The Urinary System

Muh.Iqbal Basri
Anatomy Department
Hasanuddin University
 TIU/ TIK

REN ANATOMY
URETER
UROGENITALIA
VESICA
SYSTEM
URINARIA

URETHRA

GENITALIA DEPARTMENT OF ANATOMY

MASCULINA
MEDICAL FACULTY
HASANUDDIN UNIVERSITY
CLINICAL
ANATOMY
 TIU/ TIK

URINARIUS REN

URETER

VESICA
URINARIA

URETHRA

GENITALIA GENITALIA
MASCULINA

CLINICAL
ANATOMY
The Urinary System

1. REN
2. URETER
3. VESICA URINARIA
4. URETHRA

 CAVUM PELVICUM
Composition
 Two kidney － form urin

e
 Two ureter － conduct u

rine from kidneys to bla

dder
 Bladder － receives and

stores urine
 Urethra － conducts uri

ne from bladder to exte

rior of body (discharge
d)
The Pelvic Cavity
 Bony Pelvis
 Pelvic Organs
 Reproductive System
 Kidney
General features
 Bean shaped, reddish-brow

n organs
 Superior extremity － broad

and thin
 Inferior extremity － narrow

and thick
 Anterior surface － convex

 Posterior surface － flat

 Lateral border － convex

 Medial border － concave
 Renal hilum － a vertical sl
it on the medial border of ki
dney, the structures which e
nter and leave the renal hilu
m is called renal pedicle, in
cluding the renal vein, renal
artery, renal pelvis, lymphati
c vessels and nerves
 Order of structures in the re
nal pedicle from anterior to
posterior － V. A. P.; from su
perior to inferior － A. V. P.
 Renal sinus
－ which is the renal hilum l
eads into a space within the k
idney, the renal sinus is occu
pied by the renal vessels, min
or renal calices, major renal c
alices, renal pelvis and some
adipose tissue
Structure of the kidney
 Renal cortex
 renal columns

 Renal medulla
 Renal pyramids : 15 ～ 20
 Renal papilla
 Papillary foramina
 Minor renal calices (7 － 8)
 Major real calices (2 ～ 3)
 Renal pelvis
 Polus cranialis
(=superior)

Fascia
Margo renalis
lateralis

HILUM RENALE
Enter and
leave :vasa
renalis, ureter
and saraf

Polus caudalis
(=inferior)
 About 12-20 pyramidales Cortex renalis
Consist of BASIS and
APEX PYRAMID
Papilla renalis

Pyramis renalis Calyx minor

Calyx major Pelvis renalis c.o. 2-

3 calyx major and
calyx major is
Columna renalis divided to be 7-14
Bertini calyx minor

Pelvis
Sinus renalis renalis
ureter
Urine collection
Ducts within each renal
papilla release urine
into

minor calyx

major calyx

renal pelvis

ureter
Coverings
 Fibrous capsule －
a strong fibrous capsul
e which strips easily fro
m a normal kidney surf
ace but adheres firmly t
o an organ that has bee
n inflamed
Position
 Lie behind peritoneum
one on each side of the
vertebral column high u
p on the post abdomina
l wall, upper pole neare
r to media plan than lo
wer pole
Kidney Location

Lateral to vertebral
column high on body
wall, under floating
ribs
in retro-peritoneal
position
 Fatty renal capsule － a th
ick adipose connective tissu
e capsule, surrounds the fib
rous capsule. It acts as a sh
ock absorber to protect the
kidney from jolting and jarrin
g
 Renal fascia － on outside,
surrounds both the kidney a
nd suprarenal gland, holdin
g these organs in place
 Left kidney lies at the level fro
m the lower border of T11 to L
2; the 12th rib is behind its mid
dle part of the post surface
 Right kidney lies slightly lower
than the left kidney, at the level
from the lower border of T12 to
L3; the 12th rib is behind its up
per part of the post surface
 Renal hilum at the level of L1,
is about 5cm from the posterior
median line
 Renal region － the area betw
een 12th rib and the lateral ma
rgin of erector spinae
 Relationships of kidneys
 Superiorly － suprarenal gland
 Posteriorly
 Three muscles
 Diaphragm (pleural cavity),
 Psoas major
 Quadratus lumborum
 Three nerves
 Subcostal
 Iliohypogastric
 Ilioinguinal
 Medial
 Left kidney － abdominal aorta
 Right kidney － inferior ceva van
a
 Anteriorly
 Left kidney
 Stomach (superior),
 Pancreas (middle),
 Loops of intestine and lef
t colic flexure (inferiorly)
 Right kidney
 Right lobe of liver (superi
or)
 Right colic flexure (inferi
or)
 Descending part of duod
enum (medially)
Renal segments
 The kidney is divided into fiv
e vascular segments and ea
ch is supplied by a branch o
f the renal artery; between t
he segments there is no an
astomosis.
 The segments are
 Superior segment
 Superior anterior segment
 Inferior anterior segment
 Inferior segment
 Posterior segment
Ureters
 Muscular tube, about 25cm l
ong
 Three parts
 Abdominal part － descend
on the psoas major behind t
he peritoneum
 Pelvic part － in females, pa
sses 2cm lateral to the neck
of uterus and lies below the
uterine artery
 Intramural part － passes o
bliquely through the bladder
wall for 2cm long
URETER

 Formed by smooth muscle, 25-30 cm

 Like a tube, two
 PARS ABDOMINALIS & PARS PELVICA
 Continued fromPELVIS RENALIS
 Empty to VESICA URINARIA
Three constrictions
 At the pelvoureteric junctio
n
 Where it crosses the pelvi
c inlet and iliac vessels
 Where it pierces the bladd
er wall obliquely (at intram
ural part)
Stone in ureter
Relation of abdominal part of ureter
 Anterior to left ureter
 Descending part of duodenum
 Right colic vesseles
 Iliocolic vesseles
 Testicular vesseles
 Terminal part of ileum
 Right to left ureter
 Cecum
 Vermiform appendix
 Anterior to left ureter
 Duodenojejunal flexure
 Left colic vesseles
 Testicular vesseles
Bladder

General features
 Pyramidal in shape wh

en empty, having
 Apex,
 Fundus
 Body of bladder
 Neck
VESICA URINARIA

 Connective tissue & smooth muscle

 Morfology vary regard to age, sex & volume
 There are 3 facies:

1. FACIES SUPERIOR
2. FACIES INFERO-LATERALIS
3. FACIES POSTERIOR
(=FUNDUS,=BASIS VESICAE)
 Wall of the Bladder

 Fibrous adventitia
 External
 Except on superior surface
 Muscular layer
 Detrusor Muscle
 Smooth muscle

 Inner and outer longitudinal

layers
 Middle circular layer

 Mucosa
 Distensible transitional epitheliu
m
Interior of bladder
 Mucous membrane folded, exce
pt for trigone of bladder
 Trigone of bladder － smooth tr
iangular area at inner surface of
the funds of bladder, formed by i
nternal urethral orifice anteriorly
and two ureteric orifices laerally,
in this area absents submucosal
layer, where the mucous membr
ane is firmly adherent to the mus
cular coat, and is always smooth
 Interureteric fold － muscular e
levation, between ureteric orifice
s.
Location
 In the adult, it lies in the les
ser pelvis, behind the pubic
symphysis, in front of semin
al vesicle, ampulla ductus d
eferentis and rectum in the
male, and in front of uterus
and vagina in the female.
 In the young child the empty
bladder projects above the
pelvic inlet
 Urethra

Female urethra
 Relatively short (about

5cm long), wide and str

aight
 Opens into vaginal vest

ibule
Male versus Female
Urethra

 Drains urine from bladder t

o outside
 Female = short tube
 3-4 cm or 1.5 inches
 Males = long tube
 20 cm or 8 inches
 Prostatic, Membranous, Sp
ongy (penile) urethra
 Carries sperm
Pars
membranacea

Pars prostatica

Pars spongiosa
Retroperitoneal space and content
s
 Position － it lies between t
he parietal peritoneum and t
ransvers fascia of the poste
rior abdominal wall, from dia
phragm to promontory of sa
crum, continuation with extr
aperitoneal fascia.
 Contents － kidney, suprar
enal gland, ureter, abdomin
al aorta, inferior vena cava,
nervers and lymphatics, loo
se connective tissue
Suprarenal gland
Shape and position
 Right is pyramidal in shape, left one
semilunar in shape, consisting of out
cortex and inner medulla
 Located retroperitoneally, superome
dial to superior poles of each kidney,
enclose with the kidney by the renal
fascia
Blood supply
 Arteries
 Superior suprarenal a.
 Middle suprarenal a.
 Inferior suprarenal a.
 Venous drainge
 Right suprarenal v. drains into inferior
vena cava
 Left suprarenal v. joins left renal v.
Nervers of abdomen
Lumbar plexus
 Formation: formed by a

nterior rami of L1-L3, a

part of anterior rami of
T12and L4
 Position: lies within sub

stance of psoas major

Branches
 Iliohypogastric n. Suppli
es lower part of anterior abd
ominal wall
 Ilioinguinal n. Passe
s through inguinal canal to s
upply skin of the groin and s
crotum
 Lateral femoral cutaneous
 Femoral n.
 Obturator n.
 Genitofemoral n.
Lumbar sympathetic trunk
 Made up of paired chains wi
th four to five lumbar gangli
a anterolateral to vertebral c
olumn
 Enters abdomen via the dia
phragm and as a continuati
on of he thoracic part
 Passes inferiorly behind co
mmon iliac vessels and ter
minations by joining to form
unpaired ganglion impar, an
terior to sacrum
Relations of abdominal aorta
 Anteriorly (from above down

ward)
 Pancreas
 Ascending part of duodenu
m
 Radix of mesentery
 Posteriorly
 Upper four lumber vertebra
e
 On its right
 Inferior vena cava
 On its left
 Left lumbar sympathetic tru
nk
Relations of inferior vena cava
 Anteriorly (cranially to caudally)
 Liver
 Head of pancreas
 Horizontal part of duodenum
 Right testicular (or ovarian) a.
 Radix of mesentery
 Posteriorly
 Right crus of diaphragm
 Upper four lumber vertebrae
 Left sympathetic trunk
 Parietal branches of abdominal aorta
 On its right
 Psoas major
 Right kidney
 Right suprarenal gland
 On its left
 Abdominal aorta