Urinary System

The kidneys are the primary organs of excretion. Excretion is the removal of metabolic wastes from the body. People sometimes confuse the terms excretion and defecation, but they do not refer to the same process. Defecation, the elimination of feces from the body, is a function of the digestive system. Excretion, on the other hand, is the elimination of metabolic wastes, which are the products of metabolism. For example, the undigested food and bacteria that make up feces have never been a part of the functioning of the body, while the substances excreted in urine were once metabolites in the body.

Functions of the Urinary System

The urinary system produces urine and conducts it to outside the body. As the kidneys produce urine, they carry out four functions: excretion of metabolic wastes, maintenance of water-salt balance, maintenance of acid-base balance, and secretion of hormones.

Excretion of Metabolic Wastes
The kidneys excrete metabolic wastes, notably nitrogenous wastes. Urea is the primary nitrogenous end product of metabolism in human beings, but humans also excrete some ammonium, creatinine, and uric acid. Urea is a by-product of amino acid metabolism. The breakdown of amino acids in the liver releases ammonia, which the liver combines with carbon dioxide to produce urea. Ammonia is very toxic to cells, but urea is much less toxic. Because it is less toxic, less water is required to excrete urea. Creatine phosphate is a high-energy phosphate reserve molecule in muscles. The metabolic breakdown of creatine phosphate results in creatinine. The breakdown of nucleotides, such as those containing adenine and thymine, produces uric acid. Uric acid is rather insoluble. If too much uric acid is present in blood, crystals form and precipitate out. Crystals of uric acid sometimes collect in the joints, producing a painful ailment called gout.

Maintenance of Water-Salt Balance
A principal function of the kidneys is to maintain the appropriate water-salt balance of the blood. As we shall see, blood volume is intimately associated with the salt balance of the body. As you know, salts, such as NaCl, have the ability to cause osmosis, the diffusion of water-in this case, into the blood. The more salts there are in the blood, the greater the blood volume and the greater the blood pressure. In this way, the kidneys are involved in regulating blood pressure. The kidneys also maintain the appropriate level of other ions (electrolytes), such as potassium ions (K+), bicarbonate ions (HCO3 -), and calcium ions (Ca2+), in the blood.
The kidneys are paired organs located near the small of the back in the lumbar region on either side of the vertebral column. They lie in depressions against the deep muscles of the back beneath the peritoneum, where they receive some protection from the lower rib cage. Each kidney is usually held in place by connective tissue, called renal fascia. Masses of adipose tissue adhere to each kidney. A sharp blow to the back can dislodge a kidney, which is then called a floating kidney. The kidneys are bean-shaped and reddish-brown in color. The fist-sized organs are covered by a tough capsule of fibrous connective tissue, called a renal capsule. The concave side of a kidney has a depression called the hilum where a renal artery enters and a renal vein and a ureter exit the kidney.

The ureters, which extend from the kidneys to the bladder, are small, muscular tubes about 25 cm long and 5 mm in diameter. Each descends behind the parietal peritoneum, from the hilum of a kidney, to enter the bladder posteriorly at its inferior surface. The wall of a ureter has three layers. The inner layer is a mucosa (mucous membrane), the middle layer consists of smooth muscle, and the outer layer is a fibrous coat of connective tissue. Peristaltic contractions cause urine to enter the bladder even if a person is lying down. Urine enters the bladder in spurts that occur at the rate of one to five per minute.

Urinary Bladder
The urinary bladder is located in the pelvic cavity, below the parietal peritoneum and just posterior to the pubic symphysis. In males, it is directly anterior to the rectum; in females, it is anterior to the vagina and inferior to the uterus. Its function is to store urine until it is expelled from the body. The bladder has three openings-two for the ureters and one for the urethra, which drains the bladder. The trigone is a smooth triangular area at the base of the bladder outlined by these three openings (Fig. 16.2). Collectively, the muscle layers of the bladder wall are called the detrusor muscle. The wall contains a middle layer of circular fiber and two layers of longitudinal muscle, and it can expand. The transitional epithelium of the mucosa becomes thinner, and folds in the mucosa called rugae disappear as the bladder enlarges. The bladder has other features that allow it to retain urine. After urine enters the bladder from a ureter, small folds of bladder mucosa act like a valve to prevent backward flow. Two sphincters in close proximity are found where the urethra exits the bladder. The internal sphincter occurs around the opening to the urethra. Inferior to the internal sphincter, the external sphincter is composed of skeletal muscle that can be voluntarily controlled.

The urethra is a small tube that extends from the urinary bladder to an external opening. The urethra is a different length in females than in males. In females, the urethra is only about 4 cm long. The short length of the female urethra makes bacterial invasion easier and helps explain why females are more prone to urinary tract infections than males. In males, the urethra averages 20 cm when the penis is flaccid (limp, nonerect). As the urethra leaves the male urinary bladder, it is encircled by the prostate gland. In older men, enlargement of the prostate gland can restrict urination. A surgical procedure can usually correct the condition and restore a normal flow of urine. In females, the reproductive and urinary systems are not connected. In males, the urethra carries urine during urination and sperm during ejaculation. This double function of the urethra in males does not alter the path of urine.

When the urinary bladder fills to about 250 ml with urine, stretch receptors send sensory nerve impulses to the spinal cord. Subsequently, motor nerve impulses from the spinal cord cause the urinary bladder to contract and the sphincters to relax so that urination, also called micturition, is possible (Fig. 16.2). In older children and adults, the brain controls this reflex, delaying urination until a suitable time.
Maintenance of Acid-Base Balance
The kidneys regulate the acid-base balance of the blood. In order for a person to remain healthy, the blood pH should be just about 7.4. The kidneys monitor and control blood pH, mainly by excreting hydrogen ions (H+) and reabsorbing the bicarbonate ions (HCO3-) as needed to keep blood pH at about 7.4. Urine usually has a pH of 6 or lower because our diet often contains acidic foods.

Secretion of Hormones
The kidneys assist the endocrine system in hormone secretion. The kidneys release renin, a substance that leads to the secretion of the hormone aldosterone from the adrenal cortex, the outer portion of the adrenal glands, which lie atop the kidneys. Aldosterone promotes the reabsorption of sodium ions (Na+) by the kidneys. Whenever the oxygen-carrying capacity of the blood is reduced, the kidneys secrete the hormone erythropoietin, which stimulates red blood cell production. The kidneys also help activate vitamin D from the skin. Vitamin D is the precursor of the hormone calcitriol, which promotes calcium (Ca2+) absorption from the digestive tract.

Organs of the Urinary System
The urinary system consists of the kidneys, ureters, urinary bladder, and urethra. Figure 16.1 shows these organs and also traces the path of urine.
urinary system
Figure 16.1 The urinary system. Urine is found only within the kidneys, the ureters, the urinary bladder, and the urethra.
Figure 16.2 Urination. As the bladder fills with urine, sensory impulses go to the spinal cord and then to the brain. The brain can override the urge to urinate. When urination occurs, motor nerve impulses cause the bladder to contract and an internal sphincter to open. Nerve impulses also cause an external sphincter to open.
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