Renal Anatomy Flashcards by patrick ellis

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Which structure is the most posterior in the renal hilum? [1]

Renal pelvis

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The [] is the functional unit of the kidney

The nephron is the functional unit of the kidney

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The [] filters your blood, and the [] returns needed substances to your blood and removes wastes [2]

The glomerulus filters your blood, and the tubule returns needed substances to your blood and removes wastes

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Label A-E

A: Renal artery
B: Segmental arteries
C: Interlobar arteries
D: Arcuate arteries
E: Interlobal arteries

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Label A-D

A: Afferent arterioles
B: Glomerulus
C: Efferent arterioles
D: Peritubular capillaries / vasa recta

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Where do you examine for tenderness for kidneys (name / vert level) [2]

Renal Angle [1]
Junction of 12th rib and lateral border of erector spinal [1]

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What is the hepatorenal recess a potential space between? [2]

Potential space that separates the liver and the right kidney [2]

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Hepatorenal recess can have fluid accumulate because of? [3]

haemoperitoneum (is the presence of blood in the peritoneal cavity) [1]
ascites [1]
pancreatitis [1]

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Which structures lie adjacent to the anterior aspect of the right kidney:

Label
A
B
C
D
E

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Which structures lie adjacent to the anterior aspect of the right kidney:

Label
A
B
C
D
E

A: Right suprarenal gland
B: liver
C: duodenum
D: right colic flexure
E: small intestines

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Which structures lie adjacent to the anterior aspect of the LEFT kidney

A
B
C
D
E
F
G

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What are the 3 main nerves associated with the kidney? [3]

Iliohypogastric
Ilioinguinal
Genitofemoral

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Which is the only nerve of the lumbar plexus that passes through the psoas major? [1]

Iliohypogastric
Ilioinguinal
Genitofemoral
Lateral femoral cutaneous nerve
Femoral nerve

Which is the only nerve of the lumbar plexus that passes through the psoas major? [1]

Iliohypogastric
Ilioinguinal
Genitofemoral
Lateral femoral cutaneous nerve
Femoral nerve

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Label each colour

Purple: psoas major
Green: Quadratus lumborum m
Red: Transversus abdominis m.
Blue: diaphragm

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Label each colour

Purple: psoas major
Green: Quadratus lumborum m
Red: Transversus abdominis m.
Blue: diaphragm

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Label A-C xx

A: perinephtic fat
B: renal fascia
C: paranephric fat

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The renal fascia, commonly known as Gerota’s fascia, is a collagenous connective tissue sheath which separates the [] fat from the [] fascia

The renal fascia, commonly known as Gerota’s fascia, is a collagenous connective tissue sheath which separates the perirenal fat from the pararenal fascia

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Label A-E

Label A-E

A: renal pyramid
B: major calyx
C: minor calyx
D: renal pelvis
E: ureter

Describe drainage of the kidney xx

Each renal pyramid drains into their own minor calix –> major calix –> renal pelvis –> ureter

At which structure in the kidney does is waste is drained into renal pelvis?

renal papilla

Which veins drain into the left renal vein? [3]

left gonadal (ovarian/testicular) vein,
left inferior phrenic vein
left adrenal veins.

Which structure in the bladder does the ureter enter into? [1]

trigone area (one way flap vave)

What are the 3 layers of the ureter wall? [3]

Transitional epithelial mucosa Smooth muscle muscularis Fibrous connective tissue adventitia

What are the 3 layers of the ureter wall? [3]

Transitional epithelial mucosa Smooth muscle muscularis Fibrous connective tissue adventitia

How does urine reach the bladder?

Ureters **actively** **propel** urine to the bladder via response to smooth muscle stretch

Where are the 3 places that kidney stones get stuck in the ureters? [3]

Uteropelvic junction Pelvic inlet (and iliac vessels) Uterovesical junction

Label A-C

A: Ultrapelvic junction B: Pelvic inlet C: Uterovesical junction

Ureter nerve supply: Which nerves are nerve due to kidney stones referred along? [2] Why does the referred pain change/ [1]

The loin pain is referred along the **ilioinguinal** and the **iliohypogastric** **nerves** (L1) As the stone descends the patient may start to feel pain descend over the groin and scrotum/labium majora (“from loin to groin”) This is because of the changing nerve segments and the pain is now referred through the **genitofemoral** **nerve** (L1,2)

Where do the visceral afferents enter spinal level for ureter? [1]

Visceral afferents enter at spinal levels **T11-L1/2**

Label A-E

A: trigone of bladder B: prostatic urethra C: urethretic oriface D: detrusor muscle E: vas deferes

Where do you find the bladder in children & when distended?

Abdomen

Which is the only part bladder that doesnt distend? [1]

**Trigone** is the only part of the bladder that is fixed (doesn’t expand)

Bladder wall has x3 layers what are they? [3]

Bladder wall has x3 layers - Transitional epithelial mucosa - A thick muscular layer - A fibrous adventitia

What is the muscle of the bladder called? :)

Muscle of the bladder: detrusor muscle

Different role of internal and external urethral sphincter in males? [2]

**Internal urethral sphincter (males):** involuntary sphincter at the bladder-urethra junction (preventing retrograde ejaculation) **External urethral sphincter:** voluntary sphincter surrounding the urethra as it passes through the urogenital diaphragm

IUS and EUS are either side of which organ?

IUS and EUS are either side of **prostate**

Which muscle group assists with voluntary urethral sphincter?

Levator ani muscles – voluntary urethral sphincter

Label A-F

Label the different parts of the male urethra A B C D

A: prostatic urethra B: membranous urethra C: penile urethra D: bulbar urethra

What is sympathetic innervation of bladder from? [1] What is the effect? [1] What is parasympathetic innervation of bladder from? [1] What is the effect? [1] What is somatic innervation of bladder from? [1] What is the effect? [1]

**Sympathetic** (hypogastric n; T12-L2) Stimulate contraction (closure) of the internal urethral sphincter Inhibit the detrusor muscle (prevents contraction and bladder emptying) **Parasympathetic** (S2-S4) Stimulate the detrusor muscle to contract Inhibits (opens) the internal urethral sphincters **Somatic** - external urethral sphincter (Pudendal n.S2-S4

A 25 year old female rugby player was kicked in the back during a match. She complained of severe pain on her left side (flank). Imaging revealed no broken bones. A urinalysis showed haematuria. What structures have been injured? Why flank pain? Why is the blood confined to the left? Why haematuria?

What structures have been injured? **capsule / segmental arteries** Why flank pain? **referred pain from visceral afferents sensed at flank dermatomes** Why is the blood confined to the left? **renal fascia** Why haematuria? **Rupture of renal pelvis**

A elderly man with a history of gout has a sudden onset of severe left flank pain. The pain comes in waves all night long. The pain begins to radiate into his groin and he then attends A&E. Urinalysis shows heamauturia. Imaging shows a large calculi at the level of the left common iliac . Explain the following: 1. Pain occurring in ‘waves’ 2. Location of stone 3. Radiation of pain to groin

Explain the following: 1. Pain occurring in ‘waves’ 2. Location of stone 3. Radiation of pain to groin