15. Kidneys and urinary tract Flashcards
NB. for this lecture
This lecture is all covered and gone over nicely in the third met anatomy practical
Look at THIS and look through mollyneux’s lecture on this for the relating clinical scenarios
What are the functions of the kidney?
Excrete waste products of metabolism
Maintain water and electrolyte balance
Maintain acid/base balance
Which kidney is more superior and why?
The left kidney is located more superiorly
The right kidney has the liver directly superior to it and this pushes down
What is situated on top of each kidney?
Adrenal glands
What is the hepatorenal recess and where is this?
Subhepatic recess/Morrison’s pouch
Separates the live from the right kidney
This is where fluid collects if a patient is lying supine
When might fluid collect in the hepatorenal recess?
Ascites
Pancreatitis
Which organ lies anterior to both and stretches across from the right to the left kidney?
Pancreas - head of the pancreas at the right kidney and tail of the pancreas at the left kidney
Is the pancreas retro or intraperitoneal?
Pancreas is intraperitoneal apart from the tail which is retroperitoneal
What is the shape of the right adrenal gland?
Pyramidal/triangular
What is the shape of the left adrenal gland?
Crescent shaped
Are the kidneys retroperitoneal or intraperitoneal?
Kidneys are retroperitoneal
What is Gerota’s fascia?
This is the renal fascia - the kidneys are encapsulated in their own layer of fat
At what level does the IVC penetrate the diaphragm?
T8
At what level does the oesophagus penetrate the diaphragm?
T10
At what level does the aorta penetrate the diaphragm?
T12
What is the costodiaphragmatic recess?
Aka. costophrenic recess
Potential space in the pleural cavity at the junction of the diaphragm and pleural cavity
What are the nerves of the lumbar plexus?
Subcostal Iliohypogastric Ilioinguinal Genitofemoral Lateral cutaneous Femoral Obturator
At what level does the coeliac trunk branch from the abdominal aorta?
T12
At what level does the SMA branch from the abdominal aorta?
L1
At what level does the IMA branch from the abdominal aorta?
L3
At what level do the renal arteries branch from the abdominal aorta?
L1
At what level do the gonadal arteries branch from the abdominal aorta?
L2
At what level does IVC form from the common iliac veins?
L5
How can you recognise the left renal vein from the right renal vein?
The left renal vein crosses the midline anterior to the aorta
What are the two layers that surround the kidney?
Renal fat
Renal/Garota’s fascia
These are both contained within the renal capsule
What are the branches of the renal artery?
Renal artery - segmental artery - interlobar artery - interlobular artery - arcuate artery
What is the renal papilla?
This is the top of the renal pyramid
What is the nervous innervation of the kidney?
Via the renal plexus
Where is pain from the kidney referred to?
Referred to the small of the back - the flank - lumbar quadrant
Three regions of male urethra
Prostatic
Membranous
Spongy
At what level does the aorta bifurcate into the common iliac arteries?
L4
What are the three most likely regions for a stone to lodge in the ureters?
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