Renal Flashcards
What constitutes upper urinary tract?
Kidneys and ureters
What constitutes lower urinary tract?
Bladder, prostate (men), urethra
What level is the transpyloric plane?
L1
What are the two regions of the kidney and what parts of the nephron are within each?
Cortex
- Renal corpuscle; Bowman’s capsule/space and glomerulus
Medulla
- Loop of Henle
What makes up the juxtaglomerular apparatus?
Macula densa (specialised DT cells) + juxtaglomeruar cells (specialised smooth muscle cells)
What crosses the ureters anteriorly?
Male; vas deferens
Female; uterine artery
What do the ureters pass in front of?
Common iliac vessels
What is the muscle in the bladder?
Smooth detrusor muscle
What is the triangular space between the ureteric orifices and the internal urethral meatus?
Trigone
What is the epithelium of the bladder?
transitional epithelium
What is the median umbilical ligament?
Remnant of embryological allantois
Describe the male urethra
Around 20cm total length
4 parts
- pre-prostatic
- prostatic; ~3cm long, contains prostatic duct openings
- membranous; narrowest, ~2cm long, circled by external urethral sphincter
- spongy; longest ~15cm
What innervates the external urethral sphincter?
S2, 3, 4
Blood supply to bladder?
Branches of internal iliac arteries
Motor supply of the detrusor muscle
parasympathetic nerves conveyed in pelvic splanchnic nerves
What innervates smooth muscle surrounding bladder neck in males?
Sympathetic nerves from the hypogastric plexus
Describe innervation during micturation and ejaculation
Parasympathetic causes contraction of bladder during micturation
Sympathetic prevents reflux during ejaculation
Describe the female urethra
Fibromuscular tube ~2-3cm long
Middle third encircled by striated muscle fibres of external urethral sphincter
Where are the kidneys situated?
Behind the peritoneum (retroperitoneal) in the paravertebral gutters
What is the order of passage of the urine from kidney to bladder?
Pyramids - papillae - minor calyces - major calyces - renal pelvis - ureter - bladder
What are the layers surrounding the kidney?
Kidney Renal capsule Perirenal fat Renal fascia; also encloses suprarenal gland and proximal ureter Pararenal fat
Posterior relations of the kidneys
Similar
Superior poles against diaphragm and twelfth ribs
Medial border overlaps psoas major
Inferolateral portion related to quadratus lumborum, transversus abdominis and upper part of ureter
Right anterior and medial relations of kidney
Anteriorly from above, downwards
- bare area of liver
- second part of duodenum
- right flexure of colon, coils of jejunum
Medial
- IVC
- renal vessels
- upper part of ureter
Left anterior and medial relations of kidney
Anteriorly from above, downwards
- stomach
- spleen
- splenic vessels
- tail of pancreas
- left colic flexure and coils of jejunum
Medial
- adrenal gland
- renal and suprarenal vessels
- proximal ureter
