loop of Henle | anatomy | Britannica.com Loop of Henle Alternative Titles: Henle’s loop, nephronic loop Related Topics human body Loop of Henle, long, U-shaped portion of the tubule that conducts urine within each nephron of the kidney of reptiles, birds, and mammals. The principal function of the loop of Henle appears to be the recovery of water and sodium chloride from the urine. This function allows production of urine that is far more concentrated than blood, limiting the amount of water needed as intake for survival. Many species that live in arid environments such as deserts have highly efficient loops of Henle. Each nephron of the kidney contains blood vessels and a special tubule. As the filtrate flows … Encyclopædia Britannica, Inc. The liquid entering the loop is the solution of salt, urea , and other substances passed along by the proximal convoluted tubule , from which most of the dissolved components needed by the body—particularly glucose, amino acids, and sodium bicarbonate—have been reabsorbed into the blood.

The first segment of the loop, the descending limb, is permeable to water, and the liquid reaching the bend of the loop is much richer than the blood plasma in salt and urea. As the liquid returns through the ascending limb, sodium chloride diffuses out of the tubule into the surrounding tissue, where its concentration is lower. In the third segment of the loop, the tubule wall can, if necessary, effect further removal of salt, even against the concentration gradient, in an active-transport process requiring the expenditure of energy. In a healthy person the reabsorption of salt from the urine exactly maintains the bodily requirement: during periods of low salt intake, virtually none is allowed to escape in the urine, but, in periods of high salt intake, the excess is excreted. Learn More in these related articles: in renal system (anatomy) What is the ascending loop of Henle? | Reference.com What is the ascending loop of Henle? A: Quick Answer The ascending loop of Henle is a portion of the nephron in the kidney. It connects to the descending loop of Henle and runs through the medulla of the nephron in the kidney.

Together, the descending and ascending loops of Henle reabsorb water and ions for the kidney. Full Answer The ascending loop of Henle and the descending loop of Henle have different types of cells which have different permeabilities. The descending portion is permeable to water and allows water to be absorbed by the nephron to be excreted as urine. It can also allow water to be reabsorbed by the body. The ascending loop of Henle is permeable to ions, such as sodium and potassium, and it is not permeable to water. Ions can leave or enter the urine through the ascending loop of Henle, depending on what the body needs.

Inside Your Kidneys - How Your Kidneys Work | HowStuffWorks How Your Kidneys Work Diagram showing the parts of the kidney and the nephron If you were to cut a kidney in half, you would see the following parts: Renal capsule - a thin, outer membrane that helps protect the kidney Cortex - a lightly colored outer region Medulla - a darker, reddish-brown, inner region Renal pelvis - a flat, funnel-shaped cavity that collects the urine into the ureters If you look closely at the cortex and medulla, you can see many tiny, tubular structures that stretch across both regions perpendicular to the surface of the kidney. In each kidney, there are one million of these structures, called nephrons. The nephron is the basic unit of the kidney. It's a long, thin tube that is closed at one end, has two twisted regions interspaced with a long hairpin loop, ends in a long straight portion and is surrounded by capillaries. Up Next The parts of the nephron are as follows: Bowman's capsule - This closed end at the beginning of the nephron is located in the cortex.

Proximal convoluted tubule or proximal tubule - The first twisted region after the Bowman's capsule; it's in the cortex. Loop of Henle - A long, hairpin loop after the proximal tubule, it extends from the cortex down into the medulla and back. Distal convoluted tubule or distal tubule - This second twisted portion of the nephron after the loop of Henle is located in the cortex. Collecting duct - This long straight portion after the distal tubule that is the open end of the nephron extends from the cortex down through the medulla. Each part of the nephron has different types of cells with different properties -- this is important in understanding how the kidney regulates the composition of the blood.

The nephron has a unique blood supply compared to other organs: Afferent arteriole - connects the renal artery with the glomerular capillaries Glomerular capillaries - coiled capillaries that are inside the Bowman's capsule Efferent arteriole - connects the glomerular capillaries with the peritubular capillaries Peritubular capillaries - located after the glomerular capillaries and surrounding the proximal tubule, loop of Henle, and distal tubule Interlobular veins - drain the peritubular capillaries into the renal vein The kidney is the only organ of the body in which two capillary beds, in series, connect arteries with veins. This arrangement is important for maintaining a constant blood flow through and around the nephron despite fluctuations in systemic blood pressure.

Regulating the composition of the blood involves the following: Keeping the concentrations of various ions and other important substances constant Keeping the volume of water in your body constant Removing wastes from your body Keeping the acid/base concentration of your blood constant The kidney does this by a combination of three processes: It filters 20 percent of the plasma and non-cell elements from the blood into the inside of the nephron (the lumen). It reabsorbs the components that the body needs from the lumen back into the blood. It secretes some unwanted components from the blood into the lumen of the nephron. Anything (fluid, ions, small molecules) that has not been reabsorbed from the lumen gets swept away to form the urine, which ultimately leaves the body. Through these processes, the blood is maintained with the proper composition, and excess or unwanted substances are removed from the blood into the urine. Next, we'll look at how the kidneys regulate blood composition by three main processes: Filtration 1000+ images about Nursing: A&P, Renal on Pinterest | Heart, Toilets and Models Do NOT slack on your anatomy and physiology! Know what the kidney is capable of. --- Visit for your daily dose of nursing education!

--- #nclex #nursing #nclextips #nclex_tips #nurse #nursingschool #nursing_school #nursingstudent #nursing_student See More Kidney Function and Physiology About Watch and Favorite Watch Watching this resources will notify you when proposed changes or new versions are created so you can keep track of improvements that have been made. Favorite Favoriting this resource allows you to save it in the “My Resources” tab of your account. There, you can easily access this resource later when you’re ready to customize it or assign it to your students. Kidney Function and Physiology Urine is a byproduct of the osmoregulatory function of kidneys, which filter blood, reabsorb water and nutrients, and secrete wastes. Learning Objective Outline the process by which kidneys filter blood, reabsorb nutrients and water, and produce urine Key Points Glomerular filtration, tubular reabsorption, and tubular secretion are the three primary steps in which kidneys filter blood and maintain proper electrolyte balance. Glomerular filtration removes solutes from the blood; it is the first step of urine formation.

In tubular reabsoption, the second step of urine formation, almost all nutrients are reabsorbed in the renal tubule by active or passive transport . Tubular secretion is the last step of urine formation, where solutes and waste are secreted into the collecting ducts, ultimately flowing to the bladder in the form of urine. Terms Full Text Blood Filtration and Nutrient and Water Reabsorption Kidneys filter blood in a three-step process. First, the nephrons filter blood that runs through the capillary network in the glomerulus . Almost all solutes, except for proteins , are filtered out into the glomerulus by a process called glomerular filtration. Second, the renal tubules collect the filtrate. Most of the solutes are reabsorbed in the PCT by a process called tubular reabsorption. In the loop of Henle , the filtrate continues to exchange solutes and water with the renal medulla and the peritubular capillary network. Each part of the nephron performs a different function in filtering waste and maintaining homeostatic balance.

Finally, some substances, such as electrolytes and drugs, are removed from blood through the peritubular capillary network into the distal convoluted tubule or collecting duct. Urine is a collection of substances that have not been reabsorbed during glomerular filtration or tubular reabsorbtion. Glomerular Filtration The formation of urine occurs through three steps: glomerular filtration, tubular reabsorption, and tubular secretion. The process of glomerular filtration filters out most of the solutes due to the high blood pressure and specialized membranes in the afferent arteriole . The blood pressure in the glomerulus is maintained independent of factors that affect systemic blood pressure. The "leaky" connections between the endothelial cells of the glomerular capillary network allow solutes to pass through easily. All solutes in the glomerular capillaries, including sodium ions and negatively and positively charged ions, pass through by passive diffusion; the only exception is macromolecules such as proteins. There is no energy requirement at this stage of the filtration process. Glomerular filtration rate (GFR) is the volume of glomerular filtrate formed per minute by the kidneys.

GFR is regulated by multiple mechanisms and is an important indicator of kidney function. Tubular Reabsorption and Secretion Tubular reabsorption occurs in the PCT part of the renal tubule. Almost all nutrients are reabsorbed; this occurs either by passive or active transport . Reabsorption of water and key electrolytes are regulated and influenced by hormones . Sodium (Na+) is the most abundant ion; most of it is reabsorbed by active transport and then transported to the peritubular capillaries. Because Na+ is actively transported out of the tubule, water follows to even out the osmotic pressure . Water is also independently reabsorbed into the peritubular capillaries due to the presence of aquaporins , or water channels, in the PCT. This occurs due to the low blood pressure and high osmotic pressure in the peritubular capillaries. Every solute, however, has a transport maximum; the excess solute is not reabsorbed. Kidneys' osmolarity of body fluids is maintained at 300 milliosmole (mOsm). In the loop of Henle, the permeability of the membrane changes.

The descending limb is permeable to water, not solutes; the opposite is true for the ascending limb. Additionally, the loop of Henle invades the renal medulla, which is naturally high in salt concentration. It tends to absorb water from the renal tubule and concentrate the filtrate. The osmotic gradient increases as it moves deeper into the medulla. Because two sides of the loop of Henle perform opposing functions, it acts as a countercurrent multiplier . The vasa recta around the loop of Henle acts as the countercurrent exchanger. The loop of Henle acts as a countercurrent multiplier that uses energy to create concentration gradients. The descending limb is water permeable. Water flows from the filtrate to the interstitial fluid, so osmolality inside the limb increases as it descends into the renal medulla. At the bottom, the osmolality is higher inside the loop than in the interstitial fluid. Thus, as filtrate enters the ascending limb, Na+ and Cl- ions exit through ion channels present in the cell membrane. Further up, Na+ is actively transported out of the filtrate and Cl- follows.

Osmolarity is given in units of milliosmoles per liter (mOsm/L). Additional solutes and wastes are secreted into the kidney tubules during tubular secretion, which is the opposite process to tubular reabsorption. The collecting ducts collect filtrate coming from the nephrons and fuse in the medullary papillae. From here, the papillae deliver the filtrate, now called urine, into the minor calyces that eventually connect to the ureters through the renal pelvis. Maintaining Water Volume - How Your Kidneys Work | HowStuffWorks How Your Kidneys Work Prev Next Your kidneys have the ability to conserve or waste water. For example, if you drink a large glass of water, you'll find that you will have the urge to urinate within an hour or so. In contrast, if you don't drink for a while, such as overnight, you will not produce much urine and it will usually be very concentrated (i.e. darker). How does your kidney know the difference? The answer to this question involves two mechanisms: The structure and transport properties of the loop of Henle in the nephron.

The anti-diuretic hormone (ADH), also called vasopressin, secreted by the pituitary gland. The loop of Henle has a descending limb and an ascending limb. As filtrate moves down the loop of Henle, water is reabsorbed, but ions (Na,Cl) aren't. The removal of water serves to concentrate the Na and Cl in the lumen. Now, as the filtrate moves up the other side (ascending limb), Na and Cl are reabsorbed, but water isn't. What these two transport properties do is set up a concentration difference in NaCl along the length of the loop, with the highest concentration at the bottom and lowest concentration at the top. The loop of Henle can then concentrate NaCl in the medulla. The longer the loop, the bigger the concentration gradient. This also means that the medulla tissue tends to be saltier than the cortex tissue. Up Next Can you hold your pee so long your bladder ruptures? Now, as the filtrate flows through the collecting ducts, which go back down through the medulla, water can be reabsorbed from the filtrate by osmosis.

Water moves from an area of low Na concentration (high water concentration) in the collecting ducts to an area of high Na concentration (low water concentration) in the medullary tissue. If you remove water from the filtrate at this final stage, you can concentrate the urine. ­­ADH, which is secreted by the pituitary gland, controls the ability of water to pass through the cells in the walls of the collecting ducts. If no ADH is present, then no water can pass through the walls of the ducts. The more ADH present, the more water can pass through. Specialized nerve cells, called osmoreceptors, in the hypothalamus of the brain sense the Na concentration of the blood. The nerve endings of these osmoreceptors are located in the posterior pituitary gland and secrete ADH. If the Na concentration of the blood is high, the osmoreceptors secrete ADH. If the Na concentration of the blood is low, they don't secrete ADH. In reality, there is always some very low level of ADH secreted from the osmoreceptors. Now let's look at how your kidneys maintain water volume.

Biology Water Balance and the Kidney - Shmoop Biology Here's a lightning round summary of these processes: In the filtration phase, the kidney's tubules collect water and solutes from the blood. At the reabsorption phase, the blood takes back the good stuff. Blood then gets rid of the waste and puts it into the excretory tubule in the secretion phase. When you find yourself dancing in the bathroom line at halftime, everything in the tubule is about to come out as liquid urine, in the excretion phase. Hopefully once you've made it to the front of the line. Fingers (and legs) crossed. Now that we're clear on general excretory mechanisms, let's focus on the mammalian system, where the kidneys are in charge of osmoregulation. The kidney is divided into two parts: the outer cortex and the inner medulla. In the cortex, the osmolarity is relatively low (think less salty), around 300 mOsm/L or so, but as you travel further down into the medulla, the osmolarity gets much higher (think more salty). This is important for later, so stick that fact in your back pocket.

The kidney is divided into the outer cortex and the inner medulla. Spanning these two compartments are the nephrons, where all this osmoregulation stuff goes down. The picture above is of one nephron, and we’ve got over a million of them in just one kidney (so that’s two million total for those playing at home). The nephron is made up of a tubule, a glomerulus (a tangle of capillaries), and a cup-shaped Bowman's capsule at one end that surrounds the glomerulus. The Filtration Phase Filtration (Bowman's capsule, proximal tubule): When blood enters the kidney through the renal artery, it’s jam packed with nutrients, water, proteins, and other stuff the body needs. It also has some nasty things the body wants to dump. When blood flows into the glomerulus, blood pressure forces water and solutes out of the capillaries and into the lumen of the Bowman's capsule. The nephron spans from the cortex to the inner medulla. Each section of the tubule is permeable to different nutrients or wastes.

The lucky water, salts, amino acids, vitamins, and wastes that make it into the capsule are collectively called the filtrate, which then make it past step one. Because the filtrate is being filtered from the blood into the tubule, this stage of excretion is called filtration. This whole science thing is pretty easy, right? The Reabsorption Phase Reabsorption (proximal tubule, loop of Henle): From the Bowman's capsule, the filtrate travels through another series of tubules: the proximal tubule and then the loop of Henle. As the filtrate moves through this part of the nephron,, the body fluids reabsorb lots of essential nutrients. In the proximal tubule, NaCl (sodium chloride) and about 65% of the filtered water gets reabsorbed into the interstitial fluid. It then diffuses into the capillaries that run opposite to the filtrate flow. There is also reabsorption of glucose, HCO3- (bicarbonate), and other important nutrients, as well. The blood wants what it doesn't have, in a classic "grass is greener on the other side" scenario.

Speaking of HCO3-, that buffer molecule is super important in regulating the acid/base balance of the blood. A lot of that balancing act happens at the proximal tubule. When the blood is too acidic, H+ (hydrogen ions) will get sucked into the tubule to get rid of excess acid and HCO3- will be reabsorbed to better buffer the blood. With all sorts of important nutrients and water leaving the proximal tubule, the wastes become concentrated within the tubule's lumen. At the same time, more waste is also sent directly into the proximal tubule, stuff like metabolized drugs and toxins. All of this secretion and reabsorption can seem haphazard, but it's really highly regulated. By the time the filtrate reaches the end of the proximal tubule, it is isosmotic to the interstitial fluid surrounding the tubule. Next, the filtrate takes a steep turn down towards the medulla, and into the descending loop of Henle. The body does some more reabsorbing on this leg of the trip, but the only thing the body is sucking up is water.

The tubule membrane in this part of the nephron is selectively permeable to water, so it prevents salts from being reabsorbed, upping the filtrate concentration and osmolarity (think increased saltiness) in the loop even more. The length of this descending Loop is important for water conservation. The longer it is, the more water that gets reabsorbed back into the body fluids, and the more concentrated the urine will be. The shorter it is, the less water is conserved, and the urine is more dilute. Animals that don't have ready access to water (such as camels and the kangaroo rat) will have nice, long descending loops to conserve as much water as possible, making their urine super concentrated. Fish, on the other hand, have more than enough water, and their descending Loops are short since water conservation isn't really a top priority. They're literally swimming in it. After the filtrate travels through the descending loop, it takes a sharp curve (the actual bend in the Loop), and starts moving back up the ascending part of the loop. Here, the Loop changes things up a bit, and the membrane becomes permeable to salt instead of water.

At this point, there’s more salt than water and salt travels through the membrane. Urea is also permeable in the lower part of the ascending loop. As the salt leaves the tubule, the filtrate becomes less concentrated, and hypoosmotic to the surrounding interstitial fluids. In the top, thick part of the ascending loop, there is no confusion: salt is the favorite child. The tubule actually expends energy to pump it through the membrane, but leaves water and urea in place. Salt is on its way to Disney World while the water and urea are left home to vacuum and take out the trash. Lucky salt. The Secretion Phase Secretion (distal tubule / collecting duct): In the next phase of urine's journey, ions and water can be secreted into the tubule. It's the opposite of reabsorption—instead of the body pulling all the useful stuff it can from the tubule, now it pumps extra stuff back in. When the filtrate gets to the top of the loop, it levels off and enters the distal tubule.

Depending on how the pH is looking, H+ can be secreted into the filtrate while HCO3- is reabsorbed, or the opposite can occur (hydrogen ions can be reabsorbed and bicarbonate gets secreted into the filtrate). It just depends on what the blood pH is looking like and what hormones are calling the shots. Potassium ions (K+) are secreted into the filtrate, while sodium ions (Na+) are reabsorbed into the blood. After the distal tubule, the urine flows into the collecting duct, which is the body's last chance to squeeze out any bits of watery goodness before saying sayonara. It's here that the concentration of urine is determined and regulated. If you’re a camel in the middle of the desert, it's the collecting duct, and the hormones that act on it, that prevent you from drying out and becoming a glorified raisin. When the hypoosmotic urine hits the collecting duct, the body will pump water back into the blood where it's needed, and the camel's urine becomes even more concentrated.

Urea also gets pumped out of the collecting duct, which might sound a bit counterintuitive, since urea is toxic and we want it out with the urine. We’ll get to that in a minute, but for now, know that some of the urea gets reabsorbed. The Excretion Phase Excretion (ureter / urethra): Now that urine is urine—and not a mess of proteins, urea, and potassium ions—it's time to excrete that yellow stuff out of the body. From the collecting duct, urine goes through the ureters and into the urinary bladder. This is where your pee is stored. When the bladder fills up, the body senses the volume and flips a switch in the brain that gives you that "I gotta go!" sensation. Assuming you can find a toilet (or a fire hydrant), the urine will flow out of the urethra and be expelled from the body. Between the two of them, osmoregulation and excretion make sure that our bodies retain water when we are dehydrated and that we produce dilute urine when we have been gulping down copious amounts of water.

These important systems protect us from various disorders that are associated with abnormal ion concentrations, including neurological problems. If your bodily water level drops too much, your blood volume will decrease, your brain will shrink, and you’ll have major problems. The Countercurrent Multiplier System Earlier in this section, we talked about how the concentration gradient really regulates this whole osmoregulation thing. Since it's a super important part of how the kidney does its job, and since it's worth taking the added effort to understand, we're going to look at it in a bit more detail. There are two key ways that the kidney is able to maintain this concentration gradient: the countercurrent multiplier system and the vasa recta (a group of blood vessels in the kidney). First things first—we'll start with the countercurrent multiplier system. The countercurrent part comes from the fact that the filtrate flows in opposite directions through the descending and ascending portions of the loop of Henle. That is, it has countercurrent flow. The filtrate flows down the descending loop and up the ascending loop, so they end up passing by each other going in opposite directions, like two cars passing on a road.

We're sure they say 'hello' to each other as they pass. It's a filtrate thing. When salt from the filtrate is reabsorbed at the ascending loop of Henle, the osmolarity of the interstitial fluid in the medulla gets higher. This hyperosmotic interstitial fluid is on the hunt for water to balance it out. And guess who’s there to provide it? The descending loop, which is water permeable and hands it over via osmosis. The whole system is rigged to ensure that the osmotic gradient remains constant, so both sides of the loop can continue doing what they were meant to do. Urea plays an important part in maintaining this gradient. Urea gets reabsorbed from the collecting duct and then is secreted back into the loop of Henle. This circulation of urea is important to keeping the concentration gradient from being isotonic. A little more than half of the urea that is filtered from the blood is excreted in the urine. The other half just keeps cycling around and around, helping keep the osmolarity unbalanced. We know it's complicated, but it is pretty cool to understand how all these different tasks help maintain the overall function of the kidney.

That’s well and good, but there's a major problem. If more and more water is being sent out of the descending loop into the interstitial fluid, we'd think that at some point it would strike an osmotic balance, and the kidney's work would come to a screeching halt as the concentration gradient disappears. Fortunately, vasa recta help prevent this from happening. They pull the water from the fluid into the bloodstream, keeping the high osmolarity at the inner medulla, and helping the body preserve even more water. The vasa recta are a group of bobby-pin shaped blood capillaries that provide oxygen and nutrients to the kidney's medulla. The blood in them flows counter to the filtrate flow in the Loop of Henle. Luckily, these capillaries also happen to be permeable to both salt and water. Since the descending loop is always pushing out water, the vasa recta pick up any extra so that the osmolarity gradient is maintained. Likewise, the ascending Loop of Henle is always pumping out salt, and the vasa recta support the important osmotic gradient.

Whatever water or salt is sent out of the tubule gets reabsorbed by the vasa recta to prevent the inner medulla from diluting. How's that for teamwork? Brain Snack The kidney is a pretty awesome organ. While other, more famous organs get invited to all the cool parties, this essential piece of the body doesn't get much street cred. It's small, and it can't help you decide whether your date will like the blue or green shirt better. It's still what we here at Shmoop HQ like to call a "super organ." Try these fun facts on for size: The kidney has one of the highest metabolic rates of any organ of its size, meaning it expends the most energy. Your body knows how important it is, and makes sure it has oodles of energy to do the job. While the kidney only represents less than 1% of body mass, it receives about 25% of all blood flow. Heck, it gets more blood flow than the brain or the heart. Go Team Kidney! If you were to uncoil and untwist all the nephrons in a single kidney, they'd span over 5 miles. That makes for one long trip to the bathroom.

Proportionally, the kidneys are three times larger in babies as they are in adults. No, they aren't sticking out of a baby's ears and nose, but it just goes to show how important they are even when basic thought processes haven't yet developed. What is the Loop of Henle? (with pictures) Hobbies What is the Loop of Henle? Last Modified Date: 14 January 2017 Copyright Protected: 10 hilariously insightful foreign words The loop of Henle is a part of a nephron , a tiny tube inside the kidneys that filters solutes. Each kidney contains hundreds of thousands of individual nephrons, which pass between the cortex of the kidneys and the medulla, connecting to collecting ducts which route urine to the ureter so that it can be expressed. The loop is an important part of the whole system, as it allows the kidneys to filter out salt and maintain the correct balance of water in the body. As the name would suggest, the structure is a large loop that dips down from the nephron to create a descending arm that connects with the medulla, and an ascending arm that moves back into the cortex of the kidney.

As fluids move down the loop, water is filtered out, moving into the interstitial fluid of the medulla. When the fluid moves up the ascending arm, salts are pulled out, and the cells are impermeable to water, so no additional water is lost. Because salt and water are filtered out at different points, the loop of Henle contributes to the formation of an area of high salt concentration in the medulla. Meanwhile, the filtrate in the nephron passes through to the collecting ducts. The ducts pass through the medulla, which means that they move through an area of increased salt concentration. Water moves from areas of low concentration to areas of high concentration, and it will naturally want to pass from the filtrate to the saltier surrounding tissue. The body controls the amount of water that passes through with a hormone called anti- diuretic hormone (ADH). When there is a great deal of salt in the blood, more of this hormone is produced, allowing water to flow freely through the collecting tubes and into the medulla and creating concentrated urine because less water ends up in the ureter. If the salt level in the blood is low, the collecting tubes become less permeable, allowing less water through and generating dilute urine.

Using the combination of ADH and the loop of Henle, the body can control the levels of salt and water present. When someone drinks a big glass of water, diluting salt in the blood, the kidneys express the water quickly to keep the balance level. If someone spends a few hours without drinking water, the kidneys will conserve the available water, which explains why morning urine tends to be very concentrated, because people don't usually drink during the night. The kidneys and the body can adjust their activity to compensate for things like a large intake of salt or increased water consumption to keep levels of salt and water in the body stable. In people with kidney failure, dialysis is used to replace the function of the kidneys, filtering the blood in a machine that stands in for the huge numbers of nephrons that normally do all the work. Ad Human Physiology/The Urinary System - Wikibooks, open books for an open world Human Physiology/The Urinary System This is the latest reviewed version , checked on 6 September 2014. (+) Quality: minimal 12 References Introduction The Urinary System is a group of organs in the body concerned with filtering out excess fluid and other substances from the bloodstream.

The substances are filtered out from the body in the form of urine. Urine is a liquid produced by the kidneys, collected in the bladder and excreted through the urethra. Urine is used to extract excess minerals or vitamins as well as blood corpuscles from the body. The Urinary organs include the kidneys, ureters, bladder, and urethra. The Urinary system works with the other systems of the body to help maintain homeostasis. The kidneys are the main organs of homeostasis because they maintain the acid base balance and the water salt balance of the blood. Functions of the Urinary System One of the major functions of the Urinary system is the process of excretion. Excretion is the process of eliminating, from an organism, waste products of metabolism and other materials that are of no use. The urinary system maintains an appropriate fluid volume by regulating the amount of water that is excreted in the urine. Other aspects of its function include regulating the concentrations of various electrolytes in the body fluids and maintaining normal pH of the blood. Several body organs carry out excretion, but the kidneys are the most important excretory organ.

The primary function of the kidneys is to maintain a stable internal environment (homeostasis) for optimal cell and tissue metabolism. They do this by separating urea, mineral salts, toxins, and other waste products from the blood. They also do the job of conserving water, salts, and electrolytes. At least one kidney must function properly for life to be maintained. Six important roles of the kidneys are: Regulation of plasma ionic composition. Ions such as sodium, potassium, calcium, magnesium, chloride, bicarbonate, and phosphates are regulated by the amount that the kidney excretes. Regulation of plasma osmolarity. The kidneys regulate osmolarity because they have direct control over how many ions and how much water a person excretes. Regulation of plasma volume. Your kidneys are so important they even have an effect on your blood pressure. The kidneys control plasma volume by controlling how much water a person excretes. The plasma volume has a direct effect on the total blood volume, which has a direct effect on your blood pressure. Salt(NaCl)will cause osmosis to happen; the diffusion of water into the blood. Regulation of plasma hydrogen ion concentration (pH).

The kidneys partner up with the lungs and they together control the pH. The kidneys have a major role because they control the amount of bicarbonate excreted or held onto. The kidneys help maintain the blood Ph mainly by excreting hydrogen ions and reabsorbing bicarbonate ions as needed. Removal of metabolic waste products and foreign substances from the plasma. One of the most important things the kidneys excrete is nitrogenous waste. As the liver breaks down amino acids it also releases ammonia. The liver then quickly combines that ammonia with carbon dioxide, creating urea which is the primary nitrogenous end product of metabolism in humans. The liver turns the ammonia into urea because it is much less toxic. We can also excrete some ammonia, creatinine and uric acid. The creatinine comes from the metabolic breakdown of creatine phospate (a high-energy phosphate in muscles). Uric acid comes from the break down of nucleotides. Uric acid is insoluble and too much uric acid in the blood will build up and form crystals that can collect in the joints and cause gout. Secretion of Hormones The endocrine system has assistance from the kidney's when releasing hormones. Renin is released by the kidneys.

Renin leads to the secretion of aldosterone which is released from the adrenal cortex. Aldosterone promotes the kidneys to reabsorb the sodium (Na+) ions. The kidneys also secrete erythropoietin when the blood doesn't have the capacity to carry oxygen. Erythropoietin stimulates red blood cell production. The Vitamin D from the skin is also activated with help from the kidneys. Calcium (Ca+) absorption from the digestive tract is promoted by vitamin D. CC: Chapter Check: Name the role of the kidneys and how they work? Organs in the Urinary System Kidneys And Their Structure 1. Renal pyramid 2. Interlobar artery 3. Renal artery 4. Renal vein 5. Renal hylum 6. Renal pelvis 7. Ureter 8. Minor calyx 9. Renal capsule 10. Inferior renal capsule 11. Superior renal capsule 12. Interlobar vein 13. Nephron 14. Minor calyx 15. Major calyx 16. Renal papilla 17.

Renal column The kidneys are a pair of bean shaped, brown organs about the size of your fist.It measures 10-12 cm long. They are covered by the renal capsule, which is a tough capsule of fibrous connective tissue. Adhering to the surface of each kidney is two layers of fat to help cushion them. There is a concaved side of the kidney that has a depression where a renal artery enters, and a renal vein and a ureter exit the kidney. The kidneys are located at the rear wall of the abdominal cavity just above the waistline, and are protected by the ribcage. They are considered retroperitoneal, which means they lie behind the peritoneum. There are three major regions of the kidney, renal cortex, renal medulla and the renal pelvis. The outer, granulated layer is the renal cortex. The cortex stretches down in between a radially striated inner layer. The inner radially striated layer is the renal medulla. This contains pyramid shaped tissue called the renal pyramids, separated by renal columns. The ureters are continuous with the renal pelvis and is the very center of the kidney. Renal Vein The renal veins are veins that drain the kidney.

They connect the kidney to the inferior vena cava. Because the inferior vena cava is on the right half of the body, the left renal vein is generally the longer of the two. Unlike the right renal vein, the left renal vein often receives the left gonadal vein (left testicular vein in males, left ovarian vein in females). It frequently receives the left suprarenal vein as well. Renal Artery The renal arteries normally arise off the abdominal aorta and supply the kidneys with blood. The arterial supply of the kidneys are variable and there may be one or more renal arteries supplying each kidney. Due to the position of the aorta, the inferior vena cava and the kidneys in the body, the right renal artery is normally longer than the left renal artery. The right renal artery normally crosses posteriorly to the inferior vena cava. The renal arteries carry a large portion of the total blood flow to the kidneys. Up to a third of the total cardiac output can pass through the renal arteries to be filtered by the kidneys. Ureters The ureters are two tubes that drain urine from the kidneys to the bladder. Each ureter is a muscular tube about 10 inches (25 cm) long.

Muscles in the walls of the ureters send the urine in small spurts into the bladder, (a collapsible sac found on the forward part of the cavity of the bony pelvis that allows temporary storage of urine). After the urine enters the bladder from the ureters, small folds in the bladder mucosa act like valves preventing backward flow of the urine. The outlet of the bladder is controlled by a sphincter muscle. A full bladder stimulates sensory nerves in the bladder wall that relax the sphincter and allow release of the urine. However, relaxation of the sphincter is also in part a learned response under voluntary control. The released urine enters the urethra. Urinary Bladder The urinary bladder is a hollow, muscular and distendible or elastic organ that sits on the pelvic floor (superior to the prostate in males). On its anterior border lies the pubic symphysis and, on its posterior border, the vagina (in females) and rectum (in males).

The urinary bladder can hold approximately 17 to 18 ounces (500 to 530 ml) of urine, however the desire to micturate is usually experienced when it contains about 150 to 200 ml. When the bladder fills with urine (about half full), stretch receptors send nerve impulses to the spinal cord, which then sends a reflex nerve impulse back to the sphincter (muscular valve) at the neck of the bladder, causing it to relax and allow the flow of urine into the urethra. The Internal urethral sphincter is involuntary. The ureters enter the bladder diagonally from its dorsolateral floor in an area called the trigone. The trigone is a triangular shaped area on the postero-inferior wall of the bladder. The urethra exits at the lowest point of the triangle of the trigone. The urine in the bladder also helps regulate body temperature. A bladder when operating normally empties completely upon a complete discharge, otherwise it is a sign that its elasticity is compromised, when it becomes completely void of fluid, it may cause a chilling sensation due to the rapid change of body temperature.

Urethra Female urethra (labeled at bottom right.) Male Sphincter urethrae muscle - The male urethra laid open on its anterior (upper) surface. (Region visible, but muscle not labeled.) The urethra is a muscular tube that connects the bladder with the outside of the body. The function of the urethra is to remove urine from the body. It measures about 1.5 inches (3.8 cm) in a woman but up to 8 inches (20 cm) in a man. Because the urethra is so much shorter in a woman it makes it much easier for a woman to get harmful bacteria in her bladder this is commonly called a bladder infection or a UTI. The most common bacteria of a UTI is E-coli from the large intestines that have been excreted in fecal matter. Female urethra In the human female, the urethra is about 1-2 inches long and opens in the vulva between the clitoris and the vaginal opening. Men have a longer urethra than women. This means that women tend to be more susceptible to infections of the bladder (cystitis) and the urinary tract.

Male urethra In the human male, the urethra is about 8 inches long and opens at the end of the head of the penis. The length of a male's urethra, and the fact it contains a number of bends, makes catheterisation more difficult. The urethral sphincter is a collective name for the muscles used to control the flow of urine from the urinary bladder. These muscles surround the urethra, so that when they contract, the urethra is closed. There are two distinct areas of muscle: the internal sphincter, at the bladder neck and the external, or distal, sphincter. Human males have much stronger sphincter muscles than females, meaning that they can retain a large amount of urine for twice as long, as much as 800mL, i.e. "hold it". Nephrons A nephron is the basic structural and functional unit of the kidney. The name nephron comes from the Greek word (nephros) meaning kidney. Its chief function is to regulate water and soluble substances by filtering the blood, reabsorbing what is needed and excreting the rest as urine.

Nephrons eliminate wastes from the body, regulate blood volume and pressure, control levels of electrolytes and metabolites, and regulate blood pH. Its functions are vital to life and are regulated by the endocrine system by hormones such as antidiuretic hormone, aldosterone, and parathyroid hormone. Each nephron has its own supply of blood from two capillary regions from the renal artery. Each nephron is composed of an initial filtering component (the renal corpuscle) and a tubule specialized for reabsorption and secretion (the renal tubule). The renal corpuscle filters out large solutes from the blood, delivering water and small solutes to the renal tubule for modification. Glomerulus The glomerulus is a capillary tuft that receives its blood supply from an afferent arteriole of the renal circulation. The glomerular blood pressure provides the driving force for fluid and solutes to be filtered out of the blood and into the space made by Bowman's capsule. The remainder of the blood not filtered into the glomerulus passes into the narrower efferent arteriole.

It then moves into the vasa recta, which are collecting capillaries intertwined with the convoluted tubules through the interstitial space, where the reabsorbed substances will also enter. This then combines with efferent venules from other nephrons into the renal vein, and rejoins with the main bloodstream. Afferent/Efferent Arterioles The afferent arteriole supplies blood to the glomerulus. A group of specialized cells known as juxtaglomerular cells are located around the afferent arteriole where it enters the renal corpuscle. The efferent arteriole drains the glomerulus. Between the two arterioles lies specialized cells called the macula densa. The juxtaglomerular cells and the macula densa collectively form the juxtaglomerular apparatus. It is in the juxtaglomerular apparatus cells that the enzyme renin is formed and stored. Renin is released in response to decreased blood pressure in the afferent arterioles, decreased sodium chloride in the distal convoluted tubule and sympathetic nerve stimulation of receptors (beta-adrenic) on the juxtaglomerular cells.

Renin is needed to form Angiotensin I and Angiotensin II which stimulate the secretion of aldosterone by the adrenal cortex. Glomerular Capsule or Bowman's Capsule Bowman's capsule (also called the glomerular capsule) surrounds the glomerulus and is composed of visceral (simple squamous epithelial cells) (inner) and parietal (simple squamous epithelial cells) (outer) layers. The visceral layer lies just beneath the thickened glomerular basement membrane and is made of podocytes which send foot processes over the length of the glomerulus. Foot processes interdigitate with one another forming filtration slits that, in contrast to those in the glomeruluar endothelium, are spanned by diaphragms. The size of the filtration slits restricts the passage of large molecules (eg, albumin) and cells (eg, red blood cells and platelets). In addition, foot processes have a negatively-charged coat (glycocalyx) that limits the filtration of negatively-charged molecules, such as albumin. This action is called electrostatic repulsion. The parietal layer of Bowman's capsule is lined by a single layer of squamous epithelium.

Between the visceral and parietal layers is Bowman's space, into which the filtrate enters after passing through the podocytes' filtration slits. It is here that smooth muscle cells and macrophages lie between the capillaries and provide support for them. Unlike the visceral layer, the parietal layer does not function in filtration. Rather, the filtration barrier is formed by three components: the diaphragms of the filtration slits, the thick glomerular basement membrane, and the glycocalyx secreted by podocytes. 99% of glomerular filtrate will ultimately be reabsorbed. The process of filtration of the blood in the Bowman's capsule is ultrafiltration (or glomerular filtration), and the normal rate of filtration is 125 ml/min, equivalent to ten times the blood volume daily. Measuring the glomerular filtration rate (GFR) is a diagnostic test of kidney function. A decreased GFR may be a sign of renal failure. Conditions that can affect GFR include: arterial pressure, afferent arteriole constriction, efferent arteriole constriction, plasma protein concentration and colloid osmotic pressure.

Any proteins that are roughly 30 kilodaltons or under can pass freely through the membrane. Although, there is some extra hindrance for negatively charged molecules due to the negative charge of the basement membrane and the podocytes. Any small molecules such as water, glucose, salt (NaCl), amino acids, and urea pass freely into Bowman's space, but cells, platelets and large proteins do not. As a result, the filtrate leaving the Bowman's capsule is very similar to blood plasma in composition as it passes into the proximal convoluted tubule. Together, the glomerulus and Bowman's capsule are called the renal corpuscle. Proximal Convoluted Tubule (PCT) The proximal tubule can be anatomically divided into two segments: the proximal convoluted tubule and the proximal straight tubule. The proximal convoluted tubule can be divided further into S1 and S2 segments based on the histological appearance of it's cells. Following this naming convention, the proximal straight tubule is commonly called the S3 segment. The proximal convoluted tubule has one layer of cuboidal cells in the lumen.

This is the only place in the nephron that contains cuboidal cells. These cells are covered with millions of microvilli. The microvilli serve to increase surface area for reabsorption. Fluid in the filtrate entering the proximal convoluted tubule is reabsorbed into the peritubular capillaries, including approximately two-thirds of the filtered salt and water and all filtered organic solutes (primarily glucose and amino acids). This is driven by sodium transport from the lumen into the blood by the Na+/K+ ATPase in the basolateral membrane of the epithelial cells. Much of the mass movement of water and solutes occurs in between the cells through the tight junctions, which in this case are not selective. The solutes are absorbed isotonically, in that the osmotic potential of the fluid leaving the proximal tubule is the same as that of the initial glomerular filtrate. However, glucose, amino acids, inorganic phosphate, and some other solutes are reabsorbed via secondary active transport through cotransport channels driven by the sodium gradient out of the nephron.

Loop of the Nephron or Loop of Henle The Nephron Loop or Loop of Henle. The loop of Henle (sometimes known as the nephron loop) is a U-shaped tube that consists of a descending limb and ascending limb. It begins in the cortex, receiving filtrate from the proximal convoluted tubule, extends into the medulla, and then returns to the cortex to empty into the distal convoluted tubule. Its primary role is to concentrate the salt in the interstitium, the tissue surrounding the loop. Descending limb Its descending limb is permeable to water but completely impermeable to salt, and thus only indirectly contributes to the concentration of the interstitium. As the filtrate descends deeper into the hypertonic interstitium of the renal medulla, water flows freely out of the descending limb by osmosis until the tonicity of the filtrate and interstitium equilibrate. Longer descending limbs allow more time for water to flow out of the filtrate, so longer limbs make the filtrate more hypertonic than shorter limbs.

Ascending limb Unlike the descending limb, the ascending limb of Henle's loop is impermeable to water, a critical feature of the countercurrent exchange mechanism employed by the loop. The ascending limb actively pumps sodium out of the filtrate, generating the hypertonic interstitium that drives countercurrent exchange. In passing through the ascending limb, the filtrate grows hypotonic since it has lost much of its sodium content. This hypotonic filtrate is passed to the distal convoluted tubule in the renal cortex. Distal Convoluted Tubule (DCT) The distal convoluted tubule is similar to the proximal convoluted tubule in structure and function. Cells lining the tubule have numerous mitochondria, enabling active transport to take place by the energy supplied by ATP. Much of the ion transport taking place in the distal convoluted tubule is regulated by the endocrine system. In the presence of parathyroid hormone, the distal convoluted tubule reabsorbs more calcium and excretes more phosphate. When aldosterone is present, more sodium is reabsorbed and more potassium excreted.

Atrial natriuretic peptide causes the distal convoluted tubule to excrete more sodium. In addition, the tubule also secretes hydrogen and ammonium to regulate pH. After traveling the length of the distal convoluted tubule, only 3% of water remains, and the remaining salt content is negligible. 97.9% of the water in the glomerular filtrate enters the convoluted tubules and collecting ducts by osmosis. Collecting ducts Each distal convoluted tubule delivers its filtrate to a system of collecting ducts, the first segment of which is the connecting tubule. The collecting duct system begins in the renal cortex and extends deep into the medulla. As the urine travels down the collecting duct system, it passes by the medullary interstitium which has a high sodium concentration as a result of the loop of Henle's countercurrent multiplier system. Though the collecting duct is normally impermeable to water, it becomes permeable in the presence of antidiuretic hormone (ADH). As much as three-fourths of the water from urine can be reabsorbed as it leaves the collecting duct by osmosis.

Thus the levels of ADH determine whether urine will be concentrated or dilute. Dehydration results in an increase in ADH, while water sufficiency results in low ADH allowing for diluted urine. Lower portions of the collecting duct are also permeable to urea, allowing some of it to enter the medulla of the kidney, thus maintaining its high ion concentration (which is very important for the nephron). Urine leaves the medullary collecting ducts through the renal papilla, emptying into the renal calyces, the renal pelvis, and finally into the bladder via the ureter. Because it has a different embryonic origin than the rest of the nephron (the collecting duct is from endoderm whereas the nephron is from mesoderm), the collecting duct is usually not considered a part of the nephron proper. Renal Hormones 1. Vitamin D- Becomes metabolically active in the kidney. Patients with renal disease have symptoms of disturbed calcium and phosphate balance. 2. Erythropoietin- Released by the kidneys in response to decreased tissue oxygen levels (hypoxia). 3.

Natriuretic Hormone- Released from cardiocyte granules located in the right atria of the heart in response to increased atrial stretch. It inhibits ADH secretions which can contribute to the loss of sodium and water. Formation of Urine Urine is formed in three steps: Filtration, Reabsorption, and Secretion. Filtration Blood enters the afferent arteriole and flows into the glomerulus. Blood in the glomerulus has both filterable blood components and non-filterable blood components. Filterable blood components move toward the inside of the glomerulus while non-filterable blood components bypass the filtration process by exiting through the efferent arteriole. Filterable Blood components will then take a plasma like form called glomerular filtrate. A few of the filterable blood components are water, nitrogenous waste, nutrients and salts (ions). Nonfilterable blood components include formed elements such as blood cells and platelets along with plasma proteins. The glomerular filtrate is not the same consistency as urine, as much of it is reabsorbed into the blood as the filtrate passes through the tubules of the nephron.

Reabsorption Within the peritubular capillary network, molecules and ions are reabsorbed back into the blood. Sodium Chloride reabsorbed into the system increases the osmolarity of blood in comparison to the glomerular filtrate. This reabsorption process allows water (H2O) to pass from the glomerular filtrate back into the circulatory system. Glucose and various amino acids also are reabsorbed into the circulatory system. These nutrients have carrier molecules that claim the glomerular molecule and release it back into the circulatory system. If all of the carrier molecules are used up, excess glucose or amino acids are set free into the urine. A complication of diabetes is the inability of the body to reabsorb glucose. If too much glucose appears in the glomerular filtrate it increases the osmolarity of the filtrate, causing water to be released into the urine rather than reabsorbed by the circulatory system. Frequent urination and unexplained thirst are warning signs of diabetes, due to water not being reabsorbed.

Glomerular filtrate has now been separated into two forms: Reabsorbed Filtrate and Non-reabsorbed Filtrate. Non-reabsorbed filtrate is now known as tubular fluid as it passes through the collecting duct to be processed into urine. Secretion Some substances are removed from blood through the peritubular capillary network into the distal convoluted tubule or collecting duct. These substances are Hydrogen ions, creatinine, and drugs. Urine is a collection of substances that have not been reabsorbed during glomerular filtration or tubular reabsorbtion. Maintaining Water-Salt Balance It is the job of the kidneys to maintain the water-salt balance of the blood. They also maintain blood volume as well as blood pressure. Simple examples of ways that this balance can be changed include ingestion of water, dehydration, blood loss and salt ingestion. Reabsorption of water Direct control of water excretion in the kidneys is exercised by the anti-diuretic hormone (ADH), released by the posterior lobe of the pituitary gland. ADH causes the insertion of water channels into the membranes of cells lining the collecting ducts, allowing water reabsorption to occur.

Without ADH, little water is reabsorbed in the collecting ducts and dilute urine is excreted. There are several factors that influence the secretion of ADH. The first of these happen when the blood plasma gets too concentrated. When this occurs, special receptors in the hypothalamus release ADH. When blood pressure falls, stretch receptors in the aorta and carotid arteries stimulate ADH secretion to increase volume of the blood. Reabsorption of Salt The Kidneys also regulate the salt balance in the blood by controlling the excretion and the reabsorption of various ions. As noted above, ADH plays a role in increasing water reabsorption in the kidneys, thus helping to dilute bodily fluids. The kidneys also have a regulated mechanism for reabsorbing sodium in the distal nephron. This mechanism is controlled by aldosterone, a steroid hormone produced by the adrenal cortex. Aldosterone promotes the excretion of potassium ions and the reabsorption of sodium ions. The release of Aldosterone is initiated by the kidneys. The juxtaglomerular apparatus is a renal structure consisting of the macula densa, mesangial cells, and juxtaglomerular cells.

Juxtaglomerular cells (JG cells, also known as granular cells) are the site of renin secretion. Renin is an enzyme that converts angiotensinogen (a large plasma protein produced by the liver) into Angiotensin I and eventually into Angiotensin II which stimulates the adrenal cortex to produce aldosterone. The reabsorption of sodium ions is followed by the reapsorption of water. This causes blood pressure as well as blood volume to increase. Atrial natriuretic hormone (ANH) is released by the atria of the heart when cardiac cells are stretched due to increased blood volume. ANH inhibits the secretion of renin by the juxtaglomerular apparatus and the secretion of the aldosterone by the adrenal cortex. This promotes the excretion of sodium. When sodium is excreted so is water. This causes blood pressure and volume to decrease. Hypernatremia An increase in plasma sodium levels above normal is hypernatremia. Sodium is the primary solute in the extracellular fluid. Sodium levels have a major role in osmolarity regulation. For excitable cells the electrochemical gradient for sodium across the plasma membrane is critical for life.

Water retention and an increased blood pressure usually are signs of hypernatremia. If the plasma sodium levels are below normal it is called hyponatremia. Signs of this are low plasma volume and hypotension. Diuretics A diuretic (colloquially called a water pill) is any drug that elevates the rate of bodily urine excretion (diuresis). Diuretics also decrease the extracellular fluid (ECF) volume, and are primarily used to produce a negative extracellular fluid balance. Caffeine, cranberry juice and alcohol are all weak diuretics. In medicine, diuretics are used to treat heart failure, liver cirrhosis, hypertension and certain kidney diseases. Diuretics alleviate the symptoms of these diseases by causing sodium and water loss through the urine. As urine is produced by the kidney, sodium and water – which cause edema related to the disease – move into the blood to replace the volume lost as urine, thereby reducing the pathological edema. Some diuretics, such as acetazolamide, help to make the urine more alkaline and are helpful in increasing excretion of substances such as aspirin in cases of overdose or poisoning.

The antihypertensive actions of some diuretics (thiazides and loop diuretics in particular) are independent of their diuretic effect. That is, the reduction in blood pressure is not due to decreased blood volume resulting from increased urine production, but occurs through other mechanisms and at lower doses than that required to produce diuresis. Indapamide was specifically designed with this is mind, and has a larger therapeutic window for hypertension (without pronounced diuresis) than most other diuretics. Chemically, diuretics are a diverse group of compounds that either stimulate or inhibit various hormones that naturally occur in the body to regulate urine production by the kidneys. Alcohol produces diuresis through modulation of the vasopressin system. Diseases of the Kidney Diabetic nephropathy (nephropatia diabetica), also known as Kimmelstiel-Wilson syndrome and intercapillary glomerulonephritis, is a progressive kidney disease caused by angiopathy of capillaries in the kidney glomeruli. It is characterized by nodular glomerulosclerosis. It is due to longstanding diabetes mellitus, and is a prime cause for dialysis in many Western countries.

An image of a kidney stone. In medicine, hematuria (or "haematuria") is the presence of blood in the urine. It is a sign of a large number of diseases of the kidneys and the urinary tract, ranging from trivial to lethal. Kidney stones, also known as nephrolithiases, urolithiases or renal calculi, are solid accretions (crystals) of dissolved minerals in urine found inside the kidneys or ureters. They vary in size from as small as a grain of sand to as large as a golf ball. Kidney stones typically leave the body in the urine stream; if they grow relatively large before passing (on the order of millimeters), obstruction of a ureter and distention with urine can cause severe pain most commonly felt in the flank, lower abdomen and groin. Kidney stones are unrelated to gallstones. Case Study I was 34 weeks pregnant when I noticed blood in my urine. I immediately went to my OBGYN where I was told that I had a bladder infection and given an antibiotic. The next morning I experienced the most intense pain. I was rushed to the ER where I was told that I had kidney stones.

The doctors explained that there was nothing they could do as long as I was pregnant. The next 3 weeks of my life were filled with intense pain and multiple painkillers. After I delivered my baby, CAT scans were done and I was informed that I had 6 kidney stones. It took three more weeks for me to pass all of the stones the largest measuring 5 mm. The stones were tested and I was informed that my body had been building up calcium due to my pregnancy and this was the cause of the kidney stones. I continued to have kidney pain for 6 months after passing the stones. I now live my life on a low calcium diet and the hope that my body will not develop more kidney stones. Pyelonephritis When an infection of the renal pelvis and calices, called pyelitis, spreads to involve the rest of the kidney as well, the result is pyelonephritis. It usually results from the spread of fecal bacterium Escherichia coli from the anal region superiorly through the urinary tract. In severe cases, the kidney swells and scars, abscesses form, and the renal pelvis fills with pus.

Left untreated, the infected kidney may be severely damaged, but administration of antibiotics usually achieve a total cure. glomerulonephritis Inflammation of the glomerular can be caused by immunologic abnormalities, drugs or toxins, vascular disorders, and systemic diseases. Glomerulonephritis can be acute, chronic or progressive. Two major changes in the urine are distinctive of glomerulonephritis: hematuria and proteinuria with albumin as the major protein. There is also a decrease in urine as there is a decrease in GFR (glomerular filtration rate). Renal failure is associated with oliguria (less than 400 ml of urine output per day). Renal Failure Uremia is a syndrome of renal failure and includes elevated blood urea and creatinine levels. Acute renal failure can be reversed if diagnosed early. Acute renal failure can be caused by severe hypotension or severe glomerular disease. Diagnostic tests include BUN and plasma creatinine level tests. It is considered to be chronic renal failure if the decline of renal function to less than 25%. Diabetes Insipidus This is caused by the deficiency of or decrease of ADH.

The person with (DI) has the inability to concentrate their urine in water restriction, in turn they will void up 3 to 20 liters/day. There are two forms of (DI), neurogenic, and nephrogenic. In nephrogenic (DI) the kidneys do not respond to ADH. Usually the nephrogenic (DI) is characterized by the impairment of the urine concentrating capability of the kidney along with concentration of water. The cause may be a genetic trait, electrolyte disorder, or side effect of drugs such as lithium. In the neurogenic (DI), it is usually caused by head injury near the hypophysisal tract. Urinary tract infections (UTI's) The second most common type of bacterial infections seen by health care providers is UTI's. Out of all the bacterias that colonize and cause urinary tract infections the big gun is Escherichia coli. In the hospital indwelling catheters and straight catheterizing predispose the opportunity for urinary tract infections. In females there are three stages in life that predispose urinary tract infections, that is menarche, manipulation between intercourse, and menopause. However, a small percentage of men and children will get urinary tract infections.

In men it is usually due to the prostate gland growth which usually occurs in older age men. In children it can occur 3% to 5% in girls and 1% in boys, uncircumcised boys it is more common than circumcised ones to have a urinary tract infection, in girls it may be the result of onset of toilet training, some predispositions for getting urinary tract infection include family history and urinary tract anomalies. In neonates urinary tract infections is most common when bacteremia is present. Dialysis and Kidney Transplant Plugged into dialysis Generally, humans can live normally with just one kidney. Only when the amount of functioning kidney tissue is greatly diminished will renal failure develop. If renal function is impaired, various forms of medications are used, while others are contraindicated. Provided that treatment is begun early, it may be possible to reverse chronic kidney failure due to diabetes or high blood pressure. If creatinine clearance (a measure of renal function) has fallen very low ("end-stage renal failure"), or if the renal dysfunction leads to severe symptoms, dialysis is commenced. Dialysis is a medical procedure, performed in various different forms, where the blood is filtered outside of the body.

Kidney transplantation is the only cure for end stage renal failure; dialysis, is a supportive treatment; a form of "buying time" to bridge the inevitable wait for a suitable organ. The first successful kidney transplant was announced on March 4, 1954 at Peter Bent Brigham Hospital in Boston. The surgery was performed by Dr. Joseph E. Murray, who was awarded the Nobel Prize in Medicine in 1990 for this feat. There are two types of kidney transplants: living donor transplant and a cadaveric (dead donor) transplant. When a kidney from a living donor, usually a blood relative, is transplanted into the patient's body, the donor's blood group and tissue type must be judged compatible with the patient's, and extensive medical tests are done to determine the health of the donor. Before a cadaveric donor's organs can be transplanted, a series of medical tests have to be done to determine if the organs are healthy. Also, in some countries, the family of the donor must give its consent for the organ donation. In both cases, the recipient of the new organ needs to take drugs to suppress their immune system to help prevent their body from rejecting the new kidney.

Review Questions Answers for these questions can be found here 1.While reading a blood test I notice a high level of creatinine, I could assume from this that A) There is a possibility of a UTI B) There is a possibility of diabetes C) There is a possibility of kidney failure D) There is nothing wrong, this is normal 2.Direct control of water excretion in the kidneys is controlled by A) Anti-diuretic hormone E ) all of the above 7. Why do substances in the glomerulus enter the Bowman's capsule? A ) the magnetic charge of the Bowman's capsule attracts the substances B ) the substances are actively transported into the Bowman's capsule C ) blood pressure of the glomerulus is so great that most substances in blood move into capsule D ) little green men force it in with their ray guns 8. What happens in tubular excretion? A ) urine bonds are formed between the wastes B ) wastes are diffused from the tubule C ) wastes move into the distal convoluted tubule from the blood D ) blood pressure forces wastes away from the kidney 9. The countercurrent exchange system includes_________and_________.

A ) glomerulus and macula densa B ) proximal convoluted tubule and distal convoluted tubule C ) loop of Henle and collecting tubule D ) afferent arteriole and efferent arteriole E ) ureters and bladder 10. The function of the loop of the nephron in the process of urine formation is: A ) reabsorption of water 11. Name the six important roles of the kidneys. Glossary Antidiuretic: lessening or decreasing of urine production or an agent that decreases the release of urine. Catheterisation: a catheter is a tube that can be inserted into a body cavity, duct or vessel. Catheters thereby allow drainage or injection of fluids or access by surgical instruments. The process of inserting a catheter is catheterisation. In most uses a catheter is a thin, flexible tube: a "soft" catheter; in some uses, it is a larger, solid tube: a "hard" catheter. Dehydration: condition resulting from excessive loss of body fluid. Diabetes: a general term for a disease characterized by the begining stages and onset of renal failure.

It is derived from the Greek word diabaínein, that literally means "passing through," or "siphon", a reference to one of diabetes' major symptoms—excessive urine production. Diuresis: secretion and passage of large amounts of urine. Diuretic: increasing of urine production, or an agent that increases the production of urine. Erythropoietin: hormone that stimulates stem cells in the bone marrow to produce red blood cells Fibrous Capsule: the kidney's loose connective tissue Glomerulus: capillary tuft that receives its blood supply from an afferent arteriole of the renal circulation. Gluconeogenesis: the cycle of producing a glucose form fat or protein; preformed by the kidney in times of long fasting, initially gluconeogenesis is preformed by the liver Juxtaglomerular (JG) cells: Renin-secreting cells that are in contact with the macula densa and the afferent arterioles of the renal nephron.

Juxtaglomerular apparatus (JGA): A site of juxtaglomerular cells connecting with the macula densa where renin is secreted and sensor for control of secretion of golmerular filtration rate.

Loop of Henle/ Nephron Loop: u-shaped tube that consists of a descending limb and ascending limb; primary role is to concentrate the salt in the interstitium, the tissue surrounding the loop Medullary Pyramids or Renal Pyramids: the cone shaped masses in the kidney Micturition: another name for excretions Nephron: basic structural and functional unit of the kidney; chief function is to regulate water and soluble substances by filtering the blood, reabsorbing what is needed and excreting the rest as urine Podocytes: filtration membrane, in the visceral layer of the bowman's capsule Renal Calculi: kidney stones, solid crystals of dissolved minerals in urine found inside the kidneys Renal Cortex: outer portion of the kidney Renal Lobe: each pyramid together with the associated overlying cortex Renal Pelvis: a central space, or cavity that transmits urine to the urinary bladder via the ureter Renin: hormone released by the Juxtaglomerular (JG) cells of the kidneys when blood pressure falls TURP: transurethral resection of the prostate.

During TURP, an instrument is inserted up the urethra to remove the section of the prostate that is blocking urine flow. This is most commonly caused by benign prostatic hyperplasia (BPH). A TURP usually requires hospitalization and is done using a general or spinal anesthetic. It is now the most common surgery used to remove part of an enlarged prostate. Urethra: a muscular tube that connects the bladder with the outside of the body Ureters: two tubes that drain urine from the kidneys to the bladder Urine: liquid produced by the kidneys, collected in the bladder and excreted through the urethra Urinary Bladder: a hollow, muscular and distensible or elastic organ that sits on the pelvic floor Urinary System: a group of organs in the body concerned with filtering out excess fluid and other substances from the bloodstream References

Question: The "loop of Henle" is found where in the human body?
Answer: Kidney