1. Memmler’s The Human Body in Health and Disease 11th edition
Chapter 22
The Urinary System

2. Excretion Body systems work interdependently to maintain
homeostasis by excretion
Urinary
Digestive
Respiratory
Integumentary

3. Organs of the Urinary System
Two kidneys
Two ureters
Single urinary bladder
Single urethra

4. Male urinary system, showing blood vessels.  
Zooming In: What vessel supplies blood to the kidney? What vessel drains the kidney?

5. Kidney Activities Excretion Urea Water balance maintenance
Body fluid acid–base regulation
Blood pressure regulation
Angiotensin
Aldosterone
Red blood cell production regulation

6. Kidney Structure Membranous renal capsule of fibrous connective tissue
Adipose capsule of fat
Fascia anchors kidney to peritoneum and abdominal wall
Retroperitoneal space
Right kidney lower than left to accommodate liver

7. Blood Supply to the Kidney
Renal artery supplies blood
Nephrons are functional units
Renal vein drains blood

8. Kidney Organization Hilum Renal cortex (outer portion)
Renal medulla (inner portion)
Renal pyramids
Renal pelvis
Calyces

9. Longitudinal section through the kidney
Longitudinal section through the kidney. Its internal structure is shown (left), along with an enlarged diagram of nephrons (right). Each kidney contains more than 1 million nephrons. 

10. The Nephron Functional kidney unit Glomerular (Bowman) capsule
Glomerulus
Afferent arteriole
Peritubular capillaries
Proximal convoluted tubule (PCT)
Nephron loop (Loop of Henle)
Descending limb
Ascending limb
Distal convoluted tube (DCT)
Collecting duct

11. A nephron and its blood supply
A nephron and its blood supply. The nephron regulates the proportions of water, waste, and other materials according to the body’s constantly changing needs. Materials that enter the nephron can be returned to the blood through the surrounding capillaries.  
Zooming In: Which of the two convoluted tubules is closer to the glomerular capsule? Which convoluted tubule is farther away?

12. Formation of Urine Glomerular filtration Glomerular filtrate
Tubular reabsorption
Diffusion
Osmosis
Active transport
Tubular secretion
Countercurrent mechanism
Concentration of urine
Antidiuretic hormone (ADH)

13. Summary of urine formation in a nephron.

14. Control of Blood Pressure
Juxtaglomerular apparatus: Specialized cells that regulate kidney function
Triggered by low blood pressure
Secretes renin enzyme

15. Structure of the juxtaglomerular (JG) apparatus
Structure of the juxtaglomerular (JG) apparatus. Note how the distal convoluted tubule contacts the afferent arteriole (right). Cells in these two structures make up the JG apparatus.  
Zooming In: The JG apparatus is made up of cells from which two structures?

16. The Ureters Long, slender, muscular tubes Epithelial cell lining
Involuntary muscle layer
Fibrous connective tissue coat
Entirely extraperitoneal
Extend from kidney to urinary bladder
Move urine by gravity and peristalsis

17. The Urinary Bladder Temporary reservoir for urine Multiple layers
Mucous membrane
Transitional epithelium
Rugae
Connective tissue
Three-layered coat of involuntary muscle tissue
Incomplete coat of peritoneum
Trigone

18. The Urethra Tube that extends from the bladder to the outside Male
Part of both reproductive and urinary systems
Female
Entirely separate from reproductive system

19. Urination Process of expelling urine from bladder (micturition)
Involuntary control
Internal urethral sphincter
Voluntary control
External urethral sphincter

20. The Urine 95% water, 5% dissolved solids and gases pH averages 6.0
Specific gravity measures amount of dissolved substances
Normal range to 1.040

21. Normal Constituents Dissolved solids normally found in urine
Nitrogenous waste products
Urea
Uric acid
Creatinine
Electrolytes
Sodium chloride
Sulfates
Phosphates
Pigment

22. Abnormal Constituents
Urinalysis is evaluation of urine
Glucose
Glycosuria
Albumin
Albuminuria
Blood
Hematuria
Ketones
Diabetes mellitus and starvation
White blood cells
Pyuria
Casts
Nephron disease

23. Disorders of the Urinary System
Portion of urinary system most prone to disorders is kidney

24. Kidney Disorders Kidney disorders may be acute or chronic
Acute glomerulonephritis
Most common kidney disease
Pyelonephritis
Hydronephrosis
Polycystic kidney
Tumors
Kidney stones (calculi)
Renal failure
Leads to uremia, high levels of nitrogenous waste in the blood

25. Renal Dialysis and Kidney Transplantation
Hemodialysis
Peritoneal dialysis
Kidney transplantation
Final option for treatment of kidney failure

26. Disorders of the Ureters
Subdivision at renal pelvis
Constricted or abnormally narrow parts (strictures)
Renal ptosis
Ureterocele
Ureteral stones

27. Bladder Disorders Rupture Cystitis Interstitial cystitis Tumors
90% arise from epithelial lining
If bladder removed (cystectomy), ureters diverted to part of ileum in an ilial conduit
Urinary incontinence
Stress incontinence
Urge incontinence
Overflow incontinence
Enuresis

28. Disorders of the Urethra
Congenital anomalies
Narrowing of opening or urethra itself
Presence of valve-like structure at junction of urethra and bladder
Hypospadias
Urethritis
Straddle injuries

29. The Effects of Aging Loss of ability to concentrate urine
Decrease in number and size of nephrons
Increase in blood urea nitrogen (BUN)
Urinary infections
Prostate enlargement
Decreased bladder capacity
Incontinence

30. End of Presentation