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Med School Year 3 > Kidneys & Ureter Anatomy > Flashcards

Kidneys & Ureter Anatomy Flashcards

1
Q

what are the two main roles of the kidneys?

A
  • filter and excrete waste products from the blood
  • maintain water + electrolyte balance
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2
Q

at what vertebral levels are the kidneys?

A

T12-L3

right kidney can sit higher due to liver

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3
Q

what is urine formed from?

A

excreted metabolic waste and excess electrolytes

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4
Q

what is the role of the ureter?

A

transports urine from the kidneys to the bladder for storage

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5
Q

list the 4 layers surrounding the kidney (deep-superficial):

A
  • renal capsule
  • perirenal fat
  • renal fascia
  • pararenal fat
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6
Q

what are the two main sections the kidney can be divided into?

A

renal cortex
renal medulla

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7
Q

what is the renal hilum?

A

deep fissure in medial margin of kidney where renal vessels + ureter exit/enter

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8
Q

what is the renal pelvis?

A

flattened area of kidney where urine from teh major calyx collects and then drains into ureter

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9
Q

what divides the renal medulla into pyramids?

A

renal cortex

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10
Q

what is a renal papilla?

A

apex of renal pyramid

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11
Q

what is a major calyx?

A

multiple minor calyx joined together

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12
Q

label the transverse section of the kidney

A
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13
Q

label the kidney

A
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14
Q

label the glomerulus

A
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15
Q

list the blood flow through the kidneys

A
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16
Q

label the blood supply of the kidney

A
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17
Q

label the blood supply of the nephron

A
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18
Q

the renal arteries are immediately distal to what?

A

the superior mesenteric artery

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19
Q

at the level of the hilum, the right and left renal arteries form what?

A

anterior and posterior branches

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20
Q

the renal arteries split into anterior and posterior branches at what level?

A

level of the hilum

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21
Q

the anterior division of the renal arteries and the posterior division of the renal arteries carry what proportion of blood supply respectively?

A

anterior = 75%
posterior = 25%

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22
Q

how many segmental arteries are there?

A

5

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23
Q

in what blood vessel does filtration occur in the kidney?

A

glomerular capillaries

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24
Q

what areas of the kidneys are supplied by peritubular capillaries?
what areas are supplied by vasa recta?

A

peritubular capillaries = 2/3 of cortex
vasa recta = inner 1/3 cortex and medulla

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25
Q

where do the renal veins drain?

A

IVC

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26
Q

what is Brodel’s line?

A

avascular plane on lateral border

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27
Q

what does Brodel’s line separate?

A

segments of kidneys supplied by anterior and posterior renal arteries

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28
Q

why is Brodel’s line clinically important?

A
  • access route for open and endoscopic kidney procedures
  • minimises arterial damage and ischaemia
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29
Q

label the vasculature of the kidney

A
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30
Q

what clinical variations can occur in the kidney?

A

accessory/supernumerary arteries
lower branches not undergoing atrophy as kidney ascends

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31
Q

what is an aberrant artery?

A

accessory artery that does not enter the kidney through the hilum

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32
Q

what is the lymph drainage of the kidney?

A

lateral aortic/para-aortic lymph nodes

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33
Q

what is pelvic kidney?

A
  • when kidney fails to ascend into lumbar retroperitoneal area
  • usually remains at level of common iliac artery
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34
Q

what is horseshoe kidney?

A
  • two developing kidneys fuse at isthmus (lower poles)
  • become stuck under IMA

prone to obstruction, but usually asymptomatic

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35
Q

what congenital abnormalities can occur in the kidney?

A

pelvic kidney
horseshoe kidney

36
Q

is the kidney intraperitoneal or retroperitoneal?

A

retroperitoneal

37
Q

what is a minor calyx?

A

a small chamber of the kidney that surrounds renal papilla and collects urines from that pyramid

38
Q

the renal medulla is divided into what?

A

renal pyramids

39
Q

what are renal pyramids?

A

triangular divisions of the renal medulla

40
Q

what is the inguinal canal?

A

oblique passage through abdominal wall

41
Q

where is the inguinal canal?

A

just above the medial end of the inguinal ligament

42
Q

where does the inguinal canal extend through?

A

deep inguinal ring to superficial inguinal ring

43
Q

what are the boundaries of the inguinal canal?

A

anterior - external oblique aponeurosis
posterior - transversalis fascia and conjoint tendon
floor - inguinal ligament
roof - arching fibres of interal oblique and transversus abdominis

44
Q

what forms the anterior boundary of the inguinal canal?

A

external oblique aponeurosis

45
Q

what forms the posterior boundary of the inguinal canal?

A

transversalis fascia and conjoint tendon

46
Q

what forms the floor of the inguinal canal?

A

inguinal ligament

47
Q

what forms the roof of the inguinal canal?

A

arching fibres of internal oblique and transversus abdominis

48
Q

what does the inguinal canal contain?

A

spermatic cord/round ligament
blood and lymphatic vessels
ilioinguinal nerve

49
Q
A
50
Q
A
51
Q

the course of the ureters can be split into what two parts?

A

abdominal course
pelvic course

52
Q

describe the abdominal course of the aorta?

A
  • renal pelvis
  • ureteropelvic junction
  • ureter
  • anterior surface of psoas major
  • at sacroiliac joint crosses pelvic brim and birfucation of common iliac
53
Q

where does the ureter cross the pelvic brim?

A

at sacroiliac joints

54
Q

describe the pelvic course of the ureter

A
  • lateral pelvic wall
  • at ischial spine - turns anteromedially and travels along transverse plane
  • enters bladder in oblique manner
55
Q

where does the ureter turn anteromedially and travel along hte transverse plane?

A

ischial spine

56
Q

how does the ureter vary between males and females?

A
  • females passes under uterine arteries and in close proximity to ovaries
  • males passes posteriorly to vas deferens
57
Q

why is it beneficial that the ureter enters the bladder in an oblique manner?

A
  • creates one way valve
  • high intramural pressure collapses ureters
  • prevents backflow of urine
58
Q

the abdominal course of the ureter is supplied by what arteries?

A
  • renal
  • testicular/ovarian
  • uretal branches of aorta
59
Q

the pelvic course of the ureter is supplied by what arteries?

A

superior and inferior vesical arteries

60
Q

describe the nervous supply of the ureters?

A
  • renal, testicular/ovarian and hypogastric plexuses
  • sensory fibres enter at T11-L2
61
Q

how many constrictions are there in the ureter?

A

3

62
Q

what are the 3 contrictions within the ureter?

A
  • uteropelvic junction
  • pelvic inlet
  • entrance to bladder
63
Q

why are the contrictions of the ureter clincially important?

A

common site of uteric calculus/kidney stones

64
Q

label the course of the ureter

A
65
Q

what are the adrenal glands?

A

endocrine glands that secrete steroids and catecholamine hormones into the blood

66
Q

are the adrenal glands intra or retro peritoneal?

A

retroperitoneal

67
Q

what fascia encloses the adrenal glands and kidneys?

A

perinephric fascia

68
Q

the perinephric fascia attaches the adrenal glands to what?

A

crura of diaphragm

69
Q

what separates the adrenal glands and the kidney?

A

perirenal fat

70
Q

the cortex of the adrenal gland has what embryonic origin?

A

embryonic mesoderm

71
Q

the medulla of the adrenal gland has what embryonic origin?

A

ectodermal neural crest cells

72
Q

the medulla of the adrenal glands contain what?

A

chromaffin cells

73
Q

what does the medulla of the adrenal glands secrete?

A

catecholamines (Adr) and enkephalins (pain response)

74
Q

what does the cortex of the adrenal glands secrete?

A

corticosteroids and androgens

75
Q

what are the 3 layers of the cortex?

A

zona glomerulos
zona fasciculata
zona reticularis

76
Q

the zona glomerulos produces and secretes what?

A

mineral corticosteroids

eg aldosterone

77
Q
A
78
Q

the zona fasciculata produces and secretes what?

A

corticosteroids (cortisol) and small amounts of androgens

79
Q

the zona reticularis produces and secretes what?

A

androgens (DHES) and small amounts of corticosteroids

80
Q

list the 3 layers of the cortex of teh adrenal glands and what each layer produces/secretes:

A
  • zona glomerulos - mineral corticosteroids
  • zona fasciculata - corticosteroids and small amounts of androgens
  • zona reticularis - androgens and small amounts of corticosteroids
81
Q

what arteries supply the adrenal glands? what does each come from?

A
  • superior adrenal - from inferior phrenic
  • middle adrenal - from abdominal aorta
  • inferior adrenal - from renal arteries
82
Q

describe the venous drainage of the adrenal glands:

A
  • right adrenal vein to IVC
  • left adrenal vein to left renal vein
83
Q

describe the innervation of the adrenal glands:

A
  • coeliac plexus
  • greater sphlanchnic nerves
  • medulla sympathetic fibres to T10-L1
84
Q

describe the lymph drainage of the adrenal glands

A

lumbar lymph nodes

85
Q

label the transverse section of the adrenal gland

A
86
Q

label the microscopic layers of the cortex of the adrenal glands

A

Med School Year 3 (4 decks)

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