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Testing123 > Urinary system > Flashcards

Urinary system Flashcards

1
Q

Urinary system

A

a) Kidneys
b) Urinary tract;
- renal calices
- renal pelvis
- ureters
- urinary bladder
- urethra

*Prod. of urine, thus elimination of waste from body (urea, uric acid, foreign subst…)
*Maintain fluid homeostasis - water og electrolytes
*Prod of hormones og enzymes (Erythropoietin, Renin,
1,25-dihydroxycholecalciferol)

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2
Q

Kidney (REN)

A

12x6x4 cm. 120-170gr. ventrodorsally flattened

  • Retroperitoneal
  • Frá T12-L2(3)

*right kidney aðeins lower (below liver)

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3
Q

Kidneys relations

A

Posteriorly:

  • Diaphragm (sep. kidneys from pleural cavity - costodiaphragmatic recess)
  • Psoas major m
  • Quadratus lumborum m
  • Transversus abdominis m
  • 11 og 12 ribs
  • Subcostal vessels + nerves
  • Iliohypogastric og Ilioinguinal nerves

Anteriorly;
-Right kidney) supraren. gland, liver, desc duodenum, right colic flexure og jejunum

-Left kidney) supraren. gland, stomach, spleen, body pancreas, left colic flexure, jejunum

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4
Q

Kidneys, external lýsing

A
  • Ant/Post surfaces
  • Sup/Inf extremities
  • Medial/Lateral borders (Lateral convex, Medial concave)
  • Renal hilum (in middle of medial border)
  • -> renal vessels, lymphatics + nerves and renal pelvis enter/leave kidney thru Hilum
  • left kidney L1. -right kidney L1-L2
  • structures in renal hilum: Renal vein, ant.ramus renal A, renal pelvis og post.ramus renal A.
  • Renal sinus; Renal hilum leads into the cavity (renal sinus)
  • ->þar er, renal vessels, lymphatics, nerves, renal calices, renal pelvis og perirenal fat.
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5
Q

Kidney structure (in frontal section)

A

1) fibrous capsule; covers ext. surf
2) Cortex: outer pale layer, makes up renal columns á milli renal pyramids

3) Medulla; forms renal pyramids. Bases snúa að cortex, Apices(papillae) að renal sinus.
- Renal papilla með papillary foramina, surrounded by minor calyx

*One Renal lobe= 1 pyramid og adjac. cortex

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6
Q

Nephron

A

a) Renal cortex contains: renal corpsucle, prox+distal tubule og cortical p. of collecting ducts
b) Renal medulla contains; loop of henle og medullary p. of collecting ducts
* Glomerular filtration: water, salts, nutrients og waste moves from glomerulus inn í inside of glom.capsule –>filtrate
* Tubular reabsorption: nutrients og salts actively reabsorbed from prox. conv. tubule into peritubular capillary network. Water flows passively.
* Tubular secretion: Certain molecules are actively secreted from peritubular capillary network into distal conv. tubule
* Reabsorption: of sodium from distal conv. tubule og water from collecting duct (under hormonal control)

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6
Q

Nephron

A

a) Renal cortex contains: renal corpsucle, prox+distal tubule og cortical p. of collecting ducts
b) Renal medulla contains; loop of henle og medullary p. of collecting ducts
* Glomerular filtration: water, salts, nutrients og waste moves from glomerulus inn í inside of glom.capsule –>filtrate
* Tubular reabsorption: nutrients og salts actively reabsorbed from prox. conv. tubule into peritubular capillary network. Water flows passively.
* Tubular secretion: Certain molecules are actively secreted from peritubular capillary network into distal conv. tubule
* Reabsorption: of sodium from distal conv. tubule og water from collecting duct (under hormonal control)

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7
Q

Renal fat and fascia

A

Kidneys are enclosed in fat and fascia

A)Perinephric (perirenal) fat; beint outside fibr. capsule of kidney + inside renal sinus

B)Renal (perirenal) fascia; úr anterior + post. layers

  • cranially/laterally, the ant+post layers are fused
  • medially/inferiorly, there’s no conn. milli ant+post layers
  • renal fascia einnig encloses supraren. glands

C)Paranephric (pararenal) fat; accumulation of fat posteriorly and posterolaterally outside the renal fascia

  • kidneys are held in position by
  • apposition of neighb organs
  • renal fascia + renal vessels
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8
Q

kidneys, supply

A

1) Blood supply og venous drainage;
- right+left renal artery (of abd.aorta)

Renal artery (ant og post ramus)---> Segmental aa
-->Lobar aa --> Interlobar aa
  • right+left renal veins, drained into IVC
    2) L. drainage: Lumbar l.nodes

3) Nerve supply; Renal plx
a) symp. fibers (from aortic plx, coeliac gangion and coeliac plx)

b)parasymp. fibers from Vagus n.

C)sensory fibers: from fibr. capsule, thru spinal nerves (segment T10 and T11)

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9
Q

Renal segments (respecting branching of the renal A)

A

1) ant. segment 2)ant. sup. segment 3)ant. inf. segment
4) inf. segment 5)post. segment

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10
Q

Renal calices

A

-Í renal sinus. -take urine to renal pelvis

A)Minor renal calices; 7-14 stk, att. to renal papillae (one calyx to one papilla). Drained into major calices

B)Major renal calices; oftast 3 stk (sup, middle, inf).
Drained into renal pelvis

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11
Q

Renal pelvis

A

External lýsing; funnel-shaped, flattened anteroposteriorly.
G verið dendritic eða ampullar type.

  • located in renal sinus, leaving thru renal hilum
  • Proj. onto skeleton; L1-L2

*Pelviureteric junction; ca 1/2 length milli renal hilum og inf. pole of kidney

-Relations;
Right renal pelvis; desc duodenum
Left renal pelvis; body pancreas
In both sides; renal vessels

  • Blood+nerve supply for renal pelvis og calices
  • –> same as kidneys
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12
Q

Ureter

A

-retroperitoneal -run on ant.surf of psoas major
25-30cm long og 3-6mm diameter

parts; 1)abdominal 2)pelvic 3)intramural

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13
Q

Constrictions of ureters

A

1) Pelviureteric juntion
2) Pelvic inlet (crossing w. iliac vessels)
3) Entrance to bladder

*Kidney stones may be get trapped at these constrictions

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14
Q

Ureter, abdominal part

A

Desc. in retroperitoneal space on ant.surf of Psoas major

-Relations:
Genitofemoral n
Gonadal vessels (testicular/ovarian)
Iliac vessels
*On the right; att. of root of mesentery
*On the left; att. of root of sigmoid mesocolon
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15
Q

Ureter, pelvic part

A

Males:

  • Internal iliac vessels
  • Obturator vessels and nerve
  • Deferent duct
  • Seminal vesicles

Females:

  • Internal iliac vessels
  • Obturator vessels and nerve
  • Uterine artery* (clinically important; during hysterectomy, ureter has to be identified and isolated from uterine artery)
16
Q

Ureter, supply

A

Blood supply og venous drainage;

  • Renal artery -Testicular/ovarian arteris -A. of def.duct/uterine A
  • Sup and Inf vesical aa + corresponding veins

Lymph.drainage into;

  • Lumbar l.nodes
  • Common iliac l.nodes
  • Internal iliac l.nodes
Nerve supply;
symp + parasymp fibers from-->
-Renal plx
-Testicular/ovarian plx
-deferential plx

Sensory fibers;
-thru splanchnic nerves-segments T10-L1

17
Q

Urinary bladder

A

-capacity; 200-300 ml. Exceptionally 500-750 ml.

Position;

  • In lesser pelvis
  • empty bladder er subperitoneal (behind pubic symphysis)
  • full bladder er preperitoneal (above pubic symphysis, in front of parietal peritoneum/peritoneal cavity, directly behind ant.abd.wall)
18
Q

Urinary bladder, external lýsing og parts

A

a) Apex; snýr upwards + forwards
* Median umblical ligament (urachus), cont. from it superiorly on ant.abd.wall to the umblicus

b) Body

c) Fundus/base; posteroinferior part
* hér er smooth area–> Trigone (milli openings of ureters+urethra)

d) Neck; surr. origin of urethra. Most inf. part of bladder og most fixed part
(pubovesical lig in female, puboprostatic in male)

19
Q

Urinary bladder, relations

A

Male;
-Inferiorly: Prostate

-Dorsally; Rectum (rectovesical pouch)
Seminal vesicles and deferent duct (both in rectovesical septum)

  • Dorsocranially; Sigmoid colon and Ileum
  • Ventrally; Pubic symphysis og retropubic space
  • Inferolaterally; Pelvic diaphragm

Female;
-Dorsally; uterus (Vesicouterine pouch, body of uterus) og vagina (Vesicovaginal septum, uterine cervixc + vagina)

  • Ventrally; Pubic symphysis og retropubic space
  • Inferiorly; pelvic diaphragm
20
Q

Wall of urinary bladder

A

1) mucous coat (svo submucous layer)

2) muscular coat 3)serous coat

21
Q

wall of bladder: mucous coat

A

mucous coat=interior of bladder

-mucous membrane loosely att. to muscular coat
(folded in muc. folds that disappear when bladder fills)

*Trigone; er smooth because mucosa is firmly att. to muscular coat. -Í fundus.
Bordered by orifices of ureters (posteriorly) conn. by interureteric crest og urethral orifice (anteriorly)
((In male; orifice is elevated due to middle lobe of prostate
–> uvula)

22
Q

wall of bladder, muscular layer

A

Smooth muscle that forms:
Detrusor muscle, has 3 layers
(internal-plexiform, middle-circular, outer-longitudinal)

  • Internal urethral spinchter–> involuntary, derived from circular layer.
  • rectovesical and pubovesical muscles, derived from external layer of muscular coat.
  • diff. nerve supply; parasymp. fibers for detrusor
    symp. for spinchter
23
Q

wall of bladder, serous coat

A
  • Peritoneum covers upper+posterior surf of bladder
  • Tunica adventitia
  • Paracystium; sparse tissue around the bladder

Fixation of the bladder;

  • Ventrally; pubovesical ligg. In male also puboprostatic ligg.
  • Dorsally; rectovesical ligg in male, vesicouterine ligg in female
  • Caudally; to the prostate in male, to the urethra in female
  • ->in both to urogenital diaphragm

*Behind the bladder, peritoneum forms pouch;
In male; rectovesical pouch, below it rectovesical septum
In female; vesicouterine pouch, below it vesicovaginal septum

24
Q

Male urethra 18-25cm

A
  • Internal urethral orifice surr. by internal urethral spinchter
  • External urethral orifice opens on top of the glans of penis (is the narrowest p. of urethra)

parts of male urethra:
intramural p, prostatic p, membranous p and spongy p

25
Q

parts of male urethra

A

1) Intramural (preprostatic part);
- thru bladder wall, internal urethral spinchter

2) Prostatic part;
- widest, fusiform part.
- post. wall shows urethral crest and colliculus seminalis w openins of ejaculatory ducts
- prostatic ducts open here

3) Membranous part;
- shortest, narrowed part
- runs thru urogenital diaphragm
- external urethral spinchter (derived from fibers from urogenital diaphragm)

4) Spongy part;
- within corpus spongiosum of penis
-longest part, curved in the subpubic flexure
-dilated at its ends
(proximally;ampulla, distally;navicular fossa)
-ducts of bulbourethral gland open here

  • Constrictions:
    1) ext.urethral orifice. 2)Spongy part. 3)Membr part. 4)Intramural part,
  • Dilations;
    1) navicular fossa. 2)ampulla at onset of spongy part
    3) prostatic part.
26
Q

female urethra 2,5-4 cm

A

-internal urethral orifice surr. by internal urethral sphincter

-ext. urethral orifice opens into vaginal vestibule
In front of vaginal orifice, on the papillae urethralis

  • Female urethra desc. downwards og forwards
  • Then perforates urogenital diaphragm (here surr. by ext. urethral spinchter, derived from urogenital fibers)

*Dorsally; Vagina *Ventrally; retropubic space

Testing123 (36 decks)

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