Anatomy Flashcards
Where are the kidneys located?
Retriperitoneal in the posterior abdominal wall
What organs are retroperitoneal?
DOCTORS AND DENTISTS ALWAYS PREFER KISSING A VOLUPTUOUS REDHEAD
- Duodenum (except part 1)
- Ascending colon
- Descending colon
- Adrenal glands
- Pancreas
- Kidneys
- Aorta
- Vena Cava (IVC)
- Rectum
What plane are the kidneys located in?
Transpyloric (superior right renal hilum and inferior left renal hilum….the left kidneys is a little higher than the right)
What vertebral level are the kidneys at?
T12-L2
What ribs are behind the kidneys?
11 and 12
What do the ureters travel in front of?
Trasnverse processes
What 3 nerves are posterior to the kidneys?
- Subcostal (below T12)
- Iliohypogastric (By L1, above ilioinguinal)
- Ilioinguinal (By L1)
What other big structure sits behind the kidneys on either side?
Diaphragm
What part of the kidney is at risk if an ulcer in the descending duodenum perforates posterior?
The hilum of the right kidney
What 2 structures sit in front of the superior pole of the left kidney?
Stomach and spleen
What structure sits in front of the superior pole of the right kidney?
Liver
What is a psoas abscess associated with?
TB or osteomyelitis in the spione (discitus)
What is the type of spread that would happen between the spine and psoas major?
Contiguous
What can a psoas abscess do to the renal system?
It can compress the ureters and cause hydronephrosis
What is the function of perirenal fat?
It is good for absorption and helps to support the kidney
What is another name for renal fascia?>
Gerota’s (anterior and posterior)
What connects the renal fascia to the capsule?
Trabeculae
Do the kidneys have ligaments to keep them in place?
NOPE…vasculature and fat help to do this (not much keeping the kidneys stable)
What else does the renal fascia extend to cover?
Aorta, IVC, and ureters
Is there usually a continuous connection of renal fascia across the midline?
NOPE
If you have a perinephric abscess, what is the typical treatment?
Antibiotics and percutaenous drainage
What keeps a perinephric abscess localized?
The capsule as well as fat and fascia
What is the order of structures in the renal hilum from anterior to posterior?
Vein, artery, pelvis
What structures are in the internal aspect of the kidney?
Cortex, medulla, pyramid, renal columns, papillae, minor calyces, major calyces, renal pelvis, ureter, renal sinus
If you had to pick a kidney to transplant, which would it be?
The left one because it has longer vasculature (vein)
Where is a new kidney transplanted?
In the pelvis (so it is supposed and doesn’t fall)
Where do you attach a transplanted kidney in terms of vasculature?
To one of the common iliac vessels
How many branches does the renal artery divide into?
5 (these are essentially end arteries)
What are the 4 branches in the anterior division of the renal artery?
- Apical
- Anterior superior
- Anterior inferior
- Inferior
What is the branch in the posterior division of the renal artery?
Posterior
What are the lines that separate the vascular segments of the kidney?
Line of Brodel (these segments correspond to the 5 branches from the renal artery)
How do the branches from each segmental artery divide down?
They go into interlobar, then arcuate, then smaller arteries
Where do the renal veins drain into?
The IVC
What vein drains into the left renal vein?
The left testicular vein
What vessel supplies the ureters?
They get branches as it goes down from other arteries (Renal, common iliac, inernat iliac, testicular, ect.)
Where do ureters pierce the bladder?
At the posterolateral edge
What angle do the ureters run through the muscular wall of the bladder?
Oblique
What happens to prevent backflow of urine?
When the bladder expands, it punches off the opening of the ureter (to prevent vesicouretral reflux)
What is it called when you have a swollen kidney?
Hydrpnephrosis
What is it called when you have a swollen ureter?
Hydroureter
What are some general symptoms of renal cell carcinoma?
Hematuria, pain in loin, mass
What else can renal cell carcinoma commonly invade?
The renal VEIN (potentially IVC and R atrium as well but this is rare)
What is a common presentation of carcinoma in the left renal vein?>
Varicocele (because the left testicular vein drains into the left renal vein)
What is the levels of sympathetic innervation to the kidney and upper ureter?
T10-L1
What is the sympathetic innervation to the bladder and lower ureter?
T11-L2
What is the parasympathetic innervation to the upper ureter?
VAGUS
What is the parasympathetic innervation to the lower ureter?
S2-S4 (pelvic splanchnics)
What is the parasympathetic innervation to the bladder?
Pelvic splanchnics (S2-S4) (motor to the detrusor muscle)
Can ureteric nerves be removed with no loss of function?
Yes
Where do kidney stones cause pain if they are in the upper ureter?
T10-L1 area …AKA FLANK PAIN
What are the 4 sites of constriction along the ureter where stones are most likely to lodge?
- Where the renal pelvis turns into the ureter (ureteropelvic junction)
- Where vessels cross over the ureter
- Where the ureter goes over the pelvic rim (pelvic inlet)
- As the ureter enters the bladeer