1. Stomach & intestines
sup. & inf mesenteric veins
Hepatic portal vein
Liver sinusoids
Hepatic vein
Inferior vena cava

2. Location of the Kidneys
posterior abdominal wall
retroperitoneal (intraperitoneal)
T12-L3
adrenal gland: superomedial
Functions of Kidney
filter blood plasma
excretion of waste
regulate blood volume & pressure
secrete renin – blood pressure
secrete erythropoietin – RBC
final step in vitamin D synthesis
and more……

3. Intraperitoneal Retroperitoneal
Mesentery: double layer of parietal peritoneum
that suspends digestive organs from abdominal wall
provides passageway for blood, nerves & lymph
Intraperitoneal
Retroperitoneal

4. Intraperitoneal Retroperitoneal kidneys pancreas part of duodenum
asc & desc colon
vessels, nerves
lymph vessels

5. Horseshoe kidney Pelvic kidney L1 Normal positions Transverse CT
Abnormal positions L1

6. Note testicular vein on left into renal vein

7. Renal artery & vein
Hilum
Renal capsule
Renal fascia
Adipose capsule
(perirenal fat)

10. interlobular
arcuate
interlobar
segmental
Renal a & v
Afferent a.
Efferent a.
Glomerulus

11. Nephron = Renal corpuscle + renal tubule
Renal corpuscle: glomerulus + Bowman’s (glomerular) capsule
glomerular filtration
creating plasma-like filtrate of the blood
Afferent arteriole
Glomerular capillaries
with podocytes
(visceral)
Proximal
convoluted
tubule
Efferent
arteriole
Simple, squamous epithelium
(parietal)
Vascular pole

12. Filtration membrane Podocytes Filtration slits Urinary pole
Endothelial cells w/BM
Capsule space
glomerular filtrate
Podocytes
Filtration slits
Hematuria = blood
Proteinuria = protein

13. Juxtaglomerular apparatus macula densa JG cells mesangial cells
smooth muscle
constrict afferent art
Macula densa
epithelial cells
monitor flow/comp
of fluid in DCT
comm with JG cells
DCT
Mesangial cells
Juxta = next to
Macula = spot, patch

14. Renal pelvis
ureter
Kidney stones (renal calculus)
calcium, phosphate, uric acid, protein
form in renal pelvis
excess calcium, dehydration, pH imbalance, cystitis

16. Urinary bladder Parietal peritoneum Detrusor mm
Urethral openings in trigone
Internal urethral sphincter
smooth muscle
External urethral sphincter
skeletal muscle

17. Benign Prostatic Hyperplasia (BPH)
Berry, SJ, Coffey, DS, Walsh, PC, et al. The development of human benign prostatic hyperplasia with age. J Urol 1984;132:474. accessed via UpToDate

18. Micturition reflex Learned control of micturition reflex Info to CNS
You relax external sphincter
ANS relaxes internal sphincter
1. Sense stretch
2. Contract detrusor muscle
relax external urinary sphincter
relax internal urinary sphincter (ANS)