Final Exam Flashcards
What are the 3 functions of the kidney?
Remove water, salts and products of protein metabolism from the blood
Which kidney lies slightly lower than the other and why?
the right is slightly lower
because right lobe of liver pushes it down
What 4 structures are transmitted through the hilum of the kidney
Renal Vein
Renal Artery
Ureter
Autonomic and Sensory nerves
What is the name for the expanded superior end of the ureter within hilum of kidney
Renal pelvis
What is the renal sinus filled with?
fat
The structures which enter the hilum of the kidney are collectively known as what/
renal pedicle
What is the blood supply of the kidney?
renal artery (from abdominal aorta)
what are extrahilar arteries?
accessory arteries which may originate from the abdominal aorta (above or below renal artery)
What drains the kidneys
Renal vein
True or false, the right renal vein drains an extensive region including suprarenal gland, gonad, diaphragm and body wall
False, the Left renal vein does all of that
What is the “anatomical nutcracker”
left renal vein and 3 part of duodenum may be compressed between aorta behind and superior mesenteric artery in front
what is the innervation of the kidneys? What makes up the plexus?
renal plexus
branches of: celiac plexus, aortic plexus, and direct branches from thoracic and lumbar splanchnics
What are the 4 layers covering the kidney
renal capsule (innermost)
perinephric fat
renal fascia
paranephric fat (outermost)
What are the 3 things that compose kidney stones
calcium oxalate
calcium phosphate
uric acid
What are the symptoms of kidney stones? What are some complications that can occur?
Dull ache in kidney while in the organ, then extremely painful once entering ureter
May become lodged while being passed
What are 3 risk factors for kidney stones
Being male
low fluid intake/dehydration
“stone belt” southeastern USA
Extracorcoreal shock-wave elithdripsy (ESWL) is a possible treatment for what?
Kidney stones
What is nephroptosis? Who is it more common in?
“floating kidney”
Kidney becomes hyper mobile and moves down within renal fascia
More common in very skinny people
What is the muscular tube connecting the kidney to the urinary bladder?
Ureter
The ureter has three constrictions where kidney stones can become lodged, what are they?
ureteropelvic junction
pelvic brim
where it enters the bladder
What are the 5 branches that supply blood to the ureter
renal a. gonadal a. aorta common iliac a. superior vesical a.
What 2 structures innervate the ureter
renal plexus
hypogastric plexus
What structure that lies on the superior aspect of the kidney is part of the endocrine system?
suprarenal gland
What are the 2 parts of the suprarenal gland
medulla
cortex
What are the 3 arteries supplying the suprarenal gland
superior, middle, and inferior suprarenal a.
What drains the suprarenal gland?
suprarenal vein
What two structures innervate the suprarenal gland
Celiac plexus
thoracic splanchnic nerves (sympathetics)
Where is kidney and suprarenal gland pain often referred to, why?
pain referred to paralumbar region
because receive innervation from T11-L2
What is the “psoas sign” what can a positive right psoas sign indicate?
Pain produced when thigh extended against resistance
positive right psoas sign suggests appendicitis
What percentage of people have a psoas minor?
60%
What ventral primary rami make up the lumbar plexus
L1, L2, L3, L4
What are the two branches of the lumbar plexus consisting of L1 primary rami?
Iliohyogastric and ilioinguinal Nerve
What does the ilioinguinal never accompany through inguinal canal? And what does it supply?
Accompanies the spermatic cord (round ligament of uterus in females)
Supplies skin of scrotum or labia majora
What branch of the lumbar plexus made up of ventral primary rami L1 and L2
What is the nerves 2 branches
Genitofemoral nerve Genital branch (supplies cremaster muscle) femoral branch (skin femoral triangle)
What branch of the lumbar plexus is made up of ventral primary rami L2 and L3
What does it supply
Lateral cutaneous nerve of thigh
skin of anterior and lateral aspect of thigh
What 2 branches of lumbar plexus is made up of ventral primary rami L2, L3, L4
Femoral nerve
Obturator nerve
What ventral primary rami make up sacral plexus?
L4-S4
How many branches are there in the abdominal aorta
9
What do each of the common iliac artery bifurcate into?
internal and external iliac artery
What are the 4 functions of the pelvis?
locomotion
parturition
support of abdominal viscera
protection of pelvic viscera
True or false the ASIS and upper margin of the pubic symphysis do not lie in the same vertical plane?
false, they do lie in the same plane
The tip of the coccyx and upper margin of pubic symphysis lie in which plane together?
horizontal
What are the 5 boundaries of the pelvic inlet?
sacral promontory sacral alae arcuate line pecten pubis pubic crest
The pelvis is divided into what?
False and True pelvis
What are the 4 things in the True pelvis?
Lower part of the G.I. tract
urinary bladder
lower part of ureter
internal reproductive organs
What are the 5 boundaries of the pelvic outlet
pubic symphysis ischiopubic rami ischial tuberosities sacrotuberous ligament tip of coccyx
What is a anthropoid pelvis? Who is it present in?
Long A-P diameter and short transverse diameter
In some males, in 20% of females
What is a platypelloid pelvis? Who is it present in?
short A-P diameter and wide transverse
Rare in males, 2% of females
What is a Android pelvis? Who is it present in?
heart shaped inlet
Most males, 30% of females
What is a gynecoid pelvis? Who is it present in?
Ovoid or round inlet
50% of females (no males)
Ideal for childbirth
What are general shapes of male and female pelvic inlets
Male - heart
Female - oval
The pelvic cavity and pelvic outlet is larger in what sex?
Female
Subpubic angle is larger in which sex?
female
The greater sciatic notch is more broad and shallow in which sex?
Female
Male- narrow and deep
True or false female sacrums is shorter and wider than males
true
True or false the pubic symphysis contains a cartilage disc?
True interpubic disc
True or false the sacrococcygeal joint contains intervertebral disc and is often fused
True
During pregnancy what causes the ligaments of the pelvis to loosen?
the hormone relaxin
What are the 3 things that bind the greater sciatic foramen
Greater sciatic notch
sacrotuberous
sacrospinous
What are the 3 things that bind the lesser sciatic foramen
Lesser sciatic notch
sacrotuberous
sacrospinous
Which sciatic foramen lies above pelvic floor
greater sciatic foramen
Which sciatic foramen lies below pelvic floor
lesser sciatic foramen
Name the 3 structures that pass through both the greater and lesser sciatic foramen
pudendal nerve
internal pudendal vessels
nerve to obturator internus
What structure that passes through the greater sciatic foramen is particularly vulnerable in sacrum misalignments
sciatic nerve
What are 3 intrapelvic causes of sciatica
piriformis syndrome
compression by fetal head during pregnancy
pelvic tumors
What 2 structures cover the lateral wall of pelvis
obturator internus muscle
obturator fascia
What is the important structure of the pelvic floor that supports the abdominal and pelvic viscera
pelvic diaphragm
What is a possible complication of nephroptosis
The kidney being hyper mobile can turn upside and twist, constricting the ureter and blood vessels
Name the 9 branches of the abdominal aorta
Cassandra, She Is Impossibly Magnificent, (&) Really Good Lover Man
Celiac Trunk A. Superior Mesenteric A. Inferior Mesenteric A. Inferior Phrenic A. Middle Suprarenal A. Renal A. Gonadal A. Lumbar A. Median Sacral A.
What are the two openings of the pelvic diaphragm?
Urogenital Hiatus (transmits urethra in males, urethra and vagina in females) Anal aperture
Damage to which nerve causes the pelvis to slump to the unsupported side during gait (Trendelenburg’s Sign)
Superior Gluteal N.
The levator ani has 3 major parts, what are they?
iliococcygeus
pubococcygeus
Puborectalis
What are the 3 subdivisions of the pubococcygeus part of the levator ani
Puboprostaticus
Pubovaginalis
Puboanalis
Both the puboprostaticus and pubovaginalis subdivisions of the pubococcygeus part of the levator ani, function in what?
micturition (peeing)
The lateral femoral cutaneous nerve originates from which spinal segments?
L2 and L3
The abdominal aorta bifurcates into the left and right common iliac arteries at what level. What does the common iliac branch into?
L4
the external and internal iliac a.
what are the 2 branches of the external iliac a.
deep circumflex iliac a.
inferior epigastric a.
What artery continues as the femoral a. below the inguinal ligament?
the external iliac a.
What layer of the perineum is the deepest? (most internal?
deep perineal space
True or false, the male pelvis has a broad, shallow greater sciatic notch
false, female pelvis’ do
What are the 3 branches of the posterior trunk of the internal iliac a.
iliolumbar a.
lateral sacral a.
superior gluteal a.
What are the two branches of the iliolumbar a.
iliac branch
lumbar branch
What happens to the distal portion of the umbilical artery after birth?
It is obliterated and continues as the medial umbilical ligament
The inferior vesicle a. in males is important in what?
Reproduction
Is the internal iliac a. the only supplier or blood to the pelvis?
No, it is a major supplier but there are 3 other vessels
Gonadal a.
Superior rectal a.
Median sacral a.