Anatomy #7 (Urinary) Flashcards

Question

Shape of the Kideney

Answer 1

10 cm long ; 5 cm wide ; 3 cm thick Overall - Bean shape - Can have a horse shoe kidney (kidney is conncted to the ismus) --> Kidney will usually still function normally - Has 3 lobes fused together - Inner borader = hylum = where the vessels come and go

Answer 2

Kidneys get 20% of bodies blood flow = lots of blood go through kidneys = has important vessels Left Kidney - artery comes in froy of vein (Left renal artery is infornt of vena cava) + vein is longer Right Kidney - Vein sits in fornt of the artery ; artery is lonegr BOTH 1. Right/Legt renal veins = drains blood from kidney (drain to IVC) 2. Right/left renla artery (com eoff the aorta) = going into kidey | .

Answer 3

Kidney is a viral organ if it fails the effect is not as immediate as the effect of the heart of teh brain failing BUt it is still important 1/3 of CO goes to the kidney

Answer 4

Renal Vessels are large --> lots of blood goes through Branch off the big Red = Superuor mesonteric - sits on top of the left renal - left renal = lower than the right because transverses the aorta - Left artery come in from of vein ; right side stays behind the vein KNOW THE VESSLES

Answer 5

Kidney transplants are usually straight foward because the vasculature of the kidney is mapped Surgeon needs to watch for the vessles hat go form the aorta to the kidney Renal glands are usually spared during kidney transplants - In renal vein? Lack of colateral circulation = good for surgery --> if removing kdiney for transplant or removing neoplasm = staright foward in terms of controling bleeding/having to ligate vessels - Liagte arerty first - don't want blood going into organ if there is no way to exit THEN ligate the vein AND take care of uriter AND contend with vessels going to adrenal gland --> After the kidney is free to remove - BUT bad for trauma because if have issue with ciruclation in kidnney then you can't rely on blood coming from somewhere else

Answer 6

Goes into left renal vein -- if want to miantain the adrenal gland = they need to reconnect the super renal vein somewhere or be carful to take right renal vein dustal to tributea

Answer 7

Kidney does NOT have colateral circulation Blood goes into the kidney --> Blood does whatever it needs to do --> Blood leaves - No Secondary circulation - One artery goes to the right kidney and 1 artery goes to the left kidney ALSO only one vein for each kidney to drain it Artery branches as it goes to the hylum (1 renal aretery comes off the aorta) --> goes to the different lobes

Answer 8

Preserved if possible during kidney trasnplants Function - make epinephrine (adrenaline) - Epipens = give lots of epinephorne for anophilactic shock

Answer 9

Where all the vessels come and go

Answer 10

Looks like venous tissue --> shaped like a pyrimad/funnel shaped - Collection funnel that goes to uriter - Collects urine

Answer 11

Trainglar shape - Pyrimids Lines going down deeper - interlobar vessles - first branches off the renal artery - Atery branches to interlobar arteries vessels ciruclating aorund = Arcuate arteries - arched vessles into lobes - Archiate arteryes - arching from one inter lobar to another --> create archade of arteries Interlobular Artery - arteries that go to filtering unit --> go to bomans capsuls - Branches that come off and trun to vein and come back

Answer 12

Capilary surroudning by Bomans - at the end of the interlobule artery CHECK VIDEO

Answer 13

Max Bradle made an image of the kidney - worte the anatomical part for a kidney bladder surgery Discovered the profusion of the kdiney - have reason for vasculature Found the Lobular branches split to posterior and anterior = can an avacsular plane on a mid-corconal section of the kiney - Use this section to go to the pelvis/go to the kidney --> follow the plane to the pelvis and void any major bleeding Called Brandles line (plan in kidney that is avacsular)

Answer 14

Cortext (outter layer) --> Medula (deeper)

Answer 15

Contains Lameli (dots in the cortext) Function (of lameli) - Filtering Units Image - outter pink area

Answer 16

Made up of pyrimd shaped tissue - Collection functin of kidney happens in each pyrimid units - ultimatley have area where runine collects into pelvis and then goes t the uriter Deeper part (darker part) Medula = tubules - Lobules of healey - Fuction - collecting tubes that go down - Pyrimids = linear straitions

Answer 17

Pee is Filterized --> goe sto Lameli --> goes to colecting tubes --> goes to apex of pyridmids --> Atria f pelvis --> Pelvis proper --> uriter

Answer 18

Apex of the Pyrimid (apex to a chanel that will bring urine to the pelvis) Have perefations = collecting tubules = urine drains from filtration --> goes to the atrium of the pelvis - Pyrimids terminate at a point that coinside with barnch that goes to pelvis Have papillae that face us and that go away from us

Answer 19

Arangment of pelvs is divoded into: 1. Less Calyx 2. Greater Calyx

Answer 20

Right outsdie the papillae - Come from pappilae "Hallway" --> forst area urine arives

Answer 21

Minor calix go together (less calyx come togetehr to form greater) Collection goes together Function - Funnels urine to the uriter Multiple Greater Calyxs will join together and form the pelvis

Answer 22

Capilaries in the Kidney Function - Blood is being filtered Image - Mesh like vessles at the bottom = vessels going around collecting tube (have filtration) Image - long string at bottom - medula (above that is in teh corext) - Loop of Hendle = in medul

Answer 23

Top portion - Goes to calicles Middle - Vessels go to medula + lop of henley (filter) Bottom INterlic artery and vein - Go into lobular See colecting tubules - empty into the papilae - Loops of henly go into the phyrimds - Glamerilae (filteratiin) occurs in the cortext - Colecting tubule sgoes down and dumps into apex of pyrmids - Interlobar and archeates and interlobular going to glamerlar units and then sending collecting units down to the papillae

Answer 24

Kidney stones can fil the lesser and greater calyces - Stones can make a cast of the pelvis - Stones can be staghorn = more painful --> stone forms in multiple directions - Stones are caused by the cyrtsilization of phosphates and Ca2+ (possible dairy can precipitate them + can be herditary) - Stones are painful (pain gets so bad it becomes indistiguishable)

Answer 25

Bradle = documented the hsapes of different calicies/stones - Can see the 3D of calyces or 3D of pelvis - Shows how the layers buildup over time (see mineral buildup) - Some have chnages in core (can have coagulated blood or can be broken into peices( - See one that is thick (big) --> becomes thin (formed in the lumen of the uriter) - See peliv shape or calicies shape - He had to put back together some of the stones because they were taken out during surgery and were broken

Answer 26

Some can be taken out by surgery or lithotripsy Past - Had to break up the stones and then pee it out -1800s - able to crush the stones + get the stone out one sitting - Before surgery = kidney stones were fatal NOW - break up the stone with sound wave or laser - Laser - Put a catherter into the uriter --> image opacity of stones --> break up the stones + evacuate stone with bag or aspiration

Answer 27

Catherter goes into kidney --> breaks up the stones --> removes the stones Uses sound to break up the kidney stone

Answer 28

Kidney stone is in the Lower Calcicer - Stent went up uritehra to bladder to uriter --> in stent see stone (went in to diagnose) STORY - rini had a collegue who had kidney stones --> had to wait until it passes

Answer 29

Overall - have many cysts on the kidney Aterogenic Don't know cause Can spread to the pancreus or the liver Can be asymptomatic to a certain extent - If one cyst gets big (filled with fluid) = could affect function of kidney because it pushes on the kidney

Answer 30

Tube that runs posterior to peritenium --> goes into perenium Thin walled Sits front of pelvis? Sits in soaze muscle (beefy muscle) --> goes in front of the iliac vessles - Iliac vessles = branches of the aorta Pretty long

Answer 31

There is some parastalsis in the Uriter to get usrine to the bladder - Have thin walled muscular tossie in the wall of the uriter BUT urine mostly moves through pressure and gravity (urine moves slower)

Answer 32

When surgeons do GI or whipple or kidnye surgery = they need to be carful if the uriter Need to be carful becuase they could knick the uriter = urine goes to the peretineum = causes peritinitus When they do surgery they will put a ribon on the uriter to keep eyes on it to make sure they do not knick it

Answer 33

Ureters are lined with mucousal epithelium and with longitidudal and circular musclar fibers Urine is move from the kidneys to the bladder in peristalic waves

Answer 34

Bladder = tucked below the pubic bone sytnthesis In females - uterus is on top of the bladder

Answer 35

1. Markers on the right side of image - recto-uriter puch - can get infected (infection can settle there) 2. Vesic Uteran pouch (Vesicouterine pouch) - between the uterus and the bladder - can get infceted (infection can settle there) Hard to get AB the puches

Answer 36

Uterus = on top of the bladder (Folded red) Eveyrthing in image = UNDER the peritenium

Answer 37

Goes from the bladder to outside the body - SHorter in females

Answer 38

Male uritehra is longer because travels the length of the penis

Answer 39

Distended bladder in image is wrong ecause there should not be air in the bladder ; bladder should be distended from fluid

Answer 40

Right behind the pubic synthesis

Answer 41

Under the big red crcle - next to the pubic synthesis Rectovesicular pouch = next to the big red circle Under the bladder at base of abdominal cavity

Answer 42

Bladder is covered by Rugi - Rugi = increases the surface area + allow tissue to stretch out When the bladder colapsases it is small but it can also extend and hold a lot of pee --> can do this becase the musclature is flexible + because of the surface Perferations (circles in blue) = Uriters Circle = Trigone --> has the perferations at the top --> uriters turn foward and go to the back of the bladder - Tirgine is NOT covered with rugi - Orifeces coming in = from the urtiers - urtiers come down --> go behind the bladder --> curve and go to the bladder

Answer 43

Similar to the ileosecal junction - have mechnaical arangments --> when blader is empty it opens the orifes When bladder is detsnded = increase angle of junctionn = closes off the urine from coming to pure into the bladder When blader is ecacuaed = angle opens and urine can go into the bladder

Answer 44

Urithera goes through the prostate = enlragtments of the prostate affects the flow of fluid down When older = have slow stream of urine --> have to pee at night (have to pee but can't pee fully --> makes them have to pee more often) - Swollen prostate can affect too

Answer 45

Two residents came from Patrich walshes lab Catheters --> go to the uriter and then to the bladder - Double walled to the urine can drain - Put saline to blow up the baloon to hold the catheter in bladder - In male - cathetehr goes through the prostate - Put in people going under general anestia ; always make sure pateints can pee after surgery before they leave hospital High incedince of infection after using catheter --> Residents were writting a paper about the infections and asked Rini to illustrate how the Foly catheteer goes in Rini saw that there was a cuff of latex when you remove the saline --> caused the resindets to reqirte the paper and hypothesisze that when you pull catheter the slaine leavses a cuff = when remve the catherter = roushing up the mucosa of the urithra - Recomended that you should keep 0.5 CC of slaine in = makes it round (no cuff) = no roughing

Answer 46

2 residnets came over who were working with Pat walsh --> asked rini to help with paper on increase infcetion rate with folly catheters Foly catherter - has a double lumen - Put up rutehrra to bladder - Outter lmebn they put syline syrngge and inject and inflates a baloon = prevents catehr from being pulled out of the bladder - Inner lumen - drains urine Found - when use catherter there is high inciddenos of bladder infecton --> theory was that when put cater is pulled out that movement can intrduce bacteria --> asked rini to ilutsrate that Rini saw that when yo pull slaine out it callapses the latex but leaves a little cuff (stcks to self and makes ridges) --> he told the resistdents --> said the cuff would be bad because it would rough up the mucousa To get rid of cuff = when take saline out you add back in 1 CC of fluid to get rid of ridge and make a bolbus shape End - they rewrote the paper

Answer 47

Perfected the technique of removing the prostate but keeping the bundle of nerves that goes to the penis (nerves run along the side of the prostate) To do surergy = push the nerves to the side and can get just the prostate Before = 90% impotence ; after Walsh = 40% impotence

Answer 48

Urithera is in 3 parts: 1. Prostatic - leads bladder and goes through the prostate 2. Mebranous - goes through the duct of the penis (goe sthrough muscuslar floor of the bottom of the pereneum) 3. Cavernous - goes through the penis itself Male = muscular floor of perenium - Sphricter for urithera - Damage muscle = cuases incompetance

Answer 49

Male = muscular floor of perenium - Sphricter for urithera (Acts as sphicter?) - Damage muscle = cuases incompetance Damage = more pronounced in women vecause child birth (stretches the mucles) = muscle is less effective Pelvic floor in male = important band of mucles - help supprt contents of lower abdomenial cavity - As age = candevelop urinary incotenace or decal incontence - Anything that weakens floor (body weight or child birth) = can affect urthera and lead to incotenance

Answer 50

All one section