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Flashcards in anatomy of the renal system Deck (63):
1

what layers surround the kidneys

perirenal fat (around)
renal fascia (extraperitoneal fascia)
pararenal fat (along side)

2

at what vertebral levels are the kidneys

t12 - L3

3

which kidney is lower

right

4

which kidney is longer

left

5

what are the anterior relations of the right kidney

IVC, duodenum, liver, colic flexure, suprarenal gland

6

what are the anterior relations of the left kidney

pancreas, spleen, stomach, colic flexure, small intestine

7

what ribs does the kidney overlie

10, 11, 12

8

why do the kidneys move with respiration

they lie on the diaphragm

9

what abdominal muscles do they kidneys lie on

QL, TA, psoas major

10

what is the renal column

the extension of cortex between the pyramids

11

what are the renal papillae

the part of the medulla that projects into the minor calyx

12

where in the kidney are the nephrons

renal pyramids

13

what vertebral level are the renal arteries

L1- left
L2- right
behind the renal veins
there may be extrahilar arteries branching from the aorta

14

where does lymph from the kidney go to

lumbar nodes

15

what structures are in the renal hilum, from anterior to posterior

vein
artery
pelvis

16

why is the right renal vein short

the IVC is to the right of the midline
this makes surgery difficult

17

what does the renal artery divide into

five segmental arteries that enter at the hilum

18

what arteries arise from each segmental artery

lobar arteries, one for each pyramid

19

what arteries arise from the lobar arteries

interlobar arteries

20

what are the arcuate arteries

branches of the interlobular arteries which arch over the base of the pyramids
these give off interlobular arteries

21

what do the afferent glomerular arterioles supply

renal corpuscle
arise from the branches of the interlobular arteries

22

what is the kidney nerve supply

T12 and L1

23

where is kidney pain referred to

back and lumbar regions, loin and groin

nausea and emesis may be associated due to vagal afferents

24

where is the ureter

posterior abdo wall
23-30 cm long

25

where are the narrowings of the ureter

pelvic ureteric junction
crossing the pelvic brim
passing into the bladder

26

what do the ureters cross

ant to psoas major
anterior to lumbar plexus
bifurcation of the common iliac artery
overlies the lumbar transverse process
runs medial to the sacral iliac joints
passes medial to the branches of the internal iliac on the lateral pelvic wall and floor

27

what does the pelvic ureter cross in the male

between the vas and seminal vesicle

28

where does the pelvic ureter pass in the female

posterior to ovary
inf to uterine artery
passes cervix and lateral fornix of vagina

29

where does lymph from the ureter pass

para aortic and iliac nodes

30

what is the blood supply of the ureter

Aorta
Renal
Gonadal
Common and internal iliac
Uterine, vaginal
Vesical

31

how is urine prevented from refluxing into the ureters

oblique entry
flap valve
pressure of urine forces the ureters to close

32

how far apart are the orifices of the ureters in the bladder wall

2.5 cm when empty
5cm when full

33

what muscle relaxes in order to fill the bladder

detrusor

34

what epithelium is found in the bladder

transitional

35

what part of the ANS controls the bladder wall

mostly PNS

36

what is the nerve supply of the ureters

nerves not required for peristalsis due to pacemakers

T10 -S4 from aortic, renal and pelvic plexuses

37

where is ureteric pelvic pain referred to

t11- L2
loin to groin and scrotum or labia

38

what is the nerve supply of detrusor

S2-4 parasympathetic

39

what is the function of the preprostatic sphincter

prevents backflow of semen into the bladder

sympathetic control

40

what contributes to urinary continence in females

bladder neck is above the pelvic floor so the pressure of pelvic organs and levator ani contribute to continence

41

how long is the female urethra

4 cm

42

where is the external urinary sphincter

inferior to the bladder neck
striated muscle

43

what are the four parts of the male urethra

preprostatic- int sphincter
prostatic
membranous -ex sphincter
spongey/penile urethra

44

what is the blood supply of the bladder and urethra

branches of the internal iliac
sup and inf vesical
internal pudendal
branches from adjacent structures

45

what is the venous drainage of the bladder and urethra

vesical and prostatic plexuses converging on internal pudendal and internal iliac arteries

46

what is the lymph drainage of the bladder

internal and external iliac nodes

47

how does prostate cancer spread

communications with the valveless veins of the vertebral plexuses

48

what is the nerve supply of the bladder

S2-4
pudendal nerve
pelvic plexus for ANS

49

how does micturition happen

Parasympathetic to detrusor “switched off”
in spinal cord to allow bladder to relax and
fill
Usual volume (male) about 400 ml, if reach 500 ml – pain in
lower abdomen and perineum
2. “Full”, causes
desire to micturate
Afferents (sensory) to spinal cord, then “M”
Centre in pons – stimulates preganglionic,
parasympathetic neurones at S 2, 3, 4
3. Void
1y neurones stimulate 2y neurones in bladder
wall ganglia, causing detrusor contraction
Simultaneous relaxation of external urethral sphincter (striated
muscle) – pudendal nerve (S 2, 3, 4) and contraction of abdo.
wall; sensation of urine in urethra maintains the reflex

50

where does the left renal artery arise

L1, behind the renal vein

51

where does the right renal artery arise

L2, behind the renal vein

52

what vein does the SMA overlie

left renal vein

53

what part of the duodenum overlies the hilum of the right kidney

2nd, descending

54

where is the pelvis in relation to the renal vessels

behind

55

what is nutcracker syndrome

compression of the left renal vein between the aorta and the SMA
renal venous hypertension and haematuria

56

where does the left suprarenal vein and gonadal vein drain

left renal vein

57

what arterial bifurcation do the ureters pass

common iliac artery

58

what do the ureters lie posterior to

everything except lumbar plexus, common iliac artery bifurcation

posterior to the gonadal vessels and colic vessels

59

what muscle contributes to continence in females

levator ani

60

where is the urethra embedded in females

anterior vaginal wall

61

what part of the male urethra is enclosed by the internal sphincter

preprostatic

62

what part of the male urethra is enclosed by the external sphincter

the membranous urethra

63

where is the micturition centre in the brain

pons