1. Anatomy of the Kidneys Flashcards
Where do the kidneys lie?
Retroperitoneally they lie at the level of T12-L3
The right kidney is often slightly lower (liver)
What is meant by the parencyhma of the liver?
parencyhma= functional tissue
liver parenchyma comprises of the outer cortex and the inner medulla.
Describe the ultra structure of the kidneys from the renal pyramids to the ureter?
Renal pyrammids minor calyx major calyx renal pelvis ureter
What is meant by the hilum of the kidney
The area where the vessels enters (renal artery and vein) and the ureter exits
Describe the arterial supply of the kidneys
Renal arteries, arise distally from the superior mesenteric artery
right renal artery- long and crosses vena cava
Left renal artery- shorter
Describe the venous drainage of the kidneys?
drained of venous blood by the renal veins
Right renal vein- short
Left renal vein- long and crosses the IVC
Where do the lymphatic fluid from the kidneys drain?
Lateral aortic (para-aortic)
What is meant by a pelvic kidney
Kidneys typically develop in the pelvis and ascend into the abdomen. In a pelvic kidney this does not happen
What is meant by a horseshow kidney?
The kidneys become stuck together in there ascent form the pelvis forming one big horseshoe kidney
Where are the renal glands situated?
What is their function?
Situated over the upper poles of the kidneys, lie between the kidneys and the diaphragm
They secrete steroid (cortisol) and catecholamine hormones directly into the blood
Describe the layers of the adrenal gland from outside to in?
Capsule Zona glomerulosa Zona fasciculata Zona reticularis Medulla
What do each zone secrete?
Zona glomerulosa- mineralocorticoids (aldosterone)
Zone fasciculata- coritcosteroids (cortisol)
Zona reticularis- androgens (sex hormones, DHES)
Medulla- catecholamines (adrenaline)
Describe the arterial supply to the adrenals
Superior adrenal artery - inferior phrenic artery
Middle adrenal artery- abdominal aorta
Inferior adrenal artery- arises from the renal arteries
Describe the venous drainage of the adrenals
Right adrenal vein- IVC
Left adrenal vein- Left renal vein
What is a pheochromocytoma
Tumour of the adrenal medulla causing sever excretions of adrenaline and noradrenaline
How do you treat pheochromocytoma quickly?
Phenoxybenzamine- antagonist of adrenaline
What is the job of the ureters?
They are 25cm long tubes that transport urine from the kidneys to the bladder.
They move urine through by muscular contraction, in a process not too dissimilar to peristalsis
Describe the course of the ureters
runs along the medial aspect of the psoas muscle.
enters the pelvis anteriorly to the sacroiliac joint at the bifurcation of the common iliac vessels
courses anteriorly to the internal iliac artery down the lateral pelvic sidewall.
At the level of the ischial spine it turns forward and medially to enter the posterolateral wall of the bladder,
Where are the three constrictions of the ureter?
at the pelviureteric junction (PUJ) of the renal pelvis and the ureter
as the ureter enters the pelvis and crosses over the common iliac artery bifurcation
at the vesicoureteric junction (VUJ) as the ureter obliquely enters the bladder wall
Describe the anatomy of the bladder?
Apex- located superiorly
Body- main part of the bladder
Fundus- located posteriorly, triangular shaped
Neck- forms the drainage point
What is meant by the trigone of the bladder?
The triangular area whereby the urethra and ureters enter and exit the bladder
it has small walls as it is developed by the integration of the two mesonephric ducts at the base of the bladder
Explain the arterial and venous supply of the bladder?
artery- superior vesical branch of the internal iliac vessels. men- inferior vesical, females, vaginal arteries
veins- prostate venous plexus
Where does the lymphatic fluid of the bladder drain into?
external iliac lymph nodes
internal iliac sacral and common iliac nodes
Explain the nervous supply to the bladder?
Sympathetic- hypogatric nerve (T1-L2)
Parasympathetic- pelvic nerve (S2-S4)
Somatic- Pudendal nerve (S2-S4)
What are the three areas of the male urethra?
Prosthatic- (widest and most dilatable)
Membranous urethra- (narrowest and least distensible)
Penile urethra-
