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URINARY SYSTEM
Physiology 2
Presented by: Dr. Shaimaa Nasr Amin
Lecturer of Medical Physiology
General Education Program
Introduction and physiologic
anatomy of the kidney
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1-Overview of Renal Function
Kidneys have both excretory and regulatory functions
that participates in homeostasis
*Excreting excess solutes ,water and rid waste
products
*Regulate volume and composition of body fluids
within very narrow range
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Major regulatory functions of the kidneys
1-Regulation of water and electrolyte balance.
2-Excretion of metabolic waste products.
3-Excretion of foreign chemicals.
4-Endocrine functions .
5-Regulation of arterial blood pressure.
6-Regulation of acid base balance.
7-Gluconeogenesis.
8-Secretion of prostaglandins and bradykinin.
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Physiologic anatomy of the kidneys
-Site: on the posterior wall of the abdomen ,outside the
peritoneal cavity.
-Weight= 150 gm /each kidney.
-Dimensions: Length <12cm.
Width <8cm.
-Surrounded by thin but tough capsule.
-The renal artery, vein, lymphatics, nerve supply and
ureter enter the kidney at he hilum on the medial side
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Renal mass is
divided into
Outer cortex
Granular and
deeper in colour
Inner medulla
Striated and
lighter in colour
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Pelvis
Major
calyces
Minor calyces
Renal papilla
Multiple renal
Pyramids
Medulla
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1 . Renal Vein 2 . Renal Artery 3 . Renal Calyx 4 . Medullary
Pyramid 5 . Renal Cortex 6 . Segmental Artery 7 . Interlobar Artery 8 . Arcuate Artery 9 . Arcuate Vein 10 . Interlobar Vein 11 . Segmental Vein 12 . Renal Column 13 . Renal Papillae 14 . Renal Pelvis 15 . Ureter
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Nephron as a functional unit -There are about 1.3 million
nephrons in each human kidney.
-Each is capable of forming urine
(functional unit)
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Parts of the nephron
1- Glomerulus
2-Proximal convoluted tubule
3-Loop of Henle
4-Distal convoluted tubule
5-Collecting ducts
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1-Glomerulus *Tuft of capillaries contained within the dilated blind
end of renal tubule (Bowman’s Capsule).
*The capillaries are supplied by afferent arteriole
and drained by efferent arteriole.
*It is high pressure capillary bed (,the hydrostatic
pressure is 60 mmHg)
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2-Proximal convoluted tubules *15mm ,lie in the cortex
*Wall made of single layer of cells with apical tight
junctions.
*The luminal edges have brush borders due to
presence of many microvilli.
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3- Loop of Henle U-shaped extension of PCT that dips in renal medulla.
Consists of :
a) Descending limb .
b) Ascending limb.
*The wall of the descending +lower½ of the ascending
limb= Thin Segment of loop of Henle
*Upper ½of the ascending limb = Thick segment of loop
of Henle
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4-Distal Convoluted Tubule 5mm long lies in the cortex.
No distinct brush border but there are few microvilli.
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5-Collecting Ducts 20mm long pass through renal cortex and medulla to
empty into the pelvis of the kidney
Collecting ducts lined by 2 types of cells:
2-Intercalated cells 1-Principal cells
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2-Intercalated cells
(I cells)
1-Principal cells
(P cells)
*Found in smaller number .
*Have more microvilli,
mitochondria and
cytoplasmic vesicles.
Involved in:
Acid secretion.
Bicarbonate reabsorption.
Predominant ,relatively tall
Involved in :
Na+ reabsorption.
H2O reabsorption.
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Types of Nephrons Juxtamedullary
Nephrons
Cortical Nephrons
15% 85% % of total
number
Deep in renal cortex near the
medulla
In the outer portion of renal
cortex
Glomeruli
Long &dips deeply into the
medullary pyramids
Short &,penetrate a short
distance into the medulla
Loop of Henle
Vasa recta + Peritubular
capillary
The tubule is surrounded by
peritubular capillary
Vascular
structures
supplying tubule
Play important role in urine
concentration
Special Functions
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Juxta Glomerular apparatus
-Specialized tubular and vascular cells located at the
vascular pole where afferent and efferent arterioles
enter and leave the glomerulus.
-Plays important role in auto regulation of renal blood
flow and GFR during change in arterial pressure .
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JGA Consists of:
1-Macula densa.
2-Juxtaglomerular
cells.
3-Lacis cells.
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1-Macula densa *Modified tubular cells in the initial portion of distal
tubule that comes in contact with afferent and efferent
arterioles .
*The macula densa is in close proximity to JG cells.
*They monitor the composition of fluid in tubular lumen
at this point ( chemoreceptors that is stimulated by ↓
Nacl load ) .
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2-Juxtaglomerular cells -Epithelioid granular cells located at the media of
afferent arterioles and to lesser extent the efferent arterioles as they enter the glomeruli.
*They secret renin.
*Act as baroreceptors and respond to change in perfusion pressure
*Stimulated by ↓ renal perfusion pressure or hypovolemia
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3-Lacis cells
-These agranular cells located at the
junction between afferent and efferent
arterioles.
-They contain renin .
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Renal blood flow The kidneys receive 21% of cardiac output
Renal Vascular arrangement:
*Aorta → Renal artery → interlobar arteries & Arcute & intralobular arteries
*Interlobular arteries → Afferent arterioles glomerular capillary → efferent arterioles→Peritubular capillaries → interlobular veins → arcute veins → interlobar veins → renal vien
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capillary beds 2
associated with
each nephron
Glomerular
capillary bed
Peritubular
capillary bed
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1-The glomerular capillary bed
(High pressure bed) *Receive its blood from afferent arterioles .
*The hydrostatic pressure is about 60mmHg (causes
rapid filtration of fluid).
What are the causes of this high
pressure?
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*This high pressure is due to: 1-The renal arteries are direct branches of abdominal
aorta.
2-The afferent arterioles are short straight branches of
interlobular arteries .
3-The efferent arterioles have high resistance than the
afferent arterioles.
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2-Peritubular capillary bed
(Low pressure bed) *The hydrostatic pressure is about 13mmHg.
*Behave like venous end of the capillaries.
*The low pressure permits fluid reabsorption
from the interstitium into the blood.
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Regional blood flow *Renal cortex receives most of renal blood flow 98%
for filtration of large volume of plasma through the
glomeruli.
*while renal medulla receives 2% of renal blood flow
to form concentrated urine.
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Autoregulation of renal blood flow -When the kidney is perfused at a moderate
pressure (90-220 mmHg) the renal blood flow is
relatively kept constant by change of renal
vascular resistance .
-Renal autoregulation is present in denervated and
isolated kidney (independent of nerves or
hormones)
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Mechanisms of autoregulation of renal
blood flow 1- With rise of pressure:
-Stretch cause contraction of smooth muscles of
afferent arterioles ,this prevent excessive ↑ in renal
blood flow.
-Stretch of the vascular wall ↑ Ca++ influx from ECF
into the muscle fibers causing them to contract.
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2-At low pressure:
Angiotensin II plays an important role by
constricting the efferent arteriole thus
maintaining the GFR.
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Aim of autoregulation: To maintain constant GFR and to allow control
of renal excretion of water and solutes
despite marked changes in arterial blood
pressure.
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Innervation of renal vessels and renal
tubules Sympathetic fibers supply: stimulation causes
1)Renal vessels:
V.C with ↓ in renal blood flow and GFR.
2)JGA:
↑ renin secretion by juxtaglomerular cells (mediated by B1
adrenergic receptor).
3)Renal tubule: ↑Na+ reabsorption by tubular cells by direct
action of norepinephrine on renal tubular cells.
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Thank you
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