lecture 1: The Kidney and Urinary Tract Flashcards
where is the position of the kidneys`?
- The kidneys are retroperitoneal in the upper abdomen. - The right kidney is usually lower than the left. - Superior pole of right kidney lies on 11th ICS while that of the left sits at the 11th rib. - BOTH hilum lie at the level of L1
which nerves supply the kidney?
The nerves (posterior) that supply the kidneys include: o 11th intercostal and sub-costal nerves. o Iliohypogastric nerve. o Ilioinguinal nerve.
what muscles are related to the kidney?
The muscles that are related to the kidneys include: o The diaphragm. o Transversus abdominus. o Quadratus lumborum. o Psoas Major.
what is present anterior to the kidney?
The right: liver, hepatic flexure and hilus lie BEHIND the 2nd part of the duodenum. ▪ The left: stomach, pancreas, spleen and splenic flexure.
what is the blood supply to the kidney?
- The left renal vein is longer than the right. - The left renal artery is shorter than the right.
what is the organisation of the kidneys?
- The cortex is granular-looking due to random organisation. - The medulla is striated coming down to an apex due to the radial arrangement of the tubules - Each lobe (of the multi-lobed kidney) drains through its OWN papilla and calyx - Each pyramid also receives its own blood supply and ureter branch.
*******draw and label a diagram of the kidney ****
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how are the ureters positioned?
- the ureters run vertically downwards in the lumbar transverse processes’ plane -they also run anteromedially into the bladder - the ureters run anterior to the bifurcation of the common iliac arteries -
which vessels do the ureters take supplies from?
the ureters take supplies from all of the major vessels in the abdomen - renal arterial branch - A testicular or ovarian arterial branch. - Small direct braches of the aorta itself. - External and internal iliac arterial branches
where are the sites of constrictions of the ureter?
1st – Ureteropelvic junction. o 2nd – Pelvic inlet. o 3rd – Entrance to bladder
what might happen at the constrictions of the ureter?
(sites of kidney stone blocks):
how is urine carried?
via peristalsis through a muscle coat
how does the ureter open to the bladder? what does this prevent?
- Urine is transported by peristalsis by smooth muscle walls - Urine is transported by peristalsis by smooth muscle walls
what is the structure of the bladder?
- pelvic organ - triangular pyramid with the apex pointing anteriorly and the base pointing posteriorly - lined by the urothelium
what is the urothelium?
- A 3-layered epithelium with a slow cell turnover. - Large luminal cells form a specialised low-permeability luminal membrane.
*********look and label a diagram of a ureter?
*********
*********look and label a diagram of a bladder?
*********
what happens when the bladder swells?
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
*********what are the two types of urinary sphincters?
- Sphincter vesicae – Internal sphincter (smooth) - Sphincter urethrae – External sphincter (striated).
what is the nature of he internal sphincter?
At neck of bladder. ▪ REFLEX action – to bladder wall tension. • Initiated by 300-400ml. ▪ Controlled PNS
what is the nature of the external sphincter?
In perineum. ▪ VOLUNTARY action – inhibition of nerves. ▪ Tone maintained by somatic pudendal nerves. • S2, S3, S4.
how close are the sphincters in women and men?
In women, these sphincters are VERY close. ▪ In men, these sphincters are further apart.
what is the differences between the reflex control and voluntary control of releasing the bladder?
******* look at diagram
urethra of a female?
- The women’s urethra is very short and so not very significant ( lots of UTIs) - no right angle between the urethra and bladder
