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The Renal System

Learning Outcomes 1. Identify the component parts of the renal system. 2. Describe the gross anatomy of the kidney and the anatomy of a nephron. 3. Explain the mechanisms that underpin the formation of urine; filtration, selective reabsorption, and secretion. 4. Discuss the physical characteristics and normal constituents of urine in relation to urinalysis 5. Describe the structure and functions of the ureters, bladder and urethra and describe the mechanics and control of micturition. 6. Briefly consider how renal function changes across the lifespan in healthy individuals

HAP Renal, 2012

Anatomy and Physiology of the Renal System


Macroscopic Structure
Kidneys Ureters Urinary Bladder Urethra

Kidneys form urine, the rest of system concerned with eliminating it Complete labeling exercise of urinary system (handouts to be given in class)
HAP Renal, 2012

HAP Renal, 2012

Kidneys
2 kidney bean shaped organs in upper abdomen contain NEPHRONS involved in urine formation Blood supplied by RENAL ARTERY and drained by RENAL VEIN Covered and protected by a fibrous capsule Has 3 distinct regions (REFER TO YOUR BOOK); RENAL CORTEX (glomeruli, Bowmans capsule and convoluted tubules RENAL MEDULLA (loops of Henle and collecting ducts RENAL PELVIS central area where urine collects Divided into 8 lobes
HAP Renal, 2012

http://www.neok12.com/diagram/Urinary-System-01.htm
HAP Renal, 2012

Renal System (contd)


URETERS 2 muscular tubes which transport urine from kidney to bladder, fluid moved via smooth muscle contraction or PERISTALSIS BLADDER a contractable bag in anterior part of pelvic cavity which collects urine. Made up of transitional epithelium and can expand when full holds up to 800mls URETHRA muscular tube which leaves the bladder at lowest point, moves urine from bladder to outside of body, length varies in male and female
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HAP Renal, 2012

Kidney Functions
1) Elimination of waste products 2) Control of fluids, electrolytes and acid-base balance 3) Regulation of renal and systemic BP (reninangiotensin system) 4) Stimulate RBC formation (erythropoiesis) 5) Activation of Vitamin D

HAP Renal, 2012

Microscopic Structure
NEPHRONS are the functional unit of the kidney 2 million nephrons in each kidney and called the RENAL TUBULES Responsible for; Urine production Fluid balance Electrolyte balance Acid base balance (homeostasis of blood pH) The tubule carries out the above by way of 3 distinct processes called filtration, reabsorption and secretion which occur at specific sites along the tubule (nephron)
HAP Renal, 2012

Processes of Urine Formation in Nephron


(1) Filtration or simple filtration Blood in glomerular capillaries is filtered through vessel walls(like a sieve) to form a filtrate consisting of water and small molecules; electrolytes, amino acids, glucose hormones, creatinine, urea, uric acid and drugs (2) Reabsorption Selected substances from the filtrate are reabsorbed back into blood via peritubular capillaries, moves either passively (H2O) or by active transport (Na, Cl and K), and hormones can affect this eg. ADH, aldosterone, renin, & angiotensin ll) (3) Secretion Some substances may not be cleared from blood by filtration so active transport moves these molecules into filtrate at the DCT & collecting ducts, Eg. Uric acid, creatinine, H+, K+, ammonia, penicillin etc.
HAP Renal, 2012

Anatomy and Function of Nephron (1)


Glomerulus a network of capillaires sitting within a cup-like structure or capsule, and involved in process of filtration Glomerular Capsule or Bowmans capsule a double walled epithelium cup that surrounds the glomerulus, its specialised cells (with gaps) help in filtration of blood and formation of filtrate Proximal Convoluted Tubule (PCT) first part of nephron tubule after filtration and site of most reabsorption and some secretion
HAP Renal, 2012

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Bowmanss Capsule or Renal Corpuscle

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Anatomy and Function of Nephron (2)


Loop of Henle ascending and descending limbs of tubule, concerned with reabsorption only Distal Convoluted Tubule (DCT) site of Na+ (sodium) reabsorption and some secretion Collecting Duct several DCTs empy urine into a single collecting duct, lots of collecting ducts then converge and empty into the calyces of the renal pyramids (look at diagram), and on into the renal pelvis and ureters Reabsorption and Secretion occurs here
HAP Renal, 2012

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A Nephron in Action

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Movement of Urine from Collecting Ducts


The urine moves from the collecting ducts to the bladder via the following pathway; 1. 2. 3. 4. 5. 6. 7. Collecting duct Papilla of medulla Minor or lesser _____________ Major or greater __________ Renal _____________ U_____________ Bladder
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Micturition Pathway
Basically: simple reflex (easily noted in infants) Sensory pathways When 250ml urine stretch receptors are stimulated excite sensory parasympathetic fibres Information relayed to the sacral area of the spine for integration Motor pathway AT THE SAME TIME Parasympathetic motor neurones are excited contract the detrusor muscle bladder pressure internal sphincter opens Motor neurons supplying the external sphincter via the pudendal nerve are inhibited so external sphincter opens & urine flows out (gravity helps too!)
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Control of Micturition
We learn to adapt this simple reflex Bladder wall: sensory fibres convey how full the bladder is via the spine higher centres of the brain, the thalamus & cerebral cortex (not established until 2yrs old) An awareness of level of urgency and you can override the micturition reflex by: Inhibiting the parasympathetic motor nerve fibres to the bladder Reinforcing contraction of the external sphincter As urine volume increases stretch receptor & nerve activity sensation of pressure more uncomfortable When convenient, brain centres remove inhibition and permit micturition under conscious control After micturition < 10ml urine remains in bladder and the cycle begins again
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Control of bladder emptying


The neck of the bladder (between bladder & urethra) has 2 muscular sphincters Are contracted due to CNS stimulation but relaxed in micturition Internal sphincters Has involuntary muscle fibres Normally is contracted Involuntary control External sphincter Formed of a circular band of voluntary muscle This muscle is supplied by the pudendal nerve Normally is contracted Under voluntary control

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Renal Function During the Lifespan of Healthy Individuals


1. In your table group, use your books or computers to identify a number of changes which occur in the urinary system of males and females during the normal lifespan

2. Discuss the effect these changes have on renal/urinary function 3. Feedback to the group

URINE COMPOSITION Refer to your urinalysis handout and apply in your DPS session at the end of the week.
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