1, Structure and Anatomy of the Urinary System

Question 1

What are the functions of the kidney?

Answer 1

Control volume, control osmolarity, help to control pH, excrete some waste products.

Question 2

How many times is each litre of ECF filtered a day?

Answer 2

10 times.

Question 3

What percentage of water is recovered after being filtered?

Answer 3

Over 99%.

Question 4

What percentage of Na+ and Cl- is recovered after being filtered?

Answer 4

Over 99%.

Question 5

What percentage of hydrogen carbonate is recovered after being filtered?

Answer 5

100%.

Question 6

What percentage of glucose and amino acids are recovered after being filtered?

Answer 6

100%.

Question 7

What filtrate components are not recovered?

Answer 7

Waste products like urea, some substances like H+ are actively secreted.

Question 8

What is the position of the kidneys?

Answer 8

Retroperitoneal organs that sit either side of the spine in the abdominal cavity at the level of T12-L3.

Question 9

How do the position of the left and right kidneys differ?

Answer 9

The right kidney sits slightly lower than the left due to the liver.

Question 10

What protects the tops of the kidneys?

Answer 10

The 11th and 12th ribs.

Question 11

What is the position of the bladder?

Answer 11

It sits behind the pubic bone in an adult and above it in a child.

Question 12

What is the position of the prostate?

Answer 12

It sits directly below the bladder.

Question 13

How does prostate hypertrophy affect urination?

Answer 13

It prevents it as the urethra passes through the prostate so can be blocked.

Question 14

Where do the ureters arise?

Answer 14

From the renal pelvis on the medial aspect of each kidney.

Question 15

What is the path of the ureters?

Answer 15

They leave the renal hilum and descend towards the bladder on the front of the psoas major muscle. They cross the pelvic brim near the bifurcation of the artery/ ductus deferens and down the pelvic sidewall to insert in the posterior surface of the bladder.

Question 16

What are the bony landmarks for the course of the ureters?

Answer 16

Arise at the level of L2. Descend in front of tips of lumbar spine transverse processes. Cross into pelvic brim roughly in front of the sacroiliac joint. Enters the bladder, vesico-ureteric junction, at the level of the ischial spines.

Question 17

Where are the three common sites of kidney stones?

Answer 17

The junction of the renal pelvis and the ureter, the point at which the ureters cross the brim of the pelvis, where the ureters pass into the wall of the urinary bladder.

Question 18

What is the renal cortex?

Answer 18

The outer portion of the kidney.

Question 19

What does the renal cortex contain?

Answer 19

The glomerulus, Bowman’s capsule, and parts of the renal tubules (apart from the parts of the loop of Henle, which descend into the medulla).

Question 20

Where does ultrafiltration take place?

Answer 20

In the renal cortex.

Question 21

What are the sections in the renal medulla called?

Answer 21

Pyramids.

Question 22

What are the structures in the renal medulla responsible for?

Answer 22

Maintaining the salt and water balance of the blood.

Question 23

Where does urine from the pyramids empty in to?

Answer 23

The minor calyxes.

Question 24

Where does urine empty from the pyramids to the minor calyxes?

Answer 24

At the papilla.

Question 25

What do minor calyxes join together to form around the apex of the renal pyramids?

Answer 25

Major calyxes.

Question 26

What is the path of urine from the calyxes?

Answer 26

Through the renal pelvis and into the ureters.

Question 27

How much blood do the kidneys receive?

Answer 27

20% of the cardiac output.

Question 28

Where do the renal arteries arise from?

Answer 28

The side of the abdominal aorta at the level of L1/L2, immediately below the superior mesenteric artery.

Question 29

Why is the right renal artery longer than the left?

Answer 29

Due to the position of the aorta and inferior vena cava.

Question 30

What is the most common vascular anomaly of the kidneys?

Answer 30

Supernumerary renal arteries - two or more arteries to a single kidney.

Question 31

What percentage of kidneys have supernumerary renal arteries?

Answer 31

25-40%.

Question 32

What is the course of blood through vessels from the renal artery?

Answer 32

Renal artery -> segmental artery -> interlobar artery -> arcuate artery -> interlobular artery -> afferent arteriole -> glomerulus -> efferent arteriole.