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MRCEM Primary > Kidney anatomy > Flashcards

Kidney anatomy Flashcards

1
Q

Between which vertebral levels do the kidneys lie?

A

T12-L3

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2
Q

What is the maximal vertical movement of the kidneys from end-expiratory to end-inspiration?

A

40mm

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3
Q

At which vertebral level do the renal hila sit at?

A

L1 (transpyloric plane)

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4
Q

What is the basic functional unit of the kidney?

A

Nephron

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5
Q

What is the nephron responsible for?

A

Regulation of water and soluble substances in the blood through filtration and reabsorption.

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6
Q

The nephron plays a role in homeostasis of what 3 things?

A

Blood volume
Blood pressure
Plasma osmolarity

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7
Q

How many nephrons are contained within each kidney?

A

~1 million

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8
Q

What is the first part of the nephron?

A

Renal corpuscle

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9
Q

What is the renal corpuscle composed of?

A

Glomerulus and Bowman’s capsule

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10
Q

Where in the nephron does plasma undergo filtration?

A

Renal corpuscle

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11
Q

Which arteriole of the glomerulus has a smaller diameter?

A

Efferent

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12
Q

Why does the referent arteriole in the glomerulus have a smaller diameter than the afferent arteriole?

A

In order to create a hydrostatic pressure gradient within the glomerulus.

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13
Q

The inner visceral layer of the Bowman’s capsule is formed by which types of cell?

A

Podocytes

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14
Q

What do the podocytes do?

A

Wrap around capillaries and leave slits between them (filtration slits)

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15
Q

Where does glomerular filtrate pass into after the renal corpuscle?

A

Renal tubule

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16
Q

What are the parts of the renal tubule?

A

PCT
Loop of Henle
DCT
Collecting duct

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17
Q

Which part of the kidney does the PCT lie in?

A

The cortex

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18
Q

Where does the majority of solute reabsorption occur in the renal tubule?

A

PCT

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19
Q

Reabsorption in the PCT is driven by what?

A

ATP dependent transporters

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20
Q

What types of cell are found in the PCT?

A

Cuboidal
Abdundant mitochondria
Multiple microvilli

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21
Q

Which part of the kidney does the loop of hence lie in?

A

Medulla

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22
Q

What type of cells are found in the descending loop of Henle?

A

Flat cells
Few mitochondria
Few microvilli

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23
Q

What substance is moved mainly in the descending loop of Henle?

A

Water by osmosis (no solute movement)

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24
Q

What type of cell is found in the ascending loop of henle?

A

Cuboidal cells
Impermeable to water
Plentiful mitochondria

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25
Q

Which transporters are found in the ascending loop of Henle?

A

Na K 2Cl channels

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26
Q

The different functions of the areas of the loop of hence contribute towards what?

A

Medullary concentration gradient + countercurrent multiplication

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27
Q

What is the function of the DCT?

A

Variable resorption and secretion to fine-control urine composition.

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28
Q

The DCTs of many nephrons converge into what?

A

A single collecting duct

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29
Q

The upper collecting duct is lined by what cells?

A

Columnar epithelium

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30
Q

The lower collecting duct is composed of what cells?

A

Columnar urothelium

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31
Q

What is present in the walls of the collecting duct to allow for transcellular movement of water?

A

Aquaporin channels

32
Q

The number of aquaporin channels present in the collecting duct is controlled by what?

A

ADH

33
Q

Many collecting ducts join together to form what?

A

Several hundred papillary ducts

34
Q

How many papillary ducts are there per renal papilla?

A

~30

35
Q

The contents of the papillary ducts drain into where?

A

Minor calyx in renal papilla

36
Q

Several minor calyces join form what?

A

A major calyx

37
Q

Where does urine drain from after the collecting ducts?

A

From the minor calyces to the major calyx and then to the renal pelvis

38
Q

After the renal pelvis, where does urine drain into?

A

Ureter

39
Q

Renin is produced and secreted from where?

A

Juxtaglomerular cells

40
Q

Where are juxtaglomerular cells located?

A

Walls of afferent arterioles

41
Q

How many layers fo fascia and fat are the kidneys encased in?

A

4

42
Q

What are the 4 layers encasing the kidneys from superficial to deep?

A

Pararenal fat
Renal fascia
Perirenal fat
Renal capsule

43
Q

Most par arena fat is located where?

A

Posterolateral aspect of the kidnet

44
Q

The renal fasciae also envelopes what?

A

Adrenal glands

45
Q

The renal fascia is responsible for sending what through the fat surrounding the kidney to hold it in position?

A

Bundles of collagen

46
Q

The perirenal fat is continuous with what?

A

Fat in the renal sinus at the hilum of the kidney.

47
Q

What is the renal capsule?

A

Tough fibrous capsule surrounding the kidney

48
Q

Movements of the kidney during respiration are assisted by what?

A

Perirenal and pararenal fat

49
Q

Why are the attachments of the perirenal fascia clinically important?

A

They prevent extension of perinephric abscess pus

50
Q

What is the renal fascia attached to inferiorly?

A

Posterior abdominal wall

51
Q

What is the renal fascia attached to at the renal hilum?

A

Vessels and ureter

52
Q

The parenchyma of the kidney consists of what?

A

Outer renal cortex
Inner renal medulla

53
Q

What are the 6 anterior relations of the left kidney?

A

Left adrenal gland
Spleen
Stomach
Pancreas
Left colic flexure
Jejunum

54
Q

What are the 4 anterior relations of the right kidney?

A

Right adrenal gland
Liver
Duodenum
Right colic flexure

55
Q

What are the 8 posterior relations of the left kidney?

A

Diaphragm
11th + 12th rib
Psoas major
Quadratus lumborum
Transversus abdominis
Subcostal nerve
Iliohypogastric nerve
Ilioinguinal nerve

56
Q

What are the 8 posterior relations of the right kidney?

A

Diaphragm
12th rib
Psoas major
Quadratus lumborum
Transversus abdominis
Subcostal nerve
Iliohypogastric nerve
Ilioinguinal nerve

57
Q

What is the arterial supply to the kidneys?

A

Renal arteries

58
Q

At what vertebral level do the renal arteries arise?

A

L2

59
Q

Which renal artery is longer?

A

Right renal artery (aorta sits to left of midline)

60
Q

The kidneys receive what percentage of the cardiac output?

A

20%

61
Q

The right renal artery passes behind which structures before entering the right kidney?

A

IVC
Right renal vein
Head of the pancreas
2nd part of the duodenum

62
Q

The left renal artery passes behind which structures before entering the left kidney?

A

Left renal vein
Body of pancreas
Splenic vein

63
Q

The left renal artery is crossed anteriorly by what?

A

Inferior mesenteric vein

64
Q

Where are the interlobular arteries of the kidney situated?

A

Either side of the renal pyramids.

65
Q

The inner 3rd of the cortex is supplied by what vasculature?

A

Vasa recta

66
Q

The renal vein is anterior to what at the renal hilum?

A

Renal artery

67
Q

Which renal vein is longer?

A

Left (IVC sits to the right of the midline)

68
Q

The left renal vein receives which other veins?

A

Left gonadal vein
Left suprarenal vein

69
Q

Where do the left and right renal veins drain into?

A

IVC

70
Q

Which nodes drain the left kidney?

A

Left lateral aortic lymph nodes

71
Q

Which nodes drain the right kidney?

A

Right canal lymph nodes

72
Q

What is the innervation of the kidney?

A

Renal plexus

73
Q

Where do the nerve fibres enter the kidney?

A

At the hila

74
Q

Sympathetic nervous stimulation triggers what in the kidneys?

A

Vasoconstriction + reduced renal blood flow

75
Q

Sensory input from the kidney travels to which spinal levels?

A

T10-L1 nerves

76
Q

Which dermatomes can receive referred pain from the kidneys?

A

Posterior lumbar/ flank region

77
Q

The renal plexus if formed by filaments from which areas?

A

Coeliac ganglia and plexus
Aorticorenal ganglia
Aortic plexus
Lower thoracic splanchnic nerves
1st lumbar splanchnic nerve

MRCEM Primary (39 decks)

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