12/9/2009

09 December 2009, Wednesday, AHS 1023

Munirah binti Shaban

Department of Basic Health Sciences
Kulliyyah of Allied Health Sciences
International Islamic University Malaysia

Introduction

The functions of the urinary system include

eliminating organic waste products

ii. regulating blood volume and pressure by adjusting the
volume of water lost and releasing erythropoietin and renin
iii. regulating plasma concentrations of ions by controlling the
quantities lost in urine and calcium by calcitrol.
iv. helping stabilize blood pH by controlling loss of hydrogen
and bicarbonate ions.
v. conserving nutrients, eliminates urea and uric acid
vi. assisting the liver in detoxification, and during starvation,
deaminating amino acids so that they can be catabolized by
other tissues.
i.

OBJECTIVES

1. To identify the components of the urinary system

2. To characterize the general organization of the
kidney
3. To examine the histological structure of the nephron
and the collecting ducts
4. To correlate structure of various components with
function

Organization of the Urinary System

The urinary system includes the kidneys, the ureters,

the urinary bladder and the urethra.

The kidneys produce urine - a fluid that contains
water, ions and soluble compounds.

Urine leaving the kidneys travels along the paired
ureters to the urinary bladder for temporary storage.

During urination (micturition) urine is forced out of
the body. This occurs when the contraction of the
muscular urinary bladder forces urine through the
urethra and out of the body.

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KIDNEY

highly vascular (25% cardiac
output)

produces urine (water and
electrolytes, urea, uric acid,
creatinine),
initially
an
ultrafiltrate of the blood
URETER
BLADDER
URETHRA

The Kidneys

Kidneys

The kidneys are located on either side of the vertebral column

Each kidney has the shape of a kidney bean. It is about 10

between vertebrae T12 and L3. The left kidney extends

superiorly slightly more than the right kidney.
The superior surface of each kidney is capped by adrenal
gland; lie in a retroperitoneal position.
Each kidney is protected by three layers of connective tissue:
the renal capsule (collagen fibers), adipose capsule (adipose
tissue), renal fascia (anchors the kidney to surrounding
structures).
Each kidney hangs suspended by collagen fibers from the renal
fascia and packed in as oft cushion of adipose tissue.
Floating kidney.

cm in length and weighs 150 g. The hilus provides entry for

the renal artery and renal nerves and exit for the renal
vein and the ureter.

The renal capsule has outer and inner layers.

The renal cortex is the outer layer in contact with capsule.
The renal medulla consists of 6-18 conical or triangular
structures called pyramids. The base faces cortex and tipthe renal papilla.

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Kidneys
KIDNEY

Adjacent pyramids separated by renal columns.

A renal lobe consists of a renal pyramid, the overlying area of

renal cortex, and adjacent tissues of the renal columns.

Urine production occurs in the renal lobes. Ducts within each
renal papilla discharge urine into a cup-shaped drain called
minor calyx. Four or five merge to form-major calyx and two or
three of these-renal pelvis.

Urine production occurs in microscopic structures called
nephrons present in the cortex of each lobe.

There are roughly 1.25 million nephrons in each kidney with a
combined length of 85 miles.

1) EXOCRINE PORTION

2) ENDOCRINE PORTION

- synthesis and secretion of erythropoietin (regulation of

red blood cell formation)
- synthesis and secretion of renin (hormone necessary for
control of blood pressure and blood volume)

KIDNEY (ORGANIZATION)

KIDNEY (ORGANIZATION)
GROSS STRUCTURE:
- RENAL HILUM, PELVIS, AND
SINUS
- RENAL CAPSULE
- RENAL CORTEX
- RENAL MEDULLA

M
C
M
C

CORTEX
- region immediately beneath renal
capsule
- composed of two distinct regions:
(1) CORTICAL LABYRINTH
(2) MEDULLARY RAY
MEDULLA
- located immediately beneath renal
cortex
- consists of triangular blocks of
tissue called the PYRAMIDS
- RENAL COLUMNS are strands of cortical
tissue that extend down between
adjacent pyramids

P
P
P

RC

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Cortical Labyrinth
with
interdigitating
Medullary Rays

KIDNEY (ORGANIZATION)
RENAL LOBE
- a single pyramid with its
associated overlying cortex

P
P

RENAL LOBULE

Supplementary notes: Kidney

P
P

- defined within cortex and

P
involves a single medullary
P
ray (central axis of lobule)
P
with adjacent cortical
labyrinth
- defined as a functional unit that consists of a
collecting duct and all the nephrons that it drains

Supplementary notes: Kidney

Supplementary notes: Kidney

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Supplementary notes: Kidney

Supplementary notes: Kidney

Supplementary notes: Kidney

THE NEPHRON
& COLLECTING
DUCTS

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The Nephron

The nephron is the basic functional unit of the kidney.

It consists of a renal corpuscle and renal tubule.

The renal tubule begins at the renal corpuscle. It includes a

knot of intertwined capillaries called the glomerulus

surrounded by Bowmans capsule. Blood arrives at the
glomerulus via the afferent arteriole and departs in the efferent
arteriole. Filtrate is produced at the renal corpuscle and then
enters the tubule.

The renal tubule is divided into proximal convoluted tubule,
loop of Henle and distal convoluted tubule.

The nephron empties tubular fluid into the collecting system
through a connecting tubule, a tributary of a collecting duct.

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The Nephron

The Nephron

Nephrons are responsible for the production of filtrate, the

The proximal convoluted tubule (PCT)  made of cuboidal

reabsorption of organic nutrients, the reabsorption of

water and ions, and the secretion into the tubular fluid of
waste products missed by filtration.

Roughly 85% of the nephrons are cortical nephrons found
in the cortex. These perform most of the reabsorptive and
secretory functions of the kidneys.

The juxtamedullary nephrons are found in the medulla,
with their loops of Henle extending deep into the renal
pyramids. These are responsible for the ability to produce
a concentrated urine.

cells with microvilli  actively reabsorbs nutrients, plasma

proteins, and ions from the filtrate.

The loop of Henle  made of low cuboidal or squamous
cells  includes a descending limb, and an ascending limb.
Each limb contains a thin segment and a thick segment.

The ascending limb  made of cuboidal cells with very little
microvilli  delivers fluid to the distal convoluted tubule
(DCT) which actively secretes ions, toxins, and drugs and
reabsorbs sodium ions from the tubular fluid.

The collecting system

The DCT opens into the collecting system.

This consists of connecting tubules, collecting ducts, papillary

ducts.

Individual connecting tubules connect each nephron to a nearby

collecting duct. Each collecting duct receives tubular fluid from

many connecting tubules.

Several collecting ducts converge to empty into a larger
papillary duct, which in turn empties into a minor calyx.

The epithelium lining the connecting tubule is cuboidal and
changes to columnar in the collecting and papillary ducts.

Besides transport, this adjusts composition and final osmotic
concentration and volume of urine.

1) THE NEPHRON
- distributed throughout cortex
and various zones of medulla
a) RENAL CORPUSCLE
BOWMANS CAPSULE + GLOMERULUS
b) PROXIMAL TUBULE
CONVOLUTED AND STRAIGHT
PORTIONS
c) HENLES LOOP
THICK AND THIN PORTIONS
d) DISTAL TUBULE
STRAIGHT AND CONVOLUTED
PORTIONS
2) COLLECTING DUCTS

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CORTEX:
MEDULLA:
CORTICAL LABYRINTH
1- RENAL CORPUSCLES
2- PROXIMAL CONVOLUTED
TUBULES
3- DISTAL CONVOLUTED
TUBULES
MEDULLARY RAY
1- STRAIGHT PORTIONS OF
PROXIMAL TUBULE (THICK
DESCENDING)
2- STRAIGHT PORTIONS OF DISTAL
TUBULE (THICK ASCENDING)
3- COLLECTING DUCTS

OUTER ZONE
1- STRAIGHT PORTIONS OF PROXIMAL
TUBULE (THICK DESCENDING)
2- STRAIGHT PORTIONS OF DISTAL
TUBULE (THICK ASCENDING)
3- THIN SEGMENTS OF LOOP OF
HENLE (DESCENDING & ASCENDING)
4- COLLECTING DUCTS
INNER ZONE
1- THIN SEGMENTS OF LOOP OF
HENLE (DESCENDING &
ASCENDING)
2- COLLECTING DUCTS

The Blood and Nerve Supply to the

Kidneys

1200 mL of blood flows through the kidneys each minute.

Each kidney receives from a renal artery.

The vasculature of the kidneys includes the segmental,

interlobar, arcuate, and interlobular arteries, afferent arterioles

and the venules, interlobular,
arcuate, interlobar and
segmental veins.

Blood travels from the efferent arteriole to the peritubular
capillaries and the vasa recta.

The renal nerves that innervate the kidneys and ureters are
dominated by sympathetic postganglionic fibers. Functions 
regulation of glomerular blood flow and pressure, stimulation
of renin release, direct stimulation of water and sodium
reabsorption.

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RENAL LOBULE

BLOOD FLOW (KIDNEY)

RENAL LOBULE

BLOOD FLOW (KIDNEY)

AORTA

VENA CAVA

RENAL ARTERY

RENAL VEIN

INTERLOBAR ARTERIES
- run between lobes in medulla

INTERLOBAR VEINS
- run between lobes in medulla

ARCUATE ARTERIES
- run parallel to bases of pyramids
at the corticomedullary junction

ARCUATE VEINS
- run parallel to bases of
pyramids at the
corticomedullary junction

INTERLOBULAR ARTERIES
- delineate lateral limits of renal lobules

INTERLOBULAR VEINS
- delineate lateral limits of renal
lobules

AFFERENT ARTERIOLES
- supply blood to glomerulus
GLOMERULAR CAPILLARY BED

VASA RECTA
SYSTEM

EFFERENT ARTERIOLES
- drain blood from glomerulus and form
either peritubular capillary plexus
(cortex) or vasa recta system (medulla)

PERITUBULAR
CAPILLARY
PLEXUS

ea
G
BLOOD FLOW (KIDNEY)
injection of colored
colloidin in renal artery
IA = interlobular
artery

aa
G
IA

Aging and the urinary system

G

Age related changes include:

declining numbers of functional nephrons: drops by 30-

40%

reduced GFR: this results form decreased numbers of
glomeruli. Damage to filtration apparatus, reduction in
renal blood flow.

reduced sensitivity to ADH: distal portion of nephron
and collecting system less responsive to ADH. More
sodium ions lost in urine.

problems with the micturition reflex: sphincter muscles
lose muscle tone.

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Integration with other systems

The urinary, integumentary, respiratory, and

digestive systems are sometimes considered an

anatomically diverse excretory system, whose
component work together to perform all the
excretory functions that affect the composition
of the body fluid.

RENAL CORPUSCLE
BOWMANS CAPSULE +
GLOMERULUS
FILTRATION APPARATUS
OF KIDNEY
1. BOWMANS CAPSULE:
- the beginning of the
nephron that consists of a
blind sac lined with simple
squamous epithelium that is
continuous with the PCT
- parietal layer & visceral
layer (specialized)

HISTOLOGICAL STRUCTURE
AND FUNCTION OF THE
NEPHRON & COLLECTING
DUCTS
*the epithelial changes that
occur along the uriniferous
tubules (reflects function)

RENAL CORPUSCLE
BOWMANS CAPSULE +
GLOMERULUS
FILTRATION APPARATUS
OF KIDNEY
2. GLOMERULUS:
- specialized tuft of capillaries
which housed in the capsular
space (10-20 capillary loops)
- blood flowing through
glomerulus capillaries
undergoes a filtration
process to produce the initial
urine filtrate

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GLOMERULUS (FILTRATION
MEMBRANE):
1- fenestrated capillaries;
discontinuous endothelium;
fenestrae have a diameter of
500-1000 and lack a
diaphragm
2- continuous basal lamina
3- podocytes of visceral layer;
processes contact basal lamina
and are separated by slits
measuring approximately 250

GLOMERULUS (FILTRATION MEMBRANE):

prevents RBCs and large
MW proteins from
leaving circulation,
while most other blood
constituents pass easily
into the capsular space
MESANGIAL CELLS
phagocytic cells with
a surrounding matrix
that lend structural
support to the
glomerulus

GLOMERULUS (FILTRATION
MEMBRANE):
PODOCYTE

1- fenestrated
capillaries
2- continuous basal
lamina

1 process

3- podocytes
pedicels
2

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