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Metabolism CC > Kidneys + Ureter system > Flashcards

Kidneys + Ureter system Flashcards

1
Q

Kidney location

A

Paravertebral gutters

Only palpable if enlarged or v low body fat

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2
Q

Renal angle

A

Junction of 12th rib and lateral border of erector spinae –> examine for tenderness here

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3
Q

Anterior to kidneys- RIGHT

A 
Liver
Duodenum/small intestine
Right colic (hepatic) flexure
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4
Q

Anterior to kidneys- LEFT

A 
Spleen
Stomach
Pancreas (body or tail)
Left colic (splenic) flexure
Small intestine
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5
Q

Pouch of Morisson

A

Hepatorenal recess
Where u have haemoperitoneum/ascites/pancreatitis
Fluid accumulation

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6
Q

Posterior relations to kidney

A 
Diaphragm- 11th + 12th rib, costodiaphragmatic recess
Psoas major
Quadratus lumborum m.
Transversus abdominis m.
T12- subcostal n
L1- iliohypogastric n, ilioinguinal n
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7
Q

Pararenal fat

A

Adipose tissue superficial to renal fascia

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8
Q

Perirenal fat

A

Fat between renal capsule and renal fascia

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9
Q

Renal Fascia

A

Gerota’s fascia

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10
Q

What is kidney surrounded by

A

Renal capsule

Fibrous

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11
Q

Renal artery in relation to renal vein

A

Renal artery behind renal vein when going into kidney

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12
Q

Ureter into kidney journey

A

Ureter –> Renal pelvis –> Major calyx –> Minor calyx –> renal papilla –> medullary pyramid

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13
Q

What surrounds the medullary pyramid

A

Cortex

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14
Q

Renal arteries

A

1/4 CO (1200ml/min)
Arise at L1/L2
Right renal artery passes posterior to IVC

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15
Q

Renal veins

A

Arise at L2, vertebral level
Left renal vein longer due to IVC position (on RHS of aorta)
Longer left- receives suprarenal and gonadal veins

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16
Q

Where does right renal vein drain into

A

Straight into IVC

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17
Q

Left renal vein

A

Receives left suprarenal + gonadal as longer

Then drains into IVC

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18
Q

Renal artery

A 
Divides at hilum
4/5 segmental arteries
Supply discrete "renal segments"
Gives off inferior suprarenal artery 
Gives off ureteric branch of renal artery
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19
Q

Renal segment arteries

A

Superior segmental artery
Anterior superior segmental artery
Anterior inferior segmental artery
Inferior segmental artery

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20
Q

Lobar arteries

A

1 per pyramid

  • -> arcuate
  • -> cortical radiate
  • -> afferent arterioles
  • -> glomeruli
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21
Q

Interlobar arteries

A

Run up the sides of pyramids

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22
Q

Blood route

A

Renal artery –> segmental artery –> interlobar –> arcuate –> cortical radiating arteries –> afferent arterioles–> glomeruli –> efferent arterioles –> join up with venous supply

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23
Q

T10 + T11 nerve

A

Become Lesser splanchnic

Course towards coeliac ganglion + anterior renal ganglion

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24
Q

T12 nerve

A

Gives least splanchnic nerve

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25
L1 + L2 nerve
Form lumbar splanchnic nerve
26
Pre-aortic ganglion
Sympathetic
27
Renal plexus
Mix of sympathetic and parasympathetic
28
Visceral afferent fibres
Travel through renal plexus | Enter T10-12
29
Lymphatic drainage
Suprarenal kidney --> lumbar lymph nodes Most of kidney + ureter --> lumbar lymph nodes Inferior ureter --> common iliac nodes
30
Ureters
Retroperitoneal | Smooth muscle muscular tubes
31
Ureters passage
Pass over pelvic brim at bifurcation of common iliac arteries Run on lateral walls of pelvis Opposite ischial spine, curve anteromedially
32
Ureters entrance into bladder
Oblique entrance One way flap valve Posterosuperior angles of bladder
33
Ureters muscle
Tri-layered wall
34
Ureter internal layer
Transitional epithelial mucosa
35
Ureter middle layer
Smooth muscle muscularis
36
Ureter outer layer
Fibrous connective tissue adventitia
37
Ureter MOA
Actively propel urine to bladder via response to smooth muscle stretch
38
Kidney pain
Can be referred
39
Pain in groin
Ureter
40
Ureters nerve supply
Visceral afferents enter at T11-L1/2
41
Ureters loin pain
Referred along ilioinguinal and iliohypogastric (L1)
42
Ureter pain as stone descends
Pain descend over groin and scrotum/labium majora FROM LOIN TO GROIN --> changing nerve segments --> pain now referred through genitofemoral (L1,2)
43
Urinary bladder
Retroperitoneal on pelvic floor | Posterior to pubic symphysis
44
Bladder in children
Slightly higher
45
Bladder in distension
Extend up into abdominal cavity | More at night
46
Urine accumulation
Bladder expands | No significant rise in internal pressure
47
Bladder wall layers
Transitional epithelial mucosa Thick muscular layer- Detrusor Fibrous adventitia
48
Trigone
Triangular area outlined by openings for ureters and urethra | --> infection
49
Internal urethral sphincter (males)
Involuntary sphincter at bladder-urethra junction | --> prevents retrograde ejaculation
50
External urethral sphincter
Voluntary sphincter surrounding urethra as it passes through urogenital diaphragm
51
Levator ani muscle
Voluntary urethral sphincter
52
Female urethra
Tightly bound to anterior vaginal wall | External opening lies anterior to vaginal opening and posterior to clitoris
53
Male urethra
Double curvature | 4 sections - intramural, prostatic, intermediate and spongy
54
``` Intramural urethra (pre-prostatic) MALES ```
Length varies on bladder filling
55
Prostatic urethra | MALES
Contains ejaculatory ducts
56
Intermediate (membranous) urethra | MALES
Penetrates perineal membrane | Surrounded by external urethral sphincter
57
Spongy urethra | MALES
Final part in corpus spongiosum of penis
58
Distension of bladder initiates...
Spinal (visceral afferents)
59
Micturition- Sympathetic
``` Hypogastric nerve T12-L2 Stimulate contraction (closure) of internal urethral sphincter Inhibit detrusor muscle (doesn't contract + stops bladder emptying) ```
60
Micturition- Parasympathetic
S2-S4 Stimulate detrusor muscle to contract Opens internal urethral sphincter
61
Micturition- Somatic
External urethral sphincter | Pudendal - S2-4

Metabolism CC (29 decks)

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