The Urinary System| MKDG | BSMT-IIA 1.

Physical Characteristics of Urine

7 Functions of the Urinary System

1. Urine Formation
2. Urine Transport
3. Urine Storage and Release
4. Regulates Blood Pressure
5. Stimulates Erythropoiesis (blood cell formation)
6. Activation of Vitamin D
7. pH Control

Normal Urine Characteristics

Characteristic Normal Values
Color Pale yellow to deep amber urochrome
Odor Odorless
Volume 750-2000 mL/24 hour
pH 4.5-8.0
Specific gravity 1.003-1.032
Osmolarity 40-1350 m Osmol/kg
Urobilinogen 0.2-1.0 mg/100 mL
White blood cells 0-2 HPF (per high-power field of microscope)
Leukocyte esterase None
Protein None or trace
Billrubin <0.3 mg/100 mL
Ketones None
Nitrite None
Blood None
Glucose None
 URETERS

 It is a muscular tube transporting urine from kidney to urinary

bladder.
 Length: 20-30 cm long
BLADDER  Beginning: It begins as a continuation of renal pelvis.
 Peristaltic contractions help to move the urine through the lumen
 highly distensible organ with contributions from fluid pressure without the aid of gravity.
 Detrusor muscle  collective irregular
crisscrossing bands of smooth muscle
comprising the bladder
 Interior surface is made of transitional
cellular epithelium that is structurally
suited for the large volume fluctuations
of the bladder
 When empty, it resembles columnar
epithelia, but when stretched, it
transitions to a squamous appearance
 Volumes in adults can range from nearly
zero to 500-600 ml
 The detrusor muscle contracts with significant force in the young
 It’s strength diminishes with age but voluntary contractions of
abdominal skeletal muscles can increase intra-abdominal
pressure to promote more forceful bladder emptying
 Such voluntary contraction is also used in forceful defecation and
childbirth
GROSS ANATOMY OF THE KIDNEY  Glomerulus
 Tuft of high-pressure capillaries (200 um in diameter) formed by
afferent arterioles
 Bowman’s capsule
 The rest of the nephron consists of a continuous sophisticated
tubule whose proximal end surrounds the glomerulus in an
intimate embrace
 Renal Corpuscle
 glomerulus + Bowman’s capsule
 glomerular capillaries filter the blood based on particle size. After
passing through the renal corpuscle, the capillaries form a second
arteriole, the efferent arteriole.
 These will next form a capillary network around the more distal
portions of the nephron tubule, the peritubular capillaries and vasa
recta, before returning to the venous system.
 As the glomerular filtrate progresses through the nephron, these
capillary networks recover most of the solutes and water, and return
them to the circulation.
 Since a capillary bed (the glomerulus) drains into a vessel that in turn
INTERNAL ANATOMY OF THE KIDNEY forms a second capillary bed, the definition of a portal system is met.
 This is the only portal system in which an arteriole is found between
the first and second capillary beds. (Portal systems also link the
hypothalamus to the anterior pituitary, and the blood vessels of the
digestive viscera to the liver.)
 Nephron/Uriniferous tubule = glomerulus + tubules
 Renal corpuscle = glomerulus + Bowman’s capsule

NEPHRONS & VESSELS (BLOOD FLOW IN THE NEPHRON)

 Nephrons
 are the “functional units” of the kidney;
 cleanse the blood and balance the constituents of the circulation.
 renal corpuscle consists of a small mass of capillaries called the
 (c) Filtrate is produced in the corpuscle when blood plasma is
glomerulus, housed within a bulbous glomerular capsule.
forced under pressure through the capillary fenestrations, across
 The visceral layer of the capsule is composed of complex epithelial
the filtration membrane or GBM surrounding the capillary, and
cells called podocytes, which cover each capillary, forming slit-like
through the filtration slit diaphragms located between the
spaces between interdigitating processes called pedicels.
podocyte pedicels.
 Blood enters and leaves the glomerulus through the afferent and
efferent arterioles, respectively. The scanning electron microscopy
 The micrograph shows the major (SEM) shows the distinctive
histologic features of a renal corpuscle. The appearance of podocytes and their
glomerulus (G) of capillaries is pedicel processes that cover
surrounded by the capsular space (CS) glomerural capillaries.
covered by the simple squamous parietal
layer (PL) of Bowman capsule.
 Near the corpuscle is that nephron’s
macula densa (MD) and sections of
proximal convoluted tubules (PCT) and
distal convoluted tubules (DCT)
glomerular filtration barrier Region of Histologic feature Locations Major functions
tubule
consists of three layered
PCT  simple cuboidal epith Cortex Reabsorption of all
components:  cells well stained organic nutrients,
 with numerous proteins, most water,
1. the fenestrated capillary mitochondria, prominent and electrolytes
endothelium basal folds and lateral Secretion of organic
interdigitations anions and cations,
2. the GBM, and
 long microvilli, lumens H+ and NH4+
3. filtration slit diaphragms often occluded
between pedicels. The major Loop of
component of the filter is Henle
- Thin limbs  Simple squamous epith Medulla  Passive reabsorption
formed by fusion of the basal  Few mitochondria of Na+ and Cl-
laminae of a podocyte and a
capillary endothelial cell. - TAL  Simple cuboidal epith Medulla  Active reabsorption
 No microvilli and of various
 Many mitochondria medullary electrolytes
rays
DCT Simple cuboidal epith Cortex  Reabsorption of
Cells smaller than in PCT electrolytes
Short microvilli and
basolateral folds
More empty lumens
Collecting
System
- Principal  Most abundant Medullary  Regulated
cells  Cuboidal to columnar rays and reabsorption of
 Pale-staining medulla water & electrolytes
 Distinct cell membrane  Regulated secretion
of K+

- Intercalated  Few and scattered Medulla  Reabsorption of K+

cells  Slightly darker staining (low K+ diet)
 Help maintain acid-
base balance
 (d) A cross section through a
medullary renal pyramid shows
the simple squamous
epithelium of the thin
descending and ascending
limbs of loops of Henle (T) and
its thick ascending limbs (A), as
well as the pale columnar cells of
collecting ducts (CD). Note also
the homogeneous interstitium
with capillaries smaller than the
thin limbs.

(b) A section of cortical tissue

shows one renal corpuscle (RC),
the wide, eosinophilic
proximal convoluted tubules
(PCT) with the smaller, less
well-stained distal
convoluted tubules (DCT)
(c) Diagram shows the major The JGA forms at the point of contact
structural differences between a nephron’s distal tubule (D) and
between the cuboidal cells of the vascular pole of its glomerulus (G).
proximal and distal tubules.
Cells of both tubules have basal At that point cells of the distal tubule
membrane invaginations become columnar as a thickened region
associated with mitochondria. called the macula densa (MD).

Smooth muscle cells of the afferent

arteriole’s (AA) tunica media are
converted from a contractile to a secretory
morphology as juxtaglomerular granule
cells (JG). (renin)
  Pale-staining columnar principal cells, in which ADH-regulated
aquaporins of the cell membrane allow more water reabsorption,
are clearly seen in these transversely sectioned collecting ducts
(CD), surrounded by interstitium with vasa recta

 A superficial layer of large bulbous or elliptical umbrella cells,

sometimes binucleated, which are highly differentiated to protect
the underlying cells against the potentially cytotoxic effects of
hyper tonic urine
 The thick muscularis of ureters moves urine toward the bladder
by peristaltic contractions and produces prominent mucosal folds
when the lumen is empty
 A sagittal section of a renal papilla  Histologically the muscularis
shows numerous collecting ducts (Mu) is much thicker than the
(also called the ducts of Bellini at mucosa (M) and adventitia (A).
this level) converging at the end of
the renal papilla (R) where they
empty into the minor calyx (MC).
The mucosa of the calyx contains
dense connective tissue stained
blue here and adipose tissue (A).
The ducts are embedded in
interstitial tissue, which also
contains thin limbs of the nephron  In the neck of the bladder, near
loops Inset: An enlarged area the urethra, the wall shows four
shows the columnar epithelium of layers: the mucosa with urothelium
the collecting ducts (CD), the (U) and lamina propria (LP); the thin
interstitium (I) and thin limbs (T), submucosa (S); inner, middle, and
and the protective urothelium (U) outer layers of smooth muscle (IL,
that lines the minor calyx. ML, and OL); and the adventitia (A).

 Diagram of a ureter in cross

section shows a characteristic
pattern of longitudinally folded
mucosa, surrounded by a thick  (b) When the bladder is
muscularis that moves urine by empty, the mucosa is highly
regular waves of peristalsis. The folded and the urothelium (U)
lamina propria is lined by a has bulbous umbrella cells.
unique stratified epithelium  (c) When the bladder is
called transitional epithelium full, the mucosa is pulled
or urothelium that is resistant to smooth, the urothelium (U) is
the potentially deleterious effects thinner, and the umbrella cells
of contact with hypertonic urine. are flatter
 The urethra is a fibromuscular tube that carries urine from the
bladder to the exterior of the body.
 (a) A transverse section shows that the mucosa has large
longitudinal folds around the lumen (L).

 (b) A higher magnification of the

enclosed area shows the unusual
stratified columnar nature of the
urethral epithelium (E). This thick
epithelial lining varies between
stratified columnar in some areas and
pseudostratified columnar elsewhere,
but it becomes stratified squamous at
the distal end of the urethra.