RADIOGRAPHIC ANATOMY AND PHYSIOLOGY

RAD 351
URINARY SYSTEM
 RADIOLOGICAL ANATOMY

Urinary system composed of:

 Two kidneys

 Two ureters

 Urinary bladder

 Urethra
 KIDNEYS
Weight
Shape: bean-shaped
Right kidney Left kidney
Site: retro-peritoneal organ Male 80–160 g 80–175 g
Size: 12 6  3 cm (long, wide, thick) Female 40–175 g 35–190 g
Location: lie on either side of the spine, on the posterior abdominal
wall between (T12 - L3)
Composition: it has two Poles:
 Upper: 2.5 cm away from the midline, lie at the level of
interspace between T11 - T12.
 Lower: thinner, less round, about 7.5 cm away from the
midline. Lies at the level of L3
 The adrenal glands are located on the superomedial aspect of the
kidney
 KIDNEYS

 2 Surfaces:
 Anterior:
 Posterior:

 2 Borders:
 Lateral
 Medial (hilum)

Note:
 RT kidney lower than the left one
 The left kidney is a little longer but narrower
than the right once.
 RELATIONS OF THE KIDNEYS
Anterior Surface Posterior Surface
Right:
Upper half:
• Liver
• Diaphragm
• Colon (HF)
• The12th rib
• Small intestine

Left:
Lower half:
• Spleen
• Psoas muscle
• Stomach
• Quadratus muscle
• Pancreas
• Transversus muscle
• Colon (SF)
• Small intestine
 KIDNEYS

·Attached to: ureters, renal blood vessels,

and nerves at renal hilum

· Adrenal gland -located at the top each

kidney

·Renal cortex – outer region

·Renal medulla – inside the cortex

·Renal pelvis – inner collecting tube

 STRUCTURES OF THE KIDNEY
1- Capsule: is a dense fibrous covering of kidney.
2- Parenchyma: is the solid part of the kidney.
Renal sinus

Is divided into two major structures: the renal cortex

(superficial ) and the renal medulla (deep) .
3- Cortex: is the outer layer of the parenchyma
4- Medulla: located Under the cortex composed
of 8 to 18 conical masses termed renal pyramids.
The cortex periodically dips between the pyramids to
form the renal columns, which extend to the renal sinus
5- renal papilla is the location where the renal pyramids in the
medulla empty urine into the minor calyx in the kidney
 STRUCTURES OF THE KIDNEY

6- Calyx (major/ minor): collecting area for urine within

kidney before it passes through to the renal pelvis.
7- Renal Pelvis: is a central collecting system of kidney
8- Hilum: is an area of convergence of the renal collecting
system, ureter, renal artery and vein, nerve.
9-Ureteropelvic junction: is a point at which the renal
pelvis becomes the ureter.
 STRUCTURES OF THE KIDNEY

10- Perihilar fat—layer of fat in the area of the renal hilum.

11- Perinephric fat: is a layer of fat surrounding kidney
outside of capsule.
12- Gerota’s fascia (renal fascia): is a layer of connective
tissue encapsulates the kidneys and adrenal glands.
separates perinephric fat from paranephric fat
13- paranephric fat : the fat in the front and back of the
kidney.
 URETERS

 Renal pelvis leaves each kidney at the hilum to

become the ureter.
 Pair of muscular tubes that connect the kidneys to
the bladder.
 Length: 25-30 cm / Width: 1mm to 1 cm
 Parts:
• Abdominal part: anterior to tips of transverse
process
• Pelvic part: anterior to sacroiliac joint
• Intravesical part: enters the U.B at its
posterolateral portion. anterior to ischial spine,
2cm long
 URETERIC CONSTRICTION (PATHOLOGY)

·The ureter has constrictions at three points (sites of

obstruction and stone impaction):

1- At the ureteropelvic junction

2- At the crossing of external/ common iliac

artery

3- At site of entrance to bladder

 URETERS

The RT ureter is shorter than the LT

WHY?
The left ureter is usually 1 cm longer than the right

NOTE:

-They vary in length depending upon the

height of the person and the position of the

kidneys.
- Both ureters tend to be longer in males.
 URINARY BLADDER (UB)

Shape:
• Empty: pyramidal (apex,
base)
• Full: ovoid (400-1000 cm3)
 Surfaces:
• One superior
• Two inferolateral
• Posterior
 URINARY BLADDER

Internal surface is covered by mucous

membrane except trigon

· Trigone: is a triangular portion of the

U.B along the inner posterior surface
· Has three openings:
 Two from the ureters
posteriorly
 One to exit in site of the
urethra
URINARY BLADDER
 URETHRA

Female urethra:
- A simple tubular structure
Length: about 3- 4 cm

Location
Along wall of the vagina
 URETHRA
Male Urethra
• Length: about 18-20 cm
• Location: Through the prostate and penis
 Parts of male urethra:
1. Pre-Prostatic part: very short and leads into
prostate
2. Prostatic part: (3 cm widest.) Surrounded by
prostatic gland.
3. Membranous part: (2cm) leads into the 1st
bend of the urethra. Liable for trauma,
between prostate and penis
4. Spongy part: urethra of the penis.
FUNCTIONS OF URINARY SYSTEM
FUNCTIONS OF THE URINARY SYSTEM

1.Regulates:

 Water balance

 Electrolytes

 Acid-base balance in the blood (PH)

 Blood pressure

 Red blood cell production

FUNCTIONS OF THE URINARY SYSTEM

2. Eliminate the waste products

 Nitrogenous wastes

 Toxins

 Drugs
KIDNEY/ NEPHRONS
 KIDNEY/ NEPHRONS

·The structural and functional units of

the kidneys

·Responsible for filtering the blood and

production of urine

·Main structures of the nephrons

· Glomerulus

· Renal tubule
 RENAL TUBULE

·Glomerular (Bowman’s) capsule

·Proximal convoluted tubule (PCT)

·Loop of Henle

·Distal convoluted tubule (DCT)

·Collecting duct connect to renal pelvis

 GLOMERULUS

·A specialized capillary bed

·Attached to arterioles on both sides

(maintains high pressure)

·Large afferent arteriole (entering)

·Narrow efferent arteriole (exiting)

 GLOMERULUS

·The glomerulus sits within a glomerular

capsule (the first part of the renal tubule)

·Blood pressure forces water and small solutes

across the membrane into the

capsular space

·And some important nutrients (glucose,

amino acids, vitamins)

·These are reabsorbed in the PCT

 URINE FORMATION PROCESSES

·Filtration

·Reabsorption

·Secretion
 FILTRATION

·Nonselective passive process

·Water and solutes smaller than proteins are forced through capillary walls

·Filtrate is collected in the glomerular capsule and leaves via the renal tubule
 REABSORPTION

·The peritubular capillaries reabsorb several materials

- Some water

- Glucose

- Amino acids

- Ions

·Some reabsorption is passive, where most is active

·Most reabsorption occurs in the proximal convoluted tubule

MATERIALS NOT REABSORBED

·Nitrogenous waste products

·Urea

·Uric acid

·Creatinine

·Excess water
 SECRETION – REABSORPTION IN REVERSE

·Some materials move from the peritubular capillaries into the renal
tubules sush as

- Hydrogen and potassium ions

- Creatinine

·Materials left in the renal tubule move toward the ureter

FORMATION OF URINE
 URETERS

 The tube that carries urine from the kidney to the bladder.

 Peristalsis aids gravity in urine transport

 URINARY BLADDER

·Three layers of smooth muscle

·Mucosa made of transitional epithelium

·Walls are thick and folded in an empty bladder

·Bladder can expand significantly without increasing internal

pressure
 URETHRA

·Thin-walled tube that carries urine from

the bladder to the outside of the body

·Release of urine is controlled by two

sphincters

·Internal urethral sphincter (involuntary)

·External urethral sphincter (voluntary)

 MICTURITION (VOIDING)

·Both sphincter muscles must open to allow voiding

·The internal urethral sphincter is relaxed after stretching of the bladder

·Activation is from an impulse sent to the spinal cord and then back

·The external urethral sphincter must be voluntarily relaxed

 REGULATION OF WATER AND ELECTROLYTE
REABSORPTION

·Electrolytes are essential minerals—like sodium, calcium, chloride, phosphate,

magnesium and potassium—that are vital to many key functions in the body.

·Regulation is primarily by hormones where :

·Antidiuretic hormone (ADH) prevents excessive water loss in urine(hypothalamus)

·Aldosterone regulates sodium ion content of extracellular fluid(adrenal glands)

MAINTAINING ACID-BASE BALANCE IN BLOOD

·Blood is made up of acids and bases

·The amount of acids and bases in the water/ blood can be measured on a pH scale

·The range of pH goes from 0 -14 with 7 being neutral.

·pHs of less than 7 indicate acidity, and pHs of more than 7 indicate alkaline

·Blood pH must remain between 7.35 and 7.45 to maintain homeostasis

·Even a slight change can cause health problems

 MAINTAINING ACID-BASE BALANCE
IN BLOOD
·Alkalosis – pH above 7.45

- Can occur due to decreased blood levels of carbon dioxide(co2),

which is an acid. It can also occur due to increased blood levels of
bicarbonate(Hco3), which is a base

·Acidosis – pH below 7.35

- Caused by an overproduction of acid that builds up in the blood

or an excessive loss of bicarbonate from the blood
 NEPHRON FUNCTION

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