Chapter 15

The Urinary System

Functions of the Urinary System

o Kidneys dispose of waste products in urine
o Nitrogenous wastes
o Toxins
o Drugs
o Excess ions
o Kidneys’ regulatory functions include:
o Production of renin to maintain blood pressure
o Production of erythropoietin to stimulate red blood cell
production
o Conversion of vitamin D to its active form

Organs of the Urinary System

o Kidneys
o Ureters
o Urinary bladder
o Urethra

Kidneys
o Location and structure
o The kidneys are situated against the dorsal body wall in a
retroperitoneal position (behind the parietal peritoneum)
o The kidneys are situated at the level of the T 12 to L3 vertebrae
o The right kidney is slightly lower than the left (because of
position of the liver)

Kidneys
o Kidney structure
o An adult kidney is about 12 cm (5 in) long and 6 cm (2.5 in) wide
o Renal hilum
o A medial indentation where several structures enter or exit the
kidney (ureters, renal blood vessels, and nerves)
o An adrenal gland sits atop each kidney

Kidneys
o Kidney structure (continued)
o Three protective layers enclose the kidney

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 o Fibrous capsule encloses each kidney
o Perirenal fat capsule surrounds the kidney and cushions against
blows
o Renal fascia is the most superficial layer that anchors the kidney
and adrenal gland to surrounding structures

Kidneys
o Kidney structure (continued)
o Three regions revealed in a longitudinal section
1. Renal cortex—outer region
2. Renal medulla—deeper region
o Renal (medullary) pyramids—triangular regions of tissue in the
medulla
o Renal columns—extensions of cortexlike material that separate
the pyramids

Kidneys
o Kidney structure (continued)
o Three regions (continued)
3. Renal pelvis—medial region that is a flat, funnel-shaped tube
o Calyces form cup-shaped “drains” that enclose the renal
pyramids
o Calyces collect urine and send it to the renal pelvis, on to the
ureter, and to the urinary bladder for storage

Kidneys
o Blood supply
o One-quarter of the total blood supply of the body passes
through the kidneys each minute
o Renal artery provides each kidney with arterial blood supply
o Renal artery divides into segmental arteries → interlobar
arteries → arcuate arteries → cortical radiate arteries

Kidneys
o Venous blood flow
o Cortical radiate veins → arcuate veins → interlobar veins →
renal vein
o There are no segmental veins
o Renal vein returns blood to the inferior vena cava

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Nephrons
o Structural and functional units of the kidneys
o Each kidney contains over a million nephrons
o Each nephron consists of two main structures
1. Renal corpuscle
2. Renal tubule

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Nephrons
o Renal corpuscle consists of:
1. Glomerulus, a knot of capillaries made of podocytes
o Podocytes make up the inner (visceral) layer of the glomerular
capsule
o Foot processes cling to the glomerulus
o Filtration slits create a porous membrane—ideal for filtration
2. Glomerular (Bowman’s) capsule is a cup-shaped structure that surrounds the
glomerulus
o First part of the renal tubule

Nephrons
o Renal tubule
o Extends from glomerular capsule and ends when it empties into
the collecting duct
o From the glomerular (Bowman’s) capsule, the subdivisions of
the renal tubule are:
1. Proximal convoluted tubule (PCT)
2. Nephron loop (loop of Henle)
3. Distal convoluted tubule (DCT)

Nephrons
o Cortical nephrons
o Located entirely in the cortex
o Include most nephrons
o Juxtamedullary nephrons
o Found at the cortex-medulla junction
o Nephron loop dips deep into the medulla
o Collecting ducts collect urine from both types of nephrons,
through the renal pyramids, to the calyces, and then to the renal
pelvis

Nephrons
o Two capillary beds associated with each nephron
1. Glomerulus
2. Peritubular capillary bed

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Nephrons
o Glomerulus
o Fed and drained by arterioles
o Afferent arteriole—arises from a cortical radiate artery and feeds
the glomerulus
o Efferent arteriole—receives blood that has passed through the
glomerulus
o Specialized for filtration
o High pressure forces fluid and solutes out of blood and into the
glomerular capsule

Nephrons
o Peritubular capillary beds
o Arise from the efferent arteriole of the glomerulus
o Low-pressure, porous capillaries
o Adapted for absorption instead of filtration
o Cling close to the renal tubule to receive solutes and water from
tubule cells
o Drain into the interlobar veins

Urine Formation and Characteristics

o Urine formation is the result of three processes
1. Glomerular filtration
2. Tubular reabsorption
3. Tubular secretion

Urine Formation and Characteristics

o Glomerular filtration
o The glomerulus is a filter
o Filtration is a nonselective passive process
o Water and solutes smaller than proteins are forced through
glomerular capillary walls
o Proteins and blood cells are normally too large to pass through
the filtration membrane
o Once in the capsule, fluid is called filtrate
o Filtrate leaves via the renal tubule

Urine Formation and Characteristics

o Glomerular filtration (continued)

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 o Filtrate will be formed as long as systemic blood pressure is
normal
o If arterial blood pressure is too low, filtrate formation stops
because glomerular pressure will be too low to form filtrate

Urine Formation and Characteristics

o Tubular reabsorption
o The peritubular capillaries reabsorb useful substances from the
renal tubule cells, such as:
o Water
o Glucose
o Amino acids
o Ions
o Some reabsorption is passive; most is active (ATP)
o Most reabsorption occurs in the proximal convoluted tubule

Urine Formation and Characteristics

o Tubular secretion
o Reabsorption in reverse
o Some materials move from the blood of the peritubular
capillaries into the renal tubules to be eliminated in filtrate
o Hydrogen and potassium ions
o Creatinine

Urine Formation and Characteristics

o Tubular secretion (continued)
o Secretion is important for:
o Getting rid of substances not already in the filtrate
o Removing drugs and excess ions
o Maintaining acid-base balance of blood
o Materials left in the renal tubule move toward the ureter

Urine Formation and Characteristics

o Nitrogenous wastes
o Nitrogenous waste products are poorly reabsorbed, if at all
o Tend to remain in the filtrate and are excreted from the body in
the urine
o Urea—end product of protein breakdown
o Uric acid—results from nucleic acid metabolism
o Creatinine—associated with creatine metabolism in muscles

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Urine Formation and Characteristics
o In 24 hours, about 1.0 to 1.8 liters of urine are produced
o Urine and filtrate are different
o Filtrate contains everything that blood plasma does (except
proteins)
o Urine is what remains after the filtrate has lost most of its water,
nutrients, and necessary ions through reabsorption
o Urine contains nitrogenous wastes and substances that are not
needed

Urine Formation and Characteristics

o Urine characteristics
o Clear and pale to deep yellow in color
o Yellow color is normal and due to the pigment urochrome (from
the destruction of hemoglobin) and solutes
o Dilute urine is a pale, straw color
o Sterile at the time of formation
o Slightly aromatic, but smells like ammonia with time
o Slightly acidic (pH of 6)
o Specific gravity of 1.001 to 1.035

Urine Formation and Characteristics

o Solutes normally found in urine
o Sodium and potassium ions
o Urea, uric acid, creatinine
o Ammonia
o Bicarbonate ions

Urine Formation and Characteristics

o Solutes NOT normally found in urine
o Glucose
o Blood proteins
o Red blood cells
o Hemoglobin
o WBCs (pus)
o Bile

Ureters
o Slender tubes 25–30 cm (10–12 inches) attaching the kidney to
the urinary bladder
o Continuous with the renal pelvis

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 o Enter the posterior aspect of the urinary bladder
o Run behind the peritoneum
o Peristalsis aids gravity in urine transport

Urinary Bladder
o Smooth, collapsible, muscular sac situated posterior to the
pubic symphysis
o Stores urine temporarily
o Trigone—triangular region of the urinary bladder base based on
three openings
o Two openings from the ureters (ureteral orifices)
o One opening to the urethra (internal urethral orifice)
o In males, the prostate surrounds the neck of the urinary bladder

Urinary Bladder
o Wall of the urinary bladder
o Three layers of smooth muscle collectively called the detrusor
muscle
o Mucosa made of transitional epithelium
o Walls are thick and folded in an empty urinary bladder
o Urinary bladder can expand significantly without increasing
internal pressure

Urinary Bladder
o Capacity of the urinary bladder
o A moderately full bladder is about 5 inches long and holds about
500 ml of urine
o Capable of holding twice that amount of urine

Urethra
o Thin-walled tube that carries urine from the urinary bladder to
the outside of the body by peristalsis
o Function
o Females—carries only urine
o Males—carries urine and sperm

Urethra
o Release of urine is controlled by two sphincters
1. Internal urethral sphincter
o Involuntary and made of smooth muscle

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 2. External urethral sphincter
o Voluntary and made of skeletal muscle

Urethra
o Length
o In females: 3 to 4 cm (1.5 inches long)
o In males: 20 cm (8 inches long)
o Location
o Females—anterior to the vaginal opening
o Males—travels through the prostate and penis
o Prostatic urethra
o Membranous urethra
o Spongy urethra

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Micturition
o Micturition
o Voiding, or emptying of the urinary bladder
o Two sphincters control the release of urine, the internal urethral
sphincter and external urethral sphincter
o Bladder collects urine to 200 ml
o Stretch receptors transmit impulses to the sacral region of the
spinal cord
o Impulses travel back to the bladder via the pelvic splanchnic
nerves to cause bladder contractions

Micturition
o When contractions become stronger, urine is forced past the
involuntary internal sphincter into the upper urethra
o Urge to void is felt
o The external sphincter is voluntarily controlled, so micturition
can usually be delayed

Fluid, Electrolyte, and Acid-Base Balance

o Blood composition depends on three factors
1. Diet
2. Cellular metabolism
3. Urine output

Fluid, Electrolyte, and Acid-Base Balance

o Kidneys have four roles in maintaining blood composition
1. Excreting nitrogen-containing wastes (previously discussed)
2. Maintaining water balance of the blood
3. Maintaining electrolyte balance of the blood
4. Ensuring proper blood pH

Maintaining Water Balance of the Blood

o Normal amount of water in the human body
o Young adult females = 50%
o Young adult males = 60%
o Babies = 75%
o The elderly = 45%
o Water is necessary for many body functions, and levels must be
maintained

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Maintaining Water Balance of the Blood
o Water occupies three main fluid compartments
1. Intracellular fluid (ICF)
o Fluid inside cells
o Accounts for two-thirds of body fluid
2. Extracellular fluid (ECF)
o Fluids outside cells; includes blood plasma, interstitial fluid (IF),
lymph, and transcellular fluid
3. Plasma (blood) is ECF, but accounts for 3L of total body water.
o Links external and internal environments (Figure 15.9)

Maintaining Water Balance of the Blood

o The link between water and electrolytes
o Electrolytes are charged particles (ions) that conduct electrical
current in an aqueous solution
o Sodium, potassium, and calcium ions are electrolytes

Maintaining Water Balance of the Blood

o Regulation of water intake and output
o Water intake must equal water output if the body is to remain
properly hydrated
o Sources for water intake
o Ingested foods and fluids
o Water produced from metabolic processes (10%)
o Thirst mechanism is the driving force for water intake

Maintaining Water Balance of the Blood

o Thirst mechanism
o Osmoreceptors are sensitive cells in the hypothalamus that
become more active in reaction to small changes in plasma
solute concentration
o When activated, the thirst center in the hypothalamus is notified
o A dry mouth due to decreased saliva also promotes the thirst
mechanism
o Both reinforce the drive to drink

Maintaining Water Balance of the Blood

o Sources of water output
o Lungs (insensible since we cannot sense the water leaving)

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 o Perspiration
o Feces
o Urine

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Maintaining Water Balance of the Blood
o Hormones are primarily responsible for reabsorption of water
and electrolytes by the kidneys
o Antidiuretic hormone (ADH) prevents excessive water loss in
the urine and increases water reabsorption
o ADH targets the kidney’s collecting ducts

Maintaining Electrolyte Balance

o Small changes in electrolyte concentrations cause water to
move from one fluid compartment to another
o A second hormone, aldosterone, helps regulate blood
composition and blood volume by acting on the kidney
o For each sodium ion reabsorbed, a chloride ion follows, and a
potassium ion is secreted into the filtrate
o Water follows salt: when sodium is reabsorbed, water follows it
passively back into the blood

Electrolyte Balance
o Renin-angiotensin mechanism
o Most important trigger for aldosterone release
o Mediated by the juxtaglomerular (JG) apparatus of the renal
tubules
o When cells of the JG apparatus are stimulated by low blood
pressure, the enzyme renin is released into blood

Electrolyte Balance
o Renin-angiotensin mechanism (continued)
o Renin catalyzes reactions that produce angiotensin II
o Angiotensin II causes vasoconstriction and aldosterone release
o Result is increase in blood volume and blood pressure

Maintaining Acid-Base Balance of Blood

o Blood pH must remain between 7.35 and 7.45 to maintain
homeostasis
o Alkalosis—pH above 7.45
o Acidosis—pH below 7.35
o Physiological acidosis—pH between 7.0 and 7.35

Maintaining Acid-Base Balance of Blood

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 o Kidneys play greatest role in maintaining acid-base balance
o Other acid-base controlling systems
o Blood buffers
o Respiration

Maintaining Acid-Base Balance of Blood

o Blood buffers
o Acids are proton (H+) donors
o Strong acids dissociate completely and liberate all of their H + in
water
o Weak acids, such as carbonic acid, dissociate only partially
o Bases are proton (H+) acceptors
o Strong bases dissociate easily in water and tie up H +
o Weak bases, such as bicarbonate ion and ammonia, are slower
to accept H+

Maintaining Acid-Base Balance of Blood

o Molecules react to prevent dramatic changes in hydrogen ion
(H+) concentrations
o Bind to H+ when pH drops
o Release H+ when pH rises
o Three major chemical buffer systems
1. Bicarbonate buffer system
2. Phosphate buffer system
3. Protein buffer system

Maintaining Acid-Base Balance of Blood

o The bicarbonate buffer system
o Mixture of carbonic acid (H2CO3) and sodium bicarbonate
(NaHCO3)
o Carbonic acid is a weak acid that does not dissociate much in
neutral or acid solutions
o Bicarbonate ions (HCO3−) react with strong acids to change
them to weak acids
HCl + NaHCO3 → H2CO3 + NaCl
strong acid weak base weak acid salt

Maintaining Acid-Base Balance of Blood

o The bicarbonate buffer system (continued)
o Carbonic acid dissociates in the presence of a strong base to
form a weak base and water

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 NaOH + H2CO3 → NaHCO3 + H2O
strong base weak acid weak base water

Maintaining Acid-Base Balance of Blood

o Respiratory mechanisms
o Respiratory rate can rise and fall depending on changing blood
pH to retain CO2 (decreasing the blood pH) or remove CO2
(increasing the blood pH)

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Maintaining Acid-Base Balance of Blood
o Renal mechanisms
o When blood pH rises:
o Bicarbonate ions are excreted
o Hydrogen ions are retained by kidney tubules
o When blood pH falls:
o Bicarbonate ions are reabsorbed
o Hydrogen ions are secreted
o Urine pH varies from 4.5 to 8.0

Developmental Aspects of the Urinary System

o The kidneys begin to develop in the first few weeks of
embryonic life and are excreting urine by the third month of fetal
life
o Common congenital abnormalities include polycystic kidney and
hypospadias
o Common urinary system problems in children and young to
middle-aged adults include infections caused by fecal
microorganisms, microorganisms causing sexually transmitted
infections, and Streptococcus

Developmental Aspects of the Urinary System

o Control of the voluntary urethral sphincter does not start until
age 18 months
o Complete nighttime control may not occur until the child is 4
years old
o Urinary tract infections (UTIs) are the only common problems
before old age
o Escherichia coli (E. coli), a bacterium, accounts for 80 percent
of UTIs

Developmental Aspects of the Urinary System

o Renal failure is an uncommon but serious problem in which the
kidneys are unable to concentrate urine, and dialysis must be
done to maintain chemical homeostasis of blood
o With age, filtration rate decreases and tubule cells become less
efficient at concentrating urine, leading to urgency, frequency,
and incontinence
o In men, urinary retention is another common problem

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Developmental Aspects of the Urinary System
o Problems associated with aging
o Urgency—feeling that it is necessary to void
o Frequency—frequent voiding of small amounts of urine
o Nocturia—need to get up during the night to urinate
o Incontinence—loss of control
o Urinary retention—common in males, often the result of
hypertrophy of the prostate gland

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