Urinary system Flashcards
(180 cards)
1
Q
Enumerate the components of the urinary system and their respective function
A
Kidneys- process a filtrate of the blood to form urine
Ureters - conduct urine from the kidney to bladder
Urinary bladder - temporary storage for urine
Urethra - passage thru which urine is voided
2
Q
What are the functions of the urinary system?
A
Excretory - waste products of metabolism is excreted thru production of urine
Maintenance of body homeostasis - kidneys maintain the acid base balance of the body and maintain the normal body fluid by eliminating excess waster
Endocrine - releases of hormones like erythropoietin and renin ( control blood pressure)
Reproductive - exclusive to male urethra as passageways for semen. ( in females, urethra is for urinary function only)
3
Q
Explain the gross structure of the kidney
A
Bean shaped, reddish brown organ
Retroperitoneal on the posterior abdominal wall
Extend from T12 - L3
120-170g avg 150g
10-12cm L x 5-6cm W x 3-4cm a-p thickness
4
Q
Explain the position of the kidney
A
Left kidney is 1-2cm higher than the right kidney because of the presence of the liver in the right
In a Supine position - Left kidney superior pole - T12 Inferior pole - L3 Right kidney - IVC Left kidney - aorta
5
Q
What structures can bee seen. Between the kidneys?
A
Celiac plexus and ANS ganglia
6
Q
Explain the anterior anatomical relations of the kidney
A
Right kidney :
Transpyloric plane passes thru right pole
Hepatic flexure of the colon and duodenum
Right kidney is separated from the liver by the Hepatorenal recess
Left kidney: Tail of the pancreas Splenic flexure Stomach Jejunum Descending colon
7
Q
Explain the posterior anatomical relations of the kidney
A
2/3 of the posterior kidney lie on the quadrants limbo rum ms ( part of the posterior abdominal wall)
Medially - psoas ms
Laterally - transversus abdominis
Upper 1/3 of posterior kidney lies on the abdominal surface and arcuate ligament of the diaphragm
8
Q
What are the structures to take note of during surgery of the kidney via the posterior abdominal wall?
A
Sub costal or 12th intercostal nerve
Iliohypoogastric nerve
Ilioinguinal nerve
9
Q
What is the main function of the renal fascia?
A
It provides or serves as a barrier against spread of infection
Note: renal fascia
- represents the TRUE capsule
- can be stripped off from normal parenchyma
- thin, fibrous glistening membrane which encloses the renal parenchyma
10
Q
What is the adipose capsule found immediately outside the true capsule?
A
Perirenal/ perinephric fat
11
Q
The renal capsules are compose of what structures?
A
Perirenal/perinephric fat
Gerota’s fascia/ fibrous renal fascia
Pararenal/ para nephron fat
12
Q
What is the Pararenal or para euphoric fat?
A
Extra peritoneal fat of the lumbar region
13
Q
What is the gerota’s fascia or fibrous renal fascia?
A
Fascia enclosing the Perirenal fat. Referred to as renal fascia
14
Q
What is the Perirenal or perinephric fat?
A
Adipose capsule found immediately outside the true capsule
15
Q
Explain the border curvature relationship of the kidney
A
Convex lateral border
Concave medial border
16
Q
Explain the structure of the kidney
A
Convex lateral border
Concave medial border
Rounded poles , superior and inferior
Medial surface is concave indented by the hills which leads to the renal sinus
17
Q
Differentiate renal sinus vs renal pelvis
A
Renal sinus is the area surrounding the calyces
Renal pelvis is the expanded upper end of the ureter.
18
Q
It transmits renal vessels
A
Hilus
19
Q
State the renal vessels from anterior to posterior
A
Renal vein
2 renal arteries
Ureter
20
Q
Differentiate the shape of kidney and renal pelvis
A
Kidney is bean shape or ovoid shape
Renal pelvis is flattens, funnel shape
21
Q
It is the expansion of the superior end of the ureter
A
Renal pelvis
Note: apex of the renal pelvis is continuous with the ureter
Receive 2-3 major calyces
22
Q
The minor calyces of the renal pelvis is indented by what structure?
A
Renal papilla, the apex of the renal pyramid, from which the urine is excreted
23
Q
Explain the internal appearance of the kidney
A
The renal pyramid contain the collecting tumbles and from the medulla of the kidney. The renal cortex contain the renal corpuscles.
The renal papilla, project into the minor calyces,into which they discharge urine, which then passes into the major calyces and renal pelvis
24
Q
Enumerate the structures of the renal parenchyma
A
Cortex ( outer ) - dark brown and grainy
Medulla ( inner ) - light brown and striated
25
List and explain the parts of the outer renal parenchyma.
Cortical arches
Renal columns of bertin - in between pyramids
Medullary rays - long delicate processes separating tubules
Contains Nephron - only in cortex
Note: outer renal parenchyma is also known as cortex
26
Perforated tips located in the medulla or the inner renal parenchyma where the urine passes through.
Area cribosa
Note:
Medulla have 6-10 medullary pyramids
Apex - renal papilla and area cribosa
Base - medulAry rays made up of collecting tables and LH
27
Each medullary pyramids plus the cortical tissue at its base and along it's side constitutes what structure?
Renal lobe.
28
Laterality and shaped of the suprarenal (adrenal ) glands
L suprarenal gland - crescent shape - superomedial
| R - suprarenal gland - pyramid in shaped - more apical location
29
It is located between superomedial aspects of kidney and diaphragm
Suprarenal gland
30
Suprarenal gland is separated from the kidney via a what? Which is a part of what?
Thin septum , renal fascia
31
What is the major attachment of suprarenal gland?
Diaphragmatic crura.
Suprarenal gland is not attached to the kidney so the movement of the diaphragm may move the gland
32
Compare the left and right adrenal gland by shape, location and anatomical relations
Shape: L-crescent R-pyramid
Location: L-superomedial R-more apical, located anterolateral to the right crus of diaphragm
Anatomical relations: L-related to spleen , stomach, pancreas and left crus of diaphragm
R-in contact with liver, anterolaterally
In contact with IVC, anteromedially
33
What are the parts of adrenal glands?
Suprarenal cortex - derived from mesoderm
- secretes androgen and steroids, these hormones cause the kidneys to retain sodium and water in response to stress, increasing blood volume and blood pressure.
Suprarenal medulla - from neuroectoderm
- mass of nervous tissue permeated with capillaries and sinusoids associated with sympathetic nervous system
- chromaffin cells of medulla are related to sympathetic Anglian neurons and both derivation and function
34
Chromatin cells secretes?
Catecholamines
| Where epinephrine and norepinephrine activates the body's fight or flight response
35
Why does the suprarenal gland or adrenalin gland has abundant blood supply?
Because of its endocrine function
36
What are the arterial blood supply of the adrenal gland or suprarenal gland
Superior suprarenal a. Fom inferior phrenic a.
Middle suprarenal a from abdominal aorta
Inferior suprarenal a from the renal a
37
What are the venous drainage of the suprarenal glands via suprarenal veins
R suprarenal veins -> IVC
| L suprarenal veins -> L renal vein
38
What are the nerve supply of the suprarenal glands
Celiac plexus and abdominopelvic splay chic nerves
| Presynaptic sympathetic fibers - derived from the lateral horn of gray matter of spinal cord T10-L1
39
What is the main arterial blood supply to the kidneys?
Renal Artery
40
Which renal artery is longer?
Right renal artery
41
Where does the renal artery arises?
Arises from the IV disc between the L1 and L2
42
What are the vascular/Renal segments?
```
Apical Segmental a.
Anteroinferior Segmental a.
anterosuperior Segmental a.
inferior Segmental a.
posterior Segmental a.
```
43
Where does the venous drainage of the kidneys blood supply
Renal veins -> IVC
44
Left renal vein receives blood from?
L. suprarenal v
L gonadal v
L ascending lumbar v
45
what are the microvasculature of the kidney
interlobar a
afferent arteriole
efferent arteriole
peritubular capillaries
46
a microvasculature of the kidney that is present on each side of the renal lobe
interlobar a
47
a microvasculature of the kidney that serves as the entrance to the glomerus
afferent arteriole
48
a microvasculature of the kidney that serves as the exit from the glomerus
efferent arteriole
49
In the vasa recta, the microvasculature to the kidneys loop back into thecortex to become _____?
interlobular vein
50
What are the medullary blood supply?
vasa recta
51
What are the two types of vasa recta?
vasa recta vera - true vasa recta
| vasa recta spuriae - false vasa recta
52
where does the vasa recta vera arise directly from?
arcuateor interlobular vein
53
participates in countercurrent exchange system
vasa recta vera
54
vasa recta spuriae extends to __?
cortex and the medulla
55
What are the parts of the ureter
renal pelvis
abdominal uereter - false ureter
pelvic ureter - true ureter
intravesical ureter
56
Ureters are muscular tube that is ____ in location and its length is ____. Ureters is continous superiorly with the ______.
retroperitoneal
20-25cm
renal pelvis
57
right ureter is parallel or lateral to _____ while the left ureter is parallel or lateral with the ______
IVC
| abdominal aorta
58
Ureter runs in the medial part of ____
psoas muscles
59
ureter is obliquely crossed by ____
gonadal vessels
60
ureter lies anterior to the ______ from the ____
internal iliac artery
| pelvic side wall
61
ureters enter the bladder _____?
posteriorly
62
ureters cross ________ to enter ______ near the bifurcation of ________
iliac vessels ; pelvis; internal and external arteries
63
Uereters courses under the uterine vessels very near the _____ of the uterus
isthmus
64
state the ureteric constrictions
- junction of tghe ureters and renal pelvis
- where the ureters cros the pelvic brim
- during passage thru the wall of urinary bladder
65
It is the most common pathalogic condition in the kidneys
kidney stones
66
What are the arterial blood supply of the ureters
renal a
testicular or ovarian a
abdominal a
common iliac a
67
These branches of the arterial blood supply of the ureter divide into ascending and descending branches and form ______ on the ureter wall
longitudinal anastomoses
68
Waht is the venus drainage of the ureter
renal v
| gonadal v
69
Blood vessels of the ureters are easily traumatized during surgery, damage to the small blood vessels may lead to _____
ischemia
70
histological shape of ureter
stellate shaped lumen
71
What is the epithelial lining of ureter
transitional epithelium or urothelium - ----single layer of small basal cells
- intermediate layer of one to several layers of columnar cells
- umbrella cells (polyhedral) - binucleated / multinucleated
72
umbrella (polyhedral) cells expresses _____ whcih protect the lining of the ureter from toxic effects of urine
uroplakin proteins
73
The kidney is innervated by
- renal nerve plexus
| - sympathetic and parasympathetic fibers from the abdominopelvic sphlanchnic nerves
74
The ureter is innervated by
renal, aortic, superior and inferior hypogastric nerves
75
_____ follow the sympathetic fibers to spinal ganglia and cord segments T11-L2
Visceral afferent pain fibers
76
In the renal calculi, pain is referred to the ______
(loin of the groin)
| ipsilateral lower quadrant of the anterior abdominal wall
77
Afferent pain fibers follow sympathetic fibers to the ___
spinal ganglia and cord segments T11-L2
78
Name the corresponding innervation to the following organs: kidney, abdominal part of the uterus and suprarenal gland
kidney - renal nerve plexus
abdominal part of the uterus - renal, abdominal aortic and superior hypogastric plexus
suprarenal gland - celiac plexus and greater, lesser, least splanchnic nerves
79
a. renal lymphatic vessels drain into ____
b. superior part of ureter drain into ____
c. middles part of ureter drain into ____
d. inferior part of ureter drain into ____
e. suprarenal LV from medulla drain into ____
a. R and L lumbar lymph nodes
b. lumbar nodes
c. common iliac nodes
d. common, external, internal iliac nodes
e. lumbar lymph nodes
80
Extraperitoneal organ lying within the pelvis that is receptacle for urine storage
Urinary bladder
81
Urinary bladder have strong muscular wall called
Detrusor ms
82
State the shape of the urinary bladder and its location when it is empty and full
empty - tetrahedral; lies within the lesser pelvis
filled state - bladder is ovoid shapes; ascends abdominal cavity
83
Central and superoposterio part taht expands freely, rises above pubic crest
Fundus
84
Apex is the anterosuperior portion of the bladder, connected to anterior abdominal wall by ____
median umbilical ligament (remnant of the primitive urachus)
85
The posteroinferior portion of this part bladder that has two ureteric orifices
body
86
The base of the bladder lies on t he pelvic floor forming what?
TRIGONE
87
TRIGONE is a triangular area fromed by a line drawn between twe ureteric orifices and apex formed by the ___
internal urethral meatus
88
The neck of the bladder is continous with
urethra
89
This is attached directly to the base of the bladder, anterior to the rectum
prostate gland - base
90
The base of the urinary bladder among females rest directly on the ___ and is closely related to _____
pelvic floor inferior to the uterus
anterior vaginal wall
91
Fibrous cord extending from apex of the bladder to the umbilicus
Median Umbilical Ligament
92
Median Umbilical Ligament is a remant of
urachus
93
It stabilizes the bladder anteriorly
Lateral Umbilical Ligament and Medial Umbilical Ligament
94
medial puboprostatic (males ) or medial pubovesical ligament (females) is from the ___ to ___
From the back of symphysis pubis to bladder neck and prostate (males)
95
lateral puboprostatic (males ) or lateral pubovesical ligament (females) is from the ___ to ___
from pelvic fascia at area of levator ani to the neck of the bladder and prostate
96
Stabilizes the bladder neck
lateral puboprostatic (males ) or lateral pubovesical ligament (females)
97
What are the branches of the internal ilian artery
superior vesical a. - superolateral/anterosuprior wall
| inferior vesical a.
98
the inferior vesical artery is replaces by what in the females
vaginal artery
99
inferiot vesical artery is consist of
ureter, fundus and neck of bladder, prostate and urethre
100
In the venous drainage of bladder, the pericesical plexus drains to ____ which drains to ____
inferior vesical v. ; internal iliac vein
101
Hypogastric Plexus or “Filling Nerves” is found in what vertebral level?
T11-L2
102
Inhibit detrussor muscle contraction
Hypogastric Plexus or “Filling Nerves”
103
Hypogastric Plexus or “Filling Nerves” increases _____ and stimulates _____
internal urethral sphincter tone
ejaculation
-sympathetic
104
Pelvic Splanchnic Nerves and Inferior Hypogastric Nerves or “Emptying Nerves” is found at what vertebral level
S2-S4
- parasympathetic
- relaxes the internal urethra sphincter
- contract the bladder
105
Lymphatic drainage of the bladder found in the anterior/superolaterl wall
external iliac node
106
Lymphatic drainage of the bladder found in the posterior/fundus and neck lymphatic vessels
internal iliac node
107
Lymphatic drainage of the bladder found in the neck of bladder lymphatic vessels
sacral nodes and/or common iliac nodes
108
What is the basic histological structure of the bladder
- mucosa (urothelium) - lined by transitional epithelium
- lamina propria
- muscularis mucosae (detrusor ms)
adventitia
109
Urothelium is made of
a. Basal layer
b. Intermediate layer
c. Umbrella cells
– cuboidal cells
– polygonal; has ability to stretch
– protective layer
110
Lamina propria is made of
connective tissue bed with capillaries, lymphatics and nerves
111
Inner, middle and outer layers of smooth muscles (detrusor muscles) is made of
longitudinal ms layer
| circular ms layer
112
male urethra starts from ___ to ____
- bladder neck
- external meatus of glands penis
20cm in length
113
The 3 parts of urethra
- prostatic urethra - 3cm long - widest and most dilatable portion
- membranous urethra - 2cm long - shortest and least dilatable
- spongy or penile urethra - 15cm long
114
Parts of the prostatic urethra
- urethral crest
- prostatic sinuses - where prostate glands opens
- utricle
- ejaculatory ducts
115
This is where the urinary and reproductive system of males converge
prostatic urethra
116
membranous urethra is surrounded by ____
urethral shpincter ms
117
Prostatic urethra transverses through prostate gland and terminate at _____
superior fascia of urogenital diaphragm
118
Female urethra has this type of glands that is homologous of prostate gland in males) and are found at sites of _____
paraurethral glands
external urethral meatus
female urethra -
- 4cm long
- exclusively a urinary organ
119
What are the blood supply of the urethra for males and females
males
- prostatic vesels - inferior vesical and middle rectal artery - in prostatic urethra
- dorsal artery of penis - in membrabous and spongy urethra
females
- internal pudendal a
- vaginal artery
120
What are the venous drainage of the urethra for the males and females
males - prostatic venous plexus
females- internal pudendal vein
vaginal vein
121
What innervates the male's urethra
| ?
prostatic nerve plexus - from hypogastric plexus
dorsal nerves of penis from pudendal nerve
122
Waht innervates the female's urethra?
vesical nerve plexus
| pudendal nerve
123
What are the histological parts of the male urethra
- urethral mucosa - large longitudinal folds
- prostatic urethra - lined by transitional epithelium
- membranous urethra is lined by stratified columnar and pseudostratified epithelium
- spongy urethra i slined by stratified columnar epithelium and pseudostratified columnar epithelium with stratified squamous epithelium distally
124
What are the histological parts of the female urethra (lining)
- Proximal part - lined by transitional epithelium
- distal part - lined by stratified squamous, non-keratinizing
- middle part - surrounded by external sphincter (striated ms)
125
Fibrous cord extending from apex of the bladder to the umbilicus
Median Umbilical Ligament
126
Median Umbilical Ligament is a remant of
urachus
127
It stabilizes the bladder anteriorly
Lateral Umbilical Ligament and Medial Umbilical Ligament
128
medial puboprostatic (males ) or medial pubovesical ligament (females) is from the ___ to ___
From the back of symphysis pubis to bladder neck and prostate (males)
129
lateral puboprostatic (males ) or lateral pubovesical ligament (females) is from the ___ to ___
from pelvic fascia at area of levator ani to the neck of the bladder and prostate
130
Stabilizes the bladder neck
lateral puboprostatic (males ) or lateral pubovesical ligament (females)
131
What are the branches of the internal ilian artery
superior vesical a. - superolateral/anterosuprior wall
| inferior vesical a.
132
the inferior vesical artery is replaces by what in the females
vaginal artery
133
inferiot vesical artery is consist of
ureter, fundus and neck of bladder, prostate and urethre
134
In the venous drainage of bladder, the pericesical plexus drains to ____ which drains to ____
inferior vesical v. ; internal iliac vein
135
Hypogastric Plexus or “Filling Nerves” is found in what vertebral level?
T11-L2
136
Inhibit detrussor muscle contraction
Hypogastric Plexus or “Filling Nerves”
137
Hypogastric Plexus or “Filling Nerves” increases _____ and stimulates _____
internal urethral sphincter tone
ejaculation
-sympathetic
138
Pelvic Splanchnic Nerves and Inferior Hypogastric Nerves or “Emptying Nerves” is found at what vertebral level
S2-S4
- parasympathetic
- relaxes the internal urethra sphincter
- contract the bladder
139
Lymphatic drainage of the bladder found in the anterior/superolaterl wall
external iliac node
140
Lymphatic drainage of the bladder found in the posterior/fundus and neck lymphatic vessels
internal iliac node
141
Lymphatic drainage of the bladder found in the neck of bladder lymphatic vessels
sacral nodes and/or common iliac nodes
142
Fibrous cord extending from apex of the bladder to the umbilicus
Median Umbilical Ligament
143
Median Umbilical Ligament is a remant of
urachus
144
It stabilizes the bladder anteriorly
Lateral Umbilical Ligament and Medial Umbilical Ligament
145
medial puboprostatic (males ) or medial pubovesical ligament (females) is from the ___ to ___
From the back of symphysis pubis to bladder neck and prostate (males)
146
lateral puboprostatic (males ) or lateral pubovesical ligament (females) is from the ___ to ___
from pelvic fascia at area of levator ani to the neck of the bladder and prostate
147
Stabilizes the bladder neck
lateral puboprostatic (males ) or lateral pubovesical ligament (females)
148
What are the branches of the internal ilian artery
superior vesical a. - superolateral/anterosuprior wall
| inferior vesical a.
149
the inferior vesical artery is replaces by what in the females
vaginal artery
150
inferiot vesical artery is consist of
ureter, fundus and neck of bladder, prostate and urethre
151
In the venous drainage of bladder, the pericesical plexus drains to ____ which drains to ____
inferior vesical v. ; internal iliac vein
152
Hypogastric Plexus or “Filling Nerves” is found in what vertebral level?
T11-L2
153
Inhibit detrussor muscle contraction
Hypogastric Plexus or “Filling Nerves”
154
Hypogastric Plexus or “Filling Nerves” increases _____ and stimulates _____
internal urethral sphincter tone
ejaculation
-sympathetic
155
Pelvic Splanchnic Nerves and Inferior Hypogastric Nerves or “Emptying Nerves” is found at what vertebral level
S2-S4
- parasympathetic
- relaxes the internal urethra sphincter
- contract the bladder
156
Lymphatic drainage of the bladder found in the anterior/superolaterl wall
external iliac node
157
Lymphatic drainage of the bladder found in the posterior/fundus and neck lymphatic vessels
internal iliac node
158
Lymphatic drainage of the bladder found in the neck of bladder lymphatic vessels
sacral nodes and/or common iliac nodes
159
Urothelium is made of
a. Basal layer
b. Intermediate layer
c. Umbrella cells
– cuboidal cells
– polygonal; has ability to stretch
– protective layer
160
Lamina propria is made of
connective tissue bed with capillaries, lymphatics and nerves
161
Inner, middle and outer layers of smooth muscles (detrusor muscles) is made of
longitudinal ms layer
| circular ms layer
162
male urethra starts from ___ to ____
- bladder neck
- external meatus of glands penis
20cm in length
163
The 3 parts of urethra
- prostatic urethra - 3cm long - widest and most dilatable portion
- membranous urethra - 2cm long - shortest and least dilatable
- spongy or penile urethra - 15cm long
164
Parts of the prostatic urethra
- urethral crest
- prostatic sinuses - where prostate glands opens
- utricle
- ejaculatory ducts
165
This is where the urinary and reproductive system of males converge
prostatic urethra
166
membranous urethra is surrounded by ____
urethral shpincter ms
167
Prostatic urethra transverses through prostate gland and terminate at _____
superior fascia of urogenital diaphragm
168
Female urethra has this type of glands that is homologous of prostate gland in males) and are found at sites of _____
paraurethral glands
external urethral meatus
female urethra -
- 4cm long
- exclusively a urinary organ
169
What are the blood supply of the urethra for males and females
males
- prostatic vesels - inferior vesical and middle rectal artery - in prostatic urethra
- dorsal artery of penis - in membrabous and spongy urethra
females
- internal pudendal a
- vaginal artery
170
What are the venous drainage of the urethra for the males and females
males - prostatic venous plexus
females- internal pudendal vein
vaginal vein
171
What innervates the male's urethra
| ?
prostatic nerve plexus - from hypogastric plexus
dorsal nerves of penis from pudendal nerve
172
Waht innervates the female's urethra?
vesical nerve plexus
| pudendal nerve
173
What are the histological parts of the male urethra
- urethral mucosa - large longitudinal folds
- prostatic urethra - lined by transitional epithelium
- membranous urethra is lined by stratified columnar and pseudostratified epithelium
- spongy urethra i slined by stratified columnar epithelium and pseudostratified columnar epithelium with stratified squamous epithelium distally
174
What are the histological parts of the female urethra (lining)
- Proximal part - lined by transitional epithelium
- distal part - lined by stratified squamous, non-keratinizing
- middle part - surrounded by external sphincter (striated ms)
175
Embryology, What are the 3 overlapping kidney systems
Pronephros - rudimentary and non-functional
mesonephros - functions for short time
metanephros - definitive kidneys - develops its own nephrons
176
Pronephros is an excretory organ which appears first beginning at what week of intrauterine life
4th
177
This regress in females, and serves as a conduit for the semen coming from the testes to the urethra for males
Wolffian/ mesonephric duct
178
metanephros appears in what week ?
5th
179
Metanephros collecting system originates from the ____ which delvelops from _____
ureteric bud
| mesonephric duct
180
Embryology, structures that originates from the ureteric bud
ureter
renal pelvis
calyces
collecting tubules
