Renal Anatomy

Question 1

What is the function of the urinary system?

Answer 1

Regulation of body fluid and electrolyte balance to maintain BP by blood filtration.

Question 2

With which system is the urinary system closely related to?

Answer 2

Genital system. Common final pathway (urethra) in men.

Question 3

What is the function of the kidneys?

Answer 3

Maintain homeostasis by blood filtration.

Question 4

What is the function of the ureters?

Answer 4

Carry urine from the kidneys to the bladder.

Question 5

What is the function of the bladder?

Answer 5

Temporarily stores urine (walls expand to hold it and then contract to excrete it)

Question 6

What is the function of the urethra?

Answer 6

Tube that allows urine to pass from bladder out of the body.

Question 7

Where do the kidneys lie?

Answer 7

In the paravertebral gutters on the posterior abdominal wall either side of vertebral column at level T12-L3.

Question 8

Where does the hilus of the kidney lie?

Answer 8

Transpyloric plane (L1).

Question 9

What is the hilum of the kidney?

Answer 9

Concave border where BVs and renal pelvis enters/leaves the substance of the kidney.

Question 10

Which kidney is lower and why?

Answer 10

Right - presence of liver.

Question 11

What are the four layers enclosing the kidneys?

Answer 11

1. fibrous renal capsule
2. fatty renal capsule
3. renal fascia (fibrofatty tissue)
4. pararenal fatty tissue

Question 12

Why is the kidney surrounded by so much fatty tissue?

Answer 12

As there are no bones to protect it from trauma.

Question 13

Do the kidneys move on inspiration?

Answer 13

Yes - descend on inspiration, rise on expiration.

Question 14

With which two muscles are the kidneys closely related?

Answer 14

Psoas major and quadratus lumborum.

Question 15

How are the kidneys peritonised?

Answer 15

Retroperitoneal.

Question 16

What structures will come in contact with the kidneys?

Answer 16

Liver, suprarenals, duodenum, colon, jejunum, small bowel, colonic flexure, pancreas, stomach, spleen.

Question 17

What is the sympathetic supply to the kidneys?

Answer 17

T12-L1 spinal segment nerves which pass through celiac ganglia and run with the renal artery to the kidneys.

Question 18

What is the parasympathetic supply to the kidneys?

Answer 18

Vagus.

Question 19

Where does lymph from the kidneys drain into?

Answer 19

Para-aortic lymph nodes around the origin of the renal arteries (L1).

Question 20

Describe the appearance of a horseshoe kidney.

Answer 20

Inferior poles of two kidneys have fused, can have abnormal insertion of ureters. People with horseshoe kidney are at increased risk of hydronephrosis, stone formation, tumours and infections.

Question 21

What causes a duplicated ureter?

Answer 21

Duplication of the ureteric bud from the mesonephric duct. Can result in UTIs and vesicoureteric reflux.

Question 22

What comprises the internal structure of the kidneys?

Answer 22

Renal cortex around the outside. Renal medulla in the inside. Minor calyces feed into major calyces which feed into he renal pelvis. Renal pelvis narrows into the ureter.

Question 23

What structures of the nephron are present in the cortex of the kidney?

Answer 23

Distal and proximal convoluted tubules and the glomeruli.

Question 24

What structures of the nephron are present in the medulla of the kidney?

Answer 24

Collecting ducts and loops of Henle.

Question 25

Describe the histological structure of a glomerulus.

Answer 25

Bowmen's space lies between the parietal layer of Bowman's capsule and the visceral player (podocytes).

Question 26

What is the blood supply to the kidneys?

Answer 26

Renal arteries.

Question 27

Where are the renal arteries given off the abdominal aorta?

Answer 27

L1-2 VL (just below superior mesenteric).

Question 28

Describe how the arteries divide after they enter the kidney.

Answer 28

They first divide into segmental arteries, which divide into interlobular arteries, then into arcuate arteries. Interlobular arteries pass into the cortex forming afferent arterioles (and eventually glomeruli).

Question 29

What are the differences in how the right and left renal vein travel from the IVC to the kidneys?

Answer 29

Left renal vein travels anterior to the aorta and is relatively long. Right renal vein travels directly to the kidney and is much shorter.

Question 30

What are the differences in how the right and left renal arteries travel from the aorta to the kidneys?

Answer 30

Right renal artery travels posterior to IVC and is relatively long, while right renal artery travels directly and is relatively short.

Question 31

Where do the testicular/ovarian veins drain into?

Answer 31

Left - left renal vein. | Right - IVC directly.

Question 32

How are the ureters peritonised?

Answer 32

Retroperitoneal.

Question 33

What are the ureters?

Answer 33

Distensible, msucular tubes connecting the kidneys to the bladder.

Question 34

On which muscle does the ureter descend as it travels to the bladder and which artery does it cross?

Answer 34

Psoas major and crosses bifurcation of the common iliac artery.

Question 35

What structure crosses the ureters?

Answer 35

Ductus vas deferens in males and ovarian arteries in females.

Question 36

Where are the three constrictions of the ureter?

Answer 36

1. the origin (where renal pelvis narrows to form ureters) 2. pelvic brim (where ureters cross posterior part of iliac crest) 3. vesicle-ureteric junction (where it enters the bladder)

Question 37

What crosses the apex of the bladder?

Answer 37

The median umbilical ligament as it ascends to the umbilicus. This is a remnant of the allantois (the canal that drains urinary bladder and joins to the umbilical cord).

Question 38

What kind of muscle makes up the bladder?

Answer 38

Mostly detrusor muscle (smooth muscle).

Question 39

What structure does the bladder lie behind?

Answer 39

The pubic symphysis.

Question 40

Parietal peritoneum drapes over superior surface of bladder and dips down posterior surface to form what?

Answer 40

Peritoneal pouches.

Question 41

What is the trigone of the bladder?

Answer 41

Smooth triangular region of internal bladder formed by 2 ureteric orifices and internal urethral orifice.

Question 42

What sort of epithelium lines the urinary bladder and ureters?

Answer 42

Uroepithelium (multi-layered transitional epithelium - allows stretch when bladder fills). It has a GAG layer - which enables storage of urine without a high osmotic gradient.

Question 43

What is the urethra?

Answer 43

Tube arising from the inferior part of the urinary bladder and carries urine from bladder to the exterior.

Question 44

What is a good thing to remember when interpreting X-rays and trying to find the ureters?

Answer 44

They are in line with the transverse processes of lumbar vertebrae.