URINARY SYSTEM

KIDNEYS

• Kidneys produce urine, that is carried to the

urinary bladder by the ureters
• Lie btween Th 12- L3 vertebrae. They are
located retroperitoneally
• The right kidney usually lies slightly lower
than the left kidney due to the liver
• They are bean shaped organs of each is 12
cm long.
 FUNCTIONS OF KIDNEY

• remove waste products from the body.

• remove drugs from the body.
• balance the body's fluids.
• release hormones that regulate blood
pressure (eritropoetin, renin)
• produce an active form of vitamin D
that promotes strong, healthy bones.
• control the production of red blood
cells.
KIDNEYS (continued)

• Kidneys are surrounded by a fibrous capsule

• Outer to the fibrous capsule there is a fatty
layer called the perirenal fat which is
enclosed by a weak fascia called the renal
fascia
• External to the renal fascia there is the
pararenal fat, which is most obvious on the
posterior aspect of kidneys
KIDNEYS (continued)

• Renal hilum is a cleft on the medial concave part of

the kidney where the structures enter and leave the
organ
– Renal vein, renal artery, renal pelvis are the
structures passing through the renal hilum

• Renal hilum opens to the renal sinus, a space

occupied by the calices, renal pelvis, vessels and
nerves and a variable amount of fat
KIDNEYS (continued)

• Following parts are macroscopically

visible in a longitudinal section of the
kidney
– Cortex
– Renal pyramids
– Renal columns (extension of the cortex
between the pyramids)
KIDNEYS (continued)

• Apex of the renal pyramids are called the renal

papilla, which protrudes slightly into the renal
sinus

• On each renal papilla there are a number of

holes called the papillary foramina, through
which the urine is tranferred into the minor
calices
KIDNEYS (continued)

• Minor calices unite to form 2-3 major

calices in each kidney

• Major calices unite to form the renal pelvis

• Renal pelvis continuous with the ureter

 NEPHRON
Nephrons take a simple filtrate of the
blood and modify it into
urine. Nephrons are the “functional
units” of the kidney; they cleanse the
blood and balance the constituents of
the circulation. Each kidney is made
up of over one million nephrons that
dot the renal cortex, giving it a
granular appearance.
• The arcuate arteries of the kidney, also known
as arciform arteries are vessels of the renal
circulation. They are located at the border of
the renal cortex and renal medulla.
• They are named after the fact that they are
shaped in arcs due to the nature of the shape of
the renal medulla.
• Arcuate arteries arise from renal interlobular
arteries.
 KIDNEYS (continued)

Arteries
• Renal arteries are branches of the abdominal aorta
(right renal artery is longer)
– Each renal artery gives rise to five segmental arteries
– Renal artery...... Segmental arteries…... Interlobar
arteries…. Arcuate arteries …… Interlobular artery..
Afferent arterioles…… Glomerular plexus……Efferent
arteioles

Veins
• Renal veins drain into the inferior vena cava (left renal
vein is longer)
The vasa recta of the kidney, (vasa recta renis)
are the straight arterioles, and the straight
venules of the kidney, – a series of blood
vessels in the blood supply of the kidney that
enter the medulla as the straight arterioles, and
leave the medulla to ascend to the cortex as the
straight venules.
Clinical note

Renal transplantation
• Performed in selected cases of renal failure
• Kidney can be removed from the donor sparing
suprarenal gland, which is easily separable

Renal cysts
• Adult polycystic disease is an important cause of renal
failure
• Inherited as an autosomal-dominant trait
 URETERS
• Muscular ducts that carry urine from kidneys to
the urinary bladder
• About 25-30 cm long
• Ureters has abdominal and pelvic parts
• They extend retroperitoneally, enter the lesser
pelvis at the bifurcation of the common iliac
arteries
• They then run along the lateral walls of the pelvis
and enter the urinary bladder
URETERS (continued)

Ureters enter the posterior wall of urinary

bladder
– This part has an oblique course that constitutes a
one way valve and contraction of the bladder wall
act as a sphincter preventing the reflux of urine
Clinical note

Renal and ureteric calculi (stones)

• Large calculi produce severe colicky pain due to
hyperperistalsis

• Obstruction of ureter due to a calculus may occur

anywhere throughout the course of ureter

• The three constrictions are common sites, the last

constriction being the most common
 SUPRARENAL GLANDS
• Located on the superomedial aspects of the kidneys
and easily separable from it during surgery
• Has two parts
– Suprarenal cortex
• Secretes corticosteroids and androgens

– Suprarenal medulla
• A mass of nervous tissue
• Associated with sympathetic system
• The chromaffin cells of the medulla secrete
catecholamines into the bloodstream
 URINARY BLADDER

• Reservoir for urine

• Has a distensible muscular wall
• Empty bladder lies in the lesser pelvis
– A full bladder may ascend up to the level of
umbilicus
URINARY BLADDER (continued)

– In males posteriorly related with seminal vesicles and

rectum
– In females posteriorly related with uterus
 URETHRA (male)

• Urethra is about 18-20 cm long in males

• Extends between the internal urethral orifice
(at the inferior part of the urinary bladder) and
external urethral orifice (at the tip of the glans
penis)
 URETHRA (female)

• About 4 cm long
• Extends anterior to the vagina
• Traverses the urogenital diaphragm
• Surrounded by the external urethral sphincter
Clinical note

Urethral catheterization

• Performed in order to remove urine from a person

who can not urinate or obtain an uncontaminated
urine sample
 COMMON URINARY DISEASES
• Bladder infections - (cystitis) usually caused
by bacteria.
• Enlarged prostate - in men, this can make it
difficult to empty the bladder.
• Incontinence - when urine leaks out of the
urethra.
• Kidney infections - when a bladder infection
‘backs up’ the ureters.
• Kidney stones - caused by infection and
high blood levels of calcium.
 DIALYSIS
Dialysis is a treatment for individuals
whose kidneys are failing. There are
two types of dialysis, hemodialysis
and peritoneal dialysis, that both
perform normal kidney functions,
filtering waste and excess fluid from
the blood.