Kidneys, Ureters and Suprarenal Glands Flashcards Preview

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Flashcards in Kidneys, Ureters and Suprarenal Glands Deck (41):
1

What is the location of the kidneys

Against post. abd. wall - in paravertebral gutter

T12-L3

Sup. pole of right kidney and inf. part of hilum of left kidney are at the transpyloric plane (L1)

Left kidney is narrower and longer and closer to midline

2

What is the size of the kidney

length: 11cm
Breadth: 6cm
Antero-posterior length: 3cm

150g in males. 135g in females

3

What are the surfaces and borders of the kidney

Superior and Inferior poles
Lateral and medial border (medial has hilum)
Anterior and POsterior Surfaces (Anterior against ant. abd. wall)

4

What is the organisation of structures coming out of the hilum of the kidney

VAP in an anterio-posterior direction
AVP in superior-inferior direction

5

How does the kidney lie in relation to the peritoneum

completely retroperitoneal

6

What are the anterior relations of the left and right kidney from superior to inferior for each

Right Kidney: (sup to inf)
-Suprarenal gland
-Liver
-Duodenum (descending)
-Rt. colic flexure
-Jejunum

Left Kidney: (sup to inf)
-Suprarenal sland
-Somach
-Spleen
-Pancreas
-Colon and Left Colic Flexure
-Jejunum

7

What are the posterior relations of both the left and right kidney

Left:
-Rib XI
-Rib XII

(med to lat)
-Psoas major m.
-Quadratus Lumborum m.
-Transversus Abdominus m.

Right: Same except that not the XI'th rib

8

Where does the Renal Fascia originate?

From the Subserous Extraperitoneal Fascia

9

What does the Renal Fascia split into and what does each part cover?

Anterior Layer:
-Continues over renal vessels and aorta to join opposite layer

Posterior Layer:
-Anterior to Transversalis Fascia which is on Quadratus Lumborum and Psoas Major
-Continues to join opposite layer

10

Where does the Peri-renal (perinephric) fat lie?

Between surface of kidney capsule and renal fascia. This is the Space of Gerota.

11

Where does the Para-renal (paranephric) fat lie?

Posterior to Renal Fascia.
More extensive and fibrous in new-borns than adults.

12

How many medullary pyramids does the cortex of the kidney have?

8-18

13

Explain urine drainage in kidney

Pyramid
Renal Papillae
Minor Calyces
Major Calyces (2-3 Minor Calyces)
Renal Pelvis

14

What is the function of the renal columns

To support the renal vessels and tubules

15

What is the blood supply to the kidneys? Where does it originate

Renal arteries
Originate at the Abdominal Aorta at L1 and/or L2

16

What are the relations of the Left and Right Renal arteries

Left RA:
-Post. to renal vein
-post. to pancreatic body
-post. to splenic vein
-IVC crosses the left RA anteriorly

Right RA:
-Longer than left RA
-Post to IVC
-Post to renal vein
-Post to head of pancreas
-Post to descending duodenum

17

Where do the renal veins drain into?

IVC

18

What are the relations of the left renal vein? What is this significance?

Crosses anterior to Aorta and posterior to SMA
Opens into IVC above the right vein

19

What are the tributaries of the Left and Right Renal Veins?

Left:
-Left Inferior Phrenic v
-Left Testicular (or ovarian) v
-left Suprarenal V

Right:
-No extra-renal tributaries

20

What are the 5 segmental arteries branching off from each Renal Artery

Superior (apical)
Anterosuperior
Anteroinferior
Inferior
Posterior

21

What is the lymphatic drainage of the kidneys

Lateral aortic lymph nodes

22

What is the innervation of the kidneys

Renal plexus (arising from the celiac plexus

23

What is the significance of the SMA with the rising of the kidneys during embryological development?

If kidneys dont separate properly, the kidneys can be prevented from rising due to the SMA origin stopping it

24

How long are the suprarenal glands?

4cm long

25

How do the left and right suprarenal glands vary in position?

Right one is close to IVC, left is away from aorta

26

What are the relations of the suprarenal glands

Related to superior pole of kidneys

Lower part of left gland is covered by pancreas, upper is related to stomach

Greater part of right gland is related to caudate lobe of liver and the superior recess of omental bursa

27

What is the arterial supply to the suprarenal glands

Superior suprarenal artery (from Inferior Phrenic Artery)
Middle suprarenal artery (from Aorta @L1)
Inferior suprarenal artery (from Renal Artery)

28

What is the venous drainage of the suprarenal glands

Right:
-Directly into IVC

Left:
-Left Renal Vein and then into IVC

29

What is the size of the ureters

25-30cm long
3mm in diameter

30

What is the origin of the ureters

Renal pelvis (at level of L1)

31

What is the relationship of the ureters to the peritoneum

Retroperitoneal in its enitre course

32

What are the relations (crossings) of the ureters

Crossed by vas deferns in males.
Crossed by uterine artery in females

33

What are the clinical implications of the ureters during surgery

Can be damaged as they are closely adhered to the posterior abdominal wall.

Uterine Artery runs close so many surgeons clamp the ureter by mistake instead

34

What are the relations of the ureter in the pelvic cavity in males

Ant to interal iliac artery

Medial to Obturator, Inferior vesical and Middle rectal arteries

At lower part of sciatic notch, turns to reach the lateral angle of the urinary bladder

Anterior to seminal vesicles but crossed above and anteriorly from lateral to medial by the vas deferens

35

What are the relations of the ureter in the pelvic cavity in females

Anterior to internal iliac artery

Posterior boundary of ovarian fossa

Related to uterine artery at medial part of broad ligament. The uterine artery lies superior and crosses the ureter anteriorly on the medial side

Ureter runs medially and anteriorly on lateral aspect of cervix of uterus and upper vagina

36

Where are the three ureteric constrictions

At the Ureteropelvic junction. Here, the renal pelvis narrows to form ureter.

At the pelvic brim as it crosses the common iliac vessels

At the Ureterovesical Junction. Here is enters the bladder

37

What is the arterial supply of the ureters

Ureteric Branches From

-Renal Artery (proximal end)
-Gonadal Artery (at intermediate part)
-Int. Iliac A (sup. and Inf. Vesical branches --- at the distal part)

38

What is the venous drainage of the ureters

Same as arterial supply

39

What is the Lymphatic drainage of the ureters

Lumbar LN (superior)
Iliac LN (middle)
Internal Iliac LN (inferior)

40

What is the nerve supply of the ureters

-Lesser and Lower splanchnic nerves

-Renal plexus

-Aortic plexus

-Superior and |nferior Mesenteric plexuses

41

What is hydronephrosis and what is is caused by

Dilation of part above the renal pelvis and calyces.

Caused by kidneys stones