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SM Renal > Anatomy of the Upper Urinary Tract > Flashcards

Anatomy of the Upper Urinary Tract Flashcards

1
Q

Describe how urine passes from the kidney to outside the body

A

Produced in kidney
Drained in the ureter to the bladder
Stored in the bladder
Excreted via the urethra

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2
Q

What makes up the upper urinary tract

A

Kidneys and the ureters

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3
Q

What makes up the lower urinary tract

A

Bladder and urethra

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4
Q

What parts of the urinary tract are located within the abdomen

A

The kidneys

The proximal ureters

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5
Q

Where is the division of the abdomen and the pelvis

A

In line with the iliac crests

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6
Q

What parts of the urinary tract are located within the pelvis

A

Distal ureters
Bladder
Proximal urethra

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7
Q

What parts of the urinary tract are located within the perineum

A

Distal urethra

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8
Q

What is the spinous process that lies at the division of the abdomen and pelvis

A

L4

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9
Q

What does L4 represent

A

The bifurcation of the abdominal aorta

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10
Q

Where do the kidneys sit in the body

A

retroperitoneal

in abdominal cavity but behind the peritoneum

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11
Q

What does the anterior surface of the kidneys contact

A

The peritoneum

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12
Q

What is the right kidney lateral to

A

the IVC

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13
Q

What is the left kidney lateral to

A

The Abdominal Aorta

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14
Q

What encloses the kidneys

A

The renal fat/ fascia/ capsule

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15
Q

What muscles surround the kidneys

A

Muscles of the posterior abdominal wall, muscles of the anterolateral abdominal wall and muscles of the back

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16
Q

What structures make up the renal hilum

A

Renal artery
renal vein
ureter

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17
Q

What are the posterior abdominal wall muscles that make up the posterior boundary

A

Quadratus lumborum

psoas major muscle (more anteriorly)

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18
Q

What is the name of the fat that lies between the visceral peritoneum and the deep renal fascia

A

Paranephric fat

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19
Q

What is the name of the fat that is deep to the paranephric fat and completely surrounds the kidney

A

Perinephric fat

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20
Q

What is the muscle of the side of the posterior abdominal wall

A

quadratus lumborum

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21
Q

What are the 3 muscles that lie posteriolaterally to the kidney

A

External oblique
Internal oblique
Transversus abdominis

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22
Q

What do the kidneys lie anterior to

A

Quadratus lumborum

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23
Q

What do the kidneys lie lateral to

A

psoas major

lower thoracic/ upper lumbar vertebral bodies

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24
Q

Why does the right kidney lie at a slightly inferior vertebral level

A

Due to the size of the liver

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25
Q

At what vertebral level does the left kidney sit

A

T12-L2

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26
Q

At what vertebral level does the right kidney sit

A

L1-L3

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27
Q

What ribs can protect the kidneys

A

11 and 12 - the floating ones

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28
Q

What can a fractures floating rib do to a kidney

A

Lacerate the kidney at the fracture site

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29
Q

What quadrant do the kidneys lie in

A

Left is in the left flank / LUQ

Right is in the right flank / RUQ

30
Q

Describe the structure of a normal kidney

A 
12cm long 
6cm wide 
smooth
regular 
firm
31
Q

What direction do the kidneys move on inspiration and expiration and why

A

Inferior on inspiration
Superiorly on expiration
The liver and spleen lie in contact with the diaphragm superiorly and the superior poles of the kidneys inferiorly

32
Q

Describe the anatomical location of the right kidney

A 
Posterior to:
Liver 
duodenum 
ascending colon 
right colic flexure
33
Q

Describe the anatomical location of the left kidney

A 
Posterior to:
stomach 
tail of the pancreas
hilum of the spleen 
splenic vessels
34
Q

What is the hepatorenal recess

A

one of the most dependent parts of the greater sac of the peritoneal cavity in the supine patient

35
Q

The renal arteries are anterior to the renal veins. True or False

A

False the veins are anterior to the renal arteries

36
Q

The common iliac arteries are anterior to the common iliac veins. True or False

A

True

37
Q

Where does the lymph from the kidneys drain to

A

The lumbar nodes (located around the abdominal aorta and the IVC)

38
Q

Where does lymph from the ureters drain to

A

The lumbar nodes and the iliac nodes

39
Q

Where are the iliac nodes located

A

around the common, internal and external iliac vessels

40
Q

Describe the ureteric arterial blood supply

A 
branches from:
renal artery 
abdominal aorta
Common iliac artery 
internal iliac artery 
vesical (bladder) artery
41
Q

If an AAA is infra-renal, what causes renal artery stenosis

A

Atherosclerosis

42
Q

If an AAA is suprarenal, what causes renal artery stenosis

A

The AAA itself, causing occlusion of the proximal renal artery by the aneurysm

43
Q

What is the treatment for renal artery stenosis

A

Stent into the femoral artery and push up towards the AA to reduce the pressure on the walls of the aorta

44
Q

Name some anatomical variations in the renal system

A

Horseshoe shaped kidney (R&L fuse during embryological development)
Ectopic pelvic kidney
Retrocaval ureter
Bifid renal pelvis
Bifid ureter and unilateral duplicated ureter

45
Q

Why might a patient have a solitary kidney

A

Agenesis (failure of one side to form)
Nephrectomy (pathology)
Nephrectomy (donation)

46
Q

How many pyramids does the human medulla contain

A

27

47
Q

What does each kidney consist of

A

Outer cortex and inner medulla

48
Q

How many nephrons does each pyramid contain

A

50,000

49
Q

Describe how the nephrons are arranged within the pyramid

A

Regularly arranged. running axially towards the apex of each pyramid giving the pyramids their striped appearance

50
Q

What structure connects the proximal convoluted tubule to the distal convoluted tubule

A

Loop of Henle

51
Q

Describe the course of the collecting duct

A

it passes through the pyramid to drain the modified filtrate into the minor calyx as urine

52
Q

What happens in the glomerulus

A

ultrafiltration of the blood arriving via the branches of the renal artery

53
Q

How does urine drain from the kidney

A 
Nephrons collecting duct 
minor calyx 
major calyx 
renal pelvis 
ureter
54
Q

Describe the change in size of the tubes in the kidney

A

The diameter increases until a constriction point (pelvireteric junction)

55
Q

What are the 3 anatomical sites of ureteric constriction

A

Pelviureteric junction
ureter x common iliac artery
Ureteric orifice

56
Q

What is the bony landmark at the point at which the ureter crosses the common iliac artery

A

Pelvic brim

57
Q

What is the main problem that arises at the ureteric constriction sites

A

Kidney stones (renal calculi)

58
Q

What do renal calculi form from

A

urine calcium salts

59
Q

Where do kidney stones usually develop

A

within the major and minor calyx

60
Q

What are stag horn calculus

A

a collection of kidney stones

61
Q

What would cause an internal ureteric obstruction

A

Impacted renal calculus or a blood clot

62
Q

What would cause an external ureteric compression

A

an expanding mass e.g. a tumour

63
Q

Why do kidney stones often present with colicky pain

A

The ureter has smooth muscle within its walls so peristaltic waves come to try and dislodge something that is stuck resulting in colicky pain

64
Q

What happens to urine when there is an obstruction

A

Urine is backed up towards the kidney

65
Q

If the obstruction is within the calyces or ureter, what happens to the pressure of urine

A

Unilateral back pressure of urine

66
Q

What can obstructions in the bladder cause

A

unilateral or bilateral kidney problems

67
Q

What might obstruction tot the urethra cause

A

Bilateral kidney probelsm

68
Q

What does renal failure mean

A

failure to adequately filter the blood to produce urine. This can be caused by urine being backed up into the kidney

69
Q

What is hydronephrosis

A

water inside the kidney

70
Q

What does acute hydronephrosis cause

A

painful stretching of the renal capsule. This can be palpated during clinical examination

SM Renal (23 decks)

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