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AnatomyUrinary — Transcript

by Dr. Naveen Jalota, M.D. · 5,766 words · 850 segments · language en · Watch on YouTube

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0:01hello and welcome let's start talking
0:06today let's start talking today about
0:12the urinary system now when we talk
0:16urinary system the urinary system we'll
0:18see is going to be made up of a few
0:20different organs here we can see those
0:23few different organs being depicted and
0:25being depicted in relation to you can
0:29see a whole bunch of other organs and
0:31structures there as well
0:33so here we have a good view and here we
0:36also have a very good view also so what
0:39we'll do first is we'll go through the
0:40different components here and then we'll
0:42relate everything to the other
0:44structures there as well
0:45so we talk urinary system urinary system
0:47is made up of you can see your kidneys
0:50your two kidneys your urinary bladder
0:57do you readers that are found in between
1:01the kidneys and the urinary bladder your
1:06your readers and your urethra so you've
1:11got kidneys two kidneys to your readers
1:17leading to one bladder the urinary
1:20bladder hoping to basically flow this
1:27move this urine forward to then do you
1:30read the row which will then we'll see
1:32expelled a urine for the body so kidneys
1:35your readers bladder and urethra kidneys
1:42ureter bladder you may have heard of
1:43that with the x-ray KUB kidneys ureter
1:46bladder and that's usually what they're
1:48looking at in this abdominal kind of
1:51pelvic x-ray that don't do there so here
1:54now these are the organs again of the
1:56urinary system now when we go through we
1:57talk you're in a system what we're gonna
1:59do is we'll focus on the structures one
2:02by one so we'll start off with the
2:03kidneys let's start with the kidneys we
2:05talked about the kidneys first let's
2:06talk function of the kidneys kidneys
2:07we'll see you have a few functions okay
2:09and we'll go to we'll check those out
2:11and here we could see
2:13now these kidneys the ureters the
2:18bladder and the urethra from an atom an
2:22anterior view and here you can see also
2:24the suprarenal glands above them okay we
2:27would have then the liver up in here
2:30right and here you can see the blood
2:33vessels we're gonna go to those major
2:34blood vessels we've got the abdominal
2:36aorta the inferior vena cava and then
2:38here we can see some muscles right we've
2:40gone to the iliacus and the psoas major
2:42muscles here the iliopsoas muscles and
2:46here you can appreciate then basically
2:49how the bladder is found in that pelvis
2:52so from this posterior view now you can
2:54appreciate how the kidneys are gonna be
2:56found in that I mean basically this
2:58lumbar region we're gonna go through
3:00we're gonna check out the lower thoracic
3:02lumbar and higher lumbar region and then
3:04here you can see the bladder and how
3:07it's found in the pelvis so two kidneys
3:12two you readers bladder and a urethra so
3:15I told you kidneys gonna have several
3:16functions first function we're gonna go
3:18through we're gonna talk about we're
3:19gonna check out is urine formation urine
3:22formation your information
3:25urine your information urine formation
3:33is going to occur when the kidneys
3:37filter fluid from the blood when the
3:42kidneys filter fluid from the blood this
3:47is gonna allow them to remove toxins
3:51metabolic wastes and even excess ions
3:56and this will allow these wastes the
4:02metabolic toxins the waste the excess
4:06ions to leave the body as urine while
4:12the kidneys return needed substances
4:15back to the blood so they're going to
4:19filter fluid from the blood and this
4:21will allow these components to be
4:24removed while returning
4:27needed substances back to the blood so
4:31filter blood plasma and excrete waste we
4:33can see there regulate blood volume and
4:38blood pressure we've talked about how
4:41that happens you should be able to
4:43explain that regulate osmolarity we've
4:47talked a little bit about that regulate
4:50electrolyte and acid-base balance
4:53secrete erythropoietin for red blood
4:56cell production we've seen that help
4:59synthesize vitamin D right we've talked
5:01about this along with this there's two
5:03other systems that are gonna be involved
5:05there as well helps to clear hormones
5:09and drugs
5:09so basically detoxifying free radicals
5:12also and then help support blood glucose
5:16levels during starvation so
5:19gluconeogenesis producing hormones right
5:24erythropoietin green in metabolized
5:29vitamin d to its active form right so
5:31all these basic functions you've got
5:33here now where are these kidneys found
5:38you can see they're found located lying
5:42in a retroperitoneal position between
5:48the dorsal body wall and the parietal
5:53peritoneum they're found in the superior
5:59lumbar region extending approximately
6:04from t12 down to l3 extending
6:10approximately from t12 down to l3 you
6:14can see the right kidney is slightly
6:17lower compared to the left the right
6:21kidney is slightly lowered compared to
6:25the left and that's going to be because
6:26we have our liver found here on the
6:31right side that will be occupying a good
6:34amount of space there and that causes
6:36this kidney to be found in a position
6:39slightly lower compared to
6:40the left kidney now when we talk about
6:44the size in the shape of the kidneys we
6:47talk about the size the kidneys weigh
6:48about 150 grams about five ounces when
6:53you talk about their dimensions the
6:54kidneys are going to be about 12
6:57centimeters long they're about 12
6:59centimeters long they're about 6
7:03centimeters wide about 6 centimeters
7:08wide and 3 centimeters thick about the
7:13size of a large bar of soap about the
7:17size of a large bar of soap and when you
7:19talk shape they're being shaped their
7:22kidney bean-shaped
7:23and you can see that they're very nicely
7:30now when we talk about the external
7:32anatomy of the kidneys the external
7:34anatomy you can see here the lateral
7:35surfaces convex while the medial surface
7:39is concave and the medial surface has a
7:44vertical cleft to it and the vertical
7:48cleft is called the renal hilum which
7:56we'll see is going to lead us to the
7:58renal sinus here in this location you
8:04can see you have do you readers and the
8:08blood vessels entering and exiting
8:10basically dorg and kidneys
8:15now atop each kidney we can appreciate
8:19the adrenal glands so you've got two
8:23adrenal glands or Supra renal glands we
8:28refer to them as well Supra renal above
8:31the kidneys now we talked about the
8:35renal hilum so here you'll see it's
8:37gonna contain the ureter the renal blood
8:39vessels the lymphatics okay in the
8:44nerves basically all these important
8:45organs we're going to see here in
8:46relation to the organs now when we go
8:50through and we talk about and we talk
8:54about
8:54these kidneys here you can appreciate
8:57now some supporting tissue in relation
9:00to these kidneys as well
9:02now the supporting tissue we have here
9:05so when we talk about the supporting
9:08tissue you can see the supporting tissue
9:10is gonna be made up of various factors
9:12so here we're able to appreciate that
9:14supporting tissue right in this picture
9:16here and also right in this picture here
9:18what we'll do is we'll move over to this
9:20picture here in this picture now we can
9:22appreciate the three layers which are
9:24going to be surrounding each kidney and
9:26make up the supporting tissue first we
9:29have here what we call the fibrous
9:31capsule the fibrous capsule we talked
9:34about the fibrous capsule you can see
9:35the fibrous capsule is going to be the
9:37innermost layer it's a transparent
9:41capsule and it prevents infection from
9:44spreading to the kidneys then we have
9:49the peri renal fat capsule the peri
9:53renal fat capsule is exactly what its
9:55name says it's going to be a fatty mass
9:58that surrounds and cushions the kidneys
10:02against blows then we have the renal
10:08fashio the renal fashion now you can see
10:11we've got an anterior and a posterior
10:15component now there's renal fashio as
10:18the outer layer and it's a layer of
10:20dense fibrous connective tissue it's a
10:23layer of dense fibrous connective tissue
10:25and it anchors the kidneys and the
10:29adrenal glands to the surrounding
10:32structures
10:38now in the cats you'll be able to go
10:42through basically all of this you can
10:46see the peritoneum those layers and
10:49you'll be able to appreciate that when
10:51we get to the renal system in relation
10:54to the cats and that's when you'll be
10:56able to remove that you'll be able to
10:57actually dissect out the adrenal glands
10:59there as well up till now you've just
11:02been feeling them and seeing them there
11:03and once you actually look at it and you
11:06see them you'll see the very very
11:08tiny structures so here now when we look
11:12at the internal anatomy let's move over
11:14to then this picture right in here or we
11:17can see this picture right in here now
11:20here we can see the frontal section this
11:23is going to review to us basically three
11:27different three distinct regions we can
11:31say we've got here first the renal
11:33cortex and then we've got the renal
11:35medulla and then we've got the renal
11:37pelvis so let's go through let's talk
11:39first the renal cortex the renal cortex
11:41is the most superficial region you can
11:45see here it's light in color the most
11:47superficial region light in color and it
11:51has a granular appearance - it has a
11:54granular appearance to it and you'll be
11:57able to appreciate that there with the
11:59cow kidneys you'll be able to see it
12:06very nicely
12:07we don't dissect out cat kidneys because
12:09the cat kidneys are you know really
12:11really small structures and trying to
12:13appreciate the internal anatomy inside
12:15it's just almost non-existent and so we
12:19supplement that with cow kidneys now we
12:23can see the renal medulla the renal
12:25medulla is the darker reddish brown
12:28region you see just deep to the cortex
12:32and this renal medulla you can see the
12:35zip it's it exhibits cone-shaped tissue
12:39masses that we're gonna refer to as
12:42renal pyramids these renal pyramids are
12:44cone-shaped
12:45tissue masses they have a base and they
12:48have an apex to them the base is facing
12:51the cortex the apex or the papilla you
12:55can see is facing then that pelvis now
13:03when we talk about the nephrons the
13:06nephrons are mostly found in the cortex
13:10when we go through we look at the actual
13:11nephron we'll be able to appreciate that
13:13there you see the majority of the
13:14nephron is gonna be found in the cortex
13:17and we'll have a couple of parts
13:18basically dipping down into you
13:21the medulla so then here we've got the
13:25renal columns the renal columns are
13:27going to be found as in word extensions
13:31of cortical tissue you can see that
13:34extending downward and the renal columns
13:38are found separating the pyramids from
13:42one another from then the medulla we can
13:47move down into the pelvis now when we
13:50talk about the pelvis the renal pelvis
13:53is this funnel shaped funnel shaped tube
13:58type structure you can see one side of
14:03this renal pelvis it's continuous with
14:06the ureter and the other side it's
14:11continuous with the minor and the major
14:14callous ease but which are gonna be
14:20found surrounding you can see the
14:22papillae and we talked renal pelvis so
14:29minor calyx minor calyce's you two to
14:35three come together to give rise to one
14:37major calyx and then a couple of these
14:41major calyxes a few these major calluses
14:43will come together and they're gonna
14:44give rise then to the pelvis the pelvis
14:48then continues as the ureter
14:52we saw the ureter in that initial image
14:55there and you saw how it's making its
14:58way down to the bladder so major kala
15:03sees two to three branching extensions
15:05of the pelvis and the minor calyce's
15:08you can see even more or further
15:11branches of the major Calla seized and
15:13they're surrounding the papillae
15:17so when urine is gonna make its way out
15:20its gonna get basically making its way
15:21out of this papal are there and then
15:24it's gonna get basically dropped into
15:25the minor calyx major calyx and then the
15:28pelvis and then into the ureter then the
15:30buter to bladder urethra and toilet
15:35the tree the grass and civilize so here
15:43then when we moved through we can see we
15:47want to get down to the nephron here now
15:48when we talk about the nephron in order
15:50for us to reach the nephron we're going
15:53to follow the blood supply and the
15:57arterial supply basically in and then
15:59we'll follow the venous supply all the
16:02way out so here when we go through and
16:04we talk then here we can use this image
16:06here we could use this image right
16:08inside of here now here we could see
16:10right off the bat
16:12we've got first our renal arteries the
16:14renal artery now is going to make its
16:17way further in to then the kidneys at
16:21the renal hilum we said so told you here
16:23you can appreciate all of these
16:24structures and then we talk nor it--
16:27they be found surrounding this artery
16:29and basically making their way through
16:30and all of that you can check all that
16:32out there so here you can see now the
16:34renal artery as it makes its way further
16:36into the kidneys it's going to start to
16:39branch and divide now here when it
16:42starts to branch and divide it's going
16:44to give rise first to the segmental
16:46arteries these segmental arteries then
16:49you can see are going to pass and
16:51they're going to further divide and
16:53they're going to make their way in to
16:55the columns and here you can appreciate
16:58now those arteries segment arteries are
17:01gonna become the inner lobar arteries
17:02these interloper arteries now are gonna
17:05continue deeper into the kidneys even
17:08moving further into the kidneys and as
17:10they move further up into the kidneys
17:11here you can see they're gonna start to
17:13curve and when they occurred now they're
17:16going to become known as the arcuate
17:19arteries now here you can see the
17:22arcuate artery making its way up and
17:24again making its way further up into the
17:27kidney and here then it's going to
17:29become the cortical radiate artery the
17:32cortical radiate arteries now are going
17:35to have you can tell these branches
17:36coming off from them as well making sure
17:38that the cortex is fully supplied so
17:40here what do we have we said the
17:41majority of the nephron is going to be
17:42found here now the cortical radiate
17:44artery is going to lead us to then you
17:49can see the afferent arteriole the
17:53afferent arteriole is going to continue
17:56on then to form the glomerulus to form
18:01the glomerulus here you can appreciate
18:03that glomerulus to glomerulus now is
18:06going to be in connection with the
18:09nephron so here's the initial part of
18:12the nephron and here you can see they're
18:14in contact with each other we can move
18:15over further to this picture in here and
18:18you can see blood flow is going to be
18:20into that
18:22afferent arteriole right in today from
18:24our tail then it flows into the
18:26glomerulus or whatever needs to be
18:27filtered out it's gonna get filtered out
18:28in here and whatever gets returned is
18:30going to be returned back into the
18:31circulation thanks to the afferent
18:33arteriole which then is going to collect
18:37blood from other arterioles as well the
18:40capillaries they're more specifically
18:42speaking and here we can see that blood
18:45is gonna make its way then back out of
18:47the nephron here you can see the rest of
18:52those capillaries so once this blood
18:55makes its way into the ef'n our children
18:57are chills become the peritubular
18:58capillaries the Vasa recta peritubular
19:01capillaries then and they're all going
19:03to then empty you can see here they're
19:06all going to empty them and they empty
19:09right into the cortical radiate vein now
19:14the cortical radiate vein then is going
19:17to receive this blood and it's going to
19:20circulate that blood then and put it
19:23into you can see with the arcuate veins
19:25arcueid vein then it's gonna pass this
19:27blood back to the heart then on its way
19:29back now to the heart it becomes you can
19:31see that arcuate is going to become the
19:33inner lobar vein the inner lobar vein
19:35then continues through the kidneys
19:37making its way out and it becomes the
19:39renal vein from the renal vein then we
19:42go into the inferior vena cava and we'll
19:44pick up from there when we get to
19:45circulation and we talk cardiovascular
19:48system so let's look at what we have
19:52then right up in here so this is where
19:54all the magic occurs so let's go here
19:57you can see one idea of the area there
20:00this is all the cortical Reed
20:02these are cortical nephrons these are
20:04juxta medullary nephrons you can see we
20:07have a couple of different types so
20:09let's talk nephrons nephrons now are
20:11going to be the structure on the
20:12functional unit of our kidneys each
20:16kidney contains over a million of these
20:18tiny blood processing units which are
20:22gonna carry out the process that form
20:25the processes that are gonna form urine
20:31so we saw the glomerulus first here the
20:35glomerulus is a tuft of capillaries
20:37it's a tuft a bunch of capillaries and
20:41then surrounding those capillaries is
20:44the you can see the renal corpuscle or
20:49basically more specifically speaking
20:51we're gonna see the glomerular capsule
20:53so again the glomerulus along with this
20:56capsule make up what we call the renal
20:59corpuscle so here you've got the renal
21:01corpuscle and the rest here you can see
21:04you've got the tube you'll we've got the
21:07renal tubular so let's go through you
21:10can see the glomerulus
21:12you've got the renal tubules and then
21:16the glomerular capsule surrounding that
21:20glomerulus so let's talk renal corpuscle
21:24when we talk renal corpuscle
21:26okay so nephron is going to consist of
21:29two major components okay that
21:33glomerulus you can see and then
21:35basically the capsule along with the
21:37tubular component we've got here so here
21:41now when we go through and we talked
21:43about the renal corpuscle
21:44so the renal corpuscle is going to be
21:47made up of you can see these two parts
21:48where you can see that there and then
21:49here we could see that being depicted as
21:52well so the renal corpuscle and then the
21:57tube you'll major components of the
22:00nephron so here then let's talk this GU
22:04malar capsule now the glomerular capsule
22:06you can see okay it's going to be made
22:10up of two parts you're gonna have two
22:12parts say you've got a pride of layer
22:13and you've got a visceral layer prior to
22:15layer and
22:16so layer so here the parietal layer
22:19right outside you've looked at that in
22:20the beginning of the semester and then
22:22the visceral layer is gonna be the layer
22:23right on top of here and there's that
22:27visceral layer in greater detail so here
22:32you can see you've got that glomerulus
22:34it's got all these little openings in it
22:37as well please don't allow these
22:39different components to make their way
22:40through and we can't just allow any and
22:43everything to make its way through so to
22:44help prevent that from occurring we've
22:46got these little cells on top of them
22:49podocytes
22:50which have these little foot like
22:51processes so here you can see those
22:53little sites in greater details same
22:55thing being basically you can see now
22:58here's another part basically being
23:00depicted here that glomerulus in greater
23:02detail is what we're looking at here
23:04okay so you can't see those photo sites
23:06that well that's why you can see them
23:07here and that's what you're seeing
23:08depicted here in this picture they're
23:10all a little like processes all helping
23:12to block off those tiny little openings
23:14and that's what you're seeing right in
23:15here so down here is the basement
23:18membrane and on the other side is that
23:19fenestrated endothelium of the
23:20glomerulus now here you can see
23:27everything basically in relation to each
23:30segment so you've got to know that
23:32histology basically there for each of
23:34these different segments as well so you
23:36can see we've checked that out we talked
23:38PCT proximal convoluted tubule now the
23:41next segment we're able to check out so
23:44this tubules system now is basically
23:46forming and you can see here you got the
23:47PCT proximal convoluted tubules and when
23:50you talk about the histology you can you
23:52can appreciate now here the cells and we
23:57move down into the next segment the loop
23:59of Henle you can see the loop of Henle
24:00has a descending and an a sending limb
24:03the descending limb is made up of
24:05basically just a thin segment while the
24:07ascending limb is made up of a thin and
24:09a thick segment so here you can see the
24:11thin segment here we can appreciate then
24:13you can see very nicely and then as we
24:19move back up now we move up this loop of
24:21Henle to the DCT the distal convoluted
24:23tubules we talk distal convoluted
24:25tubules okay here we're gonna be able to
24:27appreciate the histology in relation
24:30the distal convoluted tubule so you can
24:32see we're going to cuboidal columnar
24:34alright simple squamous so we're moving
24:36all around and then we moved through the
24:39DCT we move up into the collecting ducts
24:42the collecting ducts you can see receive
24:44basically many DC T's we talk about the
24:47collecting duct now you can see the
24:49structure of the collecting duct very
24:51important you understand each segment
24:54because that's how you'll be able to
24:56understand the physiology so you have to
24:58go through every segment and understand
24:59that detail there so we've got all the
25:05different parts there and then we've got
25:10the papillary duct basically that's
25:11going to be found as the merger of
25:14several collecting ducts so renal
25:19corpuscle now we can see from here the
25:23peritubular capillaries the peritubular
25:25capillaries they arise from the e ffred
25:28arteriole they arise from the efferent
25:30arteriole that's draining the glomerular
25:35and these capillaries they cling you can
25:39see closely to these adjacent renal
25:42tubules they're gonna empty into nearby
25:47venules as I mentioned and then we've
25:54got basically the different segments
25:56that we talked about as well so coming
26:01nice view here we can appreciate now
26:05next what we call the juxtaglomerular
26:07apparatus this juxtaglomerular apparatus
26:11is going to be found you can see here
26:15where you have one segment of the
26:18nephron loop coming into contact now you
26:23can see here weird our glomerulus right
26:31and then basically the vessels that are
26:33feeding the glomerulus and emptying the
26:36glomerulus so let's look at this
26:37juxtaglomerular apparatus in greater
26:39detail it's made up of three parts you
26:41got the macula densa cells you can see
26:44you're gonna be able to appreciate the
26:45juxtaglomerular cells surrounding that
26:49afferent arteriole there smooth muscle
26:52cells and then mesangial cells so we
26:54talked mesangial cells you're going to
26:56be able to appreciate the mesangial
26:57cells now here in between those two
26:59cells here you can appreciate that
27:05juxtaglomerular apparatus in greater
27:08detail now again so macula densa cells
27:11we can see here right we saw the same
27:15thing right inside of there extra
27:19glomerular mesangial cells
27:22okay the extra column Aylor mesangial
27:24cells mostly in between the two and then
27:28here you can see your granular cells so
27:34I want you to understand the function of
27:36each of these cells and how they're
27:38going to be involved in relation to
27:39blood pressure and how they're involved
27:43in relation to blood pressure
27:46next in here when we talk this segment
27:49right inside here and more specifically
27:50speaking you can see this segment is the
27:53ascending limb of the loop of Henle you
27:56have to make sure you understand that
27:57there as well and also just by looking
28:00you can appreciate the size difference
28:02between the two vessels there as well
28:03and that's telling you more blood is
28:05gonna make its way in versus the amount
28:06that's gonna be making its way out and
28:08that's gonna help to create a higher
28:10pressure gradient inside which is going
28:12to favor filtration the process of
28:14moving things out moving those
28:16substances out into you can see that
28:18capsular space so from this capsular
28:22space whatever gets filtered out is
28:26going to be passed then into you can see
28:28in detail now that PCT the PCT is
28:32considered the workhorse of the kidney
28:34the PCT has the ability to reabsorb 50
28:38to 60% of the components that get
28:41filtered right out of here
28:45so from that PCT those substances are
28:48going to be then passed along if they
28:50don't get reabsorbed by the peritubular
28:52capillaries are gonna be passed along to
28:54the loop the same thing if things don't
28:57get reabsorbed
28:57or other things aren't getting added
28:59back in this will continue the spilt
29:02rate will continue to you can see the
29:04ascending limb and then making its way
29:06forward there's gonna be basically
29:08things that are gonna be happening to it
29:10all the way through moving forward to
29:12the DCT and from the DCT we saw right
29:14into the collecting ducts so as this
29:21filtrate is making its way through you
29:23can see how concentrated it gets when it
29:25makes its way down here towards that
29:29apex you can see the osmolarity there is
29:32going to become about twelve hundred
29:33million dollars and the physiology is
29:39going to explain that but you have to go
29:41there with this basic knowledge of
29:42understanding what's happening there so
29:45has this filtrate passes through the
29:48osmolarity there you can see is about
29:50300 milliosmoles gets a little bit more
29:52concentrated a little bit more constant
29:53even further concentrate even further
29:54concentrated and then you can see it
29:56becomes less concentrated as it makes
29:57its way back up then you have to be able
30:01to explain that with the physiology when
30:03you talk renal physiology so let's move
30:10then to let's make sure you've got
30:13everything taken care of here two
30:15different types of nephrons
30:19juxtaglomerular apparatus make sure you
30:23got that distal layer there down as well
30:27all right so let's move forward then
30:31let's move forward now let's talk about
30:32the e-readers now when we talk about the
30:35you readers there you readers are
30:36slender tubes their slender tubes
30:39they're a continuation of the renal
30:41pelvis and their function is that they
30:44convey urine from the kidneys to the
30:47bladder they convey urine from the
30:50kidneys to the bladder their location
30:53they are going to be found they begin
30:59around the level of l2 they begin around
31:02the level of l2 and they're going to
31:05descend behind the peritoneum they
31:09descend behind the peritoneum they
31:10extend for about 20
31:1135 centimeters from the kidneys to the
31:15bladder behind the peritoneum okay you
31:27can see all that retroperitoneal talk
31:30I've been doing they're going to be
31:35running obliquely through to enter into
31:41the kidneys from the posterior inferior
31:46bladder wall and we can appreciate that
31:52then right inside of here very nicely so
31:58right here you can see how they make
31:59their way down so I was drawn here
32:01you've got to be able to understand
32:03they're coming down and when they're
32:05coming down right they're continuing
32:07right down in here to come in and enter
32:13that we said coming in to enter right
32:19here at the posterior inferior bladder
32:21wall let's look at the internal anatomy
32:25of the your readers the internal anatomy
32:27you'll see is made up of three layers
32:29here we can appreciate the three layers
32:31you've got first of mukou so we've
32:33talked about the mucosa you should know
32:35everything about that mucosa we did that
32:36in the beginning of the semester if you
32:38don't recall we talked about
32:40transitional epithelium there and that's
32:42what you're able to appreciate this
32:44transitional fidelium is continuous with
32:46the kidney pelvis superiorly and the
32:50bladder on its inferior medial aspect
32:56and then we can appreciate the lamina
33:00propria connective tissue support and
33:07then underneath there we've got the
33:08muscularis muscularis is typical by
33:12layered you've got a longitudinal and
33:13you've got a circular layer longitudinal
33:20on inside circular here on the outside
33:21and then we've got the adventitia
33:25right out here external to the
33:29muscularis mucosae
33:42continuing forward then so that been
33:45tisha covers the you readers external
33:46surface and it's typical fibrous
33:48connective tissue okay so make sure you
33:51know the differences in the different
33:53connective tissues there as well then
33:57we've got the urinary bladder so let's
33:58move over to the urinary bladder nice
34:00view here a little better view here we
34:02can talk
34:03you're very bladder you can see it's a
34:04smooth collapsible muscular sac it's a
34:10smooth collapsible muscular sac when we
34:15talk about the urinary bladder its
34:16function is that it stores urine
34:19temporarily have that students ask me if
34:23they hold their urine will they get more
34:24nutrients no no urine formation all that
34:29happened already in the kidneys here
34:31it's just all in the process of removing
34:32it so when you talk function of the
34:34bladder it stores urine temporarily the
34:38location it's found in for a para
34:41Tonioli in for a para Tony Lee on the
34:45pelvic floor and here you can see that
34:46peritoneum in for peritoneal e on the
34:51pelvic floor just posterior to the pubic
34:54symphysis just posterior to the pubic
34:57symphysis no ii not when you look at and
34:59you talk about the internal anatomy here
35:00you can see this internal anatomy of the
35:04bladder it has basically three openings
35:07it has openings for both of the you
35:10readers number one we saw one making its
35:12way down this way the other one does the
35:13exact same way so you got the two
35:15ureteric offices the openings for the
35:18you readers and then here you can see
35:20that bladder neck the opening basically
35:21for the urethra and then here you've got
35:28two truther muscle the detrusor muscle
35:31is all smooth muscle it's the muscular
35:33layer of this urinary bladder so that
35:37detrusor muscle the muscular layer
35:39consists of intermingled smooth muscle
35:41fibers
35:47the bladder leads us then to the urethra
35:49when we talk urethra it's a thin walled
35:53muscular tube it's lined by
35:58pseudostratified columnar epithelium
36:05near the bladder
36:07it's transitional and near the external
36:13opening become stratified squamous so
36:17you can see it all changes as it makes
36:20its way through now when we talk about
36:26the function of the urethra the function
36:28of the urethra is that it drains urine
36:31it will drain urine and drains urine
36:35from the bladder and it'll convey this
36:37urine out of the body now when you talk
36:43location it's the Lehrer is going to be
36:45found located you can see right after
36:48the bladder that's in both females and
36:51in males now here let's talk first
36:53female you read throughout the female
36:56urethra is smaller in size compared to
36:59the male urethra it's about one and a
37:02half inches long and it's tightly bound
37:05to the anterior vaginal wall it's
37:09tightly bound to the anterior vaginal
37:11wall the location of the urethra and the
37:16size of the urethra we believe all
37:19increase the chances of UTI is here in
37:23the female compared to the male so when
37:27we get to reproductive we'll talk more
37:29about the location you'll be able to see
37:31the close proximity in relation to
37:34basically the anus the anus now when we
37:42talk male urethra we'll check out there
37:44as well but the female you reach I want
37:45you to be able to appreciate the
37:46external urethral orifice the external
37:48urethral orifice is going to be the
37:50external opening it's the external
37:52opening and it's lying anterior to the
37:56vaginal opening it's lying anterior to
38:00the vaginal opening
38:01and posterior to the clitoris so
38:06anterior to the vag an opening and
38:07posterior to the clitoris to give you a
38:09full an idea of exactly where that's
38:11going to be found again you'll be able
38:12to see that in the next video when we
38:14get into reproductive now we talk male
38:18urethra the male urethra is longer in
38:23size has three different regions to it
38:30it gets divided into three different
38:32regions you have first week what we call
38:33the prostatic urethra the prosthetic
38:37urethra is the region of the urethra
38:39that's running through the prostate
38:41gland then we have the membranous
38:48urethra the membranous urethra then is
38:51the sequence of us it's a segment that
38:54runs through the urogenital diaphragm
39:03excuse me so it runs through the
39:12urogenital diaphragm and it's gonna
39:24extend for a few centimeters it extends
39:28for a few centimeters from that
39:30prostatic urethra
39:31to where the penis is going to begin
39:34then so next and we have the spongy
39:37urethra the spongy urethra is the
39:41segment of the urethra that's going to
39:43be found excuse me that's going to be
39:46found running through the penis runs
39:49through the penis and opens at its tip
39:54here we have the external urethral
39:56orifice as well the external urethral
39:58orifice is opening at the tip of the
39:59penis it's the opening at the tip of the
40:02penis now we talk external Anatomy here
40:06we've got now a couple of sphincters I'd
40:09like you to know about first we're able
40:10to appreciate now what we call the
40:12internal urethral
40:13sinter the internal urethral sphincter
40:16is going to be found at the bladder you
40:19read through a junction it's found at
40:21the bladder you read through Junction
40:24and you can see that right inside of
40:25here that's the internal urethral
40:28sphincter here with the male and then
40:31we've got the same thing here we've got
40:33the internal urethral sphincter with the
40:35female as well so it's at the bladder
40:38you read through a junction and it's a
40:39thickening of the detrusor smooth muscle
40:42it's a thickening of the detrusor smooth
40:46muscle so smooth muscle you should be
40:50able to understand what type of control
40:51it's under and then we have the external
40:54urethral sphincter we talk external
40:56urethral sphincter you can appreciate
40:57that there with the female surrounds the
40:59urethra as it passes through the
41:02urogenital diaphragm same thing here
41:06with the male external urethral
41:10sphincter the external urethral
41:14sphincter is gonna be formed by skeletal
41:16muscle by skeletal muscle it's the same
41:20thing you should know the control there
41:26alright that concludes the urinary
41:30system

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