Intro Flashcards
Why do the kidneys affect the ECF directly and the ICF indirectly?
Affect ECF via altering water and iron absorption, only the ECF affects the ICF
What is the ultrafiltrate?
Amount of water and ions that gets filtered (180/L), most is recovered
What is the anatomical location of the kidneys?
Retroperitoneal, T11/T12
What nephron structures lie in the Cortex? What’s in the medulla? Where does the medulla feed into?
Cortex: PCT and DCT
Medulla: Loop of Henle and Collecting duct -> minor - major calyx - hilum - renal pelvis - ureter
What’s the GFR per min and per day?
125 mL/min, 180L/day
What should be reabsorbed from the PCT? Why does the filtrate remain isotonic? Where does reabsorbed material filter through?
100% glucose and amino acids
K+, Na+ and water
Solute:water ratio stays same even though volumes differ
Peritubular capillaries take resorbed material
What is the main function of the Loop of Henle
Concentrate urine: Medullary interstitium is highly concentrated (water leaves) and ascending limb is impermeable to water
What is reabsorbed and secreted in the DCT?
Electrolytes, water
H+ is secreted
Which kidney is lower and why?
The right kidney due to the liver
What structure is directly behind the kidneys?
Name 3 organs your likely to find immediately anterior to the kidneys?
Diaphragm is posterior
Anterior-superior
Stomach - L kidney
Liver - R kidney
Anterior-inferior
jejunum - L kidney
SI - R kidney
What muscles lie directly behind the kidney going from medial-lateral, what separates these muscles?
Psoas major, Quadratus laborum, transverse abdominis. Separated by thoracolumbar fascia
What structure insulates and protects the kidneys? What structure directly envelopes this?
Perinephric fat, enveloped by renal fascia
What is the pathway of the ureters?
Continues off renal pelvis -> descends medial to psoas major -> crosses between common/external iliac -> bladder
What is hydronephrosis?
Kidney swelling due to urine backup
What are the 3 constriction points along the ureter?
- Ureteropelvic Junction: leaving the renal pelvis
- Pelvic inlet: crossing the external iliac artery
- Entrance to bladder
What causes Nutcracker syndrome?
SMA can compress the (longer) L renal vein against the AA -> increases pressure and inadequate venous drainage
What’s the pathway for renal arteries? What’s the pathway for the renal veins?
AA (below SMA) -> cortex:
Renal - segmental - interlobar - arcuate artery (and cortical radiate artery) -> afferent -> glomerulus
Renal veins: branch off aorta inferiorly to SMA - peritubular capillaries or vasa recta -> IVC
How does blood travel from afferent - efferent arteriole? What is a key difference between the glomerular capillaries and the peritubular capillaries?
Afferent arteriole- glomerulus - efferent arteriole- peritubular capillaries - venous system
Glomerular: specialized for filtration, increased pressure
Peritubular: specialized for absorption, decreased pressure
What is the trigone?
Triangular region between the 3 openings of the bladder
What are the 3 parts of the male urethra?
- Prostatic 2. Membranous3. Spongy
What signs on a DRE indicate cancer vs infection?
Cancer: hard lumps
Infection: soft lumps
Which arteries supply the female ureter, bladder and urethra?
Ureter: branches off renal, gonadal and inferior vesicular/uterine + directly from the aorta
Bladder: superior/inferior vesicular arteries from internal iliac arteries
Urethra: Branches off inferior vesicular, middle rectal and internal pudendal arteries
What major vein drains the female ureter, bladder and urethra
Internal iliac vein
Briefly describe the innervation behind urination
Stretch receptors in urinary wall -> afferent to micturition centre in pons -> efferent
- synapses w PS ganglia outside bladder -> contracts detrusor muscle
- Pudendal (somatic) -> relaxes external sphincter
Try to name 7 issues that would require imaging of the urinary tract
Incontinence, frequency/urgency, abdominal mass, pain in groin/lower back, hematuria, HTN, kidney failure
