Urology - Anatomy part with Kidneys anatomy

Urology - Anatomy

1. Urology
The subject of urology
Anatomy of the Human Urogenital System

2. Urology
Introduction
Urology studies :
Male genitourinary system
Woman's urinary system

3. The human kidney
General anatomical references
A pair of retroperitoneal organs
Weight: ~140 g(150 g. In men, 135 g. In women)
Size:
in length : 10-12 sm
in width : 5-7 sm
in thickness : 3 sm
Location
Projection to the spine column : T
11-L
3
Because of the inferior displacement of the right kidney by
the liver, the right kidney sits 1 to 2 cm lower than the left
kidney

4. The medulla:
a darker inner region
Represented as pyramids
The apex of the
pyramids forms the
renal papilla -which is
cupped by an
individual minor calyx
The cortex:
a pale outer region
extends downward
between the individual
pyramids to form the
columns of Bertin
Kidney structure
parenchyma

5. Kidneys
Surface Anatomy and Relationships:
Renal (Gerota) fascia:
surrounded by a layer of condensed fat called the
paranephricfat and serves as an anatomic barrier to the
spread of malignancy
The Gerotafascia encasing the kidneys, adrenal glands,
and abdominal ureters is closed superiorly and laterally
Because it is open inferiorly, abnormal process may
spread to the pelvic cavity

7. Posterior relationships of the kidneys

8. Anterior relationships of the kidneys

10. Renal Vasculature
The renal arteries arise from the aorta at the level of the intervertebral
disk between the L1 and L2 vertebrae below the junction of the Superior
mesenteric artery.
The right renal artery passes behind theInferior vena cava.

11. Renal artery branches:
each artery divides into five segmental end arteries
that do not anastomose significantly with other
segmental arteries. Therefore occlusion or injury
to a segmental branch will cause segmental renal
infarction.
1.Interlobular arteries
2.arcuate arteries
3.afferent arterioles
4.glomerulus
5.efferent arterioles

13. Renal Veins:
The renal venous drainage correlates closely with the
arterial supply
Vasa recta andthe peritubular capillaries drain into the
renal vein
The renal veins drain into the Inferior Vena Cava
The left renal vein receives the left suprarenal
(adrenal) vein and the left gonadal (testicular or
ovarian) vein
homonymous blood vessels on the right side drains
straight into the Inferior Vena Cava.

14. Renal Vein
Renal Artery
Ureter
Renal artery and vein
located in front of
the pelvis of the
kidney and
proximally to the
Ureter
Hillumof the kidney, structures:

15. The Nephron-The functional unit of the kidney
The nephron(Bowman capsule, glomerulus)
tubules(Proximal convoluted tubule, Henle loop, Distal
convoluted tubule, Collecting tubule)

17. Functions of the kidneys and urinary tract
Excretion-by which metabolic waste is eliminated from
an organism. Participates in whole-bodyhomeostasis,
regulatingacid-base
balance,electrolyteconcentrations,extracellular fluid
volume, andblood pressure
Endocrine
Synthesis of renin
Erythropoietin
Prostaglandins
Metabolic
Activation of Vit. D
Catabolism of hormones

18. Regulation of body fluid
The body fluid is divided :
Intracellular
Extracellular
Plasma
Intersticialfluid
Transcellular fluid

19. Osmoregulation and Osmotic Balance between cells and
environment

20. Transmembrane transport of substances into the cell
Passive -is a movement of ions and other atomic or
molecular substances across cell membranes without need
of energy input
active -is the movement of molecules across a membrane
against the concentration gradient. Active transport
requires cellular energy to achieve this movement
Na
+ -The most important Extracellular ion
K
+ -The most important Intracellular ion

21. Kidney physiology
Urine formation
1.Filtering –Glomerular
2.Reabsorption-process by which
thenephronremoves water and solutes from
thetubular fluid(pre-urine) and returns them to
thecirculating blood
3.Secretion-The movement of substances from the
blood to the tubules through the cells(active
transport) or to the intercellular space(passive
transport)
4.Excretion-Movement of the final product resulting
from filtration, secretion and reabsorption into tubes

23. The Ureter
Length= 22-30 sm
Layers
Transitional epithelium
Lamina propria
Muscular layers
An inner longitudinal layer of muscle
An outer circular or spiral layer of muscle
Adventitia
containing blood vessels, lymphatic vessels, and veins

24. Anatomical relationships of the ureter
Started from the Ureteropelvicsegment,which is located behind the
renal artery and vein, and thenposteriorly, both ureters descend anterior
to the psoas major muscle
Anteriorly the right ureter separates to the ascending colon, appendix
and mesenteriumof the colon.
The left ureter is in close relationship with descending colon, sigmoid
colon and their mesenteric shield.
Near the bladder, two-thirds of the ureter, the gonadal blood vessels
cross the ureter anteriorly
At the pelvic inlet, it crosses the common iliac vessels near their
bifurcation
The terminal ureter runs forward, accompanied by the neurovascular
bundle of the bladder and passes the anterior vaginal fornix just before
entering the bladder. This close proximity of the ureter to the uterine
vessels is the cause of ureteral injuries during gynecologic procedures.

26. Segmentation and Nomenclature
abdominal ureter-from therenal pelvisto
the pelvic brim
pelvic ureter-from the pelvic brim to the
bladder
intravesicalorintramural ureter-within the
bladder wall
Blood supply and lymphatic drainage
Arterial branches approach medially to the
ureter in the abdominal cavity
In the pelvic cavity –Laterally
Upper segment of the ureter –From
branches ofRenal artery, gonadal, abdominal
aorta and common iliac arteries.
Distal ureter –Blood supply comes laterally
from the superior vesical artery, a branch of
the internal iliac artery.

27. Urinary bladder
Hollow muscular organ
Capacity in Norm 450-500 ml.
Layers:
Mucosal–transitional epithelium
Connective tissue
Muscular tissue-Detrusor
The three openings, twoureteric orifices, and the
internal urethral orifice mark the triangular area
called thetrigone of the bladder.

29. Topographic Anatomy of the Male Urinary Bladder and Prostate

30. Prostate
Glandular and fibrotic-muscular organ
Normal prostateis about20 gr.
Includes prostatic part of urethra(about2.5 sm.
length)
Ejaculatory ducts passes through theprostate, and
open into theuretraat theseminal colliculus.

31. Transrectal biopsy of the prostate.
Benign prostatic hyperplasia

32. Prostate zonal anatomy:
•Transition zone -The most common site of
benign prostatic hyperplasia
•Peripheral zone -The most common place for
prostate cancer

33. Testicle and Epididymis
The average adult testicle size: 4 ×3 ×2.5 sm.

34. Penile and men’s urethra