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J Renal > ANATOMY (+ a lil bit of embryo and histo shiz) > Flashcards

ANATOMY (+ a lil bit of embryo and histo shiz) Flashcards

1
Q

how much urine does the kidney produce each day

A

1.5 litres

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2
Q

size of kidneys

A

10x5x3cm

size of clenched fist

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3
Q

are the kidneys retroperitoneal or intraperitoneal

A

retroperitoneal

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4
Q

which part of the kidneys is in contact with the peritoneum

A

anterior aspect

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5
Q

what are the layers between the anterior kidney and the peritoneum (starting from the kidney) (5)

A 
renal capsule 
Perinephric fat 
renal/deep fascia 
PARAnephric fat 
visceral peritoneum
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6
Q

what back muscle is directly posterior to the kidneys

A

quadratus lumborum

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7
Q

what back muscle is behind the kidneys but is slightly medial (beside the vertebrae)

A

psoas major

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8
Q

is the abdominal aorta to the left or the right of the IVC

A

left (patients left)

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9
Q

which vein is shorter, the R or L renal vein

A

R renal vein

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10
Q

which artery is shorter, the R or L renal artery

A

L renal artery

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11
Q

the L renal vein is longer, what drains into it that doesnt happen on the R

A

L gonadal vein drains into the L renal vein then IVC

R gonadal vein drains into IVC

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12
Q

vertebral level of R kidney

vertebral level of R kidney hilum

is it higher or lower than the L kidney

A

L1-L3

L2

lower than the L kidney bc the R has the liver on top of it = pushes it down

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13
Q

vertebral level of L kidney

vertebral level of L kidney hilum

is it higher or lower than the R kidney

A

T12-L2

L1 (bc its the left one (L1!!!!))

higher than the R kidney bc the R kidney has the liver on top of it = pushes it down

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14
Q

what is the recess between the right kidney and the liver called

A

hepatorenal recess

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15
Q

which ribs protect (and have potential to bruise) the kidneys

A

ribs 11 and 12

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16
Q

in the renal hilum, are veins or arteries in front

A

veins!!!

must know this

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17
Q

which cant you see from an anterior view; renal arteries or renal veins

A

renal arteries (they are behind the renal veins)

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18
Q

does a supra renal AAA include the renal arteries

A

yes

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19
Q

does a infra renal AAA include the renal arteries

A

no

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20
Q

how many branches of the renal artery are there

A

5

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21
Q

where does lymph from the R kidney drain

A

lumbar lymph nodes on the IVC (bc its closer)

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22
Q

where does lymph from the L kidney drain

A

lumbar lymph nodes on the abdominal aorta (bc its closer)

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23
Q

anatomical variation

what is it called when the renal pelvis splits in 2

A

bifid renal pelvis

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24
Q

where is the ureter in relation to the renal artery and renal vein

A

behind the renal artery (which is behind the renal vein)

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25
Q

what is the renal capsule made of

A

dense collagen fibres

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26
Q

what is the ‘peak’ of the pyramids in the renal medulla called

A

papillae

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27
Q

how many nephrons do we have in total

A

1 million

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28
Q

what are the 2 types of nephron called

% of both

A 
cortical nephron (80%)
juxtameduallry nephron (20%)
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29
Q

what length is the loop of henle in cortical nephrons compared to juxtameduallry nephrons

what is the blood supply to the loop of henle

A

shorter

peritubular capillaries

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30
Q

what length is the loop of henle in juxtameduallry nephrons compared to cortical nephrons

what is the blood supply to the loop of henle

A

longer = go further into medulla = produce more conc urine

vasa rectae

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31
Q

what is the blood supply into the glomerulus

A

afferent arteriole

travels Away from artery

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32
Q

what is the blood supply leaving the glomerulus (gives rise to vasa rectae OR peritubular capillaries)

A

efferent arteriole

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33
Q

what is the capsule around the glomerulus called

A

bowmans capsule

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34
Q

what are the 2 poles of the renal corpuscle (glomerulus and bowmans capsule)

A

vascular pole

urinary pole

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35
Q

what is the region between the distal convoluted tubule and the glomerulus it came from called

A

juxtaglomerular apparatus

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36
Q

what are the ‘salt sensor’ cells in the juxtaglomerular apparatus called

where are they

A

macula densa cells

distal convoluted tubule

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37
Q

in the juxtaglomerular apparatus, what do the juxtamedullary/granular cells do

where are they

A

secrete renin for RAAS

afferent arteriole

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38
Q

where are the mesangial (lacis) cells in the juxtaglomerular apparatus

A

between the macula densa cells (distal convoluted tubule) and juxtaglomerular cells (afferent arteriole)

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39
Q

route of urine after nephron (11)

A 
renal papillae (apex of medullary pyramid) 
minor calyx
major calyx
renal pelvis 
ureter 
ureteric orifices in trigone of bladder 
internal urethral orifice 
internal urethral sphincter (in males)
urethra 
external urethral sphincter
external urethral orifice
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40
Q

on xray, what are the ureters in line with

A

transverse processes of spine

41
Q

points of constriction of ureters (3)

A 
pelviureteric junction (between renal pelvis and ureter) 
crossing of common iliac artery bifurcation (into internal and external)  
ureteric orifice (opening into bladder trigone)
42
Q

where are the ureters in relation to uterine tubes and uterine artery in women

A

inferior (deep?)

‘water under the bridge’

43
Q

what is it called when you have 2 ureters on 1 side, but they join to become one before the bladder

A

bifid ureter

44
Q

what is it called when you have 2 separate ureters (dont join) on 1 side

A

duplicated ureter

45
Q

when the bladder fills with urine, which direction does it expand

A

superiorly

46
Q

is the bladder in the peritoneum

A

no

47
Q

which surface of the bladder is covered in peritoneum

A

superior

48
Q

pouch between the rectum and the uterus in women

A

rectouterine pouch (of douglas)

49
Q

pouch between the bladder and the uterus in females

A

uterovesical pouch

50
Q

pouch between the bladder and the rectum in males

A

rectovesical pouch

51
Q

what is the muscle in the bladder

what is its nerve supply

A

detrusor muscle S2-S4

52
Q

3 points that make the triangle of trigone in the bladder

A

2 ureteric orifices superiorly

1 internal urethral orifice inferiorly

53
Q

where is the base of the bladder

what is in it

A

posterior

2 ureteric orifices

54
Q

where does lymph from the bladder drain to (1)

A

sacral nodes

55
Q

where does lymph from the ureters drain to (2)

A

lumbar or iliac nodes

56
Q

blood supply to bladder

A

vesical arteries

57
Q

what type of epithelium is in the proximal urethra

A

transitional epithelium

58
Q

what type of epithelium is in the distal urethra

A

stratified squamous epithelium

59
Q

name of urethra after its passed through the prostate

A

prostatic urethra

60
Q

name of urethra when its passing through the corpus spongiosum (penis)

A

spongy urethra

61
Q

purpose of internal urethral sphincter (in males only)

A

prevent semen entering bladder during ejaculation

62
Q

internal sphincter (in males) nerve supply

A

parasympathetics and sympathetics (for contraction eg ejaculation)

63
Q

external sphincter (in females and males) nerve supply

A

S2-4 somatic motor

64
Q

which levels do the sympathetic nerves to the renal system come from

A

T10-L2

65
Q

which splanchnic nerve group do they sympathetics form T10-L2 to the renal system leave in

where do they synapse

A

abdominopelvic splanchnic nerves

abdominal sympathetic ganglia

66
Q

parasympathetic supply to the kidneys and ureters

A

CN X

67
Q

parasympathetic supply to detrusor muscle (+ hence internal urethral sphincter in males)

what does it cause

A

S2-S4

relaxation of internal urethral sphincter (in males) = can pee

68
Q

what is the general rule for the somatic sensory innervation of the renal system above the bladder (and including the top of the bladder that is touching the perineum)

what do they travel alongside

A

T11-L2

(kidneys are T11-L1)

travel alongside sympathetics

69
Q

what is the general rule for the somatic sensory innervation of the things below the bladder (including the parts of the bladder that dont touch the perineum)

what do they travel alongside

A

S2-S4

(testes are T10-T11 and travel alongside sympathetics)

travel alongside parasympathetics

70
Q

where does somatic sensory pain from testes go to

A

T10-T11

from embryological origin

71
Q

presentation of kidney pain

A

loin

72
Q

presentation of ureter pain

A

loin to groin

73
Q

presentation of bladder pain

A

dully achy suprapubic

74
Q

presentation of proximal urethra pain

A

suprapubic

75
Q

presentation of distal urethra pain

A

sharp pain in perineum

76
Q

presentation of scrotal pain (2)

A

suprapubic (dermatome bc its T10-T11)

and probs scrotum too bc of close proximity

77
Q

which nerve from the lumbosacral plexus emerges through the psoas major then travels through it

A

genitofemoral nerve L1-L2

78
Q

which BIG nerve (there are others) from the lumbosacral plexus travels lateral to the psoas major

A

femoral nerve L2-L4

79
Q

which nerve from the lumbosacral plexus travels medial to the psoas major (the rest travel through it/lateral to it)

A

obturator nerve L2-L4

80
Q

what does the femoral nerve L2-L4 supply

A

anterior thigh

81
Q

what does the obturator nerve L2-L4 supply

A

medial thigh

82
Q

what does the sciatic nerve L4-S3 supply via its 2 branches (4)

A

posterior thigh
sole of foot
anterior leg
lateral leg

83
Q

which spinal cord region is required in micturition (urination)

via which 3 nerves

A

S2-S4

visceral afferents S2-S4
pelvic splanchnic nerves for parasympathetics (relaxation of sphincter in males)
pudendal nerve

84
Q

what happens to the brain during potty training

A

central inhibition of micturition reflex

85
Q

what happens when the kidney grows without a ureteric bud

A

agenesis (no kidney growth)

86
Q

where do the kidneys originate embryologically

A

pelvis then ascend up

87
Q

in a horseshoe kidney (only 1 kidney), the inferior poles meet and fuse before ascent and get stuck under the …

A

inferior mesenteric artery

88
Q

why might kidneys be in the pelvis

A

failure to ascend (embyrologically are in the pelvis)

89
Q

what is the name for the hindgut endoderm that supplies the primitive urogenital sinus (bladder, pelvic urethra, definitive urogenital sinus)

A

cloaca

90
Q

what type of cells are in between the arterioles in the glomerulus

A

mesangial cells

91
Q

which cells are external to basement glomerular membrane and internal to the bowmans space

A

podocytes

92
Q

histology

what is in the proximal convoluted tubule that isnt in the distal convoluted tubule

how does the luminal margin look bc of this

A

microvilli

fuzzy/less defined brush border

93
Q

what does the distal convoluted tubule look like on histology compared to proximal one

A

straight border (proximal is fuzzy/less defined brush border)

94
Q

what are the 2 main types of epithelium in the nephron (dont bother learning specifics)

A

simple cuboidal and simple columnar epithelium

95
Q

what type of epithelium is in the things after the nephron eg minor calyx, major calyx, ureter etc etc

A

transitional epithelium

96
Q

which cell is associated with transitional epithelium

A

umbrella cells (look like umbrellas)

97
Q

what type of epithelium is in the bladder

A

transitional epithelium

98
Q

what type of epithelium is in the urethras (proximal and distal)

A

proximal - transitional

distal - stratified squamous, stratified columnar (up the top in men)

J Renal (12 decks)

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