The Urinary System

Copyright 2010, John Wiley & Sons, Inc.

Jay P. Jazul, MSc., CPS

University of Santo Tomas
Faculty of Pharmacy

Urinary System

Copyright 2010, John Wiley & Sons, Inc.

The Urinary System

Paired kidneys
A ureter for each kidney
Urinary bladder
Urethra

Main Functions of Urinary System

Kidneys filter blood to keep it pure

Toxins
Metabolic wastes
Excess water
Excess ions

Dispose of nitrogenous wastes from blood

Urea
Uric acid
Creatinine

Regulate the balance of water and

electrolytes, acids and bases
4

Functions of the Kidneys

1) filter blood plasma, separate

wastes, return useful materials

to the blood, and eliminate the
wastes.
Toxic nitrogenous wastes
- ammonia, urea, uric acid, creatine, and
creatinine
- cause diarrhea, vomiting, and cardiac arrhythmia,
convulsions, coma, and death.

Functions of the Kidneys

1) filter blood plasma, separate

wastes, return useful materials

to the blood, and eliminate the
wastes.

2) regulate blood volume and

osmolarity.

Functions of the Kidneys

3) produce hormones
1. renin
2. erythropoietin
3. calcitrol
4) regulate acid-base balance
of the body fluids.
5) detoxify superoxides, free
radicals, and drugs.

 Kidneys are retroperitoneal organs (see next slide)

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)

*
*

10

Note layers of
adipose (fat),
capsule, fascia

Transverse sections
show retroperitoneal
position of kidneys

Note also: liver,

aorta muscles
on CT

11

Kidney
Divided into cortex outer portion
Medulla- inner portion
Contain renal pyramids & renal columns

Urine goes into renal pelvis

Edges are made of major & minor calyces

Then out ureter

Copyright 2010, John Wiley & Sons, Inc.

Kidney

Copyright 2010, John Wiley & Sons, Inc.

- The medial surface of the kidney is concave

with a hilum carrying renal nerves and blood
vessels.

The renal parenchyma is divided into an outer cortex

and inner medulla.

Extensions of the cortex

(renal columns) project
toward the sinus, dividing
the medulla into 6-10 renal
pyramids. Each pyramid is
conical with a blunt point
called the papilla facing the
sinus.

The papilla is nestled into a

cup called a minor calyx,
which collects its urine.
Two or three minor calyces
merge to form a major
calyx. The major calyces
merge to form the renal
pelvis.

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

17

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 (one following the other)
18

Renal
Blood
Supply

Copyright 2010, John Wiley & Sons, Inc.

The Nephron
The kidney contains 1.2 million nephrons, which are
the functional units of the kidney.
A nephron consists of :
i. Blood vessels
Afferent arteriole
Glomerulus
Efferent arteriole
ii. Renal tubules
Proximal convoluted tubule
Loop of Henle
Distal convoluted tubule

Nephron

Unit of renal function: corpuscle & tubule

Corpuscle: forms filtrate
Glomerulus & Glomerular capsule (cortex)
Proximal convoluted tubule (cortex)
Descending Loop of Henle (into medulla)
ascending Loop of Henle (into medulla)
Distal convoluted tubule (cortex)
Collecting duct minor calyx
Copyright 2010, John Wiley & Sons, Inc.

Nephron

Copyright 2010, John Wiley & Sons, Inc.

Classes of
nephrons

Cortical nephrons
85% of all nephrons
Almost entirely
within cortex

Juxtamedullary
nephrons
Renal corpuscles
near cortexmedulla junction

The Nephron

glomerulus
efferent arteriole

proximal
convoluted
tubule

blood

distal
convoluted
tubule
blood

afferent arteriole

Loop of Henle

Basic Operation
Glomerular filtration-filter plasma
Tubular reabsorption
Reabsorb needed compounds & water from
filtrate

Tubular Secretion
Secrete some materials into filtrate

Copyright 2010, John Wiley & Sons, Inc.

Basic Operation

Copyright 2010, John Wiley & Sons, Inc.

Glomerular Filtration

Two layers of capsule surround glomerulus

Between is capsular space
Podocytes support capillary epithelium
Form filtration membrane
Permeable to water & solute
but not most proteins & blood cells
Copyright 2010, John Wiley & Sons, Inc.

Podocytes (Glomerulus)

Filtration Pressure

Blood pressure for filtration

Opposed by colloid osmotic pressure and
capsular pressure
Efferent and afferent arteriole diameters
adjust to maintain a net filtration pressure
Even with small changes in blood pressure
Copyright 2010, John Wiley & Sons, Inc.

Glomerular Filtration Rate

= GFR 105-125 ml/min
Determines net reabsorption because it
determines filtrate flow
ANP increases GFR
Responds to increased blood volume

Sympathetic stimulation
vasoconstriction decreased GFR
Urine production
Copyright 2010, John Wiley & Sons, Inc.

Glomerular Filtration

Copyright 2010, John Wiley & Sons, Inc.

Tubular Reabsorption

Proximal tubule
~65% Na+ & H2O
Normally 100% nutrients
~100% HCO3- (depends on blood pH)

Active transport of solutes

Osmosis moves water
Cells distal to proximal tubule fine tune
reabsorption under control
Copyright 2010, John Wiley & Sons, Inc.

Tubular Reabsorption

Copyright 2010, John Wiley & Sons, Inc.

Tubular Reabsorption

Tubular Secretion

Takes place all along tubule

Major substances : H+, K+, ammonia, urea,
creatine, drugs like penicillin
Helps regulate plasma pH 7.35-7.45
Diet is acid urine is typically acidic
Copyright 2010, John Wiley & Sons, Inc.

Tubular Secretion

Filtration, Reabsorption,
Secretion

Copyright 2010, John Wiley & Sons, Inc.

The kidney produces urine through 4 steps:

Urine Route

Collecting ducts to calyces

Calyces to ureter
Ureter to bladder
Bladder to urethra

Copyright 2010, John Wiley & Sons, Inc.

Urine Route
Collecting ducts calyces
Ureter

Lined with mucus & transitional epithelium

Pass under bladder
Full bladder prevents backflow

Bladder- directly in front of rectum

Can stretch (700-800 ml)
Smaller in females because of uterus
Three layers of detrussor muscle

Urethra- internal urethral sphincter

External urethral sphincter (voluntary)
Copyright 2010, John Wiley & Sons, Inc.

Urine Route

Copyright 2010, John Wiley & Sons, Inc.

Urinary Bladder

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

43

44

Males: urethra has three

regions (see right)

_________trigone

1. Prostatic urethra__________
2. Membranous urethra____

3. Spongy or penile urethra_____

female

45

With all the labels

DIABETES MELLITUS

- When glucose in tubular

fluid exceeds the transport
maximum (180 mg/100 ml),
it appears in urine
(glycosuria).
- Glucose in tubular fluid
hinders water reabsorption
by osmosis, causing
polyuria.

high glucose

high glucose in
filtrate

Retain H2O by
osmosis

high urine
volume

high glucose in blood

high glucose in filtrate

Exceeds Tm for glucose

Glucose in urine

Components of Urine
Urine = 1-2 l /day
95% water
+ urea, creatine, K+, ammonia, uric acid,
Na+, Cl-, Mg2+, sulfate, phosphate & Ca2+
Depends on diet and state of health

Copyright 2010, John Wiley & Sons, Inc.

Hormonal Regulation
Angiotensin II & aldosterone
Angiotensin II- stimulates NaCl in proximal tube
Aldosterone- increases Na+ reabsorption & K+
secretion in DCT & CD
More ions reabsorbed more water

ANP-increases GFR & inhibits aldosterone

action less Na+ reabsorbed
ADH- responds to increased concentration of
solute in blood + fall in BP
Copyright 2010, John Wiley & Sons, Inc.

Hormonal Regulation
ADH: important to body water balance
Increased concentration of solute in blood
+ fall in BP ADH
With no ADH: DCT & CD walls are
impermeable to water dilute urine
With ADH: water reabsorption occurs
concentrated urine

Copyright 2010, John Wiley & Sons, Inc.

Micturition = Urination
Autonomic reflex- internal sphincter
Responds to stretch like rectum

Parasympathetic detrusor muscle

contraction
Conscious control-external sphincter

Copyright 2010, John Wiley & Sons, Inc.

Aging

Kidneys shrink- decrease in capacity

Thirst decreases dehydration
urinary tract infections
Males: prostate enlargement frequent
urination & slow flow
Females: more prone to leakage of
external sphincter (incontinence)
Both: nocturia
Copyright 2010, John Wiley & Sons, Inc.

For studying

Parts of the kidney:

1. Renal pyramid
2. Efferent vessel
3. Renal artery
4. Renal vein
5. Renal hilum
6. Renal pelvis
7. Ureter
8. Minor calyx
9. Renal capsule
10. Inferior renal capsule
11. Superior renal capsule
12. Afferent vessel
13. Nephron
14. Minor calyx
15. Major calyx
16. Renal papilla
17. Renal column