Urinary Tract Reciew

Chp.
26-27 – Urinary System and Fluid Homeostasis
Know anatomy (know the parts)
EXTERNAL ANATOMY
Hilus Blood vessels and ureters enter hilus of kidney
Renal capsule Transparent membrane maintains organ shape;
actual outer layer of organ itself
Adipose capsule Cushion, helps protect from trauma
Renal fascia Dense, irregular connective tissue (membrane)
that holds kidneys against back body wall
(outermost layer)
INTERNAL ANATOMY
Parenchyma of kidney The solid part of kidney where the process of
waste excretion takes place; bulk of substance of
kidney
Renal cortex Superficial layer of kidney
Renal medulla Layer below cortex; inner portion consisting of
cone-shaped renal pyramids separated by renal
columns; most of the function of the kidney
occurs here!; renal papilla point toward center of
kidney
Renal sinus Is a hollow cavity where other structures are
located; hollow cavity that is filled with drainage
system; no urine in sinus, only tubes
Minor calyx (calyces) Cuplike structure collects urine from papillary
ducts of papilla (where urine is released)
Major calyx Tubes formed when minor calyx join together
Renal pelvis Expanded tube where major calyx empties; this
empties into ureters
Blood supply
Glomerular capillaries – where filtration of blood occurs
Afferent arterioles – go into glomerulus (provides blood)
Efferent arterioles – go out of glomerulus (drains blood)
*Changes in filtration are controlled by vasoconstriction and vasodilation of these
arterioles
Pertubular capillaries and vasa recta – carry away reabsorbed substances from filtrate
Nephron – glomerular capillaries are formed b/n the afferent and efferent arterioles; efferent arterioles
give rise to the peritubular capillaries and vasa recta; nephron is composed of a corpuscle and tubule
(renal corpuscle – site of plasma filtration).
Glomerulus – is capillaries where filtration occurs (taking fluid particles out of blood);
glomerular capillaries arise from afferent arterioles and form a ball before emptying into
efferent arteriole.
Bowman's (Glomerular) capsule – is double-walled epithelial cup that collects filtrate;
surround capsular space
Renal tubules
1. PCT (proximal convoluted tubule) – where most of the reabsorption occurs
2. Loop of Henle (Nephron loop) – dips down into the medulla
3. DCT (distal convoluted tubule
4. Collecting ducts and papillary ducts – drain urine to the renal pelvis and ureter
Renal physiology – nephrons and collecting ducts perform 3 basic functions:

1. Glomerular filtration – (blood coming in) - fluid forced out (filtrate) – a portion of the blood
plasma is filtered into kidney
2. Tubular reabsorption – water and useful substances are reabsorbed into the blood
3. Tubular secretion – wastes are removed from the blood and secreted into urine
Control of fluid homeostasis

1. Glomerular filtration rate – how fast force filtrate out of blood; amount of filtrate formed in
all renal corpuscles of both kidneys per minute; homeostasis requires GFR to be constant (too
high and useful substances are lost to speed of fluid passage; too low and sufficient waste
products may not be removed from the body)
Regulation of GFR
1. Autoregulation – raised blood pressure increases GFR; lowered blood pressure decreases
GFR
2. Neural – sympathetic decreases blood flow → decreases GFR; parasympathetic increases
blood flow → increases GFR
3. Hormonal – hormones vasoconctrict and vasodilate arteries and decreases or increases
blood flow
2. Permeability of tubules – brings water and nutrients back into blood – nephron must be
permeable enough to reabsorb 99% of filtrate; PCT do most of the work of neprhon – the rest is
just doing the fine-tuning; solutes reabsorbed by active and passive processes; water follows by
osmosis
3. Active reabsorption – requires energy and transport proteins (glucose and Na+ and K+ pumps;
water can only be reabsorbed by osmosis – must set up hypotonic and hypertonic solution
Reabsorption Routes – paracellular (b/n cells); transcellular (through cells)
Glucosuria – renal symporters can not reabsorb glucose fast enough if blood glucose level is
above 200mg/mL – some glucose remains in urine – common cause of diabetes melitis
4. Active secretion – requires energy and transport proteins (ammonia and ammonium ions and
H+ ions are secreted to maintain pH
Function of each part of the nephron
1. PCT – proximal convoluted tubule

– does most of the reabsorption – everywhere else is fine-tuning
- Na+ - symporters help reabsorb materials; water follows Na+ osmosis
- Glucose, Amino acid – and other nutrients are completely reabsorbed in the first half of the
PCT
- Intracellular sodium level – are kept low due to Na+/K+ pumps
- secretion of ammonia and ammonium ion – poisonous waste product of protein deamination in
the liver- most is converted to urea which is less toxic
2. Loop of Henle – thick limb of loop of Henle has Na+ K+ Cl- symporters that reabsorb these
ions; K+ leaks through K+ channels back into the tubular fluid leaving the interstitial fluid and
blood with a neg charge
3. DCT – distal convoluted tubule – removal of Na+ and Cl- continues in the DCT by means of
Na+ and Cl- symporter; Na+ and Cl- then reabsorbed into peritubular capillaries; DCT is major
site where parathyroid hormone stimulates reabsorption of CA+2
4. Collecting Ducts – by the end of DCT, 95% of solute and water have been reabsorbed and
returned to the bloodstream; cells in the collecting duct make the final adjustments; principal
cells reabsorb Na+ and secrete K+; intercalated cells reabsorb K+ and bicarbonate ions and
secrete H+
Hormonal regulation – hormones that affect Na+, Cl-, and water reabsorption and K+ secretion in
tubules
Increase water level in plasma
1. Aldersterone – to conserve water – decrease GFR by vasoconstricting afferent arteriole;
enhances absorption of Na+
2. ADH (antidiuretic hormone) – to conserve water – increases permeability of membranes
– allows water to follow Na+
Decrease water level in plasma
1. ANP (atrial natriuretic peptide) – inhibits reabsorption of Na+ and water in PCT and
suppresses secretion of aldosterone and ADH; keeps you from pumping Na+ into bloo
which keeps water from returning to blood.
2. Diuretics – substances that slow renal reabsorption of water and cause diuresis (increase
urine flow) – caffeine which inhibits Na+ reabsorption; prescription meds can act on
PCT, loop of Henle, or DCT; Alcohol inhibits secretion of ADH
Anatomy of urinary system below kidney
1. Ureters – tubes that carry urine from kidney to bladder

2. Urine bladder – muscular sac that stores urine until it is voided
3. Urethra – tube that carries urine out of bladder
1. Internal sphincter – involuntary
2. external sphincter – voluntary control of bladder (located in urogenital diaphragm)
Compartments where body fluids are:
1. Intracellular – fluid inside cells

2. Interstitial – fluid around cells
3. Plasma – fluid in blood
Places of exchange between compartments
1. cell membranes separate intracellular from interstitial fluid

2. capillaries walls are thin enough for exchange b/n plasma and interstitial fluids
Water gain and loss – gain from ingestion and metabolic water formed during aerobic respiration and
dehydration synthesis reactions; normally loss = gain (urine, feces, sweat, breathe)
1. Regulation of water gain – formation of metabolic water is not regulated; function of the need
for ATP; main regulator of water gain is intake regulation; stimulators of thirst center in
hypothalamus
2. Regulation of water loss – elimination of excess water or solutes occurs through urination;
demonstrates how - “water follows salt” - excrete Na+ and water will follow and decrease blood
volume
Electrolytes
Functions
1. Control osmosis b/n fluid compartments (Na+ into cell or out of cell)
2. help maintain acid-base balance (phosphates)
3. carry electric current (action potentional, Na+)
4. cofactors needed for enzymatic activity
Common electrolytes
Sodium Most abundant extracellular ion (main one outside

cell)
Chloride Most prevalent extracellular anion
Potassium Most abundant cation in intracellular fluid
Bicarbonate Common extracellular anion
Calcium Abundant extracellular cation in body fluids
Phosphate Important intracellular anion
Acid-base balance
1. homeostasis of H+ concentration is vital – proteins 3-D structure sensitive to pH changes;

normal plasma pH must be maintained b/n 7.35-7.45
2. 3 major mechanisms to regulate pH – buffer system; exhalation of CO2 (respiratory system);
kidney excretion of H+ (urinary system)
3. mess up pH and you mess up proteins
Mechanisms of regulating pH (ways of dealing with acids)

1. Buffer systems – set of chemicals that balance pH (prevent rapid, drastic changes in pH in fluids of
body; change strong acids or bases into weaker one
1. Protein – abundant in intracellular fluids and in plasma; amino acids contain at least 1 carboxyl
group and at least 1 amnio group – carboxyl group acts like an acid and releases H+; the amino
group acts like a base and combines w/ H+
2. Carbonic acid – bicarbonate buffer system – acts like extracellular and intracellular buffer
system; bicarbonate can act as a weak base (hold excess H+); carbonic acid can act as a weak
acid (dissociates into H+ ions); at a pH of 7.4, bicarbonate ion concentration is about 20x that of
carbonic acid
3. Phosphate – most important instracellulary but also acts to buffer acids in urine; dihydrogen
phosphate ion (too basic) acts as a weak acid that can buffer a strong base; monohydrogen
phosphate (too acidic) acts as a weak base by buffering that H+ released by a strong acid
2. Exhalation of carbon dioxide – carbon dioxide in plasma to form carbonic acid which decreases
pH; exhalation of carbon dioxide returns pH to normal
3. Kidney excretion of H+ - kidneys actively excrete H+ to raise pH back to normal levels

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Chp.

26-27 – Urinary System and Fluid Homeostasis

Know anatomy (know the parts)

Renal physiology – nephrons and collecting ducts perform 3 basic functions:

Control of fluid homeostasis

Function of each part of the nephron

1. PCT – proximal convoluted tubule

Anatomy of urinary system below kidney

1. Ureters – tubes that carry urine from kidney to bladder

Compartments where body fluids are:

1. Intracellular – fluid inside cells

Places of exchange between compartments

1. cell membranes separate intracellular from interstitial fluid

Sodium Most abundant extracellular ion (main one outside

1. homeostasis of H+ concentration is vital – proteins 3-D structure sensitive to pH changes;

Mechanisms of regulating pH (ways of dealing with acids)

3. Kidney excretion of H+ - kidneys actively excrete H+ to raise pH back to normal levels

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