Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

ANATOMYY2S2 > ANATOMY OF KIDNEY AND URETERS > Flashcards

ANATOMY OF KIDNEY AND URETERS Flashcards

1
Q

what is the situation/ location of kidneys?

A

retro peritoneally

posterior abdominal wall

side of the vertebral column

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is the extension of kidneys in relation to vertebrae?

A

T11

to

L3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is the difference between left and right kidney?

A

right kidney is slightly lower than the left cuz of the liver

So

Right kidney —-> T12- L3

left kidney —–> T11-L3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is the location where you palpate the kidneys?

A

lower pole of right kidney —> right lumbar region

during deep inspiration in a lean person ( during inspiration the right kidney sink down by 1 vertebral levels )

left kidney is not palpable cuz many viscera overlies it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is the level of the hilum of kidney?

A

transpyloric plane

L1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what maintains the kidney normal position ?

A

Intra abdominal pressure

renal fat and fascia ( Renal vessels, and fat within the fascia )

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

whats the clinical application of fats and fascia supporting the kidney?

A

if a significant weight loss over a short period of time

The fatty layers within the renal fascia dissolves resulting in sinking of kindeys

leading to NEPHROPTOSIS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

when does the kidney move?

A

full respiration

change from supine to erect position

MOVES ABOUT AN INCH ( 1 VERTEBRAL BODY )

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what are the anterior surface marking of kidneys?

A

Hilum ( transpyloric plane )—> 5 cm from the midline —> L1

Upper pole —–> 2.5 from the midline —> T12

Lower pole ——> 7.5 from the midline —-> L3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what are the posterior surface marking of the kidneys?

A

its called morrisons parallelogram

2 points marked at the level of T11 , 2.5 and 9 cm away from midline

2 points at the lvl of L3 same distance as above

Joint the points at quadrilateral space

Upper pole of left kidney —> 2.5 cm at T11

Upper pole of RIGHT KIDNEY —> 2.5 cm at T12

Surgeons prefer going posteriorly cuz less visceral anteriorly

Upper pole is more medial

lower pole is lateral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what are axis of kidney?

A

Long

Transverse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

describe the long axis of kidney?

A

Directed downward

laterally parallel to the lateral border of psoas major

The poles of the kidneys are not in the same plane cuz upper pole is medially and lower pole is laterally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

describe transverse axis of kidney?

A

BACKWARDS AND LATERALLY

we can see the lower pole directed laterally and backwards —> to accommodate the vertebral body ( bulges out )

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what muscle we see parallel to the long axis ?

A

psoas major

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what are factors keeping kidney in position ?

A

Pressure from neighboring viscera

disposition of renal fascia + renal fat distribution

pedicles of kidney attached to the hilum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is the renal angle/ costovertebral angle?

A

angle between the lower margin of 12 th rib and lateral margin of erector spinae

THE kidney lies close to the body surface

The perinephric abscess causes swelling and tenderness at the renal angle

Renal pain is usually felt at the renal angel as dull ache

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what are the coverings of the kidneys from within to outwards?

A

Fibrous true capsule

perinephric fat

Renal fascia/gerota

paranephric fat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

describe the fibrous true capsule ?

A

Condensation of fibrous stroma of kidneys

covers entire organs —> line the wall of renal sinus

Whenever connective tissue of any organs form a cover around it , it will always be considered a true capsule —> when cut and peeled of –> u will see the cortical part of the kidneys ( parenchyma )

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what is nephropexy?

A

Surgery to fix the movable kidneys , the fibrous capsule is divided along the lateral border of kidneys and posterior flap is rolled up and sutured to the last rib , muscle of posterior abdominal wall, etc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

describe perinephric fat?

A

Between fibrous capsule and renal fascia

Extend into renal sinus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is the renal sinus?

A

Space between the vessels and ureter on the medial aspect of the kidneys forming a small pocket of fat

it is considered the same as renal renal hilum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what is the definition of renal hilum?

A

depression on the medial border of the kidneys through which pass the segmental renal vessels and renal nerves and where the apex of the renal pelvis occurs

aka porta renis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

describe the renal fascia / gerota?

A

Condensation of extra peritoneal connective tissue around the kidneys

continuous LATERALLY WITH FASCIA TRANSVERSALIS

The perirenal fat is inside the fascia

It is considered FALSE CAPSULE formed by extra peritoneal connective tissue

2 layers :

Anterior —> fascia of TOLDT

Posterior —> ZUCKERKENDLE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what happens to the renal fascia laterally ?

A

Both layers fuse

continuous with the fascia transversalis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
what happens to the renal fascia medially?
anterior layer covers front of the kidney and RENAL VESSELS ( adventitia ) merges with opposite sides
26
what happens to the renal fascia superiorly ?
both layers fuse at the upper end Encloses the suprarenal gland attaches to the diaphragm In cases of nephrotosis even though the kidneys go down, the suprarenal glands do not and stay cuz attached to the diaphragm
27
what happens to the inferiorly to the renal fascia?
2 layers DO NOT FUSE Extends along the ureters and finally lost in the extra peritoneal tissue of iliac fossa NOT ATTACHED ANYWHERE
28
whats the fat seen behind fascia of zuckerkend ( posterior layer of the renal fascia )?
paranephric fat
29
compare the paranephric fat to the perinephric fat?
perinephric fat ---> between the true capsule and renal fascia covers the entire kidneys Paranephric fat ---> in front of the renal fascia and thoraco lumbar fascia ONLY in the posterior aspects
30
what is nephroptosis ?
abnormally mobile kidneys- --> may descend more than the normal 1 inch suprarenal glands remain in place because they lie in a separate fascial compartment are are firmly attached to the diaphragm Its distinguished from an ectopic kidney / congenital misplaced kidney by URETER OF NORMAL LENGTH : In cases of congenital anomaly --> ureter is already short so the kidney is in its natural ectopic position in cases of sudden weight loss and kidney falling down, the ureter would be really long symptoms of intermittent pain in the renal region , results from traction on the renal vessels , relived by lying down ( pain cuz of kinking and binding of vessels ) The role played by the perinephric and paranephric fat in holding the kidneys in position explains the development of nephroptosis ( FLOATING OR DROPPED KIDNEYS ) After severe weight loss
31
describe renal transplantation ?
kidneys can be removed from the donor without damaging suprarenal gland transplanted kidney is situated in the iliac fossa for support ( we are not removing the old recipients kidneys due to its anatomical relations ---> the new donor kidneys will be on iliac fossa ) renal vessels are joined to the external iliac vein and internal iliac artery to be supported by pelvis Ureter is sutured into urinary bladder
32
why does perinephric abscess extends to the pelvis?
Gravitational pull no attachments to any structures in the pelvic region ( THE RENAL FASCIA INFERIORLY IS NOT ATTACHED TO ANYTHING ) compared to holdens line ---> in holdens line we dont have a blind end
33
what are the parts of the kidneys?
2 surfaces ---> anterior/posterior 2 ends ---> upper 2.5 cm and lower 7.5 cm 2 borders ---> medial and lateral
34
what is the posterior relation of LEFT KIDNEYS?
11th and 12th ribs and muscles
35
what is the posterior relation of RIGHT kidneys?
12th rib and muscles Since its lower only 12
36
what are the muscles related POSTERIORLY to both kidneys?
Lateral most ---> Transversus abdominis Superiorly ----> diaphragm Medially ---> psoas major, quadratus lamborum ( lateral to p. major ) NO iliacus muscle because it enters the pelvis and attaches to iliac fossa so from medial to lateral : P major --> quadratus lamborum ---> transversus abdominis
37
what crosses the quadratus lamborum?
subcostal nerve and vessels iliohypogastric ilio inguinal nerves
38
what we do need to make sure of before liver and kidney surgery?
since the liver and kidney are close to the diaphragm we need to make sure to not puncture the pleural cavity and puncture the lungs
39
what is the clinical significance of psoas major ?
since psaos major is parallel to the long axis of the kidney and it is among one of the posterior relations inflammation of the surrounding pararenal areas like appendictis will causes characteristic severe psoas pain which is aggrevated by the extending the thigh and relived upon flexion ( function of psaos muscle )
40
what are the anterior relations of the LEFT kidney?
Suprarenal gland lies on the upper MEDIAL aspects SPLEEN lies on the upper LATERAL aspects the stomach lies between the splenic and suprarenal areas ( BETWEEN MEDIAL AND LATERAL ) the tail of pancreas and splenic vessels cross the hilus and body ( TAIL PANCREAS AT THE HILUM ) the lower pole is in contact with coils of JEJUNUM MEDIALLY The lower pole is in contact with the LEFT COLIC FLEXURE LATERALLY
41
what are the anterior relations of right kidney?
Upper pole medially ---? suprarenal gland hilum and medial border---> DUODENUM ( DESCENDING PART, 2ND PART ) lower pole ----> right colic flexure ( up ) and Coils of jejunum ( below ) the remaining of the anterior surface is by the liver ( superolateral )
42
what are the basic structural microscopic features of the kidney?
Outer cortex inner medulla
43
describe inner medulla?
8-18 renal pyramids ---> pale conical masses
44
what is a lobe of kindey?
1 pyramid capped with adjoining cortex
45
what is course from calyces to pelvis?
Minor calyces ---> major calyces ---> renal pelvis
46
what is the renal pelvis?
flattened funnel shaped expansion of the superior end of the ureter Receives 2-3 major calyces each major calyx divides into 2-3 minor calyces each minor calyx is indented by renal papilla
47
what is renal papilla?
Finger like projections that have holes through urine flows out apex of the renal pyramid which urine is excreted
48
what are the structures at the hilum?
from anterior to posterior : Renal vein ( most anterior ) Renal artery ( middle ) Pelvis of the ureter (most posterior ) VAP
49
what is renal sinus?
narrow space within the kidney that is entered through the renal hilum contains the renal pelvis , calices, vessels , nerves and fat outermost space between the renal parenchyma and pelvis containing the renal neurovasculature
50
Describe the ureter?
narrow muscular tube ( 25 cm long ) -- long retroperitoneal throughout their course pelvis of the ureter ---> Dilated upper end upper part lies on the posterior abdominal wall remaining part ( lower ) is within the pelvic cavity
51
what are the normal strictures of the ureter ?
Pelvi-uretric junction ---> lower pole of kindey Plevic brim/sacroiliac joint /bifurcation of common iliac artery point of entry into bladder wall/intramural part ---> narrowest of all , MEDIAL TO TIP OF ISCHIAL SPINE these are potential sites of obstructions of ureteric stones used for identifying sites of renal stones
52
what is the lymphatic drainage of kidney and ureter?
Kidneys + proximal part of ureter ----> lumbar set of lymph nodes Distal part of ureters ---> iliac lymph nodes cuz it extends into the pelvic cavity
53
what is the blood supply of the ureter?
NO specific artery , small branches from nearby arteries Branches supplying the abdominal half of the ureter approach MEDIALLY pelvic half ---> ARTERIES APPROACH LATERALLY Proximal ureter via : renal gonadal and common iliac arteries ( along the medial aspects so during surgery ITS PULLED MEDIALLY ALONG THE BLOOD SUPPLY DIRECTION) Distal ureter : INTERNAL ILIAC ARTERY AND ITS BRANCHES ----> SINCE ITS PELVIC PART THE BRANCHES COME LATERALLY ----> DURING SURGERY THE PELVIC PART IS PULLED LATERALLY ALONG THEA ARTERY
54
what is the sympathetic innervation of the kidney?
Derived from renal plexuses , preganglionic fibers - cord segments ---> T11- T12 lesser + least splanchnic nerves ---> Synapses in celiac or superior mesenteric ganglia ---> renal plexus Lesser splanchnic ----> carry sympathetics from T10-T11 level of spinal cord to the pervertebral plexus ( SUPERIOR MESENTERIC , CELIAC + AORTICORENAL ) Least splanchnic : Carry sympathetics from T12 level of spinal cord to the prevertebral plexus ( RENAL PLEXUS + INFERIOR MESENTERIC )
55
what is the innervation of ureter?
Ureteric colic arising from calculus
56
wheres the referred pain of the ureter found ?
Cutaneous segments sharing spinal cord levels T11-L2 pain typically passes from the loin to the groin from lumbar region to inguinal regions as stones progress through the urters
57
Where could the pain extend?
thigh and scrotum or labia majora genitofemoral nerves ( L1, L2 )
58
what is the origin of renal artery?
Abdominal aorta at the lvl of intervertebral disc between L1 AND L2 at right angles of abdominal aorta
59
compare left and right renal artery?
the right renal artery is longer ( cuz the aorta is on the left side so right must travel longer ) pass behind the IVC
60
what do the renal artery divide to?
divde at the hilum into : anterior and posterior branches give rise to 5 segmental arteries
61
compare left and right renal veins?
Left renal vein longer ( Cuz IVC is on the right side ) left gonadal veins drain into it instead of ivc
62
what type of arteries are segmental arteries?
end arteries they supply only specific areas without anastomoses
63
describe the renal arteries supplying the kidneys?
The area supplied by each independent surgically resectable until ( RENAL SEGMENT ) The posterior segmental ARTERY IS THE CONTINUATION OF THE POSTERIOR BRANCH OF RENAL ARTERY the rest of the segmental arteries are BRANCHES OF THE ANTERIOR BRANCH OF RENAL ARTERY so : Anterior branch of renal artery is larger it give raise to 4 segmental arteries ( 2 apicals, 1 anterosuperior, 1 anteroinferior ) Posterior give 1 and its smaller ( 1 posterior and its continuation )
64
what is brodels bloodless line and what is the significance of it?
Since the anterior and posterior segmental arteries DO NOT ANASTOMOSIS AS THEY ARE END ARTERIES they form a bloodless region without anastomosis ( avascular line ) , ITS OBLIQUE LINE Can be used to access the kidneys without disturbing blood supply
65
describe abnormal renal artery ?
about 25% of kidneys receive directly from aorta 2nd , 3rd , 4th branches enter either through the renal sinus or at the lower or upper poles Persistence of a fetal vessels not usually accompanied by veins

ANATOMYY2S2 (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions