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Renal > Anatomy > Flashcards

Anatomy Flashcards

1
Q

What does the urinary tract consist of?

A

The urinary tract consists of the anatomical structures through which urine passes from its production to its excretion (removal from the body)

  • Kidney
  • Ureter
  • Bladder
  • Urethra
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2
Q

Which structures lie in the upper urinary tract vs lower urinary tract?

A

The upper urinary tract:
- The kidneys (right & left)
- The ureters (right & left)
The lower urinary tract:
- The bladder (unpaired midline structure)
- The urethra (unpaired midline structure)

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3
Q

Which zones of the body does the urinary tract lie in?

A 
The abdomen (in the retroperitoneum):
- Kidneys
- Proximal ureters
The pelvis:
- The distal ureters 
- The bladder
- The proximal urethra
The perineum:
- The distal urethra
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4
Q

What is the false pelvis?

What does the pelvic area include?

A

False pelvis = larger area above the true pelvis

Pelvic area includes both true and false

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5
Q

What is the difference between the parietal and visceral peritoneum?

A
  • Parietal peritoneumlines the abdominal and pelvic cavities
  • Visceral peritoneumcovers the external surfaces of most abdominal organs
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6
Q

Which structures are contained in the renal hilum and what is their orientation?

A

Renal vein – most anterior
Renal artery – sits posterior to the renal vein
Ureter – sits inferiorly to the vein and artery

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7
Q

Which tissues, from anterior to posterior lie between the contents of the abdominal cavity and the kidneys?

A 
Visceral peritoneum
Paranephric fat
Renal (deep) fascia
Perinephric fat
Renal capsule
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8
Q

What lies posterior to the kidneys?

A

Posteriorly there is musculature – posterior abdominal wall muscles including quadratus luborum

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9
Q

What lies anterior to the kidneys?

A

Visceral peritoneum

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10
Q

What lies lateral to the kidneys?

A 
Anterolateral abdominal wall muscles 
From deep to superficial
- Transversus abdominis
- Internal oblique
- External oblique
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11
Q

What lies medial to the kidneys?

A

Psoas major muscle

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12
Q

What are the vertebral levels of the kidneys?

A

Right kidney - L1-3

Left kidney - T12-L2

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13
Q

In which regions/quadrants do the kidneys lie?

A

Right and left upper quadrants

Right and left lumbar (flank) regions

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14
Q

What is the hepatorenal recess?

A

A space between liver and kidney – lies within the greater sac
Fluid can collect here because it’s the most dependant (deep) part of the peritoneal cavity when the patient is lying down

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15
Q

Name four structures that the right kidney lies posterior to

A
  • Liver (& hepatorenal recess)
  • (2nd part of the) duodenum
  • Ascending colon
  • Right colic flexure
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16
Q

Name four structures that the left kidney lies posterior to

A
  • Stomach
  • Tail of the pancreas the ascending colon
  • Hilum of the spleen
  • Splenic vessels
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17
Q

What is the orientation of renal artery and vein to each other?

A

The renal veins are anterior to the renal arteries

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18
Q

What is the orientation of the common iliac arteries to the common iliac veins?

A

The common iliac arteries

are anterior to the common iliac veins

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19
Q

Where does lymph from the kidneys drain to?

A

The lymph from the kidneys drains to the lumbar nodes (located around the abdominal aorta and inferior vena cava)

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20
Q

Where does lymph from the ureters drain to?

A

Lymph from the ureters drains to the lumbar nodes & the iliac nodes (the latter located around the common, internal & external iliac vessels)

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21
Q

What do the AA and IVC bifurcate into?
At what level?
What is the orientation of arteries to veins now?

A
  • Abdominal aorta into R&L common iliac artery
  • Inferior vena cava into R&L common iliac vein
  • This happens at the level of the umbilicus
  • Artery is now anterior to vein –common iliac arteries are anterior to common iliac veins
22
Q

How can AAA be classified according to the renal arteries?

A

Below level of renal arteries vs above level of renal arteries - infra-renal vs suprarenal
Described by the location of the top of the aneurysm

23
Q

What are two possible causes of renal artery stenosis when associated with AAA?

A

When associated with AAA, renal artery stenosis may be:

  • Combined with an infra-renal AAA (both caused by atherosclerosis)
  • Due to suprarenal AAA (occlusion of the proximal renal artery by the aneurysm)
24
Q

What are the two parts to the kidney?
What does the inner part contain?
What does this contain?

A

Cortex and medulla
Medulla contains pyramids
Each pyramid contains around 50,000 nephrons

25
Q

What are the six structures in the nephron?

A 
Glomerulus
Proximal convoluted tubule
Loop of Henle
Distal convoluted tubule
Collecting duct
Minor calyx
26
Q

Describe the path of urine from collecting duct to ureter

A 
Collecting duct
Minor calyx
Major calyx
Renal pelvis
Ureter
27
Q

What are the three anatomical sites of ureteric constriction?

A
  1. Pelviureteric junction
  2. Ureter crossing anterior aspect of the common iliac artery (often crosses the bifurcation)
  3. Ureteric orifice (opening into one corner of the trigone on the floor of the bladder)
28
Q

What does the ureter have in its walls?

What happens when the ureter is blocked?

A

Smooth muscle

  • Increased peristalsis proximal to the site of the obstruction in an attempt to remove it (flush it into the bladder)
  • As peristalsis comes in waves, a patient with a ureteric obstruction tends to experience pain that “comes and goes” (“colicky”)
29
Q

What happens if there is an obstruction in

  • Calyces or ureter
  • Bladder
  • Urethra
A
  • Obstructions within the calyces or ureter cause unilateral back pressure of urine
  • Obstructions within the bladder may cause unilateral or bilateral kidney problems
  • Obstructions to the urethra cause bilateral kidney problems

Urine production will continue until the pressure within the urinary tract exceeds the pressures favouring filtration at the glomerulus

30
Q

What happens in hydronephrosis?

A

Urine back pressure into the calyces compresses the nephrons within the medullary pyramids leading to renal failure

31
Q

What are the boundaries of the false and true pelvis?

A 
The false pelvis
- From iliac crests to pelvic inlet
- Part of the abdominal cavity
The true pelvis (pelvic cavity)
- Pelvic inlet to pelvic floor
32
Q

What is the most important pelvic floor muscle?

A

Levator ani

33
Q

What is the orientation of the ureters to the common iliac vessels when entering the pelvis?

A

The ureters pass anterior to the common iliac vessels to enter the pelvi

34
Q

What direction do the ureters enter the bladder in?

A

Inferomedial direction

35
Q

What is the most inferior part of the male peritoneal cavity?

A

The rectovesicle pouch

36
Q

What is the most inferior part of the female peritoneal cavity?

A

Rectouterine pouch

pouch of Douglas

37
Q

What is the name of the pouch between the uterus and bladder?

A

Vesico-uterine pouch

38
Q

What is the orientation of the ureters to the uterine tubes/vas deferens?

A

The ureter runs inferiorly to the uterine tubes and the uterine artery
The ureter runs inferiorly to the vas deferens
Remember these as “water under the bridge”

39
Q

What is the most anterior organ in the pelvis?

A

The bladder is the most anterior organ in the pelvis lying posterior to the pubic bone (when empty)

40
Q

What is the anatomical difference in orientation of a full bladder compared to empty?

A

An empty bladder lies within the pelvis
Peritoneum covers its superior surface only
A full bladder can extend out of the pelvis: its superior part lies superior to the pubic bone
Peritoneum still only covers its superior surface

41
Q

Name a difference between the male/female urinary tract at the level of the bladder

A

In females there is no internal urethral sphincter

42
Q

What is the sac which contains the testes called?

What are the two layers of this?

A

Tunica vaginalis

  • Parietal is in contact with scrotum
  • Visceral is in contact with testicle itself
43
Q

What is a hydrocele?

A

Excess fluid within the tunica vaginalis

44
Q

What is contained in the distal aspect of the spermatic cord?

A

Vas deferens
Testicular artery
Pampiniform plexus

45
Q

Where does blood from the testicles drain into?

A

Right testicular vein into the IVC

Left testicular vein into the left renal vein

46
Q

Where is semen produced?

A

Seminal vesicle

47
Q

What lies in the centre of the prostate?

A

Prostatic urethra

48
Q

What are the three muscular layers of the penis?

What are their functions?

A

Right and left corpus cavernosum - transmit the deep arteries of the penis
Corpus spongiosum - transmits the spongy urethra and expands distally to form the glans

49
Q

What is the blood supply to the penis and scrotum?

A

Penis - deep arteries of the penis are branches of the internal pudendal artery, which is a branch of the external iliac artery branches

50
Q

Where does lymph from the scrotum, penis and testis drain to?

A

Lymph from testicles rains back to the lumbar nodes

Lymph from scrotum and penis drains to superficial inguinal lymph nodes

Renal (1 decks)

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