GUS extra short answer Flashcards
Relate the positions of the renal vein, artery and pelvis.
The renal vein is anterior to the renal artery which is anterior to the renal pelvis
What does the renal lobe consist of?
The renal lobe consists of a renal pyramid, overlying cortex and adjacent renal columns
Where does most urine production occur?
Urine production occurs in the cortex and medulla.
Describe the path of urine production to ureter.
Urine production occurs in the cortex and medulla.
Ducts within each papilla discharge urine into the cup-shape drain called the minor calyx.
4-5 minor calyces merge to form a major calyx
And 2-3 major calyces combine to form the renal pelvis-a large funnel shaped chamber .
The renal pelvis which fills most of the sinus is connected to the ureter
Compare the position and regional anatomy of the right and left kidneys
Due to the right lobe of the liver, the right kidney usually lies slightly lower than the left kidney.
The kidneys are placed at an angle to each other due to the protrusion of the lumbar vertebrae.
Anterior to right kidney is
• liver ( kidney is separated by liver by hepatorenal recess).
• Duodenum
• right colic flexure (just above inferior pole)
Left kidney is related to the
• stomach
• Spleen
• Tail of the pancreas
• Jejunum
• left colic flexure and descending colon (lateral to lower pole)
What is the kidneys primary function?
The kidneys’ role is excretion and homeostatic regulation
Briefly describe the function of the nephron
Each kidney has about 1.2 million nephrons. The nephron is the functional unit of the kidney and each nephron is supplied by an afferent arteriole.
Each nephron is composed of two principal parts: a renal corpuscle , which filters the blood plasma, and a long coiled renal tubule , which converts the filtrate to urine.
What is The flow of fluid from the point where the glomerular filtrate is formed to the point where urine leaves the body is
glomerular capsule → proximal convoluted tubule → nephron loop → distal convoluted tubule → collecting duct → papillary duct → minor calyx → major calyx → renal pelvis → ureter → urinary bladder → urethra.
What are the parts of the renal corpuscle?
The renal corpuscle consists of the glomerulus (a ball of capillaries) and a two layered glomerular capsule that encloses it.
What is the renal tubule?
The renal tubule is a duct that leads away from the glomerular capsule and ends at the tip of a medullary pyramid. It is about 3 cm long and divided into four regions: the proximal convoluted tubule, nephron loop, distal convoluted tubule, and collecting duct.
Briefly describe the structure of the bladder
muscle tissue (‘detrusor muscle’) which stretches as the bladder gradually fills. It is a temporary reservoir for urine and a full bladder contains about 500mls. Each ureter passes obliquely through the bladder wall: this prevents backflow of urine as the pressure within the bladder compresses the ends of the ureters. The inner wall is folded and formed of transitional epithelium, while the middle muscular layer (detrusor) forms three layers which interchange fibers.
Describe the pathway of the ureter
- Abdominal course retroperitoneal & adheres closely to parietal peritoneum
- travel close to the tips of the transverse processes of the lumbar vertebrae
- Right ureter is close to IVC
- As the ureters cross over the bifurcation of common iliac into internal and external iliac arteries they pass over the pelvic brim –entering the lesser pelvis.
- The ureters run along the lateral wall of the pelvis, parallel to the anterior margin of the greater sciatic notch, between the parietal peritoneum and the internal iliac artery. Opposite the ischial spine, they curve anterio- medially superior to levator ani and enter the bladder
Briefly describe a renal cyst and its importance
Renal cyst is a generic term commonly used in description of any predominantly cystic renal lesion. The majority of parenchymal cystic lesions represent benign epithelial cysts; however, malignancy such as renal cell carcinoma may also present as a cystic lesion. The main importance of cysts lies in their differentiation from kidney tumors, when they are discovered either incidentally or during evaluation of hemorrhage and pain.
List some causes of renal cysts (both single and multiple cysts)
Simple renal cysts – Can be idiopathic. Generally, does not affect renal function. Quite common & may be an incidental finding.
Acquired cystic kidney disease occurs in patients with end-stage renal disease who have undergone dialysis for many years. Multiple cysts may be present in both the cortex and the medulla and may bleed, causing hematuria.
Autosomal dominant polycystic disease
Autosomal recessive polycystic disease both cause multiple cysts
How does a patient with urinary calculi present?
Presentation:
• Sometimes asymptomatic.
• Most will result in pain.
• Small stones that arise in the kidney are more likely to pass into the ureter where they may result in renal colic.
• Haematuria, although common, may be absent in approximately 15% of patients.
• Some patients may also present with the complication of obstructive pyelonephritis, and may, therefore, have a septic clinical presentation.
What are some risk factors for urinary calculi?
- low fluid intake
- urinary tract malformations:
- urinary tract infections
- cystinuria: congenital disorder
- hypercalciuria: most common metabolic abnormality
- hyperoxaluria (high dietary oxalate (vegetarians), low gut absorption of calcium, leading to increased absorption of oxalate).
- hypocitraturia
- hyperuricosuria (gout, idiopathic, high dietary protein)
Where do urinary calculi form?
Urinary calculi form in the pelvicalyceal system & bladder.
