L16: Anatomy Of Kidneys, Ureters And Urinary Bladder

Question 1

Location of kidneys

Answer 1

Retroperitoneum

Question 2

Levels of kidney

Answer 2

T12 - L3

Question 3

Layers of kidneys

Answer 3

外 —> 內
1. Pararenal fat
2. Renal fasciae
3. Perirenal fat
4. Fibrous capsule
—> functions: hold in position, support kidneys

Kidney

5. Renal cortex
6. Renal medulla
7. Renal pyramid
8. Ureteropelvic junction

Adrenal gland

9. Adrenal cortex
10. Adrenal medulla

Question 4

Hilum of kidney

Answer 4

1. Renal artery
2. Renal vein
3. Renal pelvis

Question 5

Relative position of kidney

Answer 5

Right kidney lower than Left kidney

Question 6

Blood supply of kidney

Answer 6

Renal artery and vein

Renal artery: from abdominal aorta
Renal vein: L2, drain into IVC

Question 7

Lymph drainage of kidney

Answer 7

Lateral aortic nodes —> Lumbar trunk —> Cysterna chyli —> Thoracic duct —> BCV —> SVC

Question 8

Nerve supply of kidney

Answer 8

Renal plexus (T12 + Vagus)

Question 9

Blood supply of adrenal gland

Answer 9

Artery:
Inferior phrenic artery (Diaphragm)
Renal artery
Aorta

Vein:
R suprarenal vein —> IVC
L suprarenal vein —> Left renal vein

Question 10

Lymphatic drainage of adrenal gland

Answer 10

Lateral aortic node —> Lumbar trunk

Question 11

Nerve supply of adrenal gland

Answer 11

T5-T9 + No parasympathetic

Question 12

Location of ureter

Answer 12

Male: posterior to Ductus deferans
Female: below Uterine artery

Insert into bladder (trigone: function as a valve)

Question 13

***3 physiological narrowing of Ureter

Answer 13

1. Ureteropelvic junction
2. Ureter passes the pelvic inlet (pelvic brim)
3. Ureter inserts into urinary bladder (Ureterovesical junction)

—> Common sites of obstructions (renal stones)

Question 14

Blood supply of ureter

Answer 14

1. Renal A/V
2. Gonadal A/V
3. Iliac A/V
4. Vesical A/V

Question 15

Lymph drainage of ureter

Answer 15

Lateral aortic nodes —> Lumbar trunk

Question 16

Nerve supply of ureter

Answer 16

1. Renal plexus
2. Hypogastric plexus
3. Testicular plexus

Question 17

Pelvic inlet

Answer 17

前 —> 後

1. Linea terminalis
   - Pubic crest
   - Pecten pubis
   - Arcuate line
2. Margin of ala
3. Promontory

Function: child delivery

Question 18

Pelvis structure

Answer 18

1. Pubis
2. Ilium
3. 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

Question 19

Location of Urinary bladder

Answer 19

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)

Question 20

Structure and Layer of bladder wall

Answer 20

外 —> 內

1. Outer serous peritoneum (superior surface of bladder)
2. Detrussor muscle
3. Transitional epithelium

Support of bladder:

1. Urogenital diaphragm
2. Pelvic fascia
3. Medial umbilical ligament (umbilical artery)
4. 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

Question 21

Blood supply of bladder

Answer 21

Artery:

• Superior + Inferior vesical artery (male)
• Vaginal artery (female)

Vein:
- Vesical venous plexus —> (prostatic venous plexus (male))—> internal iliac veins

Question 22

Lymphatic drainage of bladder

Answer 22

Internal + External Iliac nodes

Question 23

Nerve supply of bladder

Answer 23

(Inferior) Hypogastric plexus (L1-L2, S2-S4)

Question 24

***Comparison between Blood supply, Nerve supply, Lymphatics drainage of 1. Kidney 2. Adrenal gland 3. Ureter 4. Bladder

Answer 24

1. Kidney:
   - Renal A/V
   - Renal plexus
   - Lateral aortic nodes
2. 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
3. Ureter
   - Renal, Gonadal, Iliac, Vesical A/V
   - Renal, Hypogastric, Testicular plexus
   - Lateral aortic nodes
4. 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