Urinary System

GN.Hassan khan
Lecturer INS-KMU
 Definitions
• Urinary System: The system which filter the
blood plasma, excrete waste products , and
regulate the body’s water, acid-base, and
electrolyte balance.
• Nephrology: study of the anatomy, physiology,
and pathology of the kidneys.
• Urology: : study of the urinary systems, and male Rp system.
 Organs of the urinary system

six organs:
• Two kidneys
• Two ureters
• One urinary bladder
• One urethra
 physiology of the Kidneys

• Excretion of wastes urea

• Regulation of blood ionic composition
• Regulation of blood PH hydrogen ion
• Regulation of blood volume Erythropoietin
• Regulation of blood pressure renin angiotensin aldosterone system
• Maintenance of blood osmolarity ALBUMIN
• Production of hormones calcitriol and erythropoietin
• Regulation of blood glucose level gluconeogenesis
• Detoxification of drugs theough peroxisome
 Anatomy of the Kidneys

• bean-shaped.
• Located between the 12 thoracic to 3 lumber
vertebrae.
• protected by eleventh and twelfth pairs of ribs.
• Lying just above the waist between the peritoneum
and the posterior wall of the abdomen, hence they
are said to be retroperitoneal (retro= behind) for
their position. RETERO back
• right kidney Lower than left because liver
 External Anatomy of kidney
• 10—12 cm long, 5—6 cm wide, and 3 cm thick.
• 135—150 g.
• center of the concave border is deep vertical
fissure called the
• renal hilum, through which ureter, blood vessels,
lymphatic vessels, and nerves emerges from the
kidney.
• Three layers of tissue surround kidney.
• superficial layer, renal fascia, thin layer of
connective tissue that attachment to the
abdominal wall.
• middle layer, adipose capsule, protects the kidney
from trauma.
• Inner layer, renal capsule smooth and transparent
sheet of dense connective tissue.
• It protects the kidney from trauma.
 Internal Anatomy of the Kidneys
• Present two reddish areas
• superficial renal cortex deep reddish renal
medulla
• Renal cortex smooth area extending from renal
capsule to the bases of the renal pyramids.
• renal columns.* Spaces which is present between
between renal pyramids*
• Renal medulla consists of cone shaped renal pyramids.
The base (wider end) of each pyramid faces the
renal cortex, and its apex (narrower end) called a
renal papilla points toward the hilum.
• Together, the renal cortex and renal pyramids
constitute the parenchyma (functional portion) of the
kidney.
• nephrons— 1 million in each kidney.
• Urine formed by the nephrons drains into the
papillary ducts of the pyramids.
• The papillary ducts drain into cuplike structures called
minor and major calyces (calyx= cup). Each kidney
has 8 to 18 minor calyces and 2 to 3 major calyces.
• From the major calyces, urine drains into a single
large cavity called the renal pelvis (pelv = basin) and
then out through the ureter to the urinary bladder.
• The renal papilla is the location where the renal
pyramids in the medulla empty urine into the
minor calyx in the kidney. Histologically it is
marked by medullary collecting ducts converging
to form a papillary duct to channel the fluid.
Transitional epithelium begins to be seen.
KIDNEY STRUCTURED
kidney 1: A longitudinal section, B nephron and adjacent blood vessels;
1 renal papilla, 2 renal column, 3 capsule, 4 renal pyramid, 5 calyx, 6 ureter, 7 renal
pelvis, 8. renal vein, 9 renal artery, 10 interlobar artery, 11 arcuate
artery, 12 interlobular artery, 13 interlobar vein, 14 cortex, 15 interlobular
vein, 16 renal sinus, 17 arcuate vein,18 medulla, 19 vasa recta, 20 loop of
Henle, 21 collecting duct, 22 arcuate vein, 23 arcuate artery, 24 proximal convoluted
tubule, 25 glomerulus, 26 Bowman's capsule, 27 distal convoluted tubule
 Blood Flow of Kidney

• Renal artery  Interlobar a.  Arcuate a. 

Interlobular a.  Afferent a.  Glomerulus 
Efferent a.  Peritubular cap. Network and Vasa
recta  Interlobular vein  Arcuate v. 
Interlobar v.  Renal v.
 Nephron
• Functional units of the kidneys.
• Nephron consists of 2 main parts: renal
corpuscle, where blood plasma is filtered, and a
renal tubule into which the filtered fluid passes.
• Renal corpuscle consists of glomerulus (capillary
network) and the glomerular (Bowman’s)
capsule, an epithelial cup that surrounds the
glomerular capillaries.
 Nephron cont….

• Blood plasma is filtered in the glomerular capsule, and

then the filtered fluid passes into the renal tubule.
• Renal tubule 3 main parts. In the order that fluid
passes through it is:
• 1) proximal convoluted tubule, 2) loop of Henle, and
3) distal convoluted tubule.
• The distal convoluted tubules of several nephrons
empty into a single collecting duct.
• Collecting ducts then unite and converge into large
papillary ducts, which drain into the minor calyces,
major calyces, renal pelvis and then ureter.
NEPHRON Anatomy
Nephron of the kidney. The labeled parts are:
1. Glomerulus, 2. Efferent arteriole, 3. Bowman's capsule, 4. Proximal
convoluted tubule, 5. Cortical collecting duct, 6. Distal convoluted tubule,
7. Loop of Henle, 8. Duct of Bellini, 9.Peritubular capillaries, 10. Arcuate
vein, 11. Arcuate artery, 12. Afferent arteriole, 13. Juxtaglomerular
apparatus.
 Venae recta
• Series of blood capillaries start from cortex
supplies of blood to medulla part of the
kidney
 Histology of Nephron and Collecting Duct
Epithelial cells form the wall of the glomerular capsule,
renal tubule, and ducts.
 Glomerular (Bowman’s) capsule consists of 2 layer
visceral and parietal layer. Both layer are covered by
simple squamous epithelium
• visceral layer epithelial cells called podocytes—footlike
projections (pedicles) wrap around the single layer of
endothelial cells of the glomerular capilaries and form
the inner wall of the capsule.
• The layer which is present above the capillaries in the
glomerulus capsule Is called visceral layer which is
cover by podocytes cells’
 Nephron cont…
• parietal layer outer wall of the capsule.
• Fluid filtered from the glomerular capillaries
enter the capsular (Bowman’s) space, the
space between the two layers of the Bowman
capsule.
 Renal Tubule and Collecting Duct:
 proximal convoluted tubule consists of simple
cuboidal epithelial cells with microvilli on their
inner surface facing the lumen to increase its
surface area for reabsorption and secretion.
• The thick ascending limb (last part) of the loop of
Henle is composed of simple columnar epithelium
which comes in contact with the afferent arteriole.
• The columnar epithelial cells in this region are
crowded together and form macula densa
(macula= spot; densa= dense).
 Nephron cont…
• Alongside the macula densa, the walls of the
afferent and efferent arterioles contain
smooth muscle fibers called juxtaglomerular
(JG) cells.
• Both macula densa and JG cells form
juxtaglomerular apparatus (JGA) which helps
in regulating blood pressure.
• The distal convoluted tubule (DCT) begins a short
distance past the macula densa. In the last part of
DCT there are two types of cells.
• [ Principal cells] which have receptors for both
(ADH) and aldosterone that reabsorb Na+, water
and secrete K+.
• [Intercalated cells] which regulate blood PH by
secreting H+ and reabsorbing HCO3 and K+.
• The collecting ducts drain into the papillary ducts.
 Flow of urine

Through Nephron down from Nephron

Bowman’s capsule Collecting duct

Proximal conv. Tubule Papillary duct
Minor calyces
Descending limb of Major calyces
loop of Henle Renal pelvis
Ascending limb of loop Ureter
of Henle Bladder
Distal conv. Tubule Urethra
 Types of Nephron

Two types:
• Cortical Nephron—Renal corpuscle originates from the
superficial part of the cortex. It has a shorter loop of Henle.
• Juxtamedullary Nephron—Renal corpuscle originates from
the deeper part of the cortex means near the medulla. It has a
longer loop of Henle.
 Urine Formation in Nephron
• To produce urine, nephron and collecting ducts
perform three basic processes—glomerular
filtration, tubular reabsorption, and tubular
secretion.
• 1. Glomerular Filtration: In the first step of urine
production, water and most solutes in blood
plasma move across the wall of the glomerular
capillaries into the glomerular capsule and then
into the renal tubule.
 Net Filtration Pressure
Glomerular filtration depends on three main pressures. One pressure promotes filtration
while the two pressures oppose filtration.
1. Glomerular Blood Hydrostatic Pressure (GBHP): It is the blood pressure in the
glomerular capillaries which is about 55 mmHg. It promotes filtration by forcing
water and solutes from blood plasma through the filtration membrane.
2. Capsular Hydrostatic Pressure (CHP): is the hydrostatic
pressure exerted against the filtration membrane by fluid already
in the capsular space and renal tubule. CHP opposes filtration
which is about 15 mmHg.
3. Blood Colloid Osmotic Pressure (BCOP): s due to the
presence of proteins such as albumen, globulins, and fibrinogens
in the blood plasma. T also opposes filtration which is about 30
mmHg.
 Net filtration pressure remains 10 mmHg which is responsible for
filtration process.

NFP = GBHP – (CHP + BCOP)

= (55 mmHg) – (15 mm Hg + 30

mm Hg)
= (55 mm Hg) – (45 mm Hg)
NFP = 10 mm Hg
 Glomerular Filtration Rate
• The amount of filtrate formed in all the renal corpuscles of both kidneys
each minute is the (GFR). In adults, the GFR averages 125 ml/min (180
liters/day) in males and 105 ml/min (150 liters/day) in females.
 If the GFR is too high: Needed substances cannot be
reabsorbed quickly enough and are lost in the urine
 If the GFR is too low: Everything is reabsorbed,
including wastes that are normally disposed off
 Urine Formation Cont…

2. Tubular Reabsorption: As the filter fluid flows along the

renal tubule and the collecting duct, the cells in the tubule
reabsorb about 99% of the filtered fluid and many useful
solutes. Thus, the water and solutes (glucose, amino acids
and electrolytes) return to the blood.
Sites of Reabsorption almost all the segments
PCT: 60 to 70 prcent absorption H2O, glucose, amino acids,
Na+, K+, Ca++, HCO3-, Uric acid
Loop of Henle: Na+,Cl-, Ca++
DCT: H2O, Na+, Ca++, HCO3
-
Calcium and sodium is common in all
 Urine Formation Cont…
3. Tubular secretion: As the fluid flows along the
renal tubule and the collecting duct, their cells
secrete wastes, drugs, and excess ions, into the
fluid. Thus tubular secretion removes waste
substances from the blood.
• H+, organic acids and bases in PCT
• Urea in Loop of Henle (thin segment)
• K+, H+, NH3 in DCT and collecting duct

 Urine Excretion = Filtration—Reabsorption + Secretion

38
 Hormones affecting Renal Function
Hormone Target Effects
Aldosterone Distal tubule, collecting duct  Na reabsorption and K secretion;
 urine volume
Angiotensin II Afferent and efferent Constricts arterioles, reduces GFR;
arterioles stimulates ADH and aldosterone
secretion; stimulates thirst; H2O intake
and urine output
ADH Collecting duct  H2O reabsorption; urine output,
increases concentration
ANP Afferent and efferent Dilates afferent arteriole, constricts
arterioles, collecting duct efferent arteriole, GFR; inhibits
secretion of renin, ADH, and
aldosterone; inhibits NaCl reabsorption
by collecting duct; urine output
Epi and Norepi JG apparatus, affr arteriole Induces renin secretion; constricts
afferent arteriole;  GFR and urine out

PTH Proximal and distal tubules, Ca++ reabsorption by loop and distal
nephron loop tubule and Mg++ reabsorption by PCT;
inhibits phosphate reabsorption by PCT;
promotes calcitriol Synthesis
 Histology of Ureter
• 25-30 cm long and 1 to 10 mm in diameter.
 Layers of ureter
• Adventitia ---- outer fibrous layer (lamina propia)
• Muscularis ----- middle smooth muscle layer. It
consists of outer circular and inner longitudinal
layer in
• Mucosa-inner folded mucous layer forming star
shape.
• The ureters open obliquely through the wall of the
posterior aspect of the urinary bladder.
 Urinary Bladder
• The urinary bladder is a hollow, distensible muscular
organ situated in the pelvic cavity posterior to the pubic
symphysis.
• In males it is anterior to the rectum;
• females, it is anterior to the vagina and inferior to the
uterus.
• Folds of the peritoneum hold the urinary bladder in
position.
• It rises into the abdominal cavity when it is full. Urinary
bladder capacity averages 700—800 ml.
• it is smaller in females because of the uterus.
• In the floor of the urinary bladder is a small triangular
area called the trigone.
• The two posterior corners of the trigone contain the
two ureteral openings and internal urethral orifice.
• The three tissue layers of the wall of the urinary
bladder are the same as those of the ureters. The
muscularis that surrounds the mucosa is also called
detrusor muscle (detrusor= to push down).
• Rugae (the folds in the mucosa) are also present to
permit expansion of the bladder.
• Inferior to the internal urethral sphincter is the
external urethral sphincter which is under voluntary
control.
Urinary Bladder
 Urethra
• small tube leading from the internal urethral orifice in
the floor of the urinary bladder to the exterior of the
body.
• female (4 cm)
• male (20 cm).
• There are two urethral sphincters, internal and external.
 The internal sphincter muscle of urethra: located at the
bladder's inferior end and the urethra's proximal end at
the junction of the urethra with the urinary bladder. The
internal sphincter is made of smooth muscle, therefore
it is under involuntary or autonomic control.
 The external sphincter muscle of urethra:
• located at the bladder's distal inferior end in females
and inferior to the prostate (at the level of the
membranous urethra) in males.
• the external sphincter is made of skeletal muscle,
therefore it is under voluntary control of the somatic
nervous system.
• The male urethra is subdivided into three regions:
• Prostatic urethra—passes through prostate
• Membranous urethra—the shortest portion which
passes through the deep perineal muscles.
• Spongy urethra—the longest portion which passes
through the penis
Urethral sphincters
 Micturition

• Discharge of urine from the urinary bladder is called

micturition, urination or voiding. (mictur=urinate).
• Micturition occurs through a combination of involuntary and
voluntary muscle contractions.
• When the volume of urine in the bladder reaches 200—400 ml,
pressure within the bladder increases , and stretch receptors
in its wall transmit nerve impulses into the spinal cord.
• These impulses propagate to the micturition center in the
sacral cord segments S2 and S3 and trigger a spinal reflex
called the micturition reflex. In this reflex action,
parasympathetic impulses propagate from the micturition
center to the urinary bladder wall and internal urinary
sphincter.
• The parasympathetic nerve impulses cause
contraction of the detrusor muscle and the
relaxation of the internal urethral sphincter
muscle.
• Simultaneously, the micturition center inhibits
somatic motor neurons that innervate skeletal
muscle in the external urethral sphincter.
• Upon contraction of the urinary bladder wall and
relaxation of the sphincters, urination takes place.