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McKinley/O’Loughlin Human Anatomy, 2nd Edition CHAPTER 27 Answers to “What Did You Learn?” 1. The organs of the urinary system are the kidneys, ureters, urinary bladder, and urethra. Urinary system organs function to filter waste products from the bloodstream, convert the filtrate into urine, and transport the urine out of the body. 2. The kidneys control blood volume under the direction of specific hormones, and they help regulate erythrocyte production by secreting the hormone erythropoietin if blood oxygen levels decrease. The erythropoietin stimulates stem cells in the bone marrow to increase erythrocyte production. 3. The renal cortex is located immediately internal to the kidney’s lateral border, and the renal medulla is located immediately internal to the renal cortex. 4. The right kidney is positioned about 2 centimeters inferior to the left kidney because of the large size of the right lobe of the liver. 5. The renal corpuscles of juxtamedullary nephrons lie adjacent to the corticomedullary junction, and their relatively long nephron loops extend deep into the medulla. The renal corpuscles of cortical nephrons are near the peripheral edge of the cortex, and their relatively short nephron loops barely penetrate the medulla. 6. Filtration is the process by which water and some dissolved solutes in the blood plasma passively move out of blood vessels into the glomerular space. Reabsorption occurs when substances originally appearing in the filtrate move by diffusion or active transport ot of the nephron back into the blood. McKinley/O’Loughlin 7. Human Anatomy, 2nd Edition The components of a nephron are the renal corpuscle, composed of a glomerulus and a glomerular capsule, and the renal tubule, composed of the proximal convoluted tubule, the nephron loop, and the distal convoluted tubule. The filtrate is produced in the renal corpuscle. As it flows through renal tubule the filtrate is modified by the diffusion and active transport of substances across the walls of the renal tubule back into the blood in the process of tubular reabsorption. Once modification of the filtrate begins, it is called tubular fluid. The tubular fluid is also modified by tubular secretion, which is the active transport of solutes out of the blood into the tubular fluid. 8. The posterior pituitary secretes antidiuretic hormone (ADH) as a consequence of dehydration. ADH secretion results in decreased water loss in urine by acting on the collecting duct epithelium to make it more able to absorb water from the tubular fluid. Thus, the urine becomes more concentrated. 9. The juxtaglomerular apparatus consists of juxtaglomerular cells and the macula densa. The juxtaglomerular cells are modified smooth muscle cells in the wall of the afferent arteriole. The macula densa cells are modified epithelial cells that line the distal convoluted tubule at the point of contact between the afferent arteriole and the distal convoluted tubule. The juxtaglomerular apparatus continuously monitors the fluid electrolyte concentration in the distal convoluted tubule (by macula densa cells). Under conditions that reduce blood volume or solute concentration, the macula densa cells stimulate the juxtaglomerular cells to release renin. Ultimately aldosterone is produced, which increases blood electrolyte concentrations and blood volume. McKinley/O’Loughlin 10. Human Anatomy, 2nd Edition The middle tunic of the ureter is called the muscularis. It consists of an inner longitudinal and an outer circular layer of smooth muscle fibers. Additionally, the smooth muscle in the inferior one-third of the ureter consists of another outer longitudinal layer of smooth muscle. These muscle layers produce peristaltic waves that proceed along the length of the ureter from the kidney toward the urinary bladder. 11. The ureters are innervated by both sympathetic fibers from the T11-L2 segments of the spinal cord, and parasympathetic fibers from CN X and the pelvic splanchnic nerves. 12. The trigone is a posteroinferior triangular area of the urinary bladder wall. It is formed by imaginary lines connecting the two posterior ureteral openings and the anterior urethral opening. Because the trigone remains immovable during shape changes as the urinary bladder fills and evacuates, it funnels urine into the urethra as the bladder wall contracts to evacuate the stored urine. 13. The initiating stimulus in the micturition reflex is the filling of the bladder with urine resulting in the distension of its wall and subsequent activation of stretch receptors. 14. The shortest and least distensible part of the male urethra is the membranous urethra, which extends from the inferior surface of the prostate gland through the urogenital diaphragm. 15. Structural changes in the kidneys affect urine production. With age, a gradual reduction in kidney size accompanies both a reduction in blood flow to the kidneys and a decrease in the number of functional nephrons in the kidney. These McKinley/O’Loughlin Human Anatomy, 2nd Edition changes lead to reduced functional capability. Reduced blood flow also contributes to a decreased glomerular filtration rate; consequently, both reabsorption and secretion are reduced. The loss of nephrons results in diminished ability to filter and cleanse the blood. Additionally, the possibility of incontinence (the inability to control the passage of urine) increases with age. 16. The urinary bladder, urethra, rectum, and anal canal are formed by the cloaca. Answers to “Content Review” 1. The urinary system filters water and waste from the blood plasma; it stores some water and waste products as urine until the body is ready to expel the urine; it excretes the urine from the bladder to outside the body; it helps maintain blood volume by preventing excess water loss; and it is responsible for regulating erythrocyte production. 2. Several layers of connective tissue coverings surround the kidneys. An external, fibrous capsule covers the outer surface of the kidney. It maintains kidney shape, protects the kidney from trauma, and helps prevent the spread of infectious pathogens. The perinephric fat (adipose capsule) is external to the fibrous capsule and completely surrounds the kidney to offer cushioning and insulation. The renal fascia is external to the perinephric fat. It anchors the kidney to the posterior abdominal wall and the peritoneum. The paranephric fat is the outermost layer that surrounds the kidney. It is composed of adipose connective tissue and lies between the renal fascia and the peritoneum. McKinley/O’Loughlin 3. Human Anatomy, 2nd Edition Blood is carried to a kidney within a renal artery. Up to five segmental (lobar) arteries branch from the renal artery within the renal sinus. Thereafter, the branching of arteries results in the interlobar arteries, the arcuate arteries, the interlobular arteries, the afferent arterioles, the glomerulus, the efferent arteriole, both the peritubular capillaries and the vasa recta, which drain into the interlobular veins, the arcuate veins, the interlobar veins, and the renal vein. Note that the efferent arteriole is still carrying blood high in oxygen. Gas and nutrient exchange for the tissues in the kidney has not yet occurred. The blood in all arteries, the arterioles, the glomerulus, the peritubular capillaries and the vasa recta is high in oxygen. The blood in all veins is low in oxygen. The peritubular and vasa recta capillary networks are responsible for the actual gas and nutrient exchange, and picking up reabsorbed materials. 4. The glomerulus is a tuft or thick tangle of fenestrated capillaries within an epithelial capsule, which together form the renal corpuscle. The visceral layer of the capsule lies directly on the surface of the glomerular capillaries. It is composed of specialized cells called podocytes that have long processes called pedicels (feet). Pedicels are separated by filtration slits. The filtration slits of the podocytes and the fenestrated glomerulus endothelium compose the filtration membrane. It is capable of selectively filtering materials from the blood. 5. The proximal convoluted tubule is lined by a simple cuboidal epithelium with tall microvilli on its apical (luminal) surface to markedly increase its reabsorption capacity. Most of the reabsorption occurs in the proximal convoluted tubules, McKinley/O’Loughlin Human Anatomy, 2nd Edition thus this apical surface modification is not required elsewhere in the nephron, such as in the distal convoluted tubule. 6. The structures of the juxtaglomerular apparatus work together to help regulate blood pressure. The macula densa cells continuously monitor electrolyte concentration in tubular fluid. If either blood volume or solute concentration is reduced, the macula densa cells detect this change and stimulate the juxtaglomerular cells to release renin. Recall from chapter 20, the renin activates the renin-angiotensin pathway resulting in the production of aldosterone (see also chapter 20) that causes electrolyte concentrations to increase in the blood and a blood volume increase to restore normal rates of filtration. 7. The ureters project through the bladder wall obliquely, consequently the ureteral walls are compressed as the bladder distends. This decreases the likelihood of urine refluxing into the ureters from the bladder. 8. The ureters are innervated by the autonomic nervous system. Parasympathetic fibers innervation has an unknown effect. Sympathetic fibers come from the T11L2 segments of the spinal cord. Pain from the ureter (such as from a kidney stone) will be referred to the T11-L2 dermatomes. These dermatomes are along a "loin to groin" region, so "loin to groin" pain typically means there is ureter and/or kidney discomfort. The bladder is supplied by both sympathetic and parasympathetic nerve fibers of the autonomic nervous system. The sympathetic fibers are from the T11-L2 segments of the spinal cord. These fibers contract the internal urethral sphincter and inhibit contraction of the detrusor muscle. Thus, sympathetic fibers inhibit micturition (urination). The parasympathetic fibers McKinley/O’Loughlin Human Anatomy, 2nd Edition come from the pelvic splanchnic nerves (S2-S4). They will relax the internal urethral sphincter (so urine can pass through) and stimulate contraction of the detrusor muscle. Thus, the parasympathetic fibers stimulate micturition. 9. Water and waste products are pushed out from the glomerulus into the capsular space of the glomerular capsule. This is called filtrate. Filtrate enters the proximal convoluted tubule and is now called tubular fluid. Tubular fluid flows through the proximal convoluted tubule, nephron loop, distal convoluted tubule, and collecting duct where reabsorption and secretion occur. The tubular fluid leaving the renal papilla is called urine. Urine passes from the renal papilla into and then through the minor calyx, major calyx, renal pelvis, ureter, urinary bladder, and finally through the urethra when the urine is voided from the body. 10. A urinary tract infection (UTI) occurs when bacteria (usually E. coli) or fungi enter the urinary tract and multiply there. Females are more prone to developing UTIs because they have a short urethra and it is close to the anus. This close proximity of urethra and anus facilitates bacterial entry into the female urethra from the digestive tract. Sexual intercourse also increases the risk of UTIs. In addition, UTIs are associated with the use of a urinary catheter (a tube inserted through the urethra and into the urinary bladder to help void urine).