dr. k urinary system
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Urinary System
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What are the organs that comprise the urinary system?
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Urinary System Organs
• Kidneys
• Urinary bladder
• Ureters
• Urethra
Copyright © 2010 Pearson Education, Inc. Figure 25.1
Esophagus (cut)Inferior vena cava
Adrenal gland
Hepatic veins (cut)
Renal artery
Renal hilum
Renal vein
Iliac crest
Kidney
Ureter
Urinary
bladder
Urethra
Aorta
Rectum (cut)
Uterus (part of female reproductive system)
Copyright © 2010 Pearson Education, Inc. Figure 25.21b
Ureter
Trigone
Peritoneum
Rugae
Detrusor muscle
Bladder neck
Internal urethralsphincter
External urethralsphincter
Urogenital diaphragm
Urethra
External urethralorifice
Ureteric orifices
(b) Female.
Copyright © 2010 Pearson Education, Inc. Figure 25.21a
Ureter
Trigone of bladder
Prostate
Membranous urethra
Prostatic urethra
Peritoneum
RugaeDetrusor muscle
Bladder neckInternal urethral sphincter
External urethral sphincterUrogenital diaphragm
Spongy urethra
Erectile tissue of penis
Ureteric orificesAdventitia
(a) Male. The long male urethra has three
regions: prostatic, membranous and spongy.
External urethral orifice
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Urethra
• Sphincters
• Internal urethral sphincter
• Involuntary (smooth muscle) at bladder-
urethra junction
• Contracts to open
• External urethral sphincter
• Voluntary (skeletal) muscle surrounding the
urethra as it passes through the pelvic floor
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Urinary System
In general, what are the functions of the urinary system?
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Urinary System General Functions
• Kidneys are major excretory organs
• Removal of toxins, metabolic wastes, and excess ions from the blood
• Regulation of blood volume, chemical composition, and pH
• Endocrine functions of kidney
• Renin: regulation of blood pressure and kidney function
• Erythropoietin: regulation of RBC production
• Activation of vitamin D
• Urinary bladder is the temporary storage reservoir for urine
• Ureters transport urine from the kidneys to the bladder
• Urethra transports urine out of the body
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What is the composition of urine?
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Physical Characteristics of Urine
• Color and transparency
• Clear, pale to deep yellow (due to urochrome)
• Drugs, vitamin supplements, and diet can alter
the color
• Cloudy urine may indicate a urinary tract
infection
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Physical Characteristics of Urine
• Odor
• Slightly aromatic when fresh
• Develops ammonia odor upon standing
• May be altered by some drugs and vegetables
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Physical Characteristics of Urine
• pH
• Slightly acidic (~pH 6, with a range of 4.5 to
8.0)
• Diet, prolonged vomiting, or urinary tract
infections may alter pH
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Chemical Composition of Urine
• 95% water and 5% solutes
• Nitrogenous wastes: urea, uric acid, and creatinine
• Other normal solutes
• Na+, K+, PO43–, and SO4
2–,
• Ca2+, Mg2+ and HCO3–
• Abnormally high concentrations of any constituent may indicate pathology
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Renal Calculi
• Kidney stones form in renal pelvis
• Crystallized calcium, magnesium, or uric acid
salts
• Larger stones block ureter, cause pressure and pain in kidneys
• May be due to chronic bacterial infection,
urine retention, ↑Ca2+ in blood, ↑pH of urine
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Location of The Kidneys
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Kidney Anatomy
• Retroperitoneal, in the superior lumbar region
• Right kidney is lower than the left
Copyright © 2010 Pearson Education, Inc. Figure 25.2a
Body wall
• Perirenalfat capsule
Renalartery
Renalvein
Inferior vena cava
Aorta
• Fibrouscapsule
• Renal fasciaanteriorposterior
Supportivetissue layers
Body of
vertebra L2
PeritoneumPeritoneal cavity(organs removed)
Anterior
Posterior(a)
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anatomy of the kidneys
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Kidney Anatomy
• Convex lateral surface, concave medial surface
• Renal hilum leads to the renal sinus
• Ureters, renal blood vessels, lymphatics, and nerves enter and exit at the hilum
• Layers of supportive tissue surround the kidney
1. Renal fascia
• The anchoring outer layer of dense fibrous connective tissue
2. Perirenal fat capsule
• A fatty cushion
3. Fibrous capsule
• Prevents spread of infection to kidney
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Internal Kidney Anatomy
• Renal cortex
• A granular superficial region
• Renal medulla
• The cone-shaped medullary (renal) pyramids separated by renal columns
• Lobe
• A medullary pyramid and its surrounding cortical tissue
• Papilla
• Tip of pyramid; releases urine into minor calyx
• Renal pelvis
• The funnel-shaped tube within the renal sinus
• Major calyces
• The branching channels of the renal pelvis that
• Collect urine from minor calyces
• Empty urine into the pelvis
• Urine flows from the pelvis to ureter
Copyright © 2010 Pearson Education, Inc. Figure 25.3
Renal cortex
Renal medulla
Major calyx
Papilla ofpyramid
Renal pelvis
Ureter
Minor calyx
Renal column
Renal pyramid in renal medulla
Fibrous capsule
Renalhilum
(a) Photograph of right kidney, frontal section (b) Diagrammatic view
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Blood and Nerve Supply
• Arterial flow into and venous flow out of the kidneys follow similar paths
• Nerve supply is via sympathetic fibers from the renal plexus
Copyright © 2010 Pearson Education, Inc. Figure 25.4a
Cortical radiate vein
Cortical radiate artery
Arcuate vein
Arcuate artery
Interlobar vein
Interlobar artery
Segmental arteries
Renal artery
Renal vein
Renal pelvis
Ureter
Renal medulla
Renal cortex
(a) Frontal section illustrating major blood vessels
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The Nephron: The Repeated Functional Unit of the Kidney
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Functions in
reabsorption
and
secretion
freely permeable to water
function more in secretion than reabsorption
function in maintaining the acid-base balance of the body and help maintain the body’s
water and salt balance
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Nephrons
• Cortical nephrons—85% of nephrons; almost entirely in the cortex
• Juxtamedullary nephrons
• Long loops of Henle deeply invade the medulla
• Extensive thin segments
• Important in the production of concentrated
urine
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Nephrons
• Structural and functional units that form urine
• ~1 million per kidney
• Parts of the nephron
• glomerulus: a tuft of capillaries
• renal tubule: begins as cup-shaped glomerular (Bowman’s) capsule surrounding the glomerulus
• renal corpuscle
• Glomerulus + its glomerular capsule
• Fenestrated glomerular endothelium
• Allows filtrate to pass from plasma into the glomerular capsule
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Renal Tubule
Glomerular capsule
• Parietal layer: simple squamous epithelium
• Visceral layer: branching epithelial podocytes
• Extensions terminate in foot processes that cling to basement membrane
• Filtration slits allow filtrate to pass into the capsular space
Copyright © 2010 Pearson Education, Inc. Figure 25.7a
Cortical nephron• Has short loop of Henle and glomerulusfurther from the corticomedullary junction
• Efferent arteriole supplies peritubular capillaries
Juxtamedullary nephron• Has long loop of Henle and glomeruluscloser to the corticomedullary junction
• Efferent arteriole supplies vasa recta
Corticomedullaryjunction
UreterRenal pelvis
Kidney
Cortex
Medulla
(a)
Cortical radiate veinCortical radiate arteryAfferent arteriole
Afferent arteriole
Collecting ductDistal convoluted tubule
Efferent arteriole
Vasa rectaLoop of HenleArcuate arteryArcuate vein
Peritubular capillaries
Glomerular capillaries (glomerulus)Glomerular(Bowman’s) capsule
Renalcorpuscle
Ascending or thick limb of the loop of Henle
Descendingor thin limb of loop of Henle
Efferent arteriole
Proximalconvoluted tubule
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Vascular Resistance in Microcirculation
• High resistance in afferent and efferent arterioles
• Causes blood pressure to decline from
~95 mm Hg to ~8 mm Hg in kidneys
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A Portion of the Nephron Called the Juxtaglomerular Apparatus
Copyright © 2010 Pearson Education, Inc. Figure 25.8
Glomerulus
Glomerular capsule
Afferent arteriole
Efferent arteriole
Red blood cell
Podocyte cell body (visceral layer)
Foot processesof podocytesParietal layer
of glomerularcapsule
Proximaltubule cell
Lumens of glomerularcapillaries
Endothelial cellof glomerularcapillary
Efferent arteriole
• Macula densa cellsof the ascending limbof loop of Henle
• Granular cells
• Extraglomerularmesangial cells
Afferent arteriole
Capsularspace
Renal corpuscleJuxtaglomerularapparatus
Mesangial cellsbetween capillaries
Juxtaglomerularapparatus
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Juxtaglomerular Apparatus (JGA)
• One per nephron
• Important in regulation of filtrate formation and blood pressure
• contains renin
• act as mechanoreceptors that sense blood pressure
• act as chemoreceptors that sense NaCl content of filtrate
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The Portion of the Nephron Called the Glomerulus: The glomerular capillaries
and filtration membrane
Copyright © 2010 Pearson Education, Inc. Figure 25.9a
Glomerular capillarycovered by podocyte-containing visceral layer of glomerular capsule
Glomerular capillaryendothelium (podocyte covering and basement membrane removed)
Proximal convolutedtubule
Parietal layerof glomerular capsule
Afferentarteriole
Glomerular capsular space
Fenestrations(pores)
Efferentarteriole
Podocytecell body
Foot processesof podocyte
Filtration slits
Cytoplasmic extensionsof podocytes
(a) Glomerular capillaries
and the visceral layer of
the glomerular capsule
Copyright © 2010 Pearson Education, Inc. Figure 25.9c
(c) Three parts of the filtration membrane
Fenestration(pore)
Filtrate in
capsular
space
Foot processesof podocyte
Filtration slit
Slit diaphragm
Capillary
Filtration membrane
• Capillary endothelium• Basement membrane• Foot processes of podocyte
of glomerular capsule
Plasma
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Filtration Membrane
• Porous membrane between the blood and the capsular space
• Consists of
1. Fenestrated endothelium of the glomerular capillaries
2. podocytes with foot processes and filtration slits
3. Gel-like basement membrane
4. glomerular mesangial cells that engulf and degrade macromolecules
• Allows passage of water and solutes smaller than most plasma proteins
• Fenestrations prevent filtration of blood cells
• Negatively charged basement membrane repels large anions such as plasma proteins
• Slit diaphragms also help to repel macromolecules
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Kidney Physiology: Mechanisms of Urine Formation
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General Facts about Urine Formation
• The kidneys filter the body’s entire plasma volume 60 times each day
• Filtrate
• Blood plasma minus proteins
• Urine
• <1% of total filtrate
• Contains metabolic wastes and unneeded substances
Copyright © 2010 Pearson Education, Inc. Figure 25.10
Corticalradiateartery
Afferent arteriole
Glomerular capillaries
Efferent arteriole
Glomerular capsule
Rest of renal tubulecontaining filtrate
Peritubularcapillary
To cortical radiate vein
Urine
Glomerular filtration
Tubular reabsorption
Tubular secretion
Three major
renal processes:
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Mechanisms of Urine Formation: A three step process
1. Glomerular filtration - passive mechanical process driven by hydrostatic pressure, GFR or glomerular filtration rate is the volume of filtrate formed per minute by the kidneys (120–125 ml/min)
2. Tubular reabsorption
• Returns all glucose and amino acids, 99% of water, salt, and other components to the blood
3. Tubular secretion
• Reverse of reabsoprtion: selective addition to urine
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If hydrostatic pressure drives glomerular filtration (#1 on previous slide), then what is
the driving force for reabsorption and secretion (#2 and #3 on previous slide)?
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If hydrostatic pressure drives glomerular filtration (#1 on previous slide), then what is
the driving force for reabsorption and secretion (#2 and #3 on previous slide)?
Passive transport (osmosis)
and
Active transport (pumps requiring energy such as ATP)
as shown in the next slide
Copyright © 2010 Pearson Education, Inc. Figure 25.16a
Loop of Henle
Osmolalityof interstitialfluid(mOsm)
Inner
medulla
Outer
medulla
CortexActive transport
Passive transport
Water impermeable
(a) Countercurrent multiplier.
The long loops of Henle of the juxtamedullary nephrons create the medullary osmotic gradient.
The ascending limb:
• Impermeable to H2O• Permeable to NaClFiltrate becomes increasingly dilute as NaCl leaves, eventually becoming hypo-osmotic to blood at 100 mOsm in the cortex. NaCl leaving the ascending limb increases the osmolality of the medullary interstitial fluid.
Filtrate entering the loop of Henle is isosmotic to both blood plasma and cortical interstitial fluid.
The descending limb:
• Permeable to H2O• Impermeable to NaClAs filtrate flows, it becomes increasingly concentrated as H2Oleaves the tubule by osmosis. The filtrate osmolality increases from 300 to 1200 mOsm.
H2O
H2O
H2O
H2O
H2O
H2O
H2O
NaCI
NaCI
NaCI
NaCI
NaCI
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What regulates the rate of glomerular fitration (urine production) ?
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Regulation of Glomerular Filtration
• GFR is tightly controlled by two types of mechanisms
• Intrinsic controls (renal autoregulation)
• Act locally within the kidney
• Extrinsic controls
• Nervous and endocrine mechanisms that
maintain blood pressure, but affect kidney
function
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Intrinsic control for the rate of glomerular fitration (urine production)
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Intrinsic Control
• ↑ BP → constriction of afferent arterioles to drive BP back
down and protect glomeruli from damage due to high BP
• ↓ BP → dilation of afferent arterioles to drive BP back up
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Extrinsic control for the rate of glomerular fitration (urine production)
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Extrinsic Controls: Sympathetic Nervous System
Under normal conditions at rest
• Renal blood vessels are dilated
• Renal autoregulation mechanisms prevail
Under extreme stress
• Norepinephrine is released by the sympathetic nervous system
• Epinephrine is released by the adrenal medulla
• Both cause constriction of afferent arterioles, inhibiting filtration and triggering the release of renin
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So what happens when renin is released?
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So what happens when renin is released?
What happens is several steps which are called the “renin-angiotensin mechanism?
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Renin-Angiotensin Mechanism
• Triggered when renin is released (by the granular cells of the JGA)
angiotensinogen (a plasma globulin)
renin →
angiotensin I
angiotensin converting enzyme (ACE) →
angiotensin II
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So now what? What is the job of angiotensin II ?
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Effects of Angiotensin II
1. Stimulates the reabsorption of Na+
2. Triggers adrenal cortex to release aldosterone
3. Stimulates the hypothalamus to release ADH and activates the thirst center
4. increases fluid reabsorption
5. decreasing the surface area available for filtration, i.e., decreases filtration
Copyright © 2010 Pearson Education, Inc. Figure 25.12
Stretch of smoothmuscle in walls of afferent arterioles
Blood pressure inafferent arterioles; GFR
Vasodilation ofafferent arterioles
GFR
Myogenic mechanismof autoregulation
Release of vasoactivechemical inhibited
Intrinsic mechanisms directly regulate GFR despite
moderate changes in blood pressure (between 80 and 180 mm Hg mean arterial pressure).
Extrinsic mechanisms indirectly regulate GFR
by maintaining systemic blood pressure, whichdrives filtration in the kidneys.
Tubuloglomerularmechanism ofautoregulation
Hormonal (renin-angiotensin)mechanism Neural controls
SYSTEMIC BLOOD PRESSURE
GFR
Macula densa cellsof JG apparatus
of kidney
Filtrate flow andNaCl in ascending
limb of Henle’s loop
Targets
Granular cells ofjuxtaglomerular
apparatus of kidney
Angiotensinogen Angiotensin II
Adrenal cortex Systemic arterioles
(+) Renin
Release
Catalyzes cascaderesulting in conversion
(+)
(+)
(+)
Kidney tubules
Aldosterone
Releases
Targets
Vasoconstriction;peripheral resistance
Blood volume
Na+ reabsorption;water follows
Systemic
blood pressure
(+)
(+)
(–)
Increase
Decrease
Stimulates
Inhibits
Baroreceptors inblood vessels of
systemic circulation
Sympatheticnervous system
(+)
(–)
Vasodilation ofafferent arterioles