Anatomy Flashcards
kidneys
retroperitoneal T12-L3 right kidney: 12th rib left kidney: 11th and 12th rib *right kidney lower: only one that is palpable normally
ureters
- descend on surface of psoas major
- cross pelvic brim at bifurcation of iliac arteries
- enter posterior wall of bladder at superior angles of trigone
bladder
rests on pelvic diaphragm just posterior to pubic symphysis
urethra
neck of bladder
passes through perineum to urethral orifice
arrangement of vessels/ureter
anterior: vein
middle: artery
posterior: ureter
renal columns
extension of renal cortex into the medulla
renal papilla
apex of medullary pyramid surrounded by minor calyx
renal corpuscle
glomerular (Bowman’s) capsule and glomerulus
nephron
renal corpuscle and tubular system (PCT, LOH, DCT, NOT including CD)
collecting ducts
empty renal papilla into minor calyx
hilum of kidney
medial
transpyloric plane
paravertebral gutter
junction between posts major and quadratus lomborum muscles
kidneys lie here
perirenal (perinephric) fat
deep to renal fascia
pararenal (paranephric) fat
superficial to renal fascia
renal fascia
fused superiorly and across hilum
open inferiorly for movement during inspiration
*infection spreads inferiorly in pelvic cavity rather than up or to contralateral kidney
nephroptosis
dropped kidney: fascia does not provide support inferiorly
differentiate from ectopic: normal length of ureter (coils and kinks)
superior to superior pole of kidney
suprarenal glands/ adrenal glands
anterior surface of right kidney
hilum: 2nd part of duodenum
most of anterior surface (superior pole to middle): liver
inferior: right colic flexure
anterior surface of left kidney
hilum, middle of kidney: pancreas
superior: gastric
upper lateral: spleen
lower lateral: descending colon
posterior surface of kidney
muscles: diaphragm, psoas major, quadratus lumborum, transversus abdominis muscles
ribs 11-12
nerves of lumbar plexus: subcostal, iliohypogastric and ilioinguinal nerves
nutcracker
aorta and superior mesenteric artery
superior: left renal vein
lower: 3rd part of duodenum
renal arteries
branch slightly below superior mesenteric branch
LV1/LV2
right: longer, passes behind IVC
branch into anterior and posterior branch before entering hilum
give off inferior suprarenal artery
renal veins
left: longer, receives left gonadal vein (right gonadal vein empties into IVC)
nutcracker syndrome
compression of left renal vein between SMA and aorta
Sx: hematuria, proteinuria, left flank pain, left testicular pain, varicocele (bag of worms)
N/V if duodenum is compressed
differentiate from hydrocele: pain reduces while lying down, does NOT transmit light
SMA sundrome
compression of duodenum between SMA and aorta
sympathetic innervation of kidney
T12
preganglionic: least splanchnic nerve
renal/aorticorenal ganglion
vasoconstriction, decreased urine production
parasympathetic innervation of kidney
dorsal motor nucleus
vagus
vasodilation, increased urine production
sensory innervation of kidney
GVA fibers traveling with sympathetic or parasympathetic feed
lymphatic drainage of kidney
lateral aortic (lumbar) or lateral caval nodes around origin of renal vessels lateral lumbar lymph to lumbar trunk to cisterna chyli to thoracic duct to junction of subclavian and jugular vein
renal transplant
site: iliac fossa of greater pelvis, attach artery and vein to external iliac, ureter to bladder
fascia between adrenal gland and kidney prevents adrenal gland damage
What embryonic tissue is the kidney derived from?
intermediate mesoderm of urogenital ridge
ureteric bud
ureter, renal pelvis, calyces, CD
absent: renal agenesis
mesonephric duct
contributes to male genital tract
metanephric mass (blastema)
cap over ureteric bud
forms nephron
absent: renal agenesis
supernumerary kidney
more than 2 kidneys
splitting of metanephric blastema
kidney lobe
medullary pyramid and overlying cortex + half of renal columns on each side of pyramid
cortical interstitial cells
fibroblasts and macrophages
medullary interstitial cells
myofibroblasts
mesangial cells
phagocytose debris, provide structural support
secrete: IL-I, PDGF
cortical labyrinths
renal corpuscles, PCT, DCT
medullary ray
straight, ascending tubules, collecting ducts
kidney lobule
medullary ray and adjacent one half of labyrinths
blood flow in kidney
renal to lobar to interlobar to arcuate to interlobular into afferent arteriole to glomerulus to efferent to pertibular capillaries to vasa recta and veins
epithelium of ureter
transitional
mucosa
submucosa
muscularis: inner longitudinal, middle circular, outer longitudinal (outer only in distal ureter)
adventitia/serosa
lower: stratified or pseudo stratified columnar epithelium
epithelium of bladder
transitional same as ureter muscular thicker suprerior surface: serosa rest: adventitia
