Renal Anatomy Flashcards
Kidney function
Excretes most of waste products of metabolism.
Controls water and electrolyte balance of body.
Maintains acid-base balance of body.
Secretes hormones and renin into the blood stream
What is the pronephros and mesonephros?
Metanephros forms what 2 structures?
Ureteric bud
Metanephrogenic blastoma
Polycystic vs Horseshoe kidney
Polycystic Kidney:
Hereditary disease.
Failure of union between convoluted tubules and collecting tubules.
Retention of urine in proximal tubules results in cysts.
Horseshoe Kidney:
Caudal ends of both kidneys fuse.
Prone to infection and stones
Kidneys develop where?
Pelvis
Kidney arterial supply is ORIGINALLY from where?
Middle sacral artery
Location of kidney
Primary retroperitoneal.
Left kidney higher than right (Liver).
Located between T12 – L3 vertebrae.
Hila of kidney: L1
Which kidney is higher?
Left
Costovertebral angle
Angle between 12th rib and vertebral column.
Occupied by the lower part of the pleural sac.
Kidney lies inferiorly.
Renal angle
The angle between the 12th rib and the lateral border of erector spinae muscle.
Occupied by kidney.
Right kidney anterior relations
Left kidney anterior relations
Kidney posterior relations
Coverings of kidney
Important bc spread of infections
What propels urine into bladder?
Smooth muscle in calyces propels urine through renal pelvis into ureters to the bladder.
Renal hilum and renal sinus
Kidney arterial supply
5 segmental branches of kidney arteries
Apical Caudal Anterior Superior Anterior Inferior Posterior
Kidney veins
Lymphatics of kidney
Lymphatics follow renal veins.
Drain into right and left lumbar nodes (caval and aortic) near origin of renal artery
Kidney innervation
Sympathetic Supply
Function: Vasomotor regulating blood flow and renin secretion.
From renal plexus, which follows renal arteries.
Post-ganglionic sympathetic from (T10 – L2).
Parasympathetic Supply
Contested: some texts state vagus nerve
More recent research suggests there is no evidence of parasympathetic supply.
**Renal function not dependant on innervation as shown with renal transplantation (complete transection of innervation).
Renal function regulated by hormones.
Staghora calculi
Struvite
Recurrent urinary tract infection increase in ammonia production increase PH decrease phosphate solubility
Ureter
25 – 30 cm
long muscular tube
Transports urine from kidney to urinary bladder.
Begins as a continuation of renal pelvis.
Peristaltic contractions
3mm in diameter
Journey of the ureter in abdomen
Journey of ureter in pelvis
Kidney stones - renal and ureteric calculi
Common clinical problem.
May cause distension of muscular tube.
Complete or intermittent obstruction of urinary flow.
Pain referred from ‘loin to groin’.
Ureteric colic is severe intermittent pain due to contraction of ureteric muscles to overcome an obstruction, usually due to stone or clot formation.
Ureteric constrictions
The ureter has constrictions at three points (sites of obstruction and stone impaction):
- Ureteropelvic junction.
- Crossing of common iliac artery.
- Site of entrance to bladder.
Arteries
- Renal artery
- Gonadal artery
- Common iliac artery
- Internal iliac artery
Bladder male vs female
Bladder external features
Pyramidal in shape
Apex: Points towards pubic symphysis
Attachment to median umbilical ligament
- Running to umbilicus
- Remnant of urachus: fibrous remnant of allantois
Base: Faces posteroinferiorly
Two inferolateral surfaces
Neck: surrounds urethra: fixed in position
Bladder ligaments
Help prevent prolapse
Bladder internal features
Bladder arterial supply
Superior vesical artery
males only- inferior vesical artery
vaginal artery in females
Bladder veinous drainage
Vesical venous plexus
Bladder drained by: Vesical venous plexus - Drains into internal iliac vein - Communicates inferiorly with: 1. Inferior prostatic inferiorly (males) 2. Utero-vaginal plexus (females)
Bladder innervation
Parasympathetic: Motor to detrusor / inhibitory to internal urethral sphincter.
Sympathetic contraction of internal urethral sphincter: nervous to go to toilet. Or during ejaculation to prevent semen entering bladder.
Visceral afferents are stimulated by stretching: bladder contracts by reflex… We learn to supress this reflex when we are get pottytrained.
Urethra female
Urethra male
