Anatomy 1 - Kidneys, Ureters, Bladder, Urethra Flashcards
What is classed as upper urinary tract ?
Kidneys and ureters
What is included in the Lower Urinary tract ?
Bladder and urethra
Where does the kidneys lie in regards to the peritoneum ?
Kidneys lie in the retroperitoneal space of the abdomen, pressed against the posterior abdominal wall.
Where does the bladder lie within the peritoneum ?
The bladder lies infraperitoneally in the pelvis.
In males it is directly anterior to the rectum.
In females it is directly anterior to the vagina and uterus.
Where does urine production occur ?
The functional units are known as a nephrons.
The nephron is the functional unit of the kidney. The glomerulus and convoluted tubules of the nephron are located in the cortex of the kidney, while the collecting ducts are located in the pyramids of the kidney’s medulla
What is the Anatomical position of the kidney ?
The kidneys lie retroperitoneally (behind the peritoneum) in the abdomen, either side of the vertebral column.
They typically extend from T12 to L3, although the right kidney is often situated slightly lower due to the presence of the liver. Each kidney is approximately three vertebrae in length.
The adrenal glands sit immediately superior to the kidneys within a separate envelope of the renal fascia.
How does urine move through the kidneys?
renal cortext ( nephrons)
pyramidsin renal medulla
minor calyces
major calyces
renal pelvis
filtered out by ureter
Where does the renal pelvis leave the kidneys ?
At the hilum
What fat surrondes the kidneys ?
Perinephric fat
Which Ureter is longer ?
The left ureter is usually 1 cm longer than the right, size varying with the position of the kidney.
Where are the ureters most likely to constrict and result in stones ?
Uretal pelvic junction
Mid-ureter
Passing into the bladder
Explain where the Trigone is and what is its importance ?
Urine enters the bladder through the left and right ureters, and exits via the urethra. Internally, these orifices are marked by the trigone – a triangular area located within the fundus.
How is the bladder fixed to the anterior umbillical wall ?
By the median umbilical ligament
How is the bladder connected to the pelvis in women?
Pubovesical ligament
How is the bladder connected to the pelvis in men?
puboprostatic ligament
Whats the outer and inner layers of the kidneys called?
Outer - Cortex
Inner - Meduula
In between the pyramids are what?
Renal column
What is the nephron made up of ?
Glomelurous and Renal Tubule
Explain where the Bowmans capsule sits
Bowman’s capsule is a part of the nephron that forms a cup-like sack surrounding the glomerulus.
What is the medical terminology for stones in the kidney?
nephrolithiasis
What is the blood supply to the kidneys
right and left renal artery
What is the function of the ureter ?
Transport urine
What are the three openings of the bladder ?
The two openings for the ureters
One for the Urethra
What is Benign prostatic Hyperplasia
Benign prostatic hyperplasia, a noncancerous enlargement of the prostate gland, is the most common benign tumor found in men
Whos more likely to get a UTI males or females ?
Females
Due to length of urethra
What is the difference between primary and secondary retroperitoneal?
Primarily retroperitoneal organs developed and remain outside of the parietal peritoneum. The oesophagus, rectum and kidneys are all primarily retroperitoneal.
Secondarily retroperitoneal organs were initially intraperitoneal, suspended by mesentery. Through the course of embryogenesis, they became retroperitoneal as their mesentery fused with the posterior abdominal wall. Thus, in adults, only their anterior surface is covered with peritoneum. Examples of secondarily retroperitoneal organs include the ascending and descending colon.
Which structures are primary retroperitoneal?
Kidney
adrenal glands
abdominal aorta
IVC
ureters
1/3rd rectum and oesophagus.
Which structures are secondary retroperitoneal?
Duodenum (Expect proximal part - duodenal cap)
Pancreas (head neck and body)
ascending colon
descending colon
Which structures are classed as intraperitoneal/subperitoneal? (Just below peritoneum)
Urinary Bladder
Urethra
Prostate
Uterus
Vagina
Overies
What is the function of the Adrenal glands ?
What hormones do the medulla produce
What hormones do the cortex produce
Secrete hormones
Medulla - Catecholamines
Cortex - Glucocortacoids (eg cortisol)
Gross heamaturia vs Microscopic haematuria
Gross - You can see the pink/red blood
Micro - cant see the blood
Must do a urinalysis to detect the blood if its micrscopic
Best imaging for nephrolithiasis
CT scan - To determine size of stone
What type of image is shown below and what view is it?
CT - Sagital
In the image above identify the following:
* Diaphragm, kidney, major calyx, posterior abdominal walls, renal pelvis, renal cortex, renal pyramid
Is this the left or the right kidney? What’s your reasoning?
Right because you can see the liver.
Whats retroperitoneal ? Think SADPUCKER
What is important about the left renal vein vs. the right renal vein? Think about length and contributions.
The left renal vein is longer than the right as it travels across the IVC, which lies on the right side of the vertebral column.
The left drains more than the right, and the left gonadal vein can be necessary in testicular conditions in male varicocele.
What is A? Artery and the organ it supplies
Inferior phrenic artery
Inferior diaphragm and adrenal gland
What is B ?Artery and the organ it supplies
Celiac Trunk
Foregut
What is C ?Artery and the organ it supplies
Middle Supra renal artery
Adrenal gland
What is D ? Artery and the organ it supplies
Left renal artery
Kidneys
What is E ?Artery and the organs it supplies
Superior mesenteric artery
Midgut
What is F ?Artery and the organ it supplies
Inferior mesenteric
Hindgut
What is G ?Artery and the organ it supplies
Median sacral artery
L4, L5, SACRUM, COCCYX, AND PART OF RECTUM
What is H ?Artery and the organ it supplies
Common illiac artery
Lower Limb
What is I ?Artery and the organ it supplies
Lumbar arteries
Spinal chord
What is J ?Artery and the organ it supplies
Testicular/ovarian arteries
Testies/Ovaries
What is K ?Artery and the organ it supplies
Middle suprarenal artery
Adrenal
What are the functions of the adrenal glands and what body system is it part of?
Hormone production, regulate metabolism, immune system, blood pressure
Endocrine system
The right and left adrenal glands generally have different anatomical shapes. What are they?
Right pyramid shape
Left semi lumar shape
No reason why
What is this scan ?
What do the two arrows show
CT scan.
White - Normal adrenal gland
Black - Pheochromocytoma
What clinical condition is present in the below image?
Stone in the right and left kidneys.
Staghorn Calculi - Branches of kidney stones filling the renal pelvis.
What forms kidney stones?
Hereditary
What we eat
Dehydration
Microscopic crystals form and accumulate - usually from calcium oxalate, magnesium ammonia phosphate, uric acid or cystine but can be from others or a combination of some/ all.
MOST COMMONLY CALCIUM OXALATE
Identify which narrowings these kidney stones are present in in the below images?
Ureterovesical junction
Identify which narrowings these kidney stones are present in in the below images?
Ureteropelvic junction
Identify which narrowings these kidney stones are present in in the below images?
Mid-Ureter
On the diagram below, draw where pain from a left renal colic could potentially be felt by a patient. Identify the dermatomes involved.
T11-L2 can also include the grown pain despite in S2/3.
During development there can be abnormalities that change the anatomy and location of the kidneys. What abnormalities are present in the images below?
What type of imagine is this ?
Horseshoe kidneys - They are fused together
MRI
During development there can be abnormalities that change the anatomy and location of the kidneys. What abnormalities are present in the images below?
Pelvic Kidney - Descended Kidney towards Pelvis
Should you refer someone with a new onset varicocele in case of cancer?
YES
headaches
heavy sweating
a rapid heartbeat (tachycardia)
high blood pressure !!!!!
a pale face
feeling or being sick
feeling anxious or panicky
shakiness (tremor)
What could this be ?
Phaeochromocytoma
Young women 4 UTIs per year what are you thinking ? 32 years old
Diabetes
Is right or left colon more at risk of cancers ?
Left because bulkier stool
