URINARY ORGANS. EXTERNAL AND INTERNAL STRUCTURE OF KIDNEY. NEPHRON MORPHOLOGICAL AND FUNCTIONAL UNIT OF KIDNEY. BLOOD SUPLYING

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1 Theme 31. Urinary organs. External and internal structure of the kidney. Nephron - structural and functional unit of the kidney. Blood supply. Shell kidney, its topography. URINARY ORGANS. EXTERNAL AND INTERNAL STRUCTURE OF KIDNEY. NEPHRON MORPHOLOGICAL AND FUNCTIONAL UNIT OF KIDNEY. BLOOD SUPLYING. CAPSULES AND TOPOGRAPHY OF KIDNEY URINARY SYSTEM includes pair organ - kidney (organ producing urine) and organs, which store up and bring out urine (ureters, urinary bladder and urethra). Two KIDNEYS are pair parenchymatic organs, which positioned in abdominal cavity behind peritoneum (retroperitoneal position) in right and left lumbar regions. Kidney is projected on front abdominal wall in epigastric, lateral and umbilical regions. Right kidney extends from Th 12 vertebra till L 3 lumbar vertebra, left one - from Th 11 vertebra till L 2 lumbar vertebra.

2 Posterior abdominal wall, after removal of the peritoneum, showing kidneys, suprarenal capsules, and great vessels. Posterior surface of each kidney in superior part adjoins to diaphragm, and in middle and inferior - to muscular bed, which is formed by muscle: psoas major, quadratus lumborum and transverse abdominis. To anterior surface of left kidney adrenal gland adjoins above, to superolateral part - spleen, to middle portion - stomach and pancreas, inferiorly - medially is loops of small intestine, and superolaterally - colon. To anterior surface of right kidney suprarenal gland adjoins above, to middle part - liver, to medial margin - duodenum, to inferiomedial - loops of small intestine and to inferiolateral - large intestine.

3 Vertical section of kidney. Each kidney has superior extremity and inferior extremity, anterior surface and posterior surface, medial margin (concave) and lateral margin (convex). On medial margin are situated the renal hilus, where artery, nerves enter, and vein, lymphatic and renal pelvis exit. The renal hilus gets into kidneys, forming a renal sinus, filled by adipose tissue, also major renal calices and minor renal calices and initial part of renal pelvis are present there.

4 VIDEO To parenchyma of the kidney a fibrous capsule adjoins. Outside from last a fatty capsule is situated, which noticeable better near posterior surface of kidney. More outer from adipose capsule renal fascia disposed, which consists of anterior sheet and posterior sheet. They fused together by superior edges and laterally. From renal fascia stratums of connective tissue draw to fibrous capsule kidney, which fix a kidney. Peritoneum adjoins to anterior sheet of renal fascia. Kidneys are fixed by abdominal pressure, renal fascia, muscular bed, renal vessels and nerves, which form a renal leg. Sagittal section through posterior abdominal wall, showing the relations of the capsule of the kidney.

5 Renal parenchyma consists of cortex (superficially) and medulla (deep location). In medulla they distinguish 7-10 renal pyramids, each from which has a base of renal pyramids and a top (apex). Last terminates in renal papilla where cribriform area disposed. The stratums of cortical matter, which form the renal columns, lie between pyramids. Cortical matter consists of convoluted part, between which the stratums of medulla are contained. They have a name medullar rays (radiata part). Each renal pyramid forms renal lobe, and one convoluted part and one radita part form renal lobule in cortex. From top of renal pyramid urine gets into minor renal calices (7-8 in number), from them urine flow into 2-3 major calices, then it moves into renal pelvis, which continues into ureter. BLOOD SUPPLYING of KIDNEYS. Kidney supplied by renal artery, which ramifies in hilus area into anterior branch and posterior branch. Last divide by segmental arteries, and segmental branches - into interlobar arteries, which ramify on border of cortex and medulla into arcuate arteries. Arcuate arteries give off the radial cortical (interlobular) arteries in cortical matter. They give beginning for numerous of afferent vasa, which disintegrate into arterial capillaries and form a renal glomerulus. From renal glomerulus moves away efferent vasa, which disintegrates into secondary arterial capillaries, that enshrouds the tubules of nephron. Such system of blood supplying, when arterial vessels have double disintegration into cappillaries called as renal miracle arterial rete. Venous capillaries form in cortical matter stellate venullae, which fall into arcuate veins. Arcuate veins continue into interlobar veins, last form a renal vein, which empties in inferior vena cava.

6 FORMING and TRANSPORTATION of URINE within the KIDNEY. Primary urine arises by filtration blood plasma in nephron capsule, which envelops each renal glomerulus. Capsule of renal glomerulus together with glomerulus form a renal corpuscle, which is situated in convoluted part of cortex. Proximal canalicule of nephron passes from renal corpuscle, which continues into nephron loop (ansa of Henle). Last continues into distal part of nephron canalicule which falling into collecting duct. All of above counted urinary tubules braid by thick net of secondary arterial capillaries and by reabsorbtion secondary urine here is formed. The elements, where urine is formed, compose function and structural kidney unit nephron:

7 After nephron urine streams into straight colligens (collecting) tubules, which terminate by pappillar foramens on top of renal pyramid. Last open on cribriform area into minor renal calices. From small renal calices urine flows into major renal calices, which join together and form a renal pelvis, last continues into ureter. VIDEO THE URETERS are pair organ length 25-З0 cm, which lies retroperitoneally. Ureter has abdominal part, pelvic part and intramural part. Last lies in the wall of urinary bladder and opens on its fundus by foramen. Ureters wall consists of external membrane, muscular membrane and mucous membrane. Muscular membrane has external circular and internal longitudinal layers. Ureter has follow narrow places:

8 at transition of renal pelvis into ureter; at transition of abdominal part into pelvic part; at transition of ureters into urinary bladder. References: 1. Gray`s Anatomy. Lawrence H. Bannister, Martin M. Berry, Patricia Collins and others. Churchhill Livingstone, p. 2. W. Kahle, H. Leonhardt, W. Platzer. Colour atlas and Textbook of Human Anatomy. Stuttgart, New York, R.D. Lockhart, G.F. Hamilton, F.W. Fyfe. Anatomy of the human body. Philadelphia. 4. F.H. Netter. Atlas of Human Anatomy. Cіba Pharmaceutіcals Dіvіsіon, p. 5. Synelnіkov R.D. The atlas of anatomy of the man. Іn the 4-th volumes. -: Medіcіna, Lecture. 7. Colіn H. Wheatley, B.Kolz. Human anatomy and physіology Reminetskyy B.Y., Fedonyuk Y.I. Human anatomy. Locomotory apparatus. Notes. Ukrmedknyha, , p.