The Urinary System

An Introduction to the Urinary System

Figure 261

3 Functions of the Urinary System

1. Excretion:

removal of organic wastes from body

fluids

2. Elimination:

discharge of waste products

3. Homeostatic regulation:

of blood plasma volume and solute

concentration

Kidneys

Organs that excrete urine

Urinary Tract

Organs that eliminate urine:

ureters (paired tubes)
urinary bladder (muscular sac)
urethra (exit tube)

Urination or Micturition

Process of eliminating urine

Contraction of muscular urinary
bladder forces urine through urethra,
and out of body

5 Homeostatic Functions of Urinary System

1. Regulate blood volume and blood pressure:

by adjusting volume of water lost in urine

releasing erythropoietin and renin

2. Regulate plasma ion concentrations:

sodium, potassium, and chloride ions (by

controlling quantities lost in urine)
calcium ion levels (through synthesis of calcitriol)

3. Help stabilize blood pH:

by controlling loss of hydrogen ions and

bicarbonate ions in urine

4. Conserve valuable nutrients:

by preventing excretion of organic nutrients

5. Assist liver to detoxify the blood

The Position of the Kidneys

Are located on either side of
vertebral column:
left kidney lies superior to
right kidney
superior surface capped by
adrenal gland

Position is maintained by:

overlying peritoneum
contact with adjacent visceral
organs
supporting connective tissues

Figure 262

 Is protected and stabilized by 3 concentric

layers of connective tissue:
1. renal capsule
1. A layer of collagen fibers
2. Covers outer surface of entire organ
2. adipose capsule
1. A thick layer of adipose tissue
2. Surrounds renal capsule
3. renal fascia
1. A dense, fibrous outer layer
2. Anchors kidney to surrounding structures

Typical Adult Kidney

Is about 10 cm long, 5.5 cm wide, and
3 cm thick
Weighs about 150 g

Hilum
Point of entry for
renal artery and
renal nerves
Point of exit for
renal vein and
ureter

Renal Sinus

Internal cavity within kidney

Lined by fibrous renal capsule

Renal Capsule

Bound to outer surfaces of structures in renal

sinus
Stabilizes positions of ureter, renal blood
vessels, and nerves

Renal Cortex

Superficial portion of kidney in contact with

renal capsule
Reddish brown and granular

Renal Pyramids

6 to 18 distinct conical or triangular structures

in renal medulla:
base abuts cortex
tip (renal papilla) projects into renal sinus

Renal Columns

Bands of cortical tissue separate adjacent

renal pyramids
Extend into medulla
Have distinctly granular texture

 Consists of:

Renal Lobe

renal pyramid
overlying area of renal cortex
adjacent tissues of renal columns

Produces urine

Renal Papilla

Ducts discharge urine into minor calyx:

cup-shaped drain

Major Calyx

Formed by 4 or 5 minor calyces

Renal Pelvis

Large, funnel-shaped chamber

Consists of 2 or 3 major calyces
Fills most of renal sinus
Connected to ureter, which drains kidney

Blood Supply to the Kidneys

Kidneys receive 20
25% of total
cardiac output
1200 ml of blood
flows through
kidneys each
minute
Kidney receives
blood through
renal artery

Figure 265

 Segmental arteries
receive blood from
renal artery
Interlobar arteries
deliver blood to
arcuate arteries and
empty into
interlobular arteries
Afferent arterioles
branch from each
interlobular artery
and deliver blood to
capillaries supplying
individual nephrons

Cortical and
Juxtamedullary Nephrons

Figure 267

Cortical Nephrons (1 of 2 types)

85% of all nephrons

Located mostly
within superficial
cortex of kidney
Loop of Henle is
relatively short
Efferent arteriole
delivers blood to a
network of
peritubular
capillaries:
which surround
entire renal tubule

Juxtamedullary Nephrons
15% of nephrons
Have long loops
of Henle that
extend deep into
medulla
Efferent Arteriole
delivers to Vasa
Recta

 Consists of
renal tubule
and renal
corpuscle
Microscopic,
tubular
structures in
cortex of each
renal lobe
Where urine
production
begins

Nephron

Renal Tubule
Long tubular
passageway
Begins at renal
corpuscle

Renal Corpuscle

Spherical structure
consisting of:

Bowmans capsule
cup-shaped chamber
capillary network
(glomerulus)

Glomerulus

Consists of 50
intertwining
capillaries
Blood delivered via
afferent arteriole
Blood leaves in
efferent arteriole

The Bowmans Capsule

Is connected to initial segment of renal tubule

Forms outer wall of renal corpuscle
Encapsulates glomerular capillaries

Podocytes

Podocytes with Pedicels

The Filtration Membrane

Fenestrated Endothelium no RBCs
pass
Lamina Densa large plasma proteins
inhibited
Filtration slits no small plasma
proteins

Filtration
Occurs in renal
corpuscle
Blood pressure:
forces water and
dissolved solutes
out of glomerular
capillaries into
capsular space
produces proteinfree solution
(filtrate) similar to
blood plasma

Glomerular Filtration
Hydrostatic Pressure
Glomerular Hydrostatic Pressure
Capsular Hydrostatic Pressure

Colloid Osmotic Pressure

Blood Colloid osmotic Pressure

Glomerular Hydrostatic Pressure

Pushes water and solutes out of plasma
Higher than in other capillaries
GHP 50mmHg

Capsular Hydrostatic Pressure

Opposes GHP by pushing filtrate into
plasma
CsHP 15mmHg

Net Hydrostatic Pressure

GHP CHP = NHP
50mmHg 15mmHg = 35mmHg
Plasma from glomerulus flows into
capsular space

Colloid Osmotic Pressure

Osmotic pressure resulting from the
presence of suspended proteins
BLOOD COLLOID OSMOTIC PRESSURE
Opposes filtration
Plasma proteins attract water
25 mmHg

Net Filtration Pressure (NFP)

NFP = NHP BCOP
NFP = 35 mmHg 25 mmHg
NFP = 10 mmHg

Colloid Osmotic Pressure

CAPSULAR COLLOID OSMOTIC PRESSURE
Only develops if plasma proteins enter the
capsular space
Promotes filtration and increases fluid loss
in urine

3 Functions of Renal Tubule

1. Reabsorb useful organic nutrients that enter
filtrate
2. Reabsorb more than 90% of water in filtrate
3. Secrete waste products that failed to enter
renal corpuscle through filtration at
glomerulus

Renal Tubule
Segments
Located in
cortex:
proximal
convoluted tubule
(PCT)
distal convoluted
tubule (DCT)

Separated by
loop of Henle:
U-shaped tube
extends partially

into medulla

Nephrons
Travelling along
tubule, filtrate
(tubular fluid)
gradually changes
composition
Changes vary with
activities in each
segment of nephron
Empties into the
collecting system:
a series of tubes
carries tubular fluid
away from nephron

Collecting Ducts
Receive fluid
from many
nephrons
Each collecting
duct:

begins in cortex
descends into
medulla
carries fluid to
papillary duct
that drains into a
minor calyx

Reabsorption
Useful materials are
recaptured before
filtrate leaves
kidneys
Reabsorption occurs
in proximal
convoluted tubule

The Proximal
Convoluted Tubule
(PCT)
Is the first segment of
renal tubule
Entrance to PCT lies
opposite point of
connection of
afferent and efferent
arterioles with
glomerulus

Proximal Convoluted Tubule

Reabsorption of:

All organic nutrients

Ions
Vitamins
Water

Secretion of drugs and toxins

The Loop of Henle

Also called nephron loop

Renal tubule turns
toward renal medulla:
leads to loop of Henle

Descending limb:

fluid flows toward renal

pelvis

Ascending limb:
fluid flows toward renal
cortex

Each limb contains:

thick segment

thin segment

The Thick Descending Limb

Has functions similar to PCT:

pumps sodium & chloride ions out of tubular fluid

Ascending Limbs

Of juxtamedullary nephrons in medulla:

create high solute conc. in peritubular fluid

The Thin Segments

Are freely permeable to water, not to solutes

Water movement helps conc. tubular fluid

The Thick Ascending Limb

Ends at a sharp angle near the renal corpuscle where DCT begins

The Distal Convoluted

Tubule (DCT)
The third segment of
the renal tubule
Initial portion passes
between afferent and
efferent arterioles
Has a smaller
diameter than PCT
Epithelial cells lack
microvilli

3 Processes of the DCT

1. Active secretion of ions, acids, drugs,
and toxins
2. Selective reabsorption of sodium and
calcium ions from tubular fluid
3. Selective reabsorption of water:

concentrates tubular fluid

Juxtaglomerular Apparatus
Area where DCT comes into close
contact with the renal corpuscle
Consists of:
Macula Densa modified DCT epithelial
cells
Juxtaglomerular cells smooth muscle
fibres of afferent arteriole

Juxtaglomerular Apparatus
Function
Secretes erythropoietin
Secretes renin
Renin leads to Aldosterone and ADH
production which affect blood volume and
pressure; urine volume and concentration

Juxtaglomerular Apparatus
Renin is released when blood flow and
pressure decline in the kidneys
Renin converts Angiotensinogen (liver
plasma protein) to Angiotensin I
Angiotensin I is then modified to
Angiotensin II by angiotensinconverting enzyme in the lung
capillaries

Juxtaglomerular Apparatus
Angiotensin II :
1. Stimulates the release of Aldosterone
from the adrenal cortex
Aldosterone accelerates sodium reabsorption
in the DCT and cortical portions of the
collecting duct
Blood volume and pressure increase
Urine volume decreases and becomes
concentrated

Juxtaglomerular Apparatus
Angiotensin II:
2. Causes constriction of efferent arterioles causing
an increase in glomerular pressure and filtration
rates
3. Causes direct reabsorption of Na and water at
the PCT
4. Causes brief vasoconstriction of arterioles and
precapillary sphincters causing an elevation of
arterial pressures throughout the body

Juxtaglomerular Apparatus
In the CNS, Angiotensin II:
5. Causes thirst sensations fluid intake
increases; blood volume and pressure
increase
6. Triggers ADH secretion reabsorption of
water at the DCT and collecting duct;
blood volume and pressure increase; urine
volume decreases and is concentrated

Juxtaglomerular Apparatus
In the CNS, Angiotensin II (contd):
7. Increases sympathetic motor tone which
mobilizes venous reserves and increasing
cardiac output
8. Stimulates peripheral vasoconstriction,
therefore, increasing blood pressure

The Collecting System

The distal
convoluted tubule:
opens into the
collecting system

Individual nephrons:
drain into a nearby
collecting duct

Several collecting ducts:

converge into a larger
papillary duct
which empties into a
minor calyx

The Collecting
System:
Transports tubular
fluid from nephron
to renal pelvis
Adjusts fluid
composition
Determines final
osmotic
concentration and
volume of urine

REABSORPTION & SECRETION

ALONG THE RENALT TUBULE

Reabsorption & Secretion at the PCT

PCT reabsorbs 60 70 % of the filtrate
1. Reabsorption of organic nutrients
More than 99% glucose, amino acids etc
Facilitated and cotransport mechanism

Reabsorption & Secretion at the PCT

2. Active Reabsorption of Ions
Na+, K+, HCO-3,Mg, PO4, SO4
Causes tubular fluid to become dilute

Reabsorption & Secretion at the PCT

3. Reabsorption of water
water reabsorbed by osmosis
Causing tubular fluid to become
concentrated

Reabsorption & Secretion at the PCT

4. Passive Reabsorption of Ions
Urea and Chloride ions diffuse
passively into peritubular fluid
Filtrate becomes dilute causing more
water to be reabsorbed

Reabsorption & Secretion at the PCT

5. Secretion
Hydrogen secreted in exchange for
Sodium
Helps to increase blood pH and
acidifies filtrate
Important in lactic acidosis and
ketoacidosis

The Countercurrent Multiplication

System
Occurs in the loop of Henle
Reabsorbs 1/2 of the water in the
filtrate and 2/3 of the Sodium Chloride
Thin descending limb permeable to
water
Thick ascending limb allows active
transport of sodium chloride only

The Countercurrent Multiplication

System
1. Sodium chloride moves into
interstitial fluid from filtrate of thick
ascending limb
2. A concentration gradient develops
between the thin descending limb
and the peritubular fluid

The Countercurrent Multiplication

System
3. Water moves from the thin descending
limb into the peritubular fluid by
osmosis
As filtrate passes through the descending
limb it loses more water because of
the sodium chloride and urea in the
interstitial fluid of the medulla

The Countercurrent Multiplication

System
4. Fluid entering the thick ascending
limb is highly concentrated.
Sodium chloride is actively lost from
thick ascending limb

The Countercurrent Multiplication

System
(Urea also reabsorbed along collecting duct
deep in medulla; not shown)

Benefits of the Countercurrent

Multiplication System
Efficient reabsorption of water and
solutes before reaching the DCT and
collecting duct system
Establishment of a concentration
gradient for the reabsorption of water
in the presence of ADH from the
collecting duct system

Reabsorption & Secretion in the

Distal Convoluted Tubule
1. Active Reabsorption of sodium and
chloride ions
Sodium is reabsorbed in exchange for
potassium using ion pumps controlled
by Aldosterone
2. Calcium reabsorption in the presence
of Parathyroid hormone and Calcitrol

Reabsorption & Secretion in the

Distal Convoluted Tubule
3. Secretion of :
potassium in exchange for sodium
hydrogen in exchange for sodium
reabsorption (pump also sensitive to
Aldosterone, therefore, prolonged
aldosterone secretion can result in
alkalosis)

Buffering of Urine
In the cells of the PCT and DCT the
NH2 group from amino acids
(deamination) bind to 2 hydrogen ions
to produce NH4
NH4 passes into the tubular fluid

Reabsorption and Secretion in the

Collecting Duct System
Sodium reabsorption controlled by
aldosterone
Bicarbonate reabsorption in exchange
for chloride ions
Urea reabsorbed at papillary duct
making medulla concentrated
Secretion of hydrogen ions or
bicarbonate ions

ADH antidiuretic hormone

Hormone causes special water channels to
appear
Increases rate of osmotic water movement
Higher levels of ADH increases:
number of water channels
water permeability of DCT and collecting system

No ADH, water is not reabsorbed

All fluid reaching DCT is lost in urine
producing large amounts of dilute urine

Diuretics
Are drugs that promote water loss in
urine (diuresis)
Diuretic therapy reduces:
blood volume
blood pressure
extracellular fluid volume

The Transport Maximum (Tm)

Concentration higher than transport
maximum:
exceeds reabsorptive abilities of nephron
some material will remain in the tubular fluid and
appear in the urine

Determines the renal threshold

the plasma concentration at which:

a specific compound or ion begins to appear in urine

Renal Threshold for Glucose

Is approximately 180 mg/dl
If plasma glucose is greater than 180 mg/dl:
Tm of tubular cells is exceeded
glucose appears in urine

Glycosuria
Is the appearance of glucose in urine

Renal Threshold for Amino Acids

Is lower than for glucose (65 mg/dl)

Amino acids commonly appear in urine:
after a protein-rich meal

Aminoaciduria
Is the appearance of amino acids in urine

 The Concentration of components

in a urine sample depends on osmotic
movement of water

Normal Urine
Is a clear, sterile solution
Yellow colour (pigment urobilin) generated in kidneys from
urobilinogens

Urine Transport,
Storage, and Elimination
Takes place in the urinary tract:
ureters
urinary bladder
urethra

Organs for the Conduction

and Storage of Urine

Figure 2618a

Organs for the Conduction

and Storage of Urine

Figure 2618b

Organs for the Conduction

and Storage of Urine

Figure 2618c

The Ureters

Are a pair of muscular tubes

Extend from kidneys to urinary bladder
Begin at renal pelvis
attached to posterior abdominal wall
Penetrate posterior wall of the urinary bladder

Pass
through
bladder
at oblique
Ureteral
openings
arewall
slit-like
rather angle
than
rounded
Shape helps prevent backflow of urine:
when urinary bladder contracts

3 Layers of the Ureter Wall

Inner mucosa:
transitional epithelium and lamina propria

Middle muscular layer:

longitudinal and circular bands of smooth muscle

Outer connective-tissue layer:

continuous with fibrous renal capsule and
peritoneum

Peristaltic Contractions

Begin at renal pelvis

Sweep along ureter
Force urine toward urinary bladder
Every 30 seconds

The Urinary Bladder

Is a hollow, muscular organ
Functions as temporary reservoir urine storage
Full bladder can contain 1 liter of urine

Bladder Position
Is stabilized by several peritoneal folds
Posterior, inferior, and anterior surfaces:
lie outside peritoneal cavity

Ligamentous bands:
anchor urinary bladder to pelvic and pubic bones

Umbilical Ligaments
Are vestiges of 2
umbilical arteries
Middle umbilical
ligament extends:
from anterior,
superior border
toward umbilicus

Lateral umbilical
ligaments:
pass along sides of
bladder to umbilicus

The Mucosa

Lining the urinary bladder has folds (rugae):

that disappear as bladder fills

The Trigone of the Urinary Bladder

Is a triangular area bounded by:
openings of ureters
entrance to urethra

Acts as a funnel:
channels urine from bladder into urethra

The Urethral Entrance

Lies at apex of trigone:
at most inferior point in urinary bladder

The Neck of the Urinary Bladder

Is the region
surrounding urethral
opening
Contains a muscular
internal urethral
sphincter (sphincter
vesicae- Smooth
muscle fibers of
sphincter provide
involuntary control
of urine discharge)

Wall of the Urinary Bladder

Contains mucosa, submucosa, and muscularis
layers:
form powerful detrusor muscle of urinary bladder
contraction compresses urinary bladder and expels
urine

The Urethra
Extends from neck of urinary bladder
To the exterior of the body

The Male Urethra

Extends from neck of urinary bladder
To tip of penis (1820 cm)

3 Parts of the Male Urethra

1. Prostatic urethra:

passes through center of prostate gland

2. Membranous urethra:

short segment that penetrates the

urogenital diaphragm

3. Spongy urethra (penile urethra):

extends from urogenital diaphragm

to external urethral orifice

The Female Urethra

Is very short (35 cm)
Extends from bladder to vestibule
External urethral orifice is near
anterior wall of vagina

The External Urethral Sphincter

In both sexes:
is a circular band of skeletal muscle
where urethra passes through urogenital diaphragm

Acts as a valve
Is under voluntary control:
via perineal branch of pudendal nerve

Has resting muscle tone

Voluntary relaxation permits micturition

How is urination regulated

voluntarily and involuntarily
and what is the micturition
reflex?

The Micturition Reflex

Coordinates the process of urination
As the bladder fills with urine:
stretch receptors in urinary bladder (>500 ml):
stimulate pelvic nerve

stimulus travels from pelvic nerves:

stimulate ganglionic neurons in wall of bladder

postganglionic neuron in intramural ganglion:

stimulates detrusor muscle contraction

interneuron relays sensation to thalamus and deliver sensation

to cerebral cortex
voluntary relaxation of external thus internal urethral sphincter

Infants

Lack voluntary control over urination

Corticospinal connections are not established

Incontinence - the inability to control

urination voluntarily

Age-Related Changes in Urinary System

Decline in number of functional nephrons
Reduced sensitivity to ADH
Problems with micturition reflex

3 Micturition Reflex Problems

1. Sphincter muscles lose tone:

leading to incontinence

2. Control of micturition can be lost due to:

a stroke
Alzheimers disease
CNS problems affecting cerebral cortex or
hypothalamus

3. In males, urinary retention may develop if

enlarged prostate gland compresses the
urethra and restricts urine flow