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Lecture
Outline
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23-1
Copyright (c) The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Urinary System
Two kidneys
Two ureters
Urethra
23-3
Kidney Location
23-4
Kidney Functions
Filters blood plasma
returns useful substances to blood
eliminates waste
Regulates
osmolarity of body fluids, blood volume, BP
acid base balance
Secretes
renin and erythropoietin
23-5
Nitrogenous Wastes
Urea
proteinsamino acids NH2
removed forms ammonia, liver
converts to urea
Uric acid
nucleic acid catabolism
Creatinine
creatine phosphate catabolism
Renal failure
azotemia: BUN, nitrogenous
wastes in blood
uremia: toxic effects as wastes
accumulate
23-6
Excretion
Separation of wastes from body fluids and
eliminating them; by four systems
respiratory: CO2
integumentary: water, salts, lactic acid, urea
digestive: water, salts, CO2, lipids, bile
pigments, cholesterol
urinary: many metabolic wastes, toxins,
drugs, hormones, salts, H+ and water
23-7
Anatomy of Kidney
Position, weight and size
retroperitoneal, level of T12 to L3
about 160 g each
about size of a bar of soap (12x6x3 cm)
Shape
lateral surface - convex; medial - concave
CT coverings
renal fascia: binds to abdominal wall
adipose capsule: cushions kidney
renal capsule: encloses kidney like cellophane
23-8
wrap
Anatomy of Kidney
Lobe of Kidney
23-10
Renal Corpuscle
Nephron loop - U
shaped; descending
and ascending limbs
thick segment
(simple cuboidal)
initial part of
descending limb and
part or all of
ascending limb,
active transport of
salts
thin segment (simple
squamous) very
water permeable
Distal convoluted
tubule (DCT)
cuboidal, minimal
microvilli
23-12
Flow of glomerular
filtrate:
glomerular capsule
PCT nephron
loop DCT
collecting duct
papillary duct
minor calyx
major calyx renal
pelvis ureter
urinary bladder
urethra
23-13
Nephrons
True proportions of nephron
loops to convoluted tubules
shown
Cortical nephrons (85%)
short nephron loops
efferent arterioles branch off
peritubular capillaries
Juxtamedullary nephrons
(15%)
very long nephron loops,
maintain salt gradient, helps
conserve water
23-14
Nephron Diagram
Renal vein
23-16
23-17
23-18
23-19
Filtration Membrane
Fenestrated endothelium
70-90nm pores exclude blood
cells
Basement membrane
proteoglycan gel, negative
charge excludes molecules >
8nm
blood plasma 7% protein,
glomerular filtrate 0.03%
Filtration slits
podocyte arms have pedicels
with negatively charged filtration
slits, allow particles < 3nm to
23-20
pass
Filtration Pressure
23-21
male
female
Juxtaglomerular Apparatus
- vasomotion
- monitor salinity
23-24
Tubuloglomerular feedback
Macula densa on DCT monitors tubular fluid
and signals juxtaglomerular cells (smooth muscle,
surrounds afferent arteriole) to constrict afferent
arteriole to GFR
23-26
23-27
23-28
Renin-Angiotensin-Aldosterone
23-29
Effects of Angiotensin II
23-30
23-31
Peritubular Capillaries
Blood has unusually high COP here, and
BHP is only 8 mm Hg (or lower when
constricted by angiotensin II); this favors
reabsorption
Water absorbed by osmosis and carries
other solutes with it (solvent drag)
23-32
23-34
Acid-base balance
secretion of hydrogen and bicarbonate ions
regulates pH of body fluids
23-36
23-37
23-38
23-39
23-40
Osmolarity 4x as concentrated
deep in medulla
Medullary portion of CD is more
permeable to water than to NaCl
23-41
Countercurrent Multiplier
Recaptures NaCl and returns it to renal medulla
Descending limb
reabsorbs water but not salt
concentrates tubular fluid
Ascending limb
Countercurrent Multiplier
of Nephron Loop Diagram
23-44
Descending capillaries
water diffuses out of blood
NaCl diffuses into blood
Ascending capillaries
water diffuses into blood
NaCl diffuses out of blood
23-45
Maintenance of Osmolarity
in Renal Medulla
23-46
Summary of Tubular
Reabsorption and Secretion
23-47
23-48
Specific gravity
density of urine ranges from 1.001 -1.028
23-50
Urine Volume
23-51
Diabetes
Chronic polyuria of metabolic origin
With hyperglycemia and glycosuria
diabetes mellitus I and II, insulin
hyposecretion/insensitivity
23-52
Diuretics
Effects
urine output
blood volume
Uses
hypertension and congestive heart failure
Mechanisms of action
GFR
tubular reabsorption
23-53
23-55
23-56
Urinary Bladder
Located in pelvic cavity, posterior to pubic
symphysis
3 layers
parietal peritoneum, superiorly; fibrous adventitia rest
muscularis: detrusor muscle, 3 layers of smooth
muscle
mucosa: transitional epithelium
Female Urethra
3 to 4 cm long
External urethral orifice
between vaginal orifice and
clitoris
Signals descend to
Result
23-61
Hemodialysis
23-62
23-63