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Self Study🥇 > L1-Anat > Flashcards

L1-Anat Flashcards

1
Q

What is the function of the URINARY SYSTEM

A

• Elimination of waste products of metabolism as urine.
• Controlling water and electrolyte balance in the body.
• Maintaining acid–base balance of the blood.

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2
Q

Kidney structure

A

The kidneys are two Reddish brown, bean-shaped structures.

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3
Q

Sit of kidney

A

In abdomen not in Pelvis 🌟(on the posterior abdominal wall)

Located high up on posterior abdominal wall
on each side of vertebral column,
from level of T12 to L3.

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4
Q

R&LKidney in the same level? why?

A

Right kidney (down)
The liver on the right side of the abdomen puts pressure on the right kidney.

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5
Q

Kidney and ureter are…

A

•They are 🌟Retroperitoneal

اللي يميزه ثبات الأعضاء ومنع حركتها

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6
Q

during respiration.

A

•They move downward vertically with diaphragm contraction

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7
Q

Ther is 2 ends / poles
The upper pole is…

A

closer to the midline than the lower pole.

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8
Q

Talk about the two surfaces:

A

Anterior; rough
• Posterior; smooth

بسبب الstructure اللي موجوده بكل من الجهتين

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9
Q

2 borders

A

Medial is convex and have hilum

Lateral is convex

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10
Q

What is the helium

A

هو المكان اللي في الorgan اللي الstructure تدخل وتطلع منو
In kidney it Lies on the medial border & it extends into a large cavity called the renal sinus.

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11
Q

What are the structures passed from helium of kidney

A

🌟From anterior →posterior
(VAP+A)

•Renal vein
•Renal artery (2 branches )
•Renal pelvis and ureter
•Renal artery (3rd branch)

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12
Q

What are the Coverings of the kidney from the most adherent

A

-Renal fibrous capsule(surrounds the kidney)
-Peri-renal fat( fat around kidney،its vessels & suprarenal gland.)
-Renal fascial capsule OR renal fascia(outer layer of condensed connective tissue continuous laterally with ‘fascia transversalis*،enclose the peri-renal fat, kidney & its suprarenal gland.)
Para-renal fat(retroperitoneal fat) : outermost layer (A part of retroperitoneal fat)

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13
Q

Internal Structure of the kidney divided into:

A

-Renal cortex (peripheral): outer thin layer makes (renal column)> extends in between the pyramid(شكلها قبه)
-Renal medulla:contain pyramids (5-11pyramids) its base toward the surface of the kidney and apex toward the inner of it
-Renal pelvic: area of upper extended part of the ureter

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14
Q

The apex of each pyramids called

A

papilla :opens and drainage in canal like structure called minor
calyces, and each 2-3 minor
calyces collected together to make major
calyces

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15
Q

What are the sinus and lobe

A

Renal Sinus > حتة الpelvic
🌟Renal Lob > pyramid + its covering cortex

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16
Q

Renal sinus

A

A space within ‘hilum, contains the renal pelvis & calyces.

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17
Q

Renal lobe

A

Each renal pyramid with its covering cortex.

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18
Q

Each kidney have ONE same anterior relation which is?

A

suprarenal gland

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19
Q

Anterior relations of R&L kidneys

A

R: R suprarenal gland,liver, duodenum, Right / hepatic colic flexure(ascending colon then it transverse)
L: •L suprarenal gland, Spleen, Stomach, Pancreas (tail), Jejunum, Coils of small intestine part of it which is the Jejunum, Left / splenic colic flexure (descending colon)

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20
Q

Posterior relations of both kidneys

A

Costo-diaphragmatic recess of ‘pleura.
Diaphragm
Muscles of the posterior abdominal wall ((Psoas major,Quadratus lumborum,Transversus abdominis))
🌟Nerves :(run downward & laterally betweenthe muscles & the kidney.)
-Subcostal n.,
-Iliohypogastric n.,
-Ilioinguinal n.

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21
Q

Left kidney rids

A

11th,12th

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22
Q

Right kidney rib

A

Last one (12th)

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23
Q

Blood Supply of the kidney

A

Renal artery”big one” (arise from abdominal aorta at the level of L2)

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24
Q

Talk about renal artery

A

Each renal artery divides into 4-5> اول ما يدخل الكلى نسميهsegmental arteries (enter the hilum, in front & behind renal pelvis).>بعد ما يدخل الكلى نسميه> lobar artery> حيدخل يعمل each lobar > 2-3interlobar arteries> Arcuate arteriesزي الأقواس(arch over ‘bases of the pyramids)> زي الاشعه من الاركوايت طالعةCortical radiat> كل واحد لمن اكبرو ألاقيه مطلع يمينه ويساره زي الشجرة اسميهم >Afferent glomerular arterioles.

25
Q

Venous drainage:

A

نفس ال Arterial supply بالزبط ولكن بالعكس وينتهي بال renal vain وحيصب طبعا في ال inferior vena cava

The renal vein emerges from the hilum in front of the renal artery and drains into the inferior vena cava, between the level of L1-L2.

26
Q

Abdominal Aorta بتطلع in which level?

A

L2

27
Q

الvein يرجع يدخل ثاني في الinferior vena cave في اي level

A

بين L1 وL2

28
Q

Lymph node of the kidney

A

دايم يكون يتبع الartery الكبير(aorta)
Lateral aortic
(Lumbar) LN

29
Q

Nerve supply of the kidney

A

ينقسم لقسمين
(sympathetic & parasympathetic) which surround the renal artery.
ال afferent fibers اللي بتطلع through the renal plexus of nerve,
تدخل ال spinal cord in T10, T11 ,T12
nerves (radiating pain)>يحصل بسبب مكان العصب

عشان كذا الألم اللي نحسو احيانا في الكلى نحسو كمان في الantiror abd wallاو نحسو على ورا

ليش الradiating pain نحسو في دي اللامكان؟لأنو مشترك ولأنه بيحصل nerve supply من خلال ذولا الspinal cord levels

30
Q

In the Surface Anatomy of the kidney The two horizontal lines are drawn at the level of (kidney level> T12,L3)

A

T11 لانه خط فبيترسم فوق حدود الكلى, L3 spines

31
Q

In the Surface Anatomy of the kidney the vertical lines are drawn at distances of ?

A

واحد medial والثاني lateral
الmedial حبعدو من الmedline ٢.٥سانتي
الlateral…….٩.٥سانتي

32
Q

What is the Morris’s quadrangular area

A

Area of the kidney after drawn on the posterior abdominal wall
( by two horizontal and two vertical lines)
واوصل بينهم

33
Q

The hilum at level of

A

L1

34
Q

The renal artery at level of

A

L2

35
Q

The renal vein at level of

A

L1&L2

36
Q

Parts of the ureter

A

هو عباره عن muscular tubes
Abdominal part
Pelvic part

37
Q

Talk about the ureter

A
  • Long: They are TWO muscular tubes, 25-30 cm long
    • Function: They convey urine from ‘kidneys to ‘urinary bladder.
    • Parts: The ureter has two parts: abdominal & pelvic parts.
38
Q

What is the Course of the ureter?

A

(Kidney and ureter are both retroperetonial structure )

-emerges from the hilum (it is a continuation of the renal pelvis)
-descend vertically in front of the lumber transverse processes.(vertical lateral of it)
-then pelvic brim and crossing the sacroiliac joint.
-then crossing the bifurcation of ‘common iliac artery
-then runs anterior to the internal iliac artery.
-the last part of the ureter curves forward medialy عشان يدخل للمثانة من خلال 🌟. superiolateral angle of ‘urinary bladder(شكلها مثلث وتكون شويا على ورا)

39
Q

What are the Common sites of the Constrictions of the Ureter

A

1-Where the renal pelvis joins the ureter الحته بين البيلفس والحالب (pelviureteric junction)
2-Where it crosses the pelvic brim
3-At level of ischial spine
4-where it pierces the bladder wallوهو داخل يحصل انو يضيق

40
Q

Why the ureter passing obliquely through its muscular wall.

A

A valve-like action, prevents the reverse flow of urine toward the kidneys as the bladder fills.
حيبدأ الurin ينزل ولو تملت المثانه حيرجع الurinثاني فوق ويعمل لي مشاكل لان مافي صمام

يمر الحالب بشكل مائل عبر الجدار العضلي للمثانة لتكوين آلية صمام وظيفي تمنع ارتجاع البول من المثانة إلى الحالب أثناء انقباض المثانة (التبول).
لماذا هذا مهم؟
1. منع الارتجاع: يسبب المرور المائل ضغطًا على الحالب مع امتلاء المثانة أو انقباضها، مما يغلق تجويف الحالب ويمنع ارتجاع البول (ارتجاع المثانة والحالب)، والذي قد يؤدي إلى التهابات أو تلف الكلى.
2. تدفق فعال: يضمن التدفق في اتجاه واحد للبول من الكلى إلى المثانة.

41
Q

Differences in ureter course between Male & Female pelvis

A

IN FEMAIL:
from posterior view
1-The ureter passes behind the ovary
*broad ligament of the uterus بيمسك في الرحم في الlateral pelvic wall to hold it in position
2-then the ureter passes behind the broad ligament
3-Then, it turns forward & medially under the base of ‘broad ligament عشان بروح قدام لان المثانه قدام في الpelvis, where the uterine artery(which supply the ureter), crosses (superiorly) above the ureter
4–- the it runs lateral to the lateral fornix of vagina to enter the bladder

IN MALE:

Near the ureter termination, it is crossed by the vas deferens before entering into the bladder.

42
Q

اش علاقه الureter بال uterine artery? او العكس

A

the uterine artery crosses (superiorly) above the ureter
💡 uterine artery supply the uterus

43
Q

Upper expanded end of the ureter is?

A

renal pelvis

44
Q

What are the anterior relation of the ureter? R&L

A

Right: duodenum,iliocolic Bood Vessel, Right colic vessel,ilieum(part of small intestine)(coils of the small intestine), Root of mesentery
Left: jejunum(coils of the small intestine),left colic vessel, Sigmoid colon, Mesocolon
ملاحظات💡
*الvessels ذي كلها بتطلع من الaorta عشان تعمل supply لل ascending Colons والdescending Colons
*الlobs حقت الsmall interesting ممسوكه بزي الشرشف من ورا مثبتها بالposterior abd wall اسمه mesentery
*كذلك الcolon بس اسمه Mesocolon

45
Q

What are the antiror Relations of the ureter? M&F

A

Male: Vas deference
Both: Gonadal Blood Vs. (Testicular/Ovarian)
Female: Uterine artery, ovaries- Base of broad ligament الي هي الصوره حقت ال ureter course in M&F

46
Q

Ureter is lateral to…

A

On the right side:IVC (inferior vena cava)
On the left side: IMA,IMV,Aorta

47
Q

Posterior relations of the ureter

A

Psoas major, 🌟genito-femoral nerve (طالع من الanterior serfuce of the Psoas major)» (نازل ورايح لقدام الCIA&IIA)

48
Q

(Arterial supply، Venous drainage، Lymph Drainage، Nerve Supply) of the ureter?

A

الحالب كل ماجاء جنب حاجة أخذ منه blood supply💡

🌟Arterial supply :Renal artery, Gonadal artery , Aorta & CIA, IIA, Superior vesical artery, inferior vesical artery
💡اللي هما رايحين للمثانة:Vesicle:

Venues drainage: corresponding to arteries مطابق

Lymph Drainage: supply هنا طول ما احنا ماشين بنعمل
» It drains into lateral aortic LN & commonLN & internal iliac LN.

Nerve Supply: sym &para symحقسمه ل
حناخد برضو من كذا plexues لان ال ureter طويل💡
حيجي له من renal
gonadal وجيجي له من
وجيجي له من الhypogastric nerve plexuses اللي فوق

49
Q

CLINICAL NOTES . . .🩸🩸🩸🩸

A

👇🏻

50
Q

Talke about Renal pain (Renal colic)من اسواء أنواع الالام اللي تجي المرضى

A

☘️It varies from dull ache pain to severe pain in flank,
☘️causes of renal pain?
🍃Infections (UTI)&raquo_space; Pain felt due to stretching the kidney capsule(fibrous OR renal).. Why stretching?
يافيها infection فنفخها او فيها inflammation فحصل لها swelling
OR
🍃 kidney stones.» Pain felt due to spasm the smooth muscle of renal pelvis…why spasm?
تحصل بسبب الAston’sاللي تكون عالقه اماً في الrenal pelvis او تكون نزلت في الureter فتعلق وتسبب pain

51
Q

Talk about Left Renal tumor..

A

الLR عندها حاجة خاصة : لو حصل renal timer in left side يحصل شيء اسمه varicocele(directed pain in the scrotom)
يعني هذي الtestes في الleft side بتعمل الvein حقها اللي هو ال testicular vein بيعمل drainage في الleft renal vein ما بتعمل دايركت drainag في الIVC🌈بيحصل فقط لو حصل tumar في الleft renal 🌈بسبب انو left renal vein that receives ‘left testicular vein in male.
فلما يكون عندي left renal tumer حيكون كبير لدرجة انو يأثر على الrenal vain انو يصير الdrainage حق ل testicular vein فيه بدل ما يكون في الIVC

52
Q

➢What are the most common sites of stone impaction in the ureter.

A

-
-
-

53
Q

Referred pain(The pain is simply felt in areas
other than the source)
الألم بيحصل حسب الstone فين واقف كل مكان لو Referred painمعين

A

💀 Referred renal pain → commonly along ‘distribution of T12 (subcostal nerve) يشمل ‘flank & anterior abdominal wall.»معناته المشكلة في نفس الكلية
💀tهنا الألم نزل شويه معناته المشكلة صارت في الحالب Renal pelvis & upper ureter send its afferent nerves into T11-L2 spinal cord&raquo_space; the pain will be in the areas that are supplied by these
segments of spinal cord (flank, loin & groin)
💀sنزلنا زياده lower ureteric stone&raquo_space; the pain will be in testis & tip of penis in male or labia in female.
💀 sometimes its pain is felt at the front of thigh through the (genitofemoral nerve)هذا العصب الوحيد اللي معدي خلف الحالب

طيب ليش بيحصل عندنا ألم في الfront of thigh?عشان حصل stimulation لل genitofemoral nerve اللي هو واحد من الrelations اللي خلف الحالب

54
Q

The factors supporting the kidney are: يخليها ماسكة في مكانها

A

🍁 kidney coveringsتثبتها في مكانها
🍁 Renal vessels.
🍁Intra-abdominal pressure

55
Q

The change of the anatomical position of the kidney known as?and why it occurs?

A

(Nephroptosis)الكلى تكون كأنها تعوم في البطن🪷
🪷تحصل بسبب انو واحد من الثلاثه factors اللي بتثبت الكلى (تغير)
A. Laceration of its coverings.
B. Sever trauma with avulsion of its blood vessels.
C. Sudden change of the intra-abdominal pressure.

56
Q

Latrogenic pnemothorax

A

بالغلط invasive procedure or surgery.
Can occur during removal of upper pole
stone in the kidney.. Due to Incision of pleura
at costo-diaphragmatic recess.

لان الكلى قريبه من الrecess فالخطاء هذا وارد

57
Q

In Kidney transplantation most cases the existing kidneys are not
removed why??

A

to reduce surgical morbidity.
إلا إذا كان منها ضرر او فيها كانسر او انفكشن

58
Q

The common site of the renal transplantationis?

A

In the iliac fossa(So, it is often necessary to
use a different blood supply.)وأغير المجرى حق الحالب القديم او اشيله

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