Anatomy of Upper Urinary Tract

The kidneys, the abdominal cavity at the rear, on both sides of the vertebral The twelfth thoracic and first three lumbar vertebrae are located at the level. Retroperitoneal located 11 cm in length, 6 cm wide, and about 3 cm thick organ weights 150 grams. According to Poller the upper to the lower pole is closer to the midline, 1 cm. Here is a little more because of the left kidney, right kidney liver. Hilum contains the inner edges are slightly concave. L1-3, right kidney, left kidney lies between T12-L3 vertebrae. Shows the rotation of 30 ° anteriorly to transverse the kidneys. Coronal plane through the upper Poller, shifted forward in the sagittal plane lower Poller.


Kidneys from the inside out, the fibrous capsule, perirenal fat tissue (Capsula adiposa), Gerota's fascia (fascia renalis), pararenal fat tissue (corpus adiposum pararenal) are surrounded by. Perirenal fatty tissue with a thick layer of fat and muscle tissue adjacent to where plain films can be distinguished from more radiolucent. Kidneys, pararenal fat through the abdominal wall and sit back. From front to back vein, artery and is located in the pelvis. Pelvis, major calyx 2-3 main, they are also many minor calyx divided into papillary ending. Necks, called a calyx infundibulum. Sine in the renal pelvis, and sometimes completely (intra-renal pelvis), and sometimes it is beyond the kidney calices entirely due to the long (extrarenal pelvis).


The kidneys are seen as hypodense on CT. Gerato's fascia, perirenal adipose tissue is located outside and gets into the adrenaline. Front and rear leaves, lateral, medial and superiorly unite, six are welcome. Observed as hyperdense on CT.


Renal parenchyma, including the cortex and medulla is two parts. The medulla consists of 8-18 pieces striped-looking pyramid. Looks at the base of the pyramids at the cortex. Heights takes its name from the papilla and the minor calyces opens. The surface of the papilla of 7 main collector channel opens (Bellini ducts), and because of this appearance is called kribroza area. The number of papillary and different location may vary between 5-11. Therefore, the calyx and the pelvis is highly variable in appearance. Papillae surrounding the minor calices, stuck on where the angle (fornices), normally sharp appearance. Infection or obstruction is blunted, losing the sharpness of the angles.


Renal artery and vein, the level of L2, the aorta and inferior vena Javanese (VCI) interests. The right renal artery, the posterior is VCI. Renal artery and vein may be variations of 25-40%. The most common variation is the increased number of renal artery. Excess of the renal artery on the right side from left, are more common in the upper pole in the lower pole. Renal artery, 5 is a segmental branch. Segmental distribution, the posterolateral part of the kidney generates a line of avascular. Segmental arteries in each pyramid will continue for the lobar artery and 2-3, they left interlobar artery extends from the cortex between pyramids.


Corticomedullary interlobar artery in the region, turning parallel to the arcuate artery is called the base of the pyramid. Arcuate artery, interlobular artery is a number. The main branches of interlobular arteries and afferent glomerular artillery they generate is distributed to one or many glomeruli. After the formation of the glomerular capillary network, the efferent arteriolar, peritubular capillary network does. This capillary plexus, combined with venous poured into interlobular veins.


Of the kidney veins, arteries, and his followers are the same name. The right renal vein is usually single and very short. The left renal vein is longer. Inferior phrenic, adrenal and gonadal 3 lumbar drain the veins. The right kidney and right paracaval interaortokaval draining lymph nodes, while the lateral para-aortic lymph nodes in the left kidney is drained.

T12-L2 level of the kidneys from renal pleksusa a group formed by the nerve cell is innervated. Kidney cortex, and afferent fibers from the T11-L2 level to reach the vicinity of the capsule, followed the same path with a small part of the Vagus Nerve. Autonomic afferent fibers in the kidney, inguinal and femoral region when they enter the spinal cord due to the same region of the somatic fibers, subcostal pain often spreads to the region and abdomen.


The ureters, renal pelvis urine in the bladder, peristaltic movements, carrying 22-30 cm long, hollow organs. Lumen is usually 3 mm in diameter. The ureter from the top down, in front of retroperitoneal region, adherent to the peritoneum as the Romans. Switches to the back of the gonadal vessels. External and internal arteries bifurcation level iliac vessels crossing pelvis enters. When the base of the bladder through the bladder into the back of the superior vesical artery. In women, uterine artery crosses the front. Abdominal and pelvic parts. Abdominal ureter, renal pelvis between the iliac vessels, pelvic ureter, bladder, iliac veins lying between. Ureter, proximal renal artery, the aorta, iliac and gonadal artery, distal internal iliac artery and branches (superior vesical, uterine, middle rectal, vaginal, inferior vesical arteries) is fed. Feeding in the upper parts of the medial ureter, the pelvic ureter is the lateral branches.


Mirrored the distribution of arterial venous distribution. Lymphatic drainage of the upper end of the renal pelvis and ureter, renal lymph nodes is. Abdominal ureter, lymph drainage of the right side, right paracaval aortocaval lymph nodes and lymph drainage while the left is the left para-aortic lymph nodes. Pelvic lymph drainage of the ureter of the internal, external and common iliac lymph nodes. In providing the spinal segments T10-L2 sympathetic innervation of the ureter Preganglionic postganglionik nerves, Aorticorenal, the superior and inferior hypogastric plexus autonomic interests. Parasympathetic innervation is S2-4. Ureter allowing the intrinsic smooth muscle contraction. The ipsilateral testis in the upper ureteral obstruction, obstructions on the right McBurney point in the middle ureter, the pain may be felt on the left McBurney point symmetry. Edema of the ureteral orifice and ureter stones, bladder irritation due to inflammation of the findings, while the pain in the scrotal (labial women) can be heard in the region.

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