L16: Anatomy Of Kidneys, Ureters And Urinary Bladder Flashcards
Location of kidneys
Retroperitoneum
Levels of kidney
T12 - L3
Layers of kidneys
外 —> 內 1. Pararenal fat 2. Renal fasciae 3. Perirenal fat 4. Fibrous capsule —> functions: hold in position, support kidneys
Kidney
- Renal cortex
- Renal medulla
- Renal pyramid
- Ureteropelvic junction
Adrenal gland
- Adrenal cortex
- Adrenal medulla
Hilum of kidney
- Renal artery
- Renal vein
- Renal pelvis
Relative position of kidney
Right kidney lower than Left kidney
Blood supply of kidney
Renal artery and vein
Renal artery: from abdominal aorta
Renal vein: L2, drain into IVC
Lymph drainage of kidney
Lateral aortic nodes —> Lumbar trunk —> Cysterna chyli —> Thoracic duct —> BCV —> SVC
Nerve supply of kidney
Renal plexus (T12 + Vagus)
Blood supply of adrenal gland
Artery:
Inferior phrenic artery (Diaphragm)
Renal artery
Aorta
Vein:
R suprarenal vein —> IVC
L suprarenal vein —> Left renal vein
Lymphatic drainage of adrenal gland
Lateral aortic node —> Lumbar trunk
Nerve supply of adrenal gland
T5-T9 + No parasympathetic
Location of ureter
Male: posterior to Ductus deferans
Female: below Uterine artery
Insert into bladder (trigone: function as a valve)
***3 physiological narrowing of Ureter
- Ureteropelvic junction
- Ureter passes the pelvic inlet (pelvic brim)
- Ureter inserts into urinary bladder (Ureterovesical junction)
—> Common sites of obstructions (renal stones)
Blood supply of ureter
- Renal A/V
- Gonadal A/V
- Iliac A/V
- Vesical A/V
Lymph drainage of ureter
Lateral aortic nodes —> Lumbar trunk
Nerve supply of ureter
- Renal plexus
- Hypogastric plexus
- Testicular plexus
Pelvic inlet
前 —> 後
- Linea terminalis
- Pubic crest
- Pecten pubis
- Arcuate line - Margin of ala
- Promontory
Function: child delivery
Pelvis structure
- Pubis
- Ilium
- Ischium
—> converge into Acetabulum (for head of femur)
Stabilised by Sacrospinous ligament, Sacrotuberous ligament
Ischia tuberosity: sitting bone
Blood supply:
Common iliac artery —> Internal iliac artery (Anterior + Posterior —> iliolumbar, lateral sacral, superior gluteal) + External iliac artery
Location of Urinary bladder
Inside pelvic cavity
Anterior: Pelvic symphysis
Posterior: Sacrum, Sacral nerves
Female: Vesicouterine pouch (space between bladder and uterus)
Male: Rectovesical pouch (space between bladder and rectum)
Structure and Layer of bladder wall
外 —> 內
- Outer serous peritoneum (superior surface of bladder)
- Detrussor muscle
- Transitional epithelium
Support of bladder:
- Urogenital diaphragm
- Pelvic fascia
- Medial umbilical ligament (umbilical artery)
- Median umbilical ligament (urachus)
Neck of bladder:
- Sphincter vesicae
—> ANS innervation
—> fixed by Pubovesical ligament (female) + Puboprostatic ligament (male)
Trigone is between: (base of bladder, most sensitive to pain, smooth lining)
- Urethral orifice
- Ureteric orifice x2
Blood supply of bladder
Artery:
- Superior + Inferior vesical artery (male)
- Vaginal artery (female)
Vein:
- Vesical venous plexus —> (prostatic venous plexus (male))—> internal iliac veins
Lymphatic drainage of bladder
Internal + External Iliac nodes
Nerve supply of bladder
(Inferior) Hypogastric plexus (L1-L2, S2-S4)
***Comparison between Blood supply, Nerve supply, Lymphatics drainage of 1. Kidney 2. Adrenal gland 3. Ureter 4. Bladder
- Kidney:
- Renal A/V
- Renal plexus
- Lateral aortic nodes - Adrenal:
- Artery: Inferior phrenic artery (Diaphragm), Renal artery, Aorta
Vein: R suprarenal vein —> IVC, L suprarenal vein —> Left renal vein
- T5-T9, no parasympathetic
- Lateral aortic nodes - Ureter
- Renal, Gonadal, Iliac, Vesical A/V
- Renal, Hypogastric, Testicular plexus
- Lateral aortic nodes - Bladder
- Artery: Superior + Inferior vesical A/V (male), Vaginal artery (female)
Vein: Vesical venous plexus —> (prostatic venous plexus (male))—> internal iliac veins
- Hypogastric plexus (L1-L2, S2-S4)
- Internal + External Iliac nodes
