URINARY SYSTEM

ANATOMY AND PHYSIOLOGY

PREPARED BY
Pro. Dr. Arpita Vaidya
? ??
 Introduction
• The urinary system is one of the excretory
system of the body. i.e. it removes the
substance that has no function in our body.
 URINARY SYSTEM
• Two Kidneys
– Which secrets urine
• Two Ureters
– Convey urine from Kidneys
to Urinary Bladder
• Urinary Bladder
– Holds Urine until excretion
• Urethra
– Conveys urine from
bladder to outside of body.
 Functions of the kidneys
a) Regulation of blood pH
b) Regulation of blood volume and composition
c) Regulate the blood pressure
d) Maintenance of electrolyte balance
e) It helps in the metabolism. Urine is stored in
the bladder. It is excreted by the process of
micturition, through the urethra.
 THE KIDNEYS

Renal Artery and Vein

*usually arise at L2 Capsule

Pelvis Major
Calyx

Ureter Cortex

Medulla
Minor
Calyx
 Organs associated with the kidneys:
• Right kidney: • Left kidney:
• Superiorly - the right • Superiorly - the left
adrenal gland adrenal gland
• Anteriorly - the right • Anteriorly - the spleen,
lobe of the liver, the stomach, pancreas, jejunum
duodenum and the hepatic and splenic flexure of the
flexure of the colon colon
• Posteriorly - the • Posteriorly - the
diaphragm and muscles of diaphragm and muscles of
the posterior abdominal the posterior abdominal
wall wall
 THE KIDNEYS
• The kidneys are reddish brown,
bean-shaped organs , lie in the
retroperitoneum against the
posterior abdominal wall on
either side of the vertebral
column region and extend from
the T12 to L3 vertebrae.
• A kidney measures approx. 11 cm
long, 6 cm in breath & 2.5 to 4 cm
in thickness.
• It weigh around 150 gms.
They consist of an outer
• cortex,
• an inner medulla and
• a pelvis.
 THE KIDNEYS
• The renal pelvis divides into
two or three major calices
and these, in turn, divide
into minor calices which
receive urine from the renal
pyramids by way of the
papillae.
 THE KIDNEYS
• The right kidney lies
approximately 1 cm lower than
the left because of the large size
of the right lobe of the liver.
• The lateral surface is convex and
the medial surface is concave,
with a vertical cleft called the
renal hilus leading to the renal
sinus
• Ureters, renal blood vessels,
lymphatics, and nerves enter and
exit at the hilus
 Gross structure of the kidney
• In the longitudinal section of the kidney three area
of tissue:
• 1. The fibrous capsule, is a thin tough, white
membrane which closely inverts the kidney & lies
the renal sinus.
• 2. The cortex, is the superficial reddish brown area.
It is present below the capsule.
• 3. The renal medulla, it is the inner region to cortex.
It is also reddish brown in colour.
 Contd…
• This part contains triangular wedges, the renal
pyramids. The base of each pyramids faces
outwards, & the narrow papilla of each face
toward the hilum. The cortical tissue dips into
the medulla between the pyramids, forming
areas known as renal columns. Each renal
papilla puts into a cuplike structure called a
calyx. The calyx join together to from a large
collection reservoir called the renal pelvis.
 Structure of kidney:
• Kidney is surrounded by an outer fibrous capsule. Below
this lies the substance of the kidney which consists of:
• An outer cortex which is reddish – brown in color
• Inner medulla which contains pyramids of the kidney.
• An upper expanded end of ureter called pelvis.
• Microscopically the kidneys are made of a number of
structural and functional units called nephrons. There are
about one million nephrons in each kidney. A nephron
consists of two parts:
• Malphigian bodies made of bowman’s capsule and
glomerulus.
• Renal tubules.
THE KIDNEYS
Internal Structure of the
Kidney
Renal Lobe

Renal pyramids

Renal papilla

Renal Columns
 PROTECTION OF THE KIDNEYS
• 3 layers of connective tissue:
Renal cortex
– Inner layer- Renal capsule

– Middle layer- Adipose capsule

– Outer layer-Renal fascia

Retroperitoneal space
 Renal Capsule, Adipose Tissue and Renal Fascia

• Renal Capsule - is a protective layer.

• The adipose capsule - hold the kidney in place
against the posterior abdominal wall and
cushions the kidneys against external blows
 Microscopic structure of the
kidney
• The kidney consists of microscopic structure,
named nephron. It is about 1.25 million per
kidney. Each nephron contains these structure,
in the order in which fluid flows through them:
• 1. Bowman’s capsule
• 2. proximal convoluted tubule
• 3. Loop of henle
• 4. Distal convoluted tubule
• 5. collecting tubule
INTERNAL STRUCUTRE OF KIDNEY
 Contd…
• Bowman’s capsule:
The Bowman’s capsule is the cup shaped mouth
of a nephron. It is composed of specialized
epithelial cells called podocytes. This part is
completely enclosed by network of arterial
capillaries, the glomerulus. The podocytes in
filtration.
 Contd…
• Proximal convoluted tubule:
It is the second part of nephron. This part
consists of epithelial cells. Thousands of
microvilli from the brush border. It greatly
increase its luminal surface area like renal
corpuscles, proximal tubules are located in the
cortex of the kidney.
 Contd…
• Loop of henle: It is the segment of renal tubule.
It consists of descending limb, a sharp turn, &
an ascending limb. The loop of henle is present
in the medulla.
• Distal convoluted tubule: It is a convoluted
portion of the tubule, beyond the loop of henle.
It is the thick ascending of the loop of henle.
• Collected duct: The collecting duct is a straight
tubule joined by the distal tubules of several
nephrons. collecting ducts join larger ducts, &
all the larger collecting ducts of one renal
pyramid converge to form one tube, that
opens at a renal papilla into one of the small
calyces.
• The afferent arteriole, enters each glomerular
capsule, then subdivided into a cluster of
Capillaries: The blood vessel leading away
from the glomerulus is the efferent arteriole;
it breaks up into a second capillary network to
supply oxygen & nutrient to the reminder of
the nephron.
 Inter lobular artery
Afferent arteriole
Glomerulus
Capillaries
Venules
Interlobular vein
 FUNCTION OF THE KIDNEYS
1) FORMATION OF URINE:
The main function of the kidney is excretion. The
urine, which formed in the kidney is stored in the
urinary bladder & excreted through the urethra.
The kidneys maintain the fluid & electrolyte
balance of the body. It also regulates the pH, by
excreting the hydrogen ions. The functional unit of
kidney is nephron, which forms urine, by means of
three process.
 Contd…
a) Simple filtration
b) Selective reabsorption
c) Secretion
 Simple Filtration
• The movement of water & solutes from the plasma
in the glomerulus, across the semipermeable
membrane. This membrane allows the small particles
to pass through & some are reabsorbed later. Blood
cells, plasma proteins and other larger molecules are
unable to filter through and remain in the
capillaries.
• The main factor establishing the pressure gradient
between the blood in the glomeruli and the filterate
in the Bowman’s capsule is the hydrostatic pressure
of blood.
 Glomerular filtration:
• Filtration of water, salts and other substance
occurs in the glomeruli. Glomerular filtrate is
the fluid that is formed after filtration. About
100 ml of glomerular filtrate is formed per
minute. This filtrate passes into the proximal
convoluted tubule.
 Auto regulation of filtration
• Renal blood flow is protected by a mechanism
called auto regulation where by renal blood
flow is maintained at a constant pressure
across a wide range of systolic blood pressure.
• Auto regulation operates independently of
nervous control: i.e. if the nerve supply to the
renal blood vessels is interrupted, auto
regulation continues to operates.
 Selective reabsorption
• Selective reabsorption is the process by which
the composition and volume of the glomerular
filtrate are altered during its passage through
the convoluted tubules, the medullary loop and
the collecting tubule.
• Active transport is carried out at carrier sites in
the epithelial membrane using chemical energy
to transport substances against their
concentration gradient.
 Tubular reabsorption:
• The rate of glomerular filtration is about 100 ml per
minute. So about 6 liter of glomerular can be formed in
one hour. But the volume of urine eliminated per day
is only about 1.5 liters. It is so, because nearly 99
percent of the glomerular filtrate is reabsorbed.
Reabsorption of water occurs in the convoluted
tubules and collecting tubule. In addition to water,
some salts are also reabsorbed in the renal tubules.
• Urine is the fluid that results from the above three
processes. It enters the collecting tubules and then
into the pelvis of kidney. From there, it enters the
urinary bladder through ureter.
 Contd…
• By the active transport include amino acid and
sodium, calcium, potassium, phosphate and chloride.
• Some ions like sodium and chloride can be absorbed
by both active and passive mechanism.
• Parathyroid hormone and calcitonin together reabsorb
of calcium and phosphate.
• ADH- increasing water re-absorption
• Aldosterone responsible for sodium re-absorption and
potassium excretion.
 Secretion
• Filtration occurs as the blood flows through the
glomerulus. Substances not required and foreign
materials, e.g. drugs including penicillin and
aspirin, may not be cleared from the blood by
filtration because of the short time it remains in
the glomerulus. Such substances are cleared by
secretion into the convoluted tubules and
excreted from the body in the urine.
 Tubular secretion
• It is an active process which occurs in the
convoluted tubules. Abnormal substances or
normal substances present in excess in blood
are eliminated by this process. Potassium,
hydrogen and drugs like penicillin are
excreted by tubular secretion.
 Composition of Urine
• Water: 96% • In other 2%
• Uric acid
• Urea: 2% • Creatinine
• Ammonia
• Sodium
• Potassium
• Chloride
• Phosphate
• Sulphate
• Oxalates
• The odour is aromatic
• The reaction is slightly acidic to litmus with an
average pH of 6
• The specific gravity varies from 1.006 to 1.025
• The quantity averages 1-2 L/24 hours
GLOMERULAR APPARATUS
 Glomerulus
• filtering blood to form urine
Ureters
• Superiorly
• Continuous with the renal
pelvis
• Inferiorly
• Pass through the abdominal
cavity, behind the peritoneum,
in front of the psoas muscle,
into the pelvic cavity where
they enter the posterior wall
of the bladder

• 25-30 cm in length
Ureter- Cross Section

• 3 layers of tissue

– Outer layer
• Fibrous tissue
– Middle layer
• Muscle
– Inner layer
• Epithelium
 Function of Ureters
• Urine in moving from the kidneys to the
bladder.
• Urine moves downward by gravity and
peristalsis (waves of contractions).
• To help prevent any back flow (reflux) of urine
back into the ureter
Bladder
 Contd…
• The bladder is roughly pear shaped, but
becomes more oval as it fills with urine.
• The urinary bladder is a muscular reservoir of
urine which lies in the anterior part of the
pelvic cavity.
• The bladder varies in its size, shape and
position according to the amount of urine it
contains and the age of person.
Bladder- Structure

• 3 layers
– Outer layer
• Loose connective tissue
– Middle layer
• Smooth muscle and
elastic fibres
– Inner layer
• Lined with transitional
epithelium
 Function of Urinary
Bladder
• Storage of urine.
– When the bladder contains between 300 to 400ml of
urine, we become aware of the need to pass urine.
• The lining of the urinary bladder contains the
detrusor muscle and when this contracts, it
empties the bladder.
• The urge to urinate usually starts when the
bladder reaches around 25% of its working
volume
 Urethra
• Extends from the base
of the bladder to the
outside world.
• Anatomical differences
mean that male and
female urethras are
different.
– Female: 4cm long
– Male: 14cm long
Urethra - Structure
• Muscle layer

• Submucosa layer

• Mucosa
 Function of Urethra
• In Men - The urethra provides an exit for urine
as well as semen during ejaculation .
• In female –
– passage for urine to flow
• There are small mucus - secreting urethral
glands, that help protect the epithelium from
the corrosive urine.
 Micturition
• When 300-400 ml of urine have accumulated in
the bladder, afferent autonomic nerve fiber in
the bladder wall sensitive to stretch are
stimulated.
• Urine passed in the response to parasympathetic
stimulation of the bladder, causing contraction of
the detrusor muscle and relaxation of the
internal urethral sphincter.
 Contd…
• When the nervous system is fully developed,
the micturition reflex is stimulated but sensory
impulses also pass upwards to the brain and
there is awareness of the need to pass urine.
• By learned and conscious effort, contraction of
the external urethral sphincter and muscles of
the pelvic floor can inhibit micturition until it is
convenient to empty the bladder
 Contd…
• In adults, urine is passed when the detrusor muscle
contracts, and there is reflex relaxation of the
internal sphincter and voluntary relaxation of the
external sphincter.
• It can be assisted by increasing the pressure within
the pelvic cavity, achieved by lowering the
diaphragm and contracting the abdominal
muscle(Valsalva’s manuever).
• Over distention is very painful and may cause
involuntary loss of urine – incontinence
 Skin and regulation of body
temperature
• The skin completely covers our body. It is also
called integumentary system. It forms the
largest part of our body. Its surface area is
about 2m2 and thickness about 1 to 2 mm.
• Skin is the outer covering of body which is in
contact with external environment.
 Structure of skin
• Skin contains glands, nails and hair. It has
three main parts:
• 1. Epidermis.
• 2. Dermis.
• 3. Hypodermis
• Between the skin and underlying structures,
there is a layer of subcutaneous fat.
 Epidermis:
1. Stratum cornium - contains scale like cells which are
constantly replaced. These cells have a protein called
keratin.
2. Stratum lucidum - a glistring layer
3. Stratum granulosum – has spindle shaped cells with
granules in the cytoplasm.
4. Stratum spinosum: this layer is composed of several layers
of polyhedral cell, that have delicate spine projecting from
their surface.
5. Stratum germinativum/basale - contains cuboidal cells. The
skin cells multiply in this layer.
 Dermis:
• It is the inner layer which forms true skin. It contains
the following structures.
1. Melanophore cells containing melanin pigment and
some elastic fibers which maintain the texture of skin.
2. Arterial and venous capillaries and sensory nerve
endings.
3. Sweat and sebaceous glands.
4. Hair roots and erector pili muscles
 Hypodermis
• It is also called subcutaneous layer. It is
composed of loose fibrous connective tissue.
This is much thicker than dermis. It is rich in
lymphatic vessel, blood vessel and nerves.
 Function of skin
1. Protection of underlying structure from injury.
2. Excretion of salts like sodium chloride and metabolites like
urea.
3. Provides sensation which gives the awareness of
environment.
4. Secretion of sweat and sebum
5. Regulation of body temperature.
6. Synthesis of vitamin D from ergosterol of skin by the action
of ultraviolet rays of sun.
 Regulation of body temperature:
• Regulation of body temperature is an important
function performed by the skin. The normal
body temperature is 98.4F. It may be slightly
lower in the morning and it may increase in
severe muscular exercise. The normal body
temperature is maintained by a balance
between heat production and heat loss.
 Heat production
• Heat can be produced in the body by the following
factors:
1. Increased activity of muscles as in severe exercise.
2. Increased activity of liver and other glandular
structures.
3. Increased metabolism like oxidation of food stuffs
and combustion of fat.
 Contd…
• Oxidation of food
• Specific dynamic action of food
• Exercise
• Strong emotion
• Hormones
• Age
• Other factors like sleep, malnutrition, starvation,
fasting, from skin
 Heat loss
• Loss of heat occurs through the skin by:
1. Conduction to objects in like clothing.
2. Convection by which the hot air around the body moves up
and it is replaced by cool air.
3. Radiation by which heat is given to the surrounding air.
4. Evaporation which makes the skin cool and leads to heat loss.
Body temperature is controlled by heat regulating center in the
hypothalamus.
 Control of body temperature
• Regulation of body temperature is under the
nervous control. Body temperature is
regulated by reflex mechanism, a centre of
control for this mechanism in the
hypothalamus. This area serves as thermostat,
as it maintains the normal body temperature.
 Vasoconstriction
When temperature is less
stimulate
Thermoreceptor
Lead to
Heat promoting centre

Vasoconstriction increase metabolism shivering

High body temperature

Normal body temperature

 Vasodilatation
When temperature is more than normal

Thermoreceptor

Heat losing centre

Vasodilation

Sweating- decrease metabolism

Loss of heat from body

Homeostasis (normal body temperature)

 Wound healing
• Wound healing is an intricate(complex)
process, in which the skin or another organ-
tissue, repairs itself after injury. It is a complex
and dynamic process of replacing devitalized
and missing cellular structures and tissue
layers.
 Conditions required for wound
healing
• Systemic factors: These include good nutritional status
and general health. Infection, impaired immunity poor
blood supply, obesity, diabetes mellitus, stress and
advancing age, reduce the rate of wound healing.
• Local factors; Local factors that facilitate wound healing
include a good blood supply to provide oxygen and
nutrients and remove waste products and freedom from
contamination e.g.microbes, foreign bodies or toxic
chemicals.
 Primary healing
• Inflammation
• Proliferation / Granulation
• Maturation / Remolding
THANK YOU