Human Anatomy,

McKinley & O'Loughlin

First Edition

Chapter 27 : Urinary System

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General Structure and Functions of the Urinary System

General Concept:

Waste products accumulate in blood Are toxic Must be removed to maintain homeostasis Urinary System organs

remove waste products from the blood then from the body

Major homeostatic system

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General Structure and Functions of the Urinary System

Organs of the Urinary System:

Kidneys Ureters Urinary Bladder Urethra filter waste products from the bloodstream convert the filtrate into urine.

Primary organs: kidneys

The Urinary Tract:

Includes:

ureters urinary bladder urethra

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Because they transport the urine out of the body.

Functions of the Urinary System

Removing waste products from the bloodstream. Storage of urine. the urinary bladder is an expandable, muscular sac that can store as much as 1 liter of urine Excretion of urine. Blood volume regulation. the kidneys control the volume of interstitial fluid and blood under the direction of certain hormones Regulation of erythrocyte production. as the kidneys filter the blood, they are also indirectly measuring the oxygen level in the blood Erythropoietin (EPO): hormone produced by kidney

Released if blood oxygen levels fall Stimulates RBC production in red bone marrow
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Kidneys: Gross and Sectional Anatomy

Retroperitoneal

Anterior surface covered with peritoneum Posterior surface against posterior abdominal wall

Superior pole: T-12 Inferior pole: L-3 Right kidney ~ 2cm lower than left Adrenal gland on superior pole
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Kidneys: Gross and Sectional Anatomy

Hilum: concave medial border Renal sinus: internal space

Houses blood vessels, lymphatic vessels, nerves Houses renal pelvis, renal calyces Also fat

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Kidneys: Gross and Sectional Anatomy

Surrounding tissues, from deep to superficial:

Fibrous capsule (renal capsule)

Dense irregular CT Covers outer surface Also called perirenal fat Completely surrounds kidney Cushioning and insulation Dense irregular CT Anchors kidney to posterior wall and peritoneum Between renal fascia and peritoneum
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Perinephric fat (adipose capsule)

Renal fascia

Paranephric fat

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Kidneys: Gross and Sectional Anatomy

Sectioned on a coronal plane:

Renal Cortex

Renal arches Renal columns Divided into renal pyramids 8 to 15 per kidney Base against cortex Apex called renal papilla
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Renal Medulla

Kidneys: Gross and Sectional Anatomy

Minor calyx:

Major calyx

Funnel shaped Receives renal papilla 8 to 15 per kidney, one per pyramid
Fusion of minor calyces 2 to 3 per kidney

Major calyces merge to form renal pelvis Renal Lobe

Pyramid plus some cortical tissue 8 to 15 per kidney

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Blood Supply to the Kidney

About 20 to 25% of cardiac output to kidneys Path:

Renal artery to segmental arteries to interlobar arteries to arcuate arteries to interlobular arteries to: Afferent arteriole to glomerulus to efferent arteriole to peritubular capilaries and vasa recta
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Blood Supply to the Kidney

Blood plasma is filtered across the glomerulus into the glomerular space. Once the blood plasma is filtered

blood leaves the glomerulus enters an efferent arteriole.

efferent arteriole is still carrying oxygenated blood

a gas and nutrient exchange with the kidney tissues has not yet occurred.
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Blood Supply to the Kidney

The efferent arterioles branch into one of two types of capillary networks: peritubular capillaries vasa recta these capillary networks are responsible for the actual exchange of gases and nutrients Peritubular capillaries: primarily in cortex Vasa recta: surround the thin tubes that project into the medulla.
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Blood Supply to the Kidney

Path for veins:

Interlobar veins to arcuate veins to interlobar veins to the renal vein

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Nephrons

The functional filtration unit in the kidney. Consists of the following:

Renal corpuscle

Proximal convoluted tubule (PCT) Nephron loop (loop of Henle)

Glomerulus Glomerular capsule (Bowmans capsule)

In both kidneys: approximately 2.5 million nephrons. Are microscopic: measure about 5 centimeters in length.
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Distal convoluted tubule (DCT) collectively called the renal tubule

Ascending loop of Henle Descending loop of Henle

Nephrons

Cortical Nephrons

Near peripheral edge of cortex Short nephron loops Have peritubular capillaries Near corticomedullary border Long nephron loops Have vasa recta
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Juxtamedullary nephrons

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Urine Formation

Three processes Filtration

Renal corpuscle: forms filtrate From blood to tubule Mostly PCT Water and salt: rest of nephron From tubule to blood From blood to tubule
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Reabsorption

Secretion

Renal Corpuscle

Vascular pole

Afferent and efferent arterioles Connects to PCT Glomerulus and glomerular capsule Capillary bed High pressure fenestrations
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Tubular pole

Two structures:

Glomerulus

Renal Corpuscle

Glomerular Capsule

Parietal layer

Simple squamous epithelium Podocytes

Visceral layer

Pedicels Filtration slits

Capsular space (Bowmans capsule): location of filtrate Filtration membrane

Fenestrations Filtration slits

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Proximal Convoluted Tubule

Begins at tubular pole of the renal corpuscle. Cells: simple cuboidal epithelium

actively reabsorb from the filtrate:

Osmosis: reabsorption of 60% to 65% of the water in filtrate. Have microvilli moved into blood plasma via the peritubular capillaries.
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almost all nutrients (glucose and amino acids) electrolytes plasma proteins

Solutes and water:

Nephron Loop (loop of Henle)

originates at end of proximal convoluted tubule projects toward and/or into the medulla. Each loop has two limbs.

descending limb:

from cortex toward and/or into the medulla returns back to the renal cortex

ascending limb:

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Distal Convoluted Tubule

begins at the end of the thick ascending limb of the nephron loop

adjacent to the afferent arteriole (important physiologically)

Juxtaglomerular apparatus.

primary function:

Secretion From blood plasma to filtrate. secretes ions

Reabsorption of water also occurs:

potassium (K+) acid (H+)

influenced by two hormones

Aldosterone antidiuretic hormone (ADH).

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Collecting Collecting Ducts

Function in a well hydrated person:

transport the tubular fluid into the papillary duct and then into the minor calyx.
water conservation more-concentrated urine is produced. Cells become permeable to water Water moves from filtrate into blood plasma Involves vasa recta.

Function in a dehydrated person:

ADH can act on the collecting duct epithelium

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Innervation of the Kidney

innervated by a mass of autonomic nervous system fibers

called the renal plexus. accompanies each renal artery enters the kidney through the hilum.

The renal plexus

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Urinary Tract : Ureters

long, fibromuscular tubes conduct urine from the kidneys to the urinary bladder. average 25 centimeters in length retroperitoneal. ureters originate at the renal pelvis extend inferiorly to enter the posterolateral wall of the base of the urinary bladder. wall is composed of three concentric tunics.

mucosa muscularis adventitia.

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Urinary Tract Urinary Bladder

The urinary bladder:

positioned immediately superior and posterior to the pubic symphysis. in females

expandable, muscular container serves as a reservoir for urine

in males

the urinary bladder is in contact with the uterus posterosuperiorly and with the vagina posteroinferiorly. it is in contact with the rectum posterosuperiorly and is immediately superior to the prostate gland.

is a retroperitoneal organ. when empty exhibits an upside-down pyramidal shape. Filling with urine distends it superiorly until it assumes an oval shape.
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Urinary Tract Urinary Bladder

Trigone

posteroinferior triangular area of the urinary bladder wall formed by imaginary lines
connect the two posterior ureteral openings and the anterior urethral opening.

The trigone remains immovable as the urinary bladder fills and evacuates. It functions as a funnel

four tunics

directs urine into the urethra as the bladder wall contracts mucosa submucosa Muscularis: called the detrusor muscle adventitia.

Internal urethral sphincter (smooth muscle)

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Micturition (Urination)

The expulsion of urine from the bladder. Initiated by a complex sequence of events called the micturition reflex. The bladder is supplied by both parasympathetic and sympathetic nerve fibers of the autonomic nervous system.

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Urethra

Fibromuscular tube

conducts urine to the exterior of the body. Tunica mucosa: is a protective mucous membrane

exits the urinary bladder through the urethral opening at anteroinferior surface

Tunica muscularis: primarily smooth muscle fibers

houses clusters of mucin-producing cells called urethral glands.

help propel urine to the outside of the body. Internal urethral sphincter

Two urethral sphincters:

External urethral sphincter

restrict the release of urine until the pressure within the urinary bladder is high enough and voluntary activities needed to release the urine are 27-45 activated.

Urethra

The internal urethral sphincter

The external urethral sphincter

involuntary (smooth muscle) superior sphincter surrounding the neck of the bladder, where the urethra originates. a circular thickening of the detrusor muscle controlled by the autonomic nervous system
inferior to the internal urethral sphincter formed by skeletal muscle fibers of the urogenital diaphragm. a voluntary sphincter controlled by the somatic nervous system this is the muscle children learn to control when they become toilet-trained
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Female Urethra

Has a single function:

to transport urine from the urinary bladder to the vestibule, an external space immediately internal to the labia minora

3 to 5 centimeters long, and opens to the outside of the body at the external urethral orifice located in the female perineum.

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Male Urethra

Urinary and reproductive functions: passageway for both urine and semen Approximately 18 to 20 centimeters long. Partitioned into three segments:

prostatic urethra is approximately 3 to 4 centimeters long and is the most dilatable portion of the urethra extends through the prostate gland, immediately inferior to the male bladder, where multiple small prostatic ducts enter it membranous urethra is the shortest and least dilatable portion extends from the inferior surface of the prostate gland through the urogenital diaphragm spongy urethra is the longest part (15 centimeters) encased within a cylinder of erectile tissue in the penis called the corpus spongiosum extends to the external urethral orifice

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Aging and the Urinary System

Changes in the size and functioning of the kidneys begin at 30. Gradual reduction in kidney size. Reduced blood flow to the kidneys. Decrease in the number of functional nephrons. Reabsorption and secretion are reduced. Diminished ability to filter and cleanse the blood. Less aldosterone or antidiuretic hormone. Ability to control blood volume and blood pressure is reduced. Bladder decreases in size. More frequent urination. Control of the urethral sphinctersand micturitionmay be lost.

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