Anatomy book - renal/urology Flashcards
Why does a renal carcinoma tend to present at a late stage rather than an early stage?
a space occupying lesion in the kidney will not cause symptoms in early stages as no closely related structures will be affected by growth
kidney innervation = autonomic, few sensory fibres, small lesion not detected
How does the anatomy of the kidney allow for a portion of the kidney to be removed rather than removal of the whole organ?
kidneys develop embryologically as lobular structures and blood supply is dictated by this development
Which lymph nodes does a renal cell carcinoma spread to first?
renal and caval lymph nodes
If haematogenous metastases occur in RCC< which structure would likely be affected first?
lungs
tumour will invade renal veins and then the IVC and will pass through the heart and to the lungs
How does the anatomy of the left and right renal veins differ? How does this affect the likelihood of haematogenous metastatic spread?
right renal vein shorter
less distance to travel for RCC to spread haematogenously
Why do the anterolateral and superior walls of the bladder have a folded nature?
to allow for distension of the bladder
What is the function of the detrusor muscle?
contract bladder wall during voiding
Where is the detrusor muscle located?
anterolateral and superior walls of the bladder
What is the functional reason for the angle at which the ureters enter the bladder?
create a pseudovalve
preventing reflux of urine to kidneys
What are the 3 most common locations that renal calculi can become lodged in the ureter?
ureteropelvic junction (UPJ)
point where the ureter passes the pelvic brim/external iliac artery
ureterovesical junction
Which structures does the ureter pass as it descends to the bladder?
psoas
common iliac
uterine artery/vas deferens
What physiological/anatomical mechanisms prevent urine backflow?
angle at which ureter enters bladder
expansion of bladder
ureters are long so would take long time for urine to reach kidney
ureter is peristaltic
Which kidney is anatomically higher?
left
Why is renal colic a colicky pain?
peristalsis of ureter
causes a crampy sensation
What is the innervation of the ureter?
autonomic
T11-L1
Where can renal colic pain be referred to?
loin to groin
bottom of ribs (T11)
How can you position the penis to help with catheterisation as the urethra enters the prostate?
gently pull the penis inferiorly
What autonomically controlled structure is at the base of the bladder?
internal urethral sphincter (involuntary control of urinary continence)
What wall of the rectum is the prostate palpated through?
anterior
Which anatomical lobe of the prostate is more commonly associated with malignant changed?
median
Enlargement of which lobe is associated with benign prostatic hyperplasia?
lateral lobes
makes groove feel more pronounced
What substance do seminal vesicles produce?
seminal fluid - fructose-rich, alkaline fluid that provides an ideal environment for spermatozoa
What is the function of the vas deferens?
transport sperm from testes to prostate
sperm will also mature on their journey through vas deferens
Why are hip and lower spine a common site of metastatic spread in prostate cancer?
venous plexus that drains the prostate connects with the venous drainage of the vertebral column
this allows for haematogenous metastatic spread to the spinal column
What is the function of the bulbourethral glands?
to secrete an alkaline mucus substance to lubricate the urethra and contribute to the final volume of semen
What structure is the scrotal ligament a remnant of?
gubernaculum
