THE URINARY

SYSTEM
CHAPTER 18
Carina C. Batol
Associate Professor IV
Bataan Peninsula State University
URINARY SYSTEM
/excretory system/
• Concerned with the removal of excess salts and metabolic wastes from the
body

Components of Urinary System

• (2) Kidneys
• (2) Ureters
• (1) Urinary Bladder
• (4) Urethra

2
3
THE KIDNEYS
EXTERNAL ANATOMY:
• Reddish-brown, bean shaped organs located at the posterior wall of abdominal region,
one on each side of the vertebral column.
• Lie against the dorsal body wall in retroperitoneal position
• Each kidney is about a size of large bar soap
• Medially concave, laterally convex
• Hilus - a small intended opening where an
artery, vein, nerves and the ureter enter and
leave the kidney.
THREE LAYERS OF TISSUE COVERING KIDNEY:
• Renal Capsule
• Adipose Capsule
• Renal Fascia 4
THE KIDNEYS
INTERNAL ANATOMY
THREE REGIONS OF THE KIDNEY:
a. Renal Pelvis
• (2-3) Major Calyces
• (8-18) Minor Calyces
b. Renal Medulla
c. Renal Cortex
• Cortical Region
• Inner Juxtamedullary

5
6
BLOOD SUPPLY
Supplying Draining
Renal Artery Interlobar veins
Segmental Arteries Arcuate veins
Lobar Arteries Renal
Interlobar Arteries
Arcuate Arteries

7
8
THE NEPHRON
 Independent urine-forming unit. Each kidney contains approximately 1million nephrons
 Accomplishes the initial filtration of blood,
 The selective reabsorption back into the blood filtered substances that are useful to the
body
 The secretion of unwanted substances
 Consists of Tubular Components and Vascular component
• Glomerulus
 a cluster of nerve endings, spores, or small blood vessels, in particular a cluster of
capillaries around the end of a kidney tubule, where waste products are filtered from
the blood.
• Glomerular Capsule ( Bowman’s Capsule)
 Portion of nephron that encloses the glomerulus
9
THE NEPHRON
• Renal Corpuscle
 Formed by the glomerular capsule and the glomerulus
• Podocytes
 Specialized epithelial cell in the inner visceral layer
• Collecting ducts
 Collects filtered substance in the kidney
• Afferent Arterioles
 Feeder vessel, supplies blood to the glomerulus
• Efferent Arterioles
 Receives the blood that passes through glomerulus

10
THE NEPHRON
Three regions of tubules:
a. Proximal convoluted Tubule
b. The loop of Henle
c. Distal Convoluted Tubules
Vascular Components of Nephron:
a. Glomerulus
b. Peritubular Capillaries
c. Vasa recta
Two types of Nephron:
a. Cortical
b. Juxtamedullary

11
12
URINE
FORMATION
FILTRATION
REABSORPTION
SECRETION

13
URINE FORMATION
A. FILTRATION
Filtration is any of various mechanical, physical or biological operations that separate
solids from fluids (liquids or gases) by adding a medium through which only the fluid can
pass. The fluid that passes through is called the filtrate.
• Glomerular Filtration
 First step of purification of the blood
• Glomerular Filtrate:
 The liquid that travels through the inner layer of Bowman’s Capsule.

14
URINE FORMATION
B. REABSORPTION
Also known as tubular reabsorption, it is where 99% of the water in the glomerular
filtrate formed in the glomerular capsule is returned to the blood while 1% is excreted in
the urine.
Most of the nutritionally important substances (glucose, small proteins, amino acids,
citric acid) and some of the inorganic ions (phosphate, sulfate) are completely reabsorbed
from the proximal convoluted tubule.
• Passive transport – osmosis
• Active transport – many selective membrane carriers for important substances (e.g.
glucose and amino acids) and few to none for nitrogenous waste products (urea,
creatinine, and uric acid)

15
URINE FORMATION
C. SECRETION
Also known as tubular secretion, takes place in the proximal and distal convoluted
tubule and collecting duct
Allows the kidneys to increase their efficiency in clearing certain substances from
blood plasma and helps maintain the normal pH of blood.
• Most important substances secreted by the tubules are
 Hydrogen ions
 Potassium – toxic in high concentrations (hyperkalemia) and can cause cardiac
arrythmias, fibrillation, muscle weakness, and cramps. Its secretion is under the control
of aldosterone.

16
CONTROL OF
BLOOD
COMPOSITION
BYTHE
KIDNEYS

17
CONTROL OF BLOOD COMPOSITION BY THE
KIDNEYS
Depends on three major factors
• Diet
• Cellular metabolism
• Urine output
Major Roles of the Kidneys
• Excretion of Nitrogen-Containing Wastes
• Maintaining Water and Electrolyte Balance of the Blood
• Ensuring Proper Blood pH

18
EXCRETION OF NITROGEN-CONTAINING
WASTES
Most important nitrogenous wastes are:
• UREA – formed by the liver, end product of protein breakdown
• URIC ACID – released when nucleic acids are metabolized
• CREATININE – associated with creatinine metabolism in muscle tissue and is actively
secreted into the filtrate.
Due to lack of membrane carriers, they tend to remain in the filtrate and are
found in high concentrations in urine.

19
MAINTAINING WATER AND ELECTROLYTE
BALANCE OF BLOOD
• The types and amounts of solutes in body fluids, especially electrolytes such as sodium,
potassium and calcium ions are important to overall body homeostasis.
• Most of the water filtered by the glomeruli is passively reabsorbed by the renal tubules
and returned to the bloodstream.
• The rate of water reabsorption can be increased or decreased to alter urine production.
• Antidiuretic hormone (ADH) controls water reabsorption
• ADH secretion is regulated by the nerve cells in the hypothalamus (monitor osmotic
concentration of the blood) and the receptors in the heart (detect changes in blood
volume).
• ADH increase the rate of tubular reabsorption of water in the kidneys when there’s a
decrease in blood volume and increase in osmotic concentration which then decreases
the urinary output.
20
MAINTAINING WATER AND ELECTROLYTE
BALANCE OF BLOOD
• ADH production is decreased when there’s an increase in blood volume and decrease in
osmotic concentration, lowering the rate of tubular reabsorption of water in the kidneys
which then increases the urinary output.
• Aldosterone also regulates water balance which levels are controlled by blood pressure,
blood volume, and osmotic concentration.
Renin cleaves
Low blood plasma protein Angiotensinogen
pressure or low Kidney produces called segment is a peptide
volume of filtrate RENIN ANGIOTENSINOGEN
molecule called
ANGIOTENSIN I
from blood

Aldosterone increases Angiotensin II Angiotensin I is

the amount of sodium stimulates converted into
reabsorbed by the aldosterone active form,
nephrons secretion ANGIOTENSIN II 21
MAINTAINING ACID-BASE BALANCE OF BLOOD
• The most important means by which kidneys maintain acid-base balance of the blood are
by:
• Excreting bicarbonate ions
• Conserving (reabsorbing) or generating new bicarbonate ions.
• As blood pH rises, bicarbonate ions are excreted and hydrogen ions are retained by the
tubule cells.
• Conversely, as blood pH falls, bicarbonate is absorbed and hydrogen ions are secreted.

22
COMPOSITION OF URINE
• Water
• Urea
• Chloride
• Potassium
• Sodium
• Creatinine
• Phosphates
• Sulfates
• Uric acid

23
COMPOSITION OF URINE
• Proteinuria – presence of protein in urine due to bleeding in the lower urinary tract and
other kidney disorders
• Albuminuria – if the protein is primarily albumin
• Kidney diseases increases the permeability of glomerular membrane, thus large quantities
of filtered plasma protein are found in urine.
• Edema is the generalized puffiness of tissues due to the accumulation of lost water caused
by the decrease of oncotic pressure of the plasma, which is due to excessive loss of
protein.
• Glycosuria – presence of glucose in urine that weren’t reabsorbed in the proximal
convoluted tubules due to the reduction of glucose reuptake of blood.

24
COMPOSITION OF URINE
• Complete kidney failure could lead
to death unless patient is
maintained by an artificial kidney
machine.

25
COMPOSITION OF
URINE
Casts – decomposed blood cells, tubule
cells, or fats that for tiny bits of hard
materials in the nephron tubules.
Calculi - also known as kidney stones, are
formed when the salts in the kidney tubules,
ureters, or bladder precipitate to form
insoluble masses.
• Both are common when diet is:
• Consistently high in minerals
• Abnormally acidic or alkaline
• Low in water
• Parathyroid glands are overactive
26
PHYSICAL PROPERTIES OF URINE
• Urine pH ranges from 5.0 to 8.0 but is usually slightly acidic
• Meat Eaters – 5.0 to 6.0
• Vegetarian – 7.0 to 8.0
• Color – translucent yellow or amber (bile pigments)
• Dark yellow, brown, or red color may be caused by not enough water intake, diet, fever,
and therapeutic drugs.
• Hematuria – reddish urine with the presence of hemoglobin from RBC
• Pyuria – urine with a milky appearance may contain fat droplets or pus
• Specific gravity of urine ranges from 1.001 to 1.035 depending on the total amount of
solute in the urine.
• Urine has aromatic but not unpleasant odor when it is fresh and free of microorganisms

27
28
VOLUME OF URINE
• Healthy person with normal physical activity and water intake will eliminate from 1000mL
to 1800mL or urine everyday
• Water consumption
• Diet (Irritant foods and Vitamin C= more urine)
• External temperature (High temperature = more sweat, less urine)
• Hormonal and enzymatic actions (ADH, renin-angiotensin)
• Blood pressure (Low BP = more urine, High BP = less urine)
• Diuretics (Therapeutic drug = more urine)
• Drugs (Nicotine = less urine)
• Emotional state (Anxiety, stress, depression = Lower Urinary Tract Symptoms or “LUTS”)

29
Accessory Excretory Structures
• Accessory structures are required to transfer, store, and eventually
eliminate urine (metabolic wastes) out from the body.
1. Ureters
2. Urinary Bladders
3. Urethra
1. Ureters
• Attached to each kidney
• Contains star-shaped Lumen that has 3 layers:
a) Tunica Mucosa
b) Tunica Muscularis
c) Tunica Adventitia
Ureter
Tunica
Tunica Mucosa
Muscularis

Tunica
Adventitia
2. Urinary Bladder
• Hollow muscular organ that collects urine from the ureters.
• Also contains 3 layers: mucosa, muscularis, adventitia
• Muscularis (middle part) is the Detrusor muscle; a smooth muscle arranged in spiral,
longitudinal, and circular bundles.
• Trigone: triangular area in the opening of ureters.
• Voluntary external
and internal
urethral sphincter:
the one that holds
the urine until
urination is
convenient. (will be
discussed in
Micturition)
Urinary Bladder

Tunica
Adventitia

Tunica Muscularis
(Detrusor muscle)
Tunica
Mucosa
The External and Internal Urethral Sphincter
3. Urethra
• Tube of smooth muscle lined with mucosa
• Transports urine outside the body during urination
• Female: 4 cm (1.5 in.) long
• Male: 20 cm (8 in.) long
Male Urethra
1. Prostatic region passes through the prostate gland.
2. Membranous portion is a short segment that passes through the excretory functions
3. Penile/ Spongy portion is the longest portion of penis from lower surface of pelvic
diaphragm to external urethral orifice.
A complex urethra structure (male)
Micturition
• or voiding/ act of emptying the bladder.
• Commonly called “Urination”
• Voluntary external sphincter – has control to hold the urine.
• Internal urethral sphincter: a smooth muscle which has no control to hold the urine.
1. Bladder can collect up to 200-400 mL
2. Impulses transmitted to sacral region, then back to the bladder via pelvic splanchnic
verve;
3. Bladder will go into reflex contraction, as the contractions become stronger, stored urine
is forced past as the internal sphincter will make you feel the urge to void.
Incontinence
• When we are unable to voluntarily control the external sphincter.
• Normal in children 2 yrs. old; or children who sleep soundly they are not awakened by the
stimulus.
• Also a result of emotional problems, pressure (as in pregnancy), or nervous system
problems (stroke or spinal cord injury)
Urinary Retention
• Opposite of incontinence
• Being unable to expel its contained urine.
• Often occurs after surgery because of the general anesthesia that takes a little time for
smooth muscle to regain activity.
• Also occurs primarily in elderly men; enlargement or hypertrophy of prostate gland: this
narrows the urethra, making it very difficult to void.
• Catheter a slender rubber drainage tube called must be inserted through the urethra,
when urinary retention is prolonged - to drain the urine and prevent bladder trauma from
excessive stretching,
Developmental Anatomy of the Kidneys
1. Pronephros – non-function/ forms in week 4 after fertilization, and degenerates late in
week 4.
2. Mesonephric – the ducts and tubules form late in week 4. Complex but non-fuctional
because it doesn’t produce true urine.
3. Metanephros – this begins to form early in week 5.
4. Week 13 – S-shaped vesicular mass develops into the distal and proximal convoluted
tubules and the loop of the nephron.
5. Week 36 – glomeruli are fully developed.
Disorders of the Urinary System
1. Acute and Chronic Renal Failure
 Nearly total stoppage of kidney function
 No urine is produced
 Caused by a diminished blood by an injury or hemorrhage, a heart attack, or a thrombosis.
2. Chronic renal failure
 Slowly develops over many years
 Causes: bacterial inflammations in the areas of renal pelvis, high blood pressure,
thirstiness, poor appetite, vomiting, frequent urination, coma, depletion of bone calcium.
3. Acute glomerulonephritis (AGN or Bright’s disease)
 Inflammation of the glomeruli w/c follows a streptococcal infection.
 Infection produces antibodies causing autoimmune inflammation in glomerulus,
damaging the endothelial capsular membrane.
 Symptoms: presence of blood cells, plasma protein, retention of water and salts in urine.
4. Pyelonephritis
 Most common kidney disease
 By bacterial infection
 From Escherichia coli, an intestinal bacterium that spreads from bladder to ureters then
back to kidneys.
 Mostly in females
 Symptoms: fever of 44°C or higher, backpain, increased leukocytes in blood, painful
urination, presence of bacteria in urine
5. Renal Calculi
 Commonly called kidney stones
 May appear anywhere in urinary tract, but usually in renal pelvis or calyx.
 Most usual type of calculus from precipitated salts of calcium.
6. Infection of the urinary Tract
Two forms of a lower urinary tract infections are:
 Cystitis - inflammation of the bladder
 Urethritis - inflammation of the urethra
 Both are much more prevalent in women than in men, however, older men are usually
affected as they begin to encounter prostate problems.
 Also cause of an Escherichia Coli or Proteus Mirabilis
 Symptoms: frequent urination, spasms of the bladder, discharge from the penis, pain
during urination, excessive urination during the night (nocturia).
ThankYou
RAMOS, JAMIE A.
LACSINA, JHERA MAE L.
LAGDAMEO, ROSE ANTONIETTE C.