Urinary System: Quick

Review
 Review of Urinary Anatomy & Physiology

Located:
Under back muscles
Behind peritoneum
Thus: retroperitoneal
Below level of lowest ribs
Right lower than left
Adrenal gland on top of
kidney
Cortex
Medulla
Contains Pyramids &
Papilla
Pelvis
Calyx = division of pelvis
Pleural = calyces
 Bladder
Lined with transitional
epithelium
Can stretch
Lined with rugae
Trigone
On posterior wall
Where ureters & urethra
open
Rigid area with NO
rugae
Micturition (voiding,
urination)
Internal urinary
sphincter
Involuntary
External urinary
sphincter
Voluntary
Stretch receptors in
bladder wall
 Nephron = functional unit
Consists of:
Renal Corpuscle
Renal Tubules
Renal Corpuscle contains:
Bowmans capsule
Part of collecting
system
Glomerulus
Afferent arteriole
Efferent arteriole
Renal Tubules
1. Proximal convoluted
tubule
2. Loop of Henle
3. Distal convoluted tubule
4. Collecting tubule
 Key point:
The cortex
contains all the
structures of the
nephron

The medulla
contains only the
collecting ducts
& the loop of
Henle
 Functions of the kidney Urine formation
1. Removes nitrogenous 1. Filtration
wastes Occurs in renal
Urea corpuscle
Uric acid 2. Reabsorption
Creatinine Occurs in proximal
Ammonia convoluted tubule
Also occurs in distal
2. Maintains homeostasis convoluted tubule
Fluid balance
It takes things back into
Electrolyte balance
blood
Acid-base balance
3. Excretory Organ 3. Secretion
Via blood filtration &
Occurs in distal
formation of urine convoluted tubule
4. Regulation of Blood Blood gives things up to
the urine
Pressure
Juxtaglomerular 4. Concentration
apparatus Occurs in collecting
RAA system tubules
Renin
Angiotensin
Aldosterone See next slide
Some Key Points of Renal Physiology
Nitrogenous wastes primarily come from breakdown of proteins
Aging & renal function
By age 35, one begins to lose nephrons
By age 80, one has approx. 30% reduction in nephron capacity
GFR = glomerular filtration rate
Normal = 125cc/min (7500cc/hour)
99% of filtered product is reabsorbed
Normal urine output = 60cc/hour (1500cc/day)
All along the duct system water is reabsorbed
Includes the prox. conv. tubule, loop of Henle, distal conv. Tubule, & collecting
tubule
Sodium follows water
Key elements involved in each process
Reabsorption = H2O(Na), proteins (amino acids), & sugars (glucose)
Secretion = ions(K+), drugs, ammonia
Concentration = more reabsorption of H2O
 2 key factors determine volume of urine produces
1. Glomerular filtration rate (GFR)
Determined by the unique arrangment of
blood vessels
2. Hormonal secretion
Determined by fluid & electrolyte balance
 Volume of urine also controlled by glomerular filtration rate
Unique arrangment of blood vessels
Afferent arteriole -----to----capillary bed-----to----efferent arteriole
-----to-----capillary bed ----to---- veins
First capillary bed = glomerular capillaries
Second capillary bed = peritubular capillaries
Purpose of this = to control the pressure in the glomerular capillaries &
consequently the glomerular filtration pressure
3 factors control this:
(1) autoregulation
Local feedback from muscle tension in afferent arteriole
Local feedback from DCT at JGA
Mediated via endothelial
secretions of glomerular capillaries
(2) sympathetic nervous system
(3) renin
 B = increase fluid volume; overhydration; high output heart
failure
C = kidney pathology
D = hypertension; arteriolar spasm
 Hormones help control the volume of urine via fluid &
electrolyte balance
The concentration factor essentially deals with urine volume
Usually more the volume = more the dilution [a direct
proportion]
1. Aldosterone
From adrenal cortex
Works on distal convoluted tubule
Causes H2O & Na+ retention
2. Atrial natriuretic hormone(ANH)
From atrial wall of heart
Works on distal convoluted tubule
Works in opposition to aldosterone
Causes H2O & Na+ loss
3. Antidiuretic hormone
From posterior pituitary
Works on collecting tubules
Causes reabsorption of H2O (Na+ goes with it)