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Renal 2020 > Anatomy > Flashcards

Anatomy Flashcards

1
Q

what does the urinary tract consist of?

A

kidneys
ureters
bladder
urethra

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2
Q

are the kidneys retroperitoneal?

A

yes

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3
Q

what does retroperitoneal mean?

A

behind the peritoneum

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4
Q

what are the kidneys enclosed within?

A 
renal capsule
perinephric fat
deep fascia
paranephric fat
visceral peritoneum
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5
Q

why does the right kidney lie inferior to the left?

A

size of the liver

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6
Q

what vertebral level does the right kidney sit at?

A

L1-3

hilum at L1/2

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7
Q

what vertebral level does the left kidney sit at?

A

T12-L2

hilum at L1

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8
Q

which ribs protect the kidney?

A

floating ribs 11 and 12

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9
Q

what do the floating ribs risk being so close to the kidneys?

A

lacerations

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10
Q

what does the renal hilum consist of?

A 
renal pelvis (posterior)
renal artery (middle)
renal vein (anterior)
lymphatics
nerves
renal sinus fat
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11
Q

why is the left renal vein longer than the right?

A

passes the aorta anteriorly to join right-sided IVC

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12
Q

why do the kidneys move inferior on inspiration?

A

liver and spleen touch the diaphragm superiorly and superior poles of the kidneys inferior

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13
Q

where does lymph from the kidney’s drain to?

A

lumbar nodes

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14
Q

where does lymph from the ureters drain to?

A

lumbar and iliac nodes

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15
Q

two types of RAS associated with AAA

A
  1. combined with infra-renal AAA

2. supra-renal AAA

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16
Q

two layers of the kidney

A

outer cortex

inner medulla

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17
Q

urine drainage pathway from the kidney

A 
nephron collecting duct
minor calyx
major calyx
renal pelvis
ureter
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18
Q

two types of ureteric obstruction

A
  1. internal

2. external

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19
Q

examples of internal ureteric obstructions

A

impacted calculus

blood clot

20
Q

examples of external ureteric obstructions

A

expanding mass

21
Q

sites of constriction in the ureters

A
  1. pelvic-ureteric junction
  2. ureter crosses common iliac artery bifurcation
  3. ureteric orifice
22
Q

what is in the walls of the ureters?

A

smooth muscle

23
Q

what produces colicky pain with an obstruction in the ureters?

A

there is increased peristalsis by the smooth muscle in the walls of the ureter proximal to the obstruction in an attempt to remove it

24
Q

what is hydronephrosis?

A

swelling of the kidney due to urine backing up which can compress nephrons and lead to kidney failure with painful stretching of the renal capsule

25
Q

what direction do the ureters enter the posterior bladder wall?

A

inferomedially

26
Q

why do the ureters enter the posterior bladder wall inferomedially?

A

prevent reflux of urine when bladder contracts

detrusor muscle also encircles the orifices and prevents reflux

27
Q

what forms the trigone?

A

two ureteric orifices

internal urethral orifice

28
Q

what is the trigone?

A

triangle shape on internal aspect of the bladder

29
Q

what is the muscle of the bladder wall called?

A

detrusor muscle

30
Q

what does the detrusor muscle form around the urethra?

A

forms the internal urethral orifice which contracts during ejaculation

31
Q

describe embryological development of the testes?

A

move from posterior abdomen through inguinal canal to the scrotum

32
Q

what does the spermatic cord consist of?

A 
testicular artery
testicular vein
vas deferens
lymphatic vessels
nerves
33
Q

what do the testes sit within?

A

tunica vaginalis

34
Q

what is a hydrocele?

A

excess fluid in the tunica vaginalis

35
Q

three motor functions of the renal system

A
  1. ureteric peristalsis
  2. bladder contraction
  3. urethral sphincter control
36
Q

what produces ureteric peristalsis?

A

autonomic action initiated by ureteric cells which have auto-rhythmicity

37
Q

what produces bladder contraction?

A

parasympathetics stimulates detrusor muscle to contract

38
Q

what are the five types of nerve fibre?

A
  1. somatic sensory
  2. visceral afferents
  3. somatic motor
  4. sympathetic
  5. parasympathetic
39
Q

role of somatic sensory nerve fibres?

A

sensations from body wall (soma)

40
Q

role of visceral afferent nerve fibres?

A

sensations from organs

41
Q

role of somatic motor nerve fibres

A

motor response to body wall (muscles)

42
Q

role of sympathetic and parasympathetic fibres

A

responses to organs

43
Q

how do sympathetic fibres reach the kidneys, ureters and bladder?

A

leave the spinal cord at T10-12 and enter sympathetic chains bilaterally
leave within abdominopelvic splanchnic nerves synapsing with abdominal sympathetic ganglia at abdominal aorta
reach organ via periarterial plexus

44
Q

how do parasympathetics innervate the kidney and ureter?

A

vagus nerve

45
Q

what parasympathetic innervates the bladder?

A

pelvic splanchnic nerves

46
Q

describe the mechanism behind urinary continence

A
  • bladder filling is sensed by stretch receptors of visceral afferents
  • enter CNS via S2-4
  • reflex is to empty bladder by stimulation of detrusor and inhibition of internal sphincter
  • brain overrides and APs in inhibitory nerves arrive
  • voluntary contraction of external sphincter and levator ani
47
Q

nerves that arise from the sacral plexus

A 
pudendal (S2,3,4)
sciatic (L4-S3)
femoral (L2-4)
obturator (L2-4)
iliohypogastric
ilioinguinal
lateral cutaneous nerve of the thigh
genitofemoral

Renal 2020 (26 decks)

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