Urinary System

Anatomy and
Physiology
Part I

Urinary System

Kidneys (2)

Most important excretory organ

Eliminate waste

Ureters (2)
Bladder (1)
Urethra (1)
Nephron Unit

Functional unit of the kidney

Formation of urine
Tubular and vascular structures

Kidney Location and

Protection

Kidneys are located in the posterior

wall of the abdominal cavity
In the retroperitoneal space
Connective tissue (renal fascia) hold
the kidneys in place
Adipose tissue cushion the kidneys
The lower rib cage partially enclose
the kidney and protect them

Urinary System
Anterior/Posterior Views

Kidney Structures

Kidney is reddish-brown
Looks like a bean
Approximately 4 inches x 2 inches
Hilus indentation where blood vessels
and structures enter or exit the kidney
Three Regions in the kidney if sliced in
half renal cortex, renal medulla, renal
pelvis

Average adult kidney weighs 113170 g.

10 12 cm long.
6 cm wide.
2.5 cm thick.
Right kidney is lower than the left
due to location of liver.

Adrenal gland lies on top of each

kidney.
Renal parenchyma is divided into
two parts:
~ Cortex
~ Medulla

Renal Cortex

Light, outside
region
Cortex means
bark
Contains: Nephron

Renal Medulla

Dark, triangular
structure
Form small cone
shaped regions called
renal pyramids
Each pyramid is
separated by renal
columns
The lower ends of the
pyramids point to the
renal pelvis

Renal Medulla

Contains: Loops
of Henle, Vasa
Recta and
collecting ducts
of the
juztamedullary
nephrons.

Each kidney
contains 8 -18
pyramids.
Pyramids drain
into 4 13
minor calices.
2 3 major
calices.

Renal pelvis

A basin that collects

the urine made by the
kidney and helps form
the upper end of the
ureter
The edges of the renal
pelvis closest to the
renal pyramids are
called calices
Calices collect the
urine formed in the
kidney

Renal pelvis

Is the beginning
of collecting
system and
composed
structures that
are designed to
COLLECT and
TRANSPORT
URINE.

How do they work?

Need a blood supply

Brought to the kidney via the renal artery
Renal artery stems from the abdominal aorta
20-25% of cardiac output goes to the kidneys
Smaller arteries supply blood to the nephron
unit
Blood leaves the kidney via the renal veins
The renal veins empty into the inferior vena
cava

Functions of the Kidneys

Excrete nitrogenous waste from the body

Urea
Ammonia
Creatinine

Regulate blood volume

Help regulate electrolyte content of the blood
Regulate acid-base balance (pH)
Regulate blood pressure
Regulates red blood cell production

The Formation of Urine

The Nephron Unit

Each kidney contains about 1 million
nephron units
The number does not increase after
birth
They cannot be replaced if damaged
2 parts
Tubular component (renal tubule)
Vascular component

Renal Tubules

Glomerular capsule (Bowmans

Capsule) C shaped capsule
surrounding the glomerulus
Glomerulus cluster of capillaries
Proximal convoluted tubule
Loop of Henle ascending and
descending limb
Distal Convoluted tubule
Collecting duct

Nephron

Renal Vasculature

Receives blood from the renal artery

Renal artery branches into the afferent arterioles
(Branches to form glomerulus)
Afferent arterioles feed into Bowmans capsule
The efferent arterioles exit Bowmans capsule
The efferent arterioles form the peritubular
capillaries
The peritubular capillaries empty into the venules,
large veins, and then into the renal veins
It is imperative you know the relationship between
the tubular and vascular structures.

Urine Formation

Formed in the nephron unit

Water and dissolved substances move
through the renal tubules and vessels
Three processes are involved in urine
formation
Glomerular filtration
Tubular reabsorption
Tubular secretion

Normal Urine

Clear and pale to deep yellow or amber

Slightly aromatic in odor
Slightly acidic 5.0 8.0
With a sp. Gravity of 1.010 1.030
(+) NA, K ions, urea uric acid,
creatinin, ammonia, and HCO3 ions
(-) Glucose, CHON, RBC, and WBC and
bile pigments

Composition of Urine

Sterile
95 % water
Nitrogen containing waste urea, uric
acid, ammonia, creatinine
Electrolytes
Light yellow color of urine is due to a
pigment called urochrome
Urochrome is formed from the
breakdown of hemoglobin in the liver

Urine Specific Gravity

Ratio of the amount of solute to the total

volume
Solute = substance dissolved in the urine
The greater the solute = greater the
specific gravity
Concentrated Urine = high specific gravity

Ex. dehydration

Dilute Urine = low specific gravity

Ex. Overhydration, diabetes insipidus

Urine Characteristics

Amount 1500 ml in 24 hours

pH average 6.0
Specific Gravity heavier than water
(1.010-1.030)
Color yellow (amber, straw colored,
concentrated, orange, brown, red,
sediment, clear or cloudy)
Dehydrated = deep yellow, dark
Overhydrated = pale yellow, colorless

Abnormal Constituents
of Urine

Albumin (protein)
Glucose
Red blood cells
Hemoglobin
White blood cells
Ketone bodies
Bilirubin

Urine Testing

Urinalysis
Microscopic exam
Culture and sensitivity
Urine dipstick
Urine Drug and alcohol screening
24 hour urine testing

Your Plumbing The

Urinary Tract
(Ureters, Urinary bladder,
Urethra)
Ureters

Transport urine, they do not alter it

in any way
Urine moves in response to gravity
and muscular movements called
peristalsis through ureters.

Your Plumbing

The Bladder

Stores urine temporarily until elimination

Located behind the symphasis pubis
A distended bladder or full bladder can be palpated
above the syphasis in the abdominal cavity.
Bladder has 4 layers

Mucous membrane
Submucosa
Detrusor muscle involuntary smooth muscle
Serosa

Contain rugae to allow for stretching

Trigone triangular area in the floor of the bladder

Urination Micturition

Expelling urine from the bladder

The urge to urinate (void) happened at about
200 ml of urine in the bladder
At about 300 ml urine in the bladder, the urge
becomes more uncomfortable
Moderately full = 500 ml urine
Overdistended bladder may have over 1000 ml
urine
Bacteria in your bladder doubles every 4 hours.
Stimulated by stretch receptors

Urethra

Carries urine from the bladder to the outside of

the body
Internal sphincter prevents urine from emptying;
composed of smooth muscle; involuntary
External sphincter at the upper portion of the
urethra allows you to resist the urge to urinate;
composed of skeletal muscle; voluntary
Female short, opens to the outside at the
urethral meatus
Male longer, passes through the prostate gland;
carries urine and sperm

Urinary Retention and

Suppression

Retention - Inability to void

Post operative; anesthesia
Bladder dysfunction

Suppression no urine formation

Kidney dysfunction

Data Collection &

Documentation

Characteristics of urine

Color
Sediment
Clear or cloudy
Odor

How does the patient/resident void?

Urinary diversions?
Signs and symptoms

Urgency
Frequency
Burning sensation
Hesitancy

What is the Costovertebral

Angle?
T11
R. Kidney

12th Rib

T12

L. Kidney

L
1

Costovertebral Angle

Region to assess for kidney tendernes

Disorders of the Urinary

System

Glomerulonephritis
Polycystic Kidney
Pyelonephritis
Renal Calculi kidney stones
Renal Failure
UTI urinary tract infection

As We Age

By age 80 there is a 50% reduction in

nephron units; therefore a decreased
ability to concentrate urine
Urinary bladder shrinks and becomes
less able to contract and relax; therefore
the elderly must void frequently
Bladder infection incidence increases
Increase in bladder incontinence due to
weakened muscles

Functions of
Genitourinary System

Filtration
Reabsorption
Secretion
Excretion
Regulation