Anatomy/Histo Review Flashcards
Describe the anterior to posterior arrangement of the 3 things in the hilum of the kidney.
Anterior to Posterior:
Renal Vein
RenalArtery
Renal Pelvis
The hilum of the kidney is at what vertebral level?
L1 (Transpyloric plane)
What ribs are associated with the right and left kidneys? Why are they different? Which one is palpable?
Right Kidney = 12 rib
Left Kidney - 11,12 ribs
The right kidney is located a little lower than the left, so it is palpable.
At what vertebral levels are the superior and inferior kidney borders?
Superior border: 12 rib
Inf. Border: L3
Which is closer to the kidney… parArenal fat or perIrenal fat?
Perirenal fat.
the “I” is inside the fascia
What is Nephroptosis?
Dropped kidney –> Occurs with abnormally mobile kidneys, and one just drops into the pelvic cavity.
Anatomically associated with a loose, kinked ureter.
Clinically associated with intermittent pain in the renal area due to the force of stretch on the renal arteries. Pain usually relieved by lying down.
Referred pain from the kidney goes to the supra-pubic area. Why?
What nerves run along the posterior abdominal wall behind the kidney?
Subcostal
Ilioinguinal
Iliohypogastric
Which renal vein is longer? What artery does it run under?
The left renal vein is longer, and it runs beneath the SMA.
Name some symptoms of Nutcracker syndrome.
“bag of worms” in the left testicle (because the left testicular vein runs directly to the Left renal artery.
Hematuria/Proteinuria
Left flank pain
Sympathetic innervation of the kidney comes primarily from which nerve?
Least thoracic splanchnic (T12)
Via which nerve does the kidney get parasympathetic innervation?
Vagus (X)
Lymphatic drainage from the kidney goes where?
Lateral Lumbar or Lateral Caval nodes near the origin of the renal artery and vein
Your patient has one large renal cyst. What do you do now?
Aspirate it and leave it alone. Single renal cysts are generally asymptomatic, and rarely cause renal dysfx.
Don’t confuse with POLYCYSTIC KIDNEY DISEASE –> inherited autosomal disorder with enlarged, cystic kidneys. Disruption of the collecting tubules causes kidney failure.
Name some symptoms of renal calculi.
Kidney stones.
Severe intermittent pain Hematuria Inability to urinate if flow blocked Pain in kidney or genitals Digestive issues
Most common tumor of the kidney
Renal Cell Carcinomas
Develop from the proximal tubular epithelium.
Weird because they grow out FROM the kidney into the fat, fascia, and vein.
Venous extension is rare for any tumor, and a distinctive trait of Renal Cell Carcinoma.
Where is a transplant kidney attached in the recipient’s body?
The renal A and V are joined to the EXTERNAL ILIAC artery and vein, and the ureter is sutured to the bladder.
It nests in the iliac fossa.
What are the 3 stages of embryonic kidney development?
Pronephros - never functions in humans and regresses quickly
Mesonephros - second kidney that functions till the final kidney can (late 1st trimester) - has a duct that empties into the cloaca.
Metanephros - final kidney. 2 parts: URETERIC BUD and the BLASTEMA (Metanephric Mass).
Both these parts are required for kidney development.
What does the ureteric bud become in the final kidney?
Drainage system: ureter, renal pelvis, major and minor calyces, collecting tubules.
WHat does the blastema form in the final kidney?
Filtration system: The renal cortex and medulla.
ALL THE NEPHRONS (functional unit of kidney)
What does the mesonephros become in men? women?
The mesonephros becomes part of the male genital tract.
It regresses in the female and becomes nothing.
The final kidney is functional at how many weeks into pregnancy
10
What are these things:
- Unilateral Renal Agenesis
- Hypoplastic Kidney
- Supranumerary Kidney
- Unilateral Renal Agenesis occurs when the ureteric bud and the blastema fail to develop or integrate with one another on one side.
- Hypoplastic kidney is a small kidney that is architecturally normal. Same density of nephrons, just tiny.
- Supranumerary Kidney results from SPLITTING OF THE BLASTEMA –> too many kidneys form.
Bilateral renal agenesis is called….
potter’s syndrome.
Fatal –> oligohydramnios (low volume of amniotic fluid)
How do you distinguish a dropped kidney from an ectopic kidney?
The ureter will be floppy and stretched in a dropped kidney, but normal and taut in an ectopic kidney (shorter).
Horseshoe kidney gets stuck on which artery as it tries to ascend to its normal anatomical position?
IMA
at the level of the lower lumbar vertebrae
What is the mechanism behind….
- Double ureter
- Ectopic Ureter
- Double Ureter - splitting of the ureteric bud
2. Ectopic Ureter - 2 ureteric buds, one normal, and one going somewhere wrong like the vagina or the urethra
The ureter runs along which muscle?
Psoas major
Describe the water under the bridge relationship.
In males, the ureter runs beneath the vas deferens
In women, the ureter runs beneath the uterine artery
In males, the neck of the bladder is immediately superior to ______________, which is why older men may develop incontinence.
The prostate is immediately inferior to the neck of the bladder.
What are the 3 sites a kidney stone can lodge?
- Junction of ureter with the renal pelvis
- Pelvic brim
- bladder wall
