Urinary system Flashcards
Urinary system
a) Kidneys
b) Urinary tract;
- renal calices
- renal pelvis
- ureters
- urinary bladder
- urethra
*Prod. of urine, thus elimination of waste from body (urea, uric acid, foreign subst…)
*Maintain fluid homeostasis - water og electrolytes
*Prod of hormones og enzymes (Erythropoietin, Renin,
1,25-dihydroxycholecalciferol)
Kidney (REN)
12x6x4 cm. 120-170gr. ventrodorsally flattened
- Retroperitoneal
- Frá T12-L2(3)
*right kidney aðeins lower (below liver)
Kidneys relations
Posteriorly:
- Diaphragm (sep. kidneys from pleural cavity - costodiaphragmatic recess)
- Psoas major m
- Quadratus lumborum m
- Transversus abdominis m
- 11 og 12 ribs
- Subcostal vessels + nerves
- Iliohypogastric og Ilioinguinal nerves
Anteriorly;
-Right kidney) supraren. gland, liver, desc duodenum, right colic flexure og jejunum
-Left kidney) supraren. gland, stomach, spleen, body pancreas, left colic flexure, jejunum
Kidneys, external lýsing
- Ant/Post surfaces
- Sup/Inf extremities
- Medial/Lateral borders (Lateral convex, Medial concave)
- Renal hilum (in middle of medial border)
- -> renal vessels, lymphatics + nerves and renal pelvis enter/leave kidney thru Hilum
- left kidney L1. -right kidney L1-L2
- structures in renal hilum: Renal vein, ant.ramus renal A, renal pelvis og post.ramus renal A.
- Renal sinus; Renal hilum leads into the cavity (renal sinus)
- ->þar er, renal vessels, lymphatics, nerves, renal calices, renal pelvis og perirenal fat.
Kidney structure (in frontal section)
1) fibrous capsule; covers ext. surf
2) Cortex: outer pale layer, makes up renal columns á milli renal pyramids
3) Medulla; forms renal pyramids. Bases snúa að cortex, Apices(papillae) að renal sinus.
- Renal papilla með papillary foramina, surrounded by minor calyx
*One Renal lobe= 1 pyramid og adjac. cortex
Nephron
a) Renal cortex contains: renal corpsucle, prox+distal tubule og cortical p. of collecting ducts
b) Renal medulla contains; loop of henle og medullary p. of collecting ducts
* Glomerular filtration: water, salts, nutrients og waste moves from glomerulus inn í inside of glom.capsule –>filtrate
* Tubular reabsorption: nutrients og salts actively reabsorbed from prox. conv. tubule into peritubular capillary network. Water flows passively.
* Tubular secretion: Certain molecules are actively secreted from peritubular capillary network into distal conv. tubule
* Reabsorption: of sodium from distal conv. tubule og water from collecting duct (under hormonal control)
Nephron
a) Renal cortex contains: renal corpsucle, prox+distal tubule og cortical p. of collecting ducts
b) Renal medulla contains; loop of henle og medullary p. of collecting ducts
* Glomerular filtration: water, salts, nutrients og waste moves from glomerulus inn í inside of glom.capsule –>filtrate
* Tubular reabsorption: nutrients og salts actively reabsorbed from prox. conv. tubule into peritubular capillary network. Water flows passively.
* Tubular secretion: Certain molecules are actively secreted from peritubular capillary network into distal conv. tubule
* Reabsorption: of sodium from distal conv. tubule og water from collecting duct (under hormonal control)
Renal fat and fascia
Kidneys are enclosed in fat and fascia
A)Perinephric (perirenal) fat; beint outside fibr. capsule of kidney + inside renal sinus
B)Renal (perirenal) fascia; úr anterior + post. layers
- cranially/laterally, the ant+post layers are fused
- medially/inferiorly, there’s no conn. milli ant+post layers
- renal fascia einnig encloses supraren. glands
C)Paranephric (pararenal) fat; accumulation of fat posteriorly and posterolaterally outside the renal fascia
- kidneys are held in position by
- apposition of neighb organs
- renal fascia + renal vessels
kidneys, supply
1) Blood supply og venous drainage;
- right+left renal artery (of abd.aorta)
Renal artery (ant og post ramus)---> Segmental aa -->Lobar aa --> Interlobar aa
- right+left renal veins, drained into IVC
2) L. drainage: Lumbar l.nodes
3) Nerve supply; Renal plx
a) symp. fibers (from aortic plx, coeliac gangion and coeliac plx)
b)parasymp. fibers from Vagus n.
C)sensory fibers: from fibr. capsule, thru spinal nerves (segment T10 and T11)
Renal segments (respecting branching of the renal A)
1) ant. segment 2)ant. sup. segment 3)ant. inf. segment
4) inf. segment 5)post. segment
Renal calices
-Í renal sinus. -take urine to renal pelvis
A)Minor renal calices; 7-14 stk, att. to renal papillae (one calyx to one papilla). Drained into major calices
B)Major renal calices; oftast 3 stk (sup, middle, inf).
Drained into renal pelvis
Renal pelvis
External lýsing; funnel-shaped, flattened anteroposteriorly.
G verið dendritic eða ampullar type.
- located in renal sinus, leaving thru renal hilum
- Proj. onto skeleton; L1-L2
*Pelviureteric junction; ca 1/2 length milli renal hilum og inf. pole of kidney
-Relations;
Right renal pelvis; desc duodenum
Left renal pelvis; body pancreas
In both sides; renal vessels
- Blood+nerve supply for renal pelvis og calices
- –> same as kidneys
Ureter
-retroperitoneal -run on ant.surf of psoas major
25-30cm long og 3-6mm diameter
parts; 1)abdominal 2)pelvic 3)intramural
Constrictions of ureters
1) Pelviureteric juntion
2) Pelvic inlet (crossing w. iliac vessels)
3) Entrance to bladder
*Kidney stones may be get trapped at these constrictions
Ureter, abdominal part
Desc. in retroperitoneal space on ant.surf of Psoas major
-Relations: Genitofemoral n Gonadal vessels (testicular/ovarian) Iliac vessels *On the right; att. of root of mesentery *On the left; att. of root of sigmoid mesocolon
Ureter, pelvic part
Males:
- Internal iliac vessels
- Obturator vessels and nerve
- Deferent duct
- Seminal vesicles
Females:
- Internal iliac vessels
- Obturator vessels and nerve
- Uterine artery* (clinically important; during hysterectomy, ureter has to be identified and isolated from uterine artery)
Ureter, supply
Blood supply og venous drainage;
- Renal artery -Testicular/ovarian arteris -A. of def.duct/uterine A
- Sup and Inf vesical aa + corresponding veins
Lymph.drainage into;
- Lumbar l.nodes
- Common iliac l.nodes
- Internal iliac l.nodes
Nerve supply; symp + parasymp fibers from--> -Renal plx -Testicular/ovarian plx -deferential plx
Sensory fibers;
-thru splanchnic nerves-segments T10-L1
Urinary bladder
-capacity; 200-300 ml. Exceptionally 500-750 ml.
Position;
- In lesser pelvis
- empty bladder er subperitoneal (behind pubic symphysis)
- full bladder er preperitoneal (above pubic symphysis, in front of parietal peritoneum/peritoneal cavity, directly behind ant.abd.wall)
Urinary bladder, external lýsing og parts
a) Apex; snýr upwards + forwards
* Median umblical ligament (urachus), cont. from it superiorly on ant.abd.wall to the umblicus
b) Body
c) Fundus/base; posteroinferior part
* hér er smooth area–> Trigone (milli openings of ureters+urethra)
d) Neck; surr. origin of urethra. Most inf. part of bladder og most fixed part
(pubovesical lig in female, puboprostatic in male)
Urinary bladder, relations
Male;
-Inferiorly: Prostate
-Dorsally; Rectum (rectovesical pouch)
Seminal vesicles and deferent duct (both in rectovesical septum)
- Dorsocranially; Sigmoid colon and Ileum
- Ventrally; Pubic symphysis og retropubic space
- Inferolaterally; Pelvic diaphragm
Female;
-Dorsally; uterus (Vesicouterine pouch, body of uterus) og vagina (Vesicovaginal septum, uterine cervixc + vagina)
- Ventrally; Pubic symphysis og retropubic space
- Inferiorly; pelvic diaphragm
Wall of urinary bladder
1) mucous coat (svo submucous layer)
2) muscular coat 3)serous coat
wall of bladder: mucous coat
mucous coat=interior of bladder
-mucous membrane loosely att. to muscular coat
(folded in muc. folds that disappear when bladder fills)
*Trigone; er smooth because mucosa is firmly att. to muscular coat. -Í fundus.
Bordered by orifices of ureters (posteriorly) conn. by interureteric crest og urethral orifice (anteriorly)
((In male; orifice is elevated due to middle lobe of prostate
–> uvula)
wall of bladder, muscular layer
Smooth muscle that forms:
Detrusor muscle, has 3 layers
(internal-plexiform, middle-circular, outer-longitudinal)
- Internal urethral spinchter–> involuntary, derived from circular layer.
- rectovesical and pubovesical muscles, derived from external layer of muscular coat.
- diff. nerve supply; parasymp. fibers for detrusor
symp. for spinchter
wall of bladder, serous coat
- Peritoneum covers upper+posterior surf of bladder
- Tunica adventitia
- Paracystium; sparse tissue around the bladder
Fixation of the bladder;
- Ventrally; pubovesical ligg. In male also puboprostatic ligg.
- Dorsally; rectovesical ligg in male, vesicouterine ligg in female
- Caudally; to the prostate in male, to the urethra in female
- ->in both to urogenital diaphragm
*Behind the bladder, peritoneum forms pouch;
In male; rectovesical pouch, below it rectovesical septum
In female; vesicouterine pouch, below it vesicovaginal septum
