URINARY SYSTEM Composition -2 kidneys, 2 ureters, UB, urethra

Kidneys -paired, bean shaped, multilobar, retroperitoneal, encapsulated, 11 cm long, 4-5 cm wide, 2-3 cm thick; R kidney 1-2 cm lower than the L Structures: Renal hilum -concavity on medial border containing renal sinus, renal pelvis, blood vessels, nerves, lymphatics Renal pelvis -funnel shaped; continuous w/ major calyces 2-3 minor caycesmajor caylx 3-4 major calycesrenal pelvis 2 Regions: 1.cortex -outer -renal corpuscles, PCT, DCT, peritubular capillaries and medullary rays 2.medulla -inner -8-10 medullary pyramids, collecting ducts, loops of Henle and vasa recta Medullary pyramids -bulk of the medulla -base is oriented towards cortex, apex (renal papilla) is oriented towards the hilum and has perforated tip (area cribrosa) -thin limbs of loop of Henle, collecting tubules Medullary rays -extensions of the medulla in to the cortex -clusters of collecting tubules and ducts Renal columns of Bertin -extensions of the cortex into the medulla; separates neighboring Pyramids Functions of the kidney 1.excretion -filtration, reabsorption 2.regulation of BP 3.regulation of body fluid volume and acid -base balance 4.secretory -renin, erythropoeitin, prostaglandin, medullipin I 5.aid in the conversion of vit. D Histology: I. Urineferous tubules -functional units of the kidneys -nephron and collecting tubules A. Nephron -functional subunit of the kidney -renal corpuscle, PCT, DCT, loop of Henle

1.Renal corpuscle -blood-filtering unit of the nephron -glomerulus and Bowmans capsule -urinary and vascular pole Bowmans capsule (glomerular capsule) -double-walled, pouch-like prox. end of nephron 1.visceral layer -inner; envelopes the glomerular capillaries -epithelium-modified squamous-podocytes 2.parietal layer -outer -epithelium-simple squamous Bowmans space -capsular space/urinary space -between the 2 layers into w/c the ultrafiltrate passes

Vascular pole Urinary pole

-site on Bowmans capsule where afferent arterioles enter and efferent arterioles exit -site on Bowmans capsule where capsular space becomes continuous w/ lumen of PCT

Podocytes -large, round cells forming the visceral layer of Bowmans capsule -highly modified to perform filtering function -completely envelop most of glomerular capillaries by inter-digitating w/ other pedicels to form filtration slits; pedicels are coated w/ podocalyxin believed to maintain their org. and shape Filtration slits -gaps between adjacent pedicels created by inter-digitation of pedicels -restricts passage of large molecules Slit diaphragms -cover the filtration slits -act as part of filtration barrier Glomerulus -small tuft of capillaries in intimate contact w/ visceral layer of Bowmans capsule -w/ fenestrae covered by thin diapragms -basal lamina-invests the glomerulus found between podocytes and glomerular endothelial cells 3 layers 1-lamina rara externa 2-lamina densa

-adjacent to podocyte epithelium; between lamina densa visceral layer of Bowmans capsule -dense central ayer; contain type IV collagen (selective macro-molecule filter) -lamina rara interna-adjacent to cap. endothelium -between lamina densa and endothelial cells of cap.

Lamina rarae -contains laminin, fibronectin and proteoglycan rich in heparan sulfate (restricts passage of neg. charged CHON) -fibronectin and laminin-aid paedicels and endothelial cells to maintain their attacment to lamina densa Mesangium -interstitial tissue between glomerular capillaries -mesangeal cells-secrete CT w/c holds capillaries together 1)extraglomerular mesangeal cells -at the vascular pole -part of JG apparatus-receptors for angiotensin II and atrial natriuretic peptide -w/ in glomerulus -phagocytose large CHON molecules and debris

2)intraglomerular mesangeal cells

Renal filtration barrier composed of -diaphragm-covered capillary fenestrations, fused basal laminae of capillary endothelial cells and podocytes and diaphragm-covered filtration slits bet. interdigitating pedicels Filtration -renal corpuscle filters blood and collects the filtrate in urinary space -fluid from glomerular capillaries is filtered by basal lamina; the fluid that penetrates the lamina densa passes thru the pores in the diaphragm of filtration slits and enters the Bowmans space -larger molecules are trapped by lamina densa and phagocytosed by intraglomerular mesangeal cells -passage of neg. charged molecules and molecules incapable of deformation are prevented by the polyanions of lamina rarae Proximal convoluted tubule -proximal tubule -PCT (pars convoluta) and descending thick limb of Henles loop (pars recta) -starts at the renal corpuscles urinary pole -lined by cuboidal epithelium-cells w/ abundant microvilli (brush border), prominent interdigitations, numerous mitochondria,apical canaliculi functions -resorbs all glucose and amino acids and 75-85% of NaCl and H2O-presence of brush border and lateral interstitial spaces -secretes into filtrate organic acids and bases -exchanges hydrogen ions for bicarbonate ions -glomerulotubular balance-presence of peritubular cap.

Loop of Henle -U-shaped tube composed of thick and thin descending limbs and thick and thin ascending limbs -thick limb-simple cuboidal epith. -thin limb-simple squamous epith. a)descending thick limb -straight portion of prox. tubule -simple cuboidal-prominent brush border

b)thin limb of Henles loop

-composed of descending segment, a loop, and ascending segment -simple squamous-cells w/ few, short, stubby microvilli c)Ascending thick limb -straight portion of distal tubule -simple cuboidal-few microvilli -returns to renal corpuscle of origin where the wall of the tubule forms macula densa Distal convoluted tubule -last segment of nephron; convoluted part of distal tubule -shorter, wider lumen, lacks brush border, less convoluted -simple cuboidal epithelium -cells more basophilic -forms a disk of tightly packed cuboidal cells (macula densa) at the point near the renal corpuscles vascular pole where it contacts w/ afferent arteriole Connecting tubules -short segment bet. DCT and collecting tubules -lined by: 1)principal cells -remove Na ions and secrete K ions 2)intercalated cells -remove K ions and secrete H ions Collecting tubules and ducts -smaller tubules -cuboidal cells -larger tubules -columnar cells -not part of the nephron 3 functional regions: 1)cortical collecting tubules-w/ in medullary rays -lined by simple cuboidal cells -principal cells, intercallated cells principal cells -centrally located nucleus;single cilium -aldosterone -sensitive cells cuboidal cells that reabsorb Na -w/ abundant apical microplicae and microvilli -resp. for urine acidification, bicarb. secretion, K reabsorption (impt. in acid-base balance)

intercallated cells

2)medullary collecting tubules -outer medulla-principal cells and intercallated cells -inner medulla-principal cells -principal cells-antidiuretic hormone sensitive cells that reabsorb H2O 3)papillary collecting tubules of Bellini -lined by simple columnar epith. w/ single central cilium -empty at area cribrosa

Juxtaglomerular apparatus -located near the renal corpuscles vascular pole Function -maintains systemic BP via the renin-angiotensin-aldosterone mechanism -cell complex formed by -renin-producing juxtaglomerular cells, extraglomerular mesangeal cells, macula densa cells -modified smooth muscle cells in afferent arterioles wall -low BP/low blood vol./low NaJG cells secrete renin reninangiotensinogenangiotensin Iangiotensin II

JG cells

Angiotensin II -potent vasoconstrictor -increases BP by-constriction of peripheral bv-release of aldostrone from adrenal cortex -direct effect on renal tubules by reabsorption of Na ions from DCTexpanding plasma volume and increasing BP Extraglomerular mesangeal cells -or Polkissen cells/pole cushion cells/lacis cells/Goormaghtigh cells -between afferent and efferent arterioles Macula densa cells -closely packed cuboidal cells at DCT -sensitive to concentration of Na ions in the fluid w/ in DCT *extraglomerular mesangeal cells and macula densa cells -responsible for glomerulotubular feedback mech. -extraglomerular mesangeal cells transmit signal from macula densa to intraglomerular mesangeal cells w/c then contract/relax to make capillary loops narrower/wider Urine formation -entire blood supply circulates thru the 2 kidneys every 5 min. -1/5 of total blood flow or 1220 ml enters the 2 kidneys per min. from w/c 125 ml of glomerular filtrate is formed -180 L of glomerular filtrate is formed per day of w/c 1.5-2 L is excreted as urine -at least 178 L is resorbed by kidneys daily Pathway of urine formation -urinary space->PCT->descending thick limb->descending thin limb->ascending thin limb->ascending thick limb->DCT->collecting tubules and ducts->renal papilla->minor calyces->major calyces->renal pelvis Renal circulation: -renal A and renal V -afferent arteriole-supplies the glomerulus -efferent arteriole-drains the glomerulus -cortical nephrons-peritubular cap.-erythropoeitin -juxtamedullary nephrons-vasa recta-closely assd. w/ loop of Henle

Excretory Passageways -minor and major calyces, renal pelvis, ureters, UB,urethra 3 layer wall -mucosa -transitional epithelium (except in urethra) over a LP -muscularis -smooth muscles -adventitia Calyces -transitional epithelium -LP -reticular, elastic fibers -muscularis -few inner longitudinal, outer circular smooth mus. -urine from ducts of Belliniminor calyces Renal pelvis -transitional epithelium -LP -reticular, elastic fibers -muscularis -inner longitudinal, outer circular smooth mus. -receives urine from major calyces Ureter -transitional epithelium-thicker than renal calyces -LP -collagen, elastic fibers -muscularis -upper 2/3-inner longitudinal, outer circular -lower 1/3-outermost longitudinal. Inner circular -contraction of muscle layersperistaltic wavespropel urine enters bladder in spurts Urinary bladder -transitional epithelium -relaxed bladder -5-6 cell layers thick w/ rounded superficial dome-shaped cells bulging into Lumen dome-shaped cells -contain plaques in their thick luminal plasma memb. and flattened elliptical vesicles in their cytoplasm -distended bladder -3-4 cell layers thick -has squamous superficial cells -thinner w/ larger luminal diameter -LP-fibroelastic CT rich in blood vessels -muscularis-3 poorly defined layers of smooth muscles-inner longitudinal, middle circular, outer longitudinal

Urethra Female -transitional epithelium near UB; remainder is stratified squamous epithelium -LP-fobroelastic vascular CT -mucus-secreting cell of Littre -muscularis-inner longitudinal, outer circular layers -surrounded by ext. sphincter of skeletal muscle allowing voluntary control of micturition Male (membranous) -pseudostratified or stratified columnar epithelium -LP -fibroelastic CT, few glands of Littre -muscularis -skeletal fibers of urogenital diaphragm -ext. sphincter of skeletal muscle-vol. control of micturition male(cavernous) -pseudostratified/stratified columnar epithelium; stratified squamous at fossa navicularis -LP -erectile tissue of corpus spongiosum; many glands of Littre -muscularis -replaced by sparse smooth muscle, many elastic fibers lining vascular spaces in erectile tissue -receives secretions of bulbourethral glands present in urogenital diaphragm