1 The Kidneys and Urinary Tract Flashcards
Q: Describe the location of the kidneys. What surrounds them? outside of that? What is posterior to them? superior to them?
A: Retroperitoneal in upper abdomen
-right usually slightly lower than left
dense fibrous capsule
enclosed within retroperitoneal space via renal fascia containing peri-renal adipose tissue
Posteriorly overlapped by diaphragm and pleural cavity superiorly
Q: To which level does the superior pole of the right kidney lie? left?
Hilum?
A: 11th ICS
11th rib
L1
Q: What is anterior to the right kidney? (2) Hilus?
A: liver, hepatic flexure
lies behind 2nd part of duodenum
Q: What is anterior to the left kidney? (3)
A: stomach, pancreas, spleen, splenic flexure
Q: Describe the renal blood supply. (4)
A: renal arteries
BP drives ultrafiltration by glomerular capillaries
renal veins
drain into IVC
Q: What does the kidney cortex look like? due to? medulla? due to?
A: Cortex: granular-looking due to random organisation
Medulla: striated due to radial arrangement of tubules and micro-vessels
Q: How many lobes does each kidney have? meaning? (2) What lies above each kidney?
A: Multilobar
each lobe drains through its own papilla and calyx
suprarenal glands
Q: Apart from venous blood, what leaves the kidneys? how? (2)
A: urine
via renal pelvis (in hilum)
and ureter
Q: Where do the ureters run? (2) What 2 structures do they cross?
A: vertically down
- posterior abdominal wall
- in plane of tips of transverse processes of lumbar vertebrae
Cross pelvic brim anterior to sacro-iliac joint and bifurcation of common iliac arteries
Q: In what direction do the ureters enter the bladder? at what level?
A: Descend anteromedially to enter bladder at level of ischial spine
Q: How is urine transported down the ureters? entry into bladder?
A: Urine transported by peristalsis in smooth muscle walls
-> open obliquely through bladder wall
Q: What occurs 3 times along the length of each ureter? Name the locations. What are these sites of?
A: 3 sites of ureteric constriction
- pelviureteric junction (just after leaves)
- crossing of pelvic brim (at location of bifurcation of common iliac As)
- traversing of bladder wall (where is enters bladder wall)
sites of renal colic from kidney stones attempting to pass
Q: What kind of organ is the bladder? Shape? specify (2). When looking from within, what shape is the posterior? name?
A: pelvic organ
Triangular pyramid: apex anteriorly; base/fundus posteriorly
triangle, trigone
Q: What lines the bladder? What is their cell turnover speed? What cells make it up? Describe. Benefit of this property?
A: Lined by urothelium = 3-layered epithelium
v. slow cell turnover
large luminal cells have highly specialised low-permeability luminal membrane -> prevents dissipation of urine-plasma gradients
Q: Name the 4 surfaces of the bladder. Apart from the 2 ureters, name 2 other attachments.
A: posterior (= triangular base/fundus)
superior surface (= triangle)
2 inferolateral surfaces
- urethra going down
- median umbilical ligament at apex- anterior (opp fundus/base)
