FUNCTIONAL ANATOMY

OF RENAL SYSTEM

By dr amber ilyas
 KIDNEYS
Ò Its main function is to excrete most
of the waste products of
metabolism

Ò It control the water and electrolyte

balance of the body

Ò It maintain acid-base balance of

the blood

Ò The waste products leave the

kidneys as urine, which passes
down the ureters to the urinary
bladder

Ò The urine leaves the body through

the urethra
 KIDNEYS
Ò Kidneys are reddish brown in
color
Ò Lie behind the peritoneum of
the posterior abdominal wall
Ò It lie high up on either side of
the vertebral column

Ò Are largely under cover of the

costal margin

Ò The right kidney lies slightly

lower than the left due to the
large size of right lobe of the
liver
 With contraction of the
Ò
diaphragm during respiration, KIDNEYS
both kidneys move downward
in a vertical direction as much
as 2.5 cm

Ò On the medial border of each

kidney is a vertical slit called
the hilum

Ò The hilum extends into a large

cavity called the renal sinus

Ò The hilum transmits the renal

vein, two branches of renal
artery, ureter, and the third
branch of renal artery from the
front backward (V.A.U.A.)
 1- Fibrous capsule:
Ò
Ò It surrounds the kidney
COVERINGS
Ò 2- Perirenal fat:
Ò It covers the fibrous capsule

Ò 3- Renal fascia:
Ò it is a condensation of
connective tissue that
encloses the kidneys and
suprarenal glands,
Ò it is continuous laterally with
the fascia transversalis
Ò 4- Pararenal fat:
Ò it lies external to the renal
fascia, and forms part of the
retroperitoneal fat
Ò Each kidney has a dark RENAL STRUCTURE
brown outer cortex and a
light brown inner medulla

Ò Medulla is composed of
about a dozen renal
pyramids

Ò Each pyramid having its

base directed laterally
toward the cortex, and its
apex, (the renal papilla),
projecting medially

Ò The cortex extends into the

medulla between adjacent
pyramids as the renal
column
Ò Extending from the bases RENAL STRUCTURE
of the renal pyramids into
the cortex are striations
known as medullary rays

Ò The renal sinus within the

hilum, contains the upper
expanded end of the
ureter, the renal pelvis

Ò Renal pelvis divides into

two or three major calyces,
which divides into two or
three minor calyces
Ò RIGHT KIDNEY ANTERIOR RELATIONS OF
Ò Suprarenal gland THE KIDNEYS
Ò Liver,
Ò Second part of the
duodenum,
Ò Right colic flexure
Ò Coils of small intestine

Ò LEFT KIDNEY
Ò Suprarenal gland,
Ò Spleen,
Ò Stomach,
Ò Pancreas (body),
Ò Left colic flexure,
Ò Descending colon
Ò Coils of jejunum
 Posterior Relations of the
RIGHT KIDNEY
Diaphragm, Kidneys
Costodiaphragmatic recess of the
pleura,
Twelfth rib & last intercostal
space,
Psoas major
Quadratus lumborum,
Transversus abdominis muscle
Subcostal nerve (T12)
Iliohypogastric nerve (L1)
Ilioinguinal nerve (L1)

LEFT KIDNEY
Same as the right except it
is higher it reaches up to the
11th rib.
 BLOOD SUPPLY

Ò The renal artery arises from

the aorta at the level of the
second lumbar vertebra

Ò Each renal artery divides into

five segmental arteries that
enter the hilum of the kidney,
four infront and one behind
the renal pelvis

Ò Lobar artery arise from each

segmental artery, one for
each renal pyramid
Ò Each lobar artery gives two or BLOOD SUPPLY
three interlobar arteries
Ò The interlobar arteries run
toward the cortex on each
side of the renal pyramid

Ò Interlobar arteries give the

arcuate arteries at the
junction of the cortex and
medulla

Ò The arcuate arteries give

several interlobular arteries

Ò Afferent glomerular arterioles

arise as branches of
interlobular arteries
 VEINS, LYMPH,
NERVE SUPPLY
Ò Renal vein emerges from the
hilum in front of the renal
artery and drains into the IVC
Ò Left renal vein is longer than
the right renal vein
Ò Lateral aortic lymph nodes lie
around the origin of the renal
artery

Ò Renal sympathetic plexus:

afferent fibers that travel
through the renal plexus enter
the spinal cord in the 10th,
11th, and 12th thoracic nerves
 The two ureters are muscular
Ò
tubes that extend from the URETERS
kidneys to the posterior
surface of the urinary bladder

Ò The urine is propelled along

the ureter by peristaltic
contractions

Ò Each ureter measures about

25 cm long

Ò Each ureter has three

constrictions along its course,
Ò 1- Where the renal pelvis joins
the ureter,
Ò 2- As it crosses the pelvic brim,
Ò 3- Where it pierces the bladder
wall ( intra-mural part)
 URETER
Ò The renal pelvis is the funnel-
shaped expanded upper end
of the ureter

Ò It lies within the hilum of the

kidney and receives the major
calyces

Ò It enters the pelvis by crossing

the bifurcation of the common
iliac artery in front of the
sacroiliac joint

Ò It runs downward & forward

on the lateral wall of the
pelvis to enter the lateral
angle of the bladder
Ò Anterior:
RELATIONS, RIGHT URETER
Ò Duodenum,
Ò Terminal part of the ileum,
Ò Right colic vessels,
Ò Iliocolic vessels,
Ò Right testicular or ovarian
vessels, and the
Ò Root of the mesentery.
Ò Posterior:
Ò Right psoas muscle,
Ò Bifurcation of the right
common iliac artery
Ò Anterior: RELATIONS, LEFT URETER
Ò Sigmoid colon,
Ò Sigmoid mesocolon,
Ò Left colic vessels,
Ò Left testicular or
ovarian vessels

Ò Posterior:
Ò Left psoas muscle,
Ò Bifurcation of left
common iliac artery
Ò Upper end is supplied by BLOOD SUPPLY
the renal artery

Ò Middle portion by
(gonadal) testicular or
ovarian artery

Ò In the pelvis is supplied

by the superior vesical
artery
Ò The lymph drains to the
lateral aortic nodes and
the iliac nodes
 NERVE SUPPLY
Ò Renal, testicular (or
ovarian), and hypogastric
plexus (in the pelvis)

Ò Afferent fibers travel with

the sympathetic nerves
and enter the spinal cord
in the first and second
lumbar segments
Ò The two suprarenal glands SUPRARENAL GLANDS
are yellowish retroperitoneal
organs that lie on the upper
poles of the kidneys

Ò They are surrounded by the

renal fascia

Ò Separated from the kidneys

by the perirenal fat

Ò Each gland has a yellow

cortex and a dark brown
medulla
Ò The cortex secretes
hormones include: SUPRARENAL GLANDS
Ò Mineral corticoids,
which control fluid and
electrolyte balance.
Ò Glucocorticoids, which
control carbohydrates,
fats, and proteins.
Ò Sex hormones, which
probably play a role in
the prepubertal
development of the sex
organs
Ò The medulla secretes
the catecholamine,
epinephrine and
norepinephrine
Ò Left suprarenal gland is LEFT SUPRARENAL GLANDS
crescentic in shape
Ò Extends along the medial
border of the left kidney
from the upper pole to
the hilum
Ò It lies behind the:
Ò The pancreas,
Ò The lesser sac,
Ò The stomach
Ò It rests posteriorly on the
diaphragm
 RIGHT SUPRARENAL GLANDS
Ò The right suprarenal
gland is pyramidal in
shap and caps the
upper pole of the right
kidney

Ò It lies behind the right

lobe of the liver and
extends medially
behind the IVC

Ò It rests posteriorly on
the diaphragm
Ò Arteries: BLOOD SUPPLY
Ò Three arteries supplying each
gland,
Ò 1- Superior suprarenal artery:
from inferior phrenic artery
Ò 2- Middle suprarenal from aorta.
Ò 3- Inferior suprarenal from renal.
Ò Veins:
Ò A single vein emerges from the
hilum of each gland:
Ò The right suprarenal vein drains
into the IVC .
Ò The left suprarenal vein drains
into the left renal
Ò The suprarenal glands of the human fetus are 10 to 20 times larger than
the adult glands relative to body weight, and are large compared with the
kidneys.
Ò These large glands result from the extensive size of the fetal cortex.

Dr. L. Tchakarov 25
 PARTS OF URINARY BLADDER

• Apex points towards the

superior edge of pubic
symphysis when bladder is
empty
• Fundus is opposite the apex,
formed by convex posterior
wall.
• Body is the major portion
between apex and fundus
• Fundus and inferolateral
surfaces meet inferiorly at the
neck
 URETHRA
• Extends from urinary bladder to
outside body
• In males – divided into prostatic
urethra (through center of prostate
gland), membranous urethra
(penetrates floor of pelvic cavity),
spongy urethra (through penis)
• Passes through urogenital diaphragm
(circular band of skeletal muscle) that
form the external urethral sphincter -
under voluntary control
• Lining is stratified columnar and then
stratified squamous epithelium with
elastic connective tissue
 Male urethra

• Urethra is about 8 inches

(20 cm) long and opens at
the end of the penis.
• In men divided into 4 parts,
named after the location:
• Intramural (preprostatic)
part
• Prostatic urethra
• Membranous urethra
• Penile urethra