KidneyStones.org Ureter Function The ureter is a thick-walled tube leading from each kidney, which carries urine to the bladder. Urine flows down partly by gravity, but mainly by a wave of contractions, called peristalsis, which pass several times per minute through the muscle layers of the urethral walls. Structure Each ureter is a tubular organ measuring about 25 centimeters (ten to twelve inches) in length beginning at the funnel-shaped renal pelvis. Within the wall of the ureter are three layers. The inner layer, or mucous coat, is continuous with the linings of the renal tubules above and the urinary bladder below. The middle layer, or the muscular coat, is composed of largely smooth muscle fibers. The outer layer, or the fibrous coat, is primarily composed of connective tissue. Each ureter enters the bladder through a tunnel in the bladder wall, which is angled to prevent the urine from running back into the ureter, known as reflux, when the bladder contracts. Anatomy of the Urinary System | Johns Hopkins Medicine Health Library Anatomy of the Urinary System See related health Click Image to Enlarge How does the urinary system work?

The urinary system's function is to filter blood and create urine as a waste by-product. The organs of the urinary system include the kidneys, renal pelvis, ureters, bladder and urethra. The body takes nutrients from food and converts them to energy. After the body has taken the food components that it needs, waste products are left behind in the bowel and in the blood. The kidney and urinary systems help the body to eliminate liquid waste called urea, and to keep chemicals, such as potassium and sodium, and water in balance. Urea is produced when foods containing protein, such as meat, poultry, and certain vegetables, are broken down in the body. Urea is carried in the bloodstream to the kidneys, where it is removed along with water and other wastes in the form of urine. Other important functions of the kidneys include blood pressure regulation and the production of erythropoietin, which controls red blood cell production in the bone marrow. Kidneys also regulate the acid-base balance and conserve fluids. Click Image to Enlarge Kidney and urinary system parts and their functions Two kidneys. This pair of purplish-brown organs is located below the ribs toward the middle of the back.

Their function is to: Remove waste products and drugs from the body Balance the body's fluids Release hormones to regulate blood pressure Control production of red blood cells The kidneys remove urea from the blood through tiny filtering units called nephrons. Each nephron consists of a ball formed of small blood capillaries, called a glomerulus, and a small tube called a renal tubule. Urea, together with water and other waste substances, forms the urine as it passes through the nephrons and down the renal tubules of the kidney. Two ureters. These narrow tubes carry urine from the kidneys to the bladder. Muscles in the ureter walls continually tighten and relax forcing urine downward, away from the kidneys. If urine backs up, or is allowed to stand still, a kidney infection can develop. About every 10 to 15 seconds, small amounts of urine are emptied into the bladder from the ureters. Bladder. This triangle-shaped, hollow organ is located in the lower abdomen. It is held in place by ligaments that are attached to other organs and the pelvic bones. The bladder's walls relax and expand to store urine, and contract and flatten to empty urine through the urethra.

The typical healthy adult bladder can store up to two cups of urine for two to five hours. Upon examination, specific "landmarks" are used to describe the location of any irregularities in the bladder. These are: Trigone: a triangle-shaped region near the junction of the urethra and the bladder Right and left lateral walls: walls on either side of the trigone Posterior wall: back wall Dome: roof of the bladder Two sphincter muscles. These circular muscles help keep urine from leaking by closing tightly like a rubber band around the opening of the bladder. Nerves in the bladder. The nerves alert a person when it is time to urinate, or empty the bladder. Urethra. This tube allows urine to pass outside the body. The brain signals the bladder muscles to tighten, which squeezes urine out of the bladder. At the same time, the brain signals the sphincter muscles to relax to let urine exit the bladder through the urethra. When all the signals occur in the correct order, normal urination occurs. Facts about urine Normal, healthy urine is a pale straw or transparent yellow color. Darker yellow or honey colored urine means you need more water.

A darker, brownish color may indicate a liver problem or severe dehydration. Pinkish or red urine may mean blood in the urine. Experience Our Care The Kidney & Urology Foundation of America and become an essential part of the fight to save and improve lives. There are no fees for patients, family and friends to get connected! KUFA has moved! 104 West 40th Street, Suite 500 New York, NY 10018 63 West Main Street, Suite G Freehold, NJ 07728 Urinary System and how it Works The organs, tubes, muscles, and nerves that work together to create, store, and carry urine are the urinary system. The urinary system includes two kidneys, two ureters, the bladder, two sphincter muscles, and the urethra. How does the urinary system work? Front view of urinary tract. Your body takes nutrients from food and uses them to maintain all bodily functions including energy and self-repair. After your body has taken what it needs from the food, waste products are left behind in the blood and in the bowel.

The urinary system works with the lungs, skin, and intestines—all of which also excrete wastes—to keep the chemicals and water in your body balanced. Adults eliminate about a quart and a half of urine each day. The amount depends on many factors, especially the amounts of fluid and food a person consumes and how much fluid is lost through sweat and breathing. Certain types of medications can also affect the amount of urine eliminated. The urinary system removes a type of waste called urea from your blood. Urea is produced when foods containing protein, such as meat, poultry, and certain vegetables, are broken down in the body. Urea is carried in the bloodstream to the kidneys. The kidneys are bean-shaped organs about the size of your fists. They are near the middle of the back, just below the rib cage. The kidneys remove urea from the blood through tiny filtering units called nephrons. Each nephron consists of a ball formed of small blood capillaries, called a glomerulus, and a small tube called a renal tubule. Urea, together with water and other waste substances, forms the urine as it passes through the nephrons and down the renal tubules of the kidney.

From the kidneys, urine travels down two thin tubes called ureters to the bladder. The ureters are about 8 to 10 inches long. Muscles in the ureter walls constantly tighten and relax to force urine downward away from the kidneys. If urine is allowed to stand still, or back up, a kidney infection can develop. Small amounts of urine are emptied into the bladder from the ureters about every 10 to 15 seconds. The bladder is a hollow muscular organ shaped like a balloon. It sits in your pelvis and is held in place by ligaments attached to other organs and the pelvic bones. The bladder stores urine until you are ready to go to the bathroom to empty it. It swells into a round shape when it is full and gets smaller when empty. If the urinary system is healthy, the bladder can hold up to 16 ounces (2 cups) of urine comfortably for 2 to 5 hours. Circular muscles called sphincters help keep urine from leaking. The sphincter muscles close tightly like a rubber band around the opening of the bladder into the urethra, the tube that allows urine to pass outside the body.

Nerves in the bladder tell you when it is time to urinate, or empty your bladder. As the bladder first fills with urine, you may notice a feeling that you need to urinate. The sensation to urinate becomes stronger as the bladder continues to fill and reaches its limit. At that point, nerves from the bladder send a message to the brain that the bladder is full, and your urge to empty your bladder intensifies. When you urinate, the brain signals the bladder muscles to tighten, squeezing urine out of the bladder. At the same time, the brain signals the sphincter muscles to relax. As these muscles relax, urine exits the bladder through the urethra. When all the signals occur in the correct order, normal urination occurs. What causes problems in the urinary system? Problems in the urinary system can be caused by aging, illness, or injury. As you get older, changes in the kidneys’ structure cause them to lose some of their ability to remove wastes from the blood. Also, the muscles in your ureters, bladder, and urethra tend to lose some of their strength. You may have more urinary infections because the bladder muscles do not tighten enough to empty your bladder completely.

A decrease in strength of muscles of the sphincters and the pelvis can also cause incontinence, the unwanted leakage of urine. Illness or injury can also prevent the kidneys from filtering the blood completely or block the passage of urine. How are problems in the urinary system detected? Urinalysis is a test that studies the content of urine for abnormal substances such as protein or signs of infection. This test involves urinating into a special container and leaving the sample to be studied. Urodynamic tests evaluate the storage of urine in the bladder and the flow of urine from the bladder through the urethra. Your doctor may want to do a urodynamic test if you are having symptoms that suggest problems with the muscles or nerves of your lower urinary system and pelvis—ureters, bladder, urethra, and sphincter muscles. Urodynamic tests measure the contraction of the bladder muscle as it fills and empties. The test is done by inserting a small tube called a catheter through your urethra into your bladder to fill it either with water or a gas. Another small tube is inserted into your rectum or vagina to measure the pressure put on your bladder when you strain or cough.

Other bladder tests use x-ray dye instead of water so that x-ray pictures can be taken when the bladder fills and empties to detect any abnormalities in the shape and function of the bladder. These tests take about an hour. What are some disorders of the urinary system? Disorders of the urinary system range in severity from easy to treat to life threatening. Benign prostatic hyperplasia (BPH) is a condition in men that affects the prostate gland, which is part of the male reproductive system. The prostate is located at the bottom of the bladder and surrounds the urethra. BPH is an enlargement of the prostate gland that can interfere with urinary function in older men. It causes blockage by squeezing the urethra, which can make it difficult to urinate. Men with BPH frequently have other bladder symptoms including an increase in frequency of bladder emptying both during the day and at night. Most men over age 60 have some BPH, but not all have problems with blockage. There are many different treatment options for BPH. Painful bladder syndrome/Interstitial cystitis (PBS/IC) is a chronic bladder disorder also known as frequency-urgency-dysuria syndrome.

In this disorder, the bladder wall can become inflamed and irritated. The inflammation can lead to scarring and stiffening of the bladder, decreased bladder capacity, pinpoint bleeding, and, in rare cases, ulcers in the bladder lining. The cause of IC is unknown at this time. Kidney stones is the term commonly used to refer to stones, or calculi, in the urinary system. Stones form in the kidneys and may be found anywhere in the urinary system. They vary in size. Some stones cause great pain while others cause very little. The aim of treatment is to remove the stones, prevent infection, and prevent recurrence. Both nonsurgical and surgical treatments are used. Kidney stones affect men more often than women. Prostatitis is inflammation of the prostate gland that results in urinary frequency and urgency, burning or painful urination, a condition called dysuria, and pain in the lower back and genital area, among other symptoms. In some cases, prostatitis is caused by bacterial infection and can be treated with antibiotics. But the more common forms of prostatitis are not associated with any known infecting organism. Antibiotics are often ineffective in treating the nonbacterial forms of prostatitis.

Proteinuria is the presence of abnormal amounts of protein in the urine. Healthy kidneys take wastes out of the blood but leave in protein. Protein in the urine does not cause a problem by itself. But it may be a sign that your kidneys are not working properly. Renal (kidney) failure results when the kidneys are not able to regulate water and chemicals in the body or remove waste products from your blood. Acute renal failure (ARF) is the sudden onset of kidney failure. This condition can be caused by an accident that injures the kidneys, loss of a lot of blood, or some drugs or poisons. ARF may lead to permanent loss of kidney function. But if the kidneys are not seriously damaged, they may recover. Chronic kidney disease (CKD) is the gradual reduction of kidney function that may lead to permanent kidney failure, or end-stage renal disease (ESRD). You may go several years without knowing you have CKD. Urinary tract infections (UTIs) are caused by bacteria in the urinary tract. Women get UTIs more often than men. UTIs are treated with antibiotics. Drinking lots of fluids also helps by flushing out the bacteria.

The name of the UTI depends on its location in the urinary tract. An infection in the bladder is called cystitis. If the infection is in one or both of the kidneys, the infection is called pyelonephritis. This type of UTI can cause serious damage to the kidneys if it is not adequately treated. Urinary incontinence, loss of bladder control, is the involuntary passage of urine. There are many causes and types of incontinence, and many treatment options. Treatments range from simple exercises to surgery. Women are affected by urinary incontinence more often than men. Urinary retention, or bladder-emptying problems, is a common urological problem with many possible causes. Normally, urination can be initiated voluntarily and the bladder empties completely. Urinary retention is the abnormal holding of urine in the bladder. Acute urinary retention is the sudden inability to urinate, causing pain and discomfort. Causes can include an obstruction in the urinary system, stress, or neurologic problems. Chronic urinary retention refers to the persistent presence of urine left in the bladder after incomplete emptying. Common causes of chronic urinary retention are bladder muscle failure, nerve damage, or obstructions in the urinary tract.

Treatment for urinary retention depends on the cause. Who can help me with a urinary problem? Your primary doctor can help you with some urinary problems. Your pediatrician may be able to treat some of your child’s urinary problems. But some problems may require the attention of a urologist, a doctor who specializes in treating problems of the urinary system and the male reproductive system. A gynecologist is a doctor who specializes in the female reproductive system and may be able to help with some urinary problems. A urogynecologist is a gynecologist who specializes in the female urinary system. A nephrologist specializes in treating diseases of the kidney. Points to Remember Your urinary system filters waste and extra fluid from your blood. Problems in the urinary system include kidney failure, urinary tract infections, kidney stones, prostate enlargement, and bladder control problems. Health professionals who treat urinary problems include general practitioners (your primary doctor), pediatricians, urologists, gynecologists, urogynecologists, and nephrologists. Printed with permission from the National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC), a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

The NIDDK is part of the National Institutes of Health of the U.S. Department of Health and Human Services. NIH Publication No. 07–3195 October 2006 Kidneys and Urinary Tract Kidneys and Urinary Tract Los riñones y las vías urinarias Kidneys and Urinary Tract Basics Our bodies produce several kinds of wastes, including sweat, carbon dioxide gas, feces (stool or poop), and urine (pee). These wastes leave the body in different ways. Sweat is released through pores in the skin. Water vapor and carbon dioxide are exhaled from the lungs. And undigested food materials are formed into feces in the intestines and excreted from the body as solid waste in bowel movements. Urine, which is produced by the kidneys, contains the byproducts of metabolism — salts, toxins, and water — that end up in the blood. The kidneys and urinary tract (which includes the kidneys, ureters, bladder, and urethra) filter and eliminate these waste substances from our blood. Without the kidneys, waste products and toxins would soon build up in the blood to dangerous levels.

Besides eliminating wastes, the kidneys and urinary tract also regulate many important body functions. For example, the kidneys monitor and maintain the body's balance of water, ensuring that our tissues receive enough water to work properly and be healthy. When doctors take a urine sample , the results reveal how well the kidneys are working. For example, blood, protein, or white blood cells in pee may indicate injury, inflammation, or infection of the kidneys, and glucose in the urine might be a sign of diabetes . What Kidneys Do Although the two kidneys work together on many vital functions, people can live a normal, healthy life with just one kidney. In fact, some people are born with just one of these bean-shaped organs. If one kidney is removed, the remaining one will enlarge within a few months to take over the role of filtering blood on its own. Every minute, more than 1 quart (about 1 liter) of blood goes to the kidneys. About one fifth of the blood pumped from the heart goes to the kidneys at any one time. Besides filtering blood, making urine, and ensuring that body tissues get enough water, the kidneys also regulate blood pressure and the level of vital salts in the blood.

The kidneys also secrete the hormone erythropoietin, which stimulates and controls red blood cell production (red blood cells carry oxygen throughout the body). Plus, the kidneys help regulate the acid-base balance (or the pH) of the blood and body fluids, which is necessary for the body to work as it should. continue How the Kidneys and Urinary Tract Work The kidneys are located just under the ribcage in the back, one on each side. The right kidney is below the liver, so it's a little lower than the left one. Each adult kidney is about the size of a fist. Each has an outer layer called the cortex, which contains the filtering units. The center part of the kidney, the medulla, has 10 to 15 fan-shaped structures called pyramids. These drain urine into cup-shaped tubes called calyxes. A layer of fat surrounds the kidneys to cushion and help hold them in place. Here's how the kidneys filter blood: Blood travels to each kidney through the renal artery, which enters the kidney at the hilus, the indentation in middle of the kidney that gives it its bean shape.

As it enters the cortex, the artery branches to envelope the nephrons — 1 million tiny filtering units in each kidney that remove the harmful substances from the blood. Each of the nephrons contain a filter called the glomerulus, which contains a network of tiny blood vessels known as capillaries. The fluid filtered from the blood by the glomerulus then travels down a tiny tube-like structure called a tubule, which adjusts the level of salts, water, and wastes that are excreted in the urine. Filtered blood leaves the kidney through the renal vein and flows back to the heart. The continuous blood supply entering and leaving the kidneys gives the kidneys their dark red color. While the blood is in the kidneys, water and some of the other blood components (such as acids, glucose, and other nutrients) are reabsorbed into the bloodstream. Left behind is urine. Urine is a concentrated solution of waste material that contains water, urea (which forms when proteins are broken down), salts, amino acids, byproducts of bile from the liver, ammonia, and any substances that cannot be reabsorbed into the blood. Urine also has urochrome, a pigmented breakdown product of blood that gives pee its yellowish color.

The renal pelvis, located near the hilus, collects the urine flowing from the calyxes. From there, urine travels out of the kidneys through the ureters to be stored in the bladder (a muscular sac in the lower abdomen). The bladder expands as it fills and can hold about 2 cups (half a liter) of urine at any given time (the average adult produces about 6 cups, or 1½ liters, of pee per day). Producing too much or not enough urine may be a sign of illness. When the bladder is full, nerve endings in its wall send impulses to the brain. When a person is ready to pee, the bladder walls contract and the sphincter (a ring-like muscle that guards the exit from the bladder to the urethra) relaxes. The pee exits the bladder and goes out of the body through the urethra, another tube-like structure. The male urethra ends at the tip of the penis; the female urethra ends just above the vaginal opening. Kidneys and Urinary Tract Problems Like other systems in the body, the entire urinary tract is subject to diseases and disorders. In kids, the more common problems include: Congenital problems of the urinary tract.

As a fetus develops in the womb, any part of the urinary tract can grow to an abnormal size or in an abnormal shape or position. One common congenital (present at birth) abnormality is duplication of the ureters, in which a kidney has two ureters coming from it instead of one. This defect happens in about 1 out of every 125 births and can cause repeated infections and scarring over time. Another congenital problem is horseshoe kidney, where the two kidneys are fused (connected) into one arched kidney that usually works normally, but is more prone to problems later in life. This condition is found in 1 out of every 500 births. Glomerulonephritis . This is an inflammation of the glomeruli, the parts of the filtering units (nephrons) of the kidney that contain a network of capillaries (tiny blood vessels). The most common form is post-streptococcal glomerulonephritis, which usually affects young children after a case of strep throat . Most kids with this type of nephritis recover fully, but a few can have permanent kidney damage that eventually requires dialysis or a kidney transplant . High blood pressure (hypertension) .

High blood pressure can happen if the kidneys are harmed by disease. The kidneys control blood pressure by regulating the amount of salt in the body. They also produce the enzyme renin that, along with other substances, controls the constriction of muscle cells in the walls of the blood vessels, which affects a person's blood pressure. Kidney (renal) failure. This can be acute (sudden) or chronic (happening over time and usually long lasting or permanent). In either form of kidney failure, the kidneys slow down or stop filtering blood effectively, causing waste products and toxic substances to build up in the blood. Acute kidney failure may be due to many things, including bacterial infection, injury, shock, heart failure, poisoning, or drug overdose. Treatment includes correcting the problem that led to the failure, and sometimes requires surgery or dialysis. Dialysis involves using a machine or other artificial device to remove excess salts, water, and other wastes from the body when the kidneys can't. Chronic kidney failure involves a deterioration of kidney function over time. In children, this can be due to acute kidney failure that doesn't get better, kidney birth defects, chronic kidney diseases , repeated kidney infections, or chronic severe high blood pressure.

If diagnosed early, chronic kidney failure can be treated but usually not reversed. The child may require a kidney transplant at some point in the future. Kidney stones (nephrolithiasis). Kidney stones (also called calculi) are due to a buildup of crystallized salts and minerals such as calcium in the urinary tract. They also can form after an infection. Kidney stones that are large enough to block the kidney or ureter can cause severe abdominal pain. The stones usually pass through the urinary tract on their own, but some need to be removed surgically. Nephritis is any inflammation of the kidney. This can be caused by infection, medicines, or an autoimmune disease (such as lupus ), but sometimes the exact cause isn't known. Nephritis is usually detected when protein and blood are found in the urine. Nephrotic syndrome. This type of kidney disease leads to loss of protein in the urine and swelling of the face (often the eyes) or body (often around the genitals). It's most common in children younger than 6 years old and affects more boys than girls. It's often treated with steroids. Urinary tract infections (UTIs) . Most UTIs are caused by intestinal bacteria (such as E.

coli) that are normally found in feces. These bacteria can cause infections anywhere in the urinary tract, including the kidneys. Most UTIs happen in the lower urinary tract (the bladder and urethra). UTIs affect both boys and girls, but in school-age children, girls are more likely to develop them than boys. This might be because girls have shorter urethras than boys. Vesicoureteral reflux (VUR) . In this condition, pee abnormally flows backward (or refluxes) from the bladder into the ureters. It may even reach the kidneys, where infection and scarring can happen over time. VUR tends to run in families. It's often found after a young child has a first urinary tract infection. Most kids outgrow mild forms of VUR, but some can develop permanent kidney damage and kidney failure later in life. Wilms' tumor . The most common kidney cancer in children, this is most often diagnosed in kids between 2 and 5 years of age, and affects boys and girls equally. What Is a Ureter? (with pictures) What Is a Ureter?

Last Modified Date: 11 January 2017 Copyright Protected: Top 10 unbelievable historical concurrencies The ureter is a small tube that connects a kidney to a urinary bladder . Humans, along with most other mammals, typically have two ureters, with one coming from each kidney. These ureters run down the back of the abdominal cavity before connecting to the urinary bladder. Kidney stones traveling down one of these tubes can be very uncomfortable or painful, and it can cause inflammation in the area. Salt and excess water are filtered from the blood by the kidneys. These bean-shaped organs are located on either side of the back of the abdomen. Ureters are the muscular tubes that lead from each of the kidneys to the urinary bladder. Each ureter is typically quite small. In an average adult, the ureters are about 3 millimeters (0.12 inches) in diameter. They may also be up to 30 millimeters (1.18 inches) long. The ureter leaves the kidney via the renal pelvis . This is a funnel-shaped part of the kidney. It is located near the center of the organ. Ureters are typically made up of three layers.

The outside layer is made from supportive connective tissue, and it is often known as the fibrous coat. The middle layer is made from smooth muscle, and it aids in peristalsis, which helps move the urine from the kidney to the bladder. Inside a ureter, a layer of smooth tissue secretes mucus, which helps line and protect the tube. Ad After leaving the kidneys, the ureter runs down the back of the abdomen. It then connects to the urinary bladder. The two ureters connect to either side of the top of the bladder, which is the organ that stores urine until it is expelled from the body. Urine is expelled from each kidney into its respective ureter. Once it enters the ureters, peristalsis moves the urine down the tube and into the bladder. During peristalsis, the walls of each ureter constrict and relax, which pushes the contents of the tube toward the other end. Ureteritis is a painful condition that occurs when a ureter becomes inflamed. This often occurs when a kidney stone is being passed from the kidney into the ureter. The sharp edges of a kidney stone can agitate the delicate lining of a ureter.

Many times, passing a kidney stone is extremely painful, and some stones are so large that they need to be broken up before they can pass through a ureter. Ad Ch 24 Urinary System - StudyBlue Good to have you back! If you've signed in to StudyBlue with Facebook in the past, please do that again.

Ch 24 Urinary System Tubes that conduct urine from the kidneys to the bladder Urethra Tube that conducts urine from the bladder to the exterior for elimination Advertisement ) Reservoir that receives and stores urine Bladder A foley catheter is inserted into this organ for drainage Kidneys Bean-shaped organs that make urine Ureters Pathogens can ascend from the bladder through these tubes to the kidneys, thereby causing a kidney infection Bladder Structure that is involved in urinary retention Bladder Structure that contains the trigone, a triangle formed by the two points of entrance of the ureters and the exit point of the urethra Urethra The external sphincter surrounds the upper region of this structure Bladder The internal sphincter is located at the exit of this structure Urethra The prostate gland encircles the proximal end of this structure Hilus The indention of the bean-shaped kidney; the point where the blood vessels, nerves, and ureter enter or exit the kidney Bladder The wall of this structure is arranged in rugae to allow for expansion Kidneys Basin within the kidney that collects the urine made by the kidney Renal columns The lighter, outer region of the kidney, called the renal cortex, extends inward to form these structures Advertisement Ren

al pyramids The darker, inner region of the kidney, called the renal medulla, forms these striped cone-shaped regions.

Calyces Cup like edges of the renal pelvis that receives the urine from the renal pyramids and empty it into the renal pelvis Calyces Cup like edges of the renal pelvis that receives the urine from the renal pyramids and empty it into the renal pelvis Renal capsule Tough outer lining that encases the kidney Bladder Storage structure that contains the detrusor muscle Bladder Storage structure that empties during micturition Glomerulus Tuft of capillaries across which water and solute are filtered Collecting ducts The distal convoluted tubule empties urine into this structure Collecting duct Structure that is most concerned with the concentration of urine Peritubular capillaries Vascular structure that surrounds the tubules; invoked in reabsorption and secretion Collecting duct The site at which hormone (ADH) is most active Proximal convoluted tubule Most reabsorption occurs across the walls of this tubular structure Peritubular capillaries The efferent arteriole extends and becomes this structure Glomerulus The afferent and efferent arterioles bracket (form bookends to) This structure Collecting duct The final adjustment of urine occurs at this site Loop of henle The

 proximal convoluted tubule extends as this structure Distal convoluted tubule Site at which aldosterone is most active Glomerulus These capillaries sit within the c-shaped bowman's capsule Pertubular capillaries Vascular structures that empties blood into the venules and eventually into the renal vein Peritubular The process of secretion causes solute to move from this structure into the tubules Loop of henle Composed of an ascending and a descending limb Peritubular capillaries Reabsorption causes water and solute to move from the tubule into this structure Loop of henle Hairpin structure between the proximal and distal tubules Collecting duct Tubular structure that carries urine from the distal tubule to the calyx Descending limb (loop of Henle) Connects the proximal convoluted tube with the ascending limb of the loop of Henley Glomerulus Connects the afferent arteriole with the efferent arteriole Ascending limb (loop of henle) Connects the descending limb of the loop of henle with the distal convoluted tubule Collecting duct Connects the distal convoluted tubule with the calyx Ureters(s

) Connects the renal pelvis with the urinary bladder Proximal convoluted tubule Connects Bowman's capsule to the loop of henle Urethra Connects the urinary bladder to the urinary meatus Ureter(s) Connects the kidney to the urinary bladder Urinary bladder Connects ureters with the urethra Peritubular capillaries Connects the efferent arteriole to the renal veins Angiotensin II Hormone that stimulates the adrenal cortex to secrete aldosterone and causes vasoconstriction of the peripheral blood vessels, thereby elevating blood pressure Aldosterone The adrenal cortical hormone that stimulates the distal tubule to reabsorb sodium and excrete potassium Converting enzyme Enzyme that changes angiotensin I to angiotensin II Aldosterone The mineralcorticoid that is called the salt-retaining hormone ADH Secreted by the posterior pituitary gland; this hormone affects the permeability of the collecting duct to water Erythropoietin Released by the kidney in response to hypoxemia; it stimulates red blood cell production by the bone marrow Renin Secreted by the juxtaglomerular apparatus (JGA) when blood pressure and/or blood volume decreases AN

P Secreted by the atrial walls in response to an increase in blood volume; causes the excretion of sodium and water Renin Enzyme that activates angiotensinogen to angiotensin I ADH A deficiency of this hormone polyuria (diuresis), sometimes up to 25 L of urine/day; this hormone deficiency disease is called diabetes insipidus PTH Stimulates the renal tubules to reabsorb calcium and to excrete phosphate BNP Hormone that is released to ventricular stretch; elevated in heart failure PTH A deficiency of this hormone causes hypocalcemic tetany Erythropoietin Hormone that is deficient in a patient with chronic renal failure; causes anemia Angiotensin II ACE inhibitors block the formation of this vasopressor hormone Aldosterone A deficiency of this hormone causes the urinary excretion of Na+ and water and the retention of K+ PTH An excess of this hormone can cause hypercalcemia and kidney stones Mucous membrane lining Part of the lower urinary tract that is inflamed with a bladder infection True statement about urine Why bladder infections are more common in men Urethra is shorter in female than in male Least true about urinary bladder The bladder wall is responsive

 to the effects of ADH Urinary output declines Not a function of aldosterone Most filtered creatinine is eliminated in the urine Most accurate statement regarding creatinine Kidney failure An elevated serum creatinine level is most inductive of True statement Most water reabsorption occurs at the proximal tubule Angiotensin II causes the adrenal cortical secretion of aldosterone When the renin-angiotensin-aldosterone system is activated Glomerulus Bowman's capsule receives water and dissolved solute from the Efferent arteriole Delivers blood to the Peritubular capillary The renal pelvis Receives urine from the calyces Angiotensin II Is produced in response to the activity of converting enzyme Urinary retention drugs (e.g., atropine) that interfere with the relaxation of the urinary bladder sphincter are most likely to cause Hypertension Person with a stenosed (narrowed) renal artery is most likely to present with Edema Person with damaged glomeruli filters large amounts of albumin and therefore develops Renal failure Kidney Stones Kidney Stones Guido R.

Zanni, PhD What Causes Kidney Stones? Kidneys are bean-shaped organs. Each person is born with 2 kidneys, which are located in the mid to lower back, with 1 kidney on each side. Kidneys filter blood and remove waste. Kidney stones are hard objects that are made from chemicals in the urine. When there is too little urine and a lot of waste, chemicals begin to form crystals. These crystals attract other chemicals that form a hard mass resembling a stone. Most stones are formed in the kidneys. When large stones leave the kidneys, they get stuck in the tube that connects the kidney to the bladder. This tube is called the ureter. There are several types of stones, which can be smooth or jagged. Different stones contain different chemicals (Table 1). If you pass a stone, try to retrieve it and take it to your doctor. Knowing the type of stone you passed helps determine treatment options. What Are the Symptoms of Kidney Stones? Small stones are usually passed without any symptoms. Medium to large stones eventually begin to move from the kidney to the ureter, where they get stuck. The main symptom is severe pain on either side of the back.

This pain results from the body’s attempt to move the stone out of the ureter and into the bladder. Many people describe the pain as the worst they have ever experienced. Pain often spreads to the lower stomach area and the groin. The pain comes and goes, lasting 20 to 60 minutes. Other symptoms may include fever, vomiting, nausea, diarrhea, blood in the urine, burning sensation when urinating, and frequent urges to urinate.3,4 Why Do Some People Get Kidney Stones? We know kidney stones run in families. If your parents or siblings had kidney stones, you have a higher risk of developing a kidney stone. Eating a diet high in salt, sugar, and animal protein is also associated with kidney stone formation.5 Some medical conditions and medications increase the risk for stone development. Medical conditions that increase the risk include high blood pressure, bladder infection, obesity, and diseases of the intestine and colon. Medications that increase the risk include drugs to treat HIV/AIDS and chemotherapy.4 What Is the Treatment? The first goal of treatment is to remove kidney stones that are stuck in the kidney, ureter, or bladder. The second goal is to treat the pain.

The third goal is to prevent future stones from forming. If you have a kidney stone that is stuck in the ureter, you will be asked to drink lots of water in a short period of time to “flush out” the stone. Minor pain is treated with OTC pain relievers. If pain is severe, you will be given a prescription pain medication. If the stone does not pass within 5 to 7 days, your doctor may try to break it into smaller pieces by using a machine that delivers shockwaves to the stone. This procedure does not work for large stones, which must be removed in a hospital. Your doctor will insert a scope (a tube with an eyepiece) and a laser into your genitals, up to the bladder, and into the ureter. The stone is then removed or broken into smaller pieces. Extremely large stones require surgery. A small incision is made into the back so the surgeon has direct access to the kidney and ureter. Once kidney stones are removed, your doctor may prescribe medication to prevent future stones. The choice of medication depends on the composition of the stone. Medications are not 100% effective.

Even with treatment, there is a 50% chance of having a second stone 5 to 7 years after the first episode.2 Can Dietary Changes Help? Diet can play a key role in preventing kidney stones. Table 2 lists several things you can do to prevent kidney stones. Dr. Zanni is a psychologist and health systems consultant based in Alexandria, Virgini References National Kidney and Urologic Diseases Information Clearinghouse. Kidney stones in adults. Accessed June 22, 2013. National Kidney Foundation. Kidney stones. Accessed June 22, 2013. Zanni G. Management and prevention of kidney stones. Pharm Times. 2006;8:102-104. Disease Symptoms & Treatment. Kidney stones. Accessed June 22, 2013. Mayo Clinic Staff. Kidney stones. Accessed June 22, 2013. National Kidney Foundation. Diet and kidney stones. Accessed June 22, 2013. National Kidney Foundation. 6 easy ways to prevent kidney stones.

Accessed June 22, 2013. National Kidney and Urologic Diseases Information Clearinghouse. Diet for kidney stone prevention. Accessed June 22, 2013. Sakhaee K, Maalouf NM, Sinnott B. Clinical review. Kidney stones 2012: pathogenesis, diagnosis, and management. J Clin Endocrinol Metab. 2012;97(6):1847-1860. SHARE THIS Kidney, Ureter, and Bladder X-ray | Johns Hopkins Medicine Health Library Kidney, Ureter, and Bladder X-ray See related health (KUB [Kidneys, Ureters, Bladder], KUB X-ray, Flat Plate of the Abdomen X-ray) Procedure overview What is a kidneys, ureter, and bladder X-ray? A kidney, ureter, and bladder (KUB) X-ray may be performed to assess the abdominal area for causes of abdominal pain, or to assess the organs and structures of the urinary and/or gastrointestinal (GI) system. A KUB X-ray may be the first diagnostic procedure used to assess the urinary system.

X-rays use invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs on film. X-rays are made by using external radiation to produce images of the body, its organs, and other internal structures for diagnostic purposes. X-rays pass through body tissues onto specially treated plates (similar to camera film) and a "negative" type picture is made (the more solid a structure is, the whiter it appears on the film). Digital films and digital media are more commonly used now than the film media. How does the urinary system work? Click Image to Enlarge The body takes nutrients from food and converts them to energy. After the body has taken the food components that it needs, waste products are left behind in the bowel and in the blood. The urinary system helps the body to eliminate liquid waste in the blood called urea, and keeps chemicals, such as potassium and sodium, and water in balance. Urea is produced when foods containing protein, such as meat, poultry, and certain vegetables, are broken down in the body. Urea is carried in the bloodstream to the kidneys, where it is removed along with water and other wastes in the form of urine. Urinary system parts and their functions: Two kidneys.

This pair of purplish-brown organs is located below the ribs toward the middle of the back. Their function is to: remove liquid waste from the blood in the form of urine keep a stable balance of salts and other substances in the blood produce erythropoietin, a hormone that aids the formation of red blood cells regulate blood pressure The kidneys remove urea from the blood through tiny filtering units called nephrons. Each nephron consists of a ball formed of small blood capillaries, called a glomerulus, and a small tube called a renal tubule. Urea, together with water and other waste substances, forms the urine as it passes through the nephrons and down the renal tubules of the kidney. Two ureters. These narrow tubes carry urine from the kidneys to the bladder. Muscles in the ureter walls continually tighten and relax forcing urine downward, away from the kidneys. If urine backs up, or is allowed to stand still, a kidney infection can develop. About every 10 to 15 seconds, small amounts of urine are emptied into the bladder from the ureters. Bladder. This triangle-shaped, hollow organ located in the pelvis.

It is held in place by ligaments that are attached to other organs and the pelvic bones. The bladder's walls relax and expand to store urine, and contract and flatten to empty urine through the urethra. The typical healthy adult bladder can store up to two cups of urine for two to five hours. Two sphincter muscles. These circular muscles help keep urine from leaking by closing tightly like a rubber band around the opening of the bladder. Nerves in the bladder. The nerves alert a person when it is time to urinate, or empty the bladder. Urethra. This tube allows urine to pass outside the body. The brain signals the bladder muscles to tighten, which squeezes urine out of the bladder. At the same time, the brain signals the sphincter muscles to relax to let urine exit the bladder through the urethra. When all the signals occur in the correct order, normal urination occurs. Facts about urine: Adults pass about a quart and a half of urine each day, depending on the fluids and foods consumed. The volume of urine formed at night is about half that formed in the daytime. Normal urine is sterile.

It contains fluids, salts and waste products, but it is free of bacteria, viruses, and fungi. The tissues of the bladder are isolated from urine and toxic substances by a coating that discourages bacteria from attaching and growing on the bladder wall. Reasons for the procedure A KUB X-ray may be performed to help diagnose the cause of abdominal pain, such as masses, perforations, or obstruction. A KUB X-ray may be taken to evaluate the urinary tract before other diagnostic procedures are performed. Basic information regarding the size, shape, and position of the kidneys, ureters, and bladder may be obtained with a KUB X-ray. The presence of calcifications ( kidney stones ) in the kidneys or ureters may be noted. There may be other reasons for your doctor to recommend a KUB X-ray. Risks of the procedure You may want to ask your doctor about the amount of radiation used during the procedure and the risks related to your particular situation. It is a good idea to keep a record of your past history of radiation exposure, such as previous scans and other types of X-rays, so that you can inform your doctor.

Risks associated with radiation exposure may be related to the cumulative number of X-ray examinations and/or treatments over a long period of time. Notify your health care provider if you are pregnant or suspect that you may be pregnant. Radiation exposure during pregnancy may lead to birth defects. There may be other risks depending on your specific medical condition. Be sure to discuss any concerns with your physician prior to the procedure. Certain factors or conditions may interfere with the accuracy of a KUB X-ray. These factors include, but are not limited to, the following: Recent barium X-rays of the abdomen Gas , feces, or foreign body in the intestine Uterine or ovarian masses, such as calcified fibromas of the uterus or ovarian lesions Before the procedure Your doctor will explain the procedure to you and offer you the opportunity to ask any questions that you might have about the procedure. Generally, no prior preparation, such as fasting or sedation, is required. Notify the radiologic technologist if you are pregnant or suspect you may be pregnant. Notify your doctor and radiologic technologist if you have taken a medication that contains bismuth, such as Pepto-Bismol, in the past four days.

Medications that contain bismuth may interfere with testing procedures. Based on your medical condition, your doctor may request other specific preparation. During the procedure A KUB X-ray may be performed on an outpatient basis or as part of your stay in a hospital. Procedures may vary depending on your condition and your doctor's practices. Generally, a KUB X-ray follows this process: You will be asked to remove any clothing, jewelry, or other objects that might interfere with the procedure. If you are asked to remove clothing, you will be given a gown to wear. You will be positioned in a manner that carefully places the part of the abdomen that is to be X-rayed between the X-ray machine and a cassette containing the X-ray film or digital media. You may be asked to stand erect, to lie flat on a table, or to lie on your side on a table, depending on the X-ray view your doctor has requested. You may have X-rays taken from more than one position. Body parts not being imaged may be covered with a lead apron (shield) to avoid exposure to the X-rays. Once you are positioned, the radiologic technologist will ask you to hold still for a few moments while the X-ray exposure is made.

It is extremely important to remain completely still while the exposure is made, as any movement may distort the image and even require another X-ray to be done to obtain a clear image of the body part in question. The X-ray beam will be focused on the area to be photographed. The radiologic technologist will step behind a protective window while the image is taken. While the X-ray procedure itself causes no pain, the manipulation of the body part being examined may cause some discomfort or pain, particularly in the case of a recent injury or invasive procedure, such as surgery. The radiologic technologist will use all possible comfort measures and complete the procedure as quickly as possible to minimize any discomfort or pain. After the procedure Generally, there is no special type of care following a KUB X-ray. However, your doctor may give you additional or alternate instructions after the procedure, depending on your particular situation. Experience Our Care

Question: What tube connects the kidney to the bladder?
Answer: Ureter