7.

1
THE KIDNEYS
 Learning Objectives
Structure and Function of the
Urinary System
(Slide 1 of 2)
1. List the major organs of the urinary system.
2. Locate or position the kidneys in the abdominal
cavity and identify the gross internal structures
visible in a coronal section.
3. Describe the renal blood supply and trace blood
flow through the specialized vessels of the kidney.
4. Discuss and compare the structure and the
functions of the ureters, urinary bladder, and
urethra.
2
 Learning Objectives
Structure and Function of the
Urinary System
(Slide 2 of 2)
5.Explain the mechanism for micturition
(urination).
6.Name the parts of a nephron and describe the
role of each component in the formation of
urine.

3
 LEARNING OBJECTIVES

List the functions of the kidneys.

Label a diagram of the kidney including:

renal hilum, renal artery, renal vein, ureter, renal pelvis,
renal sinus, cortex, capsule, renal columns, renal
medulla, medullary pyramids, renal papilla, major & minor
calyces.
 LEARNING OBJECTIVES
Label a diagram of the nephron including:
cortical nephrons, juxtamedullary nephron, glomerulus,
peritubular capillaries, vasa recta, Bowman’s capsule,
proximal convoluted tubule, loop of Henle, distal
convoluted tubule, collecting duct.

Label diagrams of the histological structure of the

glomerulus, Bowman’s capsule, proximal convoluted
tubule, loop of Henle, distal convoluted tubule,
collecting duct and ureters.
 KIDNEY FUNCTIONS

• Process of filtration of most small molecules from blood

plasma to form a filtrate
• reabsorption of most of the water and some other
molecules
• secretion of filtered substances such as urea

• Main structures of the urinary system:

• kidneys
• ureters
• bladder
• urethra
Urinary System overview
 Location and External Anatomy
of Kidneys
• Location
• External Anatomy
• Lie behind peritoneum on
posterior abdominal wall • Renal capsule
on either side of vertebral
• Surrounds each kidney
column
• Perirenal fat
• Lie on either side of the
vertebral column between • Engulfs renal capsule and acts as
T12 and L3 cushioning and source of energy

• Lumbar vertebrae and rib • Renal fascia

cage partially protect
• Anchors kidneys to abdominal
• Right kidney slightly lower wall, separates from abdomen
than left
• Hilum

• Renal artery and nerves enter and26-8

renal vein and ureter exit kidneys
 Kidney’s in situ
Located retroperitoneal
Embedded in perirenal fat
capsule
Location of Urinary System Organs
(Slide 2 of 2)

B: From Abrahams P, Marks S, Hutchings R: McMinn’s color atlas of human anatomy, ed 5, Philadelphia, 2003, Mosby.
11
 KIDNEY STRUCTURE
• Bean shaped
• Fibrous capsule
• Superior & inferior pole
• Renal hilum / pelvis - connects
– renal artery
– renal vein
– Lymph
– nerves
• renal sinus
 KIDNEY STRUCTURE
Renal Cortex
• Fibrous capsule
• Outer most layer

Renal Medulla – divided by

• medullary pyramids (n~10-18)
• Renal columns

• Minor / Major calyx

• Renal Pelvis
• Ureter
 The NEPHRON
• Smallest functional unit of kidney
• 1-4 million in each kidney
• cortical nephrons (85% of nephrons, located primarily in cortex)
• juxtamedullary nephron (located mainly medulla, important for
producing concentrated urine)

M
NEPHRON

BC
PCT DCT C
M
CD

LoH
 ARTERIES OF POSTERIOR WALL
Abdominal Aorta
Distribution Artery Level
Alimentary tract  Celiac T12
(unpaired)  Superior mesenteric L1
 Inferior mesenteric L3
Urogenital &  Suprarenal L1
endocrine glands  Renal L1
(paired)  Gonadal L2
Diaphragm & body  Subcostal* L2
wall (paired &  Inferior phrenic T12
segmental)  Lumbar L1-L4
Lower Limb (paired)  Common iliac L4
Unpaired and paired blood vessels
Inferior phrenic a
Celiac T

Middle suprarenal a

Superior mesenteric a
Renal a
Lumbar a 1-4
Gonadal a
inferiorior mesenteric a

Median sacral s
 RENAL ARTERIES / Veins
Arterial supply
•renal arteries

•from abdominal aorta

Venous drainage
•renal veins

•into IVC
Arterial Blood supply – adrenal gland
 RENAL LYMPH VESSELS
Lymph drainage
• lymph nodes
 RENAL NERVES
Nerves to renal plexus

• Parasympathetic - vagus (CN

X) to bladder only – there is no
evidence of parasympathetic
innovation of the kidney

• Sympathetic - splanchnic
nerves – to both kidney and
bladder
Nerve innervation
Sympathetic innovation is
both afferent and efferent

No evidence of
parasympathetic
innovation

The effect of sympathetic

innovation is to regulate
blood flow – to reduce
blood flow
 Ureters and Urinary Bladder

• Ureters
– Tubes through which • Urethra
urine flows from – Transports urine from
kidneys to urinary
bladder to outside of body
bladder
– Difference in length
between males and
• Urinary bladder females
– Stores urine – Sphincters
• Internal urinary
• External urinary

26-26
Female Urinary : Ureter, Bladder, Urethra
 Ureters
• Two ureters. These narrow tubes carry urine
from the kidneys to the bladder. Muscles in
the ureter walls continually tighten and relax
forcing urine downward, away from the
kidneys. If urine backs up, or is allowed to
stand still, a kidney infection can develop.
About every 10 to 15 seconds, small amounts
of urine are emptied into the bladder from the
ureters.
 URETERS
• muscular tubes (~30cm) conduct urine from kidneys to bladder
by peristaltic action
• wall of ureter consists of transitional epithelium, smooth muscle
& adventitia
 Bladder
• This triangle-shaped, hollow organ is located in the lower abdomen. It is held in place by
ligaments that are attached to other organs and the pelvic bones. The bladder's walls relax
and expand to store urine, and contract and flatten to empty urine through the urethra. The
typical healthy adult bladder can store up to 300ml of urine for two to five hours.

• Upon examination, specific "landmarks" are used to describe the location of any irregularities
in the bladder. These are:

• Trigone: a triangle-shaped region near the junction of the urethra and the bladder

• Right and left lateral walls: walls on either side of the trigone

• Posterior wall: back wall

• Dome: roof of the bladder

 The bladder
• Two sphincter muscles. These circular muscles help keep urine from
leaking out by closing tightly like a rubber band around the opening of the
bladder/urethra.

• The nerves alert a person when it is time to urinate, or empty the bladder.

• Urethra. This tube allows urine to pass outside the body. The brain signals
the bladder muscles to tighten, which squeezes urine out of the bladder.
At the same time, the brain signals the sphincter muscles to relax to let
urine exit the bladder through the urethra. When all the signals occur in
the correct order, normal urination occurs.

• The bladder is continuous with the ureters & urethra.

 The bladder
• It has a peritoneal covering on its superior surface and is considered an
infraperitoneal organ

• It has a muscle in its wall call the detrusor muscle which is a smooth muscle
innervated by the parasympathetic & sympathetic nervous systems
– Parasympathetic – during urination/micturition the detrusor CONTRACTS to empty the
bladder
– Sympathetic – all other times the detrusor is RELAXED via sympathetic branches to allow
the bladder to fill

• The detrusor muscle thickens to form the internal urethral sphincter in both
males & females & becomes continuous with the urethra

• Pudendal nerves (somatic) control external urethral sphincter & pelvic floor
muscles
Female Urinary : Ureter, Bladder, Urethra
Female Urinary : Ureter, Bladder, Urethra
Female Urinary : Ureter, Bladder, Urethra
Female Urinary : Ureter, Bladder, Urethra
Male Urinary : Bladder, Urethra
Male Urinary : Ureter, Bladder,
Urethra
Male Urinary : Bladder, Prostate, Urethra
Male Urinary : Bladder, Urethra, Prostate
 The bladder
• Two sphincter muscles. These circular muscles help keep urine from
leaking out by closing tightly like a rubber band around the opening of the
bladder.

• The nerves alert a person when it is time to urinate, or empty the bladder.

• Urethra. This tube allows urine to pass outside the body. The brain signals
the bladder muscles to tighten, which squeezes urine out of the bladder.
At the same time, the brain signals the sphincter muscles to relax to let
urine exit the bladder through the urethra. When all the signals occur in
the correct order, normal urination occurs.
Male Urinary : Bladder, Urethra
 Somatic – S2-S4 external urethral sphincter - skeletal muscle

1. Sympathetics – relax detrusor & close Internal urethral sphincter

2. Parasympathetics – contract detrusor & open internal urethral sphincter
 SUMMARY
• Kidney filters blood.
Absorbs water and some electrolytes
Removes waste products (eg urea)
Regulates blood pressure and RBC production

• Parts of the kidney

Superficial cortex, deep medulla containing pyramids

• A nephron is the functional unit of the kidney where

filtration of blood and reabsorption/excretion of
substances occurs
 Further reading
• The kidneys are situated behind the peritoneum on each side of the vertebral column. In man, the top
(upper pole) of each kidney is at the level of the twelfth thoracic vertebra and the bottom (lower pole) is
at the level of the third lumbar vertebra. Each kidney is about 12 cm long and weighs about 150 g.
• On the medial surface of each kidney (the concave surface) is a slit, the hilus, through which pass the renal
artery and vein, the lymphatics, the renal nerve and the renal pelvis, which is the funnel-shaped upper end
of the ureter.
• The blood supply to each kidney is usually a single renal artery arising from the abdominal aorta. However,
there may sometimes be additional small vessels from superior mesenteric, adrenal, spermatic or ovarian
arteries.
• If a kidney is bisected from top to bottom, the cut surface shows two distinct regions, a dark outer region,
the cortex and a paler inner region, the medulla, which is further divided into a number of conical areas,
the renal pyramids. The apex of each pyramid extends towards the renal pelvis, forming a papilla. Some
animal species have only one pyramid (and papilla) in each kidney. Striations can be seen on the renal
pyramids. These are medullary rays, which are attributed to the straight tubular elements (collecting ducts
and loops of Henle) and blood vessels (vasa recta) in this region.
Autonomic nervous system:

Sympathetic NS:
A. Thoracic splanchnic N
1. Greater splanchnic N
2. Lesser splanchnic N
3. Least splanchnic N
B. Lumbar splanchnic
C. Sacral splanchnic N