Renal medulla
Renal medulla 
1: Parenchyma
2: Cortex
3: Medulla
4: Perirenal fat
5: Capsule
6: Ureter 7: Pelvis of kidney
8: Renal artery and Renal vein
9: Hilus
10: Calyx
Vertical section of kidney. (Label "medullary sub." visible near top.)
Details Latin Medulla renalis System Urinary system Identifiers Gray's p.1221 MeSH A05.810.453.466 TA A08.1.01.020 FMA 74268 Anatomical terminology
The renal medulla is the innermost part of the kidney. The renal medulla is split up into a number of sections, known as the renal pyramids. Blood enters into the kidney via the renal artery, which then splits up to form the interlobular arteries. The interlobular arteries each in turn branch into arcuate arteries, which finally reach the glomeruli. At the glomerulus the blood reaches a highly disfavourable pressure gradient and a large exchange surface area, which forces the serum portion of the blood out of the vessel and into the renal tubules. Flow continues through the renal tubules, including the proximal tubule, the Loop of Henle, through the distal tubule and finally leaves the kidney by means of the collecting duct, leading to the renal ureter.
The renal medulla (Latin renes medulla = kidney middle) contains the structures of the nephrons responsible for maintaining the salt and water balance of the blood. These structures include the vasa rectae (both spuria and vera), the venulae rectae, the medullary capillary plexus, the loop of Henle, and the collecting tubule.[1] The renal medulla is hypertonic to the filtrate in the nephron and aids in the reabsorption of water.
Blood is filtered in the glomerulus by solute size. Ions such as sodium, chloride, potassium, and calcium are easily filtered, as is glucose. Proteins are not passed through the glomerular filter because of their large size, and do not appear in the filtrate or urine unless a disease process has affected the glomerular capsule or the proximal and distule tubules of the nephron.
| Renal medulla | ||||
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Vertical section of kidney. (Label "medullary sub." visible near top.)
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| Details | ||||
| Latin | Medulla renalis | |||
| System | Urinary system | |||
| Identifiers | ||||
| Gray's | p.1221 | |||
| MeSH | A05.810.453.466 | |||
| TA | A08.1.01.020 | |||
| FMA | 74268 | |||
| Anatomical terminology | ||||
The renal medulla is the innermost part of the kidney. The renal medulla is split up into a number of sections, known as the renal pyramids. Blood enters into the kidney via the renal artery, which then splits up to form the interlobular arteries. The interlobular arteries each in turn branch into arcuate arteries, which finally reach the glomeruli. At the glomerulus the blood reaches a highly disfavourable pressure gradient and a large exchange surface area, which forces the serum portion of the blood out of the vessel and into the renal tubules. Flow continues through the renal tubules, including the proximal tubule, the Loop of Henle, through the distal tubule and finally leaves the kidney by means of the collecting duct, leading to the renal ureter.
The renal medulla (Latin renes medulla = kidney middle) contains the structures of the nephrons responsible for maintaining the salt and water balance of the blood. These structures include the vasa rectae (both spuria and vera), the venulae rectae, the medullary capillary plexus, the loop of Henle, and the collecting tubule.[1] The renal medulla is hypertonic to the filtrate in the nephron and aids in the reabsorption of water.
Blood is filtered in the glomerulus by solute size. Ions such as sodium, chloride, potassium, and calcium are easily filtered, as is glucose. Proteins are not passed through the glomerular filter because of their large size, and do not appear in the filtrate or urine unless a disease process has affected the glomerular capsule or the proximal and distule tubules of the nephron.
Additional Images
Urinary system
| Urinary System | |
|---|---|
1. Human urinary system: 2. Kidney, 3. Renal pelvis, 4.Ureter, 5. Urinary bladder, 6. Urethra. (Left side withfrontal section)
7. Adrenal gland Vessels: 8. Renal artery and vein, 9. Inferior vena cava, 10. Abdominal aorta, 11. Common iliac artery and vein With transparency: 12. Liver, 13. Large intestine, 14.Pelvis The order of impurities being excreted from the kidneys: Kidneys → Ureters → Urinary Bladder →Urethra | |
| Details | |
| Latin | Systema urinarium |
| Identifiers | |
| TA | A08.0.00.000 |
| FMA | 7159 |
| Anatomical terminology | |
The urinary system, also known as the renal system, consists of thekidneys, ureters, bladder, and the urethra. Each kidney consists of millions of functional units called nephrons. The purpose of the renal system is to eliminate wastes from the body, regulate blood volume and blood pressure, control levels of electrolytes and metabolites, and regulate blood pH. The kidneys have extensive blood supply via the renal arteries which leave the kidneys via the renal vein. Following filtration of blood and further processing, wastes (in the form of urine) exit the kidney via the ureters, tubes made of smooth muscle fibers that propel urine towards the urinary bladder, where it is stored and subsequently expelled from the body by urination (voiding). The female and male urinary system are very similar, differing only in the length of the urethra.
Urine is formed in the kidneys through a filtration of blood. The urine is then passed through the ureters to the bladder, where it is stored. During urination, the urine is passed from the bladder through the urethra to the outside of the body.
800-2000 milliliters (mL) of urine are normally produced every day in a healthy human. This amount varies according to fluid intake and kidney function.
Structure
The urinary system refers to the structures that produce and conduct urine to the point of excretion. The human body normally has two paired kidneys, one on the left and one on the right. Urine is formed by nephrons, the functional unit of the kidney, and then flows through a system of converging tubules called collecting ducts. The collecting ducts join together to form minor calyces, then major calyces, which ultimately join the pelvis of the kidney (renal pelvis). Urine flows from the renal pelvis into the ureter, a tube-like structure that carries the urine from the kidneys into the bladder.
During urination, urine stored in the bladder is discharged through the urethra. In males, the urethra begins at the internal urethral orifice in the trigone of the bladder, continues through the external urethral orifice, and then becomes the prostatic, membranous, bulbar, and penile urethra. Urine exits through the external urethral meatus. The female urethra is much shorter, beginning at the bladder neck and terminating in the vaginal vestibule.
Development
Main article: Development of the urinary system
Histology
See also: Urothelium
Under microscopy, the urinary system is covered in a unique lining called urothelium, a type of transitional epithelium. Unlike the epithelial lining of most organs, transitional epithelium can flatten and distend. Urothelium covers most of the urinary system, including the renal pelvis and ureters.
Function
There are several functions of the Urinary System:
- Removal of waste product from the body (mainly urea and uric acid)
- Regulation of electrolyte balance (e.g. sodium, potassium and calcium)
- Regulation of acid-base homeostasis
- Controlling blood volume and maintaining blood pressure
Urine formation
Average urine production in adult humans is about 1-2 litres (L) per day, depending on state of hydration, activity level, environmental factors, weight, and the individual's health. Producing too much or too little urine requires medical attention.Polyuria is a condition of excessive urine production (> 2.5 L/day). Oliguria when < 400 mL (millilitres) are produced, and anuria one of < 100 mL per day.
The first step in urine formation is the filtration of blood in the kidneys. In a healthy human the kidney receives between 12 and 30% of cardiac output, but it averages about 20% or about 1.25 L/min.
The basic structural and functional unit of the kidney is the nephron. Its chief function is to regulate the concentration of water and soluble substances likesodium by filtering the blood, reabsorbing what is needed and excreting the rest asurine.
In the first part of the nephron, Bowman's capsule filters blood from the circulatory system into the tubules. Hydrostatic and osmotic pressure gradients facilitate filtration across a semipermeable membrane. The filtrate includes water, small molecules, and ions that easily pass through the filtration membrane. However larger molecules such as proteins and blood cells are prevented from passing through the filtration membrane. The amount of filtrate produced every minute is called the glomerular filtration rate or GFR and amounts to 180 litres per day. About 99% of this filtrate is reabsorbed as it passes through the nephron and the remaining 1% becomes urine.
The urinary system is regulated by the endocrine system by hormones such as antidiuretic hormone, aldosterone, andparathyroid hormone.
Regulation of concentration and volume
The urinary system is under influence of circulatory system, nervous system and endocrine system.
Aldosterone plays a central role regulating blood pressure through its effects on the kidney. It acts on the distal tubules and collecting ducts of the nephron and increases reabsorption of sodium from the glomerular filtrate. Reabsorption of sodium results in retention of water, which increases blood pressure and blood volume. Antidiuretic hormone (ADH), is aneurohypophysial hormone found in most mammals. Its two primary functions are to retain water in the body and to constrict blood vessels. Vasopressin regulates the body's retention of water by increasing water reabsorption in the collecting ducts of the kidney nephron. Vasopressin increases water permeability of the kidney's collecting duct and distal convoluted tubule by inducing translocation of aquaporin-CD water channels in the kidney nephron collecting duct plasma membrane.
Urination
Main article: Urination
Urination is the ejection of urine from the urinary bladder through the urethra to the outside of the body. In healthy humans (and many other animals), the process of urination is under voluntary control. In infants, some elderly individuals, and those with neurological injury, urination may occur as an involuntary reflex. Physiologically, micturition involves coordination between the central, autonomic, and somatic nervous systems. Brain centers that regulate urination include the pontine micturition center, periaqueductal gray, and the cerebral cortex. In males, urine is ejected through the penis, and in female placental mammals through the vulva.
Clinical significance
Main article: Urologic disease
Urologic disease can involve congenital or acquired dysfunction of the urinary system.
Diseases of the kidney tissue are normally treated by nephrologists, while disease of the urinary tract are treated byurologists. Gynecologists may also treat female urinary incontinence.
Diseases of other bodily systems also have a direct effect on urogenital function. For instance it has been shown thatprotein released by the kidneys in diabetes mellitus sensitises the kidney to the damaging effects of hypertension.
Diabetes also can have a direct effect in urination due to peripheral neuropathies which occur in some individuals with poorly controlled diabetes.
Urinary incontinence can result from a weakening of the pelvic floor muscles caused by factors such as pregnancy,childbirth, aging and being overweight. Pelvic floor exercises known as Kegel exercises can help in this condition by strengthening the pelvic floor. There can also be underlying medical reasons for urinary incontinence which are often treatable. In children the condition is called enuresis.
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