Urinary System

Alap Shah (ashah36@uiuc.edu) (pictures are straight from lecture and lab, but they are all very high yield) Overview Purpose Filtration, reabsorption, excretion of metabolic waste from the blood Conserve body fluid and electrolytes, regulate blood pressure Structures involved Kidneys Ureters Bladder Urethra

Kidneys Function Filter blood to produce urine removing toxic byproducts of metabolism, keeping some salts, glucose, proteins Concentrate urine to conserve body fluid levels Produce erythropoietin, renin, prostaglandins, activate vitamin D Structure Each kidney comprised of 1.3 million uriniferous tubules, made of nephron + collecting duct Renal corpuscle blood is filtered to make ultrafiltrate Fenestrated capillaries surrounded by Bowmans capsule Renal corpuscle Proximal convoluted tubule Thick descending limb Thick ascending limb Distal convoluted tubule Collecting duct Filtration Filtered blood - 1.25 L/min Filtrate - 125 mL/min Thin limb

Filtration in first capillary network because of high capillary pressure (can be have changed by constriction or dilation of afferent or efferent arteriole) Reabsorption in second capillary network because of low capillary pressure

Blood supply to kidney

Interlobar artery (vertical) Arcuate artery (horizontal) Interlobular artery (vertical) Afferent glomerular arteriole Glomerular capillary network Efferent glomerular arteriole Cortical nephrons (85% of nephrons) and Juxtamedullary nephrons (15% of nephrons) Cortical nephron short loops of Henle, extend into outer medulla Juxtamedullary nephron long loops of Henle, extend into pyramid, essential for countercurrent mechanism Countercurrent multiplier mechanism Thin descending limb freely permeable to water and salts Thin ascending limb impermeable to water Cl pump used to pull Na ions out of tube into interstitium Vasa recta freely permeable to water and salts

Countercurrent multiplier mechanism

Functions of each section of uriniferous tubule renal corpuscle filtration (creation of ultrafiltrate) proximal tubule - resorption of 67% of water and salt and all protein, amino acids, glucose, and bicarbonate henle's loop remove water, remove salts; from isotonic to hypertonic to hypotonic in juxtamedullary nephrons macula densa - monitor Na level and volume of urine in lumen of distal tubule distal tubule - responds to aldosterone by resorbing Na, Cl collecting tubule - responds to ADH / water leaves lumen, enters interstitium

Podocyte cell surrounding glomerular capillaries foot processes of cell hug capillary wall, creating 25 nm slits that filter fluid from blood negative charge on processes restrict cation movement

Juxtaglomerular apparatus macula densa between distal convoluted tubule and juxtaglomerular cells juxtaglomerular cells modified smooth muscle cells, play role in renin system macula densa senses [Na] in distal convoluted tubule, sends signals to juxtalgomerular cells to release / not release renin renin ACE angiotensinogen angiotensin I angiotensin II Effects of angiotensin II stimulates aldosterone release resorption of NaCl by distal convoluted vasoconstriction raise blood pressure stimulate ADH release resorption of NaCl by collecting duct Tubal epithelia proximal convoluted cuboidal w/ brush border thin Henle limb squamous distal convoluted cuboidal w/ basolateral foldings (no brush border) collecting duct cuboidal w/ good boundaries, (no brush border) Ureter Epithelia transitional epithelium 5 cells thick when relaxed, 3 when distended

made of special thick plaques + interplaque regions empty bladder plaques folded irregularly, at angular contours when stretched contours disappear

Clinical correlation diabetes insipidus - central (ADH) or nephrogenic (ADH receptor or water channel), polyuria, polydypsia - absence of ADH effects on collecting duct proteinuria - loss of the net negative charge on the glomerular basal lamina and/or structural defects in the filtration barrier nephronal bleeding - red blood cell casts or dysmorphic RBCs in the urine decreased glomerular filtration rate - salt retention, edema, volume overload, congestive heart failure, and hypertension Structures to find Kidney capsule outer layer of kidney cortex contains corpuscles medulla no lymphatics, no corpuscles medullary rays - straight portions of thick descending proximal, thick ascending distal, collecting ducts long and short nephrons short extend into outer medulla, long to pyramid uriniferous tubules tube from glomerulus to ureter renal corpsucle found in cortex, contains Bowmans things glomerulus capillary network within Bowmans capsule Bowman's capsule (parietal and visceral layers) Bowmans capsule + glomerulus = corpuscle visceral layer made of podocytes parietal layer layer that opens into proximal convoluted Bowman's space area where ultrafiltrate collects before proximal convoluted endothelial cells visible in glomerular capillaries podocytes cells hugging glomerular capillaries, creating filtration slits mesangial cells (intra- and extraglomerular) contractile cells sandwiched between macula densa and glomerulus also remove trapped residues from glomerular basement membrane also secrete signals vascular pole pole opposite urinary pole macula densa layer of cells between distal convoluted and glomerulus, in communication with mesangial cells urinary pole area where ultrafiltrate enters proximal convoluted proximal tubule direct continuation of Bowmans space, brush border thick limb of Henle thicker epithelium thin limb of Henle sparse squamous epithelium distal tubule cuboidal epithelium, many infoldings collecting duct where urine collects, relatively wider than other structures vasa recta extremely sparse squamous epithelium juxtaglomerular complex macula densa + juxtaglomerular cells (secretory) + mesangial cells

Ureter transitional epithelium 5 cell layers thick when relaxed smooth muscle arranged as inner longitudinal layer, outer circular layer