anatomy of the urinary system Flashcards
where are the kidney’s located
- on the posterior abdominal wall
- retroperitoneal
- from T12-L3
- right kidney is lower due to liver
what are abdominal organs related to the kidneys
- adrenal/ suprarenal gland - on top
- liver and small intestine on the left
- jejunum, spleen and stomach on the right
what structures hold the kidneys in place
- pararenal fat
- renal fascia - connective tissue anchoring kidney down
- perirenal fat- adipose tissue sitting around kidney
what are the structures inside the kindey
- renal capsule
- hilum
- renal sinus
- renal cortex
- renal medulla
- renal papilla
- minor calyx
- major calyx
- renal pelvis
- medullary pyramids
what is the renal capsule
thin tough fibrous layer that surrounds the kidney
what is the hilum
vertical slit in the medial margin of the kidney where renal vessels, nerves and lymphatics enter
what is the renal sinus
continuation of the hilum internally
what is the renal cortex
outer continuous pale layer of the kidney
what is the renal medulla
inner discontinuous aspect of the kidney
what is the renal papilla
- apical projection of the renal pyramids draining the renal tubules
what is the minor calyx
receives urine from the papillary ducts that drain the renal tubules
what is the major calyx
several minor calyces unti to for 2-3 major calyces
what is the renal plevus
funnel shaped superior end of the ureter
what is the arterial supply to the kidneys
- renal artery off at L1 and L2 of the abdominal aorta
- enter the renal hilum to supply the renal parenchyma
- also supply the adrenal gland
what is the venous drainage of the kidney
- left and right renal veins drain into the inferior vena cava
- anterior to the artery and ureter in the hilum
- left crosses the midline and is at risk of compression between superior mesenteric and aorta
what is the innervation of the kidneys
sympathetic and parasympathetic
what is the sympathetic supply to the kidney
- least splanchnic nerve (T12)
- decrease urine output
- increases fluid retention
- decreased renal blood flow
what is the parasympathetic supply to the kidneys
- vagus nerve (CNX)
- increases urine production
- decreased fluid retention
- increased renal blood flow
what are some clinical variations seen to kidneys
- horseshoe kidney
- accessory renal arteries
- kidney transplant
what are the ureters
- muscular tubes that transport urine from the kidney to the bladder
- continuous superiorly to renal pelvis at uteropelvic junction
- retroperitoneal
how does urine move through the urethra
peristalsis
where can kidney stones get stuck
- renal pelvis first constricts
- ureter crosses pelvic brin
- entrance of bladder
what is the arterial blood supply of the ureter
renal, abdominal aorta, gonadal, common iliac, internal iliac arteries
what are anastomose
blood supply having 2 vessels that connect to each other
where is the bladder located
- anteriorly in the pelvic cavity
- superior surface entering abdominal cavity when full
where do the ureters enter the baldder
top corner of the base
what is the blood supply to the bladder
- superior and inferior vesicle
- vaginal (women)
- branches off obturator and inferior gluteal
what is the sympathetic control of the bladder
filling of the bladder and contraction of the internal urethral sphincter
what is the parasympathetic control of the bladder
emptying of the bladder and relaxation of internal urethral sphincter
what do the muscle do in bladder filling
detrusor muscles relax
what do the muscles do in bladder emptying
detrusor muscles contract
what is the sympathetic innervation of the bladder
- hypogastric nerve and superior hypogastric plexus
- inhibition detrusor muscle
- ejaculation causes contraction of urethral sphincter muscle
what is the parasympathetic innervation of the bladder
- pelvic splanchnic nerves and inferior hypogastric plexus
- motor to detrusor muscle
what are the external features of the bladder
- apex (towards pubic symphsis)
- fundus/ base
- body
- neck
what is the trigone of the bladder
- triangular area inside the bladder
- smooth part of the wall
- spans between two ureteric orifices
difference in the female urethra
- 4cm long
- slightly curves
- opens into vestibule at labia minora
- more prone to UTIs
- internal pudenal and vaginal artery supply
differences in male urethra
- preprostatic
- porstatic
- membranous
- penile/ spongy
preprostatic male urethra
- surrounded by internal urethral sphincter
- self contraction and no control
- closes in ejaculation
membranous urethra men
- surrounded by external urethral sphincter
- extends from prostate to perineal membrane
penile/ spongy urethra men
- within corpus spongiosum
- many mucus secreting urethral glands
changes in catheterisation in men
- longer course with bends
- enlarged prostates/ prostatic urethra cause resistance
- misplace can cause rupture
