A01 Topography of the Kidneys and Renal Tract Flashcards Preview

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Flashcards in A01 Topography of the Kidneys and Renal Tract Deck (25)
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1
Q

List the components of the urinary system.

A

1 - 2 kidneys.

2 - 2 ureters.

3 - Urinary bladder.

4 - Urethra.

2
Q

What are rugae?

A

Folds seen in the empty bladder.

3
Q

Which type of epithelium lines the urinary bladder?

A

Transitional epithelium.

4
Q

What are ureters?

How do they function?

A
  • Long muscular tubes that convey urine from the kidneys to the bladder.
  • They do this by peristalsis.
5
Q

How does the bladder change in size during filling?

A
  • The base of the bladder changes little during filling.

- The bladder instead extends superiorly towards the pelvic brim.

6
Q

Which tissue covers the fundus of the bladder?

A

Peritoneum that is reflected from the internal aspect of the anterior abdominal wall.

7
Q

What lies below the bladder in males and females?

A
  • In females, the bladder sits on the pelvic floor at the urethra.
  • In males, the prostate gland separates the bladder from the pelvic floor, and surrounds the urethra.
8
Q

Which sphincter of the urinary system is innervated by the somatic nervous system?

A

The external urethral sphincter.

9
Q

Between which vertebral levels do the kidneys lie?

A
  • The kidneys lie between vertebral levels T12-L3.

- However, the right kidney is slightly lower.

10
Q

What are the hilums of the kidneys?

A

The area through which blood vessels, nerves and lymphatic vessels enter and leave the kidneys.

11
Q

Describe the gross blood supply to the kidney.

A
  • At the L1/L2 vertebral levels just below the origin of the superior mesenteric artery, the abdominal aorta gives rise to the renal arteries.
  • The left renal artery passes behind the left renal vein.
  • The right renal artery passes behind the inferior vena cava and the right renal vein.
  • The right renal vein receives blood directly from the right kidney and has no other branches, whereas the left renal vein has 3 other tributaries:

1 - Left gonadal vein.

2 - Left lumbar vein (there are other lumbar veins that branch directly from the vena cava).

3 - Left adrenal vein.

12
Q

Describe the course of a renal artery as it supplies the structures throughout a kidney.

A

1 - The renal artery enters the kidney through the hilum.

2 - It bifurcates at each lobe to form the interlobar arteries, which ascend the renal pyramids.

3 - The interlobar arteries then bend around the top of the renal pyramid, where they are known as arcuate arteries.

4 - The arcuate arteries give small branches known as interlobular arteries that project into the cortex. These supply the renal corpuscles.

13
Q

What is the renal capsule?

What is its function?

A
  • The renal capsule is a tough fibrous layer surrounding the kidney that is covered in a layer of perirenal fat known as the adipose capsule.
  • It supports the kidney mass and provides protection from trauma.
14
Q

List the 3 regions of the ureters where renal calculi are most likely to get stuck.

Why are these common sites of blockage?

A

1 - The pelviureteric junction.

2 - The point where the ureter passes over the pelvic brim as it crosses the common iliac artery.

3 - The vesico-ureteric junction.

  • These are common sites of blockage because they are the sites where the ureters are thinnest.
15
Q

Where would pain be referred to if a renal calculus became stuck at the pelviureteric junction?

A
  • Calculi at the pelviureteric junction cause deep flank pain due to distension of the renal capsule.
  • Pain is without radiation to the groin.
16
Q

Where would pain be referred to if a renal calculus became stuck at the point where the ureter passes over the pelvic brim?

List 2 other conditions that this pain might mimic.

A

Calculi at the point where the ureter passes over the pelvic brim cause pain between the umbilicus and groin.

  • This pain may mimic:

1 - Appendicitis (right hand side).

2 - Diverticulitis (left hand side).

17
Q

Where would pain be referred to if a renal calculus became stuck at the vesicoureteric junction?

List the nerves that refer the pain to these sites.

A
  • Calculi at the vesicoureteric junction cause pain radiating to the groin or testicle / labia majora.
  • Referred pain to these sites is conveyed by the ilioinguinal and genitofemoral nerves.
18
Q

What is the ureterorenal reflex?

A

Pain from the ureters causes a sympathetic reflex back to the kidney to constrict the renal arterioles, thereby decreasing urine output from the kidney.

19
Q

What are the spinal nerve roots of the sensory nerves supplying the ureters?

A

T11-L2.

20
Q

List the 5 main muscles that comprise the posterior abdominal wall.

A

1 - Diaphragm.

2 - Psoas major.

3 - Psoas minor.

4 - Iliacus.

5 - Quadratus lumborum.

21
Q

Describe the arterial supply to the ureters.

A
  • The upper ureter is supplied by the renal artery and by branches from the gonadal artery and aorta directly.
  • The middle ureter is supplied by the common iliac and gonadal arteries.
  • The distal ureter is supplied by branches of the common iliac and internal iliac branches, particularly uterine and superior vesical arteries.
22
Q

Define hysterectomy.

A

Removal of the:

1 - Uterus.

2 - Uterine tubes.

3 - Ovaries.

4 - Cervix.

23
Q

List 3 pouches found in the pelvis of males and females.

What is the clinical significance of these pouches?

A

Males:

1 - Rectovesical pouch.

Females:

2 - Rectouterine pouch (pouch of Douglas).

3 - Vesicouterine pouch.

  • These pouches are sites where fluids and infection can collect.
  • The rectouterine pouch (pouch of Douglas) can be used for peritoneal dialysis in end-stage kidney failure.
24
Q

What is the trigone?

List the structures that form the corners of the trigone.

A
  • The trigone is a smooth triangular region of the internal urinary bladder.
  • It is formed by the two ureteric orifices and the internal urethral orifice.
25
Q

Where is the bladder located in adults when empty and full?

Where is the bladder located in infants?

A
  • When empty, the bladder is located in the true pelvis.
  • When full, the bladder extends partially into the false pelvis.
  • In infants, the bladder is undescended and is therefore located in the abdomen until puberty.