Anatomy of the upper and lower urinary tracts Flashcards
What is the upper urinary tract?
kidneys and ureters
What is the lower urinary tract?
bladder and urethra
What parts of the urinary tract are found within the pelvis?
distal ureters; blader and proximal urethra
What are the layers anterior to the kidneys from visceral peritoneum to the kidney?
visceral peritnoneum–paranephric fat–renal (deep) fascia–perinephric fat–renal capsule
What is found in the renal hilum?
renal artery and vein and ureter
What is the most anterior structure of the renal hilum?
renal vein
What is the inferior part of the renal hilum?
ureter
What is found posterior to the kindeyts?
psoas major and quadratus lumborum and then back muscles
What are the muscles of the anterolateral abdo wall?
external oblique; internal oblique and transverse abdominus
Why is the right kidney slightly inferior to the left?
because of the liver
What vetertebral levels is the right kidney found at
L1-L3
What levels is the left kidney foudn at?
T12 - L2
Which bony strcutres are found posterior to the kidney?
floating ribs 11 and 12
What quadrants are the kidneys found in?
lumbar/flank regions (upper quadrants)
Why do the kidneys move on inspiration?
the liver and spleen lie in contact with the diaphragm superior and the kidneys inferiorly
What is significant about the hepatorenal recess?
any abnormal fluid will gather here in the supine patient
What in the hepatorenal recess found within?
greater sac of the peritoneal cavity
What is the difference bewteen the relation of the renal vein and artery and the common iliac vein and artery?
renal veins are anterior renal arteries but the common iliac arteries are anterior to the common iliac veins
Where does lymph from the kidneys drain to?
lumbar nodes
Where are the lumbar nodes located?
around the abdominal aorta and IVC
Where does the abdominal aorta bifurcate?
umbilicus
Where does the lymph from the ureters drain to?
lumbar nodes and iliac nodes
How can renal artery stenosis be associated with an infra-renal AAA?
both are caused by athersclerosis
How can renal artery stenosis be associated with a suprarenal AAA?
occlusion of the proximal renal artery by the aneurysm
What are the 2 gross layers of the kidney?
outer cortex and inner medulla
How is the medulla arranged?
into renal pyramids
What gives the pyramids their striped appearance?
regulary arranged nephrons rnning towards the apex of each pyramid
What does the collecting duct drain urine into?
minor calyx
What is the passage of filtration from the glomerulus to the collecting duct?
glomerulus–prox. convoluted tubule–loop of Henle–distal concoluted tubule–the collecting duct
How does urine from the minor calyx reach the ureter?
minor calyx–major calyx–renal pelvis–ureter
What is the first constriction in the passage of urine?
pelviureteric junction
What are the 3 sites of ureteric constriction?
pelviureteric junction; ureter corssing the anterior aspect of the common iliac artery; ureteric orifice
What type of muscle is found within the walls of the ureter?
smooth muscle
What is the urinary tracts response to obstruction?
increased peristalis proximal to the site
What is the false pelvis?
from the iliac crests to the pelvic inlet
What is the false pelvis a part of?
the abdominal cavity
What is the true pelvis?
pelvis inlet to pelvic floor
What is the true pelvis also known as?
pelvic cavity
What muscle makes up the pelvic floor?
levator ani
At what level do the ureters turn medially to enter the bladder?
ischial spine
In what direction do the ureters enter the posterior bladder wall?
inferomedial
What is the most inferior part of the male peritoneal cavity?
rectovesicle pouch
What is the purpose of the roudn ligament of the uterus?
attaches uterus to the perineum via the inguinal canal
What ar ethe 2 inferior pouches found inthe female?
vesico-uterine pouch and rectouterine pouch
What is the most inferior part of the female peritoneal cavity?
pouch of Douglas (rectouterine pouch
What is the relation of the ureter to the uterine tubes and artery?
runs inferiorly (water under the bridge)
What is the relation of the ureter to the vas deferens?
runs inferiorly
What is the arterial supply to the pevlis ?
internal iliac artery
What forms the trigone?
the 2 ureteric orificies and the internal urethral orifice
Where are the ureteric orifices found?
the base (post, aspect) of hte bladder
where is the internal urethral orifice found?
floor of the bladder
What muscles forms the bulk of the bladder wall called?
detrusor muscle
How does the detrusor muscle prevent reflux of urine furing bladder contraction?
detrusor fibres encircle the ureteric orifices and tighten during contraction
What forms the internal urethral spinchter muscle in males?
detrusor muscle
What is hte purpsoe of the internal urthral sphincter?
prevents retrograde ejaculation of semen into the bladder
What is the most anterior organ in the pelvis?
bladder
How does the body of uterus normally lie in relation to the bladder?
anteflexed position, superior to it
What lies inferior the the bladder in males?
prostate gland
What are the 2 parts of the urethra in males?
prostatic urethra and spongy urethra
What gives the spongy urethra its name?
lies within the corpus spongiosum
Where is sperm stored?
epididymis
How does sperm reach the spongy urethra from the epididymis?
–vas deferens–superficial ring–deep ring–across pelvic cavity behin bladder–sminal gland–ejaculatory canal–prostatic urethra–spongy urethra
What sac do the testis sit within in the scrotum?
tunica vaginalis
What is contained within the spermatic cord?
vas deferens; testicular artery and pampiniform plexus
What are the testicular arteries a branch of?
abdo aorta
What does the right testicular vein drain into?
IVC
What does the left testicular vein drain into?
left renal vein
Where is the epididymis palpated?
posterior aspect of the superior pole of the testis
Where does the vas deferens begin?
at the inferior pole of the testis
What are the 3 openings in the prostatic urethra?
prostatic ducts and opening of ejaculatory duct
What is the inferior aspect of the prostatic urethra in contact with?
levator ani
What are the 2 zones of the prostate gland?
peripheral and central (internal)
Where do most prostatic cancers arise?
peripheral zone
What transmits the deep arteries of the penis?
corpus cavernosum
What forms the glans?
corpus spongiosum
What is the blood supply to the penis?
deep arteries of hte penis from the internal pudendal artery (internal iliac)
What is the blood supply to the scrotum?
internal pudendal and external iliac
Where does lymph from the scrotum and most of the penis drian?
superficial inguinal nodes
Where does lumph from the testis drain to?
lumbar nodes
