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Figure 26-1 An Introduction to the Urinary System.
Organs of the Urinary System Kidney Produces urine Ureter Transports urine toward the urinary bladder Urinary bladder Temporarily stores urine prior to urination Urethra Conducts urine to exterior; in males, it also transports semen Anterior view
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26-1 Urinary System Functions
Three Functions of the Urinary System Excretion Removal of organic wastes from body fluids Elimination Discharge of waste products from body Homeostatic regulation Of blood plasma volume and solute concentration
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26-1 Urinary System Functions
Functions of the Urinary System Kidneys — organs that produce urine Urinary tract — organs that eliminate urine Ureters (paired tubes) Urinary bladder (muscular sac) Urethra (exit tube) Urination or micturition — process of eliminating urine Contraction of muscular urinary bladder forces urine through urethra, and out of body
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26-1 Urinary System Functions
Homeostatic Functions of the Urinary System Regulates blood volume and blood pressure By adjusting volume of water lost in urine Releasing erythropoietin and renin (O2 levels) Regulates plasma ion concentrations Sodium, potassium, and chloride ions (by controlling quantities lost in urine) Calcium ion levels (through synthesis of calcitriol)
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26-1 Urinary System Functions
Homeostatic Functions of Urinary System Helps stabilize blood pH By controlling loss of hydrogen ions and bicarbonate ions in urine Conserves valuable nutrients By preventing excretion while excreting organic waste products Assists liver In detoxifying poisons
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Figure 26-2a The Position of the Kidneys.
Adrenal gland Diaphragm 11th and 12th ribs Left kidney L1 vertebra Right kidney Ureter Renal artery and vein Inferior vena cava Iliac crest Aorta Urinary bladder Urethra a A posterior view of the trunk
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Figure 26-2b The Position of the Kidneys.
External oblique Parietal peritoneum Renal vein Renal artery Stomach Aorta Pancreas Ureter Spleen Left kidney Vertebra Connective tissue layers Fibrous capsule Perinephric fat Renal fascia Quadratus lumborum Psoas major Inferior vena cava b A superior view of a transverse section at the level indicated in part (a)
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Figure 26-3 The Gross Anatomy of the Urinary System.
Esophagus (cut) Diaphragm Left adrenal gland Inferior vena cava Left kidney Celiac trunk Left renal artery Right adrenal gland Right kidney Left renal vein Hilum Superior mesenteric artery Quadratus lumborum muscle Left ureter Abdominal aorta Iliacus muscle Left common iliac artery Psoas major muscle Gonadal artery and vein Peritoneum (cut) Rectum (cut) Urinary bladder Anterior view
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26-2 The Kidneys Sectional Anatomy of the Kidneys Renal sinus
Internal cavity within kidney Lined by fibrous renal capsule Bound to outer surfaces of structures in renal sinus Stabilizes positions of ureter, renal blood vessels, and nerves
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26-2 The Kidneys Renal Cortex Renal Pyramids
Superficial portion of kidney in contact with renal capsule Reddish brown and granular Renal Pyramids 6 to 18 distinct conical or triangular structures in renal medulla Base abuts cortex Tip (renal papilla) projects into renal sinus
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26-2 The Kidneys Renal Columns
Bands of cortical tissue separate adjacent renal pyramids Extend into medulla Have distinct granular texture
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26-2 The Kidneys Kidney Lobe Consists of: Produces urine
Renal pyramid Overlying area of renal cortex Adjacent tissues of renal columns Produces urine Kidney receives blood through renal artery
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26-2 The Kidneys Renal Papilla Major Calyx
Ducts discharge urine into minor calyx, a cup- shaped drain Major Calyx Formed by four or five minor calyces
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26-2 The Kidneys Renal Pelvis Large, funnel-shaped chamber
Consists of two or three major calyces Fills most of renal sinus Connected to ureter, which drains kidney
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Figure 26-4a The Structure of the Kidney.
Renal cortex Renal medulla Inner layer of fibrous capsule Renal pyramid Renal sinus Connection to minor calyx Adipose tissue in renal sinus Minor calyx Major calyx Renal pelvis Hilum Kidney lobe Renal papilla Renal columns Ureter Fibrous capsule a A diagrammatic view of a frontal section through the left kidney
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Figure 26-4b The Structure of the Kidney.
Renal cortex Renal medulla Renal pyramids Renal sinus Renal pelvis Major calyx Hilum Minor calyx Ureter Renal papilla Renal columns Kidney lobe Fibrous capsule b A frontal section of the left kidney (cadaver)
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26-2 The Kidneys Nephrons Microscopic, tubular structures in cortex of each renal lobe Where urine production begins
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26-2 The Kidneys Sympathetic Innervation
Adjusts rate of urine formation By changing blood flow and blood pressure at nephron Stimulates release of renin Which restricts losses of water and salt in urine By stimulating reabsorption at nephron
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Figure 26-5a The Blood Supply to the Kidneys.
Cortical radiate veins Cortical radiate arteries Interlobar arteries Cortex Segmental artery Adrenal artery Renal artery Renal vein Interlobar veins Arcuate veins Medulla Arcuate arteries a A sectional view, showing major arteries and veins
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Figure 26-5b The Blood Supply to the Kidneys.
Glomerulus Cortical radiate vein Afferent arterioles Cortical radiate artery Arcuate artery Arcuate vein Cortical nephron Juxtamedullary nephron Renal pyramid Interlobar vein Interlobar artery Minor calyx b Circulation in a single kidney lobe
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26-2 The Kidneys The Nephron
Consists of renal tubule and renal corpuscle Renal tubule Long tubular passageway Begins at renal corpuscle
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26-2 The Kidneys The Nephron Renal corpuscle
Spherical structure consisting of: Glomerular capsule (Bowman’s capsule) Cup-shaped chamber Capillary network (glomerulus)
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26-2 The Kidneys Glomerulus Consists of 50 intertwining capillaries
Blood delivered via afferent arteriole Blood leaves in efferent arteriole Flows into peritubular capillaries Which drain into small venules And return blood to venous system
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26-2 The Kidneys Filtration Occurs in renal corpuscle Blood pressure
Forces water and dissolved solutes out of glomerular capillaries into capsular space Produces protein-free solution (filtrate) similar to blood plasma
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26-2 The Kidneys Three Functions of the Renal Tubule
Reabsorb useful organic nutrients that enter filtrate Reabsorb more than 90 percent of water in filtrate Secrete waste products that failed to enter renal corpuscle through filtration at glomerulus
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26-2 The Kidneys Segments of the Renal Tubule Located in cortex
Proximal convoluted tubule (PCT) Distal convoluted tubule (DCT) Separated by nephron loop (loop of Henle) U-shaped tube Extends partially into medulla
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Figure 26-6 The Functional Anatomy of a Representative Nephron and the Collecting System (Part 1 of 2). NEPHRON Proximal convoluted tubule Distal convoluted tubule • Reabsorption of water, ions, and all organic nutrients • Secretion of ions, acids, drugs, toxins • Variable reabsorption of water, sodium ions, and calcium ions (under hormonal control) Cuboidal cells with abundant microvilli Cuboidal cells with few microvilli Mitochondria Renal tubule Renal corpuscle • Production of filtrate Squamous cells Efferent arteriole Afferent arteriole Glomerulus Glomerular capsule Descending limb of loop begins Ascending limb of loop ends Capsular space Nephron loop Descending limb Further reabsorption of water Thick ascending limb Squamous cells Ascending limb Reabsorption of sodium and chloride ions Thin descending limb Low cuboidal cells KEY Filtrate Solute reabsorption or secretion Water reabsorption Variable solute reabsorption or secretion Variable water reabsorption
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26-2 The Kidneys Organization of the Nephron
Traveling along tubule, filtrate (tubular fluid) gradually changes composition Changes vary with activities in each segment of nephron
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26-2 The Kidneys Each Nephron Empties into the collecting system
A series of tubes that carries tubular fluid away from nephron Collecting ducts Receive fluid from many nephrons Each collecting duct: Begins in cortex Descends into medulla Carries fluid to papillary duct that drains into a minor calyx
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Minor calyx Columnar cells
Figure 26-6 The Functional Anatomy of a Representative Nephron and the Collecting System (Part 2 of 2). COLLECTING SYSTEM Collecting duct • Variable reabsorption of water and reabsorption or secretion of sodium, potassium, hydrogen, and bicarbonate ions Intercalated cell Principal cell KEY Filtrate Papillary duct Water reabsorption • Delivery of urine to minor calyx Variable water reabsorption Solute reabsorption or secretion Minor calyx Columnar cells Variable solute reabsorption or secretion
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The circulation to a cortical nephron Peritubular capillaries Distal
Figure 26-7b The Locations and Structures of Cortical and Juxtamedullary Nephrons. Peritubular capillaries Distal convoluted tubule Efferent arteriole Afferent arteriole Renal corpuscle Collecting duct Peritubular capillaries Nephron loop b The circulation to a cortical nephron
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juxtamedullary nephron
Figure 26-7c The Locations and Structures of Cortical and Juxtamedullary Nephrons. Peritubular capillaries Distal convoluted tubule (DCT) Proximal convoluted tubule (PCT) Renal corpuscle Collecting duct Vasa recta Nephron loop c The circulation to a juxtamedullary nephron
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26-2 The Kidneys The Renal Corpuscle
Each renal corpuscle is 150–250 µm in diameter Glomerular capsule Is connected to initial segment of renal tubule Forms outer wall of renal corpuscle Encapsulates glomerular capillaries Glomerulus Knot of capillaries
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26-2 The Kidneys The Glomerular Capsule
Outer wall is lined by simple squamous capsular epithelium Continuous with visceral epithelium that covers glomerular capillaries Separated by capsular space
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26-2 The Kidneys The Visceral Epithelium Filtration Slits
Consists of large cells (podocytes) With complex processes or “feet” (pedicels) that wrap around specialized dense layer of glomerular capillaries Filtration Slits Are narrow gaps between adjacent pedicels Materials passing out of blood at glomerulus: Must be small enough to pass between filtration slits
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Figure 26-8a The Renal Corpuscle.
Glomerular capsule Capsular epithelium Visceral epithelium (podocyte) Glomerular capillary Capsular space Efferent arteriole Proximal convoluted tubule Distal convoluted tubule Juxtaglomerular complex Macula densa Juxtaglomerular cells Afferent arteriole a Important structural features of a renal corpuscle.
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Figure 26-8b The Renal Corpuscle.
Podocyte nucleus Filtration membrane Fenestrated endothelium Dense layer Filtration slits Mesangial cell Capillary endothelial cell Pores RBC Pedicels Podocyte Capsular space Capsular epithelium b This cross section through a portion of the glomerulus shows the components of the filtration membrane of the nephron.
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26-2 The Kidneys The Glomerular Capillaries Blood Flow Control
Are fenestrated capillaries Endothelium contains large-diameter pores Blood Flow Control Special supporting cells (mesangial cells) Between adjacent capillaries Control diameter and rate of capillary blood flow
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26-2 The Kidneys Filtration Blood pressure
Forces water and small solutes across membrane into capsular space Larger solutes, such as plasma proteins, are excluded
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26-2 The Kidneys Filtration at Renal Corpuscle Reabsorption Is passive
Solutes enter capsular space Metabolic wastes and excess ions Glucose, free fatty acids, amino acids, and vitamins Reabsorption Useful materials are recaptured before filtrate leaves kidneys Reabsorption occurs in proximal convoluted tubule
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26-2 The Kidneys The Proximal Convoluted Tubule (PCT)
Is the first segment of renal tubule Entrance to PCT lies opposite point of connection of afferent and efferent arterioles with glomerulus Epithelial Lining of PCT Is simple cuboidal Has microvilli on apical surfaces Functions in reabsorption Secretes substances into lumen
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26-2 The Kidneys Tubular Cells
Absorb organic nutrients, ions, water, and plasma proteins from tubular fluid Release them into peritubular fluid (interstitial fluid around renal tubule)
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26-2 The Kidneys The Nephron Loop (Loop of Henle)
Renal tubule turns toward renal medulla Descending limb Fluid flows toward renal pelvis Thick segment: Pumps sodium and chloride ions out of tubular fluid Ascending limb Fluid flows toward renal cortex Reabsorb sodium & chloride ions Thin segments: Are freely permeable to water (not solutes)
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Figure 26-6 The Functional Anatomy of a Representative Nephron and the Collecting System (Part 1 of 2). NEPHRON Proximal convoluted tubule Distal convoluted tubule • Reabsorption of water, ions, and all organic nutrients • Secretion of ions, acids, drugs, toxins • Variable reabsorption of water, sodium ions, and calcium ions (under hormonal control) Cuboidal cells with abundant microvilli Cuboidal cells with few microvilli Mitochondria Renal tubule Renal corpuscle • Production of filtrate Squamous cells Efferent arteriole Afferent arteriole Glomerulus Glomerular capsule Descending limb of loop begins Ascending limb of loop ends Capsular space Nephron loop Descending limb Further reabsorption of water Thick ascending limb Squamous cells Ascending limb Reabsorption of sodium and chloride ions Thin descending limb Low cuboidal cells KEY Filtrate Solute reabsorption or secretion Water reabsorption Variable solute reabsorption or secretion Variable water reabsorption
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26-2 The Kidneys The Distal Convoluted Tubule (DCT)
The third segment of the renal tubule Initial portion passes between afferent and efferent arterioles Has a smaller diameter than PCT Epithelial cells lack microvilli
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26-2 The Kidneys Three Processes at the DCT
Active secretion of ions, acids, drugs, and toxins Selective reabsorption of sodium and calcium ions from tubular fluid Selective reabsorption of water Concentrates tubular fluid
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26-2 The Kidneys The Juxtaglomerular Complex (JGC)
An endocrine structure that secretes: Hormone erythropoietin Enzyme renin Formed by: Macula densa Juxtaglomerular cells
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Figure 26-8a The Renal Corpuscle.
Glomerular capsule Capsular epithelium Visceral epithelium (podocyte) Glomerular capillary Capsular space Efferent arteriole Proximal convoluted tubule Distal convoluted tubule Juxtaglomerular complex Macula densa Juxtaglomerular cells Afferent arteriole a Important structural features of a renal corpuscle.
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26-2 The Kidneys The Collecting System
The distal convoluted tubule opens into the collecting system Individual nephrons drain into a nearby collecting duct Several collecting ducts: Converge into a larger papillary duct Which empties into a minor calyx Transports tubular fluid from nephron to renal pelvis Adjusts fluid composition Determines final osmotic concentration and volume of urine
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26-3 Renal Physiology The Goal of Urine Production
Is to maintain homeostasis By regulating volume and composition of blood Including excretion of metabolic waste products
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26-3 Renal Physiology Three Organic Waste Products
Urea Creatinine Uric acid Organic Waste Products Are dissolved in bloodstream Are eliminated only while dissolved in urine Removal is accompanied by water loss
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26-3 Renal Physiology The Kidneys Kidney Functions
Usually produce concentrated urine 1200–1400 mOsm/L (four times plasma concentration) Kidney Functions To concentrate filtrate by glomerular filtration Failure leads to fatal dehydration Absorbs and retains valuable materials for use by other tissues Sugars and amino acids
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26-3 Renal Physiology Basic Processes of Urine Formation Reabsorption
Filtration Reabsorption Secretion
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26-3 Renal Physiology An Overview of Renal Function
Water and solute reabsorption Primarily along proximal convoluted tubules Active secretion Primarily at proximal and distal convoluted tubules Long loops of juxtamedullary nephrons and collecting system Regulate final volume and solute concentration of urine
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Figure 26-9 An Overview of Urine Formation.
Proximal convoluted tubule Distal convoluted tubule Glomerulus Glomerular capsule Collecting duct KEY Nephron loop Filtration occurs exclusively in the renal corpuscle, across the filtration membrane. Water reabsorption occurs primarily along the PCT and the descending limb of the nephron loop, but also to a variable degree in the DCT and collecting system. Variable water reabsorption occurs in the DCT and collecting system. Solute reabsorption occurs along the PCT, the ascending limb of the nephron loop, the DCT, and the collecting system. Urine storage and elimination Variable solute reabsorption or secretion occurs at the PCT, the DCT, and the collecting system.
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Table 26-2 Normal Laboratory Values for Solutes in Plasma and Urine.
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26-3 Renal Physiology Renal Threshold for Glucose
Is approximately 180 mg/dL If plasma glucose is greater than 180 mg/dL: Tm of tubular cells is exceeded Glucose appears in urine Glycosuria
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26-3 Renal Physiology Renal Threshold for Amino Acids
Is lower than glucose (65 mg/dL) Amino acids commonly appear in urine After a protein-rich meal Aminoaciduria
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Table 26-3 Tubular Reabsorption and Secretion.
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Figure 26-11 The Response to a Reduction in the GFR (Part 2 of 2).
Autoregulation Immediate local response in the kidney HOMEOSTASIS RESTORED Increased glomerular blood pressure if sufficient Normal GFR Dilation of afferent arterioles HOMEOSTASIS DISTURBED HOMEOSTASIS Normal glomerular filtration rate Contraction of mesangial cells Decreased GFR resulting in decreased filtrate and urine production Start Constriction of efferent arterioles
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26-4 Glomerular Filtration
Hormonal Regulation of the GFR (glomeral filtration) By hormones of the: Renin–angiotensin-aldosterone system Natriuretic peptides (ANP and BNP)
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26-4 Glomerular Filtration
The Renin–Angiotensin-Aldosterone System Three stimuli cause the juxtaglomerular complex (JGC) to release renin Decline in blood pressure at glomerulus due to decrease in blood volume, fall in systemic pressures, or blockage in renal artery or tributaries Stimulation of juxtaglomerular cells by sympathetic innervation Decline in osmotic concentration of tubular fluid at macula densa
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26-4 Glomerular Filtration
The Renin–Angiotensin-Aldosterone System: Angiotensin II Activation Constricts efferent arterioles of nephron Elevating glomerular pressures and filtration rates Stimulates reabsorption of sodium ions and water at PCT Stimulates secretion of aldosterone by adrenal cortex Stimulates thirst Triggers release of antidiuretic hormone (ADH) Stimulates reabsorption of water in distal portion of DCT and collecting system
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26-4 Glomerular Filtration
The Renin–Angiotensin-Aldosterone System Aldosterone Accelerates sodium reabsorption in DCT and cortical portion of collecting system
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Figure 26-11 The Response to a Reduction in the GFR (Part 1 of 2).
Renin–Angiotensin-Aldosterone System Integrated endocrine and neural mechanisms activated Renin in the bloodstream triggers formation of angiotensin I, which is then activated to angiotensin II by angiotensin converting enzyme (ACE) in the capillaries of the lungs Endocrine response Juxtaglomerular complex increases production of renin Angiotensin II triggers increased aldosterone secretion by the adrenal glands Angiotensin II triggers neural responses Angiotensin II constricts peripheral arterioles and further constricts the efferent arterioles Aldosterone increases Na+ retention HOMEOSTASIS RESTORED Increased stimulation of thirst centers Increased systemic blood pressure Increased fluid consumption Increased glomerular pressure Increased blood volume Increased fluid retention Increased ADH production Constriction of venous reservoirs Increased cardiac output Increased sympathetic motor tone Together, angiotensin II and sympathetic activation stimulate peripheral vasoconstriction HOMEOSTASIS Normal glomerular filtration rate
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26-4 Glomerular Filtration
Hormonal Regulation of the GFR Increased Blood Volume Automatically increases GFR To promote fluid loss Hormonal factors further increase GFR Accelerating fluid loss in urine
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26-5 Reabsorption and Secretion
Recovers useful materials from filtrate Secretion Ejects waste products, toxins, and other undesirable solutes Reabsorption and Secretion Occur in every segment of nephron Except renal corpuscle Relative importance changes from segment to segment
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26-5 Reabsorption and Secretion
Aldosterone Is a hormone produced by the adrenal cortex Controls ion pump and channels Stimulates synthesis and incorporation of Na+ pumps and channels In plasma membranes along DCT and collecting duct Reduces Na+ lost in urine
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26-5 Reabsorption and Secretion
Hypokalemia Produced by prolonged aldosterone stimulation Dangerously reduces plasma concentration Natriuretic Peptides (ANP and BNP) Oppose secretion of aldosterone And its actions on DCT and collecting system Parathyroid Hormone and Calcitriol Circulating levels regulate calcium ion reabsorption at the DCT
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26-5 Reabsorption and Secretion
Hydrogen Ion Secretion Acidifies tubular fluid Elevates blood pH Accelerates when blood pH falls
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26-5 Reabsorption and Secretion
Acidosis Lactic acidosis Develops after exhaustive muscle activity Ketoacidosis Develops in starvation or diabetes mellitus
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26-5 Reabsorption and Secretion
Control of Blood pH By H+ removal and bicarbonate production at kidneys Is important to homeostasis Alkalosis Abnormally high blood pH Can be caused by prolonged aldosterone stimulation (Na+ retention coupled with H+ secretion) Which stimulates secretion
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26-5 Reabsorption and Secretion
Regulating Water and Solute Loss in the Collecting System By aldosterone Controls sodium ion pumps Actions are opposed by natriuretic peptides By ADH Controls permeability to water Is suppressed by natriuretic peptides
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26-5 Reabsorption and Secretion
ADH Hormone that causes special water channels (aquaporins) to appear in apical cell membranes Increases rate of osmotic water movement Higher levels of ADH increase: Number of water channels Water permeability of DCT and collecting system
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26-5 Reabsorption and Secretion
Without ADH: Water is not reabsorbed All fluid reaching DCT is lost in urine Producing large amounts of dilute urine
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26-5 Reabsorption and Secretion
The Hypothalamus Continuously secretes low levels of ADH DCT and collecting system are always permeable to water At normal ADH levels Collecting system reabsorbs 16.8 liters/day (9.3 percent of filtrate)
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26-5 Reabsorption and Secretion
Urine Production A healthy adult produces: 1200 mL per day (0.6 percent of filtrate) With osmotic concentration of 855–1335 mOsm/L
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26-5 Reabsorption and Secretion
Diuresis Is the elimination of urine Typically indicates production of large volumes of urine Diuretics Are drugs that promote water loss in urine Diuretic therapy reduces: Blood volume Blood pressure Extracellular fluid volume
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26-5 Reabsorption and Secretion
The Composition of Normal Urine A urine sample depends on osmotic movement of water across walls of tubules and collecting ducts Is a clear, sterile solution Yellow color (pigment urobilin) Generated in kidneys from urobilinogens Urinalysis, the analysis of a urine sample, is an important diagnostic tool
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Table 26-5 General Characteristics of Normal Urine.
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Table 26-6 Typical Values Obtained from Standard Urinalysis (Part 1 of 4).
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Table 26-6 Typical Values Obtained from Standard Urinalysis (Part 2 of 4).
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Table 26-6 Typical Values Obtained from Standard Urinalysis (Part 3 of 4).
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Table 26-6 Typical Values Obtained from Standard Urinalysis (Part 4 of 4).
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26-6 Urine Transport, Storage, and Elimination
Take place in the urinary tract Ureters Urinary bladder Urethra
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11th and 12th ribs Minor calyx Major calyx Ureter Urinary bladder
Figure A Pyelogram. 11th and 12th ribs Minor calyx Major calyx Ureter Urinary bladder Renal pelvis Kidney
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26-6 Urine Transport, Storage, and Elimination
The Ureters Are a pair of muscular tubes Extend from kidneys to urinary bladder Begin at renal pelvis Ureteral openings are slit-like rather than rounded Shape helps prevent backflow of urine when urinary bladder contracts Peristaltic Contractions of ureters move urine toward bladder
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A transverse section through the ureter.
Figure 26-19a The Histology of the Ureter, Urinary Bladder, and Urethra. Transitional epithelium Mucosa Lamina propria Smooth muscle Outer connective tissue layer Ureter LM ×65 a A transverse section through the ureter.
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26-6 Urine Transport, Storage, and Elimination
Peristaltic Contractions Begin at renal pelvis Sweep along ureter Force urine toward urinary bladder Every 30 seconds
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26-6 Urine Transport, Storage, and Elimination
The Urinary Bladder Is a hollow, muscular organ Functions as temporary reservoir for urine storage Full bladder can contain 1 liter of urine
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Figure 26-18a Organs for Conducting and Storing Urine.
Left ureter Rectum Peritoneum Urinary bladder Pubic symphysis Prostate gland External urethral sphincter Spongy urethra External urethral orifice Urethra [see part c] Urogenital diaphragm a Male
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Figure 26-18b Organs for Conducting and Storing Urine.
Rectum Right ureter Uterus Peritoneum Urinary bladder Internal urethral sphincter Pubic symphysis Urethra External urethral sphincter (in urogenital diaphragm) Vestibule Vagina b Female
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Figure 26-18c Organs for Conducting and Storing Urine.
Median umbilical ligament Ureter Lateral umbilical ligament Detrusor muscle Rugae Ureteral openings Center of trigone Neck of urinary bladder Internal urethral sphincter Prostate gland External urethral sphincter (in urogenital diaphragm) Prostatic urethra Membranous urethra c Urinary bladder in male
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26-6 Urine Transport, Storage, and Elimination
The Urethra Extends from neck of urinary bladder To the exterior of the body
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26-6 Urine Transport, Storage, and Elimination
The Female Urethra Is very short (3–5 cm; 1–2 in.) Extends from bladder to vestibule External urethral orifice is near anterior wall of vagina
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26-6 Urine Transport, Storage, and Elimination
The External Urethral Sphincter In both sexes Is a circular band of skeletal muscle Where urethra passes through urogenital diaphragm Acts as a valve Is under voluntary control Via perineal branch of pudendal nerve Has resting muscle tone Voluntary relaxation permits micturition
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26-6 Urine Transport, Storage, and Elimination
The Micturition Reflex and Urination As the bladder fills with urine: Stretch receptors in urinary bladder stimulate sensory fibers in pelvic nerve Stimulus travels from afferent fibers in pelvic nerves to sacral spinal cord Efferent fibers in pelvic nerves: Stimulate ganglionic neurons in wall of bladder
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26-6 Urine Transport, Storage, and Elimination
The Micturition Reflex and Urination Postganglionic neuron in intramural ganglion stimulates detrusor muscle contraction Interneuron relays sensation to thalamus Projection fibers from thalamus deliver sensation to cerebral cortex Voluntary relaxation of external urethral sphincter causes relaxation of internal urethral sphincter
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Figure 26-20 The Micturition Reflex (Part 1 of 2).
Senory fibers in pelvic nerves. Parasympathetic preganglionic motor fibers in pelvic nerves. L2 L3 L1 Distortion of stretch receptors. Urinary bladder Postganglionic neurons in intramural ganglia stimulate detrusor muscle contraction. L4 Start C4 Voluntary relaxation of the external urethral sphincter causes relaxation of the internal urethral sphincter. Urination occurs
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Figure 26-20 The Micturition Reflex (Part 2 of 2).
Projection fibers from thalamus deliver sensation to the cerebral cortex. C2 Brain If convenient, the individual voluntarily relaxes the external urethral sphincter. C3 The afferent fibers stimulate neurons involved with: An interneuron relays sensation to the thalamus. C1 L a local pathway, and C a central pathway
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26-6 Urine Transport, Storage, and Elimination
Infants Lack voluntary control over urination Corticospinal connections are not established Incontinence Is the inability to control urination voluntarily May be caused by trauma to internal or external urethral sphincter
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26-7 Effects of Aging on the Urinary System
Age-Related Changes Decline in number of functional nephrons Reduction in GFR Reduced sensitivity to ADH Problems with micturition reflex Sphincter muscles lose tone leading to incontinence Control of micturition can be lost due to a stroke, Alzheimer’s disease, and other CNS problems In males, urinary retention may develop if enlarged prostate gland compresses the urethra and restricts urine flow
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