Brainscape's Knowledge GenomeTM

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


See full index

Sita GenitoUrinary System > Lecture 5: Kidney, Ureter, Bladder & Posterior Abdominal Wall > Flashcards

Lecture 5: Kidney, Ureter, Bladder & Posterior Abdominal Wall Flashcards

1
Q

Key Boney Landmarks

A 
Anterior Sacro-Illiac Joint
Illiac Crest
Illiac Fossa
ASIS
Ischial Spine
Obturator Foreamen
Pubic symphysis
Lesser Trochanter
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Components of the Posterior Abdominal wall

A
  1. Iliacus
  2. Psoas Major (Ilio Psoas)
  3. Quadratus Lumborum
    Transversus
    Diaphragm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Quadratus Lumborum

A

Origin: Illiac Crest
Insertion: 12th Rib + L1-4 Transverse Processes
- More Posterior and Lateral than Psoas Major
Action:
a) Combined: i) Forced expiration ii) 12th rib support, bracing spine and ribs in place
b) Individually: Bend trunk to same side
Innervation: T12-L4 (Anterior Rami)

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

Illiacus

A

Origin: Illiac Fossa
Insertion: Combines and forms Common Tendon with Psoas Major –> inserts onto Femur’s Lesser Trochanter
Action: Hip flexion
Innervation: ** Femoral nerve L2-4

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

Psoas Major

A

Origin: T12, L1-5 Intervertebral discs –> forms archways/digitations –> allows vessels to enter
- Underneath Inguinal ligament
Insertion: Combines and forms Common Tendon with Illiacus –> inserts onto Femur’s Lesser Trochanter
Action:
a) Combined: Archways/Digitations ANTERIORLY attached to intervertrbal discs (T12/L1-5) –> affects spinal movement –> helps raise body from supine position
b) Hip flexion
c) Individually: Laterally bends trunk
Innervation: Lumbar Plexus L1-3 Direct branches

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

Aorta and IVC

A

Aorta: enters diaphragm at T12 –> 5x Lumbar arteries –> Bifurcates at L4 (superior to IVC bifurcation) –>
- Renal artery comes off at L1 (same as SMA) para-aorticly
- Gonadal (testicular/ovarian) artery comes off at L2
Lumbar Arteries and veins supply and drain Posterior abdominal wall
- Right C.I Artery overlaps Left C.I Vein (risk of compression)
IVC: enters right diaphragm at T8 –> 5x Lumbar veins –> Bifurcates at L5 (lower) –> Common Iliac Veins
- Venous drainage relatively more complex

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

Varicose Veins in Pregnant woman

A

Pregnant woman –> Right Common Iliac Artery (Right branch off aortic bifurcation) crosses over and compresses Left Common Iliac Vein –> No drainage in Left legs –> Left Leg Varicose Veins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Urinary system contents

A

Supra-renal glands –> Kidney –> Ureter –> Bladder –> urethra
- Supra renal glands technically not part of urinary system –> Deal more with Adrenalin
Location: all RETRO/INFRAperitoneal

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

Function of the Urinary system

A
  1. Waste removal
  2. Electrolyte balance
  3. pH balance
  4. BP/Volume regulation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Surface anatomy of Kidneys (and Suprarenal Glands)

A

Retroperitoneally (posterior to abdomen)
Superiorly sits ontop of Posterior abdominal muscles Psoas major and Quadratus Lumborum
Kidney’s Relationship with ribs: Posterior and Inferior
- Right Kidney Lower (T12) due to liver –> Left Kidney (L11/12)
Ureters –> exit kidney L1 –> Transpyloric Plance

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

Features of Kidneys (and Suprarenal Glands)

A

Red/brown
Smooth outer capsule
Kidney contains poles (Upper and Lower)
Hilum of each kidney: Renal Vein + Renal Artery branches + Renal Pelvis + (Lymphatics and ANS)
- Posterior to Hila vessels: Renal Pelvis + Ureters (at Ilium)
Suprarenal glands are encased in similar fascial layers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Kidney padding

A

Kidneys conduct essential functions –> Surrounded and protected from trauma –> with Fat pads:

  1. PERInephric fat (near kidney)
  2. PARAnephric fat (outside kidney)
    - B/w Peri and para nephric fat pads is RENAL FASCIA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Renal Fascia

A

Separates Peri and Para nephric fat pads
Extends over IVC, Aorta –> connects with other side –> Blends with Psoas Major Fascia
Pathological relevance: Renal Fascia –> Both Left and Right kidneys within same fascial compartment –> allows diseases to spread Left Right

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Internal Structure of Kidney

A

Capsule –> Cortex (glomerular. Smooth glandular tissue) –> Medulla (medullary rays, LOD, CD) –> Renal papilla –> Minor Calyces –> Major Calyces –> Renal pelvis –> Ureter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Differentiation b/w Kidneys’ Cortex and Medulla

A

Poor differentiation b/w Smooth Glandular tissue of cortex vs Medullar tissue –> Pathology/Something is wrong

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Relations of the Right Kidney

A

Anterior: Suprarenal gland, Under Liver, 2 Duodenum (anterior medial), Hepatic Flexure (of colon)
Posterior: Diaphragm, Psoas, Quadratus Lumborum, Transversus abdominus, Rib 12 (relatively lower), SUBCOSTAL nerve (T12 Spinal nerve)

17
Q

Relations of the Left Kidney

A

Anterior: Suprarenal gland, Spleen (anterior and superior), Stomach, Pancreas (splenorenal ligament), Jejunum, Splenic Flexure of Colon
Posterior: Diaphragm, Psoas, Quadratus Lumborum, Transversus Abdominus, Ribs 11 and 12 (relatively higher as spleen > liver), SUBCOSTAL nerve (T12 Spinal nerve)

18
Q

Blood Supply of the Kidneys

A

L1 Renal arteries and veins
Veins Anterior to Arteries –> avoids risk of compression against Posterior abdominal wall –> Spilt into septal banches
Arteries –> bifurcate into Anterior and Posterior branches –> enter Hilum of Kidneys –> segmental branches

19
Q

Blood Supply of the Supra-renal gland

A
  1. Branch from abdominal aorta
  2. Phrenic Artery
  3. Suprarenal artery
20
Q

Structures relative to Left Renal Artery

A

Vertically Ontop of LRA: SMA
Vertically Underneath LRA: Anterior Aorta
Horizontally Underneath LRA: Splenic vein + Body of pancreas

21
Q

General Notes on Kidney Blood, Nerve and Lymph

A

General Notes:

Veins anterior to arteries. Vessels come off para-aortically at L1

22
Q

Arterial Summary of Kidney Blood, Nerve and Lymph

A

Arterial:
Renal arteries off laterally at L1 –> anterior branches –> segmental branches
- double renal arteries not uncommon, embriologically multiple arteries fuse, therefore some may not have been obliterated out
Aorta located on left side of body –> RIGHT renal Artery 3x Longer –> in order to supply kidney from opposite side

23
Q

Venous Summary of Kidney Blood, Nerve and Lymph

A

Venous:
Renal veins off laterally at L1
IVC located on Right side of body –> Left Renal vein 3x longer –> in order to drain kidney from opposite side
Left Renal vein runs Vertically Posterior to SMA, Vertically Anterior to Abdominal Aorta, Horizontally INFERIOR to Splenic Vein + Body of Pancreas

24
Q

Nervous Summary of Kidney Blood, Nerve and Lymph

A 
Nervous:
Renal plexus
- Sympathetic = complicated
- Parasympathetic = Vagus nerve (Cranial nerve 10)
Referred pain --> FLANK pain
25
Q

Lymphatic Summary of Kidney Blood, Nerve and Lymph

A

(Lymphatics follow arteries) –> **Para-aortic nodes L1

- Located Posteriorly, on the side

26
Q

Ureters

A

Smooth muscle tube
Urine propelled through ureter via:
1. smooth muscle contractions
2. GFP Filtration Pressure from Glomerulus
~25cm
Exits Kidneys at L1/Hilus (same level of entering arteries) –> Runs on surface of Psoas Major
Radiologically: Roughly in line with processes of Lumbar spine
At Anterior Sacro-Iliac Joint –> Ureter Crosses bifurcation of Common Illiac artery on respective side –> continues along ileum on pelvis’ lateral wall –> towards Ischial Spine –> Enters Trigone at bladder’s Inferior surface (enters obliquely. tries to control flow)

27
Q

Most common place for ureter’s Kidney Stone to lodge

A

Narrowest part due to constriction of surround structures –> when ureter is at Anterior Sacro-Iliac Joint –> is crossing Bifurcation of Common Iliac arteries

28
Q

3x Constrictions of Ureters

A
  1. PUJ: Junction of the Renal Pelvis –> Ureter (Pelvo-Urteric Junction
  2. Anterior Sacro-Iliac Joint –> where ureters cross bifurcation of aorta into Common Iliac arteries (Pelvic Brim)
  3. Inferior Bladder’s Trigone (Ureter enters obliquely) (tries to control flow)
    - -> All 3x sites (PUJ, Anterior SIJ, Trigone) common places of kidney stone/ renal calculus obstruction
29
Q

Ureter’s Blood and Nerve supply in 1/3s

A

Superior 1/3 (proximal) –> Middle 1/3 –> Inferior 1/3 (distal)
Arterial: Renal artery –> Gonadal (testicular/ovarian) artery –> Superior Vesicular(bladder) artery (branch of Internal Iliac)
Venous: Renal vein –> Gonadal (testicular/ovarian) vein –> Superior Vesicular (bladder) artery (branch of Internal Iliac)
Nervous: Renal Plexus (sup+mid 1/3) –> Hypogastric Plexuses (controls pelvic contents/urogenital)

30
Q

Ureter’s Pain referral and Lymphatic supply

A
  • Pain referred to L1 and 2 Dermatomes (Suprapubic regions)

- Lymphatics (Lateral aortic L1 Iliac nodes) –> variable due to variable supply

31
Q

“vesicular”

A

bladder
- Hence Inferior 1/3 of both ureter’s arterial supply and venous drainage = Superior Vesicular Artery/Vein (from Internal Iliac branch)

32
Q

Bladder

A

Infraperitoneal: Partial peritoneal covering –> Stuck against the pubic bones (various ligaments helping to do so)
Transitional epithelium and rugae
Apex of bladder = Posterior to Pubic Symphisis
When Bladder located in midpubic region –> bladder fills -> rises to suprapubic region (decreased sensation’s large filling leads to increased chance of UTI urinary tract infections)
Dextrusor muscle : Smooth muscle coat
Sphincter Vesicae Smooth muscle sphincter at neck of bladder

33
Q

Bladder’s smooth muscle coat

A

Dextrusor muscle

34
Q

Bladder’s smooth muscle sphincter

A

Sphincter Vesicae (Vesicae = vesicular = bladder)
- located at neck of bladder
Internal sphincter of bladder, Prior to ureter’s involuntary control

35
Q

Sensation of bladder with position and age

A

Standing/Elderly –> Decreased sensation of bladder –> Bladder fills to large levels (2L) w/o realising/emptying –> Bladder distends into suprapubic region –> Urinary Tracts

36
Q

Trigone

A

Smooth muscle area, at Base/back of bladder
- Mucous membrane
-NO rugae
Superiorly: 2x ureters enter
–> Interuteric bar/crest b/w 2x ureters = BASE = Less mobile –> easily irritated
Inferiorly: 1x urethra exits = APEX

37
Q

Blood and nerve of the Bladder

A

Arterial:
2x superior and 1x inferior Vesicular artery from each side (branches off internal illiac)
-Note: Male Inferior vesicular artery –> tends to be Vaginal artery in females
Venous:
Vesicular plexus –> drains into Internal Illiac Vein
Nervous:
ANS –> Inferior Hypogastric Plexus (located in sacral area)
a) Sympathetic: Sacral splanchnic nerves S2-4 (L1-2 fibres)
- Note: Pain referred to Supra-pubic region due to L1-2 Dermatomes
b) Parasympathetic: Pelvic Splanchnic nerves

38
Q

Gender variation of Bladder arteries

A

Bladder arteries: 2x Superior + 1x Inferior vesicular artery
Males: Inferior vesicular arteries
Females: Vaginal artery

39
Q

Bladder Pain referral

A

Pain referred to Suprapubic region (L1-2 Dermatomes)

Sita GenitoUrinary System (28 decks)

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