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Block 2 Week 4 > Anatomy Kidney and Urinary System > Flashcards

Anatomy Kidney and Urinary System Flashcards

1
Q

The gut tube grows into the (blank)

A

abdominal coelomic cavity

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2
Q

Certain structures stay outside of the mesentery of the coelomic cavity and these are said to be (blank)

A

retroperitoneal

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3
Q

Kidneys start and end (blank)

A

retroperitoneal

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4
Q

What becomes the peritoneal layer that lines the gut tube?

A

splachnic mesoderm

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5
Q

Kidneys develop behind the (blank) from the (blank)

A

peritoneal sac

urogenital ridge

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6
Q

Is there anything in the periotoneal sac?

A

NO!

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7
Q

The urinary system (kidneys, ureters) the aorta, the adrenal glands, posterior abdominal walls and the IVC are all where?

A

in the retroperitoneal space

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8
Q

Where are the liver, stomach, and spleen located?

A

the intraperitoneal space

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9
Q

What is a good way to access the kidneys?

A

posterior abdominal wall

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10
Q

What attaches organs to posterior abdominal wall?

A

peritoneal ligaments

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11
Q

(blank) is a sheet of pearly-white fibrous tissue that takes the place of a tendon in sheetlike muscles having a wide area of attachment.

A

aponeurosis

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12
Q

What is the pearly white diamond of connective tissue that is located at the thoracic lumbar region of the back?

A

the thoracolumbar aponeurosis

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13
Q

What gives rise to muscle anteriorly and superiorly around to the front such as the latisimus doris?

A

the thoracolumbar aponeurosis

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14
Q

What is an upper limb muscle that we need to be aware of because of its size and position obscuring the posterior approach to the kidneys?

A

latissimus dorsi

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15
Q

If you reflect the latissimus dorsi what will be underneath?

A

External and internal obliques.

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16
Q

Why are the external and internal obliques orthogonal to each other?

A

to provide strength

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17
Q

The muscles that are important for getting to the kidney are what and what is there direction?

A
  • Latissimus Dorsi
  • External abdominal oblique muscles are extending medially and anteriorly, downward,
  • Internal abdominal oblique muscles are extending medially, anteriorly and upwards.
  • transversus abdominis wraps around posteriorly and takes origin from the thoracolumbar aponeurosis
  • Quadratus Lumborum
  • psoas muscle
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18
Q

What muscles does the thoracolumbar aponeurosis give rise to?

A

internal oblique, external obliques, latissimus dorsi, transversus abdominis

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19
Q

Do you ever encounter some anterior abdominal wall muscles that have posterior origins or insertions?

A

yes, like the external and internal abdominal obliques and transversus abdominis

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20
Q

A final abdominal wall muscle, the (blank) is seen as the deepest of the three (latissimus dorsi, external and internal obliques), also having an extensive origin from the posterior side of the thoracolumbar aponeurosis

A

transversus abdominis

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21
Q

What are the three anterior wall muscles you need to cut through to get to the kidney?

A

internal oblique
external oblique
transversus abdominis

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22
Q

What are the 2 posterior wall muscles you need to cut through to get to the kidney?

A

Latissimus dorsi, quadratus lumborum

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23
Q

What has the kidney line partly on this muscle. This is a very deep muscle underneath the anterior abdominal wall muscles and runs from illiac crest to 12th rib.

A

Quadratus lumborum

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24
Q

What is a large muscle forming a good deal of the posterior abdominal wall?

A

quadratus lumborum

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25
Q

Where does the quadratus lumborum extend form and to?

A

from iliac crest to the 12th rib

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26
Q

What is the top of your pelvis bone called?

A

illiac crest

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27
Q

What is right above the illiac crest?

A

quadratus lumborum

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28
Q

Which kidney is lower, the right or left?

A

the right

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29
Q

The kidney is laying right over the (blank) and a little bit of the (blank)

A

quadratus lumborum

psoas muscle

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30
Q

The lower pole of the kidney sits right above the (blank).

A

illiac crest

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31
Q

The kidneys are surrounded by both (blank) and (blank).

A

peri and para renal fat.

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32
Q

The kidneys are enclosed in a (blank), which is basically an extension of the outer covering of the renal vessels and situated posterior to the peritoneum.

A

the renal fascia

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33
Q

Where is the renal fascia situated?

A

posterior to peritoneum

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34
Q

Is perirenal or pararenal fat next to the kidney and in between the renal fascia?

A

perirenal fat

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35
Q

IS the right kidney covered by the 11th rib?

Is the left kidney?

A

no, only 12th

Yes the 11th and 12th.

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36
Q

The adrenal glands sit on top of the kidney and the (blank) slips between them.

A

renal fascia and perirenal fat

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37
Q

Are the adrenal gland and the kidney developed together?

A

no! they are not related at all!!

38
Q

Where is fat most extensive on a kidney?

A

posteriorly

39
Q

Where do kidneys develop and how?

A

in the pelvis and they ASCEND to their adult positions

40
Q

As kidneys ascend what do they establish?

A

new blood supplies (old blood supplies deteriorate) to eventually become renal artery

41
Q

Do kidneys move with inspiration?

A

yes (2-3cm)

42
Q

What are extra arteries due to miscommunication upon ascent of the kidney?

A

polar and accessory arteries

43
Q

The renal arteries come off the (blank) near the superior mesenteric artery.

A

aorta

44
Q

What does the renal artery divide into?

A

anterior and posterior segmental branches as they reach the hilum

45
Q

How many branching arteries come off of the posterior and anterior segmental branches of the kidney?

A

3-5

46
Q

Segmental branches supply a (blank) area

A

resectable

47
Q

There may be polar branches on either pole due to (blank)

A

developmental differences

48
Q

Which kidney has a longer renal artery?
Which kidney has a longer renal vein?
WHY?

A

the right side
the left side
Due to the arrangement of the aorta and the IVC (IVC is on right side so it has to travel farther to the left etc.)

49
Q

Inside of the renal hilum there is a fat filled cavity called a (blank)

A

renal sinus

50
Q

All vessels entering and leaving a kidney do so via the (blank)

A

hilum

51
Q

Where will the ureter continue to branch out into major and minor calyces? Where will blood vessels continue to branch out?

A

Renal sinus

Renal sinus

52
Q

Renal arteries also give a branch off to what?

A

the adrenal gland and ureter

53
Q

What has an extensive blood supply, getting blood from the renal artery, directly from the aorta, and from the inferior phrenic artery?

A

the adrenal gland

54
Q

Why does the adrenal gland need so much blood?

A

its an endocrine gland

55
Q

Why do ureters have blood supplies from numerous areas?

A

cuz they are so long

56
Q

The renal vein drains to the (blank)

A

IVC

57
Q

The left renal vein is longer and is located where?

A

posterior to the superior mesentaric artery (cuz it has to cross aorta to reach the IVC)

58
Q

Why is it relevant to know that the left renal vein is located posteriorly to the superior mesentaric artery?

A

Obstruction of this artery could compress this left renal vein

59
Q

The left renal vein has numerous branches to what structures?

A

diaphragm, pelvis, left gonadal vein and ascending lumbar vein which connects with azygos system (important for preventing blood backup in left testicle)

60
Q

What has a connecting with the azygos system?

A

Left renal vein! (so if you compress left renal vein you arent really in trouble because blood can still be drained to heart via azygos system)

61
Q

The right gonadal vein drains where?

A

directly to the IVC (unlike the left which goes to left renal vein)

62
Q

Where do all the collecting ducts come together?

A

At the papilla of the renal pyramid

63
Q

the renal pelvis is surrounded by lots of (blank)

A

fat (renal sinus)

64
Q

Where does the ureter get its blood supply?

A

renal, gonadel, vesicular arteries (long course into pelvis into bladder)

65
Q

What are the three sites of potential narrowing of the ureter?

A

1: transition from pelvis to ureter
2: pelvic brim
3: entrance into the bladder

66
Q

The entrance into the bladder is (blank) to prevent backflow of urine as the bladder pressure rises.

A

diagonal (oblique)

67
Q

DOes the ureter have a sphinctor?

A

no

68
Q

Ureters are very strong and muscular, why?

Do they have a significant nerve supply?

A

so they can overcome any pressure in the bladder

Yes (lots of afferents)

69
Q

sympathetics to the kidneys come from where?

A

Sympathetics to the kidneys come from the lesser (T10-11) and least (T12) thoracic splanchnics. And contributions from the first lumbar splachnics (L1)

70
Q

Where do the least and lesser splachnics synpase?

A

the aorticorenal ganglion and on ganglia near the renal artery.

71
Q

What is the major function of nerve supply to the kidneys?

A

changing blood flow

72
Q

The nerves supply to the kidney comes down through the (blank) nerves (greater less and least thoracic splachnics) which are presynaptic until they get to the (blank) where they synapse and distrubute along the plexus to the kidney.

A

splachnic

preaortic/preverterbal ganglia (aortic/ mesentaric/ renal)

73
Q

In addtion to supplying the kidney, some postsynaptic fibers will send fibers on the the (blank). What lumbar nerves will be on the ureter? .

A

ureter

L1 and L2

74
Q

Are there afferents coming back on the Ans fibers that go to the ureter? A:

A

YES! (parasympathetics and sympathetics) The difference on afferents will be quality of pain (sympathetics will be local and pain and parasympathetics will be responsible for reflexes).

75
Q

Because ANS sympathetic fibers come from many different places the quality of pain that will come back from these fibers can synapse on levels of T10-L2. So the ureter the affarant fibers coming back on these sympathetic fibers can come from as has high as T10 and low as L2 but the lower part of the ureter has even different localization. What is the bottom line of these statements?

A

Pain that is coming back from the ureter can synapse at many different levels.
resulting in referred pain at many different places

76
Q

Fibers to the kidney all come as (blank) and then synapse on ganglias

A

presynaptic

77
Q

Where are the lesser and least splachnic nerves coming from on the spinal cord?

A

T10-L1

78
Q

Where is the lesser thoracic splachnic nerve synpasing?

A

aorticorenal ganglion

79
Q

Where is the least thoracic splachnic nerve synapsing?

A

renal artery plexus/ganglion

80
Q

What parasympathetic fibers innervate the ureter and the kidney?

A

Vagus (preganglionics) and form pelvic splachnics S2,3,4 that travel up hypogastric plexus

81
Q

Pain referring from the kidneys and upper ureters can refer to dermatomes from (blank) . The location of referred pain from a kidney stone can descend as the stone passes lower in the system.

A

T10-L2

82
Q

Because the urinary system (kidney and ureter) referes from T10-L2 so you will have wide distribution of (BLANK)

A

where you will feel pain.

83
Q

What kind of gland is the adrenal gland?

A

endocrine (cortex) and neuroendocrine (medullary)

84
Q

What are the three major blood supplies to the adrenal gland?

A

superior suprarenal off inferior phrenic
middle suprarenal off aorta
inferior suprarenal off the renal

85
Q

What are the veins on the adrenal gland?

A

you have a single vein to the IVC on the right adrenal gland

you have a single vein to the renal vein on the left adrenal gland

86
Q

If you see a CT scan where you can see the right kidney before you see the left, what does this tell you?

A

that the left kidney is longer so PROBLEM!

87
Q

What is the only autonomic pathway with just one neuron?

A

the adrenal gland

88
Q

(blank) fibers innervated secretory cells of the adrenal medulla

A

preganglionic sympathetic fibers

89
Q

Fibers come off the (blank) either before (goes directly to adrenal medulla) or after the ciliac plexus (through plexus and then into adrenal medulla, no synapse) and distribute to the adrenal medulla . However some fibers do synapse in the ganglion (become post-ganglionic) if they are going where?

A

greater thoracic splachnic nerves

the cortex and blood vessels

90
Q

When the sympathetic fibers to the adrenal medulla synapse in them what do they synapse on?

A

endocromial cells that secrete epinephrine and norepinephrine->released into blood stream to the rest of body.

91
Q

So when you think adrenal medulla what do you think?

When you think adrenal cortex or adrenal blood vessels what do you think?

A

preganglionic

postganglionic

92
Q

Neuroendocrine cells get a (blank) neuron all the way down into them.

A

single (i.e they dont have post-ganglionics cuz the endocromial cells pass the message on instead)

Block 2 Week 4 (7 decks)

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