GENERALITIES

The genitourinary system, also known as

urogenital, is a set of organs responsible for:
• The production of urine through which
nitrogenous metabolic wastes (urea,
creatinine and uric acid) are eliminated
• Osmoregulation: the maintenance of
homeostasis of the body with respect to
solute concentrations and water content
• Its architecture is made up of structures
that filter body fluids
STRUCTURES THAT MAKE IT UP
• 2 KIDNEYS
• 2 URETERS
• 1 BLADDER
• 1 URETHRA
 URETERES
They are two ducts or tubes about 21 to 30 cm long, and about 3 or 4 millimeters in
diameter, quite thin.
They carry urine from the kidneys in the renal pelvis to the bladder, at the base of which
they empty, forming the so-called ureteral meatuses, whose valve arrangement allows
urine to pass drop by drop from the ureter to the bladder, but not vice versa.
Its interior is lined with epithelium and its wall contains smooth muscle.
BLADDER
It is a hollow muscular-membranous organ
It is part of the urinary tract
It receives urine from the ureters, stores it, and expels it through the urethra to the
outside of the body during urination.
The bladder wall is made up of three layers:
• Serous layer: The parietal peritoneum covers the bladder on its upper surface and
posterior part and sides when it is full.
• Muscular layer: It is made up of smooth
CULRDA
LAYER OF THE
URACO EXTERNAL CIRCULAR LIA
muscle with three layers: MUSCULAR
EPITELl0 MUSCULATURE
URINARY

V External or superficial layer: Formed by MUCOUS

CAFA VERTEX
OF THE LAYER

longitudinal muscle fibers.

MEMBRANE BLADDER
LONGITUDINAL SMOOTH ADVENTICIA
MUSCULATUREFLASHLIGHT LXTLRNA

V Middle layer: Formed by circular muscle

INTERURETERAL
RODETF MEMO
fibers. URETERAL

V Internal or deep layer: Also formed by

longitudinal fibers
The three layers of the muscularis form the
detrusor muscle , which when contracted
expels urine and has the sphincters of the
urethra as antagonists.
TRIGON9
BLADDER

• Mucous layer: It is formed by urinary UVULA

BLADDE
transitional epithelium , which is a R
OWN SHEET
stratified epithelium of up to eight layers of NECK
cells, impermeable, in contact PROSTATE BLADDER

with urine, and by the lamina propria which VERUMONTARUM, CIIFSTA

SMOOTH MUSCULATURE
LONGITUDINAL

is —ITRICULOPROSTATIC,
EJACULATORY DUCT
URETHRAL EVTERNA

of connective tissue.
FUNCTIONING OF THE BLADDER
For good bladder control, all components of the system must act together:
• The pelvic muscles must support the bladder and urethra.
• The sphincter muscles must open and close the urethra.
• The nerves must control the muscles of the bladder and pelvic floor.
/ Ureters

Ureteral openings

mucosal folds

■ Peritoneum

Detrusor
muscle
Bladder trigone

Internal urethral orifice Internal urethral sphincter

(involuntary)

External urethral sphincter in the

Urethra
deep muscles of the perineum
Coxal (voluntary)

(pubis)
Is! External inter urethral

Extomnal urothral orifice

Anterior view of frontal section
URETHRA
The urethra is the tube
through which urine passes in
its final phase of the urinary
process from the urinary
bladder to the outside of the
body during urination.
The function of the urethra is
excretory in both sexes and it
also fulfills a reproductive
function in men by allowing
the passage of semen from the
seminal vesicles that lead to
the prostate to the outside,
that is, this duct is shared by
the urinary system and the
player.
male urethra
In the male, the urethra is about twelve
centimeters long and opens to the outside in the
urethral meatus of the glans. In this long journey,
the male urethra has different portions that are:
• Prostatic urethra: It runs through the prostate
gland, this structure is where the ejaculatory
ducts pour their contents.
• Membranous urethra : It is a short one or two
centimeter portion through the pelvic floor
musculature that contains the external urethral
sphincter, a skeletal muscle that voluntarily
controls urination. The membranous urethra is
the narrowest portion of the urethra.
• Spongy urethra : It is so called because it is
located inside the corpus spongiosum of the
penis.
female urethra
• In women, the urethra is between 3.5
centimeters long and empties into the vulva
between the clitoris and the vaginal introitus.
• This short length of the female urethra explains
the greater susceptibility of urinary infections in
women.
• Its function is to transport urine from the
bladder to the outside.
 KIDNEYS
• They are two organs that are part of the urinary
system.
• They are located in the back of the abdomen, one
on each side of the spine.
• They are surrounded by adipose tissue and extend
between the eleventh rib and the third lumbar
vertebra.
• Bean or bean shape.
• Elongated from top to bottom.
• Flattened from anterior to posterior.
• Brownish red color.
• Firm consistency.
• Very resistant parenchyma

KIDNEYS ARE RESPONSIBLE FOR:

• Eliminate waste from the body
• Regulate electrolyte balance and stimulate the
production of red blood cells.
KIDNEYS ARE RESPONSIBLE FOR:
• Regulate electrolyte balance (Secret vitamin D)
• Excrete waste through urine.
• Stimulate the production of red blood cells (Secrete
erythropoietin hormone)
• Regulate the volume of extracellular fluids.
• Regulate urine production.
• Participates in the reabsorption of electrolytes.
• Regulates blood pressure (Secret hormone kallikrein)

Are my kidneys working

well?
 Relations
Right kidney.
Posterior pole: adrenal gland.
Anterior face: liver, separated by
the peritoneum.
Internal part: descending
duodenum (retroperitoneal).
Bottom pole:
Lateral aspect: right colic
angle.
Internal face: interperitoneal
small intestine.
 Relations
Left kidney.
– Upper pole internal face:
• adrenal gland .
• Intraperitoneal stomach.
• Spleen.
- Middle portion: retroperitoneal
pancreas.
- Lower portion of the lateral face:
• left colic angle.
• descending colon.
- Inferior portion of the internal
face: intraperitoneal jejunum.
 INTERNAL STRUCTURE OF THE
KIDNEY
Renal pelvis
Chalices

Marrow

Ureter

Cortex
KIDNEY PARENCHYMA
Cortex
It is the external part of
the kidney and is
approximately 1 cm thick.
It contains 75% of the
glomeruli, proximal and
distal tubules, receives
90% of renal blood flow
and its main function is
filtration, reabsorption and
secretion.

Marrow
Renal pyramids (also called
Malpighian pyramids) are
cone-shaped tissues of the
kidney. The renal medulla
is composed of 8 to 18 of
these subdivisions
conical.
Blood supply
• Each kidney receives its
blood flow from the
renal artery, two of
which branch from the
abdominal aorta.
• Upon entering the hilus
of the kidney, the renal
artery divides into
smaller interlobar
arteries located between
the renal papillae.
• In the outer medulla, the
interlobar arteries
branch into the arcuate
arteries, which run along
the border between the
medulla and the renal
cortex, still giving off
smaller branches, the
radial cortical arteries
(sometimes called the
interlobular arteries).
Blood supply
• The branches of these
cortical arteries are the
afferent arterioles that
supply the glomerular
capillaries, which drain
into the efferent
arterioles.
• The efferent arterioles
divide into peritubular
capillaries that provide
an extensive blood
supply to the cortex. The
blood goes to the
medulla (those that
belong to the
juxtamedullary
nephrons), forming the
vasa recta . Blood supply
is closely linked to blood
pressure.
SEWER
SYSTEM
 THE NEPHRON

Kidney functional units (1.2 million).

• Two parts:

– Renal corpuscle : Bowman's capsule

and nephron (filters blood plasma).

– Renal tubule : towards which the

filtered liquid passes.
Nephro
n At the microscopic level, the kidney is made up of 1
to 3 million functional units, which are called
nephrons. It is in the nephron where the filtration of
blood plasma and the formation of urine actually
occurs; The nephron is the basic
constituent unit.
Nephrons regulate water and soluble
matter (especially electrolytes) in the body
by first filtering blood under pressure, then
reabsorbing some necessary fluid and
molecules back into the blood while
excreting other unnecessary molecules.
Reabsorption and secretion are achieved
with cotransport and countertransport
mechanisms established in the nephrons
and associated collecting ducts. Blood
filtration occurs in the glomerulus, a
collection of capillaries found within a
Bowman's capsule.
Nephro
It can be said that the nephron process is divided
n
into three fundamental steps:
•Filtration : consists of filtering a certain amount of
blood through a membrane that exists between the
Bowman capsule and the glomerulus. This
glomerular filtration occurs thanks to the fact that
there is a pressure difference between the blood
pressure and the pressure inside the glomerulus
(55mmHg - 45mmHg), this pressure difference
favors the blood to filter into the glomerulus so that
it is released. formation of primary urine.
•Reabsorption : it occurs at the level of the proximal
convoluted tubule, specifically in the loop of Henle,
where orders are given to the kidney through the
brain to absorb contents needed by the body.
•Secretion : it is the opposite of Reabsorption; At this
stage, excess blood components are eliminated by
secretions to the distal convoluted tubule. Secretion
is not the same as excretion. In secretion,
substances are secreted into the lumen of the distal
convoluted tubule so that they are finally excreted
in the urine.
PHYSIOLOGY
Bowman's membrane, Glomerulus and Tubules
 Liquid flow through n. cortical.
Capsule
glomerular
(Bowman)

Branch
descendant of
Loop of Henle

Branch
ascending of
Loop of Henle
Liquid flow through n. juxtamedullary.

Capsule
glomerular
(Bowman)

fine branch Branch

ascendant of descendant of
loop of Henle loop of Henle

thick branch convoluted tubule

distal
ascendant of (drains into tubule
loop of Henle manifold)
 1. Proximal
convoluted tubule
:
They are part of the nephron.
System that filters blood that
passes through the kidneys.
Reabsorbs 60% glucose, AA, ions.
It arises from the urinary pole of
the glomerulus and continues with
the thin descending branch of
Henle.
2. Loop of Henle.
Extended to the renal medulla, “U”
shaped, returns to the renal cortex.
Connects convoluted tubules
(proximal and distal).
Concentrates urine by losing
sodium and water.
It has two branches.
 3. DISTAL
CONVOLUTED
TUBULE.
Tubular secretion: excess waste and
substances that were not initially
filtered into Bowman's Capsule are
removed from the blood for
excretion.
 4. Collecting tubule .
Recipient tubule of the distal
tubules, which fuse together until
they drain into the calyxes

kidneys .
 Features
Regulation of the ionic composition of blood:

-sodium (Na+).
-potassium (K+).
-calcium (Ca2+).
-chloride (Cl-).
-phosphate (HPO.

• Regulation of blood Ph:

The kidneys excrete a large amount of H+ ions into the urine and conserve (HCO- 3) ions.

• Regulation of plasma volume:

by conservation or elimination of water:

plasma volume = PA
plasma volume = PA
• Regulation of blood pressure:
Secreting the enzyme renin:
It activates the renin-angiotensin-aldosterone system, its increase causes a
decrease in BP.

• Maintenance of blood osmolarity:

Separately regulating the loss of water and solutes in the urine. They maintain a relative
blood osmolarity (300 mOsm/L).

• Hormone production:

Calcitrol: active form of vitamin D: regulation of calcium homeostasis. Erythropoietin:

stimulates the production of GR.

• Glucose regulation.
Excretion of waste and foreign substances:

Excretion of waste and substances that have no useful function, product of

metabolic reactions:

-Ammonia and urea (deactivation of amino acids).

-Bilirubin (hemoglobin catabolism).

-Creatinine (degradation of phosphocreatine from muscle fibers).

-Uric acid (catabolism of nucleic acids).

Others: drugs and environmental toxins.