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m2 > kidneys and urinary system anatomy > Flashcards

kidneys and urinary system anatomy Flashcards

1
Q

what are the main functions of the kidneys?

A

filter the blood of waste products

osmoregulation

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2
Q

when are the kidneys palpable?

A

if enlarged or very low body fat

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3
Q

where is the renal angle?

A

Junction of 12th rib and lat border of erector spinae (back muscles)

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4
Q

where do you palpate the kidneys?

A

renal angle

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5
Q

how do you palpate the kidneys?

A

at the renal angle, ask the patient to inspire to lower the diaphragm

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6
Q

which kidney is higher?

A

left

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7
Q

what are the kidneys covered by anteriorly?

A

extraperitoneal fat
peritoneum
other retroperitoneal structures e.g. pancreas or duodenum

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8
Q

what is anterior and to the right of the kidneys?

A 
liver
duodenum/small intestine
right colic (hepatic) flexure
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9
Q

what is anterior and to the left of the kidneys?

A 
spleen
stomach
pancreas (body or tail)
left colic (splenic) flexure
small intestine
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10
Q

what is the hepatorenal recess?

A

space between the liver and kidneys

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11
Q

what pathologies are associated with the hepatorenal recess?

A

haemoperitoneum/ascites/pancreatitis

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12
Q

what happens to the ultrasound image when organs are full of fluid?

A

the lines become sharper

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13
Q

what is posterior to the kidneys?

A 
diaphragm
11th and 12th ribs
costodiaphragmatic recess
psoas major
Quadratus lumborum m.
Transversus abdominis m.
T12 – subcostal n.
L1 
iliohypogastric n.
ilioinguinal n.
genitofemoral nerve
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14
Q

what spinal level is the subcostal nerve at?

A

T12

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15
Q

what spinal level are the iliohypogastric and ilioinguinal nerves at?

A

L1

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16
Q

what does the subcostal nerve innervate?

A

transversus abdominis muscle

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17
Q

what do the iliohypogastric and ilioinguinal nerve innervate?

A

give sensation to the front of the stomach and the upper thigh region

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18
Q

what does the genitofemoral nerve innervate?

A

gives sensation to the upper thigh

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19
Q

what is the first layer around the kidney?

A

fibrous capsule

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20
Q

what are the layers surrounding the kidney?

A

fibrous capsule
perinephric fat
renal fascia
paranephric fat

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21
Q

what is the renal fascia continuous with?

A

transversalis fascia

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22
Q

what are the kidneys continuously inferiorly?

A

ureters

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23
Q

what layer of fat is found posterior to the kidneys?

A

pararenal fat

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24
Q

what is the renal column?

A

extension of the cortex down

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25
Q

what separates the medulla into renal pyramids?

A

renal columns

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26
Q

what is the hilum?

A

where vessels enter and exit

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27
Q

describe the route of urine, starting at the renal papilla

A

papilla –> minor calyx –> major calyx –> renal pelvis –> ureter

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28
Q

what is a functional unit of the kidney called?

A

nephron

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29
Q

what does damage to the filtration membrane result in?

A

results in protein and blood cells leaking into the filtrate which arent reabsorbed

30
Q

how does insufficient blood pressure affect the glomerulus?

A

results in less filtrate being produced

31
Q

what can cause insufficient blood pressure in the kidneys?

A

atherosclerosis of renal arteries/ heart failure, shock, dehydration

32
Q

describe the arterial blood supply of the kidneys

A 
renal
segmental
interlobar
arcuate
interlobular
[glomerulus]
afferent arteriole
glomerulus
efferent arterioles
33
Q

describe the venous blood supply of the kidneys

A 
interlobular veins
arcuate veins
interlobar veins
segmental veins
renal veins
34
Q

is the hilum higher on the right or left?

A

right

35
Q

what spinal level are the renal arteries found at?

A

L1/L2

36
Q

which is longer; the left or right renal vein?

A

left

37
Q

what structure does the left renal vein travel under?

A

superior mesenteric artery

38
Q

what does the left renal vein drain into?

A

IVC

39
Q

what plexus supplies the kidneys?

A

renal plexus

40
Q

what nerves make up the renal plexus?

A

Sympathetic (T10-L2)
From thoracic and lumbar splanchnics
Parasympathetic (vagus)

41
Q

at what level do visceral afferent fibres travel?

A

T10-T12

42
Q

where do visceral afferents receive input from?

A

baroreceptors and chemoreceptors

43
Q

describe the lymphatic drainage of the kidneys

A 
kidneys
left lumbar lymph nodes
left lumbar trunk
cisterna chyli
thoracic duct
44
Q

are the ureters retroperitoneal?

A

yes

45
Q

what are the ureters?

A

muscular tubes made of smooth muscle

46
Q

where are the ureters?

A

Pass over the pelvic brim at bifurcation of common iliac arteries
Run on lateral walls of pelvis
Opposite ischial spine, curve anteromedially

47
Q

why do the ureters need a one way flap valve?

A

so that urine doesnt pass back up

48
Q

what are the layers of the ureter wall?

A

Transitional epithelial mucosa
Smooth muscle muscularis
Fibrous connective tissue adventitia

49
Q

what is the main function of the ureters and how do they do this?

A

actively propel urine to the bladder via response to smooth muscle stretch

50
Q

what are the 3 constriction sites of the ureters?

A

renal pelvis
pelvic brim
where they enter the bladder

51
Q

why can pain caused by kidney stones come in waves?

A

bc of peristalsis

ureter is trying to pass urine but it cant

52
Q

what spinal levels do visceral afferents come from?

A

T11-L1/2

53
Q

what nerve does loin pain get referred along?

A

ilioinguinal and the iliohypogastric nerves (L1)

54
Q

where is the urinary bladder found in adults?

A

retroperitoneally on the pelvic floor posterior to the pubic symphysis

55
Q

where is the urinary bladder in children?

A

higher up than in adults

56
Q

what is the function of the median umbilical ligament?

A

holds the bladder in place

57
Q

what surrounds the origin of the urethra?

A

neck of the bladder

58
Q

where does the urethra end and begin?

A

Urethra begins at the base of the bladder and ends with the external opening in the perineum

59
Q

what are the layers of the bladder wall?

A
  • Transitional epithelial mucosa
  • A thick muscular layer
  • A fibrous adventitia
60
Q

what is the trigone?

A

triangular area outlined by openings for the ureters and urethra

61
Q

what is the thick muscular layer of the bladder called?

A

detrusor muscle

62
Q

what is the urethra?

A

Muscular tube that:
Drains urine from the bladder
Conveys it out of the body

63
Q

what are the sphincters of the urethra?

A

Internal urethral sphincter (males) – involuntary sphincter at the bladder-urethra junction (preventing retrograde ejaculation)
External urethral sphincter – voluntary sphincter surrounding the urethra as it passes through the urogenital diaphragm
Levator ani muscle – voluntary urethral sphincter

64
Q

what is the femal urethra tightly bound to?

A

anterior vaginal wall

65
Q

where does the external opening of the female urethra lie?

A

external opening lies anterior to the vaginal opening and posterior to the clitoris

66
Q

what are the 4 sections of the male urethra?

A 
intramural (pre-prostatic)
prostatic
intermediate (membranous)
spongy
67
Q

which part of the male urethra contains the ejaculatory ducts?

A

prostatic

68
Q

what is micturition?

A

emptying of the bladder

69
Q

what does distention of the bladder walls initiate?

A

visceral afferents

70
Q

what does the hypogastric nerve do in micturition?

A 
Stimulate contraction (closure) of the internal urethral sphincter
Inhibit the detrusor muscle (prevents contraction and bladder emptying)
71
Q

what does the parasympathetic nerve do in micturition?

A

Stimulate the detrusor muscle to contract

Inhibits (opens) the internal urethral sphincters

72
Q

what spinal level does the pudendal come from?

A

S2-S4

m2 (24 decks)

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