URINARY SYSTEM

- Also known as the excretory system (under urinary system, not digestive)
- Concerns removal of excess metabolic wastes of the body by producing urine ; Eliminates wastes
from the body through formation of urine by the kidney
- Regulates blood volume, blood pressure and blood pH (because of the H20 elimination)
- Controls levels of electrolytes and metabolites
- Impulses from the filling bladder are carried to the spinal cord via pelvic and hypogastric nerves
- Pudendal and hypogastric nerve carry impulses from the neck of the bladder to the urethra

REMEMBER:
Lungs and skin play role in excreting waste products and fluid from the body. However, the kidneys bear
the major responsibility of eliminating nitrogenous wastes (nitrogen containing waste products), toxins,
and drugs

TERMS:
URINATION- voiding of urine from the urinary bladders
MICTURITION- physiological process of urination, which involves nerve impulses and muscular response
of lower abdomen

FUNCTIONS OF URINARY SYSTEM

1. FILTRATION OF THE BLOOD

- Filtration: process of filtering substances (gas, liquid, solid)
- Occurs in the glomerulus of the kidney nephron
- Contributes to the homeostasis (balance or equilibrium) by removing toxins and waste products

2. REABSORPTION OF VITAL NUTRIENTS, IONS, AND WATER

- Occurs in most parts of the kidney nephron
- Contributes to homeostasis by conserving important materials

3. SECRETION OF EXCESS MATERIALS

- Assist in filtration, specifically in removing material from the blood
- Contributes to homeostasis by preventing built up of substances such as drugs and waste
products

4. ACTIVATION OF VITAMIN D
- Made in the skin and is converted to vitamin D3 by the kidneys
- Contributes to homeostasis by increasing calcium absorption from the digestive tract (calcium is
needed as it strengthens bones and teeth)

5. RELEASE OF ERYTHROPOIETIN BY THE KIDNEY

- Hormone secreted by certain cells in kidneys
- Stimulates new RBC production
- RBCs assist in homeostasis by ensuring adequate oxygen and carbon dioxide transport
6. RELEASE OF RENIN BY THE KIDNEY
- Renin : proteolytic enzyme of kidneys
- Stimulates formation of powerful vasoconstrictor called angiotensin II
- Angiotensin II assist in homeostasis by causing vasoconstriction, which increases blood pressure

7. RELEASE OF PROSTAGLANDINS
- Hormone-like substance present in kidneys and body fluids
- Release of this dilate kidney blood vessels
- Contributes to homeostasis by maintaining blood flow in the kidneys

8. SECRETION OF HYDROGEN ION/ H (+1) AND REABSORPTION OF BICARBONATE/ HCO3 (-1)

- These eliminates excess hydrogen ions and conserve buffer materials such as bicarbonate
- Contributes to homeostasis by controlling acid-base conditions in the body fluid

Buffer- a chemical substance which causes resistance to pH change when acids and alkali are added
to the buffer solution
Sodium bicarbonate- one of the chief buffers of the blood and tissue fluids

STRUCTURES/ ORGANS OF THE URINARY SYSTEM

KIDNEY
- A 2 bean-shaped organ that lies in the retroperitoneal space (between the body wall and parietal
peritoneum on either side of vertebral column)
- Located in the upper abdominal area/ cavity
- The upper portion of kidneys rest on the lower surface of diaphragm enclosed by lower ribcage
- To assess location of kidney at the posterior part of the body, this extends from T12 (thoracic) to L3
(lumbar) vertebra
- The right kidney is positioned lower than the left kidney, because it is crowded by the liver

Main function: Removes dissolved waste and excess substances from the blood and urine through the
glomerulus of the nephron

REGULATORY FUNCTIONS OF THE KIDNEY

- Kidneys maintain the purity and constancy of fluids in our internal environment (perfect example of
homeostatic balance)
- The kidney filter gallons of fluid from the bloodstream which allows the toxins , metabolic wastes and
excess ions to leave the body with the urine
- Kidneys also return the needed substances to the blood
- The kidney corrects fluid and electrolyte imbalance and maintains aid base balance
- Kidney has the major responsibility for eliminating nitrogenous wastes, toxins and drugs from the
body urine— the end product

What happens if urine is not eliminated from our body?

- Toxics will remain which causes imbalance of homeostasis
 PARTS OF THE KIDNEY

HILUM- Small indented opening where an artery, vein, nerves and ureters enter and leave the kidney
RENAL ARTERY- branch of abdominal aorta entering the kidney; supplies it with oxygenated blood
RENAL VEIN- emerges from the kidney and returns deoxygenated blood to the inferior vena cava
URETERS- emerges from the kidney and transports urine to the urinary bladder

THREE LAYERS OF SUPPORTIVE TISSUE OF THE KIDNEY

1. RENAL CAPSULE
- Innermost layer which is a tough, fibrous material covering the kidney
- Continues to the surface layer of ureters; prevents the entrance of infection
2. ADIPOSE CAPSULE
- Middle layer composed of perirenal (around the kidney) fat
- Gives kidneys a protective cushion against impact and joles

3. RENAL FASCIAE
- Outermost layer which is a sub-serous fascia (composed of connective tissue) that surrounds
kidney and attaches it firmly to the posterior abdominal wall
- Flexible to permit the kidneys to shift slightly as the diaphragm moves during breathing
- Help hold the kidneys in place

INTERNAL STRUCTURES OF KIDNEY

1. RENAL PARENCHYMA
- Functional part and specialized structure of kidney (includes renal cortex and renal pelvis)
- Parenchyma: specialized part of an organ

A. RENAL CORTEX
- Outermost layer of the kidney; made of renal corpuscles and convoluted tubules
- Where most of nephrons are located: Site of glomeruli, proximal and distal tubules of nephron
- Main site for filtration, reabsorption and secretion
- Inner core of the kidney that contains the renal pyramid, renal columns, renal papillae, calyses,
renal pelvis and parts of the nephron, are not located in the cortex

B. RENAL MEDULLA
- Middle layer formed by collecting tubules and ducts
- Composed of series of triangular masses called renal pyramids, separated by renal column
- Used for salt, water, and urea absorption

2. RENAL PELVIS- collects urine from all the calyces of kidneys

a. RENAL PAPILLAE
- Projection of renal fissure located at the tip of renal pyramid
- Tip of the renal pyramid releases urine into calyx
 b. CALYX
- A collecting sac surrounding the renal papilla that transports urine from papilla to renal pelvis
- Major calyces join to form the renal pelvis that collects urine and funnels it to ureter
 Minor calyx- collects urine from the collecting ducts
 Major pelvis- collects urine from the renal sinus to the renal pelvis

NEPHRON
- Functional unit of kidney; Each kidney contains about 1 million nephrons
- Where urine is formed with the associated blood vessels
- All tubules in the body are 80 km in length (50 miles)

FUNCTIONS:
1. Accomplishes initial filtration of blood
2. Selective reabsorption back into the blood of filtered substances
3. The secretion of unwanted substances

PARTS OF THE NEPHRON

A. RENAL CAPSULES (vascular system of nephron)

- Outer membrane that encloses, supports and protects the kidney.

1. BOWMAN’S CAPSULE (GLOMERULUS CAPSULE)

- Surrounds the glomerulus, located in the cortex of the kidney
- First part of the tubular component of the nephron
- Made of squamous epithelium
- Inner layer is made of podocytes
 Podocytes: means “foot cells”; has pores and spaces between adjacent feet which
makes the layer permeable

2. GLOMERULUS
- Capillary network; covered by Bowman’s capsule
- Permeable to water, electrolytes, nutrients and waste products but not permeable to large
protein molecules
- Arises from afferent arterioles and empties to efferent arterioles

B. RENAL TUBULES
- Continuous from Bowman’s capsule and is divided into parts:
 Proximal convoluted tubule
 Distal convoluted tubule- empties into a collecting duct (papillary) which serves several
nephrons
 Ascending limb of loop of Henle
 Descending limb of loop of Henle
 Collecting ducts
 URETERS
- 2 tubules approximately 25-35 cm long
- Extends from the renal pelvis to the pelvic cavity; convey urine from kidneys to the bladder

URETEROVESICAL VALVE
- Valve between urinary bladder and ureter; Prevents the backflow of urine to the ureter

LAYERS OF URETER

1. TUNICA MUCOSA- Innermost layer; Epithelial connective tissue layer

2. TUNICA MUSCULARIS- Middle layer; Smooth muscle tissue
3. TUNICA ADVENTITIA- Outermost fibrous layer

URINARY BLADDER
- Located behind the symphysis pubis and is composed of elastic tissue
- Serves as reservoir of urine
- Capable of holding 1,000-1,800 mL; Moderately full bladder holds about 500 mL
- Internal and external sphincters control the flow of urine
- The urge to void is stimulated by the passage of urine in the internal sphincter which is involuntary
- Relaxation of the external sphincter (voluntary) produces emptying of bladder (voiding/micturition)
- The opening of the ureters and the urethra into the cavity of the bladder outline the triangular area
called trigone

TUNICS OR LAYERS OF URINARY BLADDER

1. MUCOSA- Innermost layer that permits distention of the organ; made of transitional epithelium and
Lamina propria (highly vascular layer of connective tissue)
2. SUBMUCOSA- Consist of vascular tissue which provides a rich blood supply
3. MUSCULARIS- Called the detrusor muscle, which aids in micturition; made of thick smooth muscle
4. SEROSA- Made of simple squamous epithelium; Physical and functional continuation of perineum

URETHRA
- Thin fibromuscular tube that begins at the lower opening of the bladder
- Extends through the pelvic and urogenital diaphragm to the outside of the body called the external
urethral orifice (orifice: opening)
- Small tube leading from the internal urethral orifice in the floor of the urinary bladder to the exterior of
the body
- Conveys urine from the bladder to the exterior; Terminal portion of urinary system

Internal urethral orifice: Located below the urinary bladder; connected to urethra
External urethral orifice: Urethral opening/ opening of the urethra to the exterior
 INTERNAL URETHRAL SPHINCTER
- Urethral muscle which constricts the internal urethral orifice
- Located at the junction of the urethra and urinary bladder
- Continuous to detrusor muscle (remains relax to allow the bladder to store urine; contracts during
urination to release the urine)

FEMALE’S URETHRA
- Lies directly posterior to the pubic symphysis/ pubis symphysis, length is 4 cm (1.5 in)
- Walls of female urethra consists of mucosa (mucous membrane composed of epithelium and lamina
propia) and muscularis (type of muscle)

Lamina propia- Areolar connective tissue having elastic fibers and plexus of veins
External urethral orifice- Located between the clitoris and vaginal opening; aka urogenital sphincter

MALE’S URETHRA
- Extends from the internal orifice to the exterior: passes first to the prostate then to the deep muscles
of the perineum then through the penis
- Distance of about 20 cm (8 inches)
- Made up of deep mucosa and superficial muscularis
- Discharges both urine and semen that contains sperm
- Connected to the ductus deferens or vas deferens for ejaculation of sperm

DIVISIONS OF MALE URETHRA

1. PROSTATIC URETHRA
- Passes through the prostate; 3cm (1.18 in)
- Surrounded by prostate gland

2. MEMBRANOUS URETHRA
- Shortest portion that passes to the deep muscle of perineum
- Around membranous urethra is the external urethral sphincter; 2 cm (0.787 in)

External urethral sphincter- Composed of striated muscle which is located distally and inferiorly to
the urinary bladder neck

3. SPONGY URETHRA
- Also known as Penile urethra
- Longest proportion that passes through the penis; 15 cm (5.9 in)

4. BULBAR URETHRA/ BULBOUS URETHRA

- Found under the scrotum (covers the testes) in the perineum
- Not well protected which makes it susceptible to injury

Urethral stricture- Occurrence of scarring due to swelling by injury or infection that blocks or slows
the flow of urine in the urethra
 RENAL VESSELS

1. RENAL ARTERY- transports oxygenated blood form the heart and aorta to the kidney for filtration
2. RENAL VEIN- transports filtered and deoxygenated blood from the kidney to the posterior vena
cava and heart
3. RENAL COLUMN- passageway located between the pyramids found in the medulla and used as
a space for blood vessels

FORMATION OF URINE
GLOMERULAR OR RENAL FILTRATION
- First step for purification of the blood called glomerular filtration
- Nonselective passive process in which fluids and solutes are forced through ab membrane by the
hydrostatic pressure (a force generated by the pressure of fluid on the capillary wall by plasma or
interstitial fluid)

HOW?
 Blood flows through glomerular capillaries; water and dissolved materials are forced through the
cellular lining of the capillaries by blood pressure

Glomerular filtrate- the liquid being filtrated (150- 180 L per day) which travels to the innermost
layer of Bownman’s capsule

 The filtrate that is formed is essentially blood plasma without proteins- absent because they are
too large to pass through the filtration membrane; Presence of proteins implies that there is a
problem in the glomerular filtration.

BLOOD
BLOOD CONSTITUENTS IN GLOMERULAR FILTRATE CONSTITUENTS
REMAINING IN THE
GLOMERULUS

Water CREATININE Remaining in the

Mineral salts - Chemical waste product produced by the muscles glomerulus:
Amino acids
during metabolism and smaller extent by eating
Keto acids 1. RBC
Glucose meat. If kidneys are not functioning properly, an 2. Platelets
Hormones increase of level of creatinine may accumulate in 3. Blood proteins
Creatinine the blood. Creatinine level is tested from 3-10 ml 4. WBC
Urea blood sample, or urine.
Uric acid
Toxins Normal amount of creatinine= 0.84 -1.21 mg/ dL
Drugs(medications) (deciliter)
Creatinine levels that reach up to 2.0 or more for
babies or young children, and 5.0 or more for
adults, may indicate severe kidney impairment
 TUBULAR REABSORPTION

- About 99% of water in the glomerular filtrate formed in the glomerular capsule is eventually returned
to the blood (What is only reabsorbed are the needed materials)
- Other 1% is excreted in the form of urine
- Water and selected solutes re-enter the blood in the peritubular capillaries and vasa recta
 Vasa recta/ Vasa Rectae Renis- straight arterioles and straight venules of the kidneys

- The tubular reabsorption from the tubules of the nephron is controlled by the epithelial cells of the
nephron tubule
- Mostly of the nutritionally important substances such as glucose, small proteins, amino acids, citric
acid, and inorganic ions (phosphate and sulfate) are completely reabsorbed by the proximal
convoluted tubules and collecting duct

MAIN FUNCTION: To reabsorbed filtrate needed in the body , which maintain balance of fluid,
electrolyte, and blood alkalinity

MECHANISMS OF REABSORPTION

1. ACTIVE TRANSPORT
- use of chemical energy to transport substances against concentration gradient, such as amino
acids, sodium, calcium, potassium, phosphate, chloride, ions and other substances
2. PASSIVE TRANSPORT
3. OSMOSIS
4. PINOCYTOSIS

TUBULAR SECRETION
- Final step in the composition of urine, which depends on secretion of certain substances from the
blood into the filtrate
- Substances are actively secreted from the blood in the peritubular capillaries of the renal tubule
- The tubular secretion allows the kidney to increase their efficiency in clearing certain substances from
the blood plasma; Helps maintain the normal pH (7.35-7. 45)
- The amount of urine secreted and the specific gravity and vary according to the fluid intake and the
amount of solute excreted.
- Urine production is decreased during sleeping and exercise because fluids are excreted during
sweating

SUMMARY OF URINE FORMATION

1. Blood pressure forces the plasma containing substances and small proteins out of the glomeruli in to
the Bowman’s capsule. As it passes through the capsule, the substances and small proteins are
filtered and becomes renal filtrates.
2. The filtrate then goes to the proximal convoluted tubule, where reabsorption takes place. The
nutrients and waste products located from the proximal convoluted tubule to the peritubular capillaries
are reabsorbed within 24 hours.
3. Urine passes through the loop of Henle then out of the urethra.
 EFFERENT ARTERIOLE
- Blood vessel leading away
from glomerulus
- Carries deO2 blood
- Breaks into second
capillary network to other
glomerulus
- Supplies O2 to the
remainder nephrons of the
kidneys
Distal
Convoluted Tube AFFERENT ARTERIOLE
- Blood vessel entering the
glomerulus or glomerular
sac then subsides into
clusters of capillaries

Peritubular GLOMERULUS
Capillaries - Where filtration takes
place

Renal Artery
Connected to the abdominal aorta

COMPOSITION OF URINE PHYSICAL PROPERTIES OF URINE

Water 96% Acidity- Normal pH: 5.0-8.0 or 4.6-8.0 (slightly acidic)

Urea 2%  Meat Eater- pH 5.0 – 6.0
Oxalates 2%  Vegetarian- Ph 7.0 – 8.0 (Slightly Alkaline)
Specific gravity- 1.001- 1.035 / 1.002-1.030
Substances that contains  Dependent to the total amount of solutes of urine
nitrogenchloride, potassium, Color
sodium, creatinine,
- Normally translucent; Color is due to the presence of bilirubin
phosphates and uric acid,
sulfate (bile pigment altered in the inetstines during digestion)
 Transparent- Sign of over dehydration; Normal
Oxalate: Salts of oxalic acid,  Pale Yellow- Healthy and dehydrated
organic acid from the food we  Dark Yellow- Normal but should increase water consumption
eat
 Brownish Orange- Sign of dehydration; Possible sign of
Urea: Contains nitrogen liver disease; Too much bilirubin
 Pinkish Red- Possible sign of kidney disease, UTI, or tumor;
Urine composition depends presence of blood
on diet, water consumption,  Foamy Texture- Sign of kidney disease
and exercise/ fitness of a
person
Medications such as drugs may decolorize urine
e.g. Metronidazole- antibacterial/antiprotozoal drug; dark brown
URINALYSIS
- Used to check if the person is dehydrated or has impaired kidney problems
- To perform urinalysis, urine sample must be obtained by cleaning the urethral area before
urinating, and taking the midstream urine
- Specific gravity of 1.010 indicates mild dehydration

OTHER FACTS ABOUT URINE

Low specific gravity- May indicate diseases (e.g. diabetes insipidus and glomerulonephritis) caused
by inadequate secretion of antidiuretic hormone (by pituitary gland) and is get through congenital,
infections or injury. Glomerulonephritis is a non-suppurative acute/chronic disease; inflammation of the
tiny filters in kidneys.

Higher specific gravity indicates higher level of dehydration and solute levels.

For every 2 L intake of water =800 to 2,000 mL urine is secreted. Under normal conditions, a person
should excrete 1,000 to 1,500 mL urine per day.

Urine has an aromatic but not unpleasant odor if it is fresh and free from organisms. When
microorganisms contaminate urine, urea is converted to ammonia, which produces a harsh unpleasant
smell.

TUBULAR FUNCTION
Includes tubules ( proximal and distal convoluted tubules, peritubular capillaries, ascdening and descend
loop of Henle) and collecting ducts. Reabsorption of water and electrolytes is controlled by antidiuretic
hormone (ADH) and aldosterone (adrenal glands)

BLOOD PRESSURE AND CONTROL

- Kidneys regulate blood pressure partly through the maintenance of volume
- Renin- angiotensin, a peptide hormone, is the other kidney’s control mechanism that can contribute
to the rise of blood pressure.
- When warm blood pressure drops, the cells of glomerulus release renin which activates angiotensin
to cause vasoconstriction.
- Continuous vasoconstriction increases blood pressure, which can damage the blood vessels in the
kidneys, therefore, reducing their ability to carry out their functions properly.

HORMONES THAT INFLUENCE REABSORPTION OF

WATER

1. ALDOSTERONE (adrenal cortex)

- Decreases blood pressure, which also decreases sodium levels.

2. ATRIOPEPTIN/ATRIAL NATRIURETIC PEPTIDE (atria)

- Decreases the absorption of sodium ions by kidneys to increase elimination of sodium and water
- Lowers blood pressure / blood volume
3. ANTIDIURETIC HORMONE (posterior pituitary gland)
- Maintains normal blood volume, permits kidney to produce urine
- Reabsorbs more water from renal filtrate

4. ERYTHROPOIETIN- stimulates RBC production in bone marrow

DISORDERS IN URINARY SYSTEM

CYSTITIS is an inflammation of the bladder. Inflammation is where part of your body becomes irritated,
red, or swollen. In most cases, the cause of cystitis is a urinary tract infection (UTI). A UTI happens when
bacteria enter the bladder or urethra and begin to multiply.

NEPHROLITHIASIS (kidney stones) is a disease affecting the urinary tract. Kidney stones are small
deposits that build up in the kidneys, made of calcium, phosphate and other components of foods. They
are a common cause of blood in urine.

UROLITHIASIS The process of forming stones in the kidney, bladder, and/or urethra (urinary tract).
Kidney stones are a common cause of blood in the urine and pain in the abdomen, flank, or groin. Kidney
stones occur in 1 in 20 people at some time in their life.

Nephrolithiasis vs Urolithiasis
Urolithiasis refers to stones originating anywhere in the urinary system, including the kidneys and
bladder. Nephrolithiasis refers to the presence of such stones in the kidneys.

ACUTE KIDNEY FAILURE happens when your kidneys suddenly lose the ability to eliminate excess
salts, fluids, and waste materials from the blood. This elimination is the core of your kidneys' main
function. Body fluids can rise to dangerous levels when kidneys lose their filtering ability.

URINARY TRACT INFECTION (UTI) is an infection in any part of your urinary system — your kidneys,
ureters, bladder and urethra. Most infections involve the lower urinary tract — the bladder and
the urethra. Women are at greater risk of developing a UTI than are men.
KIDNEY
NEPHRON

URETERS
URINARY BLADDER

URETHRA
RENAL VESSELS