URINARY SYSTEM

KIDNEYS
SMALL, DARK RED 5 INCHES LONG, 2.5 INCHES WIDE AND 1 INCH THICK DORSAL BODY WALL (RETROPERITONEAL) SUPERIOR LUMBAR, T12 ± L3 RIGHT IS LOWER THAN THE LEFT RENAL HILUS ± MEDIAL INDENTATION - WHERE THE URETER, BLOOD VESSELS AND NERVES EMERGE ADRENAL GLAND ON TOP

ORGANS OF THE URINARY SYSTEM

RELATIONSHIP OF KIDNEYS TO T12

INTERNAL ANATOMY OF THE KIDNEYS

BLOOD SUPPLY
RENAL ARTERY SEGMENTAL ARTERIES ± BEFORE REACHING HILUS LOBAR ARTERIES ± INSIDE THE PELVIS INTERLOBAR ARTERIES ARCUATE ARTERIES ± AT THE CORTEX- MEDULLA JUNCTION CURVING OVER MEDULLARY PYRAMIDS INTERLOBULAR ARTERIES SUPPLY THE CORTICAL TISSUES CORRESPONDING VEINS

NEPHRONS AND URINE FORMATION

NEPHRONS ± STRUCTURAL AND FUNCTIONAL UNIT OF THE KIDNEY - RESPONSIBLE FOR FORMING URINE - OVER A MILLION 2 MAIN STRUCTURES OF A NEPHRON: 1. GLOMERULUS 2. RENAL TUBULE

STRUCTURE OF A NEPHRON

NEPHRON
BOWMAN¶S CAPSULE (GLOMERULAR CAPSULE) PODOCYTES ± INNER LAYER OF CAPSULE FOOT PROCESSES FILTRATION SLITS COLLECTING DUCT PROXIMAL CONVOLUTED TUBULE LOOP OF HENLE DISTAL CONVOLUTED TUBULE

NEPHRONS
CORTICAL NEPHRON JUXTAMEDULLARY NEPHRONS 2 CAPILLARY BEDS TO EACH NEPHRON: 1. GLOMERULUS ± FED AND DRAINED BY ARTERIOLES: AFFERENT ARTERIOLE (FROM
INTERLOBAR ARTERY)

EFFERENT ARTERIOLE - SPECIALIZED FOR FILTRATION - HIGH PRESSURE ( FORCE OUT FLUIDS AND SOLUTES)

NEPHRONS
2. PERITUBULAR CAPILLARIES - ARISES FROM EFFERENT ARTERIOLE THAT DRAINS THE GLOMERULUS - LOW PRESSURE - ADOPTED FOR ABSORPTION - DRAIN INTO INTERLOBULAR VEINS LEAVING THE CORTEX

URINE FORMATION
RESULTS FROM: 1. FILTRATION 2. TUBULAR REABSORPTION 3. TUBULAR SECRETION

FILTRATION
‡ NON- SELECTIVE, PASSIVE PROCESS ‡ PROTEINS AND BLOOD CELLS CANNOT PASS (TOO LARGE) IF FOUND IN THE URINE, THER IS SOMETHING WRONG WITH FILTER ‡ NORMAL BP ± FILTRATE WILL BE FORMED ‡ LOW BP ± FILTRATE FORMATION STOPS ‡ OLIGURIA ± LOW URINARY OUTPUT (100-400 ML/DAY) ‡ ANURIA ± LESS THQAN 100 ML/DAY

TUBULAR REABSORPTION
‡ ‡ ‡ ‡ IN PROXIMAL CONVOLUTED TUBULE ACTIVE TRANSPORT V ERY SELECTIVE USEFUL SUBSTANCES LIKE WATER, GLUCOSE, AMINO ACIDS AND IONS ARE REABSORBED ‡ NITROGENOUS WASTE PRODUCTS ARE NOT REABSORBED

TUBULAR SECRETION
‡ HYDROGEN, POTASSIUM, CREATININE AND DRUGS ARE REMOVED FROM PERITUBULAR BLOOD AND SECRETED BY THE TUBULE CELLS INTO THE FILTRATE ‡ REABSORPTION IN REVERSE

CHARACTERISTICS OF URINE
‡ KIDNEYS FILTER 150- 180 LITERS OF BLOOD PLASMA THROUGH THEIR GLOMERULI PER DAY ‡ PRODUCE 1- 1.8 LITERS OF URINE PER DAY ‡ FILTRATE ± CONTAINS EVERYTHING PRESENT IN BLOOD PLASMA EXCEPT PROTEINS ‡ URINE ± CONTAINS NITROGENOUS WASTES AND UNNEEDED SUBSTANCES

CHARACTERISTICS OF URINE
‡ FRESHLY VOIDED URINE IS CLEAR AND PALE TO DEEP YELLOW ‡ UROCHROME ± PIGMENT THAT RESULTS FROM THE BODY¶S DESTRUCTION OF HEMOGLOBIN GIVING URINE ITS YELLOW COLOR ‡ URINE WHEN FORMED IS STERILE, WITH A SLIGHTLY AROMATIC ODOR ‡ WHENALLOWED TO STAND ± AMMONIA ODOR DUE TO ACTION OF BACTERIA ON URINE SOLUTES ‡ PH ± SLIGHTLY ACIDIC, AROUND 6 ‡ MORE DENSE THAN DISTILLED WATER ‡ SPECIFIC GRAVITY 1.001- 1.035

ABNORMAL URINARY CONSTUTUENTS

GLUCOSE PROTEINS PUS (WBC, BACTERIA) RBC HEMOGLOBIN BILE PIGMENT

URETERS
‡ SLENDER TUBES ‡ 10-12 INCHES LONG ‡ URINE DRAINS BY GRAVITY AND PERISTALTIC MOVEMENT OF URETERS ‡ RENAL CALCULI (KIDNEY STONES)± URIC ACID CRYSTALS FORMING DUE TO EXTREMELY CONCENTRATED URINE

URINARY BLADDER
‡ SMOOTH, COLLAPSIBLE, MUSCULAR SAC THAT TEMPORARILY STORES URINE ‡ POSTERIOR TO SYMPHYSIS PUBIS ‡ 2 URETERAL ORIFICES ‡ 1 URETHRA ‡ TRIGONE ± SMOOTH TRIANGULAR REGION OF THE BLADDER BASE OUTLINED BY THE 3 BLADDER OPENINGS

URINARY BLADDER
‡ PROSTATE GLAND ± IN MALES SURROUND THE NECK OF THE BLADDER ‡ DETRUSOR MUSCLE ± SMOOTH MUSCLE ON THE WALL OF THE BLADDER ‡ MUCOSA ± TRANSITIIONAL EPITHELIUM

URETHRA
‡ THIN- WALLED ‡ INTERNAL URETHRAL SPHINCTER ± INVOLUNTARY ‡ EXTERNAL URETHRAL SPHINCTER ± VOLUNTARY ‡ LENGTH OF URETHRA DEPENDS ON THE SEX: FEMALE ± 1.5 INCHES, OPENING IS ANTERIOR TO VAGINA MALE ± 8 INCHES (PROSTATIC, MEMBRANOUS, SPONGY REGIONS)
MALE URETHRA IS A PASSAGEWAY OF URINE AND SPERM

MICTURITION
‡ VOIDING, ACT OF EMPTYING THE BLADDER ‡ BLADDER CONTINUES TO COLLECT URINE UNTIL ABOUT 200 ML HAVE ACCUMULATED THEN STRETCH RECEPTORS ARE ACTIVATED
± TRANSMITTED TO SPINAL CORD THEN BACK AGAIN TO BLADDER ± BLADDER GOES INTO REFLEX CONTRACTIONS ± STRONGER CONTRACTIONS FORCE THE URINE PAST THE INTERNAL SPHINCTER ± PERSON FEELS THE URGE TO VOID ± PERSON KEEPS EXTERNAL SPHINCTER CLOSED OR HE DECIDES TO VOID

MICTURITIION
‡ IF PERON DECIDES NOT TO VOID, CONTRACTIONS STOP WITHIN A MINUTE ‡ URINE CONTINUES TO ACCUMULATE UNTIL 200-300 MLAND MICTURITION REFLEX OCCURS AGAIN ‡ INCONTINENCE ± WHEN ONE IS UNABLE TO CONTROL THE EXTERNAL SPHINCTER
± NORMAL BELOW 2 Y.O.

± URINARY RETENTION ± BLADDER IS UNABLE TO EXPEL ITS CONTAINED URINE

CATHETERIZATION

REPRODUCTIVE SYSTEM

MALE REPRODUCTIVE SYSTEM

TESTES (MALE GONADS)
- PRIMARY REPRODUCTIVE ORGANS IN MALES - EXOCRINE (SPERM) - ENDOCRINE (TESTOSTERONE) ± INTERSTITIAL CELLS - OLIVE SIZED (1.5 X 1 INCH) TUNICA ALBUGINEA ± CAPSULE SEMINIFEROUS TUBULE ± SPERM-FORMING RETE TESTIS ± EPIDIDYMIS

DUCT SYSTEM
1. EPIDIDYMIS 2. DUCTUS DEFERENS 3. URETHRA

EPIDIDYMIS
‡ ‡ ‡ ‡ HIGHLY COILED, 20 FEET TEMPORARY STORAGE SITE OF IMMATURE SPERM 20 DAYS TO TRAVEL, GAIN MATURITY, SWIM DURING SEXUAL STIMULATION WALLS CONTRACT TO EXPEL SPERM TO DUCTUS DEFERENS

DUCTUS DEFERENS (VAS DEFERENS)

‡ ENCLOSED WITHIN A CONNECTIVE TISSUE (SPERMATIC CORD), TOGETHER WITH BLOOD VESSELS AND NERVES ‡ EMPTIES INTO EJACULATORY DUCT WHICH PASSES THROUGH PROSTATE GLAND TO MERGE WITH URETHRA ‡ PROPELS SPERM BY PERI8STALSIS ‡ VASECTOMY ± SURGICAL CUTTING OF DUCTUS DEFERENS TO PREVENT PASSAGE OF SPERM TO URETHRA

URETHRA
‡ PROSTATIC URETHRA, MEMBRANOUS URETHRA, SPONGY (PENILE) URETHRA

ACCESSORY GLANDS
1. SEMINAL VESICLES ± 60% (THICK, YELLOWISH SECRETION
RICH IN FRUCTOSE, VITAMIN C, PROSTAGLANDINS TO NOURISH SPERM), JOINS THE DUCTUS DEFERENS TO FORM EJACULATORY DUCT

2. 3.

PROSTATE GLAND ±MILKY FLUID THAT PLAYS A ROLE IN

ACTIVATING THE SPERM, PALPATED RECTALLY

BULBOURETHRAL GLANDS (COWPER¶S GLANDS) ±

PRODUCE THICK CLEAR MUCUS DRAINING I8NTO PENILE URETHRA ( FIRST TO BE PASS OUT DURING SEXUAL EXCITATION) FOR CLEANSING AND LUBRICATING

PRODUCE THE BULK OF SEMEN (SPERMCONTAINING FLUID)

SEMEN
‡ ‡ ‡ ‡ ALKALINE (7.2- 7.6) NEUTRALIZE THE ACIDITY OF VAGINA (3.5- 4) 2- 5 ML PER EJACULATION CONTAINS 50- 130 MILLION SPERM IN EACH ML

‡ MALE INFERTILITY
± SEMEN ANALYSIS
‡ SPERM COUNT LOWER THAN 20 MILLION PER ML MAKES IMPREGNATION IMPROBABLE)

EXTERNAL GENITALIA
‡ SCROTUM ± PROVIDE TESTES WITH TEMPERATURE LOWER THAN BODY TEMPERATURE (3 DEGREES LOWER) ‡ PENIS SHAFT GLANS PENIS PREPUCE (FORESKIN) ± REMOVED DURING
CIRCUMCISION ERECTION ± FILLING OF BLOOD OF THE 3 ELONGATED ERECTILE TISSUES SURROUNDING THE URETHRA

SPERMATOGENESIS
‡ SPERM PRODUCTION ‡ BEGINS DURING PUBERTY AND CONTINUES THROUGHOUT LIFE ‡ MILLIONS OF SPERM EVERYDAY ‡ SPERMATOGONIA FOUND AT PERIPHERY OF SEMINIFEROUS TUBULE

SPERMIOGENESIS
‡ EXCESS CYTOPLASM IS SHED ‡ HEAD ‡ MIDPIECE ‡ TAIL

TESTOSTERONE PRODUCTION
‡ PRODUCED BY INTERSTITIAL CELLS ‡ LH (LEUTINIZING HORMONE) RELEASED BY ANTERIOR PITUITARY ACTIVATING THE INTERSTITIAL CELLS ‡ RESPONSIBLE FOR GROWTH SPURT DURING PUBERTY, DEVELOPMENT OF REPRODUCTIVE ORGANS, SEX DRIVE, SECONDARY SEX CHARACTERISTICS ‡ MUSCULINIZING HORMONE