The urinary system consists of: 2 kidneys-
filter blood plasma and produce urine, 2
ureters- transport urine to the urinary
bladder, 1 urinary bladder- temporarily
stores urine until elimination, 1 urethra-
conducts urine to the exterior
Urology- branch of medicine that deals
with the male and female urinary
systems, and the male reproductive
system
Nephrology- study of the
anatomy, physiology, and
pathology of the kidneys
Functions of the kidneys: 1. excretion- removal of waste
products from the body fluids. a. urea- products of amino
acid breakdown b. urobilinogen- products of hemoglobin
breakdown c. creatinine- products of the breakdown of
creatine phosphate in muscle fibers. d. uric acid- products
of nucleic acid breakdown. e. foreign chemicals- drugs
and environmental toxins 2. Regulate blood homeostasis.
a. blood volume. b. blood ionic composition. c. blood ph
Water balance in the body: the
average human body contains about
40L of total body water in the form
of intracellular fluid, interstitial
fluid, and plasma
The nephron are
the functional
units of the
kidneys. Each
kidney contains
approximately
1.25 million
nephrons
Each nephron consists of 2 main parts: renal corpuscle and
renal tubule. The renal corpuscle is the site of blood
filtration and it is composed of two parts: the glomerulus- a
capillary network and glomerular capsule- cup that
surrounds the glomerulus. The renal tubule is the
passageway where filtered fluid passes from the
glomerular capsule. It is composed of various parts: a. the
proximal convoluted tubule. b. loop of henle (descending
limb and ascending limb) c. distal convoluted tubule
Blood arrives at the nephron
through an afferent arteriole, passes
into the capillaries of the
glomerulus, then flows into an
efferent arteriole to the peritubular
capillaries and then it is collected in
a vein.
Renal physiology: to
produce urine, the nephrons
and collecting ducts
perform 3 basic functions:
1. filtration, 2. absorption,
3. secretion
The walls of each glomerulus form a filtration membrane
between the blood and the capsular space. The filtration
membrane is composed of 3 layers: 1. the cells on the
inside of the glomerulus have large fenestrations that
permit all solutes to pass, except blood and platelets 2. the
lamina densa is a matrix of fibers that prevents the
filtration of large plasma proteins. 3. The outside of the
glomerulus is covered with cells called podocytes which
have many foolike projections called pedicles that wrap
around the glomerular capillaries. The spaces between the
pedicles are filtration slits
The kidneys are capable of filtering a large volume
of blood for 3 reasons: 1. glomerular capillaries
present a large surface area for filtration 2. the
filtration membrane is thin and porous 3. glomerular
capillary blood pressure is high (55 mmHg instead of
30 mmHg in most other systemic capillaries in the
body) because the efferent arteriole is smaller in
diameter than the afferent arteriole
The
glomerular
filtration rates
(GFR) is the
amount of
filtrate that
the kidneys
produce each
minute. A
normal GFR
is 125ml/min.
Renal
clearance tests
are renal
function tests
that are
routinely used
to assess
glomerular
filtration rate to
determine if
renal function
has been
compromised
Inulin (not insulin) is an inert
polysaccharide, and often used as the
standard to calculate renal clearance
because inulin is not reabsorbed or stored
or secreted by the kidneys
Glomerular filtration rate can be modified by
altering blood pressure in the afferent and
efferent arterioles by vasodilation or
constriction. This can be induced by: Auto
regulation- baroreceptors in the afferent
arterioles monitor stretching of the vessel walls.
Hormonal regulation- renin can increase blood
pressure and increase GFR. Autonomic
regulation- sympathetic activation can cause
vasoconstriction of afferent arterioles and reduce
GFR.
Proximal convoluted tubule- about 60-70% of the filtrate is reabsorbed here.
Loop of henle- about 15-20% of fluid is reabsorbed in the loop of henle. Distal
convoluted tubule- only about 15-20% of the intial filtrate reaches the DCT.
Collection ducts- the collecting ducts collect tubular fluid from several nephrons
Reabsorption of sodium is associated with the loss of potassium. a. therefore, prolonged aldosterone
stimulation can produce hypokalemia a dangerous reduction of blood potassium concentration. b. this
is one reason why it is preferable to drink water-electrolyte solutions with during heavy or extended
exercise, rather than plain water.
Most of the remaining water is reabsorbed by facultative water reabsorption, which is regulated by the antidiuretic hormone
(ADH). a. ADH increases the permeability of the collecting duct by stimulating the addition of water channels in cell
membranes. b. If homeostasis is disrupted and blood volume or water content declines, ADH is released and stimulates water
conservation by increasing water reabsorption by the collecting ducts. c. in the absence of ADH, a large volume of dilute urine
is produced. A person suffering from diabetics insipidus may excrete up to 20 L/day
Diuretics- substances that slow
renal reabsorption of water and
cause an elevated urine flow,
which in turn reduces blood
volume
The kidenys play an important role in re-establishing blood pressure, water and electrolyte homeostasis. When renal blood flow declines
juxtaglomerular cells in the juxtaglomerular apparatus detect this and respond by secreting renin. The JGA consists of a special group of
epithelial cells of the DCT that are near the renal corpuscle and the juxtaglomerular cells which are special smooth muscle fibers in the
walls of the afferent and efferent arterioles
Dialysis- blood is cleansed
artificially by dialysis if kidneys are
so impaired by disease or injury that
they are unable to function properly
Hemodialysis- blood is
redirected to flow through
tubing made of selectively
permeable dialysis membrane
Peritoneal dialysis-
blood is cleansed inside
the body, through the
peritoneum
Kidney stones- sometimes the salt crystals present in the urine precipitate and solidify into insoluble stones.
Excessive calcium intake, low water intake, and hyperparathyroidism can lead to kidney stones. When a stone
lodges in a narrow passageway the pain can become intense. Treatments include dissolving drugs,
shock-wave therapy, or surgery
Urine is collected from collecting ducts in the kidneys and transported to the urinary bladder through the ureters.
The urinary bladder is a hollow, muscular organ that can change shape drastically depending on the volume of urine
it contains. The urethra is the tube leading from the floor of the bladder to the exterior.
Discharge of urine from the
urinary bladder is called
micturition. It occurs by a
combination of voluntary and
involuntary contractions
Urinary incontinence- lack of
voluntary control over
micturition usually due to a
weakening of muscles or damage
to nerves