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0:00hi I am oel Enriquez and this
0:02presentation contains our discussion on
0:05the urinary system browsing through the
0:08contents of this chapter I saw that most
0:11of this discuss when you get to your ABF
0:15classes so this is one of your third
0:17year subjects its full name is the
0:20analysis of urine and body fluids so for
0:24the purposes of this
0:28discussion basics para was information
0:32overload all right so I this discussion
0:35is basically an introduction to
0:39ABF the urinary system is the major
0:42expiratory system of the body now if you
0:44would remember from our previous
0:46discussions other organ systems in the
0:48body also have the capability to
0:50eliminate waste like the digestive
0:53system the digestive system could
0:56eliminate undigested food items through
0:59death ification the skin um the
1:02integumentary system could also
1:05eliminate cellular waste or small
1:08amounts of ions through sweating the
1:11respiratory system is also capable of
1:13getting rid of carbon dioxide which is
1:16basically a waste product of ATP
1:20production urinary system main
1:25character waste elimination and why is
1:28that as it says here there are other
1:30organ systems um or these other organ
1:34systems no they can't compensate if ever
1:38the kidney
1:42fails the digestive system inary or
1:46respiratory system they can't compensate
1:49all right they can't stand in place of
1:52the work that the kidneys are
1:55doing scenario if for example the integ
1:59Ary system is having difficulties
2:02excreting excess ions or maybe the
2:05digestive tract is having difficulties
2:08getting rid of excess water or other
2:10stuff like that the kidneys could
2:12totally make up for those the kidneys
2:15could just work twice as hard to
2:16eliminate all that excess water excess
2:20sodium excess
2:21potassium eliminate organ systems all
2:25right so I hope you understood that for
2:28all the other organ system
2:30elimination
2:35function if all the other organ systems
2:38to my elimination
2:44function this illustration right here
2:47shows us the components of the urinary
2:52system aside from eliminating waste and
2:55other excess materials or number
2:58one what are the other functions of the
3:01urinary system next is the regulation of
3:04blood volume and pressure which
3:07correlates to the next one which is um
3:09blood solute Co concentration so we'll
3:13discuss more about that later and also
3:21notice listed here are the structural
3:23components of the urinary system two
3:26kidneys with two uror that could connect
3:30to one urinary bladder that has one
3:33urethra
3:37so this illustration shows us the
3:40urinary system as to where it is located
3:43in relation to all the other organs in
3:46the abdominal pelvic
3:50region let's now talk about the kidneys
3:52the kidneys have been described as a
3:55bilateral
3:57retroperitoneal organs so
4:00bilateral that means that there is two
4:02of them all right one on each side next
4:06retro peronal meaning that it is
4:09positioned at the back of the peronal
4:13cavity so NASA it says here that each
4:16kidney weighs approximately 5 oz or
4:20equivalent to a bar of
4:23soap the Americans no the Americans will
4:26use anything other than the metric
4:28system
4:30um to be fair
4:34though if you compare our organs to
4:37daily household items so and but here
4:40are the descriptions regarding our
4:44kidney these next few slides talks about
4:47the structures of the kidney or the
4:49parts of the kidney all right first up
4:51is the renal capsule this is a
4:53connective tissue around each kidney
4:57okay so my connective tissue
5:01and this would protect the kidneys and
5:03act as a barrier next is theum theum is
5:08an
5:14indentation artery renal veins nerves
5:18and the Uther is also connected to the
5:22hilum the renal pelvis would contain the
5:26blood vessels and fat so blood vessels
5:30s renal sinus next the renal cortex this
5:34is the outer portion and the inner
5:37portion is referred to as the Ral medala
5:40so
5:41same organs that we've discussed in the
5:44past outside referred to as the cortex
5:47inside or the middle is referred to as
5:50the
5:53medal the renal pyramid is a cone shaped
5:57structure in the medala whose base would
5:59project into the cortex all right so
6:03positioning
6:07pyramida after that base
6:13orex now imagining a cone there's one
6:18side that is wide
6:22sidey soap or
6:26B cortex meaning point area no this is
6:31projecting to the other side so that
6:33would be referred to as the renal papill
6:36so the renal papill are the tips of the
6:38cone or the tip of the pyramids and they
6:41would drain into cises okay so we have
6:45what is known as the renal pyramid the
6:48base is um facing the cortex the tip is
6:52facing towards the cisis and D Ral
6:57papill that's that would be the the tip
7:00of the cones or the tip of the pyramids
7:04next is the renal pelvis this is where
7:06all the calluses would join together and
7:10then they would form the structure that
7:12leads to the urer all
7:15right um again within the renal medala
7:20we have these cone shaped or pyramid
7:22shaped structures
7:28bortex aysis and the tips of the
7:31pyramids or the cones would be referred
7:33to as the renal papil all right
7:38soal pelvis this is
7:43the so this is where thees would join
7:46together and after that this structure
7:49would eventually form into the
7:53uror and this illustration right here
7:55shows us all these structures that we
7:58just talked about in the prev previous
7:59slides
8:01and actual human sample on this other
8:05figure or here at figure
8:08B let's now talk about the nephron so
8:11the nefron is the functional unit of the
8:14kidney okay what is the functional unit
8:17of the kidney one nephron so each kidney
8:21has over a million nephrons and the
8:24nefron includes the renal Corpus Cel
8:27proximal convol to tubule Loop of Henley
8:31distal convoluted tubule and the
8:33collecting duct all right so on the next
8:36slide Parts
8:39nephron this illustration right here
8:41shows us the structure of the Nephron so
8:44if we were to cut the kidney and look on
8:46the
8:48inside cortex and then Meda all right or
8:52the renal pyramid
8:54notice base pyramid is
9:02cortex cix again the cix together they
9:05would create the
9:08urer
9:10structure nephron all right so right
9:12here we have our blood supply veins and
9:16arteries right then here is one renal
9:20Corel now if we open this up we would be
9:23able to see that on the inside of a
9:25renal Corel we have what is known as the
9:28B B's capsule all right so we have the
9:31Bowman's capsule and the glomerulus okay
9:35so um as we can see right here no there
9:38are two um examples that I've been shown
9:42here
9:44so proximal convoluted
9:47Tu proximal convoluted
9:52Tu renal corpos all right it is in close
9:56proximity to the renal Corpus cell after
10:00that this would
10:02continue convoluted because it has a lot
10:05of twists and curves all
10:11right Loop of Henley so the loop of
10:14Henley is this structure right here
10:17elongated u-shaped tubes right here so
10:22from from the renal corpos Cel we would
10:23have the proximal convulated tubule next
10:27um we have the um descending Loop of
10:30Henley and then the ascending Loop of
10:32Henley which is and then after that is
10:36distal convoluted tub so convoluted tub
10:41as the name
10:44implies Corel and it is still very
10:48convoluted twists and curves so this is
10:53the structure of one
10:56nefron let's now look into the different
10:58types of nephrons first is the jxa
11:00medary nephrons they have very long
11:03Loops of Henley that extend deep into
11:06the medala so um Loop of
11:10handle medary nephrons they're capable
11:13of extending further down into the
11:16medala and these JSA medary nephrons are
11:20well adapted for water
11:23conservation all right so
11:26um maybe we could say now
11:30um very efficient very efficient water
11:35reabsorption medary nephrons all right
11:38so here are the two um main points or
11:42main things that we need to remember
11:44about just the medary nephrons so they
11:48have long Loops of Henley and they are
11:50good for conserving
11:53water second type of nefron is the
11:55cortical nephrons so these have renal
11:58corpos cels that are distributed
12:01throughout the cortex and their Loops of
12:03Henley are shorter
12:06so
12:09difference Loops of heny cortical
12:14nephrons let's now look further into the
12:17renal Corpus Cel the renal corporel is
12:20the filtration portion of the nefron
12:23okay so most of the
12:27filtrational corpos filtration
12:29capabilities kid because of the renal
12:33corporel it has two parts the glus the
12:37glus is a network of capillaries that
12:40are twisted around each other making
12:43them look like a ball of Yar
12:46so illustration previous slide but
12:50that's what the glus looks like it is a
12:54kind of like Network or a mesh of
12:57capillaries next next is the Bowman's
12:59capsule the Bowman's capsule is the
13:02enlarged end of the nefron that
13:05surrounds the glus all right so this one
13:08the Bowman's capsule this would open
13:11into the proximal convoluted tubule
13:15okay Bowman's capsule proximal
13:18convoluted tub inside the Bowman's
13:20capsule it contains pyes so bites these
13:24are highly specialized epithelial cells
13:27that cover the out side of the
13:29glomerular capillary all right so
13:32phocytes they have a cell body with
13:35numerous primary secondary and tertiary
13:39extensions that are called foot
13:44processes looking further into the
13:46Bowman's capsule this is actually made
13:48up of two layers the outer layer is
13:51composed of simple squamous epithelial
13:54cells that eventually become Cube shaped
13:57at the beginning of the prox imal
13:59convoluted Tu so if you would remember
14:01from the previous
14:04slide
14:06capsule proximal convoluted Tule so as
14:10we can see right here outer layer
14:12Bowman's capsule this is made up of
14:15simpleos epithelial
14:19cells structure proximal convoluted
14:23tub
14:25cubid cells the inner layer is is made
14:29up of phocytes which would wrap around
14:32the glomerular capillaries again
14:34phocytes they have these footlik
14:37extensions or footlik
14:42structures let's now talk about the
14:44afferent arterial and the afferent
14:47arterial so the afferent arterial would
14:50Supply blood to the glomerulus for
14:53filtration all right so ging AER
14:57arterial no blood flow filter glos next
15:03is the eent arterial so the eent
15:06arterial would transport the filtered
15:09blood away from the glomerulus all right
15:12so you efferent
15:18arterial
15:19blow all right so a entrance AER exit
15:25Okay so AER arterial has smaller
15:29diameter than the aerin arterial
15:32creating a high pressure in the
15:34capillaries so my high pressure
15:37effective filtration all right so again
15:41AER
15:43arterials blood enter palang blood all
15:47right next
15:49after eer Arial filter blood all right
15:54so exit no eer arterial the blood would
15:59now
16:02exit the structures in the renal Corpus
16:05Cel would create the filtration membrane
16:08the filtrate is the fluid that has been
16:10filtered from the glomerular capillaries
16:13so this enters the Lumen inside of the
16:15burman's capsule okay so again you
16:18filtered fluid no from the blood flow
16:22that has gone through the renal corpos
16:24Cel we would refer to that as the
16:26filtrate all right so all the structures
16:29that we've previously talked about no
16:32those are the um those are the
16:34components of the corporel which creates
16:36a filtration
16:39membrane let's now talk about the jxa
16:42glomerular apparatus the jxa glomerular
16:45apparatus these are specialized cells of
16:48the afferent arterial again an afferent
16:52arterial this is where blood would enter
16:56so palang you blood flow glos for it to
17:02be filtered all right so
17:04again GL apparatus these are the
17:07specialized cells of the aerin arterial
17:11next are ju glomerular cells so chag
17:15glomerular cells these are smooth muscle
17:18cells that are located where the
17:20afferent arterial would enter the renal
17:23Corpus Cel okay so again um jsta
17:25glomerular cells they're basically just
17:28smooth muscle cells next is the macula
17:31Dena the macula is the part of the
17:35distal convoluted tubio that lies
17:37between the afferent and afferent
17:40arterials all right afferent and
17:42afferent arterials next to the renal
17:45Corpus okay the macula Dena is just a
17:49segment or a part of the distal
17:53convoluted tubulus just that it is
17:55located between the apparent and eent
18:01arterials the juular apparatus is an
18:05important regulatory structure secretion
18:08of the enzyme renin by the CH glomerular
18:11apparatus plays an important role in the
18:13regulation filtrate formation and blood
18:17pressure all right
18:19so
18:21enme J glomerular apparatus this enzyme
18:25is called renin so renin is capable of
18:30controlling or regulating two things
18:32renin could regulate filtrate formation
18:35or you fluid eventually urine and it
18:38could also regulate blood pressure right
18:42so again the jular apparatus produces an
18:46enzyme called renin renin is capable of
18:50regulating filtrate formation and blood
18:55pressure the proximal convoluted tubule
18:58is where the filtrate first passes all
19:01right so um after filter
19:04blood glus
19:08fil proximal convoluted so again
19:16proximal
19:18Corel so up next next segment proximal
19:22the tuul is the loop of Henley
19:26so ustra it has a descending paba and
19:31ascending Loops or Loops so um water and
19:36solutes would pass through the thin
19:38walls by diffusion so Loop of
19:42Hy diffuse water and solutes as needed
19:52exuse just as easily again these things
19:55could happen at the Loop of hand
20:00next the filtrate would now go through
20:02the distal convoluted tub so
20:06process once blood passes through the
20:10renal corpus
20:14cellus
20:19now
20:20process proximal convoluted tubule after
20:25that Loop of Handley and then distal
20:29convoluted
20:31Tule
20:34collecting
20:40or collecting duck so this would empty
20:43into the cisis and again the kysis would
20:47eventually um kind of like continue onto
20:50the structure that would be the
20:56uror this slide lists down the
20:58stepbystep flow of filtrate or urine
21:02through the nefron all right so again um
21:05if our nephrons are right here and the
21:07arterials that would Supply blood are
21:09right here no and we have the um
21:13afferent and the afferent
21:15arterial so enter blood through the
21:19afferent arterial if filter renal corpos
21:24Cel right here s glomerulus now the rest
21:27of the blood would exit through the
21:30eerin arterial meanwhile
21:34filate proximal convoluted tubule after
21:38that this would go through the
21:40descending Loop of Henley and then
21:43P ascending Loop of Henley and then
21:46after that it would go through the
21:48distal convoluted tubule again they have
21:52the named proximal and distal um with
21:55regards to their vicinity or close
21:58to the Ral corpos so
22:01proximal Corel dist
22:05distant Ral
22:13corput duct which is right
22:16here um collecting ducts this would now
22:19proceed to the calic so cix no we also
22:22have a structure that is referred to as
22:24the papillary duct anyway ending po
22:31cix let's now talk about urine formation
22:34so there are three processes create
22:37urine first is filtration so this would
22:40occur in the renal Corpus Cel and the
22:43blood plasma would leave the glomerulus
22:45and Enter The Bowman space all right so
22:48again um filtration this would mostly
22:51occur at the renal Corpus Cel next is
22:54tubular reabsorption so this involves
22:58removing substances from the filtrate
23:00and placing them back into the blood all
23:02right
23:04so
23:07filtrate out sodium for example now
23:11sodium levels in the body
23:16reabsorbs sodi
23:18and blood circulation all right so
23:21that's an example of how tubular
23:23reabsorption would happen next process
23:27is
23:29secretion in secretion this would
23:32involve taking substances from the blood
23:35at the nephron area other than the renal
23:38corpos Cel and putting it back into the
23:41nefron tubule so but here are the three
23:44processes involved in urine formation
23:47filtration tubular reabsorption and
23:52secretion this illustration right here
23:54shows us where those three processes
23:58would happen so right here renal Corpus
24:01this is where filtration would happen
24:04next at the proximal convoluted tubu and
24:06at the Loop of Henley that is where most
24:10of the reabsorption would happen so
24:12again if materials fil out
24:18Corel proximal convoluted tubule and
24:21loop of Henley after that the filtrate
24:24would pass through and proceed to the
24:26distal convolution tubul
24:29so third step now which is secreation so
24:34most of the things that would pass
24:35through here is ready now to be um
24:38excreted or to become
24:41urine let's discuss more about
24:44filtration so filtration this is the
24:46movement of water ions and small
24:48molecules through the filtration
24:51membrane into the Bowman's capsule all
24:53right
24:54so filtration membrane
24:58Bowman's capsule now approximately 180 L
25:03of filtrate are produced by the nephrons
25:06each day all right so
25:11nephrons together they could produce
25:14approximately 180 L of filtrate of
25:18course not all of those filtrate would
25:20be um would be secreted or become urine
25:24so as we can see right here 1% of the
25:27filtrate or 1.8 L would become urine and
25:32the rest is reabsorbed all right so 180
25:37l no is um is urinated rather no only 1%
25:43would become urine or approximately 1.8
25:50L only small molecules are able to pass
25:54through the filtration membrane all
25:56right so just ions right
25:59filtration membran substances like um
26:03glucose or proteins okay
26:07so Ur because they are too large to pass
26:11through the filtration membrane so the
26:14formation of filtrate depends on the
26:16filtration pressure filtration pressure
26:19would force the fluid across the
26:22filtration membrane all right so that's
26:24the basic concept of filtration there
26:26needs to be some form of pressure fluid
26:31from one side to the other the
26:33filtration pressure is influenced by
26:35Blood and interstitial fluid pressures
26:38as well as osmotic pressures of the
26:41plasma and interstitial fluid all right
26:44so again um take note of the things that
26:47could influence filtration pressure so
26:50blood pressure interstitial fluid
26:53pressure and osmotic
26:56pressure no together they could be
26:59factored in with the filtration
27:04pressure let's now talk more about
27:07reabsorption so 99% of the filtrate is
27:11reabsorbed and it would reenter the
27:14circulation the proximal convoluted
27:17tubule is the primary site for
27:18reabsorption of solutes and water right
27:22so solutes like again sodium chloride
27:24and other ions and of course water need
27:27to the
27:29absorb proximal convoluted Tu the
27:33descending Loop of H concentrates the
27:36filtrate and reabsorption of water and
27:38solutes from the distal convoluted tubul
27:42and collecting duct is controlled by
27:44hormones okay so there may be hormones
27:46out
27:50there or secrete substances with the
27:54help of our
27:56kidneys
27:58let's now proceed to discuss secretion
28:00so tubular secretion removes some
28:04substances from the blood all
28:07right
28:10process
28:11convoluted
28:14fil liquid
28:16materials
28:19urinate all right so these substances
28:21include byproducts of metabolism that
28:24become toxic in high concentrations and
28:27drugs or other molecules that are not
28:29normally produced by the body so
28:33byproducts of
28:34metabolism um excess things like um
28:38medications or
28:41vitamins filter
28:42out
28:46andr we have kind of like a daily dose
28:50of um kind kind of like a limit for
28:53vitamins all right so number of
28:56milligrams
28:57per day
29:01soig per day for example for
29:13vitamins still on secretion ammonia
29:16secretion is passive all right normal or
29:20automatic ammonia s blood is secrete it
29:24next secretion of hydrogen potassium
29:27creatinin histamin and penisin is by
29:31active transport so energy secrate
29:36hydrogen potassium creatinin histamine
29:39and
29:42picin the kidneys regulate blood
29:45composition and are able to produce
29:47either very diluted or very concentrated
29:51urine to maintain the extracellular
29:53fluid concentration that is close to
29:56approximately 3 00 mosm per lit
30:00okay statement normal normal fluid
30:07concentration extra cellularly is at 300
30:11milliosmoles per lit
30:19okay either DED or concentrated urine
30:24again go is to maintain the
30:28extracellular fluid
30:32concentration in the countercurrent
30:34mechanism fluids in separate structures
30:37flow in opposite directions okay so the
30:41countercurrent mechanism creates a very
30:43high solute concentration in the Medela
30:46compared to the cortex which would be
30:49called the medary
30:51concentration gradient so countercurrent
30:54mechanism po no all right
30:58fluids would flow in opposite
31:02directions flow of
31:04fluid counter
31:11Curr is that there would be a high
31:14solute concentration mat amount of
31:18particles within the filate inside of
31:21the medala so this would create some
31:23form of medary concentration gradient
31:27concentrated solutes or concentrated
31:30particles
31:32filtrate medary
31:36area the descending limb of the loop of
31:39Henley is a critical site for water
31:42reabsorption all right so my um my
31:46function descending Loop of Henley for
31:50watery absorption for conserving water
31:53all right so the filtrate leaving the
31:55proximal convoluted tubul is further
31:58concentrated as it passes through the
32:01descending Loop of
32:03Henley
32:05concentrated reabsorb water
32:08so is solutes or particles so the
32:13mechanism for this water reabsorption is
32:15osmosis basically
32:20water
32:23reabsorb the descending Loop of hendley
32:26is highly permeable to water all right
32:29so
32:32easy descending Loop of Henley as
32:35filtrate moves through the medulla
32:38containing the highly concentrated
32:40interstitial fluid water is reabsorbed
32:43out of the nefron by osmosis after that
32:47water would enter the vasara and removes
32:51excess water and solutes from the medala
32:54without changing the high concentration
32:56of solutes and the medary interstitial
33:02fluid
33:03next po you descending Loop of Henley it
33:08would um concentrate the urine by
33:11absorbing or reabsorbing
33:15water ascending Loop of Henley so the
33:18ascending Loop of Henley would dilute
33:21the filtrate by removing solutes okay
33:24so ascending Loop of Henley
33:28absor is solutes or solid
33:35particles
33:36filtrate so the thin segment of the
33:39ascending limb is not permeable to
33:43water water but this is permeable to
33:47solutes so solutes would diffuse out of
33:50the nefron now the permeability of the
33:53distal convoluted tubule and collecting
33:56duck would vary upon hormonal control so
34:01automatic permeable to water descending
34:04Loop of
34:05Henley automatic permeable to solute
34:10ascending Loop of Henley distal
34:13convoluted tubule and collecting ducts
34:16is dependent upon the control of
34:22hormones there are three major hormonal
34:25mechanisms that are in involved in
34:27regulating urine concentration and
34:30volume first up is the renin angot
34:33tensin aldosterone system or ratas so
34:37ratas is a hormone system within the
34:40body that is um necessary for the
34:43regulation of blood pressure and fluid
34:45balance primarily it is regulated by the
34:49rate of renal blood flow so it's
34:52basically three different hormones
34:55working together
34:57next is the antidiuretic hormone which
35:00we've already talked about in um
35:02previous discussions right so ADH this
35:06would help conserve water in the body so
35:10anti diuretic hormone is anti sa process
35:16urination okay and the third one is the
35:19atrial Nat uretic
35:23hormone let's now look at the RAS or r
35:26an Angiotensin aldosterone system and
35:29how this works step one the kidneys
35:32specifically J glomerular apparatus
35:35kidneys would release the enzyme renin
35:38okay so Step One release renin step two
35:42renin is to take
35:44angiotensinogen and convert it to angot
35:47tensin
35:48one functional angens one
35:53okay angens one so in step three the
35:57angot tensin converting enzyme would
36:00take angot tenin 1 and make it angot
36:04tenin 2 so just a recap
36:07organu Ace or the ensin converting
36:13enzyme it's at the lungs all right the
36:16lungs aside from helping us Breathe No
36:19and collecting
36:20oxygen lungs is to produce Ace or the
36:24Angiotensin converting enzyme again
36:27Angiotensin one would be converted by
36:30Ace into Angiotensin 2 now onto step
36:35four functional andot tensin 2 so andot
36:39tensin 2 causes vasor constriction
36:44or blood vessels which would raise blood
36:52pressure
36:53soort heart pump or push you blood and
36:58this effort is measured as a rise in
37:01blood pressure all right so an
37:06po
37:08again between anen angens one and andot
37:13tensin to okay so if anybody here plays
37:17Pokemon all right just think of it as
37:19that okay so parang
37:21Evolutions so Squirtle evolve into war
37:24ttle and then Turtle evolve into
37:28Blastoise so concept angiotensinogen
37:32would evolve into anot tensin one and
37:35then andr tensin one would evolve into
37:37andr tensin 2
37:40so um after that
37:46functional this illustration right here
37:49shows us the actions of aldosterone so
37:53if for example we have a decreased blood
37:55pressure
37:57is the kidneys would secrete the enzyme
38:01renin all right so renin would convert
38:04angiotensinogen into angot tensin one
38:08after that relase lungs Ace or the angot
38:12tensin converting enzyme andin one andin
38:172 all
38:19right andin 2 would increased
38:22aldosterone secretion so aldosterone
38:26secre
38:27there is increased um sodium and water
38:30reabsorption which also results in
38:33increased blood pressure so po this is
38:37how aldosterone would
38:55work
40:10let's now talk about the anti-diuretic
40:12hormone mechanism so anti-diuretic
40:15hormone or ADH this is Secret by the
40:18posterior pituitary gland otherwise
40:21referred to as the neuro hypothesis so
40:24um ADH
40:27secrete when the solute concentration of
40:30the blood or interstitial fluid
40:32increases all
40:35right amount of solutes in our blood
40:39then we need to have ADH or we need the
40:43action of
40:45ADH okay so ADH would act on the kidneys
40:50causing them to absorb more water to
40:53decrease the urine volume all right
40:55absorb more water so um absorb
41:01water volume of
41:03urine fluid urinate person so the result
41:08is to maintain a normal blood volume and
41:11blood pressure so as we can see right
41:14here posterior
41:18pituitary am of solutes in our
41:24blood um
41:27kidneys by the help of the ADH so
41:33ADH reabsorb water reabsorb water we
41:37achieve
41:38homeostasis balance out amount fluid and
41:42you amount solutes right so again that
41:45is how the ADH or anti-diuretic hormone
41:50would work um with regards to
41:53conservation of water or the reab
41:56absorption of water again reabsorb water
42:00this would decrease urine volume
42:09or this usually happens in
42:12times
42:14um have you ever experienced when you're
42:17eating maybe like french fries or chips
42:21or any salty
42:23foods salt content
42:32of our brain to tell our
42:38body so we need to do something to kind
42:42of like bring it back up bring back up
42:45the amount of fluid in the body so again
42:48um either start up thirst
42:55mechanism by releasing ADH so
42:59ADH kidneys to reabsorb water right so
43:03that's an example on how we may be able
43:06to observe the work of the anti-diuretic
43:11hormone let's now talk about the atrial
43:14natriuretic hormone the atrial
43:17natriuretic hormone or A&H is secreted
43:20from cardiac muscles at the right atrium
43:24so heart po
43:26you atrial natriuretic hormone all right
43:30so again atrial natriuretic hormone this
43:32is secreted by the cardiac muscle
43:35specifically at the right
43:38atrium atrial so this is secreted um by
43:43cardiac muscles no from the right atrium
43:45when blood pressure increases all right
43:50so blood
43:53pressure work heart and it would release
43:56is atrial natriuretic hormone
44:01nowag acts on the kidneys to decrease
44:05sodium reabsorption
44:08so kidney to stop or to decrease
44:14reabsorb sodium ions now sodium ions
44:18they remain in the nefron and then they
44:20would enter the urine so there is an
44:22increased loss of sodium and water to
44:25reduce blood volume and blood
44:30pressure okay
44:33so kidneys palang okay so let's now
44:37proceed to the urar and urinary bladder
44:40so the uror these are small tubes that
44:43carry urine from the renal pelvis of the
44:45kidney to the bladder so
44:48uror final filate or
44:52fate
44:54urow
44:56bladder next is the urinary bladder so
45:00this is located at the pelvic cavity all
45:03right so kidneys retrop peronal location
45:08urinary bladder poas pelvic cavity so
45:11this one stores urine so par storage
45:15site urine that has been created so this
45:19can hold a few ml or milliliters to a
45:22maximum of 1,000 Mill of urine all right
45:28an average healthy human adult no it
45:32could store approximately 1,000 Mill of
45:36urine or basically that's equivalent to
45:391
45:43liter these illustrations show us a
45:47crosssection of the uers and the urinary
45:51bladder so as we can see right here know
45:53um let's first look into the composition
45:56of the uror all right so um right here
46:01Makita ERS palang present transitional
46:05epithelium and of course right here at
46:07the urinary bladder
46:09no transitional epithelium because this
46:12urinary bladder needs to be able to
46:14stretch to hold all of those urine it it
46:19also has a smooth muscle layer and um an
46:22area of connective
46:24tissues
46:27next segment is the urethra so this one
46:29is a tube that exits the bladder all
46:32right so connect some bladder and then
46:35it would continue to the outside so this
46:37carries urine from the urinary bladder
46:40to the outside of the body it has what
46:43is known as the internal urethal
46:45sphincter this is a smooth muscle that
46:48surrounds the urethra at the junction of
46:51the urinary bladder and prevents urine
46:54from leaving the bladder
47:12urethra so that's because of the
47:14internal urethal sphincter which again
47:17is a smooth muscle that would kind of
47:19close off the junction between the
47:22urinary bladder and the
47:24urra
47:28next is the external uretheral seinor so
47:33internal external the external urethal
47:36sphincter is made up of skeletal muscles
47:39surrounding the urethra near the pelvic
47:41floor or towards the end so this allows
47:44a person to voluntarily start or stop
47:47the flow of your ve okay
47:50so internal urethal
47:53sphincter smooth muscles
47:57located urinary bladder
48:01and
48:03entrance urethra external urethal
48:06sphincter as the name implies no it is
48:09already near the outside or near the
48:12pelvic floor all right and you internal
48:15Ural sphincter is made of smooth muscles
48:17so basically
48:19involuntarily
48:21contr um external urethal sphincter this
48:25is made of of skeletal muscles meaning
48:28we could control this voluntarily so we
48:31have conscious voluntary control to
48:34start or stop the flow of urine when a
48:37person is
48:41urinating what is the micturation reflex
48:45the micturation reflex is activated by
48:47the stretch of the urinary bladder wall
48:50so urinary bladder it could hold certain
48:53amounts of urine so it has the cap
48:55capability to
48:57stretch transitional
49:00epithelium so um when the urinary
49:04bladder is fully stretched all
49:07right so Action potentials are conducted
49:10from the bladder to the spinal cord
49:13through the pelvic nerves okay so
49:16basically detect brain orend signals no
49:21bladder through the spinal cord no as it
49:24is being stretch so the parasympathetic
49:27Action potentials would cause the
49:29bladder to
49:31contract crosssection um the walls of
49:34our urinary bladder is made up of smooth
49:37muscles right so when it is fully
49:40stretched it would send a signal to the
49:42brain the brain would give a go signal
49:44to the smooth muscles to start
49:46Contracting so the stretch of the UR
49:48urinary bladder stimulates Sensory
49:51neurons to inform the brain that the
49:54person needs to use urinate okay so
49:58process and let's look at the
50:00illustration on the next
50:02slide this illustration right here shows
50:05us how the micturation reflex works
50:08again explain in a very basic way first
50:11up urine urinary bladder so um naturally
50:16it would stretch so the stretching sends
50:19potential actions through the spinal
50:22cord brain all right so
50:32cere all right so it would now send
50:35signals smooth muscles urinary bladder
50:39to contract and release the
50:44urine let's now talk about the
50:46regulation of extracellular fluid
50:49composition this is regulated by two
50:51means through thirst regulation and ion
50:55concentration
50:59regulation let's now talk about thirst
51:01regulation water intake is controlled by
51:03The Thirst center that is located in the
51:06hypothalamus all
51:08right the sensation of being thirsty and
51:11wanting to drink is brought about by the
51:14action or decisions of our hypothalamus
51:18all right so when the concentration of
51:19ions in the blood increases it stimulate
51:22The Thirst Center to cause thirst all
51:28right ions in our blood circulation this
51:32would stimulate or trigger The Thirst
51:34centor in our hypothalamus to um tell
51:38the person to drink water basically all
51:41right so again
51:44example about eating very salty foods
51:48all right so very salty foods contain a
51:50lot of sodium
51:54chloride level of sodium chloride in our
51:58circulation
51:59hypothalamus
52:01to to cause a person to be thirsty to
52:05tell a person to drink water so when
52:08water is consumed the concentration of
52:10blood ions would decrease or go back to
52:13normal and due to this dilution effect
52:16no this causes the sensation of thirst
52:18to decrease so basically The Thirst has
52:21been quenched after a person drinks
52:24water right so again The Thirst Center
52:27is located our hypothalamus The Thirst
52:30Center is activated when concentration
52:34of ions is
52:38increased let's now talk about the
52:40regulation of acidbase balance the
52:42respiratory system is actually involved
52:45in acidbase
52:47regulation so this responds rapidly to
52:50the changes in PH right so increased
52:53respiratory rate raises the blood pH
52:57making it more alkaline so there would
52:59be increased rate of carbon dioxide
53:03elimination right now reduced
53:05respiratory rate reduces the pH now it
53:08would become more acidic because there
53:11is decreased rate of carbon dioxide
53:13elimination all right so basically pH BL
53:17is carbon dioxide levels less carbon
53:21dioxide more
53:23alkaline carbon dioxide more acidic all
53:28right so increased respiratory rate
53:30or
53:38or eliminate carbonox now on the other
53:48hand eliminate n carbon dioxide so again
53:52if there is um less car carbon dioxide
53:56no there is increased rate of carbon
53:58dioxide elimination all
54:00right carbon dioxide then alkaline blood
54:04pH if there is decrease rate of carbon
54:07dioxide elimination
54:09meaning carbon
54:12dioxide acidic blood
54:16pH let's now look into the involvement
54:18of the kidneys regarding acidbase
54:21balance so the nephrons would secrete
54:23hydrogen into urine to regulate PH of
54:27body fluids or directly regulate PH of
54:30body fluids so involvement lungs carbon
54:35dioxide adjust to control the pH of the
54:39blood kidneys hydrogen ions in adjust to
54:44regulate the pH of body fluids the more
54:48hydrogen secretion if pH is decreasing
54:51so acid environment
54:55um is more hydrogen is being secr or
55:01eliminated next there would be less
55:04hydrogen secretion if the pH is
55:07increasing so
55:10alkaline body condition body fluids
55:16thenne
55:18eliminate
55:21hydrogen let's now talk about acidosis
55:24and alal osis acidosis occurs when the
55:27pH of the blood Falls below
55:317.35 so 7.35 normal slightly alkaline
55:36all right so um acidosis is below
55:427.35 so we have two kind of like forms
55:45of acidosis respiratory acidosis and
55:49metabolic acidosis in respiratory
55:52acidosis the respiratory system is
55:55unable to eliminate carbon
56:01dioxide events in respiratory acidosis
56:05the respiratory system is um failing to
56:09eliminate carbon
56:11dioxide carbon
56:13dioxide respiratory acidosis next in
56:17metabolic acidosis there is excess
56:20production of acidic substances such as
56:24lactic a acids or ketones due to
56:27increased metabolism or the decreased
56:30ability of the kidneys to eliminate
56:32hydrogen all right so there are two
56:34ways metabolic
56:38acidosis either increase
56:41metabolism or
56:44decrease eliminate kidneys hydrogen
56:50ions let's now talk about alkalosis
56:53alkalosis occurs when the pH of the
56:55blood Rises or increases above
57:007.45 okay
57:02so
57:057.45 alkaline blood pH again May
57:09respiratory and metabolic versions it in
57:12respiratory alkalosis this is a result
57:15of
57:16hyperventilation that results in low
57:18carbon dioxide concentration all
57:22right amount of carbon dioxide no is
57:27there is respiratory
57:29alkalosis next in metabolic alkalosis
57:32this results in the rapid elimination of
57:34hydrogen ions from the body resulting
57:37from severe vomiting or when there is
57:40excess aldosterone that is being
57:42secreted by the adrenal cortex all right
57:46so
57:49ways
57:53metabolis either the person is severely
57:56vomiting or there is excessive
58:00aldosterone production either way par
58:04has is rapid elimination of
58:09hydrogen these illustrations right here
58:12shows us the um signs and symptoms of a
58:15patient suffering from metabolic
58:18acidosis and if a person is suffering
58:20from respiratory acidosis and signs and
58:25symptoms then of a person that is
58:27suffering from respiratory alkalosis
58:30versus a person that is suffering from
58:33metabolic alkalosis so I highly suggest
58:36that you study these photos para if ever
58:40um questions upcoming
58:43exams situational or case study at least
58:48aware um signs and
58:50symptoms observe again here are
58:53different examples of people people who
58:54are suffering from metabolic or
58:57respiratory acidosis and respiratory and
59:00metabolic
59:03alkalosis again
59:06respiratory acidosis or alkalosis it has
59:09something to do with the function of the
59:12lungs metabolic acidosis no it has
59:16something to do either with our
59:18metabolism or the work of our
59:22kidneys if you belong to my lecture
59:24classes that ends our discussion on the
59:27urinary system thank you so much for
59:31listening if you belong to my laboratory
59:33classes let's now proceed and view some
59:36microscopic Anatomy samples on the
59:39urinary
59:44system this photo right here shows us
59:46the kidney under low power
59:50objective
59:52observation is the amount of renal
59:55corpos Sals that we're seeing
59:57so structures these circular structures
1:00:01that kind of like have a white space
1:00:04around them these are the renal Corpus
1:00:07cells
1:00:08so Bowman space you glus all right so
1:00:13again low power objective that's why um
1:00:16we're not really seeing specific details
1:00:20so again these things right here these
1:00:22circular structures right here these are
1:00:25the renal Corpus cels
1:00:28out blood vessels um as we can see right
1:00:31here
1:00:34umate Ral Corpus cells this is most
1:00:37likely the cortex all right or
1:00:39definitely no sorry for the word um this
1:00:42is definitely the
1:00:45cortex Ral Corpus cells and
1:00:50then this is the Ral
1:00:53medal
1:00:56this slide shows the renal cortex under
1:00:59high power objective
1:01:02so clusters
1:01:06oral
1:01:10corate Ral cortex all
1:01:13right almost all renal corpos cells
1:01:17could be observed at the renal cortex or
1:01:20you outer portion n
1:01:23kidneys
1:01:26this slide shows us the renal medala
1:01:28under high power objective so as we can
1:01:30see right here
1:01:33um Ral corpos cells but we're seeing a
1:01:37lot of circular structures with holes
1:01:39inside of them so these are most likely
1:01:42the tubules either the ascending or
1:01:45descending Loops of
1:01:48Henley um portions convoluted tubules
1:01:53all right but again an po this is what
1:01:55it looks like if we're looking at the
1:01:57renal medal no so it's less
1:02:01likely renal corpos cels again the renal
1:02:04corpos cells could be found at the renal
1:02:11cortex this slide shows us a low power
1:02:14objective view of the renal pelvis so um
1:02:19since
1:02:20LP very generalized view so we're seeing
1:02:25a few fat cells um we're seeing some
1:02:28transitional epithelium and then right
1:02:31here we're seeing the collecting Ducks
1:02:33so structures that that look like they
1:02:36kind of have spaces in the middle these
1:02:38are the collecting
1:02:43Ducks fat cells this is most likely the
1:02:47renal pelvis all
1:02:53right openings
1:02:57tubules pelvis we're seeing the openings
1:03:01of the collecting ducks and also some
1:03:04fat
1:03:07cells this slide right here shows us
1:03:09examples of Ral corpos
1:03:15cels structures on the inside and the
1:03:18Bowman's space all right so on the
1:03:21inside glus and then space so laas this
1:03:25is referred to as the Bowman's space and
1:03:28then all these holes that we're seeing
1:03:31right here this is the proximal
1:03:36tubules let's now take a closer look
1:03:38into the renal Corps
1:03:42so glus and the glomerular capillaries
1:03:47okay so if you would zoom in on this
1:03:50photo PDF in the future um
1:03:54as you can see right here there are
1:03:56areas where we may be able to observe
1:03:59some
1:04:02rbcs
1:04:04um reddish or dark pink you staining no
1:04:08those are actually rbcs which makes
1:04:10sense because these are capillaries so
1:04:13blood is flowing through this and would
1:04:16um would be filtered no so the filtrate
1:04:19will end up right here in the Bowman's
1:04:22space of the Bowman's capsule all right
1:04:25so right here AER and AER
1:04:31arterials um there's no way for us to
1:04:33distinguish them
1:04:36okay
1:04:41or function all right so AER arterials
1:04:46this is the place where the blood would
1:04:49first enter
1:04:51soang AER next efferent no na filter
1:04:56blood so it's time to exit all right
1:04:59through the efferent
1:05:02arterials all right so this entire thing
1:05:04right here is referred to as the renal
1:05:07Corpus
1:05:11Cel this slide right here shows us the
1:05:14structure of a urer upon crosssection so
1:05:19outermost or adventia the inside is um
1:05:23made up of smooth muscles and the inside
1:05:26right here Lumen space okay space Lumen
1:05:31and then the actual innermost layer no
1:05:34is made up of transitional epithelium so
1:05:38urer palang transitional epithelium all
1:05:43right um transitional epithelium is not
1:05:47just found at the urinary bladder urer
1:05:50palang no transitional epithelium so
1:05:55they're already capable of a bit of
1:06:00stretch this slide right here shows us
1:06:02the uror under high power objective
1:06:07so transitional epithelium notice that
1:06:11some of them are cuboidal and then some
1:06:13of them are starting to look a bit
1:06:15squamous all right so this layer right
1:06:18here you innermost this is the
1:06:21transitional epithelium right here we we
1:06:24have some connective tissues no we would
1:06:26refer to this as the lamina propia all
1:06:29right again we would refer to this as
1:06:31the
1:06:32lamia and then right
1:06:35here smooth muscles again smooth muscles
1:06:38are not
1:06:40stated they have tapered ends
1:06:46or so that's what we're seeing right
1:06:48here these pink squiggly lines these are
1:06:52the smooth muscles
1:06:56this slide right here shows us an
1:06:58illustration and a microscopic sample of
1:07:01the urinary bladders so basically the
1:07:04same po structure no there is an area
1:07:07with um smooth muscles there's an area
1:07:10of connective tissues and then the
1:07:12innermost layer no
1:07:16area urine this is made up of
1:07:19transitional
1:07:22epithelium
1:07:24here's a better picture of the urinary
1:07:26bladder again um right here we have
1:07:29smooth muscles connective tissues and
1:07:33transitional
1:07:38epithelium an
1:07:43po urinary bladder but basically the
1:07:46composition is the same there's an area
1:07:49a smooth muscles there is an area for
1:07:52connective tissues and there's an area
1:07:56and inside is poor transitional
1:08:00epithelium so this Darkly staining area
1:08:03right here no these are the transitional
1:08:06epithelium you light staining areas most
1:08:09likely these are the connective tissues
1:08:11and then these ones right here are the
1:08:13smooth
1:08:15muscles this slide right here shows us
1:08:18what transitional epithelium would look
1:08:21like when they are stretched or not
1:08:23stretched as we can see right here in
1:08:25this example
1:08:27so picture no it's showing us that the
1:08:30transitional Epi is not stretched
1:08:36so urinary
1:08:38bladder all right so they are very
1:08:41cuboidal all right
1:08:44cuboidal now if we were to stretch out
1:08:47the transitional epithelium in
1:08:50cases urine urinary bladder then F
1:08:56flatten transitional epithelium all
1:08:59right notice no a lot of the cells here
1:09:02at the top they're flattened so they
1:09:04have become squamous in
1:09:09appearance this slide right here shows
1:09:11us an example of the urethra so I think
1:09:15by
1:09:17now basic structure n all right so right
1:09:20here we have a ring of smooth muscles
1:09:25okay then next connective tissues
1:09:28transitional
1:09:29epithelium okay so transitional
1:09:32epithelium urethra so these Darkly
1:09:35staining areas right here
1:09:37no cells of the transitional epithelium
1:09:42again when they are not stretched they
1:09:43are cuboidal when they're stretched out
1:09:46they may appear
1:09:50squamous that ends our discussion on the
1:09:53urinary system this has been aurel
1:09:55Enriquez thank you so much for listening

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