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MET2 > Renal Anatomy > Flashcards

Renal Anatomy Flashcards

1
Q
A
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2
Q

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

A

Renal pelvis

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3
Q

The [] is the functional unit of the kidney

A

The nephron is the functional unit of the kidney

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4
Q

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

A

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

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5
Q

Label A-E

A

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

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6
Q

Label A-D

A

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

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7
Q
A
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8
Q

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

A

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

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9
Q

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

A

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

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10
Q

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

A

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

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11
Q

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

Label
A
B
C
D
E

A
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11
Q

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

Label
A
B
C
D
E

A

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

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12
Q

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

A
B
C
D
E
F
G

A
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13
Q

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

A

Iliohypogastric
Ilioinguinal
Genitofemoral

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14
Q

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

A

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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15
Q

Label each colour

A

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

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15
Q

Label each colour

A

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

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16
Q

Label A-C xx

A

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

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17
Q

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

A

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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18
Q

Label A-E

A
19
Q

Label A-E

A

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

20
Q

Describe drainage of the kidney xx

A

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

21
Q

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

A

renal papilla

22
Q

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

A

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

23
Q
A
24
Q

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

A

trigone area (one way flap vave)

25
Q

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

A

Transitional epithelial mucosa
Smooth muscle muscularis
Fibrous connective tissue adventitia

26
Q

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

A

Transitional epithelial mucosa
Smooth muscle muscularis
Fibrous connective tissue adventitia

27
Q

How does urine reach the bladder?

A

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

28
Q

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

A

Uteropelvic junction
Pelvic inlet (and iliac vessels)
Uterovesical junction

29
Q

Label A-C

A

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

30
Q

Ureter nerve supply:

Which nerves are nerve due to kidney stones referred along? [2]

Why does the referred pain change/ [1]

A

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)

31
Q

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

A

Visceral afferents enter at spinal levels T11-L1/2

32
Q
A
33
Q

Label A-E

A

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

34
Q

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

A

Abdomen

35
Q

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

A

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

36
Q

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

A

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

37
Q

What is the muscle of the bladder called? :)

A

Muscle of the bladder: detrusor muscle

38
Q

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

A

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

39
Q

IUS and EUS are either side of which organ?

A

IUS and EUS are either side of prostate

40
Q

Which muscle group assists with voluntary urethral sphincter?

A

Levator ani muscles – voluntary urethral sphincter

41
Q

Label A-F

A
42
Q
A
43
Q

Label the different parts of the male urethra

A
B
C
D

A

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

44
Q

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]

A

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

45
Q

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?

A

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

46
Q

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

A

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

MET2 (52 decks)

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