1. BIOL 2074: Anatomy & Physiology II Chapter 20 Urinary Brenda Holmes MSN/Ed, RN Associate Professor Biology South Arkansas Community College Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display

3. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Kidney Hilum Ureters Urethra Renal vein Renal artery Inferior vena cava Abdominal aorta Urinary bladder Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. © CNRI/SPL/Photo Researchers, Inc.

5. Location of the Kidneys Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Inferior vena cava Pancreas (a) (b) Adrenal gland Kidney Adipose tissue Kidney Spleen Large intestine Small intestine Aorta Stomach Liver Parietal peritoneum Renal fascia Renal fascia Large intestine Hip bone (cut) Parietal peritoneum Twelfth rib

6. Kidney Structure Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Renal pelvis Minor calyx Major calyx Renal papilla Renal pyramid Nephrons Renal sinus Renal medulla Renal capsule Renal cortex Ureter (a) (b) (c) Renal corpuscle Papilla Minor calyx Renal column Fat in renal sinus Collecting duct Renal medulla Renal cortex Renal tubule

7. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Inferior vena cava Renal cortex Renal pyramid Renal medulla Minor calyx Renal column Renal papilla Renal pelvis Suprarenal artery Abdominal aorta Adrenal gland Renal capsule Hilum Renal vein Suprarenal vein Ureter Renal artery

9. 20.1 Clinical Application Chronic Kidney Failure

10. Renal Blood Vessels Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. b: © L.V. Bergman/The Bergman Collection (a) (b) Cortex Medulla Renal pelvis Ureter Afferent arteriole Cortical radiate artery and vein Arcuate vein and artery Interlobar vein and artery Renal artery Renal vein Peritubular capillary Efferent arteriole Proximal convoluted tubule Cortical radiate artery and vein Distal convoluted tubule

11. Renal Blood Vessels Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. (a) : Tissues and Organs: A Text-Atlas of Scanning Electron Microscopy, by R.G. Kessel and R.H. Kardon. © 1979 W.H. Freeman and Company (b) : Courtesy of R.B. Wilson MD, Eppeley Institute for Research in Cancer, University of Nebraska Medical Center Glomerulus (a) Renal tubules Glomerulus (b) Peritubular capillary Efferent arteriole Afferent arteriole Glomerular capsule

12. The Renal Corpuscle Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Glomerulus Visceral layer of glomerular capsule Proximal convoluted tubule Parietal layer of glomerular capsule Glomerular capsule Blood flow Afferent arteriole Efferent arteriole Blood flow Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. © David M. Phillips/Visuals Unlimited Slit pore Pedicel Slit pore Pedicel Primary process of podocyte Primary process of podocyte

13. Nephrons Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Glomerulus Collecting duct Nephron loop Ascending limb Descending limb Peritubular capillary Efferent arteriole Proximal convoluted tubule Renal medulla Renal cortex Cortical radiate artery Cortical radiate vein Glomerular capsule Afferent arteriole Distal convoluted tubule From renal artery To renal vein

14. Nephrons Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Collecting ducts Epithelial cell Blood vessel Glomerulus (a) (b) Renal tubules Glomerular capsule Renal corpuscle a: © Biophoto Associates/Photo Researchers, Inc ., b: © Manfred Kage/Peter Arnold

15. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Glomerulus Nephron loop Glomerulus Afferent arteriole Glomerular capsule Efferent arteriole Podocyte Macula densa (a) (b) Glomerular capsule Afferent arteriole Juxtaglomerular apparatus Distal convoluted tubule Efferent arteriole Proximal convoluted tubule Juxtaglomerular apparatus Juxtaglomerular cells Ascending limb of nephron loop Juxtaglomerular Apparatus

16. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Cortical nephron Juxtamedullary nephron Collecting duct Renal medulla Renal cortex Cortical and Juxtamedullary Nephrons

17. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Glomerulus Nephron loop Collecting duct Afferent arteriole Vasa recta Peritubular capillaries Efferent arteriole Proximal convoluted tubule Glomerular capsule Cortical radiate artery and vein Distal convoluted tubule Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Renal artery Cortical radiate artery Afferent arteriole Efferent arteriole Cortical radiate vein Renal vein Arcuate artery Interlobar artery Glomerular capillaries Peritubular capillaries Arcuate vein Interlobar vein Blood Supply of a Nephron

18. 20.2 Clinical Application Glomerulonephritis

20. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Arteriole Venule Venule Renal tubule Tubular fluid Urine Net reabsorption Net filtration Interstitial fluid Blood flow (a) In most systemic capillaries, filtration predominates at the arteriolar end and osmotic reabsorption predominates at the venular end. Peritubular capillaries Afferent arteriole Glomerular capillaries Efferent arteriole Blood flow Tubular reabsorption Tubular secretion Glomerular filtration (b) In the kidneys, the glomerular capillaries are specialized for filtration. The renal tubule is specialized to control movements of substances back into the blood of the peritubular capillaries (tubular reabsorption) or from the blood into the renal tubule (tubular secretion). Filtered fluid Urine Formation

22. Plasma, Glomerular Filtrate, and Urine Components

26. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Bloodstream Angiotensin I Liver Kidney Lung capillaries Angiotensin II • Increased thirst Angiotensinogen Renin Stimulation Angiotensin- converting Enzyme (ACE) Release into bloodstream • Vasoconstriction • Increased aldosterone secretion • Increased ADH secretion

28. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Glomerulus (a) (b) Blood flow Blood flow Glomerulus Blood flow Afferent arteriole Glomerular capsule Glomerular filtrate Efferent arteriole Peritubular capillary Tubular reabsorption Renal tubule Renal tubule Tubular secretion Peritubular capillary Efferent arteriole Afferent arteriole Blood flow Glomerular capsule Glomerular filtrate

29. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Peritubular capillary Glomerulus + + – – – – + + – + – + – + – + – – + + + + – – + – – + + – – 1 2 3 4 Blood flow Glomerular capsule Blood flow Glomerular filtrate Proximal convoluted tubule Sodium ions are reabsorbed by active transport Negatively charged ions are attracted to positively charged ions As concentration of ions (solute) increases in plasma, osmotic pressure increases Water moves from proximal tubule to capillary by osmosis Blood flow Isotonic tubular fluid Na + Na + PO 4 –3 N + Cl – HCO 3 – Cl – Na + H 2 O H 2 O

31. 20.3 Clinical Application The Nephrotic Syndrome

33. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Blood flow Peritubular capillary Distal convoluted tubule Na + Na + Na + Na + Na + K + K + K + K + H + H + Collecting duct K + or H + Na + Na + Tubular reabsorption Tubular secretion Tubular fluid Ascending limb of nephron loop Na + Na + Na + Na + Na + Na +

35. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Collecting duct Dilute urine Concentrated urine Collecting duct H 2 O H 2 O (a) (b) Medullary interstitial fluid Distal convoluted tubule Hypertonic interstitial fluid Hypertonic interstitial fluid high ADH levels low ADH levels H 2 O H 2 O H 2 O H 2 O H 2 O H 2 O Medullary interstitial fluid

37. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Isotonic fluid Hypotonic fluid Na + Cl – (a) (b) Na + Cl – Salty H 2 O 1 2 3 Descending limb (permeable to water) Increasing NaCl concentration Thick ascending limb (impermeable to water) Hypertonic fluid Medullary interstitial fluid More salty Even more salty Na + Cl – H 2 O Na + Cl – H 2 O H 2 O H 2 O H 2 O Na + Cl – Na + Cl –

38. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. NaCl NaCl NaCl NaCl NaCl NaCl NaCl NaCl Blood flow Increasing NaCl concentration Blood flow Medullary interstitial fluid Vasa recta

45. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Mucous coat Lumen Muscular coat Fibrous coat Adipose tissue © Per H. Kjeldsen

47. Symphysis pubis Prostate gland Urinary bladder Urethra Ureter Rectum Parietal peritoneum Abdominal wall Rectum (a) (b) Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

48. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. (a) (b) Mucous coat T rigone Internal urethral sphincter Neck Prostate gland Urethra Serous coat Urinary bladder Ureter Ureter Prostate gland Urethra Region of external urethral sphincter Seminal vesicle Ductus (vas) deferens Detrusor muscle Submucous coat Openings of the ureters

49. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Muscular coat Mucous coat Lumen Submucous coat © John D. Cunningham/Visuals Unlimited

50. T rigone Ureter Penis (b) Urethra Ureter (a) Urinary bladder External urethral orifice Urinary bladder Prostate gland Bulbourethral gland Membranous urethra Prostatic urethra Penile urethra External urethral orifice Trigone Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

52. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Urethral glands Muscle layer Lumen of urethra Mucous membrane © Ed Reschke

54. Micturition

55. 20.4 Clinical Application Urinalysis: Clues to Health