Renal

Question 1

Macroscopic haematuria

Answer 1

visible blood in urine

Question 2

Microscopic haematuria

Answer 2

blood in urine, can only be seen on analysis

Question 3

Minor and major calyxes epithelium

Answer 3

transitional epithelium (urothelium)

Question 4

What is in the renal hilum?

Answer 4

renal vein, renal artery and ureter (ant. –> post.)

Question 5

Where does lymph drain from the kidney

Answer 5

to lumbar lymph nodes –> para-aortic nodes

Question 6

What are the 3 capsules of the kidney?

Answer 6

Renal capsule- adherent to surface of the kidney
Perineal fat- solid, protective tissue
Gerota’s (renal) fascia- extraperitoneal fascia

Question 7

Kidney innervation

Answer 7

SNS from sympathetic chain to renal plexus, afferent sympathetic fibres enter spinal cord T11-L2

Question 8

Muscles around kidney?

Answer 8

Psoa major, diaphragm, quadratus lumborum, transverse abdominis.

Question 9

Where do the adrenal glands lie?

Answer 9

Superior to kidney, lie within perineal fat and renal fascia

Question 10

What shape are the adrenal glands?

Answer 10

RHS- pyramidal

LHS- crescent shaped

Question 11

What is the blood supply of the adrenal glands?

Answer 11

Inferior phrenic arteries, aorta + renal arteries

Question 12

What are the functions of the adrenal glands?

Answer 12

Medulla- secretes catecholamines

Cortex- secretes corticosteroids + androgens

Question 13

What epithelium does the ureter have?

Answer 13

Transitional epithelium

Question 14

Where does the ureter go from and to?

Answer 14

pelvis of kidney —> urinary bladder

Question 15

Abdominal ureter

Answer 15

posterior to colon and mesentery- adherent to peritoneum. Lying on psoas major, anterior to transverse processes of lumbar verterbrae

Question 16

Pelvic ureter

Answer 16

begin along lateral pelvic walls, turn anetromedially at level of ischial spine. Lie close to seminal vesicle and run under vas deferens/lateral to cervix

Question 17

Blood supply of ureter

Answer 17

local arteries along it’s course

Question 18

Lymph drainage of ureter

Answer 18

renal, common/internal iliac/vesicle nodes

Question 19

What is the surface anatomy of the left kidney

Answer 19

L1

Question 20

What is the surface anatomy of the right kidney

Answer 20

L2

Question 21

Where does ureter pain refer to?

Answer 21

lumbar/suprapubic regions

Question 22

What are the risk factors for kidney stones?

Answer 22

male, 30-50YO, dehydration, immobility, increased serum calcium

Question 23

Possible complications of kidney stone

Answer 23

haemorrhage, infection, urinary obstruction, hydronephrosis

Question 24

What are the 3 man constricitons of the ureters?

Answer 24

Pelvi-uteric junction, pelvic brim and vesicouteric junction

Question 25

What is the detrusor?

Answer 25

Smooth muscle wall of the bladder

Question 26

What is the epithelial lining of the bladder?

Answer 26

urothelium

Question 27

What lies in the median umbilical fold?

Answer 27

obliterated umbilical arteru

Question 28

Where does the empty bladder lie?

Answer 28

In true pelvis, posterior to pubic symphysis

Question 29

What lies anterior to the bladder?

Answer 29

pubic symphysis

Question 30

What lies posterior to the bladder?

Answer 30

rectum/uterus

Question 31

What lies lateral to the bladder?

Answer 31

ischioanal fossa and obturators/levator ani

Question 32

What lies inferior to the bladder?

Answer 32

Prostate/pelvic fascia/peitoneum

Question 33

What lies superior to the bladder?

Answer 33

uterus/peritoneum

Question 34

What is the blood supply of the bladder?

Answer 34

superior and inferior vesical arteries from internal iliac artery

Question 35

What drains the bladder?

Answer 35

Vesical venous plexus --> internal iliac veins

Question 36

Lymph drainage of the bladder?

Answer 36

internal and external iliac nodes

Question 37

Innervation of the bladder?

Answer 37

SNS- sympathetic trunkPSNS- pelvic splanchnic nerves (S2-4)

Question 38

Female urethra

Answer 38

4cm embedded in anterior wall of vagina external urethral meatus opening- vulval vestibule

Question 39

How long is the male urethra

Answer 39

20cm

Question 40

What are the 4 parts of the male urethra

Answer 40

Pre-prostatic (within bladder neck) Prostatic (within prostate) Membranous (throuhg ext. sphincter and perineal membrane) Penile/spongy urethra

Question 41

Urethral catheteristaion

Answer 41

if urine cannot pass through urethra, facilitates flow, balloon inflated once in place

Question 42

Suprapubic catheterisation

Answer 42

draining bladder for patients who need it long term/urethral cannot be done.