Anatomy Flashcards by Zoe Doak

Describe the function of the 4 MAIN structures that urine passes through before it is excreted

Kidney = produces urine
Ureter = drains urine
Bladder = stores/voids urine 
Urethra = excretion of urine

How well did you know this?

Not at all

Perfectly

What anatomical structures make up the Upper Urinary tract?

kidneys (right &left)

ureters (right & left)

How well did you know this?

Not at all

Perfectly

What structures make up the Lower Urinary tract?

bladder

urethra

How well did you know this?

Not at all

Perfectly

What structures of the urinary tract are retroperitoneal?

kidneys

proximal ureters

How well did you know this?

Not at all

Perfectly

What parts of the urinary tract are found within the pelvis?

distal ureters
bladder
proximal urethra

How well did you know this?

Not at all

Perfectly

What urinary structure is found in the perineum?

the distal urethra

How well did you know this?

Not at all

Perfectly

What structures make up the renal hilum (from anterior to posterior)?

Renal vein
Renal artery
Ureter

How well did you know this?

Not at all

Perfectly

What muscle is found posterior to the kidneys?

Quadratus Lumborum

How well did you know this?

Not at all

Perfectly

What muscle is found medial to the kidneys?

Psoas Major

How well did you know this?

Not at all

Perfectly

What layers of muscle are found lateral to the kidney?

Transversus Abdominis
Internal Oblique
External Oblique
from kidney outwards

How well did you know this?

Not at all

Perfectly

What structures occupy the space between the anterior surface of the kidney and the visceral peritoneum?

Visceral peritoneum
Paranephric fat
Renal (deep) fascia
Perinephric fat
Renal capsule

How well did you know this?

Not at all

Perfectly

What should be noted about the blood supply to and from the kidneys on a CT scan?

The aorta is found more posterior than the IVC

How well did you know this?

Not at all

Perfectly

What vertebral level is the left kidney found at?

T12-L2

How well did you know this?

Not at all

Perfectly

What vertebral level is the right kidney found at and why is this?

L1-L3

pushed down by liver

How well did you know this?

Not at all

Perfectly

Fracture of what ribs can cause potential trauma to the kidneys?

11 or 12 (floating ribs)

sharp displaced ends may bruise/lacerate the kidney

How well did you know this?

Not at all

Perfectly

What quadrant / region is the Left kidney found in?

LUQ

Left Lumbar Region

How well did you know this?

Not at all

Perfectly

What quadrant / region is the Right kidney found in?

RUQ

Right Lumbar Region

How well did you know this?

Not at all

Perfectly

How do you “Ballot” for the kidneys?

Palpate posteriorly in the lumbar/flank region inferior to the 12th rib
Palpate Anteriorly in the RUQ
Ask patient to breathe in so that diaphragm and either liver or spleen descend and move kidney downwards so it can be felt

How well did you know this?

Not at all

Perfectly

A non-smooth kidney indicates an abnormality. TRUE/FALSE?

TRUE

How well did you know this?

Not at all

Perfectly

What structures is the Right Kidney posterior to?

liver
hepatorenal recess
2nd part of duodenum
ascending colon
right colic (hepatic) flexure

How well did you know this?

Not at all

Perfectly

What structures is the Left Kidney posterior to?

stomach
tail of the pancreas
hilum of the spleen
splenic vessels

How well did you know this?

Not at all

Perfectly

What is the significance of the hepatorenal recess?

Fluid collects here if patient is lying on their back

How well did you know this?

Not at all

Perfectly

Are the renal veins or arteries anterior at the kidneys?

Veins are anterior

How well did you know this?

Not at all

Perfectly

Are the veins or arteries anterior at the level of common iliac bifurcation?

Arteries are anterior

How well did you know this?

Not at all

Perfectly

Where does lymph from the kidneys drain to?

lumbar lymph nodes

Where does lymph from the ureters drain to?

``` Proximal = lumbar Distal = iliac ```

Describe the relationship of a supra-renal AAA to the renal arteries?

Begins above the level of the renal arteries but can also extend below the renal arteries

Describe the relationship of an infra-renal AAA to the renal arteries?

Starts below the level of the renal arteries

How are AAAs repaired?

Endovascular Aneurysm Repair (EVAR)

If the renal arteries are stenosed in an Infra-renal AAA, this is usually due to the aneurysm itself. TRUE/FALSE?

FALSE - usually due to atherosclerosis - Stenosis in supra-renal AAAs are usually due to the aneurysm itself

In what ways can the renal system vary anatomically?

``` Bifid renal pelvis Bifid Ureter OR Unilateral duplicated ureter Retrocaval Ureter (behind IVC) Horseshoe Kidney Ectopic Pelvic Kidney ```

What are the possible reasons for a patient only presenting with one kidney?

- agenesis - nephrectomy (pathology) - nephrectomy (donation)

Where in the kidney are the nephrons found?

In the renal pyramids of the medulla

What structures does urine pass through from the nephrons to the urethra?

- nephrons (collecting duct) - minor calyx - major calyx - renal pelvis - ureter

What is the largest area for collection of urine?

Renal Pelvis

What anatomical constriction landmark is marked by the wider renal pelvis becoming the narrower ureter?

pelviureteric junction

What other 2 areas are considered anatomical sites of ureteric constriction?

ureter crossing over the common iliac artery (over pelvic ridge) ureteric orifice (opening into trigone in the bladder)

What is the significance of anatomical sites of vasoconstriction?

If kidney stones form they can block flow at these sites due to the narrowings

Why does ureteric obstruction present with colicky pain? (comes and goes)

- increased peristalsis proximal to the site of the obstruction - attempt to flush it into the bladder - peristalsis comes in waves => colicky pain

An obstruction in the ureter causes a unilateral back pressure of urine. TRUE/FALSE?

TRUE

What type of back pressure is caused by an obstruction in the bladder?

unilateral or bilateral kidney problems

What type of back pressure do patients experience if their obstruction is in the urethra?

bilateral

When does back pressure cause reduced urine output?

When the pressure within the urinary tract exceeds the pressures favouring filtration at the glomerulus

What is the definition of renal failure?

failure to adequately filter the blood to produce urine

The renal capsule has the potential to stretch if the kidney swells. TRUE/FALSE?

FALSE Layer of deep fascia and is very tense (doesnt stretch) => causes patients a lot of pain

What is considered the false pelvis?

from iliac crests to pelvic inlet

What does the true pelvis extend to?

pelvic inlet to pelvic floor

What is the main muscle of the pelvic floor and where does the pelvic floor extend between?

Levator Ani | between pubic symphysis and coccyx

What is meant by a sub-peritoneal structure?

Passes below the peritoneal cavity

In an upright male, what is the most inferior part of the peritoneal cavity where fluid will collect?

Rectovesicle pouch

In an upright female what is the most inferior part of the peritoneal cavity where fluid will collect?

Rectouterine pouch (of Douglas)

What does the ureter run inferiorly to in both a male and a female?

``` Female = inferior to uterine artery Male = inferior to vas deferens ```

The arteries into the pelvis branch from what iliac artery?

Internal Iliac

What arteries go to supply the bladder, uterus and vagina?

Vesical arteries Uterine arteries Vaginal arteries

What arteries branch from the vesical arteries?

Prostatic arteries

What artery to the rectum is derived from the internal iliac artery?

Middle rectal artery

What 3 orifices form the trigone of the bladder?

2 ureteric orifices and the internal urethral orifice

What is the function of the the internal urethral sphincter muscle?

Contracts during ejaculation to prevent retrograde ejaculation of semen back into the bladder

What name is given to the normal position of the uterus and what takes most of its weight?

Anteflexed | Sits on top of bladder => this takes its weight

In what direction does the bladder expand when it fills?

Superiorly into abdominal cavity

What are the two methods of catheterisation?

``` urethral suprapubic (through anterior abdominal wall => avoiding peritoneal cavity) ```

The male urethra is much longer than the female urethra. TRUE/FALSE?

TRUE

What are the two parts of the male urethra and where are they found?

``` Spongy urethra (in corpus spongiosum) Prostatic urethra (through prostate) ```

The external urethral sphincter is INVOLUNTARY. TRUE/FALSE?

FALSE the INTERNAL urethral sphincter is INVOLUNTARY The EXTERNAL urethral sphincter in VOLUNTARY

Describe the course of the vas deferens

up through scrotum into peritoneal cavity behind bladder Down through prostate (joins with seminal gland to form ejaculatory duct) Then becomes prostatic, then spongy urethra

What structure moves with the testes when they descend into the scrotum?

Spermatic cord

What name is given to the "sac" that the testis sit inside when in the scrotum?

tunica vaginalis | visceral and parietal layer

Excess fluid in the tunica vaginalis is known as what?

hydrocele

What is contained within the spermatic cord?

vas deferens testicular artery pampiniform plexus

What is meant by testicular torsion?

- twisting of the spermatic cord - disrupts the blood supply Causes: - severe pain - danger of testicular necrosis

What structures pass through the Deep Inguinal Ring to get into/out of the inguinal canal?

``` testicular artery testicular vein vas deferens lymphatics nerves ```

Where does the vas deferens begin?

The inferior pole of the testis

Where can the head of the epididymis be palpated?

The posterior aspect of the superior pole

What part of the prostate is palpated on PR examination?

- peripheral zone | - most prostate cancers (i.e. malignant) arise in the peripheral zone

In what cylinders of tissue are the deep arteries to the penis found?

right & left corpus cavernosum

What arteries do the deep arteries of the penis branch from?

the internal pudendal artery | from the internal iliac

What is the blood supply to the scrotum?

internal pudendal | AND branches from the EXTERNAL iliac artery

What structures of the male reproductive tract drain to the superficial inguinal lymph nodes?

Scrotum & most of the penis (not the glans)

Lymph from the testis drains to what group of lymph nodes?

lumbar nodes around the abdominal aorta