URINARY ORGANS

Dr.Tri Suciati, M. Kes

Suprarenal Gland

Part of endocrine system,

Retroperitoneal viscera
Separated to kidney by fascial septum
located superomedially to the kidneys
attached primarily to the
diaphragmatic crura by the
surrounding renal fascia.
suprarenal cortex and suprarenal
medulla (the latter surrounded by the
former).
the suprarenal cortex derives from
mesoderm and secretes
corticosteroids and androgens;
the suprarenal medulla derives from
neural crest cells and secretes
catecholamines (mostly epinephrine).
The right suprarenal gland is more
pyramidal in shape and apical in
position relative to the right kidney,
whereas the left gland is more
crescentic and lies more medial to the
superior half of the kidney.

Suprarenal arteries and

vein
Arise from three sources:

superior suprarenal arteries from the inferior

phrenic arteries,
middle suprarenal arteries from the
abdominal aorta, and

inferior suprarenal arteries from the renal

arteries.
The suprarenal glands drain via:
one large suprarenal vein, the right entering the
IVC and the left entering the left renal vein.

Organs
of the
Urinary
Syste
m

kidneys
ureters
urinary
bladder
urethra

Urinary bladder provides a temporary storage reservoir

for urine

Paired ureters transport urine from the kidneys to the

bladder

Urethra transports urine from the bladder out of the body

Kidney Functions
5

Filter 200 liters of blood daily, allowing toxins, metabolic

wastes, and excess ions to leave the body in urine

Regulate volume and chemical makeup of the blood

Maintain the proper balance between water and salts, and

acids and bases

Gluconeogenesis during prolonged fasting

Production of rennin to help regulate blood pressure and

erythropoietin to stimulate RBC production

Activation of vitamin D

Layers of Tissue Supporting the Kidney

6

Renal capsule fibrous capsule that prevents kidney infection

Adipose capsule fatty mass that cushions the kidney and helps attach it to the
body wall

Renal fascia outer layer of dense fibrous connective tissue that anchors the kidney

Kidney Location and External

Anatomy

The bean-shaped kidneys lie in a

retroperitoneal position in the superior lumbar
region and extend from the twelfth thoracic to
the third lumbar vertebrae
The right kidney is lower than the left because it
is crowded by the liver
The lateral surface is convex and the medial
surface is concave, with a vertical cleft called the
renal hilus leading to the renal sinus
Ureters, renal blood vessels, lymphatics, and
nerves enter and exit at the hilus

Kidney Location and

External Anatomy

Figure 25.2a

Kidney

renal pelvis is the flattened, funnel-shaped

expansion of the superior end of the ureter
The apex of the renal pelvis is
continuous with the ureter.
The renal pelvis receives two or three
major calices (calyces), each of which
divides into two or three minor calices.
Each minor calyx is indented by a renal
papilla, the apex of the renal pyramid, from
which the urine is excreted.
In living persons, the renal pelvis and its
calices are usually collapsed (empty).

Internal Anatomy
10

A frontal section shows three distinct

regions

Cortex the light colored, granular

superficial region
Medulla exhibits cone-shaped medullary
(renal) pyramids
Pyramids

are made up of parallel bundles of

urine-collecting tubules
Renal columns are inward extensions of cortical
tissue that separate the pyramids
The medullary pyramid and its surrounding
capsule constitute a lobe

Internal Anatomy
11

Renal pelvis flat, funnel-shaped tube

lateral to the hilus within the renal sinus
Major calyces large branches of the
renal pelvis

Collect urine draining from papillae

Empty urine into the pelvis

Urine flows through the pelvis and

ureters to the bladder

Blood and Nerve Supply

13

Approximately one-fourth (1200 ml) of

systemic cardiac output flows through the
kidneys each minute
Arterial flow into and venous flow out of the
kidneys follow similar paths
The nerve supply is via the renal plexus

Renal Arteries and Vein &

Lymphatic

The renal arteries arise from the abdominal aorta at

the level of the L1-L2 IV disc. They lie anterior to the
renal veins, with the right renal artery being longer
than the left, and the left renal vein being longer than
the right.
Both renal veins receive renal and superior ureteric veins
and drain into the IVC, but the long left vein also receives
the left suprarenal vein, the left gonadal vein, and a
communication with the left ascending lumbar vein.
Near the hilum, the renal arteries divide into anterior
and posterior branches, the anterior branches giving rise
to four segmental renal arteries.
Lymphatics from the suprarenal glands, kidneys, and
upper ureters follow the venous drainage to the right or
left lumbar (caval or aortic) lymph nodes.

Neuron of kidney

Visceral afferent fibers (accompanying

the sympathetic fibers) conduct pain
sensation from the ureters to spinal cord
segments T11-L2, with sensation referred
to the corresponding dermatomes
overlying the loin and groin.
The suprarenal glands receive a rich nerve
supply via presynaptic sympathetic
fibers originating of the T10-L1 spinal cord
segments.

The Nephron
16

Nephrons are the structural and functional units that

form urine, consisting of:
Glomerulus a tuft of capillaries associated with a
renal tubule
Glomerular (Bowmans) capsule blind, cupshaped end of a renal tubule that completely
surrounds the glomerulus
Renal corpuscle the glomerulus and its Bowmans
capsule
Glomerular endothelium fenestrated epithelium
that allows solute-rich, virtually protein-free filtrate
to pass from the blood into the glomerular capsule

Nephron

CORPUSCULUM RENALIS

GLOMERULUS

CAPSULA BOWMAN

NEPHRON

TUBULUS RENALIS

TUBULUS CONTORTUS PROX

LOOP OF HENLE
TUBULUS CONVULATED DIST

Corpusculum
renalis

Merupakan unit filtrasi

plasma darah dari nephron
2 kutub : polus vascularis,
polus urinalis
Mengandung glomerulus
sistim kapiler yg
dirangkai o/ arteriole
afferen dan efferen
Diliputi oleh lamina
visceralis capsula
Bowmani, sel disebut
Podosit`
Podosit mempunyai badan
sel ,dimana akan timbul
processus primer,
secunder (pedicle)

Filtration Membrane
19

Anatomy glomerular capsule

Filter that lies between the blood and

the interior of the glomerular capsule

It is composed of three layers

Fenestrated endothelium of the

glomerular capillaries

Visceral membrane of the

glomerular capsule (podocytes)

Basement membrane composed

of fused basal laminae of the
other layers

The external parietal layer is a

structural layer

The visceral layer consists of

modified, branching epithelial
podocytes

Extensions of the octopus-like

podocytes terminate in foot
processes

Filtration slits openings

between the foot processes that
allow filtrate to pass into the
capsular space

Filtration Membrane
20

Figure 25.7a

Renal Tubule
21

Proximal convoluted tubule (PCT) composed of

cuboidal cells with numerous microvilli and mitochondria
Reabsorbs water and solutes from filtrate and secretes
substances into it

Loop of Henle a hairpin-shaped loop of the renal tubule

Proximal part is similar to the proximal convoluted tubule
Proximal part is followed by the thin segment (simple
squamous cells) and the thick segment (cuboidal to
columnar cells)

Distal convoluted tubule (DCT) cuboidal cells without

microvilli that function more in secretion than reabsorption

Renal Tubule
22

Chapter 25: Urinary System

Figure 25.4b

Connecting Tubules
23

The distal portion of the distal convoluted

tubule nearer to the collecting ducts
Two important cell types are found here

Intercalated cells
Cuboidal

cells with microvilli

Function in maintaining the acid-base balance of
the body

Principal cells
Cuboidal

cells without microvilli

Help maintain the bodys water and salt balance

URINALYSIS

25

Mechanisms of Urine
Formation

The kidneys filter the bodys entire

plasma volume 60 times each day
The filtrate:

Contains all plasma components except

protein
Loses water, nutrients, and essential ions to
become urine

The urine contains metabolic wastes and

unneeded substances

26

Physical Characteristics of
Urine

Color and transparency

pH

Clear, pale to deep yellow (due

to urochrome)

Concentrated urine has a

deeper yellow color

Slightly acidic (pH 6) with

a range of 4.5 to 8.0

Diet can alter pH

Drugs, vitamin supplements,

and diet can change the color
of urine

Cloudy urine may indicate

infection of the urinary tract
Odor

Fresh urine is slightly aromatic

Standing urine develops an

ammonia odor

Some drugs and vegetables

(asparagus) alter the usual odor

Specific gravity

Ranges from 1.001 to

1.035

Is dependent on solute
concentration

27

Chemical Composition of
Urine

Urine is 95% water and 5% solutes

Nitrogenous wastes include urea, uric acid,
and creatinine
Other normal solutes include:

Sodium, potassium, phosphate, and sulfate

ions
Calcium, magnesium, and bicarbonate ions

Abnormally high concentrations of any

urinary constituents may indicate pathology

Diuretics
28

Osmotic diuretics include:

High glucose levels carries water out with

the glucose
Alcohol inhibits the release of ADH
Caffeine and most diuretic drugs inhibit
sodium ion reabsorption
Lasix and Diuril inhibit Na+-associated
symporters

Ureters
29

Slender tubes that convey urine from the kidneys to the

bladder

Ureters enter the base of the bladder through the posterior

wall
This closes their distal ends as bladder pressure
increases and prevents backflow of urine into the ureters

Ureters have a trilayered wall

Transitional epithelial mucosa
Smooth muscle muscularis
Fibrous connective tissue adventitia

Ureters actively propel urine to the bladder via response to

smooth muscle stretch

Ureter

The ureters are muscular ducts (25-30 cm

long) with narrow lumina that carry urine
from the kidneys to the urinary bladder
They run inferiorly from the apices of the
renal pelves at the hila of the kidneys,
passing over the pelvic brim at the
bifurcation of the common iliac arteries.
They then run along the lateral wall of the
pelvis and enter the urinary bladder.

Ureters
31

Transport urin dr pelvis

renalis ke v. urinaria
Dipengaruhi o/ kontraksi
peristaltik, tekanan
hidrostatik, &gravitasi
3 penyempitan;
ureteropelvic junction,
a.iliaca communis, dinding
v.u
Inervasi;renal, aortic,
hipogastric superior &
inferior
Nyeri; illiac crest, regio
pubis, scrotum, labia mayora

Urinary Bladder
32

Smooth, collapsible, muscular sac that

temporarily stores urine
It lies retroperitoneally on the pelvic floor
posterior to the pubic symphysis

Males prostate gland surrounds the neck

inferiorly
Females anterior to the vagina and uterus

Trigone triangular area outlined by

the openings for the ureters and the
urethra

Clinically important because infections tend

to persist in this region

Urinary Bladder
34

The bladder wall has three layers

Transitional epithelial mucosa

A thick muscular layer
A fibrous adventitia

The bladder is distensible and collapses

when empty
As urine accumulates, the bladder
expands without significant rise in
internal pressure

Urinary Bladder
35

Chapter 25: Urinary System

Figure 25.18a,
b

Urethra
36

Muscular tube that:

Drains urine from the bladder
Conveys it out of the body
Sphincters keep the urethra closed when urine is not being
passed
Internal urethral sphincter involuntary sphincter at
the bladder-urethra junction
External urethral sphincter voluntary sphincter
surrounding the urethra as it passes through the
urogenital diaphragm
Levator ani muscle voluntary urethral sphincter

Chapter 25: Urinary System

Urethra
37

The female urethra is tightly bound to the

anterior vaginal wall
Its external opening lies anterior to the vaginal
opening and posterior to the clitoris
The male urethra has three named regions

Prostatic urethra runs within the prostate gland

Membranous urethra runs through the
urogenital diaphragm
Spongy (penile) urethra passes through the
penis and opens via the external urethral orifice

Uretra

Micturisi

40

Micturition (Voiding or
Urination)

The act of emptying the bladder

Distension of bladder walls initiates spinal
reflexes that:
Stimulate contraction of the external urethral
sphincter
Inhibit the detrusor muscle and internal
sphincter (temporarily)
Voiding reflexes:
Stimulate the detrusor muscle to contract
Inhibit the internal and external sphincters

41

Micturition (Voiding or
Urination)

Chapter 25: Urinary System

Figure 25.20a,

Developmental Aspects
42

Infants have small bladders and the kidneys

cannot concentrate urine, resulting in
frequent micturition
Control of the voluntary urethral sphincter
develops with the nervous system
E. coli bacteria account for 80% of all urinary
tract infections
Sexually transmitted diseases can also
inflame the urinary tract
Kidney function declines with age, with many
elderly becoming incontinent