Anatomy of the Excretory and Renal System

Question 1

What defines retroperitoneal organs? Give examples.

Answer 1

• organs that sprout behind the peritoneal layer during development
• Aorta
• IVC
• Kidneys
• Suprarenal glands

Question 2

What defines secondary retroperitoneal organs? Give examples.

Answer 2

• Organs that originated in the abdominal cavity but then moved back and lost the visceral peritoneal layer on its posterior surface
• Pancreas
• Duodenum
• Ascending and Descending Colon

Question 3

What are the abdominal wall muscles that surround the kidney?

Answer 3

• Superiorly: the Diaphragm
• Medially: Psoas major
• Posteriorly and laterally: Quadratus lumborum

Question 4

What vertebral levels are the kidneys found at?

Answer 4

• upper poles at T12
• inferior pole at L3
• the right kidney is slightly lower as it is forced down by the liver

Question 5

What is this image showing?

Answer 5

• Nonobstructing ureteral calculus (kidney stones)

Question 6

What are the neighbouring organs of the right and left kidney?

Answer 6

Right kidney: Right suprarenal gland, Liver, Right colic flexure and Duodenum

Left kidney: Left suprarenal gland, Stomach, Spleen, Pancreas, Left colic flexure, Jejunum

Question 7

What is the VAL of the kidney?

Answer 7

• Renal pelvis: leads to the ureter
• Renal artery: from the aorta: just below SMA (L2)
• Renal vein: drains to the IVC *the vein is anterior to artery*
• Lymphatics: drain to lateral aortic nodes

Question 8

What is the function of the suprarenal glands?

Answer 8

Hormone secretion

• the cortex (outer) layer: Corticosteriods- cortisol, Sex hormones - progesterone
• the medulla (inner) layer: Adrenaline

Question 9

Describe the shape, supply and innervation of the Suprarenal glands

Answer 9

• the right one is pyramidal, the left one is semilunar
• found over the kidneys separated by its own fascial compartment
• Suprarenal arteries
• Suprarenal veins
• Abdomnipelix nerve

Question 10

Describe the presentation of renal pain

Answer 10

• caused by stretching of the capsule, due to increase internal pressure, or can be from spasm of the smooth muscle of the renal pelvis
• pain is carried by afferent fibres in renal plexus (that surrounds the renal artery) that travel parallel to symp fibres
• Renal pain is generally referred to the cutaneous area of T12, i.e. the territory of subcostal nerve

Question 11

Describe renal colic

Answer 11

• this is not the same as renal pain
• the pain is not only felt in waves like renal pain but is agonizing and felt on the skin over the area supplied by that nerve
• the pain is not as specific
• can occasionally spread to eh CNS and cause nausea

Question 12

What types of renal malformations are there?

Answer 12

• Bilateral/Unilateral renal agenesis
• Supernumerary kidneys
• Renal fusion
• Ectopic kidney
• Simple/polycystic kidney