Lecture Outline: The Urinary System
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    - The Urinary System: Overview
        
            - Purpose and Components
                
                    - Last of 11 organ systems to cover, very important
- Macroscopically simple, physiologically complex
- Main structures: two kidneys, two ureters, urinary bladder
 
- Key Functions
                
                    - Ureters: tubes carrying urine from kidneys to bladder
- Urinary bladder: allows urine storage until convenient for voiding
- Urine production is continuous; bladder fills gradually
- Urination (or Micturition): intermittent voiding/emptying of bladder
 
- Location of Kidneys
                
                    - Located in the abdominal pelvic cavity
- Retroperitoneal: behind or posterior to the peritoneum
 
 
- Macroscopic Anatomy of the Kidney
        
            - External Features
                
                    - Peritoneum: serous membrane in abdominal cavity; kidneys are behind it
- Parietal peritoneum covers anterior surface of kidneys
- Kidneys embedded in the back wall
- Right kidney slightly inferior to left due to liver displacement
- Lower ribs partially protect kidneys
- Bean-shaped with a depression for plumbing attachment
- Hilum: region where major plumbing (ureter, blood vessels) attaches
 
- Internal Structure
                
                    - Renal Cortex: superficial, lighter reddish-pink, just deep to fibrous capsule
- Renal Medulla: deeper, contains renal pyramids
                        
                            - Renal pyramids: triangular-shaped, several in each kidney
- Calices (singular: calyx): goblet/funnel-shaped structures
                                
                                    - (1) Minor calyx: collects urine from one renal pyramid
- (2) Major calyx: two or more minor calyces converge
 
- Renal pelvis: larger, bowl-shaped structure, combination of major calyces
 
- Urine Pathway: Pyramids → Minor calyces → Major calyces → Renal pelvis
 
 
- Blood Supply to the Kidney
        
            - Arterial Flow
                
                    - Renal artery: brings large amount of blood to each kidney, branches off abdominal aorta
- Branches of Renal Artery (from largest to smallest)
                        
                            - Segmental arteries (supply kidney segments)
- Interlobar arteries (between pyramids, through medulla toward cortex)
- Arcuate arteries (arc over superficial part of pyramids)
- Cortical radiate arteries (radiate in renal cortex)
 
 
- Venous Return (reverse of arterial flow)
                
                    - Cortical radiate veins
- Arcuate veins
- Interlobar veins
- Renal vein: takes blood away from kidney, empties into inferior vena cava
 
 
- The Nephron: Functional Unit
        
            - Quantity and Categories
                
                    - Each kidney contains between 1 and 1.5 million nephrons
- Total: 2 to 3 million nephrons in a normal human
- Two categories:
                        
                            - Cortical nephrons: situated entirely in the cortex
- Juxtamedullary nephrons: partially in cortex, part extends into medulla; important for producing highly concentrated urine
 
 
- Main Parts of a Nephron
                
                    - Renal Corpuscle: combination of glomerulus and surrounding capsule
                        
                            - Glomerulus: ball-like capillary bed; receives blood from afferent arteriole
- Bowman's capsule (also Renal or Nephric capsule): sac-like structure surrounding glomerulus; collects filtered fluid
                                
                                    - (1) Capsular space: space inside Bowman's capsule, immediately surrounds glomerulus
 
 
- Renal Tubule: the rest of the nephron, fluid flows through it
                        
                            - Proximal convoluted tubule (PCT): first in line, convoluted/twisted
- Nephron loop (or Loop of Henle): extends into medulla (especially in juxtamedullary nephrons)
                                
                                    - (1) Descending limb: allows water to leave filtrate, concentrating it
- (2) Ascending limb: allows salt to leave filtrate (active and passive transport), maintaining medullary gradient; water does not leave
 
- Distal convoluted tubule (DCT): convoluted/twisted, empties into collecting duct
 
 
- Collecting Ducts
                
                    - Collect output from several nephrons
- Eventually empty into a minor calyx
 
 
- Major Renal Processes (Kidney Functions)
        
            - Filtration (Glomerular filtration)
                
                    - Occurs only at the glomerulus (in the renal corpuscle)
- Driven by blood pressure (hydrostatic pressure)
- Glomerular capillaries are especially leaky; surrounded by podocytes with filtration slits
- Removes anything small enough from blood, regardless of whether it's desired
- Fluid formed is called filtrate (not yet urine)
 
- Reabsorption
                
                    - Occurs along the renal tubule
- Brings necessary substances (e.g., water, glucose, amino acids) back into the bloodstream from the filtrate
 
- Secretion
                
                    - Occurs along the renal tubule
- Moves substances (e.g., larger wastes, drugs, poisons) from the bloodstream into the filtrate that were not removed by filtration
 
- Urine Formation
                
                    - Final fluid is properly called urine only after all three processes are complete, typically some distance down the collecting duct
- Once formed, urine composition does not change; water cannot be reclaimed from the bladder
 
 
- Urinary Bladder and Micturition
        
            - Anatomy of the Bladder Interior
                
                    - Trigone: triangular region formed by three openings
- Ureteral orifices: two entry points from the ureters (posterior surface)
- Internal urethral orifice: one exit point to the urethra
 
- Urethra: tube emptying the urinary bladder for micturition
                
                    - Female Urethra: dedicated tube for urine
- Male Urethra: double duty for both urine (micturition) and semen (ejaculation)
                        
                            - Membranous urethra passes through the urogenital diaphragm (floor of pelvic cavity)
 
 
- Bladder Distension and Epithelium
                
                    - Bladder is small and flat when empty, can become highly distended/stretched
- Lined by transitional epithelium: special multi-layered epithelium
                        
                            - Unstretched: columnar cells
- Stretched: cells become squamous to accommodate stretching without damage
 
 
 
- Body Water and Fluid Balance
        
            - Total Body Water Compartments (average adult: 40 liters)
                
                    - Intracellular Fluid (ICF): fluid inside cells (~25 liters, 40% of total body weight)
- Extracellular Fluid (ECF): fluid outside cells
                        
                            - Interstitial fluid: fluid between cells in tissues (not blood)
- Plasma: extracellular matrix of blood, contained within blood vessels
 
 
- Intercompartmental Exchange and Organ Systems
                
                    - Fluid compartments are always communicating and exchanging materials
- Examples of exchange with organ systems:
                        
                            - Respiratory system (lungs): exchanges O2/CO2 between air, blood, interstitial fluid, and intracellular fluid
- Digestive system: exchanges nutrients, water, and ions with blood, then to interstitial and intracellular fluid
- Urinary system: Urine is filtered blood; formed by filtration, reabsorption, and secretion
 
 
- Nitrogenous Waste
                
                    - Comes from breaking down proteins (amino acids contain nitrogen)
- Ammonia: toxic product; liver converts it to less toxic urea
- Kidneys excrete urea as part of urine
 
 
- Water Balance: Intake and Output
        
            - Daily Water Intake (adds water to body)
                
                    - Metabolism: ~10% (water produced as a byproduct of catabolizing fuels)
- Food: ~30% (water in watery foods)
- Beverages: major source, most highly variable intake
 
- Daily Water Output (removes water from body)
                
                    - Feces: ~4% (large intestine reabsorbs water)
- Sweating: variable loss
- Insensible losses: continuous, unnoticed water loss
                        
                            - Through skin (evaporation)
- Through lungs (water vapor in breath)
 
- Urine: most highly variable output
 
- Regulation of Urine Production
                
                    - Urine production matches the body's needs
- Antidiuretic hormone (ADH):
                        
                            - (1) Released when dehydrated
- (2) Tells collecting ducts to open water channels (aquaporins)
- (3) Causes water to leave filtrate and return to body, thus concentrating urine
 
- Diuresis: production of large volume of dilute urine (e.g., when overhydrated, less ADH)
- Antidiuresis: production of small volume of highly concentrated urine (e.g., when dehydrated, more ADH)
- Juxtamedullary nephrons (with long loops of Henle) are important for concentrating urine
- Concentration gradient in kidneys (cortex to medulla) established by loop of Henle allows final adjustment of urine wateriness in collecting ducts
- Homeostasis: total water intake should match total water output