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Urinary System

Urinary System. FUNCTIONS. MAINTAIN HOMEOSTASIS OF pH, COMPOSITION AND VOLUME OF BODY FLUIDS REMOVES: METABOLIC WASTE, EXCESS MATERIAL, FOREIGN SUBSTANCES (DRUGS). PARTS. KIDNEYS URETER S URINARY BLADDER URETHRA FUNCTIONS?. http://miyessence.files.wordpress.com/2006/12/urinary.jpg.

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Urinary System

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  1. Urinary System

  2. FUNCTIONS • MAINTAIN HOMEOSTASIS OF pH, COMPOSITION AND VOLUME OF BODY FLUIDS • REMOVES: • METABOLIC WASTE, EXCESS MATERIAL, • FOREIGN SUBSTANCES (DRUGS)

  3. PARTS • KIDNEYS • URETER S • URINARY BLADDER • URETHRA • FUNCTIONS?

  4. http://miyessence.files.wordpress.com/2006/12/urinary.jpg

  5. KIDNEYS • LOCATED RETROPERITONEALLY • 12TH THORACIC TO 3RD LUMBAR VERTEBRAE • RENAL SINUS AT HILUM: BLOOD VESSELS, URETER, NERVES, LYMPHATIC VESSELS • RELEASES ERYTHROPOIETIN ? • RELEASES RENIN ? • BLOOD PRESSURE • ACTIVATES VITAMIN D ? • CALCIUM ABSORPTION

  6. http://depts.washington.edu/ostomy/urostomy/urinary-sys.gif

  7. http://www.biog1105-1106.org/demos/105/unit7/media/human-urinary-system.jpghttp://www.biog1105-1106.org/demos/105/unit7/media/human-urinary-system.jpg

  8. RENAL PELVIS • FUNNEL SHAPED SAC AT URETER ORIGIN • WHERE MAJOPR CALYCES MERGE • RENAL MEDULLA: • RENAL PYRAMIDS • MINOR CALYCES TO MAJOR CALYCES • RENAL CORTEX: • OUTER LAYER • DIPS IN BETWEEN PYRAMIDS = RENAL COLUMNS RENAL CAPSULE FIBROUS CONNECTIVE TISSUE PROTECTION, MAINTAIN SHAPE

  9. BLOOD VESSELS • ARTERIES CAN CARRY 30% OF BLOOD TO KIDNEYS ? • RENAL ARTERY HAS _________________ BLOOD • RENAL VEIN HAS _________________ BLOOD

  10. ARTERIES • Descending aorta • Renal artery • Interlobar artery • Arciform arteries • Interlobular arteries • Afferent arterioles • Glomerulus • Efferent arteriole • Capillary net

  11. NEPHRON • FUNCTIONAL UNIT OF KIDNEY • 1 MILLION PER • PARTS • RENAL CORPUSCLE • GLOMERULUS • GLOMERULAR OR BOWMAN’S CAPSULE • 2 LAYERS OF SQUAMOUS EPITHELIAL • VISCERAL AND PARIETAL TO TUBULE • VISCERAL CELLS: PODOCYTES • HAVE PROCESS AND SECONDARY PROCESSES = PEDICELS, INTERDIGITATE TO FORM SLIT PORES • FUNCTION • AFFERENT AND EFFERENT ARTERIOLES

  12. GLOMERULUS http://www.jimstanis.com/images/glomerulus.jpg

  13. http://www.life-enhancement.com/images/005glomerulus.jpg

  14. PODOCYTES http://www.life-enhancement.com/images/005glomerulus.jpg

  15. RENAL TUBULE • PROXIMAL CONVOLUTED TUBULE • NEPHRON LOOP/ LOOP OF HENLE • DESCENDING LIMB • ASCENDING LIMB • DISTAL CONVOLUTED TUBULE • COLLECTING DUCT/ COLLECTING TUBULE • THROUGH RENAL PAPILAE TO MINOR CALYX

  16. RENAL TUBULE http://www.dr-aschatterjee.com/renal.html

  17. JUXTAGLOMERULAR APPARATUS • ASCENDING LIMB PASSES BETWEEN AFFERENT AND EFFERENT ARTERIOLE • MACULA DENSA = TALL DENSELY PACKED CELLS OF ASCENDING LOOP TOUCHING ASCENDING LIMB • JUXTAGLOMERULAR CELLS IN WALL OF AFFERENT ARTERIOLE (LARGE VASCULAR SMOOTH MUSCLE CELLS) • REGULATES SECRETION OF RENIN (CHAP 13)

  18. JUXTAGLOMERULAR APPARATUS http://www.cf.ac.uk/biosi/staffinfo/jacob/teaching/jga1.gif

  19. NEPHRONS • CORTICAL • 80% • CORPUSCLE IN CORTEX CLOSE TO SURFACE • SHORT NEPHRON LOOPS • JUXTAMEDULLARY • 20% • CORPUSCLE CLOSE TO MEDULLA • LONG LOOP • MOST RESPONSIBLE FOR H2O HOMEOSTASIS

  20. BLOOD SUPPLY OF NEPHRON • AFFERENT ARTERIOLE DIAMETER LARGER THAN EFFERENT ? • PERITUBULAR CAPILLARY SYSTEM • VASA RECTA AROUND JUXTAMEDULLARY NEPHRON LOOP: LOW PRESSURE

  21. URINE FORMATION • WASTES, EXCESS WATER, ELECTROLYTES • GLOMERULAR FILTRATION • FILTERS INTO NEPHRON RATHER THAN INTERSTITIAL SPACE • PRODUCES 180 L OF FLUID/DAY SO MOST? • TUBULAR REABSORPTION • PICKS UP RIGHT AMOUNT OF WATER, ELECTROLYTES, GLUCOSE • TUBULAR SECRETION • REMOVES H+, TOXINS FASTER • URINARY SECRETION = GLOMERULAR FILTRATION + TUBULAR SECRETION – TUBULAR REABSORPTION

  22. GLOMERULAR FILTRATION • MORE PERMEABLE TO SMALL MOLECULES: FENESTRATED CAPILLARIES • = WATER,GLUCOSE, AMINO ACIDS, UREA, URIC ACID, CREATINE, CREATININE, SODIUM, CHLORIDE, POTASSIUM, CALCIUM, BICARBONATE, PHOSPHATE, SULFATE

  23. FENESTRATED CAPILARIES http://www.jci.org/articles/view/23577/files/JCI0423577.f1/medium

  24. FILTRATION PRESSURE • HYDROSTATIC PRESSURE CAUSES FILTRATION • ALSO AFFECTED BY HYDROSTATIC PRESSURE IN CAPSULE AND OSMOTIC PRESSURE IN PLASMA ? • NET FILTRATION RATE = GLOMERULAR CAPILLARY HYDROSTATIC PRESSURE – CAPSULAR HYDROSTATIC PRESSURE AND GLOMERULAR CAPILLARY OSMOTIC PRESSURE

  25. NEPHRON RAP • http://www.youtube.com/watch?v=guOqyi5lUQQ

  26. URINARY SYSTEM • http://www.natgeoeducationvideo.com/film/1115/the-urinary-system

  27. DIALYSIS • http://www.youtube.com/watch?v=tQzqGHKkdE8&NR=1&feature=endscreen

  28. FILTRATION RATE • FILTRATION RATE AFFECTED BY ANYTHING THAT AFFECTS GLOMERULAR HYDROSTATIC PRESSURE, GLOMERULAR PLASMA OSMOTIC PRESSURE, OR CAPSULAR HYDROSTATIC PRESSURE • GLOMERULAR HYDROSTATIC PRESSURE IS MOST IMPORTANT: ANY CHANGE IN DIAMETER OF ARTERIOLES, VASODILATION? VASOCONSTRICTION? • MORE FLUID IS FILTERED BECAUSE OF HIGHER HYDROSTATIC PRESSURE SO COLLOIND OSMOTIC PRESSURE DOESN’T AFFECT FILTRATION AS MUCH, UNLESS IT IS LOWERED ?

  29. ANY OBSTRUCTION (?) WOULD BACK UP FLUID RAISING THE HYDROSTATIC PRESSURE OF CAPSULE AND REDUCING FILTRATION • FILTERS: 25% CARDIAC OUTPUT; 20% OF PLASMA = 125 ml/MIN; 180 L/DAY : SO PLASMA IS FILTERED 60X/DAY = 45G • SURFACE AREA OF GLOMERULAR CAPILLARIES = 2 sq m = SKIN’S SURFACE

  30. CONTROL OF FILTRATION RATEGFR • MAINLY AUTOREGULATION • BP/VOLUME DROP STIMULATES SYMPATHETIC NS = VASOCONSTRICTION OF AFFERENT ARTERIOLES = ? IF BP/VOLUME INCREASE = ? • RENIN-ANGIOTENSIN SYSTEM: RENAL BAROMETERS OF AFFERENT ARTERIOLES STIMULATE SYMPATHETIC NS TO STIMULATE JUXTAGLOMERULAR CELLS SECRETE RENIN

  31. DECREASING LEVELS OF SODIUM, POTASSIUM, CHLORIDE STIMULATE MACULA DENSA TO SECRETE RENIN • RENIN STIMULATES ANGIOTENSINOGEN  ANGIOTENSIN I; ANGIOTENSIN-CONVERTING ENZYME CAHNGES ANGIOTENSIN I  ANGIOTENSIN II • ANGIOTENSIN II: MAINTAINS SODIUM BALANCE, WATER BALANCE, BLOOD PRESSURE • CONSTRICTS AFFERENT OR EFFERENT ARTERIOLES, STIMULATES SECRETION OF ALDOSTERONE FROM ADRENAL CORTEX

  32. ANGIOTENSIN II: • VASOCONSTRICTOR OF AFFERENT AND EFFERENT ARTERIOLES • STIMULATE PRODUCTIN OF ALDOSTERONE: (FROM?) CAUSES RETENTION OF SODIUM IN DISTAL TUBULE: LOSES LESS WATER • STIMULATES RELEASE OF ADH: INCREASES PERMEABILITY OF DISTAL TUBULE AND COLLECTING DUCT • ANP: (FROM?) RELEASED WHEN BLOOD VOLUME INCREASES: SO ?

  33. TUBULAR REABSORPTION • REABSORPTION: MATERIAL TRANSPORTED OUT TO INTER STITIAL FLIUD AND DIFFUSE INTO PERITUBULAR CAPILLARIES • PASSIVE AND ACTIVE MECHANISMS • CAUSED BY: LOW HYDROSTATIC PRESSURE OF PERITUBULAR CAPILLARIES, HIGH PERMEABILITY OF CAPILLARIES, HIGHER COLLOID OSMOTIC PRESSURE OF PERITUBULAR CAPILLRIES

  34. MOSTLY IN PROXIMAL TUBULE, HAVE MICOVILLI (?) • GLUCOSE: • PROXIMAL: ACTIVE TRANSPORT • UNLESS RENAL PLASMA THRESHOLD IN REACHED (DIABETES) • WATER: • PROXIMAL: OSMOSIS • AMINO ACIDS: • PROXIMAL: ACTIVE TRANSPORT • SMALL PROTEINS: • PROXIMAL: ACTIVE TRANSPORT: ENDOCYTOSIS • CREATINE, LACTIC, CITRIC, URIC AND ASCORBIC ACID: • ACTIVE TRANSPORT • ACTIVE TRANSPORT REQUIRES CARRIER MOLECULES

  35. SODIUM AND WATER RETENTION • WATER: OSMOSIS • TIED IN WITH RETENTION OF SODIUM • SODIUM PUMP IN PROXIMAL SECTION • CHLORIDE, PHOSPHATE AND BICARBONATE MOVE WITH SODIUM IONS • MOST REABSORPTION IN PROXIMAL TUBULE (70%) • MOST SODIUM IS RETAINED (97-99%)

  36. TUBULAR SECRETION • EPITHELIAL CELLS OF TUBULES SECRETE SUBSTANCES • ACTIVE TRANSPORT: • ORGANIC COMPOUNDS LIKE PENICILLIN, HISTAMINE • HYDROGEN IONS: WHY? • POTASSIUM: WHEN ALDOSTERONE CAUSES REABSORPTION OF SODIUM = NEGATIVE CHARGE AND POTASSIUM IS SECRETED

  37. REGULATION OF URINE CONTENT • HORMONES: ANP; ALDOSTERONE; ADH • ADH FROM ? • POSTERIOR PITUITARY • CAUSES DISTAL CONVOLUTED TUBULE AND COLLECTING DUCTS TO ADD PROTEINS – AQUAORINS: WATER CHANNELS: OSMOSIS BECAUSE OF HYPERTONIC MEDULLA COUNTERCURRENT EFFECT: ASCENDING LOOP IMPERMEABLE TO WATER BUT LETS ELECTROLYTES OUT SO INSIDE IS HYPOTONIC AND OUTSIDE IS HYPERTONIC

  38. DECENDING LOOP IS PERMEABLE TO WATER NOT SOLUTES, HYPERTONIC OUTSIDE SO WATER DIFFUSES OUT: TUBULAR FLUID IS CONCENTRATED • ASCENDING LOOP REABSORBS MORE SALT, SALT CONCENTRATION KEEPS MULTIPLYING: COUNTERCURRENT MULTIPLIER • MORE THAN 4X SOLUTE CONCENTRATION THAN PLASMA • SALT DIFFUSES INTO DESCENDING VASA RECTA BUT DIFFUSES OUT OF ASCENDING: MAINTAINS SALT GRADIENT IN MEDULLA

  39. mhhe.com

  40. UREA AND URIC ACID PRODUCTION • UREA • AMINO ACID BREAKDOWN FOR GLUCONEOGENESIS • URIC ACID • METABOLISM OF A AND G • 10% EXCRETED/ MOST REABSORBED

  41. URINE COMPOSITION • VARIES ? • 95% ?;UREA, URIC ACID, CREATINE, TRACE AMINO ACIDS, ELECTROLYTES • DIET & PHYSICAL ACTIVITY

  42. VOLUME • .6-2.5L • 50-60 ml/MIN • LESS THAN 30 ml/min = KIDNEY FAILURE

  43. RENAL CLEARANCE • DEFINITION: KIDNEY’S EFFICIENCY AT REMOVING A SUBSTANCE • TESTED TO SEE IF DISEASE OR DAMAGE • INSULIN CLEARANCE TEST: GFR • CREATININE CLEARANCE TEST: GFR: KIDNEY FUNCTION: USUALLY ALL REMOVED FROM BLOOD TO URINE

  44. URETERS • 25 cm • BEHIND PARIETAL PERITONEUM TO URINARY BLADDER • 3 LAYERS: • MUCOUS COAT: TRANSITIONAL EPITHELIUM • MUSCULAR COAT: SMOOTH MUSCLE: CIRCULAR AND LONGITUDINAL LAYERS • FIBROUS COAT: CONNECTIVE TISSUE • MOVES BY PERISTALSIS: STARTED BY PRESENCE OF URINE • VALVE AT URINARY BLADDER ? • KIDNEY STONE COULD INCREASE PERISTALSIS OR SYMPATHETIC NS CONSTRICTS URETER AND KIDNEY SHUTS DOWN

  45. URINARY BLADDER • HOLLOW, BEHIND PARIETAL PERITONEUM • TRIGONE: OPENINGS TO URETER AND URETHRA • MUCOUS COAT: TRANSITIONAL EPITHELIUM • SUBMUCOSA: CONNECTIVE TISSUE WITH GLAND CELLS • MUSCULAR COAT: SMOOTH MUSCLE: DETRUSOR MUSCLE: FORMS INTERNAL URETHRAL SPHINCTER @ NECK

  46. ALWAYS SUSTAINED CONTRACTION • PARASYMPATHETIC NS: REFLEX FOR URINATION SEROUS COAT: PARIETAL PERITONEUM AT TOP, FIBROUS CONNECTIVE TISSUE REST

  47. URETHRA • MUCOUS MEMBRANE • LONGITUDINAL SMOOTH MUSCLE FIBERS • URETHRAL GLANDS: MUCOUS GLANDS • MALES: PROSTATIC URETHRA PASSES THROUGH PROSTATE; MEMBRANOUS URETHRA EXTERNAL URETHRAL SPHINCTER; PENILE URETHRA

  48. MICTURITION • MICTURITION REFLEX: • STRETCH RECEPTORS STIMULATED; SIGNAL MICTURITION REFLEX CENTER: IN SACRAL SPINAL CORD • PARASYMPATHETIC NS IMPULSE TO DETRUSOR MUSCLE TO CONTRACT • CAN STILL BE CONTROLED: EXTERNAL URETHRAL SPHINCTER, IMPULSES FROM BRAIN STEM AND CEREBRAL CORTEX • EXTERNAL URETHRAL SPHINCTER RELAXES: IMPULSES FROM HYPOTHALAMUS AND PONS • DETRUSOR MUSCLE CONTRACTS: MICTURITION • IMPULSES STOP; DETRUSOR MUSCLE RELAXES, BLADDER FILLS

  49. LIFE SPAN CHANGES • KIDNEY CELLS START TO DIE AT 20 BUT NOT NOTICED TILL AFTER 40; 1/3 LOSS BY 80 • GLOMERULI SHUT DOWN: LOSS; DAMAGE; • GFR DROPS AT 40; 75: 125ml  60ml • RENAL TUBULES THICKEN WITH FATTY ACIDS; DON’T PROCESS DRUGS AND ORGANICE MATERIAL AS WELL • BLOOD FLOW DECREASES BY 50% @ 80

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