anatomy of the urinary system

Question 1

where are the kidney’s located

Answer 1

• on the posterior abdominal wall
• retroperitoneal
• from T12-L3
• right kidney is lower due to liver

Question 2

what are abdominal organs related to the kidneys

Answer 2

• adrenal/ suprarenal gland - on top
• liver and small intestine on the left
• jejunum, spleen and stomach on the right

Question 3

what structures hold the kidneys in place

Answer 3

• pararenal fat
• renal fascia - connective tissue anchoring kidney down
• perirenal fat- adipose tissue sitting around kidney

Question 4

what are the structures inside the kindey

Answer 4

• renal capsule
• hilum
• renal sinus
• renal cortex
• renal medulla
• renal papilla
• minor calyx
• major calyx
• renal pelvis
• medullary pyramids

Question 5

what is the renal capsule

Answer 5

thin tough fibrous layer that surrounds the kidney

Question 6

what is the hilum

Answer 6

vertical slit in the medial margin of the kidney where renal vessels, nerves and lymphatics enter

Question 7

what is the renal sinus

Answer 7

continuation of the hilum internally

Question 8

what is the renal cortex

Answer 8

outer continuous pale layer of the kidney

Question 9

what is the renal medulla

Answer 9

inner discontinuous aspect of the kidney

Question 10

what is the renal papilla

Answer 10

• apical projection of the renal pyramids draining the renal tubules

Question 11

what is the minor calyx

Answer 11

receives urine from the papillary ducts that drain the renal tubules

Question 12

what is the major calyx

Answer 12

several minor calyces unti to for 2-3 major calyces

Question 13

what is the renal plevus

Answer 13

funnel shaped superior end of the ureter

Question 14

what is the arterial supply to the kidneys

Answer 14

• renal artery off at L1 and L2 of the abdominal aorta
• enter the renal hilum to supply the renal parenchyma
• also supply the adrenal gland

Question 15

what is the venous drainage of the kidney

Answer 15

• left and right renal veins drain into the inferior vena cava
• anterior to the artery and ureter in the hilum
• left crosses the midline and is at risk of compression between superior mesenteric and aorta

Question 16

what is the innervation of the kidneys

Answer 16

sympathetic and parasympathetic

Question 17

what is the sympathetic supply to the kidney

Answer 17

• least splanchnic nerve (T12)
• decrease urine output
• increases fluid retention
• decreased renal blood flow

Question 18

what is the parasympathetic supply to the kidneys

Answer 18

• vagus nerve (CNX)
• increases urine production
• decreased fluid retention
• increased renal blood flow

Question 19

what are some clinical variations seen to kidneys

Answer 19

• horseshoe kidney
• accessory renal arteries
• kidney transplant

Question 20

what are the ureters

Answer 20

• muscular tubes that transport urine from the kidney to the bladder
• continuous superiorly to renal pelvis at uteropelvic junction
• retroperitoneal

Question 21

how does urine move through the urethra

Answer 21

peristalsis

Question 22

where can kidney stones get stuck

Answer 22

• renal pelvis first constricts
• ureter crosses pelvic brin
• entrance of bladder

Question 23

what is the arterial blood supply of the ureter

Answer 23

renal, abdominal aorta, gonadal, common iliac, internal iliac arteries

Question 24

what are anastomose

Answer 24

blood supply having 2 vessels that connect to each other

Question 25

where is the bladder located

Answer 25

- anteriorly in the pelvic cavity - superior surface entering abdominal cavity when full

Question 26

where do the ureters enter the baldder

Answer 26

top corner of the base

Question 27

what is the blood supply to the bladder

Answer 27

- superior and inferior vesicle - vaginal (women) - branches off obturator and inferior gluteal

Question 28

what is the sympathetic control of the bladder

Answer 28

filling of the bladder and contraction of the internal urethral sphincter

Question 29

what is the parasympathetic control of the bladder

Answer 29

emptying of the bladder and relaxation of internal urethral sphincter

Question 30

what do the muscle do in bladder filling

Answer 30

detrusor muscles relax

Question 31

what do the muscles do in bladder emptying

Answer 31

detrusor muscles contract

Question 32

what is the sympathetic innervation of the bladder

Answer 32

- hypogastric nerve and superior hypogastric plexus - inhibition detrusor muscle - ejaculation causes contraction of urethral sphincter muscle

Question 33

what is the parasympathetic innervation of the bladder

Answer 33

- pelvic splanchnic nerves and inferior hypogastric plexus - motor to detrusor muscle

Question 34

what are the external features of the bladder

Answer 34

- apex (towards pubic symphsis) - fundus/ base - body - neck

Question 35

what is the trigone of the bladder

Answer 35

- triangular area inside the bladder - smooth part of the wall - spans between two ureteric orifices

Question 36

difference in the female urethra

Answer 36

- 4cm long - slightly curves - opens into vestibule at labia minora - more prone to UTIs - internal pudenal and vaginal artery supply

Question 37

differences in male urethra

Answer 37

- preprostatic - porstatic - membranous - penile/ spongy

Question 38

preprostatic male urethra

Answer 38

- surrounded by internal urethral sphincter - self contraction and no control - closes in ejaculation

Question 39

membranous urethra men

Answer 39

- surrounded by external urethral sphincter - extends from prostate to perineal membrane

Question 40

penile/ spongy urethra men

Answer 40

- within corpus spongiosum - many mucus secreting urethral glands

Question 41

changes in catheterisation in men

Answer 41

- longer course with bends - enlarged prostates/ prostatic urethra cause resistance - misplace can cause rupture