Urinary System

and Body Fluids

Podocytes
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Fig. 23.1
 Functions of the Urinary System
• The kidneys produce urine
• The ureters transport urine to the urinary
bladder
• The urinary bladder stores urine
• The urethra transports urine to the
outside of the body
 Functions of the Urinary System
• The following functions are performed by
the kidneys:
1. Excretion (eliminates waste)
2. Regulate blood volume and pressure
3. Regulation of the concentration of solutes in
the blood (ion concentration)
4. Regulation of extracellular fluid pH
5. Regulation of red blood cell synthesis
6. Vitamin D production
 Vitamin D Synthesis
• Vitamin D synthesized by skin in response
to UV radiation
• Most active form of vitamin D is calcitriol
• Kidney coverts precursor from skin to
calcitriol
• Aids in absorption of calcium from
digestive tract and reabsorption of calcium
by kidneys
 Erythropoiesis
• Kidney releases erythropoietin (EPO) in
response to hypoxemia
• EPO stimulates production of red blood
cells
• Production occurs in red bone marrow
• Kidney damage may lead to anemia
 Kidney Anatomy and Histology
• Location and External Anatomy of the
Kidneys
– Lie behind the peritoneum on the posterior
abdominal wall on each side of the
vertebral column
– Surrounded by a renal capsule and fat and
is held in place by the renal fascia
– The hilum, on the medial side of each
kidney, is where blood vessels and nerves
enter and exit the kidney
• i. External anatomy
• 1. Layers of tissue
• a. Renal capsule > Deep layer, acts as a
barrier to trauma
• b. Adipose tissue > Middle layer, shock
absorption.
• c. Renal fascia > Outer layer/ anchors the
kidney to abdominal wall
 External Layers of the Kidneys
(Figure 25.2)
• Fibrous capsule maintains
shape of kidney
• Adipose tissue absorbs
shock and provides
protection
• Renal fascia anchors
kidneys to posterior
abdominal wall
• ii. Internal anatomy
• 1. Renal cortex – Superficial
• 2. Renal medulla (Renal pyramids) – Deep
 Internal Anatomy and Histology of
the Kidneys
• The two layers of the kidney are the
cortex and the medulla
– The renal columns extend into the medulla
between the renal pyramids
– The tips of the renal pyramids project to the
minor calyces
• The minor calyces open into the major
calyces, which open into the renal pelvis
• The renal pelvis leads to the ureter
 URINE FLOW
Urine formed ( kidneys )
↓

renal papillae
↓

minor calyces
↓

major calyces
↓
renal pelvis
↓

ureter
 Internal Anatomy and Histology of
the Kidneys
• The functional unit of the kidney is the nephron
• The parts of a nephron are the renal corpuscle,
the proximal convoluted tubule, the loop of
Henle, and the distal convoluted tubule
– The renal corpuscle is Bowman’s capsule and the
glomerulus.
– Fluid leaves the blood in the glomerulus and enters
Bowman’s capsule
– The nephron empties through the distal convoluted
tubule into a collecting duct
– The collecting ducts empty into papillary ducts,
which empty into minor calyces
 NEPHRON
 Renal corpuscle filters
the blood
 Proximal convoluted
tubule returns filtered
substances to the blood
 loop of Henle conserve
water and solutes
 distal convoluted tubule
rids the blood of
additional wastes
 URINE FLOW
Urine formed ( kidneys ): nephron
↓
distal convoluted tubule
↓
collecting duct
↓
renal papillae
↓
minor calyces
↓
major calyces
↓
renal pelvis
↓
ureter
 Internal Anatomy and Histology of
the Kidneys
• Cortical nephrons
– 85% of total nephrons
– Located in the cortex
• Juxtamedullary nephrons
– Are located at the cortex-medulla junction
– Have loops of Henle that deeply invade the
medulla
– Have extensive thin segments
– Are involved in the production of concentrated
urine
Renal Corpuscle( structures )
• Bowman’s
capsule
• glomerulus
 Renal Corpuscle:Bowman’s
capsule
• outer • inner
 parietal layer  visceral layer
 simple squamous  podocytes
epithelial cells
 Renal Corpuscle

• The filtration membrane consists

of:
– Endothelium of glomerular
capillaries (with fenestrae)
– Basement membrane
– Podocytes (with filtration slits)
Renal Corpuscle
 Capillary Beds of the Nephron
• Every nephron has two capillary beds
– Glomerulus
– Peritubular capillaries
• Each glomerulus is:
– Fed by an afferent arteriole
– Drained by an efferent arteriole
 Blood Flow in the Nephron
• Afferent arterioles deliver blood to
nephron
• Bloods exits via efferent arterioles
• Peritubular capillaries accomplish
exchange of nutrients and wastes
• Vasa recta drains peritubular
capillaries
 Arteries of the Kidneys
Renal artery
segmental artery
interlobar artery
arcuate artery
interlobular
artery
afferent arteriole
 Arteries of the Kidneys
 Afferent arterioles supply the glomeruli.
 Efferent arteries supply the peritubular
capillaries and vasa recta.
Efferent arterioles carry blood away from
the glomeruli.
After each efferent arteriole exits the
glomerulus, it gives rise to a plexus of
capillaries: peritubular capillaries
 Veins of the Kidneys
 The peritubular capillaries drain into interlobular
veins
↓
arcuate veins
↓
interlobar veins
↓
the renal vein.
↓
inferior vena cava.
Blood Flow Through the Kidney

Fig. 23.6
• leading causes of renal failure
1. DM
[Link]
3. polycystic kidney disease ( US)
 Urine Production
• The kidneys filter the body’s entire plasma
volume 60 times each day
• The filtrate:
– Contains all plasma components except protein
– Loses water, nutrients, and essential ions to
become urine
• The urine contains metabolic wastes and
unneeded substances
• Urine is produced by the processes of
– Filtration
– Tubular reabsorption
– Tubular secretion
Urine Formation

Fig. 23.7
 Urine Production
• Filtration
– The glomerular filtration rate is the amount of
filtrate produce per minute
– The filtrate is plasma minus blood cells, platelets,
and blood proteins
• Most (99%) of the filtrate is reabsorbed
– Filtration pressure is responsible for filtrate
formation.
 Urine Production
• Tubular Reabsorption
– A transepithelial process whereby most tubule
contents are returned to the blood
– Transported substances move through three
membranes
• Luminal and basolateral membranes of tubule cells
• Endothelium of peritubular capillaries
 Urine Production
• Tubular Secretion
– Substances are secreted in the proximal or
distal convoluted tubules and the collecting
ducts
– Hydrogen ions, K+ not produced in the
body are secreted by antiport mechanisms
 Micturition Reflex
• Proper term for urination
• Urine entering bladder causes distention
(stretching) of bladder
• Parasympathetic stimulation causes detrusor
muscle to contract
• Relaxation of internal urethral sphincter allows
urine to flow into urethra
• Spinal reflex relaxes it to allow urine to continue
to flow and exit urethra
 Nerves Involved in Urination
• Pudendal nerve regulates
voluntary micturition (urination)
by regulating external urethral
sphincter
• Pelvic and hypogastric nerves
innervate urinary bladder
• Sympathetic hypogastric
inhibits detrusor muscle
contraction
• Parasympathetic pelvic
increases contraction of
detrusor muscle
 Hormonal Regulation of Urine
Concentration and Volume
• Antidiuretic Hormone (ADH)
– Secreted by the posterior pituitary
– Inhibits diuresis
• This equalizes the osmolality of the filtrate and
the interstitial fluid
–
 Hormonal Regulation of Urine
Concentration and Volume
• Renin—Angiotensin—Aldosterone
– Renin, produced by the kidneys, causes the
conversion of angiotensinogen to
angiotensin I
– Angiotensin-converting enzyme converts
angiotensin I into angiotensin II, which
stimulates aldosterone secretion from the
adrenal cortex
 Hormonal Regulation of Urine
Concentration and Volume
• Renin—Angiotensin—Aldosterone
– Aldosterone regulates the body’s water content by
regulating the body’s Na+ content
• A decrease in blood pressure results in increased renin
secretion, aldosterone secretion, Na+ reabsorption, blood
volume, and blood pressure
• An increase in blood pressure results in decreased
renin secretion, aldosterone secretion, Na+
reabsorption, blood volume, and blood pressure
 Hormonal Regulation of Urine
Concentration and Volume
• Atrial Natriuretic Hormone
– Produced by the heart when blood
pressure increases
– Inhibits Na+ reabsorption in the kidneys,
resulting in increased urine volume and
decreased blood volume and blood
pressure
– Inhibits ADH secretion and dilates arteries
and veins
ANH and the Regulation of Na+ and Water

Fig. 23.16
 Urine Movement
• Anatomy and Histology of the Ureters
and Urinary Bladder
– The walls of the ureter and urinary bladder
consist of
• Epithelium
– Transitional epithelium permits changes in size
• Lamina propria
• Muscular coat
– Contraction of the smooth muscle moves urine
• Fibrous adventitia
 Urine Movement
• Anatomy and Histology of the Urethra
– The urethra is lined with transitional and
stratified squamous epithelium
• Males have an internal urethral sphincter of
smooth muscle that prevents retrograde
ejaculation of semen
• An external urethral sphincter of skeletal
muscle allows voluntary control of urination
 Urethra
• a. Male: 20cm long Female: 3 – 4cm long
Why are female are more prone to UTI?
• b. Two types
• i. Internal urethral sphincter (Involuntary),
keeps urethra closed.
• ii. External urethral sphincter (Voluntary)
 Anatomy and Histology of
theUrinary bladder
• a. Made of smooth muscle, known as the
Detrussor muscle
• b. Can contain 500ml of urine, maximum of
700-800mL or urine will cause dribbling.
• c. Innervated by Sacral plexus S2-S3
• d. Micturition reflex – “Voiding” urge to
pee. ,
• Although if the reflex returns, the
stimulation will be stronger
 Fig.
23.17
• Urinary bladder
anterior and inferior to
uterus
• Uterus may compress
bladder in pregnancy
• Shorter urethra
increases risk of
cystitis (urinary tract
infection)

Urinary Bladder and Urethra in

Biological Females
• Urinary bladder
located superior to
prostate gland
• Enlargement of
prostate gland may
restrict flow of urine
into urethra
• Longer urethra
passes through
prostate gland, floor
of pelvis, and penis
• Longer urethra
decreases risk of Urinary Bladder and Urethra
in Biological Males
cystitis
• Biological male urethra is
substantially longer than
biological female urethra
• Divided into three sections:
• Prostatic, membranous,
and spongy urethra

The Male Urethra (Figure

25.32)
 Types of incontinence
• a. Overflow incontinence (Atonic bladder)
• i. Inability of the bladder to contract or
empty completely
• ii. Causes: Lower SCI, fecal impaction
 Stress incontinence
• i. Normal bladder, Weakness of supporting
structure (Pelvic floor muscles)
• ii. There is an increase in abdominal
pressure
• Causes: laughing, sneezing, lifting,
exercises (Any increase in abdominal
pressure)
 Urinalysis
• Urinalysis—a test that evaluates materials
found in urine
• Abnormal components of urine:
• Protein—usually indicates damage to filtration
membrane
• Glucose—usually indicates diabetic condition
• Blood—indicates structural damage to urinary
tract
• Leukocytes—indicates urinary tract infection
• Ketones—indicates body is using fat as energy
source
 Urge incontinence (Overactive
bladder, Neurogenic bladder)
• i. Involuntary contraction of the
bladder
• ii. Hyperactive micturition reflex
• iii. Causes: bladder infection, bladder
tumor, alcohol abuse, drugs
Effects of Aging on the Kidneys
• There is a gradual decrease in the size
of the kidney
– Associated with a decrease in renal blood
flow
– The number of functional nephrons
decreases
• Renin secretion and vitamin D synthesis
decreases
• Nephron secretion and absorbtion
declines
Effect of Blood Osmolality and Pressure
on Water Intake

Fig.
23.20
1. Which of these is not a general function of the
kidneys?
a. regulation of blood volume
b. regulation of solute concentration in the blood
c. regulation of the pH of the extracellular fluid
d. regulation of vitamin A synthesis
e. regulation of red blood cell synthesis
2. The cortex of the kidney contains the
a. hilum.b. glomeruli.
c. adipose tissue.
d. renal pyramids.
e. renal pelvis.
 3. Given these structures:
(1) major calyx (3) renal papilla
(2) minor calyx (4) renal pelvis
Choose the arrangement that lists the structures in
order as urine leaves the collecting duct and travels to
the ureter.
a. 1,4,2,3
b. 2,3,1,4
c. 3,2,1,4
d. 4,1,3,2
e. 4,3,2,1
4. Which of these structures contain(s)
blood?
a. glomerulus
b. vasa recta c. distal convoluted tubule
d. Bowman capsule
5. Given these blood vessels:
(1) afferent arteriole (3) glomerulus
(2) efferent arteriole (4) peritubular
capillaries
Choose the correct order as blood
passes from an interlobular artery to an
interlobular vein.
• a. 1,2,3,4 b. 1,3,2,4 c. 2,1,4,3 d. 3,2,4,1 e.
4,3,1,2
6. Increased aldosterone causes
a. increased reabsorption of Na+.
b. decreased blood volume.
c. decreased reabsorption of Cl−.
d. increased permeability of the distal
convoluted tubule to water.
e. increased volume of urine.
7. Juxtaglomerular cells are involved in the
secretion of
a. ADH.
b. angiotensin
c. aldosterone.
D. renin.
8. Angiotensin II
a. causes vasoconstriction
b. stimulates aldosterone secretion
c. stimulates ADH secretion.
d. increases the sensation of thirst.
e. All of these are correct.
9. The urinary bladder
a. is composed of skeletal muscle.
b. is lined by simple columnar epithelium.
c. is connected to the outside of the body by
the ureter.
d. is located in the pelvic cavity.
e. has two urethras and one ureter attached
to it.
1. Which of these is not a general function of the
kidneys?
a. regulation of blood volume
b. regulation of solute concentration in the blood
c. regulation of the pH of the extracellular fluid
d. regulation of vitamin A synthesis
e. regulation of red blood cell synthesis
• ans : D
2. The cortex of the kidney contains the
a. hilum.b. glomeruli.
c. adipose tissue.
d. renal pyramids.
e. renal pelvis.

• ans : B
 3. Given these structures:
(1) major calyx (3) renal papilla
(2) minor calyx (4) renal pelvis
Choose the arrangement that lists the structures in
order as urine leaves the collecting duct and travels to
the ureter.
a. 1,4,2,3
b. 2,3,1,4
c. 3,2,1,4
d. 4,1,3,2
e. 4,3,2,1
• ans : C
4. Which of these structures contain(s)
blood?
a. glomerulus
b. vasa recta c. distal convoluted tubule
d. Bowman capsule

• ANS : B
5. Given these blood vessels:
(1) afferent arteriole (3) glomerulus
(2) efferent arteriole (4) peritubular
capillaries
Choose the correct order as blood
passes from an interlobular artery to an
interlobular vein.
• a. 1,2,3,4 b. 1,3,2,4 c. 2,1,4,3 d. 3,2,4,1 e.
4,3,1,2
• ans : B
6. Increased aldosterone causes
a. increased reabsorption of Na+.
b. decreased blood volume.
c. decreased reabsorption of Cl−.
d. increased permeability of the distal
convoluted tubule to water.
e. increased volume of urine.
ANS : A
7. Juxtaglomerular cells are involved in the
secretion of
a. ADH.
b. angiotensin
c. aldosterone.
D. renin.
• ANS : D
8. Angiotensin II
a. causes vasoconstriction
b. stimulates aldosterone secretion
c. stimulates ADH secretion.
d. increases the sensation of thirst.
e. All of these are correct.
• ANS: E
9. The urinary bladder
a. is composed of skeletal muscle.
b. is lined by simple columnar epithelium.
c. is connected to the outside of the body by
the ureter.
d. is located in the pelvic cavity.
e. has two urethras and one ureter attached
to it.
• ANS : D