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MD3002 post MSA > anatomy of the renal system > Flashcards

anatomy of the renal system Flashcards

1
Q

what layers surround the kidneys

A 
perirenal fat (around)
renal fascia (extraperitoneal fascia)
pararenal fat (along side)
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2
Q

at what vertebral levels are the kidneys

A

t12 - L3

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3
Q

which kidney is lower

A

right

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4
Q

which kidney is longer

A

left

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5
Q

what are the anterior relations of the right kidney

A

IVC, duodenum, liver, colic flexure, suprarenal gland

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6
Q

what are the anterior relations of the left kidney

A

pancreas, spleen, stomach, colic flexure, small intestine

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7
Q

what ribs does the kidney overlie

A

10, 11, 12

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8
Q

why do the kidneys move with respiration

A

they lie on the diaphragm

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9
Q

what abdominal muscles do they kidneys lie on

A

QL, TA, psoas major

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10
Q

what is the renal column

A

the extension of cortex between the pyramids

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11
Q

what are the renal papillae

A

the part of the medulla that projects into the minor calyx

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12
Q

where in the kidney are the nephrons

A

renal pyramids

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13
Q

what vertebral level are the renal arteries

A

L1- left
L2- right
behind the renal veins
there may be extrahilar arteries branching from the aorta

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14
Q

where does lymph from the kidney go to

A

lumbar nodes

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15
Q

what structures are in the renal hilum, from anterior to posterior

A

vein
artery
pelvis

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16
Q

why is the right renal vein short

A

the IVC is to the right of the midline

this makes surgery difficult

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17
Q

what does the renal artery divide into

A

five segmental arteries that enter at the hilum

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18
Q

what arteries arise from each segmental artery

A

lobar arteries, one for each pyramid

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19
Q

what arteries arise from the lobar arteries

A

interlobar arteries

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20
Q

what are the arcuate arteries

A

branches of the interlobular arteries which arch over the base of the pyramids
these give off interlobular arteries

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21
Q

what do the afferent glomerular arterioles supply

A

renal corpuscle

arise from the branches of the interlobular arteries

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22
Q

what is the kidney nerve supply

A

T12 and L1

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23
Q

where is kidney pain referred to

A

back and lumbar regions, loin and groin

nausea and emesis may be associated due to vagal afferents

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24
Q

where is the ureter

A

posterior abdo wall

23-30 cm long

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25
Q

where are the narrowings of the ureter

A

pelvic ureteric junction
crossing the pelvic brim
passing into the bladder

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26
Q

what do the ureters cross

A 
ant to psoas major
anterior to lumbar plexus
bifurcation of the common iliac artery 
overlies the lumbar transverse process 
runs medial to the sacral iliac joints 
passes medial to the branches of the internal iliac on the lateral pelvic wall and floor
27
Q

what does the pelvic ureter cross in the male

A

between the vas and seminal vesicle

28
Q

where does the pelvic ureter pass in the female

A

posterior to ovary
inf to uterine artery
passes cervix and lateral fornix of vagina

29
Q

where does lymph from the ureter pass

A

para aortic and iliac nodes

30
Q

what is the blood supply of the ureter

A 
Aorta
Renal
Gonadal
Common and internal iliac
Uterine, vaginal
Vesical
31
Q

how is urine prevented from refluxing into the ureters

A

oblique entry
flap valve
pressure of urine forces the ureters to close

32
Q

how far apart are the orifices of the ureters in the bladder wall

A

2.5 cm when empty

5cm when full

33
Q

what muscle relaxes in order to fill the bladder

A

detrusor

34
Q

what epithelium is found in the bladder

A

transitional

35
Q

what part of the ANS controls the bladder wall

A

mostly PNS

36
Q

what is the nerve supply of the ureters

A

nerves not required for peristalsis due to pacemakers

T10 -S4 from aortic, renal and pelvic plexuses

37
Q

where is ureteric pelvic pain referred to

A

t11- L2

loin to groin and scrotum or labia

38
Q

what is the nerve supply of detrusor

A

S2-4 parasympathetic

39
Q

what is the function of the preprostatic sphincter

A

prevents backflow of semen into the bladder

sympathetic control

40
Q

what contributes to urinary continence in females

A

bladder neck is above the pelvic floor so the pressure of pelvic organs and levator ani contribute to continence

41
Q

how long is the female urethra

A

4 cm

42
Q

where is the external urinary sphincter

A

inferior to the bladder neck

striated muscle

43
Q

what are the four parts of the male urethra

A

preprostatic- int sphincter
prostatic
membranous -ex sphincter
spongey/penile urethra

44
Q

what is the blood supply of the bladder and urethra

A

branches of the internal iliac
sup and inf vesical
internal pudendal
branches from adjacent structures

45
Q

what is the venous drainage of the bladder and urethra

A

vesical and prostatic plexuses converging on internal pudendal and internal iliac arteries

46
Q

what is the lymph drainage of the bladder

A

internal and external iliac nodes

47
Q

how does prostate cancer spread

A

communications with the valveless veins of the vertebral plexuses

48
Q

what is the nerve supply of the bladder

A

S2-4
pudendal nerve
pelvic plexus for ANS

49
Q

how does micturition happen

A

Parasympathetic to detrusor “switched off”
in spinal cord to allow bladder to relax and
fill
Usual volume (male) about 400 ml, if reach 500 ml – pain in
lower abdomen and perineum
2. “Full”, causes
desire to micturate
Afferents (sensory) to spinal cord, then “M”
Centre in pons – stimulates preganglionic,
parasympathetic neurones at S 2, 3, 4
3. Void
1y neurones stimulate 2y neurones in bladder
wall ganglia, causing detrusor contraction
Simultaneous relaxation of external urethral sphincter (striated
muscle) – pudendal nerve (S 2, 3, 4) and contraction of abdo.
wall; sensation of urine in urethra maintains the reflex

50
Q

where does the left renal artery arise

A

L1, behind the renal vein

51
Q

where does the right renal artery arise

A

L2, behind the renal vein

52
Q

what vein does the SMA overlie

A

left renal vein

53
Q

what part of the duodenum overlies the hilum of the right kidney

A

2nd, descending

54
Q

where is the pelvis in relation to the renal vessels

A

behind

55
Q

what is nutcracker syndrome

A

compression of the left renal vein between the aorta and the SMA
renal venous hypertension and haematuria

56
Q

where does the left suprarenal vein and gonadal vein drain

A

left renal vein

57
Q

what arterial bifurcation do the ureters pass

A

common iliac artery

58
Q

what do the ureters lie posterior to

A

everything except lumbar plexus, common iliac artery bifurcation

posterior to the gonadal vessels and colic vessels

59
Q

what muscle contributes to continence in females

A

levator ani

60
Q

where is the urethra embedded in females

A

anterior vaginal wall

61
Q

what part of the male urethra is enclosed by the internal sphincter

A

preprostatic

62
Q

what part of the male urethra is enclosed by the external sphincter

A

the membranous urethra

63
Q

where is the micturition centre in the brain

A

pons

MD3002 post MSA (66 decks)

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