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Anatomy Flashcards

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1
Q

List the components of the urinary tract

A

The kidney - produces urine
The ureter - drains urine from kidney to bladder
The bladder - stores and voids urine
The urethra - excretes the urine

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2
Q

What structures are found in the upper urinary tract

A

Right and left kidneys

Right and left ureters

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3
Q

What structures are found in the lower urinary tract

A

The bladder
The urethra

Both unpaired midline structures

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4
Q

Where might an upper urinary tract infection spread to

A

The kidneys

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5
Q

Which structures are affected by a lower urinary tract infection

A

Bladder and urethra

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6
Q

Which parts of the urinary tract are found in the abdomen

A

Kidneys and proximal ureters

In retroperitoneum

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7
Q

Which parts of the urinary tract are found in the pelvis

A

Distal ureters
Bladder
Proximal urethra

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8
Q

Which parts of the urinary tract are found out in the perineum

A

Distal urethra

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9
Q

Which part of the kidney is in contact with the peritoneum

A

The anterior surface touches the visceral peritoneum

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10
Q

What is contained in the hilum of the kidney

A 
Renal vein (anterior) 
Renal artery (middle) 
Ureter (posterior)
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11
Q

What surrounded the lateral part of the kidney

A

Abdominal wall muscles

External and internal obliques and the transversus abdominus

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12
Q

How can the abdominal muscles protect the kidney

A

Guarding can help protect them from trauma

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13
Q

List the layers that surround the front of the kidney (from outside in)

A 
Visceral peroneum 
Paranephric fat 
Renal (deep) fascia 
Perinephric fat - liquid 
Renal capsule - more fascia
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14
Q

How can the renal capsule cause problems in pathology

A

Does not stretch so any swelling of the kidney causes pain

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15
Q

Describe the position of the following vessels on a CT - abdominal aorta, IVC, renal vein and artery

A

Aorta is on the patients left
IVC is anterior to this and over to the right
Renal artery comes off aorta
Vein goes to IVC

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16
Q

The kidneys lie anterior and lateral to which muscles

A

In front of quadratics lumborum

Lateral to psoas major

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17
Q

Which vertebral levels are the kidneys at

A

Left - T12-L2
Right - L1-3

Right is lower due to the liver

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18
Q

Which ribs protect the kidney

A

Floating ribs 11 and 12

They cover the posterior and lateral parts of the kidney

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19
Q

Rib fracture can do what to the kidneys

A

Cause laceration or bruising

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20
Q

In which quadrants are the kidneys found

A

Left upper and right upper

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21
Q

In which abdominal regions are the kidneys found

A

Left and right lumbar (flank)

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22
Q

How do you palpated the kidneys

A

Place hand on the back just below rib 12

Get patient to breathe in and palpate in upper quadrant

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23
Q

Describe the location of the right kidney in relation to other organs

A

Posterior to the liver, part of the duodenum, ascending colon and hepatic flexure

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24
Q

Describe the location of the left kidney in relation to other organs

A

It’s sits posterior to the stomach, tail of the pancreas, hilum of the spleen and the splenic vessels

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25
What is the significance of the hepatorenal recess
When someone lies on their back, it becomes the deepest part of the peritoneal cavity Any excess fluid will collect here
26
Where does lymph from the kidneys drain to
The lumbar nodes
27
At what level does the abdominal aorta bifurcate
Level of the umbilicus
28
Where does lymph from the ureters drain to
Lumbar nodes and the iliac nodes
29
Where do the renal veins sit in relation to the arteries
They sit in front of the arteries
30
What sits anteriorly - common iliac arteries or veins
The arteries, when the aorta bifurcated it becomes anterior to the veins
31
Describe the blood supply to the ureters
Supplied by branches of the renal artery, abdominal aorta, common iliac, internal iliac and vesical artery
32
Renal stenosis related to an infra-renal AAA is likely caused by what
Atherosclerosis
33
Renal stenosis related to a supra-renal AAA is likely caused by what
Occlusion of the renal artery by the AAA itself
34
What are the two different placements of AAA
Supra renal - occurs at the level of the renal arteries Infra-renal - occurs below the renal arteries, just above the bifurcation of the abdominal aorta
35
List some common variations in the renal system
Bifid ureter Retrocaval ureter - sits posterior to IVC Ectopic kidney - in a weird place, may be due to transplant Solitary kidney - may have not formed or been removed
36
Describe the composition of the kidney
Made up of cortex and medulla The medulla contains renal pyramids The medulla has a striated appearance due to collections of nephrons which make up the pyramids
37
Describe how urine drains from the kidney
Comes from the collecting duct of the nephrons into the minor calyx Then into major calyx Then into renal pelvis Then into ureter
38
What is the pelviureteric junction
Anatomical site of constriction between the renal pelvis and ureter The ureter is narrower than the pelvis
39
List the anatomical sites of uretic constriction
pelviureteric junction Where the ureter crosses the common iliac artery Ureteric orifice - when it opens into the floor of the bladder
40
what are renal calculi
Kidney stones
41
how do renal calculi form
From urine calcium salts | they then cause obstruction
42
What can cause a ureteric obstruction
Internal problem - stone or blood clot | External compression - tumour
43
What happens to the ureter when it becomes obstructed
The smooth muscles in the walls start contracting to try and clear the problem This leads to colicky pain
44
what is the consequence of urinary tract obstruction
The urine backs up to the kidneys | This leads to lots of back pressure and eventually renal failure
45
What is hydronephrosis
Excess urine backing up in the kidney - swells | Very painful
46
Where is the false pelvis
Goes from iliac crests to pelvic inlet | Part of the abdominal cavity
47
Where is the true pelvis
Pelvic inlet to pelvic floor | Makes up the pelvic cavity
48
Describe the path of the ureter through the pelvis
Pass through the retroperitoneum - anterior to common iliac vessels Through the false pelvis and into the true pelvis - along lateral walls At level of ischial spine it turns medially to enter the posterior aspect of the bladder
49
What is the main muscle that makes up the pelvic floor
Levator ani
50
What are the deepest parts of the pelvic cavity in men and women
In men - rectovesicle pouch (between bladder and rectum) In women its the pouch of douglas (between uterus and rectum) Any excess fluid will collect here when standing
51
Where does the ureter runs in relation to the uterine artery
Ureter runs inferiorly to the uterine artery | 'water under the bridge'
52
Where does the ureter runs in relation to the vas deferens
Runs inferiorly to the vas deferens | 'water under the bridge'
53
List arteries that branch off the internal iliac artery in women
vesicle arteries - to bladder uterine artery middle rectal artery vaginal artey
54
List arteries that branch off the internal iliac artery in men
vesical arteries- to bladder prostatic arteries - come from vesicle middle rectal artery
55
What is the trigone of the bladder
Triangle shaped area found in the internal aspect of the bladder formed by the 3 orifices of the bladder 2 ureter entrances and the internal urethral orifice Smooth part of the wall
56
What muscle is responsible for bladder contraction
the detrusor
57
What happens to the orifices when the detrusor contracts
The muscles surrounding them also contract to prevent reflux of urine
58
What is the function of the internal urethral sphincter muscle
Found in men only | Contracts during ejaculation to prevent semen entering the bladder
59
List the anatomical relations of the bladder in women
Uterus lies superior to it - separated by the uterovesical pouch Cervix/vagina is posterior It sits posterior to the pubic bone
60
List the anatomical relations of the bladder in men
It sits posterior to the pubic bone Rectum is posterior to it Prostate is inferior to it
61
What are the 2 routes of catherization
Urethral - more common | Suprapubic - through abdominal wall, must be done on full bladder
62
Describe the difference in position between the empty and full bladder
An empty bladder lies within the pelvis | A full bladder can extend out of the pelvis: its superior part lies superior to the pubic bone
63
Which surface of the bladder is covered by peritoneum
The superior surface only
64
What are the different named parts of the male urethra
Prostatic urethra - passes through prostate | Spongy urethra - passes through the corpus spongiosum of the penis
65
Is the external urethral sphincter voluntary or involuntary
Voluntary (hopefully)
66
Describe the path of sperm through the male reproductive tract
Produced in seminiferous tubules Passes to epididymis - storage Then up vas deferens Joins with seminal glands to form the ejaculatory duct Then connects to urethra, passes through prostate and out
67
What is found in the spermatic cord
Testicular artery, vein Vas deferens Lymphatic vessels Nerves - autonomic and somatic
68
The testes should be in the scrotum by birth - true or false
True
69
What covers the testis within the scrotum
A sac called the tunica vaginalis The testes push into it like the lungs do the pleura Has a visceral and parietal section
70
What is hydrocele
Abnormal fluid in the tunica vaginalis
71
What is testicular torsion
Twisting of the spermatic cord Can disrupt blood supply to the testes and leads to severe pain Risk of necrosis
72
What drains blood from the testes
Pampinform venous plexus Drains into the testicular vein The right testicular vein drains into IVC whilst the left goes to the renal vein
73
What are the different zones of the prostate
Has a central zone with peripheral zones either side | Peripheral zones are what is felt on PR (cancer is most common here anyway)
74
List the different sections of erectile tissue in the penis
Right and left corpus cavernosum Corpus spongiosum All 3 engorge with blood to cause erection
75
Where does the root of the penis attach
The ischium
76
What is the blood supply to the penis
Deep arteries of the penis which are branches of the internal pudendal artery This comes from the internal iliac
77
What is the blood supply to the scrotum
Internal pudendal artery (from internal iliac) | Branches from the external iliac artery
78
Where does lymph from the scrotum and penis (except glans) drain to
Superficial inguinal lymph nodes found in the superficial fascia in the groin
79
Where does lymph from the testis drain to
Lumbar nodes around the abdominal aorta
80
At what level does the left renal hilum lie
L1
81
At what level does the right renal hilum lie
L1/2
82
What aspects of the kidney is US good for looking at
``` Size Scarring Distension of the calyx Calculi Any abnormalities in structure ```
83
What is a pre-contrast CT used for
Good at showing calculi - stone search
84
What is a corticomedullary CT used for
Cortical enhancement | Inject iondine contrast and take image after 25-70 secs
85
What is a nephrographic CT
Take image 80-180 secs after contrast injected | Medulla and cortex are enhanced equally
86
What is an excretory CT
Take image 5-15 mins after contrast injection | Gives opacification of the renal collecting system and ureters
87
How can MRI be used to assess the kidney
shows lesions, allows for vascular assessment | Shows up most pathology
88
What is the most common type of imaging used for the bladder
US
89
Who has the longer urethra - men or women
Men

Renal (18 decks)

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