Renal system anatomy:

Introduction:
Function of the urinary system:
1. Regulation of blood ionic composition: Na+, Ca2+, Cl-, HPO422. Regulation of blood pH: kidneys excrete H+ to urine and
conserves bicarbonate ions
3. Regulation of blood volume: by conserving /eliminating water
in urine
4. Enzymatic regulation of blood pressure: kidneys secrete the
enzyme renin, which indirectly causes an increase in blood
pressure
5. Maintenance of blood osmolarity
6. Production of hormones: calcitriol (active form of vitamin D that
regulates calcium homeostasis) and erythropoietin (stimulates
production of RBC)
7. Regulation of blood glucose level

8. Excretion of wastes and foreign substances: ammonia, urea, bilirubin, creatinine, uric acid, and other foreign
substances
* renal system is composed of

Consists of 2 kidneys, 2 ureters, 1 urinary bladder, and 1 urethra. >> so although it does a big job but has
few organs

Filtration (functional part )

Conductive part

Kidney :
deals with a huge amount of
blood & discards waste products
through the urethra as urine.

-Ureter: collecting tube, it has nothing to do with reabsorption and filtration.

-Urinary bladder: muscular organ located in the pelvic region that has a certain capacity for the filling of urine.
When certain distension is reached, urine must be evacuated.
-Urethra: evacuates & takes urine, under control of human. Urine is discarded though the urethra.
The remaining water and solutes (urine), passes through the ureters, is stored in the urinary bladder until it is
removed from the body through the urethra.
The kidneys do the major work of the urinary system; the other organs (ureters, urinary bladder, and urethra)
function as

*urine composition is not changed as it passes through the conductive

part of the urinary system

Location of the kidney :

-The kidneys extend approximately from the level of the 12th thoracic
vertebra to the third lumbar vertebra in the posterior abdominal wall
-They receive some protection from ribs
Both kidneys are in direct contact with an important endocrine gland
located at the apex (upper part of kidney). Because they are above the kidney, these glands are called suprarenal gland.
This gland has no relationship with the kidney function-wise. Its just located above the kidney but does not function
with it.

The purple arrow is adipose capsule

external anatomy :
-The right lies somewhat lower than left as it is positioned
under right lobe of the liver which is much larger than
the left lobe
-The adult kidney weights about 150 g
-Dimensions are 12 cm long, 6 cm wide, 3 cm thick
-Medial surface has a vertical cleft called the renal hilus

-Atop each kidney is an adrenal gland which is unrelated

to kidney function
- 3 layers of tissue surround kidney:
1.renal capsule (dense irregular connective tissue),
2. adipose capsule (fatty tissue),
3. renal fascia (dense irregular connective tissue)
all important for protection and for holding the kidney in its place.

hilum

Internal anatomy :

Pyramids

-Cortex and medulla are the major constituents of the kidney!

-The renal cortex is light in color(pale) and has a granular

appearance
- Deep to the cortex is the renal medulla
-Darker tissue which exhibits cone shaped tissue
masses called medullary or renal pyramids

Renal
columns

-Each renal pyramid has a base which is convex, and a

apex which tapers toward its apex or papilla
The papilla is the tip of the renal pyramid that opens into
the minor calyx

The apex, or papilla, points internally

-The pyramids appear striped because they are formed almost entirely of roughly parallel bundles of urine collecting
tubules called medullary rays
Hilus or hilum : vertical cleft or slit at the center of the medial border in which
the blood vessels , the ureter , the lymphatics , the nerves pass to the kidney

-Inward extensions of cortical tissue

called renal columns separate the
pyramids so the renal column is

renal columns: portions of renal cortex that extend between renal

pyramids

-Each medullary pyramid is surrounded by a capsule of cortical tissue

to form a lobe

lobe

-renal lobe: renal pyramid + renal cortex + half of each adjacent renal
column
- parenchyma: renal cortex + renal pyramids (functional portion of kidney)
* the urine will flows from the medulla to the minor calyces >> major calyces >> renal pelvis > ureter >bladder > urethra

Blood supply :
-The kidney continuously cleanse the blood and adjust its composition
-Kidneys possess an extensive blood supply
-Under normal resting conditions, the renal arteries deliver approximately one-fourth (20%-25%) of the total systemic
cardiac output to the kidneys each minute >> about 1200 ml/min is delivered to the kidney
- the blood come from the renal artery > The right renal artery is longer than the left renal artery and right renal vein
is shorter than left renal vein
- Because the position of the aorta is more to the left (medial) and the vena cava is on the right side the length

- A vessel coming from aorta to the right must be longer. And

a vessel going from the left to the inferior vena cava should be
long
- Each renal artery divides into five segmental arteries that
enter the hilus
Each segmental artery divides into lobar and interlobar
arteries
The kidney has important subdivisions of vessels that reach the
nephrons, specifically the Bowmans capsule.
- Starting from renal pelvisthe large artery entering the
renal pelvis is the renal artery from the aorta. It will subdivide
into lower upper, middle arteries segmental arteries.
- In between the large lobes (medullary pyramids) is where the
segmental arteries will passinterlobar arteries.

- At the base of the pyramid is the area of contact between cortex and medulla.
-They run in an arch manner arcuate arteries.
- arcuate artery at the cortico-medullary junction
-From the arcuate arteries, smaller branches go in to the small
lobulesinterlobular arteries. (

cortical radiate arteries)

-From the interlobular arteries, more arteries will appro ch the
Bowmans capsule afferent arteries.
-When they approach the Bowmans capsule it breaks into
capillaries (glomerular capillaries).
- the glomerular capillaries drain into the efferent arteriole
- effereret arterioles give peritubular capillary network
-Peritubular arteries unite to form peritubular venules

*Venous drainage :

Cortical radiate veins receives blood from the vasa recta (capillaries and extensions of efferent arterioles
>interlobular veins > arcuate veins >interlobar veins > renal vein>inferior vena cava
*the blood supply starts form renal artery >> segmental artery that enter the hilus >> lobar arteries >interlobar arteries
> arcuate arteries> interlobular arteries >> afferent arteriole>> glomerular capillaries >> efferent arterioles
-The renal arteries issue at right angles from the abdominal aorta

The nephron :
- Each kidney contains over 1 million tiny blood processing units called nephrons, which carry out the processes that
form urine >> so they are the functional units
- In addition, there are thousands of collecting ducts, each of which collects urine from several nephrons and conveys it
to the renal pelvis
-located in the parynchema
- During a single day, all nephrons will filter 180 L fluid , so there is a continuous process of filtration in kidney;

-blood goes to kidney several times a day so that waste products can be filtered & excreted outside of body as urine. To
conclude, the nephron is the most important structure in the cortex that regulates these vital functions.

Parts of the nephron :

Each nephron consists of the renal corpuscle (where blood plasma is filtered) and the renal tubule
(where the filtered fluid passes)

Part

details

Renal
corpuscles

*its composed of two parts :

1- glomerulus : its a tuft of capillaries arise from the afferent arteriole
-The capillaries in the glomerulus are surrounded by 2 arterioles, whereas the capillaries of the body are
surrounded by an arteriole and a venule.
2-bowmans capsule :- its cup shaped structure surrounds the glomerulus
- its doubled layered
-Consists of visceral and parietal layers
-Visceral layer: simple squamous epithelial cells called
PODOCYTES. They wrap around the endothelial layer of
glomerular capillaries and form the INNER wall of the
capsule.
-Parietal layer: simple squamous epithelial cells that
make up the OUTER wall of the capsule.
- receives filtered fluid from capillaries

- the most proximal part of the nephron

- all glomeruli and bowmans capsules lie in the cortex

Proximal
convoluted
tubule

-travels in a long time in a short space and is very

Loop of henle

- This loop has both an ascending and descending limb

-extend to the medulla ,especially in the juxtamedullary nephron

close to the Bowmans capsule

- receive the filtered fluid from renal corpuscle
- it lies in the cortex

Distal
convoluted
tubule

-continue and take the fluid from the loop of henle

-lies in the cortex

Collecting
ducts

*At the end of the distal convoluted tubule, there will be no reabsorption at all.
What remains left is the urine, which will be discarded out of the body.
-In the end of the distal convoluted tubule, urine is collected by a series of ducts until it reaches the apex of the
medullary pyramid, then to the renal pelvis ureterurinary bladder urethra
-lie in the medulla mainly

Some notes :
1-the filtered fluid pass through capillaries >Proximal convoluted tubule Loop of Henle Distal convoluted tubule.
2-

-Normally there should be no blood in urine because if the kidney is functioning normally and efficiently, it will receive a huge
amount of blood and reabsorb it. It will then discard the filtrate into the collecting duct as urine, which should not have blood or
proteins.
-However, there may be pathological lesions causing blood and proteins in
the urine, caused by a defect in the nephronshematuria / proteinuria .
-Limited amount of nephrons are functioning normally. In certain tumors,
half of a kidney can be removed and the human can still live normally. There
is a huge reserve of nephrons in both kidneys.
3-nephrons are 2 types : - cortical
cortical
80-85%
Short loops in the cortex
Peritubular capillaries

juxtamedullary
15-20%
Long loops extend to the
medulla
Vasa recta

Ureter :
- begins at the pelvis of the kidney (medial cavity), where medulla
terminates .
-Each leaves the renal pelvis, decends behind the
peritoneum(retroperitoneal) to the base of the bladder, turns and then
runs obliquely through the medial bladder wall .
-The ureters are protected from a backflow of urine because any
increase within the bladder compresses and closes the ends of the
ureters
*Histologically, the walls of the ureter is trilayered(3 layers)
-An inner layer of transitional epithelium lines the inner mucosa
-The middle muscularis layer is composed of a an inner longitudinal
layer and an outer circular layer
-The outer layer is composed of fibrous connective tissue
-The ureters play an active role in transporting urine
-Distension of the ureters by incoming urine stimulates the muscularis
layer to contract, which propels the urine into the bladder
-The strength and frequency of peristaltic waves are adjusted to the rate of urine formation

Urinary bladder :
*it a storage organ It can expand for storage or collapse when empty, that receives the urine
from ureters > and empties into the urethra
- In females, the bladder is anterior to the vagina and uterus
- In males, the bladder lies immediately anterior to the rectum
-The interior of the bladder has openings for both ureters(ureter opening) and the urethra(intenal
urethral sphincter )
*it had a body and neck
The smooth muscles of the bladder forms folds , but at the area that connect the ureter openings and urethra
> it become smooth and called the trigone

The triangular region of the bladder base outlined by these openings is called the trigone which is a
common site of infections
Distension does not occur in the trigone, even if the urinary bladder is full. It will remain fixed in shape
so that it doesnt close the openings of the ureter

*The bladder wall has three layers

1- A mucosa containing transitional epithelium thats stratified which is unique
2- A thick muscular layers
3- A fibrous adventitia
*The muscle layer consists of smooth muscle arranged inner and outer longitudinal layers
Collectively the muscle layer is called the detrusor muscle (literally to thrust out The bladder is
very distensible and uniquely suited for its function
of urine storage)
-Empty its walls are thick and thrown into folds
(rugae) and found in the pelvis
-As it expands it becomes pear shaped and rises in
the abdominal cavity
-The bladder can store more than 300 ml of urine
without a significant increase in internal pressure
-A moderately full bladder holds approximately 500
ml
-Urine is held in the bladder until release is convenient

Urethra:
-The urethra is a thin muscular tube that drains urine from the bladder and conveys it out of the body
-Urethra is different in both sexes.
male

female

the external urethral orifice is at the tip of the penis. It the external urethral orifice opens in the vulva inside the
also passes through the prostate gland and prostatic
vagina. The urethra is shorter, and has several advantages.
urethra. The external urethral orifice is at the tip of the
penis & is longer.
-The male urethra has two basic functions
*It carries urine out of the body
*It carries semen into the female
reproductive tract

Male urethra > prostatic , membranous ,

penile(spongy)

So the major differences in the urinary systems of males and females are located in the external urethral
orifice of the urethra.
.

Because of the filtration of huge amount of blood passing through the kidneys, certain crystallized materials will
also pass. These crystallized materials can either be beneficial or useless. If they are useless, they must be
excreted with urine. If they are not excreted and stay within the bladder for a long time, they will eventually
accumulate . this explains why the urinary system is susceptible to stone formation (accumulation of crystals).
-Sometimes, these stones pass with urine out of the body without being felt. Other times, they will remain in
the pelvis of the kidney, ureter, bladder, or in urethra

.
- Stone formation is more likely to occur in males because of the constrictions in the male urethra. It
rarely occurs in females.
-These crystals may also be collected during the filtration of blood.
Notes :
-Can kidneys be removed? Yes! If there is a certain pathology/tumor in body OR in kidney donation.
-Can the suprarenal gland be removed? No! It must always be kept in the body because of its high importance.

Done by : majd alahmad