1.2: Anatomy of Upper Urinary Tract Flashcards

1
Q

What is the urinary tract?

A

This the anatomical structures that urine must pass through from production to excretion

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2
Q

What are the components of the urinary tract (4)?

A

Kidneys Ureter Bladder Urethra

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3
Q

Describe the role of kidneys in the urinary tract?

A

Produce Urine

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4
Q

Describe the role of the ureter in the urinary tract?

A

Drains urine from the kidney to the bladder

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5
Q

Describe the role of the bladder in the urinary tract?

A

Stores/voids urine

Voids = Empties

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6
Q

Describe the role of the urethra in the urinary tract?

A

Excretion of urine (Excretion of semen in males)

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7
Q

Describe the differences between the male and female urethra?

A

Males urethra is much longer

Males urethra excretions semen and urine while females just excretes urine

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8
Q

What are the two subdivisions of the urinary tract? What do they contain?

A

Upper = Kidneys and ureter

Lower = Bladder and urethra

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9
Q

The urinary tract is spread over three regions of the body… Which regions?

A

Abdomen Pelvis Perineum

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10
Q

Which part of the urinary tract is contained in the abdomen?

A

The kidneys The proximal ureter

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11
Q

Which part of the urinary tract is contained in the pelvis?

A

The distal ureter The bladder The proximal urethra

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12
Q

Which part of the urinary tract is contained the perineum?

A

The distal urethra

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13
Q

Where is the separation between the abdomen and the pelvis?

A

At the level of the hip bones (iliac crests) This is at the level of L4

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14
Q

At what vertebral level is the bifurcation of the abdominal aorta?

A

L4

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15
Q

Describe the location of the kidneys

A

These are retroperitoneal organs

Located in the abdominal cavity

Part of the upper urinary tract

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16
Q

What surface of the kidney is in contact with the peritoneum?

A

The anterior surface of the kidney is in contact with the peritoneum

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17
Q

What is the right kidney next to? What is the left kidney next to?

A

Right is next to the IVC Left is next to the abdominal aorta

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18
Q

What are the structures of the renal hilum?

A

Renal Artery Renal Vein Ureter

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19
Q

Name the structures A–>M

A

A = Anterolateral abdominal wall muscles

B = Right Back Muscles

C = Left Back Muscles

D = Posterior abdominal wall muscles

E = Renal Hilum

F = Right Kidney

G = IVC

H = Aorta

I = Right L2, Left L1

J = Psoas Major

K = Left Quadratus Lumborum

L = Renal Hilum

M = Left Kidney

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20
Q

Name the structures A –> E?

A

A = Renal Capsule B = Perinephric Fat C = Renal (Deep) Fascia D = Paranephric Fat E = Visceral Peritoneum

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21
Q

Fill in the blanks: ‘The kidneys lie anterior to XXXX and lateral to XXXX’

A

The kidneys lie anterior to quadratus lumborum and lateral to psoas major

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22
Q

Which vertebral level does the right kidney lie at?

A

L1-L3

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23
Q

Which vertebral level does the left kidney lie at?

A

T12-L2

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24
Q

Describe protection of the kidneys?

A

The kidneys are partially protected by the anterolateral abdominal wall muscles, the posterior abdominal wall muscles and the floating ribs

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25
Q

Describe the floating ribs in relation to the kidneys?

A

Ribs 11 and 12 are floating They are posterior Can fracture and cause lacerations

26
Q

Name the layers between the visceral peritoneum and the kidney?

A
  • Visceral Peritoneum - Paranephric Fat - Renal (Deep) Fascia - Perinephric Fat - Renal Capsule
27
Q

Name the anterolateral abdominal wall muscles? (From external to internal)

A

External Oblique

Internal Oblique

Transversus Abdominis

28
Q

Which regions/quadrants are the kidneys in?

A

Left = Left Flank/Left Upper Quadrant Right = Right flank/right upper quadrant

29
Q

What is palpation of the kidneys called?

A

Balloting

30
Q

Describe the anatomical relationships of the right kidney?

A

Posterior to: - Liver - Hepatorenal recess - 2nd part of the duodenum - Ascending colon - Right colic flexure

31
Q

Describe the anatomical relationships of the left kidney?

A

Posterior to: - Stomach - Tail of the pancreas - Hilum of the spleen - Splenic Vessels

32
Q

Describe the hepatorenal recess?

A

Space behind the liver Part of the greater sac Fluid collects here when the patient is lying down

33
Q

Describe arterial supply to the kidneys? (Describe position in relation to venous)

A

Renal Arteries (These are posterior to the renal veins)

34
Q

Describe venous supply to the kidneys? (Describe position in relation to arterial)

A

Renal Veins These are anterior to the renal arteries

35
Q

Describe the position of the common iliac arteries in comparison to common iliac veins?

A

Iliac arteries are anterior to the iliac veins

This is opposite to the renal arteries which are posterior to renal veins

36
Q

Describe lymph drainage of the kidneys?

A

Drains to the lumbar lymph nodes (Around aorta and IVC)

37
Q

Describe lymph drainage of the ureters?

A

Drains to the lumbar lymph nodes (around aorta and IVC) and the iliac nodes (found around the common iliac arteries)

38
Q

Describe the blood supply to the ureters?

A
  • Renal Artery - Common Iliac artery - Abdominal iliac artery - Internal Iliac Artery - Vesical Artery
39
Q

Describe the branching of the common iliac?

A

Branches into internal iliac and external iliac

40
Q

The abdominal aorta bifurcates at the level of the..?

A

Umbilicus L4

41
Q

Describe abdominal aortic aneurysms and their location in relationship to the kidneys?

A

Can be infrarenal (below level of kidneys) or suprarenal (above level of kidneys)

42
Q

If there is renal stenosis and an infrarenal AAA, what is the cause of the renal stenosis?

A

Atherosclerosis

43
Q

If there is renal stenosis and a suprarenal AAA, what is the cause of the renal stenosis?

A

The AAA

44
Q

Why would people have only one kidney?

A

Agenesis (Failure to develop) Nephrectomy (Pathology) Nephrectomy (Donation)

45
Q

Describe the general structure of the kidneys (Similar to?)

A

Have an outer cortex and an inner medulla Similar to adrenal glands

46
Q

Detailed structure of the kidneys?

A

Each kidney contains 27 pyramids These pyramids contain 50,000 nephrons The nephrons are aligned running axillary towards the apex of the pyramid Gives the pyramids a striped appearance

47
Q

What is the function of the glomerulus?

A

Ultrafiltration of the blood from the renal artery

48
Q

What is the function of the loop of Henle?

A

To connect the proximal convoluted tubule to the distal convoluted tubule

49
Q

Name these parts of this nephron? A –> F

A

A = Glomerulus B = Proximal Convoluted Tubule C = Loop of Henle D = Distal Convoluted Tubule E = Collecting Duct F = Minor Calyx

50
Q

Describe how urine drains from the kidney?

A

Collecting duct of nephron Minor Calyx Major Calyx Renal Pelvis Ureter

51
Q

Describe the size of the tubes in urine drainage from the kidney?

A

Increase in size from collecting duct right up to renal pelvis Constriction at the pelviureteric junction (large renal pelvis, small ureter)

52
Q

What are the anatomical sites of constriction?

A
  • Pelviureteric junction - Ureter crossing the common iliac artery at the pelvic brim - Ureteric Orifice (Opening into bladder)
53
Q

What are calculi?

A

These are hardening of calcium salts in the urine Also called kidney stones Develop within the major or minor calyx and cause obstruction

54
Q

Describe a ‘staghorn calculus?’

A

This is a large calculus that obstructs many calyx and the renal pelvis Can show as a filling defect

55
Q

What can cause ureter obstruction?

A
  • Internal obstruction (Calculus, blood clot) - External compression (Tumour)
56
Q

Describe the pain in kidney stones/ureter obstruction?

A

Waves of colicky pain Caused by smooth muscle peristalsis in the ureter trying to overcome obstruction

57
Q

What are the consequences of urinary tract obstruction? - In the calyces or ureter? - In the bladder? - In the urethra?

A

Calyces or ureter = Unilateral Back flow of urine Bladder = Unilateral or bilateral (depends on location) Urethra = Bilateral back flow of urine

58
Q

Describe the end stage of urinary tract obstruction?

A

The urinary production continues until the pressure within the urinary tract exceeds the pressure favouring filtration at the glomerulus Leads to renal failure

59
Q

What does renal failure mean?

A

The kidneys fail to adequately filter the blood to produce urine

60
Q

What is hydronephrosis?

A

This is water inside the kidney Caused by back pressure of urine Causes renal failure Causes painful stretching of the renal capsule