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IMED3002 > Anatomy of the ureters > Flashcards

Anatomy of the ureters Flashcards

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1
Q

How long is the ureter?

A

35 - 30 cm

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2
Q

How does the ureter propel urine towards the bladder?

A

Peristalsis

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3
Q

At what spinal level does the ureter arise?

A

Continuous with renal pelvis at L2

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4
Q

Is the ureter intra or retroperitoneal?

A

Retroperitoneal

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5
Q

How is the ureter located using the surface anatomy?

A

Ureter is a straight line 5 cm from the midsaggital plane extending from the L2 vertebra to the posterior superior iliac spine.

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6
Q

Where is the abdominal part of the ureter located?

A

From renal pelvis to bifurcation of common iliac artery

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7
Q

Where is the pelvic part of the ureter located?

A

Pelvic brim to posterior base of urinary bladder

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8
Q

What joint is located near the bifurcation of the common iliac artery?

A

The Sacroiliac joint

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9
Q

Ureter descends along medial border of the ________

A

Psoas major

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10
Q

What structures are located anteriorly to the right ureter?

A

Right testicular/ovarian vessels

Right colic/ileocolic vessels

Root of the mesentery

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11
Q

What structures are located posteriorly to the right ureter?

A

Tips of the transverse processes of the L2 - L5 vertebrae

Right genital femoral N

Right psoas muscle

Bifurcation of right common iliac artery

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12
Q

What structures lie anterior to the left ureter?

A

Left colic vessels

Left sigmoid vessels

Left testicular/ovarian vessels

Root of sigmoid mesocolon

Sigmoid colon

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13
Q

What structures lie posterior to the left ureter?

A

Tips of transverse processes

Left genital femoral nerve

Left psoas muscle

Bifurcation of left common iliac artery

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14
Q

Where do the ureters run at the pelvic brim?

A

Along the lateral pelvic wall parallel to the anterior margin of the greater sciatic notch.

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15
Q

Which direction do the ureters curve when they are opposite the ischial spine?

A

Anteromedially (they curve this direction superiorly to the levator ani)

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16
Q

How are the ductus deferans and the ureters positioned relative to each other?

A

Terminal part of the ureter enters the bladder anteriorly to the point where the ductus deferans enters the seminal vesicle

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17
Q

What structure does the ureter pass above before entering the urinary bladder?

A

The seminal vesicle

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18
Q

Which is more anterior the ureter or the ductus deferans?

A

The ureter

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19
Q

What is the path of the ductus deferens?

A

Passes through inguinal canal and attaches medially at the seminal vesicle

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20
Q

Where do the ovaries lie relative to the ureters?

A

Immediately anteriorly

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21
Q

How are the ovaries related to the ureters?

A

Ureter forms posterior wall of ovarian fossa in which the ovary lies

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22
Q

How do the ureters pass relative to the uterus?

A

The ureter passes laterally to the cervix before it attaches to the bladder then anteriorly to the anterior fornix of the vagina to attach to the nladder

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23
Q

What is the clinical significance of the pathway of the ureters relative to the uterus?

A

Damage to the ureters can occur during a hysterectomy

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24
Q

What structure lies posterior to the ureter at the entrance to the urinary bladder in males?

A

Rectovesical pouch

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25
What structure lies posterior to the ureter at the entrance to the urinary bladder in females?
Anterior fornix of the vagina
26
What structures lie laterally to the ureter in males?
Anterior branches of the internal iliac artery (umbilical, superior and inferior vesical, and obturator artery) Obturator Nerve Obturator Fascia
27
What structures lie laterally to the ureter in females?
Anterior branches of the internal iliac artery SUPERIOR VESICAL ARTERY Obturator artery Uterine artery Obturator N Obturator Fascia
28
What structures lie superior to the ureter in females?
Broad ligament Uterine artery
29
What angle do ureters enter the urinary bladder?
Posterosuperior angle of its base
30
What direction do the ureters enter the bladder?
inferomedially
31
Where is the seminal vesicle located?
posterior to the bladder
32
Where do the ductus deferens run relative to the ureters?
Anteriorly and then superiorly to where the ureters meet the bladder
33
Where are the constrictions of the ureter located?
junction between renal pelvis and ureter at level L2/L3 At the pelvic brim near the bifurcation of the common iliac artery At the entrance into urinary bladder wall
34
How many constrictions does the ureter have?
3
35
At what spinal level does the renal artery arise?
L1/L2 (like the hilum of the kidney)
36
Where does the right renal artery run relative to the IVC?
Posteriorly
37
What structure does the left renal vein pass behind?
The superior mesenteric artery
38
How much blood do the kidneys need?
They require 21% of CO
39
Do renal arteries have anastomoses?
No they are end arteries
40
What is the pathway of blood from heart to the glomerulus and back?
Heart -> Aorta -> renal artery -> Segmental artery -> Interlobular artery -> Arcuate artery -> Afferent arteriole -> Glomerulus -> Efferent arteriole -> peritubular artery and vasa recta -> Interlobular vein +arcuate vein ->arcuate vein ->Interlobular vein -> Renal vein -> IVC -> Heart
41
What are the divisions of the renal artery?
Divides into anterior and posterior divisions just before the hilum. Anterior division divides into 4 segments Posterior division continues to a segment on its own.
42
What are the anterior division's segments?
Superior Anterior superior Anterior inferior Inferior
43
What are the posterior divisions?
Posterior segment
44
What does the blood supply of the abdominal ureter consist of?
Renal artery Gonadal artery Suprarenal artery Vessels from posterior abdominal wall
45
What supplies the pelvic part of the ureter?
Common iliac vessels Internal iliac vessels Inferior vesical vessels
46
What lymphatics drain kidneys?
Lymphatics from kidneys follow renal veins and drain into: Right and Left lumbar lymph nodes Caval lymph nodes Aortic lymph nodes
47
What lymphatics do ureters drain into?
Para aortic lymph nodes
48
What lymph nodes drain superior portion of pelvic part of ureters?
external iliac lymph nodes
49
What lymph nodes drain superior portion of pelvic part of ureters?
internal iliac lymph nodes
50
Where do kidneys get their nerve supply?
Efferent fibres from renal nerve plexus
51
What is the renal nerve plexus composed of?
Sympathetic and parasympathetic nerve fibers
52
Where are the sympathetic nerve fibers that innervate the kidneys from?
T10 - L1 via abdominopelvic splanchnic nerve
53
Where are parasympathetic nerve fibers derived from?
Both vagus nerves
54
Where do visceral afferents from the kidneys go?
Visceral afferents follow sympathetic fibers retrograde to dorsal root ganglia and spinal cord segments (T11 - L2)
55
Where do visceral afferents from the ureters go?
Ureter sympathetic innervation follows pelvic splanchnic nerves to dorsal root ganglia and spinal cord segments (T10 - L2) Ureters are primarily above pelvic pain line
56
Where is the visceral efferent innervation beneath the pelvic pain line from?
S2 - S4 and they follow parasympathetic pelvic nerve
57
Where do kidneys get their parasympathetic innervation?
Vagus nerves
58
Where do ureters get their parasympathetic innervation?
S2 - S4 splanchnic nerves
59
What are stones that accumulate in calices or ureters?
calculi
60
What do calculi do that causes pain to people?
They can block passages and cause swelling and hydronephrosis which results in what is known as ureteric colic
61
Where is ureteric colic referred to?
Can be referred to lumbar or inguinal region
62
What is the functional unit of kidney called?
Uriniferous tubule which consists of nephron, collecting tubule and collecting duct
63
What are the contents of the renal corpuscle?
Glomerulus capillaries Visceral epithelium (podocytes) Parietal epithelium (bowman's capsule)
64
How many nephrons does the typical kidney have?
1.25 million
65
What percentage of nephrons are cortical nephrons?
85%
66
Where are cortical nephrons located?
Right beneath renal capsule
67
What percentage of nephrons are medullary nephrons?
15% of nephrons
68
Where are juxtamedullary nephrons located?
Close to renal medulla and have long loops of henle.
69
What do juxtamedullary nephrons do?
Contribute to kidney's ability to concentrate urine
70
Which nephrons have longer loops of henle?
Juxtamedullary nephrons
71
What are the components of the renal tubule?
Proximal and distal convoluted tubule Loop of henle
72
What is the role of the nephron?
Filter blood Concentrate urine Reabsorb nutrients and water
73
What are the 2 poles of the renal corpuscle?
Vascular pole Urinary pole
74
What are the 2 layers of the bowman's capsule?
Parietal layer Visceral layer
75
What epithelium does the parietal layer of the bowman's capsule contain?
Simple squamous epithelium
76
What cells constitute the visceral layer of the bowman's capsule?
Podocytes envelope capillary tuft
77
What is the capsular space and what is its function?
Capsular space is the space between bowman's capsule and glomerulus which receives filtered liquid filtered through capillary wall and visceral layer.
78
What are the 3 layers of filtration membrane in the renal glomerulus?
Fenestrations of endothelial cells of glomerular capillaries Combined basement membrane Filtration slits between foot processes of podocytes
79
What structural aspect of podocytes makes them so important?
They have foot processes which embrace the capillaries and create small sieve like openings
80
What are the types of processes that podocytes have?
Primary processes which are not in contact with basement membrane Secondary processes that embrace the capillaries Filtration slits which are spaces within interdigitation of secondary processes
81
What is the juxtaglomerular apparatus?
Area of specialized contact between afferent arteriole and the distal straight tubule
82
What are the 3 types of cells in the juxtaglomerular apparatus?
Juxtaglomerular granular cells Macula densa cells Extraglomerular mesangial cells
83
What are juxtaglomerular granular cells?
Modiifed smooth muscle cells in afferent arteriole that are responsible for renin release
84
What are macula densa cells?
Modified epithelial cells of distal straight tubule which contacts the vascular end of renal corpuscle and these cells signal renin release.
85
What are extraglomerular mesangial cells?
Cells located at vascular pole that clear excess debris and trapped residue from basement membrane and they are both phagocytic and contractile.
86
What are the 2 capillary beds associated with nephrons?
Glomeruli and vasa recta
87
Where does the afferent arteriole come from?
Interlobular artery
88
Where does the efferent arteriole go to?
The peritubular capillaries (or vasa recta)
89
Where do peritubular capillaries drain into?
Interlobular veins
90
Where do the vasa recta occur?
juxtamedullary nephrons
91
Do cortical nephrons have vasa recta?
Nope
92
What kind of exchange is there between ascending and descending loop of henle?
Countercurrent exchange of water and solutes
93
What are the alternating regions of the renal cortex?
Cortical labrynth which consists of glomeruli and convoluted tubules Medullary rays which consist of radially directed straight tubules of nephrons and collecting ducts
94
What lines the proximal convoluted tubule?
Cuboid epithelium
95
How many cells on proximal convoluted cross section?
3 - 4 cells
96
What is a feature of the cytoplasm of proximal convoluted tubules? Why?
It is strongly acidophilic because they have lots of mitochondria
97
What structures are unique to the proximal tubules?
The brush border surface with lots of microvilli
98
What type of epithelium does the distal convoluted tubule have?
Cuboidal epithelium
99
How are cells of the DCT different to the PCT?
DCT cells have less microvilli and a flatter surface. Wider lumen 5 - 8 nuclei in cross section instead of 3 - 4
100
What are the 2 parts of the loop of henle?
Descending thick & thin limb Ascending thick & thin limb
101
What is the difference between thick and thin limbs?
Thick epithelium is cuboidal Thin epithelium is squamous
102
What is the collecting/connecting tubule?
Tubular structure that is continuous with the nephron
103
What is the function of the collecting/connecting tubule?
Remaining filtrated is moved through to the collecting duct
104
What is the collecting duct?
Duct that collects urine from several nephrons and filters it through to the minor calyx
105
What tissue type do collecting ducts have?
In the cortex they are lined by simple cuboidal epithelium and at the apex by simple columnar epithelium
106
What are the types of cells in collecting ducts?
Principal cells with sparse short microvilli Intercalated cells with abundant microvilli
107
What happens to principal cells as they approach the renal papillae?
They lengthen
108
What happens to intercalated cells as they approach the renal papillae?
They diminish in numbers
109
What are renal papillae?
The location where the pyramids meet the minor calices
110
Are intercalated discs dark or light staining?
Dark staining
111
What shape is the lumen of the ureter?
Star shaped
112
What are the layers of the ureter?
Lumen Mucosa Muscularis propria Adventitia
113
What are the parts of the mucosa of the ureter made up of?
Epithelium: transitional epithelium (aka urothelium) Lamina propria
114
What layers are not present in the ureter?
Muscularis mucosa Submucosa
115
What are the 2 layers of smooth muscles in ureters and where are they located?
Inner longitudinal and outer circular layer They are located in the muscularis propria
116
How is the lower third of the ureter different to the rest of the ureter?
Lower third contains an additional longitudinal smooth muscle layer
117
What are the components of the adventitia of the ureter?
Dense irregular connective tissue containing blood vessels, lymphatic vessels and nerves
118
What is special about transitional epithelium?
It can contract and expand according to what is required

IMED3002 (46 decks)

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