Professional Documents
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Storage of urine
Excretion of urine.
At any given time, 20 % of blood is in the kidneys. Humans can function with one kidney.
They are one of the major homeostatic organs of the body.
They control water pH, secrete erythropoietin (a hormone that stimulates red blood cell
production) and activate vitamin D production in the skin.
Blood volume regulation.
the kidneys control the volume of interstitial fluid and blood under the direction of certain
hormones
Regulation of erythrocyte production.
as the kidneys filter the blood, they are also indirectly measuring the oxygen level in the
blood
Erythropoietin (EPO): hormone produced by kidney
Released if blood oxygen levels fall
Stimulates RBC production in red bone marrow
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The Kidney
Retroperitoneal
Anterior surface covered with peritoneum
Posterior surface against posterior abdominal wall
Superior pole: T-12
Inferior pole: L-3
Right kidney ~ 2cm lower than left
Adrenal gland on superior pole
Hilum: concave medial border
Renal sinus: internal space
Houses blood vessels, lymphatic vessels, nerves
Houses renal pelvis, renal calyces
Also fat
Surrounding tissues, from deep to superficial:
Fibrous capsule (renal capsule)
Dense irregular CT
Covers outer surface
Perinephric fat (adipose capsule)
Also called perirenal fat
Completely surrounds kidney
Cushioning and insulation
Renal fascia
Dense irregular CT
Anchors kidney to posterior wall and peritoneum
Paranephric fat
Between renal fascia and peritoneum
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*
*
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Transverse sections
show retroperitoneal
position of kidneys
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The Arteries
Aorta gives off right and left renal arteries
Renal arteries divides into 5 segmental arteries as enters hilus
of kidney
Segmentals branch into
lobar arteries
Lobars
divide
into
interlobars
Interlobars into arcuate in
junction of medulla and
cortex
Arcuates send interlobular
arteries into cortex
Cortical radiate arteries
give rise to glomerular
arterioles
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Vessels
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____vasa recta
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Nephrons
Cortical Nephrons
Near peripheral edge of cortex
Short nephron loops
Have peritubular capillaries
Juxtamedullary nephrons
Near corticomedullary border
Long nephron loops
Have vasa recta
The functional filtration unit in the kidney.
Consists of the following:
Renal corpuscle
Glomerulus
Glomerular capsule (Bowmans capsule)
Proximal convoluted tubule (PCT)
Nephron loop (loop of Henle)
Ascending loop of Henle
Descending loop of Henle
Distal convoluted tubule (DCT)
collectively called the renal tubule
In both kidneys: approximately 2.5 million nephrons.
Are microscopic: measure about 5 centimeters in length.
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Renal Corpuscle
Vascular pole
Afferent and efferent arterioles
Tubular pole
Connects to PCT
Two structures:
Glomerulus and glomerular capsule
Glomerulus
Capillary bed
High pressure
fenestrations
Glomerular Capsule
Parietal layer
Simple squamous epithelium
Visceral layer
Podocytes
Pedicels
Filtration slits
Capsular space (Bowmans capsule): location of filtrate
Filtration membrane
Fenestrations
Filtration slits
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Loop of Henle
primary function:
Secretion
From blood plasma to filtrate.
secretes ions
potassium (K+)
acid (H+)
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Bowmans Capsule
Filtration
The first event to occur in urine formation is
filtration of the blood
Filtrate will include mostly water and
dissolved solutes including wastes and
nutrients
Afferent arteriole is dilated, which increases blood
volume and pressure into the glomerulus
Efferent arteriole is constricted, which increases
pressure as blood backs up in the glomerulus
Filtrate is collected by the Bowmans capsule
Juxtaglomerular apparatus
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Bowmans
capsule
60% of
solutes
reabsorbed
by active
transport
20% of
solutes
reabsorbed
by active
transport
20% of
solutes
reabsorbed
or excreted
in the urine
Water Regulation
Kidney Disease
Diabetes Mellitus
Lack of insulin produced from the pancreas
Results in increased blood sugar levels, which in turn will result in increased
sugar concentration in the nephron
Draws water into the nephron
Results in increased sugar and water in the urine
Diabetes Insipidus
Destruction of ADH producing cells of the hypothalamus
No reabsorption of water urine output increases dramatically (20L/day)
Must drink large quantities of water, regulated with injections of ADH
Kidney Stones
The clumping and hardening of minerals from the blood
Must pass through pelvis ureters urinary bladder urethra (painful in
males)
Kidney Infections
Result when an infection reaches the kidneys and
becomes known as pyelonephritis.
Common causes can be infection from elsewhere in
the body or obstruction of the prostate gland (usually
in older men).
For children, infection can be caused by the tube that
drains urine from the kidneys and the bladder.
Kidney Stones
Are also a common kidney disorder. They form when chemicals in the urine
precipitate out and form crystals.
The most common crystals are from calcium oxalate, while others could be from uric
acid and cystine.
Kidney stones are more common in men than women and can reoccur at any time.
Factors such as recurrent urinary bladder infections, insufficient water intake and
consumption, low levels of physical activity, and too much Vitamin C and D intake
can lead to kidney stones.
One of the best ways to decrease the occurrence of stones is to drink lots of water
and to change your dietary habits.
Symptoms include severe back or abdomen pain, blood in the urine, nausea and
vomiting.
Diagnosis involves a complete medical examination, including X-rays.
Treatment may vary from letting the stones pass through the urinary tract to
ultrasound shock (or lithotripsy) to disintegrate the stones to a small size that can be
passed through the urinary tract.
Real large stones require surgery for removal.
The Ureters
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Adventitia (external)
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Urinary Bladder
Collapsible
muscular sac
Stores and expels
urine
Lies on pelvic floor
posterior to pubic
symphysis
Males: anterior to
rectum
Females: just
anterior to the
vagina and uterus
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Fibrous adventitia
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The Urethra
Smooth muscle with inner mucosa
Changes from transitional through stages to stratified squamous near end
Drains urine out of the bladder and body
Short length is why females have more urinary tract infections than males ascending bacteria from stool contamination
urethra
Urethra____
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Urethral sphincters
Internal: involuntary sphincter of smooth muscle
External: skeletal muscle inhibits urination voluntarily until
proper time (levator anni muscle also helps voluntary
constriction)
Males: urethra has
three regions (see
right)
_________trigone
1. Prostatic urethra__________
2. Membranous urethra____
female
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Micturition
AKA:
Voiding
Urinating
Emptying the bladder
The expulsion of urine from the bladder.
Initiated by a complex sequence of
events called the micturition reflex.
The
bladder
is
supplied
by
both
KNOW:
Micturition center of brain: pons
(but heavily influenced by higher centers)
Parasympathetic: to void
Sympathetic: inhibits micturition
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Urethra
Fibromuscular tube
exits the urinary bladder through the urethral opening
at anteroinferior surface
conducts urine to the exterior of the body.
Tunica mucosa: is a protective mucous membrane
houses clusters of mucin-producing cells called urethral glands.
Tunica muscularis: primarily smooth muscle fibers
help propel urine to the outside of the body.
Two urethral sphincters:
Internal urethral sphincter
restrict the release of urine until the pressure within the urinary bladder is high enough
External urethral sphincter
and voluntary activities needed to release the urine are activated.
The internal urethral sphincter
involuntary (smooth muscle)
superior sphincter surrounding the neck of the bladder, where the urethra originates.
a circular thickening of the detrusor muscle
controlled by the autonomic nervous system
The external urethral sphincter
inferior to the internal urethral sphincter
formed by skeletal muscle fibers of the urogenital diaphragm.
a voluntary sphincter
controlled by the somatic nervous system
this is the muscle children learn to control when they become toilet-trained
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Female Urethra
Has a single function:
to transport urine from the urinary bladder to the vestibule, an external
space immediately internal to the labia minora
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Male Urethra
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