0729- anatomy of kidney- CG

Question 1

Name 3 functions of kidney (renal physician)

Answer 1

• Regulate body fluid, electrolyte balance and acid-base balance.

• Remove metabolic wastes and toxins (urea, urobilinogen)

(RFT: EUC [urea creatine, CMP- calcium, mg, phosphate)

• Endocrine functions

erythropoietin, renin).

Question 2

Outline the plumbing system of urinary system (urologist)

Answer 2

Ureters transport urine from kidney to bladder.

Bladder stores urine.

Urethra discharges urine from body.

Question 3

Label

Answer 3

NB- renal sinus is the whole area occupied by calyx, blood vessels in renal pelvis

It’s actually empty space

Renal pyrmid in medulla, topped by a renal cortex. Junction is where stuff flows

Question 4

Name and label the renal segments

Answer 4

Anterior view

Superior (apical)

Anterosuperior

Anteroinferior

Inferior

Posterior view

Posterior

Inferior and superior bend onto posterior side

Kidney: segment –> lobe!

Lung and liver: lobe –> segments!

Question 5

Outline the inflow and outflow of blood supply to kidney. Which is most clinically relevant?

Answer 5

Question 6

How perfused are kidneys? Where is most of the blood in kidneys located?

Answer 6

Rich blood supply- 25% of total CO

90% blood in cortex, 10% in medulla

Altruistic organ- handle large amounts of blood but use little

Question 7

Describe the kidney’s relationship to structures around it

Answer 7

Retroperitoneal space- T12 and 12th rib to sacrum/iliac crest) (between peritoneum and posterior abdo wall- psoas major and quadratus lumborum). left kidney- T11-L2, right- T12-L3)

Other retroperitoneal organs- SAD PUCKER

3 layers (from inside)

Fibrous capsule (renal capsule)

Adipose capsule (perirenal fat)- affix it to wall

Renal fascia (dense connective tissue)

Question 8

Describe the ureters

Answer 8

Vertically down tips of transverse processes, sacro-iliac joint, and tip of ischial spines

3 constrictions- kidney stones more likely to lodge there

• Junction of renal pelvis with ureter (ureteropelvic junction)
• Crossing iliac blood vessels at pelvic brim
• ureters enter bladder (oblique course, functions like a valve)

Question 9

Compare relation of ureters in male and females

Answer 9

In females-

Ureter lies below uterine artery (water under the bridge)- be aware when doing hysterectomies(need to ligate uterine a)

Also females have uterus anterior to bladder, males have vas deferens and seminal vesicles

Question 10

Describe the bladder

Sections

• Apex!
• Base (posterior surface)!
• Superior surface (covered with peritoneum)!
• Inferolateral surfaces (X2)!
• Neck!

Position depend on filling (completely in pelvis when empty), extraperitoneal,

intra-abdominal, above pubis in children

(in males, can aspirate when full- pass needle right above pubic symphysis)

Question 11

Describe features inside the bladder

Answer 11

NB ureteral openings have ‘valve’ to prevent backflow into ureters

Question 12

Compare male and female urethra/bladders

Answer 12

Both has 2 sphincters- internal and external

Female- short, wide urethra, close to vaginal opening (UTIs more common)

Male- long, thin (esp prostate urethra), 2 curves- 1 in front of pubic symphysis- drooping dick..1 permanent- near bulb of penis, going up past bulbourethral glands)

in elderly males- may have trouble passing urine because of enlarged prostate

4 parts- prostatic, membranous, bulbar, penile