Anatomy and Physiology of

Urinary System

Dr. Soniya Rani

Assistant Professor
Department of Pharmacology,
Gitam school of Pharmacy,
Gitam Deemed to be University, Rudraram,
Patancheru, Telangana 502 329, Hyderabad
• The urinary system, also known as the renal
system or urinary tract, consists of

• The kidneys (two)

• Ureters (two)
• Bladder (one)
• The urethra(one)
• The purpose of the urinary system is to eliminate
waste from the body, regulate blood volume and
blood pressure, control levels of electrolytes and
metabolites, and regulate blood PH.
• The urinary tract is the body's drainage system for
the eventual removal of urine.
 ANATOMY OF KIDNEYS
• kidneys are two bean shaped organs
• Located at the back of the abdominal cavity in the
retroperitoneal (i. e. behind the peritoneum) space.
SIZE:-
• length: 11cm
• width:6 cm
• thick:3 cm
• weight: 150 gm
• Left kidney is approximately at the vertebral level T12 to
L3 and the right is slightly lower.
• Upper parts of the kidneys are partially protected by the
11th and 12th ribs.
 Right kidney
Anteriorly: the duodenum, hepatic
flexure of the colon & right lobe of the
liver.
Posteriorly: Diaphragm, muscles of
posterior abdominal wall.
Superiorly: the right adrenal gland.

Left kidney
Anteriorly: the spleen & splenic vessels,
jejunum splenic flexure of the colon,
pancreas & stomach.
Posteriorly: Diaphragm, muscles of
posterior abdominal wall.
Superiorly: the left adrenal gland.
• The area on the concave border is the renal
hilum, where the renal artery enters the kidney
and the renal vein and ureter leave.
• Kidney is surrounded by tough fibrous tissue, the
renal capsule.
Kidney is divided into two major structures: the
outer renal cortex and the inner renal medulla.
• these structures take the shape of 8 to 18 cone-
shaped each renal lobes, containing renal cortex
surrounding a portion of medulla called a renal
pyramid.
• Between the renal pyramids are projections of
cortex called renal columns.
Renal Capsule - dark brown fibro-connective tissue is the
outermost surface of the kidney and provide outer protective
Renal Cortex – This layer immediately under the renal
capsule. It is the outer region and is lighter in color. It contains
renal corpuscles and extends inwards as renal columns.
Renal Medulla - The medulla is below the cortex and is
divided into pyramid-shaped structures called renal pyramids.
The apex or point of the pyramid points internally.
Renal Pyramids - Made up of hundreds of collecting ducts
that are all arranged in parallel and are heading toward the renal
papilla and minor calyx. The renal pyramids are located in the
renal medulla.
Renal Papillae – Tips of the renal pyramid, deep in the renal
medulla. The renal papillae are the structures that are
immediately proximal to the minor calyx where filtrate becomes
urine as it moves from the renal papilla to the minor calyx.
Renal Columns - The renal columns are situated in between
each of the renal pyramids in the medulla. allows many blood
vessels to pass and serves to anchor renal cortex to the medulla.
Minor Calyx-is a short, cup-shaped tube that receives what is now urine from the collecting ducts. A minor calyx
collects urine from one renal papilla.

Major Calyx- The several minor calicies merge to form larger spaces called a major calyx. Each kidney has about 2-
3 major calicies. A major calyx collects urine from several minor calicies and empties the urine into the renal
pelvis. From the pelvis the urine goes to the ureter and then bladder and then urethra for excretion.
Renal Pelvis- funnel-shaped tube and is the expanded superior part of the ureter. The renal pelvis is formed by the
junction of all major calyces. Once urine exits the kidneys at the renal hilus, the renal pelvis delivers urine to the
ureter.
Renal Ureter- One ureter from each kidney carries the waste product urine from the kidneys to the urinary
bladder which is the storage facility for urine until it can be eliminated (or excreted) from the body by the urine
voiding reflex called the micturition reflex.
The Renal Artery and Vein – These two blood vessels travel through the renal hilus and deliver and return
(respectively) from 20 to 25% of the total cardiac output to the kidneys for cleansing and immediate return to the
body.
The Renal Sinus is a compartment inside the kidney containing some fat to cushion and stabilize the position of
other elements, such as the renal pelvis, lymphatic channels, calyces and the renal artery. The renal sinus contains is
not empty, but the renal vessels, nerves, renal pelvis, and the calices. The adipose tissue fat pads here act to protects
these structures.
The Renal Hilus – is that dimpled space in the medial part of the kidney which opens the kidney to the exterior. This
region is like a port of access, the indentation in the medial part of kidney is where the ureter, renal blood vessels,
lymphatics and nerves, enter or exit the kidney.
 Functions of the Kidneys
1. Regulation of Blood and Extracellular Fluid Volume
If blood volume is too high, then more filtrate is created, and therefore more urine is excreted;
if body fluids are too low, then fluid is conserved by the body, filtration at the kidneys is
decreased, and the excretion of urine (and thus water) is decreased in volume.
2. Regulation of Osmolarity
Think of the osmolarity of blood plasma as the ‘saltiness” of it. Its osmolarity is controlled by
changing the amount of water that is excreted in the urine. Normally plasma osmolarity sits in
a range of 295 to 310 mOsM. If excessive water intake caused a decrease in plasma osmolarity
below about 280 mOsM, the kidneys remove the excess water by producing more dilute urine (it
looks more pale). If plasma osmolarity goes up beyond 320 mOsM (that is, becomes very
salty), the kidneys conserve water by producing more concentrated urine (looks darker!), in
order to maintain the normal homeostatic range for plasma.
3. Maintenance of Ion Balance in Blood
Essentials ions and minerals in the body is crucial for optimum health. Ions have a significant
impact on every system in the body, especially the excitable tissues in the body that send
electrical signals, such as the nervous, cardiac and skeletal muscle systems. For example; Na+,
K+, Cl-, Ca2+, H+, Mg2+, PO4, as trace minerals are also essential for good health.
4. Homeostatic Regulation of pH in Body Fluids
The selective secretion of H+ (hydrogen ions) is an effective way to regulate any acidic
conditions, and the secretion of HCO3- is very effective for regulation of any basic or alkaline
conditions that may occur.
5. Filters Wastes and Metabolic Products from Blood and Excretes them from the Body
The urinary system removes normal metabolic waste products that are always being
generated by natural processes like urea (a product of protein breakdown or catabolism), uric
acid (a product of nucleic acid catabolism) are constantly excreted in the urine. Interestingly,
when amino acids are broken down by a process called ‘de-animation’ it generates ammonia
as a byproduct – which is toxic. It is the liver that converts ammonia to the less toxic urea,
and the kidneys that then excrete urea in the urine. Finally, creatinine (a waste product from
muscle breakdown of a creatine) is also excreted in urine.
6. Excretion of Foreign Substances from the Blood
The elimination of drugs or ‘medications’ in the urine is an example. Other harmful chemicals
such as pesticides, preservatives, artificial flavors, artificial colors, and genetically modified
food substances would all be seen by the body as ‘foreign’ or novel substances and can cause
harm to the body. Therefore, the kidney and the liver act as very effective detoxifiers (liver) and
eliminators (kidney) of these harmful substances from the body in order to protect us.
7. Production of Hormones
The kidneys function as a secondary endocrine organ. The primary role of the kidneys is to
filter blood; however, they also produce two very powerful hormones which are released into
the bloodstream and have a significant impact on many other structures in the body. The 2
hormones are:
1) Renin – this is actually an enzyme and a hormone. It is released from the juxtaglomerular
cells in the afferent arteriole of the renal corpuscle in response to increased blood osmolarity –
this condition indicates there is not enough water in the blood. The release of renin into the
blood stream triggers a series of reactions in the body and the overall response of multiple
systems is to conserve water, especially the retention water and salts by the kidneys.

2) Erythropoietin –This hormone, which is also released from the juxtaglomerular cells of the
nephron, is triggered when oxygen (O2) levels in the blood are low. It stimulates the
hemocytoblasts (stem cells in red bone marrow) to increase red blood cell formation. Having
more RBCs allows the blood to transport more O2.
• The nephron is the structural and functional unit of the
kidney, span the cortex and medulla.
• Each adult kidney contains around one million
nephrons.
• The initial filtering portion of a nephron is the renal
corpuscle which is located in the cortex.
• This is followed by a renal tubule that passes from the
cortex deep into the medullary pyramids.
• The renal corpuscle consists of capillaries called a
glomerulus and an Bowman’s capsule.
• A healthy adult has 0.8 to 1.5 million nephrons in
each kidney.
• They cleanse the blood and balance the constituents of
the circulation. The afferent arterioles form a high-
pressure capillaries into the glomerulus.
• After passing through the renal corpuscle, the
capillaries form a second arteriole, the efferent
arteriole.
• Two Types of Nephrons
• Each kidney has approximately 1.25 million nephrons, for a total of over 2.5 nephrons in the
entire renal system.
• Cortical Nephrons - 85% of nephrons in the human are this type. In these nephrons the
renal corpuscle is located high in the renal cortex and they have shorter loops of Henle.
They are called cortical nephrons because of their location higher in the renal cortex.
• Juxtamedullary Nephrons - 15% of nephrons have long loops of Henle that dip deep into
the renal medulla. Also, the renal corpuscles of these nephrons are located closer to
cortex-medulla junction.
• All of the renal corpuscles as well as both the proximal convoluted tubules (PCTs) and
distal convoluted tubules are found in cortex. Some nephrons have a short loop of Henle that
does not dip beyond the cortex.

• URINE FORMATION

• Nephrons take a simple filtrate of the blood and modify it into urine.

• Three principle functions—filtration, reabsorption, and secretion.

• They also have additional secondary functions that exert control in three areas: blood pressure
(via production of renin), red blood cell production (via the hormone), and calcium absorption
(via conversion of calcidiol into calcitriol, the active form of vitamin D).
Renal Corpuscle: -
The glomerulus is a high-pressure capillary bed between afferent and efferent arterioles.
As blood passes through the glomerulus, 10 to 20 percent of the plasma filters between these
sieve- like fingers to be captured by Bowman's capsule and funneled to the PCT (proximal
convoluted tubules).
Proximal Convoluted Tubule (PCT): -
Filtered fluid collected by Bowman's capsule enters into the PCT.
It is called convoluted due to its tortuous (i.e. full of twists and turns) path. Simple cuboidal
cells form this tubule with prominent microvilli on the luminal surface, forming a border.
These microvilli create a large surface area to maximize the absorption and secretion of
solutes (Na+, CI—, glucose, etc.), the most essential function of this portion of the nephron.
Loop of Henle:
The descending and ascending portions of the loop of Henle. The descending loop of Henle
consists of an initial short, thick portion and long, whereas the ascending loop consists of an
initial short, thin portion followed by a long, thick portion.
Distal Convoluted Tubule (DC T):
The DCT, like the PCT, is very tortuous, but it is shorter than the PCT. These cells are not as
active as those in the PCT; thus, there are fewer microvilli on the apical surface.
• Collecting Ducts
• The collecting ducts are continuous with the nephron but not technically part of it. In fact,
each duct collects filtrate from several nephrons for final modification. They are lined with
simple squamous epithelium with receptors for ADH (antidiuretic hormone) or
Vasopressin.
• Glomerular Filtration Rate (GFR):
• The volume of filtrate formed by both kidneys per minute is termed the GFR.
• The heart pumps about 5 L blood per min under resting conditions.
• Approximately 20 percent or one liter enters the kidneys to be filtered.
• On average, this liter results in the production of about 125 mL/min filtrate produced in men
(range of 90-140 mL/min) and 105 mL/min filtrate produced in women (80-125 mL/min).
• Below is a summary of the flow of fluid from where filtrate is made – at the glomerular - to
the point where urine leaves the body:
Glomerular capsule -> proximal convoluted tubule -> loop of Henle -> distal
convoluted tubule -> collecting duct -> renal papilla -> minor calyx* (fluid is
now urine) -> major calyx -> renal pelvis -> ureter -> bladder -> urethra ->
out of body.
 URETERS
• These are paired tubes about 10 inches (25 cm) long. These structures are responsible for the
transport urine from the kidney to the urinary bladder by peristalsis and some help from
gravity.

• The kidneys and ureters are completely retroperitoneal, and the bladder has a peritoneal
covering only over the dome.

• As they approach the bladder, they turn medially and penetrate the bladder wall obliquely.

• This is important because it creates an one-way valve that allows urine into the bladder but

• prevents reflux of urine from the bladder back into the ureter.
 The Urinary Bladder
• The urinary bladder is anterior to the vagina
and uterus (females) and rectum (males).
The interior surface has openings for the 2
ureters and the urethra. The smooth
triangular region of the base is outlined by
these 3 openings. This triangular area is called
the trigone. Many bladder infections persist in
this region. The role of the bladder is to store
and expel urine. The bladder can hold about
500 mL of urine.
• When about 300 mL of urine collect, stretch receptors initiate a reflex called the
micturition reflex. It produces a series of contractions of the urinary bladder, and also
relaxes the involuntary internal urethral sphincter (smooth muscle). When the
external urinary sphincter (skeletal muscle) is consciously relaxed, urine is released
from the urinary bladder when the pressure there is great enough to force urine to flow
out of the urethra.

The Urethra
• The is a tube that transports urine from the bladder to the outside of the body.

• The female urethra is 3-4 cm long and the opening is anterior to the vaginal opening.
The male urethra is about 18 cm long and the opening is at the end of the penis
 Micturition Reflex
What is Micturition?
•Micturition refers to the process of urination, the act of discharging urine from the urinary
bladder through the urethra.
Micturition Reflex: The involuntary reflex that helps control the process of urination.
•Step 1: The bladder fills with urine, stretching the walls.
•Step 2: Stretch receptors in the bladder wall are activated.
•Step 3: Signal sent to the spinal cord (sacral region).
•Step 4: Spinal cord sends signals to the detrusor muscle (bladder muscle) to contract and the
internal sphincter to relax.
•Step 5: Brain can override the reflex (conscious control) until a socially appropriate time.
Micturition Reflex
Neurological Pathways
• Afferent Pathway: Stretch receptors -> Pelvic nerve -> Spinal cord (S2-S4).
• Efferent Pathway: Spinal cord -> Parasympathetic nerves -> Detrusor muscle contraction,
internal sphincter relaxation.
• Cerebral Cortex: Conscious control, inhibition or facilitation of reflex.
Phases of Micturition
1.Filling Phase: Bladder is filling with urine, internal sphincter contracts, detrusor muscle
relaxed.
2.Voiding Phase: Bladder contracts, sphincters relax (both internal and external).
Voluntary Control of Micturition
• External Urethral Sphincter: Controlled by somatic nerves, voluntary control allows
inhibition of the micturition reflex.
• Brain Centers: The brain cortex (prefrontal cortex) allows control over the external sphincter,
enabling voluntary urination.
 Role of Kidney in Acid-Base Balance

1. Excretion of H+
2. Reabsorptionof the bicarbonate ions present in
the ultra-filtrate
3. Excretion of titrable acid
4. Excretion of ammonia

2/4/2025 Dr. Ashok Kumar J; IMS; MSU 23

 Tubular
Tubular cell Lumen
HCO -
3 HCO -
3
H+ H+

H2O + CO2 H2CO3-

Na+ Na+

2/4/2025 Dr. Ashok Kumar J; IMS; MSU 24

 Tubular cell Tubular
Lumen
HCO3- HCO3-
H+ H+ + HCO3-

H2O + CO2 H2CO3-

H2CO3-

CO2 CO2 + H2O

2/4/2025 Dr. Ashok Kumar J; IMS; MSU 25

 HCO3-
H+ H+ Na2HPO4-
H2O + CO2 H2CO3-
NaH2PO4-
Titrable acid

2/4/2025 Dr. Ashok Kumar J; IMS; MSU 26

2/4/2025 Dr. Ashok Kumar J; IMS; MSU 27
 Disorders of Kidney
• Acute Kidney Failure
• Chronic Kidney Failure
• UTI
• Calculi