Urinary System: Mr. Visanth V S Mayo School of Nursing Lucknow

Urinary System
Mr. Visanth V S
Mayo school of Nursing
Lucknow
The Urinary System
• Urinary System is one of the four excretory

systems in our body. The other three are
bowel, lungs & skin.
Components of Urinary System
Fig 7.1 Components of Urinary System
2 Kidneys
2 Ureters
Urinary Bladder
Urethra
The kidneys remove waste products of
metabolism, excess water and salts from blood
and maintain the pH .
Ureters convey urine from the kidneys to the
urinary bladder.
The urinary bladder is the muscular reservoir of
urine.
Urethra is the channel to the exterior.
The Kidneys/Renes
• Definition
– The kidneys are a pair of excretory organs

situated on the posterior abdominal wall,
one on each side of the vertebral column,
behind the peritoneum.
Location
• The kidneys occupies the
epigastric , hypochondriac,
lumbar & umbilical regions.
• Vertically they extends from
upper border of twelfth thoracic
vertebra to the center of the
body of third lumbar vertebra.
• The right kidney is slightly
lower than the left, & the left
kidney is little nearer to the
median plane than the right.
The Kidneys- Surface Anatomy
• External Features
– Each kidney is bean shaped.
– It has upper & lower poles,
medial and lateral borders,
and anterior and posterior
surfaces.
– The upper pole is broad & is
in close contact with the
corresponding suprarenal
glands.
– The lower pole is pointed.
• The lateral border is
convex.
• The medial border is
concave.
11 cm • The middle part of the
medial border is
depressed and is known
as hilum (hilus)
3cm
5cm
8
Measurements
• Color : Reddish Brown
• Length : About 11 cm long( the left
kidney is little longer & narrower than right )
• Width : 6cm broad
• Thickness : 3cm thick
• Weight
– Males : 150gm
– Females : 135gm
(In fetus the kidney is lobulated & is made up of about 12 lobules.
After birth the lobules fuse , so that in adults the kidney is
uniformly smooth)
Surface Marking- Morris Parallelogram
Anterior aspect Posterior aspect

Coverings
• It has 3 coverings
1. Innermost fibrous capsule or true capsule
2. Middle fatty capsule / perinephric fat-it is a collection
of fatty tissue. (It acts as a shock absorber & helps to
maintain the kidney in its position)
3. The false capsule – made of renal fascia .It has two
layers-Anterior & Posterior.
(Superiorly the two layers enclose the supra renal gland & then
merge with diaphragmatic fascia, that is why the kidneys move
with respiration)
Relations - Anterior
Relations - Posterior
Anatomy of Kidney
Macroscopic Structure
Macroscopic Structure Papilla
Major Renal
Calyx Pyramids
Minor
calyces
Renal Renal
Pelvis Cortex
Renal
Capsule
Ureter
Renal
Medulla
Kidney: Frontal Section
• Minor calyx: cup over papilla collects urine

Nephron
Renal Artery
Renal Vein
Anatomy of Kidney
• Renal cortex: outer 1 cm

• Renal medulla: renal columns, pyramids - papilla
• Lobe of kidney: pyramid and it’s overlying cortex
Microscopic Structure(Histology)
 The kidney may be
regarded as a collection of
millions of uriniferous
tubules.
 Each uriniferous tubule
consists of an excretory
part called nephron and of
a collecting tubule.
 Each kidney contains over
1(1-2 millions) million
nephrons and thousands of
collecting ducts
Structure of Nephron
efferent glomerulus
arteriole Bowman’s
afferent capsule
arteriole proximal
convoluted
tubule
artery
distal
convoluted
peritubular tubule
capillaries vein collecting
duct
loop of
Henle
blood
Nephron
Functioning filtration
tubular
reabsorption
and secretion
urine “refreshed” blood

Kidney Functions
• Filters blood plasma, eliminates waste, returns
useful chemicals to blood
• Regulates blood volume and pressure
• Regulates osmolarity of body fluids
• Secretes renin, activates angiotensin, aldosterone
– controls BP, electrolyte balance
• Secretes erythropoietin, controls RBC count
• Regulates PCO2 and acid base balance
• Detoxifies free radicals and drugs
• Gluconeogenesis
Blood Supply Diagram
Arterial Supply: Renal arteries which
are the direct branches of abdominal
aorta & are large in size.
Venous Drainage: Renal veins, ends
in inferior vena cava. The left renal
vein is longer than the right.
Nerve Supply: Sympathetic fibers
derived from T10,L1 segments and
parasympathetic fibers from vagus
nerve.
Lymphatic drainage: into lateral
aortic nodes.
Applied Anatomy
1. Congenital Anomalies
1. Unilateral/ Bilateral agenesis
2. Horse shoe kidney
3. Congenital poly cystic disease
4. Ectopic kidney
5. Abnormal renal arteries may arise from aorta or
superior mesenteric artery
2. Infections
3. Renal Failure
THE URETERS
• Definition
The Ureters are a pair of narrow , thick

walled muscular tubes which convey
urine from the kidneys to urinary bladder.
Dimensions
• Each Ureters is about 25cm (10 inch)long.
• The upper half lies in the abdomen and the
lower half in the pelvis.
• It measures 3mm diameter, but it slightly
constricted at three places.
– At the pelviureteric junction
– At the brim of lesser pelvis
– At its passage through the bladder wall
Parts
• For the purpose of description, ureter is divided
into 2 parts
– From the site of origin to pelvic brim- abdominal part
– From pelvic brim to entry into urinary bladder- pelvic
part
Ureter- Cross Section
• 3 layers of tissue
– Outer layer
• Fibrous tissue
– Middle layer
• Muscle
– Inner layer
• Epithelium
• Blood Supply
– Ureter is supplied by branches of
» Renal artery
» Abdominal aorta
» Gonadal artery
» Common iliac artery
» Internal iliac artery
» Inferior vesical artery
• Nerve Supply
– Autonomic nervous system
Urinary Bladder
• The urinary
bladder is a hollow
, muscular organ ,
which functions as
the reservoir for
the urine received
from the kidneys
and to discharge it
out periodically
Position
• Empty bladder , in the adult situated within the
pelvis . When distended , it rises up to the
abdominal cavity and becomes an abdomino-
pelvic organ.
• Capacity
– The mean capacity of the bladder is 220 ml, filling
beyond 220ml causes a desire to micturate. Filling
upto 500ml may be tolerated, buut it becomes
painful.
Shape
• An empty bladder is 4 sided pyramid in shape and has
– 4 angles -an apex, neck & 2 lateral angles
– 4 surfaces
• Base (posterior surface)
• 2 inferiolateral surfaces
• Superior surface
When distended it is ovoid in shape

Relations
Bladder- structure of
• 3 layers
– Outer layer
• Loose connective tissue
– Middle layer
• Smooth muscle and
elastic fibres
– Inner layer
• Lined with transitional
epithelium
35
Interior of Bladder
• The mucous membrane is straw
colored & is thrown into folds.
When bladder is distended, these
folds disappear.
• The posterior wall shows a
smooth triangular area called
trigone. There are no mucous
folds in this region.
• At the upper lateral angles of the
trigone are the ureteric openings.
• At its inferior angle is the
internal urethral orifice
Histology
Applied Anatomy
• Congenital Anomalies
– Ectopia vesicae
• Infection –Cystitis
• Neurological lesions
• Rupture of bladder
• Cancer bladder
• Urinary Incontinence
The Urethra
• The urethra is a canal extending from the neck of the bladder to
the exterior , at the external urethral orifice.
• Male: about 20 cm (8”) long
• Female: 3-4 cm (1.5”) long
– Short length is why females have more urinary tract infections than males -
ascending bacteria from stool contamination
urethra
Urethra____
39
Female Urethra
• 3 to 4 cm long
• External urethral orifice
– between vaginal orifice and
clitoris
• Internal urethral sphincter
– detrusor muscle thickened,
smooth muscle, involuntary
control
• External urethral sphincter
– skeletal muscle, voluntary
control
Male Bladder and Urethra
• 18 cm long
• Internal urethral sphincter
• External urethral sphincter
• 3 regions
– prostatic urethra
• during orgasm receives semen
– membranous urethra
• passes through pelvic cavity
– penile urethra

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Urinary System

• Urinary System is one of the four excretory

Fig 7.1 Components of Urinary System

– The kidneys are a pair of excretory organs

Anterior aspect Posterior aspect

• Minor calyx: cup over papilla collects urine

• Renal cortex: outer 1 cm

urine “refreshed” blood

The Ureters are a pair of narrow , thick

When distended it is ovoid in shape

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