Because learning changes everything.

Chapter 18
Urinary System and Fluid
Balance
Lecture Outline

Seeley’s ESSENTIALS OF
ANATOMY & PHYSIOLOGY
Eleventh Edition
Cinnamon VanPutte
Jennifer Regan
Andrew Russo

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Urinary System 1

• The urinary system is the major excretory system of the

body.

• Some organs in other systems also eliminate wastes, but

they are not able to compensate in the case of kidney
failure.

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Urinary System 2

Figure 18.1
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Urinary System Functions

1. Excretion

2. Regulation of blood volume and pressure

3. Regulation of blood solute concentration

4. Regulation of extracellular fluid pH

5. Regulation of red blood cell synthesis

6. Regulation of Vitamin D synthesis

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Components of the Urinary System

• Two kidneys

• Two ureters

• One urinary bladder

• One urethra

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Urinary System

Figure 18.2a
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Kidney Characteristics

Bilateral retroperitoneal organs

Shape and size:

• bean shaped

• weigh 5 ounces (bar of soap or size of fist)

Location:

• between 12th thoracic and 3rd lumbar vertebra

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Kidney Structures 1

Renal capsule:

• connective tissue around each kidney

• protects and acts as a barrier

Hilum:

• indentation

• contains renal artery, veins, nerves, ureter

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Kidney Structures 2

Renal sinus:

• contains renal pelvis, blood vessels, fat

Renal cortex:

• outer portion

Renal medulla:

• inner portion

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Kidney Structures 3

Renal pyramid:

• Cone shaped structures in the medulla whose bases

project into the cortex

Renal papillae:

• tip of pyramids which drain into calyces

Renal pelvis:

• where calyces join together

• narrows to form ureter

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Longitudinal Section of the Kidney

(b) Rebecca Gray/McGraw-Hill Education

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Figure 18.3
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Nephron

• The nephron is the functional unit of the kidney.

• Each kidney has over one million nephrons.

• Approximately 15% are juxtamedullary

• The nephron includes the renal corpuscle, proximal

convoluted tubule, loop of Henle, distal convoluted tubule
and collecting duct

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The Nephron

Figure 18.5
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Types of Nephrons 1

1. Juxtamedullary nephrons

• renal corpuscles are deep in the cortex near the medulla

• long loops of Henle extend deep into the medulla

• Well adapted for water conservation.

• About 15% of nephrons

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Types of Nephrons 2

2. Cortical nephrons

• Renal corpuscles distributed throughout the cortex

• Loops of Henle are shorter and closer to the outer edge of

the cortex than juxtamedullary nephrons

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Renal Corpuscle 1

The filtration portion of the nephron

Glomerulus:

• A network of capillaries twisted around each other like a

ball of yarn

Bowman’s capsule:

• enlarged end of nephron surrounds glomerulus

• opens into proximal convoluted tubule

• contains podocytes (specialized cells around glomerular

capillaries)
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Renal Corpuscle 2

• Bowman capsule consists of two layers:

• Outer layer - simple squamous epithelial cells that

become cube-shaped at the beginning of the proximal
convoluted tubule

• Inner layer - cells called podocytes, which wrap around

the glomerular capillaries

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Characteristics of Renal Corpuscle 1

• Porous capillaries - highly permeable due to the

presence of pores. Neither large proteins nor blood cells
can fit through them.

• Porous inner layer of Bowman capsule - A basement

membrane lies between the endothelial cells of the
glomerular capillaries and the podocytes of the Bowman
capsule.

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Characteristics of Renal Corpuscle 2

• High pressure

• An afferent arteriole supplies blood to the glomerulus for

filtration.

• An efferent arteriole transports the filtered blood away

from the glomerulus.

• Efferent arteriole has smaller diameter than afferent

arteriole creating a high pressure in the capillaries.

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Filtration Membrane

• The structures in the corpuscle make up the filtration

membrane.

• Consists of capillary endothelium, the basement

membrane, and the podocytes of the Bowman capsule

• Filtrate is the fluid filtered from the glomerular capillaries.

Enters the lumen inside the Bowman capsule.

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Juxtaglomerular Apparatus 1

• Juxtaglomerular apparatus – specialized cells of the

afferent arteriole and distal convoluted tubule in close
contact with each other.

• Juxtaglomerular cells – specialized smooth muscle cells

located where the afferent arteriole enters the renal
corpuscle

• Macula densa - part of the distal convoluted tubule that

lies between the afferent and efferent arterioles next to the
renal corpuscle.

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Juxtaglomerular Apparatus 2

• The juxtaglomerular apparatus is an important regulatory

structure.

• Secretion of the enzyme renin by the juxtaglomerular

apparatus plays an important role in the regulation of
filtrate formation and blood pressure.

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Renal Corpuscle and Filtration Membrane

Figure 18.6
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Nephron Components 1

Proximal convoluted tubule:

• where filtrate passes first

• drains filtrate from Bowman capsule

Loop of Henle:

• contains descending and ascending loops

• water and solutes pass through thin walls by diffusion

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Nephron Components 2

Distal convoluted tubule:

• structure between Loop of Henle and collecting duct

Collecting duct:

• empties into calyces

• carry fluid from cortex through medulla

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Flow of Filtrate through Nephron

1. Renal corpuscle

2. Proximal convoluted tubule

3. Descending loop of Henle

4. Ascending loop of Henle

5. Distal convoluted tubule

6. Collecting duct

7. Papillary duct

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 Blood Flow through Kidney

1. Renal artery
2. Interlobar artery
3. Arcuate artery
4. Interlobular artery
5. Afferent arteriole
6. Glomerulus
7. Efferent arteriole
8. Peritubular capillaries
9. Vasa recta
10. Interlobular vein
11. Arcuate vein
12. Interlobar vein
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Blood Flow Through the Kidney

Figure 18.7
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Urine Formation 1

Urine formation involves three processes:

• Filtration – occurs in the renal corpuscle, blood plasma

leave glomerulus and enters Bowman space

• Tubular Reabsorption – involves removing substances

from the filtrate and placing them back into the blood

• Secretion – involves taking substances from the blood at

a nephron area other than the renal corpuscle and putting
back into the nephron tubule

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Urine Formation 2

Figure 18.8
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Urine Formation-Filtration 1

• Movement of water, ions, small molecules through filtration

membrane into Bowman’s capsule

• 19% of plasma becomes filtrate

• 180 Liters of filtrate are produced by the nephrons each

day

• 1% of filtrate (1.8 liters) become urine, the rest is

reabsorbed

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Urine Formation-Filtration 2

• Only small molecules are able to pass through filtration

membrane

• Formation of filtrate depends on filtration pressure

• Filtration pressure forces fluid across filtration membrane

• Filtration pressure is influenced by blood and interstitial

fluid pressures, and osmotic pressures of plasma and
interstitial fluid.

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Filtration Pressure

Figure 18.9
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Urine Production-Reabsorption

• 99% of filtrate is reabsorbed and reenters circulation

• The proximal convoluted tubule is the primary site for

reabsorption of solutes and water

• The descending Loop of Henle concentrates filtrate

• Reabsorption of water and solutes from distal convoluted

tubule and collecting duct is controlled by hormones

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Reabsorption in the Proximal Convoluted Tubule

Figure 18.10
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Reabsorption in the Loop of Henle

Figure 18.11
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Reabsorption in the Thick Segment of the Ascending
Limb

Figure 18.12
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Urine Production—Secretion 1

• Tubular secretion removes some substances from the

blood.

• These substances include by-products of metabolism that

become toxic in high concentrations and drugs or other
molecules not normally produced by the body.

• Tubular secretion occurs through either active or passive

mechanisms.

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Urine Production—Secretion 2

• Ammonia secretion is passive.

• Secretion of H+, K+, creatinine, histamine, and penicillin is

by active transport.

• These substances are actively transported into the

nephron.

• The secretion of H+ plays an important role in regulating

the body fluid pH.

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Urine Concentration Mechanism 1

• The kidneys regulate blood composition and are able to

produce very dilute or very concentrated urine to maintain
the extracellular fluid concentration close to 300 mOsm/L.

• The ability to control the volume and concentration of the

urine depends on: (1) countercurrent mechanisms, (2) a
medullary concentration gradient, and (3) hormonal
mechanisms.

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Urine Concentration Mechanism 2

• Countercurrent mechanism - fluids in separate

structures flow in opposite directions relative to each other.
As they pass by each other, materials can be exchanged
between them.

• The countercurrent mechanism creates a very high solute

concentration in the medulla compared to the cortex.
Called the medullary concentration gradient.

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Urine Concentration Mechanism 3

• The medullary concentration gradient develops from (1)

the actions of the countercurrent mechanisms and (2) the
recycling of urea.

• The concentration of solutes in the medulla increases from

300 mOsm/L to 1200 mOsm/L deep in the medulla at the
tip of the renal pyramid.

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Urine Concentration Mechanism 4

• The descending limb of the loop of Henle is a critical site

for water reabsorption.

• The filtrate leaving the proximal convoluted tubule is

further concentrated as it passes through the descending
limb of the loop of Henle.

• The mechanism for this water reabsorption is osmosis.

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Urine Concentration Mechanism 5

• The wall of the thin segment of the descending limb is

highly permeable to water.

• As the filtrate moves through the medulla containing the

highly concentrated interstitial fluid, water is reabsorbed
out of the nephron by osmosis.

• The water enters the vasa recta which removes excess

water and solutes from the medulla without changing the
high concentration of solutes in the medullary interstitial
fluid.

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Urine Concentration Mechanism 6

• The ascending limb of the loop of Henle dilutes the filtrate

by removing solutes

• The thin segment of the ascending limb is not permeable

to water, but it is permeable to solutes so solutes diffuse
out of the nephron.

• The permeability of the distal convoluted tubule and

collecting duct vary depending upon hormonal control.
Concentrated urine is produced when the permeability
increases and water leaves filtrate by osmosis.

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Urine-Concentrating Mechanism

Figure 18.13
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Regulation of Urine Concentration and Volume

Three major hormonal mechanisms are involved in regulating

urine concentration and volume:

1. renin-angiotensin-aldosterone

2. the antidiuretic hormone (ADH)

3. the atrial natriuretic hormone

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Renin-Angiotensin-Aldosterone Mechanism 1

1. The juxtaglomerular apparatus of the kidneys release the

enzyme renin when blood pressure is low

2. Renin enters the blood and converts angiotensinogen to

produce angiotensin I

3. Angiotensin-converting enzyme converts angiotensin I to

angiotensin II

4. Angiotensin II causes vasoconstriction and raises blood

pressure

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Renin-Angiotensin-Aldosterone Mechanism 2

4. Angiotensin II also acts on adrenal cortex to release

aldosterone

5. Aldosterone increases rate of active transport of Na+ in

distal convoluted tubules and collecting duct

6. Volume of water in urine decreases and blood pressure

increases

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Aldosterone Actions

Figure 18.14
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Antidiuretic Hormone Mechanism

1. ADH is secreted by the posterior pituitary gland when the

solute concentration of the blood or interstitial fluid
increases

2. ADH acts of kidneys, causing them to absorb more water

(decrease urine volume)

3. Result is to maintain a normal blood volume and blood

pressure

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ADH and the Regulation of Extracellular Fluid

Figure 18.15a
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Atrial Natriuretic Hormone 1

1. ANH is secreted from cardiac muscle in the right atrium of

the heart when blood pressure increases

2. ANH acts on kidneys to decrease Na+ reabsorption

3. Sodium ions remain in nephron and enter urine

4. Increased loss of sodium and water reduce blood volume

and blood pressure

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Atrial Natriuretic Hormone 2

Figure 18.16
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Homeostatic Control of Blood and Urine Volumes

Figure 18.17
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Ureters and Urinary Bladder 1

Ureters:

• small tubes that carry urine from renal pelvis of kidney to

bladder

Urinary bladder:

• in pelvic cavity

• stores urine

• can hold a few ml to a maximum of 1000 milliliters

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Ureters and Urinary Bladder 2

©Victor Eroschenko

Figure 18.18
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Urethra 1

Urethra:

• tube that exits bladder

• carries urine from urinary bladder to outside of body

Internal urethral sphincter

• smooth muscle surrounds urethra at the junction of the

urinary bladder and prevents urine from leaving the
bladder

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Urethra 2

External urethral sphincter:

• formed of skeletal muscle surrounding the urethra near the

pelvic floor.

• allows a person to voluntarily start or stop the flow of urine

out of the urethra

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Urine Movement

Micturition reflex:

• activated by stretch of urinary bladder wall

• action potentials are conducted from bladder to spinal cord

through pelvic nerves

• parasympathetic action potentials cause bladder to

contract

• stretching of bladder stimulates sensory neurons to inform

brain person needs to urinate

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Micturition Reflex

Figure 18.19
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Body Fluid Compartments

• The intracellular fluid compartment includes the fluid

(cytosol) inside all the cells of the body.

• Approximately two-thirds of all the water in the body is in

the intracellular fluid compartment.

• The extracellular fluid compartment includes all the fluid

outside the cells.

• The extracellular fluid compartment includes, interstitial

fluid, plasma, lymph, and other special fluids, such as joint
fluid, and cerebrospinal fluid.

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Composition of Fluids

• Intracellular fluid contains a relatively high concentration of

ions, such as K+, magnesium (Mg2+), phosphate (PO43−),
and sulfate (SO42−), compared to the extracellular fluid.

• It has a lower concentration of Na+, Ca2+, Cl−, and HCO3−

than does the extracellular fluid.

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Exchange Between Fluid Compartments

• The cell membranes that separate the body fluid

compartments are selectively permeable.

• Water continually passes through them, but ions dissolved

in the water do not.

• Water movement is regulated mainly by hydrostatic

pressure differences and osmotic differences between the
compartments.

• Osmosis controls the movement of water between the

intracellular and extracellular spaces.

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Regulation of Extracellular Fluid Composition

• Thirst Regulation

• Ion Concentration Regulation

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Thirst Regulation

• Water intake is controlled by the thirst center located in

the hypothalamus

• When the concentration of ions in the blood increases, it

stimulates the thirst center to cause thirst

• When water is consumed, the concentrations of blood ions

decreases, due to a dilution effect; this causes the
sensation of thirst to decrease

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Thirst Regulation of Extracellular Fluid Concentration

Figure 18.21
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Ion Concentration Regulation 1

• Regulating the concentrations of positively charged ions,

such as Na+, K+, and Ca2+, in the body fluids is particularly
important.

• Action potentials, muscle contraction, and normal cell

membrane permeability depend on the maintenance of a
narrow range of these concentrations.

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Ion Concentration Regulation 2

• Negatively charged ions, such as Cl−, are secondarily

regulated by the mechanisms that control the positively
charged ions.

• The negatively charged ions are attracted to the positively

charged ions; when the positively charged ions are
transported, the negatively charged ions move with them.

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Sodium Ions

• Sodium ions (Na+) are the dominant ions in the

extracellular fluid.

• About 90 to 95% of the osmotic pressure of the

extracellular fluid results from sodium ions and from the
negative ions associated with them.

• Stimuli that control aldosterone secretion influence the

reabsorption of Na+ from nephrons of the kidneys and the
total amount of Na+ in the body fluids.

• Sodium ions are also excreted in sweat.

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Potassium Ions

• Electrically excitable tissues, such as muscles and nerves,

are highly sensitive to slight changes in the extracellular K+
concentration.

• The extracellular concentration of K+ must be maintained

within a narrow range for these tissues to function
normally.

• Aldosterone plays a major role in regulating the

concentration of K+ in the extracellular fluid.

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Calcium Ions

• The extracellular concentration of Ca2+ is maintained

within a narrow range.

• Increases and decreases in the extracellular concentration

of Ca2+ have dramatic effects on the electrical properties of
excitable tissues

• Parathyroid hormone (PTH), secreted by the parathyroid

glands, increases extracellular Ca2+ concentrations.

• Calcitonin reduces the blood Ca2+ concentration when it

is too high.

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Phosphate and Sulfate Ions

• Some ions, such as phosphate ions (PO43−) and sulfate

ions (SO42−), are reabsorbed by active transport in the
kidneys.

• The rate of reabsorption is slow, so that if the

concentration of these ions in the filtrate exceeds the
nephron’s ability to reabsorb them, the excess is excreted
into the urine.

• As long as the concentration of these ions is low, nearly all

of them are reabsorbed by active transport.

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Regulation of Acid-Base Balance 1

Buffers

• Chemicals that resist change in the pH of a solution

• buffers in body contain salts of weak acids or bases that

combine with H+

• three classes of buffers: proteins, phosphate buffer,

bicarbonate buffer

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Regulation of Acid-Base Balance 2

Respiratory system involvement in acid-base regulation:

• responds rapidly to changes in pH

• increased respiratory rate raises blood pH (more alkali)

due to increased rate of carbon dioxide elimination from
the body

• reduced respiratory rate reduces pH (more acidic) due to

decreased rate of carbon dioxide elimination from the body

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Regulation of Acid-Base Balance 3

Kidney Involvement in acid-base:

• nephrons secrete H+ into urine and directly regulate pH of

body fluids

• more H+ secretion if the pH is decreasing and less H+

secretion if pH is increasing

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Regulation of Acid-Base Balance 4

Figure 18.22
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Acidosis and Alkalosis 1

• Acidosis occurs when the pH of blood falls below 7.35

• Respiratory Acidosis - respiratory system is unable to

eliminate adequate amounts of CO2 from the blood.

• Metabolic acidosis - excess production of acidic

substances (lactic acid and ketone bodies) due to
increased metabolism or decreased ability of the kidneys
to eliminate H+ in the urine.

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Acidosis and Alkalosis 2

• Alkalosis occurs when the pH of blood increases above

7.45

• Respiratory alkalosis results from hyperventilation

resulting in low CO2 concentration in blood.

• Metabolic alkalosis results from the rapid elimination of

H+ from the body resulting from severe vomiting or when
excess aldosterone is secreted by the adrenal cortex.

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Urinary System - Text Alternative
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The illustration A shows anterior view of abdominal cavity that shows

liver, spleen, adrenal glands, renal artery, renal vein, left kidney, right
kidney, inferior vena cava, abdominal aorta, ureter, urinary bladder, and
urethra.

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Longitudinal Section of the Kidney - Text Alternative
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The illustration shows hilum (indentation) into which renal artery and renal
vein branch out as arteries and veins in the renal sinus. The kidney has
an outer renal capsule followed by cortex and medulla. The kidney ag
renal columns, renal sinus (space), renal papilla, renal pyramid, renal
pelvis, calyx, and ureter. The photo B shows renal capsule, cortex,
medulla, renal pyramid, renal papilla, renal column, hilum (indentation),
renal sinus (space), renal artery, renal vein, renal pelvis, calyx, and
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The Nephron - Text Alternative
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The nephron is made of renal corpuscle and renal tubule. The cortex of
the kidney has blood supply to the renal corpuscle that has bowman
capsule and glomerulus. The renal corpuscle is connected to proximal
convoluted tubule followed by loop of Henle (thin segment of descending
limb and thick segment of ascending limb), and distal convoluted tubule
that joins the collecting duct. The loop of Henle and collecting duct are
located in the renal pyramid of the medulla. The collecting duct has
papillary duct that drains into a calyx. Cortical nephrons have loops of
Henle that do not extend deep into the medulla. Juxtamedullary nephrons
have loops of Henle that extend deep into the medulla.

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Renal Corpuscle and Filtration Membrane –
Text Alternative
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The illustration A shows that the renal corpuscle consists of the Bowman capsule
and the glomerulus. The Bowman capsule is the enlarged end of a nephron,
which is indented to form a double-walled chamber. The Bowman capsule
surrounds the glomerulus, which is a network of capillaries. Blood flows from the
afferent arteriole into the glomerulus and leaves the glomerulus through the e
fferent arteriole. The illustration B shows an enlarged view of renal corpuscle. The
visceral layer of the Bowman capsule covers the glomerular capillaries. Fluid from
the blood enters the Bowman capsule by passing through the capillary walls and
the visceral layer of the Bowman capsule. From there, fluid passes into the
proximal convoluted tubule of the nephron. The juxtaglomerular apparatus
consists of cells from the wall of the afferent arteriole and the distal convoluted
tubule. The illustration C shows a glomerulus. The glomerulus is composed of
porous capillaries. The visceral layer of the Bowman capsule consists of
specialized cells called podocytes. The illustration D shows filtration membrane.
The filtration membrane consists of the porous glomerular capillary endothelium,
a basement membrane, and the podocyte cell processes. Fluid passes from the
capillary through the filtration membrane into the Bowman capsule.
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Blood Flow Through the Kidney – Text Alternative
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The illustration A and B shows a section of the kidney in which blood

through renal artery enters the interlobar artery followed by arcuate
artery, interlobular artery, afferent arteriole, glomerulus inside Bowman
capsule, efferent arteriole, Peritubular capillaries (blood flows to the vasa
recta or directly to the interlobular veins), and vasa recta. From vasa
recta blood enters the interlobular vein followed by arcuate vein,
interlobar vein, and then finally into the renal vein. The illustration C
shows that blood enters the renal artery followed by interlobar arteries,
arcuate arteries, interlobular artery, afferent arteriole, glomerulus, efferent
arteriole, and Peritubular capillaries.

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Filtration Pressure – Text Alternative
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The illustration shows a glomerulus in which glomerular capillary pressure

is 50 millimeters of mercury, capsular pressure is 10 millimeters of
mercury, and colloid osmotic pressure is 30 millimeters of mercury. The
net filtration pressure is 10 millimeters of mercury. 50 minus (30 plus 40)
equals 50 minus 40 equals 10 millimeters of mercury. Net filtration
pressure equals 10 millimeters of mercury.

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Reabsorption in the Proximal Convoluted Tubule –
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The illustration shows peritubular capillary followed by interstitial fluid

followed by proximal convoluted tubule. When blood flows into peritubular
capillary reabsorption of solutes by active transport, reabsorption of 65
percent of volume of nitrate by cotransport, and osmosis of water from
peritubular capillary occurs.

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Reabsorption in the Loop of Henle – Text Alternative
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The illustration shows reabsorption of water in thin loop segment of

ascending limb. Blood flow out of ascending vasa recta and filtrate flow in
descending limb of loop of Henle. Water moves by osmosis into the
interstitial fluid and then into the vasa recta and solutes diffuse into
descending limb of loop of Henle. Another illustration shows reabsorption
of solutes but not water in descending limb. Filtrates flow out of thin
segment of ascending limn, loop of Henle. Solutes diffuse into the
descending vasa recta through interstitial fluid. The ascending limb is not
permeable to water. Water does not move into the interstitial fluid.

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Reabsorption in the Thick Segment of the Ascending
Limb – Text Alternative
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The illustration shows filtrate flow out of thick segment of the ascending
limb, loop of Henle with no osmosis of water. Active transport of sodium
ion cotransport of potassium ion (active transport) and chloride ion
(cotransport) and blood flows into the descending vasa recta.

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Urine-Concentrating Mechanism – Text Alternative
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The illustration shows a corpuscle followed by proximal convoluted tubule

(water and nutrients leech out), descending limb of loop of Henle (water
exits), and ascending limb of loop of Henle (sodium ion, chloride ion, and
potassium ion). The illustration shows an enlarged view of the proximal
convoluted tubule in which sodium ion exits the cell while potassium
enters the cell while an ATP is converted to ADP. Through another
channel potassium and chlorine ions exit the cell. There are also separate
pumps for potassium, glucose, amino acids to exit the cell. From the inner
membrane has sodium ion pumps each with pumps for chloride ion,
glucose, ion, and amino acids. The illustration shows thick ascending
loop into which water enters along with potassium ion, sodium ion, and 2
chloride ion. From the outer membrane potassium comes into the cell
while sodium exits the cell while an ATP is converted to ADP. There are
separate pumps for chloride ion and potassium ion to exit the cell.

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Aldosterone Actions – Text Alternative
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The illustration shows that when blood pressure decreases kidney

increases section of renin that leads to conversion of angiotensinogen to
angiotensin 1 which is converted to angiotensin 2 that leads to increased
aldosterone secretion in the adrenal cortex. Aldosterone secretion leads
to increased sodium ion and water reabsorption that results in increased
blood pressure.

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ADH and the Regulation of Extracellular Fluid –
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The illustration A shows increased blood solute concentration or large

decrease in BP leads to increased ADH release. In kidney, increased
water reabsorption results in decreased solute concentration and
increased BP.

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Homeostatic Control of Blood and Urine Volumes –
Text Alternative
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The illustration shows that when high blood volume induced elevated blood pressure, homeostasis is disturbed.
Pituitary: Baroreceptors inhibit posterior pituitary ADH secretion when blood volume increases. Kidney:
Juxtaglomerular apparatus inhibit renin release when blood volume increases, which decreases aldosterone
secretion. Heart: Atrial cardiac muscle cells secrete ANH when blood volume increases. Blood vessels:
Sympathetic division baroreceptors detect increased blood volume, which causes vasodilation of renal arteries.
Decreased ADH decreases water reabsorption by the distal convoluted tubules and collecting ducts. Less water
returns to the blood and more water is lost in the urine, which decreases blood volume. Decreased aldosterone
and increased ANH decrease sodium ion reabsorption from the distal convoluted tubule and collecting duct. More
sodium ion and water are lost in the urine, which decreases blood volume. Increased renal blood flow increases
the rate of filtrate formation, and more water is lost in the urine. Reduced blood volume due to loss of water and
sodium ion in the urine lowers blood pressure and homeostasis restored. When low blood volume induced
lowered blood pressure, homeostasis is disturbed. Blood vessels: Sympathetic division baroreceptors detect
decreased blood volume, which causes vasoconstriction of renal arteries. Heart: Atrial cardiac muscle cells do not
secrete ANH when blood volume decreases. Kidney: Juxtaglomerular apparatus stimulate renin release when
blood volume decreases, which increases aldosterone secretion. Pituitary: Baroreceptors stimulate posterior
pituitary ADH secretion when blood volume decreases. Decreased renal blood flow decreases filtrate formation,
and less water is lost in urine, which increases blood volume. Increased aldosterone and decreased ANH
increase sodium ion reabsorption in the distal convoluted tubule and the collecting duct. Less sodium ion and
water are lost in the urine, which increases blood volume. Increased ADH increases the permeability of the distal
convoluted tubule and the collecting duct to water. Increased ADH also increases the sensation of thirst. Less
water is lost in the urine. Increased blood volume due to decreased sodium ion and water loss in the urine raises
blood pressure and homeostasis is restored.

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Ureters and Urinary Bladder 2 – Text Alternative
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The illustration A shows kidney with ureter connected to urinary bladder

that has an outer parietal peritoneum. The bladder has opening of ureter
trigone, opening of urethra, and location of external urethral sphincter.
The illustration B shows a cross section of ureter that has connective
tissue (lamina propria), smooth muscle layer, and connective tissue
(adventitia). An enlarged view of connective tissue shows transitional
epithelium. The illustration C shows an enlarged view of urinary bladder
wall that has transitional epithelium, connective tissues, smooth muscle
layer, and connective tissue.

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Micturition Reflex – Text Alternative
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The illustration shows stretch of bladder wall leads to action potential

conduction to spinal cord which then follows the ascending pathways and
descending pathways. In the sacral region of spinal cord somatic motor
nerves are connected to the external urethral sphincter and decreased
action potential relaxes external urinary sphincter.

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Regulation of Acid-Base Balance 4 – Text Alternative
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The illustration shows that when blood pH increases, proton decreases, and homeostasis is disturbed.
Kidney: The distal convoluted tubules decrease proton secretion into the urine and decrease bicarbonate
ion reabsorption into the blood. Lungs: The respiratory control center in the brain decreases the rate and
depth of respiration, which increases blood carbon dioxide. Buffers: Buffers release proton. Water and
carbon dioxide yield carbonic acid that yields proton and bicarbonate ion. Fewer proton are removed from
the blood, and fewer bicarbonate ion are available to bind proton. Increased blood carbon dioxide reacts
with water to produce carbonic acid, which dissociates to increase proton. Water and carbon dioxide yield
carbonic acid that yields proton and bicarbonate ion. The number of proton in the blood increases. The
blood pH decreases, proton increases, and homeostasis is restored. When blood pH decreases, proton
increases, and homeostasis is disturbed. Buffers: Buffers bind proton. Water and carbon dioxide yield
carbonic acid that yields proton and bicarbonate ion. Lungs: The respiratory control center in the brain
increases the rate and depth of respiration, which decreases blood carbon dioxide. Kidney: The distal
convoluted tubules increase proton secretion into the urine and increase bicarbonate ion reabsorption
into the blood. The number of proton in the blood decreases. Decreased blood carbon dioxide causes
proton to react with carbonate ion to form carbonic acid, which decreases proton in the blood. Water and
carbon dioxide yield carbonic acid that yields proton and bicarbonate ion. More proton is removed from
the blood, and more bicarbonate ion are available to bind proton. The blood pH increases, proton
decreases, and homeostasis is restored.

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