Tractus Urinarius

Ferdy K Cayami
 Ren
Ureter
Vesica urinaria
Urethra
Embriology
 Ren
Anatomy External
Fascia Renalis
Topography
Vascularization
Innervation
Lymph Drainage
Suprarenal gland
 Ren
Reddish brown
11 x 6 x 3 cm
150 gr Male , 135 gr Female
Superior the upper border VT12,
InferiorVL3
 Renal + glandula suprarenalis
Corpus adiposum perirenal
Fascia renalis
Corpus adiposum pararenalis
 Vascularization of Ren
A renalis
A segmentalis
A lobaris
A interlobaris
A arcuata

Brdel line
 Innervation
Plexus nervosum formed by
Ganglion coeliacus
Plexus aorticorenalis
Nervus sphlanicus major
Nervus sphlanicus minor
Plexus aorticus
 Lymph Drainage
Around tubulus renalis
Under capsula renalis
In corpus adiposum perirenal

Nnll peri aorticus (nnll aorticus lateralis)

 Suprarenal Gland
In the adult the glands measure c.50 mm
vertically, 30 mm transversely and 10 mm
anteroposteriorly.
They each weigh c.5 g (the medulla being
about one-tenth of the total weight)
Cortex and Medulla
So many function in relation with hormone
 Suprarenal Gland
Vascularization (artery)
Arteri suprarenalis superior a phrenica inferior
Arteri suprarenalis media aorta abdominalis
Arteri suprarenalis inferior a renalis
Veins
Vena suprarenalis dx vena cava inferior
Vena suprarenalis sin vena renalis
Vena accessorius (occasionally)
Lymph
Grup lateral nnll para-aorticus
 Ureter
Muscular tube with length c.25-30 cm and
diameter ca.3 mm
Pelvis renalis vesica urinaria (Ureterpelvico
junction)
3 narrowest part:
Pelvis renalis ureter (hilum renalis)
Apertura pelvis superior (crossing over artery
illiaca communis)
Entrance to vesica urinaria
 Vascularization of Ureter
Artery
Arteri renalis
Arteri gonadal (ovarica / testicularis)
Arteri illiaca communis
Arteri iliaca interna
Arteri vesicalis
Arteri uterina
Aorta abdominalis
Very good anastomosis
Vein follow the artery
 Lymph drainage
Within the ureter
submucosal,
Intramuscular
adventitial plexuses
Upper part ureter nnll paraaortici (lateral)
Middle part nnll illiaca communis
Bottom part nnll illiaca communis, illiaca
interna or illiaca externa
 Innervation of Ureter
Plexus renalis dan aorticus
Plexus hypogastricus superior et inferior
MS segment thoracic 10 12, L1 and S2-4
Referred Pain
posterior and lateral abdominal wall below the
ribs and above the iliac crest
the pubic region
the scrotum in males / the labia majora in
females
the proximal anterior aspect of the thigh.
 Vesica Urinaria
Muscular reservoir
Varies in size, shape, position and relation
Lesser pelvis abdomen
Tetrahedral shape with:
Base
Fundus
Collum
Apex
2 inferolateral surfaces
 Ligaments of Vesica Urinaria
Inferior condensations of pelvic fascia to the
pubis, lateral pelvic side-walls, and rectum.
Ligamentum pubovesicalis
condensations of connective tissue
The reflections of the peritoneum from the bladder to
the side-walls of the pelvis form the lateral ligaments,
and the sacrogenital folds constitute the posterior
ligaments.
Ligamentum umbilicalis medialis (remnants of
urachus)
 Vascularization of Vesica Urinaria
Artery
Arteri vesicalis superior arteri umbilicalis
Arteri vesicalis inferior arteri rectalis media
Veins
Plexus vesicalis vena iliaca interna
Related to plexus prostaticus / uterovaginal
Lymph
Nnll illiaca externa
Nnll illiaca interna / nnll illiaca communis
 Innervation of Vesica Urinaria
Efferent
Parasimpathetic
S2-4 n erigentes / splanchnicus pelvicus
Simpathetic
T10-12, L1-2
Plexus coeliacus and mesentericus plexus
hypogastricus some to plexus vesicalis
Afferent
Parasympathetic pathway
Simpathetic pathway
 Micturition
Storage phase
Viscoelasticity
All or none effect
Sphincter urethra internum
L center within rostral pons
Voiding phase
Stretch reach threshold
the M center in rostral pons
Descending pathway to S2-4
nervus splanchnicus pelvicus Plexus hypogastricus
inferior
 Urethra
Male Urethra
Female Urethra
 Male Urethra
Urethra posterior
Preprostatica
Prostatica
Membranaseus
Urethra anterior
Spongiosa
 Vascularization of Male Urethra
Artery
Artery urethralis arteri pudenda interna
Artery dorsalis penis
Vein
Anterior (vena dorsalis penis and vena pudenda
interna plexus prostaticus)
Posterior (plexus venosus prostaticus dan plexus
venosus vesicalis vena illiaca interna)
 Lymph of Male Urethra
Urethra posterior nnll illiaca interna + nnll illiaca
externa
Urethra membranaceus accompany the vessel
pudenda interna
Urethra anterior nnll inguinalis profundus +
nnll inguinalis superfisialis + nnll illiaca externa
(through canalis inguinalis)
 Female Urethra
c.4 cm long and 6 mm in diameter.
Orificium urethra internum crosses
membrana perinealis orificium urethra
externum (c 2.5 cm anterior of introitus
vagina)
Glandula para-urethralis Ductus para-
urethralis submucous tissue ends in a
small aperture on the lateral margin of the
orificium urethra externum
 Vascularization of Female Urethra
Artery
Arteri vaginalis
Artery vesicalis
Veins
Plexus venosus vesicalis vena pudenda interna
Lymphatic drainage
Nnll illiaca interna
Nnll illiaca externa
 Embriology of Urinary Tract
Pronephros 4 weeks
Mesonephros for krista urogenitalis
Metanephros

Diverticulum uretericum tubulus collectivus

End of 5th week
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