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What is the renal system?
Largest excretory system of the body.
Also known as the urinary system.
What structures form the renal system?
What is the main function of the renal system?
The production of urine (by the kidneys) and the excretion of this waste product via the other components of the system.
Describe the location of the kidneys.
Posterior abdominal wall
Vertebral level - T12-L3 (form in the pelvis and ascend during development)
Right kidney is lower down due to liver
What structures does the left kidney associate with posteriorly?
Ribs XI and XII
Transversus abdominis muscle
Quadratus lumborum muscle
Psoas major muscle
Subcostal, iliohypogastric and ilioinguinal nerves.
What structures does the right kidney associate with posteriorly?
Same as left kidney, except only rib XII not XI.
What structures does the left kidney associate with anteriorly?
Left colic flexure
What structures does the right kidney associate with anteriorly?
Right colic flexure
How are the kidneys held in place and protected?
By connective and adipose tissue.
What are the layers surrounding the kidney?
Surrounded by tough connective tissue capsule.
Small layer of perinephric fat.
Describe the gross surface anatomy of a kidney.
Superior pole (with adrenal gland) and inferior pole.
Anterior and posterior surfaces.
Lateral and medial margins.
Hilum on the medial aspect: renal pelvis (becomes ureter) renal artery, renal vein.
What are the layers of the kidney from outside in?
Describe the structure of the cortex and medulla.
Columns (extensions of the cortex) split the medulla into pyramids.
Describe the drainage of urine from the kidney.
Apex of a renal pyramid = renal papilla, associated with a minor calyx.
Several minor calices merge to form a major calyx.
Urine passes through the major calices into the triangular renal pelvis, a flattened and funnel-shaped structure.
From the renal pelvis, urine drains into the ureter, which transports it to the bladder for storage.
Describe the blood supply to the left and right kidneys.
Supplied by the left and right renal arteries, branches of the abdominal aorta.
Right renal artery travels posterior to the IVC and so is longer than the left.
Describe the blood supply within the kidneys.
Renal artery enters kidney via the renal hilum, dividing into segmental branches.
Each segmental artery divides to form interlobar arteries either side every renal pyramid.
Interlobar arteries divide to form the arcuate arteries.
At 90 degrees to the arcuate arteries, the interlobular arteries arise and pass through the cortex, dividing to form afferent arterioles.
The afferent arterioles form the glomerulus, where filtration takes place. The capillaries come together to form the efferent arterioles.
In the outer two-thirds of the cortex, the efferent arterioles form the peritubular network, supplying the nephron tubules with oxygen and nutrients.
The inner third of the cortex and the medulla are supplied by long, straight arteries called vasa recta.
Describe the venous drainage of the left and right kidneys.
Drained by the left and right renal veins, drain directly into the inferior vena cava.
Left renal vein travels anterior to the abdominal aorta and so is longer than the right renal vein.
What is the nephron? How many per kidney? How long?
Functional unit of the kidney (forms urine).
1-2 million per kidney
Essentially a long tube, closed at one end and joins a collecting duct at the other
Collecting duct transports urine to calices
Describe the flow of filtrate along the nephron.
Closed end = Bowman's
capsule (glomerular capsule).
Wraps around tiny arterioles (glomerulus), filtration of the blood begins here.
Filtered blood then passes into the proximal convoluted tubule.
Then, into the Loop of Henle.
Then, into the distal convoluted tubule.
Then, the straight collecting duct into the main collecting duct.
Loop of Henle and collecting duct are in the medulla - everything else in the cortex.
Describe blood flow around the nephron.
Branch of renal artery
Peritubular capillaries (supply nephron)
Branch of renal vein.
What histological feature of the kidney should you recognise?
Renal corpuscles (dark purple circles) in cortex only.
What are the ureters?
Muscular tubes that carry urine from the kidney to the bladder by peristaltic movements and gravity.
Where do the ureters cross the external iliac arteries?
Just beyond bifurcation of the common iliac artery.
What are the 3 sites of constriction of the ureters? Why are they significant?
Where kidney stones can lodge
1) Uteropelvic junction
2) Pelvic inlet
3) Entrance to bladder
What is the arterial supply of the ureters?
Receive branches from three main sources (blood supply is variable).
1. Renal arteries
2. Gonadal arteries
3. Abdominal aorta
What is the venous drainage of the ureters?
Veins of the ureters drain into the renal vein and gonadal veins.
What is the epithelium unique to the urinary system?
Transitional epithelium. Found in ureters and bladder. Protective and allows stretch.
What is the bladder?
A hollow, muscular organ which stores urine.
What is the main muscle of the bladder?
Main muscle (smooth muscle) of the bladder walls is the detrusor muscle.
How is urine expelled from the bladder?
Via the urethra.
What is the location of the bladder?
Empty bladder = lesser pelvis
Full bladder = ascends into the greater pelvis
What is the arterial supply of the bladder?
Main blood supply of the bladder is through 2 branches of the internal iliac artery
• Superior vesical arteries (anterior and superior parts)
• Inferior vesical arteries (males) (fundus and neck)
• Vaginal arteries (females)
What are the histological layers of the bladder?
2 layers of interwoven smooth muscle
What is the urethra?
Fibromuscular tube from the bladder to the external urinal orifice used to excrete urine from the body.
Describe the male urethra.
20 cm long
3 parts: prostatic, intermediate/membranous, spongy
Describe the female urethra.
3-4 cm long.
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Essentials of Human Anatomy and Physiology
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Essentials of Anatomy & Physiology
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