Anatomy- upper urinary tract Flashcards
In what “part” of the body are the kidneys located?
Retroperitoneal- between the muscles of the body wall and the parietal peritoneum
What is the approximate vertebral level of the kidneys?
Lateral to T12-L3
What may be the result of a rib fracture?
Floating ribs- the sharp end may contuse/lacerate the kidney
Describe the relationship of the kidney(s) to: a) quadratus lumborum b) psoas major c) the major blood vessels
a) anterior b) antero-lateral c) right kidney is lateral to the IVC; left kidney is lateral to the aorta
What groups of muscles protect and support the kidney?
Back muscles; posterior abdominal wall muscles, antero-lateral abdominal wall muscles
Where should the abdomen be balloted for the right and left kidneys? What direction do the kidneys move in inspiration/expiration?
Right- anteriorly in the RUQ Left- posteriorly in the left lumbar region Move down on inspiration and up on expiration
What are the approximate surface dimensions of the kidney?
About 12cm long, 6cm wide
Describe some of the structural variants of the kidney
Bifid renal pelvis Bifid/duplicated ureter Horseshoe kidney Retrocaval ureter
Clockwise from top right
Distal convoluted tubule
Collecting duct
Minor calyx
Loop of Henle
Proximal convoluted tubule
Glomerulus
From top:
Collecting duct of nephron, minor calyx, major calyx, renal pelvis, ureter
Describe the arterial supply and venous drainage of the kidney/
Renal artery lies posterior to the renal vein, entering the renal hilum
Where does the abdominal aorta bifurcate?
At the level of the umbilicus
What is the arterial blood supply to the ureter?
From: abdominal aorta, renal artery, vesical artery, common iliac, internal iliac
Where does renal lymph drain to?
Lumbar nodes
What effect might an AAA have on the renal blood supply?
May occlude the proximal renal artery
What are the three most common sites of ureteric constriction?
From superior to inferior- pelviureteric junction, where it crosses the anterior aspect of the common iliac, the ureteric orifices
What is renal colic caused by?
Persistalsis of the smooth muscle in the ureter as it attempts to remove an obstruction (e.g. renal calculus)
How can a renal obstruction lead to renal failure? What name is given to this condition, and why does it cause pain?
Increasing back-pressure into the glomeruli “cancels out” the forced favouring glomerular filtration, meaning no filtration takes place/no urine is produced
Hydronephrosis-combination of peristaltic pain and painful stretching of the renal capsule
