SUGER- renal physiology and anatomy

Question 1

what vertebral regions do the kidneys extend to and from?

Answer 1

T12 to L3

Question 2

what position is the kidney in relative to the peritoneum?

Answer 2

extraperitoneal and retroperitoneal

Question 3

what is each kidney covered by?

Answer 3

embedded in perinephric fat, covered by renal fascia

Question 4

where is the renal hilum found?

Answer 4

medial border of the kidney

Question 5

what is the pathway urine takes through the kidney (macroscopically)?

Answer 5

• renal pyramids
• renal papillae
• minor calyx
• major calyx
• renal pelvis

Question 6

on the abdominal aorta, where do the renal arteries arise?

Answer 6

immediately distal to superior mesenteric artery

Question 7

what are the borders of the inguinal canal?

Answer 7

• anterior wall- aponeurosis of external oblique
• posterior wall- transversalis fascia
• roof- transversalis fascia, internal oblique and transverses abdominis
• floor- inguinal ligament

Question 8

where is the deep inguinal ring found and what forms it?

Answer 8

• midpoint above the inguinal ligament

- formed by transversalis fascia

Question 9

where is the superficial inguinal ring found and what forms it?

Answer 9

• superior to the pubic tubercle

- evagination of external oblique

Question 10

what is contained within the inguinal canal in males?

Answer 10

spermatic cord, ilioinguinal nerve and genital branch of the genitofemoral nerve

Question 11

what is contained in the inguinal canal in females?

Answer 11

genital branch of the genitofemoral nerve, ilioinguinal nerve and round ligament of the uterus

Question 12

what are the 3 layers surrounding the spermatic cord and what is each derived from?

Answer 12

• external spermatic fascia- derived from subcutaneous fascia
• cremaster muscle and fascia- derived from internal oblique and its fascial coverings
• internal spermatic fascia- derived from transversalis fascia

Question 13

what is contained within the spermatic cord?

Answer 13

vas deferens, testicular artery, pampiniform plexus of testicular veins, genital branch of the genitofemoral nerve, lymph vessels

Question 14

what is the pathway sperm takes from the testis?

Answer 14

epididymis, vas deferens, joins w/ seminal vesicle, forms ejaculatory duct, prostatic urethra, membranous urethra, penile urethra

Question 15

how do the renal arteries branch within the kidneys?

Answer 15

renal artery- segmental branches- interlobar branches- arcuate arteries- interlobular arteries- afferent arterioles- glomerulus

Question 16

what shape is the left adrenal gland?

Answer 16

semi lunar

Question 17

what is the blood supply to the adrenal glands?

Answer 17

• superior adrenal artery- from inferior phrenic artery
• middle adrenal artery- from abdominal aorta
• inferior adrenal artery- from renal arteries

Question 18

where are the 3 ureteric narrowings?

Answer 18

• pelvi-ureteric junction
• as the ureter enters the pelvis and crosses the common iliac bifurcation
• vesicoureteric junction

Question 19

which muscles of the posterior abdominal wall flex the vertebral column?

Answer 19

psoas major and minor

Question 20

what are the terminal branches of the lumbar plexus and what are their nerve roots?

Answer 20

• iliohypogastric (T12-L1)
• ilioinguinal (L1)
• genitofemoral nerve (L1, L2)
• lateral cutaneous nerve of the thigh (L2, L3)
• obturator (L2,L3,L4)
• femoral (L2, L3, L4)

Question 21

what is the trigone marked by?

Answer 21

2 x ureteric orifices and 1x internal urethral orifice

Question 22

what is the difference in the internal urethral sphincter in males and females?

Answer 22

males- smooth muscle under autonomic control

females- functional sphincter

Question 23

what is the structure of the external urethral sphincter?

Answer 23

skeletal muscle- so is under voluntary control

Question 24

what is the blood supply to the bladder?

Answer 24

• superior and inferior vesical arteries- branches of internal iliac
• females- vaginal arteries also supply

Question 25

what provides the sympathetic nervous supply to the bladder and what does this cause?

Answer 25

- hypogastric nerve (T12-L2) | - relaxation of detrusor muscle

Question 26

what provides parasympathetic supply to the bladder?

Answer 26

- pelvic nerve (S2-S4)

Question 27

what provides somatic innervation to the bladder and what does this specifically innervate?

Answer 27

- pudendal nerve (S2-S4) | - control over external urethral sphincter

Question 28

what are the boundaries of the urogenital triangle?

Answer 28

pubic symphysis, ischiopubic rami and a theoretical line between the ischial tuberosities

Question 29

what are the layers of the urogenital triangle from deep to superficial?

Answer 29

- deep perineal pouch - perineal membrane - superficial perineal pouch - perineal fascia - skin

Question 30

what is contained within the superficial perineal pouch?

Answer 30

erectile tissue along with ischiocavernosus, bulbospongiosus and superficial transverse perineal muscles

Question 31

what is the position of the cervix?

Answer 31

anteverted and anteflexed

Question 32

what are the communications of the cervix?

Answer 32

- internal os- communication w/ uterus | - external os- communication w/ vagina

Question 33

what stabilises the position of the cervix?

Answer 33

levator ani muscle and cervical ligaments

Question 34

where is the pouch of Douglas located?

Answer 34

recto-uterine pouch | between uterus and rectum

Question 35

where is the vesicouterine pouch located?

Answer 35

between the bladder and uterus

Question 36

what are the 4 main parts of the uterine tubes?

Answer 36

isthmus, ampulla, infundibulum and fimbrae

Question 37

what attaches the ovaries to the broad ligament?

Answer 37

mesovarium

Question 38

what is the body of the penis composed of?

Answer 38

2x corpora cavernosa | 1x corpus spongiosum

Question 39

what is the glans penis?

Answer 39

expansion of the distal corpus spongiosum