Kidneys, Ureters, and Suprarenal Glands Flashcards
Where are the kidneys in relation to the peritoneum?
Primarily retroperitoneal
Where are ureters in relation to the peritoneum?
Primarily retroperitoneal
Where do ureters lead?
To urinary bladder
Where is the bladder in relation to the pelvis?
True pelvis
Where is the bladder in relation to the peritoneum?
Subperitoneal
What type of glands are suprarenal glands?
Endocrine glands
Where are the suprarenal glands in relation to the peritoneum?
Primarily retroperitoneal
Where is pararenal fat?
Posterior/posterolateral to kidney
Where is perirenal (perinephric) fat?
Completely surrounding the kidney continuing into the hilum
Where is the renal fascia?
Encloses kidney, suprarenal gland, and surrounding perirenal fat
Where is periureteric fat?
Surrounding the ureter
What do the kidneys filter?
Removes excess water, salts/minerals, wastes, or protein metabolism from blood
What do the kidneys return to blood?
Nutrients and chemicals
Where is the left kidney in relation to the spine?
Level of T12-L3
Where is the right kidney in relation to the left kidney?
About 5-6cm lower, right about iliac crest
Flank pain is an indicator of…
kidney issues
Where is the transpyloric plane?
Horizontal line across pyloric sphincter, top of right kidney, near hilum of left kidney
What structures can be found in the renal hilum?
- Renal artery and vein
- Ureter
- Entry to renal sinus
What is the function of the renal cortex?
Blood filtration and urine production
What is the function of renal medulla?
Urine transport
What are the components of the renal medulla?
- Renal pyramids
- Renal papilla
- Renal columns
Where are renal papilla?
Apex of renal pyramid
Where are renal columns?
Between renal pyramids
What is a calyx?
Chamber of kidney through which urine travels
Minor calices will join into…
major calyx
What is a renal sinus?
Space within kidney surrounding renal pelvis and calices, filled with perirrenal fat
What is the renal pelvis?
Funnel-shaped expansion leading to ureter
Major calices will join into…
renal pelvis
Right and left renal arteries are branches off of…
abdominal aorta (at L1-L2 IVD)
Which renal artery is longer and passes posterior to the inferior vena cava?
Right renal artery
Name the 5 segmental arteries coming from renal arteries
- Superior
- Antero-superior
- Antero-inferior
- Inferior
- Posterior
What is a variation of kidney blood supply found in 30% of people?
Accessory renal arteries
Both the left and right renal veins drain to…
inferior vena cava
Which portion of the kidney blood supply is asymmetrical?
Veins
Describe the venous drainage of the left kidney
Shorter pathway: left suprarenal vein and left gonadal vein drain into left renal vein; then, into inferior vena cava
Describe the venous drainage of the right kidney
Right renal vein, right suprarenal vein, and right gonadal vein all drain directly to the inferior vena cava
All lymph from the kidneys drains to… via…
cisterna chyli via right and left lumbar lymph nodes
Renal lymphatic vessels follow…
renal veins
Renal nerve plexus includes what sympathetic fibers?
Sympathetic fibers from least splanchnic nerve (T12) synapse in aorticorenal ganglion
Renal nerve plexus includes what parasympathetic fibers?
Parasympathetic fibers from vagus nerve (CN X)
What structures do ureters connect?
Kidneys to bladder
What are the three radiologically visible constrictions of the ureters?
- Junction of ureter and renal pelvis
- Ureters cross brim of pelvic inlet at common iliac bifurcation
- Passage through wall of urinary bladder
Radiologically visible constrictions of the ureters are potential sites of…
calculus (calculi) obstruction
Arteries for ureters arise from…
- renal arteries
- gonadal arteries
- abdominal aorta
- common iliac arteries
Veins for ureters drain into…
renal veins and gonadal veins
The superior portion of ureters drain lymph into…
lumbar lymph nodes
The middle and inferior portions of ureters drain lymph into…
common, external, or internal iliac lymph nodes
Which nerve plexuses innervate the ureters?
- Renal nerve plexus
- Abdominal aortic plexus
- Superior hypogastric plexus
Ureters have afferent fibers conveying pain from which spinal levels?
T11-L2
Ureteric pain typically refers to which dermatomes?
T11-L2: ipsilateral lower quadrant of anterior abdominal wall and groin
Suprarenal glands are attached to… and separated from kidneys by….
attached to diaphragmatic crura and separated from kidneys by small septum
How do the suprarenal glands differ in shape?
The right gland is pyramid shaped, the left is crescent shaped
What occurs at the hilum of the suprarenal glands?
Veins and lymph vessels exit
The cortex of the suprarenal glands is made from which embryologic cells?
Embryologic mesoderm
The medulla of the suprarenal glands is made from which embryologic cells?
Embryologic neural crest cells
The cortex of suprarenal glands secretes…
corticosteroids and androgens
What is the effect of corticosteroids and androgens from suprarenal glands?
- Kidneys retain sodium and water under stress (increasing blood volume and pressure)
- Affects muscles and other organs
What cells can be found in the medulla of suprarenal glands?
Chromaffin cells
What do Chromaffin cells secrete?
What is the function of this?
Secrete catecholamines
Function in fight or flight: epinephrine and norepinephrine
What arteries supply the suprarenal glands?
Superior, middle, and inferior suprarenal arteries
The superior suprarenal artery is a branch from…
inferior phrenic artery
The middle suprarenal artery is a branch from…
abdominal aorta
The inferior suprarenal artery is a branch from…
renal artery
What veins drain the suprarenal glands?
Right and left suprarenal veins
The right suprarenal vein drains to…
inferior vena cava
The left suprarenal vein drains to…
left renal vein
Myelinated presynaptic sympathetic fibers from the IML of T10-L1 traverse ___ and ___ without synapsing; they terminate on ___
…fibers from the IML of T10-L1 traverse sympathetic trunk and celiac ganglia without synapsing; they terminate on suprarenal medulla chromaffin cells
What spinal levels are concerned with sympathetic innervation to suprarenal glands?
T10-L1