L16 – Anatomy of the Kidneys, Ureters and Urinary Bladder Flashcards Preview

MBBS I CPRS > L16 – Anatomy of the Kidneys, Ureters and Urinary Bladder > Flashcards

Flashcards in L16 – Anatomy of the Kidneys, Ureters and Urinary Bladder Deck (81):
1

Where are the kidneys located?

Retroperitoneum= posterior to parietal peritoneum

Upper border= T12
Lower border = L3

2

What 2 types of nodes are for draining the posterior abdominal wall?

Pre-aortic nodes

Lateral aortic nodes

3

Which nodes drain lymph from kidneys, supraadrenal glands, testes, ovaries? What does the efferent lymph of these nodes form?

Lateral aortic nodes: common iliac nodes

Efferent lymph forms right and left lumbar trunk

4

What does the lateral lumbar trunk drain into until BCV?

lumbar/ para-aortic nodes+ lateral Aortic nodes > cisterna chyli > thoracic duct > BCV

5

Where does the blood supply of kidney comes from?

Renal A/V arise from abdominal aorta

6

What is the consequence of the location of the inferior vena cava on the length of renal veins?

Left renal vein is longer than right renal vein because inferior VC is located off to the right

7

What is the nerve supply of the kidney?

Renal plexus, autonomic nerves

Consists of T12 (sympathetic) and Vagus (parasympathetic)

8

Why is the right kidney at a slightly different level to the Left?

Due to right lobe of liver being lower

Right kidney is lower than left

9

What is the order of the coverings of the kidney?

(From most outer)

Pararenal fat
Renal fascia
Perirenal fat
Fibrous capsule

10

What is the role of kidney coverings?

Hold in position, structure

11

Where are renal tubules located (Loop of Henle and Collecting duct)? (not including juxtamedullary nephrons)

In the pyramids in renal medulla

12

What are the two layers of the kidney responsible for filtration?

Cortex and Medulla

13

How do the pyramids connect to major calyxes?

Pyramid > Renal papilla > minor calyx > major calyx

14

What structures are found in the hilum of kidney?

Renal A
Renal V
Renal Pelvis

15

How does the minor calyx connect with the bladder?

Minor calyx > Major calyx > Renal pelvis > Uroteropelvic junction > ureter

16

What are the two parts of the gland over the kidneys?

Supraadrenal glands

Adrenal cortex (outer) and Adrenal medulla (inner)

17

What are the functional role differences between renal medulla and renal cortex?

Cortex = filtration role

Medulla = urine concentration role

18

What structures are found in the renal cortex?

parts of juxtamedullary nephron and cortical nephron

19

Where do renal veins drain?

At level of L2, drain into Inferior VC

20

What is located anterior to right kidney?

2nd descending part of duodenum

21

What is antero-lateral to right kidney?

Right Colic Fissure

22

What is inferior to right kidney?

Small intestines

23

Inferior to L. kidney?

Jejunum

24

What is anterolateral to left kidney?

Descending colon

25

What is anterior to left kidney? (4)

Stomach
Spleen
Pancreas
Left colic fissure

26

What muscle is posterior to kidney?

Quadratus Lumborum muscle

27

Suprarenal glands. Artery supplies?

3 artery supplies:
Superior: Branch of Inferior phrenic artery (from abdominal aorta)

Middle: Branch of abdominal aorta

Inferior: Branch of Renal artery

28

Veins of suprarenal glands?

Right= inferior VC

Left = Left renal vein

29

Nerves of suprarenal glands?

Sympathetic only

T5-T9

30

Lymphatic drainage of suprarenal glands?

Lateral aortic/ lumbar nodes

31

Ureter has three physiological narrowings. Name each in sequence.

Uretopelvic junction (where renal pelvis joins ureter)

When ureters cross pelvic inlet

Uretovesical junction/ entrance to bladder

32

Why condition is common at the physiological narrowings of the ureter?

obstruction due to uretero stones

Severe nonspecific pain when ureter smooth muscle contracts

33

Ureter blood supply divided into three parts. Name each?

Upper = renal A/V

Middle= Gonadal A/V

Pelvic= Vesical A/V

34

What are the nerve supplies of ureter?

Renal, testicular and hypogastric plexuses

35

What is the lymphatic drainage of ureters?

Lateral Aortic/ lumbar nodes

36

What is the difference in the gonadal A/V supplying middle ureter between two genders?

Male = testicular A/V

Female= ovarian A/V

37

Where does vescial A/V supplying pelvic (lower) ureter come from?

From internal iliac artery branching from aorta

38

What structure lies adjacent to ureter in male and female?

Male = Ductus deferens anterior to ureter

Female = uterine arteries is anterior

39

During a surgical removal of uterus, what may be accidentally ligated?

The ureter instead of the uterine artery

Cause no renal output and enlargement of abdomen

40

What are the three components to the pelvic inlet?

Margin of Ala -formed by S1 bone, up to sarco-iliac joint

Promontory (body) -formed by protrusion of S1 bone

Linea terminalis

41

What forms Linea terminalis ? (3) (PPA)

From medial to lateral:

Pubic crest
Pecten pubis
Arcuate line

42

What is the clinical significance of the Pelvic inlet?

Important for determining the first stage of labour



Fetal distress if inlet is too small and fetus forces into pelvis

43

What are the three bones that form the Pelvis?

Ilium
Ischium
Pubis

44

Where do the three pelvic bones join?

Acetabulum, head of femur is located there

45

Diagonal conjugate vs Obstetrical conjugate

How are they measured?

Obstetrical conjugate / true conjugate only measured by X-ray = 11.5cm

Diagonal conjugate > 11.5cm, indirect measurement, ultrasound

46

Which two muscles are attached to the lateral rotator of hip joint?

Piriformis muscle on lateral wall

Obturtator intermus muscle

47

What VAN supplies the adductor muscles of the thigh?

Obturator VAN that passes through obturator canal at the medial side of thigh

48

What two ligaments attached to the lateral rotator of hip joint?

Sacrospinous and Sacrotuberous ligaments

49

What are the components of the Pelvic outlet?

Ischial tuberosity

Pubic symphysis

Ischiopubic ramus

Sacrotuberous ligament

Coccyx

50

How is diagonal conjugate measured?

Mesaure tip of S1 to lower border of pubic bone

51

How is Obstetrical/ True conjugate measured?

Only by X-ray
Actural Anterior-Posterior diameter

52

How does common iliac artery branch?

Into internal and external iliac arteries

53

How does Internal iliac artery further subdivide?

posterior ll ls sg

Anterior and Posterior divisions

Posterior is closer to spine, further divides into:

Iliolumbar, Lateral sacral and superior gluteal arteries

54

How does sacral arteries differ in origin?

Lateral sacral artery is from:
Posterior division on internal iliac artery from common iliac artery

Medial sacral artery is from: Abdominal aorta

55

What are the three divisions of one of the branches of posterior division of internal iliac artery?

Iliolumbar artery branches into iliac, lumbar and spinal branch

56

The ANTERIOR division of internal iliac artery branches into which arteries?

Umb Ob Ves IG MR IP V Uter

MR IP V V U U IG Ob
MR. IP's VERY, VERY OBSESSED with Ur 2 IGs

Umbilical artery

Obturator artery

Superior and Inferior vesical artery

Inferior gluteal (vs superior gluteal in POSTERIOR)

Middle Rectal artery

Internal Pudendal artery

Vaginal artery

Uterine Artery

57

What does the umbilical artery supply?

Bladder

58

What artery supplies the external genitalia?

Internal pudendal artery

Male= dorsal artery of penis

Female = clitoris

59

What does the inferior vesical artery supply?

Ureter and bladder

same as supeior vesical artery

60

What is anterior to the bladder?

pubic symphysis

61

What procedure is done to drain the bladder?

Suprapubic aspiration

Puncture needle above symphysis pubis to drain the bladder

62

What things are posterior to the bladder?

Sacrum
Sacral nerves
Male= rectum
Female= rectum and uterus

63

What is in the wall of the bladder?

Detrussor muscle

64

What is the difference in epithelium in the bladder wall?

Internal = transitional epithelium

External, superior outer portion = serous (parietal) peritoneal layer

65

What part of he bladder is covered by peritoneum?

Only superior portion

66

The peritoneum can reflect/fold in two ways in male and female. How?

Female= Vesico-uterine pouch, space between bladder and uterus

Male= Recto-vesical pouch, space between bladder and rectum

67

What is the sphincter on bladder and what nerve supplies this sphincter?

Sphincter vesicae

Supplied by autonomic NS

68

How is the sphincter fixed in male and female?

Male= Pubo-prostatic ligament

Female= Pubo-vesical ligament

69

What supports the bladder? ***

Urogenital diaphragm (perineal muscle)

Pelvic fascia (inferior)

Medial umbilical ligament (posterior)

Median umblilical ligament (from Urachus, anterior)

70

Trigone is where in bladder?

Triangular area at base of bladder

Lies between urethral orifice and 2 ureteric orifices

71

How is the lining of the Trigone different?

Smooth lining

72

Where is the ureteral fold?

on the superior border of trigone

73

What is the blood supply off the bladder?

Superior and inferior vesical A/V

74

What is the nerve supply of the bladder?

hypogastric plexus

Sympathetic L1-L2

Parasympathetic S2-S4

75

What procedure is done to extract urethral stone?

Transurethral cytoscopy

76

Bladder lymphatic drainage?

Internal and external iliac nodes

77

What structure is found anterior to bladder in male and female?

Male = ductus deferens, seminal vesicle

Female= uterine artery

78

What is the urogenital diaphragm formed by?

Deep transverse perineal body

Supports bladder and prostate

79

How can the male urethra be divided anatomically? (not like in embryology)

Preprostatic part

Prostatic part

Membranous part

Spongy part

80

Which of the two umbilical ligaments attached to the bladder is more anterior?

MEDIAN

81

What is the structure at the tip of the male urethra?

Navicular Fossa

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