022 Urinary System

The Urinary System: 

The Urinary System

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Function Remove nitrogenous wastes Maintain electrolyte, acid-base, and fluid balance of blood Homeostatic organ Acts as blood filter Release hormones: calcitriol & erythropoietin

Kidneys as Filters: 

Kidneys as Filters Diuretic- loose water; coffee, alcohol Antidiuretic- retain water; ADH Aldosterone- sodium & water reabsorption, and K + excretion GFR= 180 liters (50 gal) of blood/day 178-179 liters are reabsorbed back into blood Excrete a protein free filtrate

Maintaining Chemical Homeostasis: 

Maintaining Chemical Homeostasis The Urinary System

The Urinary System: 

The Urinary System

Nitrogenous Wastes: 

Nitrogenous Wastes ammonia urea uric acid

Organs of the Urinary System: 

Organs of the Urinary System kidneys ureters urinary bladder urethra

Kidney Anatomy: 

renal capsule renal cortex renal medulla renal pelvis renal pyramids ureter Kidney Anatomy

Kidney Anatomy: 

Kidney Anatomy renal artery renal vein nephron

Nephron Functioning: 

urine blood filtration tubular reabsorption and secretion Nephron Functioning “refreshed” blood

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vein artery afferent arteriole efferent arteriole glomerulus peritubular capillaries Bowman’s capsule proximal convoluted tubule distal convoluted tubule loop of Henle collecting duct

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renal cortex renal medulla Each kidney contains over 1 million nephrons and thousands of collecting ducts Collecting duct Loop of Henle PCT DCT Glomerulus

Glomerular Filtration: 

Glomerular Filtration afferent arteriole glomerulus efferent arteriole Bowman’s capsule Filters blood; proteins can’t pass through

Composition of Glomerular Filtrate: 

Composition of Glomerular Filtrate Water Small Soluble Organic Molecules Mineral Ions

Proximal Convoluted Tubule: 

Proximal Convoluted Tubule Reabsorbs: water, glucose, amino acids, and sodium. 65% of Na + is reabsorbed 65% of H 2 O is reabsorbed 90% of filtered bicarbonate (HCO 3 - ) 50% of Cl - and K +

Loop of Henle: 

Loop of Henle Creates a gradient of increasing sodium ion concentration towards the end of the loop within the interstitial fluid of the renal pyramid. 25% Na+ is reabsorbed in the loop 15% water is reabsorbed in the loop 40% K is reabsorbed in the loop

Distal Convoluted Tubule: 

Distal Convoluted Tubule Under the influence of the hormone aldosterone, reabsorbs sodium and secretes potassium. Also regulates pH by secreting hydrogen ion when pH of the plasma is low. only 10% of the filtered NaCl and 20% of water remains

Collecting Duct: 

Collecting Duct Allows for the osmotic reabsorption of water. ADH (antidiuretic hormone)- makes collecting ducts more permeable to water-- produce concentrated urine

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From the original 1800 g NaCl, only 10 g appears in the urine Urine Water - 95% Nitrogenous waste: urea uric acid creatinine Ions: sodium potassium sulfate phosphate

Hormonal Control of Kidney Function: 

Hormonal Control of Kidney Function

Hormonal Control of Kidney Function: 

Hormonal Control of Kidney Function low blood volume high plasma solute concentration hypothalamus heart receptors

Hormonal Control of Kidney Function: 

Hormonal Control of Kidney Function hypothalamus posterior pituitary antidiuretic hormone collecting ducts

Hormonal Control of Kidney Function: 

Hormonal Control of Kidney Function

Hormonal Control of Kidney Function: 

Hormonal Control of Kidney Function reduced blood pressure and glomerular filtrate juxtaglomerular apparatus renin

Hormonal Control of Kidney Function: 

Hormonal Control of Kidney Function renin angiotensinogen angiotensin I angiotensin II

Hormonal Control of Kidney Function: 

Hormonal Control of Kidney Function adrenal cortex aldosterone angiotensin II convoluted tubules

Urinary Bladder: 

Urinary Bladder ureters internal sphincters external sphincters urethra

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Bladder Mucosa (transitional epithelium) Muscular layer (detrusor muscle): 3 layers of smooth muscle Fibrous adventia

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When bladder fills with 200 ml of urine, stretch receptors transmit impulses to the CNS and produce a reflex contraction of the bladder (PNS) Diuresis (Micturition) When is incontinence normal?

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Why do doctors ask for a urine sample? Urinalysis characteristics : smell - ammonia-like pH- 4.5-8, ave 6.0 specific gravity – more than 1.0; ~1.001-1.003 color - affected by what we eat: salty foods, vitamins

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odor - normal is ammonia-like Diabetes - smells fruity or acetone like due to elevated ketone levels Odor

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pH - range 4.5-8 ave 6.0 vegetarian diet - urine is alkaline protein rich and wheat diet - urine is acidic

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Color - pigment is urochrome Yellow color due to metabolic breakdown of hemoglobin (by bile or bile pigments) Beets or rhubarb - might give a urine pink or smoky color Vitamins- vitamin C- bright yellow Infection - cloudy Color

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Water: s.g. = 1g/liter; Urine: s.g. ~ 1.001 to 1.030 Pyelonephritus - urine has high s.g.; form kidney stones Diabetes insipidus - urine has low s.g.; drinks excessive water; injury or tumor in pituitary Specific Gravity

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Glucose - when present in urine condition called glycosuria (nonpathological) [glucose not normally found in urine] Indicative of: Excessive carbohydrate intake Stress Diabetes mellitus Abnormal Constitutes of Urine

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Albumin - abnormal in urine; it’s a very large molecule, too large to pass through glomerular membrane > abnormal increase in permeability of membrane Albuminuria - nonpathological conditions- excessive exertion, pregnancy, overabundant protein intake-- leads to physiologic albuminuria Abnormal Constitutes of Urine

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Ketone bodies - normal in urine but in small amts Ketonuria - find during starvation, using fat stores Ketonuria is couples w/a finding of glycosuria-- which is usually diagnosed as diabetes mellitus RBC - hematuria Hemoglobin - Hemoglobinuria - due to fragmentation or hemolysis of RBC; conditions: hemolytic anemia, transfusion reaction, burns or renal disease Abnormal Constitutes of Urine

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Bile pigments - Bilirubinuria (bile pigment in urine)- liver pathology such as hepatitis or cirrhosis WBC - Pyuria - urinary tract infection; indicates inflammation of urinary tract Casts- hardened cell fragments, cylindrical, flushed out of urinary tract WBC casts- pyelonephritus RBC casts- glomerulonephritus Fatty casts- renal damage Abnormal Constitutes of Urine

Disorders of kidney: 1.Kidney stone 2.Pylonephritis 3. Nephrotoxicity 4. Renal ischemia: It means reduction of the blood flow through the kidneys, which is usually the result of circulatory failure. : 

Disorders of kidney: 1.Kidney stone 2.Pylonephritis 3. Nephrotoxicity 4. Renal ischemia: It means reduction of the blood flow through the kidneys, which is usually the result of circulatory failure.

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Picture For Kidney Stone

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Lithotripsy For kidney stones that do not pass on their own, a shock wave procedure called lithotripsy is often used to break up a large stone into smaller pieces to pass.

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Polyuria- Excessive Urine Output Oliguria- Decrease in Urine Output Anuria – Absence of urine output.

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