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Urinary system

~~~~~~~~~~~~~~~~~~~~ We mean by that ~~~~~~~~~~~~~~~~~~~~ 1) Kidneys ( right &left) . 2) Ureter ( right &left ) . 3) urine bladder . 4) urethra . location : lie in the back of the abdominal cavity on each side of vertebral column , since we talk 2 organs (rt&lf) it means it's
important

if you have 1 kidney you still a normal person that's mean 50% of the total function of the renal system is enough for the human that's why renal donation and loosing doesn't hurt human life. Also if we take a sagittal section and look at it we find the kidney is bean shape and it has 2 colors (cortex out side, medulla central),, why they look different we will see the reason for that !

the heart distributes the blood for the body if we are exercising the pump of the blood go to the muscle if we are thinking the pump of the blood go to the brain if we are digest some of the blood extra go to GI & if we breathing heavily extra blood go to respiratory system NOW lt's compare the portion of the blood going to the renal system with the portion going to the other system . 20% of the cardiac out put going to the kidneys but they don't need that much of blood for feeding (if we want only feeding the kidneys we need 1% of the cardiac out put ) This extra amount of the blood is for another reason this reason is the major function of renal system which is clearance , get rid of metabolic waste The major function of the renal system :1- maintaining ECF stability volume & Composition .

2- main route for eliminating potentially toxic wastes & foreign compounds from the body 3- acid-base balance (PH=7.4) 4- producing erythropoiten => the major solid basement for blood formation "erythrocyte" 5- producing renin which triggers a chain reaction important in salt conservation by kidneys (stabilize the blood pressure in long and short term ) 6- converting vitamin D into its active form

THE most strong system to keep PH = 7.4 is renal system .

The major function of cleaning by forming urine every day we loose water and drink water and we should loose the same amount we took per day if the total body fluids is constant but if there is a defect of the body fluid we should take extra fluid by input The urine out put is the way by which the kidneys work every day you should take 2.5L of fluid and loose 2.5L The major part way by which u loose body fluid is urine out put Urine out put = 1.5 L $ if we do not drink any water we should urinate .5L bcz every day the metabolic waste should diluted in .5 L of water and execrated out side it's the obligatory volume of urine THAT'S WHY PEOPLE DIE when they don't drink water bcz they loose their own water , the total body fluid is 40L if we keep it 40L we don't die but we don't keep it every day we should urinate .5L WE CAN'T LIVE MORE THAN 4 DAYZ WITHOUT WATER for other reason not for urine out put Nephron: the functional unit, 2 million in both kidneys Each nephron works independently , if I only have half of them workable (1 million) am normal physiology


1-

2 major parts of the nephron : The glomerulus . 2- tubular system .

* 80% of nephron cortical bcz mainly it's 1) located in the peripheral part of the cortex .. 2) MOST of the tubular system located in cortex, 3)don't have vascular structure . * 20% of nephrone juxtamedullary : 1) located in the border line between cortex & medulla . 2) Very long part of tubular system located in the medulla . In order to form the urine First THE GLOMERULUS : will filter huge amount of plasma by filtration NOT transport . the glomerulus structure =>> endothelial structure of capillaries
when

the vascular enter the kidney it will divide to small arteriole called afferent arteriole it goes in side the glomerulus & it divides inside by forming capillary set (net work of capillaries inside the glomerulus) after finishing these structure of the capillaries it will go out but not as venule AS efferent arteriole . The structure of vascular in side the glomerulus : Afferent arteriole >>capillaries >> Efferent arteriole And when I say arteriole u should remember the structure : endothelial cells & smooth muscle (u can constrict u can dilate ) Now when efferent goes out the glomerulus it will form another capillaries sround the tubular system & it's called pritubular capillary set Y3niii arteriole >> capillary >> arteriole >> another capillary (the main function is performed here in these 2 capillaris set ) Then we have the venules & going out side by vein & back to the heart ,,,, now out side the capillary set we have another structure of epithelial cells : Bowman's capsule >> One layer of epithelium inside & another out side and vacuoles space which is full of filtrate << .

-slide no.12 {sagittile section of glomerulus } Out side the capillary set we will have the internal layer of bowman's capsule which looks like net work of epithelial structure hugging the capillaries & these called podocytes cells& the outside epithelial structure which is located in the out side area in between we have space full of filtrate .
what

is the different between this capillary structure & the systemic capillary ^_^ ? 1) they are more permeable than systemic capillary 100 times In other word if u want to filter plasma from this capillaries u will be able to filter it every it very easily compare to the systemic capillaries ,,,, u know that capillary have small pores in it if u count them in systemic circulation u might find 10 them in each surface area but here u might find 1000 of them SO the permeability is 100 times more than systemic capillaries . 2) podocytes which is the cell of epithelial structure of bowman's capsule also they are not fill such attaching to each other they are a network with podocyte like my hand so in between my finger there is another spaces which easy for the plasma to go so the permeability is very high even in the epithelial structure . 3) they have ive charge between podocytes and endothelial & epithelial which is the basement . --- anyway--- the most important concept to understand we are talking about high permeability in the glomerulus . --- the way to form the urine is simple by looking to the 3 major process going on in the nephrone :
1) 2) 3)

Filtration {in the glomerulus } . Reassertion {in the tubular system } . Tubular secretion .

able to filter able to reabsorb & able to secret material from the plasma HOW ? BY very accurate way nephrone knows what we need & what we don't need he will look to the plasma (plasma is the fluid part of th bld which contain : Na,k ,Ca ,F , Cl ,PO4 ,organic,non-organic,metabolic waste ,uria ,uric acid , keratinin ,fatty acid , proteins , vitamins , drugs , additive ) Nephrone know that he don't need toxic material So when the toxic material filter here it will not be the absorb he know what the absorption taking back filtration taking out the absorption back ,secretion taking out so the nephron 2 million nephrones the know what u need & what u don't by this way they form the urine execration the bad material not taking them back ,taking the good material in 2 different ways : 1) partially reabsorbtion 2) completely reabsorbtion
there

nephrone

is a glucose in our plasma & the glucose is badly needed for our life so the nephrone will take back 100% of the glucose from the filtration but uria is a toxic material so they will not taking the uria back ,, Na every taking Na as a salt if u take too much salt the nephrone will leave the salt in the urine if u don't take much Na or NaCl the nephron will take back most of the Na SO by the end of the day the nephrone will deal with the filtrate by leaving bad thing taking good thing 100% , & taking some of the partially needed material . So by the end of the day we will have filtration reabsorption & secretion the next result of those 3 process is the urine formation wehen the urine is formed it will go down to the pelvis of the kidney then out side to the ureter the to urine bladder then outside by urethra , in the pelvis of the kidney & the ureter & the urine bladder & the urethra no change to the composition of the urine the only area we can change the composition of the urine is the nephrone after that those structure I told they are conductive system only but the function of the renal system located only in the nephrone let's take in details about each step of those (filtration ,absorption ,reabsorbtion ,secretion) .
1)FILTRATION

: which occur in the Glomerulus called Glomerular filtration bld go to the kidney go inside the kidney reaching the afferent

arteriole go inside the capillary set of the Glomerulus in there we will have forces tending the plasma out ,what is this forces ? 1-hydrostatic pressure = 55mmHg it will push plasma out of the capillary {from capillary to capsule } . 2-Osmotic pressure creating by plasma protein it's about 30mmHg this oncotic or colloid pressure against the filtration bcz the plasma protein located inside capillary . we have 2 compartments >> bowman's capsule & capillaries in the capillaries we have big particle of protein they suck the water back So the direction of this force is backward against the filtration .
3-bowman's

capsule is full of filtration so it will create hydrostatic pressure inside the capsule it is = 15mmHg the direction is from bowman's capsule into capillaries . The net filtration pressure is : 55mmHg outside + 30mmHg inside + 15 mmHg inside = 10 mmHg outside the capillaries to the capsule Even this number is small but is significant bcz the permeability of Glomerulus is high . So if u calculate how many ml go from capillary to bowman's capsule u get what we called GFR =>> Glomerulus filtration rate ,, GFR/min in normal adult mature male = 125 ml .. The amount of blood going to kidneys = (20-25%) of CO CO = 5L (20-25)% * 5 = 1200 ml of blood each minute going to kidneys . In the blood there is 55% plasma y3nii 1200 * 55% ta2reban === 625 ml/min of plasma we call this plasma blood flow . U have to remember those no. :D So the 625ml plasma will loose 125ml by filtration we still have 500 ml going back by efferent arteriole & to the pritubular capillary & outside the kidney -every min we filtrate 125ml . -everyhour =>> 125 * 60 = 7625ml . -everyday =>> 7625 * 24 = 183000ml .

**** every day we filtrate 180 L of plasma . The volume of plasma in our body is 3L,, which means those 3L of plasma going out the Glomerulus 60 times / day . Bcz the major function of kidneys is to clean the plasma . If u loose 180L efficiency u should get them back to blood bcz if u don't u will loose ur life .

2) REABSORBTION : That's why the 2nd process which is called tubular reabsorbtion also significant , if u calculate the rate of reabsorbtion each day = 178.5 L U filtrate 180L u reabsorbed 178.5L the remaining is 1.5L which is execration *what control the GFR to be increase OR decrease ? - normally it's 125ml/min it shouldn't be higher or lower . The most important thing is the sympathetic system for arteriole , If u stimulate sympathetic system u will cause constriction of arteriole the rate of constriction in afferent is higher than Efferent (slide 17) less affect in efferent bcz of receptor of neurons so signal will be more in the more constricted one that will reduce the amount of blood flow which means I don't get enough plasma inside the Glomerulus Less bld flow , less hydrostatic pressure ,& don't decrease the oncotic &capsule pressure that will case the hydrostatic pressure to be less & will lead to decrease in net filtration pressure which means the filtration pressure will be less SO constriction of afferent arteriole will decrease GFR the opposite it will increase GFR which is dilatation Dilate afferent arteriole , more bld flow , increase volume of plasma ,increase hydrostatic pressure ,,, that will lead to increase net filtration pressure , increase filtration pressure ,, that's why people with hypertension urinate extra bcz the filtration is more bcz the bld pressure inside capillary is more . But why in winter we urinate more ?& why sometime the color of urine dark yellow & sometime is similar to water ??? This is the complexity of the renal function {thi is the topic in the final lec. In renal system }

Some times u need water the renal system able to get back most of the water but if u don't need water the renal system able to execrate most of the water from ur body . ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ BUT sometimes when we dont need water [[ you are hydrated ]] renal system able to excrete most of the water from your body . => NOW : Everyday the level of metabolic reaction almost constant for the human being (( Normal Life )) . It secrets about 600ml of metabolic wastes as particle. Those 600ml/osmol needs to be out {{ to get rid of them }} The way to get rid of them is the [[ Uren output ]] Now if we take them and you dilute them in 0.5L of water you will get dark yellow color. BUT if we dilute them in 1.5 L of water you will get light yellow color. And if we dilute them in 5L of water you wont get any color because of the dilution factor. >>> So thats why your Uren output one day is water like color other day is light yellow and the other day is very dark yellow BECAUSE you need water , the kidney able to get back the most of the water , BUT you will still have a huge amount of metabolic wastes which diluted in small amount of water.

SO >>> you will darken the color of the output. NOW lets talk about filtration :D
3 - Filtration is 1- huge {{ 180L of plasma is getting out per day }} 2- random * Random means that the capillaries and Bowmans capsule dont distinguish between {{ sodium , chloride , potassium , urea , uric acid , amino acids , fatty acids and vitamin }} . Every thing will go out from the capillaries to the bowmans capsule.

So in another word If I take a capillary as a plasma and I take the Bowmans capsule as another compartment ! >>> What does the filtration ?! the filtration takes plasma from here to here with 2 EXEPTIONS : 1- no plasma protein 2-no blood cells >> What is the reason of these 2 EXEPTIONS ?!! :///// Because of the pore in the endothelial cells and the plots in the pedocytes Are smaller than the particles of plasma protein and they are smaller than blood cells. SO >>> automatically the hydrostatic pressure will push the blood cells and the plasma together.

BUT the blood cant go the poles the plasma protein also cant go to these plots , SO >> they will remain inside the capillaries . NOW >> the only composition of plasma is everything without plasma protein & blood cells . BUT ,,, what is {{ everything }} ?!! everything : - 150mL mol sodium -5ml mol potassium -120ml mol chloride That much protein it dispense in hoe much you ate protein at that day because it will be higher or low and so on. Since we are talking about the composition of the plasma , , , we should remember that if we take a sample of filtrate we call the plasma outside the capillaries filtrate or sometimes we call it ultra filtrate . if we take a sample from a bowmens capsule and examine it you should remember its identical to the plasma . with some Exceptions we wont go on detail about them. >>> BUT >>> remember that the filtration in bowmans capsule is identical to the plasma . *** NOW *** >>> Why is that ?! because the filtration is random huge random means doesnt select what we need & what we dont . after that when they leave the bowmans capsule , they will go through the tubular system . Here the filtrate is equal to the plasma composition.

*** when it goes down little bit now we are taking different structure and different function . What is the structure ?! now we finished the glamorous and the function of the glamorous ,,, Now we start to talk about the tubular system and the function.

Parts of the tubular system :

The Dr said if the tubular system were in one function we will see only one tubule BUT now Im going to define and going to segment the tubular system in different parts each part had its own function not for the talk of anatomy but for the talk of physiology .

1 - proximal tubule :
and now we will illustrate the proximal tubule starting from the bowmans capsule and it goes right , left , up, down , its not straight *** What is the proximal tubule ?! its the tubular system contain one layer of epithelial cell and it has special function for reabsorption. The major part of the reabsorption occur in the proximal tubule and its about 67% of the total .

Now around the proximal tubule there is a network of capillaries .

2 - Loop of henle
Loop of henle structure its like (( U )) shape , since its ((U)) shape we divide it into two parts .

1- Descending limp {{ going down }} . 2- Ascending limp {{ going up }} .

*** The Dr said : its so important to know these parts cz in the next lecture Im going to talk about different function in each segment.

3- Distal tubule its divided into two parts :


1- diluted segment of distal tubule which is the beginning of the distal tubule . 2- the final part the remaining part of distal tubules or sometimes its called the distal duct.

4- Collecting Duct :
NOW >>> each collecting part contain 8 distal ducts . in other words each connecting duct has 8 nephrons because each nephron is distal tubule. 80% of the nephron are cortex cortical . 20% of the nephron are juxtamedullary . The Dr said When I discussed the parts of the nephron each part I talked about , its surrounded by vascular capillaries all of them [[ proximal , loop of henle , distal tubule and collecting duct ]]

There is exception when we are talking about juxamedullary nephron which is 20% of the number we dont have capillary around the loop of henle , its maken without capillaries but it has extra structure special for it .

This structure we will get out from the efferent arteriole coming out from the glamorous , it will surround the proximal tubule with capillaries. But loop of henle it will go down and up ,,, parallel with the same group of henle structure .

SO >> we will have loop of henle and next to it vascular structure , this vascular structure called [[ vasa recta ]] . and it has : - descending limp of vasa recta parallel of the descending limp of loop of henle -ascending limp of vasa recta without this structure we cant live . now >> when we are talking about tubular system we have in our mind : - the proximal tubule -loop of henle with the two parts [[ descending , ascending ]] -distal tubule with the two parts -the collecting duct

This micro structure

now we will talk about the structure of each part , not in detail just to give one idea . if you take the structure of the proximal tubule (( where the yellow color is inside the tubule )) . Space where filtration occur Cell one layer of epithelial cell Basement membrane and endothelial cell and inside the blood In the proximal tubule the cells attached to each other but backward they dont attach to each other .

You studied in biology that Cells attach to each othe by tight junctions

*********in the tubular system there is tight junction but its not tight . so >> the name is tight junction but the property of that not tight which means of there is a small pressure increase it will separate the cell from each other {{ this also important for reabsorption function }} when we go to the loop of henle the cell of loop of henle is epithelial cell but they are thin , they arent thick like the proximal tubule the same apply on the collecting duct.

**** when you go to the loop of henle you will see that the tight junction in the descending limp its not tight but they are very tight in the ascending limp when you go up a little bit to the distal tubule the diluted segments have very tight junction . *** other issue is important if you count the protein transporter in the tubular system you should remember that we are talking about particle of protein , there function is transport [[ either active or passive]] . when you count those proteins the major amount of protein transporter located in [[ basolateral part ]] . the major fat transporter located in the lumenar part . the most thing that you have to remember that reabsotption is selective . but filtration is random and both of them is huge. And next lecture the Dr will start with the reabsorption .

The End

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) .... )

Done By : Hiba Abu-jumah

GaYdaa Kanaan
corrected by: Yahya Al Omary hashim gazo .