The Urinary System

The Urinary System

Paired kidneys A ureter for each kidney Urinary bladder Urethra
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Main Functions of Urinary System

Kidneys filter blood to keep it pure
Toxins Metabolic wastes Excess water Excess ions

Dispose of nitrogenous wastes from blood

Urea Uric acid Creatinine

Regulate the balance of water and electrolytes, acids and bases

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 Kidneys are retroperitoneal organs (see next slide)

Superior lumbar region of posterior abdominal wall

Lateral surface is convex Medial surface is concave

Hilus* is cleft: vessels, ureters and nerves enter and leave

Adrenal glands* lie superior to each kidney

(the yellow blob in pic)

* *

Note layers of adipose (fat), capsule, fascia

Transverse sections show retroperitoneal position of kidneys

Note also: liver, aorta muscles on CT

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 Kidney has two regions

Cortex: outer
Columns of cortex divide medulla into pyramids

Medulla: inner
Darker, cone-shaped medullary or renal pyramids Parallel bundles of urine-collecting tubules

The human kidney has lobes

Pyramid and cortical tissue surrounding it 5-11 per kidney

Renal pelvis (=basin)

Expanded, funnel shaped, superior part of ureter Branches to form two or three major calices (seen best on right pic below) Each of these divides again, minor calices: collect urine from papillae of pyramids

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The Arteries
Aorta gives off right and left renal arteries Renal arteries divides into 5 segmental arteries as enters hilus of kidney Segmentals branch into lobar arteries Lobars divide into interlobars Interlobars into arcuate in junction of medulla and cortex Arcuates send interlobular arteries into cortex Cortical radiate arteries give rise to glomerular arterioles 11

Vasculature of the kidney

The glomerular capillary bed is unusual in having arterioles going both to it and away from it (afferent and efferent), instead of a vein going away as most It is also unusual in having two capillary beds in series (one following the other)
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 Uriniferous tubule is the main structural and functional unit

To left is a single, generalized uriniferous tubule More than a million of these tubules act together to form the urine

Three main mechanisms a. Glomerular filtration b. Tubular reabsorption c. Tubular secretion Two major parts 1. A urine-forming nephron 2. A collecting duct which concentrates urine by removing water from it
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Outline
Uriniferous tubule (anatomical unit for forming urine)
Nephron
Renal corpuscle (in cortex)
Glomerulus (tuft of capillaries) Glomerular (Bowmans) capsule

Tubular section
Proximal convoluted tubule Loop of Henle Distal convoluted tubule

Collecting duct
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Outline
Uriniferous tubule (anatomical unit for forming urine)
Nephron
Renal corpuscle (in cortex)
Glomerulus (tuft of capillaries) Glomerular (Bowmans) capsule

Tubular section
Proximal convoluted tubule Loop of Henle Distal convoluted tubule

Collecting duct
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Understand at least this much:

Filtration
a. Fluid is squeezed out of the glomerular capillary bed

Resorption
b. Most nutrients, water ad essential ions are returned to the blood of the peritubular capillaries

Secretion
c. Moves additional undesirable molecules into tubule from blood of peritubular capillaries
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Nephron
Renal corpuscle Tubular section

Uriniferous tubule (anatomical unit for forming urine) Nephron Renal corpuscle (in cortex) Glomerulus (tuft of capillaries) Glomerular (Bowmans) capsule Tubular section Proximal convoluted tubule Loop of Henle Distal convoluted tubule Collecting duct

Renal corpuscle: only in cortex

Tuft of capillaries called glomerulus Surrounded by cup-shaped, hollow glomerular (Bowmans) capsule
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(refer to this pic as we go)

-------------------Visceral

layer of capsule has podocytes

Unusual branching epithelial cells Foot processes with slit processes between them
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Scanning EM of podocytes clinging to capillaries (left) and filtration membrane The capillary pores (fenestrations) diagram (right) restrict the passage of the largest
elements such as blood cells The basement membrane and slit diaphragm hold back all but the smallest proteins while letting through small molecules such as water, ions, glucose, amino acids, and urea

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Uriniferous tubule (anatomical unit for forming urine)

Nephron

Nephron
Renal corpuscle Tubular section
(processes the filtrate) Proximal convoluted tubule Loop of Henle Distal convoluted tubule (ends by joining collecting duct)

Renal corpuscle (in cortex) Glomerulus (tuft of capillaries) Glomerular (Bowmans) capsule Tubular section Proximal convoluted tubule Loop of Henle Distal convoluted tubule Collecting duct

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Uriniferous tubule (anatomical unit for forming urine)

Proximal convoluted tubule

Confined to renal cortex Cuboidal epithelial cells with long microvilli (fuzzy appearance in pics) Resorption of water, ions and solutes

Nephron

Renal corpuscle (in cortex) Glomerulus (tuft of capillaries Glomerular (Bowmans) capsu Tubular section Proximal convoluted tubule Loop of Henle Distal convoluted tubule Collecting duct

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Uriniferous tubule (anatomical unit for forming urine)

Nephron

Loop of Henle
Descending limb Thin segment Thick ascending limb

Renal corpuscle (in cortex) Glomerulus (tuft of capillaries) Glomerular (Bowmans) capsule Tubular section Proximal convoluted tubule Loop of Henle Distal convoluted tubule Collecting duct

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Uriniferous tubule (anatomical unit for forming urine)

Nephron

Distal convoluted tubule

Confined to the renal cortex Simple cuboidal epithelium Selective secretion and resorption of ions

Renal corpuscle (in cortex) Glomerulus (tuft of capillaries Glomerular (Bowmans) caps Tubular section Proximal convoluted tubule Loop of Henle Distal convoluted tubule Collecting duct

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Classes of nephrons

Cortical nephrons
85% of all nephrons Almost entirely within cortex

Juxtamedullary nephrons
Renal corpuscles near cortexmedulla junction
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Uriniferous tubule (anatomical unit for forming urine) Nephron Renal corpuscle (in cortex) Glomerulus (tuft of capillaries) Glomerular (Bowmans) capsule Tubular section Proximal convoluted tubule Loop of Henle Distal convoluted tubule Collecting duct

Collecting Ducts

Collecting Duct
Each receives urine from several nephrons Run straight through cortex into the deep medulla 25

Uriniferous tubules 1. Nephron 2. Collecting ducts

Collecting Ducts
At papilla of pyramid* ducts join to form larger papillary ducts Empty into minor calices Role: conserve 26 body fluids

The collecting ducts

The most important role is to conserve body fluids When the body must conserve water, the posterior pituitary gland secretes ADH (antidiuretic hormone) ADH increases the permeability of the collecting tubules and distal tubules to water so more is reabsorbed This decreases the total volume of urine Alcohol inhibits the release of ADH, so less water is reabsorbed producing copious amounts of dilute urine (can cause dehydration)
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Vessels
Afferent and efferent arterioles associated with glomerular capillaries
Allows high pressure for forcing filtrate out of blood About 20% of renal plasma flow is filtered each minute (125 ml/min): this is the glomerular filtration rate (GFR), an important clinical measure of renal function
This is about one liter every 8 minutes (only 1% ends up as urine)

Peritubular capillaries arise from efferent arterioles

Absorb solutes and water from tubule cells

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(vessels, continued) The Vasa recta

The Vasa recta is a portion of the peritubular capillary system which enters the medulla where the solute concentration in the interstitium is high. It acts with the loop of Henle to concentrate the urine by a complex mechanism of counter current exchange using urea. If the vasa recta did not exist, the high concentration of solutes in the medullary interstitium would be washed out.
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____vasa recta

Histology

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Juxtaglomerular apparatus

Regulation of blood pressure Granule (jg cells) modified muscle cells secreting renin in response to falling blood pressure in afferent arteriole Macula densa chemoreceptors which secrete renin if solute concentration falls
Reninangiotensin mechanism:
Sequence of reactions resulting in aldosterone secretion from adrenal cortex: increases sodium resorption from distal convoluted tubules: water follows, blood volume increases and blood pressure increases
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For studying

Parts of the kidney: 1. Renal pyramid 2. Efferent vessel 3. Renal artery 4. Renal vein 5. Renal hilum 6. Renal pelvis 7. Ureter 8. Minor calyx 9. Renal capsule 10. Inferior renal capsule 11. Superior renal capsule 12. Afferent vessel 13. Nephron 14. Minor calyx 15. Major calyx 16. Renal papilla 17. Renal column
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The Ureters

Slender tubes about 25 cm (10 ) long leaving each renal pelvis One for each kidney carrying urine to the bladder Descend retroperitonealy and cross pelvic brim Enter posterolateral corners of bladder Run medially within posterior bladder wall before opening into interior This oblique entry helps prevent backflow of urine 35

Three basic layers

Transitional epithelium of mucosa stretches when ureters fill Muscularis
Inner longitudinal, outer circular layers Inferior 3rd with extra longitudinal layer) Stimulated to contract when urine in ureter: peristaltic waves to propel urine to bladder

Ureters play an active role in transporting urine (its not just by gravity)

Adventitia (external)
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Urinary Bladder

Collapsible muscular sac Stores and expels urine Lies on pelvic floor posterior to pubic symphysis
Males: anterior to rectum Females: just anterior to the vagina and uterus
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See also brief atlas

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 If full: bladder is spherical and extends into abdominal cavity (holds about 500 ml or 1 pt) If empty: bladder lies entirely within pelvis with shape like upside-down pyramid Urine exits via the urethra Trigone is inside area between ureters and urethra: prone to infection (see slide 38)

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Bladder wall has three layers (same as ureters) Mucosa with distensible transitional epithelium and lamnia propria (can stretch) Thick muscularis called the detrusor muscle
3 layers of highly intermingled smooth muscle Squeezes urine out

Fibrous adventitia

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The Urethra
Smooth muscle with inner mucosa
Changes from transitional through stages to stratified squamous near end Drains urine out of the bladder and body

Male: about 20 cm (8) long Female: 3-4 cm (1.5) long

Short length is why females have more urinary tract infections than males ascending bacteria from stool contamination

urethra

Urethra____
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 Urethral sphincters
Internal: involuntary sphincter of smooth muscle External: skeletal muscle inhibits urination voluntarily until proper time (levator anni muscle also helps voluntary constriction)
Males: urethra has three regions (see right)

_________trigone

1. Prostatic urethra__________
2. Membranous urethra____

3. Spongy or penile urethra_____

female

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With all the labels

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 Micturition AKA:
Voiding Urinating Emptying the bladder (See book for diagram explanation p 701)

KNOW: Micturition center of brain: pons (but heavily influenced by higher centers) Parasympathetic: to void Sympathetic: inhibits micturition
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