Kidney Anatomy Flashcards

1
Q

Are the kidneys intraperitoneal or retroperitoneal?

A

Retroperitoneal

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2
Q

What vertebral levels does each kidney lie between?

A

Left -> between T12-L2
Right -> L1-L3

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3
Q

What important muscles do the kidneys lie anterior to?

A
  • Quadratus Lumborum
  • Psoas Major
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4
Q

What vertebral level are the kidney hila at?

A

L1 (think of transpyloric plane)

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5
Q

What are the layers enveloping the kidneys?

A

Acronym = PR + PR
1. Kidney
2. Renal capsule
3. Perinephric fat
4. Renal fascia
5. Paranephric fat

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6
Q

What do the left and right gonadal veins drain into?

A
  • Left gonadal vein drains into the Left Renal Vein at a 90 degree angle
  • The right gonadal vein drains into the IVC
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7
Q

What is the relationship between the left renal vein and Nutcracker Syndrome?

A
  • the left renal vein passes over the Aorta -> therefore can get compressed and lead to Nutcracker Syndrome
  • also from the SMA which is anterior to the Left renal vein
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8
Q

What are symptoms of Nutcracker Syndrome?

A
  • Varicocele
  • Flank pain
  • Haematuria (pissing blood)
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9
Q

What are causes of Nutcracker Syndrome?

A
  • Aortic aneurysm
  • Pregnancy
  • Pancreatic tumour / Renal cell carcinoma
  • Puberty growth
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10
Q

What does Varicocele present with?

A
  • dull, aching pain -> worsened when standing or walking
  • looks like bag of worms
  • does NOT transilluminate
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11
Q

What structures pass through the Renal hilum?

A

Acronym = VAP
- Renal Vein
- Renal Artery
- Renal Pelvis

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12
Q

What are the muscles in the posterior abdominal wall?

A
  • Quadratus Lumborum
  • Psoas Major
  • Iliacus
  • Psoas Minor

if someone was stabbed in the back penetrating the kidney, it is likely that the Quadratus Lumborum was also pierced

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13
Q

What is the Psoas sign?

A
  • positive sign indicates irritation of the peritoneal tissue surrounding psoas muscle -> indicates Appendicitis
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14
Q

What are the Ligaments fo the Diaphragm? and what structures pass through/underneath them?

A
  • Median Arcuate ligament -> (Aortic hiatus stuff)
  • Fibres arising from Crura of Diaphragm -> Splanchnic nerves
  • Medial Arcuate ligament -> Sympathetic trunk
  • Lateral Arcuate ligament -> Subcostal neurovascular bundle
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15
Q

What are the important nerves in the Lumbar plexus and what is their course with respect to the Psoas Major muscle?

A
  • Genitofemoral nerve -> Anterior to Psoas m
  • Lateral cutaneous nerve of thigh -> Superiorly and laterally to Psoas m
  • Femoral nerve -> Inferiorly and laterally to Psoas m
  • Obturator nerve -> Medially to Psoas m
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16
Q

Describe the course of the Renal Vasculature

A

Renal Artery (L1/L2) –> Segmental arteries –> Interlobar arteries –> Arcuate arteries –> Interlobular arteries –> Afferent arteriole –> Capillary network –> Efferent arteriole –> Interlobular veins –> Arcuate veins –> Interlobar veins –> Renal vein

17
Q

What is the Renal Corpuscle comprised of?

A
  • Glomerulus
  • Bowman’s Capsule
  • Mesangium
  • Urinary Pole
18
Q

What are the 3 cell types in the Renal Corpuscle

A
  • Endothelial Cells (capillary walls)
  • Mesangial Cells (connective tissue)
  • Podocytes (filtration barrier) -> foot processes (blood filtered through the slits)
19
Q

What is the Juxtaglomerular Apparatus responsible for?

A

responsible for controlling renin release to regulate blood pressure

20
Q

What cells are a part of the Juxtaglomerular Apparatus? and what do they do?

A

Macula densa cells -> detect Na
Juxtaglomerular cells / Granular cells -> store + release renin
Mesangial cells -> selective vasoconstriction/dilation of afferent/efferent arterioles

21
Q

Summary of Nephron

22
Q

What is the function of the PCT? What are the major transporters? What epithelium?

A

Function:
- resorbs essential or organic nutrients, water and electrolytes
Major Transporters:
- SGLT-2
- Na+/H+ exchanger
- Na+/K+ ATPase
- GLUT1/GLUT2
Epithelium:
- Simple cuboidal/columnar with microvilli

23
Q

What is the function of the DCT? What are the major transporters? What epithelium?

A

Function:
- Resorbs Na+ and Cl-
- Controls acid+base secretion
- Controls K+
Major Transporters:
- Na+/Cl- cotransporter
- Ca+ channels
- K+ ATPase
- H+/K+ ATPase
- Aquaporins
Epithelium:
- Simple cuboidal with shorter microvilli

24
Q

What is the function Loop of Henle? What are the major transporters? Epithelium?

A

Function:
- Thin descending limbs = H2O resorption
- Thick ascending limbs = electrolyte resorption
Major transporters:
- remember NK2CL cotransporter
Epithelium
- Thin limb = simple cuboidal
- Thick limb = simple squamous

25
What is the epithelium in the collecting ducts?
Simple cuboidal epithelium
26
What is the function of the ureters? what are the 3 muscle layers?
Function = propel urine to bladder 3 Muscle Layers: - Inner spiral (longitudinal) - Outer spiral (circular) - Outermost longitudinal (in lower third)
27
What is the epithelium of the ureter?
Transitional Epithelium
28
What are the 3 constrictions that Renal Stones can lodge into?
1. Origin = Pelviuteric junction 2. Pelvic Brim = crossing iliac artery 3. Vesico Ureteric Junction = just before bladder
29
30
What are the 2 sphincters of the bladder and what is their neuronal control?
- Internal urethral sphincter -> autonomic control - External urethral sphincter -> voluntary control
31
What is the epithelium for the bladder?
Transitional epithelium
32
What week does the urinary system develop?
4th week
33
What are the derivatives of Pronephros, Mesonephros and Metanephros?
Pronephros -> isnt patent Mesonephros -> Gonads and Bowman's Capsule Metanephros -> Kidneys
34
What are the steps of the development of the Nephron?
1. Mesenchymal cell condensation 2. Epithelial vesicle 3. Comma shaped body 4. S shaped body 5. Capillary Loop stage glomerulus 6. Maturing glomerulus
35
CAKUT
Ones to Remember - Polycystic Kidneys - MCKD -> most fucked - Cystic Kidneys - Aplastic kidneys