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Chapter 15 The Urinary System Functions of the Urinary System Elimination of waste products Nitrogenous wastes Toxins Drugs Regulate aspects of homeostasis Volume and chemical makeup of the blood Water and electrolyte balance Acid-base balance in the blood Produce hormones Renin: regulates blood pressure and kidney function Erythropoietin: red blood cell production Organs of the Urinary system Kidneys Filters about 200 liters of fluid daily (47 gallons!) Major excretory organs Ureters Transport urine from kidneys to bladder Urinary bladder Temporary storage reservoir for urine Urethra Transports urine from bladder to the external environment Location of the Kidneys Bean-shaped organ Lies in the superior lumbar region Extends from T12 to L3 Right kidney is slightly lower than the left Average dimensions (about the size of a bar of soap) 12 cm long; 6 cm wide; 3 cm thick Lateral surface is convex Medial surface is concave Renal hilum The ureter, blood vessels, lymphatic vessels and nerves all join the kidney here Atop each kidney is an adrenal gland Regions of the Kidney Renal cortex Outer region Renal medulla Inside the cortex Exhibit medullary pyramids Renal columns separate the pyramids Renal pelvis Inner funnel-shaped tube Continuous with the ureter leaving the hilum Figure 15.2b Kidney Structures Medullary pyramids Triangular regions of tissue in the medulla Calyces Cup-shaped structures that collect urine from the medullary pyramids and empty it into the renal pelvis Major calyces and minor calyces Blood Flow in the Kidneys As each renal artery approaches a kidney, it divides into five segmental arteries Each segmental artery branches further to form lobar arteries and then interlobar arteries The interlobar arteries branch into the arcuate arteries that arch over the bases of the medullary pyramids Small interlobular arteries radiate outward from the arcuate arteries to supply the cortical tissue Afferent arterioles branching from the interlobular arteries turn into microscopic blood vessels called the glomerulus, which is the key element of kidney function Blood Flow in the Kidneys Veins trace the pathway of arterial supply in reverse Blood leaving the renal cortex (efferent arteriole) drains into the interlobular veins, arcuate veins, interlobar vein and then renal vein(notice no segmental veins) and then the renal vein empties into the inferior vena cava Blood Flow in the Kidneys Nephrons The structural and functional units of the kidneys Kidneys contains over 1 million of these tiny blood-processing units Responsible for forming urine Each nephron consists of a glomerulus (capillaries) and renal tubule The renal tubule has a cup-shaped end called the glomerular capsule or Bowman’s capsule Glomerulus A specialized capillary bed Attached to arterioles on both sides (maintains high pressure) Large afferent arteriole Narrow efferent arteriole Endothelium of the capillaries is very porous This allows large amounts of solute-rich, protein free fluid to pass from the blood to the glomerular capsule Filtrate contains everything found in blood plasma except proteins Urine contains mostly metabolic wastes and unneeded substances Figure 15.3c Renal Tubule Four parts to the renal tubules Glomerular (Bowman’s) capsule Proximal convoluted tubule (PCT) Walls are cuboidal epithelial cells with dense microvilli Increases the surface area to reabsorb water and solutes from the filtrate Loop of Henle Descending end walls are similar to PCT Distal convoluted tubule (DCT) Empties into a collecting duct The length enhances its filtrate processing capabilities Figure 15.3b Renal Tubule Collecting ducts Receive filtrate from many nephrons Run through the medullary pyramids As they reach the renal pelvis, a couple fuse together and deliver urine into the minor calyces Figure 15.3b Nephron Capillary Beds The renal tubule of every nephron is closely associated with two capillary beds Glomerulus Produces the filtrate Peritubular capillaries Reclaims most of the filtrate Nephron Capillary Beds Glomerulus is specialized for filtration Blood pressure in glomerulus is extremely high to easily force fluids and solutes out of the blood Afferent arteriole is feeding the glomerulus and it is larger in diameter than the efferent arteriole draining the bed Between the blood and glomerular capsule lies a filtration membrane Porous membrane that allows free passage of all plasma components (water and solutes) but not blood cells Nephron Capillary Beds Peritubular capillaries Arise from efferent arteriole of the glomerulus Cling close to the renal tubule and empty into nearby venules Normal, low pressure capillaries Readily absorb solutes and water from collecting tubes Most of the resulting filtrate (99%) is reabsorbed by the renal tubule and returned to the blood in the peritubular capillaries Kidney Physiology: Urine Formation A: Interlobular artery F: Proximal convoluted tubule B: Afferent arteriole G: Loop of Henle C: Efferent arteriole H: Distal convoluted tubule D: Bowman’s (glomerular) capsule I: Collecting Duct E: Glomerulus Kidney Physiology: Urine Formation The total plasma filters into the renal tubules about every 22 minutes All of our plasma would be drained away as urine in less than 30 minutes were it not for the fact that most of the tubule contents are quickly reclaimed and returned to the blood Kidney Physiology: Urine Formation 1. Renal artery brings blood into each kidney. 2. Blood vessels branch off the main artery until they form the glomerulus (specialized capillary bed) 3. Water and other small substances such as glucose, salts, amino acids and urea are filtered out of the glomerulus and into the Bowman’s capsule. 4. As the filtrate flows through the renal tubule (PCT, loop of Henle and DCT) most of the water and nutrients are reabsorbed back into the peritubular capillaries that wrap around the nephrons. 5. Some materials are secreted back into the tubules from the blood. 6. The cleaned blood, which has slightly less water and much less waste material, leaves each kidney in the renal vein to the inferior vena cava. 7. The yellow fluid that remains in the tubule is called urine. 8. Urine leaves each kidney through the ureter and flows into the urinary bladder, where urine is stored. Kidney Physiology: Urine Formation • Pathway of Urine • Bowman’s capsule (filtrate)Proximal convoluted tubule (filtrate) loop of Henle (filtrate) distal convoluted tubule (filtrate) collecting duct (urine) minor calyces (urine) major calyces (urine) ureter (urine) bladder (urine) urethra(urine) Kidney Physiology: Urine Formation Kidneys form urine in the nephrons and adjust the blood composition with three major processes Glomerular filtration (#1) Dump filtrate into renal tubules Filters about 200 L daily and only 1.5L leaves the body as urine Tubular reabsorption (#2) Kidneys reclaim what the body needs Almost all the filtrate (99%) Water, salt, glucose and amino acids Not reabsorbed is uric acid, creatinine, urea Anything not reabsorbed becomes urine Tubular secretion (#3) Fine-tuning the body’s chemical balance Kidney Physiology: Urine Formation Step 1: Glomerular Filtration Passive, nonselective process Glomerular blood pressure is extremely high Pressure forces fluids and solutes through a membrane Small molecules such as water, salts, bicarbonate, hydrogen ions, urea, glucose, amino acids and some drugs Blood cells and large molecules cannot pass through the wall Kidney Physiology: Urine Formation Step 2: Tubular Reabsorption Selective process Begins as soon as the filtrate enters the proximal tubules Most organic nutrients are completely reabsorbed Hormones regulate the reabsorption of water and many ions Depending on substances transported, the reabsorption can be passive or active Sodium ions are the single most abundant cation in the filtrate Kidney Physiology: Urine Formation Step 2: Tubular Reabsorption Reabsorptive abilities of regions of the renal tubules Proximal convoluted tubule (PCT) Most active reabsorbing area Sodium (Na+), bicarbonate (HCO3-), chlorine (Cl-) and water Loop of Henle Water is salts are reabsorbed Vital role in kidneys ability to form dilute or concentrated urine Distal convoluted tubule (DCT) NaCl and water Most reabsorption at this time depends on the body’s needs Kidney Physiology: Urine Formation Step 2: Tubular Reabsorption Regulated by hormones Aldosterone Released when blood pressure decreases or Na+ concentration drops Antidiuretic hormone (ADH) Reabsorption of water Kidney Physiology: Urine Formation Step 3: Tubular Secretion Substances such as H+, NH4+, creatinine, organic acids move from the capillaries into the renal tubule Important for disposing substances, such as drugs or poisons that can not be filtered Eliminates undesirable substances or end products that have been reabsorbed by passive processes like urea and uric acid Physical Characteristics of Urine Color Clear to deep yellow Yellow color is due to the pigment urochrome (from the destruction of hemoglobin) More concentrated the urine, the deeper the yellow color An abnormal color such as pink or brown may result from eating certain foods (beets, rhubarb), the presence of bile pigments or blood, or from some commonly prescribed drugs and vitamins Cloudy urine may indicated a urinary tract infection Odor Slightly aromatic If allowed to stand, it develops an ammonia odor as bacteria metabolize its urea solutes Physical Characteristics of Urine pH Slightly acidic (around pH 6) Acidic diet that contains large amounts of protein and whole wheat products, diabetes mellitus and starvation produces acidic urine Vegetarian diet, prolonged vomiting, and bacterial infection of the urinary tract all can cause the urine to become alkaline Specific gravity Ratio of the mass of a substance to the mass of an equal volume of distilled water Urine is water plus solutes Distilled water specific gravity is 1.00 Urine specific gravity ranges from 1.001 to 1.035 depending on its solutes Chemical Composition of Urine Urine is 95% water and 5% solutes Solutes Urea (largest component) Uric acid Derived from the normal breakdown of amino acids End product of nucleic acid metabolism Creatinine Metabolite for creatinine phosphate which stores energy for the regeneration of ATP Normal solute concentrations in urine from high to low Urea sodium potassium phosphate sulfate creatinine uric acid Chemical Composition of Urine Abnormal Urinary Constituents Glucose (glycosuria) Benedict’s solution and heat Causes: diabetes mellitus Proteins (proteinuria) Biuret’s solution Causes: Non-pathological: excessive physical exertion, pregnancy, high-protein diet; Pathological: heart failure, severe hypertension, renal disease Chemical Composition of Urine Abnormal Urinary Constituents Hemoglobin (hemoglobinuria) Causes: transfusion reaction, hemolytic anemia, severe burns, etc. Bile pigments (bilirubinuria) Causes: liver disease (hepatitis, cirrhosis) Erythrocytes (hematuria) Causes: bleeding (due to trauma, kidney stones, or infection) Leukocytes (pyuria) Causes: urinary tract infection Ureters Slender tubes that carry urine from the kidneys to the bladder Composed of transitional epithelium Peristalsis aids gravity in urine transport Homeostatic Imbalance Kidney stones Calcium, magnesium, or uric acid salts in urine may crystallize and precipitate in the renal pelvis Most are under 5 mm in diameter and pass through the urinary tract without causing problems Larger stones can obstruct a ureter and block urine drainage Increasing pressure in the kidney causes excruciating pain Treatment includes shock wave lithiotripsy a noninvasive procedure that uses ultrasonic shock waves to shatter the stone Urinary Bladder Smooth, collapsible, muscular sac that temporarily stores urine Located on the pelvic floor just posterior to the pubic symphysis Interior has three openings called trigone Two from the ureters One to the urethra Urinary Bladder When empty, the bladder collapses and its walls are thick and have folds (rugae) Bladder can expand significantly A full bladder is about 12 cm (5 inches) long and holds approximately 500 mL (1 pint) of urine, but it can hold nearly double that if necessary Maximum capacity of the bladder is 800-1000 mL and when it is overdistended, it may burst Urine is formed continuously by the kidneys but it is stored in the bladder until it is convenient to release Urethra Thin-walled muscular tube that drains urine from the bladder to the outside of the body Release of urine (micturition or voiding)is controlled by two sphincters Internal urethral sphincter (involuntary) External urethral sphincter (voluntary) Urethra Gender Differences Length and function of the urethra differ in the two sexes Females Length: only 3–4 cm (1.5 inches) Function: carries only urine out of the body Males Length: Urethra is 20 cm (8 inches) long Double function: carries semen and urine out of the body Maintaining Water Balance Normal amount of water in the human body Young adult females – 50% because more body fat Young adult males – 60% because more muscles Babies – 75% because of low body fat and low bone mass Old age – 45% Water is necessary for many body functions and levels must be maintained Distribution of Body Fluid Total body water volume is 40 L or 60% of body weight Water occupies two main fluid compartments within the body Intracellular fluid (inside cells) About 25 L or 40% body weight Extracellular fluid (outside cells) About 15 L or 20% body weight Divided into two subcompartments Interstitial fluid (fluid in the microscopic spaces between tissue cells) Blood plasma (fluid portion of blodd) Composition of Body Fluids Water is the universal solvent in which a variety of solutes are dissolved Solutes can be classified into electrolytes and nonelectrolytes Nonelectrolytes have bonds and cannot dissociate in solution Organic molecules such as glucose, lipids, creatinine and urea Electrolytes are chemical compounds that do dissociated into ions in water Inorganic and organic acids and bases and some proteins Have the greatest ability to make fluid shifts down their gradients Most abundant solutes in body fluids Extracellular fluids have high sodium and chloride ions Intracellular fluids contains only small amounts of sodium and chloride ions; its most abundant cation is potassium anion is phosphate (HPO42) as well as high amounts of proteins Fluid Moving Among Compartments Continuous exchange and mixing of fluids are regulated by osmotic and hydrostatic pressures Water moves freely between the compartments along osmotic gradients Solutes are unequally distributed because of their size, electrical charge, or dependence on transport proteins Changes in electrolyte balance causes water to move from one compartment to another Maintaining Water Balance Body must remain properly hydrated water intake must equal water output Water intake is typically about 2500 mL a day in adults Water enters the body through ingested liquids (60%), solid foods (30%) and produced from metabolic processes (10% Water output occurs by several routes Vaporization out of the lungs and skin (28%) Perspiration of skin (8%) Leaves the body in the feces (4%) The balance (about 60%) is excreted by the kidneys in urine Maintaining Water Balance A rise in plasma concentration causes thirst (prompts us to drink water) and release of antidiuretic hormone (ADH) which causes the kidneys to conserve water and excrete concentrated urine A decline in plasma concentration inhibits thirst and ADH release and causes output of large volumes of dilute urine Regulation of Water Water intake is controlled by the thirst mechanism An increase in plasma concentrations A dry mouth occurs Less saliva production Decrease in blood pressure Water Output of certain amounts of water is unavoidable Reason why we cannot live without drinking Solute concentration and volume of urine excreted depend on fluid intake, diet and water loss via other avenues Regulation is primarily by hormones Antidiuretic hormone (ADH) prevents excessive water loss in urine Aldosterone regulates sodium ion content of extracellular fluid Osmoreceptor cells in the kidneys are active monitors Regulation of Water Dehydration When water output exceeds intake over a period of time and the body is in negative fluid balance Commonly follows hemorrhage, severe burns, prolonged vomiting or diarrhea, profuse sweating, and diuretic abuse Signs are sticky oral mucosa, thirst, dry flushed skin, and decreased water output (oliguria) Electrolyte Balance Refers to the salt balance in the body Important in controlling fluid movements and crucial for cellular activity Salts enter the body in foods and fluids Salts are lost from the body in perspiration, feces and urine Sodium holds a central position in fluid and electrolyte balance and overall body homeostasis Water follows salt A change in plasma sodium levels affects not only plasma volume and blood pressure but also the ICF and IF volumes Regulation is linked to blood pressure and aldosterone When aldosterone is high all the sodium is reabsorbed in the DCT Water follows sodium and maintains blood pressure When aldosterone is inhibited none of the sodium is reabsorbed Goal of aldosterone is to decrease urinary output and increase blood volume Acid-Base Balance All biochemical reactions are influenced by the pH of their fluid environment The acid-base balance of body fluids is closely regulated pH measures the amount of H+ ions in solution Acids are proton donors Blood normally ranges between pH 7.35 and pH 7.45 If the pH rises above 7.45 a person has alkalosis If the pH drops below 7.35 a person has acidosis H+ concentration regulation Chemical buffers resist changes within a fraction of a second Respiratory rate changes within 1-3 minutes Kidneys requires hours to a day to effect changes in blood pH Acid-Base Balance Respiratory acidosis Most common cause of acid-base imbalance Caused when a person breathes shallow or when gas exchange is hampered by diseases CO2 accumulates in the blood and causes the pH to fall Respiratory alkalosis Results from carbon dioxide being eliminated faster than it is produced otherwise known as hyperventilation Metabolic acidosis Second most common cause of acid-base imbalance Low blood pH and HCO3- levels Caused when a person ingests too much alcohol and excessive loss of HCO3- as a result of excessive diarrhea Metabolic alkalosis Rising blood pH and HCO3- levels Caused by vomiting and intake of excess base Acid-Base Balance Effects of acidosis and alkalosis Absolute blood pH limits for life are a low of 7.0 and a high of 7.8 When the pH falls below 7.0 the CNS is so depressed that the person goes into coma and death When blood pH rises above 7.8, the nervous system is overexcited and leads to muscle spasms, extreme nervousness, and convulsions; death usually results from respiratory arrest