Anatomy of the Kidney and Adrenal Gland Flashcards
Where do adrenal glands lie
Upper pole of the kidney
What is another name for adrenal gland
Suprarenal
Where does the right adrenal gland lie
Behind the liver and inferior vena cava
Where does the left adrenal gland lie
Behind the stomach and pancreas
What are the arteries supplying each gland
Superior adrenal artery
Middle adrenal artery
Inferior adrenal artery
What is the superior adrenal artery a branch of
Inferior phrenic artery
What is the middle adrenal artery a branch of
Abdominal artery
What is the inferior adrenal artery a branch of
Renal artery
What are the adrenal glands drained by
Single vein on each side
Right and left adrenal gland
What does the right adrenal gland directly drain into
Inferior vena cava
What does the left adrenal gland directly drain into
Left renal vein - then joins the inferior vena cava
What is the adrenal gland composed of
Cortex (outer part)
Medulla (inner part)
What does the cortex of the adrenal gland produce
Steroid hormones
Including:
- Cortisol
- Aldosterone
- Testosterone
What does the medulla of the adrenal gland produce
Adrenaline
What are the shape and size of the kidneys
Two bean-shaped kidneys
11cm long
7cm wide
4cm thick
Where do the kidneys lie
Extra-peritoneal structures - lie outside the peritoneum
Retro-peritoneal
Where are the kidneys located
One on either side of the upper lumbar vertebrae
What is each kidney embedded by
Perinephric fat covered by renal fascia covered by perinephric fat
What is on the medial side of the kidney
Renal hilum - where renal vessels, nerves, lymphatics and ureter enter or leave the kidney
What are the right and left arteries branches of
Abdominal aorta
What do the right and left renal veins drain into
Inferior vena cava
What is the internal aspect of the kidney composed of
Cortex
Medulla
Calyces
What is the outer part of the kidneys
Cortex
What is the medulla arranged in
Pyramids
What are the functional units of the kidneys
Nephrons
What is the role of the nephrons
Filter blood
Reabsorb water and solutes
Secrete and excrete waste products as urine
What is located in the cortex
Glomeruli
Glomerular capsules (Bowman’s capsules)
Proximal and distal tubules
Part of the collecting ducts
What is located in the renal pyramids
Nephron loop (of Henle)
Rest of the collecting ducts
From the collecting ducts where does urine travel
Down the pyramids towards the renal papilla to the minor calyx
What is the renal papilla
Apex of the pyramid
What does minor calyxes merge to form
Major calyxes
What do major calyxes merge to form
Renal pelvis
What is the renal pelvis continuous with
Ureter
How do ureters carry urine to the urinary bladder
Narrow tubes with muscular walls
Transport urine via peristalsis
Where do the ureters run
Anterior to psoas major on the posterior abdominal wall
Cross pelvic brim to enter the pelvis
Where do the ureters enter the bladder
Inferomedial aspect
What are kidney (ureteric) stones
Hard stones that can form in the kidneys and pass into the ureter
What are kidney stones normally made from
Calcium oxalate
Where do the fibres originate which supply pain to the ureters
T12 to L2 nerves
Where are the three areas kidney stones can be stuck
Pelvi-ureteric junction
Pelvic brim
Vesico-ureteric junction
Where is the pevi-ureteric junction
Between the renal pelvis and ureter
Where is the pelvic rim
Where ureter runs over the pelvic brim, anterior to the iliac artery
Where is the vesico-ureteric junction
Where the ureter joins the bladder
Are the kidneys retroperitoneal or intraperitoneal
Retroperitoneal
Where do the kidneys typically extend
T12 - L3
How large is a kidney
Approximately 3 vertebrae in the length
What are the layers in which the kidney is encased
Deep to superficial
Renal capsule
Perineal fat
Renal fascia
Pararenal fat
What is the renal capsule
Tough fibrous capsule
What is perineal fat
Collection of extraperitoneal fat
What does the renal fascia enclose
Kidneys and suprarenal glands
Where is pararenal fat mainly located
Posterolateral aspect of kidneys
What can the renal parenchyma be divided into
Outer cortex
Inner medulla
What is the apex of a renal pyramid called
Renal papilla
What collects urine from the pyramids
Minor calyx
What is the blood supply to the kidneys
Renal arteries
Where do the renal arteries arise
Directly from the abdominal aorta - immediately distal to the origin of the superior mesenteric artery
What is the order through the kidneys
Renal pyramids
Renal papilla
Minor calyx
Major calyx
Renal pelvis
Ureter
Which of the renal arteries is longer
Right due to the position of the abdominal aorta
What % of the blood does the anterior division of the renal artery carry
75%
What % of the blood does the posterior division of the renal artery carry
25%
How many segmental arteries arise from the anterior and posterior divisions of the renal arteries
5
What is the division of the segmental arteries
Interlobar arteries (located either side of every renal pyramid)
Arcuate arteries
90 degrees to the arcuate arteries - interlobular arteries
Pass through cortex become afferent arterioles
What and where is the peritubular network
Outer 2/3 of the renal cortex
Efferent arterioles for
Supplies nephron tubules with oxygen and nutrients
What is the inner 1/3 of the cortex and medulla supplied by
Vasa recta
Describe venous drainage of the kidneys
By left and right renal veins
Leave hilum anteriorly to renal arteries
Empty directly into inferior vena cava
Which renal vein is longer
Left renal vein as vena cava lies slightly to the right
How long approx. are the ureters
25cm long
Where do the ureters arise
From renal pelvis
What is the name for the point at which the renal pelvis narrows to form the ureter
Ureteropelvic junction
When ureters descend through the abdomen are they intra or retroperitoneal
Retroperitoneal
What happens to the ureters at the area of the sacroiliac joints
Ureters cross the pelvic brim
Enter the pelvic cavity
Cross the bifurcation of the common iliac arteries
What happens to the ureters in the pelvic cavity
Travel down the lateral pelvic walls
At the level of the ischial spines - turn anteromedially - moving transverse plane towards the bladder
What is the difference between the renal veins
Right
- adrenal vein drains directly into the inferior vena cava
Left
- adrenal vein drains first into the left renal vein
- then joins the inferior vena cava
