READ ME / 1: Anatomy - upper renal tract

Question 1

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.

Question 2

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.

Question 3

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.

Question 4

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.

Question 5

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 👍

Question 6

What is the purpose of the urinary tract?

Answer 6

Production and excretion of urine

Question 7

What are the functions of the

a) kidneys
b) ureters
c) bladder
d) urethra?

Answer 7

a) Produces urine

b) Drains urine to bladder

c) Stores and voids urine

d) Excretes urine from body

Question 8

Which renal organs make up the

a) upper urinary tract
b) lower urinary tract?

Answer 8

a) UUT - kidneys, ureters

b) LUT - bladder, urethra

Question 9

Which renal structure(s)

a) store and void urine
b) excretes urine
c) produces urine
d) drain urine to a?

Answer 9

a) Bladder

b) Urethra

c) Kidneys

d) Ureters

Question 10

Which cavities are the renal organs found in?

Answer 10

Abdominal cavity

True pelvic cavity

Perineum

Question 11

Which renal organs are found in the

a) abdominal cavity
b) true pelvic cavity
c) perineum?

Answer 11

a) Kidneys, PROXIMAL ureters

b) DISTAL ureters, bladder , PROXIMAL urethra

c) DISTAL urethra

Question 12

Where does the abdominal cavity stop and the pelvic cavity start?

Answer 12

Iliac crests

Question 13

Are the kidneys and proximal ureters intraperitoneal or retroperitoneal?

Answer 13

Retroperitoneal

Question 14

Where are the ureters, bladder and urethra in relation to the peritoneum?

Answer 14

Subperitoneal

meaning below

Proximal ureters are retroperitoneal along with the kidneys

Question 15

Which type of peritoneum is in contact with the anterior surface of the kidneys?

Answer 15

Visceral peritoneum

Question 16

Which important blood vessels of the abdomen are retroperitoneal?

Answer 16

Abdominal aorta

Inferior vena cava

Question 17

The abdominal aorta is found on the patient’s (left / right).

The IVC is found on the patient’s (left / right).

Answer 17

AA on the LEFT

IVC on the RIGHT

Question 18

At which vertebral levels do the

a) abdominal aorta
b) internal vena cava

bifurcate?

Answer 18

a) L3/4 - “level of the umbilicus”

b) L5

Question 19

In which cavity are the

a) bladder
b) kidneys
c) distal urethra
d) proximal ureter
e) distal ureter
f) proximal urethra

found?

Answer 19

a) True pelvic cavity

b) Abdominal cavity

c) Perineum

d) Abdominal cavity

e) True pelvic cavity

f) True pelvic cavity

Question 20

Which part of the kidney is the point where the major blood vessels and ureters insert?

Answer 20

Renal hilum

Question 21

Which glands are found at the superior pole of the kidneys?

Answer 21

Adrenal glands

Question 22

What are the three vessels found in the renal hilum?

Answer 22

Renal artery

Renal vein

Ureter

Question 23

Which is more anterior, the renal artery or vein?

Answer 23

Renal vein is ALWAYS anterior to renal artery

Question 24

The anterior surface of the kidneys is in contact with (parietal / visceral) peritoneum.

Answer 24

visceral peritoneum

Question 25

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?

Answer 25

**a) Paranephric fat** **b) Perinephric fat**

Question 26

Which fibrous layer surrounds the kidney and is deep to the renal fascia and perinephric fat?

Answer 26

**Renal capsule**

Question 27

What are two important muscles found a) **medial** b) **posterior** to the kidneys?

Answer 27

**a) Psoas major** **b) Quadratus lumborum**

Question 28

**Psoas major** joins with the **illacus** to form \_\_\_. What action does this muscle have? Which nerve supplies it?

Answer 28

**Iliopsoas** (anterior compartment of the thigh) ## Footnote **Flexes the thigh** **Femoral nerve**

Question 29

What can the abdominal muscles do to protect the kidneys?

Answer 29

**Contract** "guarding"

Question 30

The kidneys lie **\_\_\_** to **psoas major** and **\_\_\_** to **quadratus lumborum**.

Answer 30

**lateral to psoas major** **anterior to quadratus lumborum**

Question 31

What's notable about the position of the **right kidney**?

Answer 31

**Pushed inferiorly by liver** So it's lower down than the left kidney

Question 32

What are the **vertebral levels** of the a) left kidney b) right kidney?

Answer 32

**a) L kidney:** T12 - L2 **b) R kidney:** L1 - L3 "lower lumbar" (doesn't really help me)

Question 33

Which kidney is bounded by a) **L1 - L3** b) **T12 - L2**?

Answer 33

**a) Right kidney** **b) Left kidney**

Question 34

Which abdominal a) **regions** b) **quadrants** are the kidneys found in?

Answer 34

**a) L and** **R lumbar regions** ## Footnote **b) LUQ and RUQ**

Question 35

Which ribs protect the kidneys?

Answer 35

**Ribs 11 and 12** The floating ribs - doesn't attach to sternum or costal margin

Question 36

Which can happen if Ribs 11 or 12 are fractured?

Answer 36

**Kidney injury**

Question 37

How do you ballot the kidneys in an abdominal exam? Should the patient breathe during the exam?

Answer 37

**Hands anterior and posterior, below 12th rib** **Push down with anterior hand and bounce with posterior hand** Yeah, they should **inspire**

Question 38

In which direction do the kidneys move on a) **expiration** b) **inspiration**?

Answer 38

**a) Upwards on expiration** **b) Downwards on inspiration** Ballot on inspiration

Question 39

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?

Answer 39

**Hepatorenal recess** **Both**

Question 40

The renal **veins** are found ___ to the renal **arteries**.

Answer 40

**anterior**

Question 41

Where are the **common iliac arteries** found in relation to the **common iliac veins**?

Answer 41

**Anterior** opposite of renal vein/artery relationship

Question 42

Where are the a) common iliac artery and vein b) renal artery and vein found in relationship to one another?

Answer 42

**a) Renal** - vein anterior to artery **b) Common iliacs** - artery anterior to vein

Question 43

At which level does the **abdominal aorta** birfurcate into the **common iliac arteries**?

Answer 43

**Umbilcus** L3/4

Question 44

Which lymph nodes do the **kidneys** drain to?

Answer 44

**Lumbar nodes**

Question 45

Which lymph nodes do the **ureters** drain to?

Answer 45

**Lumbar nodes** **Iliac nodes**

Question 46

What is a life-threatening condition involving ballooning of the abdominal aorta?

Answer 46

**Abdominal aortic aneurysm**

Question 47

What are the two types of abdominal aortic aneurysm relative to the renal arteries?

Answer 47

**Infrarenal AAA** **Suprarenal AAA**

Question 48

What can be compromised by a AAA?

Answer 48

**Renal artery blood flow**

Question 49

What term describes **narrowing** of the renal artery?

Answer 49

**Renal artery stenosis**

Question 50

What can cause **renal artery stenosis** in a) infrarenal AAA b) suprarenal AAA?

Answer 50

**a) Atherosclerosis** **b) Direct occlusion**

Question 51

What is the dilated part of the ureter found at the renal hilum?

Answer 51

**Renal pelvis**

Question 52

What are the three layers of the kidney called?

Answer 52

**Renal capsule** **Renal cortex** **Renal medulla**

Question 53

Where in the kidney are **nephrons** found?

Answer 53

**Renal medulla**

Question 54

Within the renal medulla, what are **nephrons** arranged into?

Answer 54

**Renal pyramids**

Question 55

What gives the **renal medulla** a stripey appearance?

Answer 55

**Nephrons**

Question 56

Where does **ultrafiltration** of blood occur?

Answer 56

**Glomerulus**

Question 57

What is the path of filtrate from the **glomerulus** to the **collecting ducts**?

Answer 57

**Glomerulus** **Proximal tubules** **Loop of Henle** **Distal tubules** **Collecting duct**

Question 58

From the **collecting duct**, how does urine reach the **ureter**?

Answer 58

**Collecting duct** **Minor calyx** **Major calyx** **Renal pelvis**

Question 59

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?

Answer 59

**Pelviureteric junction**

Question 60

The ___ \_\_\_ narrows to form the ___ at the **pelviureteric junction**.

Answer 60

**renal pelvis** **ureter**

Question 61

The **pelviureteric junction** is a site of **anatomical constriction**. What are the other two?

Answer 61

**1.** Point where ureter crosses **anterior** to **common iliac artery** **2.** Ureteric orifice

Question 62

What's the proper name for **kidney stones**?

Answer 62

**Renal calculi**

Question 63

**Renal calculi** can ___ the urinary tract.

Answer 63

**block**

Question 64

What are some causes of **ureteric obstruction**?

Answer 64

**Internally** - blood clot, renal calculus **Externally** - tumour

Question 65

Which type of muscle lines the urinary tract?

Answer 65

**Smooth muscle**

Question 66

How does the body attempt to expel blockages from the urinary tract? What symptom can this cause?

Answer 66

**Peristalsis** **Renal colic**

Question 67

What is the definition of **renal failure**?

Answer 67

**Failure of the kidneys to adequately filter the blood to produce urine**

Question 68

How can **renal calculi** cause renal failure?

Answer 68

**Backflow of urine** causes **increased back pressure** Eventually **exceeds pressure required to stop glomerular filtration**

Question 69

What is **hydronephrosis**?

Answer 69

**Dilation of the renal calyces / pelvis caused by excess fluid in the kidneys** Usually secondary to **obstruction**

Question 70

How can **ureteric obstruction** cause **hydronephrosis**?

Answer 70

**Backflow of urine to the kidneys**

Question 71

Why does hydronephrosis cause pain?

Answer 71

**Stretching of the renal capsule**