Renal and urinary tract

Question 1

What is the function of the ureter?

Answer 1

Drains urine from kidney to bladder

Question 2

What is the function of the bladder?

Answer 2

Storage of urine

Question 3

What is the function of the urethra?

Answer 3

Excretion of urine

Question 4

What is the distal urethra lined with?

Answer 4

Stratified squamous mucosa

Question 5

What are the “tubes” from ureter to upper urethra lined with?

Answer 5

Transitional epithelium - or urothelium which in only found in the urinary tract

Question 6

What are the parts of the upper urinary tract?

Answer 6

Kidneys & ureters

Question 7

What makes up the renal hilum?

Answer 7

Renal artery
Renal vein
Ureter

Question 8

How many functional segments of the kidney are there?

Answer 8

5

Question 9

Where does the arterial blood for each of the 5 segmental branches of the renal artery go?

Answer 9

To the nephrons

Question 10

What are the renal pyramids - renal cortex or renal medulla?

Answer 10

Renal medulla

Question 11

How many pyramids are in each kidney?

Answer 11

27

Question 12

Roughly how many nephrons does each pyramid contain?

Answer 12

50000

Question 13

What are three sites of ureteric contriction?

Answer 13

Pelviureteric junction
Ureter crossing anterior aspect of common iliac artery
Ureteric orifice

Question 14

Where is the trigone?

Answer 14

The floor of the bladder between the bilateral & midline urethral orifaces

Question 15

Does the trigone stretch or move?

Answer 15

No

Question 16

What two things do the detrusor muscles encircle?

Answer 16

The ureteric orifaces preventing reflux of urine into ureter

The bladder neck

Question 17

What is the external urethral sphincter?

Answer 17

Skeletal muscle circularly arranged around the urethra

Question 18

What is the most inferior part of the male peritoneal cavity in the anatomic position?

Answer 18

The retrovesicle pouch

Question 19

Which structure do the ureters run anteriorly to to enter the pelvis?

Answer 19

Common iliac vessels

Question 20

What direction do the ureters take once they reach the level of the iliac spine?

Answer 20

Turn medially to enter the bladder from the posterior aspect

Question 21

Which structure does the ureter run underneath to enter the bladder in the female pelvis?

Answer 21

Uterine artery

Question 22

Where does the ureter run in relation to the vas deferens?

Answer 22

Inferiorly

Question 23

What is the muscle that forms most of the bladder wall?

Answer 23

Detrusor muscle

Question 24

What does the detrusor muscle do around the neck of the male bladder during ejaculation?

Answer 24

It forms internal urethral sphincter muscle that contracts during ejaculation to prevent retrograde ejaculation

Question 25

What part of the bladder is covered by peritoneum?

Answer 25

Superior surface

Question 26

What muscle of the posterior abdominal wall do the kidneys lie anterior to?

Answer 26

Quadratus lumborum

Question 27

What structures does the right kidney lie posterior to?

Answer 27

Liver (& hepatorenal recess) (2nd part of the) duodenum Ascending colon Right colic flexure

Question 28

What structures does the left kidney lie posterior to?

Answer 28

Stomach Tail of pancreas Hilum of spleen Splenic vessels

Question 29

Which lie anterior: renal arteries or renal veins?

Answer 29

Renal veins

Question 30

Which lie anterior: common iliac arteries or common iliac veins?

Answer 30

Common iliac arteries

Question 31

Where does the ureteric blood supply come from?

Answer 31

``` Renal artery Abdominal aorta Common iliac artery Internal iliac artery Vesical artery ```

Question 32

Where does the lymph from kidneys drain into?

Answer 32

Lumbar nodes (IVC & AA)

Question 33

Where does the lymph from the ureters drain?

Answer 33

Lumbar nodes and iliac nodes

Question 34

What type of AAA might renal stenosis be combined with?

Answer 34

An infra-renal AAA (both caused by atherosclerosis)

Question 35

What type of AAA may cause renal stenosis?

Answer 35

Supra-renal AAA (occlusion of the proximal renal artery by the aneurysm)

Question 36

What are the three anatomic sites of ureteric constriction?

Answer 36

Pelvi-ureteric junction The ureter crossing the common iliac artery anteriorly Ureteric oriface

Question 37

Which kind of muscle lines the walls of the ureter?

Answer 37

Smooth muscle

Question 38

What is the response of the ureter to an obstruction?

Answer 38

Peristalsis occurs proximally to try and wash it out

Question 39

How do sympathetic nerves reach the kidneys, ureter and bladder?

Answer 39

Exit the spinal cord between T10-L1 into the sympathetic chains Exit the sympathetic chains into the abdominal splanchnic nerves Synapse at the abdominal sympathetic ganglia which are located around the abdominal aorta Postsynaptic nerve fibres travel to the organ along the arteries which supply it

Question 40

How does parasympathetic innervation reach the kidneys and ureters?

Answer 40

Parasympathetic nerve fibres are carried within the vagus nerve

Question 41

How does parasympathetic innervation reach the bladder?

Answer 41

Carried within pelvic splanchnic nerves

Question 42

Which structures in the urinary tract are supplied by somatic motor nerve fibres?

Answer 42

Perineal structures: Urethra External urethral sphincter Levator ani

Question 43

Which nerves stimulate bladder contraction?

Answer 43

Parasympathetic innervation from pelvic splanchnic nerves from S2, 3 & 4

Question 44

How is constriction of the internal urethral sphincter in males controlled?

Answer 44

Sympathetic fibres constrict it during ejaculation | Parasympathethic fibres relax it to allow urine to flow through

Question 45

Which nerve allows control of the external urethral sphincter?

Answer 45

Somatic motor fibres in the pudendal nerve

Question 46

Which nerve allows contraction of the levator ani?

Answer 46

Somatic motor fibres in the nerve to levator ani, S2, 3, 4

Question 47

Where is pain from the kidney usually felt?

Answer 47

In the 'loin', the flank in the posterior region

Question 48

Describe the pain caused by calculi obstructing the ureter.

Answer 48

Radiating 'loin to groin' colicky pain on the affected side

Question 49

Where is pain from the bladder usually felt?

Answer 49

Suprapubic region

Question 50

Where is pain from the perineal part of the urethra usually felt?

Answer 50

Localised to the perineum

Question 51

What is the name of the layer of fat surrounding the kidneys immediately outside of the renal capsule?

Answer 51

Perinephric fat

Question 52

What is the name of the layer of fat surrounding the kidneys between the visceral peritoneum and the renal capsule?

Answer 52

Paranephric fat

Question 53

What vertebral level does the left kidney lie at?

Answer 53

T12-L2

Question 54

What vertebral level does the right kidney lie at?

Answer 54

L1-L3

Question 55

What is the most common anatomical variation in the kidneys?

Answer 55

Bifid pelvis