Kidney, Adrenals, ureters Flashcards
The kidney lies at this vertebral level
T12 to L3
What muscle is in close relation with the kidney?
psoas major
What are the coverings of the kidney
- Perirenal fat
- Renal fascia/gerota
- Pararenal fat
what are the structures that leave at the renal hilum?
- Renal vein - anterior
- Renal artery
- Renal pelvis - posterior
What are the anterior borders of the right kidney?
- Suprarenal gland
- Liver
- Duodenum second part
- Right colic flexure
What is the anterior border of the left kidney?
1. Suprarenal gland 2 Spleen 3. Pancreas 4. Stomach 5. Left colic flexure 6. Jejunum
The hilum of the left kidney is at the level of what vertebra?
L1
Ribs 11 and 12 posteriorly
150 grams
The hilum of the right kidney is at the level of what vertebra?
L1 and L2
Rib 12 posteriorly
140grams
The true renal capsule is composed of ___
Fibrous capsule
The fat covering the fibrous capsule is the _____
perirenal fat
___ fascia is the areolar tissue outside the perirenal fat; encloses the suprarenal glands
Renal fascia/gerotas fascia
__ fascia is external to the renal fascia, forms part of the retroperitoneal fat
Pararenal fat
[Outer Cortex/Inner medulla]
Forms the outer part of the kidney; projects into the medullary region between the renal pyramids
outer cortex
The renal corpuscles, PCT and DCT are seen in this part of the kidney _____
outer cortex
This part of the kidney contains the loop of henle and the collecting tubes
inner medulla
Part of the kidney consists of 8 to 12 renal pyramids
inner medulla
How many renal pyramids are there?
12
the renal pelvis is divided into how many major calyces?
2 to 3
Then divided into 2 to 3 minor calyces
The renal artery arises from the aorta at the level of?
L2
The Renal vein drains to the ____
IVC
The kidney drains to what LN
Lateral aortic or Paraaortic
What is the communication between two interlobar arteries?
Arcuate arteries
Compression of the left renal vein can be due to an aneurysm of what artery?
SMA
Left renal vein is between the abdominal aorta and the SMA
Nutcracker syndrome
[Renal transplant]
the renal artery is anastomosed to ____
internal iliac artery
[Renal transplant]
the renal vein is anastomosed to ____
external iliac vein
What are the 3 zones of the adrenal cortex?
- Glomerulosa - aldosterone
- Fasciculata - cortisol
- Reticularis - androgens
What is secreted in the adrenal emdulla?
Epinephrine and norepinephrine
[Right or left adrenal gland]
triangular
right
tRIGHTangular
[Right or left adrenal gland]
crescent shape
left = lunar = crescent
What is the embryologic origin of the adrenal cortex
mesoderm
What is the embryologic origin of the adrenal medula?
neural crest
The superior adrenal artery is a branch of?
Inferior phrenic
The middle adrenal artery is a branch of
Abdominal aorta
The inferior adrenal artery is a branch of
renal artery
The right adrenal vain drains to ___
IVC
The left renal vein drains to ____
Left renal vein then to the IVC
The adrenal gland lies at the level of what vertebra?
T12 to L1
[Diagnosis]
increased pigmentation
muscular weakness
Weight loss
hypotension
addison disease
due to adrenocortical insufficiency
[Diagnosis]
Moon-shaped facies
Truncal obesity
Hirsutism
Hypertension
Cushing syndrome due to cortical hyperplasia due to adenoma or carcinoma of the cortex
[Ureters]
Enters the pelvis at the ___
bifurcation of common iliac arteries in front of the sacroiliac joint
In males, the ureter enters the lateral angle of the bladder and is crossed by ___
vas deferens
What is the direction of the ureter as it enters the bladder of the female?
Turns forward, medially beneath the broad ligament
In females, what crosses the ureter as it pierce the bladder
uterine artery
Uterine artery is avoe the ureter
What are the posterior border of the ureter?
- R/L psoas
2. Bifurcation of R /L common iliac arteryu
What are the 3 constrictions of the ureter?
- Renal pelvis joins the ureter
- Pelvic brim and the external iliac artery
- As it pierce the bladder wall
The upper 1/3 of the ureter is supplied by what artery?
Renal artery
The middle third of the ureter is supplied by what artery?
Gonadal artery
The lower third of the artery is supplied by?
superior vesical artery
In relation to the major blood supply, the ureter lies ____ (medial/lateral) at the level of the abdomen
Lateral
In relation to the major blood supply, the ureter lies ____ (medial/lateral) at the level of the pelvis
medial
Renal colic pain is referred to what dermatomes?
T11 through L2
it is supplied by the renal plexus, testicular/ovarial plexus, hypogastric plexus
What is the size of ureteral stones wherein pain can be felt
> 3mm
or a sharp stone
Trace the pelvic course of the ureter in males
- Enters the pelvis by crossing the bifurcation of the lateral wall
- In front of the Internal Iliac artery to the
- Ischial spine. then turn forward to enter the lateral angle of the bladder
- Crossed by Vas deferens near its termination
Trace the course of the ureter at the level of the pelvis in emales
- Cross the pelvic inlet in front of the common iliac artery
- runs downward and backward INF FRONT of the internal iliac artery until the ischial spine
- Turns forward and medially beneath the broad ligament
- Forward and lateral to vagina to enter the bladder
In oophrectomy, the ureter lies ____ (lateral/medial) to the ovarian vessels
medial
In vaginal hysterectomy, the ureter is ___ (lateral/medial) to the cervix
Lateral
The common iliac artery bifurcates in to external and internal iliac in this anatomic landmark
inguinal ligament
The common iliac arteries arise at the level of ___ vertebra
L4
What is the maximum capacity of the urinary bladder?
500mL
What ligament connects the apex of the bladder to the umbilicus
mediaN umbilical ligament
the base of the urinary bladder has a ___ shape
triangular
What ligaments hold the neck of the bladder
- Puboprostatic ligament (males)
2. Pubovesical ligaments (females)
Which part of the bladder is covered with perotoneum?
superior
What are the openings of the trigone?
- Two from the ureters
2. On to the urethra
What are the true ligaments of the bladder
- Pubovesical/ Puboprostatic
2. Rectovesical
What ligament holds the bladder to the sides of the rectum and sacrum
Rectovesical
What are the false ligaments of the urinary bladder?
- Medial Umbilical (umbilical artery)
2. MediaN umbilical (urachus)
The inferior vesical artery is from the ___
internal iliac
What is the sympathetic innervation of the bladder?
upper lumbar nerve through the hypogastric plexus
What is the action of the sympathetic nerves on the bladder?
- Inhibit detrusor muscle
2. Stimulate closure of sphincter vesicae
What is the parasympathetic innervation of the bladder?
pelvic splanchnic from the 2nd, 3rd, 4th sacral nerves
What is the action of the parasympathetic nerve on the bladder
- Contraction of detrusor muscle
- Relax the sphincter vesical
to empty the bladder
[Embryology of ureter]
What are the derivatives of the Metanephric Diverticulum/ Ureteric bud?
- Ureter
- Renal Pelvis
- Renal calyces
- Collecting tubules
[Embryology of ureter]
What are the derivates of the metanephric TUBULE?
- Nephron (renal corpuscle, PCT, Loop of Henle, DCT
The vesical part of the urinary bladder is part of the ____
Urogenital Sinus
The vesical part of the urogenital sinus gives rise to ___
Urinary bladder
The pelvic part of the urogenital sinus gives rise to ___
- Urethra in the bladder neck
- Prostatic and membranous parts in males
- Entire part in females + Lower part of the vagina
The phallic part of the urogenital sinus fives rise to
Genital tubercle
The widest and most dilatable part of the urethra?
Prostatic urethra
The ejaculatory ducts open into __
prostatic urethra
The narrowest and least distensible part of the urethra is the ___
intermediate (membranous) urethra
The longest and most mobile part of the urethra
Spongy urethra
___ fascia encloses the three erectile tissue in body of penis
Buck’s Fascia
