Ureters Slender tubes attaching the kidney to the bladder • Continuous with the renal pelvis • Enter the posterior aspect of the bladder Runs behind the peritoneum Peristalsis aids gravity in urine transport Urinary Bladder Function • Smooth, collapsible, muscular sac • Temporarily stores urine Trigone Structure Bladder Wall • Three layers of smooth muscle (detrusor muscle) • Mucosa made of transitional epithelium • Walls are thick and folded in an empty bladder • Bladder can expand significantly without increasing internal pressure • Internal and external sphincters Figure 15.6 Urethra Thin-walled tube that carries urine from the bladder to the outside of the body by peristalsis Release of urine is controlled by two sphincters • Internal urethral sphincter (involuntary) • External urethral sphincter (voluntary) Length and Location • Females – 3–4 cm (1 inch), along wall of the vagina • Males – 20 cm (8 inches) through the prostate and penis Function • Females – only carries urine • Males – carries urine and is a passageway Micturition (Voiding) Both sphincter muscles must open to allow voiding • The internal urethral sphincter is relaxed after stretching of the bladder • Activation is from an impulse sent to the spinal cord and then back via the pelvic splanchnic nerves • The external urethral sphincter must be voluntarily relaxed Urinary System I: Kidneys and Urine Formation Functions of the Urinary System Organs of the Urinary System The Kidney • Coverings and Regions • Blood Flow • Nephrons: Glomeruli and Renal Tubules • Urine Formation Urinalysis Ureters, Bladder, and Urethra Characteristics of Urine Used for Medical Diagnosis Colored somewhat yellow due to the pigment urochrome (from the destruction of hemoglobin) and solutes; darker if patient dehydrated, lighter if over hydrated. Sterile Slightly aromatic Normal pH of around 6 Specific gravity of 1.001 to 1.035; higher if concentrated, lower if dilute. Checking for • Glycosuria (excessive sugary food intake or diabetes) • Proteinuria (intense exercise, pregnancy, hypertension) • Pyuria (pus from urinary tract infections) • Hemoglobinuria (from transfusion reactions or hemolytic anemia) • Bilirubinuria (hepatitis) • Pyelonephritis (high specific gravity) Urinary System II: Fluid, Electrolyte, and Acid/Base Balance Distribution of Body Fluid Maintaining Water Balance Hormornal Regulation of Water and Salt Acid-Base Balance • Blood Buffers • Regulation by Lung Respiration • Regulation by Kidney on Bicarbonate Developmental Aspects of the Urinary System Most Body Fluid is Within Cells Intracellular fluid (inside cells) Extracellular fluid (outside cells) • Interstitial fluid • Blood plasma Normal amount of water in the human body • Young adult females – 50% • Young adult males – 60% • Babies – 75% • Old age – 45% •Low Na+ and Cl– •Major cation: K+ •Major anion HPO42– Maintaining Water Balance Water intake must equal water output • Sources for water intake o Ingested foods and fluids o Water produced from metabolic processes • Sources for water output o Vaporization out of the lungs o Lost in perspiration o Leaves the body in the feces o Urine production Urine Output • Dilute urine is produced if water intake is excessive • Less urine (concentrated) is produced if large amounts of water are lost • Proper concentrations of various electrolytes must be present Maintaining Water and Electrolyte Balance Maintaining Acid-Base Balance in Blood Blood pH must remain between 7.35 and 7.45 to maintain homeostasis • Alkalosis – pH above 7.45 • Acidosis – pH below 7.35 Most ions originate as byproducts of cellular metabolism Acid-base control • Blood buffers (immediate, first line regulator of pH) • Respiration rate (reacts in 1-3 minutes) • Renal/Kidney mechanisms exert strongest effect but slow (hours-days) Chemical Buffer Systems of the Body Buffers react to prevent dramatic changes in hydrogen ion (H+) concentrations • Bind to H+ when pH drops • Release H+ (or bind OH-) when pH rises 1. Bicarbonate buffer system o Major buffer for the extracellular fluid, also intracellular fluid o H2O + CO2 <--> H2CO3 <--> HCO3- + H+ 2. Phosphate buffer system o Effective buffer in urine and ICF, where phosphate concentrations are high o (H3PO4 <--> H2PO4– + H+ <--> HPO42– + H+), 3. Protein buffer system o Mostly active within cells, some effects in plasma o Amino groups bind H+ (-NH2 + H+ <--> NH3+) o Carboxyl groups remove OH- (-COOH + OH- <--> -COO- + H2O The Bicarbonate Buffer System Renal Mechanisms of Acid-Base Balance Excrete bicarbonate ions if needed Conserve or generate new bicarbonate ions if needed • Bicarbonate conservation or production causes rise in blood pH • Bicarbonate excretion causes fall in blood pH • H+ excretion in the urine Urine pH varies from 4.5 to 8.0 CO2 + H2 O H2 CO3 - H+ + HCO3 Acidosis and Alkalosis: Why It Matters Acidosis • Blood pH below 7 depression of CNS coma death • Enzymes denature Alkalosis • Blood pH above 7.8 excitation of nervous system muscle tetany, extreme nervousness, convulsions, respiratory arrest • Enzymes denature Metabolic Acidosis and Alkalosis Any pH imbalance not caused by abnormal blood CO2 levels; indicated by abnormal HCO3– levels Metabolic Acidosis • Caused by ingestion of too much alcohol ( acetic acid), excessive loss of HCO3– (e.g., persistent diarrhea) • Causes by accumulation of lactic acid, shock, ketosis in diabetic crisis, starvation, and kidney failure Metabolic Alkalosis (much less common than metabolic acidosis) • Indicated by rising blood pH and HCO3– • Caused by vomiting of the acid contents of the stomach or by intake of excess base (e.g., antacids) Developmental Aspects of the Urinary System Fetal Development and Newborns • Functional kidneys are developed by the third month • Urinary system of a newborn o Bladder is small o Urine cannot be concentrated • Control of the voluntary urethral sphincter does not start until age 18 months • Urinary infections are the only common problems before old age Effects of Aging on Urinary System • There is a progressive decline in urinary function • The bladder shrinks with aging • Urinary retention is common in males Congenital Abnormalities of the Urinary System • Polycystic kidney • Hypospadias Hypospadias Urinary System II: Fluid, Electrolyte, and Acid/Base Balance Distribution of Body Fluid Maintaining Water Balance Hormornal Regulation of Water and Salt Acid-Base Balance • Blood Buffers • Regulation by Lung Respiration • Regulation by Kidney on Bicarbonate Developmental Aspects of the Urinary System