1. Blood supply and Nerve supply of the Kidneys, ureters, bladder and urethra

2. Blood supply of the kidneys

3. The renal arteries arise at the level of the IV disc between the L1 and the L2 vertebrae
The longer right renal artery passes posterior to the IVC,
Divides into segmental arteries…………..etc.
Supernumerary or aberrant renal arteries.
The renal veins lie anterior to the renal arteries, and the longer left renal vein passes anterior to the aorta.
The renal vein emerges from the hilum of the kidney and drains into the inferior vena cava

4. Blood supply of the ureter
The abdominal part OF THE URETER:
The arteries to the ureters arise mainly from three sources:
1-The renal artery,
2- Gonadal artery (testicular or ovarian arteries), and
3- Abdominal aorta.
The veins of the ureters drain into the IVC

6. The pelvic part of the ureter:
Branches of the common and internal iliac arteries supply the pelvic part of the ureters
Females:
Uterine artery is the most fixed
Males:
Inferior vesical arteries
Veins from the ureters accompany the arteries and have corresponding names.

7. Blood supply of the urinary bladder
Arterial supply:
Mainly from branches of the internal iliac arteries
1- Superior vesical arteries (sup.)
2- Inferior vesical arteries ( = vaginal arteries in females)
3- Obturator and inferior gluteal arteries
Venous supply:
veins draining the bladder correspond to the arteries and are tributaries of the internal iliac veins.

8. Venous supply contd.:
In Males:
Vesical venous plexus and prostatic venous plexus, drain mainly through the inferior vesical veins into the internal iliac veins
In females:
The vesical venous plexus communicates with the vaginal or uterovaginal plexus

11. The veins accompany the arteries and have similar names
Blood supply of the urethra:
Male urethra:
1- The urethra in the bladder neck and the prostatic urethra are supplied by the prostatic branches of the inferior vesical and middle rectal arteries
2- The intermediate and spongy parts of the urethra are supplied by the internal pudendal artery.
The veins accompany the arteries and have similar names

12. Arterial supply by the internal pudendal and vaginal arteries
Female urethra:
Arterial supply by the internal pudendal and vaginal arteries
The veins follow the arteries and have similar names.

13. Nerve Supply

14. Nerve supply of the kidneys:
The nerve supply is the renal sympathetic plexus.
The afferent fibers that travel through the renal plexus enter the spinal cord in the 10th, 11th, and 12th thoracic nerves.

15. Nerve supply of the Ureters:
From:
1- Renal plexus
2- Aortic plexus
3- Superior hypogastric plexus
4- Inferior hypogasrtic plexus
5- Testicular (or ovarian ) plexus
Through nerves that follow the blood vessels
Afferent fibers travel with the sympathetic nerves and enter the spinal cord in the first and second lumbar segments

17. Nerve supply of the Urinary bladder:
1- Sympathetic:
From T11 to L3 spinal cord levels, through the hypogastric plexuses and nerves, to the vesical plexus (pelvic)
2- Parasympathetic:
from the sacral spinal cord levels are conveyed by the pelvic splanchnic nerves and the inferior hypogastric plexuses

19. Nerve supply of the Male urethra:
From the prostatic nerve plexus (mixed sympathetic, parasympathetic and visceral afferent fibers)
Nerve supply of the Female urethra:
The nerves to the urethra arise from the vesical (nerve) plexus and the pudendal nerve

20. Lymphatic drainage

21. Lymphatic drainage of the kidneys:
Follow the renal veins ,and drain into the Lumbar lymph nodes (Aortic and renal)
Lymphatic drainage of the Ureters:
1- Lymphatic vessels from the Superior part of the ureter: either:
a-join those from the kidney or
b- pass directly to the lumbar (caval and aortic) nodes
2- Lymphatic vessels from the Middle part of the ureter
Drain into common iliac lymph nodes

22. drain into the common, external, or internal iliac lymph nodes.
3- Lymphatic vessels from the Lower part of the ureter:
drain into the common, external, or internal iliac lymph nodes.

24. Those from the fundus pass to the internal iliac lymph nodes.
Lymphatic drainage of the urinary bladder:
In both sexes, lymphatic vessels leave the superior surface of the bladder and pass to the external iliac lymph nodes .
Those from the fundus pass to the internal iliac lymph nodes.
Some vessels from the neck of the bladder drain into the sacral to common iliac lymph nodes.

26. A few vessels drain into the inguinal lymph nodes.
Lymphatic drainage of the Male urethra
The lymphatic vessels drain mainly into the internal iliac lymph nodes , but some lymph passes to the external iliac lymph nodes.
Lymphatic vessels from the spongy urethra pass to the deep inguinal lymph nodes.
Lymphatic drainage of the female urethra
Most lymphatic vessels from the urethra pass to the sacral and internal iliac lymph nodes .
A few vessels drain into the inguinal lymph nodes.

27. Thank You