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Yr 2 - Renal > Anatomy of Renal Tract > Flashcards

Anatomy of Renal Tract Flashcards

1
Q

What is the urethra?

A

Tube from bladder to external environment

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2
Q

What vertebral level are the kidneys?

A

T12 - L3

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3
Q

What is found on the superior surface of the left kidney?

A

Spleen

Kidney forms renal impression on spleen

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4
Q

Where does the abdominal aorta bifurcate?

A

L4

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5
Q

What are the crura of the diaphragm?

A

Attachments of diaphragm to lumbar vertebrae (right and left crus)

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6
Q

Why are the psoas major and the iliacus muscle considered together? What are they called together?

A

Similar function and same attachment –> attach to the femur

Iliopsoas

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7
Q

Where does the iliacus reside?

A

In the iliac fossa

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8
Q

What is the action of the quadratus lumborum?

A

Antagonist to rectus abdominis –> extension of the trunk

rectus abdominis acts in flexion of trunk

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9
Q

What nerve emerges from the lumbar plexus just underneath the 12th rib?

A

Subcostal nerve

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10
Q

What nerve emerges below the subcostal nerve (often as a common stalk)?

A

Common stalk splits into iliohypogastric (superior) and ilioinguinal (inferior) nerve

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11
Q

Where does the subcostal nerve, iliohypogastric and ilioinguinal nerve trace round to?

A

Anterior aspect, supplies the muscles of the posterior wall as well, skin and parietal peritoneum

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12
Q

Describe the route of the ilioinguinal nerve

A

As it transverses towards the anterior aspect, it goes between the transversus abdominis muscle and the internal oblique

As it travels round, it enters the inguinal canal (but doesn’t enter through the deep ring)

Goes towards genital region and supplies some of the skin

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13
Q

What nerve sits on top of the psoas major muscle?

A

Genitofemoral nerve –> splits into femoral and genital nerve

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14
Q

Describe the route of the genital branch

A

Passes through deep inguinal ring, through canal, out the superficial ring

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15
Q

What does the femoral branch supply?

A

Supplies skin of thigh around femur

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16
Q

What happens as the testes move through the inguinal canal? What does this mean for the genital branch?

A

Take a layer of fascia with them

Genital branch therefore has layer of fascia around it

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17
Q

Does the ilioinguinal nerve have layer of fascia around it?

A

No (even though it enters canal)

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18
Q

What happens at the renal papilla?

A

All the collecting ducts containing little bits of urine meet together (tip of renal pyramids)

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19
Q

What does each renal papilla open out into?

A

Minor calyx (2 or 3 minor calyces join together to form a major calyces)

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20
Q

What do the major calyces join to make?

A

Renal pelvis

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21
Q

What does the renal pelvis narrow to form?

A

Ureter, going towards bladder

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22
Q

Describe the ureter?

A
  • Muscular tube
  • Retroperitoneal
  • Narrow lumen
  • Has constrictions
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23
Q

What are the 3 constrictions of the ureter?

A
  1. Ureteropelvic junction: where renal pelvis narrows to form ureter
  2. Pelvic inlet: as ureter goes down towards bladder, it passes over iliac vessels and is constricted
  3. Entrance to bladder: angle changes as ureter enters bladder
24
Q

What is purpose of entrance to bladder constriction of ureter?

A

Stops urine going back up ureter

25
Q

What are kidney stones?

A

Some solutes can become crystallised to form stones

These stones can then become blocked at the 3 constrictions in the ureter

26
Q

In males as the ureter passes towards the bladder, what structure is it crossed by?

A

Ductus (vas) deferens

27
Q

What is the vas deferens?

A

Tube within spermatic cord that is transporting sperm from testes towards urethra

28
Q

What does the vas deferens empty into?

A

Part of the urethra

29
Q

Where does the prostate gland in a male sit?

A

Just underneath the bladder (so urethra has to pas through prostate gland)

30
Q

In females as the ureter passes towards the bladder, what structure is it crossed by?

A

Uterine artery

Remember: water travels under the bridge (ureter passes underneath uterine artery)

31
Q

What is a pyelogram?

A

A form of imaging of the renal pelvis and ureter.

Intravenous pyelogram – In which a contrast solution is introduced through a vein into the circulatory system

32
Q

How are kidney stones removed?

A
  • Surgery

- Lithotripsy (fire ultrasound waves to break them up and pass them out naturally)

33
Q

How are kidney stones removed?

A
  • Surgery

- Lithotripsy (fire ultrasound waves to break them up and pass them out naturally)

34
Q

The peritoneum, as it approaches the pelvis, covers the superior aspect of pelvic organs (bladder, uterus, rectum).

As the overlying peritoneum passes over these organs, and delves between them, what is formed?

A

Peritoneal pouches

Male:
- Vesicorectal pouch (between bladder and rectum)

Female:

  • Vesicouterine pouch (between the bladder and uterus)
  • Rectouterine / uterorectal pouch (between uterus and rectum)
35
Q

Why are peritoneal pouches clinically important?

A

During infection, especially in females, pouches are a common site for accumulation of free fluid or pus

36
Q

If fluid during infection resides in utero-rectal pouch, how is it removed?

A

Transvaginal approach

37
Q

What is the muscle of the bladder called?

A

Detrusor muscle

38
Q

Describe the inner surface of the bladder?

A

2 parts:

  1. Upper: rugae (folds)
  2. Lower: trigone (smooth)
39
Q

What is the trigone of the bladder?

A

Smooth triangular region of internal bladder –> different from rest of muscular bladder as does not contract

At lateral edges of the trigone is where ureters empty into

40
Q

What are the 4 parts of the male urethra?

A
  1. Pre-prostatic
  2. Prostatic
  3. Intermediate
  4. Spongy
41
Q

Where is the pre-prostatic part of the male urethra?

A

Opening of bladder to form urethra

42
Q

Where is the prostatic part of the urethra?

A

When urethra gets to prostate

43
Q

Where is the spongy part of the urethra?

A

Penile part

44
Q

What is the posterior fornix?

A

Large recess behind the cervix, close to the rectouterine pouch

45
Q

What is located behind the female urethra?

A

Vagina and posterior fornix

46
Q

Is the male or female urethra longer?

A

Male

47
Q

How is the length of the female urethra clinically important?

A

Shorter therefore increased risk of infection –> bacteria have to travel shorter distance

48
Q

What are complications of prostate hyperplasia?

A

Can begin to squeeze on walls of urethra and bladder

  • Impedes urination by distorting prostatic urethra
  • Urine can be trapped in prostatic urethra (feel you need to wee all the time)
  • Dysuria (painful or difficult urination)
  • Nocturia (waking up in night to wee)
  • Urgency
49
Q

What is the best way to clinically examine the prostate?

A

Through the rectum

50
Q

What is the best way to resect prostate?

A

TURP –> transurethral resection procedure

  • Endoscopically remove prostate
51
Q

Why do women struggle to control urination after childbirth?

A

Urethral sphincters fewer and less organised in females

52
Q

In males, what are the urethral sphincters?

A
  1. Internal urethral sphincter

2. External urethral sphincter

53
Q

What is function of internal urethral sphincter in males?

A

Stops sperm from going back into bladder

Under autonomic control

54
Q

What nervous system controls bladder filling?

A

Sympathetic

55
Q

What happens when bladder is filling?

A

Must contract external and internal urethral sphincter but relax muscular bag

56
Q

What nervous system controls bladder emptying?

A

Parasympathetic –> parasympathetic fibres contract detrusor muscle and relaxes internal urethral sphincter

57
Q

What control is the external urethral sphincter under?

A

Somatic (voluntary) –> ables you to control when you urinate

Pudendal Nerve

Yr 2 - Renal (16 decks)

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