Urinary SystemAnatomy and Physiology

Maj Mujahid Ali Khoso AFIU

Functions of the Kidney: Maintaining balance

Regulation of body fluid volume and osmolality Regulation of electrolyte balance Regulation of acid-base balance Excretion of waste products (urea, ammonia, drugs, toxins) Production and secretion of hormones Regulation of blood pressure

Organisation of the Urinary System

Kidneys Ureters Urinary bladder Urethra

Surface anatomy of the Kidney

Hilum is located on the medial surface
10 cm

3cm

5.5cm
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The Kidney and the Nephron

A.
B. C. D.

Renal Vein
Renal Artery Ureter Medulla

E.
F. 1.

Renal Pelvis
Cortex Ascending loop of Henle

2.
3.

Descending loop of Henle

Peritubular capillaries

4.
5. 6.

Proximal tubule
Glomerulus Distal tubule

The Nephron
Functional unit of the kidney (1,000,000) Responsible for urine formation:
Filtration Secretion Reabsorption

Components of the nephron Glomerulus

Afferent and Efferent arterioles Proximal Tubule Loop of Henle Distal Tubule Collecting Duct

Overview of nephron function

From http://www.emc.maricopa.edu/faculty/farabee/BIOBK/BioBookEXCRET.html

The Formation of Urine

3 processes involved in the formation of urine.
Simple filtration Selective reabsorbtion
Hormonal control Parathyroid hormone, calcitonin Anti diuretic hormone Aldosterone

Secretion
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Properties of Normal Urine

pH: 4.5-8 Water content: 93-97% Volume: 1200 mL/day Color: clear yellow Odor: varies with composition Bacterial content: sterile

Filtration

THE GLOMERULUS

Glomerular Filtration Rate (GFR)

Measure of functional capacity of the kidney Dependent on difference in pressures between capillaries and Bowmans space Normal = 120 ml/min =7.2 L/h=180 L/day!! (99% of fluid filtered is reabs.)

Reabsorption and secretion

Reabsorption
Active Transport requires ATP
Na+, K+ ATP pumps

Passive Transport Na+ symporters (glucose, a.a., etc) Na+ antiporters (H+) Ion channels Osmosis

Factors influencing Reabsorption

Saturation: Transporters can get saturated by high concentrations of a substance failure to resorb all of it results in its loss in the urine (eg, renal threshold for glucose is about 180mg/dl). Rate of flow of the filtrate: affects the time available for the transporters to reabsorb molecules.

Secretion
Proximal tubule uric acid, bile salts, metabolites, some drugs, some creatinine Distal tubule Most active secretion takes place here including organic acids, K+, H+, drugs, Tamm-Horsfall protein (main component of hyaline casts).

Hormones Produced by the Kidney

Renin:
Released from juxtaglomerular apparatus when low blood flow or low Na+. Renin leads to production of angiotensin II, which in turn ultimately leads to retention of salt and water.

Erythropoietin:
Stimulates red blood cell development in bone marrow. Will increase when blood oxygen low and anemia (low hemoglobin).

Vitamin D3:
Enzyme converts Vit D to active form 1,25(OH)2VitD. Involved in calcium homeostasis.

Renin/AII and Regulation of GFR

GFR = Kf(PGC - PBS - COPGC)

flight or fright
sympathetic tone afferent arteriolar constriction (divert cardiac output to other organs) PGC GFR and renal blood flow

Renin/AII and Regulation of GFR

GFR = Kf(PGC - PBS - COPGC)

Low BP sensed in afferent arteriole or low Na in distal tubule

renin released renin converts angiotensinogen to Angiotensin I ACE converts AI to AII efferent > afferent arteriolar constriction PGC GFR (this is AUTOREGULATION of GFR) constricts

PGC

Aldosterone
Secreted by the adrenal glands in response to angiotensin II or high potassium Acts in distal nephron to increase resorption of Na+ and Cl- and the secretion of K+ and H+ NaCl resorption causes passive retention of H2O

Anti-Diuretic Hormone (ADH)

Osmoreceptors in the brain (hypothalamus) sense Na+ concentration of blood. High Na+ (blood is highly concentrated) stimulates posterior pituitary to secrete ADH. ADH upregulates water channels on the collecting ducts of the nephrons in the kidneys. This leads to increased water resorption and decrease in Na concentration by dilution

Ureters Superiorly
Continuous with the renal pelvis

Inferiorly
Pass through the abdominal cavity, behind the peritoneum, infront of the psoas muscle, into the pelvic cavity ehere they enter the posterior wall of the bladder

25-30 cm in length
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Bladder

26

Bladder- structure of
3 layers
Outer layer
Loose connective tissue

Middle layer
Smooth muscle and elastic fibres

Inner layer
Lined with transitional epithelium
27

Urethra
Extends from the base of the bladder to the outside world. Anatomical differences mean that male and female urethras are different.
Female: long Male: long 4cm 14cm
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