KIDNEYS

Question 1

Function of the kidneys

Answer 1

• Filters blood
• Excretes waste products and toxins, and excess water and ions via urine
• Regulate blood volume

Question 2

Top 3 products excreted in the urine
* give its molecule of origin

Answer 2

1. Urea – from amino acids
2. Uric Acid – from Nucleic Acids
3. Creatinine – Creatine Phosphate (from atp production)

Question 3

Location of the Kidneys
* Superior Margin
* Inferior Margin
* Loc in the peritoneum

Answer 3

Superior Lumbar Region of the Pos Abdominal Wall
* Superior: TV 11 or TV 12
* Inferior: LV3
* Retroperitoneal

Question 4

Which kidney is lower? Why?

Answer 4

Right Kidney => Overcrowded by the Liver

Question 5

Borders:
* Medial:
* Lateral
* Superior

Answer 5

Medial: Renal Hilum
Lateral: Convex Shaped
Superior: Adrenal Glands

Question 6

External Kidneys

Structures related to the posterior kidney

Answer 6

• Psoas Major m – more medial
• Quadratus Lumborum m – lateral to psoas major
• Transversus Abdominis m

Question 7

2 Ribs protecting the kidneys

Answer 7

Rib 11 & Rib 12

Question 8

External Kidney

Structures related to the Anterior Right Kidey

Answer 8

Superior:
* Liver
* R Adrenal Gland
* Descending part of the Duodenum

Inferior
* Small Intestine
* Right Colic Flexure – Hepatic Flexure

Question 9

External Kidney

Structures related to the Anterior Left Kidney

Answer 9

Superior
* L Suprarenal Gland
* Stomach
* Spleen

Middle
* Pancreas

Inferior
* Left Colic Flexure – Splenic Fexure
* Jejunum
* Descending COlon

Question 10

Protects and cushions the kidneys from Trauma and holds them in place

Answer 10

Coverings of the Kidneys

Question 11

A surgeon is about to operate on the kidneys, at which side should he start his approach and why?

Answer 11

• At the posterolateral abdominal wall – it is where the least nerves and vessels are found
• Below T12

Question 12

What condition can be experienced by the patient if the surgeon approached the kidneys via T12 and made a wrong cut? Why is this?

Answer 12

Pneumothorax – results when the Pleural Cavity is punctured - where the superior pole of the kidney @ TV12 is related to

Question 13

Coverings of the Kidney

most intimate covering of the kidney
* function

Answer 13

Fibrous or Renal Capsule
* Maintainance of the Renal Parynchema (shape) & Inhibit infection spread by forming a barrier

Question 14

Coverings of the Kidney

Fat surrounding the renal capsule @ the periphery of the kidneys

Answer 14

Perirenal Fat

Question 15

Coverings of the Kidney

Covering of the kidneys that joins the Transversalis Fascia laterally

Answer 15

Renal Fascia

Question 16

Coverings of the Kidney

A layer of fat that is Posterior & Posterolateral to the kidneys outside the renal fascia.

Answer 16

Pararenal Fat

Question 17

Coverings of the Kidney

Enumerate the coverings of the kidneys from deep to superficial

Answer 17

Renal Capsule => Perirenal Fat => Renal Fascia => Pararenal Fat

Question 18

Internal Kidney

Lighter outer region of the Internal Kidney
* contains which structure

Answer 18

Renal Cortex
* Renal Column

Question 19

Inner darker region of the kidneys
* contains what structure

Answer 19

Renal Medulla
* Renal Pyramids

Question 20

part of the renal pyramids that is related to the minor callices

Answer 20

Apex or Papillae

Question 21

Which layer of the internal kidneys is striated?
* Striations are due to –

Answer 21

Renal Medulla
* Striations are due to the parallel bundles of urine collecting tubules

Question 22

How many lobes are in each kidney

Answer 22

5 - 11 Lobes

Question 23

Space within the medial kidneys that opens through the Renal Hilum
* It contains which structures

Answer 23

Renal Sinus
* It contains renal vessels, nerve, fat, and urine carrying tubes:
1. Renal Pelvis
2. Major Calices
3. Minor Calices

Question 24

Structure that collects urine
* These empty the urine into the __

Answer 24

Renal Calices (Minor & Major) => Renal Pelvis

Question 25

Trace the pathway of urine

Answer 25

Minor Calices => Major Calices=> Renal Pelvis => Ureter => Bladder

Question 26

Blood Supply

What part of the systemic output reaches the kidneys

Answer 26

1/4

Question 27

Coverings of the Kidney

Kidney covering that can bleed when transected

Answer 27

Fibrous or Renal Capsule

Question 28

Blood Supply

Main blood supply of the kidneys
* Branch of — @ what level?
* Which artery (L/R) is longer/shorter and why
* Which artery (L/R) is higher and why
* Divides into which arteries as it approaches the Renal Hilum

Answer 28

Renal Artery
* Abdominal Aorta between LV1 - LV2
* Right Renal a. is Longer because the Abdominal Aorta lies at the left side
* Left Renal a. is higher because the right kidney is positioned lower due to the liver
* Segmental Arteries

Question 29

Blood Supply

Main venous drainage of the kidneys
* Branch of —
* Which vein (L/R) is longer and why?

Answer 29

Renal Vein
* Inferior Vena Cava
* Left Renal Vein is longer because the IVC lies at the right side

Question 30

Blood Supply

Trace the pathway of blood through the kidneys

Answer 30

Abdominal Aorta => Renal a. => Segmental a. => Interlobar a. => Arcuate a. => Cortical Radiate a. => Afferent Glomerular ar. => Glomerulus => Efferent Gomerular ar. => Peritubular Capillaries & Vasa Recta => Cortical Radiate v. = Arcuate v. => Interlobar v => Renal v. => IVC

Question 31

Blood Supply

Position of the renal vein in reference to the renal artery

Answer 31

Renal v is Anterior to the Renal Artery

Question 32

Nerve Supply

Main nerve supply of the kidneys
* It is an offshoot of the –
* It is arranged around the —
* Supplied by the sympathetic fibers from the (2)
* Importance

Answer 32

Renal Plexus
* Offshoot of the Celiac Plexus
* Renal artery
* Sympathetic Fibers from:
1. Most Inferior Thoracic Splanchnic n.
2. 1st Lumbar Splanchnic n.
* Important in controlling the diameters of the Renal a. and for influencing urine forming functions