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Renal > Anatomy - Upper Urinary Tract > Flashcards

Anatomy - Upper Urinary Tract Flashcards

1
Q

What is the main fucntion of the urinary tract?

A

urine passes from its production to its excretion (removal from the body)

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2
Q

Part of the urinary tract

A

the kidney: produces urine

Ureter - drains urine

bladder- sotres/ voids urine

detrusser muscle - contracts to empty the contents of the bladder and pushes the urine to the urethra

urethra- excretion of urine

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3
Q

Upper Urinary tract involves

A

kidney and ureter

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4
Q

Lower urinary tract involves

A

Bladder and urethra

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5
Q

Where is the proximal half of the ureter located?

A

in the abdomen, retroperitoneal

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6
Q

What are retroperitoneal structure?

A

Things that sit behind the peritoneal cavity

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7
Q

Where is the kidney located?

A

In the abdomen, retroperitoneal

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8
Q

Where does the perineum extend to?

A

floor of pelvis to the skin of the external genitalia

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9
Q

Which urinary structures are located in the pelvis?

A

distal ureter
bladder
urethra

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10
Q

Which urinary structures are located in the perineum?

A

distal urethra

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11
Q

Which part of the kidney is in direct contact with the visceral peritoneum?

A

Anterior surface of the kidney

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12
Q

What is the hilum of the kidney?

A

It is the root of the kidney, present in the medial aspect.

Arteries, veins and urinary structures enter and exit the kidney from there

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13
Q

How is the artery, vein and ureter position in the hilum?

A

Anterior - vein
behind vein - renal artery
most posteriorly - ureter

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14
Q

What are the anterolateral abdominal wall muscles?

A

external oblique, internal oblique and trasverse abdominis

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15
Q

What is the uniqueness of peinephric fat?

A

Liquid fat, kidney floats in it

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16
Q

What are the posterior muscle layers of the kidney?

A

Psos major

Left quadratis lumborum

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17
Q

Where is the location of the iVC and aorta in a patient?

A 
Right IVC (much more anterior)
Left - Aorta
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18
Q

Where are the kidneys wrt to the vertebrae? **EXAM

A

Left kidney - T12 - L2

Right kidney - L1 - L3
pushed inferiorly because of the liver pushing it down

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19
Q

Do the ribs protect the kidney?

A

Yes and No

Ribs 11 and 12, protect it but n trauma can penetrate and cause trauma to the kidney

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20
Q

How to palpate the kidney?

A

Posteriorly below the right flank, just below the liver, as the patient to breathe in -> diaphragm descens along with the liver and it pushes the right kidney down -> you can trap the kidney btw your hands

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21
Q

How to palpate the kidney?

A

Palpate anteriorly within the RUQ

Posteriorly below the right flank, just below the liver, as the patient to breathe in -> diaphragm descens along with the liver and it pushes the right kidney down -> you can trap the kidney btw your hands

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22
Q

How should the kidneys feel on palpation?

A

Smooth, regular firm

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23
Q

Anatomical relationships

A

sits just behind the rright colonic flexure

spleen in front of the kidney

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24
Q

What is the hepato-renal recess?

A

Space in the peritoneal cavity btw the liver and kidney

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25
Q

What is the importance of the hepato-renal recess?

A

Most dependent/ deepest part in the body when the patient is lying down.

So if there is any abnormal fluid in the abdomen it collects in the hepatorenal recess

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26
Q

Venous drainage

A

Rifght and left renal vein –> IVC

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27
Q

Arterial supply

A

Right and left renal artery -> from the aorta

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28
Q

Relationship btw aorta and IVC

A

Initially the vein is anterior and artery inferior, but as we go down and the aorta bifurcates, aorta becomes anterior

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29
Q

What is the blood supply to the ureter?

A

Multiple arterial branches

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30
Q

Lymph drainage of the kidney and ureter - **EXAM

A

Lumbar lymph nodes - kidney

Ureter - 2 drainage
Proxinmal - lumbar lymph nodes
distal part - iliac lymph nodes

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31
Q

How can AAA be classified?

A

According to the renal btw the renal arteries

Infra-renal
Supra-renal

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32
Q

Which type of AAA is associated with renal artery stenosis (artherosclerosis)?

A

Infra-renal AAA

both caused by atheroscleosis

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33
Q

What is the cause of renal artery stenosis?

A

sometimes supra-renal AAA -> can lead to the occlusion of the proximal renal artery via aneurysm

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34
Q

What are a few anatominal variation in the renal system?

A

Two renal pelvis (usually only one)

Bifid ureter

Ureter sitting behind the IVC

Horseshow kidney (no embryological seperation of the right and left kidney)

Ectopic pelvic kidney (comes to the pelvis)

Kidney only on one side (agenesis - no formation, or surgery)

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35
Q

What are the two parts int he kidney?

A 
Renal cortex (pink)
Renal medulla (striped)
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36
Q

Why is the renal medulla striped?

A

Because of the numerous amounts of nephrons(50,000) and their collecting ducts stacked up on each other

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37
Q

WHat is the largest urine collecting area in the kidney?

A

Renal pelvis

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38
Q

How does the diameter of the ducts change?

A

It increases from collecting duct -> renal pelvis and decreases to ureter

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39
Q

Pelvi-ureteric unction

A

anatomical site of constriction

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40
Q

What are the anatomical sites? of constriction

A

Pelvi-uteric unction

btw the proximal and distal part of the ureter (as it changes from abdomen to pelvis) where it crosses over a bony ridge of the common iliac artery

Ureteric orifice - bilaterally, opening into one ocrner of the floor of the bladder)

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41
Q

Can the renal calculi be visulaised ion X-rays?

A

Yes, excpet in kidney stones

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42
Q

What are the causes of constriction of the ureter and causing back flow?

A

External constriction (tumour)

Internal blockage (kidney stones)

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43
Q

How does constriction of the ureter present?

A

Spasmodic pain - unilateral, due to the constriction of the smooth muscle

44
Q

What happens if the blockage is in the bladder?

A

Unilateral back pressure or bilateral

45
Q

What happens if the blockage is in the urethra?

A

bilateral black pressure

46
Q

What happens if the urine is blocked along the urinary tract?

A

Glomerulus keeps producing urine until it is pushed to the point where the glomerulus stops production (renal fialure) and squishes the renal pelvis

47
Q

What is the sign of kidney failure/ blockage?

A

Hydronephrosis - right kindey enlargement

48
Q

What is the false pelvis?

A

Superior part

49
Q

What is the true pelvis?

A

Inferior part

50
Q

What is the point that seperates the true and false pelvis?

A

Pelvic rim or pelvic inlet

51
Q

What is the immportance of false pelvis?

A

Abdominal viscera extends into the false pelvis

52
Q

Where the proper pelvic cavity start from?

A

From the pelvic inlet in the true pelvis to the levator ani (floor of the pelvis)

53
Q

What is the area between the levator ani and the skin of the external genitalia?

A

Perineum

54
Q

Where is the bladder located?

A

In the true pelvis

55
Q

what is the muscle of the pelvic floor?

A

Levator ani

56
Q

Why does the ureter change its direction as it eneters the bladder?

A

Changes its direction in an infero-medial direction to prevent the reflux of urine

57
Q

Why is the ureter route called sub-peritoneal?

A

Below the peitoneum,

once they are in the true cavity they are below the periotneum hence the name

58
Q

Most dependent part of the peritoneal cavity in men when a person is standing up

A

Recto-vesicalpouch in male

59
Q

Vesioc-uterine pouch

A

Shallow pouch

60
Q

Deepest pouch of the peritoneal cavity in the females

A

Recto-uterine pouch/ pouch of Douglass

61
Q

Anatomical relations of the pelvic uterus in females

A

Uterine artery - ureter sits behind the artery “water under the bridge:

Important in histerectomy - ligation of the uterine artery
*if the ureter crossed it can cause renal failure

62
Q

Anatomical relation in males

A

Ureter sits posterior ti the vas deferens

63
Q

*Key arteries come from where

A

common iliac artery - from the internal -> vesical arteries (supply bladder), uterine artery, middle rectal artery, vaginal artery, prostatic arteries

external iliac artery - femoral artery

64
Q

The bladder structure location

A

Sub-peritoneal

65
Q

What is the ureteric orificies?

A

ureter enters the bladder

66
Q

What is the internal uretheral orificies?

A

Single opening into the urethra

67
Q

What is the smooth triangular are in the bladder?

A

Trigone of the bladder

68
Q

What is the muscle of the bladder?

A

Detrusor muscle - has external muscles which surround the ureteric orifices which encircle it and when the bladder contracts we don’t want the urine to go up the ureter (the extra fibres close off the ureteric orifices)

69
Q

What is the use of the internal urethral sphincter muscle?

A

To ensure that the semen that is enjaculates if passed down into the urethra and not refluxed back into the bladder

70
Q

Who has the internal urethral sphicter muscle?

A

Men ONLY

71
Q

What is an antiflexed uterus?

A

Normal

72
Q

Where is the bladder present in both men and women?

A

Most anterior organ in the pelvis - just behind the pubic symphysis

73
Q

How should supra-pubic catheterisation done?

A

Only with a full bladder - or else it will penetrate the peritoneal cavity!

hence do it only on a full stomach!!!

74
Q

What is the significance of the external urethral sphincter?

A

Same place as the levator ani muscle

hence anything below external urethral muscle/ levator ani - true pelvis

If below it -> perineum

75
Q

What is the corpus spongiosum?

A

Where the spondy urethra us

76
Q

Where are the sperms produced?

A

Testicles

77
Q

Where are the sperms stored?

A

epididymis

78
Q

Route of the sperm

A

testciles -> epidydymis epididymis -> vas deferens -> inguinal cavity -> behind the bladder -> seminal glands (joins with it) –> ejaculatory duct -> prostate gland -> prostatic urethra

79
Q

Where was the testes present during the embryological development?

A

Posterior abdomen through the inguinal canal to the scrotum.

Descended with the spermatic cordd (arterial and venous supplyy, vas deferens)

80
Q

What is the tunica vaginalis?

A

Testicle pushes its way into the tunica- abdominal wall –> descended down into the scrotum and dragged with them: spca vaginalis

Parietal layer - around the scrotum

Visceral layer- in contact with the testcile

81
Q

What is a hydrocoele?

A

Abnormal fluid within the tunica vaginalis

82
Q

Venous drianage to the testicle

A

Pampiniform venous plexus

83
Q

Arterial supply to the testicle

A

Righ testicular artery

84
Q

What does the spermatic cord contain?

A

the vas deferens, testicular artery & pampiniform plexus, nerves

85
Q

What can torsion of the spermatic cord lead to?

A

Disrupt the blood supply to the testis:
severe pain
danger of testicular necrosis (cell death)

86
Q

Female equivalent of the testicular artery

A

ovarian artery and ovarian vein

gonadal artery and gonadal vein

87
Q

Where do the gonadal arteries arise from?

A

Aorta

88
Q

Where do the veins drain to?

A

Right gonadal vein - IVC

left gonandal vein - renal vein and via it to IVC

89
Q

How does the vas deferens enter the abdominal cavity?

A

via the deep ring of the inguinal canal

90
Q

location of the vas deferens and ureter

A

ureter behind the vas deferens - water under the bridge

91
Q

What are the openings to the prostatic urethra?

A

For:

prostatic ducts
prostatic urethra
opening to ejaculatory ducts

92
Q

How can the prostate gland be palpated?

A

digital rectal examination - to palpate the peripheral zone

93
Q

What is the importance of palpating the peripheral zone?

A

where prostatic cancer develops

94
Q

What are the 3 parts of erectile tissue in the penis?

A

2 Corpus cavalosum

corpus spongiosum

95
Q

What happens during an erection?

A

blood fills the erectile tissue

96
Q

Blood supply to the penis

A

Internal iliac artery - deep arteries of the penis

97
Q

Blood supply to the scrotum

A

Dual supply

blood from both internal and external iliac artery

98
Q

Lymphatic drainage of the scrotum, testicle and penis **EXAM

A

Scrotum and penis - Superficial inguinal region

testicles - lumbar nodes (due to the embryological origins of the testicle)

99
Q

Is the epipdidmymis inside or outside the tunica vaginalis?

A

It is covered by the tunican vaginalis

100
Q

Where is the epididymis palpated?

A

Posterior to the testis, at the superior pole of the testis

101
Q

Where is the vas deferens palpated?

A

In the scrotum ,within the spermatic cord superior to the testis

102
Q

What are the two zones in the prostate gland?

A

2 peripheral zones

1 centrl zone

103
Q

What is the importance of the peripheral zone of the prostate gland?

A

Higher likelihood of development of prostatic cancers in the PZ

104
Q

Which part of the prostate gland can be felt on a PR exam?

A

the PZ

105
Q

what is the ejaculatory duct?

A

It is the combined duct with the secretions of both vas deferens and the seminal vesicles

Renal (21 decks)

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