UNFINISHED Introduction & Gross anatomy and Histology of the Urinary System

Question 1

Functions of the system?

Answer 1

• Remove wastes via filtration & excretion
• Regulates plasma electrolytes and volume via RAAS
• Stabilize pH
• Reabsorption of small molecules
• Produce erythropoietin

Question 2

How are the kidneys peritonised?

At what vertebral level do they lie?

Answer 2

Only partially peritonised, Retroperitoneal

T12 - L3

Question 3

Which kidney is slightly lower than the other?

Answer 3

The right kidney is slightly lower

liver

Question 4

Which nerves run just anterior to the inferior end of the kidneys?

Answer 4

• Iliohypogastric nerve (superior)

- Ilioinguinal nerve (inferior)

Question 5

Describe the layers of fascia associated with the kidney (inner to outer)

Answer 5

• Kidney
• Renal capsule
• Perirenal fat
• Renal fascia
• Pararenal fat

Question 6

Vertebral level of the hila of the kidneys? What plane lies here?

Answer 6

• Lower border of L1 vertebral level

- Transpyloric plane

Question 7

Movement of the kidneys during breathing?

Answer 7

Down during inhalation, up during exhalation

• Due to close relationship w diaphragm

Question 8

What structures form the hilum of the kidney?

Answer 8

The kidney vessels and the ureter

Question 9

Describe the flow of urine from the renal pyramids to ureter

Answer 9

Pyramid - Papilla - Minor Calyx - Major Calyx - Renal Pelvis - Ureter

Question 10

Describe the passage of the left and right renal veins?

Answer 10

• Left: travels anterior to the aorta, is relatively long

- Right: Direct to kidneys, relatively short

Question 11

Describe the passage of the left and right renal arteries?

Answer 11

• Right: travels posterior to the IVC, is relatively long

- Left: direct to kidneys, relatively short

Question 12

What crosses the ureter superiorly in males?

Answer 12

Vas deferens

Question 13

What crosses the ureter superiorly in females?

Answer 13

Uterine artery

Question 14

Where do the ureters enter the bladder?

Answer 14

internal uteric orifices at posterolateral angle of trigone

Question 15

Where does the urethra exit the bladder?

Answer 15

internal uteric orifices at apex of trigone

Question 16

Where are the three constrictions of the ureter? Why are these clinically significant?

Answer 16

1. Where ureter passes over inferior renal pole (kidney)
2. Ureter passes over external iliac vessels
3. Ureter traverses the bladder wall

• Likely spots for kidney stones to lodge

Question 17

What arteries / veins are responsible for the vascular supply of the ureter?

Answer 17

Arteries: renal, ovarian / testicular, AA

Veins: Drain into renal & ovarian / testicular veins

Question 18

From anterior to posterior, what structures make up the renal hilum?

Answer 18

• Renal Vein
• Renal Artery
• Renal Pelvis

VAP

Question 19

Describe the arterial blood supply of the kidneys

Answer 19

• Renal arteries enter the hila and split into the segmental arteries (5 of them)
• Segmental arteries branch into interlobar arteries which travel along the borders of the medullary pyramids
• Interlobar arteries then travel around the bases of the pyramids, where they are called arcuate arteries
• Arcuate arteries then give off interlobular arteries which enter nephrons and give off afferent arterioles

Question 20

What group of lymph nodes provide lymphatic drainage to the kidneys?

Answer 20

• Lateral aortic lymph nodes

Question 21

Describe the innervation of the kidney?

Answer 21

Renal plexus:

• Sympathetic: T10-L1
• Sensory afferent: T11-L2
• Parasympathetic from vagus nerve

Question 22

What is are the embryonic and fetal predecessors of the median umbilical ligament?

Answer 22

• Embryonic: Allantois

- Fetal: embryonic urachus

Question 23

Slide on urinary bladder that is confusing me

Answer 23

check back

Question 24

What type of epithelium lines the urinary bladder?

Answer 24

Transitional epithelium