Anatomy Flashcards
What is the urinary tract?
the anatomical structures that urine passes through from its production to it’s excretion
What are the parts to the urinary tract?
Kidneys
Ureters
Bladder
urethra
What do the following parts of the urinary tract do: Kidneys: Ureter: Bladder: Urethra:
Kidneys: Produces urine
Ureter: Drains urine to the bladder
Bladder: stores and voids urine
Urethra: excretes urine
How does the urethra differ in men from women?
It is much longer
It also excretes semen.
In which three body regions does the urinary tract lie
Abdomen
pelvis
perineum
Which parts of the urinary tract lie in the abdomen?
Kidneys
Proximal ureter
Which parts of the urinary tract lie in the pelvis
Distal ureter
Bladder
Proximal urethra
Which parts of the urinary tract lie in the Perineum
distal urethra
Where is the boundary between the abdominal and pelvic regions?
the iliac crest/L4.
What happens at L4 vertebra?
The aorta bifurcates into the common iliac arteries.
the boundary between the upper and lower urinary tract is ____
L4 vertebra
The kidneys are intraperitoneal organs - true/false
False - they are retroperitoneal
The right kidney lies lateral to which structure
The inferior vena cava
The left kidney lies lateral to which structure
The abdominal aorta
What surface of the kidney is in contact with the peritoneum?
Anterior
What muscle(s) lie(s) posterior to the kidney? what are the functions of these?
posterior abdominal wall and postural muscles - they provide protection for the kidney
What structures bound the anterior border of the kidney - list from superficial to deep.
Visceral peritoneum paranephric fat Deep renal fascia perinephric fat (extends the whole way around) Renal capsule.
What is the renal capsule?
Another layer of very tough fascia which surrounds the whole kidney.
Where does the renal hilum lie?
the renal hilum lies on the medial aspect of the kidney
the renal hilum contains three structures; name them
The renal artery, renal vein and the ureter.
the renal artery and vein are branches of the ____ & ____ respectively
Abdominal aorta and IVC
The anterolateral abdominal wall muscles are the _______, _______ and _________
External oblique
Internal oblique
Transversus abdominus
The kidneys lie anterior to ______ _______muscle and lateral to ______ ______ muscle.
The kidneys lie anterior to quadrates lumborum muscle and lateral to psoas major muscle.
At what vertebral level do the kidneys lie?
Right kidney - L1-L3
Left kidney - T12-L1
Why is there a difference in the height of the left and right kidneys?
The liver is large and forces the right kidney down.
Which ribs are posteriorly related to the kidneys?
11 + 12 (floating ribs)
Why may the floating ribs cause danger to the kidneys?
they may contuse or lacerate the kidney if they fracture.
What should a normal kidney feel like on palpation?
it should be about 12cm long, 6cm wide, smooth, regular, well defined and firm to feel.
What structures is the right kidney related to?
Liver Hepatorenal recess 2nd part of duodenum Ascending colon right colonic flexure
Why is the hepatorenal recess important when lying supine?
It is the deepest part of the abdominal cavity when lying spin and so there is a tendency for fluid, if present to collect in the HR recess.
What structures is the left kidney related to?
the stomach
the tail of the pancreas
the hilum of the spleen
the splenic vessels
What is the arterial supply/venous drainage of the kidney?
Renal arteries/renal veins
the renal arteries lie anterior to the renal veins - true/false
False - lie posterior
The common iliac arteries lie anterior to the common iliac veins - true/false
True
Name all of the branches which contribute blood supply to the ureter
Renal artery, abdominal aorta, common iliac artery, internal iliac artery and vesicle artery.
What nodes drain the kidneys?
Lumbar nodes gathered around the abdominal aorta and inferior vena cava
The lymph from the ureters drain to which nodes?
Lumbar nodes, located around the AA and the IVC, iliac nodes located around the common, internal and external iliac vessels.
What are the two layers of a kidney?
Cortex
Medulla.
How many pyramids are located in the human medulla?
27
5000 nephron are contained in each medullary pyramid - true/false
False - 50,000
All the nephron are angled so as to point toward the pyramidal apex - true/false
true - this is why the medulla in a kidney is striped
Name the parts of the nephron
glomerulus, proximal convoluted tubule, loop of henlé, distal convoluted tubule, collecting duct
The collecting ducts coalesce to form a _______
Minor calyx
A number of minor calyces coalesce to form a _____
Major calyx
all major calyces join to make _____
the renal pelvis
the pelvis is much wider/narrower than the ureter
Wider
Name the three areas where constriction of the ureter can occur
pelviureteric junction
Pelvic brim-crosses the anterior aspect of the common iliac artery
The ureteric orifice of the bladder
What are renal calculi
Renal stones
Caused by hardening of calcium salts in the minor/major calyces.
The urinary tract responds to a constriction, internal or external by what mechanism?
Peristaltic wave contractions to try to dislodge the blockage.
Obstruction in the ureter or calyx causes _______ which if left untreated progresses to _______
Unlilater obstruction and progressing to unilateral kidney failure
Obstruction in the bladder causes _______ which if left untreated progresses to _______
Either unilateral or bilateral obstruction which if left untreated can lead to unilateral or bilateral failure
Obstruction in the urethra causes _______ which if left untreated progresses to _______
Bilateral obstruction and bilateral kidney failure if left untreated.
urine production will continue in obstruction until what occurs?
Until pressure in urinary tract exceeds filtration pressure in the glomerulus causing kidney failure.
What forms the pelvic floor?
The pelvic floor is made of a series of muscles called the pelvic diaphragm
What muscle is involved in the pelvic diaphragm?
Levator Ani
Where does levator ani originate and insert?
Anterior sacrum
Pubic Bone
What passes through the holes in the pelvic diaphragm?
Distal parts of the GI, the urinary tract and the reproductive tracts
Which part of the urinary tract is contained within the perineum?
The distal urethra
The ureters pass over which blood vessel to enter the pelvis?
The common iliac arteries OR the bifurcation between the internal and external iliac arteries.
Describe the route the ureters run when in the pelvic cavity
They run laterally along the walls of the pelvis until they reach the ischial tuberosity and then turn medially to enter the posterior of the bladder.
The route of the ureter in the pelvis is entirely retroperitoneal - true/false
False - it is entirely sub peritoneal.
The ureters run into the ureteric orifices of the bladder in an _______ ________ direction
Inferomedial
There is a circle of muscle which, when contracted, prevents urine flowing back into the ureters. Name this muscle and what else is it a part of?
the detrusor muscle
it is the main muscular component of the bladder walls.
Name the invagination of peritoneum found in both males and females.
The rectovesicle pouch.
What is the most inferior part of the peritoneal cavity in males?
The most inferior part is the rectovesicle pouch.
There is a structure in females that is not present in males, the eponymous name for which is the pouch of Douglas. Give its anatomical name and describe it.
It is the rectouterine pouch and is an invagination of the peritoneum to give a pouch between the rectum and the uterus.
What is the pouch between the uterus and bladder called?
The vesiculo-uterine pouch (imagine that!)
In the anatomical position, the most inferior part of the female peritoneal cavity is the rectovesicle pouch - true/false
False - the most inferior part of the female peritoneal cavity in the anatomical position is the rectouterine pouch (of Douglas).
Which structure lies very closely to the ureter in the female body? Which is the ureter?
the suspensory ligament of the ovary - the medial structure is the ureter.
the ureter runs inferior/superior to the uterine tubes and the uterine artery in females
Inferior - think of water under the bridge