Urinary System

Overview

• The principal organs of the urinary system are the kidneys,

which process blood and form urine as a waste to be excreted

• The excreted urine travels from the kidneys to the outside of the
body via accessory organs: ureters, urinary bladder and urethra
 Overview

• We often think of the urinary system primarily as a urine

producer, which it certainly is, however, a better image of the
system is that of " blood plasma balancer"

• Each kidney processes incoming blood plasma in ways that allow

it to leave the kidney in better condition
 Overview

• The water content is adjusted so that the body does not have too
much or too little water to maintain constancy of the internal
environment

• The blood content of important ions such as sodium and

potassium is adjusted to match set point levels
 Overview

• Even the pH of the blood can be altered to match the set point
level

• In these ways, the urinary system regulates the content of blood

plasma so that the homeostasis or dynamic constancy of the
entire internal fluid environment can be maintained within
normal limits
 Overview

• The urinary system's chief function is to regulate the volume and

composition of body fluids and excrete unwanted material but it
is not the only system in the body that is able to excrete
unneeded substances
 Overview

• The table compares the excretory functions of several systems.

Although all of these systems contribute to the body's effort to
remove wastes, only the urinary system can finely adjust the
water and electrolyte balance to the degree required for normal
homeostasis of body fluids
 Overview

System Organ Excretion

Nitrogen compound,
Urinary Kidney toxins, water,
electrolytes
Nitrogen compounds,
Integumentary Skin-Sweat Glands
electrolytes, water

Respiratory Lung Carbon dioxide

 System Organ Excretion

Digestive wastes, bile

Digestive Intestine pigments, salts of
heavy metals
 Urinary System

• Located in the lower abdomen

• Excretory structures include the kidneys, urinary bladder,

ureters and urethra

• The main wastes collected is called urine

• Other organs for excretion include the liver, lungs and skin
Urinary System Organization
 Kidneys

• paired bean-shaped organs located on both sides of

the spinal column

• around 5 in. long, 3 in. wide and 1 in. thick

• composed of nephrons

• organs for homeostasis for they regulate the

composition of the blood
 Blood Supply of the Kidney

• Renal Artery - carry blood with dissolved cellular wastes into the
kidney

• Renal Vein - carry filtered blood out from the kidney

 Internal Parts of Kidney

• Cortex - outer granulated layer

• Medulla - radially striated or lined layer

• Renal Pelvis - inner space or cavity continuous with the ureter

 Kidneys

• regulate the amount of water,

salts and other substances in
the blood

• fist-sized , bean shaped

structures that remove
nitrogenous wastes (urine)
and excess salts from the
blood
 Ureters

• tubes that carry urine from

the pelvis of the kidneys to
the urinary bladder
Urinary Bladder

• temporarily stores urine

until it is released from
the body
 Urethra

• tube that carries urine from

the urinary bladder to the
outside of the body

• the outer end of the urethra is

controlled by a circular
muscle called a sphincter
Each kidney is composed of three sections:

• The outer renal cortex

• The renal medulla (middle part)

• The hollow inner renal pelvis

 Cortex
• where the blood is
filtered
 Medulla
collecting ducts which
carry filtrate (filtered
substances) to the pelvis
 Pelvis
hollow cavity where urine accumulates and drains into the ureter
Parts of a Nephron
Each nephron consists of the following
parts:
• Glomerulus

• Bowman's capsule

• Proximal tubule

• Loop of Henle

• Distal tubule

• Collecting duct
Glomerulus
- a mass of thin-walled capillaries
 Bowman's Capsule
- a double-walled, cup-shaped structure
encloses the glomerulus
 Proximal Tubule
- leads from the Bowman's Capsule to
the Loop of Henle
 Loop of Henle
- is a long Loop which extends
into the medulla
 Distal Tubule
- connects the Loop of. Henle to the
collecting duct
Physiology of the Urinary System
 Kidney Functions

• The chief functions of the kidneys are to process

blood plasma and excrete urine

• These functions are vital because they maintain the

homeostatic balance of the body
• Few of the blood constituents that cannot be held
within their normal concentration ranges if the
kidneys fail:

• a)sodium

• b) potassium

• c) chloride

• d) nitrogenous wastes (especially urea)

• In short, kidney failure means homeostatic failure
and if not relieved, inevitable death

• Kidneys also perform other important functions.

They influence the rate of secretion of the
hormones antidiuretic hormone (ADH) and
aldosterone and synthesize the active form of
vitamin D, the hormone erythropoietin and
prostaglandins
• The basic functional unit of the kidney is the
nephron. It has two main parts - the renal corpuscle
and renal tubule - that form urine by means of
three processes:

• a) filtration

• b) tubular reabsorption

• c) tubular secretion
• These three mechanisms are used to process blood
plasma and form urine

• A hydrostatic pressure gradient drives the filtration

of much of the plasma into the nephron

• Because the filtrate contains materials that the body

must conserve, the walls of the tubules start
reabsorbing these materials back into the blood
• As the filtrate (urine) begins to leave the nephron,
the kidney may secrete a few "last minute" items
into the urine for excretion

• In short, the kidney does not selectively filter out

only harmful or excess material

• It first filters out much of the plasma, then

reabsorbs what should not be "thrown out" before
the filtrate reaches the end of the tubule and
becomes urine
 Filtration

• The first step in blood processing, is a physical

process that occur in the kidneys' 2.5 million renal
corpuscles

• as blood flows through the glomerular capillaries,

water and small solutes filter out of the blood into
Bowman's capsules

• the only blood constituents that do not move out are

the blood solids (cells) and most plasma proteins
 Filtration

• The result is about 180 liters of glomerular filtrate

being formed each day

• this filtration takes place through the glomerular

capsular membrane

• filtration from glomeruli into Bowman's capsules

occurs for the same reason that filtration from other
capillaries into interstitial fluid occurs - because of
the existence of a pressure gradient
 Filtration

• the main factor establishing the pressure gradient

between the blood in the glomeruli and the filtrate in
Bowman's capsule is the hydrostatic pressure of
glomerular blood

• it tends to cause filtration out of the glomerular blood

plasma into Bowman's capsules

• the intensity of glomerular hydrostatic pressure is

influenced by systemic blood pressure and the resistance
to blood flow through the glomerular capillaries
 Filtration

• however, exerting force in the opposite direction

are the osmotic pressure of glomerular blood
plasma and the hydrostatic pressure of the capsular
filtrate

• the net or effective filtration pressure (EEP)

therefore equals glomerular hydrostatic pressure
minus the sum of glomerular osmotic pressure plus
capsular hydrostatic pressure
 Filtration

• For example:

• - glomerular hydrostatic pressure = 60mm Hg

• - glomerular osmotic pressure = 32mm Hg

• - capsular hydrostatic pressure = 18mm Hg

• - capsular osmotic pressure = negligent

 Filtration

• the EEP using these three figures equals (60+0) -

(32+18), or 10mm Hg

• an effective filtration pressure of 1mm Hg produces

a glomerular filtration rate of 12.5ml per minute

• with an EEP of 10mm Hg, the glomerular filtration

rate would be 125.0ml per minute or about 180
liters in a 24-hour period, a normal rate
 Filtration

• since only about 1.5 liters of urine is excreted each

day, more than 99% of the filtrate must be
reabsorbed from the tubular segments of the
nephron

• filtration occurs more rapidly out of glomeruli than

out of other tissue capillaries
 Filtration

• Reasons

• - glomerular epithelium has many more pores in it,

so it is more permeable than tissue capillary
endothelium

• - glomerular hydrostatic pressure is higher than

tissue capillary pressure
 Filtration

• Briefly

• - the efferent arteriole has a smaller diameter than

the afferent arteriole, therefore, it offers more
resistance to blood flow out of the glomerulus than
venules offer to blood flow out of tissue capillaries
 Filtration

• Glomerular filtration rate (GFR) is directly proportional

to the effective filtration pressure (EEP) and can be
altered by changes in the systemic blood pressure

• it can also be altered indirectly by changes in the

efficiency of cardiac contraction

• stress may lead to intense sympathetic stimulation of the

arteriole with greater constriction of the afferent than
the efferent arteriole
 Filtration

• Glomerular hydrostatic pressure falls

• in severe stress, it may even drop to a level so low

that the EEP falls to zero

• no glomerular filtration then occurs

• the kidneys "shut down" or in technical language,

renal suppression occurs
 Filtration

• glomerular hydrostatic pressure and filtration are

directly related to systemic blood pressure

• that is, a decrease in blood pressure tends to

produce a decrease in both glomerular pressure and
the glomerular filtration rate
 Normal Pressure in the Renal Corpuscle

Normal Hydrostatic Pressure Osmotic Pressure

Glomerular Blood 60mm Hg 32mm Hg

Capsular Filtrate 18mm Hg 0mm Hg

Abn

Normal Hydrostatic Pressure Osmotic Pressure

Glomerular Blood 60mm Hg 32mm Hg

Capsular Filtrate 18mm Hg 5mm Hg

 Reabsorption

• the second step in urine formation, takes place by

means of passive and active transport mechanism
from all parts of the renal tubules

• a major portion of water and electrolytes and all

nutrients are reabsorbed from the proximal tubules

• the rest of the renal tubule reabsorbs comparatively

little of the filtrate
 Reabsorption

• proximal tubules reabsorb sodium and other major

ions, nutrients from the tubule fluid, glucose and
amino acids

• Concern

• - in urinalysis results glucose is present in urine, it is

known as
level is normal), the condition is renal diabetes or
renal glycosuria. It is congenital defect.
 Reabsorption

• the most common cause of glycosuria is diabetes

mellitus

• insulin deficiency or target cell dysfunction causes

glucose to accumulate in the blood causing
hyperglycemia

• the loop of Henle reabsorbs water from the tubule

fluid and picks up urea from the interstitial fluid. It
reabsorbs sodium and chloride
 Tubular Secretion

• the movement of substances out of the blood and

into tubular fluid

• descending limb of the loop of Henle removes urea

and the distal and collecting tubules secrete
potassium, hydrogen and ammonium ions
 Regulation of Urine Formation

• Antidiuretic Hormone (ADH) has central role in

the regulation of urine volume

• control of the solute concentration of urine

translates into control of urine volume

• if no water is reabsorbed by the distal and

collecting tubules, urine volume is relatively high
and water loss from the body is high
 Regulation of Urine Formation

• as water is reabsorbed under the influence of ADH,

the total volume of urine is reduced by the amount of
water removed from the tubules

• another hormone that tends to decrease urine

volume and thus conserve water is aldosterone

• it increases distal and collecting tubule absorption of

sodium, which in turn causes an osmotic imbalance
that drives the reabsorption of water from the tubule
 Regulation of Urine Formation

• because water reabsorption in the distal and

collecting tubule portion requires ADH, the
aldosterone mechanism must work in concert with
the ADH mechanism if homeostasis of the fluid
content in the body is to be maintained
 Urine Composition

• urine is approximately 95% water, in which are

dissolved several kinds of substances

• a) nitrogenous wastes - from protein catabolism,

such as:
and a nitrogenous waste produced in the liver from
the breakdown of protein. It is the main component
of urine),
breakdown of DNA or RNA),
creatinine
 Urine Composition

• b) Electrolytes - sodium, potassium, ammonium,

chloride, bicarbonate, phosphate and sulfate

• c) Toxins - during disease, bacterial poisons leave

the body in urine

• d) Pigments - yellowish pigments derived from

products of the breakdown of old red blood cells in
the liver. Various foods and drugs may contain or be
converted to pigments that are cleared from plasma
by the kidneys and are therefore found in urine
 Urine Composition

• e) Hormones - high hormone levels sometimes

result in significant amounts of hormone in the
filtrate and therefore in urine

• f) Abnormal Constituents - such as blood, glucose,

albumin, casts, or calculi (small stones)
 Characteristics of Urine

Normal Characteristics Abnormal Characteristics

Color

Abnormal color or cloudiness,

Transparent yellow, amber or which may indicate the presence of
straw color blood, bile, bacteria, drugs, food
pigments or a high solute
concentration
 Characteristics of Urine

Normal Characteristics Abnormal Characteristics

Compounds

Mineral ions (Na, Cl, K) Acetone

Nitrogenous wastes (ammonia,

Albumin
creatinine, urea, uric acid)
 Characteristics of Urine

Normal Characteristics Abnormal Characteristics

Suspended solids (bacteria, blood
Bile
cells, casts)
Urine Pigments Glucose

Slight Odor Acetone Odor

pH 4.6 - 8.0 High in alkalosis, low in acidosis

High specific gravity can cause precipitation
Specific Gravity 1.001 - 1.035 of solutes and the formation of kidney stones
 Urine Abnormalities

• Glycosuria or glucosuria - glucose in urine

• Hematuria - blood in urine

• Pyuria - pus in urine

• Polyuria - unusually large amounts of urine

• Dysuria - painful urination

• Oliguria - scant urine

• Anuria - absence of urine

 Kidney Failure

• also known as renal failure

• simply failure of the kidney to properly process

blood plasma and form urine

• acute and chronic

 Acute Renal Failure

• abrupt reduction in kidney function that is

characterized by oliguria and a sharp rise in
nitrogenous compounds in the blood

• nitrogenous wastes concentration can be assessed

through Blood Urea Nitrogen (BUN) test. High
result indicates failure of the kidney to remove urea
from the blood
 Chronic Renal Failure

• a slow, progressive condition resulting from the

gradual loss of nephrons which can lead to dozens
of diseases. Ex. infections, diabetes, tumors, etc.

• has three stages:

 Chronic Renal Failure
(Stage 1)

• some nephrons are lost but the remaining healthy

nephrons compensate by enlarging and taking over
the function of the lost nephrons

• this is often asymptomatic and may last for years,

depending on the underlying cause
 Chronic Renal Failure
(Stage 2)

• often called renal insufficiency

• the kidney can no longer adapt to the loss of

nephrons

• the remaining healthy nephrons cannot handle the

urea load

• polyuria and dehydration may occur

 Chronic Renal Failure
(Stage 3)

• is also called uremia or uremic syndrome

• very high BUN value caused by loss of kidney function

• low urine production and oliguria

• edema and hypertension occur

• the progressive loss of kidney function will eventually

cause death
 Assignment

• Differentiate neurogenic bladder from overactive bladder

• Describe the following:

• a) urethritis

• b) cystitis

• c) nephritis

• d) acute glomerulonephritis

• e) chronic glomerulonephritis

• Illustrate Hemodialysis