past the internal
urethral sphincter into the upper part of the urethra.
• External sphincter. Because the lower external sphincter is skeletal muscle and voluntarily
controlled, we can choose to keep it closed or it can be relaxed so that urine is flushed
from the body.
 Physiology of the Urinary System
Age-Related Physiological Changes in the Urinary System
The function of the kidney decreases with age but is still able to carry out excretory
functions unless a disease process intervenes. Waste products may be filtered and
excreted more slowly. Therefore, nurses must include in their responsibility the
effect of drugs that older people take to their kidneys.
Aside from the kidneys, the bladder makes more noticeable changes. Complaints of
urinary urgency and frequency are common because the capacity of the bladder and
its ability to completely empty diminish with age. It is important to note that urinary
incontinence (UI) is never normal so the nurse must promptly investigate it,
particularly when of new onset.