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Health.1 > Anatomy > Flashcards

Anatomy Flashcards

1
Q

What are the 3 major parts of the urinary system?

A
  • kidneys
  • ureters
  • bladder
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2
Q

How do the kidneys relate to the diaphragm within the abdomen?

A

anterior and inferior

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3
Q

How do the ureters relate to the muscular wall of the abdomen?

A

anterior and posterior

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4
Q

How does the bladder relate to the pubic symphysis within the abdomen?

A

bladder is posterior to it

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5
Q

What is found at the superior boundary of the abdomen?

A

the inferior thoracic aperture and diaphragm

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6
Q

What is found at the inferior boundary of the abdomen?

A

the pelvic inlet/brim

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7
Q

What is found at the posterior boundary of the abdomen? (4)

A
  • the posterior abdominal wall muscles highlighted in blue
  • vertebrae L1-L5
  • ribs 11 and 12
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8
Q

What muscle is found at the antero-lateral boundary of the abdomen?

A

the anterior abdominal wall muscles highlighted in red

- transverse abdominis

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9
Q

What plane is a major anterior anatomy landmark for the abdomen?

A

the transpyloric plane

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10
Q

What are 3 things that can be remembered from the transpyloric plane?

A
  • it’s at vertebral level L1
  • it’s the midpoint of the kidneys
  • it’s the site of the pancreas’ and duodenum’s anatomical relations to the kidneys
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11
Q

where is the transpyloric plane? halfway between….

A

halfway between:

jugular notch and pubic symphysis

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12
Q

What can be seen when you take away the anterior wall of the abdomen?

A

the greater omentum

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13
Q

What can be seen when you take away the small intestine from the abdomen? (5)

A
  • stomach
  • start of duodenum
  • Liver (retracted)
  • peritoneum (centre of LI)
  • bladder (subperitoneal)
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14
Q

What can be seen when you take away the large intestine and liver from the abdomen?

A

the kidneys being immediately anterior to the diaphragm and posterior to the peritoneum

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15
Q

What can be seen when you take away the peritoneum from the abdomen?

A

that the kidneys, ureters and major blood vessels are retroperitoneal

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16
Q

Are the kidneys, ureters, inferior vena cava and abdominal aorta:
retroperitoneal or intraperitoneal?

A

retroperitoneal (outside the red line - peritoneum)

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17
Q

Are the small intestine and stomach:

retroperitoneal or intraperitoneal?

A

intraperitoneal sit within peritoneum (red line)

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18
Q

Right kidney:
a) SUPERIORLY related structures and retro/intra peritoneal? (very top)

b) ANTERIORLY related (above)

A

a) the suprarenal gland, retroperitoneal

b) liver (separated by peritoneum)

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19
Q

Right kidney:
a) MEDIAL structure and is it retro or intraperitoneal? (in curve)

b) INFERIOR and are they retro or intraperitoneal?(back of curve)

A

a) duodenum (from stomach to SI), retroperitoneal

b) - right colic flexure (sharp bend between ascending + transverse colon of LI), retroperitoneal
- small intestine, intraperitoneal

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20
Q

Left kidney:
a) SUPERIORLY related structures and retro/intra peritoneal? (very top)

b) ANTERIORLY related (above)

A

a) - suprarenal gland, diaphragm: retroperitoneal
- stomach, spleen: intraperitoneal

b)tail of pancreas, retroperitoneal

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21
Q

Left kidney:
a) MEDIAL structure and is it retro or intraperitoneal? (in curve)

b) LATERAL and are they retro or intraperitoneal?(back of curve)

A

a) small intestine (specifically jejunum), intraperitoneal

b) left colic flexure (where transverse becomes descending colon), descending colon, retroperitoneal

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22
Q

What are the posterior anatomical relations to the kidneys? (2 - anterior view)

A
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22
Q 
3 muscles (medial to lateral) and diaphragm are the posterior anatomical relations to the kidneys?
name the muscles
A

1) psoas major
2) quadratus lumborum
3) transversus abdominis

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23
Q

What are the posterior anatomical relations to the kidneys? (3 - posterior view)

A
  • LEFT: rib 11 and 12
  • RIGHT: rib 12
  • ureters in sagittal plane w/ transverse processes of lumbar vertebrae
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24
Q

Are the kidneys and ureters intraperitoneal or retroperitoneal?

A

retroperitoneal

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25
Q

What plane do the kidneys sit in?

A

the transpyloric plane (level L1 vertebrae)

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26
Q

What are the retroperitoneal relations to the urinary system? (4)

A
  • suprarenal glands
  • posterior abdominal wall muscles
  • diaphragm
  • ascending and descending colon
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27
Q

What are the intraperitoneal relations to the urinary system?

A

right:
- duodenum

left:

  • jejunum
  • spleen
  • stomach
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28
Q

ureters are continuous superiorly with what?

A

renal pelvis- which narrows as it passes inferiorly through hileum of kidney + becomes continuous with ureter at URETEROPELVIC junction.

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29
Q

3 points along urinary course when ureters are constricted? (where kidney stones become lodged)

A
  • URETEROPELVIC junction.
  • where ureters cross common iliac vessels at pelvic brim
  • where ureters enter wall of bladder
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30
Q

what does the liver do? when used for clean up

A

directs dead cells and chemicals to digestive and urinary systems

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31
Q

what does the liver convert?

A

AAs –> toxic ammonia, liver back to urea, less toxic to be disposed

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32
Q

4 medical problems regarding urine, the causes, and indictaors

A
  • pyuria: UTI (from studying leukocytes)
  • glycosuria: diabetes mellitus (gluc)
  • hematuria: UT bleeding (erythrocytes)
  • proteinuria: pregnancy/HF/high BP (proteins)
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33
Q

what 2 things inhibit ADH and how does this = dehydration?

A

caffeine and alcohol

= no moving aquaporins = little water reabsorption = urinate more = dehrdration

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34
Q

how much do aquaporins absorb that are located on:

a) apical side of LoH desc limb
b) basal side of collecting duct

A

a) lots of reabsorption

b) less reab

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35
Q

What are the 2 main gross external features of the kidney and what do they contain?

A

HILIUM: renal pelvis, artery, vein, nerves, lymphatics (where blood vessels and nerves enter, and ureters leave at transpyloric plane)
medial side of right kidney

SINUS: major/minor calyx, perinephric fat

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36
Q

renal vein in relation to renal artery?

A

RV is always anterior (below?) to RA

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37
Q

What is the hilum of the kidney?

A

concave medial border where vessels, nerves, and the ureter connect with the kidney

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38
Q

What is the sinus of the kidney?

A

a cavity within the kidney which is occupied by the renal pelvis, renal calyces, blood vessels, nerves and fat

(occurs from the expansion of the hilum)

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39
Q

What are the gross internal features of the kidney? (3)

A

lobes

outer: cortex, renal columns
inner: medulla

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40
Q

What composes the medulla?

A

the renal pyramids, which point towards the renal sinus

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41
Q

What is found at the ‘apex’ of each renal pyramid?

A

the renal papilla

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42
Q

What does the renal papilla drain urine into?

A

the minor calyx, merges into:
the major calyx, merges into:
renal pelvis

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43
Q

How is the renal artery anatomically related to the renal vein?
and how do their lengths compare?

A

it’s posterior to the renal vein in both kidneys

diff lengths

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44
Q

where does the renal artery emerge from?

A

the abdominal aorta at the transpyloric plane, vertebrae level L1 or L2

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45
Q

what is found on the transpyloric plane?

A

pancreas and duodenum

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46
Q

Which renal artery is longer and why?

A

the right renal artery

  • abdominal aorta is to the left of the midline
  • right artery needs to pass posteriorly to the inferior vena cava (which is also on the right) in order to reach abdominal aorta on left
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47
Q

Which renal vein is longer and why?

A

the left renal vein

- has to travel longer anteriorly to abdominal aorta to reach inferior vena cava which is towards right

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48
Q

What is superior mesenteric artery syndrome in the kidneys?

A

left renal vein is compressed by the superior mesenteric artery = blood back up to kidneys affecting filtration process and damaging it

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49
Q

What 2 arteries does the renal artery branch into?

A
  • anterior

- posterior

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50
Q

What do the posterior and anterior branches of the renal artery branch into?

A

interlobar arteries (between lobes of kidney) then arcuate arteries then
interlobular arteries
…
become afferent arterioles entering glomerulus (nephron)

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51
Q

What plexus innervates the kidneys?

A

renal plexus

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52
Q

What is the origin (supply) of the renal plexus (para/sympathetic? what plexus? motor/sensory? what vertebrae?)

A
  • sympathetic nerves in prevertebral plexus (vasoconstriction, renin secretion)
  • motor and sensory information via least splanchnic nerve (T12 origin)
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53
Q

what blood supply in regions of the ureters:

a) superior
b) middle
c) inferior

A

a) renal arteries

b) - gonadal arteries
- aorta
- common iliac arteries

c) internal iliac arteries

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54
Q

What structure is anatomically related to the ureter in the pelvis in

a) females
b) males

A

a) uterine artery, wrapped around ureter

b) ductus deferens

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55
Q

What is an anatomical restriction of the ureter?

A

these are created by tight angles created by ureters of physical structures pressing on them

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56
Q

What are 3 anatomical restrictions of the ureters?

A
  • Ureteropelvic junction
  • Pelvic inlet/brim
  • Bladder entrance
57
Q

What 2 areas does the spinal cord receive sensory information from that results in referred pain?

A
  • Viscera (visceral afferent nerves – unconscious monitor of internal systems)
  • Skin and muscle (somatic afferent nerves – conscious sensation).

somatic and visceral nerves enter the spinal cord together

58
Q

What are dermatomes?

A

area that represent areas of the skin innervated by a single spinal cord segment

59
Q

In which dermatomes would pain in the ureters (e.g. from kidney stones) be felt and why?

A
  • T11-L2
  • this is where sensory innervation of the ureters reach
  • a patient would describe groin, abdominal region (see image)
60
Q

How is the bladder anatomically related to the 1) pubic symphysis 2) peritoneum?

A
  • Posterior to pubic symphysis.

- Inferior to the peritoneum.

61
Q

what is the bladder anterior to in:

a) females
b) males

A

vagina

rectum

62
Q

what are kidneys innervated by?

A

sympathetic nerves that cause vasoconstriction and renin release

63
Q

What is the bladder superior to and supported by?

A

pelvic floor muscles

64
Q

Where does the bladder sit when empty?

A

in the pelvic cavity

65
Q

Where does the bladder extend to when filling?

A

extends through pelvic brim and into abdominal cavity

66
Q

What is the female bladder blood supply? (3)

A
  • right internal iliac artery
  • vaginal artery (specific to female)
  • superior vesical artery
67
Q

What is the male bladder blood supply? (3)

A
  • right internal iliac artery
  • superior vesical artery
  • inferior vesical artery (specific to male)
68
Q

All arteries to the bladder are branches of what artery?

A

the internal iliac arteries

69
Q

Where does venous drainage for the bladder occur?

A

through the internal iliac veins

70
Q

What are the internal features of the bladder? (4)

A
  • trigone: internal surface (external is base)
  • rugae (foldings of smooth muscle)
  • ureter openings
  • internal urethral orifice and sphincter (prominent in males but less in females)
71
Q

In which pouches can fluid accumulate during infection or bleeding in the female pelvis?

A
  • recto-uterine pouch (between uterus and rectum)

- vesico-uterine pouch (between bladder and uterus)

72
Q

In what pouch can fluid accumulate during infection or bleeding in the male pelvis?

A

the recto-vesical pouch (between rectum and bladder)

73
Q

What is the structure of the female urethra?

A
  • short (4cm)

- passes through deep perineal pouch and perineal membrane

74
Q

how is female urethra controlled?

A

voluntarily controlled by external urethral sphincter

you can squeeze the hold the sphincter in

75
Q

why is the female urethra susceptible to…

UTIs (urinary tract infections)

A

it is short.

primary symptom of UTI: bladder inflammation (cystitis)

76
Q

How can UTIs affected children under 1 year old?

A

can reach kidneys, leading to pyelonephritis and renal failure, making it deadly

77
Q

How are UTIs treated?

A

oral antibiotics

78
Q

How do the female and male urethra compare?

A

male is much longer at 20cm and divided in 4 parts

79
Q

What are the 4 segments of the male urethra?

A
  • Preprostatic urethra
  • Prostatic urethra.
  • Membranous urethra
  • Spongy (penile) urethra.
80
Q

Where is the internal urethral sphincter found in men and is it voluntary or involuntary? Why is it more prominent in men?

A
  • within the preprostatic urethra segment; involuntary (smooth muscle)
  • closes off during ejaculation to prevent acidic urine mixing with sperm
81
Q

Where is the external urethral sphincter found in men and is it voluntary or involuntary?

A

within the membranous part of the urethra, being under voluntary control

82
Q

where do the urinary and reproductive systems join in maile urethra?

A

at prostatic urethra

83
Q

What is the pelvic floor?

A

funnel-shaped sling structure that attaches to the walls of the lesser pelvis
separates pelvic cavity from perineum inferiorly (region which includes the genitalia and anus).

84
Q

What is the muscle found on the pelvic floor?

and what 3 muscles is it composed of?

A

the levator ani muscle:

  • Puborectalis
  • Pubococcygeus
  • Iliococcygeus
85
Q

What 2 apertures are found within the pelvic floor and which muscle slings around them?

A
  • urogenital hiatus
  • anal apeture
  • puborectalis (innermost) slings around them and compresses anus
86
Q

What nerve supplies the levator ani muscle?

A

pudendal nerve (somatic)

87
Q

what 2 structures does the urogenital hiatus contain in females?

A

urethra

vagina

88
Q

What is the

a) sympathetic nerve supply to the bladder?
b) parasympathetic nerve supply to the bladder?

A

a) sacral splanchnic nerves (T10-L2)

b) pelvic splanchnic nerves (S2-S4)

89
Q

How does the micturition reflex work when the bladder is empty? (3)

A
  • sympathetic nerves activate
  • muscles are told to relax
  • also tells internal urethral sphincter to contract
90
Q

what receptors detect how full the bladder is?

A

stretch receptors

91
Q

How does the micturition reflex work when the bladder is full? (3)

A
  • mechano(stretch) receptors detect stretch
  • visceral afferent fibres feed to the CNS- brainstem pontine micturition centre
  • parasympathetic nerves contract the detrusor muscle and relax the internal urethral sphincter
92
Q

What is stress incontinence (more common in females) caused by?

and how can it be improved?

A

a weakened pelvic floor (muscle trauma)- levator ani muscles, which can be improved by kegel exercises in mild cases

93
Q

What triggers stress incontinence?

A
  • increased intra-abdominal pressure e.g. during coughing, laughing, sneezing, exercise as the bladder pressure > urethral pressure
  • urethral hypermobility (bladder neck/prox urethra descends out of pelvis) associated w/ impaired urethral sphincter function
94
Q

what may cause damage of ligaments in females, resulting in stress incontinence?

A

childbirth: cant form sling

95
Q

What is urge incontinence of an overactive bladder caused by?

A
  • spontaneous detrusor muscle overactivity during bladder filling (bladder pressure > urethral pressure)
  • neurogenic e.g. stroke/ multiple sclerosis
  • exacerbated by caffeine, alcohol consumption
96
Q

what is urge incontinence?

A

overactive bladder
involuntary leakage of urine w/ urgency to urinate.
more prevalent in elderly

97
Q

how can urge incontinence be combat?

A

anti-cholinergic drugs- stop contraction of smooth muscle. decreases chance but still may be exacerbated by caffeine/alcohol

98
Q

what is micturition controlled by? and how can it be overridden?

A

controlled by ANS

override: somatic nervous system

99
Q

What are the 2 main types of epithelium found within the urinary system?

A

simple
stratified (muliple layers)
- transitional- ureter, bladder

100
Q

What are the 3 shapes of simple epithelium found within the urinary system?

A
  • a: squamous
  • b: cuboidal
  • c: columnar
101
Q

3 types of simple epithelium in urinary system. where are each of them found?

a) squamous
b) cuboidal
c) columnar

A

a) LoH
b) PCT, DCT, collecting tubule
c) collecting duct

102
Q

nephron located in lobes of kidney. what 2 parts comprise it?

A

cortex

medulla (pyramids and papillae)

103
Q

whats in the cortex of nephron? (3)

A

renal corpusclce (Bowman’s capsule + glomerulus)
PCT
DCT

104
Q

whats in the medulla of nephron? (2)

A

(renal pyramids and papillae)
LoH
collecting ducts drain into minor calyx

105
Q

summary of nephron and CDs. what 6 things compose it?

A
  • renal corpuscle (Bowman’s capsule + glomerulus)
  • PCT
  • loop of Henle
  • DCT
  • juxtaglomerular apparatus
  • collecting tubule and collecting duct
106
Q

what do the macula densa in DCT do?

A

regulate BP as part of juxtaglomerular apparatus

107
Q

glomerulus is the site of?

A

ultrafiltration in blood- passes through podocyte layer and processes of viseral layer of BC –> enters space –> PCT –> inferiorly passed to medulla LoH..

108
Q

which type of epithelium found in PCT and DCT?

A

simple- cuboidal

109
Q

What composes the renal (Malpighian) corpuscle?

A
  • glomerulus (capillary bed)

- Bowman’s capsule

110
Q

What structure is the renal corpuscle continuous with?

A

PCT

111
Q

visceral layer has podocytes. why?

A

podocytes have foot processes = form slits and filter large molecules (proteins)

112
Q

location of renal corpuscle

A

in cortex, continuous with PCT

113
Q

EA at renal corpuscle will continue as…?

A

vasa recta

114
Q

what will parietal (outer) layer of bowmans capsule form?

A

simple- squamous epithelium

115
Q

What specialised feature do the epithelium of the PCT have and why?

A
  • the simple cuboidal epithelium have microvilli

- increases the surface area for the absorption of Na+

116
Q

What is the PCT’s epithelium continuous with?

A

the parietal layer of the Bowman’s capsule

117
Q

What is the difference in epithelium between the thick and thin ascending loop of Henle?

A
  • thin = simple squamous (a)

- thick = simple cuboidal (b)

118
Q

Histological section of loop of Henle and medulla- 4 components

A
  • t = thin limb of loop of Henle
  • V = vasa recta
  • CD = collecting ducts
  • CT = collecting tubules
119
Q

What is the function of the vasa recta?

A

important for counter-current multiplication; as water is removed from the thin limb of the LoH, more Na will leave via passive diffusion

120
Q

What’s the difference between the PCT and DCT’s epithelium and therefore lumen?

A

DCT has no microvilli whereas the PCT does

so DCT = larger, clear lumen

121
Q

What composes the juxtaglomerular apparatus?

A

macula densa and juxtaglomerular cells

122
Q

What is the role of the juxtaglomerular apparatus?

A

regulates blood pressure through the secretion of renin when BP low.

123
Q

How does the juxtaglomerular apparatus respond to decreased blood pressure?

A

decreased BP-decreased GFR - decreased Na+ conc in DCT fluid - Macula densa (osmoreceptors) - renin release

OR
decreased BP - JG cells (mechanoreceptors) - renin release

124
Q

What is the difference between the epithelium of the collecting tubules and collecting ducts?

A
  • collecting tubules = simple cuboidal epithelium

- collecting ducts = simple columnar epithelium

125
Q

What is the role of the collecting tubules and ducts?

A

reabsorb water and urea into the medulla (last opportunity to concentrate urine)

126
Q

Are the collecting tubules part of the nephron?

A

no

127
Q

Summary of the functions of the different parts of the nephron

A
  • PCT: Water, Na+/Glucose (active)
  • Thin LoH: passive reabsorption of water only; concentrates urine in the tubule
  • Thick LoH: Na+ only (impermeable to water)
  • DCT: Active reabsorption of Na+, secretion of H+
  • Collecting tubules: Active reabsorption of urea, H+; water reabsorption controlled by ADH.
128
Q

summary of characteristics of upper urinary system

A
  • PCT: cortex
    simple cuboidal epithelium with microvilli (brush border)
  • LoH: medulla
    simple squamous epithelium
  • DCT: cortex
    simple cuboidal epithelium no microvilli
  • Collecting tubules: medulla
    not part of nephron. simple cuboidal (proximal), simple columnar (distal), large lumen
129
Q

What is the specialised epithelium found in the ureter and bladder?

A

transitional, stratified epithelium = urothelium

  • highly folded with ability to stretch, (creating rugae in bladder)
130
Q

What do the umbrella cells within the ureter do?

A

create an impermeable barrier to the toxic urine

131
Q

What are the 2 types of smooth muscle found in the ureter?

A

longitudinal (L) and circular (C) controlled by the autonomic NS, having peristaltic movements

132
Q

What type of muscle layers found in the bladder wall?

A

smooth muscle

133
Q

function of urothelium in ureter?

A

protection from urine, ability to stretch and relax during peristalsis in ureter.

134
Q

what type of epithelium is found in bladder?

A

transitional/ urothelium

135
Q

What are 3 drug classes of diuretics? (drugs acting on nephron)

A
  • loop diuretics
  • thiazides
  • potassium sparing diuretics
136
Q

Where and how do loop diuretics work?

A

Thick ascending limb (site of Na+ transporters), reduces Na+ reabsorption, diuresis - water follow the Na+ excreted. osmotic gradient

137
Q

Where and how do thiazides (most common) work?

A

DCT, reduces Na+ reabsorption (less drastic than loop diuretics) still = diuresis

138
Q

Where and how do potassium-sparing diuretics work?

A

Aldosterone receptor antagonist at the DCT - reduces water reabsorption (avoids hypokalaemia)

139
Q

site of ultrafiltration in the blood?

A

renal corpuscle

140
Q

role of diuretics?

A

affect reabsorption of Na+ and water along diff parts of the tubule

141
Q

give an example of the three different classes of diuretic:

a) loop diuretics
b) thiazide diuretics
c) aldosterone antagonists

A

a)e.g. furosemide,
b)e.g. bendroflumethiazide
C) e.g. spirononlactone.

Health.1 (12 decks)

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