Genitourinary System, Adrenals and Posterior Wall Flashcards
innervation of ureters
-renal and hypogastric nerve plexus
-males- testicular nerve plexus
-females- ovarian nerve plexus
-peristaltic movements of smooth muscle are stimulated by stretch receptors
-parasymp increase constriction -> peristaltic movement to move urine from kidneys to bladder
-symp decreases contraction
urinary system structures
-2 kidneys
-2 ureters
-1 urinary bladder
-1 urethra
kidneys
-located retroperitoneal space on posterior abdominal wall
-superior pole - deep to 11-12 ribs
-inferior pole- 1 fingers breadth superior to iliac crest
-right kidney lies slightly lower than left > due to liver and large right lobe
-each moves inferiorly with inspiration -> 2-3 cms
-each kidney contains:
-hilum
-renal pelvis
-major and minor calyces (minors make up major)
-renal capsule
-renal cortex
-renal medulla
function of kidneys
-1. excretion of waste products from proteins metabolism via filtration in nephrons
-2. returns nutrients and chemicals back into blood via reabsorption
-3. control water and electrolyte balance
-nephron- functional unit that filters and purifies blood
-1 mil nephrons in cortex of each kidney
-each nephron consists a renal corpuscle -> contains glomerulus, bowmans capsule, and renal tubule
hilum of kidney
-located on medial concave border
-entrance for blood vessels, lymph, nerves, ureters, into renal sinus
-transmits from anterior to posterior:
-renal vein
-renal artery (2 branches) -> branches after passing through hilum
-ureter
-lymph vessels
-sympathetic nerve fibers
renal sinus
-renal pelvis, calycies, vessels, nerves, lymphatics are embedded
-mostly fat inside
coverings of the kidney
-from outer to inner
-pararenal fat
-renal fascia
-perirenal fat
-fibrous capsule
-provide support and tether ureters and renal vessels
-holds everything in position on the posterior abdominal wall
fibrous capsule
-surrounds kidney and closely applied to surface
-innermost layer
perirenal fat
-covers fibrous capsule
-surrounds kidney and vessels
renal fascia
-collection of connective tissue
-encloses kidneys and suprarenal glands
-continuous with transversalis fascia and blends with vessel sheaths
-infection can spread to abdomen***
pararenal fat
-Large in quantity
-extraperitoneal fat of lumbar region
-posterior to kidneys
-outermost layer
renal cortex
-outer layer
-renal columns- goes between renal pyramids
-medullary rays- extend from bases of the renal pyramids (collecting duct of nephron)
-contain glomerulus, proximal and distal tubules
renal medulla
-renal pyramids
-each kidney has about 12 renal pyramids
-apex (renal papilla) and base -
-apex at the minor calyx
-contains collecting ducts and loops of henle
-gives rise to medullary rays- extensions of it into the renal cortex
renal pelvis
-minor calyces make up the major calyces
-major calyces drain into renal pelvis
-flattened extension of the proximal ureter
-apex is continuous with ureter
-receives 2-3 major calyx
renal columns
-passageway for the nerves and blood vessels
lobes of kidney
made up of pyramids and associated cortex
internal structures of the kidney
-renal cortex
-renal medulla
-minor/major calyces
-renal pelvis
arterial supply to kidney
-renal arteries (off aorta)- L1-L2
-Right renal artery is longer and passes posterior to IVC bc of placement where the aorta is
-renal arteries are anterior to renal pelvis
-renal arteries divides into 5 segmental arteries
-the 5 segmental arteries branch into lobar arteries- 1 lobar artery supplies each renal pyramid
-lobar arteries branch into 2-3 interlobar arteries- in the renal columns
-at the junction of the cortex and medulla interlobar arteries branch into…
-arcuate arteries- branch up to base of pyramids
-interlobular arteries- projecting up towards capsule -> supply cortex
-then goes to afferent arterioles -> glomerulus -> efferent arterioles -> venules -> veins -> renal vein
-each segmental artery supplies a segment of the kidney independently -> preserves
lobar artery
-end artery
-cut this and it cuts perfusion to everything distal
renal veins
-veins follow the arteries
-they unite to form the right and left renal veins
-anterior to renal arteries (use this to orient urself)
-longer left renal vein receives L suprarenal and gonadal veins and drains into IVC
-right receives tributaries from right kidney and drain into IVC
innervation of kidneys
-renal nerve plexus
-arise from lesser and least splanchnic nerves from sympathetic trunk
-(dont get caught up on this)
-mainly sympathetic innervation:
-regulate blood flow and pressure
-stimulate renin release
-stimulate sodium and water reabsorption
suprarenal glands**
-paired endocrine organs surrounded by renal fascia and lies on the superomedial aspect of the front of the kidney
-each consists of 2 distinct endocrine organs -> cortex and medulla
-cortex produces steroid hormones- aldosterone (Na, K, H2O), cortisol (glucose metabolism, immune), androgens (male sexual development)
-medulla produces epinephrine and norepinephrine
-arterial supply- superior suprarenal (inferior phrenic), middle suprarenal (aorta), inferior suprarenal (renal)
-venous drainage- suprarenal vein -> IVC (R) and renal vein (L)
-innervation: celiac plexus and splanchnic nerves
-mainly preganglionic sympathetic and synapse directly with cells of medulla
ureters
-muscular ducts
-25cm
-run inferior from apices of renal pelvis at the hila along lateral wall of the pelvis and pass over the pelvis brim at the bifurcation of the common iliac arteries
-smooth muscle -> peristaltic contraction to move urine
-carry urine from kidneys to bladder
-pass over pelvic brim
-empty into urinary bladder
-3 constrictions:
-renal pelvis meets the ureter
-at the pelvic brim- at bifurcation of common iliac arteries
-at junction with the bladder
blood supply of ureters
-arterial supply- proximal ureter- renal artery
-middle ureter- ovarian/testicular artery
-distal ureter- superior vesical artery
-all the arteries anastomose with each other along the wall of the ureter
-venous drainage:
-corresponds to arteries
-to IVC
-Left renal vein receives L ovarian / testicular vein -> ivc (right goes to IVC)