READ ME / 1: Anatomy - upper renal tract Flashcards
Thanks for using my flashcards, hope you find them useful!
If you spot any errors or have suggestions, please let me know by clicking the speech bubble or sending me a message. It’s really helpful.
The questions are written using the official Dundee lectures, so you might find it useful to have them open in the background in case you get stuck.
I write the questions based on what I think the important facts are, but not everything is relevant. Don’t waste your time learning tiny details.
On the other hand, this isn’t everything you need to know - back it up with stuff from tutorials, other people’s questions, Youtube videos, Oxford handbooks etc.
There’s a good chance that older decks will be inaccurate (lectures and guidelines change year to year) so I’ll try to update them in the future.
Break a leg 👍
What is the purpose of the urinary tract?
Production and excretion of urine
What are the functions of the
a) kidneys
b) ureters
c) bladder
d) urethra?
a) Produces urine
b) Drains urine to bladder
c) Stores and voids urine
d) Excretes urine from body
Which renal organs make up the
a) upper urinary tract
b) lower urinary tract?
a) UUT - kidneys, ureters
b) LUT - bladder, urethra
Which renal structure(s)
a) store and void urine
b) excretes urine
c) produces urine
d) drain urine to a?
a) Bladder
b) Urethra
c) Kidneys
d) Ureters
Which cavities are the renal organs found in?
Abdominal cavity
True pelvic cavity
Perineum
Which renal organs are found in the
a) abdominal cavity
b) true pelvic cavity
c) perineum?
a) Kidneys, PROXIMAL ureters
b) DISTAL ureters, bladder , PROXIMAL urethra
c) DISTAL urethra
Where does the abdominal cavity stop and the pelvic cavity start?
Iliac crests
Are the kidneys and proximal ureters intraperitoneal or retroperitoneal?
Retroperitoneal
Where are the ureters, bladder and urethra in relation to the peritoneum?
Subperitoneal
meaning below
Proximal ureters are retroperitoneal along with the kidneys
Which type of peritoneum is in contact with the anterior surface of the kidneys?
Visceral peritoneum
Which important blood vessels of the abdomen are retroperitoneal?
Abdominal aorta
Inferior vena cava
The abdominal aorta is found on the patient’s (left / right).
The IVC is found on the patient’s (left / right).
AA on the LEFT
IVC on the RIGHT
At which vertebral levels do the
a) abdominal aorta
b) internal vena cava
bifurcate?
a) L3/4 - “level of the umbilicus”
b) L5
In which cavity are the
a) bladder
b) kidneys
c) distal urethra
d) proximal ureter
e) distal ureter
f) proximal urethra
found?
a) True pelvic cavity
b) Abdominal cavity
c) Perineum
d) Abdominal cavity
e) True pelvic cavity
f) True pelvic cavity
Which part of the kidney is the point where the major blood vessels and ureters insert?
Renal hilum
Which glands are found at the superior pole of the kidneys?
Adrenal glands
What are the three vessels found in the renal hilum?
Renal artery
Renal vein
Ureter
Which is more anterior, the renal artery or vein?
Renal vein is ALWAYS anterior to renal artery
The anterior surface of the kidneys is in contact with (parietal / visceral) peritoneum.
visceral peritoneum
There are two types of fat around the kidneys. Which fat
a) is found superficial to the kidneys and renal fascia?
b) is liquidy and in direct contact with the kidneys?
a) Paranephric fat
b) Perinephric fat
Which fibrous layer surrounds the kidney and is deep to the renal fascia and perinephric fat?
Renal capsule
What are two important muscles found
a) medial
b) posterior
to the kidneys?
a) Psoas major
b) Quadratus lumborum
Psoas major joins with the illacus to form ___.
What action does this muscle have? Which nerve supplies it?
Iliopsoas (anterior compartment of the thigh)
Flexes the thigh
Femoral nerve
What can the abdominal muscles do to protect the kidneys?
Contract
“guarding”
The kidneys lie ___ to psoas major and ___ to quadratus lumborum.
lateral to psoas major
anterior to quadratus lumborum
What’s notable about the position of the right kidney?
Pushed inferiorly by liver
So it’s lower down than the left kidney
What are the vertebral levels of the
a) left kidney
b) right kidney?
a) L kidney: T12 - L2
b) R kidney: L1 - L3
“lower lumbar” (doesn’t really help me)
Which kidney is bounded by
a) L1 - L3
b) T12 - L2?
a) Right kidney
b) Left kidney
Which abdominal
a) regions
b) quadrants
are the kidneys found in?
a) L and R lumbar regions
b) LUQ and RUQ
Which ribs protect the kidneys?
Ribs 11 and 12
The floating ribs - doesn’t attach to sternum or costal margin
Which can happen if Ribs 11 or 12 are fractured?
Kidney injury
How do you ballot the kidneys in an abdominal exam?
Should the patient breathe during the exam?
Hands anterior and posterior, below 12th rib
Push down with anterior hand and bounce with posterior hand
Yeah, they should inspire
In which direction do the kidneys move on
a) expiration
b) inspiration?
a) Upwards on expiration
b) Downwards on inspiration
Ballot on inspiration
What space is found posterior to the kidneys and can fill with fluid when the patient lies down?
Is it found in males or females?
Hepatorenal recess
Both
The renal veins are found ___ to the renal arteries.
anterior
Where are the common iliac arteries found in relation to the common iliac veins?
Anterior
opposite of renal vein/artery relationship
Where are the
a) common iliac artery and vein
b) renal artery and vein
found in relationship to one another?
a) Renal - vein anterior to artery
b) Common iliacs - artery anterior to vein
At which level does the abdominal aorta birfurcate into the common iliac arteries?
Umbilcus
L3/4
Which lymph nodes do the kidneys drain to?
Lumbar nodes
Which lymph nodes do the ureters drain to?
Lumbar nodes
Iliac nodes
What is a life-threatening condition involving ballooning of the abdominal aorta?
Abdominal aortic aneurysm
What are the two types of abdominal aortic aneurysm relative to the renal arteries?
Infrarenal AAA
Suprarenal AAA
What can be compromised by a AAA?
Renal artery blood flow
What term describes narrowing of the renal artery?
Renal artery stenosis
What can cause renal artery stenosis in
a) infrarenal AAA
b) suprarenal AAA?
a) Atherosclerosis
b) Direct occlusion
What is the dilated part of the ureter found at the renal hilum?
Renal pelvis
What are the three layers of the kidney called?
Renal capsule
Renal cortex
Renal medulla
Where in the kidney are nephrons found?
Renal medulla
Within the renal medulla, what are nephrons arranged into?
Renal pyramids
What gives the renal medulla a stripey appearance?
Nephrons
Where does ultrafiltration of blood occur?
Glomerulus
What is the path of filtrate from the glomerulus to the collecting ducts?
Glomerulus
Proximal tubules
Loop of Henle
Distal tubules
Collecting duct
From the collecting duct, how does urine reach the ureter?
Collecting duct
Minor calyx
Major calyx
Renal pelvis
From the collecting ducts, the renal tract gets wider and wider until it suddenly narrows at the ureter.
What is this site of constriction called?
Pelviureteric junction
The ___ ___ narrows to form the ___ at the pelviureteric junction.
renal pelvis
ureter
The pelviureteric junction is a site of anatomical constriction.
What are the other two?
1. Point where ureter crosses anterior to common iliac artery
2. Ureteric orifice
What’s the proper name for kidney stones?
Renal calculi
Renal calculi can ___ the urinary tract.
block
What are some causes of ureteric obstruction?
Internally - blood clot, renal calculus
Externally - tumour
Which type of muscle lines the urinary tract?
Smooth muscle
How does the body attempt to expel blockages from the urinary tract?
What symptom can this cause?
Peristalsis
Renal colic
What is the definition of renal failure?
Failure of the kidneys to adequately filter the blood to produce urine
How can renal calculi cause renal failure?
Backflow of urine causes increased back pressure
Eventually exceeds pressure required to stop glomerular filtration
What is hydronephrosis?
Dilation of the renal calyces / pelvis caused by excess fluid in the kidneys
Usually secondary to obstruction
How can ureteric obstruction cause hydronephrosis?
Backflow of urine to the kidneys
Why does hydronephrosis cause pain?
Stretching of the renal capsule
