Anatomy Flashcards
Components of the urinary tract
Kidneys
Ureters
Bladder
Urethra
Basic function of kidneys
Produces urine
Basic function of ureters
Drain urine from kidney
Basic function of bladder
Stores urine
Removes urine
Basic function of urethra
Excretion of urine from the body
+ excretion of semen (in males)
Components of the upper urinary tract
Kidneys and ureters
Components of the lower urinary tract
Bladder and urethra
Kidneys - overall location
Retroperitoneal organ
Located in the RUQ and LUQ
Located in the lumbar (flank) regions
Which kidney sits lower and why?
Right kidney
- due to the presence of the liver which displaces the right kidney inferiorly
Right kidney location - vertebral level
L1-L3
Left kidney location - vertebral level
T12-L2
Location of proximal part of ureters
Retroperitoneal aspect of the abdomen
Location of distal part of ureters
Pelvis
- travels through the false pelvis and into the true pelvis to attach to bladder
Location of bladder
In the pelvis
Location of proximal urethra
Pelvis
Location of distal urethra
Perineum
- passes through the pelvic floor to get to here
Kidney - components of the renal hilum
Renal vein
Renal artery
Ureter
Where is the renal hilum located?
Medial aspect of the kidney
What is located on the lateral aspect of the kidney?
Abdominal wall muscles
- external oblique
- internal oblique
- transversus abdominus
Which of the following is most anterior (i.e. furtherst away from the kidney) - paranephric fat OR perinephric fat?
Paranephric fat
What surrounds the kidney?
Renal capsule
- tough fibrous outer membrane
What muscle is located medial to the kidneys?
Psoas major
Which muscle is located immediately posterior to the kidneys?
Quadratus lumborum
What is the renal artery a branch of?
Abdominal aorta
What does the renal artery branch into in the artery?
Arterioles
- blood flows through the arterioles and into the glomerulus (in the nephrons)
Location of the renal artery in relation to the renal vein?
Posterior to the renal vein
Where does the renal vein drain to?
IVC
The renal vein always sits ANTERIOR/POSTERIOR to the renal artery?
Anterior
Common iliac veins sit ANTERIOR/POSTERIOR to common iliac arteries ??
Posterior
Where does lymph from the kidneys drain to?
Lumbar lymph nodes
- located around the IVC and abdominal aorta
Where does lymph from the ureters drain to?
Lumbar lymph nodes and the iliac nodes
Anatomical variations - bifid renal pelvis
2 elements of the renal pelvis instead of 1
Anatomical variations - bifid ureter
2 separate ureters coming from the kidney which then form a single tube
Anatomical variations - unilateral duplicated ureter
2 separated ureters coming from the kidney and they both remain distinct
Anatomical variations - retrocaval ureter
Ureter rune posterior to the IVC (when it should run anterior)
Anatomical variations - horseshoe kidney
No separation of the right and left kidney
Fusion of the kidneys
No dysfunction
Anatomical variations - ectopic kidneys
Kidney is found elsewhere in the body
Anatomical variations - absence of kidney
Due to agenesis (failure to form)
Nephrectomy
Renal cortex
Outer 1/3rd of the kidney
Granulated appearance
Renal medulla
Inner 2/3rd of the kidney
Which part of the kidney contains the renal pyramids?
Renal medulla
What is located inside the renal pyramids?
Nephrons (approx 50,000 in each renal pyramid)
What gives the renal pyramids their striated appearance?
Collecting ducts
Nephron composition (2 parts)
Renal corpuscle
- glomerulus and bowmans capsule
Renal tubules
Pathway of urine drainage from the kidneys
Collecting ducts merge at base of medullary pyramid to form renal papilla -> Minor calyx -> Major calyx -> Renal pelvis -> Ureter -> Bladder
The diameter of the urine drainage tubes increases until which point?
Anatomical constriction at the ureter
What are the 3 common anatomical sites of ureteric constriction
Pelviureteric junction
Ureter crossing anterior aspect of common iliac artery (commonly at bifuraction of common iliac)
Ureteric orifice (opening of the ureter into the bladder)
What happens as a result of ureteric Constriction?
Obstruction
- causes urin to back up towards kidneys causing hydronephrosis
Obstructions of the upper urinary tract are usually UNILATERAL/BILATERAL ?
Unilateral
Obstructions of the lower urinary tract are usually UNILATERAL/BILATERAL ?
Bilateral
What is the function of the pelvic inlet?
Divides false pelvis from true pelvis
The false pelvis is in the PELVIC/ABDOMINAL cavity?
Abdominal
The true pelvis is in the PELVIC/ABDOMINAL cavity?
Pelvic
Name the 2 openings in the pelvic floor?
Urethra
Rectum
Ureters pass ANTERIOR/POSTERIOR to common iliac arteries?
Anterior
Pathway of ureters to get to the bladder
Pass anterior to the common iliac arteries
Run along the lateral walls of the pelvis
Turn medially at the level of the ischial spine and enter the bladder
The ureters enter the ANTERIOR/POSTERIOR aspect of the bladder?
Posterior
Why does the ureter turn medially at the level of the ischial spine?
To prevent reflux of urine when the bladder contracts
In the female, where does the ureter run in relation to the uterine artery and uterine tubes?
Ureter runs BELOW the uterine artery and tubes
What is the water under the bridge analogy?
Ureter (water) runs under the bridge (uterine artery and uterine tubes)
In the male, where does the ureter run in relation to the bas deferens?
Ureter runs deep to the vas deferens
Arteries entering the pelvis are mainly branches from the EXTERNAL/INTERNAL iliac artery?
Internal
Veins draining the pelvis are mainly branches from the EXTERNAL/INTERNAL iliac vein?
Internal
Which surfaces of the bladder does peritoneum cover?
Only the superior surface
The bladder is the most ANTERIOR/POSTERIOR organ in the pelvis and it lies ANTERIOR/POSTERIOR to the pubic bone
Most anterior organ
Posterior to pubic bone
An empty bladder lies within the TRUE/FALSE pelvis and is ______ shaped
True
Pyramidal
A full bladder lies within the TRUE/FALSE/TRUE+FALSE pelvis
True and false
What are the 2 possible routes of catheterisation
Urethral
Supra-pubic
When is supra-pubic catheterisation suggested?
When the patient has a full bladder and a tube cannot be put up the urethra
The trigone is formed from:
___ ureteric orifice(s)
___ urethral orifice(s)
2 ureteric orifices
1 urethral orifice
What is the function of the trigone of the bladder?
Acts are a funnel to direct urine to the urethra
Which muscle forms the main bulk of the bladder wall?
Detrusor muscle
In order to eliminate fluid from the bladder, the detrusor muscle must CONTRACT/RELAX?
Contract
Both males and females have ___ urethral sphincters
2
- one internal
- one external
The internal urethral sphincter is composed of SMOOTH/SKELETAL muscle and is under VOLUNTARY/INVOLUNTARY control.
Smooth
Involuntary
Only males have an internal urethral sphincter
The external urethral sphincter is composed of SMOOTH/SKELETAL muscle and is under VOLUNTARY/INVOLUNTARY control
Skeletal
Voluntary
- via pudendal nerve
What additional feature does the internal urethral sphincter have in males?
Contracts to close off the bladder to ensure that semen leaves via the urethra instead of going back up into the bladder
Describe 2 mechanisms to prevent reflux of urine superiorly into the ureter
1 - medial angulation of the ureter at the level of the ischial spine
2 - detrusor muscle fibres wrap around the ureteric orifice and close this when the bladder contracts
In females, where does the body of the uterus sit in relation to the bladder?
Superior
In males, where does the prostate gland lie in relation to the bladder?
Inferior
In males, where does the first part of the urethra pass through?
Prostate gland (prostatic urethra)
Males have a shorter urethra than females. True or false?
False
- males have a longer urethra
Where does the urethra originate?
Bladder neck
Lining of the urethra
Transitional epithelium
Stratified squamous epithelium near its termination
The apex of the prostate gland is the SUPERIOR/INFERIOR portion of the prostate gland?
Inferior
The base of the prostate gland is the SUPERIOR/INFERIOR portion of the prostate gland?
Superior
Where is urine stored?
In the bladder
The nerve fibres enterina nd leaving the spinal cord levels ____ are key in the control of micturation
S2-S4
pudendal nerve
Which receptors sense the filling of the bladder?
Stretch receptors
Micturation reflex
Stimulation (contraction) of detrusor muscle +
Inhibition (relaxation) of the internal urethral sphincter which causes the urine to flow from the bladder to the proximal urethra
The brain can over-ride the micturation reflex. True or false?
True
How does the brain over-rie the micturition reflex?
AP’s within inhibitory nerve fibres pass inferiorly and inhibit the reflex (stop you from peeing)
This allows us to voluntarily contract the external sphincter until it is time to pee
What happens when it appropriate to urinate?
Inhibition of the micturition reflex is removed
Detrusor muscle contracts
Internal urethral sphincter relax
External urethral sphincter relax
Levator ani muscles relax
Anterolateral abdominal wall muscles contract
Urine is forced out of the external urethral orifice
Which nerves control the contraction of the detrusor muscle?
Involuntary control
- parasympathetic nerves
Which nerves control the relaxation of the internal urethral sphincter?
Involuntary control
- parasympathetic nerves
Which nerves control the relaxation of the external urethral sphincter
Voluntary control
- pudendal nerves
If you have a brain injury you are likely to urinate more/less often ?
More
If you have a spinal injury, you are likely to urinate more/less often?
Less
What keeps people continent?
External urethral sphincter
