The Urinary System

By: Emebet C. (MSc. in Clinical Anatomy)

 Organs of the urinary system

• The urinary system consists

of
– two kidneys,
– two ureters,
– one urinary bladder, and
– one urethra
 FUNCTIONS OF THE URINARY SYSTEM

1. Kidneys regulate blood volume and composition;

help regulate blood pressure, pH, and glucose levels;
produce two hormones (calcitriol and erythropoietin);
and excrete wastes in urine.
2. Ureters transport urine from kidneys to urinary
bladder.
3. Urinary bladder stores urine and expels it into
urethra.
4. Urethra discharges urine from body.
 Overview of Kidney Functions

 The kidneys do the major work of the urinary system:

 Regulation of blood ionic composition:
The kidneys help regulate the blood levels of several ions, most importantly
(Na+), (K+), (Ca2+), (Cl-), and (HPO42-)
 Regulation of blood pH.
The kidneys excrete a variable amount of hydrogen ions (H+) into the urine and
conserve bicarbonate ions (HCO3-), which are an important buffer of H+ in the
blood. Both of these activities help regulate blood pH.
 Regulation of blood volume.
The kidneys adjust blood volume by conserving or eliminating water in the
urine. An increase in blood volume increases blood pressure; a decrease in
blood volume decreases blood pressure
 Cont’d….
 Regulation of blood pressure.
The kidneys also help regulate blood pressure by
secreting the enzyme renin, which activates
the renin–angiotensin–aldosterone. pathway
Increased renin causes an increase in blood pressure.
 Maintenance of blood osmolarity.
By separately regulating loss of water and loss of
solutes in the urine, the kidneys maintain a relatively
constant blood osmolarity close to 300 milliosmoles
per liter (mOsm/liter)
 Cont’d….
 Production of hormones. The kidneys produce two
hormones. Calcitriol, the active form of vitamin D,
helps regulate calcium homeostasis , and
erythropoietin stimulates the production of red blood
cells.
 Regulation of blood glucose level. Like the liver, the
kidneys can use the amino acid glutamine in
gluconeogenesis, the synthesis of new glucose
molecules. They can then release glucose into the
blood to help maintain a normal blood glucose level.
 Cont’d….
 Excretion of wastes and foreign substances. By
forming urine, the kidneys help excrete wastes—
substances that have no useful function in the body.
Some wastes excreted in urine result from metabolic
reactions in the body.
These include ammonia and urea from the deamination
of amino acids; bilirubin from the catabolism of
hemoglobin; creatinine from the breakdown of creatine
phosphate in muscle fibers; and uric acid from the
catabolism of nucleic acids. Other wastes excreted in
urine are foreign substances from the diet, such as
drugs and environmental toxins.
 Anatomy of the Kidneys
• paired kidneys are reddish,
bean–shaped organs
• located just above the waist
between the peritoneum
and the posterior wall of
the abdomen.
• Because their position is
posterior to the peritoneum
of the abdominal cavity,
• The organs are said to be
retroperitoneal organs
 Cont’d….
• located between the levels of the last thoracic and
third lumbar vertebrae
• A position where they are partially protected by ribs
11 and 12.
• If these lower ribs are fractured, they can puncture the
kidneys and cause significant, even life threatening
damage.
• The right kidney is slightly lower than the left
• Because the liver occupies considerable space on the
right side superior to the kidney.
• Kidneys have external and internal structures
 External Anatomy of the Kidneys

• A typical adult kidney is 10–12 cm (4–5 in.) long, 5–

7 cm (2–3 in.) wide, and 3 cm (1 in.) thick
• The concave medial border of each kidney faces the
vertebral column.
• Near the center of the concave border is an
indentation called the renal hilum
• Through the renal hilum ureter emerges from the
kidney along with blood vessels, lymphatic vessels,
and nerves.
 External Anatomy of the Kidneys

• Three layers of tissue

surround each kidney.
The renal capsule
(deep layer)
 The adipose
capsule (middle
layer)
The renal fascia
(superficial layer)
 External Anatomy of the Kidneys

1. The deep layer, the renal capsule, is a smooth,

transparent sheet of dense irregular connective tissue
that is continuous with the outer coat of the ureter. It
serves as a barrier against trauma and helps maintain
the shape of the kidney.
2. The middle layer, the adipose capsule, is a mass of
fatty tissue surrounding the renal capsule. It also
protects the kidney from trauma and holds it firmly in
place within the abdominal cavity.
 External Anatomy of the Kidneys

3. The superficial layer, the renal fascia, is another

thin layer of dense irregular connective tissue that
anchors the kidney to the surrounding structures and
to the abdominal wall. On the anterior surface of the
kidneys, the renal fascia is deep to the peritoneum.
 Internal Anatomy of the Kidneys

• A frontal section through

the kidney reveals two
distinct regions:
• The superficial, light red
region called the renal
cortex, and
• The deep, dark red region
called the renal medulla.
 Internal Anatomy of the Kidneys

 The renal medulla consists of several cone-shaped renal

pyramids.
 The base (wider end) of each pyramid faces the renal cortex,
and its apex (narrower end), called a renal papilla, points
toward the renal hilum.
 The renal cortex is the smooth-textured area extending from
the renal capsule to the bases of the renal pyramids and into
the spaces between them.
 Those portions of the renal cortex that extend between
renal pyramids are called renal columns.
 Cont’d…
• The renal cortex is divided into:
 An outer cortical zone
An inner juxtamedullary zone
• Together, the renal cortex and renal pyramids of the renal
medulla constitute the parenchyma
• Within the parenchyma are the functional units of the
kidney—about 1 million microscopic structures called
nephrons.
• Filtrate (filtered fluid) formed by the nephrons drains into
large papillary ducts
• The papillary ducts drain into cuplike structures called
minor and major calyces
 Cont’d…
• A minor calyx receives urine from the papillary ducts of
one renal papilla and delivers it to a major calyx.
• Once the filtrate enters the calyces it becomes urine
because no further reabsorption can occur.
• From the major calyces, urine drains into a single large
cavity called the renal pelvis and then out through the
ureter to the urinary bladder.
• The hilum expands into a cavity within the kidney
called the renal sinus, which contains part of the renal
pelvis, the calyces, and branches of the renal blood
vessels and nerves.
 Blood supply of the kidney

• Because the kidneys remove wastes from the blood and

regulate its volume and ionic composition, it is not
surprising that they are abundantly supplied with blood
vessels.
• Although the kidneys constitute less than 0.5% of total
body mass, they receive 20–25% of the resting cardiac
output via the right and left renal arteries.
• In adults, renal blood flow, the blood flow through both
kidneys, is about 1200 mL per minute.
• Within the kidney, the renal artery divides into several
segmental arteries
 Blood supply of the kidney
• Segmental arteries supply different segments (areas) of
the kidney.
• Each segmental artery gives off several branches that
pass through the renal columns between the renal lobes
as the interlobar arteries
• A renal lobe consists of a renal pyramid, some of the
renal column on either side of the renal pyramid, and the
renal cortex at the base of the renal pyramid
• At the bases of the renal pyramids, the interlobar arteries
arch between the renal medulla and cortex; here they are
known as the arcuate arteries
 Blood supply of the kidney

• Divisions of the arcuate arteries produce a series of

cortical radiate arteries
• These arteries radiate outward and enter the renal cortex.
• Here the cortical radiate arteries give off branches called
afferent arterioles
• Each nephron receives one afferent arteriole, which
divides into a tangled, ball-shaped capillary network
called the glomerulus
• The glomerular capillaries then reunite to form an
efferent arteriole
• That carries blood out of the glomerulus.
 Blood supply of the kidney

• Glomerular capillaries are unique among capillaries in

the body because they are positioned between two
arterioles
• Rather than positioned between an arteriole and a
venule
• The glomeruli are considered part of both the
cardiovascular and the urinary systems
• Because they are capillary networks and they also play
an important role in urine formation
 Blood supply of the kidney

• The efferent arterioles divide to form the peritubular

capillaries
• Extending from some efferent arterioles are long,
loop-shaped capillaries called vasa recta
• The peritubular capillaries eventually reunite to form
cortical radiate veins
• Then the blood drains through the arcuate veins to the
interlobar veins
• Blood leaves the kidney through a single renal vein
that carries venous blood to the inferior vena cava
Figure. Blood supply of the kidneys
 Nerve supply of the kidney

• Many renal nerves originate in the renal ganglion

and pass through the renal plexus into the kidneys
along with the renal arteries
• Renal nerves are part of the sympathetic division of
the autonomic nervous system
• Most are vasomotor nerves that regulate the flow of
blood through the kidney
 The Nephron
Parts of a Nephron
 Nephrons are the functional units of the kidneys.
 Each nephron consists of two parts:
 A renal corpuscle, where blood plasma is filtered
 A renal tubule into which the filtered fluid (glomerular
filtrate) passes
 The two components of a renal corpuscle are:
 The glomerulus (capillary network) and
 The glomerular capsule or Bowman’s capsule
 Blood plasma is filtered in the glomerular capsule, and then
the filtered fluid passes into the renal tubule, which has
three main sections
 The Nephron

• In the order that fluid passes through them, the renal

tubule consists of :
1. Proximal convoluted tubule (PCT)
2. Nephron loop (loop of Henle), and
3. Distal convoluted tubule (DCT)
 The Nephron

• Proximal denotes the part of the tubule attached to the

glomerular capsule
• Distal denotes the part that is further away from the
glomerular capsule.
• Convoluted means the tubule is tightly coiled rather
than straight.
• The renal corpuscle and both convoluted tubules lie
within the renal cortex
 The Nephron

• The distal convoluted tubules of several nephrons

empty into a single collecting duct (CD).
• Collecting ducts then unite and converge into
several hundred large papillary ducts, which drain
into the minor calyces
• So one kidney has about 1 million nephrons, but a
much smaller number of collecting ducts and even
fewer papillary ducts
 The Nephron

• The nephron loop connects the proximal and distal

convoluted tubules
• The first part of the nephron loop is called the
descending limb of the nephron loop
• It then makes that hairpin turn and terminates at the
distal convoluted tubule and is known as the ascending
limb of the nephron loop
• The ascending limb of the nephron consists of two
portions: a thin ascending limb followed by a thick
ascending limb
Figure. The structure of nephrons and associated blood vessels. Note that the collecting
duct and papillary duct are not part of a nephron.
 The Nephron

• The lumen of the thin ascending limb is the same as in

other areas of the renal tubule
• It is only the epithelium that is thinner.
• Nephrons with long nephron loops enable the kidneys
to excrete very dilute or very concentrated urine
• About 80–85% of the nephrons are cortical nephrons
• And they have short nephron loops
• The other 15–20% of the nephrons are juxtamedullary
nephrons.
• Their renal corpuscles lie deep in the cortex, close to
the medulla and they have a long nephron loop
 Ureters
• Each of the two ureters transports urine from the renal
pelvis of one kidney to the urinary bladder.
• Three(3) factors contribute in pushing urine toward the
urinary bladder
• Peristaltic contractions of the muscular walls of
the ureters
• Hydrostatic pressure and
• Gravity
• Like the kidneys, the ureters are retroperitoneal.
• At the base of the urinary bladder, the ureters curve
medially and pass obliquely through the wall of the
posterior aspect of the urinary bladder
 Ureters

• Even though there is no anatomical valve at the

opening of each ureter into the urinary bladder, a
physiological one is quite effective.
• As the urinary bladder fills with urine, pressure
within it compresses the oblique openings into the
ureters and prevents the backflow of urine.
• When this physiological valve is not operating
properly, it is possible for microbes to travel up the
ureters from the urinary bladder to infect one or both
kidneys.
Figure Ureters
 Cont’d…
• Three layers of tissue form the wall of the ureters.
1. The deepest coat, the mucosa, is a mucous membrane
with transitional epithelium & an underlying lamina
propria of areolar connective tissue with considerable
collagen, elastic fibers,and lymphatic tissue.
2. most of the length of the ureters, the intermediate coat,
the muscularis, is composed of inner longitudinal and
outer circular layers of smooth muscle fibers.
3. The superficial coat of the ureters is the adventitia, a
layer of areolar connective tissue containing blood
vessels, lymphatic vessels, and nerves that serve the
muscularis and mucosa.
 Urinary Bladder
• The urinary bladder is a hollow, distensible muscular organ
situated in the pelvic cavity posterior to the pubic
symphysis.
• In males, it is directly anterior to the rectum
• In females, it is anterior to the vagina and inferior to the
uterus.
• Folds of the peritoneum hold the urinary bladder in
position.
• When slightely distended due to accumulation of urine, the
urinary bladder is spherical.
• When it is empty, it collapses.
• As urine volume increases, it becomes pear-shaped and
rises into the abdominal cavity.
 Cont’d…

• In the floor of the urinary bladder is a small triangular

area called the trigone.
• The two posterior corners of the trigone contain the two
ureteral openings, the internal urethral orifice
• Around the opening to the urethra the circular fibers
form an internal urethral sphincter; inferior to it is
the external urethral sphincter
Figure urinary bladder
 Urethra
• is a small tube leading from the internal urethral orifice in
the floor of the urinary bladder to the exterior of the body
• In both males and females, the urethra is the terminal
portion of the urinary system
• The male urethra is subdivided into three anatomical
regions:
(1) The prostatic urethra passes through the prostate.
(2) The intermediate (membranous) urethra, the
shortest portion, passes through the deep muscles of
the perineum.
(3) The spongy urethra, the longest portion, passes
through the penis.
 Cont’d…
• The male urethra first passes through the prostate, then
through the deep muscles of the perineum, and finally
through the penis, a distance of about 20 cm (8 in.).
• Several glands and other structures associated with
reproduction deliver their contents into the male urethra.
• The prostatic urethra contains the openings of
(1) ducts that transport secretions from the prostate and
(2) the seminal vesicles and ductus (vas) deferens
• The openings of the ducts of the bulbourethral glands or
Cowper's glands empty into the spongy urethra.
• Throughout the urethra, but especially in the spongy urethra,
the openings of the ducts of urethral glands or Littré glands
 Cont’d…

• In females, the urethra lies directly posterior to the

pubic symphysis
• has a length of 4 cm (1.5 in.)
• The opening of the urethra to the exterior, the external
urethral orifice, is located between the clitoris and the
vaginal opening
Figure Comparison between male and female urethras.