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The Urinary System
TABLE OF CONTENT 1) General Introduction 2) Anatomy of Urinary System 3) Urine Formation 4) Urine Storage and Elimination
Composition of the Urinary System
Functions of the Kidneys 1) filter blood plasma, separate wastes, return useful materials to the blood, and eliminate the wastes. Toxic  nitrogenous wastes -  ammonia, urea, uric acid, creatine, and  creatinine - cause diarrhea, vomiting, and cardiac arrhythmia, convulsions, coma, and death.
Functions of the Kidneys 1) filter blood plasma, separate wastes, return useful materials to the blood, and eliminate the wastes. 2)  regulate blood volume and osmolarity.
[object Object],[object Object],[object Object],[object Object],Functions of the Kidneys 4) regulate acid-base balance of the body fluids. 5) detoxify superoxides, free radicals, and drugs.
ANATOMY OF THE KIDNEYS
- The kidneys lie along the posterior abdominal wall
[object Object],The renal parenchyma is divided into an outer  cortex  and inner  medulla .
Extensions of the cortex ( renal columns ) project toward the sinus, dividing the medulla into 6-10  renal pyramids . Each pyramid is conical with a blunt point called the  papilla  facing the sinus.
The papilla is nestled into a cup called a  minor calyx , which collects its urine. Two or three minor calyces merge to form a  major calyx . The major calyces merge to form the  renal pelvis .
- The kidney contains 1.2 million  nephrons , which are the functional units of the kidney.  -  A nephron consists of : i.  blood vessels afferent arteriole glomerulus efferent arteriole ii.  renal tubules proximal convoluted tubule loop of Henle distal convoluted tubule The Nephron
afferent arteriole glomerulus efferent arteriole proximal convoluted tubule distal convoluted tubule Loop of Henle blood blood The Nephron
-  Most components of the nephron are within the cortex.  The Nephron
Nephrons are connected to renal artery/vein and ureter.
The glomerulus is enclosed in a two-layered glomerular (Bowman's) capsule.  Proximal tubule
URINE FORMATION
The kidney produces urine through 4 steps.
Glomerular Filtrate Tubular fluid Urine
1) Glomerular Filtration
The Filtration Membrane From the plasma to the capsular space, fluid passes through three barriers. fenestrated epithelium basement membrane foot processes
The Filtration Membrane Almost any molecule smaller than  3 nm  can pass freely through the filtration membrane into the capsular space.  These include:  Water, electrolytes, glucose, amino acids, lipids, vitamins, and nitrogenous wastes Kidney infections and trauma commonly damage the filtration membrane and allow  plasma proteins  or  blood cells  to pass through.
Blood cells in urine Plasma proteins
Filtration Pressure   Glomerular filtration follows the same principles that govern filtration in other capillaries.
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The nephron has two ways to prevent drastic changes in GFR when blood pressure rises: 1) Constriction of the afferent arteriole to reduce blood flow into the glomerulus 2) Dilation of the efferent arteriole to allow the blood to flow out more easily.  Change in an opposite direction if blood pressure falls
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1) Glomerular Filtration   2) Tubular Reabsorption 3) Tubular Secretion 4) Concentrating Urine by Collecting Duct
About  99%  of Water and other useful small molecules in the filtrate are normally reabsorbed back into plasma by renal tubules.
Reabsorption in Proximal Convoluted Tubules
- The proximal convoluted tubule (PCT) is formed by one layer of epithelial cells with long apical microvilli. - PCT reabsorbs about  65%  of the glomerular filtrate and return it to the blood.
1)  transcellular route 2)  paracellular route   Routes of  Proximal Tubular Reabsorption   PCT peritubular capillary
Mechanisms of Proximal Tubular Reabsorption   1) Solvent drag   2) Active transport of sodium. 3) Secondary active transport of glucose, amino  acids, and other nutrients.  4) Secondary water reabsorption via osmosis  5) Secondary ion reabsorption via electrostatic  attraction  6) Endocytosis of large solutes
Osmosis Water moves from a compartment of low osmolarity to the compartment of high osmolarity.  low osmolarity ( high H 2 O conc.) high osmolarity ( low H 2 O conc.) H 2 O
[object Object],[object Object],[object Object],[object Object],Proteins stay H2O Proteins
2) Active transport of sodium Sodium pumps  ( Na-K ATPase ) in basolateral membranes transport sodium out of the cells against its concentration gradient using ATP.  capillary PCT cell Tubular lumen Na + Na + K +
There are also pumps for other ions capillary PCT cell Tubular lumen Ca ++ Ca ++
- Various cotransporters can carry both Na+ and other solutes. For example, the  sodium-dependent glucose transporter  (SDGT) can carry both Na+ and glucose.  3)  Secondary active transport of glucose, amino acids, and other nutrients Na + Glucose capillary PCT cell Na + K +
Amino acids and many other nutrients are reabsorbed by their specific cotransporters with sodium. Na + capillary PCT cell amino acids 3)  Secondary active transport of glucose, amino acids, and other nutrients Na + K +
Sodium reabsorption makes both intracellular and extracellular fluid hypertonic to the tubular fluid. Water follows sodium into the peritubular capillaries. 4)  Secondary water reabsorption via osmosis H2O Na + Na + capillary PCT cell Tubular lumen
Negative ions tend to follow the positive sodium ions by electrostatic attraction.   5) Secondary ion reabsorption via electrostatic attraction  Na Na + Cl - capillary PCT cell Tubular lumen
The glomerulus filters a small amount of protein from the blood. The PCT reclaims it by  endocytosis , hydrolzes it to amino acids, and releases these to the ECF by facilitated diffusion.   6) Endocytosis of large solutes protein capillary PCT cell Tubular lumen amino acids
[object Object],[object Object],[object Object],Na + Glucose Example of diabetes
Glucose in urine high glucose in blood high glucose in filtrate Exceeds Tm for glucose
Reabsorption in the Nephron Loop
-  The primary purpose is to establish a high extracellular osmotic concentration.  -  The thick ascending limb reabsorbs solutes but is impermeable to water. Thus, the tubular fluid becomes very diluted while extracellular fluid becomes very concentrated with solutes.  mOsm/L
The high osmolarity enables the collecting duct to concentrate the urine later.
Reabsorption in Distal Convoluted Tubules
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1) Glomerular Filtration   2) Tubular Reabsorption 3) Tubular Secretion 4) Concentrating Urine by Collecting Duct
[object Object],[object Object],[object Object],H + H + capillary PCT cell Tubular lumen
1) Glomerular Filtration   2) Tubular Reabsorption 3) Tubular Secretion 4) Concentrating Urine by Collecting Duct
[object Object],[object Object],Cortex collecting  duct urine
1. Driving force The  high osmolarity  of extracellular fluid generated by  NaCl  and  urea , provides the driving force for water reabsorption. 2. Regulation The medullary portion of the CD is  not permeable to NaCl   but permeable to water , depending on ADH.  Cortex mOsm/L medulla urine
a. In a state of  full hydration , antidiuretic hormone (ADH) is not secreted and the CD permeability to water is low, leaving the water to be excreted.  Cortex mOsm/L medulla Control of Urine Concentration  depends on the body's state of hydration. urine b.  In a state of  dehydration , ADH is secreted; the CD permeability to water increases. With the increased reabsorption of water by osmosis, the urine becomes more concentrated.
Cortex medulla urine No more reabsorption after tubular fluid leaving CD urine
[object Object],[object Object],Urine Properties
        Substance Blood Plasma (total amount) Urine (amount per day) Urea 4.8 g 25 g Uric acid 0.15 g 0.8 g Creatinine 0.03 g 1.6 g Potassium 0.5 g 2.0 g Chloride 10.7 g 6.3 g Sodium 9.7 g 4.6 g Protein 200 g 0.1 g HCO 3 - 4.6 g 0 g Glucose 3 g 0 g
[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],glucose cell cell blood insulin receptors insulin pancreatic    cell glycogen
[object Object],[object Object],high urine volume high glucose high glucose in filtrate Retain H 2 O by osmosis
Diabetes insipidus - is caused by  inadequeate ADH  secretion.  - Due to the shortage of ADH, water reabsorption in CD is compromised, leading to polyuria.     urine
Diuresis  refers to excretion of large amount of urine. Natriuresis   refers to enhanced urinary excretion of sodium
Diuretics  - are chemicals that increase urine volume. They are used for treating hypertension and congestive heart failure because they reduce overall fluid volume. - work by either increasing glomerular filtration or reducing tubular reabsorption. Caffeine falls into the former category; alcohol into the latter (alcohol suppresses the release of ADH).
Many diuretics produce osmotic diuresis by inhibiting sodium reabsorption
Renal Function Tests
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Hemodialysis artificially clearing wastes from the blood
1)  Dialysis machine - efficient - inconvenient
2)  Continuous ambulatory peritoneal dialysis  (CAPD) Dialysis fluid - The peritoneal membrane is a natural dialysis membrane - convenient - less efficient
Urine Storage and Elimination
The Ureters  The ureters are muscular tubes leading from the renal pelvis to the lower bladder.
The Urinary Bladder - is a muscular sac on the floor of the pelvic cavity.  - is highly distensible and expands superiorly.
The openings of the  two ureters  and the  urethra  mark a triangular area called the  trigone  on the bladder floor.
The Urethra   - conveys urine from the urinary bladder to the outside of the body. Females   male 3-4 cm  ~18 cm  greater risk of urinary tract infections
[object Object],[object Object],[object Object],[object Object],Difficulty in voiding urine with enlarged prostate
In both sexes: - internal urethral sphincter- under involuntary control.  - external urethral sphincter - under voluntary control internal urethral sphincter external urethral sphincter
Voiding Urine in infants   micturition reflex When the bladder contains about 200 ml of urine, stretch receptors in the wall send impulses to the spinal cord. Parasympathetic signals return to stimulate contraction of the bladder and relaxation of the internal urethral sphincter.  Spinal cord
2. Once voluntary control has developed, emptying of the bladder is controlled predominantly by a micturition center in the pons. This center receives signals from stretch receptors and integrates this information with cortical input concerning the appropriateness of urinating at the moment. It sends back impulses to stimulate relaxation of the external sphincter. Once voluntary control has developed, emptying of the bladder is controlled predominantly by a micturition center in the pons. This center receives signals from stretch receptors and integrates this information with cortical input concerning the appropriateness of urinating at the moment. It sends back impulses to stimulate relaxation of the external sphincter. Voiding Urine in adults Voluntary control
SUMMARY 1) General Introduction 2) Anatomy of Urinary System 3) Urine Formation 4) Urine Storage and Elimination

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Urinary

  • 2. TABLE OF CONTENT 1) General Introduction 2) Anatomy of Urinary System 3) Urine Formation 4) Urine Storage and Elimination
  • 3. Composition of the Urinary System
  • 4. Functions of the Kidneys 1) filter blood plasma, separate wastes, return useful materials to the blood, and eliminate the wastes. Toxic nitrogenous wastes - ammonia, urea, uric acid, creatine, and creatinine - cause diarrhea, vomiting, and cardiac arrhythmia, convulsions, coma, and death.
  • 5. Functions of the Kidneys 1) filter blood plasma, separate wastes, return useful materials to the blood, and eliminate the wastes. 2) regulate blood volume and osmolarity.
  • 6.
  • 7. ANATOMY OF THE KIDNEYS
  • 8. - The kidneys lie along the posterior abdominal wall
  • 9.
  • 10. Extensions of the cortex ( renal columns ) project toward the sinus, dividing the medulla into 6-10 renal pyramids . Each pyramid is conical with a blunt point called the papilla facing the sinus.
  • 11. The papilla is nestled into a cup called a minor calyx , which collects its urine. Two or three minor calyces merge to form a major calyx . The major calyces merge to form the renal pelvis .
  • 12. - The kidney contains 1.2 million nephrons , which are the functional units of the kidney. - A nephron consists of : i. blood vessels afferent arteriole glomerulus efferent arteriole ii. renal tubules proximal convoluted tubule loop of Henle distal convoluted tubule The Nephron
  • 13. afferent arteriole glomerulus efferent arteriole proximal convoluted tubule distal convoluted tubule Loop of Henle blood blood The Nephron
  • 14. - Most components of the nephron are within the cortex. The Nephron
  • 15. Nephrons are connected to renal artery/vein and ureter.
  • 16. The glomerulus is enclosed in a two-layered glomerular (Bowman's) capsule. Proximal tubule
  • 18. The kidney produces urine through 4 steps.
  • 21. The Filtration Membrane From the plasma to the capsular space, fluid passes through three barriers. fenestrated epithelium basement membrane foot processes
  • 22. The Filtration Membrane Almost any molecule smaller than 3 nm can pass freely through the filtration membrane into the capsular space. These include: Water, electrolytes, glucose, amino acids, lipids, vitamins, and nitrogenous wastes Kidney infections and trauma commonly damage the filtration membrane and allow plasma proteins or blood cells to pass through.
  • 23. Blood cells in urine Plasma proteins
  • 24. Filtration Pressure Glomerular filtration follows the same principles that govern filtration in other capillaries.
  • 25.
  • 26.
  • 27.
  • 28. The nephron has two ways to prevent drastic changes in GFR when blood pressure rises: 1) Constriction of the afferent arteriole to reduce blood flow into the glomerulus 2) Dilation of the efferent arteriole to allow the blood to flow out more easily. Change in an opposite direction if blood pressure falls
  • 29.
  • 30.
  • 31.
  • 32. 1) Glomerular Filtration 2) Tubular Reabsorption 3) Tubular Secretion 4) Concentrating Urine by Collecting Duct
  • 33. About 99% of Water and other useful small molecules in the filtrate are normally reabsorbed back into plasma by renal tubules.
  • 34. Reabsorption in Proximal Convoluted Tubules
  • 35. - The proximal convoluted tubule (PCT) is formed by one layer of epithelial cells with long apical microvilli. - PCT reabsorbs about 65% of the glomerular filtrate and return it to the blood.
  • 36. 1) transcellular route 2) paracellular route Routes of Proximal Tubular Reabsorption PCT peritubular capillary
  • 37. Mechanisms of Proximal Tubular Reabsorption   1) Solvent drag   2) Active transport of sodium. 3) Secondary active transport of glucose, amino acids, and other nutrients.  4) Secondary water reabsorption via osmosis  5) Secondary ion reabsorption via electrostatic attraction 6) Endocytosis of large solutes
  • 38. Osmosis Water moves from a compartment of low osmolarity to the compartment of high osmolarity. low osmolarity ( high H 2 O conc.) high osmolarity ( low H 2 O conc.) H 2 O
  • 39.
  • 40. 2) Active transport of sodium Sodium pumps ( Na-K ATPase ) in basolateral membranes transport sodium out of the cells against its concentration gradient using ATP. capillary PCT cell Tubular lumen Na + Na + K +
  • 41. There are also pumps for other ions capillary PCT cell Tubular lumen Ca ++ Ca ++
  • 42. - Various cotransporters can carry both Na+ and other solutes. For example, the sodium-dependent glucose transporter (SDGT) can carry both Na+ and glucose. 3) Secondary active transport of glucose, amino acids, and other nutrients Na + Glucose capillary PCT cell Na + K +
  • 43. Amino acids and many other nutrients are reabsorbed by their specific cotransporters with sodium. Na + capillary PCT cell amino acids 3) Secondary active transport of glucose, amino acids, and other nutrients Na + K +
  • 44. Sodium reabsorption makes both intracellular and extracellular fluid hypertonic to the tubular fluid. Water follows sodium into the peritubular capillaries. 4) Secondary water reabsorption via osmosis H2O Na + Na + capillary PCT cell Tubular lumen
  • 45. Negative ions tend to follow the positive sodium ions by electrostatic attraction.   5) Secondary ion reabsorption via electrostatic attraction Na Na + Cl - capillary PCT cell Tubular lumen
  • 46. The glomerulus filters a small amount of protein from the blood. The PCT reclaims it by endocytosis , hydrolzes it to amino acids, and releases these to the ECF by facilitated diffusion. 6) Endocytosis of large solutes protein capillary PCT cell Tubular lumen amino acids
  • 47.
  • 48. Glucose in urine high glucose in blood high glucose in filtrate Exceeds Tm for glucose
  • 49. Reabsorption in the Nephron Loop
  • 50. - The primary purpose is to establish a high extracellular osmotic concentration. - The thick ascending limb reabsorbs solutes but is impermeable to water. Thus, the tubular fluid becomes very diluted while extracellular fluid becomes very concentrated with solutes. mOsm/L
  • 51. The high osmolarity enables the collecting duct to concentrate the urine later.
  • 52. Reabsorption in Distal Convoluted Tubules
  • 53.
  • 54.
  • 55.
  • 56. 1) Glomerular Filtration 2) Tubular Reabsorption 3) Tubular Secretion 4) Concentrating Urine by Collecting Duct
  • 57.
  • 58. 1) Glomerular Filtration 2) Tubular Reabsorption 3) Tubular Secretion 4) Concentrating Urine by Collecting Duct
  • 59.
  • 60. 1. Driving force The high osmolarity of extracellular fluid generated by NaCl and urea , provides the driving force for water reabsorption. 2. Regulation The medullary portion of the CD is not permeable to NaCl but permeable to water , depending on ADH. Cortex mOsm/L medulla urine
  • 61. a. In a state of full hydration , antidiuretic hormone (ADH) is not secreted and the CD permeability to water is low, leaving the water to be excreted. Cortex mOsm/L medulla Control of Urine Concentration depends on the body's state of hydration. urine b. In a state of dehydration , ADH is secreted; the CD permeability to water increases. With the increased reabsorption of water by osmosis, the urine becomes more concentrated.
  • 62. Cortex medulla urine No more reabsorption after tubular fluid leaving CD urine
  • 63.
  • 64.         Substance Blood Plasma (total amount) Urine (amount per day) Urea 4.8 g 25 g Uric acid 0.15 g 0.8 g Creatinine 0.03 g 1.6 g Potassium 0.5 g 2.0 g Chloride 10.7 g 6.3 g Sodium 9.7 g 4.6 g Protein 200 g 0.1 g HCO 3 - 4.6 g 0 g Glucose 3 g 0 g
  • 65.
  • 66.
  • 67.
  • 68.
  • 69. Diabetes insipidus - is caused by inadequeate ADH secretion. - Due to the shortage of ADH, water reabsorption in CD is compromised, leading to polyuria.  urine
  • 70. Diuresis refers to excretion of large amount of urine. Natriuresis refers to enhanced urinary excretion of sodium
  • 71. Diuretics - are chemicals that increase urine volume. They are used for treating hypertension and congestive heart failure because they reduce overall fluid volume. - work by either increasing glomerular filtration or reducing tubular reabsorption. Caffeine falls into the former category; alcohol into the latter (alcohol suppresses the release of ADH).
  • 72. Many diuretics produce osmotic diuresis by inhibiting sodium reabsorption
  • 74.
  • 75.
  • 76. Hemodialysis artificially clearing wastes from the blood
  • 77. 1) Dialysis machine - efficient - inconvenient
  • 78. 2) Continuous ambulatory peritoneal dialysis (CAPD) Dialysis fluid - The peritoneal membrane is a natural dialysis membrane - convenient - less efficient
  • 79. Urine Storage and Elimination
  • 80. The Ureters The ureters are muscular tubes leading from the renal pelvis to the lower bladder.
  • 81. The Urinary Bladder - is a muscular sac on the floor of the pelvic cavity. - is highly distensible and expands superiorly.
  • 82. The openings of the two ureters and the urethra mark a triangular area called the trigone on the bladder floor.
  • 83. The Urethra - conveys urine from the urinary bladder to the outside of the body. Females male 3-4 cm ~18 cm greater risk of urinary tract infections
  • 84.
  • 85. In both sexes: - internal urethral sphincter- under involuntary control. - external urethral sphincter - under voluntary control internal urethral sphincter external urethral sphincter
  • 86. Voiding Urine in infants micturition reflex When the bladder contains about 200 ml of urine, stretch receptors in the wall send impulses to the spinal cord. Parasympathetic signals return to stimulate contraction of the bladder and relaxation of the internal urethral sphincter. Spinal cord
  • 87. 2. Once voluntary control has developed, emptying of the bladder is controlled predominantly by a micturition center in the pons. This center receives signals from stretch receptors and integrates this information with cortical input concerning the appropriateness of urinating at the moment. It sends back impulses to stimulate relaxation of the external sphincter. Once voluntary control has developed, emptying of the bladder is controlled predominantly by a micturition center in the pons. This center receives signals from stretch receptors and integrates this information with cortical input concerning the appropriateness of urinating at the moment. It sends back impulses to stimulate relaxation of the external sphincter. Voiding Urine in adults Voluntary control
  • 88. SUMMARY 1) General Introduction 2) Anatomy of Urinary System 3) Urine Formation 4) Urine Storage and Elimination