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Structure and Function of
the Renal and Urologic
Systems
Chapter 35


                            1
Structures of the Kidney
        Kidneys
                 Retroperitoneal
                 Renal capsule
                 ...
Structures of the Kidney




                                                      3
Mosby items and derived items © 2006 ...
Structures of the Kidney
        Renal cortex
        Renal medulla
        Renal pyramids
        Renal columns
        M...
Structures of the Kidney




                                                      5
Mosby items and derived items © 2006 ...
Nephron
        1.2 million nephrons per kidney
        Functional unit of the kidney
                 Superficial cortica...
Nephron
        Renal corpuscle
                 Glomerulus
                 Bowman capsule
                 Mesangial cel...
Nephron
        Glomerular filtration membrane
                 Glomerular endothelium
                 Basement membrane
...
Nephron
        Juxtaglomerular apparatus
                 Juxtaglomerular cells
                 Macula densa




       ...
Juxtaglomerular Apparatus




                                                      10
Mosby items and derived items © 200...
Nephron
        Renal tubules
                 Proximal tubule
                 Loop of Henle
                 Distal tubu...
Structures of the Kidney




                                                      12
Mosby items and derived items © 2006...
Structures of the Kidney




                                                      13
Mosby items and derived items © 2006...
Blood Vessels
        Renal arteries
        Interlobar arteries
        Arcuate arteries
        Interlobular arteries
  ...
Structures of the Kidney




                                                      15
Mosby items and derived items © 2006...
Structures of the Kidney
        Ureters
                 30 cm long
                 Long, intertwining muscle bundles
  ...
Structures of the Kidney
        Bladder
                 Detrusor muscle
                 Transitional epithelium
       ...
Bladder and Urethra




                                                      18
Mosby items and derived items © 2006 by M...
Renal Blood Flow
        Receive 1000 to 1200 mL of blood per minute
        Glomerular filtration rate (GFR)
        Auto...
Renal Blood Flow




                                                      20
Mosby items and derived items © 2006 by Mosb...
Nephron Function
        Glomerular filtration
                 Net filtration pressure
                           Glomeru...
Glomerular Filtration




                                                      22
Mosby items and derived items © 2006 by...
Nephron Function
        Tubular reabsorption
        Tubular secretion
        Excretion
        Tubular transport
      ...
Nephron Function




                                                      24
Mosby items and derived items © 2006 by Mosb...
Nephron Function




                                                      25
Mosby items and derived items © 2006 by Mosb...
Nephron Function




                                                      26
Mosby items and derived items © 2006 by Mosb...
Concentration and Dilution of
Urine
        Countercurrent exchange system
                 Contributes to production of c...
Countercurrent Exchange System




                                                      28
Mosby items and derived items ...
Concentration and Dilution of
Urine
        Urea
        Catecholamines
        Antidiuretic hormone (ADH)
        Urodila...
Renal Hormones
        Vitamin D
        Erythropoietin




                                                      30
Mosby...
Tests of Renal Function
        Clearance and glomerular filtration rate
                 Inulin
                 Creatini...
Tests of Renal Function
        Urinalysis
                 Urine color
                 Urine pH
                 Specifi...
Tests of Renal Function
        Urinalysis
                 Reagent strips (dipsticks)
                           Glucose
...
Aging and Renal Function
        Decrease in kidney size
        Decrease in renal blood flow and GFR
        Number of ne...
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Review Anatomy And Physiology Kidney

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Transcript of "Review Anatomy And Physiology Kidney"

  1. 1. Structure and Function of the Renal and Urologic Systems Chapter 35 1
  2. 2. Structures of the Kidney Kidneys Retroperitoneal Renal capsule Renal fascia Hilum 2 Mosby items and derived items © 2006 by Mosby, Inc.
  3. 3. Structures of the Kidney 3 Mosby items and derived items © 2006 by Mosby, Inc.
  4. 4. Structures of the Kidney Renal cortex Renal medulla Renal pyramids Renal columns Minor calyx Major calyx Renal pelvis 4 Mosby items and derived items © 2006 by Mosby, Inc.
  5. 5. Structures of the Kidney 5 Mosby items and derived items © 2006 by Mosby, Inc.
  6. 6. Nephron 1.2 million nephrons per kidney Functional unit of the kidney Superficial cortical nephrons Midcortical nephrons Juxtamedullary nephrons 6 Mosby items and derived items © 2006 by Mosby, Inc.
  7. 7. Nephron Renal corpuscle Glomerulus Bowman capsule Mesangial cells Bowman space 7 Mosby items and derived items © 2006 by Mosby, Inc.
  8. 8. Nephron Glomerular filtration membrane Glomerular endothelium Basement membrane Capillary epithelium Also referred to as podocytes or visceral epithelium Filtration slits 8 Mosby items and derived items © 2006 by Mosby, Inc.
  9. 9. Nephron Juxtaglomerular apparatus Juxtaglomerular cells Macula densa 9 Mosby items and derived items © 2006 by Mosby, Inc.
  10. 10. Juxtaglomerular Apparatus 10 Mosby items and derived items © 2006 by Mosby, Inc.
  11. 11. Nephron Renal tubules Proximal tubule Loop of Henle Distal tubule Collecting duct Principal cells Intercalated cells 11 Mosby items and derived items © 2006 by Mosby, Inc.
  12. 12. Structures of the Kidney 12 Mosby items and derived items © 2006 by Mosby, Inc.
  13. 13. Structures of the Kidney 13 Mosby items and derived items © 2006 by Mosby, Inc.
  14. 14. Blood Vessels Renal arteries Interlobar arteries Arcuate arteries Interlobular arteries Afferent arterioles Glomerular capillaries Efferent arterioles Peritubular capillaries and vasa recta 14 Mosby items and derived items © 2006 by Mosby, Inc.
  15. 15. Structures of the Kidney 15 Mosby items and derived items © 2006 by Mosby, Inc.
  16. 16. Structures of the Kidney Ureters 30 cm long Long, intertwining muscle bundles Pass obliquely though posterior aspect of bladder Peristaltic activity Micturition compresses the lower end of the ureter to avoid urine reflux 16 Mosby items and derived items © 2006 by Mosby, Inc.
  17. 17. Structures of the Kidney Bladder Detrusor muscle Transitional epithelium Trigone Micturition reflex Urethra Internal and external sphincters 3 to 4 cm in females 18 to 20 cm in males 17 Mosby items and derived items © 2006 by Mosby, Inc.
  18. 18. Bladder and Urethra 18 Mosby items and derived items © 2006 by Mosby, Inc.
  19. 19. Renal Blood Flow Receive 1000 to 1200 mL of blood per minute Glomerular filtration rate (GFR) Autoregulation Myogenic mechanism Tubuloglomerular feedback Neural regulation Hormones Renin-angiotensin system Natriuretic peptides 19 Mosby items and derived items © 2006 by Mosby, Inc.
  20. 20. Renal Blood Flow 20 Mosby items and derived items © 2006 by Mosby, Inc.
  21. 21. Nephron Function Glomerular filtration Net filtration pressure Glomerular hydrostatic pressure Capsular hydrostatic pressure Blood oncotic pressure Filtration rate 21 Mosby items and derived items © 2006 by Mosby, Inc.
  22. 22. Glomerular Filtration 22 Mosby items and derived items © 2006 by Mosby, Inc.
  23. 23. Nephron Function Tubular reabsorption Tubular secretion Excretion Tubular transport Proximal tubule Loop of Henle and distal tubule Glomerulotubular balance 23 Mosby items and derived items © 2006 by Mosby, Inc.
  24. 24. Nephron Function 24 Mosby items and derived items © 2006 by Mosby, Inc.
  25. 25. Nephron Function 25 Mosby items and derived items © 2006 by Mosby, Inc.
  26. 26. Nephron Function 26 Mosby items and derived items © 2006 by Mosby, Inc.
  27. 27. Concentration and Dilution of Urine Countercurrent exchange system Contributes to production of concentrated urine Fluid flows in opposite direction through parallel tubes Fluid moves up and down the parallel limbs of the loop of Henle The longer the loop, the greater the concentration gradient 27 Mosby items and derived items © 2006 by Mosby, Inc.
  28. 28. Countercurrent Exchange System 28 Mosby items and derived items © 2006 by Mosby, Inc.
  29. 29. Concentration and Dilution of Urine Urea Catecholamines Antidiuretic hormone (ADH) Urodilantin Natriuretic peptide Diuretics 29 Mosby items and derived items © 2006 by Mosby, Inc.
  30. 30. Renal Hormones Vitamin D Erythropoietin 30 Mosby items and derived items © 2006 by Mosby, Inc.
  31. 31. Tests of Renal Function Clearance and glomerular filtration rate Inulin Creatinine Clearance and renal blood flow Blood tests Plasma creatinine concentration Plasma cystatin C concentration Blood urea nitrogen (BUN) 31 Mosby items and derived items © 2006 by Mosby, Inc.
  32. 32. Tests of Renal Function Urinalysis Urine color Urine pH Specific gravity Urine sediment RBCs Casts Crystals WBCs 32 Mosby items and derived items © 2006 by Mosby, Inc.
  33. 33. Tests of Renal Function Urinalysis Reagent strips (dipsticks) Glucose Bilirubin Urobilinogen Leukocyte esterase Nitrates Ketones Proteins RBCs, hemoglobin, and myoglobin 33 Mosby items and derived items © 2006 by Mosby, Inc.
  34. 34. Aging and Renal Function Decrease in kidney size Decrease in renal blood flow and GFR Number of nephrons decrease due to renal vascular and perfusion changes Glomerular capillaries atrophy Tubular transport response decreases Increased bladder symptoms Urgency, frequency, and nocturia 34 Mosby items and derived items © 2006 by Mosby, Inc.
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