Renal and Urology

Question 1

difference between ureter and urethra

Answer 1

ureter between kidneys and bladder

Question 2

what structure do kidneys lie within

Answer 2

posterior abdominal wall

Question 3

which ribs overlie kidneys

Answer 3

left - XI and XII
right - XII

Question 4

at what vertebral level are the hila of the kidneys

Answer 4

left - IVD of L1/2
right - body of L2

Question 5

which nerves overlie the kidneys and why is this important clinically

Answer 5

upper nerves of lumbosacral plexus - subcostal, iliohypogastric, ilioinguinal

need to not damage in surgery

Question 6

order these from superior to inferior
iliohypogastric, subcostal, ilioinguinal

Answer 6

subcostal
iliohypogastric
ilioinguinal

Question 7

what four layers surround the kidney from closest to the kidney to the peritoneum

Answer 7

renal capsule
perinephric fat
renal fascia
paranephric fat

Question 8

describe the fluid flow through the kidneys

Answer 8

cortex → medulla → papilla → minor calyx → major calyx renal pelvis → ureter

Question 9

which structure sit more anteriorly - venous or arterial

Answer 9

venous

Question 10

which structure sits on the left of the other - IVC or abdominal aorta (in the body not when you are looking at it)

Answer 10

aorta

Question 11

which artery emerges from the aorta just superiorly to the right renal vein

Answer 11

superior mesenteric

Question 12

which is longer the right or left renal vein

Answer 12

left

Question 13

which is longer the right or left renal artery

Answer 13

right

Question 14

what are the ureters

Answer 14

muscular tubes

Question 15

how is urine moved through ureters

Answer 15

by peristalsis and gravity

Question 16

how long are ureters

Answer 16

25-30cm

Question 17

what aspect of the kidneys do ureters emerge from

Answer 17

posteroinferior

Question 18

what are the three common constrictions and why are they clinically important

Answer 18

sites where renal stones commonly develop and get lodged
1. uteropelvic junction
2. crossing pelvic brim/common iliac bifurcation
3. entrance to bladder

Question 19

why is where the ureter passes the common iliac bifurcation a common constriction

Answer 19

pulsing of blood slows flow in ureter

Question 20

ureter blood supply

Answer 20

top - renal arteries
middle - common iliac a. (and sometimes gonadal a., abdominal aorta, peritoneal branches)
bottom - vesical arteries

Question 21

what muscle makes up most of the bladder wall

Answer 21

detrusor muscle

Question 22

layers of detrusor muscle

Answer 22

inner longitudinal layer
middle circular layer
outer longitudinal layer

Question 23

which part of the bladder is under voluntary control

Answer 23

external urethral sphincter

Question 24

what kind of muscle and control is the detrussor muscle

Answer 24

smooth muscle
autonomic control

Question 25

what is the non contractile area of the bladder wall called

Answer 25

trigone

Question 26

what is the purpose of the trigone

Answer 26

ensures openings to the bladder - ureteric and internal urethral openings - stay open when muscle contracts

Question 27

what is the name of the hole in the inferior aspect of the bladder leading to the urethra

Answer 27

internal urethral orifice

Question 28

what muscle surrounds the internal urethral orifice

Answer 28

internal urethral sphincter

Question 29

is the internal urethral sphincter voluntary or involuntary

Answer 29

involuntary

Question 30

where does the blood supply to the bladder arise from

Answer 30

the anterior trunk of the internal iliac artery

Question 31

what arteries supply the bladder

Answer 31

superior vesical artery inferior vesical artery/vaginal artery in females - branches from uterine artery

Question 32

what is the blood supply to the bladder from the internal iliac a.

Answer 32

1. internal iliac a. → anterior trunk of internal iliac a. → umbilical artery → superior vesical artery 2. internal iliac a. → anterior trunk of internal iliac a. → inferior vesical artery

Question 33

what type of tube is the urethra

Answer 33

fibromuscular

Question 34

what structure originates from the neck of the trigone

Answer 34

urethra

Question 35

where does the urethra terminate

Answer 35

external urethral orifice

Question 36

length of female urethra

Answer 36

3-4cm

Question 37

which direction does the female urethra curve

Answer 37

slightly anteriorly

Question 38

who is more at risk of UTIs and why - male or female

Answer 38

female as shorter urethra

Question 39

length of male urethra

Answer 39

20cm

Question 40

what are the two curvatures of the male urethra and what are the clinical implications

Answer 40

complicates catheterisation infra-pubic - anterior - at bulb of penis pre-pubic - inferior - at base of penis

Question 41

what are the four regions of the male urethra

Answer 41

pre-prostatic prostatic membranous spongy

Question 42

where is the membranous segment of the male urethra found

Answer 42

within pelvic cavity

Question 43

which region of the kidney stains darker

Answer 43

cortex

Question 44

what are medullary rays in kidney

Answer 44

collections of tubules/ducts travelling together through into the medulla

Question 45

what type of cells form bowmans capsule

Answer 45

simple squamous epithelium

Question 46

where do blood vessels enter and exit bowman's capsule

Answer 46

vascular pole

Question 47

does the basic mucosa of the urinary system have a similar structure from the renal papilla to urethra

Answer 47

yes

Question 48

what cells line the urinary tract

Answer 48

umbrella cells

Question 49

how does the uroepithelium change towards the bladder

Answer 49

no. of intermediate layers increase closer to the bladder

Question 50

How many smooth muscle layers are found in different parts of the ureter and what orientation are the layers

Answer 50

2 proximally - longitudinal and circular 3 distally - longitudinal, circular, longitudinal

Question 51

what are the layers of the bladder

Answer 51

urothelium - high no. of IC layers lamina propria 3 layers smooth muscles - longitudinal, circular, longitudinal