CPR Module (SGU) - Anatomy of the Urinary System 1 Flashcards
Which embryological rudiments develop into the urinary system?
intermediate mesoderm and urogenital sinus
Where can you find the intermediate mesoderm?
Between paraxial and lateral mesoderm
What is the urogenital sinus part of?
cloaca
What are the two parts of the urogenital ridge? What arises from each of these components?
1) nephrogenic cord which gives rise to urinary system
2) gonadal ridge which gives rise to genital system
What are the three sequential components of the embryological kidney?
1) Pronephros
2) Mesonephros
3) Metanephros
Which primitive kidney will form the permanent kidney?
Metanephros
When does the pronephros form? When does it regress? Where is it located?
1) fourth week
2) regresses by end of fourth week
3) cervical region
When does the mesonephros form? When does it regress mostly? Where is it located?
1) end of week 4
2) end of second month
3) caudal to the regressing pronephros to the cloaca
In the male embryo, some parts of the mesonephros persist, what are they?
some tubules and mesonephros duct will form ductus deferens, duct of epididymis and efferent ductules
What do the excretory tubules of the mesonephros form?
Primitive Bowman’s capsules and renal tubules
Where do the mesonephric tubules appear and what do they connect with?
appear laterally, grow into an S shaped loop and meet with tufts of primitive glomeruli
When does the metanephros appear?
5th week
What structure do the excretory ducts of the metanephros come from?
metanephric mesoderm
The ureteric bud is an outgrowth from what? What is it initially close to?
mesonephric duct, close to the cloaca
The bud is “capped” by tissue which it eventually penetrates, what is this cap?
metanephric blastema
The ureteric bud forms what structures?
Primitive renal pelvis and major calyces
The renal tubules are formed from what structure and through which process?
formed from clusters of mesenchymal cells from the metanephric blastema. induced by collecting tubules
What causes a lobulated kidney? When is it not pathological?
1) failure of the growth of connective tissue, vascularity, and nephron growth
2) kidney is normally lobulated in fetus
What forms the excretory part of the nephron? What forms the conducting part of the nephron?
1) excretory –> mesenchyme of the metanephric blastema
2) conducting –> ureteric bud
How do glomeruli form?
Through invaginations of the metanephric tubules
Where are the kidneys initially located? Which direction does the hilum face initially?
1) in the pelvis
2) ventrally
Where does the kidney initially receive its arterial supply? What about when it ascends?
1) common iliac
2) aorta
When do the kidneys reach the adrenal glands?
9th week
During a kidney’s ascent, what happens if an artery is not obliterated before it receives the next segmental arterial supply?
accessory renal arteries
What is the cause of renal agenesis?
early degeneration or failure of formation of the ureteric bud
What does bilateral renal agenesis cause?
1) olilgohydramnios
2) pulmonary hypoplasia
3) fetal demise
What is the cause of a supernumerary kidney?
development of two separate ureteric buds on a side
What causes a bifid ureter?
early, incomplete division of the ureteric bud
What causes a horseshoe kidney?
fusion of lower poles of the kidneys while still in the pelvis
What structure interrupts the ascent of a horseshoe kidney?
inferior mesenteric artery
from deep to superficial, what are the coverings of the kidney?
1) renal capsule
2) perirenal fat
3) renal fascia
4) pararenal fat
5) transversalis fascia
Where is the hepatorenal recess?
superior to the right kidney
What is another name for the hepatorenal recess? Which body position causes fluid to collect there?
1) Pouch of Morrison
2) body is supine
sensory nerves from the kidneys travel back to the CNS with which nerves?
thoracic splanchnic
What nerves form the renal plexus?
1) celiac ganglion/plexus
2) aorticorenal ganglion
3) least thoracic splanchnic nerves
4) first lumbar splanchnic nerve
5) aortic plexus
6) sympathetics from T11-L2
Most renal nerves are which type?
vasomotor
What does water under the bridge mean with respect to the ureters?
Ureters pass UNDER the uterine vessels or ductus deferens
Where does the bladder reside when it is empty? When it is full?
1) true pelvis
2) protrudes into the abdominal cavity
What supplies the blood of the urinary bladder?
superior and inferior vesicle arteries
Where does lymph from the urinary bladder drain into?
external iliac nodes
How is the urinary bladder attached to the umbilicus?
median umbilical fold
What are the ligaments which hold up the bladder?
1) pubovesical and cardinal in women
2) puboprostatic and cardinal in men
When does the bladder develop?
4-7 weeks
What divides the cloaca into the rectal and urogenital canals?
urorectal septum
What are the portions of the urogenital sinus?
1) vesical (upper) - forms bladder
2) pelvic (middle) - most of male urethra and all of female urethra
3) phallic (males)
What developmental structures form the trigone of the bladder?
caudal portion of the mesonephric ducts
What are the two pelvic pouches in females? Males?
Females: rectouterine and vesico-uterine pouch
Males: rectovesical pouch
What three muscles control micturition? How are each of these controlled?
1) detrusor muscle - tonically relax by SNS, PSNS causes contraction in micturition
2) internal urethral sphincter - SNS keeps contracted, PSNS relaxes it
3) external urethral sphincter - PUDENDAL NERVE (somatic)
What are the parasympathetic and sympathetic innervations of the bladder?
SNS - T10-12 (lesser and least splanchnics), L1-2 (lumbar splanchnics
PSNS - S2-4 (pelvic splanchnics)
How do visceral afferents for pain travel to the bladder?
Majority of bladder travel with parasympathetics
Peritoneal portion travels with sympathetics
Where does pain from the bladder refer to?
perineum
Stretch and pain in urinary bladder is carried by what?
Visceral afferents accompanying parasympathetics or sympathetics depending on location
What are the three portions of the male urethra?
1) prostatic urethra
2) membranous urethra
3) penile urethra
Why is ascending UTI in females more common?
- short urethra
- proximity to vagina and anus
- intercourse
