Urinary System

BMS2
Poppy K. Sasmita
Anatomy Department
Atma Jaya Medical Faculty 2008

Urinary system

Kidneys
Ureters
Urinary bladder
Urethra

Kidneys

Reddish brown
Lie behind the peritoneum high up on the
abdominal wall
Right kidney slightly lower than left kidney
because of the large size of the right lobe
of the liver
150 g
135 g

function is to:

remove liquid waste from the blood in the

form of urine.
keep a stable balance of salts and other
substances in the blood.
produce erythropoietin, a hormone that aids
the formation of red blood cells.

Coverings of kidneys

Fibrous capsule
Perirenal fat
Renal fascia
Para renal fat : it forms part of the retroperitoneal fat

Internal Structure of the

Kidney

Renal cortex : dark brown (outer)

Renal medulla : light brown (inner)
Renal pyramids
Renal pelvis

Continuous with ureter

Calyces

Extensions of the pelvis

Function collect urine

Important relations : Right

kidney

Anteriorly : the suprarenal gland

the liver
the second part of the duodenum
the right colic flexure
Posteriorly :
the diaphragm
the costodiaphragmatic recess of pleura
the 12 rib
the psoas, quadratus lumborum

Important relations : Left

kidney

Anteriorly :
the suprarenal gland
the spleen, the pancreas, the stomach
the left colic flexure
Posteriorly :
the diaphragm
the costodiaphragmatic recess of pleura
the 11 rib
the psoas, quadratus lumborum

Blood Supply of the Kidney

Approximately of the total blood supply of the body

passes through the kidneys each minute
Renal artery branches inside the kidney

Supplies the pyramids and the cortex

Venous blood leaves the cortex and medulla

Small veins join the renal vein

Arteries
aorta renal artery
Veins : the renal vein emerges from the hilum & drains
into the inferior vena cava

Arteries
Renal artery ( from aorta)
Segmental ant & post arteries
interlobar arteries

Arcuate arteries

Interlobular arteries
afferent glomerular arterioles glomerulus

Venous drainage
stellate vein
interlobular veins
arcuate veins
Interlobar veins
veins

renal

Nephrons and Urine

Formation

Nephrons form the urine product

Filtration
Reabsorption
Secretion

Each kidney contains about 1 million nephrons

Structure of a Nephron

2 main structures

Glomerulus a knot of capillaries

Renal tubule (about 2 inches long)

Bowmans capsule surrounds the glomerulus

Proximal convoluted tubule
Henles Loop
Distal convoluted tubule

Renal tubule enters collecting duct

Receives urine from nephrons

Delivers final urine product into the calyces

Ureters

Muscular tubes : extend from the kidneys to

the posterior surface of the urinary bladder
Each 25 cm long & 1.25 cm in diameter
Abdominal part
Pelvic part

It has 3 constrictions along its

course
: pelvis joins the ureter
1. where the renal
2. where it is kinked as it crosses the pelvic brim (tepi saluran
superior) t4 masuk pelvis,
silang arteri iliaca
3. where it pierces the bladder wall

Differences between pelvic part of

ureter
Maleand female
Female
in male
Ductus deferens crosses ureters
superiorly from lateral to medial side

Ureters lies in the extraperitoneal

connective tissue in lower and
medial part of the broad ligament of
uterus

Seminal vesicles lies below and

behind the ureter

Uterine artery lies first above and in

front of the ureter

Vesical veins surround the terminal

part of ureter

Ureter lies about 2 cm lateral to the

supravaginal portion of cervix
Ureter runs slightly above the lateral
fornix of vagina
The terminal portion of ureter lies
anterior to vagina

Blood supply
Artery
Upper : the renal artery
Middle : the testicular or ovarian artery
The lower : the superior vesica artery
Veinous drainage
Drains into veins that correspond to the
arteries

Urinary bladder

Behind the pubic bones within

the pelvis
Adult : max capacity 500 mL
Has strong muscular wall
Its shape & relations vary
according to the amount of urine
that its contains

Shape & surface of the

bladder

The empty bladder is pyramidal

Apex : anteriorly & lies behind the upper
margin of the symphysis pubis
Base
Superior surface is covered with peritoneum
Fixation by lig umbilicus
As the bladder fills : ovoid
Neck : inferior

Interior of the bladder

Mucous membrane covering the internal

surface
Trigone :
Superior angles correspond to the opening of
the ureters
Inferior angle corresponds to the internal
urethral orifice
The ureters pierces the bladder obliquely, &
this provides a valve-like action

Muscle coat of the bladder

Smooth muscle
3 layers : detrusor muscle
At the neck of the bladder, the circular
component of the muscle coat is thickened to
form sphincter vesicae

Ligaments of the bladder

Males : puboprostatic ligaments
Females : pubovesical ligaments

Blood supply

Arteries : sup & inf vesical arteries

Veins : vesical venous plexus

Urethra

Small tube
The opening of the urethra on the surface is
called the urinary meatus
Sphincter urethrae muscle
surrounds the urethra in the deep peroneal
pouch
Intern sphinter urethra : involunter
Extern sphinter urethra : volunter

Female urethrae

3.8 cm long (1,5 inc)

Extends from the neck of the bladder to the
external meatus.
It traverses the sphincter urethrae & lies
immediately in front of the vagina

Male urethrae

20 cm long (8 inc)
Extends from the neck of the bladder to the
external meatus on the glans penis
Divided 3 parts : prostatic, membranous, &
penile (spongy)
Prostatic urethrae : 3 cm
membranous urethrae : : 1.25 cm
penile urethrae : 15.75 cm

Incontinence: is an inability to control urination.

possible causes including infection, or
damage to the brain, spinal cord, nerves, or the
urethral sphincters themselves.

Urinary retention the bladder is unable to expel

its contained urine.
In males : hypertrophy of the prostate gland
and narrowing of the prostatic urethra.