Retroperitoneal structures: kidneys and ureter

Question 1

what does retroperitoneal mean

Answer 1

a structure that lies posterior to the parietal peritoneum - held against the body wall with one surface covered by peritoneum and one surface in contact with the body wall

Question 2

what is a primary retroperitoneal structure

Answer 2

formed on the body wall during development and maintain this relationship with body wall in adult form

Question 3

give 4 examples of primary retroperitoneal structures

Answer 3

kidneys
suprarenal glands
vessels (aorta, IVC)
nerves

Question 4

what are secondary retroperitoneal structures

Answer 4

develop out with the peritoneum but become covered by peritoneum by end of development and seen that way in adult form

Question 5

give 5 examples of secondary retroperitoneal structures

Answer 5

most of duodenum
pancreas
ascending colon
descending colon
upper 2/3 rectum

Question 6

the kidneys are primary/secondary retroperitoneal

Answer 6

primary

Question 7

the pancreas is primary/secondary retroperitoneal

Answer 7

secondary

Question 8

the ascending colon is primary/secondary retroperitoneal

Answer 8

secondary

Question 9

the upper 2/3 of the rectum are primary/secondary retroperitoneal

Answer 9

secondary

Question 10

the suprarenal glands are primary/secondary retroperitoneal

Answer 10

primary

Question 11

the descending colon is primary/secondary retroperitoneal

Answer 11

secondary

Question 12

most of the duodenum is primary/secondary retroperitoneal

Answer 12

secondary

Question 13

what are the 4 components of the urinary system

Answer 13

kidneys
ureters
bladder
urethra

Question 14

the hilum of the kidneys lies at what vertebral level

Answer 14

L1

Question 15

which kidney lies slightly lower than the other and why

Answer 15

right kidney lies slightly lower due to large size of the liver

Question 16

what are the anterior relations of the right kidney

Answer 16

suprarenal gland
liver
2nd part of duodenum
right colic flexure

Question 17

the upper pole of the right kidney is protected by what posteriorly

Answer 17

rib 12

Question 18

the right kidney lies on the surface of what

Answer 18

quadratus lumborum

Question 19

where does quadratus lumborum pass between

Answer 19

muscle of posterior abdominal wall that passes between 12th rib and iliac crest

Question 20

what are the posterior relations of the right kidney

Answer 20

diaphragm
rib 12
psoas
quadratus lumborum
transversus abdominis
subcostal nerve

Question 21

the upper pole of the left kidney is protected posteriorly by what

Answer 21

ribs 11 and 12

Question 22

what are the anterior relations of the left kidney

Answer 22

suprarenal gland
spleen
stomach
tail of pancreas
left colic flexure
jejenum

Question 23

what are the posterior relations of the left kidney

Answer 23

diaphragm
ribs 11 and 12
psoas
quadratus lumborum
transversus abdominis
subcostal nerve

Question 24

describe the gross appearance of the kidney

Answer 24

red-brown
smooth outer capsule
10-12cm long
6-8cm wide

Question 25

what is found at the renal hilum

Answer 25

renal artery renal vein renal pelvis that becomes ureter (also lymph and sympathetic fibres)

Question 26

what are the most posterior structures of the hilum

Answer 26

renal pelvis that becomes the ureter

Question 27

is variation of the renal arteries or veins common

Answer 27

variation of veins is rare, but renal artery variation is relatively common

Question 28

what is the name of an extra arterial vessel that enters the kidney outwith the hilum

Answer 28

supernumerary renal artery

Question 29

how is a supernumerary renal artery formed

Answer 29

non-regression of vessels during development

Question 30

what lies under the capsule of the kidney

Answer 30

paler cortex

Question 31

what is found in the cortex

Answer 31

glomeruli

Question 32

what is below the cortex

Answer 32

darker medulla

Question 33

what is contained in the medulla

Answer 33

loop of henle collecting ducts

Question 34

the ____ collect urine and channel it to the renal pelvis which becomes the ureter

Answer 34

minor calyces --> major calyx --> renal pelvis

Question 35

what surrounds each kidney

Answer 35

large peri-renal fat pad

Question 36

where are the renal arteries derived from

Answer 36

lateral branches of abdominal aorta at L1 vertebral level

Question 37

describe the divisions of the renal arteries

Answer 37

each artery divides into anterior and posterior branches and then smaller segmental arteries

Question 38

which renal artery is longer and why

Answer 38

right renal artery is longer than left as it has to travel across from the aorta which is slightly to left of midline

Question 39

the right renal artery passes where in relation to IVC

Answer 39

posterior to IVC

Question 40

what is the arterial supply like inside kidneys

Answer 40

lobar arteries interlobar arteries arcuate arteries afferent glomerular arterioles

Question 41

renal veins drain where

Answer 41

IVC

Question 42

lymph from kidneys drains where

Answer 42

lateral aortic nodes (para-aortic nodes) around origin of renal artery (L1)

Question 43

nerves for the kidney and suprarenal glands comes from where

Answer 43

renal sympathetic plexus

Question 44

afferent fibres from kidney enter spinal cord where

Answer 44

T10-12

Question 45

which renal vein is longer and why

Answer 45

left renal vein is 3x longer because it has to pass from left kidney across midline to reach IVC which lies to right side of vertebral bodies

Question 46

the left renal vein lies _____ to the SMA

Answer 46

inferior

Question 47

the left renal vein passes ____ to the pancreas

Answer 47

posterior

Question 48

the left renal vein passes behind what 2 structures

Answer 48

splenic vein body of pancreas

Question 49

what 2 veins drain into the left renal vein

Answer 49

left gonadal left suprarenal

Question 50

the right renal vein passes _____ the descending duodenum

Answer 50

behind

Question 51

where does the right gonadal vein drain

Answer 51

directly into IVC

Question 52

where do the ureters pass between

Answer 52

renal hilum to the bladder

Question 53

the ureters descend the posterior abdominal wall on what

Answer 53

anterior surface of the psoas muscle

Question 54

as the ureters enter the pelvis they cross what

Answer 54

bifurcation of common iliac artery anterior to sacro-iliac joint

Question 55

the ureters travel towards the ischial spine along what

Answer 55

lateral wall of pelvis

Question 56

where do the ureters enter the bladder

Answer 56

inferior surface of bladder as part of trigone area

Question 57

what propels urine towards the bladder

Answer 57

contractions of ureter wall and filtration pressure from glomeruli

Question 58

what are the ureters

Answer 58

long smooth muscle tubes that pass from renal hilum to the bladder

Question 59

what are the 3 constrictions of the ureters

Answer 59

1) at the junction of the ureters and the renal pelvis 2) where the ureters cross the pelvic brim 3) as they enter the bladder wall

Question 60

what landmark can be used to identify the ureters

Answer 60

they cross the bifurcation of the common iliac artery as they enter the pelvis

Question 61

in an xray when the psoas muscles cannot be seen, how are the ureters described passing

Answer 61

passing the tips of the transverse processes of lumbar vertebra

Question 62

the proximal parts of the ureters receive/drain blood from where

Answer 62

renal vessels

Question 63

the middle parts of the ureters receive/drain blood from where

Answer 63

gonadal vessels (ovarian or testicular)

Question 64

the distal parts receive/drain blood where

Answer 64

superior vesical vessels (also supply/drain bladder)

Question 65

lymph from the ureters drains where

Answer 65

para-aortic nodes and iliac nodes

Question 66

afferent nerve fibres from the ureters goes where

Answer 66

L1-L2

Question 67

pain from the ureters is referred where

Answer 67

inguinal region at top of thigh

Question 68

nerves to the ureters come from where

Answer 68

renal, testicular (or ovarian) and hypogastric plexuses

Question 69

where are the supra-renal glands found

Answer 69

superior pole of kidney

Question 70

what is the gross appearance of the supra-renal glands

Answer 70

yellow cortex brown medulla

Question 71

the right supra-renal glands is what shape

Answer 71

pyramid shaped

Question 72

the left supra-renal glands is what shape

Answer 72

crescent moon shape

Question 73

the cortex of the supra-renal glands makes what

Answer 73

corticoids (fluid, electrolyte) glucocorticoids (carbohydrates, fats, proteins)

Question 74

the medulla of the supra-renal glands makes what

Answer 74

epinephrine and norepinephrine

Question 75

where is the right supra-renal gland found

Answer 75

behind right lobe of liver

Question 76

where is the left supra-renal gland found

Answer 76

behind pancreas, stomach and lesser sac

Question 77

the supra-renal glands are what kind of glands

Answer 77

endocrine

Question 78

describe the blood supply of the supra-renal glands

Answer 78

3 arteries on each side: a superior suprarenal, a middle suprarenal and an inferior suprarenal

Question 79

the superior suprarenal artery is a branch of

Answer 79

inferior phrenic artery (first abdominal branch of aorta)

Question 80

the middle suprarenal artery is a branch of

Answer 80

direct from aorta

Question 81

the inferior suprarenal artery is a branch of

Answer 81

renal artery

Question 82

there is usually _ veins on each side

Answer 82

1

Question 83

the suprarenal vein drains where

Answer 83

directly into IVC on right into renal vein on left

Question 84

the lymph from the suprarenal glands drains where

Answer 84

paraaortic nodes at L1