urinary system Flashcards by Sarah Wang

what is the hilum

part of organ where the vessels and nerves enter or leave

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where do the kidneys sit in relation to the transpyloric plane

the hilum of the left kidney is 5cm lateral to the spinous process just above the level of the transpyloric plane
the hilum of the right kidney is 5cm lateral to the spinous process just below the level of the transpyloric plane

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why does the hillum of the right kidney sit just interior to the level of the transpyloric plane

the large liver moves the right sided organs down a bit

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what vertebral level does the transpyloric and supracristal plane discect the vertebrae at

transpyloric = T12/L1

supracristal = L3/4

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describe the location of perinephric and paranephric fat in relation to the kidney

perinephric fat = fat that sits within the renal fascia

paranephric fat = fat that sits outside the renal fascia around then kidney

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what is nephroptosis and what causes this

kidney drops down into the pelvis when the patient stands up.
due to renal fascia not being fused at the inferior side

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what are the glands found Sitting on top of the kidneys and what do they do

suprarenal glands
produce hormones that regulate metabolism, bp, response to cortisol (stress) etc

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what 4 hormones are made by suprarenal glands and there function

aldosterone (salt control in blood and body)

adrenaline

cortisol (Helping control your body’s use of fats, proteins and carbohydrates, or your metabolism.)

testosterone

estrogen

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find an image of the kidney and label its structure

cortex
medulla
major/minor calyx
papilla
renal pelvis
ureter
pyramid
renal column
renal capsule

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where does the kidney originate/ ascend from

pelvis

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what is renal ectopia and what is a common pathology because of this

kidneys fail to ascend resulting in a pelvic kidney
as they now have a shorter ureter they are more likely to develop vesicourethral reflux (urine travels wrong way)
this can cause UTI or urine incontinece

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why are people with pelvic kidneys more prone to blunt trauma

they dont have protection of perinephric fat and ribcage

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what do you call a kidney that ascends too high

thoracic kidney

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what is the role of the renal capsule

tough, fibrous layer for protection (structural role)

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what is the role of the cortex of the kidney

contains most of glomeruli where plasma is filtered from blood into filtrate that travels through tubules in nephron to become urine

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what is the role of the medulla in kidney

has stripped apperance of collecting ducts,

regulates concentration of urine

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how does the medulla regular urine concentration

it has lots of ions so water will leave the collecting ducts via osmosis as it heads towards the minor calicoes through the papillae

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where do hormones act in the kidney to increase or decrease amount of water in urine/ also used as site for drug tests

collecting ducts

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note the minor calyx drains into the major calyx then into the renal pelvis

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how many pyramids (renal tissue that helps with blood filtration and water conc) is found in each medulla

10-18

why is there a greater chance of stones in a horseshoe kidney

due to stasis (slowing or stoppage or normal flow) in abnormal drainage of kidney

why does a horseshoe kidney face more anteriorly

as they fuse underneath the inferior mesenteric artery, so they wrap around it and the ureters face more anteriorly

what is persistent fatal lobulation (normal variant)

incomplete fusion of the developing metal lobules

(can stimulate renal tumours in ultrasonography)

note that it is a normal variant to have only 1 accessory renal artery

25% of population has this

which direction do the vessels come from in the pelvis and abdomen

in abdomen = vessels come medially in pelvis = vessels come lateral

what are done with the ureters during surgery to insure they dont break

moved medially in the abdomen or laterally in pelvis (towards the vessels)

what is a urinary calculi/ stag horn or struvite stones, what causes it

- solid particles in the urinary system - caused by repetitive UTI ( consists of calcium oxalate etc)

what causes uric acid stone / gout

form when the levels of uric acid in the urine are too high, and/or the urine is too acidic on a regular basi

what do kidney stones look like on xray

ginger knobs

compare the 3 types of kidney stones: struvite, uric acid and cystine

struvite = contains mainly calcium/magnesium, caused by UTI infections uric acid = increased uric acid levels can form urate crystals in urine that end up getting settled in kidney developing stones cystine = inability to reabsorb cystine (amino acid) and it gets deposited in kidney, this eventually forms cystine stones

what are 3 common sites obstruction of renal tract

1. pelvic-ureteric junction (renal pelvis/ureter region) 2. crossing of iliac vessels 3. vesicle-ureteric junction (bladder/ureter region)

if the bladder fills, what structure does it push higher

peritoneum

why should you not place a suprapubic catheter in when the bladder is empty

you can end up piercing the bowel

why are women more susceptible to UTI's than males, what can this eventually manifest as

- they have a shorter urethra - cystitis, infection of the bladder

what do you call the structure where urine exits the urethra in male and females

external urethral orifice, is the opening where urine exits the male and female urethra.

what is a suprapubic catheter used for

hollow flexible tube that is used to drain urine from the bladder through a cut in the abdomen

in embryo, the bladder drains through a tube going through the umbilical cord called what

urachus

note the bladder moves downwards into pelvis, Sits below the pelvic brim when empty, when full arises above pubic bone

what is a urachal cysts and what pathology can this lead to and how can u treat this

- when the Uranus doesnt fuse properly when umbilical cord is cut - prone for infection, sepsis, fistula, cyst rupture - excision laparoscopically

find a diagram of the urinary bladder and label the structures

what are stretch receptors

signal the length and changes in length of muscle

where are stretch receptors found in the bladder and what is this area

trigone - located along the posterior surface of the bladder and marks the point of opening for the two ureters.

what do you call the structure in which the ureter enters in bladder found within the trigone

ureteric orifice

what are the 3 layers of the bladder

- mucosa (inner most layer with longitudinal folds) - detrusor muscle - adventitia (outer most layer)

what is the uvula of the bladder

what do you call the mucous glands found in the urethra

glands of littre

what percentage of the population have an accessory renal artery

25%

learn/understand what structures articulate with the surface of the kidneys, check images in album