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Flashcards in Anatomy Deck (122):
1

What 4 major structures make up the urinary tract?

Kidney
Ureter
Bladder
Urethra

2

What are the two parts to the urinary tract?

Upper, containing the kidneys and ureters
Lower, containing the bladder and urethra

3

What 3 body compartments does the urinary tract involve?

Abdomen
Pelvis
Peritoneum

4

What is the difference in a male and female urethra?

Female is shorter and more likely to get a lower tract UTI

5

Where in the abdomen do the kidneys lie?

Retroperitonally

6

What three structures make up the hila of the kidney?

Renal artery
Renal vein
Ureter

7

At what level does the upper urinary tract become the lower?

L4
At the iliac crest

8

What other major landmarks are at L4?

Umbilicus
Bifurcation of abdominal aorta into right and left iliac artery

9

At which vertebral level is the left kidney?

T12-L2

10

At which vertebral level is the right kidney?

L1-L3

11

Why is the right kidney more inferior?

Presence of liver pushes it down

12

Which muscles are in direct relation to the kidneys?

Psoas
Quadratus lumborum

13

What layers surround the kidney?

Visceral peritoneum
Paranephric fat
Renal fascia
Perinephric fat
Renal capsule

14

Which ribs are associated with the kidneys?

11 and 12.

15

Which region of the body do the kidneys lie?

Flank/lumbar

16

Where is the kidney clinically examined?

Posterior to 12th rib in the RUQ

17

What cavity, where water collects in the supine patient, does the kidney lie?

Hepatorenal recess

18

Describe the location of the renal veins

Anterior to renal arteries

19

Describe the location of the common iliac veins

POSTERIOR to the common iliac arteries

20

Where does the lymph from the ureters drain?

Iliac nodes
Lumbar nodes

21

Where does lymph from the kidneys drain?

Lumbar nodes alone

22

Describe an infra-renal AAA

Aneurysm is below the renal arteries

23

What is the difference in renal artery stenosis when in the presence of an infra-renal AAA and a supra-renal AAA?

An infra-renal may be caused by atherosclerosis
While a supra-renal likely to due to occlusion of the renal artery

24

How is an AAA treated?

Endovascular aneurysm repair

25

Name some common variations of the renal system

Bifid renal pelvis
Bifid ureter

26

What two layers makes up the kidney?

Outer cortex and an inner medulla with a capsule surrounding it

27

What structures are contained within the medulla?

Pyramid

28

What structures lie within the pyramid?

Nephrons

29

Name the constituents of the nephron

Glomerulus
Proximal convuluted tubule
Loop of Henle
Distal convuluted tubule
Collecting duct

30

Name the structures which are involved in urine drainage

Collecting ducts
Minor calyx
Major calyx
Renal pelvis
Ureter

31

What is the constriction at the ureter called?

Pelviureteric junction

32

What can gather at the pelviureteric junction?

Calculi

33

What makes up calculi?

Calcium salts

34

Why is calculi pain colicky?

Smooth muscle in ureter.
Increased peristalsis to remove obstruction
Wave like pain

35

What is hydronephrosis?

Back pressure not the calcyes compresses the nephrons causing painful stretching of the renal capsule leading to renal failure

36

What may be found on examination with a hydronephrosis?

Kidney enlargement

37

What is the true pelvis?

Pelvic inlet to pelvic floor

38

What separates the true pelvis from the false pelvis?

Pelvic rim/inlet

39

Which muscle can be said to separate the pelvic floor from the peritoneum?

Levator ani

40

What does levator ani do?

Constricts the rectum and bladder

41

Describe the travel of the ureters

From kidney they pass anterior to common iliacs and follow the wall of the true pelvis. Posterior to the bladder and enter into the trigone.

42

Which cavity is present in males, which is the most inferior part of the peritoneal cavity?

Rectovesicle pouch

43

Which two cavities are present in females?

Vesicouterine pouch
Rectouterine pouch

44

What structure lies immediately lateral to the ureter in females?

Suspensory ligament of the ovary

45

What connects the uterus to the perineum?

Round ligament of the uterus

46

Where does the ureter lie in relation to the uterine artery and the Vas Deferens?

Inferior to uterine tubes and uterine artery.
"Water under the bridge"

47

Where do all the arteries supplying the pelvis come from?

Internal iliac artery

48

What are the 3 orifices in the trigone?

2 ureteric orifices
1 internal urethral orifice

49

What is also present at the internal urethral orifice in males?

Internal urethral sphincter

50

Which muscle causes contractions of the bladder?

Detrusor muscle

51

How is urine reflux to the ureter prevented?

Contraction of the detrusor muscle around the ureteric orifices

52

Which pelvic organ is most anterior and sits deep to the pubic bone?

Bladder

53

What anatomical differences are present in a full and empty bladder?

Full bladder may enter into abdomen

54

What kind of muscle is the external urethral sphincter made of?

Skeletal

55

What is the difference in the male and female urethra?

Female is much shorter

56

Where is sperm produced?

Seminiferous tubules in the epididymis

57

What structure carries sperm into the ejaculatory duct?

Vas deferens

58

What structure is the vas deferens part of?

Spermatic cord

59

What else is held in the spermatic cord?

Testicular artery
Testicular vein
Vas deferens
Lymphatics

60

What two muscle groups are involved in penile erection?

Corpus spongisoum
Left and right corpus cavernosum

61

Where is semen added to sperm?

Seminal gland

62

When does the vas deferens become the prostatic urethra?

When enters the prostate gland.

63

What is the urethra called as it exits the external urethral meatus?

Spongy urethra

64

What structure does the testis sit in?

Tunica vaginalis

65

What are the two parts of the tunica vaginalis?

Parietal and visceral, with serous fluid inbetween

66

What is excess fluid between the parietal and visceral tunica vaginalis called?

Hydrocoele

67

What structure drains deoxygenated blood from the testis?

Pampiniform plexus

68

Where do the testicular veins drain to?

Left drains to left renal vein
Right drains directly to vena cava

69

Which structure allows glandular secretions from the prostate into the prostatic urethra?

Prostatic ducts

70

What are the two zones of the prostate and which is most clinically relevant?

Central
Peripheral.
Most cancers are peripheral.

71

Which penile muscle does the spongy urethra sit in?

Corpus spongiosum

72

What is the penile raphe?

On anterior surface
That line.
Scrotal raphe also exist.

73

What is the anatomically correct name for the foreskin?

Prepuce

74

What is the blood supply to the penis?

Both the deep arteries of the penis and internal pudendal artery. Internal iliac only.

75

What is the blood supply to the scrotum?

Internal pudendal and branches from external iliac

76

Where does lymph from the testis drain to?

Lumbar lymph nodes at abdominal aorta

77

Where does lymph from the penis drain to?

Superficial inguinal nodes

78

What do somatic sensory nerve fibres do?

Convey sensations from the body wall to the CNS

79

What do visceral afferent nerve fibres do?

Carry sensation from organs to the CNS

80

What do somatic motor nerves do?

Convey motor responses from the CNS to the soma

81

How are motor responses to the organs carried out?

Parasympathetic or sympathetic nerve fibres

82

On which cranial nerves are parasympathetic fibres carried?

3, 7, 9 and 10
Sacral nerve plexus

83

All the sensory nerves in the renal system are visceral afferents apart from what?

The urethra while in the perineum is a somatic sensory

84

What divides the urethra into pelvic and perineum?

Levator ani

85

What parts of the renal system are controlled by motor nerves i.e. sympathetic and parasympathetic?

Ureteric and bladder peristalsis.
Urethral sphincter control

86

Which parts of the renal system are controlled by somatic motor nerves?

External sphincter and levator ani

87

Which kinds of nerves are involved in urinary continence?

Motor nerves
Somatic motor
Visceral afferents

88

Which nerves control both the motor and sensory parts of the perineum and lower limbs?

Somatic sensory and somatic motor

89

Between which spinal cord levels can sympathetic nerve fibres leave the CNS?

T1-L2
Thoracolumbar outflow

90

Where does the sympathetic chain run?

From C1 to sacral plexus, adjacent to spinal cord

91

How do sympathetic nerve fibres reach the body wall?

Within spinal nerves

92

How do sympathetic nerve fibres reach the organs/muscles of the body?

Cardiopulmonary or abdominopelvic sphlanchnic nerves

93

Describe the route of the splanchnic nerves

They follow the arteries supplying the same structures

94

How does the spinal cord and the sympathetic nerve chain communicate?

Rami communicans

95

How many ganglia are there in the cervical region?

3
superior middle and inferior

96

How many ganglia are in the thoracic and lumbar regions?

One for each spinal cord level so 17

97

Where do sympathetic nerve fibres going to the kidneys, ureter and bladder travel to?

Leave spinal cord at T10-T12
Enter into bilateral sympathetic chain
Leave the sympathetic chain within the abdominopelvic splanchnic nerves.

98

Where do sympathetic nerve fibres going to the kidneys, ureter and bladder synapse?

Abdominal sympathetic ganglia, at the abdominal aorta

99

What is a periarterial plexus?

Collection of nerves on the outside of the arteries which are post synaptic

100

Where do the parasympathetic nerves supply?

NOT body wall
Smooth muscle/glands

101

How do the parasympathetic fibres reach the muscles of the hindgut and pelvic organs?

Pelvic splanchnic nerves

102

Which cranial nerve is the parasympathetic nerves which innervate the kidneys and ureter carried in?

CN X

103

Nerves going to which structure is carried within the pelvic splanchnic?

Bladder

104

Which spinal cord levels does the pelvic splanchnic nerve leave?

S2,3 and 4

105

Which part of the tract is involved with somatic motor nerves?

External urethral sphincter

106

Which named nerve controls the external urethral sphincter?

Pudendal

107

Which muscle is contracted in the bladder when stimulated by S2,3 and 4?

Detrusor muscle

108

When does the internal urethral sphincter contract?

In males only.
During ejaculation

109

Which nerves control levator ani?

S3 and S4.

110

What spinal nerves do the visceral afferents from the kidneys use?

T11-L1

111

What spinal nerves do the visceral afferents from the ureter use?

T11-L2

112

What is the division in visceral afferent fibres in the bladder?

Superior part, touching the peritoneum is by T11-L2
The rest, not touching the peritoneum, is by S2,3 and 4.

113

How do visceral afferents from the urethra get back to the CNS?

Run alongside parasympathetics and use S2,3 and 4.

114

Which nerve senses stretch in the bladder as it fills?

Visceral afferents
S2,3 and 4

115

What muscles are used during micturition?

Detrusor contracts
Internal urethral sphincter, external urethral sphincter and levator ani relax.

116

Where does the femoral nerve come from?

L2,3 and 4.
Anterior compartment of thigh

117

Where does the obturator nerve come from?

L2, 3 and 4
Medial compartment of thigh

118

Where does the sciatic nerve come from?

L4- S3
Posterior compartment of thigh via gluteals

119

What does the sciatic nerve split into?

Tibial nerve
Common fibular

120

What does the tibial nerve supply?

Posterior leg
Intrinsic muscles of foot

121

What does the common fibular divide into?

Superficial fibular- lateral leg
Deep fibular- anterior leg

122

What is the sural nerve?

Sensation to lateral foot