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Excretory System

Functions of the Urinary System

The principal function of the kidney is to filter blood in order to remove


cellular waste products from the body.
The kidney has other functions but it is usually associated with the excretion
of cellular waste such as :
1) urea (a nitrogenous waste produced in the liver from the breakdown of
protein. It is the main component of urine) ;
2) uric acid (usually produced from breakdown of DNA or RNA) and
3) creatinine (waste product of muscle action).
Kidneys are the primary excretory organ but other organs also function in
excretion: skin, liver and lungs
Kidneys produce urine
Urine contains 95% water plus nitrogen water and inorganic salts
Nitrogenous wastes are products of metabolism of amino acids and
nucleotides
Amino acid metabolism produces urea as main nitrogenous end products
in humans

Functions of the Urinary System

Storage of urine
Excretion of urine.
At any given time, 20 % of blood is in the kidneys. Humans can function with one kidney.
They are one of the major homeostatic organs of the body.
They control water pH, secrete erythropoietin (a hormone that stimulates red blood cell
production) and activate vitamin D production in the skin.
Blood volume regulation.
the kidneys control the volume of interstitial fluid and blood under the direction of certain
hormones
Regulation of erythrocyte production.
as the kidneys filter the blood, they are also indirectly measuring the oxygen level in the
blood
Erythropoietin (EPO): hormone produced by kidney
Released if blood oxygen levels fall
Stimulates RBC production in red bone marrow

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Urinary System Anatomy

Kidneys contribute to homeostasis, producing urine to rid body of


nitrogenous wastes and keeping pH and salt/water balance of blood within
normal range
The Path of Urine
Kidneys
Located on either side of the vertebral column just below the
diaphragm
Function is to produce urine
Ureters
Muscular tubes that run from the kidney to the bladder
Transport urine by peristaltic contractions
Urinary Bladder
Hollow muscular organ expands as urine enters
Capacity of up to 600mL of urine
Controlled by two sphincters where the urethra joins the bladder
Urethra
Duct that transports urine from urinary bladder to the external
opening

Urinary System Anatomy

Urinary System Anatomy

The Kidney

Each kidney is composed of three


sections:
the outer (renal) cortex, the (renal)
medulla (middle part)
the hollow inner (renal) pelvis.
The cortex is where the blood is
filtered.
The medulla contains the
collecting ducts which carry
filtrate (filtered substances) to
the pelvis.
The pelvis is a hollow cavity
where urine accumulates and
drains into the ureter.

Kidneys: Gross and Sectional Anatomy

Retroperitoneal
Anterior surface covered with peritoneum
Posterior surface against posterior abdominal wall
Superior pole: T-12
Inferior pole: L-3
Right kidney ~ 2cm lower than left
Adrenal gland on superior pole
Hilum: concave medial border
Renal sinus: internal space
Houses blood vessels, lymphatic vessels, nerves
Houses renal pelvis, renal calyces
Also fat
Surrounding tissues, from deep to superficial:
Fibrous capsule (renal capsule)
Dense irregular CT
Covers outer surface
Perinephric fat (adipose capsule)
Also called perirenal fat
Completely surrounds kidney
Cushioning and insulation
Renal fascia
Dense irregular CT
Anchors kidney to posterior wall and peritoneum
Paranephric fat
Between renal fascia and peritoneum

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Kidneys are retroperitoneal organs


Superior lumbar region of posterior abdominal wall

Lateral surface is convex


Medial surface is concave
Hilus* is cleft: vessels, ureters and nerves enter and leave

Adrenal glands* lie superior to each kidney


(the yellow blob in pic)

*
*

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Transverse sections
show retroperitoneal
position of kidneys

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Kidneys: Gross and Sectional Anatomy

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Kidneys: Gross and Sectional Anatomy

Sectioned on a coronal plane:


Renal Cortex
Renal arches
Renal columns
Renal Medulla
Divided into renal pyramids
8 to 15 per kidney
Base against cortex
Apex called renal papilla
Minor calyx:
Funnel shaped
Receives renal papilla
8 to 15 per kidney, one per pyramid
Major calyx
Fusion of minor calyces
2 to 3 per kidney
Major calyces merge to form renal pelvis
Renal Lobe
Pyramid plus some cortical tissue
8 to 15 per kidney

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Blood Supply to the Kidney

About 20 to 25% of cardiac output to kidneys


Path:
Renal artery to segmental arteries to interlobar arteries to arcuate arteries to interlobular
arteries to:
Afferent arteriole to glomerulus to efferent arteriole to peritubular capilaries and vasa recta
Blood plasma is filtered across the glomerulus into the glomerular space.
Once the blood plasma is filtered
blood leaves the glomerulus
enters an efferent arteriole.
efferent arteriole is still carrying oxygenated blood
a gas and nutrient exchange with the kidney tissues has not yet occurred.
The efferent arterioles branch into one of two types of capillary networks:
peritubular capillaries
vasa recta
these capillary networks are responsible for the actual exchange of gases and nutrients
Peritubular capillaries: primarily in cortex
Vasa recta: surround the thin tubes that project into the medulla.
Path for veins:
Interlobar veins to arcuate veins to interlobar veins to the renal vein

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The Arteries
Aorta gives off right and left renal arteries
Renal arteries divides into 5 segmental arteries as enters hilus
of kidney
Segmentals branch into
lobar arteries
Lobars
divide
into
interlobars
Interlobars into arcuate in
junction of medulla and
cortex
Arcuates send interlobular
arteries into cortex
Cortical radiate arteries
give rise to glomerular
arterioles
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Vasculature of the kidney

The glomerular capillary bed is unusual in having


arterioles going both to it and away from it (afferent and
efferent), instead of a vein going away as most
It is also unusual in having two capillary beds
in series
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(one following the other)

Vessels

Afferent and efferent arterioles associated with glomerular capillaries


Allows high pressure for forcing filtrate out of blood
About 20% of renal plasma flow is filtered each minute (125 ml/min): this is the
glomerular filtration rate (GFR), an important clinical measure of renal function
This is about one liter every 8 minutes (only 1% ends up as urine)

Peritubular capillaries arise from efferent arterioles


Absorb solutes and water from tubule cells

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The Vasa recta

The Vasa recta is a portion of


the
peritubular
capillary
system which enters the
medulla where the solute
concentration
in
the
interstitium is high.
It acts with the loop of Henle to
concentrate the urine by a
complex
mechanism
of
counter current exchange
using urea.
If the vasa recta did not exist,
the high concentration of
solutes in the medullary
interstitium would be washed
out.

____vasa recta
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Innervation of the Kidney


innervated by a mass of autonomic nervous system fibers
called the renal plexus.
The renal plexus
accompanies each renal artery
enters the kidney through the hilum.

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How blood is Filtered

The filtering units of the kidneys are the nephrons.


There are approximately one million nephrons in each kidney.
The nephrons are located within the cortex and medulla of each kidney.
The tubes of the nephron are surrounded by cells and a network of blood vessels
spreads throughout the tissue. Therefore, material that leaves the nephron enters the
surrounding cells and returns to the bloodstream by a network of vessels.
Each nephron consists of the following parts:
1) glomerulus ;
2) Bowmans capsule ;
3) proximal tubule ;
4) loop of Henle ;
5) distal tubule ;
6) collecting duct.

Nephrons

Cortical Nephrons
Near peripheral edge of cortex
Short nephron loops
Have peritubular capillaries
Juxtamedullary nephrons
Near corticomedullary border
Long nephron loops
Have vasa recta
The functional filtration unit in the kidney.
Consists of the following:
Renal corpuscle
Glomerulus
Glomerular capsule (Bowmans capsule)
Proximal convoluted tubule (PCT)
Nephron loop (loop of Henle)
Ascending loop of Henle
Descending loop of Henle
Distal convoluted tubule (DCT)
collectively called the renal tubule
In both kidneys: approximately 2.5 million nephrons.
Are microscopic: measure about 5 centimeters in length.

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Renal Corpuscle

Vascular pole
Afferent and efferent arterioles
Tubular pole
Connects to PCT
Two structures:
Glomerulus and glomerular capsule
Glomerulus
Capillary bed
High pressure
fenestrations
Glomerular Capsule
Parietal layer
Simple squamous epithelium
Visceral layer
Podocytes
Pedicels
Filtration slits
Capsular space (Bowmans capsule): location of filtrate
Filtration membrane
Fenestrations
Filtration slits

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Proximal Convoluted Tubule

Begins at tubular pole of the renal corpuscle.


Cells: simple cuboidal epithelium
actively reabsorb from the filtrate:
almost all nutrients (glucose and amino acids)
electrolytes
plasma proteins
Osmosis: reabsorption of 60% to 65% of the water in filtrate.
Have microvilli

Solutes and water:

moved into blood plasma

via the peritubular capillaries.


Has large surface area for tubular reabsorption
Tubular reabsorption is the transfer of water and solutes from the nephron to the surrounding capillaries
Cells have many mitochondria to supply energy for active transport
Found within the renal medulla

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Loop of Henle

Descending loop of Henle allows the reabsorption of


water
Ascending loop of Henle in impermeable to water
originates at end of proximal convoluted tubule
projects toward and/or into the medulla.
Each loop has two limbs.
descending limb:
from cortex toward and/or into the medulla
ascending limb:
returns back to the renal cortex

Distal Convoluted Tubule


begins at the end of the thick ascending limb of the nephron
loop
adjacent to the afferent arteriole (important physiologically)
Juxtaglomerular apparatus.

primary function:
Secretion
From blood plasma to filtrate.
secretes ions
potassium (K+)
acid (H+)

Reabsorption of water also occurs:


influenced by two hormones
Aldosterone
antidiuretic hormone (ADH).
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Collecting Collecting Ducts


Function in a well hydrated person:
transport the tubular fluid into the papillary duct and then into the minor
calyx.

Function in a dehydrated person:


water conservation
more-concentrated urine is produced.

ADH can act on the collecting duct epithelium


Cells become permeable to water
Water moves from filtrate into blood plasma
Involves vasa recta.

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Blood Flow Through the Nephron


Renal Artery brings waste filled blood into the
kidney
Afferent arteriole is a dilated blood vessel
leading into the glomerulus
Glomerulus is a ball of capillaries responsible
for blood filtration
Efferent arteriole is a constricted blood vessel
leaving the nephron
Blood collects in the venules that joins the renal
vein

Bowmans Capsule

Bowmans capsule is a cup-like structure that encloses the glomerulus


Collects filtrate from the glomerulus
Process is called glomerular filtration
Found within the renal cortex

Filtration
The first event to occur in urine formation is
filtration of the blood
Filtrate will include mostly water and
dissolved solutes including wastes and
nutrients
Afferent arteriole is dilated, which increases blood
volume and pressure into the glomerulus
Efferent arteriole is constricted, which increases
pressure as blood backs up in the glomerulus
Filtrate is collected by the Bowmans capsule

You need a minimum of 70mmHg of systolic


pressure for proper filtration to occur
Extremely high blood pressure can damage
the glomerulus and allow RBC and proteins
to pass into the nephron

Urine Solute Concentration


The nutrients and salts in the filtrate need to be
reabsorbed into the bloodstream. This
process includes:
60% of the solutes are reabsorbed by active
transport at the proximal convoluted tubule
20% is reabsorbed by active transport at the loop of
Henle
The remaining 20% is either reabsorbed at the
distal convoluted tubule or excreted as part of the
urine

Juxtaglomerular apparatus

Regulation of blood pressure


Granule (jg cells) modified muscle cells secreting renin in response to
falling blood pressure in afferent arteriole
Macula densa chemoreceptors which secrete renin if solute concentration
falls
Reninangiotensin
mechanism:
Sequence
of
reactions resulting
in
aldosterone
secretion
from
adrenal
cortex:
increases sodium
resorption
from
distal
convoluted
tubules:
water
follows,
blood
volume increases
and blood pressure
increases

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Bowmans
capsule
60% of
solutes
reabsorbed
by active
transport

20% of
solutes
reabsorbed
by active
transport

20% of
solutes
reabsorbed
or excreted
in the urine

Water Regulation

The kidney filters about 180 to 200L of water a day


99% of the water is reabsorbed
About 85% of the water diffuses out of the water permeable proximal
convoluted tubule and descending loop of Henle and is reabsorbed by the
capillaries
Osmoreceptors in the hypothalamus are stimulated by the high osmotic
pressure in the blood. As a result the hypothalamus stimulates:
The adrenal gland to release the hormone aldosterone
The pituitary gland to release antidiuretic hormone (ADH)
And other areas in the brain to produce the sensation of thirst

At the ascending loop of Henle NaCl is actively transported out in the


presence of the hormone Aldosterone
The distal convoluted tubule and collecting duct become permeable to water
in the presence of ADH
The remain 15% of water is reabsorbed basis on osmotic pressure of the
blood (regulated by ADH)

Kidney Disease

Diabetes Mellitus
Lack of insulin produced from the pancreas
Results in increased blood sugar levels, which in turn will result in increased
sugar concentration in the nephron
Draws water into the nephron
Results in increased sugar and water in the urine

Diabetes Insipidus
Destruction of ADH producing cells of the hypothalamus
No reabsorption of water urine output increases dramatically (20L/day)
Must drink large quantities of water, regulated with injections of ADH

Brights Disease (Nephritis)


Inflammation of the nephron
Proteins found in the urine

Kidney Stones
The clumping and hardening of minerals from the blood
Must pass through pelvis ureters urinary bladder urethra (painful in
males)

Kidney Infections
Result when an infection reaches the kidneys and
becomes known as pyelonephritis.
Common causes can be infection from elsewhere in
the body or obstruction of the prostate gland (usually
in older men).
For children, infection can be caused by the tube that
drains urine from the kidneys and the bladder.

Kidney Stones

Are also a common kidney disorder. They form when chemicals in the urine
precipitate out and form crystals.
The most common crystals are from calcium oxalate, while others could be from uric
acid and cystine.
Kidney stones are more common in men than women and can reoccur at any time.
Factors such as recurrent urinary bladder infections, insufficient water intake and
consumption, low levels of physical activity, and too much Vitamin C and D intake
can lead to kidney stones.
One of the best ways to decrease the occurrence of stones is to drink lots of water
and to change your dietary habits.
Symptoms include severe back or abdomen pain, blood in the urine, nausea and
vomiting.
Diagnosis involves a complete medical examination, including X-rays.
Treatment may vary from letting the stones pass through the urinary tract to
ultrasound shock (or lithotripsy) to disintegrate the stones to a small size that can be
passed through the urinary tract.
Real large stones require surgery for removal.

The Ureters

Slender tubes about 25


cm (10 ) long leaving
each renal pelvis
One for each kidney
carrying urine to the
bladder
Descend retroperitonealy
and cross pelvic brim
Enter posterolateral
corners of bladder
Run medially within
posterior bladder wall
before opening into
interior
This oblique entry helps
prevent backflow of urine

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Three basic layers

Transitional epithelium Ureters play an active role in


transporting urine (its not
of mucosa stretches
just by gravity)
when ureters fill
Muscularis
Inner longitudinal, outer
circular layers
Inferior 3rd with extra
longitudinal layer)
Stimulated to contract
when urine in ureter:
peristaltic waves to
propel urine to bladder

Adventitia (external)
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Urinary Bladder

See also brief atlas

Collapsible
muscular sac
Stores and expels
urine
Lies on pelvic floor
posterior to pubic
symphysis
Males: anterior to
rectum
Females: just
anterior to the
vagina and uterus
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Urinary Tract Urinary Bladder

The urinary bladder:


expandable, muscular container
serves as a reservoir for urine
positioned immediately superior and posterior to the pubic symphysis.
in females
the urinary bladder is in contact with the uterus posterosuperiorly and with the vagina posteroinferiorly.
in males
it is in contact with the rectum posterosuperiorly and is immediately superior to the prostate gland.
is a retroperitoneal organ.
when empty exhibits an upside-down pyramidal shape.
Filling with urine distends it superiorly until it assumes an oval shape.
Trigone
posteroinferior triangular area of the urinary bladder wall
formed by imaginary lines
connect the two posterior ureteral openings
and the anterior urethral opening.
The trigone remains immovable as the urinary bladder fills and evacuates.
It functions as a funnel
directs urine into the urethra as the bladder wall contracts
four tunics
mucosa
submucosa
Muscularis: called the detrusor muscle
adventitia.
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Internal urethral sphincter (smooth muscle)

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If full: bladder is spherical and extends into abdominal


cavity (holds about 500 ml or 1 pt)
If empty: bladder lies entirely within pelvis with shape
like upside-down pyramid
Urine exits via the urethra
Trigone is inside area between ureters and urethra:
prone to infection (see slide 38)

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Bladder wall has three layers (same as ureters)


Mucosa with distensible transitional epithelium and lamnia
propria (can stretch)
Thick muscularis called the detrusor muscle
3 layers of highly intermingled smooth muscle
Squeezes urine out

Fibrous adventitia

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The Urethra
Smooth muscle with inner mucosa
Changes from transitional through stages to stratified squamous near end
Drains urine out of the bladder and body

Male: about 20 cm (8) long


Female: 3-4 cm (1.5) long

Short length is why females have more urinary tract infections than males ascending bacteria from stool contamination

urethra

Urethra____

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Urethral sphincters
Internal: involuntary sphincter of smooth muscle
External: skeletal muscle inhibits urination voluntarily until
proper time (levator anni muscle also helps voluntary
constriction)
Males: urethra has
three regions (see
right)

_________trigone

1. Prostatic urethra__________
2. Membranous urethra____

3. Spongy or penile urethra_____

female

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Micturition
AKA:
Voiding
Urinating
Emptying the bladder
The expulsion of urine from the bladder.
Initiated by a complex sequence of
events called the micturition reflex.
The

bladder

is

supplied

by

both

parasympathetic and sympathetic nerve


fibers of the autonomic nervous system.

KNOW:
Micturition center of brain: pons
(but heavily influenced by higher centers)
Parasympathetic: to void
Sympathetic: inhibits micturition

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Urethra

Fibromuscular tube
exits the urinary bladder through the urethral opening
at anteroinferior surface
conducts urine to the exterior of the body.
Tunica mucosa: is a protective mucous membrane
houses clusters of mucin-producing cells called urethral glands.
Tunica muscularis: primarily smooth muscle fibers
help propel urine to the outside of the body.
Two urethral sphincters:
Internal urethral sphincter
restrict the release of urine until the pressure within the urinary bladder is high enough
External urethral sphincter
and voluntary activities needed to release the urine are activated.
The internal urethral sphincter
involuntary (smooth muscle)
superior sphincter surrounding the neck of the bladder, where the urethra originates.
a circular thickening of the detrusor muscle
controlled by the autonomic nervous system
The external urethral sphincter
inferior to the internal urethral sphincter
formed by skeletal muscle fibers of the urogenital diaphragm.
a voluntary sphincter
controlled by the somatic nervous system
this is the muscle children learn to control when they become toilet-trained

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Female Urethra
Has a single function:
to transport urine from the urinary bladder to the vestibule, an external
space immediately internal to the labia minora

3 to 5 centimeters long, and opens to the outside of the body at


the external urethral orifice located in the female perineum.

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Male Urethra

Urinary and reproductive functions:


passageway for both urine and semen
Approximately 18 to 20 centimeters long.
Partitioned into three segments:
prostatic urethra is approximately 3 to 4 centimeters long and is the most
dilatable portion of the urethra
extends through the prostate gland, immediately inferior to the male bladder,
where multiple small prostatic ducts enter it
membranous urethra is the shortest and least dilatable portion
extends from the inferior surface of the prostate gland through the urogenital
diaphragm
spongy urethra is the longest part (15 centimeters)
encased within a cylinder of erectile tissue in the penis called the corpus
spongiosum
extends to the external urethral orifice

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Aging and the Urinary System

Changes in the size and functioning of the kidneys begin at 30.


Gradual reduction in kidney size.
Reduced blood flow to the kidneys.
Decrease in the number of functional nephrons.
Reabsorption and secretion are reduced.
Diminished ability to filter and cleanse the blood.
Less aldosterone or antidiuretic hormone.
Ability to control blood volume and blood pressure is reduced.
Bladder decreases in size.
More frequent urination.
Control of the urethral sphinctersand micturitionmay be lost.

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UTI (Urinary Tract Infection)


Is a very common disorder. If the bladder has become
infected, it is known as cystitis. If the urethra is
infected., it is called urethritis.
UTI is more common in women than men because of
differences in anatomy.
Symptoms
include
painful
urination
burning
sensation), frequent urination (even if no urine
present) and bloody or brown urine.
This can lead to chills, fever, nausea, vomiting and
upper abdomen tenderness.