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Sem 3: Urinary > 1a.) Anatomy > Flashcards

1a.) Anatomy Flashcards

1
Q

Which kidney is usually higher?

A

Left (right has the liver above it)

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2
Q

Describe the anatomical position of the kidneys in terms of vertebrate

A

Right:

  • Superior: 12th rib
  • Inferior: L4

Left:

  • Superior: 11th - 12th rib
  • Inferior: L3
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3
Q

At what spinal level are the hilia, and beginning of ureters, of kidneys?

A

L1

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4
Q

Approximately, what is the lenghth and width of the kidneys?

A
  • Length: 9-14 cm
  • Width: 6-7cm
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5
Q

Male and female kidneys are generally the same size, true or false?

A

False, men usually bigger

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6
Q

State two circumstances in which you should investigate regarding size of kidneys

A
  • More than 2cm difference between left and right
  • If length is less than 8cm as it may be CKD
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7
Q

Are the kidneys retroperitoneal?

A

Yes

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8
Q

If you were balloting (palpating) kidney generally which side would you do it on and why?

What must you ask patient to do when balloting kidney and why?

A

Right side as the kideny is lower so the ribs won’t be covering it as much.

Breath in and out… breathing in lifts thoracic cage upwards and outwards to make palpation easier

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9
Q

What is the renal angle?

If someone is tender in the renal angle what is this a sign of?

A

Angle betwen 12th rib and erector spinae muscle

Sign of inflammation

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10
Q

What keeps the kidneys in place?

A

Fat and collagen bundles in fascia as the kidneys are not attached to anything

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11
Q

The kidney is surrounded by a capsule and then by anterior and posterior renal fascia; state an alternative name for posterior renal fascia

A

Garota’s fascia

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12
Q

Describe where pararenal (paranephric) fat is found

A
  • External to posterior layer of renal fascia (Garota’s fascia)
  • Extra peritoneal
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13
Q

Describe where perirenal (perinephric) fat is

A

Surrounds kidneys within renal fascia layer; it is continous with fat found in renal sinusu of kidney

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14
Q

Roughly how long and wide is the ureter?

A

25-30cm long and 1.5mm in diameter

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15
Q

What is the role of smooth muscle in the ureter?

A

Propel urine, in peristaltic waves, to bladder

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16
Q

Describe the course of the ureters

A
  • Leave hilium of kidneys
  • Descend down lateral to tips of transverse processes of vertebrate
    • MEN: Ureters go under ductus deferens superior to seminal vesicles
    • WOMEN: descends posterior to ovary and into base of broad ligament passing under the uterine artery
  • At level of ischial spine bend anteriorly to enter bladder
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17
Q

After the uteropelvic junction, the ureter can be divided into 3 segments; state and describe the locations of these segments

A
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18
Q

State most common place for ureteric injury

A

Near sacroiliac junction/pelvic brim

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19
Q

Explain how urine reflux is prevented? Why is it important that the arrangment of structures prevents urine reflux?

A

Ureter passes diagonally through the bladder wall musculature. Vital as there is no sphincter at the ureterovesical junction

*NOTE: as ureter nears bladder it coalesces with detrusor muscle of bladder and consists of coarses longitudinally aranged muscle fibres

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20
Q

What is the ureterovesical junction?

A

Junction of ureter with bladder

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21
Q

What’s the approximate length of the intramural ureter in adults?

A

1.2 - 2.5 cm

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22
Q

What kind of epithelium lines the ureter and what organs is this epithelium continous with?

A

Urothelium; continous with lining of bladder and pelvis of kidney

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23
Q

Describe 3 abnormal positions ureters can have

A
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24
Q

Describe the urethral divisions in a male

A
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25
Women do not have muscle in their internal urethral sphincter; explain why a male needs smooth muscle in the IUS
Sympathetic innervation to internal urethral sphincter makes it contract to prevent ejaculation into bladder
26
What is the navicular fossa?
Dilated part of urethra in the glans penis
27
Are the adrenal glands enclosed within the renal fascia?
Yes, but usually a septum separates adrenal glands and kidneys
28
Describe the general structure of the kidneys
Outer fibrous capsule then an outer cortex and inner medculla. Outer cortex has projections which extend into the inner aspect of the kidneys dividing the renal medulla into discontinuous triangles called renal pyramids. The apcial projection of the renal pyramids is surrounded by a minor calyx. Minor calyx's join to form major calyx's. Two or three major calyx's join to form renal pelvis
29
Label the following image
30
Describe the arterial supply to the kidneys
* Single renal artery to each kidney * Left renal artery usually arises a little higher than right renal artery * Righ renal artery is longer as it passes posterior to the inferior vena cava
31
Where is it common for kidney stones to become lodged and why?
Ureteropelvic junction, pelvic brim and when enter wall of bladder as the ureter becomes constricted
32
State the functional unit of the kidney
Nephron
33
State some roles of the nephron
* Glomerulus filters large volume of ECF * Reabsorption of substances in PCT * Reabsorption of salts and water in DT * Secretion of hydrogen ions * Passive loss of waste products
34
Label the image
35
Compare cortical and juxtamedullary nephrons in terms of: * Location * Glomerulus * Loop of Henle * Diameter AA/diamter EE * EA * Sympathetic nerve innervation * Concentration of renin * Ratio
36
State the two broad classes of nephrons and the % of each in kidneys
* **90%=** Cortical: shorter loop of Henle, outer part of cortex * **10%=** Juxtamedullary: longer loop of Henle, inner part of cortex
37
Why are the kidneys so vulnerable to ischaemic damage?
Take up a large percent (22%) of cardiac output... more than brain, heart and muscles!
38
Give the rate for renal blood flow
1.1L/min
39
Define renal plasma flow
Volume of plasma that passes through kidneys per unit time
40
All blood flows through the glomeruli in the cortex; true or false
True
41
Why is the left kidney preferred for transplant?
It has longer vessels (vein longer)
42
Describe the entire arterial supply of kidneys (from renal artery to glomerular/afferent arteriole)
43
Describe the entire venous drainage of kidneys
44
Give a summary of the blood supply to kidneys
45
What does the renal fascia blend with laterally?
Transversalis fascia
46
Can there be one or more accessory renal arteries?
Yes
47
Before the renal artery enters kidneys via the hilia what does it branch into?
Anterior and posterior divisions
48
Kidneys can sometimes be supplied by additional arteries from...? (4)
* Superior mesenteric * Suprarenal * Testicular * Ovarian
49
What is meant by the bladder base?
The posterior surface of the bladder
50
What muscle is found in the bladder wall?
Detrusor muscle
51
What is the trigone of the bladder?
Triangle and between uteric openings and internal urethral meatus
52
53
What is the internal surface of the bladder like?
Bladder mucosa has rugae structure except trigone region which is smooth
54
Describe how the internal sphincter, at the bladder neck, is made from detrusor muscle
At bladder neck detrusor muscle runs circularly to from internal urethric sphincter
55
What is the urachus and where does it attach?
Fibrous renmant of fetal allantois which is seen as medial umbilical ligament on anterior abdominal wall
56
Each nephron is composed of...?
* Glomerulus * Tubule
57
Do the urethras pass anterior or posterior to the bifurcation of common iliac?
Anterior
58
Describe where the rectovesical and rectouterine pouches are found
* Rectovesical: MEN * Rectouterine: WOMEN
59
What is the pelviureteric junction?
Junction between renal pelvis and ureter
60
What is the vesicoureteric junction?
Junction between ureter and bladder
61
How long is the urethra in: * Adult male * Adult female
* Adult male: 20cm * Adult female: 4cm
62
From the hilium, describe the course of the ureter until it enters bladder; include bony landmarks, abdominal muscles, major vessels
* Descend along anterior surface of psoas major, anterior to lateral tips of transverse process of lumbar spine * Crosses in front of bifurcation of common iliac artery and crosses pelvic brim to enter into the peritoneal cavity at the sacroiliac joint * At ischial spine turns anteromedially moving in transverse plane towards bladder
63
State the following for the epithelium in the PCT: * Epithelium type * Mitochondria * Microvilli
* Simple cuboidal * Many mitochondria * Micovillia (brusher border)
64
State the following for the epithelium found in the thin descending and ascending loop of Henle: * Epithelial type * Mitochondria
* Simple squamous * Not many mitochondria
65
State the epithelium in the thick ascending loop of Henle: * Epithelium * Mitcohondria
* Simple cuboidal * Lots of mitochondria
66
State the epithlium in the collecting ducts: * Epithelium type * How can distinguish between PCT
* Simple cuboidal * Larger lumen and no brush border
67
Summarise epithelium in nephron
68
Compare intercalated and principal cells in collecting ducts

Sem 3: Urinary (21 decks)

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