Renal Anatomy Flashcards
Which structure is the most posterior in the renal hilum? [1]
Renal pelvis
The [] is the functional unit of the kidney
The nephron is the functional unit of the kidney
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
Label A-E
A: Renal artery
B: Segmental arteries
C: Interlobar arteries
D: Arcuate arteries
E: Interlobal arteries
Label A-D
A: Afferent arterioles
B: Glomerulus
C: Efferent arterioles
D: Peritubular capillaries / vasa recta
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]
What is the hepatorenal recess a potential space between? [2]
Potential space that separates the liver and the right kidney [2]
Hepatorenal recess can have fluid accumulate because of? [3]
haemoperitoneum (is the presence of blood in the peritoneal cavity) [1]
ascites [1]
pancreatitis [1]
Which structures lie adjacent to the anterior aspect of the right kidney:
Label
A
B
C
D
E
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
Which structures lie adjacent to the anterior aspect of the LEFT kidney
A
B
C
D
E
F
G
What are the 3 main nerves associated with the kidney? [3]
Iliohypogastric
Ilioinguinal
Genitofemoral
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
Label each colour
Purple: psoas major
Green: Quadratus lumborum m
Red: Transversus abdominis m.
Blue: diaphragm
Label each colour
Purple: psoas major
Green: Quadratus lumborum m
Red: Transversus abdominis m.
Blue: diaphragm
Label A-C xx
A: perinephtic fat
B: renal fascia
C: paranephric fat
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
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
