Anatomy of the Upper Urinary Tract

Question 1

what produces urine?

Answer 1

the kidney

Question 2

what structures mark the beginning and end of the ureter?

Answer 2

start - kidney

end - bladder

Question 3

what does the bladder do?

Answer 3

stores and empties urine

Question 4

what structures make up the upper urinary tract?

Answer 4

kidneys

ureters

Question 5

what structures make up the lower urinary tract?

Answer 5

bladder

urethra

Question 6

where are the kidneys located?

Answer 6

retroperitoneum in the abdomen

Question 7

what structure marks the start of the pelvis?

Answer 7

the iliac crests

Question 8

where in the body are the ureters located?

Answer 8

proximal = in retroperitoneum
distal = in pelvis

Question 9

what part of the urinary tract is located in the perineum?

Answer 9

DISTAL urethra

Question 10

name the layers protecting the kidney from anterior to posterior

Answer 10

visceral peritoneum
paranephric fat
renal (deep) fascia
perinephric fat
renal capsule

Question 11

what muscle borders the kidney medially?

Answer 11

r/l psoas major

Question 12

what muscle borders the kidney posteriorly?

Answer 12

r/l quadratus lumborum

Question 13

what muscles border the kidney laterally?

Answer 13

external oblique
internal oblique
transversus abdominis

Question 14

what is the perineum?

Answer 14

soft tissue area below the pelvis that contains genitalia

Question 15

what kidney is more inferior to the other and why?

Answer 15

right kidney; the size of the liver pushes it down

Question 16

vertebral levels of the right kidney?

Answer 16

L1-3

Question 17

vertebral levels of the left kidney?

Answer 17

T12-L2

Question 18

the peritoneal membrane is in contact with what part of the kidney?

Answer 18

anterior part

Question 19

where is the renal hilum located?

Answer 19

medial aspect of the kidney

Question 20

name the constituents of the renal hilum

Answer 20

renal artery
renal vein
ureter

Question 21

describe the relationship between the kidneys and ribs

Answer 21

ribs 11 and 12 lie posterior to the kidney and have a role in their protection (or damage)

Question 22

what abdominal region and quadrant are the kidneys located in?

Answer 22

lumbar/flank region or upper quadrants

Question 23

do the kidneys move with inspiration? explain your answer

Answer 23

yes, are in close contact with the liver and spleen which move on inspiration

Question 24

which component of the renal hilum sits most anteriorly?

Answer 24

renal vein (always sits anterior to the artery)

Question 25

what part of the duodenum does the right kidney lie posterior to?

Answer 25

2nd part

Question 26

vessels of what organ lie anterior to the left kidney?

Answer 26

splenic

Question 27

what does a dependent area of the body mean?

Answer 27

deepest/most likely place for fluid to collect

Question 28

most dependent part of the greater sac when supine?

Answer 28

hepatorenal recess

Question 29

the common iliac arteries are anterior to the common iliac veins: T or F

Answer 29

T

Question 30

where does lymph from the kidneys drain to?

Answer 30

lumbar nodes

Question 31

where are the lumbar nodes?

Answer 31

around the abdominal aorta and IVC

Question 32

the abdominal aorta bifurcates at the level of what structure and at what vertebral level?

Answer 32

umbilicus | L4

Question 33

the IVC bifurcates at what level?

Answer 33

L5

Question 34

ureteric blood supply?

Answer 34

``` branches from: renal artery abdo aorta common iliac artery internal iliac artery vesical artery ```

Question 35

lymph from the ureters drains to?

Answer 35

lumbar nodes | iliac nodes

Question 36

which renal vein is longer and why?

Answer 36

left as the vein has to cross the abdo aorta to get there

Question 37

what kind of AAA will affect the renal arteries: suprarenal infrarenal

Answer 37

suprarenal

Question 38

most common renal anatomical variation?

Answer 38

bifid (split in 2) renal pelvis

Question 39

name the 3 layers of the kidney?

Answer 39

renal capsule renal cortex renal medulla

Question 40

which layer of the kidney contains the renal pyramids

Answer 40

medulla

Question 41

what causes the striations on the renal pyramids?

Answer 41

collecting ducts of nephrons aligned parallel

Question 42

the proximal and distal convoluted tubules are named this because of their proximity to what structure?

Answer 42

glomerulus (proximal tubule is obviously closer to this than distal)

Question 43

what do the collecting ducts of the kidney become?

Answer 43

minor calyx

Question 44

describe how urine leaves the kidney starting from the collecting duct

Answer 44

``` collecting duct minor calyx major calyx (minors joined together) renal pelvis ureter ```

Question 45

name the 3 main anatomical sites of ureteric constriction

Answer 45

pelviureteric junction when the ureter crosses the bifurcation of the aorta ureteric orifice

Question 46

where is the pelviureteric junction?

Answer 46

where the renal pelvis becomes the ureter

Question 47

what is the ureteric orifice?

Answer 47

the opening into 1 corner of the trigone

Question 48

why are the sites of ureteric constriction important?

Answer 48

renal calculi get stuck here

Question 49

what symptoms will a patient with a renal calculus complain of and why?

Answer 49

colicky pain that comes and goes; there is increased peristalsis above the site of obstruction

Question 50

a calculus in what locations would cause BIlateral backup of urine?

Answer 50

bladder | urethra

Question 51

a calculus in what locations would cause UNIlateral backup of urine?

Answer 51

ureter | calyces

Question 52

what is hydronephrosis?

Answer 52

water inside the kidney

Question 53

is hydronephrosis painful?

Answer 53

yes

Question 54

how can hydronephrosis cause renal failure?

Answer 54

back pressure of urine into the calices compresses the nephrons in the pyramids