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TABLE OF CONTENT
1) General Introduction
2) Anatomy of Urinary System
3) Urine Formation
4) Urine Storage and Elimination
Extensions of the
cortex (renal
columns) project
toward the sinus,
dividing the medulla
into 6-10 renal
pyramids. Each
pyramid is conical
with a blunt point
called the papilla
facing the sinus.
The Nephron
- The kidney contains 1.2 million nephrons, which
are the functional units of the kidney.
- A nephron consists of :
i. blood vessels
afferent arteriole
glomerulus
efferent arteriole
ii. renal tubules
proximal convoluted tubule
loop of Henle
distal convoluted tubule
The Nephron
glomerulus
efferent arteriole
proximal
convoluted
tubule
blood
distal
convoluted
tubule
blood
afferent arteriole
Loop of Henle
The Nephron
- Most components of
the nephron are within
the cortex.
URINE FORMATION
Glomerular
Filtrate
Tubular fluid
Urine
1) Glomerular Filtration
foot processes
fenestrated
epithelium
basement
membrane
Blood cells
Plasma proteins
in urine
Filtration Pressure
Glomerular filtration follows the same principles
that govern filtration in other capillaries.
Renal Autoregulation
- the ability of the kidneys to maintain a
relatively stable GFR in spite of the
changes (75 - 175 mmHg) in arterial
blood pressure.
1) myogenic response
2) tubuloglomerular feedback
1) Glomerular Filtration
2) Tubular Reabsorption
3) Tubular Secretion
4) Concentrating Urine by Collecting Duct
Reabsorption in Proximal
Convoluted Tubules
Routes of Proximal
Tubular
Reabsorption
1) transcellular route
2) paracellular route
PCT
peritubular capillary
Osmosis
Water moves from a compartment of low osmolarity
to the compartment of high osmolarity.
low osmolarity
( high H2O conc.)
H2O
high osmolarity
( low H2O conc.)
1) Solvent drag
- driven by high
colloid osmotic
pressure (COP) in the
peritubular capillaries
H2O
Proteins
- Water is reabsorbed
by osmosis and
carries all other
solutes along.
Proteins stay
Na+
Na+
K+
capillary
PCT cell
Tubular
lumen
Ca++
capillary
PCT cell
Ca++
Tubular
lumen
K+
Glucose
capillary
PCT cell
Na+
Na+
K+
amino acids
capillary
PCT cell
Na+
Na+
H2O
capillary
PCT cell
Tubular
lumen
Na
Na+
Cl-
capillary
PCT cell
Tubular
lumen
capillary
amino acids
protein
PCT cell
Tubular
lumen
Na+
Glucose
Glucose in urine
Reabsorption in the
Nephron Loop
mOsm/L
Reabsorption in Distal
Convoluted Tubules
Aldosterone
a. secreted
from
adrenal
gland in response to a
Na+ or a K+ in blood
b. to increase Na+ absorption
and K+ secretion in the DCT
and cortical portion of the
collecting duct.
c. helps to maintain blood
volume and pressure.
1) Glomerular Filtration
2) Tubular Reabsorption
3) Tubular Secretion
4) Concentrating Urine by Collecting Duct
Tubular Secretion
- Renal tubule extracts chemicals from the blood and
secretes them into the tubular fluid.
- serves the purposes of waste removal and acid-base
balance.
H+
capillary
H+
PCT cell
Tubular
lumen
1) Glomerular Filtration
2) Tubular Reabsorption
3) Tubular Secretion
4) Concentrating Urine by Collecting Duct
Cortex
2. CD reabsorbs water.
collecting
duct
urine
1. Driving force
The high
osmolarity of extracellular
fluid generated by NaCl
and urea, provides the
driving force for water
reabsorption.
Cortex
medulla
2. Regulation
The medullary
portion of the CD is not
permeable to NaCl but
permeable to water,
depending on ADH.
mOsm/L
urine
Cortex
medulla
mOsm/L
urine
Cortex
medulla
urine
urine
Urine Properties
Substance
Blood Plasma
(total amount)
4.8 g
Urine
(amount per day)
25 g
Uric acid
0.15 g
0.8 g
Creatinine
0.03 g
1.6 g
Potassium
0.5 g
2.0 g
Chloride
10.7 g
6.3 g
Sodium
9.7 g
4.6 g
Protein
200 g
0.1 g
HCO3-
4.6 g
0g
3g
0g
Urea
Glucose
Urine Volume
An average adult produces 1-2 L of urine per
day.
a. Excessive urine output is called
polyuria.
b. Scanty urine output is oliguria. An
output of less than 400 mL/day is
insufficient to excrete toxic wastes.
Diabetes
- is chronic polyuria resulting from various
metabolic disorders, including Diabetes
mellitus and Diabetes insipidus
Diabetes mellitus
pancreatic cell
- caused by either
1) deficiency of insulin
(Type I)
or
2) deficiency of insulin
receptors (Type II).
- Diabetes mellitus features
high glucose in the blood
(hyperglycemia)
insulin
receptors
insulin
cell
glucose
cell
glycogen
blood
high glucose
- When glucose in
tubular fluid exceeds
the transport maximum
(180 mg/100 ml), it
appears in urine
(glycosuria).
- Glucose in tubular
fluid hinders water
reabsorption by
osmosis, causing
polyuria.
high glucose
in filtrate
Retain H2O by
osmosis
high
urine
volume
Diabetes insipidus
- is caused by
inadequeate ADH
secretion.
- Due to the shortage
of ADH, water
reabsorption in CD is
compromised, leading
to polyuria.
urine
Diuresis
refers to excretion of large amount of urine.
Natriuresis
refers to enhanced urinary excretion of
sodium
Diuretics
- are chemicals that increase
urine volume. They are used for
treating hypertension and
congestive heart failure because
they reduce overall fluid volume.
- work by either increasing
glomerular filtration or reducing
tubular reabsorption. Caffeine
falls into the former category;
alcohol into the latter (alcohol
suppresses the release of ADH).
Renal Clearance
a. the volume of blood plasma
from which a particular waste is
removed in 1 minute.
b. can be measured indirectly by
measuring the waste
concentration in blood and
urine, and the urine volume.
Hemodialysis
artificially clearing wastes from the blood
1) Dialysis
machine
- efficient
- inconvenient
2) Continuous
ambulatory
peritoneal
dialysis (CAPD)
- The peritoneal
membrane is a natural
dialysis membrane
- convenient
- less efficient
Dialysis
fluid
The Ureters
The ureters are muscular tubes leading from the
renal pelvis to the lower bladder.
The Urethra
- conveys urine from the urinary bladder to the
outside of the body.
Females
3-4 cm
greater risk of
urinary tract
infections
male
~18 cm
In both sexes:
- internal urethral sphincter- under involuntary control.
- external urethral sphincter - under voluntary control
Spinal
cord
Voluntary
control
SUMMARY
1) General Introduction
2) Anatomy of Urinary System
3) Urine Formation
4) Urine Storage and Elimination