renal

1. Structure and Function of
the Renal and Urologic
Systems
Chapter 35
1

2. Structures of the Kidney
Kidneys
Retroperitoneal
Renal capsule
Renal fascia
Hilum
2
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3. Structures of the Kidney
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4. Structures of the Kidney
Renal cortex
Renal medulla
Renal pyramids
Renal columns
Minor calyx
Major calyx
Renal pelvis
4
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5. Structures of the Kidney
5
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6. Nephron
1.2 million nephrons per kidney
Functional unit of the kidney
Superficial cortical nephrons
Midcortical nephrons
Juxtamedullary nephrons
6
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7. Nephron
Renal corpuscle
Glomerulus
Bowman capsule
Mesangial cells
Bowman space
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8. Nephron
Glomerular filtration membrane
Glomerular endothelium
Basement membrane
Capillary epithelium
Also referred to as podocytes or visceral epithelium
Filtration slits
8
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9. Nephron
Juxtaglomerular apparatus
Juxtaglomerular cells
Macula densa
9
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10. Juxtaglomerular Apparatus
10
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11. Nephron
Renal tubules
Proximal tubule
Loop of Henle
Distal tubule
Collecting duct
Principal cells
Intercalated cells
11
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12. Structures of the Kidney
12
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13. Structures of the Kidney
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14. Blood Vessels
Renal arteries
Interlobar arteries
Arcuate arteries
Interlobular arteries
Afferent arterioles
Glomerular capillaries
Efferent arterioles
Peritubular capillaries and vasa recta
14
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15. Structures of the Kidney
15
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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
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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
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18. Bladder and Urethra
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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
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20. Renal Blood Flow
20
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21. Nephron Function
Glomerular filtration
Net filtration pressure
Glomerular hydrostatic pressure
Capsular hydrostatic pressure
Blood oncotic pressure
Filtration rate
21
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22. Glomerular Filtration
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23. Nephron Function
Tubular reabsorption
Tubular secretion
Excretion
Tubular transport
Proximal tubule
Loop of Henle and distal tubule
Glomerulotubular balance
23
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24. Nephron Function
24
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25. Nephron Function
25
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26. Nephron Function
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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
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28. Countercurrent Exchange System
28
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29. Concentration and Dilution of
Urine
Urea
Catecholamines
Antidiuretic hormone (ADH)
Urodilantin
Natriuretic peptide
Diuretics
29
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30. Renal Hormones
Vitamin D
Erythropoietin
30
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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
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32. Tests of Renal Function
Urinalysis
Urine color
Urine pH
Specific gravity
Urine sediment
RBCs
Casts
Crystals
WBCs
32
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33. Tests of Renal Function
Urinalysis
Reagent strips (dipsticks)
Glucose
Bilirubin
Urobilinogen
Leukocyte esterase
Nitrates
Ketones
Proteins
RBCs, hemoglobin, and myoglobin
33
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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
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