Anatomy

Question 1

What’s this?

Answer 1

Retroperitoneal space

Question 2

Identify those 4 strucutres

Answer 2

Question 3

What’s that?

Answer 3

Peritoneum

Question 4

What’s that?

Answer 4

Fibrous Renal capsule: Completely invest kidneys

Question 5

What’s that?

Answer 5

Perirenal (Perinephric) fat: extraperitoneal fat, Outside renal capsule surrounding the kidneys

Question 6

What’s that?

Answer 6

Renal Fascia (Gerota’s):

Membranous fat condensation,

Surrounds each kidney & suprarenal gland,

Enclosing perirenal fat.

Question 7

What’s that?

Answer 7

Perirenal (Perinephric) fat: extraperitoneal fat, Outside renal capsule surrounding the kidneys

Question 8

What’s that?

Answer 8

Transversalis fascia

Question 9

Where are kidneys located?

Answer 9

General Location:

Retroperitoneal

Ant. to quadratus lumborum,

Lat to psoas,

Under diaphragm

Left Kidney: Ant to rib 11 & 12

Vertebral level of T12 to L2

Lies post to spleen, tail of pancreas, left colic flexure

Right Kidney: Ant to rib 12

Vertebral level of L1 to L3

Post to liver, descending portion of duodenum,

right colic flexure

Question 10

What’s the arterial supply of the kidneys?

Answer 10

Renal A. from abdominal aorta (L1-L2)

Right renal: longer, passes under IVC

Accessory renal a. (common) do not enter via hilum

Question 11

What’s the venous drainage of the kidneys?

Answer 11

Renal veins from IVC, anterior to Arteries

Left renal vein is longer, passes under SMA, receives left adrenal & gonadal V.

Question 12

What’s the innervation of the kidneys?

Answer 12

Renal plexus from celiac plexus

Found along renal arteries

•Sympathetic: triggers vasoconstriction

reducing renal blood flow

•Parasympathetic: not well understood.

Question 13

Why does the kiney necroses if one part of its arterial supply is blocked?

Answer 13

Because it is composed of terminal arteries

Question 14

What are the 3 points of constriction of the ureter?

Answer 14

1. Ureteropelvic junction (junction renal pelvis / ureter)
2. Crosses iliac vessels (at the pelvic brim)
3. Traverses bladder wall (intramural part)

Question 15

What’s the urine pathway?

Answer 15

1. Renal Papilla
2. Minor Calyx
3. Major Calyx
4. Renal Pelvis
5. Ureter
6. Bladder
7. Saint-Laurent

Question 16

What’s that?

Answer 16

Inside the bladder the interureteric ridge connects the two

uretral orifice, forming the superior border of the trigone

Water under the bridge (ridge)

Question 17

What are those?

Answer 17

Left and right ureter

Question 18

Where do you do the Murphy’s sign (kidney punch)?

Answer 18

Costovertebral angle tenderness (CVAT)

Question 19

What’s that?

Answer 19

Trigone: Area forming the floor of the bladder, mucosa is firmly attached to muscle wall

Question 20

What’s the Detrusor muscle?

Answer 20

Smooth muscle in the bladder wall

Question 21

What are those?

Answer 21

Ureteric orifices: Have mucosal flaps (act as valve) to prevent vesicaluretteral reflux.

Question 22

What’s that?

Answer 22

Uvula of the bladder: Elevation of mucosa (by middle lobe of prostate) behind urethral orifice

Question 23

What’s that?

Answer 23

Urethral orifice

Question 24

In men, what is this?

Answer 24

Vas Deferens: Ampulla situated at the base of bladder

Question 25

In men, what is this?

Answer 25

Seminal Vesicles: Paired Accessory glands, Situated between bladder & rectum, Drains into prostatic urethra

Question 26

What are the prostate lobes?

Answer 26

* Ventral (anterior) lobe: ant. to the urethra, where adenoma rarely occur * Lateral lobes (2): lat. to the urethra and ejaculatory ducts, adenoma may arise in old age * Posterior lobe: between ejaculatory ducts, post. to median lobe, carcinoma may begin here * Median (middle) lobe: located above the ejaculatory ducts, common site of adenoma

Question 27

Where is situated the uterus?

Answer 27

Above the bladder, vagina is posterior to bladder so the bladder is not compressed during pregnancy

Question 28

What do the suprarenal glands look like?

Answer 28

**Right suprarenal: pyramidal shaped,** On sup. pole of right kidney, inf. to liver, ant. to diaphragm, extend medially behind IVC. **Left suprarenal: semilunar shaped,** On medial border to sup. pole of left kidney, post. to stomach and pancreas, ant. to diaphragm.

Question 29

What's the arterial supply of the suprarenals?

Answer 29

Suprarenal Arteries: * **Superior** from **inferior phrenic** from **abdominal aorta** * **Middle** from: **directly** from **abdominal aorta** * **Inferior** from: from **renal artery**

Question 30

What's the venous drainage of the suprarenals?

Answer 30

Usually 1 suprarenal vein: Right: to IVC Left: to renal vein

Question 31

What's that?

Answer 31

Superior mesenteric artery

Question 32

What are those 2 vessels?

Answer 32

Blue: renal vein Red: renal artery