Urinary System

Primary Function:
Is to maintain Homeostasis by controlling the composition, volume, and pressure of blood
Organs:
Kidneys, Ureters, Urinary Bladder, Urethra

KIDNEYS

Paired
Retroperitoneal organs (behind the peritoneum)
Surrounded by 3 layers
Renal Capsule (innermost)
Adipose Capsule
Renal Fascia

Nephrotosis- Floating Kidney

Downward displacement or dropping or dropping of the kidney

External & Internal Anatomy

Hilus-a vertical fissure found near the center of the concave medial border of the kidney
Which the ureter leaves & blood vessels, lymphatic vessels & nerves enter & Exit

Internally consist of:

~Cortex ~Medulla ~Pyramids ~Papillae ~Columns ~Calyces ~Pelves

Nephron-
Functional unit of the kidney the # is constant from birth, any injured/dead ones are not replaced
but the remaining will increase their filtering capacity to partially compensate for those lost

Blood & Nerve Supply

Blood Enters through the Renal Artery ---Exits through the Renal Vein

Renal Plexus supplies the kidney’s nerves

Nephron
Consists of
Renal Capsule-where fluid is filtered
2 components
Glomerulus- Surrounded by a double-walled epithelial cup known as a
glomerular (Bowman’s capsule)

Endothelial-capsular membrane-is the filtering unit of a nephron, which

consists of the glomerular endothelium, glomerular basement membrane and
slit membranes between pedicels of podocytes.

Renal Tubule- into which the filtered fluid passes

Consists of
Proximal convoluted tubule (PCT)
Loop of Henle (nephron loop)
Distal Convoluted tubule (DCT)

2 Types of nephrons that have differing structure & function

Cortical Nephron

Usually has its glomerulus in the outer portion of the cortex and a short loop of Henle
that penetrates only into the outer region of the medulla
 Juxtamedullary Nephron

Usually has its glomerulus deep in the cortex close to the medulla, its long loop of Henle
stretches through the medulla and almost reaches the renal papilla

Nephron Performs 3 basic functions

-glomerular filtration
-tubular reabsorption
-tubular secreation

Juxtaglomerular apparatus (JGA)

Helps regulate blood pressure and the rate of blood filtration by the kidneys

RENAL PHYSIOLOGY

Glomerular filtration

The forcing of fluids and dissolved substances through a membrane by pressure, occurs in the renal
corpuscle of the kidneys across the endothelial capular membrane.

When blood enters the glomerulus, the Blood pressure (Glomerular blood rough &
dissolved bllod componetshydrostatic pressure) forces water though the endothelial fenestrations
(pores) of the capillaries, basement membrane, and on through the filtration slits of the adjoining
visceral wall of the glomerular capsule. Fluid is known as GLOMERULAR FILTRATE

Filtration fraction is the % of plasma entering the kidneys that becomes glomerular filtrate.

Most Solutes in blood plasma (Except PROTIENS) enter glomerular filtrates normally blood cells
and proteins are not filtered.

Filtrations of blood is promoted by

GLOMERULAR BLOOD HYDROSTATIC PRESSURE (GBHP)
And is opposed by
CAPSULAR HYDROSTATIC PRESSURE (CHP) &
BLOOD COLLOID OSMOTIC PRESSURE (BCOP)

Net Filtration Pressure (NFP) is about 10 mm Hg

Glomerular filtration rate (GFR) is amount of filtrate formed in both kidney’s per min. In a adult
125/min about 180 liters in a day

If glomerular blood hudrostatic pressure falls to 45mm Hg (Normal 55 mm Hg) filtration stops
because glomerular blood hydrostatic pressure = opposing pressures. Causing: ANURIA
production of less than 50ml/day of urine.

Glomerular blood flow depends on

RENAL AUTOREGULATION
HORMONAL REGULATION (Angiotensin II and Atrial natriuretic peptide ANP)
NEURAL REGULATION

TUBULAR Reabsorption (Reabsorption)

Is the movement of water and certin components of the filtrate back into the blood.
It retains substances needed by the body including Water, Glucose, Amino Acids & ions
such as sodium, potassium, calcium chloride, bicarbonate and phosphate.
99% of glomerular filtrate is reabsorbed

Reabsorption of sodium ions is especially important because more of them pass in the glomerular
filter than any other substance except water. The Na + ions are reabsorbed in each portion of the
renal tube by several transport systems
 Active transport of Na+ promotes reabsorption of water by osmosis. 65% of the filtered water is
reabsorbed in the proximal convoluted tube.

The loss of H20 from the filtrate creates a concentration gradient for some substances such as K=
Cl- HCO3- and urea, their reabsortion is due to passive diffusion.

Transport Maximum (Tm) which is the limit on how fast a symporter can work.

GLUCOSURIA- the condition in which the blood concentration of glucose is above normal/ or
there is a malfunction in the tubular carrier mechanism where the glucose cant be reabsorbed.

THE LOOP OF HALENE reabsorbs 30% of the filtered K+ 20% Na+ 35% Cl- and 15% of H20

2 Hormones Aldosterone and ADH regulate reabsorption in the final portion of the DCT and the
collecting ducts.

90% of total h20 reabsorption occurs via Osmosis accompanying reabsorption of solutes such as
Sodium and glucose known as Obligatory Water Reabsorption. The 10% remaining is Facultative
Wter Reabsorption and is regulated by ADH.

TUBULAR SECREATION (SECREATION)

Movement of materials from blood or tubule cells into tubular fluid.

Secretes ions such as K+ H+ NH4+ wastes such as Urea & Creatine

2 Effects
1) It gets rid of certain materials
2) helps control blood pH by secreting H+ and increasing / decreasing HCO3- production

PRODUCTION OF DILUTE & CONCETRATED URINE

The rate at which water is lost from the body depends mainly on ADH which controls water permeability of
principal cells in the collecting duct known as “Counter Controlled Mechanism”

Low ADH = kidneys produce dilute urine and excrete excess water

High ADH = kidneys secrete concentrated urine and conserve water

Diuretics are drugs that increase urine flow rate.

EVALUATION OF KIDNEY FUCNTION

Different screening test

Blood Urea Nitrogen (BUN)
Which measures the level of nitrogen in the blood that is part of urea.

Renal plasma clearance

Expresses how effectively the kidneys remove substances from blood plasma

Clearance of INSULIN gives the GLOMERULAR FILTRATION RATE

Clearance of Para-aminohippuric acid gives rate of RENAL PLASMA FLOW

HEMODIALISIS THERAPY

Is a filtering of blood though a artificial kidney machine which filters blood of wastes and adds nutrients. A
portable version is known as CAPD Continuous ambulatory peritoneal dialysis.
URETERS
Are retroperitoneal & consist of mucosa, mucosa, muscularis, and fibrous coat.

Transport urine from the renal pelvis to the urinary bladder by peristalsis but hydrostatic pressure and gravity
also contribute to this transport.

Renal Caliculi- are kidney stores which are insoluble stones formed by crystal of salts present in urine.

URINARY BLADDER

Is located in the pelvic cavity and it functions to store urine before micturition (how urine is expelled from the body)

Tigone the floor of the urinary bladder is shaped like a triangle

Internal Urethral sphincter- is the opening of the urethra which consists of cirucular fibers of the muscularis

External Urethral Sphincter which consists of skeletal muscles (voluntary)

Micturition Reflex- is the volume of urine in the bladder reaches a certain amount (200-400ml) stretch
receptors in the urinary bladder wall transmit impulses that initiate micturition.

Incontinence- lack of control over micturition

URETHRA

Tube leading from the floor of the urinary badder to the exterior
3 coats in females and 2 coats in males

Function is to discharge urine from the body (in general)

URINALYSIS

The by-product of the kidneys’ activities is urine

Healthy person, urine volume pH and solute concentration vary with the needs of the internal environment.

Under certain pathological conditions, the characteristics of urine may change drastically.

Volume color turbidity odor pH and specific gravity are physical characteristics that are looked at
when analyzing urine

Chemically 95% is water 5 % solutes

Abnormal constituents analized in urinalysis

Albuminuria-albumin
Glucosuria-glucose
Hematuria- erythrocytes
Pyuria-leucocytes
Ketosis/Acetonuria-Ketones
Billirubinuria-bilirubin
Urobilinogenuria- urobillinogen

AGING & THE URINARY SYSTEM

After 40 the effectiveness of kidney fuction begins to decrease
Common problems are incontinence and UTI’s
DISORDERS:

UTI-
used to describe either infection of a part of the urinary system or presence of large numbers of
microbes in the urine.
Significant bacteriuria-presence of bacteria
Asymptomatic bacteriuria-multiplication of large # of bacteria w/o symptoms
Urethritis-inflammation of the urethra
Cystitis-inflammation of the urinary bladder
Pyelonephritis- inflammation of the kidney’s

Glomerulonephritis (Bright’s disease)-is a inflammation of the glomeruli of the kidney

Nephrotic syndrome-characterized by protein in the urine due to increased endothelia-capsular
membrane permeability

Renal failure-a reduction of cessation of glomerular filtration

Acute renal failure ARF

A progressive and generally irreversible decline in the glomerular filtThe

kidneys abruptly stop working entirely or almost entirely the main feature is
suppression of urine flow usually characterized by OLIGURIA

Chronic renal flailure CRF

Refers to a progressive and generally irreversible decline in glomerular

filtration rage that may result from chronic glomerulonephritis leading up to
loss of kidney tissue.

Polycystic Kidney disease

is the most common inherited disorder of the kidneys it is often asymptomatc

until adulthood but then may progress into renal failure

Diabetes insipidus

Is characterized by excretion of a large volume of very dilute urine. Inadeuate

secretion of ADH or an insensitivity of the renal collecting ducts to stimulation
by ADH