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A.SWAROOPA
MSC(NURSING)
VITAL ORGANS
Organs of the Renal System
• 2Kidneys
• 2Ureters
• Urinary bladder
• Urethra
• Not many
structures, but
very important!
Fi...
Kidneys
LOCATION:
 Kidneys are a pair of excretory organs situated on the
posterior abdominal wall,
 above the waist,
 ...
Renal Anatomy
• Paired retroperitoneal bean-shaped organs
• Located in the dorsal upper lumbar region
• Encased in the ren...
Kidneys
Right kidney is slightly lower than the left because the
liver occupies considerable space on the right side
super...
KidneysCOLOR AND SHAPE:
Red color and bean shaped.
CAPSULES OR COVERINGS OF KIDNEYS
 Fibrous capsule,
 Peri-renal fat,
...
11 cm
6cm
3cm
8
HEIGHT & WEIGHT:
Each kidney is 11 cm (4-5”) long, 6 cm (2-3”) broad and
3 cm (1”) thick, weight 150 g in ...
ORGANS ASSOCIATED WITH THE KIDNEYS
SUPERIORLY- RIGHT ADRENAL GLAND.
ANTERIORLY- RIGHT LOBE OF THE LIVER ,
DUODENUM, & HEPA...
Peritoneal relations:
The kidneys are
retroperitoneal.
Certain areas of each
kidney are covered in
anteriorly by peritoneu...
12
Internal Structure of the Kidney
Renal pyramids
Renal papilla
Renal Columns
Renal Lobe
13
Human Kidney
Protection of the Kidneys
• 3 layers of connective
tissue:
– Inner layer- Renal capsule
– Middle layer- Adipose
capsule
– ...
3 layers of tissue surrounds the each
kidney
DEEP LAYER ( RENAL CAPSULE ) is a smooth
transparent sheet of dense irregular...
Middle layer: the adipose capsule : is a mass
of fatty tissue surrounding the renal capsule.
it also protects the kidney f...
GROSS STRUCTURE OF THE KIDNEY
Longitudinal section there are 3 areas.
I. Fibrous capsule
II. Cortex
III. Medulla
19
RENAL FIBROUS CAPSULE: surrounds the kidney,
made of dense fibrous connective tissue.
20
CORTEX: A reddish brown layer of tissue
immediately below the capsule and out side the
pyramids.
21
MEDULLA: the inner most layer consisting of pale
conical shaped striations called renal pyramids.
Surface anatomy of the Kidney
• Hilum is located on
the medial surface
HILUM: it is the concave medial border or deep
fiss...
23
RENAL PELVIS: it is the funnel shaped structure
which acts as a receptacle of the urine formed by
the kidney.
IT HAS NUMBER OF DISTAL BRANCHES CALLED CALYCES ,
EACH OF WHICH SOROUNDS APEX OF THE RENAL PYRAMID.
URINE FORMED IN THE KI...
25
THE WALLS OF THE PELVIS CONTAINS SMOOTH
MUSCLE AND ARE LINED WITH TRANSITIONAL
EPITHELIUM.
PERISTALYSIS OF THE SMOOTH M...
The ureteric pelvis usually divides into two or
three short tubes, the major calices, each of
which subdivides into 7 to 1...
Intravenous pyelogram:
Note the calices and the
pelves of the ureters,
which differ in shape and
level.
Renal Pedicle:
The ureter and renal
vessels near the hilus form
the pedicle.
The renal vein anterior, the
ureter is poster...
The glomerular capillaries called the glomerulus.
The usual direction of blood flow is:
• Arteries
• Arterioles
• Capillar...
BLOOD SUPPLY TO KIDNEY
ARTERIAL SUPPLY
ABDOMINAL AORTA
RENAL ARTERIES
SEGMENTAL ARTERIES
INTERLOBAR ARTERIES
ARCUATE ARTER...
BLOOD SUPPLY TO KIDNEY
VENOUS SUPPLY
INFERIOR VENACAVA
RENAL VEINS
SEGMENTAL VEINS
INTERLOBAR VEINS
ARCUATE VEIN
INTER LOB...
The Blood Supply to the Kidneys
Regulates blood flow to the kidney by
causing vasodilation or vaso constriction of
renal arterioles.
Autonomic plexuses in...
Filtering & phagocytosis
Proliferation of
lymphocytes
Lumbar aortic
nodes
MUSCLES ATTACHEDTO KIDNEYS
QUADRATUS
LUMBORUM
MUSCLE
ILLIACUS MUSCLE
PSOAS MAJOR
MUSCLE
40
Parts of the kidney:
1. Renal pyramid
2. Efferent vessel
3. Renal artery
4. Renal vein
5. Renal hilum
6. Renal pelvis
7...
MICROSCOPIC ANATOMY OF THE KIDNEYS
• The functional unit of the lungs is the
alveolus.
• The functional unit of the liver ...
 Cortical nephrons with short loop of Henle.
 Juxtamedullary nephrons with long loops of Henle.
Two types of nephrons
CORTICAL NEPHRONS
i. 85% of nephrons
are in this type.
ii. Most of the parts of
nephron are in
cortex only.
iii. Length of...
The glomerular filtration membranes are consist of 3
layers of capillary wall.
---Endothelium.
---Basement membrane.
---Ep...
Histology of Filtration Membrane
1) Endothelium of glomerulus
– Single layer of capillary endothelium with
fenestrations
–...
Histology of Filtration Membrane
2) Basement membrane of glomerulus
– Between endothelium and visceral layer of glom. caps...
Histology of Filtration Membrane
3) Filtration slits in podocytes
– Podocytes
• specialized epithelium of visceral layer
•...
THE FILTRATE THEN DIFFUSES ACROSS BOWMANS SPACE
AND INTO THE TUBULES OF THE NEPHRON.
IN THE TUBULES SOME SUBSTANCES ARE AD...
LOOP OF HENLE
REABSORPS THE WATER AND IONS FROM THE URINE
• AND CONTROLS THE CONCENTRATION OF URINE.
–THICK PORTION
–THIN ...
PROXIMAL CONVOLUTED TUBULE (PCT)
LOOP OF HENLE
Descending limb of the loop of henle
ASCENDING LIMB OF THE LOOP OF HENLE
DISTAL CONVOLUTED TUBULE( DCT)
COLLECTING DUCT
TUBULE HISTOLOGY
• PCT : cuboidal cells with apical microvilli
• Descending Loop and beginning of Ascending
Loop: simple s...
The Nephron
JUXTAGLOMERULAR APPARATUS
 The distal end of the renal
tubule passes next to the
glomerulus to form the
juxtaglomerular
a...
KIDNEY FUNCTIONS
The ureter is continous with the funnel
shaped renal pelvis.
The ureters are the tubes that convey urine
from the kidneys ...
The ureter is a retroperitoneal, distensible muscular
tube that connects the kidney with the bladder.
Because of this arrangements (psoas major
muscle, sacro illiac joint , posterior wall of the
bladder ) when urine accumula...
Ureter relations
• It lies within the hilum of the
kidney and receives the major
calyces
• It enters the pelvis by crossin...
RELATIONS TO URETERANTERIOR:
• Duodenum,
• Terminal part of the ileum,
• Right colic vessels,
• Iliocolic vessels,
• Righ...
CONSIST OF 3 LAYERS OF TISSUE:
1) Outer covering of fibrous tissue.
2) Middle muscular layer consisting of smooth muscle f...
Blood Supply• Upper end is supplied by
the renal artery
• Middle portion by
(gonadal) testicular or
ovarian artery
• In th...
The lymph drains to the lateral aortic nodes
and the iliac nodes
Sympathetic supply
from renal,
Testicular, ovarian
hyogastric & pelvic
plexus.
Para sympathetic
supply from sacral
plexus.
Ureters
• Each ureter has three
constrictions along its
course,
• 1- Where the renal pelvis
joins the ureter,
• 2- As it c...
SUPRARENAL GLANDS
• The two suprarenal glands
are yellowish
retroperitoneal organs that
lie on the upper poles of the
kidn...
LEFT SUPRARENAL
GLANDS
• Left suprarenal gland is
crescentic in shape.
• Extends along the medial
border of the left kidne...
RIGHT SUPRARENAL
GLANDS• The right suprarenal gland
is pyramidal in shape and
caps the upper pole of the
right kidney.
• I...
Suprarenal Glands• The cortex secretes hormones
include:
• Mineral corticoids, which
control fluid and electrolyte
balance...
Blood SupplyARTERIES:
Three arteries supplying each gland,
• 1- Superior suprarenal artery: from
inferior phrenic artery
•...
88
URINARY BLADDER • Collapsible muscular sac.
• Stores and expels urine.
• Lies on pelvic floor
posterior to pubic
symphy...
The Final Common Pathway
• Urinary bladder
– hollow muscular organ
– generally smaller in females due to presence of a
ute...
90
91
The openings of the two ureters and the urethra mark a
triangular area called the trigone on the bladder floor.
S
T
R
U
C
...
Bladder- structure
3 layers
– Outer layer
• Loose connective tissue
– Middle layer
• Smooth muscle and
elastic fibres
– In...
• Bladder histology:
– Sphincters control entry from ureters.
– Exit at the urethra.
• circular smooth muscle fibers form ...
URETHRA
–small tube from floor of bladder to exterior
of body.
• females -- fairly straight path exits anterior to
vagina....
The Urethra
- conveys urine from the urinary bladder to the
outside of the body.
FEMALES MALE
3-4 cm (1.5”) 20 cm (8”)
gre...
The male urethra has three regions:
1) prostatic urethra
2) membranous urethra
3) penile urethra.
Difficulty in voiding ur...
URETHRAL SPHINCTERS IN BOTH SEXES:
-Internal Urethral Sphincter- under involuntary control of
smooth muscle.
-External Ure...
HISTOLOGY
FEMALE: THREE COATS
Inner mucosa,
Intermediate thin layer of spongy tissue with plexus of
veins.
Outer muscul...
100
KNOW:
-Micturation center of
brain: pons.
-Parasympathetic: to
void.
-Sympathetic: inhibits
micturation.
CONGENITAL ANOMALIES OF KIDNEY:
AGENESIS (one or both fetal kidney are absent).
HYPOPLASIA (Small kidney).
ECTOPIC KIDNEYS...
HYPOPLASIA ECTOPIC KIDNEY
HORSE SHOE PCKD PANCAKE KIDNEY
Epispadias & hypospadias:
Mutual opening located on dorsal or superior surface of the
penis. Ventral or inferior surface o...
Addison’s disease, chronic adrenal insufficiency,
hypocortisolism, and hypoadrenalism) is a rare,
chronic endocrine system...
Urinary tract
infections
is the inability to
empty the
bladder completely.
URINARY
RETENTION
CHRONIC
RENAL
FAILURE
Dialysis
the clinical purification of blood by dialysis, as a
substitute for the normal function of the kidney.
Anatomy of  kidneys
Anatomy of  kidneys
Anatomy of  kidneys
Anatomy of  kidneys
Anatomy of  kidneys
Anatomy of  kidneys
Anatomy of  kidneys
Anatomy of  kidneys
Anatomy of  kidneys
Anatomy of  kidneys
Anatomy of  kidneys
Anatomy of  kidneys
Anatomy of  kidneys
Anatomy of  kidneys
Anatomy of  kidneys
Anatomy of  kidneys
Anatomy of  kidneys
Anatomy of  kidneys
Anatomy of  kidneys
Anatomy of  kidneys
Anatomy of  kidneys
Anatomy of  kidneys
Anatomy of  kidneys
Anatomy of  kidneys
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Anatomy of kidneys

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Swaroopa Beulah Perumalla

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Anatomy of kidneys

  1. 1. A.SWAROOPA MSC(NURSING)
  2. 2. VITAL ORGANS
  3. 3. Organs of the Renal System • 2Kidneys • 2Ureters • Urinary bladder • Urethra • Not many structures, but very important! Figure 23.1a3
  4. 4. Kidneys LOCATION:  Kidneys are a pair of excretory organs situated on the posterior abdominal wall,  above the waist,  extending from upper border of T12 to L3 vertebra,  partially protected 11th & 12th pairs of ribs.
  5. 5. Renal Anatomy • Paired retroperitoneal bean-shaped organs • Located in the dorsal upper lumbar region • Encased in the renal fat pad
  6. 6. Kidneys Right kidney is slightly lower than the left because the liver occupies considerable space on the right side superior to the kidney. “THEY ARE THE RETRO PERITONEAL ORGANS”
  7. 7. KidneysCOLOR AND SHAPE: Red color and bean shaped. CAPSULES OR COVERINGS OF KIDNEYS  Fibrous capsule,  Peri-renal fat,  Renal fascia and  Para-renal fat
  8. 8. 11 cm 6cm 3cm 8 HEIGHT & WEIGHT: Each kidney is 11 cm (4-5”) long, 6 cm (2-3”) broad and 3 cm (1”) thick, weight 150 g in males and 135 g in females.
  9. 9. ORGANS ASSOCIATED WITH THE KIDNEYS SUPERIORLY- RIGHT ADRENAL GLAND. ANTERIORLY- RIGHT LOBE OF THE LIVER , DUODENUM, & HEPATIC FLEXTURE OF THE COLON. POSTERIORLY-12TH RIB DIAPHRAGM, MUSCLES OF POSTERIOR ABDOMINAL WALL (PSOAS MAJOR, QUADRATUS LUMBORUM & TRANSVERSUS ABDOMINIS.
  10. 10. Peritoneal relations: The kidneys are retroperitoneal. Certain areas of each kidney are covered in anteriorly by peritoneum, whereas others are "bare“.
  11. 11. 12
  12. 12. Internal Structure of the Kidney Renal pyramids Renal papilla Renal Columns Renal Lobe 13
  13. 13. Human Kidney
  14. 14. Protection of the Kidneys • 3 layers of connective tissue: – Inner layer- Renal capsule – Middle layer- Adipose capsule – Outer layer-Renal fascia Renal cortex Retroperitoneal space 15
  15. 15. 3 layers of tissue surrounds the each kidney DEEP LAYER ( RENAL CAPSULE ) is a smooth transparent sheet of dense irregular connective tissue that continous with the outer coat of the ureter. It serves as barrier against trauma and helps to maintain the shape of kidney.
  16. 16. Middle layer: the adipose capsule : is a mass of fatty tissue surrounding the renal capsule. it also protects the kidney from trauma. Superficial layer: renal fascia is another thin layer of dense irregular connective tissue that covers surrounding structures and to the abdominal wall.
  17. 17. GROSS STRUCTURE OF THE KIDNEY Longitudinal section there are 3 areas. I. Fibrous capsule II. Cortex III. Medulla
  18. 18. 19 RENAL FIBROUS CAPSULE: surrounds the kidney, made of dense fibrous connective tissue.
  19. 19. 20 CORTEX: A reddish brown layer of tissue immediately below the capsule and out side the pyramids.
  20. 20. 21 MEDULLA: the inner most layer consisting of pale conical shaped striations called renal pyramids.
  21. 21. Surface anatomy of the Kidney • Hilum is located on the medial surface HILUM: it is the concave medial border or deep fissure of the kidney where the renal blood & lymph vessels , urater & nerve enters. Renal Sinus: Space within hilus. Kidneys receive blood vessels and nerves.
  22. 22. 23 RENAL PELVIS: it is the funnel shaped structure which acts as a receptacle of the urine formed by the kidney.
  23. 23. IT HAS NUMBER OF DISTAL BRANCHES CALLED CALYCES , EACH OF WHICH SOROUNDS APEX OF THE RENAL PYRAMID. URINE FORMED IN THE KIDNEY PASES THROUGH PAPILLA AT THE APEX OF THE PYRAMID INTO MINOR CALYX THEN INTO MAJOR CALYX BEFORE PASSING THROUGH THE PELVIS INTO THE URETER.
  24. 24. 25 THE WALLS OF THE PELVIS CONTAINS SMOOTH MUSCLE AND ARE LINED WITH TRANSITIONAL EPITHELIUM. PERISTALYSIS OF THE SMOOTH MUSCLE IN THE WALLS OF THE CALYCES PROPELS URINE THROUGH THE PELVIS , URETERS TO THE BLADDER.
  25. 25. The ureteric pelvis usually divides into two or three short tubes, the major calices, each of which subdivides into 7 to 14 minor calices. Each minor calyx receives the openings of collecting tubules on papillae that project into the calices
  26. 26. Intravenous pyelogram: Note the calices and the pelves of the ureters, which differ in shape and level.
  27. 27. Renal Pedicle: The ureter and renal vessels near the hilus form the pedicle. The renal vein anterior, the ureter is posterior, and the arteries little high.
  28. 28. The glomerular capillaries called the glomerulus. The usual direction of blood flow is: • Arteries • Arterioles • Capillaries • Venueles • veins
  29. 29. BLOOD SUPPLY TO KIDNEY ARTERIAL SUPPLY ABDOMINAL AORTA RENAL ARTERIES SEGMENTAL ARTERIES INTERLOBAR ARTERIES ARCUATE ARTERIES INTER LOBULAR FORMS 5-8 CAPILLARIES
  30. 30. BLOOD SUPPLY TO KIDNEY VENOUS SUPPLY INFERIOR VENACAVA RENAL VEINS SEGMENTAL VEINS INTERLOBAR VEINS ARCUATE VEIN INTER LOBULAR VEINS
  31. 31. The Blood Supply to the Kidneys
  32. 32. Regulates blood flow to the kidney by causing vasodilation or vaso constriction of renal arterioles. Autonomic plexuses in the abdomen and pelvis
  33. 33. Filtering & phagocytosis Proliferation of lymphocytes
  34. 34. Lumbar aortic nodes
  35. 35. MUSCLES ATTACHEDTO KIDNEYS QUADRATUS LUMBORUM MUSCLE ILLIACUS MUSCLE PSOAS MAJOR MUSCLE
  36. 36. 40 Parts of the kidney: 1. Renal pyramid 2. Efferent vessel 3. Renal artery 4. Renal vein 5. Renal hilum 6. Renal pelvis 7. Ureter 8. Minor calyx 9. Renal capsule 10. Inferior renal capsule 11. Superior renal capsule 12. Afferent vessel 13. Nephron 14. Minor calyx 15. Major calyx 16. Renal papilla 17. Renal column
  37. 37. MICROSCOPIC ANATOMY OF THE KIDNEYS • The functional unit of the lungs is the alveolus. • The functional unit of the liver is the lobule. • The functional unit of the kidney is the NEPHRON and smaller number of collecting tubules. • Each kidney has about 18 lobes and 1 million nephrons. 41
  38. 38.  Cortical nephrons with short loop of Henle.  Juxtamedullary nephrons with long loops of Henle. Two types of nephrons
  39. 39. CORTICAL NEPHRONS i. 85% of nephrons are in this type. ii. Most of the parts of nephron are in cortex only. iii. Length of LH is short. iv. Accompanied by peritubular capillary net work. JUXTRA MEDULLARY NEPHRONS i. 15%. ii. begins at the junction of the cortex and medulla. iii. long. iv. vasa recta. DIFFERENCES BETWEEN TYPES OF NEPHRON
  40. 40. The glomerular filtration membranes are consist of 3 layers of capillary wall. ---Endothelium. ---Basement membrane. ---Epithelial podocytes. Fluid that filtered from the capillary blood into the bowman's space is called filtrate and forms the primary urine .
  41. 41. Histology of Filtration Membrane 1) Endothelium of glomerulus – Single layer of capillary endothelium with fenestrations – Prevents RBC passage; WBCs.
  42. 42. Histology of Filtration Membrane 2) Basement membrane of glomerulus – Between endothelium and visceral layer of glom. capsule – Prevents passage of large protein molecules
  43. 43. Histology of Filtration Membrane 3) Filtration slits in podocytes – Podocytes • specialized epithelium of visceral layer • footlike extensions with filtration slits between extensions – Restricts passage of medium-sized proteins
  44. 44. THE FILTRATE THEN DIFFUSES ACROSS BOWMANS SPACE AND INTO THE TUBULES OF THE NEPHRON. IN THE TUBULES SOME SUBSTANCES ARE ADDED TO THE FILTRATE AS PART OF THE URINE FORMATION. AND SOME SUBSTANCES REABSORBED OUT OF THE FILTRATE AND BACK IN TO THE BLOOD.
  45. 45. LOOP OF HENLE REABSORPS THE WATER AND IONS FROM THE URINE • AND CONTROLS THE CONCENTRATION OF URINE. –THICK PORTION –THIN PORTION • DISTAL CONVOLUTED TUBULE: regulate Na, K, PH AND FURTHER DILUTION OF URINE TAKES PLACE. • COLLECTING DUCT WHICH JOINS WITH SEVERAL TUBULES TO COLLECT THE FILTRATE AND FINAL NA REGULATION TAKES PLACE. 57
  46. 46. PROXIMAL CONVOLUTED TUBULE (PCT)
  47. 47. LOOP OF HENLE
  48. 48. Descending limb of the loop of henle
  49. 49. ASCENDING LIMB OF THE LOOP OF HENLE
  50. 50. DISTAL CONVOLUTED TUBULE( DCT)
  51. 51. COLLECTING DUCT
  52. 52. TUBULE HISTOLOGY • PCT : cuboidal cells with apical microvilli • Descending Loop and beginning of Ascending Loop: simple squamous epithelium. • Ascending limb of the Loop: –cuboidal & columnar epithelial cells. • DCT, collecting ducts : –cuboidal with specialized cells.
  53. 53. The Nephron
  54. 54. JUXTAGLOMERULAR APPARATUS  The distal end of the renal tubule passes next to the glomerulus to form the juxtaglomerular apparatus (juxta means “next to”).  The juxtaglomerular apparatus (JGA) consists of cells located in and around the glomerulus and the glomerular capsule. 66
  55. 55. KIDNEY FUNCTIONS
  56. 56. The ureter is continous with the funnel shaped renal pelvis. The ureters are the tubes that convey urine from the kidneys to the urinary bladder. URETERS The two ureters are muscular tubes that extend from the kidneys to the posterior surface of the urinary bladder where the urine is propelled along the ureter by peristaltic contractions
  57. 57. The ureter is a retroperitoneal, distensible muscular tube that connects the kidney with the bladder.
  58. 58. Because of this arrangements (psoas major muscle, sacro illiac joint , posterior wall of the bladder ) when urine accumulates and the pressure in the bladder rises, the ureters are compressed and the openings occluded. This prevent reflux of urine into the ureters (towards kidneys).
  59. 59. Ureter relations • It lies within the hilum of the kidney and receives the major calyces • It enters the pelvis by crossing the bifurcation of the common iliac artery in front of the sacroiliac joint • It runs downward & forward on the lateral wall of the pelvis to enter the lateral angle of the bladder
  60. 60. RELATIONS TO URETERANTERIOR: • Duodenum, • Terminal part of the ileum, • Right colic vessels, • Iliocolic vessels, • Right testicular or ovarian vessels. POSTERIOR: • Right psoas muscle, • Bifurcation of the right common iliac artery
  61. 61. CONSIST OF 3 LAYERS OF TISSUE: 1) Outer covering of fibrous tissue. 2) Middle muscular layer consisting of smooth muscle fibers. 3) Inner layer the mucosa, lined with transitional epithelium.
  62. 62. Blood Supply• Upper end is supplied by the renal artery • Middle portion by (gonadal) testicular or ovarian artery • In the pelvis is supplied by the superior vesical artery
  63. 63. The lymph drains to the lateral aortic nodes and the iliac nodes
  64. 64. Sympathetic supply from renal, Testicular, ovarian hyogastric & pelvic plexus. Para sympathetic supply from sacral plexus.
  65. 65. Ureters • Each ureter has three constrictions along its course, • 1- Where the renal pelvis joins the ureter, • 2- As it crosses the pelvic brim, • 3- Where it pierces the bladder wall ( intra-mural part)
  66. 66. SUPRARENAL GLANDS • The two suprarenal glands are yellowish retroperitoneal organs that lie on the upper poles of the kidneys • They are surrounded by the renal fascia • Separated from the kidneys by the perirenal fat • Each gland has a yellow cortex and a dark brown medulla
  67. 67. LEFT SUPRARENAL GLANDS • Left suprarenal gland is crescentic in shape. • Extends along the medial border of the left kidney from the upper pole to the hilum • It lies behind the: • The pancreas, • The stomach • It rests posteriorly on the diaphragm
  68. 68. RIGHT SUPRARENAL GLANDS• The right suprarenal gland is pyramidal in shape and caps the upper pole of the right kidney. • It lies behind the right lobe of the liver and extends medially behind the IVC. • It rests posteriorly on the diaphragm.
  69. 69. Suprarenal Glands• The cortex secretes hormones include: • Mineral corticoids, which control fluid and electrolyte balance. • Glucocorticoids, which control carbohydrates, fats, and proteins. • Sex hormones, which probably play a role in the prepubertal development of the sex organs • The medulla secretes the catecholamine, epinephrine and norepinephrine
  70. 70. Blood SupplyARTERIES: Three arteries supplying each gland, • 1- Superior suprarenal artery: from inferior phrenic artery • 2- Middle suprarenal from aorta. • 3- Inferior suprarenal from renal. VEINS: • A single vein emerges from the hilum of each gland: • The right suprarenal vein drains into the IVC . • The left suprarenal vein drains into the left renal
  71. 71. 88 URINARY BLADDER • Collapsible muscular sac. • Stores and expels urine. • Lies on pelvic floor posterior to pubic symphysis. – Males: anterior to rectum. – Females: just anterior to the vagina and uterus.
  72. 72. The Final Common Pathway • Urinary bladder – hollow muscular organ – generally smaller in females due to presence of a uterus – retroperitoneal in the pelvic cavity, posterior to the pelvic symphysis – freely movable. – Bladder muscle is detrusor muscle.
  73. 73. 90
  74. 74. 91
  75. 75. The openings of the two ureters and the urethra mark a triangular area called the trigone on the bladder floor. S T R U C T U R E OF “TRIGONE”
  76. 76. Bladder- structure 3 layers – Outer layer • Loose connective tissue – Middle layer • Smooth muscle and elastic fibres – Inner layer • Lined with transitional epithelium 93
  77. 77. • Bladder histology: – Sphincters control entry from ureters. – Exit at the urethra. • circular smooth muscle fibers form internal urethral sphincter. • lower is the external urethral sphincter with skeletal muscle for voluntary control.
  78. 78. URETHRA –small tube from floor of bladder to exterior of body. • females -- fairly straight path exits anterior to vagina. • males -- passes through the prostate gland and exits through the penis.
  79. 79. The Urethra - conveys urine from the urinary bladder to the outside of the body. FEMALES MALE 3-4 cm (1.5”) 20 cm (8”) greater risk of urinary tract infections
  80. 80. The male urethra has three regions: 1) prostatic urethra 2) membranous urethra 3) penile urethra. Difficulty in voiding urine with enlarged prostate
  81. 81. URETHRAL SPHINCTERS IN BOTH SEXES: -Internal Urethral Sphincter- under involuntary control of smooth muscle. -External Urethral Sphincter - under voluntary control of skeletal and levator ani muscle. internal urethral sphincter external urethral sphincter
  82. 82. HISTOLOGY FEMALE: THREE COATS Inner mucosa, Intermediate thin layer of spongy tissue with plexus of veins. Outer muscular coat continuous with the bladder. MALE TWO LAYERS Inner mucous membrane and a muscularis Outer submucosa tissue with various accessory structures which connect to it. Both genders have a stratified squamous epithelial lining.
  83. 83. 100 KNOW: -Micturation center of brain: pons. -Parasympathetic: to void. -Sympathetic: inhibits micturation.
  84. 84. CONGENITAL ANOMALIES OF KIDNEY: AGENESIS (one or both fetal kidney are absent). HYPOPLASIA (Small kidney). ECTOPIC KIDNEYS (kidney is located in an abnormal position. HORSE SHOE KINEYS (the kidneys are fused together at the lower end or base.) PAN CAKE KIDNEYS (renal fusion anomaly of the kidneys of the crossed fused variety) POLY CYSTIC KIDNEY (progressive enlargement of cysts in the kidneys )
  85. 85. HYPOPLASIA ECTOPIC KIDNEY HORSE SHOE PCKD PANCAKE KIDNEY
  86. 86. Epispadias & hypospadias: Mutual opening located on dorsal or superior surface of the penis. Ventral or inferior surface of the penis.
  87. 87. Addison’s disease, chronic adrenal insufficiency, hypocortisolism, and hypoadrenalism) is a rare, chronic endocrine systemdisorder in which the adrenal glands do not produce sufficient steroid hormones (glucocorticoids and often mineralocorticoids)
  88. 88. Urinary tract infections is the inability to empty the bladder completely. URINARY RETENTION
  89. 89. CHRONIC RENAL FAILURE
  90. 90. Dialysis the clinical purification of blood by dialysis, as a substitute for the normal function of the kidney.
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