Introduction to Urinary System PDF - Fall 2024-2025

Medicine and Surgery Program Fall 2024-2025 BMS111 Lecture No: 9 Title: Introduction to urinary system Prof. Dr. Eman Habib Assist. Prof. Rania Galhom  1)Trace the extent of the Kidney, renal pelvis and ureters By the end of th...

Medicine and Surgery Program Fall 2024-2025 BMS111 Lecture No: 9 Title: Introduction to urinary system Prof. Dr. Eman Habib Assist. Prof. Rania Galhom  1)Trace the extent of the Kidney, renal pelvis and ureters By the end of this 2)Identify the structure of the urinary bladder and its relation lecture to function you’ll be 3)Compare between male and able to: female urethra  Urinary system Image result for kidney fascia 1- Two Kidneys 2- Two Ureter 3- Urinary Bladder 4- Urethra Main Functions of Urinary System ▪ Kidneys filter blood to keep it pure ▪ Toxins ▪ Metabolic wastes ▪ Excess water ▪ Excess ions ▪ Dispose of nitrogenous wastes from blood ▪ Urea ▪ Uric acid ▪ Creatinine ▪ Regulate the balance of water and electrolytes, acids and bases 4  KIDNEYS Site : They lie in the posterior abdominal region, immediately lateral to the vertebral column in the para vertebral gutters. it extends from vertebra T12 superiorly to vertebra L3 inferiorly, T12 L3 Vertebra Para vertebral gutter  Kidney Location : o The right kidney is positioned slightly lower than the left because of the mass of the liver. o Right kidney: reach above to the 12th rib o Left kidney reaches above to the 11th and 12th ribs. 6 Gross morphology of kidney Size: 11 x 6 x 3 cm. T12 Shape: bean shaped ✓ 2 ends ▪ Upper end L3 related to suprarenal gland ▪ Lower end ✓ 2 surfaces ▪ Anterior surface ▪ Posterior surface ✓ 2 borders ▪ lateral border : convex ▪ medial border concave 7 (containing hilum). Hilum of kidney Site where renal artery enters and renal vein and ureter leave kidney at level of L1 vertebra The structures in renal hilum from anterior to posterior: Renal vein, renal artery renal pelvis Blood supply: Through the renal vessels, that enter the kidney through its hilum in front of the pelvis of the ureter. The renal artery is a branch from the abdominal aorta the renal vein drains into the inferior vena cava. Urine drainage from kidney Minor calyx Renal pyramid Major calyx Renal pelvis ureter I. Renal Pelvis = Pelvis of Ureter: 1- It is a dilatation found in the renal sinus (central recess connected to the hilum). 2- Formed by union of 3 major calyces (cranial, middle & caudal). 3- Each major calyx is formed by union of 3-4 minor calyces. 4- Each minor calyx surrounds the renal papilla (= apex of renal pyramid). 5- At the lower pole of the kidney, the abdominal part of the ureter begins.  Imaging of the kidney Liver stomac h L1 L2 L3 L4 L5  Layers of Tissue Supporting the Kidney in position (wondering kidney, floating Renal capsule kidney): Adipose capsule = Downward displacement of renal pad of fat) kidney caused by loss of supporting fat Kidney stone (renal calculus) Produces severe colicky pain while traveling down through the ureter from kidney to bladder. Common s i gns of k idney stones include nausea and vomiting, urinary frequency and urgency and pain during urination. Renal cell tumors can grow outwards from the kidney invading the fat. In addition, the tumor may spread along the renal vein and into the inferior vena cava, this venous extension is rare for any other type of tumor so when seen renal cell carcinoma should be suspected. classification | eau patient information, Human Body THE URETER 16  THE URETER A 25 – 30 cm long muscular tube Begins as a continuation of renal pelvis. transporting urine from kidney to urinary bladder. In the Abdomen: it Lies along the tip of transverse processes L2 - L5 Vertebrae Parts of ureter 1 2 3 ❑ Intramural part ▪ It is the narrowest part of the whole ureter. ▪ Passes obliquely through the wall of bladder for about ¾ inch before opening into the bladder cavity. The muscular wall of UB exerts a sort of sphincter- like action upon the ureter. Prof. Khaled Naiem Post. Surface Markings Represented by a vertical line from: from Site of hilum L2 To : PSIS dimple at level of S2.  The urinary bladder The urinary bladder is a hollow viscus with strong muscular walls It varies in size and characterized by its distensibility It act as a temporary reservoir for urine Position of urinary bladder It lies in the lower and anterior part of the lesser (true) pelvis 22 Shape: 3 sided pyramid: 1.Apex lies anteriorly behind symphysis pubis 2.Base is directed posteriorly 3.Superior surface is directed upward 4.Neck is directed inferiorly & surrounds the origin of the urethra 5.2 lateral surfaces are related to pelvic walls ❑ Position of urinary bladder : An empty bladder in adult lies almost in pelvis, its superior surface level with the superior margin of the pubic symphysis. The distended bladder rises upwards into the abdomen to the anterior abdominal wall and may reach the level of umbilicus  Suprapubic Cystotomy Related image ❑ suprapubic cystotomy : surgical approach to urinary bladder for introduction of catheters or instruments by punctured anterior abdominal wall, superior to the symphysis pubic without traversing peritoneum Relations of the urinary bladder  Differences between male and female urinary bladder Male Female related to was deferens and seminal Base related to cervix the of uterus and vagina vesicles Neck rests on the prostate gland continuous with female urethra Superior surface related to the loops of intestine related to the fundus and body of uterus _  THE URETHRA It is a canal that conveys the urine to the outside In Females: In Males: it lies behind the symphysis it extends from the neck of pubis & opens just anterior to the bladder to the external the vaginal orifice.Its length is meatus on the glans penis. about 4 cm. Urethra 1 vagina 2 3  Male urethra ▪ 20 cm long ▪ it extends from the neck of the bladder to the external meatus on the glans penis. ▪ has 3 parts: ✓ Prostatic urethra (widest part), 3-4 cm, within prostate. ✓ Membranous urethra (narrowest part), 1-2 cm. ✓ Penile urethra (longest part), 15 cm, within penis. 29 30  Male & female urethra Male urethra Female urethra ▪ Longer (16 cm) ▪ Short (4cm) ▪ Curved, S-shaped. ▪ Straight. ▪ 4 parts: pre-prostatic, ▪ No parts prostatic, membranous and penile urethra. ▪ More liable to transmit ▪ Less liable to transmit infection and cause infection urinary tract infection. 31 3- The renal hilum lies on the __________ of the kidney. A.Lateral border B.Inferior end C.Superior pole D.Medial border E.Anterior surface 4- The urinary bladder has openings to the: A. Nephron and kidney B.Urethra and ureters C.Urinary meatus and glomerulus D.Renal vein and loop of Henle E. Suprarenal gland In the opposite 1 intravenous urography define the following 2 structures 3 Renal pelvis (--) 4 Renal calyces (--) Abdominal ureter (--) 5 Pelvic ureter (---) Urinary bladder (---) A 70 years old male presented to the outpatient clinic suffering from increase frequency of urination at night and difficulty of urinating. After performing certain investigations, he was diagnosed to have benign prostatic hypertrophy. Based on your anatomical knowledge choose the correct statement: A- Theprostate is located posterior to the base of male urinary bladder. B- The prostate is located inferior to the neck of the male urinary bladder. C- The prostate is related to the apex of the male urinary bladder. D- The prostate is related to the back of the trigon.