Urinary system

Chapter # 5
 Introduction
• Urinary system is primarily concerned with:
• removal of nitrogenous wastes from body
• kidneys maintain electrolyte, acid-base and fluid
balances of blood
• waste products leave kidneys as urine - which passes
down ureters to urinary bladder
• urine leaves body in urethra

• Urinary system consists of:

• Kidneys
• Ureters
• Urinary bladder
 Kidneys
• Location and Description
• reddish brown and lie behind peritoneum high up
on posterior abdominal wall on either side of
vertebral column
• largely under cover of costal margin
• right kidney lies slightly lower than left kidney
because of large size of right lobe of liver

• on medial concave border - vertical slit that is

bounded by thick lips of renal substance and is
called hilum
• hilum extends into large cavity - renal sinus
• hilum contains - renal vein, three branches of
renal artery, ureter, lymph vessels, sympathetic
fibers

• Coverings
• kidneys have following coverings
• Fibrous capsule: surrounds kidney and is closely
applied to its outer surface
• Perirenal fat: covers fibrous capsule
• Renal fascia: condensation of connective tissue
that lies outside perirenal fat and encloses kidneys
and suprarenal glands;
• Pararenal fat: lies external to renal fascia and is
often in large quantity
• forms part of retroperitoneal fat

• perirenal fat, renal fascia, and pararenal fat support

kidneys and hold them in position on posterior
abdominal wall

• Renal Structure
• each kidney has dark brown outer cortex
• & light brown inner medulla
• medulla - composed of about dozen renal
pyramids;
• each having its base oriented toward cortex and its apex,
renal papilla, projecting medially

• cortex extends into medulla b/w adjacent pyramids

as renal columns

• extending from bases of renal pyramids into cortex

are striations - medullary rays

• renal sinus – contains upper expanded end of

ureter, renal pelvis
• divides into two or three major calyces, each of which
divides into two or three minor calyces
• each minor calyx is indented by apex of renal pyramid,
renal papilla
• Important Relations
• Right Kidney
• Anteriorly: suprarenal gland, liver, second part
of duodenum, right colic flexure
• Posteriorly: diaphragm, 12th rib, psoas

• Left Kidney
• Anteriorly: suprarenal gland, spleen, stomach,
pancreas, left colic flexure, coils of jejunum
• Posteriorly: diaphragm, 11th and 12th ribs,
psoas
• Blood Supply
• Arteries
• renal artery - usually divides into five segmental
arteries that enter hilum of kidney
• distributed to different areas of kidney
• lobar arteries arise from each segmental artery,
one for each renal pyramid
• each lobar artery gives off 2 or 3 interlobar arteries
• at junction of cortex & medulla - interlobar arteries
give off arcuate arteries
• which arch over bases of pyramids
• Veins
• renal vein emerges from hilum in front of renal
artery and drains into inferior vena cava
 Ureter
• Location and Description
• two ureters are muscular tubes that extend from
kidneys to posterior surface of urinary bladder
• urine is propelled along ureter by peristaltic
contractions of muscle coat, assisted by filtration
pressure of glomeruli

• each ureter measures about 25 cm long

• having three constrictions along its course:
• where renal pelvis joins ureter
• where it is kinked as it crosses pelvic brim
• where it pierces bladder wall
• renal pelvis is funnel-shaped expanded upper
end of ureter
• lies within hilum of kidney and receives major
calyces
• ureter emerges from hilum of kidney
• runs vertically downward behind parietal
peritoneum on psoas muscle, which separates it
from tips of transverse processes of lumbar
vertebrae

• ureter then runs down lateral wall of pelvis to

region of ischial spine and turns forward to
enter lateral angle of bladder
Ureters
• Relations
• Right Ureter
• Anteriorly: duodenum, terminal part of ileum, right
colic & ileocolic vessels, root of mesentery of small
intestine
• Posteriorly: right psoas muscle, bifurcation of right
common iliac artery

• Left Ureter
• Anteriorly: sigmoid colon & mesocolon, left colic
vessels
• Posteriorly: left psoas muscle, bifurcation of left
common iliac artery
• Blood Supply
• Arteries
• upper end, renal artery; middle portion, testicular
or ovarian artery; in pelvis, superior vesical artery
• Veins
• venous blood drains into veins that correspond to
arteries
 Urinary bladder
• Location and Description
• situated immediately behind pubic bones within
pelvis
• stores urine and in adult has maximum capacity of
about 500 ml
• has strong muscular wall

• shape and relations vary according to amount of

urine that it contains
• empty bladder in adult lies entirely within pelvis;
• as bladder fills, its superior wall rises up into hypogastric
region
• bladder is pyramidal, having apex, base and
superior and two inferolateral surfaces; also has
neck

• apex of bladder points anteriorly and lies behind

upper margin of symphysis pubis
• connected to umbilicus by median umbilical ligament

• base faces posteriorly and is triangular

• two vasa deferentia lie side by side on posterior surface
of bladder and separate seminal vesicles from each
other
• upper part of posterior surface of bladder is
covered by peritoneum, which forms anterior wall
of rectovesical pouch
• lower part of posterior surface is separated from
rectum by vasa deferentia, seminal vesicles and
rectovesical fascia

• superior surface of bladder is covered with

peritoneum and is related to coils of ileum or
sigmoid colon
• as bladder fills, it becomes ovoid and superior
surface bulges upward into abdominal cavity

• neck of bladder lies inferiorly and rests on upper

surface of prostate
• neck of bladder is held in position by puboprostatic
ligaments in male
• pubovesical ligaments in female
• when bladder fills, posterior surface and neck
remain more or less unchanged in position, but
superior surface rises into abdomen

• mucous membrane of greater part of empty

bladder is thrown into folds that disappear when
bladder is full

• area of mucous membrane covering internal

surface of base of bladder is called trigone

• superior angles of trigone correspond to openings

of ureters and inferior angle to internal urethral
orifice
• ureters pierce bladder wall obliquely
• & this provides a valvelike action, which prevents reverse
flow of urine toward kidneys as bladder fills
• muscular coat of bladder is composed of smooth
muscle and is arranged as three layers of
interlacing bundles known as detrusor muscle
• at neck of bladder, circular component of muscle
coat is thickened to form sphincter vesicae

• Blood Supply
• Arteries
• superior and inferior vesical arteries, branches of
internal iliac arteries
• Veins
• veins form vesical venous plexus that drains into
internal iliac vein