Anatomy Flashcards
What is the function of the kidney
filter blood, produce urine, secrete hormones and produce calcitriol
is the superior or inferior part of the kidney more lateral
the inferior pole
which way does the hilum of the kidney face
anteromedially
between what spinal levels would you find the right kidney? left?
right TV12-LV3
left TV11-LV2
which kidney is more easily palpated and why
right kidney because it is lower
what structures lay posterior to the kidneys
diaphragm, psoas major, quadratus lumborum, transversus abdominis, subcostal n(T12), iliohypogastric n(L1), ilioinguinal n(L1)
What can the iliopsoas test tell you about the abdomen
abdominal infection
What structures lay anterior to the right kidney
liver, duodenum, ascending colon, hepatorenal recess
what structures lay anterior to the left kidney
stomach, spleen, pancreas, jéjunum, descending colon
what is the role of the fat and fascia around kidneys
protective and to anchor kidney in place
where is the pararenal fat and the perirenal fat
pararenal is external to renal fascia
perirenal is between kidney and renal fascia
what causes nephrotosis and what is it
dropped kidney into pelvis caused by deficiency in fats and fascia around kidney- late stages starvation
how do perinephric abscesses spread
not to the contralateral kidney
inferiorlly into the pelvis because of the anterior and posterior fascia layers fuse
what are the renal papillae
apex of renal pyramid directed toward renal sinus
what is a minor calyx, major calyx?
minor- surround and drain renal papillae
major- confluence of 2-3 minor calyces
How many arteries do the renal arteries divide into
5 segmental
which renal artery is longer? vein?
right renal artery is longer, left renal vein is longer
what veins drain into left renal vein
left gonadal, left inferior phrenic, left suprarenal vein
what is nutcracker syndrome
renal vein entrapment from the left renal vein being compressed by the aorta and Superior mesenteric a
men will form varicosities around testicular vein= pain
How do autonomic fibers distribute in the abdomen
renal plexus
what levels of smypathetics distribute to renal system
T10-L1 via lesser, least and lumbar splanchnics
where are the postganglionic cell bodies located for renal sympathetics
aorticorenal and renal ganglia
do the renal sympathtetics carry efferents and afferents?
yes efferent is vasomotor
afferent- acute pain T10-L1
Where are the parasympathtetics to renal
preganglionic in vagus
postganglionic in wall of organ
what are kidney stones
concretions of salts and inorganic material that accumulate in kidney and pass into ureter
Describe the course of the ureters
inferomedially along posterior abdominal wall descending over pelvic brim to enter pelvis and then along lateral wall to enter posterior bladder wall
where do kidney stones commonly lodge
at renal pelvis.ureter junction
at passage over pelvic brim
at entry into urinary bladder
what vessels supply the ureters
upper 1/3 is from renal aa
midle 1/3 form gonaldal, aorta and common iliac aa
lower 1/3 from the internal iliac aa
where do lymphatics drain from the ureters
upper 1/3 to lumbar lymph nodes
middle 1/3 to common iliac lymph nodes
lower 1/3 to common, external and internal iliac lymph nodes
What autonomic suply does the upper ureter get?
lower?
upper from renal plexus and lower from inferior hypogastric plexuses
What sympathetic cord levels supply ureters
T10-L1/2 via lesser, least and lumbar splanchnic nn
where are the parasympathtetics to ureters
upper is from vagus
lower is from pelvic splanchnic nn
what is the efferent and afferent parasympathtetics to ureters
efferent is vasomotor and motor to smooth mm
afferent is stretch
what spinal cord levels are associated with pain from kidney or loin to groin pain
T10-L2
Where is the apex of the bladder
posterior to pubic symphysis
where is the neck of the bladder
inferior portion surrounds internal urethral orifice
where does the median umbilibal ligament attach to urinary bladder
to the apex
where does the ureter enter bladder
posterior, base surface
what is the detrusor muscles layer of bladder
3 layers of smooth muscle not well organized
what surface of bladder is covered with a serosa
the superior surface
where is the trigone of the bladder
area between ureteral orifices and internal urethral orifice
what is an extension of the ureteric muscle
the inner trigonal muslce
what is the outer tirgonal muscle
typical detrusor muscle
What is a Cystocele and what causes it
fallen bladder resulting from weakening og the pelvic diaphragm and or ligaments that support it
usually in childbirth, also obesity, chronic constipation or heavy lifting
what can a cystocele cause
urinary incontinence
How do autonomic fibers reach bladder
hypogastric plexus
what sympathetic cord levels distribute to the bladder
T10-L2 via the lumbar and sacral splanchnic nerves
what muscles are inn by the bladder sympathetics
trigonal muscle, sphincter urethrae mm and vasomotors
describe the parasympathetics to bladder and function
travel with pelvic planchnic nn with bodies in the wall of organs and contract detrusmor mm and vasomotor control.
the afferents carry stretch and pain from non-pertionealized portions of bladder
how long is the male urethra
18-22cm
what are the various portions of the male urethra
intramural from neck of bladder
prostate that extends through prostate
membranous with is the spongy penile urethra
what are the associated glands with male urethra
bulbourethral glands and the urethral(mucous secreting)
how long is the female urethra
4 cm
what are the various portions of the female urethra
superior is the pelvic portion and the inferior is the perineal portion
what glands in the female are homologous to the prostate gland in males
the paraurethral glands near open of external urethral orifice
how does micturition or urination begin
streth receptors are fired from filling and rravel through pelvic splanchnic nn S2-S4 to brainstem
descending fibers activate moto part of pelvic splachnic nn that cause contraction of detrusor mm and relaxation of the sphincter urethrae mm
what is right above right kidney, above T12 rib
diaphragmatic pleural recess of lung
what muscles form the bed for the kidneys
psoas major, quadratus lumborum and transversus abdominis
what is the most anterior structure passing into hilum of kidneys
the veins
what type of nerves are in a plexus
PANS and SANS
