2. KIDNEYS The kidney two in number reddish-brown bean-shaped organs Lie against the posterior abdominal wall at the level of T12 to L3 The R kidney is lower than the left because of the space occupied by the __ It weighs about 160 g The lateral surface is convex and the medial surface is concave, a slit called____ that receive renal nerves, blood vessels, lymphatics and ureter

3. Each kidney is about 12 cm long, 5 cm wide and about 2.5 cm thick. The left is somewhat longer, though narrower than the right . Superior to each kidneys are glands called adrenal gland The kidney adrenal gland, ureter and urinar bladder are located retroperitoneal .weight of the kidney. * adult male ranges from 4.5 – 6 ounces * adult female ranges from 4 – 5.5 ounces

4. The kidneys are protected by 3 layers of C.T. 1. Fibrous renal fascia- deep to the parietal peritoneum which binds the kidney to associated organs to abdominal wall 2. Adipose capsule- a layer of fats that cushions and hold it in place 3.Renal capsule- a fibrous sac that anchored at the hilum and encloses the rest of the kidney, it protects the kidney from infection and trauma

5. .two (2) surfaces. 1. Anterior Surface 2. Posterior Surface .two (2) borders. 1. Internal Border 2. External Border .two (2) extremities. 1. Superior Extremity 2. Inferior Extremity

7. FUNCTIONS 1. They filter blood plasma, separates waste from useful chemicals and eliminates the waste by returning the rest to the bloodstream 2. They regulate blood volume and regulate osmolarity the body fluid 3. They secretes the enzyme renin which activates hormonal mechanism That control B/P and electrolyte balance

8. 4. They secrete hormone erythropoietin, which controls the RBC count and the O2 capacity of the blood 5. They detoxify free radicals of and drugs with the use peroxisomes

12. Two (2) types of nephrons. There are two types of nephrons in the kidney, about 80% are cortical nephrons, and about 20% are juxtamedullary nephrons . 1. Cortical Nephrons 2. Juxtamedullary Nephrons

17. .in the cortex. Afferent arterioles carry blood to a glomerulus Efferent arterioles carries blood away from a glomerulus

21. Collecting tubule- the dct several nephrons drain into straigth tubule, which passes down into the medulla. Near the papilla several collecting ducts merge to form a large PAPILLARY DUCTS.

22. URINE FORMATION Urine is composed of water, certain electrolytes, and various waste products that are filtered out of the blood system. A major part of this "cleaning" of the blood takes place in the kidneys and, in particular, in the nephrons, where the blood is filtered to produce the urine. Urination is the primary method for excreting toxins, chemicals and drugs from the body .

28. Discuss urine formation and renal circulation

29. URETERS A tube that carries urine down from the kidney to the bladder. Each ureter is a muscular tube that extends from the kidney to the posterior surface of the bladder.

30. Each ureters are small tube about 25 cm long that carries urine from the renal pelvis to the urinary bladder. Smooth muscular tissue in the walls of the ureters peristaltically force the urine downward small amounts of urine are emptied into the urinary bladder from the ureters about every 10 to 15 seconds.

32. (3) The inner layer, or mucous coat - is transitional epithelium that is continuous with the linings of the renal tubules and the urinary bladder.

33. LOCATION Male: the ureter enters the pelvis by crossing the bifurcation of the common iliac artery in front of the sacroiliac joint. Each ureter then runs down the lateral wall of the pelvis in front of the internal iliac artery to the region of the ischial spine and turns forward to enter the lateral angle of the bladder.

34. Female: the ureter crosses over the pelvic inlet in front of the bifurcation of the common iliac artery. It runs downward and backward in front of the internal iliac artery and behind the ovary until it reaches the region of the ischial spine. It then turns forward and medially beneath the base of the broad ligament, where it is crossed by the uterine artery. The ureter then runs forward, lateral to the lateral fornix of the vagina, to enter the bladder.

35. BLOOD SUPPLY The arterial supply of the ureters varies according to the individual and also along the length of the ureters. Branches may be received from all of the following: *Renal arteries *Abdominal aorta *Common iliac arteries *Testicular/ovarian arteries *Internal iliac arteries *Vesical/uterine arteries

36. NERVE SUPPLY Renal, testicular(or ovarian), and hypogastric plexuses(in the pelvis).

37. URINARY BLADDER The urinary bladder is a hollow, distensible, muscular organ lying in the pelvic cavity. The wall of the bladder is made mostly of a type of smooth muscle called detrusor muscle which has several layers running in different directions. The bladder is enveloped in loose connective tissue called the vesical fascia.

40. LOCATION It is located retroperitoneally in the pelvis just posterior to the pubic symphysis. It is held in place by ligaments attached to pelvic bones.

41. FUNCTION It stores urine as temporarily reservoir for urine It is the organ that collects urine excreted by kidneys prior to disposal by urination. Urine enters the bladder via the ureters and emits via the urethra.

45. LIGAMENTS The bladder is connected to the pelvic wall by the fascia endopelvina * Pubovesicales – muscle fibers that strengthens the front of fascial attachment. * Rectovesicales – wherein other muscular fibers constitute and run from the fundus of the bladder to the sides of the rectum, in the sacrogenital folds. * Middle umbilical ligament - formed when the vertex of the bladder is joined to the umbilicus by the remains of the urachus. Broad at its attachment to the bladder but narrowing as it ascends.

47. BLOOD SUPPLY Arterial supply comes mostly from branches of the internal iliac arteries. Female: anteriosuperior parts - superior vesical arteries, posterioinferior parts - vaginal Arteries Male: anteriosuperior parts – superior vesical arteries, posterioinferior parts - inferior vesical arteries

48. Venous drainage is via venous plexuses. These drain via veins that correspond to the arteries into the internal iliac veins. Female: vesical venous plexus Male: vesical venous plexus, prostatic venous plexus

49. NERVE SUPPLY The nerves supplying the bladder form the vesical nervous plexus and are both parasympathetic and sympathetic.

51. URETHRA Muscular tube that drains urine from the bladder and conveys it out of the body. Its wall is lined with mucous membranes and contains a relatively thick layer of smooth muscle tissue. It also contains numerous mucous glands called urethral glands , that secrete mucus into the urethral canal.

53. FUNCTION * urinary canal and a passageway of cells and secretions from various reproductive organs Or it also affords an exit for the seminal products * secretion of prostatic and bulbo-urethral glands

54. THREE PORTIONS (1) PROSTATIC PORTION The widest and most dilatable part of the canal and it’s about 3 cm. long

55. LOCATION Runs almost vertically through the prostate from its base to its apex, lying nearer its anterior than its posterior surface; the form of the canal is spindle-shaped, being wider in the middle than at either extremity, and narrowest below, where it joins the membranous portion.

56. FUNCTION When distended, it may serve to prevent the passage of the semen backward into the bladder.

58. LOCATION Extend between the apex of the prostate and the bulb of the corpus spongiosum. It runs downwards and forwards through the urogenital diaphragm. A small portion is passing through the external urethral sphincter.

60. FEMALE URETHRA - is a narrow membranous canal, about 4 cm. long in length - it is placed behind the symphysis pubis, imbedded in the anterior wall of the vagina. Ends at the external orifice of urethra, which is the point at which the urine leaves the body. This is located between the clitoris and the vaginal opening

61. FUNCTION the canal that is only for the passage of urine

62. BLOOD SUPPLY The female urethra receives branches from the: *internal pudendal arteries *vaginal arteries

63. The male urethra receives branches from the: *internal pudendal arteries *arteries supplying the prostate. Veins accompany the arteries and have similar names.

64. NERVE SUPPLY The urethra receives innervation from the pudendal nerve (S2,S3,S4). Afferents from the urethra travel in the pelvic splanchnic nerves.

65. . thank you .