1. Anatomy of the Urinary System

2. Structures
Kidneys:
located under back muscles, behind parietal peritoneum, above the waistline, right slightly lower than left
Internal structure:
Cortex: outer layer
Medulla: inner portion
Pyramids: triangular sections of medulla

3. Kidney…con’t
Papilla: narrow innermost end of pyramid
Pelvis: expansion of upper end of ureter, inside the kidney
Calyces: division of the renal pelvis

4. Microscopic Structures
Nephron: functional unit of kidney
1. Renal Corpuscle:
Bowman’s capsule with glomerulus
Glomerulus: network of blood capilliaries
2. Renal Tubule:
Proximal convoluted tubule: first segment
Loop of Henle: extension of prox. Tubule; consists of descending limb, loop and ascending limb

5. Renal Tubule…con’t
Distal convoluted tubule: extension of ascending Loop of Henle
Collecting Tubule: straight extension of distal tubule

6. Ureters
Long narrow tube with expanded ends in the kidney (renal pelvis)
Lined with mucous membrane
Drains urine from kidney to urinary bladder

7. Urinary Bladder Elastic muscular organ, capable of great expansion
Lined with mucous membrane arranged with rugae
Stores urine before voiding
Voiding

8. Urethra Narrow tube from urinary bladder to exterior urinary meatus
Lined with mucous membrane
Passage for urine from bladder to meatus
Passage of semen from the body

9. Functions 1. Producing and Excreting Urine
2. Regulates chemicals in the blood
Electrolytes, acid base balance
3. maintains fluid balance
4. Regulate blood pressure through secretion of renin

10. Formation of urine 3 processes:
1. Filtration: continually in renal corpuscle,
glomerular blood pressure causes water and dissolved substance to filter out of glomeruli into bowman’s capsule,
normal rate is 125 ml/min

11. 2. Reabsorption: movement of substances out of renal tubules into blood in the peritubular capillaries;
Water, nutrients, and ions are reabsorbed
Water is reabsorbed by osmosis from proximal tubules

12. 3. Secretion: movement of substances into urine in the distal and collecting tubules
Hydrogen ions, potassium ions, and certain drugs are secreted by active transport
Ammonia is secreted by diffusion

13. Control of Urine Volume
Posterior Pituitary hormone: ADH, which decreases urine, by making collecting tubules permeable to water
If no ADH is present, collecting tubules are practically impermeable to water
Adrenal Cortex: aldosterone, important in controlling reabsorbtion of sodium

14. Abnormal amounts of Urine
Anuria: absence of urine
Oliguria: scant amounts of urine
Polyuria: excessive amounts of urine

15. Micturation Urination/Voiding Sphincter control:
Internal urethral sphincter: involuntary, located at the bladder exit
External urethral sphincter: voluntary, located just below the neck of the bladder
Most learn voluntary control between 2 and 3 years of age

16. Emptying Reflex Initiated by stretch reflex in bladder wall
Bladder wall contracts
Internal sphincter relaxes
External sphincter relaxes and bladder is emptied

17. Disorders Urinary Retention: urine produced, bladder wont empty
Urinary Suppression: no urine produced, but bladder will empty
Incontinence: Voiding involuntarily
Causes: spinal injury, stroke
Retention may cause cystitis

18. Disorders con’t Obstructive Disorders
Renal Calculi (kidney stones) block ureters, intense pain, renal colic
Neurogenic bladder: paralysis or abn functioning of bladder, prevents normal flow of urine out of the body
Tumors: renal cell carcinoma & Bladder cancer: Characterized by blood in urine

19. UTI’s Often caused by gram negative bacteria
Escherichia coli (E. coli) causes about 80% of UTIs in adults.
These bacteria are normally present in the colon and may enter the urethral opening from the skin around the anus and genitals. Women may be more susceptible to UTI because their urethral opening is near the source of bacteria (e.g., anus, vagina) and their urethra is shorter, providing bacteria easier access to the bladder.

20. UTI’s con’t
Other bacteria that cause urinary tract infections include Staphylococcus saprophyticus (5 to 15% of cases), Chlamydia trachomatis, and Mycoplasma hominis.
Men and women infected with chlamydia trachomatis or mycoplasma hominis can transmit the bacteria to their partner during sexual intercourse, causing UTI

21. Uretritis: inflammation of the urethra
Cystitis: inflammation or infection of the bladder
Pyelonephritis: inflammation of the renal pelvis and connective tissues of the kidney: acute(infectious) or chronic (autoimmune)

22. Glomerular disorders Nephrotic syndrome:
Proteinuria: protiens in urine
Hypoalbuminemia: low plasma protiens (albumin) levels
Edema: tissue swelling caused by loss of water from plasma as a result of hypoalbuminemia
Acute glomerulonephritis: caused by delayed immune response to streptococcal infection

23. Chronic Glomerulonephritis
Slow inflammatory condition caused by immune mechanisms and often leads to renal failure.

24. Renal Failure
Acute: abrupt reduction in kidney function that is usually reversible
Chronic: slow progressive loss of nephrons, caused by a variety of underlying diseases (BUN increases, GFR decreases, creatinine increases

25. Chronic Renal Failure Stage 1: some nephrons lost
Compensation by enlargement of remaining
BUN is kept normal
GFR drops (up to 75%)
Often asymptomatic, may last for years

26. Stage 2
Renal insufficiency: Kidney no longer compensates for loss of nephrons
Remaining cant handle urea load
BUN increases dramatically
Kidneys ability to concentrate urine is impaired: polyuria and dehydration occur

27. Stage 3 Called “uremia” or “uremic syndrome” High blood urea
BUN very high
Caused by loss of kidney function
GFR low=oliguria: edema and hypertension result
Dialysis or kidney transplant required or
Death occurs