What plane does the hilum of the kidneys lie on?
Transpyloric
What is the transpyloric plane a surface marking for?
Pylorus of stomach Neck of pancreas 2nd part of duodenum, duodenojejunal flexure Hilum of kidneys Origin of portal vein Start of superior mesenteric artery Termination of spinal cord Midway between jugular notch and pubic symphysis
Where is the transpyloric plane?
L1 vertebral level, crosses tip of 9th costal cartilage
What is the function of the fascial coverings of the kidney?
Afford the kidneys with protection
What are the components of the fascial coverings of the kidney?
Renal fascia, perinephric and pararenal fat
What does the renal fascia surround?
The kidneys and suprarenal glands
Where does the pararenal fat lie?
Outside of the renal fascia
What does the renal capsule cover?
The outside of the kidneys
What are the anterior relations of right the kidney?
Suprarenal gland Liver Duodenum Colon Jejunum
What are the anterior relations of the left kidney?
Suprarenal gland Spleen Stomach Pancreas Left colonic flexure Small bowel
What are the posterior relations of the kidneys?
Diaphragm
Psoas major
Quadratus lumborum
How do the kidneys move with respiration?
Move down with inspiration and up with expiration
Is the kidney retroperitoneal or intraperitoneal?
Retroperitoneal
What is the basic histology of the renal cortex?
Renal corpuscles
Proximal convoluted tubes - cuboidal and microvilli
Distal convoluted tubules - cuboidal
Collecting tubule - cuboidal
What is the basic histology of the renal medullar?
Proximal convoluted tubules
Distal convoluted tubules
Loop of Henle - thin segment, squamous epithelium
Collecting tubule
What is the basic histology of the ureter?
Transitional epithelium Star-shaped lumen Inner longitudinal smooth muscle Outer circular smooth muscle Stops back flow of urine
What is the basic histology of the bladder?
Transitional epithelium
Inner longitudinal smooth muscle
Middle circular smooth muscle
Outer longitudinal smooth muscle
What is the vertebral level of the kidneys?
T12-L3
The right kidney lies slightly lower than the left due to the liver
What are the renal arteries branches of?
The abdominal aorta
What are the segmental arteries branches of?
The renal arteries
What are the five branches of the segmental arteries?
Superior Inferior Anterior superior Anterior inferior Posterior
Where do the arcuate branches pass?
Around the circumference of the kidneys
What branches supply each nephron?
Interlobular
Where do the renal veins drain?
Into inferior vena cava
Where is the lymphatic drainage of the kidneys?
Via the lateral aortic lymph nodes
What is the nerve supply of the kidney?
Renal plexus
Sympathetic T10-L2
Sensory afferent T10-T12
What is the functional unit of the kidney?
The nephron
What are the components of the nephron?
Renal corpuscles and renal tubules
What component of the nephron contains the glomerulus and Bowman’s capsule?
Renal corpuscles
What are the components of the urinifeous tubule?
Nephron and collecting duct
Where does unfiltrated blood enter the nephron?
Through afferent arterioles
How is purified blood returned to the system?
Via the renal veins
In how many places are the ureters constricted?
3
What are the places of constriction of the ureters?
First - origin, where the ureter passes over the inferior renal pole
Second - pelvic brim, where the ureter crosses over the external iliac vessels
Third - vesico-ureteric junction, where the ureter traverses the bladder wall
(there may also be a possible constriction where the ureter passes behind the testicular or ovarian veins)
What arteries supply the ureters?
Renal
Ovarian/testicular
Abdominal aorta
Where is the venous drainage of the ureters to?
Renal and ovarian/testicular veins
What surface of the bladder is peritonised?
Superior surface only
What arteries supply the urinary bladder?
Branches of internal iliac artery
What is the venous drainage of the urinary bladder?
Drainage into the internal iliac veins
What is the lymphatic drainage of the urinary bladder?
Suprapubic part drains into external iliac lymph nodes
Infrapubic part drains into internal iliac lymph nodes
What is the nerve supply to the urinary bladder?
Sympathetic T11-L2
Parasympathetic S2-S4
Afferent sensory from parasympathetic
Somatic - pudendal nerve
What is the length of the female urethra?
About 4cm
What are the features of the female urethra?
Females don’t have an internal urethral sphincter but do have the external urethral sphincter
What are the parts of the male urethra?
Preprostatic/intramural
Prostatic
Intermediate membranous
Spongy/penile
What is the widest part of the male urethra?
Prostatic
What is the narrowest part of the male urethra?
Membranous
What is the longest part of the male urethra?
Spongy
What are the features of the male urethra?
Involuntary
- internal urethral sphincter
- smooth muscle
- constricted by sympathetic nerves
Voluntary
- external urethral sphincter
- skeletal muscle
- somatic innervation
What are the features of the prostatic urethra?
Ejaculatory duct opens into the prostatic urethra
Vas deferens and seminal vesicle join together to form ejaculatory duct
Vas deferens carries sperm from testes
Prostatic opening in prostatic urethra
Which nerves constrict the detrusor muscle during micturition?
Parasympathetic nerves
Which nerves constrict the internal urethral sphincter during ejaculation?
Sympathetic nerves
What is the vertebral level of the transpyloric plane?
T12/L1