Anatomy of the Upper Urinary Tract Flashcards
what produces urine?
the kidney
what structures mark the beginning and end of the ureter?
start - kidney
end - bladder
what does the bladder do?
stores and empties urine
what structures make up the upper urinary tract?
kidneys
ureters
what structures make up the lower urinary tract?
bladder
urethra
where are the kidneys located?
retroperitoneum in the abdomen
what structure marks the start of the pelvis?
the iliac crests
where in the body are the ureters located?
proximal = in retroperitoneum distal = in pelvis
what part of the urinary tract is located in the perineum?
DISTAL urethra
name the layers protecting the kidney from anterior to posterior
visceral peritoneum paranephric fat renal (deep) fascia perinephric fat renal capsule
what muscle borders the kidney medially?
r/l psoas major
what muscle borders the kidney posteriorly?
r/l quadratus lumborum
what muscles border the kidney laterally?
external oblique
internal oblique
transversus abdominis
what is the perineum?
soft tissue area below the pelvis that contains genitalia
what kidney is more inferior to the other and why?
right kidney; the size of the liver pushes it down
vertebral levels of the right kidney?
L1-3
vertebral levels of the left kidney?
T12-L2
the peritoneal membrane is in contact with what part of the kidney?
anterior part
where is the renal hilum located?
medial aspect of the kidney
name the constituents of the renal hilum
renal artery
renal vein
ureter
describe the relationship between the kidneys and ribs
ribs 11 and 12 lie posterior to the kidney and have a role in their protection (or damage)
what abdominal region and quadrant are the kidneys located in?
lumbar/flank region or upper quadrants
do the kidneys move with inspiration? explain your answer
yes, are in close contact with the liver and spleen which move on inspiration
which component of the renal hilum sits most anteriorly?
renal vein (always sits anterior to the artery)
what part of the duodenum does the right kidney lie posterior to?
2nd part
vessels of what organ lie anterior to the left kidney?
splenic
what does a dependent area of the body mean?
deepest/most likely place for fluid to collect
most dependent part of the greater sac when supine?
hepatorenal recess
the common iliac arteries are anterior to the common iliac veins: T or F
T
where does lymph from the kidneys drain to?
lumbar nodes
where are the lumbar nodes?
around the abdominal aorta and IVC
the abdominal aorta bifurcates at the level of what structure and at what vertebral level?
umbilicus
L4
the IVC bifurcates at what level?
L5
ureteric blood supply?
branches from: renal artery abdo aorta common iliac artery internal iliac artery vesical artery
lymph from the ureters drains to?
lumbar nodes
iliac nodes
which renal vein is longer and why?
left as the vein has to cross the abdo aorta to get there
what kind of AAA will affect the renal arteries:
suprarenal
infrarenal
suprarenal
most common renal anatomical variation?
bifid (split in 2) renal pelvis
name the 3 layers of the kidney?
renal capsule
renal cortex
renal medulla
which layer of the kidney contains the renal pyramids
medulla
what causes the striations on the renal pyramids?
collecting ducts of nephrons aligned parallel
the proximal and distal convoluted tubules are named this because of their proximity to what structure?
glomerulus (proximal tubule is obviously closer to this than distal)
what do the collecting ducts of the kidney become?
minor calyx
describe how urine leaves the kidney starting from the collecting duct
collecting duct minor calyx major calyx (minors joined together) renal pelvis ureter
name the 3 main anatomical sites of ureteric constriction
pelviureteric junction
when the ureter crosses the bifurcation of the aorta
ureteric orifice
where is the pelviureteric junction?
where the renal pelvis becomes the ureter
what is the ureteric orifice?
the opening into 1 corner of the trigone
why are the sites of ureteric constriction important?
renal calculi get stuck here
what symptoms will a patient with a renal calculus complain of and why?
colicky pain that comes and goes; there is increased peristalsis above the site of obstruction
a calculus in what locations would cause BIlateral backup of urine?
bladder
urethra
a calculus in what locations would cause UNIlateral backup of urine?
ureter
calyces
what is hydronephrosis?
water inside the kidney
is hydronephrosis painful?
yes
how can hydronephrosis cause renal failure?
back pressure of urine into the calices compresses the nephrons in the pyramids
