Anatomy Flashcards
Urinary system is located in what cavity
abdomino-pelvic
Components of the urinary system (4)
Kidneys
Ureter
Urinary bladder
Urethra
Kidneys vertebral level
T12-L3
The kidneys lie in what space on either side of the posterior abdominal wall
paravertebral gutters
The hilum of the kidney lies at what vertebral level
transpyloric plane - L1
Which kidney is higher + why
Left - because liver pressing down on right kidney
4 layers covering the kidney from inner to outer
Fibrous renal capsule
Fatty renal capsule (perirenal fat)
Renal fascia - fibrofatty tissue
Pararenal fat
Posterior relations of the kidneys (5)
Diaphragm Psoas major Quadratus lumborum Transversus abdominis Ribs 11-12
Diaphragm lies where in relation to kidneys
posterior
Diaphragm lies posterior to kidneys so what effect does it have on the kidneys during inspiration and expiration
they move down during inspiration
What nerves are posterior to the kidneys so need to be careful of these when operating
Subcostal, iliohypogastric and ilioinguinal nerves
Anterior relations of the right (4) and left kidney (5)
Right
- liver
- adrenal gland
- duodenum
- ascending colon
Left
- adrenal gland
- stomach
- spleen
- pancreas
- jejunum
Retroperitoneal means peritoneum only covers what surface
anterior
Sympathetic and parasympathetic innervation of kidneys
Sympathetic
-T12-L1 thoracic splanchnic nerves which synapse at coeliac ganglion
Parasympathetic
-vagus
Lymphatic drainage of the kidneys
para-aortic lymph nodes around the origin of the renal arteries at L1
Name some congenital abnormalities of the kidneys (3)
Horseshoe kidney
Duplicated ureter
Pelvic kidney - kidney fails to ascend, remains in pelvis
Reason for horseshoe kidney embryologically
kidneys become too close together during their ascent from the pelvis to the abdomen and inferior poles fuse
Reason for duplicated ureter embryologically
Duplication of ureteric bud of of the mesonephric duct
Histology of renal cortex is characteristic because of presence of what circular structures
glomeruli
Renal cortex contains (3)
renal corpuscle - glomerulus + bowman’s capsule
PCT
DCT
Renal medulla contains (2)
loop of henle
collecting duct
Arterial supply of the kidneys
Renal artery (left and right)
- which divides into segmental branches once it enters hilum
- each segmental artery divides a further 4 times
Structures at renal hilum
renal vein
renal artery
renal pelvis
Length of left renal vein compared to right
left is longer because it has travel anterior to aorta to reach the IVC
Length of right renal artery compared to left
right is longer as it travels posterior to IVC to reach aorta
Right renal artery in where in relation to IVC
Posterior
Left renal vein is where in relation to aorta
anterior
What vein travels up from pelvis to drain into the left renal vein
left testicular vein in males
left ovarian vein in females
Left testicular/ovarian vein drains into left renal vein
Right testicular/ovarian vein drains into
IVC
Peritonisation of ureter
retroperitoneal
As the ureter descends, they run anterior to what muscle
psoas major
Renal pelvis is formed through the merging of a few
major calyces
Major calyces are formed throughout he merging of a few
minor calyces
Each major calyx is indented by the apex of the renal pyramid known as the
renal papilla
As the ureters descend, they run along what the tips of what processes
transverse processes of the lumbar vertebrae
In males, what vessel crosses the ureter superiorly/anteriorly
vas deferens
In females, what vessel crosses the ureter superiorly
uterine artery
3 constrictions of the ureter
Junction of ureter and pelvis
When it crosses the pelvic brim where the common iliac bifurcate
When it enters the bladder wall (vesicoureteric junction)
Venous drainage of kidneys
Renal veins (left and right) –> drain into IVC
Urethra exits which part of bladder
neck
Apex of the urinary bladder is connected to umbilicus by what
Median umbilical ligament (remnant of urachus)
Internally, the 3 orifices of the bladder (formed by the right and left ureteric orifices and internal urethral orifice) form what feature
trigone (a triangular area located within the fundus (base) that has smooth walls comapared to rest)
Bladder make of what muscle
smooth muscle (Detrusor muscle)
Bony joint anterior to the apex of the urinary bladder
pubic symphysis
Peritonisation of bladder
Extraperitoneal, i.e. not in the peritoneal cavity
It’s in the pelvic cavity below so peritoneum covers superior surface of bladder only
Arterial supply of bladder
branches of internal iliac artery
Venous drainage of bladder
vesical venous plexus
Innervation of bladder
- sympathetic (to detrusor muscle and internal urethral sphincter)
- parasympathetic (to detrusor muscle)
- somatic (to external urethral sphincter)
Sympathetic
-hypogastric nerve (T12-L2)
Parasympathetic
-pelvic splanchnic (S2-S4)
Somatic to external sphincter
-pudenal nerve (S2-S4)
Lymphatic drainage of bladder (3)
superior surface - external iliac lymph nodes
fundus - internal iliac lymph nodes
Neck - sacral or common iliac lymph nodes
What epithelium lines the bladder and ureter
transitional
Function of transitional epithelium lining bladder and ureter
readily stretches to accommodate volume increase
Ureters enter pelvis as they cross
the pelvic brim (where common iliac a bifurcates)
Renal pelvis is derived embryologically from what
ureteric bud
What tissue make sup renal fascia
fibrofatty tissue
Name the tubular structures that pass the ureter anteriorly
vas defers
uterine artery
Structures passing through transpyloric plane (6)
Hilum of kidney L1 Pylorus of stomach Neck of pancreas Fundus of gallbladder SMA
Arterial supply of the ureters
Abdominal part of ureter - renal artery and testicular/ovarian
Pelvic part - branches of internal iliac a (superior/inferior vesical a)
Venous drainage of ureters
Corresponds to arterial supply so
abdominal part - renal vein, testicular/ovarian vein
Pelvic part - superior/inferior vesical veins
Why would blockage to one of the segmental arteries supplying the kidneys cause necrosis
Because the segmental arteries do NOT anastomose
The reflection of the peritoneum from the rectum to the posterior bladder wall (in males) and the posterior uterine wall (in females) forms what space
rectovesical pouch
rectouterine pouch (pouch of Douglas)
where infection and fluids can collect
Name the 4 parts of the male urethra
Intramural (preprostatic)
Prostatic
Intermediate (membranous)
Spongy (penile)
Most dilated part of the male urethra
prostatic part
Narrowest part of urethra
Intermediate (membranous) part
