US Lecture 1 - The Kidney and Urinary Tract Flashcards Preview

LSS 2 - Abdomen, Alimentary and Urinary systems > US Lecture 1 - The Kidney and Urinary Tract > Flashcards

Flashcards in US Lecture 1 - The Kidney and Urinary Tract Deck (43):
1

What does the kidney and urinary tract comprise?

Kidneys, ureters, urinary bladder and urethra

2

Where are the kidneys located?

In upper abdomen - RETROPERITONEAL, surrounded by dense fibrous capsule, which has renal fascia containing the peri-renal adipose tissue

3

What overlaps the kidneys?

The diaphragm posteriorly and the pleural cavity superiorly

4

What is the difference between the location of the right and the left kidney?

Right kidney is slightly lower than the left - superior pole of RK lies at 11th intercostal space and LK at 11th rib

5

Where are the hilums of the kidneys located?

Around L1

6

Fill in the blanks of the urinary system

7

What are the anterior relations of the kidney?

Right: liver, hepatic flexure and hilus lies behind 2nd part of duodenum Left: stomach, pancreas, spleen and splenic flexure

8

How are the kidneys supplied with blood?

Via renal arteries (short direct branches from abdominal aorta), BP drives ultrafiltration Renal vein drains into IVC

9

What does the abdomen vasculature look like in relation to the kidneys? - Fill in the blanks

10

What is the basic structure of the kidney? - FITB

11

Why does the cortex look granular?

Due to random organisation

12

Why is the medulla of the kidney striated?

Due to radial arrangement of tubules and micro-vessels

13

What is the kidney split into and why is that important?

It is multilobar, so each lobe drains through its own papilla and calyx

14

What does the structure of the inside of the kidney look like? FITB

15

Where are the ureters located?

Run vertically down posterior abdominal wall in the plane of the tips of the transverse processes of the lumbar vertebrae Crosses pelvic brim anterior to sacro-iliac joint and bifurcation of common iliac arteries

16

How do the ureters descend down the abdominal cavity?

Anteromedially to enter bladder at the level of ischial spine - need to go around the rectum (and vagina in females) to reach the bladder

17

How does urine travel down the ureter?

By peristalsis in the smooth muscle walls of the ureters - open diagonally through bladder wall

18

What are the 3 sites of ureteric constriction?

Pelviureteric junction, where ureter crosses pelvic brim and where ureter traverses bladder wall

19

Why does renal colic occur and where are they most likely to occur?

Due to kidney stones attempting to pass - in the first constriction of the ureter in the pelviuteric junction

20

What is the bladder's structure?

Pelvic organ - triangular pyramid with apex pointing anteriorly and base posteriorly Lined by urothelium (transitional epithelium), 3-layered epithelium with very slow cell turnover, large luminal cells present

21

What do luminal cells do?

Highly specialised low permeability luminal membrane which prevents dissipation of urine-plasma gradients

22

What is the structure of the bladder? - FITB

23

What are the 2 urinary sphincters?

Sphincter vesicae and sphincter urethrae

24

What is the sphincter vesicae?

Internal sphincter, smooth muscle, neck of bladder, reflex opening in response to wall tension

25

Which nervous system is the sphincter vesicae controlled by?

Parasympathetic

26

What is the sphincter urethrae?

External sphincter, striated muscle, in perineum - opened by voluntary inhibition of nerves

27

How is tone maintained?

By somatic nerves in Pudendal nerve (S2-4)

28

How does the activation of the reflex control of the internal sphincter urethrae work?

Bladder fills, stimulates stretch receptors which stimulate parasympathetic nerves and inhibit motor neurons, the PS nerve stimulate the bladder to contract, causing internal urethral sphincter to open mechanically

29

How does the activation of the voluntary control of the external sphincter urethrae work?

Cerebral cortex stimulates motor neurons and stretch receptors inhibit them - so motor neurons either cause, external US to open when motor neuron inhibited OR external US remains closed when motor neuron is stimulated

30

How is the urethra different in males than females?

Females: Paraurethral gland Males: Preprostatic/ prostatic/membranous/ spongy part of urethra

31

Fill in the blanks on the differences between male and female urethra differences

32

What is the male urethra comprised of?

Internal urethral orifice (bladder neck/outlet), prostatic urethra, membranous urethra, bulbar urethra, penile urethra, navicular fossa, external urethral meatus

33

What is the lymph drainage of the urinary system?

x

34

Under which ribs does the spleen lie?

Ribs 9-10

35

What are the posterior relations of the kidneys?

Abdominal wall: psoas major nearest to the medial side of kidney, then quadratus lumborum, and Transversus abdominis Above: diaphragm is present

36

How are the aorta and IVC arranged in the abdomen?

Aorta is to the left and IVC is to the right in the abdomen, so left renal vein is longer and passes in front of aorta, underneath IMA Renal artery passes underneath the IVC

37

What is the renal pelvis?

Each renal papilla is surrounded by a branch of the renal pelvis called a calyx. The major function of the renal pelvis is to act as a funnel for urine flowing to the ureter.

38

What is the arrangement of the urinary system in the abdomen?

39

How is the renal blood supply organised in the abdomen? FITB

X

40

How does the urine drain from the kidney?

Urine drains into the minor calyx, then major calyx which then all drains into the renal pelvis

41

From where does the ureter get its blood supply from and why does it need a blood supply?

Upper: from renal arteries Middle: common iliac arteries, some branches of abdominal aorta and gonadal arteries Lower: internal iliac arteries (and some others) Need it as it is a muscular tube and needs a continuous blood supply

42

Where is the bladder located?

Usually in the true pelvis but can be in the abdomen in children and when full in adults

43

What is the trigone?

It is a straight, not corrugated triangle shape in the bladder