Urinary System. 1. Kidneys 2. Ureters 3. Urinary bladder 4. Urethra

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1 Urinary System 1. Kidneys 2. Ureters 3. Urinary bladder 4. Urethra

2 Kidney Functions Primary functions: Filter and remove waste from plasma, Secondary functions: Produce renin, Produce EPO, Regulate blood volume and pressure, Regulate blood osmolarity. Regulate ph, Formation of calcitriol Perform gluconeogenesis.

3 Adrenal Glands Secrete: - Aldosterone - Cortisol - Epinephrine - Norepinephrine - Other hormones

4 Basic Kidney Anatomy Renal cortex Renal medulla Renal sinus contains: Renal column Minor calyx Major calyx Renal pyramid Renal pelvis Corticomedullary junction Renal artery Renal vein Renal papilla Renal lobe Ureter Fibrous capsule

5 Formed in the renal cortex Travels thru the medullary pyramids Basic Pathway of Urine Flow Drips out of the pyramids into the minor calyces Flows thru major calyces Flows thru the renal pelvis Flows thru the ureter Flows thru and is stored in the urinary bladder Flows thru the urethra

6 Basic Pathway of Renal Blood Flow Interlobar artery Arcuate artery Interlobular artery Arcuate vein Interlobular vein Nephron Segmental artery Renal artery Renal vein Interlobar vein

7 Basic Pathway of Renal Blood Flow Interlobular vein Afferent arteriole Glomerulus Renal PCT corpuscle DCT Efferent arteriole Cortex Arcuate vessels Nephron loop Medulla Peritubular capillaries (associated with convoluted tubules) Vasa recta (associated with nephron loop)

8 Glomerular filtration Tubular reabsorption The movement of substances from the blood within the glomerulus into the capsular space Tubular secretion The movement of substances from the tubular fluid back into the blood The movement of substances from the blood into the tubular fluid Peritubular capillaries Efferent arteriole Nephron loop Afferent arteriole PCT DCT Collecting tubule Glomerulus Glomerular capsule Capsular space Ascending limb Descending limb Collecting duct Vasa recta

9 By regulating how much water we reabsorb, we regulate blood volume By regulating what chemicals we reabsorb and what we secrete, we regulate blood [electrolyte] and blood ph

10 Renal Math

11 Nephron - sites of urine formation 1 million per kidney. 5 parts Glomerulus Glomerular Capsule Proximal Convoluted Tubule Loop of Henle Distal Convoluted Tubule Empty into collecting ducts.

12 Glomerular Capsule 2 layers Encloses the glomerulus. Receives filtered blood (filtrate)

13 Glomerular Capsule Parietal layer Simple squamous Contains filtrate. Visceral layer Filters Made of podocytes.

14

15 Proximal Convoluted Tubule Primary site of R&S Receives filtrate from the GC Very twisty. Simple cuboidal. Lots of microvilli. Lots of mitochondria.

16 Loop of Henle Receives filtrate from the PCT Creates a conc. gradient in the renal medulla which allows for water reabsorption from the collecting duct

17 Distal Convoluted Tubule Receives filtrate from the loop of Henle Site of hormonal adjustment of water & salt secretion/reabsorption. Simple cuboidal Fewer microvilli and mitochondria.

18 Collecting Duct Receives urine from several nephrons Extends through the renal medulla and empties into a minor calyx Simple cuboidal and columnar. Site of hormonal adjustment of water reabsorption.

19 Glomerulus High BP Due to the size differential btwn the afferent and efferent arterioles This high BP is the driving force behind the filtration

20 Peritubular Capillaries Surround renal tubules Receive blood from the efferent arteriole Sites of R&S Low BP and high OP

21 Vasa Recta Receive blood from the efferent arteriole Work with the loops of Henle to facilitate water reabsorption in the collecting duct

22 3 Steps of Urine Formation Afferent arteriole Glomerular capillaries Efferent arteriole Interlobular artery Glomerular capsule Rest of renal tubule containing filtrate Peritubular capillary Three major renal processes: Glomerular filtration Tubular reabsorption Tubular secretion To interlobular vein Urine

23 Filtration Membrane Visceral layer of glomerular capsule Pedicels Capillary lumen Glomerular capillary Filtration membrane Endothelium of fenestrated capillary Basement membrane of capillary Filtration slits of visceral layer Filtration slits Podocyte cell body

24 Filtration Membrane Endothelium (blocks formed elements) Small protein Basement membrane (blocks large proteins) Filtration slits of visceral layer (block small proteins) Leukocyte Large protein Platelet Filtrate includes water, glucose, amino acids, ions, urea, many hormones, vitamins B and C, ketones, and very small amounts of protein Erythrocyte Not filtered Capillary Filtered Capsular space

25 Filtration Pressure Glomerular capsule PCT HPg 60 out Efferent arteriole OPg 32 in Afferent arteriole NFP 10 out HPc 18 in Glomerulus Blood entering glomerulus Capsular space Glomerular hydrostatic pressure (HPg) 60 mm Hg out Blood colloid osmotic pressure (OPg) 32 mm Hg in Capsular hydrostatic pressure (HPc) 18 mm Hg in Net filtration pressure (NFP) = 10 mm Hg out

26 Glomerular Filtration Rate (ml/min) 125 ml/min Depends on glomerular BP

27 Myogenic Mechanism of Maintaining GFR Decrease in systemic blood pressure Efferent arteriole Glomerulus Afferent arteriole vasodilates Widened arteriole lumen allows more blood into glomerulus to offset a decrease in systemic blood pressure

28 Myogenic Mechanism of Maintaining GFR Increase in systemic blood pressure Efferent arteriole Glomerulus Afferent arteriole vasoconstricts Narrowed arteriole lumen allows less blood into glomerulus to offset an increase in systemic blood pressure

29 Tubuloglomerular Mechanism

30 Effect of the Sympathetic Nervous System on GFR Increased sympathetic activity NE and E cause afferent arteriole to constrict GBP and thus GFR fall What is an advantage of this process?

31 Renin-Angiotensin System BP Falls Increased sympathetic activity JG cells release renin into the plasma Renin converts the plasma protein Angiotensinogen into Angiotensin I Angiotensin I is converted into Angiotensin II by ACE the Angiotensin Converting Enzyme

32 Ag II causes Vasoconstriction Adrenal cortex to release Aldosterone Pituitary gland to release ADH Increased sodium reabsorption in DCT Increased TPR Increased water reabsorption Increased BV Thirstiness Increased BP

33 PCT Reabsorption What kind of stuff needs to be reabsorbed? Reabsorbed molecules travel from the PCT to the PTC.

34 PCT Reabsorption Filtrate in tubule lumen H2 O Luminal membrane Tubule cell Interstitial fluid Peritubular capillary Capillary Endothelial cell Paracellular Transcellular Transcellular Solutes Paracellular Basolateral membranes Active transport Passive transport

35 PCT Reabsorption Nucleus Filtrate in tubule lumen Na Tubule cell Peritubular capillary 2 + Glucose Amino acids Some ions Vitamin s H2O Interstitial fluid 3Na 3Na K 2K + + K + 4 Lipid-soluble 5 substances Cl, Ca2+, K+ and other ions, urea 6 Tight junction Primary active transport Secondary active transport Passive transport (diffusion) Transport protein Ion channel or aquaporin Cl Paracellular route Obligatory reabsorption

36 Transport Maximum

37 DCT Reabsorption Hormone dependent Fine tuning Aldosterone Parathyroid hormone

38 Loop of Henle Reabsorption Descending limb Ascending limb Urine concentration

39 Collecting Duct Reabsorption Water Depends on body s hydration levels Antidiuretic hormone

40 Tubular Secretion

41 Regulating Blood Concentration Plasma osmolarity is constantly measured by neurons in the hypothalamus. In response to changes in plasma osmolarity, hypothalamic neurons adjust their release of antidiuretic hormone from the posterior pituitary.

42 Regulating Blood Concentration ADH increases the reabsorption of water from the collecting duct.

43 High Blood Osmolarity Sensed by osmoreceptors in the hypothalamus Posterior pituitary gland increases ADH release ADH increases the permeability of the collecting duct to water Blood osmolarity falls Increased water reabsorption Facultative reabsorption

44 What will increased ADH do to: Water reabsorption Urine output Urine color Blood volume Blood pressure

45

46

47 Medullary Osmotic Gradient Osmolality of interstitial fluid (mosm) Active transport H2 O NaCI H2 O NaCI H2 O NaCI H2 O NaCI Cortex Passive transport Water impermeable H2 O Outer medulla NaCI H2 O H2 O Loop of Henle Inner medulla

48 Aldosterone Produced by the adrenal cortex. Produced when: Plasma Na+ is too low. Plasma K+ is too high. Stimulated by angiotensin II. Aldosterone acts on the DCT to increase the secretion of K+ and the reabsorption of Na+ and water.

49 How would excess aldosterone affect Plasma sodium levels Plasma potassium levels Urine output Blood volume Blood pressure

50 Diuretics Osmotic Anything that increases filtrate osmolarity increases urine output. Caffeine Inhibits renal sodium reabsorption. Alcohol Inhibits ADH release.

51 Urine Characteristics Components Volume 95% water ph of % solutes Clear to yellow Uric acid Urea Creatinine Ions

52 Ureters Ureter Mucosal folds Mucosa Muscularis Adventitia

53 Urinary Bladder Ureter Peritoneum Mucosal folds Detrusor muscle Ureteral openings Trigone Neck of urinary bladder Internal urethral sphincter Urethra External urethral sphincter (in urogenital diaphragm)

54

55 Pelvic Diaphragm

56 Urethra Ureteral openings Trigone Urinary bladder Internal urethral sphincter External urethral sphincter Urethra Urogenital diaphragm External urethral orifice Labium minus Labium majus

57 Urethra Ureteral openings Trigone Urinary bladder Internal urethral sphincter Prostate gland Prostatic urethra External urethral sphincter Membranous urethra Urogenital diaphragm Spongy urethra Penis Urethra External urethral orifice

58 Micturition

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