Urology Module Semester 4 Quiz

Urology Module - Semester 4

• Lecture name: Anatomy of the Urinary System

• Lecturer: Dr. Salam Abdulameer Almosawi

• Credentials: F.I.C.M.S.(URO)

• Contact: [email protected]

Objectives

• Understand the gross structure of the urinary system in both males and females
• Learn the overall functions of the urinary system
• Identify the anatomical position of the kidneys, ureters, bladder, and prostate, along with their relationships
• Detail the blood supply, venous drainage, and lymphatics of the urinary system

Anatomy of the Urinary System

• The urinary system consists of:
  • Kidneys
  • Ureters
  • Bladder
  • Urethra

The Kidneys

• Bean-shaped, retroperitoneal, located on either side of the vertebral column
• Extend from T12 to L3
• Right kidney typically positioned slightly more caudally
• Dimensions: approximately 11-12 cm in length, 5-7.5 cm in width, and 2.5-3.0 cm in thickness.
• Surrounded by:
  • Tough fibrous capsule
  • Perirenal fat
  • Gerotas fascia
  • Para-renal fat
• Functional unit: nephron
• Nephron structure: glomerulus, renal tubule, and collecting duct
• Filtration:
  • Occurs in specialized leaky capillaries (glomeruli) within the kidney cortex.
  • High pressure in glomeruli forces water and small molecules out of the plasma at a rate of 125 ml/min or 180 L per day, known as glomerular filtration rate (GFR).

Blood Supply of the Kidneys

• Usually supplied by a single renal artery branching from the abdominal aorta at the level of L1.
• Accessory renal arteries are sometimes present.
• Renal artery enters the kidney through the hilum, typically dividing into anterior and posterior branches.
• Abnormal arterial supply can originate from the superior mesenteric, suprarenal, testicular or ovarian arteries.

Relationships of the Kidneys

• Right Kidney:
  • Superior: adrenal gland, liver
  • Posterior: posterior abdominal wall (psoas major muscle)
  • Anterior: liver, adrenal gland, duodenum, and colon
• Left Kidney:
  • Superior: adrenal gland, spleen
  • Posterior: posterior abdominal wall (psoas major muscle)
  • Anterior: adrenal gland, spleen, stomach, pancreas, small bowel and colon

The Ureters

• Originate from the renal pelvis
• Length: 25-30 cm in adults
• Course:
  • In abdomen, runs along anterior aspect of transverse processes of lumbar vertebrae
  • Crosses pelvic brim at the sacroiliac joint, anterior to the bifurcation of common iliac artery
  • Runs posterolaterally along bladder wall before entering the bladder obliquely
• Male: passes under vas deferens, superiorly to seminal vesicle
• Female: descends posterior to ovary and into the broad ligament, passing under the uterine artery.

Blood Supply of the Ureters

• The upper part is supplied by renal arteries.
• The middle and lower parts are supplied by common iliac and internal iliac arteries.
• The lower part receives blood from uterine (female) or inferior vesical (male) arteries.
• Corresponding veins drain the ureters.

The Bladder

• Position: posterior to pubic bones and symphysis.
• Shape: empty - lies entirely within true pelvic cavity. Full – becomes spherical and can reach above the umbilicus
• Surfaces:
  • Base (posterior surface)
  • One superior surface
  • Two anterolateral surfaces
• Trigone (internal structure): triangular area defined internally by two ureteric openings and the internal urethral opening, including the interureteric ridge
• Neck: area where the base and inferolateral surfaces meet, inferiorly

The Urethra

• Female: 4-5 cm long, straight
• Male: 20 cm long, divided into
  • Posterior part (5 cm): prostatic and membranous
  • Anterior part (15 cm): bulbus and penile