Anatomy of Urinary System

UROLOGY
UROLOGY
Kidneys
Ureters
Urinary bladder
Urethra
ANATOMY OF URINARY SYSTEM
KIDNEYS
Kidneys:
Pair of excretory organs retroperitoneally located
on either side of vertebral column
Extent – T12 to L3, Rt lower than Lt
Dimensions – 12cm*6cm*3cm
Lateral border convex, medial concave with
hilum-Renal vein> Renal artery >Renal pelvis
KIDNEYS
Capsules of kidneys
Fibrous
Perirenal fat
Fascia of Gerota
Pararenal fat
KIDNEYS
Blood Supply:
Renal Arteries arise from the aorta (L1/L2)
Near hilum ,anterior & posterior divisions
Segmental Arteries >Lobar artery>Interlobar artery> arcuate artery >interlobular artery > glomerular
artery
• These supply the 5 renal vascular segments (apical, superior (anterior), inferior, middle (anterior) and
posterior).
• Each vascular segment is supplied by end arteries.
Accessory Renal artery in 30% of cases.

KIDNEYS
KIDNEYS
KIDNEYS
Venous drainage:
• The renal veins drain into the Inferior vena cava
IVC.
• The left renal vein is longer than the right renal

vein and receives the left suprarenal veins and left
gonadal vein.
• On the right, these drain directly into the IVC.

KIDNEYS
Lymphatic Drainage of the Kidneys :
• Lymphatic Drainage of the Kidneys is to the
lumbar nodes.
KIDNEYS
Nerve supply ( T10,11,12)
• The renal plexus usually continues into the kidney around the renal arteries
• Most renal nerves are vasomotor
• Sensory nerves pass back to the CNS with the thoracic splanchnic nerves
• The renal plexus gives rise to the ureteric and gonadal plexuses
KIDNEYS
URETERS
Two tubes which convey the urine from the kidneys
to the urinary bladder.
Each commences within the sinus of the
corresponding kidney as a funnel-shaped
dilatation, renal pelvis
Renal pelvis situated partly inside and partly outside
the renal sinus.
Usually placed on a level with the spinous process
of the first lumbar vertebra
URETERS
Ureter Proper measures from 25 to 30 cm in length.
Runs downward and medially in front of the Psoas
major and, the pelvic cavity and opens into the
bladder.
Constrictions
 PUJ
 At the brim of lesser pelvis
 At the bladder wall
URETERS
Blood supply
Ureter is supplied by three sets of long arteries:
Upper ( abdominal part ) supplied by

 Ureteric branch of renal artery.
Middle part supplied by.

 From abdominal aorta.
 Gonadal.
 Common iliac.
 Internal iliac arteries.
lower (pelvic part ) supplied by.

 superior & inferior vesical arteries.
 middle rectal.
 uterine arteries.
URETERS
Lymphatic drainage of ureter:
• Lymphatic run back along arteries.
• Abdominal portion drains into.
Para aortic nodes.
• Pelvic portion drains into.
Common iliac nodes.
Internal iliac nodes.
URETERS
URETERS
Innervation :
•Sympathetic innervations.
From T10-L1 segments of cord reach ureter via coeliac &
hypo gastric plexus.
 Pain fibres accompany sympathetic nerves.
•Parasympathetic innervations.
From pelvic splanchinic nerves.
 Functional significance is not clear.
URETERS
URINARY BLADDER
Musculomembranous sac which acts as a
reservoir for the urine.
Its size, position, and relations vary according to

the amount of fluid it contains.
Adult bladder normally has capacity of 400-

500ml.
URINARY BLADDER
INTERIOR OF BLADDER
URINARY BLADDER
Trigone lies immediately above the internal
urethral orifice
Ureters open at posterolateral angles of trigone
Internal sphincter is formed by detrusor and

represents bladder neck.
URINARY BLADDER
Blood supply of urinary bladder:
• Superior & inferior vesical arteries provide most of arterial

supply.
•Small contribution from.

 Obturator.
 Inferior gluteal.
 Uterine.
 Vaginal arteries.
URINARY BLADDER
URINARY BLADDER
URINARY BLADDER
Venous drainage of urinary bladder:
• Veins do not follow the arteries.
• They form plexus that converges on vesicoprostatic plexus in groove b/w

bladder & prostate.
• Plexus drain backwards across the pelvic floor to the internal iliac veins.
• There is similar plexus in female, communicating with veins in base of the

bladder.
URINARY BLADDER
URINARY BLADDER
URINARY BLADDER
Nerve supply of Urinary bladder:
•Parasympathetic:
 Main motor innervation of the bladder reach via pelvic splanchinic nerves.
 Sensation of normal bladder distention travels with parasympathetic fibres.
 Bladder pain ( stone) reach spinal cord by both sympathetic & parasympathetic
pathway. ( lateral corticospinal ).
URINARY BLADDER
URINARY BLADDER
Sympathetic :
 Come from L1 & L2 segments of spinal cord .
(Via superior & inferior hypo gastric plexus )
 Vasomotor & inhibitory to the detrusor muscle.
 Motor to superficial trigonal muscle & muscle of

bladder neck ( in the male)
URINARY BLADDER
URETHRA
A tube that connects the urinary bladder to the
genitals for the removal of fluids out of the body
Urethra only for urinating in women but for both

urinating and ejaculating in men.
The external urethral sphincter is a striated muscle

that allows voluntary control over urination.
URETHRA
URETHRA
Male – 20cm, divided into four parts :
Prostatic
Membranous
Bulbar
Penile
Female – 4cm
URETHRA
URETHRA
URETHRA
Venous Drainage:
Inferior vesical vein
Middle rectal vein
Innternal pudendal vein
URETHRA
Lymphatic Drainage:
Internal iliac nodes .
Some to external iliac noses.
URETHRA
Nerve supply of urethra:

Perineal branch of pudendal nerve.
Inferior hypo gastric plexus.
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UROLOGY

• Each vascular segment is supplied by end arteries.

Accessory Renal artery in 30% of cases.

• The left renal vein is longer than the right renal

• On the right, these drain directly into the IVC.

• Most renal nerves are vasomotor

Upper ( abdominal part ) supplied by

Middle part supplied by.

lower (pelvic part ) supplied by.

Its size, position, and relations vary according to

Adult bladder normally has capacity of 400-

Ureters open at posterolateral angles of trigone

Internal sphincter is formed by detrusor and

• Superior & inferior vesical arteries provide most of arterial

•Small contribution from.

• They form plexus that converges on vesicoprostatic plexus in groove b/w

• There is similar plexus in female, communicating with veins in base of the

 Sensation of normal bladder distention travels with parasympathetic fibres.

 Vasomotor & inhibitory to the detrusor muscle.

 Motor to superficial trigonal muscle & muscle of

Urethra only for urinating in women but for both

The external urethral sphincter is a striated muscle

Nerve supply of urethra:

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