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

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……

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

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

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

Note testicular vein on left into renal vein

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

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

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

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

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

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

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

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 5.23.2008

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)