Kidney and ureter anatomy Flashcards
What is the weight range of the kidney?
130-170 g
What is the relation of the kidneys to the vertebrae?
Extends from T12-L3, slightly lower on R
What are the layers of the covering around the kidney from deep to superficial?
Fibrous capsule
Perinephric fate
Renal fascia
Paranephric fat
What is nephroptosis/floating kidney/renal ptosis?
Abnormal condition where the kidney drops down into the pelvic when the pt stands up
What enters/exits the hilum of the kidney from anterior to posterior?
Renal vein
Renal artery
Renal pelvis
What are the relations/areas of the anterior R kidney?
Suprarenal area
Duodenal area
Hepatic area
Colic area
Jejunal area
What are the relations/areas of the anterior L kidney?
Suprarenal area
Splenic area
Gastric area
Pancreatic area
Colic area
Jejunal area
What are the relations of the posterior surface of the kidney?
Medial and lateral arcuate ligaments of diaphragm
11-12th rib (12th only on R)
Subcostal vessels and N
Iliohypogastric N
Ilioinguinal N
Psoas major
Quadratus lumborum
Transverse abdominis
What is the location of the renal angle?
On the back between lower border of 12th rib and lateral border of erector spinae muscle
At what level do the renal arteries branch from the aorta?
L2
What are the 5 segmental arteries in the kidney?
Lobar A
Interlobar A
Arcuate A
Interlobular A
Afferent glomerular arterioles
What are the 5 vascular segments of the kidney?
Apical
Superior (anterior)
Middle (anterior)
Inferior
Posterior
What is the location of the avascular plane of Brodel?
Just posterior to the lateral convex border of the kidney
What is the venous drainage of the kidney?
Efferent arteriole into peritubular capillaries and vasa recta
Then into cortical radiate V to arcuate V to interlobar V
Then into Renal V which drains into IVC
Why is the L kidney most commonly transplanted?
L renal V is 3x longer than the R as it crosses in front of the aorta to reach the IVC
What is the innervation of the kidney?
SyNS: Thoracic and lumbar spanchnic N (T11-L2) to renal plexuses
What are the tree constriction points of the ureter?
Ureteropelvic junction
Crossing the pelvic brim at the bifurcation of common iliac A
Ureterovesical junction
What forms the renal pelvis?
Union of major calyces within th erenal sinus
What is the capacity of renal pelvis?
5-7 mL
What is posteriorly related to the ureters?
Psoas major and the transverse processes of the lumbar vertebrae
Genitofemoral N
What is anteriorly related to the R ureter?
Parietal peritoneum
R gonadal vessels
Second and third parts of duodenum
Root of mesentery
What is anteriorly related to the L ureter?
Parietal peritoneum
L gonadal vessels
Apex of the V-shaped attachment of the sigmoid mesocolon
What are the pelvic relations of the ureter in a female?
Inferior to uterine A and V
Anterior to all the nerves and vessels on the lateral pelvic wall
What are the pelvic relations of the ureter in a male?
Posterolateral and inferior to ductus deferens
Anterior to all the nerves and vessels on the lateral pelvic wall
What factors prevent urine reflux from bladder into ureters?
Oblique direction of intravesical part of ureter maintained by trigonal muscle
Peristalsis of the ureteral muscle
Pressure gradients
What is the arterial supply of the proximal ureters?
Renal A
What is the arterial supply of the middle ureters?
Gonadal A
Aorta
Common iliac A
Internal iliac A
What is the arterial supply of the distal ureter?
Internal iliac A
Superior vesical A
What is the venous drainage of the ureters?
Veins correspond to arteries and drain into VC system
Where does lymph from the superior ureter drain?
Lateral aortic group of lymph nodes
Where does lymph from the middle ureter drain?
Common iliac lymph nodes
Where does lymph from the inferior ureter drain?
Internal and external iliac lymph nodes
What is the innervation of the ureters?
SyNS: T10-L2 segments
PsNS: Pelvic splanchnic (S2-S4)
Via renal, aortic, and hypogastric plexuses
What is a uretorocele?
Cystic dilatation of the inferior end of the the ureter that will result in expansion of the ureteric orifice when filled and deflation after emptying
What is thought to cause a uretorocele?
Congenital atresia of the ureteric orifice
