Lecture 11 DA Flashcards
Where do kidneys develop? What is a consequence as a result of this?
Kidneys develop lower down the abdinal wall, but they do not migrate. The differential growrate means they are found up higher, they take the blood supply of the level they were at. These vessels obliterate, called accessory renal artery, found in 25%.
Where does the accessory renal artery enter the kidney? What is its significance?
Accessory renal artery enters the hilum or penetrates the cortex/capsule directly. Significant for surgeons in segmental resection of kidneys.
What is the drainage of the kidney like?
Veins mirror arteries, most anterior, have segmental veins, merge to form renal vein at hilum.
What is the pathway taken by the left renal vein?
Left renal vein is anterior to the aorta, but behind the superior mesenteric artery.
Where does the left and right testicular vein drain to?
Left testicular vein drains the left renal vein. Right testicular vein goes direct to inferior vena cava.
What is the post posterior structure in the renal hilum?
Renal pelvis is the most posterior, gives off the ureter.
How many major calyces contribute to the renal pelvis? How many minor to the major?
3 major calyces contribute to the pelvis. The superior major calyx has 3 minor, while the other two have two each. Each minor calyx inserts to the apex of a medullary pyramid.
What is the pathway taken by the ureters?
Ureters descend on the posterior wall on psoas major, run anterior to the external iliacs. It receives blood supply as it descends.
Where are the narrowings of the ureter?
At the beginning, as it passes over the pelvic brim and the final one as it enters the bladder.
Why are narrowings of the ureter a clinical significance?
They can be the site of obstructions - kidney stones etc.
What does ureter descent roughly correspond with?
Tips of the transverse processes.
How many regions does the oesophagus traverse?
3, the neck, thorax and abdomen.
How much of the oesophagus is in the abdomen?
Half an inch (went full yankee there).
What side of the stomach does the oesophagus enter? Why is this significant?
It enters on the right side, and prevents reflux.
What are the 3 sites of narrowing for the oesophagus?
One at the cervical region - upper oesophageal sphincter.
Thoracic - aortic arch.
Abdominal - diaphragmatic orifice.
What can be said about the oesophageal lymph and blood supply on metastasis?
Different regions ahve different blood supply, so a metastasis can end up in different regions depending on the supply.
Where is the abdominal oesophagus supplied and drained by?
Supplied by left gastric artery, drained by portal, left gastric and systemic vein.
Lymph drainage is to pre-aortic nodes.
Where is the thoracic oesophagus supplied and drained by?
Supplied by oesophageal branches off the descending aorta.
Drained by azygous vein.
Lymph drainage is to mediastinal nodes.
What is a hiatus hernia?
When part of the stomach that herniates up through the oesophageal hiatus into the thorax.
paraoesophageal - stomach fold slides up, rare, 5%.
sliding - when stomach slides upward, causing oesophageal bulge.
