Review of the Kidney/Anatomy of the Urinary Tract Flashcards Preview

MSS - Renal Exam 1 > Review of the Kidney/Anatomy of the Urinary Tract > Flashcards

Flashcards in Review of the Kidney/Anatomy of the Urinary Tract Deck (64):
1

left kidney level?

TV11 - LV2

2

right kidney level?

little bit lower
TV12 - LV3

-more easily palpated**
pushed down by liver

3

nerves posterior to kidney?

subcostal ventral ramus T12
iliohypohastric ventral ramus L1
ilioinguinal ventral ramus L1

all three, motor and sensory

don't want to damage during surgery**

4

iliopsoas test

pain upon extension of thigh
-infection can spread from kidney to psoas
-also ureters, pancreas

5

anterior to right kidney?

liver
ascending colon and right colic flexure
duodenum

6

anterior of left kidney?

spleen
pancreas
stomach
descending colon and left colic flexure
small bowel
jejunum

7

peritoneum

serous membrane of abdomen

kidney lies posterior to this
therefore, considered retroperitoneal

8

renal fascia?

posterior and anterior

fuse and invest kidney and suprarenal gland

blend medially with adventitia of renal vessels

9

renal fat

some outside capsule and inside

10

renal sinus

open space of kidney
where things enter and leave

contains renal calyces, renal pelvis, vessels, nerves, and lymphatics

11

paranephric fat

outside capsule
external to renal fascia

12

perinephric fat

inside capsule
between kidney and renal fascia

PER-"I"-NEPHRIC = Inside

13

suprarenal gland

above kidney within fascia
-septum separation
-renal infection won't necessarily affect suprarenal gland

14

at hilum?

renal vein - most anterior
renal artery - posterior and superior
renal pelvis - posterior and inferior

15

cortex

where the nephrons reside

also where the medullary rays are

16

nephron

functional unit of the kidney

17

renal column of bertin

invaginations of cortex to medulla

still nephron tissue

18

medulla

mostly organized into renal pyramids
contain mainly collecting tubules

19

vasopression

control collecting tubules

20

renal papilla

end of medulla
-drips urine into minor calyx

21

calyx

minor empty to major

tubular and do have some smooth muscle

22

renal pelvis

forms from merge of major calyx

23

left renal vein

slightly longer
picks up blood from other structure

-passes between aorta and superior mesenteric artery

24

branches of renal artery?

segmental arteries
-end arteries - so blockage will kill part of kidney

**don't memorize**

25

renal vein entrapment syndrome

left renal vein gets compressed between aorta and superior mesenteric artery

hematuria, abdominal pain, left testicular pain

aka nutcracker syndrome

26

three sign of renal vein entrapment

1 - left renal vein HTN
2 - bleeding in urine (hematauria)
3 - testicular pain (because testicular vein drains to the left renal vein as well

27

kidney innervation?

renal plexus

sympathetic - preganglionic fibers T10-L1 (lateral horn)
-via lesser, least, lumbar splanchnic nerves
-mainly vasomotor and also carry pain fibers

parasympathetic - preganglionic fibers with vagus nerve
-motor to smooth muscle of calyx
-primary stretch afferent fibers

28

kidney

mainly hormonally controlled

29

kidney referred pain

dermatone - lower back to flank to inguinal to groin

patients present with pain localized here

30

spinal nerve levels of kidney?

T10-L1

31

kidney stones

can result in referred pain
-from crystals often calcium

pain that refers loin to groin

32

ureters

muscular tube transport urine from urine to urinary bladder

retroperitoneal
-course inferomedially along posterior abdominal wall, descend over brim to enter pelvis, along lateral pelvic wall to enter posterior bladder wall

33

three sites of constriction?

where kidney stone likely to be an obstruction

1 - ureter passes over inferior renal pole (abdominal part)
2 - ureter crosses over external iliac vessels (pelvic part)
3 - ureter traverses bladder wall (intramural part)

34

blood supply of ureter

aorta, gonadal artery, iliac vessels contribute

35

upper ureter innervation

sympathetic - preganglionic T10-T12 via lesser and least, and lumbar splanchnic nerves
-vasomotor, also carry pain fibers

parasympathetic - vagus nerve preganglionic
-motor to smooth muscle (peristalsis)
-carry primary stretch afferent fibers

36

lower ureter innervation

pelvic plexus

sympathetic - L1-2 via lumbar splanchnic
-vasomotor and pain fibers

parasympathetic - pelvic splanchnic nerves
-motor to smooth muscle (peristalsis)
-primary stretch afferent receptors

37

referred pain from ureter?

same as kidney

"loin to groin"

38

urinary bladder

store urine until urination
-very stretchable

-apex posterior to pubic symphysis (attachment of umbilical ligament)
base = fundus
-neck continuous with urethra

39

wall of urinary bladder

-outer - adventitia (not superior surface - peritoneum)
-detrusor muscle layer - 3 layers
-submucosa
-mucosa (lamina propria to transitional epithelium)

has rugae folds that allow stretching

40

trigone

posterior in urinary bladder
-different development than bladder

apex opens toward urethra opening

sympathetic innervation to its muscle (sphincter)
-prevents reflux of urine to urinary bladder

inner - extension of uteric muscle
outer - typical detrusor muscle

41

supportive ligaments of bladder?

pubovesicle (puboprostatic in male)
lateral ligament of urinary bladder

42

cystocele

bladder herniates through floor of pelvis
-weakening of ligaments

common cause childbirth
also, obesity, chronic constipation, heavy lifting

can cause urinary incompetence

43

innervation to bladder?

sympathetic - preganglionic T10-L2 via lumbar splanchnic nerves
-trigonal muscle
-sphincter urethrae muscle
-vasomotor and pain

parasympathetic - preganglionic pelvic splanchnic nerves
-detrusor muscles
-vasomotor
-primary stretch afferent fibers
-pain fibers

44

urethra

bladder to external environment

45

male urethra

sphincter urethral muscle

also has bulbourethral gland (cowpers) and urethral (mucuous secretion)

46

sphincter urethral muscle

-muscle for urinary continence
-has sphincter and transverse portion
-and external portion
-and deep portion

skeletal and smooth muscle components

47

female urethra

shorter
-sphincter urethral muscle
-sphincter and transverse
-external
-deep

pelvic and perineal portion

paraurethral gland (skenes) homolog to male prostate

48

micturition process

bladder fills
-stretch receptors fire
-travel to spinal cord with pelvic splanchnic nerves S2,3,4

ascending fibers then travel through spinal cord to brainstem micturition center

descending fibers from brainstem that activate motor component of pelvic splanchnic fibers
-contraction of detrusor muscle and empty of bladder
-also get descending pathway to inhibit sympathetic tone to sphincter urethral muscle AND the somatic nerve to sphincter urethra

49

function of kidney

filter blood and produce urine
erythropoietin and renin secretion
calcitriol production

50

nephrotosis

dropped kidney
-deficiency of fats and fascia surrounding the kidney (late stage of starvation)

-kidney drops into pelvis
-often asymptomatic
-acute pain in flak region that radiates to groin

51

spread of perinephric abscesses

renal fascia attaches tightly to renal vessels at renal hilum

thus, peripephric abscess cannot spread to contralateral kidney

they can spread inferiorly to the pelvis

52

renal arteries

lateral, paired visceral branches of aorta
-at LV1-2 level

right longer than left, passes posterior to IVC

divide to 5 segmental arteries

53

posterior to ureters

psoas major
common iliac vessels

54

anterior to ureters

gonadal vessels
colic vessels

55

upper 1/3 arterial to ureter

renal artery/vein

56

middle 1/3 arterial to ureter

gonadal, aorta, common iliac artery/veins

57

lower 1/3 arterial to ureter

internal iliac artery/vein

58

upper 1/3 lymph drain ureter

lumbar lymph node

59

middle 1/3 lymph drain ureter

common iliac lymph node

60

lower 1/3 lymph drain ureter

common, external, internal iliac lymph nodes

61

intramural urethra

extends through neck of bladder

male

62

prostatic urethra

extends through prostate

male

63

membranous urethra

another portion

male

64

spongy urethra

penile

male