Urinary System

The kidneys, ureters, bladder, and urethra are the primary structures of the urinary system.
They filter blood and remove waste from the body in the form of urine. The size and position of lower
urinary structures vary with male and female anatomy. The body takes nutrients from food and converts
them to energy. After the body has taken the food components that it needs, waste products are left
behind in the bowel and in the blood. The kidney and urinary systems help the body to eliminate liquid
waste called urea, and to keep chemicals, such as potassium and sodium, and water in balance. Urea is
produced when foods containing protein, such as meat, poultry, and certain vegetables, are broken
down in the body. Urea is carried in the bloodstream to the kidneys, where it is removed along with
water and other wastes in the form of urine.

Why is the urinary tract important?

 The urinary tract is important because it filters wastes and extra fluid from the bloodstream and
removes them from the body. Normal, functioning kidneys
 prevent the buildup of wastes and extra fluid in the body
 keep levels of electrolytes, such as potassium and phosphate, stable
 make hormones that help regulate blood pressure
 make red blood cells
 keep bones strong
 The ureters, bladder, and urethra move urine from the kidneys and store it until releasing it
from the body.

Structure of the Urinary System

Two kidneys. This pair of purplish-brown bean-shaped organs is located below the ribs toward the
middle of the back or back of the abdominal wall, behind the peritoneum. The kidneys sit in the back of
the abdomen between the levels of the T12 and L03 vertebrae. The kidneys reabsorb vital substances,
remove unwanted ones, and return the filtered blood back to the body. Blood enters the kidneys
through renal arteries. These arteries branch into tiny capillaries that interact with urinary structures
inside the kidneys (namely the nephrons). The nephrons are located partly in the cortex and partly
inside the renal pyramids, where the nephron tubules make up most of the pyramid mass. Nephrons
perform the primary function of the kidneys: regulating the concentration of water and other
substances in the body. They filter the blood, reabsorb what the body needs, and excrete the rest as
urine. Here the blood is filtered. Waste is removed and vital substances are reabsorbed back into the
bloodstream. The filtered blood leaves through the renal veins. All the blood in the body moves in and
out of the kidneys hundreds of times each day—that’s about 200 quarts of liquid to be filtered every 24
hours. Each kidney consists of an outer renal cortex, an inner renal medulla, and a renal pelvis. Blood is
filtered in the renal cortex. The renal medulla contains the renal pyramids, where urine formation takes
place. Urine passes from the renal pyramids into the renal pelvis. This funnel-shaped structure occupies
the central cavity of each kidney and then narrows as it extends out to join the ureter. Urine drains from
the renal pelvis into the ureter.

Their function is to:

  Produce erythropoietin, which controls red blood cell production in the bone marrow. Filter
blood (supplied by the renal arteries) to remove unwanted substances
 Remove waste products and medicines from the body
 Balance the body's fluids
 Balance a variety of electrolytes
 Release hormones to control blood pressure
 Release a hormone to control red blood cell production
 Help with bone health by controlling calcium and phosphorus

The kidneys remove urea from the blood through tiny filtering units called nephrons. These are tiny
structures in the renal pyramids that filter gallons of blood each day. Each nephron consists of a ball
formed of small blood capillaries (glomerulus) and a small tube called a renal tubule which drains the
urine and joins other tubules carrying the urine out of the kidney to the ureter. Urea, together with
water and other waste substances, forms the urine as it passes through the nephrons and down the
renal tubules of the kidney.

Two ureters. Urine drains from the renal pelvis of each kidney into the ureters. These narrow tubes
carry urine from the kidneys to the bladder. The ureters are long, thin tubes made of smooth muscle.
Muscles in the ureter walls keep tightening and relaxing. This forces urine downward, away from the
kidneys. If urine backs up, or is allowed to stand still, a kidney infection can develop.

Bladder. In women, the bladder is located in front of the vagina and below the uterus. In men, the
bladder sits in front of the rectum and above the prostate gland. The bladder's walls relax and expand to
store urine. The bladder expands like an elastic sac to hold more urine. As it reaches capacity, the
process of micturition, or urination, begins. Involuntary muscle movements send signals to the nervous
system, putting the decision to urinate under conscious control. The bladder is shaped like a pyramid
when empty. It becomes more oval as it fills with urine and expands. A smooth muscle called the
detrusor surrounds the bladder, and folds called rugae line the interior wall. These structures give the
bladder elasticity and allow it to expand. The floor of the bladder includes a funnel-like region called the
trigone (a triangle-shaped region near the junction of the urethra and the bladder), formed by the two
ureteral orifices and the internal urethral sphincter. Urine flows into the bladder via the ureteral
orifices and out through the internal sphincter.The bladder wall is made up of 3 main layers.

 The urothelium is the inner lining of the bladder. It is made up of urothelial cells (also called
transitional cells). The urothelium is also called the transitional epithelium.
 The lamina propria (also called the submucosa) is a thin layer of connective tissue that
surrounds the urothelium. It contains blood vessels, nerves and glands.
 The muscularis propria is the thick, outer muscle layer of the bladder. It is made up of 3 layers
of muscle that work automatically without you thinking about it (called smooth muscle).

Two sphincter muscles. The internal urethral sphincter and the external urethral sphincter both
provide muscle control for the flow of urine. They keep urine from leaking by closing tightly like a rubber
band around the opening of the bladder. The internal sphincter is involuntary. It surrounds the opening
of the bladder to the urethra and relaxes to allow urine to pass. The external sphincter is voluntary. It
surrounds the urethra outside the bladder and must be relaxed for urination to occur.

Nerves in the bladder. The nerves alert a person when it is time to urinate, or empty the bladder.
Urethra. This tube allows urine to pass outside the body. The brain signals the bladder muscles to
tighten. This squeezes urine out of the bladder. At the same time, the brain signals the sphincter
muscles to relax to let urine exit the bladder through the urethra.

Filtration, Reabsorption, Secretion: The Three Steps of Urine Formation

The kidneys filter unwanted substances from the blood and produce urine to excrete them. There are
three main steps of urine formation: glomerular filtration, reabsorption, and secretion. These processes
ensure that only waste and excess water are removed from the body.

1. The Glomerulus Filters Water and Other Substances from the Bloodstream

Each kidney contains over 1 million tiny structures called nephrons. Each nephron has a glomerulus, the
site of blood filtration. The glomerulus is a network of capillaries surrounded by a cuplike structure, the
glomerular capsule (or Bowman’s capsule). As blood flows through the glomerulus, blood pressure
pushes water and solutes from the capillaries into the capsule through a filtration membrane. This
glomerular filtration begins the urine formation process.

2. The Filtration Membrane Keeps Blood Cells and Large Proteins in the Bloodstream

Inside the glomerulus, blood pressure pushes fluid from capillaries into the glomerular capsule through
a specialized layer of cells. This layer, the filtration membrane, allows water and small solutes to pass
but blocks blood cells and large proteins. Those components remain in the bloodstream. The filtrate (the
fluid that has passed through the membrane) flows from the glomerular capsule further into the
nephron.

3. Reabsorption Moves Nutrients and Water Back into the Bloodstream

The glomerulus filters water and small solutes out of the bloodstream. The resulting filtrate contains
waste, but also other substances the body needs: essential ions, glucose, amino acids, and smaller
proteins. When the filtrate exits the glomerulus, it flows into a duct in the nephron called the renal
tubule. As it moves, the needed substances and some water are reabsorbed through the tube wall into
adjacent capillaries. This reabsorption of vital nutrients from the filtrate is the second step in urine
creation.

4. Waste Ions and Hydrogen Ions Secreted from the Blood Complete the Formation of Urine

The filtrate absorbed in the glomerulus flows through the renal tubule, where nutrients and water are
reabsorbed into capillaries. At the same time, waste ions and hydrogen ions pass from the capillaries
into the renal tubule. This process is called secretion. The secreted ions combine with the remaining
filtrate and become urine. The urine flows out of the nephron tubule into a collecting duct. It passes out
of the kidney through the renal pelvis, into the ureter, and down to the bladder.

5. Urine Is 95% Water

The nephrons of the kidneys process blood and create urine through a process of filtration,
reabsorption, and secretion. Urine is about 95% water and 5% waste products. Nitrogenous wastes
excreted in urine include urea, creatinine, ammonia, and uric acid. Ions such as sodium, potassium,
hydrogen, and calcium are also excreted.
 Micturition, or urination, is the act of emptying the bladder. When the bladder is full of urine,
stretch receptors in the bladder wall trigger the micturition reflex. The detrusor muscle that surrounds
the bladder contracts. The internal urethral sphincter relaxes, allowing for urine to pass out of the
bladder into the urethra. Both of these reactions are involuntary. The external urethral sphincter is
voluntary. It must be relaxed for urine to flow through the urethra and outside the body. Smooth muscle
stretch initiates the micturition reflex by activating stretch receptors in the bladder wall. This autonomic
reflex causes the detrusor muscle to contract and the internal urethral sphincter muscle to relax,
allowing urine to flow into the urethra. The stretch receptors also send a message to the thalamus and
the cerebral cortex, giving voluntary control over the external urethral sphincter. We usually gain this
control of urination between the ages of 2 and 3, as our brains develop.

Urinary System Common Diseases and Disorders

1. Kidney Stones – It can form when mineral and acid salts in the urine crystallize and stick
together. If the stone is small, it can pass easily through the urinary system and out of the body.
A larger stone can get stuck in the urinary tract, however. A stuck kidney stone causes pain and
can block the flow of urine.

2. Urinary Incontinence Is the Loss of Bladder Control - Most bladder control issues arise when
the sphincter muscles of the urethra are too weak or too active. If the sphincter muscles are too
weak, a cough or sneeze can cause urination. Sphincter muscles that are too active can trigger a
sudden, strong urge to urinate with little urine in the bladder. These issues are diagnosed as
urinary incontinence (UI).

3. Fluid-filled Cysts Can Develop in the Kidneys - A simple kidney cyst is a rounded pouch or a
closed pocket that is usually filled with fluid. In polycystic kidney disease (PKD), clusters of cysts
form inside the kidneys and take the place of the normal tissue. The affected kidneys become
enlarged and work poorly. PKD is an inherited condition that often leads to kidney failure,
requiring dialysis or kidney transplantation.

4. Chronic Kidney Disease Can Lead to Kidney Failure - In chronic kidney disease (CKD), the
kidneys are damaged and unable to filter blood properly. This damage can lead to a build-up of
waste substances in the body and to other problems, including kidney failure. The most
common causes of CKD include diabetes, heart disease, and high blood pressure.

Facts about urine

 Normal, healthy urine is a pale straw or transparent yellow color.

 Darker yellow or honey colored urine means you need more water.
 A darker, brownish color may indicate a liver problem or severe dehydration.
 Pinkish or red urine may mean blood in the urine.
What's Pee Made Of?

Urine contains:

 water
 urea, a waste product that forms when proteins are broken down
 urochrome, a pigmented blood product that gives urine its yellowish color
 salts
 creatinine, a waste product that forms with the normal breakdown of muscle
 byproducts of bile from the liver
 ammonia

What affects the amount of urine a person produces?

The amount of urine a person produces depends on many factors, such as the amounts of liquid
and food a person consumes and the amount of fluid lost through sweat and breathing. Certain
medications, medical conditions, and types of food can also affect the amount of urine produced.