1. 泌尿系統
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2. Urinary System Organization
Functions of the Urinary System
Eliminate organic wastes
Regulate plasma ion levels
Regulate blood volume and blood pressure
Adjust water loss
Release cardiovascular hormones
Stabilize blood pH
Conserve nutrients
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3. Urinary System Organization腎臟
輸尿管 膀胱 尿道
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4. The Kidneys Anatomy of the Kidney Kidneys are retroperitoneal
Left kidney superior to right左高於右
Fibrous capsule腎被膜 surrounds the kidney
Renal artery and renal nerve enter at hilum腎門
每分鐘腎血流量1.2~1.3L (20%總血量)
Renal vein and ureter exit at hilum
Copyright © 2007 Pearson Education, Inc., publishing as Benjamin Cummings

5. An Overview of Kidney Anatomy
The Kidneys
An Overview of Kidney Anatomy
Figure 18-2a

6. The Kidneys Internal Anatomy of the Kidney Nephrons腎元 Renal pelvis腎盂
Urine produced by nephrons
About a million nephrons per kidney
Renal pelvis腎盂
Urine collects here from calyces腎盞
Input from two major calyces
Each major calyx is fed by four to five minor calyces
Urine leaves pelvis to ureter 皮質 髓質
腎錐體

7. The Structure of the Kidney
The Kidneys
The Structure of the Kidney
近曲小管
腎小體
遠曲小管
亨利氏環
集尿管
Figure 18-3(c)

8. The Kidneys Kidney Blood Supply Renal artery腎動脈
Interlobar arteries葉間動脈
Arcuate arteries弓狀動脈
Interlobular arteries小葉間動脈
腎靜脈
小葉間靜脈
弓狀靜脈
葉間靜脈

9. The Blood Supply to the Kidneys
Figure 18-4(b)

10. The Blood Supply to the Kidneys
輸入小動脈
腎小管周圍血管
輸出小動脈
腎絲球
Figure 18-4(c)

11. The Kidneys
The Blood Supply to the Kidneys
腎絲球
直血管
Figure 18-4(d)

12. The Kidneys The Nephron腎元 Basic functional unit of the kidney
Two parts to the nephron
Renal corpuscle 腎小體
Renal tubule 腎小管
Feeds into collecting system
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13. The Kidneys Pathway of Urine through the Nephron
First, filtered in the renal corpuscle鮑氏囊
Urine begins as filtrate
Next, filtrate flows into renal tubule
First, into the proximal convoluted tubule (PCT)近曲小管
Next, the loop of Henle亨利氏環
Finally, the distal convoluted tubule (DCT)遠曲小管
Last, exits to collecting duct集尿管
Copyright © 2007 Pearson Education, Inc., publishing as Benjamin Cummings

14. A Representative Nephron and the Collecting System
The Kidneys
A Representative Nephron and the Collecting System
Figure 18-5

15. Principles of Urine Production
Primary Purpose of Urine Production
Excretion of dissolved solutes
Metabolic wastes
Urea (21 g per day)
Creatinine肌酸酉干 (1.8 g per day)
Uric acid (480 mg per day)
Excess ions
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16. Principles of Urine Production
Processes in Urine Formation
Filtration過濾
Reabsorption再吸收
Secretion分泌
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17. Principles of Urine Production
Water Balance in the Kidney
More than 99% of water is reabsorbed from the filtrate by the renal tubules
Water content of normal urine ranges from 93% to 97%
Copyright © 2007 Pearson Education, Inc., publishing as Benjamin Cummings

18. Principles of Urine Production

19. Transport, Storage, & Excretion
Ureters 輸尿管　(30 cm)
Ureters extend from renal pelvis to urinary bladder
Push urine toward bladder
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20. Transport, Storage, & Excretion
Urinary Bladder 膀胱
Distensible muscular sac for urine storage (1L/time)
Internal features include
Trigone膀胱三角
Neck
Internal urethral sphincter尿道括闊約肌
Detrussor muscle逼尿肌
Contraction forces urine into urethra尿道
Copyright © 2007 Pearson Education, Inc., publishing as Benjamin Cummings

21. Transport, Storage, & Excretion
Organs for the Conduction and Storage of Urine
Figure 18-10(a)

22. Transport, Storage, & Excretion
Organs for the Conduction and Storage of Urine
Figure 18-10(b)

23. Transport, Storage, & Excretion
Organs for the Conduction and Storage of Urine
Figure 18-10(c)

24. Transport, Storage, & Excretion
The Urethra　尿道
Longer in males (18~20 cm) than females (2.5~3 cm)
External urethral sphincter formed by a circular band of skeletal muscle of pelvic floor 骨盆底
Under voluntary control
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25. Transport, Storage, & Excretion
Micturition Reflex and Urination
Urination coordinated by micturition reflex
排尿反射
Initiated by stretch receptors in the bladder wall
200 ml urine
Voluntary urination couples reflex with relaxation of external urinary sphincter
Permits internal urinary sphincter to open (極限500 ml urine)
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26. Transport, Storage, & Excretion
The Micturition Reflex
Figure 18-11

27. Fluid, Electrolyte, & Acid-Base

28. Aging and the Urinary System
Age-Related Changes in Urinary System
Loss of functional nephrons
Reduced GFR
Reduced response to ADH
Urinary retention in men with prostate enlargement前列腺肥大
Drop in body water and mineral content
Disorders of fluid, electrolyte, or acid-base balance
Copyright © 2007 Pearson Education, Inc., publishing as Benjamin Cummings