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Kidneys
Kidneys
Kidneys
Kidneys
Kidneys
Kidneys
Kidneys
Kidneys
Kidneys
Kidneys
Kidneys
Kidneys
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Kidneys

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  • 1. Kidneys and Urination
    • Kidney
      • Location and blood supply
      • Internal anatomy
      • Microscopic anatomy and function
    • Ureter
    • Bladder and urethra
  • 2. Location of kidney
    • Retroperotoneal at mid-abdomen
    • T12-L3
    • NAV enters at hilus
      • Renal aa. off aorta
      • Renal vv to IVC
      • Nerves all autonomics--renal plexus
    • Ureter--exits at hilus
    • “ Ad”renal gland superior to kidney--unrelated in function
      • Own blood supply
      • Endocrine gland
  • 3. Internal anatomy of kidney
    • NAV branch out from hilus
    • Collecting ducts unite and urine leaves through ureter at hilus
    • Cortex is outer/superficial tissue
      • Light, granular
      • Functioning nephrons here
    • Medulla is inner/deep tissue
      • Darker
      • Pyramid-cone shape
      • Collecting tubules unite into ducts into ureter
  • 4.
    • Lobe of kidney is medullary pyramid plus cortex around it
    • Cortex contains urine-concentrating nephrons
    • Medullary pyramids
      • Tubules receive concentrated urine from cortex
      • Appear striated because contains parallel converging urine-collecting tubules
    • Flow of urine
      • Collecting tubes of medullary pyramid  minor calyx  major calyx  renal pelvis  ureter
    Pg 679 Internal anatomy of kidney--details
  • 5. Microscopic anatomy and function
    • Nephron or urine-concentrating unit is in outer cortex--millions
    • Capillaries surround glomerulus (ball) and filtrate passes into duct
    • Counter-current exchange in ducts (Loop of Henle) concentrates urine)
    More details at “How Stuff Works” http:// science.howstuffworks.com/kidney.htm/printable
  • 6. Ureter--from kidney to bladder
    • LAYERS OF URETER
    • External connective tissue--adventitia
    • Middle muscular layer--muscularis
      • Smooth Muscle
      • Inner Longitudinal
      • Outer Circular
      • External longitudinal (on distal third)
      • Peristaltic action moves urine to bladder (and stones!!)
    • Inner lining of transitional (stretchy) epithelium--Mucosa
  • 7. Bladder
    • Muscular (what kind?) sac that fills with urine from ureters
    • Anterior against pubis in pelvis (more with pelvis)
    • Filled with urine expands into abdomen
    • Blood supply from internal iliac arteries
    • Innervation is autonomic from hypogastric plexus
  • 8. Layers of bladder wall
    • Outer connective tissue--adventitia
    • Middle muscular layer (“detrusal” or expulsor)--inner and outer longitudinal fibers around middle circular fibers
    • Inner transitional (stretchy) epithelium
    • Bladder can expand 15 times its empty volume to hold 500 ml of urine
    • Trigone is triangle between ureters/urethra--persistent sight of infection
  • 9. Urethra
    • Drains urine from bladder to outside
    • Female = short tube
    • Males = long tube
      • Prostatic, Membranous, Spongy (penile) portions
      • Also carries sperm
    • Internal Urethral Sphincter
      • Between bladder + urethra
      • Thickening of detrusor (smooth muscle)
    • External Urethral Sphincter
      • Within urogenital diaphragm
      • Skeletal muscle = voluntary control urination
    • External Urethral Orifice
      • Males = end of penile urethra
      • Females = anterior to vaginal opening, posterior to clitoris
    • (more later with pelvis)
  • 10. For nice review of kidneys and urination http:// webanatomy.net/anatomy/urinary_notes.htm Micturition = Urination
    • Emptying bladder
      • Stretch receptors in bladder respond when bladder full
      • Parasympathetic signals detrusor muscle to contract and internal urinary sphincter to open (also inhibits sympathetic pathways that would prevent urination)
      • Other brain receptors can inhibit urination by relaxing detrusor, and keep external urinary sphincter closed
      • Voluntary contraction of abdominal wall muscles increases abdominal pressure
      • Voluntary relaxation of external urethral sphincter
    See pg 692, M&M
  • 11. Ascent of the kidney in development
    • Kidneys from intermediate mesoderm
    • Pronephric kidney in fetus shows segmental body plan
    • Fish with dorsal renal tissue lateral to vertebral column for most of length
    • In human, metanephric kidney migrates from inferior to superior
    • Variation in kidney shape not uncommon (horseshoe kidney
    • Ureter also from intermediate mesoderm
  • 12.  

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