Digestive and Urinary Systems

Digestive System: So there you are, sitting at lunch, enjoying some grilled chicken pizza and a few orange wedges. When you're finished, you take a last drink of milk, wipe your mouth, and head to your next class. In a few minutes you're thinking about the capital of Oregon or your science fair project. You've completely forgotten about that pizza lunch you just ate. But it's still in your stomach — sort of like a science experiment that happens all the time! The Mouth Starts Everything Moving Your digestive system started working even before you took the first bite of your pizza. And the digestive system will be busy at work on your chewed-up lunch for the next few hours — or sometimes days, depending upon what you've eaten. This process, called digestion, allows your body to get the nutrients and energy it needs from the food you eat. So let's find out what's happening to that pizza, orange, and milk. Even before you eat, when you smell a tasty food, see it, or think about it, digestion begins. Saliva, or spit, begins to form in your mouth. When you do eat, the saliva breaks down the chemicals in the food a bit, which helps make the food mushy and easy to swallow. Your tongue helps out, pushing the food around while you chew with your teeth. When you're ready to swallow, the tongue pushes a tiny bit of mushed-up food called a bolus toward the back of your throat and into the opening of your esophagus, the second part of the digestive tract. On the Way Down The esophagus is like a stretchy pipe that's about 10 inches long. It moves food from the back of your throat to your stomach. But also at the back of your throat is your windpipe, which allows air to come in and out of your body. When you swallow a small ball of mushed-up food or liquids, a special flap called the epiglottis flops down over the opening of your windpipe to make sure the food enters the esophagus and not the windpipe. If you've ever drunk something too fast, started to cough, and heard someone say that your drink "went down the wrong way," the person meant that it went down your windpipe by mistake. This happens when the epiglottis doesn't have enough time to flop down, and you cough involuntarily to clear your windpipe. Once food has entered the esophagus, it doesn't just drop right into your stomach. Instead, muscles in the walls of the esophagus move in a wavy way to slowly squeeze the food through the esophagus. This takes about 2 or 3 seconds. See You in the Stomach Your stomach, which is attached to the end of the esophagus, is a stretchy sack shaped like the letter J. It has three important jobs: to store the food you've eaten to break down the food into a liquidy mixture to slowly empty that liquidy mixture into the small intestine The stomach is like a mixer, churning and mashing together all the small balls of food that came down the esophagus into smaller and smaller pieces. It does this with help from the strong muscles in the walls of the stomach and gastric juices that also come from the stomach's walls. In addition to breaking down food, gastric juices also help kill bacteria that might be in the eaten food. Onward to the small intestine! The small intestine is a long tube that's about 1½ inches to 2 inches around, and it's packed inside you beneath your stomach. If you stretched out an adult's small intestine, it would be about 22 feet long — that's like 22 notebooks lined up end to end, all in a row! The small intestine breaks down the food mixture even more so your body can absorb all the vitamins, minerals, proteins, carbohydrates, and fats. The chicken on your pizza is full of proteins — and a little fat — and the small intestine can help extract them with a little help from three friends: the pancreas, liver, and gallbladder. Those organs send different juices to the first part of the small intestine. These juices help to digest food and allow the body to absorb nutrients. The pancreas makes juices that help the body digest fats and protein. A juice from the liver called bile helps to absorb fats into the bloodstream. And the gallbladder serves as a warehouse for bile, storing it until the body needs it. Your food may spend as long as 4 hours in the small intestine and will become a very thin, watery mixture. It's time well spent because, at the end of the journey, the nutrients from your pizza, orange, and milk can pass from the intestine into the blood. Once in the blood, your body is closer to benefiting from the complex carbohydrates in the pizza crust, the vitamin C in your orange, the protein in the chicken, and the calcium in your milk. Next stop for these nutrients: the liver! And the leftover waste — remnants of the food that your body can't use — goes on to the large intestine. Love Your Liver The nutrient-rich blood comes directly to the liver for processing. The liver filters out harmful substances or wastes, turning some of the waste into more bile. The liver even helps figure out how many nutrients will go to the rest of the body, and how many will stay behind in storage. For example, the liver stores certain vitamins and a type of sugar your body uses for energ That's One Large Intestine At 3 or 4 inches around, the large intestine is fatter than the small intestine and it's almost the last stop on the digestive tract. Like the small intestine, it is packed into the body, and would measure 5 feet long if you spread it out. The large intestine has a tiny tube with a closed end coming off it called the appendix. It's part of the digestive tract, but it doesn't seem to do anything, though it can cause big problems because it sometimes gets infected and needs to be removed. Like we mentioned, after most of the nutrients are removed from the food mixture there is waste left over — stuff your body can't use. This stuff needs to be passed out of the body. Can you guess where it ends up? Well, here's a hint: It goes out with a flush. Before it goes, it passes through the part of the large intestine called the colon, which is where the body gets its last chance to absorb the water and some minerals into the blood. As the water leaves the waste product, what's left gets harder and harder as it keeps moving along, until it becomes a solid. Yep, it's poop (also called stool or a bowel movement). The large intestine pushes the poop into the rectum, the very last stop on the digestive tract. The solid waste stays here until you are ready to go to the bathroom. When you go to the bathroom, you are getting rid of this solid waste by pushing it through the anus (say: ay-nus). There's the flush we were talking about! Dig That Digestive System You can help your digestive system by drinking water and eating a healthy diet that includes foods rich in fiber. High-fiber foods, like fruits, vegetables, and whole grains, make it easier for poop to pass through your system. The digestive system is a pretty important part of your body. Without it, you couldn't get the nutrients you need to grow properly and stay healthy. And next time you sit down to lunch, you'll know where your food goes — from start to finish! Urinary System:

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The organs, tubes, muscles, and nerves that work together to create, store, and carry urine are the urinary system. The urinary system includes two kidneys, two ureters, the bladder, two sphincter muscles, and the urethra.

How does the urinary system work? Your body takes nutrients from food and uses them to maintain all bodily functions including energy and self-repair. After your body has taken what it needs from the food, waste products are left behind in the blood and in the bowel. The urinary system works with the lungs, skin, and intestines—all of which also excrete wastes—to keep the chemicals and water in your body balanced. Adults eliminate about a quart and a half of urine each day. The amount depends on many factors, especially the amounts of fluid and food a person consumes and how much fluid is lost through sweat and breathing. Certain types of medications can also affect the amount of urine eliminated. The urinary system removes a type of waste called urea from your blood. Urea is produced when foods containing protein, such as meat, poultry, and certain vegetables, are broken down in the body. Urea is carried in the bloodstream to the kidneys. The kidneys are bean-shaped organs about the size of your fists. They are near the middle of the back, just below the rib cage. The kidneys remove urea from the blood through tiny filtering units called nephrons. Each nephron consists of a ball formed of small blood capillaries, called a glomerulus, and a small tube called a renal tubule. Urea, together with water and other waste substances, forms the urine as it passes through the nephrons and down the renal tubules of the kidney. From the kidneys, urine travels down two thin tubes called ureters to the bladder. The ureters are about 8 to 10 inches long. Muscles in the ureter walls constantly tighten and relax to force urine downward away from the kidneys. If urine is allowed to stand still, or back up, a kidney infection can develop. Small amounts of urine are emptied into the bladder from the ureters about every 10 to 15 seconds. The bladder is a hollow muscular organ shaped like a balloon. It sits in your pelvis and is held in place by ligaments attached to other organs and the pelvic bones. The bladder stores urine until you are ready to go to the bathroom to empty it. It swells into a round shape when it is full and gets smaller when empty. If the urinary system is healthy, the bladder can hold up to 16 ounces (2 cups) of urine comfortably for 2 to 5 hours. Circular muscles called sphincters help keep urine from leaking. The sphincter muscles close tightly like a rubber band around the opening of the bladder into the urethra, the tube that allows urine to pass outside the body. Nerves in the bladder tell you when it is time to urinate, or empty your bladder. As the bladder first fills with urine, you may notice a feeling that you need to urinate. The sensation to urinate becomes stronger as the bladder continues to fill and reaches its limit. At that point, nerves from the bladder send a message to the brain that the bladder is full, and your urge to empty your bladder intensifies. When you urinate, the brain signals the bladder muscles to tighten, squeezing urine out of the bladder. At the same time, the brain signals the sphincter muscles to relax. As these muscles relax, urine exits the bladder through the urethra. When all the signals occur in the correct order, normal urination occurs. What causes problems in the urinary system? Problems in the urinary system can be caused by aging, illness, or injury. As you get older, changes in the kidneys’ structure cause them to lose some of their ability to remove wastes from the blood. Also, the muscles in your ureters, bladder, and urethra tend to lose some of their strength. You may have more urinary infections because the bladder muscles do not tighten enough to empty your bladder completely. A decrease in strength of muscles of the sphincters and the pelvis can also cause incontinence, the unwanted leakage of urine. Illness or injury can also prevent the kidneys from filtering the blood completely or block the passage of urine. How are problems in the urinary system detected? Urinalysis is a test that studies the content of urine for abnormal substances such as protein or signs of infection. This test involves urinating into a special container and leaving the sample to be studied. Urodynamic tests evaluate the storage of urine in the bladder and the flow of urine from the bladder through the urethra. Your doctor may want to do a urodynamic test if you are having symptoms that suggest problems with the muscles or nerves of your lower urinary system and pelvis—ureters, bladder, urethra, and sphincter muscles. Urodynamic tests measure the contraction of the bladder muscle as it fills and empties. The test is done by inserting a small tube called a catheter through your urethra into your bladder to fill it either with water or a gas. Another small tube is inserted into your rectum or vagina to measure the pressure put on your bladder when you strain or cough. Other bladder tests use x-ray dye instead of water so that x-ray pictures can be taken when the bladder fills and empties to detect any abnormalities in the shape and function of the bladder. These tests take about an hour. What are some disorders of the urinary system? Disorders of the urinary system range in severity from easy to treat to life threatening. Benign prostatic hyperplasia (BPH) is a condition in men that affects the prostate gland, which is part of the male reproductive system. The prostate is located at the bottom of the bladder and surrounds the urethra. BPH is an enlargement of the prostate gland that can interfere with urinary function in older men. It causes blockage by squeezing the urethra, which can make it difficult to urinate. Men with BPH frequently have other bladder symptoms including an increase in frequency of bladder emptying both during the day and at night. Most men over age 60 have some BPH, but not all have problems with blockage. There are many different treatment options for BPH. Painful bladder syndrome/Interstitial cystitis (PBS/IC) is a chronic bladder disorder also known as frequency-urgency-dysuria syndrome. In this disorder, the bladder wall can become inflamed and irritated. The inflammation can lead to scarring and stiffening of the bladder, decreased bladder capacity, pinpoint bleeding, and, in rare cases, ulcers in the bladder lining. The cause of IC is unknown at this time. Kidney stones is the term commonly used to refer to stones, or calculi, in the urinary system. Stones form in the kidneys and may be found anywhere in the urinary system. They vary in size. Some stones cause great pain while others cause very little. The aim of treatment is to remove the stones, prevent infection, and prevent recurrence. Both nonsurgical and surgical treatments are used. Kidney stones affect men more often than women. Prostatitis is inflammation of the prostate gland that results in urinary frequency and urgency, burning or painful urination, a condition called dysuria, and pain in the lower back and genital area, among other symptoms. In some cases, prostatitis is caused by bacterial infection and can be treated with antibiotics. But the more common forms of prostatitis are not associated with any known infecting organism. Antibiotics are often ineffective in treating the nonbacterial forms of prostatitis. Proteinuria is the presence of abnormal amounts of protein in the urine. Healthy kidneys take wastes out of the blood but leave in protein. Protein in the urine does not cause a problem by itself. But it may be a sign that your kidneys are not working properly. Renal (kidney) failure results when the kidneys are not able to regulate water and chemicals in the body or remove waste products from your blood. Acute renal failure (ARF) is the sudden onset of kidney failure. This condition can be caused by an accident that injures the kidneys, loss of a lot of blood, or some drugs or poisons. ARF may lead to permanent loss of kidney function. But if the kidneys are not seriously damaged, they may recover. Chronic kidney disease (CKD) is the gradual reduction of kidney function that may lead to permanent kidney failure, or end-stage renal disease (ESRD). You may go several years without knowing you have CKD. Urinary tract infections (UTIs) are caused by bacteria in the urinary tract. Women get UTIs more often than men. UTIs are treated with antibiotics. Drinking lots of fluids also helps by flushing out the bacteria. The name of the UTI depends on its location in the urinary tract. An infection in the bladder is called cystitis. If the infection is in one or both of the kidneys, the infection is called pyelonephritis. This type of UTI can cause serious damage to the kidneys if it is not adequately treated. Urinary incontinence, loss of bladder control, is the involuntary passage of urine. There are many causes and types of incontinence, and many treatment options. Treatments range from simple exercises to surgery. Women are affected by urinary incontinence more often than men. Urinary retention, or bladder-emptying problems, is a common urological problem with many possible causes. Normally, urination can be initiated voluntarily and the bladder empties completely. Urinary retention is the abnormal holding of urine in the bladder. Acute urinary retention is the sudden inability to urinate, causing pain and discomfort. Causes can include an obstruction in the urinary system, stress, or neurologic problems. Chronic urinary retention refers to the persistent presence of urine left in the bladder after incomplete emptying. Common causes of chronic urinary retention are bladder muscle failure, nerve damage, or obstructions in the urinary tract. Treatment for urinary retention depends on the cause. Who can help me with a urinary problem? Your primary doctor can help you with some urinary problems. Your pediatrician may be able to treat some of your child’s urinary problems. But some problems may require the attention of a urologist, a doctor who specializes in treating problems of the urinary system and the male reproductive system. A gynecologist is a doctor who specializes in the female reproductive system and may be able to help with some urinary problems. A urogynecologist is a gynecologist who specializes in the female urinary system. A nephrologist specializes in treating diseases of the kidney. Points to Remember Your urinary system filters waste and extra fluid from your blood. Problems in the urinary system include kidney failure, urinary tract infections, kidney stones, prostate enlargement, and bladder control problems. Health professionals who treat urinary problems include general practitioners (your primary doctor), pediatricians, urologists, gynecologists, urogynecologists, and nephrologists.

The principal function of the urinary system is to maintain the volume and composition of body fluids within normal limits. One aspect of this function is to rid the body of waste products that accumulate as a result of cellular metabolism. Other aspects of its function include regulating the concentrations of various electrolytes in the body fluids and maintaining normal pH of the blood. In addition to maintaining fluid homeostasis in the body, the urinary system controls red blood cell production by secreting the hormone erythropoietin. The urinary system also plays a role in maintaining normal blood pressure by secreting the enzyme renin. The urinary system consists of the kidneys, ureters, urinary bladder, and urethra. The kidneys form the urine and account for the other functions attributed to the urinary system. The ureters carry the urine away from kidneys to the urinary bladder, which is a temporary reservoir for the urine. The urethra is a tubular structure that carries the urine from the urinary bladder to the outside. Kidneys The kidneys are the primary organs of the urinary system. The kidneys are the organs that filter the blood, remove the wastes, and excrete the wastes in the urine. They are the organs that perform the functions of the urinary system. The other components are accessory structures to eliminate the urine from the body. The paired kidneys are located between the twelfth thoracic and third lumbar vertebrae, one on each side of the vertebral column. The right kidney usually is slightly lower than the left because the liver displaces it downward. The kidneys protected by the lower ribs, lie in shallow depressions against the posterior abdominal wall and behind the parietal peritoneum. This means they are retroperitoneal. Each kidney is held in place by connective tissue, called renal fascia, and is surrounded by a thick layer of adipose tissue, called perirenal fat, which helps to protect it. A tough, fibrous, connective tissue renal capsule closely envelopes each kidney and provides support for the soft tissue that is inside. In the adult, each kidney is approximately 3 cm thick, 6 cm wide, and 12 cm long. It is roughly bean-shaped with an indentation, called the hilum, on the medial side. The hilum leads to a large cavity, called the renal sinus, within the kidney. The ureter and renal vein leave the kidney, and the renal artery enters the kidney at the hilum. The outer, reddish region, next to the capsule, is the renal cortex. This surrounds a darker reddish-brown region called the renal medulla. The renal medulla consists of a series of renal pyramids, which appear striated because they contain straight tubular structures and blood vessels. The wide bases of the pyramids are adjacent to the cortex and the pointed ends, called renal papillae, are directed toward the center of the kidney. Portions of the renal cortex extend into the spaces between adjacent pyramids to form renal columns. The cortex and medulla make up the parenchyma, or functional tissue, of the kidney. The central region of the kidney contains the renal pelvis, which is located in the renal sinus and is continuous with the ureter. The renal pelvis is a large cavity that collects the urine as it is produced. The periphery of the renal pelvis is interrupted by cuplike projections called calyces. A minor calyx surrounds the renal papillae of each pyramid and collects urine from that pyramid. Several minor calyces converge to form a major calyx. From the major calyces the urine flows into the renal pelvis and from there into the ureter. Each kidney contains over a million functional units, called nephrons, in the parenchyma (cortex and medulla). A nephron has two parts: a renal corpuscle and a renal tubule. The renal corpuscle consists of a cluster of capillaries, called the glomerulus, surrounded by a double-layered epithelial cup, called the glomerular capsule. An afferent arteriole leads into the renal corpuscle and an efferent arteriole leaves the renal corpuscle. Urine passes from the nephrons into collecting ducts then into the minor calyces. The juxtaglomerular apparatus, which monitors blood pressure and secretes renin, is formed from modified cells in the afferent arteriole and the ascending limb of the nephron loop. Ureter Each ureter is a small tube, about 25 cm long, that carries urine from the renal pelvis to the urinary bladder. It descends from the renal pelvis, along the posterior abdominal wall, behind the parietal peritoneum, and enters the urinary bladder on the posterior inferior surface. The wall of the ureter consists of three layers. The outer layer, the fibrous coat, is a supporting layer of fibrous connective tissue. The middle layer, the muscular coat, consists of inner circular and outer longitudinal smooth muscle. The main function of this layer is peristalsis to propel the urine. The inner layer, the mucosa, is transitional epithelium that is continuous with the lining of the renal pelvis and the urinary bladder. This layer secretes mucus which coats and protects the surface of the cells. Urinary Bladder The urinary bladder is a temporary storage reservoir for urine. It is located in the pelvic cavity, posterior to the symphysis pubis, and below the parietal peritoneum. The size and shape of the urinary bladder varies with the amount of urine it contains and with pressure it receives from surrounding organs. The inner lining of the urinary bladder is a mucous membrane of transitional epithelium that is continuous with that in the ureters. When the bladder is empty, the mucosa has numerous folds called rugae. The rugae and transitional epithelium allow the bladder to expand as it fills. The second layer in the walls is the submucosa that supports the mucous membrane. It is composed of connective tissue with elastic fibers. The next layer is the muscularis, which is composed of smooth muscle. The smooth muscle fibers are interwoven in all directions and collectively these are called the detrusor muscle. Contraction of this muscle expels urine from the bladder. On the superior surface, the outer layer of the bladder wall is parietal peritoneum. In all other regions, the outer layer is fibrous connective tissue. There is a triangular area, called the trigone, formed by three openings in the floor of the urinary bladder. Two of the openings are from the ureters and form the base of the trigone. Small flaps of mucosa cover these openings and act as valves that allow urine to enter the bladder but prevent it from backing up from the bladder into the ureters. The third opening, at the apex of the trigone, is the opening into the urethra. A band of the detrusor muscle encircles this opening to form the internal urethral sphincter. Urethra The final passageway for the flow of urine is the urethra, a thin-walled tube that conveys urine from the floor of the urinary bladder to the outside. The opening to the outside is the external urethral orifice. The mucosal lining of the urethra is transitional epithelium. The wall also contains smooth muscle fibers and is supported by connective tissue. The internal urethral sphincter surrounds the beginning of the urethra, where it leaves the urinary bladder. This sphincter is smooth (involuntary) muscle. Another sphincter, the external urethral sphincter, is skeletal (voluntary) muscle and encircles the urethra where it goes through the pelvic floor. These two sphincters control the flow of urine through the urethra. In females, the urethra is short, only 3 to 4 cm long. The external urethral orifice opens to the outside just anterior to the opening for the vagina. In males, the urethra is much longer, about 20 cm in length, and transports both urine and semen. The first part, next to the urinary bladder, passes through the prostate gland and is called the prostatic urethra. The second part, a short region that penetrates the pelvic floor and enters the penis, is called the membranous urethra. The third part, the spongy urethra, is the longest region. This portion of the urethra extends the entire length of the penis, and the external urethral orifice opens to the outside at the tip of the penis.