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BIOM20002 - HSF > Lecture 62 - Structure of Kidneys > Flashcards

Lecture 62 - Structure of Kidneys Flashcards

1
Q

How big are the kidneys?

A

10 cm long
5 cm wide
2.5 cm thick

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2
Q

Where do the kidneys sit?

A

Against posterior abdominal wall

Anterior surface: peritoneum
Posterior surface: posterior abdominal wall structures

T12 - L3
- they sit either side of these vertebrae

Anterior to the 12th rib

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3
Q

Describe the relationship of the kidneys to the peritoneum

A

Retroperitoneum

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4
Q

Do the kidneys move?

A

Yes
Due to their close relationship to the diaphragm
They move as the diaphragm moves

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5
Q

Describe the differences of the left and right kidneys

A

Left kidney is higher than the right

Due to the liver on the right side

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6
Q

What are paravertebral gutters?

A

The vertebral column punch anteriorally into the abdominal cavity, forming these gutters.

The kidneys sit almost behind the vertebral column in these gutters

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7
Q

What is the best way to access the kdineys during surgery?

A

Through the posterior route

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8
Q

How is the kidney functionally organised?

A

Clusters of secretory cells into:

  • cortex
  • medulla
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9
Q

What are the coverings of the kidney?

A

Serosa

Capsule
- fibrous

Surrounded by fat: perirenal fat

Renal fascia
- surrounds the whole thing

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10
Q

What is the hilum?

A

Entrance of:

Nerves
Vessels
Ducts

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11
Q

Describe the cortex and the medulla

A

Outer, continuous, pale, cortex

Inner, discontinuous, dark, medulla
- pyramids

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12
Q

Describe the renal pyramids

A

Base of the pyramid facing the cortex

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13
Q

What is the vertical slit?

A

The hilum

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14
Q

Describe the plane of the hilum of the kidneys

A

Faces Anteromedially

NB: the kidneys are in the paravertebral gutters

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15
Q

Describe the structure of the hilum.

What is the spatial relationship?

A

Anterior to posterior:

  • Renal vein
  • Renal artery
  • Ureteric pelvis

NB

  • nerves
  • lymphatics
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16
Q

Describe the ureteric pelvis

A

Dilated upper end of the ureter

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17
Q

What is the renal sinus?

A

A fat filled space
Within the kidney
Connects to the hilum

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18
Q

What is the origin of the renal arteries?

A

Paired branches from the abdomical aorta

At the superior mesenteric artery level

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19
Q

What are the three paired arteries that come off the abdominal aorta?

A

Renal arteries
Adrenal arteries
Testicular / ovarian arteries

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20
Q

Describe the relative position of the IVC and the aorta

A

Right side: IVC

Left: aorta

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21
Q

Why are veins always in front of the artery?

A

Arteries are pulsatile

They would compress the vein if they were in front

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22
Q

Into what does the renal artery divide into?

When does this happen?

A

5 segmental arteries

Before entering via the hilum

23
Q

What is the accessory renal artery?

A

The kidneys start development lower down
At this time, they get there blood supply from further down

Sometimes these arteries persist

24
Q

Why does the renal artery split into 5 segmental arteries?

A

This happens with vital organs

If one artery is lost, the rest of the structure can still function.

25
How many functional segments of the kidney are there? | What are the features?
5 functional segments Each has its own artery and vein If there is a problem with one segment, the whole kidney is not lost. - affected segment can be removed be itself
26
Draw the renal segments
:)
27
Which renal vein has to cross over the aorta?
Left renal vein must cross over
28
Where does the renal pelvis sit in the hilum?
Most posterior
29
Describe the shape of the ureteric pelvis
Flattened Funnel shaped --> forming ureter
30
What does the calyceal system do?
Connects the medullary pyramids with the ureteric pelvis
31
What is the structure?
2 or 3 major calyces unite to form the ureteric pelvis 2 or 3 minor calyces unite to form a major calyx Apex of medullary pyramid inserting into the minor calyx
32
Describe the heirarchy of structures in the kidney
``` Collecting duct Minor calyx Major calyx Ureteric pelvis Ureter ```
33
Describe the location of the ureters
(Retroperitoneal) 4 points: 1. On posterior abdominal wall 2. Pass over pelvic brim 3. Side wall of pelvis 4. Approach bladder from behind
34
How long is the ureter?
25-30 cm
35
What do we always see in muscular tubes?
Normal narrowings at: - beginning - end eg. - oesophagus - ureter
36
Where would kidney stones likely get lodged?
1. Pelvi ureteric junction (PUJ) - narrowing of the ureter at the beginning 2. Crossing of pelvic brim 3. Crossing bladder wall
37
Where do the ureters get their blood supply?
Serial blood supply at all different levels Pick up their blood supply from the region its passing through No single blood supply
38
Where is the bladder located?
When empty: deep in the pelvis When full: pushes up into abdomen
39
What is the shape of the bladder?
Pyramid tipped forwards Base of the pyramid pointing posterior Apex of pyramid pointing anterior
40
Where do the ureters enter the bladder?
Posterior aspect of bladder
41
Where does the urethra exit the bladder?
Posterior aspect of the bladder
42
Describe the internal surface of the bladder
Detrusor muscle - Irregular muscular ridges Apart from Trigone - smooth
43
Describe the wall of the bladder
Thick muscular wall
44
What happens at the trigone? Draw the structure of the trigone
Base of triangle: (suprolateral) - Ureters enter Apex of triangle: - urethra exits Slide 21
45
In males, what is located under the bladder?
The prostate
46
Which part of the bladder is supported? Why?
Neck of the bladder Where the urethra exits This allows the bladder to expand as it fills
47
Describe the course of the ureters into the bladder
Obliquely through the bladder wall
48
What happens when the bladder contracts?
Urine passes out of the urethra to the exterior No urine flows back up the ureters, because the ureters are occluded by the muscle contracting
49
Compare the male and female urethra
Male: long - Cons: much more difficult to catheterise - Pros: much less prone to UTI Female: short - Pros: easy to place a catheter - Cons: more prone to UTI
50
What is the perineum?
Area beneath the pelvis
51
What happens to the prostate as males age?
Benign prostatic hypertrophy Compression of the urethra - can't empty bladder properly
52
Describe the course of the urethra in males
1. Pre-prostatic part of urethra 2. Prostatic part of urethra 3. Membranous part of urethra 4. Penile part of urethra
53
What are the two components of the capillaries into which things are reabsorbed in the nephron?
Peritubuar capillaries: PCT, DCT Vasa recta: Loop of Henla

BIOM20002 - HSF (60 decks)

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