THE URINARY

SYSTEM

Dr Mlelwa (MD)
 Learning objectives
By the end of this session a learner must be able to;
• Define the urinary system
• Explain the functions of the urinary system.
• Describe the functional anatomy of the kidney and function
of its’ parts.
• Describe the process of urine formation.
• Briefly explain the disorders of urinary system.
• Understand some common biomedical devices used in urinary
system
 Introduction to urinary system
• The urinary system is also called the excretory system of
the body because one of its functions is to remove waste
products from the blood and eliminate them from the body.
• Excretion is the process by which the unwanted substances
and metabolic wastes are eliminated from the body.
• However not only the kidneys/urinary system performs the
excretory function.
Introduction to urinary system cont..
• Other excretory organs or systems in the body include;
1. Digestive system excretes food residues in the form of
feces. Some bacteria and toxic substances also are
excreted through feces
2. Lungs remove carbon dioxide and water vapor
3. Skin excretes water, salts and some wastes. It also
removes heat from the body
4. Liver excretes many substances like bile pigments, heavy
metals, drugs, toxins, bacteria, etc. through bile.
 Introduction to urinary system cont..
NOW, The Definition of urinary system;
• The Urinary System is a group of organs in the body
concerned with filtering out excess fluid and other
substances from the bloodstream.
• The substances are filtered out from the body in the form
of urine
Introduction to urinary system cont..
• Although various organs are involved in removal of wastes
from the body, their excretory capacity is limited.
• But renal system or urinary system has maximum excretory
capacity and so it plays a major role in homeostasis.
• Renal system includes:
1) A pair of kidneys
2) Ureters
3) Urinary bladder
4) Urethra.
Organs of the urinary system
 Organs of the urinary system cont..
• Kidneys produce the urine.
• Ureters transport the urine to urinary bladder.
• Urinary bladder stores the urine until it is voided (emptied).
• Urine is voided from bladder through urethra
Functions of the urinary system
1) Excretion of waste products
2) Maintenance of water balance
3) Maintenance of electrolyte balance
4) Maintenance of acid-base balance
5) Hemopoietic function
6) Endocrine function
7) Regulation of blood pressure
8) Regulation of blood calcium level
Functions of the urinary system cont..
1. Excretion of Waste Products
• Kidneys excrete the unwanted waste products, which are
formed during metabolic activities:
✓Urea (end product of amino acid metabolism)
✓Uric acid (end product of nucleic acid metabolism)
✓Creatinine (end product of metabolism in muscles)
✓Bilirubin (end product of hemoglobin degradation)
✓Products of metabolism of other substances.
• Kidneys also excrete harmful foreign chemical substances
such as toxins, drugs, heavy metals, pesticides, etc.
Functions of the urinary system cont..
2. Maintenance of Water Balance
• Kidneys maintain the water balance in the body by
conserving water when it is decreased and excreting water
when it is excess in the body.
3. Maintenance of Electrolyte Balance
• Maintenance of electrolyte balance, especially sodium is in
relation to water balance. Kidneys retain sodium if the
osmolarity of body water decreases and eliminate sodium
when osmolarity increases.
Functions of the urinary system cont..
3. Maintenance of Acid–Base Balance
• The pH of the blood and body fluids should be maintained
within narrow range for healthy living. Body is under
constant threat to develop acidosis, because of production
of lot of acids during metabolic activities.
• However, it is prevented by kidneys, lungs and blood
buffers, which eliminate these acids.
• Among these, kidneys plays a major role in preventing
acidosis.
Functions of the urinary system cont..
4. Hemopoietic function
• Kidneys stimulate the production of erythrocytes by secreting
erythropoietin. Erythropoietin is the important stimulating factor for
erythropoiesis. Another hormone is thrombopoietin (make platelets)
5. Endocrine function
• Kidneys secrete many hormonal substances in addition to
erythropoietin and thrombopoietin .
• Hormones secreted by kidneys
• i. Erythropoietin
• ii. Thrombopoietin
• iii. Renin
• iv. 1,25-dihydroxycholecalciferol (calcitriol)
• v. Prostaglandins.
Functions of the urinary system cont..
6. Regulation of blood pressure
• Kidneys play an important role in the long-term regulation of
arterial blood pressure by two ways:
i. By regulating the volume of extracellular fluid
ii. Through renin-angiotensin mechanism.
7. „Regulation of blood calcium level
• Kidneys play a role in the regulation of blood calcium level by
activating 1,25-dihydroxycholecalciferol into vitamin D.
Vitamin D is necessary for the absorption of calcium from
intestine
 kidneys
• External Anatomy of the kidney
• A pair of reddish brown, bean shaped organ located in the
posterior wall of the abdominal region, one in each side of
the vertebral column. They usually span between T12 to L3.
• Kidney is a compound tubular gland covered by a connective
tissue capsule.
• There is a depression on the medial border of kidney called
hilum, through which renal artery, renal veins, nerves and
ureter pass.
Fibrous capsule hilum

Renal artery

Renal vein
• Internal Anatomy of the kidney
• Components of kidney are arranged in three layers:
• 1. Outer cortex
• 2. Inner medulla
• 3. Renal pelvis.
1. Outer cortex
• The renal cortex is the outermost portion of the kidney.
• It is divided in to two region the outer cortical and the
inner juxtamedullary region.
• The cortical tissue that penetrates between pyramids forms
Renal Columns.
• The renal columns composed of mainly collecting tubules.
2. The renal medulla
• The Renal medulla is the middle portion of the kidney.
• It consists of 8 to 18 renal pyramids, which are
longitudinally striped, one cone shaped area.
• The base of each pyramid is adjacent to the outer cortex.
• The apex of each renal pyramid ends in papilla, which opens
to a minor calyx.
• Pyramids contain tubules and collecting ducts of the
nephron.
3. The renal pelvis
• The renal pelvis is the large collecting space within the
kidney formed from the expanded upper portion of the
ureters.
• The pelvis branch to two cavities, these are 2-3 major
calyces and 8 to 18 minor calyces.
Blood supply of the kidney
• Renal Artery – branches off of the aorta bringing waste-
filled blood into the kidney for filtering in the nephrons;
Each minute, the kidneys receive 20% of the blood pumped
by the heart.
• Renal Vein – removes the filtered blood from the kidneys to
the inferior vena cava.
• Every minute 1300 mL of blood enter the kidneys, 1299 mL
leave the kidney. and 1 mL leaves as urine.
Functional anatomy of the kidney
 The nephron
• Nephron is defined as the structural and functional unit of
kidney. Each kidney consists of 1 to 1.3 millions of nephrons.
• The number of nephrons starts decreasing after about 45
to 50 years of age at the rate of 0.8% to 1% every year.
• Each nephron is formed by two parts (Fig. next page):
1. A blind end called renal corpuscle or Malpighian corpuscle
2. A tubular portion called renal tubule.
Structure of nephron
STRUCTURE OF RENAL CORPUSCLE
• Renal corpuscle is formed by
two portions:
• 1. Glomerulus
Bowman capsule
• 2. Bowman capsule.
• Function of the renal
corpuscle is the filtration of
blood which forms the first
phase of urine formation.
TUBULAR PORTION OF NEPHRON
• Tubular portion of nephron is the continuation of Bowman
capsule.
• It is made up of three parts:
1. Proximal convoluted tubule
2. Loop of Henle
3. Distal convoluted tubule.
 Urine formation
• Urine formation is a blood cleansing function.
• Normally, about 1,300 mL of blood (26% of cardiac output)
enters the kidneys.
• Kidneys excrete the unwanted substances along with water
from the blood as urine.
• Normal urinary output is 1 L/day to 1.5 L/day.
 Urine formation cont…
• The urine formation includes
three processes:
A. Glomerular filtration
B. Tubular reabsorption
C. Tubular secretion.
• Among these three processes
filtration is the function of
the glomerulus. Reabsorption
and secretion are the
functions of tubular portion of
the nephron.
 Glomerular filtration
• When blood passes through glomerular capillaries, the
plasma is filtered into the Bowman capsule.
• All the substances of plasma are filtered except the plasma
proteins (because of their large size).
• The filtered fluid is called glomerular filtrate.
• Glomerular filtration is called ultrafiltration because even
the minute particles are filtered.
 Tubular reabsorption
• Tubular reabsorption is the process by which water and
other substances are transported from renal tubules back
to the blood.
• Large quantity of water (more than 99%), electrolytes and
other substances are reabsorbed by the tubular epithelial
cells.
• The reabsorption can either be active (needs ATP) or
passive (follows concentration gradient).
 Tubular reabsorption cont…
• Tubular reabsorption is known as selective reabsorption
because the tubular cells reabsorb only the substances
necessary for the body.
• Essential substances such as glucose, amino acids and
vitamins are completely reabsorbed from renal tubule.
• Whereas the unwanted substances like metabolic waste
products are not reabsorbed and excreted through urine.
 Tubular secretion
• Tubular secretion is the process by which the substances
are transported from blood into renal tubules. It is also
called tubular excretion.
• Substances secreted include potassium, ammonia, hydrogen
ions, urea but also drugs and toxins.
 SUMMARY OF URINE FORMATION
• Urine formation takes place in three processes:
1. Glomerular filtration
• Plasma is filtered in glomeruli and the substances reach the renal
tubules along with water as filtrate.
2. Tubular Reabsorption
• The 99% of filtrate is reabsorbed in different segments of renal
tubules.
3. Tubular Secretion
• Some substances are transported from blood into the renal
tubule.
• With all these changes, the filtrate becomes urine.
 Accessory Excretory structures
• Urine is formed in the kidney, but accessory structures are
required to transfer, store and eventually eliminate urine
from the body.
• These structures are
a. The two ureters,
b. Urinary bladder and
c. Urethra.
These 3 structures are generally called the Urinary tracts.
 ureters
• ureters are tubes made of
smooth muscle fibers that
propel urine from the
kidneys to the urinary
bladder.
• In the adult, the ureters
are usually 25–30 cm (10–
12 in) long and around 3–
4 mm (0.12–0.16 in) in
diameter.
 Urinary bladder
• Urinary bladder is a hollow,
muscular organ that collects
urine from the ureters and
store until it is excreted.
• Small, size when empty
• Can hold up to 800 ml
voluntarily
• Up to 2000 ml when
obstructed
• Wall consists of 4 layers
(same as GI tract)
 urethra
male:
-dual function,
-rid body of urine,
- release of seminal fluid during
orgasm
female:
-single function: rids body of
urine
-shorter
-more prone to UTI’s
• Female: 4cm long
• Male:18-20cm long
 Urine & urination
• Composition of urine varies
depending on the diet,
exercise, water consumption
and other factors.
• Urine is a transparent
solution that can range from
colorless to amber but is
usually a pale yellow.
• The PH of urine is 5.0 to 8.0
(mostly acidic)
 Urine & urination cont…
• Proteins, glucose, casts (decomposed blood) and calculi from
minerals are abnormal if present in urine.
• In adult human, the average production is about 1 – 2L per
day.
• Polyuria is a condition of excessive production of urine (> 2.5
L/day), in contrast to oliguria where < 400 mL are produced
per day, or anuria with a production of < 100 mL per day.
 Urine & urination cont…
• The volume and
concentration of urine is
controlled by:
1. Antidiuretic hormone
2. Aldosterone
3. The Renin – angiotensin
mechanism
 Urine & urination cont…
Urination/micturation
• Urination is emptying of the bladder; it is the process of
conscious and unconscious nerve control. Steps of urination
are:
1. Conscious desire to urinate
2. Pelvic diaphragm muscle relax
3. Urinary bladder neck Moves down, outlet Opens, wall
stretch, and wall stretch Receptors are stimulated.
4. Smooth muscle of Urinary bladder Contracts & urine
ejects
 Urinary system disorders
• Urinary tract infections (uti)
✓Upper UTI (cystitis)
✓Lower UTI (pyelonephritis)
• Urethritis
• Urolithiasis/kidney stones/renal calculi
• Kidney failure (acute or chronic)
• Urinary incontinence
• Tumors/cancers (renal or bladder tumors)
• Polycystic kidney disease
• Congenital anomalies of urinary system (e.g horse shoe kidney)
 Biomedical devices used in urinary
system
1. Urine analyzer machine
• Is the device used in the
clinical setting to perform
automatic urine testing.
• The units can detect and
quantify a number of
analytes including bilirubin,
protein, glucose and red
blood cells.
 Biomedical devices used in urinary
system cont…
2. Dialysis and Artificial Kidney
• Dialysis is the procedure to
remove waste materials and
toxic substances and to
restore normal volume and
composition of body fluid in
severe renal failure.
• It is also called hemodialysis.
• Artificial kidney/dialyzer is
the machine that is used to
carry out dialysis during renal
failure.
 evaluation
• What is the urinary system and describe its components
• Explain the functions of urinary system
• Describe the structure the nephron
• Explain the process of urine formation
• Mention the organs regarded as urinary tract
• Mention the composition of urine
• Briefly explain disorders of urinary system.
• Describe the biomedical devices used in urinary system and
briefly explain about hemodialysis.
 Individual assignment
• Go and read about renin angiotensin mechanism