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RENAL > Anatomy > Flashcards

Anatomy Flashcards

1
Q

Describe the function of the 4 MAIN structures that urine passes through before it is excreted

A 
Kidney = produces urine
Ureter = drains urine
Bladder = stores/voids urine 
Urethra = excretion of urine
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2
Q

What anatomical structures make up the Upper Urinary tract?

A

kidneys (right &left)

ureters (right & left)

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3
Q

What structures make up the Lower Urinary tract?

A

bladder

urethra

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4
Q

What structures of the urinary tract are retroperitoneal?

A

kidneys

proximal ureters

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5
Q

What parts of the urinary tract are found within the pelvis?

A
  • distal ureters
  • bladder
  • proximal urethra
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6
Q

What urinary structure is found in the perineum?

A

the distal urethra

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7
Q

What structures make up the renal hilum (from anterior to posterior)?

A

Renal vein
Renal artery
Ureter

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8
Q

What muscle is found posterior to the kidneys?

A

Quadratus Lumborum

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9
Q

What muscle is found medial to the kidneys?

A

Psoas Major

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10
Q

What layers of muscle are found lateral to the kidney?

A

Transversus Abdominis
Internal Oblique
External Oblique
from kidney outwards

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11
Q

What structures occupy the space between the anterior surface of the kidney and the visceral peritoneum?

A
  • Visceral peritoneum
  • Paranephric fat
  • Renal (deep) fascia
  • Perinephric fat
  • Renal capsule
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12
Q

What should be noted about the blood supply to and from the kidneys on a CT scan?

A

The aorta is found more posterior than the IVC

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13
Q

What vertebral level is the left kidney found at?

A

T12-L2

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14
Q

What vertebral level is the right kidney found at and why is this?

A

L1-L3

pushed down by liver

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15
Q

Fracture of what ribs can cause potential trauma to the kidneys?

A

11 or 12 (floating ribs)

sharp displaced ends may bruise/lacerate the kidney

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16
Q

What quadrant / region is the Left kidney found in?

A

LUQ

Left Lumbar Region

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17
Q

What quadrant / region is the Right kidney found in?

A

RUQ

Right Lumbar Region

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18
Q

How do you “Ballot” for the kidneys?

A
  • Palpate posteriorly in the lumbar/flank region inferior to the 12th rib
  • Palpate Anteriorly in the RUQ
  • Ask patient to breathe in so that diaphragm and either liver or spleen descend and move kidney downwards so it can be felt
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19
Q

A non-smooth kidney indicates an abnormality. TRUE/FALSE?

A

TRUE

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20
Q

What structures is the Right Kidney posterior to?

A
  • liver
  • hepatorenal recess
  • 2nd part of duodenum
  • ascending colon
  • right colic (hepatic) flexure
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21
Q

What structures is the Left Kidney posterior to?

A
  • stomach
  • tail of the pancreas
  • hilum of the spleen
  • splenic vessels
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22
Q

What is the significance of the hepatorenal recess?

A

Fluid collects here if patient is lying on their back

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23
Q

Are the renal veins or arteries anterior at the kidneys?

A

Veins are anterior

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24
Q

Are the veins or arteries anterior at the level of common iliac bifurcation?

A

Arteries are anterior

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25
Q

Where does lymph from the kidneys drain to?

A

lumbar lymph nodes

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26
Q

Where does lymph from the ureters drain to?

A 
Proximal = lumbar
Distal = iliac
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27
Q

Describe the relationship of a supra-renal AAA to the renal arteries?

A

Begins above the level of the renal arteries but can also extend below the renal arteries

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28
Q

Describe the relationship of an infra-renal AAA to the renal arteries?

A

Starts below the level of the renal arteries

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29
Q

How are AAAs repaired?

A

Endovascular Aneurysm Repair (EVAR)

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30
Q

If the renal arteries are stenosed in an Infra-renal AAA, this is usually due to the aneurysm itself. TRUE/FALSE?

A

FALSE

  • usually due to atherosclerosis
  • Stenosis in supra-renal AAAs are usually due to the aneurysm itself
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31
Q

In what ways can the renal system vary anatomically?

A 
Bifid renal pelvis
Bifid Ureter OR Unilateral duplicated ureter
Retrocaval Ureter (behind IVC)
Horseshoe Kidney
Ectopic Pelvic Kidney
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32
Q

What are the possible reasons for a patient only presenting with one kidney?

A
  • agenesis
  • nephrectomy (pathology)
  • nephrectomy (donation)
33
Q

Where in the kidney are the nephrons found?

A

In the renal pyramids of the medulla

34
Q

What structures does urine pass through from the nephrons to the urethra?

A
  • nephrons (collecting duct)
  • minor calyx
  • major calyx
  • renal pelvis
  • ureter
35
Q

What is the largest area for collection of urine?

A

Renal Pelvis

36
Q

What anatomical constriction landmark is marked by the wider renal pelvis becoming the narrower ureter?

A

pelviureteric junction

37
Q

What other 2 areas are considered anatomical sites of ureteric constriction?

A

ureter crossing over the common iliac artery (over pelvic ridge)

ureteric orifice (opening into trigone in the bladder)

38
Q

What is the significance of anatomical sites of vasoconstriction?

A

If kidney stones form they can block flow at these sites due to the narrowings

39
Q

Why does ureteric obstruction present with colicky pain? (comes and goes)

A
  • increased peristalsis proximal to the site of the obstruction
  • attempt to flush it into the bladder
  • peristalsis comes in waves => colicky pain
40
Q

An obstruction in the ureter causes a unilateral back pressure of urine. TRUE/FALSE?

A

TRUE

41
Q

What type of back pressure is caused by an obstruction in the bladder?

A

unilateral or bilateral kidney problems

42
Q

What type of back pressure do patients experience if their obstruction is in the urethra?

A

bilateral

43
Q

When does back pressure cause reduced urine output?

A

When the pressure within the urinary tract exceeds the pressures favouring filtration at the glomerulus

44
Q

What is the definition of renal failure?

A

failure to adequately filter the blood to produce urine

45
Q

The renal capsule has the potential to stretch if the kidney swells. TRUE/FALSE?

A

FALSE
Layer of deep fascia and is very tense (doesnt stretch)
=> causes patients a lot of pain

46
Q

What is considered the false pelvis?

A

from iliac crests to pelvic inlet

47
Q

What does the true pelvis extend to?

A

pelvic inlet to pelvic floor

48
Q

What is the main muscle of the pelvic floor and where does the pelvic floor extend between?

A

Levator Ani

between pubic symphysis and coccyx

49
Q

What is meant by a sub-peritoneal structure?

A

Passes below the peritoneal cavity

50
Q

In an upright male, what is the most inferior part of the peritoneal cavity where fluid will collect?

A

Rectovesicle pouch

51
Q

In an upright female what is the most inferior part of the peritoneal cavity where fluid will collect?

A

Rectouterine pouch (of Douglas)

52
Q

What does the ureter run inferiorly to in both a male and a female?

A 
Female = inferior to uterine artery
Male = inferior to vas deferens
53
Q

The arteries into the pelvis branch from what iliac artery?

A

Internal Iliac

54
Q

What arteries go to supply the bladder, uterus and vagina?

A

Vesical arteries
Uterine arteries
Vaginal arteries

55
Q

What arteries branch from the vesical arteries?

A

Prostatic arteries

56
Q

What artery to the rectum is derived from the internal iliac artery?

A

Middle rectal artery

57
Q

What 3 orifices form the trigone of the bladder?

A

2 ureteric orifices and the internal urethral orifice

58
Q

What is the function of the the internal urethral sphincter muscle?

A

Contracts during ejaculation to prevent retrograde ejaculation of semen back into the bladder

59
Q

What name is given to the normal position of the uterus and what takes most of its weight?

A

Anteflexed

Sits on top of bladder => this takes its weight

60
Q

In what direction does the bladder expand when it fills?

A

Superiorly into abdominal cavity

61
Q

What are the two methods of catheterisation?

A 
urethral
suprapubic (through anterior abdominal wall => avoiding peritoneal cavity)
62
Q

The male urethra is much longer than the female urethra. TRUE/FALSE?

A

TRUE

63
Q

What are the two parts of the male urethra and where are they found?

A 
Spongy urethra (in corpus spongiosum)
Prostatic urethra (through prostate)
64
Q

The external urethral sphincter is INVOLUNTARY. TRUE/FALSE?

A

FALSE
the INTERNAL urethral sphincter is INVOLUNTARY
The EXTERNAL urethral sphincter in VOLUNTARY

65
Q

Describe the course of the vas deferens

A

up through scrotum
into peritoneal cavity
behind bladder
Down through prostate (joins with seminal gland to form ejaculatory duct)
Then becomes prostatic, then spongy urethra

66
Q

What structure moves with the testes when they descend into the scrotum?

A

Spermatic cord

67
Q

What name is given to the “sac” that the testis sit inside when in the scrotum?

A

tunica vaginalis

visceral and parietal layer

68
Q

Excess fluid in the tunica vaginalis is known as what?

A

hydrocele

69
Q

What is contained within the spermatic cord?

A

vas deferens
testicular artery
pampiniform plexus

70
Q

What is meant by testicular torsion?

A
  • twisting of the spermatic cord
  • disrupts the blood supply
    Causes:
  • severe pain
  • danger of testicular necrosis
71
Q

What structures pass through the Deep Inguinal Ring to get into/out of the inguinal canal?

A 
testicular artery
testicular vein
vas deferens
lymphatics
nerves
72
Q

Where does the vas deferens begin?

A

The inferior pole of the testis

73
Q

Where can the head of the epididymis be palpated?

A

The posterior aspect of the superior pole

74
Q

What part of the prostate is palpated on PR examination?

A
  • peripheral zone

- most prostate cancers (i.e. malignant) arise in the peripheral zone

75
Q

In what cylinders of tissue are the deep arteries to the penis found?

A

right & left corpus cavernosum

76
Q

What arteries do the deep arteries of the penis branch from?

A

the internal pudendal artery

from the internal iliac

77
Q

What is the blood supply to the scrotum?

A

internal pudendal

AND branches from the EXTERNAL iliac artery

78
Q

What structures of the male reproductive tract drain to the superficial inguinal lymph nodes?

A

Scrotum & most of the penis (not the glans)

79
Q

Lymph from the testis drains to what group of lymph nodes?

A

lumbar nodes around the abdominal aorta

RENAL (24 decks)

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