“URINARY

SYSTEM”
MS.PRIYA YADAV
URINARY SYSTEM
 The urinary system is functional in turning toxic substances into
the urine, storing and carrying urine, and safely eliminating it
from the body.
 In addition to waste removal, which is the main function of the
urinary system, it is also involved in other vital functions such as
maintaining proper chemical and water balance and ensuring
the body is hydrated enough by controlling the electrolyte
levels. Further, the system regularly monitors and regulates the
acidity of the body fluids.
STRUCTURAL & FUNCTIONAL UNIT OF
KIDNEY
A nephron is the basic structural and functional unit of
the kidney. They are the microscopic structure
composed of a renal corpuscle and a renal tubule
Urinary system – Parts
• The main parts of the urinary system are –
• Kidneys
• Ureters
• Urinary bladder
• Urethra
• Urinary sphincter muscles
 KIDNEY

Kidneys are paired bean-shaped structures forming the core of the

urinary system. They are situated on either side of the spine towards the
back, just below the rib cage.
The right kidney is somewhat lower compared to the left to
accommodate the liver.
Each kidney in an average adult weighs about 5 ounces and is about 5
inches in length, 3 inches in width and 1 inch in thickness.
• Renal capsule – The innermost layer formed by the smooth fibrous
membrane
• Adipose capsule – a layer of fatty tissue
• Renal fascia – the outermost layer comprising connective tissue
holding the kidney to the abdominal wall
Structure of kidney

 The outer section of the kidney is known as the cortex. The medulla is
in the centre of the kidney and comprises 10-15 cone-shaped
collecting ducts referred to as renal pyramids.
 These structures pour the urine into the minor calyces – the cup-
shaped receptacles.
 Urine from here flows into the major calyces – the larger openings. It
takes place via the renal pelvis (funnel-shaped) and to the ureter and
the bladder.
 Ureters extend from each kidney – hollow, fine tubes reaching into
the bladder. Each ureter extends about 12 inches, its widest part is
about 0.5 inches. Ureters penetrate the walls of the bladder from
either side, which forms a U shape.
 The Ureters at the terminal of the U connect to the triangular-shaped
section on the bladder base known as the trigone.
BLADDER
 The muscular hollow bladder keeps urine till eliminated. It is
positioned in the abdomen behind the pubic bone. At the base of the
trigone, there is an opening to the urethra in the neck of the bladder,
via which urine moves out of the body.
 The fine, muscular tube of the urethra connects the bladder to the
outside, rendering a route for urine to exit the body. The urethra’s
wall comprises a mucous membrane and a layer of smooth muscle
tissue. There is a difference in the function, path and length of the
urethra in males and females.
 In males, the urethra is ~8 inches long
 In females, the urethra is ~1.5 inches long,
Urinary Sphincter

 Sphincters are two groups of muscles, which regulate the urine flow out of the bladder.
The urethra and bladder meet at a ring of smooth muscles – internal urethral
sphincters, which are involuntary muscles stopping urine from back-flow up the
urethra to the bladder.

 The external urethral sphincters present at the end of the urethra are voluntary
muscles which release and strain to start and stop the flow of urine.
FUNCTION OF KIDNEY
 Filtration of Blood: The kidneys filter waste products, toxins, and
excess substances (like water, salts, and urea) from the blood,
forming urine.
 Regulation of Fluid and Electrolyte Balance: The kidneys
maintain a proper balance of water, sodium, potassium, and other
electrolytes in the body. This helps to regulate blood pressure and
fluid balance.
 Acid-Base Balance: They help maintain the pH of the blood by
excreting hydrogen ions and reabsorbing bicarbonate, thus helping to
keep the body’s acid-base balance stable.
 Regulation of Blood Pressure: Through the renin-angiotensin-
aldosterone system, kidneys help regulate blood pressure by
controlling blood volume and the amount of sodium in the blood.
 Excretion of Waste Products: The kidneys excrete metabolic
waste products, like urea, creatinine, and uric acid, which are
produced from the breakdown of proteins and other compounds.
 Erythropoiesis Regulation: The kidneys produce erythropoietin, a
hormone that stimulates the production of red blood cells in the bone
marrow in response to low oxygen levels in the blood.
 Detoxification: The kidneys help to detoxify the body by filtering out harmful
substances, such as drugs or alcohol, from the bloodstream.
 Activation of Vitamin D: The kidneys convert vitamin D into its active form, which
helps regulate calcium and phosphorus levels, promoting bone health.
 Together, these functions help maintain homeostasis in the body, ensuring that
various systems work properly.
STYRUCTURAL AND FUNCTIONAL
UNIT OF KIDNEY.
 The nephron is the functional unit of the kidney and is responsible for
filtering blood, reabsorbing essential substances, and excreting waste
products as urine. Each kidney contains about 1 million nephrons, and their
structure is specifically designed to efficiently filter blood and regulate fluid,
electrolyte, and acid-base balance.
 The renal corpuscle is responsible for the initial filtration of blood and
consists of two parts:
• Glomerulus: A network of tiny capillaries where blood filtration takes place.
Blood enters the glomerulus via the afferent arteriole and is filtered into the
Bowman's capsule. The filtration barrier allows small molecules like water,
glucose, and electrolytes to pass into the nephron while preventing larger
molecules like proteins and blood cells from entering the filtrate.
• Bowman’s Capsule (or Glomerular Capsule): A double-walled, cup-like
structure that surrounds the glomerulus. The inner wall is in direct contact
with the glomerular capillaries, where filtration occurs. The outer wall collects
the filtered fluid (filtrate) that then moves into the renal tubules.
 2. Renal Tubule (Filtrate Processing Unit)
 After the filtrate enters the Bowman's capsule, it moves into the renal
tubule, which has three main parts:
 Proximal Convoluted Tubule (PCT):
• Located right after the Bowman's capsule.
• The majority of reabsorption occurs here, where substances like
glucose, amino acids, water, sodium, and other essential ions are
reabsorbed back into the bloodstream.
• Also, some secretion of waste products occurs here
 Loop of Henle:
• A U-shaped portion of the nephron that extends into the renal
medulla.
• It has two parts: the descending limb (which is permeable to water)
and the ascending limb (which is impermeable to water but actively
transports sodium, chloride, and potassium).
• The loop creates a concentration gradient in the renal medulla, which
helps with water reabsorption and the concentration of urine.
 Distal Convoluted Tubule (DCT):
• Located after the loop of Henle.
• This part is responsible for the further regulation of sodium,
potassium, and calcium through the actions of hormones such as
aldosterone and parathyroid hormone (PTH).
• Some waste products like hydrogen ions and urea are also secreted
into the filtrate here.
• Final regulation of water and electrolyte balance: The presence
of antidiuretic hormone (ADH) determines the permeability of the
collecting duct to water. When ADH is present, water is reabsorbed,
concentrating the urine. If ADH is absent, the collecting duct remains
impermeable to water, leading to the excretion of dilute urine.
 Acid-base balance: The collecting duct also helps regulate
the blood’s pH by secreting hydrogen ions (H⁺) or
bicarbonate ions (HCO₃⁻) into the urine as necessary.
 Blood supply of nephron
 Afferent Arteriole: The blood vessel that carries blood into
the glomerulus.
 Efferent Arteriole: The blood vessel that carries blood
away from the glomerulus after filtration.
 Peritubular Capillaries: These are capillaries that surround
the renal tubules. They allow for the reabsorption of
substances from the filtrate back into the blood and the
secretion of substances into the filtrate.
 URINE FORMATION
 Waste is excreted from the human body, mainly in the form
of urine. Our kidneys play a major role in the process of
excretion. Constituents of normal human urine include 95
per cent water and 5 per cent solid waste.
 Urine formation in our body is mainly carried out in three
phases namely
1. Glomerular filtration
2. Reabsorption
3. Secretion
 Glomerular filtration
 Glomerular filtration occurs in the glomerulus where
blood is filtered. This process occurs across the three
layers- the epithelium of Bowman’s capsule, the
endothelium of glomerular blood vessels, and a
membrane between these two layers.
 Blood is filtered in such a way that all the
constituents of the plasma reach the Bowman’s
capsule, except proteins. Therefore, this process is
known as ultrafiltration.
 Reabsorption
 Around 99 per cent of the filtrate obtained is
reabsorbed by the renal tubules. This is known as
reabsorption. This is achieved by active and passive
transport.
 Secretion
 The next step in urine formation is tubular secretion. Here,
tubular cells secrete substances like hydrogen ions, potassium
ions, etc. into the filtrate. Through this process, the ionic, acid-
base and the balance of other body fluids are maintained. The
secreted ions combine with the filtrate and form urine. The
urine passes out of the nephron tubule into a collecting duct.
 Urine
 The urine produced is 95% water and 5% nitrogenous wastes.
Wastes such as urea, ammonia, and creatinine are excreted in
the urine. Apart from these, the potassium, sodium and calcium
ions are also excreted.
Electrolytes: Their Balance and Imbalance

 Electrolytes are minerals in your blood and other body fluids that carry an
electric charge. They are crucial for many body functions, including nerve
signaling, muscle function, hydration, and maintaining the pH balance of your
body. The most common electrolytes in the body are:
• Sodium (Na⁺) – Regulates fluid balance and is critical for muscle and nerve
function.
• Potassium (K⁺) – Essential for proper muscle function, nerve signaling, and
heart function.
• Chloride (Cl⁻) – Often paired with sodium to help maintain fluid balance.
• Calcium (Ca²⁺) – Vital for muscle function, nerve signaling, and bone health.
• Magnesium (Mg²⁺) – Important for muscle and nerve function, and
regulating blood sugar levels.
• Bicarbonate (HCO₃⁻) – Helps maintain the acid-base balance (pH) in the
body
Electrolyte balance
 Electrolyte balance is the state where the body maintains optimal
levels of electrolytes in the extracellular and intracellular spaces.
These electrolytes are regulated through various mechanisms,
primarily through:
• Kidneys: They filter excess electrolytes and water out of the
bloodstream and excrete them in urine.
• Hormonal control: Hormones like aldosterone (for sodium and
potassium balance) and antidiuretic hormone (ADH, for water
balance) play major roles in regulating electrolyte levels.
• Dietary intake: The food and fluids you consume significantly
influence electrolyte levels
• Maintaining balance is critical because both high and low
concentrations of electrolytes can lead to serious health problems. If
any electrolytes become too high or too low, it can disrupt the
function of organs like the heart, brain, and muscles.
Electrolyte imbalance
 Hyponatremia (Low Sodium)
• Symptoms: Nausea, headache, confusion, fatigue, and seizures.
• Causes: kidney problems, or excessive sweating without proper
electrolyte replenishment.
 Hypernatremia (High Sodium)
• Symptoms: Thirst, confusion, muscle twitching, and in severe cases,
coma.
• Causes: Dehydration, kidney dysfunction, or excessive sodium intake.
 Hypokalaemia (Low Potassium)
• Symptoms: Weakness, fatigue, muscle cramps, arrhythmias (irregular
heartbeats).
• Causes: Diarrhoea, vomiting, excessive use of diuretics, or kidney issue
 Hyperkalaemia (High Potassium)
• Symptoms: Muscle weakness, fatigue, arrhythmias, and possible
cardiac arrest in extreme cases.
• Causes: Kidney failure, excessive potassium supplements, or certain
medications.
 Hypocalcaemia (Low Calcium)
• Symptoms: Muscle cramps, tingling, numbness, seizures.
• Causes: Vitamin D deficiency, hypoparathyroidism, or chronic kidney
disease
 Hypercalcemia (High Calcium)
• Symptoms: Fatigue, nausea, vomiting, kidney stones, and confusion.
• Causes: Overactive parathyroid glands, cancer, or excessive vitamin D
intake.
• .
Acidosis and Alkalosis

 Acidosis and alkalosis refer to disturbances in the body's pH level,

which is normally tightly regulated around 7.35–7.45. The body has
two main types of acidosis and alkalosis: metabolic and
respiratory.
 Acidosis is a condition where the blood becomes too acidic. This can
be caused by an excess of hydrogen ions (H⁺) or a loss of bicarbonate
(HCO₃⁻).
 Metabolic Acidosis: This occurs when there is an accumulation of
acids in the body or a loss of bicarbonate.
• Causes: Diabetic ketoacidosis, kidney disease, or lactic acidosis.
• Symptoms: Rapid breathing, confusion, fatigue, and in severe cases,
coma
• Respiratory Acidosis: This occurs when the lungs cannot remove
enough carbon dioxide (CO₂), leading to a buildup of CO₂ in the blood,
which reacts with water to form carbonic acid.
 Causes: Chronic obstructive pulmonary disease (COPD), respiratory
failure, or pneumonia.
 Symptoms: Shortness of breath, confusion, drowsiness, and cyanosis
(bluish skin color).
Alkalosis (pH > 7.45)
 Alkalosis is a condition where the blood becomes too alkaline (basic).
This can be due to a loss of hydrogen ions (H⁺) or an excess of
bicarbonate (HCO₃⁻).
 Metabolic Alkalosis: This occurs when there is an excess of
bicarbonate in the blood or a loss of acid.
• Causes: Vomiting, excessive use of antacids, or diuretic use.
• Symptoms: Muscle twitching, hand tremors, and confusion.
 Respiratory Alkalosis: This happens when the lungs excrete too
much CO₂ due to rapid breathing (hyperventilation), leading to an
excess of bicarbonate.
• Causes: Anxiety, pain, fever, or high altitude.
• Symptoms: Dizziness, tingling, and shortness of breath.
RENIN ANGIOTENSINOGEN
MECHANISM
The renin-angiotensin mechanism is a critical hormone system
that helps regulate blood pressure, fluid balance, and electrolyte
homeostasis. It's mainly involved in maintaining blood pressure and
fluid volume through a cascade of biochemical steps. Here's how it
works:
 Renin Release
• The juxtaglomerular cells in the kidneys detect changes in blood
pressure, sodium levels, and fluid volume.
• When blood pressure drops, sodium concentration in the kidneys
decreases, or sympathetic nerve activity increases, these cells release
renin into the bloodstream.
 Renin Converts Angiotensinogen to Angiotensin I
• Renin is an enzyme that acts on angiotensinogen, a protein
produced by the liver.
• Renin cleaves angiotensinogen to produce angiotensin I, an
inactive precursor.
 Conversion to Angiotensin II
• Angiotensin I is relatively inactive, but when it passes through the
lungs (or other tissues with angiotensin-converting enzyme
(ACE)), it is converted to angiotensin II, the active form.
• Angiotensin-converting enzyme (ACE) converts angiotensin I into
angiotensin II.
Effects of Angiotensin II

 Angiotensin II has several important physiological effects that increase

blood pressure and fluid volume:
• Vasoconstriction: It constricts blood vessels, increasing the total
peripheral resistance (TPR) and, thus, raising blood pressure.
• Aldosterone Secretion: Angiotensin II stimulates the adrenal glands to
release aldosterone, a hormone that acts on the kidneys to increase
sodium reabsorption. This leads to water retention, increasing blood
volume and, consequently, blood pressure.
• ADH Release: It stimulates the release of antidiuretic hormone (ADH)
(also called vasopressin) from the posterior pituitary. ADH increases water
reabsorption in the kidneys, contributing to increased blood volume.
• Thirst Mechanism: Angiotensin II also triggers the sensation of thirst,
encouraging the intake of fluids, which can further help increase blood
volume and pressure.
• Sympathetic Nervous System Activation: Angiotensin II can enhance
sympathetic nervous system activity, leading to further vasoconstriction
and increased heart rate.
 Feedback Regulation
• When blood pressure or blood volume increases, the release of renin
is suppressed through negative feedback mechanisms. This helps
prevent excessive blood pressure elevation.
GFR
 Glomerular Filtration Rate (GFR) is the rate at which blood is
filtered through the glomeruli in the kidneys. It is a measure of kidney
function that indicates how well the kidneys are clearing waste and
excess fluids from the blood.
 GFR is typically expressed in milliliters per minute (mL/min).
 The higher the GFR, the better the kidneys are functioning.
 A decrease in GFR may indicate kidney damage or impaired kidney
function.
 The normal range for Glomerular Filtration Rate (GFR) in healthy
adults is generally:
• 90 to 120 mL/min OR 180L/DAY