Anatomy of the Urinary System

Question 1

What is kidneys relationship with the peritoneum?

Answer 1

Retroperitoneal organs, peritoneum on anterior surface only

Question 2

Where are the kidneys located?

Answer 2

T12-L3

Question 3

What protects the tops of the kidney?

Answer 3

11th and 12th ribs

Question 4

Where is the bladder located?

Answer 4

Behind pubic bone in adults (above in children)

Distends upwards when full

Question 5

Where is the prostate located?

Answer 5

Below bladder, urethra passes through it

Question 6

What is posterior to the kidneys?

Answer 6

Diaphragm
Psoas major
Quadratus lumborum
Transversus abdominis

Question 7

What is anterior to the right kidney?

Answer 7

Liver and descending duodenum

Question 8

What is anterior to the left kidney?

Answer 8

Spleen, pancreas and stomach

Question 9

What layers cover kidney (deep to superficial)?

Answer 9

Fibrous capsule
Peri-renal fat
Renal fascia
Para-renal fat (posterolateral)

Question 10

Describe the internal structures of the kidney (outside to in):

Answer 10

Cortex -> Medulla -> Papilla -> Minor calyx -> Major calyx -> Renal pelvis -> Ureter

Question 11

Where do the renal arteries arise from and at what level?

Answer 11

Abdominal aorta at L1/2

Question 12

What is above the renal arteries and why is this important clinically?

Answer 12

Superior mesenteric artery, if there is an aneurysm, may stop renal blood flow

Question 13

What is the path of blood supply in the kidneys?

Answer 13

Renal -> Segmental -> Interlobar -> Arcuate -> Interlobular -> Afferent arteriole -> Glomerulus -> Efferent arteriole

Question 14

Which renal artery is longer and what is its position compared to the IVC?

Answer 14

Right, posterior to IVC

Question 15

Which renal vein is longer and what is its position compared to the aorta?

Answer 15

Left, anterior to aorta

Question 16

Describe the path of the ureters:

Answer 16

Arise from medial aspect of kidney and descend along transverse processes of lumbar vertebrae, anterior to psoas major.
Cross pelvic brim (ovarian artery anterior) at bifurcation of iliac arteries, under uterine artery/vas deferens and enter bladder obliquely on posterior side

Question 17

Why is it important that the ureters enter the bladder obliquely?

Answer 17

Stops reflux when bladder fills, as this puts pressure on ureters

Question 18

Where are stones likely to cause blockage in ureter?

Answer 18

Uretero-pelvic junction
At pelvic brim
Uretero-vesical junction

Question 19

What muscle makes up the bladder?

Answer 19

Detrusor muscle

Question 20

What are the regions of the bladder (top to bottom)?

Answer 20

Apex (connected to umbilicus by median umbilical ligament)
Body
Fundus (trigone here)
Neck

Question 21

What is the trigone?

Answer 21

Smooth triangular area where ureters enter and urethral orifice is

Question 22

What are the four sections of the male urethra?

Answer 22

Pre-prostatic
Prostatic
Membranous
Spongy

Question 23

Why are women more at risk of UTI?

Answer 23

Their urethra is much shorter (4cm)

Question 24

What is the bladder’s blood supply?

Answer 24

Superior vesical artery and inferior vesical/vaginal artery

Question 25

What is the ureter’s blood supply?

Answer 25

Renal, ovarian, superior vesical and inferior vesical arteries

Question 26

What dermatomes are ureteric pain felt in?

Answer 26

T11-L2