DLA 72 Clinical anatomy of the renal system

Question 1

What is located at the superior pole of the Left kidney? anterior view

Answer 1

adrenal gland/suprarenal gland, peritoneum covering of stomach and spleen

Question 2

what is at the medial pole of the left kidney? anterior view

Answer 2

tail of pancreases, left coiled/splenic flexure ( union point of transverse and descending colon

Question 3

what is located inferiorly of the left kidney? anterior view

Answer 3

peritoneum covering the small intestine, especially the jejunum

Question 4

What is located superior to left kidney? posterior view

Answer 4

lies on 11th and 12 rib ( with subcostal nerve and vessels, iliohypogastric and illioinguinal nerves running posterior and diagonal to it
- the diaphragm separates it from the thorax

Question 5

what is inferior to left kidney? posterior view

Answer 5

related to the muscles of the posterior abdomen ( from medial to lateral) psoas major, quadrates laborum, and transverses abdominis

Question 6

where is the diaphragm?

Answer 6

poster to the superior poles of the kidneys

Question 7

where is the bladder found?

Answer 7

at the pelvis

Question 8

what is the renal hilum?

Answer 8

a concavity located on the medial border of each kidney where structures enter and leave.

contains 3 main structures:

• Renal vein ( most anterior)
• Renal artery ( branches)
• Pelvis of the Ureter

Question 9

what are the coverings of kidney?

Answer 9

the capsule on the kidney is covered by the perirenal/pernephric fat and that is covered by the renal fascia that is then covered by the pararenal/ paraneprhic fat

Question 10

What is the purpose of the renal capsule?

Answer 10

it is fibrous so it is a very tough covering, it is a tough fibrous capsule surrsouding the kidney. It directly covers the renal cortex.

it protects the kidney from trauma and damage. it also penetrates the renal parenchyma to form trabeculae that lobulate the kidneys

Question 11

where is the renal cortex located?

Answer 11

beneath the renal capsule, extends inwards as the renal column between the renal pyramids of the medulla and contains nephrons.

Question 12

What makes up the renal medulla?

Answer 12

• darker in color with striated appearance, composed of 8-16 renal pyramids.
• apex of pyramids is directed into the sinus as renal papilla.
• surface of papilla is perforated by the ducts of Bellini

Question 13

what is a hepatorenal recess?

Answer 13

• pouch of Morrison
• it is located superior to the right kidney
• posterior to the liver.
• Fluid in the abdomen will accumulate in this space when the body is supine

If the fluid accumulates there, you can investigate this with a FAST focused assessment with sonography for trauma exam

normally no fluid here unless trauma

Question 14

The sympathetic innervation to the kidneys, ureters and bladder are derived from what?

Answer 14

the lesser and least thoracic splanchnic and lumbar splanchnic nerves.

ureters receive their innervation segmentally.

Question 15

The renal plexus is formed from

Answer 15

sympathetics from T11-L2 found in

• celiac ganglion and plexus
• aorticorenal ganglion
• the lower ( least) thoracic splanchnic nerves
• 1st lumbar splanchnic nerves

( nerves can come form any of these areas)

Question 16

urogentical vesicle junction supplied by

Answer 16

L1-L2 from the T11-L2 pain by kidneys

Question 17

renal arterial circulation

riding Segways intergalactically an interesting alien got extremely perverted.

Answer 17

renal artery>segmental artery> interlobar arteries>arcuate artery ( divides cortex and medulla)>interlobular arteries>afferent arterioles> glomerular capillaries> efferent arterioles> peritubular capillaries/ vasarecta> Interlobular veins> arcuate veins> interlobular veins> segmental veins> Renal veins

Question 18

Renal veins drain the ______, which subsequently drain into the ______.

Answer 18

kidneys, inferior vena cava

Question 19

The left renal vein passes anterior to the _______and drains the Left ______ and left ______.

Answer 19

aorta
suprarenal vein
gonadal vein

Question 20

The right renal vein passes posterior to the second part of the ______ and the head of the ______.
It drains the ______..

The right suprarenal vein drains directly into the _______.

Answer 20

duodenum
pancrease
right kidney

inferior vena cava ( IVC)

Question 21

The lymphatic drainage of the kidney is into

Answer 21

left and right lumbar ( aortic and canal) lymph nodes

Question 22

the lymphatic drainage of the upper ureter is to ______ or _______

Answer 22

kidney lymphatics or lumbar lymph nodes

Question 23

The lymphatic drainage of middle ureter is to

Answer 23

common iliac lymph nodes

Question 24

the lymphatic drainage of lower ureter is to

Answer 24

common, external, and internal iliac lymph nodes

Question 25

the lymphatic drainage of the pelvic ureter and bladder is to

Answer 25

internal iliac lymph nodes

Question 26

The suprarenal glands are supplied by what arteries?

Answer 26

superior suprarenal arteries - supplied by branches from the inferior phrenic arteries

middle suprarenal arteries- from the aorta

inferior suprarenal arteries- from the renal arteries.

Question 27

The left suprarenal vein drains into ________.

the right suprarenal vein drains into _______

Answer 27

left renal vein

inferior vena cava