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1 PowerPoint Lecture Outlines to accompany
Hole’s Human Anatomy and Physiology Tenth Edition Shier w Butler w Lewis Chapter 20 20-1 Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

2 Chapter 20 Urinary System

3 Location of Kidneys 20-3

4 Kidneys 20-4

5 Renal Blood Vessels 20-5

6 Renal Blood Vessels 20-6

7 Glomerular Capsule 20-7

8 Nephron and Associated Blood Vessels

9 Renal Cortex and Renal Medulla

10 Juxtaglomerular Apparatus

11 Types of Nephrons cortical nephrons 80% of nephrons
juxtamedullary nephrons regulate water balance 20-11

12 Blood Supply of Nephron
The capillary loop of the vasa recta is closely associated with the nephron loop of the juxtamedullary nephron 20-12

13 Summary of Blood Flow Through Kidney and Nephron

14 Urine Formation Glomerular Filtration
substances move from blood to glomerular capsule Tubular Reabsorption substances move from renal tubules into blood of peritubular capillaries glucose, water, urea, proteins, creatine amino, lactic, citric, and uric acids phosphate, sulfate, calcium, potassium, and sodium ions Tubular Secretion substances move from blood of peritubular capillaries into renal tubules drugs and ions 20-14

15 Glomerular Filtration
Glomerular filtrate passes through the fenestrae of the capillary endothelium 20-15

16 Glomerular Filtrate and Urine Composition

17 Glomerular Filtration Rate
Net Filtration Pressure = force favoring filtration – forces opposing filtration (glomerular capillary ( capsular hydrostatic pressure hydrostatic pressure) and glomerular capillary osmotic pressure ) 20-17

18 Amounts of Glomerular Filtrate and Urine
average amounts over a 24 hour period 20-18

19 Control of Filtration Rate
Increased sympathetic impulses decrease GFR by causing afferent arterioles to constrict Renin-angiotensin system (shown) Autoregulation 20-19

20 Tubular Reabsorption 20-20

21 Tubular Reabsorption of Water and Ions

22 Sodium and Water Filtration, Reabsorption, and Excretion

23 Tubular Secretion 20-23

24 Secretion of Ions In distal convoluted tubules, potassium ions or hydrogen ions may be passively secreted in response to active reabsorption of sodium ions 20-24

25 Countercurrent Mechanism
helps maintain the NaCl concentration gradient in the medullary interstitial fluid 20-25

26 Countercurrent Mechanism of Vasa Recta
fluid in ascending limb becomes hypotonic as solute is reabsorbed fluid in descending limb becomes hypertonic as it loses water by osmosis 20-26

27 Effect of ADH on Renal Tubules
without ADH, DCT and collecting duct are impermeable to water with ADH, DCT and collecting duct become permeable to water with ADH, water is reabsorbed by osmosis into hypertonic medullary interstitial fluid 20-27

28 Urea and Uric Acid Excretion
product of amino acid catabolism plasma concentration reflects the amount or protein in diet enters renal tubules through glomerular filtration 50% reabsorbed rest is excreted Uric Acid product of nucleic acid metabolism enters renal tubules through glomerular filtration 100% reabsorbed 10% secreted and excreted 20-28

29 Renal Clearance the rate at which a chemical is removed from the plasma tests of renal clearance inulin clearance test creatinine clearance test paraminohipparic acid test tests of renal clearance used to calculate glomerular filtration rate 20-29

30 Elimination of Urine nephrons collecting ducts renal papillae
minor and major calyces renal pelvis ureters urinary bladder urethra outside world 20-30

31 Ureters 25 cm long extend downward posterior to the parietal peritoneum parallel to vertebral column in pelvic cavity, join urinary bladder wall of ureter mucous coat muscular coat fibrous coat 20-31

32 Location of Male and Female Urinary Bladders

33 Urinary Bladder Longitudinal section and posterior view of male urinary bladder 20-33

34 Cross Section of Urethra

35 Male and Female Urethras

36 Micturition bladder distends and stretch receptors stimulated
micturition center activated in sacral portion of spinal cord parasympathetic nerve impulses cause detrusor muscle to contract need to urinate is sensed voluntary contraction of external urethral sphincter prevents urination when decision is made to urinate, external urethral sphincter relaxes, detrusor muscle contracts, and urine is expelled 20-36

37 Life-Span Changes kidneys appear scarred and grainy kidney cells die
by age 80, kidneys have lost a third of their mass kidney shrinkage due to loss of glomeruli proteinuria may develop renal tubules thicken harder for kidneys to clear certain substances bladder, ureters, and urethra lose elasticity bladder holds less urine 20-37

38 Clinical Application Glomerulonephritis inflammation of glomeruli
may be acute or chronic acute glomerulonephritis usually occurs as an immune reaction to a Streptococcus infection antigen-antibody complexes deposited in glomeruli and cause inflammation most patients recover from acute glomerulonephritis chronic glomerulonephritis is a progressive disease and often involves diseases other than that caused by Streptococcus renal failure may result from chronic glomerulonephritis 20-38

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