Urinary System -

actually a miniature filtering or sieving

device which consists of a tightly
 Regulates the quantity and composition of
coiled network of capillaries
the fluids by removing metabolic waste from
b. Bowman’s capsule
our body
- thin walled sac-like structure,
 Helps in retaining proper amounts of water,
surrounds the glomerulus
salts and nutrients
 Renal tubular
Components:
*waste is filtered from the blood and collected as
 Kidney urine
 Ureters
*healthy kidneys act like a strong filter to make sure
 Urinary bladder
the right amount of waste and fluids are removed
 Urethra
from our body
Kidney
Ureter
 Dark red, slightly flattened bean-shaped
- A long tube where the urine from both
organs each about 10 cm long, 5 cm wide,
kidneys slides down
2-3 cm thick; 120-170 g ave. weight
- Opens into a storage sack known as urinary
Main job: to filter the waste out of the blood bladder

Main function: remove waste products and excess Urinary Bladder

water from the blood with the help of tiny filters
- Where urine is stored until the bladder is
present in it – Nephrons
emptied by urinating
Location: against the back wall of the abdominal - Connected to another tube-like structure
cavity below the diaphragm, one on either side of called the urethra
the vertebral column
Urethra
Position: slightly asymmetrical; the left is placed a
- Where the removal of the urine out of the
little higher than the right
body takes place
Outer surface: convex
*everyday our kidneys process around 200L of
Inner surface: concave; has a deep notch; you can blood and around 1-2L of waste is removed as
see the ureter, and renal artery and vein entering urine
the kidney through this notch
Functions of the Kidneys:
Fibrous capsule – surrounds the inside of the
 Removing metabolic wastes in the form of
kidney with two zones: [both zones together
urine
comprise millions of nephrons
 Filters large amount of blood plasma, they
1. Cortex – reddish-brown layer of the tissue are well positioned to detect changes in
below the capsule blood volume and composition, and respond
2. Medulla – form of pale conical shape accordingly
striations *kidneys filter about 50 gal of blood/day
 Maintaining blood homeostasis of many
Nephron – structural and functional unit of a kidney blood parameters such as:
Each nephron consists of:  Blood volume and pressure
 Osmolality
 Renal corpuscle – composed of two  Concentrations of various solutes
structures:  Blood pH
a. Glomerulus  RBC count
- tangled cluster of blood capillaries
Nephrons – functional units of the kidneys where
urine formation occurs
  Promotes the release of
vasopressin and aldosterone
2 Major Parts:
 Stimulates thirst centers in
 Glomerular capsule/Bowman’s capsule the brain to encourage water
- Where blood plasma is filtered first intake
 Renal Tubule  Atrial Natriuretic Peptide [vasodilation]
- Connects to a common collecting - ANP, secreted by atrial myocardium
duct of the heart in response to high blood
pressure
Process: Overview - Inhibits secretion of renin and
 Blood plasma is filtered in the bowman’s aldosterone, and sodium reabsorption
capsule - Reduces blood pressure through:
 Filtrate moves through the long winding  Directly dilates blood vessels
renal tubule, alongside the network of blood  Increases glomerular filtration
capillaries, before draining into the rate
collecting duct  Removing more fluid in urine
 The long passage is where the blood Control of Blood pH – Acid-base balance – done
reabsorbs what is needed and additional by adjusting the amount of excreted acids and
wastes are removed reabsorbed bicarbonate
*this process determines the composition of urine Plasma bicarbonate – filtered in the glomerulus
and is regulated accordingly to the body’s needs during the first step of urine formation, then
Control of blood volume/pressure – done in the reabsorbed back into the blood in the proximal
kidney by removing more or less water as tubule
necessary The amount of reabsorbed bicarbonate – regulated
Water excretion (by the kidneys) – regulated by a in response to changes in blood pH
number of hormones, including: *increases during acid loads and decreases during
*red = increase blood pressure, green = decrease alkali loads
blood pressure *collecting duct generates new bicarbonate which
 Vasopressin [water retention] exits into the blood during high acid load
- also known as antidiuretic hormone Control of Blood Cell Count
released in response to low blood
pressure or high plasma osmolality Eryhtropoietin (EPO) – a stimulating factor for red
- causes the kidney to retain more blood cells formation
water by increasing water
Low levels of EPO – produced to compensate for
permeability of collecting duct
normal blood cell turnover
 Aldosterone [sodium retention]
- the salt-retaining hormone secreted Oxygen-deficiency – results when RBC count drops
by the adrenal cortex in response to such as during blood loss, detected by the kidney
low blood sodium which responds by increasing EPO secretion
- acts on the distal tubule and
Calcium Homeostasis
collecting duct to increase
reabsorption of sodium, then increase Parathyroid Hormone (PTH)
retention of water
 Renin [angiotensin II] - Causes the kidneys to retain calcium
- Response to low blood pressure - produced in response to low blood calcium
- Initiates a two-step process that levels, stimulates the kidneys to produce the
produces the hormone angiotensin II hormone calcitriol
which increases blood pressure by:
 Constricts blood vessels
Calcitriol – promotes absorption of dietary calcium 5. Distal Convoluted Tubule – where the
in the small intestine and increases calcium secretion of ammonia, hydrogen and
reabsorption by the kidney potassium ions, and drugs takes place
6. Collecting duct
The Nephron and Urine Formation
Urine Formation
[Nephron – functional unit of the kidney and
responsible for urine formation] 3 Processes involved:
Urinary System is closely associated with the 1. Glomerular Formation
Cardiovascular System: - Separation of smaller substances in
the plasma such as glucose, amino
Since the cardiovascular system contains blood
acids, ions (sodium and chloride) and
which has the plasma containing the electrolytes,
water from larger substances in the
salts and waste products that the body wants to get
plasma such as platelets, WBC, RBC
rid of.
and proteins
Parts of the cardiovascular system that are 2. Tubular Reabsorption
associated with a nephron: - Movement of substances from the
tubules of the nephron into the
[recap] peritubular capillaries
 arteries 3. Tubular Secretion
- blood vessels that carry blood away - Movement of substances from the
from the heart peritubular capillaries into the tubules
- carries oxygen-rich blood of the nephron
 veins Process of Urine Formation
- blood vessels that carry blood to the
heart  First occurs at renal corpuscle; substances are
- carries oxygen-poor blood delivered to the nephron via afferent arteriole
and into the glomerulus
1. Arteriole – tiny branches off of the renal  [filtering] Smaller substances easily diffuse
artery across the membrane of bowman’s capsule
 Afferent Arteriole branching from an leaving behind the larger substances in the
arteriole which enters or is glomerulus and will be moved into efferent
connected to glomerulus arteriole
 Efferent Arteriole is what exits from  The smaller substances left in the bowman’s
glomerulus; give way to or give rise capsule is called the filtrate and will move
to peritubular capillaries through the kidney tubules depending on the
2. Venules – merge to form the renal vein body’s needs
3. Peritubular capillaries – surrounds the tubes  These substances can be absorbed or added to
of the nephron be eliminated as waste and moves into the
proximal convoluted tubule
Parts of the Nephron  Substances in the plasma are reabsorbed back
1. Renal Corpuscle into the body via the peritubular capillaries
a. Bowman’s capsule – c-shaped  Substances move into the u-shaped structure
b. Glomerulus called the Loop of Henle (2 parts) where
2. Proximal Convoluted Tubule – where the absorption occurs
reabsorption of plasma substances occurs  Substances enter the distal convoluted tubule
3. Descending Limb of the Loop of Henle – where secretion occurs
further reabsorption of water takes place  Finally entering the collecting duct, where the
4. Ascending Limb of the Loop of Henle – last reabsorption of water takes place, where
further reabsorption of sodium and chloride dilution or concentration of urine occurs
ions takes place
  Diabetes (Type 1 and 2) – damages blood
vessels, destroying renal tissue
 Hypertension
 Metabolic syndrome – excess abdominal fat
 Glomerulonephritis – inflammation of
Process of Urination
glomeruli
*urine occurs once it is produced by the kidney and  Interstitial nephritis – inflammation of
transported to the urinary bladder interstitium
 Polycystic kidney disease – cysts in the
Micturition – another term for urination
kidney
 Urinary bladder – composed of transitional  Vesicoureteral reflux – urine to back up intro
epithelial tissue and smooth muscle, embedded the kidneys
in the wall of the urinary bladder  Pyelonephritis – recurrent kidney infection
 Sensory receptors/Stretch receptors – attached  Chronic urinary obstruction – enlarged
to the sensory neurons that will synapse at the prostate, kidney stones, cancers
spinal cord with motor neurons  Acute kidney injury
 Motor neurons – stimulate the contraction of
smooth muscles that line in the bladder walls Glomerular Filtration Rate (GFR) – basis of
 When the bladder becomes distended because evaluation of severity of renal disease; indicator of
it is filling with urine, the stretch receptors within how well the blood is filtered by the kidneys
the walls of the bladder send an action potential
down the sensory neuron and will carry on to
the motor neuron causing the smooth muscles
of the urinary bladder to contract
 Another action potential of the sensory neuron
will be sent up to the spinal cord to the motor
cortex of the cerebrum
 Another action potential with motor input will be GFR Rate – calcuated as the funtion of serum
sent up to another motor neuron to stimulate creatinine, a waste product that accumulates in
the opening of the urinary sphincters [2]: blood plasma when renal function declines
a) Internal sphincter – closest to the urinary  Normal: GFR ≥ 90mL/min/1.73 m2
bladder; is composed of smooth muscle (many stages in between)
and under involuntary control
 End stage: GFR < 15mL/min/1.73 m2
b) External sphincter – composed of
skeletal muscle and is under voluntary
control
 As the smooth muscle that line in the urinary *the calculation takes into account the patient’s
bladder contract, the urinary sphincters relax age, gener, and race
and open allowing urine to pass through into *symptoms develop slowly over time, progressing
urethra from renal insufficiency to end-stage renal failure
_________________________________________ *often, initial loss of renla tissues does not produce
Chronic Kidney Disease (CKD) any symptoms because the remaining healthy
tisses becomes more active and can temporarily
- Gradual loss of renal function, developing compensate for the loss
over the course of months or years
- Many conditions, both within and outside of Renal adaptation – a phenomenon in which
the kidneys, can cause progressive damage symptoms appear when a significant portion of
to the kidneys over time, leading to CKD kidney function is already lost

Causes: *the ability to concentrate urine is usually the first to

be impaired, resulting to frequent trips to the
bathroom at night
Early signs: Diagnosis is based on renal function tests, which
includes blood and urine analysis.
 Nocturia
 Fatigue  Serum creatinin and urea (BUN)
 Loss of appetite  Serum electrolytes
 Decrease mental ability  Urinary sediment
 Urine ouput
Functions of kidney:  Urinalysis (sodium, urea, protein, creatinine)
 Waste removal Ultrasound – is performed to detect renal
 Blood pH control obstruction; may help to distinguish CKD from AKI
 Fluid/electrolyte – CKd patients who usually have smaller kidneys
 Hormone production
Treatments:
*loss of kidney function may result in a number of
 Control the underlying condition (diabetes,
complications:
high blood pressure)
 Accumulation of nitrogenous/toxic wastes –  Treat complications (treat acidsis, anemia)
symptoms: nausea, comiting, confusion,  Nutrition supplements (calcium, vitamin D)
seizures and restrictions (less potassium, proteins)
 Reduced excretion of hydrogen ions –  End-stage kidney disease – dialysis or
increased blood acidity/metabolic acidosis kidney transplantation
 Reduced excretion of potassium –r
potassium overload in the blood, or
hyperkalemia = causes cardiac arrythmias
* occurs only in advanced stage, but
excessive potassium intake or use of drugs
that prevent potassium excretion may
precipitate the condition to earlier stage
 Reduced phosphate excretion –
hyperphosphatemia
 Reduced renal pproduction of calcitriol
(vitamin D) – hypercalcemia or low blood
calcium level which stimulates production of
PTH by PT gland
*promotes calcium release from bones in an
attempt to raise blood calcium
 More PTH, calcium release from bones –
overactive parathyroid gland or secondary
hyperparathyroidism which can develop
before hypocalcecmia occurs
*as the bones continuously lose calcium to
the blood, they become thin and weakened,
also known as renal osteodystrophy
Symptoms:
- Bone and joint pain
- Increased risk of fractures
 Reduced renal secretion of erythropoietin,
stimulating factor for RBC formation –
anemia