Give the bony landmarks of the upper and lower poles of the kidneys
Left Kidney: T11-T12 → L2-L3
Right Kidney: T12 → L3-L4
At what vertebral level would you find the hilum of the kindeys?
L1
Where are the kidneys postioned in relation to the peritoneum?
They are retroperitoneal
What is the normal width and legnth of the kidney?
6-7 cm wide
9-14 cm long
With regards to legnth and width, under what circumstances might you want to investigate the kidney?
- >2 cm difference between Left and Right
- Renal legnth <8cm
What is the renal angle?
The angle between the 12th rib and Erector Spinae muscle where the kidney can be palpated
Describe the layers of fat and fascia that surround the kidney
- Kidney surrounded by capsule
- Surrounded by Perirenal fat
- Surrounded by renal fascia (Garota's fascia)
- Surrounded by Pararenal fat
What is the function of the renal fat and fascia layers?
Keep the kidneys in anatomical postion as there are no ligaments keep them in place
What is the typical legnth and diameter of a ureter?
- 25-30cm long
- 1.5mm diameter
How can the ureter be divided into 3 segments?
- Abdominal (proximal)
- Pelvic (middle)
- Intramural (distal)
What is the most common area for the ureter to be injured?
at the pelvic brim or between L4 and L5
What is the Vesicular Uretal Junction
The Junction where the ureter enters the bladder and coalesces with the detrusor muscles
How is urine reflux prevented in the bladder?
- Ureter passes diagonally though bladder wall
- destrusor muscle forms a flap to stop reflux
- this has nothing to do with sphnicters
What kind of epithelium is the lumen of ureter, bladder and pelvis of the kidney lined with?
Urothelium
What is the trigone of the bladder?
- Triangular area of smooth muscle in the bladder
- Formed between the 2 ureteric openings and the internal urethral orifice
What is the difference in legnth between male and female urethras?
- Female: ~4 cm
- Male: ~ 15 cm
Label the strucutures of the male urethra
Label 1-5 on the female urethra
Identify 1-7 on this cross section of the kidney
- Renal Pelvis
- Medulla
- Cortex
- Renal Pyramid
- Renal lobe
- Minor Calyx
- Major Calyx
What are the 2 broad categories of nephron and what are the main differences betweent them?
-
Cortical (90% of nephrons)- short loop of Henle
-
Juxtamedullary (10% of nephrons)- longer loops of Henle
Describe the landmarks for the renal vessels
- Renal artery arises directly from abdominal aorta
- Renal vein has to pass over the aorta and under the superior mesenteric artery to reach the IVC
Name the different types of artery found in the kidney and their anatomical postion
-
Renal artery - enters via hilum
-
Segmental artery (x5)- branch off renal artery
-
Interlobar artery- between the pyramids
-
Arcuate artery- between cortex and medulla
-
Interlobular- within the cortex of lobe
From the hilum describe the course of the ureter until it enters the bladder
- From hilum, enter abdomen through anterior surface of psoas major
- Crosses brim of pelvis at sacro-iliac join and enters the pelvic cavity
- Crosses the bifurcation of the common iliac
- Moves transversely towards bladder at level is ischial spine
List 3 common sites where renal stones can lodge due to non-uniformity of ureter lumen diameter
