anatomy Flashcards
what parts of the urinary tract are in the abdomen (retroperitoneal)?
kidneys & proximal ureters
what parts of the urinary tract are in the pelvis?
distal ureters
bladder
proximal urethra
what part of the urinary tract is in the perineum?
distal urethra
what are the layers surrounding the kidney from deep to superficial?
renal capsule
perinephric fat
renal (deep) fascia
paranephric fat
visceral peritoneum
where are the kidneys in the body?
anterior to quadratus lumborum & lateral to psoas major
they lie lateral to the lower thoracic/upper lumbar vertebra; bodies
which kidney sits higher?
left- liver means right kidney is located inferior to left
left is at T12-L2
right is at L1-L3
what regions and quadrants are the kidneys located in?
flanks (right and left upper quadrants)
what structures is the right kidney posterior to?
the liver (& hepatorenal recess)
the (2nd part of the) duodenum
the ascending colon
right colic flexure
what structures is the left kidney posterior to?
stomach
tail of pancreas
hilum of the spleen
splenic vessels
where does lymph from the kidneys drain to?
lumbar lymph nodes
where does lymph from the ureters drain to?
lumbar and iliac nodes
how does urine drain from the kidney?
collecting duct –> minor calyx –> major calyx –> renal pelvis –> ureter
tubes widen as it progresses and then ureter is thinner
what are the 3 sites of ureteric constriction?
- pelviureteric junction
- ureter crossing anterior aspect of common iliac artery
- ureteric orifice
kidneys stones could potentially get stuck at each of these sites
what do renal calculi (stones) form from?
urine calcium salts
what is the urinary tract’s response to urteter obstruction / compression?
- increased peristalsis proximal to the site of the obstruction in an attempt to remove it (flush it into the bladder)
- as peristalsis comes in waves, a patient with a ureteric obstruction tends to experience pain that “comes and goes” (“colicky”)
what happens as a result of urine back pressure?
hydronephrosis (water in the kidney) leading to kidney failure
where does the pelvic floor lie between?
true pelvis and perineum
why are there openings in the pelvic floor?
to allow distal parts of alimentary, renal and reproductive tracts to pass through from pelvic cavity into the perineum
name a pelvic floor muscle
levator ani
describe the pathway of the ureters
The ureters pass anterior to the common iliac vessels to enter the pelvis
They run anteriorly (along the lateral walls of the pelvis)
At the level of the ischial spine, they turn medially to enter the posterior aspect of the bladder
this route is sub peritoneal
they then enter the posterior bladder wall in an inferomedial direction preventing urine reflux
what does the term ‘water under the bridge’ mean?
the ureter runs inferiorly to uterine tubes / vas deferens
what 3 structures form the trigone of the bladder?
2 ureteric orifices and the internal urethral orifice
what feature is present in only the male bladder?
around the neck of the male bladder, the detrusor muscle forms the internal urethral sphincter muscle which contracts during ejaculation to prevent retrograde ejaculation of semen back into the bladder
what are the 2 methods of catheterisation?
urethral or suprapubic
when should you insert a suprapubic catheter?
when the bladder is full to avoid piercing the peritoneal cavity
what are the contents of the spermatic cord
testicular artery, testicular vein, vas deferens, lymphatic vessels draining testis, nerves (autonomic for smooth muscle of vas) and somatic (for cremaster muscle)
what do the testes sit inside within the scrotum?
tunica vaginalis
what is excess fluid within the tunica vaginalis called?
hydrocele
what is the contents of the right spermatic cord?
the vas deferens, testicular artery & pampiniform plexus
what is the blood supply and venous drainage of the testis?
r & l testicular arteries, l renal vein
r & l testicular veins
testicular arteries and veins pass through inguinal ring
where is the epidiymis palpated?
the posterior aspect of the testis: its proximal end (the head) is located at the posterior aspect of the superior pole of the testis
where is the vas deferens palpated?
within the spermatic cord; within the scrotum, superior to the testis; it feels like a thick piece of string
what opening do you see running along either side of the prostatic urethra?
prostatic ducts
what are the regions of the prostate gland?
2 peripheral zones
central zone (internal)
prostatic urethra
what is the arterial supply of the penis?
deep arteries of the penis; branches of the internal pudendal artery (from the internal iliac)
what is the blood supply to the scrotum?
internal pudendal artery - external & internal iliac artery branches
what type of nerves carry sensory information from organs to CNS?
visceral afferent
what type of nerves carry sensations from the body wall to CNS?
somatic sensory
what type of nerves carry motor responses from the CNS to the body wall?
somatic motor
what type of nerves carry motor responses from the CNS to the organs?
sympathetic and parasympathetic nerve fibres
where to sympathetic fibres leave the spinal cord?
between T10 and L2
do not synapse- synapse at abdominal sympathetic ganglia
what cranial nerves so parasympathetic fibres leave the CNS via?
III, VII, IX & X
what cranial nerve carries parasympathetic nerve fibres to kidneys and ureters?
CN X
what is the only part of the CNS which will receive innervation from somatic nerves?
parts on the body wall (perineum)
where is pain from the (perineal part of the) urethra usually felt?
quite localised in the perineum
where is pain from the bladder usually felt?
suprapubic region, in the midline
where is pain from the kidney usually felt?
the ‘loin’ - posterior spect of flank on affected side
where is pain from a calculus obstructing the ureter usually felt?
‘loin to groin’ on affected side
