Anatomy and

Physiology
of Urinary System

Renal Functions

1. Regulating the water concentration, inorganic-ion

composition, and volume of the internal environment.

by excreting just enough water and inorganic ions to

keep the amounts of these substances in the body
relatively constant.

2. Excreting metabolic waste products into the urine as

fast as they are produced.

keeps waste products, which can be toxic, from

accumulating in the body, e.g. urea, creatinine, uric acid.

3. Excreting, in the urine, of some foreign

chemicals, such as drugs, pesticides, and food

additives, and their metabolites.
4. Gluconeogenesis

During prolonged fasting, the kidneys synthesize

glucose from amino acids and other precursors and
release it into the blood. It supplies approximately
20 percent as much glucose as the liver does at
such times.
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5. kidneys act as endocrine glands, secreting at

least three hormones: erythropoietin (described

in Chapter 14), renin, and 1,25-dihydroxyvitamin
D3.

Structure of Kidney
and Urinary System

The two kidneys lie in the

back of the abdominal wall
but not actually in the
abdominal cavity.

Retroperitoneal

The urine flows from the

kidneys through the
ureters into the bladder,
from which it is eliminated
via the urethra

Each kidney contains

approximately 1 million
similar subunits called
nephrons.

Each nephron consists of

(1) an initial filtering
component called the renal
corpuscle, and (2) a
tubule that extends out
from the renal corpuscle.

Each renal corpuscle contains a compact tuft of

interconnected capillary loops called the glomerulus
(plural, glomeruli), or glomerular capillaries.

Each glomerulus is supplied with blood by an arteriole called

an afferent arteriole.

The glomerulus protrudes into a fluid-filled capsule called

Bowmans capsule.

The combination of a glomerulus and a Bowmans capsule

constitutes a renal corpuscle.

 As blood flows through the glomerulus, a portion

of the plasma filters into Bowmans capsule.

The remaining blood then leaves the glomerulus

by another arteriole, the efferent arteriole.

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 Blood in the glomerulus is separated from the fluid

in Bowmans space by a filtration barrier

consisting of three layers:

the single-celled capillary endothelium,

a noncellular proteinaceous layer of basement

membrane (also termed basal lamina) between the
endothelium and the next layer,

the single-celled epithelial lining of Bowmans

capsule called podocytes.
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 each tubule is surrounded by capillaries, called the

peritubular capillaries
Within each nephron, the two sets of capillaries

(glomerular cappilaries and peritubular capillaries) are

connected to each other by an efferent arteriole, the
vessel by which blood leaves the glomerulus.
After supplying the tubules with blood, the peritubular

capillaries then join together to form the veins by which

blood leaves the kidney.

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Near its end, the ascending limb of each loop of Henle passes
between the afferent and efferent arterioles of that loops own
nephron.

There is a patch of cells in the wall of the ascending limb called

the macula densa, and the wall of the afferent arteriole
contains secretory cells known as juxtaglomerular (JG) cells.

The combination of macula densa and juxtaglomerular cells is

known as the juxtaglomerular apparatus (JGA).

The juxtaglomerular cells secrete the hormone renin.

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Basic Renal
Processes

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Not all of these

processesfiltration,
secretion,
reabsorptionapply
to all substances.

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Rate of Glomerular
Filtration
The volume of fluid filtered from the glomeruli into Bowmans

space per unit time is known as the glomerular filtration

rate (GFR).
GFR is determined not only by the net filtration pressure but

also by the permeability of the corpuscular membranes and the

surface area available for filtration.
The glomerular capillaries are so much more permeable to fluid

than muscle or skin capillaries

the net glomerular filtration pressure causes massive filtration.

In a 70-kg person, the GFR averages 180 L/day (125 ml/min)!

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 GFR is not a fixed value but is subject to

physiological regulation. As we shall see, this is

achieved mainly by neural and hormonal input
to the afferent and efferent arterioles, which
results in changes in net glomerular filtration
pressure.

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Konstriksi pada Afferent Arteriol peningkatan resistensi

arteriol penurunan tekanan arteri dan kapiler glomerular
penurunan PGC penurunan GFR

Konstriksi pada Efferent Arteriol Dam Back darah di kapiler

glomerulus menyebabkan peningkatan PGC GFR meningkat

Jika terjadi konstriksi bersamaan pada afferent dan efferent

arteriol tidak ada perubahan GFR

Dilatasi pada Afferent dan Efferent Arteriol memberikan efek

berlawanan dari konstriksi
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Tubular Reabsorption

The values in this table are typical for a normal person on an

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average diet.

 Three important conclusions:

1.

The filtered loads are enormous, generally larger than

the amounts of the substances in the body.

2.

Reabsorption of waste products is relatively

incomplete

3.

Reabsorption of most useful plasma components (for

example, water, inorganic ions, and organic nutrients)
is relatively complete

Reabsorption can occur by:

Active: uses ATP and carrier: nutrients, amino acids,

glucose, minerals

Passive diffusion: water,

urea, Cl27

Reabsorption of water

Always permeable to water:

Proximal tubule

Descending limb of the loop Henle

Never permeable to water:

Ascending limb of the loop of Henle

Sometimes permeable to water:

Distal tubule

Collecting duct
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Tubular Secretion

Tubular secretion moves substances from

peritubular capillaries into the tubular lumen.

The most important substances secreted by the

tubules are hydrogen ions and potassium, but a

large number of normally occurring organic
anions, such as choline and creatinine, are also
secreted. So are many foreign chemicals, such as
penicillin.
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Micturition

Urine flow through the ureters to the bladder is

propelled by contractions of the ureter-wall

smooth muscle.
The urine is stored in the bladder and

intermittently ejected during urination, or

micturition.

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The bladder is a balloon-like chamber with walls of smooth

muscle collectively termed the detrusor muscle.

The contraction of the detrusor muscle squeezes on the urine in

the bladder lumen to produce urination.

Part of the detrusor muscle at the base (or neck) of the

bladder where the urethra begins functions as a sphincter called
the internal urethral sphincter.

Just below the internal urethral sphincter, a ring of skeletal

muscle surrounds the urethra. This is the external urethral
sphincter, the contraction of which can prevent urination even
when the detrusor muscle contracts strongly
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What happens during

micturition?

The bladder fills with urine the pressure within bladder

increases stretch receptors in the bladder wall The afferent
fibers from these receptors enter the spinal cord stimulate the
parasympathetic neurons cause the detrusor muscle to contract
the contraction facilitates the opening of the internal urethral
sphincter. Simultaneously, the afferent input from the stretch
receptors reflexly inhibits the sympathetic neurons to the internal
urethral sphincter, which further contributes to its opening. In
addition, the afferent input also reflexly inhibits the somatic motor
neurons to the external urethral sphincter, causing it to relax
Both sphincters are now open the contraction of the detrusor
muscle is able to produce urination.

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