Kidneys Flashcards
1
Q
describe the relationship of the right kidney to other organs
A
- anterior:
- Adrenal gland
- liver
- duodenum
- colon
- small intestine
- posterior
- diaphragm
- rib 12
- transversus abdominis (most lateral)
- quadratus lumborum
- psoas major (most medial)
2
Q
describe the relationship of the left kidney
A
- anterior:
- adrenal gland
- stomach
- spleen
- tail of pancreas
- colon
- small intestine
- posterior:
- rib 11
- diaphragm
- rib 12
- TA
- QL
- PM
3
Q
describe the renal coverings
A
- renal capsule:
- CT closely adhered to the kidney
- enters the renal hilum and lines the renal sinus
- enclosing the capsule is a layer of extraperitoneal fat
- perirenal (perinephric) fat
- enclosing the perirenal fat is a membranous condensation of the extraperitoneal fascia
- renal fascia
- the adrenal gland is also enclosed by this fascia
4
Q
describe the hepatorenal recess
A
- superior to right kidney
- posterior to liver
- fluid in the abdomen will accumulate in this space when the body is supine
- it is one of the locations investigated during a FAST exam
- aka pouch of Morrison
5
Q
describe the cortex and medulla
A
- cortex
- continuous band of tissue surrounding the medulla
- has extensions into the medulla known as the renal columns
- contains all the renal corpuscles
- medulla
- divided into triangular pyramids by the renal columns
- contains the continuation of collecting ducts and tubules
- each renal pyramid has a papilla which drains into a minor calyx
6
Q
describe the initial development of the kidney
A
- starts as longitudinal elevation of intermediate mesoderm on the dorsal wall of the embryo
- urogenital ridge:
- nephrogenic cord: gives rise to urinary system comp.
- gonadal rige: gives rise to genital system comp.
7
Q
describe the 3 sequential systems that develop from the kidney
A
- pronephros: rudimentary non functional
- mesonephros: functions very briefly during the early fetal period
- metanephros: will form the permanent kidney
8
Q
describe the pronephros
A
- degenerates beginning of week 4
- forms vestigial excretory units; nephrotomes
9
Q
describe the development of the nephron
A
- nephron formation is complete at birth, with 1-2 million nephrons in each kidney
- excretory part: Bowman’s capsule, PCT, LoH, DCT, develop from mesenchyme of the metanephric blastema
- conducting part: collecting tubules, minor calyces, major calyces, pelvis and ureter, develop from the ureteric bud
10
Q
describe renal agenesis
A
early degeneration or failure of formation of the ureteric bud
- unilateral:
- more common in boys
- L kidkney usually the one absent
- asymptomatic if other kidney is normal
- bilateral
- oligohydramnios (less amniotic fluid)
- pulmonary hypoplasia
- incompatible with post-natal life
- POTTER sequence
11
Q
describe supernumerary kidney
A
- if the supernumerary kidney has its own separate ureter (rather than a bifid ureter) there were probably 2 separate ureteric buds on that side
- when there are separate ureters, one may have a fistulous opening into urethra, vagina or vestibule
12
Q
describe horseshoe kidney
A
- fusion of lower poles while still in pelvis
- ascent interrupted at the inferior mesenteric artery
13
Q
name the 3 constrictions of the ureter
A
- at the junction of the ureters and renal pelvis (UPJ = uteropelvic junction)
- at the point that the ureter crosses the brim of the pelvic outlet
- during their passage through the wall of the urinary bladder (UVJ = uterovesical junction)
14
Q
contrast the path of the ureter in male vs female
A
- male: ureters pass under ductus deferens
- female: ureters pass under uterine artery
15
Q
describe crossed fused ectopia
A
- left kidney fused with right kidney (while in pelvis) and then was carried along with the ascent of the right kidney
