Urinary System & Male Genital System

Dezhi Wang Department of Anatomy, Medical School of Wuhan University

Manneken Pis, a small bronze statue of a little boy peeing, is one of Brussels most famous landmarks.

Q:

1. Which organ produces urine? 2. To transport urine to the environment, how many organs serve as passageway?

URINARY SYSTEM
Composing and functions: Kidney 肾
produce urine Urinary tract Ureter 输尿管 carry urine to the bladder Urinary bladder 膀胱 stores urine temporarily Urethra 尿道 carry urine to the outside genital functions (male) Other functions : Regulating blood volume and blood pressure by adjusting the volume of water lost in urine… Regulating ions in blood by controlling the quantities lost in urine… Helping to stabilize blood pH Helping the liver to detoxify poisons such as urea and uric acid…

Features of kidneys
bean-shaped, the size : 10cm x 5cm x 4cm Two extremities:
Superior extremity (broader) Inferior extremity (thicker)

Two surfaces:
Anterior surface (convex) Posterior surface (plane)

Two borders:
Lateral border (convex) Medial border (concave) Renal hilum 肾门 nerves a slit where vessels and ant. post. V A sup. A V

enter and leave the kidney Renal pedicle 肾蒂 the structures Main structures which pass through the renal hilum and the connective tissue Renal sinus 肾窦 an internal cavity within the kidney, containing the

P inf. P

Coverings of kidney
Three layers (from inside to outside)

Maintaining the kidney’s shape and forming a barrier from the surrounding region

Fibrous capsule: a layer of fibers that covers the outer surface of kidney closely Adipose capsule: a thick layer of adipose tissue
act as a soft cushion

Renal fascia: a dense, fibrous outer layer which enclose the kidneys and suprarenal gland, can be divided into anterior and posterior layers
Fibers from the renal fascia cross the adipose capsule to the fibrous capsule to fix the kidney

Location of kidneys

The kidneys are located on the posterior abdominal wall, either side of the vertibral column. The kidneys extend from the level of the 11th or 12th thoracic vertebra superiorly to the third lumbar vertebra inferiorly. The 12th ribs are behind the posterior surface of the kidneys The right kidney Lies slightly inferior to the left kidney

Structure of kidney

Renal cortex Renal column Renal medulla

The superficial area Inward extensions of the renal cortex The deep darker area

Structure of kidney
urine Renal papillae Papillary foramina Minor renal calices Major renal calices Renal pelvis Becomes narrow Ureter 输尿管

ureter
Junction of the ureter and the renal pelvis Abdominal part terminal part of left common iiliac A. beginning of right external iiliac A. Junction of ureter and the wall of bladder Ureteric orifice

Three parts

Pelvic part Intramural part

ureter
Abdominal part

Junction of ureter and the renal pelvis

The first narrowed place The second narrowed place

Three parts

Pelvic part Intramural part

terminal part of left common iiliac A. beginning of right external iiliac A. Junction of ureter and the wall of bladder Ureteric orifice

The narrowest place Kidney stones tend to lodge in the three narrowed places

A radiographic view of the urinary system (Posterior view. Obtained by taking an x-ray of the kidneys after a radiopaque compound has been administered.)

location of urinary bladder
Empty bladder
Lies entirely within the pelvis Posterior to the pubic symphysis Anterior to the rectum (male) or the vagina and uterus (female)

Full bladder
roughly spherical and expands superiorly into the abdominal cavity

Features and of empty bladder
Empty bladder has the shape of an upside-down pyramid with four parts Apex, fundus, body and neck and

four triangular surfaces four angles

Structure of urinary bladder
Trigone of bladder
A triangular smooth area at the base of the bladder between the openings of the two ureters and that of the urethra Each year in the US, approximately 52,000 new cases of bladder cancer are diagnosed, and millions of new cases in India and China. The bladder cancer rate is highest among cigarette smokers and employees of chemical and rubber companies. A fold of mucous membrane between the ureteric orifices It is the landmark to find the ureteric orifices when the urinary bladder is examined with cystoscope in the living body The trigone is of special clinical importance because infections and cancers tend to persist in this region

Interureteric fold

Urethra
Extends from the neck of the urinary bladder to the exterior, between internal and external urethral orifice.

Male urethra has three parts Female urethra
short and straight

Urinary tract infections occur in about 40% of women. Most urinary tract infections occur in sexually active young women, because intercourse drives bacteria from the vagina and the external genital region (and from the anus as well) through the nearby opening---the short urethra and toward the bladder. The infection of the bladder, can spread superiorly to infect the ureters and kidneys.

Urethral sphincter
Internal urethral sphincter: A thickening of the smooth muscle around the internal urethral orifice

External urethral sphincter: A circular band of skeletal muscle in the urogenital diaphragm, which can be used voluntarily to inhibit urination until the proper time.

Male genital organs

Internal genital organs
Gonad Testes Reproductive duct Accessory glands Epididymis, Ductus deferens, Ejaculatory duct, Urethra Seminal vesicles, Prostate gland, Bubourethral glands Scrotum , Penis

External genital organs

Testes
Tunica albuginea Septa testis   Lobules of testis Seminiferous tubules sperms

Testes and epididymis
sperms Rete testis Efferent ductules Head of epididymis Body of epididymis Tail of epididymis

Ductus deferens

Ductus deferens
The level of tail of epididymis Testicular part Funicular part Inguinal part The shortest part The level of head of epididymis Can be palpated easily The superficial inguinal ring Lies in the inguinal canal The deep inguinal ring Pelvic part The longest part The junction of the semianl vesical and ductus deferens

Four parts

Seminal vesicles and ejaculatory duct
Seminal vesicle
The yellow secretion constitutes 60% of the volume of semen

The end of ductus deferents

Excretory duct of seminal vesicle

Ejaculatory duct
Open into Prostatic urethra

Spermatic cord and scrotum
Spermatic cord
Deep inguinal ring upper extremity of testis Ductus deferens Testicular artery Pampiniform plexus of vein Nervous plexus Lymphatic Vessels

Contents

Spermatic cord and scrotum
Coverings of testis
Skin Scrotum Dartos External spermatic fascia Cremaster Internal spermatic fascia

Coverings of Spermatic cord

Sperm cannot be produced at the core body temperature of 37℃, the scrotum’s superficial position provides an environment that is about 3 ℃ cooler, an essential adaptation. Furthermore, the scrotum responds to changes in external temperature. If the external temperature is too high…

Prostate gland
Inferior to the neck of urinary bladder Superior to the urogenital diaphragm Posterior to the pubic symphysis Anterior to the ampulla of rectum Apex of prostate Base of prostate Three parts Corpus glandulae The milky secretion constitutes about 1/3 of the volume of semen
Prostate enlargement occurs in about 50% of men at age 50 and 80% of men at age 70. It often begins with the hesitation to urinate, a weak stream and increased urinary urgency and frequency and may cause urinary obstruction finally. A digital rectal exam can help diagnose the disease, because there is a shallow sulcus lies in the midline of the posterior wall of prostate, the shallow sulcus disappears when the prostate enlarges.

Bulbourethral gland
Pea-sized glands (round and with the diameters approaching 10 mm inferior to the prostate, within the urogenital diaphragm
The bulbourethral glands produce a thin, clear fluid, some of which enter the spongy urethra when a male becomes sexually excited prior to ejaculation. which constitutes less than 5% of the volume of semen. There are some sperms within the secretion of bulbourethral glands, so some females pregnant after coitus interruptus.

magnify

Three parts:

penis
Neck of penis

Glans of penis: thickened distal end Body of penis: the movable portion Root of penis: the posterior portion

Prepuce

the folded skin upon the neck and glans

Orifice The free border of of the prepuce prepuce Cavernous bodies
Long cylindrical erectile bodies Covered with albuginea Two cavernous body of penis The proximal end crus penis glans penis bulb of penis One cavernous body of urethra The enlarged distal end The enlarged proximal end

male urethra
Prostatic portion

Anterior urethra Posterior urethra

Urethral crest: a longitudinal mucosal fold on the posterior wall Seminal colliculus: a prominence on the urethral crest Openings of ejaculatory duct, prostate Membranous portion Cavernous portion

Two curves Three constriction Three dilated places

Semen
A typical ejaculation release 2~5ml of semen. This volume of fluid, called a ejaculate, contains: Spermatozoa. A normal sperm count ranges from 20 million to 100 million spermatozoa per cubic milliliter of sperm. Seminal fluid. Seminal fluid, the fluid component of semen, is a mixture of glandular secretions with a distinct ionic and nutrient composition. A typical sample of seminal fluid contains the combined secretions of the seminal vesicle (60%), the prostate gland (30%), the sustentacular cells and epididymis (5%), the bulbourethral glands (less than 5%). Enzymes .

Male sexual response
The chief phases of the male sexual response are: 1. Erection, which allows penis to penetrate into the female vagina; Erection results from engorgement of the cavernous bodies with blood. During sexual excitement, the arteries supplying the cavernous bodies dilate, increasing the flow of blood to the vascular spaces within, and the smooth muscle in the partitions in these bodies relaxes, allowing the bodies to expand as the blood enter them. As the cavernous bodies begin to swell, they press on the small vein that normally drain them, slowing venous drainage and maintaining engorgement. 2. Ejaculation, which expels semen into the vagina. Ejaculation begins with a strong contraction of the smooth musculature throughout the reproductive ducts and glands, which squeeze the semen toward and into the urethra. Simultaneously, the bulbospongiosus muscle of the penis contracts rapidly, aqueezing the semen onward through the cavernous portion of urethra and out of body.

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