ANATOMY & PHYSIOLOGY OF THE URINARY

SYSTEM.
Presented by:-
MR. SAIHOU SANNEH
RN, RM, BSN&RH, FWACN.
 URINARY SYSTEM

The urinary system is responsible for

filtering wastes from the blood and
also, forming and secreting urine.
 ORGANS FORMING THE URINARY
SYSTEM
The urinary system is composed of:
- 2 Kidneys (Left & Right) which are the
primary organs for urine formation and
- The Accessory structures for the
transport and storage of urine, and these
includes:-
2 Ureters (left & right)
1 Urinary Bladder
1 Urethra
 THE KIDNEYS
GROSS STRUCTURE
Situation:
The Kidneys are 2 bean-shaped organs
located in the abdominal cavity, at the
level between the 12th thoracic and 3rd
lumbar vertebrae, one on each side of
the vertebral column.
Right kidney usually lies slightly inferior
to the left kidney due to pressure of the
liver.
 THE KIDNEYS CONT’D..
(GROSS STRUCTURE)
• Each kidney is surrounded by a
considerable amount of fat that helps to
support and maintain it in position.
• An average adult kidney is about 11cm –
13cm long, 5cm-7cm wide and 2.5cm-3cm
thick.
• The kidneys weighs about 120-170gms.
SAMPLE OF THE RIGHT
KIDNEY
THE RIGHT KIDNEY
Human kidney
 Relations
Of The Kidneys
• Anteriorly

Right right colic flexure

coils of small intestine
descending portion of duodenum
suprarrenal gland
stomach
Superiorly--------suprarenal, liver

Left pancreas
spleen
coils of small intestine
left colic flexure
 Relations
Of The kidneys
• Posteriorly
diaphragm
psoas and quadratus lumborum
lumbar plexus
• Laterally
Right- liver
Left- spleen
descending colon
ABDOMINAL DIVISIONS
 THE KIDNEYS
(Gross Anatomy Cont’d..)
• Internally, the kidneys can be divided
into 2 supportive and protective layers:
(Outer & Inner layers).
• THE OUTER LAYER is made up of thin,
smooth and fibrous tissue called RENAL
CAPSULE.
• This capsule covers most part of the
kidney except at the HILUM ( the area
where the renal artery enter and renal
vein & Ureter exit the kidney.
 THE KIDNEYS
(Gross Anatomy)
• The capsule is made mainly of fat and
connective tissue called GEROTIA’S
FASCIA.
• THE INNER LAYER is the functional
tissue and is composed of 2 very
important sections. These are:-
• The cortex
• The medulla.
 THE KIDNEYS
(Gross Anatomy)
• THE CORTEX is the layer next to the
renal capsule and THE MEDULLA lies
next to the Cortex.
• These two layers contain some fan-like
structures in sections or columns called
PYRAMIDS.
• There are about 12 – 18 pyramids in each
kidney.
• The tip or base of the pyramids are called
PAPILLAE.
 THE KIDNEYS
(Gross Anatomy)
• The papilla collects urine from the
pyramids and drains it into the collecting
tubes called MINOR CALYX.
• The Minor Calyces are cup-like
structures that merge to form MAJOR
CALYX.
• The Major calyces also merge to form a
funnel-shaped sac called THE RENAL
PELVIS.
 THE KIDNEYS
(Gross Structure)
• The lumen of the renal pelvis narrows
to form the URETER
• The Ureter connects to the URINARY
BLADDER and
• The Urinary bladder finally connects to
the URETHRA and then to the external.
 THE KIDNEYS
(Microscopic Structure)
• The kidney is composed of a NEPHRON.
• The Nephron is the functional unit of the
kidney responsible for urine formation
from the blood.
• Each kidney has over 1 million nephrons
and each nephron separately makes urine
from the blood.
• There are 2 kinds of nephrons. These
are:-
 THE KIDNEYS
(Microscopic Structure cont)
A) CORTICAL NEPHRON:- This kind is
short and all its parts are located in the
renal cortex.
B) JUXTAMEDULLARY NEPHRON:- This
type constitute about 20% of all nephrons.
• They are longer and their tubes are like
blood vessels.
• They are found deep into the medulla and
they mainly help to concentrate the urine in
terms of low fluid intake.
 THE KIDNEYS
(Microscopic Structure Cont)
• Each nephron is composed of distinct parts.
These are:-
• THE BOWMAN’S CAPSULE
• THE GLOMERULUS and
• THE TUBULAR SYSTEM which is composed
of:-
• PROXIMAL CONVOLUTED TUBULE
• LOOP OF HENLE
• DISTAL CONVOLUTED TUBULE and
• THE COLLECTING DUCT.
 THE KIDNEYS
(Microscopic Structure)
• THE BOWMAN’S CAPSULE is a cup-like
structure that surrounds the glomerulus.
• THE GLOMERULUS is the capillary network of
afferent and efferent arterioles formed in the
cup of the Bowman’s capsule.
• THE PROXIMAL CONVOLUTED TUBULE is the
narrow part of the tubule tissue of the
bowman’s capsule located close to it.
• It twists and turns, and finally straightens into
a descending limb.
 THE KIDNEYS
(Microscopic Structure)
• THE LOOP OF HENLE is a descending loop
that dips in the direction of the medulla but
forms a hair-pin loop and ascends into the
cortex.
• THE DISTAL CONVOLUTED TUBULE is the
thick segment of the ascending loop of Henle
that also gets twisted and ends at the
collecting ducts.
• THE COLLECTING DUCTS are located in the
kidneys.
• They collect urine and pass it through the
papillae to empty into the renal pelvis.
SAMPLE OF A NEPHRON
THE NEPHRON
 BLOOD SUPPLY TO THE
KIDNEYS
• The kidneys receive blood supply of about
600 – 1.3litres per minute which is about 20-
25% of the cardiac output.
• This blood reaches the kidneys via a single
RENAL ARTERY which branches from the
abdominal aorta.
• The renal artery divides into smaller arteries
to supply all the areas of the renal tissue
(Parenchyma).
 BLOOD SUPPLY TO THE
KIDNEYS
• Each of these small branches eventually
form an afferent arteriole which feed the
nephron directly to form urine.
• The afferent arterioles divides into a
capillary network called glomerulus.
• The network in the glomerulus eventually
unite to form efferent arterioles which collect
wastes out to the abdominal vein and then
to the inferior vena cava.
 BLOOD SUPPLY TO THE
KIDNEYS
• Specialized cells in the afferent and
efferent arterioles, and the distal
convoluted tubule called Juxta
Glomerular Complex (JGC) cells or
Macula Densa, produce and store RENIN.
• Renin is a special hormone that regulates
blood flow to the kidneys.
• It also regulates glomerular filtration rate
(GFR) and systemic blood pressure.
 BLOOD SUPPLY TO THE KIDNEYS
RENIN is secreted when the JGC-Cells
sense some changes or a drop in the
following:-
• Reduced blood volume
• Decreased blood pressure or
• Decreased sodium volume.
• When this happens, Renin will be
secreted and it will act on an inactive
plasma protein in the liver called
ANGIOTENSINOGEN and converts it into
ANGIOTENSIN-I.
 BLOOD SUPPLY TO THE
KIDNEYS
• Angiotensin-I is immediately further
degraded or broken down by another
enzyme in the kidneys called
ANGIOTENSIN-CONVERTING ENZYME
(ACE) to form ANGIOTENSIN-II.
• Angiotensin-II causes constriction of
many blood vessels especially that of
the peripherals.
• This causes a widespread reaction
leading to secretion of ALDOSTERONE.
 BLOOD SUPPLY TO THE
KIDNEYS
• Aldosterone acts on the distal
convoluted tubule causing increase
kidney reabsorption of sodium and
water to restore blood pressure, blood
volume and blood sodium level.
• This process is however temporal and
need to be regulated if not, the blood
pressure may rise up again persistently.
BLOOD SUPPLY TO KIDNEYS
BLOOD SUPPLY TO KIDNEYS
 FUNCTIONS OF THE
KIDNEYS
• The kidneys are responsible for the
formation of urine. In order to achieve this,
they perform both REGULATORY and
HORMONAL functions.
• THE REGULATORY FUNCTION:- This
function involves the regulation or control of
fluid, electrolyte and acid-base balance.
• This process occurs in 3 stages and
includes:-
 FUNCTIONS OF THE KIDNEYS
• A) Glomerular Filtration:- This is the first stage
of urine formation.
• When blood from the afferent arterioles enter the
glomerulus, H20, electrolytes and other particles
such as creatinine, glucose, urea, nitrogen &
others are filtered across the glomerular
membrane and into the bowman’s capsule.
• Large molecular weight substances such as
albumin, globulin, RBCs and others do not pass
through the filtrate as they are not supposed to
be present in the final urine.
 FUNCTIONS OF THE KIDNEYS
• A normal filtration rate is about 125mls/minute
and is called Glomerular Filtration Rate (GFR).
• Approximately, 1-3litres of urine is excreted in
an average normal adult.
• The GFR is related to the blood flow and the
ability of the kidneys to self regulate this keeps
the GFR constant.
• The GFR is also controlled by the constricting
and dilating afferent and efferent arterioles.
• When the afferent arterioles constrict and/or
efferent arterioles dilate, pressure in the
Glomerular capillaries decreases, viz-a-viz.
 FUNCTIONS OF THE
KIDNEYS
• B) Tubular Reabsorption:- This is the 2nd
stage of urine formation.
• It maintains the normal filtrate of urine output
at 1-3litres/day to prevent dehydration.
• As the filtrate process passes through the
nephron, variable amounts of H20 and
electrolytes are reabsorbed and returned to
the blood to be used by the body cells.
 FUNCTIONS OF THE
KIDNEYS
• In the loop of Henle, reabsorption continues and
H20 is also conserved.
• In the distal convoluted tubule, two important
functions occur. These are:-
• Regulation of H20 and acid-base balance.
• These two functions are as result of influence of
some hormones such as:-
• i) antidiuretic hormone (ADH):- This one is
released by the posterior pituitary gland and it
helps in H20 reabsorption. ADH makes the
tubules to increase their permeability to H20.
 FUNCTIONS OF THE
KIDNEYS
ii) Aldosterone:- this hormone is released
from the renal cortex and distal convoluted
tubule.
• Aldosterone helps in the regulation of H20
and sodium and also in the excretion of
potassium.
• Acid-base regulation involves reabsorbing
and conserving bicarbonate while secreting
hydrogen ions.
 FUNCTIONS OF THE
KIDNEYS
C) Tubular Secretion:- This is the 3rd stage of
urine formation.
• In this process, substances move from the blood
into the tubular filtrate.
• The molecules pass from the peritubular
capillaries across the capillary membrane to the
cells that line the tubules.
• From there, the substances move into the urine
to enter the collecting ducts, to the renal pelvis,
ureters, bladder, urethra and finally out of the
body.
 FUNCTIONS OF THE
KIDNEYS
2. HORMONAL FUNCTION:- In this function, the
kidneys deal with the control of RBCs formation,
blood pressure and vitamin D activation.
• During this process, the kidneys produce Renin,
Prostaglandins, Bradykinin, Erythropoietin and
activated Vitamin D.
i) Renin production:- Renin helps in the
regulation of B/P. It is released when there is a
decrease in blood flow, volume or pressure
through the renal arterioles or when there is a
reduced sodium ion concentration in the blood.
 FUNCTIONS OF THE
KIDNEYS
ii) Prostaglandin Production:- The kidneys
produces prostaglandin E2 (PGE2) and
Prostacylin.
• These two hormones help to regulate glomerular
filtrate. PGE2 also inhibits ADH action.
ii) Bradykinin Production:- The presence of
angiotensin II, prostaglandin and ADH stimulates
the release of bradykinin.
• Bradykinin dilates the afferent arterioles and
increase capillary membrane permeability to
some solutes.
 FUNCTIONS OF THE
KIDNEYS
iv) Erythropioetin Production:- This
substance is produced and released in
response to decreased O2 tension in the
renal blood supply.
• Erythropoietin stimulates red blood cell
production in the bone marrow.
• When the kidney function is destroyed,
erythropoietin production is decreased.
 FUNCTIONS OF THE
KIDNEYS
v) Vitamin D Activation:- metabolic
conversion of vitamin D takes place in the
skin through exposure to ultra-violet light.
• In this process, vitamin D is converted to
active form (1,25-dihydroxycholecalciferol)
• Activated vitamin D is necessary for
calcium absorption in the G.I.T.
 URINARY SYSTEM
Ureters
• The ureters are muscular ducts that transfer
urine from the renal pelvises of the kidneys to
the urinary bladder.
• They are located on either side of the intra
abdominal cavity.
• The ureter is about 25cm -45cm long and
1cm-1.5cm in diameter.
• The diameter of the ureter narrows in 3
areas.
 URINARY SYSTEM
Ureters
• The upper 3rd narrows at the point where the renal
pelvis becomes the ureter and is called Uretero-
Pelvis Junction (UPJ).
• It narrows as it arches towards the abdominal wall
called aorto-iliac bend.
• It also narrows upon entering the posterior wall of
the urinary bladder at an oblique angle called
Uretero-Vesical Junction(UVJ).
• The ureter tunnels through the bladder tissue a
few centimeters in an angle called TRIGON.
 URINARY SYSTEM
Ureters
• The ureter is composed of 3 layers.
• THE OUTER LAYER of mucus lining.
• THE MIDDLE LAYER contain muscle
fibers and nerve fibers from the lower
spinal cord.
• THE INNER LAYER is of fibrous tissue.
URINARY SYSTEM
Ureters
 RELATIONS OF THE
URETERS
Relations
• Abdominal portion
Anterior
duodenum
Right mesentery root
gonadal vessels

Left gonadal vessels

• At the pelvic brim cross anterior to the

common iliac a. or external iliac a.
 URINARY SYSTEM
Ureters
Relations
• Pelvic portion
Male
ductus deferens
seminal gland
Female
Ovaries
broad ligament of uterus and uterine
Uterus
vagina
THE URETERS
 URINARY SYSTEM
Urinary bladder
• The urinary bladder is a collapsable storage sac
composed of muscular tissue.
• Its upper surface lies next to the peritoneal cavity.
• On average, about 200 – 250mls can make the
bladder to distend.
• When urine quantity reaches 400mls, the person
will feel uncomfortable.
• The bladder capacity varies with individuals
ranging from 1000mls to 1800mls.
 Urinary bladder

• The distension of the bladder stimulates

the receptors in the bladder wall.
• This causes reflex contraction of the
bladder and also relaxation of the external
sphincter and emptying of the bladder.
• The voluntary contraction of the external
sphincter is a learned response and
controlled by normal neurological function.
 Urinary bladder
• Any damage to the urethra, spinal cord or
motor area complex can lead to incontinence.
• The normal average urine output of an
average normal adult is about 1500mls to
2500mls/24hrs. This may vary with food and
fluid intake, weather or health status.
• Most people void 5 – 6 times/24hours also
depending on food & fluid intake, weather and
health status.
 Urinary bladder
FUNCTIONS
• Serve as a recevoir for temporary storage
of urine.
• Provides continence and enables voiding
or micturition.
• It secrets some fluid that resist bacteria
invasion.
THE URINARY BLADDER
 RELATIONS OF THE
BLADDER
Relations
• Anterior
Empty- pubic symphysis
Full- anterior abdominal wall
• Posterior
Female-uterus and vagina
Male- seminal glands
deferens ductus
rectum
 THE URETHRA
• The urethra is a narrow tube-like structure
that is line with mucus membrane and
epithelial cells.
• In men, the urethra is about 15cm- 20cm
long with its meatus located at the tip.
• In women, the urethra is about 2.5cm –
5cm long and lies behind the symphysis
pubis anterior to the bladder.
• Its meatus bends slightly below the clitoris
 URINARY SYSTEM
Urethra
The urethra is made up of 3 sections in males.
THE PROSTATIC URETHRA:- Passes through
the prostate gland form the bladder.
MEMBRANOUS URETHRA:- Transverses the
walls of the pelvic floor.
CAVENOUS URETHRA:- Extends the whole
length of the penis.
Normally, the urethra contains some bacteria
but the mucus membrane lining it secrets a
substance that is bacteriostatic.
 THE END.

THANK YOU.
ANY
QUESTIONS?