Introduction to Renal

Question 1

What are the functions of the urinary system?

Answer 1

• Filtration and Excretion of metabolic waste form blood
• BP regulation via RAAS
• Plasma electrolyte conc. regulation
• Stabilizes pH
• Conserves Nutrient
• Reabsorption of small molecules e.g. AAs. glc. Peptides
• Erythropoietin Production

Question 2

Describe the peritonisation of the kidney?

Answer 2

Retroperitoneal

• But only partially peritonised depending on if the structure lying on the kidney is retro or intra peritoneal

Question 3

What are the layers of kidney, fat, fascia etc?

Answer 3

• Kidney
• Renal Capsule
• Perirenal fat
• Renal Fascia
• Pararenal Fat

Question 4

What are the organs lying on the ant right kidney?

Answer 4

• Right Suprarenal Gland
• Liver
• Right Colic Flexure
• Duodenum

Question 5

What are the organs lying on the ant. Left Kidney?

Answer 5

• Left Suprarenal Gland
• Stomach
• Spleen
• Pancreas
• Desc colon

Question 6

What are the important structures post to the kidney?

Answer 6

• 12th rib
• Subcostal nerve
• Iliohypogastric nerve
• Ilioinguinal nerve

Question 7

What are the branches of the collection system within the kidney?

Answer 7

• Ureter
• Pelvis
• Major Calyx
• Minor Calyx
  
  • Papilla (the curved ending of the minor calyx)
• Pyramid (Parenchyma, between columns)

Question 8

What makes up a renal lobe?

Answer 8

• Renal Pyramid and associated cortex

Question 9

What order are the vessels in the kidney hilum?

Answer 9

Anterior to Posterior: VAP

• Vein
• Artery
• Pelvis

Question 10

What are the levels of branches of the renal artery?

Answer 10

Renal artery branches inside the liver:

• 5 segmental branches ⇒ Interlobar branches ⇒ Arcuate branches ⇒ Interlobular Branches

Question 11

What lymphatics drain the kidneys?

Answer 11

Lateral Aortic Nodes

Question 12

Where are the 3 constrictions of the ureter?

Answer 12

1) As it passes over the inferior renal pole at pevlo-uretic junction 2) As it crosses the common iliac artery bifurcation 3) As it traverses the bladder wall (vesicouretic junction)

Question 13

What embryological remnants are part of the bladder?

Answer 13

Median Umbilical Ligament = Remant of urachus

• Two medial umbilical folds
  
  • Occluded embryological umbiical artery
• Two lateral umbilical folds
  
  • Inf. Epigastric vessels

Question 14

How is the bladder peritonised?

Answer 14

• Retroperitoneal like kidneys
  
  • In women its partially peritonised due to the uterus sitting on top

Question 15

Describe the vasculature of the urinary bladder?

Answer 15

• Internal iliac arteries branches
  
  • Tributaries of internal iliac veins

Question 16

Explain the lymphatics of the urinary bladder?

Answer 16

• Suprapubic - External iliac nodes
• Infrapubic - Internal iliac nodes

Question 17

What nerves supply the detrusor muscle (wall of bladder)?

Answer 17

• Symp - T10-L2
• Parasymp - S2-S4

Question 18

What mnerves supply the urinary sphincters?

Answer 18

• Parasymp - S2-4 - Int Urethral sphincter
• Somatic - S2-4 - Ext Urethral Sphincter
  
  • Aka pudendal nerve

Question 19

What supplies sensation to the bladder?

Answer 19

Parasympathetic fibres carry pain and distension feeling from the urinary bladder

Question 20

What are the parts of the urethra?

Answer 20

Preprostatic aka intramural Prostatic Membranous Spongy (in the dick)`

Question 21

Where are the urinary sphincters found?

Answer 21

• Internal - Just after the bladder, seperating the preprostatic and prostatic parts of the urethra
• External - Around the spongy urethra

Question 22

Which part of the urethra is the widest & narrowest?

Answer 22

• Widest = Prostatic cos thats where semen enters
• Thinnest = Membranous

Question 23

What makes up the nephron

Answer 23

The renal corpuscle + Renal tubules:

• Renal corpuscle ⇒ Proximal convuluted tubule ⇒ Loop of Henle ⇒ Distal convuluted Tubule

Question 24

What makes up the uriniferous tubule?

Answer 24

The nephron + the Collecting duct