Lecture 11 RH Flashcards
Where are the kidneys located during development and what happens to them during growth?
Kidneys develop on the lower part of the posterior abdominal wall. However their position changes to a higher position due to the growth rate of surrounding structures.
What are accessory renal arteries and where do they enter the kidneys?
Accessory renal arteries either enter the hilum or penetrate the capsule directly. They are a remnant of development that stay after birth in 25% of people.
Where are renal veins located in the kidneys?
renal veins are the most anterior structure in the hilum.
Where is IVC located?
IVC sits to the right of the abdominal aorta.
Where does the renal vein run relative to the aorta?
renal vein runs anterior to abdominal aorta.
Where do the testicular veins drain into?
The left testicular vein drains into the left renal vein.
The right testicular vein drains directly into IVC
Where is the renal pelvis located within the hilum?
It is the most posterior structure of the hilum
What types of callyces does the kidney have?
Major callyces are the first branches of the renal pelvis
Minor callyces are the smallest and most distal branches of the renal pelvis.
What are the kidney’s medullary pyramids?
Pyramidal tissue in the kidney’s medulla. Their apexes feeds into the minor callyces. These feed into major callyces and then the renal pelvis.
Where are the ureters located relative to the structures of the abdomen?
ureters are muscular tubes and are 25 - 30 cm long and they initially descend on posterior abdominal wall. The ureters descend anterior to psoas major and then tips over pevic brim and into the bladder.
What blood vessels supply the ureters?
Ureter is supplied by various blood vessels along its path.
Principle of muscular tubes in anatomy:
A muscular tube is associated with a normal site of narrowing at the beginning and the end of the tube.
Where are the sites of narrowing of the ureter? What is the clinical significance of these narrowings?
Where the ureteric pelvis converges is the first site of narrowing. When it feeds into the bladder is the second site of narrowing. Over the pelvic brim it gets narrower as well. They are potential sites of obstruction (kidney stone).
What do the ureters’ pathways correspond with?
Descent of the ureters corresponds with the tips of the transverse processes.
What are the key features to look for to understand abdominal viscera?
quadrant in which viscera is located
relationship to peritoneum
Identifying features
Neurovascular supply
Where does the oesophagus begin?
oesophagus begins at the cricoid cartilage at C6
Where does the oesophagus end?
it descends through posterior mediastinum through the oesophageal hiatus which is a sling formed by the left crus of the diaphragm. (diaphragm contraction closes the oesophagus at the level of about T10)
Where does the oesophagus penetrate the stomach?
half an inch below the diaphragm. It penetrates into the middle of the stomach on the right.
What structure lines the oesophagus?
stratified squamus epithelium.
Where are the sites of narrowing of the oesophagus located?
3 sites of narrowing:
Cervical: upper oesophageal sphincter
Thoracic: aortic arch Left main bronchus
Abdominal: diaphragmatic orifice
What is the arterial supply of the oesophagus?
Supplied by 3 different arteries at 3 different locations:
Cervical: Inferior thyroid artery
Thoracic: oesophageal branches from aorta
Abdomen: Left gastric artery form the aorta
What veins drain the oesophagus?
Drained by 3 different veins at 3 different locations:
Cervical: Brachiocephalic systemic
Thoracic: azygous
Abdomen: Left gastric portal overlaps systemic
What lymphatics drain the oesophagus?
Cervical: Deep cervical nodes
Thoracic: Mediastinal nodes
Abdomen: Pre-aortic nodes
What is a hiatus hernia?
Upper part of the stomach herniates through the oesophageal hiatus of the diaphragm.
