AP01 - Topography of the Urinary system Flashcards
What are rugae?
ridges made by he inward folding of the walls of an organ
At what vertebral level does teh aorta form the renal arteries?
L2
What is the Line of Brodel, what is its’ clinical significance?
An avascular line along the lateral posterior border of the kidney, marking the boundary between arterial supply of the anterior and posterior renal arteries.
useful for surgery
What proportions of the kindey do the anterior and posterior segments of the renal artery supply?
anterior 75%
posterior 25%
they do not re-converge, so some parts are in danger of avascular necrosis
From renal artery to renal vein, what are the vessels in the kidney?
renal artery segmental artery interlobular artery arcuate artery cortical radiate artery afferent arterioles glomerulus efferent arteriole peritubular capillaries venule cortical radiate vein arcuate vein interlobular vein renal vein
What is the peritubuar network and what does it supply?
supplies the nephron tubules and the outer 2/3 of the cortex
What do the vesa recta supply?
the inner 1/3 of the medulla
What 4 muscles line the posterior surface of the kidney?
DIaphragm
Transersus abdominis
quadratus lomborum
psoas major
What is the renal papilla?
the part of the renal pyramid where it converges and hence empties into the minor calyx
what is contained within the renal hilum?
renal artery
renal vein
renal pelvis / ureter
Who would normally get Pelvic-uretic obstruction?
What happens next?
children, as it’s usually congenital
hydronephrosis
if bad surgery
if the result of infection - antibiotics
What does the laterocostal fascia sit between, and what does it split into?
parietal peritoneum and transversalis fascia
it splits into gerota’s and zuckerland’s fascia
What happens in nutcracker syndrome, and what are the symptoms?
Aorta and SMA compress left renal vein
flank pain and haematuria
How is nutcracker syndrome treated?
stenting, surgery, or routine urinalysis
What processs is used in nephrostomy?
under US, with LA pain relief
urine held in a lil plastic bag
a urostomy is just a bit more distal
Name 2 numeric developmental abnormalities of the kidney
renal agenesis
supernumerary kindey
Name 4 fusion developmental abnormalities of the kidney
horseshoe kidney
cross fused renal ectopia
pancake kidney
supernumerary kidney
Name 5 location developmental abnormalities of the kindey
pelvis kidney intrathroacic kidney crossed renal ectopia abnormal renal rotation nephroptosis
Name 4 shape developmental abnormalities of the kidney
persisten fetal lobulation
hypertrophied column of Bertin
Hilar lip
dromedary lip
Name 3 vascular developmental abnormalities of the kidney
accessory renal arteries
retroaortic / circumaortic left renal vein
supernumerary renal veins
Name 3 collecting system developmental abnormalities of the kidney
duplex collecting system
bifid collecting system
retrocaval ureter
What are the 3 categories for renal cancer staging?
T - size
N - nodal involvement
M - metastasis
Name 3 pressure points on the ureter
Peliv-uretic junction
passage between common iliac and internal iliac
passage into urinary bladder
What pain is associated with ureteric obstruction?
severe flank pain radiating to the groin, commonly referred to lower abdomen and to ipsilateral groin
What are the borders of the proximal ureter?
UPJ to superior margin of sacrum
What are the border of the middle ureter?
overlies the sacrum
What are the borders of the distal ureter?
from inferior margin of the sacrum to ureteral orifice
Who more commonly gets staghorn canaliculi?
women, it’s the result of recurrent infection
What are staghorn canaliculi made of?
struvite (magnesium ammonium phosphate MAP)
What pelvic pouch is in males?
rectovesical pouch
What pelvic pouches are in females?
viscerouterine pouch
rectouterine pouch
What 3 orifices form the trigone?
ureteric orifices
urethral orifice
How is renal colic pain characterised?
loin to groin
How does the surface of the trigone differ to the rest of the internal bladder wall?
is is smooooooth:)
What are the 3 segments of the male urethra?
prostatic
membranous
spongy
What is the prostate for and what structure is in there?
forming semen, it hence has the ejaculatory duct
What is the difference in urethral sphincter between males and females?
males - internal (autonomic), external (somatic
females - external (somatic)
What gland is on the urethra in males and females?
males - bubo-urethral gland
females - para-urethral gland (skene’s gland)
What does the internal urethral sphincter prevent in males?
seminal regurgitation
What is the difference between a male and female catheter?
female one is way smaller
What male birth defect is associated with the urethra?
hypospadias
urethral opening is between the penis tip and sacrum, along the bottom of the shaft of the penis
