Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

SMP - SDR > Lecture 23 - Clinical Genitourinary Anatomy > Flashcards

Lecture 23 - Clinical Genitourinary Anatomy Flashcards

1
Q

Most common presentations for a renal mass? What to note?

A
  1. Flank pain
  2. Hematuria
  3. Abdominal/flank mass

Note: in the real world, you incidentally discover it on imagine and the patient has no symptoms because usually in the parenchyma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How would a renal mass cause flank pain?

A

Renal capsule is affected

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How would a renal mass cause hematuria?

A

Collecting system is invaded by the mass

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

3 approaches to nephrectomy?

A
  1. Laparoscopic
  2. Robotic
  3. Open
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Arterial blood supply to suprarenal glands? Asymmetry?

A
  1. Superior suprarenal arteries from the inferior phrenic arteries
  2. Middle suprarenal artery from the abdominal aorta
  3. Inferior suprarenal arteries from the renal arteries

Shorter on the left, longer on the right

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Which renal artery is longer than the other? Which one arises higher?

A

Right one is longer

Left one arises higher

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Venous drainage of suprarenal glands?

Asymmetry?

A

Single vein leaving hilum of each gland:

  • Right one drains into IVC directly and is short
  • Left one drains into left renal vein and is longer
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Which kidney is better for transplants?

A

Left one because longer vein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How many lumbar veins are there?

A

5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Do all lumbar veins drain into the IVC?

A

NOPE

Only the 3rd and 4th do

5th: drains into iliolumbar vein
1st and 2nd drain into ascending lumbar veins connecting common iliac veins, iliolumbar veins, and lumbar veins with azygos and hemiazygos veins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What 5 structures enter/exit the kidney at the renal hilum? Describe their location.

A
  1. Renal vein (superior/anterior)
  2. Renal artery (superior/posterior)
  3. Renal pelvis (inferior)
  4. Lymphatics
  5. Nerves
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is located anterior to the right suprarenal gland?

A
  1. Right liver lobe

2. IVC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is located anterior to the left suprarenal gland?

A
  1. Stomach
  2. Pancreas
  3. Sometimes spleen
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What 5 structures are in contact with the anterior surface of the right kidney? Indicate which ones are separate from kidney by a layer of peritoneum.

A
  1. Right suprarenal gland (small part of the superior pole)
  2. ***Liver (a large part of the rest of the upper part)
  3. Descending part of the duodenum (hilum)
  4. Right colic flexure (inferior pole on lateral side)
  5. ***Intraperitoneal small intestine (inferior pole on small intestine)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What 6 structures are in contact with the anterior surface of the left kidney? Indicate which ones are separate from kidney by a layer of peritoneum.

A
  1. Left suprarenal gland (small part of the superior pole)
  2. ***Stomach and spleen (a large part of the rest of the upper part)
  3. Pancreas (hilum)
  4. Left colic flexure (middle lateral part)
  5. Descending colon (lower lateral part)
  6. ***Jejunum (lower medial part)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is in contact with both kidneys on posterior surface? 6 structures. What is posteriorly located but not in direct contact?

A
  1. Diaphragm
  2. Ribs (see other flashcard)
  3. Psoas major, quadratus lomborum, and transversus abdomonis (medial to lateral)
  4. Subcostal VAN
  5. Iliohypogastric nerve
  6. Ilio-inguinal nerve

+ Costodiaphragmatic recesses

17
Q

Classic presentation for kidney stones?

A
  1. Flank pain radiating
  2. Colic quality pain
  3. Hematuria
18
Q

What value is very important for patients with kidney stones?

A

Nitrate/leukocyte esterase negative: no infection, meaning not as bad as an emergency

If it was positive, could cause sepsis

19
Q

4 treatments for 5 mm kidney stone without infection?

A
  1. MET: medical expulsive therapy = hydration + pain control + nausea control +/- alpha blockers
  2. ESWL: extracorporeal shock wave lithotripsy to break it down
  3. URS: ureteroscypy +/- Laser lithothripsy/Stent(to avoid spasms or more stones obstructing it)/Basket
  4. PCNL: percutaneous nephrolithotomy
20
Q

% chance of a 5 mm stone passing?

A

50%

21
Q

How do we call a study of the collecting system via catheter?

A

Pyelogram

22
Q

What makes the ureter peristalse?

A

It has its own pacemaker

23
Q

Ureteral course?

A
  1. Begin posterior to renal artery
  2. Continue along anterior edge of psoas (gonadal arteries cross anterior to ureter in this region)
  3. Over iliac vessels at bifurcation
24
Q

Patient presents with blood at meatus - where could it be coming from? How to diagnose?

A
  1. Kidney injury
  2. UPJ disruption
  3. Ureter injury
  4. Bladder injury
  5. Urethral injury

Diagnosis: retrograde urethrogram with contrast

25
Q

Big distinction for bladder injuries? Which requires surgery?

A

Whether they are intra or extra peritoneal

Intraperitoneal injury requires surgical repair because urine will just continue to dump in it

Extraperitoneal injury can be fixed with a Foley catheter

26
Q

Can you fracture your penis? Explain. What is this called?

A

YUP

Corpora cavernosa rupture and sometimes even the corpus spongiosum

Eggplant sign if blood is contained within Buck’s fascia

Butterfly hematoma if the blood is not contained within Buck’s fascia, and contained by Colle’s Fascia in perineum, Darto’s fascia in scrotum and penis, Scarpa’s fascia in abdomen

27
Q

Once penis fracture is repaired, can you regain erectile function?

A

YUP

28
Q

Can you repair a minor rupture to testicule? What about a major one?

A

Minor: yup

Major: need to remove testicle because it would just die and would be very painful

29
Q

What is priapism?

A

Erect penis does not return to its flaccid state, despite the absence of both physical and psychological stimulation, within four hours => causes corpora cavernosa fibrosis

30
Q

Blood supply of ureters? What to note?

A

Branches from:

  1. Renal arteries (upper end)
  2. Abdominal aorta or gonadal arteries or common iliac arteries (middle part)
  3. Internal iliac arteries (lower end)

=> arteries reaching the ureters divide into ascending and descending branches, which form longitudinal anastomoses

In the abdomen, blood supply to ureters arrives from their medial side, whereas in the pelvis blood arrives from their lateral side

SMP - SDR (23 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions