PowerPoint® Lecture Slides

Prepared by Patty Bostwick-Taylor,

Florence-Darlington Technical College

CHAPTER 15
The Urinary
System

© 2012 Pearson Education, Inc.

 Functions of the Urinary System

• Elimination of waste products

• Nitrogenous wastes
• Toxins
• Drugs

© 2012 Pearson Education, Inc.

 Functions of the Urinary System

• Regulate aspects of homeostasis

• Water balance
• Electrolytes
• Acid-base balance in the blood
• Blood pressure
• Red blood cell production
• Activation of vitamin D

© 2012 Pearson Education, Inc.

 Organs of the Urinary System

• Kidneys
• Ureters
• Urinary bladder
• Urethra

© 2012 Pearson Education, Inc.

 Hepatic veins (cut)

Inferior vena cava

Adrenal gland Renal artery

Renal hilum
Aorta Renal vein
Kidney
Iliac crest
Ureter

Rectum (cut)
Uterus (part
of female
reproductive Urinary
system) bladder
Urethra

(a)
© 2012 Pearson Education, Inc. Figure 15.1a
 12th rib

(b)
© 2012 Pearson Education, Inc. Figure 15.1b
 Location of the Kidneys

• Against the dorsal body wall in a

retroperitoneal position (behind the parietal
peritoneum)
• At the level of the T12 to L3 vertebrae
• The right kidney is slightly lower than the left
(due to position of the liver)

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 Kidney Features

• Renal hilum
• A medial indentation where several
structures enter or exit the kidney (ureters,
renal blood vessels, and nerves)
• An adrenal gland sits atop each kidney

© 2012 Pearson Education, Inc.

 Hepatic veins (cut)

Inferior vena cava

Adrenal gland Renal artery

Renal hilum
Aorta Renal vein
Kidney
Iliac crest
Ureter

Rectum (cut)
Uterus (part
of female
reproductive Urinary
system) bladder
Urethra

(a)
© 2012 Pearson Education, Inc. Figure 15.1a
 Coverings of the Kidneys

• Fibrous capsule
• Surrounds each kidney
• Perirenal fat capsule
• Surrounds the kidney and cushions against
blows
• Renal fascia
• Outermost capsule that helps hold the
kidney in place against the muscles of the
trunk wall

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 Regions of the Kidney

• Renal cortex—outer region

• Renal medulla—inside the cortex
• Renal pelvis—inner collecting tube

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 Cortical radiate
vein
Cortical radiate
artery
Arcuate vein
Arcuate artery
Renal column Interlobar vein
Interlobar artery
Segmental
arteries

Renal
cortex
Renal vein
Renal artery
Minor calyx
Renal pelvis
Major calyx
Renal Ureter
pyramid

Fibrous capsule

(b)
© 2012 Pearson Education, Inc. Figure 15.2b
 Kidney Structures

• Renal or medullary pyramids—triangular

regions of tissue in the medulla
• Renal columns—extensions of cortex-like
material inward that separate the pyramids
• Calyces—cup-shaped structures that funnel
urine towards the renal pelvis

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 Renal column

Major calyx

Renal
cortex

Minor calyx

Renal
pyramid

(a)
© 2012 Pearson Education, Inc. Figure 15.2a
 Blood Supply

• One-quarter of the total blood supply of the

body passes through the kidneys each minute
• Renal artery provides each kidney with arterial
blood supply
• Renal artery divides into segmental arteries 
interlobar arteries  arcuate arteries 
cortical radiate arteries

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 Blood Supply

• Venous blood flow

• Cortical radiate veins  arcuate veins 
interlobar veins  renal vein
• There are no segmental veins

© 2012 Pearson Education, Inc.

© 2012 Pearson Education, Inc. Figure 15.2c
 Nephron Anatomy and Physiology

• The structural and functional units of the

kidneys
• Responsible for forming urine
• Main structures of the nephrons
• Glomerulus
• Renal tubule

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 Cortical
nephron Fibrous capsule

Renal cortex Collecting

Renal medulla duct
Renal
cortex Proximal
Renal pelvis convoluted
tubule
Glomerulus
Ureter Juxtamedullary
Distal
convoluted nephron
tubule
Loop
Renal of Henle
medulla

(a)

© 2012 Pearson Education, Inc. Figure 15.3a

 Nephron Anatomy

• Glomerulus
• Knot of capillaries
• Capillaries are covered with podocytes from the
renal tubule
• Glomerulus sits within a glomerular (Bowman’s)
capsule (the first part of the renal tubule)
• Inner layer of the capsule contains podocytes
• Podocytes have filtration slits and foot
processes that stick to the glomerulus

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 PCT Glomerular
capsular
space

Glomerular
capillary
covered by
podocytes

Efferent
arteriole

Afferent
arteriole

(c)
© 2012 Pearson Education, Inc. Figure 15.3c
 Filtration slits

Podocyte
cell body

Foot
processes

(d)
© 2012 Pearson Education, Inc. Figure 15.3d
 Nephron Anatomy

• Renal tubule extends from glomerular capsule

and ends at the collecting duct
• Glomerular (Bowman’s) capsule
• Proximal convoluted tubule (PCT)
• Loop of Henle
• Distal convoluted tubule (DCT)

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 Proximal
Peritubular convoluted Glomerular
capillaries tubule (PCT) capillaries

Distal
convoluted
tubule Glomerular
(DCT)
(Bowman’s) capsule

Efferent arteriole
Afferent arteriole
Cells of the
juxtaglomerular
apparatus
Cortical radiate artery
Arcuate artery

Arcuate
vein Cortical radiate
vein

Collecting duct
Loop of Henle
(b)
© 2012 Pearson Education, Inc. Figure 15.3b
 Types of Nephrons

• Cortical nephrons
• Located entirely in the cortex
• Includes most nephrons
• Juxtamedullary nephrons
• Found at the boundary of the cortex and
medulla

© 2012 Pearson Education, Inc.

 Cortical
nephron Fibrous capsule

Renal cortex Collecting

Renal medulla duct
Renal
cortex Proximal
Renal pelvis convoluted
tubule
Glomerulus
Ureter Juxtamedullary
Distal
convoluted nephron
tubule
Loop
Renal of Henle
medulla

(a)

© 2012 Pearson Education, Inc. Figure 15.3a

 Collecting Duct

• Receives urine from many nephrons

• Run through the medullary pyramids
• Deliver urine into the calyces and renal pelvis

© 2012 Pearson Education, Inc.

 Proximal
Peritubular convoluted Glomerular
capillaries tubule (PCT) capillaries

Distal
convoluted
tubule Glomerular
(DCT)
(Bowman’s) capsule

Efferent arteriole
Afferent arteriole
Cells of the
juxtaglomerular
apparatus
Cortical radiate artery
Arcuate artery

Arcuate
vein Cortical radiate
vein

Collecting duct
Loop of Henle
(b)
© 2012 Pearson Education, Inc. Figure 15.3b
 Nephron Anatomy

• Nephrons are associated with two capillary

beds
• Glomerulus
• Peritubular capillary bed

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 Glomerulus

• Fed and drained by arterioles

• Afferent arteriole—arises from a cortical
radiate artery and feeds the glomerulus
• Efferent arteriole—receives blood that has
passed through the glomerulus
• Specialized for filtration
• High pressure forces fluid and solutes out of
blood and into the glomerular capsule

© 2012 Pearson Education, Inc.

 PCT Glomerular
capsular
space

Glomerular
capillary
covered by
podocytes

Efferent
arteriole

Afferent
arteriole

(c)
© 2012 Pearson Education, Inc. Figure 15.3c
 Afferent arteriole
Glomerular
capillaries
Efferent
Cortical arteriole
radiate
artery
Glomerular
1
capsule
Rest of
renal tubule
containing
filtrate
Peritubular
2 capillary

To cortical
radiate vein
Three major
renal processes: Urine
1 Glomerular filtration: Water and solutes smaller than proteins are forced through the
capillary walls and pores of the glomerular capsule into the renal tubule.
2 Tubular reabsorption: Water, glucose, amino acids, and needed ions are transported
out of the filtrate into the tubule cells and then enter the capillary blood.
3 Tubular secretion: H+, K+, creatinine, and drugs are removed from the peritubular
blood and secreted by the tubule cells into the filtrate.
© 2012 Pearson Education, Inc. Figure 15.4
 Peritubular Capillary Beds

• Arise from efferent arteriole of the glomerulus

• Normal, low pressure capillaries
• Adapted for absorption instead of filtration
• Cling close to the renal tubule to reabsorb
(reclaim) some substances from collecting
tubes

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 Proximal
Peritubular convoluted Glomerular
capillaries tubule (PCT) capillaries

Distal
convoluted
tubule Glomerular
(DCT)
(Bowman’s) capsule

Efferent arteriole
Afferent arteriole
Cells of the
juxtaglomerular
apparatus
Cortical radiate artery
Arcuate artery

Arcuate
vein Cortical radiate
vein

Collecting duct
Loop of Henle
(b)
© 2012 Pearson Education, Inc. Figure 15.3b
 Urine Formation

• Glomerular filtration
• Tubular reabsorption
• Tubular secretion

© 2012 Pearson Education, Inc.

 Afferent arteriole
Glomerular
capillaries
Efferent
Cortical arteriole
radiate
artery
Glomerular
1
capsule
Rest of
renal tubule
containing
filtrate
Peritubular
2 capillary

To cortical
radiate vein
Three major
renal processes: Urine
1 Glomerular filtration: Water and solutes smaller than proteins are forced through the
capillary walls and pores of the glomerular capsule into the renal tubule.
2 Tubular reabsorption: Water, glucose, amino acids, and needed ions are transported
out of the filtrate into the tubule cells and then enter the capillary blood.
3 Tubular secretion: H+, K+, creatinine, and drugs are removed from the peritubular
blood and secreted by the tubule cells into the filtrate.
© 2012 Pearson Education, Inc. Figure 15.4
 Glomerular Filtration

• Nonselective passive process

• Water and solutes smaller than proteins are
forced through capillary walls
• Proteins and blood cells are normally too large
to pass through the filtration membrane
• Filtrate is collected in the glomerular capsule
and leaves via the renal tubule

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 Tubular Reabsorption

• The peritubular capillaries reabsorb useful

substances
• Water
• Glucose
• Amino acids
• Ions
• Some reabsorption is passive, most is active
• Most reabsorption occurs in the proximal
convoluted tubule

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 Proximal tubule Distal tubule
Glomerular
HCO3– Glucose and
capsule NaCl NaCl
H2O amino acids

Blood
Some drugs H+ K+ and
and poisons some Collecting
Filtrate duct
drugs
H2O Cortex
Salts (NaCl, etc.) Medulla
HCO3– (bicarbonate)
H+ H2O
Loop of
Urea Henle NaCl
Glucose; amino acids
NaCl
Some drugs
H2O
Reabsorption K+
Active transport
Passive transport Urea
Secretion NaCl H2O
(active transport)

Urine
(to renal pelvis)
© 2012 Pearson Education, Inc. Figure 15.5
 Tubular Reabsorption

• What materials are not reabsorbed?

• Nitrogenous waste products
• Urea—protein breakdown
• Uric acid—nucleic acid breakdown
• Creatinine—associated with creatine
metabolism in muscles

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 Tubular Secretion: Reabsorption in
Reverse
• Some materials move from the blood of the
peritubular capillaries into the renal tubules
• Hydrogen and potassium ions
• Creatinine
• Process is important for getting rid of
substances not already in the filtrate
• Materials left in the renal tubule move toward
the ureter

© 2012 Pearson Education, Inc.

 Proximal tubule Distal tubule
Glomerular
HCO3– Glucose and
capsule NaCl NaCl
H2O amino acids

Blood
Some drugs H+ K+ and
and poisons some Collecting
Filtrate duct
drugs
H2O Cortex
Salts (NaCl, etc.) Medulla
HCO3– (bicarbonate)
H+ H2O
Loop of
Urea Henle NaCl
Glucose; amino acids
NaCl
Some drugs
H2O
Reabsorption K+
Active transport
Passive transport Urea
Secretion NaCl H2O
(active transport)

Urine
(to renal pelvis)
© 2012 Pearson Education, Inc. Figure 15.5
 Characteristics of Urine

• In 24 hours, about 1.0 to 1.8 liters of urine are

produced
• Urine and filtrate are different
• Filtrate contains everything that blood plasma
does (except proteins)
• Urine is what remains after the filtrate has lost
most of its water, nutrients, and necessary ions
through reabsorption
• Urine contains nitrogenous wastes and
substances that are not needed

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 Characteristics of Urine

• Yellow color due to the pigment urochrome

(from the destruction of hemoglobin) and
solutes
• Dilute urine is a pale, straw color
• Sterile
• Slightly aromatic
• Normal pH of around 6
• Specific gravity of 1.001 to 1.035

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 Characteristics of Urine

• Solutes normally found in urine

• Sodium and potassium ions
• Urea, uric acid, creatinine
• Ammonia
• Bicarbonate ions

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 Characteristics of Urine

• Solutes NOT normally found in urine

• Glucose
• Blood proteins
• Red blood cells
• Hemoglobin
• White blood cells (pus)
• Bile

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 Abnormal Urine Constituents
Substance Name of Condition Possible Causes
Glucose Glucosuria Excess sugary intake;
diabetes mellitus

Proteins Proteinuria Physical exertion, pregnancy;

glomerulonephritis,
hypertension
Pus (WBCs and Pyuria Urinary tract infection
bacteria)

RBCs Hematuria Bleeding in the urinary tract

Hemoglobin Hemoglobinuria Various: transfusion
reaction, hemolytic anemia

Bile pigments Bilirubinuria Liver disease (hepatitis)

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 Ureters

• Slender tubes attaching the kidney to the

bladder
• Continuous with the renal pelvis
• Enter the posterior aspect of the bladder
• Runs behind the peritoneum
• Peristalsis aids gravity in urine transport

© 2012 Pearson Education, Inc.

 Hepatic veins (cut)

Inferior vena cava

Adrenal gland Renal artery

Renal hilum
Aorta Renal vein
Kidney
Iliac crest
Ureter

Rectum (cut)
Uterus (part
of female
reproductive Urinary
system) bladder
Urethra

(a)
© 2012 Pearson Education, Inc. Figure 15.1a
 Urinary
bladder

Ureter

Ureteral orifice Internal urethral

Trigone orifice

External urethral
Internal urethral
sphincter
sphincter
Urogenital
diaphragm
Urethra

© 2012 Pearson Education, Inc. Figure 15.6

 Urinary Bladder

• Smooth, collapsible, muscular sac

• Temporarily stores urine
• Trigone—triangular region of the bladder base
• Three openings
• Two from the ureters
• One to the urethra
• In males, the prostate gland surrounds the
neck of the bladder

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 Urinary
bladder

Ureter

Ureteral orifice Internal urethral

Trigone orifice

External urethral
Internal urethral
sphincter
sphincter
Urogenital
diaphragm
Urethra

© 2012 Pearson Education, Inc. Figure 15.6

 Urinary Bladder Wall

• Three layers of smooth muscle collectively

called the detrusor muscle
• Mucosa made of transitional epithelium
• Walls are thick and folded in an empty bladder
• Bladder can expand significantly without
increasing internal pressure

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 Urinary Bladder Capacity

• A moderately full bladder is about 5 inches

long and holds about 500 mL of urine
• Capable of holding twice that amount of urine

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 Umbilicus

Superior wall
of distended bladder

Superior wall
of empty bladder
Pubic
symphysis

© 2012 Pearson Education, Inc. Figure 15.7

 Urethra

• Thin-walled tube that carries urine from the

bladder to the outside of the body by
peristalsis
• Release of urine is controlled by two
sphincters
• Internal urethral sphincter
• Involuntary and made of smooth muscle
• External urethral sphincter
• Voluntary and made of skeletal muscle

© 2012 Pearson Education, Inc.

 Urinary
bladder

Ureter

Ureteral orifice Internal urethral

Trigone orifice

External urethral
Internal urethral
sphincter
sphincter
Urogenital
diaphragm
Urethra

© 2012 Pearson Education, Inc. Figure 15.6

 Urethra Gender Differences

• Length
• Females is 3 to 4 cm (1 inch)
• Males is 20 cm (8 inches)
• Location
• Females—anterior to the vaginal opening
• Males—travels through the prostate and penis
• Prostatic urethra
• Membranous urethra
• Spongy urethra

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 Urethra Gender Differences

• Function
• Females—only carries urine
• Males—carries urine and is a passageway
for sperm cells and semen

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 Micturition (Voiding)

• Both sphincter muscles must open to allow

voiding
• The internal urethral sphincter is relaxed after
stretching of the bladder
• Pelvic splanchnic nerves initiate bladder to go
into reflex contractions
• Urine is forced past the internal urethra sphincter
and the person feels the urge to void
• The external urethral sphincter must be
voluntarily relaxed to void

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 Fluid, Electrolyte, and Acid-Base Balance

• Blood composition depends on three factors

• Diet
• Cellular metabolism
• Urine output

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 Fluid, Electrolyte, and Acid-Base Balance

• Kidneys have four roles in maintaining blood

composition
• Excretion of nitrogen-containing wastes
(previously discussed)
• Maintaining water balance of the blood
• Maintaining electrolyte balance of the blood
• Ensuring proper blood pH

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 Maintaining Water Balance

• Normal amount of water in the human body

• Young adult females = 50 percent
• Young adult males = 60 percent
• Babies = 75 percent
• The elderly = 45 percent
• Water is necessary for many body functions,
and levels must be maintained

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 Distribution of Body Fluid

• Intracellular fluid (ICF)

• Fluid inside cells
• About two-thirds of body fluid
• Extracellular fluid (ECF)
• Fluids outside cells that includes
• Interstitial fluid
• Blood plasma

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© 2012 Pearson Education, Inc. Figure 15.8
 Lungs Gastrointestinal Kidneys
tract

Blood O2 CO2 Nutrients H2O, H2O, Nitrogenous

plasma Ions Ions wastes

Interstitial O2 CO2 Nutrients H2O Ions Nitrogenous

fluid wastes

Intracellular
fluid in tissue cells
© 2012 Pearson Education, Inc. Figure 15.9
 The Link Between Water and Salt

• Solutes in the body include electrolytes like

sodium, potassium, and calcium ions
• Changes in electrolyte balance causes water
to move from one compartment to another
• Alters blood volume and blood pressure
• Can impair the activity of cells

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 Maintaining Water Balance

• Water intake must equal water output

• Sources for water intake
• Ingested foods and fluids
• Water produced from metabolic processes
• Thirst mechanism is the driving force for water
intake

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 Maintaining Water Balance

• Sources for water output

• Vaporization out of the lungs (insensible
since we cannot sense the water leaving)
• Lost in perspiration
• Leaves the body in the feces
• Urine production

© 2012 Pearson Education, Inc.

© 2012 Pearson Education, Inc. Figure 15.10
 Maintaining Water Balance

• Dilute urine is produced if water intake is

excessive
• Less urine (concentrated) is produced if large
amounts of water are lost
• Proper concentrations of various electrolytes
must be present

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 Regulation of Water and
Electrolyte Reabsorption
• Osmoreceptors
• Sensitive cells in the hypothalamus
• React to small changes in solute blood
composition by becoming more active
• When activated, the thirst center in the
hypothalamus is notified
• A dry mouth due to decreased saliva also
promotes the thirst mechanism

© 2012 Pearson Education, Inc.

© 2012 Pearson Education, Inc. Figure 15.11
 Regulation of Water and
Electrolyte Reabsorption
• Regulation occurs primarily by hormones
• Antidiuretic hormone (ADH)
• Prevents excessive water loss in urine
• Causes the kidney’s collecting ducts to
reabsorb more water
• Diabetes insipidus
• Occurs when ADH is not released
• Leads to huge outputs of dilute urine

© 2012 Pearson Education, Inc.

 Regulation of Water and
Electrolyte Reabsorption
• Regulation occurs primarily by hormones
(continued)
• Aldosterone
• Regulates sodium ion content of ECF
• Sodium is the electrolyte most responsible
for osmotic water flows
• Aldosterone promotes reabsorption of
sodium ions
• Remember, water follows salt!

© 2012 Pearson Education, Inc.

 Regulation of Water and
Electrolyte Reabsorption
• Renin-angiotensin mechanism
• Mediated by the juxtaglomerular (JG) apparatus of
the renal tubules
• When cells of the JG apparatus are stimulated by
low blood pressure, the enzyme renin is released
into blood
• Renin produces angiotensin II
• Angiotensin causes vasoconstriction and
aldosterone release
• Result is increase in blood volume and blood
pressure

© 2012 Pearson Education, Inc.

© 2012 Pearson Education, Inc. Figure 15.12
 Maintaining Acid-Base Balance in Blood

• Blood pH must remain between 7.35 and 7.45

to maintain homeostasis
• Alkalosis—pH above 7.45
• Acidosis—pH below 7.35
• Physiological acidosis—pH between 7.35
and 7.0
• Most ions originate as by-products of cellular
metabolism

© 2012 Pearson Education, Inc.

 Maintaining Acid-Base Balance in Blood

• Acids produced by the body

• Phosphoric acid, lactic acid, fatty acids
• Carbon dioxide forms carbonic acid
• Ammonia
• Most acid-base balance is maintained by the
kidneys
• Other acid-base controlling systems
• Blood buffers
• Respiration

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 Blood Buffers

• Acids are proton (H+) donors

• Strong acids dissociate completely and liberate
all of their H+ in water
• Weak acids, such as carbonic acid, dissociate
only partially
• Bases are proton (H+) acceptors
• Strong bases dissociate easily in water and
tie up H+
• Weak bases, such as bicarbonate ion and
ammonia, are slower to accept H+

© 2012 Pearson Education, Inc.

© 2012 Pearson Education, Inc. Figure 15.13
 Blood Buffers

• Molecules react to prevent dramatic changes

in hydrogen ion (H+) concentrations
• Bind to H+ when pH drops
• Release H+ when pH rises
• Three major chemical buffer systems
• Bicarbonate buffer system
• Phosphate buffer system
• Protein buffer system

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 The Bicarbonate Buffer System

• Mixture of carbonic acid (H2CO3) and sodium

bicarbonate (NaHCO3)
• Carbonic acid is a weak acid that does not
dissociate much in neutral or acid solutions
• Bicarbonate ions (HCO3–) react with strong
acids to change them to weak acids
HCl + NaHCO3  H2CO3 + NaCl
strong acid weak base weak acid salt

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 The Bicarbonate Buffer System

• Carbonic acid dissociates in the presence of a

strong base to form a weak base and water
NaOH + H2CO3  NaHCO3 + H2O
strong base weak acid weak base water

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 Respiratory System Controls of
Acid-Base Balance
• Carbon dioxide in the blood is converted to
bicarbonate ion and transported in the plasma
• Increases in hydrogen ion concentration
produces more carbonic acid
• Excess hydrogen ion can be blown off with the
release of carbon dioxide from the lungs
• Respiratory rate can rise and fall depending
on changing blood pH

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 Renal Mechanisms of Acid-Base Balance

• Excrete bicarbonate ions if needed

• Conserve (reabsorb) or generate new
bicarbonate ions if needed

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 Renal Mechanisms of Acid-Base Balance

• When blood pH rises

• Bicarbonate ions are excreted
• Hydrogen ions are retained by kidney
tubules
• When blood pH falls
• Bicarbonate ions are reabsorbed
• Hydrogen ions are secreted
• Urine pH varies from 4.5 to 8.0

© 2012 Pearson Education, Inc.

 Developmental Aspects of the Urinary
System
• Functional kidneys are developed by the third
month of fetal life
• Urinary system of a newborn
• Bladder is small
• Urine cannot be concentrated for first
2 months
• Void 5 to 40 times per day

© 2012 Pearson Education, Inc.

 Developmental Aspects of the Urinary
System
• Control of the voluntary urethral sphincter
does not start until age 18 months
• Complete nighttime control may not occur until
the child is 4 years old
• Urinary infections are the only common
problems before old age
• Escherichia coli (E. coli), a type of bacteria,
accounts for 80 percent of UTI (urinary tract
infections)

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 Aging and the Urinary System

• There is a progressive decline in urinary

function
• The bladder shrinks and loses bladder tone
with aging

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 Aging and the Urinary System

• Associated problems with aging

• Urgency—feeling that it is necessary to void
• Frequency—frequent voiding of small amounts
of urine
• Nocturia—need to get up during the night to
urinate
• Incontinence—loss of control
• Urinary retention—common in males, often the
result of hypertrophy of the prostate gland

© 2012 Pearson Education, Inc.