URINARY

Question 1

Level of left kidney

Answer 1

11th rib

Question 2

Level of right kidney

Answer 2

11th Intercostal space

11th ICS

Question 3

Outer layer of kidney

Answer 3

Dense fibrous capsule

Question 4

What surrounds kidneys?

Answer 4

Fascial pouch / Renal fascia which contains peri-renal adipose tissue

Question 5

Which kidney is higher/lower?

Answer 5

Right kidney is slightly lower than left

Question 6

What level does the hilum of the kidneys lie at?

Answer 6

L1

Question 7

What are the anterior relations of the right and left kidney?

Answer 7

Right: liver, hepatic flexure and the hilum is behind the 2nd part of the duodenum
Left: stomach, pancreas, spleen and splenic flexure

Question 8

How is urine transported in the ureters?

Answer 8

Peristalsis of smooth muscle walls

Question 9

What are the 3 sites of ureteric constriction?

What is a constriction?

Answer 9

Pelviureteric junction
Where ureter crosses pelvic brim
Where ureter traverses bladder wall

Constrictions are sites of renal colic caused by kidney stones attempting to pass

Question 10

What lines the bladder?

Answer 10

Urothelium (transitional epithelium) - 3 layered epithelium with very slow cell turnover

Question 11

What is a characteristic of the luminal cells of the bladder?

Answer 11

Large luminal cells have specialised low-permeability luminal membrane which prevents dissipation of urine-plasma gradient

Question 12

What are the two urinary sphincters? Describe them

Answer 12

Sphincter vesicae and sphincter urethrae

Sphincter vesicae
internal sphincter - smooth muscle
at neck of bladder
reflex opening due to bladder wall tension
relaxed by PNS
contracted by SNS

Sphincter urethrae
external sphincter - striated muscle
in perineum
tone maintained by somatic nerves in pudendal nerve (S2-4)
opened by voluntary inhibition of nerves