Transcript for:
Anatomy of the Kidneys

What’s up. Meditay here. Let’s talk about the anatomy of the urinary system. In this segment, we will be talking about the anatomy of the Kidneys. Alright, so the Urinary system consists of all the organs involved in handling the urine. These are the Kidneys, the Ureter, the Urinary bladder, and the urethra. Our goal is to cover the anatomy of all these structures you see here, step by step, and we’ll start with the Kidneys In this video, we're first going to talk about the functions of the kidneys. Then we’ll talk about the external structures and the coverings of the kidneys. After that, we’ll open up the kidney and cover the internal structures. When we’re done with the kidneys, we’ll talk about the general anatomy of the nephron, which is the functional unit of the kidney. Alright, so here you see an anterior view of the body. The kidneys are these bean-shaped paired organs you have on the backside within the ribs. The first thing you need to keep in mind is that the Right kidney is placed a little lower than the left kidney, possibly because the liver occupies a huge part of the right side of the abdominal cavity. But they both start approximately from the 12th thoracic vertebrae. But the left one ends at approximately the 2nd lumbar vertebra, and the right kidney ends at approximately the 3rd Lumbar Vertebra. Ok, so first off, what are the functions of the kidneys? There are three main functions that the kidneys have. And they are Plasma filtration, Excretion of waste products, and acid-base homeostasis. And the kidneys are able to do all that with the help of something we call a nephron. We’ll talk a little more detail through the nephron at the end of this video, but the head of the nephron, is called a Renal Corpuscle, and this is the part that primarily filtrates the plasma. So, what is plasma? When you first draw blood from the body, into a tube, you’ll get whole blood. And if you put this tube with whole blood into a centrifuge, and start the machine, it’ll spin around so fast, that it’s going to separate the blood, as you see here. Now we’re left with Pure erythrocytes at the bottom, buffy coat, consisting of white blood cells mainly, and plasma. So when whole blood goes through the renal corpuscle, the plasma is going to get filtrated. So that’s what we mean with plasma filtration. Next, excretion of waste products. So the plasma consists of everything that’s not cells. That is water, proteins, nutrients, electrolytes, and here in bold. Metabolic Waste products. As you see here. So what kind of metabolic waste products do we have? We have (ammonia, uric acid, urea, creatine, creatinine, and different types of amino acids) are considered as metabolic waste products, and they get excreted out through the renal corpuscle, and this si very important, it’s dangerous if we get too much of these waste products. Now, your body is in a perfect state when there’s a balance between acid and base, around 7.35 to 7.45 is our natural state where all processes within us happen optimally. But sometimes, something happens that makes our blood either acidic or alkaline, called acidosis and alkalosis. We don’t like that, and when the pH gets too deviated, it gets even worse. And this process is usually regulated primarily through the lungs and the kidneys. There are other functions the kidneys have as well, such as hormone production, producing hormones like erythropoietin that stimulate RBC production, and Vit D metabolism by activating vit D, since most vitamin D in our blood is in an inactive state. So that’s the functions of the kidneys- They’re very important to our body, kidneys are. Now let’s start with the kidneys anatomy by looking at the external structures. So the kidneys are about 120-200 grams, these numbers really deviate depending on the source you’re studying from, but they're about 10 to 13 centimeters long and 5-6 centimeters wide, and about 4 cm thick. The kidney has an inferior Pole, and a Superior Pole. And on the superior pole, you’ll find the suprarenal gland resting on it as you see here. They also have two margins. There’s a lateral border or lateral margin, and there’s the medial border. The medial border has an area called hilum of the Kidneys, and if you remember what a hilum is. A hilum is the entrance into an organ. So this place is the only place structures can go in and out from the kidneys. You’ll find blood vessels and nerves and lymph vessels going in and out, as well as the ureter. So that was all the external structures of the kidneys. Let’s now look how the kidneys are covered. Here you see a posterior view of the body. Let’s now make a transverse cut and look at the kidneys from this perspective to see how the kidneys are covered. Ok, So here are two kidneys, superior view. Here is the Vertebra and in front of them are the Inferior vena cava and the abdominal aorta. So the first covering that’s around the kidneys are the fibrous capsule, which are dense fibers that protect the kidneys. Around the fibrous capsule, there are the adipose capsule, we call it the perinephric fat, peri means around, so the fat around the kidneys. And as you see here, this fat is thicker posteriorly than anteriorly. And it's quite logical if you think about it as the kidneys are closer to the posterior abdominal wall, this fatty capsule protects it from any concussion, as well as protecting them from becoming cold. Ok, sot that’s these two. Then, externally to the fatty layer, we have a fasciae covering it, called the Renal Fascia. And this fascia has two parts or two layers. We have an anterior layer and a posterior layer. Laterally, they’re both going to fuse, as you see here. Both these posterior layers are going to go in front of the vertebra and fuse with it, while the anterior layer will go in front of the blood vessels and fuse with the other layer on the other side. The anterior layer or prerenal layer is also called Fascia of Toldt. While the Posterior later, or the Retrorenal Layer, which is also called Layer of Zuckerkandl. And they both lie behind the peritoneum. These two layers remain separated below the kidneys, creating a space between them. So that’s generally how the kidneys are covered. Now let’s go ahead and open up the kidney, just like that, to cover the internal structures of it. The kidneys have a compartment within them called the Sinus Renalis, or the Renal Sinus. And it’s filled up by fat called the renal sinus fat. And between the fat, you’ll find the renal pelvis and the renal calyces, which lead the urine from the kidneys down to the ureter. And I’ll show you this in a little more detail in a minute. But the actual kidneys consist of the renal medulla and the renal cortex. Some parts of the cortex are also going to extend down between the medulla. So let’s first cover the Renal Cortex. So the renal cortex is dark brown in color and soft and granule in consistence. It can be between 4-11mm thick. Again these numbers deviate a lot from source to source, but we also got parts of the cortex going down in between the medulla, which are just extensions of the cortex, called the renal columns. Now, what makes up the renal cortex? If we take a small bit of the kidneys and zoom in. Remember the kidneys main functional unit are the nephrons. There’s gonna be a lot of nephrons within one kidney, around 1 to 1,5 million nephrons. And if we divide the nephron like this. You’ll see that parts of it lie in the cortex, and part of it lies in the medulla. So the renal Cortex is composed of the renal corpuscle, the proximal convoluted tube, and the distal convoluted tube. The rest of the nephron is in the Medulla, so let’s talk about the medulla a little bit. The renal medulla consists of these renal pyramids. There are about 7-18 of those within one kidney. Here comes the tricky part with these pyramids. Each of these pyramidal structures together with their adjacent cortex will form lobes we call renal lobes. Now the renal pyramid is called a pyramid because of its shape. There’s going to be a base that is directed towards the cortex. And on the other side, there’s going to be the apex of the renal pyramid. And these apices will fuse together and form a renal papilla. I’ll show you this in a little more detail when we go through the nephron. But another thing that’s important to mention when talking about the renal medulla is that there are going to be parts of the medulla that radiated towards the cortex, which we call renal medullary rays. Now let’s go back to this picture again. Now we know that when we talk about the renal medulla. We’re talking about the Pyramid. And you’ll find the rest of the nephron here. Which is the Loop of Henle, and the collecting duct. Ok. So let's continue from the renal papilla. The renal papilla is going to have these openings of the papillary ducts, which lead the urine from the pyramids, towards the Minor Renal Calyces. And these minor renal calyces are going to fuse into the major renal calyces. There are usually 2 or 3 of these major renal calyces. The urine will then flow into the renal pelvis, to then go down towards the Ureter. So that’s all we need to know for the anatomy of the kidney. Now let’s do the anatomy of the nephron. And to do that, we’re going to isolate one renal lobe, and look at a detailed view of it. So the renal cortex and its renal colums go between the renal pyramids. And below the renal pyramid, you’ll find the minor renal calyces. Alright. SO the nephron consists of a Renal Corpuscle, located in the renal cortex. And the renal corpuscle consists of a glomerulus, which are many capillary loops as you see here. So blood will flow in through an afferent arteriole, remember a stands for arrive. So afferent arterioles arrive into the glomerulus, and they exit as efferent arteriole. E for exit. And the glomerulus is surrounded by a glomerular capsule. Which as you see here consists of an internal part and an external part. And between them is where the tubular system is going to continue, so the urine flows between the two layers you see here. So that’s the renal corpuscle. After the renal corpuscle is the Proximal Convoluted tube, which also lies in the cortex. The proximal convoluted tube has two parts. There’s a convoluted part, which curves, and a straight part. Then the nephron continues into the renal pyramid as the Loop of Henle. There’s a descending part and an ascending part, which extends up to the renal cortex as the Distal Convoluted Tube. Now up until this step. The plasma has been filtrated into primary urine. Electrolytes and other minerals have been reabsorbed and secreted out throughout the whole tube. And at this point. The urine is now finished to be called secondary urine, which is what we generally call urine. Now the urine will continue through the collecting ducts. These collecting ducts will all come together, fuse, and form the papillary ducts. At this point, the papillary ducts will open up as small openings, into the minor renal calyces. So that was everything I had for the anatomy of the kidneys. I really hope this video helped you understand the anatomy of it. In the next video, we’re going to talk about the anatomy of the Ureter, Urinary bladder, and the Urethra n both male and female.