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Renal and Urology > anatomy lecture 1; the upper urinary tract > Flashcards

anatomy lecture 1; the upper urinary tract Flashcards

1
Q

what is the urinary tract

A

the anatomical structures through which urine passes through from its production to its excretion

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2
Q

the kidney

A

produces urine

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3
Q

the ureter

A

drains the urine (from kidney to bladder)

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4
Q

the bladder

A

stores and voids the urine

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5
Q

the urethra

A

excretes urine (and semen in males)

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6
Q

clinical definition of the upper urinary tract

A
  • the kidneys (right and left)

- the ureters (right and left)

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7
Q

an upper urinary tract infection can spread to

A

the kidneys

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8
Q

clinical definition of the lower urinary tract

A
  • the bladder (unpaired midline structure)

- the urethra (unpaired midline structure)

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9
Q

A lower urinary tract infection can spread to the

A

urethra and the bladder

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10
Q

where is the urinary tract

A
  • the abdomen= retroperitoneum contains the kidneys and the proximal ureters
  • the pelvis= contains the distal ureters, the bladder and the proximal urethra
  • the perineum= contains the distal urethra
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11
Q

the kidney are what type of organs

A

retroperitoneal and located in the abdominal cavity behind the peritoneum

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12
Q

kidney structure

A
  • superior pole
  • anterior surface
  • inferior pole
  • renal hilum
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13
Q

Structures of the renal hilum

A
  • renal artery
  • renal vein
  • ureters
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14
Q

the kidneys are located

A
  • posterior to there own visceral peritoneum
  • enclosed within the renal fat, fascia and capsule
  • surrounded by skeletal muscles
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15
Q

the visceral peritoneum

A

is most anterior

behind the visceral peritoneum is the paranephric fat, renal fascia, perinephric fat, renal capsule

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16
Q

the kidneys are surrounded by skeletal muscles

A
  • muscles of the posterior abdominal wall= quadrates lumborum
  • muscles of the anteroom-lateral abdominal wall= external oblique, internal oblique, transversus abdominus
  • muscles of the back
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17
Q

muscle guarding

A

can protect the kidneys from trauma

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18
Q

kidneys are located lateral to 4 specific structures what are they

A
  • right kidney is lateral to the inferior vena cava
  • left kidney is located lateral to the abdominal aorta
  • psoas major
  • T12-L3 vertebral bodies
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19
Q

axis CT scan of kidneys structures which you should annotate

A
  • vertebral body
  • muscles of the back
  • abdominal aorta
  • inferior vena cava
  • renal artery
  • renal vein
  • posts major muscles
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20
Q

where exactly are the kidneys?

A

the kidneys lie anterior to the quadratus lumborum muscle and lateral to the posts major muscle

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21
Q

the kidneys lie lateral to the

A

lower thoracic and upper lumber vertebral bodies (T12-L3) but due to the size of then liver the right kidney lies slightly inferior to the left kidney

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22
Q

exact location of right kidney

A

L1- L3

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23
Q

exact location of the left kidney

A

T12-L2

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24
Q

what are the posterior locations of the kidneys

A

floating ribs and 11 and 12

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25
Q

floating ribs 11 and 12 offer

A

some protection to the kidneys from trauma however, if these ribs fracture the sharp end can cause contusion (bruising) or laceration of the kidneys

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26
Q

surface anatomy of the kidneys

A

each kidney can be palpated in the upper quadarant/ flank region respectively

27
Q

clinical examination

A

balloting the kidney

28
Q

a normal kidney is

A

6cm wide, 12cm long, smooth, regular and firm

29
Q

if palpating the right kidney

A
  • palpate posteriorly within the right flank and palpate anterior within the right upper quadrant
30
Q

the liver and spleen

A

lie in contact with the diaphragm superiorly and the superior poles of the kidneys inferiorly, so the kidneys move inferiorly on inspirations and superiorly on expiration

31
Q

as the patient breathes in

A

the kidney descends and can be trapped for palpation

32
Q

right kidney is posterior to

A

the liver (and the hepato-renal recess), the 2nd part of the duodenum, ascending colon and colic flexure

33
Q

left kidney is posterior to

A

the stomach, tail of the pancreas, hilum of the spleen, splenic vessels

34
Q

the hepato-renal recess

A

is one of the deepest part of the greater sac of the peritoneal cavity in the supine patient

35
Q

renal veins are

A

anterior to the renal arteries

36
Q

common iliac arteries are

A

anterior to the common iliac veins

37
Q

most lymph from the kidneys

A

drains into the lumbar nodes located around the abdominal aorta and the inferior vena cava

38
Q

the abdominal aorta bifurcates at the level of the

A

umbilicus

39
Q

arterial supply to the ureter

A

branches from the renal artery, abdominal aorta, common iliac artery, internal iliac artery, the vestal artery (bladder artery)

40
Q

lymph from the ureters drains into the

A

lumbar nodes and the iliac nodes

41
Q

the iliac nodes are located around the

A

common iliac, external iliac and internal iliac vessels

42
Q

when associated with AAA

A

renal artery stenosis may be:

  • combined with an infra-renal AAA both caused by atherosclerosis
  • due to a supra-renal AAA, occlusion of the superior renal artery caused by the aneurysm
43
Q

anatomical variations in the renal system

A
  • bifid renal pelvis
  • bifid ureter and unilateral, duplicated ureters
  • rectocaval urters (ureter cross behind the inferior vena cava)
  • horseshoe kidney (during foetal development the kidneys suffer together)
  • ectopic pelvic kidney (kidney does not ascend during normal foetal development and remains in the pelvis)
44
Q

causes of a solitary kidney

A

agenesis, nephrectomy for a pathology or from donation

45
Q

each kidney consists of an

A

outer corte and inner medulla

46
Q

the inner medulla is made up of

A

renal pyramids

47
Q

each renal pyramids contains

A

50,000 nephrons

48
Q

the regularly arranged nephrons

A

which runs axially towards the apex of each pyramid give the renal pyramids there striped appearance

49
Q

structure of a nephron

A

glomerulus–> proximal convoluted tubule–> loop of henle–> distal convoluted tubule–> collecting duct

50
Q

what happens at the glomerulus

A

ultra-filtration of blood arriving via brashness of the renal artery

51
Q

the collecting duct passes thorough

A

the renal pyramid to drain the modified filtrate into the minor calyx as urine

52
Q

how does urine drain from the kidney

A

collecting ducts of nephrons–> minor calyx–> major calyx–> renal pelvis–> ureter

53
Q

diameter of the drainage tubes

A

continuously increased from collecting ducts to the renal pelvis until it reaches the pelvico-ureteric junction where the wider renal pelvis becomes the narrower ureter

54
Q

anatomical sites of constrictions

A
  1. pelvics-ureteric junctions
  2. ureter crossing the common iliac artery
  3. ureteric orifice= opening of the ureter into one corned of the trigone of the bladder
55
Q

renal calculi (stones)

A

can form from urine calcium slats and obstruct the urinary tract from within, renal calculi tend to be visible on X-ray

56
Q

obstruction of the ureter can be caused by

A
  • internal obstruction caused by renal calculi or a blood clot
  • external compression (from an expanding mass or tumour)
57
Q

the ureter has what in its walls?

A

smooth muscle, therefore if there is an obstruction, peristalsis increase proximal to the site of the obstruction to try and unblock it, as peristalsis comes in waves, this is why people with renal obstruction experiences colicky pain which comes in waves

58
Q

consequences of a urinary obstruction

A
  • obstruction can cause urine to back up in the tract towards the kidneys
  • obstruction within calyxes of ureters causes unilateral back pressure
  • obstruction within the bladder causes unilateral or bilateral kidney problems
  • obstructions to the urethra causes bilateral kidney problems
59
Q

urine production will continue

A

until the pressure within the urinary tract exceeds the pressing favouring filtration in the glomerulus and causes renal failure

60
Q

renal failure mean

A

failure to adequately filter blood to produce urine

61
Q

hydronephrosis means

A

water inside of the kidney

62
Q

hydronephrosis

A

urine back pressure into the calyxes compresses the nephrons within the medullary pyramids and causes renal failure

63
Q

acute hydronephrosis causes

A

painful stretching of the renal capsule

Renal and Urology (51 decks)

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