URINARY SYSTEM T- Toxin removal
The nitrogenous waste products are poorly
 Composed of the two kidneys which is
the right and the left kidneys, two ureters,
urinary bladder and urethra
 A large volume of blood flows through
the kidney which remove substances
from the blood to form urine.
 The urine contains excess water and ions,
metabolic wastes like urea, creatinine and
toxic substances consumed with the food.
The urine produced by the kidneys flow
through the ureters, and the urinary
bladder where it is stored until it is
eliminated through the urethra.
KIDNEYS (“A WET BED”)
A – Acid base balance
The kidney secretes variable amount of
hydrogen to help regulate the extracellular
fluid ph. The ph determines the acidity or
alkalinity of the fluid. (THE blood pH is 7.35-
7.45;normal. Low; acid :: High; alkaline)
W- Water removal
We know that the kidneys are the major
excretory organ in our body, that removes
excess water.
Note: Water is not always excreted via the
renal system. It can be also eliminated through
the GIT, respiratory system, or through our
perspiration
E – Erythropoiesis
Erythropoietin is a hormone primarily
produced by the kidneys. This hormone plays
a key role in the production of red blood cells,
and the process is known as erythropoiesis.
This is the process of producing red blood
cells via the stimulation of the bone marrow
by the erythropoietin.
reabsorbed, so tubules cells have few
membranes carrier to reabsorb these
substances because we do not need them, so
they tend to remain in the filtrate and they are
found in high concentrations in the urine
excreted from the body. Various ions are
reabsorbed and allowed to go out in the urine,
and according to what is needed at a particular
time to maintain the proper pH and the
electrolyte composition of the blood.
Common nitrogenous waste includes:
 Urea which is formed by the liver as an
end product of protein breakdown when
amino acids are used to produce energy.
 Uric acid which is released when nucleic
acids are metabolized
 Creatinine which is associated with
creatinine metabolism and the muscle
tissue.
B - BP control
RAAS is an important mechanism that
regulate the blood pressure.
E - Electrolyte Balance
The kidneys help regulate the concentration of
major molecules and ions like the glucose,
sodium, chloride, potassium, calcium,
bicarbonate and phosphate.
D - Vitamin D activation
The kidneys convert vitamin D from the
supplements that we take or from the food we
eat, to the active form of vitamin D that is
needed by our body.
KIDNEY
A pair of bean-shaped organ found along the
posterior wall of the abdominal cavity, with
one kidney on the either side of the vertebral
column.
Note:
 The left kidney is higher than the right
kidney due to that larger size of the liver
on the right side of our body.
 Each kidney approximately weighs 125
to 170 g in males. And 115 to 155 g in
females.
 The kidney is located posterior to the
peritoneum and they touch the muscles of
the back. It’s located is called
retroperitoneal.
 Our kidneys are also surrounded by a
layer of adipose tissue that holds them in
place and protects them from physical
damage.
HILUM - on the medial side of every kidney
there is a hilum, where the renal arteries and
the nerves enter, and where the renal veins
and the ureter exit
3 LAYERS OF THE FATTY POUCH
Renal Capsule (Fibrous capsule) – A fibrous
layer of connective tissue covering the kidney
parenchyma.
 The innermost layer. This is strong and
fibrous. And it’s attached to the kidneys,
and prevents infection.
Perirenal Fat (or adipose capsule) – A
region of adipose against the kidney (in which
the adrenal glands are embedded)
 A protective layer that protects the
kidneys from injury.
Renal Fascia – A thin layer of connective
tissue encircling the kidneys.
 Anchors the kidney to the peritoneum
and the abdominal wall.
 Renal; Latin word for kidney
 The fat surrounding the kidneys is
important in holding them in their normal
body position. If the amount of fatty
tissue dwindles like as with rapid weight
loss, the kidneys may drop to a lower
position. The condition is called ptosis.
Ptosis creates problems if the ureter
become kinked.
 If the ureters become kinked, the urine
can no longer pass through it, and the
urine backs up and exerts pressure on the
kidney tissue. This condition is called
hydronephrosis, which can severely
damage the kidney.
STRUCTURE OF THE KIDNEYS
The kidney structure has two layers:
- Outer (renal cortex): contains many
capillaries and is made up of renal
corpuscles (part of the nephron which is
made of glomerulus and bowman’s
capsule) and renal tubules.
- Inner (renal medulla): contains many
blood vessels and tubules. Triangle
sections of tissues can be found in the
renal medulla.
- These triangular sections of tissue that
constitutes the medulla is called the renal
pyramids. There are 8-18 renal pyramids
in every kidney. The structure that
separates the pyramids are called the renal
columns and they also transmits blood
vessels.
- When you look at closely, we can find
tubules or tubes. The tips of the tubes are
what we call the renal papilla or renal
papillae.
- The renal papillae are considered the apex 9. Peritubular capillaries/vasa recta are
of the renal pyramid. They are projecting specialized portion of peritubular capillaries
toward the center of the kidneys, and they that extends deep into the medulla of the
are surrounded by a funnel- shaped kidney and surround the loops of Henle and
structure which we call as the minor the collecting ducts.
calyx.
10. Blood coming from the peritubular
- These minor calyxes will join together to
capillaries including the vasa recta enters the
form the major calyx.
interlobular veins, and the veins of the kidney
- The major calyxes will join together to
run parallel to the arteries and they have
form the renal pelvis. The renal pelvis is
similar names but in reverse.
the large funnel wherein the major
calyxes from all the renal pyramids join to 11. Arcuate veins
form this structure.
12. Interlobar veins
- These renal pelvis narrows to form a
small tube called as the ureter, wherein 13. Segmental veins
the ureter exits the kidney and is
14.Renal veins which exit our kidneys.
connected to the urinary bladder.

FUNCTIONAL UNIT OF THE KIDNEYS

BLOOD FLOW THROUGH THE
KIDNEY Nephron
1. Renal Artery - Branch off from the  Functional unit of the kidney
abdominal aorta and enter the kidneys. They  Produce urine
give rise to several branches  Nephron is made up of many tubules
2. Segmental arteries  Over 1 million nephrons in every kidney.
 Each nephron is composed of the renal
3. Interlobar arteries pass between the renal corpuscle which is made up of the
pyramids glomerulus and the bowman’s capsule.
4. Arcuate arteries arch between the cortex
and the medulla

5. Interlobular arteries branch off the

arcuate arteries to project into the cortex.

6. The afferent arterioles arise from the

branches of the interlobular arteries and
extend to the glomerular capillaries.

7. Glomerular capillaries

8. Efferent arterioles extend from the

glomerular capillaries and then going to the
peritubular capillaries which surrounds the
proximal and distal tubules and the loops of  Proximal Convoluted tubule
Henle.
 Loop of Henle composed of the
descending limb and ascending limb.
o The descending limb: the
substances travel going
downward.
o The ascending limb: the
substances travel going
upward.
 Distal Convoluted tubule
TWO TYPES OF NEPHRONS
Cortical
 Account to 80 -85% of the total
nephron
 More abundant compare to juxta
medullary
 Have shorter nephron loop
 The loop of Henle of the cortical
nephron does not extend deep into the
medulla and they are only located in
the renal cortex (outer layer of the
kidney)
Juxta Medullary
 Account for the 15-20% of the
nephrons
 Have longer nephron loops
 The renal corpuscles are located in the
cortex yet very near the cortex
medulla junction.
 They have loops of Henle that extend
deep into the medulla of the kidney.
That is why it is called juxta medulla
PARTS OF THE NEPHRON
Glomerulus – Tuft of capillaries with
fenestrations or pores. These fenestrations
allow the filtrate to pass through except for
the majority of the proteins and blood cells
Note: proteinuria; protein in urine, hematuria;
blood in urine
Proximal Convoluted tubule (PCT) – Lined
with cuboidal cells with brush border or
microvilli. The cells reabsorb substances from
the filtrate as well as secrete substances into
the filtrate
Loop of Henle – Composed of the descending
limb and ascending limb.
o The descending limb: substance
going downward, the descending limb
is made up of thin segment of simple
squamous epithelium and is highly
permeable to water.
o The ascending limb: upward,
contains thick segment, and is
impermeable to water.
Distal Convoluted tubule (DCT) – lines with
cuboidal cells, and the cells are thinner. These
cells play a role in secreting substances into
the filtrate rather than removing substances
from it.
There are two types of cells:
1. Intercalated cells with microvilli:
Function is for the acid-base balance of the
blood.
2. Principal cells: Do not have microvilli.
Function is for the sodium and water balance.
Collecting duct – not part of the nephron.
Passes through the renal pyramids which are
located in the renal medulla and ends in the
renal papillae where it empties into a minor
calyx.; surrounds the tips of the tubules/renal
papillae that join together to form a major
calyx; joined together to form the renal
pelvis; narrows down to form the ureter; tube
that delivers the urine from the kidney going
to the urinary bladder.
Review:
From the afferent arteriole, the blood goes to
the glomerulus, and the blood is filtered. The
filtered substances which are called the
filtrate, will proceed to the bowman’s capsule
(glomerular capsule). Both the glomerulus
and the glomerular capsule compose the renal
corpuscle. These bowman’s capsule surrounds
the glomerulus, and the filtrate is caught by
the glomerular capsule.
Glomerular Filtration Rate (GFR) – the
amount of filtrate being made by the kidney.
 125 mL/min (normal GFR)
 180 L/day (1 day)
 Out of 180 Liters, the kidney only
produces 1-2 liters of urine per day or
only 1% of the 180.
URINE FORMATION: 3 MAJOR URINE
PROCESS
1. Glomerular formation - There is a
movement of substances from the blood
within the glomerulus into the capsular
space or the bowman’s capsule. In
glomerular filtration, the blood is
filtered in the glomerulus. The water
and the solutes which are smaller than
proteins are forced through the capillary
walls and the pores of the glomerular
capsule into the renal tubule.
2. Tubular reabsorption – Movement of
substances from the tubular fluid back
into the blood. Almost all desirable
organic substances are reabsorbed like
water, glucose, amino acids and the
needed ions. They are transported out of
the filtrate into the tubule cells and enter
the capillary blood. 99% of the filtrate
is reabsorbed. 65 % is reabsorb in the
PCT, 15% in the descending loop of
Henle, and 19% in the DCT and
collecting duct.
3. Tubular secretion – Movement of
substances from the blood into the
tubular fluid. In tubular secretion, all
the undesirable substances are excreted
in the urine.
Micturition / Voiding / Urination - Is a
reflex action. The process of releasing urine
from the urinary bladder through the urethra
and out of the body. The process of urination
begins when the muscles of the urethral
sphincter relax, allowing the urine to pass
through the urethra. At the same time that the
sphincter is relax, the smooth muscle in the
walls of the urinary bladder contract to expel
the urine from the bladder. The stretch
receptors activate the detrusor muscle, and
relax the internal urethral sphincter and the
external urethral sphincter is under voluntary
control after approximately 2 years old and
this has to do with the growth of the spinal
cord and the appropriate nerves.
 Urine - 1-2 L produced a day. If the
amount of urine in the urinary bladder is
150 mL, that is the time we can feel the
urge to urinate.
 Around 500 mL – When a person can no
longer hold the urine.
Note:
The bladder can actually hold 1 L of urine.
 The normal yellow color of the urine is
due to urochrome which is a pigment
arising from the body’s breakdown of
hemoglobin. And as a rule, the greater
the solute concentration, the deeper the
yellow color. Abnormal yellow color
may also be due to certain foods as well
 as to various drugs like vitamin C, and ABNORMAL URINARY
also due to bile or blood.
 The odor of the freshly voided urine is
slightly aromatic, but bacterial action
gives it an ammonia like odor when left
standing. Certain diseases may also alter
the characteristic odor of the urine.
 pH level of the urine ranges from 4.5 to
8. But its average value is 6, which is
slightly acidic. The food that we eat may
CONSTITUENTS
influence the pH of our urine.
 Specific gravity is the relative weight of a
specific volume of a liquid compared
with an equal volume of distilled water. PROTEINURIA
Specific gravity of distilled water is 1 - In pregnancy, urinary protein excretion
because 1mL weighs 1g, and because normally increases substantially.
urine contains many dissolved solutes it However, urinary protein excretion is
weighs more than water. Its customary considered abnormal when the level
specific gravity ranges from 1.001 – 1.03. exceeds 300 mg a day. In many pregnant
Urine with a specific gravity of 1.001 women, proteinuria appears to increase
contains few solutes and is very dilute. further at the time of labor and delivery.
 Dilute urine is common when a person
drinks large amount of water, uses
diuretics, or suffers from chronic renal HEMOGLOBINURIA
failure.
 Conditions that produce urine with a high - Hemolytic anemia is a condition
specific gravity include limited fluid characterized by the rapture of red
intake, fever, and kidney inflammation. blood cells.
 If urine becomes excessively
concentrated, some of the solutes begin
to precipitate or crystalize forming RAAS (Renin Angiotensin Aldosterone
kidney stones or what we call as the renal System) - A mechanism that is extremely
calculi. important for regulating the blood pressure.
As well as the amount of blood volume.

TWO FACTORS THAT TRIGGERS THE

RAAS:

1.Hypovolemia – Decreased blood volume

2.Hypotension – Decreased blood pressure

Either way, the cells of the juxta glomerular
cells of the kidneys are stimulated either by
LBP in the afferent arteriole/changes in the
solute content to filtrate they respond by
releasing the enzyme renin; This renin acts on
the protein called as the angiotensinogen
(already present in the blood) which is
produced by the liver. The amino acids are
removed leaving only angiotensin I. The
angiotensin I is rapidly converted to a smaller
peptide called as angiotensin II by the
angiotensin converting enzyme or A.C.E. The
A.C.E is secreted into the lungs and kidneys
by cells in the endothelium or inner layer of
the blood vessels.
 Angiotensin II in return, acts on the
blood vessels causing the BV to constrict.
Vasoconstriction is the medical term for
the constrictions of the blood vessels.
Vasodilation which is the dilation of the
blood vessels. This vasoconstriction leads
to an increase in the peripheral resistance
which could increase the blood pressure.
 The Angiotensin II also acts on the
adrenal cortical cells to promote the
release of a hormone known as
aldosterone. Aldosterone is a hormone
that promotes water and sodium
retention. And as a result, the blood
volume increases as well as the blood
pressure.
URETERS
- A pair of tubes that carry the urine from
the kidneys going to the urinary bladder.
- Ureters are 10-12 inches long and they
run on the left and right sides of the body
parallel to the vertebral column.
- Gravity and peristalsis of the smooth
muscle tissue in the walls of the ureters
moves the urine toward the urinary
bladder.
- The ends of the ureters extend slightly
into the urinary bladder and are sealed at
the point of entry to the bladder by the
ureterovesical valve. These valves prevent
the urine from flowing back towards the
kidneys.
URINARY BLADDER
- Sac-like hallow organ for the urine
storage
- Located along the body’s midline at the
inferior end of the pelvis. You can find
here the trigone which is a triangular
section of the bladder that is outlined by
three openings. (2 ureteric orifices: where
ureters enter and 1 urethral orifice)
URETHRA
- The urethra carries the urine from the
urinary bladder going to the exterior of
the body.
- The urethral orifice or meatus is the
external opening of the urethra where the
urine comes out.
FEMALE URETHRA
- Shorter than the male. Around 2 in in
length
- The opening is located below the clitoris
and above the vaginal opening
- The shorter urethra is one of the reasons
why women get UTI more often. The
shorter urethra makes it easier for the
bacteria to get into the bladder.
MALE URETHRA
 Around 8-10 in length and ends at the tip
of the penis.
 Because of the length, the male urethra is
divided into three regions.
1. Prostatic: passes through the prostate gland
2. Membranous: passes through the
urogenital diaphragm. Urogenital diaphragm
is a double layer of pelvic fascia with its
included muscle that is situated between the
ischial and pubic rami, and supports the
prostate in the male, and gives passage to the
membranous part of the urethra.
2. Penile/spongy: passes through the length of
the penis.
3. The hormone produced by the kidney
that plays an important role in RBC
production
4. Give 2 layers of the kidney structure
5. The innermost layer of the fatty pouch
that protects the kidney
6. The parts of nephron
7. The major functions of nephron
8. The pair of tubes that carry the urine
from the kidney to the urinary bladder
9. The average GFR in a day: how many
% becomes urine
10. What type of kidney stones are
radiopaque in x-ray?

 The flow of urine in the urethra is

controlled by the internal and external
urethral sphincter muscles.
 The internal urethral sphincter is made of
smooth muscle, and opens involuntarily
when the bladder reaches a certain set
level of distention. The opening of the
internal sphincter which results in the
sensation of “needing to urinate”.
 The I.S is made up of skeletal muscle and
may be opened to allow the urine to pass
through the urethra or may be held close
to the delay urination.

KIDNEY STONES (nephrolithiasis; renal

calculi)

- Hard deposits made of minerals and salts

that is formed inside our kidneys.
Diet, excess body weight, medical
conditions, certain supplements and
medications are among the many causes
of kidney stones

REVIEW:

1. Give the location of the kidneys

2. The functional unit of the kidney