anatomi urinarius

Embed Size (px)

Citation preview

  • 8/13/2019 anatomi urinarius

    1/41

    The Urinary System

    Muh.Iqbal Basri

    Anatomy DepartmentHasanuddin University

  • 8/13/2019 anatomi urinarius

    2/41

    1. REN

    2. URETER

    3. VESICA URINARIA4. URETHRA

    CAVUM PELVICUM

    The Urinary System

  • 8/13/2019 anatomi urinarius

    3/41

    Composition

    Two kidneyform urine

    Two ureterconducturine from kidneys to

    bladder

    Bladderreceives and

    stores urine

    Urethraconducts

    urine from bladder to

    exterior of body

    (discharged)

  • 8/13/2019 anatomi urinarius

    4/41

    The Pelvic Cavity

    Bony Pelvis

    Pelvic Organs

    Reproductive System

  • 8/13/2019 anatomi urinarius

    5/41

    Kidney

    General features Bean shaped, reddish-

    brown organs

    Superior extremitybroad

    and thin

    Inferior extremitynarrow

    and thick

    Anterior surfaceconvex

    Posterior surfaceflat

    Lateral borderconvex

  • 8/13/2019 anatomi urinarius

    6/41

    Medial borderconcave

    Renal hiluma vertical slit

    on the medial border of

    kidney, the structures whichenter and leave the renal

    hilum is called renal

    pedicle, including the renal

    vein, renal artery, renal

    pelvis, lymphatic vesselsand nerves

    Order of structures in the

    renal pedicle from anterior

    to posteriorV. A. P.; from

    superior to inferiorA. V. P.

  • 8/13/2019 anatomi urinarius

    7/41

    Renal sinus

    which is the renal hilumleads into a space within the

    kidney, the renal sinus is

    occupied by the renal vessels,

    minor renal calices, major

    renal calices, renal pelvis andsome adipose tissue

  • 8/13/2019 anatomi urinarius

    8/41

    Structure of the kidney

    Renal cortex

    renal columns Renal medulla

    Renal pyramids : 1520

    Renal papilla

    Papillary foramina Minor renal calices (78)

    Major real calices (23)

    Renal pelvis

  • 8/13/2019 anatomi urinarius

    9/41

    Polus cranialis(=superior)

    Polus caudalis(=inferior)

    FasciarenalisMargo

    lateralis

    HILUM RENALEEnter and leave

    :vasa renalis,ureter and saraf

  • 8/13/2019 anatomi urinarius

    10/41

    Cortex renalis

    Pyramis renalis

    About 12-20 pyramidalesConsist of BASIS and

    APEX PYRAMID

    Papilla renalis

    Calyx minor

    Pelvis renalis c.o. 2-3 calyx major and

    calyx major isdivided to be 7-14

    calyx minor

    Pelvisrenalis

    ureter

    Columna renalisBertini

    Sinus renalis

    Calyx major

  • 8/13/2019 anatomi urinarius

    11/41

    Urine collection

    Ducts within each renal

    papilla release urine

    into

    major calyx

    renal pelvis

    ureter

    minor calyx

  • 8/13/2019 anatomi urinarius

    12/41

    Coverings

    Fibrous capsule

    a strong fibrous capsulewhich strips easily from

    a normal kidney surface

    but adheres firmly to an

    organ that has beeninflamed

  • 8/13/2019 anatomi urinarius

    13/41

    Position Lie behind peritoneum

    one on each side of thevertebral column high

    up on the post

    abdominal wall, upper

    pole nearer to mediaplan than lower pole

  • 8/13/2019 anatomi urinarius

    14/41

    Kidney Location

    Lateral to vertebral

    column high on bodywall, under floating

    ribs

    in retro-peritoneal

    position

  • 8/13/2019 anatomi urinarius

    15/41

    Fatty renal capsulea

    thick adipose connective

    tissue capsule, surroundsthe fibrous capsule. It acts

    as a shock absorber to

    protect the kidney from

    jolting and jarring

    Renal fasciaon outside,surrounds both the kidney

    and suprarenal gland,

    holding these organs in

    place

  • 8/13/2019 anatomi urinarius

    16/41

    Left kidneylies at the level

    from the lower border of T11 toL2; the 12th rib is behind itsmiddle part of the post surface

    Right kidneylies slightly lowerthan the left kidney, at the levelfrom the lower border of T12 toL3; the 12th rib is behind itsupper part of the post surface

    Renal hilumat the level of L1,is about 5cm from the posteriormedian line

    Renal regionthe areabetween 12th rib and thelateral margin of erector spinae

  • 8/13/2019 anatomi urinarius

    17/41

    Superiorlysuprarenal gland

    Posteriorly

    Three muscles

    Diaphragm (pleural cavity),

    Psoas major

    Quadratus lumborum Three nerves

    Subcostal

    Iliohypogastric

    Ilioinguinal

    Medial Left kidneyabdominal aorta

    Right kidneyinferior ceva vana

    Relationships of kidneys

  • 8/13/2019 anatomi urinarius

    18/41

    Anteriorly

    Left kidney

    Stomach (superior),

    Pancreas (middle),

    Loops of intestine and

    left colic flexure

    (inferiorly)

    Right kidney

    Right lobe of liver

    (superior)

    Right colic flexure

    (inferior) Descending part of

    duodenum (medially)

  • 8/13/2019 anatomi urinarius

    19/41

    Renal segments The kidney is divided into

    five vascular segments and

    each is supplied by a

    branch of the renal artery;

    between the segments

    there is no anastomosis. The segments are

    Superior segment

    Superior anterior segment

    Inferior anterior segment

    Inferior segment

    Posterior segment

  • 8/13/2019 anatomi urinarius

    20/41

  • 8/13/2019 anatomi urinarius

    21/41

    Ureters

    Muscular tube, about 25cmlong

    Three parts

    Abdominal partdescend

    on the psoas major behind

    the peritoneum Pelvic partin females,

    passes 2cm lateral to the

    neck of uterus and lies

    below the uterine artery

    Intramural partpassesobliquely through the

    bladder wall for 2cm long

  • 8/13/2019 anatomi urinarius

    22/41

    URETER

    Formed by smooth muscle, 25-30 cm

    Like a tube, two

    PARS ABDOMINALIS & PARS PELVICA Continued fromPELVIS RENALIS

    Empty to VESICA URINARIA

  • 8/13/2019 anatomi urinarius

    23/41

    Three constrictions

    At the pelvoureteric

    junction

    Where it crosses the

    pelvic inlet and iliac

    vessels Where it pierces the

    bladder wall obliquely (at

    intramural part)

  • 8/13/2019 anatomi urinarius

    24/41

    Stone in ureter

  • 8/13/2019 anatomi urinarius

    25/41

    Relation of abdominal partof ureter

    Anterior to left ureter

    Descending part of duodenum

    Right colic vesseles

    Iliocolic vesseles

    Testicular vesseles

    Terminal part of ileum Right to left ureter

    Cecum

    Vermiform appendix

    Anterior to left ureter

    Duodenojejunal flexure Left colic vesseles

    Testicular vesseles

  • 8/13/2019 anatomi urinarius

    26/41

    Bladder

    General features

    Pyramidal in shape

    when empty, having

    Apex, Fundus

    Body of bladder

    Neck

  • 8/13/2019 anatomi urinarius

    27/41

    VESICA URINARIA

    Connective tissue & smooth muscle

    Morfology vary regard to age, sex & volume

    There are 3 facies:

    1. FACIES SUPERIOR

    2. FACIES INFERO-LATERALIS

    3. FACIES POSTERIOR(=FUNDUS,=BASIS VESICAE)

  • 8/13/2019 anatomi urinarius

    28/41

    Wall of the Bladder

    Fibrous adventitia External

    Except on superior surface

    Muscular layer

    Detrusor Muscle Smooth muscle

    Inner and outer longitudinal

    layers

    Middle circular layer

    Mucosa

    Distensible transitional

    epithelium

  • 8/13/2019 anatomi urinarius

    29/41

    Interior of bladder Mucous membrane folded,

    except for trigone of bladder Trigone of bladdersmooth

    triangular area at inner surfaceof the funds of bladder, formedby internal urethral orificeanteriorly and two ureteric

    orifices laerally, in this areaabsents submucosal layer,where the mucous membrane isfirmly adherent to the muscularcoat, and is always smooth

    Interureteric foldmuscularelevation, between uretericorifices.

  • 8/13/2019 anatomi urinarius

    30/41

    Location In the adult, it lies in the

    lesser pelvis, behind the

    pubic symphysis, in front of

    seminal vesicle, ampulla

    ductus deferentis and

    rectum in the male, and in

    front of uterus and vagina in

    the female.

    In the young child the empty

    bladder projects above thepelvic inlet

  • 8/13/2019 anatomi urinarius

    31/41

    UrethraFemale urethra

    Relatively short (about

    5cm long), wide andstraight

    Opens into vaginal

    vestibule

  • 8/13/2019 anatomi urinarius

    32/41

    Male versus Female

  • 8/13/2019 anatomi urinarius

    33/41

    Urethra

    Drains urine from bladder

    to outside

    Female = short tube

    3-4 cm or 1.5 inches

    Males = long tube

    20 cm or 8 inches

    Prostatic, Membranous,

    Spongy (penile) urethra

    Carries sperm

  • 8/13/2019 anatomi urinarius

    34/41

    Pars prostatica

    Pars

    membranacea

    Pars spongiosa

  • 8/13/2019 anatomi urinarius

    35/41

    Retroperitoneal space and contents

    Positionit lies betweenthe parietal peritoneum andtransvers fascia of theposterior abdominal wall,from diaphragm topromontory of sacrum,continuation withextraperitoneal fascia.

    Contentskidney,suprarenal gland, ureter,abdominal aorta, inferior

    vena cava, nervers andlymphatics, looseconnective tissue

  • 8/13/2019 anatomi urinarius

    36/41

    Suprarenal gland

    Shape and position

    Right is pyramidal in shape, left onesemilunar in shape, consisting of outcortex and inner medulla

    Located retroperitoneally,superomedial to superior poles ofeach kidney, enclose with thekidney by the renal fascia

    Blood supply

    Arteries Superior suprarenal a.

    Middle suprarenal a.

    Inferior suprarenal a.

    Venous drainge Right suprarenal v. drains into inferior

    vena cava

    Left suprarenal v. joins left renal v.

  • 8/13/2019 anatomi urinarius

    37/41

    Nervers of abdomen

    Lumbar plexus

    Formation: formed by

    anterior rami of L1-L3,

    a part of anterior rami

    of T12and L4

    Position: lies within

    substance of psoas

    major

  • 8/13/2019 anatomi urinarius

    38/41

    Branches Iliohypogastric n.

    Supplies lower part of

    anterior abdominal wall Ilioinguinal n.

    Passes through inguinal

    canal to supply skin of the

    groin and scrotum

    Lateral femoral cutaneous

    Femoral n.

    Obturatorn.

    Genitofemoral n.

  • 8/13/2019 anatomi urinarius

    39/41

    Lumbar sympathetic trunk

    Made up of paired chainswith four to five lumbarganglia anterolateral tovertebral column

    Enters abdomen via thediaphragm and as acontinuation of he thoracicpart

    Passes inferiorly behindcommon iliac vessels andterminations by joining toform unpaired ganglionimpar, anterior to sacrum

  • 8/13/2019 anatomi urinarius

    40/41

    Relations of abdominal aorta

    Anteriorly (from above

    downward)

    Pancreas

    Ascending part of

    duodenum

    Radix of mesentery

    Posteriorly Upper four lumber

    vertebrae

    On its right

    Inferior vena cava

    On its left

    Left lumbar sympathetic

    trunk

  • 8/13/2019 anatomi urinarius

    41/41

    Relations of inferior vena cava

    Anteriorly (cranially to caudally)

    Liver

    Head of pancreas Horizontal part of duodenum

    Right testicular (or ovarian) a.

    Radix of mesentery

    Posteriorly

    Right crus of diaphragm

    Upper four lumber vertebrae

    Left sympathetic trunk

    Parietal branches of abdominal aorta

    On its right

    Psoas major

    Right kidney Right suprarenal gland

    On its left

    Abdominal aorta