anatomi urinarius

8/13/2019 anatomi urinarius

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The Urinary System

Muh.Iqbal Basri

Anatomy DepartmentHasanuddin University


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1. REN

2. URETER

3. VESICA URINARIA4. URETHRA

CAVUM PELVICUM

The Urinary System


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Composition

Two kidneyform urine

Two ureterconducturine from kidneys to

bladder

Bladderreceives and

stores urine

Urethraconducts

urine from bladder to

exterior of body

(discharged)


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The Pelvic Cavity

Bony Pelvis

Pelvic Organs

Reproductive System


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Kidney

General features Bean shaped, reddish-

brown organs

Superior extremitybroad

and thin

Inferior extremitynarrow

and thick

Anterior surfaceconvex

Posterior surfaceflat

Lateral borderconvex


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Medial borderconcave

Renal hiluma vertical slit

on the medial border of

kidney, the structures whichenter and leave the renal

hilum is called renal

pedicle, including the renal

vein, renal artery, renal

pelvis, lymphatic vesselsand nerves

Order of structures in the

renal pedicle from anterior

to posteriorV. A. P.; from

superior to inferiorA. V. P.


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Renal sinus

which is the renal hilumleads into a space within the

kidney, the renal sinus is

occupied by the renal vessels,

minor renal calices, major

renal calices, renal pelvis andsome adipose tissue


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Structure of the kidney

Renal cortex

renal columns Renal medulla

Renal pyramids : 1520

Renal papilla

Papillary foramina Minor renal calices (78)

Major real calices (23)

Renal pelvis


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Polus cranialis(=superior)

Polus caudalis(=inferior)

FasciarenalisMargo

lateralis

HILUM RENALEEnter and leave

:vasa renalis,ureter and saraf


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Cortex renalis

Pyramis renalis

About 12-20 pyramidalesConsist of BASIS and

APEX PYRAMID

Papilla renalis

Calyx minor

Pelvis renalis c.o. 2-3 calyx major and

calyx major isdivided to be 7-14

calyx minor

Pelvisrenalis

ureter

Columna renalisBertini

Sinus renalis

Calyx major


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Urine collection

Ducts within each renal

papilla release urine

into

major calyx

renal pelvis

ureter

minor calyx


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Coverings

Fibrous capsule

a strong fibrous capsulewhich strips easily from

a normal kidney surface

but adheres firmly to an

organ that has beeninflamed


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Position Lie behind peritoneum

one on each side of thevertebral column high

up on the post

abdominal wall, upper

pole nearer to mediaplan than lower pole


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Kidney Location

Lateral to vertebral

column high on bodywall, under floating

ribs

in retro-peritoneal

position


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Fatty renal capsulea

thick adipose connective

tissue capsule, surroundsthe fibrous capsule. It acts

as a shock absorber to

protect the kidney from

jolting and jarring

Renal fasciaon outside,surrounds both the kidney

and suprarenal gland,

holding these organs in

place


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Left kidneylies at the level

from the lower border of T11 toL2; the 12th rib is behind itsmiddle part of the post surface

Right kidneylies slightly lowerthan the left kidney, at the levelfrom the lower border of T12 toL3; the 12th rib is behind itsupper part of the post surface

Renal hilumat the level of L1,is about 5cm from the posteriormedian line

Renal regionthe areabetween 12th rib and thelateral margin of erector spinae


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Superiorlysuprarenal gland

Posteriorly

Three muscles

Diaphragm (pleural cavity),

Psoas major

Quadratus lumborum Three nerves

Subcostal

Iliohypogastric

Ilioinguinal

Medial Left kidneyabdominal aorta

Right kidneyinferior ceva vana

Relationships of kidneys


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Anteriorly

Left kidney

Stomach (superior),

Pancreas (middle),

Loops of intestine and

left colic flexure

(inferiorly)

Right kidney

Right lobe of liver

(superior)

Right colic flexure

(inferior) Descending part of

duodenum (medially)


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Renal segments The kidney is divided into

five vascular segments and

each is supplied by a

branch of the renal artery;

between the segments

there is no anastomosis. The segments are

Superior segment

Superior anterior segment

Inferior anterior segment

Inferior segment

Posterior segment


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Ureters

Muscular tube, about 25cmlong

Three parts

Abdominal partdescend

on the psoas major behind

the peritoneum Pelvic partin females,

passes 2cm lateral to the

neck of uterus and lies

below the uterine artery

Intramural partpassesobliquely through the

bladder wall for 2cm long


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URETER

Formed by smooth muscle, 25-30 cm

Like a tube, two

PARS ABDOMINALIS & PARS PELVICA Continued fromPELVIS RENALIS

Empty to VESICA URINARIA


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Three constrictions

At the pelvoureteric

junction

Where it crosses the

pelvic inlet and iliac

vessels Where it pierces the

bladder wall obliquely (at

intramural part)


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Stone in ureter


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Relation of abdominal partof 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


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Bladder

General features

Pyramidal in shape

when empty, having

Apex, Fundus

Body of bladder

Neck


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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)


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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

epithelium


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Interior of bladder Mucous membrane folded,

except for trigone of bladder Trigone of bladdersmooth

triangular area at inner surfaceof the funds of bladder, formedby internal urethral orificeanteriorly and two ureteric

orifices laerally, in this areaabsents submucosal layer,where the mucous membrane isfirmly adherent to the muscularcoat, and is always smooth

Interureteric foldmuscularelevation, between uretericorifices.


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Location In the adult, it lies in the

lesser pelvis, behind the

pubic symphysis, in front of

seminal vesicle, ampulla

ductus deferentis and

rectum in the male, and in

front of uterus and vagina in

the female.

In the young child the empty

bladder projects above thepelvic inlet


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UrethraFemale urethra

Relatively short (about

5cm long), wide andstraight

Opens into vaginal

vestibule


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Male versus Female


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Urethra

Drains urine from bladder

to outside

Female = short tube

3-4 cm or 1.5 inches

Males = long tube

20 cm or 8 inches

Prostatic, Membranous,

Spongy (penile) urethra

Carries sperm


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Pars prostatica

Pars

membranacea

Pars spongiosa


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Retroperitoneal space and contents

Positionit lies betweenthe parietal peritoneum andtransvers fascia of theposterior abdominal wall,from diaphragm topromontory of sacrum,continuation withextraperitoneal fascia.

Contentskidney,suprarenal gland, ureter,abdominal aorta, inferior

vena cava, nervers andlymphatics, looseconnective tissue


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Suprarenal gland

Shape and position

Right is pyramidal in shape, left onesemilunar in shape, consisting of outcortex and inner medulla

Located retroperitoneally,superomedial to superior poles ofeach kidney, enclose with thekidney 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.


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Nervers of abdomen

Lumbar plexus

Formation: formed by

anterior rami of L1-L3,

a part of anterior rami

of T12and L4

Position: lies within

substance of psoas

major


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Branches Iliohypogastric n.

Supplies lower part of

anterior abdominal wall Ilioinguinal n.

Passes through inguinal

canal to supply skin of the

groin and scrotum

Lateral femoral cutaneous

Femoral n.

Obturatorn.

Genitofemoral n.


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Lumbar sympathetic trunk

Made up of paired chainswith four to five lumbarganglia anterolateral tovertebral column

Enters abdomen via thediaphragm and as acontinuation of he thoracicpart

Passes inferiorly behindcommon iliac vessels andterminations by joining toform unpaired ganglionimpar, anterior to sacrum


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Relations of abdominal aorta

Anteriorly (from above

downward)

Pancreas

Ascending part of

duodenum

Radix of mesentery

Posteriorly Upper four lumber

vertebrae

On its right

Inferior vena cava

On its left

Left lumbar sympathetic

trunk


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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

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