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URINARY > Lecture 2: Anatomy of the urinary system > Flashcards

Lecture 2: Anatomy of the urinary system Flashcards

1
Q

What are the functions of the kidney and urinary tract?

A
  • Excretion of waste products and drugs: filter plasma
  • Regulation: Controls body fluid volume and ionic compounds. Major role in homeostasis. Involved in the acid-base balance
  • Endocrine: site of synthesis of renin (BP and sodium balance), site of EPO production (erythrocyte production), site of prostaglandins (regulation of renal function)
  • Metabolism: where vit D is metabolised into its active form. Site of catabolism for low-molecular-weight proteins (insulin/PTH/calcitonin)
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2
Q

Where is the anatomical location of the kidneys?

A

Retroperitoneal on the posterior abdominal wall, either side of the vertebral column
-located between T12 and L3 vertebrae
-partially protected by ribs 11 and 12
(look at size difference b/w to two kidneys in one person)

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3
Q

What is the size of the kidneys?

A

11cm long
6cm wide
140g

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4
Q

Which kidney is higher up?

A

Left

As the liver sits on top of the right kidney, pushing it down slightly

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5
Q

What is the hilum of the kidney?

A

Part of the kidney that makes it bean shaped, where all the tubes enter the kidney.
-located at L1

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6
Q

What structure comes out of the kidneys?

A

Ureter, which travels down the lumbar spinal processes into the pelvis

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7
Q

When do the ureters move inwards towards the bladder?

A

At the level of the ischial spine

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8
Q

How is the kidney held in place?

A

-pararenal fat (in line with kidney)
-renal fascia
-perirenal fat (near to kidney)
-renal capsule
Then withing the capsule is the kidney
(however the kidneys aren’t in a fixed position)

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9
Q

What is the blood supply to the kidney?

A

-abdominal aorta (left/right renal artery comes directly off the aorta to supply the left/right kidneys)
In front of this is the inferior vena cava (IVC)
-the IVC has branches coming directly off called the right/left renal vein

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10
Q

What is the structure of the inner kidney?

A
  • cortex

- medulla (renal pyramids found here)

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11
Q

What is encompassed in the renal lobe?

A

The renal pyramid as well as the cortex above it. There are many renal lobes

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12
Q

What is found between the renal lobes?

A

Renal columns

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13
Q

Where are the nephrons found?

A

Within the renal lobes, collecting ducts run into the minor calyces, which in turn feed into the major calyces, which then feeds into the renal pelvis, and then the ureter

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14
Q

How does the osmolality change in the medulla?

A

Gets more salty the further in you go

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15
Q

What are the two different types of nephron?

A
  • cortical, short LoH (85% of nephrons in body)
  • juxtamedullary, long LoH (15% of nephrons in body): good at concentrating urine ad have lots of space for water reabsorption
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16
Q

What feeds the blood supply into the nephron?

A

Afferent arteriole, which then forms a network of capillaries known as the glomerulus which is encased by Bowman’s capsule

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17
Q

How does the blood leave the glomerulus?

A

Efferent arteriole (leaving through an arteriole and NOT A VEIN!)

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18
Q

What cells sit on top of the capillaries in Bowman’s capsule?

A

Podocytes (large cells)

  • protrusions (foot processes), which wrap around the capillaries forming slits: one part of the filtration system
  • stop really large solutes passing through
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19
Q

Whats the first part of the nephron after the glomerulus?

A

Proximal convoluted tubule

  • reabsorb a high proportion of solutes
  • all AA’s and glucose absorbed here
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20
Q

What are the different part of the LoH?

A

LoH is found after the proximal convoluted tubule

  • descending limb (thin)
  • ascending limb (thick and thin)
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21
Q

What is found after the LoH in the nephron?

A

Distal convoluted tubule

-nestles near the glomerulus forming the juxtaglomerular apparatus

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22
Q

What feeds into the collecting duct?

A

Distal convoluted tubule. Many nephrons feed into one collecting duct

23
Q

Where do the blood vessels for the nephrons come off?

A

Arcuate artery- arc across the lobe

Interlobular artery comes off the arcuate artery, and off this artery the afferent arterioles branch off

24
Q

What comes off the efferent arteriole?

A

Web of capillaries that flow around the nephrons.

Known as the peritubular capillaries

25
Q

What is different about the capillaries on the juxtamedullary nephron in contrast to the cortical nephron?

A

The juxtamedullary have vesa recta, which is almost like an extension of the peritubular capillaries. This is where we can absorb more water back into the body

26
Q

Why is the juxtaglomerular apparatus important?

A

Helps glomerulus sense what is happening to the composition of fluid in the distal tubule.

27
Q

What special cells line the distal convoluted tubule in the juxtaglomerulus apparatus?

A

Macula Densa cells: sense how salty the fluid is, to determine how much flow should be coming through the glomerulus

28
Q

What cells do the macula densa cells communicate with?

A

Granular cells, which can produce renin/cause constriction of afferent/efferent arterioles: altering the flow of blood through the glomerulus

29
Q

What are the supporting cells in the juxtaglomerular apparatus?

A

Extraglomerular mesangial cells

  • pass the messages
  • secrete substances
  • provide skeleton to hold the capillary network
30
Q

What is an important landmark to look for coming off the aorta?

A

Superior mesenteric artery

-comes off aorta and lies over the top of the left renal vein

31
Q

Where does the adrenal gland drain into?

A

Right- adrenal vein directly into the IVC

Left- adrenal vein into the left renal vein

32
Q

Which renal vein is longer?

A

Left

33
Q

Which renal artery is longer/greater distance?

A

Right, as it has to go behind the IVC to reach the kidney

34
Q

How does the artery continue through the kidney?

A
  • renal artery
  • renal artery then splits into the segmental artery (which then splits into 5), which then go on to split into the interlobar arteries
  • interlobar arteries split into the arcuate artery
  • the arcuate artery splits into the interlobular arteries
  • the interlobular artery splits into the afferent arteriole
  • afferent arteriole > glomerulus > efferent arteriole
35
Q

Where does the blood go after it leaves the efferent arterioles?

A
  • peritubular capillaries

- vasa recta

36
Q

What is the venule system within the kidney towards the renal vein?

A
  • interlobular vein
  • arcuate vein
  • interlobar vein
  • renal vein
37
Q

What are the ureters made from?

A

Lining of smooth muscle fibres that propel urine (peristaltic waves) to the bladder

38
Q

How long are the ureters?

A

25-30 cm long

1.5 mm diameter

39
Q

Where are the ureters found?

A
  • retroperitoneal

- lateral to the tips of the transverse processes of the lumbar vertebrae

40
Q

What are the different segments on the ureter?

A

Ureter comes out of the kidney at the pelviureteric junction (PUJ)

  • abdominal segment (proximal)
  • pelvis segment (middle)
  • intramural segment (distal)
41
Q

Where is the most common area for ureteric injury?

A

Pelvic brim

42
Q

Where does the ureter cross the sacrum?

A

S1 joint

43
Q

Where do the ureters enter the bladder?

A

Posteriorly

44
Q

How do the ureters enter the bladder and what is the point called where they enter?

A

At an oblique angle

  • Vesicoureteral junction is where the ureters enter the bladder
  • the urine then pushes the opening closed, stopping reflux of the urine back up the ureters due to the oblique angle
45
Q

What forms the trigone?

A

-2 ureteric openings in the bladder
-tip of the bladder
Forms a triangle down to the internal urethral meatus (sphincter of the bladder)

46
Q

What muscle is our bladder made from?

A

Detrusor muscle. This has folds called rugae. As people age, sometimes the muscle can thin.

47
Q

What is the function of rugae?

A

To allow the bladder to contract and expand

48
Q

What is the bladder lined with?

A

Transitional epithelium: urothelium

49
Q

Where does the bladder rest when it is empty?

A

Rests on symphysis pubis (behind)
Women-in front of vagina/uterus/rectum
Men- in front of rectum

50
Q

How much can the bladder hold?

A

750ml of fluid

51
Q

Where do you find the urothelium?

A
  • lumen of ureter
  • bladder
  • pelvis of kidney
52
Q

Why are women more prone to UTI’s?

A

Because the external urethral meatus is very close to the vaginal opening

53
Q

What are the urethral divisions in women?

A
  • uteric openings
  • trigone
  • internal urethral sphincter
  • urogenital diaphragm including external urethral sphincter (voluntary control here)
54
Q

What are the urethral divisions in men?

A
  • internal urethral sphincter (meatus)
  • prostatic urethra (urethra through prostate gland)
  • external urethral sphincter (urogenital diaphragm)= voluntary control of urination, here it is called the membranous urethra
  • bulbous urethra (as it passes through bulbous muscle)
  • penile/spongy urethra (as passes through penis)
  • navicular fossa (opens out slightly)
  • external urethral meatus

URINARY (9 decks)

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