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P H Y S I O L O G Y

The urinary system


Miloslav Hronek
The parts of the
urinary system (excluding
the urethra) and some associated
structures.
(Waugh, Anne . Ross and Wilson
Anatomy and Physiology in Health and
Illness, 11th Edition. Churchill
Livingstone, 062010. p. 330).
A longitudinal
section of the right
kidney.
(Waugh, Anne . Ross and Wilson Anatomy
and Physiology in Health and Illness, 11th
Edition. Churchill Livingstone, 062010. p.
331).
A nephron and
associated blood
vessels.
(Waugh, Anne . Ross and Wilson
Anatomy and Physiology in Health
and Illness, 11th Edition. Churchill
Livingstone, 062010. p. 332).
16 % 4 %
Elimination of waste products
Elimination organs: lungs, skin, GIT, kidneys
Prime function of kidneys
regulation of composition and volume of blood
excretion of wastes and water
removing of hydrogenium(regulation of pH)
regulation blood pressure by juxtaglomerular
apparatus
macula densa (monitor salt)
juxtaglomerular cells in the wall of the afferent arteriole
(secretion renin)
metabolism
gluconeogenesis (synthesis of new glucose molecules from
aminoacids
AA glu)
synthesis of calcitriol (vitamine D)
secretion of erythropoetin
Kidney
1. Nephrons
control blood concentration
and volume (remove water and
volume) .
removing of toxic wastes
dissolved in plasma from blood
ultrafiltration
2. Other parts
passageways and storage
areas
renal tubule
reabsorption and secretion
Nephron
performs 3
processes
The glomerulus and
glomerular capsule.
(Waugh, Anne . Ross and Wilson Anatomy and
Physiology in Health and Illness, 11th
Edition. Churchill Livingstone, 062010. p.
334).
Glomerulus
GLOMERULUS
Filtration function, formation of primary urine
Description membrane of glomerulus
endothelium(fenestrations - 50 - 100 nm)
restricts passage of blood cells
basement membrane
fibrils in glycoprotein matrix
restricts passage of larger proteins
podocytes
specialized epithelial cells with pedicels
spaces filtration slits - restricts passage of medium sized proteins
Glomerular filtration
separation of large and small particles (to mol. weight 68 000)
filtration process
cardiac output 5 l/min perfusion of kidney 1200 ml/min -
glomerular filtration rate (125 ml/min flow into tubules)
regulation of GFR:
renal autoregulation by blood pressure (renin)
neural regulation
sympathetic stimulation (aff. and eff. arterioles constrict)
hormonal regulation
atrial natriuretic peptide (when increase blood volume - promote excretion of
water and sodium)
angiotensin (vasoconstrictor, aldosteron - reabsorption of Na+,
thirst, ADH, BP)
Negative feedback
regulation of secretion of
atrial natriuretic peptide
(ANP).
(Waugh, Anne . Ross and Wilson Anatomy and
Physiology in Health and Illness, 11th Edition.
Churchill Livingstone, 062010. p. 336).
Net filtration pressure
Constituents of glomerular filtrate and glomerular capillaries
(Waugh, Anne . Ross and Wilson Anatomy and Physiology in Health and Illness, 11th Edition. Churchill Livingstone, 062010. p. 334).
The juxtaglomerular Apparatus
Angiotensin-converting enzyme
Renal corpuscle
Proximal convoluted tubule
Distal convuluted tubule
Distal tubule and collecting duct
Intercalated cells in late distal
tubule and collecting duct
Tubular reabsorption
(returns nutrients to the body)
a)Water
reabsorption of 99 % (170 l/day, reabsorption of 168.5
l/day, 1.5 l/day to urine)
under control of ADH
b)Glucose
glycosuria (1800 mg/l in the urine)
c)Na
+
reabsorption 7/8 of NaCl in proximal tubules
reabsorption 1/8 of NaCl in the loops of Henle and distal
tubules under control of aldosteron
d)Urea
from Krebs urea cycle (de-amination), excretion 20
g/day
e)Uric acid
excretion 20 mg/l, 2 g/day
f) Creatinine
from muscle
Other hormones - influence selective
reabsorption
parathyroid hormone
comes from the parathyroid glands
regulates the reabsorption of calcium and phosphate from the
distal collecting tubules increase of calcium level in the plasma.
antidiuretic hormone
secreted by the posterior lobe of the pituitary gland
increases the permeability of the distal convoluted tubules
and collecting tubules,
increasing water reabsorption.
Negative feedback
regulation of secretion of
antidiuretic hormone
(ADH).
(Waugh, Anne . Ross and Wilson Anatomy and Physiology
in Health and Illness, 11th Edition. Churchill Livingstone,
062010. p. 335).
Negative feedback regulation of
aldosterone secretion.
ACE = angiotensin-converting enzyme.
(Waugh, Anne . Ross and Wilson Anatomy and Physiology in Health
and Illness, 11th Edition. Churchill Livingstone, 062010. p. 336).
Tubular secretion
secretion of K
+
, H
+
, NH
4
+
excretion of drugs (penicilin, diuretics)
Summary of the
three processes
that form urine.
(Waugh, Anne . Ross and Wilson
Anatomy and Physiology in Health
and Illness, 11th Edition. Churchill
Livingstone, 062010. p. 336).
Section of the
bladder showing
the trigone.
(Waugh, Anne . Ross and Wilson
Anatomy and Physiology in Health
and Illness, 11th Edition. Churchill
Livingstone, 062010. p. 341).
Urine bladder
capacity (700 - 800 ml)
Micturition (urination)
when UB exceeds 200 400 ml stretch
receptor transmit sensory impulses to the spinal
cord sensory tract to cortex conscious desire
to expel urine urination reflex
parasympathetic fibers conduct motor impulses to the
urinary bladder wall and urethral sphincter
nerve impulses from cerebral cortex inhibit to the external
urethral sphincter
Control of micturition after
bladder control is established.
(Waugh, Anne . Ross and Wilson Anatomy and
Physiology in Health and Illness, 11th Edition.
Churchill Livingstone, 062010. p. 342).
Evaluation of kidney function
Blood urea nitrogen test
measure the nitrogen in blood (urea)
GFR - blood urea nitrogen
Measurement of plasma creatinine
creatinine end product of catabolism of creatinine
phosphate in skeletal muscle
poor renal function
creatinine level rises above 15 mg/l
Renal plasma clearance (RPC)
expresses how effectively the kidneys remove a
substance from blood plasma
low RPC indicates a low rate of excretion in the urine
RPC = U*V/P (ml/min)
U (concentration of the substance in urine)
V (volume of urine)
P (concentration of the substance in plasma, in mg/ml)
Creatinine clearance = 140 ml/min
Clearance of inuline = 125 ml/min
Renal plasma flow
substance para-aminohippuric acid
clearance of PAH = 600 ml/min
Thank you for attention.