Anatomy

Question 1

what four structures make up the urinary tract and what are there functions?

Answer 1

kidney- produces urine

ureter- drains urine

bladder- stores/voids urine

urethra- excretion of urine

Question 2

what structures make up the upper urinary tract?

Answer 2

kidneys

ureters

Question 3

what structures make up the lower urinary tract?

Answer 3

urethra

bladder

Question 4

what structures of the urinary tract are foundin the retoperitoneum?

Answer 4

kidneys

proximal ureters

Question 5

the distal ureters, bladder and proximal urethra are found where?

Answer 5

the pelvis

Question 6

where is the distal urethra found?

Answer 6

the perineum

Question 7

what makes up the hilum of the kidneys?

Answer 7

renal artery

renal vein

ureter

Question 8

what is more anterior, renal artery or vein?

Answer 8

renal vein sits anterior to the renal artery

Question 9

what are the layers of tissue in front of the kidneys from superficial to deep?

Answer 9

visceral peritoneum

paranephric fat

renal (deep) fascia

perinephric fat

renal capsule

Question 10

what are the three layers of abdominal muscles?

Answer 10

external oblique

internal oblique

transversus abdominis

Question 11

what muscles do the kidneys anterior and lateral to?

Answer 11

psoas major

qaudratus lumborum

Question 12

what are the vertebral levels of the kidneys?

Answer 12

right L1-L3

left T12-L2

n.b: liver displace sright kidney inferiorly

Question 13

of what importance are the floatign ribs (11&12) in relation to the kidneys?

Answer 13

offer some protection against penetrating trauma

but- if fractures the sharp displaced end could contuse or lacerate the kidney

Question 14

what regions are the kidneys found in?

Answer 14

both upper quadrants or lumbar regions (flanks)

Question 15

what term is used to describe the clinical exam of the kidney?

Answer 15

balloting

Question 16

how do the kidneys move with regards to respiration?

Answer 16

inferiorly on inspiration

superiorly on expiration

Question 17

describe a ‘normal’ kidney

Answer 17

12cm long

6cm wide

smooth

firm

Question 18

lymph from the kidneys drains where?

Answer 18

lumbar nodes (located around abdominal aorta and IVC)

Question 19

lymph from ureters drains where?

Answer 19

lumbar nodes and iliac nodes

Question 20

what is the ureteric blood supply?

Answer 20

branches from:

renal artery

abdominal aorta

common iliac

internal iliac

vesical (bladder) artery

Question 21

when assoc with AAA renal artery stenosis may be combined with what?

Answer 21

infra-renal AAA

Question 22

when assoc with AAA renal artery stenosis may be due to what?

Answer 22

suprarenal AAA (occlusion of proximal renal artery by the aneurysm)

Question 23

failure of a kidney to form is known as what?

Answer 23

agenesis

Question 24

what are the two kinds of nephrectomy?

Answer 24

pathological

donation

Question 25

each kidney consists of what?

Answer 25

outer cortex inner medulla

Question 26

what contains the renal pyramids?

Answer 26

medulla

Question 27

what give sthe pyramids their striped appearance?

Answer 27

regularly arranged nephrons

Question 28

how does urine drain from the kidney?

Answer 28

1. nephrons collecting duct 2. minor calyx 3. major calyx 4. renal pelvis 5. ureter

Question 29

the tubes drainign urien continue to widen until what point?

Answer 29

constriction at the ***pelviureteric junction*** wider renal pelvis becomes narrower ureter

Question 30

what are the three sites of ureteric constriction?

Answer 30

pelviureteric junction ureter crossing anterior aspect of common iliac artery ureteric orifice

Question 31

what forms kidney stones?

Answer 31

urine calcium salts

Question 32

what are kidney stones termed?

Answer 32

renal calculi

Question 33

renal calculi tend to be visible on which type of imaging?

Answer 33

x-rays

Question 34

obstruction of the ureter can occur as a result of what?

Answer 34

**internal obstruction**- renal calculus or blood clot **external compression** i.e tumour/mass

Question 35

whtat type of muscle encompasses the ureter walls?

Answer 35

smooth muscle

Question 36

what is the urinary tracts response to obstruction?

Answer 36

**increased peristalsis**- proximal to site of obstruction

Question 37

what type of pain do patients complain of with a ureteric obstruction?

Answer 37

'colicky' pain that tends to come and go in waves

Question 38

obstruction casuing urine to back up in to the kidneys can lead to what?

Answer 38

**renal failure-** failure to adeqautely filter the blood to produce urine

Question 39

when will urine production cease?

Answer 39

urine production will continue until the pressure within the urinary tract exceeds the pressure favouring filtration at the glomerulus

Question 40

define hydronephrosis

Answer 40

'water inside the kidney' urine back pressure into calyces compresses nephrons leadign to renal failure

Question 41

acute hydronephrosis causes what?

Answer 41

painful stretching of the renal capsule