kidney and urinary tract

Question 1

The Kidneys

§ The kidneys are retroperitoneal in

Answer 1

The Kidneys

§ The kidneys are retroperitoneal in the upper abdomen.

Question 2

each kidney is surrounded by? and outside?

Answer 2

§ Each kidney is surrounded by a dense fibrous capsule and outside that is a fascial pouch called the renal fascia (containing adipose).

Question 3

which kidney is lower?

Answer 3

§ The right kidney is usually lower than the left.

Question 4

superior pole of right kidney lies on

while the left sits at?

Answer 4

o Superior pole of right kidney lies on 11th ICS while that of the left sits at the 11th rib.

Question 5

both hilum lie at

Answer 5

BOTH hilum lie at the level of L1.

Question 6

The nerves (posterior) that supply the kidneys include:

Answer 6

§ The nerves (posterior) that supply the kidneys include: Relate to below.
o 11th intercostal and sub-costal nerves.
o Iliohypogastric nerve.
o Ilioinguinal nerve.

Question 7

The muscles that are related to the kidneys include:

Answer 7

The muscles that are related to the kidneys include: 
o The diaphragm. 
o Transversus abdominus. 
o Quadratus lumborum. 
o Psoas Major.

Question 8

Blood Supply. Due to the positions of the vena cava and aorta: which side is longer?

Answer 8

Blood Supply
§ Due to the positions of the vena cava and aorta:
o The left renal vein is longer than the right.
o The left renal artery is shorter than the right.

Question 9

The Organisation of the Kidney 
§ The cortex is 
§ The medulla is 
§ Each lobe (of the multi-lobed kidney) drains through
§ Each pyramid also receives

Answer 9

The Organisation of the Kidney
§ The cortex is granular-looking due to random organisation.
§ The medulla is striated due to radial arrangements of tubules.
§ Each lobe (of the multi-lobed kidney) drains through its OWN papilla and calyx (all minor calyxi to one major calyx).
§ Each pyramid also receives its own blood supply and ureter branch.

Question 10

§ The ureters take supplies from all major vessels in the abdomen: which are?

Answer 10

§ The ureters take supplies from all major vessels in the abdomen:
o A renal arterial branch.
o A testicular or ovarian arterial branch.
o Small direct braches of the aorta itself.
o External and internal iliac arterial branches.

Question 11

Constrictions of the ureter include (sites of kidney stone blocks):

Answer 11

Constrictions of the ureter include (sites of kidney stone blocks):
o 1st – Ureteropelvic junction.
o 2nd – Pelvic inlet.
o 3rd – Entrance to bladder.

Question 12

Urine is transported by peristalsis by

How does the ureter prevent backflow

Answer 12

§ Urine is transported by peristalsis by smooth muscle walls.
§ Ureter opens obliquely into bladder – prevents backflow.

Question 13

Bladder Anatomy

Lined by

Answer 13

Lined by urothelium.

Question 14

How many layers of endothelium does the bladder have?

Answer 14

o A 3-layered epithelium with a slow cell turnover.

o Large luminal cells form a specialised low-permeability luminal membrane.

Question 15

what happens if the bladder swells

Answer 15

As ureter runs obliquely in, as the bladder swells (due to corrugated internal membrane), the ureters are pushed back and function as a self-shutting valve.

Question 16

how many holes do women and men have in the inferior peritoneum

Answer 16

Women have 2 holes in the inferior peritoneum (vagina and ureter) while men have 1 (and a prostate).

Question 17

Urinary Sphincters

§ The 2 types of sphincter are? and how do they work?

Answer 17

Urinary Sphincters
§ The 2 types of sphincter are:
o Sphincter vesicae – Internal sphincter (smooth).
§ At neck of bladder.
§ REFLEX action – to bladder wall tension.
· Initiated by 300-400ml.
§ relaxed by parasympathetic NS and contracted by sympathetic

o Sphincter urethrae – External sphincter (striated).
§ In perineum.
§ VOLUNTARY action – inhibition of nerves.
§ Tone maintained by somatic pudendal nerves.
· S2, S3, S4.
opened by voluntary inhibition of nerves
§ In women, these sphincters are VERY close.
§ In men, these sphincters are further apart.
§ Both reflex and voluntary control is stimulated by the stretch receptors

Question 18

why do women have a higher risk of STIs

Answer 18

The women’s urethra is very short and so not very significant – this contributes to the higher prevalence of STIs among women (compared to men).

Question 19

Men have their urethra organised in 7 areas:

+ Helpful Pneumonic:

Answer 19

Men have their urethra organised in 7 areas: Helpful Pneumonic: 
o Internal urethral orifice – bladder neck, bladder outlet. In 
o Prostatic urethra. Prague, 
o Membranous urethra. Men 
o Bulbar urethra. Buy 
o Penile urethra. Prostitutes 
o Navicular fossa. Named 
o External urethral meatus. Emily