Kidney, Adrenal Gland, Ureter Flashcards
What are the three ways to get kidney damage?
1) fail to properly profuse the kidney with blood
2) disease which directly effect the kidney tissue/electrolyte balances
3) bladder or prostate issues that cause back pressure into the kidney
What nerves exit the lumbar plexus?
“I Twice Get Laid on Fridays”
Iliohypogastric (L1)
Ilioinguinal (L1)
Genitofemoral (L1, L2)
Lateral cutaneous nerve (L2, L3)
Obturator (L2, L3, L4)
Femoral (L2, L3, L4)
What ligament connects the kidney to the spleen?
splenorenal ligament
What part of the pancreas does the splenic artery run along?
The tail
What are the 4 layers surrounding the kidney?
renal capsule
Perirenal fat (innermost)
gerota’s fascia
pararenal fat
What is the gerota’s fascia continous with?
the transversalis fascia
What muscles lie posteriorly to the kidney?
Psoas major muscle
quadratus lumborum muscle
What exits the hilum of the kidney?
The ureter, renal blood vessels, lyphatics
What is the order of the structures exiting the hilum of the kidney?
superficial = vein
middle = artery
deep = ureter
or “VAP” for vein, artery, pelvis
What is the blood supply to the kidney?
Renal artery - four segments on the anterior side and one segment of this on the posterior side
Describe the structures within the kidney
Outermost = cortex - contains bowman’s capsules and the glomerulus
middle = medulla- cone shaped medullary pyramids
medulla drains into minor calyx
minor calyx drains into major calyx
Major calyx drains into the renal pelvis
renal pelvis to the ureter
What does the medulla of the kidney contain?
these medullas are made up of parallel bundles of urine- collecting tubules
What structure lies just anterior to the right renal hilum?
The first part of the duodenum
How long is the ureter usually?
30 cm
What is the blood supply of the ureter?
RGSI - looks like RCSI but isn;t
Renal
Gonadal
Superior vesical
Inferior vesical (vaginal in women)
What sort of surface cells make up the ureter?
transitional epithelium - watertight junctions but distensible
Where would pain be refered to from the ureter?
“loin to groin”
Where is the ureter susceptible to constriction/stone lodgement?
uteropelvic junction
where it runs over the pelvic inlet
entrance to the bladder
What is the nerve supply to the ureter?
Nervous supply to the ureters is delivered via the renal, testicular/ovarian and hypogastric plexuses.
What are the majority of kidney stones made of?
majority are calcium oxalate phosphate - which would appear on an x ray
Others include urate, cystine, and struvite - these may not appear on an X ray and require a CT or ultrasound
What separates the kidney from the adrenal gland?
The gerota’s fascia
What are the two areas of the adrenal gland?
cortex = regulated by pituitary, hypothalamus, and renin-angiotensin axis
medulla = contains chromaffin cells to produce adrenalin and noradrenaline
What are the vessels supporting the adrenal gland?
Blood Supply
Superior adrenal artery – arises from the inferior phrenic artery
Middle adrenal artery – arises from the abdominal aorta.
Inferior adrenal artery – arises from the renal arteries.
Right and left adrenal veins drain the glands. The right adrenal vein drains into the inferior vena cava, whereas the left adrenal vein drains into the left renal vein.
What is Vesico-Ureteric reflux?
can be due to a number of things
- high pressure voiding states, posterior urethral valves, neuropathic bladder, duplex collecting system, bladder exstrophy,
can cause distention of the ureter, renal pelvis, and calyces,
