TY - CHAP M1 - Book, Section TI - The Urinary System A1 - Suneja, Manish A1 - Szot, Joseph F. A1 - LeBlond, Richard F. A1 - Brown, Donald D. PY - 2020 T2 - DeGowin’s Diagnostic Examination, 11e AB - The urinary system includes the kidneys, renal pelvis, ureters, urinary bladder, and urethra. The kidney filters the blood at the glomerulus, reabsorbs and secretes solutes and fluid in the renal tubules, and concentrates the urine in the medullary collecting ducts. Urine passes down the ureters to the bladder by gravity and peristalsis filling the urinary bladder. At the ureterovesical junction the ureters are compressed by detrusor muscle tone as they pass obliquely through the bladder wall. This compression increases during detrusor contraction preventing urine from refluxing into the ureters. The detrusor actively relaxes as the bladder fills maintaining a low pressure within the bladder until it reaches capacity. Further filling stretches the bladder wall rapidly increasing intravesical pressure. The urethra exits the bladder through the urethral sphincter and the urogenital septum. This sphincter has involuntary smooth muscle under parasympathetic and sympathetic control, and voluntary striated muscle innervated via the lumbosacral plexus. Continence requires tonic urethral sphincter smooth muscle contraction and active inhibition of detrusor contraction. Voiding requires detrusor contraction and simultaneous relaxation of the urethral sphincter muscles. SN - PB - McGraw Hill CY - New York, NY Y2 - 2024/04/24 UR - accessmedicine.mhmedical.com/content.aspx?aid=1189114451 ER -