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Renal > Anatomy > Flashcards

Anatomy Flashcards

1
Q

What 4 major structures make up the urinary tract?

A

Kidney
Ureter
Bladder
Urethra

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2
Q

What are the two parts to the urinary tract?

A

Upper, containing the kidneys and ureters

Lower, containing the bladder and urethra

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3
Q

What 3 body compartments does the urinary tract involve?

A

Abdomen
Pelvis
Peritoneum

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4
Q

What is the difference in a male and female urethra?

A

Female is shorter and more likely to get a lower tract UTI

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5
Q

Where in the abdomen do the kidneys lie?

A

Retroperitonally

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6
Q

What three structures make up the hila of the kidney?

A

Renal artery
Renal vein
Ureter

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7
Q

At what level does the upper urinary tract become the lower?

A

L4

At the iliac crest

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8
Q

What other major landmarks are at L4?

A

Umbilicus

Bifurcation of abdominal aorta into right and left iliac artery

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9
Q

At which vertebral level is the left kidney?

A

T12-L2

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10
Q

At which vertebral level is the right kidney?

A

L1-L3

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11
Q

Why is the right kidney more inferior?

A

Presence of liver pushes it down

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12
Q

Which muscles are in direct relation to the kidneys?

A

Psoas

Quadratus lumborum

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13
Q

What layers surround the kidney?

A 
Visceral peritoneum
Paranephric fat
Renal fascia
Perinephric fat
Renal capsule
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14
Q

Which ribs are associated with the kidneys?

A

11 and 12.

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15
Q

Which region of the body do the kidneys lie?

A

Flank/lumbar

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16
Q

Where is the kidney clinically examined?

A

Posterior to 12th rib in the RUQ

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17
Q

What cavity, where water collects in the supine patient, does the kidney lie?

A

Hepatorenal recess

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18
Q

Describe the location of the renal veins

A

Anterior to renal arteries

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19
Q

Describe the location of the common iliac veins

A

POSTERIOR to the common iliac arteries

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20
Q

Where does the lymph from the ureters drain?

A

Iliac nodes

Lumbar nodes

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21
Q

Where does lymph from the kidneys drain?

A

Lumbar nodes alone

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22
Q

Describe an infra-renal AAA

A

Aneurysm is below the renal arteries

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23
Q

What is the difference in renal artery stenosis when in the presence of an infra-renal AAA and a supra-renal AAA?

A

An infra-renal may be caused by atherosclerosis

While a supra-renal likely to due to occlusion of the renal artery

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24
Q

How is an AAA treated?

A

Endovascular aneurysm repair

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25
Q

Name some common variations of the renal system

A

Bifid renal pelvis

Bifid ureter

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26
Q

What two layers makes up the kidney?

A

Outer cortex and an inner medulla with a capsule surrounding it

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27
Q

What structures are contained within the medulla?

A

Pyramid

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28
Q

What structures lie within the pyramid?

A

Nephrons

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29
Q

Name the constituents of the nephron

A 
Glomerulus
Proximal convuluted tubule
Loop of Henle
Distal convuluted tubule
Collecting duct
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30
Q

Name the structures which are involved in urine drainage

A 
Collecting ducts
Minor calyx
Major calyx
Renal pelvis
Ureter
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31
Q

What is the constriction at the ureter called?

A

Pelviureteric junction

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32
Q

What can gather at the pelviureteric junction?

A

Calculi

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33
Q

What makes up calculi?

A

Calcium salts

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34
Q

Why is calculi pain colicky?

A

Smooth muscle in ureter.
Increased peristalsis to remove obstruction
Wave like pain

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35
Q

What is hydronephrosis?

A

Back pressure not the calcyes compresses the nephrons causing painful stretching of the renal capsule leading to renal failure

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36
Q

What may be found on examination with a hydronephrosis?

A

Kidney enlargement

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37
Q

What is the true pelvis?

A

Pelvic inlet to pelvic floor

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38
Q

What separates the true pelvis from the false pelvis?

A

Pelvic rim/inlet

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39
Q

Which muscle can be said to separate the pelvic floor from the peritoneum?

A

Levator ani

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40
Q

What does levator ani do?

A

Constricts the rectum and bladder

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41
Q

Describe the travel of the ureters

A

From kidney they pass anterior to common iliacs and follow the wall of the true pelvis. Posterior to the bladder and enter into the trigone.

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42
Q

Which cavity is present in males, which is the most inferior part of the peritoneal cavity?

A

Rectovesicle pouch

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43
Q

Which two cavities are present in females?

A

Vesicouterine pouch

Rectouterine pouch

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44
Q

What structure lies immediately lateral to the ureter in females?

A

Suspensory ligament of the ovary

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45
Q

What connects the uterus to the perineum?

A

Round ligament of the uterus

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46
Q

Where does the ureter lie in relation to the uterine artery and the Vas Deferens?

A

Inferior to uterine tubes and uterine artery.

“Water under the bridge”

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47
Q

Where do all the arteries supplying the pelvis come from?

A

Internal iliac artery

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48
Q

What are the 3 orifices in the trigone?

A

2 ureteric orifices

1 internal urethral orifice

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49
Q

What is also present at the internal urethral orifice in males?

A

Internal urethral sphincter

50
Q

Which muscle causes contractions of the bladder?

A

Detrusor muscle

51
Q

How is urine reflux to the ureter prevented?

A

Contraction of the detrusor muscle around the ureteric orifices

52
Q

Which pelvic organ is most anterior and sits deep to the pubic bone?

A

Bladder

53
Q

What anatomical differences are present in a full and empty bladder?

A

Full bladder may enter into abdomen

54
Q

What kind of muscle is the external urethral sphincter made of?

A

Skeletal

55
Q

What is the difference in the male and female urethra?

A

Female is much shorter

56
Q

Where is sperm produced?

A

Seminiferous tubules in the epididymis

57
Q

What structure carries sperm into the ejaculatory duct?

A

Vas deferens

58
Q

What structure is the vas deferens part of?

A

Spermatic cord

59
Q

What else is held in the spermatic cord?

A

Testicular artery
Testicular vein
Vas deferens
Lymphatics

60
Q

What two muscle groups are involved in penile erection?

A

Corpus spongisoum

Left and right corpus cavernosum

61
Q

Where is semen added to sperm?

A

Seminal gland

62
Q

When does the vas deferens become the prostatic urethra?

A

When enters the prostate gland.

63
Q

What is the urethra called as it exits the external urethral meatus?

A

Spongy urethra

64
Q

What structure does the testis sit in?

A

Tunica vaginalis

65
Q

What are the two parts of the tunica vaginalis?

A

Parietal and visceral, with serous fluid inbetween

66
Q

What is excess fluid between the parietal and visceral tunica vaginalis called?

A

Hydrocoele

67
Q

What structure drains deoxygenated blood from the testis?

A

Pampiniform plexus

68
Q

Where do the testicular veins drain to?

A

Left drains to left renal vein

Right drains directly to vena cava

69
Q

Which structure allows glandular secretions from the prostate into the prostatic urethra?

A

Prostatic ducts

70
Q

What are the two zones of the prostate and which is most clinically relevant?

A

Central
Peripheral.
Most cancers are peripheral.

71
Q

Which penile muscle does the spongy urethra sit in?

A

Corpus spongiosum

72
Q

What is the penile raphe?

A

On anterior surface
That line.
Scrotal raphe also exist.

73
Q

What is the anatomically correct name for the foreskin?

A

Prepuce

74
Q

What is the blood supply to the penis?

A

Both the deep arteries of the penis and internal pudendal artery. Internal iliac only.

75
Q

What is the blood supply to the scrotum?

A

Internal pudendal and branches from external iliac

76
Q

Where does lymph from the testis drain to?

A

Lumbar lymph nodes at abdominal aorta

77
Q

Where does lymph from the penis drain to?

A

Superficial inguinal nodes

78
Q

What do somatic sensory nerve fibres do?

A

Convey sensations from the body wall to the CNS

79
Q

What do visceral afferent nerve fibres do?

A

Carry sensation from organs to the CNS

80
Q

What do somatic motor nerves do?

A

Convey motor responses from the CNS to the soma

81
Q

How are motor responses to the organs carried out?

A

Parasympathetic or sympathetic nerve fibres

82
Q

On which cranial nerves are parasympathetic fibres carried?

A

3, 7, 9 and 10

Sacral nerve plexus

83
Q

All the sensory nerves in the renal system are visceral afferents apart from what?

A

The urethra while in the perineum is a somatic sensory

84
Q

What divides the urethra into pelvic and perineum?

A

Levator ani

85
Q

What parts of the renal system are controlled by motor nerves i.e. sympathetic and parasympathetic?

A

Ureteric and bladder peristalsis.

Urethral sphincter control

86
Q

Which parts of the renal system are controlled by somatic motor nerves?

A

External sphincter and levator ani

87
Q

Which kinds of nerves are involved in urinary continence?

A

Motor nerves
Somatic motor
Visceral afferents

88
Q

Which nerves control both the motor and sensory parts of the perineum and lower limbs?

A

Somatic sensory and somatic motor

89
Q

Between which spinal cord levels can sympathetic nerve fibres leave the CNS?

A

T1-L2

Thoracolumbar outflow

90
Q

Where does the sympathetic chain run?

A

From C1 to sacral plexus, adjacent to spinal cord

91
Q

How do sympathetic nerve fibres reach the body wall?

A

Within spinal nerves

92
Q

How do sympathetic nerve fibres reach the organs/muscles of the body?

A

Cardiopulmonary or abdominopelvic sphlanchnic nerves

93
Q

Describe the route of the splanchnic nerves

A

They follow the arteries supplying the same structures

94
Q

How does the spinal cord and the sympathetic nerve chain communicate?

A

Rami communicans

95
Q

How many ganglia are there in the cervical region?

A

3

superior middle and inferior

96
Q

How many ganglia are in the thoracic and lumbar regions?

A

One for each spinal cord level so 17

97
Q

Where do sympathetic nerve fibres going to the kidneys, ureter and bladder travel to?

A

Leave spinal cord at T10-T12
Enter into bilateral sympathetic chain
Leave the sympathetic chain within the abdominopelvic splanchnic nerves.

98
Q

Where do sympathetic nerve fibres going to the kidneys, ureter and bladder synapse?

A

Abdominal sympathetic ganglia, at the abdominal aorta

99
Q

What is a periarterial plexus?

A

Collection of nerves on the outside of the arteries which are post synaptic

100
Q

Where do the parasympathetic nerves supply?

A

NOT body wall

Smooth muscle/glands

101
Q

How do the parasympathetic fibres reach the muscles of the hindgut and pelvic organs?

A

Pelvic splanchnic nerves

102
Q

Which cranial nerve is the parasympathetic nerves which innervate the kidneys and ureter carried in?

A

CN X

103
Q

Nerves going to which structure is carried within the pelvic splanchnic?

A

Bladder

104
Q

Which spinal cord levels does the pelvic splanchnic nerve leave?

A

S2,3 and 4

105
Q

Which part of the tract is involved with somatic motor nerves?

A

External urethral sphincter

106
Q

Which named nerve controls the external urethral sphincter?

A

Pudendal

107
Q

Which muscle is contracted in the bladder when stimulated by S2,3 and 4?

A

Detrusor muscle

108
Q

When does the internal urethral sphincter contract?

A

In males only.

During ejaculation

109
Q

Which nerves control levator ani?

A

S3 and S4.

110
Q

What spinal nerves do the visceral afferents from the kidneys use?

A

T11-L1

111
Q

What spinal nerves do the visceral afferents from the ureter use?

A

T11-L2

112
Q

What is the division in visceral afferent fibres in the bladder?

A

Superior part, touching the peritoneum is by T11-L2

The rest, not touching the peritoneum, is by S2,3 and 4.

113
Q

How do visceral afferents from the urethra get back to the CNS?

A

Run alongside parasympathetics and use S2,3 and 4.

114
Q

Which nerve senses stretch in the bladder as it fills?

A

Visceral afferents

S2,3 and 4

115
Q

What muscles are used during micturition?

A

Detrusor contracts

Internal urethral sphincter, external urethral sphincter and levator ani relax.

116
Q

Where does the femoral nerve come from?

A

L2,3 and 4.

Anterior compartment of thigh

117
Q

Where does the obturator nerve come from?

A

L2, 3 and 4

Medial compartment of thigh

118
Q

Where does the sciatic nerve come from?

A

L4- S3

Posterior compartment of thigh via gluteals

119
Q

What does the sciatic nerve split into?

A

Tibial nerve

Common fibular

120
Q

What does the tibial nerve supply?

A

Posterior leg

Intrinsic muscles of foot

121
Q

What does the common fibular divide into?

A

Superficial fibular- lateral leg

Deep fibular- anterior leg

122
Q

What is the sural nerve?

A

Sensation to lateral foot

Renal (16 decks)

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