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MB2: Renal > Anatomy > Flashcards

Anatomy Flashcards

1
Q

true/false - kidney and proximal ureters are retroperitoneal

A

true

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2
Q

what abdo wall muscles lie lateral to the kidneys

A

external/internal oblique

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3
Q

describe the contents of the renal hilum and their relations to each other

A

renal artery posterior
renal vein anterior
ureter inferior

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4
Q

what abdo wall muscles lie deep to the kidney

A

quadratus lumborum

psoas major

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5
Q

what is the relevance of muscle guarding to the kidneys

A

acts to protect the kidneys

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6
Q

what spinal level does the right kidney sit

A

L1-L3

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7
Q

what spinal level does the left kidney sit

A

T12-L2

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8
Q

what ribs offer protection to the kidneys and what is a potential issue

A

ribs 11-12

rib fractures can cause laceration to the kidneys

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9
Q

approx size of a normal kidney

A

12x6cm

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10
Q

anatomical relationships of the right kidney to other organs

A

posterior to liver and hepatorenal recess
2nd part duodenum
ascending colon
right colic flexure

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11
Q

anatomical relationships of the left kidney to other organs

A

stomach
splenic hilum
splenic vessels
tail of pancreas

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12
Q

what lymph nodes do the kidneys drain to

A

lumbar

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13
Q

what lymph nodes do the ureters drain to

A

lumbar and iliac

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14
Q

what is found in the renal medulla

A

renal pyramds

contains nephrons

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15
Q

describe drainage of the kidney

A

collecting ducts converge to minor calyx, then to major calyx, then to renal pelvis and ureter

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16
Q

the constriction between the renal pelvis and the ureter is known as?

A

pelviureteric junction

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17
Q

name 3 sites of anatomical constriciton in the ureter

A

pelviureteric junction
ureter crossing ant aspect common iliac and pelvic rum
ureteric orifice

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18
Q

describe the passage of urine through the ureters

A

flows through by peristaltic waves

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19
Q

consequences of any ureter/bladder obstruction

A

back pressure either unilaterla or bilateral to kidneys
this continues until pressure exceseds filtration pressure wothin glomerulus
this leads to hydronephrosis and renal failure

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20
Q

boundaries of the false pelvis?

A

iliac crests to pelvic inlet

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21
Q

boundaries of the true pelvis?

A

pelvic inlet to pelvic floor

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22
Q

name a muscle of the pelvic floor

A

levator ani

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23
Q

openings of the pelvic floor in men and women?

A

men have 2 - urethra, anus

women have 3 - urethra, vagina, anus

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24
Q

describe the passage of the ureters from kidney to bladder

A

travel down false pelvis and pass ant to common iliac to enter true pelvis
turns medially at ischial spine and enters bladder posteroinferior

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25
Q

how does the ureter relate anatomically to the vas deferens

A

inferior to vas deferens

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26
Q

how does the ureter relate anatomically to the uterine artery and tubes

A

runs inferior, water under the bridge

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27
Q

what arteries in women arise from the internal iliac within the pelvis

A

vesical
uterine
midline rectal
vaginal

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28
Q

what arteries in men arise from the internal iliac within the pelvis

A

prostatic
vesical
middle rectal

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29
Q

what is the hepatorenal recess

A

most dependent part of the abdominal cavity when the patient is lying on back

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30
Q

most inferior part of the peritoneum in men?

A

rectovesical pouch

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31
Q

most inferior part of the peritoneum in women

A

there is two
pouch of douglas is deeper and is the rectouterine
vesicouterine is less deep

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32
Q

what is the trigone

A

two ureteric orifices and the internal ureteric orifice form a triangular patch on posterior bladder

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33
Q

what muscle makes up the wall of the bladder

A

detrustor muscle

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34
Q

what special sphincter is present in the male bladder and what is its function

A

internal urethral sphincter, formed from thickening of detrusor
prevents retrograde ejactulation

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35
Q

anatomical relations of the male bladder

A

prostate inferior

rectum posterior

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36
Q

anatomical relations of the female bladder

A

uterus lies superior anteflexed and seperated by uterovesicle pouch

37
Q

where does the bladder lie when empty/full

A

true pelvis when empty

false pelvis when full

38
Q

approx length of the female urethra

A

4cm

39
Q

approx length of the male urethra

A

20cm

40
Q

describe passage of urine from bladder to the outside in men

A

passes from bladder though internal urethral spincter/orifice to urethra, then to prostatic urethra, to external urethral sphincter, then to spongy urethra and to external urethral meatus

41
Q

describe passage of sperm from testes to penis

A

seminiferous tubules to epididymus, to vas deferens
passes in spermatic cord into abdo wall and posterior to bladder to join seminal gland
joins ejaculatory ducts and forms part of the prostatic urethra
then passes into the spongy urethra

42
Q

what is the tunica vaginalis

A

sac containing testes

visceral lines testes and parietal lines inner scrotum

43
Q

contents of spermatic cord

A

vas deferens
testicular artery
nerves
pampiniform venous plexus

44
Q

arterial supply to the testes?

A

from testicular artery from abdo aorta

45
Q

venous drainage from the testes?

A

right to IVC

left to left renal, then to IVC

46
Q

passage of the vas deferens?

A

superiro from testes to superficial inguinal ring to deep, presents in abdo cavity and passes posterior and medial to bladder
then joins ejaculatory duct and seminal vesicle, comes togehter to form prostatic urethra

47
Q

true/false - vas deferens passes anterior to ureter

A

true

48
Q

what are the prostatic ducts

A

ducts with glandular secretions which drain to prostatic urethra

49
Q

what is the inferior section of the prostate in contact with

A

levator ani

50
Q

sections of the penis

A

root
body
glans
external urethral orifice

51
Q

layers of the penis

A

skin
superifical fascia
deep fascia
erectile tissue cylinders

52
Q

what are the 3 erectile tissue cylinders

A

corpus spongiosum

2 corpus cavernosum

53
Q

arterial supply to penis?

A

branches of pudendal from internal iliac

54
Q

arterial supply to scrotum

A

from external iliac and internal pudendal from internal iliac

55
Q

lymph drainage of penis and scrotum

A

to superficial ingiunal lymph nodes

56
Q

lymph drainage of the testes

A

lumbar lymph nodes

57
Q

modalities of sensory pain to kidney

A

visceral afferent

58
Q

modalities of sensory pain to testes

A

visceral afferent

59
Q

modalities of sensory pain to bladder

A

visceral afferent

60
Q

modalities of sensory pain to ureter

A

visceral afferent

61
Q

modalities of sensory pain to urethra

A

visceral afferent except in perineum

62
Q

modalities of renal motor to ureters

A

ANS

63
Q

modalities of renal motor to bladder

A

ANS

64
Q

modalities of renal motor to urethral sphincters

A

ANS/somatic sensory

65
Q

modalities associated with urinary continence?

A

somatic motor
visceral afferent
sympathetic
parasympathetic

66
Q

modalities and supply of the lumbar and sacral plexus

A

somatic moror and sensory

supplies lower limbs ansd perineum

67
Q

summarise basic sympathetic nervous system outflow

A

leaves T1-L2
pass into the symapthetic chain so all spinal nerves have sympathetic supply
travel to body organs by splanchnic nerves

68
Q

how does the SNS get to the kidneys, bladder and ureter

A

leaves T10-L2
leaves by abdominopelvic splanchnic nerves
synapse at abdominal sympathetic ganglia and then passes to organs by periarterial plexus

69
Q

summarise PNS outflow

A

leaves by III, VII, IX, X and by sacral nerves

cannot innervate smooth muscle or glands of body wall

70
Q

describe PNS outflow to the kidneys and ureter

A

carried by vagus nerve

enters diaphragm by periarterial plexis to enter kidneys and ureter

71
Q

describe PNS outflow to the bladder

A

passes through pelvic splanchnic nerves leaving S2-4

72
Q

where is kidney pain felt

A

felt in loin/flank

73
Q

where is ureter pain felt

A

loin to groin

74
Q

where is bladder pain felt

A

suprapubic

75
Q

where is perineal urethral pain felt

A

localised to perineum

76
Q

describe passage of pain perception in kidneys

A

travels along SNS by T11-L1

77
Q

describe passage of pain perception in ureter

A

run SNS by T12-L2

78
Q

describe passage of pain perception in bladder

A

affernts touching the perineum on sup bladder enter SNS T11-T2 midline
part below peritoneum run PNS on S2-S4

79
Q

describe passage of pain perception in urethra

A

run PNS to S2-S4 if prox urethra above pelvis

rest is somatic sensory from S2-4 so can be easily localised in perineum

80
Q

DDx pain kidney

A 
skin
MSK 
verebral 
spinal nerve root compression 
LL pneumonia
81
Q

DDx pain bladder

A

hindgut organs

uterine

82
Q

DDx pain ureter

A

femoral hernia
lymphadenopathy
testicular

83
Q

DDx pain urethra

A

vaginal tear
anal canal fissure
perineal genital ulcers

84
Q

describe passage of pain perception in testis

A

SNS from T10-L1

pain can also be felt localised L1 in scrotum

85
Q

DDx pain testes

A

skin lesions

strangulated inguinal hernia

86
Q

function of visceral afferents in micturition

A

S2-4

sense stretch

87
Q

function of PNS In micturition

A

pelvic splanchnic nerves
contraction of detrusor
S2-4

88
Q

function of pudendal nerve in micturition

A

somatic sensory and motor
S2-4
allows voluntary relaxation of external urethral sphincter

89
Q

describe the process of urinary continence

A

bladder fills to send stretch relay by visceral afferent to CNS (S2-4)
reflex stimulation detrusor and relaxation of internal urethral sphincter in en
brain override if those who are ‘trained’
once appropriate this is lifted to cause detrusor contraction, relaxation of IUS, levator ani, EUS and abdo wall contraction

MB2: Renal (11 decks)

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