Clinically Relevant Anatomy of the Urinary Tract

Question 1

What comprises the upper urinary tract?

Answer 1

Kidneys and ureters

Question 2

What comprises the lower urinary tract?

Answer 2

Bladder and urethra

Question 3

Which parts of the urinary tract are retroperitoneal?

Answer 3

Kidneys and proximal ureters

Question 4

Which aspects of the urinary tract are pelvic in location?

Answer 4

Distal ureters

Bladder

Proximal urethra

Question 5

Which aspect of the urinary tract is found in the perineum?

Answer 5

Distal urethra

Question 6

Where do the renal arteries arise?

Answer 6

Aorta

Question 7

The renal veins sit ________ to the renal arteries

Answer 7

The renal veins sit anterior to the renal arteries

Question 8

Which type of fat directly surrounds the kidneys?

Answer 8

Perinephric fat

Question 9

Where do the renal veins drain?

Answer 9

IVC

Question 10

At which vertebral levels do the right and left kidneys sit respectively?

Answer 10

Right: L1-L3

Left: T12-L2

(due to the size of the liver ont he right side)

Question 11

Which space can be found anterior to the right kidney?

Answer 11

Hepatorenal recess

Question 12

When the aorta divides the common iliac arteries are _______ to the common iliac veins

Answer 12

When the aorta divides the common iliac arteries are anterior to the common iliac veins

Question 13

What is the arterial supply of the ureters?

Answer 13

Many arterial branches contribute along its length

1. The renal artery
2. The abdominal aorta
3. The common iliac artery
4. The internal iliac artery
5. The vesical (bladder) artery

Question 14

What is the lymphatic drainage of the kidneys?

Answer 14

Lumbar nodes

Question 15

What is the lymphatic drainage of the ureters?

Answer 15

Lumbar and iliac nodes

Question 16

What are the two classifications of AAA depending on their association with the kidneys?

Answer 16

Infrarenal (below renal arteries)

Suprarenal (involves renal arteries)

Question 17

What is a bifid renal pelvis?

Answer 17

A congenital renal tract abnormality characterised as a duplication of the renal pelvis that unite to form the ureter

Question 18

What is a horseshoe kidney?

Answer 18

Congenital abnormality involving failure of the kidneys to properly divide into two separate organs

Question 19

What are the three most common reasons for only one kidney to be present?

Answer 19

1. Agenesis
2. Surgical removal
3. Donation

Question 20

Anterior to the IVC sits which structure related to the kidney?

Answer 20

Ureter

Question 21

A kidney is comprised of which two main parts?

Answer 21

Cortex and medulla

Question 22

Why does the medullary tissue within the kidney appear striated?

Answer 22

Due to the regularity of the nephrons which make it up

Question 23

Where do the collecting ducts of the nephrons drain?

Answer 23

Minor calyx

Question 24

Where do the minor calyces drain?

Answer 24

Major calyces which drain into the renal pelvis

Question 25

What are the three main sites of ureteric constriction?

Answer 25

1. Pelviureteric junction
2. Ureter crossing anterior aspect of the common iliac artery (often crosses the bifurcation)
3. Ureteric orifice (opening into one corner of the trigone on the floor of the bladder)

Question 26

In which two ways can an obstruction occur in the urinary tract?

Answer 26

Internally (renal calculi)

Externally (tumour)

Question 27

How does the urinary system respond to obstruction?

Answer 27

Peristaltic contractions increase

(causes colicky pain)

Question 28

Obstructions to the urinary tract can lead to back pressure which may cause what?

Answer 28

Hydronephrosis

(can cause renal failure)

This occurs when back pressure exceeds glomerular pressure

Question 29

How can renal failure be defined?

Answer 29

A failure to adequately filter the blood to produce urine