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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
what separates the medulla into renal pyramids?
renal columns
26
what is the hilum?
where vessels enter and exit
27
describe the route of urine, starting at the renal papilla
papilla --> minor calyx --> major calyx --> renal pelvis --> ureter
28
what is a functional unit of the kidney called?
nephron
29
what does damage to the filtration membrane result in?
results in protein and blood cells leaking into the filtrate which arent reabsorbed
30
how does insufficient blood pressure affect the glomerulus?
results in less filtrate being produced
31
what can cause insufficient blood pressure in the kidneys?
atherosclerosis of renal arteries/ heart failure, shock, dehydration
32
describe the arterial blood supply of the kidneys
``` renal segmental interlobar arcuate interlobular [glomerulus] afferent arteriole glomerulus efferent arterioles ```
33
describe the venous blood supply of the kidneys
``` interlobular veins arcuate veins interlobar veins segmental veins renal veins ```
34
is the hilum higher on the right or left?
right
35
what spinal level are the renal arteries found at?
L1/L2
36
which is longer; the left or right renal vein?
left
37
what structure does the left renal vein travel under?
superior mesenteric artery
38
what does the left renal vein drain into?
IVC
39
what plexus supplies the kidneys?
renal plexus
40
what nerves make up the renal plexus?
Sympathetic (T10-L2) From thoracic and lumbar splanchnics Parasympathetic (vagus)
41
at what level do visceral afferent fibres travel?
T10-T12
42
where do visceral afferents receive input from?
baroreceptors and chemoreceptors
43
describe the lymphatic drainage of the kidneys
``` kidneys left lumbar lymph nodes left lumbar trunk cisterna chyli thoracic duct ```
44
are the ureters retroperitoneal?
yes
45
what are the ureters?
muscular tubes made of smooth muscle
46
where are the ureters?
Pass over the pelvic brim at bifurcation of common iliac arteries Run on lateral walls of pelvis Opposite ischial spine, curve anteromedially
47
why do the ureters need a one way flap valve?
so that urine doesnt pass back up
48
what are the layers of the ureter wall?
Transitional epithelial mucosa Smooth muscle muscularis Fibrous connective tissue adventitia
49
what is the main function of the ureters and how do they do this?
actively propel urine to the bladder via response to smooth muscle stretch
50
what are the 3 constriction sites of the ureters?
renal pelvis pelvic brim where they enter the bladder
51
why can pain caused by kidney stones come in waves?
bc of peristalsis | ureter is trying to pass urine but it cant
52
what spinal levels do visceral afferents come from?
T11-L1/2
53
what nerve does loin pain get referred along?
ilioinguinal and the iliohypogastric nerves (L1)
54
where is the urinary bladder found in adults?
retroperitoneally on the pelvic floor posterior to the pubic symphysis
55
where is the urinary bladder in children?
higher up than in adults
56
what is the function of the median umbilical ligament?
holds the bladder in place
57
what surrounds the origin of the urethra?
neck of the bladder
58
where does the urethra end and begin?
Urethra begins at the base of the bladder and ends with the external opening in the perineum
59
what are the layers of the bladder wall?
- Transitional epithelial mucosa - A thick muscular layer - A fibrous adventitia
60
what is the trigone?
triangular area outlined by openings for the ureters and urethra
61
what is the thick muscular layer of the bladder called?
detrusor muscle
62
what is the urethra?
Muscular tube that: Drains urine from the bladder Conveys it out of the body
63
what are the sphincters of the urethra?
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
what is the femal urethra tightly bound to?
anterior vaginal wall
65
where does the external opening of the female urethra lie?
external opening lies anterior to the vaginal opening and posterior to the clitoris
66
what are the 4 sections of the male urethra?
``` intramural (pre-prostatic) prostatic intermediate (membranous) spongy ```
67
which part of the male urethra contains the ejaculatory ducts?
prostatic
68
what is micturition?
emptying of the bladder
69
what does distention of the bladder walls initiate?
visceral afferents
70
what does the hypogastric nerve do in micturition?
``` Stimulate contraction (closure) of the internal urethral sphincter Inhibit the detrusor muscle (prevents contraction and bladder emptying) ```
71
what does the parasympathetic nerve do in micturition?
Stimulate the detrusor muscle to contract | Inhibits (opens) the internal urethral sphincters
72
what spinal level does the pudendal come from?
S2-S4

m2 (24 decks)

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