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ANATOMY AND PHYSIOLOGY OF THE URINARY SYSTEM

FUNCTIONS:

1. Excretion- removes waste products, many of which are toxic, from the blood.
2. Regulation of blood volume and blood pressure- the kidneys play a major role in
controlling the extracellular fluid volume in the body by producing either a large
amount of diluted urine or small amount of concentrated urine.
3. Regulation of the concentration of solutes in the blood- kidneys help regulate the
concentration of major molecules and ions such as glucose, cl, na, k, hco3, hpo4
4. Regulation of extracellular fluid ph- secretes variable amounts of h+ to help regulate
extracellular fluid ph.
5. Regulation of red blood cell synthesis- kidneys secrete a hormone, Erythropoietin,
which regulates the synthesis of rbc in bone marrow
6. Vitamin D synthesis-kidneys play an important role in controlling blood levels of Ca
by regulating the synthesis of vit. D.

ANATOMY OF THE URINARY SYSTEM

I. KIDNEYS
– Bean-shaped organs, each about the size of a tightly clenched fist. They lie on the
posterior abdominal wall, behind the peritoneum, with one kidney on either side of
the vertebral column.

Internal and external structures of the kidney:

A. RENAL CAPSULE - A connective tissue that surrounds each kidney. Around it is


a thick layer of fat which protects the kidney from mechanical shock.
B. HILIUM- located at the middle side of the kidney where the renal artery and
nerves enter and where the renal vein and ureter exit the kidney.
C. The kidney is divided into an OUTER CORTEX and INNER MEDULLA which
surrounds the renal sinus.
D. RENAL SINUS- a cavity which contains blood vessels. Part of the system for
collecting urine and fat.
E. RENAL PYRAMIDS- located at the boundary between the cortex and the
medulla, and its tips project toward the center of the kidney.
F. CALYX- a funnel- shaped structure which surrounds the tip of each renal
pyramid.
G. RENAL PELVIS- a larger funnel wherein calyces from all the renal pyramids
join. It then narrows to form small tubule called ureter, which exits the kidney and
connects to the urinary bladder.
H. NEPHRON- the functional unit of the kidney. There are approximately 1.3
million of them in each kidney.
-fluid enters the renal corpuscle and the flows in the prximal tubule. Fr. There it
flows into the loop of henle. The fluid flows through the ascending loop of henle
to the distal tubule. Many tubules empty into a collecting duct, which carries ducts
empty into a papillary duct, and the papillary ducts empty their contents to the
calyx.
• RENAL CORPUSCLE- Consist of:
➢ Bowman’s capsule- consist of enlarge end of the nephron, which
indented to form a double- walled chamber. The inner layer of it
consist of padocytes, which wrap around the glomerular capillaries.
The outer layer of it consist of simple squamous epithelial cells.
➢ Glomerulus- a tuft of capillaries which occupies the indention,
which resembles a ball of a yarn.
• PROXIMAL TUBULE
• LOOP OF HENLE- Consist of:
➢ Thin Ascending limb- permeable to solutes but not water which
pass through the walls of the nephron through diffusion.
➢ Thin descending limb- permeable to water and solutes which pass
through the walls of the nephron through diffusion.
• COLLECTING DUCT
• PAPILLARY DUCT

I. ARETERIES AND VEINS:

RENAL ARTERIES- branch off the abdominal area and enter the kidneys.

➢ Interlobular arteries- pass between the renal pyramids and give rise
to arcuate arteries, which arch between the cortex and medulla.
➢ Afferent arterioles- arise from the branches of the interlobular
arteries and extend to the glomerulus.
➢ Efferrent arterioles- extend from the glomerular capilliaries to the
peritubular capillaries (around the tubes), which surround the
proximal and distal tubules and the loop of henle.
➢ Vasa recta- specialized portions of peritubular cappilaries that
extend deep into the medulla of the kidney and surrounds the loop
of henle and collecting ducts.

JUXTAGLOMERULAR APPARATUS- formed where the distal tubule comes into contact
with the afferent arteriole. It consists of specialized cells of the walls of the distal tubules and
collecting ducts. These cells secrete renin and play an important role in blood pressure
regulation.

I. URETERS
– Are small tubules that carry urine from the renal pelvis of the kidney to the posterior
inferior portion of the urinary bladder.

I. URINARY BLADDER
– A hollow muscular container that lies in the pelvic cavity just posterior to the
symphysis pubis. It functions to store urine, and its size depends on the quantity of
urine present. It can hold from a few milliliters to a maximum about 1000 ml of urine.
– When the urinary bladder reaches a volume of a few hundred bladder ml, the wall of
the urinary is stretched enough to activate a reflex that causes the smooth muscle of
the urinary bladder to contract, and most of the urine flows out of the urinary bladder
through the urethra.

I. URETHRA
– The tube that exits the urinary bladder inferiorly and anteriorly. It carries urine from
the bladder to the outside of the body.
-at the junction of the urinary bladder and uretha, the smooth muscles of the bladder
wall forms the INTERNAL URINARY SPHINCTER in MALES. None in FEMALE.
Elastic fibers at the junction of the urinary bladder and urethra keep urine from
passing through the urethra until the urinary bladder pressure increases.
INVOLUNTARY CONTROL- males.
- external urinary sphincter-formed of skeletal muscle the sorrounds the urethra as the
urethra extends through the pelvic floor. VOLUNTARY control.

THREE PROCESSES IN URINE FORMATION:

1. FILTRATION- the movement of materials across the filtration membrane into the
bowman’s capsule to form filtrate.
-blood cells and protein which are too large to pass through the filtration membrane.
- Filtrate contains no cells and small amount of protein.
2. REABSORPTION- solutes are reabsorbed across the wall of the nephron into the
interstitial fluid by transport processes, such as active transport and cotransport.
– Water is reabsorbed across the wall of the nephron by osmosis.
– Water and solutes pass the interstitial fluid into the peri tubular capillaries.
– About 99% of the original filtrate volume is reabsorbed and enters the peritubular
capillaries. The reabsorbed filtrate flows through the renal veins to enter general
circulation.
– PROXIMAL TUBULE- primary site of reabsorption of solutes ad water. 65% of
filtrate volume is reabsorbed by it.
– DESCENDING LOOP OF HENLE- it concentrate the urine. 15%
– THIN SEGMENT OF DESCENDING LOH- is permeable to water and moderately
permeable to solutes.
– As the filtrate passes through the d. Limb of loh into the medulla of the kidney, water
moves out of the nephron by OSMOSIS and some solutes move into the nephron by
DIFFUSION.
– ASCENDING LOH- functions to DILUTE the filtrate by removing solutes.
– THIN ASCNDING limb- NOT Permeable to water, but permeable to solutes. As a
result, NA, K, CL but little water are removed from the filtrate.
– The cuboidal cells of the THICK ASCENDING LIMb actively transport NA+ OUT
of nephron, and K+ and Cl- are cotransported with na+.
1. SECRETION- solutes are secreted across the wall of the nephron into the filtrate.

REGULATION OF URINE CONCENTRATION AND VOLUME


➢ If the body fluid concentration increases above normal levels, the kidneys produce a
smaller than normal amount of concentrated urine. This eliminates solutes and
conserves water, both which help to lower the body fluid concentration back to
normal. On the other hand, if the body fluid concentration decreases, the kidneys
produce large volume of dilute urine. As a result, water is lost, solutes are conserved
and the body fluid concentration increases.
➢ As increase in blood volume can increase blood pressure, and a decrease in blood
volume can decrease blood pressure. When blood volume increases above normal, the
kidneys produced large volume of urine. The loss of water in the urine lowers blood
volume.

A. Hormonal Mechanisms
• Antidiuretic hormone (ADH) - it is secreted by the posterior pituitary gland
through the regulation of the hypothalamus, passes through the circulatory
system to the kidneys.
-It regulates the amount of water reabsorbed by the distal tubules and
collecting ducts.
When adh level INCREASE, the permeability of the distal tubules and
collecting ducts to water INCREASES, and the more water is reabsorbed from
the filtrate.- less water lost in the urine
When adh level DECREASE, the permeability of the distal tubules and
collecting ducts to water decrease and less water is reabsorbed from the
filtrate.- more water lost in the urine.
• Renin- Angiotensin- Aldosterone
-Renin and Angiotensin help regulate aldosterone secretion.
- Renin is secreted by cells of the juxtaglomerular apparati in the kidneys. It is
an enzyme that acts on a protein produced by the liver called angiotensin.
Amino acid are removed from angiotensin, leaving angiotensin I. Angiotensin
I is rapidly converted by angiotensin- converting enzyme (ACE). Angiotensin
II acts on the adrenal cortex causing it to secrete aldosterone.
- Aldosterone increases the rate of active transport of sodium in the distal
tubules and collecting ducts.
Stimulation of r-a-a INCREASE ALDOSTERONE therefore increase NA+
reabsorption in the distal and collecting ducts; less NA and water are lost in
the urine.
Inhibition on r-a-a DECREASE ALDOSTERONE therefore Decreased NA+
reabsoprtion in the d. Tubule and c. Duct.; more NA+ and water are lost in the
urine.
• Atrial Natriuretic Hormone
-is secreted from cardiac muscle cells in the right atrium of the heart when
blood pressures in the right atrium increases above normal values.
-it acts on kidneys to decrease sodium reabsorption.
Decrease ANH secretion increase NA reabsorption in the distal and collecting;
less na and water are lost in the urine
Increase ANH secretion decrease NA reabsorption in the d. Tubule and c.
Tube; more na and water are lost in the urine

B. Sympathetic Innervation on Kidney Function

• Sympathetic neurons with norepinephrine as their neurotransmitter substance


innervate the blood vessesl of the kidney.
Increase sympathetic stimulation results in vasodilation of renal arteries;
decreased renal blood flow decreases the rate of filtrate and less water is lost
in the urine.
Decrease sympathetic stimulation results in vasodilation of the renal arteries;
increased renal blood flow increases water and na loss in the urine.

BODY FLUID COMPARTMENTS

A. Intracellular compartment- includes fluids inside the cells of the body. Approximately
2/3 of all water in the body is in the intracellular fluid compartment.
B. Extracellular compartment- includes all fluids found outside the cells. It constitutes
approximately 1/3 of total body water. It includes the interstitial fluid, the plasma
within the blood vessels and fluid in the lymphatic vessels.

COMPOSITION OF FLUIDS IN THE BODY FLUID COMPARTMENT

➢ The intracellular fluid contains relatively high concentration of ions such as


potassium, magnesuim, phosphate, and sulfate ions, compared with extracellular fluid.
But it has a lower concentration of sodium, calcium, chloride, bicarbonate and protein
than that of the extracellular fluid.

EXCHANGE BETWEEN BODY FLUID COMPARTMENT

➢ The major influence controlling the movement of water between the intracellular and
extracellular spaces is osmosis.

REGULATION OF EXTRACELLULAR FLUID COMPOSITION

A. THIRST
➢ Water intake is controlled by neurons in the hypothatlamus, collectively called thirst
center.
➢ When the concentration of the blood increases (increased osmolality), the thirsr center
responds by initiating the sensation of thirst. When water or some other dilute solution
is consumed, the concentration of the blood decreases, and the sensation of the thirst
also decreases.

A. IONS
-the kidney function to regulate the composition of extracellular fluid. If water content
or concentration of ions in the extracellular fluid deviates from its normal range, cell
cant control the substances across their cell membranes or the composition of their
intracellular fluid. As a consequence abnormal cell function or cell death could
happen.
a. Sodium ions
-major ions in the extracellular fluid.
-the kidneys provide the major route by which the excess sodium is excreted.
-stimuli that control aldosterone secretion influence the reabsorption of
sodium from nephrons of the kidneys and total amount of sodium in the body
fluids.
-it is also secreted from the body in sweat.
-the mechanism that play important roles in controlling sodium are the
ADH,ANH and renin- angiostenin- aldosterone secretion.

b. Potassium ions

- aldosterone play a major role in regulating the concentration of potassium in


the extracellular fluid.

- dehydration, circulatory system shock resulting from plasma loss and tissue
damage due to injuries such as severe burns, all cause the extracellular
potassium to become more concentrated than normal. In response, aldosterone
secretion from the adrenal cortex increases and causes potassium secretion to
increase in the distal tubules and collecting ducts of kidney into the urine.

c. Calcium ions
- decreased extracellular calcium concentration make the cell membranes
more permeable to sodium, thus making them more electrically excitable. It
causes spontaneous action potentials in nerve and muscle cells, resulting in
hyperexcitability and tetany of muscles. Increased extracellular calcium
concentrations make cell membranes less permeable to sodium, thus making
them less electricity excitable. It inhibits action potentials in nerve and muscle
cells, resulting in reduced excitability and either muscle weakness or paralysis.

-PTH is secreted by parathyroid gands.

-pth causes osteoclast to degrade bone and relase CA+ into the body fluids. It
also increases the rate of reabsorption fron the kidney nephron.

- vit D increases ca+ concentration in the blood by increasing the rate of ca+
absorption bt the intestine.

-CALCITONIN- sereted by thyroid gland. It reduces blood ca+ concentration


when it is too high.and inhibits its secretion if the Blood ca+ is too low.

d. Phosphate and sulfate ions

-they are reabsorbed by active transport in the kidneys. The rate of


reabsorption is slow so that, if the concentration of these ions in the filtrate
exceeds the ability of the nephron to reabsorb them, the excess is excreted to
the urine. As long as the concentration of these ions are low, nearly all of them
are reabsorbed by active transport.
REGULATION OF ACID- BASE BALANCE

The kidney is one of the factors that could control the ph body fluids.

Buffers

-Are chemicals that resist a change in pH of a solution when either acids or bases are
added to the sloution.
- Protein and phosphate ions in the body fluids combine with a large number of
hydrogen. When the hydrogen conecntration increases, protein and phosphate
combine with hydrogen to prevent a decrease in pH. Conversely, when hydrogen
concentration decreases, protein and phosphate release hydrogen to prevent increase
in pH.

B. Respiratory System

- increasing carbon dioxide levels and decreasing body fluid pH stimulate neurons in
the respiratory center of the brain and cause the rate and depth of ventilation to
increase. As a result of increased rate and depth of ventilation, carbon dioxide is
eliminated from the body through the lungs at the greater rate, and the concentration
of carbon dioxide in the body fluids decreases. As carbon dioxide levels decline, the
concentration of hydrogen also declines. The pH therefore increases back to its
normal range.

- if carbon dioxide levels become too low or the pH of the body fluids is elevated, the
rate and depth of respiration decline. As a consequence, the rate at which carbon
dioxide is eliminated from the body is reduced. Carbon dioxide then accumulates in
the body fluids because it is continually produced as a by- product of metabolism. As
carbon dioxide accumulate in the body fluids, so do hydrogen, resulting in a decrease
pH.

C. Kidneys

-the nephrons of the kidneys secrete hydrogen in to the urine and therefore can
directly regulate pH of the body fluids. Cells in the wall of the distal tubule are the
primary responsible in the secretion of hydrogen.

-As the pH of the body fluids decreases below normal, the rate at which the distal
tubules secrete hydrogen increases. At the same time, reabsorption of bicarbonate
increases. On the other hand, as the body fluid pH increases above normal, the rate of
hydrogen secretion by the distal tubules declines and the amount of bicarbonate lost in
the urine increases. Consequently, the blood pH decreases toward its normal value.