Abdomen 5 Flashcards
What are the suprarenal glands? what surrounds them?
Paired endocrine glands (adrenoglands) - produce hormones
Lie in upper pole of kidney
surrounded by renal fascia
What is the difference in shape between the left and right adrenal gland?
Right kidney = Pyramidal shape
Left Kidney = Crescent shape
2 components of the suprarenal glands
Yellow cortex (outer)
Brown medulla (inner)
2 features of the yellow cortex
Derived from mesoderm
Secretes corticosteroids and androgens ie, cortisol
2 features of the brown medulla
Derived from the neural crest
Main source of catecholamines (adrenaline and noradrenaline)
importance of renal fascia
covering of suprarenal glands, and is seperate to kidneys -
so if kidney is affected, surparenal glands stay protected
What is the arterial supply to the suprarenal gland? (3)
3-
1. Superior suprarenal artery - comes from Inferior phrenic artery
- Middle suprarenal artery - comes from Aorta
- Inferior suprarenal artery - comes from Renal artery
Venous drainage of the suprarenal glands? (2) and clin significance of L
only 2
right and left suprarenal veins (r = drain into IVC) (l = drain into L renal vein)
Drainage is different on the left side as the aorta is in the way, so it is safer for the vessel to not cross over the aorta
L = preffered site for donor , may get compressed by anurism. is longer
4 functions of the kidneys
Kidney and peritoneum
- Excretes most of waste products of metabolism.
- Controls water and electrolyte balance of body.
- Maintains acid-base balance of body.
Secretes hormones and renin into the blood stream
Primary retroperitoneal
At what vertebral level would we find the kidneys?
Where do we find the hila of the kidneys?
Which kidney is higher?
*Located between T12 – L3 vertebrae.
*Hila of kidney: L1.
- Between rib 11 and 12 (floating
they move w diaphragm bc of close relation
Left
Right is lower (due to liver)
What are the anterior relations of the right kidney? 5
7 anterior left kidney relations
What are the posterior bony and muscular relations of the kidneys?
Muscular Transversus abdominis
Superior poles of L+ R kidney related to diaphragm
Medially = psoas major
Laterally = quadratus lumborum
Identify the coverings of the kidneys on the diagram and function
REPI REPA
- Renal capsule
- Perinephric Fat
- Renal Fascia (continuous with transversalis fascia)
- Paranephric fat
What is the purpose of the paranephric fat?
Insulates and protects the kidneys
Which covering on the kidney is continous with the transversalis fascia and fascia over the diaphragm
renal fascia
Label the kidneys
Contents of hilum of kidney
*Transmits, from anterior to posterior, the renal vein, renal artery & the ureter (VAU). ant to post
Lymph vessels & sympathetic fibers also pass through the hilum
what is the Calyx muscles
Smooth muscle in calyces propels urine through renal pelvis into ureters to the bladder
What is the renal sinus?
Will contain the renal pelvis (upper expanded part of ureter)
(perinephric fat will also continue here)
What is the arterial supply of the kidneys? (v similar to bronchus tree)
Abdominal aorta —> Renal arteries —> Segmental arteries —> Lobar arteries —> Interlobar arteries —> Arcuate arteries —> Interlobular arteries
The segmental arteries of the kidneys will divide the kidney into 5 vascular segments
Determine these segments
What is the venous drainage of the kidneys?
- Venous drainage will follow arterial drainage
- Interlobular veins will receive efferent glomerular veins from Bowmann’s Capsule and drain into the arcuate veins
- Arcuate veins and interlobar veins
- They drain into the multiple renal veins which will not align to the segmental artery
- These will flow into the left and right renal vein
efferent glomelular veins –> interlobular –> arcuate –> interlobar –> renal veins –> L + R renal vein
L renal vein is 3x longer than right, so preffered for renal donation
Which renal vein is longer and why?
What is the clinical significance of this?
Left is longer because inferior vena cava is a right side structure and needs to travel over the aorta
1) means if there is an aneurysm in the aorta/ SMA and may compress renal vein
2) Longer vein means left kidney is more likely to be used for transplantation
3 veins to the left renal vein
*Receives left gonada (testicular or ovarian) vein, inferior phrenic and left suprarenal vein.
What is the renal lymphatic drainage?
Will follow the renal veins
Drain into right and left lumbar nodes (caval and aortic) near Renal artery
What is the difference in what the left and right renal vein receive?
Left = receives left gonadal and inferior phrenic and suprarenal then to IVC
Right drains directly into IVC
What is the nerve supply to kidneys?
Mainly regulated by hormones (no evidence of parasymp supply)
Sympathetic
= Vasomotor regulating BF and renin secretion
Come from renal plexus
Post-ganglionic (T10-L2)
What is a staghorn calculus?
Build up of struvite
Solid mass will take up kidney itself
Occur in recurrent UTI’s
Is renal function dependent on innervation?
**Renal function not dependant on innervation as shown with renal transplantation (complete transection of innervation).
Renal function regulated by hormones.
Contractions in ureter
Peristaltic
What is the course of the ureter in the abdomen ? and what peritenom?
retroperitineal
· They run inferiorly (down), anterior to the psoas major muscle.
- Cross anterior to genitofemoral nerve
- Obliquely crossed by gonadal vessels
· Enter the pelvis anterior to the bifurcation of the common iliac arteries (L4/L5)