08-01 URI Gx Urinary System and Retroperitoneal Organs Flashcards
1
Q
CAVITIES of Retroperitoneum
A
- Dorsal (posterior): cranial, spinal
- Ventral (anterior): thoracic, abdominal, pelvic cavity. (abdominopelvic cavity [in females])
2
Q
enclosed by peritoneum; within the peritoneal cavity
A
Intraperitoneal
3
Q
covered by peritoneum ANTERIORLY
A
retroperitoneal
4
Q
anatomical space behind the peritoneum
A
retroperitoneum
5
Q
subdivisions of the retroperitoneum (based on kidneys)
A
- Anterior Pararenal Space (APS)
- Perirenal Space (PS)
- Posterior Pararenal Space (PPS)
6
Q
Borders of Anterior Pararenal Space
A
- Parietal peritoneum (anteriorly)
- Anterior portion of renal fascia (posteriorly)
7
Q
Contents of Anterior Pararenal Space
A
- Pancreas
- Colon
- Duodenum
(mnemonic: Pussy Cat Dolls)
8
Q
Borders of Perirenal Space
A
Anterior and Posterior portion of the renal fascia
9
Q
Contents of Perirenal Space
A
- Kidneys
- Renal vessels
- Ureter
10
Q
Borders of Posterior Pararenal Space
A
- posterior portion of renal fascia (anteriorly)
- posterior abdominal wall muscles (posteriorly)
11
Q
Contents of Posterior Pararenal Space
A
-fat
12
Q
Potential Spaces in the Retroperitoneum
A
Retromesenteric Space (RMP) Retrorenal Space (RRS)
13
Q
potential space between APS and PS
A
Retromesenteric Space (RMP)
14
Q
potential space between PS and PPS
A
Retrorenal Space (RRS)
15
Q
PERITONEAL ORGANS
A
(mnemonic: SAD PUCKER)
Suprarenal gland Aorta/IVC Duodenum (descending and horizontal portion) Pancreas (head, neck and body) Ureter Colon (ascending and descending) Kidneys Esophagus Rectum
16
Q
SECONDARY REROPERITONEAL ORGANS
A
- Pancreas
- Colon
- Duodenum
(mnemonic: Pussy Cat Dolls)
17
Q
Muscles of Posterior Abdominal Wall
A
- Psoas Major
- Psoas Minor
- Quadratus Lumborum
- Iliacus
18
Q
origin of psoas minor
A
T12-L1
19
Q
insertion of psoas minor
A
pectineal line;
ilipubic eminence
20
Q
innervation of psoas minor
A
anterior rami of L1
21
Q
main action of psoas minor
A
weak flexion of lumbar vertebra
22
Q
3 largest branches of the lumbar plexus
A
femoral nerve,
obturator nerve,
lumbosacral trunk
23
Q
composed of T12 (subcostal nerve) and L1-L5 (ventral rami)
A
Lumbar Plexus
24
Q
(lumbar plexus) arises from L2-L4
A
femoral nerve and
obturator nerve
25
(lumbar plexus) arises from L5
lumbosacral trunk
26
(lumbar plexus) arises from T12 & L1
iliohypogastric adn ilioinguinal
27
(lumbar plexus) arises from T12, L1, L2
genitofemoral nerve
28
(lumbar plexus) arises from L2, L3
Lateral Cutaneous Nerve of thigh/ Lateral Femoral Nerve
29
the only ones from the posterior division are ___; the rest is from the anterior division
Lateral Cutaneous Nerve of thigh/ Lateral Femoral Nerve
30
innervations. iliohypogastric. sensory:
skin above the inguinal ligament
31
innervations. iliohypogastric. motor:
transverse abdominis;
internal oblique
(similar with ilioinguinal)
32
innervations. ilioinguinal. sensory:
skin over the pubic symphysis;
| lateral aspect of the scrotum and labia majora
33
innervations. ilioinguinal. motor:
transverse abdominis;
internal oblique
(similar with iliohypogastric)
34
innervations. genitofemoral. sensory:
in males: spermatic cord
in females: inguinal canal
skin below the inguinal ligament
35
innervations. genitofemoral. motor:
cremasteric muscle in males
36
innervations. obturator.sensory:
medial and distal portion of the thigh
37
innervations. obturator. motor:
pectineus;
obturator externus;
gracilis;
adductors (magnus, longus, and brevis)
38
innervations. lateral cutaneous. sensory:
lateral portion of the thigh
39
innervations. lateral cutaneous. motor:
n/a
40
innervations. femoral. sensory:
anterior portion of the thigh;
posterior lower leg;
hindfoot
41
innervations. femoral. motor:
pectineus,
iliopsoas,
sartorius,
quadriceps femoris
42
covers the kidney and the adrenal gland
Gerota's Fascia
| aka perirenal/renal fascia
43
location of kidneys
at the level of T12-L3
44
external to the renal fascia is ____ aka _____, the extrapritoneal fat of the lumbar region
paranephric fat (aka pararenal fat body)
45
surrounds the kidney and their vessels
perinephric fat (perirenal fat)
46
Gerota's Fascia will blend with the ____ superiorly and___ inferiorly (fat pad)
liver capsule ;
disappears
47
Gerota's Fascia divides into 2:
Toldt's Fascia - anterior portion; medial side, and
Zuckerland's Fascia - posterior portion; lateral side
48
fascia that covers the IVC and the aorta
Toldt's Fascia
49
fascia that will blend with the psoas muscle fascia and Toldt's fasica to become Gerota's fascia
Zuckerland's Fascia
50
Gerota's fascia will blend with the
transversalis fascia
51
which fat is inside the Gerota's fascia?
perirenal fat
52
separates kidneys from the adrenal glands
renal capsule
53
entrance to renal sinus
renal hilum
54
where renal artery enters;
| exit point of renal vein and ureter;
renal hilum
| Note: RV more anterior to RA;
RA more anterior to RP
RV>RA>RP)
55
separates the kidney and the liver
hepatorenal recess
56
flattened funnel-shaped expansion of the superior end of the ureter
renal pelvis
57
the ___ of the renal pelvis is continuous with the ureter
apex
58
renal pelvis divides into 2 or 3 ___ which then divides into 2 or 3 ____
major calyces;
minor calyces
59
apex of the renal pyramid which indent each minor calyx
renal pailla
60
renal artery is arises from the ___ at the level of ___
abdominal aorta;
| L1 and L2
61
renal artery bifurcates as they enter the hilum
A) anterior division
- superior (apical)
- anterosuperior
- anteroinferior
- inferior (basal)
B) posterior division
62
reference on how to resect the kidney, bloodless, from superior to inferior pole, 1-2cm from convexity of kidney
Brodel's line
63
renal artery will branch into
suprarenal artery
64
longer. right or left renal artery
right
65
higher. right or left renal artery
left
66
crossed by the inferior mesenteric vein
left artery
67
clin corr: blocked RA, high BP
Renal Artery Stenosis
68
clin corr: SMA and aorta aneurysm compresses the 3rd part of duodenum = abdominal pain = refuse eating
Food Fear Syndrome
69
longer. right or left renal vein?
left
70
both renal veins drains to
directly to the IVC
71
left renal vein receives blood from:
- left inferior phrenic vein,
- left suprarenal vein,
- left gonadal vein (M: left testicular vein, or F: left ovarian vein,
- left 2nd lumbar vein
72
clin corr: SMA and aorta aneurysm will compress left renal vein. this will manifest as left testicular pain (in males) or left abdominal pain (in females)
Nutcracker Syndrome
73
ANS innervation of the kidneys
- celiac ganglion
- lowet splanchnic neve
- aorticorenal ganglion
- aortic plexus
74
clin corr: stones
Nephrolithiasis (Staghorn Calculi)
75
clin corr: tube is blocked by urine; distention and dilation of renal pelvis and calyx
hydronephrosis
76
clin corr: infection of kidney
pyelonephritis
77
crosses over pelvic brim at the bifurcation of the common iliac arteries
ureter
78
fusion of major calyces;
extends inferiorly and medially;
anterior to psoas major;
penetrate the posterior urinary bladder
ureter
79
divisions of ureter & blood supply
1) superior - renal artery
2) middle - superior vesical artery
3) inferior - inferior vesical artery
80
3 common constrictions which are common sites for stone lodging
1. at the kidney hilum
2. as it crosses the pelvic brim
3. as it enters the bladder
81
innervation of ureter
- from ANS
- T10-T12, L1, S2-S4
- derived fom superior/inferior hypogastric plexus, renal and aorta
82
lymphatics of ureter
superior: goes to the kidneys or lumbar nodes
middle: goes to common iliac
inferior: goes to common, internal and external
83
clin corr: uterine artery over the ureter
"water under the bridge"
84
stones in the ureter
ureterolithiasis
85
location of adrenal (suprarenal) glands
at the anterosuperior pole of the kidneys
86
adrenal gland is surrounded by
periphrenic fat and renal fascia
87
2 regions of adrenal gland
cortex (autonomic and endocrine), and
| medulla
88
shape of adrenal glands
right - pyramidal
| left - semilunar
89
major attachment of the adrenal glands
diaphragmatic crura (NOT kidneys)
90
borders of right adrenal gland
posterior: IVC and right lobe of the liver
anterior:
to the diaphragm,
superior pole of the kidney
medial:
right celiac ganglion, and
right inferior phrenic artery
91
borders of the left adrenal gland
posterior:
- stomach
- spleen
- pancreas
- splenic artery
medial:
- left celiac ganglion
- left inferior phrenic
- gastric artery
92
part of the adrenal gland that is derived from mesoderm and secretes corticosteroids and androgens
suprarenal cortex
93
part of the adrenal gland that is derived from the neural crest cells and is a mass of nervous tissue permeated with capillaries and sinusoids
suprarenal medulla
94
blood supply of adrenal glands
1) superior adrenal artery - from left and right inferior phrenic artery
2) middle adrenal artery - from abdominal aorta
3) inferior adrenal artery - from renal artery
95
venous drainage of adrenal glands
right - drains directy to IVC
left - drains to left renal vein
96
clin corr: tumor of adrenal medulla will elicit epinephrine, epinephrine = hypertension
Pheochromocytoma
97
in males, the only structure that passes between the ureter and the peritoneum is the
ductus deferens
98
most constant arteries supplying the terminal parts of the ureter in females
uterine arteries
99
most constant arteries supplying the terminal parts of the ureter in males
inferior vesical arteries
100
bladder not attached to the pelvic bone. has a space known as
RETZUS SPACE
101
boundaries of urinary bladder in male
- anterior: pubic symphisis
- superior: organs
- posterior: rectum
- inferior: prostate
102
boundaries of urinary bladder in female
- anterior: pubic symphisis
- superior: uterus
- posterior: rectum
- inferior: vaginal canal
103
apex of the bladder points toward the ___ when bladder is empty
superior edge of pubic symphisis
104
walls of bladder are composed chiefly of the
detrusor muscle
105
located at the angels of the trigone of the bladder
ureteric orifices and internal urethral orifice
106
normal capacity of the bladder
400-600mL
107
bladder is a 3 sided pyramid.
apex - median umbilical ligament (urachus)
base - trigone (2 urethral opening), fundus
108
surfaces of the bladder
a) superior surface - covered by peritoneum (subperitoneal)
| b) inferolateral surface (2) - with medial umbilical lifament (the obliterated umbilical artery)
109
most inferior part of the blader;
| secured by pubovesical ligament (in females) and puboprostatic ligament (in males)
neck
110
sympathetic innervation during micturition
relax detrusor muscle; sphincter contracts
111
parasympathetic innervation during micturition
contracts bladder; sphincter relaxes
112
main arteries supplying the bladder are branches of
internal iliac artery
113
arterial blood supply of the bladder
- superior vesical arteries (anterosuperior parts)
- inferior vesical arteries (fundus and neck of bladder)
- vaginal arteries (postero-inferior parts of bladder)
114
venous drainage of bladder - tributaries of
internal iliac vein
115
venous drainage of bladder (male)
- vesical venous plexus
- prostatic venous plexus
- inferior vesical plexus
- internal vertebral plexus
116
venous drainage of bladder (female)
-uterovaginal plexus
117
lymphatic drainage of bladder
superior: external iliac lymph node
fundus: internal iliac lymph node
neeck: sacral lymph node, common iliac lymph node
118
clin corr: urinary bladder stone
cystolithiases
119
clin corr: weak bladder support wall = uterus herniate in bladder
cystocele
120
length of male urethra
18-20 cm long
121
segments of male urethra
preprostatic, prostatic, spongy, penile
122
arterial supply of male urethra
- inferior vesical artery
- middle rectal artery
- internal pudental artery
123
venous drainage of male urethra
- prostatic venous plexus (proximal)
| - deep dorsal vein of penis (distal)
124
lymphatic drainage of male urethra
- external and internal iliac lymph nodes
| - deep inguinal lymph nodes
125
innervations of male urethra
-prostatic nerve plexus (arising as organ-specific extension of inferior hypogastric nerve
126
length of female urethra
3-4 cm
127
paraurethral glands found on each side of the urethra; these glands have common para-urethral duct which opens near the external urethral sphincter; prostate homologue
Skene's gland
128
arterial supply of female urethra
vaginal artery and
| internal pudental artery
129
venous drainage of female urethra
vaginal vein and
| internal pudental vein
130
lymphatic drainage of female urethra
- internal iliac and sacral lymph nodes
| - deep inguinal lymph nodes
131
innervations of female urethra
- vesical nerve plexus
| - pudental nerve
132
clin corr related to urethra
1) benign (nodular) prostatic hyperplasia
| 2) lower UTI
133
Which of the following subdivisions of the retroperitoneum contains variable amount of fat?
A. Anterior pararenal space B. Posterior pararenal space
C. Perirenal space
D. None of the above
B. Posterior pararenal space
134
forms the posterior border of the perirenal space
Zuckerkandl’s fascia
135
innervated by the femoral nerve (L2-L4)
iliacus
136
nerve of the lumbar plexus is found within the spermatic cord
Genital branch of Genitofemoral
137
Motor innervation of the cremasteric muscle comes from which nerves of the lumbar plexus
Genital branch of Genitofemoral
138
provide sensory innervation below the inguinal ligament
Femoral branch of Genitofemoral
139
lateral cutaneous nerve of the thigh is formed by which lumbar ventral of rami
L2 and L3
140
largest nerve of the lumbar plexus comes from the ventral of rami of:
L2 – L4
largest nerve is femoral nerve
141
Which of the divisions of the male urethra prevents retrograde flow into the bladder during ejaculation?
Pre-prostatic
142
Is crossed anteriorly by the superior
| mesenteric artery
left renal vein
143
Adrenal medulla synthesizes
adrenalin
144
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Behind the kidney:
A. Diaphragm
B. Subcostal nerve
C. Quadratus lumborum
D. Twelfth rib
E. All of the above
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E. All of the above
