The Urinary
System
Organs of the Urinary system
Kidneys (2)
Ureters (2)
Urinary bladder (1)
Urethra (1)
Location of the Kidneys
Dimensions
Reddish-brown, bean shaped
12cm long, 6cm wide, 3cm thick
High on posterior abdominal wall
at the level of T12 to L3- superior lumbar region
Retroperitoneal & against the dorsal body wall
The right kidney is slightly lower than the left ,convex
laterally
Attached to ureters, renal blood vessels, and nerves
at renal hilus (medial indention)
Atop each kidney is an adrenal gland
Coverings of the Kidneys
Adipose capsule
Surrounds the kidney
Provides protection to the kidney
Helps keep the kidney in its correct location against
muscles of posterior trunk wall
Ptosis-kidneys drop to a lower position due to rapid
fat loss, creating problems with the ureters.
Ptosis can lead to hydronephrosis, a condition
where urine backs up the ureters and exerts
pressure on the kidney tissue.
Renal capsule
Surrounds each kidney
Regions of the Kidney
Three regions of kidneys
Renal cortex – outer region, forms
an outer shell
Renal columns – extensions of
cortex- material inward
Renal medulla – inside the cortex,
contains medullary (renal) pyramids
Medullary pyramids – triangular
regions of tissue in the
medulla, appear striated
Renal pelvis – inner collecting tube,
divides into major and minor
calyces
Calyces – cup-shaped
structures enclosing the tips of
the pyramids that collect and
funnel urine towards the renal
pelvis
Functions of the Urinary System
Elimination of waste products
filtering gallons of fluid from the bloodstream every day
creating “filtrate”
“filtrate” includes: metabolic wastes, ionic salts, toxins, drugs
Maintenance of blood
Red blood cell production- by producing hormone
erythropoietin to stimulate RBC production in bone
marrow
Blood pressure (vessel size)- by producing renin which
causes vasoconstriction
Blood volume (water balance)- ADH released from
Anterior Pituitary targets the kidney to limit water loss
when blood pressure decreases or changes in blood
composition
Blood composition (electrolyte balance)- water follows
salt; aldosterone reclaims sodium to the blood
Blood pH- regulates H+ ions and HCO3- ions
Blood Flow in the Kidneys
Rich blood supply to filter blood and adjust blood composition
~¼ of blood supply passes through the kidneys each minute
Blood enters the kidneys under extremely high pressure
Renal artery arises from abdominal aorta, divides into Segmental
artery at hilus
Inside renal pelvis, Segmental artery divides into Lobar artery, which
branch into Interlobar artery travelling thru the renal column to reach
the renal cortex
At the medulla-cortex junction, the Interlobar artery curves over the
medullary pyramids as the Arcuate artery.
Small Interlobular arterioles branch off of the Arcuate artery and
move away from the renal cortex and into the Nephron of the kidney
Blood Flow in the Kidneys
The final branches of the interlobular arteries are called afferent
arterioles.
Afferent arterioles lead to the glomerulus, a network of capillaries
that are involved in filtration.
Leading away from the glomerulus, blood less filtrate travels through
the efferent arterioles and into the peritubular capillaries.
From there, blood moves through similar veins that parallel the
arteries at their respective locations.
Nephrons
The structural and functional units of the kidneys
Over 1 million
Responsible for forming urine
Consist of renal corpuscle and renal tubule
Renal corpuscle composed of a knot of capillaries
called the Glomerulus (a.k.a. Bowman’s Capsule)
Renal tubule- enlarged, closed, cup-shaped end
Glomerulus
A specialized capillary bed fed and
drained by arterioles.
Glomerular capillaries filter fluid from
the blood into the renal tubule
GC is attached to arterioles on both
sides in order to maintain high pressure
Large afferent arteriole-arises from
interlobular artery (feeder vessel);
large in diameter, high resistance
vessels that force fluid & solutes
(filtrate) out of the blood into the
glomerular capsule.
99% of the filtrate will be reclaimed
by the renal tubule cells and
returned to the blood in the
peritubular capillary beds(blood
vessels surrounding renal tubule) .
Narrow efferent arteriole-merges to
become the interlobular vein; draining
vessel.
Glomerulus
Glomerular capillaries are covered with
podocytes from the inner (visceral) layer of
the glomerular capsule.
Podocytes have long, branching
processes called pedicels that
intertwine with one another and cling to
the glomerular capillaries.
Filtration slits between the pedicels
form a porous membrane around the
glomerular capillaries.
The glomerular capillaries sit within a
glomerular capsule (Bowman’s capsule)
Expansion of renal tubule
Receives filtered fluid
Renal Tubule
Glomerular (Bowman’s) capsule
enlarged beginning of renal tubule
Proximal convoluted tubule- lumen
surface (surface exposed to filtrate) is
covered with dense microvilli to increase
surface area.
The descending limb of the nephron -
Loop of Henle
The ascending limb of the nephron coils
tightly again into the distal convoluted
tubule
Urine Formation Processes
Filtration- Water & solutes
smaller than proteins are forced
through the capillary walls and
pores (of the glomerulus) into the
renal tubule (Bowman’s capsule).
Reabsorption- Water, glucose,
amino acids & needed ions are
transported out of the filtrate into
the peritubular capillary cells and
then enter the capillary blood.
Secretion- Hydrogen ions,
Potassium ions, creatinine & drugs
are removed from the peritubular
capillaries (blood) and secreted by
the peritubular capillary cells into
the filtrate.
Filtration
Beginning step of urine formation
Occurs at the glomerulus, nonselective passive process
Water and solutes smaller than proteins are forced through
capillary walls of the glomerulus, which act as a filter.
Fenestrations – (openings in glomerular walls) make
glomerulus more permeable than other arterioles.
Podocytes cover capillaries, make membrane impermeable to
plasma proteins.
Blood cells cannot pass
out to the capillaries; filtrate
is essentially blood plasma
w/o blood proteins, blood cells.
Filtrate is collected in the
glomerular (Bowman’s) capsule
and leaves via the renal tubule
Reabsorption
The composition of urine is different than the composition of
glomerular filtrate.
Tubular reabsorption returns substances to the internal
environment of the blood by moving substances through
the renal tubule walls into the peritubular capillaries (99%)
Some water, ions, glucose, amino acids
Some reabsorption is passive = water osmosis
= small ions diffusion
Most is active using protein carriers by active transport
Most reabsorption occurs in the proximal convoluted
tubule, where microvilli cells act as transporters, taking up
needed substances from the filtrate and absorbing them
into the peritubular capillary blood.
Substances that remain in the renal tubule become more
concentrated as water is reabsorbed from the filtrate.
Reabsorption – sodium and water
The sodium potassium pump reabsorbs 70% of sodium ions
in the PCT.
The positive sodium ions attract negative ions across the
membrane as well
Water reabsorption occurs passively across the membrane
to areas of high solute concentration
Therefore, more sodium reabsorption = more water
reabsorption
Active transport of sodium
ions occurs along remainder
of nephron and collecting duct
Almost all sodium ions
and water are reabsorbed.
Materials Not Reabsorbed
Nitrogenous waste products
Urea – formed by liver; end product of
protein breakdown when amino acids are
used to produce energy
Uric acid – released when nucleic acids are
metabolized
Creatinine – associated with creatine
metabolism in muscle tissue
Excess water
Secretion – Reabsorption in Reverse
Some materials move from the peritubular capillaries
into the renal tubules to be eliminated in urine.
Example:
Hydrogen ions; potassium ions
Creatinine
Drugs; penicillin; histamine
Process is important for getting rid of substances not
already in the filtrate or for controlling pH.
Materials left in the renal tubule move toward the
ureter
Formation of Urine
Summary:
• glomerular filtration of
materials from blood
plasma
•Reabsorption of
substances, including
glucose; water, sodium
•Secretion of substances,
including penicillin,
histamine, hydrogen and
potassium ions
Maintaining Water Balance
Normal amount of water in the human
body
Young adult females – 50%
Young adult males – 60%
Babies – 75%
Old age – 45%
Water is necessary for many body
functions and levels must be maintained
Maintaining Acid-Base Balance in
Blood
Blood pH must remain between 7.35 and 7.45 to maintain
homeostasis
Alkalosis – pH above 7.45
Acidosis – pH below 7.35
Most acid-base balance is maintained by the kidneys
Excrete bicarbonate ions if needed
Conserve / generate new bicarbonate ions if needed
Excrete hydrogen ions if needed
Conserve / generate new hydrogen ions if needed
Regulation of these ions results in a urine pH range of 4.5 to 8.0
Acidic urine: protein-rich diet, starvation, diabetes
Basic urine: bacterial infections, vegetarian diet
Characteristics of Urine Used for
Medical Diagnosis
Colored somewhat yellow due to the
pigment urochrome (from the
destruction of hemoglobin/bilirubin by-
product) and solutes
Sterile
Slightly aromatic
Normal pH of around 6
Specific gravity of 1.001 to 1.035
Urine composition
Composition differs considerably based upon diet,
metabolic activity, urine output.
~95% water, contains urea and uric acid,
electrolytes and amino acids (trace amount)
Volume produced ranges from 0.6-2.5 liters per day
(1.8L average).
Depends on fluid intake, body and ambient air
temperature, humidity, respiratory rate, emotional
state
Output of 50-60ml per hour normal, less than 30ml
per hour may indicate kidney failure
Ureters
Slender tubes attaching the kidney to the bladder 10-12” long & ¼”
diameter
Superior end is continuous with the renal pelvis of the kidney
Mucosal lining is continuous with that lining the renal pelvis and
the bladder below.
Enter the posterior aspect of the bladder at a slight angle
Runs behind the peritoneum
Peristalsis aids gravity in urine transport from the kidneys to the
bladder.
Smooth muscle layers in the ureter walls contract to propel urine.
There is a valve-like fold of bladder mucosa that flap over the ureter
openings to prevent backflow.
Renal calculi= calculus means little stone; result of precipitated uric
acid salts created by bacterial infections, urinary retention, and
alkaline urine. Lithotripsy or surgery are common treatments.
Urinary Bladder
Smooth, collapsible, muscular sac
Temporarily stores urine
Located retroperitoneally in the pelvis
posterior to the pubic symphysis.
Urinary Bladder
Trigone – three openings
Two from the ureters (ureteral orifices)
One to the urethra (internal urethral orifice) which drains the
bladder.
Common site for bacterial infections
In males, prostate gland surrounds the neck of the bladder where it
empties into the urethra.
Urinary Bladder Wall
Three layers of smooth muscle (detrusor muscle)
Mucosa made of transitional epithelium
Walls are thick and folded in an empty bladder 2-3” long
Bladder can expand significantly without increasing
internal pressure
As it fills, the bladder rises superiorly in the abdominal
cavity becoming firm and pear shaped.
A moderately full bladder can hold ~500mL (1 pint) of
urine.
A full bladder can stretch to hold more than twice that
amount.
Urethra
Thin-walled tube that carries urine from the bladder to
the outside of the body by peristalsis
Release of urine is controlled by two sphincters
Internal urethral sphincter (involuntary) – a thickening
of smooth muscle at the bladder-urethra jxn. keeps
urethra closed when urine is not being passed.
External urethral sphincter (voluntary) --
skeletal muscle that controls urine as the
urethra passes through the pelvic floor.
Urethra Gender Differences
Length
Females – 3–4 cm (1-1.5 inches)
Males – 20 cm (7-8 inches)
Location
Females – along wall of the vagina
Males – through the prostate and penis
Function
Females – only carries urine
Males – carries urine and is a passageway for
sperm cells
Urethra Gender Differences
Females:
•Feces can enter urethral opening causing
•Uretritis-inflammation of the urethra
•Pyelitis or pyelonephritis-inflammation of the kidneys
•Urinary tract infections-bacterial infection
•Dysuria
•Urgency
•Frequency
•Fever
•Cloudy urine
•Bloody urine
Males:
•Prostatic, membranous and spongy (penile) urethrae
•Enlargement of the prostate gland causes urinary retention
•can be corrected with a catheter
Micturition (Voiding)
Both sphincter muscles must open to allow
voiding
The internal urethral sphincter is relaxed after
stretching of the bladder ~200mL
Activation is from an impulse sent to the spinal
cord and then back via the pelvic nerves
The external urethral sphincter must be
voluntarily relaxed
Incontinence-inability to control micturition
Retention-inability to micturate