The Urinary

System

dr.Mey Biwanna

The Urinary System

Paired kidneys
A ureter for each kidney
Urinary bladder
Urethra
2

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
3

 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)

*
*

Note layers of
adipose (fat),
capsule, fascia

Transverse sections
show retroperitoneal
position of kidneys

Note also: liver,

aorta muscles
on CT
7

 Kidney has two regions

Cortex: outer
Columns of cortex divide medulla into pyramids

Medulla: inner
Darker, cone-shaped medullary or renal pyramids
Parallel bundles of urine-collecting tubules

The human kidney has lobes

Pyramid and cortical tissue surrounding it
5-11 per kidney

Renal pelvis (=basin)

Expanded, funnel shaped, superior part of ureter
Branches to form two or three major calices (seen best on right pic below)
Each of these divides again, minor calices: collect urine from papillae of
pyramids

10

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
11

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)
12

 Uriniferous tubule is the main structural and

functional unit
To left is a single, generalized
uriniferous tubule
More than a million of these
tubules act together to form the
urine
Three main mechanisms
a. Glomerular filtration
b. Tubular reabsorption
c. Tubular secretion
Two major parts
1. A urine-forming nephron
2. A collecting duct which
concentrates urine by removing
water from it
13

Outline
Uriniferous tubule (anatomical unit for
forming urine)
Nephron
Renal corpuscle (in cortex)
Glomerulus (tuft of capillaries)
Glomerular (Bowmans) capsule

Tubular section
Proximal convoluted tubule
Loop of Henle
Distal convoluted tubule

Collecting duct
14

Outline
Uriniferous tubule (anatomical unit for
forming urine)
Nephron
Renal corpuscle (in cortex)
Glomerulus (tuft of capillaries)
Glomerular (Bowmans) capsule

Tubular section
Proximal convoluted tubule
Loop of Henle
Distal convoluted tubule

Collecting duct
15

Understand at least this much:

Filtration
a. Fluid is squeezed out of
the glomerular capillary
bed

Resorption
b. Most nutrients, water ad
essential ions are
returned to the blood of
the peritubular
capillaries

Secretion
c. Moves additional
undesirable molecules
into tubule from blood of
peritubular capillaries
16

Nephron
Renal corpuscle
Tubular section

Uriniferous tubule (anatomical unit for forming urine)

Nephron
Renal corpuscle (in cortex)
Glomerulus (tuft of
capillaries)
Glomerular (Bowmans)
capsule
Tubular section
Proximal convoluted tubule
Loop of Henle
Distal convoluted tubule
Collecting duct

Renal corpuscle: only in

cortex
Tuft of capillaries called
glomerulus
Surrounded by cup-shaped,
hollow glomerular
(Bowmans) capsule
17

(refer to this
pic as we go)
-------------------Visceral

layer of
capsule has
podocytes
Unusual branching
epithelial cells
Foot processes with
slit processes
between them
18

Scanning EM of podocytes clinging to

capillaries (left) and filtration membrane
The capillary pores (fenestrations)
diagram (right)
restrict the passage of the largest
elements such as blood cells
The basement membrane and slit
diaphragm hold back all but the smallest
proteins while letting through small
molecules such as water, ions, glucose,
amino acids, and urea

19

Uriniferous tubule (anatomical unit for forming urine)

Nephron
Renal corpuscle
Tubular section

Nephron
Renal corpuscle (in cortex)
Glomerulus (tuft of capillaries)
Glomerular (Bowmans) capsule
Tubular section
Proximal convoluted tubule
Loop of Henle
Distal convoluted tubule
Collecting duct

(processes the filtrate)

Proximal convoluted
tubule
Loop of Henle
Distal convoluted
tubule
(ends by joining
collecting duct)

20

Proximal convoluted
tubule
Confined to renal
cortex
Cuboidal
epithelial cells
with long
microvilli (fuzzy
appearance in
pics)
Resorption of
water, ions and
solutes

Uriniferous tubule (anatomical unit for forming urine)

Nephron

Renal corpuscle (in cortex)

Glomerulus (tuft of capillaries)
Glomerular (Bowmans) capsu
Tubular section
Proximal convoluted tubule
Loop of Henle
Distal convoluted tubule
Collecting duct

21

Uriniferous tubule (anatomical unit for forming urine)

Nephron

Loop of Henle
Descending limb

Renal corpuscle (in cortex)

Glomerulus (tuft of capillaries)
Glomerular (Bowmans) capsule
Tubular section
Proximal convoluted tubule
Loop of Henle
Distal convoluted tubule
Collecting duct

Thin segment
Thick ascending
limb

22

Uriniferous tubule (anatomical unit for forming urine)

Nephron

Distal convoluted tubule

Confined to the
renal cortex
Simple cuboidal
epithelium
Selective
secretion and
resorption of ions

Renal corpuscle (in cortex)

Glomerulus (tuft of capillaries
Glomerular (Bowmans) caps
Tubular section
Proximal convoluted tubule
Loop of Henle
Distal convoluted tubule
Collecting duct

23

Classes of
nephrons

Cortical nephrons
85% of all
nephrons
Almost entirely
within cortex

Juxtamedullary
nephrons
Renal corpuscles
near cortexmedulla junction

24

Uriniferous tubule (anatomical unit for forming urine)

Nephron
Renal corpuscle (in cortex)
Glomerulus (tuft of capillaries)
Glomerular (Bowmans) capsule
Tubular section
Proximal convoluted tubule
Loop of Henle
Distal convoluted tubule
Collecting duct

Collecting Ducts

Collecting Duct
Each receives
urine from
several
nephrons
Run straight
through cortex
into the deep
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medulla

Uriniferous tubules
1. Nephron
2. Collecting ducts

Collecting Ducts

At papilla of
pyramid* ducts join
to form larger
papillary ducts
Empty into minor
calices
Role: conserve
body 26
fluids

The collecting ducts

The most important role is to conserve body
fluids
When the body must conserve water, the
posterior pituitary gland secretes ADH
(antidiuretic hormone)
ADH increases the permeability of the collecting
tubules and distal tubules to water so more is
reabsorbed
This decreases the total volume of urine
Alcohol inhibits the release of ADH, so less
water is reabsorbed producing copious amounts
of dilute urine (can cause dehydration)
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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

28

(vessels, continued)
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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Histology

30

31

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

32

33

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

34

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 urine35

Three basic layers

Transitional epithelium
of mucosa stretches
when ureters fill
Muscularis

Ureters play an active

role in transporting urine
(its not just by gravity)

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)
36

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
37

38

39

40

 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)

41

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

42

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____

43

 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

44

With all the labels

45

 Micturition
AKA:
Voiding
Urinating
Emptying the bladder
(See book for diagram
explanation p 701)

KNOW:
Micturition center of brain:
pons
(but heavily influenced by
higher centers)
Parasympathetic: to void
Sympathetic: inhibits
micturition
46