5/18/2024

Urinary
System

Learning objectives
• Identify the organs of the urinary system and
describe the functions of the system.
• Describe the location of the of the kidneys,
• Identify major blood vessels associated with
each kidney and trace the path of blood flow
through a kidney
• Describe the structure of a nephron.

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1.Excretion
3 functions
• Removal of metabolic wastes,
of urinary toxic substances and excess
system substances from body.

2.Homeostatic regulation

• Volume and solute

concentration of blood

Functions of the Kidney

Substances harmful at high concentrations must
be excreted.
Metabolic Waste
• urea (from protein),
• uric acid (from nucleic acids),
• creatinine (from muscle creatine),
• urobilin (an end product of hemoglobin
breakdown that gives urine much of its color),
• metabolites of various hormones.
Foreign substances- drugs, nicotine ……

Excess substances-
Water
Minerals
salts

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2.Homeostatic functions of urinary system

Regulating blood volume • By adjusting volume of water lost in urine

and blood pressure • Releasing erythropoietin and renin

• By controlling quantities of sodium, potassium, chloride, and

Regulating plasma ion other ions lost in urine
concentrations • Calcium ion level controlled through synthesis of calcitriol

Helping to stabilize • By controlling loss of hydrogen and bicarbonate ions in urine

blood pH

Balancing nutrient levels

Gluconeogenesis

Kidneys—paired organs that

produce urine

Organs of Urinary tract—eliminates urine

urinary • Ureters (paired tubes)

• Urinary bladder (muscular sac)
system • Urethra (exit tube-move urine to
exterior; in males-transports
semen
Urination or micturition—process of
eliminating urine
•

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Renal
calices
Renal
pelvis

Bladder

Kidneys
• Located on either side of
vertebral column
• Left kidney is slightly superior
to right kidney
• Superior surface is capped by
adrenal gland
• Position is maintained by
-Overlying peritoneum
-Contact with adjacent
-visceral organs
-Supporting connective
tissues

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External Parietal Renal

Position & oblique peritoneum Stomach vein
Renal
artery Aorta
Associated
Structures of the
Kidneys
Pancreas
Ureter
Spleen
Left Vertebra
kidney

Connective
Tissue Layers

Fibrous capsule
Perinephric fat
Renal fascia

Quadratus Psoas Inferior

A superior view of a transverse section lumborum major vena cava
at the level indicated in part a

© 2018 Pearson Education, Inc. 12

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Renal cortex

Renal medulla Renal

pyramids

The Internal Anatomy

Renal sinus

of the Kidney .
Renal pelvis
Hilum Major calyx

Minor calyx
Ureter
Renal papilla
Renal columns

Kidney lobe

Fibrous
capsule

b A frontal section of the left cadaver kidney © 2018 Pearson Education, Inc.
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The Internal Anatomy

of the Kidney . Renal cortex

Renal medulla

Renal pyramid
Inner layer of
fibrous capsule

Renal sinus Connection to

minor calyx
Adipose tissue Minor calyx
in renal sinus
Major calyx
Renal pelvis
Hilum
Kidney lobe
Renal papilla

Renal columns

Ureter
Fibrous capsule

a A diagrammatic view of a frontal section through the left kidney

© 2018 Pearson Education, Inc.

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• Renal cortex
– Superficial region of kidney in contact with fibrous
capsule
• Renal pyramids
– 6 to 18 triangular structures in renal medulla
• Base of each pyramid abuts cortex
• Tip (renal papilla) projects into renal sinus
• Renal columns
– Bands of cortical tissue that separate adjacent
renal pyramids
Internal •
– Extend into medulla
Kidney lobe
Anatomy of – Consists of
• A renal pyramid
the Kidney • Overlying area of renal cortex
• Adjacent tissues of renal columns
– Produces urine
• Minor Calyx- Ducts within each renal papilla discharge
urine into a a cup-shaped drain
• Major calyx- Formed by four or five minor calyces
• Renal pelvis -Large, funnel-shaped chamber formed by
2-3 major calyces
– Fills most of renal sinus (Internal cavity within
kidney)
– Connected to ureter, which drains kidney

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Renal blood flow ~ 1200ml of blood /min

Kidneys process 180L of blood –derived fluid daily of which 1.5L
leaves the body as urine and the rest returns to the circulation

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The Blood Supply to the Kidneys.

Glomerulus

Cortical radiate vein Afferent

arterioles
Cortical radiate artery

Arcuate artery

Arcuate vein Cortical

nephron
Juxtamedullary
nephron
Renal
pyramid

Interlobar vein
Interlobar artery

Minor calyx

b Circulation in a single kidney lobe

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• The arteries and arterioles

What is the that provide blood flow to
importance the kidneys must maintain
of blood sufficient blood flow to
flow and keep the tissues of the
blood kidneys alive and also
pressure in maintain sufficient blood
kidneys pressure to allow wastes to
be separated from the
blood.

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• Innervate kidneys and ureters

• Enter each kidney at hilum
• Follow branches of renal arteries
to individual nephrons
Renal • Sympathetic innervation
nerves • Adjusts rate of urine formation
• By changing blood flow at
nephron
• Influences urine composition
• By stimulating release of renin

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STRUCTURAL AND FUNCTIONAL UNIT OF KIDNEY

NEPHRON

• >1 million /kidney

Cortical nephrons—85%
of nephrons;
• almost entirely in
the cortex

Juxtamedullary nephrons
• Long loops of
Henle deeply
invade the medulla
• Extensive thin
segments
• Important in the
production of
concentrated urine

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Overview of Functional Anatomy

• The nephron consists of:

• Tubular components
(epithelial structure)
• Proximal convoluted
tubule
• Distal convoluted tubule
• Nephron loop (loop of
Henle)
• Collecting duct

• Tubovascular component
• Juxtaglomerular appartus

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Glomerulus- both fed and drained by arterioles unlike other capillaries

Peritubular capillaries
• low pressure ,
• porous capillaries absorbs solute and water from tubule cells as they are
reclaimed from filtrate,
• empty into venules.

Vasa recta-thin walled

• plays a role in forming concentrated urine.

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Path of urine
drainage from
collecting duct

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The Nephron

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The Nephron- Glomerulus

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Learning objectives
• Describe the normal physical and chemical
properties of urine.
• List abnormal urine components
• Describe the basic processes that form urine.
• Distinguish the differences between plasma
and glomerular filtrate
• Describe glomerular filtration rate (GFR)
• Describe the mechanisms that regulate GFR

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Goal of urine production

• Maintain homeostasis
• By regulating volume
and composition of
blood
• Involves excretion of
metabolic wastes

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• 95% Water
• Urea- by product of amino acid catabolism (
determinant of dietary protein intake)
• Uric acid– metabolic by product of certain
organic bases
• electrolytes

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Urine formation and

the adjustment of
blood composition
involves 3 processes

• Glomerular
filteration
• Tubular
reabsorption
• Tubular
secretion

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Why is the blood pressure in the glomerulus high ( 55mmHg)?

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Factors Controlling Glomerular Filtration

The glomerular hydrostatic pressure (GHP) is the blood pressure in the glomerular capillaries.
This pressure tends to push water and solute molecules out of the plasma and into the filtrate. The
GHP, which averages 50 mm Hg, is significantly higher than capillary pressures elsewhere in the
systemic circuit, because the efferent arteriole is smaller in diameter than the afferent arteriole.

The blood colloid osmotic pressure

(BCOP) tends to draw water out of the
filtrate and into the plasma; it thus opposes
Filtrate in filtration. Over the entire length of the
capsular glomerular capillary bed, the BCOP
space averages about 25 mm Hg.

The net filtration pressure (NFP) is the

Plasma net pressure acting across the glomerular
proteins 50 capillaries. It represents the sum of the
10 hydrostatic pressures and the colloid
25 mm osmotic pressures. Under normal
Hg circumstances, the net filtration pressure is
15 approximately 10 mm Hg. This is the
average pressure forcing water and
Solutes dissolved substances out of the glomerular
capillaries and into the capsular space.

Capsular hydrostatic pressure (CsHP)

opposes GHP. CsHP, which tends to push
water and solutes out of the filtrate and into
the plasma, results from the resistance of
The capsular colloid osmotic pressure filtrate already present in the nephron that
is usually zero because few, if any, plasma must be pushed toward the renal pelvis.
proteins enter the capsular space. The difference between GHP and CsHP is
the net hydrostatic pressure (NHP).

b Net filtration pressure © 2018 Pearson Education, Inc. 32

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Filtration pressure -10mmHg

 Not high, but filtration is
possible due to large
surface area and nature of
Glomerular filtration membrane
Filtration  creates a Glomerular
filtration rate (GFR) of 125
ml/min ( all glomeruli
combined)

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Glomerular Filtration Rate (GFR)

The glomerular filtration rate is the volume of filtrate
formed each minute by the combined activity of all
approx. 2 million glomeruli of the kidneys.

Why does GFR need to be tightly regulated ?

GFR ↑urine output ↓blood volume

blood pressure

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• 3 interacting levels of control

• Autoregulation (local level)
Regulation • Hormonal regulation (initiated
by kidneys)
of GFR
• Autonomic regulation (by
sympathetic division
of ANS)

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Regulation of GFR
1.Renal autoregulation – intrinsic
mechanism
the kidney itself can adjust the dilation or
constriction of the afferent arterioles,
which counteracts changes in blood
pressure.

This intrinsic mechanism works over a

large range of blood pressure but can
malfunction if you have kidney disease.

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Regulation of GFR- Intrinsic Controls

• Maintains a nearly constant GFR when MAP is in the
range of 80–180 mm Hg

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Regulation of GFR- Intrinsic Controls

• Maintains a nearly constant GFR when MAP is in the
range of 80–180 mm Hg
1. Myogenic mechanism
Afferent arteriole smooth muscle responds to stretch

•  BP  constriction of afferent
arterioles→constric on restricts blood flow
into glomerulus
– Helps maintain normal GFR
– Protects glomeruli from damaging high
BP
•  BP  dilation of afferent arterioles
– Helps maintain normal GFR

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RENIN _ANGIOTENSIN_ALDOSTERONE SYSTEM

Neural & Hormonal

• Stress shunts
STIMULUS: blood to vital
low blood volume
/blood pressure (
organs:
dehydration /blood • Norepinephrine
loss) causes
JGA apparatus
responds vasoconstriction
of afferent
arterioles &
inhibits filtrate
formation
• Triggers RAAS

increase in systemic blood pressure and

blood volume and restoration of normal GF
R

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Reabsorption and Secretion

• 3 functions of renal tubule
– Reabsorbing useful organic nutrients in filtrate
– Reabsorbing more than 90 percent of water in
filtrate
– Secreting any wastes that did not enter filtrate at
glomerulus

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Urine Formation- step 2

Tubular reabsorption

• Reclaims most of the

filtered contents and
returns to the blood.
• Begins in the Proximal
tubule
– Na+, Cl-, Mg2+, Ca2+
– HCO3-
– Nutrients _glucose,
AA, vitamins
– Water
– Lipid soluble solutes
– Urea

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Urine Formation- step 3

Tubular Secretion
Tubules also secrete
substances into the
filtrate.

Important functions:
Replaces Disposes of
Disposes of
substances in excess K+ Controls pH (
substances not
filtrate that were (aldosterone acid –base
in original filtrate
reabsorbed driven active balance)
(certain drugs)
(urea/uric acid) secretion)

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Regulation of urine concentration and

volume
Counter current multiplier
• process of using energy to generate an osmotic
gradient that enables you to reabsorb water from
the tubular fluid and produce concentrated urine.
• This mechanism prevents you from producing large
quantities of dilute urine every day, and is the reason
why you don’t need to be continually drinking in
order to stay hydrated.

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How is urine concentration and volume

regulated?
• COUNTER CURRENT MULTIPLIER

 Interstitial fluid develops a concentration gradient that is

maintained by the movement of H2O and NaCl.

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Formation of Dilute and Concentrated Urine

Figure 25.15a, b

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Comparison of blood and glomerular filtrate

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Flow of fluid from

the point where the
glomerular filtrate
is formed to the
point where urine
leaves the body

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Chronic kidney disease

(CKD) is defined as a
GFR of less than 60
ml/min.

associated with an
increased risk of
progression of kidney
disease, and in
particular, an increased
risk of death from
cardiovascular disease.

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Chronic Kidney Disease

Gradual loss of kidney function.

In the early stages of chronic kidney disease, you may have few signs or symptoms.
Chronic kidney disease may not become apparent until your kidney function is
significantly impaired.

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Pathophysiology of Renal Failure

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Diagnosis
• Kidney damage is usually ascertained by markers rather than
by kidney biopsy.
 Persistent proteinuria is the principal marker of kidney
damage
 Abnormalities in urine sediment,
 abnormalities in blood and urine chemistry measurements,
 abnormal findings on imaging studies.

Persons with normal GFR but with markers of kidney damage are
at ↑ risk for adverse outcomes of chronic kidney disease

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• The extent of tubulointerstitial fibrosis correlates best with

the deterioration in glomerular filtration rate in all kidney
diseases
• This is due to the under- lying scarring process characterized
by depletion of kidney cells and replacement by
extracellular matrix

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