1 Urinary System Anatomy Flashcards
Which landmarks in the body can be used to locate the kidney? (vertically)
Left kidney:
Upper pole: T11-T12
Lower pole: L2-L3
higher due to liver on the right
Right kidney:
Upper pole: T12
Lower pole: L3-L4
What is are the typical dimensions (length and height) of the kidneys in cm?
What is normal range for the weight of a kidney?
170-220g
In terms of kidney size, when would we need to carry out further investigations?
- If >2cm difference in dimensions between L and R kidney
- If <8cm in length- may be CKD
Fill in the missing labels in the following image:
At what vertebral level can the hilum of each kidney usually be found?
L1
What is the renal angle?
Angle between 12th rib and erector spinae muscle
Area where tenderness can be reported
Why are kidneys surrounded by fascia and so much fat?
Only thing holding them in position
(kidneys move up and down during breathing)
Label the 3 layers on the following diagram surrounding the kidneys:
Perirenal fat= continuous with fat found in renal sinus of kidney
Renal fascia= aka Garota’s fascia
Pararenal fat= extra peritoneal, associated with lumbar region
How do the ureters propel urine to the urinary bladder?
Smooth muscle fibres
Peristaltic waves
What are the usual dimensions of the ureters (length and diameter)?
Length: 25-30 cm
Diameter: about 1.5mm
Where do the ureters run with relation to the lumbar vertebrae?
Lateral to tips of transverse processes
Name the 3 sections that the ureter is divided into.
Where do the ureters run with relation to the gonadal vessels?
Underneath (water under the bridge)
Important to remember in surgery
(Ureters tilt in anteriorly at the point of the ischial spine)
Where is the ureter most prone to damage?
Near pelvic brim
How is urine reflux from the bladder to the ureters prevented?
Ureters (in intramural (distal) segment) run obliquely through bladder wall musculature–> forms flap
Ureter in intramural part= 1.2-2.5cm
Where can urothelium be found?
Lining bladder, ureter and pelvis of kidney
Fill in labels 1-6 in the following diagram.
If the bladder is full, where can it be palpated? (bony landmark)
Above pubic symphysis
Fill in the missing labels on the following prosection:
Fill in the missing labels in the following diagram:
What is the function of the Internal urinary sphincter?
Prevent retrograde ejaculation
(not much function in women)
What is the external urinary sphinter responsible for?
(sits in Urogenital diaphragm in men and women)
Continence
Label the names of the divisions of the urethra:
Fill in the missing labels on the following diagram:
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Where is the glomerulus found in the kidney?
Within the cortex
What occurs at the papilla in the kidney?
Location where the renal pyramids in the medulla empty urine into the minor calyx in the kidney
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What are the 2 broad classes of nephron and what are the main differences between them?
- Cortical (90%)
- Short loops of Henle
- Juxtamedullary (10%)
- Long loop of Henle
Which artery can be used as a landmark to locate the renal vessels?
Superior mesenteric artery- hooks over renal vessels
Why are the kidneys so ulnerable to ischaemic damage? (Eg if blood pressure drops)
Require large blood flow (22% of cardiac output)
BP drop likely to damage kidneys first
Why are left kidneys preferential for transplants?
Long vessels
Fill in the missing labels:
Identify the following arteries on the diagram:
Renal
Segmental
Interlobar
Arcuate
Fill in the missing gaps in the following diagram:
What is the glomerulus?
Tuft of capillaries between afferent and efferent arteriole
Within the ureter, at what 3 points is a kidney stone likely to get stuck?
- Pelvoureteric junction
- Pelvic brim
- Entering bladder
If the hilum of each kidney can be seen on a CT scan, what vertebral level is that CT scan at?
L1
The vasa recta can be found in the medulla of the kidney. What vessel does it branch off?
Branches of efferent arteriole
A patient with a known abdominal aortic aneurysm presents with nausea and unilateral flank pain. What is the most likely cause for their symptoms?
Ureter entrapment
Unilateral hydronephrosis
What is likely to be present in the urine due to renal vein entrapment syndrome?
- Haematuria
- Proteinuria
Useful to see where is peri and where is pararenal:
