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Function of the urinary system

- dispose some of the waste byproducts of the metabolic reactions in human body
- plays a major role in fluid and electrolyte balance

Name the different components of the urinary system.

1. Kidneys
2. Ureters
3. Urinary bladder
4. Urethra

Other terms for kidney

Ren, Renal, Nephro

What is Nephritis

Inflammation of the kidney

Kidneys

Two bean shaped organs

Where are the kidneys located?

Located behind the peritoneum on either side of the vertebral column at the level of vertebrae TXII to LIII
- On the posterior wall

Why is the right kidney is slightly lower than the left?

Due to the presence of the kidney.

The kidney has ___ surfaces, ___ borders and ____ poles

- Two (anterior and posterior surface)
- Two (medial and lateral border)
- Two (superior and inferior)

What is the anterior surface of the kidney related to?

- of right kidney related to liver and duodenum
- of left kidney related to spleen and stomach

What is the posterior surface of the kidney related to?

Of both kidneys related to diaphragm, psoas major, quadratas lumborum, transverse abdominis

Superior pole

- in touch with suprarenal (adrenal) gland

Inferior pole

- farther from the vertebral column and is round

Lateral border

Convex

Medial border

Concave
-houses the renal hilum

What are the contents of the renal hilum?

Contains renal vein/artery, renal pelvis (based on its physiology =urine), lymphatics, nerve fibers and fat

What is the renal capsule?

Fibrous capsule: is intimately attached to surface of kidney and partially extends to the interior of the renal hilum
- covers the entire kidney

Renal sinus is lined with what?

The renal capsule.

Characteristics of the renal capsule

No finger like projections, so it is really easy to peel off.

Coverings of the kidney vs adrenal gland.

They surround the kidney but the coverings of the adrenal gland are separate (individual)

Renal fascia

- Anterior / Posterior
- surrounds the kidney and the adrenal gland individually.

Paranephric fat

- Located behind the kidney and cushions it.
- Invests the kidney outside the renal fascia

Perinephric fat

Invests the kidney outside the fibrous capsule but inside renal fascia.

Main divisons in the coronal section of the kidney?

1. Cortex (outer region)
2. Medulaa (inner region)

Cortex is bounded by what?

B/w the renal capsule and renal pyramids

Renal columns

Cortex invaginates/extends b/w the renal pyramids to form them.

Renal lobe is made up of what?

Each pyramid + overlying cortex

What does the medulla consist of?

8-12 renal pyramids

Base of each pyramid faces...

The cortex

What does the apex of each pyramid point towards?

The renal hilum

What is the apex of the renal pyramid called?

Renal papilla

The apex of each pyramid opens into what structure?

A minor calyx

What forms a major calyx?

3-4 minor calyces

The Major calyces join to form what structure?

The renal pelvis

What does the renal pelvis end as?

The ureter

What are the spaces b/w the minor calyces filled with?

Renal arteries and veins

Ureter

Muscular tube (25 cm), starts from renal pelvis and ends at the urinary bladder (inside true pelvis).
- retroperitoneal organs

Ureter pathway

Passes behind the peritoneum, in front of the psoas major muscle and after crossing the common illiac artery enters the pelvis. The pelvic part is crossed by the ductus deference in male and uterine artery in female.

Name the three constrictions in the ureter.

1. Junction at the renal pelvis / ureter.
2. Where the ureter passes over the common iliac artery.
3. At the entrance of the urinary bladder

Function of the ureter

Passes the urine

What is renal colic pain?

Irritation of the nerve fibres passing behind the ureter.

Urinary bladder

Hollow muscular organ in true pelvis posterior the symphysis pubis.
- in front of rectum in males and in front of uterus and vagina in females

Anatomy when urinary bladder is empty

Is pyramid w/ 3 surfaces, a base, an apex, and a neck.

Where can it go when the urinary bladder is really full?

All the way into the abdomen (leaves the true pelvis)

Name the surfaces of the urinary bladder.

1. Superior
2. Posterior
3. Inferolateral

Describe the Superior Surface

Covered by peritoneum and is related to sigmoid colon (in male), uterus in female, and the coils of the small intestine in both genders.

Inferolateral surface is related to?

Related to muscles of the pelvic wall and pelvic diaphragm (anus)

Base (fundus) of the bladder

Receives the ureters at its superolateral angles and gives rise to the urethra at its inferior angle.
- related to the anterior wall of the vagina and part of the uterus

Base of the bladder is related to?

The ductus deference, seminal vesicles and rectum in males and to the uterus in females.

Describe the apex of the bladder.

Located behind the symphysis pubis and is connected to the umbilicus by the median umbilical ligament.

Neck of the bladder

Most inferior part and is related to the prostate in male and external urethral sphincter in female

What is the rectovesical pouch?

The peritoneum covering the superior surface of the bladder reflects anterior surface of the rectum (males)

What is the uterovesical pouch?

Peritoneal layer covering the superior surface of the bladder reflects to cover the body of the uterus
- b/w bladder and uterus

What is the rectouterine pouch?

Peritoneal layer covering the superior surface of the bladder reflects to cover the body of the uterus and then reflects on the anterior surface of the rectum
- b/w the rectum and the uterus

What is the recouterine pouch also called?

Pouch of douglas
- Is the deepest pouch in the female abdominal cavity.

Where do the ureters enter the urinary bladder?

Through the funds or posterior surface of the bladder.

What is the trigone?

A smooth inverted triangular area inside the urinary bladder b/c the mucousal membrane is not thrown into folds.

Why is the trigone not folded?

B/c the mucous membrane is tightly attached to the underlying tissue and therefore not folded.

What is the urethra?

Duct or tube that connects the bladder and brings the urine to the outside.

Urethra has a dual function in males

Part of the reproductive system to drain the sperm.

Name the four parts of the male urethra.

1. Preprostatic part of urethra
2. Prostatic part of urethra
3. Membranous part of urethra
4. Spongy part of urethra

Preprostatic part of urethra

- starts from the neck of the bladder at the internal urethral orifice and ends at the prostatic urethra
- Is surrounded by the involuntary internal urethral sphincter

Function of the urethral sphincter

Contracts and closes so that sperm will not go back into the urinary bladder.

Prostatic part of urethra

- passes thru the prostrate gland and is the widest part of the urethra.
- Prostatic / ejaculatory ducts open here

What part of the urethra is the sperm drained into?

The prostatic part.

Membranous part of the urethra

- passes thru the anterior part of the pelvic floor
- surrounded / guarded by the voluntary external urethral sphincter
- narrowest and shortest part of the urethra

What enervates the external urethral sphincter?

Pedundle nerve

Spongy part of the urethra (aka penile urethra)

- longest part of the urethra that passes through the bulb and corpus spongiosum of the penis and ends at the external urethral orifice
- bulbourethral glands open to the spongy urethra

Bulbourethral gland/duct drain what into where?

Drain the secretions into the penile urethra. Changes the pH of the duct (now sperm d/n die.

Navicular fossa

The end of the penile urethra where it is expanded.

Female urethral pathway

Starts from the internal urethral orifice at the neck of the urinary bladder and ends at the external urethral orifice to the exterior below the clitoris at the vestibule

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