Miloslav Hronek The parts of the urinary system (excluding the urethra) and some associated structures. (Waugh, Anne . Ross and Wilson Anatomy and Physiology in Health and Illness, 11th Edition. Churchill Livingstone, 062010. p. 330). A longitudinal section of the right kidney. (Waugh, Anne . Ross and Wilson Anatomy and Physiology in Health and Illness, 11th Edition. Churchill Livingstone, 062010. p. 331). A nephron and associated blood vessels. (Waugh, Anne . Ross and Wilson Anatomy and Physiology in Health and Illness, 11th Edition. Churchill Livingstone, 062010. p. 332). 16 % 4 % Elimination of waste products Elimination organs: lungs, skin, GIT, kidneys Prime function of kidneys regulation of composition and volume of blood excretion of wastes and water removing of hydrogenium(regulation of pH) regulation blood pressure by juxtaglomerular apparatus macula densa (monitor salt) juxtaglomerular cells in the wall of the afferent arteriole (secretion renin) metabolism gluconeogenesis (synthesis of new glucose molecules from aminoacids AA glu) synthesis of calcitriol (vitamine D) secretion of erythropoetin Kidney 1. Nephrons control blood concentration and volume (remove water and volume) . removing of toxic wastes dissolved in plasma from blood ultrafiltration 2. Other parts passageways and storage areas renal tubule reabsorption and secretion Nephron performs 3 processes The glomerulus and glomerular capsule. (Waugh, Anne . Ross and Wilson Anatomy and Physiology in Health and Illness, 11th Edition. Churchill Livingstone, 062010. p. 334). Glomerulus GLOMERULUS Filtration function, formation of primary urine Description membrane of glomerulus endothelium(fenestrations - 50 - 100 nm) restricts passage of blood cells basement membrane fibrils in glycoprotein matrix restricts passage of larger proteins podocytes specialized epithelial cells with pedicels spaces filtration slits - restricts passage of medium sized proteins Glomerular filtration separation of large and small particles (to mol. weight 68 000) filtration process cardiac output 5 l/min perfusion of kidney 1200 ml/min - glomerular filtration rate (125 ml/min flow into tubules) regulation of GFR: renal autoregulation by blood pressure (renin) neural regulation sympathetic stimulation (aff. and eff. arterioles constrict) hormonal regulation atrial natriuretic peptide (when increase blood volume - promote excretion of water and sodium) angiotensin (vasoconstrictor, aldosteron - reabsorption of Na+, thirst, ADH, BP) Negative feedback regulation of secretion of atrial natriuretic peptide (ANP). (Waugh, Anne . Ross and Wilson Anatomy and Physiology in Health and Illness, 11th Edition. Churchill Livingstone, 062010. p. 336). Net filtration pressure Constituents of glomerular filtrate and glomerular capillaries (Waugh, Anne . Ross and Wilson Anatomy and Physiology in Health and Illness, 11th Edition. Churchill Livingstone, 062010. p. 334). The juxtaglomerular Apparatus Angiotensin-converting enzyme Renal corpuscle Proximal convoluted tubule Distal convuluted tubule Distal tubule and collecting duct Intercalated cells in late distal tubule and collecting duct Tubular reabsorption (returns nutrients to the body) a)Water reabsorption of 99 % (170 l/day, reabsorption of 168.5 l/day, 1.5 l/day to urine) under control of ADH b)Glucose glycosuria (1800 mg/l in the urine) c)Na + reabsorption 7/8 of NaCl in proximal tubules reabsorption 1/8 of NaCl in the loops of Henle and distal tubules under control of aldosteron d)Urea from Krebs urea cycle (de-amination), excretion 20 g/day e)Uric acid excretion 20 mg/l, 2 g/day f) Creatinine from muscle Other hormones - influence selective reabsorption parathyroid hormone comes from the parathyroid glands regulates the reabsorption of calcium and phosphate from the distal collecting tubules increase of calcium level in the plasma. antidiuretic hormone secreted by the posterior lobe of the pituitary gland increases the permeability of the distal convoluted tubules and collecting tubules, increasing water reabsorption. Negative feedback regulation of secretion of antidiuretic hormone (ADH). (Waugh, Anne . Ross and Wilson Anatomy and Physiology in Health and Illness, 11th Edition. Churchill Livingstone, 062010. p. 335). Negative feedback regulation of aldosterone secretion. ACE = angiotensin-converting enzyme. (Waugh, Anne . Ross and Wilson Anatomy and Physiology in Health and Illness, 11th Edition. Churchill Livingstone, 062010. p. 336). Tubular secretion secretion of K + , H + , NH 4 + excretion of drugs (penicilin, diuretics) Summary of the three processes that form urine. (Waugh, Anne . Ross and Wilson Anatomy and Physiology in Health and Illness, 11th Edition. Churchill Livingstone, 062010. p. 336). Section of the bladder showing the trigone. (Waugh, Anne . Ross and Wilson Anatomy and Physiology in Health and Illness, 11th Edition. Churchill Livingstone, 062010. p. 341). Urine bladder capacity (700 - 800 ml) Micturition (urination) when UB exceeds 200 400 ml stretch receptor transmit sensory impulses to the spinal cord sensory tract to cortex conscious desire to expel urine urination reflex parasympathetic fibers conduct motor impulses to the urinary bladder wall and urethral sphincter nerve impulses from cerebral cortex inhibit to the external urethral sphincter Control of micturition after bladder control is established. (Waugh, Anne . Ross and Wilson Anatomy and Physiology in Health and Illness, 11th Edition. Churchill Livingstone, 062010. p. 342). Evaluation of kidney function Blood urea nitrogen test measure the nitrogen in blood (urea) GFR - blood urea nitrogen Measurement of plasma creatinine creatinine end product of catabolism of creatinine phosphate in skeletal muscle poor renal function creatinine level rises above 15 mg/l Renal plasma clearance (RPC) expresses how effectively the kidneys remove a substance from blood plasma low RPC indicates a low rate of excretion in the urine RPC = U*V/P (ml/min) U (concentration of the substance in urine) V (volume of urine) P (concentration of the substance in plasma, in mg/ml) Creatinine clearance = 140 ml/min Clearance of inuline = 125 ml/min Renal plasma flow substance para-aminohippuric acid clearance of PAH = 600 ml/min Thank you for attention.