Renal System

I. Components of Renal System

K idneys Responsible for urine formation
U reter
B ladder Passageway of Urine
U rethra

II. General Fxn of Renal System

1. Elimination of waste products
2. Acid-Base Balance
3. Controls the plasma (H2O) volume in the body
4. Controls the BP
a. Releases enzyme “Renin” who activates the Renin Angiotensin-Aldosterone-System (RAAS)

Dehydration/Excessive Bleeding
↓
↓ Blood Volume
↓
↓ BP
↓
Activation of Juxtaglomerular Cells “Renin”
↓
↑ Renin
↓
Renin Angiotensinogen – A1
↓
↑ A1
↓
as blood flow occurs in capillaries of LUNGS ->
ACE converts A1 to A2 a potent vasoconstrictor
↓
↑ A2
↓
A2: Stimulates the Adrenal Cortex to secrete
Aldosterone which H2O is reabsorbed while
maintaining the electrolytes
↓
↑ Blood Volume
↓
Normal Blood Pressure

5. Produce: Hormone
a. Calcitriol = active form of Vit D.; Aka – 1, 25 – Dihydroxycholecalciferol
b. Erythropoietin: stimulation of new RBC in bone marrow

III. Anatomy of Kidneys

1. Bean shape
2. Level: T12 – L3
3. Location: retroperitoneal
a. External Anatomy: layers of tissues surrounding
i. Renal Capsule – barrier to trauma
ii. Adipose Tissue – fats; middle layer of tissue
iii. Renal Fascia – anchor the kidneys on the abdominal wall
1. Sudden Fall of kidneys 2 decrease in fatty tissue: nephro-ptosis
b. Internal Anatomy
i. Renal Cortex – outer region
ii. Renal medulla – inner region; (+) renal pyramids

IV. Nephron
1. 2 million Nephron, 1 million for each kidney

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 Renal System Module

2. Functional Unit of kidneys

3. Responsible for the urine formation
4. 2 Main structures
a. Renal Corpuscle (G+B.C.)
b. Renal Tubules (PCT+DCT+LOH+CT)

5. 2 Types of Nephron
a. Cortical Nephron – part of a nephron that lies in the renal cortex
b. Juxtamedullary Nephron – part of a nephron that lies in the renal medulla
i. Cortical Collecting Tubule – CT in the renal cortex
ii. Medullary Collecting Tubule – CT in the Renal Medulla

Urine Formation
1. Glomerular Filtration
a. Filtration membrane – allow the H2O, small solutes to pass through; (-) proteins, platelets, blood cells to pass
through
b. Glomerular Filtration Rate (GFR) – amount of filtrate formed in all renal corpuscle in (B) kidneys in each minute
i. (N) Male: 125 mL/min
ii. (N) Female: 105 mL/min
iii. Board Exam: What is the Average GFR? A – 125 mL/min
c. Net filtration pressure
i. 10 mmHg “Ten-net”
2. Tubular Reabsorption
a. PCT – “workhouse of nephron”
i. 65% reabsorption of water
ii. Concentrated luminal fluid
iii. Board Exam Question: The tubule that is most permeable to water? A – PCT
b. Thin Descending LOH
i. 10% Reabsorption of water
ii. More Concentrated luminal fluid

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 Renal System Module

iii. Board Exam Question: Where is the most concentrated luminal fluid located? A – Thin Descending LOH (if
there is no TDLOH, choose PCT)
c. Thin Ascending LOH
i. Reabsorption of solutes
ii. Diluted luminal fluid
d. Thick Ascending LOH
i. Reabsorption of solutes
ii. More Diluted luminal fluid
e. CT/DCT
i. Diluted luminal fluid
f. Urine
i. Diluted in Nature
ii. Diluted in Minor Calyx, Major Calyx, Ureter, Bladder
iii. Responsible for color of urine – urochrome/urobilin – pale yellow to orange
g. Dehydration
i. ADH/Vasopressin released
ii. Reabsorption of H2O in Kidneys
iii. Attachments: DCT/CT
iv. Board Exam Question: In the presence of ADH, where is the most concentrated urine located?
1. PCT
2. DCT
3. CCT
4. MCT

VI. Ureter
1. 25 to 30 cm long
2. Composed of Smooth muscle

VII. Urinary Bladder

1. Smooth Muscle – detrusor muscle
2. Storage of urine – (N) 500 mL; Max 700-800 mL
3. Dribbles – slow release of urine when at max capacity
4. Innervated by S2, S3, S4
5. Micturition Reflex – “Voiding” (urge to urinate) – 200-300 mL of urine

VIII. Urethra
1. Terminal end organ of renal system
2. Male – 20 cm long
3. Female – 3-4 cm long
4. 2 sphincters
a. External Urinary Sphincter – Voluntary
b. Internal Urinary Sphincter – Involuntary

Types of Urinary Incontinence

1. Overflow Incontinence
a. Aka: Atonic Bladder
b. Inability of the Urinary Bladder to empty completely
c. (+) Dribbles
d. Mx: Credés Maneuver
i. Manual downward P° in suprapubic region
2. Stress Incontinence
a. (N) Urinary Bladder
b. Weakness of supporting structures
c. Activity: laughing, lifting, coughing, sneezing, exercises (↑ Abdominal Pressure)
d. Mx: Kegel’s Exercises
3. Urge Incontinence
a. Aka: Overactive Bladder/Neurogenic Bladder
b. Involuntary contraction of the Urinary Bladder
c. 2° to drugs, alcoholism, bladder Infection, Bladder tumor

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