Anatomy of the kidney Flashcards

1
Q

Kidneys start and end retroperitoneally, which means that they form behind the ________________.

A

Peritoneal sac

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2
Q

Upper limb muscle posterior to the kidney, connected to the thoracolumbar aponeurosis

A

Latissimus dorsi

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3
Q

Stomach, spleen, and liver are all surrounded by

A

peritoneal sac

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4
Q

Deepest abdominal muscle beneath internal oblique. Extensive origin from the posterior side of the thoracolumbar aponeurosis

A

transversus abdominis

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5
Q

Large muscle forming a good deal of the posterior abdominal wall and extending from the iliac crest to the 12th rib. The kidney sits on this muscle.

A

quadratus lumborum

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6
Q

Which kidney is usually lower?

A

Right (due to liver)

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7
Q

Extension of outer covering of renal vessels

A

Renal fascia

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8
Q

A layer of renal fascia slips in between the kidney and the

A

adrenal gland

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9
Q

The kidneys develop in the pelvis and ultimately ___________

A

ascend

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10
Q

Main arteries to the kidney come off of the

A

aorta

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11
Q

The arteries then divide into anterior and posterior branches with ________ segmental branches.

A

3-5

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12
Q

Renal artery is longer on which side?

Renal vein is longer on which side?

A

Right; left

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13
Q

All vessels leaving the kidney and the ureter leave via this structure

A

the hilum

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14
Q

Fat filled cavity in the center of the kidney where arteries begin branching

A

renal sinus

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15
Q

The left renal vein is located posterior to the _______ and crosses the aorta to get to the _____.

A

superior mesenteric artery; IVC

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16
Q

The left vein also drains blood from the ________ and has a connection to the ____________.

A

Left gonadal vein; azygos system

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17
Q

The right renal vein goes straight into the

A

IVC

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18
Q

3 narrowings of ureter

A
  1. where the ureter leaves the pelvis of the kidney
  2. where the ureter passes out of the abdominal cavity and courses over the pelvic brim
  3. where the ureter enters the bladder at an oblique angle
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19
Q

Ureter has at least 3 blood supplies

A

renal, gonadal, vesicular arteries

  1. aorta
  2. renal artery
  3. small vessels off of artery to the bladder
20
Q

Sympathetics to the kidneys come from the _________ and synapse in the __________ and on ganglia near the renal artery. There are also contributions from the first lumbar splanchnic nerve.

A

lesser (T10-11) and least (T12) thoracic splanchnics

aortico-renal ganglion

21
Q

Pain referring from the kidneys and upper ureters can refer to dermatomes from _______. The location of referred pain form a kidney stone can descend as the stone passes lower in the system.

A

T10-L2.

22
Q

Adrenal gland has a rich blood supply

A
Superior suprarenal off inferior phrenic
Middle suprarenal directly off the aorta
Inferior suprarenal off the renal
Single vein
Goes to the IVC on the right
To the renal vein on the left
23
Q

Adrenal gland receives __________ sympathetic fibers

A

preganglionic

24
Q

The renal arteries come off of the aorta near the superior mesenteric artery and divide into anterior and posterior segmental branches as they reach the __________.

A

Hilum

25
Q

Segmental branches supply a _____________ area. There may be polar branches on either pole. Why?

A

resectable; during development, establishment of new blood supply as the kidneys ascend

26
Q

Sympathetics traveling on the lesser thoracic splanchnics synapse where?

A

Aorticorenal ganglion

27
Q

Sympathetics traveling on the least thoracic splanchnics synapse where?

A

Renal artery, plexus, and ganglion

28
Q

Parasympathetics can come from the vagus all the way down, and travel back up via the ______________. Or they can come from _______ and synapse in the plexus.

A

Hypogastric plexus

S2-S4

29
Q

Are the aorta and IVC within the peritoneal sac?

A

No!

30
Q

What lies in the space between the organs and the peritoneal sac?

A

Nothing, maybe some serous fluid

31
Q

The visceral layer of the peritoneal sac surrounds the spleen, liver, and stomach, while the parietal layer reflects onto

A

the body wall

32
Q

The kidney lies right over this muscle

A

quadratus lumborum

33
Q

The lower part of the right kidney lies just at the

A

iliac crest

34
Q

3 layers of abdominal muscles that must be cut through to get to the kidney

A
  1. external oblique
  2. internal oblique
  3. transversus abdominis
35
Q

Where do the kidneys develop?

A

In the pelvis

36
Q

What are polar arteries?

A

Arteries that have grown out to kidney thinking that the kidneys were going to continue to ascend.

37
Q

What does it mean that areas of the kidney are resectable?

A

You could cut off a segment of the blood supply, and a small chunk of the kidney would lose color!

38
Q

What happens in the renal sinus?

A

Arteries continue to branch and ureter branches into major calyces, etc

39
Q

The renal artery gives blood supply to the ______ on both sides

A

ureter

40
Q

Possible sites of ectopic uretal orifices in females and males

A

trigone, bladder neck, urethra, vestibule (less common = vagina, cervix, uterus)

41
Q

Right ureter compressed between IVC and spine leading to right sided hydroureter and hydronephrosis

A

Retrocaval ureter

42
Q

Purpose of intravenous pyelogram?

A

Visualize the renal parenchyma

43
Q

Purpose of retrograde pyelogram?

A

Visualize the renal collecting system

44
Q

Purpose of intracorporal/peritoneal dialysis?

A

Reduce BUN, serum creatinin, and serum uric acid

45
Q

Purpose of extracorporal dialysis?

A

Reduce BUN, serum creatinin, and serum uric acid.

Also eliminate drugs and poisons in overdose patients

46
Q

Layers of musculature over the kidney (from superior to deep)

A

Latissimus dorsi
External oblique
Internal oblique
Transversus abdominus