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1、Urinary System泌尿系統(tǒng)Urinary System泌尿系統(tǒng) CompositionKidney 腎form urineUreter 輸尿管conduct urine from kidneys to bladderUrinary bladder 膀胱receives and stores urineUrethra 尿道conducts urine from bladder to exterior of body (discharged)Kidney 腎 General featuresBean shaped, reddish-brown organsSuperior extremi
2、tybroad and thinInferior extremitynarrow and thickAnterior surfaceconvexPosterior surfaceflatLateral borderconvexKidney 腎Medial borderconcave Renal hilum 腎門a vertical slit on the medial border of kidney Renal pedicle腎蒂 the structures which enter and leave the renal hilum,including the renal vein, re
3、nal artery, renal pelvis, lymphatic vessels and nervesOrder of structures in the renal pedicle From anterior to posteriorrenal V, renal A, renal pelvis.From superior to inferior renal A. renal V. renal pelvis.Kidney 腎 Renal sinus 腎竇 The renal hilum extends into a large cavity within the kidneyConten
4、ts: Occupied by the renal vessels, minor renal calices, major renal calices, renal pelvis and some adipose tissuekidney Renal structure腎的結(jié)構(gòu)Renal cortex 腎皮質(zhì)renal columns 腎柱Renal medulla 腎髓質(zhì) Renal pyramids 腎錐體 (1520)Renal papilla 腎乳頭Papillary foramina 乳頭孔Minor renal calices 腎小盞 (78)Major renal calices
5、 腎大盞 (23)Renal pelvis 腎盂Renal cortex consist of renal units,which produces the urinekidney Coverings of kidney Fibrous capsule 纖維囊Fatty renal capsule 脂肪囊Renal fascia 腎筋膜kidneyCoverings of kidney Fibrous capsule 纖維囊 A strong fibrous capsule which strips easily from a normal kidney surface but adheres
6、 firmly to an organ that has been inflamed kidneyFatty renal capsule 脂肪囊 A thick adipose connective tissue capsule, surrounds the fibrous capsuleIt acts as a shock absorber to protect the kidney from jolting and jarringRenal fascia 腎筋膜 On outside, surrounds both the kidney and suprarenal glandHoldin
7、g these organs in place kidney Position of Kidney Lie behind the peritoneum, high up on the posterior abdominal wall on either side of the vertebral column Upper pole nearer to media plan than lower pole KidneyLeft kidney Lies at the level from the lower border of T11 to intervertebral disc between
8、L2-L3The 12th rib is behind its middle part of the post surfaceRight kidney Lies slightly lower than the left kidney, at the level from the upper border of T12 to L3The 12th rib is behind its upper part of the post surfaceRenal hilumAt the level of L1About 5cm from the posterior median lineRenal reg
9、ionThe area between 12th rib and the lateral margin of erector spinae Renal segments腎段The kidney is divided into five vascular segments and each is supplied by a branch of the renal artery; between the segments there is no anastomosis. Renal segmentsSuperior segment Superior anterior segmentInferior
10、 anterior segment Inferior segmentPosterior segmentResin corrosion cast of human kidneys. Ureter, pelvis and calyces are yellow; aorta, renal arteries and their branches are red. Coronal multislice CT scans of the right and left suprarenal glands.CT renal venogram. Acquired from a multislice CT exam
11、ination and reconstructed as a 3D surface shaded reformat.Variations Renal calculus (stone in the kindey) 腎功能衰竭kidney failure 尿毒癥uremia/toxuria 腎移植kidney transplantation Ureters 輸尿管Muscular tube, about 20-30cm long and 0.5-1.0cm wide (diameter) DivisionsAbdominal part輸尿管腹部descend on the psoas major
12、behind the peritoneum Pelvic part輸尿管盆部in females, passes 2cm lateral to the neck of uterus and lies below the uterine arteryIntramural part輸尿管壁內(nèi)段passes obliquely through the bladder wall for 1.5cm longUreters 輸尿管 Three constrictions1st constriction: at pelvoureteric junction2nd constriction: where u
13、reter crosses the pelvic inlet and iliac vessels3rd constriction: at intramural partMultislice CT urogram. Coronal reformat showing the enhancing renal parenchyma and both ureters along their entire length. Multislice CT urogram. 3D-surface shaded reformat showing the kidneys, ureters, bladder and s
14、urrounding bony anatomy.Stone in ureterUrinary bladder 膀胱 General features pyramidal in shape when empty, having Apex 膀胱尖Fundus膀胱底Body of bladder膀胱體Neck膀胱頸Normal volum of bladder adult:350-500ml maxium:800ml newborn:110 of adultUrinary bladder 膀胱 Trigone of bladder 膀胱三角Smooth triangular area at inne
15、r surface of the funds of bladderFormed by internal urethral orifice anteriorly and two ureteric orifices laterallyIn this area absents submucosal layer, where the mucous membrane is firmly adherent to the muscular coat, and is always smooth Interureteric fold 輸尿管間襞 Muscular elevationBetween ureteric orifices.Urinary bladder 膀胱 Position In the adult, it lies in the lesser pelvis, behind the pubic symphysis, in front of seminal vesicle, ampulla ductus deferentis and rectum in the male, and in front of uterus and vagina in the
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