KUB, pelvis and repro Flashcards
how big is a normal kidney?
12 x 6 x 3
which kidney is lower?
the right is lower
the surface marking of the hilum of the kidney is ?
the transpyloric plane 5 cm from the midline
immediate posterior relation of the kidneys is? (4)
the costodiaphragmatic recess of the pleura
the ileohypogastric and ileoinjoinal nerves
psoas muscle
the subcostal artery nerve and vein after emerging through the lateral arcuate ligament
the shape of the right suprarenal gland is?
pyramidal
the location of the right suprarenal gland ?
upper pole of right kidney, behind the IVC and in front of the right crus of the diaphragm, and bare area of the liver
what shape is the left suprarenal gland?
cresentric shape
where can the left suprarenal gland be located
is applied to the medial border of the left kidney , above the hilum behind the peritoneum of the posterior wall of the lesser sac.
the transverslis fascia splits retroperitoneally into an anterior and posterior layer to form what?
gerotas fascia, ‘pre and retrorenal fascia’, fuses at the upper pole but ober inferiorly and medially.
how many minor calyces are there in a typical kidney ?
7-14
and 2- 3 major calyses
the anterior relations of the right kidney are (4)?
the right lobe of the liver, anteriroly
the hepatic flexure
the duodenum medially
what are the anterior relations of the left kidney ? (5)
tip of left lobe of liver anteriorly as well as fundus of stomach
tail of pancreas medially and anterirly
splenic flexure ant but infeorly
spleen laterally
how many degrees posterirly are the kidneys rotated ?
30 degrees
what are the names of the 4 anteriro renal arteries?
apical, upper, middle and lower (segmental branches) 70% f renal blodo flow
how many posterior segmental arteries are there in the kidney?
1
which is more anteriro? the renal artery or vein?
the vein
pus in the renal fascia can burst and track where?
retroperitoneally into the pelvis
how much blood does the kidney recieve every minute?
1L
the lymphatic drainage of the kidney is?
to the paraaortic nodes at the level of origin of the renal arteries. the surface fo the upper pole may drain through the diaphragm into nodes in the posterior mediastinum
how long is the ureter?
25 cm long
the 3 points of narrowing of the ureter are?
PUJ
crossign the pelvic rim
and the JUV termination in the bladder mucosa
on the psoas musle what is the orientation of these three structures? genitofemoral berve, ureter adn gonadal vessels.
the gonadal vessels are most anterior followed by the ureter then the genitofemoral nerve.
All under peritoneum
the root of the mesently ont he roght does cross it later downthe way
the left ureter is in what relation to the inferior mesenteric vessels?
to the left (lateral)
which vessel crosses the left ureter ?
And which part of the bowel just before entering the pelvis?
the left colic left lateral side
and the apex of the sigmoid
when does the ureter leave the psoas muscle?
at the bifurcation of the common iliac artery over the sacroiliac joint
on the left the apex of the sigmoid colon is the guide to then it eter the pelvis
the radiological marker of the ureter is the lumbar area is?
just medial to the tips of the transverse processes of the lumbar vertebrae
the blood supply to the ureter?
the upper end is supplied by the ureteric branch of the renal artery
the middle by gonadal and common iliac
and the lower end by branches from the inferior and superiro vesical and middle rectal arteries and uterine arteries.
all make anastomoses with eachother in the adventitia
the venous drainage of the ureter?
drains into the renal, gonadal and internal iliac veins.
the nerve supply to the ureter is?
sympathetic supply from celiac and hypogastric plexi pain fibres, PNS also unsure of significance
the transitional epithelium of the ureter is lined with muscularis mucosae (T/F?)
false
the blood supply to the adrenal gland?
3 arteries.
superior: inferior phrenic
renal
aorta
- vein drains into renal vein on the left and IVC on the right.
nerve supply to the adrenal glands
pre ganglionic myelinated from splanchnic nerves via the aortic and renal plexus, fibres synapse directly with the medullary cells. .
blood vessels have usual post ganglionic sympathetic supply although cortical contrl is not neural but by ACTH and the anterior pituitary.
the layer beneath the connective tissue capsule around the adrenal gland is called?
the zona glomerulosa
the second layer of the adrenal gland is called?
the zona fasiculata
the innermost layer of the adrenal gland is called the?
zona reticularis
what does the adrenal medulla secrete?
catecholamines: adrenaline 80% and noradrenaline (20%) and soem dopamine
what is the embryological origin of the adrenal gland?KIB
the medulla is derived from the neural creat and is ectodermal and the cortex is derived in situ from the mesoderm of the intermediate cell mass.
the emerging sacral nerves lie in what relation to the piriformis muscle in and out fo the pelvis?
int he pelvis the nerves are anterior to the pirifirmis, once throught the greater sciatic foramen you find the sciatic nerve under the piroformis
the pubic muscle below piroformis is?
ischiococcygeus (also just known as coccygeus)
nerve supply is S4 and S5
what are the two parts of levator ani?
ileococcygeus and pubococcogeus
their fibres run in continuity from the ischeal spine to the body of the pubis
they cross the obturator fascia
what two muscles can be found in order lower than coccygeus? (ischiococcygeus)
ileococcygeus and pubococcygeus (levator ani muscles)
what is the name of the muscle which is a U shaped sling which holds the anorectal junction angled forward ?
pubo rectalis
what is the name of the muscle which is a U shaped sling passes behind the prostate and and into the perineal body?
levator prostate
in the woman levator vaginalis
the pelvic floor is innervated by which nerves?
the perineal branche of S 3 and S4
S2 does the external sphincter not levator ani
S4 does not do the sphincter
regarding the pelvic wall fascia, the vessesls and nerves are above or below the fascia?
nerve are above and vessels are in . the sacral plexus however is within the fascia between it and piriformis
the vessels to the buttock do have to pierce the fascia to get to the muscle.
in the male the trigone overlies which part of the prostate?
the median lobe
what is the blood supply to the bladder?
the sup adn inf vesicular arteries
smaller contributions from the obturator, inferior gluteal, uterine and vaginal arteries
the venous drainage of the bladder?
the vesicoprostatic plexus, drains backwards towards the internal iliac
the main motor innervation of the bladder is?
PNS: the pelvic sphlancic nerves
sympathetic fibres - superior hypogastric and pelvic plexus. comes from L1 and L2 segments (inhibitory)
the innerveation of the internal schincger fo the bladder is?
sympathetic superior hypogastric and pelvic slexi L1 and L2
sensation of bladder filling is via what nerves to what tract?
paraympathitic fibres and in the spinal cord along the gracile tract
bladder pain is transmitted by what nerves adn what tract inthe spine?
PNS and SNS, spinothalamic tract.
the histology of the bladder is?
MM is thick and lax, lined by transitional epithelium, no glands, mucus comes from urethral galnds, there is no muscularis mucosae
the ureter runs over or under the iliac vessels?
over
does the ureter run over or under the ovary?
under
in the male the ductus differens crosses the ureter in what way?
superficially crosses then runs medial to it
the upper end of the seminal vesicle is in what relation to the ureter?
lies just below where the ureter enters the bladder
the uterine artery passes the ureter in what location?
the artery is superficial to the ureter.
the ureter enters the bladder in the woman in what relation to the cervix?
penetrates the condensed tissue which is the cervical ligament , crossing the lateral vaginal fornix 1 - 2 cm away from the cervix before entering the bladder in front of the fornix.
where can the prostatic plexus ov veins be located?
between the prostate capsule and the pelvic fascia
the histology of the prostate can be discribes as?
fibromuscular stroma with acini glands , a mixture fo CT and smooth muscle , numerous small ducts open up intot he prostatic urethra.
what is the prostate lobe anterior to the urethra called?
anterior lobe
which lobe is lokely to enlarge and obstruct the urethra in BPH?
the middle lobe
which lobes in the prostate are most susceptible to cancerous change?
the posterior and lateral lobes
where do the ejaculatory ducts open?
on the urethral crest
the blood supply to the prostate?
prostatic branch of the inferior vesical artery with some small branches from the middle rectal and internal pudendal vessels.
the lymph drainage of the prostate?
to the internal iliac adn sacral plexus , some may reack external iliac.
the nerve supply to the prostate?
the acini are under PNC cholinergic control but ejacultion is muscle fibres fromt he stroma contract to empty the glands during ejaculation which are SNS controlled (adrenergic controlled) from the inferior hypogastric plexus.
