UROGENITAL

SYSTEM
ACHMAD AMINUDDIN

UROGENITAL SYSTEM

CONSIST

OF

URINARY SYSTEM.
GENITAL SYSTEM.

URINARY SYSTEM
CONSIST

OF

KIDNEY.
URETER.
URINARY BLADDER.
URETHRA.

THE RENAL ARTERIES AND

VEINS
The

renal arteries arise at the level

of the IV disc betwen the L1 and L2
vertebrae.
The longer right renal artery passes
posterior to the IVC.
Typically, each artery divides close to
the hilum into 5 segmental arteries
that are end arteries

THE DISTRIBUTION OF THE

SEGMENTAL ARTERIES
FROM THE ANTERIOR BRANCH OF THE RENAL
ARTERY
- The superior ( apical ) segment;
- the superior ( apical ) segment a.
- The anterosuperior and anteroi
inferior segment ;
- the anterosuperior segmental a
- the anteroinferior segmental a.
- The inferior segment;
- the inferior segmental artery
FROM THE POSTERIOR BRANCH OF THE RENAL A
- The posterior segment ;
- the posterior segmental artery.

THE RENAL VEINS

The

right and left renal veins lie

anterior to the right and left renal
arteries.
The longer left renal vein receives ;
- the left suprarenal vein.
- the left gonadal ( testicular or
ovarian ) vein.
and passes anterior to the aorta

AUTONOMIC NERVOUS SYSTEM

SYMPATHETIC STIMLATION
Vasoconstriction of renal vessels slows
urine formation,internal sphincter of
bladder contracted to maintain urinary
continence.
PARASYMPATHETIC STIMULATION
Inhibits contraction of internal sphincter of
bladder, contracts detrussor muscle of
bladder wall causing urination

KIDNEY
LIE RETROPERITONEALLY.
ONE ON EACH SIDE OF THE VERTEBRAL
COLUMN AT THE LEVEL OF T12 TO L3.
THE POSTERIOR SURFACE OF THE KIDNEY
IS RELATE TO THE QUADRATUS LUMBORUM
M.
THE LIVER,DUODENUM,AND ASCEN DING
COLON ARE ANTERIOR TO THE RIGHT
KIDNEY.
THE LEFT KIDNEY IS RELATED TO THE
STOMACH, SPLEEN, PANCREAS, JEJUNUM
AND DESCENDING COLON.

KIDNEY

THE RENAL HILUM

IS THE ENTRANCE TO THE SPACE WITHIN THE
KIDNEY.
AT THE HILUM THE RENAL VEIN IS ANTERIOR
TO THE RENAL ARTERY,WICH IS ANTERIOR TO
THE RENAL PELVIS.

THE RENAL SINUS

THAT IS OCCUPIED MOSTLY BY FAT IN WICH
THE RENAL PELVIS,CALICES, VESSEL AND
NERVES ARE EMBEDDED.

URETER
THE MUSCULAR DUCT WIH NARROW
LUMINA THAT CARRY URINE FROM
KIDNEY TO THE URINARY BLADDER.
THE SUPERIOR EXPANDED

THE RENAL PELVIS, is formed through the

merging of 2 or 3
MAJOR CALICES, each ofwhich was formed by
the merging of 2 or 3
MINOR CALICES, each minor calyx is intended
by the apex of the
RENAL PYRAMID ; RENAL PAPILLA

URETER
RUN

INFEROMEDIALLY ALONG THE

TRANSVERSE PROCESSES LUMBAR
VERTEBRAE.
CROSS THE EXTERNAL ILIAC ARTERI
JUST BEYOND THE BIFURCATION OF
THE COMMON ILIAC ARTERI,THEN
RUNS ALONG THE LATERAL WALL OF
THE PELVIS TO ENTER THE URINARY
BLADDER

SUPRA RENAL GLANDS

LOCATED

BETWEEN THE
SUPEROMEDIAL ASPECTS OF THE
KIDNEYS AND THE DIAPHRAGMATIC
CRURA.
SECRETE CORTICOSTEROID AND
ANDROGEN AND MAKE EPINEPHRINE
AND NOREPINEPHRINE

SUPRA RENAL GLANDS

THE

TRIANGULAR RIGHT GLAND

LIES ANTERIOR TO DIAPHRAGM AND

MAKE CONTACT WITH I.V.C. ANTEROME
DIALLY AND THE LIVER ANTEROLATERA
LLY
THE

SEMILUNAR LEFT GLAND

RELATED TO THE SPLEEN, STOMACH,

PANCREAS AND THE LEFT CRUS OF THE
DIAPHRAGM

URINARY BLADDER

IS HELD BY
THE PUBOPROSTATIC LIG.
THE PUBOVESICAL LIG.

- male.
- female.

THE APEX OF THE BLADDER

TOWARD TO THE SUPERIOR EDGE OF THE PUBIC
SYMPHISIS.

THE BODY OF THE BLADDER

BETWEEN THE APEX AND FUNDUS.

THE FUNDUS OF THE BLADDER

FORMED BY POSTERIOR WALL.

THE NECK OF THE BLADDER

THE INFEROLATERAL SURFACE CONVERGE

INNERVATION OF THE BLADDER

Sympathetic fibers from the T11 L2 or
L3 to the vesical (pelvic ) plexuses
primarily through the hypogastric plexuses
and nerves
Parasympathetic fibers, from neuron in the
S2 S4 spinal cord segments and pass
from the anterior rami of spinal nerves S2
S4 via the pelvic splanchnic nerves and
inferior hypogastric and vesical (pelvic)
plexuses to the bladder.

INNERVATION OF THE BLADDER

Sensory fibers from the blader are
visceral.
Reflex afferents
- from the inferior part of the, follow
the course of the parasympathetic
fibers.
- from the superior surface of the
bladder, follow the sympathetic
fibers.

ARTERIAL SUPPLY OF THE

BLADDER
In

males
- Superior vesical arteries, supply
anterosuperior parts.
- Inferior vesical arteries,supply the
fundus and neck
In females
- Superior vesical arteries
- Vaginal arteries.

VENOUS SUPPLY OF YHE

BLADDER
The

combined plexus complex envelops

the fundus and prostat, the seminal
glands, the ductus deferents and the
inferior ends of the ureter
- vesical venous plexus, drains to
- inferior vesical veins.
- internal vertebral venous plex
- prostatic venous plexus
- deep dorsal vein of the penis

VENOUS SUPPLY OF THE

BLADDER
In

female, the vesical venous plexus

envelops the pelvic part of the
urethra and the neck of the bladder,
receive blood from the dorsal vein of
the clitoris, and communicates with
the vaginal or uterovaginal plexus

fig 3.13 c

390

fig 3.13 b

LYMPHATIC DRAINAGE
FIG 3.16 A , 396

MALE URETHRA
A MUSCULAR TUBE THAT CONVEYS URINE
FROM THE INTERNAL URETH- RAL
ORIFICE OF THE URINARY BLADDER TO
THE EXTERIOR THRO- UHG THE EXTERNAL
URETHRAL ORI- FICE AT THE TIP OF THE
GLANDS PENIS.
DEVIDED INTO

PREPROSTATIC URETHRA (INTRAMURAL)

PROSTATIC URETHRA.
INTERMEDIATE PART (MEMBRANOUS PART )
SPONGI ( PENILE ) PART.

PROXIMAL MALE URETHRA

Consist of intramural and prostatic uretha

Arterial supply, are supplied by prostatic branches
of the inferior vesical and middle rectal arteries.
Venous and lymphatic drainage
Venous blood drains into the prostatic venous
plexus
The lymph darins to the internal iliac lymph nodes
and into the external iliac ln
Innervation,are derived from the prostatic plexus
( sympathetic, parasympathetic and visceral
afferent ), an inferior extension of the vesical
plexus.

DISTAL MALE URETHRA

The intermediate ( membranous ) part of the

urethra
Posterolateral of this part are the bulbourethral
glands
The spongy urethra
Expanded the intrabulbar fossa
_ the navicular fossa
Opening the ducts of ;
- the bulbourethal glands.
- the urethral glands ( Littre glands )

DISTAL MALE URETHRA

Arterial supply, from branches of the dorsal artery

of the penis.
Vein drainage, veins accompany the arteries.
Lymphatic vessel, drains into the internal iliac
lymph nodes, deep inguinal lymph nodes, some
pass to the external iliac nodes
Innervation, the intermediate part is the same as
that of the prostatic part.
The dorsal nerve of the penis, a branch of the
pudendal n , provide somatic innervation of the
spongy part of the urethra.

yabl 3.7 pg 402

FEMALE URETHRA

THE SHORT FEMALE URETHRA PASSES

ANTEROINFERIORLY FROM THE INTERNAL
URETHRAL ORIFICE TO THE EXTERNAL URETHRAL
ORIFICE IN THE VESTIBULE OF VAGI NA.
LIES ANTERIOR TO THE VAGINA.
URETHRA PASSES WITH THE VAGINA THROUGH
THE PELVIC DIAHRAGM, EXTERNAL URETHRAL
SPHINCTER AND OERINEAL MEMBRANE.
THE PARAURETHRAL GLANDS, THE DUCTS OPENS
ONE ON EACH SIDE OF THE URETHRA.
THE INFERIOR HALF IS LOCATED INTHE
PERINEUM

FEMALE URETHRA
ARTERIAL SUPPLY , from the internal
pudendal and vaginal arteries.
LYMPHATIC DRAINAGE, to the sacral and
internal iliac lymph nodes. From the distal
urethra drains to the inguinal lymph nodes.
INNERVATION, from the vesical plexus and
pudendal nerve.
Visceral afferents run in the pelvic
splanchnic nerves.
Somatic afferents from the pudendal
nerve.

MALE INTERNAL GENITAL

ORGAN
INCLUDE

TESTES.
EPIDIDYMIS.
DUCTUS DEFERENS.
SEMINAL GLAND.
EJACULATORY DUCT.
PROSTATE.
BULBOURETHRAL GLAND

TESTIS
SUSPENDED IN THE SCROTUM BY THE
SPERMATIC CORD.
THE SPERMS ARE FORMED IN THE
SEMINIFEROUS TUBULES THAT ARE
JOINED BY STRAIGHT TUBULE TO THE
RETE TESTIS.
THE TUNICA VAGINALIS IS A CLOSED
PERITONEAL SAC SOROUNDING THE
TESTIS

VISCERAL LAYER.
PARIETAL LAYER.

EPIDIDYMIS
CONSIST

OF

HEAD
FORMED BY THE COILED ENDS OF 12 TO 14
EFFERENT DUCTULES.

BODY
CONSIST OF THE CONVOLUTED DUCT OF THE
EPIDIDYMIS.

TAIL
CONTINUOUS WITH DUCTUS DEFERENS

DUCTUS DEFERENS
BEGINS IN THE TAIL OF THE EPIDIDYMIS.
ASCENDS IN THE SPERMATIC CORD.
PASSES THROUGH THE INGUINAL CANAL.
CROSSES OVER THE EXTERNAL ILIAC
VESSELS AND ENTER THE PELVIS.
PASSES ALONG THE LATERAL WALL OF
THE PELVIS WHERE IT LIES EXTRA
PERITONEALLY.
ENDS BY JOINING THE DUCT OF THE
SEMINAL GLAND TO FORM THE
EJACULATORY DUCT.

SEMINAL GLAND
LIES BETWEEN FUNDUS OF THE BLADDER
AND RECTUM.
OBLIQUALLY PLACED SUPERIOR TO THE
PROSTAT.
SECRETE A THICK ALKALINE FLUID THAT
MIXES WIT5H THE SPERM AS THEY PASS
INTO THE EJACULATORY DUCT AND
URETHRA.
THE DUCT OF THE SEMINAL GLAND JOINT
THE DUCTUS DEFERENS TO FORM THE
EJACULATORY DUCT

EJACULATORY DUCT
ARISE BY THE UNION OF THE DUCT OF A
SEMINAL GLAND WITH THE DUCTUS
DEFERENS.
PASS ANTEROINFERIORLY THROUGH THE
POSTERIOR PART OF THE PROSTAT AND
ALONG THE SIDES OF THE PROSTATIC
UTRICLE.
TRAVERSE THE MAIN PART OF THE
PROSTAT AND CONVERGE TO OPEN BY
SLIT LIKE APERTURE ON OR JUST WITHIN
THE OPENING OF THE PROSTATIC
UTRICLE

PROSTATE

LIKE AN INVERTED PYRAMID THAT HAS

A BASE.
SUPERIOR ASPECT CLOSELY RELATED TO THE NECK OF
THE BLADDER.

AN APEX.
INFERIOR ASPECT THAT IS INCONTACT WITH FASCIA
ON THE SUPERIOR ASPECT OF THE URETHRAL
SPHINCTER AND DEEP PERINEAL M.

A POSTERIOR SURFACE.
RELATED TO THE AMPULA OF THE RECTUM.

INFEROLATERAL SURFACE.
RELATED TO THE LEVATOR ANI.

BULBO URETHRAL GLAND

LIE POSTEROLATERAL TO THE
INTERMEDIATE PART OF THE URETHRA.
THE DUCT OF THIS GLAND OPPEN INTO
THE PROXIMAL PART OF THE
SPONGYURETHRA IN THE BULB OF THE
PENIS.
THE MUCUS LIKE SECRETION ENTER THE
URETHRA DURING SEXUAL AROUSAL

FEMALE INTERNAL GENITAL

ORGAN
INCLUDE
VAGINA
UTERUS
UTERINE
OVARIES

TUBE

VAGINA
MUSCULOMEMBRANOUS

TUBE,
EXTENDS FROM THE CERVIX OF THE
UTERUS TO THE VESTIBULE OF THE
VAGINA.
THE VAGINAL FORNIX
ANTERIOR
LATERAL
POSTERIOR.

VAGINA
SERVES

AS A CANAL FOR
MENSTRUAL FLUID.
FORM THE INFERIOR PART OF THE
PELVIC ( BIRTH ) CANAL.
RECEIVES THE PENIS AND EJACULA
TE DURING SEXUAL INTERCOURSE
COMMUNICATES SUPERIORLY WITH
THE CERVICAL CANAL AND
INFERIORLY WITH THE VESTIBULE.

FOUR MUSCLES OF THE

VAGINA

PUBOVAGINALIS

M.
EXTERNAL URETHRAL SPHINCTER M.
URETHROVAGINAL SPHINCTER M.
BULBOSPONGIOSUS M.

ARTERIAL SUPPLY OF THE

VAGINA
THE

SUPERIOR PART OF THE VAGINA

DERIVE FROM THE UTERINE
ARTERIES.
THE MIDDLE AND INFERIOR PART OF
THE VAGINA DERIVE FROM THE
VAGINAL AND INTERNAL PUDENDAL
ARTERIES.

UTERUS
A

THICK- WALLED, PEARSHAPED,HOLLOW MUSCULAR ORGAN

LIES IN THE LESSER PELVIC.
HAS
BODY
FUNDUS
ISTHMUS.

THE WAAL OF THE BODY OF

THE UTERUS
PERIMETRIUM.
MYOMETRIUM.
ENDOMETRIUM.

ARTERIAL SUPPLY OF THE

UTERUS
THE

UTERINE ARTERIES.
THE OVARIAN ARTERIES
( COLLATERAL )

CERVIX
THE

CYLINDRICAL, NARROW
INFERIOR PART OF THE UTERUS
THAT PROTRUDES IN TO THE UPPER
MOST PART OF THE VAGINA.

UTERUS
THE

BROAD LIGAMENT
THE SUSPENSORY LIGAMENT OF
OVARY
THE LIGAMENT OF OVARY
THE ROUND LIGAMENT OF UTERUS

UTERINE TUBE
EXTENDS

FROM THE UTERINE HORN

AND OPEN INTO THE PERITONEAL
CAVITY NEAR THE OVARIES.
LIE IN THE MESOSALPINX.
DIVISIBLE INTO
INFUNDIBULUM
AMPULA
ISTHMUS
UTERINE PART.

OVARIES
LOCATED CLOSE TO THE LATERAL PELVIC
WALL SUSPENDED BY THE MESOVARIUM.
CONNECTS TO THE LATERAL WALL OF THE
PELVIS BY THE SUSPENSORY LIGAMENT
OF THE OVARY.
ATTACHES TO THE UTERUS BY THE
LIGAMENT OF OVARY, CONNECT THE
PROXIMAL END OF THE OVARY TO THE
LATERAL ANGLE OF THE UTERUS.