Flashcards in Urinary: Anatomy of the Kidneys and Ureters Deck (14):
Describe tha anatomical locations of the kidneys
Retroperitoneal - sit either side of vertebral column
T12-L3 however right kidney often sits lower due to liver
What is the normal size of the kidneys?
~11 cm long
What are the layers of the kidney from deep to superficial?
Renal capsule - tough, fibrous
Perirenal fat - extraperitoneal fat
Renal fascia - enclose kidneys and adrenals
Pararenal fat - mainly on posterolateral
What is the blood supply to the kidneys?
Supplied via the renal arteries which arise directly from the abdo aorta, immediately distal to sup mesenteric.
The right renal artery crosses under the IVC
How do the renal arteries split in the kidneys?
Renal artery enters the kidney via the hilium and split into segmental arteries.
Each segmental divides into interlobular arteries either side of every renal pyramid.
Interlobular split into arcuate arteries.
The interlobular arteries pass through cortex and divide to form afferent arterioles.
What is the embryological basis for accessory renal arteries?
The kidneys ascend and there are branches that branch off the aorta and usually regress. If they dont regress there are accessory arteries contributing to the renal blood supply.
What is the significance of accessory renal arteries being terminal/end arteries?
They supply blood to a small part of the kidneys. If they get blocked this can lead to tissue ischaemia
What is the venous drainage of the kidneys?
Drained via the right and left renal veins which leave the hilium anteriorly to the renal arteries. They empty directly into the IVC
Describe the anatomical course of the ureters
Renal pelvis narrows to form the ureters (uteropelvic junction). Ureters descend through the retroperitoneal cavity along the anterior surface of the psoas major muscle. The ureters cross the pelvic brim (sacro-iliac joint) crossing the bifurcation of the common iliac arteries.
Run down the lateral pelvic walls, and at the level of the ischial spines move in a transverse plane towards the bladder. Enter the bladder obliquely to create a one way valve.
Why is it important to identify the ureters during an hysterectomy?
The uterine artery has to be clamped during the surgery - important not to clamp the ureters. The ureters pass under the uterine artery 'water under the bridge'
In men what structure do the ureters cross?
Ureters cross under the vas deferens
What is the vascular supply to the ureters?
In the abdomen they are supplied by renal arteries and testicular/ovarian arteries
In the pelvis they are supplied by superior and inferior vesical arteries
(veins are named the same)
What are the locations that a renal calculus is most likely to get stuck?
- uretopelvic junction
- pelvic brim
- vesicoureteric junction