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The Urinary System Major Organs of the Urinary System • Kidneys- a pair of glandular organs which remove waste products from the blood to form urine. • Ureters-muscular tubes which convey urine from the kidneys to the urinary bladder. • Urinary Bladder-muscular sac which stores urine until micturation can occur. • Urethra-tubelike structure which conveys urine from the urinary bladder to outside the body. Kidneys Location: • Reddish brown bean shaped organ located retroperitoneally. • Imbedded in the parietal peritoneum of the abdominal cavity against the deep muscles of the back • Held in position by connective tissue (renal fascia) and surrounded by adipose tissue (renal fat) • Located between the 12th thoracic and 3rd lumbar vertebrae • The left kidney is usually 1-2 cm higher than the right. • It is encased in a tough fiberous capsule called the tunica fibrosa Structure of the kidney • Lateral surface is convex • Medial surface is concave • A medial depression is a hollow chamber called the renal sinus • The entrance to the sinus is called the hilum. • Thru it pass the blood vessels, nerves, lymphatic vessels and the ureter. • The superior end of the ureter is expanded to form a funnel shaped part called the renal pelvis. • The renal pelvis is divided into major calyces and further divided into minor calyces (calyx) Kidney Structure (cont) • There are several projections of kidney tissue into the renal sinus which form the kidney wall. • These projections are called the renal papilla and each are pierced by tiny openings into a minor calyx Kidney is divided into 2 regions: Medulla- inner portion composed of collecting ducts and loops of Henle , has a striated appearance Cortex-outer portion, composed of nephrons which give it a grainy appearance. Some of the cortex dips into the medulla to form columns. Renal Blood Vessels • Supplied by the renal artery. • Enters the kidney thru the hilum and breaks into smaller arteries called afferent arterioles. • Venous blood is returned in a series of veins and passes out of the kidney through the renal veins. The Nephron • Functional unit of the kidney • Some 1 million per kidney • This is where the waste products are removed from the blood. Composed of 2 parts: Renal corpuscle-composed of a tangled cluster of blood capillaries called the glomerulus. Renal Tubule-consists of a long tube that is surrounded by blood capillaries called the peritubular capillaries. • Leads away from Bowman’s capsule and becomes highly coiled and is called the PCT. (proximal convoluted tubule) Renal Tubule (cont) • This tubule then dips and rises again to form a loop called The Loop of Henle. • The tubule then becomes highly convoluted again to form the DCT. (distal convoluted tubule) • It is shorter and not as coiled as the PCT. • Several DCT’s merge to form a larger tube called a Collecting Duct. • Which passes into the renal medulla becoming larger and larger as it merges with other collecting ducts. Functions of the Nephron • Removal of waste substances from the blood. • Reabsorption of water and electrolyte concentrations. Blood Supply of the Nephron • The afferent arteriole supplies blood to the glomerulus. • Blood from the glomerulus leaves by way of the efferent arteriole. • The efferent arteriole then branches into a complex of freely anastomosing network of capillaries that surround the renal tubule called the peritubular capillary system. Urine Formation Urine is the end product of the kidneys: • Urine contains wastes, excess water, and excess electrolytes. Glomerular Filtration • The liquid forced from the glomerulus is actually blood plasma, once it enters Bowman’s capsule it is referred to as glomerular filtrate. • There are no large proteins or red blood cells in glomerular filtrate. • It contains: water, glucose, amino acids, urea, uric acid, sodium, chlorine, potassium, and calcium ions. Glomerular filtration • It is squeezed out of the glomerulus at a rate of 125/ml a min. • 180 liters a day or 45 gallons a day. • The entire content of blood plasma filters through the glomeruli about 60 times a day. • The nephrons of the kidneys make up 2 square meters of surface area about the size of the human skin. • The glomerulus filters this glomerular filtrate and Bowman’s capsule receives it. Tubular Reabsorption • The reabsorption into the blood of water, glucose, and electrolytes to maintain proper blood content of these substances. • PCT reabsorbs water by osmosis. • The passive transport of glucose, sodium, potassium, chlorine, and amino acids also occurs here. • Descending Loop of Henle active transport of sodium and chlorine occurs. • Ascending Loop of Henle active transport of chlorine and the subsequent passive transport of sodium. Tubular reabsorption (cont.) • DCT- active transport of water only. • This occurs in the presence of ADH (antidiuretic hormone) which increases the absorption of water. Tubular Secretion • The addition of materials to the glomerular filtrate from the blood. • This process provides 2 functions. 1. Controls the blood pH. 2. Rids the body of certain materials. Hydrogen and ammonia are secreted into the filtrate. Urine Composition Water -95% Other electrolytes 1% Urea- 2.5% Uric acid .3% Sodium chloride 1% Other substances .2% Urea is ammonia and carbon dioxide stuck together. Nitrogenous waste produced by protein catabolism. Uric acid can form insoluble crystals, components of kidney stones and cause gout. • These figures can vary depending on diet. Characteristics: Volume- urine production is 1-3 liters a day. pH- varies from 5.0-7.8 Elimination of Urine After being formed, urine passes from the collecting ducts thru openings in the renal papillae and enters the major calyces of the kidney. From there it passes thru thru the renal pelvis and is conveyed by the ureter to the urinary bladder. It is excreted outside the body via the urethra The Ureters Paired tubular organs 10 in. length Superior end is expanded to form a funnel shaped renal pelvis Inferior end joins the urinary bladder from underneath It conveys urine from the kidney to the urinary bladder. Composed of 3 layers 1. mucous coat- inner, transitional epith. 2. Muscular coat- smooth muscle, circular and longitudinal planes, peristalsis helps convey urine. 3. Fibrous coat- serous epithelium and connective tissue. Outer layer The Urinary Bladder • Hollow, distensible, muscular organ • Located within the pelvic cavity behind the pubic symphysis • In male, lies against the rectum posteriorly. • In female, contacts the anterior walls of the uterus and vagina. The bladder is somewhat spherical, when empty the inner wall is highly folded. • As it fills with urine the walls become smoother and it swells and extends upward into a dome. Urinary bladder • The floor of the bladder internally is called the trigone. • It has an opening at each of its angles. • The upper corners are the ureters and the lower corner is the urethra. Bladder wall consists of 4 layers: 1. Mucous coat-transitional epi., adapted for stretching and shrinking. 2. Submucous coat-connective tissue w/ lots of elastic fibers 3. Muscular coat-course bundles of smooth muscle in all planes • Detrusor muscle-contraction of this muscle forces urine out of the bladder. Parasympathetic control. 4. Serous coat-serous epithelium w/some fibrous connective tissue The Urethra Function- to convey urine from the urinary bladder to outside the body. • Lined w/mucous membrane and large amounts of smooth muscle. Contains many mucous glands. • In female, 1.6 to 2 in. in length • In male, around 8 in. in length, functions as both a urinary canal and as a passageway for cells and secretions of the male reproductive system. Divided into 3 segments: 1. Prostatic urethra- thru prostate gland. 2. Membranous urethra-external urethral sphincter located here. Controls urination 3. Penile urethra- thru the penis, exits the body thru the external urethral orifice Micturation • Process by which urine is expelled from the urinary bladder. • It involves the contraction of the detrusor muscle and is aided by the contraction of the abdominal muscles. • Relaxation of the ext. urethral sphincter voluntary • The need to urinate is stimulated by distention of the bladder as it fills with urine. • Micturation reflex center located in the sacral segments of the spinal cord. • Reflex can be overridden by parts of the cerebral cortex and midbrain. 3-4 yrs of age. Potty training • Hypothalamus and pons may assist in this. • Bladder may hold up to 800-1000ml need to urinate at 150ml. feeling uncomfortable at 300ml. Disorders and Diseases of the Urinary Tract Nephritis- inflammation of the nephron. • Glomerular- glomerulus • Pylenonephritis- inflammation of the renal pelvis • Proteinuria, glycosuria, hematuria Gout- uric acid crystals form in the joints. arthritis, swelling, pain in lower extremities. Hemodialysis- machine removes waste products from the blood. Takes the place of healthy kidneys. Has to be done every 3 days or so. Renal Caliculi (Kidney Stones) • Caused by uric acid combining with calcium oxalates, calcium phosphate, or magnesium phosphate which form crystals within collecting ducts, renal pelvis or ureter. • This blocks the flow of urine, backing up the system decreasing urine production. • If stone passes into the ureter it may stimulate severe pain. Which usually begins in the region of the kidney and tends to radiate to the pelvis or legs, or groin. Lithotripsy Medical procedure used to break up kidney stones by bombarding them with ultrasound waves or a blast of ultra sound. UTI (urinary tract infection) • More common in women that men due to the shortness of the urethra. • Usually a streptococcus or E. coliform bacteria.