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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
floating ribs 11 and 12 offer
some protection to the kidneys from trauma however, if these ribs fracture the sharp end can cause contusion (bruising) or laceration of the kidneys
26
surface anatomy of the kidneys
each kidney can be palpated in the upper quadarant/ flank region respectively
27
clinical examination
balloting the kidney
28
a normal kidney is
6cm wide, 12cm long, smooth, regular and firm
29
if palpating the right kidney
- palpate posteriorly within the right flank and palpate anterior within the right upper quadrant
30
the liver and spleen
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
as the patient breathes in
the kidney descends and can be trapped for palpation
32
right kidney is posterior to
the liver (and the hepato-renal recess), the 2nd part of the duodenum, ascending colon and colic flexure
33
left kidney is posterior to
the stomach, tail of the pancreas, hilum of the spleen, splenic vessels
34
the hepato-renal recess
is one of the deepest part of the greater sac of the peritoneal cavity in the supine patient
35
renal veins are
anterior to the renal arteries
36
common iliac arteries are
anterior to the common iliac veins
37
most lymph from the kidneys
drains into the lumbar nodes located around the abdominal aorta and the inferior vena cava
38
the abdominal aorta bifurcates at the level of the
umbilicus
39
arterial supply to the ureter
branches from the renal artery, abdominal aorta, common iliac artery, internal iliac artery, the vestal artery (bladder artery)
40
lymph from the ureters drains into the
lumbar nodes and the iliac nodes
41
the iliac nodes are located around the
common iliac, external iliac and internal iliac vessels
42
when associated with AAA
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
anatomical variations in the renal system
- 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
causes of a solitary kidney
agenesis, nephrectomy for a pathology or from donation
45
each kidney consists of an
outer corte and inner medulla
46
the inner medulla is made up of
renal pyramids
47
each renal pyramids contains
50,000 nephrons
48
the regularly arranged nephrons
which runs axially towards the apex of each pyramid give the renal pyramids there striped appearance
49
structure of a nephron
glomerulus--> proximal convoluted tubule--> loop of henle--> distal convoluted tubule--> collecting duct
50
what happens at the glomerulus
ultra-filtration of blood arriving via brashness of the renal artery
51
the collecting duct passes thorough
the renal pyramid to drain the modified filtrate into the minor calyx as urine
52
how does urine drain from the kidney
collecting ducts of nephrons--> minor calyx--> major calyx--> renal pelvis--> ureter
53
diameter of the drainage tubes
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
anatomical sites of constrictions
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
renal calculi (stones)
can form from urine calcium slats and obstruct the urinary tract from within, renal calculi tend to be visible on X-ray
56
obstruction of the ureter can be caused by
- internal obstruction caused by renal calculi or a blood clot - external compression (from an expanding mass or tumour)
57
the ureter has what in its walls?
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
consequences of a urinary obstruction
- 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
urine production will continue
until the pressure within the urinary tract exceeds the pressing favouring filtration in the glomerulus and causes renal failure
60
renal failure mean
failure to adequately filter blood to produce urine
61
hydronephrosis means
water inside of the kidney
62
hydronephrosis
urine back pressure into the calyxes compresses the nephrons within the medullary pyramids and causes renal failure
63
acute hydronephrosis causes
painful stretching of the renal capsule

Renal and Urology (51 decks)

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