Human Anatomy & Physiology II – Dr.

Sullivan
Unit VII – Urinary System – Chapter 23
I. Summary
a) The urinary system consists of two kidneys (left & right), two ureters (left & right), one urinary
bladder, and one urethra.
b) After blood is filtered by the kidneys and most of the water and solutes are returned to the
bloodstream, the remaining water and solutes constitute urine.
c) Urine travels from the kidney to the urinary bladder via the ureter. It is stored in the bladder until
it is ready to be expelled from the body through the urethra.
II. The Kidneys (renal = kidney)
a) The kidneys have many functions and do most of the work of the urinary system.
i) Regulation of blood ions – the kidneys help regulate the concentrations of sodium,
potassium, calcium, chloride, and phosphate ions in the blood.
ii) Maintains blood osmolarity (how much of a solution is made of dissolved particles) – by
regulating loss of water and solutes in the urine, blood osmolarity can be kept constant.
iii) Regulation of blood volume – conserving or eliminating water can adjust the blood volume.
iv) Regulation of blood pressure with two methods
(1) Renin-Angiotensin Pathway
(a) Dehydration results in a decrease in blood volume and blood pressure
(b) This stimulates the kidney to secrete an enzyme called Renin into the bloodstream.
(c) Renin comes in contact with a plasma protein called angiotensinogen (produced by
the liver).
(d) Renin converts angiotensinogen into angiotensin I.
(e) When blood flows to the lungs, an enzyme called angiotensin converting enzyme
(ACE) converts angiotensin I into angiotensin II.
(f) Angiotensin II causes vasoconstriction of the arterioles, increasing blood pressure.
(g) Angiotensin II also stimulates the adrenal cortex to secrete a hormone called
Aldosterone, which stimulates the kidneys to reabsorb water and sodium, therefore
increasing blood volume, which increases blood pressure.
(h) ACE Inhibitors: powerful anti-hypertensive drugs for reducing blood pressure.
v) Reduce blood pressure in two ways: decreased blood volume and arteriole constriction.
(1) Kidneys can also adjust the resistance of blood flowing through the kidneys, which
affects the systemic vascular resistance and change blood pressure.
vi) Regulation of blood pH – by excreting H+ (acid) ions into the urine and conserving
bicarbonate (base).
vii) Release of hormones – The kidneys release two hormones
(1) Calcitrol – active form of Vitamin D for regulation of calcium homestasis.
(2) Erythropoietin – stimulates production of red blood cells.
viii) Regulation of blood glucose level – the kidneys can convert the amino acid glutamine into
glucose via gluconeogenesis, and release the glucose into the bloodstream.
ix) Excretion of wastes and foreign substances – the kidneys create urine to help dispose of
wastes such as ammonia & urea left from breaking down from amino acids, bilirubin from
hemoglobin, creatinine from muscle fibers, and uric acid from nucleic acids.
(1) Foreign substances like drugs and environmental toxins are also excreted by the kidneys
in the urine.
b) Anatomy of Kidneys
i) Kidneys are retroperitoneal
ii) They are bean-shaped and just above the waste on either side of the body from about T12-
L3. The right kidney is slightly lower than the left due to the liver.
iii) Medially and near the center there is a concave area called the renal hilus where the ureter,
nerves, and blood & lymph vessels enter and exit the kidney.
iv) Renal Cortex – the superficial, smooth-textured, reddish portion of the kidney
v) Renal Medulla – the deep, internal reddish-brown region of the kidney.
 vi) Renal Pyramids – 8-18 cone-shaped structures in the medulla that funnel toward the renal
hilus
vii) Renal Papilla – the narrow end of the renal pyramid
viii) Renal Columns – the portion of the medulla in between the pyramids.
(1) Parenchyma – functional portion of the kidney consisting of the renal cortex and the
renal pyramids together
ix) Nephron – the functional unit of the kidney that produce urine and channel it to the papillary
ducts
x) Minor calyx – collects urine from the renal papilla and channels it to the major calyx
xi) Renal Pelvis – urine drains from the major calyx into the renal pelvis and then out through
the ureter and to the urinary bladder.
c) Blood and the Kidneys
i) The kidneys receive 20-25% of the resting cardiac output every minute
ii) Blood enters the kidney through the renal artery
iii) From here, the arteries branch out 5 times to eventually become an afferent arteriole
carrying blood toward the nephron.
iv) Each nephron receives one afferent arteriole.
v) The arteriole branches out into a tangled, ball-shaped, network of capillaries called a
glomerulus.
vi) Then, the capillaries converge to form an efferent arteriole that drains blood out of the
glomerulus.
(1) This is the only place that a capillary is in between two arterioles and not an arteriole and
venule.
vii) After this, the efferent arterioles branch out into peritubular capillaries surrounding the
nephron, which then converge to become peritubular venules that eventually converge into
the renal vein for venous return.
d) The Nephron – the functional unit of the kidney
i) Two portions:
(1) Renal corpuscle – where blood is filtered
(2) Renal tubule – where the filtered fluid passes
(a) Surrounded by peritubular capillaries so that fluid can be reabsorbed from the tubule
into the bloodstream after it is filtered.
(3) Renal Corpuscle has two components
(a) Glomerulus: ball of fenestrated capillaries that filter out blood plasma
(b) Glomerular capsule (bowman’s capsule) – a double walled cup that surrounds the
glomerulus.
(i) From the glomerular capsule, fluid that is filtered out of the blood plasma passes
into the renal tubule.
(4) The Renal tubule is divided into three sections
(a) Proximal Convoluted Tubule (PCT)
(b) Loop of Henle
(c) Distal Convoluted Tubule (DCT)
e) Urine Production
i) The blood enters the glomerulus via the afferent arteriole.
ii) Blood is filtered in the glomerulus and the plasma filtered out enters the glomerular capsule.
iii) Blood that remained enters the efferent arteriole and flows to the peritubular capillary.
iv) The filtered plasma then enters the proximal convoluted tubule.
(1) Here reabsorption of water and some solutes (Na, H, HCO3, Cl, K, Ca, Glucose, amino
acids) into the bloodstream via the peritubular capillaries takes place.
v) When the tubular fluid gets to the Loop of Henle, 65% of the water and solutes have been
reabsorbed into the blood.
(1) The Loop of Henle reabsorbs another 15% of the water as well as 20-30% of the Na, K,
and Ca.
vi) After the loop of Henle, the tubular fluid enters the distal convoluted tubule. 80% of the
water has already been reabsorbed.
 (1) Here, Na & Cl reabsorption continues and by the time the tubular fluid leaves here, 90-
95% of the water and solutes have been reabsorbed.
vii) From the distal convoluted tubule, the fluid enters the collecting duct.
(1) The rest of reabsorption happens here. What’s left over drains into the papillary duct
and becomes urine for excretion
viii) Urine is water and waste products.
(1) During times of dehydration, urine is dark, thick and concentrated with solutes
(2) In times of good hydration, urine is dilute and clear.
III. Urine elimination
a) Urine leaves the kidney from the renal pelvis into the ureter.
b) The ureter takes the urine to the urinary bladder
c) Urine is stored in the urinary bladder until it is full enough to cause the micturition reflex:
i) The urinary bladder wall contains a circular muscle called the detrusor muscle.
ii) Stretch receptors within the detrusor muscle of the bladder are stimulated as the detrusor
muscle distends when the bladder fills up. The detrusor muscle contracts around the bladder
cavity, forcing pressure to increase in the urinary bladder cavity and urine to leave the bladder
(similar to the left & right ventricles of the heart contracting, forcing blood out). The
involuntary internal urethral sphincter (between the bladder and the urethra) relaxes
allowing urine to leave the bladder and enter the urethra.
iii) The external urethral sphincter (voluntary) remains closed so urine does not yet leave the
body.
d) When you feel the pressure of the bladder filling up and the micturition reflex, you voluntarily
relax the external urethral sphincer, allowing the urine to leave the body on your own terms.