Abdomen, Pelvis and perineum 3

Question 1

Where are the kidneys positioned?

Answer 1

Kidneys are retroperitoneal in the posterior abdominal region

Question 2

Where does the right kidney lie relative to the left kidney?

Answer 2

Right kidney sits slightly lower than the left one, which helps to make space to accommodate the large size of the liver located on that side of abdomen

Question 3

Describe the arrangement of fascia and fat surrounding the kidneys

Answer 3

• Immediately outside the renal capsule the perinephric fat completely surrounds the kidney
• Enclosing the perinephric fat is the renal fascia
• A final layer of paranephric fat completes the fat and fascias associated with the kidney

Question 4

What is the surface of the kidney like?

Answer 4

Each kidney has a smooth anterior and posterior surface covered by a fibrous capsule, which is easily removable except during disease.

Question 5

What is the position of the kidneys relative to other organs - ANTERIORLY

Answer 5

• Positioned superior to both kidneys are the suprarenal glands
• Anterior to the left kidney is the spleen, stomach, pancreas, left colic flexure and jejunum,
• Anterior to the right kidney lie, the liver, duodenum, right colic flexure and ascending colon.
  -The right kidney and liver are separated by the hepatorenal recess, also known as Morisons pouch.

Question 6

What is the position of the kidneys relative to other organs - POSTERIORLY

Answer 6

Posteriorly, both kidneys are associated with the:
- diaphragm
- psoas major
- quadratus lumborum
- transversus abdominismuscles,
- subcostal nerveand vessels,
- iliohypogastric and ilioinguinal nerves.

• The left kidney is also posteriorly associated with the 11th and 12thribs, while the right is mainly associated with the 12thrib.

Question 7

What structure is number 1

Answer 7

Renal capsule

Question 8

What structure is number 2

Answer 8

Fat body of renal sinus

Question 9

What structure is number 1

Answer 9

Minor calyx

Question 10

What structure is number 2

Answer 10

Major calyx

Question 11

What structure is number 3

Answer 11

Renal pelvis

Question 12

What structure is number 1

Answer 12

Interlobar artery of kidney

Question 13

What structure is number 2

Answer 13

Interlobar vein of kidney

Question 14

What structure is number 3

Answer 14

Renal artery

Question 15

What structure is number 4

Answer 15

Renal vein

Question 16

What structure is number 5

Answer 16

Inferior segmental artery of kidney

Question 17

What structure is number 1

Answer 17

Renal cortex

Question 18

What structure is number 2

Answer 18

Renal pyramid

Question 19

What structure is number 3

Answer 19

Renal papilla

Question 20

Describe the lymphatic drainage of each kidney

Answer 20

The lymphatic drainage of each kidney is to the lateral aortic (lumbar) nodes around the origin of the renal artery

Question 21

What are ureters?

Answer 21

The ureters are muscular tubes that transport urine from the kidneys to the bladder

Question 22

How is the ureter formed?

Answer 22

They are continuous superiorly with the renal pelvis, which is a funnel-shaped structure in the renal sinus. The renal pelvis is formed from a condensation of two or three major calices, which in turn are formed by the condensation of several minor calices. The minor calices surround a renal papilla.

Question 23

What is the name of the point where the renal pelvis becomes continuous with the ureter?

Answer 23

Ureteropelvic junction

Question 24

When the ureters descend to the bladder from the kidney, how many times do they constrict?

Answer 24

3

Question 25

Where are the 3 points at which the ureter constricts on its way to the bladder?

Answer 25

▪ The first point is at the ureteropelvic junction.
▪ The second point is where the ureters cross the common iliac vessels at the pelvic brim.
▪ The third point is where the ureters enter the wall of the bladder.

Question 26

Why are the 3 points at which the ureter constricts on its way to the bladder
clinically significant?

Answer 26

Kidney stones can become lodged at these constrictions

Question 27

Which arteries supply the upper end of the ureters

Answer 27

Renal arteries

Question 28

Which arteries supply the middle of the ureters

Answer 28

• the abdominal aorta,
• the testicular or ovarian arteries
• the common iliac arteries

Question 29

Which arteries supply the part of the ureters in the pelvic cavity

Answer 29

one or more arteries from branches of the internal iliac arteries.

Question 30

Which lymph nodes do the upper end of the ureters drain into

Answer 30

lateral aortic (lumbar) nodes

Question 31

Which lymph nodes do the middle of the ureters drain into

Answer 31

lymph nodes associated with the common iliac vessels

Question 32

Which lymph nodes do the inferior part of the ureters drain into

Answer 32

lymph nodes associated with the external and internal iliac vessels

Question 33

Describe the position of the bladder

Answer 33

The bladder sits underneath the peritoneum which creates associated ‘pouches’ in the inferior peritoneal cavity.
- Most anterior organ in the pelvic cavity

Question 34

What are the names of the pouches created by the position of the bladder?

Answer 34

FEMALE: vesicouterine and rectouterine pouches
MALE: rectovesical pouch

Question 35

Describe the postition of the bladder when it is full (in relation to cavities)

Answer 35

it is entirely situated in the pelvic cavity when empty, it expands superiorly into the abdominal cavity when full

Question 36

What is the structure at number 1 ?

Answer 36

Left and right ureters

Question 37

What is the structure at number 2?

Answer 37

Urethra

Question 38

What is the structure at number 4?

Answer 38

Trigone

Question 39

What is the structure at number 5?

Answer 39

Neck of bladder

Question 40

What is the structure at number 6?

Answer 40

Sphincter urethrae muscle

Question 41

What is the difference between the male and female bladder?

Answer 41