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Renal > Anatomy > Flashcards

Anatomy Flashcards

1
Q

What does the urinary tract consist of?

A

Kidney Ureter Bladder Urethra

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2
Q

Function of kidney?

A

Produces urine

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3
Q

Function of ureter?

A

Drains urine (from kidney to bladder)

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4
Q

Function of bladder?

A

Stores/ voids (empties) urine

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5
Q

Function of urethra?

A

Excretion of urine (& semen in males)

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6
Q

Upper urinary tract?

A

Kidneys Ureters

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7
Q

Lower urinary tract?

A

Bladder Urethra

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8
Q

Where may an upper urinary tract infection spread to?

A

Kidneys

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9
Q

Where in abdominal cavity are the kidneys?

A

Retroperitoneal

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10
Q

Where are the kidneys located?

A

Posterior to visceral peritoneum Enclosed within renal fat capsule Surrounded by skeletal muscles

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11
Q

Which muscles surround the fat capsule?

A

Muscles of the posterior abdominal wall Muscles of the antero-lateral abdominal wall Muscles of the back

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12
Q

What are the anterolateral abdominal wall muscles?

A

External oblique Internal oblique Transversus abdominis

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13
Q

Which important structures are situated at hilum of kidney?

A

Renal artery Renal vein Ureter

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14
Q

What is the most anterior structure at the hilum of kidney?

A

Renal vein

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15
Q

What surrounds kidney?

A

Renal capsule

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16
Q

What is the renal capsule?

A

Tough fibrous tissue Closely encapsulates kidney all around its surface

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17
Q

What lies anterior to renal capsule?

A

Perinephric fat

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18
Q

Perinephric fat?

A

Liquid-y, fatty layer surrounding renal capsule

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19
Q

Anterior to perinephric fat?

A

Renal (deep fascia)

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20
Q

Anterior to renal fascia?

A

Paranephric fat

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21
Q

Final layer anterior to kidney?

A

Visceral peritoneum

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22
Q

Beyond visceral peritoneum?

A

Peritoneal cavity

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23
Q

What lies posterior to kidney?

A

Posterior abdominal wall muscles Quadratus lumborum Psoas major

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24
Q

Where do kidneys lie in relation to quadrates lumborum?

A

Kidneys lie anterior to quadrates lumborum

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25
Q

Where do kidneys lie in relation to psoas major?

A

Kidneys lie lateral to psoas major

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26
Q

Which kidney lies more inferiorly and why?

A

Due to the size of the liver the right kidney lies at a slightly inferior vertebral level

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27
Q

What vertebral level does right kidney lie at?

A

L1-L3

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28
Q

Which vertebral level does left kidney lie at?

A

T12- L2

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29
Q

Where do floating ribs 11 and 12 lie in relation to kidneys?

A

Posteriorly

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30
Q

Which regions/ quadrants are kidneys found in?

A

Both upper quadrants or lumbar (flank) regions

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31
Q

Anatomical relations to right kidney?

A

Posterior to: - Liver (& hepatorenal recess) - 2nd part of duodenum - Ascending colon - Right colic flexure

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32
Q

Anatomical relations to left kidney?

A

Posterior to: - Stomach - Tail of pancreas - Hilum of spleen - Splenic vessels

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33
Q

Hepatorenal recess?

A

Pouch between right kidney and liver One of most dependent parts of greater sac of peritoneal cavity

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34
Q

Where are renal veins in relation to renal arteries?

A

The renal veins are anterior to the renal arteries

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35
Q

Where do renal veins drain back towards?

A

Inferior vena cava

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36
Q

Where does ureteric arterial bloody supply branch from?

A

The renal artery The abdominal aorta The common iliac artery the internal iliac artery The vesical (bladder) artery

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37
Q

Common iliac arteries in relation to common iliac veins?

A

Common iliac arteries are anterior to the common iliac veins

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38
Q

Where does lymph from kidneys drain to?

A

Lumbar nodes

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39
Q

Where does abdominal aorta bifurcate?

A

At level of umbilicus

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40
Q

Where does lymph from ureters drain to?

A

Lumbar nodes & iliac nodes

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41
Q

Anatomical variations in renal system?

A

Bifurcation of renal pelvis Bifid ureter (ureter should be single structure) Retrocaval ureter (ureter passing anterior to vena cava rather than behind) Horseshoe kidney (union between right- and left-hand kidneys) Ectopic kidney (located down within pelvis) Solitary kidney

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42
Q

What does kidney consist of?

A

Outer cortex and inner medulla

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43
Q

What does the medulla contain?

A

Renal pyramids

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44
Q

What does the renal pyramids contain?

A

Nephrons (50000)

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45
Q

What gives pyramids their striped appearance?

A

Regularly arranged nephrons

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46
Q
A
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47
Q

How does urine drain from kidney?

A

Nephrons collecting duct –> Minor calyx –> major calyx –> renal pelvis –> ureter

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48
Q

Anatomical sites of constriction in the urinary tract?

A

Pelviureteric junction

Ureter

Ureteric orifice

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49
Q
A
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50
Q

What are common iliac arteries branches of?

A

Abdominal aorta

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51
Q

What can cause obstruction of ureter?

A

Internal (e.g. impacted calculus or blood clot)

External (e.g. expanding mass (tumour))

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52
Q

What do ureter walls contain?

A

Smooth muscle

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53
Q

Urinary tract response to obstruction?

A

Increased peristalsis proximal to site of obstruction

Peristalsis comes in waves -> pain that comes and goes/ colicky

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54
Q

How do ureters enter pelvis?

A

Ureters pass from retroperitoneum, through false pelvis and into true pelvis

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55
Q

False pelvis?

A

From iliac crests to pelvic inlet

Part of abdominal cavity

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56
Q

True pelvis?

A

(Pelvic cavity)

Pelvic inlet to pelvic floor

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57
Q

Where is bladder found?

A

Pelvic cavity

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58
Q

Pelvic floor muscles?

A

Levator ani (pelvic diaphragm)

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59
Q

Where does urethra pass through?

A

Urethra passes through pelvic floor into perineum

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60
Q

Openings in pelvic floor?

A

Distal parts of alimentary, renal and reproductive tracts pass through

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61
Q

Where is the pelvic floor?

A

From pelvic cavity into perineum

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62
Q

Perineum?

A

Shallow compartment between pelvic floor and skin

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63
Q

Where do the ureters pass to enter pelvis?

A

Ureters pass anterior to common iliac vessels to enter pelvis

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64
Q

Where do the ureters pass to enter bladder?

A

At level of ischial spine, ureters turn medially to enter posterior aspect of bladder

65
Q

How can the route of the ureters be described?

A

Sub peritoneal (below peritoneal cavity)

66
Q

In what direction to the ureters enter the posterior bladder wall?

A

Inferomedial direction

67
Q

Male rectovesicle pouch?

A

Forms between rectum & bladder

Most dependent part of peritoneal cavity (deepest) when in anatomical (standing upright) position

68
Q

Anatomical relations of pelvic ureters in female?

A

Ureter runs inferior to uterine tubes and uterine artery

69
Q

Anatomical relations of pelvic ureters in male?

A

Ureter runs inferiorly to vas deferens

70
Q

Vasculature in females?

A

Vesical arteries -> bladder

Uterine artery-> uterus

Middle rectal artery -> part of rectum

Vaginal artery -> vagina

71
Q

Vasculature in males?

A

Vesical arteries -> bladder

Middle rectal artery -> part of rectum

Prostatic arteries (often branches of vesical arteries) -> prostate gland

72
Q

Common iliac arteries?

A

2 large arteries which originate from aortic bifurcation at level of 4th lumbar vertebra

They end in front of sacroiliac joint

Each bifurcates into external and internal iliac arteries

73
Q

Ureteric orifices?

A

L & R ureteric orifices are openings in which bladder will receive urine from ureters

74
Q

What is the interal urethral orifice?

A

Below ureteric orifice

Opening of bladder into urethra

75
Q

Where are ureteruc orifices situated?

A

In base (posterior aspect) of bladder

76
Q

Where is internal urethral orifice situated?

A

On inferior aspect (floor) of bladder

77
Q

Trigon of bladder?

A

Triangle between 3 openings

78
Q

Which muscle forms bulk of bladder wall?

A

Detrusor muscle

79
Q

Detrusor smooth muscle fibers encircle ureteric orifices

These muscles also contract when bladder contracts -> closes off the ureteric orifices and prevents reflux of urine back up and into ureters

A
80
Q

What does detrusor muscle form around neck of male bladder?

A

Internal urethra sphincter muscle

81
Q

Function of internal urethra sphincter muscle in males?

A

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

82
Q

In males what is the common tube for urine and semen

A

Urethra

83
Q

What is the most anterior organ ltying posterior to pubic bone in females?

A

Bladder (when empty)

84
Q

In females where does body of uterus lie in relation to bladder?

A

Superior

85
Q

What separates bladder and body of uterus?

A

Uterovesicle pouch

86
Q

What is the most anterior organ lying posterior to pubic bone in males?

A

Bladder (when empty)

87
Q

Where does prostate gland lie in relation to bladder?

A

Inferiro

88
Q

Where does rectum lie in relation to bladder?

A

Posterior

89
Q

Most dependent pouch of peritoneal cavity in male?

A

Rectovesicle pouch

90
Q

Where does an empty bladder lie and what happens when bladder fills?

A

Empty bladder lies within true pelvis

When bladder starts to fill -> extends superiorly and can leave true pelvis and enter false pelvis (part of abdominal cavity)

91
Q

Which part of bladder wall is in contact with peritoneum?

A

ONLY the superior part of bladder wall

92
Q

In what position does uterus sit on top of empty bladder?

A

Anti- flexed

93
Q

Path of urine in females?

A

Urine from bladder -> through internal urethral orifice -> into urethra

Female then relaxes external urethral sphincter (voluntary skeletal muscle) -> urine exits out through external urethral orifice

No internal urethral sphincter

94
Q

Path of urine in males?

A

Urine passes through internal urethral orifice -> passes through part of urethra contained within prostate gland (prostatic urethra) -> then through external urethral sphincter (relaxes) -> urine passes into spongy urethra (within corpus spongiosum (in penis)) -> urine exits through external urethra orifice

95
Q

Where is sperm produced?

A

In seminferous tubules in testes which are in scrotum

96
Q

Where is sperm stored?

A

Epididymis

97
Q

Embryological development of tested?

A

Testes move from their original position in the posterior abdomen, through the inguinal canal to the scrotum

98
Q

Spermatic cord?

A

A collection of structures which support the functioning of the testis (testicular artery, testicular vein, vas deferens, lymphatic vessels draining testis, nerves (autonomic for smooth muscle of vas) and somatic (for cremaster muscle

99
Q

Inside scrotum where do testes sit?

A

Within sac called tunica vaginalis

100
Q

Main articular supply to testicle?

A

Testicualr artery

101
Q

Pampiniform venous plexus?

A

Plexus of veins which wraps itself around testicular artery to drain deoxygenated venous blood from testicle

102
Q

Where do right & left testicular ateries arise?

A

From abdominal aorta

103
Q

Venous drainage of right testicular vein?

A

Right testicular vein drains right testicle directly back to right inferior vena cava

104
Q

Venous drainage of left testicular vein?

A

Drains left tesicle back to left renal vein

105
Q

Route of vas deferens?

A

Vas deferens pass superiorly within spermatic cord

Then enters inguinal canal via superficial ring outlined

Pass through inguinal canal and exit via deep inguinal ring

Then within abdominal cavity

Pass posterior to bladder

106
Q

Where does ureter pass in relation to vas deferens?

A

Posteriorly

107
Q

Prostatic ducts?

A

Through which glandular secretions from prostate gland drain into prostatic urethra

108
Q

Prostate gland?

A

Walnut sized

Surrounds prostatic urethra

109
Q

Zones of prostate?

A

Peripheral

Central (internal)

110
Q

What does penis consist of?

A

Root

Body

Glands

Opening (external urethral orifice)

Superficial and deep fascia

Erectile tissue (corpus spongiosum, R&L corpus cavernosum)

111
Q

Corpus spongiosum?

A

Transmits spngy urethra and expands directly to form glans

112
Q

Arterial blood supply to penis?

A

Deep arteries of penis

Branch of internal pudendal artery which is a branch of internal iliac

113
Q

Blood supply to scrotum?

Dual origin (internal and external iliac arteries)

From internal pudendal and branches from external iliac artery

A

Dual origin (internal and external iliac arteries)

From internal pudendal and branches from external iliac artery

114
Q

Lymphatic drainage of scrotum and penis?

A

Lymph from scrotum and most of penis drains to superficial inguinal lymph nodes

115
Q

Lymphatic drainage of testis?

A

Drains to lumbar nodes around abdominal aorta

116
Q

Somatic sensory nerves?

A

Sensations from the body wall (soma) i.E. Our external environment are conveyed to the CNS by nerve fibres called “somatic sensory” nerve fibres

117
Q

Visceral afferent nerve fibers?

A

Sensations from our organs i.E. Our internal environment are conveyed to the CNS by nerve fibres called “visceral afferent” nerve fibres

118
Q

Somatic motor nerve fibers?

A

Motor responses to our body wall (soma) i.e. our external environment are conveyed from the CNS by nerve fibres called “somatic motor” nerve fibres and stimulate skeletal (voluntary) muscles to contract

119
Q

Motor responses to organs are conveyed from CNS by which nerve fibers?

A

Parasympathetic and sympathetic nerve fibers

120
Q

Which nerve fibers control ureteric peristalsis?

A

Sympathetic/ parasympathetic

121
Q

Which nerve fibers control bladder contraction?

A

Sympathetic/ parasympathetic (internal sphincter)

Somatic motor (external sphincter & levator ani)

122
Q

Which nerve fibers associated with pain from kidneys, ureters, bladder?

A

Visceral afferent

123
Q

Which nerve fibres associated with pain from urethra?

A

Visceral afferent (in pelvis)

Somatic sensory (in perineum)

124
Q

Which nerve fibers associated with pain from testes?

A

Visceral afferent (somatic presentation also)

125
Q

Nerve fibers responsible for voluntary control of elimination of urine from bladder?

A

Sympathetic

Parasympathetic

Somatic moto

Visceral afferent

126
Q

Lumbar and sacral (motor & sensory) nerve fibers associated with perineum and lower limbs?

A

Somatic sensory & somatic motor

127
Q

How do sympathetic nerve fibers leave CNS?

A

Only within the spinal nerves between spinal cord levels T1-L2 (“thoracolumbar outflow”)

128
Q

How do sympathetic fibers reach smooth muscle/ glands of body wall?

A

Within spinal nerves

129
Q

How do sympathetic nerve fibres reach smooth muscle/ glands of body other than body wall?

A

Within nerves called splanchnic nerves – cardiopulmonary or abdominopelvic

130
Q

How do sympathetic nerve fibers reach glands of the head?

A

By following (“hitching a ride with”) the arteries which supply the same structures

131
Q

How do sympathetic nerve fibers get from CNS to kidneys, ureters and bladder?

A

Leave the spinal cord approx. between levels T10 and L2

Enter the sympathetic chains (bilaterally) but do not synapse

Leave the sympathetic chains within abdominopelvic splanchnic nerves

Synapse at the abdominal sympathetic ganglia which are located around the abdominal aorta

Postsynaptic sympathetic nerve fibres pass from the ganglia onto the surface of the arteries which are heading towards the organs they need to innervate.

132
Q
A
133
Q

How do parasympathetic fibers leave CNS?

A

Only within 4 cranial nerves and the sacral spinal nerves (“craniosacral outflow”)

134
Q

How do parasympathetic fibres reach smooth muscle/ glands of head and body?

A

Via cranial nerves

135
Q

How do parasympathetic fibres reach the smooth muscle/glands of the hindgut and pelvic organs?

A

Via pelvic splanchnic nerves

136
Q

How do parasympathetic nerve fibres get from CNS to kidneys and ureter?

A

Carried within the vagus nerves (CNX)

137
Q

How do parasympathetic nerve fibres get from CNS to bladder?

A

Carried within pelvic splanchnic nerves

138
Q

How do somatic motor nerve fibres get from CNS to kidneys, ureters and bladder?

A

THEY DON’T

Somatic fibres only go to body wall structures

139
Q

Where do somatic fibres go in renal system?

A

Parts of perineum e.g. urethra and its sphincter (external urethral sphincter and levator ani)

140
Q

Above levator ani muscle?

A

Pelvis

141
Q

Below levator ani muscle?

A

Perineum

142
Q

Where is kidney pain felt?

A

Loin

Posterior aspect of flank region on affected side

143
Q

Pain from bladder?

A

Suprapubic region (midline)

144
Q

Pain from obstruction of ureter?

A

Radiating from “loin to groin” on affected side

145
Q

Pain from perineal part of urethra?

A

Localised in perineum

146
Q

How do visceral afferent nerve fibres get from kidneys to CNS?

A

Visceral afferents from the kidneys run alongside sympathetic fibres back to the spinal cord

They enter the spinal cord approx. Between levels T11 and L1

147
Q

How do visceral afferent nerve fibers get from ureters to CNS?

A

Visceral afferents from the ureters run alongside sympathetic fibres back to the spinal cord

They enter the spinal cord between levels T11 and L2

148
Q

How do visceral afferent nerve fibres get from part of bladder touching peritoneum to CNS?

A

Visceral afferents carrying pain from that part of the bladder which touches the peritoneum (superior part) run alongside sympathetic fibres back to the spinal cord

They enter the spinal cord between levels T11 – L2 and the pain is perceived by the patient as suprapubic pain (midline)

149
Q

How do visceral afferent nerve fibres get from part of bladder not touching peritoneum to CNS?

A

Visceral afferent fibres from the rest of the bladder (that not touching the peritoneum) run alongside the parasympathetic nerve fibres back to spinal cord levels S2,S3, S4

150
Q

Visceral afferent nerve fibers?

A

Conduct sensory impulses (pain or reflex) from internal organs, glands, blood vessels to central nervous system

151
Q

How do visceral afferent and somatic sensory nerve fibres get from proximal urethra to CNS?

A

Run alongside the parasympathetic nerve fibres back to spinal cords levels S2,S3,S4

152
Q

How do visceral afferent and somatic sensory nerve fibres get from non proximal part of urethra to CNS?

A

carried within the pudendal nerve also back to spinal cord levels S2,S3,S4

153
Q

How do pain fibres get from testis to CNS?

A

Visceral afferents run alongside sympathetic fibres back to the spinal cord to levels T10-11

154
Q

Which nerve fibers are key in controlling micturition (urine flow)?

A

Nerve fibers entering and leaving spinal cord at S2-S4

155
Q

Control of detrusor muscle contraction?

A

parasympathetic

156
Q

Internal urethral sphincter control?

A

Parasympathetic

157
Q

Control of external urethral sphincter and levator ani muscles?

A

Somatic motor

158
Q

Control of external urethral orifice?

A

Somatic motor nerve fibres

Renal (3 decks)

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