UNIVERSITY OF HEALTH AND ALLIED SCIENCES

SCHOOL OF ALLIED HEALTH SCIENCES

COURSE TITLE: ANATOMY AND PHYSIOLOGY II

COURSE CODE: SBBS 221

INDEX NUMBER: UHAS202332820

 ANATOMY OF THE URINARY SYSTEM

The urinary system's function is to filter blood and create urine as a waste by-product. The
organs of the urinary system include the kidneys, renal pelvis, ureters, bladder and urethra.

The body takes nutrients from food and converts them to energy. After the body has taken the
food components that it needs, waste products are left behind in the bowel and in the blood.

The kidney and urinary systems help the body to eliminate liquid waste called urea, and to keep
chemicals, such as potassium and sodium, and water in balance. 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, where it is removed along with water and other
wastes in the form of urine.
 Two ureters: The ureters are thin bilateral tubes with a diameter of 3-4mm. These
narrow tubes carry urine from the kidneys to the bladder. Muscles in the ureter walls
continually tighten and relax forcing urine downward, away from the kidneys. If urine
backs up, or is allowed to stand still, a kidney infection can develop. About every 10 to
15 seconds, small amounts of urine are emptied into the bladder from the ureters.
 Bladder. This triangle-shaped, hollow organ is located in the lower abdomen. It is held
in place by ligaments that are attached to other organs and the pelvic bones. The bladder's
walls relax and expand to store urine, and contract and flatten to empty urine through the
urethra. The typical healthy adult bladder can store up to two cups of urine for two to five
hours.

Upon examination, specific "landmarks" are used to describe the location of any
irregularities in the bladder. These are:
 o Trigone: a triangle-shaped region near the junction of the urethra and the
bladder
o Right and left lateral walls: walls on either side of the trigone
o Posterior wall: back wall
o Dome: roof of the bladder

 Two sphincter muscles. These circular muscles help keep urine from leaking by
closing tightly like a rubber band around the opening of the bladder.
 Nerves in the bladder. The nerves alert a person when it is time to urinate, or empty
the bladder.
 Urethra. This tube allows urine to pass outside the body. The brain signals the bladder
muscles to tighten, which squeezes urine out of the bladder. At the same time, the brain
signals the sphincter muscles to relax to let urine exit the bladder through the urethra.
When all the signals occur in the correct order, normal urination occurs.
Facts about urine

 Normal, healthy urine is a pale straw or transparent yellow color.

 Darker yellow or honey colored urine means you need more water.
 A darker, brownish color may indicate a liver problem or severe dehydration.
 Pinkish or red urine may mean blood in the urine.

QUESTION 2

Micturition (Urinary) Reflex

Micturition, also known as urination, is the process of expelling urine from the bladder. The
purpose of urination is to eliminate metabolic products and toxic wastes from the body that
have been filtered from the blood by the kidneys. It is a complex mechanism that involves
coordination by the sympathetic, parasympathetic and somatic nervous systems, and it is the
higher centers within the brain that allow for urination to occur at the right time. Normal
muscle tone, absence of physical obstructions and psychological inhibition are other
important factors that play a role in this process . The urinary tract comprises of two mutually
dependent components: the upper tract, which contains the kidneys and ureters, and the
lower tract consisting of the bladder and urethra. The lower tract is involved in the
micturition reflex. The bladder is a hollow organ that functions as reservoir for the storage
and periodic elimination of urine. The bladder’s walls are made up of three layers of smooth
muscle, known as the detrusor. At the bottom of the bladder is an outlet into the urethra
known as the bladder neck, which is surrounded by a ring of smooth muscle known as the
internal urethral sphincter and is involuntarily controlled. The urethra, the passage in which
urine is excreted out of the body. The pelvic floor musculature encircles the urethra creating
the external urethral sphincter, which operates under conscious control. During storage, both
the internal and external sphincters are contracted to prevent leakage. Normally, the detrusor
muscle is relaxed, which allows the bladder to expand as it fills with urine. When the
bladder is full, the detrusor contracts to expel urine out of the body through the urethra. A
normal healthy adult bladder can hold anywhere from 300-500mL of urine for 2-5 hours.
Differences do exist between the male and female anatomy of the urinary tract;
however, these differences mostly concern the urethra. More specifically, the male
urethra passes through the prostate gland at the base of the bladder. The urethra then
passes through the penis, making it much longer than the female urethra. The female
urethra exits just anterior to the vaginal opening.

Mechanism
Micturition is a complex and highly distributed process, involving pathways at multiple
levels of the brain, spinal cord and PNS, in addition to being mediated by multiple
neurotransmitters. At the most basic level, the micturition reflex is triggered when the
bladder fills with urine. The detrusor muscle remains relaxed until the bladder fills to about
250 mL with urine. As the bladder fills, the detrusor muscle contracts, which increases the
pressure within the bladder, stimulating stretch receptors within the detrusor and exciting
parasympathetic fibres to relay this information to the sacral nerves of the spine. These
fibres help convey the bladder’s degree of fullness. Within the spine, this information is
integrated and the relayed to the brain via two different sets of neurons. The brain
determines the urgency and responds by sending command signals back to the bladder to
either hold on or void. If the response is to void, parasympathetic motor neurons cause
contraction of the detrusor muscle, which causes the intra-bladder pressure to increase. As a
result of the increased pressure, the internal sphincter opens by relaxing, thus allowing urine
to enter the bladder neck and flow into the urethra. Simultaneously, somatic motor neurons
inhibit the pudendal nerve which causes the external sphincter to also relax, allowing urine
to be expelled from the body. Typically, around 50mL remains in the bladder after a
voluntary void in a normal healthy adult.

QUESTION 3
Cystitis (sis-TIE-tis) is the medical term for inflammation of the bladder. Inflammation is when a
part of your body is swollen and hot. It can also be painful. Most of the time, cystitis happens
when there's an infection caused by bacteria. This is called a urinary tract infection (UTI).
Having a bladder infection can be painful and annoying. It can become a serious health problem
if the infection spreads to your kidneys. Cystitis also may occur as a reaction to certain drugs or
radiation therapy. Things that sometimes irritate the bladder, such as hygiene products,
spermicide jelly or long-term catheter use, can also lead to cystitis. Cystitis can also happen as a
complication of another illness. The usual treatment for cystitis caused by bacteria is to take
antibiotic medication. Treatment for other types of cystitis depends on the cause.

Symptoms
Cystitis signs and symptoms may include:
 A strong, persistent urge to urinate
 Pain or a burning feeling when urinating
 Passing frequent, small amounts of urine
 Blood in the urine (hematuria)
 Passing cloudy or strong-smelling urine
 Pelvic discomfort
 A feeling of pressure in the area below your belly button (abdomen)
 Low-grade fever

Symptoms of cystitis
1. A Strong, Persistent Urge to Urinate
This occurs due to inflammation of the bladder lining, which irritates nerve endings and creates a constant
sensation of needing to urinate. Even if the bladder is nearly empty, the irritation makes it feel full.
2. Pain or a Burning Feeling When Urinating (Dysuria)
Inflammation in the bladder and urethra makes the passage of urine painful. The acidic urine passing over
inflamed tissue causes a stinging or burning sensation. This is one of the most common symptoms of a
urinary tract infection (UTI).
3. Passing Frequent, Small Amounts of Urine
Due to irritation, the bladder cannot hold as much urine as usual. The inflamed bladder sends signals to
empty even when it is not full. This leads to frequent urination, often with only a small volume of urine.
4. Blood in the Urine (Hematuria)
The infection can damage tiny blood vessels in the bladder, causing bleeding. Blood may appear as pink,
red, or brownish discoloration in the urine. Sometimes, blood is only detected under a microscope
(microscopic hematuria).
5. Passing Cloudy or Strong-Smelling Urine
Bacterial infection produces waste products and pus, making urine cloudy. Some bacteria, like Proteus
mirabilis, release ammonia, giving urine a strong, foul odor. The smell can also come from white blood
cells fighting the infection.
6. Pelvic Discomfort
The bladder is located in the lower pelvis, and inflammation can cause dull or sharp pain in this region.
This discomfort may worsen as the bladder fills.
7. A Feeling of Pressure in the Lower Abdomen
The inflamed bladder swells slightly, causing a sensation of pressure or fullness in the lower belly. This
can be mistaken for menstrual cramps or gastrointestinal discomfort.
8. Low-Grade Fever
A mild fever (below 100.4°F or 38°C) may develop as the body fights the infection. A higher fever could
indicate that the infection has spread to the kidneys (pyelonephritis), which is more serious.
What is urethritis?
Urethritis is an inflammation (swelling and irritation) of the urethra, the tube that takes urine
(pee) from your bladder to the outside of your body. Typically, urethritis is caused by an
infection. Most commonly, but not always, the cause is a sexually transmitted infection (STI).

Symptoms and Causes

1. Pain While Peeing (Dysuria)
Inflammation of the urethral lining makes it sensitive to urine, which contains salts and waste products.
As urine passes through the inflamed area, it causes a stinging or burning sensation. A sharp or burning
pain while urinating, often worsening toward the end of the urine stream. Bacterial infections (such as
Chlamydia or Gonorrhea), irritation from chemicals (soaps, spermicides), or trauma.
2. Pain During Sexual Intercourse (Dyspareunia)
Inflammation in the urethra can make friction from sexual activity painful, as the tissues are already
irritated. A deep or sharp pain in the pelvic region or a burning sensation during or after intercourse.
Sexually transmitted infections (STIs), bacterial infections, or irritation from latex condoms or lubricants.
3. Itchiness at the Tip of the Urethra
The immune response to an infection can cause irritation and itching in the urethra. This is common with
bacterial and viral infections. A tingling or itchy sensation at the opening of the urethra, which may be
mild or intense. STIs, yeast infections, chemical irritation from soaps or douches, or even dehydration
(which makes urine more concentrated and irritating).
4. Penile Discharge, Including Pus and/or Blood
When the urethra is infected, it produces excess mucus and pus as the body fights off bacteria. Blood may
appear due to irritation or damage to the urethral lining.
How It Looks:
Clear, white, yellow, or greenish discharge.
Pus-like consistency in severe cases.
Blood-tinged discharge in cases of significant inflammation.
STIs (Gonorrhea, Chlamydia), urinary tract infections (UTIs), or trauma from catheter use.
5. Pelvic Pain
Inflammation in the urethra can extend to the bladder or surrounding pelvic tissues, causing discomfort or
cramping. A dull ache or sharp pain in the lower abdomen or pelvis. May worsen after urinating or during
physical activity. Severe urethritis, bladder infections, or inflammation spreading to the prostate (in
men).
6. Differences in Symptoms between Men and Women
More likely to experience noticeable symptoms like pain, discharge, and irritation. Symptoms may be
mild or absent, which makes diagnosis harder. Some women may only notice frequent urination or mild
discomfort.

PYELONEPHRITIS
A kidney infection (pyelonephritis) is a type of urinary tract infection (UTI). Bacteria cause it
when they move from another part of the body, like the bladder, up to one or both of the kidneys.
Kidney infections can be more serious than lower UTIs. A kidney infection is a type of urinary
tract infection (UTI). A lower UTI and a kidney infection can have similar symptoms, but a
kidney infection is more likely to suddenly make one feel sick, give one a fever or cause pain in
your lower back or side.
Symptoms of a Kidney Infection
1. Fever
Your immune system raises your body temperature to fight off the bacterial infection in the kidneys.
High temperature (above 100.4°F or 38°C).
Can be accompanied by sweating.
A persistent high fever may indicate that the infection is worsening.
2. Chills
Your body shivers as a reaction to the fever, trying to generate heat.
Sudden shivering or shaking episodes.
Can occur even if you feel very hot.
Bacterial infections, especially in the kidneys.
3. Pain in Your Lower Back or Side (Flank Pain)
The kidneys are located in the upper back, near the spine. When they become inflamed, they cause pain in
the lower back or sides.
A dull ache or sharp stabbing pain in the side, below the ribs.
Pain may worsen with movement or pressure.
Some people confuse kidney pain with muscle pain or back pain.
4. Pain When You Pee (Dysuria)
The infection irritates the urinary tract, making urination painful. A burning or stinging sensation while
urinating .More intense than typical bladder infections.
5. Bloody or Cloudy Pee (Hematuria or Pyuria) That Might Smell Bad
Bacteria can damage kidney tissues, causing small amounts of blood to mix with urine.
White blood cells fight the infection, leading to pus in the urine.
The presence of bacteria and their waste products cause a foul odor.
Urine may appear pink, red, or brownish.
Thick, cloudy, or murky urine.
Strong, foul-smelling odor.
6. Urgent or Frequent Need to Pee
The infection irritates the bladder and urinary tract, making you feel like you need to pee often—even if
little urine comes out.
Constant urge to urinate, even after just going.
Only
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