Flashcards in Renal and urinary tract Deck (55):
What is the function of the ureter?
Drains urine from kidney to bladder
What is the function of the bladder?
Storage of urine
What is the function of the urethra?
Excretion of urine
What is the distal urethra lined with?
Stratified squamous mucosa
What are the "tubes" from ureter to upper urethra lined with?
Transitional epithelium - or urothelium which in only found in the urinary tract
What are the parts of the upper urinary tract?
Kidneys & ureters
What makes up the renal hilum?
How many functional segments of the kidney are there?
Where does the arterial blood for each of the 5 segmental branches of the renal artery go?
To the nephrons
What are the renal pyramids - renal cortex or renal medulla?
How many pyramids are in each kidney?
Roughly how many nephrons does each pyramid contain?
What are three sites of ureteric contriction?
Ureter crossing anterior aspect of common iliac artery
Where is the trigone?
The floor of the bladder between the bilateral & midline urethral orifaces
Does the trigone stretch or move?
What two things do the detrusor muscles encircle?
The ureteric orifaces preventing reflux of urine into ureter
The bladder neck
What is the external urethral sphincter?
Skeletal muscle circularly arranged around the urethra
What is the most inferior part of the male peritoneal cavity in the anatomic position?
The retrovesicle pouch
Which structure do the ureters run anteriorly to to enter the pelvis?
Common iliac vessels
What direction do the ureters take once they reach the level of the iliac spine?
Turn medially to enter the bladder from the posterior aspect
Which structure does the ureter run underneath to enter the bladder in the female pelvis?
Where does the ureter run in relation to the vas deferens?
What is the muscle that forms most of the bladder wall?
What does the detrusor muscle do around the neck of the male bladder during ejaculation?
It forms internal urethral sphincter muscle that contracts during ejaculation to prevent retrograde ejaculation
What part of the bladder is covered by peritoneum?
What muscle of the posterior abdominal wall do the kidneys lie anterior to?
What structures does the right kidney lie posterior to?
Liver (& hepatorenal recess)
(2nd part of the) duodenum
Right colic flexure
What structures does the left kidney lie posterior to?
Tail of pancreas
Hilum of spleen
Which lie anterior: renal arteries or renal veins?
Which lie anterior: common iliac arteries or common iliac veins?
Common iliac arteries
Where does the ureteric blood supply come from?
Common iliac artery
Internal iliac artery
Where does the lymph from kidneys drain into?
Lumbar nodes (IVC & AA)
Where does the lymph from the ureters drain?
Lumbar nodes and iliac nodes
What type of AAA might renal stenosis be combined with?
An infra-renal AAA (both caused by atherosclerosis)
What type of AAA may cause renal stenosis?
Supra-renal AAA (occlusion of the proximal renal artery by the aneurysm)
What are the three anatomic sites of ureteric constriction?
The ureter crossing the common iliac artery anteriorly
Which kind of muscle lines the walls of the ureter?
What is the response of the ureter to an obstruction?
Peristalsis occurs proximally to try and wash it out
How do sympathetic nerves reach the kidneys, ureter and bladder?
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
How does parasympathetic innervation reach the kidneys and ureters?
Parasympathetic nerve fibres are carried within the vagus nerve
How does parasympathetic innervation reach the bladder?
Carried within pelvic splanchnic nerves
Which structures in the urinary tract are supplied by somatic motor nerve fibres?
External urethral sphincter
Which nerves stimulate bladder contraction?
Parasympathetic innervation from pelvic splanchnic nerves from S2, 3 & 4
How is constriction of the internal urethral sphincter in males controlled?
Sympathetic fibres constrict it during ejaculation
Parasympathethic fibres relax it to allow urine to flow through
Which nerve allows control of the external urethral sphincter?
Somatic motor fibres in the pudendal nerve
Which nerve allows contraction of the levator ani?
Somatic motor fibres in the nerve to levator ani, S2, 3, 4
Where is pain from the kidney usually felt?
In the 'loin', the flank in the posterior region
Describe the pain caused by calculi obstructing the ureter.
Radiating 'loin to groin' colicky pain on the affected side
Where is pain from the bladder usually felt?
Where is pain from the perineal part of the urethra usually felt?
Localised to the perineum
What is the name of the layer of fat surrounding the kidneys immediately outside of the renal capsule?
What is the name of the layer of fat surrounding the kidneys between the visceral peritoneum and the renal capsule?
What vertebral level does the left kidney lie at?
What vertebral level does the right kidney lie at?