Urinary System 1 - The kidney and urinary tract Flashcards Preview

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Flashcards in Urinary System 1 - The kidney and urinary tract Deck (24)
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1
Q

What are the contents of the urinary tract?

A
  • Kidneys
  • Ureters
  • Urinary bladder
  • Urethra
2
Q

Describe the position of the kidneys

A
  • Retroperitoneal in the upper abdomen
  • Covered with a dense fibrous capsule and fascial pouch containing peri-renal adipose tissue
  • Overlapped posterosuperiorly by the diaphragm and pleural cavity
  • Right kidney is lower than the left
3
Q

Describe the spinal level of the kidney

A
  • Superior pole of the right kidney is at the level of the 11th intercostal space
  • Left kidney superior pole is at the 11th rib
  • Hilum is at the level of L1
4
Q

List the layers around the kidney

A
  • Perinephric fat
  • Renal fascia
  • Paranephric fat
  • Transversalis fascia
5
Q

List the posterior relations of the kidney

A
  • Transversus abdominis muscle (lateral under rib 12)
  • Quadratus lumborum muscle (between transversus and psoas major muscles)
  • Psoas major muscle (under rib 12, medially)
  • Diaphragm covers the kidneys down to rib 12
6
Q

List the anterior relations of the kidney

A
  • Right - liver, hepatic flexure (hilus behind 2nd part of duodenum)
  • Left - stomach, pancreas, spleen and splenic flexure
7
Q

What is the hepatic flexure?

A

The sharp bend between the ascending colon and the transverse colon

8
Q

Describe the blood supply of the kidney

A
  • Rich supply via renal arteries
  • Short direct branches from the abdominal aorta
  • Blood pressure drives ultrafiltation
  • Renal veins drain into the IVC
9
Q

What is attached to the superior pole of the kidney?

A

Adrenal/supradrenal glands

10
Q

Describe the structure of the kidney

A
  • Cortex is granular-looking due to random organisation
  • Medulla striated because of radial arrangement of tubules and micro-vessels
  • Human kidney is multilobar – like a lot of simple kidneys stuck together
  • Each lobe drains through its own papilla and calyx via the renal medulla
11
Q

Describe the position of the ureters

A
  • Run vertically down the posterior abdominal wall in the vertical plane of the tips of the transverse process of the lumbar vertebrae
  • Cross the pelvic brim anterior to the sacro-iliac joint & bifurcation of the common iliac arteries
  • Descend anteromedially to enter bladder at the level of the ischial spine
12
Q

How do the ureters transport urine?

A

By peristalsis of the smooth muscle walls

13
Q

List the sites of ureteric constriction

A
  • Pelviureteric junction
  • Where the ureter crosses the pelvic brim
  • Where the ureter transverses bladder wall
14
Q

Describe the shape of the bladder

A

Triangular pyramid with apex pointing anteriorly and base posteriorly

15
Q

Describe the anatomy of the bladder and its location

A
  • Pelvic organ
  • Lined with urothelium
  • 3-layered epithelium with slow cell turn over
  • Large luminal cells have highly specialised low-permiability luminal membrane
  • Prevents dissipation of urine-plasma gradients
16
Q

Where is the pubovesical ligament?

A

Attaches the neck of the bladder to the inferior aspect of the pubis bones

17
Q

Where is the puboprostatic ligament?

A

Extends laterally from the prostate to the tendinous arch of the pelvic fascia and continues forward and medially from the tendinous arch to the pubis.

18
Q

What are the two urinary sphincters?

A
  • Sphincter vesicae (internal sphincter - smooth muscle)

- Sphincter urethrae (external sphincter - striated muscle)

19
Q

Describe the control of the sphincter vesicae

A
  • Smooth muscle, internal
  • At the neck of the bladder
  • Reflex opening in response to bladder wall tension
  • Relaxed by PNS, contracts by SNS
20
Q

Describe control of the sphincter urethrae

A
  • In the perineum (external)
  • Tone maintained by somatic nerves in pudenal nerve (S2, 3, 4)
  • Opened by voluntary inhibition of nerves
21
Q

Summarise the nervous control of the bladder

A
  • Bladder fills stimulating stretch receptors
  • This stimulates parasympathetic nerves to make the bladder contracts, opening the internal urethral sphincter
  • Stretch receptors inhibit motor neurons, which opens the external urethral sphincter. Cerebral cortex stimulation causes the sphincter to become closed
22
Q

How is the urethra different in males and females?

A
  • Shorter in females, 2 inches compared to 8 inches in males

- In males there are multiple parts of the urethra

23
Q

List the parts of the urethra in males

A
  • Preprostatic part of urethra
  • Prostatic part
  • Membranous part
  • Spongy part
24
Q

Describe lymphatic drainage of the urinary system

A
  • Vessels from the superiolateral region drain into external iliac lymph nodes
  • Vessels from the neck and fundus draining into the internal iliac lymph nodes and some into the sacral or common iliac lymph nodes.