Gross Anatomy Of Kidney Flashcards
(30 cards)
Why is left kidney slightly higher than right kidney?
Because of presence of liver on right
Lateral branches of abdominal aorta
1st - Inferior phrenic artery
2nd - Middle suprarenal artery
3rd - Renal artery
4th - Gonadal artery
Where do right and left renal vein drain?
IVC
Which is longer right or left renal vein?
Left renal vein
Which is longer right or left renal artery?
Right renal artery
Which artery aneurysm blocks left renal vein?
Superior mesenteric artery aneurysm
Tributaries of left renal vein
Ureteric vein
Adrenal vein
Gonadal vein
Single kidney GFR can be calculated by what scan?
Tc99 DTPA scan
What are all the anastomosis done to donor kidney and recipient body?
Donor ureter to recipient bladder
Donor renal artery to recipient internal/external iliac artery
Donor renal vein and recipient external iliac vein
In which quadrant the donor kidney placed in ?
Right iliac fossa
Adrenelectomy is done in anterior/posterior approach?
Posterior approach
(Laproscopic retroperitoneal adrenelectomy)
Nephrectomy is done in anterior/posterior approach?
Anterior approach
How many major calyx and how many minor calyces are present in kidney?
Major 3 - 4
Minor 9 - 12
Most vulnerable part of medulla
Papilla because it has very low blood supply
They are easily detached and can be excreted in urine —— papillary neceosis
What is an uncomplicated UTI ?
Cystitis of healthy, sexually active, young, adult, woman
Other all UTI are complicated
What is investigation protocol for complicated uti?
- USG abdomen (to look out for some causes) if those causes are ruled out then we consider acute pyelonephritis
- Give treatment for pyelonephritis
- If infection not subsided then take cect to rule out papillary necrosis and renal abscess
What will you rule out in USG abdomen if complicated uti is present?
- Obstruction
- Emphysematous pyelonephritis
- Pelvicalyceal abnormalities
If these conditions are ruled out then we will start treating for acute pyelonephritis
Treatment for acute pyelonephritis
1) Amikacin (but it has a S/E of nephrotoxicity so not used now regularly)
2) Cefoperazone Sulbactam 1.5mg iv bd
3) piperacillin tazobactam 4.5g iv qid
How can you ensure that contrast material used in ct is not toxic to kidneys ?
These contrast material are low volume and ISO osmolar
What are all the cect features of papillary necrosis ?
1) Slightly enlarged kidneys
2) Thickened infundibulum and ureter
3) Patchy hypodensities
Causes for papillary necrosis
Complicated UTI in diabetic nephropathy
Analgesic nephropathy (Phenacetin + Aspirin + Caffeine———- CKD
Snake bite
Sickle cell anemia
Types of papillary necrosis
1) Medullary type
2) papillary type
What are Medullary type of papillary necrosis ?
1) Central erosion type
2) Central erosion with ball on tree appearance
Finally resulting in Calyceal blunting
What are papillary type of papillary necrosis ?
1) Unilateral forniceal erosion
2) Bilateral forniceal erosion with lobster claw appearance
3) Necrotic papillae retained in calyx after sloughing
Finally resulting in Calyceal blunting
