Kidneys & Ureter Anatomy

Question 1

what are the two main roles of the kidneys?

Answer 1

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

Question 2

at what vertebral levels are the kidneys?

Answer 2

T12-L3

right kidney can sit higher due to liver

Question 3

what is urine formed from?

Answer 3

excreted metabolic waste and excess electrolytes

Question 4

what is the role of the ureter?

Answer 4

transports urine from the kidneys to the bladder for storage

Question 5

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

Answer 5

• renal capsule
• perirenal fat
• renal fascia
• pararenal fat

Question 6

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

Answer 6

renal cortex
renal medulla

Question 7

what is the renal hilum?

Answer 7

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

Question 8

what is the renal pelvis?

Answer 8

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

Question 9

what divides the renal medulla into pyramids?

Answer 9

renal cortex

Question 10

what is a renal papilla?

Answer 10

apex of renal pyramid

Question 11

what is a major calyx?

Answer 11

multiple minor calyx joined together

Question 12

label the transverse section of the kidney

Answer 12

Question 13

label the kidney

Answer 13

Question 14

label the glomerulus

Answer 14

Question 15

list the blood flow through the kidneys

Answer 15

Question 16

label the blood supply of the kidney

Answer 16

Question 17

label the blood supply of the nephron

Answer 17

Question 18

the renal arteries are immediately distal to what?

Answer 18

the superior mesenteric artery

Question 19

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

Answer 19

anterior and posterior branches

Question 20

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

Answer 20

level of the hilum

Question 21

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

Answer 21

anterior = 75%
posterior = 25%

Question 22

how many segmental arteries are there?

Answer 22

5

Question 23

in what blood vessel does filtration occur in the kidney?

Answer 23

glomerular capillaries

Question 24

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

Answer 24

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

Question 25

where do the renal veins drain?

Answer 25

IVC

Question 26

what is Brodel's line?

Answer 26

avascular plane on lateral border

Question 27

what does Brodel's line separate?

Answer 27

segments of kidneys supplied by anterior and posterior renal arteries

Question 28

why is Brodel's line clinically important?

Answer 28

* access route for open and endoscopic kidney procedures * minimises arterial damage and ischaemia

Question 29

label the vasculature of the kidney

Answer 29

Question 30

what clinical variations can occur in the kidney?

Answer 30

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

Question 31

what is an aberrant artery?

Answer 31

accessory artery that does not enter the kidney through the hilum

Question 32

what is the lymph drainage of the kidney?

Answer 32

lateral aortic/para-aortic lymph nodes

Question 33

what is pelvic kidney?

Answer 33

* when kidney fails to ascend into lumbar retroperitoneal area * usually remains at level of common iliac artery

Question 34

what is horseshoe kidney?

Answer 34

* two developing kidneys fuse at isthmus (lower poles) * become stuck under IMA | prone to obstruction, but usually asymptomatic

Question 35

what congenital abnormalities can occur in the kidney?

Answer 35

pelvic kidney horseshoe kidney

Question 36

is the kidney intraperitoneal or retroperitoneal?

Answer 36

retroperitoneal

Question 37

what is a minor calyx?

Answer 37

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

Question 38

the renal medulla is divided into what?

Answer 38

renal pyramids

Question 39

what are renal pyramids?

Answer 39

triangular divisions of the renal medulla

Question 40

what is the inguinal canal?

Answer 40

oblique passage through abdominal wall

Question 41

where is the inguinal canal?

Answer 41

just above the medial end of the inguinal ligament

Question 42

where does the inguinal canal extend through?

Answer 42

deep inguinal ring to superficial inguinal ring

Question 43

what are the boundaries of the inguinal canal?

Answer 43

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

Question 44

what forms the anterior boundary of the inguinal canal?

Answer 44

external oblique aponeurosis

Question 45

what forms the posterior boundary of the inguinal canal?

Answer 45

transversalis fascia and conjoint tendon

Question 46

what forms the floor of the inguinal canal?

Answer 46

inguinal ligament

Question 47

what forms the roof of the inguinal canal?

Answer 47

arching fibres of internal oblique and transversus abdominis

Question 48

what does the inguinal canal contain?

Answer 48

spermatic cord/round ligament blood and lymphatic vessels ilioinguinal nerve

Question 51

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

Answer 51

abdominal course pelvic course

Question 52

describe the abdominal course of the aorta?

Answer 52

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

Question 53

where does the ureter cross the pelvic brim?

Answer 53

at sacroiliac joints

Question 54

describe the pelvic course of the ureter

Answer 54

* lateral pelvic wall * at ischial spine - turns anteromedially and travels along transverse plane * enters bladder in oblique manner

Question 55

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

Answer 55

ischial spine

Question 56

how does the ureter vary between males and females?

Answer 56

* females passes under uterine arteries and in close proximity to ovaries * males passes posteriorly to vas deferens

Question 57

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

Answer 57

* creates one way valve * high intramural pressure collapses ureters * prevents backflow of urine

Question 58

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

Answer 58

* renal * testicular/ovarian * uretal branches of aorta

Question 59

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

Answer 59

superior and inferior vesical arteries

Question 60

describe the nervous supply of the ureters?

Answer 60

* renal, testicular/ovarian and hypogastric plexuses * sensory fibres enter at T11-L2

Question 61

how many constrictions are there in the ureter?

Answer 61

3

Question 62

what are the 3 contrictions within the ureter?

Answer 62

* uteropelvic junction * pelvic inlet * entrance to bladder

Question 63

why are the contrictions of the ureter clincially important?

Answer 63

common site of uteric calculus/kidney stones

Question 64

label the course of the ureter

Answer 64

Question 65

what are the adrenal glands?

Answer 65

endocrine glands that secrete steroids and catecholamine hormones into the blood

Question 66

are the adrenal glands intra or retro peritoneal?

Answer 66

retroperitoneal

Question 67

what fascia encloses the adrenal glands and kidneys?

Answer 67

perinephric fascia

Question 68

the perinephric fascia attaches the adrenal glands to what?

Answer 68

crura of diaphragm

Question 69

what separates the adrenal glands and the kidney?

Answer 69

perirenal fat

Question 70

the cortex of the adrenal gland has what embryonic origin?

Answer 70

embryonic mesoderm

Question 71

the medulla of the adrenal gland has what embryonic origin?

Answer 71

ectodermal neural crest cells

Question 72

the medulla of the adrenal glands contain what?

Answer 72

chromaffin cells

Question 73

what does the medulla of the adrenal glands secrete?

Answer 73

catecholamines (Adr) and enkephalins (pain response)

Question 74

what does the cortex of the adrenal glands secrete?

Answer 74

corticosteroids and androgens

Question 75

what are the 3 layers of the cortex?

Answer 75

zona glomerulos zona fasciculata zona reticularis

Question 76

the zona glomerulos produces and secretes what?

Answer 76

mineral corticosteroids | eg aldosterone

Question 78

the zona fasciculata produces and secretes what?

Answer 78

corticosteroids (cortisol) and small amounts of androgens

Question 79

the zona reticularis produces and secretes what?

Answer 79

androgens (DHES) and small amounts of corticosteroids

Question 80

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

Answer 80

* zona glomerulos - mineral corticosteroids * zona fasciculata - corticosteroids and small amounts of androgens * zona reticularis - androgens and small amounts of corticosteroids

Question 81

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

Answer 81

* superior adrenal - from inferior phrenic * middle adrenal - from abdominal aorta * inferior adrenal - from renal arteries

Question 82

describe the venous drainage of the adrenal glands:

Answer 82

* right adrenal vein to IVC * left adrenal vein to left renal vein

Question 83

describe the innervation of the adrenal glands:

Answer 83

* coeliac plexus * greater sphlanchnic nerves * medulla sympathetic fibres to T10-L1

Question 84

describe the lymph drainage of the adrenal glands

Answer 84

lumbar lymph nodes

Question 85

label the transverse section of the adrenal gland

Answer 85

Question 86

label the microscopic layers of the cortex of the adrenal glands

Answer 86