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APPLIED APPLIED ANATOMY & ANATOMY &
PHYSIOLOGY OF THE PHYSIOLOGY OF THE URINARY SYSTEM URINARY SYSTEM
DR. S ChakradharDR. S Chakradhar 11
Functional Anatomy and PhysiologyFunctional Anatomy and Physiology
Kidney size = 11-14cmKidney size = 11-14cm
Located retro - peritoneally on either side of vertebral Located retro - peritoneally on either side of vertebral column, column,
Extends from T12 to L3.Extends from T12 to L3.
Left kidney is slightly higher than Right.Left kidney is slightly higher than Right.
Kidneys receive about 20-25% of the cardiac output. Kidneys receive about 20-25% of the cardiac output.
DR. S ChakradharDR. S Chakradhar 22
Gross structure Gross structure
33Dr S ChakradharDr S Chakradhar
Nephron Nephron It is the structural & functional unit of kidney.It is the structural & functional unit of kidney.
Parts Parts Glomerulus / Renal CorpusclesGlomerulus / Renal Corpuscles Renal tubuleRenal tubule
Bowman's Capsule / Glomerular CapsuleBowman's Capsule / Glomerular Capsule Proximal Convoluted tubuleProximal Convoluted tubule Descending limb of loopDescending limb of loop Loop of HenleLoop of Henle Ascending limb of loopAscending limb of loop Distal convoluted tubuleDistal convoluted tubule Collecting ductCollecting duct
DR. S ChakradharDR. S Chakradhar 44
Glomerulus
Distal Convoluted
Tubule
Proximal Convoluted
Tubule
Loop of HenleThin descending
limb
Loop of HenleThin ascending
limb
Loop of HenleThick ascending
limbCollecting
Duct
DR. S ChakradharDR. S Chakradhar 66
Blood Supply Blood Supply
Blood Supply Blood Supply
Glomerulus ( Renal Corpuscle) Glomerulus ( Renal Corpuscle) Capillary tuft surrounded by bowman’s capsule Capillary tuft surrounded by bowman’s capsule Bowmen’s space ( urinary space)Bowmen’s space ( urinary space) Components:Components:
Capillaries: endothelial cellsCapillaries: endothelial cells Podocytes ( visceral epithelium): podocytes foot Podocytes ( visceral epithelium): podocytes foot
processes processes Mesengial cells Mesengial cells Parietal epitheliumParietal epithelium
PodocytesPodocytes
Dr S Chakradhar Dr S Chakradhar 1010
Mesangial Cells Mesangial Cells Lie in the central region of the glomerulus. Lie in the central region of the glomerulus. Contraction of these cells decreases GFR while relaxation Contraction of these cells decreases GFR while relaxation
increases GFRincreases GFR
Dr S Chakradhar Dr S Chakradhar 1111
Filtration barrierFiltration barrier Capillary endothelium, Capillary endothelium, Basement membrane, and Basement membrane, and Visceral Epithelium (podocytes)Visceral Epithelium (podocytes)
Filtration slits Filtration slits
Capillary SpaceCapillary Space
EndotheliumEndothelium
Urinary Urinary SpaceSpace
GBMGBM
PodocytePodocyte
Urine formation Urine formation
DR. S ChakradharDR. S Chakradhar 1313
DR. S ChakradharDR. S Chakradhar 1414
Juxta - glomerular apparatusJuxta - glomerular apparatus Macula densaMacula densa – modified cells of distal tubule near afferent – modified cells of distal tubule near afferent
arteriole are taller arteriole are taller Juxtaglomerular cellJuxtaglomerular cells are myoepithelial cells in afferent s are myoepithelial cells in afferent
arteriole. They secrete renninarteriole. They secrete rennin Polkissen cells/Lacis cells -Polkissen cells/Lacis cells -outside the kidney glomerulus outside the kidney glomerulus
near the macula densa and bound laterally by afferent and near the macula densa and bound laterally by afferent and efferent arterioles.efferent arterioles.
Renin Angiotensin Renin Angiotensin
DR. S ChakradharDR. S Chakradhar 1616
Functions of the kidneys:Functions of the kidneys: Formation & secretion of urine Formation & secretion of urine Control of the internal environmentControl of the internal environment
Salt, water, osmolarity, plasma volume/ BPSalt, water, osmolarity, plasma volume/ BP Acid-base control; HAcid-base control; H++, HCO, HCO33
--
Other ions; KOther ions; K++, Ca, Ca++++, phosphate, Mg, phosphate, Mg++++
Excretion; urea, creatinine, urates, drugsExcretion; urea, creatinine, urates, drugs EndocrineEndocrine
Renin, angiotensin, aldosterone axisRenin, angiotensin, aldosterone axis 1,25 OH Vit D1,25 OH Vit D33
ErythropoietinErythropoietin
DR. S ChakradharDR. S Chakradhar 1717
SummarySummary
Think of the kidney as an organ of Think of the kidney as an organ of
homeostasishomeostasis
not as an organ of excretionnot as an organ of excretion
Lower Urinary TractLower Urinary Tract
DR. S ChakradharDR. S Chakradhar 1919
Micturation Micturation
DR. S ChakradharDR. S Chakradhar 2020
