Urinary System

- Composed of kidneys, ureters, urinary bladder, urethra, and associated structures.

Functions:
- Maintaining extracellular fluid balance
- Excretes wastes
- Maintaining blood pH
Urinary Structures
 Right and Left Kidney is located Retroperitoneally, along the posterior abdominal wall
Kidney Features:
- Renal Fat Pad- tissue that surrounds and protects each kidney
- Renal Capsule- fibrous outer wall of the kidney
- Hilum- indentation of the medial side of each kidney where vessels and nerves enter or exit.
 Renal Sinus- a fat filled cavity
 Renal Pelvis- wide section of the urinary channel distal to the ureter
 Calyces- branches of the pelvis extending from the kidney tissue proper.
 Top: Last thoracic vertebra-L3
 Right kidney is lower because it is displaced by the liver
 Ureters- Muscular tube that exits each kidney at the hilum and extends posteriorly to the pelvic cavity; urine formed passes through the
2 ureters.
 Urinary Bladder- Collapsible, muscular sac for the temporary storage of urine.
- 1L of urine= 500ml.
- Feel discomfort; stretched and signals the brain to urinate
 Urethra- muscular tube that extends from the anterior floor of the bladder to the outside of the body.
- Female- short tube that end in the anterior of the vagina
- Male- much longer, extending all the way to the penis. Conducts semen and urine.
 Urinary Sphincter- voluntary. Control flow through the urethra relax and allow urine to exit to the body.
- Passes the urethra
 Kidney- intricate organ in the urinary system
- Has the urinary capsule
 Renal Cortex- first layer
- Inside is the Medulla where the Renal Pyramids are found with Renal Columns
- Passes minor and major Calyx
- Renal Pyramids- cone shaped sections of tissue lying mostly within the medulla
 Renal Pelvis is connected to the Ureter
 Cortex- outside
 Nephron- functional unit of kidneys in the renal pyramid
- 1.3 million each kidney
- Filters dirt in the blood
Urine
1st : Renal Corpuscle- roughly spherical structure at the beginning of the nephron.
- Glomerulus- inner portion of the renal corpuscle; a ball of glomerular capillaries; like a ball of yarn
- Bowman’s capsule- surrounding the glomerulus; double-walled. Seen as a very thin white or light area. Lumen of the capsule
appears white.
- Podocytes- visceral wall of Bowman’s capsule. Have extensions that form a Filtration Membrane
- Renal Tubules- tissue surrounding each renal corpuscle.
2nd : Proximal Convoluted Tubule- is a narrow channel proceeding from the Bowman’s capsule of the renal corpuscle. Convoluted meaning it is
coiled.
- Half of Loop of Henle- continuation of the proximal tubule.
- Descending (dips in the medulla) and Ascending limb
3rd : Distal Convoluted Tubule- from the ascending loop of Henle.
4th : Collecting Duct- a tubule that collects urine from many nephrons and conducts it from the renal pyramid to a calyx.
- Urine is voided during Urination or Micturition
- Juxtaglomerular Apparatus- formed when afferent arteriole and distal tubule meet. “Near the Glomerulus”
- Secretes Renin- enzyme that catalyzes conversion of angiotensinogen to angiotensin I
 Glomerulus- the dark region forming the center of the renal corpuscle. A network of glomerular capillaries.

Urine Formation
3 Major

1. Glomerular Filtration
- What cones out is called Filtrate
- move to Proximal Convoluted Tubule
2. Tubular Reabsorption
- Move to Proximal Convoluted Tubule
- Reabsorption of Sodium and Water
- Goes up to the Distal Convoluted Tubule
3. Tubular Secretion
- Filtrate moves to Proximal Convoluted Tubule to the Blood Stream
 Distal Convoluted Tubule- what need to be brought out. Collect what’s left; shorter than PCT
- Goes to the Renal Pelvis to your urethra
- 30mL of urine every hour.
Urinalysis
- The examination of urine and its contents.
- Reflects the overall status of extracellular fluid because it is derived from blood, and its contents have been adjusted at some
extent on the basis of homeostatic balance.
- To know if you have Urinary Tract Infection
- Have UTI though they don’t feel anything
Physical Properties
Usual colors:
 Normal- Colorless (high H2O), straw, yellow(urochrome), amber
- Transparency- normal urine is clear to slightly cloudy. Cloudy urine may contain fat globules, epithelial cells, mucus, microbes,
or chemicals.
- Color- amber, straw, or transparent yellow
- Urochromes- such as urobilinogen (bacterial product derived from bilirubin)
- Yellow-brown to greenish- high concentration of bile pigments are present.
- Red-to-dark-brown- presence of blood
 Abnormal- Pink, red, brown (too concentrated urine)
 Lack of water=nutritional problem. Medication can also discolor urine. Ie. TB Meds.
Usual Appearances (opacity):
 Normal- clear; can be cloudy but not too much.
 Abnormal- turbid, cloudy, and opaque, unless the specimen has remained at room or refrigerated temp.
Chemical Properties:
 Leukocytes- occasional WBCs are normal, but values increase in urinary infections.
 Nitrite- cloudy urine indicates presence of large amounts of bacteria, as in an infection (UTI)
 Urobilinogen- excessive RBC destruction or liver disease (supporting brown colored urine)
 Protein- indicate hypertension or kidney disease.
- Presence of Albumin
- Detectable levels after exercise is normal
 Urine is sterile inside the body. Outside, gets contaminated
 pH- normal urine pH is 4.6-8
- Determinant of acidity
- Lower: Acidosis, starvation and dehydration
- Higher: Alkalosis, urinary infections
 Occult Blood- RBCs or free hemoglobin
- Occult “hidden”
- Hemoglobin- may indicate kidney infection or presence of stones in the kidney, ureter, or bladder
 Specific Gravity- ratio of urine density to water density.
- Normal urine is 1.001-1.030 (lower values indicate kidney disease; higher values indicate dehydration or diabetes mellitus.)
 Ketone- by-product of fat metabolism. May be present during fasting. Diabetes Mellitus or low-carb. Diet.
 Bilirubin- product of RBC destruction in the liver may indicate liver disease or bile tract obstruction if present
 Glucose- trace amounts may be present after eating a meal high in crabs. High levels may indicate Diabetes Mellitus or Pituitary
problems

Microscopy
 Casts- Greater number of Hyaline Casts may be seen associated w/ proteinuria or renal disease.
 Cellular Casts- most commonly result when disease processes such as ischemia (lack of oxygen), infarction, or nephrotoxicity.
- Nephrotoxicity- abuse on kidneys w/ drugs.
 Waxy Casts- found especially in chronic renal disease and are associated w/ chronic renal failure. Glomerulonephritis
 Cells- trace of blood or microbial cells present may indicate urinary problem.
 WBC
- Pyuria- increased. Generally, indicate the presence of an inflammatory process
 RBC
- Hematuria, hemorrhage, inflammation, necrosis, trauma, neoplasia(cancer)
- Squamous cells- represent contamination
 Crystals- roughly cylindrical masses of cells, granules, or other substances
 Amorphous Urates- acidic urine
 Amorphous Phosphates- alkaline
 Triple Phosphate Crystals- formation is formed in neutral to alkaline urine
 Uric Acid Crystals- seen in acidic urine

 Trichomonas Viginalis- sexually transmitted disease