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Renal > Anatomy of the Upper Urinary Tract > Flashcards

Anatomy of the Upper Urinary Tract Flashcards

1
Q

What is the route of urine flow?

A

Kidney produces urine - ureter drains from kidney to bladder - bladder stores and voids urine - urethra excretes urine

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2
Q

What structures make up the upper urinary tract?

A

Kidneys and ureters = infection of this area may spread to the kidneys

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3
Q

What structures make up the lower urinary tract?

A

Bladder and urethra = infection of this area will involve these structures

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4
Q

What parts of the urinary tract are found in the abdomen?

A

In the retroperitoneum = kidneys, proximal ureters

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5
Q

What parts of the urinary system are present in the pelvis?

A

Distal ureters, bladder, proximal urethra

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6
Q

What part of the urinary tract is found in the perineum?

A

Distal urethra

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7
Q

What are the contents of the hilum of the kidneys?

A

Renal artery, renal vein, ureter

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8
Q

What part of the abdomen are the kidneys found in?

A

In the abdominal cavity behind the peritoneum

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9
Q

What are the layers of tissue that surround the kidneys (from superficial to deep)?

A

Visceral peritoneum, paranephric fat, renal (deep) fascia, perinephric fat, renal capsule

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10
Q

What muscles are the kidneys related to?

A

Anterior to quadratus lumborum and lateral to psoas major

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11
Q

What is the relationship of the kidneys to the lower thoracic/upper lumbar vertebral bodies?

A

Lateral to the vertebral bodies

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12
Q

What vertebral level are the kidneys found at?

A

Right kidney = L1-L3

Left kidney = T12-L2

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13
Q

Why is the right kidney slightly inferior to the left kidney?

A

Due to the liver

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14
Q

What ribs are posteriorly related to the kidneys?

A

Ribs 11 and 12 = offer protection against penetrating injury but can bruise/lacerate the kidneys if they fracture

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15
Q

What sections of the abdomen are the kidneys found in?

A

Left and right upper quadrants

Left and right hyperchondria

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16
Q

What are the anatomical relationships of the liver and spleen?

A

In contact with the diaphragm superiorly and the superior poles of the kidneys inferiorly

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17
Q

How do the kidneys move during breathing?

A

Move inferiorly on inspiration and superiorly on expiration

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18
Q

How would you ballot the right kidney?

A

Palpate posteriorly within the right flank just below rib 12

Palpate anteriorly within the RUQ

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19
Q

How does breathing aid balloting the kidneys?

A

As the patient breathes in the kidneys descend and may be trapped for examination between the palpating hands

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20
Q

What structures is the right kidney posterior to?

A

Liver, hepatorenal recess, second part of the duodenum, right colic flexure, ascending colon

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21
Q

What structures is the left kidney posterior to?

A

Stomach, tail of the pancreas, hilum of the spleen, splenic vessels

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22
Q

What is significant about the hepatorenal recess?

A

One of the lowest dependent parts of the greater sac of the peritoneal cavity in the supine patient

23
Q

What are the renal veins anterior to?

A

The renal arteries

24
Q

What are the common iliac arteries anterior to?

A

Common iliac veins

25
Q

Where does lymph from the kidneys drain to?

A

The lumbar nodes = located around the abdominal aorta and the IVC

26
Q

Where does the abdominal aorta bifurcate?

A

At the level of the umbilicus

27
Q

What vessels give branches to supply the ureter?

A

Renal artery, abdominal aorta, common iliac artery, internal iliac artery, vesical artery

28
Q

Where does lymph from the ureters drain to?

A

Lumbar nodes

Iliac nodes = located around the common, internal and external arteries

29
Q

What are the characteristics of renal stenosis when it is associated with AAA?

A

Combined with infra-renal AAA = both caused by atherosclerosis
Due to supra-renal occlusion = occlusion of proximal renal artery by the aneurysm

30
Q

What are some anatomical variations that exists in the upper urinary tract?

A

Bifid renal pelvis, bifid ureter and unilateral duplicated ureter, horseshoe kidney, retrocaval ureter, ectopic pelvic kidney

31
Q

What are some causes of a solitary kidney?

A

Agenesis, nephrectomy (pathology-driven or donation)

32
Q

What does each kidney consist of?

A

An outer cortex and inner medulla

33
Q

What does the medulla of the kidney contain?

A

Renal pyramids = each pyramid contains around 50,000 nephrons

34
Q

What gives the renal pyramids their striped appearance?

A

Nephrons run axially towards the apex of each pyramid

35
Q

What route does urine drain through the kidney via?

A

Nephron collecting duct - minor calyx - major calyx - renal pelvis - ureter

36
Q

What happens to the diameter of the urine drainage tubes at the pelviureteric junction?

A

The diameter increases = the wider renal pelvis becomes the narrower ureter

37
Q

Where are the sites of ureteric constriction?

A

Pelviureteric junction
Ureter crossing anterior aspect of common iliac artery (often crosses bifurcation)
Ureteric orifice

38
Q

What is the ureteric orifice?

A

Opening into one corner of the trigone on the floor of the bladder

39
Q

What are renal calculi?

A

Kidney stones = usually visible on x-ray

40
Q

What are filling defects in the kidney suggestive of?

A

Renal calculi

41
Q

What are renal calculi formed from?

A

Urine calcium salts = may obstruct the urinary tract

42
Q

What can cause obstruction of the ureter?

A

Internal obstruction = impacted renal stone, blood clot

External compression = expanding mass (tumour)

43
Q

What is in the walls of the ureter?

A

Smooth muscle

44
Q

How does the urinary tract respond to obstruction?

A

Increased peristalsis proximal to the site of the obstruction in an attempt to flush the obstruction into the bladder

45
Q

What kind of pain to patients with urinary tract obstruction present with?

A

Colicky pain = due to the fact that peristalsis comes in waves

46
Q

What do obstructions cause?

A

Back up of urine in the tract towards the kidneys

47
Q

What do obstructions in the calyces or ureter cause?

A

Unilateral back pressure of urine

48
Q

What do obstructions within the bladder cause?

A

Unilateral or bilateral kidney problems

49
Q

What do obstructions in the urethra cause?

A

Bilateral kidney problems

50
Q

How does obstruction of the urinary tract affect urine production?

A

Urine production continues until the pressure within the urinary tract exceeds the pressures favouring filtration at the glomerulus

51
Q

What is renal failure?

A

Failure to adequately filter blood to produce urine

52
Q

What is hydronephrosis?

A

Water inside the kidneys

53
Q

What can hydronephrosis lead to?

A

Renal failure = due to urine back pressure into the calyces compresses the nephrons within the medullary pyramids

54
Q

What does acute hydronephrosis cause?

A

Painful stretching of the renal capsule

Renal (36 decks)

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