Renal Flashcards
Macroscopic haematuria
visible blood in urine
Microscopic haematuria
blood in urine, can only be seen on analysis
Minor and major calyxes epithelium
transitional epithelium (urothelium)
What is in the renal hilum?
renal vein, renal artery and ureter (ant. –> post.)
Where does lymph drain from the kidney
to lumbar lymph nodes –> para-aortic nodes
What are the 3 capsules of the kidney?
Renal capsule- adherent to surface of the kidney
Perineal fat- solid, protective tissue
Gerota’s (renal) fascia- extraperitoneal fascia
Kidney innervation
SNS from sympathetic chain to renal plexus, afferent sympathetic fibres enter spinal cord T11-L2
Muscles around kidney?
Psoa major, diaphragm, quadratus lumborum, transverse abdominis.
Where do the adrenal glands lie?
Superior to kidney, lie within perineal fat and renal fascia
What shape are the adrenal glands?
RHS- pyramidal
LHS- crescent shaped
What is the blood supply of the adrenal glands?
Inferior phrenic arteries, aorta + renal arteries
What are the functions of the adrenal glands?
Medulla- secretes catecholamines
Cortex- secretes corticosteroids + androgens
What epithelium does the ureter have?
Transitional epithelium
Where does the ureter go from and to?
pelvis of kidney —> urinary bladder
Abdominal ureter
posterior to colon and mesentery- adherent to peritoneum. Lying on psoas major, anterior to transverse processes of lumbar verterbrae
Pelvic ureter
begin along lateral pelvic walls, turn anetromedially at level of ischial spine. Lie close to seminal vesicle and run under vas deferens/lateral to cervix
Blood supply of ureter
local arteries along it’s course
Lymph drainage of ureter
renal, common/internal iliac/vesicle nodes
What is the surface anatomy of the left kidney
L1
What is the surface anatomy of the right kidney
L2
Where does ureter pain refer to?
lumbar/suprapubic regions
What are the risk factors for kidney stones?
male, 30-50YO, dehydration, immobility, increased serum calcium
Possible complications of kidney stone
haemorrhage, infection, urinary obstruction, hydronephrosis
What are the 3 man constricitons of the ureters?
Pelvi-uteric junction, pelvic brim and vesicouteric junction
What is the detrusor?
Smooth muscle wall of the bladder
What is the epithelial lining of the bladder?
urothelium
What lies in the median umbilical fold?
obliterated umbilical arteru
Where does the empty bladder lie?
In true pelvis, posterior to pubic symphysis
What lies anterior to the bladder?
pubic symphysis
What lies posterior to the bladder?
rectum/uterus
What lies lateral to the bladder?
ischioanal fossa and obturators/levator ani
What lies inferior to the bladder?
Prostate/pelvic fascia/peitoneum
What lies superior to the bladder?
uterus/peritoneum
What is the blood supply of the bladder?
superior and inferior vesical arteries from internal iliac artery
What drains the bladder?
Vesical venous plexus –> internal iliac veins
Lymph drainage of the bladder?
internal and external iliac nodes
Innervation of the bladder?
SNS- sympathetic trunkPSNS- pelvic splanchnic nerves (S2-4)
Female urethra
4cm
embedded in anterior wall of vagina
external urethral meatus opening- vulval vestibule
How long is the male urethra
20cm
What are the 4 parts of the male urethra
Pre-prostatic (within bladder neck)
Prostatic (within prostate)
Membranous (throuhg ext. sphincter and perineal membrane)
Penile/spongy urethra
Urethral catheteristaion
if urine cannot pass through urethra, facilitates flow, balloon inflated once in place
Suprapubic catheterisation
draining bladder for patients who need it long term/urethral cannot be done.
