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BIOM20002 - HSF > Lecture 62 - Structure of Kidneys > Flashcards

Lecture 62 - Structure of Kidneys Flashcards

1
Q

How big are the kidneys?

A

10 cm long
5 cm wide
2.5 cm thick

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2
Q

Where do the kidneys sit?

A

Against posterior abdominal wall

Anterior surface: peritoneum
Posterior surface: posterior abdominal wall structures

T12 - L3
- they sit either side of these vertebrae

Anterior to the 12th rib

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3
Q

Describe the relationship of the kidneys to the peritoneum

A

Retroperitoneum

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4
Q

Do the kidneys move?

A

Yes
Due to their close relationship to the diaphragm
They move as the diaphragm moves

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5
Q

Describe the differences of the left and right kidneys

A

Left kidney is higher than the right

Due to the liver on the right side

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6
Q

What are paravertebral gutters?

A

The vertebral column punch anteriorally into the abdominal cavity, forming these gutters.

The kidneys sit almost behind the vertebral column in these gutters

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7
Q

What is the best way to access the kdineys during surgery?

A

Through the posterior route

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8
Q

How is the kidney functionally organised?

A

Clusters of secretory cells into:

  • cortex
  • medulla
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9
Q

What are the coverings of the kidney?

A

Serosa

Capsule
- fibrous

Surrounded by fat: perirenal fat

Renal fascia
- surrounds the whole thing

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10
Q

What is the hilum?

A

Entrance of:

Nerves
Vessels
Ducts

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11
Q

Describe the cortex and the medulla

A

Outer, continuous, pale, cortex

Inner, discontinuous, dark, medulla
- pyramids

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12
Q

Describe the renal pyramids

A

Base of the pyramid facing the cortex

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13
Q

What is the vertical slit?

A

The hilum

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14
Q

Describe the plane of the hilum of the kidneys

A

Faces Anteromedially

NB: the kidneys are in the paravertebral gutters

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15
Q

Describe the structure of the hilum.

What is the spatial relationship?

A

Anterior to posterior:

  • Renal vein
  • Renal artery
  • Ureteric pelvis

NB

  • nerves
  • lymphatics
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16
Q

Describe the ureteric pelvis

A

Dilated upper end of the ureter

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17
Q

What is the renal sinus?

A

A fat filled space
Within the kidney
Connects to the hilum

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18
Q

What is the origin of the renal arteries?

A

Paired branches from the abdomical aorta

At the superior mesenteric artery level

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19
Q

What are the three paired arteries that come off the abdominal aorta?

A

Renal arteries
Adrenal arteries
Testicular / ovarian arteries

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20
Q

Describe the relative position of the IVC and the aorta

A

Right side: IVC

Left: aorta

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21
Q

Why are veins always in front of the artery?

A

Arteries are pulsatile

They would compress the vein if they were in front

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22
Q

Into what does the renal artery divide into?

When does this happen?

A

5 segmental arteries

Before entering via the hilum

23
Q

What is the accessory renal artery?

A

The kidneys start development lower down
At this time, they get there blood supply from further down

Sometimes these arteries persist

24
Q

Why does the renal artery split into 5 segmental arteries?

A

This happens with vital organs

If one artery is lost, the rest of the structure can still function.

25
Q

How many functional segments of the kidney are there?

What are the features?

A

5 functional segments

Each has its own artery and vein

If there is a problem with one segment, the whole kidney is not lost.
- affected segment can be removed be itself

26
Q

Draw the renal segments

A

:)

27
Q

Which renal vein has to cross over the aorta?

A

Left renal vein must cross over

28
Q

Where does the renal pelvis sit in the hilum?

A

Most posterior

29
Q

Describe the shape of the ureteric pelvis

A

Flattened
Funnel shaped
–> forming ureter

30
Q

What does the calyceal system do?

A

Connects the medullary pyramids with the ureteric pelvis

31
Q

What is the structure?

A

2 or 3 major calyces unite to form the ureteric pelvis

2 or 3 minor calyces unite to form a major calyx

Apex of medullary pyramid inserting into the minor calyx

32
Q

Describe the heirarchy of structures in the kidney

A 
Collecting duct
Minor calyx
Major calyx
Ureteric pelvis
Ureter
33
Q

Describe the location of the ureters

A

(Retroperitoneal)
4 points:
1. On posterior abdominal wall

  1. Pass over pelvic brim
  2. Side wall of pelvis
  3. Approach bladder from behind
34
Q

How long is the ureter?

A

25-30 cm

35
Q

What do we always see in muscular tubes?

A

Normal narrowings at:

  • beginning
  • end

eg.

  • oesophagus
  • ureter
36
Q

Where would kidney stones likely get lodged?

A
  1. Pelvi ureteric junction (PUJ)
    - narrowing of the ureter at the beginning
  2. Crossing of pelvic brim
  3. Crossing bladder wall
37
Q

Where do the ureters get their blood supply?

A

Serial blood supply at all different levels
Pick up their blood supply from the region its passing through

No single blood supply

38
Q

Where is the bladder located?

A

When empty: deep in the pelvis

When full: pushes up into abdomen

39
Q

What is the shape of the bladder?

A

Pyramid tipped forwards

Base of the pyramid pointing posterior
Apex of pyramid pointing anterior

40
Q

Where do the ureters enter the bladder?

A

Posterior aspect of bladder

41
Q

Where does the urethra exit the bladder?

A

Posterior aspect of the bladder

42
Q

Describe the internal surface of the bladder

A

Detrusor muscle
- Irregular muscular ridges

Apart from Trigone
- smooth

43
Q

Describe the wall of the bladder

A

Thick muscular wall

44
Q

What happens at the trigone?

Draw the structure of the trigone

A

Base of triangle: (suprolateral)
- Ureters enter

Apex of triangle:
- urethra exits

Slide 21

45
Q

In males, what is located under the bladder?

A

The prostate

46
Q

Which part of the bladder is supported?

Why?

A

Neck of the bladder

Where the urethra exits

This allows the bladder to expand as it fills

47
Q

Describe the course of the ureters into the bladder

A

Obliquely through the bladder wall

48
Q

What happens when the bladder contracts?

A

Urine passes out of the urethra to the exterior

No urine flows back up the ureters, because the ureters are occluded by the muscle contracting

49
Q

Compare the male and female urethra

A

Male: long

  • Cons: much more difficult to catheterise
  • Pros: much less prone to UTI

Female: short

  • Pros: easy to place a catheter
  • Cons: more prone to UTI
50
Q

What is the perineum?

A

Area beneath the pelvis

51
Q

What happens to the prostate as males age?

A

Benign prostatic hypertrophy

Compression of the urethra
- can’t empty bladder properly

52
Q

Describe the course of the urethra in males

A
  1. Pre-prostatic part of urethra
  2. Prostatic part of urethra
  3. Membranous part of urethra
  4. Penile part of urethra
53
Q

What are the two components of the capillaries into which things are reabsorbed in the nephron?

A

Peritubuar capillaries: PCT, DCT

Vasa recta: Loop of Henla

BIOM20002 - HSF (60 decks)

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