Anatomy 1 - Upper Urinary Tract Flashcards
What is the name for the anatomical structures through which urine passes from its production to its excretion?
Urinary tract
What structure produces urine?
Kidney
What structure drains urine from the kidney to the bladder?
Ureter
What structure stores/ voids urine?
Bladder
What structure is urine excreted from the bladder through?
Urethra
What 2 substances does the urethra carry in men?
Urine
Semen
What structures make up the upper urinary tract?
Kidneys
Ureters
What structures make up the lower urinary tract?
Bladder
Urethra
Where in the abdomen are the kidneys and proximal ureters located?
In the retroperitoneum
What parts of the urinary tract are located in the pelvis?
Distal ureters
Bladder
Proximal urethra
What part of the body is the distal urethra located in?
Perineum
What does retroperitoneal mean?
Located in the abdominal cavity behind the peritoneum
What are the structures of the renal hilum?
Renal artery
Renal vein
Ureter
What is the name of the top part of the kidney?
Bottom part?
Superior and inferior pole
When looking at the anterior kidney, is the renal artery or vein anterior?
Renal vein
Name the layers between the visceral peritoneum and the kidney?
Visceral peritornum Paranephric fat Renal (deep) fascia Perinephric fat Renal capsule
Why is it important that the kidney is surrounded by skeletal muscles?
Muscle guarding can protect the kidneys from trauma
What muscles of the posterior abdominal wall helps to protect the kidney?
Psoas major
Quadratus lumborum
Is the abdominal aorta or IVC located more to the right?
IVC
Muscles of the anterolateral abdominal wall that helps protect the kidney?
External oblique
Internal oblique
Transversus abdominis
Which kidney lies sightly inferior?
Why?
Right = inferior
Size of the liver
Vertebral level of the right kidney?
L1-L3
Vertebral level of the left kidney?
T12 -L2
What is boney structures are posteriorly related to the kidneys?
The floating ribs (protect them but can contuse or lacerate if they fracture)
Which quadrants of the abdomen are the kidneys located in?
Right and left upper qudarants
Name the 9 regions of the abdomen?
Right/ left hypocondrium Epigastric Right and left lumbar/ flank region Umbilical Right and left inguinal region/ iliac fossa Pubic
What region of the abdomen are the kidneys located in?
The flank/ lumber regions
How long is the normal kidney approximately?
12cm
How wide approximately is the normal kidney?
6cm
How do the kidneys move in relation to breathing?
Inferiorly with inspiration and superiorly with expiration (due to relation with the liver and spleen which lie in contact with the diaphragm)
Which kidney lies posterior to the liver (and hepatorenal recess), 2nd part of the duodenum, ascending colon and right colic flexure?
Right kidney
Which kidney lies posterior to the stomach, tail of the pancreas, hilum of the spleen and splenic vessels?
Left kidney
Are the common iliac arteries anterior or posterior to the common iliac veins?
Anterior
Which lymph nodes do the kidneys drain to?
Lumbar nodes
Where are the lumbar lymph nodes located?
Around the abdominal aorta and inferior vena cava
At what level does the abdominal aorta bifurcate?
At the level of the umbilicus
What is the ureteric arterial blood supply branches from? (5)
The renal artery The abdominal aorta The common iliac artery The internal iliac artery The vesical (bladder) artery
What lymph nodes does lymph from the ureters drain to?
The lumbar nodes and iliac nodes
Where are the iliac lymph nodes located?
Around the common, internal and external iliac vessels
What is the name for an AAA which is located in the part of the abdomen below the kidneys?
Infra-renal AAA
What is the name for an AAA which involves part of the abdomen above the kidneys?
Suprarenal AAA
Name the type of repair for AAA that is less invasive than open surgery?
Endo-Vascular Aneursym Repair (EVAR)
How is renal artery stenosis and infra-renal AAA associated?
Both can be caused by atherosclerosis = can get them both at the same time
How is renal artery stenosis and supra-renal AAA related?
Can get renal artery stenosis caused by a suprarenal AAA (occlusion of proximal renal artery by the aneurysm)
What is the most common anatomical variation in the renal system?
Bifid renal pelvis
What is the second most common anatomical variations in the renal system?
Bifid ureter
Unilateral duplicated ureter
What is the third most common variation in the renal system?
Horseshoe kidney
What is the name for the anatomical variation in the renal system where the ureter passes posterior to the IVC?
Retrocaval ureter
Name for the birth defect where a normal kidney is located in the pelvis?
Ectopic pelvic kidney
Causes of a solitary kidney? (3)
Agenesis (failure to develop)
Nephrectomy (pathology)
Nephrectomy (donation)
What are the 2 main parts of the kidney?
Outer cortex
Inner medulla
(like the adrenal glands)
What structures does the renal medulla contain?
Renal pyramids
What structures does each renal pyramid contain?
Approx. 50,000 nephrons
What gives the pyramids their striped appearance?
Regularly arranged nephrons (running axially towards the apex of each pyramid)
Parts of a nephron?
Glomerulus Proximal convoluted tubule Loop of Henle Distal convoluted tubule Collecting duct
What is the purpose of the glomerulus?
Ultrafiltration of the blood arriving via branches of the renal artery
Purpose of the collecting duct?
Passes through the pyramid to drain the modified filtrate into the minor calyx as urine
What does urine drain to after the nephrons collecting duct?
Minor Calyx
Major Calyx
Renal Pelvis
Ureter
What happens to the diameter of the urine drainage tubes?
Increases until a constriction at the pelviureteric junction where the wider renal pelvis becomes the narrower ureter
What are the 3 anatomical sites of ureteric constriction?
Pelviureteric junction
Ureter crossing anterior aspect of the common iliac artery
(often crosses the bifurcation)
Ureteric orifice
What is the ureteric orifice?
Opening of the ureter into one corner of the trigone on the floor of the bladder
Scientific name for kidney stones?
Renal calculi
What do renal calculi form from?
Urine calcium salts
How can renal calculi often be visualised?
On X-rays
What type of imaging can be performed to show the structures of the urinary tract?
IV urogram
What is the name for a large renal calculi that takes up more than one branch of the collecting system in the renal pelvis of the kidney?
Staghorn calculus
What causes renal colic?
Increased peristalsis proximal to the site of a ureteric obstruction
Does a urinary tract obstruction within the bladder have the potential to cause unilateral or bilateral kidney problems?
Can cause either
When there is urinary tract obstruction that has caused the back up of urine towards the kidney, when will the production of urine continue until?
The pressure within the urinary tract exceeds the pressures favouring filtration at the glomerulus
What is renal failure?
Failure to adequately filter the blood to produce urine
What is the name for stretched/ swollen kidney(s) due to the build up of urine in them?
Hydronephrosis