human urogenital system - direktori file upifile.upi.edu/direktori/fpok/jur._pend._kesehatan...human...
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26-1
Human Urogenital System
26-2
Urogenital System Functions
• Filtering of blood, Removal of wastes and
metabolites
• Regulation of
– blood volume and composition
– concentration of blood solutes
– pH of extracellular fluid
– blood cell synthesis
• Synthesis of Vitamin D
• Reproduction and sexual function
26-3
Urinary System Anatomy
26-4
Location and External Anatomy
of Kidneys
• Location
– Lie behind peritoneum on
posterior abdominal wall
on either side of vertebral
column
– Lumbar vertebrae and rib
cage partially protect
– Right kidney slightly lower
than left
• External Anatomy
– Renal capsule
• Surrounds each kidney
– Perirenal fat
• Engulfs renal capsule and acts as
cushioning and source of energy
– Renal fascia
• Anchors kidneys to abdominal
wall, separates from abdomen
– Hilum
• Renal artery and nerves enter and
renal vein and ureter exit kidneys
26-5
Internal Anatomy of Kidneys
• Cortex: Outer area
– Renal columns
• Medulla: Inner area
– Renal pyramids
• Calyces
– Major: Converge to form
pelvis
– Minor: Papillae extend
• Nephron: Functional unit
of kidney
– Juxtamedullary
– Cortical
26-6
The Nephron
26-7
Histology of the Nephron
26-8
Internal Anatomy of Kidneys
• Renal corpuscle
– Bowman’s or Renal capsule
• Parietal layer
• Visceral layer
– Glomerulus
• Network of capillaries goes into another capillary bed called the peritubular Capillaries
- Arterioles
– Afferent
• Blood to glomerulus
– Efferent
• Drains not into veinule but another arteriole
• Tubules
– Proximal (convoluted) tubule
– Loops of Henle
• Descending limb
• Ascending limb
– Distal (convoluted) tubules
• Collecting ducts
26-9
Renal Corpuscle
26-10
Kidney Blood Flow
26-11
Ureters and Urinary Bladder
• Ureters
– Tubes through which
urine flows from
kidneys to urinary
bladder
• Urinary bladder
– Stores urine
• Urethra
– Transports urine from
bladder to outside of
body
– Difference in length
between males and
females
– Sphincters
• Internal urinary
• External urinary
26-12
Ureters and Urinary Bladder
26-13
Urine Formation
26-14
Filtration
• Filtration
– Renal filtrate
• Plasma minus blood
cells and blood proteins
• Most (99%) reabsorbed
• Filtration membrane
– Fenestrated
endothelium, basement
membrane and pores
formed by podocytes
• Filtration pressure
– Responsible for filtrate formation
– Glomerular capillary pressure (GCP) minus capsule pressure (CP) minus colloid osmotic pressure (COP)
– Changes caused by glomerular capillary pressure
EFP = GCP – CP – COP
Where Effective filtration pressure = EFP
26-15
Filtration Pressure
26-16
Tubular Reabsorption• Reabsorption almost 90%
takes place in Proximal tubule via
– Passive transport
– Active transport
– Cotransport
• Specialization of tubule segments
• Distal tubule and collecting duct affected by hormones like ADH & Aldosterone
• Substances transported
– Active transport moves Na+ across nephron wall
– Other ions and molecules moved by cotransport
– Passive transport moves water, urea, lipid-soluble, nonpolar compounds
26-17
Reabsorption in Proximal Nephron
26-18
Reabsorption in Loop of Henle
26-19
Reabsorption in Loop of Henle
26-20
Tubular Secretion
• Substances enter proximal or distal tubules
and collecting ducts
• H+, K+ and some substances not produced in
body are secreted by countertransport
mechanisms
26-21
Secretion of Hydrogen and
Potassium
26-22
Urine Production
• In Proximal tubules
– Na+ and other substances removed
– Water follows passively
– Filtrate volume reduced
• In descending limb of loop of Henle
– Water exits passively, solute enters
– Filtrate volume reduced 15%
• In ascending limb of loop of Henle– Na+, Cl-, K+ transported out of
filtrate
– Water remains
• In distal tubules and collecting ducts– Water movement out
regulated by ADH
• If absent, water not reabsorbed and dilute urine produced
• If ADH present, water moves out, concentrated urine produced
26-23
Filtrate and Medullary
Concentration Gradient
26-24
Medullary Concentration and
Urea Cycling
26-25
Urine Concentration Mechanism
• When large volume of
water consumed
– Eliminate excess
without losing large
amounts of electrolytes
– Response is kidneys
produce large volume
of dilute urine
• When drinking water
not available
– Kidneys produce small
volume of concentrated
urine
– Removes waste and
prevents rapid
dehydration
26-26
Urine Concentrating Mechanism
26-27
Hormonal Mechanisms
• ADH
– Secreted by posterior
pituitary
– Increases water
permeability in distal
tubules and collecting ducts
• Aldosterone
– Produced in adrenal cortex
– Affects Na+ and Cl-
transport in nephron and
collecting ducts
• Renin
– Produced by kidneys,
causes production of
angiotensin II
• Atrial natriuretic
hormone
– Produced by heart when
blood pressure increases
• Inhibits ADH production
• Reduces ability of kidney
to concentrate urine
26-28
Effect of ADH on Nephron
26-29
Aldosterone Effect on Distal
Tubule
26-30
Autoregulation and
Sympathetic Stimulation
• Autoregulation
– Involves changes in
degree of constriction
in afferent arterioles
– As systemic BP
increased, afferent
arterioles constrict and
prevent increase in
renal blood flow
• Sympathetic stimulation
– Constricts small arteries
and afferent arterioles
– Decreases renal blood
flow
26-31
Clearance and Tubular Load
• Plasma clearance
– Volume of plasma
cleared of a specific
substance each minute
– Used to estimate GFR
– Used to calculate renal
plasma flow
– Used to determine
which drugs or other
substances excreted by
kidney
• Tubular load
– Total amount of
substance that passes
through filtration
membrane into
nephrons each minute
– Normally glucose is
almost completed
reabsorbed
26-32
Tubular Maximum
• Tubular maximum
– Maximum rate at
which a substance can
be actively absorbed
– Each substance has its
own tubular maximum
26-33
Urine Flow and
Micturition Reflex
• Urine flow
– Hydrostatic pressure
forces urine through
nephron
– Peristalsis moves urine
through ureters
• Micturition reflex
– Stretch of urinary
bladder stimulates
reflex causing bladder
to contract, inhibiting
urinary sphincters
– Higher brain centers
can stimulate or inhibit
reflex
26-34
Micturition Reflex
26-35
Effects of Aging on Kidneys
• Gradual decrease in size of kidney
– Decrease in kidney size leads to decrease in renal blood flow
• Decrease in number of functional nephrons
• Decrease in renin secretion and vitamin D synthesis
• Decline in ability of nephron to secrete and absorb
26-36
Kidney Dialysis
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