Urinary System

1. LECTURE NOTES FOR UNIT FIFTEEN – URINARY SYSTEM

Medical Anatomy and Physiology

I. FUNCTIONS OF THE URINARY SYSTEM

A. Primary function:

B. Excretes:

C.

D. Helps in metabolic processes

1. _______________________during times of starvation
2. secretes _______________________to stimulate production of red blood cells
3. participates in the synthesis of calcitriol (_____________________________)

II. IDENTIFY THE FOUR MAJOR STRUCTURES OF THE URINARY SYSTEM

The URINARY SYSTEM is composed of the ____________(2), ___________(2),

_______________and the ______________

A. The Ureters:

1. Anatomical Structure: tubes that are actually an extension of the renal pelvis
that extend to 25 to 30 cm (10 to 12 inches) from the kidney to the urinary
bladder

2. Histology: comprised of three layers of tissue

a. Mucosa: inner layer - secretes mucus and protects the walls of the
A ureters from urine which is much more acidic
Step b. Muscularis: middle layer - made of smooth muscle tissue whose
Beyond primary function is peristalsis
c. Fibrous Coat: outer layer - functions to protect and anchor the ureters
in place within the abdominopelvic cavity

3. Physiology: primary function of the ureters is to simply transport urine from

the kidneys to the urinary bladder:
a. peristaltic action of the smooth muscle of the muscularis layer of the
ureters.
b. hydrostatic pressure: fluid pressure created by urine production &
collection in the renal pelvis.
c. gravity

B. The Urinary Bladder:

1. Structure: when filled with urine, is a somewhat pear shaped organ

Unit Fifteen – Urinary System Page 2 draft copy

Medical Anatomy and Physiology

Trigone: a small triangular area pointed anteriorly, the openinsg to the

urethra is found at the apex of this triangle. The openings to the ureters
are also found here.

2. Histology: made up of four layers of tissue

a. Mucosa: innermost layer - composed primarily of transitional
epithelium that has the ability to stretch and return to normal position
A b. Submucosa: second layer - a layer of connective tissue that connects the
mucosa layer to the muscularis layer of the urinary bladder
Step
c. Detrusor: the third layer of tissue - consists of three layers of smooth
Beyond muscle running:
i. inner: longitudinally arranged
ii. middle: circular arrangement
iii. outer: longitudinally arranged
d. Serous Coat: outermost layer - formed by the peritoneum and covers
only the superior surface of the organ

3. Physiology:
Micturition: the physical process of expelling urine from the urinary bladder
(urination or voiding)

C. The Urethra:

A 1.The terminal portion of the urinary system that serves as a passageway for
Step discharging urine from the body
Beyond
2.Urethral Orifice: the opening of the urethra to the exterior

D. The Kidneys:

III. IDENTIFY THE GROSS ANATOMY OF THE KIDNEYS

The kidneys are paired reddish organs that resemble a kidney bean in shape. They are
located just above the waist between the _________________and the _______________of the
abdomen and are therefore said to be______________________. They measure about 10 - 12 cm
(_____ to ______ inches) long, 5 to 7.5 cm (2 to 3 inches) wide, and 2.5 cm (1 inch) thick and
are roughly the size of a________. The concave border faces ____________while the convex
surface is positioned_______________. The __________is the notch near the center of the
concave medial border through which the ureter leaves the kidney, and blood and lymphatic
vessels and nerves enter and leave the kidney. The ______________is the cavity within the
kidney that originates at the hilus.

A. Layers of External Renal Tissue:

Unit Fifteen – Urinary System Page 3 draft copy

Medical Anatomy and Physiology

1. The Renal Capsule: the innermost layer of the tissue surrounding each kidney
comprised of smooth, transparent, fibrous membrane that serves as a :

2. The Adipose Capsule: a mass of ___________________surrounding the renal

capsule that _____________________________and holds it firmly in place
within the abdominal cavity.

3. The Renal Fascia: the outermost layer of renal tissue that ___________the
kidney to surrounding structures within the abdominal wall.

B. Internal Anatomy of the Kidney:

1. The Cortex:

2. The Medulla:

3. Renal (Medullary) Pyramids:

4. Renal Pelvis:

5. Calyces:

IV. IDENTIFY THE MICROSCOPIC STRUCTURE OF THE NEPHRONS

The nephrons are the ________________________of the kidneys. They __________the

blood removing __________products and ___________urine. The nephron is located in both the
_______________and _________________area of the kidney.

A. Structures of the Nephron:

1. Renal Corpuscle:

a. Glomerular (Bowman’s) Capsule:

b. Glomerulus: a

i. Afferent Arteriole: a blood vessel that brings blood into the

A glomerulus large diameter arteriole
Step ii. Efferent Arteriole: blood vessel that exits the glomerulus small
Beyond diameter arteriole
iii. Fenestrae: large pores in the endothelial walls of the
capillaries of the glomerulus through which salts and other
waste products diffuse out of the bloodstream
iv. Podocytes: cells of the walls of the Bowman’s Capsule that
have slits in them that work in conjunction with the fenestrae of

Unit Fifteen – Urinary System Page 4 draft copy

Medical Anatomy and Physiology

the glomerulus to act as a filtration membrane to remove waste

products another substances from the blood

2. Renal Tubule:

a. Proximal Convoluted Tubule (PCT)

b. Loop of Henle (Nephron Loop)
i. descending limb
ii. ascending limb
c. Distal Convoluted Tubule (DCT)

3. Peritubular Capillaries:
a.
b.

4. Juxtaglomerular Apparatus
a. located where the distal convoluted tubule contacts the afferent
A
arterioles
Step b. plays an important role in regulating rate of urine formation and
Beyond regulating blood pressure

B. Function of the Nephrons:

1. Controls blood concentration and volume by removing selected amount of

water and solutes
2. Regulates blood pH
3. Removes toxic wastes from the blood
A 4. The fluid and solutes removed from the blood by the nephrons is collectively
Step called urine
Beyond 5. Entire volume of blood in the body is filtered by the kidneys approximately 60
times each day
a. filters about 180 liters (45 gallons) of fluid a day
b. 99% of fluid that passes through the kidneys is returned to the blood

V. NAME AND DESCRIBE THE THREE BASIC PHYSIOLOGICAL PROCESSES IN

URINE FORMATION
There are three process involved in urine formation all associated with nephron function.

A. Glomerular Filtration:

1.

2.

B. Tubular Absorption:

Unit Fifteen – Urinary System Page 5 draft copy

Medical Anatomy and Physiology

1.
a.
b.
c.

2. as the filtrate passes through the renal tubules about _____% of it is reabsorbed
by the body
a. only ____% of the filtrate actually leaves the body as urine (1.5 liters a
day)
b. materials commonly reabsorbed include: water, glucose, amino acids,
urea, and ions such as Na+, K+, Ca(+2), Cl-, HCO3-, and HPO4(-2)
c.

C. Tubular Secretion:

1.

2. secreted substances include: K+, H+, ammonia,

3.

4.

VI. IDENTIFY THE PHYSICAL CHARACTERISTICS AND NORMAL

CONSTITUENTS OF URINE

Urinalysis:

A. Volume:

1. normally about 1000 ml to 2000 ml (________quarts) per day. Influenced by:

a. Blood Pressure: if blood pressure were to fall the kidneys would try to
increase blood pressure by :

b. Blood Concentration: kidneys maintain optimal blood concentration by

controlling the concentration of ____________in both the blood and
urine

c. Temperature: an increase in body temperature causes less blood to be

shunted to the kidneys and causes the kidneys to _______________
water to maintain optimal blood plasma volume. This causes
an______________ is urine volume.

d. Diuretics:

Unit Fifteen – Urinary System Page 6 draft copy

Medical Anatomy and Physiology

i. Examples:
ii.

e. Emotions: some emotional states can affect urine volume and output
such as nervousness may cause ______________production and
discharging of urine

B. Physical characteristics of urine:

1. Color:

2. Turbidity:

3. Odor:

4. pH: avg. is about ______but has a range from _______________

1. varies considerably with the _________
2. vegetarians have a more ________________Ph

5. Specific Gravity: 1.001 to 1.035 – refers to the concentration of urine when

compared to water.

C. Chemical composition of urine: water accounts for about ______% of the total volume
of urine with the remaining ______% consisting of solutes derived from cellular
metabolism and outside sources such as drugs

1. Organic components of urine:

1. Urea: a crystalline solid found in blood, lymph, and urine formed by
____________________
2. Uric Acid: a crystalline acid occurring as an end product of
______________________
3. Creatine: the decomposition product of the metabolism of
phosphocreatine - an end product of muscle metabolism and/or energy
metabolism
4. Ketone Bodies: substances containing carbonyl groups as a result of
__________________________- a sign of metabolic acidosis
5. Hippuric Acid: an acid formed in the body by the combination benzoic
acid and glycerine
6. Indican: potassium salt of indoxylsulfate found in sweat and urine -
gives urine a yellow pigment

2. Inorganic components of urine:

a. NaCl d. SO4 2-
b. PO4 3- e. NH 4+
c. Mg2+ f. Ca 2+

Unit Fifteen – Urinary System Page 7 draft copy

Medical Anatomy and Physiology

D. Abnormal Constituents of Urine:

1. Albumin (albuminuria): may indicate kidney damage or disease as a result of:

a. increased blood pressure c. ether poisoning
b. bacterial toxins d. heavy metal toxicity
2. Glucose (glucosuria or glycosuria): can be linked to diabetes, high stress
levels, or liver disease
3. Erythrocytes (hematuria): blood in the urine that may be linked to acute
inflammation of the urinary organs as a result of kidney stones, tumors,
trauma, or kidney disease
4. Leukocytes (pyuria): leukocytes or other components of pus in the urine that
usually indicates infection of the urinary system
5. Ketone Bodies (ketosis or acetonuria): could indicate diabetes, starvation, or
too little CHO in the diet
6. Bilirubin (bilirubinuria): small amounts are normal, excessive amounts could
indicate urinary dysfunctioning or hepatitis.
7. Urobilinogen (urobilinogenuria): small amounts are normal, excessive
amounts could indicate urinary system dysfunctioning or possibly liver
dysfunction, congestive heart failure, cirrhosis of the liver or infectious
mononucleosis
A 8. Casts: tiny masses of material that have hardened and assumed the shape of
Step the lumens of the tubules they were flushed out of. They are named after the
substances they are made out of:
Beyond a. WBC casts c. RBC casts
b. fatty casts d. endothelial cell casts
9 Renal Calculi (kidney stones):crystals of salts formed in the urinary system
a. conditions leading to the development of kidney stones include:
i. ingestion of excessive mineral salts
ii. insufficient water consumption
iii. over activity of parathyroid gland
10. Microbes: bacteria in the urine.

E. Urea and Uric Acid Formation:

1. nitrogen containing waste products resulting from metabolism
2. urea enters the renal tubule filtration system and about 50% is reabsorbed by
he process of diffusion
3. remaining 50% excreted in the urine
4. a by product of amino acid metabolism so the amount of urea in the urine can
correlate to the amount of protein in the diet

Unit Fifteen – Urinary System Page 8 draft copy

Medical Anatomy and Physiology

VII. DESCRIBE THE METHODS OF FLUID INTAKE AND OUTPUT BY THE BODY

A. Micturition:

B. Voiding:

C. Sweat:

D. Feces:

E. Exhaled Vapor:

Unit Fifteen – Urinary System Page 9 draft copy

Medical Anatomy and Physiology

Prefixes, Suffixes, Root Words ren/o kidney

-al pertaining to -scopy process of viewing
albumin/o albumin -sis state of
an without son/o sound
azot/o urea, nitrogen tom/o cut, section
calc/i calcium, stone -tomy to cut into, incision
-cele protrusion, herniation -tripsy surgical crushing
cyst/o urinary bladder -trophy nourishment, growth,
dia through, apart, across development
diure to urinate ur/o urine, urinary tract
dys bad, painful, difficult ureter/o ureter
-ectasia expansion, dilitation, urethr/o urethra
stretching -uria urine, urination
-ectomy removal of, excision urin/o urine, urinary tract
edem edema or swelling ven/o vein
-emia blood condition vesic/o urinary bladder, sac
-esis condition of xanth/o yellow
glomerul/o glomerulus
gluc/o sugar Medical Terms
glyc/o sugar albuminuria albumin in the urine
glycos sugar anuria no urine
-gram picture of azotemia condition of nitrogen or urea
hemat/o blood in the blood
hydr/o water calc(ulus) condition of stones
-iasis pathological condition or cystitis inflammation of the urinary
abnormal condition bladder
-itis inflammation, infection of cystocele protrusion of the urinary
lith/o stone bladder
-logy study of cystoscopy procedure to view the urinary
-lysis destruction of bladder
-malacia softening cystourethroscopy procedure to view the
meat/o opening or passageway urinary bladder and the
-megaly enlargement urethra
nephr/o kidney dialysis "through dissolution"
noct/i night (refers to the process of
olig/o few, scanty, small amount separating as the blood
-ologist one who studies, a specialist moves through the nephron).
-ology study of diuresis condition of urinating
-orrhaphy suture or repair dysuria painful or difficult urination
-otomy cut into or incision edema swelling
-pathy disease glomerulonephritis
-pexy surgical fixation inflammation of the
poly many glomerulus and the nephron.
-ptosis drooping glycosuria sugar in the urine
py/o pus hematuria blood in the urine
pyel/o kidney pelvis lithotomy incision to remove stones

Unit Fifteen – Urinary System Page 10 draft copy

Medical Anatomy and Physiology

lithotripsy surgical crushing of stones pyuria pus in the urine

nephrectomy removal of the kidney renal pertaining to the kidney
nephritis inflammation of the kidney sonogram picture created by sound
nephromalacia softening of the kidney urethritis inflammation of the urethra
nephromegaly enlargement of the kidney urology study of the urine
nephrosis condition of the kidney uroxanthin pertaining to the yellow
nephrologist a specialist of the kidney pigment of urine
nephrology study of the kidney
nephropathy disease of the kidney
nephropexy surgical fixation of the Medical Abbreviations
kidney cc cubic centimeter
nephroptosis drooping or dropped position GU genitourinary
of the kidney H2O water
nocturia night time urination ml milliliter
oliguria a small amount of urine I&O intake and output
polyuria excessive urination L liter
pyelectasia dilation or stretching of the UA urinalysis
renal pelvis UTI urinary tract infection
pyelogram picture of the renal pelvis
pyelolithotomy incision into the kidney
pelvis to remove stones
pyelonephrosis disease condition of the
renal pelvis
pyeloureterectasis dilatation of the kidney
pelvis and the ureter.

Unit Fifteen – Urinary System Page 11 draft copy

 Medical Anatomy and Physiology

3. DISEASES AND DISORDERS FOR UNIT FIFTEEN – URINARY SYSTEM

A. Cystitis:

B. Diabetes Insipidus:

C. Glomerulonephritis (Bright’s Disease):

D. Incontinence:

E. Kidney Stones:

F. Nephrotic Syndrome (Nephritis):

G. Renal Failure:

H. Renal Ptosis:

I. Urinary Tract Infections:

Unit Fifteen – Urinary System Page 12 draft copy

Medical Anatomy and Physiology

4. RELATED CAREERS FOR UNIT FIFTEEN – URINARY SYSTEM

THERAPEUTIC
Urologist
Urologists specialize in diseases of the kidney, bladder or urinary system.
See Unit One – Physician information

Nephrologist
Nephrologists specialize in disease and disorder associated with the nephron
See Unit One - Physician information

Medical Assistant
• Training: Associate’s or 1-2 years of appropriate Health Science training
• Job Outlook to 2005: Above average growth
• Average Salary: $10,500-$24,00 (See CHOICES for current information)
• Description: A medical assistant works under the supervision of a physician. They prepare
patients for examination, take vital signs and medical histories, assist with procedures and
treatments, perform basic lab tests, prepare and maintain equipment and supplies and/or
perform secretarial duties.

Unit Fifteen – Urinary System Page 13 draft copy

 Medical Anatomy and Physiology

5. STUDENT ACTIVITIES FOR UNIT FIFTEEN – URINARY SYSTEM

WORKSHEET - The Urinary System

Name _____________________________________________________ Period _________

1. Identify three functions of the urinary system:

1.

2.

3.

2. Identify the four major structures of the urinary system and state their primary function:

1.

2.

3.

4.

3. Identify the three mechanisms of moving urine from the kidneys to the bladder
through the ureters:

1.

2.

3.

4. List the four tissue layers of the urinary bladder from the innermost layer to the most
(superficial) layer:

1.

2.

3.

4.

5. What is the name of the triangular area within the bladder between the openings of the
two ureters and the urethra: ________________________________________

Unit Fifteen – Urinary System Page 14 draft copy

 Medical Anatomy and Physiology

6. List three terms used to describe the elimination of urine from the bladder:
1.

2.

3.

7. Identify the protective layers of renal tissue from the layer next to the kidney to the most
outer (superficial) layer:

1.

2.

3.

8. The functional unit of the kidney is the .

9. What percentage of the blood filtered by the kidney gets eliminated from the body as
urine?

10. Identify the structures that make up the renal corpuscle:

11. Arrange the sections of the Renal Tubule from the proximal to distal regions:
( Collecting Duct, Loop Of Henle, Proximal Convoluted Tubule, Distal Convoluted
Tubule)

12. Identify and describe the three basic physiological process in urine formation:

1.

2.

13. The blood vessels surrounding the renal tubules that allow the processes of tubular
reabsorption and tubular secretion and excretion to occur are the ________________
__________________________________________________________________________

Unit Fifteen – Urinary System Page 15 draft copy

Medical Anatomy and Physiology

14. Identify the five physical characteristics of urine:

1.

2.

3.

4.

5.

15. All of the following are normal organic components of urine EXCEPT:

-Urea -Creatine
-Uric Acid -Hippuric Acid
-NaCl -Ketone Bodies

16. If the following abnormal constituents of urine were present in a routine urinalysis,
what would be the most likely cause.

Abnormal Constituent: Most Likely Cause:

1. Glucose

2. Erythrocytes

3. Leukocytes

4. Ketone Bodies

5. Microbes:

17. Match the diseases and abnormalities commonly associated with the urinary system with
the most appropriate description:

A. Incontinence B. Diabetes Insipidus C. Renal Ptosis

D. Urinary Tract Infections E. Cystitis F. Renal Failure
G. Nephrotic Syndrome H. Glomerulonephritis I. Kidney Stones
(Nephritis) (Bright’s Disease)

Unit Fifteen – Urinary System Page 16 draft copy

Medical Anatomy and Physiology

1. inflammation of the bladder usually occurring secondary to ascending urinary tract

infections.

2. polyuria and polydipsia caused by inadequate secretion of vasopressin (ADH) by the

posterior pituitary gland (Neurohypophysis).

3. a form of nephritis in which the lesions primarily involve the glomeruli.

4. the inability to retain urine, feces, or semen through the loss of sphincter control or
because of cerebral or spinal lesions.

5. calculus or crystalline masses present in the pelvis of the kidney composed primarily
of urates, oxalates, phosphates, and carbonates of varying size.

6. inflammation of the kidney including the glomeruli, renal tubules, and interstitial
tissue.

7. failure of the kidneys to perform their essential functions. Usually less than 10% of
total kidney function.

8. dropping or drooping of the kidney from its normal position.

9. infection of the urinary tract (kidneys, ureters, bladder, urethra) by microorganisms.

Unit Fifteen – Urinary System Page 17 draft copy

Medical Anatomy and Physiology

Unit Fifteen – Urinary System Page 18 draft copy