Urinary System

Introduction
• The urinary system plays a vital part in maintaining
homeostasis of water and electrolytes within the body.
• The kidneys produce urine, which contains metabolic
waste products, including the nitrogenous compounds
urea and uric acid, excess ions and, sometimes,
excreted drugs.
• The urinary system is the main excretory system and
consists of the following structures:
– two kidneys, which secrete urine.
– two ureters that convey the urine from the kidneys to the
urinary bladder.
– the urinary bladder, which collects and stores urine .
– the urethra, through which urine leaves the body.
Image of Urinary system
 Kidney
• Kidneys are bean-shaped organs, about 11 cm
long, 6 cm wide and 3 cm thick; they weigh
around 150 g.
• The kidneys lie on the posterior abdominal wall,
one on each side of the vertebral column, behind
the peritoneum and below the diaphragm.
• They extend from the level of the 12th thoracic
vertebra to the 3rd lumbar vertebra, receiving
some protection from the lower ribcage.
• The right kidney is usually slightly lower than the
left, probably because of the considerable space
occupied by the liver.
 Structure of Kidney
• Three different areas of tissue are clearly distinguishable to the naked eye
when viewing a longitudinal section of the kidney:
– an outer fibrous capsule, surrounding the kidney
– the cortex, a reddish-brown layer of tissue immediately below the
capsule and surrounding the renal pyramids
– the medulla, the innermost layer, consisting of pale, conical-shaped,
striated structures, the renal pyramids. Each pyramid has a pointed end
called the papilla.
• The hilum is the concave medial border of the kidney, where the renal
blood and lymph vessels, the ureter and nerves enter.
• Urine formed within the kidney passes through a renal papilla into the
drainage system that begins at a minor calyx.
• Several minor calyces merge into a major calyx, and two or three major
calyces combine, forming the renal pelvis, a hollow funnel-shaped structure
that narrows when it leaves the kidney as the ureter.
Imager of Kidney
 Functions of kidney
• Formation of urine, maintaining water, electrolyte and
acid-base balance
• Excretion of waste products
• Production and secretion of erythropoietin, the
hormone that stimulates formation of red blood cells
(erythropoiesis).
• Production and secretion of renin, an important enzyme
in the long-term control of blood pressure.
• Production of Hormones: They produce calcitriol (the
active form of vitamin D) which regulates calcium
homeostasis and erythropoietin which stimulates RBC
production.
 Nephron
• The kidney contains 1-2 million functional units, the
nephrons.
• The nephron is essentially a tubule that is closed at one
end and opens into a collecting duct at the other end.
• The closed or blind end forms the cup-shaped
glomerular (Bowman's) capsule, the glomerulus.
• Continuing from the glomerular capsule, the remainder
of the nephron is about 3 cm long and described in
three parts:
– the proximal convoluted tubule
– the medullary loop (loop of Henle)
– the distal convoluted tubule, leading into a collecting duct.
• The collecting ducts unite, forming larger ducts that
empty into the minor calyces.
Image of nephron
 Ureter
• The ureters carry urine from the kidneys to the
urinary bladder.
• They are hollow muscular tubes about 25-30
cm long with a diameter of approximately 3
mm.
• The ureter is continuous with the funnel-
shaped renal pelvis. It travels downwards
through the abdominal cavity, behind the
peritoneum into the pelvic cavity.
 Structure of Ureter

• The walls of the ureters consist of three layers

of tissue:
– an outer covering of fibrous connective tissue,
continuous with the fibrous capsule of the kidney.
– a middle muscular layer consisting of interlacing
smooth muscle fibres.
– an inner layer, the mucosa, composed of
transitional epithelium.
 Function of Ureter
• They transport urine from the renal pelvis of
the kidney to the urinary bladder.
• Peristalsis is an intrinsic property of the
smooth muscle layer that propels urine along
the ureter. Peristaltic waves occur several
times per minute, increasing in frequency with
the volume of urine produced, and sending
little spurts of urine along the ureter towards
the bladder.
 Urinary Bladder
• The urinary bladder is a reservoir for urine.
• It lies in the pelvic cavity and its size and
position vary, depending on the volume of
urine it contains.
 Structure of Urinary bladder
• The bladder is roughly pear-shaped, but becomes more
balloon-shaped as it fills with urine.
• The bladder opens into the urethra at its lowest point,
the neck.
• The bladder wall is composed of three layers:
– The outer layer of loose connective tissue, containing blood
and lymphatic vessels and nerves, covered on the upper
surface by the peritoneum.
– The middle layer, consisting of interlacing smooth muscle
fibres and elastic tissue loosely arranged in three layers.
This is called the detrusor muscle, and when it contracts, it
empties the bladder.
– The inner mucosa, composed of transitional epithelium that
readily permits distension of the bladder as it fills.
Image of Urinary Bladder
 Function of urinary bladder
• Urinary bladder performs the following
functions:
– It is a reservoir for urine,
– It expels urine via urethra.
 Urethra
• The urethra is a canal extending from the neck of
the bladder to the exterior, at the external urethral
orifice.
• It is closed by the external urethral sphincter (a
muscular structure) which keeps the urine in the
bladder till urination.
• It is longer in the male than in the female.
• The male urethra is associated with both the
urinary and the reproductive systems.
• The female urethra is approximately 4 cm long
and 6 mm in diameter.
 Physiology of Urine formation
• The kidneys form urine, which passes to the
bladder for storage prior to excretion.
• There are three processes involved in the
formation of urine:
– Filtration
– selective reabsorption
– secretion.
 Filtration
• Filtration takes place through the semipermeable walls of the
glomerulus and glomerular capsule
• Water and other small molecules readily pass through,
although some are reabsorbed later.
• The fluid filtered from the bloodstream into the glomerular
capsule is now called filtrate.
• Blood cells, plasma proteins and other large molecules are too
large to filter through and therefore remain in the capillaries.
• The volume of filtrate formed by both kidneys each minute is
called the glomerular filtration rate (GFR).
• In a healthy adult the GFR is about 125 mL/min, i.e. 180 litres
of filtrate are formed each day by the two kidneys.
• Nearly all of the filtrate is later reabsorbed from the kidney
tubules, with less than 1%, i.e. 1-1.5 litres, excreted as urine.
 Selective reabsorption
• Most reabsorption from the filtrate back into the blood takes
place in the proximal convoluted tubule, whose epithelial
lining possesses microvilli to increase surface area for
absorption.
• Many substances are reabsorbed here, including water,
electrolytes and organic nutrients such as glucose and amino
acids.
• Only 60-70% of filtrate reaches the medullary loop. Much
of this, especially water, sodium and chloride, is reabsorbed
in the loop, so that only 15-20% of the original filtrate
reaches the distal convoluted tubule.
• More electrolytes are reabsorbed here, especially sodium, so
the filtrate entering the collecting ducts is actually quite
dilute.
• The main function of the collecting ducts is to reabsorb as
much water as the body needs
 Tubular secretion
• Filtration occurs as blood flows through the
glomerulus.
• Substances not required and foreign materials,
e.g. drugs including penicillin and aspirin, may
not be entirely filtered out of the blood because of
the short time they remain in the glomerulus or
because the molecules are too large to pass
through the filtration pores.
• Such substances are cleared by secretion from the
peritubular capillaries into the filtrate within the
convoluted tubules.
Image of reabsorption and secretion
Image of urine formation
 Composition of Urine
• Urine is clear and amber in colour.
• The constituents of urine are:
– • Water 96%
– Urea 2%
– Uric acid
– Creatinine
– Ammonia
– Sodium
– Potassium
– Chlorides
– Phosphates
– Sulphates
– Oxalates
 Micturition
• In infants, accumulation of urine in the bladder
activates stretch receptors in the bladder wall,
generating sensory (afferent) impulses that are
transmitted to the spinal cord, where a spinal
reflex is initiated.
• This stimulates involuntary contraction of the
detrusor muscle and relaxation of the internal
urethral sphincter, and expels urine from the
bladder: this is known as micturition, urination
or voiding of urine.
 Micturition
• When bladder control is established, the
micturition reflex is still stimulated but sensory
impulses also pass upwards to the brain and
there is awareness of the need to pass urine as
the bladder fills (around 300-400 mL in
adults).
• By learned and conscious effort, contraction of
the external urethral sphincter and muscles of
the pelvic floor can inhibit micturition until it
is convenient to pass urine.
Renin-angiotensin system