1. Kidneys

2. Ureters

3. Urinary bladder

4. Urethra

Urinary System

Kidney Functions

• Primary functions:– Filter and remove waste

from plasma,

– Regulate blood volume and pressure,

– Regulate blood osmolarity.

• Secondary functions:– Produce renin,

– Produce EPO,

– Regulate pH,

– Formation of calcitriol

– Perform gluconeogenesis.

Secrete:- Aldosterone- Cortisol- Epinephrine- Norepinephrine- Other hormones

Adrenal Glands

Renal cortex

Renal sinuscontains:

Minor calyxMajor calyx

Renal pelvis

Renal artery

Renal vein

Ureter

Fibrous capsule

Renal lobe

Renal papilla

Corticomedullary junction

Renal pyramid

Renal column

Renal medulla

Basic Kidney Anatomy

Formed in the renal cortex

Travels thru the medullary pyramids

Drips out of the pyramids into the minor calyces

Flows thru major calyces

Flows thru the renal pelvis

Flows thru the ureter

Flows thru and is stored in the urinary bladder

Flows thru the urethra

Basic Pathway of Urine Flow

Renal vein

Nephron

Renal artery

Segmentalartery

Arcuate veinInterlobar vein

Interlobar artery Arcuate artery Interlobular artery

Interlobular vein

Basic Pathway of

Renal Blood Flow

Peritubularcapillaries

(associatedwith convoluted

tubules)

Medulla

Cortex

DCT

Nephron loop

Arcuatevessels

PCTRenalcorpuscleInterlobular

vein

Glomerulus

Efferent arteriole

Vasa recta(associated withnephron loop)

Afferent arteriole

Basic Pathway of

Renal Blood Flow

Tubular secretionTubular reabsorptionGlomerular filtration

The movement of substances fromthe blood within the glomerulus

into the capsular space

The movement of substancesfrom the tubular fluid back

into the blood

The movement of substancesfrom the blood into the

tubular fluid

Collectingtubule

Collecting duct

Vasa recta

Capsular space

Glomerularcapsule

Glomerulus

Afferentarteriole

Efferentarteriole

Nephron loop

DCT

Descendinglimb

Ascendinglimb

PCT

Peritubular capillaries

By regulating how much water we reabsorb, we regulate blood volume

By regulating what chemicals we reabsorb and what we secrete, we regulate blood [electrolyte] and blood pH

Renal Math

Nephron - sites of urine formation

• 1 million per kidney.

• 5 parts– Glomerulus– Glomerular Capsule– Proximal Convoluted Tubule– Loop of Henle– Distal Convoluted Tubule

• Empty into collecting ducts.

Glomerular Capsule• 2 layers • Encloses the glomerulus.• Receives filtered blood (filtrate)

• Parietal layer– Simple

squamous– Contains filtrate.

• Visceral layer– Filters– Made of podocytes.

Glomerular Capsule

Proximal Convoluted Tubule• Primary site of R&S

• Receives filtrate from the GC

• Very twisty.

• Simple cuboidal.

• Lots of microvilli.

• Lots of mitochondria.

Loop of Henle• Receives filtrate from

the PCT

• Creates a conc. gradient in the renal medulla which allows for water reabsorption from the collecting duct

Distal Convoluted Tubule

• Receives filtrate from the loop of Henle

• Site of hormonal adjustment of water & salt secretion/reabsorption.

• Simple cuboidal

• Fewer microvilli and mitochondria.

Collecting Duct• Receives urine from several

nephrons

• Extends through the renal medulla and empties into a minor calyx

• Simple cuboidal and columnar.

• Site of hormonal adjustment of water reabsorption.

Glomerulus• High BP

– Due to the size differential btwn the afferent and efferent arterioles

– This high BP is the driving force behind the filtration

•Surround renal tubules

•Receive blood from the

efferent arteriole

•Sites of R&S

•Low BP and high OP

Peritubular Capillaries

•Receive blood from

the efferent arteriole

•Work with the loops of Henle

to facilitate water reabsorption

in the collecting duct

Vasa Recta

Interlobularartery

Afferent arteriole Glomerular capillaries

Efferent arteriole

Glomerular capsuleRest of renal tubulecontaining filtrate

Peritubularcapillary

To interlobular vein

Urine

Glomerular filtrationTubular reabsorptionTubular secretion

Three majorrenal processes:

3 Steps of Urine Formation

Filtration MembraneVisceral layer of glomerular capsule

Podocyte cell bodyFiltration slitsPedicels

Capillary lumen

Glomerular capillary

Filtration membraneEndothelium offenestrated capillaryBasement membraneof capillary

Filtration slitsof visceral layer

Endothelium (blocks formed elements)Basement membrane (blocks largeproteins)Filtration slits of visceral layer (blocksmall proteins)

Filtrateincludes water,

glucose, amino acids,ions, urea, many

hormones, vitaminsB and C, ketones, and

very small amountsof protein

Capsular spaceCapillary

Filtered

Smallprotein

Leukocyte

Largeprotein

Platelet

Erythrocyte

Not filtered

Filtration Membrane

Capsular space

Glomerulus

HPg 60 out

OPg 32 in

HPc 18 in

Blood enteringglomerulus

Afferentarteriole

Efferentarteriole

Glomerularcapsule

Glomerular hydrostatic pressure (HPg)

Capsular hydrostatic pressure (HPc)

Blood colloid osmotic pressure (OPg)

60 mm Hg out

32 mm Hg in

18 mm Hg in

–

–

Net filtration pressure (NFP) 10 mm Hg out=

PCT

NFP 10 out

Filtration Pressure

Glomerular Filtration Rate (ml/min)• 125 mL/min

• Depends on glomerular BP

Myogenic Mechanism of Maintaining GFR

Decrease in systemic blood pressure

Efferentarteriole

Glomerulus

Widened arteriole lumen allows more blood intoglomerulus to offset adecrease in systemicblood pressure

Afferentarteriolevasodilates

Myogenic Mechanism of Maintaining GFR

Increase in systemic blood pressure

Efferentarteriole

Glomerulus

Afferentarteriolevasoconstricts

Narrowed arteriole lumenallows less blood intoglomerulus to offset anincrease in systemicblood pressure

Tubuloglomerular Mechanism

Effect of the Sympathetic Nervous System on GFR

Increased sympathetic activity

NE and E cause afferent arteriole to constrict

GBP and thus GFR fall

What is an advantage of this process?

BP Falls

JG cells release renin into the plasma

Renin converts the plasma protein Angiotensinogen into Angiotensin I

Angiotensin I is converted into Angiotensin II by ACE – the Angiotensin Converting Enzyme

Increased sympathetic

activity

Renin-Angiotensin System

Ag II causes Vasoconstriction

Adrenal cortex to release

Aldosterone

Pituitary gland to release ADH

Increased TPR

Increased sodium reabsorption in DCT

Increased water reabsorption

Increased BV

Thirstiness Increased BP

PCT Reabsorption• What kind of “stuff” needs to be

reabsorbed?

• Reabsorbed molecules travel from the PCT to the PTC.

Activetransport Passivetransport

Peri-tubular

capillary

Filtratein tubulelumen

Transcellular

Paracellular

Paracellular

CapillaryEndothelial cell

Luminalmembrane

Solutes

H2O

Tubule cell

Interstitialfluid

Transcellular

Basolateralmembranes

PCT Reabsorption

Filtratein tubulelumen

GlucoseAmino acidsSome ionsVitamins

Lipid-solublesubstances

Nucleus

Tubule cell

Paracellularroute

Interstitialfluid

Peri-tubular

capillary

Tight junction

Primary active transport

Passive transport (diffusion)

Secondary active transport Transport protein Ion channel or aquaporin

Cl–, Ca2+, K+

and otherions, urea

Cl–

3Na+

2K+

3Na+

2K+

K+

H2O

Na+

6

5

4

3

2

1

PCT Reabsorption

Obligatory reabsorption

Transport Maximum

DCT Reabsorption

• Hormone dependent

• Fine tuning

• Aldosterone

• Parathyroid hormone

Loop of Henle Reabsorption

• Descending limb

• Ascending limb

• Urine concentration

• Water

• Depends on body’s hydration levels

• Antidiuretic hormone

Collecting Duct Reabsorption

Tubular Secretion

Regulating Blood Concentration

• Plasma osmolarity is constantly measured by neurons in the hypothalamus.

• In response to changes in plasma osmolarity, hypothalamic neurons adjust their release of antidiuretic hormone from the posterior pituitary.

ADH increases the reabsorption of water from the collecting duct.

Regulating Blood Concentration

High Blood Osmolarity

Sensed by osmoreceptors in the hypothalamus

Posterior pituitary gland increases ADH release

ADH increases the permeability of the collecting duct to water

Increased water reabsorptionBlood

osmolarity falls

Facultative reabsorption

What will increased ADH do to:

• Water reabsorption

• Urine output

• Urine color

• Blood volume

• Blood pressure

Loop of Henle

Osmolalityof interstitialfluid(mOsm)

Innermedulla

Outermedulla

Cortex Active transport Passive transportWater impermeable

H2O

H2O

H2O

H2O

H2O

H2O

H2O

NaCI

NaCI

NaCI

NaCI

NaCI

Medullary Osmotic Gradient

Aldosterone• Produced by the adrenal cortex.• Produced when:

– Plasma Na+ is too low.– Plasma K+ is too high.– Stimulated by angiotensin II.

Aldosterone acts on the DCT to increase the secretion of K+ and the reabsorption of Na+ and water.

How would excess aldosterone affect

• Plasma sodium levels

• Plasma potassium levels

• Urine output

• Blood volume

• Blood pressure

Diuretics• Osmotic

– Anything that increases filtrate osmolarity increases urine output.

• Caffeine– Inhibits renal sodium reabsorption.

• Alcohol– Inhibits ADH release.

Urine

• Characteristics– Volume

– pH of 4.5 - 8

– Clear to yellow

• Components– 95% water

– 5% solutes• Uric acid• Urea• Creatinine• Ions

Ureters

Adventitia

Muscularis

Mucosa

Mucosalfolds

Ureter

Ureter

PeritoneumMucosalfoldsDetrusor muscle

Ureteral openingsTrigoneNeck of urinary bladder

Internal urethral sphincter

Urethra

External urethral sphincter(in urogenital diaphragm)

Urinary Bladder

Pelvic Diaphragm

Labiumminus

Labiummajus

Urethra

Externalurethral orifice

Urogenitaldiaphragm

External urethral sphincter

Internal urethral sphincter

Urinary bladderTrigone

Ureteral openings

Urethra

Penis

Externalurethral orifice

Spongyurethra

Urogenitaldiaphragm

External urethralsphincter

Prostate gland

Internal urethralsphincter

Prostaticurethra

Membranousurethra

Urinary bladderTrigone

Ureteral openings

Urethra

Urethra

Micturition