Dunnick, 5th: Anatomy and Procedures Flashcards
The kidney is divided into an outer cortex and an inner medulla by the ____ at the base of each pyramid
Arcuate artery
Columns of cortical tissue sometimes descend between the medullary pyramids and are often referred to as a ____
Column of Bertin
Or septal cortex
Large column of Berthin is most common at the junction ofthe superior and middle thirds of the kidney.
The following make up the intrarenal collecting system, except:
a. Calyces
b. Infundibulum
c. Pelvis
d. Proximal ureter
e. All of the above are part of the intrarenal collecting system
d. Proximal ureter
It is the space around the collecting system and contains a variable amount of fat, along with branches of the renal artery, vein, and lymphatics
Renal sinus
The following structures are located within the anterior pararenal space, except:
a. Tail of the pancreas
b. D2-D4 of the duodenum
c. Ascending and descending colon
d. Hepatic and splenic arteries
a. Tail of the pancreas
The calyx is the cup-shaped portion of the intrarenal collecting system and the rim of the cup is the ____
Fornix
The long axes of the kidneys are deviated approximately ____ degrees from the spine, with the top of the kidneys closer to the spine
20
The perirenal space is defined by what fascia?
Gerota’s fascia
The following are part of the extraperitoneal space, except:
a. Space of Retzius
b. Rectovesical space
c. Presacral space
d. Perirectal space
e. All of the above are extraperitoneal spaces
b. Rectovesical space
Rectovesical space is intraperitoneal
RETROVESICAL SPACE is extraperitoneal
Which of the following statements are false:
a. The right adrenal lies above and anteromedial to the upper pole of the right kidney and best seen on axial immediately posterior to the inferior vena cava (IVC) just below the liver
b. The left adrenal is also above and anteromedial to the upper pole of the ipsilateral kidney and lies posterior to the pancreas
c. The right adrenal typically has an inverted Y appearance, whereas the left tends to resemble a three- pointed star
d. In patients with renal agenesis or ectopy, the ipsilateral adrenal gland has a linear shape
b. The left adrenal is also above and anteromedial to the upper pole of the ipsilateral kidney and lies posterior to the pancreas
The left adrenal is also anteromedial to the ipsilateral kidney but usually seen AT THE SAME LEVEL AS THE UPPER RENAL POLE and lies posterior to the pancreas
Adrenal gland
a. Normal weight
b. Normal width
a. 5g
b. 3-6 mm up to 1 cm
Arterial supply of the adrenal gland comes from what arteries?
a. Superior portion: Superior adrenal artery from inferior phrenic artery
b. Middle portion: Middle adrenal artery from aorta
c. Inferior portion: Inferior adrenal artery from renal artery
Which of the following is false regarding the drainage of the adrenal glands:
a. Each adrenal is drained by a single central vein (adrenal vein)
b. The right adrenal vein directly enters into the anterior aspect of IVC
c. Ocassionally, the right adrenal vein may join an accessory hepatic vein before entering the IVC
d. The left adrenal vein enters the inferior phrenic vein before joining the left renal vein
e. The right adrenal vein is shorter and has smaller caliber than the left
b. The right adrenal vein directly enters into the anterior aspect of the IVC
POSTERIOR aspect of the IVC
Narrowest portion of the ureter
Ureterovesical junction
The ureters enter the bladder obliquely and course submucosally for about ____ before terminating at the lateral margin of the trigone as ureteral orifice
2 cm
The predominant vessel supplying the distal ureter is ____
Inferior vesical artery
Proximal ureter: Renal artery
Mid ureter: Aorta, lumbar, gonadal and iliac arteries
Muscle of the urinary bladder
Detrusor muscle
Between the ureteric orifices is a muscular ridge, known as the ____, which forms the base of the trigone
Interureteric ridge
Venous drainage of urinary bladder
Primarily drains into hypogastric (internal iliac) veins
Auxiliary veins connect the vesical venous plexus to the hemorrhoidal veins that drain into the intervertebral venous plexus. This is the route of vesical venous drainage when the IVC is blocked.
Lymphatic drainage of the urinary bladder
External and iliac lymph nodes
Normal length of the prostatic urethra
3.5 cm
The prostatic urethra is approximately 3.5 em in length, passes through the prostate gland, and ends at the superior aspect of the urogenital diaphragm
A longitudinal ridge of smooth muscle extends from the bladder neck to the membranous urethra on the posterior wall of the posterior urethra. This longitudinal smooth muscle bundle swells just proximal to the membranous urethra to form a 1-cm-long ovoid mound on the urethral floor called ____
Verumontanum (colliculus)
A small depres- sion in the verumontanum is known as the UTRICLE
This the portion of the urethra which marks the change in epithelial lining from transitional epithelium to stratified columnar epithelium
Membranous urethra
Prostatic urethra: Transitional cells
Rest of the urethra: Stratified columnar cells
External meatus: Stratified squamous cells
This is the narrowest part of the urethra
Membranous urethra
SHORTEST AND NARROWEST SEGMENT
1 cm in length, passing through the urogenital diaphragm
Proximal landmark: Distal end of the verumontanum
Distal landmark: Tip of the cone of the bulbous urethra