Ahmad Aulia Jusuf/ Histology FMUI/2009

Ahmad Aulia Jusuf/ Histology FMUI/2009
Monday, June 15, 2009 RENAL AND BODY FLUID All images in this document is removed due to copyright restriction Ahmad Aulia Jusuf, MD, PhD Department of Histology Faculty of Medicine University of Indonesia 2009 Urinary System

Monday, June 15, 2009 INTRODUCTION Urinary system consists of two kidneys two ureters a urinary bladder a urethra Monday, June 15, 2009 Urinary System/AAJ/Histology FMUI Urinary System

Monday, June 15, 2009 INTRODUCTION Functions of urinary system The maintenance of water and electrolyte homeostasis Excretion of many toxic metabolic waste products The end product of urinary system is urine kidneys ureter urinary bladder urethra outside of the body In female urethra is solely a urinary duct In male it also serves as the pathway for ejaculation of the semen Monday, June 15, 2009 Urinary System/AAJ/Histology FMUI Urinary System

Urinary System/AAJ/Histology FMUI
INTRODUCTION Functions of urinary system Has an endocrine function Renin : regulation of blood pressure Erythropoietin : stimulation of erythrocyte production Converting the pro-vitamin D to active vit D Monday, June 15, 2009 Urinary System/AAJ/Histology FMUI

KIDNEY Anatomical appearance a large, reddish, bean-shape organ Location retroperitoneal area right side is lower than left side Wrapped by the perirenal fat Monday, June 15, 2009 Urinary System/AAJ/Histology FMUI

Kidney Hemisections view Hillus Renal artery and vein lymph vessel ureter Cortex dark-brown and granular renal corpuscle proximal and distal convoluted tubules medullary rays (processus of Ferreini) Monday, June 15, 2009 Urinary System/AAJ/Histology FMUI

KIDNEY Hemisection view Medulla renal pyramids pyramid-shape, pale,striated regions Base of pyramids is toward to cortex apex of pyramids is toward to medulla as renal papilla (area cribrosa) perforated by ducts of Bellini Monday, June 15, 2009 Urinary System/AAJ/Histology FMUI

KIDNEY Hemisection view Medulla minor calyces major calyces renal pelvis cortical columns of Bertini Monday, June 15, 2009 Urinary System/AAJ/Histology FMUI

URINIFEROUS TUBULES A functional unit nephron renal corpuscle (Malphigian corpuscle) glomerulus Bowman’s capsule Renal tubule proximal and distal convoluted tubule loop of Henle collecting tubule Monday, June 15, 2009 Urinary System/AAJ/Histology FMUI

NEPHRON 2 types cortical nephrons juxtamedullary nephrons Monday, June 15, 2009 Urinary System/AAJ/Histology FMUI

GLOMERULUS A globular network of anastomosing capillaries arise from branches of afferent glomerular arteriole invaginates Bowman’s capsule Vascular pole invested by podocytes viseral layer of Bowman’s capsule Monday, June 15, 2009 Urinary System/AAJ/Histology FMUI

GLOMERULUS Monday, June 15, 2009 Urinary System/AAJ/Histology FMUI

GLOMERULUS Glomerular capillaries Fenestrated type capillaries Endothelium: thin Round fenestrated >>> (70-100nm) Specific properties Pore diaphragma (--) Surface endothelium has negatively charge due to the present of glycoprotein called as podocalxin Monday, June 15, 2009 Urinary System/AAJ/Histology FMUI

GLOMERULUS Glomerular capillaries the space between glomerular capillaries are occupied by mesangium Connective tissue Mesangial intraglomerular cells Extracellular matrix, free from fibrous elements Monday, June 15, 2009 Urinary System/AAJ/Histology FMUI

GLOMERULUS Mesangial intraglomerular cells A specialized type of pericytes Phagocytic cells may participate in the continuous turn over of basal lamina Contratile and responds to angiotensin II and other vasoconstrictor Monday, June 15, 2009 Urinary System/AAJ/Histology FMUI

GLOMERULUS Mesangial intraglomerular cells Has a specific receptor for atriopeptides hormone secreted by myocardium Regulating in capillary vasodilatation Monday, June 15, 2009 Urinary System/AAJ/Histology FMUI

BOWMAN’S CAPSULE Consists of Visceral layer Podocytes Completely invest the glomerular Parietal layer Simple squamous epithelium Continuous at the urinary pole of renal corpuscle (tubular pole) to the proximal convoluted tubule Monday, June 15, 2009 Urinary System/AAJ/Histology FMUI

BOWMAN CAPSULE Monday, June 15, 2009 Urinary System/AAJ/Histology FMUI

BOWMAN’S CAPSULE Podocytes Has the primary processes embrace the capilleries give the secondary processes (pedicles) directly applied to the lamina rara externa Filtration slit diaphragma between pedicles Small pores Monday, June 15, 2009 Urinary System/AAJ/Histology FMUI

BOWMAN’S CAPSULE Monday, June 15, 2009 Urinary System/AAJ/Histology FMUI

BOWMAN’S CAPSULE Podocytes the plasma membrane of pedicles has a prominent glycocalyx with (-) charged Significant component of the filtration barrier Monday, June 15, 2009 Urinary System/AAJ/Histology FMUI

GLOMERULAR BASEMENT MEMBRANE
basal lamina Thicker membrane Elaborated by both capillary endothelial cells and podocytes Collagen type IV, fibronectin, laminin and proteoglycans Monday, June 15, 2009 Urinary System/AAJ/Histology FMUI

GLOMERULAR BASEMENT MEMBRANE
ME: 3 layers Lamina rara externa Between lamina densa and viseral layer of Bowman Lamina densa Middle layer 300 nm Collagen type IV Lamina rara interna Between lamina densa and endothelial cells of capillaries Monday, June 15, 2009 Urinary System/AAJ/Histology FMUI

GLOMERULAR FILTRATION
Filtration of blood plasma in glomerulus A continous process Essential for elimination of nitrogenous wastes Control of extracellular fluid composition and blood volume Structural components of the filter The fenestrated endothelium Basal lamina Filtration slit diaphragma Monday, June 15, 2009 Urinary System/AAJ/Histology FMUI

CORTEX OF THE KIDNEY Covered by capsule, perirenal connective and adipose tissues Consist of Renal corpuscle Proximal and distal convoluted tubule Juxtaglomerular complex Medullary rays (processes of Ferreini) Monday, June 15, 2009 Urinary System/AAJ/Histology FMUI

PROXIMAL CONVOLUTED TUBULE
Prox convoluted tubule Continuation of pars parietal of Bowman’s capsule A coil tube 14 nm in length Acidophilic stained Simple cuboidal epithelium with the unclear boundaries Monday, June 15, 2009 Urinary System/AAJ/Histology FMUI

A Coil tube The nucleus of cells Round, blue, located slightly far one to the others The cytoplasm Acidophilic due to the present of granule Brush border at the surface cell toward to the lumen Monday, June 15, 2009 Urinary System/AAJ/Histology FMUI

Functions Reabsoption of 80% of all filtrated fluid from the tubular filtrate Protein amino acid Glucose Water most ions and electrolyte All of glucose, amino acids and protein are reabsorbed Drains out the fluid with the normal osmolarity Monday, June 15, 2009 Urinary System/AAJ/Histology FMUI

DISTAL TUBULE Distal tubule subdivided into 2 pars Pars recta (ascending thick limb) continuation of ascending thin limb of Henle’s loop 9 to 10 nm in length; mm in diameter located in the outer part of medulla not permeable to water and urea permeable to sodium and chloride Pars convoluted (distal convoluted tubule) Monday, June 15, 2009 Urinary System/AAJ/Histology FMUI

DISTAL TUBULE Monday, June 15, 2009 Urinary System/AAJ/Histology FMUI

DISTAL CONVOLUTED TUBULE
Continuation of ascending thick limb of Henle loop Located in cortex Simple cuboidal cells with the clear boundaries Nucleus : round, blue Cytoplasm: basophilic granule Brush Border (-) Monday, June 15, 2009 Urinary System/AAJ/Histology FMUI

DISTAL CONVOLUTED TUBULE
Functions Reabsoption of sodium ions from tubular fluid Secretion of hydrogen and potassium ions into tubular fluid (acid-base balance) Controlled by hormone aldosterone Monday, June 15, 2009 Urinary System/AAJ/Histology FMUI

JUXTAGLOMERULAR APPARATUS
Composed of Macula densa Juxtaglomerular cells Extraglomerular mesangial (Polkissen or Goormaghtigh or lacis) cells Monday, June 15, 2009 Urinary System/AAJ/Histology FMUI

Macula densa Interpose between pars recta and pars convoluted Lies between the afferent and efferent glomerular arterioles The cells: tall and narrow The nuclei of these cells appear to be much closer together Monday, June 15, 2009 Urinary System/AAJ/Histology FMUI

Functions Osmoreceptor for sodium concentration Juxtaglomerular cells Modified smooth muscle in the tunica media of afferent arteriole close to the renal corpuscle Contain the granule Renin Erythropoetin Monday, June 15, 2009 Urinary System/AAJ/Histology FMUI

Extraglomerular mesangial cells Lacis or polkissen or Goormaghtigh cells Located between afferent and efferent arteriole and macula densa Groups of small, flat and bright cells with cytoplasmic processes Monday, June 15, 2009 Urinary System/AAJ/Histology FMUI

Functions Not yet clear Give the signals of sodium concentration changes from the macula densa to the juxtaglomerular cells Monday, June 15, 2009 Urinary System/AAJ/Histology FMUI

Monday, June 15, 2009 Urinary System/AAJ/Histology FMUI

THE MEDULLA OF KIDNEY Composed of a number of renal pyramids Loop of Henle Collecting tubule of koligens Collecting or papillary duct of Bellini Calyx minor Monday, June 15, 2009 Urinary System/AAJ/Histology FMUI

MEDULLA OF KIDNEY Collumna renalis of Bertini The part of renal cortex which is located in the medulla Monday, June 15, 2009 Urinary System/AAJ/Histology FMUI

THE LOOP OF HENLE Consist of Pars recta of proximal tubule (the thick descending limb) The thin descending limb The thin ascending limb The thick ascending limb Monday, June 15, 2009 Urinary System/AAJ/Histology FMUI

THE LOOP OF HENLE The parts of recta Straight part of proximal tubule, extends down to the outer medulla Has the same apperance to the proximal convoluted tubule with the smaller diameter Monday, June 15, 2009 Urinary System/AAJ/Histology FMUI

THE LOOP OF HENLE The thin descending and ascending limb The appearance similar to the blood capillary Simple squamous epithelium The lumen is round and not contain the erythrocytes Monday, June 15, 2009 Urinary System/AAJ/Histology FMUI

THE LOOP OF HENLE Thick ascending limb The appearance similar to distal convoluted tubule Monday, June 15, 2009 Urinary System/AAJ/Histology FMUI

COLLECTING TUBULE OF KOLIGENS
joins the distal convoluted to collecting duct of Bellini located in medulla histologically similar to distal convoluted tubule simple cuboidal cells with visible cell membrane Monday, June 15, 2009 Urinary System/AAJ/Histology FMUI

PAPILLARY DUCT OF BELLINI
Histologically simple columnar epithelium functions Passive reabsoption of water (concentrate the osmolarity of urine) influenced by ADH (antidiuretic hormone /vasopressin) secretion of H+ and K+ reabsorption of Na+ and HCO3- Monday, June 15, 2009 Urinary System/AAJ/Histology FMUI

PAPILLARY DUCT OF BELLINI
2 type of cells Principal cells Cytoplasm: pale with scanty organelles short microvilli and a single cilium reabsorb Na+ and secreted K+ Intercalated cells cytoplasm: dark due to mitochondria and polyribosome >> reabsorb bicarbonate and secrete H+ Monday, June 15, 2009 Urinary System/AAJ/Histology FMUI

CALYCES Calyces Minor calyx A funnel-shaped chamber, accept the urine leaving the ducts of Bellini at the area cribrosa lined by transitional epithelium contains a thin smooth muscle in lamina propria Major calyx Monday, June 15, 2009 Urinary System/AAJ/Histology FMUI

RENAL INTERSTITIUM Cortex of kidney connective tissue fibroblast macrophage Medulla of kidney connective tissue >> Laden interstitial cells prostaglandin medullipin I Monday, June 15, 2009 Urinary System/AAJ/Histology FMUI

RENAL VASCULATURE A. renalis (branch of aorta abdominalis) anterior & posterior branch segmental artery lobar artery interlobaris artery arcuate artery interlobular artery afferent artery Glomerular capillaries efferent artery vasa recta Monday, June 15, 2009 Urinary System/AAJ/Histology FMUI

URETER Cylindrical tube , 3- 4 mm in diameter, cm in length Histologically tunica mucosa transtitional epithelium tunica muscularis 2/3 proximal outer: circular inner: longitudinal Monday, June 15, 2009 Urinary System/AAJ/Histology FMUI

URETER Tunica muscularis 1/3 distal outer : longitudinal middle: circular inner: longitudinal Tunica adventisia fibrous connective tissue Monday, June 15, 2009 Urinary System/AAJ/Histology FMUI

URINARY BLADDER Organ for storing urine until the pressure become sufficient to induce the the urge for voiding consists of tunica mucosa transtitional epithelium lamina propria collagen and elastic fibers Monday, June 15, 2009 Urinary System/AAJ/Histology FMUI

URINARY BLADDER Tunica muscularis a thick coat 3 interlaced layers of smooth muscle arranged in anastomosing bundle difficult to distinguished Tunica adventisia/serosa a dense, irregular collagen elastic fibers Monday, June 15, 2009 Urinary System/AAJ/Histology FMUI

URETHRA A single tubular structure Communicates the urinary bladder with the outside In male longer than female Also as a route for semen Monday, June 15, 2009 Urinary System/AAJ/Histology FMUI

URETHRA In female 4-5 cm in length and 5-6 mm in diameter Lined by Transtitional epithelium near the bladder Stratified squamous non keratinized epithelium Monday, June 15, 2009 Urinary System/AAJ/Histology FMUI

URETHRA In male 15-20 cm in length 3 parts Pars prostatica Pars membranous Pars cavernosa (penile) Monday, June 15, 2009 Urinary System/AAJ/Histology FMUI

URETHRA Pars prostatica 3-4 cm in length Lies entirely in the prostate gland Lined by transtitional epithelium Pars membranous 1-2 cm in length Pass through the perineal membrane Lined by stratified columnar epithelium Monday, June 15, 2009 Urinary System/AAJ/Histology FMUI

Monday, June 15, 2009 URETHRA Pars cavernosa (penile) The longest part (about 15 cm ) in length Located in the corpus spongiose urethra Lined by stratified columnar epithelium stratified squamous nonkeratinized epithelium Monday, June 15, 2009 Urinary System/AAJ/Histology FMUI Urinary System

Monday, June 15, 2009 TERIMA KASIH THANK YOU SEE YOU AGAIN Monday, June 15, 2009 Urinary System/AAJ/Histology FMUI Urinary System

Ahmad Aulia Jusuf/ Histology FMUI/2009

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