Pre-practical anatomy

Question 1

At what vertebral level is the transpyloric plane?

Answer 1

L1

Question 2

What organs are found along the transpyloric plane?

Answer 2

o	Pylorus of stomach
o	Neck of pancreas
o	2nd part of duodenum, duodenojejunal flexure
o	Hilus of kidney
o	Origin of portal vein
o	Start of SMA
o	Termination of the spinal cord

Question 3

Describe a horseshoe kidney

Answer 3

Horseshoe kidney - Inferior pole fused. Isthmus made up of fibrous tissue/ functioning parenchyma. Can have abnormal position, abnormal insertion of ureter. More prone to hydronephrosis, infection, stone formation, tumours. Gets caught by IMA leading to lower position, can be absolutely normal but more prone to develop stones or hydronephrosis

Question 4

Describe a pancake kidney

Answer 4

Pancake kidney – also called discoid; upper and lower poles are fused

Question 5

Describe the formation of duplicated ureters

Answer 5

Duplicated ureter - Formed due to duplication of ureteric bud from the mesonephric duct. Can be entirely asymptomatic, though can result in vesicoureteric reflux and UTI. Must think of this if you suspect stones and examine imaging

Question 6

What structures are found in the cortex?

Answer 6

Renal corpuscles, PCT, DCT in cortex

Question 7

What structures are found in the medulla?

Answer 7

Loop of Henle and collecting ducts in medulla

Question 8

Describe the 3 sites of constriction of the ureters

Answer 8

1 – where pelvis narrows to form ureter at origin

2 – pelvic brim: where it crosses the pelvic brim; bony hip bone, where the ureter crosses the posterior aspect of iliac crest to go into pelvic cavity

3 – VUJ: where it enters the bladder