08-01 URI Gx Urinary System and Retroperitoneal Organs Flashcards Preview

ANATOMY > 08-01 URI Gx Urinary System and Retroperitoneal Organs > Flashcards

Flashcards in 08-01 URI Gx Urinary System and Retroperitoneal Organs Deck (144)
1

CAVITIES of Retroperitoneum

- Dorsal (posterior): cranial, spinal
- Ventral (anterior): thoracic, abdominal, pelvic cavity. (abdominopelvic cavity [in females])

2

enclosed by peritoneum; within the peritoneal cavity

Intraperitoneal

3

covered by peritoneum ANTERIORLY

retroperitoneal

4

anatomical space behind the peritoneum

retroperitoneum

5

subdivisions of the retroperitoneum (based on kidneys)

1. Anterior Pararenal Space (APS)
2. Perirenal Space (PS)
3. Posterior Pararenal Space (PPS)

6

Borders of Anterior Pararenal Space

- Parietal peritoneum (anteriorly)
- Anterior portion of renal fascia (posteriorly)

7

Contents of Anterior Pararenal Space

-Pancreas
-Colon
-Duodenum

(mnemonic: Pussy Cat Dolls)

8

Borders of Perirenal Space

Anterior and Posterior portion of the renal fascia

9

Contents of Perirenal Space

-Kidneys
-Renal vessels
-Ureter

10

Borders of Posterior Pararenal Space

-posterior portion of renal fascia (anteriorly)
-posterior abdominal wall muscles (posteriorly)

11

Contents of Posterior Pararenal Space

-fat

12

Potential Spaces in the Retroperitoneum

Retromesenteric Space (RMP)
Retrorenal Space (RRS)

13

potential space between APS and PS

Retromesenteric Space (RMP)

14

potential space between PS and PPS

Retrorenal Space (RRS)

15

PERITONEAL ORGANS

(mnemonic: SAD PUCKER)

Suprarenal gland
Aorta/IVC
Duodenum (descending and horizontal portion)
Pancreas (head, neck and body)
Ureter
Colon (ascending and descending)
Kidneys
Esophagus
Rectum

16

SECONDARY REROPERITONEAL ORGANS

-Pancreas
-Colon
-Duodenum

(mnemonic: Pussy Cat Dolls)

17

Muscles of Posterior Abdominal Wall

-Psoas Major
-Psoas Minor
-Quadratus Lumborum
-Iliacus

18

origin of psoas minor

T12-L1

19

insertion of psoas minor

pectineal line;
ilipubic eminence

20

innervation of psoas minor

anterior rami of L1

21

main action of psoas minor

weak flexion of lumbar vertebra

22

3 largest branches of the lumbar plexus

femoral nerve,
obturator nerve,
lumbosacral trunk

23

composed of T12 (subcostal nerve) and L1-L5 (ventral rami)

Lumbar Plexus

24

(lumbar plexus) arises from L2-L4

femoral nerve and
obturator nerve

25

(lumbar plexus) arises from L5

lumbosacral trunk

26

(lumbar plexus) arises from T12 & L1

iliohypogastric adn ilioinguinal

27

(lumbar plexus) arises from T12, L1, L2

genitofemoral nerve

28

(lumbar plexus) arises from L2, L3

Lateral Cutaneous Nerve of thigh/ Lateral Femoral Nerve

29

the only ones from the posterior division are ___; the rest is from the anterior division

Lateral Cutaneous Nerve of thigh/ Lateral Femoral Nerve

30

innervations. iliohypogastric. sensory:

skin above the inguinal ligament

31

innervations. iliohypogastric. motor:

transverse abdominis;
internal oblique

(similar with ilioinguinal)

32

innervations. ilioinguinal. sensory:

skin over the pubic symphysis;
lateral aspect of the scrotum and labia majora

33

innervations. ilioinguinal. motor:

transverse abdominis;
internal oblique

(similar with iliohypogastric)

34

innervations. genitofemoral. sensory:

in males: spermatic cord
in females: inguinal canal

skin below the inguinal ligament

35

innervations. genitofemoral. motor:

cremasteric muscle in males

36

innervations. obturator.sensory:

medial and distal portion of the thigh

37

innervations. obturator. motor:

pectineus;
obturator externus;
gracilis;
adductors (magnus, longus, and brevis)

38

innervations. lateral cutaneous. sensory:

lateral portion of the thigh

39

innervations. lateral cutaneous. motor:

n/a

40

innervations. femoral. sensory:

anterior portion of the thigh;
posterior lower leg;
hindfoot

41

innervations. femoral. motor:

pectineus,
iliopsoas,
sartorius,
quadriceps femoris

42

covers the kidney and the adrenal gland

Gerota's Fascia
(aka perirenal/renal fascia)

43

location of kidneys

at the level of T12-L3

44

external to the renal fascia is ____ aka _____, the extrapritoneal fat of the lumbar region

paranephric fat (aka pararenal fat body)

45

surrounds the kidney and their vessels

perinephric fat (perirenal fat)

46

Gerota's Fascia will blend with the ____ superiorly and___ inferiorly (fat pad)

liver capsule ;

disappears

47

Gerota's Fascia divides into 2:

Toldt's Fascia - anterior portion; medial side, and

Zuckerland's Fascia - posterior portion; lateral side

48

fascia that covers the IVC and the aorta

Toldt's Fascia

49

fascia that will blend with the psoas muscle fascia and Toldt's fasica to become Gerota's fascia

Zuckerland's Fascia

50

Gerota's fascia will blend with the

transversalis fascia

51

which fat is inside the Gerota's fascia?

perirenal fat

52

separates kidneys from the adrenal glands

renal capsule

53

entrance to renal sinus

renal hilum

54

where renal artery enters;
exit point of renal vein and ureter;

renal hilum

Note: RV more anterior to RA;
RA more anterior to RP)
(RV>RA>RP)

55

separates the kidney and the liver

hepatorenal recess

56

flattened funnel-shaped expansion of the superior end of the ureter

renal pelvis

57

the ___ of the renal pelvis is continuous with the ureter

apex

58

renal pelvis divides into 2 or 3 ___ which then divides into 2 or 3 ____

major calyces;

minor calyces

59

apex of the renal pyramid which indent each minor calyx

renal pailla

60

renal artery is arises from the ___ at the level of ___

abdominal aorta;
L1 and L2

61

renal artery bifurcates as they enter the hilum

A) anterior division
- superior (apical)
- anterosuperior
- anteroinferior
- inferior (basal)

B) posterior division

62

reference on how to resect the kidney, bloodless, from superior to inferior pole, 1-2cm from convexity of kidney

Brodel's line

63

renal artery will branch into

suprarenal artery

64

longer. right or left renal artery

right

65

higher. right or left renal artery

left

66

crossed by the inferior mesenteric vein

left artery

67

clin corr: blocked RA, high BP

Renal Artery Stenosis

68

clin corr: SMA and aorta aneurysm compresses the 3rd part of duodenum = abdominal pain = refuse eating

Food Fear Syndrome

69

longer. right or left renal vein?

left

70

both renal veins drains to

directly to the IVC

71

left renal vein receives blood from:

-left inferior phrenic vein,
-left suprarenal vein,
-left gonadal vein (M: left testicular vein, or F: left ovarian vein,
-left 2nd lumbar vein

72

clin corr: SMA and aorta aneurysm will compress left renal vein. this will manifest as left testicular pain (in males) or left abdominal pain (in females)

Nutcracker Syndrome

73

ANS innervation of the kidneys

-celiac ganglion
-lowet splanchnic neve
-aorticorenal ganglion
-aortic plexus

74

clin corr: stones

Nephrolithiasis (Staghorn Calculi)

75

clin corr: tube is blocked by urine; distention and dilation of renal pelvis and calyx

hydronephrosis

76

clin corr: infection of kidney

pyelonephritis

77

crosses over pelvic brim at the bifurcation of the common iliac arteries

ureter

78

fusion of major calyces;
extends inferiorly and medially;
anterior to psoas major;
penetrate the posterior urinary bladder

ureter

79

divisions of ureter & blood supply

1) superior - renal artery
2) middle - superior vesical artery
3) inferior - inferior vesical artery

80

3 common constrictions which are common sites for stone lodging

1. at the kidney hilum
2. as it crosses the pelvic brim
3. as it enters the bladder

81

innervation of ureter

-from ANS
-T10-T12, L1, S2-S4
-derived fom superior/inferior hypogastric plexus, renal and aorta

82

lymphatics of ureter

superior: goes to the kidneys or lumbar nodes

middle: goes to common iliac

inferior: goes to common, internal and external

83

clin corr: uterine artery over the ureter

"water under the bridge"

84

stones in the ureter

ureterolithiasis

85

location of adrenal (suprarenal) glands

at the anterosuperior pole of the kidneys

86

adrenal gland is surrounded by

periphrenic fat and renal fascia

87

2 regions of adrenal gland

cortex (autonomic and endocrine), and
medulla

88

shape of adrenal glands

right - pyramidal
left - semilunar

89

major attachment of the adrenal glands

diaphragmatic crura (NOT kidneys)

90

borders of right adrenal gland

posterior: IVC and right lobe of the liver

anterior:
to the diaphragm,
superior pole of the kidney

medial:
right celiac ganglion, and
right inferior phrenic artery

91

borders of the left adrenal gland

posterior:
-stomach
-spleen
-pancreas
-splenic artery

medial:
-left celiac ganglion
-left inferior phrenic
-gastric artery

92

part of the adrenal gland that is derived from mesoderm and secretes corticosteroids and androgens

suprarenal cortex

93

part of the adrenal gland that is derived from the neural crest cells and is a mass of nervous tissue permeated with capillaries and sinusoids

suprarenal medulla

94

blood supply of adrenal glands

1) superior adrenal artery - from left and right inferior phrenic artery
2) middle adrenal artery - from abdominal aorta
3) inferior adrenal artery - from renal artery

95

venous drainage of adrenal glands

right - drains directy to IVC

left - drains to left renal vein

96

clin corr: tumor of adrenal medulla will elicit epinephrine, epinephrine = hypertension

Pheochromocytoma

97

in males, the only structure that passes between the ureter and the peritoneum is the

ductus deferens

98

most constant arteries supplying the terminal parts of the ureter in females

uterine arteries

99

most constant arteries supplying the terminal parts of the ureter in males

inferior vesical arteries

100

bladder not attached to the pelvic bone. has a space known as

RETZUS SPACE

101

boundaries of urinary bladder in male

- anterior: pubic symphisis
- superior: organs
- posterior: rectum
- inferior: prostate

102

boundaries of urinary bladder in female

- anterior: pubic symphisis
- superior: uterus
- posterior: rectum
- inferior: vaginal canal

103

apex of the bladder points toward the ___ when bladder is empty

superior edge of pubic symphisis

104

walls of bladder are composed chiefly of the

detrusor muscle

105

located at the angels of the trigone of the bladder

ureteric orifices and internal urethral orifice

106

normal capacity of the bladder

400-600mL

107

bladder is a 3 sided pyramid.

apex - median umbilical ligament (urachus)

base - trigone (2 urethral opening), fundus

108

surfaces of the bladder

a) superior surface - covered by peritoneum (subperitoneal)
b) inferolateral surface (2) - with medial umbilical lifament (the obliterated umbilical artery)

109

most inferior part of the blader;
secured by pubovesical ligament (in females) and puboprostatic ligament (in males)

neck

110

sympathetic innervation during micturition

relax detrusor muscle; sphincter contracts

111

parasympathetic innervation during micturition

contracts bladder; sphincter relaxes

112

main arteries supplying the bladder are branches of

internal iliac artery

113

arterial blood supply of the bladder

- superior vesical arteries (anterosuperior parts)
- inferior vesical arteries (fundus and neck of bladder)
- vaginal arteries (postero-inferior parts of bladder)

114

venous drainage of bladder - tributaries of

internal iliac vein

115

venous drainage of bladder (male)

-vesical venous plexus
-prostatic venous plexus
-inferior vesical plexus
-internal vertebral plexus

116

venous drainage of bladder (female)

-uterovaginal plexus

117

lymphatic drainage of bladder

superior: external iliac lymph node

fundus: internal iliac lymph node

neeck: sacral lymph node, common iliac lymph node

118

clin corr: urinary bladder stone

cystolithiases

119

clin corr: weak bladder support wall = uterus herniate in bladder

cystocele

120

length of male urethra

18-20 cm long

121

segments of male urethra

preprostatic, prostatic, spongy, penile

122

arterial supply of male urethra

-inferior vesical artery
-middle rectal artery
-internal pudental artery

123

venous drainage of male urethra

-prostatic venous plexus (proximal)
-deep dorsal vein of penis (distal)

124

lymphatic drainage of male urethra

-external and internal iliac lymph nodes
-deep inguinal lymph nodes

125

innervations of male urethra

-prostatic nerve plexus (arising as organ-specific extension of inferior hypogastric nerve

126

length of female urethra

3-4 cm

127

paraurethral glands found on each side of the urethra; these glands have common para-urethral duct which opens near the external urethral sphincter; prostate homologue

Skene's gland

128

arterial supply of female urethra

vaginal artery and
internal pudental artery

129

venous drainage of female urethra

vaginal vein and
internal pudental vein

130

lymphatic drainage of female urethra

-internal iliac and sacral lymph nodes
-deep inguinal lymph nodes

131

innervations of female urethra

-vesical nerve plexus
-pudental nerve

132

clin corr related to urethra

1) benign (nodular) prostatic hyperplasia

2) lower UTI

133

Which of the following subdivisions of the retroperitoneum contains variable amount of fat?
A. Anterior pararenal space B. Posterior pararenal space
C. Perirenal space
D. None of the above

B. Posterior pararenal space

134

forms the posterior border of the perirenal space

Zuckerkandl’s fascia

135

innervated by the femoral nerve (L2-L4)

iliacus

136

nerve of the lumbar plexus is found within the spermatic cord

Genital branch of Genitofemoral

137

Motor innervation of the cremasteric muscle comes from which nerves of the lumbar plexus

Genital branch of Genitofemoral

138

provide sensory innervation below the inguinal ligament

Femoral branch of Genitofemoral

139

lateral cutaneous nerve of the thigh is formed by which lumbar ventral of rami

L2 and L3

140

largest nerve of the lumbar plexus comes from the ventral of rami of:

L2 – L4

largest nerve is femoral nerve

141

Which of the divisions of the male urethra prevents retrograde flow into the bladder during ejaculation?

Pre-prostatic

142

Is crossed anteriorly by the superior
mesenteric artery

left renal vein

143

Adrenal medulla synthesizes

adrenalin

144

Behind the kidney:
A. Diaphragm
B. Subcostal nerve
C. Quadratus lumborum
D. Twelfth rib
E. All of the above

E. All of the above