The Urinary System
The Medics Club 2023-24
Rumaisa, Grade 8
The 4 main functions of the urinary system are:
● Eliminate liquid waste called urea (substance formed by protein breakdown in the liver)
● To maintain balance of chemicals (such as potassium and sodium) and salinity
● Regulate blood pressure
● Red blood cell production
Source: Johns Hopkins Medicine (2)
Structure
1: Human urinary system
2: Kidney
3: Renal pelvis
4: Ureter
5: Urinary bladder
6: Urethra
7: Adrenal gland
8: Renal artery and vein
9: Inferior vena cava
10: Abdominal aorta
11: Common iliac artery and vein
12: Liver
13: Large intestine
14: Pelvis
Source: Wikipedia (1)
Kidneys
(1: Human urinary system), (2: Kidney), (3: Renal pelvis), (7: Adrenal gland), (8: Renal artery and vein)
A pair of kidneys receive 25% of the blood pumped by the heart. The kidneys are mainly responsible for detecting
waste in your blood and disposing of it by turning it into urine. The body’s eight litres of blood pass through
functioning kidneys between 20-25 times a day, meaning they filter 180 litres every 24 hours. The ingredients in your
blood change constantly based on ingested food and drink, explaining the importance of the kidneys being on
permanent duty.
Source: Emma Bryce, TED-Ed (3)
Anatomy of the Kidney:
Renal artery: Blood vessel that carries oxygenated blood from
the heart to the kidneys. This blood has waste which is
removed by the kidneys and its oxygenated properties provide
the kidneys with nutrition and oxygen.
Renal vein: Blood vessel that carries deoxygenated blood from
the kidneys to the heart. This blood has been filtered in the
kidneys and is now lacking impurities.
Hilum: An entry and exit site for structures servicing the kidney:
blood vessels, nerves, lymphatics, and ureters.
Renal cortex: The outer part of the kidney. Where the filtering
actually takes place.
Renal medulla: The inner part of the kidney.
Renal pelvis: The chamber of the kidney responsible for collecting urine right before it leaves the kidney.
Minor calyx: Receives and collects urine that is released
through the apex of the renal pyramids and passes through the
renal papillary ducts and renal papilla and into the minor calyx.
Major calyx: Collects urine from minor calyces and
accumulates it into the renal pelvis.
Renal papilla: A gateway for renal filtrate to pass through, from
the apex of the renal pyramid to the minor calyx.
Renal pyramids: Kidney tissue shaped like pyramids, which are
part of the renal medulla and the parenchyma of the kidney.
They are primarily important for urine production.
Renal columns: Dips around the renal pyramid. They are a part
of the renal cortex.
Fibrous capsule: Tough, fibrous tissue having roughly 2 mm in width and encapsulating the kidney.
Renal sinus: A hollow area inside the kidney housing fat responsible for protecting the structures inside the kidney.
Perirenal adipose tissue: Also called perinephric adipose tissue, this is fat which surrounds the kidney and keeps it
stable in the urinary system. It also prevents any external damage to the kidneys.
RENAL MICROANATOMY:
Nephrons
While the above structures in the kidney are responsible for processing produced
urine, urine is actually intricately made in the renal parenchyma, which houses
over a million nephrons. Nephrons – as seen in the diagram on the left – are
units in the renal pyramids and renal cortex which remove impurities from the
blood and process it into urine.
The two parts of a nephron: Glomerular capsule and a renal tubule.
Renal tubules of several nephrons connect to a common collecting duct.
Glomerulus: A network of capillaries (blood vessels with thin walls, which is
where veins and arteries meet).
Bowman’s capsule: A cup-like sac that
surrounds the glomerular capillary loops
and creates a urinary space through which
filtrate can enter the nephron and pass to
the proximal convoluted tubule.
Proximal convoluted tubule: Responsible
for reabsorbing filtered glucose and other substances (sodium, water, chloride,
amino acids, urea) into the
peritubular capillaries (through
epithelial cells).
Peritubular capillaries: The
capillaries surrounding the renal
tubules branch out from the
efferent arteriole and rejoin to
form venules that drain into the
renal vein, by which blood leaves
the kidney. They secrete waste
into the renal tubule.
Pressure gradient: High to low,
causes waste to leave the glomerulus and enter the Bowman’s Capsule.
Loop of Henle (descending and ascending): Maintain an osmolarity gradient (https://youtu.be/aubZU0iWtgI) in the
medulla that enables the collecting ducts to concentrate urine at a later stage.
Descending loop of Henle: Permeable to water, but not salt. which is reabsorbed,
Ascending loop of Henle: Permeable to salt (sodium chloride), impermeable to water.
Distal convoluted tubule: Regulates pH.
Collecting duct: Contiguous with the distal convoluted tubule of several nephrons.
3 MAIN STEPS OF URINE FORMATION IN NEPHRONS
1. Glomerular filtration
The process through which filtrate is removed from blood.
Blood enters the glomerulus via the afferent arteriole, and
leaves via the efferent arteriole. Since the afferent arteriole
is much larger than the efferent one, there is a much higher
hydrostatic pressure in these capillaries than normal,
creating a pressure gradient, and driving waste of the blood
out of the glomerulus and into the Bowman’s capsule.
The glomerular filtration rate (GFR) describes the amount of
filtrate produced per minute. This rate is regulated through
sympathetic (via the nervous system) control and hormonal
control.
The substances of this filtrate include water, inorganic ions, glucose, amino acids, and metabolic wastes such as
urea and creatinine (produced in the muscles).
2. Tubular secretion and reabsorption
After glomerular filtrate is extracted from the glomerulus, it travels down the:
1) Proximal convoluted tubule
Filtered glucose and other substances (water, inorganic ions, glucose, amino
acids, and metabolic wastes such as urea and creatinine) are absorbed into the
peritubular capillaries.
2) Descending loop of Henle
Permeable to water but not to filtrate, so, at this stage, the urine is more
concentrated or “salty.” This saline gradient can be seen in Diagram 1.2.
3) Ascending loop of Henle
Permeable to filtrate but not water, so the substance is more diluted again.
4) Distal convoluted tubule
A pathway connecting the nephron to the collecting duct. Urine is still permeable
at this stage.
3. Water conservation
5) Collecting duct
A pathway for urine to exit the renal medulla and enter the renal pelvis.
This part of the nephron is also permeable to water, and is under
hormonal control and control of the central nervous system. This
allows water concentration in urine to be regulated based on the
condition of the person.
Detailed Diagrams:
Sources:
National Center for Biotechnology Information (6)
Science Direct (7)
Alila Medical Media (8)
Khan Academy (9)
Kidney Facts
- In the human body, the right kidney is located slightly lower than the left one since the liver’s bulkiness
effectively pushes it down (Source: Dr. John Campbell 4).
- Together, the renal cortex and the renal medulla make up the parenchyma of the kidneys, which is the
functioning part that filters blood and makes urine (4).
- Renal pain is one of the most extreme types of pain, which is primarily because the fibrous tissue
surrounding the kidneys, also known as the renal capsule, is rich in nociceptors, otherwise called pain
receptors (4).
- On top of the renal capsule, the kidney often has perirenal tissue, which, like the pericardium of the heart,
keeps the kidneys stable in the abdominal cavity. It also has perirenal / perinephric adipose tissue, which is
fat that surrounds the kidneys to prevent any external traumas (4).
- Most people have 6-10 renal pyramids, with 8 being the average (4).
- A mature human kidney is estimated to have 900,000 glomeruli (Source: NIH 6).
- Our glomerular filtrate volume in a day is 150 litres for women and 180 litres for men (6).
- Only 1% of this 150-180 L is excreted, while the remaining 99% is reabsorbed by the renal tubule (6).
Additional:
The Adrenal Gland
The adrenal glands are small, triangular glands located on the top
of both kidneys, thus being named adrenal (since “renal” means
relating to the kidneys). These glands produce hormones that
help regulate your metabolism, heart rate, blood pressure,
immune system, response to stress, and other essential
functions.
Some of the hormones released:
- Cortisol (metabolism and stress response)
- Adrenaline (response to stress: fight or flight)
- Aldosterone (regulating blood pressure)
- Androgens and estrogens (regulates the physiology of the
reproductive system)
Source: Johns Hopkins Medicine (5)
Most other hormones are released by the hypothalamus and
pituitary gland in the brain.
Major Blood Vessels
(8: Renal artery and vein), (9: Inferior vena cava), (10: Abdominal aorta), (11: Common iliac artery and vein)
Renal artery and vein: The renal artery and vein both enter the kidney via the renal hilum. The renal artery branches
out into smaller arterioles and connects with the miniscule renal venules, forming capillaries. The renal venules come
together to form the renal vein and carry blood to the heart.
Inferior vena cava: The renal veins of each of the two kidneys in the mammalian body come together to the inferior
vena cava, which heads up to the heart to get oxygenated.
Abdominal aorta: The renal arteries of each of the two kidneys in the mammalian body come together to the
abdominal aorta, which continues circulating in the body, in order to support life by providing nutrients to all organs
and tissue.
Common iliac artery and vein: Pairs of blood vessels which supply blood to the lower half of the body.
Ureter
(4: Ureter)
The ureters start at the renal hilum and are continuous with the renal pelvis. They allow the flow of urine from the
kidneys to the bladder.
● There are two ureters, one attached to each kidney.
● The ureters go down the posterior side of the abdominal cavity and are connected to the posterior side of the
bladder.
○ Retroperitoneal. Behind the peritoneal (membrane lining the abdominal cavity)
● Each ureter is about 25 cm long and nearly 3 mm in diameter (the same thickness as a
grain of rice).
● The lumen of the ureter has common constriction locations: (see diagram →)
○ Renal pelvis-ureter
○ Pelvic brim
○ Part of ureter attached to bladder wall
○ These are the locations more susceptible to kidney stones.
Source: The Noted Anatomist (10)
Bladder
(5: Urinary bladder), (6: Urethra)
● Located in the pelvic cavity.
● Stores urine until voluntary (or, in some cases, involuntary) urination.
● The size depends on the volume of liquid inside it.
● As it fills up, it makes a circle shape, and as it fills up more, it forms a
pear shape.
● The passing of urine through the ureters is an active, peristaltic
(relating to contracting and relaxing/expanding movements) process.
● Infra-peritoneal (below the peritoneum) in both males and females.
Source: The Noted Anatomist (10)
Urine Composition
More than 90% of urine is simply water.
The majority of the remainder includes: inorganic salts (sodium chloride –table salt–, calcium chloride, etc) , urea
(nitrogenous byproduct of protein breakdown in liver), organic compounds (carbohydrates, fats, proteins, etc), and
ammonia (nitrogenous byproduct of metabolism in muscle tissues, is later converted into urea in the liver).
Urine may also contain: proteins, hormones, and a range of metabolites (substance produced as a result of
metabolism), which depends on what is introduced into the body.
Surrounding Organs
(12: Liver), (13: Large intestine), (14: Pelvis), Urethra
Intestine: Responsible for breaking down proteins into amino acids / ammonia.
Liver: The liver is responsible for processing amino acids / ammonia into urea, which is then absorbed into the
bloodstream and received by nephrons in the kidney as part of glomerular filtrate.
Pelvis: Middle part of the human body between the lumbar region of the abdomen superiorly and thighs inferiorly.
Urethra: Tube/duct which allows for urine to leave the body. Length and location is dependent on gender.
Facts
- The urethra is smaller in women and longer in men (4).
Physiology
1. We drink water.
2. Water travels down the digestive tract and to the small intestine.
3. It is absorbed into the bloodstream via villi present in the small intestine.
4. As this same blood moves through the body, it picks up extra fluid, chemicals, and waste.
5. The renal artery enters the kidney via the renal hilum.
6. This artery branches out into much smaller arterioles.
7. These miniscule arterioles then group together to form the glomerulus.
8. Filtrate from the glomerulus is collected in the Bowman’s capsule.
9. This filtrate travels through the tubule of the nephrons (about 1 million of which we have in the renal medulla
of each kidney), where the concentration of filtrate and water in the urine is controlled.
a. The filtrate and water which is not needed in urine is expelled to the peritubular capillaries, which end
up as the renal vein and exit the kidney. They head to the heart to get oxygenated.
10. As the final product of urine exits the collecting duct (last part of) the nephrons, it enters the renal pelvis and
exits via the ureter.
11. The ureter helps transport this urine to the bladder, where it is stored.
12. Sphincter muscles of the bladder contract when it is time for urination, and urine exits the body and is
expelled to the external environment via the urethra.
Malfunctions and Illnesses
● Urinary Tract Infection (UTI)
● Kidney stones
● Pyelitis
● Nephritis
● Pyelonephritis
○ Itis = inflammation, usually caused by infection
● Ureteral tumours
● Kidney failure (link)
Vocabulary
Word Meaning
Renal parenchyma The most functional part of the kidney, which includes the renal medulla and the renal
cortex.
Capillary A type of blood vessel that forms a network between arterioles and venules (usually with
hairlike thickness).
Lumen The central cavity of a hollow / tubular structure.
Abdomen Portion of the body between the thorax and pelvis, containing mainly digestive organs.
Sources
1. Wikipedia: The Urinary System
2. Johns Hopkins: Anatomy of the Urinary System
3. TED-Ed: How do your kidneys work?
4. Dr. John Campbell: Urinary system and kidneys
5. Johns Hopkins: Adrenal Glands
6. National Center for Biotechnology Information: Anatomy, Abdomen and Pelvis: Bowman Capsule
7. Science Direct: Peritubular Capillaries
8. Alila Medical Media: Formation of Urine - Nephron Function, Animation.
9. Khan Academy: Diffusion and osmosis
10. The Noted Anatomist: Ureter, Bladder and Urethra
https://quizlet.com/588935670/kidney-anatomy-diagram/
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