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urinary system > Anatomy > Flashcards

Anatomy Flashcards

1
Q

location of the kidneys

A

R lower than L
superior pole R - level with 11th ICS
L at 11th rib
hilum at L1 for both - because vertebrae so big

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2
Q

position of kidney raltive to thorax

A

diaphragm is between the kidney and the rib

lung between the diaphragm and the rib

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3
Q

position of kidney relative to abdominal wall

A

ab wall lined by transversalis fascia
fascia goes round kidney and becomes renal fascia
encorportating perinephric fat
fascia continues and covers the great vessels

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4
Q

position of kidney relative to spleen

A

spleen at ribs 9 and 10

more latera; than L kidney

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5
Q

posterior relations of the kidneys

A

top relates to the diaphragm
medial - psoas major muscle
middle - quadratus lumborum muscle
lateral - transversalis abdominal muscle

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6
Q

nerves

A

last IC nerve
subcostal nerve
iliohypogastric nerve
ilioinguinal nerve

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7
Q

anterior relations of the kidney

A

R - liver, hepatic flexure; hilus lies behind 2nd part of duodenum
L - stomach, pancreas, spleen and splenic flexure

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8
Q

hepatic flexure

A

of colon

ascending colon turn to transverse colon

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9
Q

splenic flexure

A

transverse colon -> descending

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10
Q

why do the flexures exist

A

the top corners of the colon attach to the posterior abdominal wall

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11
Q

relation of pancreas and kidney

A

only related to the L kidney

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12
Q

position of the ureters

A

vertically down posterior abdominal wall
along tips of transverse process of lumbar vertebrae
cross pelvic brim anterior to sacro-iliac joint and bifurcation of the common iliac arteries
descend anteromedially to enter bladder at level of ischial spine

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13
Q

blood supply

A 
from every major vessel they cross
renal 
gonadal
common iliac
internal iliac - (they go between internal and external iliac)
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14
Q

how do they move urine

A

very muscular - sm

peristalsis

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15
Q

connection of ureters with bladder

A

obliquely

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16
Q

places of ureteric constriction

A

pelviureteric junction - top of ureter
where ureter crosses pelvic brim
where it crosses bladder wall

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17
Q

significance of ureteric constriction

A

where kidney stones likely to get stuck

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18
Q

structure of ureters

A

endothelium - transitional, when empty layers on top of each other, can be pulled into single layer so not stratified
circular muscle coat - peristalsis

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19
Q

male urethra

A

through prostrate - may be constrictions

2 right angles

20
Q

female urethra

A

short and straight

21
Q

structural anatomy of the bladder

A

triangular pyramid
apex point anteriorly, base posteriorly
urothelium - transitional epithelium
3 layered epi - slow turn over
large luminal cells - low permeability luminal membrane
prevent dissipation of urine plasma gradients

22
Q

ureter and the bladder

A

enter at superior posterior junction

close as urine enters - prevent backflow

23
Q

trigone

A 
triangle formed by the entry of the ureters and exit via urethra 
smooth 
epi stretched 
attached to material below 
bladder cancer likely to occur here
24
Q

position of the bladder

A

held in place by pubovesical ligament or puboprostic ligament

25
Q

perineal pouch

A

where the external sphincter is

26
Q

urethra in males

A

have to go through prostate which sits on perineal membrane

27
Q

sphincter vesicae

A 
internal sphincter 
sm
at neck of bladder
reflex opening - response to bladder wall tension 
relaxed by PNS 
contracts by SNS
28
Q

sphincter urethrae

A

external sphincter
in perineum
tone maintained by somatic nerves in pudenal nerve - S2, 3, 4
opened by vol inhibition of nerves

29
Q

position of male internal sphincter

A

between bladder and prostate

30
Q

control of sphincter vesicae

A 
bladder fills 
stretch receptors 
PNS 
bladder contracts 
internal sphincter opens
31
Q

control of sphincter urethrae

A

cerebral cortex
motor neuron
inhibits opening
have to actively inhibit pudenal nerve

32
Q

where are the kidneys in the abdomen

A

retroperitoneal

33
Q

external features of the kidneys

A

surrounded by dense fibrous capsule
outside capsule is fascial pouch containing peri-renal adipose tissue
overlapped postero-superiorly by diaphragm and pleural cavity

34
Q

function of the fascial pouch

A

separate renal fascia from kidney

35
Q

how does the development of the kidney affect the structure

A

develop as discrete lobules and fuse

accessory arteries, veins, ureters common - failure of developmental process

36
Q

kidney structure

A

cortex granular - irregular features eg glomerulus
medulla striated - radial arrangement of tubules
multilobular
each lobule drain through own papilla and calyx
renal column - cortex between the medulla

37
Q

renal pyramids

A

base faces the cortex
apex inwards towards the renal sinus
apec is the renal papilla
renal papilla is surrounded by the minor calyx
minor calyx receive urine - eventually become ureter
in renal sinus minor calices unite and form major calyx
2 or 3 major calices join to make renal pelvis - funnel shaped renal end of ureters

38
Q

functional significance of the blood supply

A

abundant

blood pressure drives ultrafiltration

39
Q

relative positions of aorta and IVC

A

aorta L of midline

IVC - R

40
Q

renal arteries

A

R renal artery longer than L

got to pass behind the IVC

41
Q

Renal veins

A

L renal vein longer
got to pass in front of aorta
goes under the superior mesenteric artery

42
Q

pathophysiological effect of renal artery location

A

if aneurysm in aorta

block flow through renal vein

43
Q

abdominal arteries

A

celiac trunk - midline - supply the foregut
superior mesenteric artery - midline - supply panc and lower intestine
L and R gonadal arteries - in same place for either sex

44
Q

kidney hilum

A

anteriorly - vein -> artery

posteriorly - renal pelvis

45
Q

location of vessels when in kidney

A

closely related

46
Q

blood supply to the kidney

A

renal artery branch to each lobe
arcuate arteries form at the top of the medulla and anastomose with adjacent arteries
afferent vessel form glomerulus

47
Q

lymphatic drainage

A

mirror the arteries
from bladder - internal iliac and common iliac nodes
from ureters - root of gonadal arteries, inferior and superior mesentry, renal - - paraaortic nodes
pulsation of artery drive lymph upwards

urinary system (9 decks)

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