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Urinary System
Filtering of the Blood Electrolyte Regulation pH Regulation Regulation of Blood Volume Stimulation of Erythropoiesis Vitamin D Synthesis
Two ureters, which transport urine from the kidneys to The urinary bladder, which acts as a reservoir for urine The urethra, the duct through which urine from the bladder
flows to the outside of the body during urination
REABSORB
SECRETE
Kidney Anatomy
External Anatomy
Renal capsule Adipose capsule Renal fascia
Internal Anatomy
Renal pelvis, branches into major calyces and minor calyces Renal medulla, consists of 8-18 renal pyramids (tubulus and collecting ducts of the nephrons) Renal cortex, divided into the outer cortical region (renal columns) and the inner juxtamedullary
Blood flow
Nephron
Nephron the histological and functional unit of the kidney Each nephron is an independent urine making unit ~ 1.3 million nephrons per kidney ~ 50-55mm in length Two types of nephrons : Cortical (found in the outer 2/3 of the cortex) and Juxtamedullary nephrons (found at
the cortex/medulla junction, Fewer in number, Very long loops of Henle to make concentrated urine)
Juxtaglomerular Apparatus
Nephron Histology I
Nephron Histology II
Podocytes
The spaces between the pedicels provide a passageway for materials to enter the nephron (except proteins which are not filtered out of the blood).
FILTER
Glomerular Filtration
Useful subtances such as H2O, Na+, glucose and amino acids are returned to the blood
REABSORB
Tubular Reabsorption
Products such as K+, H+, certain drugs and organic compounds may be excreted
SECRETE
Tubular Secretion
Glomerular Filtration
The filtration slits of the visceral layer of the glomerular capsule and the podocytes
Normally, none of the blood cells can pass through this barrier, include protein molecule
The high hydrostatic pressure of the blood in the glomerulus is primarily responsible for the production of the glomerular (ultra)filtrate.
GFR is ~ 120 ml/min = ~ 180 L/day
Vasoconstriction or vasodilation of glomerular afferent arterioles affects the rate of blood flow and, therefore, affects the GFR.
blood flow = blood flow = GFR GFR..
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Normal : 25 mmHg
Cardiovascular shock:
Decreases glomerular capillary hydrostatic pressure. Decreases urine output (UO).
When MAP drops to 70 mm Hg, afferent arteriole dilates. When MAP increases, vasoconstrict afferent arterioles. Tubuloglomerular feedback:
Increased flow of filtrate sensed by macula densa cells in thick ascending LH.
Signals afferent arterioles to constrict..
Renin-Angiotension-Aldosterone System
Tubular Reabsorption
About 99% of the filtrate is reabsorbed. Water can only be reabsorbed by osmosis.
There are no water pumps. Because the osmotic pressure of the filtrate is about the same as plasma, ~ 300 mOsm, ions must be transported to affect the osmotic pressures. Na+ diffuses into the cuboidal tubular cells at the apical surface from the filtrate.
Glucose is frequently cotransported with Na+..
The Na+ is then pumped by active transport into the surrounding tissue fluid.
Na+/K+ pumps are only located at the basal and lateral surfaces.
Cl- ions then follow the Na+ by diffusion into the cell. The NaCl creates an osmotic gradient and water flows by osmosis out of the filtrate and into the tissue fluid.
About 85% of salts and water are reabsorbed in the early regions of the nephron..
The composition of the filtrate is fine tuned in the remaining areas of the nephron. In the loop of Henle, more materials are reabsorbed from the filtrate into the tissue fluid then blood.
In the thick portion of the ascending limb, Na+ diffuses from the filtrate into the cells at the apical surface. At the same time K+ and Cl- are actively transported into the cell at the apical surface..
Na+ is then actively transported across the basal and lateral surfaces into the tissue fluid (blood) by Na+/K+ pumps in the membrane. Cl- passively follows the Na+ out of the cell and into the tissue fluid. K+ diffuses back into the filtrate and the tissue fluid..
The descending limb of the loop of Henle is permeable to water but (probably) impermeable to NaCl. Because of the actions of the ascending limb the tissue fluid surrounding this region of the nephron is hypertonic.
Therefore, water moves by osmosis from the filtrate in the descending limb into the tissue fluid..
Urea also contributes to the high osmolality of the tissue fluid surrounding the loop of Henle. Urea can diffuse out of the collecting duct into the tissue fluid then back into the ascending limb. The urea is then transported into the filtrate where it diffuses out through the collecting duct wall and into the tissue fluid, then back into the ascending limb, etc..
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In the collecting ducts, the remainder of the water is reabsorbed from the filtrate into the tissue fluid then the blood. The medullary regions of the collecting ducts are impermeable to NaCl in the surrounding tissue fluid, therefore, water diffuses out of the collecting ducts. The water moves through water channels produced from aquaporin proteins. The number of water channels is influenced by ADH. Stimulates fusion of vesicles with plasma membrane. Incorporates water channels into plasma membrane..
Tulular Load
amount of a substance passing the filtration membrane per minute Tubular Maximum the maximum rate at which a substance can be reabsorbed Spillage
Tubular Secretion
Ureters
Uroliths
Urinary Bladder
Trigone
Cystitis
Urine Production
Urine is created in renal cortex and renal medulla Drains out end of renal papilla, into renal pelvis, into ureter, and then into the bladder
Prime Regulators
ADH / Antidiuretic Hormone
Posterior pituitary Diabetes insipidus insufficient ADH / dilute urine
Renin-Angiotensin-Aldosterone
Adrenal Cortex Associated with BP Regulation
Production of Vit D3
In DCT and CCD, the remaining Na+ and K+ is reabsorbed under the influence of aldosterone.
Aldosterone is the principal mineralocorticoid (secreted by ?) Aldosterone stimulate the reabsorption of Na+ in exchange for K+ -- therefore, K+ is excreted.
In the absence of aldosterone, ~ 2% of Na+ is excreted and 100% of K+ is reabsorbed. When aldosterone is secreted in max. amounts, 100% of Na+ is reabsorbed and > 50% of K+ is excreted.
K+ can only be secreted in the urine in the presence of aldosterone..
Aldosterone secretion is regulated by negative feedback of blood [K+] & [Na+]. Rise in [K+] directly stimulates aldosterone secretion.
The more aldosterone secreted, the more K+ secreted into the filtrate and therefore excreted from the body.
Renin (an enzyme) converts angiotensinogen into angiotensin I. Angiotensin I is then converted into angiotensin II by angiotensin-converting enzyme (ACE). Angiotensin II stimulates aldosterone secretion (and a rise in blood pressure).
Powerful vasoconstrictor. Stimulates thirst..
Renin-Angiotension-Aldosterone System
Atrial natriuretic peptide, secreted by the atria of the heart, stimulates the kidneys to excrete more Na+. Water then follows the Na+ by osmosis. This lowers the blood volume (& blood pressure)..