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URINARY SYSTEM

URINARY SYSTEM. KIDNEYS AND URETERS. 1- Describe the normal site, size, shape and position of the kidney 2- Delineate the surface anatomy of the kidney 3- Describe the facsia surrounding the kidney 4- Describe the blood supply of the kidney

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URINARY SYSTEM

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  1. URINARY SYSTEM KIDNEYS AND URETERS

  2. 1- Describe the normal site, size, shape and position of the kidney • 2- Delineate the surface anatomy of the kidney • 3- Describe the facsia surrounding the kidney • 4- Describe the blood supply of the kidney • 5- Describe the beginning termination, and parts of the ureter • 6- Discuss the normal sites of ureteric constrictions OBJECTIVES

  3. Organs of the Urinary System

  4. Organs of the Urinary system • Kidneys • Ureters • Urinary bladder • Urethra Figure 23.1a

  5. Kidneys

  6. Bean shaped organs • Located retroperitoneally • Lateral to T12–L3 vertebrae • R kidney lower than L (due to R lobe of liver) • kidney levels change during respiration and postural changes • Average kidney • 12 cm tall, 6 cm wide, 3 cm thick • tilted: superior poles are closer to midline than inferior • Hilum • On concave surface • Vessels, lymphatics and nerves enter and exit • Renal capsule surrounds the kidney Location and External Anatomy of Kidneys

  7. Relationship of the Kidneys to Vertebra and Ribs Figure 23.1b

  8. 1. renal fascia (outer) Extraperitoneal fascia, attaches kidney to posterior abdominal wall – flexible, allows kidney to move with respiration covered by a layer of fat (Pararenal or paranephric) The suprarenal glands are included inside this layer 2. perirenal fat (middle layer) protective cushion Completely surrounds the kidney 3. renal capsule (innermost) layer of collagen fibers - barrier against trauma, infection etc. kidney hangs suspended by collagen fibers and packed in soft cushion of adipose tissue Renal fascia and fat

  9. outer cortex: pale, inner medulla 6-18 conical renal pyramids apex - renal papilla projects into the renal sinus renal columns extensions from cortex inward to renal sinus between adjacent renal pyramids Internal anatomy

  10. ureter enters renal sinus, it expands to form a chamber called - renal pelvis pelvis branches to form 2-3 major calyces branch further to form 6-8 minor calyces Each minor calyx surrounds the papilla of a renal pyramid ducts within papilla connect to wall of the calyx and discharge urine produced in the cortex and medulla Urine passes through the calyces into the ureter Internal anatomy

  11. Blood Supply • Single renal artery arises just inferior to the origin of the superior mesenteric artery between vertebrae LI and LII • The left renal arteryusually arises a little higher than the right, and the right renal arteryis longer and passes posterior to the inferior vena cava. • Extra hilar arteries???

  12. Multiple renal veins contribute to the formation of the leftandright renal veins, both of which are anterior to the renal arteries • Importantly, the longer left renal vein crosses the midline anterior to the abdominal aorta and posterior to the superior mesenteric artery and can be compressed by an aneurysm in either of these two vessels.

  13. Renal arteries from abdominal aorta enter hilum and branch: 1. Interlobar arteries - pass through renal columns and reach junction between medulla and cortex 2. Arcuate arteries run parallel with the base of the pyramids 3. Interlobular arteries move up into the cortex and branch to form the afferent arteriole The peritubular capillaries unite to form the interlobular veins, arcuate vein, interlobar vein, renal vein The renal vein exits at hilus and joins the IVC Blood supply of the kidney:

  14. = Functional unit of the kidney, ~ 1 million nephrons per kidney! Tubular components: • Glomerular (Bowman’s) capsule– • Proximal convoluted tubule– • Loop of Henle- hair-pin loop • thin descending limb, thick ascending limb 4. Distal convoluted tubule- last section • specialized region - Juxta glomerular apparatus Distal convoluted tubule opens into the collecting system collecting ducts papillary ducts minor calyx… Nephron

  15. Made up of blood vessels: 1. Glomerulus- network of capillaries within Bowman’s capsule 2. Afferent arteriole - leading into glomerulus 3. Efferent arteriole - leading out of glomerulus 4. Peritubular capillaries - surrounding tubules 5. Vasa recta- specialised loops of blood vessels around long Loop of Henle (juxtamedullary nephrons) Vascular components of nephron

  16. Nephrons: 85% are cortical, 15% are juxtamedullaryMartini p957

  17. Ureters

  18. tubes that transport urine from renal pelvis to bladder • 20-30 cm long • Run from the renal pelves, pass over the pelvic brim at the bifurcation of the common iliac arteries. • Then along the lateral wall of the pelvis, to enter the UB Ureters Pyelogram (colour-enhanced)

  19. Sites of constriction of the ureters: 1- At the junction of the ureter and the renal pelvis ( Ureteropelvic junction) 2- Where the ureters cross the common iliac arteries at the pelvic brim 3- during their entery through the wall of the urinary bladder. Stones become lodged in these sites

  20. THANK YOU

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