Normal Anatomy Flashcards
What do the kidneys filter?
Blood
What do kidneys make?
Urine
How many kidneys do we have?
2
Each kidney is as big as
Your fist
How long are ureters?
25 cm in length
What carries urine from your kidneys to your bladder?
Ureters
Where is the ureters located?
In the retroperitoneal cavity
Renal pelvis lies within
The hilum of the kidney
The ureter courses along the
Lateral wall of the pelvis
Ueteropelvic junction UPJ
Area that connects the renal pelvis (part of the kidney) to one of the tubes (ureters) that move urine to the bladder
Utererovesicle junction UVJ
The site of entry of the ureter into the bladder
Bladder
Large muscular bag
The urinate bladder has a
Posterior and lateral openings (for ureters and anterior openings for the urethra)
Urinary bladder is lined with
Highly elastic transitional epithelium
When the bladder is full it is
Smooth and stretched
When the bladder is empty it is
A series of folds
how much of urine can the bladder hold?
2 cups of urine
urethra
this tube carries urine from the bladder out of your body
where does the urethra end
it ends in an opening to the outside of your body in the penis (in men) or in front of the vagina (in women)
what is the function of the kidneys
to excrete urine
what do the kidneys clean?
clean toxins and waste out of the body
how much blood does the kidneys filter
about half a cup of blood every minute
blood flows into your kidney through a
large blood vessel called renal artery
tiny blood vessels in the kidney
filter the blood
the substance your body needs flow through
the renal vein and return to your bloodstream
urine travels through
tubes of muscle called ureters to your bladder
your bladder stores urine until
you release it through urination
homeostasis
helps the body maintain a stable internal environment
kidneys are one of the
major homeostatic organs of the body
kidneys control
water pH, secrete erythropoietin and activate vitamin D production in the skin
kidneys are composed of three section
- the outer (renal) cortex
- the hollow inner (renal) pelvis
- the (renal) medulla (middle part)
the cortex
is where the blood is filtered
the medulla
contains the collecting ducts which carry filtrate (filtered substances) to the pelvis
Medullary pyramids are
separated by bands of intervening parenchyma that extend toward the renal sinus
the pelvis
is a hollow cavity where urine accumulates and drains into the water
the filtering units of the kidneys are
the nephrons
how many nephrons are in each kidney
one million
where are the nephrons located
within the cortex and medulla of each kidney
what are the 4 tasks nephrons perform
- filtration
- reabsorption
- secretion
- excretion
each nephron consists of what parts
- glomerulus
- bowmans capsule
- loop of Henle
- afferent arteriole
- efferent arteriole
- collecting duct
the nephrons are in the
renal parenchyma
what are nephrons two main structures
- renal corpuscle
- renal tubule
nephrons filter
the blood and produce urine
where is blood filtered
in the renal corpuscle
where does the filtered fluid pass through
renal tubule
as the filtrate moves through the tubule
substances needed by the body are returned to the blood via efferent arteriole
waste products access
water and other substances not needed by the body pass into the collecting duct as urine
dirty blood comes in from
the renal artery and moves to the afferent arteriole
blood then travels into the
glomerulus where filtration occurs (renal corpuscle)
clean blood exits via
efferent arterioles and flows into the renal vein to go back into the bloodstream
other blood wastes that the body doesnt need
continue to become urine (through the renal tubules)
renal corpuscle contains
glomerulus and bowman’s capsule
were does filtration happen
within the renal corpuscle
what are the structures within the renal corpuscle
- glomerulus
-renal capsule
glomerulus
a little knot of capillaries
renal capsule (bowman’s capsule)
wraps around the glomerulus
the fluid that has been filtered out out of the blood is called
filtrate
the renal corpuscle is the
first part of the nephron and serves as the bridge between the vasculature and urinary system
renal tubule contains
proximal convoluted tubule loop of Henle distal convoluted tubule collecting duct
after the renal corpuscle filters the blood where does it get sent to
sends the filtrate to the renal tubule, the second part of the nephron
the filtrate that is caught in Bowman’s capsule is then
funneled into the renal tunule
the filtrate that is caught in Bowman’s capsule is then
funneled into the renal tubule
what are the four main regions that make up renal tubule
- proximal convoluted
- loop of Henle
- distal convoluted tubule
- collecting duct
proximal convoluted tubule
this part of the tubule comes directly off Bowman’s capsule
loop of Henle
the proximal convoluted tubule leads into the loop of Henle
distal convoluted tubule
the loop of Henle leads into the distal convoluted tubule
the glomerulus filters
water and small solutes out of the bloodstream
the resulting filtrate contains
waste, but also other substances the body needs: essential ions, glucose, amino acids and smaller proteins
the needed substances and some water are
reabsorbed through the tube wall into the efferent arteriole and into the bloodstream
when the unneeded waste (or filtrate)
it flows into a duct in the nephron called renal tubule
this reabsorption of vital nutrients
from the filtrate is the second step in urine creation
waste ions and hydrogen ions secreted from
the blood complete the formation of urine
the filtrate absorbed in the
glomerulus flows through the renal tubule, where nutrients and water are resorbed into the capillaries
the secreted ions combine with
the remaining filtrate and become urine
where does urine flow out of
the nephron tubule into a collecting duct
urine passes through the
renal pelvis, into the ureter, and down to the bladder
the glomerulus
an area of thin-walled capillaries
the Bowman’s capsule
is a double-walled, cup-shaped structure
the proximal tubule
leads from the Bowman’s capsule to the loop of Henle
the loop of Henle
is a long loop which extends into the medulla
the distal tubule
connects the loop of Henle to the collecting duct
what cellular waste does the kidneys excrete
- urea
- uric acid
- creatinine
urea
a nitrogenous waste produced in the liver from the breakdown of protein.
what is the main component of urine
urea
uric acid
usually produced from breakdown of DNA or RNA
creatinine
waste product of muscle action
since the kidneys control what leaves and what remains in the nephrons,
they maintain the levels of water, ions, and other materials nearly constant and within the limits to maintain homeostasis
what supplies the kidney
the main renal artery
when a person is resting how much blood is pumped to the kidneys
approximately 1.2 liters of blood per minute
the renal arteries are
lateral branches of the aorta that are located just inferior to the SMA
the renal artery breaks down
into smaller segmental arteries, the interlobar arteries and finally into tiny arcuate arteries
the renal artery breaks down into
- segmental arteries
- interlobar arteries
- arcuate arteries
how many veins join to form the renal vein
5 to 6
renal vein emerges
from the renal hilum anterior to the renal artery
the left renal vein course
transversely across the body going anterior to the aorta and posterior to the SMA
urinalysis
essential to detect urinary tract disorders
hematuria
blood in urine
pyuria
pus in urine
serum creatinine
a serum creatinine blood test measures the amount of creatinine in your blood
if your kidneys are not working like they should
your serum creatinine level goes up
blood urea nitrogen (BUN)
this test measures the amount of urea nitrogen in your blood
urea nitrogen
is a waste product your body makes from the breakdown of protein in the foods you eat
hematocrit
relative ratio of plasma to packed cell volume in the blood
decreased hematocrit occurs
with acute hemorrhagic process secondary to disease and blunt trauma
hemoglobin
this is present in urine whenever extensive damage or destruction of the functioning erythrocytes occur
how are kidneys imagined
in a supine or decub position
why does the right kidney lies slightly lower than the left kidney
because the large right lobe of the liver pushes it inferiorly
what color and shape is the kidney?
-dark red
- bean-shaped organs
how long is the kidney
- 9 to 12 cm long
- 5 cm wide
- 2.5 cm thick
how many times is the kidney measured
twice in sagittal and once in transverse
normal kidneys have a
smooth outer contours surrounded by reflected echoes of perirenal fat
the renal parenchyma surrounds
the fatty central renal sinus
what does the renal sinus contains
- calyces
- infundibula
- pelvis
- vessels
- lymphatics
because of the fat interface
the renal sinus is imaged as an area of intense echoes with variable contours
outer cortex is
darker than the inner medulla because of increased blood perfusion
inner surface of the medulla is
folded into projections called pyramids
where the renal vessels and ureter enter and exit
renal hilum
hypoechoic pyramids are
separated by bands of intervening parenchyma that extend toward the renal sinus
pyramids are
uniform in size, shape (triangular) and distribution
apex of the pyramid points toward
the sinus
base lies adjacent to the
renal cortex
interlobar arteries lie
alongside the pyramids
arcuate vessels lie
at the base of the pyramids
renal fascia
is a layer of connective tissue encapsulating the kidneys
what is renal fascia also known as
gerota’s fascia
parenchyma of renal cortex
lies beneath the renal capsule
anterior to the right kidney
- right adrenal gland and liver
- morison’s pouch
- second part of the duodenum
- right colic flexure
morison’s pouch
area between the liver and right kidney
what is the most common cause for fluid accumulation in the abdomen
morison’s pouch
anterior to the left kidney
- left adrenal gland
- spleen, stomach and pancreas
- left colic flexure
- coils of jejunum
posterior to the right kidney
-diaphragm
- costodiaphragmatic recess of the pleura
- 12th rib
- psoas muscle
- quadratus lumborum
- transverse abdominis muscles
column of bertin
prominent invaginations of the cortex at varying depths within the medullary substance of the kidneys
sonographic findings of column of bertin
- renal mass effect produced by hypertrophied column of bertin
- contiguity with the renal cortex is evident, and overall echogenicity is the like that of the renal parenchyma
dromedary hump
is a budge of cortical tissue on the lateral surface of a kidney
dromedary hump is more common in the
left kidney
dromedary hump may mimic
a renal neoplasm
junctional parenchymal defect
is a triangular, echogenic are typically located anteriorly and superiorly
junctional parenchymal defect is a result
of partial fusion of two parenchymal masses called ranunculi during normal development
fetal lobulation usually is present in
children up to 5 years of age
with fetal lobulation surfaces of the kidneys are generally
indented in between the calyces, giving the kidneys a slightly lobulated appearance
sinus lipomatosis is characterized by
the deposition of a moderate amount of fat in the renal sinus, with parenchymal atrophy
sonographic findings of extrarenal pelvis
pelvis appears as a central cystic area that is either partially or entirely beyond the confines of the bulk of the renal substance
extrarenal pelvis can usually
decompress when patient is turned in prone position
extrarenal pelvis
dilated renal pelvis
renal agenesis
absence of a kidney or failure for a kidney to form
renal agenesis may be
bilateral or unilateral
unilateral renal agenesis results in
solitary kidney
bilateral renal agenesis is a very
rare and is incompatible with life
double collecting system
a rare renal anomaly with a duplication of the renal pelvis and ureter
horseshoe kidney
as fusion of the lower poles of the kidney
what is the common anomaly of renal fusion
horseshoe kidney
ectopic kidney
a kidney that is not located in its usual position
what is the most common ectopic kidney
pelvic kidney
what should not be misdiagnosed as a pelvic tumor
pelvic kidney
if there is an absence of a kidney in the normal renal fossa
sonographer must look in the pelvis to rule an ectopic kidney
renal masses categorized with sonography as
-cystic
- solid
- complex
cystic mass
- smooth, thin, well-defined border
- round or oval shape
- sharp interface between the cyst and renal parenchyma
- no internal echoes (anechoic)
- increased posterior acoustic enhancement
solid mass
- irregular borders
- poorly defined interface between the mass and kidney
- low-level internal echoes
- weak posterior border (because of the increased attenuation of the mass)
- poor though-transmission
complex mass shows characteristics associated
with both cystic and solid lesions
complex mass has areas of
necrosis, hemorrhage, abscess or calcification within the mass
the Bosniak classification of cysts is
used to determine the appropriate work-up for a cystic mass
needle aspiration may be recommended to obtain
fluid from the lesion to evaluate its internal composition
the Bosniak classification is
widely used by radiologist and urologist for addressing the clinical problem assessing renal cyst
what is a common form of ureteral stricture
ureteral narrowing as a result of fibrosis is a
ureterocele
cyst like enlargement of the lower end of the ureter
what is ureterocele caused by
congenital or acquired stenosis of the distal end of the ureter
cystoscopy
a procedure that uses a tube to examine the bladder and the urethra
what is cystoscopy usually used for
used to examine the bladder because it can diagnose early neoplasms
transabdominal sonography will allow
visualization of the most lesions greater then 5mm
TGC is adjusted to
reduce anterior wall artifacts
how do you measure the bladder wall
measure anterior wall in transverse
bladder wall should be
what is the bladder wall measurement
3 to 6 mm
what do you look for in bladder walls
asymmetry in the walls
what do you evaluate in the bladder
residual volume
