Holes Human Anatomy and Physiology Eleventh Edition Shier

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Hole’s Human Anatomy and Physiology Eleventh Edition Shier w Butler w Lewis Chapter 20

Hole’s Human Anatomy and Physiology Eleventh Edition Shier w Butler w Lewis Chapter 20 Copyright © The Mc. Graw-Hill Companies, Inc. Permission required for reproduction or display. 1

URINARY SYSTEM Consists of kidneys ureters urinary bladder urethra 2

URINARY SYSTEM Consists of kidneys ureters urinary bladder urethra 2

URINARY SYSTEM 3

URINARY SYSTEM 3

EXSTROPHY OF THE BLADDER 4

EXSTROPHY OF THE BLADDER 4

REPAIRING EXSTROPHY OF THE BLADDER 5

REPAIRING EXSTROPHY OF THE BLADDER 5

KIDNEYS Reddish brown, bean-shaped organ Enclosed in tough, fibrous capsule Approximately 12 cm high

KIDNEYS Reddish brown, bean-shaped organ Enclosed in tough, fibrous capsule Approximately 12 cm high 6 cm wide 3 cm thick Left slightly larger 6

LOCATION OF KIDNEYS positioned retroperitoneally - behind the parietal peritoneum 7

LOCATION OF KIDNEYS positioned retroperitoneally - behind the parietal peritoneum 7

LOCATION OF KIDNEYS Lie on either side of the vertebral column, High on the

LOCATION OF KIDNEYS Lie on either side of the vertebral column, High on the posterior wall of the abdominal cavity, just at the 12 th rib Left slightly higher than right Surrounded by fat 8

KIDNEY STRUCTURE Renal Sinus Concave area Contains Renal Pelvis Is entrance for blood vessels

KIDNEY STRUCTURE Renal Sinus Concave area Contains Renal Pelvis Is entrance for blood vessels and ureter – area is called hilum 9

KIDNEY STRUCTURE 3 Main areas 1. Renal Cortex – outer shell 2. Renal Medulla

KIDNEY STRUCTURE 3 Main areas 1. Renal Cortex – outer shell 2. Renal Medulla – main area of tissue 3. Renal Pelvis -2 types of funnel shaped calyces (major calyx and minor calyx) 10

KIDNEY STRUCTURE Cortex and Medulla contain functional units of kidneys called nephron 11

KIDNEY STRUCTURE Cortex and Medulla contain functional units of kidneys called nephron 11

FUNCTIONS OF THE KIDNEYS Ø removal of metabolic wastes (contain nitrogen and sulfur hence

FUNCTIONS OF THE KIDNEYS Ø removal of metabolic wastes (contain nitrogen and sulfur hence smell of urine) from the blood and excretion to the outside of the body Ø regulation of § red blood cell production (by hormone erythropoietin) § blood pressure (by enzyme renin) § calcium ion absorption (activates Vitamin D) § volume, composition, and p. H of the blood 12

RENAL BLOOD VESSELS Kidneys receive 15 -30% of cardiac output (blood pumped with each

RENAL BLOOD VESSELS Kidneys receive 15 -30% of cardiac output (blood pumped with each heart beat) 13

RENAL BLOOD VESSELS Interlobular vessels go to nephron. Two types: 1. Afferent – incoming

RENAL BLOOD VESSELS Interlobular vessels go to nephron. Two types: 1. Afferent – incoming vessel 2. Efferent – outgoing vessel 14

URINE FORMATION • nephrons remove wastes from the blood and regulate water and electrolyte

URINE FORMATION • nephrons remove wastes from the blood and regulate water and electrolyte concentrations • urine is the final product of the processes of: • glomerular filtration • tubular reabsorption • tubular secretion • https: //www. youtube. com/watch? v=Oky. FPMXa 28 c 15

STRUCTURE OF A NEPHRON Functional kidney About kidney unit of 1 million per Consist

STRUCTURE OF A NEPHRON Functional kidney About kidney unit of 1 million per Consist of 2 parts Renal Corpuscle Renal Tubule 16

NEPHRON POSITION 17

NEPHRON POSITION 17

2 PARTS OF RENAL CORPUSCLE Glomerulus 1. § § cluster of blood capillaries Where

2 PARTS OF RENAL CORPUSCLE Glomerulus 1. § § cluster of blood capillaries Where filtration of blood occurs Bowman’s capsule 2. § § § Glomerular capsule Saclike structure Catches the filtrate from the glomerulus 18

GLOMERULUS 19

GLOMERULUS 19

GLOMERULAR FILTRATION As a result of the smaller Efferent arteriole the blood in the

GLOMERULAR FILTRATION As a result of the smaller Efferent arteriole the blood in the Glomerulus is under great pressure. The pressure forces substances out of the capillaries and into the Bowman Capsule Proteins are too large to pass and are not normally filtered out 20

GLOMERULAR FILTRATE AND URINE COMPOSITION 21

GLOMERULAR FILTRATE AND URINE COMPOSITION 21

GLOMERULAR CAPSULE Collects the filtrate from the glomerulus and directs it into the tubule.

GLOMERULAR CAPSULE Collects the filtrate from the glomerulus and directs it into the tubule. 22

AMOUNTS OF GLOMERULAR FILTRATE AND URINE average amounts over a 24 hour period 180

AMOUNTS OF GLOMERULAR FILTRATE AND URINE average amounts over a 24 hour period 180 L of filtrate produced each 24 hours. Would dehydrate if reabsorption didn’t take place. 23

CONTROL OF FILTRATION RATE • Primarily three Renin-Angiotensin system mechanisms are responsible for keeping

CONTROL OF FILTRATION RATE • Primarily three Renin-Angiotensin system mechanisms are responsible for keeping the GFR constant • Increased sympathetic impulses decrease GFR by causing afferent arterioles to constrict • Renin-angiotensin system • Autoregulation 24

TUBULAR REABSORPTION • transports substances from the glomerular filtrate into the blood within the

TUBULAR REABSORPTION • transports substances from the glomerular filtrate into the blood within the peritubular capillary Most of the fluids and particles filtered out initially will be returned to the blood. This happens in the proximal convoluted tubule and Loop of Henle. 25

SODIUM AND WATER REABSORPTION • osmosis reabsorbs water in response to reabsorbing sodium and

SODIUM AND WATER REABSORPTION • osmosis reabsorbs water in response to reabsorbing sodium and other solutes by active transport in the proximal portion of the renal tubule 26

SODIUM AND WATER FILTRATION, REABSORPTION, AND EXCRETION 27

SODIUM AND WATER FILTRATION, REABSORPTION, AND EXCRETION 27

TUBULAR SECRETION • transports substances from the blood within the peritubular capillary into the

TUBULAR SECRETION • transports substances from the blood within the peritubular capillary into the renal tubule 28

TUBULAR SECRETION In distal convoluted tubules, potassium ions or hydrogen ions may be passively

TUBULAR SECRETION In distal convoluted tubules, potassium ions or hydrogen ions may be passively secreted in response to active reabsorption of sodium ions 29

REGULATION OF URINE CONCENTRATION AND VOLUME • the distal convoluted tubule and collecting duct

REGULATION OF URINE CONCENTRATION AND VOLUME • the distal convoluted tubule and collecting duct are impermeable to water, so water may be excreted as dilute urine • if ADH is present, these segments become permeable, and water is reabsorbed by osmosis into the hypertonic medullary interstitial fluid 30

URINE FORMATION • Glomerular Filtration • substances move from blood to glomerular capsule •

URINE FORMATION • Glomerular Filtration • substances move from blood to glomerular capsule • Tubular Reabsorption • substances move from renal tubules into blood of peritubular capillaries • glucose, water, urea, proteins, creatine • amino, lactic, citric, and uric acids • phosphate, sulfate, calcium, potassium, and sodium ions • Tubular Secretion • substances move from blood of peritubular capillaries into renal tubules • drugs and ions • https: //www. youtube. com/watch? v=o. CQ-5 iw. TQv. M 31

ROLE OF ADH IN REGULATING URINE CONCENTRATION AND VOLUME 32

ROLE OF ADH IN REGULATING URINE CONCENTRATION AND VOLUME 32

FUNCTIONS OF NEPHRON COMPONENTS 33

FUNCTIONS OF NEPHRON COMPONENTS 33

UREA AND URIC ACID EXCRETION Urea • by-product of amino acid catabolism Uric Acid

UREA AND URIC ACID EXCRETION Urea • by-product of amino acid catabolism Uric Acid • product of nucleic acid metabolism • plasma concentration reflects the amount or protein in diet • enters renal tubules through glomerular filtration • most reabsorption occurs by active transport • contributes to the reabsorption of water from the collecting duct • ~10% secreted and excreted 34

URINE COMPOSITION • about 95% water • usually contains urea, uric acid, and creatinine

URINE COMPOSITION • about 95% water • usually contains urea, uric acid, and creatinine • may contain trace amounts of amino acids and varying amounts of electrolytes • volume varies with fluid intake and environmental factors 35

ELIMINATION OF URINE Flow of urine: 1. nephrons 2. collecting ducts 3. renal papillae

ELIMINATION OF URINE Flow of urine: 1. nephrons 2. collecting ducts 3. renal papillae 4. minor and major calyces 5. renal pelvis 6. ureters 7. urinary bladder 8. urethra 9. outside 36

URETERS • 25 cm long • extend downward posterior to the parietal peritoneum •

URETERS • 25 cm long • extend downward posterior to the parietal peritoneum • parallel to vertebral column • in pelvic cavity, join urinary bladder • Peristaltic waves move urine • wall of ureter • mucous coat • muscular coat • fibrous coat 37

URINARY BLADDER • hollow, distensible, muscular organ located within the pelvic cavity, posterior to

URINARY BLADDER • hollow, distensible, muscular organ located within the pelvic cavity, posterior to the symphysis pubis and inferior to the parietal peritoneum 38

URINARY BLADDER • the internal floor of the bladder includes a triangular area called

URINARY BLADDER • the internal floor of the bladder includes a triangular area called the trigone which has an opening at each of three angles 39

URETHRA • tube that conveys urine from the urinary bladder to the outside of

URETHRA • tube that conveys urine from the urinary bladder to the outside of the body 40

MICTURITION • urination reflex • Distension of the bladder walls stimulates the urge to

MICTURITION • urination reflex • Distension of the bladder walls stimulates the urge to urinate. • Urethral sphincters (internal & external) relax to open passageway 41

CROSS SECTION OF URETHRA 42

CROSS SECTION OF URETHRA 42

MICTURITION 43

MICTURITION 43

LIFE-SPAN CHANGES • kidneys appear scarred and grainy • kidney cells die • by

LIFE-SPAN CHANGES • kidneys appear scarred and grainy • kidney cells die • by age 80, kidneys have lost a third of their mass • kidney shrinkage due to loss of glomeruli • proteinuria may develop • renal tubules thicken • harder for kidneys to clear certain substances • bladder, ureters, and urethra lose elasticity • bladder holds less urine 44

KIDNEY STONES 45

KIDNEY STONES 45

CLINICAL APPLICATION Glomerulonephritis • inflammation of glomeruli • may be acute or chronic •

CLINICAL APPLICATION Glomerulonephritis • inflammation of glomeruli • may be acute or chronic • acute glomerulonephritis usually occurs as an immune reaction to a Streptococcus infection • antigen-antibody complexes deposited in glomeruli and cause inflammation • most patients recover from acute glomerulonephritis • chronic glomerulonephritis is a progressive disease and often involves diseases other than that caused by Streptococcus • renal failure may result from chronic glomerulonephritis 46