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SF3.05_Urogenital Development_SEIDEN > Adult Kidney, bladder, ureter > Flashcards

Adult Kidney, bladder, ureter Flashcards

1
Q

Identify all:

A
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2
Q

What enters/exits the renal hilium?

A
  1. renal artery
  2. renal vein
  3. renal pelvis (connects to ureter)
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3
Q

Layout of renal artery, renal vein, and renal pelvis in hilium:

A

Anterior to posterior: VAP

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4
Q

Label all:

A
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5
Q

Renal papillae:

A
  • tips of the renal pyramids
  • renal pyramids = where collecting ducts are
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6
Q

Hydronephrosis:

A
  • dilation of the renal pelvis and calyces due to an obstruction of the conductive system.
  • Can damage kidney funciton.
  • Usually due to a stone.
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7
Q

Intrarenal arteries of kidney in branching order:

A
  1. renal artery
  2. segmental arteries
  3. interlobar arteries
  4. arcuate arteries
  5. interlobular arteries
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8
Q

The kidney is surrounded by:

A
  • fat (perirenal and pararenal)
  • muscle (psoas major, quadratus lumborum, Transverse Abdominis, Lat. Dorsi)
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9
Q

Label all:

A
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10
Q

Label all:

A
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11
Q

Which kidney is lower, right or left?

A

right, due to liver

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12
Q

Left kidney is covered by what ribs?

A

11th and 12th ribs

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13
Q

Right kidney is covered by what ribs?

A

12th rib only

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14
Q

Label what covers each portion of the kidney:

A
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15
Q

The adult kidneys are located where?

A
  • retroperitoneal space
  • T12 to L3
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16
Q

Fat layers surrounding kidney:

A
  1. perirenal fat (on kidney)
  2. renal fascia
  3. pararenal fat (continuous with retroperitoneal fat)
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17
Q

Muscles surrounding kidney, from medial to lateral:

A
  1. psoas major
  2. quadratus lumborum
  3. transverse Abdominis
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18
Q

Organs surrounding the right kidney, by retroperitoneal and peritoneal divisions:

A
  • Retro:
    • bare area of liver
    • hepatic flexure of colon
    • duodenum
  • Peri:
    • ileum
19
Q

Organs surrounding the left kidney, by retroperitoneal and peritoneal divisions:

A
  • Retro:
    • tail of the pancreas
    • splenic flexure of colon
  • Peri:
    • stomach
    • spleen
    • jejunum
20
Q

The left and right renal veins drain into:

A

IVC

21
Q

Path of left renal vein to the IVC:

A
  • left renal vein longer than right (IVC on right).
  • sandwiched between aorta superior mesenteric artery.
22
Q

What veins drain into the left renal vein?

A
  • left adrenal vein
  • left gonadal vein
23
Q

Drainage of right adrenal and gonadal veins:

A
  • directly into IVC.
24
Q

Superior mesenteric artery syndrome:

A
  • left renal vein compressed between SMA and aorta.
  • venous drainage from left kidney, left adrenal gland and left gonad compromised.
  • varicocele in male left testis may result.
  • third portion of duodenum also compressed, pain after meals.
25
Q

Label all:

A
26
Q

Ureter path from kidney to bladder:

A

forms from renal pelvis.

  1. runs down abdomen in retroperitoneal space on anterior psoas major.
  2. crosses pelvic brim to enter pelvis.
  3. runs down posterolateral pelvic wall.
  4. crosses anteriorly along pelvic floor to reach bladder.
  5. passes obliquely through bladder wall.
27
Q

The ureter has three distinct points of narrowing where ureteral stones are most likely to become impacted:

A
  1. ureteropelvic junction
    • where renal pelvis transitions to ureter
  2. where crosses pelvic brim at common iliac artery bifurcation.
  3. ureterovesical junction
    • where ureter passes through bladder wall.
28
Q

Most frequent site for impaction of ureteral stones:

A
  • ureterovesicle junction
  • smallest diameter of ureter
29
Q

Blood supply to ureter:

A
  • superior = renal artery branches.
  • mid-inferior = branches of gonadal artery, abdominal aorta, common iliac artery, internal iliac artery.
30
Q

Site of kidney transplant and reason for site:

A
  • near bladder in pelvis.
  • not possible to retain blood supply for entire ureter.
  • only upper portion of ureter is transplanted, along with its blood supply from renal artery.
31
Q

The two muscles of the bladder and their innervation:

A
  1. detrusor muscle (smooth; parasympathetic)
  2. internal urethral sphincter (smooth; sympathetic)
32
Q

Detrusor muscle location, function, innervation:

A
  • smooth muscle; most of bladder wall.
  • contract to compress bladder lumen, expelling urine.
  • parasympathetic.
33
Q

Internal urethral sphincter location, function, innervation:

A
  • smooth muscle; neck of bladder.
  • contract to constrict urethra opening, retaining urine in the bladder.
  • sympathetic.
34
Q

Bladder Trigone:

A
  • Smooth triangular region of bladder wall.
  • bounded by two ureters and urethra.
35
Q

Path of ureter penetrating bladder walls:

A
  • oblique-tunnel fashion.
  • prevents backflow of urine from bladder back into ureters when bladder wall contracts due to detrusor muscle.
36
Q

The two spincters of the bladder, type of muscle and innervation:

A
  • internal urethral sphincter; smooth; sympathetic
  • external sphincter; skeletal; pudendal nerve
37
Q

The bladder receives its blood supply from:

A

branches of internal iliac arteries.

38
Q

Parasympathetic innervation to kidney and upper ureter:

A

via vagus nerve

39
Q

Sympathetic innervation to kidney and upper ureter:

A
  • Lesser Splanchnic N.
  • Least Splanchnic N.
  • 1st Lumbar Splanchnic N.
40
Q

Sympathetic innervation to bladder and lower ureter:

A
  • Lumbar Splanchnic N.
  • Sacral Splanchnic N.
41
Q

Parasympathetic innervation to bladder and lower ureter:

A

Pelvic Splanchnic N.

42
Q

Pain sensation from ureter during stone impaction:

A
  • pain fibers on same course as preganglionic sympathetics.
  • T10-L2.
  • referred pain to T10-L2 dermatomes.
43
Q

Progression of pain sensation from ureter during stone impaction:

A
  • Pain will start at T10 dermatome and move to L2 dermatome over days.
  • Loin to groin pain.
  • Pain is always unilateral. Never crosses the midline.

SF3.05_Urogenital Development_SEIDEN (3 decks)

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