Lecture 18 & 19: The Urinary System Flashcards Preview

CHI 280: Human Anatomy I > Lecture 18 & 19: The Urinary System > Flashcards

Flashcards in Lecture 18 & 19: The Urinary System Deck (33):
0

Renal development

Slide 4
Pro nephrons (1 nephron)
-4th-5th week
-non functional

2nd: Mesonephrons
-degenerating pro nephrons
-10-50 nephrons
-transient
-4th-12th week
-functional

3rd: Metanephros
-one million nephrons
-degenerating mesonephric duct
-5th week onwards
-functional
-permanent

1

Renal development - look at slide 5
What has grown by 12th week?
20th week?
36th week?
24-30 weeks

12th week: kidney functioning (foetus swallowing amniotic fluid and urinates into amniotic cavity
20th week: branching of collecting ducts complete, 1/3 of nephrons formed
36th week: nephrogenesis complete
Born 24-30 weeks: reduced nephron number, limited post-natal nephrogenesis
Implications for adult disease: reduced nephron number ➡ high blood pressure

2

Surface anatomy. We're are the kidneys located

Posterior abdominal wall
-extend from vertebral level T12-L3
-superior poles of kidneys deep to ribs 11 and 12
-inferior pole of right kidney 1 fingers width superior to iliac crest
Why is the right kidney lower than the left? Because of the liver

Slide 7

3

What protects the posterior aspect of the Superior poles of the kidneys from ribs?

Kidneys are deep to the posterior abdominal wall muscle in what region?

The diaphragm

Hypochondrium regions

4

Why is there so much fat surrounding the kidneys?

It acts as a layer of protection and cushioning
Look at slide 9

5

Renal fascia is continuous superiorly with fascia lining on the inferior surface of the diaphragm.
What affect with respiration have on the kidney?

Don't know brutha will have to find out
Slide 10

6

What is the average renal mobility during forced expiration and during quiet respiration

4cm
1cm

7

Kidneys are RETROPERITONEAL true/false?

True

8

Learn the diagram on slide 13
Ureter passes anterior to?
Left ovarian/testicular vein drains back to?
Other retroperitoneal structures drain back to?

Ureter passes anterior to? Psoas major muscle and external iliac blood vessels
Left ovarian/testicular vein drains back to? To left renal artery
Other retroperitoneal structures drain back to? IVC

9

Learn the cadava diagram on slide 14

Do it homie G

10

Which is most to least anterior?
Renal artery, renal vein, renal pelvis?

Renal vein➡ renal artery➡ renal pelvis
Slide 15

11

What vertebral level does the renal blood vessels lay?

L1
Learn slide 16

12

What provides blood supply to the bladder?

Via the superior and inferior vesical arteries which branch from the internal iliac arteries
Slide 17

13

Be able to label the diagram of cadaver on slide 18

Do it

14

Posterior abdominal wall
The paired renal arteries branch from abdominal aorta at vertebral level _____ posterior to ______

Transpyloric line, which pancreas traverses, is also at vertebral level_____

The paired renal arteries branch from abdominal aorta at vertebral level (L1)_____ posterior to ______(pancreas)

Transpyloric line, which pancreas traverses, is also at vertebral level_____(L1)
Slide 19

15

Gross anatomy. Label slide 20 and 21

Doooo it

16

Microscopic anatomy slide 22 label,
Nephron= functional unit of kidney

Yee

17

Functional anatomy of the kidney. Slide 23
Glomeruli are located in____
Tubules extend in______
Tubules drain to_______
Collecting ducts form _____that drain filtrate (urine) into ______

Glomeruli are located in____(cortex)
Tubules extend in______(medulla)
Tubules drain to_______(collecting ducts)
Collecting ducts form ____(renal pyramids)_that drain filtrate (urine) into ______(minor calyces)
Minor➡major calyces➡ renal pelvis ➡ ureter

18

Renal innovation

The renal plexus travels along the renal artery
-carries mixed sympathetic and parasympathetic fibres from lesser and least thoracic and first lumbar splanchnic nerves.
Sympathetic fibres are vasomotor and modulate the diameter of renal arterioles to regulate renal blood flow.

19

Renal innervation
Parasympathetic?

Sympathetic?

Parasympathetic:
-vagus nerve to kidneys
-pelvic splanchnic nerves (S2-S4; not part of sympathetic trunk) to distal ureters

Sympathetic:
-lesser and lest thoracic splanchnic nerves to kidneys, proximal ureters.

20

Renal stones (calculi)
Location?
We're abouts?
We're does the pain radiate?
Pain distribution reflects pathway of _____?

-located in kidney or within ureters
-usually at points of relative constriction
A) junction of ureters and renal pelvis
B) where they cross external iliac artery and pelvic brim
C) were they pass through bladder wall

Pain can radiate from "loin to groin"
Pain distribution reflects pathway of visceral afferents (triggered by distended ureter) that course to spinal cord levels T11-L1 via the sympathetic splanchnic nerves.
Slide 27

21

Peritoneal reflections. Explain them

The pelvic peritoneal reflections are boundaries between extra peritoneal structures and the peritoneal cavity. The peritoneal reflections over the pelvic organs, vessels, and ligaments define the peritoneal pelvic recesses.

Peritoneal reflections:
-abdominal peritoneum reflects onto superior surface of pelvic
-loose attachment to anterior abdominal wall to allow movement of bladder

22

Females peritoneal reflections

-reflects from bladder to body of uterus forming vesico-uterine pouch.
-reflects from vagina into rectum forming recto-uterine pouch (pouch of Douglas)
-uterine tubes, ovaries and body of uterus superior to pelvic pain line. Cervix and vagina inferior to pelvic pain line

23

Male peritoneal reflections

Reflects from bladder and seminal vesicles onto rectum forming recto-vesical pouch.

24

Pelvic pain line. Don't really understand the pelvic pain line
Slide 31
Superior to the line visceral afferent fibres follow sympathetic fibres back to_____
Inferior to the line: visceral afferent fibres follow parasympathetic fibres back to _____
Referred pain to the dermatomes ➡
We're do you feel ovulation pain?
Where do you feel pain after a Pap smear?
Ectopic pregnancy pain?

Pelvic pain line.
Superior to the line visceral afferent fibres follow sympathetic fibres back to_____(T12-L2 spinal cord)
Inferior to the line: visceral afferent fibres follow parasympathetic fibres back to _____(S2-S4 spinal cord)
Referred pain to the dermatomes ➡
We're do you feel ovulation pain?
Where do you feel pain after a Pap smear?
Ectopic pregnancy pain?
Don't knowww

25

Urinary bladder
Posterior to?
Healthy bladder can store how much urine?
Were does it sit when empty and were full?
The superior surface is covered by the______
Has a strong muscular wall called____which is innervated by____
Inner layer of wall is cover by?

Urinary bladder
Posterior to? Pubic symphysis when empty
Healthy bladder can store how much urine? 500ml
Were does it sit when empty and were full?
Empty: in pelvis
Full: superior to pubic bones when full (can reach umbillicus)
The superior surface is covered by the______(peritoneum)
Has a strong muscular wall called____(detrusor muscle) which is innervated by____sacral visceral afferent neurons?
Inner layer of wall is cover by? Mucous membrane

26

Walls of bladder composed chiefly of the ____
What muscle contracts during ejaculations to prevent semen entering bladder?
What is the trigone of the bladder? Slide 33

Walls of bladder composed chiefly of the ___(detrusor muscle)_
What muscle contracts during ejaculations to prevent semen entering bladder? Muscle fibres form the involuntary internal urethral sphincter contracts
What is the trigone of the bladder? Slide 33
Smooth triangular portion of the bladder wall formed by the 2 ureter openings and the urethra. Mesodermal origin

27

Male urinary bladder slide 34 and 35 memorise

Internal urethral sphincter= smooth muscle (detrusor m.)
-involuntary
-controlled by ANS
External urethral sphincter
=skeletal muscle (levator ani m.)
-voluntary
-controlled by somatic nerves

28

Female urinary bladder slide 36 memorise

External urethral sphincter only = skeletal muscle (levator ani m.)
-voluntary
-controlled by somatic nerves

29

Slide 37: distension of the urinary bladder. Know how to label it

H

30

Innervation of the bladder

-inferior hypo gastric plexuses
-sympathetic fibres from IML at L1/L2
-parasympathetic fibres from S2-S4 via pelvic splanchnic nerves.
-afferent sensory fibres travel back along the pelvic splanchnic nerves

What information are these sensory fibres going to send to the CNS

31

Urination needs 3 things to occur simultaneously: what?

1. Detrusor muscle (smooth) to contract
2. Internal urethral sphincter (smooth) to open
3. External urethral sphincter (skeletal) to open

Autonomic and voluntary control! Except for young children

32

What happens when you decide to pee?

Parasympathetic stimulation, sympathetic inhibition = detrusor m. Contracts, interval sphincter relaxes and opens (in males only), voluntary relax levator ani m. To open external sphincter

Not to pee, too busy:
Reduced parasympathetic stimulation, increase sympathetic stimulation, increase nerve activity to lavator ani.m (via pudendal nerve S2-S4) to keep it contracted...more urine accumulates.