15. Kidneys and urinary tract

Question 1

NB. for this lecture

Answer 1

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

Question 2

What are the functions of the kidney?

Answer 2

Excrete waste products of metabolism
Maintain water and electrolyte balance
Maintain acid/base balance

Question 3

Which kidney is more superior and why?

Answer 3

The left kidney is located more superiorly

The right kidney has the liver directly superior to it and this pushes down

Question 4

What is situated on top of each kidney?

Answer 4

Adrenal glands

Question 5

What is the hepatorenal recess and where is this?

Answer 5

Subhepatic recess/Morrison’s pouch
Separates the live from the right kidney
This is where fluid collects if a patient is lying supine

Question 6

When might fluid collect in the hepatorenal recess?

Answer 6

Ascites

Pancreatitis

Question 7

Which organ lies anterior to both and stretches across from the right to the left kidney?

Answer 7

Pancreas - head of the pancreas at the right kidney and tail of the pancreas at the left kidney

Question 8

Is the pancreas retro or intraperitoneal?

Answer 8

Pancreas is intraperitoneal apart from the tail which is retroperitoneal

Question 9

What is the shape of the right adrenal gland?

Answer 9

Pyramidal/triangular

Question 10

What is the shape of the left adrenal gland?

Answer 10

Crescent shaped

Question 11

Are the kidneys retroperitoneal or intraperitoneal?

Answer 11

Kidneys are retroperitoneal

Question 12

What is Gerota’s fascia?

Answer 12

This is the renal fascia - the kidneys are encapsulated in their own layer of fat

Question 13

At what level does the IVC penetrate the diaphragm?

Answer 13

T8

Question 14

At what level does the oesophagus penetrate the diaphragm?

Answer 14

T10

Question 15

At what level does the aorta penetrate the diaphragm?

Answer 15

T12

Question 16

What is the costodiaphragmatic recess?

Answer 16

Aka. costophrenic recess

Potential space in the pleural cavity at the junction of the diaphragm and pleural cavity

Question 17

What are the nerves of the lumbar plexus?

Answer 17

Subcostal 
Iliohypogastric
Ilioinguinal 
Genitofemoral 
Lateral cutaneous
Femoral 
Obturator

Question 18

At what level does the coeliac trunk branch from the abdominal aorta?

Answer 18

T12

Question 19

At what level does the SMA branch from the abdominal aorta?

Answer 19

L1

Question 20

At what level does the IMA branch from the abdominal aorta?

Answer 20

L3

Question 21

At what level do the renal arteries branch from the abdominal aorta?

Answer 21

L1

Question 22

At what level do the gonadal arteries branch from the abdominal aorta?

Answer 22

L2

Question 23

At what level does IVC form from the common iliac veins?

Answer 23

L5

Question 24

How can you recognise the left renal vein from the right renal vein?

Answer 24

The left renal vein crosses the midline anterior to the aorta

Question 25

What are the two layers that surround the kidney?

Answer 25

Renal fat
Renal/Garota’s fascia

These are both contained within the renal capsule

Question 26

What are the branches of the renal artery?

Answer 26

Renal artery - segmental artery - interlobar artery - interlobular artery - arcuate artery

Question 27

What is the renal papilla?

Answer 27

This is the top of the renal pyramid

Question 28

What is the nervous innervation of the kidney?

Answer 28

Via the renal plexus

Question 29

Where is pain from the kidney referred to?

Answer 29

Referred to the small of the back - the flank - lumbar quadrant

Question 30

Three regions of male urethra

Answer 30

Prostatic
Membranous
Spongy

Question 31

At what level does the aorta bifurcate into the common iliac arteries?

Answer 31

L4

Question 32

What are the three most likely regions for a stone to lodge in the ureters?

Answer 32

1 -