Nur Hayati

Anatomy-Histology
Department
Faculty of Medicine UMY

Introduction
Cellular metabolism produces wastes
CO2
Urea
Ammonia

Kidneys rid the body of most

nitrogenous wastes
Kidneys regulate the chemical make-up
of blood

Functions of Urinary System

(Kidneys):
Regulate fluid balance (fluid
volume) of the body
Excrete organic waste products
and conserve nutrients, etc
Stabilize pH
Regulate ion concentrations in
the blood

The Urinary System

The Urinary System

The kidney
and ureter
The lower
urinary tract
Vesica
urinaria
Urethrae

Male versus Female

The Urinary System

Human Anatomy, 3rd edition

Prentice Hall, 2001

THE KIDNEYS (REN)

Reddish-brown, glistening, smooth

surface
kidney-shaped
Adult: 11X6X3
Features:

Two surfaces: anterior & posterior

(facies anterior & posterior)
Two borders: medial & lateral (margo
medialis & lateralis)
Two poles: upper & lower (extremitas
superior & inferior)
A hilum (hilum renalis): at the middle of
the medial border:
a, v. renalis
ureter

THE KIDNEYS (REN)

Lie against the dorsal

body wall
Beneath the parietal
peritoneum
retroperinetoneal
VT XII-VL III
Ren sinistra > ren dextra
Ren dextra > caudal
than ren sinistra
hepar

Ren

External Structure of the Kidney

Renal capsule
Connective tissue

Renal artery
Blood (oxygenated) to the kidney

Renal vein
Receives blood from kidney

Ureter
Drains urine

Internal Structure of the Kidney

Renal cortex
Renal medulla
Renal pyramids

Renal pelvis
Continuous with ureter

Calyces
Extensions of the pelvis
Function collect urine

Structure of the Kidney

Urine collection:
Ducts within each renal
papilla release urine
into minor calyx
major calyx
renal pelvis
ureter

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

A Typical Nephron

A Typical Nephron

Renal Corpuscles

A Renal Corpuscle

Nerves and Vessels

Arterial

supply:

a. renalis ( dx & sn) a. segmentalis (hilum)

a. lobaris (sinus) a. interlobaris (papilla)
a. arcuata a. interlobularis (cortex)
arteriola glomerulus (afferent arteriola)

vena:
v. renalis v. cava inferior

Nerve

supply:

plexus renalis ( bersifat vasomotor)

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

Blood Supply of the Kidney

Blood Supply of the Nephron

Urine Formation
Filtration
Blood in afferent arteriole is under high pressure
Glomerulus acts as a filter
Filtrate = the substance that is filtered from the blood into
the renal tubule
Blood leaves the glomerulus through the efferent arteriole

Reabsorption
Filtrate contains useful substances which are returned to the
blood
Most occurs in the proximal convoluted tubules

Secretion
Substances move from blood (capillaries) into the filtrate
Important in controlling pH of blood

The Ureters

Kidney urinary
bladder
25-30 cm long ; 3
mm in diameter
Parts:
The pelvis of ureter
The abdominal part
The pelvic part

Structure

Narrowing of the ureters:

At the junction of its pelvis & abdominal part

At the pelvic brim the abdominal part
continues into the pelvic part
Proximal to its opening into the bladder lumen

Ureter wall:

Tunica fibrosa
Tunica muscularis peristaltic
Tunica mucosa Transitional epithelium,
multilayered

Urine transported down the ureters by

active peristalsis few drops 3-5 X/mnt

Nerves and Vessels

Nerve

supply:

Sympathetic fibre VT11 VL1

parasympathetic fiber VS 2-4
Most of the nerves sensory:
Stretching of the wall
Acute pain
Powerfull, spasmodic contraction
Ureteric colic

Nerves and Vessels

Arterial supply:
The renal arteries
Lateral branches coming directly off the
abdominal aorta
The gonadal arteries
The common & internal iliac arteries
The inferior vesical artery

Venous drainage:
Renal, internal iliac & inferior vesical veins

THE URINARY BLADDER

(VESICA URINARIA)

Distensible, as
reservoir for urine
Capacity: 300-500
ml desire to
urinate
Contraction of the
muscular wall
empties it of urine
through the urethra

Shape

Pyramid:
The base (fundus)
triangular
The two inferolateral
surface corpus
Apex

The bladder neck

urethra

Position

Posterior to symphisis
pubis
Apex median
umbilical ligament
(ligamentum ubilicale
medianum) derived
from urachus

Structure

The wall of the bladder:

Tunica mucosa transitional

epithelium
Tunica muscularis m. detrussor
empties the bladder

Internal structure:
osteum ureteris
ostium urethra interna (OUI)
trigonum vesicae m.
trigonalis surround the
ureteric orifices continous
into the part of the urethra
m. sphincter vesicae

Supporting ligaments
diaphragma

pelvis, lig. Umbilicale

mediana & lig. Umbilicale laterale
( obliterasi a. umbilicalis)
Condensation of fibrous tissue run
from the bladder neck:
Anteriorly: pubovesical / puboprostatic
ligaments (ligamentum
pubovesicalis/puboprostatica)
Laterally: lateral ligements

Nerves and Vessels

Nerve supply: vesical plexus (plexus vesicalis:

Parasympathetic fibre segment S2-S4
Sympathetic fibre segments T11-L2 (relaksasi
m. detrusor & kontraksi sphincter)

Motor fibre parasympathetic kontraksi m.

detrusor & relaksasi sphincter
Sensory fibre parasympathetic & sympathetic
information on the degree of filling bladder
Arterial supply: a. vesicalis superior & a. vesicalis
inferior (branches of the internal iliac artery)
Venous drainage: plexus venosus internal iliac
veins

THE URETHRA

THE FEMALE:
4 cm long
End at urethral
meatus (ostium
urethra externa)
vestibulum vagina

20-25 cm long
3 parts:
The prostatic
urethra (pars
prostatica urethra):
Ejaculatory ducts &
the ducts of the
prostatic gland

The membranous
urethra (pars
membranacea
urethra)
The penile urethra
(pars spongiosa
urethra):
The ducts of the
bulbourethral glands

The Male
Urethra

Nerves and Vessels

Nerve supply:
Sacral segments S2-S4 (plexus splanchnicus)
Segments T11-12 (plexus hypogastricus)
Motor nerves:
Sympathetic fibre proximal intrinsic sphincter of
smooth muscle (m. sphincter vesicae)
Somatic fibre distal intrinsic sphincter of striated
muscle (m. sphincter urethra)

Arterial supply: a. vesicalis inferior, a. profunda

penis, a. urethralis

MICTURITION

Pressure within the bladder rise afferent

impulses n. splanchnicus pelvicus S2-4

parasympathetic motor: contraction of m.

detrussor, relaxation of m. sphincter vesicae
Somatic fibre relaxation of m. sphincter urethra
Relaxation of the pelvic floor muscles
Full contraction of the detrussor assisted by the
muscle of the anterior wall and diaphragma

The ability to stop the flow of urine voluntary

in midstream:
Contraction of the intrinsic striated sphincter
Contraction of the pelvic floor