1. Anatomy of the Kidneys

Question 1

Where do the kidneys lie?

Answer 1

Retroperitoneally they lie at the level of T12-L3

The right kidney is often slightly lower (liver)

Question 2

What is meant by the parencyhma of the liver?

Answer 2

parencyhma= functional tissue

liver parenchyma comprises of the outer cortex and the inner medulla.

Question 3

Describe the ultra structure of the kidneys from the renal pyramids to the ureter?

Answer 3

Renal pyrammids
minor calyx
major calyx
renal pelvis
ureter

Question 4

What is meant by the hilum of the kidney

Answer 4

The area where the vessels enters (renal artery and vein) and the ureter exits

Question 5

Describe the arterial supply of the kidneys

Answer 5

Renal arteries, arise distally from the superior mesenteric artery

right renal artery- long and crosses vena cava
Left renal artery- shorter

Question 6

Describe the venous drainage of the kidneys?

Answer 6

drained of venous blood by the renal veins

Right renal vein- short
Left renal vein- long and crosses the IVC

Question 7

Where do the lymphatic fluid from the kidneys drain?

Answer 7

Lateral aortic (para-aortic)

Question 8

What is meant by a pelvic kidney

Answer 8

Kidneys typically develop in the pelvis and ascend into the abdomen. In a pelvic kidney this does not happen

Question 9

What is meant by a horseshow kidney?

Answer 9

The kidneys become stuck together in there ascent form the pelvis forming one big horseshoe kidney

Question 10

Where are the renal glands situated?

What is their function?

Answer 10

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

Question 11

Describe the layers of the adrenal gland from outside to in?

Answer 11

Capsule
Zona glomerulosa
Zona fasciculata
Zona reticularis
Medulla

Question 12

What do each zone secrete?

Answer 12

Zona glomerulosa- mineralocorticoids (aldosterone)
Zone fasciculata- coritcosteroids (cortisol)
Zona reticularis- androgens (sex hormones, DHES)
Medulla- catecholamines (adrenaline)

Question 13

Describe the arterial supply to the adrenals

Answer 13

Superior adrenal artery - inferior phrenic artery

Middle adrenal artery- abdominal aorta

Inferior adrenal artery- arises from the renal arteries

Question 14

Describe the venous drainage of the adrenals

Answer 14

Right adrenal vein- IVC

Left adrenal vein- Left renal vein

Question 15

What is a pheochromocytoma

Answer 15

Tumour of the adrenal medulla causing sever excretions of adrenaline and noradrenaline

Question 16

How do you treat pheochromocytoma quickly?

Answer 16

Phenoxybenzamine- antagonist of adrenaline

Question 17

What is the job of the ureters?

Answer 17

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

Question 18

Describe the course of the ureters

Answer 18

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,

Question 19

Where are the three constrictions of the ureter?

Answer 19

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

Question 20

Describe the anatomy of the bladder?

Answer 20

Apex- located superiorly
Body- main part of the bladder
Fundus- located posteriorly, triangular shaped
Neck- forms the drainage point

Question 21

What is meant by the trigone of the bladder?

Answer 21

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

Question 22

Explain the arterial and venous supply of the bladder?

Answer 22

artery- superior vesical branch of the internal iliac vessels. men- inferior vesical, females, vaginal arteries

veins- prostate venous plexus

Question 23

Where does the lymphatic fluid of the bladder drain into?

Answer 23

external iliac lymph nodes

internal iliac sacral and common iliac nodes

Question 24

Explain the nervous supply to the bladder?

Answer 24

Sympathetic- hypogatric nerve (T1-L2)

Parasympathetic- pelvic nerve (S2-S4)

Somatic- Pudendal nerve (S2-S4)

Question 25

What are the three areas of the male urethra?

Answer 25

Prosthatic- (widest and most dilatable)

Membranous urethra- (narrowest and least distensible)

Penile urethra-