Renal Flashcards
Where are the kidneys located?
Retroperitoneal abdomen
R = L1-L3
L = T12-L2
What surrounds the kidneys (outer to inner)
Visceral peritoneum Paranephric fat Renal fascia Perinephric fat Renal capsule
What back muscle is medial to kidneys?
Psoas major
What muscle is posterior to kidneys?
Quadratus lumborum
Normal size of kidney?
12cm long, 6cm wide
Blood supply to kidneys
Left and right renal branches from abdominal aorta
Venous kidney drainage
Left and right renal veins that drain into inferior vena cava that lies anterior to renal arteries and on RHS of abdominal aorta
The common iliac arteries are posterior to the common ilic veins. T/F
False
The vena cava is anterior to the abdominal aorta but the common iliac arteries are anterior to the common iliac veins
Lymph drainage of kidneys
lumbar lymph nodes
Lymph drainage from ureters
lumbar AND iliac nodes
Ureteric arterial supply
Branches from renal artery, abdominal aorta, common iliac, internal iliac and vesicle artery (lots)
Types of AAA (to do with kidneys obvs)
Infra-renal = below renal arteries Supra-renal = affects above and below renal arteries
How do the different types of AAA lead to renal artery stenosis?
Infra-renal = atherosclerosis Supra-renal = occlusion of proximal renal artery
Name for problem of never growing a kidney
Agenesis
Where are the physiological sites of constriction for urine drainage?
Pelviuretric junction
Ureter crossing common iliac artery
Ureteric orifice into bladder
What forms renal calculi?
urine calcium salts
What is hydronephrosis?
urine back pressure leading to renal failure
Give a pelvic floor muscle
Levator Ani
Describe path of ureter in females
Passes underneath the uterine tube and artery
‘Water under the bridge’
What is the trigone
Area of bladder in triangle shape made up from
2x ureteric orifices and 1x internal urethras orifice
How does ureteric orifice anatomy prevent reflux?
Enters bladder in an inferiomedial direction
Has extra detrouser muscle fibres around that contract and close orifice when bladder contracts to prevent back flow
What sphincter do boys have that girls don’t?
internal urethral sphincter that is closed when ejaculating to prevent back flow of semen
Forms of catheterisation
Urethral or suprapubic
Name all the orifices/sphincters
internal urethral orifice
internal urethral sphincter (men only)
external urethral sphincter
external urethral orifice
What divides the pelvis and the perineum?
Levator ani
Function of corpus cavernosum
engorge with blood to make erection
Function of corpus spongiosum
prevent urethra from pinching closed when erection (but does get engorged too)
Where is the ejaculatory duct?
Part of vas deferent tube that has been through seminal vesicle and now in prostate
What is the name of the sac the tests sit in within the scrotum?
Tunica vaginalis (has a visceral and parietal layer)
What is a hydrocele?
Excess fluid between the two layers of tunica vaginalis
Name of venous plexus draining testes?
Pampiniform venous plexus
What does seminal vesicle make?
Fructose for sperm energy
What does prostate make?
PSA for ensuring correct viscocity of semen
What size should the prostate be?
Walnut sized
Where does penis lymph drain to?
inguinal nodes
Where does testicular lymph drain to?
Lumbar nodes
What does somatic mean?
Body wall
What does visceral/parasympathetic/sympathetic mean?
visceral
What is the point of splanchnic nerves?
Used to get nerves to parts other than the body wall aka they’re for all the organs
What level do renal sympathetics leave the chain?
T10-L2
How do renal sympathetics get from chain to kidney
Leave chain at T10-L2
Use abdominopelvic splanchnic nerves then synapse at abdominal sympathetic ganglia at the abdominal aorta
Travel on the surface of arteries (periarticular plexus)
Then get to kidney
What nerve carries kidney parasympathetics?
Vagus, CNX
What nerve carries bladder parasympathetics?
Pelvic splanchnic nerves (sacral spinal nerves) leaving spine at S2,3,4
What parts of the renal system gets somatic motor fibres?
Perineum (body wall)
What level does sensory info from kidney/ureters/bladder enter spinal cord?
Follows alongside sympathetic fibres then enter spinal cord at T11-L1
What level does sensory info from urethra (remember it is a somatic organ) enter spinal cord?
S2,3,4
What level does pain from testes enter spinal cord?
T10-T11
What nerves tell brain the bladder is filling up?
Visceral afferents of S2,3,4
What stimulates detrouser contraction and micturition?
Parasympathetic fibres of S2,3,4 via pelvic splanchnic nerves
