URINARY SYSTEM stimulation of the bone marrow by the

erythropoietin.

 Composed of the two kidneys which is T- Toxin removal

the right and the left kidneys, two
The nitrogenous waste products are
ureters, urinary bladder and urethra
poorly reabsorbed, so tubules cells have
 A large volume of blood flows through
few membranes carrier to reabsorb these
the kidney which remove substances
substances because we do not need
from the blood to form urine.
them, so they tend to remain in the filtrate
 The urine contains excess water and and they are found in high concentrations
ions, metabolic wastes like urea, in the urine excreted from the body.
creatinine and toxic substances Various ions are reabsorbed and allowed
consumed with the food. The urine to go out in the urine, and according to
produced by the kidneys flow through what is needed at a particular time to
the ureters, and the urinary bladder maintain the proper pH and the electrolyte
where it is stored until it is eliminated composition of the blood.
through the urethra.
Common nitrogenous waste includes:

KIDNEYS ( “A WET BED” )

 Urea which is formed by the liver as
A – Acid base balance an end product of protein breakdown
when amino acids are used to
The kidney secretes variable amount of
produce energy.
hydrogen to help regulate the extracellular
 Uric acid which is released when
fluid ph. The ph determines the acidity or
nucleic acids are metabolized
alkalinity of the fluid.
 Creatinine which is associated with
W- Water removal creatinine metabolism and the muscle
tissue.
We know that the kidneys are the major
excretory organ in our body, that removes B - BP control
excess water.
RAAS is an important mechanism that
Note: Water is not always excreted via the regulate the blood pressure.
renal system. It can be also eliminated
E - Electrolyte Balance
through the GIT, respiratory system, or
through our perspiration The kidneys help regulate the
concentration of major molecules and ions
E – Erythropoiesis
like the glucose, sodium, chloride,
Erythropoietin is a hormone primarily potassium, calcium, bicarbonate and
produced by the kidneys. This hormone phosphate.
plays a key role in the production of red
D - Vitamin D activation
blood cells, and the process is known as
erythropoiesis. This is the process of The kidneys convert vitamin D from the
producing red blood cells via the supplements that we take or from the food
we eat, to the active form of vitamin D that region of adipose against the kidney (in
is needed by our body. which the adrenal glands are embedded)

 A protective layer that protects the

kidneys from injury.
KIDNEY
Renal Fascia – A thin layer of connective
A pair of bean-shaped organ found along
tissue encircling the kidneys.
the posterior wall of the abdominal cavity,
with one kidney on the either side of the  Anchors the kidney to the peritoneum
vertebral column. and the abdominal wall.
Note:  Renal; Latin word for kidney
 The fat surrounding the kidneys is
 The left kidney is higher than the right important in holding them in their
kidney due to that larger size of the normal body position. If the amount of
liver on the right side of our body. fatty tissue dwindles like as with rapid
 Each kidney approximately weighs weight loss, the kidneys may drop to a
125 to 170 g in males. And 115 to 155 lower position. The condition is called
g in females. ptosis. Ptosis creates problems if the
 The kidney is located posterior to the ureter become kinked.
peritoneum and they touch the  If the ureters become kinked, the urine
muscles of the back. It’s located is can no longer pass through it, and the
called retroperitoneal. urine backs up and exerts pressure on
 Our kidneys are also surrounded by a the kidney tissue. This condition is
layer of adipose tissue that holds them called hydronephrosis, which can
in place and protects them from severely damage the kidney.
physical damage.

STRUCTURE OF THE KIDNEYS

HILUM - on the medial side of every
The kidney structure has two layers:
kidney there is a hilum, where the renal
arteries and the nerves enter, and where - Outer (renal cortex): contains
the renal veins and the ureter exit many capillaries and is made up of
renal corpuscles (part of the
nephron which is made of
3 LAYERS OF THE FATTY POUCH glomerulus and bowman’s capsule)
and renal tubules.
Renal Capsule (Fibrous capsule) – A
fibrous layer of connective tissue covering - Inner (renal medulla): contains
the kidney parenchyma. many blood vessels and tubules.
Triangle sections of tissues can be
 The innermost layer. This is strong found in the renal medulla.
and fibrous. And it’s attached to the - These triangular sections of tissue
kidneys, and prevents infection. that constitutes the medulla is
Perirenal Fat (or adipose capsule) – A called the renal pyramids. There
are 8-18 renal pyramids in every
 kidney. The structure that 6. The afferent arterioles arise from the
separates the pyramids are called branches of the interlobular arteries and
the renal columns and they also extend to the glomerular capillaries.
transmits blood vessels.
7. Glomerular capillaries
- When you look at closely, we can
find tubules or tubes. The tips of 8. Efferent arterioles extend from the
the tubes are what we call the renal glomerular capillaries and then going to
papilla or renal papillae. the peritubular capillaries which surrounds
- The renal papillae are considered the proximal and distal tubules and the
the apex of the renal pyramid. They loops of Henle.
are projecting toward the center of
9. Peritubular capillaries/vasa recta are
the kidneys, and they are
specialized portion of peritubular
surrounded by a funnel- shaped
capillaries that extends deep into the
structure which we call as the
medulla of the kidney and surround the
minor calyx.
loops of Henle and the collecting ducts.
- These minor calyxes will join
together to form the major calyx. 10. Blood coming from the peritubular
- The major calyxes will join together capillaries including the vasa recta enters
to form the renal pelvis. The renal the interlobular veins, and the veins of the
pelvis is the large funnel wherein kidney run parallel to the arteries and they
the major calyxes from all the renal have similar names but in reverse.
pyramids join to form this structure. 11. Arcuate veins
- These renal pelvis narrows to form
a small tube called as the ureter, 12. Interlobar veins
wherein the ureter exits the kidney 13. Segmental veins
and is connected to the urinary
bladder. 14.Renal veins which exit our kidneys.

BLOOD FLOW THROUGH THE KIDNEY FUNCTIONAL UNIT OF THE KIDNEYS

1. Renal Artery - Branch off from the Nephron

abdominal aorta and enter the kidneys.  Functional unit of the kidney
They give rise to several branches
 Produce urine
2. Segmental arteries  Nephron is made up of many tubules
 Over 1 million nephrons in every
3. Interlobar arteries pass between the
kidney.
renal pyramids
 Each nephron is composed of the
4. Arcuate arteries arch between the renal corpuscle which is made up of
cortex and the medulla the glomerulus and the bowman’s
capsule.
5. Interlobular arteries branch off the
arcuate arteries to project into the cortex.
  Have longer nephron loops
 The renal corpuscles are located in
the cortex yet very near the cortex
medulla junction.
 They have loops of Henle that
extend deep into the medulla of the
kidney. That is why it is called juxta
medulla

PARTS OF THE NEPHRON

Glomerulus – Tuft of capillaries with
fenestrations or pores. These
fenestrations allow the filtrate to pass
 Proximal Convoluted tubule through except for the majority of the
proteins and blood cells
 Loop of Henle composed of the
descending limb and ascending limb. Proximal Convoluted tubule – Lined
o The descending limb: the with cuboidal cells with brush border or
substances travel going microvilli. The cells reabsorb substances
downward. from the filtrate as well as secrete
o The ascending limb: the substances into the filtrate
substances travel going
Loop of Henle - Composed of the
upward.
descending limb and ascending limb.
 Distal Convoluted tubule
o The descending limb: The
descending limb is made up
TWO TYPES OF NEPHRONS of simple squamous
epithelium and is highly
Cortical
permeable to water.
 Account to 80 -85% of the total o The ascending limb:
nephron Ascending limb is
 More abundant compare to juxta impermeable to water.
medullary
 Have shorter nephron loop Distal Convoluted tubule - lines with
 The loop of Henle of the cortical cuboidal cells, and the cells are thinner.
nephron does not extend deep into These cells play a role in secreting
the medulla and they are only substances into the filtrate rather than
located in the renal cortex removing substances from it.
Juxta Medullary

 Account for the 15-20% of the

nephrons
 within the glomerulus into the capsular
space or the bowman’s capsule. In
There are two types of cells:
glomerular filtration, the blood is filtered in
1. Intercalated cells with microvilli: the glomerulus. The water and the solutes
Function is for the acid-base balance of which are smaller than proteins are forced
the blood. through the capillary walls and the pores
of the glomerular capsule into the renal
tubule.
2. Principal cells: Do not have microvilli.
Tubular reabsorption – Movement of
Function is for the sodium and water
substances from the tubular fluid back into
balance.
the blood. Almost all desirable organic
Collecting duct – not part of the nephron. substances are reabsorbed like water,
Passes through the renal pyramids and glucose, amino acids and the needed
ends in the renal papillae where it empties ions. They are transported out of the
into a minor calyx. filtrate into the tubule cells and enter the
capillary blood. 99% of the filtrate is
reabsorbed. 65 % is reabsorb in the PCT,
Review: 15% in the descending loop of Henle, and
19% in the DCT and collecting duct.
From the afferent arteriole, the blood goes
to the glomerulus, and the blood is Tubular secretion – Movement of
filtered. The filtered substances which are substances from the blood into the tubular
called the filtrate, will proceed to the fluid. In tubular secretion, all the
bowman’s capsule (glomerular capsule). undesirable substances are excreted in
Both the glomerulus and the glomerular the urine.
capsule compose the renal corpuscle.
These bowman’s capsule surrounds the
glomerulus, and the filtrate is caught by Micturition / Voiding / Urination - Is a
the glomerular capsule. reflex action. The process of releasing
urine from the urinary bladder through the
Glomerular Filtration Rate (GFR) – the
urethra and out of the body. The process
amount of filtrate being made by the
of urination begins when the muscles of
kidney.
the urethral sphincter relax, allowing the
 125 mL/min (normal GFR) urine to pass through the urethra. At the
 180 L/day (1 day) same time that the sphincter is relax, the
 Out of 180 Liters, the kidney only smooth muscle in the walls of the urinary
produces 1-2 liters of urine per day or bladder contract to expel the urine from
only 1% of the 180. the bladder. The stretch receptors activate
the detrusor muscle, and relax the internal
urethral sphincter and the external
URINE FORMATION: urethral sphincter is under voluntary
control after approximately 2 years old
Glomerular formation - There is a and this has to do with the growth of the
movement of substances from the blood spinal cord and the appropriate nerves.
 Urine - 1-2 L produced a day. If the drinks large amount of water, uses
amount of urine in the urinary bladder diuretics, or suffers from chronic renal
is 150 mL, that is the time we can feel failure.
the urge to urinate.  Conditions that produce urine with a
 Around 500 mL – When a person can high specific gravity include limited
no longer hold the urine. fluid intake, fever, and kidney
inflammation.
 If urine becomes excessively
Note: concentrated, some of the solutes
begin to precipitate or crystalize
The bladder can actually hold 1 L of urine.
forming kidney stones or what we call
 The normal yellow color of the urine is as the renal calculi.
due to urochrome which is a pigment
arising from the body’s breakdown of
ABNORMAL URINARY CONSTITUENTS
hemoglobin. And as a rule, the greater
the solute concentration, the deeper
the yellow color. Abnormal yellow
color may also be due to certain foods
as well as to various drugs like vitamin
C, and also due to bile or blood.
 The odor of the freshly voided urine is
slightly aromatic, but bacterial action
gives it an ammonia like odor when
left standing. Certain diseases may
also alter the characteristic odor of the
PROTEINURIA
urine.
 pH level of the urine ranges from 4.5 - In pregnancy, urinary protein
to 8. But its average value is 6, which excretion normally increases
is slightly acidic. The food that we eat substantially. However, urinary
may influence the pH of our urine. protein excretion is considered
 Specific gravity is the relative weight abnormal when the level exceeds
of a specific volume of a liquid 300 mg a day. In many pregnant
compared with an equal volume of women, proteinuria appears to
distilled water. Specific gravity of increase further at the time of labor
distilled water is 1 because 1mL and delivery.
weighs 1g, and because urine
contains many dissolved solutes it
weighs more than water. Its HEMOGLOBINURIA
customary specific gravity ranges from
- Hemolytic anemia is a condition
1.001 – 1.03. Urine with a specific
characterized by the rapture of red
gravity of 1.001 contains few solutes
blood cells.
and is very dilute.
 Dilute urine is common when a person
 adrenal cortical cells to promote the
release of a hormone known as
RAAS (Renin Angiotensin Aldosterone
aldosterone. Aldosterone is a
System) - A mechanism that is extremely
hormone that promotes water and
important for regulating the blood
sodium retention. And as a result, the
pressure. As well as the amount of blood
blood volume increases as well as the
volume.
blood pressure.

TWO FACTORS THAT TRIGGERS THE

URETERS
RAAS:
- A pair of tubes that carry the urine
1. Decreased on blood volume
from the kidneys going to the
(hypovolemia)
urinary bladder.
2. Decreased blood pressure - Ureters are 10-12 inches long and
(hypotension) they run on the left and right sides
of the body parallel to the vertebral
column.
Either way, the cells of the juxta - Gravity and peristalsis of the
glomerular cells of the kidneys are smooth muscle tissue in the walls
stimulated to release renin which is any of the ureters moves the urine
enzyme, and this is released to the blood. toward the urinary bladder.
This renin acts on the protein called as the - The ends of the ureters extend
angiotensinogen which is produced by the slightly into the urinary bladder and
liver. The amino acids are removed are sealed at the point of entry to
leaving only angiotensin I. The the bladder by the ureterovesical
angiotensin I is rapidly converted to a valve. These valves prevent the
smaller peptide called as angiotensin II by urine from flowing back towards the
the angiotensin converting enzyme or kidneys.
A.C.E. The A.C.E is secreted into the
lungs and kidneys by cells in the
endothelium or inner layer of the blood URINARY BLADDER
vessels.
- Sac-like hallow organ for the urine
 Angiotensin II in return, acts on the storage
blood vessels causing the BV to - Located along the body’s midline at
constrict. Vasoconstriction is the the inferior end of the pelvis. You
medical term for the constrictions of can find here the trigone which is a
the blood vessels. Vasodilation which triangular section of the bladder
is the dilation of the blood vessels. that is outlined by three openings.
This vasoconstriction leads to an (2 ureteric orifices and 1 urethral
increase in the peripheral resistance orifice)
which could increase the blood
pressure.
 The Angiotensin II also acts on the
URETHRA  The flow of urine in the urethra is
controlled by the internal and external
- The urethra carries the urine from
urethral sphincter muscles.
the urinary bladder going to the
 The internal urethral sphincter is made
exterior of the body.
of smooth muscle, and opens
- The urethral orifice or meatus is the
involuntarily when the bladder reaches
external opening of the urethra
a certain set level of distention. The
where the urine comes out.
opening of the internal sphincter which
results in the sensation of “needing to
urinate”.
FEMALE URETHRA
 The I.S is made up of skeletal muscle
- Shorter than the male. Around 2 in and may be opened to allow the urine
in length to pass through the urethra or may be
- The opening is located below the held close to the delay urination.
clitoris and above the vaginal
opening
- The shorter urethra is one of the KIDNEY STONES (nephrolithiasis; renal
reasons why women get UTI more calculi)
often. The shorter urethra makes it
- Hard deposits made of minerals
easier for the bacteria to get into
and salts that is formed inside our
the bladder.
kidneys.
Diet, excess body weight, medical
conditions, certain supplements
MALE URETHRA
and medications are among the
 Around 8-10 in length and ends at the many causes of kidney stones
tip of the penis.
 Because of the length, the male
urethra is divided into three regions.

1. Prostatic: passes through the prostate

gland
2. Membranous: passes through the
urogenital diaphragm. Urogenital
diaphragm is a double layer of pelvic
fascia with its included muscle that is
situated between the ischial and pubic
rami, and supports the prostate in the
male, and gives passage to the
membranous part of the urethra.
2. Penile/spongy: passes through the
length of the penis.