Anatomy of renal tract Flashcards
What are the 4 major parts of the renal system?
Kidneys
Ureter
Bladder
Urethra
What two parts make up the upper renal tract?
Kidneys
Ureter
What two parts make up the lower renal tract?
Bladder
Urethra
Describe the location of the right kidney
L1-L3
Retroperitoneal
Right hypochondrium
Posterior to: liver, hepatorenal recess, duodenum and colon
Describe the location of the left kidney
T12-L2
Retroperitoneal
Left hypochondrium
Posterior to: stomach, pancreas and spleen
What three compartments are is the renal tract found in?
Abdomen
Pelvis
Peritoneum
What parts of the renal tract are found in the abdomen?
Kidneys
Proximal ureter
What parts of the renal tract are found in the pelvis?
Distal ureter
Bladder
Proximal urethra
What part of the renal tract is found in the peritoneum?
Distal urethra
On which side is the aorta located?
Left
On which side is the IVC located?
Right- and more anterior to aorta
From anterior to posterior what is the order of vessels at the hilum of the kidney
Vein
Artery
Ureter
What muscles are located close to the kidneys?
Abdo wall muscles:
External + internal oblique and transversus abdominis
Quadratus lumborum
Psoas Major
From external to internal what fascia surrounds the kidneys?
Visceral peritoneum Paranephric fat Renal fascia Perinephric fat Renal capsule
Describe the paranephric fat
Solid
Describe the perinephric fat
Liquid
Why can swelling in the kidney cause pain?
Renal capsule tight therefore cannot expand
What bony structure protects the kidneys?
Ribs 11 and 12
Which is more anterior between common iliac arteries and veins?
Arteries
Which is more anterior between IVC and abdominal aorta at the level of the kidneys?
IVC
In relation to the renal arteries what two forms of AAA are possible?
Infrarenal
suprarenal
At what level do the renal arteries arise?
Between L1 and L2
What developmental abnormalities of the kidneys can be seen?
Agenesis Horseshoe Bifid renal pelvis Bifid ureter Ectopic pelvic kidney
How is it possible to have one kideny?
Agenesis
Pathological loss
Donation
What are the three natural sites of constriction of the ureter?
Pelviureteric junction- as exits kidney
As crosses iliac crest/common iliac artery
Ureteric oriface as enters bladder
What are the two sites of pathological ureteral constriction?
External pressure
Internal blockage
What can cause an internal blockage of the ureter?
Renal calculi/stones
What can result from a blockage of the ureter?
Back flow into the kidney and eventually renal failure
What is renal failure?
A failure to adequately filter blood to produce urine
What is hydronephrosis?
Blockage in renal tract leading to back pressure in kidney and expansion
What are the two areas of the pelvis?
True and false pelvis
Where is the false pelvis found?
Iliac crest to pelvic inlet
Where is the true pelvis found?
Pelvic inlet to pelvic floor
What makes up the pelvic floor/diaphragm?
Levator ani
Describe the route of the distal ureters
Anterior to common iliac arteries
Run along walls of pelvis
At level of ischial spine turn medially to enter posterior bladder
Where is the bladder located in respect to the rectum and uterus?
Anterior
What 3 arteries to the lower renal tract do we need to know?
Vesical
Uterine/prostatic
Vaginal
What is the trigone?
A smooth triangle found in the bladder
What make up the three points of the trigone?
2 ureteric orifices
Internal urethral oriface
What surrounds the upper part of the urethra in males?
Prostate
What is the bladder made up of?
Detrusens/smooth muscle
Where is an empty bladder entirely found?
Pelvis
Where can a full bladder extend to?
Out of pelvis into abdomen
What are the two routes of catheterisation?
Urethral
Suprapubic
What must a bladder be for suprapubic catheterisation?
Full
How long is the female urethra?
4cm
How many sphincters does the female urethra have?
2:
Internal- SM, involuntary
External- Skeletal muscle, voluntary
Where does the urethra end?
External urethral oriface
How long in the urethra in males?
20cm
What does the urethra pass through immediately after exiting the bladder in males?
Prostate gland
What is the urethra called when it passes through the prostate?
Prostatic urethra
Where is the external urethral sphincter found in males?
Just distal to the prostate gland
Where is the external urethral sphincter found in females?
At the junction between pelvis and peritoneum
Where does the urethra pass after the prostate in males?
Penis
What is the urethra called when it passes through the penis?
Spongy urethra
Why is it called the spongy urethra?
Because it passes through the corpus spongiosum
Where does lymph from the kidneys drain?
Lumbar nodes
Where does lymph from the ureters drain?
Lumbar and Iliac nodes
What kind of cells is the prostatic urethra made of?
Transitional epithelium
What kind of cells in the spongy urethra made of?
Stratified epithelium
What cell type surrounds the bladder?
Urothelium
What cell type lines the ureter?
Urothelium
Where is urothelium found?
Ureter and bladder
Describe urothelium
Transitional stratified epithelium
3-6 cells deep
Umbrella shaped to allow expansion
At what levels do sympathetic fibres to the renal tract arise?
T10-L2
How do nerve fibres reach/exit the renal tract?
By travelling along the blood vessels.
Which parasympathetic nerve innervates the kidneys and ureter?
Vagus CNX
Where do visceral afferent fibres from most of the renal tract enter the spinal cord?
T11-L1
Where do visceral afferent fibres from the urethra enter the spinal cord?
S2-4
What two nerves are important in controlling urine flow?
Pelvic splanchnic and pudendal nerves
Where do the pelvic splanchnic and pudendal nerves arise from?
S2-4
Are the bladder and internal urethral sphincters sympathetic or parasympathetic?
Parasympathetic
