Structure and Function of the Kidney and Ureters PDF

Structure and Function of the Kidney and Ureters Prof Peter Bazira Learning outcomes Describe the position and functional anatomy of the kidneys and ureters. Describe important anatomical relations of the kidneys to other abdominal and pelvic structures. Discuss the clinical significance of renal an...

Structure and Function of the Kidney and Ureters Prof Peter Bazira Learning outcomes Describe the position and functional anatomy of the kidneys and ureters. Describe important anatomical relations of the kidneys to other abdominal and pelvic structures. Discuss the clinical significance of renal and ureteric anatomy in relation to urinary stones. Describe the anatomy and embryology of the renal and urinary tract (Block outcome) Urinary tract (renal system) Overview Kidneys, ureters, urinary bladder, urethra, and related structures Filtration of metabolic waste and other similar waste substances from the blood stream. Divisions – descriptive Upper urinary tract = Kidneys and ureters Lower urinary tract = Urinary bladder and urethra Development Development Development Kidneys Anatomical location Retroperitoneal ~ 12 cm x 6 cm x 3 cm T12 to L3 vertebral levels Renal hilum opens anteromedially towards abdominal aorta (not directly medially) Perinephric fat, renal fascia, paranephric fat Right slightly lower than left Note the muscular bed – psoas major, transversus abdominis, quadratus lumborum, and the diaphragm Kidneys Anatomical coverings smooth fibrous renal capsule perinephric fat, renal fascia, and paranephric fat Kidneys Anatomical relations – posterior muscular bed – psoas major medially, transversus abdominis laterally, quadratus lumborum posteriorly, and diaphragm superiorly costodiaphragmatic pleural recess & lower ribs Subcostal neurovascular structures + iliohypogastric & ilioinguinal nerves. Kidneys Anterior relations – left Splenic flexure of the colon Body of the pancreas + splenic vessels Left suprarenal gland Medial surface of the spleen Posterior surface of the gastric fundus *part of stomach bed* Kidneys Anterior relations – right Duodenum, D2, adjacent the hilum. Hepatic flexure of the colon Right suprarenal gland (base) Hepatorenal pouch (of Morison) of peritoneal cavity Kidneys Blood supply Kidneys Blood supply Kidneys Kidneys Internal anatomy & function overview Nephrons: renal functional units Renal corpuscle and renal tubule For a detailed treatise on renal function, including glomerular function, tubular function, and acidbase balance, see recorded lectures by Dr Ahmed Aburima Kidneys Innervation sympathetic from aorticorenal ganglia – Coeliac ganglia derivative sympathetic NS regulates blood flow and renin release – influencing blood pressure and overall kidney function. renal artery stenosis – renal ischemia – negatively impacts kidney function and blood pressure regulation. Ureters Location renal pelvis to posterior bladder wall ~ 25 – 30cm 3 anatomical segments Ureters Structure muscular wall with spirally arranged fibres inner longitudinal and outer circular with third outer longitudinal layer (of Waldeyer) near urinary bladder 1. 2. 3. 4. 5. 6. 7. 8. mucosa smooth muscle layers adventitia mesoureter vasculature adventitial vascular plexus perforating arteries mucosal vascular plexus Ureters Location + Blood supply renal pelvis to posterior bladder wall muscular peristaltic tubes (smooth, bilayer) that connect the kidneys to the urinary bladder. peristaltic movement for urine transport transitional (urinary) epithelium Ureters Location + Relations Abdominal descent along psoas major crossing the pelvic brim near the iliac vessels Pelvic relations to pelvic brim and iliac vessels proximity to reproductive organs (e.g., uterus, ovaries, prostate) Ureters Innervation sympathetic (1) – vasomotor and parasympathetic sympathetic (T12-L1) via coeliac+renal ganglia Afferents accompany sympathetics (*pain distribution) parasympathetic via pelvic splanchnics Kidneys & Ureters Lymphatic drainage Ureters Constrictions + calculi Learning outcomes Describe the position and functional anatomy of the kidneys and ureters. Describe important anatomical relations of the kidneys to other abdominal and pelvic structures. Discuss the clinical significance of renal and ureteric anatomy in relation to urinary stones. Describe the anatomy and embryology of the renal and urinary tract (Block outcome) PLEASE GET IN TOUCH If you are interested in working with Hull York Medical School in the future, please get in touch Professor Peter Bazira E: [email protected] or [email protected] #HYMS20