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F 18 Urinary (BI-104)

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Jennifer Jezylo

on 27 November 2018

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Transcript of F 18 Urinary (BI-104)

Urinary (excretory)
Urinary System Organs -
Kidneys – paired
Located along the backbone
Retro-peritoneal (outside of the peritoneal cavity)
Three regions (macroscopically) –
Renal Cortex – Outer layer
Medulla – Renal pyramids
Renal Pelvis –
Continuous with the ureter
Concave side has a hilum, where the renal artery and vein enter/exit and the ureter exits

Adrenal glands located above each kidney
Important in short/long-term STRESS
What are the long term stress hormones?
What are the short term stress hormones?
Kidneys are RETRO-PERITONEAL!
Three regions (macroscopically)
Internally -
Each minor calyx (calyses in the plural) is a small tube which collects urine from the papillae of each pyramid

The minor calyses join to form the major calyses, which join to form the
renal pelvis
, an expanded portion of the ureter
Kidney Coverings -
Renal capsule
Surrounds each kidney
Adipose capsule
Surrounds the kidney
Provides protection for the kidney
Helps keep the kidney in its correct location
Ureters –
Connect kidneys with bladder (exit the hilum)
Peristalsis moves urine through the ureters

Urinary bladder –
Hollow, muscular sac
Can hold > ½ liter (~500ml)
Urine held in by two sphincters
Internal urethral sphincter (smooth muscle) -involuntary
External urethral sphincter (skeletal muscle)-voluntary
Urethra –
Connects bladder with the exterior
Females –
Shorter and wider urethra
More prone to urinary infection for this reason
**In females there's no connection between the reproductive and urinary systems
Males –
Urethra in males encircled by the prostate gland
Enlarged prostate can cause difficult urination
NOTE: Connection between the reproductive and urinary systems
Urethra carries urine during urination and semen during ejaculation
Prostatic urethra – passes through prostate gland
Membranous urethra – passes through the muscular floor of the pelvic cavity (site of the external urethral sphincter)
Penile urethra – extends through the penis
The bladder is located anterior to the rectum in males, and anterior to the uterus in females
Urinary Bladder - Muscular (smooth muscle) urine vat
Trigone – three openings:
2 from the ureters, 1 to the urethra (UTIs frequently occur here)
Urination (
Micturition
) -
Stretch receptors activated when the bladder is ~ 1/3 full → nerve impulses to spinal cord via the parasympathetic NS → impulses from spinal cord → Bladder contracts and sphincters relax → Urination
Brain has control of the reflex
Microscopic kidney unit (NEPHRON or renal tubule) is the functional kidney unit -
Produces urine
Urine from many nephrons flows into common collecting duct
Nephrons → collecting ducts → renal pelvis → ureter → bladder → urethra → toilet
Each nephron has its own blood supply:
Renal artery → Afferent arteriole → glomerulus (a knotted capillary bed) → Efferent arteriole → Peritubular capillary network → Renal venule → Renal vein
Types of nephrons -
(1) Cortical nephrons (includes most nephrons)
Located entirely in the cortex
Nephron types -
(2) Juxtamedullary nephrons
Found at the boundary of the cortex & medulla
Nephron anatomy (from proximal to distal)
Bowman’s capsule (glomerular capsule) - Cup-like structure surrounding the glomerulus
- Functions to filter the blood, producing a glomerular filtrate
Glomerulus (AKA renal corpuscle) -
A specialized
capillary bed
within Bowman's capsule
Attached to arterioles on both sides (maintains high pressure)
Large afferent arteriole (lumen is large)
Narrow efferent arteriole (lumen is much smaller)
Causes BLOOD PRESSURE in the glomerulus to be HIGH
MOVES SUBSTANCES into the glomerular capsule by
filtration
Filtration - Passive transport process based on PRESSURE differences across the membrane
Glomerular filtration –
Begins when blood moves from the afferent arteriole into the glomerulus
Glomerular filtration occurs here=
Passive process (No energy needed)
Depends on
pressure differences
… NOT concentration differences
Water and solutes (smaller than proteins) are forced through capillary walls
Filtration of blood:
Formed elements (blood cells, platelets, large proteins, etc.) stay in the blood
Small molecules (H2O, nitrogenous waste, some nutrients like glucose, ions, small proteins/amino acids etc.) enter the glomerulus
Forms glomerular filtrate
This is ~ the same composition as plasma
Filtered blood leaves via
efferent arteriole
~ hundreds of liters of H2O filtered each day + lots of other important stuff

Filtrate is collected in the glomerular capsule (aka Bowman's capsule) and ostly leaves via the proximal convoluted tubule ...
Proximal convoluted tubule (PCT)
– (Proximal to distal)
Lots of mitochondria in these cells (lots of energy needed)
Many microvilli to ↑↑↑ surface area
Functions to re-absorb most filtrate components
Loop of Henle (loop of the nephron)

*
Descending limb
– Re-absorption of solutes (sodium etc) and
allows H2O to be re-absorbed
*
Ascending limb
– Re-absorption of solutes (sodium etc) BUT
not permeable to water (H2O stays in the tubule)
Functions to help in urine concentration
Distal convoluted tubule (DCT)

Functions mostly in tubular secretion
Some re-absorption
Collecting ducts

Water re-absorption (but not much else)
**IF ADH is present in the blood**
Distal tubules from many nephrons enter one collecting duct
Many collecting ducts merge into the renal pelvis
Formation of Urine -
In the Proximal Convoluted Tubule (PTC) and distally ...
Tubular re-absorption (most H2O, some nutrients and ions as needed by body) –
Occurs within the peritubular capillaries surrounding the nephron –
Active transport (energy required)
Na+ ions actively re-absorbed (most in the PTC) … Remember the SODIUM/POTASSIUM pump!)
Cl- ions passively follow
H2O passively re-absorbed (osmosis)
Nutrients (glucose and amino acids) selectively re-absorbed in the proximal convoluted tubule
**Each substance has a maximum absorption rate….if this is
exceeded, the substance leaves with the urine
Ex. Glucose (diabetes mellitus)
Ex. Proteins (eclampsia)
Tubular Secretion - (another way substances are added to the urine)
Mostly happens in the
Distal Convoluted Tubule (DCT)
Active transport of some substances
from the blood (peritubular capillaries) into the tubular fluid
H+ ions, K+ ions, creatinine, some medications (drugs)
***This is the main way the kidney controls blood pH (H+ ions)
So
urine
contains glomerular filtrate components that have not been re-absorbed + substances that have been secreted into the tubules
Two ways that substances can enter the urine =
Glomerular filtration (glomerulus)
Tubular secretion (mostly distal tubule)
Urine characteristics
Pretty yellow due to the pigments urochrome and urobilinogen (from the breakdown of hemoglobin) and solutes
Sterile (NO microbes!)
Slightly aromatic
Normal pH of around 6 (Carnivores)
Functions of the excretory system ...
(Putting it all together)
1)
Excretion of metabolic waste

Nitrogenous waste –
Mostly
Urea
By-product of amino acid metabolism (Protein breakdown)
Produced in the liver: (ammonia + CO2 → urea)
Urea is much less toxic than ammonia
Ammonium
– some ammonia is not combined with CO2 and is excreted as ammonia (tubular secretion)
Creatinine
Creatine phosphate (high energy storage molecule in skeletal muscles) → creatinine + energy
Creatinine excreted in urine
Uric acid

Product of nucleotide (from DNA and RNA) break-down
Insoluble, so crystals can form collecting in kidneys (kidney stones) and/or joints (gout)
2) Maintaining blood water/salt balance and controlling blood pressure -

Mostly via HORMONES!!!
Re-absorption (back into the blood) of H2O
Antidiuretic hormone (ADH)

Produced in the hypothalamus (brain) and secreted by the posterior pituitary gland -
Works to ↑ H2O re-absorption → ↑ blood volume/↑ blood pressure
Ex. On a hot day, ADH released → ↑ H2O re-absorption →
urine is more concentrated
Most H2O re-absorption from ADH occurs in the descending loop of Henle and
the collecting ducts
Remember, water is NOT re-absorbed from the ascending loop of Henle
2) Water/salt balance (Continued)
Re-absorption of salts –
> 99% of Na+ that is filtered at the glomerulus is returned to the blood
Most re-absorbed at the proximal tubule (PCT)
Some at the ascending Loop of Henle
The rest at the distal tubule (DCT) and collecting ducts
Regulated by hormones
(Here they are again)
Aldosterone
– Secreted by the adrenal gland (cortex) → ↑ excretion of K+ ions and ↑ re-absorption of Na+ ions (Sodium-potassium pump)
Renin is an enzyme that regulates this
Renin is secreted by the kidney (when blood pressure in the glomerulus is low)
→ $ release of aldosterone (by the adrenal cortex)
↑ salts in blood cause →↑ H2O in blood (where sodium goes, water follows)→
↑ blood volume/↑ blood pressure
ANH (Atrial Natriuretic Hormone)
- Secreted by the atria of the heart when blood volume is too high (baro-receptor stimulation) → Inhibits renin secretion → Sodium leaves (where sodium goes .... water follows) →
↓ blood volume/↓ blood pressure

Helps maintain blood level of other ions (K+, HCO3-,Ca++)
3) Maintenance of acid/base balance of the blood -
Blood pH = ~ 7.35-7.45 (slightly alkaline)
Maintained in three main ways ....
Bicarbonate buffer system
– Makes quick changes in blood pH
H+ + HCO3- ↔ H2CO3 ↔ H2O + CO2
Respiratory system
- Breathing out or retention of CO2 by lungs helps (REMEMBER HOW THIS WORKS!!)
Kidneys are the main control
through excretion/re-absorption of H+ ions and excretion /re-absorption of HCO3- ions AS NEEDED
Urine pH usually acidic (<6) due to acidic foods consumed
Blood pH too low?
(Too many H+ ions in blood and/or too much CO2) = ACIDOSIS
Excretion (into urine) of H+ ions and re-absorption (into blood) of HCO3- ions (by tubular secretion)
Blood pH too high?
(Not enough H+ ions in the blood and/or too little CO2) = ALKALOSIS
Re-absorption (into blood) of H+ ions and excretion (into urine) of HCO3- ions
**Remember that HCO3- ions act as a blood buffer
Excretory system functions (continued)
4) Assist endocrine system by…..
Secretes renin
causing aldosterone to be released from adrenal cortex
Erythropoietin
– Hormone that stimulates RBC production and maturation in the red bone marrow
PTH activates vitamin D here
(produced on the skin from uV light and cholesterol), which is used to form the hormone calcitriol →↑ Ca++ absorption from digestive tract
Excretory system functions -

1) Excretion of metabolic (liquid) wastes
Urea/ammonia
Creatinine
Uric acid (crystals = gout)

2) Maintaining acid/base balance
Secretes and re-absorbs H+ ions
Re-absorbs and secretes HCO3- ions as needed

3) H2O/ salt balance
H2O = ADH
Salt = Aldosterone (antagonist = ANH)

4) Hormone secretion
Erythropoietin
Renin system
PTH activates vitamin D
The three processes carried out by the kidneys include
1)
Glomerular filtration
(Glomerulus) - produces filtrate
2)
Tubular re-absorption
(All through the nephron in the peri-tubular capillaries) - moves substances back into the blood
3)
Tubular secretion
(DCT) - active transport of substances from the blood to the urine
8. The serous membranes lining the walls of the abdominal cavity are the ...
a. Visceral pleura
b. Parietal peritoneum
c. Ventral to the kidneys
d. Visceral peritoneum
e. Both b and c
10. Peristalsis ...
a. Occurs in the digestive tract and in other hollow organs
b. Is due to cilia moving substances
c. Is due to skeletal muscle contraction
d. Refers to a membrane in the abdominal cavity
e. All of the above
13. Inflammation of the urinary bladder is ...
a. Bladderitis
b. Cystitis
c. Urinitis
d. Urethritis
e. Both a and b
10. The micturition reflex is mostly controlled by the ...
a. Somatic nervous system
b. Central nervous system
c. Sympathetic nervous system
d. Parasympathetic nervous system
e. Voluntary nervous system
11. Afferent means ...
a. Going towards
b. Going away from
c. Rich and powerful
d. Sensory
e. Both a and d
Other pigments produced by RBC breakdown include ...
a. Bilirubin
b. Biliverdin
c. Pigments that color the feces
d. Ingredients in bile salts
e. All of the above
Too much CO2 in the blood will ...
a. Stimulate respiration
b. Depress respiration
c. Increase blood pH
d. Cause an alkalosis
e. All of the above, except a
2. The three (3) ways that blood pH is maintained are ...
a. Respiratory, digestive, and excretory systems
b. Bicarbonate buffer, respiratory, digestive systems
c. Respiratory, bicarbonate buffer, and excretory systems
d. Lymphatic, respiratory, and excretory systems
e. Immune, lymphatic, and excretory systems
1. The four basic tissue types include ...
a. Muscle
b. Skeletal
c. Connective
d. Hyaline
e. Stratified
7. The hormone from the hypothalamus that increases water absorption from the kidney is ...
a. Oxytocin
b. Anti-diuretic Hormone (ADH)
c. Erythropoeitin
d. Aldosterone
e. Atrial Naturetic Hormone (ANH)
6. The hormone that help increase calcium absorption from the digestive tract is ...
a. Calcitonin
b. Parathyroid Hormone (PTH)
c. Calcitriol
d. Thymocin
e. Aldosterone
3. The term "renal" refers to the ...
a. Liver
b. Stomach
c. Kidney
d. Spleen
e. Heart
5. Inflammation of the membranes of the abdominal cavity is called ...
a. Meningitis
b. Myocarditis
c. Peritonitis
d. Pleurisy
e. Membranitis
9. The renal artery ...
a. Exits the hilum of the kidney
b. Carries deoxygenated blood
c. Empties into the inferior vena cava
d. Is a branch of the abdominal aorta
e. Drains the peri-tubular capillaries

4. Functions of the excretory system include ...
a. Draining excess tissue fluid
b. Storing fat and minerals
c. Transporting nutrients
d. Controlling acid/base balance of the blood
e. Secreting melatonin

7. Renin is a(n) ....
a. Enzyme
b. Hormone
c. Waste product
d. Nutrient
e. Neurotransmitter

12. The micturition reflex depends on stimulation of ...
a. Taste buds
b. Chemoreceptors
c. Stretch receptors
d. Nociceptors
e. Photoreceptors

11. The control of digestive processes is mainly the job of the...
a. Thalamus
b. Cerebral cortex
c. Cerebellum
d. Parasympathetic nervous system
e. Sympathetic nervous system

6. The ureters move urine distally towards the bladder through ...
a. Conscious control of skeletal muscle
b. Peristalsis
c. Sphincter control
d. Gravity
e. Both b and d

8. A nephron is ...
a. The functional part of the respiratory system
b. The microscopic filtering unit in the kidney
c. Important in controlling most hormone secretion
d. Part of the diencephalon
e. Non-functional in the adult human
The kidney are located
retroperitoneal
(dorsal to the peritoneum) on the posterior abdominal wall
The left kidney is at the level of T12
The right kidney is (slightly) lower to accommodate the liver

Blood supply of the kidneys:
Oxygenated blood enters kidneys by the renal arteries >>>> afferent arterioles > glomerulus > efferent arterioles > peritubular capillaries >>>> renal vein


1. Pammy is a 24 year old African American woman who was training for a spring marathon until an Achilles tendon tear side-lined her. She is brought into your emergency room by her roommate Barry, who found her wandering around outside with no coat, acting disoriented. Pammy tells you that she had taken four aspirin (acetylsalicylic acid) this morning, hoping to go for an early afternoon training run, and when it didn’t seem to help, she repeated that dose a few hours later. Pammy’s respiration is very rapid and deep. All other parameters are within normal limits. You quickly determine that Pammy has an extreme metabolic acidosis from the excess acid (acetylsalicylic acid) in her bloodstream.
Do you think Pammy’s blood CO2 levels are high or low?
A) High - Her pH must be too low
B) Low - She's breathing fast, deep,and getting rid of CO2
C) High - She has an acidosis
D) Low - Pammy has an alkalosis
E) None of the above
3. Walter is a nineteen year-old college student who arrived at your hospital after his roommate found him passed out on the bathroom floor this morning. Upon examination, you find that Walter’s heart rate is 40 bpm, blood pressure is 97/50 mmHg, temperature is 36.2 C, and his respirations are extremely shallow and slow. He smells strongly of alcohol, and does not respond to your repeated questions.
Why are Walter's respirations slow and shallow (depressed)?
a. Acidosis
b. Alkalosis
c. Too much blood CO2
d. Alcohol poisoning
e. Both c and d
2. Are Pammy's H+ levels high or low
a) High (she has acetylsalicylic acid poisoning)
b) Low
9. What are the hormones released from the adrenal gland in response to short term stress?
a. Epinephrine/nor-epinephrine
b. Aldosterone/cortisol
c. Thyroid hormone/ ANH
d. Lutenizing Hormone/Follicle Stimulating Hormone
e. Insulin/glucagon
4. Endocrine glands ...
a. Release products through ducts
b. Release hormones into the blood
c. Include the pancreas
d. All of the above
e. Both b and c

Exocrine glands ...
5. Exocrine glands ...
a. Release products through ducts
b. Release hormones into the blood
c. Include the pancreas
d. All of the above
e. Both a and c
Glomerulus
& glomerular capsule
Retroperitoneal
Nephrons
What's this?
a. Urethra
b. Transverse section of the prostate
c. Ureter
d. Duodenum
e. Tracheal cross section
What's this?
a. Pancreas
b. Urinary bladder
c. Nephron
d. Adrenal gland
e. Pituitary
What part of the autonomic nervous system normally controls urination?
a. Somatic
b. Craniosacral
c. Thoracolumbar
d. Peripheral
e. Central
Name a substance normally found in the glomerular filtrate BUT not in the urine:
a. Ammonia
b. Urea
c. Urobilinogen
d. Glucose
e. Blood
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